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Sample records for surgical findings methods

  1. Surgical and pathological findings of meningocele manque

    International Nuclear Information System (INIS)

    Nishimoto, Hiroshi; Kurihara, Jun; Kishimoto, Hiroshi; Takezawa, Youko

    2006-01-01

    We reviewed the neuroradiological presentation and long-term outcomes in patients with meningocele manque. From April 1983 through March 2005, 15 children (7 boys and 8 girls) aged 12 days to 1 year underwent surgical exploration for suspected occult spinal dysraphism and were found to have manifestations of meningocele manque and other anomalies. All patients had cutaneous manifestations (small skin defects, hemangioma, and vestigial tails). No patient had abnormal neurological or urological findings other than skin stigmata. Spinal ultrasonography or magnetic resonance performed before surgery showed low-lying spinal conus, intrathecal dorsal bands, or subcutaneous tracts. These bands were confirmed at surgery in all patients. Histologic and immunohistochemical studies of these bands showed peripheral nerves, ganglia, collagen fibers, muscle fibers, and small vessels. These findings suggest that the bands were of hamartomatous origin. Sectioning of dorsal tethering bands of meningocele manque provided good long-term results. These dorsal tethering bands should be sought in the evaluation of patients with occult spinal dysraphism and surgically transected. (author)

  2. Surgical and pathological findings of meningocele manque

    International Nuclear Information System (INIS)

    Nishimoto, Hiroshi; Kurihara, Jun

    2006-01-01

    We review and describe the neuroradiological presentation and long-term outcomes in patients with meningocele manque. From April 1983 through March 2005, 15 children (7 boys and 8 girls) aged 12 days to 1 year underwent surgical exploration for suspected occult spinal dysraphism and were found to have manifestations of meningocele manque and other anomalies. All patients had cutaneous manifestations (small skin defect, hemangioma and human tails). No patient had abnormal neurological or urological findings other than skin stigmata. Spinal ultrasonography or MRI performed preoperatively showed low-lying spinal conus, intrathecal dorsal bands or subcutaneous tracts. These bands were confirmed at surgery in all patients. Histology and immunohistochemistry of these bands shows peripheral nerves, ganglions, collagen fibers, muscle fibers and small vessels. These findings suggested that these bands had hamartomatous origins. Sectioning of dorsal tethering bands of meningocele manque had good long-term results. These dorsal tethering bands should be sought in the evaluation of patients with occult spinal dysraphism and surgically transected. (author)

  3. Comparison of preoperative neuroradiographic findings and surgical findings in lumbar disc herniation

    Energy Technology Data Exchange (ETDEWEB)

    Takahara, Kazuhiro; Sera, Keisuke; Nakamura, Masakazu; Uchida, Takeshi [Nagasaki Mitsubishi Hospital (Japan); Ito, Nobuyuki

    1997-09-01

    Surgical findings in lumbar disc hernia were compared to pre-operative MRI, CTM and myelogram findings. Ninety-one cases were studied using Love`s method. The accuracy of hernia diagnosis in MRI was 59.3%, 41.2% in CTM, and 35.2% in myelogram. At the L5/S1 disc level, the accuracy of hernia diagnosis by CTM and myelogram was decreased. MRI was useful for the diagnosis and cure of lumbar disc herniation. (author)

  4. Comparison of preoperative neuroradiographic findings and surgical findings in lumbar disc herniation

    International Nuclear Information System (INIS)

    Takahara, Kazuhiro; Sera, Keisuke; Nakamura, Masakazu; Uchida, Takeshi; Ito, Nobuyuki.

    1997-01-01

    Surgical findings in lumbar disc hernia were compared to pre-operative MRI, CTM and myelogram findings. Ninety-one cases were studied using Love's method. The accuracy of hernia diagnosis in MRI was 59.3%, 41.2% in CTM, and 35.2% in myelogram. At the L5/S1 disc level, the accuracy of hernia diagnosis by CTM and myelogram was decreased. MRI was useful for the diagnosis and cure of lumbar disc herniation. (author)

  5. Finding the unexpected: pathological examination of surgically resected femoral heads

    International Nuclear Information System (INIS)

    Fornasier, V.L.; Battaglia, D.M.

    2005-01-01

    To study the clinically diagnosed disease process but also identify additional, clinically undetected pathologies in femoral heads resected for replacement arthroplasty. A retrospective review was carried out of the pathological findings in 460 surgically resected femoral heads. Serial sections were submitted to low-energy fine-detail radiography, then decalcified sections stained by the WHO method were examined. The preoperative clinical and imaging diagnoses were compared with the pathological findings and special interest was placed on assessing the clinical significance of any unexpected, clinically undetected findings. The most common findings included the presence of bone islands (solitary osteomas) and areas of avascular necrosis in addition to the primary joint disease for which the patient underwent surgery. The preoperative symptomatology did not distinguish between the known primary disease and the additional pathological findings. Some of the clinically unidentified lesions were of a size that fell below the ability of current clinical investigations to detect. However, the finding of lesions by tissue fine-detail radiography indicates that current, more sensitive clinical imaging techniques may identify them. Careful examination of surgically resected femoral heads is important to ensure that all pathologies are identified and assessed for clinical relevance. (orig.)

  6. Finding the unexpected: pathological examination of surgically resected femoral heads

    Energy Technology Data Exchange (ETDEWEB)

    Fornasier, V.L. [St. Michael' s Hospital, University of Toronto, Department of Laboratory Medicine and Pathobiology, Toronto, Ontario (Canada); Battaglia, D.M. [St. Michael' s Hospital, University of Toronto, Department of Laboratory Medicine and Pathobiology, Toronto, Ontario (Canada); St. Michael' s Hospital, University of Toronto, Division of Pathology, Toronto, Ontario (Canada)

    2005-06-01

    To study the clinically diagnosed disease process but also identify additional, clinically undetected pathologies in femoral heads resected for replacement arthroplasty. A retrospective review was carried out of the pathological findings in 460 surgically resected femoral heads. Serial sections were submitted to low-energy fine-detail radiography, then decalcified sections stained by the WHO method were examined. The preoperative clinical and imaging diagnoses were compared with the pathological findings and special interest was placed on assessing the clinical significance of any unexpected, clinically undetected findings. The most common findings included the presence of bone islands (solitary osteomas) and areas of avascular necrosis in addition to the primary joint disease for which the patient underwent surgery. The preoperative symptomatology did not distinguish between the known primary disease and the additional pathological findings. Some of the clinically unidentified lesions were of a size that fell below the ability of current clinical investigations to detect. However, the finding of lesions by tissue fine-detail radiography indicates that current, more sensitive clinical imaging techniques may identify them. Careful examination of surgically resected femoral heads is important to ensure that all pathologies are identified and assessed for clinical relevance. (orig.)

  7. Surgical approaches to chronic pancreatitis: indications and imaging findings.

    Science.gov (United States)

    Hafezi-Nejad, Nima; Singh, Vikesh K; Johnson, Stephen I; Makary, Martin A; Hirose, Kenzo; Fishman, Elliot K; Zaheer, Atif

    2016-10-01

    Chronic pancreatitis (CP) is an irreversible, inflammatory process characterized by progressive fibrosis of the pancreas that can result in abdominal pain, exocrine insufficiency, and diabetes. Inadequate pain relief using medical and/or endoscopic therapies is an indication for surgery. The surgical management of CP is centered around three main operations including pancreaticoduodenectomy (PD), duodenum-preserving pancreatic head resection (DPPHR) and drainage procedures, and total pancreatectomy with islet autotransplantation (TPIAT). PD is the method of choice when there is a high suspicion for malignancy. Combined drainage and resection procedures are associated with pain relief, higher quality of life, and superior short-term and long-term survival in comparison with the PD. TPIAT is a reemerging treatment that may be promising in subjects with intractable pain and impaired quality of life. Imaging examinations have an extensive role in pre-operative and post-operative evaluation of CP patients. Pre-operative advanced imaging examinations including CT and MRI can detect hallmarks of CP such as calcifications, pancreatic duct dilatation, chronic pseudocysts, focal pancreatic enlargement, and biliary ductal dilatation. Post-operative findings may include periportal hepatic edema, pneumobilia, perivascular cuffing and mild pancreatic duct dilation. Imaging can also be useful in the detection of post-operative complications including obstructions, anastomotic leaks, and vascular lesions. Imaging helps identify unique post-operative findings associated with TPIAT and may aid in predicting viability and function of the transplanted islet cells. In this review, we explore surgical indications as well as pre-operative and post-operative imaging findings associated with surgical options that are typically performed for CP patients.

  8. Accuracy of MRI findings in chronic lateral ankle ligament injury: Comparison with surgical findings

    Energy Technology Data Exchange (ETDEWEB)

    Park, H.-J. [Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Department of Radiology, Kangwon National University, School of Medicine, Chuncheon (Korea, Republic of); Cha, S.-D. [Department of Orthopedic Surgery, Myongji Hospital, Kwandong University, College of Medicine, Koyang (Korea, Republic of); Kim, S.S. [Department of Radiology, Kangwon National University, School of Medicine, Chuncheon (Korea, Republic of); Rho, M.-H., E-mail: parkhiji@kangwon.ac.kr [Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Kwag, H.-J. [Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Park, N.-H. [Department of Radiology, Myongji Hospital, Kwandong University, College of Medicine, Koyang (Korea, Republic of); Lee, S.-Y. [Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2012-04-15

    Aim: To evaluate the accuracy of magnetic resonance imaging (MRI) findings in chronic lateral ankle ligament injury in comparison with that of surgical findings. Materials and methods: Forty-eight cases (25 men, 23 women, mean age 36 years) of clinically suspected chronic ankle ligament injury underwent MRI studies and surgery. Sagittal, coronal, and axial, T1-weighted, spin-echo, proton density and T2-weighted, fast spin-echo images with fat saturation were obtained in all patients. MRI examinations were read in consensus by two fellowship-trained academic musculoskeletal radiologists who evaluated the lateral ankle ligaments, including the anterior talofibular ligament (ATFL) and calcaneofibular ligament (CFL) without clinical information. The results of the MRI studies were then compared with the surgical findings. Results: The MRI findings of ATFL injury showed a sensitivity of detection of complete tears of 75% and specificity of 86%. The sensitivity of detection of partial tears was 75% and the specificity was 78%. The sensitivity of detection of sprains was 44% and the specificity was 88%. Regarding the MRI findings of CFL injury, the sensitivity of detection of complete tears was 50% and the specificity was 98%. The sensitivity of detection of partial tear was 83% and the specificity was 93%. The sensitivity of detection of sprains was 100% and the specificity was 90%. Regarding the ATFL, the accuracies of detection were 88, 58, 77, and 85% for no injury, sprain, partial tear, and complete tear, respectively, and for the CFL the accuracies of detection were 90, 90, 92, and 96% for no injury, sprain, partial tear, and complete tear, respectively. Conclusions: The diagnosis of a complete tear of the ATFL on MRI is more sensitive than the diagnosis of a complete tear of the CFL. MRI findings of CFL injury are diagnostically specific but are not sensitive. However, only normal findings and complete tears were statistically significant between ATFL and CFL (p

  9. Accuracy of MRI findings in chronic lateral ankle ligament injury: Comparison with surgical findings

    International Nuclear Information System (INIS)

    Park, H.-J.; Cha, S.-D.; Kim, S.S.; Rho, M.-H.; Kwag, H.-J.; Park, N.-H.; Lee, S.-Y.

    2012-01-01

    Aim: To evaluate the accuracy of magnetic resonance imaging (MRI) findings in chronic lateral ankle ligament injury in comparison with that of surgical findings. Materials and methods: Forty-eight cases (25 men, 23 women, mean age 36 years) of clinically suspected chronic ankle ligament injury underwent MRI studies and surgery. Sagittal, coronal, and axial, T1-weighted, spin-echo, proton density and T2-weighted, fast spin-echo images with fat saturation were obtained in all patients. MRI examinations were read in consensus by two fellowship-trained academic musculoskeletal radiologists who evaluated the lateral ankle ligaments, including the anterior talofibular ligament (ATFL) and calcaneofibular ligament (CFL) without clinical information. The results of the MRI studies were then compared with the surgical findings. Results: The MRI findings of ATFL injury showed a sensitivity of detection of complete tears of 75% and specificity of 86%. The sensitivity of detection of partial tears was 75% and the specificity was 78%. The sensitivity of detection of sprains was 44% and the specificity was 88%. Regarding the MRI findings of CFL injury, the sensitivity of detection of complete tears was 50% and the specificity was 98%. The sensitivity of detection of partial tear was 83% and the specificity was 93%. The sensitivity of detection of sprains was 100% and the specificity was 90%. Regarding the ATFL, the accuracies of detection were 88, 58, 77, and 85% for no injury, sprain, partial tear, and complete tear, respectively, and for the CFL the accuracies of detection were 90, 90, 92, and 96% for no injury, sprain, partial tear, and complete tear, respectively. Conclusions: The diagnosis of a complete tear of the ATFL on MRI is more sensitive than the diagnosis of a complete tear of the CFL. MRI findings of CFL injury are diagnostically specific but are not sensitive. However, only normal findings and complete tears were statistically significant between ATFL and CFL (p

  10. Surgical findings at laparatomy for uterine fibroid in University of ...

    African Journals Online (AJOL)

    A three year review of the surgical findings at Laparotomy for uterine fibroids at the ... that uterine fibroid plays a role in the process of spontaneous conception. ... Other factors found to be associated with uterine fibroid are the numbers, size, ...

  11. Solitary rectal ulcer syndrome: clinical findings, surgical treatment, and outcomes.

    Science.gov (United States)

    Torres, Carlos; Khaikin, Marat; Bracho, Jorge; Luo, Cheng Hua; Weiss, Eric G; Sands, Dana R; Cera, Susan; Nogueras, Juan J; Wexner, Steven D

    2007-11-01

    Solitary rectal ulcer syndrome (SRUS) is a rare disorder often misdiagnosed as a malignant ulcer. Histopathological features of SRUS are characteristic and pathognomonic; nevertheless, the endoscopic and clinical presentations may be confusing. The aim of the present study was to assess the clinical findings, surgical treatment, and outcomes in patients who suffer from SRUS. A retrospective chart review was undertaken, from January 1989 to May 2005 for all patients who were diagnosed with SRUS. Data recorded included: patient's age, gender, clinical presentation, past surgical history, diagnostic and preoperative workup, operative procedure, complications, and outcomes. During the study period, 23 patients were diagnosed with SRUS. Seven patients received only medical treatment, and in three patients, the ulcer healed after medical treatment. Sixteen patients underwent surgical treatment. In four patients, the symptoms persisted after surgery. Two patients presented with postoperative rectal bleeding requiring surgical intervention. Three patients developed late postoperative sexual dysfunction. One patient continued suffering from rectal pain after a colostomy was constructed. Median follow-up was 14 (range 2-84) months. The results of this study show clearly that every patient with SRUS must be assessed individually. Initial treatment should include conservative measures. In patients with refractory symptoms, surgical treatment should be considered. Results of anterior resection and protocolectomy are satisfactory for solitary rectal ulcer.

  12. Hilar cholangiocarcinoma: MR correlation with surgical and histological findings

    International Nuclear Information System (INIS)

    Chryssou, E.; Guthrie, J.A.; Ward, J.; Robinson, P.J.

    2010-01-01

    Aim: To evaluate magnetic resonance cholangiography (MRC) with high-resolution dynamic gadolinium-enhanced magnetic resonance imaging (MRI) in determining the imaging features of hilar cholangiocarcinoma that relate to tumour extent and influence resectability. Materials and methods: Twenty-six patients that underwent resection were reviewed. Tumour location and extent, lobar atrophy, the degree of portal vein and hepatic artery involvement were recorded. The findings were correlated with surgical and histopathological findings. Results: Biliary assessment was concordant in 14 and discordant in eight of 14 stented and four of 12 non-stented patients. In 63/82 veins and 43/74 arteries results were fully concordant. The mean sensitivity, specificity, positive and negative predictive values (PPV, NPV) in predicting involvement of the main portal vein (MPV) at surgery were 83.3, 100, 100, and 92.5%; of the left main branch of the portal vein (LPV) were 100, 91.6, 93.3, and 100%; and of the right branch of the portal vein (RPV) were 87.5, 100, 100, and 87.5%. The sensitivity, specificity, PPV and NPV of MRI in determining histological involvement of the MPV was 75, 90.9, 60, and 92.5%; 100, 73.3, 73, and 100% for the LPV, and 100, 66.6, 42.8, and 100% for the RPV, respectively. Conclusion: MRC with high-resolution dynamic gadolinium-enhanced MRI is effective in determining tumour extent and vascular involvement, but prior stenting may lead to overestimation.

  13. Hilar cholangiocarcinoma: MR correlation with surgical and histological findings

    Energy Technology Data Exchange (ETDEWEB)

    Chryssou, E. [MRI Department, Clinical Radiology, St James' s University Hospital, Beckett Street, Leeds LS9 7TF (United Kingdom); Guthrie, J.A., E-mail: ashguthrie@hotmail.co [MRI Department, Clinical Radiology, St James' s University Hospital, Beckett Street, Leeds LS9 7TF (United Kingdom); Ward, J.; Robinson, P.J. [MRI Department, Clinical Radiology, St James' s University Hospital, Beckett Street, Leeds LS9 7TF (United Kingdom)

    2010-10-15

    Aim: To evaluate magnetic resonance cholangiography (MRC) with high-resolution dynamic gadolinium-enhanced magnetic resonance imaging (MRI) in determining the imaging features of hilar cholangiocarcinoma that relate to tumour extent and influence resectability. Materials and methods: Twenty-six patients that underwent resection were reviewed. Tumour location and extent, lobar atrophy, the degree of portal vein and hepatic artery involvement were recorded. The findings were correlated with surgical and histopathological findings. Results: Biliary assessment was concordant in 14 and discordant in eight of 14 stented and four of 12 non-stented patients. In 63/82 veins and 43/74 arteries results were fully concordant. The mean sensitivity, specificity, positive and negative predictive values (PPV, NPV) in predicting involvement of the main portal vein (MPV) at surgery were 83.3, 100, 100, and 92.5%; of the left main branch of the portal vein (LPV) were 100, 91.6, 93.3, and 100%; and of the right branch of the portal vein (RPV) were 87.5, 100, 100, and 87.5%. The sensitivity, specificity, PPV and NPV of MRI in determining histological involvement of the MPV was 75, 90.9, 60, and 92.5%; 100, 73.3, 73, and 100% for the LPV, and 100, 66.6, 42.8, and 100% for the RPV, respectively. Conclusion: MRC with high-resolution dynamic gadolinium-enhanced MRI is effective in determining tumour extent and vascular involvement, but prior stenting may lead to overestimation.

  14. CT of lumbar spine disk herniation: correlation with surgical findings

    International Nuclear Information System (INIS)

    Firooznia, H.; Benjamin, V.; Kricheff, I.I.; Rafii, M.; Golimbu, C.

    1984-01-01

    Computed tomography (CT) of the lumbar spine was performed with selectively positioned 5-mm-thick axial cross sections to examine each disk level from the top of the neural foramen to the pedicle of the next caudad vertebra. One hundred consecutive patients with 116 surgical disk explorations were reviewed. There was agreement between the CT and surgical findings in 89 patients (104 explorations) in determination of presence or absence of a herniated nucleus pulposus (HNP). Discrepancy occurred in 12 instances (11 patients): two because of incorrect interpretations, five in previously operated patients, three in spondylolisthesis, and two in spinal stenosis. There were 97 true-positives, eight false-negatives, seven true-negatives, and four false-positives. If nine previously operated patients are excluded from the study, then CT was accurate in detection of presence or absence of an HNP in 93% of the disk explorations

  15. Surgical techniques and radiological findings of meniscus allograft transplantation.

    Science.gov (United States)

    Lee, Hoseok; Lee, Sang Yub; Na, Young Gon; Kim, Sung Kwan; Yi, Jae Hyuck; Lim, Jae Kwang; Lee, So Mi

    2016-08-01

    Meniscus allograft transplantation has been performed over the past 25 years to relieve knee pain and improve knee function in patients with an irreparable meniscus injury. The efficacy and safety of meniscus allograft transplantation have been established in numerous experimental and clinical researches. However, there is a lack of reviews to aid radiologists who are routinely interpreting images and evaluating the outcome of the procedures, and also meniscus allograft transplantation is not widely performed in most hospitals. This review focuses on the indications of the procedure, the different surgical techniques used for meniscus allograft transplantation according to the involvement of the lateral and medial meniscus, and the associated procedures. The postoperative radiological findings and surgical complications of the meniscus allograft transplantation are also described in detail. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  16. Hippocampal sclerosis: correlation of MR imaging findings with surgical outcome

    International Nuclear Information System (INIS)

    Kim, Yoon Hee; Chang, Kee Hyun; Kim, Kyung Won; Han, Moon Hee; Park, Sung Ho; Nam, Hyun Woo; Choi, Kyu Ho; Cho, Woo Ho

    2001-01-01

    Atrophy and a high T2 signal of the hippocampus are known to be the principal MR imaging findings of hippocampal sclerosis. The purpose of this study was to determine whether or not individual MRI findings correlate with surgical outcome in patients with this condition. Preoperative MR imaging findings in 57 consecutive patients with pathologically-proven hippocampal sclerosis who underwent anterior temporal lobectomy and were followed-up for 24 months or more were retrospectively reviewed, and the results were compared with the postsurgical outcome (Engel classification). The MR images included routine sagittal T1-weighted and axial T2-weighted spin-echo images, and oblique coronal T1-weighted 3D gradient-echo and T2-weighted 2D fast spin-echo images obtained on either a 1.5 T or 1.0 T unit. The images were visually evaluated by two neuroradiologists blinded to the outcome; their focus was the presence or absence of atrophy and a high T2 hippocampal signal. Hippocampal atrophy was seen in 96% of cases (55/57) [100% (53/53) of the good outcome group (Engel class I and II), and 50% (2/4) of the poor outcome group (class III and IV)]. A high T2 hippocampal signal was seen in 61% of cases (35/57) [62% (33/53) of the good outcome group and 50% (2/4) of the poor outcome group]. All 35 patients with a high T2 signal had hippocampal atrophy. 'Normal' hippocampus, as revealed by MR imaging, occurred in 4% of patients (2/57), both of whom showed a poor outcome (Engel class III). The presence or absence of hippocampal atrophy correlated well with surgical outcome (p 0.05). Compared with a high T2 hippocampal signal, hippocampal atrophy is more common and correlates better with surgical outcome. For the prediction of this, it thus appears to be the more useful indicator

  17. Study of breast implant rupture: MRI versus surgical findings.

    Science.gov (United States)

    Vestito, A; Mangieri, F F; Ancona, A; Minervini, C; Perchinunno, V; Rinaldi, S

    2012-09-01

    This study evaluated the role of breast magnetic resonance (MR) imaging in the selective study breast implant integrity. We retrospectively analysed the signs of breast implant rupture observed at breast MR examinations of 157 implants and determined the sensitivity and specificity of the technique in diagnosing implant rupture by comparing MR data with findings at surgical explantation. The linguine and the salad-oil signs were statistically the most significant signs for diagnosing intracapsular rupture; the presence of siliconomas/seromas outside the capsule and/or in the axillary lymph nodes calls for immediate explantation. In agreement with previous reports, we found a close correlation between imaging signs and findings at explantation. Breast MR imaging can be considered the gold standard in the study of breast implants.

  18. MRI and pathological findings of epileptogenic lesions removed surgically

    International Nuclear Information System (INIS)

    Moritake, Kouzo; Kikuchi, Haruhiko; Minamikawa, Jun

    1990-01-01

    MRI revealed focal cerebral lesions in 19 patients, 12 males and 7 females, who had suffered from disabling seizures refractory to medical therapy for over one year; the lengths of the periods of therapy ranged from one to 17 years; mean: 8.8 years. Their ages at surgery ranged from 3 to 46 years; mean: 15.2 years. The results of other preoperative and intraoperative examinations, including mobile long-term ambulatory EEG monitoring, local CBF two-dimensional imaging by SPECT, and intraoperative cortical EEG, justified the surgical resection of those lesions revealed by MRI. These lesions were removed totally or subtotally. The pathological findings of the excised lesions were neuronal loss and gliosis in 10 cases (porencephaly, 2; arachnoid cyst, 3; post-traumatic scar, 1; nonspecific infarct, 4), hamartomatous pathology in 5 (hemartoma, 1; tuberous sclerosis, 4), and neoplasm in 4 (low-grade astrocytoma, 2; oligodendroglioma, 1; epidermoid, 1). The common pathological feature of these lesions was the proliferation of abnormal glial cells, which are sensitive to MRI imaging, especially to T 2 -weighted images. The postoperative follow-up terms of these 19 patients ranged from 6 to 23 months; mean: 15 months. Epileptic attacks had ceased in 12 of the 19 patients (63%), and there had been a marked improvement in both the frequency and severity of attacks in another 4. No permanent surgical complications or worsening of the seizures were seen in any patient. In conclusion, MRI is sensitive to epileptogenic lesions in patients with medically intractable epilepsy and is helpful in defining their configurations and margins and in planning the surgical approach. (author)

  19. Classification of the supraspinatus lesions based on the correlation between MRI and surgical findings

    International Nuclear Information System (INIS)

    Capiel, Carlos A. h; Sammartino, Mario R.; Bouzas, Carlos A.; Mussini, Daniel

    2001-01-01

    Objective: The purpose of this study was to evaluate the sensitivity of MR in the diagnosis of supraspinatus disorders and to report a classification based on the correlation between MR and surgical findings. Materials and methods: Thirty-nine patients with clinical suspected rotator cuff abnormalities were examined with MR. Two radiologists interpreted the images without knowledge of the surgical findings. MR findings were correlated with surgical ones. The classification used divides the supraspinatus disorders in two groups: a) With tendinous continuity (tendinosis and partial cuff tear); and b) Interruption of the tendinous continuity (full-thickness tear). Full thickness tears can be with severe or small retraction. Results: All the patients had full-thickness tear. MR correctly diagnosed thirty-eight tears with a sensitivity of 97,4%. Twelve tears showed small retraction and twenty-seven a severe retraction. Five patients had irreparable lesions. Conclusion: MR is an excellent method in the diagnosis of rotator cuff disorders. The classification based on the correlation between MR and surgical findings supplies an accurate diagnosis and gives an integrated scope of supraspinatus disorders. In this way the orthopaedic surgeons can define if the disorders can be clinically or surgically treated, and in this case, determine the type of surgery required (open surgery or arthroscopy). (author)

  20. Surgical transposition of the ovaries: imaging findings in 14 patients.

    Science.gov (United States)

    Kier, R; Chambers, S K

    1989-11-01

    Pelvic radiation therapy for cervical or vaginal cancer often leads to ovarian failure. To remove the ovaries from the radiation portal and preserve their function, they can be transposed to the lateral abdomen. Serial imaging studies in 14 patients who had undergone ovarian transposition (five bilateral, nine unilateral) were reviewed. Images obtained included 32 CT scans, 20 sonograms, and one MR image. Most transposed ovaries were located along the paracolic gutters near the iliac crests, creating an extrinsic mass effect on adjacent bowel. Detection of surgical clips on the ovary on CT scans allowed confident recognition of all 19 transposed ovaries. Cysts in the transposed ovaries, noted on most imaging studies, did not correlate with complications of pain or hormonal dysfunction. In one case, a large physiologic cyst in a transposed ovary distorted the cecum and was mistaken for a mucocele of the appendix. In another case, a large ovarian cyst was thought to be tumor recurrence or a lymphocele. These findings indicate that although the transposed ovaries can be recognized on CT scans by the surgical clips attached to the ovaries, the appearance of the ovary does not predict reliably the development of complications.

  1. Surgical transposition of the ovaries: Imaging findings in 14 patients

    International Nuclear Information System (INIS)

    Kier, R.; Chambers, S.K.

    1989-01-01

    Pelvic radiation therapy for cervical or vaginal cancer often leads to ovarian failure. To remove the ovaries from the radiation portal and preserve their function, they can be transposed to the lateral abdomen. Serial imaging studies in 14 patients who had undergone ovarian transposition (five bilateral, nine unilateral) were reviewed. Images obtained included 32 CT scans, 20 sonograms, and one MR image. Most transposed ovaries were located along the paracolic gutters near the iliac crests, creating an extrinsic mass effect on adjacent bowel. Detection of surgical clips on the ovary on CT scans allowed confident recognition of all 19 transposed ovaries. Cysts in the transposed ovaries, noted on most imaging studies, did not correlate with complications of pain or hormonal dysfunction. In one case, a large physiologic cyst in a transposed ovary distorted the cecum and was mistaken for a mucocele of the appendix. In another case, a large ovarian cyst was thought to be tumor recurrence or a lymphocele. These findings indicate that although the transposed ovaries can be recognized on CT scans by the surgical clips attached to the ovaries, the appearance of the ovary does not predict reliably the development of complications

  2. Comparison between computed tomographic and surgical findings in nine large-breed dogs with lumbosacral stenosis

    International Nuclear Information System (INIS)

    Jones, J.C.; Sorjonen, D.C.; Simpson, S.T.; Coates, J.R.; Lenz, S.D.; Hathcock, J.T.; Agee, M.W.; Bartels, J.E.

    1996-01-01

    In a three-year prospective study, computed tomographic (CT) and surgical findings were compared for nine large breed dogs with lumbosacral stenosis. Surgically-excised tissue was examined histologically in seven dogs and additional necropsy evaluation was performed in one dog. The CT abnormalities observed at sites of confirmed cauda equina compression were: loss of epidural fat, increased soft tissue opacity, bulging of the intervertebral disc margin, spondylosis, thecal sac displacement, narrowed intervertebral foramen, narrowed vertebral canal, thickened articular process, articular process subluxation, articular process osteophyte, and telescoped sacral lamina. The CT characteristics of lumbosacral degenerative disease and discospondylitis were similar to those described in humans. In three dogs, CT findings at the site of cauda equina compression were consistent with congenital or developmental spinal stenosis, but the method of surgical exposure precluded confirmation. Epidural fibrosis (eight dogs) and multi-level CT abnormalities (six dogs) were identified but the cause(s) and significance were unknown

  3. Correlation of plain radiographic and lumbar myelographic findings with surgical findings in thoracolumbar disc disease

    International Nuclear Information System (INIS)

    Oldby, N.J.; Dyce, J.; Houlton, J.E.F.

    1994-01-01

    The results of a prospective study to compare the plain radiographic and lumbar myelographic findings with the surgical findings in 70 cases of suspected thoracolumbar disc protrusion in the dog are reported. The aim was to assess the relative accuracy of disc lesion localisation using plain and contrast radiography. From the plain radiographs, the affected disc space was correctly identified in 40 cases (57.1 per cent), and incorrectly identified in seven. More than one site was identified in 11; in eight of these dogs, the affected disc space was strongly suspected. It was not possible to identify an affected disc in 12 cases. The site of disc protrusion was accurately identified by myelography in 60 dogs (85.7 per cent). In four dogs, myelography was helpful in identifying an adjacent disc and, in a further two, cord swelling was found at surgery. In one dog, neither disc material nor cord swelling was identified. Three myelograms were non-diagnostic

  4. Comparison of CT findings with upper GI series and surgical findings

    Energy Technology Data Exchange (ETDEWEB)

    Hong, Jin Kyo; Suh, Soo Jhi; Kim, Soon Yong [School of Medicine, Kyung Hee University, Seoul (Korea, Republic of)

    1981-09-15

    The authors made comparative studies of CT findings with upper GI series and surgical findings in 20 cases of histologically proven gastric cancers. The identification of chickening of gastric wall and local and remote metastasis by CT was thought to be great value in treatment planning and prediction of prognosis of the patients. The results were as follows: 1. Of 20 cases, 19 cases demonstrated thickening of gastric wall. Among 3 cases suggested as early cancer on upper GI series, 2 cases demonstrated thickened gastric wall on CT and it was proved to be advanced cancer at surgery. 2. Out of 8 cases showed no definite metastasis on CT, 4 cases had malignant infiltration histologically in the regional lymph nodes. But they were less than 1.5 cm in diameter. 3. The frequency order of remote metastasis found by CT was pancreas, liver, left adrenal gland and lung in organs and retroperitoneal, retrocrural and regional nodes in lymph nodes.

  5. Veterinary Students' Recollection Methods for Surgical Procedures

    DEFF Research Database (Denmark)

    Langebaek, Rikke; Tanggaard, Lene; Berendt, Mette

    2016-01-01

    When veterinary students face their first live animal surgeries, their level of anxiety is generally high and this can affect their ability to recall the procedure they are about to undertake. Multimodal teaching methods have previously been shown to enhance learning and facilitate recall; however......, student preferences for recollection methods when translating theory into practice have not been documented. The aim of this study was to investigate veterinary students' experience with recollection of a surgical procedure they were about to perform after using multiple methods for preparation. From...... a group of 171 veterinary students enrolled in a basic surgery course, 26 students were randomly selected to participate in semi-structured interviews. Results showed that 58% of the students used a visual, dynamic method of recollection, mentally visualizing the video they had watched as part...

  6. Sonography findings in tears of the extensor pollicis longus tendon and correlation with CT, MRI and surgical findings

    International Nuclear Information System (INIS)

    Ruiz Santiago, Fernando; Garofano Plazas, Pilar; Fernandez, Juan Miguel Tristan

    2008-01-01

    We present our experience in the diagnosis of extensor pollicis longus tendon tears using different imaging methods. In the past 2 years, 12 patients (7 males, 5 females) with extension deficit of distal phalanx of thumb were diagnosed with extensor pollicis longus tendon (EPL) rupture by means of different imaging methods. The ultrasound pattern consisted of a gap between tendon stumps occupied by a continuous (eight cases) or discontinuous (four cases) attenuated hypoechoic string. In nine cases, the tendon ends were identified as a thickened stump-like structure. In the other three cases, tendon stumps were attenuated and mixed with atrophic muscle or wrist subcutaneous fat. All ultrasound findings were confirmed by CT, MR and/or surgical findings

  7. [Endoscopic calcaneoplasty (ECP) in Haglund's syndrome. Indication, surgical technique, surgical findings and results].

    Science.gov (United States)

    Jerosch, J; Sokkar, S; Dücker, M; Donner, A

    2012-06-01

    Posterior calcaneal exostosis treatment modalities have given rise to many controversial opinions. After failure of the conservative treatment, surgical bursectomy and resection of the calcaneal exostosis are indicated by many authors. But clinical studies also show a high rate of unsatisfactory results with a relative high incidence of complications. The minimally invasive surgical technique by an endoscopic calcaneoplasty (ECP) could be an option to overcome some of these problems. Between 1999 und 2010 we operated 164 patients with an age range between 16 and 67 years, 81 males and 83 females. The radiological examination prior to surgery documented in all cases a posterior superior calcaneal exostosis that showed friction to the Achilles tendon. All patients included in the study had no clinical varus of the hind foot, nor cavus deformities. All patients had undergone a trial of conservative treatment for at least 6 months and did not show a positive response. The average follow-up was 46.3 (range: 8-120) months. According to the Ogilvie-Harris score 71 patients presented good and 84 patients excellent results, while 5 patients showed fair results, and 4 patients only poor results. All the post-operative radiographs showed sufficient resection of the calcaneal spur. In 61 patients the preoperative MRI showed a partial rupture of the Achilles tendon close to the insertion side. In no case could we observe a complete tear at the time of follow-up. Only minor postoperative complications were observed. In many patients we could observe a chondral layer at the posterior aspect of the calcaneus. Close to the intersion the Achilles tendon showed also in many patients a chondroide metaplasia. ECP is an effective and minimally invasive procedure for the treatment of patients with calcaneal exostosis. After a short learning curve the endoscopic exposure is superior to the open technique, has less morbidity, less operating time, and nearly no complications. Moreover, the

  8. MnDPDP-enhanced MR imaging of the liver. Correlation with surgical findings

    International Nuclear Information System (INIS)

    Kane, P.A.; Ayton, V.; Walters, H.L.; Benjamin, I.; Heaton, N.D.; Williams, R.; Karani, J.B.

    1997-01-01

    Purpose: To compare lesion detection and characterisation predicted by MnDPDP-enhanced MR imaging with surgical excision and pathological examination. Material and Methods: Ninety patients were intravenously infused at a rate of 2 to 3 ml/min with 5 μmol/kg mangafodipir trisodium (MnDPDP, Teslascan). The patients were examined with spin-echo and gradient-echo T1-weighted MR imaging at 1 h and 24 h after the end of infusion. The results were compared with identical pre-contrast sequences. In 20 of these patients, the pre-operative MR findings were compared with intra-operative ultrasonography and histology of the resected liver specimens. Results: In those with liver metastases, there was a good correlation between MR and the hepatic disease in 11 out of 14 cases. In the group with primary liver tumours, MR findings correlated with hepatic disease in 5 out 6 cases. (orig./AJ)

  9. Agreement between computed tomography, magnetic resonance imaging, and surgical findings in dogs with degenerative lumbosacral stenosis.

    Science.gov (United States)

    Suwankong, Niyada; Voorhout, George; Hazewinkel, Herman A W; Meij, Björn P

    2006-12-15

    To assess the extent of agreement between computed tomography (CT), magnetic resonance imaging (MRI), and surgical findings in dogs with degenerative lumbosacral stenosis. Observational study. 35 dogs with degenerative lumbosacral stenosis. Results of preoperative CT and MRI were compared with surgical findings with respect to degree and location of disk protrusion, position of the dural sac, amount of epidural fat, and swelling of spinal nerve roots. A lumbosacral step was seen on radiographic images from 22 of 32 (69%) dogs, on CT images from 23 of 35 (66%) dogs, and on MR images from 21 of 35 (60%) dogs. Most dogs had slight or moderate disk protrusion that was centrally located. There was substantial or near perfect agreement between CT and MRI findings in regard to degree of disk protrusion (kappa, 0.88), location of disk protrusion (0.63), position of the dural sac (0.89), amount of epidural fat (0.72), and swelling of spinal nerve roots (0.60). The degree of agreement between CT and surgical findings and between MRI and surgical findings was moderate in regard to degree and location of disk protrusion (kappa, 0.44 to 0.56) and swelling of spinal nerve roots (0.40 and 0.50). Results indicate that there is a high degree of agreement between CT and MRI findings in dogs with degenerative lumbosacral stenosis but that the degree of agreement between diagnostic imaging findings and surgical findings is lower.

  10. Vacuum sealing and cooling as methods to preserve surgical specimens

    DEFF Research Database (Denmark)

    Kielsgaard Kristensen, Thomas; Engvad, Birte; Nielsen, Ole

    2011-01-01

    Recently, vacuum-based preservation of surgical specimens has been proposed as a safe alternative to formalin fixation at the surgical theater. The method seems feasible from a practical point of view, but no systematic study has examined the effect of vacuum sealing alone with respect to tissue...

  11. Abnormal imaging findings of the breast related to hormone replacement therapy: analysis of surgically excised cases

    Energy Technology Data Exchange (ETDEWEB)

    Moon, Woo Kyung; Cha, Joo Hee; Cho, Kyung Soo; Choi, Een Wan; Lee, Yu Jin; Im, Jung Gi [College of Medicine, Seoul National Univ., Seoul (Korea, Republic of); Kim, Hyung Seok [Wooridul Spine Hospital, Seoul (Korea, Republic of); Chung, Sun Yang [Bundang CHA General Hospital, Sungnam (Korea, Republic of); Cho, Nariya [Gil Medical Center, Incheon (Korea, Republic of)

    2004-02-01

    To correlate the mammographic and ultrasonographic findings with the pathologic results in women undergoing hormone replacement therapy (HRT), and to determine the characteristic clinical, mammographic or histologic findings of breast cancer in these patients. Twenty-five breast lesions in 25 patients aged 44-65 (mean, 55.5) years undergoing HRT were surgically removed due to abnormal mammographic findings or the presence of palpable masses. Mammograms in all patients and ultrasonograms in 23 were retrospectively analyzed in terms of the shape and margin of the mass, and microcalcifications, and the imaging findings were correlated with the pathologic results. As a control group, 45 cancer patients not undergoing HRT were selected. Using the student t test, detection methods, tumor size, mammographic findings, and the proportion of intraductal cancers were compared between to two groups. Surgical excision revealed ten benign lesions (four fibroadenomas and six cases of fibrocystic change) and 15 cancers (three intraductal and twelve invasive ductal cancers). Abnormal findings at mammography were a mass in 16 cases, clustered microcalcifications in seven, and a mass with microcalcifications in two. Mammography showed that all four circumscribed masses were benign. Five of seven ill-defined masses (71%) and all six spiculated masses were malignant. Three of seven cases (43%) with microcalcifications, and both with a mass and microcalcification, were malignant. In two cases in which ultrasonography revealed cystic lesions, histologic examination showed that fibrocystic change had occurred. Compared to non-HRT-related cancers, HRT-related cancers were more often detected by mammography (60% vs 16%; p<0.001), smaller (17 mm vs 24 mm, p<0.01), showed microcalcification only (20% vs 13%; p<0.05), and were intraductal (20% vs 7%; p<0.01). In patients with HRT, mammographic findings of an ill-defined or spiculated mass, or one with microcalcifications, were associated with

  12. Abnormal imaging findings of the breast related to hormone replacement therapy: analysis of surgically excised cases

    International Nuclear Information System (INIS)

    Moon, Woo Kyung; Cha, Joo Hee; Cho, Kyung Soo; Choi, Een Wan; Lee, Yu Jin; Im, Jung Gi; Kim, Hyung Seok; Chung, Sun Yang; Cho, Nariya

    2004-01-01

    To correlate the mammographic and ultrasonographic findings with the pathologic results in women undergoing hormone replacement therapy (HRT), and to determine the characteristic clinical, mammographic or histologic findings of breast cancer in these patients. Twenty-five breast lesions in 25 patients aged 44-65 (mean, 55.5) years undergoing HRT were surgically removed due to abnormal mammographic findings or the presence of palpable masses. Mammograms in all patients and ultrasonograms in 23 were retrospectively analyzed in terms of the shape and margin of the mass, and microcalcifications, and the imaging findings were correlated with the pathologic results. As a control group, 45 cancer patients not undergoing HRT were selected. Using the student t test, detection methods, tumor size, mammographic findings, and the proportion of intraductal cancers were compared between to two groups. Surgical excision revealed ten benign lesions (four fibroadenomas and six cases of fibrocystic change) and 15 cancers (three intraductal and twelve invasive ductal cancers). Abnormal findings at mammography were a mass in 16 cases, clustered microcalcifications in seven, and a mass with microcalcifications in two. Mammography showed that all four circumscribed masses were benign. Five of seven ill-defined masses (71%) and all six spiculated masses were malignant. Three of seven cases (43%) with microcalcifications, and both with a mass and microcalcification, were malignant. In two cases in which ultrasonography revealed cystic lesions, histologic examination showed that fibrocystic change had occurred. Compared to non-HRT-related cancers, HRT-related cancers were more often detected by mammography (60% vs 16%; p<0.001), smaller (17 mm vs 24 mm, p<0.01), showed microcalcification only (20% vs 13%; p<0.05), and were intraductal (20% vs 7%; p<0.01). In patients with HRT, mammographic findings of an ill-defined or spiculated mass, or one with microcalcifications, were associated with

  13. Evaluation of two surveillance methods for surgical site infection

    Directory of Open Access Journals (Sweden)

    M. Haji Abdolbaghi

    2006-08-01

    Full Text Available Background: Surgical wound infection surveillance is an important facet of hospital infection control processes. There are several surveillance methods for surgical site infections. The objective of this study is to evaluate the accuracy of two different surgical site infection surveillance methods. Methods: In this prospective cross sectional study 3020 undergoing surgey in general surgical wards of Imam Khomeini hospital were included. Surveillance methods consisted of review of medical records for postoperative fever and review of nursing daily note for prescription of antibiotics postoperatively and during patient’s discharge. Review of patient’s history and daily records and interview with patient’s surgeon and the head-nurse of the ward considered as a gold standard for surveillance. Results: The postoperative antibiotic consumption especially when considering its duration is a proper method for surgical wound infection surveillance. Accomplishments of a prospective study with postdischarge follow up until 30 days after surgery is recommended. Conclusion: The result of this study showed that postoperative antibiotic surveillance method specially with consideration of the antibiotic usage duration is a proper method for surgical site infection surveillance in general surgery wards. Accomplishments of a prospective study with post discharge follow up until 30 days after surgery is recommended.

  14. MR imaging findings of painful type II accessory navicular bone: correlation with surgical and pathologic studies

    International Nuclear Information System (INIS)

    Choi, Yun Sun; Lee, Kyung Tai; Kim, Eun Kyung; Kang, Heung Sik

    2004-01-01

    To evaluate the MR imaging findings of painful type II accessory navicular bone and to correlate these with the surgical and pathologic findings. The MR images of 17 patients with medial foot pain and surgically proven type II accessory navicular abnormalities were reviewed. The changes of signal intensity in the accessory navicular, synchondrosis and adjacent soft tissue, the presence of synchondrosis widening, and posterior tibial tendon (PTT) pathology on the T1-weighted and fat-suppressed T2-weighted images were analyzed. The MR imaging findings were compared with the surgical and pathologic findings. The fat-suppressed T2-weighted images showed high signal intensity in the accessory navicular bones and synchondroses in all patients, and in the soft tissue in 11 (64.7%) of the 17 patients, as well as synchondrosis widening in 3 (17.6%) of the 17 patients. The MR images showed tendon pathology in 12 (75%) of the 16 patients with PTT dysfunction at surgery. The pathologic findings of 16 surgical specimens included areas of osteonecrosis with granulomatous inflammation, fibrosis and destruction of the cartilage cap. The MR imaging findings of painful type II accessory navicular bone are a persistent edema pattern in the accessory navicular bone and within the synchondrosis, indicating osteonecrosis, inflammation and destruction of the cartilage cap. Posterior tibial tendon dysfunction was clinically evident in most patients

  15. Epidermolysis bullosa acquisita: clinical manifestations, microscopic findings, and surgical periodontal therapy. A case report.

    Science.gov (United States)

    Hakki, S S; Celenligil-Nazliel, H; Karaduman, A; Usubütün, A; Ertoy, D; Ayhan, A; Ruacan, S

    2001-04-01

    Epidermolysis bullosa acquisita (EBA) is an uncommon, acquired, chronic subepidermal bullous disease. This report describes a case of EBA with gingival involvement. A 43-year-old woman with EBA was referred to our clinic for periodontal therapy because of gingival tenderness and bleeding. She has been on cyclosporin A therapy for the last 2 years. Clinical findings were analyzed. Anterior gingivectomy operations were performed in 2 stages. The samples obtained during the surgery were examined using histopathologic, immunohistologic, and electronmicroscopic methods. Long-term effects of the surgical periodontal treatment on gingiva were evaluated both clinically and microscopically. The dentition displayed minimal enamel hypoplasia. Decayed, missing, and filled surfaces score was found to be elevated. Periodontal examination showed generalized diffuse gingival inflammation and gingival enlargement localized mainly to the anterior region. Nikolsky's sign was positive. However, wound healing was uneventful after the operations. Microscopic findings were similar to those obtained from the skin. Twenty-one months after the operations, Nikolsky's sign was negative and no remarkable gingival inflammation was noted. Microscopic examination revealed that the blisters were fewer in number and smaller in size. These results indicate that gingival tissues may also be involved in EBA. Uneventful wound healing after periodontal surgery in this case suggests that periodontal surgery can be performed in patients with EBA. Moreover, both our clinical and histopathologic findings imply that gingivectomy proves useful in maintaining gingival integrity in these patients. Our data may also suggest that the patients with EBA are highly likely to develop dental caries.

  16. Surface anatomy scanning (SAS) in intracranial tumours: comparison with surgical findings

    International Nuclear Information System (INIS)

    Sumida, M.; Uozumi, T.; Kiya, K.; Arita, K.; Kurisu, K.; Onda, J.; Satoh, H.; Ikawa, F.; Yukawa, O.; Migita, K.; Hada, H.; Katada, K.

    1995-01-01

    We evaluated the usefulness of surface anatomy scanning (SAS) in intracranial tumours, comparing it with surgical findings. We examined 31 patients with brain tumours preoperatively. The tumours included 16 meningiomas, 8 gliomas, 4 metastases and 3 others. SAS clearly demonstrated the tumours, allowing them to be distinguished from the structures of the brain surface, including oedema, except in cases of metastasis. SAS clearly demonstrated large cortical veins. SAS is useful for three-dimensional delineation of the brain surface before surgery. (orig.)

  17. MR imaging of intramedullary tumors of the spinal cord: comparison with surgical findings

    International Nuclear Information System (INIS)

    Choe, Du Whan; Hwang, Hee Young; Lee, Hyeon Kyeong; Han, Moon Hee; Kim, In One; Kim, Hyen Jip; Chang, Kee Hyung

    1991-01-01

    To evaluate the capability of MR imaging to localize intramedullary tumors of the spinal cord and to distinguish solid from cystic components. MR images of 12 patients with surgically-proven intramedullary spinal cord tumor were retrospectively reviewed and correlated with surgical findings. Histologic diagnosis consisted of 3 astrocytomas, 4 ependymomas, 2 gangliogliomas, and one case of lipoma, lymphoma, and glioblastoma multiform each. MR scans were obtained on a 2.0T or a 0.5T with T1-and T2-weighted spin-echo pulse sequences in sagittal and axial planes. Contrast enhancement was performed with Gd-DTPA in 9 patients. All tumors expanded the spinal cord and showed an extent of involvement ranging from 2 to 5 vertebral heights, except for the gangliogliomas which involved the spinal cord more extensively. Contrast enhancement was seen in all 9 patients. Intratumoral cavities were observed in 1 out of 3 astrocytomas and 2 gangliogliomas. Peritumoral syringomyelia was seen in 2 out of 4 ependymonas and 2 gangliogliomas. In most cases, the MR findings correlated well with the surgical findings with respect to the extent, distinctness of the tumor margin, intratumoral cavity, and associated syringomyelia. It is concluded that MR imaging is a very useful diagnostic tool in the evaluation of intramedullary spinal cord tumors

  18. Finding protein sites using machine learning methods

    Directory of Open Access Journals (Sweden)

    Jaime Leonardo Bobadilla Molina

    2003-07-01

    Full Text Available The increasing amount of protein three-dimensional (3D structures determined by x-ray and NMR technologies as well as structures predicted by computational methods results in the need for automated methods to provide inital annotations. We have developed a new method for recognizing sites in three-dimensional protein structures. Our method is based on a previosly reported algorithm for creating descriptions of protein microenviroments using physical and chemical properties at multiple levels of detail. The recognition method takes three inputs: 1. A set of control nonsites that share some structural or functional role. 2. A set of control nonsites that lack this role. 3. A single query site. A support vector machine classifier is built using feature vectors where each component represents a property in a given volume. Validation against an independent test set shows that this recognition approach has high sensitivity and specificity. We also describe the results of scanning four calcium binding proteins (with the calcium removed using a three dimensional grid of probe points at 1.25 angstrom spacing. The system finds the sites in the proteins giving points at or near the blinding sites. Our results show that property based descriptions along with support vector machines can be used for recognizing protein sites in unannotated structures.

  19. Triple pathological findings in a surgically amenable patient with mesial temporal lobe epilepsy

    Directory of Open Access Journals (Sweden)

    Fumin Tong

    2015-01-01

    Full Text Available Mesial temporal sclerosis (MTS is a well-recognized cause of intractable epilepsy; however, coexistence with focal cortical dysplasia (FCD is less common. Middle fossa epidermoid cysts are rare and may involve the temporal lobe. Most epidermoids are clinically silent, slow-growing, and seldom associated with overt symptomatology, including seizures. We describe a patient with multiple comorbidities including left MTS and a large epidermoid cyst involving the left quadrigeminal plate cistern compressing upon the cerebellar vermis and tail of the left hippocampus, resulting in refractory left temporal lobe epilepsy. The patient underwent left anterior temporal lobectomy. The surgical pathology demonstrated a third pathological finding of left temporal FCD type Ia. The patient has been seizure-free since the surgery. This case provides additional information with regard to the understanding of epileptogenicity and surgical planning in patients with MTS and epidermoid cysts.

  20. Magnetic resonance imaging findings associated with surgically proven rotator interval lesions

    Energy Technology Data Exchange (ETDEWEB)

    Vinson, Emily N.; Major, Nancy M. [Duke University Medical Center, Department of Radiology, P.O. Box 3808, Durham, NC (United States); Higgins, Laurence D. [Brigham and Women' s Hospital, Department of Orthopedic Surgery, Boston, MA (United States)

    2007-05-15

    To identify shoulder magnetic resonance imaging (MRI) findings associated with surgically proven rotator interval abnormalities. The preoperative MRI examinations of five patients with surgically proven rotator interval (RI) lesions requiring closure were retrospectively evaluated by three musculoskeletal-trained radiologists in consensus. We assessed the structures in the RI, including the coracohumeral ligament, superior glenohumeral ligament, fat tissue, biceps tendon, and capsule for variations in size and signal alteration. In addition, we noted associated findings of rotator cuff and labral pathology. Three of three of the MR arthrogram studies demonstrated extension of gadolinium to the cortex of the undersurface of the coracoid process compared with the control images, seen best on the sagittal oblique images. Four of five of the studies demonstrated subjective thickening of the coracohumeral ligament, and three of five of the studies demonstrated subjective thickening of the superior glenohumeral ligament. Five of five of the studies demonstrated a labral tear. The MRI arthrogram finding of gadolinium extending to the cortex of the undersurface of the coracoid process was noted on the studies of those patients with rotator interval lesions at surgery in this series. Noting this finding - especially in the presence of a labral tear and/or thickening of the coracohumeral ligament or superior glenohumeral ligament - may be helpful in the preoperative diagnosis of rotator interval lesions. (orig.)

  1. Surgical method for prevention of scaring in conducting sinustrabeculectomy

    Directory of Open Access Journals (Sweden)

    Zhuravleva A.N.

    2017-06-01

    Full Text Available Prolonged hypotensive effect in the postoperative period is one of the main tasks of modern glaucoma surgery. In connection with this, the aim of our study is to develop a surgical method of prevention of scarring during the classical sinustrabeculectomy. Material and Methods. The operation was performed in 13 patients (13 eyes with primary open angle glaucoma (POAG ll-lll (B-C in steps aged 50-70 years. The duration of observation up of 2 year. Results. After 9-12 months of hypotensive efficacy was 100% (13 eyes in 20-24 months — 98% (12 of 13 eyes. The result was confirmed using standard methods of examination (visometry, tonometry, computerized perimetry, tonography et al., in the early postoperative period was performed optical coherence tomography of the anterior segment, then — ultrasound biomicroscopy. Conclusions. Developed a new version of the surgical treatment of glaucoma a long-acting hypotensive effect.

  2. A Simple and Automatic Method for Locating Surgical Guide Hole

    Science.gov (United States)

    Li, Xun; Chen, Ming; Tang, Kai

    2017-12-01

    Restoration-driven surgical guides are widely used in implant surgery. This study aims to provide a simple and valid method of automatically locating surgical guide hole, which can reduce operator's experiences and improve the design efficiency and quality of surgical guide. Few literatures can be found on this topic and the paper proposed a novel and simple method to solve this problem. In this paper, a local coordinate system for each objective tooth is geometrically constructed in CAD system. This coordinate system well represents dental anatomical features and the center axis of the objective tooth (coincide with the corresponding guide hole axis) can be quickly evaluated in this coordinate system, finishing the location of the guide hole. The proposed method has been verified by comparing two types of benchmarks: manual operation by one skilled doctor with over 15-year experiences (used in most hospitals) and automatic way using one popular commercial package Simplant (used in few hospitals).Both the benchmarks and the proposed method are analyzed in their stress distribution when chewing and biting. The stress distribution is visually shown and plotted as a graph. The results show that the proposed method has much better stress distribution than the manual operation and slightly better than Simplant, which will significantly reduce the risk of cervical margin collapse and extend the wear life of the restoration.

  3. Assessment methods in surgical training in the United Kingdom

    Directory of Open Access Journals (Sweden)

    Evgenios Evgeniou

    2013-02-01

    Full Text Available A career in surgery in the United Kingdom demands a commitment to a long journey of assessment. The assessment methods used must ensure that the appropriate candidates are selected into a programme of study or a job and must guarantee public safety by regulating the progression of surgical trainees and the certification of trained surgeons. This review attempts to analyse the psychometric properties of various assessment methods used in the selection of candidates to medical school, job selection, progression in training, and certification. Validity is an indicator of how well an assessment measures what it is designed to measure. Reliability informs us whether a test is consistent in its outcome by measuring the reproducibility and discriminating ability of the test. In the long journey of assessment in surgical training, the same assessment formats are frequently being used for selection into a programme of study, job selection, progression, and certification. Although similar assessment methods are being used for different purposes in surgical training, the psychometric properties of these assessment methods have not been examined separately for each purpose. Because of the significance of these assessments for trainees and patients, their reliability and validity should be examined thoroughly in every context where the assessment method is being used.

  4. Alternative Polyadenylation: Methods, Findings, and Impacts

    Directory of Open Access Journals (Sweden)

    Wei Chen

    2017-10-01

    Full Text Available Alternative polyadenylation (APA, a phenomenon that RNA molecules with different 3′ ends originate from distinct polyadenylation sites of a single gene, is emerging as a mechanism widely used to regulate gene expression. In the present review, we first summarized various methods prevalently adopted in APA study, mainly focused on the next-generation sequencing (NGS-based techniques specially designed for APA identification, the related bioinformatics methods, and the strategies for APA study in single cells. Then we summarized the main findings and advances so far based on these methods, including the preferences of alternative polyA (pA site, the biological processes involved, and the corresponding consequences. We especially categorized the APA changes discovered so far and discussed their potential functions under given conditions, along with the possible underlying molecular mechanisms. With more in-depth studies on extensive samples, more signatures and functions of APA will be revealed, and its diverse roles will gradually heave in sight. Keywords: Alternative polyadenylation, Next-generation sequencing, 3′UTR, Alternative splicing, Gene regulation

  5. Epiretinal proliferation in lamellar macular holes and full-thickness macular holes: clinical and surgical findings.

    Science.gov (United States)

    Lai, Tso-Ting; Chen, San-Ni; Yang, Chung-May

    2016-04-01

    To report the clinical findings and surgical outcomes of lamellar macular holes (LMH) with or without lamellar hole-associated epiretinal proliferation (LHEP), and those of full-thickness macular holes (FTMH) presenting with LHEP. From 2009 to 2013, consecutive cases of surgically treated LMH, and all FTMH cases with LHEP were reviewed, given a follow-up time over 1 year. In the LMH group (43 cases), those with LHEP (19 cases) had significantly thinner bases and larger openings than those without (24 cases). The rate of disrupted IS/OS line was higher in the LHEP subgroup preoperatively (68.4 % vs 37.5 %), but similar between subgroups postoperatively (36.8 % and 33.3 %). The preoperative and postoperative visual acuity showed no significant difference between two subgroups. In the FTMH group (13 cases), the average hole size was 219.2 ± 92.1 μm. Permanent or transient spontaneous hole closure was noted in 69.2 % of cases. An intact IS-OS line was found in only 23 % of cases at the final follow-up. In the LMH group, LHEP was associated with a more severe defect but didn't affect surgical outcomes. In the FTMH group, spontaneous hole closure was frequently noted. Despite small holes, disruption of IS-OS line was common after hole closure.

  6. Congenital malformations of the external and middle ear: high-resolution CT findings of surgical import

    International Nuclear Information System (INIS)

    Swartz, J.D.; Faerber, E.N.

    1985-01-01

    The external auditory canal, middle ear, and bulk of the ossicular chain develop from the first branchial groove, first and second branchial arches, and first pharyngeal pouch. Embryologic development of these structures is complex and only rarely are two anomalies identical. This study includes 11 cases of unilateral external auditory canal atresia and two cases of bilateral atresia. Eight cases (four bilateral) of isolated congenital ossicular anomalies are also included. Emphasis is placed on findings of surgical import. All patients were studied with computed tomography only, because it was believed that the bony and soft-tissue detail achieved is superior to that with conventional multidirectional tomography

  7. A new surgical method for penile girth enhancement

    OpenAIRE

    Li, Xiaoge; Tao, Ling; Cao, Chuan; Shi, Haishan; Li, Le; Chen, Liang; Li, Shirong

    2015-01-01

    Objective: We developed a new surgical model of penile girth enhancement in dog, with minimal damage, fewer complications, and high success rate, to enable the experimental investigation of penile implants. Methods: We obtained materials for penile girth enhancement by processing the pericardium and blood vessel wall collected from pigs. Incisions were made at the penile bulb for the implantation of the materials, and facilitate observation and data collection, based on the anatomical feature...

  8. A new surgical method for penile girth enhancement.

    Science.gov (United States)

    Li, Xiaoge; Tao, Ling; Cao, Chuan; Shi, Haishan; Li, Le; Chen, Liang; Li, Shirong

    2015-01-01

    We developed a new surgical model of penile girth enhancement in dog, with minimal damage, fewer complications, and high success rate, to enable the experimental investigation of penile implants. We obtained materials for penile girth enhancement by processing the pericardium and blood vessel wall collected from pigs. Incisions were made at the penile bulb for the implantation of the materials, and facilitate observation and data collection, based on the anatomical features of dog's penis. We measured the girth of the flaccid penis before and after the operation, and erectile function at 1-month postoperation. In addition to evaluation of recovery from the incision and local pathological changes, ultrasonic examination was performed to monitor the long-term changes associated with implantation. The mean girth of the flaccid penis significantly increased from 7.37±0.40 cm before the operation, to 8.70±0.56 cm postoperation. Dogs resumed normal mating at 1 month after the operation, without any significant change in the mating time. Ultrasonic examination clearly illustrated the implants, and helped in the measurement of the distance between the materials and the baculum. Chinese Rural dog is a promising animal model for penile girth enhancement surgery. The findings demonstrated that surgical implantation into penile bulb was associated with less damage, faster postoperative recovery, and higher success. For the first time, ultrasonic examination provided objective data on the surgical outcomes of penile girth enhancement.

  9. Measuring the surgical 'learning curve': methods, variables and competency.

    Science.gov (United States)

    Khan, Nuzhath; Abboudi, Hamid; Khan, Mohammed Shamim; Dasgupta, Prokar; Ahmed, Kamran

    2014-03-01

    To describe how learning curves are measured and what procedural variables are used to establish a 'learning curve' (LC). To assess whether LCs are a valuable measure of competency. A review of the surgical literature pertaining to LCs was conducted using the Medline and OVID databases. Variables should be fully defined and when possible, patient-specific variables should be used. Trainee's prior experience and level of supervision should be quantified; the case mix and complexity should ideally be constant. Logistic regression may be used to control for confounding variables. Ideally, a learning plateau should reach a predefined/expert-derived competency level, which should be fully defined. When the group splitting method is used, smaller cohorts should be used in order to narrow the range of the LC. Simulation technology and competence-based objective assessments may be used in training and assessment in LC studies. Measuring the surgical LC has potential benefits for patient safety and surgical education. However, standardisation in the methods and variables used to measure LCs is required. Confounding variables, such as participant's prior experience, case mix, difficulty of procedures and level of supervision, should be controlled. Competency and expert performance should be fully defined. © 2013 The Authors. BJU International © 2013 BJU International.

  10. [Choice of the method of surgical treatment of chronic pancreatitis].

    Science.gov (United States)

    Vorobeĭ, A V; Shuleĭko, A Ch; Orlovskiĭ, Iu N; Vizhinis, Iu I; Butra, Iu V; Lagodich, N A

    2014-01-01

    An analysis of surgical treatment of 187 patients with chronic pancreatitis was made during 3-year period in the department of surgery clinic of Byelorussian Medical Academy of Post-Graduate Education. Drainage operations were performed on 28 patients, resection-drainage operations were carried out on 130 patients and resection operations had 19 patients. The laser beam technologies were successfully applied during operations on the pancreas in 43 patients. Postoperative complications (14.8%) were analyzed and structured. Methods of corrections and ways of prophylaxis of complication development were provided. On the basis of the complication analysis and new conception concerning peripheral pancreatic hypertension the authors offered the rational approaches to choice of operations on the pancreas in case of chronic pancreatitis. The authors developed the classification of pancreatoductolitiasis, pancreatic hypertension and a new strategy of surgical management of chronic pancreatitis.

  11. Septic osteitis of the distal phalanx: findings and surgical treatment in 18 cases

    International Nuclear Information System (INIS)

    Cauvin, E.R.J.; Munroe, G.A.

    1998-01-01

    Eighteen cases of septic osteitis of the distal phalanx were diagnosed clinically and confirmed at surgery over a 6 year period (1990-1996). Focal bone lysis was the most common radiographic finding. Sequestra were identified in 4 horses, one of which was associated with a fractured plantar process. All the horses were treated surgically with open debridement. The septic process recurred in 4 horses: one was subjected to euthanasia due to navicular bursa infection, secondary to a pathological fracture, the other 3 horses responded to further debridement. A pathological fracture occurred in another horse. All the survivors were not lame 3 months post operatively, although complete healing took 1-12 months. Long term follow up was available in 14 cases. One was retired, all the other horses were back in work at a similar level of performance. This series indicates that surgical treatment of septic pedal osteitis carries a fair to good prognosis despite a high rate of post operative complications and convalescence period of up to 12 months

  12. Comparison of impact of four surgical methods on surgical outcomes in endoscopic dacryocystorhinostomy.

    Science.gov (United States)

    Roh, Hyun Cheol; Baek, Sehyun; Lee, Hwa; Chang, Minwook

    2016-06-01

    To evaluate differences in the surgical outcomes of endoscopic dacryocystorhinostomy (DCR) according to four different surgical methods. This retrospective study included 222 patients who underwent endoscopic DCR from 2011 to 2013. All patients were assigned to one of four groups according to instruments for incision of nasal mucosa and the formation of mucosal flap: group 1, a sickle knife with mucosal flap; group 2, a sickle knife without mucosal flap; group 3, electrocautery with mucosal flap; and group 4, electrocautery without mucosal flap. The follow up period was at least 6 months. There were 33 eyes in group 1, 44 eyes in group 2, 49 eyes in group 3, and 97 eyes in group 4. There were no significant differences in success rate between groups (P = 0.878). Wound healing time was significantly different between groups (P knife may be more helpful and effective for shortening wound healing time rather than making mucosal flaps in endoscopic DCR. Copyright © 2016 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  13. The Business Engineering Surgical Technologies (BEST) teaching method: incubating talents for surgical innovation.

    Science.gov (United States)

    de Ruijter, V; Halvax, P; Dallemagne, B; Swanström, L; Marescaux, J; Perretta, S

    2015-01-01

    Technological innovation in surgical science and healthcare is vital and calls for close collaboration between engineering and surgery. To meet this objective, BEST was designed as a free sustainable innovative teaching method for young professionals, combining surgery, engineering, and business in a multidisciplinary, high-quality, low-cost, and learning-by-doing philosophy. This paper reviews the initial outcomes of the program and discusses lessons learned and future directions of this innovative educational method. BEST educational method is delivered in two parts: the first component consisting of live streaming or pre-recorded online lectures, with an interdisciplinary profile focused on surgery, engineering, and business. The second component is an annual 5-day on-site course, organized at IRCAD-IHU, France. The program includes workshops in engineering, entrepreneurship team projects, and in-depth hands-on experience in laparoscopy, robotic surgery, interventional radiology, and flexible endoscopy with special emphasis on the interdisciplinary aspect of the training. A panel of surgeons, engineers, well-established entrepreneurs, and scientists assessed the team projects for potential patent application. From November 2011 till September 2013, 803 individual and institutional users from 79 different countries attended the online course. In total, 134 young professionals from 32 different countries applied to the onsite course. Sixty participants were selected each year for the onsite course. In addition, five participants were selected for a web-based team. Thirteen provisional patents were filed for the most promising projects. BEST proved to be a global talent incubator connecting students to high-quality education despite institutional and economical boundaries. Viable and innovative ideas arose from this revolutionary approach which is likely to spin-off significant technology transfer and lead the way for future interdisciplinary hybrid surgical

  14. Prospective analysis of skin findings in surgical critically Ill patients intensive care unit

    Directory of Open Access Journals (Sweden)

    Suzan Demir Pektas

    2017-01-01

    Full Text Available Background: Intensive Care Units (ICUs are places where critically ill patients are managed. Aim: We aimed to investigate skin disorders that developed in critically ill surgical patients during their stay in the ICU. Methods: The prevalence of dermatological disorders and factors affecting their clinical features was prospectively analyzed in surgical ICU patients. We recorded age, sex, type of ICU, comorbidities, skin disorders, time to consultation, duration of ICU stay, and mortality rate. Results: Our study included 605 patients (mean age of 60.1 ± 20.2 years; 56.4% males. Seventy-three (12.1% patients were consulted with the Dermatology Department, among which 28.8% had infectious dermatological lesions, 26% dermatoses, and 45.2% drug reactions. The most common infectious dermatological disorder was wound infection (55.6%, the most common drug reaction was maculopapular drug eruption (75.8%, and the most common dermatosis was frictional blisters (47.4%. Multiple comorbidities, hypertension, diabetes mellitus, coronary artery disease, Parkinson disease, and stroke increased dermatological disorders (P < 0.05. The consulted patients had a median ICU stay of 7 days (range 2–53 days; consultation was significantly more common when it exceeded 10 days (74% vs. 26%, P < 0.05. The consulted patients died more commonly (P < 0.05. Infectious dermatological disorders and dermatoses were more common in patients older and younger than 50 years, respectively (P < 0.05. Dermatoses were more common among women (P < 0.05. The median time to consultation was 6 (2–30 days; it was longest for dermatological infections and shortest for dermatoses (P < 0.05. Infectious dermatological disorders were significantly more common among the deceased patients (P < 0.05. Conclusion: Multiple factors including multiple comorbidities, duration of ICU stay, time to consultation, and mortality increase dermatological disorders among surgical ICU patients.

  15. Is Video-Based Education an Effective Method in Surgical Education? A Systematic Review.

    Science.gov (United States)

    Ahmet, Akgul; Gamze, Kus; Rustem, Mustafaoglu; Sezen, Karaborklu Argut

    2018-02-12

    Visual signs draw more attention during the learning process. Video is one of the most effective tool including a lot of visual cues. This systematic review set out to explore the influence of video in surgical education. We reviewed the current evidence for the video-based surgical education methods, discuss the advantages and disadvantages on the teaching of technical and nontechnical surgical skills. This systematic review was conducted according to the guidelines defined in the preferred reporting items for systematic reviews and meta-analyses statement. The electronic databases: the Cochrane Library, Medline (PubMED), and ProQuest were searched from their inception to the 30 January 2016. The Medical Subject Headings (MeSH) terms and keywords used were "video," "education," and "surgery." We analyzed all full-texts, randomised and nonrandomised clinical trials and observational studies including video-based education methods about any surgery. "Education" means a medical resident's or student's training and teaching process; not patients' education. We did not impose restrictions about language or publication date. A total of nine articles which met inclusion criteria were included. These trials enrolled 507 participants and the total number of participants per trial ranged from 10 to 172. Nearly all of the studies reviewed report significant knowledge gain from video-based education techniques. The findings of this systematic review provide fair to good quality studies to demonstrate significant gains in knowledge compared with traditional teaching. Additional video to simulator exercise or 3D animations has beneficial effects on training time, learning duration, acquisition of surgical skills, and trainee's satisfaction. Video-based education has potential for use in surgical education as trainees face significant barriers in their practice. This method is effective according to the recent literature. Video should be used in addition to standard techniques

  16. Surgical evaluation of magnetic resonance imaging findings in piriformis muscle syndrome

    International Nuclear Information System (INIS)

    Pecina, Hrvoje Ivan; Boric, Igor; Smoljanovic, Tomislav; Pecina, Marko; Duvancic, Davor

    2008-01-01

    The objective of this study was to evaluate the accuracy of magnetic resonance imaging (MRI) in the diagnosis of the piriformis muscle syndrome (PMS). In ten patients, seven female and three male, with a long history of clinical symptoms of the PMS, an MRI was performed as the last preoperative diagnostic tool. All patients were imaged using 2T MR system (Elscint, Haifa, Israel). Axial and coronal spin-echo, fast spin-echo (FSE), and fat-suppressed FSE-weighted images were made through the pelvic region with 3-mm section thickness and a 0.5-mm gap to show the whole piriformis muscle and the course of sciatic nerve on its way out of the pelvis. A routine examination also included axial fast spin-echo T2, three-dimensional gradient echo. In seven cases, an MRI abnormality for the PMS was found. In two women, the MRI demonstrated a bigastric appearance of the piriformis muscle with a tendinous portion between the muscle heads and the course of the common peroneal nerve through the muscle between the tendinous portions of the muscle. In one female patient, the common peroneal nerve passed through the hypertrophied piriformis muscle. In four patients, the MRI showed a hypertrophied aspect of the piriformis muscle and an anteriorly displaced sciatic nerve. All MRI findings were confirmed surgically. In three patients, no apparent abnormalities could be observed, but after a surgical treatment, i.e., a tenotomy of the piriformis muscle and neurolysis of the sciatic nerve, all symptoms disappeared. In piriformis muscle syndrome, MRI may demonstrate signal abnormalities of the sciatic nerve as well as its relationship with the normal and abnormal piriformis muscle. (orig.)

  17. Surgical insertion of transmitters and telemetry methods in fisheries research

    DEFF Research Database (Denmark)

    Rub, A. Michelle Wargo; Jepsen, Niels; Liedtke, Theresa L.

    2014-01-01

    ) will be described. Effects of surgical insertion of transmitters (ie, tagging) and aspects of the surgical implantation process where collaboration and professional exchanges among nonveterinarian researchers and veterinarians may be most fruitful will be discussed. Although this report focuses on surgical...

  18. Surgical Assisting

    Science.gov (United States)

    ... instruction, including: Microbiology Pathophysiology Pharmacology Anatomy and physiology Medical terminology Curriculum . Course content includes: Advanced surgical anatomy Surgical microbiology Surgical pharmacology Anesthesia methods and agents Bioscience Ethical ...

  19. Methods and findings of the SNR study

    International Nuclear Information System (INIS)

    Koeberlein, K.; Schaefer, H.; Spindler, H.

    1983-01-01

    A featfinding committee of the German Federal Parliament in July 1980 recommended to perform a ''risk-oriented study'' of the SNR-300, the German 300 MW fast breeder prototype reactor being under construction in Kalkar. The main aim of this study was to allow a comparative safety evaluation between the SNR-300 and a modern PWR, thus to prepare a basis for a political decision on the SNR-300. Methods and main results of the study are presented in this paper. In the first step of the risk analysis six groups of accidents have been identified which may initiate core destruction. These groups comprise all conceivable courses, potentially leading to core destruction. By reliability analyses, expected frequency of each group has been calculated. In the accident analysis potential failure modes of the reactor tank have been investigated. Core destruction may be accompanied by the release of significant amounts of mechanical energy. The primary coolant system of SNR-300 is designed to withstand mechanical energy releases up to 370 MJ. Design features make it possible to cool the molten core inside the reactor tank. (orig./RW) [de

  20. A method of pre-surgical oral orthopaedics.

    Science.gov (United States)

    DiBiase, D D; Hunter, S B

    1983-01-01

    A preliminary report of a technique of pre-surgical treatment in cleft lip and palate patients is outlined utilizing an adjustable intra-oral appliance with extra-oral strapping. The appliance is constructed with an adjustable spring for expansion and two shelves overlapping in the midline to allow palatal continuity during treatment. Frequently, only one appliance for each patient is required. The techniques of appliance construction, pre-surgical management and surgical repair of the lip are outlined.

  1. Relationship between brain’s CT scan findings and consciousness level, surgical findings and outcome of the patients with traumatic intracranial hemorrhage

    Directory of Open Access Journals (Sweden)

    Elham Shobeiri

    2014-06-01

    Full Text Available Background: Traumatic brain injury is one of the most common causes of death among 1-45 year-old people. The aim of this study was to determine the relationship between CT scan findings of brain and consciousness level, surgical findings and outcome of the patients with traumatic intracranial hemorrhage. Method: This study was a descriptive-analytical study which was conducted on 41 patients with visible and measurable traumatic intracranial hematoma detected by CT scan who referred to Taleghani hospital in Kermanshah. The patients’ consciousness level was measured and recorded by GCS (Glasco Coma Score on admission and in intervals of 6 and 24 hours after operation. Data were analyzed by statistical tests run bySPSS software (version 20. Results: Based on the CT scan findings, the hematoma location in 18 patients (43.9% was epidural, in 11 (26.8% patients was subdural and in 12 (29.3 % patients was intraparenchymal. Loss of consciousness on admission in 48.4% of patients was mild in degree, in 29% of patients was moderate and in 22.6% of patients was severe. In the operated patients, there was a significant correlation between the patients’ outcome and consciousness level on admission, before surgery, 24 hours after surgery and on discharge time. Also, there was a significant correlation between the outcome of non-operated patients and consciousness level on discharge. Conclusion: The results of this study indicate that the outcome of the patients with brain injury was dependent on the consciousness level and there was a reverse correlation between hematoma volume and amount of midline shift in CT scan.

  2. High-resolution computed tomography findings of early mucinous adenocarcinomas and their pathologic characteristics in 22 surgically resected cases

    Energy Technology Data Exchange (ETDEWEB)

    Miyata, Naoko, E-mail: n.miyata@scchr.jp [Division of Thoracic Surgery, Shizuoka Cancer Center Hospital, 1007 Shimonagakubo, Nagaizumi, Sunto-gun, Shizuoka 411-8777 (Japan); Endo, Masahiro [Division of Diagnostic Radiology, Shizuoka Cancer Center Hospital (Japan); Nakajima, Takashi [Division of Pathology, Shizuoka Cancer Center Hospital (Japan); Kojima, Hideaki; Maniwa, Tomohiro; Takahashi, Shoji; Isaka, Mitsuhiro [Division of Thoracic Surgery, Shizuoka Cancer Center Hospital, 1007 Shimonagakubo, Nagaizumi, Sunto-gun, Shizuoka 411-8777 (Japan); Kameya, Toru [Division of Pathology, Shizuoka Cancer Center Hospital (Japan); Ohde, Yasuhisa [Division of Thoracic Surgery, Shizuoka Cancer Center Hospital, 1007 Shimonagakubo, Nagaizumi, Sunto-gun, Shizuoka 411-8777 (Japan)

    2015-05-15

    Highlights: • We clinicopathologically reviewed 22 cases of early mucinous adenocarcinoma. • Radiologically, all cases showed solid or part-solid nodules. • Lobular-bounded margins were observed in 7 cases. • The radiological features could be histologically attributed to mucin production. • One-third of the cases were preoperatively misdiagnosed as inflammatory nodules. - Abstract: Background: The pathological criteria of early-stage mucinous adenocarcinoma of the lung have recently been defined; however, its characteristic radiologic imaging findings are still poorly understood. Thus, this study aimed to clarify the radiologic and pathological findings of early-stage mucinous adenocarcinoma. Materials and methods: In this study, we clinicopathologically reviewed 22 cases of surgically resected mucinous adenocarcinoma in situ (AIS) and minimal invasive adenocarcinoma (MIA), and attempted to elucidate the characteristic radiologic features of early mucinous adenocarcinomas using high-resolution computed tomography (HRCT). Results: Radiologically, the mean value of the maximum diameter of 22 tumours was 2.1 cm (range, 1.0–2.9 cm). Based on the HRCT findings, the tumours were divided into part-solid ground glass nodules (n = 11) and solid nodules (n = 11). The mean CT attenuation value was 25.7 HU (range, 17–35 HU). All tumours, except 3 tumours pathologically diagnosed as AIS, showed air-containing features. According to the preoperative CT findings, 7 (35%) cases were diagnosed as inflammatory nodules. Of these, 4 cases had lobular-bounded margins, and 3 showed vaguely outlined ground glass shadows. Conclusion: The characteristic HRCT findings of mucinous AIS and MIA were solid or part-solid nodules with air-containing spaces. However, some AIS and MIA nodules showed lobular-bounded margins or marginally vaguely outlined ground glass shadows, and were difficult to differentiate from inflammatory nodules.

  3. High-resolution computed tomography findings of early mucinous adenocarcinomas and their pathologic characteristics in 22 surgically resected cases

    International Nuclear Information System (INIS)

    Miyata, Naoko; Endo, Masahiro; Nakajima, Takashi; Kojima, Hideaki; Maniwa, Tomohiro; Takahashi, Shoji; Isaka, Mitsuhiro; Kameya, Toru; Ohde, Yasuhisa

    2015-01-01

    Highlights: • We clinicopathologically reviewed 22 cases of early mucinous adenocarcinoma. • Radiologically, all cases showed solid or part-solid nodules. • Lobular-bounded margins were observed in 7 cases. • The radiological features could be histologically attributed to mucin production. • One-third of the cases were preoperatively misdiagnosed as inflammatory nodules. - Abstract: Background: The pathological criteria of early-stage mucinous adenocarcinoma of the lung have recently been defined; however, its characteristic radiologic imaging findings are still poorly understood. Thus, this study aimed to clarify the radiologic and pathological findings of early-stage mucinous adenocarcinoma. Materials and methods: In this study, we clinicopathologically reviewed 22 cases of surgically resected mucinous adenocarcinoma in situ (AIS) and minimal invasive adenocarcinoma (MIA), and attempted to elucidate the characteristic radiologic features of early mucinous adenocarcinomas using high-resolution computed tomography (HRCT). Results: Radiologically, the mean value of the maximum diameter of 22 tumours was 2.1 cm (range, 1.0–2.9 cm). Based on the HRCT findings, the tumours were divided into part-solid ground glass nodules (n = 11) and solid nodules (n = 11). The mean CT attenuation value was 25.7 HU (range, 17–35 HU). All tumours, except 3 tumours pathologically diagnosed as AIS, showed air-containing features. According to the preoperative CT findings, 7 (35%) cases were diagnosed as inflammatory nodules. Of these, 4 cases had lobular-bounded margins, and 3 showed vaguely outlined ground glass shadows. Conclusion: The characteristic HRCT findings of mucinous AIS and MIA were solid or part-solid nodules with air-containing spaces. However, some AIS and MIA nodules showed lobular-bounded margins or marginally vaguely outlined ground glass shadows, and were difficult to differentiate from inflammatory nodules

  4. Current Status of Surgical Planning for Orthognathic Surgery: Traditional Methods versus 3D Surgical Planning

    Directory of Open Access Journals (Sweden)

    Jeffrey A. Hammoudeh, MD, DDS

    2015-02-01

    Conclusions: It is our opinion that virtual model surgery will displace and replace traditional model surgery as it will become cost and time effective in both the private and academic setting for practitioners providing orthognathic surgical care in cleft and noncleft patients.

  5. Imaging in chronic achilles tendinopathy: a comparison of ultrasonography, magnetic resonance imaging and surgical findings in 27 histologically verified cases

    International Nuclear Information System (INIS)

    Aastroem, M.; Gentz, C.F.; Nilsson, P.; Rausing, A.; Sjoeberg, S.; Westlin, N.

    1996-01-01

    Objective. To compare information gained by ultrasonography and magnetic resonance imaging (MRI) in chronic achilles tendinopathy with regard to the nature and severity of the lesion. Design. Imaging of both achilles tendons with ultrasonography and MRI was performed prior to unilateral surgery. Operative findings and histological biopsies together served as a reference. Patients. Twenty-seven patients (22 men, 5 women; mean age 44 years; 21 athletes) suffering from chronic achilles tendinopathy participated in the study. Eighteen patients had unilateral and 9 had bilateral symptoms. Results and conclusions. Surgical findings included 4 partial ruptures, 21 degenerative lesions and 2 macroscopically normal cases. Microscopy revealed tendinosis (degeneration) in all tendon biopsies, including cases with a partial rupture, but only slight changes in the paratendinous tissues (paratenon). Ultrasonography was positive in 21 of 26 and MRI in 26 of 27 cases. Severe intratendinous abnormalities and a sagittal tendon diameter >10 mm suggested a partial rupture. In tendons with a false negative result histopathological changes were mild and a tendency towards a better clinical outcome was noted in the sonographic cases. Assessment of the paratenon was unreliable with both methods. Ultrasonography and MRI give similar information and may have their greatest potential as prognostic instruments. (orig.). With 2 figs., 1 tab

  6. Importance of Clinical and Laboratory Findings in the Diagnosis and Surgical Prognosis of Patients with Constrictive Pericarditis

    Directory of Open Access Journals (Sweden)

    Fábio Fernandes

    2017-10-01

    Full Text Available Abstract Background: International studies have reported the value of the clinical profile and laboratory findings in the diagnosis of constrictive pericarditis. However, Brazilian population data are scarce. Objective: To assess the clinical characteristics, sensitivity of imaging tests and factors related to the death of patients with constrictive pericarditis undergoing pericardiectomy. Methods: Patients with constrictive pericarditis surgically confirmed were retrospectively assessed regarding their clinical and laboratory variables. Two methods were used: transthoracic echocardiography and cardiac magnetic resonance imaging. Mortality predictors were determined by use of univariate analysis with Cox proportional hazards model and hazard ratio. All tests were two-tailed, and an alpha error ≤ 5% was considered statically significant. Results: We studied 84 patients (mean age, 44 ± 17.9 years; 67% male. Signs and symptoms of predominantly right heart failure were present with jugular venous distention, edema and ascites in 89%, 89% and 62% of the cases, respectively. Idiopathic etiology was present in 69.1%, followed by tuberculosis (21%. Despite the advanced heart failure degree, low BNP levels (median, 157 pg/mL were found. The diagnostic sensitivities for constriction of echocardiography and magnetic resonance imaging were 53.6% and 95.9%, respectively. There were 9 deaths (10.7%, and the risk factors were: anemia, BNP and C reactive protein levels, pulmonary hypertension >55 mm Hg, and atrial fibrillation. Conclusions: Magnetic resonance imaging had better diagnostic sensitivity. Clinical, laboratory and imaging markers were associated with death.

  7. Real-time three-dimensional transesophageal echocardiography in valve disease: comparison with surgical findings and evaluation of prosthetic valves.

    Science.gov (United States)

    Sugeng, Lissa; Shernan, Stanton K; Weinert, Lynn; Shook, Doug; Raman, Jai; Jeevanandam, Valluvan; DuPont, Frank; Fox, John; Mor-Avi, Victor; Lang, Roberto M

    2008-12-01

    Recently, a novel real-time 3-dimensional (3D) matrix-array transesophageal echocardiographic (3D-MTEE) probe was found to be highly effective in the evaluation of native mitral valves (MVs) and other intracardiac structures, including the interatrial septum and left atrial appendage. However, the ability to visualize prosthetic valves using this transducer has not been evaluated. Moreover, the diagnostic accuracy of this new technology has never been validated against surgical findings. This study was designed to (1) assess the quality of 3D-MTEE images of prosthetic valves and (2) determine the potential value of 3D-MTEE imaging in the preoperative assessment of valvular pathology by comparing images with surgical findings. Eighty-seven patients undergoing clinically indicated transesophageal echocardiography were studied. In 40 patients, 3D-MTEE images of prosthetic MVs, aortic valves (AVs), and tricuspid valves (TVs) were scored for the quality of visualization. For both MVs and AVs, mechanical and bioprosthetic valves, the rings and leaflets were scored individually. In 47 additional patients, intraoperative 3D-MTEE diagnoses of MV pathology obtained before initiating cardiopulmonary bypass were compared with surgical findings. For the visualization of prosthetic MVs and annuloplasty rings, quality was superior compared with AV and TV prostheses. In addition, 3D-MTEE imaging had 96% agreement with surgical findings. Three-dimensional matrix-array transesophageal echocardiographic imaging provides superb imaging and accurate presurgical evaluation of native MV pathology and prostheses. However, the current technology is less accurate for the clinical assessment of AVs and TVs. Fast acquisition and immediate online display will make this the modality of choice for MV surgical planning and postsurgical follow-up.

  8. Surgical outcome prediction in patients with advanced ovarian cancer using computed tomography scans and intraoperative findings

    Directory of Open Access Journals (Sweden)

    Ha-Jeong Kim

    2014-09-01

    Conclusion: The combination of omental extension to the stomach or spleen and involvement of inguinal or pelvic lymph nodes in preoperative CT scans is considered predictive of suboptimal cytoreduction. These patients may be more appropriately treated with neoadjuvant chemotherapy followed by surgical cytoreduction.

  9. Retained Intra-Abdominal Surgical Clamp Complicating Emergency Laparotomy: Incidental Finding on Hysterosalpingogram for Evaluation of Tubal Infertility

    Directory of Open Access Journals (Sweden)

    Adebiyi Gbadebo Adesiyun

    2014-01-01

    Full Text Available The finding of intraperitoneal foreign body complicating surgical intervention broadly remains as an issue of safety in the operative room, a source of emotive concern for the patient, and an upsetting but equally embarrassing situation to the surgeon and the team. However, in the media world, it is a source of sumptuous and captivating headline on the newspaper and to the legal profession, an attractive case to prosecute. A middle age teacher presented with secondary infertility. She had emergency laparotomy fifteen years ago for ruptured tubal ectopic pregnancy in a private hospital and postoperative period was uneventful. Amongst other investigations to find out the cause of infertility, she had hysterosalpingography and a radio-opaque clamp was visualized on the films. She was counselled and had laparotomy. A pair of surgical Kocher clamps was retrieved buried in the mesentery.

  10. Assessment of MRI issues at 3-Tesla for metallic surgical implants: findings applied to 61 additional skin closure staples and vessel ligation clips

    Directory of Open Access Journals (Sweden)

    Gill Amreeta

    2012-01-01

    Full Text Available Abstract Purpose Metallic skin closure staples and vessel ligation clips should be tested at 3-Tesla to characterize MRI issues in order to ensure patient safety. Therefore, metallic surgical implants were assessed at 3-Tesla for magnetic field interactions, MRI-related heating, and artifacts. Methods A skin closure staple (Visistat Skin Stapler, staple, Polytetrafluoroethylene, PTFE, coated 316L/316LVM stainless steel; Teleflex Medical, Durham, NC and a vessel ligation clip (Hemoclip Traditional, stainless steel; Teleflex Medical, Durham, NC that represented the largest metallic sizes made from materials with the highest magnetic susceptibilities (i.e., based on material information among 61 other surgical implants (52 metallic implants, 9 nonmetallic implants underwent evaluation for magnetic field interactions, MRI-related heating, and artifacts using standardized techniques. MRI-related heating was assessed by placing each implant in a gelled-saline-filled phantom with MRI performed using a transmit/receive RF body coil at an MR system reported, whole body averaged SAR of 2.9-W/kg for 15-min. Artifacts were characterized using T1-weighted, SE and GRE pulse sequences. Results Each surgical implant showed minor magnetic field interactions (20- and 27-degrees, which is acceptable from a safety consideration. Heating was not substantial (highest temperature change, ≤ 1.6°C. Artifacts may create issues if the area of interest is in the same area or close to the respective surgical implant. Conclusions The results demonstrated that it would be acceptable for patients with these metallic surgical implants to undergo MRI at 3-Tesla or less. Because of the materials and dimensions of the surgical implants that underwent testing, these findings pertain to 61 additional similar implants.

  11. Assessment of MRI issues at 3-Tesla for metallic surgical implants: findings applied to 61 additional skin closure staples and vessel ligation clips

    Science.gov (United States)

    2012-01-01

    Purpose Metallic skin closure staples and vessel ligation clips should be tested at 3-Tesla to characterize MRI issues in order to ensure patient safety. Therefore, metallic surgical implants were assessed at 3-Tesla for magnetic field interactions, MRI-related heating, and artifacts. Methods A skin closure staple (Visistat Skin Stapler, staple, Polytetrafluoroethylene, PTFE, coated 316L/316LVM stainless steel; Teleflex Medical, Durham, NC) and a vessel ligation clip (Hemoclip Traditional, stainless steel; Teleflex Medical, Durham, NC) that represented the largest metallic sizes made from materials with the highest magnetic susceptibilities (i.e., based on material information) among 61 other surgical implants (52 metallic implants, 9 nonmetallic implants) underwent evaluation for magnetic field interactions, MRI-related heating, and artifacts using standardized techniques. MRI-related heating was assessed by placing each implant in a gelled-saline-filled phantom with MRI performed using a transmit/receive RF body coil at an MR system reported, whole body averaged SAR of 2.9-W/kg for 15-min. Artifacts were characterized using T1-weighted, SE and GRE pulse sequences. Results Each surgical implant showed minor magnetic field interactions (20- and 27-degrees, which is acceptable from a safety consideration). Heating was not substantial (highest temperature change, ≤ 1.6°C). Artifacts may create issues if the area of interest is in the same area or close to the respective surgical implant. Conclusions The results demonstrated that it would be acceptable for patients with these metallic surgical implants to undergo MRI at 3-Tesla or less. Because of the materials and dimensions of the surgical implants that underwent testing, these findings pertain to 61 additional similar implants. PMID:22230200

  12. Computer-Based Training Methods for Surgical Training

    Science.gov (United States)

    2009-10-07

    said surgical procedure. 32. The rm:thod of daim 30. whcn.:in st~id linul dm ;~.:­ dimcnsional model is used to evaluate pcrKwmancc charac...of Environmental Aging Upon the Load Bearing Properties and Polyurethane Foams. Noble PC; Goode B; Krouskop TA; and Crisp B. Journal Rehab. Res. and...Surgery 77A: 513-523, 1995. 32. Partial Tears of the Anterior Cruciate Ligament. Are They Clinically Detectable? Lintner DM , Kamaric E, Moseley JB

  13. Clinical and Surgical Findings and Outcome Following Rumenotomy in Adult Dairy Cattle Affected with Recurrent Rumen Tympany Associated with Non-Metallic Foreign Bodies

    OpenAIRE

    Z. Bani Ismail; A. Al-Majali; K. Al-Qudah

    2007-01-01

    Medical records of 31 adult dairy cows suffering from recurrent rumen tympany for at least 1 month duration that underwent exploratory laparotomy and rumenotomy were reviewed and information was obtained on signalment, history, physical examination findings, laboratory findings and surgical findings. Cases were categorized according to surgical findings into 3 groups. Group 1 (n = 10) included cattle with reticuloruminal, metallic foreign bodies and perireticular adhesions/inflammation, group...

  14. Surgical Regenerative Treatments for Peri-Implantitis: Meta-analysis of Recent Findings in a Systematic Literature Review

    Directory of Open Access Journals (Sweden)

    Povilas Daugela

    2016-09-01

    Full Text Available Objectives: The purpose of the present study was to systematically review the literature on the surgical regenerative treatment of the peri-implantitis and to determine an effective therapeutic predictable option for their clinical management. Material and Methods: The study searched MEDLINE and EMBASE databases from 2006 to 2016. Clinical human studies that had reported changes in probing depth (PD and/or bleeding on probing (BOP and/or radiologic marginal bone level (RBL changes after peri-implantitis surgical treatment at 12-month follow-up or longer were included accordingly to PRISMA guidelines. Results: The initial search obtained 883 citations. After screening and determination of eligibility, 18 articles were included in the review. The meta-analysis of selected studies revealed that the weighted mean RBL fill was 1.97 mm (95% confidence interval [CI] = 1.58 to 2.35 mm, PD reduction was 2.78 mm (95% CI = 2.31 to 3.25 mm, and BOP reduced by 52.5% (95% CI = 41.6 to 63.1%. Defect fill in studies using and not using barrier membranes for graft coverage was 1.86 mm (95% CI = 1.36 to 2.36 mm and 2.12 mm (95% CI = 1.46 to 2.78 mm correspondingly. High heterogeneity among the studies regarding defects morphology, surgical protocols, and selection of biomaterials were found. Conclusions: All included studies underlined an improvement of clinical conditions after the surgical regenerative treatment of peri-implantitis, however, there is a lack of scientific evidence in the literature regarding the superiority of the regenerative versus non-regenerative surgical treatment. The presence of a barrier membrane or submergence in the regenerative procedure does not seem to be fundamental in order to obtain clinical success of the surgery.

  15. Weierstrass method for quaternionic polynomial root-finding

    Science.gov (United States)

    Falcão, M. Irene; Miranda, Fernando; Severino, Ricardo; Soares, M. Joana

    2018-01-01

    Quaternions, introduced by Hamilton in 1843 as a generalization of complex numbers, have found, in more recent years, a wealth of applications in a number of different areas which motivated the design of efficient methods for numerically approximating the zeros of quaternionic polynomials. In fact, one can find in the literature recent contributions to this subject based on the use of complex techniques, but numerical methods relying on quaternion arithmetic remain scarce. In this paper we propose a Weierstrass-like method for finding simultaneously {\\sl all} the zeros of unilateral quaternionic polynomials. The convergence analysis and several numerical examples illustrating the performance of the method are also presented.

  16. Clinical, magnetic resonance imaging, and histopathologic findings in 6 dogs with surgically resected extraparenchymal spinal cord hematomas.

    Science.gov (United States)

    Hague, D W; Joslyn, S; Bush, W W; Glass, E N; Durham, A C

    2015-01-01

    Extraparenchymal spinal cord hematoma has been described in veterinary medicine in association with neoplasia, intervertebral disk disease, and snake envenomation. There are rare reports of spontaneous extraparenchymal spinal cord hematoma formation with no known cause in human medicine. Multiple cases of spontaneous extraparenchymal spinal cord hematoma have not been described previously in veterinary medicine. To describe the signalment, clinical findings, magnetic resonance imaging (MRI) features, and surgical outcomes in histopathologically confirmed extraparenchymal spinal cord hematomas in dogs with no identified underlying etiology. Six dogs had MRI of the spinal cord, decompressive spinal surgery, and histopathologic confirmation of extraparenchymal spinal cord hematoma not associated with an underlying cause. Multi-institutional retrospective study. Six patients had spontaneous extraparenchymal spinal cord hematoma formation. MRI showed normal signal within the spinal cord parenchyma in all patients. All hematomas had T2-weighted hyperintensity and the majority (5/6) had no contrast enhancement. All dogs underwent surgical decompression and most patients (5/6) returned to normal or near normal neurologic function postoperatively. Follow-up of the patients (ranging between 921 and 1,446 days) showed no progression of neurologic clinical signs or any conditions associated with increased bleeding tendency. Before surgery and histopathology confirming extraparenchymal hematoma, the primary differential in most cases was neoplasia, based on the MRI findings. This retrospective study reminds clinicians of the importance of the combination of advanced imaging combined with histopathologic diagnosis. The prognosis for spontaneous spinal cord extraparenchymal hematoma with surgical decompression appears to be favorable in most cases. Copyright © 2015 by the American College of Veterinary Internal Medicine.

  17. A new method for finding vacua in string phenomenology

    Energy Technology Data Exchange (ETDEWEB)

    Gray, James [Institut d' Astrophysique de Paris and APC, Universite de Paris 7, 98 bis, Bd. Arago 75014, Paris (France); He, Yang-Hui [Rudolf Peierls Centre for Theoretical Physics, University of Oxford, 1 Keble Road, Oxford OX1 3NP (United Kingdom)]|[Merton College, Oxford, OX1 4JD and Mathematical Institute, Oxford University, Oxford (United Kingdom); Ilderton, Anton [School of Mathematics and Statistics, University of Plymouth, Drake Circus, Plymouth PL4 8AA (United Kingdom); Lukas, Andre [Rudolf Peierls Centre for Theoretical Physics, University of Oxford, 1 Keble Road, Oxford OX1 3NP (United Kingdom)

    2007-05-15

    One of the central problems of string-phenomenology is to find stable vacua in the four dimensional effective theories which result from compactification. We present an algorithmic method to find all of the vacua of any given string-phenomenological system in a huge class. In particular, this paper reviews and then extends hep-th/0606122 to include various nonperturbative effects. These include gaugino condensation and instantonic contributions to the superpotential. (authors)

  18. Centroid finding method for position-sensitive detectors

    International Nuclear Information System (INIS)

    Radeka, V.; Boie, R.A.

    1979-10-01

    A new centroid finding method for all detectors where the signal charge is collected or induced on strips of wires, or on subdivided resistive electrodes, is presented. The centroid of charge is determined by convolution of the sequentially switched outputs from these subdivisions or from the strips with a linear centroid finding filter. The position line width is inversely proportional to N/sup 3/2/, where N is the number of subdivisions

  19. Centroid finding method for position-sensitive detectors

    International Nuclear Information System (INIS)

    Radeka, V.; Boie, R.A.

    1980-01-01

    A new centroid finding method for all detectors where the signal charge is collected or induced on strips or wires, or on subdivided resistive electrodes, is presented. The centroid of charge is determined by convolution of the sequentially switched outputs from these subdivisions or from the strips with a linear centroid finding filter. The position line width is inversely proportional to N 3 sup(/) 2 , where N is the number of subdivisions. (orig.)

  20. THE METHOD OF SURGICAL TREATMENT OF HUMERAL EPICONDYLITIS

    Directory of Open Access Journals (Sweden)

    S. B. Korolev

    2011-01-01

    Full Text Available Method of treatment of epicondylitis of humeral bone is descripted. This metod is proposited to use if conservative therapy was not effective. Experience of use this method show excellent results.

  1. Complex radial folds versus subtle signs of intracapsular rupture of breast implants: MR findings with surgical correlation.

    Science.gov (United States)

    Soo, M S; Kornguth, P J; Walsh, R; Elenberger, C D; Georgiade, G S

    1996-06-01

    Detection of intracapsular rupture of silicone breast prostheses using MR imaging is often performed by identifying the "linguine sign" [1]. The linguine sign is easily differentiated from simple radial folds that are seen in intact implants. However, more subtle signs of intracapsular rupture, including undulating subcapsular lines and the "teardrop sign," are less often recognized [2-5] and may prove difficult for the less experienced radiologist to differentiate from complex radial folds of intact implants. In this essay, we illustrate the MR imaging findings of complex radial folds in intact implants and compare them with findings of incomplete shell collapse in ruptured implants in a surgically confirmed series of explanted silicone breast prostheses.

  2. Autopsy findings in surgical-radiotherapeutically treated bladder carcinoma - conclusions for optimization of radiotherapy

    International Nuclear Information System (INIS)

    Fueller, J.; Kob, D.; Fritzsche, V.

    1989-01-01

    Autopsy findings in patients with bladder carcinoma, treated by combined operation and radiotherapy, revealed tendencies of tumor spread as well as complications and late effects of radiotherapy. In 24.5% of the cases tumor tissue was found within the bladder and in 30.5% within the minor pelvis. Metastases were found in 24.1% in iliac lymph nodes, in 21.3% in abdominal lymph nodes. Liver, lungs, bones, and kidneys are main organs for hematological metastasizing. Little or undifferentiated carcinomas and squamous cell carcinomas showed a greater tendency to metastasize than highly and medium-differentiated ureteral carcinomas. The least radiotherapeutical complications and late effects were found in a fractionation with daily 1.5 Gy and a total dose of 60 Gy. (author)

  3. Surgical results and MRI findings of cervical myelopathy treated with anterior decompression and fusion

    International Nuclear Information System (INIS)

    Miyazato, Takenari; Teruya, Yoshimitsu; Kinjo, Yukio

    1995-01-01

    We reviewed 19 patients with cervical myelopathy treated with anterior decompression and fusion. Etiology of cervical myelopathy was cervical disc herniation (CDH) in 13 patients and cervical spondylosis (CSM) in 6. Clinical recovery rate (%) was calculated from preoperative cervical myelopathy score (JOA) and the score at follow-up. Correlation between the clinical recovery rate and MRI findings (area and flatness at the narrowest part of the spinal cord), age at surgery, duration of myelopathy and pre-operative clinical score were analyzed separately in the CDH and CSM groups. Clinical recovery rate averaged 69% in the CDH group and 75% in the CSM group. In the CDH group, average clinical recovery rate in patients younger than 60 years was 80 and in patients over 60 years was 60. There was a significant negative correlation between the clinical recovery rate and age at surgery (p<0.05). No significant correlation was found between the clinical recovery rate and other factors investigated. (author)

  4. MRI findings in patients with defecatory dysfunction after surgical correction of anorectal malformation

    International Nuclear Information System (INIS)

    Cui, Yong; Shao, Guang-rui; Wang, Ruo-yi; Zhang, Yuan; Zhang, Shu-hui

    2013-01-01

    Postoperative anorectal malformation patients frequently have defecatory dysfunction. MRI may be useful in the management of these patients. To analyze static and dynamic MRI findings in patients with defecatory dysfunction after correction of anorectal malformation (ARM), and compare differences between patients with constipation and fecal incontinence. Pelvic MRI studies of 20 constipated and 32 incontinent postoperative ARM patients were analyzed retrospectively to determine the location and morphology of the neorectum, presence of peritoneal fat herniation, presence of scarring, development of the striated muscle complex (SMC) and any other abnormalities. The two groups were then compared using χ 2 -test. Eighteen patients also underwent MRI defecography to evaluate pelvic floor function and abnormalities are reported. The children with incontinence were more likely to have abnormal location of the neorectum (P = 0.031), increased anorectal angle (ARA) (P = 0.031) and peritoneal fat herniation (P = 0.032), and less likely to have dilation of the neorectum (P = 0.027), than the children with constipation. There were no significant differences between the two groups in incidence of focal stenosis of the neorectum (P = 0.797), presence of extensive scarring (P = 0.591) and developmental agenesis of the SMC (P > 0.05). MRI defecography showed 6 anterior rectoceles, 6 cystoceles and 18 pelvic floor descents. MRI is a helpful imaging modality in postoperative ARM patients with defecatory dysfunction, and it shows distinct differences between the children with constipation and incontinence and provides individualized information to guide further treatment. (orig.)

  5. Histopathological findings in a surgically resected thalamic cavernous hemangioma 1 year after 40-Gy irradiation.

    Science.gov (United States)

    Nyáry, István; Major, Otto; Hanzély, Zoltán; Szeifert, György T

    2005-01-01

    Stereotactic radiosurgery is a controversial treatment modality in the management of cerebral cavernous hemangiomas (CHs), and results vary from center to center. Even the interpretation of treatment failure is controversial. It is suggested that the systematic pathological investigation of irradiated specimens could help to resolve the controversy. A hemorrhagic lesion in the posterior part of the thalamus had been diagnosed as a tumor and was treated with 40-Gy fractionated radiotherapy. One year after this treatment the case was reconsidered based on new imaging evidence, and the lesion was removed by conventional craniotomy. Histopathological examination revealed a CH with postirradiation changes. Compared with nonirradiated control CH tissue samples, there was endothelial cell destruction and marked fibrosis with scar tissue formation in the stroma of the treated lesion. The histopathological findings in this specimen were similar to those described in arteriovenous malformations after gamma knife surgery. The results of light microscopic investigations suggest that the ionizing effect of radiation energy evokes vascular and connective tissue stroma changes in CHs as well.

  6. MRI findings in patients with defecatory dysfunction after surgical correction of anorectal malformation

    Energy Technology Data Exchange (ETDEWEB)

    Cui, Yong; Shao, Guang-rui [Second Hospital of Shandong University, Department of Radiology, Jinan (China); Wang, Ruo-yi [Second Hospital of Shandong University, Department of Pediatric Surgery, Jinan (China); Zhang, Yuan [Second Hospital of Shandong University, Evidence-based Medical Center, Jinan (China); Zhang, Shu-hui [Second Hospital of Shandong University, Department of Laboratory, Jinan (China)

    2013-08-15

    Postoperative anorectal malformation patients frequently have defecatory dysfunction. MRI may be useful in the management of these patients. To analyze static and dynamic MRI findings in patients with defecatory dysfunction after correction of anorectal malformation (ARM), and compare differences between patients with constipation and fecal incontinence. Pelvic MRI studies of 20 constipated and 32 incontinent postoperative ARM patients were analyzed retrospectively to determine the location and morphology of the neorectum, presence of peritoneal fat herniation, presence of scarring, development of the striated muscle complex (SMC) and any other abnormalities. The two groups were then compared using {chi} {sup 2}-test. Eighteen patients also underwent MRI defecography to evaluate pelvic floor function and abnormalities are reported. The children with incontinence were more likely to have abnormal location of the neorectum (P = 0.031), increased anorectal angle (ARA) (P = 0.031) and peritoneal fat herniation (P = 0.032), and less likely to have dilation of the neorectum (P = 0.027), than the children with constipation. There were no significant differences between the two groups in incidence of focal stenosis of the neorectum (P = 0.797), presence of extensive scarring (P = 0.591) and developmental agenesis of the SMC (P > 0.05). MRI defecography showed 6 anterior rectoceles, 6 cystoceles and 18 pelvic floor descents. MRI is a helpful imaging modality in postoperative ARM patients with defecatory dysfunction, and it shows distinct differences between the children with constipation and incontinence and provides individualized information to guide further treatment. (orig.)

  7. Histopathological findings in a surgically resected thalamic cavernous hemangioma 1 year after 40-Gy irradiation.

    Science.gov (United States)

    Nyáry, István; Major, Otto; Hanzély, Zoltán; Szeifert, György T

    2005-01-01

    ✓ Stereotactic radiosurgery is a controversial treatment modality in the management of cerebral cavernous hemangiomas (CHs), and results vary from center to center. Even the interpretation of treatment failure is controversial. It is suggested that the systematic pathological investigation of irradiated specimens could help to resolve the controversy. A hemorrhagic lesion in the posterior part of the thalamus had been diagnosed as a tumor and was treated with 40-Gy fractionated radiotherapy. One year after this treatment the case was reconsidered based on new imaging evidence, and the lesion was removed by conventional craniotomy. Histopathological examination revealed a CH with postirradiation changes. Compared with nonirradiated control CH tissue samples, there was endothelial cell destruction and marked fibrosis with scar tissue formation in the stroma of the treated lesion. The histopathological findings in this specimen were similar to those described in arteriovenous malformations after gamma knife surgery. The results of light microscopic investigations suggest that the ionizing effect of radiation energy evokes vascular and connective tissue stroma changes in CHs as well.

  8. CT findings and surgical treatment of atlanto-axial rotatory fixation

    International Nuclear Information System (INIS)

    Shoji, Akira; Harano, Hideyuki; Okumura, Terufumi; Nakagawa, Hiroshi; Sugiyama, Tadamitsu.

    1984-01-01

    A case of atlanto-axial rotatory fixation (AARF) was presented in a 19-year-old female who developed sudden onset of neck pain and limitation of neck movement after direct carotid angiography for seizure disorder. Neurological examination was negative except for cock-robin posture and mild hypesthesia and hypalgesia in left C 2 distribution. Plain films of the cervical spine disclosed abnormal alignment of C 1 -C 2 and possible rotational dislocation. Bilateral selective vertebral angiography showed marked anterior and posterior displacement of left and right vertebral artery, respectively, at the level of C 1 . On CT metrizamide myelography, there was clockwise rotation of C 1 on C 2 with locked facet on the left but no evidence of cord compression was found. With diagnosis of AARF, manual reduction under general anesthesia and with fluoroscopic control was first attempted without success. Therefore, the patient underwent open reduction by using high speed air-drill and posterior fusion of C 1 to C 3 with acryl and wire. Postoperative course was uneventful and the patient went back to work as a computer operator in three months. The etiology of AARF was described by many authors, but in our case, congenital hypogenesis of transverse and alar ligaments plus minor trauma was most suggested. For neurological manifestations of AARF, occipital neuralgia, headache, neck pain, limitation of neck movement and cock-robin posture were reported, but the cock-robin posture was most characteristic and was an important symptom for the early diagnosis. In neuroradiological findings of AARF, plain CT and CT metrizamide myelography are very useful. Because they clearly demonstrate the degree of rotation and interlocking of atlanto-axial joints, and the presence of cord compression. (author)

  9. CT findings and surgical treatment of atlanto-axial rotatory fixation. A case report

    Energy Technology Data Exchange (ETDEWEB)

    Shoji, Akira; Harano, Hideyuki; Okumura, Terufumi [Fukuroi Municipal Hospital, Shizuoka (Japan); Nakagawa, Hiroshi; Sugiyama, Tadamitsu

    1984-07-01

    A case of atlanto-axial rotatory fixation (AARF) was presented in a 19-year-old female who developed sudden onset of neck pain and limitation of neck movement after direct carotid angiography for seizure disorder. Neurological examination was negative except for cock-robin posture and mild hypesthesia and hypalgesia in left C/sub 2/ distribution. Plain films of the cervical spine disclosed abnormal alignment of C/sub 1/-C/sub 2/ and possible rotational dislocation. Bilateral selective vertebral angiography showed marked anterior and posterior displacement of left and right vertebral artery, respectively, at the level of C/sub 1/. On CT metrizamide myelography, there was clockwise rotation of C/sub 1/ on C/sub 2/ with locked facet on the left but no evidence of cord compression was found. With diagnosis of AARF, manual reduction under general anesthesia and with fluoroscopic control was first attempted without success. Therefore, the patient underwent open reduction by using high speed air-drill and posterior fusion of C/sub 1/ to C/sub 3/ with acryl and wire. Postoperative course was uneventful and the patient went back to work as a computer operator in three months. The etiology of AARF was described by many authors, but in our case, congenital hypogenesis of transverse and alar ligaments plus minor trauma was most suggested. For neurological manifestations of AARF, occipital neuralgia, headache, neck pain, limitation of neck movement and cock-robin posture were reported, but the cock-robin posture was most characteristic and was an important symptom for the early diagnosis. In neuroradiological findings of AARF, plain CT and CT metrizamide myelography are very useful. Because they clearly demonstrate the degree of rotation and interlocking of atlanto-axial joints, and the presence of cord compression.

  10. A New Method for Surgical Treatment of Subcondylar Fractures: A Case Report

    Directory of Open Access Journals (Sweden)

    Gholamreza Shirani

    2017-12-01

    Full Text Available AbstractSubcondylar fractures are common in the maxillofacial region following direct trauma to the mandibular ramus. The literature is replete with articles written on the treatment of subcondylar fractures, encompassing a plethora of various surgical approaches; however, the best treatment procedure has remained controversial. Such fractures are either treated by open reduction with internal fixation or closed reduction with maxillomandibular fixation. In this article, we describe a new surgical method for treatment of subcondylar fractures.

  11. Comparison of four surgical methods for eyebrow reconstruction

    Directory of Open Access Journals (Sweden)

    Omranifard Mahmood

    2007-01-01

    Full Text Available Background: The eyebrow plays an important role in facial harmony and eye protection. Eyebrows can be injured by burn, trauma, tumour, tattooing and alopecia. Eyebrow reconstructions have been done via several techniques. Here, our experience with a fairly new method for eyebrow reconstruction is presented. Materials and Methods: This is a descriptive-analytical study which was done on 76 patients at the Al-Zahra and Imam Mousa Kazem hospitals at Isfahan University of Medical University, Isfahan, Iran, from 1994 to 2004. Totally 86 eyebrows were reconstructed. All patients were examined before and after the operation. Methods which are commonly applied in eyebrow reconstruction are as follows: 1. Superficial Temporal Artery Flap (Island, 2. Interpolitation Scalp Flap, 3. Graft. Our method which is named Forehead Facial Island Flap with inferior pedicle provides an easier approach for the surgeon and more ideal hair growth direction for the patient. Results: Significantly lower rates of complication along with greater patient satisfaction were obtained with Forehead Facial Island Flap. Conclusions: According to the acquired results, this method seems to be more technically practical and aesthetically favourable when compared to others.

  12. Hypoplastic thumb type IIIB: An alternative method for surgical repair

    Directory of Open Access Journals (Sweden)

    Salih Onur Basat

    2014-08-01

    Full Text Available Hypoplastic thumb is the second most common congenital deformity of the thumb. Thumb hypoplasia is characterized by diminished thumb size, metacarpal adduction, metacarpophalangeal joint instability, and thenar muscle hypoplasia. In the literature, different classification types of hypoplastic thumb have been used and different treatment methods described. In this case we presented an alternative palliative treatment method for a ten-year-old patient with modified Blauth's classification type IIIB hypoplastic thumb and one-year follow-up results. [Hand Microsurg 2014; 3(2.000: 59-61

  13. Does Categorization Method Matter in Exploring Volume-Outcome Relation? A Multiple Categorization Methods Comparison in Coronary Artery Bypass Graft Surgery Surgical Site Infection.

    Science.gov (United States)

    Yu, Tsung-Hsien; Tung, Yu-Chi; Chung, Kuo-Piao

    2015-08-01

    Volume-infection relation studies have been published for high-risk surgical procedures, although the conclusions remain controversial. Inconsistent results may be caused by inconsistent categorization methods, the definitions of service volume, and different statistical approaches. The purpose of this study was to examine whether a relation exists between provider volume and coronary artery bypass graft (CABG) surgical site infection (SSI) using different categorization methods. A population-based cross-sectional multi-level study was conducted. A total of 10,405 patients who received CABG surgery between 2006 and 2008 in Taiwan were recruited. The outcome of interest was surgical site infection for CABG surgery. The associations among several patient, surgeon, and hospital characteristics was examined. The definition of surgeons' and hospitals' service volume was the cumulative CABG service volumes in the previous year for each CABG operation and categorized by three types of approaches: Continuous, quartile, and k-means clustering. The results of multi-level mixed effects modeling showed that hospital volume had no association with SSI. Although the relation between surgeon volume and surgical site infection was negative, it was inconsistent among the different categorization methods. Categorization of service volume is an important issue in volume-infection study. The findings of the current study suggest that different categorization methods might influence the relation between volume and SSI. The selection of an optimal cutoff point should be taken into account for future research.

  14. METHODS OF FINDING BUSINESS PARTNERS OF MANUFACTURING FIRMS IN JAPAN

    Directory of Open Access Journals (Sweden)

    Nobuhiro Takahashi

    2017-09-01

    Full Text Available This paper addresses new methods of finding business partners for joint development in Japan. These methods create opportunities for a manufacturing firm, which has excellent technology, to find an appropriate business partner. We call these methods the Osaka model. In the model, a company finds a business partner among plenty of companies, while they establish mutual trust and solve higher levels of technological difficulties. The model shares strong points of both spot transaction and conventional co-development. In other words, this model takes advantages of both Western style and Japanese style inter-business relationship. This paper also argues the environment for encouraging the model. The area should be a place where you can obtain many sources of information. Increasing meetings or facilities on specific themes is an effective method to encourage the model in the area. In addition, a database with which each technological seed has been already arranged with their technological needs is beneficial for matching them. If such a database becomes a shared knowledge in the area, the model would be promoted.

  15. Is hospital information system relevant to detect surgical site infection? Findings from a prospective surveillance study in posterior instrumented spinal surgery.

    Science.gov (United States)

    Boetto, J; Chan-Seng, E; Lonjon, G; Pech, J; Lotthé, A; Lonjon, N

    2015-11-01

    Spinal instrumentation has a high rate of surgical site infection (SSI), but results greatly vary depending on surveillance methodology, surgical procedures, or quality of follow-up. Our aim was to study true incidence of SSI in spinal surgery by significant data collection, and to compare it with the results obtained through the hospital information system. This work is a single center prospective cohort study that included all patients consecutively operated on for spinal instrumentation by posterior approach over a six-month period regardless the etiology. For all patients, a "high definition" prospective method of surveillance was performed by the infection control (IC) department during at least 12 months after surgery. Results were then compared with findings from automatic surveillance though the hospital information system (HIS). One hundred and fifty-four patients were included. We found no hardly difference between "high definition" and automatic surveillance through the HIS, even if HIS tended to under-estimate the infection rate: rate of surgical site infection was 2.60% and gross SSI incidence rate via the hospital information system was 1.95%. Smoking and alcohol consumption were significantly related to a SSI. Our SSI rates to reflect the true incidence of infectious complications in posterior instrumented adult spinal surgery in our hospital and these results were consistent with the lower levels of published infection rate. In-house surveillance by surgeons only is insufficiently sensitive. Further studies with more patients and a longer inclusion time are needed to conclude if SSI case detection through the HIS could be a relevant and effective alternative method. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  16. Surgical antibiotic prophylaxis in children: a mixed method study on healthcare professionals attitudes.

    Science.gov (United States)

    Giusti, Angela; Spila Alegiani, Stefania; Ciofi Degli Atti, Marta Luisa; Colaceci, Sofia; Raschetti, Roberto; Arace, Pasquale; Spiazzi, Raffaele; Raponi, Massimiliano

    2016-12-05

    Qualitative and quantitative research investigating determinants of adherence to clinical guidelines (GLs) on surgical antibiotic prophylaxis (SAP) are scarce. We conducted a mixed-method study aimed at investigating barriers and at describing attitudes of healthcare professionals (HCPs) regarding SAP in three Italian children's hospitals. The study comprised two sequential phases: 1) collection of qualitative data through focus groups; 2) conduction of a survey on HCPs attitudes towards SAP. Focus groups were carried out in each hospital with a theoretical convenience sample of 10-15 HCPs. Categorical analysis was conducted. Emerging categories and additional topics derived by literature search were used to develop the survey questionnaire, which included 13 questions expressed through a 4-point Likert scale. Members of surgical teams were invited by e-mail to fill in the questionnaire. We summed up the points assigned to each 4-point Likert scale response and calculated a cumulative score expressing overall concordance to expected HCPs attitudes on SAP. We conducted univariate and multivariate analysis to evaluate the relationship among characteristics of respondents and concordance with expected attitudes. The main categories identified in the qualitative phase included determinants of general adherence to GLs (e.g., relevance of clinical judgment), individual determinants (e.g., poor knowledge on hospital data) and organizational/structural determinants (e.g., patient flows). A total of 357 HCPs participated in the survey (response rate: 82.1%). Among respondents, 75% reported that SAP should be performed with first or second-generation cephalosporins, 44% that 2-3 days of antibiotic administration are useful as a precaution after surgery, 32% that SAP is needed for all surgical procedures. At multivariate analysis, professional category (physicians vs nurses; OR: 3.31; 95%CI: 1.88-5.82), and hospital (hospital 1 and 2 vs hospital 3; ORs: 2.79, 95%CI: 1

  17. Comparative evaluation of skin cancer therapy with impulse laser radiation and surgical methods

    International Nuclear Information System (INIS)

    Moskalik, K.G.; Kozlov, A.P.

    1980-01-01

    Altogether 324 patients with skin basilomas, 559 with recurrent basiloma and 38 with squamous-cell carcinoma of the skin were treated by means of impulse neodymium laser radiation. A follow-up period was up to 7 years. It was shown that impulse laser radiation is a highly effective means of treating skin cancer, having a number of advantages over the radiation and surgical methods. Laser radiation is also highly effective in the treatment of basiloma relapses. If relapses accounted for by the development of a radioresistant tumour occur at the sites where surgical eXcision yields an unstatisfactory cosmetic effect, laser therapy should be considered a method of choice

  18. [TVT (transvaginal mesh) surgical method for complex resolution of pelvic floor defects].

    Science.gov (United States)

    Adamík, Z

    2006-01-01

    Assessment of the effects of a new surgical method for complex resolution of pelvic floor defects. Case study. Department of Obstetrics and Gynaecology, Bata Hospital, Zlín. We evaluated the procedures and results of the new TVM (transvaginal mesh) surgical method which we used in a group of 12 patients. Ten patients had vaginal prolapse following vaginal hysterectomy and in two cases there was uterine prolapse and vaginal prolapse. Only in one case there was a small protrusion in the range of 0.5 cm which we resolved by removal of the penetrated section. The resulting anatomic effect was very good in all the cases.

  19. Clinical effect comparison of different surgical methods for treating diabetic retinopathy

    Directory of Open Access Journals (Sweden)

    Qing Wu

    2014-12-01

    Full Text Available AIM: To compare the clinical results of different surgical methods for diabetic antipathy. METHODS: Eighty cases(102 eyeswith diabetic antipathy were selected in our hospital from January 2012 to December 2013. Thirty-eight cases(48 eyesin group A received joint surgical treatment, 42 cases(54 eyesin group B took staging of surgical treatment. The clinical effect was observed in both groups.RESULTS: The vision after surgery was improved than that of before surgery in two groups, there were no significant differences(P>0.05. A postoperative complication rate was 16.7% in group A and 22.2% in group B, showed no significant difference(P>0.05. CONCLUSION: Surgery and staging joint surgery are both feasible for diabetic retinopathy patients, can, improve the visionr. Both of them are worthy of clinical application.

  20. The assessment of surgical skills as a complement to the training method. Revision.

    Science.gov (United States)

    Sánchez-Fernández, J; Bachiller-Burgos, J; Serrano-Pascual, Á; Cózar-Olmo, J M; Díaz-Güemes Martín-Portugués, I; Pérez-Duarte, F J; Hernández-Hurtado, L; Álvarez-Ossorio, J L; Sánchez-Margallo, F M

    2016-01-01

    The acquisition and improvement of surgical skills constitute a fundamental element in the training of any practitioner. At present, however, the assessment of these skills is a scarcely developed area of research. The aim of this study was to analyse the peculiarities of the various assessment systems and establish the minimum criteria that a skills and knowledge assessment system should meet as a method for assessing surgical skills in urological surgery. Scientific literature review aimed at the various currently available assessment systems for skills and competencies (technical and nontechnical), with a special focus on the systematic reviews and prospective studies. After conducting the review, we found that the various assessment systems for surgical competence have, in our opinion, a number of shortcomings. There is a certain degree of subjectivity in the assessment of surgeons by the evaluators. The assessment of nontechnical competencies is not formally recorded. There is no description of a follow-up assessment or any basic parameters associated with healthcare quality. There is no registration of associated competencies associated with the various surgical techniques. There is also no ranking of these competencies and the specific peculiarities for their application. We believe that the development of a new assessment system for surgical competencies (technical and nontechnical) aimed at assessing urologists in the various surgical techniques is necessary. To this end, our team has worked on developing the Evaluation System for Surgical Competencies on Laparoscopy, which is based on the definition, ranking and assessment of competencies demonstrated by surgeons. Copyright © 2015 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

  1. Surgical body modification and altruistic individualism: a case for cyborg ethics and methods.

    Science.gov (United States)

    Frank, Arthur W

    2003-12-01

    Three cases of pediatric surgical body modification--limb lengthening, normalization of genitalia, and craniofacial surgery--are considered through the moral language used by those who experience these surgeries. This language has been described as altruistic individualism. Decision making remains individualist, but it also shows considerable concern for others; egoism is complementary with altruism. The altruistic individualist is one of many incompatible identities that are predicted and described by the figure of the cyborg. Cyborgs suggest both ethics and qualitative methods appropriate to surgically shaped children.

  2. Robust EM Continual Reassessment Method in Oncology Dose Finding

    Science.gov (United States)

    Yuan, Ying; Yin, Guosheng

    2012-01-01

    The continual reassessment method (CRM) is a commonly used dose-finding design for phase I clinical trials. Practical applications of this method have been restricted by two limitations: (1) the requirement that the toxicity outcome needs to be observed shortly after the initiation of the treatment; and (2) the potential sensitivity to the prespecified toxicity probability at each dose. To overcome these limitations, we naturally treat the unobserved toxicity outcomes as missing data, and use the expectation-maximization (EM) algorithm to estimate the dose toxicity probabilities based on the incomplete data to direct dose assignment. To enhance the robustness of the design, we propose prespecifying multiple sets of toxicity probabilities, each set corresponding to an individual CRM model. We carry out these multiple CRMs in parallel, across which model selection and model averaging procedures are used to make more robust inference. We evaluate the operating characteristics of the proposed robust EM-CRM designs through simulation studies and show that the proposed methods satisfactorily resolve both limitations of the CRM. Besides improving the MTD selection percentage, the new designs dramatically shorten the duration of the trial, and are robust to the prespecification of the toxicity probabilities. PMID:22375092

  3. Locally advanced cancer of the tongue base: new method of surgical treatment

    Directory of Open Access Journals (Sweden)

    I. A. Zaderenko

    2018-01-01

    Full Text Available Introduction. Patients are characterized by locally advanced tumors in 70–80 % of cases at presentation, so possibility of cure and surgical treatment is limited. Total glossectomy, tongue base resection is associated with severe and permanent disability. Such surgical procedures lead to severe dysphagia, alalia and social maladjustment. Enumerated issues motivated us to develop new method of surgical treatment  of locally advanced base of tongue cancer.Objective is to introduce new opportunities of surgical treatment of locally advanced cancer of the tongue base.Materials and methods. Glossectomy is accomplished in 5 patients suffering from tongue cancer and admitted to N.N. Blokhin National Medical Research Center of Oncology. Swallowing and speech is preserved in all 5 cases.Results. The main advantage of the proposed method is that the cut out muscle flap has a different innervation from different cranial nerves involved in the rate of swallowing, so there is not just a mechanical movement of the epiglottis, but also the control of swallowing by the central nervous system. The reduction of injury and operation time in the proposed method is due to the fact that tissues directly contacting with the defect are used to preserve swallowing and speech. The proposed muscle flap has various sources of blood supply, which improves its nutrition and reduces the risk of complications, and healing occurs in a shorter time in comparison with the prototype. All of the above reduces the duration of hospitalization for an average of 7–9 days.Conclusion. The developed surgical technique allows to achieve early rehabilitation; patients are able to breathe effortlessly, swallow and speak. There is no need in permanent tracheostoma and percutaneous endoscopic gastrostomy tube. All patients remains socially active. 

  4. New method of surgical treatment of patients with recurrent ingrown nail

    Directory of Open Access Journals (Sweden)

    Kondulukov A.N.

    2011-12-01

    Full Text Available The article discusses the surgical treatment of ingrown nail in patients with recurrent disease. The advantages of a new method of operation have been explained in the article. It gives a detailed description of the operation. The clinical and additional methods of research have confirmed the fact that a new operation reduces the wound healing period and the number of ingrown nail recurrences

  5. MR imaging and MR cholangiopancreatography in the preoperative evaluation of hilar cholangiocarcinoma: correlation with surgical and pathologic findings

    Energy Technology Data Exchange (ETDEWEB)

    Masselli, Gabriele; Gualdi, Gianfranco [Umberto I Hospital-La Sapienza University Rome, Department of Radiology, Rome (Italy); Manfredi, Riccardo [University of Verona, Department of Radiology, Verona (Italy); Vecchioli, Amorino [A. Gemelli Hospital-University of Sacred Heart, Department of Radiology, Rome (Italy)

    2008-10-15

    The primary aim was to evaluate delayed contrast-enhanced MRI in depicting perineural spread of hilar cholangiocarcinoma (CCC) and consequently to determine the capability of MRI/MRCP for staging CCC. Fifteen patients that underwent MRI/MRCP and surgical treatment were retrospectively included. Two radiologists evaluated MR images to assess delayed periductal enhancement, extent of bile duct stenosis, liver parenchymal and vascular involvement and presence of liver atrophy. An agreement between delayed enhancement of the bile duct walls and perineural neoplastic spread showed a very good correlation factor (0.93). The overall accuracy in detecting biliary neoplastic invasion was higher for delayed T1-weighted images (93.3%) than for the MRCP images (80%), and T1-delayed image increased the MR accuracy in assessing the neoplastic resectability (p < 0.05). MRI correctly predicted vascular involvement in 73% and liver involvement in 80% of the cases. The number of overall correctly assessed patients with regard to resectability was 11 true positive, 1 false positive and 3 true negative. The combination of MRI/MRCP is a reliable diagnostic method for staging hilar cholangiocarcinomas. Delayed periductal enhancement is accurate in the evaluation of neoplastic perineural spread, and it can improve diagnostic accuracy to identify resectable and unresectable tumours. (orig.)

  6. Computer-enhanced visual learning method: a paradigm to teach and document surgical skills.

    Science.gov (United States)

    Maizels, Max; Mickelson, Jennie; Yerkes, Elizabeth; Maizels, Evelyn; Stork, Rachel; Young, Christine; Corcoran, Julia; Holl, Jane; Kaplan, William E

    2009-09-01

    Changes in health care are stimulating residency training programs to develop new methods for teaching surgical skills. We developed Computer-Enhanced Visual Learning (CEVL) as an innovative Internet-based learning and assessment tool. The CEVL method uses the educational procedures of deliberate practice and performance to teach and learn surgery in a stylized manner. CEVL is a learning and assessment tool that can provide students and educators with quantitative feedback on learning a specific surgical procedure. Methods involved examine quantitative data of improvement in surgical skills. Herein, we qualitatively describe the method and show how program directors (PDs) may implement this technique in their residencies. CEVL allows an operation to be broken down into teachable components. The process relies on feedback and remediation to improve performance, with a focus on learning that is applicable to the next case being performed. CEVL has been shown to be effective for teaching pediatric orchiopexy and is being adapted to additional adult and pediatric procedures and to office examination skills. The CEVL method is available to other residency training programs.

  7. A novel surgical method for total nail ablation: Use of triple flap technique

    Directory of Open Access Journals (Sweden)

    Berna Aksoy

    2017-11-01

    Full Text Available Total nail ablation for the treatment of onychodystrophies can be performed by using chemicals, surgical resection or laser ablation of nail matrix. A female patient with bilateral severe onychodystrophy as a result of inadvertent previous nail surgeries was treated surgically. Proximal complete nail matrix resection and distal 10 mm wide transverse strip partial nail bed resection were performed. A 5 mm wide transverse strip of nail bed was left intact proximally. Proximal nail matrix defect was closed by using the skin of proximal nail fold. The distal nail bed defect was reconstructed by using triple flap technique which was composed of a main central advancement flap containing ventral toe skin and two side flaps containing nail fold skin. The patient healed without any problem and her nail problem was treated successfully. The cosmetic appearance of her first toes was acceptable. Surgical nail ablation followed by volar skin coverage of dorsal surface of the distal phalanx bone by using triple flap technique is an effective surgical treatment method for the correction of advanced nail plate deformities requiring total nail ablation. 

  8. Methods for Finding Legacy Wells in Large Areas

    Energy Technology Data Exchange (ETDEWEB)

    Hammack, Richard W. [National Energy Technology Lab. (NETL), Pittsburgh, PA, (United States); Veloski, Garret A. [National Energy Technology Lab. (NETL), Pittsburgh, PA, (United States); Hodges, D. Greg [Fugro Airborne Surveys, Mississauga, ON (Canada); White, Jr., Curt M. [National Energy Technology Lab. (NETL), Pittsburgh, PA, (United States)

    2016-06-16

    United States. When abandoned, many wells were not adequately sealed and now provide a potential conduit for the vertical movement of liquids and gases. Today, groundwater aquifers can be contaminated by surface pollutants flowing down wells or by deep, saline water diffusing upwards. Likewise, natural gas, carbon dioxide (CO2), or radon can travel upwards via these wells to endanger structures or human health on the surface. Recently, the need to find and plug wells has become critical with the advent of carbon dioxide injection into geologic formations for enhanced oil recovery (EOR) or carbon storage. The potential for natural gas or brine leakage through existing wells has also been raised as a concern in regions where shale resources are hydraulically fractured for hydrocarbon recovery. In this study, the National Energy Technology Laboratory (NETL) updated existing, effective well finding techniques to be able to survey large areas quickly using helicopter or ground-vehicle-mounted magnetometers, combined with mobile methane detection. For this study, magnetic data were collected using airborne and ground vehicles equipped with two boom-mounted magnetometers, or on foot using a hand-held magnetometer with a single sensor. Data processing techniques were employed to accentuate well-casing-type magnetic signatures. To locate wells with no magnetic signature (wells where the steel well casing had been removed), the team monitored for anomalous concentrations of methane, which could indicate migration of volatile compounds from deeper sedimentary strata along a well or fracture pathway. Methane measurements were obtained using the ALPIS DIfferential Absorption Lidar (DIAL) sensor for helicopter surveys and the Apogee leak detection system (LDS) for ground surveys. These methods were evaluated at a 100-year-old oilfield in Wyoming, where a helicopter magnetic survey accurately located 93% of visible wells. In addition, 20% of the wells found by the survey were

  9. Methods for Finding Legacy Wells in Large Areas

    Energy Technology Data Exchange (ETDEWEB)

    Hammack, Richard [National Energy Technology Lab. (NETL), Pittsburgh, PA, (United States); Veloski, Garret [National Energy Technology Lab. (NETL), Pittsburgh, PA, (United States); Hodges, D. Greg [Fugro Airborne Surveys, Mississauga, ON (Canada); White, Jr., Charles E. [National Energy Technology Lab. (NETL), Pittsburgh, PA, (United States)

    2016-06-16

    More than 10 million wells have been drilled during 150 years of oil and gas production in the United States. When abandoned, many wells were not adequately sealed and now provide a potential conduit for the vertical movement of liquids and gases. Today, groundwater aquifers can be contaminated by surface pollutants flowing down wells or by deep, saline water diffusing upwards. Likewise, natural gas, carbon dioxide (CO2), or radon can travel upwards via these wells to endanger structures or human health on the surface. Recently, the need to find and plug wells has become critical with the advent of carbon dioxide injection into geologic formations for enhanced oil recovery (EOR) or carbon storage. The potential for natural gas or brine leakage through existing wells has also been raised as a concern in regions where shale resources are hydraulically fractured for hydrocarbon recovery. In this study, the National Energy Technology Laboratory (NETL) updated existing, effective well finding techniques to be able to survey large areas quickly using helicopter or ground-vehicle-mounted magnetometers, combined with mobile methane detection. For this study, magnetic data were collected using airborne and ground vehicles equipped with two boom-mounted magnetometers, or on foot using a hand-held magnetometer with a single sensor. Data processing techniques were employed to accentuate well-casing-type magnetic signatures. To locate wells with no magnetic signature (wells where the steel well casing had been removed), the team monitored for anomalous concentrations of methane, which could indicate migration of volatile compounds from deeper sedimentary strata along a well or fracture pathway. Methane measurements were obtained using the ALPIS DIfferential Absorption Lidar (DIAL) sensor for helicopter surveys and the Apogee leak detection system (LDS) for ground surveys. These methods were evaluated at a 100-year-old oilfield in Wyoming, where a helicopter magnetic

  10. Teaching methods and surgical training in North American graduate periodontics programs: exploring the landscape.

    Science.gov (United States)

    Ghiabi, Edmond; Taylor, K Lynn

    2010-06-01

    This project aimed at documenting the surgical training curricula offered by North American graduate periodontics programs. A survey consisting of questions on teaching methods employed and the content of the surgical training program was mailed to directors of all fifty-eight graduate periodontics programs in Canada and the United States. The chi-square test was used to assess whether the residents' clinical experience was significantly (Pperiodontal plastic procedures, hard tissue grafts, and implants. Furthermore, residents in programs offering a structured preclinical component performed significantly more procedures (P=0.012) using lasers than those in programs not offering a structured preclinical program. Devising new and innovative teaching methods is a clear avenue for future development in North American graduate periodontics programs.

  11. Postoperative intraabdominal fluid collections : a modified percutaneous drainage method using a surgical drain track

    International Nuclear Information System (INIS)

    Lee, Deok Hee; Kim, Gab Choul; Hwang, Jae Cheol; Yoon, Hyun Ki; Song, Ho Young; Sung, Kyu Bo

    2000-01-01

    In the management of postoperative fluid collection, the conventional percutaneous drainage method can be employed. Because of abdominal incisions and various types of surgical drains and/or T-tubes, the application of this method is not always easy, however. We inserted a drainage catheter through a pre-existing percutaneous track formed by a surgical drain located adjacent to the site of abnormal fluid collection. There was no need to remove the drain nor make an additional puncture in the abdominal wall. A dilator was inserted along the drain, and a guide wire was used to negotiate its intraperitoneal track and reach the accumulated fluid. The procedure was simple and safe. We briefly describe our experience of this modified percutaneous drainage technique, as used in three cases involving postoperative fluid collection. (author)

  12. Neuroradiological methods and findings on presurgical evaluation of epileptic children

    International Nuclear Information System (INIS)

    Ostertun, B.; Elger, C.E.; Solymosi, L.; Kurthen, M.; Schramm, J.

    1993-01-01

    Epilepsy in childhood is often caused by morphological abnormalities and is frequently pharmacoresistant. Therefore it represents a challenge to the neuroradiologist because early and accurate diagnosis of abnormal morphology is the basis for planning surgical intervention with a high change of controlling seizures and a low risk of complications. Both morphological (radiography, CT, MRI and angiography) and functional examinations [intracarotid amobarbital test (IAT)] are essential parts of the presurgical evaluation. In most cases MRI has proved to be most sensitive in detecting lesions except for some calcifications. Routine protocols for brain examinations are not sufficient, missing about 22% of lesions. Therefore a refined MRI and CT protocol is proposed. Even in very young children IAT can be performed at very low risk; these tests contribute highly valuable information about hemispheric dominance and other functions in more than 80% of procedures that is indispensable if postoperative neurological and neuropsychological deficits are to be avoided. (orig.) [de

  13. No. 360-Induced Abortion: Surgical Abortion and Second Trimester Medical Methods.

    Science.gov (United States)

    Costescu, Dustin; Guilbert, Édith

    2018-06-01

    This guideline reviews evidence relating to the provision of surgical induced abortion (IA) and second trimester medical abortion, including pre- and post-procedural care. Gynaecologists, family physicians, nurses, midwives, residents, and other health care providers who currently or intend to provide and/or teach IAs. Women with an unintended or abnormal first or second trimester pregnancy. PubMed, Medline, and the Cochrane Database were searched using the key words: first-trimester surgical abortion, second-trimester surgical abortion, second-trimester medical abortion, dilation and evacuation, induction abortion, feticide, cervical preparation, cervical dilation, abortion complications. Results were restricted to English or French systematic reviews, randomized controlled trials, clinical trials, and observational studies published from 1979 to July 2017. National and international clinical practice guidelines were consulted for review. Grey literature was not searched. The quality of evidence in this document was rated using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) methodology framework. The summary of findings is available upon request. IA is safe and effective. The benefits of IA outweigh the potential harms or costs. No new direct harms or costs identified with these guidelines. Copyright © 2018 Society of Obstetricians and Gynaecologists of Canada. All rights reserved.

  14. 99mTc-HMPAO WBC-scintigraphy: Are all positive findings in traumatology mandatory for surgical invention?

    International Nuclear Information System (INIS)

    Winker, K.H.; Weller, S.; Reuland, P.; Feine, U.

    1989-01-01

    In 5 case reports of traumatology patients the authors describe a subgroup of patients (IYON = infection yes, operation no) with positive WBC scan and proven infection, which do not need surgical intervention and can be treated by conservative means. (orig.) [de

  15. Methods for identifying surgical wound infection after discharge from hospital: a systematic review

    Directory of Open Access Journals (Sweden)

    Moore Peter J

    2006-11-01

    Full Text Available Abstract Background Wound infections are a common complication of surgery that add significantly to the morbidity of patients and costs of treatment. The global trend towards reducing length of hospital stay post-surgery and the increase in day case surgery means that surgical site infections (SSI will increasingly occur after hospital discharge. Surveillance of SSIs is important because rates of SSI are viewed as a measure of hospital performance, however accurate detection of SSIs post-hospital discharge is not straightforward. Methods We conducted a systematic review of methods of post discharge surveillance for surgical wound infection and undertook a national audit of methods of post-discharge surveillance for surgical site infection currently used within United Kingdom NHS Trusts. Results Seven reports of six comparative studies which examined the validity of post-discharge surveillance methods were located; these involved different comparisons and some had methodological limitations, making it difficult to identify an optimal method. Several studies evaluated automated screening of electronic records and found this to be a useful strategy for the identification of SSIs that occurred post discharge. The audit identified a wide range of relevant post-discharge surveillance programmes in England, Scotland and Wales and Northern Ireland; however, these programmes used varying approaches for which there is little supporting evidence of validity and/or reliability. Conclusion In order to establish robust methods of surveillance for those surgical site infections that occur post discharge, there is a need to develop a method of case ascertainment that is valid and reliable post discharge. Existing research has not identified a valid and reliable method. A standardised definition of wound infection (e.g. that of the Centres for Disease Control should be used as a basis for developing a feasible, valid and reliable approach to defining post

  16. An integrating factor matrix method to find first integrals

    International Nuclear Information System (INIS)

    Saputra, K V I; Quispel, G R W; Van Veen, L

    2010-01-01

    In this paper we develop an integrating factor matrix method to derive conditions for the existence of first integrals. We use this novel method to obtain first integrals, along with the conditions for their existence, for two- and three-dimensional Lotka-Volterra systems with constant terms. The results are compared to previous results obtained by other methods.

  17. Multiple methods of surgical treatment combined with primary IOL implantation on traumatic lens subluxation/dislocation in patients with secondary glaucoma

    OpenAIRE

    Wang, Rui; Bi, Chun-Chao; Lei, Chun-Ling; Sun, Wen-Tao; Wang, Shan-Shan; Dong, Xiao-Juan

    2014-01-01

    AIM:To describe clinical findings and complications from cases of traumatic lens subluxation/dislocation in patients with secondary glaucoma, and discuss the multiple treating methods of operation combined with primary intraocular lens (IOL) implantation.METHODS:Non-comparative retrospective observational case series. Participants:30 cases (30 eyes) of lens subluxation/dislocation in patients with secondary glaucoma were investigated which accepted the surgical treatment by author in the Opht...

  18. Video Coaching as an Efficient Teaching Method for Surgical Residents-A Randomized Controlled Trial.

    Science.gov (United States)

    Soucisse, Mikael L; Boulva, Kerianne; Sideris, Lucas; Drolet, Pierre; Morin, Michel; Dubé, Pierre

    As surgical training is evolving and operative exposure is decreasing, new, effective, and experiential learning methods are needed to ensure surgical competency and patient safety. Video coaching is an emerging concept in surgery that needs further investigation. In this randomized controlled trial conducted at a single teaching hospital, participating residents were filmed performing a side-to-side intestinal anastomosis on cadaveric dog bowel for baseline assessment. The Surgical Video Coaching (SVC) group then participated in a one-on-one video playback coaching and debriefing session with a surgeon, during which constructive feedback was given. The control group went on with their normal clinical duties without coaching or debriefing. All participants were filmed making a second intestinal anastomosis. This was compared to their first anastomosis using a 7-category-validated technical skill global rating scale, the Objective Structured Assessment of Technical Skills. A single independent surgeon who did not participate in coaching or debriefing to the SVC group reviewed all videos. A satisfaction survey was then sent to the residents in the coaching group. Department of Surgery, HôpitalMaisonneuve-Rosemont, tertiary teaching hospital affiliated to the University of Montreal, Canada. General surgery residents from University of Montreal were recruited to take part in this trial. A total of 28 residents were randomized and completed the study. After intervention, the SVC group (n = 14) significantly increased their Objective Structured Assessment of Technical Skills score (mean of differences 3.36, [1.09-5.63], p = 0.007) when compared to the control group (n = 14) (mean of differences 0.29, p = 0.759). All residents agreed or strongly agreed that video coaching was a time-efficient teaching method. Video coaching is an effective and efficient teaching intervention to improve surgical residents' technical skills. Crown Copyright © 2017. Published by Elsevier

  19. Surface characterization of retinal tissues for the enhancement of vitreoretinal surgical methods

    Science.gov (United States)

    Valentin-Rodriguez, Celimar

    Diabetic retinopathy is the most common ophthalmic complication of diabetes and the leading cause of blindness among adults, ages 30 to 70. Surgery to remove scar tissue in the eye is the only corrective treatment once the retina is affected. Visual recovery is often hampered by retinal trauma during surgery and by low patient compliance. Our work in this project aimed to improve vitreoretinal surgical methods from information gathered by sensitive surface analysis of pre-retinal tissues found at the vitreoretinal interface. Atomic force microscopy characterization of human retinal tissues revealed that surgically excised inner limiting membrane (ILM) has a heterogeneous surface and is mainly composed of globular and fibrous structures. ILM tissues also show low adhesion for clean unmodified surfaces as opposed to those with functional groups attractive to those on the ILM surface, due to their charge. Based on these observations, layer-by-layer films with embedded gold nanoparticles with a positive outer charge were designed. These modifications increased the adhesion between surgical instruments and ILM by increasing the roughness and tuning the film surface charge. These films proved to be stable under physiological conditions. Finally, the effect of vital dyes on the topographical characteristics of ILMs was characterized and new imaging modes to further reveal ILM topography were utilized. Roughness and adhesion force data suggest that second generation dyes have no effect on the surface nanostructure of ILMs, but increase adhesion at the tip sample interface. This project clearly illustrates that physicochemical information from tissues can be used to rationally re-design surgical procedures, in this case for tissue removal purposes. This rational design method can be applied to other soft tissue excision procedures as is the case of cataract surgery or laparoscopic removal of endometrial tissue.

  20. An effective method of surgical treatment of refractory glaucoma patients using Ex-PRESSTM filtering device

    Directory of Open Access Journals (Sweden)

    Sergey Yuryevich Astakhov

    2013-03-01

    Full Text Available Based on data obtained from examination and subsequent follow-up of 47 patients (50 eyes with refractory glaucoma, an efficacy estimation of a new method of the Ex-PRESSTM filtering device implantation was performed. The data analysis showed that the proposed surgical procedure has a low level of intra- and post-operative complications, is characterized by technical ease, and provides a long term stabilization of the glaucomatous process. Therefore it is possible to draw a conclusion that the Ex-PRESSTM filtering device implantation is an effective method for the treatment of refractory glaucoma.

  1. A new hierarchical method to find community structure in networks

    Science.gov (United States)

    Saoud, Bilal; Moussaoui, Abdelouahab

    2018-04-01

    Community structure is very important to understand a network which represents a context. Many community detection methods have been proposed like hierarchical methods. In our study, we propose a new hierarchical method for community detection in networks based on genetic algorithm. In this method we use genetic algorithm to split a network into two networks which maximize the modularity. Each new network represents a cluster (community). Then we repeat the splitting process until we get one node at each cluster. We use the modularity function to measure the strength of the community structure found by our method, which gives us an objective metric for choosing the number of communities into which a network should be divided. We demonstrate that our method are highly effective at discovering community structure in both computer-generated and real-world network data.

  2. EPA flow reference method testing and analysis: Findings report

    International Nuclear Information System (INIS)

    1999-06-01

    This report describes an experimental program sponsored by the US Environmental Protection Agency (EPA) to evaluate potential improvements to the Agency's current reference method for measuring volumetric flow (Method 2, 40 CFR Part 60, Appendix B). Method 2 (Determination of Stack Gas Velocity and Volumetric Flow Rate (Type S Pitot Tube)) specifies measurements to determine volumetric flow, but does not prescribe specific procedures to account for yaw or pitch angles of flow when the flow in the stack is not axial. Method 2 also allows the use of only two probe types, the Type S and the Prandtl

  3. Methods to Find the Number of Latent Skills

    Science.gov (United States)

    Beheshti, Behzad; Desmarais, Michel C.; Naceur, Rhouma

    2012-01-01

    Identifying the skills that determine the success or failure to exercises and question items is a difficult task. Multiple skills may be involved at various degree of importance, and skills may overlap and correlate. In an effort towards the goal of finding the skills behind a set of items, we investigate two techniques to determine the number of…

  4. The functional variable method for finding exact solutions of some ...

    Indian Academy of Sciences (India)

    Abstract. In this paper, we implemented the functional variable method and the modified. Riemann–Liouville derivative for the exact solitary wave solutions and periodic wave solutions of the time-fractional Klein–Gordon equation, and the time-fractional Hirota–Satsuma coupled. KdV system. This method is extremely simple ...

  5. Non-surgical sterilisation methods may offer a sustainable solution to feral horse (Equus caballus) overpopulation.

    Science.gov (United States)

    Hall, Sally Elizabeth; Nixon, Brett; Aitken, R John

    2017-09-01

    Feral horses are a significant pest species in many parts of the world, contributing to land erosion, weed dispersal and the loss of native flora and fauna. There is an urgent need to modify feral horse management strategies to achieve public acceptance and long-term population control. One way to achieve this is by using non-surgical methods of sterilisation, which are suitable in the context of this mobile and long-lived species. In this review we consider the benefits of implementing novel mechanisms designed to elicit a state of permanent sterility (including redox cycling to generate oxidative stress in the gonad, random peptide phage display to target non-renewable germ cells and the generation of autoantibodies against proteins essential for conception via covalent modification) compared with that of traditional immunocontraceptive approaches. The need for a better understanding of mare folliculogenesis and conception factors, including maternal recognition of pregnancy, is also reviewed because they hold considerable potential in providing a non-surgical mechanism for sterilisation. In conclusion, the authors contend that non-surgical measures that are single shot and irreversible may provide a sustainable and effective strategy for feral horse control.

  6. Effect of modified surgical method on subcutaneous hydrops of patients with breast cancer after modified radical mastectomy

    OpenAIRE

    Yan Li; Hua-Feng Pan; Gui-Lan Sun

    2016-01-01

    Objective: Through prospective randomized clinical study,to observe the preventive effect of improved surgical method to subcutaneous hydrops after modified radical mastec tomy. Method: A total of 80 cases of patients who have done modified radical mastectomy were selected, and randomly divided them into study group (40 cases) and control group (40 cases), then adopted different surgical methods as followed respectively, to observe the daily drainage volume at the first 3 d after ...

  7. Assessment of MRI issues at 3-Tesla for metallic surgical implants: findings applied to 61 additional skin closure staples and vessel ligation clips.

    Science.gov (United States)

    Gill, Amreeta; Shellock, Frank G

    2012-01-09

    Metallic skin closure staples and vessel ligation clips should be tested at 3-Tesla to characterize MRI issues in order to ensure patient safety. Therefore, metallic surgical implants were assessed at 3-Tesla for magnetic field interactions, MRI-related heating, and artifacts. A skin closure staple (Visistat Skin Stapler, staple, Polytetrafluoroethylene, PTFE, coated 316L/316LVM stainless steel; Teleflex Medical, Durham, NC) and a vessel ligation clip (Hemoclip Traditional, stainless steel; Teleflex Medical, Durham, NC) that represented the largest metallic sizes made from materials with the highest magnetic susceptibilities (i.e., based on material information) among 61 other surgical implants (52 metallic implants, 9 nonmetallic implants) underwent evaluation for magnetic field interactions, MRI-related heating, and artifacts using standardized techniques. MRI-related heating was assessed by placing each implant in a gelled-saline-filled phantom with MRI performed using a transmit/receive RF body coil at an MR system reported, whole body averaged SAR of 2.9-W/kg for 15-min. Artifacts were characterized using T1-weighted, SE and GRE pulse sequences. Each surgical implant showed minor magnetic field interactions (20- and 27-degrees, which is acceptable from a safety consideration). Heating was not substantial (highest temperature change, ≤ 1.6°C). Artifacts may create issues if the area of interest is in the same area or close to the respective surgical implant. The results demonstrated that it would be acceptable for patients with these metallic surgical implants to undergo MRI at 3-Tesla or less. Because of the materials and dimensions of the surgical implants that underwent testing, these findings pertain to 61 additional similar implants.

  8. Finding function: evaluation methods for functional genomic data

    Directory of Open Access Journals (Sweden)

    Barrett Daniel R

    2006-07-01

    Full Text Available Abstract Background Accurate evaluation of the quality of genomic or proteomic data and computational methods is vital to our ability to use them for formulating novel biological hypotheses and directing further experiments. There is currently no standard approach to evaluation in functional genomics. Our analysis of existing approaches shows that they are inconsistent and contain substantial functional biases that render the resulting evaluations misleading both quantitatively and qualitatively. These problems make it essentially impossible to compare computational methods or large-scale experimental datasets and also result in conclusions that generalize poorly in most biological applications. Results We reveal issues with current evaluation methods here and suggest new approaches to evaluation that facilitate accurate and representative characterization of genomic methods and data. Specifically, we describe a functional genomics gold standard based on curation by expert biologists and demonstrate its use as an effective means of evaluation of genomic approaches. Our evaluation framework and gold standard are freely available to the community through our website. Conclusion Proper methods for evaluating genomic data and computational approaches will determine how much we, as a community, are able to learn from the wealth of available data. We propose one possible solution to this problem here but emphasize that this topic warrants broader community discussion.

  9. Localisation of cancer of the ovary and metastases using 123I-labelled monoclonal antibody HMFG-2 compared to surgical findings

    International Nuclear Information System (INIS)

    Britton, K.E.; Granowska, M.; Shepherd, J.

    1985-01-01

    The value of radioimmunoscintigraphy is investigated in the localization of cancer of the ovary and metastases using 123 I-labelled monoclonal antibody HMFG-2 compared to surgical findings. The results show that the HMFG-2 imaging is good in staging and determining the results of chemotherapy in known ovarian cancer but poor in screening patients presenting with a pelvic mass or those with carcinoma of the ovary. The requirements for improvements in radioimmunoscintigraphy are discussed. (UK)

  10. Magnetic resonance imaging findings of periosteal interposition in a distal tibial Salter-Harris type I fracture with surgical correlation: A case report

    International Nuclear Information System (INIS)

    Kim, Nara; Jung, Jee Young; Kang, Ki Ser

    2013-01-01

    The complication of growth disturbance after physeal fracture of the distal tibia has been well recognized. Although irreducible fractures of the physis due to trapped soft tissue, including periosteum, are not common, it could still cause growth disturbances. Therefore, the detection of periosteal interposition with physeal injury on imaging study is important. We present a case of a 10-year-old girl with surgically confirmed periosteal interposition in the distal tibial Salter-Harris type I fracture, through magnetic resonance imaging findings.

  11. Magnetic resonance imaging findings of periosteal interposition in a distal tibial Salter-Harris type I fracture with surgical correlation: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Nara; Jung, Jee Young; Kang, Ki Ser [Chung-Ang University Hospital, Seoul (Korea, Republic of)

    2013-08-15

    The complication of growth disturbance after physeal fracture of the distal tibia has been well recognized. Although irreducible fractures of the physis due to trapped soft tissue, including periosteum, are not common, it could still cause growth disturbances. Therefore, the detection of periosteal interposition with physeal injury on imaging study is important. We present a case of a 10-year-old girl with surgically confirmed periosteal interposition in the distal tibial Salter-Harris type I fracture, through magnetic resonance imaging findings.

  12. Post coital penile ring entrapment: A report of a non-surgical extrication method

    Directory of Open Access Journals (Sweden)

    Agu Thaddeus Chika

    2016-01-01

    Full Text Available This case report shows how a simple but painstaking method of milking and levering in a slippery field was used to remove a thick metallic ring entrapped at the root of the penis after sexual intercourse. A ring can be removed easily from an organ if the inter-phase is made slippery. However this must be weighed against the handling difficulties posed by a wet slippery surface. With perseverance and the use of unconventional instrument, the ring was successfully extricated as a day case and without a surgical incision.

  13. Publication Voting Power (PVP): method of finding Evidence-Support

    African Journals Online (AJOL)

    Background: Extracting the best evidence that support a procedure is a difficult, time consuming task that needs expert statistical knowledge. A way to make weighting evidence more simple and straight for busy clinicians is needed. Methods: The publications about the procedure under question are lined in an ascending ...

  14. Research on Language Learning Strategies: Methods, Findings, and Instructional Issues.

    Science.gov (United States)

    Oxford, Rebecca; Crookall, David

    1989-01-01

    Surveys research on formal and informal second-language learning strategies, covering the effectiveness of research methods involving making lists, interviews and thinking aloud, note-taking, diaries, surveys, and training. Suggestions for future and improved research are presented. (131 references) (CB)

  15. Functional Imaging of Autonomic Regulation: Methods and Key Findings

    Directory of Open Access Journals (Sweden)

    Paul M Macey

    2016-01-01

    Full Text Available Central nervous system processing of autonomic function involves a network of regions throughout the brain which can be visualized and measured with neuroimaging techniques, notably functional magnetic resonance imaging (fMRI. The development of fMRI procedures has both confirmed and extended earlier findings from animal models, and human stroke and lesion studies. Assessments with fMRI can elucidate interactions between different central sites in regulating normal autonomic patterning, and demonstrate how disturbed systems can interact to produce aberrant regulation during autonomic challenges. Understanding autonomic dysfunction in various illnesses reveals mechanisms that potentially lead to interventions in the impairments. The objectives here are to: 1 describe the fMRI neuroimaging methodology for assessment of autonomic neural control, 2 outline the widespread, lateralized distribution of function in autonomic sites in the normal brain which includes structures from the neocortex through the medulla and cerebellum, 3 illustrate the importance of the time course of neural changes when coordinating responses, and how those patterns are impacted in conditions of sleep-disordered breathing, and 4 highlight opportunities for future research studies with emerging methodologies. Methodological considerations specific to autonomic testing include timing of challenges relative to the underlying fMRI signal, spatial resolution sufficient to identify autonomic brainstem nuclei, blood pressure and blood oxygenation influences on the fMRI signal, and the sustained timing, often measured in minutes of challenge periods and recovery. Key findings include the lateralized nature of autonomic organization, which is reminiscent of asymmetric motor, sensory and language pathways. Testing brain function during autonomic challenges demonstrate closely-integrated timing of responses in connected brain areas during autonomic challenges, and the involvement with

  16. Method to Find Recovery Event Combinations in Probabilistic Safety Assessment

    International Nuclear Information System (INIS)

    Jung, Woo Sik; Riley, Jeff

    2016-01-01

    These research activities may develop mathematical methods, engineering analyses, and business processes. The research activities of the project covered by this scope are directed toward the specific issues of implementing the methods and strategies on a computational platform, identifying the features and enhancements to EPRI tools that would be necessary to realize significant improvements to the risk assessments performed by the end user. Fault tree analysis is extensively and successfully applied to the risk assessment of safety-critical systems such as nuclear, chemical and aerospace systems. The fault tree analysis is being used together with an event tree analysis in PSA of nuclear power plants. Fault tree solvers for a PSA are mostly based on the cutset-based algorithm. They generate minimal cut sets (MCSs) from a fault tree. The most popular fault tree solver in the PSA industry is FTREX. During the course of this project, certain technical issues (see Sections 2 to 5) have been identified that need to be addressed regarding how minimal cut sets are generated and quantified. The objective of this scope of the work was to develop new methods or techniques to address these technical limitations. By turning on all the cutset initiators (%1, %2, %3, %), all the possible minimal cut sets can be calculated easier than with the original fault tree. It is accomplished by the fact that the number of events in the minimal cut sets are significantly reduced by using cutset initiators instead of random failure events. And byy turning on a few chosen cutset initiators and turning off the other cutset initiators, minimal cut sets of the selected cutset initiator(s) can be easily calculated. As explained in the previous Sections, there is no way to calculate these minimal cut sets by turning off/on the random failure events in the original fault tree

  17. Method to Find Recovery Event Combinations in Probabilistic Safety Assessment

    Energy Technology Data Exchange (ETDEWEB)

    Jung, Woo Sik [Sejong University, Seoul (Korea, Republic of); Riley, Jeff [Electric Power Research, Palo Alto (United States)

    2016-05-15

    These research activities may develop mathematical methods, engineering analyses, and business processes. The research activities of the project covered by this scope are directed toward the specific issues of implementing the methods and strategies on a computational platform, identifying the features and enhancements to EPRI tools that would be necessary to realize significant improvements to the risk assessments performed by the end user. Fault tree analysis is extensively and successfully applied to the risk assessment of safety-critical systems such as nuclear, chemical and aerospace systems. The fault tree analysis is being used together with an event tree analysis in PSA of nuclear power plants. Fault tree solvers for a PSA are mostly based on the cutset-based algorithm. They generate minimal cut sets (MCSs) from a fault tree. The most popular fault tree solver in the PSA industry is FTREX. During the course of this project, certain technical issues (see Sections 2 to 5) have been identified that need to be addressed regarding how minimal cut sets are generated and quantified. The objective of this scope of the work was to develop new methods or techniques to address these technical limitations. By turning on all the cutset initiators (%1, %2, %3, %), all the possible minimal cut sets can be calculated easier than with the original fault tree. It is accomplished by the fact that the number of events in the minimal cut sets are significantly reduced by using cutset initiators instead of random failure events. And byy turning on a few chosen cutset initiators and turning off the other cutset initiators, minimal cut sets of the selected cutset initiator(s) can be easily calculated. As explained in the previous Sections, there is no way to calculate these minimal cut sets by turning off/on the random failure events in the original fault tree.

  18. Findings from analysing and quantifying human error using current methods

    International Nuclear Information System (INIS)

    Dang, V.N.; Reer, B.

    1999-01-01

    In human reliability analysis (HRA), the scarcity of data means that, at best, judgement must be applied to transfer to the domain of the analysis what data are available for similar tasks. In particular for the quantification of tasks involving decisions, the analyst has to choose among quantification approaches that all depend to a significant degree on expert judgement. The use of expert judgement can be made more reliable by eliciting relative judgements rather than absolute judgements. These approaches, which are based on multiple criterion decision theory, focus on ranking the tasks to be analysed by difficulty. While these approaches remedy at least partially the poor performance of experts in the estimation of probabilities, they nevertheless require the calibration of the relative scale on which the actions are ranked in order to obtain the probabilities of interest. This paper presents some results from a comparison of some current HRA methods performed in the frame of a study of SLIM calibration options. The HRA quantification methods THERP, HEART, and INTENT were applied to derive calibration human error probabilities for two groups of operator actions. (author)

  19. Assessing Backwards Integration as a Method of KBO Family Finding

    Science.gov (United States)

    Benfell, Nathan; Ragozzine, Darin

    2018-04-01

    The age of young asteroid collisional families can sometimes be determined by using backwards n-body integrations of the solar system. This method is not used for discovering young asteroid families and is limited by the unpredictable influence of the Yarkovsky effect on individual specific asteroids over time. Since these limitations are not as important for objects in the Kuiper belt, Marcus et al. 2011 suggested that backwards integration could be used to discover and characterize collisional families in the outer solar system. But various challenges present themselves when running precise and accurate 4+ Gyr integrations of Kuiper Belt objects. We have created simulated families of Kuiper Belt Objects with identical starting locations and velocity distributions, based on the Haumea Family. We then ran several long-term test integrations to observe the effect of various simulation parameters on integration results. These integrations were then used to investigate which parameters are of enough significance to require inclusion in the integration. Thereby we determined how to construct long-term integrations that both yield significant results and require manageable processing power. Additionally, we have tested the use of backwards integration as a method of discovery of potential young families in the Kuiper Belt.

  20. [Neck lymphatic metastasis, surgical methods and prognosis in early tongue squamous cell carcinoma].

    Science.gov (United States)

    Wang, L S; Zhou, F T; Han, C B; He, X P; Zhang, Z X

    2018-02-09

    Objective: To investigate the different pattern of neck lymph node metastasis, the choice of surgical methods and prognosis in early tongue squamous cell carcinoma. Methods: A total of 157 patients with early oral tongue squamous cell carcinoma were included in this study. Statistical analysis was performed to identify the pattern of lymph node metastasis, to determine the best surgical procedure and to analyze the prognosis. Results: The occurrence of cervical lymph node metastasis rate was 31%(48/157). Neck lymphatic metastasis was significantly related to tumor size ( P= 0.026) and histology differentiation type ( P= 0.022). The rate of metastasis was highest in level Ⅱ [33% (16/48)]. In level Ⅳ, the incidence of lymph node metastasis was 5%(7/157), and there was no skip metastases. The possibility of level Ⅳ metastasis was higher, when level Ⅱ ( P= 0.000) or Ⅲ ( P= 0.000) involved. The differentiation tumor recurrence, neck lymphatic metastasis and adjuvant radiotherapy were prognostic factors ( Psquamous cell carcinoma, simultaneous glossectomy and neck dissection should be performed. Level Ⅳ metastasis rate is extremely low, so supraomohyoid neck dissection is sufficient for most of the time. The histology differentiation type, neck lymphatic metastasis and adjuvant radiotherapy are independent prognostic factors.

  1. A method for establishing human primary gastric epithelial cell culture from fresh surgical gastric tissues.

    Science.gov (United States)

    Aziz, Faisal; Yang, Xuesong; Wen, Qingping; Yan, Qiu

    2015-08-01

    At present, biopsy specimens, cancer cell lines and tissues obtained by gastric surgery are used in the study and analysis of gastric cancer, including the molecular mechanisms and proteomics. However, fibroblasts and other tissue components may interfere with these techniques. Therefore, the present study aimed to develop a procedure for the isolation of viable human gastric epithelial cells from gastric surgical tissues. A method was developed to culture human gastric epithelial cells using fresh, surgically excised tissues and was evaluated using immunocytochemistry, periodic acid-Schiff (PAS) staining and cell viability assays. Low cell growth was observed surrounding the gastric tissue on the seventh day of tissue explant culture. Cell growth subsequently increased, and at 12 days post-explant a high number of pure epithelial cells were detected. The gastric cancer cells exhibited rapid growth with a doubling time of 13-52 h, as compared to normal cells, which had a doubling time of 20-53 h. Immunocytochemical analyses of primary gastric cells revealed positive staining for cytokeratin 18 and 19, which indicated that the culture was comprised of pure epithelial cells and contained no fibroblasts. Furthermore, PAS staining demonstrated that the cultured gastric cells produced neutral mucin. Granulin and carbohydrate antigen 724 staining confirmed the purity of gastric cancer and normal cells in culture. This method of cell culture indicated that the gastric cells in primary culture consisted of mucin-secreting gastric epithelial cells, which may be useful for the study of gastric infection with Helicobacter pylori and gastric cancer.

  2. Our findings, my method: Framing science in televised interviews.

    Science.gov (United States)

    Armon, Rony; Baram-Tsabari, Ayelet

    2017-11-01

    The public communication of science and technology largely depends on their framing in the news media, but scientists' role in this process has only been explored indirectly. This study focuses on storied accounts told by scientists when asked to present their research or provide expert advice in the course of a news interview. A total of 150 items from a current affairs talk show broadcast in the Israeli media were explored through a methodology combining narrative and conversation analysis. Using the concept of framing as originally proposed by Erving Goffman, we show that researchers use personal accounts as a way of reframing news stories introduced by the program hosts. Elements of method and rationale, which are usually considered technical and are shunned in journalistic reports, emerged as a crucial element in the accounts that experts themselves provided. The implications for framing research and science communication training are discussed.

  3. Finding Similarities in Ancient Ceramics by EDXRF and Multivariate Methods

    International Nuclear Information System (INIS)

    Civici, N.; Stamati, F.

    1999-01-01

    We have studied 39 samples of fragments from ceramic roof tiles with different stamps(Diamalas and Heraion), dated between 330 to 170 BC and found at the archaeological site of Dimales, some 30 km from the Adriatic coast. The data from these samples were compared with those obtained from 7 samples of similar objects and period with the stamp H eraion , found at the archaeological site of APOLLONIA. The samples were analyzed by energy-dispersive X -ray fluorescence(EDXRF), using of the x-ray lines of the elements to the intensity of the Compton peak. The results have been treated with diverse multivariate methods. The application of hierarchical cluster analysis and factor analysis permitted the identification of two main clusters. The first cluster is composed from the ''Heraion'' samples discovered in Apollonia, while the second comprises all the samples discovered in Dimale independent of their stamp. (authors)

  4. Effectiveness of various surgical methods in treatment of Hirschsprung’s disease in children

    Directory of Open Access Journals (Sweden)

    Lukač Marija

    2016-01-01

    Full Text Available Background/Aim. Hirschsprung’s disease is the most common identifiable developmental disorder of the enteric nervous system, characterized by a failure of its formation in a variable segment of distal bowel. Currently available surgical therapies for Hirschsprung’s disease, although lifesaving, are associated with numerous complications. The aim of our study was to evaluate the effectiveness of different surgical methods and the incidence of serious complications after radical surgery of rectosigmoid Hirschsprung’s disease. Methods. A retrospective analysis, from June 1997 until May 2012 was carried out on 84 patients operated for Hirschsprung’s disease of rectosigmoid colon. Transanal endorectal pull-through was performed in 30 (35.7% patients (group I, while 54 (64.3% patients were operated by other (Soave, Duhamel or Swenson procedures (group II. The age at operation, the incidence and severity of postoperative complications, the need for previous colostomy and the number of reoperations are countered in order to evaluate the efficacy of surgical procedures. Results. In the group I, the mean age at operation was 9.41 ± 6.37 months and in the group II the mean age at operation was 16.8 ± 13.9 months which was significantly higher (p < 0.01. In the group I there were only 3 (10% patients with complications, one (3% of them was prone to only one redo procedure (1.00 ± 0.00 and there was no need for previous colostomy in all patients (100%. In the group II there were 16 (30% patients with significantly frequent complications (p < 0.05, about 2 reoperations on the average (1.94 ± 1.84 in 4 of them (25% and 22 (41% redo procedures, which was, in total, significantly higher than in the group I (p < 0.01. Only Soave’s procedure was performed without previous colostomy in 20 (37% patients. Conclusion. Transanal endorectal pull-through in surgical treatment of patients with Hirschsprung’s disease is more effective than other procedures

  5. Planning Pharmacies: An Operational Method to Find the Best Location

    Directory of Open Access Journals (Sweden)

    Simona Tondelli

    2014-05-01

    Full Text Available The theme of the spatial distribution of the pharmacies on the territory is closely connected to urban planning and to services supply. In Italy, the regulatory change that took place in 2012, triggered partly by the need to adhere more to a constantly changing economic system, has led to a revision of the existing situation, consisting both on the method to quantify the pharmacies distribution and on the efficiency of the service. If Law 27/2012 has effectively allowed municipalities to increase the number of pharmacies that they can settle on the municipal territory, it has also started a process of rethinking the logic of pharmacies location and of their catchment areas. In this framework, the present paper aims to discuss the merits of a regulatory evolutions that sparked the process of liberalization of locations, integrating the law guidelines and goals with an operating logic process, usable and useful to translate goals into planning actions in a continuous dialogue between law and territory, constraints and opportunities, equity and accessibility of the care services. Following this logic operations, we have investigated the urban context of Castelfranco Emilia, assuming the location of new offices on the basis of pharmaceutical analyzes.

  6. Onychomycosis: Clinical findings, etiological agents and evaluation of laboratory methods

    Directory of Open Access Journals (Sweden)

    Dubljanin Eleonora

    2014-01-01

    Full Text Available The aim of this study was to identify the etiological agents in patients with suspected onychomycosis, and to carry out comparative testing of individual or combinations of tests: direct microscopy with KOH and Blankophor (BP, culturing on Sabouraud’s dextrose agar (SDA, diluted Sabouraud’s dextrose agar (D-SDA and dermatophyte test medium (DTM. From 70 nail samples (65 toenails, 5 fingernails, 46 (60.5% had at least one of five positive tests. Isolation was possible in 41, while in 5 samples the presence of fungi was observed by KOH and/or BP. Dermatophytes were most frequently isolated (80.5% where Trichophyton rubrum was predominant. Candida spp. was isolated in 9.8%, Aspergillus spp. 4.9%, Alternaria spp. 2.4% and Fusarium spp. 2.4%. Application of BP as an individual test was the most sensitive method. The combination of BP with DTM or D-SDA provides the best sensitivity and allows the identification of fungi to the species/genus level.

  7. Saturated salt solution method: a useful cadaver embalming for surgical skills training.

    Science.gov (United States)

    Hayashi, Shogo; Homma, Hiroshi; Naito, Munekazu; Oda, Jun; Nishiyama, Takahisa; Kawamoto, Atsuo; Kawata, Shinichi; Sato, Norio; Fukuhara, Tomomi; Taguchi, Hirokazu; Mashiko, Kazuki; Azuhata, Takeo; Ito, Masayuki; Kawai, Kentaro; Suzuki, Tomoya; Nishizawa, Yuji; Araki, Jun; Matsuno, Naoto; Shirai, Takayuki; Qu, Ning; Hatayama, Naoyuki; Hirai, Shuichi; Fukui, Hidekimi; Ohseto, Kiyoshige; Yukioka, Tetsuo; Itoh, Masahiro

    2014-12-01

    This article evaluates the suitability of cadavers embalmed by the saturated salt solution (SSS) method for surgical skills training (SST). SST courses using cadavers have been performed to advance a surgeon's techniques without any risk to patients. One important factor for improving SST is the suitability of specimens, which depends on the embalming method. In addition, the infectious risk and cost involved in using cadavers are problems that need to be solved. Six cadavers were embalmed by 3 methods: formalin solution, Thiel solution (TS), and SSS methods. Bacterial and fungal culture tests and measurement of ranges of motion were conducted for each cadaver. Fourteen surgeons evaluated the 3 embalming methods and 9 SST instructors (7 trauma surgeons and 2 orthopedists) operated the cadavers by 21 procedures. In addition, ultrasonography, central venous catheterization, and incision with cauterization followed by autosuture stapling were performed in some cadavers. The SSS method had a sufficient antibiotic effect and produced cadavers with flexible joints and a high tissue quality suitable for SST. The surgeons evaluated the cadavers embalmed by the SSS method to be highly equal to those embalmed by the TS method. Ultrasound images were clear in the cadavers embalmed by both the methods. Central venous catheterization could be performed in a cadaver embalmed by the SSS method and then be affirmed by x-ray. Lungs and intestines could be incised with cauterization and autosuture stapling in the cadavers embalmed by TS and SSS methods. Cadavers embalmed by the SSS method are sufficiently useful for SST. This method is simple, carries a low infectious risk, and is relatively of low cost, enabling a wider use of cadavers for SST.

  8. Methods for Finding Legacy Wells in Residential and Commercial Areas

    Energy Technology Data Exchange (ETDEWEB)

    Hammack, Richard W. [National Energy Technology Lab. (NETL), Pittsburgh, PA, (United States); Veloski, Garret A. [National Energy Technology Lab. (NETL), Pittsburgh, PA, (United States)

    2016-06-16

    In 1919, the enthusiasm surrounding a short-lived gas play in Versailles Borough, Pennsylvania resulted in the drilling of many needless wells. The legacy of this activity exists today in the form of abandoned, unplugged gas wells that are a continuing source of fugitive methane in the midst of a residential and commercial area. Flammable concentrations of methane have been detected near building foundations, which have forced people from their homes and businesses until methane concentrations decreased. Despite mitigation efforts, methane problems persist and have caused some buildings to be permanently abandoned and demolished. This paper describes the use of magnetic and methane sensing methods by the National Energy Technology Laboratory (NETL) to locate abandoned gas wells in Versailles Borough where site access is limited and existing infrastructure can interfere. Here, wells are located between closely spaced houses and beneath buildings and parking lots. Wells are seldom visible, often because wellheads and internal casing strings have been removed, and external casing has been cut off below ground level. The magnetic survey of Versailles Borough identified 53 strong, monopole magnetic anomalies that are presumed to indicate the locations of steel-cased wells. This hypothesis was tested by excavating the location of one strong, monopole magnetic anomaly that was within an area of anomalous methane concentrations. The excavation uncovered an unplugged gas well that was within 0.2 m of the location of the maximum magnetic signal. Truck-mounted methane surveys of Versailles Borough detected numerous methane anomalies that were useful for narrowing search areas. Methane sources identified during truck-mounted surveys included strong methane sources such as sewers and methane mitigation vents. However, inconsistent wind direction and speed, especially between buildings, made locating weaker methane sources (such as leaking wells) difficult. Walking surveys with

  9. A broadly applicable surgical teaching method: evaluation of a stepwise introduction to cataract surgery.

    Science.gov (United States)

    Kloek, Carolyn E; Borboli-Gerogiannis, Sheila; Chang, Kenneth; Kuperwaser, Mark; Newman, Lori R; Lane, Anne Marie; Loewenstein, John I

    2014-01-01

    Although cataract surgery is one of the most commonly performed surgeries in the country, it is a microsurgical procedure that is difficult to learn and to teach. This study aims to assess the effectiveness of a new method for introducing postgraduate year (PGY)-3 ophthalmology residents to cataract surgery. Hospital-based ophthalmology residency program. Retrospective cohort study. PGY-3 and PGY-4 residents of the Harvard Medical School Ophthalmology Residency from graduating years 2010 to 2012. In July 2009, a new method of teaching PGY-3 ophthalmology residents cataract surgery was introduced, which was termed "the stepwise introduction to cataract surgery." This curriculum aimed to train residents to perform steps of cataract surgery by deliberately practicing each of the steps of surgery under a structured curriculum with faculty feedback. Assessment methods included surveys administered to the PGY-4 residents who graduated before the implementation of these measures (n = 7), the residents who participated in the first and second years of the new curriculum (n = 16), faculty who teach PGY-4 residents cataract surgery (n = 8), and review of resident Accreditation Council for Graduate Medical Education surgical logs. Resident survey response rate was 100%. Residents who participated in the new curriculum performed more of each step of cataract surgery in the operating room, spent more time practicing each step of cataract surgery on a cataract surgery simulator during the PGY-3 year, and performed more primary cataract surgeries during the PGY-3 year than those who did not. Faculty survey response rate was 63%. Faculty noted an increase in resident preparedness following implementation of the new curriculum. There was no statistical difference between the precurriculum and postcurriculum groups in the percentage turnover of cataracts for the first 2 cataract surgery rotations of the PGY-4 year of training. The introduction of cataract surgery to PGY-3 residents

  10. Truth in Reporting: How Data Capture Methods Obfuscate Actual Surgical Site Infection Rates within a Health Care Network System.

    Science.gov (United States)

    Bordeianou, Liliana; Cauley, Christy E; Antonelli, Donna; Bird, Sarah; Rattner, David; Hutter, Matthew; Mahmood, Sadiqa; Schnipper, Deborah; Rubin, Marc; Bleday, Ronald; Kenney, Pardon; Berger, David

    2017-01-01

    Two systems measure surgical site infection rates following colorectal surgeries: the American College of Surgeons National Surgical Quality Improvement Program and the Centers for Disease Control and Prevention National Healthcare Safety Network. The Centers for Medicare & Medicaid Services pay-for-performance initiatives use National Healthcare Safety Network data for hospital comparisons. This study aimed to compare database concordance. This is a multi-institution cohort study of systemwide Colorectal Surgery Collaborative. The National Surgical Quality Improvement Program requires rigorous, standardized data capture techniques; National Healthcare Safety Network allows 5 data capture techniques. Standardized surgical site infection rates were compared between databases. The Cohen κ-coefficient was calculated. This study was conducted at Boston-area hospitals. National Healthcare Safety Network or National Surgical Quality Improvement Program patients undergoing colorectal surgery were included. Standardized surgical site infection rates were the primary outcomes of interest. Thirty-day surgical site infection rates of 3547 (National Surgical Quality Improvement Program) vs 5179 (National Healthcare Safety Network) colorectal procedures (2012-2014). Discrepancies appeared: National Surgical Quality Improvement Program database of hospital 1 (N = 1480 patients) routinely found surgical site infection rates of approximately 10%, routinely deemed rate "exemplary" or "as expected" (100%). National Healthcare Safety Network data from the same hospital and time period (N = 1881) revealed a similar overall surgical site infection rate (10%), but standardized rates were deemed "worse than national average" 80% of the time. Overall, hospitals using less rigorous capture methods had improved surgical site infection rates for National Healthcare Safety Network compared with standardized National Surgical Quality Improvement Program reports. The correlation coefficient

  11. Descriptive analysis of sonographic findings, surgical and pathological in patients with acute appendicitis in the Hospital San Juan de Dios in the year 2010

    International Nuclear Information System (INIS)

    Murillo Arguello, Fabiola

    2012-01-01

    The Hospital San Juan de Dios has found without studies correlating the ultrasound findings, with the pathology of acute appendicitis by surgery and histological analysis, especially that meets in the same study the utility of ultrasound in the diagnosis. For that reason, the ultrasonographic findings, pathological and surgical of patients with appendiceal pathology are described in the Servicio de Radiologia of Hospital San Juan de Dios in the year 2010. A revision of 324 dossiers in patients with positive biopsy is performed; however, 23% have result without alterations by ultrasound. The female sex has obtained the largest number of diagnosis by ultrasound. The age group for both sexes is found between 21-30 years. The most common transoperative finding has been grade I appendicitis and no perforated appendicitis have prevailed regarding biopsies reported in the pathology service. The validity of ultrasonography is determined to aid in decision making in pathology of acute appendicitis in the emergency room and avoid or reduce complications that can lead a diagnostic doubt, this will inform the surgeon the possible findings when the surgical intervention. Additionally, the diagnosis of acute appendicitis may be discarded when are encountered other pathologies such as ovarian cysts, kidney stones, among others, avoiding unnecessary surgeries. The costs to the institution are reduced by decreasing the hospital stay and the use of operating rooms [es

  12. Three-dimensional vision enhances task performance independently of the surgical method.

    Science.gov (United States)

    Wagner, O J; Hagen, M; Kurmann, A; Horgan, S; Candinas, D; Vorburger, S A

    2012-10-01

    Within the next few years, the medical industry will launch increasingly affordable three-dimensional (3D) vision systems for the operating room (OR). This study aimed to evaluate the effect of two-dimensional (2D) and 3D visualization on surgical skills and task performance. In this study, 34 individuals with varying laparoscopic experience (18 inexperienced individuals) performed three tasks to test spatial relationships, grasping and positioning, dexterity, precision, and hand-eye and hand-hand coordination. Each task was performed in 3D using binocular vision for open performance, the Viking 3Di Vision System for laparoscopic performance, and the DaVinci robotic system. The same tasks were repeated in 2D using an eye patch for monocular vision, conventional laparoscopy, and the DaVinci robotic system. Loss of 3D vision significantly increased the perceived difficulty of a task and the time required to perform it, independently of the approach (P robot than with laparoscopy (P = 0.005). In every case, 3D robotic performance was superior to conventional laparoscopy (2D) (P < 0.001-0.015). The more complex the task, the more 3D vision accelerates task completion compared with 2D vision. The gain in task performance is independent of the surgical method.

  13. Observed Differences between Males and Females in Surgically Treated Carpal Tunnel Syndrome Among Non-manual Workers: A Sensitivity Analysis of Findings from a Large Population Study

    Science.gov (United States)

    Farioli, Andrea; Curti, Stefania; Bonfiglioli, Roberta; Baldasseroni, Alberto; Spatari, Giovanna; Mattioli, Stefano; Violante, Francesco Saverio

    2018-01-01

    Abstract Objectives We aimed at assessing whether differences among males and females in carpal tunnel syndrome (CTS) epidemiology might be attributable to segregation with respect to occupational biomechanical exposures or differential access to care by sex. Methods We analysed surgically treated cases of CTS occurring among non-manual workers in Tuscany between 1997 and 2000. We conducted a Monte Carlo simulation to estimate the difference in occupational biomechanical exposures between males and females necessary to explain the observed incidence rate ratios. We also accounted for the sex-specific probability of receiving surgery after the diagnosis of CTS, as women were reported to be more likely to undergo surgery in a subset of our study population. We quantified the hypothetical biomechanical overload through the hand activity level (HAL) metric proposed by the American Conference of Governmental Industrial Hygienists. To quantify the effect of HAL on CTS risk, we assumed a prior distribution based on findings from two large cohort studies of industrial workers. Results After adjustment for the probability of receiving surgery, women showed a 4-fold incidence of CTS as compared with men. To explain this association among non-manual workers, women should have an average value of HAL at least 5 points higher. Conclusions Our analysis does not support the hypothesis that the difference in CTS incidence between males and females is entirely attributable to occupational risk factors or to differential access to surgery. The causal pathway between sex and CTS might include more determinants such as hormonal factors, anthropometric characteristics, and non-occupational exposure to biomechanical overload (e.g. household tasks). PMID:29579135

  14. Anterolateral Approach for Central Thoracic Disc Prolapse-Surgical Strategies Used to Tackle Differing Operative Findings: 3-Dimensional Operative Video.

    Science.gov (United States)

    Patel, Krunal; Budohoski, Karol P; Kenyon, Olivia R P; Barone, Damiano G; Santarius, Thomas; Kirollos, Ramez W; Mannion, Richard J; Trivedi, Rikin A

    2018-04-02

    Thoracic disc prolapses causing cord compression can be challenging. For compressive central disc protrusions, a posterior approach is not suitable due to an unacceptable level of cord manipulation. An anterolateral transthoracic approach provides direct access to the disc prolapse allowing for decompression without disturbing the spinal cord. In this video, we describe 2 cases of thoracic myelopathy from a compressive central thoracic disc prolapse. In both cases, informed consent was obtained. Despite similar radiological appearances of heavy calcification, intraoperatively significant differences can be encountered. We demonstrate different surgical strategies depending on the consistency of the disc and the adherence to the thecal sac. With adequate exposure and detachment from adjacent vertebral bodies, soft discs can be, in most instances, separated from the theca with minimal cord manipulation. On the other hand, largely calcified discs often present a significantly greater challenge and require thinning the disc capsule before removal. In cases with significant adherence to dura, in order to prevent cord injury or cerebrospinal fluid leak a thinned shell can be left, providing total detachment from adjacent vertebrae can be achieved. Postoperatively, the first patient, with a significantly calcified disc, developed a transient left leg weakness which recovered by 3-month follow-up. This video outlines the anatomical considerations and operative steps for a transthoracic approach to a central disc prolapse, whilst demonstrating that computed tomography appearances are not always indicative of potential operative difficulties.

  15. Four-dimensional CT angiography (4D-CTA) in the evaluation of juvenile nasopharyngeal angiofibromas: comparison with digital subtraction angiography (DSA) and surgical findings.

    Science.gov (United States)

    Xiao, Zebin; Zheng, Yingyan; Li, Jian; Chen, Dehua; Liu, Fang; Cao, Dairong

    2017-12-01

    To explore the value of four-dimensional CT angiography (4D-CTA) in the preoperative evaluation of juvenile nasopharyngeal angiofibromas (JNAs) using 320-row volume CT. 4D-CTA and DSA data of 18 patients with histopathologically proven JNAs were retrospectively reviewed. The location, extent, feeding vessels and stage of JNAs were assessed by two radiologists independently and blindly. The agreements between both reviewers and between 4D-CTA and surgical findings for assessing the above indicators were analysed, respectively. The radiation dose and the number of feeding arteries between 4D-CTA and digital subtraction angiography (DSA) were also compared. 4D-CTA showed high diagnostic consistency with surgical pathology for JNAs with consistent rates of 96.2 and 100% in both reviewers, respectively. The effective dose of 4D-CTA was significantly less than that of DSA (p 0.05). 4D-CTA can provide a reliable preoperative diagnosis and assessment of JNAs, which is useful for determining the surgical strategy and management of this condition.

  16. [Surgical methods for delivery in modern obstetrics and their influence on maternal and infant health].

    Science.gov (United States)

    Kokhanevych, Ie V; Mitsoda, R M; Konoplianko, T V; Konoplianko, V V

    2000-03-01

    The article addresses issues of comparative characterization of deliveries involving surgery and impact thereof on the health of the mother and her child. Risk factors are identified that the mother and her child run in sectio cesarea, in application of obstetrical forceps, and in vacuum-extraction of the fetus. Cesarean section was found out to be the most acceptable mode of delivery in origination of organic and functional nervous system involvement in children but the most ill-chosen and unpropitious one in the mother, especially so in those groups at risk for bleeding, septic complications, and genital endometriosis. Among those surgical methods of delivery being the least traumatic to the mother are obstetrical forceps and vacuum-extraction of the fetus.

  17. Artificial aortic valve dysfunction due to pannus and thrombus – different methods of cardiac surgical management

    Science.gov (United States)

    Marcinkiewicz, Anna; Kośmider, Anna; Walczak, Andrzej; Zwoliński, Radosław; Jaszewski, Ryszard

    2015-01-01

    . Conclusions Precise and modern diagnostic methods facilitated selection of the treatment method. However, the intraoperative view also seems to be crucial in individualizing the surgical approach. PMID:26702274

  18. Artificial aortic valve dysfunction due to pannus and thrombus - different methods of cardiac surgical management.

    Science.gov (United States)

    Ostrowski, Stanisław; Marcinkiewicz, Anna; Kośmider, Anna; Walczak, Andrzej; Zwoliński, Radosław; Jaszewski, Ryszard

    2015-09-01

    Approximately 60 000 prosthetic valves are implanted annually in the USA. The risk of prosthesis dysfunction ranges from 0.1% to 4% per year. Prosthesis valve dysfunction is usually caused by a thrombus obstructing the prosthetic discs. However, 10% of prosthetic valves are dysfunctional due to pannus formation, and 12% of prostheses are damaged by both fibrinous and thrombotic components. The authors present two patients with dysfunctional aortic prostheses who were referred for cardiac surgery. Different surgical solutions were used in the treatment of each case. The first patient was a 71-year-old woman whose medical history included arterial hypertension, stable coronary artery disease, diabetes mellitus, chronic obstructive pulmonary disease (COPD), and hypercholesterolemia; she had previously undergone left-sided mastectomy and radiotherapy. The patient was admitted to the Cardiac Surgery Department due to aortic prosthesis dysfunction. Transthoracic echocardiography revealed complete obstruction of one disc and a severe reduction in the mobility of the second. The mean transvalvular gradient was very high. During the operation, pannus covering the discs' surface was found. A biological aortic prosthesis was reimplanted without complications. The second patient was an 87-year-old woman with arterial hypertension, persistent atrial fibrillation, and COPD, whose past medical history included gastric ulcer disease and ischemic stroke. As in the case of the first patient, she was admitted due to valvular prosthesis dysfunction. Preoperative transthoracic echocardiography revealed an obstruction of the posterior prosthetic disc and significant aortic regurgitation. Transesophageal echocardiography and fluoroscopy confirmed the prosthetic dysfunction. During the operation, a thrombus growing around a minor pannus was found. The thrombus and pannus were removed, and normal functionality of the prosthetic valve was restored. Precise and modern diagnostic methods

  19. A review of surgical methods (excluding hair transplantation and their role in hair loss management today

    Directory of Open Access Journals (Sweden)

    Sandeep S Sattur

    2011-01-01

    Full Text Available There is more than one way to manage hair loss surgically. Apart from hair transplantation, there are other techniques which have been used by many to treat baldness. This article attempts to review the surgical methodology and philosophy that have acted as guiding lights in the approach to surgical treatment of baldness over the years and reviews the current role of other techniques in the armamentarium of hair restoration surgeons today.

  20. Why do patients decline surgical trials? Findings from a qualitative interview study embedded in the Cancer Research UK BOLERO trial (Bladder cancer: Open versus Lapararoscopic or RObotic cystectomy).

    Science.gov (United States)

    Harrop, Emily; Kelly, John; Griffiths, Gareth; Casbard, Angela; Nelson, Annmarie

    2016-01-19

    Surgical trials have typically experienced recruitment difficulties when compared with other types of oncology trials. Qualitative studies have an important role to play in exploring reasons for low recruitment, although to date few such studies have been carried out that are embedded in surgical trials. The BOLERO trial (Bladder cancer: Open versus Lapararoscopic or RObotic cystectomy) is a study to determine the feasibility of randomisation to open versus laparoscopic access/robotic cystectomy in patients with bladder cancer. We describe the results of a qualitative study embedded within the clinical trial that explored why patients decline randomisation. Ten semi-structured interviews with patients who declined randomisation to the clinical trial, and two interviews with recruiting research nurses were conducted. Data were analysed for key themes. The majority of patients declined the trial because they had preferences for a particular treatment arm, and in usual practice could choose which surgical method they would be given. In most cases the robotic option was preferred. Patients described an intuitive 'sense' that favoured the new technology and had carried out their own inquiries, including Internet research and talking with previous patients and friends and family with medical backgrounds. Medical histories and lifestyle considerations also shaped these personalised choices. Of importance too, however, were the messages patients perceived from their clinical encounters. Whilst some patients felt their surgeon favoured the robotic option, others interpreted 'indirect' cues such as the 'established' reputation of the surgeon and surgical method and comments made during clinical assessments. Many patients expressed a wish for greater direction from their surgeon when making these decisions. For trials where the 'new technology' is available to patients, there will likely be difficulties with recruitment. Greater attention could be paid to how messages about

  1. History and future of human cadaver preservation for surgical training: from formalin to saturated salt solution method.

    Science.gov (United States)

    Hayashi, Shogo; Naito, Munekazu; Kawata, Shinichi; Qu, Ning; Hatayama, Naoyuki; Hirai, Shuichi; Itoh, Masahiro

    2016-01-01

    Traditionally, surgical training meant on-the-job training with live patients in an operating room. However, due to advancing surgical techniques, such as minimally invasive surgery, and increasing safety demands during procedures, human cadavers have been used for surgical training. When considering the use of human cadavers for surgical training, one of the most important factors is their preservation. In this review, we summarize four preservation methods: fresh-frozen cadaver, formalin, Thiel's, and saturated salt solution methods. Fresh-frozen cadaver is currently the model that is closest to reality, but it also presents myriad problems, including the requirement of freezers for storage, limited work time because of rapid putrefaction, and risk of infection. Formalin is still used ubiquitously due to its low cost and wide availability, but it is not ideal because formaldehyde has an adverse health effect and formalin-embalmed cadavers do not exhibit many of the qualities of living organs. Thiel's method results in soft and flexible cadavers with almost natural colors, and Thiel-embalmed cadavers have been appraised widely in various medical disciplines. However, Thiel's method is relatively expensive and technically complicated. In addition, Thiel-embalmed cadavers have a limited dissection time. The saturated salt solution method is simple, carries a low risk of infection, and is relatively low cost. Although more research is needed, this method seems to be sufficiently useful for surgical training and has noteworthy features that expand the capability of clinical training. The saturated salt solution method will contribute to a wider use of cadavers for surgical training.

  2. Long-standing morel-lavallee lesion in the proximal thigh: ultrasound and MR findings with surgical and histopathological correlation

    International Nuclear Information System (INIS)

    Puig, J.; Pelaez, I.; Banos, J.; Balliu, E.; Maroto, A.; Pedraza, S.; Casas, M.

    2006-01-01

    A 65-year-old man presented with a soft mass in his proximal right thigh. Ultrasonography showed a well-defined anechoic lesion with slightly internal echoes. On MRI, the mass was hypointense and minimally hyperintense compared with muscle at T 1 and hyperintense at T 2 , with a hypointense peripheral rim on both sequences. No signal loss was observed on T 1 -weighted fat-suppression MRI. The clinical setting, imaging findings and histopathological features were consistent with a long-standing Morel-Lavallee lesion

  3. Surgical Findings and Outcomes in Premenopausal Breast Cancer Patients Undergoing Oophorectomy: A Multicenter Review From the Society of Gynecologic Surgeons Fellows Pelvic Research Network.

    Science.gov (United States)

    Harvey, Lara F B; Abramson, Vandana G; Alvarez, Jimena; DeStephano, Christopher; Hur, Hye-Chun; Lee, Katherine; Mattingly, Patricia; Park, Beau; Piszczek, Carolyn; Seifi, Farinaz; Stuparich, Mallory; Yunker, Amanda

    2018-01-01

    To describe the procedures performed, intra-abdominal findings, and surgical pathology in a cohort of women with premenopausal breast cancer who underwent oopherectomy. Multicenter retrospective chart review (Canadian Task Force classification II-3). Nine US academic medical centers participating in the Fellows' Pelvic Research Network (FPRN). One hundred twenty-seven women with premenopausal breast cancer undergoing oophorectomy between January 2013 and March 2016. Surgical castration. The mean patient age was 45.8 years. Fourteen patients (11%) carried a BRCA mutations, and 22 (17%) carried another germline or acquired mutation, including multiple variants of uncertain significance. There was wide variation in surgical approach. Sixty-five patients (51%) underwent pelvic washings, and 43 (35%) underwent concurrent hysterectomy. Other concomitant procedures included midurethral sling placement, appendectomy, and hysteroscopy. Three patients experienced complications (transfusion, wound cellulitis, and vaginal cuff dehiscence). Thirteen patients (10%) had ovarian pathology detected on analysis of the surgical specimen, including metastatic tumor, serous cystadenomas, endometriomas, and Brenner tumor. Eight patients (6%) had Fallopian tube pathology, including 3 serous tubal intraepithelial cancers. Among the 44 uterine specimens, 1 endometrial adenocarcinoma and 1 multifocal endometrial intraepithelial neoplasia were noted. Regarding the entire study population, the number of patients meeting our study criteria and seen by gynecologic surgeons in the FPRN for oophorectomy increased by nearly 400% from 2013 to 2015. Since publication of the Suppression of Ovarian Function Trial data, bilateral oophorectomy has been recommended for some women with premenopausal breast cancer to facilitate breast cancer treatment with aromatase inhibitors. These women may be at elevated risk for occult abdominal pathology compared with the general population. Gynecologic surgeons

  4. Fractures of the distal clavicle: comparison between two surgical treatment methods

    Directory of Open Access Journals (Sweden)

    José Carlos Souza Vilela

    2015-04-01

    Full Text Available OBJECTIVE: To compare the clinical and radiographic results from osteosynthesis of fractures of the lateral third of the clavicle, using two methods: T plates or anchors together with Kirschner wires.METHODS: Fifteen patients of mean age 34.3 years (range: 19-57 and mean follow-up 22.7 months (range: 14-32 were evaluated. In nine cases, a T plate was used; and in six cases, coracoclavicular fixation was used with anchors in the coracoid process and Kirschner wires through the acromioclavicular joint. The evaluation included the Constant score, personal satisfaction and radiographic assessment.RESULTS: Both types of treatment achieved consolidation in all cases. Group 1 presented a higher Constant score (83.4 than that of Group 2 (76.4 (p = 0.029. Neither of the techniques presented any severe complications, and mild complications were only observed in Group 2 (80%, mostly consisting of migration of the Kirschner wire and superficial infection.CONCLUSION: Surgical treatment of fractures of the distal clavicle using T plates provided the same consolidation rate as shown by coracoclavicular fixation with anchors in the coracoid process and Kirschner wires through the acromioclavicular joint, and better clinical results.LEVEL OF EVIDENCE: Level III evidence was obtained. Comparative retrospective study and therapeutic study were performed.

  5. Clinical, laboratory and instrumental methods of pre-surgical diagnosis of the parathyroid glands cancer

    Directory of Open Access Journals (Sweden)

    Natalia G. Mokrysheva

    2017-12-01

    Full Text Available Backgraund. When defining symptomatic primary hyperparathyroidism (PHPT, differential diagnosis between a benign and malignant neoplasm of parathyroid glands (PG may be challenging. The diagnosis of carcinoma or a benign tumor determines the extent of the surgical intervention and further observation tactics. Aims. The purpose of the study is to determine the clinical and laboratory and instrumental predictors of PG cancer. Materials and methods. A retrospective study included 385 patients with PHPT (273 with adenomas of the PG, 66 with hyperplasia, and 19 patients with cancer of the PG, who had been examined and operated from 2000 to 2014. The primary goal of the study was to define the level of ionized calcium (Ca++, parathyroid hormone (PTH, and the volume of the tumor PG specific for cancer of the PG. The level of parathyroid hormone (PTH was determined by electrochemoluminescent method on the Roche analyzer Cobas 6000; ionized calcium (Ca++ ion-selective method. The size of the PG was determined by the ellipse formula: V(cm3 = (A × B × C × 0.49 by ultrasound investigation using the Valuson E8 device from General Electric. Results. The group of patients with PG carcinoma showed the increased level of Ca++ of more than 1.60 mmol/l (p = 0.004 and increased level of PTH of more than 600 pg/ml (p = 0.03. The size of tumors of more than 6 cm3 is more typical to malignant neoplasm compared to the adenoma of the PG (p = 0.01. Conclusions. The group of patients with PHPT that are at risk of having PG carcinoma include individuals that have a combination of the following indicators: PTH levels of more than 600 pg/ml, an increase in ionized calcium of more than 1.60 mmol/l, the tumor size of more than 6 cm3.

  6. Lumbar spinal fusion. Outcome in relation to surgical methods, choice of implant and postoperative rehabilitation.

    Science.gov (United States)

    Christensen, Finn Bjarke

    2004-10-01

    Chronic low back pain (CLBP) has become one of the most common causes of disability in adults under 45 years of age and is consequently one of the most common reasons for early retirement in industrialised societies. Accordingly, CLBP represents an expensive drain on society's resources and is a very challenging area for which a consensus for rational therapy is yet to be established. The spinal fusion procedure was introduced as a treatment option for CLBP more than 70 years ago. However, few areas of spinal surgery have caused so much controversy as spinal fusion. The literature reveals divergent opinions about when fusion is indicated and how it should be performed. Furthermore, the significance of the role of postoperative rehabilitation following spinal fusion may be underestimated. There exists no consensus on the design of a program specific for rehabilitation. Ideally, for any given surgical procedure, it should be possible to identify not only possible complications relative to a surgical procedure, but also what symptoms may be expected, and what pain behaviour may be expected of a particular patient. The overall aims of the current studies were: 1) to introduce patient-based functional outcome evaluation into spinal fusion treatment; 2) to evaluate radiological assessment of different spinal fusion procedures; 3) to investigate the effect of titanium versus stainless steel pedicle screws on mechanical fixation and bone ingrowth in lumbar spinal fusion; 4) to analyse the clinical and radiological outcome of different lumbar spinal fusion techniques; 5) to evaluate complications and re-operation rates following different surgical procedures; and 6) to analyse the effect of different rehabilitation strategies for lumbar spinal fusion patients. The present thesis comprises 9 studies: 2 clinical retrospective studies, 1 clinical prospective case/reference study, 5 clinical randomised prospective studies and 1 animal study (Mini-pigs). In total, 594 patients

  7. Distress among women taking part in surgical continuity of care for breast cancer - a mixed methods study

    DEFF Research Database (Denmark)

    Jørgensen, Lone

    during breast cancer trajectory. Overall, distress has been linked to suffering, and lower quality of life, increased admission rates, and greater health care costs. This thesis uses mixed methods to investigate the prevalence of distress among women taking part in surgical continuity of care at time...

  8. A Low-Cost Teaching Model of Inguinal Canal: A Useful Method to Teach Surgical Concepts in Hernia Repair

    Science.gov (United States)

    Ansaloni, Luca; Catena, Fausto; Coccolini, Frederico; Ceresoli, Marco; Pinna, Antonio Daniele

    2014-01-01

    Objectives: Inguinal canal anatomy and hernia repair is difficult for medical students and surgical residents to comprehend. Methods: Using low-cost material, a 3-dimensional inexpensive model of the inguinal canal was created to allow students to learn anatomical details and landmarks and to perform their own simulated hernia repair. In order to…

  9. Added value of cardiac computed tomography for evaluation of mechanical aortic valve: Emphasis on evaluation of pannus with surgical findings as standard reference.

    Science.gov (United States)

    Suh, Young Joo; Lee, Sak; Im, Dong Jin; Chang, Suyon; Hong, Yoo Jin; Lee, Hye-Jeong; Hur, Jin; Choi, Byoung Wook; Chang, Byung-Chul; Shim, Chi Young; Hong, Geu-Ru; Kim, Young Jin

    2016-07-01

    The added value of cardiac computed tomography (CT) with transesophageal echocardiography (TEE) for evaluating mechanical aortic valve (AV) dysfunction has not yet been investigated. The purposes of this study were to investigate the added value of cardiac CT for evaluation of mechanical AVs and diagnoses of pannus compared to TEE, with surgical findings of redo-aortic valve replacement (AVR) used as a standard reference. 25 patients who underwent redo-AVR due to mechanical AV dysfunction and cardiac CT before redo-AVR were included. The presence of pannus, encroachment ratio by pannus, and limitation of motion (LOM) were evaluated on CT. The diagnostic performance of pannus detection was compared using TEE, CT, and CT+TEE, with surgical findings as a standard reference. The added value of CT for diagnosing the cause of mechanical AV dysfunction was assessed compared to TTE+TEE. In two patients, CT analysis was not feasible due to severe metallic artifacts. On CT, pannus and LOM were found in 100% (23/23) and 60.9% (14/23). TEE identified pannus in 48.0% of patients (12/25). CT, TEE, and CT+TEE correctly identified pannus with sensitivity of 92.0%, 48.0%, and 92.0%, respectively (P=0.002 for CT vs. TEE). In 11 of 13 cases (84.6%) with inconclusive or negative TEE results for pannus, CT detected the pannus. Among 13 inconclusive cases of TTE+TEE for the cause of mechanical AV dysfunction, CT suggested 6 prosthetic valve obstruction (PVO) by pannus, 4 low-flow low-gradient PVO, and one LOM without significant PVO. Cardiac CT showed added diagnostic value with TEE in the detection of pannus as the cause of mechanical AV dysfunction. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  10. Effect of modified surgical method on subcutaneous hydrops of patients with breast cancer after modified radical mastectomy

    Directory of Open Access Journals (Sweden)

    Yan Li

    2016-01-01

    Full Text Available Objective: Through prospective randomized clinical study,to observe the preventive effect of improved surgical method to subcutaneous hydrops after modified radical mastec tomy. Method: A total of 80 cases of patients who have done modified radical mastectomy were selected, and randomly divided them into study group (40 cases and control group (40 cases, then adopted different surgical methods as followed respectively, to observe the daily drainage volume at the first 3 d after surgery; when the drainage volume ≤ 20 mL, 24 h after surgery, removed the drainage tubes, to record the drainage days, total cases who occured subcutaneous hydrops and all adverse events after surgery. Results: Study group: the first 3 d of daily drainage volume declined quickly, and were accordingly less than that in control group; and ≤ 50 mL/24 h on the third day. Drainage total days median (4 d were less than that in control group (7 d; subcutaneous hydrops occurrence rate was only 2%, which wasgreatly lower than that in control group (14%, statistics difference had significance. Through the comparison between study group and control group, this surgical method improvement will not bring any surgical safety problems, such as hematoma, wound infection, skin flap necrosis and upper limb LOM etc. Only extended the surgical time slightly. While in control group, drainage tubes fell into the dead space or were blocked frequently, then induced hydrops; but in study group, due to the suture of latissimus dorsi leading edge and chestwall, dead space disappeared at this spot, drainage tube were not blocked any more. Conclusion: In mastectomy and axillary lymph dissection, due to axillary dissection, ligation might lead to open lymphatic tissue, added that suture fixed latissimus dorsi leading edge and skin flap leading to disappeared dead space, compared with traditional surgical method, this improved surgical method could obviously reduce the occurrence rate of hydrops

  11. Performance of statistical process control methods for regional surgical site infection surveillance: a 10-year multicentre pilot study.

    Science.gov (United States)

    Baker, Arthur W; Haridy, Salah; Salem, Joseph; Ilieş, Iulian; Ergai, Awatef O; Samareh, Aven; Andrianas, Nicholas; Benneyan, James C; Sexton, Daniel J; Anderson, Deverick J

    2017-11-24

    Traditional strategies for surveillance of surgical site infections (SSI) have multiple limitations, including delayed and incomplete outbreak detection. Statistical process control (SPC) methods address these deficiencies by combining longitudinal analysis with graphical presentation of data. We performed a pilot study within a large network of community hospitals to evaluate performance of SPC methods for detecting SSI outbreaks. We applied conventional Shewhart and exponentially weighted moving average (EWMA) SPC charts to 10 previously investigated SSI outbreaks that occurred from 2003 to 2013. We compared the results of SPC surveillance to the results of traditional SSI surveillance methods. Then, we analysed the performance of modified SPC charts constructed with different outbreak detection rules, EWMA smoothing factors and baseline SSI rate calculations. Conventional Shewhart and EWMA SPC charts both detected 8 of the 10 SSI outbreaks analysed, in each case prior to the date of traditional detection. Among detected outbreaks, conventional Shewhart chart detection occurred a median of 12 months prior to outbreak onset and 22 months prior to traditional detection. Conventional EWMA chart detection occurred a median of 7 months prior to outbreak onset and 14 months prior to traditional detection. Modified Shewhart and EWMA charts additionally detected several outbreaks earlier than conventional SPC charts. Shewhart and SPC charts had low false-positive rates when used to analyse separate control hospital SSI data. Our findings illustrate the potential usefulness and feasibility of real-time SPC surveillance of SSI to rapidly identify outbreaks and improve patient safety. Further study is needed to optimise SPC chart selection and calculation, statistical outbreak detection rules and the process for reacting to signals of potential outbreaks. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights

  12. Evaluation of Acute Aortic Dissection Type a Factors and Comparison the Postoperative Clinical Outcomes between Two Surgical Methods.

    Science.gov (United States)

    Shemirani, Hasan; Mirmohamadsadeghi, Amir; Mahaki, Behzad; Farhadi, Sadaf; Badalabadi, Reza Mohseni; Bidram, Peyman; Badalabadi, Mehdi Mohseni

    2017-01-01

    Although aortic dissection is a rare disease, it causes high level of mortality. If ascending aorta gets involved in this disease, it is known as type A. According to small number of studies about this disease in Iran, this study conducted to detect the factors related to acute aortic dissection type A, its surgery consequences and the factors affecting them. In this historical cohort study, all patients having acute aortic dissection type A referring to Chamran Hospital from 2006 to 2012 were studied. The impact of two surgical methods including antegrade cerebral perfusion (ACP) and retrograde cerebral one (RCP) on surgical and long-term mortality and recurrence of dissection was determined. The relation of mortality rate and hemodynamic instability before surgery, age more than 70 years old, ejection fraction lower than 50%, prolonged cardiopulmonary bypass pump (CPBP) time and excessive blood transfusion, was assessed. Surgery and long-term mortality and recurrence of dissection were 35.3%, 30.8% and 30.4%. Surgical and long-term death in the patients being operated by ACP method was lower than those one being operated by RCP ( P RCP according to the surgical and long-term mortality.

  13. Laparoscopy training in surgical education: the utility of incorporating a structured preclinical laparoscopy course into the traditional apprenticeship method.

    Science.gov (United States)

    De Win, Gunter; Van Bruwaene, Siska; Aggarwal, Rajesh; Crea, Nicola; Zhang, Zhewen; De Ridder, Dirk; Miserez, Marc

    2013-01-01

    To investigate whether preclinical laparoscopy training offers a benefit over standard apprenticeship training and apprenticeship training in combination with simulation training. This randomized controlled trial consisted of 3 groups of first-year surgical registrars receiving a different teaching method in laparoscopic surgery. The KU LEUVEN Faculty of Medicine is the largest medical faculty in Belgium. Thirty final-year medical students starting a general surgical career in the next academic year. Thirty final-year medical students were randomized into 3 groups, which differed in the way they were exposed to laparoscopic simulation training but were comparable in regard to ambidexterity, sex, age, and laparoscopic psychomotoric skills. The control group received only clinical training during surgical residentship, whereas the interval group received clinical training in combination with simulation training. The registrars were allowed to do deliberate practice. The Centre for Surgical Technologies Preclinical Training Programme (CST PTP) group received a preclinical simulation course during the final year as medical students, but was not exposed to any extra simulation training during surgical residentship. At the beginning of surgical residentship and 6 months later, all subjects performed a standardized suturing task and a laparoscopic cholecystectomy in a POP Trainer. All procedures were recorded together with time and motion tracking parameters. All videos were scored by a blinded observer using global rating scales. At baseline the 3 groups were comparable. At 6 months, for suturing, the CST PTP group was better than both the other groups with respect to time, checklist, and amount of movements. The interval group was better than the control group on only the time and checklist score. For the cholecystectomy evaluation, there was a statistical difference between the CST PTP study group and both other groups on all evaluation scales in favor of the CST PTP

  14. Evaluation of Acute Aortic Dissection Type a Factors and Comparison the Postoperative Clinical Outcomes between Two Surgical Methods

    Directory of Open Access Journals (Sweden)

    Hasan Shemirani

    2017-01-01

    Full Text Available Background: Although aortic dissection is a rare disease, it causes high level of mortality. If ascending aorta gets involved in this disease, it is known as type A. According to small number of studies about this disease in Iran, this study conducted to detect the factors related to acute aortic dissection type A, its surgery consequences and the factors affecting them. Materials and Methods: In this historical cohort study, all patients having acute aortic dissection type A referring to Chamran Hospital from 2006 to 2012 were studied. The impact of two surgical methods including antegrade cerebral perfusion (ACP and retrograde cerebral one (RCP on surgical and long-term mortality and recurrence of dissection was determined. The relation of mortality rate and hemodynamic instability before surgery, age more than 70 years old, ejection fraction lower than 50%, prolonged cardiopulmonary bypass pump (CPBP time and excessive blood transfusion, was assessed. Results: Surgery and long-term mortality and recurrence of dissection were 35.3%, 30.8% and 30.4%. Surgical and long-term death in the patients being operated by ACP method was lower than those one being operated by RCP (P < 0.001. Excessive blood transfusion and unstable hemodynamic condition had significant effect on surgical mortality (P = 0.014, 0.030, respectively. CPBP time and unstable hemodynamic condition affected long-term mortality significantly (P = 0.002. Conclusion: The result found that ACP is the preferable kind of surgery in comparison with RCP according to the surgical and long-term mortality.

  15. Surgical management of pilonidal sinus patients by primary and secondary repair methods: a comparative study

    Directory of Open Access Journals (Sweden)

    Haji Barati B

    2010-12-01

    Full Text Available "n Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Arial; mso-bidi-theme-font:minor-bidi;} Background: Gross difference in return to work exists in pilonidal sinus patients operated by primary and secondary repair. This survey was to evaluate the results of surgical management of pilonidal sinus with primary or secondary closure."n"nMethods: In a randomized clinical trial, patients with pilonidal sinus referring to the surgical clinic of Shariati Hospital in Tehran, Iran between March 2007 and March 2009 were underwent either excision with midline closure (primary, n=40, or excision without closure (secondary, n=40. The recorded outcomes were hospital stay, healing time, time off work, postoperative pain, patient's satisfaction and the recurrence rate."n"nResults: Majority of the patients were male (87.50%. There was no significant difference in the hospital stay. Time off work (8.65±1.73 Vs. 11.53±2.33 days, p=0.001 and healing time (3.43±0.92 Vs. 5.3±0.79 days, p=0.001 were shorter in primary group; but, there were no significant differences in hospital stay and number of visits. Intensity of postoperative pain in the 1st (37.75±6.5 Vs. 43.63±5.06, p=0.001, 2nd (26.75±6.66 Vs. 34.63±5.48, p=0.001, 3rd (18.25±6.05 Vs. 27.88±6.88, p=0.001, and 7th (8.45±3.85 Vs. 17.88±6.19, p=0.001 days were

  16. The Global Optimal Algorithm of Reliable Path Finding Problem Based on Backtracking Method

    Directory of Open Access Journals (Sweden)

    Liang Shen

    2017-01-01

    Full Text Available There is a growing interest in finding a global optimal path in transportation networks particularly when the network suffers from unexpected disturbance. This paper studies the problem of finding a global optimal path to guarantee a given probability of arriving on time in a network with uncertainty, in which the travel time is stochastic instead of deterministic. Traditional path finding methods based on least expected travel time cannot capture the network user’s risk-taking behaviors in path finding. To overcome such limitation, the reliable path finding algorithms have been proposed but the convergence of global optimum is seldom addressed in the literature. This paper integrates the K-shortest path algorithm into Backtracking method to propose a new path finding algorithm under uncertainty. The global optimum of the proposed method can be guaranteed. Numerical examples are conducted to demonstrate the correctness and efficiency of the proposed algorithm.

  17. A method of handing down surgical clipping technique for cerebral aneurysm

    International Nuclear Information System (INIS)

    Idei, Masaru; Yamane, Kanji; Okita, Shinji; Kumano, Kiyoshi; Nakae, Ryuta

    2009-01-01

    Meticulous clipping techniques are essential to obtain good results. Recently, the introduction of intravascular surgery for cerebral aneurysms has decreased the number of the direct clipping surgeries. And the increasing number of the lawsuits against doctors further discourages young surgeons from attempting clipping. As a result, young neurosurgeons, have less experience performing clipping. Therefore, we must learn clipping techniques from expert neurosurgeons under the limitation of having fewer opportunities to perform clipping surgery. In this paper, I present my experiences and discuss ways to obtain techniques for clipping surgery. I performed surgical clipping in 19 cases, 12 unruptured and 7 ruptured aneurysms, 7 males and 12 females aged from 36 to 79 years old (mean 61.9 years). Postoperatively, there were no symptomatic complications, but there were 2 asymptomatic infarctions that were revealed on CT scan. Intraoperative premature rupture occurred in 1 patient with a ruptured aneurysm. Techniques of manipulation with micro-forceps, suction and spatula are required for successful clipping. Off-the-job training of dissecting chicken wing arteries and rat abdominal aortas and vena cavas is useful. Moreover, actual experiences of surgical operations are essential. Surgical experiences raise the motivation of young neurosurgeons and encourage them to train more. We believe that this benign cycle contributes to meticulous surgical skills. (author)

  18. Surgical ergonomics. Analysis of technical skills, simulation models and assessment methods.

    Science.gov (United States)

    Papaspyros, Sotiris C; Kar, Ashok; O'Regan, David

    2015-06-01

    Over the past two centuries the surgical profession has undergone a profound evolution in terms of efficiency and outcomes. Societal concerns in relation to quality assurance, patient safety and cost reduction have highlighted the issue of training expert surgeons. The core elements of a training model build on the basic foundations of gross and fine motor skills. In this paper we provide an analysis of the ergonomic principles involved and propose relevant training techniques. We have endeavored to provide both the trainer and trainee perspectives. This paper is structured into four sections: 1) Pre-operative preparation issues, 2) technical skills and instrument handling, 3) low fidelity simulation models and 4) discussion of current concepts in crew resource management, deliberate practice and assessment. Rehearsal, warm-up and motivation-enhancing techniques aid concentration and focus. Appropriate posture, comprehension of ergonomic principles in relation to surgical instruments and utilisation of the non-dominant hand are essential skills to master. Low fidelity models can be used to achieve significant progress through the early stages of the learning curve. Deliberate practice and innate ability are complementary to each other and may be considered useful adjuncts to surgical skills development. Safe medical care requires that complex patient interventions be performed by highly skilled operators supported by reliable teams. Surgical ergonomics lie at the heart of any training model that aims to produce professionals able to function as leaders of a patient safety oriented culture. Copyright © 2015 IJS Publishing Group Limited. Published by Elsevier Ltd. All rights reserved.

  19. Text-in-context: a method for extracting findings in mixed-methods mixed research synthesis studies.

    Science.gov (United States)

    Sandelowski, Margarete; Leeman, Jennifer; Knafl, Kathleen; Crandell, Jamie L

    2013-06-01

    Our purpose in this paper is to propose a new method for extracting findings from research reports included in mixed-methods mixed research synthesis studies. International initiatives in the domains of systematic review and evidence synthesis have been focused on broadening the conceptualization of evidence, increased methodological inclusiveness and the production of evidence syntheses that will be accessible to and usable by a wider range of consumers. Initiatives in the general mixed-methods research field have been focused on developing truly integrative approaches to data analysis and interpretation. The data extraction challenges described here were encountered, and the method proposed for addressing these challenges was developed, in the first year of the ongoing (2011-2016) study: Mixed-Methods Synthesis of Research on Childhood Chronic Conditions and Family. To preserve the text-in-context of findings in research reports, we describe a method whereby findings are transformed into portable statements that anchor results to relevant information about sample, source of information, time, comparative reference point, magnitude and significance and study-specific conceptions of phenomena. The data extraction method featured here was developed specifically to accommodate mixed-methods mixed research synthesis studies conducted in nursing and other health sciences, but reviewers might find it useful in other kinds of research synthesis studies. This data extraction method itself constitutes a type of integration to preserve the methodological context of findings when statements are read individually and in comparison to each other. © 2012 Blackwell Publishing Ltd.

  20. Development of a semi-automated method for subspecialty case distribution and prediction of intraoperative consultations in surgical pathology

    Directory of Open Access Journals (Sweden)

    Raul S Gonzalez

    2015-01-01

    Full Text Available Background: In many surgical pathology laboratories, operating room schedules are prospectively reviewed to determine specimen distribution to different subspecialty services and to predict the number and nature of potential intraoperative consultations for which prior medical records and slides require review. At our institution, such schedules were manually converted into easily interpretable, surgical pathology-friendly reports to facilitate these activities. This conversion, however, was time-consuming and arguably a non-value-added activity. Objective: Our goal was to develop a semi-automated method of generating these reports that improved their readability while taking less time to perform than the manual method. Materials and Methods: A dynamic Microsoft Excel workbook was developed to automatically convert published operating room schedules into different tabular formats. Based on the surgical procedure descriptions in the schedule, a list of linked keywords and phrases was utilized to sort cases by subspecialty and to predict potential intraoperative consultations. After two trial-and-optimization cycles, the method was incorporated into standard practice. Results: The workbook distributed cases to appropriate subspecialties and accurately predicted intraoperative requests. Users indicated that they spent 1-2 h fewer per day on this activity than before, and team members preferred the formatting of the newer reports. Comparison of the manual and semi-automatic predictions showed that the mean daily difference in predicted versus actual intraoperative consultations underwent no statistically significant changes before and after implementation for most subspecialties. Conclusions: A well-designed, lean, and simple information technology solution to determine subspecialty case distribution and prediction of intraoperative consultations in surgical pathology is approximately as accurate as the gold standard manual method and requires less

  1. Complex radiological diagnosis and choice of a method of surgical treatment of the lung and the liver hydatidosis

    International Nuclear Information System (INIS)

    Ikramov, A.I.

    2003-01-01

    In dissertation work there were analyzed results of diagnosis and surgical treatment 1.741 patients with lung and liver hydatidosis. The investigations were executed with application of a complex of radiologic methods such X-ray, sonography, CT and MRI tomography. Were analyzed separate and cumulative information of the listed methods on the basis of their sensitivity, specificity and general accuracy. The questions of classification of complicated forms of the lung hydatidosis and criteria to differential diagnosis of spherical lung formations and liver focal formations are discussed. The technique of transthoracic sonography for revealing and differential diagnostics subpleural localization of the hydatidosis and congestions of a liquid in pleural cavity is developed. The indications and contraindications to use transcutaneus fine needle biopsy for diagnostics of the hydatidosis are determined. On the basis of results of complex X-ray diagnostics the original algorithms of a sequence of performance various methods of visualization are developed. The indications to performance pancreatocholangiography are proved at suspicion on ruptured hydatid cysts into biliar tract with mechanical jaundice. The analysis of results of traditional surgical treatment of the hydatidosis, and low invasive transcutaneus procedures, endovisual surgical operations and chemotherapy is carried out. The indications to performance of the listed methods are developed depending on the form and stage of disease, localization of cysts. Were analyzed results of transcutaneus aspiration and drainage of residual cavities after hydatidectomy. The comparative estimation to traditional surgical methods, CT- and US-guided transcutaneus aspirations, drainage is given. Are determined a role and place of complex radiological diagnosis with use sonography, X-ray and CT in early and late postoperative complications after hydatidectomy from the lung and liver (pleural effusion, subdiaphragmal abscess and

  2. Effective Leadership of Surgical Teams: A Mixed Methods Study of Surgeon Behaviors and Functions.

    Science.gov (United States)

    Stone, Juliana L; Aveling, Emma-Louise; Frean, Molly; Shields, Morgan C; Wright, Cameron; Gino, Francesca; Sundt, Thoralf M; Singer, Sara J

    2017-08-01

    The importance of effective team leadership for achieving surgical excellence is widely accepted, but we understand less about the behaviors that achieve this goal. We studied cardiac surgical teams to identify leadership behaviors that best support surgical teamwork. We observed, surveyed, and interviewed cardiac surgical teams, including 7 surgeons and 116 team members, from September 2013 to April 2015. We documented 1,926 surgeon/team member interactions during 22 cases, coded them by behavior type and valence (ie, positive/negative/neutral), and characterized them by leadership function (conductor, elucidator, delegator, engagement facilitator, tone setter, being human, and safe space maker) to create a novel framework of surgical leadership derived from direct observation. We surveyed nonsurgeon team members about their perceptions of individual surgeon's leadership effectiveness on a 7-point Likert scale and correlated survey measures with individual surgeon profiles created by calculating percentage of behavior types, leader functions, and valence. Surgeon leadership was rated by nonsurgeons from 4.2 to 6.2 (mean, 5.4). Among the 33 types of behaviors observed, most interactions constituted elucidating (24%) and tone setting (20%). Overall, 66% of interactions (range, 43%-84%) were positive and 11% (range, 1%-45%) were negative. The percentage of positive and negative behaviors correlated strongly (r = 0.85 for positive and r = 0.75 for negative, p leadership. Facilitating engagement related most positively (r = 0.80; p = 0.03), and negative forms of elucidating, ie, criticism, related most negatively (r = -0.81; p = 0.03). We identified 7 surgeon leadership functions and related behaviors that impact perceptions of leadership. These observations suggest actionable opportunities to improve team leadership behavior. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  3. Mentor Tutoring: An Efficient Method for Teaching Laparoscopic Colorectal Surgical Skills in a General Hospital.

    Science.gov (United States)

    Ichikawa, Nobuki; Homma, Shigenori; Yoshida, Tadashi; Ohno, Yosuke; Kawamura, Hideki; Wakizaka, Kazuki; Nakanishi, Kazuaki; Kazui, Keizo; Iijima, Hiroaki; Shomura, Hiroki; Funakoshi, Tohru; Nakano, Shiro; Taketomi, Akinobu

    2017-12-01

    We retrospectively assessed the efficacy of our mentor tutoring system for teaching laparoscopic colorectal surgical skills in a general hospital. A series of 55 laparoscopic colectomies performed by 1 trainee were evaluated. Next, the learning curves for high anterior resection performed by the trainee (n=20) were compared with those of a self-trained surgeon (n=19). Cumulative sum analysis and multivariate regression analyses showed that 38 completed cases were needed to reduce the operative time. In high anterior resection, the mean operative times were significantly shorter after the seventh average for the tutored surgeon compared with that for the self-trained surgeon. In cumulative sum charting, the curve reached a plateau by the seventh case for the tutored surgeon, but continued to increase for the self-trained surgeon. Mentor tutoring effectively teaches laparoscopic colorectal surgical skills in a general hospital setting.

  4. Finding-equal regression method and its application in predication of U resources

    International Nuclear Information System (INIS)

    Cao Huimo

    1995-03-01

    The commonly adopted deposit model method in mineral resources predication has two main part: one is model data that show up geological mineralization law for deposit, the other is statistics predication method that accords with characters of the data namely pretty regression method. This kind of regression method may be called finding-equal regression, which is made of the linear regression and distribution finding-equal method. Because distribution finding-equal method is a data pretreatment which accords with advanced mathematical precondition for the linear regression namely equal distribution theory, and this kind of data pretreatment is possible of realization. Therefore finding-equal regression not only can overcome nonlinear limitations, that are commonly occurred in traditional linear regression or other regression and always have no solution, but also can distinguish outliers and eliminate its weak influence, which would usually appeared when Robust regression possesses outlier in independent variables. Thus this newly finding-equal regression stands the best status in all kind of regression methods. Finally, two good examples of U resource quantitative predication are provided

  5. Parallel shooting methods for finding steady state solutions to engine simulation models

    DEFF Research Database (Denmark)

    Andersen, Stig Kildegård; Thomsen, Per Grove; Carlsen, Henrik

    2007-01-01

    Parallel single- and multiple shooting methods were tested for finding periodic steady state solutions to a Stirling engine model. The model was used to illustrate features of the methods and possibilities for optimisations. Performance was measured using simulation of an experimental data set...

  6. Abortion - surgical

    Science.gov (United States)

    Suction curettage; Surgical abortion; Elective abortion - surgical; Therapeutic abortion - surgical ... Surgical abortion involves dilating the opening to the uterus (cervix) and placing a small suction tube into the uterus. ...

  7. Modification of backgammon shape cathode and graded charge division readout method for a novel triple charge division centroid finding method

    International Nuclear Information System (INIS)

    Javanmardi, F.; Matoba, M.; Sakae, T.

    1996-01-01

    Triple Charge Division (TCD) centroid finding method that uses modified pattern of Backgammon Shape Cathode (MBSC) is introduced for medium range length position sensitive detectors with optimum numbers of cathode segments. MBSC pattern has three separated areas and uses saw tooth like insulator gaps for separating the areas. Side areas of the MBSC pattern are severed by a central common area. Size of the central area is twice of the size of both sides. Whereas central area is the widest area among three, both sides' areas have the main role in position sensing. With the same resolution and linearity, active region of original Backgammon pattern increases twice by using MBSC pattern, and with the same length, linearity of TCD centroid finding is much better than Backgammon charge division readout method. Linearity prediction of TCD centroid finding and experimental results conducted us to find an optimum truncation of the apices of MBCS pattern in the central area. The TCD centroid finding has an especial readout method since charges must be collected from two segments in both sides and from three segments in the central area of MBSC pattern. The so called Graded Charge Division (GCD) is the especial readout method for TCD. The GCD readout is a combination of the charge division readout and sequence grading of serial segments. Position sensing with TCD centroid finding and GCD readout were done by two sizes MBSC patterns (200mm and 80mm) and Spatial resolution about 1% of the detector length is achieved

  8. The study of surgical image quality evaluation system by subjective quality factor method

    Science.gov (United States)

    Zhang, Jian J.; Xuan, Jason R.; Yang, Xirong; Yu, Honggang; Koullick, Edouard

    2016-03-01

    GreenLightTM procedure is an effective and economical way of treatment of benign prostate hyperplasia (BPH); there are almost a million of patients treated with GreenLightTM worldwide. During the surgical procedure, the surgeon or physician will rely on the monitoring video system to survey and confirm the surgical progress. There are a few obstructions that could greatly affect the image quality of the monitoring video, like laser glare by the tissue and body fluid, air bubbles and debris generated by tissue evaporation, and bleeding, just to name a few. In order to improve the physician's visual experience of a laser surgical procedure, the system performance parameter related to image quality needs to be well defined. However, since image quality is the integrated set of perceptions of the overall degree of excellence of an image, or in other words, image quality is the perceptually weighted combination of significant attributes (contrast, graininess …) of an image when considered in its marketplace or application, there is no standard definition on overall image or video quality especially for the no-reference case (without a standard chart as reference). In this study, Subjective Quality Factor (SQF) and acutance are used for no-reference image quality evaluation. Basic image quality parameters, like sharpness, color accuracy, size of obstruction and transmission of obstruction, are used as subparameter to define the rating scale for image quality evaluation or comparison. Sample image groups were evaluated by human observers according to the rating scale. Surveys of physician groups were also conducted with lab generated sample videos. The study shows that human subjective perception is a trustworthy way of image quality evaluation. More systematic investigation on the relationship between video quality and image quality of each frame will be conducted as a future study.

  9. An effective method for finding special solutions of nonlinear differential equations with variable coefficients

    International Nuclear Information System (INIS)

    Qin Maochang; Fan Guihong

    2008-01-01

    There are many interesting methods can be utilized to construct special solutions of nonlinear differential equations with constant coefficients. However, most of these methods are not applicable to nonlinear differential equations with variable coefficients. A new method is presented in this Letter, which can be used to find special solutions of nonlinear differential equations with variable coefficients. This method is based on seeking appropriate Bernoulli equation corresponding to the equation studied. Many well-known equations are chosen to illustrate the application of this method

  10. AN EFFICIENT DATA MINING METHOD TO FIND FREQUENT ITEM SETS IN LARGE DATABASE USING TR- FCTM

    Directory of Open Access Journals (Sweden)

    Saravanan Suba

    2016-01-01

    Full Text Available Mining association rules in large database is one of most popular data mining techniques for business decision makers. Discovering frequent item set is the core process in association rule mining. Numerous algorithms are available in the literature to find frequent patterns. Apriori and FP-tree are the most common methods for finding frequent items. Apriori finds significant frequent items using candidate generation with more number of data base scans. FP-tree uses two database scans to find significant frequent items without using candidate generation. This proposed TR-FCTM (Transaction Reduction- Frequency Count Table Method discovers significant frequent items by generating full candidates once to form frequency count table with one database scan. Experimental results of TR-FCTM shows that this algorithm outperforms than Apriori and FP-tree.

  11. Development of safe mechanism for surgical robots using equilibrium point control method.

    Science.gov (United States)

    Park, Shinsuk; Lim, Hokjin; Kim, Byeong-sang; Song, Jae-bok

    2006-01-01

    This paper introduces a novel mechanism for surgical robotic systems to generate human arm-like compliant motion. The mechanism is based on the idea of the equilibrium point control hypothesis which claims that multi-joint limb movements are achieved by shifting the limbs' equilibrium positions defined by neuromuscular activity. The equilibrium point control can be implemented on a robot manipulator by installing two actuators at each joint of the manipulator, one to control the joint position, and the other to control the joint stiffness. This double-actuator mechanism allows us to arbitrarily manipulate the stiffness (or impedance) of a robotic manipulator as well as its position. Also, the force at the end-effector can be estimated based on joint stiffness and joint angle changes without using force transducers. A two-link manipulator and a three-link manipulator with the double-actuator units have been developed, and experiments and simulation results show the potential of the proposed approach. By creating the human arm-like behavior, this mechanism can improve the performance of robot manipulators to execute stable and safe movement in surgical environments by using a simple control scheme.

  12. Use of Eye Tracking as an Innovative Instructional Method in Surgical Human Anatomy.

    Science.gov (United States)

    Sánchez-Ferrer, María Luísa; Grima-Murcia, María Dolores; Sánchez-Ferrer, Francisco; Hernández-Peñalver, Ana Isabel; Fernández-Jover, Eduardo; Sánchez Del Campo, Francisco

    Tobii glasses can record corneal infrared light reflection to track pupil position and to map gaze focusing in the video recording. Eye tracking has been proposed for use in training and coaching as a visually guided control interface. The aim of our study was to test the potential use of these glasses in various situations: explanations of anatomical structures on tablet-type electronic devices, explanations of anatomical models and dissected cadavers, and during the prosection thereof. An additional aim of the study was to test the use of the glasses during laparoscopies performed on Thiel-embalmed cadavers (that allows pneumoinsufflation and exact reproduction of the laparoscopic surgical technique). The device was also tried out in actual surgery (both laparoscopy and open surgery). We performed a pilot study using the Tobii glasses. Dissection room at our School of Medicine and in the operating room at our Hospital. To evaluate usefulness, a survey was designed for use among students, instructors, and practicing physicians. The results were satisfactory, with the usefulness of this tool supported by more than 80% positive responses to most questions. There was no inconvenience for surgeons and that patient safety was ensured in the real laparoscopy. To our knowledge, this is the first publication to demonstrate the usefulness of eye tracking in practical instruction of human anatomy, as well as in teaching clinical anatomy and surgical techniques in the dissection and operating rooms. Copyright © 2017 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  13. SURGICAL TREATMENT OF MANDIBULAR CONDYLE FRACTURES USING THE TRANSPAROTID FACELIFT APPROACH – INTRODUCING A NEW METHOD OF TREATMENT

    Directory of Open Access Journals (Sweden)

    Aleš Vesnaver

    2004-07-01

    Full Text Available Background. In the past, fractures of the mandibular condylar process were treated almost exclusively conservatively at our institution, by means of a three week period of intermaxillary fixation (IMF, followed by excercises and a soft diet. In the last three years, we started treating these fractures surgically with increasing frequency by open reduction and internal fixation with mini plates and screws. Our goal was to determine the safety and efficiency of surgical treatment as the results of conservative treatment were often unsatisfactory.Patients and methods. So far, 34 patients with 36 extraarticular condyle fractures were treated surgically by a periauricular transparotid approach. The operative procedure is demanding. Namely, branches of the facial nerve have to be identified, dissected and retracted, in order to reach the fracture site. The fracture was reduced and fixed with one or two mini plates. Patients were carefully followed up and were asked to answer a survey paper, which was completed by 32 patients.Results. All of the patients were able to open their mouth immediately postoperatively. The postoperative IMF lasted 1 week at maximum and the facial symetry was achieved in all cases. Pre-traumatic occlusion was achieved in 31 out of 33 dentate patients (94%. Eight out of 36 cases (22% had transitory weakness of the facial nerve branches, most often the buccal and zygomatic branch. Of these, 5 resolved completely at 2–8 weeks, while a mild degree of weakness is still present in the lower eyelid and half of the upper lip in a female patient, 13 months postoperatively. The cosmetic effect is good as the periauricular facelift incision leaves a barely perceptible scar. According to the postoperative survey completed by 32 patients, 30 of them (94% were very satisfied with the outcome of treatment.Conclusion. The procedure is safe with a careful surgical technique and the results of operative treatment are excellent.

  14. General method to find the attractors of discrete dynamic models of biological systems

    Science.gov (United States)

    Gan, Xiao; Albert, Réka

    2018-04-01

    Analyzing the long-term behaviors (attractors) of dynamic models of biological networks can provide valuable insight. We propose a general method that can find the attractors of multilevel discrete dynamical systems by extending a method that finds the attractors of a Boolean network model. The previous method is based on finding stable motifs, subgraphs whose nodes' states can stabilize on their own. We extend the framework from binary states to any finite discrete levels by creating a virtual node for each level of a multilevel node, and describing each virtual node with a quasi-Boolean function. We then create an expanded representation of the multilevel network, find multilevel stable motifs and oscillating motifs, and identify attractors by successive network reduction. In this way, we find both fixed point attractors and complex attractors. We implemented an algorithm, which we test and validate on representative synthetic networks and on published multilevel models of biological networks. Despite its primary motivation to analyze biological networks, our motif-based method is general and can be applied to any finite discrete dynamical system.

  15. General method to find the attractors of discrete dynamic models of biological systems.

    Science.gov (United States)

    Gan, Xiao; Albert, Réka

    2018-04-01

    Analyzing the long-term behaviors (attractors) of dynamic models of biological networks can provide valuable insight. We propose a general method that can find the attractors of multilevel discrete dynamical systems by extending a method that finds the attractors of a Boolean network model. The previous method is based on finding stable motifs, subgraphs whose nodes' states can stabilize on their own. We extend the framework from binary states to any finite discrete levels by creating a virtual node for each level of a multilevel node, and describing each virtual node with a quasi-Boolean function. We then create an expanded representation of the multilevel network, find multilevel stable motifs and oscillating motifs, and identify attractors by successive network reduction. In this way, we find both fixed point attractors and complex attractors. We implemented an algorithm, which we test and validate on representative synthetic networks and on published multilevel models of biological networks. Despite its primary motivation to analyze biological networks, our motif-based method is general and can be applied to any finite discrete dynamical system.

  16. Trends in Radical Surgical Treatment Methods for Breast Malignancies in China: A Multicenter 10-Year Retrospective Study.

    Science.gov (United States)

    Zhang, Bai-Lin; Sivasubramaniam, Priya G; Zhang, Qian; Wang, Jing; Zhang, Bin; Gao, Ji-Dong; Tang, Zhong-Hua; Chen, Guo-Ji; Xie, Xiao-Ming; Wang, Zhongzhao; Yang, Hong-Jian; He, Jian-Jun; Li, Hui; Li, Jia-Yuan; Fan, Jin-Hu; Wang, Xiang; Qiao, You-Lin

    2015-09-01

    Incidence rates of breast cancer continue to rise in the People's Republic of China. The purpose of this study was to describe Chinese trends in radical surgical modalities and influential imaging and demographic factors for breast malignancies. This study was a hospital-based, multicenter, 10-year (1999-2008), retrospective study. Descriptive statistical tests were used to illustrate information regarding radical surgical trends for the treatment of breast malignancies. Chi-square tests were used to assess effect of demographic factors in addition to imaging and pathological data on the specific surgical method. A total of 4,211 patients were enrolled in the survey. Among them, 3,335 patients with stage 0 to stage III disease undergoing mastectomy or breast-conserving surgery (BCS) were included in the final analysis. The rate of BCS increased from 1.53% in 1999 to 11.88% in 2008. The rate of mastectomy declined over this time period, from 98.47% in 1999 to 88.12% in 2008, with increasing use of diagnostic imaging methods and pathological biopsies. A significantly greater percentage of patients with office work, high education levels, unmarried status, younger age, and early pathological stages preferred BCS compared with mastectomy. Rates of mastectomy in China remain elevated due to diagnosis at higher stages; however, because of increased use of diagnostic imaging, improvement of biopsy methods, and patient education, rates of less invasive lumpectomy are increasing and rates of mastectomy have decreased in China. In this study, 4,211 cases were collected from 1999 to 2008 through a multicenter retrospective study of varying geographic and socioeconomic areas to illustrate trends of surgeries in the People's Republic of China. The correlations between demographic and tumor characteristics and among methods of surgical treatment were explored. This study shows that the rate of breast-conserving surgery (BCS) increased and the rate of mastectomy declined over

  17. Methods for synthesizing findings on moderation effects across multiple randomized trials.

    Science.gov (United States)

    Brown, C Hendricks; Sloboda, Zili; Faggiano, Fabrizio; Teasdale, Brent; Keller, Ferdinand; Burkhart, Gregor; Vigna-Taglianti, Federica; Howe, George; Masyn, Katherine; Wang, Wei; Muthén, Bengt; Stephens, Peggy; Grey, Scott; Perrino, Tatiana

    2013-04-01

    This paper presents new methods for synthesizing results from subgroup and moderation analyses across different randomized trials. We demonstrate that such a synthesis generally results in additional power to detect significant moderation findings above what one would find in a single trial. Three general methods for conducting synthesis analyses are discussed, with two methods, integrative data analysis and parallel analyses, sharing a large advantage over traditional methods available in meta-analysis. We present a broad class of analytic models to examine moderation effects across trials that can be used to assess their overall effect and explain sources of heterogeneity, and present ways to disentangle differences across trials due to individual differences, contextual level differences, intervention, and trial design.

  18. Methods for Synthesizing Findings on Moderation Effects Across Multiple Randomized Trials

    Science.gov (United States)

    Brown, C Hendricks; Sloboda, Zili; Faggiano, Fabrizio; Teasdale, Brent; Keller, Ferdinand; Burkhart, Gregor; Vigna-Taglianti, Federica; Howe, George; Masyn, Katherine; Wang, Wei; Muthén, Bengt; Stephens, Peggy; Grey, Scott; Perrino, Tatiana

    2011-01-01

    This paper presents new methods for synthesizing results from subgroup and moderation analyses across different randomized trials. We demonstrate that such a synthesis generally results in additional power to detect significant moderation findings above what one would find in a single trial. Three general methods for conducting synthesis analyses are discussed, with two methods, integrative data analysis, and parallel analyses, sharing a large advantage over traditional methods available in meta-analysis. We present a broad class of analytic models to examine moderation effects across trials that can be used to assess their overall effect and explain sources of heterogeneity, and present ways to disentangle differences across trials due to individual differences, contextual level differences, intervention, and trial design. PMID:21360061

  19. A New Hybrid Viscoelastic Soft Tissue Model based on Meshless Method for Haptic Surgical Simulation

    Science.gov (United States)

    Bao, Yidong; Wu, Dongmei; Yan, Zhiyuan; Du, Zhijiang

    2013-01-01

    This paper proposes a hybrid soft tissue model that consists of a multilayer structure and many spheres for surgical simulation system based on meshless. To improve accuracy of the model, tension is added to the three-parameter viscoelastic structure that connects the two spheres. By using haptic device, the three-parameter viscoelastic model (TPM) produces accurate deformationand also has better stress-strain, stress relaxation and creep properties. Stress relaxation and creep formulas have been obtained by mathematical formula derivation. Comparing with the experimental results of the real pig liver which were reported by Evren et al. and Amy et al., the curve lines of stress-strain, stress relaxation and creep of TPM are close to the experimental data of the real liver. Simulated results show that TPM has better real-time, stability and accuracy. PMID:24339837

  20. A Mixed Method Research for Finding a Model of Administrative Decentralization

    OpenAIRE

    Tahereh Feizy; Alireza Moghali; Masuod Geramipoor; Reza Zare

    2015-01-01

    One of the critical issues of administrative decentralization in translating theory into practice is understanding its meaning. An important method to identify administrative decentralization is to address how it can be planned and implemented, and what are its implications, and how it would overcome challenges. The purpose of this study is finding a model for analyzing and evaluating administrative decentralization, so a mixed method research was used to explore and confirm the model of Admi...

  1. Error-finding and error-correcting methods for the start-up of the SLC

    International Nuclear Information System (INIS)

    Lee, M.J.; Clearwater, S.H.; Kleban, S.D.; Selig, L.J.

    1987-02-01

    During the commissioning of an accelerator, storage ring, or beam transfer line, one of the important tasks of an accelertor physicist is to check the first-order optics of the beam line and to look for errors in the system. Conceptually, it is important to distinguish between techniques for finding the machine errors that are the cause of the problem and techniques for correcting the beam errors that are the result of the machine errors. In this paper we will limit our presentation to certain applications of these two methods for finding or correcting beam-focus errors and beam-kick errors that affect the profile and trajectory of the beam respectively. Many of these methods have been used successfully in the commissioning of SLC systems. In order not to waste expensive beam time we have developed and used a beam-line simulator to test the ideas that have not been tested experimentally. To save valuable physicist's time we have further automated the beam-kick error-finding procedures by adopting methods from the field of artificial intelligence to develop a prototype expert system. Our experience with this prototype has demonstrated the usefulness of expert systems in solving accelerator control problems. The expert system is able to find the same solutions as an expert physicist but in a more systematic fashion. The methods used in these procedures and some of the recent applications will be described in this paper

  2. "Expectations to Change" ((E2C): A Participatory Method for Facilitating Stakeholder Engagement with Evaluation Findings

    Science.gov (United States)

    Adams, Adrienne E.; Nnawulezi, Nkiru A.; Vandenberg, Lela

    2015-01-01

    From a utilization-focused evaluation perspective, the success of an evaluation is rooted in the extent to which the evaluation was used by stakeholders. This paper details the "Expectations to Change" (E2C) process, an interactive, workshop-based method designed to engage primary users with their evaluation findings as a means of…

  3. Using Machine Learning Methods Jointly to Find Better Set of Rules in Data Mining

    Directory of Open Access Journals (Sweden)

    SUG Hyontai

    2017-01-01

    Full Text Available Rough set-based data mining algorithms are one of widely accepted machine learning technologies because of their strong mathematical background and capability of finding optimal rules based on given data sets only without room for prejudiced views to be inserted on the data. But, because the algorithms find rules very precisely, we may confront with the overfitting problem. On the other hand, association rule algorithms find rules of association, where the association resides between sets of items in database. The algorithms find itemsets that occur more than given minimum support, so that they can find the itemsets practically in reasonable time even for very large databases by supplying the minimum support appropriately. In order to overcome the problem of the overfitting problem in rough set-based algorithms, first we find large itemsets, after that we select attributes that cover the large itemsets. By using the selected attributes only, we may find better set of rules based on rough set theory. Results from experiments support our suggested method.

  4. Multiple methods of surgical treatment combined with primary IOL implantation on traumatic lens subluxation/dislocation in patients with secondary glaucoma.

    Science.gov (United States)

    Wang, Rui; Bi, Chun-Chao; Lei, Chun-Ling; Sun, Wen-Tao; Wang, Shan-Shan; Dong, Xiao-Juan

    2014-01-01

    To describe clinical findings and complications from cases of traumatic lens subluxation/dislocation in patients with secondary glaucoma, and discuss the multiple treating methods of operation combined with primary intraocular lens (IOL) implantation. Non-comparative retrospective observational case series. 30 cases (30 eyes) of lens subluxation/dislocation in patients with secondary glaucoma were investigated which accepted the surgical treatment by author in the Ophthalmology of Xi'an No.4 Hospital from 2007 to 2011. According to the different situations of lens subluxation/dislocation, various surgical procedures were performed such as crystalline lens phacoemulsification, crystalline lens phacoemulsification combined anterior vitrectomy, intracapsular cataract extraction combined anterior vitrectomy, lensectomy combined anterior vitrectomy though peripheral transparent cornea incision, pars plana lensectomy combined pars plana vitrectomy, and intravitreal cavity crystalline lens phacofragmentation combined pars plana vitrectomy. And whether to implement trabeculectomy depended on the different situations of secondary glaucoma. The posterior chamber intraocular lenses (PC-IOLs) were implanted in the capsular-bag or trassclerally sutured in the sulus decided by whether the capsular were present. visual acuity, intraocular pressure, the situation of intraocular lens and complications after the operations. The follow-up time was 11-36mo (21.4±7.13). Postoperative visual acuity of all eyes were improved; 28 cases maintained IOP below 21 mm Hg; 2 cases had slightly IOL subluxation, 4 cases had slightly tilted lens optical area; 1 case had postoperative choroidal detachment; 4 cases had postoperative corneal edema more than 1wk, but eventually recovered transparent; 2 cases had mild postoperative vitreous hemorrhage, and absorbed 4wk later. There was no postoperative retinal detachment, IOL dislocation, and endophthalmitis. To take early treatment of traumatic lens

  5. Delayed peripheral nerve repair: methods, including surgical 'cross-bridging' to promote nerve regeneration.

    Science.gov (United States)

    Gordon, Tessa; Eva, Placheta; Borschel, Gregory H

    2015-10-01

    Despite the capacity of Schwann cells to support peripheral nerve regeneration, functional recovery after nerve injuries is frequently poor, especially for proximal injuries that require regenerating axons to grow over long distances to reinnervate distal targets. Nerve transfers, where small fascicles from an adjacent intact nerve are coapted to the nerve stump of a nearby denervated muscle, allow for functional return but at the expense of reduced numbers of innervating nerves. A 1-hour period of 20 Hz electrical nerve stimulation via electrodes proximal to an injury site accelerates axon outgrowth to hasten target reinnervation in rats and humans, even after delayed surgery. A novel strategy of enticing donor axons from an otherwise intact nerve to grow through small nerve grafts (cross-bridges) into a denervated nerve stump, promotes improved axon regeneration after delayed nerve repair. The efficacy of this technique has been demonstrated in a rat model and is now in clinical use in patients undergoing cross-face nerve grafting for facial paralysis. In conclusion, brief electrical stimulation, combined with the surgical technique of promoting the regeneration of some donor axons to 'protect' chronically denervated Schwann cells, improves nerve regeneration and, in turn, functional outcomes in the management of peripheral nerve injuries.

  6. Delayed peripheral nerve repair: methods, including surgical ′cross-bridging′ to promote nerve regeneration

    Directory of Open Access Journals (Sweden)

    Tessa Gordon

    2015-01-01

    Full Text Available Despite the capacity of Schwann cells to support peripheral nerve regeneration, functional recovery after nerve injuries is frequently poor, especially for proximal injuries that require regenerating axons to grow over long distances to reinnervate distal targets. Nerve transfers, where small fascicles from an adjacent intact nerve are coapted to the nerve stump of a nearby denervated muscle, allow for functional return but at the expense of reduced numbers of innervating nerves. A 1-hour period of 20 Hz electrical nerve stimulation via electrodes proximal to an injury site accelerates axon outgrowth to hasten target reinnervation in rats and humans, even after delayed surgery. A novel strategy of enticing donor axons from an otherwise intact nerve to grow through small nerve grafts (cross-bridges into a denervated nerve stump, promotes improved axon regeneration after delayed nerve repair. The efficacy of this technique has been demonstrated in a rat model and is now in clinical use in patients undergoing cross-face nerve grafting for facial paralysis. In conclusion, brief electrical stimulation, combined with the surgical technique of promoting the regeneration of some donor axons to ′protect′ chronically denervated Schwann cells, improves nerve regeneration and, in turn, functional outcomes in the management of peripheral nerve injuries.

  7. Numerical Methods Are Feasible for Assessing Surgical Techniques: Application to Astigmatic Keratotomy

    Energy Technology Data Exchange (ETDEWEB)

    Ariza-Gracia, M.A.; Ortilles, A.; Cristobal, J.A.; Rodriguez, J.F.; Calvo, B.

    2016-07-01

    The present study proposes an experimental-numerical protocol whose novelty relies on using both the inflation and the indentation experiments simultaneously to obtain a set of material parameters which accounts for both deformation modes of the cornea: the physiological (biaxial tension) and the non-physiological (bending). The experimental protocol characterizes the corneal geometry and the mechanical response of the cornea when subjected to the experimental tests using an animal model (New Zealand rabbit's cornea). The numerical protocol reproduces the experimental tests by means of an inverse finite element methodology to obtain the set of material properties that minimizes both mechanical responses at the same time. To validate the methodology, an Astigmatic Keratotomy refractive surgery is performed on 4 New Zealand rabbit corneas. The pre and post-surgical topographies of the anterior corneal surface were measured using a MODI topographer (CSO, Italy) to control the total change in astigmatism. Afterwards, the surgery is numerically reproduced to predict the overall change of the cornea. Results showed an acceptable numerical prediction, close to the average experimental correction, validating the material parameters obtained with the proposed protocol. (Author)

  8. Effect of different surgical methods on traumatic response degree and osteoblast-osteoclast balance in patients with distal tibial fracture

    Directory of Open Access Journals (Sweden)

    Yun-Qiang Fan

    2017-01-01

    Full Text Available Objective: To study the effect of different surgical methods on trauma response degree and osteoblast-osteoclast balance in patients with distal tibial fracture. Methods: 58 cases of patients with distal tibial fracture who received open reduction and internal fixation in Orthopedics Department of our hospital from May 2013 to October 2015 were selected as research subjects and divided into delayed group (n = 29 and routine group (n = 29 according to different timing of surgery. Delayed group received open reduction and internal fixation 7–15 d after trauma and routine group received open reduction and internal fixation within 24 h after trauma. Levels of serum stress response indicators and osteoblast-osteoclast markers were compared between two groups. Results: On the day after operation, serum adrenocorticotropic hormone, cortisol, renin, angiotensin II, epinephrine and norepinephrine levels of delayed group were significantly lower than those of control group (P<0.05; on the 7th day after operation, serum osteocalcin, procollagen type I carboxyl-terminal peptide and bone alkaline phosphatase of delayed group were significantly higher than those of control group (P<0.05 while cross-linked carboxyl-terminal telopeptide of type I collagen and tartrate-resistant acid phosphatase isoform 5b levels were significantly lower than those of control group (P<0.05. Conclusions: Delayed open reduction and internal fixation treatment of distal tibial fracture can reduce the trauma caused by surgical procedures, increase osteoblast viability and inhibit osteoclast viability, which are conducive to fracture healing.

  9. Finding all solutions of nonlinear equations using the dual simplex method

    Science.gov (United States)

    Yamamura, Kiyotaka; Fujioka, Tsuyoshi

    2003-03-01

    Recently, an efficient algorithm has been proposed for finding all solutions of systems of nonlinear equations using linear programming. This algorithm is based on a simple test (termed the LP test) for nonexistence of a solution to a system of nonlinear equations using the dual simplex method. In this letter, an improved version of the LP test algorithm is proposed. By numerical examples, it is shown that the proposed algorithm could find all solutions of a system of 300 nonlinear equations in practical computation time.

  10. Development of an integrated optical coherence tomography-gas nozzle system for surgical laser ablation applications: preliminary findings of in situ spinal cord deformation due to gas flow effects.

    Science.gov (United States)

    Wong, Ronnie; Jivraj, Jamil; Vuong, Barry; Ramjist, Joel; Dinn, Nicole A; Sun, Cuiru; Huang, Yize; Smith, James A; Yang, Victor X D

    2015-01-01

    Gas assisted laser machining of materials is a common practice in the manufacturing industry. Advantages in using gas assistance include reducing the likelihood of flare-ups in flammable materials and clearing away ablated material in the cutting path. Current surgical procedures and research do not take advantage of this and in the case for resecting osseous tissue, gas assisted ablation can help minimize charring and clear away debris from the surgical site. In the context of neurosurgery, the objective is to cut through osseous tissue without damaging the underlying neural structures. Different inert gas flow rates used in laser machining could cause deformations in compliant materials. Complications may arise during surgical procedures if the dura and spinal cord are damaged by these deformations. We present preliminary spinal deformation findings for various gas flow rates by using optical coherence tomography to measure the depression depth at the site of gas delivery.

  11. A Root-MUSIC-Like Direction Finding Method for Cyclostationary Signals

    Directory of Open Access Journals (Sweden)

    Yide Wang

    2005-01-01

    Full Text Available We propose a new root-MUSIC-like direction finding algorithm that exploits cyclostationarity in order to improve the direction-of-arrival estimation. The proposed cyclic method is signal selective, it allows to increase the resolution power and the noise robustness significantly, and it is also able to handle more sources than the number of sensors. Computer simulations are used to show the performance of the algorithm.

  12. Numerical form-finding method for large mesh reflectors with elastic rim trusses

    Science.gov (United States)

    Yang, Dongwu; Zhang, Yiqun; Li, Peng; Du, Jingli

    2018-06-01

    Traditional methods for designing a mesh reflector usually treat the rim truss as rigid. Due to large aperture, light weight and high accuracy requirements on spaceborne reflectors, the rim truss deformation is indeed not negligible. In order to design a cable net with asymmetric boundaries for the front and rear nets, a cable-net form-finding method is firstly introduced. Then, the form-finding method is embedded into an iterative approach for designing a mesh reflector considering the elasticity of the supporting rim truss. By iterations on form-findings of the cable-net based on the updated boundary conditions due to the rim truss deformation, a mesh reflector with a fairly uniform tension distribution in its equilibrium state could be finally designed. Applications on offset mesh reflectors with both circular and elliptical rim trusses are illustrated. The numerical results show the effectiveness of the proposed approach and that a circular rim truss is more stable than an elliptical rim truss.

  13. Validity of a structured method of selecting abstracts for a plastic surgical scientific meeting

    NARCIS (Netherlands)

    van der Steen, LPE; Hage, JJ; Kon, M; Monstrey, SJ

    In 1999, the European Association of Plastic Surgeons accepted a structured method to assess and select the abstracts that are submitted for its yearly scientific meeting. The two criteria used to evaluate whether such a selection method is accurate were reliability and validity. The authors

  14. Functional cine MR imaging for the detection and mapping of intraabdominal adhesions: method and surgical correlation

    Energy Technology Data Exchange (ETDEWEB)

    Buhmann-Kirchhoff, Sonja; Reiser, Maximilian; Lienemann, Andreas [University Hospital Grosshadern, Ludwig-Maximilians-University Munich, Department of Clinical Radiology, Munich (Germany); Lang, Reinhold; Steitz, Heinrich O.; Jauch, Karl W. [University Hospital Munich-Grosshadern, Department of Surgery, Munich (Germany); Kirchhoff, Chlodwig [University Hospital Munich-Innenstadt, Department of Surgery, Munich (Germany)

    2008-06-15

    The purpose of this study was to evaluate the presence and localization of intraabdominal adhesions using functional cine magnetic resonance imaging (MRI) and to correlate the MR findings with intraoperative results. In a retrospective study, patients who had undergone previous abdominal surgery with suspected intraabdominal adhesions were examined. A true fast imaging with steady state precession sequence in transverse/sagittal orientation was used for a section-by-section dynamic depiction of visceral slide on a 1.5-Tesla system. After MRI, all patients underwent anew surgery. A nine-segment abdominal map was used to document the location and type of the adhesions. The intraoperative results were taken as standard of reference. Ninety patients were enrolled. During surgery 71 adhesions were detected, MRI depicted 68 intraabdominal adhesions. The most common type of adhesion in MRI was found between the anterior abdominal wall and small bowel loops (n = 22, 32.5%) and between small bowel loops and pelvic organs (n = 14, 20.6%). Comparing MRI with the intraoperative findings, sensitivity varied between 31 and 75% with a varying specificity between 65 and 92% in the different segments leading to an overall MRI accuracy of 89%. Functional cine MRI proved to be a useful examination technique for the identification of intraabdominal adhesions in patients with acute or chronic pain and corresponding clinical findings providing accurate results. However, no differentiation for symptomatic versus asymptomatic adhesions is possible. (orig.)

  15. Search methods that people use to find owners of lost pets.

    Science.gov (United States)

    Lord, Linda K; Wittum, Thomas E; Ferketich, Amy K; Funk, Julie A; Rajala-Schultz, Päivi J

    2007-06-15

    To characterize the process by which people who find lost pets search for the owners. Cross-sectional study. Sample Population-188 individuals who found a lost pet in Dayton, Ohio, between March 1 and June 30, 2006. Procedures-Potential participants were identified as a result of contact with a local animal agency or placement of an advertisement in the local newspaper. A telephone survey was conducted to identify methods participants used to find the pets' owners. 156 of 188 (83%) individuals completed the survey. Fifty-nine of the 156 (38%) pets were reunited with their owners; median time to reunification was 2 days (range, 0.5 to 45 days). Only 1 (3%) cat owner was found, compared with 58 (46%) dog owners. Pet owners were found as a result of information provided by an animal agency (25%), placement of a newspaper advertisement (24%), walking the neighborhood (19%), signs in the neighborhood (15%), information on a pet tag (10%), and other methods (7%). Most finders (87%) considered it extremely important to find the owner, yet only 13 (8%) initially surrendered the found pet to an animal agency. The primary reason people did not surrender found pets was fear of euthanasia (57%). Only 97 (62%) individuals were aware they could run a found-pet advertisement in the newspaper at no charge, and only 1 person who was unaware of the no-charge policy placed an advertisement. Veterinarians and shelters can help educate people who find lost pets about methods to search for the pets' owners.

  16. CT two-dimensional reformation versus three-dimensional volume rendering with regard to surgical findings in the preoperative assessment of the ossicular chain in chronic suppurative otitis media

    International Nuclear Information System (INIS)

    Guo, Yong; Liu, Yang; Lu, Qiao-hui; Zheng, Kui-hong; Shi, Li-jing; Wang, Qing-jun

    2013-01-01

    Purpose: To assess the role of three-dimensional volume rendering (3DVR) in the preoperative assessment of the ossicular chain in chronic suppurative otitis media (CSOM). Materials and methods: Sixty-six patients with CSOM were included in this prospective study. Temporal bone was scanned with a 128-channel multidetector row CT and the axial data was transferred to the workstation for multiplanar reformation (MPR) and 3DVR reconstructions. Evaluation of the ossicular chain according to a three-point scoring system on two-dimensional reformation (2D) and 3DVR was performed independently by two radiologists. The evaluation results were compared with surgical findings. Results: 2D showed over 89% accuracy in the assessment of segmental absence of the ossicular chain in CSOM, no matter how small the segmental size was. 3DVR was as accurate as 2D for the assessment of segmental absence. However, 3DVR was found to be more accurate than 2D in the evaluation of partial erosion of segments. Conclusion: Both 3DVR and 2D are accurate and reliable for the assessment of the ossicular chain in CSOM. The inclusion of 3DVR images in the imaging protocol improves the accuracy of 2D in detecting ossicular erosion from CSOM

  17. CT two-dimensional reformation versus three-dimensional volume rendering with regard to surgical findings in the preoperative assessment of the ossicular chain in chronic suppurative otitis media

    Energy Technology Data Exchange (ETDEWEB)

    Guo, Yong, E-mail: guoyong27@hotmail.com [Department of Radiology, Navy General Hospital, 6# Fucheng Road, Beijing 100048 (China); Liu, Yang, E-mail: liuyangdoc@sina.com [Department of Otorhinolaryngology, Navy General Hospital, 6# Fucheng Road, Beijing 100048 (China); Lu, Qiao-hui, E-mail: Luqiaohui465@126.com [Department of Radiology, Navy General Hospital, 6# Fucheng Road, Beijing 100048 (China); Zheng, Kui-hong, E-mail: zhengkuihong1971@sina.com [Department of Radiology, Navy General Hospital, 6# Fucheng Road, Beijing 100048 (China); Shi, Li-jing, E-mail: Shilijing2003@yahoo.com.cn [Department of Radiology, Navy General Hospital, 6# Fucheng Road, Beijing 100048 (China); Wang, Qing-jun, E-mail: wangqingjun77@163.com [Department of Radiology, Navy General Hospital, 6# Fucheng Road, Beijing 100048 (China)

    2013-09-15

    Purpose: To assess the role of three-dimensional volume rendering (3DVR) in the preoperative assessment of the ossicular chain in chronic suppurative otitis media (CSOM). Materials and methods: Sixty-six patients with CSOM were included in this prospective study. Temporal bone was scanned with a 128-channel multidetector row CT and the axial data was transferred to the workstation for multiplanar reformation (MPR) and 3DVR reconstructions. Evaluation of the ossicular chain according to a three-point scoring system on two-dimensional reformation (2D) and 3DVR was performed independently by two radiologists. The evaluation results were compared with surgical findings. Results: 2D showed over 89% accuracy in the assessment of segmental absence of the ossicular chain in CSOM, no matter how small the segmental size was. 3DVR was as accurate as 2D for the assessment of segmental absence. However, 3DVR was found to be more accurate than 2D in the evaluation of partial erosion of segments. Conclusion: Both 3DVR and 2D are accurate and reliable for the assessment of the ossicular chain in CSOM. The inclusion of 3DVR images in the imaging protocol improves the accuracy of 2D in detecting ossicular erosion from CSOM.

  18. Surgical lighting

    NARCIS (Netherlands)

    Knulst, A.J.

    2017-01-01

    The surgical light is an important tool for surgeons to create and maintain good visibility on the surgical task. Chapter 1 gives background to the field of (surgical) lighting and related terminology. Although the surgical light has been developed strongly since its introduction a long time ago,

  19. Partial matricectomy with curettage and electrocautery: a comparison of two surgical methods in the treatment of ingrown toenails.

    Science.gov (United States)

    Ozan, Firat; Doğar, Fatih; Altay, Taşkin; Uğur, Sabri Gökhan; Koyuncu, Şemmi

    2014-10-01

    An ingrown toenail is a common, painful, and debilitating condition. This study aims to compare 2 surgical methods (partial matricectomy with curettage and electrocautery) in the treatment of ingrown toenails. A total of 92 ingrown nails of the big toe in 86 patients underwent partial matricectomy with curettage, whereas 57 ingrown nails of the big toe in 52 patients underwent partial matricectomy with electrocautery. Recurrence was observed in 2 toenails in the partial matricectomy with curettage group, whereas no recurrence was observed in the partial matricectomy with electrocautery group (p > .05). The mean period of postoperative pain was 2.3 and 3.1 days in the curettage group and the electrocautery group, respectively (p electrocautery in respect of reduced inflammation and duration of pain.

  20. The Straightened Splenic Vessels Method Improves Surgical Outcomes of Laparoscopic Distal Pancreatectomy.

    Science.gov (United States)

    Nagakawa, Yuichi; Sahara, Yatsuka; Hosokawa, Yuichi; Takishita, Chie; Kasuya, Kazuhiko; Tsuchida, Akihiko

    2017-01-01

    In laparoscopic distal pancreatectomy (LDP), isolating the splenic artery and vein requires advanced techniques. This study aimed to assess the efficacy of a novel method termed the 'straightened splenic vessels' (SSV) method for isolating the splenic vessels in LDP. In SSV, to adjust the instrument axis, the splenic artery was straightened by grasping 2 points of its nerve sheath. Then, the layer between the splenic artery's nerve sheath and the pancreatic parenchyma was dissected. Next, the pancreas was mobilized from body to tail, and the splenic vein was straightened by 3-point retraction before isolation. To evaluate this method's efficacy, we investigated 51 patients who underwent LDP. In 39 patients who underwent LDP with splenectomy, the mean operating time was significantly shorter in the SSV group than in the conventional group (p = 0.004). In 12 patients who underwent LDP with preserving the splenic vessels, the mean intraoperative blood loss in the SSV group was 27.6 ml, which was significantly lower than that in the conventional group (p = 0.012). This method may be applied as a standard procedure with little blood loss and short operation time for LDP. Larger prospective studies are needed to further evaluate the feasibility. © 2017 S. Karger AG, Basel.

  1. A simple method for finding explicit analytic transition densities of diffusion processes with general diploid selection.

    Science.gov (United States)

    Song, Yun S; Steinrücken, Matthias

    2012-03-01

    The transition density function of the Wright-Fisher diffusion describes the evolution of population-wide allele frequencies over time. This function has important practical applications in population genetics, but finding an explicit formula under a general diploid selection model has remained a difficult open problem. In this article, we develop a new computational method to tackle this classic problem. Specifically, our method explicitly finds the eigenvalues and eigenfunctions of the diffusion generator associated with the Wright-Fisher diffusion with recurrent mutation and arbitrary diploid selection, thus allowing one to obtain an accurate spectral representation of the transition density function. Simplicity is one of the appealing features of our approach. Although our derivation involves somewhat advanced mathematical concepts, the resulting algorithm is quite simple and efficient, only involving standard linear algebra. Furthermore, unlike previous approaches based on perturbation, which is applicable only when the population-scaled selection coefficient is small, our method is nonperturbative and is valid for a broad range of parameter values. As a by-product of our work, we obtain the rate of convergence to the stationary distribution under mutation-selection balance.

  2. Methodically finding solutions of equipments for carrying out experiments in materials testing and research. Pt. 2

    International Nuclear Information System (INIS)

    Findeisen, D.; Nachtweide, D.; Kuntze, G.

    1983-01-01

    In comparison with the development of industrial products the development of test equipments is of special kind, which is demonstrated by methodical proceeding for finding solutions and by potentialities for technical design and production of test equipment engineering. Some general principles are turned out and explained by several realized examples of design belonging to the sphere of materials testing in den Federal Institute of Materials Testing (BAM) representative of other problems. User are large scientific institutes independent of university, scientific institutes as members of university just as test stands and quality control offices of industrial works. (orig.) [de

  3. Multiple methods of surgical treatment combined with primary IOL implantation on traumatic lens subluxation/dislocation in patients with secondary glaucoma

    Directory of Open Access Journals (Sweden)

    Rui Wang

    2014-04-01

    Full Text Available AIM:To describe clinical findings and complications from cases of traumatic lens subluxation/dislocation in patients with secondary glaucoma, and discuss the multiple treating methods of operation combined with primary intraocular lens (IOL implantation.METHODS:Non-comparative retrospective observational case series. Participants:30 cases (30 eyes of lens subluxation/dislocation in patients with secondary glaucoma were investigated which accepted the surgical treatment by author in the Ophthalmology of Xi''an No.4 Hospital from 2007 to 2011. According to the different situations of lens subluxation/dislocation, various surgical procedures were performed such as crystalline lens phacoemulsification, crystalline lens phacoemulsification combined anterior vitrectomy, intracapsular cataract extraction combined anterior vitrectomy, lensectomy combined anterior vitrectomy though peripheral transparent cornea incision, pars plana lensectomy combined pars plana vitrectomy, and intravitreal cavity crystalline lens phacofragmentation combined pars plana vitrectomy. And whether to implement trabeculectomy depended on the different situations of secondary glaucoma. The posterior chamber intraocular lenses (PC-IOLs were implanted in the capsular-bag or trassclerally sutured in the sulus decided by whether the capsular were present. Main outcome measures:visual acuity, intraocular pressure, the situation of intraocular lens and complications after the operations.RESULTS: The follow-up time was 11-36mo (21.4±7.13. Postoperative visual acuity of all eyes were improved; 28 cases maintained IOP below 21 mm Hg; 2 cases had slightly IOL subluxation, 4 cases had slightly tilted lens optical area; 1 case had postoperative choroidal detachment; 4 cases had postoperative corneal edema more than 1wk, but eventually recovered transparent; 2 cases had mild postoperative vitreous hemorrhage, and absorbed 4wk later. There was no postoperative retinal detachment, IOL

  4. Method of surgical renewal of continuity of pelvic ring in children with extrophy of bladder

    Directory of Open Access Journals (Sweden)

    O. V. Shchekin

    2013-04-01

    Full Text Available Section of back and interbone sacroiliac ligaments from both sides, at extrophy of bladder, instead of osteotomу of iliac bones allows easily to liquidate large diastasis between pubic bones, to carry out them osteosintez, to normalize the location of hip joints and enables to carry out plastic of bladder. Thus there is no bleeding, as ligament have not blood vessels, and there is no cutting or damage of ligatures in the place of osteosinthesis of pubic bones. 3 children aged from 3 weeks to 1 year are operated according to this method. Complications were not present.

  5. Surgical treatment of chronic sacrococcygeal pilonidal sinus. Open method versus primary closure

    International Nuclear Information System (INIS)

    Kareem, Tayeb S.

    2006-01-01

    Objective was to study the comparison between the primary closure and open technique after excision of chronic sacrococcygeal pilonidal sinus. A randomized study was designed and 77 patients with chronic sacrococcygeal pilonidal sinus were included in this study. This study took place in Rizgary Teaching Hospital, Erbil, Kurdistan, Iraq, from January 1997 to August 2003. The patients were separated into 2 groups; Group A (37 patients) were treated by open method (excision and healing by secondary intention) and Group B (40 patients) for whom primary midline suturing was performed after excision of the pilonidal sinus. The follow up ranged from 1.5-5.5 years (mean 4.16) was through outpatient visits. The Student t test was applied for statistical analysis for the operating time, hospital-stay, time off from work and wound healing time; and the results show extremely significant differences between the 2 groups (p<0.0001). The statistical analysis of the total number of postoperative complications of both techniques showed a significant difference (p=0.0401), while the differences were insignificant for each complication when analyzed separately. Excision and primary closure for chronic sacrococcygeal pilonidal sinus is superior to excision and healing by secondary intention. We believe that primary midline suturing is a useful method for management of chronic sacrococcygeal pilonidal sinus. (author)

  6. [Comparison of effectiveness between two surgical methods in treatment of thoracolumbar brucella spondylitis].

    Science.gov (United States)

    Yang, Xinming; Zuo, Xianhong; Jia, Yongli; Chang, Yuefei; Zhang, Peng; Ren, Yixing

    2014-10-01

    To compare the effectiveness between the method of simple posterior debridement combined with bone grafting and fusion and internal fixation and the method of one-stage anterior radical debridement combined with bone grafting and fusion and posterior internal fixation in the treatment of thoracolumbar brucella spondylitis so as to provide the reference for the clinical treatment. A retrospective analysis was made on the clinical data of 148 cases of thoracolumbar brucella spondylitis between January 2002 and January 2012. Simple posterior debridement combined with bone grafting and fusion and internal fixation was used in 78 cases (group A), and one-stage anterior radical debridement combined with bone grafting and fusion and posterior internal fixation in 70 cases (group B). There was no significant difference in gender, age, disease duration, involved vertebral segments, erythrocyte sedimentation rate (ESR), visual analogue scale (VAS) score, neural function grade of America Spinal Injury Association (ASIA), and kyphosis Cobb angle before operation between 2 groups (P > 0.05). The peri operation period indexes (hospitalization time, operation time, and intraoperative blood loss) and the clinical effectiveness indexes (VAS score, ASIA grade, Cobb angle, and ESR) were compared; the bone fusion and the internal fixation were observed. Incision infection and paravertebral and/or psoas abscess occurred in 2 and 3 cases of group A respectively. All incisions healed by first intention and 2 cases had pneumothorax in group B. The operation time and the hospitalization time of group A were significantly shorter than those of group B (P average. The VAS, ESR, and Cobb angle were significantly decreased at each time point after operation when compared with preoperative ones in 2 groups (P 0.05). The neurological function was significantly improved at 3 months after operation; there were 1 case of ASIA grade C, 14 cases of grade D, and 63 cases of grade E in group A, and

  7. An automated method to find transition states using chemical dynamics simulations.

    Science.gov (United States)

    Martínez-Núñez, Emilio

    2015-02-05

    A procedure to automatically find the transition states (TSs) of a molecular system (MS) is proposed. It has two components: high-energy chemical dynamics simulations (CDS), and an algorithm that analyzes the geometries along the trajectories to find reactive pathways. Two levels of electronic structure calculations are involved: a low level (LL) is used to integrate the trajectories and also to optimize the TSs, and a higher level (HL) is used to reoptimize the structures. The method has been tested in three MSs: formaldehyde, formic acid (FA), and vinyl cyanide (VC), using MOPAC2012 and Gaussian09 to run the LL and HL calculations, respectively. Both the efficacy and efficiency of the method are very good, with around 15 TS structures optimized every 10 trajectories, which gives a total of 7, 12, and 83 TSs for formaldehyde, FA, and VC, respectively. The use of CDS makes it a powerful tool to unveil possible nonstatistical behavior of the system under study. © 2014 Wiley Periodicals, Inc.

  8. BAYESIAN DATA AUGMENTATION DOSE FINDING WITH CONTINUAL REASSESSMENT METHOD AND DELAYED TOXICITY

    Science.gov (United States)

    Liu, Suyu; Yin, Guosheng; Yuan, Ying

    2014-01-01

    A major practical impediment when implementing adaptive dose-finding designs is that the toxicity outcome used by the decision rules may not be observed shortly after the initiation of the treatment. To address this issue, we propose the data augmentation continual re-assessment method (DA-CRM) for dose finding. By naturally treating the unobserved toxicities as missing data, we show that such missing data are nonignorable in the sense that the missingness depends on the unobserved outcomes. The Bayesian data augmentation approach is used to sample both the missing data and model parameters from their posterior full conditional distributions. We evaluate the performance of the DA-CRM through extensive simulation studies, and also compare it with other existing methods. The results show that the proposed design satisfactorily resolves the issues related to late-onset toxicities and possesses desirable operating characteristics: treating patients more safely, and also selecting the maximum tolerated dose with a higher probability. The new DA-CRM is illustrated with two phase I cancer clinical trials. PMID:24707327

  9. Reducing false-positive incidental findings with ensemble genotyping and logistic regression based variant filtering methods.

    Science.gov (United States)

    Hwang, Kyu-Baek; Lee, In-Hee; Park, Jin-Ho; Hambuch, Tina; Choe, Yongjoon; Kim, MinHyeok; Lee, Kyungjoon; Song, Taemin; Neu, Matthew B; Gupta, Neha; Kohane, Isaac S; Green, Robert C; Kong, Sek Won

    2014-08-01

    As whole genome sequencing (WGS) uncovers variants associated with rare and common diseases, an immediate challenge is to minimize false-positive findings due to sequencing and variant calling errors. False positives can be reduced by combining results from orthogonal sequencing methods, but costly. Here, we present variant filtering approaches using logistic regression (LR) and ensemble genotyping to minimize false positives without sacrificing sensitivity. We evaluated the methods using paired WGS datasets of an extended family prepared using two sequencing platforms and a validated set of variants in NA12878. Using LR or ensemble genotyping based filtering, false-negative rates were significantly reduced by 1.1- to 17.8-fold at the same levels of false discovery rates (5.4% for heterozygous and 4.5% for homozygous single nucleotide variants (SNVs); 30.0% for heterozygous and 18.7% for homozygous insertions; 25.2% for heterozygous and 16.6% for homozygous deletions) compared to the filtering based on genotype quality scores. Moreover, ensemble genotyping excluded > 98% (105,080 of 107,167) of false positives while retaining > 95% (897 of 937) of true positives in de novo mutation (DNM) discovery in NA12878, and performed better than a consensus method using two sequencing platforms. Our proposed methods were effective in prioritizing phenotype-associated variants, and an ensemble genotyping would be essential to minimize false-positive DNM candidates. © 2014 WILEY PERIODICALS, INC.

  10. Results of lateral ankle ligament repair surgery in one hundred and nineteen patients: do surgical method and arthroscopy timing matter?

    Science.gov (United States)

    Araoye, Ibukunoluwa; De Cesar Netto, Cesar; Cone, Brent; Hudson, Parke; Sahranavard, Bahman; Shah, Ashish

    2017-11-01

    Ankle sprains are the most common athletic injury. One of five chronic lateral ankle instability patients will require surgery, making operative outcomes crucial. The purpose of this study is to determine if operative method influences failure and complication rates in chronic lateral ankle ligament repair surgery. We retrospectively reviewed 119 cases (118 patients) of lateral ankle ligament surgery between 2006 and 2016. Patient charts and operative reports were examined for demographics, use and timing of ankle arthroscopy, ligament fixation method, type of surgical incision, presence of calcaneofibular ligament repair, and operative technique. Impact of operative methods on failure (one-year minimum follow-up) and complication outcomes was explored using Chi-square test of independence (or Fisher's exact test). Statistical significance was set at p less than .05. Mean age at surgery was 40 (range, 18-73) years. Mean follow-up was 51 (range, 12-260) weeks. Failure rate was 8.4% (10/89 cases) while complication rate was 17.6% (21/119). Failure rate did not differ significantly between any data subgroups (p > .05). Single stage arthroscopy was associated with a significantly lower complication rate (11%, 4/37) than double-stage arthroscopy (47%, 9/19) (p anchor ligament fixation (9%, 6/67) compared to direct suture ligament fixation (29%, 15/52) (p anchors and concurrent ankle arthroscopy may be favourable options to achieve fewer complications in chronic lateral ankle instability repair surgery.

  11. Better evidence for earlier assessment and surgical intervention for refractory epilepsy (The BEST study): a mixed methods study protocol.

    Science.gov (United States)

    Rapport, Frances; Shih, Patti; Mitchell, Rebecca; Nikpour, Armin; Bleasel, Andrew; Herkes, Geoffrey; Vagholkar, Sanjyot; Mumford, Virginia

    2017-08-21

    One-third of patients with refractory epilepsy may be candidates for resective surgery, which can lead to positive clinical outcomes if efficiently managed. In Australia, there is currently between a 6-month and 2-year delay for patients who are candidates for respective epilepsy surgery from the point of referral for surgical assessment to the eventual surgical intervention. This is a major challenge for implementation of effective treatment for individuals who could potentially benefit from surgery. This study examines implications of delays following the point of eligibility for surgery, in the assessment and treatment of patients, and the factors causing treatment delays. Mixed methods design: Observations of qualitative consultations, patient and healthcare professional interviews, and health-related quality of life assessments for a group of 10 patients and six healthcare professionals (group 1); quantitative retrospective medical records' reviews examining longitudinal outcomes for 50 patients assessed for, or undergoing, resective surgery between 2014 and 2016 (group 2); retrospective epidemiological study of all individuals hospitalised with a diagnosis of epilepsy in New South Wales (NSW) in the last 5 years (2012-2016; approximately 11 000 hospitalisations per year, total 55 000), examining health services' use and treatment for individuals with epilepsy, including refractory surgery outcomes (group 3). Ethical approval has been granted by the North Sydney Local Health District Human Research Ethics Committee (HREC/17/HAWKE/22) and the NSW Population & Health Services Research Ethics Committee (HREC/16/CIPHS/1). Results will be disseminated through publications, reports and conference presentations to patients and families, health professionals and researchers. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  12. Substantion of Choosing the Method of Surgical Treatment of Complicated Forms of Chronic Pancreatitis

    Directory of Open Access Journals (Sweden)

    I.Ya. Budzak

    2013-04-01

    Full Text Available In the Institute’s clinic during 2010–2012, 43 patients were operated for complicated forms of chronic pancreatitis. Based on the data of computed tomography and endoscopic retrograde cholangiopancreatography, the variants of pathology of the pancreas, which are significant for the selection of operation method, were chosen. Evaluation of intraoperative biopsies showed that the main manifestation of chronic pancreatitis in all cases was evident fibrosis of gland tissue. In this evaluation, in patients with III degree of fibrosis, fibrous tissue was 68.2–76.4 % of the area of pancreas, and exocrine one — 16.2–24.8 %, in patients with IV degree of fibrosis, respectively 79.5–95.5 and 2.3–10.8 %. Indications for organ-preserving resection, resection-draining interventions and isolated, draining pancreatic ductal system operations have been indicated. Specific weight of combined resection-draining interventions with preservation of the duodenum was 30.2 %, the overall mortality rate — 2.3 %, duration of postoperative bed-day (9.1 ± 0.8.

  13. Indication for the operative methods in surgical treatment of cervical spondylotic myelopathy

    International Nuclear Information System (INIS)

    Kobayashi, Akira; Inoue, Shunichi; Watabe, Tsuneo; Nagase, Joji; Harada, Yoshitada

    1984-01-01

    Indication for the operative methods for cervical spondylotic myelopathy was examined in 16 patients undergoing CT-myelography before and after operation. There was a highly significant correlation between the anteroposterior (A-P) diameter of the spinal cord and clinical symptoms. Patients with shorter A-P diameter of the spinal cord tended to have severer preoperative clinical symptoms. Clinical symptoms improved as the post operative A-P diameter of the spinal cord increased. Fixation with decompression of the anterior spinal cord should be indicated when constriction of 5 mm or less of the spinal cord is seen segmentally at the level of the intervertebral disc. Dilation of the spinal cavity should be indicated when the constriction of the spinal cord is 5 mm or less at all levels of the cervical spinal cord. In performing fixation with anterior decompression, 15 mm is considered to be the most suitable width for complete and safe decompression of the flattened spinal cord with a wide transverse diameter. (Namekawa, K)

  14. MRI and its role in the evaluation and surgical decision making in patients with challenging IPP presentations: descriptions of MRI findings and algorithm for patient management.

    Science.gov (United States)

    McPhail, E Fred; Nehra, Ajay; Bruner, Bryan C; Kawashima, Akira; King, Bernard F; Kim, Bohyun

    2012-06-01

    Study Type - Diagnostic (case series) Level of Evidence 4 What's known on the subject? and What does the study add? It is known that magnetic resonance imaging (MRI) is safe and effective for imaging patients with inflatable penile prostheses (IPPs). Previous series have reported results of MRI for imaging series of patients with IPPs. The impact on management in particular with regard to salvage procedures is not well defined. This study represents the largest known experience with MRI evaluation of IPPs. This also provides an algorithm that assists with decisions regarding utilization of MRI and treatment planning based on results. • In some patients who undergo placement of an inflatable penile prosthesis (IPP) the device may function inadequately. We describe the use of magnetic resonance imaging (MRI) for anatomical localization and detection of prosthesis malrotation, angulation, displacement and erosion in IPPs with equivocal clinical examination. • We prospectively performed MRI by a defined protocol including T1-weighted imaging, and transaxial, sagittal and coronal fat-saturated fast spin-echo T2-weighted imaging in both deflated and inflated states to evaluate patients seen at our referral centre for IPP-related complaints. • We retrospectively reviewed 32 such MRI studies performed as a supplement to clinical examination between 2000 and 2008. • Of 32 cases, 75% (24/32) underwent surgical intervention. Of these, 45% (11/24) underwent device salvage procedures including cylinder revision in 33% (8/24), cylinder replacement in 8% (2/24) and pump replacement in 4% (1/24). • MRI was most useful for determination of surgical approach in those with abnormal physical examination, and for justification of either surgical or expectant management in those with indeterminate physical examination. • MRI is safe and effective for imaging genitourinary prostheses. • We found MRI to be a valuable adjunct for evaluation of IPP-related complaints when

  15. Mixed-Methods Assessment of Trauma and Acute Care Surgical Quality Improvement Programs in Peru.

    Science.gov (United States)

    LaGrone, Lacey N; Fuhs, Amy K; Egoavil, Eduardo Huaman; Rodriguez Castro, Manuel J A; Valderrama, Roberto; Isquith-Dicker, Leah N; Herrera-Matta, Jaime; Mock, Charles N

    2017-04-01

    Evidence for the positive impact of quality improvement (QI) programs on morbidity, mortality, patient satisfaction, and cost is strong. Data regarding the status of QI programs in low- and middle-income countries, as well as in-depth examination of barriers and facilitators to their implementation, are limited. This cross-sectional, descriptive study employed a mixed-methods design, including distribution of an anonymous quantitative survey and individual interviews with healthcare providers who participate in the care of the injured at ten large hospitals in Lima, Peru. Key areas identified for improvement in morbidity and mortality (M&M) conferences were the standardization of case selection, incorporation of evidence from the medical literature into case presentation and discussion, case documentation, and the development of a clear plan for case follow-up. The key barriers to QI program implementation were a lack of prioritization of QI, lack of sufficient human and administrative resources, lack of political support, and lack of education on QI practices. A national program that makes QI a required part of all health providers' professional training and responsibilities would effectively address a majority of identified barriers to QI programs in Peru. Specifically, the presence of basic QI elements, such as M&M conferences, should be required at hospitals that train pre-graduate physicians. Alternatively, short of this national-level organization, efforts that capitalize on local examples through apprenticeships between institutions or integration of QI into continuing medical education would be expected to build on the facilitators for QI programs that exist in Peru.

  16. THE USE OF THE PATENT ANALYSIS METHOD FOR FINDING ANALOGUES AND PROTOTYPES OF RECEIVED TECHNICAL SOLUTIONS

    Directory of Open Access Journals (Sweden)

    Irina Petrova

    2016-03-01

    Full Text Available The research deals with the issue of the patent analysis efficiency, which is a necessary stage of seaching analogues and prototypes to obtain technical solutions. The article presents the results of analyzing the present automation systems for finding necessary information in the patent databases and identifies their advantages and disadvantages. It gives a description of the “Intellect” system, which is an example of software systems for the conceptual design stage support. Materials and Methods The article presents some of the possible ways to organize the patents-analogues search process and specific features of searching analogues and prototypes for the generated parametric structure scheme of the technical solution, which is the result of the synthesis of a new information-measuring and control system element in the “Intellect” system. The description of the proposed search query forming method is given. The article gives the structure of the patent passport, which must be stored in a database to organize the process of searcing analogues and prototypes. There given a description of algorithms for automatic adding a patent to the database, recalculating the weights while adding a patent by experts, identifying the fact of using different physical and technical effects in a patent. Results The final part of the article contains an example of the results of testing the developed subsystem implementing the proposed method. According to the test results it is concluded that the selected software and algorithmic solutions are effective.

  17. Data-driven methods towards learning the highly nonlinear inverse kinematics of tendon-driven surgical manipulators.

    Science.gov (United States)

    Xu, Wenjun; Chen, Jie; Lau, Henry Y K; Ren, Hongliang

    2017-09-01

    Accurate motion control of flexible surgical manipulators is crucial in tissue manipulation tasks. The tendon-driven serpentine manipulator (TSM) is one of the most widely adopted flexible mechanisms in minimally invasive surgery because of its enhanced maneuverability in torturous environments. TSM, however, exhibits high nonlinearities and conventional analytical kinematics model is insufficient to achieve high accuracy. To account for the system nonlinearities, we applied a data driven approach to encode the system inverse kinematics. Three regression methods: extreme learning machine (ELM), Gaussian mixture regression (GMR) and K-nearest neighbors regression (KNNR) were implemented to learn a nonlinear mapping from the robot 3D position states to the control inputs. The performance of the three algorithms was evaluated both in simulation and physical trajectory tracking experiments. KNNR performed the best in the tracking experiments, with the lowest RMSE of 2.1275 mm. The proposed inverse kinematics learning methods provide an alternative and efficient way to accurately model the tendon driven flexible manipulator. Copyright © 2016 John Wiley & Sons, Ltd.

  18. Surgical smoke.

    Science.gov (United States)

    Fan, Joe King-Man; Chan, Fion Siu-Yin; Chu, Kent-Man

    2009-10-01

    Surgical smoke is the gaseous by-product formed during surgical procedures. Most surgeons, operating theatre staff and administrators are unaware of its potential health risks. Surgical smoke is produced by various surgical instruments including those used in electrocautery, lasers, ultrasonic scalpels, high speed drills, burrs and saws. The potential risks include carbon monoxide toxicity to the patient undergoing a laparoscopic operation, pulmonary fibrosis induced by non-viable particles, and transmission of infectious diseases like human papilloma virus. Cytotoxicity and mutagenicity are other concerns. Minimisation of the production of surgical smoke and modification of any evacuation systems are possible solutions. In general, a surgical mask can provide more than 90% protection to exposure to surgical smoke; however, in most circumstances it cannot provide air-tight protection to the user. An at least N95 grade or equivalent respirator offers the best protection against surgical smoke, but whether such protection is necessary is currently unknown.

  19. Randomized Comparison of Uterine Artery Embolization (UAE) with Surgical Treatment in Patients with Symptomatic Uterine Fibroids (REST Trial): Subanalysis of 5-Year MRI Findings

    Energy Technology Data Exchange (ETDEWEB)

    Ananthakrishnan, Ganapathy, E-mail: ganapathy.ananthakrishnan@nhs.net [Gartnavel General Hospital, Department of Interventional Radiology (United Kingdom); Murray, Lilian, E-mail: Lilian.murray@glasgow.ac.uk [Vital Statistics (United Kingdom); Ritchie, Moira, E-mail: moira.ritchie@ggc.scot.nhs.uk [Gartnavel General Hospital, Department of Interventional Radiology (United Kingdom); Murray, Gordon, E-mail: Gordon.murray@ed.ac.uk [Centre for Population Health Sciences, University of Edinburgh, Department of Medical Statistics (United Kingdom); Bryden, Fiona, E-mail: Fiona.bryden@ggc.scot.nhs.uk [Stobhill Hospital (United Kingdom); Lassman, Sue, E-mail: sue.lassman@ggc.scot.nhs.uk [Gartnavel General Hospital, Department of Interventional Radiology (United Kingdom); Lumsden, Mary Ann, E-mail: Maryann.lumsden@glasgow.ac.uk [Room 12, Level 4, Walton Building, Department of Medical Education and Gynaecology, Reproductive and Maternal Medicine (United Kingdom); Moss, Jon G., E-mail: jon.moss@ggc.scot.nhs.uk [Gartnavel General Hospital, Department of Interventional Radiology (United Kingdom)

    2013-06-15

    Purpose. To report 5-year contrast-enhanced magnetic resonance imaging findings of the REST trial recruits who underwent either uterine artery embolization (UAE) or myomectomy. Methods. A total of 157 patients were randomized to UAE or surgery (hysterectomy or myomectomy). Ninety-nine patients who had UAE and eight patients who had myomectomy were analyzed. MRI scans at baseline, 6 months, and 5 years were independently interpreted by two radiologists. Dominant fibroid diameter, uterine volume, total fibroid infarction (complete 100 %, almost complete 90-99 %, partial <90 %), and new fibroid formation were the main parameters assessed and related to the need for reintervention. Results. In the UAE group, mean {+-} standard deviation uterine volume was 670 {+-} 503, 422 {+-} 353, and 292 {+-} 287 mL at baseline, 6 months, and 5 years, respectively. Mean dominant fibroid diameter was 7.6 {+-} 3.0, 5.8 {+-} 2.9, and 5 {+-} 2.9 cm at baseline, 6 months, and 5 years. Fibroid infarction at 6 months was complete in 35 % of women, almost complete in 29 %, and partial in 36 %. Need for reintervention was 19, 10, and 33 % in these groups, respectively (p = 0.123). No myomectomy cases had further intervention. At 5 years, the prevalence of new fibroid was 60 % in the myomectomy group and 7 % in the UAE group (p = 0.008). Conclusion. There is a further significant reduction in both uterine volume and dominant fibroid diameter between 6 months and 5 years after UAE. Complete fibroid infarction does not translate into total freedom from a subsequent reintervention. New fibroid formation is significantly higher after myomectomy.

  20. Electrocution of Raptors on Power Lines: A Review of Necropsy Methods and Findings.

    Science.gov (United States)

    Kagan, R A

    2016-09-01

    Decades after the problem was first identified, power line electrocution continues to be a cause of avian mortality. Currently, several federal laws protect eagles and other migratory birds, meaning that utility companies may be liable for electrocution-related deaths. Veterinarians and veterinary pathologists called upon to diagnose and treat electrocuted birds should keep this in mind when conducting clinical and postmortem examinations. This review details necropsy findings and methods used to diagnose electrocution. A combination of gross, subgross, and radiographic examinations can aid in identification of subtle injury. Diagnosis is made based on the presence of skin and/or feather burns. Other necropsy findings may include skin lacerations, subcutaneous burns, bruising, limb avulsion, hemopericardium, and vascular rupture. At the US Fish and Wildlife Service's National Forensics Laboratory, from 2000 to 2015, 417 raptor deaths were determined to have been caused by electrocution. Bald eagles and golden eagles were the most commonly submitted species. In a retrospective review of 377 cases, for which whole bodies were submitted, 18% of the electrocuted birds had only a single, small (less than 3 cm in diameter) external burn. Small, isolated burns tended to occur on the undersides of the wings at and distal to the elbow and on the lower legs and feet. These areas should be most carefully examined in cases where electrocution injury is not immediately apparent. © The Author(s) 2016.

  1. School Locations and Traffic Emissions — Environmental (InJustice Findings Using a New Screening Method

    Directory of Open Access Journals (Sweden)

    Philine Gaffron

    2015-02-01

    Full Text Available It has been shown that the location of schools near heavily trafficked roads can have detrimental effects on the health of children attending those schools. It is therefore desirable to screen both existing school locations and potential new school sites to assess either the need for remedial measures or suitability for the intended use. Current screening tools and public guidance on school siting are either too coarse in their spatial resolution for assessing individual sites or are highly resource intensive in their execution (e.g., through dispersion modeling. We propose a new method to help bridge the gap between these two approaches. Using this method, we also examine the public K-12 schools in the Sacramento Area Council of Governments Region, California (USA from an environmental justice perspective. We find that PM2.5 emissions from road traffic affecting a school site are significantly positively correlated with the following metrics: percent share of Black, Hispanic and multi-ethnic students, percent share of students eligible for subsidized meals. The emissions metric correlates negatively with the schools’ Academic Performance Index, the share of White students and average parental education levels. Our PM2.5 metric also correlates with the traffic related, census tract level screening indicators from the California Communities Environmental Health Screening Tool and the tool’s tract level rate of asthma related emergency department visits.

  2. Attitudes of Registered and Licensed Practical Nurses About the Importance of Families in Surgical Hospital Units: Findings From the Landspitali University Hospital Family Nursing Implementation Project.

    Science.gov (United States)

    Blöndal, Katrin; Zoëga, Sigridur; Hafsteinsdottir, Jorunn E; Olafsdottir, Olof Asdis; Thorvardardottir, Audur B; Hafsteinsdottir, Sigrun A; Sveinsdóttir, Herdis

    2014-08-01

    The purpose of this study was to examine attitudes of registered nurses and licensed practical nurses about the importance of the family in surgical hospital units before (T1) and after (T2) implementation of a Family Systems Nursing educational intervention based on the Calgary Family Assessment and Intervention Models. This study was part of the Landspitali University Hospital Family Nursing Implementation Project and used a nonrandomized, quasi-experimental design with nonequivalent group before and after and without a control group. There were 181 participants at T1 and 130 at T2. No difference was found in nurses' attitudes as measured by the Families Importance in Nursing Care-Nurses' Attitudes (FINC-NA) questionnaire, before and after the educational intervention. Attitudes toward families were favorable at both times. Analysis of demographic variables showed that age, work experience, and workplace (inpatient vs. outpatient units) had an effect on the nurses' attitudes toward families. The influence of work experience on attitudes toward family care warrants further exploration. © The Author(s) 2014.

  3. The Dietary Patterns Methods Project: Synthesis of Findings across Cohorts and Relevance to Dietary Guidance1234

    Science.gov (United States)

    Liese, Angela D; Krebs-Smith, Susan M; Subar, Amy F; George, Stephanie M; Harmon, Brook E; Neuhouser, Marian L; Boushey, Carol J; Schap, TusaRebecca E; Reedy, Jill

    2015-01-01

    The Dietary Patterns Methods Project (DPMP) was initiated in 2012 to strengthen research evidence on dietary indices, dietary patterns, and health for upcoming revisions of the Dietary Guidelines for Americans, given that the lack of consistent methodology has impeded development of consistent and reliable conclusions. DPMP investigators developed research questions and a standardized approach to index-based dietary analysis. This article presents a synthesis of findings across the cohorts. Standardized analyses were conducted in the NIH-AARP Diet and Health Study, the Multiethnic Cohort, and the Women’s Health Initiative Observational Study (WHI-OS). Healthy Eating Index 2010, Alternative Healthy Eating Index 2010 (AHEI-2010), alternate Mediterranean Diet, and Dietary Approaches to Stop Hypertension (DASH) scores were examined across cohorts for correlations between pairs of indices; concordant classifications into index score quintiles; associations with all-cause, cardiovascular disease (CVD), and cancer mortality with the use of Cox proportional hazards models; and dietary intake of foods and nutrients corresponding to index quintiles. Across all cohorts in women and men, there was a high degree of correlation and consistent classifications between index pairs. Higher diet quality (top quintile) was significantly and consistently associated with an 11–28% reduced risk of death due to all causes, CVD, and cancer compared with the lowest quintile, independent of known confounders. This was true for all diet index–mortality associations, with the exception of AHEI-2010 and cancer mortality in WHI-OS women. In all cohorts, survival benefit was greater with a higher-quality diet, and relatively small intake differences distinguished the index quintiles. The reductions in mortality risk started at relatively lower levels of diet quality. Higher scores on each of the indices, signifying higher diet quality, were associated with marked reductions in mortality

  4. Development of a novel method for surgical implant design optimization through noninvasive assessment of local bone properties.

    Science.gov (United States)

    Schiuma, D; Brianza, S; Tami, A E

    2011-03-01

    A method was developed to improve the design of locking implants by finding the optimal paths for the anchoring elements, based on a high resolution pQCT assessment of local bone mineral density (BMD) distribution and bone micro-architecture (BMA). The method consists of three steps: (1) partial fixation of the implant to the bone and creation of a reference system, (2) implant removal and pQCT scan of the bone, and (3) determination of BMD and BMA of all implant-anchoring locations along the actual and alternative directions. Using a PHILOS plate, the method uncertainty was tested on an artificial humerus bone model. A cadaveric humerus was used to quantify how the uncertainty of the method affects the assessment of bone parameters. BMD and BMA were determined along four possible alternative screw paths as possible criteria for implant optimization. The method is biased by a 0.87 ± 0.12 mm systematic uncertainty and by a 0.44 ± 0.09 mm random uncertainty in locating the virtual screw position. This study shows that this method can be used to find alternative directions for the anchoring elements, which may possess better bone properties. This modification will thus produce an optimized implant design. Copyright © 2010 IPEM. Published by Elsevier Ltd. All rights reserved.

  5. Old Wine in New Skins: The Sensitivity of Established Findings to New Methods

    Science.gov (United States)

    Foster, E. Michael; Wiley-Exley, Elizabeth; Bickman, Leonard

    2009-01-01

    Findings from an evaluation of a model system for delivering mental health services to youth were reassessed to determine the robustness of key findings to the use of methodologies unavailable to the original analysts. These analyses address a key concern about earlier findings--that the quasi-experimental design involved the comparison of two…

  6. Computer-designed surgical guide template compared with free-hand operation for mesiodens extraction in premaxilla using “trapdoor” method

    Science.gov (United States)

    Hu, Ying Kai; Xie, Qian Yang; Yang, Chi; Xu, Guang Zhou

    2017-01-01

    Abstract The aim of this study was to introduce a novel method of mesiodens extraction using a vascularized pedicled bone flap by piezosurgery and to compare the differences between a computer-aided design surgical guide template and free-hand operation. A total of 8 patients with mesiodens, 4 with a surgical guide (group I), and 4 without it (group II) were included in the study. The surgical design was to construct a trapdoor pedicle on the superior mucoperiosteal attachment with application of piezosurgery. The bone lid was repositioned after mesiodens extraction. Group I patients underwent surgeries based on the preoperative planning with surgical guide templates, while group II patients underwent free-hand operation. The outcome variables were success rate, intraoperative time, anterior nasal spine (ANS) position, changes of nasolabial angle (NLA), and major complications. Data from the 2 groups were compared by SPSS 17.0, using Wilcoxon test. The operative time was significantly shorter in group I patients. All the mesiodentes were extracted successfully and no obvious differences of preoperative and postoperative ANS position and NLA value were found in both groups. The patients were all recovered uneventfully. Surgical guide templates can enhance clinical accuracy and reduce operative time by facilitating accurate osteotomies. PMID:28658139

  7. Cooling as a method of finding topological dislocations in lattice models

    International Nuclear Information System (INIS)

    Gomberoff, K.

    1989-01-01

    It is well known that the O(3) two-dimensional model has configurations with topological charge Q=1 and action S/sub min/=6.69. Since the exponent characterizing the renormalization-group behavior of this model is 4π such configurations invalidate the standard scaling behavior of the topological susceptibility. The analog exponent for the four-dimensional lattice SU(2) gauge model is 10.77. If there would exist configurations with Q=1 and S<10.77 in this model, they would invalidate the standard scaling behavior of its topological susceptibility. Kremer et al. have calculated the action of different configurations during cooling runs. They report that they do not find any configuration with S<12.7 and Q=1. I show that in the O(3) two-dimensional model cooling runs fail to uncover the well-known configurations with S<8. We conclude that the cooling method is not effective in uncovering the smallest action configurations in the Q=1 sector

  8. Novel method of finding extreme edges in a convex set of N-dimension vectors

    Science.gov (United States)

    Hu, Chia-Lun J.

    2001-11-01

    As we published in the last few years, for a binary neural network pattern recognition system to learn a given mapping {Um mapped to Vm, m=1 to M} where um is an N- dimension analog (pattern) vector, Vm is a P-bit binary (classification) vector, the if-and-only-if (IFF) condition that this network can learn this mapping is that each i-set in {Ymi, m=1 to M} (where Ymithere existsVmiUm and Vmi=+1 or -1, is the i-th bit of VR-m).)(i=1 to P and there are P sets included here.) Is POSITIVELY, LINEARLY, INDEPENDENT or PLI. We have shown that this PLI condition is MORE GENERAL than the convexity condition applied to a set of N-vectors. In the design of old learning machines, we know that if a set of N-dimension analog vectors form a convex set, and if the machine can learn the boundary vectors (or extreme edges) of this set, then it can definitely learn the inside vectors contained in this POLYHEDRON CONE. This paper reports a new method and new algorithm to find the boundary vectors of a convex set of ND analog vectors.

  9. Acquiring minimally invasive surgical skills

    OpenAIRE

    Hiemstra, Ellen

    2012-01-01

    Many topics in surgical skills education have been implemented without a solid scientific basis. For that reason we have tried to find this scientific basis. We have focused on training and evaluation of minimally invasive surgical skills in a training setting and in practice in the operating room. This thesis has led to an enlarged insight in the organization of surgical skills training during residency training of surgical medical specialists.

  10. Intervertebral disc disease in dogs - Part 2: Comparison of clinical, magnetic resonance imaging, and histological findings in 74 surgically treated dogs

    NARCIS (Netherlands)

    Kranenburg, H.C.; Grinwis, G.C.M.; Bergknut, N.; Gahrmann, Ninke; Voorhout, G.; Hazewinkel, H.A.W.

    The relationship between intervertebral disc (IVD) disease and IVD degeneration remains unclear. The aim of the present study was to compare the clinical severity of IVD herniation (IVDH), determined with a neurological grading system, with findings of magnetic resonance imaging (MRI) and

  11. Differences in mechanisms of failure, intraoperative findings, and surgical characteristics between single- and multiple-revision ACL reconstructions: a MARS cohort study.

    Science.gov (United States)

    Chen, James L; Allen, Christina R; Stephens, Thomas E; Haas, Amanda K; Huston, Laura J; Wright, Rick W; Feeley, Brian T

    2013-07-01

    The factors that lead to patients failing multiple anterior cruciate ligament (ACL) reconstructions are not well understood. Multiple-revision ACL reconstruction will have different characteristics than first-time revision in terms of previous and current graft selection, mode of failure, chondral/meniscal injuries, and surgical charactieristics. Case-control study; Level of evidence, 3. A prospective multicenter ACL revision database was utilized for the time period from March 2006 to June 2011. Patients were divided into those who underwent a single-revision ACL reconstruction and those who underwent multiple-revision ACL reconstructions. The primary outcome variable was Marx activity level. Primary data analyses between the groups included a comparison of graft type, perceived mechanism of failure, associated injury (meniscus, ligament, and cartilage), reconstruction type, and tunnel position. Data were compared by analysis of variance with a post hoc Tukey test. A total of 1200 patients (58% men; median age, 26 years) were enrolled, with 1049 (87%) patients having a primary revision and 151 (13%) patients having a second or subsequent revision. Marx activity levels were significantly higher (9.77) in the primary-revision group than in those patients with multiple revisions (6.74). The most common cause of reruptures was a traumatic, noncontact ACL graft injury in 55% of primary-revision patients; 25% of patients had a nontraumatic, gradual-onset recurrent injury, and 11% had a traumatic, contact injury. In the multiple-revision group, a nontraumatic, gradual-onset injury was the most common cause of recurrence (47%), followed by traumatic noncontact (35%) and nontraumatic sudden onset (11%) (P < .01 between groups). Chondral injuries in the medial compartment were significantly more common in the multiple-revision group than in the single-revision group, as were chondral injuries in the patellofemoral compartment. Patients with multiple-revision ACL

  12. CT findings in initial diagnosis and follow-up in surgically and medically treated intracerebral hemorrhage of non-traumatic and non-aneurysmatic origin

    International Nuclear Information System (INIS)

    Nahser, H.C.; Loehr, E.; Nau, H.E.; Reinhardt, V.

    1980-01-01

    The potential of computerized tomography (CT) in diagnosis and follow-up of intracerebral hemorrhage is demonstrated. The study is based on 37 patients suffering from medical diseases such as high blood pressure, diabetics, generalized arteriosclerosis, valvular heart disease and anticoagulation therapy. Ensuing complications, such as rupture into the ventricles and hydrocephalus, are being discussed. Special effort is made to explain the finding of the hyperdense ring structure occurring after contrast enhancement. (orig.) 891 MG/orig. 892 MKO [de

  13. Infant feeding experiences among teen mothers in North Carolina: Findings from a mixed-methods study

    Directory of Open Access Journals (Sweden)

    Samandari Ghazaleh

    2011-09-01

    Full Text Available Abstract Background Adolescent mothers in the U.S. are much less likely to initiate breastfeeding than older mothers, and teens who do initiate breastfeeding tend to breastfeed for shorter durations. The purpose of this mixed-methods study is to investigate breastfeeding practices, barriers and facilitators among adolescent mothers ages 17 and younger. Methods Quantitative descriptive analyses are conducted using data from the North Carolina Pregnancy Risk Assessment Monitoring System (PRAMS. The population-based sample comprises 389 teens ages 13-17 giving birth to a live born infant in North Carolina in 2000 - 2005 and in 2007. Qualitative analyses are based on in-depth interviews with 22 Black, White and Hispanic teen mothers residing in rural and urban areas of North Carolina conducted between November 2007 and February 2009. Results In quantitative analyses, 52% (196 of 389 of North Carolina teen mothers initiated breastfeeding, but half of those who initiated breastfeeding (92/196 stopped within the first month postpartum. Hispanic teens (44/52 or 89% were much more likely than Black (61/159 or 41% or White teens (87/164 or 52% to initiate breastfeeding and to continue for a longer duration. Nearly sixty two percent (29/52 of Hispanic respondents breastfed for greater than four weeks as compared to 16% (29/159 of Black respondents and 26% (39/164 of White respondents. Common barriers to breastfeeding initiation and continuation included not liking breastfeeding, returning to school, nipple pain, and insufficient milk. Qualitative data provided context for the quantitative findings, elucidating the barriers and facilitators to breastfeeding from the teens' perspective and insight into the ways in which breastfeeding support to teens could be enhanced. Conclusions The large number of adolescents ceasing breastfeeding within the first month points to the need for more individualized follow-up after hospital discharge in the first few days

  14. Interprofessional teamwork in comprehensive primary healthcare services: Findings from a mixed methods study.

    Science.gov (United States)

    Bentley, Michael; Freeman, Toby; Baum, Fran; Javanparast, Sara

    2018-05-01

    This article draws on data from a 5-year project that examined the effectiveness of Comprehensive primary healthcare (CPHC) in local communities. A hallmark of CPHC services is interprofessional teamwork. Drawing from this study, our article presents factors that enabled, or hindered, healthcare teams working interprofessionally in Australian primary healthcare (PHC) services. The article reports on the experiences of teams working in six Australian PHC services (four managed by state governments, one non-government sexual health organisation, and one Aboriginal community-controlled health service) during a time of significant health sector restructure. Findings are drawn from two key methods: an online survey of practitioners and managers (n = 154), and interviews with managers and practitioners (n = 60) from the six study sites. The majority of survey respondents worked with other health professionals in their service to provide interprofessional care to clients. Processes included formal team meetings, case conferencing, referring clients to other health professionals if needed, informal communication with other health professionals about clients, and team-based delivery of care. A range of interrelated factors affected interprofessional work at the services, from contextual, organisational, processual, and relational domains. Funding cuts and policy changes that saw a reorientation and re-medicalisation of South Australian services undermined interprofessional work, while a shared CPHC culture and commitment among some staff was helpful in resisting some of these effects. The co-location of services was a factor in PHC teams working interprofessionally and not only enabled some PHC teams to work more interprofessionally but also created barriers to interprofessional teamwork through disruption resulting from restructuring of services. Our study indicates the importance of decision makers taking into account the potential effects of policy and structural

  15. Reconciling incongruous qualitative and quantitative findings in mixed methods research: exemplars from research with drug using populations.

    Science.gov (United States)

    Wagner, Karla D; Davidson, Peter J; Pollini, Robin A; Strathdee, Steffanie A; Washburn, Rachel; Palinkas, Lawrence A

    2012-01-01

    Mixed methods research is increasingly being promoted in the health sciences as a way to gain more comprehensive understandings of how social processes and individual behaviours shape human health. Mixed methods research most commonly combines qualitative and quantitative data collection and analysis strategies. Often, integrating findings from multiple methods is assumed to confirm or validate the findings from one method with the findings from another, seeking convergence or agreement between methods. Cases in which findings from different methods are congruous are generally thought of as ideal, whilst conflicting findings may, at first glance, appear problematic. However, the latter situation provides the opportunity for a process through which apparently discordant results are reconciled, potentially leading to new emergent understandings of complex social phenomena. This paper presents three case studies drawn from the authors' research on HIV risk amongst injection drug users in which mixed methods studies yielded apparently discrepant results. We use these case studies (involving injection drug users [IDUs] using a Needle/Syringe Exchange Program in Los Angeles, CA, USA; IDUs seeking to purchase needle/syringes at pharmacies in Tijuana, Mexico; and young street-based IDUs in San Francisco, CA, USA) to identify challenges associated with integrating findings from mixed methods projects, summarize lessons learned, and make recommendations for how to more successfully anticipate and manage the integration of findings. Despite the challenges inherent in reconciling apparently conflicting findings from qualitative and quantitative approaches, in keeping with others who have argued in favour of integrating mixed methods findings, we contend that such an undertaking has the potential to yield benefits that emerge only through the struggle to reconcile discrepant results and may provide a sum that is greater than the individual qualitative and quantitative parts

  16. Evolving issues in the prevention of surgical site infections.

    LENUS (Irish Health Repository)

    Quinn, A

    2009-06-01

    Surgical site infection is one of the more common causes of post-operative morbidity. Such infections contribute to prolonged recovery, delayed discharge and increasing costs to both patients and the health service. In the current climate increased emphasis is being placed on minimising the risks of acquiring or transmitting these nosocomial infections. This article reviews the current literature obtained from a Pubmed database search in relation to three specific aspects of surgical site infection: compliance with prophylactic antibiotics, post-discharge surveillance and novel methods for preventing surgical site infections. These topics represent areas where many institutions will find room for improvement in the prevention of surgical site infections. Tight adherence to prophylactic antibiotic guidelines, close followup of surgical wounds during and after hospital discharge, and attention to oxygenation status and the body temperature of patients may all prove to be useful adjuncts in significantly decreasing surgical site infections.

  17. Tracking-by-detection of surgical instruments in minimally invasive surgery via the convolutional neural network deep learning-based method.

    Science.gov (United States)

    Zhao, Zijian; Voros, Sandrine; Weng, Ying; Chang, Faliang; Li, Ruijian

    2017-12-01

    Worldwide propagation of minimally invasive surgeries (MIS) is hindered by their drawback of indirect observation and manipulation, while monitoring of surgical instruments moving in the operated body required by surgeons is a challenging problem. Tracking of surgical instruments by vision-based methods is quite lucrative, due to its flexible implementation via software-based control with no need to modify instruments or surgical workflow. A MIS instrument is conventionally split into a shaft and end-effector portions, while a 2D/3D tracking-by-detection framework is proposed, which performs the shaft tracking followed by the end-effector one. The former portion is described by line features via the RANSAC scheme, while the latter is depicted by special image features based on deep learning through a well-trained convolutional neural network. The method verification in 2D and 3D formulation is performed through the experiments on ex-vivo video sequences, while qualitative validation on in-vivo video sequences is obtained. The proposed method provides robust and accurate tracking, which is confirmed by the experimental results: its 3D performance in ex-vivo video sequences exceeds those of the available state-of -the-art methods. Moreover, the experiments on in-vivo sequences demonstrate that the proposed method can tackle the difficult condition of tracking with unknown camera parameters. Further refinements of the method will refer to the occlusion and multi-instrumental MIS applications.

  18. Findings, theories and methods in the study of children's national identifications and national attitudes

    NARCIS (Netherlands)

    Barrett, M.; Oppenheimer, L.

    2011-01-01

    This paper reviews some of the relevant background findings against which the empirical studies reported in this special issue were designed. Particular attention is given to previous findings on the development of children’s national knowledge, national attitudes and national identifications. The

  19. Detection of left atrial thrombus in patients with mitral stenosis and atrial fibrillation: retrospective comparison of two-phase computed tomography, transoesophageal echocardiography and surgical findings

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Bo Hwa; Ko, Sung Min [Konkuk University Medical Center, Konkuk University School of Medicine, Department of Radiology, Research Institute of Medical Science, Seoul (Korea, Republic of); Hwang, Hweung Kon [Konkuk University Medical Center, Konkuk University School of Medicine, Department of Cardiology, Seoul (Korea, Republic of); Song, Meong Gun; Shin, Je Kyoun [Konkuk University Medical Center, Konkuk University School of Medicine, Department of Thoracic surgery, Seoul (Korea, Republic of); Kang, Woon Seok; Kim, Tae-Yop [Konkuk University Medical Center, Konkuk University School of Medicine, Department of Anesthesiology, Seoul (Korea, Republic of)

    2013-11-15

    This retrospective study aims to assess the accuracy of two-phase computed tomography (CT) and transoesophageal echocardiography (TEE) for the detection of left atrial (LA) thrombus in patients with mitral stenosis (MS) and atrial fibrillation (AF), by using intraoperative findings as the reference standard. Preoperative two-phase CT and intraoperative TEE were performed in 106 patients with MS and AF. The ratio (LAA/AA{sub L}) of Hounsfield units (HU) in the LA appendage (LAA) to the ascending aorta (AA) was calculated on the late-phase CT image. LA echodense masses on TEE and LA filling defects on two-phase CT were observed in 29 and 39 patients, respectively. Thirty-five LA thrombi were identified at surgery in 27 patients. Compared with the intraoperative findings, per-patient sensitivity, specificity, positive and negative predictive values of two-phase CT were 100 %, 85 %, 69 % and 100 %, and those by using TEE were 93 %, 95 %, 86 % and 97 % in detecting LAA thrombus. After adopting the cut-off value of 0.5 for the LAA/AA{sub L} HU ratio, the specificity and positive predictive value of two-phase CT were increased to 96 % and 90 %, respectively. Two-phase CT with a cut-off value of LAA/AA{sub L} HU ratio of 0.5 provides high performance for the detection of LAA thrombus. (orig.)

  20. A method for safely resecting anterior butterfly gliomas: the surgical anatomy of the default mode network and the relevance of its preservation.

    Science.gov (United States)

    Burks, Joshua D; Bonney, Phillip A; Conner, Andrew K; Glenn, Chad A; Briggs, Robert G; Battiste, James D; McCoy, Tressie; O'Donoghue, Daniel L; Wu, Dee H; Sughrue, Michael E

    2017-06-01

    OBJECTIVE Gliomas invading the anterior corpus callosum are commonly deemed unresectable due to an unacceptable risk/benefit ratio, including the risk of abulia. In this study, the authors investigated the anatomy of the cingulum and its connectivity within the default mode network (DMN). A technique is described involving awake subcortical mapping with higher attention tasks to preserve the cingulum and reduce the incidence of postoperative abulia for patients with so-called butterfly gliomas. METHODS The authors reviewed clinical data on all patients undergoing glioma surgery performed by the senior author during a 4-year period at the University of Oklahoma Health Sciences Center. Forty patients were identified who underwent surgery for butterfly gliomas. Each patient was designated as having undergone surgery either with or without the use of awake subcortical mapping and preservation of the cingulum. Data recorded on these patients included the incidence of abulia/akinetic mutism. In the context of the study findings, the authors conducted a detailed anatomical study of the cingulum and its role within the DMN using postmortem fiber tract dissections of 10 cerebral hemispheres and in vivo diffusion tractography of 10 healthy subjects. RESULTS Forty patients with butterfly gliomas were treated, 25 (62%) with standard surgical methods and 15 (38%) with awake subcortical mapping and preservation of the cingulum. One patient (1/15, 7%) experienced postoperative abulia following surgery with the cingulum-sparing technique. Greater than 90% resection was achieved in 13/15 (87%) of these patients. CONCLUSIONS This study presents evidence that anterior butterfly gliomas can be safely removed using a novel, attention-task based, awake brain surgery technique that focuses on preserving the anatomical connectivity of the cingulum and relevant aspects of the cingulate gyrus.

  1. Quality of life in child and adolescent illness: concepts, methods, and findings

    National Research Council Canada - National Science Library

    Koot, Hans M; Wallander, Jan Lance

    2001-01-01

    ... and Findings Edited by Hans M. Koot Erasmus University Rotterdam, The Netherlands and Jan L. Wallander University of Alabama, Birmingham, USA I ~ ~~o~~~n~~~up LONDON...

  2. Finding a Neurosurgeon

    Science.gov (United States)

    Tip: Finding A Neurosurgeon The first step in getting proper treatment for Chiari is to find the right doctor. While many patients are ... surgical, Conquer Chiari recommends that patients see a neurosurgeon for evaluation. As a policy, Conquer Chiari does ...

  3. A path method for finding energy barriers and minimum energy paths in complex micromagnetic systems

    International Nuclear Information System (INIS)

    Dittrich, R.; Schrefl, T.; Suess, D.; Scholz, W.; Forster, H.; Fidler, J.

    2002-01-01

    Minimum energy paths and energy barriers are calculated for complex micromagnetic systems. The method is based on the nudged elastic band method and uses finite-element techniques to represent granular structures. The method was found to be robust and fast for both simple test problems as well as for large systems such as patterned granular media. The method is used to estimate the energy barriers in CoCr-based perpendicular recording media

  4. The Expanded FindCore Method for Identification of a Core Atom Set for Assessment of Protein Structure Prediction

    Science.gov (United States)

    Snyder, David A.; Grullon, Jennifer; Huang, Yuanpeng J.; Tejero, Roberto; Montelione, Gaetano T.

    2014-01-01

    Maximizing the scientific impact of NMR-based structure determination requires robust and statistically sound methods for assessing the precision of NMR-derived structures. In particular, a method to define a core atom set for calculating superimpositions and validating structure predictions is critical to the use of NMR-derived structures as targets in the CASP competition. FindCore (D.A. Snyder and G.T. Montelione PROTEINS 2005;59:673–686) is a superimposition independent method for identifying a core atom set, and partitioning that set into domains. However, as FindCore optimizes superimposition by sensitively excluding not-well-defined atoms, the FindCore core may not comprise all atoms suitable for use in certain applications of NMR structures, including the CASP assessment process. Adapting the FindCore approach to assess predicted models against experimental NMR structures in CASP10 required modification of the FindCore method. This paper describes conventions and a standard protocol to calculate an “Expanded FindCore” atom set suitable for validation and application in biological and biophysical contexts. A key application of the Expanded FindCore method is to identify a core set of atoms in the experimental NMR structure for which it makes sense to validate predicted protein structure models. We demonstrate the application of this Expanded FindCore method in characterizing well-defined regions of 18 NMR-derived CASP10 target structures. The Expanded FindCore protocol defines “expanded core atom sets” that match an expert’s intuition of which parts of the structure are sufficiently well-defined to use in assessing CASP model predictions. We also illustrate the impact of this analysis on the CASP GDT assessment scores. PMID:24327305

  5. Reliability of change in lumbar MRI findings over time in patients with and without disc prosthesis - comparing two different image evaluation methods

    International Nuclear Information System (INIS)

    Berg, Linda; Espeland, Ansgar; Gjertsen, Oeivind; Hellum, Christian; Neckelmann, Gesche; Johnsen, Lars G.; Eide, Geir E.

    2012-01-01

    To assess the reliability of change in lumbar magnetic resonance imaging (MRI) findings evaluated retrospectively by direct comparison of images and by non-comparison. Pre-treatment and 2-year follow-up MRI was performed in 126 patients randomized to disc prosthesis surgery or non-surgical treatment. Two experienced radiologists independently evaluated progress and regress for Modic changes, disc findings, and facet arthropathy (FA) at L3/L4, L4/L5, and L5/S1, both by non-comparison and by comparison of initial and follow-up images. FA was evaluated at all levels, and other findings at non-operated levels. We calculated prevalence- and bias-adjusted kappa (PABAK) values for interobserver agreement. The impact of an adjacent prosthesis (which causes artefacts) and image evaluation method on PABAK was assessed using generalized estimating equations. Image comparison indicated good interobserver agreement on progress and regress (PABAK 0.63-1.00) for Modic changes, posterior high-intensity zone, disc height, and disc contour at L3-S1 and for nucleus pulposus signal and FA at L3/L4; and moderate interobserver agreement (PABAK 0.46-0.59) on decreasing nucleus signal and increasing FA at L4-S1. Image comparison indicated lower (but fair) interobserver agreement (PABAK 0.29) only for increasing FA at L5/S1 in patients with prosthesis in L4/L5 and/or L5/S1. An adjacent prosthesis had no overall impact on PABAK values (p ≥ 0.22). Comparison yielded higher PABAK values than non-comparison (p < 0.001). Regarding changes in lumbar MRI findings over time, comparison of images can provide moderate or good interobserver agreement, and better agreement than non-comparison. An adjacent prosthesis may not reduce agreement on change for most findings. (orig.)

  6. Radiological findings in angiofibroma

    Energy Technology Data Exchange (ETDEWEB)

    Schick, B. [Univ. of Marburg (Germany). Dept. of Ear, Nose and Throat Diseases; Kahle, G. [Univ. of Marburg, (Germany). Inst.of Radiology

    2000-11-01

    Surgery after pre-operative embolization has become the main treatment modality in angiofibroma therapy. As surgical planning is based on precise pre-operative tumour evaluation, knowledge of the characteristic growth patterns is of great interest. Analysis of tumour extension and blood supply, as well as methods of controlling intra-operative bleeding, help in determining the appropriate surgical approach. Though benign, angiofibroma demonstrates a locally aggressive nature. This fibrovascular tumour is characterised by typical radiological findings and by predictable growth patterns. The tumour extension and blood supply can be accurately determined by CT, MR imaging and angiography. With classic radiological findings, no pre-operative biopsy is necessary in most angiofibromas. Advances in radiological imaging have contributed to improved surgical planning and tumour resection. The surgeon is able to select the least traumatic approach with secure haemostatic control, which is also critical for avoiding the disturbance of facial skeletal growth in this group of young patients. Embolization, pre-operative autologous donation and the cell saver system for immediate retransfusion of the collected blood after filtration, are important tools for dealing with blood loss in angiofibroma surgery as they minimize homologous blood transfusion.

  7. Finding ultracool brown dwarfs with MegaCam on CFHT: method and first results

    Science.gov (United States)

    Delorme, P.; Willott, C. J.; Forveille, T.; Delfosse, X.; Reylé, C.; Bertin, E.; Albert, L.; Artigau, E.; Robin, A. C.; Allard, F.; Doyon, R.; Hill, G. J.

    2008-06-01

    Aims: We present the first results of a wide field survey for cool brown dwarfs with the MegaCam camera on the CFHT telescope, the Canada-France Brown Dwarf Survey, hereafter CFBDS. Our objectives are to find ultracool brown dwarfs and to constrain the field-brown dwarf mass function thanks to a larger sample of L and T dwarfs. Methods: We identify candidates in CFHT/MegaCam i' and z' images using optimised psf-fitting within Source Extractor, and follow them up with pointed near-infrared imaging on several telescopes. Results: We have so far analysed over 350 square degrees and found 770 brown dwarf candidates brighter than z'_AB=22.5. We currently have J-band photometry for 220 of these candidates, which confirms 37% as potential L or T dwarfs. Some are among the reddest and farthest brown dwarfs currently known, including an independent identification of the recently published ULAS J003402.77-005206.7 and the discovery of a second brown dwarf later than T8, CFBDS J005910.83-011401.3. Infrared spectra of three T dwarf candidates confirm their nature, and validate the selection process. Conclusions: The completed survey will discover ~100 T dwarfs and ~500 L dwarfs or M dwarfs later than M8, approximately doubling the number of currently known brown dwarfs. The resulting sample will have a very well-defined selection function, and will therefore produce a very clean luminosity function. Based on observations obtained with MegaPrime/MegaCam, a joint project of CFHT and CEA/DAPNIA, at the Canada-France-Hawaii Telescope (CFHT) which is operated by the National Research Council (NRC) of Canada, the Institut National des Sciences de l'Univers of the Centre National de la Recherche Scientifique (CNRS) of France, and the University of Hawaii. This work is based in part on data products produced at TERAPIX and the Canadian Astronomy Data Centre as part of the Canada-France-Hawaii Telescope Legacy Survey, a collaborative project of NRC and CNRS. Based on observations made

  8. Breast lesions with imaging-histologic discordance during US-guided 14G automated core biopsy: can the directional vacuum-assisted removal replace the surgical excision? Initial findings

    International Nuclear Information System (INIS)

    Kim, Min Jung; Kim, Eun-Kyung; Lee, Ji Young; Youk, Ji Hyun; Oh, Ki Keun; Park, Byeong-Woo; Kim, Seung-Il; Kim, Haeryoung

    2007-01-01

    The purpose of this study was to determine the frequency of carcinoma at percutaneous directional vacuum-assisted removal (DVAR) in women with imaging-histologic discordance during ultrasound (US)-guided automated core needle biopsy, and to determine the role of DVAR in breast lesions with imaging-histologic discordance. A US-guided 14-gauge automated core needle biopsy was performed on 837 consecutive lesions. Imaging-histologic discordance was prospectively considered in 33 of 634 benign biopsies. DVAR was recommended in those lesions. Among the 33 lesions, 26 lesions that underwent subsequent DVAR or surgical excision made up our study population. Medical records, imaging studies, and histologic findings were reviewed. Among the 26 lesions, 18 lesions underwent subsequent US-guided DVAR, with 8-gauge probes for 15 of the lesions, and 11-gauge for three of the lesions. Two lesions were diagnosed as having carcinoma (2/18, 11.1% of upgrade rate; 3.1-32.8% CI). The remaining eight lesions underwent subsequent surgical excision, and carcinoma was diagnosed in one case (12.5% of upgrade rate; 2.2-47.1% CI). A US-guided DVAR of the breast mass with imaging-histologic discordance during US-guided 14-gauge automated core needle biopsy is a valuable alternative to surgery as a means of obtaining a definitive histological diagnosis. (orig.)

  9. Supply versus demand: a review of application trends to Canadian surgical training programs.

    Science.gov (United States)

    Austin, Ryan E; Wanzel, Kyle R

    2015-04-01

    Despite increases in medical school enrolment, applications to surgical residency programs in Canada have been in decline over the past decade, with an increasing number of unmatched surgical residency positions. We examined the current status of surgical residency in Canada and analyzed application trends (2002–2013) for surgical training programs across Canada. Our findings suggest that most undergraduate medical schools across Canada are having difficulty fostering interest in surgical careers. We propose that a lack of adequate early exposure to the surgical specialties during undergraduate training is a critical factor. Moving forward, we must examine how the best-performing institutions and surgical programs have maintained interest in pursuing surgical careers and adapt our recruitment methods to both maintain and grow future interest. As Mary Engelbreit said, "If you don't like something, change it; if you can't change it, change the way you think about it."

  10. Surgical orthodontics.

    Science.gov (United States)

    Strohl, Alexis M; Vitkus, Lauren

    2017-08-01

    The article reviews some commonly used orthodontic treatments as well as new strategies to assist in the correction of malocclusion. Many techniques are used in conjunction with surgical intervention and are a necessary compliment to orthognathic surgery. Basic knowledge of these practices will aid in the surgeon's ability to adequately treat the patient. Many orthodontists and surgeons are eliminating presurgical orthodontics to adopt a strategy of 'surgery first' orthodontics in orthognathic surgery. This has the benefit of immediate improvement in facial aesthetics and shorter treatment times. The advent of virtual surgical planning has helped facilitate the development of this new paradigm by making surgical planning faster and easier. Furthermore, using intraoperative surgical navigation is improving overall precision and outcomes. A variety of surgical and nonsurgical treatments may be employed in the treatment of malocclusion. It is important to be familiar with all options available and tailor the patient's treatment plan accordingly. Surgery-first orthodontics, intraoperative surgical navigation, virtual surgical planning, and 3D printing are evolving new techniques that are producing shorter treatment times and subsequently improving patient satisfaction without sacrificing long-term stability.

  11. A simple method for finding the scattering coefficients of quantum graphs

    International Nuclear Information System (INIS)

    Cottrell, Seth S.

    2015-01-01

    Quantum walks are roughly analogous to classical random walks, and similar to classical walks they have been used to find new (quantum) algorithms. When studying the behavior of large graphs or combinations of graphs, it is useful to find the response of a subgraph to signals of different frequencies. In doing so, we can replace an entire subgraph with a single vertex with variable scattering coefficients. In this paper, a simple technique for quickly finding the scattering coefficients of any discrete-time quantum graph will be presented. These scattering coefficients can be expressed entirely in terms of the characteristic polynomial of the graph’s time step operator. This is a marked improvement over previous techniques which have traditionally required finding eigenstates for a given eigenvalue, which is far more computationally costly. With the scattering coefficients we can easily derive the “impulse response” which is the key to predicting the response of a graph to any signal. This gives us a powerful set of tools for rapidly understanding the behavior of graphs or for reducing a large graph into its constituent subgraphs regardless of how they are connected

  12. Literature Shows Recurring Efforts at Finding a Method of Teaching Ethics.

    Science.gov (United States)

    Knudtson, Judy

    1994-01-01

    Reviews classroom journalism texts and articles published in "Quill and Scroll" and this journal since the early 1970s. Notes that the topic of ethics has been addressed recurrently. Finds a wealth of commitment to and concern for ethical issues for high school journalists. (RS)

  13. A comparison of three clustering methods for finding subgroups in MRI, SMS or clinical data

    DEFF Research Database (Denmark)

    Kent, Peter; Jensen, Rikke K; Kongsted, Alice

    2014-01-01

    ). There is a scarcity of head-to-head comparisons that can inform the choice of which clustering method might be suitable for particular clinical datasets and research questions. Therefore, the aim of this study was to perform a head-to-head comparison of three commonly available methods (SPSS TwoStep CA, Latent Gold...... LCA and SNOB LCA). METHODS: The performance of these three methods was compared: (i) quantitatively using the number of subgroups detected, the classification probability of individuals into subgroups, the reproducibility of results, and (ii) qualitatively using subjective judgments about each program...... classify individuals into those subgroups. CONCLUSIONS: Our subjective judgement was that Latent Gold offered the best balance of sensitivity to subgroups, ease of use and presentation of results with these datasets but we recognise that different clustering methods may suit other types of data...

  14. Dual phase helical CT versus portal venous phase CT for the detection of colorectal liver metastases: Correlation with intra-operative sonography, surgical and pathological findings

    International Nuclear Information System (INIS)

    Scott, D. John; Guthrie, J. Ashley; Arnold, Paul; Ward, Janice; Atchley, Julian; Wilson, Daniel; Robinson, Philip J.

    2001-01-01

    AIM: To assess whether dual phase helical computed tomography (DPCT) of the liver improves the detection of colorectal liver metastases compared with portal venous phase (PVP) imaging alone. MATERIALS AND METHODS: DPCT was performed in 33 consecutive patients before laparotomy for resection of colorectal liver metastases. CT comprised 8-mm slice collimation with a pitch of 1 to 1.25; imaging was commenced 20-25 and 65-70 s after the start of injection of 150 ml of contrast medium at 5 ml/s to coincide with hepatic arterial phase (HAP) and PVP contrast enhancement, respectively. Four blinded observers independently reviewed the HAP, PVP and DPCT images recording the site and size of all lesions. Alternative-free response receiver operating characteristic (AFROC) methodology was used to analyse the results, which were correlated with surgery, intra-operative ultrasound and histology. RESULTS: The mean observer sensitivities for malignant lesion detection were 75.3% for DPCT, 69.7% for PVP imaging and 66.7% for HAP imaging alone. There was a statistically significant improvement in malignant lesion detection using DPCT when compared with PVP imaging alone (P < 0.05). The mean areas under the AFROC curves were 0.84 for DPCT and 0.82 for PVP (P < 0.03) imaging alone. CONCLUSION: The detection of colorectal liver metastases was marginally better with DPCT than with PVP imaging alone, but the discovery of additional lesions did not affect the management of any of the patients in this study. Scott, D.J. et al. (2001)

  15. Surgical Approach, Findings, and Eight-Year Follow-Up in a Twenty-Nine Year Old Female With Freeman-Sheldon Syndrome Presenting With Blepharophimosis Causing Near-Complete Visual Obstruction.

    Science.gov (United States)

    Portillo, Augusto L; Poling, Mikaela I; McCormick, Rodger J

    2016-07-01

    The authors describe the surgical approach, findings, and 8-year follow-up in a 29-year-old woman, with severe Freeman-Sheldon syndrome, presenting with congenital blepharophimosis of both upper eyelids resulting in near-complete functional visual obstruction. To avoid possible Freeman-Sheldon syndrome-associated complications of malignant hyperthermia, difficult vascular access, and challenging endotracheal intubation, the surgery was completed under local anesthesia without sedation, and anatomical and functional correction was immediate and remained stable at 8-year follow-up. Unlike many congenital craniofacial syndromes, which frequently involve life-long impairments, important implications exist for plastic surgeons to facilitate opportunities for patients to overcome functional limitations.

  16. Finding all real roots of a polynomial by matrix algebra and the Adomian decomposition method

    Directory of Open Access Journals (Sweden)

    Hooman Fatoorehchi

    2014-10-01

    Full Text Available In this paper, we put forth a combined method for calculation of all real zeroes of a polynomial equation through the Adomian decomposition method equipped with a number of developed theorems from matrix algebra. These auxiliary theorems are associated with eigenvalues of matrices and enable convergence of the Adomian decomposition method toward different real roots of the target polynomial equation. To further improve the computational speed of our technique, a nonlinear convergence accelerator known as the Shanks transform has optionally been employed. For the sake of illustration, a number of numerical examples are given.

  17. Towards understanding household-level forest reliance in Cambodia - study sites, methods, and preliminary findings

    DEFF Research Database (Denmark)

    Ra, Koy; Pichdara, Lonn; Dararath, Yem

    There is growing international interest in the role of forests in poverty prevention and reduction. In consequence, this broad area of investigation has been subject to increased research; one major international research project is that facilitated by the Poverty Environment Network (PEN). This ......). This project covers a large number of sites in 26 countries throughout the tropics. The present report contains contextual details, methodological information and preliminary findings for the PEN sites in Cambodia....

  18. [Evaluation of early physiotherapy in patients after surgical treatment of cruciate ligament injury by bone-tendon-bone method].

    Science.gov (United States)

    Klupiński, Kamil; Krekora, Katarzyna; Woldańska-Okońska, Marta

    2014-01-01

    improvement has been obtained in all examined patients after anterior cruciate ligament reconstruction by bone - tendon - bone method at every stage of rehabilitation in relation to the initial values. Early motor physiotherapy has a significant impact on the condition of patients treated both surgically and conservatively. The differences observed between the groups in the range of the measurement of movement in the knee joint, the measurement of musculoskeletal strength, severity of pain in the knee joint, transpatellar anthropometric measurement of the knee joint and linear measurements of the thigh and shin were caused by necessary surgery which leads to the conclusion that the therapeutic rehabilitation should be longer in the investigated group. In this group introduction of physical therapy with analgesic effects is also of importance. Taking into account good results observed in patients from the control group, who were treated conservatively, the possible indications for surgery should be carefully considered.

  19. CT findings of pancreatic carcinoma. Evaluation with the combined method of early enhancement CT and high dose enhancement CT

    International Nuclear Information System (INIS)

    Itoh, Shigeki; Endo, Tokiko; Isomura, Takayuki; Ishigaki, Takeo; Ikeda, Mitsuru; Senda, Kouhei.

    1995-01-01

    Computed tomographic (CT) findings of pancreatic ductal adenocarcinoma were studied with the combined method of early enhancement CT and high dose enhancement CT in 72 carcinomas. Common Findings were change in pancreatic contour, abnormal attenuation in a tumor and dilatation of the main pancreatic duct. The incidence of abnormal attenuation and dilatation of the main pancreatic duct and bile duct was constant regardless of tumor size. The finding of hypoattenuation at early enhancement CT was most useful for demonstrating a carcinoma. However, this finding was negative in ten cases, five of which showed inhomogenous hyperattenuation at high dose enhancement CT. The detection of change in pancreatic contour and dilatation of the main pancreatic duct was most frequent at high dose enhancement CT. The finding of change in pancreatic contour and/or abnormal attenuation in a tumor could be detected in 47 cases at plain CT, 66 at early enhancement CT and 65 at high dose enhancement CT. Since the four cases in which neither finding was detected by any CT method showed dilatated main pancreatic duct, there was no case without abnormal CT findings. This combined CT method will be a reliable diagnostic technique in the imaging of pancreatic carcinoma. (author)

  20. Exploration of barriers and facilitators to publishing local public health findings: A mixed methods protocol

    OpenAIRE

    Smith, Selina A.; Webb, Nancy C.; Blumenthal, Daniel S.; Willcox, Bobbie; Ballance, Darra; Kinard, Faith; Gates, Madison L.

    2016-01-01

    Background Worldwide, the US accounts for a large proportion of journals related to public health. Although the American Public Health Association (APHA) includes 54 affiliated regional and state associations, little is known about their capacity to support public health scholarship. The aim of this study is to assess barriers and facilitators to operation of state journals for the dissemination of local public health research and practices. Methods A mixed methods approach will be used to co...

  1. Hybrid of Natural Element Method (NEM with Genetic Algorithm (GA to find critical slip surface

    Directory of Open Access Journals (Sweden)

    Shahriar Shahrokhabadi

    2014-06-01

    Full Text Available One of the most important issues in geotechnical engineering is the slope stability analysis for determination of the factor of safety and the probable slip surface. Finite Element Method (FEM is well suited for numerical study of advanced geotechnical problems. However, mesh requirements of FEM creates some difficulties for solution processing in certain problems. Recently, motivated by these limitations, several new Meshfree methods such as Natural Element Method (NEM have been used to analyze engineering problems. This paper presents advantages of using NEM in 2D slope stability analysis and Genetic Algorithm (GA optimization to determine the probable slip surface and the related factor of safety. The stress field is produced under plane strain condition using natural element formulation to simulate material behavior analysis utilized in conjunction with a conventional limit equilibrium method. In order to justify the preciseness and convergence of the proposed method, two kinds of examples, homogenous and non-homogenous, are conducted and results are compared with FEM and conventional limit equilibrium methods. The results show the robustness of the NEM in slope stability analysis.

  2. Surgical treatment of Achilles tendon ruptures: the comparison of open and percutaneous methods in a rabbit model.

    Science.gov (United States)

    Yılmaz, Güney; Doral, Mahmut Nedim; Turhan, Egemen; Dönmez, Gürhan; Atay, Ahmet Özgür; Kaya, Defne

    2014-09-01

    This study was intended to investigate the healing properties of open and percutaneous techniques in a rabbit model and compare histological, electron microscopical, and biomechanical findings of the healed tendon between the groups. Twenty-six rabbits were randomly assigned to two groups of thirteen rabbits each. Percutaneous tenotomy of the Achilles tendon (AT) was applied through a stab incision on the right side 1.5 cm above the calcaneal insertion in all animals. Using the same Bunnell suture, the first group was repaired with the open and the second group was repaired with the percutaneous method. ATs were harvested at the end of eight weeks for biomechanical and histological evaluation. When the sections were evaluated for fibrillar density under electron microscopy, it was noted that fibrils were more abundant in the percutaneous repair group. The tendon scores in the percutaneous group were less than the open group indicating closer histological morphology to normal. The difference was not significant (p=0.065). The mean force to rupture the tendon was 143.7± 9.5 N in percutaneous group and 139.2±8.2 N in the open group. The difference was not significant (p=0.33). Percutaneous techniques provide as good clinical results as the open techniques do. The healing tendon shows better findings in histological and electron microscopical level with percutaneous technique.

  3. Is there a role for virtual otoscopy in the preoperative assessment of the ossicular chain in chronic suppurative otitis media? Comparison of HRCT and virtual otoscopy with surgical findings

    Energy Technology Data Exchange (ETDEWEB)

    Pandey, A.K. [University of British Columbia, Department of Radiology, St. Paul Hospital, Vancouver, BC (Canada); Bapuraj, J.R. [University of Michigan, Division of Neuroradiology, Department of Radiology, University Hospital, Ann Arbor, MI (United States); Gupta, A.K. [Post Graduate Institute of Medical Education and Research, Department of Otolaryngology, Chandigarh (India); Khandelwal, N. [Post Graduate Institute of Medical Education and Research, Department of Radiodiagnosis, Chandigarh (India)

    2009-06-15

    The aim of this study was to assess the role of virtual otoscopy and 3D ossicular reconstruction in the preoperative assessment of the ossicles in chronic suppurative otitis media. Thirty three patients of chronic suppurative otitis media with conductive deafness (air-bone gap > 35 dB) were included in this prospective study. All patients underwent axial multidetector CT. The axial CT data set was utilized for multiplanar 2D reformations as well as virtual otoscopy (VO) and 3D reconstructions. The imaging findings on these two techniques were read independently by two radiologists with respect to different parts of the ossicular chain by using a three-point scoring system and were compared with surgical findings. Both imaging techniques had comparable accuracy for evaluation of larger ossicular parts. However, for evaluation of stapes superstructure, VO/3D images were more accurate (85.29%) than 2D images (76.97%). Assessment of the lenticular process and incudostapedial joint by HRCT and 2D reformatted images was not reliable (P > 0.1); however, significant correlation (P < 0.001) was present between VO/3D and the operative findings. Virtual otoscopy improves evaluation of the ossicular chain particularly that of smaller structures such as the lenticular process, incudostapedial joint and stapes superstructure which may influence decisions regarding planning of ossiculoplasty. (orig.)

  4. Is there a role for virtual otoscopy in the preoperative assessment of the ossicular chain in chronic suppurative otitis media? Comparison of HRCT and virtual otoscopy with surgical findings

    International Nuclear Information System (INIS)

    Pandey, A.K.; Bapuraj, J.R.; Gupta, A.K.; Khandelwal, N.

    2009-01-01

    The aim of this study was to assess the role of virtual otoscopy and 3D ossicular reconstruction in the preoperative assessment of the ossicles in chronic suppurative otitis media. Thirty three patients of chronic suppurative otitis media with conductive deafness (air-bone gap > 35 dB) were included in this prospective study. All patients underwent axial multidetector CT. The axial CT data set was utilized for multiplanar 2D reformations as well as virtual otoscopy (VO) and 3D reconstructions. The imaging findings on these two techniques were read independently by two radiologists with respect to different parts of the ossicular chain by using a three-point scoring system and were compared with surgical findings. Both imaging techniques had comparable accuracy for evaluation of larger ossicular parts. However, for evaluation of stapes superstructure, VO/3D images were more accurate (85.29%) than 2D images (76.97%). Assessment of the lenticular process and incudostapedial joint by HRCT and 2D reformatted images was not reliable (P > 0.1); however, significant correlation (P < 0.001) was present between VO/3D and the operative findings. Virtual otoscopy improves evaluation of the ossicular chain particularly that of smaller structures such as the lenticular process, incudostapedial joint and stapes superstructure which may influence decisions regarding planning of ossiculoplasty. (orig.)

  5. The Lagrangian Multiplier Method of Finding Upper and Lower Limits to Critical Stresses of Clamped Plates

    Science.gov (United States)

    1946-01-01

    geometrica ~ boundary condi- tions of the problem. (2) The energy of the load-plate system is computed for this deflection surface and is then minimized...and interpolating to find the k that makes the seriw vanish. The correct value of m is that which gives the lowest value of k. For two half waves (m=2...the square plate, the present rekdively simple upper- and lower-limit calcula- tions show that his est,imatd limit of error is correct for this case

  6. A numerical method for finding sign-changing solutions of superlinear Dirichlet problems

    Energy Technology Data Exchange (ETDEWEB)

    Neuberger, J.M.

    1996-12-31

    In a recent result it was shown via a variational argument that a class of superlinear elliptic boundary value problems has at least three nontrivial solutions, a pair of one sign and one which sign changes exactly once. These three and all other nontrivial solutions are saddle points of an action functional, and are characterized as local minima of that functional restricted to a codimension one submanifold of the Hilbert space H-0-1-2, or an appropriate higher codimension subset of that manifold. In this paper, we present a numerical Sobolev steepest descent algorithm for finding these three solutions.

  7. The Findings from the OECD/NEA/CSNI UMS (Uncertainty Method Study)

    International Nuclear Information System (INIS)

    D'Auria, F.; Glaeser, H.

    2013-01-01

    Within licensing procedures there is the incentive to replace the conservative requirements for code application by a 'best estimate' concept supplemented by an uncertainty analysis to account for predictive uncertainties of code results. Methods have been developed to quantify these uncertainties. The Uncertainty Methods Study (UMS) Group, following a mandate from CSNI (Committee on the Safety of Nuclear Installations) of OECD/NEA (Organization for Economic Cooperation and Development / Nuclear Energy Agency), has compared five methods for calculating the uncertainty in the predictions of advanced 'best estimate' thermal-hydraulic codes. Most of the methods identify and combine input uncertainties. The major differences between the predictions of the methods came from the choice of uncertain parameters and the quantification of the input uncertainties, i.e. the wideness of the uncertainty ranges. Therefore, suitable experimental and analytical information has to be selected to specify these uncertainty ranges or distributions. After the closure of the Uncertainty Method Study (UMS) and after the report was issued comparison calculations of experiment LSTF-SB-CL-18 were performed by University of Pisa using different versions of the RELAP 5 code. It turned out that the version used by two of the participants calculated a 170 K higher peak clad temperature compared with other versions using the same input deck. This may contribute to the differences of the upper limit of the uncertainty ranges. A 'bifurcation' analysis was also performed by the same research group also providing another way of interpreting the high temperature peak calculated by two of the participants. (authors)

  8. An efficient search method for finding the critical slip surface using the compositional Monte Carlo technique

    International Nuclear Information System (INIS)

    Goshtasbi, K.; Ahmadi, M; Naeimi, Y.

    2008-01-01

    Locating the critical slip surface and the associated minimum factor of safety are two complementary parts in a slope stability analysis. A large number of computer programs exist to solve slope stability problems. Most of these programs, however, have used inefficient and unreliable search procedures to locate the global minimum factor of safety. This paper presents an efficient and reliable method to determine the global minimum factor of safety coupled with a modified version of the Monte Carlo technique. Examples arc presented to illustrate the reliability of the proposed method

  9. Simultaneous hit finding and timing method for pulse shape analysis of drift chamber signals

    Energy Technology Data Exchange (ETDEWEB)

    Schaile, D; Schaile, O; Schwarz, J

    1986-01-01

    An algorithm for the analysis of the digitized signal waveform of drift chamber pulses is described which yields a good multihit resolution and an accurate drift time determination with little processing time. The method has been tested and evaluated with measured pulse shapes from the full size prototype of the OPAL central detector which were digitized by 100 MHz FADCs. (orig.).

  10. Simultaneous hit finding and timing method for pulse shape analysis of drift chamber signals

    Energy Technology Data Exchange (ETDEWEB)

    Schaile, D; Schaile, O; Schwarz, J

    1986-01-01

    An algorithm for the analysis of the digitized signal waveform of drift chamber pulses is described which yields a good multihit resolution and an accurate drift time determination with little processing time. The method has been tested and evaluated with measured pulse shapes from the full size prototype of the OPAL central detector which were digitized by 100 MHz FADCs.

  11. Towards predicting the (dis)comfort performance by modelling: methods and findings

    NARCIS (Netherlands)

    Naddeo, A.

    2017-01-01

    The research work underlying this thesis starts from a societal issue: A comfortable artefact helps people to improve their well-being and can be sold easier.
    In order to fulfil these two requirements (wellbeing and companies’ profit) a comfort-driven human-centred design method is

  12. A Simple Method to Find out when an Ordinary Differential Equation Is Separable

    Science.gov (United States)

    Cid, Jose Angel

    2009-01-01

    We present an alternative method to that of Scott (D. Scott, "When is an ordinary differential equation separable?", "Amer. Math. Monthly" 92 (1985), pp. 422-423) to teach the students how to discover whether a differential equation y[prime] = f(x,y) is separable or not when the nonlinearity f(x, y) is not explicitly factorized. Our approach is…

  13. Paediatric cardiac CT examinations: impact of the iterative reconstruction method ASIR on image quality - preliminary findings

    International Nuclear Information System (INIS)

    Mieville, Frederic A.; Gudinchet, Francois; Rizzo, Elena; Ou, Phalla; Brunelle, Francis; Bochud, Francois O.; Verdun, Francis R.

    2011-01-01

    Radiation dose exposure is of particular concern in children due to the possible harmful effects of ionizing radiation. The adaptive statistical iterative reconstruction (ASIR) method is a promising new technique that reduces image noise and produces better overall image quality compared with routine-dose contrast-enhanced methods. To assess the benefits of ASIR on the diagnostic image quality in paediatric cardiac CT examinations. Four paediatric radiologists based at two major hospitals evaluated ten low-dose paediatric cardiac examinations (80 kVp, CTDI vol 4.8-7.9 mGy, DLP 37.1-178.9 mGy.cm). The average age of the cohort studied was 2.6 years (range 1 day to 7 years). Acquisitions were performed on a 64-MDCT scanner. All images were reconstructed at various ASIR percentages (0-100%). For each examination, radiologists scored 19 anatomical structures using the relative visual grading analysis method. To estimate the potential for dose reduction, acquisitions were also performed on a Catphan phantom and a paediatric phantom. The best image quality for all clinical images was obtained with 20% and 40% ASIR (p < 0.001) whereas with ASIR above 50%, image quality significantly decreased (p < 0.001). With 100% ASIR, a strong noise-free appearance of the structures reduced image conspicuity. A potential for dose reduction of about 36% is predicted for a 2- to 3-year-old child when using 40% ASIR rather than the standard filtered back-projection method. Reconstruction including 20% to 40% ASIR slightly improved the conspicuity of various paediatric cardiac structures in newborns and children with respect to conventional reconstruction (filtered back-projection) alone. (orig.)

  14. Paediatric cardiac CT examinations: impact of the iterative reconstruction method ASIR on image quality - preliminary findings

    Energy Technology Data Exchange (ETDEWEB)

    Mieville, Frederic A. [University Hospital Center and University of Lausanne, Institute of Radiation Physics, Lausanne (Switzerland); University Hospital Center and University of Lausanne, Institute of Radiation Physics - Medical Radiology, Lausanne (Switzerland); Gudinchet, Francois; Rizzo, Elena [University Hospital Center and University of Lausanne, Department of Radiology, Lausanne (Switzerland); Ou, Phalla; Brunelle, Francis [Necker Children' s Hospital, Department of Radiology, Paris (France); Bochud, Francois O.; Verdun, Francis R. [University Hospital Center and University of Lausanne, Institute of Radiation Physics, Lausanne (Switzerland)

    2011-09-15

    Radiation dose exposure is of particular concern in children due to the possible harmful effects of ionizing radiation. The adaptive statistical iterative reconstruction (ASIR) method is a promising new technique that reduces image noise and produces better overall image quality compared with routine-dose contrast-enhanced methods. To assess the benefits of ASIR on the diagnostic image quality in paediatric cardiac CT examinations. Four paediatric radiologists based at two major hospitals evaluated ten low-dose paediatric cardiac examinations (80 kVp, CTDI{sub vol} 4.8-7.9 mGy, DLP 37.1-178.9 mGy.cm). The average age of the cohort studied was 2.6 years (range 1 day to 7 years). Acquisitions were performed on a 64-MDCT scanner. All images were reconstructed at various ASIR percentages (0-100%). For each examination, radiologists scored 19 anatomical structures using the relative visual grading analysis method. To estimate the potential for dose reduction, acquisitions were also performed on a Catphan phantom and a paediatric phantom. The best image quality for all clinical images was obtained with 20% and 40% ASIR (p < 0.001) whereas with ASIR above 50%, image quality significantly decreased (p < 0.001). With 100% ASIR, a strong noise-free appearance of the structures reduced image conspicuity. A potential for dose reduction of about 36% is predicted for a 2- to 3-year-old child when using 40% ASIR rather than the standard filtered back-projection method. Reconstruction including 20% to 40% ASIR slightly improved the conspicuity of various paediatric cardiac structures in newborns and children with respect to conventional reconstruction (filtered back-projection) alone. (orig.)

  15. A critical assessment of theoretical methods for finding reaction pathways and transition states of surface processes

    International Nuclear Information System (INIS)

    Klimes, JirI; Michaelides, Angelos; Bowler, David R

    2010-01-01

    The performance of a variety of techniques for locating transition states on potential energy surfaces is evaluated within the density functional theory framework. Diffusion of a water molecule across NaCl(001) and HCl bond breaking on the same surface are treated as general test cases; the former is an example of a low barrier diffusion process and the latter an example of a relatively high barrier covalent bond rupture event. The methods considered include the nudged elastic band (NEB), Dewar, Healy and Stewart (DHS), dimer, constrained optimization (CO), activation-relaxation technique (ART) and one-side growing string (OGS) as well as novel combinations of the DHS with growing string (DHS + GS) and DHS plus climbing image (CI-DHS). A key conclusion to come from this study is that the NEB method is relatively fast, especially when just a single (climbing) image is used. Indeed, using more images represents an unnecessary computational burden for our set of processes. The dimer method exhibits variable performance; being poor for the water diffusion processes, which have small activation energies, but much more efficient for the HCl bond breaking process which has a higher barrier. When only a poor initial guess of the transition state geometry is available, the CI-DHS scheme is one of the most efficient techniques considered. And as a means to quickly establish an approximate minimum energy pathway the DHS + GS scheme offers some potential.

  16. A comparison of companion matrix methods to find roots of a trigonometric polynomial

    Science.gov (United States)

    Boyd, John P.

    2013-08-01

    A trigonometric polynomial is a truncated Fourier series of the form fN(t)≡∑j=0Naj cos(jt)+∑j=1N bj sin(jt). It has been previously shown by the author that zeros of such a polynomial can be computed as the eigenvalues of a companion matrix with elements which are complex valued combinations of the Fourier coefficients, the "CCM" method. However, previous work provided no examples, so one goal of this new work is to experimentally test the CCM method. A second goal is introduce a new alternative, the elimination/Chebyshev algorithm, and experimentally compare it with the CCM scheme. The elimination/Chebyshev matrix (ECM) algorithm yields a companion matrix with real-valued elements, albeit at the price of usefulness only for real roots. The new elimination scheme first converts the trigonometric rootfinding problem to a pair of polynomial equations in the variables (c,s) where c≡cos(t) and s≡sin(t). The elimination method next reduces the system to a single univariate polynomial P(c). We show that this same polynomial is the resultant of the system and is also a generator of the Groebner basis with lexicographic ordering for the system. Both methods give very high numerical accuracy for real-valued roots, typically at least 11 decimal places in Matlab/IEEE 754 16 digit floating point arithmetic. The CCM algorithm is typically one or two decimal places more accurate, though these differences disappear if the roots are "Newton-polished" by a single Newton's iteration. The complex-valued matrix is accurate for complex-valued roots, too, though accuracy decreases with the magnitude of the imaginary part of the root. The cost of both methods scales as O(N3) floating point operations. In spite of intimate connections of the elimination/Chebyshev scheme to two well-established technologies for solving systems of equations, resultants and Groebner bases, and the advantages of using only real-valued arithmetic to obtain a companion matrix with real-valued elements

  17. [Plastic surgery of the thoracic wall as a method of thoracic wall reconstruction after complete surgical wound disintegration after sternotomy].

    Science.gov (United States)

    Hájek, T; Jirásek, K; Urban, M; Straka, Z

    1998-12-01

    During the period between January 1996 and July 1998 in our department 1920 patients were operated on account of heart disease from median sternotomy. In 17 patients, i.e. in 0.9% during the early postoperative period the surgical wound disintegrated incl. dehiscence of the sternum and the development of postoperative mediastinitis. In 14 of these patients the authors reconstructed the defect of the thoracic wall by their own modification of Jurkiewicz plastic operation using the pectoral muscles. One patient from this group died, in the remaining 13 patients the wound healed without deformity of the chest and without signs of instability, without restriction of movement and function.

  18. The Family Investigation of Nephropathy and Diabetes (FIND): design and methods.

    Science.gov (United States)

    Knowler, William C; Coresh, Josef; Elston, Robert C; Freedman, Barry I; Iyengar, Sudha K; Kimmel, Paul L; Olson, Jane M; Plaetke, Rosemarie; Sedor, John R; Seldin, Michael F

    2005-01-01

    The Family Investigation of Nephropathy and Diabetes (FIND) is a multicenter study designed to identify genetic determinants of diabetic nephropathy. It is conducted in eight U.S. clinical centers and a coordinating center, and with four ethnic groups (European Americans, African Americans, Mexican Americans, and American Indians). Two strategies are used to localize susceptibility genes: a family-based linkage study and a case-control study using mapping by admixture linkage disequilibrium (MALD). In the family-based study, probands with diabetic nephropathy are recruited with their parents and selected siblings. Linkage analyses will be conducted to identify chromosomal regions containing genes that influence the development of diabetic nephropathy or related quantitative traits such as serum creatinine concentration, urinary albumin excretion, and plasma glucose concentrations. Regions showing evidence of linkage will be examined further with both genetic linkage and association studies to identify genes that influence diabetic nephropathy or related traits. Two types of MALD studies are being done. One is a case-control study of unrelated individuals of Mexican American heritage in which both cases and controls have diabetes, but only the case has nephropathy. The other is a case-control study of African American patients with nephropathy (cases) and their spouses (controls) unaffected by diabetes and nephropathy; offspring are genotyped when available to provide haplotype data. Identification of genes that influence susceptibility to diabetic nephropathy will lead to a better understanding of how nephropathy develops. This should eventually lead to improved treatment and prevention.

  19. The use of multicriteria decision making methods to find the environmental costs of hydropower development alternatives

    International Nuclear Information System (INIS)

    Carlsen, A.J.; Wenstoep, F.

    1994-01-01

    The conference paper deals with a decision support system (DSS) developed to find the costs of environmental goods. The system is based on multicriteria decision making and uses pairwise comparisons of two and two criteria. The criteria weights are calculated with linear regression. When one criterion is monetary, all criteria weights can be expressed in monetary units when the weights are known. The DSS has been tested on a hydropower project in the area of Sauda in Norway. To represent the decision makers, three panels each consisting of three persons were formed. The persons were selected from governmental agencies, the developers, the local environmental administration and a local politician. The DSS worked well with the panels. One problem was that impacts of hydropower projects are very site specific and also hard to quantify. Therefore, a considerable amount of time was used in creating a cognitive understanding of the issues involved and how they were represented by quantitative criteria. Some had also difficulties in accepting the principle of expressing environmental goods in monetary units. The results so far are preliminary. This research work is part of the Norwegian research programme Energy, Environment and Development. 3 refs., 4 figs., 2 tabs

  20. Microplastic pollution in China's inland water systems: A review of findings, methods, characteristics, effects, and management.

    Science.gov (United States)

    Zhang, Kai; Shi, Huahong; Peng, Jinping; Wang, Yinghui; Xiong, Xiong; Wu, Chenxi; Lam, Paul K S

    2018-07-15

    The pollution of marine environments and inland waters by plastic debris has raised increasing concerns worldwide in recent years. China is the world's largest developing country and the largest plastic producer. In this review, we gather available information on microplastic pollution in China's inland water systems. The results show that microplastics are ubiquitous in the investigated inland water systems, and high microplastic abundances were observed in developed areas. Although similar sampling and analytical methods were used for microplastic research in inland water and marine systems, methods of investigation should be standardized in the future. The characteristics of the detected microplastics suggest secondary sources as their major sources. The biological and ecological effects of microplastics have been demonstrated, but their risks are difficult to determine at this stage due to the discrepancy between the field-collected microplastics and microplastics used in ecotoxicological studies. Although many laws and regulations have already been established to manage and control plastic waste in China, the implementation of these laws and regulations has been ineffective and sometimes difficult. Several research priorities are identified, and we suggest that the Chinese government should be more proactive in tackling plastic pollution problems to protect the environment and fulfill international responsibilities. Copyright © 2018 Elsevier B.V. All rights reserved.

  1. [Simulation in surgical training].

    Science.gov (United States)

    Nabavi, A; Schipper, J

    2017-01-01

    Patient safety during operations hinges on the surgeon's skills and abilities. However, surgical training has come under a variety of restrictions. To acquire dexterity with decreasingly "simple" cases, within the legislative time constraints and increasing expectations for surgical results is the future challenge. Are there alternatives to traditional master-apprentice learning? A literature review and analysis of the development, implementation, and evaluation of surgical simulation are presented. Simulation, using a variety of methods, most important physical and virtual (computer-generated) models, provides a safe environment to practice basic and advanced skills without endangering patients. These environments have specific strengths and weaknesses. Simulations can only serve to decrease the slope of learning curves, but cannot be a substitute for the real situation. Thus, they have to be an integral part of a comprehensive training curriculum. Our surgical societies have to take up that challenge to ensure the training of future generations.

  2. Surgical competence.

    Science.gov (United States)

    Patil, Nivritti G; Cheng, Stephen W K; Wong, John

    2003-08-01

    Recent high-profile cases have heightened the need for a formal structure to monitor achievement and maintenance of surgical competence. Logbooks, morbidity and mortality meetings, videos and direct observation of operations using a checklist, motion analysis devices, and virtual reality simulators are effective tools for teaching and evaluating surgical skills. As the operating theater is also a place for training, there must be protocols and guidelines, including mandatory standards for supervision, to ensure that patient care is not compromised. Patients appreciate frank communication and honesty from surgeons regarding their expertise and level of competence. To ensure that surgical competence is maintained and keeps pace with technologic advances, professional registration bodies have been promoting programs for recertification. They evaluate performance in practice, professional standing, and commitment to ongoing education.

  3. A Comparative Study of Surgical Training in South East Asia, Australia and The United Kingdom

    Directory of Open Access Journals (Sweden)

    Siew Kheong Lum

    2009-07-01

    Conclusion: Quality of training can be improved by changing to a curriculum and competency based model, utilization of continuous assessment methods, reducing service requirements and better compensation for trainers. Southeast Asia has the potential to provide centres of excellence for surgical training. Surgical educators in SEA will find useful information in this paper to improve their programs which will hopefully evolve into a common core curriculum and enable cross border exchange of surgical trainees in SEA for broader exposure.

  4. The value of earth observations: methods and findings on the value of Landsat imagery

    Science.gov (United States)

    Miller, Holly M.; Serbina, Larisa O.; Richardson, Leslie A.; Ryker, Sarah J.; Newman, Timothy R.

    2016-01-01

    Data from Earth observation systems are used extensively in managing and monitoring natural resources, natural hazards, and the impacts of climate change, but the value of such data can be difficult to estimate, particularly when it is available at no cost. Assessing the socioeconomic and scientific value of these data provides a better understanding of the existing and emerging research, science, and applications related to this information and contributes to the decision making process regarding current and future Earth observation systems. Recent USGS research on Landsat data has advanced the literature in this area by using a variety of methods to estimate value. The results of a 2012 survey of Landsat users, a 2013 requirements assessment, and 2013 case studies of applications of Landsat imagery are discussed.

  5. Three-Dimensional Computed Tomography as a Method for Finding Die Attach Voids in Diodes

    Science.gov (United States)

    Brahm, E. N.; Rolin, T. D.

    2010-01-01

    NASA analyzes electrical, electronic, and electromechanical (EEE) parts used in space vehicles to understand failure modes of these components. The diode is an EEE part critical to NASA missions that can fail due to excessive voiding in the die attach. Metallography, one established method for studying the die attach, is a time-intensive, destructive, and equivocal process whereby mechanical grinding of the diodes is performed to reveal voiding in the die attach. Problems such as die attach pull-out tend to complicate results and can lead to erroneous conclusions. The objective of this study is to determine if three-dimensional computed tomography (3DCT), a nondestructive technique, is a viable alternative to metallography for detecting die attach voiding. The die attach voiding in two- dimensional planes created from 3DCT scans was compared to several physical cross sections of the same diode to determine if the 3DCT scan accurately recreates die attach volumetric variability

  6. Description and pilot results from a novel method for evaluating return of incidental findings from next-generation sequencing technologies.

    Science.gov (United States)

    Goddard, Katrina A B; Whitlock, Evelyn P; Berg, Jonathan S; Williams, Marc S; Webber, Elizabeth M; Webster, Jennifer A; Lin, Jennifer S; Schrader, Kasmintan A; Campos-Outcalt, Doug; Offit, Kenneth; Feigelson, Heather Spencer; Hollombe, Celine

    2013-09-01

    The aim of this study was to develop, operationalize, and pilot test a transparent, reproducible, and evidence-informed method to determine when to report incidental findings from next-generation sequencing technologies. Using evidence-based principles, we proposed a three-stage process. Stage I "rules out" incidental findings below a minimal threshold of evidence and is evaluated using inter-rater agreement and comparison with an expert-based approach. Stage II documents criteria for clinical actionability using a standardized approach to allow experts to consistently consider and recommend whether results should be routinely reported (stage III). We used expert opinion to determine the face validity of stages II and III using three case studies. We evaluated the time and effort for stages I and II. For stage I, we assessed 99 conditions and found high inter-rater agreement (89%), and strong agreement with a separate expert-based method. Case studies for familial adenomatous polyposis, hereditary hemochromatosis, and α1-antitrypsin deficiency were all recommended for routine reporting as incidental findings. The method requires definition of clinically actionable incidental findings and provide documentation and pilot testing of a feasible method that is scalable to the whole genome.

  7. The Teaching of General Solution Methods to Pattern Finding Problems through Focusing on an Evaluation and Improvement Process.

    Science.gov (United States)

    Ishida, Junichi

    1997-01-01

    Examines the effects of a teaching strategy in which fifth-grade students evaluated the strengths or weaknesses of solution methods to pattern finding problems, including an experimental and control group each consisting of 34 elementary students, in Japan. The experimental group showed a significantly better performance on the retention test…

  8. Finding an optimal method for imaging lymphatic vessels of the upper limb

    International Nuclear Information System (INIS)

    O'Mahony, Susan; Purushotham, Arnie D.; Rose, Sarah L.; Chilvers, Alison J.; Ballinger, James R.; Solanki, Chandra K.; Barber, Robert W.; Peters, A. Michael; Mortimer, Peter S.

    2004-01-01

    Lymphoscintigraphy involves interstitial injection of radiolabelled particulate materials or radioproteins. Although several variations in the technique have been described, their place in clinical practice remains controversial. Traditional diagnostic criteria are based primarily on lymph node appearances but in situations such as breast cancer, where lymph nodes may have been excised, these criteria are of limited use. In these circumstances, lymphatic vessel morphology takes on greater importance as a clinical endpoint, so a method that gives good definition of lymphatic vessels would be useful. In patients with breast cancer, for example, such a method, used before and after lymph node resection, may assist in predicting the development of breast cancer-related lymphoedema. The aim of this study was to optimise a method for the visualisation of lymphatic vessels. Subcutaneous (sc) and intradermal (id) injection sites were compared, and technetium-99m nanocolloid, a particulate material, was compared with 99m Tc-human immunoglobulin (HIG), which is a soluble macromolecule. Twelve normal volunteers were each studied on two occasions. In three subjects, id 99m Tc-HIG was compared with sc 99m Tc-HIG, in three id 99m Tc-nanocolloid was compared with sc 99m Tc-nanocolloid, in three id 99m Tc-HIG was compared with id 99m Tc-nanocolloid and in three sc 99m Tc-HIG was compared with sc 99m Tc-nanocolloid. Endpoints were quality of lymphatic vessel definition, the time after injection at which vessels were most clearly visualised, the rate constant of depot disappearance (k) and the systemic blood accumulation rate as measured by gamma camera imaging over the liver or cardiac blood pool. Excellent definition of lymphatic vessels was obtained following id injection of either radiopharmaceutical, an injection route that was clearly superior to sc. Differences between radiopharmaceuticals were less clear, although after id injection, 99m Tc-HIG gave images that were

  9. Atmospheric Deposition: Sampling Procedures, Analytical Methods, and Main Recent Findings from the Scientific Literature

    Directory of Open Access Journals (Sweden)

    M. Amodio

    2014-01-01

    Full Text Available The atmosphere is a carrier on which some natural and anthropogenic organic and inorganic chemicals are transported, and the wet and dry deposition events are the most important processes that remove those chemicals, depositing it on soil and water. A wide variety of different collectors were tested to evaluate site-specificity, seasonality and daily variability of settleable particle concentrations. Deposition fluxes of POPs showed spatial and seasonal variations, diagnostic ratios of PAHs on deposited particles, allowed the discrimination between pyrolytic or petrogenic sources. Congener pattern analysis and bulk deposition fluxes in rural sites confirmed long-range atmospheric transport of PCDDs/Fs. More and more sophisticated and newly designed deposition samplers have being used for characterization of deposited mercury, demonstrating the importance of rain scavenging and the relatively higher magnitude of Hg deposition from Chinese anthropogenic sources. Recently biological monitors demonstrated that PAH concentrations in lichens were comparable with concentrations measured in a conventional active sampler in an outdoor environment. In this review the authors explore the methodological approaches used for the assessment of atmospheric deposition, from the analysis of the sampling methods, the analytical procedures for chemical characterization of pollutants and the main results from the scientific literature.

  10. Insights on leadership from early career nurse academics: findings from a mixed methods study.

    Science.gov (United States)

    Halcomb, Elizabeth; Jackson, Debra; Daly, John; Gray, Joanne; Salamonson, Yenna; Andrew, Sharon; Peters, Kath

    2016-03-01

    To explore the perceptions of early career nursing academics on leadership in academia. There is growing emphasis on leadership capacity building across all domains of nursing. However, there is limited evidence on leadership capacity in early career academics. This study tested an intervention to develop leadership capacity amongst early career nursing academics in two Australian universities. A sequential mixed methods design, using online surveys and semi-structured interviews, was used to collect data. Twenty-three early career nursing academics participated. Most had experience of formal leadership roles and were aware of its importance to them as they developed their academic careers. Participants were able to discuss their own views of themselves as leaders; their perceptions of their own needs for leadership development, and ways in which they could seek to develop further as leaders. There is a need to provide initial and ongoing opportunities for leadership development amongst nurse academics. These opportunities should be contextualised and recognise factors such as gender, and the effects of structural oppression. Nurse academics are involved in the preparation of the next generation of clinical leaders and it is imperative that they are able to articulate a clear view of leadership. © 2015 John Wiley & Sons Ltd.

  11. Occupational burnout among radiation therapists in Australia: Findings from a mixed methods study

    International Nuclear Information System (INIS)

    Singh, N.; Wright, C.; Knight, K.; Baird, M.; Akroyd, D.; Adams, R.D.; Schneider, M.E.

    2017-01-01

    Introduction: Evidence demonstrates that health care professionals in the palliative care context are more burned out than other health professionals. The aims of this study were to examine: (1) occupational burnout levels among radiation therapists in Australia, (2) association between demographic factors on burnout and (3) radiation therapists' perceptions of burnout. Methods: A cross-sectional online survey including the Maslach Burnout Inventory was administered to Radiation Therapists in Australia. Data were analysed using SPSS Ver 20 and open ended comments were analysed thematically using Nvivo 10. Results: A total of 200 radiation therapists participated in the survey. RTs had a high mean (±SD) burnout score for emotional exhaustion (38.5 ± 8.2), depersonalisation (17.5 ± 4.7) and personal achievement (30.5.3 ± 4.3) compared to RTs and health workers in other studies. High levels of emotional exhaustion, depersonalisation and low levels of personal achievement were present in 93% (186/200), 87% (174/200) and 61% (122/200) of participants respectively. RTs identified high workload and staff shortages, interpersonal conflict and technology as key sources of stress in the RT work environment. Conclusion: Australian RTs' level of burnout on all three stages of burnout exceed previously reported burnout levels for similar cohorts both locally and internationally. It is important that future interventions aimed at minimising or preventing stressors are identified and implemented in the radiation therapy work environment. - Highlights: • The burnout rate is higher among Australian RTs compared to studies in other countries. • Dealing with patients and their emotions were not a contributing factor to RTs' stress. • Challenging interpersonal relationships between staff was identified as one of the key stressors. • It is important that future interventions aimed at minimising or preventing stressors are recognised.

  12. Exploring community gardens in a health disparate population: findings from a mixed methods pilot study.

    Science.gov (United States)

    Zoellner, Jamie; Zanko, Ashley; Price, Bryan; Bonner, Jennifer; Hill, Jennie L

    2012-01-01

    Despite recommendations, there have been few efforts to apply the community-based participatory research (CBPR) approach in the development, implementation, and evaluation of community gardens. As guided by the CBPR approach and grounded in a social-ecological model and behavioral theory, the purpose of this mixed methods study was to understand opinions and interests in developing and implementing a community garden and to understand factors impacting fruit, vegetable, and gardening behaviors. Community and academic members collaborated to develop and execute this study. The qualitative phase- targeting regional key informants-was designed to elicit perceived benefits and challenges of community gardens at the environmental, community, and individual levels. The quantitative phase targeted low resourced youth and parents and included a variety of validated theory-based questionnaires to understand factors impacting fruit, vegetable, and gardening behaviors. Major benefits of community gardens that emerged from the 10 qualitative interviews included increasing community cohesion and improving nutrition and physical activity factors. The quantitative phase included 87 youth and 67 parents. Across 16 items for fruits and vegetables, the average willingness to try was 1.32 (standard deviation [SD] = 0.40) on a 2-point scale. The majority of youth indicated they would work in a garden (n = 59; 68%) and eat food grown in their garden (n = 71; 82%). Among parents, gardening attitude, belief, and self-efficacy scores were all above average; however, gardening intentions were neutral. This research illustrates the successful partnering a community-academic team and has provided the partnership with a clearer lens to conceptualize and launch future regional community garden efforts.

  13. Healthy bread initiative: methods, findings, and theories--Isfahan Healthy Heart Program.

    Science.gov (United States)

    Talaei, Mohammad; Mohammadifard, Noushin; Khaje, Mohammad-Reza; Sarrafzadegan, Nizal; Sajjadi, Firoozeh; Alikhasi, Hasan; Maghroun, Maryam; Iraji, Farhad; Ehteshami, Shahram

    2013-03-01

    The scientific evidences show that the content, baking methods, and types of bread can make health impacts. Bread, as a major part of Iranian diet, demonstrates a significant potential to be targeted as health promotion subject. Healthy Food for Healthy Communities (HFHC) was a project of Isfahan Healthy Heart Program (IHHP), consisting of a wide variety of strategies, like Healthy Bread (HB) Initiative. The HB Initiative was designed to improve the behaviour of both producers and consumers, mainly aiming at making high-fibre, low-salt bread, eliminating the use of baking soda, providing enough rest time for dough before baking (at least one hour), and enough baking time (at least one minute in oven). A workshop was held for volunteer bakers, and a baker-to-baker training protocol under direct supervision was designed for future volunteers. Cereal Organization was persuaded to provide less refined flour that contained more bran. Health messages in support of new breads were disseminated by media and at bakeries by health professionals. Evaluation of the HB Initiative was done using before-after assessments and population surveys. While HB was baked in 1 (0.01%) bakery at baseline, 402 (41%) bakeries in the intervention area joined the HB Initiative in 2009. Soda was completely eliminated and fibre significantly increased from 4 +/- 0.4 g% before study to 12 +/- 0.6 g% after the intervention (p bread decreased from 13 +/- 1.8 g% to 2 +/- 0.5 g% and was expressed as the most important advantage of this initiative by consumers. People who lived in Isfahan city consumed whole bread 6 times more than those who lived in reference area Arak (p breads as a healthy choice that were compatible with local dishes and made a model to solve the longstanding problems of bread. It used various health promotion approaches but was best consistent with Beattie's model.

  14. An efficient method to find potentially universal population genetic markers, applied to metazoans

    Directory of Open Access Journals (Sweden)

    Chenuil Anne

    2010-09-01

    Full Text Available Abstract Background Despite the impressive growth of sequence databases, the limited availability of nuclear markers that are sufficiently polymorphic for population genetics and phylogeography and applicable across various phyla restricts many potential studies, particularly in non-model organisms. Numerous introns have invariant positions among kingdoms, providing a potential source for such markers. Unfortunately, most of the few known EPIC (Exon Primed Intron Crossing loci are restricted to vertebrates or belong to multigenic families. Results In order to develop markers with broad applicability, we designed a bioinformatic approach aimed at avoiding multigenic families while identifying intron positions conserved across metazoan phyla. We developed a program facilitating the identification of EPIC loci which allowed slight variation in intron position. From the Homolens databases we selected 29 gene families which contained 52 promising introns for which we designed 93 primer pairs. PCR tests were performed on several ascidians, echinoderms, bivalves and cnidarians. On average, 24 different introns per genus were amplified in bilaterians. Remarkably, five of the introns successfully amplified in all of the metazoan genera tested (a dozen genera, including cnidarians. The influence of several factors on amplification success was investigated. Success rate was not related to the phylogenetic relatedness of a taxon to the groups that most influenced primer design, showing that these EPIC markers are extremely conserved in animals. Conclusions Our new method now makes it possible to (i rapidly isolate a set of EPIC markers for any phylum, even outside the animal kingdom, and thus, (ii compare genetic diversity at potentially homologous polymorphic loci between divergent taxa.

  15. Preliminary study on magnetic tracking-based planar shape sensing and navigation for flexible surgical robots in transoral surgery: methods and phantom experiments.

    Science.gov (United States)

    Song, Shuang; Zhang, Changchun; Liu, Li; Meng, Max Q-H

    2018-02-01

    Flexible surgical robot can work in confined and complex environments, which makes it a good option for minimally invasive surgery. In order to utilize flexible manipulators in complicated and constrained surgical environments, it is of great significance to monitor the position and shape of the curvilinear manipulator in real time during the procedures. In this paper, we propose a magnetic tracking-based planar shape sensing and navigation system for flexible surgical robots in the transoral surgery. The system can provide the real-time tip position and shape information of the robot during the operation. We use wire-driven flexible robot to serve as the manipulator. It has three degrees of freedom. A permanent magnet is mounted at the distal end of the robot. Its magnetic field can be sensed with a magnetic sensor array. Therefore, position and orientation of the tip can be estimated utilizing a tracking method. A shape sensing algorithm is then carried out to estimate the real-time shape based on the tip pose. With the tip pose and shape display in the 3D reconstructed CT model, navigation can be achieved. Using the proposed system, we carried out planar navigation experiments on a skull phantom to touch three different target positions under the navigation of the skull display interface. During the experiments, the real-time shape has been well monitored and distance errors between the robot tip and the targets in the skull have been recorded. The mean navigation error is [Formula: see text] mm, while the maximum error is 3.2 mm. The proposed method provides the advantages that no sensors are needed to mount on the robot and no line-of-sight problem. Experimental results verified the feasibility of the proposed method.

  16. Acquiring minimally invasive surgical skills

    NARCIS (Netherlands)

    Hiemstra, Ellen

    2012-01-01

    Many topics in surgical skills education have been implemented without a solid scientific basis. For that reason we have tried to find this scientific basis. We have focused on training and evaluation of minimally invasive surgical skills in a training setting and in practice in the operating room.

  17. Healthy Bread Initiative: Methods, Findings, and Theories—Isfahan Healthy Heart Program

    Science.gov (United States)

    Talaei, Mohammad; Khaje, Mohammad-Reza; Sarrafzadegan, Nizal; Sajjadi, Firoozeh; Alikhasi, Hasan; Maghroun, Maryam; Iraji, Farhad; Ehteshami, Shahram

    2013-01-01

    The scientific evidences show that the content, baking methods, and types of bread can make health impacts. Bread, as a major part of Iranian diet, demonstrates a significant potential to be targeted as health promotion subject. Healthy Food for Healthy Communities (HFHC) was a project of Isfahan Healthy Heart Program (IHHP), consisting of a wide variety of strategies, like Healthy Bread (HB) Initiative. The HB Initiative was designed to improve the behaviour of both producers and consumers, mainly aiming at making high-fibre, low-salt bread, eliminating the use of baking soda, providing enough rest time for dough before baking (at least one hour), and enough baking time (at least one minute in oven). A workshop was held for volunteer bakers, and a baker-to-baker training protocol under direct supervision was designed for future volunteers. Cereal Organization was persuaded to provide less refined flour that contained more bran. Health messages in support of new breads were disseminated by media and at bakeries by health professionals. Evaluation of the HB Initiative was done using before-after assessments and population surveys. While HB was baked in 1 (0.01%) bakery at baseline, 402 (41%) bakeries in the intervention area joined the HB Initiative in 2009. Soda was completely eliminated and fibre significantly increased from 4±0.4 g% before study to 12±0.6 g% after the intervention (p<0.001). The preparation and baking times remarkably increased. Wastage of bread decreased from 13±1.8 g% to 2±0.5 g% and was expressed as the most important advantage of this initiative by consumers. People who lived in Isfahan city consumed whole bread 6 times more than those who lived in reference area Arak (p<0.001). The HB Initiative managed to add new breads as a healthy choice that were compatible with local dishes and made a model to solve the long-standing problems of bread. It used various health promotion approaches but was best consistent with Beattie's model. PMID

  18. Comparison of fatigue accumulated during and after prolonged robotic and laparoscopic surgical methods: a cross-sectional study.

    Science.gov (United States)

    González-Sánchez, Manuel; González-Poveda, Ivan; Mera-Velasco, Santiago; Cuesta-Vargas, Antonio I

    2017-03-01

    The aim of the present study was to analyse the fatigue experienced by surgeons during and after performing robotic and laparoscopic surgery and to analyse muscle function, self-perceived fatigue and postural balance. Cross-sectional study considering two surgical protocols (laparoscopic and robotic) with two different roles (chief and assistant surgeon). Fatigue was recorded in two ways: pre- and post-surgery using questionnaires [Profile of Mood States (POMS), Quick Questionnaire Piper Fatigue Scale and Visual Analogue Scale (VAS)-related fatigue] and parametrising functional tests [handgrip and single-leg balance test (SLBT)] and during the intervention by measuring the muscle activation of eight different muscles via surface electromyography and kinematic measurement (using inertial sensors). Each surgery profile intervention (robotic/laparoscopy-chief/assistant surgeon) was measured three times, totalling 12 measured surgery interventions. The minimal duration of surgery was 180 min. Pre- and post-surgery, all questionnaires showed that the magnitude of change was higher for the chief surgeon compared with the assistant surgeon, with differences of between 10 % POMS and 16.25 % VAS (robotic protocol) and between 3.1 % POMS and 12.5 % VAS (laparoscopic protocol). In the inter-profile comparison, the chief surgeon (robotic protocol) showed a lower balance capacity during the SLBT after surgery. During the intervention, the kinematic variables showed significant differences between the chief and assistant surgeon in the robotic protocol, but not in the laparoscopic protocol. Regarding muscle activation, there was not enough muscle activity to generate fatigue. Prolonged surgery increased fatigue in the surgeon; however, the magnitude of fatigue differed between surgical profiles. The surgeon who experienced the greatest fatigue was the chief surgeon in the robotic protocol.

  19. Surgical Navigation

    DEFF Research Database (Denmark)

    Azarmehr, Iman; Stokbro, Kasper; Bell, R. Bryan

    2017-01-01

    Purpose: This systematic review investigates the most common indications, treatments, and outcomes of surgical navigation (SN) published from 2010 to 2015. The evolution of SN and its application in oral and maxillofacial surgery have rapidly developed over recent years, and therapeutic indicatio...

  20. Surgical Instrument

    NARCIS (Netherlands)

    Dankelman, J.; Horeman, T.

    2009-01-01

    The present invention relates to a surgical instrument for minimall-invasive surgery, comprising a handle, a shaft and an actuating part, characterised by a gastight cover surrounding the shaft, wherein the cover is provided with a coupler that has a feed- through opening with a loskable seal,

  1. A Review on Hot-IP Finding Methods and Its Application in Early DDoS Target Detection

    Directory of Open Access Journals (Sweden)

    Xuan Dau Hoang

    2016-10-01

    Full Text Available On the high-speed connections of the Internet or computer networks, the IP (Internet Protocol packet traffic passing through the network is extremely high, and that makes it difficult for network monitoring and attack detection applications. This paper reviews methods to find the high-occurrence-frequency elements in the data stream and applies the most efficient methods to find Hot-IPs that are high-frequency IP addresses of IP packets passing through the network. Fast finding of Hot-IPs in the IP packet stream can be effectively used in early detection of DDoS (Distributed Denial of Service attack targets and spreading sources of network worms. Research results show that the Count-Min method gives the best overall performance for Hot-IP detection thanks to its low computational complexity, low space requirement and fast processing speed. We also propose an early detection model of DDoS attack targets based on Hot-IP finding, which can be deployed on the target network routers.

  2. Retained surgical sponge

    International Nuclear Information System (INIS)

    Koyama, Masashi; Kurono, Kenji; Iida, Akihiko; Suzuki, Hirochika; Hara, Masaki; Mizutani, Hirokazu; Ohba, Satoru; Mizutani, Masaru; Nakajima, Yoichiro.

    1993-01-01

    The CT, US, and MRI findings of confirmed retained surgical sponges were reviewed. The CT examinations in eight lesions demonstrated round or oval masses with heterogeneous internal structures. The US examinations in 5 lesions demonstrated low echogenic masses with high echogenic internal structures, which suggested retained surgical sponges. MR imagings in three lesions showed slightly high intensity comparable to that of muscles on T1-weighted images and high signal intensity on T2-weighted images, suggesting fluid collections of high protein concentration. (author)

  3. The improvement of the methods of radial diagnosis and surgical treatment of patients with rheumatoid arthritis of knee and elbow joints

    International Nuclear Information System (INIS)

    Karimov, M.Yu.

    2005-05-01

    Aim of the inquiry: To improve the radial diagnosis of rheumatoid arthritis of knee and elbow joints and to work out new approaches of orthopedic-surgical treatment. Method of research: roentgenography, roentgen densitometry, magnetic resonance imaging, digital subtraction angiography, neutron activation analysis, electromyography, topographic anatomical study, arthroscopy. The results achieved and their novelty: For the first time the data about the peculiarities of blood circulation after long period corticosteroid therapy and without applying corticosteroid therapy, in patients with RA are presented according to the data of angiography. The MRI was supplemented - semiotics of knee and elbow joints affection in RA, which allowed to estimate the stage and the activity of the process more objective way. Also the RD, EMG were carried out and the estimation of condition of the patients with RA was worked out by points, that allowed to see the effectiveness of surgical treatment of RA. The results of NAA of the structure of knee joint of patients with RA allow to determine the distribution of macro- and microelements in tissues of knee. The quantitative estimation of osteoporosis by RD method gives an opportunity to evaluate objectively its degree. According to the results of topographic anatomical study of knee and elbow joints the following have been worked out: the lateral parapatellar approach to structure of knee joints and expanded intermuscular one to structures of elbow joint, which is less traumatic and promotes early rehabilitation of the patients with RA, and also promotes to radical ablation of synovial membrane of elbow joint, which is the reason of joint deformity. By the method of arthroscopy the peculiarities of steroid arthropathy of knee joint of patients with RA have been identified for the first time. Practical value:of the work contains the elaboration of the complex of radial method (roentgenographia, RD, MRI, DSA, NAA) of the diagnosis of the RA

  4. Methods dentists use to diagnose primary caries lesions prior to restorative treatment: findings from The Dental PBRN

    DEFF Research Database (Denmark)

    Rindal, D Brad; Gordan, Valeria V; Litaker, Mark S

    2010-01-01

    To (1) quantify the diagnostic techniques used by Dental Practice-Based Research Network (DPBRN) dentists before they decide to treat primary caries lesions surgically and (2) examine whether certain dentist, practice, and patient characteristics are associated with their use.......To (1) quantify the diagnostic techniques used by Dental Practice-Based Research Network (DPBRN) dentists before they decide to treat primary caries lesions surgically and (2) examine whether certain dentist, practice, and patient characteristics are associated with their use....

  5. Use of traditional and modern contraceptives among childbearing women: findings from a mixed methods study in two southwestern Nigerian states.

    Science.gov (United States)

    Ajayi, Anthony Idowu; Adeniyi, Oladele Vincent; Akpan, Wilson

    2018-05-09

    Contraceptive use has numerous health benefits such as preventing unplanned pregnancies, ensuring optimum spacing between births, reducing maternal and child mortality, and improving the lives of women and children in general. This study examines the level of contraceptive use, its determinants, reasons for non-use of contraception among women in the reproductive age group (18-49 years) in two southwestern Nigerian states. The study adopted an interviewer-administered questionnaire to collect data from 809 participants selected using a 3-stage cluster random sampling technique. We also conducted 46 in-depth interviews. In order to investigate the association between the socio-demographic variables and use of contraceptive methods, we estimated the binary logistic regression models. The findings indicated that knowledge of any methods of contraception was almost universal among the participants. The rates of ever use and current use of contraception was 80 and 66.6%, respectively. However, only 43.9% of the participants had ever used any modern contraceptive methods, considered to be more reliable. The fear of side effects of modern contraceptive methods drove women to rely on less effective traditional methods (withdrawal and rhythm methods). Some women employed crude and unproven contraceptive methods to prevent pregnancies. Our findings show that the rate of contraceptive use was high in the study setting. However, many women chose less effective traditional contraceptive methods over more effective modern contraceptive methods due to fear of side effects of the latter. Patient education on the various options of modern contraceptives, their side effects and management would be crucial towards expanding the family planning services in the study setting.

  6. Evaluating Mind Fitness Training and Its Potential Effects on Surgical Residents’ Well-Being: A Mixed Methods Pilot Study.

    Science.gov (United States)

    Lases, S S; Lombarts, M J M H; Slootweg, Irene A; Arah, Onyebuchi A; Pierik, E G J M; Heineman, Erik

    2016-01-01

    Residents’ well-being is essential for both the individual physician and the quality of patient care they deliver. Therefore, it is important to maintain or possibly enhance residents’ well-being. We investigated (i) the influence of mind fitness training (MFT) on quality of care-related well-being characteristics: work engagement, empathy, work satisfaction and stress perception and explored (ii) residents’ perceptions of MFT. A multicenter study was conducted in eight Dutch teaching hospitals, from September 2012 to February 2014, using mixed methods—that is, quantitative and qualitative approaches to data collection and analysis. Eighty-nine surgical residents were invited to participate in pre- and post-intervention questionnaire surveys. Twenty-two residents participated in MFT and were additionally invited to evaluate the training by post-intervention interviews including open questions. At baseline 22 (100%) residents in intervention group and 47 (70.2%) residents in control group, and postintervention 20 (90.9 %) residents in intervention group and 41 (66.1%) residents in control group completed the questionnaires. In intervention-group, residents’ specialty satisfaction increased by 0.23 point on 5-point Likert scale (95% CI 0.23–0.24, P < 0.001) while stress scores decreased by -0.94 point on 10-point scale (95% CI -1.77 to -0.12, P = 0.026). No substantial changes were observed in control group. Participation in MFT was positively associated with residents’ empathy (b = 7.22; 95% CI 4.33–10.11; P < 0.001) and specialty satisfaction scores (b = 0.42; 95% CI 0.18–0.65; P = 0.001). Residents positively evaluated MFT with median scores of 6.80 for training design and 7.21 for outcome (10-point scale). Residents perceived improvement in focusing skills and reported being more aware of their own state of mind and feeling calmer and more in control. Mind fitness training could improve residents’ empathy, specialty satisfaction, stress

  7. Waterless Hand Rub Versus Traditional Hand Scrub Methods for Preventing the Surgical Site Infection in Orthopedic Surgery.

    Science.gov (United States)

    Iwakiri, Kentaro; Kobayashi, Akio; Seki, Masahiko; Ando, Yoshiyuki; Tsujio, Tadao; Hoshino, Masatoshi; Nakamura, Hiroaki

    2017-11-15

    MINI: Fourteen hundred consecutive patients were investigated for evaluating the utility of waterless hand rub before orthopaedic surgery. The risk in the surgical site infection incidence was the same, but costs of liquids used for hand hygiene were cheaper and the hand hygiene time was shorter for waterless protocol, compared with traditional hand scrub. A retrospective cohort study with prospectively collected data. The aim of this study was to compare SSI incidences, the cost of hand hygiene agents, and hand hygiene time between the traditional hand scrub and the waterless hand rub protocols before orthopedic surgery. Surgical site infections (SSI) prolong hospitalization and are a leading nosocomial cause of morbidity and a source of excess cost. Recently, a waterless hand rub protocol comprising alcohol based chlorhexidine gluconate for use before surgery was developed, but no studies have yet examined its utility in orthopedic surgery. Fourteen hundred consecutive patients who underwent orthopedic surgery (spine, joint replacement, hand, and trauma surgeries) in our hospital since April 1, 2012 were included. A total of 712 cases underwent following traditional hand scrub between April 1, 2012 and April 30, 2013 and 688 cases underwent following waterless hand rub between June 1, 2013 and April 30, 2014. We compared SSI incidences within all and each subcategory between two hand hygiene protocols. All patients were screened for SSI within 1 year after surgery. We compared the cost of hand hygiene agents and hand hygiene time between two groups. The SSI incidences were 1.3% (9 of 712) following the traditional protocol (2 deep and 7 superficial infections) and 1.1% (8 of 688) following the waterless protocol (all superficial infections). There were no significant differences between the two groups. The costs of liquids used for one hand hygiene were about $2 for traditional hand scrub and less than $1 for waterless hand rub. The mean hand hygiene time was 264

  8. Surgical management of venous malformations.

    Science.gov (United States)

    Loose, D A

    2007-01-01

    Among vascular malformations, the predominantly venous malformations represent the majority of cases. They form a clinical entity and therefore need clear concepts concerning diagnosis and treatment. This paper presents an overview of contemporary classification as well as tactics and techniques of treatment. According to the Hamburg Classification, predominantly venous malformations are categorized into truncular and extratruncular forms, with truncular forms distinguished as obstructions and dilations, and extratruncular forms as limited or infiltrating. The tactics of treatment represent surgical and non-surgical methods or combined techniques. Surgical approaches utilize different tactics and techniques that are adopted based on the pathologic form and type of the malformation: (I) operation to reduce the haemodynamic activity of the malformation; (II) operation to eliminate the malformation; and (III) reconstructive operation. As for (I), a type of a tactic is the operation to derive the venous flow. In (II), the total or partial removal of the venous malformation is demonstrated subdivided into three different techniques. In this way, the infiltrating as well as the limited forms can be treated. An additional technique is dedicated to the treatment of a marginal vein. Approach (III) involves the treatment of venous aneurysms, where a variety of techniques have been successful. Long-term follow-up demonstrates positive results in 91% of the cases. Congenital predominantly venous malformations should be treated according to the principles developed during the past decades in vascular surgery, interventional treatment and multidisciplinary treatment. The days of predominantly conservative treatment should be relegated to the past. Special skills and experiences are necessary to carry out appropriate surgical strategy, and the required operative techniques should be dictated by the location and type of malformation and associated findings.

  9. Surgical checklists: the human factor.

    LENUS (Irish Health Repository)

    O Connor, Paul

    2013-05-14

    BACKGROUND: Surgical checklists has been shown to improve patient safety and teamwork in the operating theatre. However, despite the known benefits of the use of checklists in surgery, in some cases the practical implementation has been found to be less than universal. A questionnaire methodology was used to quantitatively evaluate the attitudes of theatre staff towards a modified version of the World Health Organisation (WHO) surgical checklist with relation to: beliefs about levels of compliance and support, impact on patient safety and teamwork, and barriers to the use of the checklist. METHODS: Using the theory of planned behaviour as a framework, 14 semi-structured interviews were conducted with theatre personnel regarding their attitudes towards, and levels of compliance with, a checklist. Based upon the interviews, a 27-item questionnaire was developed and distribute to all theatre personnel in an Irish hospital. RESULTS: Responses were obtained from 107 theatre staff (42.6% response rate). Particularly for nurses, the overall attitudes towards the effect of the checklist on safety and teamworking were positive. However, there was a lack of rigour with which the checklist was being applied. Nurses were significantly more sensitive to the barriers to the use of the checklist than anaesthetists or surgeons. Moreover, anaesthetists were not as positively disposed to the surgical checklist as surgeons and nurse. This finding was attributed to the tendency for the checklist to be completed during a period of high workload for the anaesthetists, resulting in a lack of engagement with the process. CONCLUSION: In order to improve the rigour with which the surgical checklist is applied, there is a need for: the involvement of all members of the theatre team in the checklist process, demonstrated support for the checklist from senior personnel, on-going education and training, and barriers to the implementation of the checklist to be addressed.

  10. The Shortlist Method for fast computation of the Earth Mover's Distance and finding optimal solutions to transportation problems.

    Science.gov (United States)

    Gottschlich, Carsten; Schuhmacher, Dominic

    2014-01-01

    Finding solutions to the classical transportation problem is of great importance, since this optimization problem arises in many engineering and computer science applications. Especially the Earth Mover's Distance is used in a plethora of applications ranging from content-based image retrieval, shape matching, fingerprint recognition, object tracking and phishing web page detection to computing color differences in linguistics and biology. Our starting point is the well-known revised simplex algorithm, which iteratively improves a feasible solution to optimality. The Shortlist Method that we propose substantially reduces the number of candidates inspected for improving the solution, while at the same time balancing the number of pivots required. Tests on simulated benchmarks demonstrate a considerable reduction in computation time for the new method as compared to the usual revised simplex algorithm implemented with state-of-the-art initialization and pivot strategies. As a consequence, the Shortlist Method facilitates the computation of large scale transportation problems in viable time. In addition we describe a novel method for finding an initial feasible solution which we coin Modified Russell's Method.

  11. Clinical Characteristics of Asymmetric Bilateral Gynecomastia: Suggestion of Desirable Surgical Method Based on a Single-Institution Experience.

    Science.gov (United States)

    Lee, Sung Ryul; Lee, Seung Geun; Byun, Geon Young; Kim, Myoung Jin; Koo, Bum Hwan

    2018-06-01

    Asymmetric bilateral gynecomastia (ABGM) is uncommon, and reports on its characteristics are rare. In the present study, we investigated the clinical characteristics and surgical treatment of ABGM. We conducted a retrospective study of 1159 patients with gynecomastia who underwent subcutaneous mastectomy with liposuction at Damsoyu Hospital from January 2014 to February 2016. We then analyzed differences in the characteristics and operative results between two groups of patients: those with asymmetric and symmetric gynecomastia. Asymmetric gynecomastia was defined as gynecomastia meeting both of the following criteria: (1) upon physical examination, the size of the palpable mass below the nipple-areolar complex was twice as large as the smaller one, and (2) upon ultrasonography, the depth of the glandular tissue under the nipple-areolar complex was twice as large as the smaller one. Fifty-four patients were diagnosed with asymmetric gynecomastia. Among them, 51 had ABGM and three had unilateral gynecomastia. In the asymmetric group, more patients had a larger left than right breast (33 patients, 64.7%). The incidence of true-type (entirely glandular) breasts was significantly higher in the asymmetric group (84.3%) than in the symmetric group (p < 0.001). The asymmetry ratios in the asymmetric and symmetric groups were 1.87 ± 2.07 and 0.20 ± 0.16, respectively (p < 0.001). Bilateral mastectomy provided an acceptable and symmetric cosmetic outcome in patients with ABGM. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

  12. Preoperative management of surgical patients by "shortened fasting time": a study on the amount of total body water by multi-frequency impedance method.

    Science.gov (United States)

    Taniguchi, Hideki; Sasaki, Toshio; Fujita, Hisae

    2012-01-01

    Preoperative fasting is an established procedure to be practiced for patients before surgery, but optimal preoperative fasting time still remains controversial. The aim of this study was to investigate the effect of "shortened preoperative fasting time" on the change in the amount of total body water (TBW) in elective surgical patients. TBW was measured by multi-frequency impedance method. The patients, who were scheduled to undergo surgery for stomach cancer, were divided into two groups of 15 patients each. Before surgery, patients in the control group were managed with conventional preoperative fasting time, while patients in the "enhanced recovery after surgery (ERAS)" group were managed with "shortened preoperative fasting time" and "reduced laxative medication." TBW was measured on the day before surgery and the day of surgery before entering the operating room. Defecation times and anesthesia-related vomiting and aspiration were monitored. TBW values on the day of surgery showed changes in both groups as compared with those on the day before surgery, but the rate of change was smaller in the ERAS group than in the control group (2.4±6.8% [12 patients] vs. -10.6±4.6% [14 patients], pfasting time" and "reduced administration of laxatives" is effective in the maintenance of TBW in elective surgical patients.

  13. 3D Surgical Simulation

    Science.gov (United States)

    Cevidanes, Lucia; Tucker, Scott; Styner, Martin; Kim, Hyungmin; Chapuis, Jonas; Reyes, Mauricio; Proffit, William; Turvey, Timothy; Jaskolka, Michael

    2009-01-01

    This paper discusses the development of methods for computer-aided jaw surgery. Computer-aided jaw surgery allows us to incorporate the high level of precision necessary for transferring virtual plans into the operating room. We also present a complete computer-aided surgery (CAS) system developed in close collaboration with surgeons. Surgery planning and simulation include construction of 3D surface models from Cone-beam CT (CBCT), dynamic cephalometry, semi-automatic mirroring, interactive cutting of bone and bony segment repositioning. A virtual setup can be used to manufacture positioning splints for intra-operative guidance. The system provides further intra-operative assistance with the help of a computer display showing jaw positions and 3D positioning guides updated in real-time during the surgical procedure. The CAS system aids in dealing with complex cases with benefits for the patient, with surgical practice, and for orthodontic finishing. Advanced software tools for diagnosis and treatment planning allow preparation of detailed operative plans, osteotomy repositioning, bone reconstructions, surgical resident training and assessing the difficulties of the surgical procedures prior to the surgery. CAS has the potential to make the elaboration of the surgical plan a more flexible process, increase the level of detail and accuracy of the plan, yield higher operative precision and control, and enhance documentation of cases. Supported by NIDCR DE017727, and DE018962 PMID:20816308

  14. [Surgical therapy of gynecomastia].

    Science.gov (United States)

    Heckmann, A; Leclère, F M; Vogt, P M; Steiert, A

    2011-09-01

    Nowadays surgical intervention is an essential part of the treatment of idiopathic gynecomastia. Choosing the right method is crucial and is based on the current status in the clinical and histological evaluation. Before finalizing the process of choosing a specific method a prior interdisciplinary evaluation of the patient is necessary to ascertain clear indications for a surgical intervention. Liposuction is one of the methods which have become popular in recent years. The advantages are the possible combination with traditional techniques, such as subcutaneous mastectomy or periareolar mastopexy. The main indication is for gynecomastia stage IIa/b and is justifiable due to the reduction in surgical complications and scarring. Furthermore this technique provides an excellent aesthetical outcome for the patient. A total of 162 patients suffering from gynecomastia stages I-III (according to Simon) were surgically treated between 2000 and 2010 and these cases were retrospectively evaluated. The results showed a decline in the use of a T-shaped incision in combination with subcutaneous mastectomy with periareolar tightening compared to an increase in the use of subcutaneous mastectomy in combination with liposuction. The excised tissue should always be sent for histological examination to make sure no malignant cells were present.

  15. Surgical intervention in patients with necrotizing pancreatitis

    NARCIS (Netherlands)

    Besselink, MG; de Bruijn, MT; Rutten, JP; Boermeester, MA; Hofker, HS; Gooszen, HG

    Background: This study evaluated the various surgical strategies for treatment of (suspected) infected necrotizing pancreatitis (INP) and patient referrals for this condition in the Netherlands. Methods: This retrospective study included all 106 consecutive patients who had surgical treatment for

  16. Surgical versus non-surgical management of abdominal injury.

    Science.gov (United States)

    Oyo-Ita, Angela; Chinnock, Paul; Ikpeme, Ikpeme A

    2015-11-13

    Injury to the abdomen can be blunt or penetrating. Abdominal injury can damage internal organs such as the liver, spleen, kidneys, intestine, and large blood vessels. There are controversies about the best approach to manage abdominal injuries. To assess the effects of surgical and non-surgical interventions in the management of abdominal trauma in a haemodynamically stable and non-peritonitic abdomen. We searched the Cochrane Injuries Group's Specialised Register, The Cochrane Library, Ovid MEDLINE(R), Ovid MEDLINE(R) In-Process & Other Non-Indexed Citations, Ovid MEDLINE(R) Daily and Ovid OLDMEDLINE(R), EMBASE Classic+EMBASE (Ovid), ISI WOS (SCI-EXPANDED, SSCI, CPCI-S & CPSI-SSH), CINAHL Plus (EBSCO), and clinical trials registers, and screened reference lists. We ran the most recent search on 17 September 2015. Randomised controlled trials of surgical interventions and non-surgical interventions involving people with abdominal injury who were haemodynamically stable with no signs of peritonitis. The abdominal injury could be blunt or penetrating. Two review authors independently applied the selection criteria. Data were extracted by two authors using a standard data extraction form, and are reported narratively. Two studies are included, which involved a total of 114 people with penetrating abdominal injuries. Both studies are at moderate risk of bias because the randomisation methods are not fully described, and the original study protocols are no longer available. The studies were undertaken in Finland between 1992 and 2002, by the same two researchers.In one study, 51 people were randomised to surgery or an observation protocol. None of the participants in the study died. Seven people had complications: 5 (18.5%) in the surgical group and 2 (8.3%) in the observation group; the difference was not statistically significant (P = 0.42; Fischer's exact). Among the 27 people who had surgery, 6 (22.2%) surgeries were negative laparotomies, and 15 (55.6%) were non

  17. A new surgical technique of intra-scleral tube fixation in Ahmed Glaucoma Valve implantation: ‘Scleral Sleeve Method’

    Directory of Open Access Journals (Sweden)

    Charudutt Kalamkar

    2017-10-01

    Full Text Available Purpose: To present a new surgical technique ‘Scleral Sleeve Method’ which would reduce the risk of Ahmed Glaucoma Valve (AGV tube related complications in patients undergoing AGV FP7 (New World Medical Inc., Rancho Cucamonga, CA for refractory glaucoma. Design: Prospective, Non-Randomized, hospital based interventional case series. Subjects: A total of 16 eyes of adult patients (10 males and 6 females with refractory glaucoma. Methods: Instead of using sutures to fix the AGV tube to sclera, we devised a novel method of intra-scleral tube fixation by creating a scleral tunnel fashioned in form of sleeve. Main outcome measure: Post-operative tube related complications. Result: There were no tube related complications such as exposure, extrusion or retraction in any of the cases. Conclusion: Use of scleral sleeve method for tube fixation, along with graft to cover the tube, will provide additional safety measure and reduce the risks of tube related complications. Keywords: Ahmed Glaucoma Valve, Scleral Sleeve Method, Intra-scleral tube fixation

  18. Effect of different anesthesia methods on plasma neuropeptides levels during the peri-operative period in surgical patients with hypertension

    International Nuclear Information System (INIS)

    Li Hong; He Haomin; Tian Xiaoping

    2003-01-01

    Objective: To explore the effect of different anesthesia methods on the levels of plasma neuropeptides during the peri-operative period in patients with hypertension. Methods: Ninety hypertensive patients undergoing upper abdominal operations were randomly allocated to equal divided epidural anesthesia, general anesthesia and combined Groups. Plasma neuropeptide Y(NPY) concentrations were measured before anesthesia, at 15 min after anesthesia, 20 min after operation and 10 min after completion of the operation. Results: BP, HR and NPY were significantly changed in both E group and G group after anesthesia and operation (compared vs before anesthesia, p<0.01). BP, HR and NPY were significantly changed in C group after operation compared with those in both E and G group (p<0.05) . Conclusion: The combined anesthesia method is effective in inhibits the stress response during upper abdominal operation in the hypertensive patients

  19. Analysis of stress-strain state of a human eye by the method of elastotonometry after the surgical correction of hyperopia

    Science.gov (United States)

    Bauer, S. M.; Venatovskaya, L. A.

    2018-05-01

    The mathematical model of measuring of the intraocular pressure (IOP) by Maklakoff tonometer in the software package ANSYS, Inc. is presented. The dependence of the tonometric pressure on the weight of the tonometer before and after LASIK and Femto LASIK surgical corrections of hyperopia is analized. Cornea-scleral eye shell is modeled as two thin transversely isotropic joint spherical shells with different radii of curvature and biomechanical properties. To analyze the biomechanical state of the corneoscleral shell of the eye after the surgery the elastotonometry method is used. Firstly sequential measurements of intraocular pressure by Maklakoff tonometers weighting 5; 7.5; 10 and 15 g is carried out, then the dependence curve of tonometric IOP vs. tonometer weight is plotted and analyzed. The results of the calculations are compared with the clinical data.

  20. Incidence, causes and pattern of cancellation of Elective surgical ...

    African Journals Online (AJOL)

    This study was carried out to assess the incidence, causes and pattern of cancellation of elective surgical operations in our setting and to find the appropriate solutions for better patient management. Methods: This was a prospective hospital-based study which was conducted in a teaching hospital at Bugando medical ...

  1. A new method of surgical navigation for orthognathic surgery: optical tracking guided free-hand repositioning of the maxillomandibular complex.

    Science.gov (United States)

    Li, Biao; Zhang, Lei; Sun, Hao; Shen, Steve G F; Wang, Xudong

    2014-03-01

    In bimaxillary orthognathic surgery, the positioning of the maxilla and the mandible is typically accomplished via 2-splint technique, which may be the sources of several types of inaccuracy. To overcome the limitations of the 2-splint technique, we developed a new navigation method, which guided the surgeon to free-hand reposition the maxillomandibular complex as a whole intraoperatively, without the intermediate splint. In this preliminary study, the feasibility was demonstrated. Five patients with dental maxillofacial deformities were enrolled. Before the surgery, 3-dimensional planning was conducted and imported into a navigation system. During the operation, a tracker was connected to the osteotomized maxillomandibular complex via a splint. The navigation system tracked the movement of the complex and displayed it on the screen in real time to guide the surgeon to reposition the complex. The postoperative result was compared with the plan by analyzing the measured distances between the maxillary landmarks and reference planes, as determined from computed tomography data. The mean absolute errors of the maxillary position were clinically acceptable (<1.0 mm). Preoperative preparation time was reduced to 100 minutes on average. All patients were satisfied with the aesthetic results. This navigation method without intraoperative image registration provided a feasible means of transferring virtual planning to the real orthognathic surgery. The real-time position of the maxillomandibular complex was displayed on a monitor to visually guide the surgeon to reposition the complex. In this method, the traditional model surgery and the intermediate splint were discarded, and the preoperative preparation was simplified.

  2. Preliminary study of clinical staging of moderately advanced and advanced thoracic esophageal carcinoma treated by non-surgical methods

    International Nuclear Information System (INIS)

    Zhu Shuchai; Li Ren; Li Juan; Qiu Rong; Han Chun; Wan Jun

    2004-01-01

    Objective: To explore the clinical staging of moderately advanced and advanced thoracic esophageal carcinoma by evaluating the prognosis and provide criteria for individual treatment. Methods: The authors retrospectively analyzed 500 patients with moderately advanced and advanced thoracic esophageal carcinoma treated by radiotherapy alone. According to the primary lesion length by barium meal X-ray film, the invasion range and the relation between location and the surrounding organs by CT scans the disease category was classified by a 6 stage method and a 4 stage method. With the primary lesion divide into T1, T2a, T2b, T3a, T3b and T4 incorporating the locregional lymph node metastasis, a 6 stage system was obtained, I, IIa , IIb, IIIa, IIIb and IV. The results of this as compared with those of 4 stage system, the following data were finally arrived at. Results: Among the 500 cases, there were T1 23, T2a 111, T2b 157, T3a 84, T3b 82 and T4 43. The survival rates of these six categories showed significant differences (χ 2 =63.32, P 2 =56.29, P 2 =94.29, P 2 =83.48, P<0.05). Conclusions: Both the 6 stage and 4 stage systems are adaptable to predict prognosis of moderately advanced and advanced esophageal carcinoma treated by radiotherapy alone. For simplicity and convenience, the 4 stage classification is recommended. (authors)

  3. Meeting report: discussions and preliminary findings on extracellular RNA measurement methods from laboratories in the NIH Extracellular RNA Communication Consortium

    Directory of Open Access Journals (Sweden)

    Louise C. Laurent

    2015-08-01

    Full Text Available Extracellular RNAs (exRNAs have been identified in all tested biofluids and have been associated with a variety of extracellular vesicles, ribonucleoprotein complexes and lipoprotein complexes. Much of the interest in exRNAs lies in the fact that they may serve as signalling molecules between cells, their potential to serve as biomarkers for prediction and diagnosis of disease and the possibility that exRNAs or the extracellular particles that carry them might be used for therapeutic purposes. Among the most significant bottlenecks to progress in this field is the lack of robust and standardized methods for collection and processing of biofluids, separation of different types of exRNA-containing particles and isolation and analysis of exRNAs. The Sample and Assay Standards Working Group of the Extracellular RNA Communication Consortium is a group of laboratories funded by the U.S. National Institutes of Health to develop such methods. In our first joint endeavour, we held a series of conference calls and in-person meetings to survey the methods used among our members, placed them in the context of the current literature and used our findings to identify areas in which the identification of robust methodologies would promote rapid advancements in the exRNA field.

  4. Clinical observation of a modified surgical method: posterior vaginal mesh suspension of female rectocele with intractable constipation.

    Science.gov (United States)

    Hong, Ling; Li, Huai-Fang; Sun, Jing; Zhu, Jian-Long; Ai, Gui-hai; Li, Li; Zhang, Bo; Chi, Feng-li; Tong, Xiao-Wen

    2012-01-01

    To explore the feasibility and effectiveness of a modified posterior vaginal mesh suspension method in treating female rectocele with intractable constipation. Descriptive study (Canadian Task Force classification II-3). The study was performed in the Study Center for Female Pelvic Dysfunction Disease, Department of Obstetrics and Gynecology, Tongji Hospital, Tongji University School of Medicine, Shanghai, China. The Study Center includes 15 physicians, most of whom have received advanced training in pelvic floor dysfunctional disease and can skillfully perform many types of operations in patients with such disease. Almost 1500 operations to treat pelvic floor dysfunctional disease are performed every year at the center. Thirty-six women with rectocele with intractable constipation. Posterior vaginal mesh suspension. All patients were followed up for 15 to 36 months. In 29 patients, the condition was cured completely; in 5 patients it had improved; and in 2 patients, the intervention had no effect. Insofar as recovery and improved results, the overall effectiveness rate was 94.4%. Posterior vaginal mesh suspension is an effective, harmless, and convenient method for treatment of female rectocele with intractable constipation. It has positive short-term curative effects, with few complications and sequelae. However, the long-term effects of posterior vaginal mesh suspension should be evaluated. Copyright © 2012 AAGL. Published by Elsevier Inc. All rights reserved.

  5. How does sagittal imbalance affect the appropriateness of surgical indications and selection of procedure in the treatment of degenerative scoliosis? Findings from the RAND/UCLA Appropriate Use Criteria study.

    Science.gov (United States)

    Daubs, Michael D; Brara, Harsimran S; Raaen, Laura B; Chen, Peggy Guey-Chi; Anderson, Ashaunta T; Asch, Steven M; Nuckols, Teryl K

    2018-05-01

    Degenerative lumbar scoliosis (DLS) is often associated with sagittal imbalance, which may affect patients' health outcomes before and after surgery. The appropriateness of surgery and preferred operative approaches has not been examined in detail for patients with DLS and sagittal imbalance. The goals of this article were to describe what is currently known about the relationship between sagittal imbalance and health outcomes among patients with DLS and to determine how indications for surgery in patients with DLS differ when sagittal imbalance is present. This study included a literature review and an expert panel using the RAND/University of California at Los Angeles (UCLA) Appropriateness Method. To develop appropriate use criteria for DLS, researchers at the RAND Corporation recently employed the RAND/UCLA Appropriateness Method, which involves a systematic review of the literature and multidisciplinary expert panel process. Experts reviewed a synopsis of published literature and rated the appropriateness of five common operative approaches for 260 different clinical scenarios. In the present work, we updated the literature review and compared panelists' ratings in scenarios where imbalance was present versus absent. This work was funded by the Collaborative Spine Research Foundation, a group of surgical specialty societies and device manufacturers. On the basis of 13 eligible studies that examined sagittal imbalance and outcomes in patients with DLS, imbalance was associated with worse functional status in the absence of surgery and worse symptoms and complications postoperatively. Panelists' ratings demonstrated a consistent pattern across the diverse clinical scenarios. In general, when imbalance was present, surgery was more likely to be appropriate or necessary, including in some situations where surgery would otherwise be inappropriate. For patients with moderate to severe symptoms and imbalance, a deformity correction procedure was usually appropriate

  6. A mixed methods investigation of dropout among talented young dancers: findings from the UK Centres for Advanced Training.

    Science.gov (United States)

    Walker, Imogen J; Nordin-Bates, Sanna M; Redding, Emma

    2012-01-01

    The aim of this study was to understand reasons for dropout from a dance-talent program in the UK, using a mixed methods design. In-depth interviews were conducted with ten dropout students to explore the influencing factors in their decision to leave the program. In order to triangulate these findings, reasons for dropout were then examined from descriptive records of 147 young dancers who had withdrawn from the talent program over a four-year period. Overall, the most frequently cited reasons for dropping out were conflicting demands, change in aspirations, course content, difficulty making friends, and lost passion. Injury, financial factors, low perceived competence, and teacher behavior emerged as minor reasons. Intervention strategies that focus on changes in course content may be the easiest to implement and most effective means to enhance student retention.

  7. When are night shifts effective for nursing student clinical learning? Findings from a mixed-method study design.

    Science.gov (United States)

    Palese, Alvisa; Basso, Felix; Del Negro, Elena; Achil, Illarj; Ferraresi, Annamaria; Morandini, Marzia; Moreale, Renzo; Mansutti, Irene

    2017-05-01

    Some nursing programmes offer night shifts for students while others do not, mainly due to the lack of evidence regarding their effectiveness on clinical learning. The principal aims of the study were to describe nursing students' perceptions and to explore conditions influencing effectiveness on learning processes during night shifts. An explanatory mixed-method study design composed of a cross-sectional study (primary method, first phase) followed by a descriptive phenomenological study design (secondary method, second phase) in 2015. Two bachelor of nursing degree programmes located in Northern Italy, three years in length and requiring night shifts for students starting in the second semester of the 1st year, were involved. First phase: all nursing students ending their last clinical placement of the academic year attended were eligible; 352 out the 370 participated. Second phase: a purposeful sample of nine students among those included in the first phase and who attended the highest amount of night shifts were interviewed. First phase: a questionnaire composed of closed and open-ended questions was adopted; data was analyzed through descriptive statistical methods. Second phase: an open-ended face-to-face audio-recorded interview was adopted and data was analyzed through content analysis. Findings from the quantitative phase, showed that students who attended night shifts reported satisfaction (44.7%) less frequently than those who attended only day shifts (55.9%). They also reported boredom (23.5%) significantly more often compared to day shift students (p=0001). Understanding of the nursing role and learning competence was significantly inferior among night shift students as compared to day shift students, while the perception of wasting time was significantly higher among night shift students compared to their counterparts. Night shift students performed nursing rounds (288; 98.2%), non-nursing tasks (247; 84.3%) and/or less often managed clinical problems

  8. Surgical management of spasmodic torticollis

    Directory of Open Access Journals (Sweden)

    Wael Fouad

    2011-12-01

    Full Text Available Introduction: Spasmodic torticollis (ST is a neuromuscular disorder characterized by uncontrolled clonic and intermittently tonic spasm of the neck muscles. Objective: This retrospective study was done to study clinical picture and to evaluate the surgical results of different surgical procedures in 11 patients who had spasmodic torticollis. Methods: The male to female ratio was 1–2 (4 males and 7 females and their ages ranged from 18 to 65 years. The X-ray of the cervical spine was performed before the operation to exclude cervical disorders that can cause symptoms similar to spasmodic torticollis. MRI of the head and neck was performed in all patients, without finding significant brain lesions. Electromyography of the cervical muscles was performed preoperatively and postoperatively. All cases underwent surgery in the form of variable combinations of ventral rhizotomy of C1, C2+ selective peripheral denervation of neck muscles involved according to the type of torticollis. Mean postoperative follow up period was 24 months. Results: There was no operative mortality. As regards the morbidity, one patient had deficiency of shoulder elevation that was transient and improved after 3 months; one patient had wound infection that responded well to antibiotics after culture and sensitivity. Postoperative dysphagia was found in two cases that improved in one of them after two months. At the last follow up examination period, excellent results were obtained in 55% of patients, good results in 18% of patients, fair results in 18% of patients, and poor results in 9% of cases. Conclusion: There is no standard surgical procedure for treatment of ST; this is adapted to each patient according to type of torticollis. Better results were obtained in simple torticollis (excellent results in 100%, than in complex type (excellent and good results in 33.3%. Keywords: Focal dystonia, Spasmodic torticollis, Anterior rhizotomy, Selective denervation

  9. Isotope nephrography in the assessment of different methods of surgical repair of the kidney after blunt lesions of intermediate degree

    International Nuclear Information System (INIS)

    Hoeflin, F.G.; Schoenenberger, A.; Mettler, D.; Roesler, H.; Zimmermann, A.; Bilweis, J.; Zingg, E.

    1986-01-01

    Despite recent improvements in diagnostic facilities there are no clear guidelines for the management of intermediate degree blunt renal trauma. Sixteen experimentally induced blunt renal lesions in pigs were treated either with a new alloplastic renal capsule made to our specifications of semi-elastic Vicryl mesh or with homologous pig fibrin sealant of with through-and-through chromic catgut sutures. Postoperative renal function was repeatedly assessed in all animals by isotope renography using 123 I-hippuric acid. Results: At surgery the Vicryl mesh was easily and quickly applied. The two other procedures were technically more demanding and time-consuming. Full haemostasis was obtained with all three methods. Kidneys which had been repaired with the Vicryl mesh contained considerably less scar tissue at the site of parenchymal rupture and showed neither perirenal fibrosis nor atrophy of the parenchyma in the vicintiy of the capsule. In a first net version, where high initial tension was applied, final clearance was significantly lower than in the other groups, due to an initial transient ischemic period. A modified technique with a second, final net version allowing controlled expansion of the kidneys during the postoperative period resulted in optimal late results. (Author)

  10. Survey compare team based learning and lecture teaching method, on learning-teaching process nursing student\\'s, in Surgical and Internal Diseases course

    Directory of Open Access Journals (Sweden)

    AA Vaezi

    2015-12-01

    Full Text Available Introduction: The effect of teaching methods on learning process of students will help teachers to improve the quality of teaching by selecting an appropriate method. This study aimed to compare the team- based learning and lecture teaching method on learning-teaching process of nursing students in surgical and internal diseases courses. Method: This quasi-experimental study was carried on the nursing students in the School of Nursing and Midwifery in Yazd and Meybod cities. Studied sample was all of the students in the sixth term in the Faculty of Nursing in Yazd (48 persons and the Faculty of Nursing in Meybod (28 persons. The rate of students' learning through lecture was measured using MCQ tests and teaching based on team-based learning (TBL method was run using MCQ tests (IRAT, GRAT, Appeals and Task group. Therefore, in order to examine the students' satisfaction about the TBL method, a 5-point Likert scale (translated questionnaire (1=completely disagree, 2= disagree, 3=not effective, 4=agree, and 5=completely agree consisted of 22 items was utilized. The reliability and validity of this translated questionnaire was measured. The collected data were analyzed through SPSS 17.0 using descriptive and analytical statistic. Result: The results showed that the mean scores in team-based learning were meaningful in individual assessment (17±84 and assessment group (17.2±1.17. The mean of overall scores in TBL method (17.84±0.98% was higher compared with the lecture teaching method (16±2.31. Most of the students believed that TBL method has improved their interpersonal and group interaction skills (100%. Among them, 97.7% of students mentioned that this method (TBL helped them to understand the course content better. The lowest levels of the satisfaction have related to the continuous learning during lifelong (51.2%. Conclusion: The results of the present study showed that the TBL method led to improving the communication skills, understanding

  11. Design of the Endobronchial Valve for Emphysema Palliation Trial (VENT: a non-surgical method of lung volume reduction

    Directory of Open Access Journals (Sweden)

    Noppen Marc

    2007-07-01

    Full Text Available Abstract Background Lung volume reduction surgery is effective at improving lung function, quality of life, and mortality in carefully selected individuals with advanced emphysema. Recently, less invasive bronchoscopic approaches have been designed to utilize these principles while avoiding the associated perioperative risks. The Endobronchial Valve for Emphysema PalliatioN Trial (VENT posits that occlusion of a single pulmonary lobe through bronchoscopically placed Zephyr® endobronchial valves will effect significant improvements in lung function and exercise tolerance with an acceptable risk profile in advanced emphysema. Methods The trial design posted on Clinical trials.gov, on August 10, 2005 proposed an enrollment of 270 subjects. Inclusion criteria included: diagnosis of emphysema with forced expiratory volume in one second (FEV1 100%; residual volume > 150% predicted, and heterogeneous emphysema defined using a quantitative chest computed tomography algorithm. Following standardized pulmonary rehabilitation, patients were randomized 2:1 to receive unilateral lobar placement of endobronchial valves plus optimal medical management or optimal medical management alone. The co-primary endpoint was the mean percent change in FEV1 and six minute walk distance at 180 days. Secondary end-points included mean percent change in St. George's Respiratory Questionnaire score and the mean absolute changes in the maximal work load measured by cycle ergometry, dyspnea (mMRC score, and total oxygen use per day. Per patient response rates in clinically significant improvement/maintenance of FEV1 and six minute walk distance and technical success rates of valve placement were recorded. Apriori response predictors based on quantitative CT and lung physiology were defined. Conclusion If endobronchial valves improve FEV1 and health status with an acceptable safety profile in advanced emphysema, they would offer a novel intervention for this progressive and

  12. Finding possible transition states of defects in silicon-carbide and alpha-iron using the dimer method

    CERN Document Server

    Gao Fei; Weber, W J; Corrales, L R; Jonsson, H

    2003-01-01

    Energetic primary recoil atoms from ion implantation or fast neutron irradiation produce isolated point defects and clusters of both vacancies and interstitials. The migration energies and mechanisms for these defects are crucial to successful multiscale modeling of microstructural evolution during ion-implantation, thermal annealing, or under irradiation over long periods of time. The dimer method is employed to search for possible transition states of interstitials and small interstitial clusters in SiC and alpha-Fe. The method uses only the first derivatives of the potential energy to find saddle points without knowledge of the final state of the transition. In SiC, the possible migration pathway for the C interstitial is found to consist of the first neighbor jump via a Si site or second neighbor jump, but the relative probability for the second neighbor jump is very low. In alpha-Fe, the possible transition states are studied as a function of interstitial cluster size, and the lowest energy barriers corr...

  13. Non-Surgical Breast-Conserving Treatment (KORTUC-BCT Using a New Radiosensitization Method (KORTUC II for Patients with Stage I or II Breast Cancer

    Directory of Open Access Journals (Sweden)

    Yasuhiro Ogawa

    2015-11-01

    Full Text Available The purpose of the present study was to establish a non-surgical breast-conserving treatment (BCT using KORTUC II radiosensitization treatment. A new radiosensitizing agent containing 0.5% hydrogen peroxide and 0.83% sodium hyaluronate (a CD44 ligand has been developed for intra-tumoral injection into various tumors. This new method, named KORTUC II, was approved by our local ethics committee for the treatment of breast cancer and metastatic lymph nodes. A total of 72 early-stage breast cancer patients (stage 0, 1 patient; stage I, 23; stage II, 48 were enrolled in the KORTUC II trial after providing fully informed consent. The mean age of the patients was 59.7 years. A maximum of 6 mL (usually 3 mL for tumors of less than approximately 3 cm in diameter of the agent was injected into breast tumor tissue twice a week under ultrasonographic guidance. For radiotherapy, hypofraction radiotherapy was administered using a tangential fields approach including an ipsilateral axillary region and field-in-field method; the energy level was 4 MV, and the total radiation dose was 44 Gy administered as 2.75 Gy/fraction. An electron boost of 3 Gy was added three times. Treatment was well tolerated with minimal adverse effects in all 72 patients. No patients showed any significant complications other than mild dermatitis. A total of 24 patients under 75 years old with stage II breast cancer underwent induction chemotherapy (EC and/or taxane prior to KORTUC II treatment, and 58 patients with estrogen receptor-positive tumors also received hormonal therapy following KORTUC II. The mean duration of follow-up as of the end of September 2014 was 51.1 months, at which time 68 patients were alive without any distant metastases. Only one patient had local recurrence and died of cardiac failure at 6.5 years. Another one patient had bone metastases. For two of the 72 patients, follow-up ended after several months following KORTUC II treatment. In conclusion, non-surgical

  14. Mixed methods evaluation of targeted case finding for cardiovascular disease prevention using a stepped wedged cluster RCT

    Directory of Open Access Journals (Sweden)

    Marshall Tom

    2012-10-01

    Full Text Available Abstract Background A pilot project cardiovascular prevention was implemented in Sandwell (West Midlands, UK. This used electronic primary care records to identify untreated patients at high risk of cardiovascular disease then invited these high risk patients for assessment by a nurse in their own general practice. Those found to be eligible for treatment were offered treatment. During the pilot a higher proportion of high risk patients were started on treatment in the intervention practices than in control practices. Following the apparent success of the prevention project, it was intended to extend the service to all practices across the Sandwell area. However the pilot project was not a robust evaluation. There was a need for an efficient evaluation that would not disrupt the planned rollout of the project. Methods/design Project nurses will sequentially implement targeted cardiovascular case finding in a phased way across all general practices, with the sequence of general practices determined randomly. This is a stepped wedge randomised controlled trial design. The target population is patients aged 35 to 74, without diabetes or cardiovascular disease whose ten-year cardiovascular risk, (determined from data in their electronic records is ≥20%. The primary outcome is the number of high risk patients started on treatment, because these data could be efficiently obtained from electronic primary care records. From this we can determine the effects of the case finding programme on the proportion of high risk patients started on treatment in practices before and after implementation of targeted case finding. Cost-effectiveness will be modelled from the predicted effects of treatments on cardiovascular events and associated health service costs. Alongside the implementation it is intended to interview clinical staff and patients who participated in the programme in order to determine acceptability to patients and clinicians. Practical

  15. Comparison of a new hydro-surgical technique to traditional methods for the preparation of full-thickness skin grafts from canine cadaveric skin and report of a single clinical case.

    Science.gov (United States)

    Townsend, F I; Ralphs, S C; Coronado, G; Sweet, D C; Ward, J; Bloch, C P

    2012-01-01

    To compare the hydro-surgical technique to traditional techniques for removal of subcutaneous tissue in the preparation of full-thickness skin grafts. Ex vivo experimental study and a single clinical case report. Four canine cadavers and a single clinical case. Four sections of skin were harvested from the lateral flank of recently euthanatized dogs. Traditional preparation methods used included both a blade or scissors technique, each of which were compared to the hydro-surgical technique individually. Preparation methods were compared based on length of time for removal of the subcutaneous tissue from the graft, histologic grading, and measurable thickness as compared to an untreated sample. The hydro-surgical technique had the shortest skin graft preparation time as compared to traditional techniques (p = 0.002). There was no significant difference in the histological grading or measurable subcutaneous thickness between skin specimens. The hydro-surgical technique provides a rapid, effective debridement of subcutaneous tissue in the preparation of full-thickness skin grafts. There were not any significant changes in histological grade and subcutaneous tissue remaining among all treatment types. Additionally the hydro-surgical technique was successfully used to prepare a full-thickness meshed free skin graft in the reconstruction of a traumatic medial tarsal wound in a dog.

  16. Surgical Skills Beyond Scientific Management.

    Science.gov (United States)

    Whitfield, Nicholas

    2015-07-01

    During the Great War, the French surgeon Alexis Carrel, in collaboration with the English chemist Henry Dakin, devised an antiseptic treatment for infected wounds. This paper focuses on Carrel's attempt to standardise knowledge of infected wounds and their treatment, and looks closely at the vision of surgical skill he espoused and its difference from those associated with the doctrines of scientific management. Examining contemporary claims that the Carrel-Dakin method increased rather than diminished demands on surgical work, this paper further shows how debates about antiseptic wound treatment opened up a critical space for considering the nature of skill as a vital dynamic in surgical innovation and practice.

  17. Disconnects in pedagogy and practice in community health nursing clinical experiences: Qualitative findings of a mixed method study.

    Science.gov (United States)

    Pijl-Zieber, Em M; Barton, Sylvia; Awosoga, Olu; Konkin, Jill

    2015-10-01

    Many baccalaureate schools of nursing are using non-traditional placements for undergraduate community health clinical rotations. These placements occur at agencies not organizationally affiliated with the health care system and they typically do not employ registered nurses (RNs). In this paper, we describe the qualitative findings of a mixed method study that explored these gaps as they relate to pre-registration nursing students' preparation for community health roles. While non-traditional community health placements offer unique opportunities for learning through carefully crafted service learning pedagogy, these placements also present challenges for student preparation for practice in community health roles. The theory-practice gap and the gap between the expected and actual performance of new graduates are accentuated through the use of non-traditional community clinical experiences. These gaps are not necessarily due to poor pedagogy, but rather due to the perceptions and values of the stakeholders involved: nursing students, community health nursing faculty, and community health nurses. New ways must be developed between academe and community health practice areas to provide students with opportunities to develop competence for practice. Copyright © 2015 Elsevier Ltd. All rights reserved.

  18. Meat intake, cooking methods, dietary carcinogens, and colorectal cancer risk: findings from the Colorectal Cancer Family Registry.

    Science.gov (United States)

    Joshi, Amit D; Kim, Andre; Lewinger, Juan Pablo; Ulrich, Cornelia M; Potter, John D; Cotterchio, Michelle; Le Marchand, Loic; Stern, Mariana C

    2015-06-01

    Diets high in red meat and processed meats are established colorectal cancer (CRC) risk factors. However, it is still not well understood what explains this association. We conducted comprehensive analyses of CRC risk and red meat and poultry intakes, taking into account cooking methods, level of doneness, estimated intakes of heterocyclic amines (HCAs) that accumulate during meat cooking, tumor location, and tumor mismatch repair proficiency (MMR) status. We analyzed food frequency and portion size data including a meat cooking module for 3364 CRC cases, 1806 unaffected siblings, 136 unaffected spouses, and 1620 unaffected population-based controls, recruited into the CRC Family Registry. Odds ratios (OR) and 95% confidence intervals (CI) for nutrient density variables were estimated using generalized estimating equations. We found no evidence of an association between total nonprocessed red meat or total processed meat and CRC risk. Our main finding was a positive association with CRC for pan-fried beefsteak (P(trend) carcinogens relevant for CRC risk. © 2015 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

  19. Cash transfers for HIV prevention: what do young women spend it on? Mixed methods findings from HPTN 068

    Directory of Open Access Journals (Sweden)

    Catherine MacPhail

    2017-07-01

    Full Text Available Abstract Background Social grants have been found to have an impact on health and wellbeing in multiple settings. Who receives the grant, however, has been the subject of discussion with regards to how the money is spent and who benefits from the grant. Methods Using survey data from 1214 young women who were in the intervention arm and completed at least one annual visit in the HPTN 068 trial, and qualitative interview data from a subset of 38 participants, we examined spending of a cash transfer provided to young women conditioned on school attendance. Results We found that spending was largely determined and controlled by young women themselves and that the cash transfer was predominately spent on toiletries, clothing and school supplies. In interview data, young women discussed the significant role of cash transfers for adolescent identity, specifically with regard to independence from family and status within the peer network. There were almost no negative consequences from receiving the cash transfer. Conclusions We established that providing adolescents access to cash was not reported to be associated with social harms or negative consequences. Rather, spending of the cash facilitated appropriate adolescent developmental behaviours. The findings are encouraging at a time in which there is global interest in addressing the structural drivers of HIV risk, such as poverty, for young women. Trial registration Clinicaltrials.gov NCT01233531 (1 Nov 2010. First participant enrolled 5 March 2011.

  20. Meat intake, cooking methods, dietary carcinogens, and colorectal cancer risk: findings from the Colorectal Cancer Family Registry

    International Nuclear Information System (INIS)

    Joshi, Amit D; Kim, Andre; Lewinger, Juan Pablo; Ulrich, Cornelia M; Potter, John D; Cotterchio, Michelle; Le Marchand, Loic; Stern, Mariana C

    2015-01-01

    Diets high in red meat and processed meats are established colorectal cancer (CRC) risk factors. However, it is still not well understood what explains this association. We conducted comprehensive analyses of CRC risk and red meat and poultry intakes, taking into account cooking methods, level of doneness, estimated intakes of heterocyclic amines (HCAs) that accumulate during meat cooking, tumor location, and tumor mismatch repair proficiency (MMR) status. We analyzed food frequency and portion size data including a meat cooking module for 3364 CRC cases, 1806 unaffected siblings, 136 unaffected spouses, and 1620 unaffected population-based controls, recruited into the CRC Family Registry. Odds ratios (OR) and 95% confidence intervals (CI) for nutrient density variables were estimated using generalized estimating equations. We found no evidence of an association between total nonprocessed red meat or total processed meat and CRC risk. Our main finding was a positive association with CRC for pan-fried beefsteak (P trend < 0.001), which was stronger among MMR deficient cases (heterogeneity P = 0.059). Other worth noting associations, of borderline statistical significance after multiple testing correction, were a positive association between diets high in oven-broiled short ribs or spareribs and CRC risk (P trend = 0.002), which was also stronger among MMR-deficient cases, and an inverse association with grilled hamburgers (P trend = 0.002). Our results support the role of specific meat types and cooking practices as possible sources of human carcinogens relevant for CRC risk

  1. Differential impact of contraceptive methods on seizures varies by antiepileptic drug category: Findings of the Epilepsy Birth Control Registry.

    Science.gov (United States)

    Herzog, Andrew G; Mandle, Hannah B; Cahill, Kaitlyn E; Fowler, Kristen M; Hauser, W Allen

    2016-07-01

    The aim of this study was to determine whether categories of contraception differ in their impact on seizures in women with epilepsy and whether the impact varies by antiepileptic drug category. Retrospective survey data came from 2712 contraceptive experiences reported by 1144 women with epilepsy. We compared risk ratios for reports of increase and decrease in seizure frequency on hormonal versus nonhormonal contraception, stratified by antiepileptic drug categories. More women with epilepsy reported a change in seizures on hormonal (28.2%) than on nonhormonal contraception (9.7%) (pcontraception (4.2%) was 4.47 (pcontraception (5.5%) was 1.71, pcontraception, the risk ratio for seizure increase was greater than for decrease (1.98, pmethod with a greater risk ratio for seizure decrease than combined pills. Seizure increase was greater for hormonal than nonhormonal contraception for each antiepileptic drug category (pcontraception, relative to the non-enzyme-inducing antiepileptic drug category which had the lowest rate, each of the other categories had significantly greater risks for seizure increase, especially the enzyme-inhibiting (valproate) category (risk ratio=2.53, p=0.0002). The findings provide community-based, epidemiological survey evidence that contraceptive methods may differ in their impact on seizures and that this impact may vary by antiepileptic drug category. Copyright © 2016. Published by Elsevier Inc.

  2. A Randomized Trial Evaluating Two Approaches for Promoting Pharmacy-Based Referrals to the Tobacco Quitline: Methods and Baseline Findings

    Science.gov (United States)

    Zillich, Alan J.; Corelli, Robin L.; Zbikowski, Susan M.; Magnusson, L. Brooke; Fenlon, Christine M.; Prokhorov, Alexander V.; de Moor, Carl; Hudmon, Karen S.

    2012-01-01

    Background Historically, community pharmacies have not integrated tobacco cessation activities into routine practice, instead unbundling them as unique services. This approach might have limited success and viability. Objective The objective of this report is to describe the methods and baseline findings for a two-state, randomized trial evaluating two intervention approaches for increasing pharmacy-based referrals to their state’s tobacco quitline. Methods Participating community pharmacies in Connecticut (n=32) and Washington (n=32) were randomized to receive either (a) on-site education with an academic detailer, describing methods for implementing brief interventions with patients and providing referrals to the tobacco quitline, or (b) quitline materials delivered by mail. Both interventions advocated for pharmacy personnel to ask about tobacco use, advise patients who smoke to quit, and refer patients to the tobacco quitline for additional assistance with quitting. Study outcome measures include the number of quitline registrants who are referred by pharmacies (before and during the intervention period), the number of quitline materials distributed to patients, and self-reported behavior of cessation counseling and quitline referrals, assessed using written surveys completed by pharmacy personnel (pharmacists, technicians). Results Pharmacists (n=124) and pharmacy technicians (n=127), representing 64 participating pharmacies with equal numbers of retail chain and independently-owned pharmacies, participated in the study. Most pharmacists (67%) and half of pharmacy technicians (50%) indicated that they were “not at all” familiar with the tobacco quitline. During the baseline (pre-intervention) monitoring period, the quitline registered 120 patients (18 in CT and 102 in WA) who reported that they heard about the quitline from a pharmacy. Conclusion Novel tobacco intervention approaches are needed to capitalize on the community pharmacy’s frequent

  3. A New Method for Treatment of Lymphedema of Limbs: Standardized Manual Massage with a New Device Linforoll in Conservative and Surgical Therapy Protocols.

    Science.gov (United States)

    Olszewski, Waldemar L; Zaleska, Marzanna; Michelin, Sandro

    2016-12-01

    Edema fluid in lymphedematous limbs should be evacuated to sites where it can be absorbed. It should be moved either to the hypogastrium or arm/scapular regions along tissue channels or implanted silicon channels or through lymphovenous anastomoses. For that purpose, the manual lymphatic drainage of limb is an effective method. Standardization of manual massage applied force and timing becomes necessary. A device with known pressing area and continuously showing the applied force while moving it toward the root of the limb is needed. Moreover, force could be adjusted to the stiffness of the massaged tissues that varies at different levels of the limb. Results from such a device would be repeatable and reproducible by others. In this study we present data on tissue fluid hydromechanics obtained from 20 patients with obstructive limb lymphedema during massage with a massaging roller called Linforoll. Linforoll is composed of a hand piece with roller and pressure sensor connected wireless to the computer displaying the pressure curve of the applied force. Electron microscopy studies for checking eventual tissue changes were done. Linforoll provides the possibilities of: 1) regulating the applied force according to the hydromechanic conditions of the massaged tissues; 2) standardization of massage repeatable in the same patient; 3) decrease of limb volume; 4) evident increase in tissue elasticity; 5) application as a driving force for fluid flow along the surgically implanted tubing and vessels running to the lymphovenous shunts.

  4. [Surgical treatment of gynecomastia: an algorithm].

    Science.gov (United States)

    Wolter, A; Scholz, T; Diedrichson, J; Liebau, J

    2013-04-01

    Gynecomastia is a persistent benign uni- or bilateral enlargement of the male breast ranging from small to excessive findings with marked skin redundancy. In this paper we introduce an algorithm to facilitate the selection of the appropriate surgical technique according to the presented morphological aspects. The records of 118 patients (217 breasts) with gynecomastia from 01/2009 to 08/2012 were retrospectively reviewed. The authors conducted three different surgical techniques depending on four severity grades. The outcome parameters complication rate, patient satisfaction with the aesthetic result, nipple sensitivity and the need to re-operate were observed and related to the employed technique. In 167 (77%) breasts with moderate breast enlargement without skin redundancy (Grade I-IIa by Simon's classification) a subcutaneous semicircular periareolar mastectomy was performed in combination with water-jet assisted liposuction. In 40 (18%) breasts with skin redundancy (Grade IIb) a circumferential mastopexy was performed additionally. An inferior pedicled mammaplasty was used in 10 (5%) severe cases (Grade III). Complication rate was 4.1%. Surgical corrections were necessary in 17 breasts (7.8%). The patient survey revealed a high satisfaction level: 88% of the patients rated the aesthetic results as "very good" or "good", nipple sensitivity was rated as "very good" or "good" by 83%. Surgical treatment of gynecomastia should ensure minimal scarring while respecting the aesthetic unit. The selection of the appropriate surgical method depends on the severity grade, the presence of skin redundancy and the volume of the male breast glandular tissue. The presented algorithm rarely leads to complications, is simple to perform and shows a high satisfaction rate and a preservation of the nipple sensitivity. © Georg Thieme Verlag KG Stuttgart · New York.

  5. Surgical versus non-surgical management for pleural empyema.

    Science.gov (United States)

    Redden, Mark D; Chin, Tze Yang; van Driel, Mieke L

    2017-03-17

    Empyema refers to pus in the pleural space, commonly due to adjacent pneumonia, chest wall injury, or a complication of thoracic surgery. A range of therapeutic options are available for its management, ranging from percutaneous aspiration and intercostal drainage to video-assisted thoracoscopic surgery (VATS) or thoracotomy drainage. Intrapleural fibrinolytics may also be administered following intercostal drain insertion to facilitate pleural drainage. There is currently a lack of consensus regarding optimal treatment. To assess the effectiveness and safety of surgical versus non-surgical treatments for complicated parapneumonic effusion or pleural empyema. We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (2016, Issue 9), MEDLINE (Ebscohost) (1946 to July week 3 2013, July 2015 to October 2016) and MEDLINE (Ovid) (1 May 2013 to July week 1 2015), Embase (2010 to October 2016), CINAHL (1981 to October 2016) and LILACS (1982 to October 2016) on 20 October 2016. We searched ClinicalTrials.gov and WHO International Clinical Trials Registry Platform for ongoing studies (December 2016). Randomised controlled trials that compared a surgical with a non-surgical method of management for all age groups with pleural empyema. Two review authors independently assessed trials for inclusion and risk of bias, extracted data, and checked the data for accuracy. We contacted trial authors for additional information. We assessed the quality of the evidence using the GRADE approach. We included eight randomised controlled trials with a total of 391 participants. Six trials focused on children and two on adults. Trials compared tube thoracostomy drainage (non-surgical), with or without intrapleural fibrinolytics, to either VATS or thoracotomy (surgical) for the management of pleural empyema. Assessment of risk of bias for the included studies was generally unclear for selection and blinding but low for attrition and reporting bias. Data analyses compared

  6. CF findings of bowel infarction in 56 surgical patients, 5 of whom with reversible ischemia; Aspetti alla tomografia computerizzata dell'infarto intestinale. 56 pazienti sottoposti a interventi chirurgico di cui 5 con ischemia mesenterica reversibile.

    Energy Technology Data Exchange (ETDEWEB)

    Salzano, A.; De Rosa, A.; Carbone, M.; Ginolfi, F.; Rossi, E.; Amodio, F. [Naples Univ. Federico 2. (Italy). Ist. di Scienze Radiologiche; Muto, M.; Tuccillo, M. [Azienda Sanitaria di Rilievo Nazionale A. Cardarelli, Naples (Italy). Servizio di Neuroradiologia

    1999-04-01

    Bowel infarction is a rare and typical condition of the elderly; despite improvements in diagnostic imaging and vascular surgery, bowel infarction remains a major cause of acute abdomen, with mortality rates ranging 70-80%. Diagnosis on often late because clinical signs, laboratory data and radiologic findings are a specific. The authors investigated radiographic and particular CT patterns of intestinal infraction in 56 patients submitted to surgery within 12 hours of admission. We also report the CT findings of 5 of these patients who had reversible mesenteric ischemia. CT is more sensitive than radiography and does not exhibit the limitations of angiography (i.e., invasiveness, radiation exposure and complex organization). Therefore CT can presently be considered the method of choice in patients with suspected bowel infarction. [Italian] L'infarto intestinale rappresenta una malattia rara e tipica del soggeto anziano; nonostante il notevole perfezionamento delle tecniche di diagnostica per immagini e il progresso della chirurgia vascolare, rimane ancora oggi una delle piu' temibili condizioni di addome acuto, con mortalita' superiore al 70-80%. Il riconoscimento diagnostico e' tardivo per l'aspecificita' dei dati di laboratorio, dei segni clinici e degli esami radiologici. La TC presenta maggiore afficacia diagnostica rispetto all'esame radiografico diretto e non ha limiti che caratterizzano l'angiografia, quali l'invasivita', radioesposizione e complessita' organizzativa: attualmente la metodica TC puo' essere indicata come indagine di scelta in pazienti con sospetto infarto intestinale.

  7. Bacterial migration through punctured surgical gloves under real surgical conditions

    Directory of Open Access Journals (Sweden)

    Heidecke Claus-Dieter

    2010-07-01

    Full Text Available Abstract Background The aim of this study was to confirm recent results from a previous study focussing on the development of a method to measure the bacterial translocation through puncture holes in surgical gloves under real surgical conditions. Methods An established method was applied to detect bacterial migration from the operating site through the punctured glove. Biogel™ double-gloving surgical gloves were used during visceral surgeries over a 6-month period. A modified Gaschen-bag method was used to retrieve organisms from the inner glove, and thus-obtained bacteria were compared with micro-organisms detected by an intra-operative swab. Results In 20 consecutive procedures, 194 gloves (98 outer gloves, 96 inner gloves were examined. The rate of micro-perforations of the outer surgical glove was 10% with a median wearing time of 100 minutes (range: 20-175 minutes. Perforations occurred in 81% on the non-dominant hand, with the index finger most frequently (25% punctured. In six cases, bacterial migration could be demonstrated microbiologically. In 5% (5/98 of outer gloves and in 1% (1/96 of the inner gloves, bacterial migration through micro-perforations was observed. For gloves with detected micro-perforations (n = 10 outer layers, the calculated migration was 50% (n = 5. The minimum wearing time was 62 minutes, with a calculated median wearing time of 71 minutes. Conclusions This study confirms previous results that bacterial migration through unnoticed micro-perforations in surgical gloves does occur under real practical surgical conditions. Undetected perforation of surgical gloves occurs frequently. Bacterial migration from the patient through micro-perforations on the hand of surgeons was confirmed, limiting the protective barrier function of gloves if worn over longer periods.

  8. Evolution of surgical skills training

    Science.gov (United States)

    Roberts, Kurt E; Bell, Robert L; Duffy, Andrew J

    2006-01-01

    Surgical training is changing: one hundred years of tradition is being challenged by legal and ethical concerns for patient safety, work hours restrictions, the cost of operating room time, and complications. Surgical simulation and skills training offers an opportunity to teach and practice advanced skills outside of the operating room environment before attempting them on living patients. Simulation training can be as straight forward as using real instruments and video equipment to manipulate simulated “tissue” in a box trainer. More advanced, virtual reality simulators are now available and ready for widespread use. Early systems have demonstrated their effectiveness and discriminative ability. Newer systems enable the development of comprehensive curricula and full procedural simulations. The Accreditation Council of Graduate Medical Education’s (ACGME) has mandated the development of novel methods of training and evaluation. Surgical organizations are calling for methods to ensure the maintenance of skills, advance surgical training, and to credential surgeons as technically competent. Simulators in their current form have been demonstrated to improve the operating room performance of surgical residents. Development of standardized training curricula remains an urgent and important agenda, particularly for minimal invasive surgery. An innovative and progressive approach, borrowing experiences from the field of aviation, can provide the foundation for the next century of surgical training, ensuring the quality of the product. As the technology develops, the way we practice will continue to evolve, to the benefit of physicians and patients. PMID:16718842

  9. The Virtual Surgical Pelvis : Anatomy Visualization for Education and Surgical Planning

    NARCIS (Netherlands)

    Smit, N.N.

    2016-01-01

    This thesis deals with visualizing anatomical data for medical education and surgical planning purposes. To this end, we have developed a detailed virtual atlas, the Virtual Surgical Pelvis (VSP),which unifies surgically relevant knowledge on pelvic anatomy. We provide methods to share the knowledge

  10. Micro-surgical endodontics.

    Science.gov (United States)

    Eliyas, S; Vere, J; Ali, Z; Harris, I

    2014-02-01

    Non-surgical endodontic retreatment is the treatment of choice for endodontically treated teeth with recurrent or residual disease in the majority of cases. In some cases, surgical endodontic treatment is indicated. Successful micro-surgical endodontic treatment depends on the accuracy of diagnosis, appropriate case selection, the quality of the surgical skills, and the application of the most appropriate haemostatic agents and biomaterials. This article describes the armamentarium and technical procedures involved in performing micro-surgical endodontics to a high standard.

  11. Experimental Validation of the Dynamic Inertia Measurement Method to Find the Mass Properties of an Iron Bird Test Article

    Science.gov (United States)

    Chin, Alexander W.; Herrera, Claudia Y.; Spivey, Natalie D.; Fladung, William A.; Cloutier, David

    2015-01-01

    The mass properties of an aerospace vehicle are required by multiple disciplines in the analysis and prediction of flight behavior. Pendulum oscillation methods have been developed and employed for almost a century as a means to measure mass properties. However, these oscillation methods are costly, time consuming, and risky. The NASA Armstrong Flight Research Center has been investigating the Dynamic Inertia Measurement, or DIM method as a possible alternative to oscillation methods. The DIM method uses ground test techniques that are already applied to aerospace vehicles when conducting modal surveys. Ground vibration tests would require minimal additional instrumentation and time to apply the DIM method. The DIM method has been validated on smaller test articles, but has not yet been fully proven on large aerospace vehicles.

  12. Core trainee boot camp-A method for improving technical and non-technical skills of novice surgical trainees. A before and after study.

    Science.gov (United States)

    Bamford, R; Langdon, L; Rodd, C A; Eastaugh-Waring, S; Coulston, J E

    2018-04-10

    The transition to surgical training can be a stressful time for trainees and is most evident during national handover periods where new graduates start and senior trainees rotate to new programmes. During this time, patient mortality can increase and Hospital efficiency reduces. This influence is compounded by the impact of working time directives. Intensive, simulation rich training programmes or "Boot Camps" have been postulated as a solution. This article highlights the development of a surgical boot camp for novice surgical trainees and the impact this can have on training. A novel surgical boot camp was developed for all trainees within a surgical training region including nine acute NHS trusts. Participating cohort of trainees completed pre and post course questionnaires to assess technical and non-technical skills. 25 trainees attended and completed the pre and post boot camp questionnaire. Significant improvements were seen with technical skills (p = 0.0429), overall non-technical skills (p skills (p = 0.005) and outpatient skill (p = 0.002). Trainees reported significantly increased ability to assess and manage a critically unwell patient (p = 0.001) and a trauma patient (p = 0.001). 96% of trainees have utilised the skills they learnt on Boot Camp and all trainees would recommend it as an induction programme. Surgical Boot Camps offer a timely chance to develop technical and non-technical skills whilst enhancing a trainee's confidence and knowledge and reduce the patient safety impact of the handover period. Copyright © 2018. Published by Elsevier Ltd.

  13. Using dummies for surgical skills training

    DEFF Research Database (Denmark)

    Langebæk, Rikke

    2011-01-01

    Effective acquisition of a skill requires practise. Therefore it is of great importance to provide veterinary students with opportunities to practice their surgical skills before carrying out surgical procedures on live patients. Some veterinary schools let students perform entire surgical...... procedures on research animals, in order to learn the basic skills along the way. From an ethical point of view it is questionable however to use live research animals for the sole purpose of practising surgery, and also, research animals are very costly. It is therefore necessary to identify alternative...... teaching methods for veterinary surgical training. At the Department of Small Animal Clinical Sciences, Faculty of Life Sciences, a number of low fidelity, stuffed toy animal dummies was developed for the Surgical Skills Lab in order to teach 4th year students the basic surgical skills. In the Surgical...

  14. Síndrome de Möbius: achados clínicos e cirúrgicos em 7 pacientes Möbius syndrome: clinical and surgical findings in 7 patients

    Directory of Open Access Journals (Sweden)

    Galton Carvalho Vasconcelos

    2001-06-01

    Full Text Available Objetivo: Avaliar o quadro clínico, as anormalidades gestacionais e de parto e os resultados na cirurgia de estrabismo em pacientes com síndrome de Möbius. Métodos: Foram estudados, retrospectivamente, 7 pacientes com diagnóstico de síndrome de Möbius, dos quais 6 foram submetidos à cirurgia de estrabismo. Resultados: Além dos achados clássicos que caracterizam a síndrome, em todos os casos estudados observaram-se alterações gestacionais ou de parto. Em 2 pacientes encontrou-se no per-operatório, inserção posteriorizada do reto medial. Graças à fixação cruzada, esses pacientes geralmente não desenvolvem ambliopia. Conclusão: A cirurgia, quando indicada, deve constar apenas dos retrocessos musculares e acredita-se que o planejamento cirúrgico deva ser menor do que o feito em casos de paralisia isolada do nervo abducente de mesmo valor.Purpose: To evaluate clinical features, pregnancy and labour abnormalities and the results of strabismus surgery in patients with Möbius syndrome. Methods: The authors studied retrospectively 7 patients with Möbius syndrome, of whom 6 were submitted to strabismus surgery. Results: In addition to the classical findings that characterize the syndrome, pregnancy and labour insults were observed in all cases. In 2 patients a posterior medial rectus insertion was found during surgery. Due to cross-fixation, these patients usually do not develop amblyopia. Conclusions: Surgery should consist of muscle recessions, but recessing them less than it would be done for similar isolated abducens palsy.

  15. An Example of the Use of Research Methods and Findings as an Experiential Learning Exercise in an Accounting Theory Course

    Science.gov (United States)

    Bublitz, Bruce; Philipich, Kirk; Blatz, Robert

    2015-01-01

    The purpose of this teaching note is to describe an experiential learning exercise used in a master's level financial accounting theory course. The experiential exercise illustrates how order effects can affect user's judgments, a long-standing research finding. This experiential exercise was used in an attempt to make students more cognizant of…

  16. Minimizing surgical skin incision scars with a latex surgical glove.

    Science.gov (United States)

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

    2013-04-01

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

  17. Experimental Validation of the Dynamic Inertia Measurement Method to Find the Mass Properties of an Iron Bird Test Article

    Science.gov (United States)

    Chin, Alexander; Herrera, Claudia; Spivey, Natalie; Fladung, William; Cloutier, David

    2015-01-01

    This presentation describes the DIM method and how it measures the inertia properties of an object by analyzing the frequency response functions measured during a ground vibration test (GVT). The DIM method has been in development at the University of Cincinnati and has shown success on a variety of small scale test articles. The NASA AFRC version was modified for larger applications.

  18. For a reasoned development of experimental methods in information and communication sciences Some epistemological findings of methodological pluralism

    Directory of Open Access Journals (Sweden)

    Didier COURBET

    2013-07-01

    Full Text Available If multidisciplinarity is necessary, first, for studying the widest possible set of communication phenomena (organizational, in groups, interpersonal, media, computer-mediated communication... and, secondly, for grasping the complexity of the different moments of the same phenomenon of communication (production, content, reception, circulation ..., methodological pluralism is also important. However, French research in communication sciences leaves in the shade a number of phenomena and moments of communication that could be better understood thanks to the experimental method. We will underline that the epistemological issues related to rational use of the experimental method in communication sciences are not negligible: it allows the study of objects that cannot be investigated with other methods and offers the opportunity to build knowledge by the refutation of hypotheses and theoretical propositions. We will clarify some epistemological misunderstandings concerning this method. First, it is actually a method of studying complex systems and communication processes. Secondly, its use is not incompatible with constructivism.

  19. Real-time inextensible surgical thread simulation.

    Science.gov (United States)

    Xu, Lang; Liu, Qian

    2018-03-27

    This paper discusses a real-time simulation method of inextensible surgical thread based on the Cosserat rod theory using position-based dynamics (PBD). The method realizes stable twining and knotting of surgical thread while including inextensibility, bending, twisting and coupling effects. The Cosserat rod theory is used to model the nonlinear elastic behavior of surgical thread. The surgical thread model is solved with PBD to achieve a real-time, extremely stable simulation. Due to the one-dimensional linear structure of surgical thread, the direct solution of the distance constraint based on tridiagonal matrix algorithm is used to enhance stretching resistance in every constraint projection iteration. In addition, continuous collision detection and collision response guarantee a large time step and high performance. Furthermore, friction is integrated into the constraint projection process to stabilize the twining of multiple threads and complex contact situations. Through comparisons with existing methods, the surgical thread maintains constant length under large deformation after applying the direct distance constraint in our method. The twining and knotting of multiple threads correspond to stable solutions to contact and friction forces. A surgical suture scene is also modeled to demonstrate the practicality and simplicity of our method. Our method achieves stable and fast simulation of inextensible surgical thread. Benefiting from the unified particle framework, the rigid body, elastic rod, and soft body can be simultaneously simulated. The method is appropriate for applications in virtual surgery that require multiple dynamic bodies.

  20. How do clinical genetics consent forms address the familial approach to confidentiality and incidental findings? A mixed-methods study.

    Science.gov (United States)

    Dheensa, Sandi; Crawford, Gillian; Salter, Claire; Parker, Michael; Fenwick, Angela; Lucassen, Anneke

    2018-01-01

    Genetic test results can be relevant to patients and their relatives. Questions thus arise around whether clinicians regard genetic information as confidential to individuals or to families, and about how they broach this and other issues, including the potential for incidental findings, in consent (forms) for genetic testing. We conducted a content analysis of UK-wide genetic testing consent forms and interviewed 128 clinicians/laboratory scientists. We found that almost all genetic services offered patients multiple, sometimes unworkable, choices on forms, including an option to veto the use of familial genetic information to benefit relatives. Participants worried that documented choices were overriding professional judgement and cautioned against any future forms dictating practice around incidental findings. We conclude that 'tick-box' forms, which do little to enhance autonomy, are masking valid consent processes in clinical practice. As genome-wide testing becomes commonplace, we must re-consider consent processes, so that they protects patients'-and relatives'-interests.

  1. Radiographic localization of unerupted teeth: further findings about the vertical tube shift method and other localization techniques.

    Science.gov (United States)

    Jacobs, S G

    2000-10-01

    The parallax method (image/tube shift method, Clark's rule, Richards' buccal object rule) is recommended to localize unerupted teeth. Richards' contribution to the development of the parallax method is discussed. The favored method for localization uses a rotational panoramic radiograph in combination with an occlusal radiograph involving a vertical shift of the x-ray tube. The use of this combination when localizing teeth and supernumeraries in the premolar region is illustrated. When taking an occlusal radiograph to localize an unerupted maxillary canine, clinical situations are presented where modification of the vertical angulation of the tube of 70 degrees to 75 degrees or of the horizontal position of the tube is warranted. The limitations of axial (true, cross-sectional, vertex) occlusal radiographs are also explored.

  2. A new generalized exponential rational function method to find exact special solutions for the resonance nonlinear Schrödinger equation

    Science.gov (United States)

    Ghanbari, Behzad; Inc, Mustafa

    2018-04-01

    The present paper suggests a novel technique to acquire exact solutions of nonlinear partial differential equations. The main idea of the method is to generalize the exponential rational function method. In order to examine the ability of the method, we consider the resonant nonlinear Schrödinger equation (R-NLSE). Many variants of exact soliton solutions for the equation are derived by the proposed method. Physical interpretations of some obtained solutions is also included. One can easily conclude that the new proposed method is very efficient and finds the exact solutions of the equation in a relatively easy way.

  3. American Pediatric Surgical Association

    Science.gov (United States)

    American Pediatric Surgical Association Search for: Login Resources + For Members For Professionals For Training Program Directors For Media For ... Surgical Outcomes Surveys & Results Publications Continuing Education + ExPERT Pediatric Surgery NaT Annual Meeting CME MOC Requirements Residents / ...

  4. Abortion - surgical - aftercare

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000658.htm Abortion - surgical - aftercare To use the sharing features on ... please enable JavaScript. You have had a surgical abortion. This is a procedure that ends pregnancy by ...

  5. Urogynecologic Surgical Mesh Implants

    Science.gov (United States)

    ... procedures performed to treat pelvic floor disorders with surgical mesh: Transvaginal mesh to treat POP Transabdominal mesh to treat ... address safety risks Final Order for Reclassification of Surgical Mesh for Transvaginal Pelvic Organ Prolapse Repair Final Order for Effective ...

  6. New multimedia advances in surgical information.

    Science.gov (United States)

    Glenn, Ian C; Abdulhai, Sophia; Lamoshi, Abdulraouf; Ponsky, Todd A

    2018-06-01

    When discussing new trends in pediatric surgery, the tendency is to focus on novel surgical technology and techniques. However, it is equally important to examine how the practicing surgeon stays abreast in an ever-changing field. This article serves as a brief guide to the future of surgical education for the attending surgeon. Broadly, advances in surgical education consist of new methods of filtration and delivery of knowledge.

  7. Mechanical ventilation strategies for the surgical patient

    NARCIS (Netherlands)

    Schultz, Marcus J.; Abreu, Marcelo Gama de; Pelosi, Paolo

    2015-01-01

    Purpose of review To summarize clinical evidence for intraoperative ventilation settings, which could protect against postoperative pulmonary complications (PPCs) in surgical patients with uninjured lungs. Recent findings There is convincing evidence for protection against PPCs by low tidal volumes:

  8. Tomography methods for diagnostic examination of cerebrovascular disease: a comparative evaluation of SPECT, PET and MR/CT findings

    International Nuclear Information System (INIS)

    Reiche, W.; Kaiser, H.J.; Weiller, C.; Altehoefer, C.; Buell, U.; Isensee, C.

    1991-01-01

    Single Photon Emissions Computerized Tomography (SPECT), Positron Emissions Tomography (PET), Magnetic Resonance Tomography (MR), and Transmission Computerized Tomography (CT) complement each other and lead to a consideration of the cerebrovascular disease under patho-physiological aspects. Indications for the combined application of functionally oriented (SPECT/PET) and morphologically oriented (CT/MR) examination methods with cerebrovascular disease are presented. (orig./MG) [de

  9. The Continuing Search to Find a More Effective and Less Intimidating Way to Teach Research Methods in Higher Education

    Science.gov (United States)

    Bell, Robin

    2016-01-01

    Existing literature examining the teaching of research methods highlights difficulties students face when developing research competencies. Studies of student-centred teaching approaches have found increased student performance and improved confidence in undertaking research projects. To develop a student-centred approach, it could be beneficial…

  10. A genetic-algorithm-based method to find unitary transformations for any desired quantum computation and application to a one-bit oracle decision problem

    Energy Technology Data Exchange (ETDEWEB)

    Bang, Jeongho [Seoul National University, Seoul (Korea, Republic of); Hanyang University, Seoul (Korea, Republic of); Yoo, Seokwon [Hanyang University, Seoul (Korea, Republic of)

    2014-12-15

    We propose a genetic-algorithm-based method to find the unitary transformations for any desired quantum computation. We formulate a simple genetic algorithm by introducing the 'genetic parameter vector' of the unitary transformations to be found. In the genetic algorithm process, all components of the genetic parameter vectors are supposed to evolve to the solution parameters of the unitary transformations. We apply our method to find the optimal unitary transformations and to generalize the corresponding quantum algorithms for a realistic problem, the one-bit oracle decision problem, or the often-called Deutsch problem. By numerical simulations, we can faithfully find the appropriate unitary transformations to solve the problem by using our method. We analyze the quantum algorithms identified by the found unitary transformations and generalize the variant models of the original Deutsch's algorithm.

  11. Finding Relevant Parameters for the Thin-film Photovoltaic Cells Production Process with the Application of Data Mining Methods.

    Science.gov (United States)

    Ulaczyk, Jan; Morawiec, Krzysztof; Zabierowski, Paweł; Drobiazg, Tomasz; Barreau, Nicolas

    2017-09-01

    A data mining approach is proposed as a useful tool for the control parameters analysis of the 3-stage CIGSe photovoltaic cell production process, in order to find variables that are the most relevant for cell electric parameters and efficiency. The analysed data set consists of stage duration times, heater power values as well as temperatures for the element sources and the substrate - there are 14 variables per sample in total. The most relevant variables of the process have been found based on the so-called random forest analysis with the application of the Boruta algorithm. 118 CIGSe samples, prepared at Institut des Matériaux Jean Rouxel, were analysed. The results are close to experimental knowledge on the CIGSe cells production process. They bring new evidence to production parameters of new cells and further research. © 2017 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.

  12. Method for finding the distribution function of the ions formed in an electrode sheath in a plasma

    International Nuclear Information System (INIS)

    Chumenkov, V.

    1981-01-01

    A steady-state one-dimensional kinetic equation is studied for the ions formed in an electrode sheath in a discharge in a transverse magnetic field and also in the ionization--acceleration zone of Hall accelerators. Only single ionization of atoms by electron impact is considered in the collision term on the right side of the equation. The variables which appear on the right side are grouped into an expression which is a measure of the ion energy distribution. The problem is solved through the use of an empirical expression for the integrated ion energy distribution. This approach for finding the ion distribution function makes it a comparatively simple matter to trace the evolution of the distribution function due to changes in the external parameters (the magnetic field, the discharge voltage, and the pressure) or in the geometric characteristics of the discharge apparatus

  13. MR findings of craniopharyngioma

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Sung Moon; Woo, Young Hoon; Joo, Yang Goo; Suh, Soo Jhi [College of Medicine, Keimyung University, Daegu (Korea, Republic of)

    1992-11-15

    Craniopharyngioma is a benign, slow-growing tumor that constitues 3-9% of all intracranial tumors, and arises from epithelial remnants of the Rathke's pouch. We analyzed MR (2.0T) findings of ten cases with surgically proved craniopharyngioma retrospectively. CT was available in five cases, and Gd-DTPA was used in six cases. Characteristic findings of craniopharyngioma in MRI included multilocularity and variable signal intensities within each loculus that were more prominent in T1WI. Detection rate of calcification in MR was 60%. Six cases with Gd-DTPA enhancement revealed irregular or rim-like enhancement. MRI provides useful information regarding the location, extent and biochemical characteristics of the oraniopharyngioma as well as its relationship to the neighboring structures which will be valuable in planning surgical resection.

  14. MR findings of craniopharyngioma

    International Nuclear Information System (INIS)

    Lee, Sung Moon; Woo, Young Hoon; Joo, Yang Goo; Suh, Soo Jhi

    1992-01-01

    Craniopharyngioma is a benign, slow-growing tumor that constitues 3-9% of all intracranial tumors, and arises from epithelial remnants of the Rathke's pouch. We analyzed MR (2.0T) findings of ten cases with surgically proved craniopharyngioma retrospectively. CT was available in five cases, and Gd-DTPA was used in six cases. Characteristic findings of craniopharyngioma in MRI included multilocularity and variable signal intensities within each loculus that were more prominent in T1WI. Detection rate of calcification in MR was 60%. Six cases with Gd-DTPA enhancement revealed irregular or rim-like enhancement. MRI provides useful information regarding the location, extent and biochemical characteristics of the oraniopharyngioma as well as its relationship to the neighboring structures which will be valuable in planning surgical resection

  15. Paediatric cardiac CT examinations: impact of the iterative reconstruction method ASIR on image quality--preliminary findings.

    Science.gov (United States)

    Miéville, Frédéric A; Gudinchet, François; Rizzo, Elena; Ou, Phalla; Brunelle, Francis; Bochud, François O; Verdun, Francis R

    2011-09-01

    Radiation dose exposure is of particular concern in children due to the possible harmful effects of ionizing radiation. The adaptive statistical iterative reconstruction (ASIR) method is a promising new technique that reduces image noise and produces better overall image quality compared with routine-dose contrast-enhanced methods. To assess the benefits of ASIR on the diagnostic image quality in paediatric cardiac CT examinations. Four paediatric radiologists based at two major hospitals evaluated ten low-dose paediatric cardiac examinations (80 kVp, CTDI(vol) 4.8-7.9 mGy, DLP 37.1-178.9 mGy·cm). The average age of the cohort studied was 2.6 years (range 1 day to 7 years). Acquisitions were performed on a 64-MDCT scanner. All images were reconstructed at various ASIR percentages (0-100%). For each examination, radiologists scored 19 anatomical structures using the relative visual grading analysis method. To estimate the potential for dose reduction, acquisitions were also performed on a Catphan phantom and a paediatric phantom. The best image quality for all clinical images was obtained with 20% and 40% ASIR (p ASIR above 50%, image quality significantly decreased (p ASIR, a strong noise-free appearance of the structures reduced image conspicuity. A potential for dose reduction of about 36% is predicted for a 2- to 3-year-old child when using 40% ASIR rather than the standard filtered back-projection method. Reconstruction including 20% to 40% ASIR slightly improved the conspicuity of various paediatric cardiac structures in newborns and children with respect to conventional reconstruction (filtered back-projection) alone.

  16. An econometric method for estimating population parameters from non-random samples: An application to clinical case finding.

    Science.gov (United States)

    Burger, Rulof P; McLaren, Zoë M

    2017-09-01

    The problem of sample selection complicates the process of drawing inference about populations. Selective sampling arises in many real world situations when agents such as doctors and customs officials search for targets with high values of a characteristic. We propose a new method for estimating population characteristics from these types of selected samples. We develop a model that captures key features of the agent's sampling decision. We use a generalized method of moments with instrumental variables and maximum likelihood to estimate the population prevalence of the characteristic of interest and the agents' accuracy in identifying targets. We apply this method to tuberculosis (TB), which is the leading infectious disease cause of death worldwide. We use a national database of TB test data from South Africa to examine testing for multidrug resistant TB (MDR-TB). Approximately one quarter of MDR-TB cases was undiagnosed between 2004 and 2010. The official estimate of 2.5% is therefore too low, and MDR-TB prevalence is as high as 3.5%. Signal-to-noise ratios are estimated to be between 0.5 and 1. Our approach is widely applicable because of the availability of routinely collected data and abundance of potential instruments. Using routinely collected data to monitor population prevalence can guide evidence-based policy making. Copyright © 2017 John Wiley & Sons, Ltd.

  17. The complex treatment of acute pancreatitis using miniinvasive surgical treatment

    Directory of Open Access Journals (Sweden)

    G. I. Ohrimenko

    2015-06-01

    Full Text Available Nowadays methods used in acute pancreatitis diagnostic do not allow to find the most optimal indications, terms of surgical drainage approaches in surgical treatment of acute pancreatitis. Aim. In order to develop optimal diagnostic and treatment algorithm 316 patients took part in the study. Methods and results. Surgery outcomes were assessed by the next methods: ultrasound, computed tomography. We determined that destructive changes in pancreas in group of sterile pancreatic necrosis were limited. In cases of infected pancreatic necrosis the damage was spread and the disease course was septic. That’s why the operative treatment in cases of sterile pancreatitis has to be used with strict indications such as fermentative peritonitis, acute liquid formations, acute pseudocysts. Conclusion. In such cases miniinvasive surgery is mainly used while in the cases of infected pancreatic necrosis we ought to choose open surgery treatment.

  18. Evolving Educational Techniques in Surgical Training.

    Science.gov (United States)

    Evans, Charity H; Schenarts, Kimberly D

    2016-02-01

    Training competent and professional surgeons efficiently and effectively requires innovation and modernization of educational methods. Today's medical learner is quite adept at using multiple platforms to gain information, providing surgical educators with numerous innovative avenues to promote learning. With the growth of technology, and the restriction of work hours in surgical education, there has been an increase in use of simulation, including virtual reality, robotics, telemedicine, and gaming. The use of simulation has shifted the learning of basic surgical skills to the laboratory, reserving limited time in the operating room for the acquisition of complex surgical skills". Copyright © 2016 Elsevier Inc. All rights reserved.

  19. Non-vascular surgical mediastinum

    International Nuclear Information System (INIS)

    Schiavon, S.; Trenaghi, P.; Nardini, S.; Pagan, V.

    1989-01-01

    A review was made of the chest X-ray features of 120 patients who underwent surgical treatment for mediastinal non-vascular pathologies over the past 12 years in the Mestre Hospital. A method of analysis is proposed which takes into account not only the differences between the immediate post-operative period and the follow-up, but also the anatomotopographic partition and the surgical practice. Normal and pathological patterns for both of the above periods are described. The ''dimness'' of the arial tracheogram is emphasized as a usefull and early sign of mediastinal recurrence

  20. Surgical options after Fontan failure

    DEFF Research Database (Denmark)

    van Melle, Joost P; Wolff, Djoeke; Hörer, Jürgen

    2016-01-01

    by the European Congenital Heart Surgeons Association among 22 member centres. Outcome of surgery to address failing Fontan was collected in 225 patients among which were patients with Fontan takedown (n=38; 17%), Fontan conversion (n=137; 61%) or HTX (n=50; 22%). RESULTS: The most prevalent indication...... for failing Fontan surgery was arrhythmia (43.6%), but indications differed across the surgical groups (p...OBJECTIVE: The objective of this European multicenter study was to report surgical outcomes of Fontan takedown, Fontan conversion and heart transplantation (HTX) for failing Fontan patients in terms of all-cause mortality and (re-)HTX. METHODS: A retrospective international study was conducted...

  1. Innovation in pediatric surgical education.

    Science.gov (United States)

    Clifton, Matthew S; Wulkan, Mark L

    2015-06-01

    Pediatric surgical training in the United States remained basically unchanged from the model developed by Ladd and Gross in the 1930s until recently. Standardized curriculum and novel evaluation methods are now being implemented. Pediatric Surgical education is currently undergoing a transition to competency-based evaluation and promotion. Unfortunately, there is little data on the efficacy of these changes. This presents an opportunity for further study of how we conduct training, and how we evaluate and promote our trainees. Copyright © 2015 Elsevier Inc. All rights reserved.

  2. An Innovative Method of Measuring Changes in Access to Healthful Foods in School Lunch Programs: Findings from a Pilot Evaluation.

    Directory of Open Access Journals (Sweden)

    Allison P Hawkes

    Full Text Available A large local health department in Colorado partnered with 15 school districts to develop an approach to evaluate changes in access to healthy foods in reimbursable school lunches and a la carte offerings.School district nutrition managers were engaged at the start of this project. Health department dietitians developed criteria to classify food items as "Lower Fat and less added Sugar" (LFS and "Higher Fat and more added Sugar" (HFS based on the percentage of calories from fat and grams of added sugar. Lunch production sheets were obtained for two time periods, food items and the number of planned servings recorded. LFS and HFS planned servings were summed for each time period, and a LFS to HFS ratio calculated by dividing LFS planned servings by HFS planned servings. Additional analyses included calculating LFS: HFS ratios by school district, and for a la carte offerings.In 2009, the LFS: HFS ratio was 2.08, in 2011, 3.71 (P<0.0001. The method also detected changes in ratios at the school district level. For a la carte items, in 2009 the ratio of LFS: HFS was 0.53, and in 2011, 0.61 (not statistically significant.This method detected an increase in the LFS: HFS ratio over time and demonstrated that the school districts improved access to healthful food/drink by changing the contents of reimbursable school lunches. The evaluation method discussed here can generate information that districts can use in helping sustain and expand their efforts to create healthier environments for children and adults. Although federal regulations now cover all food and beverages served during the school day, there are still opportunities to improve and measure changes in food served in other settings such as child care centers, youth correction facilities, or in schools not participating in the National School Lunch Program.

  3. Characterization of a millefiori glass find from Aquincum by SEM-EDX and micro-PIXE methods

    International Nuclear Information System (INIS)

    Uzonyi, I.; Csontos, K.; Verebes, A.; Cserhati, C.; Csedreki, L.; Kis-Varga, M.; Kiss, A.Z.

    2011-01-01

    Research has been focused on the analysis of archaeological glasses from the Roman age and medieval times. Study of ancient millefiori type glasses from the collection of Hungarian Museums has been started. A test measurement, carried out on a glass fragment supposedly part of a dish, was performed by SEM-EDX and micro-PIXE methods. Complementary analytical data were obtained for texture and composition. Results suggest that Roman and Mesopotamian techniques were used together. Our data contribute to data bases of millefiori glasses.

  4. Characterization of a millefiori glass find from Aquincum by SEM-EDX and micro-PIXE methods

    Energy Technology Data Exchange (ETDEWEB)

    Uzonyi, I., E-mail: uzonyi@atomki.hu [Institute of Nuclear Research of the Hungarian Academy of Sciences, H-4026 Debrecen, Bem ter 18/C (Hungary); Csontos, K.; Verebes, A. [Budapest History Museum, Aquincum Museum H-8211 Budapest, Zahony u. 4. (Hungary); Cserhati, C. [Department of Solid State Physics, University of Debrecen H-4032 Debrecen, Bem ter 18/B (Hungary); Csedreki, L.; Kis-Varga, M.; Kiss, A.Z. [Institute of Nuclear Research of the Hungarian Academy of Sciences, H-4026 Debrecen, Bem ter 18/C (Hungary)

    2011-10-15

    Research has been focused on the analysis of archaeological glasses from the Roman age and medieval times. Study of ancient millefiori type glasses from the collection of Hungarian Museums has been started. A test measurement, carried out on a glass fragment supposedly part of a dish, was performed by SEM-EDX and micro-PIXE methods. Complementary analytical data were obtained for texture and composition. Results suggest that Roman and Mesopotamian techniques were used together. Our data contribute to data bases of millefiori glasses.

  5. Consumer Attitudes and Perceptions on mHealth Privacy and Security: Findings From a Mixed-Methods Study.

    Science.gov (United States)

    Atienza, Audie A; Zarcadoolas, Christina; Vaughon, Wendy; Hughes, Penelope; Patel, Vaishali; Chou, Wen-Ying Sylvia; Pritts, Joy

    2015-01-01

    This study examined consumers' attitudes and perceptions regarding mobile health (mHealth) technology use in health care. Twenty-four focus groups with 256 participants were conducted in 5 geographically diverse locations. Participants were also diverse in age, education, race/ethnicity, gender, and rural versus urban settings. Several key themes emerged from the focus groups. Findings suggest that consumer attitudes regarding mHealth privacy/security are highly contextualized, with concerns depending on the type of information being communicated, where and when the information is being accessed, who is accessing or seeing the information, and for what reasons. Consumers frequently considered the tradeoffs between the privacy/security of using mHealth technologies and the potential benefits. Having control over mHealth privacy/security features and trust in providers were important issues for consumers. Overall, this study found significant diversity in attitudes regarding mHealth privacy/security both within and between traditional demographic groups. Thus, to address consumers' concerns regarding mHealth privacy and security, a one-size-fits-all approach may not be adequate. Health care providers and technology developers should consider tailoring mHealth technology according to how various types of information are communicated in the health care setting, as well as according to the comfort, skills, and concerns individuals may have with mHealth technology.

  6. Interwoven histories: Mental health nurses with experience of mental illness, qualitative findings from a mixed methods study.

    Science.gov (United States)

    Oates, Jennifer; Drey, Nicholas; Jones, Julia

    2018-02-15

    The effects of mental health nurses' own experience of mental illness or being a carer have rarely been researched beyond the workplace setting. This study aimed to explore how the experience of mental illness affects mental health nurses' lives outside of and inside work. A sample of 26 mental health nurses with personal experience of mental illness took part in semistructured interviews. Data were analysed thematically using a six-phase approach. The analysis revealed the broad context of nurses' experiences of mental illness according to three interwoven themes: mental illness as part of family life; experience of accessing services; and life interwoven with mental illness. Participants typically described personal and familial experience of mental illness across their life course, with multiple causes and consequences. The findings suggest that nurses' lives outside of work should be taken into account when considering the impact of their personal experience of mental illness. Similarly being a nurse influences how mental illness is experienced. Treatment of nurses with mental illness should account for their nursing expertise whilst recognizing that the context for nurses' mental illness could be much broader than the effect of workplace stress. © 2018 Australian College of Mental Health Nurses Inc.

  7. Diagnostic methods in finding out the causes of infertility, results of HSG examination and laparoscopy in infertile women examined at the Gynecological Ward of the City Hospital

    International Nuclear Information System (INIS)

    Kwasniewski, S.; Kukulski, P.; Szymanski, J.; Kwasniewska, A.

    1993-01-01

    The paper presents diagnostic methods and the results of hysterosalpingography (HSG) and laparoscopy examination, with special attention being drawn to the usefulness of these methods in finding out the causes of infertility. 51 patients with primary and second infertility were examined. HSG and laparoscopy make it possible to diagnose correctly the cause of infertility. They also enable adequate and early classification of patients for further diagnosis and treatment at highly specialized centers dealing with the problems of infertility. (author)

  8. Surgical Management of Localized Scleroderma.

    Science.gov (United States)

    Lee, Jae Hyun; Lim, Soo Yeon; Lee, Jang Hyun; Ahn, Hee Chang

    2017-09-01

    Localized scleroderma is characterized by a thickening of the skin from excessive collagen deposits. It is not a fatal disease, but quality of life can be adversely affected due to changes in skin appearance, joint contractures, and, rarely, serious deformities of the face and extremities. We present six cases of localized scleroderma in face from our surgical practice. We reviewed six localized scleroderma cases that were initially treated with medication and then received follow-up surgery between April 2003 and February 2015. Six patients had facial lesions. These cases presented with linear dermal sclerosis on the forehead, oval subcutaneous and dermal depression in the cheek. En coup de sabre (n=4), and oval-shaped lesion of the face (n=2) were successfully treated. Surgical methods included resection with or without Z-plasty (n=3), fat graft (n=1), dermofat graft (n=1), and adipofascial free flap (n=1). Deformities of the affected parts were surgically corrected without reoccurrence. We retrospectively reviewed six cases of localized scleroderma that were successfully treated with surgery. And we propose an algorithm for selecting the best surgical approach for individual localized scleroderma cases. Although our cases were limited in number and long-term follow-up will be necessary, we suggest that surgical management should be considered as an option for treating scleroderma patients.

  9. Three-dimensional surgical simulation.

    Science.gov (United States)

    Cevidanes, Lucia H C; Tucker, Scott; Styner, Martin; Kim, Hyungmin; Chapuis, Jonas; Reyes, Mauricio; Proffit, William; Turvey, Timothy; Jaskolka, Michael

    2010-09-01

    In this article, we discuss the development of methods for computer-aided jaw surgery, which allows us to incorporate the high level of precision necessary for transferring virtual plans into the operating room. We also present a complete computer-aided surgery system developed in close collaboration with surgeons. Surgery planning and simulation include construction of 3-dimensional surface models from cone-beam computed tomography, dynamic cephalometry, semiautomatic mirroring, interactive cutting of bone, and bony segment repositioning. A virtual setup can be used to manufacture positioning splints for intraoperative guidance. The system provides further intraoperative assistance with a computer display showing jaw positions and 3-dimensional positioning guides updated in real time during the surgical procedure. The computer-aided surgery system aids in dealing with complex cases with benefits for the patient, with surgical practice, and for orthodontic finishing. Advanced software tools for diagnosis and treatment planning allow preparation of detailed operative plans, osteotomy repositioning, bone reconstructions, surgical resident training, and assessing the difficulties of the surgical procedures before the surgery. Computer-aided surgery can make the elaboration of the surgical plan a more flexible process, increase the level of detail and accuracy of the plan, yield higher operative precision and control, and enhance documentation of cases. 2010 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

  10. Surgical management of Gerhardt syndrome.

    Science.gov (United States)

    Chirilă, M; Mureşan, R; Cosgarea, M; Tomescu, E

    2010-01-01

    Adduction bilateral vocal fold immobility syndrome may be due by both recurrent laryngeal nerves paralysis--Gerhardt syndrome--and all intrinsic laryngeal muscles paralysis--Riegel syndrome. Etiology of Gerhardt syndrome is thyroid surgery, intubation's maneuver, trauma, neurological disorders, extrala-ryngeal malignancies. The manifestations of Gerhardt syndrome are inspiratory dyspnea and slightly influenced voicing by paramedian vocal folds paralysis with an important narrowing of the airway at the glottic level. The surgical procedures for enlargement of the glottic space can be classified in many ways and their major characteristics are: changes at the glottic level; surgical approach: open neck or endoscopic, with or without opening of the mucosal lining; the need for tracheostomy; the equipment used. The aim of this review is to expound the variety of interventions through the last century marked by the development of the diagnostic methods, the anesthesia and the surgical armament with sophisticated instruments and technologies.

  11. Ongoing challenges to finding people with Parkinson's disease for epidemiological studies: a comparison of population-level case ascertainment methods.

    Science.gov (United States)

    Harris, M Anne; Koehoorn, Mieke; Teschke, Kay

    2011-07-01

    Locating Parkinson's disease cases for epidemiological studies has long been challenging. Self reports, secondary records of physician diagnosis and drug tracer methods each exhibit known disadvantages but have rarely been compared directly. Prescriptions of levodopa have in some studies been considered to comprise a reasonable proxy for Parkinson's disease diagnosis. We tested this assumption by comparing three methods of population-level case ascertainment. We compared the number of Parkinson's disease cases in British Columbia derived from self-reports in the 2001 Canadian Community Health Survey to those obtained from administrative records of filled levodopa prescriptions and to Parkinson's disease diagnoses from physician visit billing and hospital discharge records in 1996 and 2005. We directly compared a case definition based on levodopa prescriptions with a definition based on records of physician diagnosis by calculating positive predictive value and sensitivity. Crude prevalence estimates ranged from approximately 100 to 200 per 100,000. Levodopa-based case definitions overestimated prevalence, while physician- and hospital-record-based case definitions provided lower prevalence estimates compared to survey derived estimates. The proportion of levodopa users with a diagnosis of Parkinson's disease declined from 62% to 52% between 1996 and 2005. This decrease was most dramatic among women (64%-44%) and those under age 65 (54%-39%). Sex and age trends suggest increasing use of levodopa among patients with conditions other than Parkinson's disease, such as restless legs syndrome. Increased non-Parkinson's levodopa use decreases the efficiency of levodopa as a Parkinson's disease case tracer. Copyright © 2011 Elsevier Ltd. All rights reserved.

  12. Finding out who is nesting where: a method for locating nest sites of hole-nesting species prior to egg laying

    NARCIS (Netherlands)

    Grieco, F.

    2000-01-01

    A method to find out which species is more likely to start egg laying in a certain nestbox is described. Nestboxes were visited daily and the behaviour of the birds (Great, Blue and Coal Tits) that appeared around the nestbox was observed. The birds' response consisted mainly of giving alarm calls

  13. The TIMSS Videotape Classroom Study: Methods and Findings from an Exploratory Research Project on Eighth-Grade Mathematics Instruction in Germany, Japan, and the United States.

    Science.gov (United States)

    Stigler, James W.; Gonzales, Patrick; Kawanaka, Takako; Knoll, Steffen; Serrano, Ana

    1999-01-01

    Describes the methods and preliminary findings of the Videotape Classroom Study, a video survey of eighth-grade mathematics lessons in Germany, Japan, and the United States. Part of the Third International Mathematics and Science study, this research project is the first study of videotaped records from national probability samples. (SLD)

  14. Post-therapeutic imaging findings

    Energy Technology Data Exchange (ETDEWEB)

    Pollice, Saverio, E-mail: saveriopollice@hotmail.it [Department of Radiology and Neuroradiology, “L. Bonomo Hospital”, 76123 Andria, BT (Italy); Muto, Mario, E-mail: mutomar@tiscali.it [Department of Neuroradiology, “Cardarelli Hospital”, Naples (Italy); Scarabino, Tommaso, E-mail: tscarabino@hotmail.com [Department of Radiology and Neuroradiology, “L. Bonomo Hospital”, 76123 Andria, BT (Italy)

    2015-05-15

    Highlights: • This study is the result of collaboration between neuroradiologists and neurosurgeons. • Comparison between neuroimaging techniques to better evaluate the complications after treatment of the spin. • Evaluation of the imaging features of complications and definition of follow-up. - Abstract: Any surgical approach modifies the normal anatomical and functional arrangement of the segmental spine which is aimed, therefore image interpretation cannot ignore a correct set of knowledge in the field of anatomy, pathophysiology, drug compliance, interventional radiology and surgery. Neuroradiological imaging has an important role before surgery to direct the surgeon or interventional radiologist during the operation, both in post-surgery, where imaging examination can rightly evaluate properties and effects of the treatment and can detect potential complications as infections, abscess, bleeding, exuberant scar, mobilization and rupture of devices. The available methods of imaging are the X-rays (XR) made at least in two projections, Computed Tomography (CT) with MPR (multiplanar) and VR (volume rendering) reconstruction, and Magnetic Resonance (MR), often performed before and after contrast media injection. Imaging assessment of spine after surgery is complex and depends upon several factors, including surgical procedures and disease for which it was performed; biomechanical of the underlying cortical and cancellous bone findings; conditions of muscles, intervertebral disk and ligaments; time since surgery procedures; duration and nature of the post-surgical syndrome. Depending upon several factors, one or a combination of complementary imaging modalities (X-rays, Computed Tomography, Magnetic Resonance) may be required to evaluate effectiveness of the treatment; to demonstrate any clinically relevant abnormality at the treated region and adjacent structures (complications such as inflammation, abscesses, bleeding and misplacement of the device); to

  15. Post-therapeutic imaging findings

    International Nuclear Information System (INIS)

    Pollice, Saverio; Muto, Mario; Scarabino, Tommaso

    2015-01-01

    Highlights: • This study is the result of collaboration between neuroradiologists and neurosurgeons. • Comparison between neuroimaging techniques to better evaluate the complications after treatment of the spin. • Evaluation of the imaging features of complications and definition of follow-up. - Abstract: Any surgical approach modifies the normal anatomical and functional arrangement of the segmental spine which is aimed, therefore image interpretation cannot ignore a correct set of knowledge in the field of anatomy, pathophysiology, drug compliance, interventional radiology and surgery. Neuroradiological imaging has an important role before surgery to direct the surgeon or interventional radiologist during the operation, both in post-surgery, where imaging examination can rightly evaluate properties and effects of the treatment and can detect potential complications as infections, abscess, bleeding, exuberant scar, mobilization and rupture of devices. The available methods of imaging are the X-rays (XR) made at least in two projections, Computed Tomography (CT) with MPR (multiplanar) and VR (volume rendering) reconstruction, and Magnetic Resonance (MR), often performed before and after contrast media injection. Imaging assessment of spine after surgery is complex and depends upon several factors, including surgical procedures and disease for which it was performed; biomechanical of the underlying cortical and cancellous bone findings; conditions of muscles, intervertebral disk and ligaments; time since surgery procedures; duration and nature of the post-surgical syndrome. Depending upon several factors, one or a combination of complementary imaging modalities (X-rays, Computed Tomography, Magnetic Resonance) may be required to evaluate effectiveness of the treatment; to demonstrate any clinically relevant abnormality at the treated region and adjacent structures (complications such as inflammation, abscesses, bleeding and misplacement of the device); to

  16. Risk factors for surgical site infections following clean orthopaedic ...

    African Journals Online (AJOL)

    Risk factors for surgical site infections following clean orthopaedic operations. ... the host and environmental risk factors for surgical site infections following clean ... Materials and Methods: Consecutive patients who satisfied the inclusion ...

  17. The application of infrared chemical imaging to the detection and enhancement of latent fingerprints: method optimization and further findings.

    Science.gov (United States)

    Tahtouh, Mark; Despland, Pauline; Shimmon, Ronald; Kalman, John R; Reedy, Brian J

    2007-09-01

    Fourier transform infrared (FTIR) chemical imaging allows the collection of fingerprint images from backgrounds that have traditionally posed problems for conventional fingerprint detection methods. In this work, the suitability of this technique for the imaging of fingerprints on a wider range of difficult surfaces (including polymer banknotes, various types of paper, and aluminum drink cans) has been tested. For each new surface, a systematic methodology was employed to optimize settings such as spectral resolution, number of scans, and pixel aggregation in order to reduce collection time and file-size without compromising spatial resolution and the quality of the final fingerprint image. The imaging of cyanoacrylate-fumed fingerprints on polymer banknotes has been improved, with shorter collection times for larger image areas. One-month-old fingerprints on polymer banknotes have been successfully fumed and imaged. It was also found that FTIR chemical imaging gives high quality images of cyanoacrylate-fumed fingerprints on aluminum drink cans, regardless of the printed background. Although visible and UV light sources do not yield fingerprint images of the same quality on difficult, nonporous backgrounds, in many cases they can be used to locate a fingerprint prior to higher quality imaging by the FTIR technique. Attempts to acquire FTIR images of fingerprints on paper-based porous surfaces that had been treated with established reagents such as ninhydrin were all unsuccessful due to the swamping effect of the cellulose constituents of the paper.

  18. Towards Safe Robotic Surgical Systems

    DEFF Research Database (Denmark)

    Sloth, Christoffer; Wisniewski, Rafael

    2015-01-01

    a controller for motion compensation in beating-heart surgery, and prove that it is safe, i.e., the surgical tool is kept within an allowable distance and orientation of the heart. We solve the problem by simultaneously finding a control law and a barrier function. The motion compensation system is simulated...... from several initial conditions to demonstrate that the designed control system is safe for every admissible initial condition....

  19. The Tourette International Collaborative Genetics (TIC Genetics) study, finding the genes causing Tourette syndrome: objectives and methods.

    Science.gov (United States)

    Dietrich, Andrea; Fernandez, Thomas V; King, Robert A; State, Matthew W; Tischfield, Jay A; Hoekstra, Pieter J; Heiman, Gary A

    2015-02-01

    Tourette syndrome (TS) is a neuropsychiatric disorder characterized by recurrent motor and vocal tics, often accompanied by obsessive-compulsive disorder and/or attention-deficit/hyperactivity disorder. While the evidence for a genetic contribution is strong, its exact nature has yet to be clarified fully. There is now mounting evidence that the genetic risks for TS include both common and rare variants and may involve complex multigenic inheritance or, in rare cases, a single major gene. Based on recent progress in many other common disorders with apparently similar genetic architectures, it is clear that large patient cohorts and open-access repositories will be essential to further advance the field. To that end, the large multicenter Tourette International Collaborative Genetics (TIC Genetics) study was established. The goal of the TIC Genetics study is to undertake a comprehensive gene discovery effort, focusing both on familial genetic variants with large effects within multiply affected pedigrees and on de novo mutations ascertained through the analysis of apparently simplex parent-child trios with non-familial tics. The clinical data and biomaterials (DNA, transformed cell lines, RNA) are part of a sharing repository located within the National Institute for Mental Health Center for Collaborative Genomics Research on Mental Disorders, USA, and will be made available to the broad scientific community. This resource will ultimately facilitate better understanding of the pathophysiology of TS and related disorders and the development of novel therapies. Here, we describe the objectives and methods of the TIC Genetics study as a reference for future studies from our group and to facilitate collaboration between genetics consortia in the field of TS.

  20. Numerical methods for finding periodic points in discrete maps. High order islands chains and noble barriers in a toroidal magnetic configuration

    Energy Technology Data Exchange (ETDEWEB)

    Steinbrecher, G. [Association Euratom-Nasti Romania, Dept. of Theoretical Physics, Physics Faculty, University of Craiova (Romania); Reuss, J.D.; Misguich, J.H. [Association Euratom-CEA Cadarache, 13 - Saint-Paul-lez-Durance (France). Dept. de Recherches sur la Fusion Controlee

    2001-11-01

    We first remind usual physical and mathematical concepts involved in the dynamics of Hamiltonian systems, and namely in chaotic systems described by discrete 2D maps (representing the intersection points of toroidal magnetic lines in a poloidal plane in situations of incomplete magnetic chaos in Tokamaks). Finding the periodic points characterizing chains of magnetic islands is an essential step not only to determine the skeleton of the phase space picture, but also to determine the flux of magnetic lines across semi-permeable barriers like Cantori. We discuss here several computational methods used to determine periodic points in N dimensions, which amounts to solve a set of N nonlinear coupled equations: Newton method, minimization techniques, Laplace or steepest descend method, conjugated direction method and Fletcher-Reeves method. We have succeeded to improve this last method in an important way, without modifying its useful double-exponential convergence. This improved method has been tested and applied to finding periodic points of high order m in the 2D 'Tokamap' mapping, for values of m along rational chains of winding number n/m converging towards a noble value where a Cantorus exists. Such precise positions of periodic points have been used in the calculation of the flux across this Cantorus. (authors)

  1. Computers and virtual reality for surgical education in the 21st century.

    Science.gov (United States)

    Haluck, R S; Krummel, T M

    2000-07-01

    Surgeons must learn to perform operations. The current system of surgical resident education is facing many challenges in terms of time efficiency, costs, and patient safety. In addition, as new types of operations are developed rapidly, practicing surgeons may find a need for more efficient methods of surgical skill education. An in-depth examination of the current learning environment and the literature of motor skills learning provides insights into ways in which surgical skills education can be improved. Computers will certainly be a part of this process. Computer-based training in technical skills has the potential to solve many of the educational, economic, ethical, and patient safety issues related to learning to perform operations. Although full virtual-reality systems are still in development, there has been early progress that should encourage surgeons to incorporate computer simulation into the surgical curriculum.

  2. MR findings of chondromalacia Patella : correlation of the grade and associated lesions with arthroscopic findings

    International Nuclear Information System (INIS)

    Chung, Yon Su; Kwon, Soon Tae; Lee, Hwan Do; Kang, Yong Soo; Byun, Ki Yong; Rhee, Kwang Jin

    1998-01-01

    To assess the MR findings of chondromalacia patella and correlate the grade and associated lesions with the arthroscopic findings. Twenty-five patients with pain in the anterior part of the knee underwent fat-suppressed axial and coronal T2-weighted and T2-weighted imaging, using a 10-cm field of view, and a 5-inch general purpose coil. We retrospectively assessed these findings, and the locations, grades and associated lesions, and correlated these with arthroscopic findings. We evaluated the exact location and grade of chondromalacia patella and associated lesions, as seen on MR images. These and the arthroscopic findings showed close correlation, and in cases involving this condition, MRI is thus a useful indicator of an appropriate surgical method and plan. (author). 18 refs., 5 figs

  3. MR findings of chondromalacia Patella : correlation of the grade and associated lesions with arthroscopic findings

    Energy Technology Data Exchange (ETDEWEB)

    Chung, Yon Su; Kwon, Soon Tae; Lee, Hwan Do; Kang, Yong Soo; Byun, Ki Yong; Rhee, Kwang Jin [Chungnam National Univ., Taejon (Korea, Republic of). Coll. of Medicine

    1998-02-01

    To assess the MR findings of chondromalacia patella and correlate the grade and associated lesions with the arthroscopic findings. Twenty-five patients with pain in the anterior part of the knee underwent fat-suppressed axial and coronal T2-weighted and T2-weighted imaging, using a 10-cm field of view, and a 5-inch general purpose coil. We retrospectively assessed these findings, and the locations, grades and associated lesions, and correlated these with arthroscopic findings. We evaluated the exact location and grade of chondromalacia patella and associated lesions, as seen on MR images. These and the arthroscopic findings showed close correlation, and in cases involving this condition, MRI is thus a useful indicator of an appropriate surgical method and plan. (author). 18 refs., 5 figs.

  4. The incidence, root-causes, and outcomes of adverse events in surgical units: implication for potential prevention strategies

    Directory of Open Access Journals (Sweden)

    Groenewegen Peter P

    2011-05-01

    Full Text Available Abstract Background We need to know the scale and underlying causes of surgical adverse events (AEs in order to improve the safety of care in surgical units. However, there is little recent data. Previous record review studies that reported on surgical AEs in detail are now more than ten years old. Since then surgical technology and quality assurance have changed rapidly. The objective of this study was to provide more recent data on the incidence, consequences, preventability, causes and potential strategies to prevent AEs among hospitalized patients in surgical units. Methods A structured record review study of 7,926 patient records was carried out by trained nurses and medical specialist reviewers in 21 Dutch hospitals. The aim was to determine the presence of AEs during hospitalizations in 2004 and to consider how far they could be prevented. Of all AEs, the consequences, responsible medical specialty, causes and potential prevention strategies were identified. Surgical AEs were defined as AEs attributable to surgical treatment and care processes and were selected for analysis in detail. Results Surgical AEs occurred in 3.6% of hospital admissions and represented 65% of all AEs. Forty-one percent of the surgical AEs was considered to be preventable. The consequences of surgical AEs were more severe than for other types of AEs, resulting in more permanent disability, extra treatment, prolonged hospital stay, unplanned readmissions and extra outpatient visits. Almost 40% of the surgical AEs were infections, 23% bleeding, and 22% injury by mechanical, physical or chemical cause. Human factors were involved in the causation of 65% of surgical AEs and were considered to be preventable through quality assurance and training. Conclusions Surgical AEs occur more often than other types of AEs, are more often preventable and their consequences are more severe. Therefore, surgical AEs have a major impact on the burden of AEs during hospitalizations

  5. Automatic NC-Data generation method for 5-axis cutting of turbine-blades by finding Safe heel-angles and adaptive path-intervals

    International Nuclear Information System (INIS)

    Piao, Cheng Dao; Lee, Cheol Soo; Cho, Kyu Zong; Park, Gwang Ryeol

    2004-01-01

    In this paper, an efficient method for generating 5-axis cutting data for a turbine blade is presented. The interference elimination of 5-axis cutting currently is very complicated, and it takes up a lot of time. The proposed method can generate an interference-free tool path, within an allowance range. Generating the cutting data just point to the cutting process and using it to obtain NC data by calculating the feed rate, allows us to maintain the proper feed rate of the 5-axis machine. This paper includes the algorithms for: (1) CL data generation by detecting an interference-free heel angle, (2) finding the optimal tool path interval considering the cusp-height, (3) finding the adaptive feed rate values for each cutter path, and (4) the inverse kinematics depending on the structure of the 5-axis machine, for generating the NC data

  6. Gamma graphic findings in giant hepatic hemangioma

    International Nuclear Information System (INIS)

    Cano, R.; Morales, R.; Mendoza, P.; Ramirez, E.; Aguilar, C.

    1994-01-01

    The aim of the present work is to describe gamma graphic findings in patients with giant hepatic hemangiomas, when evaluated with 99m Tc red blood cell (RBC) imaging. Three patients with clinical suspicion of giant hepatic hemangiomas, who had had, ultrasound and computed tomography were studied with RBC using in vivo labelling with pyrophosphate. All cases had dynamic and static views. All cases showed hypoperfusion in dynamics views and over perfusion in delayed studies. Surgery confirmed diagnosis in two cases. 99m Tc RBC is a good method for diagnosis of giant hepatic hemangioma, which generally needs surgical treatment. (Authors). 24 refs., 2 figs

  7. Assessment of Surgical Skills and Competency.

    Science.gov (United States)

    Bhatti, Nasir I

    2017-10-01

    Evaluation of surgical skills and competency are important aspects of the medical education process. Measurable and reproducible methods of assessment with objective feedback are essential components of surgical training. Objective Structured Assessment of Technical Skills (OSATS) is widely used across the medical specialties and otolaryngology-specific tools have been developed and validated for sinus and mastoid surgery. Although assessment of surgical skills can be time-consuming and requires human and financial resources, new evaluation methods and emerging technology may alleviate these barriers while also improving data collection practices. Copyright © 2017 Elsevier Inc. All rights reserved.

  8. Deriving DICOM surgical extensions from surgical workflows

    Science.gov (United States)

    Burgert, O.; Neumuth, T.; Gessat, M.; Jacobs, S.; Lemke, H. U.

    2007-03-01

    The generation, storage, transfer, and representation of image data in radiology are standardized by DICOM. To cover the needs of image guided surgery or computer assisted surgery in general one needs to handle patient information besides image data. A large number of objects must be defined in DICOM to address the needs of surgery. We propose an analysis process based on Surgical Workflows that helps to identify these objects together with use cases and requirements motivating for their specification. As the first result we confirmed the need for the specification of representation and transfer of geometric models. The analysis of Surgical Workflows has shown that geometric models are widely used to represent planned procedure steps, surgical tools, anatomical structures, or prosthesis in the context of surgical planning, image guided surgery, augmented reality, and simulation. By now, the models are stored and transferred in several file formats bare of contextual information. The standardization of data types including contextual information and specifications for handling of geometric models allows a broader usage of such models. This paper explains the specification process leading to Geometry Mesh Service Object Pair classes. This process can be a template for the definition of further DICOM classes.

  9. Thoracic textilomas: CT findings

    Energy Technology Data Exchange (ETDEWEB)

    Machado, Dianne Melo; Zanetti, Glaucia; Araujo Neto, Cesar Augusto; Nobre, Luiz Felipe; Meirelles, Gustavo de Souza Portes; Silva, Jorge Luiz Pereira e; Guimaraes, Marcos Duarte; Escuissato, Dante Luiz; Souza Junior, Arthur Soares; Hochhegger, Bruno; Marchiori, Edson, E-mail: edmarchiori@gmail.com [Hospital Universitario Antonio Pedro (HUAP/UFF), Niteroi, RJ (Brazil)

    2014-09-15

    Objective: the aim of this study was to analyze chest CT scans of patients with thoracic textiloma. Methods: this was a retrospective study of 16 patients (11 men and 5 women) with surgically confirmed thoracic textiloma. The chest CT scans of those patients were evaluated by two independent observers, and discordant results were resolved by consensus. Results: the majority (62.5%) of the textilomas were caused by previous heart surgery. The most common symptoms were chest pain (in 68.75%) and cough (in 56.25%). In all cases, the main tomographic finding was a mass with regular contours and borders that were well-defined or partially defined. Half of the textilomas occurred in the right hemithorax and half occurred in the left. The majority (56.25%) were located in the lower third of the lung. The diameter of the mass was ≤ 10 cm in 10 cases (62.5%) and > 10 cm in the remaining 6 cases (37.5%). Most (81.25%) of the textilomas were heterogeneous in density, with signs of calcification, gas, radiopaque marker, or sponge-like material. Peripheral expansion of the mass was observed in 12 (92.3%) of the 13 patients in whom a contrast agent was used. Intraoperatively, pleural involvement was observed in 14 cases (87.5%) and pericardial involvement was observed in 2 (12.5%). Conclusions: it is important to recognize the main tomographic aspects of thoracic textilomas in order to include this possibility in the differential diagnosis of chest pain and cough in patients with a history of heart or thoracic surgery, thus promoting the early identification and treatment of this postoperative complication. (author)

  10. Co-crystal of Tramadol-Celecoxib in Patients with Moderate to Severe Acute Post-surgical Oral Pain: A Dose-Finding, Randomised, Double-Blind, Placebo- and Active-Controlled, Multicentre, Phase II Trial.

    Science.gov (United States)

    López-Cedrún, José; Videla, Sebastián; Burgueño, Miguel; Juárez, Inma; Aboul-Hosn, Samir; Martín-Granizo, Rafael; Grau, Joan; Puche, Miguel; Gil-Diez, José-Luis; Hueto, José-Antonio; Vaqué, Anna; Sust, Mariano; Plata-Salamán, Carlos; Monner, Antoni

    2018-06-01

    Co-crystal of tramadol-celecoxib (CTC), containing equimolar quantities of the active pharmaceutical ingredients (APIs) tramadol and celecoxib (100 mg CTC = 44 mg rac-tramadol hydrochloride and 56 mg celecoxib), is a novel API-API co-crystal for the treatment of pain. We aimed to establish the effective dose of CTC for treating acute pain following oral surgery. A dose-finding, double-blind, randomised, placebo- and active-controlled, multicentre (nine Spanish hospitals), phase II study (EudraCT number: 2011-002778-21) was performed in male and female patients aged ≥ 18 years experiencing moderate to severe pain following extraction of two or more impacted third molars requiring bone removal. Eligible patients were randomised via a computer-generated list to receive one of six single-dose treatments (CTC 50, 100, 150, 200 mg; tramadol 100 mg; and placebo). The primary efficacy endpoint was the sum of pain intensity difference (SPID) over 8 h assessed in the per-protocol population. Between 10 February 2012 and 13 February 2013, 334 patients were randomised and received study treatment: 50 mg (n = 55), 100 mg (n = 53), 150 mg (n = 57), or 200 mg (n = 57) of CTC, 100 mg tramadol (n = 58), or placebo (n = 54). CTC 100, 150, and 200 mg showed significantly higher efficacy compared with placebo and/or tramadol in all measures: SPID (0-8 h) (mean [standard deviation]): - 90 (234), - 139 (227), - 173 (224), 71 (213), and 22 (228), respectively. The proportion of patients experiencing treatment-emergent adverse events was lower in the 50 (12.7% [n = 7]), 100 (11.3% [n = 6]), and 150 (15.8% [n = 9]) mg CTC groups, and similar in the 200 mg (29.8% [n = 17]) CTC group, compared with the tramadol group (29.3% [n = 17]), with nausea, dizziness, and vomiting the most frequent events. Significant improvement in the benefit-risk ratio was observed for CTC (doses ≥ 100 mg) over tramadol and placebo in

  11. Recognizing surgical patterns

    NARCIS (Netherlands)

    Bouarfa, L.

    2012-01-01

    In the Netherlands, each year over 1700 patients die from preventable surgical errors. Numerous initiatives to improve surgical practice have had some impact, but problems persist. Despite the introduction of checklists and protocols, patient safety in surgery remains a continuing challenge. This is

  12. Surgical medical record

    DEFF Research Database (Denmark)

    Bulow, S.

    2008-01-01

    A medical record is presented on the basis of selected linguistic pearls collected over the years from surgical case records Udgivelsesdato: 2008/12/15......A medical record is presented on the basis of selected linguistic pearls collected over the years from surgical case records Udgivelsesdato: 2008/12/15...

  13. Value innovation: an important aspect of global surgical care.

    Science.gov (United States)

    Cotton, Michael; Henry, Jaymie Ang; Hasek, Lauren

    2014-01-06

    Limited resources in low- and middle-income countries (LMICs) drive tremendous innovation in medicine, as well as in other fields. It is not often recognized that several important surgical tools and methods, widely used in high-income countries, have their origins in LMICs. Surgical care around the world stands much to gain from these innovations. In this paper, we provide a short review of some of these successful innovations and their origins that have had an important impact in healthcare delivery worldwide. Examples of LMIC innovations that have been adapted in high-income countries include the Bogotá bag for temporary abdominal wound closure, the orthopaedic external fixator for complex fractures, a hydrocephalus fluid valve for normal pressure hydrocephalus, and intra-ocular lens and manual small incision cataract surgery. LMIC innovations that have had tremendous potential global impact include mosquito net mesh for inguinal hernia repair, and a flutter valve for intercostal drainage of pneumothorax. Surgical innovations from LMICs have been shown to have comparable outcomes at a fraction of the cost of tools used in high-income countries. These innovations have the potential to revolutionize global surgical care. Advocates should actively seek out these innovations, campaign for the financial gains from these innovations to benefit their originators and their countries, and find ways to develop and distribute them locally as well as globally.

  14. Shoulder morbidity after non-surgical treatment of the neck.

    NARCIS (Netherlands)

    van Wouwe, V.; de Bree, R.; Kuik, D.J.; de Goede, C.J.T.; de Leeuw, I.M.; Leemans, C.R.

    2009-01-01

    Background and purpose: Reports on shoulder function after non-surgical treatment are not available. In the present study shoulder morbidity after surgical and non-surgical treatment of the neck is determined and compared. Materials and methods: In 100 head and neck cancer patients 174 neck sides

  15. Surgical treatment for residual or recurrent strabismus

    Directory of Open Access Journals (Sweden)

    Tao Wang

    2014-12-01

    Full Text Available Although the surgical treatment is a relatively effective and predictable method for correcting residual or recurrent strabismus, such as posterior fixation sutures, medial rectus marginal myotomy, unilateral or bilateral rectus re-recession and resection, unilateral lateral rectus recession and adjustable suture, no standard protocol is established for the surgical style. Different surgical approaches have been recommended for correcting residual or recurrent strabismus. The choice of the surgical procedure depends on the former operation pattern and the surgical dosages applied on the patients, residual or recurrent angle of deviation and the operator''s preference and experience. This review attempts to outline recent publications and current opinion in the management of residual or recurrent esotropia and exotropia.

  16. The effect of fasting on surgical performance

    DEFF Research Database (Denmark)

    Schefte, David Fenger; Rosenstock, Steffen Jais

    2016-01-01

    BACKGROUND: It is unknown whether fasting has any impact on surgical performance. This simulator-based study investigates whether fasting affects surgical performance. METHODS: Twelve healthy medical students [seven women, mean age 26.5 years (range 23-34)] with no prior experience with surgical...... simulators underwent a short course introduction to the LapSim(®) simulator. After having reached a predefined level, the participants performed five simulated salpingectomies on the LapSim(®) simulator 5-30 days after the initial introduction. The procedures took place at 9 a.m. and 2 p.m. after fasting...... in the longitudinal axis with the left hand. CONCLUSION: The simulator-based study suggests that 17 h of fasting does not deteriorate surgical performance. Further studies on the effect of fasting on surgical performance are needed....

  17. Surgical Treatment of Tattoo Complications.

    Science.gov (United States)

    Sepehri, Mitra; Jørgensen, Bo

    2017-01-01

    With a continuing increase in the number of tattoos performed worldwide, the need to treat tattoo complications is growing. Earlier treatments of chronic inflammatory tattoo reactions were dominated by a medical approach, or with no active intervention. In this chapter, we will address modern surgical approaches applied to situations when medical treatment is inefficient and lasers are not applicable. Dermatome shaving is positioned as first-line treatment of allergic tattoo reactions and also indicated in a number of other tattoo reactions, supplemented with excision in selected cases. The methods allow fundamental treatment with removal of the culprit pigment from the dermis. The different instruments, surgical methods, and treatment schedules are reviewed, and a guide to surgeons is presented. Postoperative treatments and the long-term outcomes are described in detail. An algorithm on specialist treatment and follow-up of tattoo reactions, which can be practiced in other countries, is presented. © 2017 S. Karger AG, Basel.

  18. A new method for finding the minimum free energy pathway of ions and small molecule transportation through protein based on 3D-RISM theory and the string method

    Science.gov (United States)

    Yoshida, Norio

    2018-05-01

    A new method for finding the minimum free energy pathway (MFEP) of ions and small molecule transportation through a protein based on the three-dimensional reference interaction site model (3D-RISM) theory combined with the string method has been proposed. The 3D-RISM theory produces the distribution function, or the potential of mean force (PMF), for transporting substances around the given protein structures. By applying the string method to the PMF surface, one can readily determine the MFEP on the PMF surface. The method has been applied to consider the Na+ conduction pathway of channelrhodopsin as an example.

  19. Module based training improves and sustains surgical skills

    DEFF Research Database (Denmark)

    Carlsen, C G; Lindorff-Larsen, K; Funch-Jensen, P

    2015-01-01

    PURPOSE: Traditional surgical training is challenged by factors such as patient safety issues, economic considerations and lack of exposure to surgical procedures due to short working hours. A module-based clinical training model promotes rapidly acquired and persistent surgical skills. METHODS...... hernia repair was preferable in both short and long-term compared with standard clinical training. The model will probably be applicable to other surgical training procedures....

  20. Hemorrhoidectomy - making sense of the surgical options

    Science.gov (United States)

    Yeo, Danson; Tan, Kok-Yang

    2014-01-01

    While debate continues as to which is the best surgical method for the treatment of hemorrhoids, none of the currently available surgical methods approach the ideal surgical option, which is one that is effective while being safe and painless. In reality, the less painful the procedure, the more likely it is to be associated with recurrence post-op. Where hemorrhoids surgery is concerned, there isn’t a “one size fits all” option. Most of the randomized controlled trials performed to date include hemorrhoids of various grades and with a focus on only comparing surgical methods while failing to stratify the outcomes according to the grade of hemorrhoid. We believe that surgery needs to be tailored not only to the grade of the hemorrhoids, but also to the size, circumferential nature of the disease, and prevailing symptomatology. PMID:25493010

  1. Quantification of surgical blood loss.

    Science.gov (United States)

    Lee, Marcel H; Ingvertsen, Britt T; Kirpensteijn, Jolle; Jensen, Asger L; Kristensen, Annemarie T

    2006-06-01

    To compare gravimetric and colorimetric methods of quantifying surgical blood loss, and to determine if there is a correlation between preoperative hemostatic tests (buccal mucosa bleeding time [BMBT] and intraoperative blood loss). Prospective clinical study. Dogs (n=15) admitted for cutaneous tumor excision, orthopedic procedure, or exploratory laparotomy. Intraoperative blood loss was quantified by measuring irrigation fluid and weighing surgical sponges used for blood and fluid collection during surgery. Results of gravimetric measurements were then correlated to blood loss quantified using spectrophotometric analysis of hemoglobin (Hb) content. Hemostatic variables including BMBT were measured before surgery and compared with the calculated amount of blood loss. Blood loss quantified by gravimetric measurement showed a significant correlation with colorimetric determination of Hb content in surgical sponges and collected irrigation fluid (r=0.93, P<.0001). BMBT correlated weakly but significantly with intraoperative blood loss (r=0.56, P<.05). Quantifying intraoperative blood loss using spectrophotometric Hb analysis accurately assessed the amount of blood loss; however, it is a time-consuming procedure, primarily applicable as a research tool. Gravimetric evaluation of intraoperative blood loss was found to be an accurate method, which can be recommended for use in a clinical setting. Estimation of blood loss using a gravimetric method is accurate and applicable in the clinical setting and provides surgeons with a simple and objective tool to evaluate intraoperative blood loss.

  2. A colorimetric method for highly sensitive and accurate detection of iodide by finding the critical color in a color change process using silver triangular nanoplates

    Energy Technology Data Exchange (ETDEWEB)

    Yang, Xiu-Hua; Ling, Jian, E-mail: lingjian@ynu.edu.cn; Peng, Jun; Cao, Qiu-E., E-mail: qecao@ynu.edu.cn; Ding, Zhong-Tao; Bian, Long-Chun

    2013-10-10

    Graphical abstract: -- Highlights: •Demonstrated a new colorimetric strategy for iodide detection by silver nanoplates. •The colorimetric strategy is to find the critical color in a color change process. •The colorimetric strategy is more accurate and sensitive than common colorimetry. •Discovered a new morphological transformation phenomenon of silver nanoplates. -- Abstract: In this contribution, we demonstrated a novel colorimetric method for highly sensitive and accurate detection of iodide using citrate-stabilized silver triangular nanoplates (silver TNPs). Very lower concentration of iodide can induce an appreciable color change of silver TNPs solution from blue to yellow by fusing of silver TNPs to nanoparticles, as confirmed by UV–vis absorption spectroscopy and transmission electron microscopy (TEM). The principle of this colorimetric assay is not an ordinary colorimetry, but a new colorimetric strategy by finding the critical color in a color change process. With this strategy, 0.1 μM of iodide can be recognized within 30 min by naked-eyes observation, and lower concentration of iodide down to 8.8 nM can be detected using a spectrophotometer. Furthermore, this high sensitive colorimetric assay has good accuracy, stability and reproducibility comparing with other ordinary colorimetry. We believe this new colorimetric method will open up a fresh insight of simple, rapid and reliable detection of iodide and can find its future application in the biochemical analysis or clinical diagnosis.

  3. A colorimetric method for highly sensitive and accurate detection of iodide by finding the critical color in a color change process using silver triangular nanoplates

    International Nuclear Information System (INIS)

    Yang, Xiu-Hua; Ling, Jian; Peng, Jun; Cao, Qiu-E.; Ding, Zhong-Tao; Bian, Long-Chun

    2013-01-01

    Graphical abstract: -- Highlights: •Demonstrated a new colorimetric strategy for iodide detection by silver nanoplates. •The colorimetric strategy is to find the critical color in a color change process. •The colorimetric strategy is more accurate and sensitive than common colorimetry. •Discovered a new morphological transformation phenomenon of silver nanoplates. -- Abstract: In this contribution, we demonstrated a novel colorimetric method for highly sensitive and accurate detection of iodide using citrate-stabilized silver triangular nanoplates (silver TNPs). Very lower concentration of iodide can induce an appreciable color change of silver TNPs solution from blue to yellow by fusing of silver TNPs to nanoparticles, as confirmed by UV–vis absorption spectroscopy and transmission electron microscopy (TEM). The principle of this colorimetric assay is not an ordinary colorimetry, but a new colorimetric strategy by finding the critical color in a color change process. With this strategy, 0.1 μM of iodide can be recognized within 30 min by naked-eyes observation, and lower concentration of iodide down to 8.8 nM can be detected using a spectrophotometer. Furthermore, this high sensitive colorimetric assay has good accuracy, stability and reproducibility comparing with other ordinary colorimetry. We believe this new colorimetric method will open up a fresh insight of simple, rapid and reliable detection of iodide and can find its future application in the biochemical analysis or clinical diagnosis

  4. Right-ventricular and left-ventricular function parameters in patients with and without outflow tract patches as determined by radionuclide methods at least 10 years following surgical correction of Fallot's tetralogy in the adult individuals

    International Nuclear Information System (INIS)

    Seidel, P.

    1988-01-01

    During a period starting in 1983 and ending in April 1984 radionuclide ventriculography was performed in 26 patients subjected to surgical correction of Fallot's tetralogy after having reached adulthood. They were divided into two groups according to the surgical methods used. Patients showing no right-ventricular outflow patch were assigned to group I, while group II was made up of individuals that had received outflow tract patches of Dacron or Teflon for pressure reduction in the right ventricle. The parameters registered during radionuclide ventriculography, in which the tracer substance TC 99m was administered into a peripheral vein, included the endiastolic volume, endsystolic volume, stroke volume, global ejection fraction and cardiac index. For resting patients, these values were calculated using the first-pass technique, the determinations during exercise on the ergometer were based on equilibrium radionuclide ventriculography. It could be concluded from the results obtained here that non-invasive endocardial scintigraphy is a sensitive method that can be used both at rest and during exercise on the ergometer to detect function disorders of the right and left ventricles. (orig./MG) [de

  5. Global pathways to men's caregiving: mixed methods findings from the International Men and Gender Equality Survey and the Men Who Care study.

    Science.gov (United States)

    Kato-Wallace, Jane; Barker, Gary; Eads, Marci; Levtov, Ruti

    2014-01-01

    Promoting men's participation in unpaid care work is part of the Programme of Action for the International Conference on Population and Development. However, men's involvement in care work does not mirror the advances women have made in paid work outside the home. This mixed method study explores which men are more involved in caregiving, and what childhood and adulthood factors influence their level of involvement. Quantitative research presents findings from 1169 men across six countries with children aged 0-4, and a qualitative study presents findings from in-depth interviews with 83 men engaged in atypical caregiving practices. Survey research finds that being taught to care for children, witnessing one's father take care of one's siblings, respondents' present attitudes about gender equality and having outside help (or none, in some cases) were all also associated with men's higher level of involvement. Qualitative research reveals that men's experiences of violence, the normalisation of domestic work as children and life circumstances rather than greater-than-average beliefs in gender equality all propelled them into care work. Findings suggest that engaging more men into care work implies changes to policies and structural realities in the workplace coupled with changing gender attitudes. These insights inform policy and practice aimed at promoting greater involvement in care work by men.

  6. Find an Orthopaedic Foot and Ankle MD/DO

    Science.gov (United States)

    ... All Site Content AOFAS / FootCareMD / Find a Surgeon Find a Foot & Ankle Orthopaedic Surgeon Page Content Who ... your prescribed treatment (surgical and/or non-surgical) ​ Find a Surgeon ​ Click here to find a foot ...

  7. A comparison of three clustering methods for finding subgroups in MRI, SMS or clinical data: SPSS TwoStep Cluster analysis, Latent Gold and SNOB.

    Science.gov (United States)

    Kent, Peter; Jensen, Rikke K; Kongsted, Alice

    2014-10-02

    There are various methodological approaches to identifying clinically important subgroups and one method is to identify clusters of characteristics that differentiate people in cross-sectional and/or longitudinal data using Cluster Analysis (CA) or Latent Class Analysis (LCA). There is a scarcity of head-to-head comparisons that can inform the choice of which clustering method might be suitable for particular clinical datasets and research questions. Therefore, the aim of this study was to perform a head-to-head comparison of three commonly available methods (SPSS TwoStep CA, Latent Gold LCA and SNOB LCA). The performance of these three methods was compared: (i) quantitatively using the number of subgroups detected, the classification probability of individuals into subgroups, the reproducibility of results, and (ii) qualitatively using subjective judgments about each program's ease of use and interpretability of the presentation of results.We analysed five real datasets of varying complexity in a secondary analysis of data from other research projects. Three datasets contained only MRI findings (n = 2,060 to 20,810 vertebral disc levels), one dataset contained only pain intensity data collected for 52 weeks by text (SMS) messaging (n = 1,121 people), and the last dataset contained a range of clinical variables measured in low back pain patients (n = 543 people). Four artificial datasets (n = 1,000 each) containing subgroups of varying complexity were also analysed testing the ability of these clustering methods to detect subgroups and correctly classify individuals when subgroup membership was known. The results from the real clinical datasets indicated that the number of subgroups detected varied, the certainty of classifying individuals into those subgroups varied, the findings had perfect reproducibility, some programs were easier to use and the interpretability of the presentation of their findings also varied. The results from the artificial datasets

  8. Evidence-informed health policy 1 – Synthesis of findings from a multi-method study of organizations that support the use of research evidence

    Directory of Open Access Journals (Sweden)

    Moynihan Ray

    2008-12-01

    Full Text Available Abstract Background Organizations have been established in many countries and internationally to support the use of research evidence by producing clinical practice guidelines, undertaking health technology assessments, and/or directly supporting the use of research evidence in developing health policy on an international, national, and state or provincial level. Learning from these organizations can reduce the need to 'reinvent the wheel' and inform decisions about how best to organize support for such organizations, particularly in low- and middle-income countries (LMICs. Methods We undertook a multi-method study in three phases – a survey, interviews, and case descriptions that drew on site visits – and in each of the second and third phases we focused on a purposive sample of those involved in the previous phase. We used the seven main recommendations that emerged from the advice offered in the interviews to organize much of the synthesis of findings across phases and methods. We used a constant comparative method to identify themes from across phases and methods. Results Seven recommendations emerged for those involved in establishing or leading organizations that support the use of research evidence in developing health policy: 1 collaborate with other organizations; 2 establish strong links with policymakers and involve stakeholders in the work; 3 be independent and manage conflicts of interest among those involved in the work; 4 build capacity among those working in the organization; 5 use good methods and be transparent in the work; 6 start small, have a clear audience and scope, and address important questions; and 7 be attentive to implementation considerations, even if implementation is not a remit. Four recommendations emerged for the World Health Organization (WHO and other international organizations and networks: 1 support collaborations among organizations; 2 support local adaptation efforts; 3 mobilize support; and 4 create

  9. Surgical ethics: surgical virtue and more.

    Science.gov (United States)

    Vercler, Christian J

    2015-01-01

    The encounter between a patient and her surgeon is unique for several reasons. The surgeon inflicts pain upon a patient for the patient's own good. An operative intervention is irreducibly personal, such that the decisions about and performance of operations are inseparable from the idiosyncrasies of the individual surgeon. Furthermore, there is a chasm of knowledge between the patient and surgeon that is difficult to cross. Hence, training in the discipline of surgery includes the inculcation of certain virtues and practices to safeguard against abuses of this relationship and to make sure that the best interests of the patient are prioritized. The stories in this issue are evidence that in contemporary practice this is not quite enough, as surgeons reflect on instances they felt were ethically challenging. Common themes include the difficulty in communicating surgical uncertainty, patient-surgeon relationships, ethical issues in surgical training, and the impact of the technological imperative on caring for dying patients.

  10. Healing incisional surgical wounds using Rose Hip oil in rats

    Directory of Open Access Journals (Sweden)

    Lainy Carollyne da Costa Cavalcante

    2017-03-01

    Full Text Available Purpose: To evaluate incisional surgical wound healing in rats by using Rose Hip (Rosa rubiginosa L. oil. Methods: Twenty-one days after the oophorectomy procedure, twenty-seven female, adult, Wistar rats were distributed into three groups: Control group (wound treatment with distilled water; Collagenase group (treatment with collagenase ointment; and Rose Hip group (wound treatment with Rose Hip oil. Each group was distributed according to the date of euthanasia: 7, 14 and 21 days. The wound was evaluated considering the macroscopic and microscopic parameters. Results: The results indicated differences in the healing of incisional wounds between treatments when compared to control group. Accelerated wound healing was observed in the group treated with Rose Hip oil in comparison to the control and collagenase, especially after the 14th day. Morphometric data confirmed the structural findings. Conclusion: There was significant effect in topical application of Rose Hip oil on incisional surgical wound healing.

  11. Attrition from surgical residency training: perspectives from those who left.

    Science.gov (United States)

    Bongiovanni, Tasce; Yeo, Heather; Sosa, Julie A; Yoo, Peter S; Long, Theodore; Rosenthal, Marjorie; Berg, David; Curry, Leslie; Nunez-Smith, Marcella

    2015-10-01

    High rates of attrition from general surgery residency may threaten the surgical workforce. We sought to gain further insight regarding resident motivations for leaving general surgery residency. We conducted in-depth interviews to generate rich narrative data that explored individual experiences. An interdisciplinary team used the constant comparative method to analyze the data. Four themes characterized experiences of our 19 interviewees who left their residency program. Participants (1) felt an informal contract was breached when clinical duties were prioritized over education, (2) characterized a culture in which there was no safe space to share personal and programmatic concerns, (3) expressed a scarcity of role models who demonstrated better work-life balance, and (4) reported negative interactions with authority resulting in a profound loss of commitment. As general surgery graduate education continues to evolve, our findings may inform interventions and policies regarding programmatic changes to boost retention in surgical residency. Copyright © 2015 Elsevier Inc. All rights reserved.

  12. Surgical techniques for treatment of gastroesophageal reflux disease

    Directory of Open Access Journals (Sweden)

    Carlos Édder de Mello Cardoso Lima

    2015-12-01

    Full Text Available Gastroesophageal reflux is one of the most frequently gastrointestinal tract diseases currently found, having a great impact on the patient's quality of life. Purpose: to analyze the main surgical techniques used in the treatment of this pathology, their indications, advantages and disadvantages. Methods: this is a literature review. Thirteen articles published between 1998 and 2013 in the Lilacs, Bireme e Scielo databases, addressing different surgical techniques for the treatment of gastroesophageal reflux were selected. Results: Five hundred and thirty-eight total fundoplications and 466 partial fundoplications were performed. Conclusion: The findings of this review show that total fundoplication is the most commonly used technique in the treatment of gastroesophageal reflux disease.

  13. Evidence-informed health policy 1 - synthesis of findings from a multi-method study of organizations that support the use of research evidence.

    Science.gov (United States)

    Lavis, John N; Oxman, Andrew D; Moynihan, Ray; Paulsen, Elizabeth J

    2008-12-17

    Organizations have been established in many countries and internationally to support the use of research evidence by producing clinical practice guidelines, undertaking health technology assessments, and/or directly supporting the use of research evidence in developing health policy on an international, national, and state or provincial level. Learning from these organizations can reduce the need to 'reinvent the wheel' and inform decisions about how best to organize support for such organizations, particularly in low- and middle-income countries (LMICs). We undertook a multi-method study in three phases - a survey, interviews, and case descriptions that drew on site visits - and in each of the second and third phases we focused on a purposive sample of those involved in the previous phase. We used the seven main recommendations that emerged from the advice offered in the interviews to organize much of the synthesis of findings across phases and methods. We used a constant comparative method to identify themes from across phases and methods. Seven recommendations emerged for those involved in establishing or leading organizations that support the use of research evidence in developing health policy: 1) collaborate with other organizations; 2) establish strong links with policymakers and involve stakeholders in the work; 3) be independent and manage conflicts of interest among those involved in the work; 4) build capacity among those working in the organization; 5) use good methods and be transparent in the work; 6) start small, have a clear audience and scope, and address important questions; and 7) be attentive to implementation considerations, even if implementation is not a remit. Four recommendations emerged for the World Health Organization (WHO) and other international organizations and networks: 1) support collaborations among organizations; 2) support local adaptation efforts; 3) mobilize support; and 4) create global public goods. This synthesis of

  14. Estimation Of Young’s Modulus Of Elesticity By The Form Finding Of Grid Shell Structures By The Dynamic Relaxation Method

    Directory of Open Access Journals (Sweden)

    Grančičová Ivana

    2015-12-01

    Full Text Available The paper is basically focused on the process of form finding by the dynamic relaxation method (DRM with the aid of computational tools that enable us to make many calculations with different inputs. There are many important input values with a significant impact on the course of the calculations and the resulting displacement of a structure. One of these values is Young’s modulus of elasticity. This value has a considerable impact on the final displacement of a grid shell structure and the resulting internal forces.

  15. Surgical site infections

    African Journals Online (AJOL)

    Decrease the inflammatory response Vasodilatation leads to better perfusion and ... Must NOT be allowed to come in contact with brain, meninges, eyes or .... project (SCIP): Evolution of National Quality Measure. Surgical. Infection 2008 ...

  16. Surgical Critical Care Initiative

    Data.gov (United States)

    Federal Laboratory Consortium — The Surgical Critical Care Initiative (SC2i) is a USU research program established in October 2013 to develop, translate, and validate biology-driven critical care....

  17. Ambulatory Surgical Measures - Facility

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Ambulatory Surgical Center Quality Reporting (ASCQR) Program seeks to make care safer and more efficient through quality reporting. ASCs eligible for this...

  18. Surgical Management of Hemorrhoids

    Science.gov (United States)

    Agbo, S. P.

    2011-01-01

    Hemorrhoids are common human afflictions known since the dawn of history. Surgical management of this condition has made tremendous progress from complex ligation and excision procedures in the past to simpler techniques that allow the patient to return to normal life within a short period. Newer techniques try to improve on the post-operative complications of older ones. The surgical options for the management of hemorrhoids today are many. Capturing all in a single article may be difficult if not impossible. The aim of this study therefore is to present in a concise form some of the common surgical options in current literature, highlighting some important post operative complications. Current literature is searched using MEDLINE, EMBASE and the Cochrane library. The conclusion is that even though there are many surgical options in the management of hemorrhoids today, most employ the ligature and excision technique with newer ones having reduced post operative pain and bleeding. PMID:22413048

  19. Surgical site infections

    African Journals Online (AJOL)

    Surgical site infections (SSIs) are a worldwide problem that has ... deep tissue is found on clinical examination, re-opening, histopathological or radiological investigation ..... Esposito S, Immune system and SSI, Journal of Chemotherapy, 2001.

  20. Surgical management of pain

    African Journals Online (AJOL)

    If these therapies fail, and with a thorough multidisciplinary approach involving carefully ... Generally, surgical pain management is divided into neuro- modulative .... 9 suggested. It is important to be sure that the underlying instability or.

  1. Long-term psychosocial consequences of surgical congenital malformations.

    Science.gov (United States)

    Diseth, Trond H; Emblem, Ragnhild

    2017-10-01

    Surgical congenital malformations often represent years of treatment, large number of hospital stays, treatment procedures, and long-term functional sequels affecting patients' psychosocial functioning. Both functional defects and psychosocial difficulties that occur commonly in childhood may pass through adolescence on to adulthood. This overview presents reports published over the past 3 decades to elucidate the long-term psychosocial consequences of surgical congenital malformations. Literature searches conducted on PubMed database revealed that less than 1% of all the records of surgical congenital malformations described long-term psychosocial consequences, but with diverse findings. This inconsistency may be due to methodological differences or deficiencies; especially in study design, patient sampling, and methods. Most of the studies revealed that the functional deficits may have great impact on patients' mental health, psychosocial functioning, and QoL; both short- and long-term negative consequences. Factors other than functional problems, e.g., repeated anesthesia, multiple hospitalization, traumatic treatment procedures, and parental dysfunctioning, may also predict long-term mental health and psychosocial functioning. Through multidisciplinary approach, pediatric surgeons should also be aware of deficits in emotional and psychosocial functioning. To achieve overall optimal psychosocial functioning, the challenge is to find a compromise between physically optimal treatment procedures and procedures that are not psychologically detrimental. Copyright © 2017. Published by Elsevier Inc.

  2. Correlation of clinical, radiographic, and surgical localization of intervertebral disc extrusion in small-breed dogs: a prospective study of 50 cases

    International Nuclear Information System (INIS)

    Schulz, K.S.; Walker, M.; Moon, M.; Waldron, D.; Slater, M.; McDonald, D.E.

    1998-01-01

    Objective-To compare prospectively clinical, radiographic, and surgical findings of intervertebral disc extrusion (IDE) localization in small-breed dogs and to determine the best means of lesion localization for the purpose of hemilaminectomy. Study Design-Clinical, radiographic, and surgical findings of small-breed dogs with thoracolumbar IDE were prospectively compared for agreement on lesion localization. Sample Population-50 small-breed dogs with IDE treated at the three participating veterinary hospitals were included in the study if no other confounding diseases were identified and if the owner gave permission for diagnostic tests and surgery. Methods-Clinical and surgical findings were recorded by the surgeon assigned to the case. Radiographic studies were evaluated independently by two radiologists blinded as to the clinical and surgical findings. K values and 95% confidence intervals were calculated for agreement on lesion localization by clinical, radiographic, and surgical means and for agreement between radiologists. Results-K values for agreement of lesion localization were as follows: clinical versus surgical, 0.595; radiologist A versus radiologist B, 0.81; radiologist A versus surgical findings, 0.60; radiologist B versus surgical findings, 0.71. Both radiologists interpretation of IDE localization agreed with surgical localization in 60% of cases. Conclusions-Clinical lateralization of IDE was found to be the least reliable factor of those studied for determining on which side the hemilaminectomy should be performed. Results of this study differ from those of previous studies examining the reliability of myelography to localize the site of IDE accurately. The results of this study further suggest that surgery may not be an absolute standard for determination of the localization of IDE in small-breed dogs. Clinical Relevance-Intervertebral disc extrusion in small-breed dogs frequently results in bilateral distribution of extruded material. Computed

  3. MRI findings of vermian medulloblastoma

    International Nuclear Information System (INIS)

    Jung, Seung Eun; Choi, Kyu Ho; Chung, Myung Hee; Yang, Il Kwon; Shinn, Kyung Sub; Park, Young Sub

    1996-01-01

    To find characteristic MRI features of vermian medulloblastoma. Materials and methods; MRI studies and medical records were retrospectively reviewed for 12 patients with surgically proven midline medulloblastoma. The assessment concerned appearance of the mass in relation to surrounding structures: MR signal intensity; the enhancement pattern; the mass's location and size: presence of a cystic/necrotic area, calcification, or vascular void: extension through the foramen Luschka: degree of hydrocephalus: and presence of tonsillar herniation. The midline medulloblastoma commonly showed roundish moon-surface appearance, especially on the axial T2-weighted images. All tumors showed heterogeneous signal intensities mainly due to intratumoral cystic/necrotic or hemorrhagic changes. The tumors were commonly located at mid-and/or inferior vermis. Occasionally the tumors extended through the foramen Luschka, and caused obstructive hydrocephalus of moderate to severe degree. Post-contrast study showed heterogeneous, dense contrast enhancement in the majority of patients. The MR finding of the moon-surface appearance formed by both the mass and the intratumoral cystic/necrotic change as seen on axial T2-weighted images could be helpful in the diagnosis of vermian medulloblastoma

  4. Clinical and Surgical Anatomy of the Neck

    OpenAIRE

    Fernández Russo, Gustavo A.H.

    2012-01-01

    Introduction: to bring relevance on morphological details pertaining to medical and surgical applicability and demonstrate its value as an unavoidable mainstay for diagnosis and mangement of head and neck pathology.Materials and method: a. standarized dissections, of preserved adult human corpses, to obtain anatomical pieces for teaching purposes in school of medicine, axial slices and its comparative study with computed tomography (CT) images. b.application of normalized surgical techniques...

  5. Endotoxins in surgical instruments of hip arthroplasty

    OpenAIRE

    Goveia, Vania Regina; Mendoza, Isabel Yovana Quispe; Guimarães, Gilberto Lima; Ercole, Flavia Falci; Couto, Bráulio Roberto Gonçalves Marinho; Leite, Edna Marilea Meireles; Stoianoff, Maria Aparecida Resende; Ferreira, José Antonio Guimarães

    2016-01-01

    Abstract OBJECTIVE To investigate endotoxins in sterilized surgical instruments used in hip arthroplasties. METHOD A descriptive exploratory study conducted in a public teaching hospital. Six types of surgical instruments were selected, namely: acetabulum rasp, femoral rasp, femoral head remover, chisel box, flexible bone reamer and femoral head test. The selection was based on the analysis of the difficulty in removing bone and blood residues during cleaning. The sample was made up of 60...

  6. Surgical Approaches to First Branchial Cleft Anomaly Excision: A Case Series.

    Science.gov (United States)

    Quintanilla-Dieck, Lourdes; Virgin, Frank; Wootten, Chistopher; Goudy, Steven; Penn, Edward

    2016-01-01

    Objectives. First branchial cleft anomalies (BCAs) constitute a rare entity with variable clinical presentations and anatomic findings. Given the high rate of recurrence with incomplete excision, identification of the entire tract during surgical treatment is of paramount importance. The objectives of this paper were to present five anatomic variations of first BCAs and describe the presentation, evaluation, and surgical approach to each one. Methods. A retrospective case review and literature review were performed. We describe patient characteristics, presentation, evaluation, and surgical approach of five patients with first BCAs. Results. Age at definitive surgical treatment ranged from 8 months to 7 years. Various clinical presentations were encountered, some of which were atypical for first BCAs. All had preoperative imaging demonstrating the tract. Four surgical approaches required a superficial parotidectomy with identification of the facial nerve, one of which revealed an aberrant facial nerve. In one case the tract was found to travel into the angle of the mandible, terminating as a mandibular cyst. This required en bloc excision that included the lateral cortex of the mandible. Conclusions. First BCAs have variable presentations. Complete surgical excision can be challenging. Therefore, careful preoperative planning and the recognition of atypical variants during surgery are essential.

  7. Surgical Approaches to First Branchial Cleft Anomaly Excision: A Case Series

    Directory of Open Access Journals (Sweden)

    Lourdes Quintanilla-Dieck

    2016-01-01

    Full Text Available Objectives. First branchial cleft anomalies (BCAs constitute a rare entity with variable clinical presentations and anatomic findings. Given the high rate of recurrence with incomplete excision, identification of the entire tract during surgical treatment is of paramount importance. The objectives of this paper were to present five anatomic variations of first BCAs and describe the presentation, evaluation, and surgical approach to each one. Methods. A retrospective case review and literature review were performed. We describe patient characteristics, presentation, evaluation, and surgical approach of five patients with first BCAs. Results. Age at definitive surgical treatment ranged from 8 months to 7 years. Various clinical presentations were encountered, some of which were atypical for first BCAs. All had preoperative imaging demonstrating the tract. Four surgical approaches required a superficial parotidectomy with identification of the facial nerve, one of which revealed an aberrant facial nerve. In one case the tract was found to travel into the angle of the mandible, terminating as a mandibular cyst. This required en bloc excision that included the lateral cortex of the mandible. Conclusions. First BCAs have variable presentations. Complete surgical excision can be challenging. Therefore, careful preoperative planning and the recognition of atypical variants during surgery are essential.

  8. Post surgical complications from students' large animal surgical ...

    African Journals Online (AJOL)

    A retrospective study of post surgical complications was conducted on records of students' Large Animal Surgical Laboratories in the Faculty of Veterinary Medicine (F.V.M.), Ahmadu Bello University (A.B.U), Zaria from 1989 to 1993. Three hundred and eleven surgical complications were recorded from five surgical ...

  9. Cochrane Qualitative and Implementation Methods Group guidance series-paper 3: methods for assessing methodological limitations, data extraction and synthesis, and confidence in synthesized qualitative findings.

    Science.gov (United States)

    Noyes, Jane; Booth, Andrew; Flemming, Kate; Garside, Ruth; Harden, Angela; Lewin, Simon; Pantoja, Tomas; Hannes, Karin; Cargo, Margaret; Thomas, James

    2018-05-01

    The Cochrane Qualitative and Implementation Methods Group develops and publishes guidance on the synthesis of qualitative and mixed-method implementation evidence. Choice of appropriate methodologies, methods, and tools is essential when developing a rigorous protocol and conducting the synthesis. Cochrane authors who conduct qualitative evidence syntheses have thus far used a small number of relatively simple methods to address similarly written questions. Cochrane has invested in methodological work to develop new tools and to encourage the production of exemplar reviews to show the value of more innovative methods that address a wider range of questions. In this paper, in the series, we report updated guidance on the selection of tools to assess methodological limitations in qualitative studies and methods to extract and synthesize qualitative evidence. We recommend application of Grades of Recommendation, Assessment, Development, and Evaluation-Confidence in the Evidence from Qualitative Reviews to assess confidence in qualitative synthesized findings. This guidance aims to support review authors to undertake a qualitative evidence synthesis that is intended to be integrated subsequently with the findings of one or more Cochrane reviews of the effects of similar interventions. The review of intervention effects may be undertaken concurrently with or separate to the qualitative evidence synthesis. We encourage further development through reflection and formal testing. Copyright © 2017 Elsevier Inc. All rights reserved.

  10. Do psychological variables affect early surgical recovery?

    Directory of Open Access Journals (Sweden)

    Michael N Mavros

    Full Text Available BACKGROUND: Numerous studies have examined the effect of psychological variables on surgical recovery, but no definite conclusion has been reached yet. We sought to examine whether psychological factors influence early surgical recovery. METHODS: We performed a systematic search in PubMed, Scopus and PsycINFO databases to identify studies examining the association of preoperative psychological variables or interventions with objectively measured, early surgical outcomes. RESULTS: We identified 16 eligible studies, 15 of which reported a significant association between at least one psychological variable or intervention and an early postoperative outcome. However, most studies also reported psychological factors not influencing surgical recovery and there was significant heterogeneity across the studies. Overall, trait and state anxiety, state anger, active coping, subclinical depression, and intramarital hostility appeared to complicate recovery, while dispositional optimism, religiousness, anger control, low pain expectations, and external locus of control seemed to promote healing. Psychological interventions (guided relaxation, couple support visit, and psychiatric interview also appeared to favor recovery. Psychological factors unrelated to surgical outcomes included loneliness, perceived social support, anger expression, and trait anger. CONCLUSION: Although the heterogeneity of the available evidence precludes any safe conclusions, psychological variables appear to be associated with early surgical recovery; this association could bear important implications for clinical practice. Large clinical trials and further analyses are needed to precisely evaluate the contribution of psychology in surgical recovery.

  11. Mastoidectomy: anatomical parameters x surgical difficulty

    Directory of Open Access Journals (Sweden)

    Pereira Júnior, Anastácio Rodrigues

    2012-01-01

    Full Text Available Introduction: The lowered temporal meninges and/ or anterior sigmoid sinus are contiditions that can determine surgical difficulties in performing mastoidectomy. Objective: To correlate in the tomography the extent of the prolapse of the sigmoid sinus and of temporal meninges with the surgical difficulty in the mastoidectomy. Method: The tomographic measurements of prolapse sigmoid and of temporal meninges were correlated with the presence or non-presence of the surgical difficulty observed during the mastoidectomy procedure in patients with ostomatoiditis chronic (n=30. Form of study: Contemporary cohort transverse. Results: In 10 patients were observed surgical difficulty distributed as: due to prolapse of the sigmoid sinus (n = 2 or temporal meninges prolapse (n = 7 or both (n = 1. In patients in which the surgical difficulty was due to sigmoid sinus prolapse, the tomography distance of the anterior border of the sigmoid sinus to posterior wall of external auditory canal was lower than 9 mm. In patients in which surgical difficulty was due to temporal meninges prolapse, the tomographic distance to the upper plane of the petrous bone was 7 mm. Conclusion: The computerized tomography distance between the temporal meninges and the upper plane of the petrous bone 7 mm and the distance of the anterior border of the sigmoid sinus to posterior wall of external auditory canal was lower than 9 mm are predictive to the surgical difficulties to perform mastoidectomy.

  12. The pregnant female surgical resident

    Directory of Open Access Journals (Sweden)

    Shifflette V

    2018-05-01

    Full Text Available Vanessa Shifflette,1 Susannah Hambright,2 Joseph Darryl Amos,1 Ernest Dunn,3 Maria Allo4 1Associates in Surgical Acute Care, Methodist Dallas Medical Center, Dallas, TX, USA; 2Methodist Surgical Associates, Methodist Dallas Medical Center, Dallas, TX, USA; 3Graduate Medical Education - General Surgery, Methodist Dallas Medical Center, Dallas, TX, USA; 4Santa Clara Valley Medical Center, San Jose, CA, USA Background: Surgery continues to be an intense, time-consuming residency. Many medical students decide against surgery as a profession due to the long work hours and family strain. The pregnant female surgical resident has an added stress factor compared to her male counterpart. Methods: We distributed an electronic, online 26-question survey to 32 general surgery programs in the southwestern region of the United States. Each program distributed our survey to the female surgical residents who had been pregnant during residency in the last 5 years. Each program was re-contacted 6 weeks after the initial contact. Most questions were in a 5-point Likert scale format. The responses were collected and analyzed using the Survey Monkey website. Results: An unvalidated survey was sent to 32 general surgery programs and 26 programs responded (81%. Each program was asked for the total number of possible responses from female residents that met our criteria (60 female residents. Seven of the programs (27% stated that they have had zero residents pregnant. We had 22 residents respond (37%. Over half of the residents (55% were pregnant during their 2nd or 3rd year of residency, with only 18% pregnant during a research year. Thirty-one percent had a lower American Board of Surgery In-Training Exam (ABSITE score. Ninety percent of the residents were able to take 4 weeks or more for maternity leave. Most of the residents (95% stated that they would do this again during residency given the opportunity, but many of the residents felt that returning back to work

  13. Heterotopic pregnancy: Sonographic findings

    International Nuclear Information System (INIS)

    Kwon, Tae Hee

    1999-01-01

    To evaluate the sonographic findings of the heterotopic pregnancy which is increasing recently. Thirty-nine cases of heterotopic pregnancy after ovulation induction and IVF-ET (In Vitro Fertilization-Embryo Transfer) during the recent 3 years were analyzed. They were diagnosed by ultrasonography and proved surgically afterwards. Sonographic findings were analyzed focusing on gestational week of intrauterine pregnancy and location of ectopic pregnancy. In particular, adnexal mass was evaluated with regard to size and the characteristic findings such as ectopic gestational sac (echogenic ring). Also, overian cyst and fluid collection in cul-de-sac space were reviewed carefully. Heterotopic pregnancy was proved surgically by salpingectomy in 33 cases and by resection of cornus in six cases. Sonographic diagnosis using transvaginal ultrasound was made from five weeks to nine weeks two days (six weeks and four days in average) from last menstral period in all 39 cases. Ectopic pregnancy was identified in ampullary part in 29 cases, in the isthmic portion of tube in four cases and in the cornus of uterus in six cases. The intrauterine pregnancy was diagnosed by identifying the intrauterine gestational saccontaining a yolk sac in seven cases and the embryo with fetal heart beat in the remaining 32 cases. Adnexal masses of heterotopic pregnancy were less than 3 cm in diameter in 2 cases (57%), 3-4 cm in 11 cases (28%) and more than 4 cm in 6 cases (15%). A characteristic finding of ectopic mass was echogenic ring which was visible in 33 (84.6%) cases by transvaginal ultrasound. Six cases had pelvic hematosalpinx and two had pelvic hematoma. Of 10 cases (26%) which were identified to have ovarian hyperstimulation syndrome, eight (21%) had large amount of fluid collection in cul-de-sac and abdomen. Ultrasonographic identification of the intrauterine pregnancy and the ectopic chorion ring is effective for the early diagnosis of the heterotopic pregnancy.

  14. Surgical Approaches to the Oral Cavity Primary and Neck

    International Nuclear Information System (INIS)

    Shah, Jatin P.

    2007-01-01

    Purpose: A variety of surgical approaches used to treat primary oral cavity tumors are described to delineate the technique and rationale behind each treatment choice. Methods and Materials: Size, location, proximity to bone, lymph node status, histology, and prior treatment considerations are employed to determine the most appropriate surgical approach for primary oral cavity tumors. Results: Oncologic outcomes and physical function show the best results from surgical treatment of many primary oral cavity, but necessitates careful selection of surgical approach. Conclusion: Each surgical approach must be selected based upon relevant tumor, patient and physician factors

  15. Surgical smoke and ultrafine particles

    Directory of Open Access Journals (Sweden)

    Nowak Dennis

    2008-12-01

    Full Text Available Abstract Background Electrocautery, laser tissue ablation, and ultrasonic scalpel tissue dissection all generate a 'surgical smoke' containing ultrafine ( Methods To measure the amount of generated particulates in 'surgical smoke' during different surgical procedures and to quantify the particle number concentration for operation room personnel a condensation particle counter (CPC, model 3007, TSI Inc. was applied. Results Electro-cauterization and argon plasma tissue coagulation induced the production of very high number concentration (> 100000 cm-3 of particles in the diameter range of 10 nm to 1 μm. The peak concentration was confined to the immediate local surrounding of the production side. In the presence of a very efficient air conditioning system the increment and decrement of ultrafine particle occurrence was a matter of seconds, with accumulation of lower particle number concentrations in the operation room for only a few minutes. Conclusion Our investigation showed a short term very high exposure to ultrafine particles for surgeons and close assisting operating personnel – alternating with longer periods of low exposure.

  16. Uncommon surgical emergencies in neonatology

    Directory of Open Access Journals (Sweden)

    R. Angotti

    2014-12-01

    Full Text Available Objective. Over the past decade, multiple factors have changed the pattern of neonatal surgical emergencies. An increase in prenatal screenings and the development of neonatal tertiary care centres have changed the clinical approach to these kids. Materials and methods. Between 1995 to 2011 were retrospectively reviewed 34 patients with diagnosis of uncommon rare neonatal surgical emergencies at our institute. We analyzed: sex, gestational age, weight at birth, primary pathology, prenatal diagnosis, associated anomalies, age and weight at surgery, clinical presentation, start of oral feeding and hospitalization. The follow-up was performed at 6,12, 24 and 36 months. Results. There were 21 male and 13 female. The gestational age ranged between 28 and 36 weeks. The weight at birth ranged between 700 and 1400 grams. Oral feeding was started between 4th and 10th postoperative day. The average hospitalization was about 70.47 days. To date, all patients have finished the followup. They are healthy. Conclusion. The outcome of the patients with uncommon surgical emergencies is different based on the etiology. Overall survival is generally good but is influenced by the associated anomalies.

  17. Surgical management of radiation enterocolitis

    International Nuclear Information System (INIS)

    Sakaguchi, Masahiro; Katsumi, Masaharu; Ishimoto, Kiwao; Yamamoto, Shinji; Yukawa, Hirofumi; Koh, Kenzo; Yamaguchi, Kazuya; Ohta, Masataka; Hayashido, Motonori

    1986-01-01

    Radiotherapy for malignant tumors is effective and established. However, there are many complications in radiotherapy. A typical complication is radiation enterocolitis. It is difficult to treat severe histological damage to the irradiated tissues. This paper reports our experience with 26 patients with radiation enterocolitis for whom surgical treatment was given during a period of 16 years in our surgical department. The most frequent original disease requiring irradiation was cancer of the cervix uteri (15 cases) which was followed by cancer of the urinary bladder (7 cases). All of these patients had received external 60 Co irradiation. The ileum was the most frequent site of the lesion, followed by the rectum, sigmoid and descending colon. The period between the end of irradiation and the onset of enterocolitis ranged from 2 months to 10 years, with an average of 28 months. The main symptoms were intestinal obstruction in the ileum, and melena and fistula in the rectum and sigmoid colon. Intestinal resection was performed in 10 patients, a bypass operation in 4, and colostomy in 12. As to types of intestinal suture in these cases, Gambee's single layer method was thought useful from our experience. Colostomy as surgical management of melena and fistula did not yield satisfactory results. (author)

  18. Evaluation of an antimicrobial surgical glove to inactivate live human immunodeficiency virus following simulated glove puncture.

    Science.gov (United States)

    Edmiston, Charles E; Zhou, S Steve; Hoerner, Pierre; Krikorian, Raffi; Krepel, Candace J; Lewis, Brian D; Brown, Kellie R; Rossi, Peter J; Graham, Mary Beth; Seabrook, Gary R

    2013-02-01

    Percutaneous injuries associated with cutting instruments, needles, and other sharps (eg, metallic meshes, bone fragments, etc) occur commonly during surgical procedures, exposing members of surgical teams to the risk for contamination by blood-borne pathogens. This study evaluated the efficacy of an innovative integrated antimicrobial glove to reduce transmission of the human immunodeficiency virus (HIV) following a simulated surgical-glove puncture injury. A pneumatically activated puncturing apparatus was used in a surgical-glove perforation model to evaluate the passage of live HIV-1 virus transferred via a contaminated blood-laden needle, using a reference (standard double-layer glove) and an antimicrobial benzalkonium chloride (BKC) surgical glove. The study used 2 experimental designs. In method A, 10 replicates were used in 2 cycles to compare the mean viral load following passage through standard and antimicrobial gloves. In method B, 10 replicates were pooled into 3 aliquots and were used to assess viral passage though standard and antimicrobial test gloves. In both methods, viral viability was assessed by observing the cytopathic effects in human lymphocytic C8166 T-cell tissue culture. Concurrent viral and cell culture viability controls were run in parallel with the experiment's studies. All controls involving tissue culture and viral viability were performed according to study design. Mean HIV viral loads (log(10)TCID(50)) were significantly reduced (P reduction (log reduction and percent viral reduction) of the HIV virus ranged from 1.96 to 2.4 and from 98.9% to 99.6%, respectively, following simulated surgical-glove perforation. Sharps injuries in the operating room pose a significant occupational risk for surgical practitioners. The findings of this study suggest that an innovative antimicrobial glove was effective at significantly (P < .01) reducing the risk for blood-borne virus transfer in a model of simulated glove perforation. Copyright

  19. Finding Sliesthorp?

    DEFF Research Database (Denmark)

    Dobat, Andres S.

    2016-01-01

    In 2003, a hitherto unknown Viking age settlement was discovered at Füsing in Northern Germany close to Hedeby/Schleswig, the largest of the early Scandinavian towns. Finds and building features suggest a high status residence and a seat of some chiefly elite that flourished from around 700 to th...... and the transformation of socio‐political structures in Northern Europe as it transitioned from prehistory into the middle Ages....

  20. [Comparative description and retrospective analisis of modern methods of surgical wounds closure for intraoperative prophylaxis of development of pathologic cutaneous cicatrices].

    Science.gov (United States)

    Stavyts'kyĭ, S O; Avetikov, D S; Lokes, K P; Rozkolupa, O O; Boĭko, I V

    2014-05-01

    The experience of application of various methods of closure was presented for the head and neck cutaneous wound surfaces after elective operative interventions. The variant of the postoperative results estimation and optimization of the wounds healing by primary closure was proposed.

  1. Anxiety in veterinary surgical students

    DEFF Research Database (Denmark)

    Langebæk, Rikke; Eika, Berit; Jensen, Asger Lundorff

    2012-01-01

    The surgical educational environment is potentially stressful and this can negatively affect students' learning. The aim of this study was to investigate whether veterinary students' level of anxiety is higher in a surgical course than in a non-surgical course and if pre-surgical training...... in a Surgical Skills Lab (SSL) has an anxiety reducing effect. Investigations were carried out as a comparative study and a parallel group study. Potential participants were fourth-year veterinary students who attended a surgical course (Basic Surgical Skills) and a non-surgical course (Clinical Examination...... and 28 students from 2010). Our results show that anxiety levels in veterinary students are significantly higher in a surgical course than in a non-surgical course (p...

  2. [Surgical site infections: antibiotic prophylaxis in surgery].

    Science.gov (United States)

    Asensio, Angel

    2014-01-01

    Surgical site infections (SSI) are very common, and represent more than 20% of all hospital-acquired infections. SSIs are associated with a higher mortality, as well as to an extended hospital stay and costs, depending on the surgical procedure and type of SSI. Advances in control practices for these infections include improvement in operating room ventilation, sterilization methods, barriers, and surgical techniques, as well as in surgical antimicrobial prophylaxis. For the latter, the antimicrobial agent should: be active against the most common pathogens, be administered in an appropriate dosage and in a time frame to ensure serum and tissue concentrations over the period of potential contamination, be safe, and be administered over the shortest effective time period to minimize adverse events, development of resistances, and cost. Copyright © 2013 Elsevier España, S.L. All rights reserved.

  3. Surgical simulation in orthopaedic skills training.

    Science.gov (United States)

    Atesok, Kivanc; Mabrey, Jay D; Jazrawi, Laith M; Egol, Kenneth A

    2012-07-01

    Mastering rapidly evolving orthopaedic surgical techniques requires a lengthy period of training. Current work-hour restrictions and cost pressures force trainees to face the challenge of acquiring more complex surgical skills in a shorter amount of time. As a result, alternative methods to improve the surgical skills of orthopaedic trainees outside the operating room have been developed. These methods include hands-on training in a laboratory setting using synthetic bones or cadaver models as well as software tools and computerized simulators that enable trainees to plan and simulate orthopaedic operations in a three-dimensional virtual environment. Laboratory-based training offers potential benefits in the development of basic surgical skills, such as using surgical tools and implants appropriately, achieving competency in procedures that have a steep learning curve, and assessing already acquired skills while minimizing concerns for patient safety, operating room time, and financial constraints. Current evidence supporting the educational advantages of surgical simulation in orthopaedic skills training is limited. Despite this, positive effects on the overall education of orthopaedic residents, and on maintaining the proficiency of practicing orthopaedic surgeons, are anticipated.

  4. A comprehensive method to find RPO trajectory and incentive scheme for promotion of renewable energy in India with study of impact of RPO on tariff

    International Nuclear Information System (INIS)

    Shereef, R.M.; Khaparde, S.A.

    2013-01-01

    Renewable Purchase Obligation (RPO) regime in India started in 2011 with the announcement of benchmark RPO (BRPO) of states for the Financial Year (FY) 2011 by respective State Electricity Regulatory Commissions (SERC), to promote Renewable Energy (RE). The report submitted to Forum of Regulators (FoR) in this regard has recommended uniform rate of increase of BRPO of states and studied the impact of RPO on tariff for FY 2011–2015. However, more rigorous analysis is needed for fixing BRPO in a scientific manner and for fair allocation of incentives to promote RE. This paper attempts to evaluate all states on a common platform to find BRPO, giving due weightage to the state-wise energy demand and RE generation, ensuring minimum change in BRPO of consecutive years and hence less impact of RPO on tariff. To encourage the states to align their actual RPO with BRPO, a financial incentive scheme is proposed giving due weightage to RE consumption, RE capacity addition and RPO compliance of the states. The methods are illustrated for the Indian states using real system data. A study of RPO's impact on electricity tariff of Indian states is also conducted and reported for FY 2011–2015, considering Renewable Energy Certificate (REC). - Author-Highlights: • Proposes a comprehensive method to find the BRPO of Indian states for promoting RE. • Minimum change in BRPO of consecutive years hence less impact of RPO on tariff. • Incentive scheme to encourage the states to align their actual RPO with BRPO. • Study of impact of RPO on tariff of Indian states is conducted

  5. SURGICAL SITE INFECTION: REVIEW

    Directory of Open Access Journals (Sweden)

    P. H. M. Bonai

    2016-07-01

    Full Text Available Nosocomial infection or nosocomial infection (NI is one of the factors that increase the cost of maintaining patients in the health system, even in processes that should safely occur, such as hospital patients and performing simple and routine surgical procedures surgical centers and clinics leading to complications resulting from these infections that prolong hospital stay and promote pain and suffering to the patient, resulting in the defense of the quality of services and influencing negatively the hospitals. Therefore, the aim of this study was to review the factors that result in surgical site infection, with the purpose of better understanding of the subject and the possibility of preventive actions to better treatment outcome of the patient.

  6. Simulated surgical workshops enhance medical school students’ preparation for clinical rotation

    Directory of Open Access Journals (Sweden)

    Patricia Johnson

    2013-02-01

    Full Text Available BackgroundA major focus of the medical school curriculum is to ensure medical students are well prepared prior to entering clinical rotations, which includes the compulsory surgical rotation.AimsThe objective of this research was to design and formally evaluate a set of real-life surgical workshops aimed at better preparing medical students for their clinical rotation in surgery. These workshops would be incorporated into the pre-clinical medical school curriculum.MethodDedicated surgical workshops were introduced into the preclinical component of the Bachelor of Medicine/Bachelor of Surgery (MBBS program at our University in 2009. These workshops encompassed training in the clinical skills needed in the perioperative and wider hospital setting. A survey comprising of eight to nine ranked questions (utilising a five-point Likert Scale as well as three short answer questions was administered to the medical students after they completed their compulsory surgical clinical rotation.ResultsThe overall response rate to the survey evaluating the surgical workshops was 79% (123/155. The mean of the ranked questions ranged from 4.05 to 4.89 which indicated that the students found the workshops useful. When evaluating the short answer questions (via topic coding, additional information was provided that supported and explained the survey findings and also included suggestions for improvements.ConclusionThe findings of the medical student survey demonstrated the value of incorporating dedicated preparatory surgical workshops in the medical school pre-clinical curriculum. However, further research is warranted to determine if this inclusion translated into improved student performance during the clinical surgical rotation.

  7. Local antimicrobial administration for prophylaxis of surgical site infections.

    Science.gov (United States)

    Huiras, Paul; Logan, Jill K; Papadopoulos, Stella; Whitney, Dana

    2012-11-01

    Despite a lack of consensus guidelines, local antibiotic administration for prophylaxis of surgical site infections is used during many surgical procedures. The rationale behind this practice is to provide high antibiotic concentrations at the site of surgery while minimizing systemic exposure and adverse effects. Local antibiotic administration for surgical site prophylaxis has inherent limitations in that antibiotics are applied after the incision is made, rather than the current standard for surgical site prophylaxis that recommends providing adequate antibiotic concentrations at the site before the incision. The efficacy and safety of local application of antibiotics for surgical site prophylaxis have been assessed in different types of surgery with a variety of antibiotic agents and methods of application. We identified 22 prospective, randomized, controlled trials that evaluated local application of antibiotics for surgical site prophylaxis. These trials were subsequently divided and analyzed based on the type of surgical procedure: dermatologic, orthopedic, abdominal, colorectal, and cardiothoracic. Methods of local application analyzed included irrigations, powders, ointments, pastes, beads, sponges, and fleeces. Overall, there is a significant lack of level I evidence supporting this practice for any of the surgical genres evaluated. In addition, the literature spans several decades, and changes in surgical procedures, systemic antibiotic prophylaxis, and microbial flora make conclusions difficult to determine. Based on available data, the efficacy of local antibiotic administration for the prophylaxis of surgical site infections remains uncertain, and recommendations supporting this practice for surgical site prophylaxis cannot be made. © 2012 Pharmacotherapy Publications, Inc.

  8. [Surgical technique for cesarean section of Eduardo Porro (1842-1902) and its significance for obstetric development. In the 150th anniversary year of the method's creator].

    Science.gov (United States)

    Waszyński, E

    1994-04-01

    It has passed 150th birth anniversary of a great, Italian Obstetrician Eduardo Porro, author of a cesarean section technique consisted of uterine corpus amputation and suturing of the cervix stump into the abdominal wall incision. Eduardo Porro was born in 1842 in Padwa. In 1876, he became the Head of Obstetrics Department in Pawia, and since 1882, the Head of Midwifery School in Milano. He died on May 25th, 1901. That original cesarean section method was introduced by him in 1876. Its main idea was exsection of the uterus, infected at the time of labor. The operation was also performed because of other reasons, such as: wide uterine ruptures, osteomalation, spacions vaginal cicatrization, and uterine atony. In the second part of the 18th century, maternal mortality following so called, classical cesarean section was nearly 100 percent. Introducing the Porro's operative technique decreased maternal mortality to 58%. This method aroused an interest of cesarean section technique improvement at all. The twilight, of the Porro's operation took place in the 1920s as the new method appeared, elaborated by Adolf Kehrer--uterine lower segment transverse incision.

  9. Hide and vanish: data sets where the most parsimonious tree is known but hard to find, and their implications for tree search methods.

    Science.gov (United States)

    Goloboff, Pablo A

    2014-10-01

    Three different types of data sets, for which the uniquely most parsimonious tree can be known exactly but is hard to find with heuristic tree search methods, are studied. Tree searches are complicated more by the shape of the tree landscape (i.e. the distribution of homoplasy on different trees) than by the sheer abundance of homoplasy or character conflict. Data sets of Type 1 are those constructed by Radel et al. (2013). Data sets of Type 2 present a very rugged landscape, with narrow peaks and valleys, but relatively low amounts of homoplasy. For such a tree landscape, subjecting the trees to TBR and saving suboptimal trees produces much better results when the sequence of clipping for the tree branches is randomized instead of fixed. An unexpected finding for data sets of Types 1 and 2 is that starting a search from a random tree instead of a random addition sequence Wagner tree may increase the probability that the search finds the most parsimonious tree; a small artificial example where these probabilities can be calculated exactly is presented. Data sets of Type 3, the most difficult data sets studied here, comprise only congruent characters, and a single island with only one most parsimonious tree. Even if there is a single island, missing entries create a very flat landscape which is difficult to traverse with tree search algorithms because the number of equally parsimonious trees that need to be saved and swapped to effectively move around the plateaus is too large. Minor modifications of the parameters of tree drifting, ratchet, and sectorial searches allow travelling around these plateaus much more efficiently than saving and swapping large numbers of equally parsimonious trees with TBR. For these data sets, two new related criteria for selecting taxon addition sequences in Wagner trees (the "selected" and "informative" addition sequences) produce much better results than the standard random or closest addition sequences. These new methods for Wagner

  10. New treatment method for developmental dysplasia of the hips after walking age. Arthroscopic reduction with limboplasty based on the findings of preoperative imaging

    International Nuclear Information System (INIS)

    Kitano, Toshio; Morita, Mitsuaki; Nakagawa, Keisuke; Wada, Mayuko; Kuroda, Takaaki; Imai, Yuuki; Sakai, Toshiyuki; Eguchi, Yoshitaka

    2010-01-01

    What makes treatment choice for developmental dysplasia of the hips diagnosed after walking age difficult is the poor understanding of prereduction conditions that obstruct the reduction in spatial terms. To evaluate these problems, we employed subtraction three-dimensional imaging to search for the factors involved in intraarticular obstruction. On the basis of the findings of preoperative subtraction three-dimensional imaging from computed tomography, we developed a new method, a minimum invasive arthroscopic reduction with limboplasty, for reduction of developmental dysplasia of the hips after walking age. The purposes of this report were to: describe the technique of the arthroscopic procedure, and evaluate our new method using radiographic parameters. Ten patients with ten hips with developmental dysplasia after walking age treated by arthroscopic reduction with limboplasty were included in this study. The mean age of the patients at reduction was 22.6 months (range, 18.6-29.