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Sample records for surgical instruments viii

  1. Encapsulation process sterilizes and preserves surgical instruments

    Science.gov (United States)

    Montgomery, L. C.; Morelli, F. A.

    1964-01-01

    Ethylene oxide is blended with an organic polymer to form a sterile material for encapsulating surgical instruments. The material does not bond to metal and can be easily removed when the instruments are needed.

  2. Surgical Instrument Sets for Special Operations Expeditionary Surgical Teams.

    Science.gov (United States)

    Hale, Diane F; Sexton, Justin C; Benavides, Linda C; Benavides, Jerry M; Lundy, Jonathan B

    The deployment of surgical assets has been driven by mission demands throughout years of military operations in Iraq and Afghanistan. The transition to the highly expeditious Golden Hour Offset Surgical Transport Team (GHOST- T) now offers highly mobile surgical assets in nontraditional operating rooms; the content of the surgical instrument sets has also transformed to accommodate this change. The 102nd Forward Surgical Team (FST) was attached to Special Operations assigned to southern Afghanistan from June 2015 to March 2016. The focus was to decrease overall size and weight of FST instrument sets without decreasing surgical capability of the GHOST-T. Each instrument set was evaluated and modified to include essential instruments to perform damage control surgery. The overall number of main instrument sets was decreased from eight to four; simplified augmentation sets have been added, which expand the capabilities of any main set. The overall size was decreased by 40% and overall weight decreased by 58%. The cardiothoracic, thoracotomy, and emergency thoracotomy trays were condensed to thoracic set. The orthopedic and amputation sets were replaced with an augmentation set of a prepackaged orthopedic external fixator set). An augmentation set to the major or minor basic sets, specifically for vascular injuries, was created. Through the reorganization of conventional FST surgical instrument sets to maintain damage control capabilities and mobility, the 102nd GHOST-T reduced surgical equipment volume and weight, providing a lesson learned for future surgical teams operating in austere environments. 2017.

  3. 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...

  4. Endotoxins in surgical instruments of hip arthroplasty

    Directory of Open Access Journals (Sweden)

    Vania Regina Goveia

    2016-06-01

    Full Text Available 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 surgical instruments, which were tested for endotoxins in three different stages. The EndosafeTM Gel-Clot LAL (Limulus Amebocyte Lysate method was used. RESULT There was consistent gel formation with positive analysis in eight instruments, corresponding to 13.3%, being four femoral rasps and four bone reamers. CONCLUSION Endotoxins in quantity ≥0.125 UE/mL were detected in 13.3% of the instruments tested.

  5. 21 CFR 870.4500 - Cardiovascular surgical instruments.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Cardiovascular surgical instruments. 870.4500 Section 870.4500 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... surgical instruments. (a) Identification. Cardiovascular surgical instruments are surgical instruments that...

  6. Recent technological advancements in laparoscopic surgical instruments

    Science.gov (United States)

    Subido, Edwin D. C.; Pacis, Danica Mitch M.; Bugtai, Nilo T.

    2018-02-01

    Laparoscopy was a progressive step to advancing surgical procedures as it minimised the scars left on the body after surgery, compared to traditional open surgery. Many years later, single-incision laparoscopic surgery (SILS) was created where, instead of having multiple incisions, only one incision is made or multiple small incisions in one location. SILS, or laparoendoscopic single-site surgery (LESS), may produce lesser scars but drawbacks for the surgeons are still present. This paper aims to present related literature of the recent technological developments in laparoscopic tools and procedure particularly in the vision system, handheld instruments. Tech advances in LESS will also be shown. Furthermore, this review intends to give an update on what has been going on in the surgical robot market and state which companies are interested and are developing robotic systems for commercial use to challenge Intuitive Surgical's da Vinci Surgical System that currently dominates the market.

  7. 21 CFR 888.4540 - Orthopedic manual surgical instrument.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Orthopedic manual surgical instrument. 888.4540... (CONTINUED) MEDICAL DEVICES ORTHOPEDIC DEVICES Surgical Devices § 888.4540 Orthopedic manual surgical instrument. (a) Identification. An orthopedic manual surgical instrument is a nonpowered hand-held device...

  8. [History of surgical instruments. 9. Surgical instruments and development of surgical technique of lithotomy incision].

    Science.gov (United States)

    Sachs, M; Peters, J

    1999-01-01

    Lithotomy, i.e. the surgical method of cutting for stone in the bladder, belongs to the oldest and, due to the high risk, most notorious operating techniques. Records of stone-cuttings date as far back as Ancient Greece. The first detailed description of the procedure and instrumentation of lithotomy is to be found by Celsus (1. century AD). The patient in the lithotomy position, the neck of the bladder is approached by a median incision of the perineum. Celsus is also the first to mention special stone-hooking instruments ("uncus") to aid in extracting the bladder-stones. Medico-historical development lead to constant changes in the technique as well as in the instrumentation, since the lack of analgesia and anaesthesia necessitated quick operations of only a few minutes. A key step in the progress of operation was the introduction of so-called path-finders and directing probes in the 16th century. The opening of the bladder from the perineal incision was now accompanied by the simultaneous admission of a metal catheter into the bladder via urethra, thus providing the "Lithotomist", through manual control of the catheter, with an enhanced orientation towards the position of urethra and bladder. At that time, the dissection was conducted bluntly and without direct view of the situation, i.e. without an exact representation of the structures to be separated. Thanks to the improved instrumentation, the instruments could now be guided along a probe directly into the bladder, thus alleviating the tedious search for the opening after changing instruments, all the while with an agitated, pressing patient. Famous names in the development of the lithotomy with an perineal incision are the medical doctor Mariano Santo (around 1488-1564), the barber-surgeon Frère Jacques de Beaulieu (1651-1719) and later Johann Jakob Rau M.D. (1668-1719). Only later, to avoid injury to the perineum, the suprasymphyseal approach ("Sectio alta") was adopted (primarily by Pierre Franco 1556

  9. Endotoxins in surgical instruments of hip arthroplasty.

    Science.gov (United States)

    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

    To investigate endotoxins in sterilized surgical instruments used in hip arthroplasties. 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 surgical instruments, which were tested for endotoxins in three different stages. The EndosafeTM Gel-Clot LAL (Limulus Amebocyte Lysate method) was used. There was consistent gel formation with positive analysis in eight instruments, corresponding to 13.3%, being four femoral rasps and four bone reamers. Endotoxins in quantity ≥0.125 UE/mL were detected in 13.3% of the instruments tested. Investigar endotoxinas em instrumentais cirúrgicos esterilizados empregados em artroplastias do quadril. Estudo exploratório, descritivo, desenvolvido em um hospital público de ensino. Foram selecionados seis tipos de instrumentais, a saber: raspa acetabular, raspa femural, saca-cabeça de fêmur, formão box, fresa de fêmur e cabeça de prova de fêmur. A seleção foi feita a partir da análise da dificuldade para a remoção de resíduos de sangue e osso durante a limpeza. A amostra foi constituída por 60 instrumentais cirúrgicos, que foram testados para endotoxinas em três momentos distintos. Foi utilizado o método de gel-clot pelo Limulus Amebócito Lisado (LAL) Endosafe(tm). Houve formação de gel consistente com análise positiva em oito instrumentais, o que corresponde a 13,3%, sendo quatro raspas de fêmur e quatro fresas de fêmur. Foram detectadas endotoxinas em quantidade ≥0,125 UE/mL em 13,3% dos instrumentais testados.

  10. Surgical instrument similarity metrics and tray analysis for multi-sensor instrument identification

    Science.gov (United States)

    Glaser, Bernhard; Schellenberg, Tobias; Franke, Stefan; Dänzer, Stefan; Neumuth, Thomas

    2015-03-01

    A robust identification of the instrument currently used by the surgeon is crucial for the automatic modeling and analysis of surgical procedures. Various approaches for intra-operative surgical instrument identification have been presented, mostly based on radio-frequency identification (RFID) or endoscopic video analysis. A novel approach is to identify the instruments on the instrument table of the scrub nurse with a combination of video and weight information. In a previous article, we successfully followed this approach and applied it to multiple instances of an ear, nose and throat (ENT) procedure and the surgical tray used therein. In this article, we present a metric for the suitability of the instruments of a surgical tray for identification by video and weight analysis and apply it to twelve trays of four different surgical domains (abdominal surgery, neurosurgery, orthopedics and urology). The used trays were digitized at the central sterile services department of the hospital. The results illustrate that surgical trays differ in their suitability for the approach. In general, additional weight information can significantly contribute to the successful identification of surgical instruments. Additionally, for ten different surgical instruments, ten exemplars of each instrument were tested for their weight differences. The samples indicate high weight variability in instruments with identical brand and model number. The results present a new metric for approaches aiming towards intra-operative surgical instrument detection and imply consequences for algorithms exploiting video and weight information for identification purposes.

  11. Minimizing electromagnetic interference from surgical instruments on electromagnetic surgical navigation.

    Science.gov (United States)

    Stevens, Faustin; Conditt, Michael A; Kulkarni, Nikhil; Ismaily, Sabir K; Noble, Philip C; Lionberger, David R

    2010-08-01

    Electromagnetic computer-assisted surgery (EM-CAS) can be affected by various metallic or ferromagnetic factors. We determined to what extent metals interfere with accuracy and identified measures to prevent interference from occurring. Using an EM-CAS system, we made six standard measurements of tibiofemoral position and alignment on a surrogate knee. A stainless steel mallet was positioned 10 cm from the stylus, and then 10 cm from the localizer to create errors attributable to electromagnetic interference. The experiment was repeated with bars of different metals placed 10 cm from the stylus. The maximum errors recorded with a mallet were: varus/valgus alignment, -2.7 degrees and 2.4 degrees; flexion/extension, -5.8 degrees and 3.0 degrees; lateral resection level, -3.1 and 7.5 mm; and medial resection level, -4.0 and 2.3 mm, respectively. The smallest errors were recorded with cylinders of titanium, cobalt-chrome alloy, and stainless steels. When moved more than 10 cm away from the stylus, errors became negligible. The accuracy of EM navigation systems is affected substantially by the size, type, proximity, and shape of metal objects. Stainless steel objects, such as cutting blocks and trial prostheses, should be kept more than 10 cm from EM-CAS instruments to minimize error.

  12. Planck 2015 results: VIII. High Frequency Instrument data processing: Calibration and maps

    DEFF Research Database (Denmark)

    Adam, R.; Ade, P. A R; Aghanim, N.

    2016-01-01

    This paper describes the processing applied to the cleaned, time-ordered information obtained from the Planck High Frequency Instrument (HFI) with the aim of producing photometrically calibrated maps in temperature and (for the first time) in polarization. The data from the entire 2.5-year HFI....... Finally, we discuss the major systematic effects and in particular the leakage induced by flux mismatch between the detectors that leads to spurious polarization signal....

  13. Evaluation of Sensor Configurations for Robotic Surgical Instruments

    Science.gov (United States)

    Gómez-de-Gabriel, Jesús M.; Harwin, William

    2015-01-01

    Designing surgical instruments for robotic-assisted minimally-invasive surgery (RAMIS) is challenging due to constraints on the number and type of sensors imposed by considerations such as space or the need for sterilization. A new method for evaluating the usability of virtual teleoperated surgical instruments based on virtual sensors is presented. This method uses virtual prototyping of the surgical instrument with a dual physical interaction, which allows testing of different sensor configurations in a real environment. Moreover, the proposed approach has been applied to the evaluation of prototypes of a two-finger grasper for lump detection by remote pinching. In this example, the usability of a set of five different sensor configurations, with a different number of force sensors, is evaluated in terms of quantitative and qualitative measures in clinical experiments with 23 volunteers. As a result, the smallest number of force sensors needed in the surgical instrument that ensures the usability of the device can be determined. The details of the experimental setup are also included. PMID:26516863

  14. Planck 2015 results. VIII. High Frequency Instrument data processing: Calibration and maps

    CERN Document Server

    Adam, R.; Aghanim, N.; Arnaud, M.; Ashdown, M.; Aumont, J.; Baccigalupi, C.; Banday, A.J.; Barreiro, R.B.; Bartolo, N.; Battaner, E.; Benabed, K.; Benoît, A.; Benoit-Lévy, A.; Bernard, J.-P.; Bersanelli, M.; Bertincourt, B.; Bielewicz, P.; Bock, J.J.; Bonavera, L.; Bond, J.R.; Borrill, J.; Bouchet, F.R.; Boulanger, F.; Bucher, M.; Burigana, C.; Calabrese, E.; Cardoso, J.-F.; Catalano, A.; Challinor, A.; Chamballu, A.; Chiang, H.C.; Christensen, P.R.; Clements, D.L.; Colombi, S.; Colombo, L.P.L.; Combet, C.; Couchot, F.; Coulais, A.; Crill, B.P.; Curto, A.; Cuttaia, F.; Danese, L.; Davies, R.D.; Davis, R.J.; de Bernardis, P.; de Rosa, A.; de Zotti, G.; Delabrouille, J.; Delouis, J.-M.; Désert, F.-X.; Diego, J.M.; Dole, H.; Donzelli, S.; Doré, O.; Douspis, M.; Ducout, A.; Dupac, X.; Efstathiou, G.; Elsner, F.; Enßlin, T.A.; Eriksen, H.K.; Falgarone, E.; Fergusson, J.; Finelli, F.; Forni, O.; Frailis, M.; Fraisse, A.A.; Franceschi, E.; Frejsel, A.; Galeotta, S.; Galli, S.; Ganga, K.; Ghosh, T.; Giard, M.; Giraud-Héraud, Y.; Gjerløw, E.; González-Nuevo, J.; Górski, K.M.; Gratton, S.; Gruppuso, A.; Gudmundsson, J.E.; Hansen, F.K.; Hanson, D.; Harrison, D.L.; Henrot-Versillé, S.; Herranz, D.; Hildebrandt, S.R.; Hivon, E.; Hobson, M.; Holmes, W.A.; Hornstrup, A.; Hovest, W.; Huffenberger, K.M.; Hurier, G.; Jaffe, A.H.; Jaffe, T.R.; Jones, W.C.; Juvela, M.; Keihänen, E.; Keskitalo, R.; Kisner, T.S.; Kneissl, R.; Knoche, J.; Kunz, M.; Kurki-Suonio, H.; Lagache, G.; Lamarre, J.-M.; Lasenby, A.; Lattanzi, M.; Lawrence, C.R.; Le Jeune, M.; Leahy, J.P.; Lellouch, E.; Leonardi, R.; Lesgourgues, J.; Levrier, F.; Liguori, M.; Lilje, P.B.; Linden-Vørnle, M.; López-Caniego, M.; Lubin, P.M.; Macías-Pérez, J.F.; Maggio, G.; Maino, D.; Mandolesi, N.; Mangilli, A.; Maris, M.; Martin, P.G.; Martínez-González, E.; Masi, S.; Matarrese, S.; McGehee, P.; Melchiorri, A.; Mendes, L.; Mennella, A.; Migliaccio, M.; Mitra, S.; Miville-Deschênes, M.-A.; Moneti, A.; Montier, L.; Moreno, R.; Morgante, G.; Mortlock, D.; Moss, A.; Mottet, S.; Munshi, D.; Murphy, J.A.; Naselsky, P.; Nati, F.; Natoli, P.; Netterfield, C.B.; Nørgaard-Nielsen, H.U.; Noviello, F.; Novikov, D.; Novikov, I.; Oxborrow, C.A.; Paci, F.; Pagano, L.; Pajot, F.; Paoletti, D.; Pasian, F.; Patanchon, G.; Pearson, T.J.; Perdereau, O.; Perotto, L.; Perrotta, F.; Pettorino, V.; Piacentini, F.; Piat, M.; Pierpaoli, E.; Pietrobon, D.; Plaszczynski, S.; Pointecouteau, E.; Polenta, G.; Pratt, G.W.; Prézeau, G.; Prunet, S.; Puget, J.-L.; Rachen, J.P.; Reinecke, M.; Remazeilles, M.; Renault, C.; Renzi, A.; Ristorcelli, I.; Rocha, G.; Rosset, C.; Rossetti, M.; Roudier, G.; Rusholme, B.; Sandri, M.; Santos, D.; Sauvé, A.; Savelainen, M.; Savini, G.; Scott, D.; Seiffert, M.D.; Shellard, E.P.S.; Spencer, L.D.; Stolyarov, V.; Stompor, R.; Sudiwala, R.; Sutton, D.; Suur-Uski, A.-S.; Sygnet, J.-F.; Tauber, J.A.; Terenzi, L.; Toffolatti, L.; Tomasi, M.; Tucci, M.; Tuovinen, J.; Valenziano, L.; Valiviita, J.; Van Tent, B.; Vibert, L.; Vielva, P.; Villa, F.; Wade, L.A.; Wandelt, B.D.; Watson, R.; Wehus, I.K.; Yvon, D.; Zacchei, A.

    2016-01-01

    This paper describes the processing applied to the Planck High Frequency Instrument (HFI) cleaned, time-ordered information to produce photometrically calibrated maps in temperature and (for the first time) in polarization. The data from the 2.5 year full mission include almost five independent full-sky surveys. HFI observes the sky over a broad range of frequencies, from 100 to 857 GHz. To get the best accuracy on the calibration over such a large range, two different photometric calibration schemes have been used. The 545 and 857 GHz data are calibrated using models of planetary atmospheric emission. The lower frequencies (from 100 to 353 GHz) are calibrated using the time-variable cosmological microwave background dipole which we call the orbital dipole. This source of calibration only depends on the satellite velocity with respect to the solar system and permits an independent measurement of the amplitude of the CMB solar dipole (3364.5 +/- 0.8 \\mu K) which is 1\\sigma\\ higher than the WMAP measurement wit...

  15. Left-handed surgical instruments - a guide for cardiac surgeons.

    Science.gov (United States)

    Burdett, Clare; Theakston, Maureen; Dunning, Joel; Goodwin, Andrew; Kendall, Simon William Henry

    2016-08-19

    For ease of use and to aid precision, left-handed instruments are invaluable to the left-handed surgeon. Although they exist, they are not available in many surgical centres. As a result, most operating theatre staff (including many left-handers) have little knowledge of their value or even application. With specific reference to cardiac surgery, this article addresses the ways in which they differ, why they are needed and what is required - with tips on use.

  16. Surgical site infections following instrumented stabilization of the spine

    Directory of Open Access Journals (Sweden)

    Dapunt U

    2017-09-01

    Full Text Available Ulrike Dapunt,1 Caroline Bürkle,1 Frank Günther,2 Wojciech Pepke,1 Stefan Hemmer,1 Michael Akbar1 1Clinic for Orthopedics and Trauma Surgery, Center for Orthopedics, Trauma Surgery and Spinal Cord Injury, Heidelberg University Hospital, 2Department for Infectious Diseases, Medical Microbiology and Hygiene, Heidelberg University, Heidelberg, Germany Background: Implant-associated infections are still a feared complication in the field of orthopedics. Bacteria attach to the implant surface and form so-called biofilm colonies that are often difficult to diagnose and treat. Since the majority of studies focus on prosthetic joint infections (PJIs of the hip and knee, current treatment options (eg, antibiotic prophylaxis of implant-associated infections have mostly been adapted according to these results. Objective: The aim of this study was to evaluate patients with surgical site infections following instrumented stabilization of the spine with regard to detected bacteria species and the course of the disease. Patients and methods: We performed a retrospective single-center analysis of implant-associated infections of the spine from 2010 to 2014. A total of 138 patients were included in the study. The following parameters were evaluated: C-reactive protein serum concentration, microbiological evaluation of tissue samples, the time course of the disease, indication for instrumented stabilization of the spine, localization of the infection, and the number of revision surgeries required until cessation of symptoms. Results: Coagulase-negative Staphylococcus spp. were most commonly detected (n=69, 50%, followed by fecal bacteria (n=46, 33.3%. In 23.2% of cases, no bacteria were detected despite clinical suspicion of an infection. Most patients suffered from degenerative spine disorders (44.9%, followed by spinal fractures (23.9%, non-degenerative scoliosis (20.3%, and spinal tumors (10.1%. Surgical site infections occurred predominantly within 3

  17. Femoral Test Bed for Impedance Controlled Surgical Instrumentation

    Directory of Open Access Journals (Sweden)

    Christian Brendle

    2012-01-01

    Full Text Available The risk for patients during the standard procedure of revision of cemented artificial hip joints is unsatisfactorily highdue to its high level of invasiveness and limited access to the operative field. To reduce this risk we are developing anImpedance Controlled Surgical Instrumentation (ICOS system, which aims to establish real-time control during a BoneCement (BC milling process. For this, the relationship between the thickness of the BC and its frequency-dependentelectrical impedance is used to estimate the residual BC thickness. The aim is to avoid unintended cutting of boneby detecting the passage of the BC/bone boundary layer by the milling head. In a second step, an estimation of theresidual BC thickness will be used to improve process control. As a first step towards demonstrating the feasibility ofour approach, presented here are experimental studies to characterize the BC permittivity and to describe the process indetail. The results show that the permittivity properties of BC are dominated by its polymethyl methacrylate (PMMAfraction. Thus, PMMA can be used as a substitute for future experiments. Furthermore, a Femoral Test Bed (FTB wasdesigned. Using this setup we show it is feasible to accurately distinguish between slightly different thicknesses of BC.

  18. Applying lean methods to improve quality and safety in surgical sterile instrument processing.

    Science.gov (United States)

    Blackmore, C Craig; Bishop, Robbi; Luker, Samuel; Williams, Barbara L

    2013-03-01

    Surgical instrument processing is critical to safe, high-quality surgical care but has received little attention in the medical literature. Typical hospitals have inventories in the tens of thousands of surgical instruments organized into thousands of instrument sets. The use of these instruments for multiple procedures per day leads to millions of instrument sets being reprocessed yearly in a single hospital. Errors in the processing of sterile instruments may lead to increased operative times and costs, as well as potentially contributing to surgical infections and perioperative morbidity. At Virginia Mason Medical Center (Seattle), a quality monitoring approach was developed to identify and categorize errors in sterile instrument processing, through use of a daily defect sheet. Lean methods were used to improve the quality of surgical instrument processing through redefining operator roles, alteration of the workspace, mistake-proofing, quality monitoring, staff training, and continuous feedback. To study the effectiveness of the quality improvement project, a before/after comparison of prospectively collected sterile processing error rates during a 37-month time frame was performed. Before the intervention, instrument processing errors occurred in 3.0% of surgical cases, decreasing to 1.5% at the final follow-up (p instrument processing errors are a barrier to the highest quality and safety in surgical care but are amenable to substantial improvement using Lean techniques.

  19. Computational modeling and design of a new open clip surgical instrument.

    Science.gov (United States)

    Li, Jeremy Zheng

    2009-08-01

    This research introduces a new surgical clip instrument with improved mechanism to apply the metal clips to patient's vessel/tissues in the surgical operations. The improved clip delivery system has been designed and developed in the instrument to improve the clip distal move from clip channel into jaw guide track and resolve the problems of clip accidental shooting out when clip is being loaded into jaw pair by compression spring that has been normally used in some current surgical clip instruments. With this improvement, this new surgical open clip instrument can prevent patient's vessels and tissues from being damaging because the distal move of clips is well controlled without clip drop-off incident. Plus the operational force to form the clip is lower than regular surgical instruments due to new mechanism design. In addition to the above, the manufacturing and product cost can be decreased because the dimensional tolerance of components, such as clip channel and jaw guide track, can be wider due to this new instrument design. The prototype of this new instrument is analyzed and optimized through computer aided modeling and simulation, in order to prove its feasible function, reliable performance, and mechanical advantage. All these improved features have also been tested and verified through the prototype. With some further improvement to this new instrument design and valuable evaluations from surgeon and clinical fields in next several months, the commercial availability of this surgical clip instrument will be anticipate in 1-2 years.

  20. Research on seamless development of surgical instruments based on biological mechanisms using CAD and 3D printer.

    Science.gov (United States)

    Yamamoto, Ikuo; Ota, Ren; Zhu, Rui; Lawn, Murray; Ishimatsu, Takakazu; Nagayasu, Takeshi; Yamasaki, Naoya; Takagi, Katsunori; Koji, Takehiko

    2015-01-01

    In the area of manufacturing surgical instruments, the ability to rapidly design, prototype and test surgical instruments is critical. This paper provides a simple case study of the rapid development of two bio-mechanism based surgical instruments which are ergonomic, aesthetic and were successfully designed, prototyped and conceptually tested in a very short period of time.

  1. Medical Devices; General and Plastic Surgery Devices; Classification of the Magnetic Surgical Instrument System. Final order.

    Science.gov (United States)

    2016-09-21

    The Food and Drug Administration (FDA) is classifying the Magnetic Surgical Instrument System into class II (special controls). The special controls that will apply to the device are identified in this order and will be part of the codified language for the magnetic surgical instrument system's classification. The Agency is classifying the device into class II (special controls) in order to provide a reasonable assurance of safety and effectiveness of the device.

  2. Influence of usage history, instrument complexity, and different cleaning procedures on the cleanliness of blood-contaminated dental surgical instruments

    NARCIS (Netherlands)

    Wu, G.; Yu, X.F.

    2009-01-01

    Our study assessed the factors that influence the resistance of blood residues on dental surgical instruments to washer‐disinfector-based cleaning procedures in a clinical setting. The use of 2 additional cleaning methods—presoaking and scrubbing by hand—and the use of newer and/or less structurally

  3. An Instrumented Minimally Invasive Surgical Tool: Design and Calibration

    Directory of Open Access Journals (Sweden)

    Philip R. Roan

    2011-01-01

    Full Text Available Minimally invasive surgical procedures have improved the standard of patient care by reducing recovery time, chance of infection, and scarring. A recent review estimates that leaks occur in 3% to 6% of bowel anastomoses, resulting in “increased morbidity and mortality and adversely [affecting] length of stay, cost, and cancer recurrence” [23]. Many of these leaks are caused by poor handling and ischemic tissue.

  4. Patient Participation in Surgical Treatment Decision Making from the Patients' Perspective: Validation of an Instrument

    Directory of Open Access Journals (Sweden)

    Liv-Helen Heggland

    2012-01-01

    Full Text Available The aim of this paper is to describe the development of a new, brief, easy-to-administer self-reported instrument designed to assess patient participation in decision making in surgical treatment. We describe item generation, psychometric testing, and validity of the instrument. The final scale consisted of four factors: information dissemination (5 items, formulation of options (4 items, integration of information (4 items, and control (3 items. The analysis demonstrated a reasonable level of construct validity and reliability. The instrument applies to patients in surgical wards and can be used to identify the health services that are being provided and the areas that could strengthen patient participation.

  5. Surgical Site Infection Following Posterior Instrumented Surgery for Thoracolumbar Burst Fractures

    Directory of Open Access Journals (Sweden)

    A Zulkefli

    2009-11-01

    Full Text Available OBJECTIVES: To study the prevalence and the risk factors for surgical site infection in patients who underwent posterior instrumented surgery for thoracolumbar burst fractures. METHODOLOGY: Retrospective review of cases operated between year 2006 and 2007. The final end point is the detection of surgical site infection within one year. RESULTS: A total of 38 cases were reviewed. Surgical site infection occurred in 5 cases. Only one had deep infection. The onset of infection occurred within one month in all cases. The risk factors studied were smoking, timing of surgery, duration of surgery, neurological deficit, associated injuries and high dose methylprednisolone administration. None of them were statistically significant as risk factors for surgical site infection. CONCLUSION: The prevalence of surgical site infection in patients who underwent posterior instrumented surgery for thoracolumbar burst fractures was 13%.

  6. Identification of surgical instruments using UHF-RFID technology

    Directory of Open Access Journals (Sweden)

    Bourouah Mohamed

    2015-09-01

    Full Text Available The paper presents research, development and advantage of Radio Frequency IDentification (RFID technology based system for medical instrument management and safe usage. The system is developed for two scenarios. In the first scenario, a Ultra High Frequency (UHF is used and the UHF–interrogator system with UHF-antennas is constructed to work as conveyor-belt and instruments are placed between two antennas. Second scenario, suitable for the operating rooms, includes four antennas, placed under the table with instruments, system’s phase shifter, inserted between the antenna and reader in order to reduce the effect of dead spots, caused by the electromagnetic reflections. High reliable identification rate is achieved by synchronizing phase shifters with particular interrogator. The system is software calibrated and can be re-calibrated at run-time to achieve high efficiency of power transmission to the antenna and in order to enable the receiver to decode the tag signals. With currently on the market available RFID tags and previously mentioned technology approaches, detection rate of 87.5% can be achieved.

  7. Factors determining the potential for onward transmission of variant Creutzfeldt–Jakob disease via surgical instruments

    Science.gov (United States)

    Garske, Tini; Ward, Hester J.T; Clarke, Paul; Will, Robert G; Ghani, Azra C

    2006-01-01

    While the number of variant Creutzfeldt–Jakob disease (vCJD) cases continues to decline, concern has been raised that transmission could occur directly from one person to another through routes including the transfer of blood and shared use of surgical instruments. Here we firstly present data on the surgical procedures undertaken on vCJD patients prior to onset of clinical symptoms, which supports the hypothesis that cases via this route are possible. We then apply a mathematical framework to assess the potential for self-sustaining epidemics via surgical procedures. Data from hospital episode statistics on the rates of high- and medium-risk procedures in the UK were used to estimate model parameters, and sensitivity to other unknown parameters about surgically transmitted vCJD was assessed. Our results demonstrate that a key uncertainty determining the scale of an epidemic and whether it is self-sustaining is the number of times a single instrument is re-used, alongside the infectivity of contaminated instruments and the effectiveness of cleaning. A survey into the frequency of re-use of surgical instruments would help reduce these uncertainties. PMID:17015298

  8. A Historical Glance at the Arabo-Islamic Surgical Instruments During the Ages.

    Science.gov (United States)

    Tsoucalas, Gregory; Sgantzos, Markos

    2017-06-01

    Arabo-Islamic physicians demonstrated exceptional skill and innovation in surgery, by having used the instruments introduced by ancient Greeks and Greco-Roman surgeons. In many cases they have manufactured their own innovative designs promoting further the success of the difficult surgical operations of their era. The surgical instruments and the surgeon's boxes, used to regularise the plethora of the metallic items, were decorated with fine designs, in order to depict the Arab civilisation. For the first time surgery became a separate medical art, while Arabo-Islamic medicine re-introduced ancient Greek and Byzantine surgery to the world.

  9. Validation of cleaning evaluation of surgical instruments with RFID tags attached based on cleaning appraisal judgment guidelines.

    Science.gov (United States)

    Yamashita, Kazuhiko; Kusuda, Kaori; Tokuda, Yoko; Onishi, Akiko; Tanaka, Kiyohito; Shimizu, Masatake; Kanda, Ryohei; Honda, Hiroshi; Komino, Masaru; Iwakami, Yumi; Ohta, Yuji; Okubo, Takashi

    2013-01-01

    In medical institutions, the threat of infection is closely focused, in particular, inspections regarding surgical site infections (SSI) are carried out. In this study, development of the application of Radio frequency identification (RFID) tags for surgical instrument has been promoted. It enables traceability and individual management of surgical instruments. An experiment was carried out following the cleaning Appraisal guidelines, which contaminated surgical instruments, and using the washer-disinfector (WD) as the main cleaner for surgical instruments with developed RFID tags attached to them. As a result, all of the instruments with RFID tags, the amount of residual protein was less than the recommended acceptable level of 100µg. If WD is used correctly, a sufficient cleaning effect can be expected. From this result, it became evident that the secondary infection risk is low from surgical instrument with RFID tags attached.

  10. Development and validation of an objective instrument to measure surgical performance at tonsillectomy.

    Science.gov (United States)

    Roberson, David W; Kentala, Erna; Forbes, Peter

    2005-12-01

    The goals of this project were 1) to develop and validate an objective instrument to measure surgical performance at tonsillectomy, 2) to assess its interobserver and interobservation reliability and construct validity, and 3) to select those items with best reliability and most independent information to design a simplified form suitable for routine use in otolaryngology surgical evaluation. Prospective, observational data collection for an educational quality improvement project. The evaluation instrument was based on previous instruments developed in general surgery with input from attending otolaryngologic surgeons and experts in medical education. It was pilot tested and subjected to iterative improvements. After the instrument was finalized, a total of 55 tonsillectomies were observed and scored during academic year 2002 to 2003: 45 cases by residents at different points during their rotation, 5 by fellows, and 5 by faculty. Results were assessed for interobserver reliability, interobservation reliability, and construct validity. Factor analysis was used to identify items with independent information. Interobserver and interobservation reliability was high. On technical items, faculty substantially outperformed fellows, who in turn outperformed residents (P reliability and good construct validity. Factor analysis demonstrated that patient care is a distinct domain in surgical skill. Although the interobserver reliability for some patient care items reached statistical significance, it was not high enough for "high stakes testing" purposes. Using reliability and factor analysis results, we propose a simplified instrument for use in evaluating trainees in otolaryngologic surgery.

  11. Cost Savings of Standardization of Thoracic Surgical Instruments: The Process of Lean.

    Science.gov (United States)

    Cichos, Kyle H; Linsky, Paul L; Wei, Benjamin; Minnich, Douglas J; Cerfolio, Robert J

    2017-12-01

    Our objective is to show the effect that standardization of surgical trays has on the number of instruments sterilized and on cost. We reviewed our most commonly used surgical trays with the 3 general thoracic surgeons in our division and agreed upon the least number of surgical instruments needed for mediastinoscopy, video-assisted thoracoscopic surgery, robotic thoracic surgery, and thoracotomy. We removed 59 of 79 instruments (75%) from the mediastinoscopy tray, 45 of 73 (62%) from the video-assisted thoracoscopic surgery tray, 51 of 84 (61%) from the robotic tray, and 50 of 113 (44%) from the thoracotomy tray. From January 2016 to December 2016, the estimated savings by procedure were video-assisted thoracoscopic surgery (n = 398) $21,890, robotic tray (n = 231) $19,400, thoracotomy (n = 163) $15,648, and mediastinoscopy (n = 162) $12,474. Estimated total savings were $69,412. The weight of the trays was reduced 70%, and the nonsteamed sterilization rate (opened trays that needed to be reprocessed) decreased from 2% to 0%. None of the surgeons requested any of the removed instruments. Standardization of thoracic surgical trays is possible despite having multiple thoracic surgeons. This process of lean (the removal of nonvalue steps or equipment) reduces the number of instruments cleaned and carried and reduces cost. It may also reduce the incidence of "wet loads" that require the resterilization of instruments. Copyright © 2017 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  12. Reduction and standardization of surgical instruments in pediatric inguinal hernia repair.

    Science.gov (United States)

    Koyle, Martin A; AlQarni, Naif; Odeh, Rakan; Butt, Hissan; Alkahtani, Mohammed M; Konstant, Louis; Pendergast, Lisa; Koyle, Leah C C; Baker, G Ross

    2018-02-01

    To standardize and reduce surgical instrumentation by >25% within a 9-month period for pediatric inguinal hernia repair (PIHR), using "improvement science" methodology. We prospectively evaluated instruments used for PIHR in 56 consecutive cases by individual surgeons across two separate subspecialties, pediatric surgery (S) and pediatric urology (U), to measure actual number of instruments used compared with existing practice based on preference cards. Based on this evaluation, a single preference card was developed using only instruments that had been used in >50% of all cases. A subsequent series of 52 cases was analyzed to assess whether the new tray contained the ideal instrumentation. Cycle time (CT), to sterilize and package the instruments, and weights of the trays were measured before and after the intervention. A survey of operating room (OR) nurses and U and S surgeons was conducted before and after the introduction of the standardized tray to assess the impact and perception of standardization. Prior to creating the standardized tray, a U PIHR tray contained 96 instruments with a weight of 13.5 lbs, while the S set contained 51, weighing 11.2 lbs. The final standardized set comprised 28 instruments and weighed 7.8 lbs. Of 52 PIHRs performed after standardization, in three (6%) instances additional instruments were requested. CT was reduced from 11 to 8 min (U and S respectively) to instrumentation for other common surgeries. Standardization of surgical equipment can be employed across disciplines with the potential to reduce costs and positively impact quality, safety, and efficiencies. Copyright © 2017 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

  13. Analysis of surgical smoke produced by various energy-based instruments and effect on laparoscopic visibility.

    Science.gov (United States)

    Weld, Kyle J; Dryer, Stephen; Ames, Caroline D; Cho, Kuk; Hogan, Chris; Lee, Myonghwa; Biswas, Pratim; Landman, Jaime

    2007-03-01

    We analyzed the smoke plume produced by various energy-based laparoscopic instruments and determined its effect on laparoscopic visibility. The Bipolar Macroforceps, Harmonic Scalpel, Floating Ball, and Monopolar Shears were applied in vitro to porcine psoas muscle. An Aerodynamic Particle Sizer and Electrostatic Classifier provided a size distribution of the plume for particles >500 nm and Visibility was calculated using the measured-size distribution data and the Rayleigh and Mie light-scattering theories. The real-time instruments were successful in measuring aerosolized particle size distributions in two size ranges. Electron microscopy revealed smaller, homogeneous, spherical particles and larger, irregular particles consistent with cellular components. The aerosol produced by the Bipolar Macroforceps obscured visibility the least (relative visibility 0.887) among the instruments tested. Particles from the Harmonic Scalpel resulted in a relative visibility of 0.801. Monopolar-based instruments produced plumes responsible for the poorest relative visibility (Floating Ball 0.252; Monopolar Shears 0.026). Surgical smoke is composed of two distinct particle populations caused by the nucleation of vapors as they cool (the small particles) and the entrainment of tissue secondary to mechanical aspects (the large particles). High concentrations of small particles are most responsible for the deterioration in laparoscopic vision. Bipolar and ultrasonic instruments generate a surgical plume that causes the least deterioration of visibility among the instruments tested.

  14. 3D printing of surgical instruments for long-duration space missions.

    Science.gov (United States)

    Wong, Julielynn Y; Pfahnl, Andreas C

    2014-07-01

    The first off-Earth fused deposition modeling (FDM) 3D printer will explore thermoplastic manufacturing capabilities in microgravity. This study evaluated the feasibility of FDM 3D printing 10 acrylonitrile butadiene styrene (ABS) thermoplastic surgical instruments on Earth. Three-point bending tests compared stiffness and yield strength between FDM 3D printed and conventionally manufactured ABS thermoplastic. To evaluate the relative speed of using four printed instruments compared to conventional instruments, 13 surgeons completed simulated prepping, draping, incising, and suturing tasks. Each surgeon ranked the performance of six printed instruments using a 5-point Likert scale. At a thickness of 5.75 mm or more, the FDM printing process had a less than 10% detrimental effect on the tested yield strength and stiffness of horizontally printed ABS thermoplastic relative to conventional ABS thermoplastic. Significant weakness was observed when a bending load was applied transversely to a 3D printed layer. All timed tasks were successfully performed using a printed sponge stick, towel clamp, scalpel handle, and toothed forceps. There was no substantial difference in time to completion of simulated surgical tasks with control vs. 3D printed instruments. Of the surgeons, 100%, 92%, 85%, 77%, 77%, and 69% agreed that the printed smooth and tissue forceps, curved and straight hemostats, tissue and right angle clamps, respectively, would perform adequately. It is feasible to 3D print ABS thermoplastic surgical instruments on Earth. Loadbearing structures were designed to be thicker, when possible. Printing orientations were selected so that the printing layering direction of critical structures would not be transverse to bending loads.

  15. Highly sensitive rapid fluorescence detection of protein residues on surgical instruments

    International Nuclear Information System (INIS)

    Kovalev, Valeri I; Bartona, James S; Richardson, Patricia R; Jones, Anita C

    2006-01-01

    There is a risk of contamination of surgical instruments by infectious protein residues, in particular, prions which are the agents for Creutzfeldt-Jakob Disease in humans. They are exceptionally resistant to conventional sterilization, therefore it is important to detect their presence as contaminants so that alternative cleaning procedures can be applied. We describe the development of an optimized detection system for fluorescently labelled protein, suitable for in-hospital use. We show that under optimum conditions the technique can detect ∼10 attomole/cm 2 with a scan speed of ∼3-10 cm 2 /s of the test instrument's surface. A theoretical analysis and experimental measurements will be discussed

  16. On using an array of fiber bragg grating sensors for closed-loop control of flexible minimally invasive surgical instruments

    NARCIS (Netherlands)

    Roesthuis, Roy; Janssen, Sander; Misra, Sarthak

    2013-01-01

    Flexible minimally invasive surgical instruments can be used to target difficult-to-reach locations within the human body. Accurately steering these instruments requires information about the three-dimensional shape of the instrument. In the current study, we use an array of Fiber Bragg Grating

  17. A novel 4-DOF surgical instrument with modular joints and 6-Axis Force sensing capability.

    Science.gov (United States)

    Li, Kun; Pan, Bo; Zhang, Fuhai; Gao, Wenpeng; Fu, Yili; Wang, Shuguo

    2017-03-01

    It is difficult for surgeons to exert appropriate forces during delicate operations due to lack of force feedback in robot-assisted minimally invasive surgery (RMIS). A 4-DOF surgical grasper with a modular wrist and 6-axis force sensing capability is developed. A grasper integrated with a miniature force and torque sensor based on the Stewart platform is designed, and a cable tension decomposition mechanism is designed to alleviate influence of the cable tension to the sensor. A modularized wrist consisting of four joint units is designed to facilitate integration of the sensor and eliminate coupled motion of the wrist. Sensing ranges of this instrument are ±10 N and ±160 N mm, and resolutions are 1.2% in radial directions, 5% in axial direction, and 4.2% in rotational directions. An ex vivo experiment shows that this instrument prototype successfully measures the interaction forces. A 4-DOF surgical instrument with modular joints and 6-axis force sensing capability is developed. This instrument can be used for force feedback in RMIS. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  18. A Clinical Trial of Contamination of Surgical Instruments with Staphylococcus aureus During Long Time Orthopedic Surgeries

    Directory of Open Access Journals (Sweden)

    Mojgan Pirmoradian

    2013-07-01

    Full Text Available Background and Objectives: Approximately 5% of patients undergoing surgery develop surgical site infections (SSI, which prolong the length of hospital stay to 9.7 days. This study was performed aimed to determine the amount of contamination of sterile surgical instruments with Staphylococcus aureus during long time orthopedic surgeries.Methods: In This study done as a prospective study, 245 sterile surgical instruments were sampled. The contaminated samples at every hour were excluded from samples of next hour. Then, antibiotic susceptibility of Staphylococcus aureus strains was tested by 14 antibiotics using disk diffusion method according to the recommendations of CLSI. The MIC of the strains towards methicillin was tested through microdilution method, and PCR was done on mecA gene. Data and results were analyzed by chi-square statistical test and significance level was considered to be p<0/05.Results: Out of a total of 110 specimens obtained immediately after opening the sterile covering, 5 cultures were positive (4.54%; 10 (10.98% in 91 samples taken after surgery; 5 (15.62% in 32 samples taken 2 hours after surgery; and 1 (8.33% 1 in 12 samples taken 3 hours after surgery. The highest resistance of the isolates was against ceftazidime (85.71%, and all strains were sensitive to vancomycin (100%. In MIC test, 52.38% of the strains were resistant to methicillin, and 66.66% of the strains had mecA gene in the PCR method.Conclusion: Considering high contamination rate of surgical instruments with S. aureus, it is recommended that the covering of the sterile trays should not be opened until they are specifically needed during the procedure.

  19. Surgical guides (patient-specific instruments) for pediatric tibial bone sarcoma resection and allograft reconstruction.

    Science.gov (United States)

    Bellanova, Laura; Paul, Laurent; Docquier, Pierre-Louis

    2013-01-01

    To achieve local control of malignant pediatric bone tumors and to provide satisfactory oncological results, adequate resection margins are mandatory. The local recurrence rate is directly related to inappropriate excision margins. The present study describes a method for decreasing the resection margin width and ensuring that the margins are adequate. This method was developed in the tibia, which is a common site for the most frequent primary bone sarcomas in children. Magnetic resonance imaging (MRI) and computerized tomography (CT) were used for preoperative planning to define the cutting planes for the tumors: each tumor was segmented on MRI, and the volume of the tumor was coregistered with CT. After preoperative planning, a surgical guide (patient-specific instrument) that was fitted to a unique position on the tibia was manufactured by rapid prototyping. A second instrument was manufactured to adjust the bone allograft to fit the resection gap accurately. Pathologic evaluation of the resected specimens showed tumor-free resection margins in all four cases. The technologies described in this paper may improve the surgical accuracy and patient safety in surgical oncology. In addition, these techniques may decrease operating time and allow for reconstruction with a well-matched allograft to obtain stable osteosynthesis.

  20. Surgical Guides (Patient-Specific Instruments for Pediatric Tibial Bone Sarcoma Resection and Allograft Reconstruction

    Directory of Open Access Journals (Sweden)

    Laura Bellanova

    2013-01-01

    Full Text Available To achieve local control of malignant pediatric bone tumors and to provide satisfactory oncological results, adequate resection margins are mandatory. The local recurrence rate is directly related to inappropriate excision margins. The present study describes a method for decreasing the resection margin width and ensuring that the margins are adequate. This method was developed in the tibia, which is a common site for the most frequent primary bone sarcomas in children. Magnetic resonance imaging (MRI and computerized tomography (CT were used for preoperative planning to define the cutting planes for the tumors: each tumor was segmented on MRI, and the volume of the tumor was coregistered with CT. After preoperative planning, a surgical guide (patient-specific instrument that was fitted to a unique position on the tibia was manufactured by rapid prototyping. A second instrument was manufactured to adjust the bone allograft to fit the resection gap accurately. Pathologic evaluation of the resected specimens showed tumor-free resection margins in all four cases. The technologies described in this paper may improve the surgical accuracy and patient safety in surgical oncology. In addition, these techniques may decrease operating time and allow for reconstruction with a well-matched allograft to obtain stable osteosynthesis.

  1. An integrated approach to endoscopic instrument tracking for augmented reality applications in surgical simulation training.

    Science.gov (United States)

    Loukas, Constantinos; Lahanas, Vasileios; Georgiou, Evangelos

    2013-12-01

    Despite the popular use of virtual and physical reality simulators in laparoscopic training, the educational potential of augmented reality (AR) has not received much attention. A major challenge is the robust tracking and three-dimensional (3D) pose estimation of the endoscopic instrument, which are essential for achieving interaction with the virtual world and for realistic rendering when the virtual scene is occluded by the instrument. In this paper we propose a method that addresses these issues, based solely on visual information obtained from the endoscopic camera. Two different tracking algorithms are combined for estimating the 3D pose of the surgical instrument with respect to the camera. The first tracker creates an adaptive model of a colour strip attached to the distal part of the tool (close to the tip). The second algorithm tracks the endoscopic shaft, using a combined Hough-Kalman approach. The 3D pose is estimated with perspective geometry, using appropriate measurements extracted by the two trackers. The method has been validated on several complex image sequences for its tracking efficiency, pose estimation accuracy and applicability in AR-based training. Using a standard endoscopic camera, the absolute average error of the tip position was 2.5 mm for working distances commonly found in laparoscopic training. The average error of the instrument's angle with respect to the camera plane was approximately 2°. The results are also supplemented by video segments of laparoscopic training tasks performed in a physical and an AR environment. The experiments yielded promising results regarding the potential of applying AR technologies for laparoscopic skills training, based on a computer vision framework. The issue of occlusion handling was adequately addressed. The estimated trajectory of the instruments may also be used for surgical gesture interpretation and assessment. Copyright © 2013 John Wiley & Sons, Ltd.

  2. Evaluation of the Unit Rod surgical instrumentation in Duchenne scoliosis. A retrospective study.

    Science.gov (United States)

    Nedelcu, T; Georgescu, I

    2016-01-01

    The article represents a retrospective clinical and radiological study. Objectives. Evaluating the safety and efficiency of the surgical treatment by using the Unit Rod for scoliosis in adolescents and children presenting Duchenne's muscular dystrophy. Summary. Surgical management of myopathic scoliosis still causes controversies regarding the timing of surgery (patient's age), the pelvic inclusion in the arthrodesis or the advantages of surgery over the conservatory treatment. The patients are very fragile and a long surgery with massive blood loss could lead to serious complications. Unit Rod instrumentation is simple, confers excellent stability and has a low rate of complications. Methods. This is a retrospective clinical and radiological study with a medium follow-up of 6.9 years including 13 patients diagnosed with Duchenne myopathy. All investigated patients were non-ambulatory at the time of surgery and have been treated by the Unit Rod technique at the University Hospital of Rouen between 2002 and 2008. Spinal fusion was, in all cases, realized from T2 to pelvis. Galveston technique of pelvic fixation and Luque's sublaminar wire instrumentation of the spine were used. Results. The results obtained with this treatment and post-surgery complications were analyzed and compared with those from literature. The advantages of this technique consist mostly in a good and stable pelvic fixation, a short interventional time, a minimal blood loss and few complications. Cobb angle correction is similar to that obtained by other surgical procedures. Conclusions. Using the Unit Rod instrumentation of scoliosis in Duchenne's muscular dystrophy is safe, has excellent outcomes, brings post-surgery improvements, and has minor intra and post-surgery complications. The low cost of this treatment could make it a first choice for medical health systems with financial problems.

  3. 21 CFR 878.4810 - Laser surgical instrument for use in general and plastic surgery and in dermatology.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Laser surgical instrument for use in general and plastic surgery and in dermatology. 878.4810 Section 878.4810 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices § 878.4810 Laser...

  4. Highly sensitive rapid fluorescence detection of protein residues on surgical instruments

    Energy Technology Data Exchange (ETDEWEB)

    Kovalev, Valeri I [School of Engineering and Physical Sciences, Heriot-Watt University, Edinburgh EH14 4AS (United Kingdom); Bartona, James S [School of Engineering and Physical Sciences, Heriot-Watt University, Edinburgh EH14 4AS (United Kingdom); Richardson, Patricia R [School of Chemistry, University of Edinburgh, Edinburgh, EH9 3JJ (United Kingdom); Jones, Anita C [School of Chemistry, University of Edinburgh, Edinburgh, EH9 3JJ (United Kingdom)

    2006-07-15

    There is a risk of contamination of surgical instruments by infectious protein residues, in particular, prions which are the agents for Creutzfeldt-Jakob Disease in humans. They are exceptionally resistant to conventional sterilization, therefore it is important to detect their presence as contaminants so that alternative cleaning procedures can be applied. We describe the development of an optimized detection system for fluorescently labelled protein, suitable for in-hospital use. We show that under optimum conditions the technique can detect {approx}10 attomole/cm{sup 2} with a scan speed of {approx}3-10 cm{sup 2}/s of the test instrument's surface. A theoretical analysis and experimental measurements will be discussed.

  5. Design and control of a 3-DOF hydraulic driven surgical instrument

    Directory of Open Access Journals (Sweden)

    Cuntz Timo

    2015-09-01

    Full Text Available Although the use of minimally invasive surgery techniques has steadily increased, the development of new tools for these procedures has stagnated. Indeed a new generation of surgical instruments, with tips that have multiple degrees of freedom, has been developed. However, they are facing so many technical problems that none have been able to establish themselves in the medical market. To overcome the problems these instruments are facing, a micro hydraulic power transmission system has been developed and been presented in [1]. With these driving units it was possible to design an instrument for minimally invasive surgery with a tip which is movable in 3 degrees of freedom (DOF and that is light in weight, small in size and powerful in movements and gripping. This paper presents the mechanical setup (including dimensions and materials, describes the theoretical basis for the control with the inverse kinematic model, discusses the external drives setup and gives first performance data of this novel hydraulically actuated laparoscopic instrument with 3 degrees of freedom.

  6. Surgical robotics beyond enhanced dexterity instrumentation: a survey of machine learning techniques and their role in intelligent and autonomous surgical actions.

    Science.gov (United States)

    Kassahun, Yohannes; Yu, Bingbin; Tibebu, Abraham Temesgen; Stoyanov, Danail; Giannarou, Stamatia; Metzen, Jan Hendrik; Vander Poorten, Emmanuel

    2016-04-01

    Advances in technology and computing play an increasingly important role in the evolution of modern surgical techniques and paradigms. This article reviews the current role of machine learning (ML) techniques in the context of surgery with a focus on surgical robotics (SR). Also, we provide a perspective on the future possibilities for enhancing the effectiveness of procedures by integrating ML in the operating room. The review is focused on ML techniques directly applied to surgery, surgical robotics, surgical training and assessment. The widespread use of ML methods in diagnosis and medical image computing is beyond the scope of the review. Searches were performed on PubMed and IEEE Explore using combinations of keywords: ML, surgery, robotics, surgical and medical robotics, skill learning, skill analysis and learning to perceive. Studies making use of ML methods in the context of surgery are increasingly being reported. In particular, there is an increasing interest in using ML for developing tools to understand and model surgical skill and competence or to extract surgical workflow. Many researchers begin to integrate this understanding into the control of recent surgical robots and devices. ML is an expanding field. It is popular as it allows efficient processing of vast amounts of data for interpreting and real-time decision making. Already widely used in imaging and diagnosis, it is believed that ML will also play an important role in surgery and interventional treatments. In particular, ML could become a game changer into the conception of cognitive surgical robots. Such robots endowed with cognitive skills would assist the surgical team also on a cognitive level, such as possibly lowering the mental load of the team. For example, ML could help extracting surgical skill, learned through demonstration by human experts, and could transfer this to robotic skills. Such intelligent surgical assistance would significantly surpass the state of the art in surgical

  7. Surgical exposures and options for instrumentation in acetabular fracture fixation: Pararectus approach versus the modified Stoppa.

    Science.gov (United States)

    Bastian, J D; Savic, M; Cullmann, J L; Zech, W D; Djonov, V; Keel, M J

    2016-03-01

    As an alternative to the modified Stoppa approach, the Pararectus approach is used clinically for treatment of acetabular fractures involving the anterior column. The current study assessed the surgical exposure and the options for instrumentation using both of these approaches. Surgical dissections were conducted on five human cadavers (all male, mean age 88 years (82-97)) using the modified Stoppa and the Pararectus approach, with the same skin incision length (10cm). Distal boundaries of the exposed bony surfaces were marked using a chisel. After removal of all soft-tissues, distances from the boundaries in the false and true pelvis were measured with reference to the pelvic brim. The exposed bone was coloured and calibrated digital images of each inner hemipelvis were taken. The amount of exposed surface using both approaches was assessed and represented as a percentage of the total bony surface of each hemipelvis. For instrumentation, a suprapectineal quadrilateral buttress plate was used. Screw lengths were documented, and three-dimensional CT reconstructions were performed to assess screw trajectories qualitatively. Wilcoxon's signed rank test for paired groups was used (level of significance: pfracture fixation in the posterior pelvic ring and allows for the option to extend the approach without a new incision. Copyright © 2016 Elsevier Ltd. All rights reserved.

  8. Surgical risks and perioperative complications of instrumented lumbar surgery in patients with liver cirrhosis

    Directory of Open Access Journals (Sweden)

    Tung-Yi Lin

    2014-02-01

    Full Text Available Background: Patients with liver cirrhosis have high surgical risks due to malnutrition, impaired immunity, coagulopathy, and encephalopathy. However, there is no information in English literature about the results of liver cirrhotic patients who underwent instrumented lumbar surgery. The purpose of this study is to report the perioperative complications, clinical outcomes and determine the surgical risk factors in cirrhotic patients. Methods: We retrospectively reviewed 29 patients with liver cirrhosis who underwent instrumented lumbar surgery between 1997 and 2009. The hepatic functional reserves of the patients were recorded according to the Child-Turcotte-Pugh scoring system. Besides, fourteen other variables and perioperative complications were also collected. To determine the risks, we divided the patients into two groups according to whether or not perioperative complications developed. Results: Of the 29 patients, 22 (76% belonged to Child class A and 7 (24% belonged to Child class B. Twelve patients developed one or more complications. Patients with Child class B carried a significantly higher incidence of complications than those with Child class A (p = 0.011. In the Child class A group, patients with 6 points had a significantly higher incidence of complications than those with 5 points (p = 0.025. A low level of albumin was significantly associated with higher risk, and a similar trend was also noted for the presence of ascites although statistical difference was not reached. Conclusion: The study concludes that patients with liver cirrhosis who have undergone instrumented lumbar surgery carry a high risk of developing perioperative complications, especially in those with a Child-Turcotte-Pugh score of 6 or more.

  9. Surgical Outcome of Reduction and Instrumented Fusion in Lumbar Degenerative Spondylolisthesis

    Directory of Open Access Journals (Sweden)

    Farzad Omidi-Kashani

    2016-02-01

    Full Text Available Background: Lumbar degenerative spondylolisthesis (LDS is a degenerative slippage of the lumbar vertebrae. We aimed to evaluate the surgical outcome of degenerative spondylolisthesis with neural decompression, pedicular screw fixation, reduction, and posterolateral fusion. Methods: This before-after study was carried out on 45 patients (37 female and 8 male with LDS operated from August 2008 to January 2011. The patients’ pain and disability were assessed by visual analogue scale (VAS and Oswestry disability index (ODI questionnaire. In surgery, we applied distraction force to facilitate slip reduction. All the intra- and postoperative complications were recorded. The paired t-test and Pearson correlation coefficient were used for statistical analysis. Results: The mean age of patients and mean follow-up period were 58.3±3.5 years and 31.2±4.8 months, respectively. The mean slip correction rate was 52.2% with a mean correction loss of 4.8%. Preoperative VAS and ODI improved from 8.8 and 71.6 to postoperative 2.1 and 28.7, respectively. Clinical improvement was more prominent in more reduced patients, but Pearson coefficient could not find a significant correlation. Conclusion: Although spinal decompression with fusion and posterior instrumentation in surgical treatment of the patients with LDS result in satisfactory outcome, vertebral reduction cannot significantly enhance the clinical improvement.

  10. Patient-Reported Outcome Instruments for Surgical and Traumatic Scars: A Systematic Review of their Development, Content, and Psychometric Validation.

    Science.gov (United States)

    Mundy, Lily R; Miller, H Catherine; Klassen, Anne F; Cano, Stefan J; Pusic, Andrea L

    2016-10-01

    Patient-reported outcomes (PROs) are of growing importance in research and clinical care and may be used as primary outcomes or as compliments to traditional surgical outcomes. In assessing the impact of surgical and traumatic scars, PROs are often the most meaningful. To assess outcomes from the patient perspective, rigorously developed and validated PRO instruments are essential. The authors conducted a systematic literature review to identify PRO instruments developed and/or validated for patients with surgical and/or non-burn traumatic scars. Identified instruments were assessed for content, development process, and validation under recommended guidelines for PRO instrument development. The systematic review identified 6534 articles. After review, we identified four PRO instruments meeting inclusion criteria: patient and observer scar assessment scale (POSAS), bock quality of life questionnaire for patients with keloid and hypertrophic scarring (Bock), patient scar assessment questionnaire (PSAQ), and patient-reported impact of scars measure (PRISM). Common concepts measured were symptoms and psychosocial well-being. Only PSAQ had a dedicated appearance domain. Qualitative data were used to inform content for the PSAQ and PRISM, and a modern psychometric approach (Rasch Measurement Theory) was used to develop PRISM and to test POSAS. Overall, PRISM demonstrated the most rigorous design and validation process, however, was limited by the lack of a dedicated appearance domain. PRO instruments to evaluate outcomes in scars exist but vary in terms of concepts measured and psychometric soundness. This review discusses the strengths and weaknesses of existing instruments, highlighting the need for future scar-focused PRO instrument development. 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 Table of Contents or the online Instructions to Authors www

  11. Evaluating the Impact of Radio Frequency Identification Retained Surgical Instruments Tracking on Patient Safety: Literature Review.

    Science.gov (United States)

    Schnock, Kumiko O; Biggs, Bonnie; Fladger, Anne; Bates, David W; Rozenblum, Ronen

    2017-02-22

    Retained surgical instruments (RSI) are one of the most serious preventable complications in operating room settings, potentially leading to profound adverse effects for patients, as well as costly legal and financial consequences for hospitals. Safety measures to eliminate RSIs have been widely adopted in the United States and abroad, but despite widespread efforts, medical errors with RSI have not been eliminated. Through a systematic review of recent studies, we aimed to identify the impact of radio frequency identification (RFID) technology on reducing RSI errors and improving patient safety. A literature search on the effects of RFID technology on RSI error reduction was conducted in PubMed and CINAHL (2000-2016). Relevant articles were selected and reviewed by 4 researchers. After the literature search, 385 articles were identified and the full texts of the 88 articles were assessed for eligibility. Of these, 5 articles were included to evaluate the benefits and drawbacks of using RFID for preventing RSI-related errors. The use of RFID resulted in rapid detection of RSI through body tissue with high accuracy rates, reducing risk of counting errors and improving workflow. Based on the existing literature, RFID technology seems to have the potential to substantially improve patient safety by reducing RSI errors, although the body of evidence is currently limited. Better designed research studies are needed to get a clear understanding of this domain and to find new opportunities to use this technology and improve patient safety.

  12. Is there a role for the use of aviation assessment instruments in surgical training preparation? A feasibility study.

    Science.gov (United States)

    Stolk-Vos, Aline C; Heres, Marion H; Kesteloo, Jasper; Verburg, Dick; Hiddema, Frans; Lie, Desiree A; de Korne, Dirk F

    2017-01-01

    Selection for surgical residency programmes could potentially be improved through pretraining preparation, after assessment of surgical candidates' sensorimotor skills and personality traits. Existing aviation pilot selection instruments are available to test sensorimotor skills and personality traits. This study examined selected instruments to assess medical trainees' sensorimotor skills and personality traits. Aviation's validated computer-based Computerized Pilot Aptitude and Screening System (COMPASS) and Checklist Professional Profile (CPP) were applied to 166 final year medical students during a surgical clerkship between 2013 and 2015. All trainees completed COMPASS and CPP within the prescribed 2 hours. Compared with an age-matched and gender-matched cohort of 165 pilot candidates, medical trainees scored significantly higher on eye-hand coordination (peye-hand-foot coordination (p<0.001), spatial orientation (p<0.001), persuasiveness (p<0.001), stress tolerance (p<0.001), dominance (p<0.001), ambition (p<0.001) and resilience (p<0.001). Final year medical trainees from one medical school were able to complete aviation's sensorimotor skills and personality traits selection instruments within the set time frame. They scored differently from aviation trainees on selected skills and personality traits. The applicability and utility of aviation instruments to presurgical training preparation remains to be tested. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  13. RESULTS OF SURGICAL TREATMENT OF INFANTILE AND JUVENILE SCOLIOSIS USING VARIOUS INSTRUMENTATION

    Directory of Open Access Journals (Sweden)

    M. V. Mikhailovsky

    2015-01-01

    Full Text Available Introduction. The analysis Results of surgical treatment of growing children with infantile and juvenile scoliosis (IS can the optimal method of treatment select. In young children with significant growth potential spinal fusion may not be the best option as it limits further longitudinal growth of the spine and may to the thoracic insufficiency syndrome result. To address this problem recently several techniques focused, their have advantages and drawbacks.Material and methods. Since 2008 year 127 patients (64 girls, 63 boys aged (4.5 ± 2.1 years were operated on. In group I 65 patients were operated on using VEPTR (Vertical Expandable Prosthetic Titanium Rib instrumentation, in group II 42 patients using various spinal instrumentation. 20 patients with congenital kyphosis were excluded. The average follow-up time was (5.6 ± 1.1 years.Results. In group I average value of the primary scoliotic curve before surgery was (74.7 ± 22.9, secondary curve (42.8 ± 16.0, thoracic kyphosis (46.3 ± 27.4, lumbar lordosis (54.6 ± 14. Average value of the primary scoliotic curve after surgery was reduced to (51 ± 20 (correction 31.7%, at followup to (56.5 ± 18.5, secondary curve (31.8 ± 12.8 (25.7%, at follow-up to (32.4 ± 18.4, thoracic kyphosis (36.8 ± 20.8 (20,5%, at follow-up to (41.8 ± 21.0, lumbar lordosis (45.4 ± 12.7 (16,9%, at follow-up to (48.2 ± 11.7 (p < 0.05. Space available for lung before surgery was (84.5 ± 8.7 %, after surgery was (94.8 ± 6.7%, at follow-up increased to (98.6 ± 5.4 % (p < 0.05. Complications included 11 implant dislocations and 1 infection. In group II average value of the primary scoliotic curve before surgery was (87.6 ± 6.6, secondary curve (47.8 ± 4.6, thoracic kyphosis (61.4 ± 10.4, lumbar lordosis (61.8 ± 4.9. Average value of the primary scoliotic curve after surgery was reduced to 50.6 ± 5.3 (correction 42.3%, at follow-up to (66.1 ± 6.3

  14. [Surgical instruments for impossible births in the Museum of History of Medicine in Roma].

    Science.gov (United States)

    Caruso, Claudia; Marinozzi, Silvia

    2006-01-01

    The Museum of History of Medicine of Rome collects gynaecological and obstetrical instruments. Forceps and embriotomy instruments illustrate the evolution of a sort of an "obstetrical speciality", from antiquity to XIX century. The article focuses mainly on the gradual transformation of forceps's use, from abortive to useful instrument for childbirth.

  15. Surgical instrument biocontaminant fluorescence detection in ambient lighting conditions for hospital reprocessing and sterilization department (Conference Presentation)

    Science.gov (United States)

    Baribeau, François; Bubel, Annie; Dumont, Guillaume; Vachon, Carl; Lépine, André; Rochefort, Stéphane; Massicotte, Martin; Buteau-Vaillancourt, Louis; Gallant, Pascal; Mermut, Ozzy

    2017-03-01

    Hospitals currently rely on simple human visual inspection for assessing cleanliness of surgical instruments. Studies showed that surgical site infections are in part attributed to inadequate cleaning of medical devices. Standards groups recognize the need to objectively quantify the amount of residues on surgical instruments and establish guidelines. We developed a portable technology for the detection of contaminants on surgical instruments through fluorescence following cleaning. Weak fluorescence signals are usually detected in the obscurity only with the lighting of the excitation source. The key element of this system is that it works in ambient lighting conditions, a requirement to not disturb the normal workflow of hospital reprocessing facilities. A biocompatible fluorescent dye is added to the detergent and labels the proteins of organic residues. It is resistant to the harsh environment in a washer-disinfector. Two inspection devices have been developed with a 488nm laser as the excitation source: a handheld scanner and a tabletop station using spectral-domain and time-domain ambient light cancellation schemes. The systems are eye safe and equipped with image processing and interfacing software to provide visual or audible warnings to the operator based on a set of adjustable signal thresholds. Micron-scale residues are detected by the system which can also evaluate soil size and mass. Unlike swabbing, it can inspect whole tools in real-time. The technology has been validated in an independent hospital decontamination research laboratory. It also has potential applications in the forensics, agro-food, and space fields. Technical aspects and results will be presented and discussed.

  16. Evaluation of the Unit Rod surgical instrumentation in Duchenne scoliosis. A retrospective study

    OpenAIRE

    Nedelcu, T; Georgescu, I

    2016-01-01

    The article represents a retrospective clinical and radiological study. Objectives. Evaluating the safety and efficiency of the surgical treatment by using the Unit Rod for scoliosis in adolescents and children presenting Duchenne?s muscular dystrophy. Summary. Surgical management of myopathic scoliosis still causes controversies regarding the timing of surgery (patient?s age), the pelvic inclusion in the arthrodesis or the advantages of surgery over the conservatory treatment. The patients a...

  17. Instrumentation

    International Nuclear Information System (INIS)

    Prieur, G.; Nadi, M.; Hedjiedj, A.; Weber, S.

    1995-01-01

    This second chapter on instrumentation gives little general consideration on history and classification of instrumentation, and two specific states of the art. The first one concerns NMR (block diagram of instrumentation chain with details on the magnets, gradients, probes, reception unit). The first one concerns precision instrumentation (optical fiber gyro-meter and scanning electron microscope), and its data processing tools (programmability, VXI standard and its history). The chapter ends with future trends on smart sensors and Field Emission Displays. (D.L.). Refs., figs

  18. The impact of the use of different types of gloves and bare hands for preparation of clean surgical instruments 1

    Science.gov (United States)

    Bruna, Camila Quartim de Moraes; de Souza, Rafael Queiroz; Massaia, Irineu Francisco Silva; Cruz, Áurea Silveira; Graziano, Kazuko Uchikawa

    2016-01-01

    ABSTRACT Objectives: to determine if there are differences on the safety of the preparation of clean surgical instruments using different types of gloves and bare hands and evaluate the microbiological load of these preparations without gloves. Method: laboratory procedure with a pragmatic approach, in which the samples were handled with different types of gloves and bare hands. In addition, cytotoxicity assays were carried out by means of the agar diffusion method. Further samples were subjected to microbiological analysis after being handled without gloves. Results: none of the samples showed cytotoxic effect. All microbiological cultures showed growth of microorganisms, but no microorganism has been recovered after autoclaving. Conclusion: there were no differences in the cytotoxic responses regarding the use of different types of gloves and bare hands in the handling of clean surgical instruments, which could entail iatrogenic risk. It is noteworthy that the use of gloves involves increase in the costs of process and waste generation, and the potential allergenic risk to latex. PMID:27737375

  19. 28 CFR 552.13 - X-ray, major instrument, fluoroscope, or surgical intrusion.

    Science.gov (United States)

    2010-07-01

    ... 28 Judicial Administration 2 2010-07-01 2010-07-01 false X-ray, major instrument, fluoroscope, or... INSTITUTIONAL MANAGEMENT CUSTODY Searches of Housing Units, Inmates, and Inmate Work Areas § 552.13 X-ray, major... reasons only, with the inmate's consent. (b) The institution physician may authorize use of an X-ray for...

  20. Segmental Pedicle Screw Instrumentation and Fusion Only to L5 in the Surgical Treatment of Flaccid Neuromuscular Scoliosis.

    Science.gov (United States)

    Takaso, Masashi; Nakazawa, Toshiyuki; Imura, Takayuki; Fukuda, Michinari; Takahashi, Kazuhisa; Ohtori, Seiji

    2018-03-01

    A retrospective cohort study was performed. The purpose of this study was to determine the efficacy and safety of stopping segmental pedicle screw instrumentation constructs at L5 in the treatment of neuromuscular scoliosis. Duchenne muscular dystrophy and spinal muscular atrophy are flaccid neuromuscular disorders in which gradual deterioration is the hallmark and have a lot of characteristics in common despite differences in etiology. Instrumentation and fusion to the sacrum/pelvis has been a mainstay in the surgical treatment of flaccid neuromuscular scoliosis and recommended to correct pelvic obliquity. However, the caudal extent of instrumentation and fusion in the surgical treatment of flaccid neuromuscular scoliosis has remained a matter of considerable debate and there have been few studies on the use of segmental pedicle screw instrumentation for flaccid neuromuscular scoliosis. From 2005 to 2007, a total of 27 consecutive patients with neuromuscular disorders (20 Duchenne muscular dystrophy and 7 spinal muscular atrophy), aged 11 to 17 years, underwent segmental pedicle screw instrumentation and fusion only to L5. Assessment was performed clinically and with radiologic measurements. Minimum 2-year follow-up was required for inclusion in this study. Twenty patients were enrolled in this study. No patient was lost to follow-up. All patients had L5 tilt of less than 15° and a coronal curve with apex L2 or higher preoperatively. Preoperative coronal curve averaged 70° (range: 51°-88°), with a postoperative mean of 15° (range: 5°-25°) and 17° (range: 6°-27°) at the last follow-up. The pelvic obliquity improved from 15° (range: 9°-25°) preoperatively to 5° (range: 3°-8°) postoperatively and 6° (range: 3°-8°) at the last follow-up. The L5 tilt improved from 9° (range: 2°-14°) preoperatively to 2° (range: 0°-4°) postoperatively and 2° (range: 0°-5°) at the last follow-up. Physiologic sagittal plane alignment was recreated after surgery

  1. Instrumentation

    International Nuclear Information System (INIS)

    Decreton, M.

    2001-01-01

    SCK-CEN's research and development programme on instrumentation involves the assessment and the development of sensitive measurement systems used within a radiation environment. Particular emphasis is on the assessment of optical fibre components and their adaptability to radiation environments. The evaluation of ageing processes of instrumentation in fission plants, the development of specific data evaluation strategies to compensate for ageing induced degradation of sensors and cable performance form part of these activities. In 2000, particular emphasis was on in-core reactor instrumentation applied to fusion, accelerator driven and water-cooled fission reactors. This involved the development of high performance instrumentation for irradiation experiments in the BR2 reactor in support of new instrumentation needs for MYRRHA, and for diagnostic systems for the ITER reactor

  2. Instrumentation

    Energy Technology Data Exchange (ETDEWEB)

    Decreton, M

    2001-04-01

    SCK-CEN's research and development programme on instrumentation involves the assessment and the development of sensitive measurement systems used within a radiation environment. Particular emphasis is on the assessment of optical fibre components and their adaptability to radiation environments. The evaluation of ageing processes of instrumentation in fission plants, the development of specific data evaluation strategies to compensate for ageing induced degradation of sensors and cable performance form part of these activities. In 2000, particular emphasis was on in-core reactor instrumentation applied to fusion, accelerator driven and water-cooled fission reactors. This involved the development of high performance instrumentation for irradiation experiments in the BR2 reactor in support of new instrumentation needs for MYRRHA, and for diagnostic systems for the ITER reactor.

  3. Instrumentation

    International Nuclear Information System (INIS)

    Decreton, M.

    2002-01-01

    SCK-CEN's R and D programme on instrumentation involves the development of advanced instrumentation systems for nuclear applications as well as the assessment of the performance of these instruments in a radiation environment. Particular emphasis is on the use of optical fibres as umbilincal links of a remote handling unit for use during maintanance of a fusion reacor, studies on the radiation hardening of plasma diagnostic systems; investigations on new instrumentation for the future MYRRHA accelerator driven system; space applications related to radiation-hardened lenses; the development of new approaches for dose, temperature and strain measurements; the assessment of radiation-hardened sensors and motors for remote handling tasks and studies of dose measurement systems including the use of optical fibres. Progress and achievements in these areas for 2001 are described

  4. Instrumentation

    Energy Technology Data Exchange (ETDEWEB)

    Decreton, M

    2002-04-01

    SCK-CEN's R and D programme on instrumentation involves the development of advanced instrumentation systems for nuclear applications as well as the assessment of the performance of these instruments in a radiation environment. Particular emphasis is on the use of optical fibres as umbilincal links of a remote handling unit for use during maintanance of a fusion reacor, studies on the radiation hardening of plasma diagnostic systems; investigations on new instrumentation for the future MYRRHA accelerator driven system; space applications related to radiation-hardened lenses; the development of new approaches for dose, temperature and strain measurements; the assessment of radiation-hardened sensors and motors for remote handling tasks and studies of dose measurement systems including the use of optical fibres. Progress and achievements in these areas for 2001 are described.

  5. Instrumentation

    International Nuclear Information System (INIS)

    Umminger, K.

    2008-01-01

    A proper measurement of the relevant single and two-phase flow parameters is the basis for the understanding of many complex thermal-hydraulic processes. Reliable instrumentation is therefore necessary for the interaction between analysis and experiment especially in the field of nuclear safety research where postulated accident scenarios have to be simulated in experimental facilities and predicted by complex computer code systems. The so-called conventional instrumentation for the measurement of e. g. pressures, temperatures, pressure differences and single phase flow velocities is still a solid basis for the investigation and interpretation of many phenomena and especially for the understanding of the overall system behavior. Measurement data from such instrumentation still serves in many cases as a database for thermal-hydraulic system codes. However some special instrumentation such as online concentration measurement for boric acid in the water phase or for non-condensibles in steam atmosphere as well as flow visualization techniques were further developed and successfully applied during the recent years. Concerning the modeling needs for advanced thermal-hydraulic codes, significant advances have been accomplished in the last few years in the local instrumentation technology for two-phase flow by the application of new sensor techniques, optical or beam methods and electronic technology. This paper will give insight into the current state of instrumentation technology for safety-related thermohydraulic experiments. Advantages and limitations of some measurement processes and systems will be indicated as well as trends and possibilities for further development. Aspects of instrumentation in operating reactors will also be mentioned.

  6. Instruments

    Energy Technology Data Exchange (ETDEWEB)

    Buehrer, W. [Paul Scherrer Inst. (PSI), Villigen (Switzerland)

    1996-12-31

    The present paper mediates a basic knowledge of the most commonly used experimental techniques. We discuss the principles and concepts necessary to understand what one is doing if one performs an experiment on a certain instrument. (author) 29 figs., 1 tab., refs.

  7. Three-dimensional modeling of physiological tremor for hand-held surgical robotic instruments.

    Science.gov (United States)

    Tatinati, Sivanagaraja; Yan Naing Aye; Pual, Anand; Wei Tech Ang; Veluvolu, Kalyana C

    2016-08-01

    Hand-held robotic instruments are developed to compensate physiological tremor in real-time while augmenting the required precision and dexterity into normal microsurgical work-flow. The hardware (sensors and actuators) and software (causal linear filters) employed for tremor identification and filtering introduces time-varying unknown phase-delay that adversely affects the device performance. The current techniques that focus on three-dimensions (3D) tip position control involves modeling and canceling the tremor in 3-axes (x, y, and z axes) separately. Our analysis with the tremor data recorded from surgeons and novice subjects show that there exists significant correlation in tremor motion across the dimensions. Motivated by this, a new multi-dimensional modeling approach based on extreme learning machines (ELM) is proposed in this paper to correct the phase delay and to accurately model tremulous motion in three dimensions simultaneously. A study is conducted with tremor data recorded from the microsurgeons to analyze the suitability of proposed approach.

  8. Vertebral Osteomyelitis Caused by Mycobacterium abscessus Surgically Treated Using Antibacterial Iodine-Supported Instrumentation

    Directory of Open Access Journals (Sweden)

    Satoshi Kato

    2014-01-01

    Full Text Available Mycobacterium abscessus infections rarely develop in healthy individuals, and mostly they occur in immunocompromised hosts. Vertebral osteomyelitis due to Mycobacterium abscessus is very rare and only three previous cases of spinal infection caused by Mycobacterium abscessus have been reported. Mycobacterium abscessus isolates are uniformly resistant to antituberculous agents and can display a virulent biofilm-forming phenotype. The patient was a 67-year-old woman with vertebral osteomyelitis of the L1-2. She was healthy without immune-suppressed condition, history of trauma, or intravenous drug use. The smear examination of the specimen harvested by CT-guided puncture of the paravertebral abscess revealed Mycobacterium abscessus. Her disease condition did not abate with conservative treatment using antimicrobial chemotherapy. Radical debridement of the vertebral osteomyelitis and anterior reconstruction from T12 to L2 using antibacterial iodine-supported instrumentation were performed. Chemotherapy using clarithromycin, amikacin, and imipenem was applied for 6 months after surgery as these antibiotics had been proven to be effective to Mycobacterium abscessus after surgery. Two years after surgery, the infected anterior site healed and bony fusion was successfully achieved without a recurrence of infection.

  9. The impact of the use of different types of gloves and bare hands for preparation of clean surgical instruments.

    Science.gov (United States)

    Bruna, Camila Quartim de Moraes; Souza, Rafael Queiroz de; Massaia, Irineu Francisco Silva; Cruz, Áurea Silveira; Graziano, Kazuko Uchikawa

    2016-10-10

    to determine if there are differences on the safety of the preparation of clean surgical instruments using different types of gloves and bare hands and evaluate the microbiological load of these preparations without gloves. laboratory procedure with a pragmatic approach, in which the samples were handled with different types of gloves and bare hands. In addition, cytotoxicity assays were carried out by means of the agar diffusion method. Further samples were subjected to microbiological analysis after being handled without gloves. none of the samples showed cytotoxic effect. All microbiological cultures showed growth of microorganisms, but no microorganism has been recovered after autoclaving. there were no differences in the cytotoxic responses regarding the use of different types of gloves and bare hands in the handling of clean surgical instruments, which could entail iatrogenic risk. It is noteworthy that the use of gloves involves increase in the costs of process and waste generation, and the potential allergenic risk to latex. determinar se existe diferenças na segurança do preparo de instrumentais cirúrgicos relacionada ao uso de distintos tipos de luvas e das mãos nuas no preparo, e avaliar a carga microbiológica destes preparados sem luvas. experimento laboratorial com abordagem pragmática, onde amostras foram manipuladas com diferentes tipos de luvas e com as mãos nuas, elaborado teste de citotoxicidade por meio da difusão em ágar. Outras Amostras sofreram análise microbiológica após serem manipuladas sem luvas. nenhuma das amostras apresentou efeito citotóxico. Todas as culturas microbiológicas apresentaram crescimento de microrganismos, embora nenhum microrganismo tenha sido recuperado após a autoclavação. não houve diferenças nas respostas citotóxicas relacionadas ao uso de diferentes tipos de luvas e das mãos nuas na manipulação do instrumental cirúrgico limpo que sinalizasse risco de iatrogenia. Ressalta-se que o uso de luvas

  10. Evaluation of surgical strategy of conventional vs. percutaneous robot-assisted spinal trans-pedicular instrumentation in spondylodiscitis.

    Science.gov (United States)

    Keric, Naureen; Eum, David J; Afghanyar, Feroz; Rachwal-Czyzewicz, Izabela; Renovanz, Mirjam; Conrad, Jens; Wesp, Dominik M A; Kantelhardt, Sven R; Giese, Alf

    2017-03-01

    Robot-assisted percutaneous insertion of pedicle screws is a recent technique demonstrating high accuracy. The optimal treatment for spondylodiscitis is still a matter of debate. We performed a retrospective cohort study on surgical patients treated with pedicle screw/rod placement alone without the application of intervertebral cages. In this collective, we compare conventional open to a further minimalized percutaneous robot-assisted spinal instrumentation, avoiding a direct contact of implants and infectious focus. 90 records and CT scans of patients treated by dorsal transpedicular instrumentation of the infected segments with and without decompression and antibiotic therapy were analysed for clinical and radiological outcome parameters. 24 patients were treated by free-hand fluoroscopy-guided surgery (121 screws), and 66 patients were treated by percutaneous robot-assisted spinal instrumentation (341 screws). Accurate screw placement was confirmed in 90 % of robot-assisted and 73.5 % of free-hand placed screws. Implant revision due to misplacement was necessary in 4.95 % of the free-hand group compared to 0.58 % in the robot-assisted group. The average intraoperative X-ray exposure per case was 0.94 ± 1.04 min in the free-hand group vs. 0.4 ± 0.16 min in the percutaneous group (p = 0.000). Intraoperative adverse events were observed in 12.5 % of free-hand placed pedicle screws and 6.1 % of robot robot-assisted screws. The mean postoperative hospital stay in the free-hand group was 18.1 ± 12.9 days, and in percutaneous group, 13.8 ± 5.6 days (p = 0.012). This study demonstrates that the robot-guided insertion of pedicle screws is a safe and effective procedure in lumbar and thoracic spondylodiscitis with higher accuracy of implant placement, lower radiation dose, and decreased complication rates. Percutaneous spinal dorsal instrumentation seems to be sufficient to treat lumbar and thoracic spondylodiscitis.

  11. A study on factors of dissatisfaction and stress of the blacksmiths resulting from the organizational culture in the surgical instrument industry of India

    Directory of Open Access Journals (Sweden)

    Tirthankar Ghosh

    2011-01-01

    Full Text Available Background: It is important to understand what motivates workers and the extent to which the organization and other contextual variables satisfy them. The aim of the study was to determine factors of dissatisfaction resulting from the organizational culture among the blacksmiths involved in the surgical instrument industry. Materials and Methods: Fifty male surgical blacksmiths each of the skilled and unskilled groups of the forging section were selected. Organizational Role Stress Scale was used to measure the individuals′ role stress and several forms of conflict within an organization. Also, the organizational culture and personal involvement in an organization was measured among the surgical blacksmiths. Results: The mean score for total role stress for Skilled was 71.7 and for unskilled was 77.2. The most frequent type of organizational culture was reported to be hierarchy, both by skilled and unskilled surgical blacksmiths, followed by market and clan culture. Conclusion: This study shows that the skilled surgical blacksmiths have lower level of stress and conflicts in comparison with unskilled surgical blacksmiths. Both skilled and unskilled surgical blacksmiths estimated their level of personal involvement as low and indicated insufficient involvement in work teams. The satisfaction of the employees with their status and role in the organizational culture was also poor for both skilled and unskilled surgical blacksmiths.

  12. A study on factors of dissatisfaction and stress of the blacksmiths resulting from the organizational culture in the surgical instrument industry of India.

    Science.gov (United States)

    Ghosh, Tirthankar; Das, Banibrata; Gangopadhyay, Somnath

    2011-07-01

    It is important to understand what motivates workers and the extent to which the organization and other contextual variables satisfy them. The aim of the study was to determine factors of dissatisfaction resulting from the organizational culture among the blacksmiths involved in the surgical instrument industry. Fifty male surgical blacksmiths each of the skilled and unskilled groups of the forging section were selected. Organizational Role Stress Scale was used to measure the individuals' role stress and several forms of conflict within an organization. Also, the organizational culture and personal involvement in an organization was measured among the surgical blacksmiths. The mean score for total role stress for Skilled was 71.7 and for unskilled was 77.2. The most frequent type of organizational culture was reported to be hierarchy, both by skilled and unskilled surgical blacksmiths, followed by market and clan culture. This study shows that the skilled surgical blacksmiths have lower level of stress and conflicts in comparison with unskilled surgical blacksmiths. Both skilled and unskilled surgical blacksmiths estimated their level of personal involvement as low and indicated insufficient involvement in work teams. The satisfaction of the employees with their status and role in the organizational culture was also poor for both skilled and unskilled surgical blacksmiths.

  13. 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.

  14. Alfonso VIII, Cruzada y Cristiandad = Alfonso VIII, Crusade and Christendom

    Directory of Open Access Journals (Sweden)

    Carlos de Ayala Martínez

    2016-06-01

    Full Text Available Lacruzada fue el cauce más directo para la integración de la Península Ibérica en el conjunto de la Cristiandad. Este hecho se pone especialmente de relieve cuando nos acercamos al reinado de Alfonso VIII de Castilla. El monarca, que casó con la hija del rey de Inglaterra, comprometió el matrimonio de su primogénita con el heredero del emperador alemán y casó a otra de sus hijas con el futuro rey de Francia, representa esa plena integración cuyo seguimiento es posible a través de diversos indicadores –políticos, ideológicos, culturales…-, que, en todo caso, refuerzan la imagen propagandística de un rey al servicio de la defensa de la Cristiandad.Crusading was the most effective method of integrating the Iberian Peninsula within Christendom. This fact is most evident when we consider the reign of Alfonso VIII of Castile. This monarch married the daughter of the king of England, arranged the marriage of his eldest daughter with the heir of the German Emperor and married another of his daughters with the future king of France. These actions convey the need for maximum integration which can be traced using several indicators –political, ideological, cultural...– that moreover reinforce the propaganda image of a king at the service and in defence of Christianity.

  15. Surgical Instrument Decontamination Unit

    Science.gov (United States)

    1989-02-15

    Assoc, Sci Ed 37:246, 1948. 31. Toledo RT, Escher FE, Ayers JC: "Sporicidal properties of hydrogen peroxide against food spoilage organisms," Appl...chemical disinfectants utilized was formaldehyde which combines chemically with critical bacterial cell components to prevent their replication. As the...formaldehyde which combines chemically with critical bacterial cell components to prevent their replication. As the health effects of formaldehyde

  16. Cronica descoperirilor monetare (VIII / Chronicle of monetary findings (VIII

    Directory of Open Access Journals (Sweden)

    Ana Boldureanu

    2014-10-01

    Full Text Available The author presents the finds of coins in the historical territory of Moldova, which were recorded during 2013 - the first half of 2014. There were examined three ancient coins and one Byzantine coin found in the Ocniţa District. They were minted under the emperors Septimius Severus (193-211, Maximianus Herculius (286-305 and Decentius (350-353. The Byzantine coin is class A2 anonymous follis issued during the reign of Basil II, Constantine VIII and Roman III (976(?-030/1035. There are presented findings of medieval coins from Bolohani, Orhei, Brătuleni (Nisporeni District, Hincăuţi, Edineţ, Lăpuşna, Hânceşti, Oprişeni (Glyboka District, Chernivtsi region of Ukraine, Zguriţa (Ocniţa District etc. All of them will complete the list of coin finds from Moldova and provide researchers new documentary sources.

  17. Single-stage posterior transforaminal lumbar interbody fusion, debridement, limited decompression, 3-column reconstruction, and posterior instrumentation in surgical treatment for single-segment lumbar spinal tuberculosis

    OpenAIRE

    Zeng, Hao; Wang, Xiyang; Zhang, Penghui; Peng, Wei; Zhang, Yupeng; Liu, Zheng

    2015-01-01

    Objective: The aim of this study is to determine the feasibility and efficacy of surgical management of single-segment lumbar spinal tuberculosis (TB) by using single-stage posterior transforaminal lumbar interbody fusion, debridement, limited decompression, 3-column reconstruction, and posterior instrumentation.Methods: Seventeen cases of single-segment lumbar TB were treated with single-stage posterior transforaminal lumbar interbody fusion, debridement, limited decompression, 3-column reco...

  18. Lacerations to Zones VIII and IX: It Is Not Just a Tendon Injury

    Directory of Open Access Journals (Sweden)

    Charla R. Fischer

    2011-01-01

    Full Text Available Extensor tendon injuries are widely believed to be straightforward problems that are relatively simple to manage. However, these injuries can be complex and demand a thorough understanding of anatomy to achieve the best functional outcomes. When lacerations occur in the forearm as in Zones VIII and IX injury, the repair of the extensor tendon and muscle, and posterior interosseous nerve (PIN is often challenging. A review of the literature shows little guidance and attention for these injuries. We present four patients with injuries to Zones VIII and IX as well as a review of surgical technique, postoperative rehabilitation, and pearls that may be of benefit to those managing these injuries.

  19. 12 CFR 611.1137 - Title VIII service corporations.

    Science.gov (United States)

    2010-01-01

    ... Organizations § 611.1137 Title VIII service corporations. (a) What is a title VIII service corporation? A title VIII service corporation is a service corporation organized for the purpose of exercising the... 12 Banks and Banking 6 2010-01-01 2010-01-01 false Title VIII service corporations. 611.1137...

  20. Factors for a Good Surgical Outcome in Posterior Decompression and Dekyphotic Corrective Fusion with Instrumentation for Thoracic Ossification of the Posterior Longitudinal Ligament: Prospective Single-Center Study.

    Science.gov (United States)

    Imagama, Shiro; Ando, Kei; Kobayashi, Kazuyoshi; Hida, Tetsuro; Ito, Kenyu; Tsushima, Mikito; Ishikawa, Yoshimoto; Matsumoto, Akiyuki; Morozumi, Masayoshi; Tanaka, Satoshi; Machino, Masaaki; Ota, Kyotaro; Nakashima, Hiroaki; Nishida, Yoshihiro; Matsuyama, Yukihiro; Ishiguro, Naoki

    2017-12-01

    Surgery for thoracic ossification of the posterior longitudinal ligament (T-OPLL) is still challenging, and factors for good surgical outcomes are unknown. To identify factors for good surgical outcomes with prospective and comparative study. Seventy-one consecutive patients who underwent posterior decompression and instrumented fusion were divided into good or poor outcome groups based on ≥50% and good outcome were analyzed. Patients with a good outcome (76%) had significantly lower nonambulatory rate and positive prone and supine position tests preoperatively; lower rates of T-OPLL, ossification of the ligamentum flavum, high-intensity area at the same level, thoracic spinal cord alignment difference, and spinal canal stenosis on preoperative magnetic resonance imaging; lower estimated blood loss; higher rates of intraoperative spinal cord floating and absence of deterioration of intraoperative neurophysiological monitoring; and lower rates of postoperative complications (P good surgical outcome. This study demonstrated that early surgery is recommended during these positive factors. Appropriate surgical planning based on preoperative thoracic spinal cord alignment difference, as well as sufficient spinal cord decompression and reduction of complications using intraoperative ultrasonography and intraoperative neurophysiological monitoring, may improve surgical outcomes. Copyright © 2017 by the Congress of Neurological Surgeons

  1. Comparison of functional outcomes following surgical decompression and posterolateral instrumented fusion in single level low grade lumbar degenerative versus isthmic spondylolisthesis.

    Science.gov (United States)

    Omidi-Kashani, Farzad; Hasankhani, Ebrahim Ghayem; Rahimi, Mohammad Dawood; Khanzadeh, Reza

    2014-06-01

    The two most common types of surgically treated lumbar spondylolisthesis in adults include the degenerative and isthmic types. The aim of this study was to compare the functional outcomes of surgical decompression and posterolateral instrumented fusion in patients with lumbar degenerative and isthmic spondylolisthesis. In this retrospective study, we reviewed the clinical outcomes in surgically treated patients with single level, low grade lumbar degenerative, and isthmic spondylolisthesis (groups A and B, respectively) from August 2007 to April 2011. We tried to compare paired settings with similar initial conditions. Group A included 52 patients with a mean age of 49.2 ± 6.1 years, and group B included 52 patients with a mean age of 47.3 ± 7.4 years. Minimum follow-up was 24 months. The surgical procedure comprised neural decompression and posterolateral instrumented fusion. Pain and disability were assessed by a visual analog scale (VAS) and the Oswestry Disability Index (ODI), respectively. The Wilcoxon and Mann-Whitney U-tests were used to compare indices. The most common sites for degenerative and isthmic spondylolisthesis were at the L4-L5 (88.5%) and L5-S1 (84.6%) levels, respectively. Surgery in both groups significantly improved VAS and ODI scores. The efficacy of surgery based on subjective satisfaction rate and pain and disability improvement was similar in the degenerative and isthmic groups. Notable complications were also comparable in both groups. Neural decompression and posterolateral instrumented fusion significantly improved pain and disability in patients with degenerative and isthmic spondylolisthesis. The efficacy of surgery for overall subjective satisfaction rate and pain and disability improvement was similar in both groups.

  2. Development and initial validation of a virtual reality haptically augmented surgical knot-tying trainer for the Autosuture ENDOSTITCH instrument.

    Science.gov (United States)

    Kurenov, Sergei; Punak, Sukitti; Peters, Jorg; Lee, Constance; Cendan, Juan

    2009-01-01

    The Autosuture Endostitch device (Covidien, CT) is difficult to learn. In particular, the handle requires the use of a toggle which is unique in this instrument. We have developed a virtual reality trainer for the device that offers the use of the actual instrument handle while creating a visible virtual instrument tip complete with virtual needle and suture on a monitor. This report represents the development and initial validation experiments for the device.

  3. Minimally invasive surgical instruments with an accessory channel capable of integrating fibre-optic cable for optical biopsy: a review of the state of the art.

    Science.gov (United States)

    Jelínek, Filip; Arkenbout, Ewout A; Sakes, Aimée; Breedveld, Paul

    2014-08-01

    This review article provides a comprehensive overview and classification of minimally invasive surgical instruments with an accessory channel incorporating fibreoptics or another auxiliary device for various purposes. More specifically, this review was performed with the focus on the newly emerging field of optical biopsy, its objective being to discuss primarily the instruments capable of carrying out the optical biopsy and subsequent tissue resection. Instruments housing the fibreoptics for other uses, as well as instruments with an accessory channel capable of housing the fibreoptics instead of their original auxiliary device after relevant design modifications, supplement the review. The entire Espacenet and Scopus databases were searched, yielding numerous patents and articles on conceptual and existing instruments satisfying the criteria. The instruments were categorised based on the function the fibreoptics or the auxiliary device serves. On the basis of their geometrical placement with respect to the tissue resector or manipulator, the subcategories were further defined. This subdivision was used to identify the feasibility of performing the optical biopsy and the tissue resection in an accurate and successive fashion. In general, the existing concepts or instruments are regarded as limited with regard to such a functionality, either due to the placement of their accessory channel with or without the fibreoptics or due to the operational restrictions of their tissue manipulators. A novel opto-mechanical biopsy harvester, currently under development at Delft University of Technology, is suggested as a promising alternative, ensuring a fast and accurate succession of the optical and the mechanical biopsies of a flat superficial tissue. © IMechE 2014.

  4. 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.

  5. The Medical Vestment and Surgical Instruments of Saint Cosmas and Damian on Sinai Icons From the Seventh to the Eighteenth Century.

    Science.gov (United States)

    Beldekos, Dimitris; Karamanou, Marianna; Poulakou-Rebelakou, Effie; Ploumpidis, Dimitris; Androutsos, George

    2015-12-01

    The iconography of the doctor saints Cosmas and Damian and the artistic representations of their miracles are important sources for the history of medicine. Within the sphere of physician-saints, Cosmas and Damian have the greatest number of iconographic depictions in Byzantine and Post-Byzantine art. In most of their representations, they wear long robes as a sort of professional mantles and carry surgical instruments and boxes indicating their status as doctors. The progress of Byzantine surgery could be attested by these objects, some of them mentioned in collections of miracle stories and documented in medical sources.

  6. Does the piezoelectric surgical technique produce fewer postoperative sequelae after lower third molar surgery than conventional rotary instruments? A systematic review and meta analysis.

    Science.gov (United States)

    Al-Moraissi, E A; Elmansi, Y A; Al-Sharaee, Y A; Alrmali, A E; Alkhutari, A S

    2016-03-01

    A systematic review and meta-analysis was conducted to answer the clinical question "Does the piezoelectric surgical technique produce fewer postoperative sequelae after lower third molar surgery than conventional rotary instruments?" A systematic and electronic search of several databases with specific key words, a reference search, and a manual search were performed from respective dates of inception through November 2014. The inclusion criteria were clinical human studies, including randomized controlled trials (RCTs), controlled clinical trials (CCTs), and retrospective studies, with the aim of comparing the piezoelectric surgical osteotomy technique to the standard rotary instrument technique in lower third molar surgery. Postoperative sequelae (oedema, trismus, and pain), the total number of analgesics taken, and the duration of surgery were analyzed. A total of nine articles were included, six RCTs, two CCTs, and one retrospective study. Six studies had a low risk of bias and three had a moderate risk of bias. A statistically significant difference was found between piezoelectric surgery and conventional rotary instrument surgery for lower third molar extraction with regard to postoperative sequelae (oedema, trismus, and pain) and the total number of analgesics taken (P=0.0001, P=0.0001, Psurgery time was required in the piezoelectric osteotomy group (Psurgery significantly reduced the occurrence of postoperative sequelae (oedema, trismus, and pain) and the total number of analgesics taken compared to the conventional rotary instrument technique in lower third molar surgery, but required a longer surgery time. Copyright © 2015 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  7. VIII International Congress of Engineering Physics

    International Nuclear Information System (INIS)

    2017-01-01

    The Physicist Engineering is a multidisciplinary profession in which an undergraduate student integrates and applies their knowledge of Physics, Mathematics, and Computing to adapt and innovate all kind of technologies, as well as to development and apply theoretical knowledge to different fields of science and engineering. A Physicist Engineer, supported by a solid preparation in science and engineering is available to study, analyze, identify, and solve problems in different fields of science and technology for industries, hospitals, research laboratories, institutes and governmental organizations focused on metrology, optics, energy, materials, instrumentation of sophisticated equipment. The Physicist Engineering bachelor degree is a national and international reference to encouraging all those students to apply knowledge through active participation in the operation, planning, and management of projects. The technological and scientific impact of a Physicist Engineering undergraduate and graduate students, as well as the tutorial of the research professor that are interested in Physics and Physics Engineering, may be found in a biennial event like the International Conference on Physicist Engineering, through the diffusion of both experimental and theoretical research and teaching. In order to promote and encourage strength academic goals among universities and research institutions, the International Conference on Physics Engineering Committee, integrated by a faculty meeting of the Universidad Autónoma Metropolitana, Campus Azcapotzalco, has decided to grant the VIII International Congress of Physics Engineering to the Universidad Autónoma de Yucatán, which is going to take place on Mérida, November 7 th to 11 th , 2016. This conference considers different topics as: Renewables Energies Engineering Materials Technology Nanotechnology Medical Physics Education in Physics Engineering Nuclear Engineering High Precision Instrumentation Atmosphere Physics

  8. Comparison of drugs use according to surgical procedures as instrument for budgeting and improvement of prescription efficiency.

    Science.gov (United States)

    Closon, M C

    1999-08-01

    Making an effort to control health expenditure's escalation, especially in hospital, the Belgian government is planning and experimenting with prospective budgeting. A research financed by the Ministry of Public Health allows us to point out the structure of the pathologies treated as well as other variables included in the medical MBDS like urgency, number of diseased systems, ... and explains a high percentage of the variance (62%) in drugs expenditures of the surgical cases. These variables have to be used in order to calibrate hospital drugs budgets. The Interdisciplinary Centre in Health Economics has developed tools to compare drugs prescriptions by type of surgical procedures in order to help hospitals to evaluate their performance should such drugs budgets be progressively introduced.

  9. Physicochemical characterisation of rVIII-SingleChain, a novel recombinant single-chain factor VIII.

    Science.gov (United States)

    Schmidbauer, Stefan; Witzel, Reinhild; Robbel, Lars; Sebastian, Petra; Grammel, Nicolas; Metzner, Hubert J; Schulte, Stefan

    2015-08-01

    rVIII-SingleChain is a novel recombinant single-chain factor VIII (FVIII) construct, comprising covalently bonded heavy and light chains. Post-translational modifications of FVIII affect physicochemical parameters, including hydrophobicity and charge. The most relevant post-translational modifications of FVIII products are N-glycosylation of asparagine residues and tyrosine sulphations. Here, the physicochemical properties, thrombin cleavage products and post-translational modifications of rVIII-SingleChain were investigated and compared against commercially available recombinant FVIII (rFVIII) products with a predominant two-chain structure (B-domain deleted rFVIII and full-length rFVIII). rVIII-SingleChain was expressed in Chinese hamster ovary (CHO) cells and purified by chromatographic methods. Physicochemical properties of rVIII-SingleChain or thrombin-derived cleavage products were assessed using size-exclusion chromatography, reversed-phase chromatography and sodium dodecyl sulphate polyacrylamide gel electrophoresis. Analysis of the respective carbohydrate structures was performed after release of N-glycans by PNGase F followed by fluorescence labelling and high-performance liquid chromatography. Proteolysis by trypsin generated the corresponding peptides, which were analysed for sulphated tyrosines by liquid chromatography-electrospray ionisation time of flight-mass spectrometry. rVIII-SingleChain was shown to be of high purity and homogeneity, and presented a well-defined single-chain molecule with predominant β-sheet conformation. The coagulation-relevant thrombin-activation products of rVIII-SingleChain were comparable with those obtained by activation of commercially available rFVIII products. rVIII-SingleChain post-translational modifications were similar to other CHO cell-derived rFVIII products for N-glycopattern and tyrosine sulphation. In conclusion, rVIII-SingleChain is of high homogeneity and purity, and provides an expected cleavage pattern on

  10. Health hazards of child labor in the leather products and surgical instrument manufacturing industries of Sialkot, Pakistan.

    Science.gov (United States)

    Junaid, Muhammad; Malik, Riffat Naseem; Pei, De-Sheng

    2017-07-01

    Child labor is a major challenge in the developing countries and comprehensive health hazard identification studies on this issue are still lacking. Therefore, the current study is an effort to highlight the health concerns of child labor exposed in the key small scale industries of Sialkot, Pakistan. Our findings revealed jolting levels of heavy metals in the urine, blood, serum, saliva, and hair samples collected from the exposed children. For example, in the urine samples, Cd, Cr, Ni, and Pb were measured at the respective concentrations of 39.17, 62.02, 11.94 and 10.53 μg/L in the surgical industries, and 2.10, 4.41, 1.04 and 5.35 μg/L in the leather industries. In addition, source apportionment revealed polishing, cutting, and welding sections in the surgical industries and surface coating, crusting, and stitching sections in the leather industries were the highest contributors of heavy metals in the bio-matrices of the exposed children, implying the dusty, unhygienic, and unhealthy indoor working conditions. Further, among all the bio-matrices, the hair samples expressed the highest bioaccumulation factor for heavy metals. In accordance with the heavy metal levels reported in the exposed children, higher oxidative stress was found in the children working in the surgical industries than those from the leather industries. Moreover, among heavy metals' exposure pathways, inhalation of industrial dust was identified as the primary route of exposure followed by the ingestion and dermal contact. Consequently, chemical daily intake (CDI), carcinogenic and non-carcinogenic hazard quotients (HQs) of heavy metals were also reported higher in the exposed children and were also alarmingly higher than the corresponding US EPA threshold limits. Taken all together, children were facing serious health implications in these industries and need immediate protective measures to remediate the current situation. Copyright © 2017 Elsevier Ltd. All rights reserved.

  11. [Surgical instruments and the emblems of Alsatien craftsmen and the archives of Obernai (16th-17th centuries)].

    Science.gov (United States)

    Muller, Christine

    2011-01-01

    This study presents some original data concerning the instruments used by Alsatian surgeons-barbers from the 16th to the 18th century. Emblems of professions frequently appear on private houses in Alsace, and 35 emblems of surgeons-barbers have been discovered; six, particularly chararacteristic, are analysed here (Soultz 1568, Marlenheim 1581, Sainte-Croix-en-Plaine 1587, Rosheim 1681, Rosheim 1733, and Wasselonne 1738). The razor (Schermesser), the lancet (Lanzette), and the "flame" (Lasseisen, Fliete) are the most frequently represented instruments. Unpublished inventories after death also bring instructive data and in particular those of the barbers Hans Artz of Molsheim (1597) and Jacob Pflieger of Obernai (c. 1608-1609). At last, are evoked unpublished mentions concerning two barbers originating from Obernai who exercised in Eastern Europe (Sebald Korn around 1583, and Johannes Baur around 1637).

  12. 77 FR 64401 - Order of Succession for HUD Region VIII

    Science.gov (United States)

    2012-10-19

    ... Region VIII AGENCY: Office of Field Policy and Management, HUD. ACTION: Notice of Order of Succession... Field Offices (Region VIII). This Order of Succession supersedes all previous Orders of Succession for HUD Region VIII. DATES: Effective Date: October 9, 2012. FOR FURTHER INFORMATION CONTACT: Lawrence D...

  13. Single-stage posterior transforaminal lumbar interbody fusion, debridement, limited decompression, 3-column reconstruction, and posterior instrumentation in surgical treatment for single-segment lumbar spinal tuberculosis.

    Science.gov (United States)

    Zeng, Hao; Wang, Xiyang; Zhang, Penghui; Peng, Wei; Liu, Zheng; Zhang, Yupeng

    2015-01-01

    The aim of this study is to determine the feasibility and efficacy of surgical management of single-segment lumbar spinal tuberculosis (TB) by using single-stage posterior transforaminal lumbar interbody fusion, debridement, limited decompression, 3-column reconstruction, and posterior instrumentation. Seventeen cases of single-segment lumbar TB were treated with single-stage posterior transforaminal lumbar interbody fusion, debridement, limited decompression, 3-column reconstruction, and posterior instrumentation. The mean follow-up was 36.9 months (range: 24-62 months). The kyphotic angle ranged from 15.2-35.1° preoperatively, with an average measurement of 27.8°. The American Spinal Injury Association (ASIA) score system was used to evaluate the neurological deficits and erythrocyte sedimentation rate (ESR) used to judge the activity of TB. Spinal TB was completely cured in all 17 patients. There was no recurrent TB infection. The postoperative kyphotic angle was 6.6-10.2°, 8.1° in average, and there was no significant loss of the correction at final follow-up. Solid fusion was achieved in all cases. Neurological condition in all patients was improved after surgery. Single-stage posterior transforaminal lumbar interbody fusion, debridement, limited decompression, 3-column reconstruction, and posterior instrumentation can be a feasible and effective method the in treatment of single-segment lumbar spinal TB.

  14. Blood coagulation factor VIII: An overview

    Indian Academy of Sciences (India)

    Factor VIII (FVIII) functions as a co-factor in the blood coagulation cascade for the proteolytic activation of factor X by factor IXa. Deficiency of FVIII causes hemophilia A, the most commonly inherited bleeding disorder. This review highlights current knowledge on selected aspects of FVIII in which both the scientist and the ...

  15. Blood coagulation factor VIII: An overview

    Indian Academy of Sciences (India)

    Unknown

    Santagostina E and Castaman G 2001 TT virus contaminates first generation recombinant factor VIII concentrates; Blood. 98 2571–2573. Azzi A, Morfini M and Mannucci P M 1999 The transfusion associated transmission of parvovirus B19; Transfus. Med. Rev. 13 194–204. Bowen D J 2002 Haemophilia A and Haemophilia ...

  16. Analysis of the learning curve for transurethral resection of the prostate. Is there any influence of musical instrument and video game skills on surgical performance?

    Science.gov (United States)

    Yamaçake, Kleiton Gabriel Ribeiro; Nakano, Elcio Tadashi; Soares, Iva Barbosa; Cordeiro, Paulo; Srougi, Miguel; Antunes, Alberto Azoubel

    2015-09-01

    To evaluate the learning curve for transurethral resection of the prostate (TURP) among urology residents and study the impact of video game and musical instrument playing abilities on its performance. A prospective study was performed from July 2009 to January 2013 with patients submitted to TURP for benign prostatic hyperplasia. Fourteen residents operated on 324 patients. The following parameters were analyzed: age, prostate-specific antigen levels, prostate weight on ultrasound, pre- and postoperative serum sodium and hemoglobin levels, weight of resected tissue, operation time, speed of resection, and incidence of capsular lesions. Gender, handedness, and prior musical instrument and video game playing experience were recorded using survey responses. The mean resection speed in the first 10 procedures was 0.36 g/min and reached a mean of 0.51 g/min after the 20(th) procedure. The incidence of capsular lesions decreased progressively. The operation time decreased progressively for each subgroup regardless of the difference in the weight of tissue resected. Those experienced in playing video games presented superior resection speed (0.45 g/min) when compared with the novice (0.35 g/min) and intermediate (0.38 g/min) groups (p=0.112). Musical instrument playing abilities did not affect the surgical performance. Speed of resection, weight of resected tissue, and percentage of resected tissue improve significantly and the incidence of capsular lesions reduces after the performance of 10 TURP procedures. Experience in playing video games or musical instruments does not have a significant effect on outcomes.

  17. Development of an Educational Game to Set Up Surgical Instruments on the Mayo Stand or Back Table: Applied Research in Production Technology.

    Science.gov (United States)

    Paim, Crislaine Pires Padilha; Goldmeier, Silvia

    2017-01-10

    Existing research suggests that digital games can be used effectively for educational purposes at any level of training. Perioperative nursing educators can use games to complement curricula, in guidance and staff development programs, to foster team collaboration, and to give support to critical thinking in nursing practice because it is a complex environment. To describe the process of developing an educational game to set up surgical instruments on the Mayo stand or back table as a resource to assist the instructor in surgical instrumentation training for students and nursing health professionals in continued education. The study was characterized by applied research in production technology. It included the phases of analysis and design, development, and evaluation. The objectives of the educational game were developed through Bloom's taxonomy. Parallel to the physical development of the educational game, a proposed model for the use of digital elements in educational game activities was applied to develop the game content. The development of the game called "Playing with Tweezers" was carried out in 3 phases and was evaluated by 15 participants, comprising students and professional experts in various areas of knowledge such as nursing, information technology, and education. An environment was created with an initial screen, menu buttons containing the rules of the game, and virtual tour modes for learning and assessment. The "digital" nursing student needs engagement, stimulation, reality, and entertainment, not just readings. "Playing with Tweezers" is an example of educational gaming as an innovative teaching strategy in nursing that encourages the strategy of involving the use of educational games to support theoretical or practical classroom teaching. Thus, the teacher does not work with only 1 type of teaching methodology, but with a combination of different methodologies. In addition, we cannot forget that skill training in an educational game does not

  18. Accuracy of a direct drill-guiding system with minimal tolerance of surgical instruments used for implant surgery: a prospective clinical study.

    Science.gov (United States)

    Lee, Du-Hyeong; An, Seo-Young; Hong, Min-Ho; Jeon, Kyoung-Bae; Lee, Kyu-Bok

    2016-06-01

    A recently introduced direct drill-guiding implant surgery system features minimal tolerance of surgical instruments in the metal sleeve by using shank-modified drills and a sleeve-incorporated stereolithographic guide template. The purpose of this study was to evaluate the accuracy of this new guided surgery system in partially edentulous patients using geometric analyses. For the study, 21 implants were placed in 11 consecutive patients using the direct drill-guiding implant surgery system. The stereolithographic surgical guide was fabricated using cone-beam computed tomography, digital scanning, computer-aided design and computer-assisted manufacturing, and additive manufacturing processes. After surgery, the positional and angular deviations between planned and placed implants were measured at the abutment level using implant-planning software. The Kruskal-Wallis test and Mann-Whitney U test were used to compare the deviations (α=.05). The mean horizontal deviations were 0.593 mm (SD 0.238) mesiodistally and 0.691 mm (SD 0.344) buccolingually. The mean vertical deviation was 0.925 mm (SD 0.376) occlusogingivally. The vertical deviation was significantly larger than the horizontal deviation (P=.018). The mean angular deviation was 2.024 degrees (SD 0.942) mesiodistally and 2.390 degrees (SD 1.142) buccolingually. The direct drill-guiding implant surgery system demonstrates high accuracy in placing implants. Use of the drill shank as the guiding component is an effective way for reducing tolerance.

  19. Efficacy and safety of rVIII-SingleChain: results of a phase 1/3 multicenter clinical trial in severe hemophilia A

    Science.gov (United States)

    Mahlangu, Johnny; Kuliczkowski, Kazimierz; Karim, Faraizah Abdul; Stasyshyn, Oleksandra; Kosinova, Marina V.; Lepatan, Lynda Mae; Skotnicki, Aleksander; Boggio, Lisa N.; Klamroth, Robert; Oldenburg, Johannes; Hellmann, Andrzej; Santagostino, Elena; Baker, Ross I.; Fischer, Kathelijn; Gill, Joan C.; P’Ng, Stephanie; Chowdary, Pratima; Escobar, Miguel A.; Khayat, Claudia Djambas; Rusen, Luminita; Bensen-Kennedy, Debra; Blackman, Nicole; Limsakun, Tharin; Veldman, Alex; St. Ledger, Katie

    2016-01-01

    Recombinant VIII (rVIII)-SingleChain is a novel B-domain–truncated recombinant factor VIII (rFVIII), comprised of covalently bonded factor VIII (FVIII) heavy and light chains. It was designed to have a higher binding affinity for von Willebrand factor (VWF). This phase 1/3 study investigated the efficacy and safety of rVIII-SingleChain in the treatment of bleeding episodes, routine prophylaxis, and surgical prophylaxis. Participants were ≥12 years of age, with severe hemophilia A (endogenous FVIII <1%). The participants were allocated by the investigator to receive rVIII-SingleChain in either an on-demand or prophylaxis regimen. Of the 175 patients meeting study eligibility criteria, 173 were treated with rVIII-SingleChain, prophylactically (N = 146) or on-demand (N = 27). The total cumulative exposure was 14 306 exposure days (EDs), with 120 participants reaching ≥50 EDs and 52 participants having ≥100 EDs. Hemostatic efficacy was rated by the investigator as excellent or good in 93.8% of the 835 bleeds treated and assessed. Across all prophylaxis regimens, the median annualized spontaneous bleeding rate was 0.00 (Q1, Q3: 0.0, 2.4) and the median overall annualized bleeding rate (ABR) was 1.14 (Q1, Q3: 0.0, 4.2). Surgical hemostasis was rated as excellent/good in 100% of major surgeries by the investigator. No participant developed FVIII inhibitors. In conclusion, rVIII-SingleChain is a novel rFVIII molecule showing excellent hemostatic efficacy in surgery and in the control of bleeding events, low ABR in patients on prophylaxis, and a favorable safety profile in this large clinical study. This trial was registered at www.clinicaltrials.gov as #NCT01486927. PMID:27330001

  20. 26 CFR 1.1275-4 - Contingent payment debt instruments.

    Science.gov (United States)

    2010-04-01

    ...) An inflation-indexed debt instrument (as defined in § 1.1275-7); or (viii) A debt instrument issued... interest that accrues in each accrual period is the product of the comparable yield of the debt instrument..., 1998 (the product of the debt instrument's adjusted issue price on July 1, 1998 ($1,162) and the...

  1. Preparing for ENDF/B-VIII

    Science.gov (United States)

    Brown, David

    2017-09-01

    Although the next major release of the ENDF/B library is not due until the 2017-2018 time frame, ENDF/B-VIII is already positioned to become the most important release of the library in some time. ENDF/B-VIII will be built around the Neutron Reaction Standards as well as the 1H, 16O, 56Fe, 235U, 238U and 239Pu evaluations developed as part of the Coordinated International Evaluation Library Organization (CIELO) pilot project. In this contribution, we summarize these improvements as well as the many other improvements to ENDF that have already been made or are scheduled to be made in the next year. Improvements already included in the ENDF/B-VIII beta releases: • Aggressive use of the flexible and physically correct LRF=7 resolved resonance format in 12 updated evaluations (35,37Cl, 40Ca, 54,56,57Fe, 63,65Cu and 182,183,184,186W) • Thermal capture gammas from the EGAF project (6,7Li, 11B, 19F, 23Na, 27Al, 28Si, 35,37Cl) • Thermal Scattering Law evaluations from NCSU (α and β phase SiO2, SiC, lucite, BeO, and polyethylene) and from the CAB-CNL collaboration (heavy and light water) • Many new evaluations in the neutron sublibrary (n, 12,13C, 40Ar, 54,57,58Fe, 58,59,60,61,62,64Ni, 63,65Cu, 73As, 120Sn, 236m1Np) Inclusion of Red Cullen's EPICS2014 library, updating the photo-atomic, electron and atomic-relaxation sublibraries. Many improvements are planned in the next year including new evaluations such as charged particle evaluations translated from LLNL's ECPL. In addition to these major changes, ENDF/B-VIII will be the first official library released simultaneously in the legacy ENDF-6 and the newly developed Generalized Nuclear Data (GND) formats.

  2. The influence of prophylactic factor VIII in severe hemophilia A

    Science.gov (United States)

    Gissel, Matthew; Whelihan, Matthew F; Ferris, Lauren A; Mann, Kenneth G; Rivard, Georges E; Brummel-Ziedins, Kathleen E

    2013-01-01

    Introduction Hemophilia A individuals displaying a similar genetic defect have heterogeneous clinical phenotypes. Aim To evaluate the underlying effect of exogenous factor (f)VIII on tissue factor (Tf)-initiated blood coagulation in severe hemophilia utilizing both empirical and computational models. Methods We investigated twenty-five clinically severe hemophilia A patients. All individuals were on fVIII prophylaxis and had not received fVIII from 0.25 to 4 days prior to phlebotomy. Coagulation was initiated by the addition of Tf to contact-pathway inhibited whole blood ± an anti-fVIII antibody. Aliquots were quenched over 20 min and analyzed for thrombin generation and fibrin formation. Coagulation factor levels were obtained and used to computationally predict thrombin generation with fVIII set to either zero or its value at the time of the draw. Results Due to prophylactic fVIII, at the time of the blood draw, the individuals had fVIII levels that ranged from hemophilia A. The combination of each individual's coagulation factors (outside of fVIII) determine each individual's baseline thrombin potential and may affect bleeding risk. PMID:21899664

  3. Construction of a mouse model of factor VIII deficiency by gene targeting

    Energy Technology Data Exchange (ETDEWEB)

    Bi, L.; Lawler, A.; Gearhart, J. [Univ. of Pennsylvania School of Medicine, Philadelphia, PA (United States)] [and others

    1994-09-01

    To develop a small animal model of hemophilia A for gene therapy experiments, we set out to construct a mouse model for factor VIII deficiency by gene targeting. First, we screened a mouse liver cDNA library using a human FVIII cDNA probe. We cloned a 2.6 Kb partial mouse factor VIII cDNA which extends from 800 base pairs of the 3{prime} end of exon 14 to the 5{prime} end of exon 26. A mouse genomic library made from strain 129 was then screened to obtain genomic fragments covering the exons desired for homologous recombination. Two genomic clones were obtained, and one covering exon 15 through 22 was used for gene targeting. To make gene targeting constructs, a 5.8 Kb genomic DNA fragment covering exons 15 to 19 of the mouse FVIII gene was subcloned, and the neo expression cassette was inserted into exons 16 and 17 separately by different strategies. These two constructs were named MFVIIIC-16 and MFVIIIC-17. The constructs were linearized and transfected into strain 129 mouse ES cells by electroporation. Factor VIII gene-knockout ES cell lines were selected by G-418 and screened by genomic Southern blots. Eight exon 16 targeted cell lines and five exon 17 targeted cell lines were obtained. Three cell lines from each construct were injected into blastocysts and surgically transferred into foster mothers. Multiple chimeric mice with 70-90% hair color derived from the ES-cell genotype were seen with both constructs. Germ line transmission of the ES-cell genotype has been obtained for the MFVIIIC-16 construct, and multiple hemophilia A carrier females have been identified. Factor VIII-deficient males will be conceived soon.

  4. Posterior lumbar interbody fusion with instrumented posterolateral fusion in adult spondylolisthesis: description and association of clinico-surgical variables with prognosis in a series of 36 cases

    Science.gov (United States)

    Gomez-Moreta, Juan A.; Hernandez-Vicente, Javier

    2015-01-01

    Background We present our experience in the treatment of patients with isthmic or degenerative spondylolisthesis, by means of a posterior lumbar interbody fusion (PLIF) and instrumented posterolateral fusion (IPLF), and we compare them with those published in the literature. We analyse whether there exists any statistical association between the clinical characteristics of the patient, radiological characteristics of the disease and our surgical technique, with the complications and the clinical-radiological prognosis of the cases. Method We designed a prospective study. A total of 36 cases were operated. The patients included were 14 men and 22 women, with an average age of 57.17±27.32 years. Our technique consists of PLIF+IPLF, using local bone for the fusion. The clinical results were evaluated with the Visual Analogical Scale (VAS) and the Kirkaldy-Willis criteria. The radiological evaluation followed the Bratingan (PLIF) and Lenke (IPLF) methodology. A total of 42 variables were statistically analysed by means of SPSS18. We used the Paired Student's T-test, logistic regression and Pearson's Chi-square-test. Results The spondylolisthesis was isthmic in 15 cases and degenerative in 21 cases. The postoperative evaluations had excellent or good results in 94.5% (n = 34), with a statistically significant improvement in the back pain and sciatica (p spondylolisthesis, isthmic or degenerative, refractory to conservative treatment, for the obtaining the best clinical results and rates of fusion, with similar risks to those of the other published techniques. Our statistical analysis could contribute to improve outcomes after surgery. PMID:26196029

  5. Investigation of Structural, Compositional and Anti-Microbial Properties of Copper Thin Film Using Direct Current Magnetron Sputtering for Surgical Instruments

    Science.gov (United States)

    Kalaiselvam, S.; Sandhya, J.; Krishnan, K. V. Hari; Kedharnath, A.; Arulkumar, G.; Roseline, A. Ameelia

    Surgical instruments and other bioimplant devices, owing to their importance in the biomedical industry require high biocompatibility to be used in the human body. Nevertheless, issues of compatibility, bacterial infections are quite common in such devices. Hence development of surface coatings on various substrates for implant applications is a promising technique to combat the issues arising in these implant materials. The present investigation aims at coating copper on stainless steel substrate using DC Magnetron sputtering which is used to achieve film of required thickness (0.5-8μm). The deposition pressure, substrate temperature, power supply, distance between the specimen and target are optimized and maintained constant, while the sputtering time (30-110min) is varied. The sputtered copper thin film’s morphology, composition are characterized by SEM and EDAX. X-ray diffraction analysis shows copper oriented on (111) and (002) and copper oxide on (111) planes. The contact angle of copper thin film is 92∘ while AISI 316L shows 73∘. The antimicrobial studies carried in Staphylococcus aureus, Escherichia Coli, Klebsiella pneumonia and Candida albicans show that the maximum reduction was seen upto 35, 26, 54, 39CFU/mL, respectively after 24h. The cell viability is studied by MTT assay test on Vero cell line for 24h, 48h and 72h and average cell viability is 43.85%. The copper release from the thin film to the culture medium is 6691μg/L (maximum) is estimated from AAS studies. The copper coated substrate does not show much reaction with living Vero cells whereas the bacteria and fungi are found to be destroyed.

  6. VIII International Meeting on Lorentzian Geometry

    CERN Document Server

    Flores, José; Palomo, Francisco; GeLoMa 2016; Lorentzian geometry and related topics

    2017-01-01

    This volume contains a collection of research papers and useful surveys by experts in the field which provide a representative picture of the current status of this fascinating area. Based on contributions from the VIII International Meeting on Lorentzian Geometry, held at the University of Málaga, Spain, this volume covers topics such as distinguished (maximal, trapped, null, spacelike, constant mean curvature, umbilical...) submanifolds, causal completion of spacetimes, stationary regions and horizons in spacetimes, solitons in semi-Riemannian manifolds, relation between Lorentzian and Finslerian geometries and the oscillator spacetime. In the last decades Lorentzian geometry has experienced a significant impulse, which has transformed it from just a mathematical tool for general relativity to a consolidated branch of differential geometry, interesting in and of itself. Nowadays, this field provides a framework where many different mathematical techniques arise with applications to multiple parts of mathem...

  7. PENINGKATAN PEMBELAJARAN MENULIS PUISI BEBAS MELALUI MEDIA LAGU MEDLEY SISWA KELAS VIII SMP SINTANG

    Directory of Open Access Journals (Sweden)

    Rohanawati Silalahi

    2015-05-01

    Full Text Available Penelitian ini bertujuan untuk meningkatkan pembelajaran menulis puisi bebas melalui media lagu medley siswa kelas VIII B SMP Sintang. Subjek penelitian adalah siswa kelas VIII B SMP Sintang. Penelitian ini merupakan Penelitian Tindakan Kelas (PTK. Prosedur pelaksanaan dan implementasi penelitian dilaksanakan dalam dua siklus. Teknik pengumpulan data berupa obsevasi, wawancara, catatan lapangan, angket, evaluasi dan dokumentasi. Instrumen pengumpulan data meliputi lembar wawancara, lembar catatan lapangan, lembar angket, lembar tes hasil belajar dan lembar portofolio serta dokumentasi foto kegiatan. Teknik analisis data yang digunakan adalah analisis data kuantitatif dan kualitatif. Hasil penelitian ini menunjukkan bahwa penggunaan media lagu medley dapat meningkatkan pembelajaran menulis puisi bebas. Peningkatan hasil atau produk dapat dilihat dari perbandingan skor rata-rata keterampilan menulis puisi bebas siswa pada setiap siklus. Nilai rata-rata siswa pada tahap pratindakan adalah 55,23, pada saat siklus I meningkat menjadi 71,18, dan pada siklus II meningkat menjadi 73,4. ___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ DEVELOPING THE TEACHING OF FREE VERSE WRITING THROUGH MEDLEY SONG MEDIA TO GRADE VIII STUDENTS OF SMP SINTANG   Abstract This study aims to improve the teaching of free verse writing through medley song media to Grade VIII B students of SMP Sintang. The research subjects were Grade VIII B students of SMP Sintang,. This was a classroom action research (CAR. The research procedure and implementation were conducted in two cycles. The data were collected through observations, field notes, questionnaires, evaluations, and documentations. The data collecting instruments included interview sheets, field note sheets

  8. Ultramorphology of the root surface subsequent to hand-ultrasonic simultaneous instrumentation during non-surgical periodontal treatments: an in vitro study

    Directory of Open Access Journals (Sweden)

    Simone D. Aspriello

    2011-02-01

    Full Text Available OBJECTIVE: The purpose of this study was to investigate the ultramorphology of the root surfaces induced by mechanical instrumentation performed using conventional curettes or piezoelectric scalers when used single-handedly or with a combined technique. MATERIAL AND METHODS: Thirty single-rooted teeth were selected and divided into 3 groups: Group A, instrumentation with curettes; Group B instrumentation with titanium nitride coated periodontal tip mounted in a piezoelectric handpiece; Group C, combined technique with curette/ultrasonic piezoelectric instrumentation. The specimens were processed and analyzed using confocal and scanning electron microscopy. Differences between the different groups of instrumentation were determined using Pearson's χ2 with significance predetermined at α=0.001. RESULTS: Periodontal scaling and root planing performed with curettes, ultrasonic or combined instrumentation induced several morphological changes on the root surface. The curettes produced a compact and thick multilayered smear layer, while the morphology of the root surfaces after ultrasonic scaler treatment appeared irregular with few grooves and a thin smear layer. The combination of curette/ultrasonic instrumentation showed exposed root dentin tubules with a surface morphology characterized by the presence of very few grooves and slender remnants of smear layer which only partially covered the root dentin. In some cases, it was also possible to observe areas with exposed collagen fibrils. CONCLUSIONS: The curette-ultrasonic simultaneous instrumentation may combine the beneficial effects of each instrument in a single technique creating a root surface relatively free from the physical barrier of smear layer and dentin tubules orifices partial occlusion.

  9. Laparoendoscopic single-site (LESS retroperitoneal partial adrenalectomy using a custom-made single-access platform and standard laparoscopic instruments: Technical considerations and surgical outcomes

    Directory of Open Access Journals (Sweden)

    Chen-Hsun Ho

    2015-01-01

    Conclusion: Our results clearly demonstrate that LESS retroperitoneal partial adrenalectomy can be performed safely and effectively using a custom-made single-access platform and standard laparoscopic instruments.

  10. 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. ...

  11. Long-Term Seizure, Quality of Life, Depression, and Verbal Memory Outcomes in a Controlled Mesial Temporal Lobe Epilepsy Surgical Series Using Portuguese-Validated Instruments.

    Science.gov (United States)

    Dias, Luis Augusto; Angelis, Geisa de; Teixeira, Wagner Afonso; Casulari, Luiz Augusto

    2017-08-01

    We aimed to evaluate long-term surgical outcomes in patients treated for mesial temporal lobe epilepsy compared with a similar group of patients who underwent a preoperative evaluation. Patient interviews were conducted by an independent neuropsychologist and included a sociodemographic questionnaire and validated versions of the Beck Depression Inventory-II, Adverse Events Profile, Quality of Life in Epilepsy-31, and Rey Auditory Verbal Learning Test. Seventy-one patients who underwent surgery and 20 who underwent mesial temporal lobe epilepsy preoperative evaluations were interviewed. After an 81-month mean postoperative follow-up, 44% of the surgical patients achieved complete seizure relief according to the Engel classification and 68% according to the International League Against Epilepsy classification. The surgical group had a significantly lower prevalence of depression (P = 0.002) and drug-related adverse effects (P = 0.002). Improvement on unemployment (P = 0.02) was achieved but not on driving or education. Delayed verbal memory recall was impaired in 76% of the surgical and 65% of the control cases (P = 0.32). Regarding the Quality of Life in Epilepsy-31, the operated patients scored higher in their total score (mean, 75.44 vs. mean, 60.08; P life. Our study found that, although surgical treatment was effective, its impact on social indicators was modest. Moreover, the self-reported quality of life relied not only on seizure control but also on depressive symptoms and antiepileptic drug burden. Copyright © 2017 The Author(s). Published by Elsevier Inc. All rights reserved.

  12. A multicenter study of the outcomes of the surgical treatment of adolescent idiopathic scoliosis using the Scoliosis Research Society (SRS) outcome instrument.

    Science.gov (United States)

    Merola, Andrew A; Haher, Thomas R; Brkaric, Mario; Panagopoulos, Georgia; Mathur, Samir; Kohani, Omid; Lowe, Thomas G; Lenke, Larry G; Wenger, Dennis R; Newton, Peter O; Clements, David H; Betz, Randal R

    2002-09-15

    A multicenter study of the outcomes of the surgical treatment of adolescent idiopathic scoliosis using the Scoliosis Research Society Questionnaire (SRS 24). To evaluate the patient based outcome of the surgical treatment of adolescent idiopathic scoliosis. A paucity of information exists with respect to patient measures of outcome regarding the surgical treatment of adolescent idiopathic scoliosis. To our knowledge, no prospective outcome study on this topic thus far exists. Using the SRS 24 questionnaire, seven scoliosis centers agreed to prospectively assess outcome for surgically treated patients with adolescent idiopathic scoliosis. Data were collected before surgery and at 24 months after surgery. Data were analyzed using paired and independent samples t test for all seven SRS 24 questionnaire domains (Pain, General Self-Image, Postoperative Self-Image, Postoperative Function, Function From Back Condition, General Level of Activity, and Satisfaction) using Statistical Package for Social Science. The domains were analyzed with respect to the total cohort, gender, curve magnitude, and type of surgery using independent-samples t tests. A total of 242 patients were included in our analysis. A baseline preoperative pain level of 3.68 of 5 was found. This improved to 4.63 after surgery, representing an improvement of 0.95 points. Surgical intervention was associated with improving outcome when compared with preoperative status. Pain, General Self-Image, Function From Back Condition, and Level of Activity all demonstrated statistically significant improvement as compared with preoperative status (P adolescent scoliosis population. Pain scores were improved in our study population at the 2-year postsurgical follow-up. Statistically significant improvements were likewise seen in the General Self-Image, Function From Back Condition, and Level of Activity domains. The present study demonstrates the ability of surgery to improve the outcome of patients afflicted with

  13. Surgical navigation with QR codes

    Directory of Open Access Journals (Sweden)

    Katanacho Manuel

    2016-09-01

    Full Text Available The presented work is an alternative to established measurement systems in surgical navigation. The system is based on camera based tracking of QR code markers. The application uses a single video camera, integrated in a surgical lamp, that captures the QR markers attached to surgical instruments and to the patient.

  14. AAV5-Factor VIII Gene Transfer in Severe Hemophilia A.

    Science.gov (United States)

    Rangarajan, Savita; Walsh, Liron; Lester, Will; Perry, David; Madan, Bella; Laffan, Michael; Yu, Hua; Vettermann, Christian; Pierce, Glenn F; Wong, Wing Y; Pasi, K John

    2017-12-28

    Patients with hemophilia A rely on exogenous factor VIII to prevent bleeding in joints, soft tissue, and the central nervous system. Although successful gene transfer has been reported in patients with hemophilia B, the large size of the factor VIII coding region has precluded improved outcomes with gene therapy in patients with hemophilia A. We infused a single intravenous dose of a codon-optimized adeno-associated virus serotype 5 (AAV5) vector encoding a B-domain-deleted human factor VIII (AAV5-hFVIII-SQ) in nine men with severe hemophilia A. Participants were enrolled sequentially into one of three dose cohorts (low dose [one participant], intermediate dose [one participant], and high dose [seven participants]) and were followed through 52 weeks. Factor VIII activity levels remained at 3 IU or less per deciliter in the recipients of the low or intermediate dose. In the high-dose cohort, the factor VIII activity level was more than 5 IU per deciliter between weeks 2 and 9 after gene transfer in all seven participants, and the level in six participants increased to a normal value (>50 IU per deciliter) that was maintained at 1 year after receipt of the dose. In the high-dose cohort, the median annualized bleeding rate among participants who had previously received prophylactic therapy decreased from 16 events before the study to 1 event after gene transfer, and factor VIII use for participant-reported bleeding ceased in all the participants in this cohort by week 22. The primary adverse event was an elevation in the serum alanine aminotransferase level to 1.5 times the upper limit of the normal range or less. Progression of preexisting chronic arthropathy in one participant was the only serious adverse event. No neutralizing antibodies to factor VIII were detected. The infusion of AAV5-hFVIII-SQ was associated with the sustained normalization of factor VIII activity level over a period of 1 year in six of seven participants who received a high dose, with

  15. Idiopathic Acquired Hemophilia A with Undetectable Factor VIII Inhibitor

    Directory of Open Access Journals (Sweden)

    Nicholas B. Abt

    2014-01-01

    Full Text Available Objective. We present the case of a 73-year-old female, with no family or personal history of a bleeding disorder, who had a classic presentation for acquired hemophilia A. Factor VIII activity was low but detectable and a factor VIII inhibitor was undetectable. Methods. The patient’s plasma was comprehensively studied to determine the cause of the acquired coagulopathy. Using the Nijmegen modification of the Bethesda assay, no factor VIII autoantibody was measureable despite varying the incubation time from 1 to 3 hours. Results. The aPTT was prolonged at 46.8 seconds, which did not correct in the 4 : 1 mix but did with 1 : 1 mix. Using a one stage factor VIII activity assay, the FVIII activity was 16% and chromogenic FVIII activity was also 16%. The patient was treated with recombinant FVII and transfusion, significantly reducing bleeding. Long-term therapy was initiated with cyclophosphamide and prednisone with normalization of FVIII activity. Conclusions. Physicians can be presented with the challenging clinical picture of an acquired factor VIII inhibitor without a detectable inhibitor by the Bethesda assay. Standard therapy for an acquired hemophilia A should be considered.

  16. Shift and Duty Scheduling of Surgical Technicians in Naval Hospitals

    National Research Council Canada - National Science Library

    Nurse, Nigel

    2004-01-01

    Surgical technicians at Naval hospitals provide a host of services related to surgical procedures that include handing instruments to surgeons, assisting operating room nurses, prepping and cleaning...

  17. Improving attitudes toward mathematics learning with problem posing in class VIII

    Science.gov (United States)

    Vionita, Alfha; Purboningsih, Dyah

    2017-08-01

    This research is classroom action research which is collaborated to improve student's behavior toward math and mathematics learning at class VIII by using problem posing approach. The subject of research is all of students grade VIIIA which consist of 32 students. This research has been held on two period, first period is about 3 times meeting, and second period is about 4 times meeting. The instrument of this research is implementation of learning observation's guidance by using problem posing approach. Cycle test has been used to measure cognitive competence, and questionnaire to measure the students' behavior in mathematics learning process. The result of research shows the students' behavior has been improving after using problem posing approach. It is showed by the behavior's criteria of students that has increasing result from the average in first period to high in second period. Furthermore, the percentage of test result is also improve from 68,75% in first period to 78,13% in second period. On the other hand, the implementation of learning observation by using problem posing approach has also improving and it is showed by the average percentage of teacher's achievement in first period is 89,2% and student's achievement 85,8%. These results get increase in second period for both teacher and students' achievement which are 94,4% and 91,11%. As a result, students' behavior toward math learning process in class VIII has been improving by using problem posing approach.

  18. The labour ward analgesic service at King Edward VIII Hospital ...

    African Journals Online (AJOL)

    Abstract The provision of analgesic services to the labour ward at King Edward VIII Hospital was studied during a I-week period. Of249 patients, 113 (45%) received no analgesia whatsoever. Intramuscular pethidine was the commonest form of analgesia and was used in 97 patients (39%). Thirty-six patients (14%) received ...

  19. Nijmegen-Bethesda assay to measure factor VIII inhibitors.

    Science.gov (United States)

    Duncan, Elizabeth; Collecutt, Margaret; Street, Alison

    2013-01-01

    Hemophilia A is an inherited bleeding disorder caused by a deficiency of factor VIII coagulant activity (FVIII:C). Patients are treated with infusions of either plasma-derived or recombinant factor VIII. However, some patients develop inhibitory antibodies (inhibitors) to infused factor VIII which render it ineffective. The original Bethesda method was developed to standardize measurement of inhibitors in a factor VIII neutralization assay. One Bethesda unit is defined as that amount of inhibitor that results in 50% residual FVIII:C activity of a defined test mixture. In the Nijmegen modification of the original Bethesda method, the pH and the protein concentration of the test mixture is further standardized. As a result, the FVIII:C in the test mixture is less prone to artifactual deterioration and the test has improved specificity. Even with a standardized procedure a number of factors can affect the performance of the test and it is important for laboratory staff to be aware of their impact on the result outcome.

  20. New study on the XeVIII spectrum

    International Nuclear Information System (INIS)

    Gallardo, M.; Raineri, M.; Giuliani, M.; Lagorio, C.; Padilla, S.; Sarmiento, R.; Reyna Almandos, J.G.

    2005-01-01

    Capillary light sources were used to observe the spectrum of seven-times-ionized xenon, XeVIII, in the 300-6000 A wavelength range. Twenty-eight energy levels belonging to the 5s-9s, 5d-9d, 5g-9g, 7i-10i, 9l, 5p-9p, 4f-9f, 6h-9h and 8k-10k configurations were adjusted and 38 new spectral lines were classified. The XeVIII ionization energy was determined with improved accuracy using the polarization model. The analysis was supported by Hartree-Fock calculations. The weighted oscillator strengths for all the observed spectral lines were also calculated considering the fitted values for the energy parameters

  1. Transforaminal intrathecal delivery of nusinersen using cone-beam computed tomography for children with spinal muscular atrophy and extensive surgical instrumentation: early results of technical success and safety.

    Science.gov (United States)

    Weaver, John J; Natarajan, Niranjana; Shaw, Dennis W W; Apkon, Susan D; Koo, Kevin S H; Shivaram, Giri M; Monroe, Eric J

    2018-03-01

    Nusinersen, the only treatment approved by the United States Food and Drug Administration for spinal muscular atrophy (SMA), is delivered intrathecally. Many children with SMA have extensive spinal instrumentation and deformities, often precluding the use of standard approaches for gaining intrathecal access. Furthermore the anatomical distortion that often occurs with rotoscoliosis can complicate the use of fluoroscopic guidance. Compared to fluoroscopy, CT affords superior guidance for complex needle placements. This opens up alternatives to the posterior (interlaminar) technique, including transforaminal and caudal approaches. This study describes the early results of technical success, complications and radiation dose of intrathecal delivery of nusinersen using cone-beam CT guidance with two-axis fluoroscopic navigational overlay. We conducted a retrospective review of 15 consecutive nusinersen injections performed in four children with SMA and extensive spinal hardware precluding standard posterior lumbar puncture techniques. These children were treated using transforaminal thecal access employing cone-beam CT with navigational overlay. We analyzed results including technical success, complications and total fluoroscopy time. All procedures were technically successful. No major complications and one minor complication were reported; the minor complication was a post-procedural neuropathic headache that was attributed to procedural positioning and was treated successfully with gabapentin. The average procedural fluoroscopy time and air kerma were 1.9 min and 55.8 mGy, respectively. Cone-beam CT guidance with two-axis navigational overlay is a safe, effective method for gaining transforaminal intrathecal access in children with spinal abnormalities and hardware precluding the use of standard techniques.

  2. Characterization of five partial deletions of the factor VIII gene

    International Nuclear Information System (INIS)

    Youssoufian, H.; Antonarakis, S.E.; Aronis, S.; Tsiftis, G.; Phillips, D.G.; Kazazian, H.H. Jr.

    1987-01-01

    Hemophilia A is an X-linked disorder of coagulation caused by a deficiency of factor VIII. By using cloned DNA probes, the authors have characterized the following five different partial deletions of the factor VIII gene from a panel of 83 patients with hemophilia A: (i) a 7-kilobase (kb) deletion that eliminates exon 6; (ii) a 2.5-kb deletion that eliminates 5' sequences of exon 14; (iii) a deletion of at least 7 kb that eliminates exons 24 and 25; (iv) a deletion of at least 16 kb that eliminates exons 23-25; and (v) a 5.5-kb deletion that eliminates exon 22. The first four deletions are associated with severe hemophilia A. By contrast, the last deletion is associated with moderate disease, possibly because of in-frame splicing from adjacent exons. None of those patients with partial gene deletions had circulating inhibitors to factor VIII. One deletion occurred de novo in a germ cell of the maternal grandmother, while a second deletion occurred in a germ cell of the maternal grandfather. These observations demonstrate that de novo deletions of X-linked genes can occur in either male or female gametes

  3. Scoliosis research society outcome instrument in evaluation of long-term surgical results in spondylolysis and low-grade isthmic spondylolisthesis in young patients.

    Science.gov (United States)

    Helenius, Ilkka; Lamberg, Tommi; Osterman, Kalevi; Schlenzka, Dietrich; Yrjönen, Timo; Tervahartiala, Pekka; Seitsalo, Seppo; Poussa, Mikko; Remes, Ville

    2005-02-01

    A retrospective follow-up study of low-grade (slip Society questionnaire and compare it with Oswestry Disability Index and radiographic parameters in patients with isthmic spondylolisthesis. A few studies have examined long-term patient outcome using validated questionnaires or compared it with radiographic parameters after surgery for isthmic spondylolisthesis in young patients. The Scoliosis Research Society questionnaire provides patient-oriented information on back pain, cosmetic aspects, patient satisfaction, and level of activity and might therefore be suitable for evaluation of surgical outcome after isthmic spondylolisthesis in young patients. However, there are no studies assessing the usefulness of the Scoliosis Research Society questionnaire for these patients. One hundred and eight patients treated at a mean (range) age of 15.9 (range, 8.1-19.8) years with posterior (n = 29) or posterolateral (n = 79) in situ fusion for isthmic spondylolisthesis participated in the present study. The follow-up rate was 83% after a mean of 20.8 (range, 15.1-25.9) years. The mean age at follow-up observation was 36.7 years. Radiographs were obtained before surgery, at 2-year follow-up observation, and at final follow-up review. The Scoliosis Research Society and Oswestry Disability Index questionnaires were completed, and a physical examination was performed at the final follow-up visit. Nonunion after primary operation was found in 10 (34%) patients after posterior fusion and in 10 (13%) patients after posterolateral fusion (P = 0.0017). The mean (range) anterior slip was 25.2% (0-50%) before surgery and 24.2% (0-78%) at final follow-up observation. Lumbosacral kyphosis increased significantly during the follow-up period. The Scoliosis Research Society questionnaire yielded a total of 94.0 (range, 44-114) points. On the Scoliosis Research Society questionnaire, 14 (14%) patients reported back pain often or very often at rest. The Oswestry Disability Index scores averaged

  4. The C1 and C2 domains of blood coagulation factor VIII mediate its endocytosis by dendritic cells.

    Science.gov (United States)

    Gangadharan, Bagirath; Ing, Mathieu; Delignat, Sandrine; Peyron, Ivan; Teyssandier, Maud; Kaveri, Srinivas V; Lacroix-Desmazes, Sébastien

    2017-02-01

    The development of inhibitory antibodies to therapeutic factor VIII is the major complication of replacement therapy in patients with hemophilia A. The first step in the initiation of the anti-factor VIII immune response is factor VIII interaction with receptor(s) on antigen-presenting cells, followed by endocytosis and presentation to naïve CD4 + T cells. Recent studies indicate a role for the C1 domain in factor VIII uptake. We investigated whether charged residues in the C2 domain participate in immunogenic factor VIII uptake. Co-incubation of factor VIII with BO2C11, a monoclonal C2-specific immunoglobulin G, reduced factor VIII endocytosis by dendritic cells and presentation to CD4 + T cells, and diminished factor VIII immunogenicity in factor VIII-deficient mice. The mutation of basic residues within the BO2C11 epitope of C2 replicated reduced in vitro immunogenic uptake, but failed to prevent factor VIII immunogenicity in mice. BO2C11 prevents factor VIII binding to von Willebrand factor, thus potentially biasing factor VIII immunogenicity by perturbing its half-life. Interestingly, a factor VIII Y1680C mutant, that does not bind von Willebrand factor, demonstrated unaltered endocytosis by dendritic cells as well as immunogenicity in factor VIII-deficient mice. Co-incubation of factor VIII Y1680C with BO2C11, however, resulted in decreased factor VIII immunogenicity in vivo In addition, a previously described triple C1 mutant showed decreased uptake in vitro, and reduced immunogenicity in vivo, but only in the absence of endogenous von Willebrand factor. Taken together, the results indicate that residues in the C1 and/or C2 domains of factor VIII are implicated in immunogenic factor VIII uptake, at least in vitro Conversely, in vivo, the binding to endogenous von Willebrand factor masks the reducing effect of mutations in the C domains on factor VIII immunogenicity. Copyright© Ferrata Storti Foundation.

  5. PENGARUH PENERAPAN PENDEKATAN REALISTIK SETTING KOOPERATIF TERHADAP KEMAMPUAN KOMUNIKASI MATEMATIKA SISWA KELAS VIII

    Directory of Open Access Journals (Sweden)

    Andi Alim Syahri

    2017-12-01

    This study aims to determine the effect of learning mathematics through Realistic Cooperative Setting Approach to students mathematics’ communication skill of VIII grade of SMP Muhammadiyah 6 Makassar academic year 2017/2018. This Pre-Experiment research involved one class as a case study without control class with One-Group Pre-Test and Post-Test design. The subject of this research were 33 student’s of VIIIB consist of 12 male and 21 female.  The research were conducted in 6 meeting. The instrument of this research were test to saw the students’ written communication ability, observation sheet to observed students’ oral communication ability during the learning process, observation sheet of learning implementation to observed teacher ability in managed learning process in appropriate with RPP and questionnaire to measured the student response in learning trough Realistic Cooperative Setting Approach. The result of this research showed that: (1 most of the students’ mathematical communication skill before and after taught by Realistic Cooperative Setting Approach were successive 6,15 and 29,93 from the ideal 60 with average normalized gain score 0.44  means that increase was in the medium category, (2 the average percentage of frequency of the students’ oral communication ability was 76,63%, (3 the average implementation of learning was 3,6 in good category, and (4 the questionnaire showed that students’ response to Realistic Cooperative Setting Approach inclined to be positive with  percentage 88%. From the result of this research, can be concluded that the application of Realistic Cooperative Setting Approach influenced the students mathematics’ communication skill of VIII grade of SMP Muhammadiyah 6 Makassar.

  6. 40 CFR Appendix Viii to Part 600 - Fuel Economy Label Formats

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 29 2010-07-01 2010-07-01 false Fuel Economy Label Formats VIII... POLICY FUEL ECONOMY AND CARBON-RELATED EXHAUST EMISSIONS OF MOTOR VEHICLES Pt. 600, App. VIII Appendix VIII to Part 600—Fuel Economy Label Formats EC01MY92.117 EC01MY92.118 EC01MY92.119 EC01MY92.120...

  7. Differential proteolytic activation of factor VIII-von Willebrand factor complex by thrombin

    International Nuclear Information System (INIS)

    Hill-Eubanks, D.C.; Parker, C.G.; Lollar, P.

    1989-01-01

    Blood coagulation factor VIII (fVIII) is a plasma protein that is decreased or absent in hemophilia A. It is isolated as a mixture of heterodimers that contain a variably sized heavy chain and a common light chain. Thrombin catalyzes the activation of fVIII in a reaction that is associated with cleavages in both types of chain. The authors isolated a serine protease from Bothrops jararacussu snake venom that catalyzes thrombin-like heavy-chain cleavage but not light-chain cleavage in porcine fVIII as judged by NaDodSO 4 /PAGE and N-terminal sequence analysis. Using a plasma-free assay of the ability of activated 125 I-fVIII to function as a cofactor in the activation of factor X by factor IXa, they found that fVIII is activated by the venom enzyme. The venom enzyme-activated fVIII was isolated in stable form by cation-exchange HPLC. von Willebrand factor inhibited venom enzyme-activated fVIII but not thrombin-activated fVIII. These results suggest that the binding of fVIII to von Willebrand factor depends on the presence of an intact light chain and that activated fVIII must dissociate from von Willebrand factor to exert its cofactor effect. Thus, proteolytic activation of fVIII-von Willebrand factor complex appears to be differentially regulated by light-chain cleavage to dissociate the complex and heavy-chain cleavage to activate the cofactor function

  8. War and peace: Factor VIII and the adaptive immune response.

    Science.gov (United States)

    Georgescu, Maria T; Lai, Jesse D; Hough, Christine; Lillicrap, David

    2016-03-01

    The development of neutralizing anti-factor VIII (FVIII) antibodies (inhibitors) remains a major challenge for FVIII replacement therapy in hemophilia A patients. The adaptive immune response plays a crucial role in the development and maintenance of inhibitors. In this review, we focus on our current understanding of FVIII interactions with cells of the adaptive immune system and the phenotype of the resultant response. Additionally, we examine both current and novel FVIII tolerance induction methods that function at the level of the adaptive immune response. Copyright © 2015 Elsevier Inc. All rights reserved.

  9. PENERAPAN METODE PENEMUAN TERBIMBING DI KELAS VIII SMP

    Directory of Open Access Journals (Sweden)

    Toni Hidayat

    2017-08-01

    Full Text Available This study was a classroom action research which aims to investigate how the implementation of guided discovery learning can improve students’ activeness and attainment in the class VIII of Laboraturium UM Senior High School Malang city. The study subject was Class VIII that consists of 36 students, year 2016/2017. This study consisted of two cycles, and the data was collected from the result of the final test, observation, and interview. Based on the research of cycle I, the students’ activeness with mean scores of the meeting I, II, III was 78.88%, 79%, 86.6% respectively. The students’ activeness on cycle II, the mean scores of analyst meeting V and VI were 89.22% and 92.24% respectively. The result of Mathematics learning was increased, it is shown on the test mean of the cycle I that was achieved by 36 students with the percentage of successful learning 83 %. On the cycle test II, the average of 36 gained 82 (score with 7.2 increased from the score mean of the cycle I and with classical mastery learning cycle II 88.88%. Penelitian ini merupakan Penelitian Tindakan Kelas (PTK yang bertujuan untuk mengetahui bagaimana penerapan metode penemuan terbimbing yang dapat meningkatan keaktifan dan hasil belajar siswa kelas VIII SMP Laboratorium UM Kota Malang. Subjek penelitian ini ialah siswa kelas VIII yang berjumlah 36 siswa tahun pelajaran 2016/2017. Penelitian ini terdiri atas dua siklus dan data dikumpulkan dari hasil tes akhir tindakan, observasi, dan wawancara. Berdasarakan hasil penelitian pada siklus I, keaktifan siswa siswa dengan skor rata-rata pertemuan I, II, III adalah 78,88% 79,%, dan 86,6%. Aktivitas siswa pada siklus II, rata-rata skor pengamat pertemuan V dan VI berturut-turut 89,22 % dan 92,24%. Hasil belajar matematika siswa meningkat, hal ini terlihat bahwa rata-rata tes siklus I yang diperoleh 36 siswa sebesar 74,8 dengan presentase keberhasilan belajar 83,33%. Pada tes siklus II rata-rata nilai menjadi 82 dengan

  10. Factor VIII gene (F8) mutation and risk of inhibitor development in nonsevere hemophilia a

    NARCIS (Netherlands)

    C.L. Eckhardt (Corien); A.S. van Velzen (Alice); M.A.D. Peters (Marjolein); J. Astermark (Jan); P.P. Brons; G. Castaman (Giancarlo); M.H. Cnossen (Marjon); N. Dors (N.); C. Escuriola-Ettingshausen (Carmen); K. Hamulyák (K.); D.P. Hart (Daniel); C.R.M. Hay (Charles R.); S. Haya (Saturnino); W.L. van Heerde; C. Hermans (Cédric); M. Holmström (Margareta); V. Jimenez-Yuste (Victor); R.D. Keenan (Russell); R. Klamroth (Robert); B.A.P. Laros-Van Gorkom (Britta); F.W.G. Leebeek (Frank); R. Liesner (Ri); A. Mäkipernaa (Anne); C. Male (Christoph); E.P. Mauser-Bunschoten (Eveline); M.G. Mazzucconi (Maria); S. McRae (Simon); K. Meijer (K.); M. Mitchell (Michael); M. Morfini (Massimo); M.R. Nijziel (Marten); J. Oldenburg (Jan); K. Peerlinck; P. Petrini (Pia); H. Platokouki (Helena); S.E. Reitter-Pfoertner (Sylvia); E. Santagostino (Elena); P. Schinco (Piercarla); F.J.W. Smiers (Frans); K.D. Siegmund (Kimberly); A. Tagliaferri (Annarita); T.T. Yee (Thynn); P.W. Kamphuisen (Pieter Willem); J.G. van der Bom (Anske); K. Fijnvandraat

    2013-01-01

    textabstractNeutralizing antibodies (inhibitors) toward factor VIII form a severe complication in nonsevere hemophilia A, profoundly aggravating the bleeding pattern. Identification of high-risk patients is hampered by lack of data that take exposure days to therapeutic factor VIII concentrates into

  11. Effectiveness of Mind Mapping in English Teaching among VIII Standard Students

    Science.gov (United States)

    Hallen, D.; Sangeetha, N.

    2015-01-01

    The aim of the study is to find out the effectiveness of mind mapping technique over conventional method in teaching English at high school level (VIII), in terms of Control and Experimental group. The sample of the study comprised, 60 VIII Standard students in Tiruchendur Taluk. Mind Maps and Achievement Test (Pretest & Posttest) were…

  12. Phage display technology: a tool to explore the diversity of inhibitors to blood coagulation factor VIII

    NARCIS (Netherlands)

    Voorberg, J.; van den Brink, E. N.

    2000-01-01

    Hemophilia A is a X-linked bleeding disorder that is caused by the functional absence of blood coagulation factor VIII. The bleeding tendency in hemophilia A patients can be corrected by the administration of plasma-derived or recombinant factor VIII concentrates. A serious complication in

  13. Human heart cytochrome c oxidase subunit VIII. Purification and determination of the complete amino acid sequence

    NARCIS (Netherlands)

    van Kuilenburg, A. B.; Muijsers, A. O.; Demol, H.; Dekker, H. L.; van Beeumen, J. J.

    1988-01-01

    Subunit VIII was purified from a preparation of the human heart cytochrome c oxidase and its complete amino acid sequence was determined. The sequence proved to be much more related to that of the bovine liver oxidase subunit VIII than to that found in bovine heart. Our finding of a 'liver-type'

  14. Paducah-Louisville Consortium; Project VIII: Focus on Dropouts... a New Design. Final Evaluation Report.

    Science.gov (United States)

    Paducah Public Schools, KY.

    Project VIII is an innovative behavioral science oriented educational program, funded under Title VIII Elementary Secondary Education Act, designed to attack the personal, social, and educational problems of children whose previous record of school failure and frustration has indicated high dropout potential. The program is operated as a…

  15. 4p-5s transitions in YVII, VIII, ZrVIII, IX, NbIX, X and MoX, XI

    International Nuclear Information System (INIS)

    Rahimullah, K.; Chaghtai, M.S.Z.; Khatoon, S.

    1976-01-01

    The spectra of Y VII, VIII, Zr VIII, IX, Nb X and Mo X, XI are studied for the first time and the 1971 analysis of Nb IX is improved. By analyses of the transitions 4s 2 4psup(k)-4s 2 4psup(k-1)5s all the levels of the configurations 4p 3 , 4p 2 5s, 4p 2 and 4p5s are established in the spectra concerned. (Auth.)

  16. Surgical Audit

    African Journals Online (AJOL)

    2010-01-06

    Jan 6, 2010 ... A good way to describe the first surgical audits is that they were 'polite, restrained discussions'. This was the situation before the development of quality assurance in the business world. As this slowly infiltrated into the medical profession the discussions changed to more cri- teria based surgical audits.

  17. Potential role of a new PEGylated recombinant factor VIII for hemophilia A

    Directory of Open Access Journals (Sweden)

    Wynn TT

    2016-06-01

    Full Text Available Tung Thanh Wynn,1 Burak Gumuscu,2,3 1Department of Pediatrics, Division of Pediatric Hematology/Oncology, University of Florida, Gainesville, FL, 2Pediatric Hematology-Oncology, Bon Secours Health System, St. Mary’s Hospital, Richmond, VA, 3Department of Pediatrics, Division of Pediatric Hematology/Oncology, University of Virginia, Charlottesville, VA, USA Abstract: Hemophilia A, a deficiency in the activity of coagulation factor (F VIII, is an X-linked bleeding disorder with an approximate incidence of one in 5,000 male infants. Bleeding-related complications often result in greater severity of disease, poor quality of life, surgical interventions for severe joint destruction, and shortened life span. With the availability of plasma-derived and recombinant FVIII products, the benefits of primary prophylaxis were demonstrated and is now the standard of care for patients with severe factor deficiencies. Current hemophilia research is focusing on the creation of new factor replacement therapies with longer half-lives; accessing alternative mechanisms to achieve desired hemostasis and enhance bypassing ­activity; and limiting the immunogenicity of the protein. PEGylation involves the covalent attachment of polyethylene glycol (PEG to a protein, peptide, or a small molecule drug. PEG effectively increases the molecular weight and size of the protein by creating a hydrophilic cloud around the molecule. This molecular change may reduce susceptibility of the molecule to proteolytic activity and degradation. It is also believed that PEGylation changes the surface charge of the protein that ultimately interferes with some receptor-mediated clearance processes. The half-life of PEGylated factor is more prolonged when compared to non-PEGylated full-length recombinant FVIII. The dawn of a new era in the care of hemophilia patients is upon us with the release of recombinant FVIII products with extended half-lives, and products with even more extended half

  18. Acquired factor VIII inhibitor syndrome: A rare cause of hematuria

    Directory of Open Access Journals (Sweden)

    Muthuvel Seral Kannan

    2015-01-01

    Full Text Available A 50-year-old woman presented with gross hematuria for 1 month. Clinical examinations, laboratory investigations, ultrasound and contrast computed tomography were normal, except anemia. Cystoscopy revealed bloody efflux from the right side. Retrograde pyelogram showed filling defect in the renal pelvis and biopsy was inconclusive. Renal angiogram was normal. She developed ecchymosis on the right thigh and arm with elevated activated partial thromboplastin time. The partial thromboplastin time correction study and Bethesda study confirmed the presence of acquired factor VIII inhibitor (acquired hemophilia. With flexible ureterorenoscopy, the mass in the renal pelvis was removed and its histopathology revealed clotted blood. The patient was subsequently managed with steroids and Factor eight inhibitor bypass activity.

  19. Penggunaan Media Software GeoGebra untuk Meningkatkan Kemampuan Representasi Matematis Siswa SMP Kelas VIII

    Directory of Open Access Journals (Sweden)

    Marini Oktaria

    2016-06-01

    Full Text Available Rendahnya kemampuan representasi matematis siswa menjadi salah satu penyebab rendahnya prestasi belajar matematika siswa. Hal ini diperkuat dengan hasil laporan TIMSS dan PISA yang menunjukkan rendahnya kemampuan matematika siswa Indonesia. Untuk membantu siswa meningkatkan kemampuan representasi matematis digunakan suatu media pembelajaran matematika. Salah satu media pembelajaran matematika yang dapat merepresentasikan model matematika adalah software GeoGebra. Maka dari itu, penelitian ini bertujuan untuk mengetahui apakah software GeoGebra dapat meningkatkan kemampuan representasi matematis siswa pada materi SPLDV. Sampel dalam penelitian ini adalah siswa kelas VIII.2 SMP Islamic Village tahun ajaran 2015/2016 semester II sebanyak 29 orang dengan purposive sampling. Instrumen penelitian berupa tes uraian untuk mengukur kemaampuan representasi matematis. Metode dalam penelitian ini adalah metode kuantitatif jenis pra eksperimen dengan one group pretest-posttest design. Analisis data penelitian ini menggunakan uji non-parametrik Wilcoxon Signed Ranks Test. Hasil penelitian menunjukkan bahwa penggunaan media software GeoGebra dapat meningkatkan kemampuan representasi matematis siswa pada materi sistem persamaan linier dua variabel (SPLDV. Peningkatan yang diperoleh berada pada kategori sedang sebesar 0,651.Low ability students 'mathematical representation became one of the causes of low achievement of students' mathematics learning. This was reinforced by the results of the TIMSS and PISA report which indicates a low ability students' mathematical Indonesia. To help students improve mathematical representation, it needs to use a medium of learning mathematics. One math learning media that can represent mathematical models were software GeoGebra. Therefore, this study aims to determine whether the software GeoGebra can improve students' mathematical representation at SPLDV material. The sample in this study were students VIII.2 SMP Islamic

  20. Attracting students to surgical careers: preclinical surgical experience.

    Science.gov (United States)

    Antiel, Ryan M; Thompson, Scott M; Camp, Christopher L; Thompson, Geoffrey B; Farley, David R

    2012-01-01

    Along with a decline in interest in general surgery among United States medical school graduates, reports indicate a decrease in the amount of time students are spending on their surgical clerkship. In an effort to offer early exposure to general surgery as well as to equip students with the basic surgical skills that will enhance their third-year clerkship experience, we developed a preclinical surgical experience. Students were surveyed to determine whether the surgical selective changed student level of comfort with basic surgical skills. Surveys were administered, preexperience and postexperience to the medical students enrolled in the surgery selective. The students were asked to rate their comfort level with 12 unique surgical skills. Comfort with the task was evaluated using a 10-point Likert scale. Analyses were conducted to evaluate the impact of the surgical experience on student comfort levels with the surgical skills. The self-reported comfort levels of students increased significantly after the experience in all 12 areas. The greatest change in comfort level (greater than or equal to mean difference of 4) occurred in the surgical technique categories: knot tying (mean difference: 4.9, p < 0.0001), suturing (mean difference: 4.85, p < 0.0001), correctly making an incision (mean difference: 4.95, p < 0.0001), using a needle driver (mean difference: 5.35, p < 0.0001), holding pickups (mean difference: 4.6, p < 0.0001), use of laparoscopic instruments (mean difference: 4.8, p < 0.0001), and use of surgical simulators (mean difference: 6.0, p < 0.0001). Our preclinical surgical experience serves as a model of an effective modality providing early exposure to general surgery. The experience provides trainees with basic surgical skills well before they begin their third-year clerkships. Copyright © 2012 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  1. Radioisotope instruments

    CERN Document Server

    Cameron, J F; Silverleaf, D J

    1971-01-01

    International Series of Monographs in Nuclear Energy, Volume 107: Radioisotope Instruments, Part 1 focuses on the design and applications of instruments based on the radiation released by radioactive substances. The book first offers information on the physical basis of radioisotope instruments; technical and economic advantages of radioisotope instruments; and radiation hazard. The manuscript then discusses commercial radioisotope instruments, including radiation sources and detectors, computing and control units, and measuring heads. The text describes the applications of radioisotop

  2. Expression of factor VIII-related antigen in human aqueous drainage channels.

    Science.gov (United States)

    Krohn, J

    1999-02-01

    Previous studies have indicated that there are preformed channels at the inner aspect of the anterior sclera, capable of draining fluid from the suprachoroidal space into scleral veins. The aim of this study was to characterize the cellular lining of these channels, and to compare it with the endothelium of Schlemm's canal, the collector channels and the scleral blood vessels. Histological sections from the angular region of human eyes were prepared by an immunoperoxidase method to evaluate the expression of factor VIII-related antigen in different aqueous drainage channels. The cellular lining of the scleral channels showed a weak immunostaining to factor VIII-related antigen. Factor VIII-related antigen was also detected in the endothelium of the collector channels and Schlemm's canal. The positive immunoreaction to factor VIII-related antigen indicates that the previously described scleral channels, the collector channels and Schlemm's canal are all lined by an endothelium derived from a vascular origin.

  3. Class VIII Medical Materiel Controls in the U.S. European Command

    National Research Council Canada - National Science Library

    1991-01-01

    .... Class VIII medical materiel inventories are maintained as part of the U.S. war reserve stocks to ensure military readiness and to provide needed health care during wartime or contingencies. The U.S...

  4. Bulk moduli and equations of state of ice VII and ice VIII

    Science.gov (United States)

    Klotz, S.; Komatsu, K.; Kagi, H.; Kunc, K.; Sano-Furukawa, A.; Machida, S.; Hattori, T.

    2017-05-01

    The compression behavior of deuterated ice VII and VIII was investigated by high pressure neutron scattering in the pressure range 2-13.7 GPa between 93 and 300 K. We establish equations of state which contain accurate values for the bulk moduli B0, their pressure derivatives B0', as well as the ambient pressure volume V0. These equations of state hold over a large part of the stability domain of ice VII, by comparison with available x-ray data, and to at least ≈13 GPa for ice VIII. They are indistinguishable at low pressures, but beyond ≈7 GPa and at low temperatures ice VIII appears to become stiffer than expected. This might be related to an anomalous phonon hardening observed previously in ice VIII in this P /T range [D. D. Klug et al., Phys. Rev. B 70, 144113 (2004), 10.1103/PhysRevB.70.144113].

  5. Pengaruh Layanan Informasi Pendidikan Seks terhadap Pengetahuan Siswa Tentang Seks Kelas VIII SMPN

    OpenAIRE

    Citrawati, Neka; Yuline, Yuline; Endang, Busri

    2017-01-01

    This study aims to find out more about how big the influence of sex education information services to students' knowledge about sex in class VIII SMPN 1 Matan Hilir Selatan. The form of this study is the study of relationships. The sample of this research is class VIII students. Data collection techniques used is indirect kominaksi technique in the form of questionnaire amounted to 47 questions on the variables of sex education information services and 47 questions on the student's knowledge ...

  6. Agnostic stacking of intergalactic doublet absorption: measuring the Ne VIII population

    Science.gov (United States)

    Frank, Stephan; Pieri, Matthew M.; Mathur, Smita; Danforth, Charles W.; Shull, J. Michael

    2018-05-01

    We present a blind search for doublet intergalactic metal absorption with a method dubbed `agnostic stacking'. Using a forward-modelling framework, we combine this with direct detections in the literature to measure the overall metal population. We apply this novel approach to the search for Ne VIII absorption in a set of 26 high-quality COS spectra. We probe to an unprecedented low limit of log N>12.3 at 0.47≤z ≤1.34 over a path-length Δz = 7.36. This method selects apparent absorption without requiring knowledge of its source. Stacking this mixed population dilutes doublet features in composite spectra in a deterministic manner, allowing us to measure the proportion corresponding to Ne VIII absorption. We stack potential Ne VIII absorption in two regimes: absorption too weak to be significant in direct line studies (12.3 13.7). We do not detect Ne VIII absorption in either regime. Combining our measurements with direct detections, we find that the Ne VIII population is reproduced with a power-law column density distribution function with slope β = -1.86 ^{+0.18 }_{ -0.26} and normalization log f_{13.7} = -13.99 ^{+0.20 }_{ -0.23}, leading to an incidence rate of strong Ne VIII absorbers dn/dz =1.38 ^{+0.97 }_{ -0.82}. We infer a cosmic mass density for Ne VIII gas with 12.3 < log N < 15.0 of Ω _{{{Ne {VIII}}}} = 2.2 ^{+1.6 }_{ _-1.2} × 10^{-8}, a value significantly lower that than predicted by recent simulations. We translate this density into an estimate of the baryon density Ωb ≈ 1.8 × 10-3, constituting 4 per cent of the total baryonic mass.

  7. Agnostic Stacking of Intergalactic Doublet Absorption: Measuring the Ne VIII Population

    Science.gov (United States)

    Frank, Stephan; Pieri, Matthew M.; Mathur, Smita; Danforth, Charles W.; Michael Shull, J.

    2018-02-01

    We present a blind search for doublet intergalactic metal absorption with a method dubbed `agnostic stacking'. Using a forward-modelling framework we combine this with direct detections in the literature to measure the overall metal population. We apply this novel approach to the search for Ne VIII absorption in a set of 26 high-quality COS spectra. We probe to an unprecedented low limit of log N>12.3 at 0.47≤z ≤1.34 over a pathlength Δz = 7.36. This method selects apparent absorption without requiring knowledge of its source. Stacking this mixed population dilutes doublet features in composite spectra in a deterministic manner, allowing us to measure the proportion corresponding to Ne VIII absorption. We stack potential Ne VIII absorption in two regimes: absorption too weak to be significant in direct line studies (12.3 13.7). We do not detect Ne VIII absorption in either regime. Combining our measurements with direct detections, we find that the Ne VIII population is reproduced with a power law column density distribution function with slope β = -1.86+0.18-0.26 and normalisation log f_{13.7} = -13.99+0.20-0.23, leading to an incidence rate of strong Ne VIII absorbers dn/dz =1.38+0.97-0.82. We infer a cosmic mass density for Ne VIII gas with 12.3 < log N < 15.0 of Ω _{Ne VIII} = 2.2+1.6-1.2 × 10^{-8}, a value significantly lower that than predicted by recent simulations. We translate this density into an estimate of the baryon density Ωb ≈ 1.8 × 10-3, constituting 4% of the total baryonic mass.

  8. A Cranial Trauma was the Cause of Death of Charles VIII of France (1470-1498).

    Science.gov (United States)

    Markatos, Konstantinos; Karamanou, Marianna; Arkoudi, Konstantina; Konstantinidi, Apostolia; Androutsos, Georgios

    2017-09-01

    This article summarizes the reign, life and death, of Charles VIII of France. Also we intend to investigate current views on his cause of death, contradictions and opinions of his biographers. Poisoning, disease, and injury are the possible causes of his death but, according to the literature, cranial trauma was the most probable cause of death of the King Charles VIII of France. Copyright © 2017 Elsevier Inc. All rights reserved.

  9. SURGICAL ANATOMY

    African Journals Online (AJOL)

    SURGICAL ANATOMY. Rare high origin of the radial artery: a bilateral, symmetrical ease. I. O. ()koro and B. C. J iburum. Department of Anatomy, College of Medicine, lrno State University, Owerri, Nigeria. Reprint requests to: Dr I. O. 0k0r0, Department of Anatomy, [mo State University, P. M. B. 2000. Owerri, Nigeria.

  10. SURGICAL TECHNIQUE

    African Journals Online (AJOL)

    Conclusion:Foraminotomy with or without discectomy is a simple posterior surgical approach to T B spine with good neurological outcome. It is adapted to our ... of the spine also referred to as. (HIV/AIDS) further challenge the outcome. These .... treatment; or for spinal cord or nerve root from 2 weeks depending on patient ...

  11. Pharmacokinetics and hemostatic effect of different factor VIII/von Willebrand factor concentrates in von Willebrand's disease type III.

    Science.gov (United States)

    Lethagen, S; Berntorp, E; Nilsson, I M

    1992-12-01

    Four different plasma-derived concentrates composed of coagulation factor VIII (FVIII) and von Willebrand factor (vWF) of varying quality (Hemate-P, Behring; Profilate, Alpha; and F VIII-VHP-vWF, C.R.T.S Lille), or almost purified vWF (Facteur Willebrand, C.R.T.S Lille) and one recombinant F VIII concentrate (Recombinate, Baxter) were given, in doses of 30-60 IU VIII: C/kg or 70-110 IU RCof/kg, to five patients with von Willebrand's disease type III, in order to evaluate the role of the vWF in factor F VIII concentrates. All plasma concentrates except Profilate had a multimeric vWF pattern almost similar to that of normal plasma. Bleeding time (b.t.), VIII: C, vWF:Ag, ristocetin cofactor activity, and multimeric pattern of the plasma-vWF were followed for 72 h. Both Duke b.t. and the multimeric pattern in plasma normalized after infusion of Hemate-P, F VIII-VHP-vWF, and Facteur Willebrand and, to a lesser extent, after Profilate. As expected, in response to Recombinate there was no effect on primary hemostasis, and the half-life of F VIII procoagulant activity (VIII: C) was very short. Normalization of the vWF is important not only for improving the primary hemostasis, but also for maintaining the plasma F VIII concentration on a high level, both by reducing the elimination rate of infused F VIII and via a secondary release of endogenous F VIII. If a prompt hemostatic effect is required, we recommend a concentrate containing both F VIII and all vWF multimers, but for prophylactic treatment, pure vWF may be used.

  12. Surgical speech disorders.

    Science.gov (United States)

    Shen, Tianjie; Sie, Kathleen C Y

    2014-11-01

    Most speech disorders of childhood are treated with speech therapy. However, two conditions, ankyloglossia and velopharyngeal dysfunction, may be amenable to surgical intervention. It is important for surgeons to work with experienced speech language pathologists to diagnose the speech disorder. Children with articulation disorders related to ankyloglossia may benefit from frenuloplasty. Children with velopharyngeal dysfunction should have standardized clinical evaluation and instrumental asseessment of velopharyngeal function. Surgeons should develop a treatment protocol to optimize speech outcomes while minimizing morbidity. Copyright © 2014 Elsevier Inc. All rights reserved.

  13. Surgical Navigation

    DEFF Research Database (Denmark)

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

    2017-01-01

    body removal, respectively. The average technical system accuracy and intraoperative precision reported were less than 1 mm and 1 to 2 mm, respectively. In general, SN is reported to be a useful tool for surgical planning, execution, evaluation, and research. The largest numbers of studies and patients......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 indications...... surgery, skull-base surgery, and foreign body removal were the areas of interests. Results: The search generated 13 articles dealing with traumatology; 5, 6, 2, and 0 studies were found that dealt with the topics of orthognathic surgery, cancer and reconstruction surgery, skull-base surgery, and foreign...

  14. Factor VIII and fibrinogen recovery in plasma after Theraflex methylene blue-treatment: effect of plasma source and treatment time.

    Science.gov (United States)

    Rapaille, André; Reichenberg, Stefan; Najdovski, Tome; Cellier, Nicolas; de Valensart, Nicolas; Deneys, Véronique

    2014-04-01

    The quality of fresh-frozen plasma is affected by different factors. Factor VIII is sensitive to blood component storage processes and storage as well as pathogen-reduction technologies. The level of fibrinogen in plasma is not affected by the collection processes but it is affected by preparation and pathogen-reduction technologies. The quality of plasma from whole blood and apheresis donations harvested at different times and treated with a pathogen-reduction technique, methylene blue/light, was investigated, considering, in particular, fibrinogen and factor VIII levels and recovery. The mean factor VIII level after methylene blue treatment exceeded 0.5 IU/mL in all series. Factor VIII recovery varied between 78% and 89% in different series. The recovery of factor VIII was dependent on plasma source as opposed to treatment time. The interaction between the two factors was statistically significant. Mean levels of fibrinogen after methylene blue/light treatment exceeded 200 mg/dL in all arms. The level of fibrinogen after treatment correlated strongly with the level before treatment. There was a negative correlation between fibrinogen level before treatment and recovery. Pearson's correlation coefficient between factor VIII recovery and fibrinogen recovery was 0.58. These results show a difference in recovery of factor VIII and fibrinogen correlated with plasma source. The recovery of both factor VIII and fibrinogen was higher in whole blood plasma than in apheresis plasma. Factor VIII and fibrinogen recovery did not appear to be correlated.

  15. Estudo anatômico da cóclea para confecção de instrumental para a cirurgia de implante coclear com 2 feixes de eletrodos em cócleas ossificadas Cochlear anatomy study used to design surgical instruments for cochlear implants with two bundles of electrodes in ossified cochleas

    Directory of Open Access Journals (Sweden)

    Mariana Bogar

    2008-04-01

    distances between cochleostomies and ICA in cadaver temporal bones. 2 Design an instrument that can be used in cochlear implant surgery to introduce an implant with two bundles of electrodes. STUDY DESIGN: Experimental prospective. MATERIALS AND METHODS: In 21 temporal bones from cadavers we performed: 1 canal wall down mastoidectomy; 2 cochleostomy in the cochlear basal and middle turns; 3 ICA identification; 4 Length determination between the cochleostomies and the artery. RESULTS: the average distance ± standard deviation obtained for the upper tunnel was of 8.2 ± 1.1 mm and for the lower tunnel it was of 8.1± 1.3 mm. The shortest distance found was of 6.5 mm for the upper tunnel and 6.0 mm for the lower tunnel. CONCLUSION: Despite the values calculated, we concluded that the best value to be considered in creating a surgical instrument are the minimum lengths obtained for each one of the cochlear turns, because this is the safest way to avoid damaging the ICA, that can be fatal.

  16. Instrumentation Facility

    Data.gov (United States)

    Federal Laboratory Consortium — Provides instrumentation support for flight tests of prototype weapons systems using a vast array of airborne sensors, transducers, signal conditioning and encoding...

  17. Time-action analysis of instrument positioners in laparoscopic cholecystectomy

    NARCIS (Netherlands)

    den Boer, K. T.; Bruijn, M.; Jaspers, J. E.; Stassen, L. P. S.; Erp, W. F. M.; Jansen, A.; Go, P. M. N. Y. H.; Dankelman, J.; Gouma, D. J.

    2002-01-01

    BACKGROUND: Instrument positioners can position and lock a laparoscopic instrument. This study uses time-action analysis to evaluate objectively whether IPs can substitute for a surgical assistant efficiently and safely. METHODS: In four hospitals, 78 laparoscopic cholecystectomies were randomly

  18. Surgical endodontics.

    Science.gov (United States)

    Carrotte, P

    2005-01-22

    Root canal treatment usually fails because infection remains within the root canal. An orthograde attempt at re-treatment should always be considered first. However, when surgery is indicated, modern microtechniques coupled with surgical magnification will lead to a better prognosis. Careful management of the hard and soft tissues is essential, specially designed ultrasonic tips should be used for root end preparation which should ideally be sealed with MTA. All cases should be followed up until healing is seen, or failure accepted, and should form a part of clinical audit.

  19. Myosin VIII regulates protonemal patterning and developmental timing in the moss Physcomitrella patens.

    Science.gov (United States)

    Wu, Shu-Zon; Ritchie, Julie A; Pan, Ai-Hong; Quatrano, Ralph S; Bezanilla, Magdalena

    2011-09-01

    Plants have two classes of myosins. While recent work has focused on class XI myosins showing that myosin XI is responsible for organelle motility and cytoplasmic streaming, much less is known about the role of myosin VIII in plant growth and development. We have used a combination of RNAi and insertional knockouts to probe myosin VIII function in the moss Physcomitrella patens. We isolated Δmyo8ABCDE plants demonstrating that myosin VIII is not required for plant viability. However, myosin VIII mutants are smaller than wild-type plants in part due to a defect in cell size. Additionally, Δmyo8ABCDE plants produce more side branches and form gametophores much earlier than wild-type plants. In the absence of nutrient media, Δmyo8ABCDE plants exhibit significant protonemal patterning defects, including highly curved protonemal filaments, morphologically defective side branches, as well as an increase in the number of branches. Exogenous auxin partially rescues protonemal defects in Δmyo8ABCDE plants grown in the absence of nutrients. This result, together with defects in protonemal branching, smaller caulonemal cells, and accelerated development in the Δmyo8ABCDE plants, suggests that myosin VIII is involved in hormone homeostasis in P. patens.

  20. The F309S mutation increases factor VIII secretion in human cell line

    Directory of Open Access Journals (Sweden)

    Daianne Maciely Carvalho Fantacini

    2016-06-01

    Full Text Available ABSTRACT OBJECTIVES: The capacity of a human cell line to secrete recombinant factor VIII with a F309S point mutation was investigated, as was the effect of the addition of chemical chaperones (betaine and sodium-4-phenylbutyrate on the secretion of factor VIII. METHODS: This work used a vector with a F309S mutation in the A1 domain to investigate FVIII production in the HEK 293 human cell line. Factor VIII activity was measured by chromogenic assay. Furthermore, the effects of chemical drugs on the culture were evaluated. RESULTS: The addition of the F309S mutation to a previously described FVIII variant increased FVIII secretion by 4.5 fold. Moreover, the addition of betaine or sodium-4-phenylbutyrate increased the secretion rate of FVIIIΔB proteins in HEK 293 cells, but the same effect was not seen for FVIIIΔB-F309S indicating that all the recombinant protein produced had been efficiently secreted. CONCLUSION: Bioengineering factor VIII expressed in human cells may lead to an efficient production of recombinant factor VIII and contribute toward low-cost coagulation factor replacement therapy for hemophilia A. FVIII-F309S produced in human cells can be effective in vivo.

  1. Desenvolvimento de inibidores do fator VIII na hemofilia A Development of factor VIII inhibitors in hemophilia A

    Directory of Open Access Journals (Sweden)

    Daniel G. Chaves

    2009-01-01

    Full Text Available A hemofilia A é uma coagulopatia genética com herança recessiva ligada ao cromossomo X que afeta 1-2 a cada 10 mil indivíduos do sexo masculino nascidos vivos. Estes indivíduos têm baixas concentrações ou ausência do fator VIII (FVIII da coagulação no plasma e apresentam quadros hemorrágicos leves, moderados e graves, dependendo da atividade de FVIII circulante. Estes pacientes necessitam de constante reposição proteica e aproximadamente 30% deles desenvolvem aloanticorpos contra a proteína exógena. A síntese dos anticorpos anti-FVIII é iniciada quando o FVIII exógeno é endocitado por células apresentadoras de antígeno, degradado e apresentado às células T CD4+ na forma de peptídeos ligados a moléculas do complexo maior de histocompatibilidade (MHC de classe II. Alguns fatores de risco (paciente/tratamento podem ser relacionados ao desenvolvimento desta resposta imune. Neste contexto, as mutações no gene do FVIII e polimorfismos em genes envolvidos na resposta imune são candidatos moleculares como determinantes imunogenéticos na predisposição para o desenvolvimento de inibidores. Por não ser completamente entendido e controlado, o desenvolvimento desta resposta imune contra o FVIII constitui o maior problema decorrente do tratamento de indivíduos portadores de hemofilia A e faz-se necessária busca de opções que visem minimizar suas ações deletérias. Algumas alternativas de tratamento têm se mostrado eficazes no tratamento (anti-CD20, plasmaférese, concentrado de complexo protrombínico (PCCs, concentrado de complexo protrombínico ativado (APCCs, fator VII humano ativado, mas a retirada ou neutralização específica dos inibidores de FVIII ainda não foram alcançadas.Hemophilia A, which affects 1-2:10,000 live-born male neonates, is a genetic coagulopathy with recessive inheritance linked to the X chromosome. These individuals have low concentrations or no coagulation factor VIII (FVIII in the plasma

  2. Diagnostic accuracy study of a factor VIII ELISA for detection of factor VIII antibodies in congenital and acquired haemophilia A.

    Science.gov (United States)

    Batty, Paul; Moore, Gary W; Platton, Sean; Maloney, James C; Palmer, Ben; Bowles, Louise; Pasi, K John; Rangarajan, Savita; Hart, Daniel P

    2015-10-01

    Antibody formation to factor VIII (FVIII) remains the greatest clinical and diagnostic challenge to the haemophilia-treating physician. Current guidance for testing for inhibitory FVIII antibodies (inhibitors) recommends the functional Nijmegen-Bethesda assay (NBA). A FVIII ELISA offers a complementary, immunological approach for FVIII antibody testing. It was the aim of this study to retrospectively evaluate the performance of a FVIII ELISA (index) for detection of FVIII antibodies, compared with the NBA (reference). All samples sent for routine FVIII antibody testing at two haemophilia Comprehensive Care Centres, were tested in parallel using the NBA and a solid-phase, indirect FVIII ELISA kit (Immucor). A total of 497 samples from 239 patients (severe haemophilia A=140, non-severe haemophilia A=85, acquired haemophilia A=14) were available for analysis. Sixty-three samples tested positive by the NBA (prevalence 12.7%, 95% confidence interval [CI], 9.9-15.9 %), with a median inhibitor titre of 1.2 BU/ml (range 0.7-978.0). The FVIII ELISA demonstrated a specificity of 94.0% (95%CI, 91.3-96.0), sensitivity of 77.8% (95%CI, 65.5-87.3), negative predictive value of 96.7% (95%CI, 94.5-98.2), positive predictive value 65.3% (95%CI, 53.5-76.0), negative likelihood ratio 0.2 (95%CI, 0.1-0.4), positive likelihood ratio 13.0 (95%CI, 8.7-19.3) and a diagnostic odds ratio of 54.9 (95%CI, 27.0-112.0). Strong positive correlation (r=0.77, pNBA (log adjusted) and FVIII ELISA optical density. In conclusion, FVIII ELISA offers a simple, specific, surveillance method enabling batch testing of non-urgent samples for the presence of FVIII antibodies.

  3. Hemorrhagic episodes in hemophiliacs stimulating abdominal surgical emergencies

    International Nuclear Information System (INIS)

    Rabie, Mohammad E.; Al-Tayeb, Abdul-Rehman E.; Zafer, Mubarak H.; Seikha, Anwar A.

    2004-01-01

    Hemophiliacs are subjected to develop episodes of spontaneous bleeding at different sites of the body, primarily the knees. On occasions such episodes affect the abdomen. The picture engendered in such cases may mimic that of an abdominal emergency requiring surgical intervention.Such ill advised and unwarranted intervention may end with the patient's death.With the proper emloyment of radiology, the correct diagonosis may be reached and consequently, conservative treatment, in which factor VIII plays the major role, instituted. Here we describe the clinical course of two patients with hemophilia A who suffered bleeding in the abdomen and were treated conservatively with a successfull outcome. (author)

  4. Modelling of non-linear elastic tissues for surgical simulation

    NARCIS (Netherlands)

    Misra, Sarthak; Ramesh, K.T.; Okamura, Allison M.

    2010-01-01

    Realistic modelling of the interaction between surgical instruments and human organs has been recognised as a key requirement in the development of high-fidelity surgical simulators. Primarily due to computational considerations, most of the past real-time surgical simulation research has assumed

  5. Estudo citofotométrico da expressão do marcador tumoral Fator VIII e fatores prognósticos no adenocarcinoma gástrico Cytophotometric study of the expression of the tumoral marker Factor VIII and prognostic factors in gastrci adenocarcinoma

    Directory of Open Access Journals (Sweden)

    Mary Tossa Nakamura

    2007-12-01

    ção III ou IV apresentaram índice de marcagem maiores do que aqueles com Bormann I ou II, porém sem correlação com a profundidade de invasão tumoral, grau de diferenciação, envolvimento nodal e padrão histológico. CONCLUSÕES: O presente estudo identificou e marcou 95,24% das amostras para o Fator VIII. Em relação aos fatores prognósticos não houve correlação significativa exceto entre o Fator VIII e a classificação de Bormann no qual o tipo III ou IV foi maior que o tipo I ou II.INTRODUCTION: Regarding gastric cancer, the incidence, diagnosis and therapeutic options showed improvement in the last decades, but prognosis remains gloomy, specially due the fact that most patients, already diagnosed present advanced tumors, metastatic and not liable to be surgically resected. Molecular biology is an area in science, which can give the answer to many questions and current scientific facts show that the this should be through detection of tumoral markers. The great advances in informatics refined cell image analysis by image cytophotometry makes it possible to study cell proliferation and angiogenesis in various tumor processes using immunohistochemistry and several markers. At present, studies are conducted to demonstrate the prognostic value of their expressions, however, in gastric adenocarcinoma the results have been divergent and studies are scarce. AIM: To identify and quantify the expression of cell proliferation markers using Ki-67 and of angiogenesis with Factor VIII in gastric adenocarcinoma using cytophotometry, and compare their expressions with factors such as Bormanns´ classification, tumor invasion depth, degree of differentiation, nodal involvement, histologic pattern and age. METHODS: Twenty-one patients with gastric adenocarcinoma identified between 1998 and 2006 were studied. Ki-67 and Factor VIII expressions were performed using immunohistochemistry with clone MIB-1 primary antibodies, monoclonal for Ki-67 and policlonal for Factor VIII

  6. Evaluating the Relational Coordination instrument

    DEFF Research Database (Denmark)

    Edwards, Kasper; Lundstrøm, Sanne Lykke

    2014-01-01

    and surgical performance. This has prompted the attention of both practitioners and politicians some of who perceive relational coordination as a means to attain better performance. The relational coordination instrument has been validated as a measure of teamwork from the following perspectives: internal...... consistency, interrater agreement and reliability, structural validity, content validity. However as relational coordination is being used as a diagnostics tool it is important to examine further if the instrument can measure changes. Indeed we need to know how precise and sensitive the instrument is when...

  7. Hemodialysis in a patient with severe hemophilia A and factor VIII inhibitor.

    Science.gov (United States)

    Gopalakrishnan, Natarajan; Usha, Thiruvengadam; Thopalan, Balasubramaniyan; Dhanapriya, Jeyachandran; Dineshkumar, Thanigachalam; Thirumalvalavan, Kaliaperumal; Sakthirajan, Ramanathan

    2016-10-01

    Hemophilia A is a hereditary X-linked recessive disease caused by mutations in the gene encoding factor VIII (FVIII), occurring in 1 out of 10,000 persons. Life expectancy and quality of life have dramatically improved recently in patients with hemophilia. Chronic kidney disease and need for renal replacement therapy in these patients are rare. The development of inhibitors to FVIII is the most serious complication of hemophilia and makes treatment of bleeds very challenging. We describe here a 28-year-old male patient with severe hemophilia A with presence of factor VIII inhibitor, who had end stage renal disease. Central venous access device was inserted along with infusion of factor eight inhibitor bypass activity before and after the procedure. He is currently on thrice weekly hemodialysis and doing well for 6 months without bleeding episodes. To our knowledge, hemophilia A with factor VIII inhibitor managed with hemodialysis has not been reported so far. © 2016 International Society for Hemodialysis.

  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. SURGICAL NUTRITION

    Directory of Open Access Journals (Sweden)

    Danny Kurniawan Darianto

    2015-07-01

    Full Text Available A patient undergoing surgery faces great physiologic and psychologic stress. so nutritional demands are greatly increased during this period and deficiencies can easily develop. If these deficiencies are allowed to develop and are not in screening, serious malnutrition and clinical problem can occur. Therefore careful attention must be given to a patient's nutritional status in preparation of surgery, as well as to the individual nutritional needs. If these needs are met, complications are less likely developing. Natural resources provide for rapid recovery. Proper nutrition can speed healing in surgical patients with major trauma, severe malnutition, burns, and other severe illnesses. New techniques for tube feeding, intravenous nutrition for patients with serious weight loss due to gastrointestinal disorders, and use of supplements can hasten wound healing and shorten recovery times.

  10. Spectrophotometric determination of hydrogen peroxide with osmium(VIII) and m-carboxyphenylfluorone.

    Science.gov (United States)

    Hoshino, Mitsuru; Kamino, Shinichiro; Doi, Mitsunobu; Takada, Shingo; Mitani, Shota; Yanagihara, Rika; Asano, Mamiko; Yamaguchi, Takako; Fujita, Yoshikazu

    2014-01-03

    Spectrophotometric determination of hydrogen peroxide was accomplished with osmium(VIII) and m-carboxyphenylfluorone (MCPF) in the presence of cetyltrimethylammonium chloride (CTAC). In the determination of hydrogen peroxide based on the fading of the color of osmium(VIII)-MCPF complex, Beer's law was obeyed in the range 20-406 ng mL(-1), with an effective molar absorption coefficient (at 580 nm) of 5.21×10(4) L mol(-1) cm(-1) and a relative standard deviation of 0.33% (n=6). Further, we performed the characterization of MCPF and obtained the crystal structure. Copyright © 2013 Elsevier B.V. All rights reserved.

  11. Structure of D2O ice VIII from in situ powder neutron diffraction

    International Nuclear Information System (INIS)

    Jorgensen, J.D.; Beyerlein, R.A.; Watanabe, N.; Worlton, T.G.

    1984-01-01

    Structural parameters for D 2 O ice VIII have been determined by Rietveld refinement of time-of-flight powder neutron diffraction data collected in situ at 28 kbar and -4 0 C. The D 2 O molecule has a bond length of 0.973 (11) A and a bond angle of 104(2) 0 . O--DxxxO bonds are slightly bent with an angle of 177(1) 0 . Thus, the D 2 O molecules in ice VIII are essentially identical to those observed in other high pressure ice structures for which accurate structural data are available

  12. Upregulation of collagen VIII following porcine coronary artery angioplasty is related to smooth muscle cell migration not angiogenesis.

    Science.gov (United States)

    Sinha, S; Kielty, C M; Heagerty, A M; Canfield, A E; Shuttleworth, C A

    2001-10-01

    Type VIII collagen is upregulated after vessel injury, and this collagen has been implicated in both smooth muscle cell migration and angiogenesis. This study examines the temporal and spatial pattern of expression of type VIII collagen in porcine coronary vessels at specific time points after balloon angioplasty. In situ hybridization studies demonstrated that collagen VIII messenger ribonucleic acid (mRNA) was markedly elevated in the neoadventitia at 3 days post-angioplasty. By 14 days, elevated collagen VIII message was seen mainly in the neointima and this expression decreased to background levels by 90 days. The distribution of collagen VIII protein, detected using immunohistochemistry, was similar but the up-regulation lagged behind the mRNA increase by a few days. Pre-treatment of sections with pepsin highlighted variations in the organization and appearance of extracellular collagen VIII containing structures in both injured and normal vessels. New vessel formation was evident in the neoadventitia after 3 days, but there was no colocalization of type VIII collagen immunostaining with that of von Willebrand factor (a marker of endothelial cells) in the neoadventitia. These data show that up-regulation of collagen VIII in the neoadventitia is an important early marker of the coronary arterial response to injury, and is not associated with new vessel formation.

  13. Intracellular retention of a factor VIII protein with an Arg2307-->Gln mutation as a cause of haemophilia A

    NARCIS (Netherlands)

    Voorberg, J.; de Laaf, R. T.; Koster, P. M.; van Mourik, J. A.

    1996-01-01

    Substitution of Arg2307 by Gln in factor VIII has been found to be associated with mild to moderate haemophilia A [Gitschier, Wood, Shuman and Lawn (1986) Science 232, 1415-1416]. We have introduced this particular point mutation into a B-domain-deleted factor VIII cDNA and expressed the modified

  14. Luminescence Instrumentation

    DEFF Research Database (Denmark)

    Jain, Mayank; Bøtter-Jensen, Lars

    2014-01-01

    This chapter gives an introduction to instrumentation for stimulated luminescence studies, with special focus on luminescence dating using the natural dosimeters, quartz and feldspars. The chapter covers basic concepts in luminescence detection, and thermal and optical stimulation, and reference...

  15. Instrumental analysis

    International Nuclear Information System (INIS)

    Kim, Seung Jae; Seo, Seong Gyu

    1995-03-01

    This textbook deals with instrumental analysis, which consists of nine chapters. It has Introduction of analysis chemistry, the process of analysis and types and form of the analysis, Electrochemistry on basic theory, potentiometry and conductometry, electromagnetic radiant rays and optical components on introduction and application, Ultraviolet rays and Visible spectrophotometry, Atomic absorption spectrophotometry on introduction, flame emission spectrometry and plasma emission spectrometry. The others like infrared spectrophotometry, X-rays spectrophotometry and mass spectrometry, chromatography and the other instrumental analysis like radiochemistry.

  16. 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.

  17. 21 CFR 872.4565 - Dental hand instrument.

    Science.gov (United States)

    2010-04-01

    ..., operative dental amalgam carver, surgical bone chisel, operative amalgam and foil condenser, endodontic... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Dental hand instrument. 872.4565 Section 872.4565...) MEDICAL DEVICES DENTAL DEVICES Surgical Devices § 872.4565 Dental hand instrument. (a) Identification. A...

  18. Quark matter coupled to domain walls in Bianchi types II, VIII and IX ...

    Indian Academy of Sciences (India)

    In this study of Bianchi types II, VIII and IX Universes, quark matter coupled to domain walls in the context of general relativity are explored. To obtain deterministic solution of the Einstein's field equations, various techniques are adopted. The features of the obtained solution are discussed.

  19. Storage and regulated secretion of factor VIII in blood outgrowth endothelial cells

    NARCIS (Netherlands)

    van den Biggelaar, M.; Bouwens, E.A.M.; Kootstra, N.A.; Hebbel, R.P.; Voorberg, J.; Mertens, K.

    2009-01-01

    Background Gene therapy provides an attractive alternative for protein replacement therapy in hemophilia A patients. Recent studies have shown the potential benefit of directing factor (F)VIII gene delivery to cells that also express its natural carrier protein von Willebrand factor (VWF). In this

  20. Storage and regulated secretion of factor VIII in blood outgrowth endothelial cells

    NARCIS (Netherlands)

    van den Biggelaar, Maartje; Bouwens, Eveline A. M.; Kootstra, Neeltje A.; Hebbel, Robert P.; Voorberg, Jan; Mertens, Koen

    2009-01-01

    Gene therapy provides an attractive alternative for protein replacement therapy in hemophilia A patients. Recent studies have shown the potential benefit of directing factor (F)VIII gene delivery to cells that also express its natural carrier protein von Willebrand factor (VWF). In this study, we

  1. Safety and Efficacy of BAY 94-9027, a Prolonged-Half-Life Factor VIII

    DEFF Research Database (Denmark)

    Reding, M T; Ng, H J; Poulsen, Lone Hvitfeldt

    2017-01-01

    BACKGROUND: BAY 94-9027 is a B-domain-deleted prolonged-half-life recombinant factor VIII (FVIII) conjugates in a site-specific manner with polyethylene glycol. OBJECTIVE: Assess efficacy and safety of BAY 94-9027 for prophylaxis and treatment of bleeds in patients with severe hemophilia A PATIEN...

  2. Mechanistic aspects of Os(VIII) catalysed oxidation of loop diuretic ...

    Indian Academy of Sciences (India)

    Mechanistic aspects of Os(VIII) catalysed oxidation of loop diuretic drug furosemide by Ag(III) periodate complex in aqueous alkaline medium. SHWETA J MALODEa, NAGARAJ P SHETTIb and SHARANAPPA T NANDIBEWOORa,∗. aPost-Graduate Department of Studies in Chemistry, Karnatak University, Dharwad 580 ...

  3. Aspectos literarios de la obra de don Joan de Castellanos : Capitulo VIII

    Directory of Open Access Journals (Sweden)

    Mario Germán Romero

    1966-03-01

    Full Text Available Capítulo VIII. Los discursos de Jiménez de Quesada. Toda historia de la literatura colombiana comienza con el nombre del licenciado don Gonzalo Jiménez de Quesada. Que era un letrado, no puede ponerse en duda. Los escritos que de él conocemos justifican plenamente el título.

  4. Factor VIII and von Willebrand factor co-delivery by endothelial cells

    NARCIS (Netherlands)

    Bouwens, E.A.M.

    2011-01-01

    A defect in coagulation factor VIII (FVIII) results in the inherited bleeding disorder hemophilia A. Current treatment of hemophilia A is hampered by the need of frequent administration of costly FVIII products. Therefore gene therapy is an attractive alternative for protein replacement to treat

  5. Analysis of mutations in the entire coding sequence of the factor VIII gene

    Energy Technology Data Exchange (ETDEWEB)

    Bidichadani, S.I.; Lanyon, W.G.; Connor, J.M. [Glascow Univ. (United Kingdom)] [and others

    1994-09-01

    Hemophilia A is a common X-linked recessive disorder of bleeding caused by deleterious mutations in the gene for clotting factor VIII. The large size of the factor VIII gene, the high frequency of de novo mutations and its tissue-specific expression complicate the detection of mutations. We have used a combination of RT-PCR of ectopic factor VIII transcripts and genomic DNA-PCRs to amplify the entire essential sequence of the factor VIII gene. This is followed by chemical mismatch cleavage analysis and direct sequencing in order to facilitate a comprehensive search for mutations. We describe the characterization of nine potentially pathogenic mutations, six of which are novel. In each case, a correlation of the genotype with the observed phenotype is presented. In order to evaluate the pathogenicity of the five missense mutations detected, we have analyzed them for evolutionary sequence conservation and for their involvement of sequence motifs catalogued in the PROSITE database of protein sites and patterns.

  6. In vivo recovery and safety of human factor VIII product AAFACT in patients with haemophilia A

    NARCIS (Netherlands)

    Vossebeld, P. J. M.; Tissing, M. H.; van den Berg, H. M.; Leebeek, F. W. G.; de Goede-Bolder, A.; Novakova, I. R. O.; Gerrits, W. B. J.; Peters, M.; Koopman, M. M. W.; Faber, A.; Hiemstra, H.; Grob, P.; Strengers, P. F. W.

    2003-01-01

    AAFACT, a monoclonal purified, solvent/detergent treated human plasma-derived coagulation factor VIII concentrate obtained from plasma of voluntary, non-remunerated blood donors, is manufactured and marketed in the Netherlands by Sanquin Plasma Products since 1995. In a postmarketing surveillance

  7. Exact Bianchi type-VIII and type-IX cosmological models with matter and electromagnetic fields

    Science.gov (United States)

    Lorenz, Dieter

    1980-10-01

    Exact solutions of the Einstein-Maxwell equations of Bianchi types VIII and IX are derived. The solutions represent axisymmetric universes with source-free electromagnetic fields and the matter content of the models is a perfect fluid, with equation of state p=ɛ.

  8. Exact Bianchi type-VIII and type-IX cosmological models with matter and electromagnetic fields

    Energy Technology Data Exchange (ETDEWEB)

    Lorenz, D.

    1980-10-15

    Exact solutions of the Einstein-Maxwell equations of Bianchi types VIII and IX are derived. The solutions represent axisymmetric universes with source-free electromagnetic fields and the matter content of the models is a perfect fluid, with equation of state p=epsilon.

  9. Thermal management for LLNL/UC/SSRL bending magnet beamline VIII at Stanford Synchrotron Radiation Laboratory

    International Nuclear Information System (INIS)

    Berglin, E.J.; Younger, F.C.

    1986-05-01

    All the important heat loads on the elements of Beamline VIII are cataloged. The principal elements are identified and their heat loads tabulated for various loading scenarios. The expected heat loads are those from normal operations including the anticipated performance improvements planned for the SPEAR ring and from abnormal operations due to positional perturbations of the electron beam

  10. Absorption signatures of warm-hot gas at low redshift : Ne VIII

    NARCIS (Netherlands)

    Tepper-García, T

    2013-01-01

    At z {lt} 1 a large fraction of the baryons is thought to reside in diffuse gas that has been shock-heated to high temperatures (10$^{5}$-10$^{6}$ K). Absorption by the 770.41, 780.32 å doublet of Ne VIII in quasar spectra represents a unique tool to study this elusive warm-hot phase. We have

  11. Limited promiscuity of HLA-DRB1 presented peptides derived of blood coagulation factor VIII

    NARCIS (Netherlands)

    van Haren, Simon D.; Wroblewska, Aleksandra; Herczenik, Eszter; Kaijen, Paul H.; Ruminska, Aleksandra; ten Brinke, Anja; Meijer, Alexander B.; Voorberg, Jan

    2013-01-01

    The formation of inhibitory antibodies directed against coagulation factor VIII (FVIII) is a severe complication in the treatment of hemophilia A patients. The induction of anti-FVIII antibodies is a CD4(+) T cell-dependent process. Activation of FVIII-specific CD4(+) T cells is dependent on the

  12. Home therapy with continuous infusion of factor VIII after minor surgery or serious haemorrhage.

    Science.gov (United States)

    Varon, D; Schulman, S; Bashari, D; Martinowitz, U

    1996-10-01

    Administration of factor VIII (F VIII) concentrates by continuous infusion is now routinely used at several haemophilia centers but almost exclusively for hospitalized patients. We evaluated various aspects of home therapy with continuous infusion of an immunoaffinity purified F VIII concentrate (Monoclate P®, Armour) in patients who would normally have been treated with high doses in bolus injections or with continuous infusion as in-patients. Twenty haemophilia A patients, eight after minor surgery and 12 for serious haemorrhage, received continuous infusion with undiluted F VIII by a minipump for a mean of 0.9 days in the hospital, followed by 3.3 days at home. Infusion bags were exchanged every 2.5 days. No haemorrhagic complications occurred, and five haemorrhages that had been resistant to treatment with bolus injections responded promptly to the continuous infusion. There were no technical problems and patient compliance and acceptance was good. We find this mode of therapy safe, efficacious and convenient for the patients as well as for the staff.

  13. Lithium ionophore VIII as an extraordinarily effective receptor for the strontium cation: Experimental and theoretical study

    Czech Academy of Sciences Publication Activity Database

    Makrlík, E.; Novák, Vít; Vaňura, P.; Bouř, Petr

    2014-01-01

    Roč. 1061, Mar 5 (2014), s. 110-113 ISSN 0022-2860 Institutional support: RVO:61388963 Keywords : strontium cation * lithium ionophore VIII * complexation * extraction and stability constants * DFT calculations * structures Subject RIV: CF - Physical ; Theoretical Chemistry Impact factor: 1.602, year: 2014

  14. Complexation of the cesium cation with lithium ionophore VIII: extraction and DFT study

    Czech Academy of Sciences Publication Activity Database

    Makrlík, E.; Novák, Vít; Vaňura, P.; Bouř, Petr

    2013-01-01

    Roč. 298, č. 3 (2013), s. 2065-2068 ISSN 0236-5731 Institutional support: RVO:61388963 Keywords : cesium cation * lithium ionophore VIII * complexation * extraction and stability constants * water-nitrobenzene system * DFT calculations * structures Subject RIV: CB - Analytical Chemistry , Separation Impact factor: 1.415, year: 2013

  15. Instrumental Capital

    Directory of Open Access Journals (Sweden)

    Gabriel Valerio

    2007-07-01

    Full Text Available During the history of human kind, since our first ancestors, tools have represented a mean to reach objectives which might otherwise seemed impossibles. In the called New Economy, where tangibles assets appear to be losing the role as the core element to produce value versus knowledge, tools have kept aside man in his dairy work. In this article, the author's objective is to describe, in a simple manner, the importance of managing the organization's group of tools or instruments (Instrumental Capital. The characteristic conditions of this New Economy, the way Knowledge Management deals with these new conditions and the sub-processes that provide support to the management of Instrumental Capital are described.

  16. Innovative instrumentation

    International Nuclear Information System (INIS)

    Anon.

    1983-01-01

    At this year's particle physics conference at Brighton, a parallel session was given over to instrumentation and detector development. While this work is vital to the health of research and its continued progress, its share of prime international conference time is limited. Instrumentation can be innovative three times — first when a new idea is outlined, secondly when it is shown to be feasible, and finally when it becomes productive in a real experiment, amassing useful data rather than operational experience. Hyams' examples showed that it can take a long time for a new idea to filter through these successive stages, if it ever makes it at all

  17. Instrumented SSH

    Energy Technology Data Exchange (ETDEWEB)

    Campbell, Scott; Campbell, Scott

    2009-05-27

    NERSC recently undertook a project to access and analyze Secure Shell (SSH) related data. This includes authentication data such as user names and key fingerprints, interactive session data such as keystrokes and responses, and information about noninteractive sessions such as commands executed and files transferred. Historically, this data has been inaccessible with traditional network monitoring techniques, but with a modification to the SSH daemon, this data can be passed directly to intrusion detection systems for analysis. The instrumented version of SSH is now running on all NERSC production systems. This paper describes the project, details about how SSH was instrumented, and the initial results of putting this in production.

  18. VIII Olimpíada Brasileira de Astronomia e Astronáutica

    Science.gov (United States)

    Garcia Canalle, João Batista; Villas da Rocha, Jaime Fernando; Wuensche de Souza, Carlos Alexandre; Pereira Ortiz, Roberto; Aguilera, Nuricel Villalonga; Padilha, Maria De Fátima Catta Preta; Pessoa Filho, José Bezerra; Soares Rodrigues, Ivette Maria

    2007-07-01

    Neste trabalho apresentamos as motivações pelas quais organizamos, em conjunto, pela primeira vez, a Olimpíada Brasileira de Astronomia incluindo a Astronáutica, em colaboração com a Agência Espacial Brasileira. Esta ampliação contribuiu para atrair ainda mais alunos, professores, escolas e patrocinadores para participarem desta Olimpíada. Em 2005 participaram da VIII Olimpíada Brasileira de Astronomia e Astronáutica (VIII OBA) 187.726 alunos distribuídos por 3.229 escolas, pertencentes a todos os estados brasileiros, incluindo o Distrito Federal. O crescimento em número de alunos participantes foi 52,4% maior do que em 2004. Em abril de 2005 organizamos, em Itapecerica da Serra, SP, um curso para os 50 alunos previamente selecionados e participantes da VII OBA e ao final selecionamos, dentre eles, uma equipe de 5 alunos, os quais representaram o Brasil na X Olimpíada Internacional de Astronomia, na China, em outubro de 2005. Ganhamos, pela primeira vez, uma medalha de ouro naquele evento. Em Agosto de 2005, organizamos a VIII Escola de Agosto para 50 alunos e respectivos professores, em Águas de Lindóia, SP, juntamente com a XXXI reunião anual da Sociedade Astronômica Brasileira (SAB). Em novembro de 2005 realizamos a I Jornada Espacial, em São José dos Campos, com 22 alunos e 22 professores selecionados dentre os participantes que melhores resultados obtiveram nas questões de Astronáutica da VIII OBA. Neste trabalho detalhamos os resultados da VIII OBA bem como as ações subseqüentes.

  19. Monoclonal purified F VIII for continuous infusion: stability, microbiological safety and clinical experience.

    Science.gov (United States)

    Schulman, S; Varon, D; Keller, N; Gitel, S; Martinowitz, U

    1994-09-01

    Replacement therapy for patients with hemophilia A postoperatively or for major hemorrhage, administered as a continuous infusion, is efficient and reduces the requirement for factor VIII (F VIII). The convenience of the method is increased by using a minipump and not diluting the concentrate further after reconstitution. A monoclonally purified F VIII concentrate (Monoclate-P), was evaluated for its stability after reconstitution in different infusion systems, for its microbiological safety as well as clinical safety and efficacy in continuous infusion. The F VIII activity was unaffected by 2 of the 3 infusion systems at room temperature during 15 days, whereas in the third (CADD-1) it decreased below 80% of initial value after 3-7 days. Addition of heparin (1 U/ml) or low molecular weight heparin (1 anti-Xa U/ml), which are used to prevent thrombophlebitis at the site of infusion, did not affect the stability. Nine out of 9 samples taken from the infusion systems after 3 days and again after 7 days were sterile. After inoculation with Staphylococcus aureus or Escherichia coli the bacterial growth in samples of the reconstituted concentrate was not different from that in lidocaine in saline or heparin in saline. F VIII was given in continuous infusion with a minipump (Infu-Med) to 12 patients undergoing major surgery and 8 patients with major hemorrhage for a total of 157 days. A progressive decrease of the clearance was seen during the first 5 days of infusion from 3.0 to 1.7 ml/kg/h. Hemostasis was effectively achieved, and no infectious complications were registered.(ABSTRACT TRUNCATED AT 250 WORDS)

  20. RELATIONSHIP OF INTEREST, LEARNING MOTIVATION AND ATTITUDE WITH RESULTS LEARNING CLASS VIII SMP STATE 13 MAKASSAR

    Directory of Open Access Journals (Sweden)

    Putri Athirah Azis

    2016-12-01

    Full Text Available The study aims at examining (1 the correlation of learning interest towards learning result of grade students, (2 the correlation of learning motivation towards learning result of grade students, (3 the correlation of students attitude towards learning result, (4 the correlationof interest, learning motivation, and attitude collaboratively towards learning result. The study is an ex post facto. The population of the study was grade VIII at SMPN 13 Makassar. Samples were 105 students taken by employing random sampling technique. Data were collected through questionnaire and documentation. Data were analyzed using regression test. The result of study reveal that (1 there is significant correlation (p<0,01 of interest towards learning result of grade VIII students at SMPN 13 Makassar. Co-efficient correlation (r is 0,718 and its effectiveness contribution (R2 is 51,5%, (2 there is significant correlation (p<0,01 of motivation towards learning result of grade VIII students at SMPN 13 Makassar. Co-efficient correlation (r is 0,775 and its effectiveness contribution (R2 is 60,1%, (3 there is significant correlation (p<0,01 of attitude towards learning result of grade VIII students at SMPN 13 Makassar. Co-efficient correlation (r is 0,737 and its effectiveness contribution (R2 is 54,4%, (4 there is significant correlation (p<0,01 of interest, motivation and attitude collaboratively towards learning result of grade VIII students at SMPN 13 Makassar. Co-efficient correlation (r is 0,861 and its effectiveness contribution (R2 is 74,1%,

  1. Active instruments

    DEFF Research Database (Denmark)

    Lim, Miguel Antonio; Ørberg, Jakob Williams

    2017-01-01

    ) show the dynamic nature of policy processes, and (3) consider the search for policy reference points among the different actors. We present rankers in motion, policies in motion, and finally the complex nature of the ranking device that needs to be both a relevant and malleable policy instrument...

  2. Seismic instrumentation

    International Nuclear Information System (INIS)

    Maubach, K.

    1982-01-01

    For better understanding of the specification for seismic instrumentation of a nuclear power plant, the lecture gives some fundamental remarks to the seismic risk in the Federal Republic of Germany and to the data characterizing an earthquake event. Coming from the geophysical properties of an earthquake, the quantities are explained which are used in the design process of nuclear power plants. This process is shortly described in order to find the requirements for the specification of the seismic instrumentation. In addition the demands of licensing authorities are given. As an example the seismic instrumentation of KKP-1, BWR, is shown. The paper deals with kind and number of instruments, their location in the plant and their sensitivity and calibration. Final considerations deal with the evaluation of measured data and with plant operation after an earthquake. Some experience concerning the earthquake behaviour of equipment not designed to withstand earthquake loads is mentioned. This experience has initiated studies directed to quantification of the degree of conservatism of the assumptions in the seismic design of nuclear power plants. A final garget of these studies are more realistic design rules. (RW)

  3. Specific membrane binding of factor VIII is mediated by O-phospho-L-serine, a moiety of phosphatidylserine.

    Science.gov (United States)

    Gilbert, G E; Drinkwater, D

    1993-09-21

    Phosphatidylserine, a negatively charged lipid, is exposed on the platelet membrane following cell stimulation, correlating with the expression of factor VIII receptors. We have explored the importance of the negative electrostatic potential of phosphatidylserine vs chemical moieties of phosphatidylserine for specific membrane binding of factor VIII. Fluorescein-labeled factor VIII bound to membranes containing 15% phosphatidic acid, a negatively charged phospholipid, with low affinity compared to phosphatidylserine-containing membranes. Binding was not specific as it was inhibited by other proteins in plasma. Factor VIII bound to membranes containing 10% phosphatidylserine in spite of a varying net charge provided by 0-15% stearylamine, a positively charged lipid. The soluble phosphatidylserine moiety, O-phospho-L-serine, inhibited factor VIII binding to phosphatidylserine-containing membranes with a Ki of 20 mM, but the stereoisomer, O-phospho-D-serine, was 5-fold less effective. Furthermore, binding of factor VIII to membranes containing synthetic phosphatidyl-D-serine was 5-fold less than binding to membranes containing phosphatidyl-L-serine. Membranes containing synthetic phosphatidyl-L-homoserine, differing from phosphatidylserine by a single methylene, supported high-affinity binding, but it was not specific as factor VIII was displaced by other plasma proteins. O-Phospho-L-serine also inhibited the binding of factor VIII to platelet-derived microparticles with a Ki of 20 mM, and the stereoisomer was 4-fold less effective. These results indicate that membrane binding of factor VIII is mediated by a stereoselective recognition O-phospho-L-serine of phosphatidylserine and that negative electrostatic potential is of lesser importance.

  4. Population pharmacokinetics of recombinant coagulation factor VIII-SingleChain in patients with severe hemophilia A.

    Science.gov (United States)

    Zhang, Y; Roberts, J; Tortorici, M; Veldman, A; St Ledger, K; Feussner, A; Sidhu, J

    2017-06-01

    Essentials rVIII-SingleChain is a unique recombinant factor VIII (FVIII) molecule. A population pharmacokinetic model was based on FVIII activity of severe hemophilia A patients. The model was used to simulate factor VIII activity-time profiles for various dosing scenarios. The model supports prolonged dosing of rVIII-SingleChain with intervals of up to twice per week. Background Single-chain recombinant coagulation factor VIII (rVIII-SingleChain) is a unique recombinant coagulation factor VIII molecule. Objectives To: (i) characterize the population pharmacokinetics (PK) of rVIII-SingleChain in patients with severe hemophilia A; (ii) identify correlates of variability in rVIII-SingleChain PK; and (iii) simulate various dosing scenarios of rVIII-SingleChain. Patients/Methods A population PK model was developed, based on FVIII activity levels of 130 patients with severe hemophilia A (n = 91 for ≥ 12-65 years; n = 39 for  85% and > 93% of patients were predicted to maintain FVIII activity level above 1 IU dL -1 , at all times with three-times-weekly dosing (given on days 0, 2, and 4.5) at the lowest (20 IU kg -1 ) and highest (50 IU kg -1 ) doses, respectively. For twice weekly dosing (days 0 and 3.5) of 50 IU kg -1 rVIII-SingleChain, 62-80% of patients across all ages were predicted to maintain a FVIII activity level above 1 IU dL -1 at day 7. Conclusions The population PK model adequately characterized rVIII-SingleChain PK, and the model can be utilized to simulate FVIII activity-time profiles for various dosing scenarios. © 2017 The Authors. Journal of Thrombosis and Haemostasis published by Wiley Periodicals, Inc. on behalf of International Society on Thrombosis and Haemostasis.

  5. Retained Surgical Foreign Bodies after Surgery

    Directory of Open Access Journals (Sweden)

    Valon A. Zejnullahu

    2017-01-01

    Full Text Available The problem of retained surgical bodies (RSB after surgery is an issue for surgeons, hospitals and the entire medical team. They have potentially harmful consequences for the patient as they can be life threatening and usually, a further operation is necessary. The incidence of RSB is between 0.3 to 1.0 per 1,000 abdominal operations, and they occur due to a lack of organisation and communication between surgical staff during the process. Typically, the RSB are surgical sponges and instruments located in the abdomen, retroperitoneum and pelvis.

  6. Instrumentation development

    International Nuclear Information System (INIS)

    Anon.

    1976-01-01

    Areas being investigated for instrumentation improvement during low-level pollution monitoring include laser opto-acoustic spectroscopy, x-ray fluorescence spectroscopy, optical fluorescence spectroscopy, liquid crystal gas detectors, advanced forms of atomic absorption spectroscopy, electro-analytical chemistry, and mass spectroscopy. Emphasis is also directed toward development of physical methods, as opposed to conventional chemical analysis techniques for monitoring these trace amounts of pollution related to energy development and utilization

  7. Nuclear instrumentation

    International Nuclear Information System (INIS)

    Weill, Jacky; Fabre, Rene.

    1981-01-01

    This article sums up the Research and Development effort at present being carried out in the five following fields of applications: Health physics and Radioprospection, Control of nuclear reactors, Plant control (preparation and reprocessing of the fuel, testing of nuclear substances, etc.), Research laboratory instrumentation, Detectors. It also sets the place of French industrial activities by means of an estimate of the French market, production and flow of trading with other countries [fr

  8. Planck intermediate results: VIII. Filaments between interacting clusters

    DEFF Research Database (Denmark)

    Bartlett, J.G.; Cardoso, J.-F.; Castex, G.

    2013-01-01

    . The Planck satellite has provided hundreds of detections of the hot gas in clusters of galaxies via the thermal Sunyaev-Zel'dovich (tSZ) effect and is an ideal instrument for studying extended low-density media through the tSZ effect. In this paper we use the Planck data to search for signatures...... of this intercluster medium. We obtain a temperature of kT = 7.1 ± 0.9 keV (consistent with previous estimates) and a baryon density of (3.7 ± 0.2) × 10-4 cm -3. Conclusions. The Planck satellite mission has provided the first SZ detection of the hot and diffuse intercluster gas. © 2013 ESO....

  9. Comparação do poder de correção do instrumental de Luque-Galveston e do parafuso pedicular no tratamento cirúrgico da escoliose neuromuscular Comparación del poder de corrección del instrumental de Luque-Galveston y del tornillo pedicular en el tratamiento quirúrgico de la escoliosis neuromuscular Comparison between deformity correction of Luque-Galveston instrumentation and pedicle screw fixation in the surgical treatment of neuromuscular scoliosis

    Directory of Open Access Journals (Sweden)

    Murilo Tavares Daher

    2009-06-01

    (p=0.045. CONCLUSIONS: postoperative major curve correction was similar with pedicle screws and Luque-Galveston instrumentation, but pelvic obliquity correction was greater when pedicle screw was used in the surgical treatment of neuromuscular scoliosis.

  10. Extremity War Injuries VIII: sequelae of combat injuries.

    Science.gov (United States)

    Andersen, Romney C; D'Alleyrand, Jean-Claude G; Swiontkowski, Marc F; Ficke, James R

    2014-01-01

    The 2013 Extremity War Injury symposium focused on the sequelae of combat-related injuries, including posttraumatic osteoarthritis, amputations, and infections. Much remains to be learned about posttraumatic arthritis, and there are few circumstances in which a definitive arthroplasty should be performed in an acutely injured and open joint. Although the last decade has seen tremendous advances in the treatment of combat upper extremity injuries, many questions remain unanswered, and continued research focusing on improving reconstruction of large segmental defects remains critical. Discussion of infection centered on the need for novel methods to reduce the bacterial load following the initial débridement procedures. Novel methods of delivering antimicrobial therapy and anti-inflammatory medications directly to the wound were discussed as well as the need for near real-time assessment of bacterial and fungal burden and further means of prevention and treatment of biofilm formation and the importance of animal models to test therapies discussed. Moderators and lecturers of focus groups noted the continuing need for improved prehospital care in the management of junctional injuries, identified optimal strategies for both surgical repair and/or reconstruction of the ligaments in multiligamentous injuries, and noted the need to mitigate bone mineral density loss following amputation and/or limb salvage as well as the necessity of developing better methods of anticipating and managing heterotopic ossification.

  11. Surgical treatment of degenerative spondylolisthesis.

    Science.gov (United States)

    Guigui, P; Ferrero, E

    2017-02-01

    Degenerative spondylolisthesis is a common pathology, often causing lumbar canal stenosis. There is, however, no strong consensus regarding the various medical and surgical treatments available. Surgery is indicated mainly for perceived functional impairment; when the indication is accepted, several questions determine the choice of surgical strategy. Improvement in neurological symptoms is one of the main treatment objectives. For this, it is useful to perform radicular decompression. Some authors recommend indirect decompression by interbody fusion (ALIF, TLIF, XLIF), others by means of an interspinous spacer but the most frequent technique is direct posterior decompression. In degenerative spondylolisthesis, functional results seem to be improved by associating stabilization to decompression, to prevent secondary destabilization. The following risk factors for destabilization are recognized: anteroposterior hypermobility, angular hypermobility and large disc height. Two stabilization techniques have been described: "dynamic" stabilization and (more frequently) fusion. Spinal instrumentation is frequently associated to fusion, in which case, it is essential for fusion position and length to take account of pelvic incidence and the patient's overall pattern of balance. Posterolateral fusion may be completed by interbody fusion (PLIF or TLIF). This has the theoretic advantage of increasing graft area and stability, restoring local lordosis and opening the foramina. Surgical treatment of degenerative spondylolisthesis usually consists in posterior release associated to instrumented fusion, but some cases can be more complex. It is essential for treatment planning to take account of the patient's general health status as well as symptomatology and global and segmental alignment. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  12. 21 CFR 872.4120 - Bone cutting instrument and accessories.

    Science.gov (United States)

    2010-04-01

    ... (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Surgical Devices § 872.4120 Bone cutting instrument and accessories. (a) Identification. A bone cutting instrument and accessories is a metal device intended for use... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Bone cutting instrument and accessories. 872.4120...

  13. 21 CFR 882.4275 - Dowel cutting instrument.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Dowel cutting instrument. 882.4275 Section 882...) MEDICAL DEVICES NEUROLOGICAL DEVICES Neurological Surgical Devices § 882.4275 Dowel cutting instrument. (a) Identification. A dowel cutting instrument is a device used to cut dowels of bone for bone grafting. (b...

  14. 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.

  15. Batatins VIII-XI, glycolipid ester-type dimers from Ipomoea batatas.

    Science.gov (United States)

    Rosas-Ramírez, Daniel; Pereda-Miranda, Rogelio

    2015-01-23

    Sweet potato (Ipomoea batatas) is native to the tropics of Central and South America, where many varieties have been consumed for more that 5000 years. In developing countries, this crop is a recognized effective food for fighting malnutrition. Purification of the minor lipophilic glicolipids found in the n-hexane-soluble resin glycosides from the white-skinned variety was performed by preparative-scale recycling HPLC. Application of column overload, peak shaving, heart cutting, and recycling techniques permitted the purification of four new oligosaccharide ester-type dimer derivatives of jalapinolic acid, batatins VIII-XI (1-4). The structural characterization of these complex lipo-oligosaccharides was performed through NMR spectroscopy and MS, indicating that batatins VIII-XI (1-4) possess an oligomeric structure consisting of two pentasaccharide units of the known simonic acid B.

  16. Detection of Intracellular Factor VIII Protein in Peripheral Blood Mononuclear Cells by Flow Cytometry

    Directory of Open Access Journals (Sweden)

    Gouri Shankar Pandey

    2013-01-01

    Full Text Available Flow cytometry is widely used in cancer research for diagnosis, detection of minimal residual disease, as well as immune monitoring and profiling following immunotherapy. Detection of specific host proteins for diagnosis predominantly uses quantitative PCR and western blotting assays. In this study, we optimized a flow cytometry-based detection assay for Factor VIII protein in peripheral blood mononuclear cells (PBMCs. An indirect intracellular staining (ICS method was standardized using monoclonal antibodies to different domains of human Factor VIII protein. The FVIII protein expression level was estimated by calculating the mean and median fluorescence intensities (MFI values for each monoclonal antibody. ICS staining of transiently transfected cell lines supported the method's specificity. Intracellular FVIII protein expression was also detected by the monoclonal antibodies used in the study in PBMCs of five blood donors. In summary, our data suggest that intracellular FVIII detection in PBMCs of hemophilia A patients can be a rapid and reliable method to detect intracellular FVIII levels.

  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. Kinetic Consequences of Chemisorbed Oxygen Atoms during Methane Oxidation on Group VIII Metal Clusters

    OpenAIRE

    Chin, Ya Huei

    2011-01-01

    Molecular insights and the kinetic relevance of reaction elementary steps for methane activation on Group VIII metal and oxide clusters are established based on kinetic, isotopic, and theoretical assessments. These fundamental understandings enable accurate prediction of complex rate dependencies and cluster size effects during methane conversion reactions in catalytic partial oxidation, reforming, and combustion processes.Kinetics of methane reactions with oxygen are described by several reg...

  19. The impact of von Willebrand factor on factor VIII memory immune responses

    OpenAIRE

    Chen, Juan; Schroeder, Jocelyn A.; Luo, Xiaofeng; Shi, Qizhen

    2017-01-01

    Immune tolerance induction (ITI) with aggressive infusion of factor VIII (FVIII) is the current strategy used to eradicate FVIII inhibitors and restore normal FVIII pharmacokinetics in inhibitor patients. Whether the use of FVIII products containing von Willebrand factor (VWF) will affect the efficacy of ITI is still controversial. In this study, we explored the impact of VWF on FVIII memory immune responses in hemophilia A (HA) mice. A T-cell proliferation assay and cytokine profile analysis...

  20. Penggunaan Mind Map Diiringi Musik Klasik Dalam Pembelajaran Matematika Untuk Siswa Kelas VIII SMPN 1 Sawahlunto

    OpenAIRE

    Ramadhona, Rezky

    2016-01-01

    Penelitian ini bertujuan untuk mengetahui apakah motivasi dan hasil belajar belajar matematika siswa kelas VIII SMPN 1 Sawahlunto setelah menggunakan mind map dan musik klasik lebih baik dari sebelum menggunakan mind map dan musik klasik. Jenis penelitian ini adalah penelitian eksperimen dengan menggunakan dua model rancangan yaitu One Group Pretest Posttest Design untuk melihat dampak perlakuan terhadap motivasi belajar dan Randomized Control Group Only Design untuk melihat dampak perlakuan ...

  1. Constraining the Milky Way's Hot Gas Halo with O VII and O VIII Emission Lines

    Science.gov (United States)

    Miller, Matthew J.; Bregman, Joel N.

    2015-02-01

    The Milky Way hosts a hot (≈2 × 106 K), diffuse, gaseous halo based on detections of z = 0 O VII and O VIII absorption lines in quasar spectra and emission lines in blank-sky spectra. Here we improve constraints on the structure of the hot gas halo by fitting a radial model to a much larger sample of O VII and O VIII emission line measurements from XMM-Newton/EPIC-MOS spectra compared to previous studies (≈650 sightlines). We assume a modified β-model for the halo density distribution and a constant-density Local Bubble from which we calculate emission to compare with the observations. We find an acceptable fit to the O VIII emission line observations with χ 2red (dof) = 1.08 (644) for best-fit parameters of no r_c3β = 1.35 +/- 0.24 cm-3 kpc3β and β = 0.50 ± 0.03 for the hot gas halo and negligible Local Bubble contribution. The O VII observations yield an unacceptable χ 2red (dof) = 4.69 (645) for similar best-fit parameters, which is likely due to temperature or density variations in the Local Bubble. The O VIII fitting results imply hot gas masses of M(properties, temperature and entropy gradients in the halo gas, and the gas metallicity distribution. The combination of absorption and emission line analyses implies a sub-solar gas metallicity that decreases with radius, but that also must be >=0.3 Z ⊙ to be consistent with the pulsar dispersion measure toward the Large Magellanic Cloud.

  2. VIII All-Russian symposium on molecular liquid chromatography and capillary electrophoresis. Program. Summary of reports

    International Nuclear Information System (INIS)

    2001-01-01

    Program and summary of reports of the VIII All-Russian symposium on molecular liquid chromatography and capillary electrophoresis are performed. The meeting took place 15-19 October, 2001 in Moscow. Many problems of liquid and ion exchange chromatography, capillary electrophoresis, thin-layer chromatography have been discussed extensively. Reports covering properties of sorbents and devices for chromatography are incorporated in the collection [ru

  3. Structural characterization of the novel aminoglycoside phosphotransferase AphVIII from Streptomyces rimosus with enzymatic activity modulated by phosphorylation

    Energy Technology Data Exchange (ETDEWEB)

    Boyko, Konstantin M., E-mail: kmb@inbi.ras.ru [Bach Institute of Biochemistry, Federal Research Centre of Biotechnology of the Russian Academy of Sciences, Leninsky Prospekt. 33, Bld. 2, 119071, Moscow (Russian Federation); National Research Center “Kurchatov Institute”, Kurchatov Complex of NBICS-technologies, Akad. Kurchatova sqr., 1, Moscow, 123182 (Russian Federation); Gorbacheva, Marina A.; Korzhenevskiy, Dmitry A. [National Research Center “Kurchatov Institute”, Kurchatov Complex of NBICS-technologies, Akad. Kurchatova sqr., 1, Moscow, 123182 (Russian Federation); Alekseeva, Maria G.; Mavletova, Dilara A.; Zakharevich, Natalia V.; Elizarov, Sergey M.; Rudakova, Natalia N.; Danilenko, Valery N. [Vavilov Institute of General Genetics, Russian Academy of Sciences, Gubkina str. 3, Moscow, 119333 (Russian Federation); Popov, Vladimir O. [Bach Institute of Biochemistry, Federal Research Centre of Biotechnology of the Russian Academy of Sciences, Leninsky Prospekt. 33, Bld. 2, 119071, Moscow (Russian Federation); National Research Center “Kurchatov Institute”, Kurchatov Complex of NBICS-technologies, Akad. Kurchatova sqr., 1, Moscow, 123182 (Russian Federation)

    2016-09-02

    Aminoglycoside phosphotransferases represent a broad class of enzymes that promote bacterial resistance to aminoglycoside antibiotics via the phosphorylation of hydroxyl groups in the latter. Here we report the spatial structure of the 3′-aminoglycoside phosphotransferase of novel VIII class (AphVIII) solved by X-ray diffraction method with a resolution of 2.15 Å. Deep analysis of APHVIII structure and its comparison with known structures of aminoglycoside phosphotransferases of various types reveals that AphVIII has a typical two-domain fold and, however, possesses some unique characteristics that distinguish the enzyme from its known homologues. The most important difference is the presence of the activation loop with unique Ser146 residue. We demonstrate that in the apo-state of the enzyme the activation loop does not interact with other parts of the enzyme and seems to adopt catalytically competent state only after substrate binding. - Highlights: • 3D structure of the novel aminoglycoside phosphotransferase AphVIII was obtained. • AphVIII activation loop is clearly identified in the electron density. • AphVIII has some unique structural features in its substrate C-ring binding pocket.

  4. "Antihemophilic factor is not the only answer for all factor VIII deficiencies." Case report of odontogenic infection in a patient with hemophilia A, complicated by factor VIII inhibitors, and managed by transfusion of antihemophilic factor and factor VIII inhibitor bypass activity.

    Science.gov (United States)

    Sudheesh, K M; Bharani, K S N Siva; Kiran, H Y; Hanagavadi, Suresh

    2016-09-01

    Dental extraction in hemophiliacs with acquired inhibitors is always a risky procedure, which often presents a lot of problems associated with bleeding. A known case of hemophilia A complicated with factor VIII inhibitors and having odontogenic infection was successfully managed by transfusion of factor VIII inhibitor bypass activity (FEIBA) and antihemophilic factor. Past medical history was significant for multiple factor VIII transfusions. Bethesda assay done to identify inhibitors revealed low titer factor VIII inhibitors. Extraction of the involved tooth was done after transfusion of FEIBA with low-dose protocols. Minimal bleeding was noted after extraction which was controlled by local measures. FEIBA was proven to be highly effective, and no side effects of the product were observed.

  5. A close insight to factor VIII inhibitor in the congenital hemophilia A.

    Science.gov (United States)

    Tabriznia-Tabrizi, Shamsoreza; Gholampour, Marzie; Mansouritorghabeh, Hassan

    2016-09-01

    Hemophilia A (HA) has an X-linked pattern of inheritance and is the most common of the hemorrhagic disorders. HA is caused by a decreased or deficiency of the functional clotting factor VIII (FVIII) and effects 1 in 5000-10,000 male births. The common treatment for hemophilia is replacement therapy by plasma-derived or recombinant FVIII. Approximately 20-30% of people with a severe type of HA develop an inhibitor and this phenomenon is the main challenge in the management of these patients. Genetic factors and environmental determinants contribute to inhibitor development. Here, the roles of various genetic and environmental factors such as the type of FVIII concentrate used, the number of exposure days, and peak treatment time will be discussed in detail. It seems this information is helpful for hematologists. A literature review was done in January 2016 on PubMed and Scopus using the following keywords:' h(a)emophilia A & factor VIII inhibitor', 'h(a)emophilia A & factor VIII alloantibody', 'h(a)emophilia A & inhibitor'. There was no time limitation; however, there was an English language limitation placed on the articles selected. Expert commentary: Influential genetic and environmental factors in developing inhibitors have been discussed. Most of the risk factors are related to previously untreated patients with hemophili.

  6. Development of the evaluation instrument use CIPP on the implementation of project assessment topic optik

    Science.gov (United States)

    Asfaroh, Jati Aurum; Rosana, Dadan; Supahar

    2017-08-01

    This research aims to develop an evaluation instrument models CIPP valid and reliable as well as determine the feasibility and practicality of an evaluation instrument models CIPP. An evaluation instrument models CIPP to evaluate the implementation of the project assessment topic optik to measure problem-solving skills of junior high school class VIII in the Yogyakarta region. This research is a model of development that uses 4-D. Subject of product trials are students in class VIII SMP N 1 Galur and SMP N 1 Sleman. Data collection techniques in this research using non-test techniques include interviews, questionnaires and observations. Validity in this research was analyzed using V'Aikens. Reliability analyzed using ICC. This research uses 7 raters are derived from two lecturers expert (expert judgment), two practitioners (science teacher) and three colleagues. The results of this research is the evaluation's instrument model of CIPP is used to evaluate the implementation of the implementation of the project assessment instruments. The validity result of evaluation instrument have V'Aikens values between 0.86 to 1, which means a valid and 0.836 reliability values into categories so well that it has been worth used as an evaluation instrument.

  7. Surgical handicraft: teaching and learning surgical skills.

    Science.gov (United States)

    Barnes, R W

    1987-05-01

    Surgeons choose their profession with a strong desire to excel at manual therapeutic skills. Although we mime our mentors, we have often received the torch of technique in the absence of a systematic program to optimally develop our manual dexterity. The operating room is the ultimate arena to refine one's technical ability, but a surgical skills laboratory should assume increasing importance in introducing the trainee to the many nuances of the fine manual motor skills necessary for optimal surgical technique. Surgical educators should address the science of surgical handicraft in a manner similar to the science of preoperative and postoperative surgical principles that have been espoused over the past 40 years. Although it has been euphemistically said that "you can teach a monkey to operate," few of us have broken the process down into the basic elements to accomplish such a goal. In view of the increasing complexity of operations and equipment, the constraints on animal laboratories and teaching caseloads, and the mounting economic and medico-legal pressures, the development of optimal surgical skills should be a major objective of every surgical training program. By developing novel programs and scientifically evaluating the results of such endeavors, surgical faculties may find increased academic rewards for being a good teacher.

  8. Virtual reality in surgical education.

    Science.gov (United States)

    Ota, D; Loftin, B; Saito, T; Lea, R; Keller, J

    1995-03-01

    Virtual reality (VR) is an emerging technology that can teach surgeons new procedures and can determine their level of competence before they operate on patients. Also VR allows the trainee to return to the same procedure or task several times later as a refresher course. Laparoscopic surgery is a new operative technique which requires the surgeon to observe the operation on a video-monitor and requires the acquisition of new skills. VR simulation could duplicate the operative field and thereby enhance training and reduce the need for expensive animal training models. Our preliminary experience has shown that we have the technology to model tissues and laparoscopic instruments and to develop in real time a VR learning environment for surgeons. Another basic need is to measure competence. Surgical training is an apprenticeship requiring close supervision and 5-7 years of training. Technical competence is judged by the mentor and has always been subjective. If VR surgical simulators are to play an important role in the future, quantitative measurement of competence would have to be part of the system. Because surgical competence is "vague" and is characterized by such terms as "too long, too short" or "too close, too far," it is possible that the principles of fuzzy logic could be used to measure competence in a VR surgical simulator. Because a surgical procedure consists of a series of tasks and each task is a series of steps, we will plan to create two important tasks in a VR simulator and validate their use. These tasks consist of laparoscopic knot tying and laparoscopic suturing. Our hypothesis is that VR in combination with fuzzy logic can educate surgeons and determine when they are competent to perform these procedures on patients.

  9. 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 ...

  10. Optimizing surgical f

    Directory of Open Access Journals (Sweden)

    Sabry Mohamed Amin

    2016-07-01

    Conclusions: In our study both dexmedetomidine and esmolol were effective in reducing MABP, and lowering the heart rate providing dry surgical field and ensured good surgical condition during cochlear implant surgery in pediatric patients.

  11. 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 / ...

  12. Dry-heat treatment process for enhancing viral safety of an antihemophilic factor VIII concentrate prepared from human plasma.

    Science.gov (United States)

    Kim, In Seop; Choi, Yong Woon; Kang, Yong; Sung, Hark Mo; Shin, Jeong Sup

    2008-05-01

    Viral safety is a prerequisite for manufacturing clinical antihemophilic factor VIII concentrates from human plasma. With particular regard to the hepatitis A virus (HAV), a terminal dry-heat treatment (100 degrees for 30 min) process, following lyophilization, was developed to improve the virus safety of a solvent/detergent-treated antihemophilic factor VIII concentrate. The loss of factor VIII activity during dry-heat treatment was of about 5%. No substantial changes were observed in the physical and biochemical characteristics of the dry-heat-treated factor VIII compared with those of the factor VIII before dry-heat treatment. The dry-heat-treated factor VIII was stable for up to 24 months at 4oC. The dry-heat treatment after lyophilization was an effective process for inactivating viruses. The HAV, murine encephalomyocarditis virus (EMCV), and human immunodeficiency virus (HIV) were completely inactivated to below detectable levels within 10 min of the dry-heat treatment. Bovine herpes virus (BHV) and bovine viral diarrhea virus (BVDV) were potentially sensitive to the treatment. However porcine parvovirus (PPV) was slightly resistant to the treatment. The log reduction factors achieved during lyophilization and dry-heat treatment were > or =5.55 for HAV, > or =5.87 for EMCV, > or =5.15 for HIV, 6.13 for BHV, 4.46 for BVDV, and 1.90 for PPV. These results indicate that dry-heat treatment improves the virus safety of factor VIII concentrates, without destroying the activity. Moreover, the treatment represents an effective measure for the inactivation of non-lipid-enveloped viruses, in particular HAV, which is resistant to solvent/detergent treatment.

  13. Seismic instrumentation

    International Nuclear Information System (INIS)

    1984-06-01

    RFS or Regles Fondamentales de Surete (Basic Safety Rules) applicable to certain types of nuclear facilities lay down requirements with which compliance, for the type of facilities and within the scope of application covered by the RFS, is considered to be equivalent to compliance with technical French regulatory practice. The object of the RFS is to take advantage of standardization in the field of safety, while allowing for technical progress in that field. They are designed to enable the operating utility and contractors to know the rules pertaining to various subjects which are considered to be acceptable by the Service Central de Surete des Installations Nucleaires, or the SCSIN (Central Department for the Safety of Nuclear Facilities). These RFS should make safety analysis easier and lead to better understanding between experts and individuals concerned with the problems of nuclear safety. The SCSIN reserves the right to modify, when considered necessary, any RFS and specify, if need be, the terms under which a modification is deemed retroactive. The aim of this RFS is to define the type, location and operating conditions for seismic instrumentation needed to determine promptly the seismic response of nuclear power plants features important to safety to permit comparison of such response with that used as the design basis

  14. Three-Dimensional Printing Surgical Applications.

    Science.gov (United States)

    AlAli, Ahmad B; Griffin, Michelle F; Butler, Peter E

    2015-01-01

    Three-dimensional printing, a technology used for decades in the industrial field, gains a lot of attention in the medical field for its potential benefits. With advancement of desktop printers, this technology is accessible and a lot of research is going on in the medical field. To evaluate its application in surgical field, which may include but not limited to surgical planning, surgical education, implants, and prosthesis, which are the focus of this review. Research was conducted by searching PubMed, Web of science, and other reliable sources. We included original articles and excluded articles based on animals, those more than 10 years old, and those not in English. These articles were evaluated, and relevant studies were included in this review. Three-dimensional printing shows a potential benefit in surgical application. Printed implants were used in patient in a few cases and show successful results; however, longer follow-up and more trials are needed. Surgical and medical education is believed to be more efficient with this technology than the current practice. Printed surgical instrument and surgical planning are also believed to improve with three-dimensional printing. Three-dimensional printing can be a very powerful tool in the near future, which can aid the medical field that is facing a lot of challenges and obstacles. However, despite the reported results, further research on larger samples and analytical measurements should be conducted to ensure this technology's impact on the practice.

  15. Crystal Structure of Human Factor VIII: Implications for the Formation of the Factor IXa-Factor VIIIa Complex

    Energy Technology Data Exchange (ETDEWEB)

    Ngo, J.C.; Huang, M.; Roth, D.A.; Furie, B.C.; Furie, B. (Wyeth); (MBL)

    2008-06-03

    Factor VIII is a procofactor that plays a critical role in blood coagulation, and is missing or defective in hemophilia A. We determined the X-ray crystal structure of B domain-deleted human factor VIII. This protein is composed of five globular domains and contains one Ca{sup 2+} and two Cu{sup 2+} ions. The three homologous A domains form a triangular heterotrimer where the A1 and A3 domains serve as the base and interact with the C2 and C1 domains, respectively. The structurally homologous C1 and C2 domains reveal membrane binding features. Based on biochemical studies, a model of the factor IXa-factor VIIIa complex was constructed by in silico docking. Factor IXa wraps across the side of factor VIII, and an extended interface spans the factor VIII heavy and light chains. This model provides insight into the activation of factor VIII and the interaction of factor VIIIa with factor IXa on the membrane surface.

  16. Crystal Structure of Human Factor VIII: Implications for the Formation of the Factor IXa-Factor VIIIa Complex

    Energy Technology Data Exchange (ETDEWEB)

    Chi Ki Ngo,J.; Huang, M.; Roth, D.; Furie, B.; Furie, B.

    2008-01-01

    Factor VIII is a procofactor that plays a critical role in blood coagulation, and is missing or defective in hemophilia A. We determined the X-ray crystal structure of B domain-deleted human factor VIII. This protein is composed of five globular domains and contains one Ca(2+) and two Cu(2+) ions. The three homologous A domains form a triangular heterotrimer where the A1 and A3 domains serve as the base and interact with the C2 and C1 domains, respectively. The structurally homologous C1 and C2 domains reveal membrane binding features. Based on biochemical studies, a model of the factor IXa-factor VIIIa complex was constructed by in silico docking. Factor IXa wraps across the side of factor VIII, and an extended interface spans the factor VIII heavy and light chains. This model provides insight into the activation of factor VIII and the interaction of factor VIIIa with factor IXa on the membrane surface.

  17. Analysis of inversions in the factor VIII gene in Spanish hemophilia A patients and families

    Energy Technology Data Exchange (ETDEWEB)

    Domenech, M.; Tizzano, E.; Baiget, M. [Hospital de Sant Pau, Barcelona (Spain); Altisent, C. [Hospital Vall d`Hebron, Barcelona (Spain)

    1994-09-01

    Intron 22 is the largest intron of the factor VIII gene and contains a CpG island from which two additional transcripts originate. One of these transcripts corresponds to the F8A gene which have telomeric extragenic copies in the X chromosome. An inversion involving homologous recombination between the intragenic and the distal or proximal copies of the F8A gene has been recently described as a common cause of severe hemophilia A (HA). We analyzed intron 22 rearrangements in 195 HA patients (123 familial and 72 sporadic cases). According to factor VIII levels, our sample was classified as severe in 114 cases, moderate in 29 cases and mild in 52 cases. An intron 22 (F8A) probe was hybridized to Southern blots of BcII digested DNA obtained from peripheral blood. A clear pattern of altered bands identifies distal or proximal inversions. We detected an abnormal pattern identifying an inversion in 49 (25%) of the analyzed cases. 43% of severe HA patients (49 cases) showed an inversion. As expected, no inversion was found in the moderate and mild group of patients. We found a high proportion (78%) of the distal rearrangement. From 49 identified inversions, 33 were found in familial cases (27%), while the remaining 15 were detected in sporadic patients (22%) in support that this mutational event occurs with a similar frequency in familial or sporadic cases. In addition, we detected a significant tendency of distal inversion to occur more frequently in familial cases than in sporadic cases. Inhibitor development to factor VIII was documented in approximately 1/3 of the patients with inversion. The identification of such a frequent molecular event in severe hemophilia A patients has been applied in our families to carrier and prenatal diagnosis, to determine the origin of the mutation in the sporadic cases and to detect the presence of germinal mosaicism.

  18. Comercio Internacional mediterráneo en el siglo VIII a.C.

    Directory of Open Access Journals (Sweden)

    Paloma Cabrera Bonet

    2018-01-01

    Full Text Available The VIII century B.C. saw, for the first time after the breakdown of the system in the Late Bronze Age, the revival of a true intemational trade at a growing scale, especíally protagonized by Phoenicians and Greeks. In this article we analyze sorne aspects of this phenomenon, from the Aegean to the Far West, which made possíble, through a vaste network of trading routes, a large multinational ínteractíon. We understand the international trade as a key factor in the proccess of economic, social and political changes of the Mediterranean areas submerged in this complex "world-system".

  19. Estudo da articulação temporomandibular em camundongos deficientes de fator VIII

    OpenAIRE

    Patricia do Socorro Queiroz Feio

    2010-01-01

    Resumo: A hemofilia é uma doença hemorrágica hereditária ligada ao cromossomo X, decorrente da ausência ou da baixa quantidade no plasma dos fatores de coagulação Fator VIII (hemofilia A) ou do Fator IX (hemofilia B). Clinicamente, a hemofilia se caracteriza por episódios recorrentes de sangramentos profundos, que podem ocorrer espontaneamente ou em decorrência de traumatismos. O sistema músculo-esquelético é freqüentemente afetado pelos eventos hemorrágicos nos pacientes portadores de hemofi...

  20. Underground Test Area Subproject Phase I Data Analysis Task. Volume VIII - Risk Assessment Documentation Package

    Energy Technology Data Exchange (ETDEWEB)

    None

    1996-12-01

    Volume VIII of the documentation for the Phase I Data Analysis Task performed in support of the current Regional Flow Model, Transport Model, and Risk Assessment for the Nevada Test Site Underground Test Area Subproject contains the risk assessment documentation. Because of the size and complexity of the model area, a considerable quantity of data was collected and analyzed in support of the modeling efforts. The data analysis task was consequently broken into eight subtasks, and descriptions of each subtask's activities are contained in one of the eight volumes that comprise the Phase I Data Analysis Documentation.

  1. IMPLIKASI YURIDIS PUTUSAN MK NOMOR 46/PUU- VIII/ 2010 TERHADAP AKTA KELAHIRAN ANAK LUAR KAWIN

    Directory of Open Access Journals (Sweden)

    Djumikasih Djumikasih

    2014-08-01

    Full Text Available Abstract This paper aims to identify and analyze what the juridical implications of the publication of the decision of the Constitutional Court No. 46/PUU-VIII / 2010 on Child Outside Marriage Deed which has been published by the Department of Population and Civil Registration prior to the establishment of the Constitutional Court's decision . The method used in this study is a normative juridical approach legislation. From the discussion, it can be concluded that the Constitutional Court 46/PUU-VIII/2010 Number of Tests on Article 43 paragraph ( 1 Marriage Act ( Act No. 1 of 1974 when viewed from the angle of legal certainty it will lead to legal certainty . But the decision will not have any juridical implications of the child's birth certificate that has been published outside of marriage and illegitimate child who was born before the date of February 17, 2012, as if enacted would be contrary to the principle of legality is interpreted Article 47 of the Law on the Constitutional Court and Article 28 ( i of the 1945 Constitution . Likewise, if the terms of the fairness and usefulness , especially for justice seekers / applicant , the timing of this decision is not fair and not useful , because although the Court granted the petition but the Constitutional Court can not be applied to her .   Key words: yuridical implication, birth certificate, children who are born outside of marriage   Abstrak   Tulisan ini bertujuan untuk mengetahui dan menganalisis apa implikasi yuridis dari terbitnya putusan MK Nomor 46/PUU-VIII/ 2010 terhadap Akta Anak Luar Kawin yang sudah diterbitkan oleh Dinas Kependudukan dan Catatan Sipil sebelum lahirnya putusan MK tersebut. Metode yang digunakan dalam penelitian ini adalah yuridis normative dengan pendekatan perundang-undangan. Dari pembahasan dapat disimpulkan bahwa Putusan MK Nomer 46/PUU-VIII/2010 tentang Pengujian terhadap Pasal 43 ayat (1 UU Perkawinan (UU NO 1 Tahun 1974 jika dilihat dari sudut kepastian

  2. Optimisation of the Factor VIII yield in mammalian cell cultures by reducing the membrane bound fraction

    DEFF Research Database (Denmark)

    Kolind, Mille Petersen; Nørby, Peder Lisby; Berchtold, Martin Werner

    2011-01-01

    In vivo, clotting Factor VIII (FVIII) circulates in plasma bound to von Willebrand factor (vWF), and the vWF:FVIII complex prevents binding of FVIII to phosphatidylserine (PS). Activation of FVIII by thrombin releases FVIII from vWF, and subsequently FVIII binds to PS exposed on activated platelets...... or ortho-phospho-L-serine (OPLS) demonstrated that annexin V and OPLS were able to reduce the membrane bound fraction of rFVIII by 70% and 30%, respectively. Finally, adding OPLS to CHO cells stably expressing FVIII increased the yield by 50%. Using this new knowledge, the recovery of rFVIII could...

  3. Modeling of tool-tissue interactions for computer-based surgical simulation: a literature review

    NARCIS (Netherlands)

    Misra, Sarthak; Ramesh, K.T.; Okamura, Allison M.

    2008-01-01

    Surgical simulators present a safe and potentially effective method for surgical training, and can also be used in robot-assisted surgery for pre- and intra-operative planning. Accurate modeling of the interaction between surgical instruments and organs has been recognized as a key requirement in

  4. KEEFEKTIFAN MODEL TGT DENGAN PENDEKATAN SCIENTIFIC BERBANTUAN CD PEMBELAJARAN TERHADAP KEMAMPUAN PEMECAHAN MASALAH SISWA SMP KELAS VIII PADA MATERI LINGKARAN

    Directory of Open Access Journals (Sweden)

    Singgih Baswendro

    2015-11-01

    Full Text Available Artikel ini dibuat berdasarkan penelitian skripsi yang telah dilaksanakan. Tujuan penelitian ini adalah (1 untuk mengetahui hasil kemampuan pemecahan masalah siswa kelas VIII pada materi lingkaran dengan menggunakan model TGT mencapai KKM, dan (2 untuk mengetahui rata-rata kemampuan pemecahan masalah siswa dengan model TGT lebih tinggi daripada dengan model ekspositori. Penelitian ini dilaksanakan di SMP Negeri 3 Ungaran dengan populasi siswa kelas VIII tahun ajaran 2014/2015. Pengambilan kelas sampel menggunakan teknik cluster random sampling. Untuk mengetahui hasil penelitian ini, data hasil akhir diuji dengan uji proporsi dan uji perbedaan rata-rata. Hasil penelitan ini menunjukkan bahwa (1 hasil kemampuan pemecahan masalah siswa kelas VIII pada materi lingkaran dengan menggunakan model TGT mencapai KKM, dan (2 rata-rata kemampuan pemecahan masalah siswa dengan model TGT lebih tinggi daripada dengan model ekspositori. Dengan ini maka model TGT dengan pendekatan scientific berbantuan CD pembelajaran efektif terhadap kemampuan pemecahan masalah siswa.

  5. ПРОПРІАТИВИ У ПОЛІКОМПОНЕНТНИХ ЕПОНІМАХ ХІРУРГІЧНИХ ІНСТРУМЕНТІВ / PROPER NAMES IN MULTICOMPONENT EPONYMS OF SURGICAL INSTRUMENTS

    Directory of Open Access Journals (Sweden)

    Марія ТЕЛЕКИ

    2016-03-01

    Full Text Available Тeleky Mariia. Proper names in multicomponent eponyms of surgical instruments. The article represents а general characteristic of proper names in multicomponent eponymic names of surgical instruments for general and special purpose that operate in Ukrainian language; their terminological status has been clarified, the description of extra linguistic factors that determine the creation, appearance and functioning of eponymic terms has been carried out; lexico-semantic and pragmatic features of eponymic terms have been characterized; thematic groups of analysed proper names in multicomponent eponyms and their productive derivational models have been singled out. With the development of medical sciences and technological progress new eponymical terms more often get into the sphere of professional use, in the base of which are the inventions, the creators of which are single scientists and whole scientific schools. There is a need for specialized reference books, dictionaries, the use of which considerably reduces the time of medical specialist for interpretation the eponymical term. Research questions of proper names in multicomponent eponyms continue to be urgent today. The research allows promoting cross-language coordination and ensuring comparability of medical terminological vocabulary, enriching the terminological system, exchanging the scientific information and improving the quality process in professional communication. The proper names composed of multicomponent eponyms are special names that respond the main signs of the term. 1. Eponymical terms of proper names represent complex of medical concepts and they are the part of the language of surgical medicine. They are the reflection of the development of medical knowledge and revealing of professional activities. 2. Among the eponymic terms, the most productive by the number of components is the word – formation model of "a noun in the nominative case + proper name in the genitive

  6. The head that wears the crown: Henry VIII and traumatic brain injury.

    Science.gov (United States)

    Ikram, Muhammad Qaiser; Sajjad, Fazle Hakim; Salardini, Arash

    2016-06-01

    Henry VIII of England is one of the most controversial figures in European history. He was born on 28 June 1491 as the second son of Henry VII and Elizabeth of York and became the heir to the English throne after his elder brother died prematurely. A contradictory picture of Henry's character emerges from history: the young Henry was a vigorous, generous and intelligent king who saw early military and naval successes. In contrast, in his later years he became cruel, petty and tyrannical. His political paranoia and military misjudgements are in direct contrast to his earlier successes and promise. Several hypotheses have been put forward regarding his transformation from a renaissance king to a later medieval tyrant, including endocrinopathies, psychiatric illnesses and traumatic brain injury. In this paper we examine the historical evidence linking the change in Henry's personality and health problems to traumatic brain injury. To our knowledge this is the first systematic neurological study of traumatic brain injury in Henry VIII. Copyright © 2015 Elsevier Ltd. All rights reserved.

  7. KEANEKARAGAMAN HYMENOPTERA PARASITOID PADA PERKEBUNAN KELAPA SAWIT PTPN VIII CINDALI, BOGOR

    Directory of Open Access Journals (Sweden)

    Ichsan Luqmana Indra Putra

    2016-09-01

    Full Text Available Diversity of parasitic Hymenoptera in PTPN VIII oil palm plantation Cindali, Bogor. One group of important natural enemies in oil palm plantation is parasitic Hymenoptera. The purpose of this research is to know the diversity and fluctuation of parasitic Hymenoptera PTPN VIII Cindali oil palm plantation. This research was conducted in 6 blocks of oil palm in September 2014 – June 2015. There were 5 plots in every observation blocks 39.2 x 39.2 m in size, and used direct and indirect method. Direct method done by 5 plants in every plots was taken randomized to observed and taken the herbivore insects to reared until the parasitic Hymenoptera came out. Observation of cover crops conducted by 3 subplots determined diagonally in every plots 9.8 x 9.8 m in size and herbivore insects was observed and collected. Indirect methods used sweep net and yellow pan trap. The result of this research, 26 parasitic Hymenoptera families was found, with the Braconidae was the most morphospecies found and the most individual amount was Scelionidae. The abundance of parasitoid in every month fluctuated.

  8. Innovative Approaches for Immune Tolerance to Factor VIII in the Treatment of Hemophilia A

    Science.gov (United States)

    Sherman, Alexandra; Biswas, Moanaro; Herzog, Roland W.

    2017-01-01

    Hemophilia A (coagulation factor VIII deficiency) is a debilitating genetic disorder that is primarily treated with intravenous replacement therapy. Despite a variety of factor VIII protein formulations available, the risk of developing anti-dug antibodies (“inhibitors”) remains. Overall, 20–30% of patients with severe disease develop inhibitors. Current clinical immune tolerance induction protocols to eliminate inhibitors are not effective in all patients, and there are no prophylactic protocols to prevent the immune response. New experimental therapies, such as gene and cell therapies, show promising results in pre-clinical studies in animal models of hemophilia. Examples include hepatic gene transfer with viral vectors, genetically engineered regulatory T cells (Treg), in vivo Treg induction using immune modulatory drugs, and maternal antigen transfer. Furthermore, an oral tolerance protocol is being developed based on transgenic lettuce plants, which suppressed inhibitor formation in hemophilic mice and dogs. Hopefully, some of these innovative approaches will reduce the risk of and/or more effectively eliminate inhibitor formation in future treatment of hemophilia A. PMID:29225598

  9. PROSES BERPIKIR SISWA KELAS VIII DALAM MENYELESAIKAN SOAL MATEMATIKA TIMSS MATERI BESAR SUDUT DALAM BENTUK GEOMETRIS

    Directory of Open Access Journals (Sweden)

    Nurul Hidayati Arifani

    2017-07-01

    Full Text Available This study aims to describe the students' thinking process in solving TIMSS math problem on measurement of angle in geometric shapes based on Polya’s problem solving step associated with Swartz’s thinking process theory. The subject of the research was a grade VIII student in SMP Negeri 4 Malang who was classified as intelligent but made many mistakes when completing the test. Data collection methods used were test and interview methods. The results show that students go through the step of generating ideas, clarifying ideas, assessing the reasonableness of ideas, and thinking complex on every step of problem solving, but at the look back step, students do not clarify the idea. Penelitian ini bertujuan untuk mendeskripsikan proses berpikir siswa dalam menyelesaikan soal matematika TIMSS materi besar sudut dalam bentuk geometris berdasarkan langkah penyelesaian masalah Polya yang dikaitkan dengan teori proses berpikir Swartz. Subjek penelitian adalah seorang siswa kelas VIII di SMP Negeri 4 Malang yang tergolong pandai, tetapi banyak melakukan kesalahan saat menyelesaikan soal tes. Metode pengumpulan data yang digunakan adalah metode tes dan wawancara. Hasil penelitian menunjukkan bahwa siswa dalam menyelesaikan soal TIMSS melalui tahap menghasilkan ide, mengklarifikasi ide, menilai kelayakan ide, dan berpikir kompleks pada setiap langkah penyelesaian masalah. Namun, pada tahap memeriksa kembali, siswa tidak melakukan pengklarifikasian ide.

  10. Indonesian Interference on English Language in VIII Grade Junior High School Students

    Directory of Open Access Journals (Sweden)

    Agustia Km Tri Sutrisna

    2018-01-01

    Full Text Available This study aims to determine the type of Indonesian interference found in English language among class VIII SMPK 2 Harapan Untal-Untal students. This research is done by analyzing the result of simple text translation done by the students of class VIII SMPK 2 Harapan Untal-Untal, then from the translation result will be analyzed what kind of interference that appeared. Methods of data collection in this study using observational research methods and literature. The data that have been collected in the form of simple translations from the students will be analyzed descriptively using related theories to find out what kind of interference found in the analysis. Further, in relating to interference, it will find a way out to reduce and even eliminate Indonesian interference itself. The results to be achieved in this research is recognize the level of Indonesian language interference in the use of English among the junior high school students, then find the practical efforts to be done so that interference does not increased. So, the use and English understanding can be done as much as possible. The finding of the paper found that 6 interference such as grammar structure, subject pronoun, adjectives, auxiliaries, preposition and word order.

  11. KEEFEKTIFAN MODEL PEMBELAJARAN PROBLEM BASED LEARNING BERNUANSA ETNOMATEMATIKA TERHADAP KEMAMPUAN PEMECAHAN MASALAH SISWA KELAS VIII

    Directory of Open Access Journals (Sweden)

    Dian Insani Abdullah

    2015-11-01

    Full Text Available Tujuan penelitian ini untuk mengetahui model pembelajaran PBL bernuansa etnomatematika efektif terhadap kemampuan pemecahan masalah siswa. Populasi dalam penelitian ini adalah siswa pada kelas VIII SMP N 1 Demak tahun pelajaran 2014/2015. Pengambilan sampel menggunakan cluster random sampling. Pengumpulan data dilakukan dengan metode dokumentasi, observasi, angket, dan tes. Analisis data menggunakan menggunakan uji One Sample T Test, uji proporsi, uji Independent Samples T Test dan uji regresi linear berganda. Hasil Penelitian menunjukkan bahwa (1 kemampuan pemecahan masalah siswa yang memperoleh pembelajaran model PBL bernuansa etnomatematika mencapai KKM, (2 kemampuan pemecahan masalah siswa yang memperoleh pembelajaran model PBL mencapai KKM (3 kemampuan pemecahan masalah siswa yang memperoleh pembelajaran model PBL bernuansa etnomatematika lebih tinggi daripada kemampuan pemecahan  masalah siswa dengan model PBL, (4 terdapat perbedaan sikap terhadap budaya lokal antara sebelum dan setelah diterapkan pembelajaran model PBL bernuansa etnomatematika dan (5 aktivitas belajar siswa dan sikap terhadap budaya lokal siswa berpengaruh terhadap kemampuan pemecahan masalah siswa, sehingga dapat disimpulkan model pembelajaran PBL bernuansa etnomatematika efektif terhadap kemampuan pemecahan masalah siswa kelas VIII.

  12. Evaluation of B&W UO2/ThO2 VIII experimental core: criticality and thermal disadvantage factor analysis

    Energy Technology Data Exchange (ETDEWEB)

    Carlo Parisi; Emanuele Negrenti

    2017-02-01

    In the framework of the OECD/NEA International Reactor Physics Experiment (IRPHE) Project, an evaluation of core VIII of the Babcock & Wilcox (B&W) Spectral Shift Control Reactor (SSCR) critical experiment program was performed. The SSCR concept, moderated and cooled by a variable mixture of heavy and light water, envisaged changing of the thermal neutron spectrum during the operation to encourage breeding and to sustain the core criticality. Core VIII contained 2188 fuel rods with 93% enriched UO2-ThO2 fuel in a moderator mixture of heavy and light water. The criticality experiment and measurements of the thermal disadvantage factor were evaluated.

  13. Immune tolerance induction with highly purified plasma-derived factor VIII containing von Willebrand factor in hemophilia A patients with high-responding inhibitors.

    Science.gov (United States)

    Orsini, Frédérique; Rotschild, Chantal; Beurrier, Philippe; Faradji, Albert; Goudemand, Jenny; Polack, Benoît

    2005-09-01

    We retrospectively evaluated the efficacy of immune tolerance induction (ITI) in a homogenous cohort of eight patients with constitutive severe hemophilia A with high-responding factor VIII (FVIII) inhibitors using Facteur VIII-LFB/Factane, a highly purified FVIII concentrate containing von Willebrand factor (VWF).

  14. 46 CFR 54.01-2 - Adoption of division 1 of section VIII of the ASME Boiler and Pressure Vessel Code.

    Science.gov (United States)

    2010-10-01

    ... Boiler and Pressure Vessel Code. 54.01-2 Section 54.01-2 Shipping COAST GUARD, DEPARTMENT OF HOMELAND... division 1 of section VIII of the ASME Boiler and Pressure Vessel Code. (a) Pressure vessels shall be designed, constructed, and inspected in accordance with section VIII of the ASME Boiler and Pressure Vessel...

  15. A DFT study to unravel the ligand exchange kinetics and thermodynamics of Os(VIII) oxo/hydroxido/aqua complexes in aqueous matrices.

    Science.gov (United States)

    van Niekerk, Daniel M E; Gerber, Wilhelmus J; Koch, Klaus R

    2016-04-28

    The Os(VIII) oxo/hydroxido complexes that are abundant in mild to relatively concentrated basic aqueous solutions are Os(VIII)O4, [Os(VIII)O4(OH)](-) and two cis-[Os(VIII)O4(OH)2](2-) species. Os(VIII) complexes that contain water ligands are thermodynamically unfavoured w.r.t. the abovementioned species. Os(VIII)O4 reacts with hydroxide in two, consecutive, elementary coordination sphere expansion steps to form the [Os(VIII)O4(OH)](-) complex and then the cis-[Os(VIII)O4(OH)2](2-) species. The Gibbs energy of activation for both reactions, in the forward and reverse direction, are in the range of 6-12 kcal mol(-1) and are relatively close to diffusion-controlled. The thermodynamic driving force of the first reaction is the bonding energy of the Os(VIII)-OH metal-hydroxido ligand, while of the second reaction it is the relatively large hydration energy of the doubly-charged cis-[Os(VIII)O4(OH)2](2-) product compared to the singly-charged reactants. The DFT-calculated (PBE-D3 functional) in the simulated aqueous phase (COSMO) is -2.4 kcal mol(-1) for the first reaction and -0.6 kcal mol(-1) for the second reaction and agree to within 1 kcal mol(-1) with reported experimental values, at -2.7 and 0.3 kcal mol(-1) respectively. From QTAIM and EDA analyses it is deduced that the Os(VIII)[double bond, length as m-dash]O bonding interactions are ionic (closed-shell) and that Os(VIII)-OH bonding interactions are polar covalent (dative). In contrast to QTAIM, NCI analysis allowed for the identification of relatively weak intramolecular hydrogen bonding interactions between neighbouring oxo and hydroxido ligands in both [Os(VIII)O4(OH)](-) and cis-[Os(VIII)O4(OH)2](2-) complexes.

  16. Incidence of factor VIII inhibitor development in severe hemophilia A patients treated only with one brand of highly purified plasma-derived concentrate.

    Science.gov (United States)

    Guérois, C; Laurian, Y; Rothschild, C; Parquet-Gernez, A; Duclos, A M; Négrier, C; Vicariot, M; Fimbel, B; Fressinaud, E; Fiks-Sigaud, M

    1995-02-01

    The incidence of factor VIII inhibitor was studied in a cohort of 56 previously untreated patients with severe hemophilia A (factor VIII below 1 U/dl). They received only one brand of highly purified factor VIII concentrate (HPSD-VIII) prepared by conventional chromatography with a solvent-detergent step for viral inactivation. Follow-up since the first infusion of HPSD-VIII was from 1 to 76 months (mean = 29) and cumulative exposure days (CED) from 1 to over 100 (median = 26). Five patients (9%) developed an inhibitor after 6 to 19 CED, only one being a high responder (2%), showing a low incidence of inhibitor compared with previous studies using high purity plasma-derived or recombinant products.

  17. Computer-Assisted Technique for Surgical Tooth Extraction

    Directory of Open Access Journals (Sweden)

    Hosamuddin Hamza

    2016-01-01

    Full Text Available Introduction. Surgical tooth extraction is a common procedure in dentistry. However, numerous extraction cases show a high level of difficulty in practice. This difficulty is usually related to inadequate visualization, improper instrumentation, or other factors related to the targeted tooth (e.g., ankyloses or presence of bony undercut. Methods. In this work, the author presents a new technique for surgical tooth extraction based on 3D imaging, computer planning, and a new concept of computer-assisted manufacturing. Results. The outcome of this work is a surgical guide made by 3D printing of plastics and CNC of metals (hybrid outcome. In addition, the conventional surgical cutting tools (surgical burs are modified with a number of stoppers adjusted to avoid any excessive drilling that could harm bone or other vital structures. Conclusion. The present outcome could provide a minimally invasive technique to overcome the routine complications facing dental surgeons in surgical extraction procedures.

  18. Image-guided surgical navigation in otology.

    Science.gov (United States)

    Kohan, Darius; Jethanamest, Daniel

    2012-10-01

    To evaluate the efficacy of image-guided surgical navigation (IGSN) in otologic surgery and establish practice guidelines. Prospective study. Between January 2003 and January 2010, all patients requiring complicated surgery for chronic otitis media, glomus jugulare, atresia, cerebrospinal fluid leak with or without encephalocele, and cholesterol granuloma of the petrous apex were offered IGSN. The accuracy of IGSN relative to pertinent pathology and 11 anatomic landmarks was established. Additionally IGSN-related operative time, complications, and surgical outcome were recorded. In the study period there were 820 otologic procedures, among 94 patients (96 ears) with disease meeting proposed criteria. Thirteen patients (15 procedures) consented to the use of IGSN. All patients had a minimum 6 months of follow-up. The average additional operative time required was 36.7 minutes. The mean accuracy error was 1.1 mm laterally at the tragus but decreased to 0.8 mm medially at the level of the oval window. The mean accuracy of IGSN was within 1 mm in 10 of the 11 targeted surgical anatomic landmarks. Interactive image-guided surgical navigation during complex otologic surgery may improve surgical outcome and decrease morbidity by providing an accurate real-time display of surgical instrumentation relative to patient anatomy and pathology. In select cases, the extra cost of imaging immediately prior to surgery and extra operating room time may be compensated by enhancing the ability to distinguish distorted anatomy relative to disease, potentially improving surgical outcome. IGSN, although useful, does not replace surgical expertise and experience. Copyright © 2012 The American Laryngological, Rhinological, and Otological Society, Inc.

  19. 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.

  20. Purification and characterization of factor VIII 1,689-Cys: a nonfunctional cofactor occurring in a patient with severe hemophilia A.

    Science.gov (United States)

    O'Brien, D P; Tuddenham, E G

    1989-06-01

    We have purified the factor VIII from a CRM+ Hemophilia A plasma (90 U/dL VIII:Ag but 0 U/dL VIII:C) and analyzed the protein before and after thrombin activation by Western blotting with monoclonal antibodies (MoAbs). Normal or patient citrated plasma was ultracentrifuged, cryo-ethanol-precipitated and chromatographed on Sepharose 6B. The void volume fractions were reduced and subjected to ion exchange chromatography yielding material of specific activity approximately 1,000 U/mg protein (VIII:C or VIII:Ag). Factor VIII purified in this way from normal plasma is fully activatable by thrombin with proteolytic fragmentation as previously described by F. Rotblat et al (Biochemistry 24: 4294, 1985). Factor VIII 1,689-Cys has the normal distribution of factor VIII light and heavy chains prior to thrombin activation. After exposure to thrombin the heavy chain polypeptides were fully proteolysed but the light chain was totally resistant to cleavage. This is consistent with the demonstration in the patient's leucocyte DNA of a C to T transition in codon 1,689 converting Arg to Cys at the light chain thrombin cleavage site as previously described by J. Gitschier et al (Blood 72:1022, 1988). Uncleaved light chain of Factor VIII 1,689-Cys is not released from von Willebrand factor (vWF) by thrombin, but this is not the sole cause of the functional defect since the protein purified free of vWF has no coagulant activity. We conclude that the functional defect in factor VIII 1,689-Cys is a consequence of failure to release the acidic peptide from the light chain upon thrombin activation.

  1. Epitope mapping of inhibitory antibodies targeting the C2 domain of coagulation factor VIII by hydrogen-deuterium exchange mass spectrometry

    Science.gov (United States)

    Sevy, Alexander M.; Healey, John F.; Deng, Wei; Spiegel, P. Clint; Meeks, Shannon L.; Li, Renhao

    2014-01-01

    Summary Background The development of anti-factor VIII (fVIII) antibodies (inhibitors) is a significant complication in the management of patients with hemophilia A, leading to significant increases in morbidity and treatment cost. Using a panel of anti-fVIII monoclonal antibodies (MAbs) to different epitopes on fVIII, we recently have shown that epitope specificity, inhibitor kinetics, and time to maximum inhibition are more important than inhibitor titer in predicting response to fVIII and the combination of fVIII and recombinant factor VIIa. In particular, a subset of high-titer inhibitors responded to high dose fVIII, which would not be predicted based on their inhibitor titer alone. Thus the ability to quickly map the epitope spectrum of patient plasma using a clinically feasible assay may fundamentally change how clinicians approach the treatment of high-titer inhibitor patients. Objectives To map the epitopes of anti-fVIII MAbs, of which 3 are classical inhibitors and one non-classical, using hydrogen-deuterium exchange coupled with liquid chromatography-mass spectrometry (HDX-MS). Methods Binding epitopes of 4 MAbs targeting fVIII C2 domain were mapped using HDX-MS. Results The epitopes determined by HDX-MS are consistent with those obtained earlier through structural characterization and antibody competition assays. In addition classical and non-classical inhibitor epitopes could be distinguished using a limited subset of C2-derived peptic fragments. Conclusion Our results demonstrate the effectiveness and robustness of the HDX-MS method for epitope mapping and suggest a potential role of rapid mapping of fVIII inhibitor epitopes in facilitating individualized treatment of inhibitor patients. PMID:24152306

  2. 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...

  3. 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

  4. Surgical management of pain

    African Journals Online (AJOL)

    the spinal cord.[4] In this article, the reader is referred back to this illustration to understand the surgical techniques used to manage pain. Pain is caused by ... Injured dorsal root neurons discharge at higher frequencies and more spontaneously than normally. Surgical techniques. The physician should ensure that treat-.

  5. Surgical site infections

    African Journals Online (AJOL)

    the development of SSI. Complications associated with surgical site infections7. • Longer hospital stay with risk of acquiring other hospital acquired infections like pneumonia. • Require more surgical procedures. • Risk for development of resistance to antibiotics. • Risk for development of necrotizing fasciitis with skin loss.

  6. Low activated incore instrument

    Science.gov (United States)

    Ekeroth, D.E.

    1994-04-19

    Instrumentation is described for nuclear reactor head-mounted incore instrumentation systems fabricated of low nuclear cross section materials (i.e., zirconium or titanium). The instrumentation emits less radiation than that fabricated of conventional materials. 9 figures.

  7. Evaluating musical instruments

    International Nuclear Information System (INIS)

    Campbell, D. Murray

    2014-01-01

    Scientific measurements of sound generation and radiation by musical instruments are surprisingly hard to correlate with the subtle and complex judgments of instrumental quality made by expert musicians

  8. Evaluating musical instruments

    Energy Technology Data Exchange (ETDEWEB)

    Campbell, D. Murray

    2014-04-01

    Scientific measurements of sound generation and radiation by musical instruments are surprisingly hard to correlate with the subtle and complex judgments of instrumental quality made by expert musicians.

  9. Analysis of factor VIII gene inversions in 164 unrelated hemophilia A families

    Energy Technology Data Exchange (ETDEWEB)

    Vnencak-Jones, L.; Phillips, J.A. III; Janco, R.L. [Vanderbilt Univ. School of Medicine, Nashville, TN (United States)] [and others

    1994-09-01

    Hemophilia A is an X-linked recessive disease with variable phenotype and both heterogeneous and wide spread mutations in the factor VIII (F8) gene. As a result, diagnostic carrier or prenatal testing often relies upon laborious DNA linkage analysis. Recently, inversion mutations resulting from an intrachromosomal recombination between DNA sequences in one of two A genes {approximately}500 kb upstream from the F8 gene and a homologous A gene in intron 22 of the F8 gene were identified and found in 45% of severe hemophiliacs. We have analyzed banked DNA collected since 1986 from affected males or obligate carrier females representing 164 unrelated hemophilia A families. The disease was sporadic in 37%, familial in 54% and in 10% of families incomplete information was given. A unique deletion was identified in 1/164, a normal pattern was observed in 110/164 (67%), and 53/164 (32%) families had inversion mutations with 43/53 (81%) involving the distal A gene (R3 pattern) and 10/53 (19%) involving the proximal A gene (R2 pattern). While 19% of all rearrangements were R2, in 35 families with severe disease (< 1% VIII:C activity) all 16 rearrangements seen were R3. In 18 families with the R3 pattern and known activities, 16 (89%) had levels < 1%, with the remaining 2 families having {le} 2.4% activity. Further, 18 referrals specifically noted the production of inhibitors and 8/18 (45%) had the R3 pattern. Our findings demonstrate that the R3 inversion mutation patterns is (1) only seen with VIII:C activity levels of {le} 2.4%, (2) seen in 46% of families with severe hemophilia, (3) seen in 45% of hemophiliacs known to have inhibitors, (4) not correlated with sporadic or familial disease and (5) not in disequilibrium with the Bcl I or Taq I intron 18 or ST14 polymorphisms. Finally, in families positive for an inversion mutation, direct testing offers a highly accurate and less expensive alternative to DNA linkage analysis.

  10. Keefektifan Experiential Learning Berbantuan Origami Terhadap Kemampuan Keruangan Siswa Kelas VIII

    Directory of Open Access Journals (Sweden)

    Isnaeni Umi Machromah

    2014-11-01

    Full Text Available AbstrakPenelitian eksperimen ini bertujuan untuk mengetahui keefektifan pembelajaran Experiential Learning berbantuan origami terhadap kemampuan keruangan siswa dengan kualifikasi keefektifan yang telah ditentukan. Populasi yaitu siswa kelas VIII SMP Negeri 3 Colomadu tahun pelajaran 2012/2013. Sampel diambil secara simple random sampling. Hasil penelitian ini yaitu: (1 Uji proporsi ketuntasan belajar menunjukkan siswa kelompok eksperimen telah mencapai ketuntasan belajar; (2 Uji perbedaan dua rata-rata menghasilkan simpulan bahwa rata-rata hasil post-test kemam-puan keruangan siswa kelompok eksperimen lebih dari kelompok kontrol; (3 Analisis re-gresi menunjukkan bahwa motivasi belajar siswa memberikan pengaruh positif sebesar 49,3% terhadap kemampuan keruangan siswa; (4 Uji gain ternormalisasi menunjukkan terdapat peningkatan kemampuan keruangan siswa secara signifikan pada kategaori sedang untuk kelompok eksperimen dan kategori rendah untuk kelompok kontrol. Simpulan yang diperoleh yaitu Experiential Learning berbantuan origami efektif terhadap kemampuan keruangan siswa kelas VIII. AbstractThis experiment research aims to determine the effectiveness of Experiential Learning with Origami to the students’s spatial abilities by the criteria of effectiveness. The population of this research is students of grade VIII of SMP Negeri 3 Colomadu 2012/2013 academic year. Independent variables used in this research are learning by Experiential Learning with origami and student’s motivation. While the dependent variable is the student’s spatial abilities. This research is using documentation, spatial abilities’s test, dan motivation’s scale for collecting data method. Result of this research are: (1 proportion test show that the experiment group has reached mastering of learning clasically and personally; (2 result of spatial ablities’s post test in experiment group better than control group; (3 result of regretion shows that student

  11. Factor VIII S373L: mutation at P1' site confers thrombin cleavage resistance, causing mild haemophilia A.

    Science.gov (United States)

    Johnson, D J; Pemberton, S; Acquila, M; Mori, P G; Tuddenham, E G; O'Brien, D P

    1994-04-01

    A novel CRM+ mutation, factor VIII position 373 serine to leucine substitution (FVIII 373-Leu) was identified during a survey of Factor VIII (FVIII) mutations. We have purified the variant protein from the patient's plasma in order to allow further characterisation of the molecule. The CRM+ plasma contained 120% Factor VIII antigen (FVIII:Ag) and 6% Factor VIII coagulant activity (FVIII:C). After purification the mutant FVIII was subjected to thrombin proteolysis, and was thereby activated 5.6-fold compared with 7-fold for wild type molecule. Subsequently, spontaneous inactivation of the mutant was much slower than noted for wild type FVIII. Western blot analysis using monoclonal antibodies demonstrated that thrombin cleavage of FVIII 373-Leu at positions 740 and 1689 were normal but that cleavage at position 372 was completely absent. Crystallographic coordinates of the active site of thrombin complexed to fibrinopeptide A were used to explore possible mechanistic reasons for the failure of thrombin to cleave the mutant FVIII at position 372. Steric hindrance between the mutant side chain and the side chain of the P1 residue was apparent. We conclude that the functional defect of FVIII 373-Leu results from the inability of thrombin to cleave the mutant at position 372-373, and propose that this is due to steric hindrance by the side chain of leucine 373, preventing correct formation of the enzyme substrate complex.

  12. 75 FR 36426 - Legislative Changes to Nursing Student Loan Program Authorized Under Title VIII of the Public...

    Science.gov (United States)

    2010-06-25

    ... Changes to Nursing Student Loan Program Authorized Under Title VIII of the Public Health Service Act....) 111-148. Section 5202 of the ACA changes the Nursing Student Loan (NSL) program by: (1) Increasing the... degree in nursing. Below are details on how the ACA changes Sections 836(a), 836(b)(1), and 836(b)(3) of...

  13. Joint bleeds increase the inhibitor response to human factor VIII in a rat model of severe haemophilia A

    DEFF Research Database (Denmark)

    Löfgren, Karin Maria; Søndergaard, H.; Skov, Søren

    2016-01-01

    Introduction The most serious complication in haemophilia A (HA) replacement therapy with coagulation factor VIII (FVIII) is neutralizing antibodies, i.e. inhibitors. It has been hypothesized that danger signals generated during a bleed might have an adjuvant effect on the immune response to FVIII...

  14. Evaluation of the biological differences of canine and human factor VIII in gene delivery: Implications in human hemophilia treatment

    Science.gov (United States)

    The canine is the most important large animal model for testing novel hemophilia A(HA) treatment. It is often necessary to use canine factor VIII (cFIII) gene or protein for the evaluation of HA treatment in the canine model. However, the different biological properties between cFVIII and human FVII...

  15. Break-through bleeding in relation to predicted factor VIII levels in patients receiving prophylactic treatment for severe hemophilia A

    NARCIS (Netherlands)

    Collins, P. W.; Blanchette, V. S.; Fischer, K.; Bjorkman, S.; Oh, M.; Fritsch, S.; Schroth, P.; Spotts, G.; Astermark, J.; Ewenstein, B.

    Background: The role of prophylactic factor VIII (FVIII) to decrease hemophilic bleeding and arthropathy is well established. The rationale for this strategy is to convert patients with severe hemophilia A to a moderate clinical phenotype by reducing time spent with a FVIII level <1 IU dL(-1).

  16. Exact Bianchi type-II, VIII and IX perfect fluid cosmological models in Saez-Ballester theory of gravitation

    Science.gov (United States)

    Rao, V. U. M.; Vijaya Santhi, M.; Vinutha, T.

    2008-09-01

    Exact Bianchi type-II, VIII and IX cosmological models are obtained in a scalar tensor theory proposed by Saez and Ballester (Phys. Lett. A 113:467, 1986) with perfect fluid as a source. Some physical and geometrical properties of the models are studied. It is observed that the models are free from initial singularities and they are expanding with time.

  17. Analysis of factor VIII inhibitors in a haemophilia A patient with an Arg(593)-> Cys mutation using phage display

    NARCIS (Netherlands)

    Bril, Wendy S.; Turenhout, Ellen A. M.; Kaijen, Paul H. P.; van den Brink, Edward N.; Koopman, Maria M. W.; Peters, Marjolein; Voorberg, Jan

    2002-01-01

    We characterized anti-factor VIII antibodies in a mild haemophilia A patient with an Arg(593)-->Cys mutation in the A2 domain, using V gene phage-display technology. All isolated single-chain variable-domain antibody fragments were directed against residues Arg(484)-Ile(508), a binding site for

  18. Changes in the Factor VIII C2 domain upon membrane binding determined by hydrogen-deuterium exchange MS.

    Science.gov (United States)

    Pantazatos, Dionysios; Gessner, Christopher R; Woods, Virgil L; Gilbert, Gary E

    2014-08-01

    Factor VIII enhances the catalytic activity of Factor IXa in a membrane-bound enzyme complex and both proteins are necessary to prevent haemophilia. Tandem lectin-like C domains mediate the membrane binding of Factor VIII and membrane-interactive residues have been identified. However, the available data provide little insight into the dynamic changes that occur upon membrane binding. We used time-based hydrogen-deuterium exchange MS to evaluate the dynamics of FVIII-C2 (Factor VIII C2 domain) alone and when membrane bound. The results confirm the participation of previously identified membrane-interactive loops in the binding mechanism. In addition, they indicate that a long peptide segment, encompassing a membrane-interactive loop and strands of the β-barrel core, is remarkably dynamic prior to membrane binding. The flexibility is reduced following membrane binding. In addition, regions that interact with the A1 and C1 domains have reduced solvent exchange. Thus the isolated C2 domain has extensive flexibility that is subject to stabilization and could be related to interactions between domains as well as between Factor VIII and Factor IXa or Factor X. These results confirm that the proposed membrane-binding loops of the FVIII-C2 interact with the membrane in a manner that leads to protection from solvent exposure.

  19. Effectiveness of Peer Tutoring in Learning English among Tutors and Tutees of Class VIII Students in Kancheepuram DT

    Science.gov (United States)

    Marieswari, M.; Prema, N.

    2016-01-01

    The peer who teaches to their mates is peer tutoring. It is a common instructional strategy used in classrooms. The aim of this study is to know whether there is any improvement in achievement marks of tutors and tutees after the process of peer tutoring. Class VIII students were selected as the sample for the present experimental study. The…

  20. Paducah-Louisville Consortium. Project VIII: Focus on Dropouts... A New Design. Final Evaluation Report, 1971-72.

    Science.gov (United States)

    Lyne, Evelyn

    Project VIII is an innovative behavioral science-oriented educational program for potential dropouts. It is designed to reduce the dropout rate in grades 9 through 12, increase attendance in grades 7 through 12, decrease discipline referrals and suspensions, increase reading and math achievement in grades 3 through 11, and improve the student's…

  1. Modification of an exposed loop in the C1 domain reduces immune responses to factor VIII in hemophilia A mice

    NARCIS (Netherlands)

    Wroblewska, Aleksandra; van Haren, Simon D.; Herczenik, Eszter; Kaijen, Paul; Ruminska, Aleksandra; Jin, Sheng-Yu; Zheng, X. Long; van den Biggelaar, Maartje; ten Brinke, Anja; Meijer, Alexander B.; Voorberg, Jan

    2012-01-01

    Development of neutralizing Abs to blood coagulation factor VIII (FVIII) provides a major complication in hemophilia care. In this study we explored whether modulation of the uptake of FVIII by APCs can reduce its intrinsic immunogenicity. Endocytosis of FVIII by professional APCs is significantly

  2. Instrumented stabilization in spinal tuberculosis.

    Science.gov (United States)

    Jain, Anil Kumar; Jain, Saurabh

    2012-02-01

    Spinal tuberculosis (TB) produces neurological complications and grotesque spinal deformity, which in children increases even with treatment and after achieving healing. Long-standing, severe deformity leads to painful costo-pelvic impingement, respiratory distress, risk of developing late-onset paraplegia and consequent reduction in quality and longevity of life. The treatment objective is to avoid the sequelae of neural complications and achieve the healed status with a near-normal spine. In TB, the spine may become unstable if all three columns are diseased. Pathological fracture/dislocation of a diseased vertebral body may occur secondary to mechanical insult. Surgical decompression adds further instability, as part of the diseased vertebral body is excised. The insertion of a metallic implant is to provide mechanical stability and the use of an implant in tubercular infection is safe. Indications for instrumented stabilisation can be categorised as: (a) pan vertebral disease, in which all three columns are diseased; (b) long-segment disease, in which after surgical decompression a bone graft >5 cm is inserted with instrumentation to prevent graft-related complications and consequent progression of kyphosis and neural complications and (c) when surgical correction of a kyphosis is performed when both anterior decompression and posterior column shortening is required. The implant choice should be individualised according to the case. Pedicle screw fixation in kyphus correction in healed disease is a most suitable implant. Hartshill sublaminar wiring stabilisation in active disease is a suitable implant to stabilise the spine, taking purchase against healthy posterior complex of the vertebral body to save a segment.

  3. 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.

  4. X-ray spectral line coincidences between fluorine VIII (and IX) and transition metal lines

    International Nuclear Information System (INIS)

    Charatis, G.; Rockett, P.D.; Burkhalter, P.G.

    1983-01-01

    X-ray spectroscopy was performed in the 12 to 15 A region, recording L-shell lines from selected laser-irradiated transition metals. Line coincidences and near coincidences were identified between Fe, Cr, Mn, and Ni L-spectra, and F VIII and F IX K-shell lines. Wavelengths were determined to accuracies of 1 to 3 mA and will be utilized in selecting potential pumping candidates in future x-ray lasing schemes. High-resolution x-ray spectra were collected under controlled illumination and target conditions using 1.05 μm and 0.527 μm laser excitation with the KMS CHROMA laser

  5. PENERAPAN PENDEKATAN CINEMATHERAPY UNTUK MENINGKATKAN PERILAKU PROSOSIAL PADA SISWA KELAS VIII DI BOSOWA INTERNATIONAL SCHOOL MAKASSAR

    Directory of Open Access Journals (Sweden)

    Haeruddin Niva

    2016-06-01

    Full Text Available The objectives of the research are: (i to know the prosocial behavioral level of the students in Bosowa International School Makassar before and after giving cinematography approach, and (ii to know whether or not the approach is able to enhance the prosocial behavior of the students in Bosowa International School Makassar. The research is a quantitative research using experimental method. The research design used is quasi experimental design with non-equivalent control group design. The data collection technique applied is scale and FGD (Focus Group Discussion. The findings shows that (i the prosocial behavioral level of the students was low in pretest while after giving treatment there were significant increase to the prosocial behavior in the experimental group, and (ii the cinematography approach was able to increase the prosocial behavior of the Grade VIII students in Bosowa Internatinal School Makassar. 

  6. [Immune mechanisms involved in the development and eradication of anti-factor VIII alloantibodies in hemophilia].

    Science.gov (United States)

    Ishiguro, Akira

    2011-01-01

    Hemophilia A is an X-linked hereditary bleeding disorder caused by a congenital deficiency in blood coagulation factor VIII (FVIII). Therapy to prevent or treat bleeding is replacement of FVIII. The most significant complication of treatment in patients with hemophilia A is the development of alloantibodies that inhibit FVIII activity, termed inhibitors. In the presence of inhibitors, replacement of the missing clotting factor with FVIII preparations becomes less effective. Once replacement therapy is ineffective, morbidity increases. It remains unsolved to prevent inhibitor formation. The only strategy is long-term administration of a large quantity of FVIII in an attempt to eradicate the inhibitors through immune tolerance. However, little is known about the mechanisms involved in the induction of tolerance. This review will focus on the current understanding of why inhibitors develop and can be eradicated. The development of inhibitors by intravenous infusions of FVIII without adjuvant poses an intriguing challenge to immunologists.

  7. Evaluation of Neutron Reactions on Iron Isotopes for CIELO and ENDF/B-VIII.0

    Science.gov (United States)

    Herman, M.; Trkov, A.; Capote, R.; Nobre, G. P. A.; Brown, D. A.; Arcilla, R.; Danon, Y.; Plompen, A.; Mughabghab, S. F.; Jing, Q.; Zhigang, G.; Tingjin, L.; Hanlin, L.; Xichao, R.; Leal, L.; Carlson, B. V.; Kawano, T.; Sin, M.; Simakov, S. P.; Guber, K.

    2018-02-01

    A new suite of evaluations for 54,56,57,58Fe has been developed in the framework of the CIELO international collaboration. New resolved resonance ranges were evaluated for 54Fe and 57Fe, while modifications were applied to resonances in 56Fe. The low energy part of the 56Fe file is almost totally based on measurements. At higher energies in 56Fe and in the whole fast neutron range for minor isotopes the evaluation consists of model predictions carefully adjusted to available experimental data. We also make use of the high quality and well experimentally-constrained dosimetry evaluations from the IRDFF library. Special attention was dedicated to the elastic angular distributions, which were found to affect results of the integral benchmarking. The new set of iron evaluations was developed in concert with other CIELO evaluations and they were tested together in the integral experiments before being adopted for the ENDF/B-VIII.0 library.

  8. MENINGKATKAN TANGGUNG JAWAB SOSIAL SISWA KELAS VIII MELALUI LAYANAN BIMBINGAN KELOMPOK

    Directory of Open Access Journals (Sweden)

    Ummi Farikhatun Nisa

    2012-12-01

    Full Text Available The purpose of this research was to determine the efforts and success in improving students' social responsibility through group counseling services. Type of research used action research. Subjects were 12 students who had low social responsibility and being. Data collection technique used were psychological scales and observation. Data analysis techniques used are non-parametric statistics with the Wilcoxon test. Based on the calculations for the Wilcoxon test, a small amount of levels or Z value was 78.0. While Ztabel for n = 12 with an error level of 5% value is 14. So Z 78.0> 14.0 Ztabel or imply hypothesis accepted. These results demonstrate social responsibility of students prior to obtaining counseling services group at 51.93% (low. After following the guidance services at 81.51% (high. Conclusions from this research is a social responsibility to the students of class VIII SMP Putra Bangsa Bantarkawung increase after getting tutoring services group.

  9. Symposium by NATO Defense Research Group Panel VIII on Computer-Based Instruction in Military Environments

    CERN Document Server

    Weddle, Peter

    1987-01-01

    This collection of papers is the result of a symposium sponsored by NATO's Defense Research Group Panel VIII in the Spring of 1985. The symposium came into being when it became obvious to the NATO countries that research, development and utilization of advanced technologies for training was the best means of increasing both training effectiveness and efficiency. This symposium was the second in a series of three devoted to training. The series was structured to cover all aspects of training. The first series addressed the value of training, the second one dealt with the application of training technologies and the third and last of the series focused on academic issues concerned with the effect of prior learning on subsequent learning. The fact that a major American publisher has determined that computer based instruction is the technology of greatest interest to the NATO community is not surprising. Advances in microprocessor technology have revolutionized both how and where we train. During this symposium t...

  10. Simple and surgical exodontia.

    Science.gov (United States)

    DeBowes, Linda J

    2005-07-01

    Preemptive and postoperative pain management is part of patient care when performing extractions. Simple extractions can become complicated when tooth roots are fractured. Adequate lighting,magnification, and surgical techniques are important when per-forming surgical (complicated) extractions. Radiographs should be taken before extractions and also during the procedure to assist with difficult extractions. Adequate flap design and bone removal are necessary when performing surgical extractions. Complications, including ocular trauma, jaw fracture, and soft tissue trauma, are avoided or minimized with proper patient selection and technique.

  11. IOT Overview: IR Instruments

    Science.gov (United States)

    Mason, E.

    In this instrument review chapter the calibration plans of ESO IR instruments are presented and briefly reviewed focusing, in particular, on the case of ISAAC, which has been the first IR instrument at VLT and whose calibration plan served as prototype for the coming instruments.

  12. Bioengineered coagulation factor VIII enables long-term correction of murine hemophilia A following liver-directed adeno-associated viral vector delivery

    Directory of Open Access Journals (Sweden)

    Harrison C Brown

    2014-01-01

    Full Text Available Clinical data support the feasibility and safety of adeno-associated viral (AAV vectors in gene therapy applications. Despite several clinical trials of AAV-based gene transfer for hemophilia B, a unique set of obstacles impede the development of a similar approach for hemophilia A. These include (i the size of the factor VIII (fVIII transgene, (ii humoral immune responses to fVIII, (iii inefficient biosynthesis of human fVIII, and (iv AAV vector immunity. Through bioengineering approaches, a novel fVIII molecule, designated ET3, was developed and shown to improve biosynthetic efficiency 10- to 100-fold. In this study, the utility of ET3 was assessed in the context of liver-directed, AAV-mediated gene transfer into hemophilia A mice. Due to the large size of the expression cassette, AAV-ET3 genomes packaged into viral particles as partial genome fragments. Despite this potential limitation, a single peripheral vein administration of AAV-ET3 into immune-competent hemophilia A mice resulted in correction of the fVIII deficiency at lower vector doses than previously reported for similarly oversized AAV-fVIII vectors. Therefore, ET3 appears to improve vector potency and mitigate at least one of the critical barriers to AAV-based clinical gene therapy for hemophilia A.

  13. Factor VIII brand and the incidence of factor VIII inhibitors in previously untreated UK children with severe hemophilia A, 2000-2011

    Science.gov (United States)

    Palmer, Benedict P.; Chalmers, Elizabeth A.; Hart, Daniel P.; Liesner, Ri; Rangarajan, Savita; Talks, Katherine; Williams, Michael; Hay, Charles R. M.

    2014-01-01

    The effect of recombinant factor VIII (rFVIII) brand on inhibitor development was investigated in all 407 severe hemophilia A previously untreated patients born in the United Kingdom (UK) between 1 January 2000 and 31 December 2011. Eighty-eight (22%) had been in the RODIN study. Information was extracted from the National Haemophilia Database. Because exposure days (EDs) were not known for some patients, time from first treatment was used as a surrogate for rFVIII exposure. An inhibitor developed in 118 (29%) patients, 60 high and 58 low titer, after a median (interquartile range) of 7.8 (3.3-13.5) months from first exposure and 16 (9-30) EDs. Of 128 patients treated with Kogenate Bayer/Helixate NexGen, 45 (35.2%, 95% confidence interval [CI] 27.4-43.8) developed an inhibitor compared with 42/172 (24.4%, 95% CI 18.6% to 31.4%) with Advate (P = .04). The adjusted hazard ratio (HR) (95% CI) for Kogenate Bayer/Helixate NexGen compared with Advate was 2.14 (1.12-4.10) (P = .02) for high titer and 1.75 (1.11-2.76) (P = .02) for all inhibitors. When excluding UK-RODIN patients, the adjusted HR (95% CI) for high-titer inhibitors was 2.00 (0.93-4.34) (P = .08). ReFacto AF was associated with a higher incidence of all, but not high-titer, inhibitors than Advate. These results will help inform debate around the relative immunogenicity and use of rFVIII brands. PMID:25339360

  14. Factor VIII brand and the incidence of factor VIII inhibitors in previously untreated UK children with severe hemophilia A, 2000-2011.

    Science.gov (United States)

    Collins, Peter W; Palmer, Benedict P; Chalmers, Elizabeth A; Hart, Daniel P; Liesner, Ri; Rangarajan, Savita; Talks, Katherine; Williams, Michael; Hay, Charles R M

    2014-11-27

    The effect of recombinant factor VIII (rFVIII) brand on inhibitor development was investigated in all 407 severe hemophilia A previously untreated patients born in the United Kingdom (UK) between 1 January 2000 and 31 December 2011. Eighty-eight (22%) had been in the RODIN study. Information was extracted from the National Haemophilia Database. Because exposure days (EDs) were not known for some patients, time from first treatment was used as a surrogate for rFVIII exposure. An inhibitor developed in 118 (29%) patients, 60 high and 58 low titer, after a median (interquartile range) of 7.8 (3.3-13.5) months from first exposure and 16 (9-30) EDs. Of 128 patients treated with Kogenate Bayer/Helixate NexGen, 45 (35.2%, 95% confidence interval [CI] 27.4-43.8) developed an inhibitor compared with 42/172 (24.4%, 95% CI 18.6% to 31.4%) with Advate (P = .04). The adjusted hazard ratio (HR) (95% CI) for Kogenate Bayer/Helixate NexGen compared with Advate was 2.14 (1.12-4.10) (P = .02) for high titer and 1.75 (1.11-2.76) (P = .02) for all inhibitors. When excluding UK-RODIN patients, the adjusted HR (95% CI) for high-titer inhibitors was 2.00 (0.93-4.34) (P = .08). ReFacto AF was associated with a higher incidence of all, but not high-titer, inhibitors than Advate. These results will help inform debate around the relative immunogenicity and use of rFVIII brands. © 2014 by The American Society of Hematology.

  15. Health physics instrument manual

    International Nuclear Information System (INIS)

    Gupton, E.D.

    1978-08-01

    The purpose of this manual is to provide apprentice health physics surveyors and other operating groups not directly concerned with radiation detection instruments a working knowledge of the radiation detection and measuring instruments in use at the Laboratory. The characteristics and applications of the instruments are given. Portable instruments, stationary instruments, personnel monitoring instruments, sample counters, and miscellaneous instruments are described. Also, information sheets on calibration sources, procedures, and devices are included. Gamma sources, beta sources, alpha sources, neutron sources, special sources, a gamma calibration device for badge dosimeters, and a calibration device for ionization chambers are described

  16. Astronomical Instruments in India

    Science.gov (United States)

    Sarma, Sreeramula Rajeswara

    The earliest astronomical instruments used in India were the gnomon and the water clock. In the early seventh century, Brahmagupta described ten types of instruments, which were adopted by all subsequent writers with minor modifications. Contact with Islamic astronomy in the second millennium AD led to a radical change. Sanskrit texts began to lay emphasis on the importance of observational instruments. Exclusive texts on instruments were composed. Islamic instruments like the astrolabe were adopted and some new types of instruments were developed. Production and use of these traditional instruments continued, along with the cultivation of traditional astronomy, up to the end of the nineteenth century.

  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. Ambulatory Surgical Measures - State

    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...

  19. Surgical Treatments for Fibroids

    Science.gov (United States)

    ... NICHD Research Information Find a Study More Information Preeclampsia and Eclampsia About NICHD Research Information Find a ... Treatments Share Facebook Twitter Pinterest Email Print Surgical Treatments for Fibroids If you have moderate or severe ...

  20. Ambulatory Surgical Measures - National

    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...

  1. [Surgical treatment of ulcer].

    Science.gov (United States)

    Ungeheuer, E; Schröder, D; Lüders, K

    1978-04-27

    The standard of today in surgical treatment of the duodenal and gastric ulcer in Germany is shown. Positive and negative aspects of the different methods are discussed. Special technics are recommended for the different types of gastroduodenal ulcera.

  2. Disruptive visions: surgical education.

    Science.gov (United States)

    Satava, R M

    2004-05-01

    Technological change, decreased financial support for medical education, and social oversight (in the form of the "To Err Is Human" report, HIPPA, and reduced work hours) are forcing a rethinking of the traditional model of surgical education to improve patient safety. New approaches to evaluating surgical competence, such as objective assessment, in combination with new technologies, such as the Internet and surgical simulators, provide the tools to effect a revolution in surgical education and training. Competency based upon quantifiable criteria measures must replace the traditional subjective assessment. The implementation requires accurately defining the elements of training, establishing new quantifiable metrics, stringently measuring performance against criterion, and reporting outcomes throughout the career of a surgeon.

  3. 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....

  4. Troubleshooting in nuclear instruments

    International Nuclear Information System (INIS)

    1987-06-01

    This report on troubleshooting of nuclear instruments is the product of several scientists and engineers, who are closely associated with nuclear instrumentation and with the IAEA activities in the field. The text covers the following topics: Preamplifiers, amplifiers, scalers, timers, ratemeters, multichannel analyzers, dedicated instruments, tools, instruments, accessories, components, skills, interfaces, power supplies, preventive maintenance, troubleshooting in systems, radiation detectors. The troubleshooting and repair of instruments is illustrated by some real examples

  5. Laparoscopic adrenalectomy: Surgical techniques

    Directory of Open Access Journals (Sweden)

    Matthew J Mellon

    2008-01-01

    Full Text Available Since its first description in 1992, laparoscopic adrenalectomy has become the gold standard for the surgical treatment of most adrenal conditions. The benefits of a minimally invasive approach to adrenal resection such as decreased hospital stay, shorter recovery time and improved patient satisfaction are widely accepted. However, as this procedure becomes more widespread, critical steps of the operation must be maintained to ensure expected outcomes and success. This article reviews the surgical techniques for the laparoscopic adrenalectomy.

  6. Níveis de ansiedade de alunos de graduação em enfermagem frente à primeira instrumentação cirúrgica Niveles de ansiedad de los alumnos de pregrado en enfermería delante de la primera instrumentación quirúrgica Nursing undergraduates' anxiety about the first surgical instrumentation

    Directory of Open Access Journals (Sweden)

    Rachel de Carvalho

    2004-12-01

    ' anxiety about the first surgical instrumentation. The sample consisted of 30 sixth-period students who were enrolled in the subject Surgical Nursing. Data were collected through the STAI (State-Trait Anxiety Inventory. We identified that 90% of the students demonstrated low levels of trait anxiety. As to state anxiety, the most frequent observations were: low anxiety level on the first day of theoretical class (76.7%. medium anxiety level at the lab (53% and medium anxiety level during supervised training (80%. Furthermore, we identified a small number of students with high anxiety levels. The statistical analysis shows significant differences among the mean levels of state-anxiety during the three data collection phases.

  7. 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 ...

  8. Mentoring console improves collaboration and teaching in surgical robotics.

    Science.gov (United States)

    Hanly, Eric J; Miller, Brian E; Kumar, Rajesh; Hasser, Christopher J; Coste-Maniere, Eve; Talamini, Mark A; Aurora, Alexander A; Schenkman, Noah S; Marohn, Michael R

    2006-10-01

    One of the most significant limitations of surgical robots has been their inability to allow multiple surgeons and surgeons-in-training to engage in collaborative control of robotic surgical instruments. We report the initial experience with a novel two-headed da Vinci surgical robot that has two collaborative modes: the "swap" mode allows two surgeons to simultaneously operate and actively swap control of the robot's four arms, and the "nudge" mode allows them to share control of two of the robot's arms. The utility of the mentoring console operating in its two collaborative modes was evaluated through a combination of dry laboratory exercises and animal laboratory surgery. The results from surgeon-resident collaborative performance of complex three-handed surgical tasks were compared to results from single-surgeon and single-resident performance. Statistical significance was determined using Student's t-test. Collaborative surgeon-resident swap control reduced the time to completion of complex three-handed surgical tasks by 25% compared to single-surgeon operation of a four-armed da Vinci (P collaboration during robotic surgery and improves the performance of complex surgical tasks. The mentoring console has the potential to improve resident participation in surgical robotics cases, enhance resident education in surgical training programs engaged in surgical robotics, and improve patient safety during robotic surgery.

  9. Training program for fundamental surgical skill in robotic laparoscopic surgery.

    Science.gov (United States)

    Suh, Irene; Mukherjee, Mukul; Oleynikov, Dmitry; Siu, Ka-Chun

    2011-09-01

    Although the use of robotic laparoscopic surgery has increased in popularity, training protocols for gaining proficiency in robotic surgical skills are not well established. The purpose of this study was to examine a fundamental training program that provides an effective approach to evaluate and improve robotic surgical skills performance using the da Vinci(™) Surgical System. Fifteen medical students without any robotic surgical experience were recruited. Participants went through a 4-day training program for developing fundamental robotic surgical skills and received a retention test 1 day after the completion of training. Data analysis included time to task completion, average speed, total distance traveled and movement curvature of the instrument tips, and muscle activities of the participants' forearms. Surgical performance was graded by the modified Objective Structured Assessment of Technical Skills for robotic laparoscopic surgery. Finally, participants evaluated their own performance after each session through questionnaires. Significant training effects were shown for the time to task completion (p movement curvature (p mastery, familiarity, and self-confidence and less difficulty in performing fundamental tasks with the surgical robot in both post-testing and retention sessions. Our 4-day training program comprising of a series of training tasks from fundamental to surgical skill levels was effective in improving surgical skills. Further studies are required to verify these findings with a longer period of retention. Copyright © 2011 John Wiley & Sons, Ltd.

  10. The International Association of Student Surgical Societies: creation and dissemination.

    Science.gov (United States)

    Chandauka, Tinashe; Leusink, Astrid; Hsiao, Marvin; Kahn, Delawir; Azzie, Georges

    2016-10-01

    While initiatives exist to address the worldwide need for surgeons, none involve a student-driven solution from low- and middle-income countries (LMICs). In response to falling surgical residency enrolment in South Africa, the students at the University of Cape Town (UCT) founded the UCT Surgical Society and were subsequently instrumental in creating the International Association of Student Surgical Societies (IASSS). The IASSS currently includes 25 societies in 15 countries. Its primary objectives are building sustainable networks for mutually beneficial exchanges, supporting student-driven projects, understanding issues impacting student interest in surgery, promoting global fellowship, creating an elective database and providing assistance to student surgical societies. The IASSS is a unique student-led initiative trying to improve surgical care in LMICs.

  11. PENGEMBANGAN MODEL PEMBELAJARAN BERBASIS MASALAH YANG BERMUATAN NILAI-NILAI PENDIDIKAN KARAKTER DALAM PEMBELAJARAN MENULIS CERPEN PADA KELAS VIII SMP

    Directory of Open Access Journals (Sweden)

    Aditya Dwi Haryawan

    2014-08-01

    Full Text Available Menulis merupakan suatu keterampilan yang harus dimiliki peserta didik sekolah menengah pertama. Melaluitulisan, peserta didik dapat menyampaikan pengalaman, pikiran, perasaan, atau keinginan. Masalah penelitianini adalah (1 bagaimanakah kebutuhan pengembangan model pembelajaran berbasis masalah yang bermuatannilai-nilai pendidikan karakter dalam pembelajaran menulis cerpen berdasarkan persepsi guru dan pesertadidik kelas VIII SMP?; (2 bagaimanakah prinsip-prinsip pengembangan model pembelajaran berbasis masalahyang bermuatan nilai-nilai pendidikan karakter dalam pembelajaran menulis cerpen pada peserta didik kelasVIII SMP? (3 bagaimanakah pengembangan prototipe model pembelajaran berbasis masalah yang bermuatannilai-nilai pendidikan karakter dalam pembelajaran menulis cerpen pada kelas VIII SMP?; (4 bagaimanakahkeberterimaan penerapan pengembangan model pembelajaran berbasis masalah yang bermuatan nilai-nilaipendidikan karakter dalam pembelajaran menulis cerpen pada kelas VIII SMP. Dalam penelitian ini digunakandesain Research and Development. Tahapan yang dilakukan dalam penelitian ini adalah studi pustaka, analisiskebutuhan, pengembangan model yang dikembangkan, uji validasi, revisi, implementasi, revisi akhir,pengembangan model/produk akhir. Pengumpulan data dilakukan dengan observasi, angket, wawancara, tes,dan dokumentasi foto. Writing is a skill that must be owned by middle school students. Through writing, students canconvey experiences, thoughts, feelings, or desires. The research problem is (1 How can the needsof the development of PBL model that charged the values of character education in learning towrite short stories on the perceptions of teachers and students of class VIII?; (2 How do thecharacteristics of the development of PBL model value-laden -the value of character education inlearning to write short stories at the high school of learner assessment system class?; (3 How isthe development of a prototype model of PBL  charged

  12. Validity of evaluation instrument on the implementation of performance assessment to measure science process skills

    Directory of Open Access Journals (Sweden)

    Marina Ramadani

    2017-10-01

    Full Text Available This study aims to develop an evaluation instrument CIPP (context, input, process, product model that suitable at implementation of performance assessment instrument to measure students' science process skills of junior high school. Methods in this study are research and development (R & D which is adopted by model Borg & Gall model. This evaluation instrument used one of evaluation CIPP model with context, input, process, and product components. The evaluation instrument is used to determine the implementation of performance assessment instrument to measure junior high school students' science process skills in excretion system topic. This development study involves some experts to give validation of the development of feasibility products. Experts involved, they are two lecturers of evaluation expert, two junior high school science teachers, and four peers. The validity of evaluation instruments was analyzed using V'aiken formula. The results of this study are evaluation instrument of CIPP model of the implementation of performance assessment to measure junior high school students' science process skills of grade VIII in excretion system topic. The results of the validity of this product indicates that this evaluation instruments are eligible in using with V'eiken coefficient of 0.86. It indicates that the evaluation instruments are valid in substance, construction, and language aspects.

  13. Surgical Emphysema: A Rare Complication of a Simple Surgical Dental Extraction Without the Use of an Air-Driven Rotor.

    Science.gov (United States)

    Gowans, Keegan; Patel, Muneer; Lewis, Khari

    2017-03-01

    Surgical emphysema is a rare complication of dental extractions, often associated with the use of high-speed air rotors. This report describes a case of extensive surgical emphysema following a simple surgical extraction of a LL6 under local anaesthetic. There was no use of air-driven handpieces during the procedure. The patient developed extensive surgical emphysema bi-laterally in both cervical neck and facial planes. After prophylactic antibiotics with careful monitoring in a secondary care setting, the patient made a full unremarkable recovery. Clinical relevance: Simple extraction of teeth is a procedure carried out daily by most general dental practitioners. However, the risk of surgical emphysema without the use of high-speed air rotors or instruments using pressurized air/water is not well known or documented.

  14. 21 CFR 884.4520 - Obstetric-gynecologic general manual instrument.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Obstetric-gynecologic general manual instrument... Surgical Devices § 884.4520 Obstetric-gynecologic general manual instrument. (a) Identification. An obstetric-gynecologic general manual instrument is one of a group of devices used to perform simple...

  15. Surgical implantation of transmitters into fish

    Science.gov (United States)

    Mulcahy, Daniel M.

    2003-01-01

    Although the Animal Welfare Act does not cover poikilotherms, individual institutions and policies and legal requirements other than the Animal Welfare Act (e.g., the US Public Health Service and the Interagency Research Animal Committee's Principles for the Utilization and Care of Vertebrate Animals Used in Testing, Research, and Training) require the review of projects involving fish by institutional animal care and use committees (IACUCs). IACUCs may, however, lack the knowledge and experience to evaluate fish projects judiciously, especially when the projects are in field settings. Surgeries involving implantation of transmitters and other instruments into the coelom, which now comprise a very common research tool in the study of free-ranging fishes, are examples of surgeries that use a broad spectrum of surgical and anesthetic techniques, some of which would not be considered acceptable for similar work on mammals. IACUCs should apply the standards they would expect to be used for surgeries on homeotherms to surgeries on fish. Surgeons should be carefully trained and experienced. Surgical instruments and transmitters should be sterile. Regulations and laws on the use of drugs in animals should be followed, particularly those concerned with anesthetics and antibiotics used on free-ranging fish. Exceptions to surgical procedures should be made only when circumstances are extreme enough to warrant the use of less than optimal procedures.

  16. Surgical camps: the Ugandan experience

    African Journals Online (AJOL)

    Northern Uganda to offer free surgical services and to teach basic surgical skills to up-country doctors. The team, consisting of 10 surgeons in various specialities, two anaesthetists and two surgical residents, saw 500 patients, of whom 272 had surgery. This was the frrst such surgical camp organised by the Ugandan.

  17. 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

  18. Surgical skills training restructured for the 21st century.

    Science.gov (United States)

    Morris, Michael; Caskey, Robert; Mitchell, Marc; Sawaya, David

    2012-09-01

    Few if any medical schools have a comprehensive surgical skills program taking medical students from learning basic knot tying and surgical skills to performing these skills at a level adequate for function during a primary care, surgical, or subspecialty residency. We have designed and continue to refine a program, which consists of five workshops focused on basic surgical skills, which are applicable to all medical and surgical disciplines. During the first workshop students learn how to tie both one- and two-handed surgical knots. The second workshop involves teaching students differences in suture type and use, instrument handling, and suturing techniques. The third workshop is used to address problems and refine techniques previously learned in the first two sessions. The fourth workshop comprises a final examination to evaluate suture and knot tying skills. The fifth session is a voluntary knot tying and suturing competition with awards for speed, finesse, aesthetics, and the watertightness of a vascular surgical repair. Surgical faculty and house staff are present at each workshop to provide direction and constructive criticism. Fifty-seven third-year medical students have completed the surgical skills curriculum. Statistical analysis demonstrates significant improvement in both knot tying and suturing (P < 0.05) for these students. Forty-four percent of students have successfully sewn a watertight anastomosis. We hypothesize that this curriculum will produce medical students with basic surgical skills, appreciation of surgical technique, and the confidence to perform basic surgical skills at completion of the curriculum. Copyright © 2012 Elsevier Inc. All rights reserved.

  19. Research reactor instrumentation

    International Nuclear Information System (INIS)

    Boeck, H.; Villa, M.

    2001-02-01

    This is a textbook on research reactor instrumentation for training purposes, it gives a survey on research reactor instrumentation requirements and eight exercises covering the major aspects of this topic are presented. (author)

  20. Building a framework for ergonomic research on laparoscopic instrument handles.

    Science.gov (United States)

    Li, Zheng; Wang, Guohui; Tan, Juan; Sun, Xulong; Lin, Hao; Zhu, Shaihong

    2016-06-01

    Laparoscopic surgery carries the advantage of minimal invasiveness, but ergonomic design of the instruments used has progressed slowly. Previous studies have demonstrated that the handle of laparoscopic instruments is vital for both surgical performance and surgeon's health. This review provides an overview of the sub-discipline of handle ergonomics, including an evaluation framework, objective and subjective assessment systems, data collection and statistical analyses. Furthermore, a framework for ergonomic research on laparoscopic instrument handles is proposed to standardize work on instrument design. Copyright © 2016 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

  1. Tecniche costruttive e forme di potere nella Toscana sud-occidentale (secc. VIII-XIV

    Directory of Open Access Journals (Sweden)

    Bianchi, Giovanna

    2005-12-01

    Full Text Available This paper tells about the analysis of the building techniques of elevations inferred from data obtained in extensive projects of archaeological research executed in western Tuscany's rural field from half '90s of last century to present. The text looks over the changes from wooden building trade related to the first high rise habitants in VIIth-VIIIth century, until the pattern settlements in the second half of VIIIth and XIth centuries, characterized by the first use of masonry and the presence of expert master builders. The more complex organization of the building workshops for castles of the XIth and XIIth centuries in relation with the liege lord's rising politic abusive authority is explained in the following part. The subsequent formation of new suburbs between the XIIIth and the XIV centuries is characterized by a different way of use of building techniques, often founded over pre-existing castles, linked to local council, up to the political and economical influence of Pisa in this territory.Nell’articolo si tratta l’analisi delle tecniche murarie desunta da dati provenienti da ampi progetti di indagine archeologica svolti in ambito rurale nella Toscana occidentale dalla metà degli anni Novanta dello scorso secolo ad oggi. Nel testo si esaminano i cambiamenti dei modi di edificare a partire dall’edilizia in legno dei primi abitati di altura di VII-VIII secolo, sino agli insediamenti più strutturati di seconda metà VIII e IX secolo, caratterizzati da un primo uso della pietra e dalla presenza di maestranze specializzate. In seguito si analizza la più complessa organizzazione del cantiere propria della costruzione dei castelli di XI e XII secolo in rapporto ai poteri politici ed economici delle nascenti signorie territoriali. Un differente uso delle tecniche costruttive caratterizza la successiva formazione di nuovi borghi tra XIII e XIV secolo, spesso impiantati sui preesistenti castelli, legati ai locali organismi comunali

  2. Aging and ABO blood type influence von Willebrand factor and factor VIII levels through interrelated mechanisms.

    Science.gov (United States)

    Albánez, S; Ogiwara, K; Michels, A; Hopman, W; Grabell, J; James, P; Lillicrap, D

    2016-05-01

    Essentials von Willebrand factor (VWF) and factor VIII (FVIII) levels are modulated by age and ABO status. The effect of aging and ABO blood type on VWF and FVIII was assessed in 207 normal individuals. Aging and ABO blood type showed combined and bidirectional influences on VWF and FVIII levels. Aging and ABO blood type influence VWF levels through both secretion and clearance mechanisms. Background The effect of aging and ABO blood type on plasma levels of von Willebrand factor (VWF) and factor VIII (FVIII) have been widely reported; however, a comprehensive analysis of their combined effect has not been performed and the mechanisms responsible for the age-related changes have not been determined. Objectives To assess the influence of aging and ABO blood type on VWF and FVIII levels, and to evaluate the contribution of VWF secretion and clearance to the age-related changes. Methods A cross-sectional observational study was performed in a cohort of 207 normal individuals, whose levels of VWF, FVIII, VWF propeptide (VWFpp), VWFpp/VWF:Ag ratio and blood type A antigen content on VWF (A-VWF) were quantified. Results Aging and ABO blood type exerted interrelated effects on VWF and FVIII plasma levels, because the age-related increase in both proteins was significantly higher in type non-O individuals (β = 0.011 vs. 0.005). This increase with age in non-O subjects drove the differences between blood types in VWF levels, as the mean difference increased from 0.13 U/mL in the young to 0.57 U/mL in the old. Moreover, A-VWF was associated with both VWF antigen (β = 0.29; 95% confidence interval [CI], 0.09, 0.50) and VWF clearance (β = -0.15; 95% CI, -0.25, -0.06). We also documented an effect of ABO blood type on VWF secretion with aging, as old individuals with blood type non-O showed higher levels of VWFpp (mean difference 0.29 U/mL). Conclusions Aging and ABO blood type have an interrelated effect on VWF and FVIII levels, where the effect of one is significantly

  3. Performing the Super Instrument

    DEFF Research Database (Denmark)

    Kallionpaa, Maria

    2016-01-01

    The genre of contemporary classical music has seen significant innovation and research related to new super, hyper, and hybrid instruments, which opens up a vast palette of expressive potential. An increasing number of composers, performers, instrument designers, engineers, and computer programmers...... provides the performer extensive virtuoso capabilities in terms of instrumental range, harmony, timbre, or spatial, textural, acoustic, technical, or technological qualities. The discussion will be illustrated by a composition case study involving augmented musical instrument electromagnetic resonator...

  4. Instrument Modeling and Synthesis

    Science.gov (United States)

    Horner, Andrew B.; Beauchamp, James W.

    During the 1970s and 1980s, before synthesizers based on direct sampling of musical sounds became popular, replicating musical instruments using frequency modulation (FM) or wavetable synthesis was one of the “holy grails” of music synthesis. Synthesizers such as the Yamaha DX7 allowed users great flexibility in mixing and matching sounds, but were notoriously difficult to coerce into producing sounds like those of a given instrument. Instrument design wizards practiced the mysteries of FM instrument design.

  5. PENGARUH KEMANDIRIAN BELAJAR DAN PENGGUNAAN UANG SAKU TERHADAP PRESTASI BELAJAR KOMPETENSI DASAR EKONOMI KELAS VII DAN VIII

    Directory of Open Access Journals (Sweden)

    Apri Dwi Astuti

    2012-10-01

    Full Text Available Kemandirian belajar membantu siswa untuk bertanggung jawab dan menumbuhkan kesadaran belajar. Penggunaan uang saku menumbuhkan jiwa mandiri, jujur dan komitmen. Adapun hasil observasi awal menunjukkan masih ada siswa kels VII dan VIII SMP Semesta untuk kompetensi dasar ekonomi dibawah KKM. Tujuan penelitian ini untuk mengetahui pengaruh kemandirian belajar dn penggunaan uang saku terhadap prestasi belajar kompetensi dasar ekonomi kelas VII dan VIII SMP Semesta. Populasi penelitian ini adalah semua siswa kelas VII dan VIII SMP Semesta Boarding School Semarang. Variabel penelitian ini adalah kemandirian belajar dan penggunaan uang saku sebagai variabel bebas, sedangkan untuk� variabel terikat adalah prestasi belajar kompetensi dasar ekonomi. Data diambil dengan metode wawancara, kuesioner dan dokumentasi guru. Analisis data menggunakan analisis regresi linear berganda.Berdasarkan penelitian secara simultan menunjukkan adanya pengaruh antara kemandirian belajar dan penggunaan uang saku terhadap prestasi belajar kompetensi dasar ekonomi sebesar 51,3%. Secara parsial, pengaruh kemandirian belajar terhadap prestasi belajar kompetensi dasar ekonomi sebesar 66,2% dan pengaruh penggunaan uang saku terhadap prestasi belajar kompetensi dasar ekonomi sebesar 62,5%.Berdasarkan hasil penelitian diatas disimpulkan bahwa kemandirian belajar dan penggunaan uang saku berpengaruh positif baik secara simultan maupun parsial terhadap prestasi belajar kompetensi dasar ekonomi kelas VII dan VIII SMP Semesta Boarding school semarang tahun pelajaran 2011/2012. Saran yang berkaitan dengan penelitian ini yaitu : 1 Sekolah disarankan untuk memberikan batasan siswa pulang ke rumah agar dapat membantu siswa beradaptasi dengan cepat dan mudah tinggal di asrama. 2 Orang tua disarankan untuk memberikan uang saku yang disesuaikan dengan kebutuhan siswa. 3 Siswa disarankan untuk meningkatkan kemandirian dalam aspek belajar terutama bagi mata pelajaran yang masih kurang dari

  6. Comparative profiling of HLA-DR and HLA-DQ associated factor VIII peptides presented by monocyte-derived dendritic cells.

    Science.gov (United States)

    Peyron, Ivan; Hartholt, Robin B; Pedró-Cos, Laura; van Alphen, Floris; Brinke, Anja Ten; Lardy, Neubury; Meijer, Alexander B; Voorberg, Jan

    2018-01-01

    The development of anti-factor VIII antibodies is a major complication of the treatment of patients with hemophilia A. Generation of high affinity anti-factor VIII antibodies is dependent on help provided by CD4 + T cells that recognize factor VIII-derived peptides presented on class II major histocompatibility complex on the surface of antigen-presenting cells. In order to identify the immune-dominant epitopes that can be presented to CD4 + T cells, we previously developed a mass spectrometry-based method to identify factor VIII-derived peptides that are presented on human leukocyte antigen (HLA)-DR. In the present work, we compared the repertoire of FVIII-derived peptide presented on HLA-DR and HLA-DQ. Monocyte-derived dendritic cells from nine HLA-typed healthy donors were pulsed with recombinant factor VIII. HLA-DR and HLA-DQ molecules were purified using monoclonal antibodies. Our data show that HLA-DQ and HLA-DR present a similar repertoire of factor VIII-derived peptides. However, the number of peptides associated with HLA-DQ was lower than that with HLA-DR. We also identified a peptide, within the acidic a3 domains of factor VIII, which is presented with higher frequency on HLA-DQ. Interestingly, this peptide was found to have a higher predicted affinity for HLA-DQ than for HLA-DR. Taken together, our data suggest that HLA-DQ participates in the presentation of factor VIII peptides, thereby contributing to the development of inhibitory antibodies in a proportion of patients with severe hemophilia A. Copyright© 2018 Ferrata Storti Foundation.

  7. Influence Model Assisted Learning Cycle Mind Map to Achievement Physics Laboratory Judging from the performance Grade VIII SMPN 1 Rejoso Pasuruan

    OpenAIRE

    Ary Analisa Rahma

    2014-01-01

    Pengaruh Model Siklus Belajar Berbantuan Mind Map terhadap Prestasi Belajar Fisika Ditinjau dari Kinerja Laboratorium Siswa Kelas VIII SMPN 1 Rejoso Kabupaten Pasuruan Abstract: This study aimed to examine the effect of the learning cycle models aided the mind map on the learning achievement in terms of the performance of laboratory physics class VIII student on light material in SMP Negeri 1 Rejoso Pasuruan. This study is a quasi-experimental research. The research design used is a 2 x 2...

  8. Penggunaan Media Presentase Microsoft Power Point Untuk Meningkatkan Hasil Belajar IPS Terpadu Pada Siswa Kelas VIII a SMP Negeri 2 Tanantovea

    OpenAIRE

    Hitler, Ahmad

    2014-01-01

    Permasalahan yang diangkat dalam penelitian adalah apakah dengan penggunaan media Presentase Microsoft Power Point pada mata pembelajaran IPS Terpadu dapat meningkatkan hasil belajar siswa kelas VIII A di SMP Negeri 2 Tanantovea. Penelitian ini bertujuan untuk meningkatkan hasil belajar siswa pada pokok bahasan Kolonialisme dan Imperialisme Barat di kelas VIII A SMP Negeri 2 Tanantovea. Penelitian ini dilakukan dalam 2 siklus, setiap siklus terdiri dari perencanaan, pelaksanaan tindakan, obs...

  9. Surgical Treatment of Atrial Fibrillation: A Review

    Directory of Open Access Journals (Sweden)

    Nadine Hiari

    2011-01-01

    Full Text Available Atrial fibrillation is the most commonly sustained arrhythmia in man. While it affects millions of patients worldwide, its incidence will markedly increase with an aging population. Primary goals of AF therapy are to (1 reduce embolic complications, particularly stroke, (2 alleviate symptoms, and (3 prevent long-term heart remodelling. These have been proven to be a challenge as there are major limitations in our knowledge of the pathological and electrophysiological mechanisms underlying AF. Although advances continue to be made in the medical management of this condition, pharmacotherapy is often unsuccessful. Because of the high recurrence rate of AF despite antiarrhythmic drug therapy for maintenance of sinus rhythm and the adverse effects of these drugs, there has been growing interest in nonpharmacological strategies. Surgery for treatment of AF has been around for some time. The Cox-Maze procedure is the gold standard for the surgical treatment of atrial fibrillation and has more than 90% success in eliminating atrial fibrillation. Although the cut and sew maze is very effective, it has been superseded by newer operations that rely on alternate energy sources to create lines of conduction block. In addition, the evolution of improved ablation technology and instrumentation has facilitated the development of minimally invasive approaches. In this paper, the rationale for surgical ablation for atrial fibrillation and the different surgical techniques that were developed will be explored. In addition, it will detail the new approaches to surgical ablation of atrial fibrillation that employ alternate energy sources.

  10. Aeroacoustics of Musical Instruments

    NARCIS (Netherlands)

    Fabre, B.; Gilbert, J.; Hirschberg, Abraham; Pelorson, X.

    2012-01-01

    We are interested in the quality of sound produced by musical instruments and their playability. In wind instruments, a hydrodynamic source of sound is coupled to an acoustic resonator. Linear acoustics can predict the pitch of an instrument. This can significantly reduce the trial-and-error process

  11. MENINGKATKAN AKTIVITAS DAN HASIL BELAJAR MATERI KURVA PERMINTAAN DAN KURVA PENAWARAN DENGAN PEMBELAJARAN SCAFFOLDING PADA KELAS VIII MTS MUHAMMADIYAH KAJEN

    Directory of Open Access Journals (Sweden)

    M Yusuf Supriyadi

    2013-11-01

    Full Text Available Penelitian ini merupakan penelitian tindakan kelas dengan tujuan untuk mengetahui ada tidaknya peningkatan aktivitas dan hasil belajar siswa setelah metode pembelajaran Scaffolding diterapkan pada materi kurva permintaan dan kurva penawaran kelas VIII A MTs. Muhammadiyah Kajen. Penelitian dilaksanakan dalam 2 siklus. Setiap siklus meliputi perencanaan, pelaksanaan, observasi, dan refleksi. Subjek penelitian ini adalah siswa kelas VIII E MTs. Muhammadiyah Kajen Tahun Ajaran 2013/2014. Sementara faktor yang diteliti di antaranya adalah aktivitas siswa, aktivitas guru, dan hasil belajar siswa. Tujuan penelitian ini adalah. Hasil penelitian siklus I dan siklus II menunjukkan peningkatan aktivitas siswa dan aktivitas guru. Rata-rata hasil belajar dan ketuntasan klasikal juga mengalami peningkatan. Hasil penelitian dapat disimpulkan bahwa pembelajaran Scaffolding dapat meningkatan aktivitas dan hasil belajar. Saran dari hasil penelitian ini adalah: Guru dapat menerapkan pembelajaran Scaffolding pada materi kurva permintaan dan kurva penawaran. Guru harus mempersiapkan pembelajaran dengan baik agar proses pembelajaran berlangsung dengan sesuai rencana. This research is a classroom action research which aims to determine whether there is an increase in activity and student achievement after Scaffolding learning applied to the lesson ofdemand and supply curve in class VIII A MTs. Muhammadiyah Kajen.. This research conducted in two cycles. Each cycle includes planning, implementation, observation, and reflection. The subjects of this Research were students of class VIII E MTs. Muhammadiyah Kajen Academic Year 2013/2014. The factors studied include student activities, teacher activities, and student learning outcomes. The results in the first and second cycle showed increased student and teacher activity. Average classical completeness of learning outcome is also increased. The research can be concluded that Scaffolding Learning can be increase learning

  12. Neurotology findings in patients with diagnosis of vascular loop of cranial nerves VIII in magnetic resonance imaging

    Directory of Open Access Journals (Sweden)

    Grocoske, Francisco Luiz Busato

    Full Text Available Introduction: The vascular compression by redundant vessels under the VIII cranial nerves has been studied since the 80's, and many authors proposed correlations between the compression and the otoneurological findings (vertigo, tinnitus, hypoacusis, audiometry and electrophysiological findings. Objective: Analyze and correlate the different signs and otoneurological symptoms, the audiological findings and its incidence over individuals with Vascular Loop (VL diagnosis of VIII cranial nerves by magnetic resonance imaging (MRI. Method: Retrospective study through the analysis of medical records of 47 patients attended in the otoneurology clinic of Clinical Hospital of UFPR. All the patients have MRI exams with compatible pictures of VL of the VIII cranial nerves. Results: The tinnitus was the most frequent symptom, in 83% of the patients, followed by hypoacusis (60% and vertigo (36%. The audiometry presented alterations in 89%, the brainstem evoked auditory potential in 33% and the vecto-electronystagmography in 17% of the patients. Was not found statistically significant relation between the buzz or hypoacusis, and the presence of VL in MRI. Only 36% of patients had complaints of vertigo, the main symptom described in theory of vascular compression of the VIII pair of nerve. As in the audiometry and in brainstem evoked auditory potential was not found a statistically significant relation between the exam and the presence of the VL in the RMI. Conclusion: The results show independence between the findings of the RMI, clinical picture and audiological results (p>0,05 suggesting that there are no exclusive and direct relation between the diagnosis of vascular loop in the MRI and the clinical picture matching.

  13. The Funnel Geometry of Open Flux Tubes in the Low Solar Corona Constrained by O VI and Ne VIII Outflow

    Science.gov (United States)

    Byhring, Hanne S.; Esser, Ruth; Lie-Svendsen, Oystein

    2008-01-01

    Model calculations show that observed outflow velocities of order 7-10 km/s of C IV and O VI ions, and 15-20 km/s of Ne VIII ions, are not only consistent with models of the solar wind from coronas holes, but also place unique constraints on the degree of flow tube expansion as well as the location of the expansion in the transition region/lower corona.

  14. Development of Integrated Natural Science Teaching Materials Webbed Type with Applying Discourse Analysis on Students Grade VIII in Physics Class

    Science.gov (United States)

    Sukariasih, Luh

    2017-05-01

    This study aims to produce teaching materials integrated natural science (IPA) webbed type of handout types are eligible for use in integrated science teaching. This type of research IS a kind of research and development / Research and Development (R & D) with reference to the 4D development model that is (define, design, develop, and disseminate). Data analysis techniques used to process data from the results of the assessment by the validator expert, and the results of the assessment by teachers and learners while testing is limited (12 students of class VIII SMPN 10 Kendari) using quantitative descriptive data analysis techniques disclosed in the distribution of scores on the scale of five categories grading scale that has been determined. The results of due diligence material gain votes validator material in the category of “very good” and “good”, of the data generated in the feasibility test presentation obtained the category of “good” and “excellent”, from the data generated in the feasibility of graphic test obtained the category of “very good “and” good “, as well as of the data generated in the test the feasibility of using words and language obtained the category of“very good “and” good “, so with qualifications gained the teaching materials IPA integrated type webbed by applying discourse analysis on the theme of energy and food for Junior High School (SMP) grade VIII suitable as teaching materials. In limited testing, data generated in response to a science teacher at SMPN 10 Kendari to product instructional materials as “excellent”, and from the data generated while testing is limited by the 12 students of class VIII SMPN 10 Kendari are more students who score indicates category “very good”, so that the qualification obtained by the natural science (IPA) teaching material integrated type webbed by applying discourse analysis on the theme of energy and food for SMP / class VIII fit for use as teaching material.

  15. Procedure simplification: the role of single-use instruments in total knee arthroplasty.

    Science.gov (United States)

    Bhadra, Arup K; Kwiecien, Grzegorz J; Harwin, Steven F; Johnson, Aaron J; Mont, Michael A; Malkani, Arthur L

    2012-12-01

    In orthopaedic surgery, surgical site contamination leading to periprosthetic infections is a major concern with important morbidity, financial and emotional burden. Single-use instruments developed for total knee arthroplasties are intended to simplify the surgical procedure, decrease the number of surgical trays that require sterilization and reprocessing, decrease the incidence of possible contamination through breaks in surgical wraps, and improve operating room efficiency. As the demand for total knee arthroplasty continues to rise, a greater burden on the healthcare system may be created. The use of single-use instruments, cutting guides, and trials will play an increasing role in total knee arthroplasty through improved operating room efficiency.

  16. Costs associated with instrument sterilization in gynecologic surgery.

    Science.gov (United States)

    Van Meter, Mary M; Adam, Rony A

    2016-11-01

    With rising health care expenditures, hospitals must contain costs in ways that maintain high-quality patient care. A significant portion of perioperative costs are associated with materials and supplies; many reusable instruments on surgical trays go unused, which may account for significant annual excess processing costs. Reorganizing gynecologic trays to contain fewer instruments can result in significant cost savings. In the field of operative gynecology, there has been considerable attention to the various costs and surgical outcomes that are associated with hysterectomy performed in the abdominal, vaginal, and laparoscopic approaches; however, little research has been done on the cost differences that are associated with the reusable instruments that are used in these approaches. This study aimed to identify the percent usage of instruments within gynecologic surgery and to identify differences by surgical approach. We further aimed to estimate the costs of sterilizing surgical instruments and estimate the excess costs that are associated with processing unused instruments. This was a single site observational study. Specific instruments that were used from incision to closure were recorded on operating room count sheets via direct observation of surgeries that were performed in the gynecologic operating rooms by a trained investigator. Cost data on instrument transportation, employee wages, and instrument replacement was obtained from institutional supply chain management. In total, 28 surgical cases (5 abdominal, 11 laparoscopic, and 12 vaginal) were analyzed, with an average of 2 hours 37 minutes operating room time and 5.4 instrument trays for each case. One hundred fifty trays were observed. Trays had an average of 38 instruments per tray (range, 1-141). Surgeons used an average of 36.7 instruments of 184 available instruments per case, for a usage rate of 20.5±2.8%. A significant difference was noted between usage rates in abdominal cases (26.3±6

  17. PENGEMBANGAN KARAKTER KEDISIPLINAN DAN KEMAMPUAN PEMECAHAN MASALAH MELALUI MODEL LAPS-HEURISTIK MATERI LINGKARAN KELAS-VIII

    Directory of Open Access Journals (Sweden)

    Sri Wahyuni

    2015-08-01

    Full Text Available Tujuan penelitian ini adalah untuk mengetahui (1 apakah pembelajaran dengan model pembelajaran LAPS-Heuristik pada materi lingkaran kelas-VIII dapat mengembangkan karakter kedisiplinan peserta didik, (2 apakah pembelajaran dengan model pembelajaran LAPS-Heuristik pada materi lingkaran kelas-VIII dapat meningkatkan kemampuan pemecahan masalah peserta didik, (3 apakah kemampuan pemecahan masalah matematika peserta didik yang diajar dengan model pembelajaran LAPS-Heuristik pada materi lingkaran kelas-VIII dapat mencapai kriteria ketuntasan minimal yang ditentukan. Desain penelitian ini adalah kualitatif deskriptif, artinya menggambarkan atau mendeskripsikan kejadian-kejadian yang menjadi pusat perhatian secara kualitatif dan berdasar data kualitatif. Penentuan sumber data dalam penelitian ini menggunakan teknik purposive sampling, yaitu dipilih dengan pertimbangan dan tujuan tertentu. Data diperoleh dengan observasi, wawancara, dan tes yang kemudian dianalisis menggunakan analisis kualitatif dan analisis gain untuk mengukur peningkatan. Analisis kualitatif menunjukkan karakter kedisiplinan dan kemampuan pemecahan masalah peserta didik meningkat, serta kemampuan pemecahan masalah peserta didik mencapai KKM melalui model pembelajaran LAPS-Heuristik.

  18. Partial correction of a severe molecular defect in hemophilia A, because of errors during expression of the factor VIII gene

    Energy Technology Data Exchange (ETDEWEB)

    Young, M.; Antonarakis, S.E. [Univ. of Geneva (Switzerland); Inaba, Hiroshi [Tokyo Medical College (Japan)] [and others

    1997-03-01

    Although the molecular defect in patients in a Japanese family with mild to moderately severe hemophilia A was a deletion of a single nucleotide T within an A{sub 8}TA{sub 2} sequence of exon 14 of the factor VIII gene, the severity of the clinical phenotype did not correspond to that expected of a frameshift mutation. A small amount of functional factor VIII protein was detected in the patient`s plasma. Analysis of DNA and RNA molecules from normal and affected individuals and in vitro transcription/translation suggested a partial correction of the molecular defect, because of the following: (i) DNA replication/RNA transcription errors resulting in restoration of the reading frame and/or (ii) {open_quotes}ribosomal frameshifting{close_quotes} resulting in the production of normal factor VIII polypeptide and, thus, in a milder than expected hemophilia A. All of these mechanisms probably were promoted by the longer run of adenines, A{sub 10} instead of A{sub 8}TA{sub 2}, after the delT. Errors in the complex steps of gene expression therefore may partially correct a severe frameshift defect and ameliorate an expected severe phenotype. 36 refs., 6 figs.

  19. Establishment of the 2nd Korean national biological reference standard for blood coagulation factor VIII:C concentrate.

    Science.gov (United States)

    Lee, Naery; Seo, Ji Suk; Kim, Jae Ok; Ban, Sang Ja

    2017-05-01

    Since the 1st Korean national biological reference standard for factor (F)VIII concentrate, established in 2001, has shown declining potency, we conducted this study to replace this standard with a 2nd Korean national biological reference standard for blood coagulation FVIII concentrate. The candidate materials for the 2nd standard were prepared in 8000 vials with 10 IU/ml of target potency, according to the approved manufacturing process of blood coagulation Factor VIII:C Monoclonal Antibody-purified, Freeze-dried Human Blood Coagulation Factor VIII:C. Potency was evaluated by one-stage clotting and chromogenic methods and the stability was confirmed to meet the specifications during a period of 73 months. Since the potencies obtained by the two methods differed significantly (P < 0.015), the values were determined separately according to the geometric means (8.9 and 7.4 IU/vial, respectively). The geometric coefficients of interlaboratory variability were 3.4% and 7.6% by the one-stage clotting and chromogenic assays, respectively. Copyright © 2017 International Alliance for Biological Standardization. Published by Elsevier Ltd. All rights reserved.

  20. A Surgical Treatment Of

    African Journals Online (AJOL)

    user

    Email: sakeemng@yahoo.com. Snoring is now seen as one end of sleep-related breathing disorder resulting ultimately in obstructive sleep apnea. Uvulopalatopharyngoplasty (UPPP) is the first surgical procedure specifically designed to alleviate the abnormalities, although the use of laser appears to be the new trend.

  1. ANIMAL MODELS IN SURGICAL

    African Journals Online (AJOL)

    ASSEMBLED BY

    1 Dept.of Veterinary Surgery and Medicine 2Veterinary Teaching Hospital Ahmadu Bello University. Zaria .... unnecessary suffering., Administration of poisons .... way that humans are. Vivisection/ Surgical Training And Research. Animal model use: In both the human and veterinary medical practice, there continue to be ...

  2. Joseph Lister's surgical revolution.

    Science.gov (United States)

    Toledo-Pereyra, Luis H

    2010-10-01

    Joseph Lister (1827-1912), renowned British surgeon-scientist, introduced to the world the use and appreciation of the antiseptic method for the prevention of wound sepsis. Armed with the ideas of Louis Pasteur (1822-1895) regarding the role of microorganisms in infections or the so-called germ theory of disease, he advanced the surgical field by using antiseptics, such as carbolic acid, in the treatment of contaminated wounds. These developments constituted a real surgical revolution. No breakthrough before Lister's, except perhaps the discovery of anesthesia, had contributed to such an incredible advancement in relationship to the surgical arena. After 1867, the year in which Lister published his remarkable paper in Lancet, it was possible to appropriately treat or prevent wound infections with the use of antiseptics at the site of the operated wound. Lister's method was complicated but produced its desired effect--to diminish wound morbidity and patient mortality. His contribution was secured for future generations and a surgical revolution had begun!

  3. Oxidation of factor VIII increases its immunogenicity in mice with severe hemophilia A.

    Science.gov (United States)

    Peyron, Ivan; Dimitrov, Jordan D; Delignat, Sandrine; Gangadharan, Bagirath; Srivastava, Alok; Kaveri, Srinivas V; Lacroix-Desmazes, Sébastien

    2018-03-01

    The development of antibodies against therapeutic factor VIII (FVIII) represents the major complication of replacement therapy in patients with severe hemophilia A. Amongst the environmental risk factors that influence the anti-FVIII immune response, the presence of active bleeding or hemarthrosis has been evoked. Endothelium damage is typically associated with the release of oxidative compounds. Here, we addressed whether oxidation contributes to FVIII immunogenicity. The control with N-acetyl cysteine of the oxidative status in FVIII-deficient mice, a model of severe hemophilia A, reduced the immune response to exogenous FVIII. Ex vivo exposure of therapeutic FVIII to HOCl induced a mild oxidation of the molecule as evidenced by the loss of free amines and resulted in increased FVIII immunogenicity in vivo when compared to native FVIII. The increased immunogenicity of oxidized FVIII was not reverted by treatment of mice with N-acetyl cysteine, and did not implicate an increased maturation of professional antigen-presenting cells. Our data document that oxidation influences the immunogenicity of therapeutic FVIII. Copyright © 2018 Elsevier Inc. All rights reserved.

  4. Recombinant to modified factor VIII and factor IX - chromogenic and one-stage assays issues.

    Science.gov (United States)

    Kitchen, S; Kershaw, G; Tiefenbacher, S

    2016-07-01

    The recent development of modified recombinant factor VIII (FVIII) and factor IX (FIX) therapeutic products with extended half-lives will create challenges for the haemostasis laboratory in obtaining recovery estimates of these products in clinical samples using existing assays. The new long-acting therapeutic concentrates contain molecular modifications of Fc fusion, site-specific of polyethylene glycol or albumin fusion. The optimum methods for monitoring each new product will need to be assessed individually and laboratories should select an assay which gives similar results to the assay used to assign potency to the product in question. For some extended half-life FVIII and FIX products some one stage assays are entirely unsuitable for monitoring purposes. For most products and assay reagents studied so far, and reviewed in this manuscript, chromogenic FVIII or FIX assays can be safely used with conventional plasma standards. If one stage assays are used then they should be performed using carefully selected reagents/methods which have been shown to recover activity close to the labelled potency for the specific product being monitored. © 2016 John Wiley & Sons Ltd.

  5. IMPLEMENTASI PENDEKATAN KONFLIK KOGNITIF DALAM PEMBELAJARAN FISIKA UNTUK MENUMBUHKAN KEMAMPUAN BERPIKIR KRITIS SISWA SMP KELAS VIII

    Directory of Open Access Journals (Sweden)

    A. Setyowati

    2012-01-01

    Full Text Available Tujuan dari penelitian ini adalah untuk mengetahui pengaruh implementasi pendekatan konflik kognitif dalam pembelajaran fisikapokok bahasan tekanan pada siswa kelas VIII terhadap kemampuan berpikir kritis, pemahaman konsep dan hasil belajar kognitifsiswa. Penelitian ini merupakan penelitian eksperimen. Setelah dilakukan pengambilan sampel secara random sampling,diperoleh kelas VIIIB sebagai kelas eksperimen dan kelas VIIIC sebagai kelas kontrol. Dari analisis uji rata-rata dua pihak atau uji tdiperoleh harga t tabel < t hitung yang berarti bahwa terdapat perbedaan yang signifikan terhadap rata-rata kemampuan berpikir kritis,pemahaman konsep dan hasil belajar kognitif kedua kelompok. Kesimpulan dari penelitian ini adalah implementasi pendekatankonflik kognitif pada pokok bahasan tekanan efektif digunakan dalam menumbuhkan kemampuan berpikir kritis, pemahamankonsep dan hasil belajar kognitif siswa kelas VIIISMP. This experiment research aims to examine the influence of cognitive conflict approach application to physics lesson with pressuretopic on critical thinking ability, concept understanding and cognitive learning achievement of the student. The random samplingused resulted class VIIIC as control group and VIIIB as experiment group. The t-test was performed to analyse the average ofcritical thinking ability, concept understanding and cognitive learning achievement of both groups. It was concluded thatimplementation of cognitive conflict approach to physics lesson with pressure topic can grow critical thinking ability, conceptunderstanding and cognitive learning achievement of the JHS student.Keyword: cognitive conflict approach, critical thinking ability, concept understanding, cognitive learning achievement

  6. Human liver sinusoidal endothelial cells but not hepatocytes contain factor VIII.

    Science.gov (United States)

    Shahani, T; Covens, K; Lavend'homme, R; Jazouli, N; Sokal, E; Peerlinck, K; Jacquemin, M

    2014-01-01

    Although the liver is the major site of coagulation factor VIII (FVIII) synthesis, the type of cells producing FVIII within the liver is still unclear. To measure FVIII in extracts of primary liver sinusoidal endothelial cells (LSECs) and hepatocytes, thereby preventing potential bias resulting from the modifications of the cell phenotype that can take place during in vitro culture. LSECs were purified by flow cytometry cell sorting on the basis of their coexpression of Tie2 and CD32b. The purity of the cells was controlled by RNA sequencing. FVIII activity (FVIII:C) in extracts of purified cells was measured with a sensitive FVIII chromogenic assay, in which the specificity of the reaction is controlled by neutralization of FVIII activity with specific inhibitor antibodies. The FVIII:C concentration in purified LSECs ranged from 0.3 to 2.8 nU per cell. In contrast, FVIII:C was undetectable in hepatocytes. The intracellular FVIII:C concentrations are therefore at least 10-100-fold higher in LSECs than in hepatocytes. Our data demonstrate that LSECs, but not hepatocytes, contain measurable amounts of FVIII:C, and suggest that the former are the main cells producing FVIII in the human liver. © 2013 International Society on Thrombosis and Haemostasis.

  7. PENGGUNAAN MIND MAP DIIRINGI MUSIK KLASIK DALAM PEMBELAJARAN MATEMATIKA UNTUK SISWA KELAS VIII SMPN 1 SAWAHLUNTO

    Directory of Open Access Journals (Sweden)

    Rezky Ramadhona

    2016-06-01

    Full Text Available Penelitian ini bertujuan untuk mengetahui apakah motivasi dan hasil belajar belajar matematika siswa kelas VIII SMPN 1 Sawahlunto setelah menggunakan mind map dan musik klasik lebih baik dari sebelum menggunakan mind map dan musik klasik. Jenis penelitian ini adalah penelitian eksperimen dengan menggunakan dua model rancangan yaitu One Group Pretest Posttest Design untuk melihat dampak perlakuan terhadap motivasi belajar dan Randomized Control Group Only Design untuk melihat dampak perlakuan terhadap hasil belajar. Pengumpulan data dalam penelitian ini menggunakan angket dan tes akhir berupa soal essai. Data yang diperoleh dianalisis dengan menggunakan Uji-t. Hasil penelitian menunjukkan bahwa motivasi belajar matematika siswa cenderung meningkat. Jadi disimpulkan bahwa motivasi belajar matematika siswa setelah menggunakan mind map dan musik klasik lebih baik dari pada sebelum menggunakan mind map dan musik klasik. Dari hasil uji hipotesis untuk data hasil belajar pada selang kepercayaan α = 0,05 diperoleh P-value = 0,022. Jadi dapat disimpulkan bahwa hasil belajar matematika siswa yang menggunakan mind map dan musik klasik lebih baik dari hasil belajar matematika siswa yang tidak menggunakan mind map dan musik klasik. Kata Kunci: Mind Map, Musik Klasik DOI: http://dx.doi.org/10.22342/jpm.10.2.3636.87-92

  8. [Determinants of the elevated factor VIII activity in patients following venous thromboembolism].

    Science.gov (United States)

    Lech, Monika; Kościelniak, Barbara; Bryk, Agata; Undas, Anetta

    2016-01-01

    Activity of factor VIII (FVIII) increased above 150% of reference range predisposes to venous thromboembolism (VTE). The aim of this study was to identify predictors of increased FVIII activity in patients following VTE. 241 (38% men) patients presented due to objectively documented VTE episode at least 3 months ago were included in this study. FVIII activity was measured using a clotting assay on the analyzer BCS XP. Among 241 patients with VTE, activity of FVIII above 150% (FVIII ≥ 150%) was observed in 96 (40%). These patients were older (p = 0.035) and their concentrations of fibrinogen and C-reactive protein (CRP) were higher by 12% and 88% (p 200%) and this group was also older (p = 0.015), more patients in that group had obesity (p = 0.015), idiopathic VTE (p = 0.043), less of them had positive family history (p = 0.010) and they were characterized by fibrinogen and CRP increased by 28% (p 200% (p = 0.016). The activity of FVIII in patients after VTE episode is influenced by age, concentration of fibrinogen, bilirubin, hemoglobin, glucose, CRP and homocysteine. Our results suggest the role of environmental factors, mainly inflammatory response in maintaining elevated FVIII activity following VTE.

  9. Transgenic rabbits as a model organism for production of human clotting factor VIII

    International Nuclear Information System (INIS)

    Vasicek, D.; Chrenek, P.; Makarevich, A.; Bauer, M.; Jurcik, R.; Suvegova, K.; Rafay, J.; Bulla, J.; Hetenyi, L.; Erickson, J.; Paleyanda, R.K.

    2005-01-01

    Human clotting factor VIII (hFVIII) is a very complex and large protein whose expression is difficult, as hFVIII requires extensive post-translational modification to be biologically active. This paper reports the generation of transgenic rabbits as a model species for testing the expression of hFVIII in the mammary gland. For micro-injection, a fusion gene construct was used, consisting of 2.5 kb murine whey acidic protein (mWAP) promoter, 7.2 kb cDNA of hFVIII, and 4.6 kb of 3' flanking sequences of the mWAP gene. from 130 micro-injected zygotes transferred into recipients, 30 offspring were delivered. The pups were screened for the transgene by PCR, using DNA isolated from the ear, and results were confirmed by Southern blot analysis. The transgene was identified in one female founder animal, and it was transmitted to the offspring in a Mendelian fashion, thus demonstrating stable integration of the gene construct into the germline of the transgenic rabbits. (author)

  10. Allometry of Factor VIII and informed scaling of next generation therapeutic proteins

    Science.gov (United States)

    Kosloski, Matthew P.; Pisal, Dipak S.; Mager, Donald E.; Balu-Iyer, Sathy V.

    2013-01-01

    Allometric scaling has been applied to the pharmacokinetics (PK) of factor VIII (FVIII), but published relationships are based on relatively small subsets of available data. Numerous next generation forms of FVIII are being developed (e.g. Fc fusion, PEGylated, and liposomal formulations) and traditional pharmacokinetic scaling of these products would not incorporate the wealth of existing knowledge for current FVIII therapy in humans. We conducted a meta-analysis and developed allometric relationships of FVIII from over 100 PK studies collected from literature. Normalized Wajima curves were used to relate mean FVIII profiles between species. An ‘informed scaling’ approach was derived for predicting first-in-human PK parameters and demonstrated with a case study for an Fc fusion FVIII. NCA values for FVIII PK were well described by the allometric equations CL=6.59·W0.85 and Vss=65.0·W0.97. A subset of studies characterized by two compartment modeling showed strong linearity in scaling of total clearance and central volume, but more variability in distributional clearance and peripheral volume. Wajima curves for FVIII superimposed across species and the disposition of Fc fusion FVIII in humans was well predicted by ‘informed scaling.’ This approach might be generally applicable for predicting human PK of next generational therapeutics. PMID:23620343

  11. Phonon dynamics in type-VIII silicon clathrates: Beyond the rattler concept

    Science.gov (United States)

    Norouzzadeh, Payam; Myles, Charles W.; Vashaee, Daryoosh

    2017-05-01

    Clathrates can form a type of guest-host solid structures that, unlike most crystalline solids, have very low thermal conductivity. It is generally thought that the guest atoms caged inside the host framework act as "rattlers" and induce lattice dynamics disorders responsible for the small thermal conductivity. We performed a systematic study of the lattice dynamical properties of type-VIII clathrates with alkali and alkaline-earth guests, i.e., X8S i46 (X =Na , K, Rb, Cs, Ca, Sr, and Ba). The energy dependent participation ratio (PR) and the atomic participation ratio of phonon modes extracted from density functional theory calculations revealed that the rattler concept is not adequate to describe the effect of fillers as they manifest strong hybridization with the framework. For the case of heavy fillers, such as Rb, Sr, Cs, and Ba, a phonon band gap was formed between the acoustic and optical branches. The calculated PR indicated that the fillers suppress the acoustic phonon modes and change the energy transport mechanism from propagative to diffusive or localized resulting in "phonon-glass" characteristics. This effect is stronger for the heavy fillers. Furthermore, in all cases, the guest insertion depressed the phonon bandwidth, reduced the Debye temperature, and reduced the phonon group velocity, all of which should lead to reduction of the thermal conductivity.

  12. Anxiety in veterinary surgical students

    DEFF Research Database (Denmark)

    Eika, Berit; Langebæk, Rikke; Jensen, A.L.

    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...... Skills); both courses were offered in multiple classes (with a total of 171 students in 2009 and 156 students in 2010). All classes in 2009 participated in the SSL stage of the Basic Surgical Skills course before performing live-animal surgery, and one class (28 students) in 2010 did not. Two validated...

  13. Clinical Performance of Emergency Surgical Officers in Southern ...

    African Journals Online (AJOL)

    GB

    The proportion of cesarean and instrumental deliveries over the total deliveries were 13% and 0.7%, respectively. Explorative laparotomies and appendectomies were the majority of the non-obstetric emergency operations. Interviewed staff in the respective hospitals stated that ESOs' clinical decision making, surgical skill ...

  14. Surgical Robotics Research in Cardiovascular Disease

    International Nuclear Information System (INIS)

    Pohost, Gerald M; Guthrie, Barton L; Steiner, Charles

    2008-01-01

    This grant is to support a research in robotics at three major medical centers: the University of Southern California-USC- (Project 1); the University of Alabama at Birmingham-UAB-(Project 2); and the Cleveland Clinic Foundation-CCF-(Project 3). Project 1 is oriented toward cardiovascular applications, while projects 2 and 3 are oriented toward neurosurgical applications. The main objective of Project 1 is to develop an approach to assist patients in maintaining a constant level of stress while undergoing magnetic resonance imaging or spectroscopy. The specific project is to use handgrip to detect the changes in high energy phosphate metabolism between rest and stress. The high energy phosphates, ATP and phosphocreatine (PCr) are responsible for the energy of the heart muscle (myocardium) responsible for its contractile function. If the blood supply to the myocardium in insufficient to support metabolism and contractility during stress, the high energy phosphates, particularly PCr, will decrease in concentration. The high energy phosphates can be tracked using phosphorus-31 magnetic resonance spectroscopy ( 31 P MRS). In Project 2 the UAB Surgical Robotics project focuses on the use of virtual presence to assist with remote surgery and surgical training. The goal of this proposal was to assemble a pilot system for proof of concept. The pilot project was completed successfully and was judged to demonstrate that the concept of remote surgical assistance as applied to surgery and surgical training was feasible and warranted further development. The main objective of Project 3 is to develop a system to allow for the tele-robotic delivery of instrumentation during a functional neurosurgical procedure (Figure 3). Instrumentation such as micro-electrical recording probes or deep brain stimulation leads. Current methods for the delivery of these instruments involve the integration of linear actuators to stereotactic navigation systems. The control of these delivery devices

  15. Hydraulic Robotic Surgical Tool Changing Manipulator.

    Science.gov (United States)

    Pourghodrat, Abolfazl; Nelson, Carl A; Oleynikov, Dmitry

    2017-03-01

    Natural orifice transluminal endoscopic surgery (NOTES) is a surgical technique to perform "scarless" abdominal operations. Robotic technology has been exploited to improve NOTES and circumvent its limitations. Lack of a multitasking platform is a major limitation. Manual tool exchange can be time consuming and may lead to complications such as bleeding. Previous multifunctional manipulator designs use electric motors. These designs are bulky, slow, and expensive. This paper presents design, prototyping, and testing of a hydraulic robotic tool changing manipulator. The manipulator is small, fast, low-cost, and capable of carrying four different types of laparoscopic instruments.

  16. Surgical Robotics Research in Cardiovascular Disease

    Energy Technology Data Exchange (ETDEWEB)

    Pohost, Gerald M; Guthrie, Barton L; Steiner, Charles

    2008-02-29

    This grant is to support a research in robotics at three major medical centers: the University of Southern California-USC- (Project 1); the University of Alabama at Birmingham-UAB-(Project 2); and the Cleveland Clinic Foundation-CCF-(Project 3). Project 1 is oriented toward cardiovascular applications, while projects 2 and 3 are oriented toward neurosurgical applications. The main objective of Project 1 is to develop an approach to assist patients in maintaining a constant level of stress while undergoing magnetic resonance imaging or spectroscopy. The specific project is to use handgrip to detect the changes in high energy phosphate metabolism between rest and stress. The high energy phosphates, ATP and phosphocreatine (PCr) are responsible for the energy of the heart muscle (myocardium) responsible for its contractile function. If the blood supply to the myocardium in insufficient to support metabolism and contractility during stress, the high energy phosphates, particularly PCr, will decrease in concentration. The high energy phosphates can be tracked using phosphorus-31 magnetic resonance spectroscopy ({sup 31}P MRS). In Project 2 the UAB Surgical Robotics project focuses on the use of virtual presence to assist with remote surgery and surgical training. The goal of this proposal was to assemble a pilot system for proof of concept. The pilot project was completed successfully and was judged to demonstrate that the concept of remote surgical assistance as applied to surgery and surgical training was feasible and warranted further development. The main objective of Project 3 is to develop a system to allow for the tele-robotic delivery of instrumentation during a functional neurosurgical procedure (Figure 3). Instrumentation such as micro-electrical recording probes or deep brain stimulation leads. Current methods for the delivery of these instruments involve the integration of linear actuators to stereotactic navigation systems. The control of these delivery

  17. Removal of surgical smear layer.

    Science.gov (United States)

    Fabiani, Cristiano; Franco, Vittorio; Covello, Francesco; Brambilla, Eugenio; Gagliani, Massimo M

    2011-06-01

    During apicoectomy and retrograde cavity preparation, a smear layer, which contains microorganisms and necrotic pulpal tissues, is formed on the dentinal surfaces cut by the instruments. Bacteria can survive and proliferate inside or below the smear layer. The purpose of this study was to evaluate in vitro two different procedures for the removal of the smear layer in retrocavities prepared with ultrasonic retrotips. Twenty-eight single-rooted teeth were cleaned, shaped, and obturated with gutta-percha and sealer. The apical 3 mm of each root were cut with a carbide bur, and retrograde cavities were prepared with ProUltra ultrasonic retrotips (Maillefer Dentsply, Baillagues, Switzerland) at a depth of 3 mm. Teeth in group A were treated with a gel of 35% orthophosphoric acid for 15 seconds, and teeth in group B were treated with a gel of 24% EDTA at a neutral pH for 2 minutes. The samples were prepared for scanning electron microscopic observation and scored for the presence of the smear layer on the retrocavity walls. Eighty percent of the teeth in group A showed an optimal degree of cleanliness of the walls, with dentinal tubules completely open. The majority of analyzed samples coming from group B showed dentinal tubules covered with the smear layer. The analysis of the samples showed that orthophosphoric acid is more effective than EDTA in removing surgical smear layer even with less time of action. Copyright © 2011 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  18. Instrumentation for accelerators

    International Nuclear Information System (INIS)

    Sen, T.J.; De, T.K.; Ranganathan, M.K.; Basak, G.C.

    1989-01-01

    Along with the various system development for the accelerator, it was necessary to develop the instrumentation facility for the cyclotron. It started with the development of various vacuum instruments like ionization gauge control unit for measurement of pressure from 10 -4 torr to 10 -9 torr, discharge gauge control unit from 10 -4 torr to 10 -7 torr, thermocouple gauge control unit from 1 torr to 10 -3 torr. Process control instrumentation includes temperature measurement for freon cooled baffle and als o for low conductivity water. Control console required various digital panel meters for measurement of various parameters of the cyclotron. Various radiation monitoring instruments are also taken care of by the instrumentation facility. This paper describes in brief these various instruments. (author). 3 f igs

  19. Instrumentation a reader

    CERN Document Server

    Pope, P

    1990-01-01

    This book contains a selection of papers and articles in instrumentation previously pub­ lished in technical periodicals and journals of learned societies. Our selection has been made to illustrate aspects of current practice and applications of instrumentation. The book does not attempt to be encyclopaedic in its coverage of the subject, but to provide some examples of general transduction techniques, of the sensing of particular measurands, of components of instrumentation systems and of instrumentation practice in two very different environments, the food industry and the nuclear power industry. We have made the selection particularly to provide papers appropriate to the study of the Open University course T292 Instrumentation. The papers have been chosen so that the book covers a wide spectrum of instrumentation techniques. Because of this, the book should be of value not only to students of instrumen­ tation, but also to practising engineers and scientists wishing to glean ideas from areas of instrumen...

  20. Radiation measurement instruments

    International Nuclear Information System (INIS)

    Anon.

    1992-01-01

    The requirements and characteristics of radiation measurement instruments vary according to the circumstances under which they are used (field, area, laboratory conditions) and according to their purpose (radiation survey, personal monitoring, use in emergencies, or alpha, beta or gamma counting). In fact, radiation measurement instruments are so varied that only an overview has been presented here. Groups of instruments for these and other conditions or uses are presented in tabular form together with their operational characteristics and requirements. While examples of calibrations, efficiencies and variability of all the listed instruments are not given in this chapter, these parameters are illustrated for the most important types of gamma and beta survey instruments, in some cases with a specific instrument used as an example. Some of the important parameters that need to be considered for laboratory counting of alpha and beta particles are presented. Charts for determination of optimum sample and background counting times, errors and statistics are given

  1. Parapharyngeal Tumours - Surgical Expertise

    Directory of Open Access Journals (Sweden)

    Kinjal Shankar Majumdar

    2014-12-01

    Full Text Available Introduction We present our experience in the management of parapharyngeal tumours. A conservative trans-cervical approach was found to be feasible and effective in majority of the cases over radical ones, which may be required in malignancies and skull-base involvement.   Methods Fifteen patients with parapharyngeal tumours treated surgically in the Department of ENT, Nilratan Sircar Medical College in last 3 years were included in the study. 80% of the cases were benign, most common being Schwannoma. Most important investigation was found to be MRI.   Conclusion The study gives an overview regarding the surgical approach, based upon the extent and histology of the tumour. Trans-cervical approachwas found to be the most effective.

  2. Radiation protection instrument 1993

    International Nuclear Information System (INIS)

    1993-04-01

    The Radiation Protection Instrument, 1993 (Legislative Instrument 1559) prescribes the powers and functions of the Radiation Protection Board established under the Ghana Atomic Energy Commission by the Atomic Energy Commission (Amendment) Law, 1993 (P.N.D.C. Law 308). Also included in the Legislative Instrument are schedules on control and use of ionising radiation and radiation sources as well as procedures for notification, licensing and inspection of ionising radiation facilities. (EAA)

  3. Parapharyngeal Tumours - Surgical Expertise

    OpenAIRE

    Kinjal Shankar Majumdar

    2014-01-01

    Introduction We present our experience in the management of parapharyngeal tumours. A conservative trans-cervical approach was found to be feasible and effective in majority of the cases over radical ones, which may be required in malignancies and skull-base involvement.   Methods Fifteen patients with parapharyngeal tumours treated surgically in the Department of ENT, Nilratan Sircar Medical College in last 3 years were included in the study. 80% of the cases were benign, mos...

  4. Severe Hemophilia A in a Male Old English Sheep Dog with a C→T Transition that Created a Premature Stop Codon in Factor VIII

    Science.gov (United States)

    Lozier, Jay N; Kloos, Mark T; Merricks, Elizabeth P; Lemoine, Nathaly; Whitford, Margaret H; Raymer, Robin A; Bellinger, Dwight A; Nichols, Timothy C

    2016-01-01

    Animals with hemophilia are models for gene therapy, factor replacement, and inhibitor development in humans. We have actively sought dogs with severe hemophilia A that have novel factor VIII mutations unlike the previously described factor VIII intron 22 inversion. A male Old English Sheepdog with recurrent soft-tissue hemorrhage and hemarthrosis was diagnosed with severe hemophilia A (factor VIII activity less than 1% of normal). We purified genomic DNA from this dog and ruled out the common intron 22 inversion; we then sequenced all 26 exons. Comparing the results with the normal canine factor VIII sequence revealed a C→T transition in exon 12 of the factor VIII gene that created a premature stop codon at amino acid 577 in the A2 domain of the protein. In addition, 2 previously described polymorphisms that do not cause hemophilia were present at amino acids 909 and 1184. The hemophilia mutation creates a new TaqI site that facilitates rapid genotyping of affected offspring by PCR and restriction endonuclease analyses. This mutation is analogous to the previously described human factor VIII mutation at Arg583, which likewise is a CpG dinucleotide transition causing a premature stop codon in exon 12. Thus far, despite extensive treatment with factor VIII, this dog has not developed neutralizing antibodies (‘inhibitors’) to the protein. This novel mutation in a dog gives rise to severe hemophilia A analogous to a mutation seen in humans. This model will be useful for studies of the treatment of hemophilia. PMID:27780008

  5. Safety, efficacy and pharmacokinetics of rVIII-SingleChain in children with severe hemophilia A: results of a multicenter clinical trial.

    Science.gov (United States)

    Stasyshyn, O; Djambas Khayat, C; Iosava, G; Ong, J; Abdul Karim, F; Fischer, K; Veldman, A; Blackman, N; St Ledger, K; Pabinger, I

    2017-04-01

    Essentials rVIII-SingleChain is a novel recombinant factor VIII with covalently bonded heavy and light chains. Efficacy, safety and pharmacokinetics were studied in pediatric patients with severe hemophilia A. Across all prophylaxis regimens, the median annualized spontaneous bleeding rate was 0.00. rVIII-SingleChain showed excellent hemostatic efficacy and a favorable safety profile. Background rVIII-SingleChain is a novel B-domain truncated recombinant factor VIII (rFVIII) comprised of covalently bonded FVIII heavy and light chains, demonstrating a high binding affinity to von Willebrand factor. Objectives This phase III study investigated the safety, efficacy and pharmacokinetics of rVIII-SingleChain in previously treated pediatric patients hemophilia A. Patients/Methods Patients could be assigned to prophylaxis or on-demand therapy by the investigator. For patients assigned to prophylaxis, the treatment regimen and dose were based on the bleeding phenotype. For patients receiving on-demand therapy, dosing was guided by World Federation of Hemophilia recommendations. The primary endpoint was treatment success, defined as a rating of 'excellent' or 'good' on the investigator's clinical assessment of hemostatic efficacy for all treated bleeding events. Results The study enrolled 84 patients (0 to 50 EDs. In the 347 bleeds treated and evaluated by the investigator, hemostatic efficacy was rated as excellent or good in 96.3%. The median annualized spontaneous bleeding rate was 0.00 (Q1, Q3: 0.00, 2.20), and the median annualized bleeding rate was 3.69 (Q1, Q3: 0.00, 7.20) across all prophylaxis regimens. No participant developed an inhibitor. Conclusions rVIII-SingleChain is a novel rFVIII molecule showing excellent hemostatic efficacy and a favorable safety profile in a clinical study in children hemophilia A. © 2017 The Authors. Journal of Thrombosis and Haemostasis published by Wiley Periodicals, Inc. on behalf of International Society on Thrombosis and

  6. Ocean Optics Instrumentation Systems

    Data.gov (United States)

    Federal Laboratory Consortium — FUNCTION: Provides instrumentation suites for a wide variety of measurements to characterize the ocean’s optical environment. These packages have been developed to...

  7. Networked Instrumentation Element

    Data.gov (United States)

    National Aeronautics and Space Administration — Armstrong researchers have developed a networked instrumentation system that connects modern experimental payloads to existing analog and digital communications...

  8. Creating a Super Instrument

    DEFF Research Database (Denmark)

    Kallionpää, Maria; Gasselseder, Hans-Peter

    2015-01-01

    interested in different ways of "supersizing" acoustic instruments in order to open up previously-unheard instrumental sounds. This leads us to the question of what constitutes a super instrument and what challenges does it pose aesthetically and technically? Although the classical music performers have......Thanks to the development of new technology, musical instruments are no more tied to their existing acoustic or technical limitations as almost all parameters can be augmented or modified in real time. An increasing number of composers, performers, and computer programmers have thus become...

  9. Instrument validation project

    International Nuclear Information System (INIS)

    Reynolds, B.A.; Daymo, E.A.; Geeting, J.G.H.; Zhang, J.

    1996-06-01

    Westinghouse Hanford Company Project W-211 is responsible for providing the system capabilities to remove radioactive waste from ten double-shell tanks used to store radioactive wastes on the Hanford Site in Richland, Washington. The project is also responsible for measuring tank waste slurry properties prior to injection into pipeline systems, including the Replacement of Cross-Site Transfer System. This report summarizes studies of the appropriateness of the instrumentation specified for use in Project W-211. The instruments were evaluated in a test loop with simulated slurries that covered the range of properties specified in the functional design criteria. The results of the study indicate that the compact nature of the baseline Project W-211 loop does not result in reduced instrumental accuracy resulting from poor flow profile development. Of the baseline instrumentation, the Micromotion densimeter, the Moore Industries thermocouple, the Fischer and Porter magnetic flow meter, and the Red Valve Pressure transducer meet the desired instrumental accuracy. An alternate magnetic flow meter (Yokagawa) gave nearly identical results as the baseline fischer and Porter. The Micromotion flow meter did not meet the desired instrument accuracy but could potentially be calibrated so that it would meet the criteria. The Nametre on-line viscometer did not meet the desired instrumental accuracy and is not recommended as a quantitative instrument although it does provide qualitative information. The recommended minimum set of instrumentation necessary to ensure the slurry meets the Project W-058 acceptance criteria is the Micromotion mass flow meter and delta pressure cells

  10. Instrument performance evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Swinth, K.L.

    1993-03-01

    Deficiencies exist in both the performance and the quality of health physics instruments. Recognizing the implications of such deficiencies for the protection of workers and the public, in the early 1980s the DOE and the NRC encouraged the development of a performance standard and established a program to test a series of instruments against criteria in the standard. The purpose of the testing was to establish the practicality of the criteria in the standard, to determine the performance of a cross section of available instruments, and to establish a testing capability. Over 100 instruments were tested, resulting in a practical standard and an understanding of the deficiencies in available instruments. In parallel with the instrument testing, a value-impact study clearly established the benefits of implementing a formal testing program. An ad hoc committee also met several times to establish recommendations for the voluntary implementation of a testing program based on the studies and the performance standard. For several reasons, a formal program did not materialize. Ongoing tests and studies have supported the development of specific instruments and have helped specific clients understand the performance of their instruments. The purpose of this presentation is to trace the history of instrument testing to date and suggest the benefits of a centralized formal program.

  11. Surgical management of obesity.

    Science.gov (United States)

    Torres-Landa, Samuel; Kannan, Umashankkar; Guajardo, Isabella; Pickett-Blakely, Octavia E; Dempsey, Daniel T; Williams, Noel N; Dumon, Kristoffel R

    2018-02-01

    Obesity is a spreading epidemic associated with significant morbidity and mortality with a prevalence of over 36% worldwide. In the face of a growing epidemic, increasing medical costs, and the disappointing limitations of medical and lifestyle modification bariatric surgery was found to consistently lead to significant weight loss and improvement in obesity-associated comorbidities when compared to non-surgical interventions. Bariatric procedures fall within three basic categories: restrictive procedures, malabsorptive procedures, and procedures that combine both restrictive and malabsorptive mechanisms. Four major procedures are currently performed (most often laparoscopically): Roux-en-Y gastric bypass, biliopancreatic diversion with duodenal switch, adjustable gastric banding, and sleeve gastrectomy. Although the laparoscopic Roux-en-Y gastric bypass was the most frequently performed bariatric procedure, the laparoscopic sleeve gastrectomy has since become the most popular. Bariatric surgery currently has similar mortality rates to standard general surgical operations. Morevoer, bariatric surgery reduces mortality by the improvement and remission of obesity-related comorbidities. Newer minimally-invasive weight loss procedures and endoscopic methods continue to evolve as we expand our understanding of the intricacies of obesity and the effects of currently available surgical treatments.

  12. [Surgical robotics in neurosurgery].

    Science.gov (United States)

    Haidegger, Tamás; Benyó, Zoltán

    2009-09-06

    Surgical robotics is one of the most dynamically advancing areas of biomedical engineering. In the past few decades, computer-integrated interventional medicine has gained significance internationally in the field of surgical procedures. More recently, mechatronic devices have been used for nephrectomy, cholecystectomy, as well as in orthopedics and radiosurgery. Estimates show that 70% of the radical prostatectomies were performed with the da Vinci robot in the United States last year. Robot-aided procedures offer remarkable advantages in neurosurgery both for the patient and the surgeon, making microsurgery and Minimally Invasive Surgery a reality, and even complete teleoperation accessible. This paper introduces surgical robotic systems developed primarily for brain and spine applications, besides, it focuses on the different research strategies applied to provide smarter, better and more advanced tools to surgeons. A new system is discussed in details that we have developed together with the Johns Hopkins University in Baltimore. This cooperatively-controlled system can assist with skull base drilling to improve the safety and quality of neurosurgery while reducing the operating time. The paper presents the entire system, the preliminary results of phantom and cadaver tests and our efforts to improve the accuracy of the components. An effective optical tracking based patient motion compensation method has been implemented and tested. The results verify the effectiveness of the system and allow for further research.

  13. Allergy to Surgical Implants.

    Science.gov (United States)

    Pacheco, Karin A

    2015-01-01

    Surgical implants have a wide array of therapeutic uses, most commonly in joint replacements, but also in repair of pes excavatum and spinal disorders, in cardiac devices (stents, patches, pacers, valves), in gynecological implants, and in dentistry. Many of the metals used are immunologically active, as are the methacrylates and epoxies used in conjunction with several of these devices. Allergic responses to surgical components can present atypically as failure of the device, with nonspecific symptoms of localized pain, swelling, warmth, loosening, instability, itching, or burning; localized rash is infrequent. Identification of the specific metal and cement components used in a particular implant can be difficult, but is crucial to guide testing and interpretation of results. Nickel, cobalt, and chromium remain the most common metals implicated in implant failure due to metal sensitization; methacrylate-based cements are also important contributors. This review will provide a guide on how to assess and interpret the clinical history, identify the components used in surgery, test for sensitization, and provide advice on possible solutions. Data on the pathways of metal-induced immune stimulation are included. In this setting, the allergist, the dermatologist, or both have the potential to significantly improve surgical outcomes and patient care. Copyright © 2015 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  14. Fuzzy-logic-assisted surgical planning in adolescent idiopathic scoliosis.

    Science.gov (United States)

    Nault, Marie-Lyne; Labelle, Hubert; Aubin, Carl-Eric; Sangole, Archana; Balazinski, Marek

    2009-06-01

    Selection of appropriate curve fusion levels for surgery in adolescent idiopathic scoliosis (AIS) is a complex and difficult task and, despite numerous publications, still remains a highly controversial topic. To evaluate a fuzzy-logic-based surgical planning tool by comparing the results suggested by the software with the average outcome recommended by a panel of 5 expert spinal deformity surgeons. It is hypothesized that, given the same information, the fuzzy-logic tool will perform as favorably as the surgeons. Proof-of-concept study evaluating the use of a fuzzy-logic-assisted surgical planning tool in AIS to select the appropriate spinal curve to be instrumented. A cohort of 30 AIS surgical cases with a main thoracic curve was used. Each case included standard measurements recorded from preoperative standing postero-anterior and lateral, supine side bending, and 1-year postoperative standing radiographs. Five experienced spinal deformity surgeons evaluated each case independently and gave their preferred levels of instrumentation and fusion. The cases were then presented to the fuzzy-logic tool to determine whether the high thoracic and/or lumbar curves were to be instrumented. For each case, a percentage value was obtained indicating inclusion/exclusion of the respective curves in the surgical instrumentation procedure. Kappa statistics was used to compare the model output and the average decision of the surgeons. Kappa values of 0.71 and 0.64 were obtained, respectively, for the proximal thoracic and lumbar curves models, thus suggesting a good agreement of the fusion recommendations made by the fuzzy-logic tool and the surgeons. Given the same information, the fuzzy-logic-assisted recommendation of the curve to be instrumented compared favorably with the collective decision of the surgeons. The findings thus suggest that a fuzzy-logic approach is helpful in assisting surgeons with the preoperative selection of curve instrumentation and fusion levels in AIS.

  15. Nigerian Journal of Surgical Research

    African Journals Online (AJOL)

    The Nigerian Journal of Surgical Research is a publication of the Surgical Research Society with main office in Zaria, Nigeria. Zaria is home to Ahmadu Bello University (ABU), a premier university in Nigeria. The aim of The Nigerian Journal of Surgical Research is to cover developments and advances in the broad field of ...

  16. A Model for Predicting Persistent Elevation of Factor VIII among Patients with Acute Ischemic Stroke

    Science.gov (United States)

    Samai, Alyana A.; Boehme, Amelia K.; Shaban, Amir; George, Alexander J.; Dowell, Lauren; Monlezun, Dominique J.; Leissinger, Cindy; Schluter, Laurie; El Khoury, Ramy; Martin-Schild, Sheryl

    2016-01-01

    Background and Purpose Elevated levels of coagulation factor VIII (FVIII) may persist independent of the acute-phase response; however, this relationship has not been investigated relative to acute ischemic stroke (AIS). We examined the frequency and predictors of persistently elevated FVIII in AIS patients. Methods AIS patients admitted between July 2008 and May 2014 with elevated baseline FVIII levels and repeat FVIII levels drawn for more than 7 days postdischarge were included. The patients were dichotomized by repeat FVIII level for univariate analysis at 150% and 200% activity thresholds. An adjusted model was developed to predict the likelihood of persistently elevated FVIII levels. Results Among 1616 AIS cases, 98 patients with elevated baseline FVIII had repeat FVIII levels. Persistent FVIII elevation was found in more than 75% of patients. At the 150% threshold, the prediction score ranged from 0 to 7 and included black race, female sex, prior stroke, hyperlipidemia, smoking, baseline FVIII > 200%, and baseline von Willebrand factor (vWF) level greater than 200%. At the 200% threshold, the prediction score ranged from 0–5 and included female sex, prior stroke, diabetes mellitus, baseline FVIII level greater 200%, and baseline vWF level greater than 200%. For each 1-point increase in score, the odds of persistent FVIII at both the 150% threshold (odds ratio [OR] = 10.4, 95% confidence interval [CI] 1.63–66.9, P = .0134) and 200% threshold (OR = 10.2, 95% CI 1.82–57.5, P = .0083) increased 10 times. Conclusion Because an elevated FVIII level confers increased stroke risk, our model for anticipating a persistently elevated FVIII level may identify patients at high risk for recurrent stroke. FVIII may be a target for secondary stroke prevention. PMID:26777556

  17. To serve and protect: The modulatory role of von Willebrand factor on factor VIII immunogenicity.

    Science.gov (United States)

    Hartholt, Robin B; van Velzen, Alice S; Peyron, Ivan; Ten Brinke, Anja; Fijnvandraat, Karin; Voorberg, Jan

    2017-09-01

    Hemophilia A is a bleeding disorder characterized by the absence or dysfunction of blood coagulation factor VIII (FVIII). Patients are treated with regular infusions of FVIII concentrate. In response to treatment, approximately 30% of patients with severe hemophilia A develop inhibitory antibodies targeting FVIII. Both patient and treatment related risk factors for inhibitor development have been described. Multiple studies comparing the immunogenicity of recombinant and plasma-derived FVIII have yielded conflicting results. The randomized controlled SIPPET (Survey of Inhibitors in Plasma-Product Exposed Toddlers) trial demonstrated an increased risk of inhibitor development of recombinant FVIII when compared to von Willebrand factor (VWF)-containing plasma-derived FVIII. Presently, it is unclear which mechanism underlies the reduced immunogenicity of plasma-derived FVIII. In this review we address the potential role of VWF on FVIII immunogenicity and we discuss how VWF affects the immune recognition, processing and presentation of FVIII. We also briefly discuss the potential impact of glycan-composition on FVIII immunogenicity. It is well established that VWF shields the uptake of FVIII by antigen presenting cells. We have recently shown that VWF binds to the surface of dendritic cells. Here, we present a novel model in which surface bound FVIII-VWF complexes regulate the internalization of FVIII. Binding of FVIII to VWF is critically dependent on sulfation of Tyr1699 (HVGS numbering) in the light chain of FVIII. Incomplete sulfation of Tyr1699 has been suggested to occur in several recombinant FVIII products resulting in a loss of VWF binding. We hypothesize that this results in alternative pathways of FVIII internalization by antigen presenting cells which are not regulated by VWF. This hypothetical mechanism may explain the reduced immunogenicity of VWF containing plasma-derived FVIII concentrates as found in the SIPPET study. Copyright © 2017. Published by

  18. Complement C3 is a novel modulator of the anti-factor VIII immune response.

    Science.gov (United States)

    Rayes, Julie; Ing, Mathieu; Delignat, Sandrine; Peyron, Ivan; Gilardin, Laurent; Vogel, Carl-Wilhelm; Fritzinger, David C; Frémeaux-Bacchi, Véronique; Kaveri, Srinivas V; Roumenina, Lubka T; Lacroix-Desmazes, Sébastien

    2018-02-01

    Development of neutralizing antibodies against therapeutic Factor VIII (FVIII) is the most serious complication of the treatment of hemophilia A. There is growing evidence to show the multifactorial origin of the anti-FVIII immune response, combining both genetic and environmental factors. While a role for the complement system on innate as well as adaptive immunity has been documented, the implication of complement activation on the onset of the anti-FVIII immune response is unknown. Here, using in vitro assays for FVIII endocytosis by human monocyte-derived dendritic cells and presentation to T cells, as well as in vivo complement depletion in FVIII-deficient mice, we show a novel role for complement C3 in enhancing the immune response against therapeutic FVIII. In vitro , complement C3 and its cleavage product C3b enhanced FVIII endocytosis by dendritic cells and presentation to a FVIII-specific CD4 + T-cell hybridoma. The C1 domain of FVIII had previously been shown to play an important role in FVIII endocytosis, and alanine substitutions of the K2092, F2093 and R2090 C1 residues drastically reduce FVIII uptake in vitro Interestingly, complement activation rescued the endocytosis of the FVIII C1 domain triple mutant. In a mouse model of severe hemophilia A, transient complement C3 depletion by humanized cobra venom factor, which does not generate anaphylatoxin C5a, significantly reduced the primary anti-FVIII immune response, but did not affect anti-FVIII recall immune responses. Taken together, our results suggest an important adjuvant role for the complement cascade in the initiation of the immune response to therapeutic FVIII. Copyright© 2018 Ferrata Storti Foundation.

  19. Nonneutralizing antibodies against factor VIII and risk of inhibitor development in severe hemophilia A.

    Science.gov (United States)

    Cannavò, Antonino; Valsecchi, Carla; Garagiola, Isabella; Palla, Roberta; Mannucci, Pier Mannuccio; Rosendaal, Frits R; Peyvandi, Flora

    2017-03-09

    The development of anti-factor VIII (FVIII) neutralizing antibodies (inhibitors) is the major complication in hemophilia A. Nonneutralizing antibodies (NNAs) have been detected in hemophilia patients and also in unaffected individuals. The aim of this study was to assess the prevalence of NNAs and to evaluate whether their presence is associated with the development of inhibitors in a cohort of previously untreated or minimally treated patients with hemophilia A; plasma samples of 237 patients with severe hemophilia A enrolled in the SIPPET trial were collected before any exposure to FVIII concentrates and analyzed for the presence of anti-FVIII NNAs. Patients were observed for the development of neutralizing antibodies. NNAs were found in 18 (7.6%) of 237 patients at screening, and there was a clear age gradient. Of those with NNAs, 7 patients subsequently developed an inhibitor for a cumulative incidence of 45.4% (95% confidence interval [CI], 19.5% to 71.3%); among the 219 patients without NNAs, 64 (29%) developed an inhibitor (cumulative incidence, 34.0%; 95% CI, 27.1%-40.9%). In Cox regression analyses, patients with NNAs at screening had an 83% higher incidence of inhibitor development than patients without NNAs (hazard ratio [HR], 1.83; 95% CI, 0.84-3.99). For high-titer inhibitors, the incidence rate had an almost threefold increase (HR, 2.74; 95% CI, 1.23-6.12). These associations did not materially change after adjustment. The presence of anti-FVIII NNAs in patients with severe hemophilia A who were not previously exposed to FVIII concentrates is associated with an increased incidence of inhibitors. © 2017 by The American Society of Hematology.

  20. Rancang Bangun Perangkat Eksperimen Hukum Archimedes untuk MTs LB/A Yaketunis Kelas VIII

    Directory of Open Access Journals (Sweden)

    Rofiqoh Utami

    2014-06-01

    Full Text Available Blind students find difficulties whenever they are involved in the experiment of Archimedes principle as it requests an active visual role. Thus, it is very important to design a special tool for blind students so their practice of Archimedes principle become easier. This paper discusses a research finding which is an innovation of adaptive tools for blind students, such as beaker glass with Braille number, dynamometer with modification and Braille number (Braille Spring Balance and recording lesson about Archimedes principle. This research done for students MTs LB / A Yaketunis Class VIII which aims at analyzing the quality of each tool by media experts, lesson experts, and physics teacher of MTs LB/A.This research is R & D with procedural models adapted from the development of the 4-D models, namely Define, Design, Develop, and Disseminate. According to media expert assessment, beaker glass with Braille number and Braille spring balance has a very good quality with percentage of their respective 100% of the ideal score, while the assessment by lesson experts for each tool have a good quality with percentage 80% and 73.33% of the ideal score, and physics teacher of MTs LB / A assessment for each tool have a very good quality with percentage 100%. According to the media and lesson experts, the recording lesson about Archimedes principle have a good quality with percentage 80% of the ideal score, according to physics teacher MTs LB / A, the recording tool has excellent quality either with percentage 91.82% of the ideal score. This research recommends the blinds students to utilize these innovative-adaptive tools which will enable them appropriately practice Archimedes principle as non-blind students.

  1. STUDI KOMPARASI PEMBELAJARAN NOVICK DAN GROUP INVESTIGATION TERHADAP KEMAMPUAN SPASIAL SISWA KELAS VIII MATERI GEOMETRI

    Directory of Open Access Journals (Sweden)

    Dian Nailis Suroyya

    2015-03-01

    Full Text Available Tujuan penelitian ini adalah mengetahui apakah apakah rata-rata kemampuan spasial siswa pada kelas yang menggunakan model pembelajaran Novick lebih baik dari rata-rata kemampuan spasial siswa pada kelas yang menggunakan model pembelajaran Direct Instruction, mengetahui apakah rata-rata kemampuan spasial siswa pada kelas yang menggunakan model pembelajaran Group Investigation lebih baik dari rata-rata kemampuan spasial siswa pada kelas yang menggunakan model pembelajaran Direct Instruction, mengetahui apakah rata-rata kemampuan spasial siswa pada kelas yang menggunakan model pembelajaran Novick lebih baik dari rata-rata kemampuan spasial siswa pada kelas yang menggunakan model pembelajaran Group Investigation, dan mengetahui apakah peningkatan kemampuan spasial siswa pada kelas yang menggunakan model pembelajaran Novick lebih baik dari peningkatan kemampuan spasial siswa pada kelas yang menggunakan model pembelajaran Group Investigation. Populasi dalam penelitian ini adalah seluruh siswa kelas VIII MTs N 1 Kudus tahun pelajaran 2013/2014. Pengambilan sampel menggunakan teknik random sampling. Data diperoleh melalui metode tes dan data dianalisis menggunakan uji t. Hasil penelitian menunjukkan bahwa rata-rata kemampuan spasial siswa pada kelas yang menggunakan model pembelajaran Novick dan rata-rata kemampuan spasial siswa pada kelas yang menggunakan model pembelajaran Group Investigation lebih baik dari rata-rata kemampuan spasial siswa pada kelas yang menggunakan model pembelajaran Direct Instruction, rata-rata kemampuan spasial siswa pada kelas yang menggunakan model pembelajaran Novick kurang dari atau sama dengan kemampuan rata-rata kemampuan spasial siswa pada kelas yang menggunakan model pembelajaran Group Investigation, dan peningkatan kemampuan spasial siswa pada kelas yang menggunakan model pembelajaran Novick kurang dari atau sama dengan peningkatan kemampuan spasial siswa pada kelas yang menggunakan model pembelajaran Group

  2. Frequencies of VNTR and RFLP polymorphisms associated with factor VIII gene in Singapore

    Energy Technology Data Exchange (ETDEWEB)

    Fong, I.; Lai, P.S.; Ouah, T.C. [National Univ. of Singapore (Malaysia)] [and others

    1994-09-01

    The allelic frequency of any polymorphism within a population determines its usefulness for genetic counselling. This is important in populations of non-Caucasian origin as RFLPs may significantly differ among ethnic groups. We report a study of five intragenic polymorphisms in factor VIII gene carried out in Singapore. The three PCR-based RFLP markers studied were Intron 18/Bcl I, Intron 19/Hind III and Intron 22/Xba I. In an analysis of 148 unrelated normal X chromosomes, the allele frequencies were found to be A1 = 0.18, A2 = 0.82 (Bcl I RFLP), A1 = 0.80, A2 = 0.20 (Hind III RFLP) and A1 = 0.58, and A2 = 0.42 (Xba I RFLP). The heterozygosity rates of 74 females analyzed separately were 31%, 32% and 84.2%, respectively. Linkage disequilibrium was also observed to some degree between Bcl I and Hind III polymorphism in our population. We have also analyzed a sequence polymorphism in Intron 7 using hybridization with radioactive-labelled {sup 32}P allele-specific oligonucleotide probes. This polymorphism was not very polymorphic in our population with only 2% of 117 individuals analyzed being informative. However, the use of a hypervariable dinucleotide repeat sequence (VNTR) in Intron 13 showed that 25 of our of 27 (93%) females were heterozygous. Allele frequencies ranged from 1 to 55 %. We conclude that a viable strategy for molecular analysis of Hemophilia A families in our population should include the use of Intron 18/Bcl I and Intron 22/Xba I RFLP markers and the Intron 13 VNTR marker.

  3. Valor preditivo da expressão dos anticorpos Antifator VIII no carcinoma epidermóide do esôfago Predictive value of antifactor VIII antibody expression in squamous cell carcinoma of the esophagus

    Directory of Open Access Journals (Sweden)

    Sebastião Gonzaga Barbosa-Neto

    2007-12-01

    Full Text Available RACIONAL: O carcinoma epidermóide do esôfago apresenta alta mortalidade, baixo índice de diagnóstico precoce e altos custos nos tratamentos, com resultados freqüentemente desapontadores e prognóstico sombrio. O melhor entendimento das técnicas de biologia molecular com citofotometria de imagem, permitiu avançar no conhecimento das alterações na expressão das proteínas desse câncer. OBJETIVOS: Quantificar a expressão das proteínas envolvidas na angiogênese e correlacioná-las com variáveis clínico-patológicas. MÉTODOS: Com o uso da técnica de imunoistoquímica, citofotometria de imagem pelo sistema SAMBA, foram analisadas 29 amostras de carcinoma epidermóide do esôfago incluídas em blocos de parafina. Critérios clínicos como idade, sexo e histopatológicos do grau de diferenciação tumoral, tamanho e localização do tumor foram analisados. Os parâmetros analisados foram o índice de marcagem e a densidade óptica. O marcador utilizado foi o anticorpo anti-Fator VIII. RESULTADOS: Foi possível verificar que as expressões médias do marcador no índice de marcagem foram maiores que as da densidade óptica. Fator VIII apresentou leituras homogêneas. O índice de marcagem foi de 80,17+/-10,40 com P=0,073 e a densidade óptica 51,25+/-11,02 com P=0,245. CONCLUSÃO: A análise quantificação da expressão das proteínas envolvidas na angiogênese permite definir subgrupos de acordo com a diferenciação do carcinoma, estágio tumoral, tamanho e localização do tumor, porém não associa-se com o sexo e a idade dos pacientes, e a densidade óptica do Fator VIII não tem expressão significativa em nenhum dos subgrupos analisados.BACKGROUND: Squamous cell carcinoma of the esophagus exhibits high mortality rate, rare precocious diagnosis, and expensive treatments, presenting frequently disappointed results and poor prognosis. The better understanding about Molecular Biology techniques using cytophotometric imaging allowed

  4. Instrumentation Design and Development Facilities

    Data.gov (United States)

    Federal Laboratory Consortium — RTTC has facilities for design, development and fabrication of: custominstrumentation, mobile instrumentation, miniaturized instrumentation, wirelessinstrumentation,...

  5. Clinical Performance of Emergency Surgical Officers in Southern Ethiopia.

    Science.gov (United States)

    Gobeze, Abera A; Kebede, Zelalem; Berhan, Yifru; Ghosh, Biku

    2016-09-01

    Serious shortage of gynecologists and surgeons for several decades leading to a three-year masters level training was initiated in 2009. However, systematic analysis was not done to assess the graduates' performance. The purpose of this study was to assess improvement in access to emergency surgical and obstetrical care services. Both quantitative and qualitative methods were employed to assess the competence of emergency surgical officers (ESOs) in their decision making and surgical skills in eight hospitals between 2012 and 2014. Anesthesia time, post-operative hospital stay and change in hemoglobin level were, among others, used as proxy indicators of their surgical skills. A total of 4075 obstetric and surgical operations was performed in the study hospitals. Of which, 93% were done on emergency base. Of the total emergency procedures, 3570(94%) were done by ESOs. Nearly two-thirds (63%) of all the emergency operations were cesarean sections, which were done by ESOs. Out of 239 uterine ruptures, hysterectomy was done for 58%. The proportion of cesarean and instrumental deliveries over the total deliveries were 13% and 0.7%, respectively. Explorative laparotomies and appendectomies were the majority of the non-obstetric emergency operations. Interviewed staff in the respective hospitals stated that ESOs' clinical decision making, surgical skill and commitment to discharge their responsibilities were in the best possible. The study showed that deployment of ESOs made the emergency surgery services accessible to the majority, and their clinical decision making and surgical skills were remarkable.

  6. The effect of music on robot-assisted laparoscopic surgical performance.

    Science.gov (United States)

    Siu, Ka-Chun; Suh, Irene H; Mukherjee, Mukul; Oleynikov, Dmitry; Stergiou, Nick

    2010-12-01

    Music is often played in the operating room to increase the surgeon's concentration and to mask noise. It could have a beneficial effect on surgical performance. Ten participants with limited experience with the da Vinci robotic surgical system were recruited to perform two surgical tasks: suture tying and mesh alignment when classical, jazz, hip-hop, and Jamaican music were presented. Kinematics of the instrument tips of the surgical robot and surface electromyography of the subjects were recorded. Results revealed that a significant music effect was found for both tasks with decreased time to task completion (P = .005) and total travel distance (P = .021) as well as reduced muscle activations ( P = .016) and increased median muscle frequency (P = .034). Subjects improved their performance significantly when they listened to either hip-hop or Jamaican music. In conclusion, music with high rhythmicity has a beneficial effect on robotic surgical performance. Musical environment may benefit surgical training and make acquisition of surgical skills more efficient.

  7. Overview of LOFT instrumentation

    International Nuclear Information System (INIS)

    Bixby, W.W.

    1979-01-01

    A description of instrumentation used in the Loss-of-Fluid Test (LOFT) large break Loss-of-Coolant Experiments is presented. Emphasis is placed on hydraulic and thermal measurements in the primary system piping and components, reactor vessel, and pressure suppression system. In addition, instrumentation which is being considered for measurement of phenomena during future small break testing is discussed

  8. Trends in the Surgical Correction of Gynecomastia

    Science.gov (United States)

    Brown, Rodger H.; Chang, Daniel K.; Siy, Richard; Friedman, Jeffrey

    2015-01-01

    Gynecomastia refers to the enlargement of the male breast due to a proliferation of ductal, stromal, and/or fatty tissue. Although it is a common condition affecting up to 65% of men, not all cases require surgical intervention. Contemporary surgical techniques in the treatment of gynecomastia have become increasingly less invasive with the advent of liposuction and its variants, including power-assisted and ultrasound-assisted liposuction. These techniques, however, have been largely limited in their inability to address significant skin excess and ptosis. For mild to moderate gynecomastia, newer techniques using arthroscopic morcellation and endoscopic techniques promise to address the fibrous component, while minimizing scar burden by utilizing liposuction incisions. Nevertheless, direct excision through periareolar incisions remains a mainstay in treatment algorithms for its simplicity and avoidance of additional instrumentation. This is particularly true for more severe cases of gynecomastia requiring skin resection. In the most severe cases with significant skin redundancy and ptosis, breast amputation with free nipple grafting remains an effective option. Surgical treatment should be individualized to each patient, combining techniques to provide adequate resection and optimize aesthetic results. PMID:26528088

  9. Surgical consideration of cervical dumbbell tumors.

    Science.gov (United States)

    Tomii, Masato; Itoh, Yasunobu; Numazawa, Shinichi; Watanabe, Kazuo

    2013-10-01

    Nineteen patients with cervical dumbbell tumors treated surgically were analyzed retrospectively. Surgical strategies for dumbbell tumor were discussed from the perspective of safe, less-invasive surgery. Patients included 6 men and 13 women, with a mean age at the time of surgery of 48.3 years (range, 25-70 years). Underlying pathologies included 16 schwannomas, 2 neurofibromas, and 1 double tumor (schwannoma and meningioma). According to Eden's classification, one patient was classified as Type 1, 5 as Type 2, 8 as Type 3, and 5 as Type 4. In 13 cases, tumors were excised through the posterior approach alone, compared to five cases using the anterior approach. One case was excised using combined anterior and posterior approaches. Facetectomy was not performed in 18 cases. In one case, the facet joint on one side had already destroyed and needed instrumentation. Tumors were totally excised in all cases. Postoperatively, the patients did not display any further neurological deficit, with the exception of transient radiculopathy in two patients. Major surgical complications and cerebrospinal fluid leakage were not seen. Tumor recurrence and spinal segmental instability were not found during follow-up period (mean, 41.6 months). Dumbbell tumor surgery requires sufficient debulking of the epidural and paravertebral mass, using intraoperative nerve stimulation and Doppler ultrasonography to detect the vertebral artery. When using a posterior approach, recapping laminoplasty using an ultrasonic bone curette is very useful to remove tumor without sacrificing facet joints.

  10. [Changing surgical therapy because of clinical studies?].

    Science.gov (United States)

    Schwenk, W; Haase, O; Müller, J M

    2002-04-01

    The randomised controlled clinical trial (RCT) is a powerful instrument to evaluate different therapeutic regimens. In a survey among 115 physicians visiting the 25th annual meeting of the Surgical Society of Berlin and Brandenburg, the RCT was judged to be very important when changes of therapeutic strategies are discussed. 90 % of all participants claimed to use data from RCTs in the clinical routine and 89 % would participate in such a trial. In official (e. g. discussions during coffee breaks at scientific meetings) or non-medical (e. g. non-scientific press or media) sources of information were assessed as irrelevant for decisions regarding therapeutic strategies. However, in contrast to this view laparoscopic cholecystectomy was introduced into clinical practice rapidly because patients informed by external (non-medical) sources preferred to be operated on with the "modern" technique. Clinical trials with a high level of evidence had no relevant influence on the rapid distribution of laparoscopic cholecystectomy. Controversial discussions concerning the extent of lymphadenectomy with gastric resection for carcinoma demonstrate that the value of excellent clinical RCTs is low if their results challenge a stable paradigma of the surgical scientific society. To allow a rational judgement, new surgical technologies should undergo a scientific gradual evaluation in agreement with the principles of evidence based medicine.

  11. The Effect of Growth Temperature and V/III Flux Ratio of MOCVD Antimony Based Semiconductors on Growth Rate and Surface Morphology

    Directory of Open Access Journals (Sweden)

    Ramelan Ari Handono

    2017-01-01

    Full Text Available Epitaxial Alx Ga1-x Sb layers on GaSb and GaAs substrates have been grown by atmospheric pressure metalorganic chemical vapor deposition using TMAl, TMGa and TMSb. Nomarski microscope and a profiler were employed to examine the surface morphology and growth rate of the samples. We report the effect of growth temperature and V/III flux ratio on growth rate and surface morphology. Growth temperatures in the range of 520°C and 680°C and V/III ratios from 1 to 5 have been investigated. A growth rate activation energy of 0.73 eV was found. At low growth temperatures between 520 and 540°C, the surface morphology is poor due to antimonide precipitates associated with incomplete decomposition of the TMSb. For layers grown on GaAs at 580°C and 600°C with a V/III ratio of 3 a high quality surface morphology is typical, with a mirror-like surface and good composition control. It was found that a suitable growth temperature and V/III flux ratio was beneficial for producing good AlGaSb layers. Undoped AlGaSb grown at 580°C with a V/III flux ratio of 3 at the rate of 3.5 μm/hour shows p-type conductivity with smooth surface morphology

  12. Voice tuning with new instruments for type II thyroplasty in the treatment of adductor spasmodic dysphonia.

    Science.gov (United States)

    Sanuki, Tetsuji; Yumoto, Eiji; Toya, Yutaka; Kumai, Yoshihiko

    2016-10-01

    Adductor spasmodic dysphonia is a rare voice disorder characterized by strained and strangled voice quality with intermittent phonatory breaks and adductory vocal fold spasms. Type II thyroplasty differs from previous treatments in that this surgery does not involve any surgical intervention into the laryngeal muscle, nerve or vocal folds. Type II thyroplasty intervenes in the thyroid cartilage, which is unrelated to the lesion. This procedure, conducted with the aim of achieving lateralization of the vocal folds, requires utmost surgical caution due to the extreme delicacy of the surgical site, critically sensitive adjustment, and difficult procedures to maintain the incised cartilages at a correct position. During surgery, the correct separation of the incised cartilage edges with voice monitoring is the most important factor determining surgical success and patient satisfaction. We designed new surgical instruments: a thyroid cartilage elevator for undermining the thyroid cartilage, and spacer devices to gauge width while performing voice monitoring. These devices were designed to prevent surgical complications, and to aid in selecting the optimal size of titanium bridges while temporally maintaining a separation during voice monitoring. We designed new surgical instruments, including a thyroid cartilage elevator and spacer devices. Precise surgical procedures and performing voice tuning during surgery with the optimal separation width of the thyroid cartilage are key points for surgical success. We introduce the technique of voice tuning using these surgical tools in order to achieve a better outcome with minimal surgical complications. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  13. Manual Control for Medical Instruments in Minimally Invasive Surgery

    NARCIS (Netherlands)

    Fan, C.

    2014-01-01

    With the introduction of new technologies, surgical procedures have been varying from free access in open surgery towards limited access in minimal invasive surgery. During such procedures, surgeons have to manoeuver the instruments from outside the patient while looking at the monitor. Long and

  14. Modified rotatory instruments for transphenoidal surgery: technical note.

    Science.gov (United States)

    Marino Júnior, R

    1979-12-01

    A series of modified gyratory bayonets instruments is described. They have the advantage to allow any adjustable position within a 360 degree rotation angle, during the various surgical steps of transphenoidal surgery, thus keeping the surgeon's hand always at the same position.

  15. Modified rotatory instruments for transphenoidal surgery: technical note

    Directory of Open Access Journals (Sweden)

    Raul Marino Jr

    1979-12-01

    Full Text Available A series of modified gyratory bayonets instruments is described. They have the advantage to allow any adjustable position within a 360° rotation angle, during the various surgical steps of transphenoidal surgery, thus keeping the surgeon's hand always at the same position.

  16. The importance of protecting surgical instrument tables from intraoperative contamination in clean surgeries Importancia de la protección de la mesa de instrumentos quirúrgicos en la contaminación intraoperatoria de cirugías limpias Importância da proteção da mesa de instrumentais cirúrgicos na contaminação intraoperatória de cirurgias limpas

    Directory of Open Access Journals (Sweden)

    Aline Mesquita Amaral

    2013-02-01

    Full Text Available OBJECTIVE: to compare the degree of bacterial contamination of surgical instrument tables used in clean surgical procedures, either protected with plastic fields, sterilized with ethylene oxide, or disinfected with 70% alcohol and 1% iodine solutions. This is a randomized clinical trial in which samples were collected from the surfaces of surgical instrument tables before and after each procedure. Microbiological analysis was performed to identify microorganisms and their respective antimicrobial resistance. RESULTS: Bacterial growth in the surgeries using sterilized plastic was 5.71% before and 28.6% after surgery and, 2.9% and 45.7% respectively in surgeries using disinfection with 70% alcohol and 1% iodine solutions; no statistical difference was found between the methods. CONCLUSION: both methods present similar protection, however, 70% alcohol and 1% iodine do not generate solid waste.El objetivo del estudio fue analizar el grado de contaminación bacteriana de la mesa de instrumentos quirúrgicos en dos casos, después del uso: cubierta protectora plástico de la mesa quirúrgica esterilizada con óxido de etileno o desinfección con solución de alcohol a 70% y yodo a 1%, en procedimientos quirúrgicos limpios. Se trata de un experimento clínico aleatorio, con recolección de muestras de las superficies de las mesas de instrumentos quirúrgicos, antes y después de cada procedimiento, con posterior análisis microbiológica para identificar los microorganismos y la resistencia antimicrobiana. En las cirugías en que el plástico esterilizado fue utilizado, el crecimiento bacteriano fue de 5,71% antes y 28,6% después de la cirugía, en cuanto que en las desinfecciones con solución de alcohol a 70% y yodo a 1%, el crecimiento fue de 2,9% antes y 45,7% después, lo que indica que no hubo diferencia significativa entre los métodos empleados. Los dos métodos tienen poder de protección semejante, considerando que el alcohol a 70% y yodo a

  17. EFFECT OF INFORMATION SERVICES USING THE MEDIA FILM TO SELF-CONFIDENCE STUDENT OF CLASS VIII SMP NEGERI 8 METRO

    Directory of Open Access Journals (Sweden)

    MUDAIM MUDAIM

    2015-06-01

    Full Text Available Abstract: Pessimism and attitudes that consider themselves weak and does not have the ability when facing a problem will make individual impediment in the task of development. Problems confidence that underlies the research are: a Students are less confident in the ability it has, b Students feel pessimistic when faced with an issue, c Student perception subjectively, d Students still do not do the work independently, and e negative minded students with a state-owned. The problems of this study are whether there is an influence of information services using the medium of film to the confidence of eighth-grade students of SMP Negeri 8 Metro. The purpose of this study was to determine whether there is an influence of information services using the medium of film to the self-confidence of students in class VIII SMP Negeri 8 Metro. Subject participant is graders VIII-E total 30 students. Data were collected by questionnaire self-confidence and analyzed the data used is the t-test. The results of this study, shown by the difference in change scores of confidence from the pre-test and post-test of 17.1. Testing the hypothesis obtained calculation results thitung6,036> table = 1.699. The conclusion is that the information services implemented using the film medium can be a positive influence on self-esteem, especially students of class VIII. The advice given is to use the medium of film should be done intensively and more creative by BK teachers in giving information service. Keywords: Confidence, Service Information Using Media Film.

  18. Development and preliminary validation of a post-fistula repair reintegration instrument among Ugandan women

    OpenAIRE

    El Ayadi, Alison; Nalubwama, Hadija; Barageine, Justus; Neilands, Torsten B.; Obore, Susan; Byamugisha, Josaphat; Kakaire, Othman; Mwanje, Haruna; Korn, Abner; Lester, Felicia; Miller, Suellen

    2017-01-01

    Background Obstetric fistula is a debilitating and traumatic birth injury affecting 2?3 million women globally, mostly in sub-Saharan Africa and Asia. Affected women suffer physically, psychologically and socioeconomically. International efforts have increased access to surgical treatment, yet attention to a holistic outcome of post-surgical rehabilitation is nascent. We sought to develop and pilot test a measurement instrument to assess post-surgical family and community reintegration. Metho...

  19. [What's new in instrumental dermatology?].

    Science.gov (United States)

    Amici, J-M

    2014-12-01

    This "What's new in instrumental dermatology" focuses on cutaneous oncologic surgery, base on a review of the 2012-2014 literature. First, the ability of dermatologists to make a good "oncologic reading of tumors" is the key of radical surgical treatment. Advantages and disadvantages of the biopsy are discussed. Then, the second message is the management of anticoagulants, that should not be interrupted for skin surgery. Despite recommendations, this practice is not followed in 40% of cases; this point is critical because bleeding complications are minor compared to potential morbidity of thrombotic events when stopping these medications. Regarding infection, nasal carriage of Staphylococcus aureus is identified as a risk factor for wound infection. A preoperative shower with chlorhexidine and mupirocin topical decolonization of nostril reduces this risk. Surgical techniques are trying to reach minimalism, by reducing undermining and scarring. On the trunk, using deep slow resorbable sutures improve scarring. In addition using adhesive sutures (strip) reduce the wideness of scar. On the face, the lower third of the nose is the most challenging because of the free edges, which are deformable. In this location bilobed or trilobed transposition flap offer the advantage of remaining in the nasal aesthetic unit and not disturbing the free edges of the nasal orifices. Regarding scarring, early hypertrophic scar is now well defined and linked with transposition flaps of the nasal region. An early treatment with intralesional corticosteroid injection appears to be effective. Finally, the biological mechanism of the effectiveness of compression in the prevention and treatment of dystrophic scar is now clear. The mechanotransduction explain how a mechanical stress of the skin activates biological cell pathways, which regulate the quality of collagen synthesis and the arrangement of skin fibrosis. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  20. Surgical infections with Mycoplasma

    DEFF Research Database (Denmark)

    Levi-Mazloum, Niels Donald; Prag, Jørgen Brorson; Jensen, J S

    1997-01-01

    Mycoplasma hominis and Ureaplasma urealyticum are common inhabitants of the human genital tract. Evidence for an aetiological role in pyelonephritis, pelvic inflammatory disease, post-abortion and post-partum fever has been presented. There are sporadic reports of Mycoplasma causing serious extra...... extragenital infection such as septicemia, septic arthritis, neonatal meningitis and encephalitis. We review 38 cases of surgical infections with Mycoplasma.......Mycoplasma hominis and Ureaplasma urealyticum are common inhabitants of the human genital tract. Evidence for an aetiological role in pyelonephritis, pelvic inflammatory disease, post-abortion and post-partum fever has been presented. There are sporadic reports of Mycoplasma causing serious...

  1. [Surgical methods of abortion].

    Science.gov (United States)

    Linet, T

    2016-12-01

    A state of the art of surgical method of abortion focusing on safety and practical aspects. A systematic review of French-speaking or English-speaking evidence-based literature about surgical methods of abortion was performed using Pubmed, Cochrane and international recommendations. Surgical abortion is efficient and safe regardless of gestational age, even before 7 weeks gestation (EL2). A systematic prophylactic antibiotics should be preferred to a targeted antibiotic prophylaxis (grade A). In women under 25 years, doxycycline is preferred (grade C) due to the high prevalence of Chlamydia trachomatis. Systematic cervical preparation is recommended for reducing the incidence of complications from vacuum aspiration (grade A). Misoprostol is a first-line agent (grade A). When misoprostol is used before a vacuum aspiration, a dose of 400 mcg is recommended. The choice of vaginal route or sublingual administration should be left to the woman: (i) the vaginal route 3 hours before the procedure has a good efficiency/safety ratio (grade A); (ii) the sublingual administration 1 to 3 hours before the procedure has a higher efficiency (EL1). The patient should be warned of more common gastrointestinal side effects. The addition of mifepristone 200mg 24 to 48hours before the procedure is interesting for pregnancies between 12 and 14 weeks gestations (EL2). The systematic use of nonsteroidal anti-inflammatory drugs is recommended for limiting the operative and postoperative pain (grade B). Routine vaginal application of an antiseptic prior to the procedure cannot be recommended (grade B). The type of anesthesia (general or local) should be left up to the woman after explanation of the benefit-risk ratio (grade B). Paracervical local anesthesia (PLA) is recommended before performing a vacuum aspiration under local anesthesia (grade A). The electric or manual vacuum methods are very effective, safe and acceptable to women (grade A). Before 9 weeks gestation

  2. Seleucid, Demotic and Mediterranean mathematics versus Chapters VIII and IX of the Nine Chapters: accidental or significant similarities?

    DEFF Research Database (Denmark)

    Høyrup, Jens

    Similarities of geometrical diagrams and arithmetical structures of problems have often been taken as evidence of transmission of mathematical knowledge or techniques between China and “the West”. Confronting on one hand some problems from Chapter VIII of the Nine Chapters with comparable problems...... known from Ancient Greek sources, on the other a Seleucid collection of problems about rectangles with a subset of the triangle problems from Chapter IX, it is concluded, (1) that transmission of some arithmetical riddles without method – not “from Greece” but from a transnational community of traders...

  3. Recombinant factor VIII Fc fusion protein for the prevention and treatment of bleeding in children with severe hemophilia A.

    Science.gov (United States)

    Young, G; Mahlangu, J; Kulkarni, R; Nolan, B; Liesner, R; Pasi, J; Barnes, C; Neelakantan, S; Gambino, G; Cristiano, L M; Pierce, G F; Allen, G

    2015-06-01

    Prophylactic factor replacement, which prevents hemarthroses and thereby reduces the musculoskeletal disease burden in children with hemophilia A, requires frequent intravenous infusions (three to four times weekly). Kids A-LONG was a phase 3 open-label study evaluating the safety, efficacy and pharmacokinetics of a longer-acting factor, recombinant factor VIII Fc fusion protein (rFVIIIFc), in previously treated children with severe hemophilia A (endogenous FVIII level of hemophilia A. © 2015 The Authors. Journal of Thrombosis and Haemostasis published by Wiley Periodicals, Inc. on behalf of International Society on Thrombosis and Haemostasis.

  4. Evaluation of the integrity of reactor vessels designed to ASME Code, Sections I and/or VIII

    International Nuclear Information System (INIS)

    Hoge, K.G.

    1976-01-01

    A documented review of nuclear reactor pressure vessels designed to ASME Code, Sections I and/or VIII is made. The review is primarily concerned with the design specifications and quality assurance programs utilized for the reactor vessel construction and the status of power plant material surveillance programs, pressure-temperature operating limits, and inservice inspection programs. The following ten reactor vessels for light-water power reactors are covered in the report: Indian Point Unit No. 1, Dresden Unit No. 1, Yankee Rowe, Humboldt Bay Unit No. 3, Big Rock Point, San Onofre Unit No. 1, Connecticut Yankee, Oyster Creek, Nine Mile Point Unit No. 1, and La Crosse

  5. Love and/in psychoanalysis: a commentary on Lacan's reading of Plato's Symposium in Seminar VIII: Transference.

    Science.gov (United States)

    Fink, Bruce

    2015-02-01

    What is love and what part does it play in psychoanalysis? Where are the analyst and the analysand situated in relation to the roles defined as those of the "lover" and the "beloved"? Jacques Lacan explores these and other questions in his soon-to-be-published Seminar VIII: Transference by providing an extensive commentary on Plato's most famous dialogue on love, the Symposium. This paper outlines some of the major points about love that grow out of Lacan's reading of the dialogue and examines their relevance to the analytic setting. Can the analyst be characterized as a sort of modern-day Socrates?

  6. EK(b)P Keskkomitee VIII pleenumi stenogramm / tõlk. Mart Arold, tõlk. Jaan Isotamm

    Index Scriptorium Estoniae

    1999-01-01

    EK(b)P Keskkomitee VIII pleenum, 21.-23. märts 1950. Sõnavõtud: N. Karotamm, P. Ponomarenko, I. Käbin, V. Kuusik, A. Jaanus, V. Hiznjakov, E. Ristimägi, I. Suija, H. Ajo, A. Meri, G. Abels, M. Assin, G. Latõshov, Rumjantsev, Müürisepp. Kommenteerinud Viktor Niitsoo. Algus: Akadeemia (1998) nr. 12, lk. 2655-2683 ; Järg nr.2;3;4;5;6;7;8;9;10 lk.415-446;639-670;863-894;1087-1118;1310-1342;1534-1566;1759-1790;2017-2048;2220-2256

  7. Paleopatología dental de una muestra esquelética de Tarraco (Siglos I-VIII)

    OpenAIRE

    Salagaray García, Maria Teresa

    2017-01-01

    Las patologías dentales nos permiten comprender no solo esl estado de salud, sino también el progreso económico, social y cultural de las poblaciones pretéritas. La presente muestra consta de 332 individuos, 6240 dientes pertenecientes a diez yacimientos de Tarraco comprendidos entre los siglos I y VIII d.C. El presente trabajo pretende no sólo conocer la prevalencia de los dientes perdidos ante mortem, caries, reabsorción alveolar, cálculo, fístula, desgaste e hipoplasia sino también la rela...

  8. SURgical interventions with FEIBA (SURF): international registry of surgery in haemophilia patients with inhibitory antibodies.

    Science.gov (United States)

    Négrier, C; Lienhart, A; Numerof, R; Stephens, D; Wong, W Y; Baghaei, F; Yee, T T

    2013-05-01

    Factor VIII Inhibitor Bypassing Activity (FEIBA) can effectively achieve haemostasis in haemophilia patients with inhibitors. Further evaluation of FEIBA in surgical settings is of significant interest considering the relatively limited prospective data published to date. The aim of the study is to evaluate the perioperative efficacy and safety of FEIBA in haemophilia patients with inhibitors. Haemophilia patients with inhibitors who underwent surgical procedures and received FEIBA for perioperative haemostatic control were prospectively enrolled in an open-label, noninterventional, postauthorization study [SURgical interventions with FEIBA (SURF)]. Outcome measures included haemostatic efficacy, safety, FEIBA exposure and blood loss associated with the perioperative use of FEIBA. Thirty-five surgical procedures were performed at 19 centres worldwide in patients with congenital haemophilia A, congenital haemophilia B, or acquired haemophilia A. Haemorrhagic risk was severe in 37.1% (13 of 35) of the procedures, moderate in 25.7% (9 of 35) and mild in 37.1% (13 of 35). One moderate risk surgery was excluded from the efficacy analyses because it did not meet all protocol requirements. Haemostasis was judged to be 'good' or 'excellent' in 91.2% (31 of 34) of surgical procedures and 'fair' in 8.8% (3 of 34). Among the 12 adverse events, three were serious adverse events (SAEs), two of which were unrelated to FEIBA therapy; one SAE, a clot in an arteriovenous fistula, was deemed to be possibly related to therapy. This prospective investigation confirms that FEIBA can be safely and effectively used when performing surgical procedures in haemophilia patients with inhibitors. © 2013 Blackwell Publishing Ltd.

  9. Remote instrument telemaintenance.

    Science.gov (United States)

    Laugier, A; Allahwerdi, N; Baudin, J; Gaffney, P; Grimson, W; Groth, T; Schilders, L

    1996-07-01

    In the past decade, great technological progress has been made in telemaintenance of mainframe and mini computers. As hardware technology is now available at an acceptable cost, computer aided trouble-shooting can be adapted to laboratory instrumentation in order to significantly improve repair time, avoid instrument downtime by taking advantage of predictive methods, and provide general diagnostic assistance. Depending on the size of the instrument, the telemaintenance facility can be dedicated to a single instrument or alternatively a telemaintenance server can manage multiple distributed small instruments through a Local Area Network. As complex failures can occur, the local diagnosis capabilities may be exceeded and automatic dialing for connection to computerized Remote Maintenance Centers is needed. The main advantages of such a centre, as compared to local diagnosis systems, are the increased access to more information and experience of failures from instrument installations, and consequently the provision of training data updates for Artificial Neural Networks and Knowledge Based Systems in general. When an abnormal situation is detected or anticipated by a diagnosis module, an automatic alert is given to the user, local diagnosis is activated, and for simple solutions, instructions are given to the operator. In the last resort, a human expert can be alerted who, with remote control tools, can attend to the failures. For both local and remote trouble-shooting, the data provided by the instrument and connected workstation is of paramount importance for the efficiency and accuracy of the diagnosis. Equally, the importance of standardization of telemaintenance communication protocols is addressed.

  10. Medical instruments in museums

    DEFF Research Database (Denmark)

    Söderqvist, Thomas; Arnold, Ken

    2011-01-01

    This essay proposes that our understanding of medical instruments might benefit from adding a more forthright concern with their immediate presence to the current historical focus on simply decoding their meanings and context. This approach is applied to the intriguingly tricky question of what...... actually is meant by a "medical instrument." It is suggested that a pragmatic part of the answer might lie simply in reconsidering the holdings of medical museums, where the significance of the physical actuality of instruments comes readily to hand....

  11. Instrumentation reference book

    CERN Document Server

    Boyes, Walt

    2002-01-01

    Instrumentation is not a clearly defined subject, having a 'fuzzy' boundary with a number of other disciplines. Often categorized as either 'techniques' or 'applications' this book addresses the various applications that may be needed with reference to the practical techniques that are available for the instrumentation or measurement of a specific physical quantity or quality. This makes it of direct interest to anyone working in the process, control and instrumentation fields where these measurements are essential.* Comprehensive and authoritative collection of technical information* Writte

  12. Microcomputers for nuclear instrumentation

    International Nuclear Information System (INIS)

    Byrd, J.S.

    1979-01-01

    Small, desk-top Commodore PET computers are being used to solve nuclear instrumentation problems at the Savannah River Laboratory (SRL). The ease of operating, programing, interfacing, and maintaining the PET computer makes it a cost-effective solution to many real-time instrumentation problems that involve both data acquisition and date processing. The IEEE-488 GPIB (General Purpose Instrument Bus) is an integral part of the PET hardware. This paper reviews GPIB design concepts and discusses SRL applications that use the PET computer as a GPIB controller. 11 figures, 2 tables

  13. The latest radiation instrument

    International Nuclear Information System (INIS)

    Kang, Se Sik; Gwon, Dal Gwan; Kim, Gyeong Geum

    2008-08-01

    This book deals with the latest radiation instrument, which is comprised of eight chapters. It explains X rays instrument for medial treatment, X-ray tube instrument and permissible burden with its history, structure and characteristic high voltage apparatus with high voltage rectifier circuit, X-ray control apparatus for medical treatment, X-ray image equipment X-ray television apparatus and CCD 205, X-ray apparatus of install and types, Digital X-ray apparatus with CR 261 and DR 269, performance management on X-ray for medical treatment with its history, necessity and management in the radiation field.

  14. Soil monitoring instrumentation

    International Nuclear Information System (INIS)

    Umbarger, C.J.

    1980-01-01

    The Los Alamos Scientific Laboratory (LASL) has an extensive program for the development of nondestructive assay instrumentation for the quantitative analysis of transuranic (TRU) materials found in bulk solid wastes generated by Department of Energy facilities and by the commercial nuclear power industry. Included are wastes generated in decontamination and decommissioning of outdated nuclear facilities as well as wastes from old waste burial ground exhumation programs. The assay instrumentation is designed to have detection limits below 10 nCi/g wherever practicable. Because of the topic of this workshop, only the assay instrumentation applied specifically to soil monitoring will be discussed here. Four types of soil monitors are described

  15. Soil monitoring instrumentation

    International Nuclear Information System (INIS)

    Umbarger, C.J.

    1981-01-01

    The Los Alamos Scientific Laboratory (LASL) has an extensive program for the development of nondestructive assay instrumentation for the quantitative analysis of transuranic (TRU) materials found in bulk solid wastes generated by Department of Energy facilities and by the commercial nuclear power industry. Included are wastes generated in decontamination and decommissioning of outdated nuclear facilities, as well as from old waste-burial-ground exhumation programs. The assay instrumentation is designed to have detection limits below 10 nCi/g wherever practicable. The assay instrumentation that is applied specifically to soil monitoring is discussed

  16. Reducing healthcare costs facilitated by surgical auditing: a systematic review.

    Science.gov (United States)

    Govaert, Johannes Arthuur; van Bommel, Anne Charlotte Madeline; van Dijk, Wouter Antonie; van Leersum, Nicoline Johanneke; Tollenaar, Robertus Alexandre Eduard Mattheus; Wouters, Michael Wilhemus Jacobus Maria

    2015-07-01

    Surgical auditing has been developed in order to benchmark and to facilitate quality improvement. The aim of this review is to determine if auditing combined with systematic feedback of information on process and outcomes of care results in lower costs of surgical care. A systematic search of published literature before 21-08-2013 was conducted in Pubmed, Embase, Web of Science, and Cochrane Library. Articles were selected if they met the inclusion criteria of describing a surgical audit with cost-evaluation. The systematic search resulted in 3608 papers. Six studies were identified as relevant, all showing a positive effect of surgical auditing on quality of healthcare and therefore cost savings was reported. Cost reductions ranging from $16 to $356 per patient were seen in audits evaluating general or vascular procedures. The highest potential cost reduction was described in a colorectal surgical audit (up to $1,986 per patient). All six identified articles in this review describe a reduction in complications and thereby a reduction in costs due to surgical auditing. Surgical auditing may be of greater value when high-risk procedures are evaluated, since prevention of adverse events in these procedures might be of greater clinical and therefore of greater financial impact. This systematic review shows that surgical auditing can function as a quality instrument and therefore as a tool to reduce costs. Since evidence is scarce so far, further studies should be performed to investigate if surgical auditing has positive effects to turn the rising healthcare costs around. In the future, incorporating (actual) cost analyses and patient-related outcome measures would increase the audits' value and provide a complete overview of the value of healthcare.

  17. Journal of Surgical Technique and Case Report

    African Journals Online (AJOL)

    The aim of Journal of Surgical Technique and Case Report is to advance surgical knowledge and practice by promoting the reporting of innovative and reproducible surgical techniques and illustrative surgical cases on various surgical disciplines. The journal encourages authoritative synthesis of current surgical literature ...

  18. Pneumatic-type surgical robot end-effector for laparoscopic surgical-operation-by-wire.

    Science.gov (United States)

    Lee, Chiwon; Park, Woo Jung; Kim, Myungjoon; Noh, Seungwoo; Yoon, Chiyul; Lee, Choonghee; Kim, Youdan; Kim, Hyeon Hoe; Kim, Hee Chan; Kim, Sungwan

    2014-09-05

    Although minimally invasive surgery (MIS) affords several advantages compared to conventional open surgery, robotic MIS systems still have many limitations. One of the limitations is the non-uniform gripping force due to mechanical strings of the existing systems. To overcome this limitation, a surgical instrument with a pneumatic gripping system consisting of a compressor, catheter balloon, micro motor, and other parts is developed. This study aims to implement a surgical instrument with a pneumatic gripping system and pitching/yawing joints using micro motors and without mechanical strings based on the surgical-operation-by-wire (SOBW) concept. A 6-axis external arm for increasing degrees of freedom (DOFs) is integrated with the surgical instrument using LabVIEW® for laparoscopic procedures. The gripping force is measured over a wide range of pressures and compared with the simulated ideal step function. Furthermore, a kinematic analysis is conducted. To validate and evaluate the system's clinical applicability, a simple peg task experiment and workspace identification experiment are performed with five novice volunteers using the fundamentals of laparoscopic surgery (FLS) board kit. The master interface of the proposed system employs the hands-on-throttle-and-stick (HOTAS) controller used in aerospace engineering. To develop an improved HOTAS (iHOTAS) controller, 6-axis force/torque sensor was integrated in the special housing. The mean gripping force (after 1,000 repetitions) at a pressure of 0.3 MPa was measured to be 5.8 N. The reaction time was found to be 0.4 s, which is almost real-time. All novice volunteers could complete the simple peg task within a mean time of 176 s, and none of them exceeded the 300 s cut-off time. The system's workspace was calculated to be 11,157.0 cm3. The proposed pneumatic gripping system provides a force consistent with that of other robotic MIS systems. It provides near real-time control. It is more durable than the

  19. Modern spinal instrumentation. Part 1: Normal spinal implants

    International Nuclear Information System (INIS)

    Davis, W.; Allouni, A.K.; Mankad, K.; Prezzi, D.; Elias, T.; Rankine, J.; Davagnanam, I.

    2013-01-01

    The general radiologist frequently encounters studies demonstrating spinal instrumentation, either as part of the patient's postoperative evaluation or as incidental to a study performed for another purpose. There are various surgical approaches and devices used in spinal surgery with an increased understanding of spinal and spinal implant biomechanics drives development of modern fixation devices. It is, therefore, important that the radiologist can recognize commonly used devices and identify their potential complications demonstrated on imaging. The aim of part 1 of this review is to familiarize the reader with terms used to describe surgical approaches to the spine, review the function and normal appearances of commonly used instrumentations, and understand the importance of the different fixation techniques. The second part of this review will concentrate on the roles that the different imaging techniques play in assessing the instrumented spine and the recognition of complications that can potentially occur.

  20. Synthesis of dispersive iron or iron–silver nanoparticles on engineered capsid pVIII of M13 virus with electronegative terminal peptides

    International Nuclear Information System (INIS)

    Zhang, Shuai; Nakano, Kazuhiko; Zhang, Shu-liang; Yu, Hui-min

    2015-01-01

    M13 is a filamentous Escherichia coli virus covered with five types of capsid proteins, in which pVIII with ∼2700 copies was around the cylindered surface and pIII with five copies located at one end of the phage particle. The pIII-engineered M13 phages with enhanced binding specificity toward Fe were screened after five rounds of biopanning, and the one containing ATPTVAMSLSPL peptide at pIII-terminus was selected for mediated synthesis of zero valent (ZV) Fe nanoparticles (NPs) with the wild M13 as control. Under a reducing environment, uniformly dispersed ZVFeNPs with diameter of 5–10 nm were both synthesized and the morphologies after annealing were confirmed to be face-centered cubic type. The synthesized FeNPs mediated by the two phages showed no significant difference, revealing that the pVIII capsid did dominant contribution to metal binding in comparison with the pIII. A novel pVIII-engineered M13 containing AAEEEDPAK at terminus, named as 4ED-pVIII-M13, was constructed and it carried one more negatively charged residue than the wild one (AEGDDPAK). Metal adsorption quantification showed that the binding affinity of the 4ED-pVIII-M13 toward Ag and Ni ions improved to 62 and 18 % from original 21 and 6 %, respectively. The binding affinity toward Fe remained constant (∼85 %). ZVFe–Ag bi-NPs were successfully synthesized through mediation of 4ED-pVIII-M13. Particularly, the Fe:Ag ratio in the bi-NPs was conveniently controlled through changing the molar concentration of FeCl 2 and AgNO 3 solution before reduction

  1. Synthesis of dispersive iron or iron-silver nanoparticles on engineered capsid pVIII of M13 virus with electronegative terminal peptides

    Science.gov (United States)

    Zhang, Shuai; Nakano, Kazuhiko; Zhang, Shu-liang; Yu, Hui-min

    2015-10-01

    M13 is a filamentous Escherichia coli virus covered with five types of capsid proteins, in which pVIII with 2700 copies was around the cylindered surface and pIII with five copies located at one end of the phage particle. The pIII-engineered M13 phages with enhanced binding specificity toward Fe were screened after five rounds of biopanning, and the one containing ATPTVAMSLSPL peptide at pIII-terminus was selected for mediated synthesis of zero valent (ZV) Fe nanoparticles (NPs) with the wild M13 as control. Under a reducing environment, uniformly dispersed ZVFeNPs with diameter of 5-10 nm were both synthesized and the morphologies after annealing were confirmed to be face-centered cubic type. The synthesized FeNPs mediated by the two phages showed no significant difference, revealing that the pVIII capsid did dominant contribution to metal binding in comparison with the pIII. A novel pVIII-engineered M13 containing AAEEEDPAK at terminus, named as 4ED-pVIII-M13, was constructed and it carried one more negatively charged residue than the wild one (AEGDDPAK). Metal adsorption quantification showed that the binding affinity of the 4ED-pVIII-M13 toward Ag and Ni ions improved to 62 and 18 % from original 21 and 6 %, respectively. The binding affinity toward Fe remained constant ( 85 %). ZVFe-Ag bi-NPs were successfully synthesized through mediation of 4ED-pVIII-M13. Particularly, the Fe:Ag ratio in the bi-NPs was conveniently controlled through changing the molar concentration of FeCl2 and AgNO3 solution before reduction.

  2. Synthesis of dispersive iron or iron–silver nanoparticles on engineered capsid pVIII of M13 virus with electronegative terminal peptides

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Shuai; Nakano, Kazuhiko; Zhang, Shu-liang; Yu, Hui-min, E-mail: yuhm@tsinghua.edu.cn [Tsinghua University, Key Laboratory of Industrial Biocatalysis of the Ministry of Education, Department of Chemical Engineering (China)

    2015-10-15

    M13 is a filamentous Escherichia coli virus covered with five types of capsid proteins, in which pVIII with ∼2700 copies was around the cylindered surface and pIII with five copies located at one end of the phage particle. The pIII-engineered M13 phages with enhanced binding specificity toward Fe were screened after five rounds of biopanning, and the one containing ATPTVAMSLSPL peptide at pIII-terminus was selected for mediated synthesis of zero valent (ZV) Fe nanoparticles (NPs) with the wild M13 as control. Under a reducing environment, uniformly dispersed ZVFeNPs with diameter of 5–10 nm were both synthesized and the morphologies after annealing were confirmed to be face-centered cubic type. The synthesized FeNPs mediated by the two phages showed no significant difference, revealing that the pVIII capsid did dominant contribution to metal binding in comparison with the pIII. A novel pVIII-engineered M13 containing AAEEEDPAK at terminus, named as 4ED-pVIII-M13, was constructed and it carried one more negatively charged residue than the wild one (AEGDDPAK). Metal adsorption quantification showed that the binding affinity of the 4ED-pVIII-M13 toward Ag and Ni ions improved to 62 and 18 % from original 21 and 6 %, respectively. The binding affinity toward Fe remained constant (∼85 %). ZVFe–Ag bi-NPs were successfully synthesized through mediation of 4ED-pVIII-M13. Particularly, the Fe:Ag ratio in the bi-NPs was conveniently controlled through changing the molar concentration of FeCl{sub 2} and AgNO{sub 3} solution before reduction.

  3. Carbon Footprint Reduction Instruments

    Science.gov (United States)

    This page outlines the major differences between Renewable Energy Certificates (REC) and Project Offsets and what types of claims each instrument allows the organization to make in regards to environmental emissions claims.

  4. CCAT Heterodyne Instrument Development

    Data.gov (United States)

    National Aeronautics and Space Administration — This work will extend and proof-out the design concept for a high pixel count (128 pixels in 2 bands) submillimeter-wave heterodyne receiver array instrument for the...

  5. Fiber Optics Instrumentation Development

    Science.gov (United States)

    Chan, Patrick Hon Man; Parker, Allen R., Jr.; Richards, W. Lance

    2010-01-01

    This is a general presentation of fiber optics instrumentation development work being conducted at NASA Dryden for the past 10 years and recent achievements in the field of fiber optics strain sensors.

  6. Medical instruments in museums

    DEFF Research Database (Denmark)

    Söderqvist, Thomas; Arnold, Ken

    2011-01-01

    This essay proposes that our understanding of medical instruments might benefit from adding a more forthright concern with their immediate presence to the current historical focus on simply decoding their meanings and context. This approach is applied to the intriguingly tricky question of what a...... actually is meant by a "medical instrument." It is suggested that a pragmatic part of the answer might lie simply in reconsidering the holdings of medical museums, where the significance of the physical actuality of instruments comes readily to hand.......This essay proposes that our understanding of medical instruments might benefit from adding a more forthright concern with their immediate presence to the current historical focus on simply decoding their meanings and context. This approach is applied to the intriguingly tricky question of what...

  7. Challenges in marine instrumentation

    Digital Repository Service at National Institute of Oceanography (India)

    Afzulpurkar, S.; Desa, E.; Joseph, A.; Chakraborty, B.; Nayak, M.R.; Ranade, G.

    challenge for technology. Biosensors which can detect bioluminescence and other biological activities would play a major role. Autonomous instrumentation outfitted with different types of in-situ sensors would collect data without disturbing the system...

  8. Nuclear instrument technician training

    International Nuclear Information System (INIS)

    Wollesen, E.S.

    1991-01-01

    This paper reports on Nuclear Instrument Technician (NIT) training that has developed at an accelerated rate over the past three decades. During the 1960's commercial nuclear power plants were in their infancy. For that reason, there is little wonder that NIT training had little structure and little creditability. NIT training, in many early plants, was little more than On-The Job Training (OJT). The seventies brought changes in Instrumentation and Controls as well as emphasis on the requirements for more in depth training and documentation. As in the seventies, the eighties saw not only changes in technologies but tighter requirements, standardized training and the development of accredited Nuclear Instrument Training; thus the conclusion: Nuclear Instrument Training Isn't What It Used To Be

  9. Quantitative analysis of residual protein contamination of podiatry instruments reprocessed through local and central decontamination units.

    Science.gov (United States)

    Smith, Gordon Wg; Goldie, Frank; Long, Steven; Lappin, David F; Ramage, Gordon; Smith, Andrew J

    2011-01-10

    The cleaning stage of the instrument decontamination process has come under increased scrutiny due to the increasing complexity of surgical instruments and the adverse affects of residual protein contamination on surgical instruments. Instruments used in the podiatry field have a complex surface topography and are exposed to a wide range of biological contamination. Currently, podiatry instruments are reprocessed locally within surgeries while national strategies are favouring a move toward reprocessing in central facilities. The aim of this study was to determine the efficacy of local and central reprocessing on podiatry instruments by measuring residual protein contamination of instruments reprocessed by both methods. The residual protein of 189 instruments reprocessed centrally and 189 instruments reprocessed locally was determined using a fluorescent assay based on the reaction of proteins with o-phthaldialdehyde/sodium 2-mercaptoethanesulfonate. Residual protein was detected on 72% (n = 136) of instruments reprocessed centrally and 90% (n = 170) of instruments reprocessed locally. Significantly less protein (p podiatry instruments when protein contamination is considered, though no significant difference was found in residual protein between local decontamination unit and central decontamination unit processes for Blacks files. Further research is needed to undertake qualitative identification of protein contamination to identify any cross contamination risks and a standard for acceptable residual protein contamination applicable to different instruments and specialities should be considered as a matter of urgency.

  10. Quantitative analysis of residual protein contamination of podiatry instruments reprocessed through local and central decontamination units

    Directory of Open Access Journals (Sweden)

    Ramage Gordon

    2011-01-01

    Full Text Available Abstract Background The cleaning stage of the instrument decontamination process has come under increased scrutiny due to the increasing complexity of surgical instruments and the adverse affects of residual protein contamination on surgical instruments. Instruments used in the podiatry field have a complex surface topography and are exposed to a wide range of biological contamination. Currently, podiatry instruments are reprocessed locally within surgeries while national strategies are favouring a move toward reprocessing in central facilities. The aim of this study was to determine the efficacy of local and central reprocessing on podiatry instruments by measuring residual protein contamination of instruments reprocessed by both methods. Methods The residual protein of 189 instruments reprocessed centrally and 189 instruments reprocessed locally was determined using a fluorescent assay based on the reaction of proteins with o-phthaldialdehyde/sodium 2-mercaptoethanesulfonate. Results Residual protein was detected on 72% (n = 136 of instruments reprocessed centrally and 90% (n = 170 of instruments reprocessed locally. Significantly less protein (p Conclusions Overall, the results show the superiority of central reprocessing for complex podiatry instruments when protein contamination is considered, though no significant difference was found in residual protein between local decontamination unit and central decontamination unit processes for Blacks files. Further research is needed to undertake qualitative identification of protein contamination to identify any cross contamination risks and a standard for acceptable residual protein contamination applicable to different instruments and specialities should be considered as a matter of urgency.

  11. VIRUS instrument collimator assembly

    Science.gov (United States)

    Marshall, Jennifer L.; DePoy, Darren L.; Prochaska, Travis; Allen, Richard D.; Williams, Patrick; Rheault, Jean-Philippe; Li, Ting; Nagasawa, Daniel Q.; Akers, Christopher; Baker, David; Boster, Emily; Campbell, Caitlin; Cook, Erika; Elder, Alison; Gary, Alex; Glover, Joseph; James, Michael; Martin, Emily; Meador, Will; Mondrik, Nicholas; Rodriguez-Patino, Marisela; Villanueva, Steven; Hill, Gary J.; Tuttle, Sarah; Vattiat, Brian; Lee, Hanshin; Chonis, Taylor S.; Dalton, Gavin B.; Tacon, Mike

    2014-07-01

    The Visual Integral-Field Replicable Unit Spectrograph (VIRUS) instrument is a baseline array 150 identical fiber fed optical spectrographs designed to support observations for the Hobby-Eberly Telescope Dark Energy Experiment (HETDEX). The collimator subassemblies of the instrument have been assembled in a production line and are now complete. Here we review the design choices and assembly practices used to produce a suite of identical low-cost spectrographs in a timely fashion using primarily unskilled labor.

  12. Maintenance of scientific instruments

    International Nuclear Information System (INIS)

    Lucero, E.

    1986-01-01

    During the last years Colombia has increased the use of nuclear techniques, instruments and equipment in ambitious health programs, as well as in research centers, industry and education; this has resulted in numerous maintenance problems. As an alternative solution IAN has established a Central Maintenance Laboratory for nuclear instruments within an International Atomic Energy Agency program for eight Latin American and nine Asian Countries. Established strategies and some results are detailed in this writing

  13. Guideline Implementation: Surgical Smoke Safety.

    Science.gov (United States)

    Fencl, Jennifer L

    2017-05-01

    Research conducted during the past four decades has demonstrated that surgical smoke generated from the use of energy-generating devices in surgery contains toxic and biohazardous substances that present risks to perioperative team members and patients. Despite the increase in information available, however, perioperative personnel continue to demonstrate a lack of knowledge of these hazards and lack of compliance with recommendations for evacuating smoke during surgical procedures. The new AORN "Guideline for surgical smoke safety" provides guidance on surgical smoke management. This article focuses on key points of the guideline to help perioperative personnel promote smoke-free work environments; evacuate surgical smoke; and develop education programs and competency verification tools, policies and procedures, and quality improvement initiatives related to controlling surgical smoke. Perioperative RNs should review the complete guideline for additional information and for guidance when writing and updating policies and procedures. Copyright © 2017 AORN, Inc. Published by Elsevier Inc. All rights reserved.

  14. Surgical scar revision: An overview

    Directory of Open Access Journals (Sweden)

    Shilpa Garg

    2014-01-01

    Full Text Available Scar formation is an inevitable consequence of wound healing from either a traumatic or a surgical intervention. The aesthetic appearance of a scar is the most important criteria to judge the surgical outcome. An understanding of the anatomy and wound healing along with experience, meticulous planning and technique can reduce complications and improve the surgical outcome. Scar revision does not erase a scar but helps to make it less noticeable and more acceptable. Both surgical and non-surgical techniques, used either alone or in combination can be used for revising a scar. In planning a scar revision surgeon should decide on when to act and the type of technique to use for scar revision to get an aesthetically pleasing outcome. This review article provides overview of methods applied for facial scar revision. This predominantly covers surgical methods.

  15. Prolonged activity of a recombinant factor VIII-Fc fusion protein in hemophilia A mice and dogs

    Science.gov (United States)

    Dumont, Jennifer A.; Liu, Tongyao; Low, Susan C.; Zhang, Xin; Kamphaus, George; Sakorafas, Paul; Fraley, Cara; Drager, Douglas; Reidy, Thomas; McCue, Justin; Franck, Helen W. G.; Merricks, Elizabeth P.; Nichols, Timothy C.; Bitonti, Alan J.; Pierce, Glenn F.

    2012-01-01

    Despite proven benefits, prophylactic treatment for hemophilia A is hampered by the short half-life of factor VIII. A recombinant factor VIII-Fc fusion protein (rFVIIIFc) was constructed to determine the potential for reduced frequency of dosing. rFVIIIFc has an ∼ 2-fold longer half-life than rFVIII in hemophilia A (HemA) mice and dogs. The extension of rFVIIIFc half-life requires interaction of Fc with the neonatal Fc receptor (FcRn). In FcRn knockout mice, the extension of rFVIIIFc half-life is abrogated, and is restored in human FcRn transgenic mice. The Fc fusion has no impact on FVIII-specific activity. rFVIIIFc has comparable acute efficacy as rFVIII in treating tail clip injury in HemA mice, and fully corrects whole blood clotting time (WBCT) in HemA dogs immediately after dosing. Furthermore, consistent with prolonged half-life, rFVIIIFc shows 2-fold longer prophylactic efficacy in protecting HemA mice from tail vein transection bleeding induced 24-48 hours after dosing. In HemA dogs, rFVIIIFc also sustains partial correction of WBCT 1.5- to 2-fold longer than rFVIII. rFVIIIFc was well tolerated in both species. Thus, the rescue of FVIII by Fc fusion to provide prolonged protection presents a novel pathway for FVIII catabolism, and warrants further investigation. PMID:22246033

  16. Vertical Bridgman growth of thermoelectric clathrate Ba8Ga16Sn30 with a type-VIII structure

    Science.gov (United States)

    Chen, Y. X.; Niitani, K.; Izumi, J.; Suekuni, K.; Takabatake, T.

    2014-09-01

    Type-VIII clathrate Ba8Ga16Sn30 (BGS) is a promising thermoelectric material with tunable carrier types. We have studied the Bridgman growth conditions by combining differential thermal analysis (DTA) and powder X-ray diffraction analysis. It is found that the raw elements Ba, Ga, and Sn react at 465 °C to form the type-VIII BGS compound. The DTA indicates the presence of a liquidus line above the peritectic point of BGS at 495 °C. By using the vertical Bridgman method, single crystals of n-type and p-type BGS have been grown from Sn-rich and Ga-rich initial compositions, respectively. The obtained crystals of n-type Ba8Ga16Sn30 and p-type Ba8Ga16Sn30-xGex (x≈0.7) are 10 mm sized. On several parts cut from the grown crystals, the Seebeck coefficient and electrical resistivity have been measured up to 330 °C. The values weakly change along the vertical direction of the crystals, keeping the thermoelectric power factors as high as 12 and 9 μW/K2 cm, respectively, for n- and p-type crystals.

  17. Il ruolo di El Escorial, V.III.6 e dei suoi discendenti nella tradizione manoscritta del Lucullus

    Directory of Open Access Journals (Sweden)

    Corinna Senore

    2017-05-01

    Full Text Available L’articolo riguarda un gruppo di sette codici che tramanda il testo del Lucullus di Cicerone e che appartiene al ramo della tradizione discendente dal manoscritto Wien, Österreichische Nationalbibliothek 189. I sette manoscritti costituiscono uno stadio della tradizione caratterizzato dalla presenza di tre lacune testuali. Sulla base di alcuni elementi paleografici e della presenza di una glossa riportata a margine del testo di uno di essi, El Escorial, V.III.6 (Scor4, e inglobata all’interno del testo degli altri sei, è possibile individuare in Scor4 il capostipite di questo gruppo della tradizione. Lo studio si occupa inoltre di fare chiarezza sui rapporti che intercorrono tra i sei discendenti di Scor4. The article focuses on a group of seven codices which carry the text of Cicero’s Lucullus. This group belongs to the branch of the tradition descending from the manuscript Wien, Österreichische Nationalbibliothek 189. The seven manuscripts represent a step of the tradition marked by the presence of some textual lacunas. I start from some paleographic elements and from the presence of a gloss on text’s margin of one of them, El Escorial, V.III.6 (Scor4. The gloss has been then incorporated in the text of the other six manuscripts and I assume that Scor4 is the founder of this group of tradition. Furthermore, this article aims to clarify the relations between the six descendants of Scor4.

  18. Future of radiological instrumentation

    International Nuclear Information System (INIS)

    Lucas, A.C.

    1988-01-01

    Future trends in the development of radiation protection instrumentation can be expected to be closely related to current trends in political and social activity that drive legislation, rule-making, and standard practice, with assistance provided by trends in material and electronic technology. Wide-range performance will be emphasized to arm the daily worker with instruments that routinely log background rates and, at the same time, are prepared to measure accident rates. Separate and simultaneous accumulation of data from several sensors to ensure complete coverage of the radiation types will be common. Mathematical manipulation of data will provide for summary data logging and, in some cases, solutions to integral equations to provide corrections to experimental data. Instruments will become more reliable by way of self-checking and correction. Miniaturization and large-scale integration of measuring instruments will provide some instrumentation for the people at large. To be effective, the instruments will necessarily cover a wide range and be very reliable. The net result of these several trends will provide for a widespread understanding of radiation protection and an implementation of as low as reasonably achievable among large segments of the population

  19. [The instrument for thermography].

    Science.gov (United States)

    Hamaguchi, Shinsuke

    2014-07-01

    Thermography is an imaging method using the instrument to detect infrared rays emitted from the body surface, and to plot them as a distribution diagram of the temperature information. Therefore, a thermographic instrument can be assumed to measure the skin temperature of the diseased region. Such an instrument is a useful device for noninvasive and objective assessment of various diseases. Examination using a thermographic instrument can assess the autonomic dysfunction by measuring the skin blood flow involved with the sympathetic innervation. Thermography is useful in assisting the determination of the therapeutic effect. However, autonomic dysfunction should be confirmed correctly with the assessment of thermatome that shows abnormal thermal distribution in the region of the disease. Thermography should make noticeable the difference between the body temperature of abnormal and normal sites, and show the alteration of temperature. Monitoring using thermography is useful to determine the effect of sympathetic nerve block. If a thermographic instrument is used, it is important that examiners should understand the function of the instrument, as well as its advantages and disadvantages.

  20. Problems with radiological surveillance instrumentation

    International Nuclear Information System (INIS)

    Swinth, K.L.; Tanner, J.E.; Fleming, D.M.

    1984-09-01

    Many radiological surveillance instruments are in use at DOE facilities throughout the country. These instruments are an essential part of all health physics programs, and poor instrument performance can increase program costs or compromise program effectiveness. Generic data from simple tests on newly purchased instruments shows that many instruments will not meet requirements due to manufacturing defects. In other cases, lack of consideration of instrument use has resulted in poor acceptance of instruments and poor reliability. The performance of instruments is highly variable for electronic and mechanical performance, radiation response, susceptibility to interferences and response to environmental factors. Poor instrument performance in these areas can lead to errors or poor accuracy in measurements

  1. The methodological quality of systematic reviews comparing temporomandibular joint disorder surgical and non-surgical treatment

    Directory of Open Access Journals (Sweden)

    Vasconcelos Belmiro CE

    2008-09-01

    Full Text Available Abstract Background Temporomandibular joint disorders (TMJD are multifactor, complex clinical problems affecting approximately 60–70% of the general population, with considerable controversy about the most effective treatment. For example, reports claim success rates of 70% and 83% for non-surgical and surgical treatment, whereas other reports claim success rates of 40% to 70% for self-improvement without treatment. Therefore, the purpose of this study was to (1 identify systematic reviews comparing temporomandibular joint disorder surgical and non-surgical treatment, (2 evaluate their methodological quality, and (3 evaluate the evidence grade within the systematic reviews. Methods A search strategy was developed and implemented for MEDLINE, Cochrane Library, LILACS, and Brazilian Dentistry Bibliography databases. Inclusion criteria were: systematic reviews (± meta-analysis comparing surgical and non-surgical TMJD treatment, published in English, Spanish, Portuguese, Italian, or German between the years 1966 and 2007(up to July. Exclusion criteria were: in vitro or animal studies; narrative reviews or editorials or editorial letters; and articles published in other languages. Two investigators independently selected and evaluated systematic reviews. Three different instruments (AMSTAR, OQAQ and CASP were used to evaluate methodological quality, and the results averaged. The GRADE instrument was used to evaluate the evidence grade within the reviews. Results The search strategy identified 211 reports; of which 2 were systematic reviews meeting inclusion criteria. The first review met 23.5 ± 6.0% and the second met 77.5 ± 12.8% of the methodological quality criteria (mean ± sd. In these systematic reviews between 9 and 15% of the trials were graded as high quality, and 2 and 8% of the total number of patients were involved in these studies. Conclusion The results indicate that in spite of the widespread impact of TMJD, and the multitude of

  2. MENINGKATKAN KETRAMPILAN MEMBUAT DAN MEMBACA KURVE KESEIMBANGAN SERTA HASIL BELAJAR SISWA MENGGUNAKAN METODE DISCOVERY DENGAN MENGGUNAKAN MEDIA VISUAL PADA SISWA KELAS VIII C SMP MUHAMMADIYAH 1 KUDUS

    Directory of Open Access Journals (Sweden)

    Desi Riana Prihandika

    2014-11-01

    Full Text Available Dari observasi awal yang dilakukan di SMP Muhammadiyah 1 Kudus, Pada mata pelajaran IPS khususnya pada materi kurve keseimbangan kurang variatif yaitu hanya ceramah tanpa variasi. Sedangkan materi yang diajarkan adalah aplikatif yaitu menuntut adanya keterampilan dari siswa.Untuk meningkatkan keterampilan siswa membuatdanmembacakurvekeseimbangan maka dilakukan penelitian tindakan kelas dengan Metode Discovery. Subjek penelitian ini adalah siswa kelas VIII C SMP Muhammadiyah 1 Kudus. Prosedur penelitian ini merupakan proses pembelajaran yang terdiri dari 2 siklus, dimana setiap siklus meliputi perencanaan, pelaksanaan tindakan, observasi dan refleksi. Instrumen yang digunakan yaitu lembar observasi dan test keterampilan. Hasil penelitian ini diperoleh presentase keterampilan siswa pada pembelajaran siklus I dengan kategori baik dan pada siklus II meningkat menjadi dengan kategori amat baik, persentase aktivitas guru pada pembelajaran siklus I dengan kategori amat baik dan pada siklus II meningkat menjadi dengan kategori amat baik, Berdasarkan hasil penelitian di atas dapat diambil kesimpulan bahwa, adanya peningkatan keterampilan siswa membuatdanmembacakurvekeseimbangankelas VIII C. From the first observation done in Muhammadiyah 1 Junior High School Kudus, gained information based on the interview result with the teacher of Social Studies grade VIII. Indeed, learning method that usually used are still conventional on Social Studies especially in equilibrium curve lesson is less variativethat is only speech without variants. Whereas the lessons taught are applicative that is demand skill existence for the students. The lesson that felt hard to understand to students are generally the lesson on making equilibrium curve and on reading curve mostly students still don’t understand the meaning of that curve. This is strengthened by average value on equilibrium cost lesson especially equilibrium curve on the VIII grade classified to quite low if

  3. Pisanello’s hat. The costume and weapons depicted in Pisanello’s medal for John VIII Palaeologus. A discussion of the saber and related weapons

    Directory of Open Access Journals (Sweden)

    Alexander, David

    2004-12-01

    Full Text Available A group of six drawings by the Veronese artist Antonio Pisano depicted the Bizantine Emperor John VIII Paleologus wearing costumes and weapons according to islamic types. This paper studies these objects in relation to other contemporary islamic weapons.

    Un grupo de seis dibujos del artista veronés Antonio Pisano representa al emperador bizantino Juan VIII Paleólogo vestido y armado según modelos islámicos. Este trabajo estudia dichos objetos en relación a otras armas islámicas contemporáneas.

  4. Global curriculum in surgical oncology.

    Science.gov (United States)

    Are, C; Berman, R S; Wyld, L; Cummings, C; Lecoq, C; Audisio, R A

    2016-06-01

    The significant global variations in surgical oncology training paradigms can have a detrimental effect on tackling the rising global cancer burden. While some variations in training are essential to account for the differences in types of cancer and biology, the fundamental principles of providing care to a cancer patient remain the same. The development of a global curriculum in surgical oncology with incorporated essential standards could be very useful in building an adequately trained surgical oncology workforce, which in turn could help in tackling the rising global cancer burden. The leaders of the Society of Surgical Oncology and European Society of Surgical Oncology convened a global curriculum committee to develop a global curriculum in surgical oncology. A global curriculum in surgical oncology was developed to incorporate the required domains considered to be essential in training a surgical oncologist. The curriculum was constructed in a modular fashion to permit flexibility to suit the needs of the different regions of the world. Similarly, recognizing the various sociocultural, financial and cultural influences across the world, the proposed curriculum is aspirational and not mandatory in intent. A global curriculum was developed which may be considered as a foundational scaffolding for training surgical oncologists worldwide. It is envisioned that this initial global curriculum will provide a flexible and modular scaffolding that can be tailored by individual countries or regions to train surgical oncologists in a way that is appropriate for practice in their local environment. Copyright © 2016 Society of Surgical Oncology, European Society of Surgical Oncology. Published by Elsevier Ltd.. All rights reserved.

  5. Surgical treatment of aortic coarctation

    OpenAIRE

    Omeje, IC; Poruban, R; ?ag?t, M; Nos?l, M; Hra?ka, V

    2004-01-01

    Coarctation of the aorta accounts for about 8% of all congenital heart diseases. Since the first successful case of surgical treatment in 1944 by Crafoord and Nylin1 in Sweden, several surgical techniques have been employed in the treatment of this anomaly. This article reviews by illustration the various surgical options in coarctation of the aorta with emphasis on our preferred technique – the extended resection and end-to-end anastomosis. Why the extended resection technique? Our exper...

  6. Modelling and evaluation of surgical performance using hidden Markov models.

    Science.gov (United States)

    Megali, Giuseppe; Sinigaglia, Stefano; Tonet, Oliver; Dario, Paolo

    2006-10-01

    Minimally invasive surgery has become very widespread in the last ten years. Since surgeons experience difficulties in learning and mastering minimally invasive techniques, the development of training methods is of great importance. While the introduction of virtual reality-based simulators has introduced a new paradigm in surgical training, skill evaluation methods are far from being objective. This paper proposes a method for defining a model of surgical expertise and an objective metric to evaluate performance in laparoscopic surgery. Our approach is based on the processing of kinematic data describing movements of surgical instruments. We use hidden Markov model theory to define an expert model that describes expert surgical gesture. The model is trained on kinematic data related to exercises performed on a surgical simulator by experienced surgeons. Subsequently, we use this expert model as a reference model in the definition of an objective metric to evaluate performance of surgeons with different abilities. Preliminary results show that, using different topologies for the expert model, the method can be efficiently used both for the discrimination between experienced and novice surgeons, and for the quantitative assessment of surgical ability.

  7. Tophi - surgical treatment.

    Science.gov (United States)

    Słowińska, Iwona; Słowiński, Radosław; Rutkowska-Sak, Lidia

    2016-01-01

    Gout is an inflammatory joint disease associated with deposition of monosodium urate crystals in the bones forming the joints, in periarticular tissues and in other organs. The disease is one of the most frequent causes of disability. This paper presents the case of a 57-year-old male patient treated for generalised gout. A "clinical mask" suggesting another disease was the cause of making the correct diagnosis only six years after the occurrence of the first manifestations. The patient, with high values of inflammatory markers, severe pain and advanced joint destruction, was given an aggressive anti-inflammatory treatment. The unsatisfactory effect of the conservative treatment forced the authors to perform surgical resection of the gouty nodules in the hands. After several operations the function of the hand joints operated on, appearance of the hands and the quality of the patient's life improved significantly.

  8. Anterior inferior cerebellar artery aneurysms: Segments and results of surgical and endovascular managements

    Science.gov (United States)

    Lv, Xianli; Ge, Huijian; He, Hongwei; Jiang, Chuhan

    2016-01-01

    Background Anterior inferior cerebellar artery (AICA) aneurysms are rare and published clinical experience with these aneurysms is limited. Objective The objective of this article is to report angiographic characteristics and results associated with premeatal, meatal and postmeatal segments, surgical and endovascular therapies. Methods A literature review was performed through PubMed using “anterior inferior cerebellar artery aneurysm” through January 2016. Clinical data, angiograms, management techniques, and patient outcomes were reviewed for 47 collected cases in 30 previous reports. Results Of these aneurysms, 21 (44.7%) were associated with meatal segment, 10 (21.3%) were postmeatal and 16 (34.0%) were premeatal. Patients with meatal aneurysms are more likely to present with subarachnoid hemorrhage and hearing loss and facial palsy (77.8%). Patient outcomes of meatal aneurysms presented with more neuropathies (51.7%) and cerebellar symptoms (14.3%) (p = 0.049). Four cases of meatal aneurysm with preoperative cranial nerve deficits (two VII and two VIII) showed improvement after surgery. Endovascular treatment achieved outcomes similar to surgical treatment (p = 0.327). Conclusions AICA aneurysms have a predilection for meatal segment. Patients with meatal aneurysms are more likely to present with subarachnoid hemorrhage and hearing loss and facial palsy. Patient outcomes of meatal aneurysms presented with more neuropathies and cerebellar symptoms. Endovascular treatment achieved outcomes similar to surgical treatment. PMID:27485045

  9. Instrumentation Research and Support Services.

    Science.gov (United States)

    1985-09-30

    Sonda III rocket would be launched to measure the disturbed ionosphere. OSU was assigned the responsibility for overall construction and build-up of...the Black Brant VIII payloads, while Northeastern University was to do the Sonda III portions of the experiment. The Black Brant payloads were quite...A20.123-2 was launched at 21:i1:02 GM T reaching an apogee of 548.49 Km. at T + 6 min. and 22 sec. The Sonda III failed to take wind correction and

  10. 21 CFR 884.4530 - Obstetric-gynecologic specialized manual instrument.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Obstetric-gynecologic specialized manual... Gynecological Surgical Devices § 884.4530 Obstetric-gynecologic specialized manual instrument. (a) Identification. An obstetric-gynecologic specialized manual instrument is one of a group of devices used during...

  11. Surgical gesture classification using Dynamic Time Warping and affine velocity.

    Science.gov (United States)

    Cifuentes, Jenny; Minh Tu Pham; Moreau, Richard; Prieto, Flavio; Boulanger, Pierre

    2017-07-01

    Minimally Invasive Surgery (MIS) has become widespread as an important surgical technique due to its advantages related to pain relief and short recovery time periods. However, this approach implies the acquisition of special surgical skills, which represents a challenge in the objective assessment of surgical gestures. In this way, several studies shown that kinematics and kinetic analysis of hand movement is a valuable assessment tool of basic surgical skills in MIS. In addition, recent researches proved that human motion performed during surgery can be described as a sequence of constant affine velocity movements. In this paper, we present a novel method to classify gestures based on an affine velocity analysis of 3D motion and an implementation of the Dynamic Time Warping algorithm. In particular, affine velocity calculation correlates kinematics and geometrical variables such as curvature, torsion, and euclidean velocity, reducing the dimension of the conventional 3D problem. In this way, using the simplicity of dynamic time warping algorithm allows us to perform an accurate classification, easier to implement and understand. Experimental validation of the algorithm is presented based on the position and orientation data of a laparoscope instrument, determiMinimally Invasive Surgery (MIS) has become widespread as an important surgical technique due to its advantages related to pain relief and short recovery time periods. However, this approach implies the acquisition of special surgical skills, which represents a challenge in the objective assessment of surgical gestures. In this way, several studies shown that kinematics and kinetic analysis of hand movement is a valuable assessment tool of basic surgical skills in MIS. In addition, recent researches proved that human motion performed during surgery can be described as a sequence of constant affine velocity movements. In this paper, we present a novel method to classify gestures based on an affine velocity

  12. GPU based real-time instrument tracking with three dimensional ultrasound.

    Science.gov (United States)

    Novotny, Paul M; Stoll, Jeffrey A; Vasilyev, Nikolay V; del Nido, Pedro J; Dupont, Pierre E; Howe, Robert D

    2006-01-01

    Real-time 3D ultrasound can enable new image-guided surgical procedures, but high data rates prohibit the use of traditional tracking techniques. We present a new method based on the modified Radon transform that identifies the axis of instrument shafts as bright patterns in planar projections. Instrument rotation and tip location are then determined using fiducial markers. These techniques are amenable to rapid execution on the current generation of personal computer graphics processor units (GPU). Our GPU implementation detected a surgical instrument in 31 ms, sufficient for real-time tracking at the 26 volumes per second rate of the ultrasound machine. A water tank experiment found instrument tip position errors of less than 0.2 mm, and an in vivo study tracked an instrument inside a beating porcine heart. The tracking results showed good correspondence to the actual movements of the instrument.

  13. Reactor instrumentation and control

    International Nuclear Information System (INIS)

    Wach, D.; Beraha, D.

    1980-01-01

    The methods for measuring radiation are shortly reviewed. The instrumentation for neutron flux measurement is classified into out-of-core and in-core instrumentation. The out-of-core instrumentation monitors the operational range from the subcritical reactor to full power. This large range is covered by several measurement channels which derive their signals from counter tubes and ionization chambers. The in-core instrumentation provides more detailed information on the power distribution in the core. The self-powered neutron detectors and the aeroball system in PWR reactors are discussed. Temperature and pressure measurement devices are briefly discussed. The different methods for leak detection are described. In concluding the plant instrumentation part some new monitoring systems and analysis methods are presented: early failure detection methods by noise analysis, acoustic monitoring and vibration monitoring. The presentation of the control starts from an qualitative assessment of the reactor dynamics. The chosen control strategy leads to the definition of the part-load diagram, which provides the set-points for the different control systems. The tasks and the functions of these control systems are described. In additiion to the control, a number of limiting systems is employed to keep the reactor in a safe operating region. Finally, an outlook is given on future developments in control, concerning mainly the increased application of process computers. (orig./RW)

  14. Instrumental analysis, second edition

    International Nuclear Information System (INIS)

    Christian, G.D.; O'Reilly, J.E.

    1988-01-01

    The second edition of Instrumental Analysis is a survey of the major instrument-based methods of chemical analysis. It appears to be aimed at undergraduates but would be equally useful in a graduate course. The volume explores all of the classical quantitative methods and contains sections on techniques that usually are not included in a semester course in instrumentation (such as electron spectroscopy and the kinetic methods). Adequate coverage of all of the methods contained in this book would require several semesters of focused study. The 25 chapters were written by different authors, yet the style throughout the book is more uniform than in the earlier edition. With the exception of a two-chapter course in analog and digital circuits, the book purports to de-emphasize instrumentation, focusing more on the theory behind the methods and the application of the methods to analytical problems. However, a detailed analysis of the instruments used in each method is by no means absent. The book has the favor of a user's guide to analysis

  15. Instrumentation for environmental monitoring

    International Nuclear Information System (INIS)

    McLaughlin, R.D.; Hunt, M.S.; Murphy, D.L.; Chen, C.R.

    1979-06-01

    In the last few years a much greater emphasis has been placed upon understanding, controlling and monitoring the environmental effects of the advancing technologies. This has resulted in rapid advances in techniques for environmental monitoring. To aid the concerned scientist in keeping abreast of these developments, the Lawrence Berkeley Laboratory publishes a collection of volumes entitled Instrumentation for Environmental Monitoring. Separated into four volumes covering four media, AIR, WATER, RADIATION, and BIOMEDICAL, they provide a source book for three types of material: (1) Monitoring Rationale. They describe the characteristics, forms, and effects of a wide variety of pollutants and the means of controlling them. Federal regulations are explained and summarized. (2) Analytical Techniques. Methods of determining specific pollutants are described with special emphasis on the principles that form the basis of instrumental methods. (3) Commercial Instrumentation. The features of most commercially available instrumentation used for the determination and monitoring of each pollutant are presented in a manner that facilitates instrumental comparisons. Examples of the types of material in the volumes and the use of the volumes are presented

  16. Acute Perioperative Comparison of Patient-Specific Instrumentation versus Conventional Instrumentation Utilization during Bilateral Total Knee Arthroplasty

    Directory of Open Access Journals (Sweden)

    Jerrod A. Steimle

    2018-01-01

    Full Text Available Utilizing patient-specific instrumentation during total knee arthroplasty has gained popularity in recent years with theoretical advantages in blood loss, intraoperative time, length of stay, postoperative alignment, and functional outcome, amongst others. No study has compared acute perioperative measures between patient-specific instrumentation and conventional instrumentation in the bilateral total knee arthroplasty setting. We compared patient-specific instrumentation versus conventional instrumentation in the setting of bilateral total knee arthroplasty to determine any benefits in the immediate perioperative period including surgical time, blood loss, pain medication use, length of stay, and discharge disposition. A total of 49 patients with standard instrumentation and 31 patients with patient-specific instrumentation were retrospectively reviewed in a two-year period at one facility. At baseline, the groups were comparable with respect to age, ASA, BMI, and comorbid conditions. We analyzed data on operative time, blood loss, hemoglobin change, need for transfusion, pain medication use, length of stay, and discharge disposition. There was no statistically significant difference between groups in regards to these parameters. Patient-specific instrumentation in the setting of bilateral total knee arthroplasty did not provide any immediate perioperative benefit compared to conventional instrumentation.

  17. Quantitative analysis of residual protein contamination of podiatry instruments reprocessed through local and central decontamination units

    Science.gov (United States)

    2011-01-01

    Background The cleaning stage of the instrument decontamination process has come under increased scrutiny due to the increasing complexity of surgical instruments and the adverse affects of residual protein contamination on surgical instruments. Instruments used in the podiatry field have a complex surface topography and are exposed to a wide range of biological contamination. Currently, podiatry instruments are reprocessed locally within surgeries while national strategies are favouring a move toward reprocessing in central facilities. The aim of this study was to determine the efficacy of local and central reprocessing on podiatry instruments by measuring residual protein contamination of instruments reprocessed by both methods. Methods The residual protein of 189 instruments reprocessed centrally and 189 instruments reprocessed locally was determined using a fluorescent assay based on the reaction of proteins with o-phthaldialdehyde/sodium 2-mercaptoethanesulfonate. Results Residual protein was detected on 72% (n = 136) of instruments reprocessed centrally and 90% (n = 170) of instruments reprocessed locally. Significantly less protein (p decontamination unit and central decontamination unit processes for Blacks files. Further research is needed to undertake qualitative identification of protein contamination to identify any cross contamination risks and a standard for acceptable residual protein contamination applicable to different instruments and specialities should be considered as a matter of urgency. PMID:21219613

  18. Biochemistry Instrumentation Core Technology Center

    Data.gov (United States)

    Federal Laboratory Consortium — The UCLA-DOE Biochemistry Instrumentation Core Facility provides the UCLA biochemistry community with easy access to sophisticated instrumentation for a wide variety...

  19. Heat Flux Instrumentation Laboratory (HFIL)

    Data.gov (United States)

    Federal Laboratory Consortium — Description: The Heat Flux Instrumentation Laboratory is used to develop advanced, flexible, thin film gauge instrumentation for the Air Force Research Laboratory....

  20. Computer based policy making in draining old surgical techniques.

    Science.gov (United States)

    Dragomirescu, E; Stavri, E; Dimitriu, R; Belu, I

    1995-01-01

    The discopathy disease has an important incidence all over the world affecting more men than women and is influenced by social factors. The treatment has often surgical indication. The operating techniques on one hand are dependent on the equipment, instruments and expertise and on the other hand they are related to the specificity of the case, surgeon's inspiration etc. These factors are influencing the postoperative patient evolution.

  1. Surgical innovations in canine gonadectomy

    NARCIS (Netherlands)

    Van Goethem, Bart

    2016-01-01

    In this thesis some recent technological developments in human surgery are evaluated for their potential use in veterinary medicine by introducing them as surgical innovations for canine gonadectomy. Barbed sutures achieve wound apposition without surgical knot tying and thus avoid knot-associated

  2. Mortality in Emergency Surgical Oncology

    NARCIS (Netherlands)

    Bosscher, M. R. F.; van Leeuwen, B. L.; Hoekstra, H. J.

    Cancer patients can experience problems related to their disease or treatment. This study evaluated reasons for presentation at the emergency room (ER) and outcome of surgical oncology patients. A retrospective chart review for all surgical oncology patients who presented at the ER of the UMCG for

  3. Surgical innovation : The ethical agenda

    NARCIS (Netherlands)

    Broekman, Marike L.|info:eu-repo/dai/nl/343152347; Carrière, Michelle E.; Bredenoord, Annelien L.|info:eu-repo/dai/nl/240834666

    2016-01-01

    The aim of the present article was to systematically review the ethics of surgical innovation and introduce the components of the learning health care system to guide future research and debate on surgical innovation. Although the call for evidence-based practice in surgery is increasingly high on

  4. Surgical residency: A tenant's view

    African Journals Online (AJOL)

    'To sleep: perchance to dream', is the frequent mantra of the surgical resident. However, unlike. Hamlet, there is no ensuing speculation as to what dreams may come as there are seldom any!! Surgical residency has been both vilified and immortalized, but the fact remains that it is one of the most challenging, provocative ...

  5. Instrumentation Video Systems

    Science.gov (United States)

    Lida, Hitoshi

    1981-10-01

    The use of video equipment as instrumentation has been increasing steadily over the past decade. An indication of this trend can be found close to home: notice how rapidly the number of television (TV) displays has grown at our technical exhibits. It is this exhibited equipment and other equipment like it which form the subject of this summary. We will limit our discussions to readily available hardware (and a little software) and leave reports of the leading edge development work to other issues of this journal. We hope, in this manner, to present useful information to those who need to apply video to their instrumen-tation problems now. Along the way we will occasionally indicate what equipment might soon result from current research, but our clear emphasis will be on the state of the art of accessible instrumentation video.

  6. The IKARUS instrument

    International Nuclear Information System (INIS)

    Gerster, H.J.; Stein, G.

    1994-01-01

    When the Federal Government decided on a 25% reduction of CO 2 emissions till 2005 in 1990 the necessity resulted that an instrument has to be developed for the analysis and assessment of the ecological, economic and energetic impact of different reduction strategies. The development task was awarded by the BMFT to the Research Centre Juelich in cooperation with well-known institutions of energy system research. The total instrument is scheduled to be finished by the end of 1994. For the decentral use of the instrument by a wide specialist public the developed models and data banks which are equipped with a user-friendly surface are suited for larger PCs (486, 16 MB RAM/500-1000 MB ROM). (orig.) [de

  7. Calibration of Geodetic Instruments

    Directory of Open Access Journals (Sweden)

    Marek Bajtala

    2005-06-01

    Full Text Available The problem of metrology and security systems of unification, correctness and standard reproducibilities belong to the preferred requirements of theory and technical practice in geodesy. Requirements on the control and verification of measured instruments and equipments increase and the importance and up-to-date of calibration get into the foreground. Calibration possibilities of length-scales (of electronic rangefinders and angle-scales (of horizontal circles of geodetic instruments. Calibration of electronic rangefinders on the linear comparative baseline in terrain. Primary standard of planar angle – optical traverse and its exploitation for calibration of the horizontal circles of theodolites. The calibration equipment of the Institute of Slovak Metrology in Bratislava. The Calibration process and results from the calibration of horizontal circles of selected geodetic instruments.

  8. Aethalometer™ Instrument Handbook

    Energy Technology Data Exchange (ETDEWEB)

    Sedlacek, Arthur J. [Brookhaven National Lab. (BNL), Upton, NY (United States)

    2016-04-01

    The Aethalometer is an instrument that provides a real-time readout of the concentration of “Black” or “Elemental” carbon aerosol particles (BC or E) in an air stream (see Figure 1 and Figure 2). It is a self-contained instrument that measures the rate of change of optical transmission through a spot on a filter where aerosol is being continuously collected and uses the information to calculate the concentration of optically absorbing material in the sampled air stream. The instrument measures the transmitted light intensities through the “sensing” portion of the filter, on which the aerosol spot is being collected, and a “reference” portion of the filter as a check on the stability of the optical source. A mass flowmeter monitors the sample air flow rate. The data from these three measurements is used to determine the mean BC content of the air stream.

  9. ISSUERS OF FINANCIAL INSTRUMENTS

    Directory of Open Access Journals (Sweden)

    Cristian GHEORGHE

    2016-05-01

    Full Text Available The rules laid down by Romanian Capital Market Law and the regulations put in force for its implementation apply to issuers of financial instruments admitted to trading on the regulated market established in Romania. But the issuers remain companies incorporated under Company Law of 1990. Such dual regulations need increased attention in order to observe the legal status of the issuers/companies and financial instruments/shares. Romanian legislator has chosen to implement in Capital Market Law special rules regarding the administration of the issuers of financial instruments, not only rules regarding admitting and maintaining to a regulated market. Thus issuers are, in Romanian Law perspective, special company that should comply special rule regarding board of administration and general shareholders meeting.

  10. Surgical procedures for voice restoration

    Science.gov (United States)

    Nawka, Tadeus; Hosemann, Werner

    2005-01-01

    Surgical procedures for voice restoration serve to improve oral communication by better vocal function. They comprise of phonomicrosurgery, with direct and indirect access to the larynx; laryngoplasty; laryngeal injections; and surgical laryngeal reinnervation. The basis for modern surgical techniques for voice disorders is the knowledge about the ultrastructure of the vocal folds and the increasing experience of surgeons in voice surgery, while facing high social and professional demands on the voice. Vocal activity limitation and participation restriction has become more important in the artistic and social areas. A number of surgical methods that have been developed worldwide for this reason, are presented in this article. Functional oriented surgery has to meet high standards. The diagnostics of vocal function has to be multi-dimensional in order to determine the indication and the appropriate surgical intervention. PMID:22073062

  11. Surgical Management of Calcaneal Malunion

    Directory of Open Access Journals (Sweden)

    Guang-Rong Yu

    2013-06-01

    Full Text Available Calcaneal malunion is a common complication after conservative treatment or incorrect surgical treatment of calcaneal fracture. The typical pathoanatomies of calcaneal malunion are subtalar joint incongruity, loss of calcaneal height, arch collapse, varus or valgus deformity of the calcaneus, heel widening and so on. Calcaneal malunion often needs to be treated surgically. The classification of calcaneal malunion and the detailed clinical and radiographical assessment play important roles for surgical option. The main surgical methods include in situ subtalar arthrodesis, reconstruction of calcaneal thalamus and subtalar arthrodesis, calcaneal osteotomy with subtalar arthrodesis, corrective calcaneal osteotomy without subtalar arthrodesis. Each option has its different indications, advantages and disadvantages. Thus, the surgical treatment should be individualised.

  12. Virtual Sensor Test Instrumentation

    Science.gov (United States)

    Wang, Roy

    2011-01-01

    Virtual Sensor Test Instrumentation is based on the concept of smart sensor technology for testing with intelligence needed to perform sell-diagnosis of health, and to participate in a hierarchy of health determination at sensor, process, and system levels. A virtual sensor test instrumentation consists of five elements: (1) a common sensor interface, (2) microprocessor, (3) wireless interface, (4) signal conditioning and ADC/DAC (analog-to-digital conversion/ digital-to-analog conversion), and (5) onboard EEPROM (electrically erasable programmable read-only memory) for metadata storage and executable software to create powerful, scalable, reconfigurable, and reliable embedded and distributed test instruments. In order to maximize the efficient data conversion through the smart sensor node, plug-and-play functionality is required to interface with traditional sensors to enhance their identity and capabilities for data processing and communications. Virtual sensor test instrumentation can be accessible wirelessly via a Network Capable Application Processor (NCAP) or a Smart Transducer Interlace Module (STIM) that may be managed under real-time rule engines for mission-critical applications. The transducer senses the physical quantity being measured and converts it into an electrical signal. The signal is fed to an A/D converter, and is ready for use by the processor to execute functional transformation based on the sensor characteristics stored in a Transducer Electronic Data Sheet (TEDS). Virtual sensor test instrumentation is built upon an open-system architecture with standardized protocol modules/stacks to interface with industry standards and commonly used software. One major benefit for deploying the virtual sensor test instrumentation is the ability, through a plug-and-play common interface, to convert raw sensor data in either analog or digital form, to an IEEE 1451 standard-based smart sensor, which has instructions to program sensors for a wide variety of

  13. Robotic technologies in surgical oncology training and practice.

    Science.gov (United States)

    Orvieto, Marcelo A; Marchetti, Pablo; Castillo, Octavio A; Coelho, Rafael F; Chauhan, Sanket; Rocco, Bernardo; Ardila, Bobby; Mathe, Mary; Patel, Vipul R

    2011-09-01

    The modern-day surgeon is frequently exposed to new technologies and instrumentation. Robotic surgery (RS) has evolved as a minimally invasive technique aimed to improve clinical outcomes. RS has the potential to alleviate the inherent limitations of laparoscopic surgery such as two dimensional imaging, limited instrument movement and intrinsic human tremor. Since the first reported robot-assisted surgical procedure performed in 1985, the technology has dramatically evolved and currently multiple surgical specialties have incorporated RS into their daily clinical armamentarium. With this exponential growth, it should not come as a surprise the ever growing requirement for surgeons trained in RS as well as the interest from residents to receive robotic exposure during their training. For this reason, the establishment of set criteria for adequate and standardized training and credentialing of surgical residents, fellows and those trained surgeons wishing to perform RS has become a priority. In this rapidly evolving field, we herein review the past, present and future of robotic technologies and its penetration into different surgical specialties. Copyright © 2010 Elsevier Ltd. All rights reserved.

  14. One-step (standard) versus two-step surgical approach in adolescent idiopathic scoliosis posterior spinal fusion: Which is better?

    Science.gov (United States)

    Ramirez, Norman; Valentin, Pablo; García-Cartagena, Manuel; Samalot, Solais; Iriarte, Ivan

    2016-07-01

    A retrospective cohort study with IRB approval. Significant blood loss remains an important concern in terms of the performance of the posterior spinal fusion in adolescent idiopathic scoliosis. Several strategies have been reported to minimize blood loss during surgery. In order to address the need to minimize blood loss without sacrificing the quality of the fusion, in our hospital, we adopted a two-step surgical approach. This surgical approach consist of the exposure and instrumentation of the lumbar region prior to and followed by an extension of the surgical incision to the thoracic region for its subsequent instrumentation. The main purpose of this study was to compare a two-step surgical approach with the one-step (standard) approach. This study was a review of all the data on consecutive posterior spinal fusion surgeries performed by a specific two-surgeon team during 2004-2013. Demographics, surgical variables, radiographic findings, and outcomes regarding blood loss, morbidity, and the duration of the procedure were evaluated. Eighty-five patients underwent the standard surgical exposure, and 41 patients underwent the two-step surgical technique. With the exception of BMI, neither group showed any statistically preoperative variable significant differences. None of the postoperative outcome variables were statistically significant between both surgical approaches. No differences were detected in terms of using a two-step surgical approach versus the one-step standard surgical approach regarding perioperative blood loss, surgical time, or complications. Level of evidence III.

  15. Non-surgical management of periodontal disease.

    Science.gov (United States)

    Darby, I

    2009-09-01

    Non-surgical removal of plaque and calculus has been part of the initial phase of the management of patients with gingivitis and periodontitis for decades. It consists of patient motivation and oral hygiene instruction as well as mechanical removal of supra and subgingival plaque deposits. The purpose of this review was to assess recent changes. The article reports on changes in our understanding of plaque as a biofilm, developments in patient plaque control, chemical plaque control and scaling instruments. It also comments on full-mouth disinfection, the use of lasers and host modulation. Modern technology has made removal of microbial deposits by the patient and dental professionals more efficient. However, other advancements need to be used in conjunction with mechanical debridement at this time.

  16. Interfacing to accelerator instrumentation

    International Nuclear Information System (INIS)

    Shea, T.J.

    1995-01-01

    As the sensory system for an accelerator, the beam instrumentation provides a tremendous amount of diagnostic information. Access to this information can vary from periodic spot checks by operators to high bandwidth data acquisition during studies. In this paper, example applications will illustrate the requirements on interfaces between the control system and the instrumentation hardware. A survey of the major accelerator facilities will identify the most popular interface standards. The impact of developments such as isochronous protocols and embedded digital signal processing will also be discussed

  17. Spectroelectrochemical Instrument Measures TOC

    Science.gov (United States)

    Kounaves, Sam

    2011-01-01

    A spectroelectrochemical instrument has been developed for measuring the total organic carbon (TOC) content of an aqueous solution. Measurements of TOC are frequently performed in environmental, clinical, and industrial settings. Until now, techniques for performing such measurements have included, various ly, the use of hazardous reagents, ultraviolet light, or ovens, to promote reactions in which the carbon contents are oxidized. The instrument now being developed is intended to be a safer, more economical means of oxidizing organic carbon and determining the TOC levels of aqueous solutions and for providing a low power/mass unit for use in planetary missions.

  18. Standard NIM instrumentation system

    CERN Document Server

    1990-01-01

    NIM is a standard modular instrumentation system that is in wide use throughout the world. As the NIM system developed and accommodations were made to a dynamic instrumentation field and a rapidly advancing technology, additions, revisions and clarifications were made. These were incorporated into the standard in the form of addenda and errata. This standard is a revision of the NIM document, AEC Report TID- 20893 (Rev 4) dated July 1974. It includes all the addenda and errata items that were previously issued as well as numerous additional items to make the standard current with modern technology and manufacturing practice.

  19. Instrumentation Cables Test Plan

    Energy Technology Data Exchange (ETDEWEB)

    Muna, Alice Baca [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); LaFleur, Chris Bensdotter [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2016-10-01

    A fire at a nuclear power plant (NPP) has the potential to damage structures, systems, and components important to safety, if not promptly detected and suppressed. At Browns Ferry Nuclear Power Plant on March 22, 1975, a fire in the reactor building damaged electrical power and control systems. Damage to instrumentation cables impeded the function of both normal and standby reactor coolant systems, and degraded the operators’ plant monitoring capability. This event resulted in additional NRC involvement with utilities to ensure that NPPs are properly protected from fire as intended by the NRC principle design criteria (i.e., general design criteria 3, Fire Protection). Current guidance and methods for both deterministic and performance based approaches typically make conservative (bounding) assumptions regarding the fire-induced failure modes of instrumentation cables and those failure modes effects on component and system response. Numerous fire testing programs have been conducted in the past to evaluate the failure modes and effects of electrical cables exposed to severe thermal conditions. However, that testing has primarily focused on control circuits with only a limited number of tests performed on instrumentation circuits. In 2001, the Nuclear Energy Institute (NEI) and the Electric Power Research Institute (EPRI) conducted a series of cable fire tests designed to address specific aspects of the cable failure and circuit fault issues of concern1. The NRC was invited to observe and participate in that program. The NRC sponsored Sandia National Laboratories to support this participation, whom among other things, added a 4-20 mA instrumentation circuit and instrumentation cabling to six of the tests. Although limited, one insight drawn from those instrumentation circuits tests was that the failure characteristics appeared to depend on the cable insulation material. The results showed that for thermoset insulated cables, the instrument reading tended to drift

  20. Analisis Deskriptif Soal Geometri dalam Buku Matematika Bilingual untuk Sekolah Menengah Pertama Kelas VIII Berdasarkan Kriteria International Assessment TIMSS 2007

    Directory of Open Access Journals (Sweden)

    Etik Rahayu

    2012-06-01

    Full Text Available Tujuan penelitian ini adalah untuk mendeskripsikan  domain kognitif dan aspek kognitif (required behavior soal matematika dalam Buku Matematika Bilingual untuk Sekolah Menengah Pertama (SMP Kelas VIII berdasarkan kriteria International Assessment TIMSS 2007 dan proporsinya. Metode penelitian yang digunakan adalah deskriptif kualitatif, dengan subjek penelitian adalah soal geometri dalam Buku Matematika Bilingual SMP. yang berjudul “Mathematics for Junior High School Grade VIII 1st Semester” dan “Mathematics for Junior High School Grade VIII 2nd Semester” karangan karangan M. Cholik Adinawan dan Sugijono. Pengumpulan data menggunakan metode observasi dan wawancara tentang penggunaan buku matematika bilingual yang paling banyak digunakan di kota semarang. Pedoman analisis soal berdasarkan kriteria International Assessment TIMSS 2007, dengan validasi hasil oleh ahli. Hasil penelitian menunjukkan bahwa soal yang dianalisis memuat satu hingga tujuh aspek kognitif. Sebagian besar soal memuat 4 aspek kognitif yaitu 44.04 %, diikuti soal dengan 3 aspek kognitif  yaitu 36, 42%,  soal dengan 2 aspek kognitif yaitu 14, 90%, kemudian 1,99% untuk soal dengan 1 atau 5 aspek kognitif, dan 0,33% untuk soal dengan 6 atau 7 aspek kognitif. Proporsi tinggi pada recall (28.26% dan compute (26.57%, diikuti dengan SRP (10.85%, implement (10.65%, retrieve (8.36%, recognize (6.17%, analyze (1.99%, measure (1.59%, generalize (1.09%, SNRP (1.00%, classify (0.80%, represent (0.80%, justify (0.80%, select (0.60%, model (0.30%, synthesis (0.20%. Secara keseluruhan berdasarkan International Assessment TIMSS 2007 soal yang termasuk domain knowing memiliki persentase paling tinggi (52.28%, domain knowing-applying (24.83%, domain knowing- reasoning (12.91%, dan hanya sedikit yang termasuk domain knowing-apllying-reasoning (3.97%. Serta terdapat 4 soal (1.32% yang mempunyai ketidaksesuaian penggunaan mathematics terms serta 1 soal (0

  1. Recurrent myocardial infarctions in a young football player secondary to thrombophilia, associated with elevated factor VIII activity

    Directory of Open Access Journals (Sweden)

    Vacek TP

    2014-10-01

    Full Text Available Thomas P Vacek, Shipeng Yu, Shahnaz Rehman, Blair P Grubb, Daniel Kosinski, Cherian Verghese, Ehab A Eltahawy, Shafiq Qaiser Department of Medicine, University of Toledo Medical Center, Toledo, OH, USAAbstract: Myocardial infarction (MI due to coronary atherosclerosis in young adults is uncommon; rare causes such as cocaine abuse, arterial dissection, and thromboembolism should be considered. A 21-year-old football player, and otherwise healthy African American man, developed chest pain during exercise while bench-pressing 400 lbs. Acute MI was diagnosed based on physical examination, electrocardiography findings, and elevated cardiac enzymes. Coronary arteriography showed a thrombus occluding the proximal left anterior descending artery (LAD. Aggressive antiplatelet therapy with aspirin, clopidogrel, and eptifibatide was pursued, in addition to standard post-MI care. This led to the successful resolution of symptoms and dissolution of the thrombus, demonstrated by repeat coronary arteriography. Five months later, he presented with similar symptoms during exercise after lifting heavy weights, and was found to have another acute MI. Coronary arteriography again showed a thrombus occluding the LAD. No evidence of coronary artery dissection or vasospasm was found. Only mild atherosclerotic plaque burden was observed on both occasions by intravascular ultrasound. A bare metal stent was placed at the site as it was thought this site had acted as a nidus for small plaque rupture and thrombus formation. Elevated serum factor VIII activity at 205% (reference range 60%–140% was found, a rare cause of hypercoagulability. Further workup revealed a patent foramen ovale during a Valsalva maneuver by transesophageal echocardiography. Both events occurred during weight lifting, which can transiently increase right heart pressure in a similar way to the Valsalva maneuver. In light of all the findings, we concluded that an exercise-related increase in factor

  2. [VIPoma: surgical treatment].

    Science.gov (United States)

    Procacciante, F; Picozzi, P; Fantini, A; Pacifici, M; Di Nardo, A; Ribotta, G; Delle Fave, G; Catani, M; Ruggeri, S; Romeo, F

    1992-02-01

    This paper reports a case of pancreatic VIPoma with widespread hepatic metastasis which was treated for approximately 2 years with a synthetic somatostatin analog (SMS 201/995). The treatment of choice in cases in which the tumour was fully removable is surgical resection. This occurred rarely since approximately 80% of VIPomas are malignant and are operated late when local infiltration is already widespread; in addition, 50% of cases are already metastasised at diagnosis. In this case, due to the infiltration of the superior mesenteric artery by the primary tumour it was necessary to carry out a left pancreasectomy which included two-thirds of the neoplastic mass. This was justified by slow tumour growth and also facilitated control of diarrhea and ensured a greater efficacy of possible postoperative chemotherapy. The use of synthetic somatostatin analog (SMS 201/995) enabled diarrhea to be satisfactorily controlled and is therefore specifically indicated for this type of tumour. NSE serum assay (neuron specific enolase) allowed the evolution of disease to be monitored during follow-up.

  3. Surgical treatment of thymoma.

    Science.gov (United States)

    Miller, Quintessa; Moulton, Michael J; Pratt, Jerry

    2002-01-01

    A case report is presented of a 66-year-old white woman with a 3-month history of atypical chest pain and shortness of breath. A lateral chest radiograph demonstrated an anterior mediastinal density. A subsequent computed tomography (CT) scan revealed a mass in the right anterolateral mediastinum. Fine-needle aspiration (FNA) revealed tumor cells positive for cytokeratin and negative for leukocyte common antigen. The differential diagnosis at that time included thymoma versus thymic carcinoid. She underwent a median sternotomy with complete thymectomy. The pathology revealed a large thymoma with microinvasion into the surrounding adipose tissue. She had an uneventful postoperative course and later underwent adjuvant radiation therapy. Surgical treatment of thymoma is discussed, with emphasis on diagnosis and treatment. Although some patients may present with symptoms caused by involvement of surrounding structures, most thymomas are discovered incidentally on chest radiograph. Various diagnostic procedures can aid the surgeon in ruling out other neoplasms, such as lymphoma or germ cell tumors. Prognosis is not based on histology, but on the tumor's gross characteristics at operation. Benign tumors are noninvasive and encapsulated. All patients with potentially resectable lesions should undergo en-bloc excision. Radiation or chemotherapy should be instituted in more advanced tumors.

  4. Inspector-instrument interface in portable NDA instrumentation

    International Nuclear Information System (INIS)

    Halbig, J.K.; Klosterbuer, S.F.

    1981-01-01

    Recent electronics technology advances make it possible to design sophisticated instruments in small packages for convenient field implementation. This report describes an inspector-instrument interface design which allows communication of procedures, responses, and results between the instrument and user. The interface has been incorporated into new spent-fuel instrumentation and a battery-powered multichannel analyzer

  5. Comparative analysis of activity of coagulation Factors V and VIII and level of fibrinogen in fresh frozen plasma and frozen plasma

    Directory of Open Access Journals (Sweden)

    Mitu Dogra

    2015-01-01

    Full Text Available Background: The aim of this study was to analyse and compare the activity of factor V, VIII and fibrinogen level in fresh frozen plasma and frozen plasma frozen after 8 hrs but within 24 hours after phlebotomy. Materials and Methods: Fresh frozen plasma separated from whole blood within 8 hours was compared with plasma separated within 24 hours after phlebotomy in terms of coagulation factors V and VIII and level of fibrinogen by standard methods using semi automated coagulometer sysmex CA50. Results: Longer storage of whole blood before processing resulted in significant decrease (18.4% in activity of factor VIII but the fall in activity of factor V (6.52% or level of fibrinogen (1.81% was not significant. Discussion: These data suggest that there is good retention of coagulation factors in both types of plasma. Although there is significant fall in activity of factor VIII, but it is an acute phase reactant and raised in most of the diseases so it is suggested that frozen plasma would be an acceptable product for most patients requiring fresh frozen plasma.

  6. High-resolution mapping of epitopes on the C2 domain of factor VIII by analysis of point mutants using surface plasmon resonance

    OpenAIRE

    Nguyen, Phuong-Cac T.; Lewis, Kenneth B.; Ettinger, Ruth A.; Schuman, Jason T.; Lin, Jasper C.; Healey, John F.; Meeks, Shannon L.; Lollar, Pete; Pratt, Kathleen P.

    2014-01-01

    Amino acid residues comprising B-cell epitopes recognized by neutralizing anti-factor VIII antibodies (inhibitors) have been identified.Amino acids contributing significant antigen–antibody binding avidity are candidates for mutagenesis in the design of less antigenic proteins.

  7. Hemophilia as a defect of the tissue factor pathway of blood coagulation: Effect of factors VIII and IX on factor X activation in a continuous-flow reactor

    International Nuclear Information System (INIS)

    Repke, D.; Gemmell, C.H.; Guha, A.; Turitto, V.T.; Nemerson, Y.; Broze, G.J. Jr.

    1990-01-01

    The effect of factors VIII and IX on the ability of the tissue factor-factor VIIa complex to activate factor X was studied in a continuous-flow tubular enzyme reactor. Tissue factor immobilized in a phospholipid bilayer on the inner surface of the tube was exposed to a perfusate containing factors VIIa, VIII, IX, and X flowing at a wall shear rate of 57, 300, or 1130 sec -1 . The addition of factors VIII and IX at their respective plasma concentrations resulted in a further 2 endash-to 3 endash fold increase. The direct activation of factor X by tissue factor-factor VIIa could be virtually eliminated by the lipoprotein-associated coagulation inhibitor. These results suggest that the tissue factor pathway, mediated through factors VIII and IX, produces significant levels of factor Xa even in the presence of an inhibitor of the tissue factor-factor VIIa complex; moreover, the activation is dependent on local shear conditions. These findings are consistent both with a model of blood coagulation in which initiation of the system results from tissue factor and with the bleeding observed in hemophilia

  8. Retsensioon : Riigikogu VII, VIII ja IX koosseis. Statistikat ja kommentaare. Peatoimetaja Aaro Mõttus. Tallinn : Riigikogu Kantselei, Eesti Rahvusraamatukogu, 2004. 326 lk. / Mart Nutt

    Index Scriptorium Estoniae

    Nutt, Mart, 1962-

    2004-01-01

    Arvustus: Riigikogu VII, VIII ja IX koosseis. Statistikat ja kommentaare / peatoim. Aaro Mõttus. Tallinn : Riigikogu Kantselei, Eesti Rahvusraamatukogu, 2004. - Lisatud: Ott Heinapuu tutvustav sõnum retsenseeritud väljaande kohta lk. 193. - Vt. ka: http://www.riigikogu.ee/rito/index.php?id=11357

  9. Reticular Basement Membrane Vessels Are Increased in COPD Bronchial Mucosa by Both Factor VIII and Collagen IV Immunostaining and Are Hyperpermeable

    Directory of Open Access Journals (Sweden)

    Amir Soltani

    2012-01-01

    Full Text Available Background and Objective. Using Collagen IV staining, we have previously reported that the reticular basement membrane (Rbm is hypervascular and the lamina propria (LP is hypovascular in COPD airways. This study compared Collagen IV staining with vessels marked with anti-Factor VIII and examined vessel permeability in bronchial biopsies from COPD and normal subjects using albumin staining. Results. Anti-Collagen IV antibody detected more vessels in the Rbm (P=0.002 and larger vessels in both Rbm (P<0.001 and LP (P=0.003 compared to Factor VIII. COPD airways had more vessels (with greater permeability in the Rbm (P=0.01 and fewer vessels (with normal permeability in the LP compared to controls with both Collagen IV and Factor VIII antibodies (P=0.04 and P=0.01. Conclusion. Rbm vessels were increased in number and were hyperpermeable in COPD airways. Anti-Collagen IV and anti-Factor VIII antibodies did not uniformly detect the same vessel populations; the first is likely to reflect larger and older vessels with the latter reflecting smaller, younger vessels.

  10. Report on corrections and future considerations for Appendices II–VIII of the International Code of Nomenclature for Algae, Fungi, and Plants

    Science.gov (United States)

    For the first time, the main text and Appendices II–VIII of the International Code of Nomenclature were separately published following decisions of the Melbourne Nomenclature Section, which contributed to subsequent development of an online resource capable of producing the Appendices in real time. ...

  11. Factor VIII C1 domain spikes 2092-2093 and 2158-2159 comprise regions that modulate cofactor function and cellular uptake

    NARCIS (Netherlands)

    Bloem, Esther; van den Biggelaar, Maartje; Wroblewska, Aleksandra; Voorberg, Jan; Faber, Johan H.; Kjalke, Marianne; Stennicke, Henning R.; Mertens, Koen; Meijer, Alexander B.

    2013-01-01

    The C1 domain of factor VIII (FVIII) has been implicated in binding to multiple constituents, including phospholipids, von Willebrand factor, and low-density lipoprotein receptor-related protein (LRP). We have previously described a human monoclonal antibody called KM33 that blocks these

  12. Identification of coagulation factor VIII A2 domain residues forming the binding epitope for low-density lipoprotein receptor-related protein.

    Science.gov (United States)

    Sarafanov, Andrey G; Makogonenko, Evgeny M; Pechik, Igor V; Radtke, Klaus-Peter; Khrenov, Alexey V; Ananyeva, Natalya M; Strickland, Dudley K; Saenko, Evgueni L

    2006-02-14

    Regulation of the coagulation factor VIII (fVIII) level in circulation involves a hepatic receptor low-density lipoprotein receptor-related protein (LRP). One of two major LRP binding sites in fVIII is located within the A2 domain (A2), likely exposed within the fVIII complex with von Willebrand factor and contributing to regulation of fVIII via LRP. This work aimed to identify A2 residues forming its LRP-binding site, previously shown to involve residues 484-509. Isolated A2 was subjected to alanine-scanning mutagenesis followed by expression of a set of mutants in a baculovirus system. In competition and surface plasmon resonance assays, affinities of A2 mutants K466A, R471A, R484A, S488A, R489A, R490A, H497A, and K499A for LRP were found to be decreased by 2-4-fold. This correlated with 1.3-1.5-fold decreases in the degree of LRP-mediated internalization of the mutants in cell culture. Combining these mutations into pairs led to cumulative effects, i.e., 7-13-fold decrease in affinity for LRP and 1.6-2.2-fold decrease in the degree of LRP-mediated internalization in cell culture. We conclude that the residues mentioned above play a key role in formation of the A2 binding epitope for LRP. Experiments in mice revealed an approximately 4.5 times shorter half-life for A2 in the circulation in comparison with that of fVIII. The half-lives of A2 mutant R471A/R484A or A2 co-injected with receptor-associated protein, a classical ligand of LRP, were prolonged by approximately 1.9 and approximately 3.5 times, respectively, compared to that of A2. This further confirms the importance of the mutated residues for interaction of A2 with LRP and suggests the existence of an LRP-dependent mechanism for removing A2 as a product of dissociation of activated fVIII from the circulation.

  13. Expressão citofotométrica dos marcadores tumorais CD-34 e fator VIII no câncer de cólon

    Directory of Open Access Journals (Sweden)

    Cacilda Joyce Ferreira da Silva Garcia

    Full Text Available OBJETIVOS: Verificar a posssibilidade de quantificar a expressão dos marcadores tumorais CD-34 e Fator VIII no câncer de cólon; verificar se existe superioridade entre um marcador e outro para estudo da angiogênese; verificar se há correlação na análise do índice de marcagem e a densidade óptica média nos marcadores utilizados. MÉTODOS: Dezessete casos de adenocarcinoma colorretal recuperados de blocos de parafina e confirmados pela hematoxilina-eosina, foram submetidos à coloração imunoistoquímica pelo método da estreptoavidina-biotina-peroxidase e utilizados os marcadores tumorais CD-34 e Fator VIII. Após este processo as lâminas foram submetidas à leitura no sistema Samba 4000® e avaliadas pelo software Immuno®. Os parâmetros estudados foram: índice de marcagem e densidade óptica, expressos por médias, medianas, valores mínimos, valores máximos e desvios-padrão, analisados estatisticamente. RESULTADOS: Para o marcador CD-34 não houve normalidade dos dados em relação ao índice de marcagem e houve para a densidade óptica. Para o Fator VIII, houve normalidade de dados em relação ao índice de marcagem e para a densidade óptica. CONCLUSÃO: Foi possível quantificar a expressão dos marcadores tumorais CD-34 e Fator VIII através do índice de marcagem e da densidade óptica média; não houve diferença entre os marcadores em relação à média do índice de marcagem e da densidade óptica, não sendo possível definir superioridade entre um e outro; não foi observada tendência à correlação quando comparados densidade óptica e índice de marcagem do Fator VIII e do CD-34 isoladamente estudados; não houve correlação entre o índice de marcagem do Fator VIII quando comparado com o CD-34, bem como a densidade óptica do Fator VIII com o CD-34.

  14. [Nutritional status of elderly surgical patients].

    Science.gov (United States)

    Damuleviciene, Gyte; Lesauskaite, Vita; Macijauskiene, Jūrate

    2008-01-01

    The aim of this study was to assess nutritional status of aged surgical patients, to determine the prevalence of malnutrition and factors associated with it. A total of 156 patients aged 45 years and more, treated at the Departments of Surgery and Urology of Kaunas 2nd Clinical Hospital, were enrolled in the study. Elderly group (aged 65 years and more) consisted of 99 patients, and middle-aged group (45 to 64 years old) of 57 patients. The following anthropometric measurements were performed: weight, height, mid-arm circumference; hemoglobin, serum albumin level, and total lymphocyte count were determined. Standard assessment scales included Instrumental Activities of Daily Living, Geriatric Depression Scale, and Mini Mental State Exam. Statistical analysis was performed with the help of SPSS 12.0. Malnutrition was diagnosed in 53.5% of older patients and in 15.8% of middle-aged patients (Pcognitive functions than among those without impaired cognitive functions (in 100% of patients with medium impaired cognitive function, in 59.3% of patients with mild impaired cognitive function, and in 44.4% of patients with unimpaired cognitive function, Pfunctional level than the remaining (IADL score of 3.97 and 4.75 for men, 5.38 and 6.89 for women, respectively; P0.05). Malnutrition was diagnosed more frequently in elderly surgical patients than in middle-aged patients. Obesity was more common in women than in men. The prevalence of obesity was not associated with age. Malnutrition in elderly surgical patients was associated with poor functional status, impaired cognitive function, and urgent operation.

  15. Integrating Nephelometer Instrument Handbook

    Energy Technology Data Exchange (ETDEWEB)

    Uin, J. [Brookhaven National Lab. (BNL), Upton, NY (United States)

    2016-03-01

    The Integrating Nephelometer (Figure 1) is an instrument that measures aerosol light scattering. It measures aerosol optical scattering properties by detecting (with a wide angular integration – from 7 to 170°) the light scattered by the aerosol and subtracting the light scattered by the carrier gas, the instrument walls and the background noise in the detector (zeroing). Zeroing is typically performed for 5 minutes every day at midnight UTC. The scattered light is split into red (700 nm), green (550 nm), and blue (450 nm) wavelengths and captured by three photomultiplier tubes. The instrument can measure total scatter as well as backscatter only (from 90 to 170°) (Heintzenberg and Charlson 1996; Anderson et al. 1996; Anderson and Ogren 1998; TSI 3563 2015) At ARM (Atmospheric Radiation Measurement), two identical Nephelometers are usually run in series with a sample relative humidity (RH) conditioner between them. This is possible because Nephelometer sampling is non-destructive and the sample can be passed on to another instrument. The sample RH conditioner scans through multiple RH values in cycles, treating the sample. This kind of setup allows to study how aerosol particles’ light scattering properties are affected by humidification (Anderson et al. 1996). For historical reasons, the two Nephelometers in this setup are labeled “wet” and “dry”, with the “dry” Nephelometer usually being the one before the conditioner and sampling ambient air (the names are switched for the MAOS measurement site due to the high RH of the ambient air).

  16. AC resistance measuring instrument

    Science.gov (United States)

    Hof, P.J.

    1983-10-04

    An auto-ranging AC resistance measuring instrument for remote measurement of the resistance of an electrical device or circuit connected to the instrument includes a signal generator which generates an AC excitation signal for application to a load, including the device and the transmission line, a monitoring circuit which provides a digitally encoded signal representing the voltage across the load, and a microprocessor which operates under program control to provide an auto-ranging function by which range resistance is connected in circuit with the load to limit the load voltage to an acceptable range for the instrument, and an auto-compensating function by which compensating capacitance is connected in shunt with the range resistance to compensate for the effects of line capacitance. After the auto-ranging and auto-compensation functions are complete, the microprocessor calculates the resistance of the load from the selected range resistance, the excitation signal, and the load voltage signal, and displays of the measured resistance on a digital display of the instrument. 8 figs.

  17. Measurement and Instrumentation

    Energy Technology Data Exchange (ETDEWEB)

    Kirkham, Harold

    2018-01-02

    This is a chapter for a book called the Standard Handbook for Electrical Engineering. Though it is not obvious from the title, the book deals mainly with power engineering. The first chapter (not mine) is about the fundamental quantities used in measurement. This chapter is about the process and the instrumentation.

  18. Instruments for Everyone.

    Science.gov (United States)

    Perkins-Bosarge, Sarah

    1998-01-01

    Thanks to an entrepreneurial principal, nearly 75% of a rural New York State school's upper-division students participate in band. To ensure access, the principal bargains with second-hand dealers for instruments (using fees from photo profits) and charges kids a fee of $1 to $15 yearly. Consulting with the music teacher avoids duplication and…

  19. Economic Policy Instruments

    DEFF Research Database (Denmark)

    Klemmensen, Børge

    2007-01-01

    Økonomiske instrumenter begrundes med behovet for politiske indgreb, der muliggør internaliseringen af omkostningerne ved de miljøpåvirkninger, produktion and levevis afstedkommer, således at hensyntagen til miljøet bliver en del af virksomheders og husholdningers omkostninger og dermed en tilsky...

  20. Designing Intelligent Instruments

    Science.gov (United States)

    Knuth, Kevin H.; Erner, Philip M.; Frasso, Scott

    2007-11-01

    Remote science operations require automated systems that can both act and react with minimal human intervention. One such vision is that of an intelligent instrument that collects data in an automated fashion, and based on what it learns, decides which new measurements to take. This innovation implements experimental design and unites it with data analysis in such a way that it completes the cycle of learning. This cycle is the basis of the Scientific Method. The three basic steps of this cycle are hypothesis generation, inquiry, and inference. Hypothesis generation is implemented by artificially supplying the instrument with a parameterized set of possible hypotheses that might be used to describe the physical system. The act of inquiry is handled by an inquiry engine that relies on Bayesian adaptive exploration where the optimal experiment is chosen as the one which maximizes the expected information gain. The inference engine is implemented using the nested sampling algorithm, which provides the inquiry engine with a set of posterior samples from which the expected information gain can be estimated. With these computational structures in place, the instrument will refine its hypotheses, and repeat the learning cycle by taking measurements until the system under study is described within a pre-specified tolerance. We will demonstrate our first attempts toward achieving this goal with an intelligent instrument constructed using the LEGO MINDSTORMS NXT robotics platform.