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Sample records for surgical sex reassignment

  1. Surgical treatment of locally advanced anal cancer after male-to-female sex reassignment surgery

    Institute of Scientific and Technical Information of China (English)

    Marco Caricato; Fabio Ausania; Giovanni Francesco Marangi; Ilaria Cipollone; Gerardo Flammia; Paolo Persichetti; Lucio Trodella; Roberto Coppola

    2009-01-01

    We present a case of a transsexual patient who underwent a partial pelvectomy and genital reconstruction for anal cancer after chemoradiation. This is the first case in literature reporting on the occurrence of anal cancer after male-to-female sex reassignment surgery. We describe the surgical approach presenting our technique to avoid postoperative complications and preserve the sexual reassignment.

  2. Sex reassignment surgery

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    Bižić Marta

    2015-01-01

    Full Text Available Transsexualism, or gender incongruence, presents a state in which a person's assigned sex at birth conflicts with their psychological gender. It is classified in International Classification of Diseases as F64. Treating these persons require multidisciplinary approach, including psychiatrist, endocrinologist, gynecologist, urologist, plastic and reconstructive surgeon. Genital reconstruction is the final step in transition, and can be performed when all other conditions required by World Professional Association for Transgender Health (WPATH are accomplished. Female to male sex reassignment surgery Several surgical procedures can be done in female to male transsexuals, including mastectomy, removal of female genitalia, metoidioplasty, scrotoplasty with implantation of testicular implants, as well as total phalloplasty. The current operative technique of metoidioplasty comprise the following steps: vaginal removal, the release of the ventral chordee and clitoral ligaments, straightening and lengthening of the clitoris, urethroplasty by combining buccal mucosa graft and genital flaps and scrotoplasty with insertion of testicle prostheses. The goal is to perform all these procedures in one stage, and that makes our team famous worldwide. Metoidioplasty results in excellent cosmetic outcome with completely preserved sensitivity and sexual arousal, enables voiding while standing, but without ability to penetrate due to small size of the neophallus. Considering these advantages, including low complication rate, patients often choose this option. For those who require bigger phallus which enables implantation of penile prosthesis, several surgical techniques have been reported using either available local vascularized tissue or microvascular tissue transfer. However, none of them satisfy all the goals of modern penile construction, i.e. reproducibility, tactile and erogenous sensation, a competent neourethra with a meatus at the top of the neophallus

  3. Phantom erectile penis after sex reassignment surgery

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    Kimata,Yoshihiro

    2008-06-01

    Full Text Available Between January 2001 and December 2007, we performed vaginoplasty as sex reassignment surgery in a total of 14 male-to-female transsexual (MTFTS patients [1]. Several complications occurred such as partial flap necrosis, rectovaginal fistula formation and hypersensitivity of the neoclitoris. Just after the operation, some patients feel that their penises still exist, but by several weeks postoperatively, this sensation has disappeared. Herein we report a case of MTFTS in whom the sensation of a phantom erectile penis persisted for much longer.

  4. Long-term follow-up of transsexual persons undergoing sex reassignment surgery: cohort study in Sweden.

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    Cecilia Dhejne

    Full Text Available CONTEXT: The treatment for transsexualism is sex reassignment, including hormonal treatment and surgery aimed at making the person's body as congruent with the opposite sex as possible. There is a dearth of long term, follow-up studies after sex reassignment. OBJECTIVE: To estimate mortality, morbidity, and criminal rate after surgical sex reassignment of transsexual persons. DESIGN: A population-based matched cohort study. SETTING: Sweden, 1973-2003. PARTICIPANTS: All 324 sex-reassigned persons (191 male-to-females, 133 female-to-males in Sweden, 1973-2003. Random population controls (10:1 were matched by birth year and birth sex or reassigned (final sex, respectively. MAIN OUTCOME MEASURES: Hazard ratios (HR with 95% confidence intervals (CI for mortality and psychiatric morbidity were obtained with Cox regression models, which were adjusted for immigrant status and psychiatric morbidity prior to sex reassignment (adjusted HR [aHR]. RESULTS: The overall mortality for sex-reassigned persons was higher during follow-up (aHR 2.8; 95% CI 1.8-4.3 than for controls of the same birth sex, particularly death from suicide (aHR 19.1; 95% CI 5.8-62.9. Sex-reassigned persons also had an increased risk for suicide attempts (aHR 4.9; 95% CI 2.9-8.5 and psychiatric inpatient care (aHR 2.8; 95% CI 2.0-3.9. Comparisons with controls matched on reassigned sex yielded similar results. Female-to-males, but not male-to-females, had a higher risk for criminal convictions than their respective birth sex controls. CONCLUSIONS: Persons with transsexualism, after sex reassignment, have considerably higher risks for mortality, suicidal behaviour, and psychiatric morbidity than the general population. Our findings suggest that sex reassignment, although alleviating gender dysphoria, may not suffice as treatment for transsexualism, and should inspire improved psychiatric and somatic care after sex reassignment for this patient group.

  5. Feminine transformations: gender reassignment surgical tourism in Thailand.

    Science.gov (United States)

    Aizura, Aren Z

    2010-10-01

    Every year, hundreds of transgendered people from the United States, Europe, Asia, Canada, and Australia travel to Thailand to undergo cosmetic and gender reassignment surgeries (GRS). Many GRS clinics market themselves almost exclusively to non-Thai trans women (people assigned a male sex at birth who later identify as female). This article draws on ethnographic research with patients visiting Thailand for GRS to explore how trans women patients related their experience of medical care in Thailand to Thai cultural traditions, in particular "traditional" Thai femininity and Theravada Buddhist rituals and beliefs. Foreign patients in Thai hospital settings engage not only with medical practices but also with their perceptions of Thai cultural traditions--which inflect their feminine identifications. I draw on two patients' accounts of creating personal rituals to mark their gender reassignment surgery, placing these accounts within the context of biomedical globalization and debates about the touristic appropriation of non-"Western" cultural practices.

  6. Sex reassignment surgery for male to female transsexuals: initial experience in Okayama university hospital.

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    Nagai,Atsushi

    2005-10-01

    Full Text Available

    The first case of sex reassignment surgery (SRS in our hospital was performed in January 2001; as of February, 2005, 4 cases of MTF-SRS had been performed. In the 2 most recent cases, we used penile and scrotal skin flaps to avoid complications. The depth and width of the new vagina was made to be adequate for sexual intercourse. Future attention should be focused on devising a surgical technique that will help prevent the complications of partial necrosis of the epidermal skin and wound dehiscence. Although ours is only an initial experience, we describe our surgical technique herein.

  7. The development of sex reassignment surgery in Thailand: a social perspective.

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    Chokrungvaranont, Prayuth; Selvaggi, Gennaro; Jindarak, Sirachai; Angspatt, Apichai; Pungrasmi, Pornthep; Suwajo, Poonpismai; Tiewtranon, Preecha

    2014-01-01

    This paper reviews the development of gender reassignment in Thailand during the period of 1975-2012, in terms of social attitude, epidemiology, surgical patients' profile, law and regulation, religion, and patients' path from psychiatric assessment to surgery. Thailand healthcare for transsexual patients is described. Figures related to the number of sex reassignment surgeries performed in Thailand over the past 30 years are reported. Transsexual individuals are only apparently integrated within the Thail society: the law system of Thailand in fact, does not guarantee to transsexuals the same rights as in other Western countries; the governmental healthcare does not offer free treatments for transsexual patients. In favor of the transsexual healthcare, instead, the Medical Council of Thailand recently published a policy entitled "Criteria for the treatment of sex change, Census 2009." The goal of this policy was to improve the care of transsexual patients in Thailand, by implementing the Standards of Care of the World Professional Association of Transgender Health. Currently, in Thailand, there are 6 major private groups performing sex reassignment surgery, and mostly performing surgery to patients coming from abroad. Particularly, the largest of these (Preecha's group) has performed nearly 3000 vaginoplasties for male-to-female transsexuals in the last 30 years.

  8. The Development of Sex Reassignment Surgery in Thailand: A Social Perspective

    Directory of Open Access Journals (Sweden)

    Prayuth Chokrungvaranont

    2014-01-01

    Full Text Available This paper reviews the development of gender reassignment in Thailand during the period of 1975–2012, in terms of social attitude, epidemiology, surgical patients’ profile, law and regulation, religion, and patients’ path from psychiatric assessment to surgery. Thailand healthcare for transsexual patients is described. Figures related to the number of sex reassignment surgeries performed in Thailand over the past 30 years are reported. Transsexual individuals are only apparently integrated within the Thail society: the law system of Thailand in fact, does not guarantee to transsexuals the same rights as in other Western countries; the governmental healthcare does not offer free treatments for transsexual patients. In favor of the transsexual healthcare, instead, the Medical Council of Thailand recently published a policy entitled “Criteria for the treatment of sex change, Census 2009.” The goal of this policy was to improve the care of transsexual patients in Thailand, by implementing the Standards of Care of the World Professional Association of Transgender Health. Currently, in Thailand, there are 6 major private groups performing sex reassignment surgery, and mostly performing surgery to patients coming from abroad. Particularly, the largest of these (Preecha’s group has performed nearly 3000 vaginoplasties for male-to-female transsexuals in the last 30 years.

  9. Combined vaginoplasty technique for male-to-female sex reassignment surgery: Operative approach and outcomes.

    Science.gov (United States)

    Papadopulos, Nikolaos A; Zavlin, Dmitry; Lellé, Jean-Daniel; Herschbach, Peter; Henrich, Gerhard; Kovacs, Laszlo; Ehrenberger, Benjamin; Machens, Hans-Guenther; Schaff, Juergen

    2017-10-01

    Several therapy options exist for male-to-female (MTF) transgenders desiring sex reassignment. Surgery includes numerous different procedures. Of those, vaginoplasty is predominant and aims at providing attractive esthetics and fully functional genitals. This study aimed to present the surgical results of our modified combined vaginoplasty technique in a consecutive patient cohort. We included 40 MTF transgender patients who underwent a two-stage sex reassignment surgery (SRS) in an observational prospective study between September 2012 and January 2014. Demographic characteristics, medical and surgical history, operative details, and outcomes after surgery were documented. Postoperatively, 23 patients received a pelvic examination following the standardized protocol. Measured vaginal depth was 11.77-14.99 cm depending on the size of the dilator used (25-40 mm). Vaginal, clitoral, and labial sensitivities were intact and favorable in all examined patients. Nineteen women (47.5%) opted for breast augmentations to achieve a feminine cosmesis, making it the most common nongenital operation. Complications were mostly minor and temporary. Severe adverse events, such as wound infections (n = 3), colon injuries (3), short (1) or narrow (1) vaginas, or partial clitoral necroses (1), were rare and immediately addressed by the surgical team. No vaginal construction was lost, and no secondary reconstructive approaches were required. Satisfactory physical results and favorable low rates of complications endorse our combined technique for MTF SRS. These findings, however, need to be confirmed by other research groups as well. Therefore, in our opinion, MTF SRS remains an evolving area of development, whose research is aiming to establish a state-of-the-art surgical technique. Copyright © 2017 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  10. Neovaginal construction in vaginal aplasia and sex-reassignment surgery.

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    Siemssen, P A; Matzen, S H

    1997-03-01

    During the period 1984-1994 33 patients were admitted to the department of plastic surgery for the purpose of neovaginal construction. They comprised 22 patients with vaginal agenesis or aplasia and 11 transsexual men. In most cases neovaginal construction was done by blunt dissection and lining with a split thickness skin graft from the thigh, and in the cases of sex-reassignment surgery genital skin was also used. The two groups differed as the patients with vaginal agenesis or aplasia had remarkably few complications compared with the transsexual group. The most common complications were defects in the skin grafts and vaginal stenosis. The transsexuals therefore had an extended recovery period including several admissions and visits to the outpatient clinic. The difference in genotype does not explain the high complication rate in the transsexual group as eight in the vaginal agenesis or aplasia group had Morris syndrome (testicular feminisation (XY)). However, the phenotype may be of importance in vaginal construction as the male (transsexual) pelvis is narrow and the levator muscles are stronger than those in the female pelvis.

  11. Sexual and physical health after sex reassignment surgery.

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    De Cuypere, Griet; T'Sjoen, Guy; Beerten, Ruth; Selvaggi, Gennaro; De Sutter, Petra; Hoebeke, Piet; Monstrey, Stan; Vansteenwegen, Alfons; Rubens, Robert

    2005-12-01

    A long-term follow-up study of 55 transsexual patients (32 male-to-female and 23 female-to-male) post-sex reassignment surgery (SRS) was carried out to evaluate sexual and general health outcome. Relatively few and minor morbidities were observed in our group of patients, and they were mostly reversible with appropriate treatment. A trend toward more general health problems in male-to-females was seen, possibly explained by older age and smoking habits. Although all male-to-females, treated with estrogens continuously, had total testosterone levels within the normal female range because of estrogen effects on sex hormone binding globulin, only 32.1% reached normal free testosterone levels. After SRS, the transsexual person's expectations were met at an emotional and social level, but less so at the physical and sexual level even though a large number of transsexuals (80%) reported improvement of their sexuality. The female-to-males masturbated significantly more frequently than the male-to-females, and a trend to more sexual satisfaction, more sexual excitement, and more easily reaching orgasm was seen in the female-to-male group. The majority of participants reported a change in orgasmic feeling, toward more powerful and shorter for female-to-males and more intense, smoother, and longer in male-to-females. Over two-thirds of male-to-females reported the secretion of a vaginal fluid during sexual excitation, originating from the Cowper's glands, left in place during surgery. In female-to-males with erection prosthesis, sexual expectations were more realized (compared to those without), but pain during intercourse was more often reported.

  12. Long-term follow-up of individuals undergoing sex reassignment surgery: Psychiatric morbidity and mortality

    DEFF Research Database (Denmark)

    Simonsen, Rikke Kildevaeld; Giraldi, Annamaria; Kristensen, Ellids

    2016-01-01

    BACKGROUND: There is a lack of long-term register-based follow-up studies of sex-reassigned individuals concerning mortality and psychiatric morbidity. Accordingly, the present study investigated both mortality and psychiatric morbidity using a sample of individuals with transsexualism which...

  13. Controversies of Sex Re-assignment in Genetic Males with Congenital Inadequacy of the Penis.

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    Raveenthiran, Venkatachalam

    2017-07-08

    Sex assignment in 46XY genetic male children with congenital inadequacy of the penis (CIP) is controversial. Traditionally, children with penile length less than 2 cm at birth are considered unsuitable to be raised as males. They are typically re-assigned to female-sex and feminizing genitoplasty is usually done in infancy. However, the concept of cerebral androgen imprinting has caused paradigm shift in the philosophy of sex re-assignment. Masculinization of the brain, rather than length of the penis, is the modern criterion of sex re-assignment in CIP. This review summarizes the current understanding of the complex issue. In 46XY children with CIP, male-sex assignment appears appropriate in non-hormonal conditions such as idiopathic micropenis, aphallia and exstrophy. Female-sex re-assignment appears acceptable in complete androgen insensitivity (CAIS), while partial androgen insensitivity syndrome (PAIS) patients are highly dissatisfied with the assignment of either sex. Children with 5-alpha reductase deficiency are likely to have spontaneous penile lengthening at puberty. Hence, they are better raised as males. Although female assignment is common in pure gonadal dysgenesis, long-term results are not known to justify the decision.

  14. Surgical site infections in genital reconstruction surgery for gender reassignment, Detroit: 1984-2008.

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    Zhao, Jing J; Marchaim, Dror; Palla, Mohan B; Bogan, Christopher W; Hayakawa, Kayoko; Tansek, Ryan; Moshos, Judy; Muthusamy, Arunkumar; Kotra, Harikrishna; Lephart, Paul R; Wilson, Alan N; Kaye, Keith S

    2014-04-01

    Gender reassignment surgery (i.e., male-to-female or female-to-male) entails a series of complex surgical procedures. We conducted a study to explore epidemiologic characteristics of patients who underwent genital reconstruction operations as components of gender reassignment and to analyze risk factors for surgical-site infections (SSIs) following these operations. The study was a retrospective cohort study conducted from 1984-2008 at Harper University Hospital, a tertiary hospital with 625 beds in Detroit, Michigan. Surgical site infection was defined according to established criteria. Records were available for 82 patients who underwent a total of 1,383 operations as part of genital-reconstruction processes. Thirty-nine (47.6%) of the patients underwent female-to-male reassignment (FTM) and 43 (52.4%) underwent male-to-female reassignment (MTF). The average age of the study cohort was 39.5±9.8 y. Of the patients in the cohort, 56 (68.3%) were Caucasian and 67 (81.7%) were single. The average number of operative encounters per patient was 11.8±4.6 for FTM and 4.9±2.4 for MTF. Forty-three (52.4%) patients developed an SSI at least once during their genital reconstruction process, of whom 34 (87%) were in the FTM group and nine (21%) in the MTF group (pinfections, followed by Enterobacteriaceae (50%), Enterococcus (39%), and Pseudomonas aeruginosa (33.3%). Surgical site infection was associated independently with an increased frequency of operative procedures and operating room encounters. More than 50% of patients who underwent genital reconstruction operations developed an SSI at some point during the genital reconstruction process. Surgical site infections are more common in FTM than in MTF reconstruction operations, and for both FTM and MTF, SSIs are associated independently with an increased frequency of total operative procedures and encounters.

  15. Long-Term Follow-Up of Individuals Undergoing Sex-Reassignment Surgery: Somatic Morbidity and Cause of Death

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    Simonsen, Rikke Kildevæld; Hald, Gert Martin; Kristensen, Ellids; Giraldi, Annamaria

    2016-01-01

    Introduction Studies of mortality and somatic well-being after sex-reassignment surgery (SRS) of transsexual individuals are equivocal. Accordingly, the present study investigated mortality and somatic morbidity using a sample of transsexual individuals who comprised 98% (n = 104) of all surgically reassigned transsexual individuals in Denmark. Aims To investigate somatic morbidity before and after SRS and cause of death and its relation to somatic morbidity after SRS in Danish individuals who underwent SRS from 1978 through 2010. Methods Somatic morbidity and mortality in 104 sex-reassigned individuals were identified retrospectively by data from the Danish National Health Register and the Cause of Death Register. Main Outcome Measures Somatic morbidity and cause of death. Results Overall, 19.2% of the sample were registered with somatic morbidity before SRS and 23.1% after SRS (P = not significant). In total, 8.6% had somatic morbidity before and after SRS. The most common diagnostic category was cardiovascular disease, affecting 18 individuals, 9 before and 14 after SRS, and 5 of those 14 who were affected after SRS had cardiovascular disease before and after SRS. Ten individuals died after SRS at an average age of 53.5 ± 7.9 years (male to female) and 53.5 ± 7.3 years (female to male). Conclusion Of 98% of all Danish transsexuals who officially underwent SRS from 1978 through 2010, one in three had somatic morbidity and approximately 1 in 10 had died. No significant differences in somatic morbidity or mortality were found between male-to-female and female-to-male individuals. Despite the young average age at death and the relatively larger number of individuals with somatic morbidity, the present study design does not allow for determination of casual relations between, for example, specific types of hormonal or surgical treatment received and somatic morbidity and mortality. PMID:26944779

  16. Sex reassignment technology: the dilemma of transsexuals in Islam and Christianity.

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    Ishak, Mohd Shuhaimi Bin Haji; Haneef, Sayed Sikandar Shah

    2014-04-01

    The birth of people with confused or ambiguous sex makeup as a biological fact since the annals of history has posed the challenge of accommodating them within the binary gender of sociocultural systems. In this process, the role of religion as a defining factor in social engineering has been paramount. Major religions, such as Islam and Christianity, have addressed this issue within the frame of their God-ordained laws by devising a set of moral and legal imperatives specific to the "third gender." Modern developments in medicine and biology, however, have made sex reassignment possible for this category of people, today called transsexuals. The question is: How do Islam and Christianity respond to it. After presenting an analytical view of both Muslim scholars and Christian religious authorities on the legitimacy of sex reassignment for transsexuals, this paper attempts to explore if such a dilemma can be resolved.

  17. Status of sex reassignment surgery for gender identity disorder in Japan.

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    Masumori, Naoya

    2012-05-01

    An incongruence between one's physiological sex and the gender identity that is one's basic sense of self as a man or a woman is known as gender identity disorder. In general, the conditions of physiological men having female gender identity and physiological women having male gender identity are called male-to-female and female-to-male gender identity disorder, respectively. Although the precise pathogenesis of gender identity disorder remains unclear, the prevalence of gender identity disorder is quite high, with the rates calculated for male-to-female to be 1:25,000 and female-to-male to be 1:12,000 in Hokkaido, Japan. The diagnosis and treatment of gender identity disorder in Japan are based on the Diagnostic and Therapeutic Guidelines for Patients with Gender Identity Disorder, 4th edition. Although gender identity disorder was previously thought to be a psychiatric condition, it is extremely difficult to assign gender identity to physiological sex by psychiatric and psychological treatments. To adapt the figure of the body to the native gender identity, physical treatments such as administration of cross-sex steroids and sex reassignment surgery are considered. However, there are very few institutions that routinely carry out sex reassignment surgery in Japan, even though it is mandatory for changing sex on the census register at the present time. Sex reassignment surgery for male-to-female and female-to-male patients includes orchiectomy, penectomy, clitoroplasty, vaginoplasty and vulvoplasty, and hysterectomy, ovariectomy, metoidioplasty and phalloplasty, respectively. To provide accurate information about physical treatment for patients with gender identity disorder, even urologists who are not actively involved in the diagnosis and treatment of gender identity disorder should understand the fundamental aspects and contemporary problems of gender identity disorder.

  18. Minnesota Multiphasic Personality Inventory-2 Profiles of Patients with Gender Identity Disorder Requesting Sex Reassignment Surgery.

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    Karia, Sagar; Jamsandekar, Sanhita; Alure, Alpa; De Sousa, Avinash; Shah, Nilesh

    2016-01-01

    Gender identity disorder (GID) is a distressing disorder characterized by a persistent unhappiness with one's own sex and a desire to be of the opposite sex as well as seeking sex reassignment surgery for the same. The aim of the study was to assess the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) profiles in patients with GID and examine differences in the profiles based on original gender of the patients. Twenty-seven patients with GID that fulfilled the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition Text Revision criteria for the same were participants of the study. They were administered the MMPI-2 and the scores across various scales were statistically analyzed. Before analysis, the sample was divided into groups according to gender, i.e., male-to-female and female-to-male patients who were requesting sex reassignment surgery. No significant elevation of scores on any of the scales was noted in keeping with the fact that patients with GID usually demonstrate minimal psychopathology. All patients showed elevation on at least one subscale other than the masculinity-femininity subscale. No differences across gender were noted indicating that gender was probably not a determinant of psychopathology in GID. MMPI-2 profiles in patients with GID failed to reveal major psychopathology though the MMPI still remains a useful tool in the assessment of this population.

  19. The Role of Clitoral Anatomy in Female to Male Sex Reassignment Surgery

    Science.gov (United States)

    2014-01-01

    Introduction. Controversies on clitoral anatomy and its role in female sexual function still make clitoral reconstructive surgery very challenging. We evaluated the role of clitoral anatomic features in female to male sex reassignment surgery. Material and Methods. The study included 97 female transsexuals, aged from 18 to 41 years, who underwent single stage metoidioplasty between March 2008 and January 2013. The operative technique involved vaginectomy, the release of clitoral ligaments and urethral plate, urethroplasty by combining buccal mucosa graft and genital flaps, and scrotoplasty with insertion of testicle prostheses. Postoperative questionnaire was used to evaluate aesthetic, functional, and sexual outcome. Results. The mean followup was 30 months. The mean length of the neophallus was 7 cm, compared to mean preoperative length of the hypertrophied clitoris of 3.3 cm. Complications occurred in 27.84% of all patients, related mostly to urethroplasty. Voiding while standing was achieved in all cases. None of the patients had problems in sexual arousal, masturbation, or orgasms. Conclusion. Accurate knowledge of the clitoral anatomy, physiology, and neurovascular supply is crucial for a successful outcome of female to male sex reassignment surgery. Our approach appears to ensure overall satisfaction and high quality of sexual life. PMID:24982953

  20. The Role of Clitoral Anatomy in Female to Male Sex Reassignment Surgery

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    Vojkan Vukadinovic

    2014-01-01

    Full Text Available Introduction. Controversies on clitoral anatomy and its role in female sexual function still make clitoral reconstructive surgery very challenging. We evaluated the role of clitoral anatomic features in female to male sex reassignment surgery. Material and Methods. The study included 97 female transsexuals, aged from 18 to 41 years, who underwent single stage metoidioplasty between March 2008 and January 2013. The operative technique involved vaginectomy, the release of clitoral ligaments and urethral plate, urethroplasty by combining buccal mucosa graft and genital flaps, and scrotoplasty with insertion of testicle prostheses. Postoperative questionnaire was used to evaluate aesthetic, functional, and sexual outcome. Results. The mean followup was 30 months. The mean length of the neophallus was 7 cm, compared to mean preoperative length of the hypertrophied clitoris of 3.3 cm. Complications occurred in 27.84% of all patients, related mostly to urethroplasty. Voiding while standing was achieved in all cases. None of the patients had problems in sexual arousal, masturbation, or orgasms. Conclusion. Accurate knowledge of the clitoral anatomy, physiology, and neurovascular supply is crucial for a successful outcome of female to male sex reassignment surgery. Our approach appears to ensure overall satisfaction and high quality of sexual life.

  1. Psychosocial Adjustment to Sex Reassignment Surgery: A Qualitative Examination and Personal Experiences of Six Transsexual Persons in Croatia

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    Nataša Jokić-Begić

    2014-01-01

    Full Text Available In Croatia, transgender individuals face numerous social and medical obstacles throughout the process of transition. The aim of this study was to depict the factors contributing to the psychosocial adjustment of six transsexual individuals living in Croatia following sex reassignment surgery (SRS. A combination of quantitative and qualitative self-report methods was used. Due to the specificity of the sample, the data were collected online. Standardized questionnaires were used to assess mental health and quality of life alongside a series of open-ended questions divided into 4 themes: the decision-making process regarding SRS; social and medical support during the SRS process; experience of discrimination and stigmatizing behaviors; psychosocial adjustment after SRS. Despite the unfavorable circumstances in Croatian society, participants demonstrated stable mental, social, and professional functioning, as well as a relative resilience to minority stress. Results also reveal the role of pretransition factors such as high socioeconomic status, good premorbid functioning, and high motivation for SRS in successful psychosocial adjustment. During and after transition, participants reported experiencing good social support and satisfaction with the surgical treatment and outcomes. Any difficulties reported by participants are related to either sexual relationships or internalized transphobia. The results also demonstrate the potentially protective role that a lengthier process of transition plays in countries such as Croatia.

  2. Male Prison Inmates With Gender Dysphoria: When Is Sex Reassignment Surgery Appropriate?

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    Osborne, Cynthia S; Lawrence, Anne A

    2016-10-01

    Gender dysphoria (GD), a feeling of persistent discomfort with one's biologic sex or assigned gender, is estimated to be more prevalent in male prison inmates than in nonincarcerated males; there may be 3000-4000 male inmates with GD in prisons in the United States. An increasing number of U.S. prison systems now offer gender dysphoric inmates diagnostic evaluation, psychotherapy, cross-sex hormone therapy, and opportunities, albeit limited, to enact their preferred gender role. Sex reassignment surgery (SRS), however, has not been offered to inmates except in response to litigation. In the first case of its kind, the California Department of Corrections and Rehabilitation recently agreed to provide SRS to an inmate and developed policy guidelines for its future provision. In other recent cases, U.S. courts have ruled that male inmates with GD are entitled to SRS when it is medically necessary. Although these decisions may facilitate the provision of SRS to inmates in the future, many U.S. prison systems will probably remain reluctant to offer SRS unless legally compelled to do so. In this review, we address the medical necessity of SRS for male inmates with GD. We also discuss eligibility criteria and the practical considerations involved in providing SRS to inmates. We conclude by offering recommendations for physicians, mental health professionals, and prison administrators, designed to facilitate provision of SRS to inmates with GD in a manner that provides humane treatment, maximizes the likelihood of successful outcomes, minimizes risk of regret, and generates data that can help inform future decisions.

  3. [Girl or boy?--Parents' preferences, choice of sex, and sex reassignment surgery for children with disorders of sex development].

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    Ude-Koeller, Susanne; Muller, Luise; Wiesemann, Claudia

    2006-03-01

    Ethical guidelines for the treatment of newborns with disorders of sex development have come under critical discussion. Former patients urgently demand a reassessment of surgical genital corrections, arguing that modern societies are more willing to tolerate sexual ambiguity and that clear-cut gender differences are becoming less and less important. The growing children's rights movement has stressed the fact that children are not just objects of their parents and society's expectations. The limits of parental decision making in case of sexual ambiguity are an object of ongoing controversies. We discuss the relative authority of parents' wishes in the determination of the newborn child's sex. We reject a purely autonomy based approach. Our arguments are based on a relational ethics of parenthood.

  4. Long-Term Follow-Up of Individuals Undergoing Sex-Reassignment Surgery

    DEFF Research Database (Denmark)

    Simonsen, Rikke Kildevæld; Hald, Gert Martin; Kristensen, Ellids

    2016-01-01

    -reassigned individuals were identified retrospectively by data from the Danish National Health Register and the Cause of Death Register. Main Outcome Measures: Somatic morbidity and cause of death. Results: Overall, 19.2% of the sample were registered with somatic morbidity before SRS and 23.1% after SRS (P...... = not significant). In total, 8.6% had somatic morbidity before and after SRS. The most common diagnostic category was cardiovascular disease, affecting 18 individuals, 9 before and 14 after SRS, and 5 of those 14 who were affected after SRS had cardiovascular disease before and after SRS. Ten individuals died...

  5. Current and recalled childhood gender identity in community youth in comparison to referred adolescents seeking sex reassignment.

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    Sumia, Maria; Lindberg, Nina; Työläjärvi, Marja; Kaltiala-Heino, Riittakerttu

    2017-04-01

    We studied current (GIDYQ-A) and recalled (RCGI) childhood gender identity among 719 upper secondary school students 401 girls, mean age 17.0 (SD = 0.88) years old and 318 boys, mean age 17.2 (SD = 0.86 years old in Finland. We also compared these dimensions of identity in community youth to same dimensions among adolescent sex reassignment (SR) applicants. Most community youth scored high on the normative, cis-gender end of gender experience (median score 4.9 for boys and 4.9 for girls) and recalled fairly gender typical childhood behaviours and experiences. The girls displayed more gender non-conformity in childhood. Among the boys 2.2% and among the girls 0.5% displayed potentially clinically significant gender dysphoria on the GIDYQ-A. The community youth differed clearly from adolescent SR applicants on current and recalled childhood gender identity (SR applicants were 47, 6 natal boys and 41 natal girls, average ages were 16.4 years old (SD = 0.93) and girls were on average 16.8 years old (SD = 1.0). Copyright © 2017 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

  6. Experiences of Discrimination, Harassment, and Violence in a Sample of Italian Transsexuals Who Have Undergone Sex-Reassignment Surgery.

    Science.gov (United States)

    Prunas, Antonio; Bandini, Elisa; Fisher, Alessandra D; Maggi, Mario; Pace, Valeria; Quagliarella, Luca; Todarello, Orlando; Bini, Maurizio

    2016-01-12

    The present study aims to provide an overview of experiences of discrimination, harassment, and violence in a sample of Italian transsexuals who have undergone sex-reassignment surgery (SRS). Lack of support for gender transition from family members was also assessed, before and after SRS. Data were collected in the context of a multicentric study (Milan, Florence, and Bari) on SRS outcome. Patients who underwent SRS were contacted and asked to fill out a questionnaire concerning experiences of discrimination, harassment, violence, and crime they might have experienced in previous years. Seventy-two participants took part in the research: 46 were male-to-female (MtF; 64%) and 26 were female-to-male (FtM; 36%). Thirty-six percent of the total sample (with no differences between MtF and FtM) experienced at least one episode of harassment, violence, or discrimination. The workplace was reported to be the social area with the highest risk of discrimination and harassment (22% of participants). Reports of more than one incident of discrimination, harassment, and violence characterized the majority of participants in the MtF sample. Compared with previous studies carried out in other countries, a much larger proportion of participants could count on a supportive family environment before and after transition. Our results show that Italian society at large is prejudiced against transsexuals, but at a more "micro" level, having a trans person as a family member might result in a protective and tolerant attitude. © The Author(s) 2016.

  7. Transgender women and the Gender Reassignment Process: subjection experiences, suffering and pleasure in body adaptation

    Directory of Open Access Journals (Sweden)

    Analídia Rodolpho Petry

    Full Text Available OBJECTIVE: This article seeks to understand the experiences of transgender women in relation to the hormone therapy and sex reassignment surgery that make up the Gender Reassignment Process. METHOD: It is a qualitative study inserted into the field of cultural and gender studies. Data collection used narrative interviews, conducted in 2010 and 2011, with seven transsexual women who had been undergoing the Gender Reassignment Process for at least two years. The data was submitted to a thematic analysis. RESULTS: The results show that the transformation processes for construction of the female body include behavior adaptation, posture modification, voice modulation, hormone use, vaginal canal dilation and surgical complications. Such processes subject the body to be built as idealized to fit the gender identity, infringing on pleasures and afflictions. CONCLUSION: We concluded that the discussion involving the Gender Reassignment Process brings allowances for nursing regarding body changes experienced by transgender women.

  8. Experiment of nurture: ablatio penis at 2 months, sex reassignment at 7 months, and a psychosexual follow-up in young adulthood.

    Science.gov (United States)

    Bradley, S J; Oliver, G D; Chernick, A B; Zucker, K J

    1998-07-01

    Guidelines of psychosexual management for infants born with physical intersex conditions are intended to assist physicians and parents in making decisions about sex of assignment and rearing including the following: 1) sex assignment should be to the gender that carries the best prognosis for good reproductive function, good sexual function, normal-looking external genitalia and physical appearance, and a stable gender identity; 2) the decision regarding sex assignment should be made as early as possible, preferably during the newborn period, with an upper age limit for reversal of an initial sex assignment no later than 18 to 24 months; and 3) there should be minimal uncertainty and ambiguity on the part of parents and professionals regarding the final decision about sex assignment and rearing. J. Money used these guidelines in a case of a biologically normal male infant (one of a pair of monozygotic twins) whose penis was accidentally ablated during a circumcision at the age of 7 months. The decision to reassign the infant boy to the female sex and to rear him as a girl was made at 17 months, with surgical castration and initial genital reconstruction occurring at 21 months. Money reported follow-up data on this child through the age of 9 years. Although the girl was described as having many "tomboyish" behavioral traits, a female gender identity had apparently differentiated. Thus, it was concluded that gender identity is sufficiently incompletely differentiated at birth as to permit successful assignment of a genetic male as a girl, in keeping with the experiences of rearing. Subsequent follow-up by other investigators reported that by early adolescence the patient had rejected the female identity and began to live as a male at the age of 14 years. In adulthood, the patient recalled that he had never felt comfortable as a girl, and his mother reported similar recollections. At age 25, the patient married a woman and adopted her children. The patient reported

  9. Gender identity, gender assignment and reassignment in individuals with disorders of sex development: a major of dilemma.

    Science.gov (United States)

    Fisher, A D; Ristori, J; Fanni, E; Castellini, G; Forti, G; Maggi, M

    2016-11-01

    Disorders of Sex Development (DSD) are a wide range of congenital conditions characterized by an incongruence of components involved in sexual differentiation, including gender psychosexual development. The management of such disorders is complex, and one of the most crucial decision is represented by gender assignment. In fact, the primary goal in DSD is to have a gender assignment consistent with the underlying gender identity in order to prevent the distress related to a forthcoming Gender Dysphoria. Historically, gender assignment was based essentially on surgical outcomes, assuming the neutrality of gender identity at birth. This policy has been challenged in the past decade refocusing on the importance of prenatal and postnatal hormonal and genetic influences on psychosexual development. (1) to update the main psychological and medical issues that surround DSD, in particular regarding gender identity and gender assignment; (2) to report specific clinical recommendations according to the different diagnosis. A systematic search of published evidence was performed using Medline (from 1972 to March 2016). Review of the relevant literature and recommendations was based on authors' expertise. A review of gender identity and assignment in DSD is provided as well as clinical recommendations for the management of individuals with DSD. Given the complexity of this management, DSD individuals and their families need to be supported by a specialized multidisciplinary team, which has been universally recognized as the best practice for intersexual conditions. In case of juvenile GD in DSD, the prescription of gonadotropin-releasing hormone analogues, following the World Professional Association for Transgender Health and the Endocrine Society guidelines, should be considered. It should always be taken into account that every DSD person is unique and has to be treated with individualized care. In this perspective, international registries are crucial to improve the

  10. Long-Term Follow-Up of Individuals Undergoing Sex-Reassignment Surgery: Somatic Morbidity and Cause of Death

    Directory of Open Access Journals (Sweden)

    Rikke Kildevæld Simonsen, MA

    2016-03-01

    Conclusion: Of 98% of all Danish transsexuals who officially underwent SRS from 1978 through 2010, one in three had somatic morbidity and approximately 1 in 10 had died. No significant differences in somatic morbidity or mortality were found between male-to-female and female-to-male individuals. Despite the young average age at death and the relatively larger number of individuals with somatic morbidity, the present study design does not allow for determination of casual relations between, for example, specific types of hormonal or surgical treatment received and somatic morbidity and mortality.

  11. The kindest cut? Surgical castration, sex offenders and coercive offers.

    Science.gov (United States)

    McMillan, John

    2014-09-01

    The European Committee for the Prevention of Torture and Inhuman or Degrading Treatment or Punishment (CPT) have conducted visits and written reports criticising the surgical castration of sex offenders in the Czech Republic and Germany. They claim that surgical castration is degrading treatment and have called for an immediate end to this practice. The Czech and German governments have published rebuttals of these criticisms. The rebuttals cite evidence about clinical effectiveness and point out this is an intervention that must be requested by the sex offender and cannot occur without informed consent. This article considers a number of relevant arguments that are not discussed in these reports but which are central to how we might assess this practice. First, the article discusses the possible ways in which sex offenders could be coerced into castration and whether this is a decisive moral problem. Then, it considers a number of issues relevant to determining whether sex offenders are harmed by physical castration. The article concludes by arguing that sex offenders should not be coerced into castration, be that via threats or offers, but that there is no reason to think that this is occurring in the Czech Republic or Germany. In some cases, castration might be useful for reconfiguring a life that has gone badly awry and where there is no coercion, the European Committee for the Prevention of Torture and Inhuman or Degrading Treatment or Punishment are mistaken about this being degrading treatment.

  12. Optical Photon Reassignment Microscopy (OPRA)

    CERN Document Server

    Roth, Stephan; Wicker, Kai; Heintzmann, Rainer

    2013-01-01

    To enhance the resolution of a confocal laser scanning microscope the additional information of a pinhole plane image taken at every excitation scan position can be used [C. J. R. Sheppard, Super-resolution in confocal imaging, Optik 80, 5354 (1988)]. This photon reassignment principle is based on the fact that the most probable position of an emitter is at half way between the nominal focus of the excitation laser and the position corresponding to the (off centre) detection position. Therefore, by reassigning the detected photons to this place, an image with enhanced detection efficiency and resolution is obtained. Here we present optical photon reassignment microscopy (OPRA) which realises this concept in an all-optical way obviating the need for image-processing. With the help of an additional intermediate optical beam expansion between descanning and a further rescanning of the detected light, an image with the advantages of photon reassignment can be acquired. Due to its simplicity and flexibility this m...

  13. Using the Defensive Style Questionnaire to evaluate the impact of sex reassignment surgery on defensive mechanisms in transsexual patients Aplicação do Defensive Style Questionnaire para avaliar o impacto da cirurgia de redesignação sexual nos mecanismos de defesa de pacientes transexuais

    Directory of Open Access Journals (Sweden)

    Maria Inês Lobato

    2009-12-01

    Full Text Available Objective: To evaluate the impact of sex reassignment surgery on the defense mechanisms of 32 transsexual patients at two different points in time using the Defensive Style Questionnaire. Method: The Defensive Style Questionnaire was applied to 32 patients upon their admission to the Gender Identity Disorder Program, and 12 months after they had undergone sex reassignment surgery. Results: There were changes in two defense mechanisms: anticipation and idealization. However, no significant differences were observed in terms of the mature, neurotic and immature categories. Discussion: One possible explanation for this result is the fact that the procedure does not resolve gender dysphoria, which is a core symptom in such patients. Another aspect is related to the early onset of the gender identity disorder, which determines a more regressive defensive structure in these patients. Conclusion: Sex reassignment surgery did not improve the defensive profile as measured by the Defensive Style Questionnaire.Objetivo: Avaliar o efeito da cirurgia de redesignação sexual nos mecanismos de defesa de 32 pacientes transexuais em dois momentos do estudo usando o Defensive Style Questionnaire. Método: O Defensive Style Questionnaire foi aplicado a 32 pacientes quando ingressaram no Programa de Transtorno de Identidade de Gênero e 12 meses após a cirurgia de redesignação sexual. Resultados: Houve modificações em dois mecanismos de defesa: antecipação e idealização; porém, sem mudanças significativas nos fatores maduro, neurótico e imaturo. Discussão: Uma possibilidade para esse resultado é o fato de a intervenção cirúrgica não resolver a disforia de gênero (principal sintoma desses pacientes. Outro aspecto está relacionado com o fato de o transtorno de identidade de gênero ser instalado precocemente, o que determina uma estrutura defensiva mais regressiva para esses pacientes. Conclusão: A cirurgia de redesignação sexual não foi

  14. Stop codon reassignments in the wild.

    Science.gov (United States)

    Ivanova, Natalia N; Schwientek, Patrick; Tripp, H James; Rinke, Christian; Pati, Amrita; Huntemann, Marcel; Visel, Axel; Woyke, Tanja; Kyrpides, Nikos C; Rubin, Edward M

    2014-05-23

    The canonical genetic code is assumed to be deeply conserved across all domains of life with very few exceptions. By scanning 5.6 trillion base pairs of metagenomic data for stop codon reassignment events, we detected recoding in a substantial fraction of the >1700 environmental samples examined. We observed extensive opal and amber stop codon reassignments in bacteriophages and of opal in bacteria. Our data indicate that bacteriophages can infect hosts with a different genetic code and demonstrate phage-host antagonism based on code differences. The abundance and diversity of genetic codes present in environmental organisms should be considered in the design of engineered organisms with altered genetic codes in order to preclude the exchange of genetic information with naturally occurring species.

  15. Surgical options in disorders of sex development (dsd) with ambiguous genitalia.

    Science.gov (United States)

    Vidal, Isabelle; Gorduza, Daniela Brindusa; Haraux, Elodie; Gay, Claire-Lise; Chatelain, Pierre; Nicolino, Marc; Mure, Pierre-Yves; Mouriquand, Pierre

    2010-04-01

    Disorders of sexual development (DSD) include three main groups of patients: (1) The virilised 46,XX DSD essentially represented by congenital adrenal hyperplasia (CAH) ; (2) The undervirilised 46,XY DSD essentially represented by hypospadias; and (3) the chromosomic jigsaws essentially represented by mixed gonadal dysgenesis. It is in this last group that gender assignment remains a difficult decision involving various indicators, which can be split into four categories: (1) the inside sex (i.e., genes, hormones and target tissues); (2) the outside sex (i.e., anatomy of genitalia including size of the genital tubercle, mullerian cavity and potential adult height of the patient); (3) the functional sex (i.e., potential sexuality and fertility); and (4) and the social sex (i.e., the cultural medium in which the child is brought up). The challenge is to outline the future individual identity of the child in the postnatal period using these indicators. Current evolutions of surgical techniques of 'feminisation' and 'masculinisation' are described as well as their outcomes.

  16. 46,XX patients with congenital adrenal hyperplasia: initial assignment as male, reassigned female.

    Science.gov (United States)

    Lee, Peter A; Witchel, Selma F

    2005-02-01

    Six 46,XX patients with congenital adrenal hyperplasia (CAH) presented with genital ambiguity, five so severe that initial gender assignment was male. Once diagnosis was realized, parents were involved in evaluation and chose sex re-assignment as female. To date, these girls and their parents all indicate satisfaction with their decision for a female sex of rearing. The girls have a female gender identity with behavior characteristics known for females with CAH. Thus, while outcome is satisfactory, it is realized that for most, expression of sexual orientation and adult life adjustments have not yet occurred.

  17. Stop Codon Reassignment in the Wild

    Energy Technology Data Exchange (ETDEWEB)

    Ivanova, Natalia [Lawrence Berkeley National Lab. (LBNL), Walnut Creek, CA (United States). Dept. of Energy Joint Genome Inst.; Schwientek, Patrick [Lawrence Berkeley National Lab. (LBNL), Walnut Creek, CA (United States). Dept. of Energy Joint Genome Inst.; Tripp, H. James [Lawrence Berkeley National Lab. (LBNL), Walnut Creek, CA (United States). Dept. of Energy Joint Genome Inst.; Rinke, Christian [Lawrence Berkeley National Lab. (LBNL), Walnut Creek, CA (United States). Dept. of Energy Joint Genome Inst.; Pati, Amrita [Lawrence Berkeley National Lab. (LBNL), Walnut Creek, CA (United States). Dept. of Energy Joint Genome Inst.; Huntemann, Marcel [Lawrence Berkeley National Lab. (LBNL), Walnut Creek, CA (United States). Dept. of Energy Joint Genome Inst.; Visel, Axel [Lawrence Berkeley National Lab. (LBNL), Walnut Creek, CA (United States). Dept. of Energy Joint Genome Inst.; Woyke, Tanja [Lawrence Berkeley National Lab. (LBNL), Walnut Creek, CA (United States). Dept. of Energy Joint Genome Inst.; Kyrpides, Nikos [Lawrence Berkeley National Lab. (LBNL), Walnut Creek, CA (United States). Dept. of Energy Joint Genome Inst.; Rubin, Edward [Lawrence Berkeley National Lab. (LBNL), Walnut Creek, CA (United States). Dept. of Energy Joint Genome Inst.

    2014-03-21

    Since the discovery of the genetic code and protein translation mechanisms (1), a limited number of variations of the standard assignment between unique base triplets (codons) and their encoded amino acids and translational stop signals have been found in bacteria and phages (2-3). Given the apparent ubiquity of the canonical genetic code, the design of genomically recoded organisms with non-canonical codes has been suggested as a means to prevent horizontal gene transfer between laboratory and environmental organisms (4). It is also predicted that genomically recoded organisms are immune to infection by viruses, under the assumption that phages and their hosts must share a common genetic code (5). This paradigm is supported by the observation of increased resistance of genomically recoded bacteria to phages with a canonical code (4). Despite these assumptions and accompanying lines of evidence, it remains unclear whether differential and non-canonical codon usage represents an absolute barrier to phage infection and genetic exchange between organisms. Our knowledge of the diversity of genetic codes and their use by viruses and their hosts is primarily derived from the analysis of cultivated organisms. Advances in single-cell sequencing and metagenome assembly technologies have enabled the reconstruction of genomes of uncultivated bacterial and archaeal lineages (6). These initial findings suggest that large scale systematic studies of uncultivated microorganisms and viruses may reveal the extent and modes of divergence from the canonical genetic code operating in nature. To explore alternative genetic codes, we carried out a systematic analysis of stop codon reassignments from the canonical TAG amber, TGA opal, and TAA ochre codons in assembled metagenomes from environmental and host-associated samples, single-cell genomes of uncultivated bacteria and archaea, and a collection of phage sequences

  18. Gender reassignment surgery for male primary transsexuals

    African Journals Online (AJOL)

    treatment of primary transsexualism remains ... of surgical complications and improved results. With ... postoperative pain and discomfort they could expect, and the vital .... operation which initially seemed successful was due to .... intervention.

  19. 42 CFR 421.114 - Assignment and reassignment of providers by CMS.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Assignment and reassignment of providers by CMS. 421.114 Section 421.114 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH... Assignment and reassignment of providers by CMS. CMS may assign or reassign any provider to any...

  20. 75 FR 24828 - Promoting a Competitive Market for Capacity Reassignments

    Science.gov (United States)

    2010-05-06

    ... Federal Energy Regulatory Commission proposes in this Notice of Proposed Rulemaking to lift the price cap for all transmission customers reassigning transmission capacity beyond October 1, 2010. The reforms... this Notice of Proposed Rulemaking (NOPR) to lift the price cap for all transmission...

  1. 75 FR 58293 - Promoting a Competitive Market for Capacity Reassignment

    Science.gov (United States)

    2010-09-24

    ... Energy Regulatory Commission 18 CFR Part 35 Promoting a Competitive Market for Capacity Reassignment..., 2010. The removal of the price cap is intended to help facilitate the development of a market for..., 2010. FOR FURTHER INFORMATION CONTACT: Laurel Hyde (Technical Information), Office of Energy...

  2. 5 CFR 9901.353 - Setting pay upon reassignment.

    Science.gov (United States)

    2010-01-01

    ... allowance payable for the position held prior to the reassignment, provided the resulting base salary does... increase; (ii) Critical mission or business requirements; (iii) Need to advance multi-functional... contribution; (vii) Location of position; (viii) Specialized skills, knowledge, or education possessed by the...

  3. Reassignment of scattered emission photons in multifocal multiphoton microscopy.

    Science.gov (United States)

    Cha, Jae Won; Singh, Vijay Raj; Kim, Ki Hean; Subramanian, Jaichandar; Peng, Qiwen; Yu, Hanry; Nedivi, Elly; So, Peter T C

    2014-06-05

    Multifocal multiphoton microscopy (MMM) achieves fast imaging by simultaneously scanning multiple foci across different regions of specimen. The use of imaging detectors in MMM, such as CCD or CMOS, results in degradation of image signal-to-noise-ratio (SNR) due to the scattering of emitted photons. SNR can be partly recovered using multianode photomultiplier tubes (MAPMT). In this design, however, emission photons scattered to neighbor anodes are encoded by the foci scan location resulting in ghost images. The crosstalk between different anodes is currently measured a priori, which is cumbersome as it depends specimen properties. Here, we present the photon reassignment method for MMM, established based on the maximum likelihood (ML) estimation, for quantification of crosstalk between the anodes of MAPMT without a priori measurement. The method provides the reassignment of the photons generated by the ghost images to the original spatial location thus increases the SNR of the final reconstructed image.

  4. Age trend of the male to female sex ratio in surgical gastric cancer patients at a single institution.

    Science.gov (United States)

    Yu, Junxiu; He, Yongjun; Guo, Zhen

    2014-08-21

    In previous reports concerning the association between sex disparity and age, gastric cancer (GC) patients were simply divided into younger and older groups by age. We analyzed the age trend of the male to female sex ratio (MFSR) in GC based on patient sequential age in order to observe the changing process of MFSR with age. One thousand seven hundred fifty-one surgical gastric adenocarcinoma patients aged 26 to 85 years were investigated between January 1996 and December 2010. The patients were grouped by age intervals of 5 years. The Cochran-Armitage trend test was used to determine how the MFSR changed with age. The median age of the 1,751 patients with GC was 60 years (26 to 85 years). There were 1,334 male and 417 female patients (MFSR was 3.20). Cochran-Armitage trend test analysis showed that total MFSR increased significantly with age (Z = 5.964, P trend test showed that MFSR increased significantly with age from 26 to 60 years (Z = 7.433, P trend until 60 years of age. The male GC patients showed an increasing tendency, and female GC patients showed a decreasing tendency with age. This trend reached a plateau phase after 60 years of age.

  5. Review of recent outcome data of disorders of sex development (DSD): emphasis on surgical and sexual outcomes.

    Science.gov (United States)

    Lee, Peter; Schober, Justine; Nordenström, Anna; Hoebeke, Piet; Houk, Christopher; Looijenga, Leendert; Manzoni, Gianantonio; Reiner, William; Woodhouse, Christopher

    2012-12-01

    This paper is a review of some of the recent publications regarding outcome of DSD patients, with an emphasis upon surgical and sexual outcomes. Currently available outcome studies of patients with DSDs have limitations because of multiple factors, including lack of representative patient sampling, and lack of adequate information concerning both medical and surgical care, and psychological, social and family support. The most frequent reports involve females with 21-α-hydroxylase deficiency congenital adrenal hyperplasia (CAH). This most common form of DSD, if one excludes hypospadias and cryptorchidism, is an excellent example of a form of DSD in which all aspects of outcome, regarding surgery, sexual functionality and sensitivity, psychological input and endocrine hormonal therapy, carry a major role. The goals of therapy include a surgical outcome with a good cosmetic appearance and functionality with potential for sexual intercourse with sufficient sensitivity for satisfactory responsiveness. Endocrine replacement therapy should provide a normal adrenal hormonal milieu, while sex steroid therapy may be indicated. Psychological care should be provided from birth with gradual transition primarily to the patient, including basic counseling with full disclosure, although adjustment depends upon the patient's personality and parents' abilities and acceptance. Among forms of DSD involving gonadal insufficiency, hormonal replacement therapy should provide physiologic levels. Among females, estrogen therapy enhances healing after feminizing surgery and is required from puberty throughout adult life to maintain femininity, sexual organs and bone health, and enhance gender and sexuality. Among males, appropriate testosterone therapy maintains stamina, muscle tone, bone health, libido, sexual potency and general well-being, while benefit for healing after genital surgery is unclear. Further, outcome is clearly related to predominant cultural factors. Outcome studies

  6. 5 CFR 335.102 - Agency authority to promote, demote, or reassign.

    Science.gov (United States)

    2010-01-01

    ... authorized; (d) Promote, demote, or reassign (1) a status quo employee and (2) an employee serving under an.... (2) This paragraph applies to a career, career-conditional, status quo, indefinite, or term employee... reassign. 335.102 Section 335.102 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL...

  7. 76 FR 36512 - USDA Increases the Domestic Sugar Overall Allotment Quantity, Reassigns Domestic Cane Sugar...

    Science.gov (United States)

    2011-06-22

    ... Office of the Secretary USDA Increases the Domestic Sugar Overall Allotment Quantity, Reassigns Domestic Cane Sugar Allotments, and Increases the Fiscal Year 2011 Raw Sugar Tariff-Rate Quota AGENCY: Office of... in the domestic sugar Overall Allotment Quantity (OAQ); a reassignment of surplus sugar under...

  8. An Improved Multiple Faults Reassignment based Recovery in Cluster Computing

    CERN Document Server

    Bansal, Sanjay

    2011-01-01

    In case of multiple node failures performance becomes very low as compare to single node failure. Failures of nodes in cluster computing can be tolerated by multiple fault tolerant computing. Existing recovery schemes are efficient for single fault but not with multiple faults. Recovery scheme proposed in this paper having two phases; sequentially phase, concurrent phase. In sequentially phase, loads of all working nodes are uniformly and evenly distributed by proposed dynamic rank based and load distribution algorithm. In concurrent phase, loads of all failure nodes as well as new job arrival are assigned equally to all available nodes by just finding the least loaded node among the several nodes by failure nodes job allocation algorithm. Sequential and concurrent executions of algorithms improve the performance as well better resource utilization. Dynamic rank based algorithm for load redistribution works as a sequential restoration algorithm and reassignment algorithm for distribution of failure nodes to l...

  9. Review of recent outcome data of disorders of sex development (DSD) : Emphasis on surgical and sexual outcomes

    NARCIS (Netherlands)

    Lee, Peter; Schober, Justine; Nordenstrom, Anna; Hoebeke, Piet; Houk, Christopher; Looijenga, Leendert; Manzoni, Gianantonio; Reiner, William; Woodhouse, Christopher

    2012-01-01

    This paper is a review of some of the recent publications regarding outcome of DSD patients, with an emphasis upon surgical and sexual outcomes. Currently available outcome studies of patients with DSDs have limitations because of multiple factors, including lack of representative patient sampling,

  10. 75 FR 22095 - USDA Reassigns Domestic Cane Sugar Allotments and Increases the Fiscal Year 2010 Raw Sugar Tariff...

    Science.gov (United States)

    2010-04-27

    ...; ] DEPARTMENT OF AGRICULTURE Office of the Secretary USDA Reassigns Domestic Cane Sugar Allotments and Increases the Fiscal Year 2010 Raw Sugar Tariff-Rate Quota AGENCY: Office of the Secretary, USDA. ACTION: Notice. SUMMARY: The Secretary of Agriculture today announced a reassignment of surplus sugar under domestic cane...

  11. 75 FR 38764 - USDA Reassigns Domestic Cane Sugar Allotments and Increases the Fiscal Year 2010 Raw Sugar Tariff...

    Science.gov (United States)

    2010-07-06

    ... USDA Reassigns Domestic Cane Sugar Allotments and Increases the Fiscal Year 2010 Raw Sugar Tariff-Rate... announced a reassignment of surplus sugar under domestic cane sugar allotments of 300,000 short tons raw value (STRV) to imports, and increased the fiscal year (FY) 2010 raw sugar tariff-rate quota (TRQ) by...

  12. 76 FR 20305 - USDA Reassigns Domestic Cane Sugar Allotments and Increases the Fiscal Year 2011 Raw Sugar Tariff...

    Science.gov (United States)

    2011-04-12

    ...; ] DEPARTMENT OF AGRICULTURE Office of the Secretary USDA Reassigns Domestic Cane Sugar Allotments and Increases the Fiscal Year 2011 Raw Sugar Tariff-Rate Quota AGENCY: Office of the Secretary, USDA. ACTION: Notice. SUMMARY: The Secretary of Agriculture today announced a reassignment of surplus sugar under domestic cane...

  13. Application of Reassigned Wavelet Scalogram in Wind Turbine Planetary Gearbox Fault Diagnosis under Nonstationary Conditions

    Directory of Open Access Journals (Sweden)

    Xiaowang Chen

    2016-01-01

    Full Text Available Wind turbine planetary gearboxes often run under nonstationary conditions due to volatile wind conditions, thus resulting in nonstationary vibration signals. Time-frequency analysis gives insight into the structure of an arbitrary nonstationary signal in joint time-frequency domain, but conventional time-frequency representations suffer from either time-frequency smearing or cross-term interferences. Reassigned wavelet scalogram has merits of fine time-frequency resolution and cross-term free nature but has very limited applications in machinery fault diagnosis. In this paper, we use reassigned wavelet scalogram to extract fault feature from wind turbine planetary gearbox vibration signals. Both experimental and in situ vibration signals are used to evaluate the effectiveness of reassigned wavelet scalogram in fault diagnosis of wind turbine planetary gearbox. For experimental evaluation, the gear characteristic instantaneous frequency curves on time-frequency plane are clearly pinpointed in both local and distributed sun gear fault cases. For in situ evaluation, the periodical impulses due to planet gear fault are also clearly identified. The results verify the feasibility and effectiveness of reassigned wavelet scalogram in planetary gearbox fault diagnosis under nonstationary conditions.

  14. Gender Re-assignment at 17; Medical, Ethical, Religious and Cultural Dilemma!

    Directory of Open Access Journals (Sweden)

    Ojo EO

    2009-01-01

    Full Text Available To The Editor: Gender re-assignment after attainment of puberty is a challenging exercise. The problem is further compounded in places with limited diagnostic and counseling facilities. We report on a teenager who was raised as a boy until he started to have regular menstruation. The difficulties encountered in the management of this case are highlighted.

  15. Gender Re-assignment at 17; Medical, Ethical, Religious and Cultural Dilemma!

    OpenAIRE

    M, Bukar; Kwaghe GV; Bakari AA; Audu BM; Ojo EO; U, Ngilari

    2009-01-01

    To The Editor: Gender re-assignment after attainment of puberty is a challenging exercise. The problem is further compounded in places with limited diagnostic and counseling facilities. We report on a teenager who was raised as a boy until he started to have regular menstruation. The difficulties encountered in the management of this case are highlighted.

  16. 变性手术及相关问题%Transsexualism and sex reassignment surgery

    Institute of Scientific and Technical Information of China (English)

    朱辉; 蔡志明

    2004-01-01

    期望作为异性来生活和被人们接受,通常伴有对自己解剖性别的不适感和不恰当感,并希望通过外科手术和激素治疗使自己的身体尽可能和所偏爱的性别一致。这种现象称为易性症(Transsexualism)。本病最早由Esquirol报道(1838),由Caldwell(1949)正式予以命名。易性症是一种少见的性身份障碍(disorder of gender identity),国外有统计发病率为1/(5~l0万),男女比例约为3:1。在我国,易性症患者由于受到社会生活环境及伦理道德的约束,主动求医者很少,但这种状况随着社会的进步已有很大改变。

  17. A Greedy reassignment algorithm for the PBS minimum monitor unit constraint

    Science.gov (United States)

    Lin, Yuting; Kooy, Hanne; Craft, David; Depauw, Nicolas; Flanz, Jacob; Clasie, Benjamin

    2016-06-01

    Proton pencil beam scanning (PBS) treatment plans are made of numerous unique spots of different weights. These weights are optimized by the treatment planning systems, and sometimes fall below the deliverable threshold set by the treatment delivery system. The purpose of this work is to investigate a Greedy reassignment algorithm to mitigate the effects of these low weight pencil beams. The algorithm is applied during post-processing to the optimized plan to generate deliverable plans for the treatment delivery system. The Greedy reassignment method developed in this work deletes the smallest weight spot in the entire field and reassigns its weight to its nearest neighbor(s) and repeats until all spots are above the minimum monitor unit (MU) constraint. Its performance was evaluated using plans collected from 190 patients (496 fields) treated at our facility. The Greedy reassignment method was compared against two other post-processing methods. The evaluation criteria was the γ-index pass rate that compares the pre-processed and post-processed dose distributions. A planning metric was developed to predict the impact of post-processing on treatment plans for various treatment planning, machine, and dose tolerance parameters. For fields with a pass rate of 90  ±  1% the planning metric has a standard deviation equal to 18% of the centroid value showing that the planning metric and γ-index pass rate are correlated for the Greedy reassignment algorithm. Using a 3rd order polynomial fit to the data, the Greedy reassignment method has 1.8 times better planning metric at 90% pass rate compared to other post-processing methods. As the planning metric and pass rate are correlated, the planning metric could provide an aid for implementing parameters during treatment planning, or even during facility design, in order to yield acceptable pass rates. More facilities are starting to implement PBS and some have spot sizes (one standard deviation) smaller than 5

  18. Facilitating appreciation of anatomical variation and development of teamwork skills in the gross anatomy laboratory using a cadaver reassignment system.

    Science.gov (United States)

    Sprunger, Leslie K

    2008-01-01

    Developing a mental map of the body in three dimensions incorporating normal anatomical variations is a challenge for students of gross anatomy. Acquisition of this ability is facilitated by frequently reassigning students to work on different specimens in gross anatomy laboratories, a significant departure from traditional teaching strategies. This article analyzes student and faculty experiences with a reassignment system over a six-year period, including effects on early professional development and students' attitudes toward the cadavers. Students were strongly supportive of the method, noting that specimen reassignments facilitated learning, encouraged dissection skill building, and fostered collaborative interactions. Students' perception of the value of the contribution of each cadaver to their education was preserved and, for many, enhanced. Frequent specimen reassignments offer an opportunity to model public accountability for work and some aspects of the relationships between multiple health care teams caring for a patient.

  19. On the Use of Time–Frequency Reassignment and SVM-Based Classifier for Audio Surveillance Applications

    Directory of Open Access Journals (Sweden)

    Souli S. Sameh

    2014-11-01

    Full Text Available In this paper, we propose a robust environmental sound spectrogram classification approach. Its purpose is surveillance and security applications based on the reassignment method and log-Gabor filters. Besides, the reassignment method is applied to the spectrogram to improve the readability of the time-frequency representation, and to assure a better localization of the signal components. Our approach includes three methods. In the first two methods, the reassigned spectrograms are passed through appropriate log-Gabor filter banks and the outputs are averaged and underwent an optimal feature selection procedure based on a mutual information criterion. The third method uses the same steps but applied only to three patches extracted from each reassigned spectrogram. The proposed approach is tested on a large database consists of 1000 sounds belonging to ten classes. The recognition is based on Multiclass Support Vector Machines.

  20. A New Reassigned Spectrogram Method in Interference Detection for GNSS Receivers.

    Science.gov (United States)

    Sun, Kewen; Jin, Tian; Yang, Dongkai

    2015-09-02

    Interference detection is very important for Global Navigation Satellite System (GNSS) receivers. Current work on interference detection in GNSS receivers has mainly focused on time-frequency (TF) analysis techniques, such as spectrogram and Wigner-Ville distribution (WVD), where the spectrogram approach presents the TF resolution trade-off problem, since the analysis window is used, and the WVD method suffers from the very serious cross-term problem, due to its quadratic TF distribution nature. In order to solve the cross-term problem and to preserve good TF resolution in the TF plane at the same time, in this paper, a new TF distribution by using a reassigned spectrogram has been proposed in interference detection for GNSS receivers. This proposed reassigned spectrogram method efficiently combines the elimination of the cross-term provided by the spectrogram itself according to its inherent nature and the improvement of the TF aggregation property achieved by the reassignment method. Moreover, a notch filter has been adopted in interference mitigation for GNSS receivers, where receiver operating characteristics (ROCs) are used as metrics for the characterization of interference mitigation performance. The proposed interference detection method by using a reassigned spectrogram is evaluated by experiments on GPS L1 signals in the disturbing scenarios in comparison to the state-of-the-art TF analysis approaches. The analysis results show that the proposed interference detection technique effectively overcomes the cross-term problem and also keeps good TF localization properties, which has been proven to be valid and effective to enhance the interference Sensors 2015, 15 22168 detection performance; in addition, the adoption of the notch filter in interference mitigation has shown a significant acquisition performance improvement in terms of ROC curves for GNSS receivers in jamming environments.

  1. Efficient Reassignment of a Frequent Serine Codon in Wild-Type Escherichia coli.

    Science.gov (United States)

    Ho, Joanne M; Reynolds, Noah M; Rivera, Keith; Connolly, Morgan; Guo, Li-Tao; Ling, Jiqiang; Pappin, Darryl J; Church, George M; Söll, Dieter

    2016-02-19

    Expansion of the genetic code through engineering the translation machinery has greatly increased the chemical repertoire of the proteome. This has been accomplished mainly by read-through of UAG or UGA stop codons by the noncanonical aminoacyl-tRNA of choice. While stop codon read-through involves competition with the translation release factors, sense codon reassignment entails competition with a large pool of endogenous tRNAs. We used an engineered pyrrolysyl-tRNA synthetase to incorporate 3-iodo-l-phenylalanine (3-I-Phe) at a number of different serine and leucine codons in wild-type Escherichia coli. Quantitative LC-MS/MS measurements of amino acid incorporation yields carried out in a selected reaction monitoring experiment revealed that the 3-I-Phe abundance at the Ser208AGU codon in superfolder GFP was 65 ± 17%. This method also allowed quantification of other amino acids (serine, 33 ± 17%; phenylalanine, 1 ± 1%; threonine, 1 ± 1%) that compete with 3-I-Phe at both the aminoacylation and decoding steps of translation for incorporation at the same codon position. Reassignments of different serine (AGU, AGC, UCG) and leucine (CUG) codons with the matching tRNA(Pyl) anticodon variants were met with varying success, and our findings provide a guideline for the choice of sense codons to be reassigned. Our results indicate that the 3-iodo-l-phenylalanyl-tRNA synthetase (IFRS)/tRNA(Pyl) pair can efficiently outcompete the cellular machinery to reassign select sense codons in wild-type E. coli.

  2. Towards Reassignment of the Methionine Codon AUG to Two Different Noncanonical Amino Acids in Bacterial Translation

    Directory of Open Access Journals (Sweden)

    Alessandro De Simone

    2016-06-01

    Full Text Available Genetic encoding of noncanonical amino acids (ncAAs through sense codon reassignment is an efficient tool for expanding the chemical functionality of proteins. Incorporation of multiple ncAAs, however, is particularly challenging. This work describes the first attempts to reassign the sense methionine (Met codon AUG to two different ncAAs in bacterial protein translation. Escherichia coli methionyl-tRNA synthetase (MetRS charges two tRNAs with Met: tRNAfMet initiates protein synthesis (starting AUG codon, whereas elongator tRNAMet participates in protein elongation (internal AUG codon(s. Preliminary in vitro experiments show that these tRNAs can be charged with the Met analogues azidohomoalanine (Aha and ethionine (Eth by exploiting the different substrate specificities of EcMetRS and the heterologous MetRS / tRNAMet pair from the archaeon Sulfolobus acidocaldarius, respectively. Here, we explored whether this configuration would allow a differential decoding during in vivo protein initiation and elongation. First, we eliminated the elongator tRNAMet from a methionine auxotrophic E. coli strain, which was then equipped with a rescue plasmid harboring the heterologous pair. Although the imported pair was not fully orthogonal, it was possible to incorporate preferentially Eth at internal AUG codons in a model protein, suggesting that in vivo AUG codon reassignment is possible. To achieve full orthogonality during elongation, we imported the known orthogonal pair of Methanosarcina mazei pyrrolysyl-tRNA synthetase (PylRS / tRNAPyl and devised a genetic selection system based on the suppression of an amber stop codon in an important glycolytic gene, pfkA, which restores enzyme functionality and normal cellular growth. Using an evolved PylRS able to accept Met analogues, it should be possible to reassign the AUG codon to two different ncAAs by using directed evolution. This work is licensed under a Creative Commons Attribution 4.0 International

  3. Total synthesis, assignment of the relative and absolute stereochemistry, and structural reassignment of phostriecin (aka Sultriecin).

    Science.gov (United States)

    Burke, Christopher P; Haq, Nadia; Boger, Dale L

    2010-02-24

    A total synthesis of phostriecin (2), previously known as sultriecin (1), its structural reassignment as a phosphate versus sulfate monoester, and the assignment of its relative and absolute stereochemistry are disclosed herein. Key elements of the work, which provided first the originally assigned sulfate monoester 1 and then the reassigned and renamed phosphate monoester 2, relied on diagnostic (1)H NMR spectroscopic properties of the natural product for the assignment of relative and absolute stereochemistry as well as the subsequent structural reassignment, and a convergent asymmetric total synthesis to provide the unequivocal authentic materials. Key steps of the synthetic approach include a Brown allylation for diastereoselective introduction of the C9 stereochemistry, an asymmetric CBS reduction to establish the lactone C5-stereochemistry, diastereoselective oxidative ring expansion of an alpha-hydroxyfuran to access the pyran lactone precursor, and single-step installation of the sensitive Z,Z,E-triene unit through a chelation-controlled cuprate addition with installation of the C11 stereochemistry. The approach allows ready access to analogues that can now be used to probe important structural features required for protein phosphatase 2A inhibition, the mechanism of action defined herein.

  4. Reassigned time-frequency peak filtering for seismic random noise attenuation

    Science.gov (United States)

    Lin, H.; Li, Y.; Ma, H.

    2012-12-01

    Seismic noise attenuation for the aim of improving signal-to-noise ratio (S/N) plays an important role in seismic data processing for detailed description of oil and gas reservoirs. In particular, strong seismic random noise, which is unpredictable and incoherent in space and time, always degrades the qualities of seismic exploration and much more difficult to be suppressed than coherent noise, since only its statistical properties can be used. It is a common problem in random noise attenuation to keep the signal with minimized distortion. Multi-direction, multi-scale and time-varying methods can be considered as appropriate for tracking the signal characteristics varying in time. In particular, time-frequency based methods might better recover the local characteristics of the non-stationary seismic signal, which is important to produce a satisfactory random noise attenuation result. Time-frequency peak filtering(TFPF), which has already proved to be a powerful tool for Gaussian random noise attenuation in linear signal, can be alternative tool for seismic random noise attenuation. Indeed, seismic noise sometimes may have an asymmetric Wigner-Ville spectrum(WVS) and the seismic signal is nonlinear in time, which might induce amplitude attenuation and residual random noise in the results. This work reports the preliminary results from an improved TFPF method planned to obtain more accurate estimation of the seismic signal by increasing the signal concentration of the time-frequency distribution(TFD) during TFPF. At the beginning the improved reassignment TFPF(RTFPF) encoded the seismic trace as an instantaneous frequency (IF) of the analytic signal generated by frequency modulation. After that the smooth pseudo Wigner-Ville distribution(SPWVD) of the coded analytic signal was computed. The separate frequency window of the SPWVD helps to smooth away the random oscillations introduced by the WVS of seismic noise and nonlinear signal component in the pseudo Wigner

  5. Synthesis of four diastereomers of sclerophytin F and structural reassignment of several sclerophytin natural products.

    Science.gov (United States)

    Clark, J Stephen; Delion, Laëtitia; Farrugia, Louis J

    2015-03-16

    Synthesis of the triol that has been proposed to be the marine natural product sclerophytin F has been completed along with the syntheses of three diastereomers. Comparison of the NMR spectroscopic data for all four compounds to the data reported for the natural product reveals that sclerophytin F is not the 3S diastereomer of sclerophytin A as proposed by Friedrich and Paquette. Re-analysis of the NMR spectroscopic data for known sclerophytin natural products and synthetic analogues leads to the conclusion that sclerophytins E and F are the same compound. This finding has allowed structural reassignment of several other cladiellin natural products.

  6. Iterative generalized time-frequency reassignment for planetary gearbox fault diagnosis under nonstationary conditions

    Science.gov (United States)

    Chen, Xiaowang; Feng, Zhipeng

    2016-12-01

    Planetary gearboxes are widely used in many sorts of machinery, for its large transmission ratio and high load bearing capacity in a compact structure. Their fault diagnosis relies on effective identification of fault characteristic frequencies. However, in addition to the vibration complexity caused by intricate mechanical kinematics, volatile external conditions result in time-varying running speed and/or load, and therefore nonstationary vibration signals. This usually leads to time-varying complex fault characteristics, and adds difficulty to planetary gearbox fault diagnosis. Time-frequency analysis is an effective approach to extracting the frequency components and their time variation of nonstationary signals. Nevertheless, the commonly used time-frequency analysis methods suffer from poor time-frequency resolution as well as outer and inner interferences, which hinder accurate identification of time-varying fault characteristic frequencies. Although time-frequency reassignment improves the time-frequency readability, it is essentially subject to the constraints of mono-component and symmetric time-frequency distribution about true instantaneous frequency. Hence, it is still susceptible to erroneous energy reallocation or even generates pseudo interferences, particularly for multi-component signals of highly nonlinear instantaneous frequency. In this paper, to overcome the limitations of time-frequency reassignment, we propose an improvement with fine time-frequency resolution and free from interferences for highly nonstationary multi-component signals, by exploiting the merits of iterative generalized demodulation. The signal is firstly decomposed into mono-components of constant frequency by iterative generalized demodulation. Time-frequency reassignment is then applied to each generalized demodulated mono-component, obtaining a fine time-frequency distribution. Finally, the time-frequency distribution of each signal component is restored and superposed to

  7. Passivity-Based Nonlinear Excitation Control of Power Systems with Structure Matrix Reassignment

    Directory of Open Access Journals (Sweden)

    Bing Chu

    2013-08-01

    Full Text Available Passivity-based control is widely used in electronic circuit systems because it can utilize their internal structures to facilitate the controller design. In this paper, we first propose a dissipative Hamiltonian realization of power systems and discuss the disadvantages of the traditional passivity-based excitation controller. Then, a novel excitation controller is put forward to reassign the interconnection and dissipative matrix, and the corresponding Hamiltonian function. Simulation results verify that the proposed controller can effectively improve the transient stability of the power system.

  8. Improving signal-to-noise ratio of structured light microscopy based on photon reassignment.

    Science.gov (United States)

    Singh, Vijay Raj; Choi, Heejin; Yew, Elijah Y S; Bhattacharya, Dipanjan; Yuan, Luo; Sheppard, Colin J R; Rajapakse, Jagath C; Barbastathis, George; So, Peter T C

    2012-01-01

    In this paper, we report a method for 3D visualization of a biological specimen utilizing a structured light wide-field microscopic imaging system. This method improves on existing structured light imaging modalities by reassigning fluorescence photons generated from off-focal plane excitation, improving in-focus signal strength. Utilizing a maximum likelihood approach, we identify the most likely fluorophore distribution in 3D that will produce the observed image stacks under structured and uniform illumination using an iterative maximization algorithm. Our results show the optical sectioning capability of tissue specimens while mostly preserving image stack photon count, which is usually not achievable with other existing structured light imaging methods.

  9. Optimized Hybrid Resource Allocation in Wireless Cellular Networks with and without Channel Reassignment

    Directory of Open Access Journals (Sweden)

    Xin Wu

    2010-01-01

    Full Text Available In cellular networks, it is important to determine an optimal channel assignment scheme so that the available channels, which are considered as “limited” resources in cellular networks, are used as efficiently as possible. The objective of the channel assignment scheme is to minimize the call-blocking and the call-dropping probabilities. In this paper, we present two efficient integer linear programming (ILP formulations, for optimally allocating a channel (from a pool of available channels to an incoming call such that both “hard” and “soft” constraints are satisfied. Our first formulation, ILP1, does not allow channel reassignment of the existing calls, while our second formulation, ILP2, allows such reassignment. Both formulations can handle hard constraints, which includes co-site and adjacent channel constraints, in addition to the standard co-channel constraints. The simplified problem (with only co-channel constraints can be treated as a special case of our formulation. In addition to the hard constraints, we also consider soft constraints, such as, the packing condition, resonance condition, and limiting rearrangements, to further improve the network performance. We present the simulation results on a benchmark 49 cell environment with 70 channels that validate the performance of our approach.

  10. 78 FR 60283 - Guidance for Temporary Reassignment of State and Local Personnel During a Public Health Emergency

    Science.gov (United States)

    2013-10-01

    ... HUMAN SERVICES Guidance for Temporary Reassignment of State and Local Personnel During a Public Health... (PAHPRA), Public Law 113-5, amends section 319 of the Public Health Service (PHS) Act to provide the... personnel during a declared Federal public health emergency upon request by a state or tribal...

  11. 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. ...

  12. Super-resolution spinning-disk confocal microscopy using optical photon reassignment.

    Science.gov (United States)

    Azuma, Takuya; Kei, Takayuki

    2015-06-01

    Spinning-disk confocal microscopy is a proven technology for investigating 3D structures of biological specimens. Here we report a super-resolution method based on spinning-disk confocal microscopy that optically improves lateral resolution by a factor of 1.37 with a single exposure. Moreover, deconvolution yields twofold improvement over the diffraction limit. With the help of newly modified Nipkow disk which comprises pinholes and micro-lenses on the front and back respectively, emitted photons from specimen can be optically reassigned to the most probable locations they originate from. Consequently, the improvement in resolution is achieved preserving inherent sectioning capabilities of confocal microscopy. This extremely simple implementation will enable reliable observations at super high resolution in biomedical routine research.

  13. The influence of surgical experience, type of instructions given to patients and patient sex on postoperative pain intensity following lower wisdom tooth surgery.

    Science.gov (United States)

    Matijević, Marko; Uzarević, Zvonimir; Gvozdić, Vlatka; Mikelić, Valentina Matijević; Leović, Dinko; Macan, Darko

    2013-03-01

    The aim of this study was to determine the extent to which the intensity of postoperative pain in the first seven days after lower wisdom tooth extraction is affected by operator experience, patient level of information and patient sex. Postoperative pain intensity after lower wisdom tooth extraction was assessed in 108 patients. Depending on the type of information given to each patient individually, the patients were divided into two groups: test group in which patients were provided with detailed standard written and verbal instructions and control group where patients only received detailed standard written instructions about treatment after surgery. Each of these two groups was divided into three subgroups depending on operator experience. Results of this study showed that the type of information irrespective of being given verbally or not had no effects on postoperative pain intensity, whereas operator experience and patient sex influenced postoperative pain intensity.

  14. Surgical Assisting

    Science.gov (United States)

    ... Insert and remove Foley urinary bladder catheter Place pneumatic tourniquet Confirm procedure with surgeon Drape patient within ... Technology and Surgical Assisting (NBSTSA) offers the CertifiedSurgical First Assistant (CSFA) credential, and the National Surgical Assistant ...

  15. Simulated evolution applied to study the genetic code optimality using a model of codon reassignments

    Directory of Open Access Journals (Sweden)

    Monteagudo Ángel

    2011-02-01

    Full Text Available Abstract Background As the canonical code is not universal, different theories about its origin and organization have appeared. The optimization or level of adaptation of the canonical genetic code was measured taking into account the harmful consequences resulting from point mutations leading to the replacement of one amino acid for another. There are two basic theories to measure the level of optimization: the statistical approach, which compares the canonical genetic code with many randomly generated alternative ones, and the engineering approach, which compares the canonical code with the best possible alternative. Results Here we used a genetic algorithm to search for better adapted hypothetical codes and as a method to guess the difficulty in finding such alternative codes, allowing to clearly situate the canonical code in the fitness landscape. This novel proposal of the use of evolutionary computing provides a new perspective in the open debate between the use of the statistical approach, which postulates that the genetic code conserves amino acid properties far better than expected from a random code, and the engineering approach, which tends to indicate that the canonical genetic code is still far from optimal. We used two models of hypothetical codes: one that reflects the known examples of codon reassignment and the model most used in the two approaches which reflects the current genetic code translation table. Although the standard code is far from a possible optimum considering both models, when the more realistic model of the codon reassignments was used, the evolutionary algorithm had more difficulty to overcome the efficiency of the canonical genetic code. Conclusions Simulated evolution clearly reveals that the canonical genetic code is far from optimal regarding its optimization. Nevertheless, the efficiency of the canonical code increases when mistranslations are taken into account with the two models, as indicated by the

  16. An Application of Reassigned Time-Frequency Representations for Seismic Noise/Signal Decomposition

    Science.gov (United States)

    Mousavi, S. M.; Langston, C. A.

    2016-12-01

    Seismic data recorded by surface arrays are often strongly contaminated by unwanted noise. This background noise makes the detection of small magnitude events difficult. An automatic method for seismic noise/signal decomposition is presented based upon an enhanced time-frequency representation. Synchrosqueezing is a time-frequency reassignment method aimed at sharpening a time-frequency picture. Noise can be distinguished from the signal and suppressed more easily in this reassigned domain. The threshold level is estimated using a general cross validation approach that does not rely on any prior knowledge about the noise level. Efficiency of thresholding has been improved by adding a pre-processing step based on higher order statistics and a post-processing step based on adaptive hard-thresholding. In doing so, both accuracy and speed of the denoising have been improved compared to our previous algorithms (Mousavi and Langston, 2016a, 2016b; Mousavi et al., 2016). The proposed algorithm can either kill the noise (either white or colored) and keep the signal or kill the signal and keep the noise. Hence, It can be used in either normal denoising applications or in ambient noise studies. Application of the proposed method on synthetic and real seismic data shows the effectiveness of the method for denoising/designaling of local microseismic, and ocean bottom seismic data. References: Mousavi, S.M., C. A. Langston., and S. P. Horton (2016), Automatic Microseismic Denoising and Onset Detection Using the Synchrosqueezed-Continuous Wavelet Transform. Geophysics. 81, V341-V355, doi: 10.1190/GEO2015-0598.1. Mousavi, S.M., and C. A. Langston (2016a), Hybrid Seismic Denoising Using Higher-Order Statistics and Improved Wavelet Block Thresholding. Bull. Seismol. Soc. Am., 106, doi: 10.1785/0120150345. Mousavi, S.M., and C.A. Langston (2016b), Adaptive noise estimation and suppression for improving microseismic event detection, Journal of Applied Geophysics., doi: http

  17. Revision of the genus Philonome Chambers and its proposed reassignment to the family Tineidae (Lepidoptera, Tineoidea

    Directory of Open Access Journals (Sweden)

    Jae-Cheon Sohn

    2015-04-01

    Full Text Available The New World genus Philonome Chambers, 1874 is revised. This genus comprises twelve species, seven of which are described as new: two species, P. nigrescens sp. n. and P. wielgusi sp. n., from the United States; four species, P. albivittata sp. n., P. curvilineata sp. n., P. kawakitai sp. n., and P. lambdagrapha sp. n., from French Guiana; and one species, P. penerivifera sp. n., from Brazil. Lectotypes are designated for Philonome clemensella Chambers, 1874 and P. rivifera Meyrick, 1915. Partially on evidence of their head morphology and particularly from molecular evidence, the genus Philonome, previously associated with Bucculatricidae or Lyonetiidae, is reassigned to Tineidae. A possible systematic position of Philonome within Tineidae is discussed. Eurynome Chambers, 1875, is synonymized with Argyresthia Hübner, 1825 (Argyresthiidae. Photographs of adults and illustrations of genitalia, when available, are provided for all described species of Philonome and two species previously misplaced in Philonome, Argyresthia luteella (Chambers, 1875 and Elachista albella (Chambers, 1877. In addition, DNA barcodes were used for the delimitation of most species.

  18. Localization of brain activities using multiway analysis of EEG tensor via EMD and reassigned TF representation.

    Science.gov (United States)

    Pouryazdian, Saeed; Beheshti, Soosan; Krishnan, Sridhar

    2015-01-01

    Electroencephalogram (EEG) is widely used for monitoring, diagnosis purposes and also for study of brain's physiological, mental and functional abnormalities. Processing of information by the brain is reflected in dynamical changes of the electrical activity in time, frequency, and space. EEG signal processing tends to describe and quantify these variations in such a way that they are localized in temporal, spectral and spatial domain. Here we use multi-way (Tensor) analysis for localizing the EEG events. We used EMD process for decomposing EEG into distinct oscillatory modes, which are then mapped to TF plane using the near optimal Reassigned Spectrogram. Temporal, Spatial and Spectral information of the Multichannel EEG are then used to generate a three-way Frequency-Time-Space EEG tensor. Exploiting EMD also enables us to detrend the EEG recordings. Simulation results on both synthetic and real EEG data show that tensor analysis greatly improve separation and localization of overlapping events in EEG and it could be effectively exploited for detecting and characterizing the evoked potentials.

  19. Management of children with disorders of sex development:20-year experience in southern Thailand

    Institute of Scientific and Technical Information of China (English)

    Somchit Jaruratanasirikul; Vorapun Engchaun

    2014-01-01

    Background: Disorders of sex development (DSD) is a group of sexual differentiation disorders resulting in genital anomalies with defects in gonadal hormone synthesis and/or incomplete genital development. These conditions result in problems concerning the sex assignment of the child. This study aims to describe the clinical features, diagnosis and management of children with DSD in southern Thailand. Methods: The medical records of 117 pediatric patients diagnosed with DSD during the period of 1991- 2011 were retrospectively reviewed. Results: Disorders of sex development were categorized into 3 groups: sex chromosome abnormalities (53.0%), 46,XX DSD (29.9%) and 46,XY DSD (17.1%). The two most common etiologies of DSD were Turner syndrome (36.8%) and congenital adrenal hyperplasia (29.9%). Ambiguous genitalia/intersex was the main problem in 46,XX DSD (94%) and 46,XY DSD (100%). Sex reassignment was done in 5 children (4.3%) at age of 3-5 years: from male to female in 4 children (1 patient with congenital adrenal hyperplasia, 1 patient with 45,X/46,XY DSD, and 2 patients with 46,XX ovotesticular DSD) and from female to male in 1 patient with 46,XX ovotesticular DSD. Of the total 20 children with 46,XY DSD, 16 (80%) were raised as females. Conclusion: Management of DSD children has many aspects of concern. Sex assignment/reassignment depends on the phenotype (phallus size) of the external genitalia rather than the sex chromosome.

  20. Management of children with disorders of sex development: 20-year experience in southern Thailand.

    Science.gov (United States)

    Jaruratanasirikul, Somchit; Engchaun, Vorapun

    2014-05-01

    Disorders of sex development (DSD) is a group of sexual differentiation disorders resulting in genital anomalies with defects in gonadal hormone synthesis and/or incomplete genital development. These conditions result in problems concerning the sex assignment of the child. This study aims to describe the clinical features, diagnosis and management of children with DSD in southern Thailand. The medical records of 117 pediatric patients diagnosed with DSD during the period of 1991-2011 were retrospectively reviewed. Disorders of sex development were categorized into 3 groups: sex chromosome abnormalities (53.0%), 46,XX DSD (29.9%) and 46,XY DSD (17.1%). The two most common etiologies of DSD were Turner syndrome (36.8%) and congenital adrenal hyperplasia (29.9%). Ambiguous genitalia/intersex was the main problem in 46,XX DSD (94%) and 46,XY DSD (100%). Sex reassignment was done in 5 children (4.3%) at age of 3-5 years: from male to female in 4 children (1 patient with congenital adrenal hyperplasia, 1 patient with 45,X/46,XY DSD, and 2 patients with 46,XX ovotesticular DSD) and from female to male in 1 patient with 46,XX ovotesticular DSD. Of the total 20 children with 46,XY DSD, 16 (80%) were raised as females. Management of DSD children has many aspects of concern. Sex assignment/reassignment depends on the phenotype (phallus size) of the external genitalia rather than the sex chromosome.

  1. Feature extraction Based on Reassignment Gabor Transform and Radon Transform%基于重排Gabor变换和Radon变换的特征提取技术∗

    Institute of Scientific and Technical Information of China (English)

    严辉容; 李兴慧; 覃才友

    2015-01-01

    基于重排Gabor变换和Radon变换理论,提出了基于重排Gabor变换和Radon变换的故障诊断技术。文章首先利用重排Gabor变换时频聚集性特点,对含噪信号进行重排Gabor变换,再将Gabor展开系数进行Radon变换,在Radon变换平面上提取像点,再进行Radon逆变换,实现信号降噪。仿真结果表明,该方法有效地抑制了噪声的干扰,成功地提取了故障特征信号。%According to the reassignment Gabor transform and Radon transform, and a feature extraction method based on the reassignment Gabor transform and Radon transform is proposed. Firstly, the reassign-ment Gabor transform is applied to the noise signal on the basis of its characteristics, and the Gabor coeffi-cients Gabor transform are processed by the Radon transform, and the image point in Radon transform plane is selected, Then the de-noised Gabor coefficients could be obtained by the Radon inverse transform. The simulated results indicate that this method can effectively reduce the noise interference, and the fault features are extracted successfully for mechanical diagnosis.

  2. Reassignment of oxygen-related defects in CdTe and CdSe

    Energy Technology Data Exchange (ETDEWEB)

    Bastin, Dirk

    2015-05-22

    This thesis reassigns the O{sub Te}-V{sub Cd} complex in CdTe and the O{sub Se}-V{sub Cd} complex in CdSe to a sulfur-dioxygen complex SO{sub 2}*, and the O{sub Cd} defect in CdSe to a V{sub Cd}H{sub 2} complex using Fourier transformed infrared absorption spectroscopy. The publications of the previous complexes were investigated by theoreticians who performed first-principle calculations of theses complexes. The theoreticians ruled out the assignments and proposed alternative defects, instead. The discrepancy between the experimentally obtained and theoretically proposed defects was the motivation of this work. Two local vibrational modes located at 1096.8 (ν{sub 1}) and 1108.3 cm{sup -1} (ν{sub 2}) previously assigned to an O{sub Te}-V{sub Cd} complex are detected in CdTe single crystals doped with CdSO{sub 4} powder. Five weaker additional absorption lines accompanying ν{sub 1} and ν{sub 2} could be detected. The relative intensities of the absorption lines match a sulfur-dioxygen complex SO{sub 2}* having two configurations labeled ν{sub 1} and ν{sub 2}. A binding energy difference of 0.5±0.1 meV between the two configurations and an energy barrier of 53±4 meV separating the two configurations are determined. Uniaxial stress applied to the crystal leads to a splitting of the absorption lines which corresponds to an orthorhombic and monoclinic symmetry for ν{sub 1} and ν{sub 2}, respectively. In virgin and oxygen-doped CdSe single crystals, three local vibrational modes located at 1094.1 (γ{sub 1}), 1107.5 (γ{sub 2}), and 1126.3 cm{sup -1} (γ{sub 3}) previously attributed to an O{sub Se}-V{sub Cd} complex could be observed. The signals are accompanied by five weaker additional absorption features in their vicinity. The additional absorption lines are identified as isotope satellites of a sulfur-dioxygen complex SO{sub 2}* having three configurations γ{sub 1}, γ{sub 2}, and γ{sub 3}. IR absorption measurements with uniaxial stress applied to the

  3. Families of seven male-to-female transexuals after 5-7 years: Sociological sexology.

    Science.gov (United States)

    Money, J; Clarke, F; Mazur, T

    1975-03-01

    Four black and three whilte families have a male-to-female transexual member surgically reassigned more than 5 years ag. The black families were more open than the white in declaring the reassignment within the family and community. Thereby they relieved themselves and the transexual member of a need for deception, defiance, or defensiveness, and they were less scheming and manipulative. Without the anxiety of concealment, they could feel more positive about sex reassignment as a form of rehabilitation. A formal public declaration of sex reassignment, analogous to a declared change of citizenship, would be advantageous in transexual rehabilitation.

  4. Re-description and Reassignment of the Damselfish Abudefduf luridus (Cuvier, 1830) Using Both Traditional and Geometric Morphometric Approaches

    Energy Technology Data Exchange (ETDEWEB)

    Cooper, W. James [Washington State Univ., Pullman, WA (United States); Albertson, R Craig [Univ. of Massachusetts, Amherst, MA (United States); Jacob, Rick E. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Westneat, Mark W. [Field Museum of Natural History, Chicago, IL (United States)

    2014-12-01

    Here we present a re-description of Abudefduf luridus and reassign it to the genus Similiparma. We supplement traditional diagnoses and descriptions of this species with quantitative anatomical data collected from a family-wide geometric morphometric analysis of head morphology (44 species representing all 30 damselfish genera) and data from cranial micro-CT scans of fishes in the genus Similiparma. The use of geometric morphometric analyses (and other methods of shape analysis) permits detailed comparisons between the morphology of specific taxa and the anatomical diversity that has arisen in an entire lineage. This provides a particularly useful supplement to traditional description methods and we recommend the use of such techniques by systematists. Similiparma and its close relatives constitute a branch of the damselfish phylogenetic tree that predominantly inhabits rocky reefs in the Atlantic and Eastern Pacific, as opposed to the more commonly studied damselfishes that constitute a large portion of the ichthyofauna on all coral-reef communities.

  5. Dynamically reassigning a connected node to a block of compute nodes for re-launching a failed job

    Science.gov (United States)

    Budnik, Thomas A [Rochester, MN; Knudson, Brant L [Rochester, MN; Megerian, Mark G [Rochester, MN; Miller, Samuel J [Rochester, MN; Stockdell, William M [Byron, MN

    2012-03-20

    Methods, systems, and products for dynamically reassigning a connected node to a block of compute nodes for re-launching a failed job that include: identifying that a job failed to execute on the block of compute nodes because connectivity failed between a compute node assigned as at least one of the connected nodes for the block of compute nodes and its supporting I/O node; and re-launching the job, including selecting an alternative connected node that is actively coupled for data communications with an active I/O node; and assigning the alternative connected node as the connected node for the block of compute nodes running the re-launched job.

  6. Yeast mitochondrial threonyl-tRNA synthetase recognizes tRNA isoacceptors by distinct mechanisms and promotes CUN codon reassignment

    Energy Technology Data Exchange (ETDEWEB)

    Ling, Jiqiang; Peterson, Kaitlyn M.; Simonovic, Ivana; Cho, Chris; Soll, Dieter; Simonovic, Miljan (Yale); (UIC)

    2014-03-12

    Aminoacyl-tRNA synthetases (aaRSs) ensure faithful translation of mRNA into protein by coupling an amino acid to a set of tRNAs with conserved anticodon sequences. Here, we show that in mitochondria of Saccharomyces cerevisiae, a single aaRS (MST1) recognizes and aminoacylates two natural tRNAs that contain anticodon loops of different size and sequence. Besides a regular ?? with a threonine (Thr) anticodon, MST1 also recognizes an unusual ??, which contains an enlarged anticodon loop and an anticodon triplet that reassigns the CUN codons from leucine to threonine. Our data show that MST1 recognizes the anticodon loop in both tRNAs, but employs distinct recognition mechanisms. The size but not the sequence of the anticodon loop is critical for ?? recognition, whereas the anticodon sequence is essential for aminoacylation of ??. The crystal structure of MST1 reveals that, while lacking the N-terminal editing domain, the enzyme closely resembles the bacterial threonyl-tRNA synthetase (ThrRS). A detailed structural comparison with Escherichia coli ThrRS, which is unable to aminoacylate ??, reveals differences in the anticodon-binding domain that probably allow recognition of the distinct anticodon loops. Finally, our mutational and modeling analyses identify the structural elements in MST1 (e.g., helix {alpha}11) that define tRNA selectivity. Thus, MTS1 exemplifies that a single aaRS can recognize completely divergent anticodon loops of natural isoacceptor tRNAs and that in doing so it facilitates the reassignment of the genetic code in yeast mitochondria.

  7. Should human beings have sex? Sexual dimorphism and human enhancement.

    Science.gov (United States)

    Sparrow, Robert

    2010-07-01

    Since the first sex reassignment operations were performed, individual sex has come to be, to some extent at least, a technological artifact. The existence of sperm sorting technology, and of prenatal determination of fetal sex via ultrasound along with the option of termination, means that we now have the power to choose the sex of our children. An influential contemporary line of thought about medical ethics suggests that we should use technology to serve the welfare of individuals and to remove limitations on the opportunities available to them. I argue that, if these are our goals, we may do well to move towards a "post sex" humanity. Until we have the technology to produce genuine hermaphrodites, the most efficient way to do this is to use sex selection technology to ensure that only girl children are born. There are significant restrictions on the opportunities available to men, around gestation, childbirth, and breast-feeding, which will be extremely difficult to overcome via social or technological mechanisms for the foreseeable future. Women also have longer life expectancies than men. Girl babies therefore have a significantly more "open" future than boy babies. Resisting the conclusion that we should ensure that all children are born the same sex will require insisting that sexual difference is natural to human beings and that we should not use technology to reshape humanity beyond certain natural limits. The real concern of my paper, then, is the moral significance of the idea of a normal human body in modern medicine.

  8. Surgical Navigation

    DEFF Research Database (Denmark)

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

    2017-01-01

    were identified in the field of traumatology. Treatment of complex orbital fractures was considerably improved by the use of SN compared with traditionally treated control groups. Conclusions: SN seems to be a very promising addition to the surgical toolkit. Planning details of the surgical procedure...... in a 3-dimensional virtual environment and execution with real-time guidance can significantly improve precision. Among factors to be considered are the financial investments necessary and the learning curve....

  9. Sex Stereotype

    Institute of Scientific and Technical Information of China (English)

    倪媛

    2014-01-01

    This paper analyzes the social phenomenon—sex stereotype.The paper illustrates the characteristics of stereotype and discusses about the factors which influence sex stereotypes and the reasons of its existence.And it also found the positive role that sex stereotype plays in the communication.

  10. First total synthesis of a natural product containing a chiral, beta-diketone: synthesis and stereochemical reassignment of siphonarienedione and siphonarienolone.

    Science.gov (United States)

    Calter, Michael A; Liao, Wensheng

    2002-11-06

    The first total syntheses of siphonarienolone and siphonarienedione are described. The development of a stereoselective synthesis of beta-diketones facilitated the synthesis of the latter compound. The synthesis of the structures proposed for the natural products afforded compounds whose spectral data did not match those of the natural products. However, the synthesis of compounds isomeric to the proposed structures at C(4) and C(5) afforded compounds identical to the natural products, thereby reassigning the stereochemistry of the natural products.

  11. Novel Ciliate Genetic Code Variants Including the Reassignment of All Three Stop Codons to Sense Codons in Condylostoma magnum.

    Science.gov (United States)

    Heaphy, Stephen M; Mariotti, Marco; Gladyshev, Vadim N; Atkins, John F; Baranov, Pavel V

    2016-11-01

    mRNA translation in many ciliates utilizes variant genetic codes where stop codons are reassigned to specify amino acids. To characterize the repertoire of ciliate genetic codes, we analyzed ciliate transcriptomes from marine environments. Using codon substitution frequencies in ciliate protein-coding genes and their orthologs, we inferred the genetic codes of 24 ciliate species. Nine did not match genetic code tables currently assigned by NCBI. Surprisingly, we identified a novel genetic code where all three standard stop codons (TAA, TAG, and TGA) specify amino acids in Condylostoma magnum We provide evidence suggesting that the functions of these codons in C. magnum depend on their location within mRNA. They are decoded as amino acids at internal positions, but specify translation termination when in close proximity to an mRNA 3' end. The frequency of stop codons in protein coding sequences of closely related Climacostomum virens suggests that it may represent a transitory state. © The Author 2016. Published by Oxford University Press on behalf of the Society for Molecular Biology and Evolution.

  12. An unusual tRNAThr derived from tRNAHis reassigns in yeast mitochondria the CUN codons to threonine

    Science.gov (United States)

    Su, Dan; Lieberman, Allyson; Lang, B. Franz; Simonović, Miljan; Söll, Dieter; Ling, Jiqiang

    2011-01-01

    The standard genetic code is used by most living organisms, yet deviations have been observed in many genomes, suggesting that the genetic code has been evolving. In certain yeast mitochondria, CUN codons are reassigned from leucine to threonine, which requires an unusual tRNAThr with an enlarged 8-nt anticodon loop (). To trace its evolutionary origin we performed a comprehensive phylogenetic analysis which revealed that evolved from yeast mitochondrial tRNAHis. To understand this tRNA identity change, we performed mutational and biochemical experiments. We show that Saccharomyces cerevisiae mitochondrial threonyl-tRNA synthetase (MST1) could attach threonine to both and the regular , but not to the wild-type tRNAHis. A loss of the first nucleotide (G−1) in tRNAHis converts it to a substrate for MST1 with a Km value (0.7 μM) comparable to that of (0.3 μM), and addition of G−1 to allows efficient histidylation by histidyl-tRNA synthetase. We also show that MST1 from Candida albicans, a yeast in which CUN codons remain assigned to leucine, could not threonylate , suggesting that MST1 has coevolved with . Our work provides the first clear example of a recent recoding event caused by alloacceptor tRNA gene recruitment. PMID:21321019

  13. Creating Sex

    DEFF Research Database (Denmark)

    Cahana, Jonathan

    2016-01-01

    Thomas Laqueur’s influential yet controversial study Making Sex has, in many ways, revolutionized our understanding of sexuality in antiquity. Yet, most of Laqueur’s critics and supporters stressed the one-sex body, while the crux of his argument is the primacy of gender. Moreover, a systematic...

  14. Sex Offenders.

    Science.gov (United States)

    Hayes, Susan

    1991-01-01

    This paper on the problem of sex offending among individuals with intellectual disabilities examines the incidence of this problem, characteristics of intellectually disabled sex offenders, determination of whether the behavior is a paraphilia or functional age-related behavior, and treatment options, with emphasis on the situation in New South…

  15. Sex determination

    OpenAIRE

    McCullagh, W. McK. H.

    2013-01-01

    How the sex of offspring is determined has puzzled philosophers and scientists for millennia. Modern science has identified both genetic and environmental factors, but the question is still not yet fully answered.

  16. Why Sex?

    DEFF Research Database (Denmark)

    Nielsen, Rasmus

    2006-01-01

    It is assumed that most organisms have sex because the resulting genetic recombination allows Darwinian selection to work better. It is now shown that in water fleas, recombination does lead to fewer deleterious mutations.......It is assumed that most organisms have sex because the resulting genetic recombination allows Darwinian selection to work better. It is now shown that in water fleas, recombination does lead to fewer deleterious mutations....

  17. A study of gender outcome of Egyptian patients with 46,XY disorder of sex development.

    Science.gov (United States)

    Ismail, S I; Mazen, I A

    2010-09-01

    Children with disorder of sex development (DSD) may be born with ambiguous genitalia. Decision-making in relation to sex assignment has been perceived as extremely disturbing and difficult to families and health care professionals. This is mainly due to a general paucity of information about the condition and an exaggerated feeling of stigma and shame associated with genital abnormalities. This is the first study in Egypt aimed at studying the psychosexual development and gender outcome of 40 Egyptian patients with 46,XY DSD focusing on the impact of social and religious factors. The patients were subjected to history-taking, pedigree analysis, full clinical examination, and cytogenetic studies. Hormonal, radiological investigations and molecular studies were performed when possible. Accordingly, they were classified into 4 groups: (1) sex chromosome aneuploid DSD (mixed gonadal dysgenesis) and (2) disorders of gonadal development (gonadal dysgenesis); (3) androgen biosynthesis defect (5alpha-reductase deficiency, 17beta-hydroxysteroid dehydrogenase deficiency), and (4) defect in androgen action (androgen insensitivity syndrome). The psychosexual development was assessed using adapted structured questionnaire and the Bem sex role inventory for patients below and above 12 years of age, respectively. Thirty-two patients (80%) were initially assigned as females; 3 patients with gonadal dysgenesis, 1 patient with 5alpha-reductase deficiency, and 1 patient with androgen insensitivity were reassigned as male. Male reassignment also was recorded in 5 patients with 17beta-hydroxysteroid dehydrogenase deficiency and one of them showed sex reversal twice. Gender outcome of our patients is elusive; the social component has a significant impact on the gender outcome in our society, even more than religion. We recommend that in the future more and more patients should be analyzed as well. These studies should be designed to emphasize the quality of life of DSD patients.

  18. The dilemma of the gender assignment in a Portuguese adolescent with disorder of sex development due to 17β-hydroxysteroid-dehydrogenase type 3 enzyme deficiency.

    Science.gov (United States)

    Costa, Carla; Castro-Correia, Cíntia; Mira-Coelho, Alda; Monteiro, Bessa; Monteiro, Joaquim; Hughes, Ieuan; Fontoura, Manuel

    2014-01-01

    The development of male internal and external genitalia in an XY fetus requires a complex interplay of many critical genes, enzymes, and cofactors. The enzyme 17β-hydroxysteroid-dehydrogenase type 3 (17βHSD3) is present almost exclusively in the testicles and converts Delta 4-androstenodione (Δ4) to testosterone. A deficiency in this enzyme is rare and is a frequently misdiagnosed autosomal recessive cause of 46,XY, disorder of sex development. The case report is of a 15-year-old adolescent, who was raised according to female gender. At puberty, the adolescent had a severe virilization and primary amenorrhea. The physical examination showed a male phenotype with micropenis and blind vagina. The Tanner stage was A3B1P4, nonpalpable gonads. The karyotype revealed 46,XY. The endocrinology study revealed: testosterone=2.38 ng/ml, Δ4>10.00 ng/ml, and low testosterone/Δ4 ratio=0.23. Magnetic resonance imaging of the abdominal-pelvic showed the presence of testicles in inguinal canal, seminal vesicle, prostate, micropenis, and absence of uterus and vagina. The genetic study confirmed the mutation p.Glu215Asp on HSD17B3 gene in homozygosity. The dilemma of sex reassignment was seriously considered when the diagnosis was made. During all procedures the patient was accompanied by a child psychiatrist/psychologist. The teenager desired to continue being a female, so gonadectomy was performed. Estrogen therapy and surgical procedure to change external genitalia was carried out. In this case, there was a severe virilization at puberty. It is speculated to be due to a partial activity of 17βHSD3 in the testicles and/or extratesticular ability to convert Δ4 to testosterone by 17βHSD5. Prenatal exposure of the brain to androgens has increasingly been put forward as a critical factor in gender identity development, but in this case the social factor was more important for the gender assignment. In this case, we highlight the late diagnosis, probably because the patient

  19. Surgical castration, coercion and ethics

    DEFF Research Database (Denmark)

    Ryberg, Jesper; Petersen, Thomas Søbirk

    2014-01-01

    that the matter is more complicated than his approach to it suggests. The first thing that adds to the complexity of the discussion concerns the alternative for sex offenders who do not accept the offer of castration. As mentioned, it is likely that these offenders will be kept in prison. McMillan even underlines......John McMillan's detailed ethical analysis concerning the use of surgical castration of sex offenders in the Czech Republic and Germany is mainly devoted to considerations of coercion.1 This is not surprising. When castration is offered as an option to offenders and, at the same time, constitutes...... the only means by which these offenders are likely to be released from prison, it is reasonable—and close to the heart of modern medical ethics—to consider whether the offer involves some kind of coercion. However, despite McMillan's seemingly careful consideration of this question, it appears to us...

  20. [Lethal sex].

    Science.gov (United States)

    Rabinerson, David; Ben-Shitrit, Gadi; Glezerman, Marek

    2011-03-01

    Asphyxiophilic sex is a form of autoerotic activity, in which the user creates mechanical means (such as hanging or bondage) in order to achieve cerebral hypoxia, which, in turn, enhances sexual, as well as orgasmic, stimulus. Failure of safety mechanisms, created by the user, may lead to instant death as a result of asphyxiation or strangulation. This kind of sexual practice is more prevalent among men than in women. In cases of death, it is difficult to relate it to the sexual practice itself. Suicide and homicide are the main differential diagnoses. Closely related derivatives of asphyxiophilic sex are anesthesiophilia (inhalation of variable volatile substances) and electrophilia (use of electric current during sexual activity)--both also intended to enhance the sexual stimulation. These forms of sexual practice are less prevalent than asphyxiophilia.

  1. Sex during Pregnancy

    Science.gov (United States)

    ... Your 1- to 2-Year-Old Sex During Pregnancy KidsHealth > For Parents > Sex During Pregnancy A A ... safe sexual relationship during pregnancy. Is Sex During Pregnancy Safe? Sex is considered safe during all stages ...

  2. When Sex Is Painful

    Science.gov (United States)

    ... AQ FREQUENTLY ASKED QUESTIONS GYNECOLOGIC PROBLEMS FAQ020 When Sex Is Painful • How common is painful sex? • What causes pain during sex? • Where is pain during sex felt? • When should ...

  3. Sex during Pregnancy

    Science.gov (United States)

    ... Habits for TV, Video Games, and the Internet Sex During Pregnancy KidsHealth > For Parents > Sex During Pregnancy ... satisfying and safe sexual relationship during pregnancy. Is Sex During Pregnancy Safe? Sex is considered safe during ...

  4. When Sex Is Painful

    Science.gov (United States)

    ... AQ FREQUENTLY ASKED QUESTIONS GYNECOLOGIC PROBLEMS FAQ020 When Sex Is Painful • How common is painful sex? • What causes pain during sex? • Where is pain during sex felt? • When should ...

  5. A re-assigned American mink (Neovison vison) map optimal for genome-wide studies

    DEFF Research Database (Denmark)

    Anistoroaei, Razvan Marian; Nielsen, Vivi; Markakis, Marios Nektarius

    2012-01-01

    to 14 linkage groups corresponding to the mink autosomes. Six markers are unlinked and four markers are allocated to the X chromosome by homology but no linkage was detected. The sex-average linkage map spans 1192 centiMorgans (cM) with an average intermarker distance of 11.4cM and 1648cM when the ends...

  6. 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.

  7. Surgical innovation as sui generis surgical research.

    Science.gov (United States)

    Lotz, Mianna

    2013-12-01

    Successful innovative 'leaps' in surgical technique have the potential to contribute exponentially to surgical advancement, and thereby to improved health outcomes for patients. Such innovative leaps often occur relatively spontaneously, without substantial forethought, planning, or preparation. This feature of surgical innovation raises special challenges for ensuring sufficient evaluation and regulatory oversight of new interventions that have not been the subject of controlled investigatory exploration and review. It is this feature in particular that makes early-stage surgical innovation especially resistant to classification as 'research', with all of the attendant methodological and ethical obligations--of planning, regulation, monitoring, reporting, and publication--associated with such a classification. This paper proposes conceptual and ethical grounds for a restricted definition according to which innovation in surgical technique is classified as a form of sui generis surgical 'research', where the explicit goal of adopting such a definition is to bring about needed improvements in knowledge transfer and thereby benefit current and future patients.

  8. The challenges in diagnosis and gender assignment in disorders of sex development presenting to a pediatric surgical unit in a developing country: the role of laparoscopy and simple tests for gender identity.

    Science.gov (United States)

    Chowdhury, Tanvir K; Kabir, Mahfuzul; Chowdhury, Md Zonaid; Hutson, John M; Banu, Tahmina

    2014-12-01

    We aimed to assess how the diagnosis and determination of gender identity of disorders of sex development (DSD) is different in a developing country from Western medicine, and whether a pediatric surgery department can determine the underlying diagnosis and use simple tools to determine the likely gender identity (GI). We reviewed the records of DSD patients admitted to the Department of Pediatric Surgery, Chittagong Medical College & Hospital (CMCH), Chittagong, Bangladesh, from January 2006 to December 2012 and performed a cross-sectional study on GI and gender-related behavior in these patients during the year 2012. DSD boys and girls answered a GI interview and had their gender role behavior assessed by observations of structural toy play and analyzed for differences in scores. This cohort of DSD patients presented in mid-childhood (6 months-16 years, mean 6.9 years) rather than infancy, and 30% came from consanguineous unions. Congenital adrenal hyperplasia (CAH) constituted only 11 of 50 (22%) of the DSD cohort, and not all families had access to steroid hormone replacement. A simple assessment of GI and gender-related behavior allowed effective gender assignment, as there was significant difference between DSD boys and girls in GI and gender-related behavior score. DSD management in Bangladesh provides some unique challenges because of limited resources. A national reference laboratory for biochemical and genetic testing and development of a quaternary referral center for DSD patients will be helpful. Continued use of the GI interview and gender-related behavior study will enable effective interim decisions about diagnosis and management. Copyright © 2014 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

  9. Genomics of sex determination.

    Science.gov (United States)

    Zhang, Jisen; Boualem, Adnane; Bendahmane, Abdelhafid; Ming, Ray

    2014-04-01

    Sex determination is a major switch in the evolutionary history of angiosperm, resulting 11% monoecious and dioecious species. The genomic sequences of papaya sex chromosomes unveiled the molecular basis of recombination suppression in the sex determination region, and candidate genes for sex determination. Identification and analyses of sex determination genes in cucurbits and maize demonstrated conservation of sex determination mechanism in one lineage and divergence between the two systems. Epigenetic control and hormonal influence of sex determination were elucidated in both plants and animals. Intensive investigation of potential sex determination genes in model species will improve our understanding of sex determination gene network. Such network will in turn accelerate the identification of sex determination genes in dioecious species with sex chromosomes, which are burdensome due to no recombination in sex determining regions. The sex determination genes in dioecious species are crucial for understanding the origin of dioecy and sex chromosomes, particularly in their early stage of evolution.

  10. SEX EDUCATION

    Directory of Open Access Journals (Sweden)

    R N Srivastava

    1994-06-01

    Full Text Available Sex, though not everything in life, is a profoundly important aspect of human existence. It has evolved to serve more than reproductive functions; relational and recreational functions having taken precedence over procrea­tional. Sex has come to play a much wider socio-psychological function.Human sexuality is complex and multidimensional. It is subject to influence by multitude of factors often grouped as biological (e.g. genes, hormones, psychological (e.g. fear, anxiety, mood and socio-cultural (e.g. sex roles, values- religious/moral/ethical, customs. It is the interaction and interrelationship of these factors from the time of conception, through intrauterine life, infancy, childhood and adolescence, till adulthood (even later in life that determine the sexual development expressed as sexual attitudes and behaviour of the people. Learning, both social and cognitive, plays a significantly important role in such development.Sexual dysfunctions in men and women, result from factors often categorised as physical or organic and psychological; more often a combination may be involved. Experience has shown that in majority of men and women in India having sexual problems, ignorance misconceptions and prevailing myths are invariably responsible in the causation of Ihese problems. Sexual problems in individual man (e.g. erectile failure and woman (e.g. vaginismus cause anxiety, feelings of frustration, lowered self esteem and symptoms of depression. The condition may also affect the spouse; he/she, as a reaction to the problem in the partner, may develop sexual and psychosocial problems including distressed marital relationship. This may also have influence on general couple relationship, effecting adversely the quality of family life.Modern therapeutic endevours have made it possible now to offer effective therapy to most people who seek help for their sexual problems, thus preventing the consequences on couple relationship. However, there is also

  11. Uncommon surgical emergencies in neonatology.

    Science.gov (United States)

    Angotti, R; Bulotta, A L; Ferrara, F; Molinaro, F; Cerchia, E; Meucci, D; Messina, M

    2014-12-30

    Objective. Over the past decade, multiple factors have changed the pattern of neonatal surgical emergencies. An increase in prenatal screenings and the development of neonatal tertiary care centres have changed the clinical approach to these kids. Materials and methods. Between 1995 to 2011 were retrospectively reviewed 34 patients with diagnosis of uncommon rare neonatal surgical emergencies at our institute. We analyzed: sex, gestational age, weight at birth, primary pathology, prenatal diagnosis, associated anomalies, age and weight at surgery, clinical presentation, start of oral feeding and hospitalization. The follow-up was performed at 6,12, 24 and 36 months. Results. There were 21 male and 13 female. The gestational age ranged between 28 and 36 weeks. The weight at birth ranged between 700 and 1400 grams. Oral feeding was started between 4th and 10th postoperative day. The average hospitalization was about 70.47 days. To date, all patients have finished the followup. They are healthy. Conclusion. The outcome of the patients with uncommon surgical emergencies is different based on the etiology. Overall survival is generally good but is influenced by the associated anomalies.

  12. Fluidity models in ancient Greece and current practices of sex assignment.

    Science.gov (United States)

    Chen, Min-Jye; McCann-Crosby, Bonnie; Gunn, Sheila; Georgiadis, Paraskevi; Placencia, Frank; Mann, David; Axelrad, Marni; Karaviti, L P; McCullough, Laurence B

    2017-06-01

    Disorders of sexual differentiation such as androgen insensitivity and gonadal dysgenesis can involve an intrinsic fluidity at different levels, from the anatomical and biological to the social (gender) that must be considered in the context of social constraints. Sex assignment models based on George Engel's biopsychosocial aspects model of biology accept fluidity of gender as a central concept and therefore help establish expectations within the uncertainty of sex assignment and anticipate potential changes. The biology underlying the fluidity inherent to these disorders should be presented to parents at diagnosis, an approach that the gender medicine field should embrace as good practice. Greek mythology provides many accepted archetypes of change, and the ancient Greek appreciation of metamorphosis can be used as context with these patients. Our goal is to inform expertise and optimal approaches, knowing that this fluidity may eventually necessitate sex reassignment. Physicians should provide sex assignment education based on different components of sexual differentiation, prepare parents for future hormone-triggered changes in their children, and establish a sex-assignment algorithm. Copyright © 2017 Elsevier Inc. All rights reserved.

  13. 几种重排算法在地震信号处理中的实验分析%Experiments and analysis in seismic data processing with several kinds of reassignment methods

    Institute of Scientific and Technical Information of China (English)

    周竹生; 陈高祥

    2013-01-01

    The main idea of reassignment method in time-frequency analysis is presented and some expressions used to compute the accurate location of the local energy gravity center are given;then two numerical experiments are presented to show how these reassignment methods work individually as used to process single-trace seismic data. Based on the experiments, some conclusions are drawn that the reassignment methods can not only effectively reduce cross-terms, but also lead to a good time-frequency concentration. Compared with others, the reassignment spectrogram has the best potential for ideal time-frequency concentration, especially when the dominant frequen-cies are required to be underlined. The reassignment smoothing pseudo Wigner-Ville distribution can also achieve perfect effects though it is a little worse than the former one. The pseudo Margenau-Hill distribution is the worst of the three, since it fails to relocate the dispersive energy to the calculated center. A pretty precise instantaneous fre-quency section can be produced when the reassignment method is applied to deal with seismic signals.%  阐述了时频分析技术中重排算法的基本思想,给出了部分重排算法的局部能量重心表达式;设计了两个数值实验,利用几种重排算法对单道地震信号进行了计算和分析比较。结果表明:重排算法不仅能有效抑制交叉项,同时也能提高时频聚集性,从而获得更理想的局部信号特征。其中以重排 Spectrogram 分布的时频聚集能力最佳,尤其适合于突出主频信号;重排平滑伪Wigner-Ville分布同样也能够获得较理想的时频效果,但稍弱于前一种方法;重排伪MH分布的时频聚集性相对较差,没有对分散的能量进行有效的重新分配处理。重排算法因其突出的时频聚集能力,应用在地震剖面中可以得到更加细致的瞬时频率特征。

  14. Hernia Surgical Mesh Implants

    Science.gov (United States)

    ... Prosthetics Hernia Surgical Mesh Implants Hernia Surgical Mesh Implants Share Tweet Linkedin Pin it More sharing options ... majority of tissue used to produce these mesh implants are from a pig (porcine) or cow (bovine) ...

  15. Urogynecologic Surgical Mesh Implants

    Science.gov (United States)

    ... Prosthetics Urogynecologic Surgical Mesh Implants Urogynecologic Surgical Mesh Implants Share Tweet Linkedin Pin it More sharing options ... majority of tissue used to produce these mesh implants are from a pig (porcine) or cow (bovine). ...

  16. 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 / ...

  17. 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.

  18. 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 ...

  19. Sex Bias in Children.

    Science.gov (United States)

    Zalk, Sue Rosenberg; And Others

    This study investigated children's sex biased attitudes as a function of the sex, age, and race of the child as well as a geographical-SES factor. Two attitudes were measured on a 55-item questionnaire: Sex Pride (attributing positive characteristics to a child of the same sex) and Sex Prejudice (attributing negative characteristics to a child of…

  20. Sex-linked dominant

    Science.gov (United States)

    Inheritance - sex-linked dominant; Genetics - sex-linked dominant; X-linked dominant; Y-linked dominant ... can be either an autosomal chromosome or a sex chromosome. It also depends on whether the trait ...

  1. Sex and Arthritis

    Science.gov (United States)

    ... Well with Rheumatic Disease Sex & Arthritis Sex and Arthritis Fast Facts Sex and arthritis can coexist. Open ... ability for sexual expression and enjoyment. Impact of Arthritis on Sexual Expression Aspects of arthritis which can ...

  2. Surgical Lasers In Gynecology

    Science.gov (United States)

    Schellhas, Helmut F.; Barnes, Alfonso E.

    1982-12-01

    Multipurpose surgical CO2 lasers marketed in the USA have been developed to be applicable to a variety of surgical procedures in many surgical fields. They are all suited for endoscopic surgical procedures and can be fitted to all standard surgical microscopes. They all can adjust the focal length of the laser beam to the different standard focal lengths of the surgical microscope which for instance in laryngoscopy is 400 mm and in colposcopy 300 mm. One laser instrument can even change the spot size in a given focal distance which is very advantageous for some microsurgical procedures (Merrimack Laboratories 820). All multipurpose surgical CO2 laser systems provide a multi-articulated surgical arm for free-hand surgery. The surgical arms are cumbersome to use but they are adapted to the surgeons needs with ingenuity. The practicality of the multi-articulated surgical arms depends mostly on the distance of the handpiece from the surgical console which now is also overbridged by the laser tube in most surgical laser system. The spot size of the beam is variable in most handpieces by interchangeable lenses which modify the focal distance of the beam and the power density. Another common feature in all systems is a coaxial He-Ne pilot light which provides a red spot which unfortunately becomes invisible in a bleeding surgical field. Most surgical laser systems have a spacial mode of TEM 00 which is essential for incisional surgery. The continuous mode of beam delivery is used for incisional surgery and also for most endoscopic procedures.

  3. Systematic revision of the adeleid haemogregarines, with creation of Bartazoon n. g., reassignment of Hepatozoon argantis Garnham, 1954 to Hemolivia, and molecular data on Hemolivia stellata

    Science.gov (United States)

    Karadjian, Grégory; Chavatte, Jean-Marc; Landau, Irène

    2015-01-01

    Life cycles and molecular data for terrestrial haemogregarines are reviewed in this article. Collection material was re-examined: Hepatozoon argantis Garnham, 1954 in Argas brumpti was reassigned to Hemolivia as Hemolivia argantis (Garnham, 1954) n. comb.; parasite DNA was extracted from a tick crush on smear of an archived slide of Hemolivia stellata in Amblyomma rotondatum, then the 18S ssrRNA gene was amplified by PCR. A systematic revision of the group is proposed, based on biological life cycles and phylogenetic reconstruction. Four types of life cycles, based on parasite vector, vertebrate host and the characteristics of their development, are defined. We propose combining species, based on their biology, into four groups (types I, II, III and IV). The characters of each type are defined and associated with a type genus and a type species. The biological characters of each type are associated with a different genus and a type species. The phylogenetic reconstruction with sequences deposited in the databases and our own new sequence of Hemolivia stellata is consistent with this classification. The classification is as follows: Type I, Hepatozoon Miller, 1908, type species H. perniciosum Miller, 1908; Type II, Karyolysus Labbé, 1894, type species K. lacertae (Danilewsky, 1886) Reichenow, 1913; Type III Hemolivia Petit et al., 1990, type species H. stellata, Petit et al., 1990; and Type IV: Bartazoon n. g., type species B. breinli (Mackerras, 1960). PMID:26551414

  4. Surgical Treatment of Calcaneal Spur.

    Directory of Open Access Journals (Sweden)

    Eduardo Sarmiento Sánchez

    2007-12-01

    Full Text Available Background: Pain in the plantar region of the heel is technically known as talalgia, and it is a very frequent complaint in the orthopaedic service in Guyana. Due to its frequent mortality, the current investigation was carried out. Objectives: To characterize the application of the surgical treatment to a group of patients in Guyana. Method: 70 patients surgically treated were studied presenting rebel talalgia with no responses to the conservative treatment. Age, sex, race, educational level, antibiotic prophylaxis, final outcomes, and patient's satisfaction with the treatment were the set of variables selected. Results: High morbidity of the heel pain syndrome was evidenced in this studied. The most frequent cause was the calcaneal spur. There is predominance in female Indian race. The high influenced of the socio-cultural factor in the genesis of this disease is proved as well as the impossibility of carrying out the conservative treatment due to high cost of medications. Conclusions: The efficacy achieved with combined treatment technique allowed the results obtained. All this contributed to achieve high satisfaction levels.

  5. Manual of Surgical Instruments

    Directory of Open Access Journals (Sweden)

    Olga Lidia Sánchez Sarría

    2014-10-01

    Full Text Available Surgical instruments are the group of tools used in surgical procedures. They are very expensive and sophisticated. Consequently, a standardized and meticulous care is essential; they should go through the decontamination, cleaning and sterilization process. These instruments are designed in order to provide surgeons with tools that help them to perform a basic surgical procedure; there are multiple variations and the design depends on their function. This paper aims at showing all surgical instruments that can be used in an operating room during surgery and are not generally included in the medical literature.

  6. Surgical ethics and the challenge of surgical innovation.

    Science.gov (United States)

    Angelos, Peter

    2014-12-01

    Surgical ethics as a specific discipline is relatively new to many. Surgical ethics focuses on the ethical issues that are particularly important to the care of surgical patients. Informed consent for surgical procedures, the level of responsibility that surgeons feel for their patients' outcomes, and the management of surgical innovation are specific issues that are important in surgical ethics and are different from other areas of medicine. The future of surgical progress is dependent on surgical innovation, yet the nature of surgical innovation raises specific concerns that challenge the professionalism of surgeons. These concerns will be considered in the following pages.

  7. 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

  8. 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...

  9. Tactical and surgical techniques issues in the surgical treatment of incisional hernias

    OpenAIRE

    2014-01-01

    Abstract Within five years, between 2006 and 2011, a total of 368 incisional hernias have been operated in the Surgery Clinic 1, University Emergency Hospital Bucharest. The study followed the morphological and biological parameters, associated pathology, tactics and surgical technique used and postoperative morbidity. The average age of patients was 61.75 years, female sex was predominant (81.25%), and incisional hernias were large and giant in a percentage of 73.37%. Locations were predomin...

  10. 408 Cases of Genital Ambiguity Followed by Single Multidisciplinary Team during 23 Years: Etiologic Diagnosis and Sex of Rearing

    Science.gov (United States)

    De Paula, Georgette Beatriz; Barros, Beatriz Amstalden; Carpini, Stela; Tincani, Bruna Jordan; Mazzola, Tais Nitsch; Sanches Guaragna, Mara; Piveta, Cristiane Santos da Cruz; de Oliveira, Laurione Candido; Andrade, Juliana Gabriel Ribeiro; Guaragna-Filho, Guilherme; Barbieri, Pedro Perez; Ferreira, Nathalia Montibeler; Miranda, Marcio Lopes; Gonçalves, Ezequiel Moreira; Morcillo, Andre Moreno; Viguetti-Campos, Nilma Lucia; Silva, Roberto Benedito de Paiva; Marques-de-Faria, Antonia Paula; De Mello, Maricilda Palandi; Maciel-Guerra, Andrea Trevas

    2016-01-01

    Objective. To evaluate diagnosis, age of referral, karyotype, and sex of rearing of cases with disorders of sex development (DSD) with ambiguous genitalia. Methods. Retrospective study during 23 years at outpatient clinic of a referral center. Results. There were 408 cases; 250 (61.3%) were 46,XY and 124 (30.4%) 46,XX and 34 (8.3%) had sex chromosomes abnormalities. 189 (46.3%) had 46,XY testicular DSD, 105 (25.7%) 46,XX ovarian DSD, 95 (23.3%) disorders of gonadal development (DGD), and 19 (4.7%) complex malformations. The main etiology of 46,XX ovarian DSD was salt-wasting 21-hydroxylase deficiency. In 46,XX and 46,XY groups, other malformations were observed. In the DGD group, 46,XY partial gonadal dysgenesis, mixed gonadal dysgenesis, and ovotesticular DSD were more frequent. Low birth weight was observed in 42 cases of idiopathic 46,XY testicular DSD. The average age at diagnosis was 31.7 months. The final sex of rearing was male in 238 cases and female in 170. Only 6.6% (27 cases) needed sex reassignment. Conclusions. In this large DSD sample with ambiguous genitalia, the 46,XY karyotype was the most frequent; in turn, congenital adrenal hyperplasia was the most frequent etiology. Malformations associated with DSD were common in all groups and low birth weight was associated with idiopathic 46,XY testicular DSD. PMID:28018429

  11. 408 Cases of Genital Ambiguity Followed by Single Multidisciplinary Team during 23 Years: Etiologic Diagnosis and Sex of Rearing

    Directory of Open Access Journals (Sweden)

    Georgette Beatriz De Paula

    2016-01-01

    Full Text Available Objective. To evaluate diagnosis, age of referral, karyotype, and sex of rearing of cases with disorders of sex development (DSD with ambiguous genitalia. Methods. Retrospective study during 23 years at outpatient clinic of a referral center. Results. There were 408 cases; 250 (61.3% were 46,XY and 124 (30.4% 46,XX and 34 (8.3% had sex chromosomes abnormalities. 189 (46.3% had 46,XY testicular DSD, 105 (25.7% 46,XX ovarian DSD, 95 (23.3% disorders of gonadal development (DGD, and 19 (4.7% complex malformations. The main etiology of 46,XX ovarian DSD was salt-wasting 21-hydroxylase deficiency. In 46,XX and 46,XY groups, other malformations were observed. In the DGD group, 46,XY partial gonadal dysgenesis, mixed gonadal dysgenesis, and ovotesticular DSD were more frequent. Low birth weight was observed in 42 cases of idiopathic 46,XY testicular DSD. The average age at diagnosis was 31.7 months. The final sex of rearing was male in 238 cases and female in 170. Only 6.6% (27 cases needed sex reassignment. Conclusions. In this large DSD sample with ambiguous genitalia, the 46,XY karyotype was the most frequent; in turn, congenital adrenal hyperplasia was the most frequent etiology. Malformations associated with DSD were common in all groups and low birth weight was associated with idiopathic 46,XY testicular DSD.

  12. Seasonality and surgical management of intussusception over 10 ...

    African Journals Online (AJOL)

    Seasonality and surgical management of intussusception over 10 years at Harare Children's ... Log in or Register to get access to full text downloads. ... To determine the type and method of treatment of intussusception at HCH. ... Information regarding sex, age, anatomical subtype and procedure performed was recorded.

  13. 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.

  14. Multiscale Surgical Telerobots

    Energy Technology Data Exchange (ETDEWEB)

    Miles, R R; Seward, K P; Benett, W J; Tendick, F; Bentley, L; Stephan, P L

    2002-01-23

    A project was undertaken to improve robotic surgical tools for telerobotic minimally invasive surgery. The major objectives were to reduce the size of the tools to permit new surgical procedures in confined spaces such as the heart and to improve control of surgical tools by locating positional sensors and actuators at the end effector rather than external to the patient as is currently the state of the technology. A new compact end-effector with wrist-like flexibility was designed. Positional sensors based on MEMS microfabrication techniques were designed.

  15. A Study of Surgical Management of Diabetic Limb Complications Among Rural Population

    OpenAIRE

    2012-01-01

    Surgical complication of diabetes mellitus has been a common clinical problem among the rural population because of illiteracy and poor health education. The present study was undertaken to evaluate patients with respect to age, sex, presentation and to do other specific investigations. The patients were treated by conservative or surgical methods, and the outcome was monitored.

  16. Surgical Management of Traumatic Penile Amputation: A Case Report and Review of the World Literature

    Directory of Open Access Journals (Sweden)

    Omer A. Raheem, MD

    2015-03-01

    Conclusion: We review the literature and case reports on penile amputation and its etiology, surgical management, variables effecting outcomes, and its complications. Raheem OA, Mirheydar HS, Patel ND, Patel SH, Suliman A, and Buckley JC. Surgical management of traumatic penile amputation: A case report and review of the world literature. Sex Med 2015;3:49–53.

  17. Insects and sex

    OpenAIRE

    Beukeboom, Leo

    2005-01-01

    Most organisms reproduce sexually, but the evolution of sexual reproduction is not yet well understood. Sexual reproduction leads to new variation and adaptations to the environment, but sex is also costly. Some insects reproduce without sex through parthenogenesis or paedogenesis. Almost all sexual insects have two separate sexes, male and female. There are many mechanisms of sex determination. Most insects have male heterogamety (males XY, females XX). Female heterogamety and haplodiploidy ...

  18. Guide to Surgical Specialists

    Science.gov (United States)

    ... have expertise in the following areas of responsibility: neonatal surgery (specialized knowledge in the surgical repair of ... and non-operative management of certain types of pain. Common conditions managed by neurologic surgeons include disorders ...

  19. 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....

  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. 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...

  2. Surgical site infections

    African Journals Online (AJOL)

    and mortality as well as significant financial implications. Worldwide it has ... common nosocomial infection amongst surgical patients with up to 38% .... antibiotics as soon as the sensitivity results are available. ... Breast surgery. Staph Aureus/ ...

  3. Sex Differences in Cognition

    Science.gov (United States)

    Fairweather, Hugh

    1976-01-01

    Sex differences in cognitive skills, grouped into motor, spatial and linguistic areas, are assessed in relation to current theories of cerebral lateralization. Few convincing sex differences exist, either overall, or in interactions with functional localization. Qualifying criteria include age, birth order, culture, sex of experimenter and sex…

  4. History of commercializing sexed semen for cattle.

    Science.gov (United States)

    Garner, D L; Seidel, G E

    2008-04-15

    Although the basic principles controlling the sex of mammalian offspring have been known for a relatively long time, recent application of certain modern cellular methodologies has led to development of a flow cytometric system capable of differentiating and separating living X- and Y-chromosome-bearing sperm in amounts suitable for AI and therefore, commercialization of this sexing technology. After a very long history of unsuccessful attempts to differentiate between mammalian sperm that produce males from those that produce females, a breakthrough came in 1981 when it was demonstrated that precise DNA content could be measured. Although these initial measurements of DNA content killed the sperm in the process, they led to the ultimate development of a sperm sorting system that was capable, not only of differentiating between live X- and Y-sperm, but of sorting them into relatively pure X- and Y-sperm populations without obvious cellular damage. Initial efforts to predetermine the sex of mammalian offspring in 1989 required surgical insemination, but later enhancements provided sex-sorted sperm in quantities suitable for use with IVF. Subsequent advances in flow sorting provided minimal numbers of sperm sufficient for use in AI. It was not until the flow cytometric sorting system was improved greatly and successful cryopreservation of sex-sorted bull sperm was developed that efficacious approaches to commercialization of sexed semen could be implemented worldwide in cattle. A number of companies now offer sex-sorted bovine sperm. Innovative approaches by a diverse group of scientists along with advances in computer science, biophysics, cell biology, instrumentation, and applied reproductive physiology provided the basis for commercializing sexed semen in cattle.

  5. Sexing young snowy owls

    Science.gov (United States)

    Seidensticker, M.T.; Holt, D.W.; Detienne, J.; Talbot, S.; Gray, K.

    2011-01-01

    We predicted sex of 140 Snowy Owl (Bubo scandiacus) nestlings out of 34 nests at our Barrow, Alaska, study area to develop a technique for sexing these owls in the field. We primarily sexed young, flightless owls (3844 d old) by quantifying plumage markings on the remiges and tail, predicting sex, and collecting blood samples to test our field predictions using molecular sexing techniques. We categorized and quantified three different plumage markings: two types of bars (defined as markings that touch the rachis) and spots (defined as markings that do not touch the rachis). We predicted sex in the field assuming that males had more spots than bars and females more bars than spots on the remiges and rectrices. Molecular data indicated that we correctly sexed 100% of the nestlings. We modeled the data using random forests and classification trees. Both models indicated that the number and type of markings on the secondary feathers were the most important in classifying nestling sex. The statistical models verified our initial qualitative prediction that males have more spots than bars and females more bars than spots on flight feathers P6P10 for both wings and tail feathers T1 and T2. This study provides researchers with an easily replicable and highly accurate method for sexing young Snowy Owls in the field, which should aid further studies of sex-ratios and sex-related variation in behavior and growth of this circumpolar owl species. ?? 2011 The Raptor Research Foundation, Inc.

  6. 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

  7. A Sex Work Research Symposium: Examining Positionality in Documenting Sex Work and Sex Workers’ Rights

    Directory of Open Access Journals (Sweden)

    Megan Lowthers

    2017-04-01

    Full Text Available Historically, academic literature on sex work has documented the changing debates, policies, and cultural discourse surrounding the sex industry, and their impact on the rights of sex workers worldwide. As sex work scholars look to the future of sex workers’ rights, however, we are also in a critical moment of self-reflection on how sex work scholarship engages with sex worker communities, produces knowledge surrounding sex work, and represents the lived experiences of sex workers’ rights, organizing, and activism. In this short Communication, proceedings from a recent sex work research symposium entitled, Sexual Economies, Politics, and Positionality in Sex Work Research are presented. Held at the Centre for Refugee Studies at York University, this symposium is a response to the need for sex work researchers, sex workers, and sex worker-led organizations to come together and critically examine the future of research on sex work and the politics of documenting sex workers’ rights.

  8. Sex determination in amphibians.

    Science.gov (United States)

    Nakamura, Masahisa

    2009-05-01

    The heterogametic sex is male in all mammals, whereas it is female in almost all birds. By contrast, there are two heterogametic types (XX/XY and ZZ/ZW) for genetic sex determination in amphibians. Though the original heterogametic sex was female in amphibians, the two heterogametic types were probably interchangeable, suggesting that sex chromosomes evolved several times in this lineage. Indeed, the frog Rana rugosa has the XX/XY and ZZ/ZW sex-determining systems within a single species, depending on the local population in Japan. The XY and ZW geographic forms with differentiated sex chromosomes probably have a common origin as undifferentiated sex chromosomes resulted from the hybridization between the primary populations of West Japan and Kanto forms. It is clear that the sex chromosomes are still undergoing evolution in this species group. Regardless of the presence of a sex-determining gene in amphibians, the gonadal sex of some species can be changed by sex steroids. Namely, sex steroids can induce the sex reversal, with estrogens inducing the male-to-female sex reversal, whereas androgens have the opposite effect. In R. rugosa, gonadal activity of CYP19 (P450 aromatase) is correlated with the feminization of gonads. Of particular interest is that high levels of CYP19 expression are observed in indifferent gonads at time before sex determination. Increases in the expression of CYP19 in female gonads and CYP17 (P450 17alpha-hydroxylase/C17-20 lyase) in male gonads suggest that the former plays an important role in phenotypic female determination, whereas the latter is needed for male determination. Thus, steroids could be the key factor for sex determination in R. rugosa. In addition to the role of sex steroids in gonadal sex determination in this species, Foxl2 and Sox3 are capable of promoting CYP19 expression. Since both the genes are autosomal, another factor up-regulating CYP19 expression must be recruited. The factor, which may be located on the X or W

  9. Anxiety in veterinary surgical students

    DEFF Research Database (Denmark)

    Langebæk, Rikke; Eika, Berit; Jensen, Asger Lundorff

    2012-01-01

    The surgical educational environment is potentially stressful and this can negatively affect students' learning. The aim of this study was to investigate whether veterinary students' level of anxiety is higher in a surgical course than in a non-surgical course and if pre-surgical training...... in a Surgical Skills Lab (SSL) has an anxiety reducing effect. Investigations were carried out as a comparative study and a parallel group study. Potential participants were fourth-year veterinary students who attended a surgical course (Basic Surgical Skills) and a non-surgical course (Clinical Examination...... and 28 students from 2010). Our results show that anxiety levels in veterinary students are significantly higher in a surgical course than in a non-surgical course (p...

  10. Surgical Treatment for Pulmonary Hamartomas

    Directory of Open Access Journals (Sweden)

    Funda Ižncekara

    2015-11-01

    Full Text Available Aim: In this study, we evaluated the patients operated for hamartoma and treated endobronchially and the diagnostic value of this approach has been examined. Material and Method: 59 patients (24 females, 35 males; mean age 53 years, range 28-78 years which were operated and endobronchial treated for hamartoma in our clinic between January 2003 - January 2013 were analyzed retrospectively. Patient age, sex, symptoms, histopathological, surgical procedures and treatment outcomes were evaluated. Results: The most common complaint was shortness of breath, while 25 patients were asymptomatic. Thoracotomy and mass enucleation in 29 patients (%49,15, thoracotomy and wedge resection in 18 patients (%30.5, VATS and wedge resection in 4 patients (%6.77, thoracotomy and upper lobectomy in 4 patients (%6.77, thoracotomy and lower lobectomy in 2 patients (%3.38 and left upper lobe segmentectomy in 1 patient (%1.69 and right upper bronchial sleeve resection in 1 patient were performed. The postoperative pathology of lesions examined and diagnosis were chondroid hamartoma in 28 , pulmonary hamartoma in 20 , hamartoma chondrolypomatous in 11 and the bronchial hamartoma in 2 . No mortality was observed intraoperatively. Discussion: Although hamartomas are benign , diagnosis should be made because it can be confused with lung cancer. Definitive diagnosis and treatment can be performed successfully through VATS in primarily appropriate cases with minimal morbidity or thoracotomy or endobronchial treatment.

  11. Surgical bleeding in microgravity

    Science.gov (United States)

    Campbell, M. R.; Billica, R. D.; Johnston, S. L. 3rd

    1993-01-01

    A surgical procedure performed during space flight would occur in a unique microgravity environment. Several experiments performed during weightlessness in parabolic flight were reviewed to ascertain the behavior of surgical bleeding in microgravity. Simulations of bleeding using dyed fluid and citrated bovine blood, as well as actual arterial and venous bleeding in rabbits, were examined. The high surface tension property of blood promotes the formation of large fluid domes, which have a tendency to adhere to the wound. The use of sponges and suction will be adequate to prevent cabin atmosphere contamination with all bleeding, with the exception of temporary arterial droplet streams. The control of the bleeding with standard surgical techniques should not be difficult.

  12. Surgical management of presbyopia

    Directory of Open Access Journals (Sweden)

    Torricelli AA

    2012-09-01

    Full Text Available André AM Torricelli, Jackson B Junior, Marcony R Santhiago, Samir J BecharaDivision of Ophthalmology, University of São Paulo Medical School, São Paulo, BrazilAbstract: Presbyopia, the gradual loss of accommodation that becomes clinically significant during the fifth decade of life, is a physiologic inevitability. Different technologies are being pursued to achieve surgical correction of this disability; however, a number of limitations have prevented widespread acceptance of surgical presbyopia correction, such as optical and visual distortion, induced corneal ectasia, haze, anisometropy with monovision, regression of effect, decline in uncorrected distance vision, and the inherent risks with invasive techniques, limiting the development of an ideal solution. The correction of the presbyopia and the restoration of accommodation are considered the final frontier of refractive surgery. The purpose of this paper is to provide an update about current procedures available for presbyopia correction, their advantages, and disadvantages.Keywords: presbyopia, surgical correction, treatment

  13. Description of sex difference as prescription for sex change: on the origins of facial feminization surgery.

    Science.gov (United States)

    Plemons, Eric D

    2014-10-01

    This article explores the research project that led to the development of facial feminization surgery, a set of bone and soft tissue reconstructive surgical procedures intended to feminize the faces of male-to-female trans- women. Conducted by a pioneering surgeon in the mid-1980s, this research consisted of three steps: (1) assessments of sexual differences of the skull taken from early 20th-century physical anthropology, (2) the application of statistical analyses taken from late 20th-century orthodontic research, and (3) the vetting of this new morphological and metric knowledge in a dry skull collection. When the 'feminine type' of early 20th-century physical anthropology was made to articulate with the 'female mean' of 1970s' statistical analysis, these two very different epistemological artifacts worked together to produce something new: a singular model of a distinctively female skull. In this article, I show how the development of facial feminization surgery worked across epistemic styles, transforming historically racialized and gendered descriptions of sex difference into contemporary surgical prescriptions for sex change. Fundamental to this transformation was an explicit invocation of the scientific origins of facial sexual dimorphism, a claim that frames surgical sex change of the face as not only possible, but objectively certain.

  14. Sex, epilepsy, and epigenetics.

    Science.gov (United States)

    Qureshi, Irfan A; Mehler, Mark F

    2014-12-01

    Epilepsy refers to a heterogeneous group of disorders that are associated with a wide range of pathogenic mechanisms, seizure manifestations, comorbidity profiles, and therapeutic responses. These characteristics are all influenced quite significantly by sex. As with other conditions exhibiting such patterns, sex differences in epilepsy are thought to arise-at the most fundamental level-from the "organizational" and "activational" effects of sex hormones as well as from the direct actions of the sex chromosomes. However, our understanding of the specific molecular, cellular, and network level processes responsible for mediating sex differences in epilepsy remains limited. Because increasing evidence suggests that epigenetic mechanisms are involved both in epilepsy and in brain sexual dimorphism, we make the case here that analyzing epigenetic regulation will provide novel insights into the basis for sex differences in epilepsy.

  15. Sex, epilepsy, and epigenetics

    OpenAIRE

    2014-01-01

    Epilepsy refers to a heterogeneous group of disorders that are associated with a wide range of pathogenic mechanisms, seizure manifestations, comorbidity profiles, and therapeutic responses. These characteristics are all influenced quite significantly by sex. As with other conditions exhibiting such patterns, sex differences in epilepsy are thought to arise—at the most fundamental level—from the “organizational” and “activational” effects of sex hormones as well as from the direct actions of ...

  16. Erecting Sex: Hermaphrodites and the Medieval Science of Surgery.

    Science.gov (United States)

    DeVun, Leah

    2015-01-01

    This essay focuses on "hermaphrodites" and the emerging profession of surgery in thirteenth- and fourteenth-century Europe. During this period, surgeons made novel claims about their authority to regulate sexual difference by surgically ''correcting" errant sexual anatomies. Their theories about sex, I argue, drew upon both ancient roots and contemporary conflicts to conceptualize sexual difference in ways that influenced Western Europe for centuries thereafter. I argue that a close examination of medieval surgical texts complicates orthodox narratives in the broader history of sex and sexuality: medieval theorists approached sex in sophisticated and varied manners that belie any simple opposition of modern and premodern paradigms. In addition, because surgical treatments of hermaphrodites in the Middle Ages prefigure in many ways the treatment of atypical sex (a condition now called, controversially, intersex or disorders/differences of sex development) in the modern world, I suggest that the writings of medieval surgeons have the potential to provide new perspectives on our current debates about surgery and sexual difference.

  17. [Optimizing surgical hand disinfection].

    Science.gov (United States)

    Kampf, G; Kramer, A; Rotter, M; Widmer, A

    2006-08-01

    For more than 110 years hands of surgeons have been treated before a surgical procedure in order to reduce the bacterial density. The kind and duration of treatment, however, has changed significantly over time. Recent scientific evidence suggests a few changes with the aim to optimize both the efficacy and the dermal tolerance. Aim of this article is the presentation and discussion of new insights in surgical hand disinfection. A hand wash should be performed before the first disinfection of a day, ideally at least 10 min before the beginning of the disinfection as it has been shown that a 1 min hand wash significantly increases skin hydration for up to 10 min. The application time may be as short as 1.5 min depending on the type of hand rub. Hands and forearms should be kept wet with the hand rub for the recommended application time in any case. A specific rub-in procedure according to EN 12791 has been found to be suitable in order to avoid untreated skin areas. The alcohol-based hand rub should have a proven excellent dermal tolerance in order to ensure appropriate compliance. Considering these elements in clinical practice can have a significant impact to optimize the high quality of surgical hand disinfection for prevention of surgical site infections.

  18. Surgical treatment in thoraco-lumbar region fractures.

    Directory of Open Access Journals (Sweden)

    Jorge Alberto Jerez Labrada

    2008-08-01

    Full Text Available Background: thoraco-lumbar fractures may affect people at any moment of their lives, especially at their most fruitful and useful stage. Its correct diagnosis and treatment may directly influence in the posterior evolution of the patients. Objectives: to evaluate the results of the surgical treatment in thoraco-lumbar region fractures. Methods: a descriptive retrospective correlational study of series cases which included 54 patients attended due to thoraco-lumbar region fractures in the University Hospital “Dr. Gustavo Aldereguía Lima” in Cienfuegos city, Cuba from January 1999 to June 2007. Age, sex, etiology of the fracture, type and level of the fractures, associated diseases, surgical techniques used for, pre and post operatory neurological damage, usage of metilprednisolone, complications and final results were the variables taken into consideration in this study. Results: most of the patients belonged to male sex under the age of 45. The totality of the cases had type IV fracture, and a great part of them had Denis type II fracture having surgical treatment. The causes of the lesions were traffic accidents, working accidents and height falls. The most useful surgical techniques were posterior decompression, instrumentation and fusion. Surgery improved the neurological damage in almost half of sick patients with this condition. Complications were minimum and rupture of the implant was predominant. Conclusion: surgical treatment in thoraco-lumbar region fractures had satisfactory results in our milieu.

  19. [da Vinci surgical system].

    Science.gov (United States)

    Watanabe, Gou; Ishikawa, Norihiro

    2014-07-01

    The da Vinci surgical system was developed by Intuitive Surgical Inc. in the United States as an endoscopic surgical device to assist remote control surgeries. In 1998, the Da Vinci system was first used for cardiothoracic procedures. Currently a combination of robot-assisted internal thoracic artery harvest together with coronary artery bypass grafting (CABG) through a mini-incision (ThoraCAB) or totally endoscopic procedures including anastomoses under robotic assistance (TECAB) are being conducted for the treatment of coronary artery diseases. With the recent advances in catheter interventions, hybrid procedures combining catheter intervention with ThoraCAB or TECAB are anticipated in the future.On the other hand, with the decrease in number of coronary artery bypass surgeries, the share of valvular surgeries is expected to increase in the future. Among them, mitral valvuloplasty for mitral regurgitation is anticipated to be conducted mainly by low-invasive procedures, represented by minimally invasive cardiac surgery( MICS) and robot-assisted surgery. Apart from the intrinsic good surgical view, robotic-assisted systems offer additional advantages of the availability of an amplified view and the easy to observe the mitral valve in the physiological position. Thus, robotic surgical surgeries that make complicated procedures easier are expected to accomplish further developments in the future. Furthermore, while the number of surgeries for atrial septal defects has decreased dramatically following the widespread use of Amplatzer septal occluder, robotic surgery may become a good indication for cases in which the Amplatzer device is not indicated. In Japan, clinical trial of the da Vinci robotic system for heart surgeries has been completed. Statutory approval of the da Vinci system for mitral regurgitation and atrial septal defects is anticipated in the next few years.

  20. The evolution of sex ratios and sex-determining systems

    NARCIS (Netherlands)

    Uller, Tobias; Pen, Ido; Wapstra, Erik; Beukeboom, Leo W.; Komdeur, Jan

    Sex determination is a fundamental process governed by diverse mechanisms. Sex ratio selection is commonly implicated in the evolution of sex-determining systems, although formal models are rare. Here, we argue that, although sex ratio selection can induce shifts in sex determination, genomic

  1. The evolution of sex ratios and sex-determining systems

    NARCIS (Netherlands)

    Uller, Tobias; Pen, Ido; Wapstra, Erik; Beukeboom, Leo W.; Komdeur, Jan

    2007-01-01

    Sex determination is a fundamental process governed by diverse mechanisms. Sex ratio selection is commonly implicated in the evolution of sex-determining systems, although formal models are rare. Here, we argue that, although sex ratio selection can induce shifts in sex determination, genomic confli

  2. Plant Sex Determination.

    Science.gov (United States)

    Pannell, John R

    2017-03-06

    Sex determination is as important for the fitness of plants as it is for animals, but its mechanisms appear to vary much more among plants than among animals, and the expression of gender in plants differs in important respects from that in most animals. In this Minireview, I provide an overview of the broad variety of ways in which plants determine sex. I suggest that several important peculiarities of plant sex determination can be understood by recognising that: plants show an alternation of generations between sporophytic and gametophytic phases (either of which may take control of sex determination); plants are modular in structure and lack a germ line (allowing for a quantitative expression of gender that is not common in animals); and separate sexes in plants have ultimately evolved from hermaphroditic ancestors. Most theorising about sex determination in plants has focused on dioecious species, but we have much to learn from monecious or hermaphroditic species, where sex is determined at the level of modules, tissues or cells. Because of the fundamental modularity of plant development and potentially important evolutionary links between monoecy and dioecy, it may be useful to relax the distinction often made between 'developmental sex determination' (which underpins the development of male versus female flowers in monoecious species) and 'genetic sex determination' (which underpins the separation of males and females in dioecious species, often mediated by a genetic polymorphism and sex chromosomes). I also argue for relaxing the distinction between sex determination involving a genetic polymorphism and that involving responses to environmental or hormonal cues, because non-genetic cues might easily be converted into genetic switches.

  3. Sex tourism in Thailand.

    Science.gov (United States)

    Van Kerkwijk, C

    1992-01-01

    Many foreigners visit Thailand in search of sex. While long-distance tourism was long enjoyed by members of more privileged social classes, even the lower economical classes of Japan, Malaysia, Europe, America, and Australia can now afford to travel over long distances. This relatively new breed of tourist is more likely to be of lower socioeconomic and educational status and less likely to use condoms when having sex. An estimated 30,000 sex workers are active in Bangkok, of whom 7000/10,000 are females who work specifically in the tourism sector. 1/2-1/3 of the 600 commercial sex establishments in the city are visited by foreigners. Phuket, Pattaya, Koh Samui, and Chiangmai are also well-frequented by sex tourists. Overall, a large, diverse, inexpensive, and accessible commercial sex market exists in Thailand. One may meet sex workers quasi-ubiquitously and be assured to find someone capable of meeting one's sexual needs. With these attributes, Thailand strongly attracts tourists in search of sex. A certain degree of recklessness also prevails among those on vacation. Away from the peers and social mores of their native lands, tourists may engage in sexually activities without criticism. Likewise, Thai sex workers who cater to foreigners, especially females, enjoy more freedom and control in sexual relations than their peers who work among nationals. Neither single nor married women in Thailand are allowed much sexual freedom and are traditionally expected to be obliging docile, and submissive. The greater than normal personal latitude enjoyed by both sex worker and foreigner lead to more negotiation on condom use and overall lower use. As such, Thailand's commercial sex market with foreigners' involvement therein threatens to spread HIV to many other countries throughout the world.

  4. Single-Sex Classrooms

    Science.gov (United States)

    Protheroe, Nancy

    2009-01-01

    Although single-sex education was once the norm in the U.S., the practice has largely been confined to private schools for more than a century. However, with the introduction of the final version of the U.S. Department of Education's so-called single-sex regulations in 2006, public schools were allowed greater flexibility to offer single-sex…

  5. Sex Discrimination in Coaching.

    Science.gov (United States)

    Dessem, Lawrence

    1980-01-01

    Even in situations in which the underpayment of girls' coaches is due to the sex of the students coached rather than to the sex of the coaches, the coaches and the girls coached are victims of unlawful discrimination. Available from Harvard Women's Law Journal, Harvard Law School, Cambridge, MA 02138. (Author/IRT)

  6. Sex Away from Home

    Science.gov (United States)

    Greenwald, Harold

    1971-01-01

    The reasons why people who are normally truthful to their spouses engage in sex away from home are discussed. These reasons can include loneliness, ego building or the opportunity to have homosexual relations. Sex away from home is likely to increase since the number of people traveling is increasing. (Author/CG)

  7. Insects and sex

    NARCIS (Netherlands)

    Beukeboom, Leo

    2005-01-01

    Most organisms reproduce sexually, but the evolution of sexual reproduction is not yet well understood. Sexual reproduction leads to new variation and adaptations to the environment, but sex is also costly. Some insects reproduce without sex through parthenogenesis or paedogenesis. Almost all sexual

  8. Sex Determination, Sex Ratios, and Genetic Conflict

    NARCIS (Netherlands)

    Werren, John H.; Beukeboom, Leo W.

    1998-01-01

    Genetic mechanisms of sex determination are unexpectedly diverse and change rapidly during evolution. We review the role of genetic conflict as the driving force behind this diversity and turnover. Genetic conflict occurs when different components of a genetic system are subject to selection in

  9. Sex Determination, Sex Ratios, and Genetic Conflict

    NARCIS (Netherlands)

    Werren, John H.; Beukeboom, Leo W.

    1998-01-01

    Genetic mechanisms of sex determination are unexpectedly diverse and change rapidly during evolution. We review the role of genetic conflict as the driving force behind this diversity and turnover. Genetic conflict occurs when different components of a genetic system are subject to selection in oppo

  10. Vitiligo- A surgical approach

    Directory of Open Access Journals (Sweden)

    Deepti Ghia

    2012-01-01

    Full Text Available Aims and objective- To describe the spectrum of surgical modalities for stable vitiligo patients Methods- Patients having stable vitiligo since past 2 years with no improvement with medical line of treatment were enrolled for surgery after informed consent. Depending upon the size and location of vitiligo patch different modalities were performed. Suction blister, mini-punch grafting, split thickness skin grafting, trypsinised melanocyte-keratinocyte transfer and non-trypsinised melanocyte- keratinocyte transfer (Jodhpur technique and follicular grafting technique have been described photographically which have been performed at a tertiary care hospital. Conclusion- Vitiligo is often difficult to treat, stable patches resistant to medical line of management do respond to surgical treatment; however it is very important to choose the modality of surgery according location of the patch, size of the lesion and available resources.

  11. Spacecraft surgical scrub system

    Science.gov (United States)

    Abbate, M.

    1980-01-01

    Ease of handling and control in zero gravity and minimizing the quantity of water required were prime considerations. The program tasks include the selection of biocidal agent from among the variety used for surgical scrub, formulation of a dispensing system, test, and delivery of flight dispensers. The choice of an iodophore was based on effectiveness on single applications, general familiarity among surgeons, and previous qualification for space use. The delivery system was a choice between the squeeze foamer system and impregnated polyurethane foam pads. The impregnated foam pad was recommended because it is a simpler system since the squeeze foamer requires some applicator to effectively clean the skin surfaces, whereas the form pad is the applicator and agent combined. Testing demonstrated that both systems are effective for use as surgical scrubs.

  12. Gossypiboma—Retained Surgical Sponge

    Directory of Open Access Journals (Sweden)

    Hung-Shun Sun

    2007-11-01

    Full Text Available Intra-abdominal retained surgical sponge is an uncommon surgical error. Herein, we report a 92-year-old woman who was brought to the emergency room for acute urinary retention. She had a history of vaginal hysterectomy for uterine prolapse 18 years previously, performed at our hospital. Retained surgical sponge in the pelvic cavity was suspected by abdominal computed tomography. The surgical gauze was removed by laparotomy excision and the final diagnosis was gossypiboma.

  13. Hepatic surgical anatomy.

    Science.gov (United States)

    Skandalakis, John E; Skandalakis, Lee J; Skandalakis, Panajiotis N; Mirilas, Petros

    2004-04-01

    The liver, the largest organ in the body, has been misunderstood at nearly all levels of organization, and there is a tendency to ignore details that do not fit the preconception. A complete presentation of the surgical anatomy of the liver includes the study of hepatic surfaces, margins, and fissures; the various classifications of lobes and segments; and the vasculature and lymphatics. A brief overview of the intrahepatic biliary tract is also presented.

  14. The clipping technique based robust LPFT and its reassignment method%脉冲噪声环境中基于clipping方法的鲁棒LPFT及其重排算法

    Institute of Scientific and Technical Information of China (English)

    李秀梅; 鞠颖拓

    2012-01-01

    In this paper, a new clipping technique based robust LPFT is proposed to process time-varying signals in the impulsive noise. First, the clipping technique is used to suppress the impulsive noise to achieve good time-frequency representation for the time-varying signal. Then, the reassignment method is combined with the LPFT to improve the time-frequency concentration in the time-frequency domain. Simulations show that, compared with the median filter based robust LPFT, the clipping technique based robust LPFT can also provide good representation for signals in the impulsive noise, with smaller MSE and less computational complexity. Moreover, the reassignment method is combined with the clipping technique based robust LPFT to effectively improve the time-frequency concentration. Therefore, the clipping technique based robust LPFT and its reassignment method is an effective method to process signals corrupted by the impulsive noise, as well as to achieve improved time-frequency concentration.%为了更好地处理脉冲噪声环境中的时变信号,本文提出了基于clipping方法的鲁棒局部多项式傅里叶变换(LPFT)及其重排算法.首先利用clipping方法对信号中掺杂的脉冲噪声进行抑制,得到较好的信号时频分布表示,然后将重排算法与该鲁棒LPFT相结合,以提高信号的时频聚集性.通过实验仿真可以看出,与基于中值滤波器的鲁棒LPFT相比,基于clipping方法的鲁棒LPFT同样能对被脉冲噪声干扰的信号给出较好的时频表示,而且其瞬时频率估计的最小均方误差(MSE)较低,计算量较小.并且,本文在基于clipping方法的鲁棒LPFT对掺杂脉冲噪声的信号进行处理的基础上,利用重排算法与其结合,有效增强了信号的时频聚集性.因此基于clipping方法的鲁棒LPFT及其重排算法是一种高效的处理脉冲噪声干扰信号及提高信号时频聚集性的方法.

  15. Louis Pasteur surgical revolution.

    Science.gov (United States)

    Toledo-Pereyra, Luis H

    2009-01-01

    Louis Pasteur (1822-1895) is considered the most notable medical scientist of his time and perhaps one of the most distinguished of all times in the history of medicine. From Dole in France to Paris, from a student of crystals to "living ferments," and from chemistry to biology and medicine, Pasteur changed the world for the benefit of humanity. The genius of Pasteur dealt with the most pressing issues of his time, basing the germ theory on the effects that microorganisms had on fermentation and putrefaction of organic matter, which gave birth to the science of bacteriology. Many other difficult problems in medicine and biology were tackled by Pasteur, culminating in the spectacular results seen with the treatment of rabies. Surgery was no exception to the scientific conquests of Pasteur. The transformation of the surgical world arose from the antiseptic concepts of Lister that were based on the germ theory of the disease, which had been derived from the germ theory of fermentation and putrefaction discovered by Pasteur. The acceptance of these principles represented the surgical revolution brought on by the science of Pasteur, a revolution that is now accepted in our daily care of surgical patients.

  16. Guideline implementation: Surgical attire.

    Science.gov (United States)

    Cowperthwaite, Liz; Holm, Rebecca L

    2015-02-01

    Surgical attire helps protect patients from microorganisms that may be shed from the hair and skin of perioperative personnel. The updated AORN "Guideline for surgical attire" provides guidance on scrub attire, shoes, head coverings, and masks worn in the semirestricted and restricted areas of the perioperative setting, as well as how to handle personal items (eg, jewelry, backpacks, cell phones) that may be taken into the perioperative suite. This article focuses on key points of the guideline to help perioperative personnel adhere to facility policies and regulatory requirements for attire. The key points address the potential benefits of wearing scrub attire made of antimicrobial fabric, covering the arms when in the restricted area of the surgical suite, removing or confining jewelry when wearing scrub attire, disinfecting personal items that will be taken into the perioperative suite, and sending reusable attire to a health care-accredited laundry facility after use. Perioperative RNs should review the complete guideline for additional information and for guidance when writing and updating policies and procedures.

  17. 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.

  18. Sex and Fertility After SCI

    Science.gov (United States)

    ... About Blog Facing Disability Jeff Shannon Donate Experts \\ Sex and Fertility After Spinal Cord Injury Topics Adult ... Spasticity, Physical Therapy-Lokomat Spasticity, Physical Therapy-Lokomat Sex and Fertility After Spinal Cord Injury Sex and ...

  19. Debridement for surgical wounds.

    Science.gov (United States)

    Dryburgh, Nancy; Smith, Fiona; Donaldson, Jayne; Mitchell, Melloney

    2008-07-16

    Surgical wounds that become infected are often debrided because clinicians believe that removal of this necrotic or infected tissue will expedite wound healing. There are numerous methods available but no consensus on which one is most effective for surgical wounds. The aim of this review is to determine the effect of different methods of debridement on the rate of debridement and healing of surgical wounds. We developed a search strategy to search the following electronic databases: Wounds Group Specialised Trials Register (searched 3/3/08) , Cochrane Central Register of Controlled Trials (CENTRAL) (the Cochrane Library, 2008, issue 1), MEDLINE (1950 to February Week 3 2008 ), EMBASE (1980 to 2008 Week 09) and CINHAL (1982 to February Week 4 2008). We checked the citations within obtained studies to identify additional papers and also relevant conference proceedings. We contacted manufactures of wound debridement agents to ascertain the existence of published, unpublished and ongoing trials. Our search was not limited by language or publication status. We included relevant randomised controlled trials (RCT) with outcomes including at least one of the following: time to complete debridement, or time to complete healing. Two authors independently reviewed the abstracts and titles obtained from the search, two extracted data independently using a standardised extraction sheet, and two independently assessed methodological quality. One author was involved in all stages of the data collection and extraction process, thus ensuring continuity. Five RCTs were eligible for inclusion; all compared treatments for infected surgical wounds and reported time required to achieve a clean wound bed (complete debridement). One trial compared an enzymatic agent (Streptokinase/streptodornase) with saline-soaked dressings and reported the time to complete debridement. Four of the trials compared the effectiveness of dextranomer beads or paste with other products (different comparator

  20. [Negotiating safer sex].

    Science.gov (United States)

    Gordon, G; Charnock, D

    1991-01-01

    Women have generally assumed responsibility for contraception since the appearance of oral contraceptives and IUDs. But AIDS prevention programs are now asking women to assume responsibility for safer sex through use of condoms, a male method. Women are being asked to carry condoms, to negotiate their use each time they have sex, and to insist if the partner resists. The problem with this strategy is that frequently it is the male partner who makes sexual decisions, and women have less negotiating power. Women are considered feminine if they assume a passive role in sexual activity. This work suggests strategies to improve the negotiating power of women. Options and problems of speaking about safer sex vary in accordance with the nature of the relationship. A woman with a new partner can try to ascertain his sexual history, but may gain no information on his probable health even if he tells her the truth. It may be easier to convince him to use a condom at least in the beginning of the romance. Women working in the sex industry often have greater trouble convincing their friends and lovers to use a condom than their clients. Some family planning workers have begun to speak of safer sex with all their clients. Role playing and workshops or discussions with small groups of women having similar problems may help women overcome their reticence about discussing sexual topics. Some general suggestions to help women negotiate safer sex include choosing an opportune moment and planning in advance what to say; daring to speak directly without beating around the bush (the partner may also be gathering courage to speak); practicing placing condoms on objects and if necessary placing one on the partner without speaking; being honest with the partner about sex, love, and fidelity; and remembering that protection from condoms is mutual given that it is not possible to know who is infected. Until now, programs to help women practice safer sex have concentrated on sex industry

  1. Sex education in Portugal.

    Science.gov (United States)

    Frade, A; Vilar, D

    1991-05-01

    The article on sex education in Portugal covers background, the educational system, the clashes of the 1960's over sex education, the Committee for the Study of Sexuality and Education (CSSE), the policies, politics and social movements during the period 1974 - 1984, the discussions in Parliament, the 1988 Reform of the Educational System, the Family Planning Association (FPA) and sex education, and the future role of the FPA. It was not until the institution of the multiparity parliamentary system in 1974 that discussing social and political changes was possible, culminating in 1984 with new legislation on abortion, family planning, and sex education. School reform came in 1987/8 with the Ministry of Education primarily responsible for curricula. The 1960's brought with it the influence of the Catholic Church. Change came in the form of progressivism among Catholics who replaced dogma with dialogue and listening. Sex education was considered as preparation for marriage, but masturbation, contraception, and prostitution were also discussed. In addition, the founder of FPA chaired the CSSE in 1971 and opened up debate on sex issues and drafted a bill to establish co-education in Portuguese schools. The revolution of 1974 brought an end to censorship and brought forth a policy of developing family planning. Changed in the Family Code gave women greater equality. UNFPA supported teacher training in non-sexist education. With human reproduction included in the natural sciences, there was still no school sex education policy and contraception was only sometimes represented in the biology curriculum. The focus of FPA was on contraception and abortion. Finally in the 1980's, the first sex education programs were developed for out-of-school youth. Even though in the 1970's there were leftists groups promoting sex education, it took leftist parliamentary power to get legislation on sex education in the schools adopted. The Ministry of Education however was pressured by the

  2. New Frontiers in Surgical Innovation.

    Science.gov (United States)

    Jackson, Ryan S; Schmalbach, Cecelia E

    2017-08-01

    It is an exciting time for head and neck surgical innovation with numerous advances in the perioperative planning and intraoperative management of patients with cancer, trauma patients, and individuals with congenital defects. The broad and rapidly changing realm of head and neck surgical innovation precludes a comprehensive summary. This article highlights some of the most important innovations from surgical planning with sentinel node biopsy and three-dimensional, stereolithic modeling to intraoperative innovations, such as transoral robotic surgery and intraoperative navigation. Future surgical innovations, such as intraoperative optical imaging of surgical margins, are also highlighted. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. The seventh penis: towards effective psychoanalytic work with pre-surgical transsexuals.

    Science.gov (United States)

    Withers, Robert

    2015-06-01

    The author reflects on his contrasting analytic work with two transsexual patients. He uses three previous psychoanalytic studies (Stoller, Morel and Lemma) to explore whether effective analytic work with the issues driving a person's determined wish for sex reassignment surgery (SRS) is possible. Particular consideration is given to how such work might navigate a path between traumatizing and pathologizing the patient on the one hand and avoiding important analytic material out of fear of so doing on the other. The author proceeds to ask whether it is possible to tell in advance, with any degree of reliability, who is and who is not likely to benefit from surgery. He considers certain diagnostic issues in relation to these questions. Illustrations are given of how, in practice, countertransference anxieties about psychopathologizing transsexual patients can contribute to significant difficulties in working clinically with them. It is argued that the understanding and containment of such anxieties could eventually lead to more effective analytic work, and that such work might be further facilitated by considering the contribution of mind-body dissociation to transsexualism. © 2015, The Society of Analytical Psychology.

  4. A Sex Work Research Symposium: Examining Positionality in Documenting Sex Work and Sex Workers’ Rights

    National Research Council Canada - National Science Library

    Megan Lowthers; Magdalena Sabat; Elya M Durisin; Kamala Kempadoo

    2017-01-01

    Historically, academic literature on sex work has documented the changing debates, policies, and cultural discourse surrounding the sex industry, and their impact on the rights of sex workers worldwide...

  5. Sex, Deportation and Rescue

    DEFF Research Database (Denmark)

    Plambech, Sine

    2017-01-01

    This contribution explores the economies interlinked by the migration of Nigerian women sex workers. The literature and politics of sex work migration and human trafficking economies are commonly relegated to the realm that focuses on profits for criminal networks and pimps, in particular...... recirculating the claim that human trafficking is the “third largest” criminal economy after drugs and weapons. Based on ethnographic fieldwork among Nigerian sex worker migrants conducted in Benin City, Nigeria, in 2011 and 2012, this study brings together four otherwise isolated migration economies...... – facilitation, remittances, deportation, and rescue – and suggests that we have to examine multiple sites and relink these in order to more fully understand the complexity of sex work migration. Drawing upon literature within transnational feminist analysis, critical human trafficking studies, and migration...

  6. Juvenile Sex Offenders.

    Science.gov (United States)

    Ryan, Eileen P; Otonichar, Joseph M

    2016-07-01

    Sexual offending by juveniles accounts for a sizable percentage of sexual offenses, especially against young children. In this article, recent research on female juvenile sex offenders (JSOs), risk factors for offending in juveniles, treatment, and the ways in which these youth may differ from general delinquents will be reviewed. Most JSOs do not go on to develop paraphilic disorders or to commit sex offenses during adulthood, and as a group, they are more similar to nonsexual offending juvenile delinquents than to adult sex offenders. Recent research has elucidated some differences between youth who commit sex offenses and general delinquents in the areas of atypical sexual interests, the use of pornography, and early sexual victimization during childhood.

  7. Analysis of surgical intervention populations using generic surgical process models.

    Science.gov (United States)

    Neumuth, Thomas; Jannin, Pierre; Schlomberg, Juliane; Meixensberger, Jürgen; Wiedemann, Peter; Burgert, Oliver

    2011-01-01

    According to differences in patient characteristics, surgical performance, or used surgical technological resources, surgical interventions have high variability. No methods for the generation and comparison of statistical 'mean' surgical procedures are available. The convenience of these models is to provide increased evidence for clinical, technical, and administrative decision-making. Based on several measurements of patient individual surgical treatments, we present a method of how to calculate a statistical 'mean' intervention model, called generic Surgical Process Model (gSPM), from a number of interventions. In a proof-of-concept study, we show how statistical 'mean' procedure courses can be computed and how differences between several of these models can be quantified. Patient individual surgical treatments of 102 cataract interventions from eye surgery were allocated to an ambulatory or inpatient sample, and the gSPMs for each of the samples were computed. Both treatment strategies are exemplary compared for the interventional phase Capsulorhexis. Statistical differences between the gSPMs of ambulatory and inpatient procedures of performance times for surgical activities and activity sequences were identified. Furthermore, the work flow that corresponds to the general recommended clinical treatment was recovered out of the individual Surgical Process Models. The computation of gSPMs is a new approach in medical engineering and medical informatics. It supports increased evidence, e.g. for the application of alternative surgical strategies, investments for surgical technology, optimization protocols, or surgical education. Furthermore, this may be applicable in more technical research fields, as well, such as the development of surgical workflow management systems for the operating room of the future.

  8. Is a Little Knowledge a Good Thing? College Students Gain Knowledge, but Knowledge Increase Does Not Equal Attitude Change regarding Same-Sex Sexual Orientation and Gender Reassignment Surgery in Sexuality Courses

    Science.gov (United States)

    Noland, Ramona M.; Bass, Martha A.; Keathley, Rosanne S.; Miller, Rowland

    2009-01-01

    The gains in knowledge and changes of attitudes of students in undergraduate sexuality courses in two different academic disciplines were compared to those of their peers without college sexuality education in a variety of other psychology courses. All students had similar scores on tests of sexual anatomy, behavior, and health at the start of the…

  9. Nursing Care for sex reassignment surgery: a study of nine male-to-female transsexualism cases%易性癖患者男变女手术的护理

    Institute of Scientific and Technical Information of China (English)

    唐易姿; 刘真丽; 李学德; 胡小芳; 贲晶华

    2014-01-01

    目的:探讨易性癖男-女变性手术前后的护理方法,提高护理质量.方法:对我院男科中心病区9例男变女手术患者实施精心有效的护理.结果:经过护理,无并发症,效果满意,康复出院.结论:针对变性手术,开展有效的护理,对术后患者康复至关重要.

  10. Laparoscopy in sex reassignment surgery for female-to-male transsexualism patients%腹腔镜手术在女性易性癖患者性再赋手术中的应用价值

    Institute of Scientific and Technical Information of China (English)

    李文; 刘彦; 金志军; 刘晓军; 胡电

    2004-01-01

    目的:介绍腹腔镜下女性内生殖器官全切除的手术方法,探讨腹腔镜手术在性再赋手术中的应用价值.方法:2000年1月至2004年5月因女变男易性癖行腹腔镜下女性内生殖器官全切除手术患者24例,腹腔镜手术应用改良的开放式穿刺进腹,常规镜下全子宫及双附件切除操作,注水分离阴道壁,钝、锐性剥离,切开子宫直肠陷凹达阴道直肠间隙,翻出子宫及附件,保留尿道下方部分阴道壁后,切除全子宫、双附件及大部分阴道,封闭阴道穴腔.结果:24例患者均成功完成手术.手术平均时间为(91.3±17.2)min,出血量为(254.6±84.5)ml,腹部切口愈合时间为(3.4±0.7)d,进食时间为术后(12.2±11.8)h.其中有6例患者同期完成性再赋,余为2期手术完成.结论:用本方法进行女性易性癖患者腹腔镜下女性内生殖器官全切除手术,创伤小,术后恢复快,腹部切口瘢痕美观,有利于1期完成性再赋手术,有较大的应用价值.

  11. Nursing Care in the Sex Reassignment Surgery for One Case of Male-to-female Transsexualism%1例易性癖男变女变性术的手术配合

    Institute of Scientific and Technical Information of China (English)

    尤祥妹; 裘佶烈; 庞凌凌

    2006-01-01

    对1例男性易性癖患者进行男变女的变性手术.提出术前做好患者心理及资料准备、物品及环境准备;术中密切观察手术进程,根据手术要求准确传递各类手术器械及物品,严格手术间管理;术后严格消毒、处理物品及手术间,是手术成功的主要措施之一.

  12. Is a Little Knowledge a Good Thing? College Students Gain Knowledge, but Knowledge Increase Does Not Equal Attitude Change regarding Same-Sex Sexual Orientation and Gender Reassignment Surgery in Sexuality Courses

    Science.gov (United States)

    Noland, Ramona M.; Bass, Martha A.; Keathley, Rosanne S.; Miller, Rowland

    2009-01-01

    The gains in knowledge and changes of attitudes of students in undergraduate sexuality courses in two different academic disciplines were compared to those of their peers without college sexuality education in a variety of other psychology courses. All students had similar scores on tests of sexual anatomy, behavior, and health at the start of the…

  13. [Duane vertical surgical treatment].

    Science.gov (United States)

    Merino, M L; Gómez de Liaño, P; Merino, P; Franco, G

    2014-04-01

    We report 3 cases with a vertical incomitance in upgaze, narrowing of palpebral fissure, and pseudo-overaction of both inferior oblique muscles. Surgery consisted of an elevation of both lateral rectus muscles with an asymmetrical weakening. A satisfactory result was achieved in 2 cases, whereas a Lambda syndrome appeared in the other case. The surgical technique of upper-insertion with a recession of both lateral rectus muscles improved vertical incomitance in 2 of the 3 patients; however, a residual deviation remains in the majority of cases. Copyright © 2011 Sociedad Española de Oftalmología. Published by Elsevier Espana. All rights reserved.

  14. Diverticulitis: selective surgical management.

    Science.gov (United States)

    Rugtiv, G M

    1975-08-01

    The surgical treatment of complications of diverticulitis remains most challenging. A review of twenty years' experience with one hundred fifteen cases is presented with one proved anastomotic leak and no deaths. Interval primary resection with anastomosis for chronic recurrent disease including colovesical fistula and mesocolic abscess was proved sate with low morbidity. The three-stage procedure for perforated diverticulitis with spreading peritonitis or pericolic abscess was associated with a high rate of complications and morbidity. An aggressive approach with resection without anastomosis in two stages is indicated.

  15. Somatic sex determination.

    Science.gov (United States)

    Zarkower, David

    2006-02-10

    C. elegans occurs in two natural sexes, the XX hermaphrodite and the XO male, which differ extensively in anatomy, physiology, and behavior. All somatic differences between the sexes result from the differential activity of a "global" sex determination regulatory pathway. This pathway also controls X chromosome dosage compensation, which is coordinated with sex determination by the action of the three SDC proteins. The SDC proteins control somatic and germline sex by transcriptional repression of the her-1 gene. HER-1 is a secreted protein that controls a regulatory module consisting of a transmembrane receptor, TRA-2, three intracellular FEM proteins, and the zinc finger transcription factor TRA-1. The molecular workings of this regulatory module are still being elucidated. Similarity of TRA-2 to patched receptors and of TRA-1 to GLI proteins suggests that parts of the global pathway originally derived from a Hedgehog signaling pathway. TRA-1 controls all aspects of somatic sexual differentiation, presumably by regulating a variety of tissue- and cell-specific downstream targets, including the cell death regulator EGL-1 and the male sexual regulator MAB-3. Sex determination evolves rapidly, and conservation of sexual regulators between phyla has been elusive. An apparent exception involves DM domain proteins, including MAB-3, which control sexual differentiation in nematodes, arthropods, and vertebrates. Important issues needing more study include the detailed molecular mechanisms of the global pathway, the identities of additional sexual regulators acting in the global pathway and downstream of TRA-1, and the evolutionary history of the sex determination pathway. Recently developed genetic and genomic technologies and comparative studies in divergent species have begun to address these issues.

  16. AIDS and sex tourism.

    Science.gov (United States)

    Herold, E S; Van Kerkwijk, C

    1992-01-01

    Tourists traveling internationally lower their inhibitions and take greater risks than they would typically in their home cultures. Loneliness, boredom, and a sense of freedom contribute to this behavioral change. Some tourists travel internationally in search of sexual gratification. This motivation may be actively conscious or subconscious to the traveler. Billed as romantic with great natural beauty, Thailand, the Philippines, Brazil, the Dominican Republic, and Kenya are popular destinations of tourists seeking sex. The Netherlands and countries in eastern Europe are also popular. With most initial cases of HIV infection in Europe having histories of international travel, mass tourism is a major factor in the international transmission of AIDS. While abroad, tourists have sex with casual partners, sex workers, and/or other tourists. Far from all tourists, however, carry and consistently use condoms with these partners. One study found female and non white travelers to be less likely than Whites and males to carry condoms. The risk of HIV infection increases in circumstances where condoms are not readily available in the host country and/or are of poor quality. Regarding actual condom use, a study found only 34% of sex tourists from Switzerland to consistently use condoms while abroad. 28% of men in an STD clinic in Melbourne, Australia, reported consistent condom use in sexual relations while traveling in Asia; STDs were identified in 73% of men examined. The few studies of tourists suggest that a significant proportion engage in risky behavior while traveling. HIV prevalence is rapidly increasing in countries known as destinations for sex tourism. High infection rates are especially evident among teenage sex workers in Thailand. Simply documenting the prevalence of risky behavior among sex tourists will not suffice. More research is needed on travelers and AIDS with particular attention upon the motivating factors supporting persistent high-risk behavior.

  17. Minimally invasive surgical technique for tethered surgical drains

    Directory of Open Access Journals (Sweden)

    Shane R Hess

    2017-01-01

    Full Text Available A feared complication of temporary surgical drain placement is from the technical error of accidentally suturing the surgical drain into the wound. Postoperative discovery of a tethered drain can frequently necessitate return to the operating room if it cannot be successfully removed with nonoperative techniques. Formal wound exploration increases anesthesia and infection risk as well as cost and is best avoided if possible. We present a minimally invasive surgical technique that can avoid the morbidity associated with a full surgical wound exploration to remove a tethered drain when other nonoperative techniques fail.

  18. 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.

  19. Open Cholecystectomy for Surgical Treatment of Gallstones

    Directory of Open Access Journals (Sweden)

    Jorge Luis Estepa Pérez

    2015-02-01

    Full Text Available Background: cholecystectomy is one of the surgical procedures that are still practiced despite the passing of time. It remains the appropriate method to perform in the absence of advanced technology. Objective: to describe the results of the open cholecystectomy in the treatment of gallstones. Methods: a descriptive study was conducted in patients operated on for gallstones in 2012 in the María G. Guerrero Ramos Comprehensive Diagnostic Center in the Capital District, Bolivarian Republic of Venezuela. The information was obtained from medical records and a data collection model. The variables analyzed were: age, sex, associated diseases, signs and symptoms, results of the surgical treatment, outcome and complications. Results: a total of 147 patients underwent surgery; the 41-60 year age group and female patients predominated; right hypochondrial pain and intolerance to fatty foods and grains were the major signs and symptoms. Cefazolin was the most widely used antibiotic. Patients recovered satisfactorily, complications were minimal. Conclusions: open cholecystectomy remains useful for the treatment of gallstones in the absence of advanced technology.

  20. 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.

  1. Tophi – surgical treatment

    Science.gov (United States)

    Słowińska, Iwona; Słowiński, Radosław

    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. PMID:27994273

  2. Neuronavigation. Principles. Surgical technique.

    Science.gov (United States)

    Ivanov, Marcel; Ciurea, Alexandru Vlad

    2009-01-01

    Neuronavigation and stereotaxy are techniques designed to help neurosurgeons precisely localize different intracerebral pathological processes by using a set of preoperative images (CT, MRI, fMRI, PET, SPECT etc.). The development of computer assisted surgery was possible only after a significant technological progress, especially in the area of informatics and imagistics. The main indications of neuronavigation are represented by the targeting of small and deep intracerebral lesions and choosing the best way to treat them, in order to preserve the neurological function. Stereotaxis also allows lesioning or stimulation of basal ganglia for the treatment of movement disorders. These techniques can bring an important amount of confort both to the patient and to the neurosurgeon. Neuronavigation was introduced in Romania around 2003, in four neurosurgical centers. We present our five-years experience in neuronavigation and describe the main principles and surgical techniques.

  3. Surgical education in Mexico.

    Science.gov (United States)

    Cervantes, Jorge

    2010-05-01

    Surgical education in Mexico basically follows the same model as in the United States, with a selection process resembling the matching program. There is a 4-year training period during which residents in their third year spend 4 months as the sole surgeon in a rural community. During the senior year they are entitled to an elective period in a place of their choosing. After completion of the 4 years, residents have to present a thesis and undergo an oral examination before getting a university diploma. They are then encouraged to pass the written and oral examination of the Mexican Board of Surgery before they are fully certified to enter practice in a public or private hospital.

  4. Sex allocation and sex determination in squamate reptiles.

    Science.gov (United States)

    Wapstra, E; Warner, D A

    2010-01-01

    Reptiles possess a wide variety of sex determining mechanisms, more so than any other vertebrate group. They offer outstanding opportunities to understand the evolutionary transitions between modes of sex determination. In this review, we argue that sex allocation theory is fundamental for understanding the selective causes of such shifts. Whether selection for biased sex allocation actually results in evolutionary shifts in sex determination depends on the overall strength, direction and consistency of selection and to what extent existing reproductive systems can establish novel links between factors causing sex-specific fitness and mechanisms of sex determination. Perhaps one of the most exciting advances in recent years has been the phylogenetically diverse range in reptile taxa that form the basis of research on the evolution of sex determination. The traditional use of long-lived oviparous species (especially turtles and crocodiles) is now expanded to include a range of short-lived taxa that exhibit both genetic sex determination and environment-/temperature-dependent sex determination (particularly agamid lizards), as well as a greater emphasis on viviparous species. If selection on differential sex allocation is a key selective pressure for the evolution of sex-determining mechanisms, these taxa will provide considerable insights into the integrated fields of sex allocation biology and sex determination. (c) 2009 S. Karger AG, Basel.

  5. Sex Hormones and Tendon

    DEFF Research Database (Denmark)

    Hansen, Mette; Kjaer, Michael

    2016-01-01

    The risk of overuse and traumatic tendon and ligament injuries differ between women and men. Part of this gender difference in injury risk is probably explained by sex hormonal differences which are specifically distinct during the sexual maturation in the teenage years and during young adulthood....... The effects of the separate sex hormones are not fully elucidated. However, in women, the presence of estrogen in contrast to very low estrogen levels may be beneficial during regular loading of the tissue or during recovering after an injury, as estrogen can enhance tendon collagen synthesis rate. Yet...... has also been linked to a reduced responsiveness to relaxin. The present chapter will focus on sex difference in tendon injury risk, tendon morphology and tendon collagen turnover, but also on the specific effects of estrogen and androgens....

  6. Corruption and sex

    Directory of Open Access Journals (Sweden)

    Milutinović-Bojanić Sanja

    2013-01-01

    Full Text Available Taking into account the difference between the ancient and modern (even postmodern understandings of corruption, I am curious to explore why the bond linking corruption and sex seems so obvious. I have no intention of investigating both phenomena in the context of any moral category. What then did Flaubert have on his mind when he wrote that Rodolphe “treated Emma quite sans façon. He made of her something supple and corrupt.” What underpins the irresistible attraction between corruption and sex? Why is it impossible to eradicate corruption and repress sex and perceive them as solely functional strategies of generation and reproduction? This short outline follows certain philosophical remarks of Luce Irigaray and her thematization of the sexual difference in the demarcation of generation and corruption.

  7. Sex Trafficking of Minors.

    Science.gov (United States)

    Moore, Jessica L; Kaplan, Dana M; Barron, Christine E

    2017-04-01

    Sex trafficking is an increasingly recognized global health crisis affecting every country and region in the world. Domestic minor sex trafficking is a subset of commercial sexual exploitation of children, defined as engagement of minors (<18 years of age) in sexual acts for items of value (eg, food, shelter, drugs, money) involving children victimized within US borders. These involved youth are at risk for serious immediate and long-term physical and mental health consequences. Continued efforts are needed to improve preventive efforts, identification, screening, appropriate interventions, and subsequent resource provision for victimized and high-risk youth.

  8. Patient Satisfaction of Surgical Treatment of Clitoral Phimosis and Labial Adhesions Caused by Lichen Sclerosus

    Directory of Open Access Journals (Sweden)

    Anne N. Flynn, MD

    2015-12-01

    Conclusions: This study shows high patient satisfaction and low complication risk associated with surgical correction of clitoral phimosis and lysis of vulvar adhesions for VGF caused by LS. Patients reported improvement in clitoral sensation and ability to achieve orgasm, as well as decreased dyspareunia. Surgical correction of vulvar scarring is a viable option to restore vulvar anatomy and sexual function in appropriate candidates with anogenital LS. Flynn AN, King M, Rieff M, Krapf J, and Goldstein AT. Patient satisfaction of surgical treatment of clitoral phimosis and labial adhesions caused by lichen sclerosus. Sex Med 2015;3:251–255.

  9. Acquiring minimally invasive surgical skills

    NARCIS (Netherlands)

    Hiemstra, Ellen

    2012-01-01

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

  10. 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 n

  11. Surgical treatment of acquired tracheocele.

    Science.gov (United States)

    Porubsky, Edward A; Gourin, Christine G

    2006-06-01

    Acquired tracheoceles are rare clinical entities that can cause a variety of chronic and recurrent aerodigestive tract symptoms. The management of acquired tracheoceles is primarily conservative, but surgical intervention may be indicated for patients with refractory symptoms. We present a case of acquired tracheocele and describe a method of successful surgical management.

  12. 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 n

  13. Sex and deleterious mutations.

    Science.gov (United States)

    Gordo, Isabel; Campos, Paulo R A

    2008-05-01

    The evolutionary advantage of sexual reproduction has been considered as one of the most pressing questions in evolutionary biology. While a pluralistic view of the evolution of sex and recombination has been suggested by some, here we take a simpler view and try to quantify the conditions under which sex can evolve given a set of minimal assumptions. Since real populations are finite and also subject to recurrent deleterious mutations, this minimal model should apply generally to all populations. We show that the maximum advantage of recombination occurs for an intermediate value of the deleterious effect of mutations. Furthermore we show that the conditions under which the biggest advantage of sex is achieved are those that produce the fastest fitness decline in the corresponding asexual population and are therefore the conditions for which Muller's ratchet has the strongest effect. We also show that the selective advantage of a modifier of the recombination rate depends on its strength. The quantification of the range of selective effects that favors recombination then leads us to suggest that, if in stressful environments the effect of deleterious mutations is enhanced, a connection between sex and stress could be expected, as it is found in several species.

  14. Sex Education and Ideals

    Science.gov (United States)

    de Ruyter, Doret J.; Spiecker, Ben

    2008-01-01

    This article argues that sex education should include sexual ideals. Sexual ideals are divided into sexual ideals in the strict sense and sexual ideals in the broad sense. It is argued that ideals that refer to the context that is deemed to be most ideal for the gratification of sexual ideals in the strict sense are rightfully called sexual…

  15. Sex, Courtship, and Marriage.

    Science.gov (United States)

    Seiferth, Berniece

    The author presents an historical perspective on abortion, contraception and marriage as a prelude to an examination of changing attitudes toward sex. The article deals with the negative effects attributed to the increased incidence of early dating and early marriage of teenagers in the United States. The author also assumes positions on such…

  16. Sex Therapy and Mastectomy

    Science.gov (United States)

    Witkin, Mildred Hope

    1975-01-01

    Because the emotional trauma associated with a mastectomy exceeds the physical trauma, the recovery of the woman is greatly affected by the response of her husband or lover. Sex therapy, therefore, involves the couple. The approach described is aimed at assisting the couple to confront and integrate the mastectomy experience. (Author)

  17. When Sex Meets Law

    Institute of Scientific and Technical Information of China (English)

    YIN PUMIN

    2010-01-01

    @@ Ma Yaohai,an associate professor of computer science at Nanjing University of Technology in east China's Jiangsu Province,was sentenced to three and a half years in prison on May 20 for organizing group-sex parties,renewing nationwide debate on sexual freedom in China.

  18. Sex Therapy and Mastectomy

    Science.gov (United States)

    Witkin, Mildred Hope

    1975-01-01

    Because the emotional trauma associated with a mastectomy exceeds the physical trauma, the recovery of the woman is greatly affected by the response of her husband or lover. Sex therapy, therefore, involves the couple. The approach described is aimed at assisting the couple to confront and integrate the mastectomy experience. (Author)

  19. Sex education in Cyprus.

    Science.gov (United States)

    Patsalides, N

    1991-05-01

    The objective of educating people on family planning and sexuality issues has been carried forth by the Family Planning Association of Cyprus (FPAC) since 1971. The promotion of sex education in schools has generated respect for their expertise. Sex education has reached the agenda of the General Assembly of Parliament only to be postponed due to the April 1991 end of term dismissal. A newly elected Parliament are not expected to act immediately. The Ministry of Education Committee on Health Education has been actively counseled since 1974, and most recently in their examination of the possibilities of school sex education and training of high school teachers. The Ministry of Education has authority over primary and secondary education, which is compulsory up to 3 years of secondary education. The approach of FPAC has been to work with parents first in education lectures at various well publicized locations. The agenda was to inform about FPAC, explain the purpose and meaning of sex education, and show the Merry-Go-Round educational film followed by a question and answer session. Eventually, presentations involved children with parent observation. In 1977, authorization from the Ministry of Education gave official approval to FPAC, but not on school premises. FPAC went directly to headmasters and gained support in primary schools to organize sessions on school premises, which successfully involved many primary schools even in the much needed rural areas. Home Economics and Child Care, offered in the 5th and 6th grades was the only vehicle for gaining permission to enter secondary schools. In Larnaca, secondary school headmasters at the 3rd and 6th grade levels permitted invitations which requested parental permission. Lecture topics on human reproduction, sex roles, and disease and contraception were also provided in a follow-up letter. Higher education levels were involved through youth clubs and evening lectures. In 1988, FPAC urged the Director General of the

  20. Sex and life expectancy.

    Science.gov (United States)

    Seifarth, Joshua E; McGowan, Cheri L; Milne, Kevin J

    2012-12-01

    A sexual dimorphism in human life expectancy has existed in almost every country for as long as records have been kept. Although human life expectancy has increased each year, females still live longer, on average, than males. Undoubtedly, the reasons for the sex gap in life expectancy are multifaceted, and it has been discussed from both sociological and biological perspectives. However, even if biological factors make up only a small percentage of the determinants of the sex difference in this phenomenon, parity in average life expectancy should not be anticipated. The aim of this review is to highlight biological mechanisms that may underlie the sexual dimorphism in life expectancy. Using PubMed, ISI Web of Knowledge, and Google Scholar, as well as cited and citing reference histories of articles through August 2012, English-language articles were identified, read, and synthesized into categories that could account for biological sex differences in human life expectancy. The examination of biological mechanisms accounting for the female-based advantage in human life expectancy has been an active area of inquiry; however, it is still difficult to prove the relative importance of any 1 factor. Nonetheless, biological differences between the sexes do exist and include differences in genetic and physiological factors such as progressive skewing of X chromosome inactivation, telomere attrition, mitochondrial inheritance, hormonal and cellular responses to stress, immune function, and metabolic substrate handling among others. These factors may account for at least a part of the female advantage in human life expectancy. Despite noted gaps in sex equality, higher body fat percentages and lower physical activity levels globally at all ages, a sex-based gap in life expectancy exists in nearly every country for which data exist. There are several biological mechanisms that may contribute to explaining why females live longer than men on average, but the complexity of the

  1. Sex Education: Talking to Toddlers and Preschoolers about Sex

    Science.gov (United States)

    Healthy Lifestyle Sexual health Sex education often begins with a child's curiosity about his or her body. Here's how to set the stage for sex education — and how to answer your child's questions. ...

  2. [Sex chromosomes and meiosis].

    Science.gov (United States)

    Guichaoua, M-R; Geoffroy-Siraudin, C; Tassistro, V; Ghalamoun-Slaimi, R; Perrin, J; Metzler-Guillemain, C

    2009-01-01

    Sex chromosome behaviour fundamentally differs between male and female meiosis. In oocyte, X chromosomes synapse giving a XX bivalent which is not recognizable in their morphology and behaviour from autosomal bivalents. In human male, X and Y chromosomes differ from one another in their morphology and their genetic content, leading to a limited pairing and preventing genetic recombination, excepted in homologous region PAR1. During pachytene stage of the first meiotic prophase, X and Y chromosomes undergo a progressive condensation and form a transcriptionally silenced peripheral XY body. The condensation of the XY bivalent during pachytene stage led us to describe four pachytene substages and to localize the pachytene checkpoint between substages 2 and 3. We also defined the pachytene index (PI=P1+P2/P1+P2+P3+P4) which is always less than 0.50 in normal meiosis. XY body undergoes decondensation at diplotene stage, but transcriptional inactivation of the two sex chromosomes or Meiotic Sex Chromosome Inactivation (MSCI) persists through to the end of spermatogenesis. Sex chromosome inactivation involves several proteins, some of them were now identified. Two isoforms of the HP1 protein, HP1beta and HP1gamma, are involved in the facultative heterochromatinization of the XY body, but the initiation of this process involves the phosphorylation of the protein H2AX by the kinase ATR whose recruitment depends on BRCA1. Extensive researches on the inactivation of the sex chromosomes during male meiosis will allow to a better understanding of some male infertilities.

  3. Functional penile reconstruction: What do we have as on today?

    Directory of Open Access Journals (Sweden)

    Hussein Ghanem

    2006-01-01

    Full Text Available Penile reconstructive surgeries are performed mainly as radical treatment for conditions associated with congenital abnormalities of the urethra or penis, after penile trauma, penile cancer, short penis, corporal fibrosis and in cases of gender reassignment. In this article, we review the controversial penile augmentation topic, clarifying how most workers disagree with its scientific basis. We also highlight recent advances in surgical techniques in treatment of penile injuries and those employed for female-to-male sex reassignment procedures. We also propose a practical approach for evaluating and counseling patients complaining of a small sized penis.

  4. [Surgical wound infection in patients undergoing extra-anatomical arterial surgery. A retrospective study].

    Science.gov (United States)

    Monreal, M; Callejas, J M; Lisbona, C; Martorell, A; Lerma, R; Boabaid, R; Mejía, S

    1993-01-01

    We present a retrospective review of a series of patients from our Service submitted to surgical extra-anatomical grafts. Correlation between diverse variants and ulterior obliteration by thrombosis or infection of the surgical wounds is analyzed. The series included 133 patients surgically treated between 1986 and 1991. The studied variants were: sex, age, type of graft, the material used, length and type of anesthesia, presentation of hypotension during the surgical intervention, diabetes, platelet recount. Fourteen patients (11%) presented early graft obliteration and 15 (11%) presented an infection of their surgical wound. Only the platelet variant showed statistical differences in patients presenting infection. A high recount of platelets could be a factor risk of infection.

  5. Surgical infection in art.

    Science.gov (United States)

    Meakins, J L

    1996-12-01

    The earliest images of medicine and surgery in Western art are from the late Middle Ages. Although often attractive, at that time they were illustrative and mirrored the text on how to diagnose or treat a specific condition. These drawings in medieval manuscripts represent management of abscesses, perianal infection and fistulas, amputation, and wound dressings. With the Renaissance, art in all its forms flourished, and surgeons were represented at work draining carbuncles, infected bursae, and mastoiditis; managing ulcers, scrofula, and skin infections; and performing amputations. Specific diagnosis can be made, such as streptococcal infection in the discarded leg of the miraculous transplantation performed by Saints Cosmas and Damian and in the works of Rembrandt van Rijn and Frederic Bazille. Evocations of cytokine activity are evident in works by Albrecht Dürer, Edvard Munch, and James Tissot. The iconography of society's view of a surgeon is apparent and often not complimentary. The surgeon's art is a visual art. Astute observation leads to early diagnosis and better results in surgical infection and the septic state. Learning to see what we look at enhances our appreciation of the world around us but, quite specifically, makes us better clinicians.

  6. Disestablishing Sex: The Case for Released-Time Sex Education

    Science.gov (United States)

    Glanzer, Perry L.

    2011-01-01

    Allowing nonschool organizations to provide sex education in a released-time format would disestablish state-funded sex education and give families a choice in the sex education that would be provided for their children. Released-time programs, as originally conceived and currently practiced, allow students to be released for a period of time…

  7. Disestablishing Sex: The Case for Released-Time Sex Education

    Science.gov (United States)

    Glanzer, Perry L.

    2011-01-01

    Allowing nonschool organizations to provide sex education in a released-time format would disestablish state-funded sex education and give families a choice in the sex education that would be provided for their children. Released-time programs, as originally conceived and currently practiced, allow students to be released for a period of time…

  8. Surgical Responses of Medial Rectus Muscle Recession in Thyroid Eye Disease-Related Esotropia.

    Directory of Open Access Journals (Sweden)

    In Jeong Lyu

    Full Text Available We evaluate the surgical outcomes and surgical responses of medial rectus muscle (MR recession patients with thyroid eye disease (TED-related esotropia (ET. The surgical dose-response curves 1 week postoperatively and at the final visit were analyzed. Univariable and multivariable linear regression analyses were applied to investigate factors influencing surgical dose-response. A total of 43 patients with TED-related ET that underwent MR recession were included. The final success rate was 86.0% and the rate of undercorrection was 14.0%. The surgical dose-response curves of TED-related ET showed a gentle slope compared with those of standard surgical tables. In the univariable model, simultaneous vertical rectus muscle recession was the only significant factor influencing surgical dose-response of MR recession in TED-related ET (β = -0.397, P = 0.044. In a model adjusted for age, sex, type of surgery, and preoperative horizontal angle of deviation, simultaneous vertical rectus muscle recession showed marginal significance (β = -0.389, P = 0.064. The surgical dose-response curve of TED-related ET was unique. Simultaneous vertical rectus muscle recession was associated with increased surgical dose-response in TED-related ET.

  9. The incidence of burns among sex-trafficking victims in India.

    Science.gov (United States)

    Rahman, Nadia; Sinha, Indranil; Husain, Fatima; Shah, Ajul; Patel, Anup

    2014-09-01

    Sex trafficking remains a flagrant violation of human rights, creating many public health concerns. During the initiation period, these victims experience acts of violence including gang rapes, subjecting them to traumatic injuries that include burns. Furthermore, lack of access to health care, particularly surgical, keeps them from receiving treatment for these functionally debilitating contractures caused by burns. This piece provides an overview of burns among sex-trafficked victims in India and the efforts by Cents of Relief to address the associated surgical burden of disease.

  10. Hypnotic Psychotherapy with Sex Offenders

    Science.gov (United States)

    Moseley, Sullivan; Briggs, Wanda P.; Magnus, Virginia

    2005-01-01

    The authors review the literature on the prevalence of sex offenders; multiple treatment modalities; and implications of the use of hypnotic psychotherapy, coupled with cognitive behavioral treatment programs, for treating sex offenders. (Contains 2 tables.)

  11. SHBG (Sex Hormone Binding Globulin)

    Science.gov (United States)

    ... as: Testosterone-estrogen Binding Globulin; TeBG Formal name: Sex Hormone Binding Globulin Related tests: Testosterone , Free Testosterone, ... I should know? How is it used? The sex hormone binding globulin (SHBG) test may be used ...

  12. Sex and Fertility After SCI

    Medline Plus

    Full Text Available ... having sex after a spinal cord injury? Can men and women still have sex after a spinal ... spinal cord injury? How is sexual function in men affected by a spinal cord injury ? What are ...

  13. The ABCs of Sex Ed.

    Science.gov (United States)

    Sroka, Stephen R.

    2002-01-01

    Cites statistics on extent of sexually transmitted diseases and pregnancies among adolescents; describes ideological dispute over how to teach sex education; advocates teaching the ABCs of sex education: Abstinence, Be Monogamous, and Condoms. (PKP)

  14. Sex Differences and Sex Steroids in Lung Health and Disease

    Science.gov (United States)

    Townsend, Elizabeth A.; Miller, Virginia M.

    2012-01-01

    Sex differences in the biology of different organ systems and the influence of sex hormones in modulating health and disease are increasingly relevant in clinical and research areas. Although work has focused on sex differences and sex hormones in cardiovascular, musculoskeletal, and neuronal systems, there is now increasing clinical evidence for sex differences in incidence, morbidity, and mortality of lung diseases including allergic diseases (such as asthma), chronic obstructive pulmonary disease, pulmonary fibrosis, lung cancer, as well as pulmonary hypertension. Whether such differences are inherent and/or whether sex steroids play a role in modulating these differences is currently under investigation. The purpose of this review is to define sex differences in lung structure/function under normal and specific disease states, with exploration of whether and how sex hormone signaling mechanisms may explain these clinical observations. Focusing on adult age groups, the review addresses the following: 1) inherent sex differences in lung anatomy and physiology; 2) the importance of certain time points in life such as puberty, pregnancy, menopause, and aging; 3) expression and signaling of sex steroid receptors under normal vs. disease states; 4) potential interplay between different sex steroids; 5) the question of whether sex steroids are beneficial or detrimental to the lung; and 6) the potential use of sex steroid signaling as biomarkers and therapeutic avenues in lung diseases. The importance of focusing on sex differences and sex steroids in the lung lies in the increasing incidence of lung diseases in women and the need to address lung diseases across the life span. PMID:22240244

  15. The Surgical Treatment of Mycetoma.

    Science.gov (United States)

    Suleiman, Suleiman Hussein; Wadaella, El Sammani; Fahal, Ahmed Hassan

    2016-06-01

    Surgical intervention is an integral component in the diagnosis and management of mycetoma. Surgical treatment is indicated for small, localised lesions and massive lesions to reduce the mycetoma load and to enable better response to medical therapy. It is also a life-saving procedure in patients with massive disease and sepsis. Surgical options for mycetoma treatment range from a wide local surgical excision to repetitive debridement excisions to amputation of the affected part. Adequate anaesthesia, a bloodless field, wide local excision with adequate safety margins in a suitable surgical facility, and expert surgeons are mandatory to achieve the best surgical outcome. Surgical intervention in mycetoma is associated with considerable morbidity, deformities, and disabilities, particularly in advanced disease. These complications can be reduced by educating patients to seek medical advice earlier when the lesion is small, localised, and amenable to surgery. There is no evidence for mycetoma hospital cross infection. This communication is based on the authors' experience in managing over 7,200 mycetoma patients treated at the Mycetoma Research Centre, University of Khartoum, Sudan.

  16. The Surgical Treatment of Mycetoma.

    Directory of Open Access Journals (Sweden)

    Suleiman Hussein Suleiman

    2016-06-01

    Full Text Available Surgical intervention is an integral component in the diagnosis and management of mycetoma. Surgical treatment is indicated for small, localised lesions and massive lesions to reduce the mycetoma load and to enable better response to medical therapy. It is also a life-saving procedure in patients with massive disease and sepsis. Surgical options for mycetoma treatment range from a wide local surgical excision to repetitive debridement excisions to amputation of the affected part. Adequate anaesthesia, a bloodless field, wide local excision with adequate safety margins in a suitable surgical facility, and expert surgeons are mandatory to achieve the best surgical outcome. Surgical intervention in mycetoma is associated with considerable morbidity, deformities, and disabilities, particularly in advanced disease. These complications can be reduced by educating patients to seek medical advice earlier when the lesion is small, localised, and amenable to surgery. There is no evidence for mycetoma hospital cross infection. This communication is based on the authors' experience in managing over 7,200 mycetoma patients treated at the Mycetoma Research Centre, University of Khartoum, Sudan.

  17. The influence of physiological and surgical menopause on coronary heart disease risk markers

    NARCIS (Netherlands)

    Verhoeven, Marieke O.; van der Mooren, Marius J.; Teerlink, Tom; Verheijen, Rene H. M.; Scheffer, Peter G.; Kenemans, Peter

    2009-01-01

    Objective: To investigate the influence of physiological and surgical menopause oil Serum concentrations of corollary heart disease (CHD) risk markers and sex hormones. Design: Physiological menopausal transition was investigated in two studies. In a longitudinal Study, 16 women were followed from 2

  18. Outcome after surgical repair of congenital cardiac malformations at school age.

    NARCIS (Netherlands)

    Rijken, R.E.A. van der; Maassen, B.A.M.; Walk, T.L.M.; Daniels, O.; Hulstijn-Dirkmaat, G.M.

    2007-01-01

    OBJECTIVES: To explore the long-term physical, educational, behavioural, and emotional outcome of patients undergoing surgical correction of congenital cardiac disease at school age, and to investigate the relation, if any, between the outcome and comorbidity, age and sex, and level of complexity of

  19. Constipation and Nonspecific Abdominal Pain in Teenage Girls Referred for Emergency Surgical Consultation

    NARCIS (Netherlands)

    Buddingh, K. Tim; Wieselmann, Eva; Heineman, Erik; Broens, Paul M. A.

    Objective: The aim of this study was to describe the discharge diagnoses of children receiving surgical consultation for acute abdominal pain according to age and sex. Methods: Retrospective chart review. Results: Nine hundred forty-one children were included. Appendicitis was confirmed in 31% of

  20. The influence of physiological and surgical menopause on coronary heart disease risk markers

    NARCIS (Netherlands)

    Verhoeven, Marieke O.; van der Mooren, Marius J.; Teerlink, Tom; Verheijen, Rene H. M.; Scheffer, Peter G.; Kenemans, Peter

    2009-01-01

    Objective: To investigate the influence of physiological and surgical menopause oil Serum concentrations of corollary heart disease (CHD) risk markers and sex hormones. Design: Physiological menopausal transition was investigated in two studies. In a longitudinal Study, 16 women were followed from 2

  1. YY Sex: a Polar Candidate

    Science.gov (United States)

    Gabdeev, M. M.; Shimanskiy, V. V.; Borisov, N. V.; Tazieva, Z. R.

    2017-06-01

    We present spectroscopic investigations of a cataclysmic variable star, YY Sex. There are some uncertainties in the classification of this object. We calculate Doppler maps for Hβ and HeII λ4686Å and show that there is no sign of disk accretion in YY Sex. Consequently, we conclude that YY Sex is a polar.

  2. Sex Education: Challenges and Choices

    Science.gov (United States)

    MacKenzie, Alison; Hedge, Nicki; Enslin, Penny

    2017-01-01

    Noting public concern about sexual exploitation, abuse and sexualisation, we argue that sex education in the UK needs revision. Choice is a feature of current sex education policy and, acknowledging that choice can be problematic, we defend its place in an approach to sex education premised on informed deliberation, relational autonomy, a…

  3. Single Sex Education. WEEA Digest.

    Science.gov (United States)

    Pollard, Diane S.

    Title IX of the Educational Amendments of 1972 prohibits discrimination on the basis of sex in educational institutions that receive federal financial assistance. This digest focuses on the theme of single-sex education. Articles featured in this issue include: (1) "Single-Sex Education" (Diane S. Pollard); (2) "A Legal Framework for Single-Sex…

  4. Sex Stereotyping by Tomorrow's Executives.

    Science.gov (United States)

    Kovach, Kenneth A.

    1985-01-01

    Describes a study in which 512 college seniors were surveyed to see if members of one sex would implicitly stereotype by sex to a greater degree than the other. Questions concerned job/home conflicts and selection and promotion. Results indicated that men and women are equally guilty of sex stereotyping, which works against women in the workplace.…

  5. Surgical treatment of pediatric rhinosinusitis.

    Science.gov (United States)

    Isaacson, G

    2015-08-01

    Pediatric rhinosinusitis is a common sequela of upper respiratory infections in children. It is usually a self-limited disease, sometimes requiring antibiotic therapy. Surgery may be indicated in children who suffer complication of acute rhinosinusitis, severe recurrent acute rhinosinusitis, rhinosinusitis in cystic fibrosis with or without polyposis, chronic rhinosinusitis refractory to maximal medical management, allergic fungal sinusitis, and paranasal sinus mucoceles. Surgical options include, adenoidectomy, sinus puncture and lavage, open surgical approaches, endoscopic sinus surgery, balloon sinuplasty, and turbinectomy or turbinate reduction. This paper reviews the anatomy and physiology of rhinosinusitis in children and current knowledge of the indications and best methods of surgical treatment.

  6. Towards Safe Robotic Surgical Systems

    DEFF Research Database (Denmark)

    Sloth, Christoffer; Wisniewski, Rafael

    2015-01-01

    A proof of safety is paramount for an autonomous robotic surgical system to ensure that it does not cause trauma to patients. However, a proof of safety is rarely constructed, as surgical systems are too complex to be dealt with by most formal verification methods. In this paper, we design...... a controller for motion compensation in beating-heart surgery, and prove that it is safe, i.e., the surgical tool is kept within an allowable distance and orientation of the heart. We solve the problem by simultaneously finding a control law and a barrier function. The motion compensation system is simulated...

  7. Surgical Skills Beyond Scientific Management

    Science.gov (United States)

    Whitfield, Nicholas

    2015-01-01

    During the Great War, the French surgeon Alexis Carrel, in collaboration with the English chemist Henry Dakin, devised an antiseptic treatment for infected wounds. This paper focuses on Carrel’s attempt to standardise knowledge of infected wounds and their treatment, and looks closely at the vision of surgical skill he espoused and its difference from those associated with the doctrines of scientific management. Examining contemporary claims that the Carrel–Dakin method increased rather than diminished demands on surgical work, this paper further shows how debates about antiseptic wound treatment opened up a critical space for considering the nature of skill as a vital dynamic in surgical innovation and practice. PMID:26090737

  8. Retained surgical sponge: An enigma

    Directory of Open Access Journals (Sweden)

    Gurjit Singh

    2013-01-01

    Full Text Available Retained surgical sponge in the body following a surgery is called "gossypiboma". A 27-year-old female who had undergone lower segment cesarean section 4 months earlier was admitted with complaints of pain abdomen with a palpable mass in left iliac fossa. X-ray, ultrasonography, and CT scan findings were suggestive of retained surgical sponge. Surgical sponge was removed following laparotomy. Surgeons must be aware of the risk factors that lead to gossypiboma, and measures should be taken to prevent it. Besides increasing morbidity and possible mortality, it may result in libel suit for compensation.

  9. Surgical research using national databases.

    Science.gov (United States)

    Alluri, Ram K; Leland, Hyuma; Heckmann, Nathanael

    2016-10-01

    Recent changes in healthcare and advances in technology have increased the use of large-volume national databases in surgical research. These databases have been used to develop perioperative risk stratification tools, assess postoperative complications, calculate costs, and investigate numerous other topics across multiple surgical specialties. The results of these studies contain variable information but are subject to unique limitations. The use of large-volume national databases is increasing in popularity, and thorough understanding of these databases will allow for a more sophisticated and better educated interpretation of studies that utilize such databases. This review will highlight the composition, strengths, and weaknesses of commonly used national databases in surgical research.

  10. Surgical education through video broadcasting.

    Science.gov (United States)

    Nagengast, Eric S; Ramos, Margarita S; Sarma, Hiteswar; Deshpande, Gaurav; Hatcher, Kristin; Magee, William P; Campbell, Alex

    2014-09-01

    Surgical training is facing new obstacles. As advancements in medicine are made, surgeons are expected to know more and to be able to perform more procedures. In the western world, increasing restrictions on residency work hours are adding a new hurdle to surgical training. In low-resource settings, a low attending-to-resident ratio results in limited operative experience for residents. Advances in telemedicine may offer new methods for surgical training. In this article, the authors share their unique experience using live video broadcasting of surgery for educational purposes at a comprehensive cleft care center in Guwahati, India.

  11. Surgical Templates for Dental Implant Positioning; Current ...

    African Journals Online (AJOL)

    applied scientifically based research techniques to develop an endosseous implant that forms ... KEYWORDS: Dental implants, surgical templates, surgical procedure, stent .... during the surgical stage for single implant therapy.[24] Afterward,.

  12. Same-sex parenting

    OpenAIRE

    Lokar, Daša

    2012-01-01

    Homosexuality has always caused a lot of fears, doubts, prejudice and stereotypes among people. Gay men and lesbians are being prosecuted, stigmatized, discriminated and put down just because of their sexual orientation. Nowadays we hear many discussions about the modern family relationships and partnerships, among which same-sex partnerships and families are also included. Public discussions are mainly concentrated on the question whether or not homosexual couples can be fit parents. Althoug...

  13. Wolbachia and Sex

    OpenAIRE

    Aper, Ian J.; Weglarz, Katie; Dohlen, Carol Von

    2016-01-01

    Insects with complex life cycles provide an ideal system for investigating the relationship between sex-skewing bacterial symbionts and the secondary loss of sexual reproduction. This research utilized the insect family Adelgidae, a group notorious for having peculiar and complex life cycles. In this family, some species have lost their sexual generation entirely, trapping them in asexual reproduction. Additionally, these insects are known to harbor multiple symbionts, both obligate and facul...

  14. Evidence-based surgical wound care on surgical wound infection.

    Science.gov (United States)

    Reilly, Jaqueline

    2002-09-01

    Surgical wound infection is an important outcome indicator in the postoperative period. A 3-year prospective cohort epidemiological study of 2202 surgical patients from seven surgical wards across two hospitals was carried out using gold standard surveillance methodology. This involved following patients up as inpatients and postdischarge surveillance to 30 days by an independent observer. The results led to the development of a mathematical model for risk of clean, elective surgical wound infection. Risk of surgical wound infection was increased by smoking, higher body mass index, presence of malignancy, haematoma formation, increasing numbers of people in theatre, adherent dressing usage, and higher times to suture removal (P<0.05). The results show that this type of surveillance is an effective way of collecting accurate data on wound infection rates. It was noted that patient care practices affected the surgical wound infection rate and the surveillance was used to facilitate the adoption of evidence-based practice, through recommendations for clean surgery, to reduce the risk from extrinsic risk factors for wound infection. As a result of the implementation of this evidence-based practice there was a significant reduction (P<0.05) in the clean wound infection rate.

  15. The SW Sex enigma

    CERN Document Server

    Dhillon, V S; Marsh, T R

    2012-01-01

    The SW Sex stars are a class of cataclysmic variables, originally identified because they shared a number of enigmatic properties - most notably, single-peaked emission lines instead of the double-peaked lines one would expect from their high-inclination accretion discs. We present high time-resolution spectrophotometry of the eclipsing nova-like variables SW Sex and DW UMa, two of the founding members of the SW Sex class. Both systems show single-peaked Balmer and HeII 4686A emission lines that appear to originate from a region in the disc that lies close to, but downstream of, the bright spot. The emission-line light curves are consistent with the finding from X-ray and ultraviolet observations that we predominantly see the flared disc rim and the unobscured back portion of the disc in these systems. In DW UMa, the HeII 4686A emission line originates from close to the white dwarf and exhibits flaring. Such flares have been used to argue for magnetically-channelled accretion, as in the intermediate polars, b...

  16. Sex steroids and bone.

    Science.gov (United States)

    Manolagas, S C; Kousteni, S; Jilka, R L

    2002-01-01

    The adult skeleton is periodically remodeled by temporary anatomic structures that comprise juxtaposed osteoclast and osteoblast teams and replace old bone with new. Estrogens and androgens slow the rate of bone remodeling and protect against bone loss. Conversely, loss of estrogen leads to increased rate of remodeling and tilts the balance between bone resorption and formation in favor of the former. Studies from our group during the last 10 years have elucidated that estrogens and androgens decrease the number of remodeling cycles by attenuating the birth rate of osteoclasts and osteoblasts from their respective progenitors. These effects result, in part, from the transcriptional regulation of genes responsible for osteoclastogenesis and mesenchymal cell replication and/or differentiation and are exerted through interactions of the ligand-activated receptors with other transcription factors. However, increased remodeling alone cannot explain why loss of sex steroids tilts the balance of resorption and formation in favor of the former. Estrogens and androgens also exert effects on the lifespan of mature bone cells: pro-apoptotic effects on osteoclasts but anti-apoptotic effects on osteoblasts and osteocytes. These latter effects stem from a heretofore unexpected function of the classical "nuclear" sex steroid receptors outside the nucleus and result from activation of a Src/Shc/extracellular signal-regulated kinase signal transduction pathway probably within preassembled scaffolds called caveolae. Strikingly, estrogen receptor (ER) alpha or beta or the androgen receptor can transmit anti-apoptotic signals with similar efficiency, irrespective of whether the ligand is an estrogen or an androgen. More importantly, these nongenotropic, sex-nonspecific actions are mediated by the ligand-binding domain of the receptor and can be functionally dissociated from transcriptional activity with synthetic ligands. Taken together, these lines of evidence strongly suggest that

  17. 基于小波再分配尺度谱的Lamb波时频特性研究%Research of lamb wave time-frequency characteristics based on wavelet reassignment scalogram

    Institute of Scientific and Technical Information of China (English)

    2013-01-01

    Based on acousto-ultrasonic technique, experimental studies are performed to explore the characteristics of the lamb wave produced in the aluminum plate. Mainly, the wavelet reassignment scalogram analysis is utilized to investigate the propagation characteristic of the lamb wave. Various comparing experiments and theoretical study are performed on the aluminum plates with and without artificial crack damage respectively. Some valuable results are obtained, and this provides some referable basis for further application research of acoustic-ultrasonic technique with respect to the area of the structure health monitoring.%  基于声—超声技术,对铝板中Lamb波的时频特性进行理论和实验研究,采用小波再分配尺度谱方法对铝板中Lamb波的时频特性进行实验研究和深入探讨,并对铝板中有无模拟损伤的情况做了对比研究和分析,研究相应Lamb波的信号特征,从而实现了铝板结构损伤监测的定性研究。

  18. Extending DFT-based genetic algorithms by atom-to-place re-assignment via perturbation theory: A systematic and unbiased approach to structures of mixed-metallic clusters

    Energy Technology Data Exchange (ETDEWEB)

    Weigend, Florian, E-mail: florian.weigend@kit.edu [Institut für Physikalische Chemie, Abteilung für Theoretische Chemie, Karlsruher Institut für Technologie, Fritz-Haber-Weg 2, 76131 Karlsruhe, Germany and Institut für Nanotechnologie, Karlsruher Institut für Technologie, Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen (Germany)

    2014-10-07

    Energy surfaces of metal clusters usually show a large variety of local minima. For homo-metallic species the energetically lowest can be found reliably with genetic algorithms, in combination with density functional theory without system-specific parameters. For mixed-metallic clusters this is much more difficult, as for a given arrangement of nuclei one has to find additionally the best of many possibilities of assigning different metal types to the individual positions. In the framework of electronic structure methods this second issue is treatable at comparably low cost at least for elements with similar atomic number by means of first-order perturbation theory, as shown previously [F. Weigend, C. Schrodt, and R. Ahlrichs, J. Chem. Phys. 121, 10380 (2004)]. In the present contribution the extension of a genetic algorithm with the re-assignment of atom types to atom sites is proposed and tested for the search of the global minima of PtHf{sub 12} and [LaPb{sub 7}Bi{sub 7}]{sup 4−}. For both cases the (putative) global minimum is reliably found with the extended technique, which is not the case for the “pure” genetic algorithm.

  19. Extending DFT-based genetic algorithms by atom-to-place re-assignment via perturbation theory: a systematic and unbiased approach to structures of mixed-metallic clusters.

    Science.gov (United States)

    Weigend, Florian

    2014-10-07

    Energy surfaces of metal clusters usually show a large variety of local minima. For homo-metallic species the energetically lowest can be found reliably with genetic algorithms, in combination with density functional theory without system-specific parameters. For mixed-metallic clusters this is much more difficult, as for a given arrangement of nuclei one has to find additionally the best of many possibilities of assigning different metal types to the individual positions. In the framework of electronic structure methods this second issue is treatable at comparably low cost at least for elements with similar atomic number by means of first-order perturbation theory, as shown previously [F. Weigend, C. Schrodt, and R. Ahlrichs, J. Chem. Phys. 121, 10380 (2004)]. In the present contribution the extension of a genetic algorithm with the re-assignment of atom types to atom sites is proposed and tested for the search of the global minima of PtHf12 and [LaPb7Bi7](4-). For both cases the (putative) global minimum is reliably found with the extended technique, which is not the case for the "pure" genetic algorithm.

  20. Surgical Treatment of Winged Scapula

    National Research Council Canada - National Science Library

    Galano, Gregory J; Bigliani, Louis U; Ahmad, Christopher S; Levine, William N

    2008-01-01

    .... Although nonoperative treatment is successful in some patients, failures have led to the evolution of surgical techniques involving various combinations of fascial graft and/or transfer of adjacent muscles...

  1. Essential Tremor (ET): Surgical Options

    Science.gov (United States)

    ... t respond to propranolol, primidone, or other common ET medications and whose tremor has become debilitating, there ... treatments were first introduced. Current surgical options for ET include Deep Brain Stimulation (DBS) , Focused Ultrasound Thalamotomy , ...

  2. Surgical treatment of cranial neuralgias.

    Science.gov (United States)

    Franzini, Angelo; Ferroli, Paolo; Messina, Giuseppe; Broggi, Giovanni

    2010-01-01

    The most common types of cranial neuralgias amenable to surgical therapeutic options are trigeminal neuralgia and glossopharyngeal neuralgia, the former having an approximate incidence of 5/100000 cases per year and the latter of 0.05/100000 cases per year. Surgical therapy of these pathological conditions encompasses several strategies, going from ablative procedures to neurovascular decompression, to radiosurgery. The choice of the most appropriate surgical option (which must be taken into account when all conservative treatments have proven to be unsuccessful) has to take into account many factors, the most important ones being neuroradiological evidence of a neurovascular conflict, severity of symptoms, the age and clinical history of the patient, and the patient's overall medical condition. In this chapter we report our experience with the treatment of trigeminal and glossopharyngeal neuralgia, describing the surgical procedures performed and reviewing the most recent aspects on this subject in the past literature.

  3. Surgical trainees and trauma emergencies.

    Science.gov (United States)

    Wybaillie, E; Broos, P L O

    2010-01-01

    An accident and emergency (A&E) training has been suggested as an essential part of the basic surgical training. The A&E curriculum should be divided into three sections: a critical curriculum, a core curriculum and a comprehensive curriculum. For instance, the critical curriculum contains topics that provide the opportunity to translate the ABCDE principles of trauma management into practice. Furthermore, a post in the A&E department provides the surgical trainee with significant exposure to the management of the polytrauma patient and to the management of other acute general surgical, urological and orthopaedic conditions. By presenting better educational programs and by reducing the non-medical tasks a trainee has to deal with, the education of surgical trainees during A&E attachment can be improved.

  4. Access to Specialized Surgical Care

    African Journals Online (AJOL)

    to reduce the global burden of disease (GBD), it is ... global players have supported efforts to improve access and safety of surgery ... (i) strengthening surgical services at district hospitals ... of the surrounding community and a model for other.

  5. Sex differences in brain epigenetics.

    Science.gov (United States)

    Menger, Yannick; Bettscheider, Marc; Murgatroyd, Chris; Spengler, Dietmar

    2010-12-01

    Sexual differentiation of the brain takes place during a perinatal-sensitive time window as a result of gonadal hormone-induced activational and organizational effects on neuronal substrates. Increasing evidence suggests that epigenetic mechanisms can contribute to the establishment and maintenance of some aspects of these processes, and that these epigenetic mechanisms may themselves be under the control of sex hormones. Epigenetic programming of neuroendocrine and behavioral phenotypes frequently occurs sex specifically, pointing to sex differences in brain epigenetics as a possible determinant. Understanding how sex-specific epigenomes and sex-biased responses to environmental cues contribute to the development of brain diseases might provide new insights for epigenetic therapy.

  6. Attitudes about Sex Selection and Sex Preference in Iranian Couples Referred for Sex Selection Technology

    Science.gov (United States)

    Ahmadi, Seyedeh Fatemeh; Shirzad, Mahdi; Kamali, Koorosh; Ranjbar, Fahimeh; Behjati-Ardakani, Zohreh; Akhondi, Mohammad Mehdi

    2015-01-01

    Background Gender preference is prevalent in some communities and using medical techniques to choose the baby's sex may cause the gender discrimination and gender imbalance in communities. Therefore, evaluating the gender preferences and attitudes towards using sex selection technologies seems to be necessary. Methods This cross-sectional study was conducted in Avicenna Fertility Center. Participants were 100 women with one child who were referred for sex selection. Data were collected through self-developed questionnaires. The questions were designed by the researchers at the experts’ panel. To determine the validity of the questionnaire, the viewpoints of professors specialized in these issues were obtained. The statistical analysis of the data was performed using SPSS software (Version 11.5), and p < 0.05 was considered significant. Results Tendency toward the male was more than female sex (55.5% male, 15.5% female and 28.5% no tendency). Majority of participants agreed with sex selection with medical reason and sex selection in order to balance the family. Women's level of education had positive effect on agreements to fetal sex selection with medical and non-medical reasons (p < 0.001). Conclusion Although gender preferences were toward the male sex but this preference was not very strong. Most participants agreed with non-medical sex selection for balancing the sex composition of their children. It doesn't seem that non-medical sex selection for family balancing causes severe sex imbalance in Iran. PMID:25717434

  7. Intermittent exotropia: Surgical treatment strategies

    Directory of Open Access Journals (Sweden)

    Jai Aditya Kelkar

    2015-01-01

    Full Text Available Surgical management of intermittent exotropias (IXTs is ambiguous, with techniques of management varying widely between institutions. This review aims to examine available literature on the surgical management of IXT. A literature search was performed using PubMed, Web of Knowledge, LILACS, and the University of Liverpool Orthoptic Journals and Conference Transactions Database. All English-language papers published between 1958 and the present day were considered.

  8. Aesthetic Surgical Crown Lengthening Procedure.

    Science.gov (United States)

    de Oliveira, Pablo Santos; Chiarelli, Fabio; Rodrigues, José A; Shibli, Jamil A; Zizzari, Vincenzo Luca; Piattelli, Adriano; Iezzi, Giovanna; Perrotti, Vittoria

    2015-01-01

    The aim of this case report was to describe the surgical sequence of crown lengthening to apically reposition the dentogingival complex, in addition to an esthetic restorative procedure. Many different causes can be responsible for short clinical crown. In these cases, the correct execution of a restorative or prosthetic rehabilitation requires an increasing of the crown length. According to the 2003 American Academy of Periodontology (Practice Profile Survey), crown lengthening is the most habitual surgical periodontal treatment.

  9. Aesthetic Surgical Crown Lengthening Procedure

    Science.gov (United States)

    de Oliveira, Pablo Santos; Chiarelli, Fabio; Rodrigues, José A.; Shibli, Jamil A.; Zizzari, Vincenzo Luca; Piattelli, Adriano; Iezzi, Giovanna; Perrotti, Vittoria

    2015-01-01

    The aim of this case report was to describe the surgical sequence of crown lengthening to apically reposition the dentogingival complex, in addition to an esthetic restorative procedure. Many different causes can be responsible for short clinical crown. In these cases, the correct execution of a restorative or prosthetic rehabilitation requires an increasing of the crown length. According to the 2003 American Academy of Periodontology (Practice Profile Survey), crown lengthening is the most habitual surgical periodontal treatment. PMID:26609452

  10. Aesthetic Surgical Crown Lengthening Procedure

    Directory of Open Access Journals (Sweden)

    Pablo Santos de Oliveira

    2015-01-01

    Full Text Available The aim of this case report was to describe the surgical sequence of crown lengthening to apically reposition the dentogingival complex, in addition to an esthetic restorative procedure. Many different causes can be responsible for short clinical crown. In these cases, the correct execution of a restorative or prosthetic rehabilitation requires an increasing of the crown length. According to the 2003 American Academy of Periodontology (Practice Profile Survey, crown lengthening is the most habitual surgical periodontal treatment.

  11. Surgical Treatment of Facial Paralysis

    OpenAIRE

    Mehta, Ritvik P.

    2009-01-01

    The management of facial paralysis is one of the most complex areas of reconstructive surgery. Given the wide variety of functional and cosmetic deficits in the facial paralysis patient, the reconstructive surgeon requires a thorough understanding of the surgical techniques available to treat this condition. This review article will focus on surgical management of facial paralysis and the treatment options available for acute facial paralysis (2 yr). For acute facial paralysis, the main surgi...

  12. Innovation in pediatric surgical education.

    Science.gov (United States)

    Clifton, Matthew S; Wulkan, Mark L

    2015-06-01

    Pediatric surgical training in the United States remained basically unchanged from the model developed by Ladd and Gross in the 1930s until recently. Standardized curriculum and novel evaluation methods are now being implemented. Pediatric Surgical education is currently undergoing a transition to competency-based evaluation and promotion. Unfortunately, there is little data on the efficacy of these changes. This presents an opportunity for further study of how we conduct training, and how we evaluate and promote our trainees.

  13. Talking to Your Kids about Sex

    Science.gov (United States)

    ... editorial staff Categories: Kids and Teens, Sex and Birth Control, Sex and SexualityTags: Adolescent Kids and Teens, Sex and Birth Control, Sex and Sexuality January 2017 Copyright © American Academy ...

  14. The many costs of sex.

    Science.gov (United States)

    Lehtonen, Jussi; Jennions, Michael D; Kokko, Hanna

    2012-03-01

    Explaining the evolution of sex is challenging for biologists. A 'twofold cost' compared with asexual reproduction is often quoted. If a cost of this magnitude exists, the benefits of sex must be large for it to have evolved and be maintained. Focusing on benefits can be misleading, as this sidelines important questions about the cost of sex: what is the source of the twofold cost: males, genome dilution or both? Does the cost deviate from twofold? What other factors make sex costly? How should the costs of sex be empirically measured? The total cost of sex and how it varies in different contexts must be known to determine the benefits needed to account for the origin and maintenance of sex. Copyright © 2011 Elsevier Ltd. All rights reserved.

  15. Evolution of surgical skills training

    Institute of Scientific and Technical Information of China (English)

    Kurt E Roberts; Robert L Bell; Andrew J Duffy

    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.

  16. Bacterial migration through punctured surgical gloves under real surgical conditions

    Directory of Open Access Journals (Sweden)

    Heidecke Claus-Dieter

    2010-07-01

    Full Text Available Abstract Background The aim of this study was to confirm recent results from a previous study focussing on the development of a method to measure the bacterial translocation through puncture holes in surgical gloves under real surgical conditions. Methods An established method was applied to detect bacterial migration from the operating site through the punctured glove. Biogel™ double-gloving surgical gloves were used during visceral surgeries over a 6-month period. A modified Gaschen-bag method was used to retrieve organisms from the inner glove, and thus-obtained bacteria were compared with micro-organisms detected by an intra-operative swab. Results In 20 consecutive procedures, 194 gloves (98 outer gloves, 96 inner gloves were examined. The rate of micro-perforations of the outer surgical glove was 10% with a median wearing time of 100 minutes (range: 20-175 minutes. Perforations occurred in 81% on the non-dominant hand, with the index finger most frequently (25% punctured. In six cases, bacterial migration could be demonstrated microbiologically. In 5% (5/98 of outer gloves and in 1% (1/96 of the inner gloves, bacterial migration through micro-perforations was observed. For gloves with detected micro-perforations (n = 10 outer layers, the calculated migration was 50% (n = 5. The minimum wearing time was 62 minutes, with a calculated median wearing time of 71 minutes. Conclusions This study confirms previous results that bacterial migration through unnoticed micro-perforations in surgical gloves does occur under real practical surgical conditions. Undetected perforation of surgical gloves occurs frequently. Bacterial migration from the patient through micro-perforations on the hand of surgeons was confirmed, limiting the protective barrier function of gloves if worn over longer periods.

  17. Sex Determination, Sex Chromosomes, and Karyotype Evolution in Insects.

    Science.gov (United States)

    Blackmon, Heath; Ross, Laura; Bachtrog, Doris

    2017-01-01

    Insects harbor a tremendous diversity of sex determining mechanisms both within and between groups. For example, in some orders such as Hymenoptera, all members are haplodiploid, whereas Diptera contain species with homomorphic as well as male and female heterogametic sex chromosome systems or paternal genome elimination. We have established a large database on karyotypes and sex chromosomes in insects, containing information on over 13000 species covering 29 orders of insects. This database constitutes a unique starting point to report phylogenetic patterns on the distribution of sex determination mechanisms, sex chromosomes, and karyotypes among insects and allows us to test general theories on the evolutionary dynamics of karyotypes, sex chromosomes, and sex determination systems in a comparative framework. Phylogenetic analysis reveals that male heterogamety is the ancestral mode of sex determination in insects, and transitions to female heterogamety are extremely rare. Many insect orders harbor species with complex sex chromosomes, and gains and losses of the sex-limited chromosome are frequent in some groups. Haplodiploidy originated several times within insects, and parthenogenesis is rare but evolves frequently. Providing a single source to electronically access data previously distributed among more than 500 articles and books will not only accelerate analyses of the assembled data, but also provide a unique resource to guide research on which taxa are likely to be informative to address specific questions, for example, for genome sequencing projects or large-scale comparative studies.

  18. Surgical versus non-surgical treatment of congenital hyperinsulinism.

    Science.gov (United States)

    Mazor-Aronovitch, Kineret; Landau, Heddy; Gillis, David

    2009-03-01

    Congenital hyperinsulinism is a functional disorder of insulin secretion. In its diffuse severe form, it is traditionally treated with over 95% pancreatectomy. However, even after this procedure normoglycemia is not always achieved. Non-surgical therapy with frequent or continuous feeding, medication and close monitoring is another alternative. In this review we compare the two approaches to this condition focusing on early complications, diabetes, neurological outcome and home management issues. Early complications of pancreatectomy include mechanical, metabolic and infectious complications. Non-surgical interventions can be complicated by unwarranted effects of medications and of invasive procedures. Diabetes occurs with both approaches but much less frequently and years later with non-surgical treatment. Regarding neurodevelopmental outcome, most data come from heterogeneous groups. Nevertheless, it appears that outcome is not adversely affected by avoiding surgery. Home management is far more difficult for the non-surgical form. When the non-surgical approach is successful in achieving normoglycemia and parents are highly motivated, this mode of therapy should be considered.

  19. "Sex Hormones" in Secondary School Biology Textbooks

    Science.gov (United States)

    Nehm, Ross H.; Young, Rebecca

    2008-01-01

    This study explores the extent to which the term "sex hormone" is used in science textbooks, and whether the use of the term "sex hormone" is associated with pre-empirical concepts of sex dualism, in particular the misconceptions that these so-called "sex hormones" are sex specific and restricted to sex-related physiological functioning. We found…

  20. Environmental sex reversal, Trojan sex genes, and sex ratio adjustment: conditions and population consequences.

    Science.gov (United States)

    Stelkens, Rike B; Wedekind, Claus

    2010-02-01

    The great diversity of sex determination mechanisms in animals and plants ranges from genetic sex determination (GSD, e.g. mammals, birds, and most dioecious plants) to environmental sex determination (ESD, e.g. many reptiles) and includes a mixture of both, for example when an individual's genetically determined sex is environmentally reversed during ontogeny (ESR, environmental sex reversal, e.g. many fish and amphibia). ESD and ESR can lead to widely varying and unstable population sex ratios. Populations exposed to conditions such as endocrine-active substances or temperature shifts may decline over time due to skewed sex ratios, a scenario that may become increasingly relevant with greater anthropogenic interference on watercourses. Continuous exposure of populations to factors causing ESR could lead to the extinction of genetic sex factors and may render a population dependent on the environmental factors that induce the sex change. However, ESR also presents opportunities for population management, especially if the Y or W chromosome is not, or not severely, degenerated. This seems to be the case in many amphibians and fish. Population growth or decline in such species can potentially be controlled through the introduction of so-called Trojan sex genes carriers, individuals that possess sex chromosomes or genes opposite from what their phenotype predicts. Here, we review the conditions for ESR, its prevalence in natural populations, the resulting physiological and reproductive consequences, and how these may become instrumental for population management.

  1. Random sex determination: When developmental noise tips the sex balance.

    Science.gov (United States)

    Perrin, Nicolas

    2016-12-01

    Sex-determining factors are usually assumed to be either genetic or environmental. The present paper aims at drawing attention to the potential contribution of developmental noise, an important but often-neglected component of phenotypic variance. Mutual inhibitions between male and female pathways make sex a bistable equilibrium, such that random fluctuations in the expression of genes at the top of the cascade are sufficient to drive individual development toward one or the other stable state. Evolutionary modeling shows that stochastic sex determinants should resist elimination by genetic or environmental sex determinants under ecologically meaningful settings. On the empirical side, many sex-determination systems traditionally considered as environmental or polygenic actually provide evidence for large components of stochasticity. In reviewing the field, I argue that sex-determination systems should be considered within a three-ends continuum, rather than the classical two-ends continuum.

  2. Sex Ratio Elasticity Influences the Selection of Sex Ratio Strategy

    Science.gov (United States)

    Wang, Yaqiang; Wang, Ruiwu; Li, Yaotang; (Sam) Ma, Zhanshan

    2016-01-01

    There are three sex ratio strategies (SRS) in nature—male-biased sex ratio, female-biased sex ratio and, equal sex ratio. It was R. A. Fisher who first explained why most species in nature display a sex ratio of ½. Consequent SRS theories such as Hamilton’s local mate competition (LMC) and Clark’s local resource competition (LRC) separately explained the observed deviations from the seemingly universal 1:1 ratio. However, to the best of our knowledge, there is not yet a unified theory that accounts for the mechanisms of the three SRS. Here, we introduce the price elasticity theory in economics to define sex ratio elasticity (SRE), and present an analytical model that derives three SRSs based on the following assumption: simultaneously existing competitions for both resources A and resources B influence the level of SRE in both sexes differently. Consequently, it is the difference (between two sexes) in the level of their sex ratio elasticity that leads to three different SRS. Our analytical results demonstrate that the elasticity-based model not only reveals a highly plausible mechanism that explains the evolution of SRS in nature, but also offers a novel framework for unifying two major classical theories (i.e., LMC & LRC) in the field of SRS research. PMID:28009000

  3. Sex Ratio Elasticity Influences the Selection of Sex Ratio Strategy

    Science.gov (United States)

    Wang, Yaqiang; Wang, Ruiwu; Li, Yaotang; (Sam) Ma, Zhanshan

    2016-12-01

    There are three sex ratio strategies (SRS) in nature—male-biased sex ratio, female-biased sex ratio and, equal sex ratio. It was R. A. Fisher who first explained why most species in nature display a sex ratio of ½. Consequent SRS theories such as Hamilton’s local mate competition (LMC) and Clark’s local resource competition (LRC) separately explained the observed deviations from the seemingly universal 1:1 ratio. However, to the best of our knowledge, there is not yet a unified theory that accounts for the mechanisms of the three SRS. Here, we introduce the price elasticity theory in economics to define sex ratio elasticity (SRE), and present an analytical model that derives three SRSs based on the following assumption: simultaneously existing competitions for both resources A and resources B influence the level of SRE in both sexes differently. Consequently, it is the difference (between two sexes) in the level of their sex ratio elasticity that leads to three different SRS. Our analytical results demonstrate that the elasticity-based model not only reveals a highly plausible mechanism that explains the evolution of SRS in nature, but also offers a novel framework for unifying two major classical theories (i.e., LMC & LRC) in the field of SRS research.

  4. Cheiloscopy for sex determination

    Directory of Open Access Journals (Sweden)

    Shailesh M Gondivkar

    2009-01-01

    Full Text Available Background: Identification of an individual is a pre-requisite for certification of death and for personal, social and legal reasons. The study of lip-prints (cheiloscopy was thought of as a method of identification of a person. It is safe to assume that cheiloscopy, in its present stage of development, has become a means of criminalistic identification dealing with lip-prints. Objective: The objective of the study was to check for any peculiar lip patterns in relation to the sex of the individual and determine the most common lip patterns in the Indian population. Materials and Methods: This study was conducted on 140 subjects, which included 70 males and 70 females, in the age group of 0-70 years. After applying lip stick evenly, the lip-print of each subject was obtained on a simple bond paper by researcher number 1. The lip-print was then analyzed and interpreted by researcher number 2 to determine the sex of individuals. Results: We found that 67 of the actual 70 lip-prints of females were correctly identified and 65 of the 70 males were correctly diagnosed as males. Type C (47.14% was the most commonly occurring trend in females whereas Type B (70% was the most commonly occurring trend in males. Conclusion: Along with other traditional methods, cheiloscopy can also serve as very important tool in the identification of a person based on the characteristic arrangement of lines appearing on the red part of the lips.

  5. Using dummies for surgical skills training

    DEFF Research Database (Denmark)

    Langebæk, Rikke

    2011-01-01

    teaching methods for veterinary surgical training. At the Department of Small Animal Clinical Sciences, Faculty of Life Sciences, a number of low fidelity, stuffed toy animal dummies was developed for the Surgical Skills Lab in order to teach 4th year students the basic surgical skills. In the Surgical...... this a relatively low budget solution with a big ethical benefit....

  6. 21 CFR 878.4040 - Surgical apparel.

    Science.gov (United States)

    2010-04-01

    ... known as scrub suits, are excluded. (b) Classification. (1) Class II (special controls) for surgical... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Surgical apparel. 878.4040 Section 878.4040 Food... DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices § 878.4040 Surgical apparel....

  7. Surgical treatment for male prolactinoma

    Science.gov (United States)

    Song, Yi-Jun; Chen, Mei-Ting; Lian, Wei; Xing, Bing; Yao, Yong; Feng, Ming; Wang, Ren-Zhi

    2017-01-01

    Abstract A total of 184 cases of surgically treated male prolactinoma were analyzed retrospectively to summarize the outcome of this surgical intervention. We analyzed the general characteristics, clinical manifestations, hormone levels, imaging features, preoperative treatments, surgical outcomes, pathology results, and follow-up records for all included patients. The most common clinical manifestations included sexual dysfunction (47.4%), headache (55.9%), and visual disturbance (46.7%). Serum prolactin levels ranged from 150 to 204,952 ng/mL. Tumor size varied from 6 to 70 mm. Pituitary adenomas grew in a parasellar pattern with visual deficits occurring 40.7% of the time. After surgical therapy, 88.6% of patients achieved symptom relief, and 98.4% experienced an immediate postoperative decline in prolactin level. Fifty-seven patients (31.0%) achieved initial remission, and 26 patients (45.6%) experienced recurrence. Hence, our results suggest that in male prolactinoma characterized by a large pituitary diameter and high serum prolactin level, tumor size predicts the degree of gross resection. The prognostic predictors included preoperative tumor growth pattern and Ki-67 index. Citation: Yi-jun S, Mei-ting C, Wei L, Bing X, Yong Y, Ming F, Ren-zhi W. (2016) Surgical treatment for male prolactinoma: a retrospective study of 184 cases PMID:28079813

  8. Can we measure surgical resilience?

    Science.gov (United States)

    Graham, David; Becerril-Martinez, Guillermo; Quinto, Lena; Zhao, Dong Fang

    2016-01-01

    Surgical resilience describes psychological resilience within a surgical setting. Within a surgical setting, psychologically resilient patients have improved recovery and wound-healing. The search for biological correlates in resilient patients has led to the hypothesis that certain endogenous biomarkers (namely neuropeptide Y (NPY), testosterone, and dehydroepiandrosterone (DHEA)) are altered in resilient patients. The concept of surgical resilience raises the question of whether enhanced recovery following surgery can be demonstrated in patients with high titres of resilience biomarkers as compared to patients with low titres of resilience biomarkers. To determine the prognostic value of resilience biomarkers in surgical recovery, a cohort of patients undergoing major surgery should initially be psychometrically tested for their resilience levels before and after surgery so that biomarker levels of NPY, testosterone and DHEA can be compared to a validated psychometric test of resilience. The primary outcome would be length of hospital stay with and without an enhanced recovery program. Secondary outcome measures such as complications, time in rehabilitation and readmission could also be included. If the hypothesis is upheld, resilience biomarkers could be used to support more individualised perioperative management and lead to more efficient and effective allocation of healthcare resources.

  9. Sex Determination Mechanisms in Fish

    Institute of Scientific and Technical Information of China (English)

    ZHANG Quanqi; SUN Xiaohua; QI Jie; WANG Zhigang; WANG Xinglian; WANG Xubo; ZHAI Teng

    2009-01-01

    In fish, sex determination (SD) system shows high variation. The SD mechanisms include environmental and genetic regulation. The research on SD system and related genes in intensively studied fish species was reviewed. Although some genes have been described as sex-related, only DMRTlbY can be considered as a master sex determination gene and none of them has been util-ized in aquaculture. The variation of fish SD system, the importance of sex-related genes in evolution research and the relations be-tween environmental factors and sex-related genes were also discussed. The fish sex determination mechanism remains largely un-known. Further research needs to be done considering the significance of fish SD studies in basic and applied aspects.

  10. Anatomy and Surgical Relevance of Rouviere's Sulcus

    Science.gov (United States)

    Morjane, Abdelwaheb

    2013-01-01

    Rouviere's sulcus (RS) (i.e., incisura hepatis dextra, Gans incisura) represents an important anatomical landmark. The aim of the study was to determine the frequency of the RS, its description, its location, its relations to the right portal pedicle and to the plane of the common bile duct, and the evaluation of the surgical relevance of the obtained data. Forty macroscopically healthy and undamaged livers were removed during autopsies from cadavers of both sexes. The RS was present in 82% of the cases and in these the open RS was identified in 70% of the livers. The fused type was observed in 12% of the cases; 18% of the livers had no sulcus. The mean length of the open type RS was 28 ± 2 mm (range 24–32 mm) and its mean depth was 6 ± 2 mm (range 4–8 mm). The right posterior sectional pedicle was found in the RS in 70% of the cases. In 5% of the livers, we also dissected a branch of the anterior sectional pedicle. Inside 25% of the RS, we found the vein of segment 6. The RS identification may avoid bile duct injury during laparoscopic cholecystectomy and enables elective vascular control during the right liver resection. PMID:24319350

  11. Surgical treatment of facial paralysis.

    Science.gov (United States)

    Mehta, Ritvik P

    2009-03-01

    The management of facial paralysis is one of the most complex areas of reconstructive surgery. Given the wide variety of functional and cosmetic deficits in the facial paralysis patient, the reconstructive surgeon requires a thorough understanding of the surgical techniques available to treat this condition. This review article will focus on surgical management of facial paralysis and the treatment options available for acute facial paralysis (facial paralysis (3 weeks to 2 yr) and chronic facial paralysis (>2 yr). For acute facial paralysis, the main surgical therapies are facial nerve decompression and facial nerve repair. For facial paralysis of intermediate duration, nerve transfer procedures are appropriate. For chronic facial paralysis, treatment typically requires regional or free muscle transfer. Static techniques of facial reanimation can be used for acute, intermediate, or chronic facial paralysis as these techniques are often important adjuncts to the overall management strategy.

  12. MALNUTRITION IN THE SURGICAL PATIENTS

    Directory of Open Access Journals (Sweden)

    Andonovska Biljana J.

    2016-12-01

    Full Text Available The term 'malnutrition' is a broad term used to describe any imbalance in the diet. In 2009 it was confirmed that malnutrition is an urgent health problem. The reasons for which malnutrition may develop are different. Loss on cellular, physical and physiological level happens as a consequence of malnutrition. Studies show that in surgical practice there is malnutrition in 50% of patients and that there is an association between inadequate nutritional status and surgical result. It leads to prolonged treatment, increasing of the level of morbidity and mortality, increased hospital costs, etc. Sometimes malnutrition is unrecognised, untreated and worsened in hospitals. For this reason this paper will elaborate: nutrition and a surgical patient, assessment of a nutritional status, assessment of energy requirements, and enteral and parenteral nutrition in order to determine the conditions and procedures that affect the appearance, recognition and treatment of malnutrition.

  13. Surgical Complications of Cochlear Implantation

    Directory of Open Access Journals (Sweden)

    Basir Hashemi

    2010-03-01

    Full Text Available Cochlear implantation is a method used for the treatment ofpatients with profound hearing loss. This procedure may theaccompanied by some major or minor complications. Weevaluated the surgical complications of cochlear implantationin Fars province (south of Iran. A total of 150 patients withcochlear implantation were enrolled in the present study. Mostof the patients were pre-lingual children and most of our deviceswere nucleus prosthesis. We had three device failuresand four major complications, including one misplaced electrode,one case of meningitis, one case of foreign body reactionto suture and one case with extensive hematoma. Thesecomplications were managed successfully by surgical interventionor re-implantation. Facial nerve damage or woundbreakdown was not seen. Minor complications including smallhematoma, edema, stitch infection and dizziness were found in15 cases, which were managed medically. In our center, therate of minor complications was comparable to other centersin the world. But the rate of major surgical complications waslower than other centers.

  14. Nutrition support in surgical oncology.

    Science.gov (United States)

    Huhmann, Maureen B; August, David A

    2009-01-01

    This review article, the second in a series of articles to examine the American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.) Guidelines for the Use of Parenteral and Enteral Nutrition in Adult and Pediatric Patients, evaluates the evidence related to the use of nutrition support in surgical oncology patients. Cancer patients develop complex nutrition issues. Nutrition support may be indicated in malnourished cancer patients undergoing surgery, depending on individual patient characteristics. As with the first article in this series, this article provides background concerning nutrition issues in cancer patients, as well as discusses the role of nutrition support in the care of surgical cancer patients. The goal of this review is to enrich the discussion contained in the clinical guidelines as they relate to recommendations made for surgical patients, cite the primary literature more completely, and suggest updates to the guideline statements in light of subsequently published studies.

  15. [Surgical adrenal approaches: learned experiences].

    Science.gov (United States)

    Bravo-Lázaro, Santos; Hernandis-Villalba, Juan; Meroño-Carbajosa, Emilio; Navío-Perales, Juan; Marzal-Felici, Vicente

    2014-01-01

    Laparoscopic surgery is the standard approach for surgical adrenal gland pathology. However, the open procedure still has its role. Our intention is to report our results and experience using different techniques. A retrospective study of 40 patients was carried out. Demographic and surgical data were analyzed. Thirty two patients had benign pathology and eight had malignant tumors. Laparotomy was performed in 18 patients: seven patients with malignant tumors and 11 with benign pathology. Young's approach was indicated in four patients. Laparoscopic aproach was indicated in 25 patients with seven patients requiring conversion to laparotomy. The conversion rate was 28% In most cases, the laparoscopic approach is the standard technique. Appropriate case selection is of primary importance. Other surgical techniques should be considered if necessary.

  16. Sex and Age Differences in Body-Image, Self-Esteem, and Body Mass Index in Adolescents and Adults After Single-Ventricle Palliation

    OpenAIRE

    Pike, Nancy A.; Evangelista, Lorraine S.; Doering, Lynn V.; Eastwood, Jo-Ann; Lewis, Alan B.; Child, John S.

    2012-01-01

    Single-ventricle congenital heart disease (SVCHD) requires multiple palliative surgical procedures that leave visible surgical scars and physical deficits, which can alter body-image and self-esteem. This study aimed to compare sex and age differences in body-image, self-esteem, and body mass index (BMI) in adolescents and adults with SVCHD after surgical palliation with those of a healthy control group. Using a comparative, cross-sectional design, 54 adolescent and adult (26 male and 28 fema...

  17. Emotions in veterinary surgical students

    DEFF Research Database (Denmark)

    Langebæk, Rikke; Eika, Berit; Pedersen, Lene Tanggaard

    2012-01-01

    A surgical educational environment is potentially stressful and can negatively affect students' learning. The aim of the present study was to investigate the emotions experienced by veterinary students in relation to their first encounter with live-animal surgery and to identify possible sources...... of positive and negative emotions, respectively. During a Basic Surgical Skills course, 155 veterinary fourth-year students completed a survey. Of these, 26 students additionally participated in individual semi-structured interviews. The results of the study show that students often experienced a combination...

  18. Sense about Sex: Media, Sex Advice, Education and Learning

    Science.gov (United States)

    Attwood, Feona; Barker, Meg John; Boynton, Petra; Hancock, Justin

    2015-01-01

    The media are widely acknowledged as important in sex and relationship education, but they are usually associated with "bad" effects on young people in contrast to the "good" knowledge represented by more informational and educational formats. In this paper we look at sex advice giving in newspapers, magazines and television in…

  19. Sex ratio variation and sex determination in Urtica dioica

    NARCIS (Netherlands)

    Glawe, Grit Anja

    2006-01-01

    This thesis will first document on variation in progeny sex ratios among individual female plants of Urtica dioica at our field site in Meijendel (Chapter 2). Next, we show that there is also considerable sex ratio variation among male and female flowering shoots in 26 natural populations studied

  20. Sex ratio variation and sex determination in Urtica dioica

    NARCIS (Netherlands)

    Glawe, Grit Anja

    2006-01-01

    This thesis will first document on variation in progeny sex ratios among individual female plants of Urtica dioica at our field site in Meijendel (Chapter 2). Next, we show that there is also considerable sex ratio variation among male and female flowering shoots in 26 natural populations studied (C

  1. Sense about Sex: Media, Sex Advice, Education and Learning

    Science.gov (United States)

    Attwood, Feona; Barker, Meg John; Boynton, Petra; Hancock, Justin

    2015-01-01

    The media are widely acknowledged as important in sex and relationship education, but they are usually associated with "bad" effects on young people in contrast to the "good" knowledge represented by more informational and educational formats. In this paper we look at sex advice giving in newspapers, magazines and television in…

  2. Sex differences in the brain-an interplay of sex steroid hormones and sex chromosomes.

    Science.gov (United States)

    Grgurevic, Neza; Majdic, Gregor

    2016-09-01

    Although considerable progress has been made in our understanding of brain function, many questions remain unanswered. The ultimate goal of studying the brain is to understand the connection between brain structure and function and behavioural outcomes. Since sex differences in brain morphology were first observed, subsequent studies suggest different functional organization of the male and female brains in humans. Sex and gender have been identified as being a significant factor in understanding human physiology, health and disease, and the biological differences between the sexes is not limited to the gonads and secondary sexual characteristics, but also affects the structure and, more crucially, the function of the brain and other organs. Significant variability in brain structures between individuals, in addition to between the sexes, is factor that complicates the study of sex differences in the brain. In this review, we explore the current understanding of sex differences in the brain, mostly focusing on preclinical animal studies.

  3. Sex Disparities in Stroke

    DEFF Research Database (Denmark)

    Dehlendorff, Christian; Andersen, Klaus Kaae; Olsen, Tom Skyhøj

    2015-01-01

    BACKGROUND: Uncertainty remains about whether stroke affects men and women similarly. We studied differences between men and women with regard to stroke severity and survival. METHODS AND RESULTS: We used the Danish Stroke Registry, with information on all hospital admissions for stroke in Denmark...... between 2003 and 2012 (N=79 617), and the Danish Register of Causes of Death. Information was available on age, sex, marital status, stroke severity, stroke subtype, socioeconomic status, and cardiovascular risk profile. We studied only deaths due to the index stroke, with the assumption that death...... reported on death certificates as due to stroke was related to the index stroke if death occurred within the first week or month after stroke. Multivariate Cox regression analysis and multiple imputation were applied. Stroke was the cause of death for 4373 and 5512 of the 79 617 patients within 1 week (5...

  4. Hepatitis C and sex.

    Science.gov (United States)

    Page, Emma E; Nelson, Mark

    2016-04-01

    An outbreak of acute hepatitis C among HIV-positive men who have sex with men (MSM) in the last decade has been shown to be sexually transmitted. Initially recreational drug use, in particular drug injection, was not prevalent among those becoming infected with hepatitis C. However more recently chemsex (the use of drugs to enhance sexual experience) and its associated drugs, which are not uncommonly injected, have become more frequently reported among those diagnosed with hepatitis C. It is hoped that the widespread -introduction of direct-acting antivirals and upscaling of numbers treated may have a positive impact on this epidemic. However their introduction may negatively impact on the perceived risk of acquiring hepatitis C and in conjunction with the introduction of HIV transmission prevention strategies may result in increased transmissions and spread to the HIV-negative MSM population.

  5. Sex in the Workplace

    Institute of Scientific and Technical Information of China (English)

    村边

    1996-01-01

    读西方出版物上写Sex的文章,我们的心难免会“咯噔”一下。而Sex in the Workplace(工作场合的性)一文却别开生面,值得一读。近年来,工作场合的“性骚扰”(Sexual Harassment)问题的议论也时占我报刊一隅,然比较而言,Sex in the Workplace一文剖精析微、辨证全面,更具警策性。诸如,文章谈及——As a woman, you’re responsible for the signals you send. And when you wear revealing miniskirts, the message men get is ’Look at me.’女性在工作场合着超短裙被认定不宜,本文对男性提出独到的劝言——Just as men often respond intensely to what women wear, women often react strongly to what men say. 在body language(身势语)一节,文章提及女性有25种以上的姿势在男性心目中是provocative(具有挑逗性)的;本文还认为:work intimacy(工作亲密)≠sexual intimacy(性亲密);末尾,本文提出:Before you tell a risque(有伤风化的)joke, ask yourself how your mother or wife might react. If you are wondering whether you should buy an off-color(黄色下流的)card for a male colleague, think about how your father or husband might feel. 这两句议论倒让读者联想到汉语“苦口婆心”之说。 全

  6. Mixed-Sex or Single-Sex Education: How Would Young People Like Their Sex Education and Why?

    Science.gov (United States)

    Strange, Vicki; Forrest, Simon; Oakley, Ann

    2003-01-01

    Examined adolescents views about sex education, specifically their views about interaction in single- and mixed-sex groups. Surveys of English secondary school students indicated that most girls, and one-third of boys, want some or all of their sex education to be delivered in single-sex groups. Girls' experiences of sex education with boys…

  7. The surgical treatment of cloaca.

    Science.gov (United States)

    Bischoff, Andrea

    2016-04-01

    Similar to other anorectal malformations, cloaca also represents a spectrum of defects that goes from "benign" cloaca with a good functional prognosis that can be repaired with a relatively simple surgical technique, to very complex malformations with many anatomic variations that require different surgical maneuvers to be able to successfully reconstruct those patients. The group of patients born with a "benign" type of cloaca will have bowel and urinary control, will become sexually active and may get pregnant and deliver by cesarean section. All this is possible, provided the malformation is repaired with a meticulous and delicate technique. Fortunately this represents more than 50% of all cloacas. Our belief is that the surgical technique to repair this group of defects is reproducible and can be taught to pediatric surgical trainees. On the other hand, complex cloaca with a common channel longer than 3 cm should be repaired by surgeons fully dedicated to repair these malformations. The experience reported in this paper is based on 570 patients with cloaca operated by Dr. Alberto Peña and the author in the last 8 years. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. Surgical treatment of primary hyperparathyroidism

    DEFF Research Database (Denmark)

    Brasso, K; Karstrup, S; Lundby, C M

    1994-01-01

    One hundred and two patients with primary hyperparathyroidism underwent a total of 108 bilateral neck explorations with attempted identification and biopsy of all four glands. Hypercalcaemia was surgically eliminated in 97 of 102 patients (95%). Of the remaining hypercalcaemic patients one was cu......--including bilateral neck exploration and attempted biopsies of all parathyroid glands--is safe with a high cure rate....

  9. Surgical Training in the Netherlands

    NARCIS (Netherlands)

    Borel Rinkes, I.H.M.; Gouma, D.J.; Hamming, J.F.

    2008-01-01

    Surgical training in the Netherlands has traditionally been characterized by learning on the job under the classic master-trainee doctrine. Over the past decades, it has become regionally organized with intensive structural training courses, and a peer-based quality control system. Recently, the nat

  10. Surgical smoke and infection control.

    NARCIS (Netherlands)

    Alp, E.; Bijl, D.; Bleichrodt, R.P.; Hansson, B.M.; Voss, A.

    2006-01-01

    Gaseous byproducts produced during electrocautery, laser surgery or the use of ultrasonic scalpels are usually referred to as 'surgical smoke'. This smoke, produced with or without a heating process, contains bio-aerosols with viable and non-viable cellular material that subsequently poses a risk of

  11. Posterior fossa meningioma (surgical experiences)

    African Journals Online (AJOL)

    Wael M. Moussa

    2012-08-27

    Aug 27, 2012 ... Morbidity included decreased level of consciousness, cranial nerve palsy and wound infection. ..... (10 cases), trigeminal nerve compression (6 cases), facial nerve .... and magnetic resonance imaging for surgical planning for menin- ... anatomy scanning in the operation of intracranial parasagittal.

  12. Surgical pearl: the temporary assistant.

    Science.gov (United States)

    Jacobs, Aleda A; Orengo, Ida F

    2008-04-15

    A simple maneuver is presented which simultaneously facilitates both adequate surgical site exposure and sufficient traction. A single suture with high tensile strength can be utilized to this end. This technique is especially helpful when the cutaneous surgeon is operating alone.

  13. Surgical options after Fontan failure

    DEFF Research Database (Denmark)

    van Melle, Joost P; Wolff, Djoeke; Hörer, Jürgen;

    2016-01-01

    OBJECTIVE: The objective of this European multicenter study was to report surgical outcomes of Fontan takedown, Fontan conversion and heart transplantation (HTX) for failing Fontan patients in terms of all-cause mortality and (re-)HTX. METHODS: A retrospective international study was conducted by...

  14. Surgical Lasers In Veterinary Medicine

    Science.gov (United States)

    Newman, H. C.

    1987-03-01

    Veterinary medicine is a latecomer in benefiting from the advent of surgical lasers. It is ironic that although most of the basic work in lasers is carried out in animal species with which we are most conversant, veterinary medicine as a profession has not been very extensively involved.

  15. Surgical management of tubal pregnancy

    NARCIS (Netherlands)

    Mol, F.

    2013-01-01

    The work presented in this thesis first addresses the magnitude of the clinical problem of surgically treated tubal pregnancy in The Netherlands. Next, we studied the adherence to recommendations from the Dutch guideline on diagnosis and management of ectopic pregnancy. A systematic review and meta-

  16. Surgical Treatment of Mirizzi Syndrome

    Directory of Open Access Journals (Sweden)

    Е.М. Goch

    2010-06-01

    Full Text Available The results of treatment of 53 patients with Mirizzi syndrome are presented in the work. The article focuses on the modern classification of syndrome, diagnostics and surgical approach according to the severity of duct damage. Mirizzi syndrome proves to be the complication of cholelithiasis. It is one of the most complicated problems of biliary surgery

  17. [Surgical education has its price].

    Science.gov (United States)

    Schröder, W; Krones, C J

    2012-04-01

    The radical economisation of the German health-care system has caused an increasing cost awareness. Following this trend, medical education has been identified as a possible expense factor. The theoretical and practical training of young doctors needs time and costs money. However, a detailed cost analysis is still not available, since the complex daily work schedule of young professionals only allows the calculation of single cost factors. Investigations in the USA estimate the costs of surgical training at US$ 80 000 per year and per resident. At present in Germany, surgical training is indirectly financed by the DRG flat rates of the health insurance companies. Possible alternatives include the implementation of a "training fond" which is financed by a percentage fee of the DRG's as well as an on-top funding by the federal government. This "training fond" would support only those surgical units that offer a structured and certified training to surgical residents. However, a systematic cost analysis of such a structured curriculum is necessary for any further discussion.

  18. Pseudothrombocytopenia in cardiac surgical practice.

    Science.gov (United States)

    Nair, Sukumaran K; Shah, Roma; Petko, Matus; Keogh, Bruce E

    2007-08-01

    Pseudothrombocytopenia is observed occasionally in post-cardiac surgical patients. It is commonly due to EDTA-mediated immunological mechanisms, which lead to agglutination of functionally intact platelets. This condition is harmless and does not warrant platelet transfusion. We describe an instance of pseudothrombocytopenia in our practice and discuss its clinical relevance.

  19. Surgical smoke and infection control.

    NARCIS (Netherlands)

    Alp, E.; Bijl, D.; Bleichrodt, R.P.; Hansson, B.M.; Voss, A.

    2006-01-01

    Gaseous byproducts produced during electrocautery, laser surgery or the use of ultrasonic scalpels are usually referred to as 'surgical smoke'. This smoke, produced with or without a heating process, contains bio-aerosols with viable and non-viable cellular material that subsequently poses a risk of

  20. Low Sex Drive in Women

    Science.gov (United States)

    Diseases and Conditions Low sex drive in women By Mayo Clinic Staff A woman's sexual desire naturally fluctuates over the years. Highs and lows commonly ... and anti-seizure medications also can cause low sex drive in women. If you have a persistent ...

  1. Sex Hormones and Ischemic Stroke

    DEFF Research Database (Denmark)

    Holmegard, Haya N; Nordestgaard, Børge G; Jensen, Gorm B

    2016-01-01

    CONTEXT AND OBJECTIVE: Whether endogenous sex hormones are associated with ischemic stroke (IS) is unclear. We tested the hypothesis that extreme concentrations of endogenous sex hormones are associated with risk of IS in the general population. DESIGN, SETTING, AND PARTICIPANTS: Adult men (n...

  2. Sex steroids and lipoprotein metabolism

    NARCIS (Netherlands)

    Gevers Leuven, J.A.

    1994-01-01

    Lipoprotein metabolism is involved in atherogenesis. Female sex-hormones have substantial effects on both lipoprotein metabolism and the vessel wall. Cholesterol, one of the major lipids in lipoproteins, is both the substrate for, and the target of, the steroidal sex hormones.

  3. [Sex-linked juvenile retinoschisis].

    Science.gov (United States)

    François, P; Turut, P; Soltysik, C; Hache, J C

    1976-02-01

    About 13 observations of sexe linked juvenile retinoschisis, the authors describe the ophthalmoscopic, fluorographic and functional aspects of the disease whose caracteristics are:--its sexe linked recessive heredity; --its clinical characterestics associating: a microcystic macular degeneration, peripheral retinal lesions, vitreous body alterations, --an electroretinogram of the negative type.

  4. Sex Differences and Individual Differences

    Science.gov (United States)

    Plomin, Robert; Foch, Terryl T.

    1981-01-01

    Sex differences and their relationship to individual differences were examined for Maccoby and Jacklin's sex differences summaries, for a diverse set of measures of specific cognitive abilities (including verbal ability), and for objective personality assessments of 216 school-age children. Average differences between groups appeared to be trivial…

  5. Sex Differences in Dichotic Listening

    Science.gov (United States)

    Voyer, Daniel

    2011-01-01

    The present study quantified the magnitude of sex differences in perceptual asymmetries as measured with dichotic listening. This was achieved by means of a meta-analysis of the literature dating back from the initial use of dichotic listening as a measure of laterality. The meta-analysis included 249 effect sizes pertaining to sex differences and…

  6. Teaching Sex Education in Thailand

    Science.gov (United States)

    Kay, Noy S.; Jones, Megan R.; Jantaraweragul, Sudgasame

    2010-01-01

    The purposes of this study were to examine the current situation pertaining to the teaching of sex education and identify barriers to teaching sex education among Thai health education teachers. A survey questionnaire was administered to 193 health education teachers who participated in this study. The questionnaire was comprised of three parts:…

  7. Moral Pluralism and Sex Education

    Science.gov (United States)

    Corngold, Josh

    2013-01-01

    How should common schools in a liberal pluralist society approach sex education in the face of deep disagreement about sexual morality? Should they eschew sex education altogether? Should they narrow its focus to facts about biology, reproduction, and disease prevention? Should they, in addition to providing a broad palette of information about…

  8. Surgical treatment of post-infarction left ventricular pseudoaneurysm: Case series highlighting various surgical strategies

    Directory of Open Access Journals (Sweden)

    Edvin Prifti, MD, PhD

    2017-04-01

    Conclusion: In conclusion, this study revealed that surgical repair of post infarct left ventricular pseudoaneurysm was associated with an acceptable surgical mortality rate, that cardiac rupture did not occur in surgically treated patients.

  9. Surgical Treatment in patients with impacted teeth in maxillofacial department Artemisa (1994-2010

    Directory of Open Access Journals (Sweden)

    Juan Carlos Quintana Díaz

    2015-08-01

    Full Text Available Objective: To determine the behavior of the dental retention in the patients with impacted teeth and surgically operated in the Maxillofacial Surgical Service at Ciro Redondo General and Educational Hospital during the period between 1994 to 2010. Materials and methods: A descriptive retrospective study. The universe of work was constituted by the 2.064 patients of both sexes surgically operated, for having impacted teeth, in the service and during the period between January of 1994 to December of 2010. Results: A total of 3.153 surgical interventions were performed. There was predominance of the female sex and of white-colored patients. The most affected age group was from 16 to 34 years old with a total of 1.521 patients both females and males constituting the 73,8% of the cases. Discussion: The most frequent indication of treatment was the pericoronaritis and the surgical removal was the treatment most utilized in the 90,5 % of the cases. 

  10. Surgical travellers: tapestry to Bayeux.

    Science.gov (United States)

    Hedley-Whyte, John; Milamed, Debra R

    2014-09-01

    The planning for surgery in war was revisited in 1937 when Ian Fraser was elected a member of the Surgical Travellers. At their 1938 Surgical Travellers meeting in Vienna, Ian and Eleanor Fraser were evicted from their hotel room by the Nazis. The 1939 meeting in Belfast discussed the organization of surgery and the conduct of Emergency Medical Service Hospitals in the United Kingdom; the vast majority were to be under civilian government and military control. From 1943 lengthy and informative organizational meetings were held at least monthly under the chairmanship of Sir Alexander Hood, KBE, Head of the RAMC. Surgical Consultants, now Major Generals, Brigadiers or Full Colonels in the British and U.S. Armies stationed in the UK, prepared for the invasion of Europe. The allocation of medical, surgical, nursing and auxiliary responsibilities was delineated. Liaison with the RAF and US Army Air Force was close as it was with the proposed leaders, Ulstermen Brooke and Montgomery. Montgomery chose Arthur Porritt as Surgeon in Chief to Supreme Headquarters Allied Expeditionary Force (SHAEF), and Eisenhower, General Albert W. Kenner. Just after D-Day, Porritt met Ian Fraser, who had waded in on Arromanches Beach. The triage and evacuation plans for Allied casualties had been controversial, particularly as regards Landing Ship Tanks (LSTs). The dispute with the Hood-selected surgeons on one side, against medical and surgical deployment of LSTs, and Admiral Ernest King and Winston Churchill on the other, favouring LST use for surgery and evacuation. King and Churchill were correct but total Allied air superiority allowed wide use of many of the Allies' Dakotas; 10,000 DC-3s were eventually in service. Supported by forty Allied combat planes to each Luftwaffe, the dispute about Landing Ship Tank use in about a fortnight became moot. The multifaceted role of the Princess Royal in the Emergency Medical Services of the United Kingdom and her close liaison with the Consultant

  11. Surgical management of chronic pancreatitis

    Institute of Scientific and Technical Information of China (English)

    Stavros Gourgiotis; Stylianos Germanos; Marco Pericoli Ridolifni

    2007-01-01

    BACKGROUND:Treatment of chronic pancreatitis (CP) is a challenging condition for surgeons. During the last decades, increasing knowledge about pathophysiology of CP, improved results of major pancreatic resections, and integration of sophisticated diagnostic methods in clinical practice have resulted in signiifcant changes in surgery for CP. DATA SOURCES:To detail the indications for CP surgery, the surgical procedures, and outcome, a Pubmed database search was performed. The abstracts of searched articles about surgical management of CP were reviewed. The articles could be identiifed and further scrutinized. Further references were extracted by cross-referencing. RESULTS: Main indications of CP for surgery are intractable pain, suspicion of malignancy, and involvement of adjacent organs. The goal of surgical treatment is to improve the quality of life of patients. The surgical approach to CP should be individualized according to pancreatic anatomy, pain characteristics, baseline exocrine and endocrine function, and medical co-morbidity. The approach usually involves pancreatic duct drainage and resection including longitudinal pancreatojejunostomy, pancreatoduodenectomy (Whipple's procedure), pylorus-preserving pancreatoduodenectomy, distal pancreatectomy, total pancreatectomy, duodenum-preserving pancreatic head resection (Beger's procedure), and local resection of the pancreatic head with longitudinal pancreatojejunostomy (Frey's procedure). Non-pancreatic and endoscopic management of pain has also been advocated. CONCLUSIONS:Surgical procedures provide long-term pain relief, a good postoperative quality of life with preservation of endocrine and exocrine pancreatic function, and are associated with low early and late mortality and morbidity. In addition to available results from randomized controlled trials, new studies are needed to determine which procedure is the most effective for the management of patients with CP.

  12. Sex differences in primary hypertension

    Science.gov (United States)

    2012-01-01

    Men have higher blood pressure than women through much of life regardless of race and ethnicity. This is a robust and highly conserved sex difference that it is also observed across species including dogs, rats, mice and chickens and it is found in induced, genetic and transgenic animal models of hypertension. Not only do the differences between the ovarian and testicular hormonal milieu contribute to this sexual dimorphism in blood pressure, the sex chromosomes also play a role in and of themselves. This review primarily focuses on epidemiological studies of blood pressure in men and women and experimental models of hypertension in both sexes. Gaps in current knowledge regarding what underlie male-female differences in blood pressure control are discussed. Elucidating the mechanisms underlying sex differences in hypertension may lead to the development of anti-hypertensives tailored to one's sex and ultimately to improved therapeutic strategies for treating this disease and preventing its devastating consequences. PMID:22417477

  13. Constructions of Sex and Gender

    DEFF Research Database (Denmark)

    Schleicher, Marianne

    2011-01-01

    Responding to the ethical and performative call of Judith Butler not to propagate the sex- and gender-related violence of the imbedded discourse that we study, this article inquires into the discursive strategies of Jewish scripture by analysing how it orchestrates certain norms of sex and gender...... and make them serve the overall aim of securing cultural survival. Following this, it traces reflections on persons of ambiguous or indeterminate sex from rabbinic to modern Judaism so as to inquire into the rabbinic dependency on scripture when non-conforming individuals challenge its bipolar sex...... Jews and non-Jews are able to influence their own representations of sex and gender and thus liberate themselves from the normativity implied by scriptural discourse....

  14. Same sex families and children

    Directory of Open Access Journals (Sweden)

    Mršević Zorica

    2009-01-01

    Full Text Available Introduction comprises the information on two main forms of same sex families, civic partnership (same sex partnership and same sex marriage. Countries and various status modalities of legal regulations are mentioned. The main part of the text is dedicated to presentation of the findings of the most recent research on various aspects regarding children of same sex partnerships. It comprises presentations grouped in four main chapters: acceptance of same sex partnerships, acceptance of legal recognition of the same sex partnerships, family plans of homosexual teenagers, and raising children within and by the same sex partners. Also the real life cases mirroring legal changes through their life destinies are presented, such is e.g. the Irish way to legalization of the same sex partnerships. In addition, a love story of two women crowned by giving birth of their four children is mentioned. Reasons against and negative reactions the author puts under the title Homophobia. In the Concluding remarks, the author presents the most recent examples of legal changes happened in Norway, Ecuador, and in the American states of California and Connecticut. It was also stated that in European countries of low birth rate, the same sex families are inevitably identified as one of demographically valuable source of creating and raising children, which is worthy to be supported, rather than being hindered without reason and discriminated. Although different than a model of heterosexual family, same sex partnerships neither are harrowing to traditional family values, nor reflex of any kind of promiscuous, antisocial behavior, avoidance of parenthood, and negation of family. Quite opposite, these families are an outcome of endeavors of homosexuals not to be deprived of family, parenthood and all of other values of stabile, monogamous, emotional/sexual socially accepted and legally recognized and regulated conventional family. .

  15. Mortality in asymptomatic vs. symptomatic patients surgically treated for non-small cell lung cancer (NSCLC)

    DEFF Research Database (Denmark)

    Madsen, Kirsten Riis; Bødtger, Uffe

    ’s index of co-morbidity, FEV1, former malignancy, symptoms at time of diagnosis, pre- and post-surgical TNM stage, and 12-months mortality post-surgery were recorded. Results: 130 patients were included: 51 (39%) asymptomatic and 79 symptomatic at NSCLC diagnosis with no differences concerning age, sex......, tobacco pack years, or FEV1. Former malignancy was significantly more prevalent among asymptomatic than symptomatic subjects (33 % vs. 11%), with insignificant differences in prevalence of other co-morbidities or in post-surgical TNM (82% vs 85% in stages IA-IIB). 12-months mortality was insignificantly...

  16. Surgical management of 143 patients with adult primary retroperitoneal tumor

    Institute of Scientific and Technical Information of China (English)

    Yuan-Hong Xu; Ke-Jian Guo; Ren-Xuan Guo; Chun-Lin Ge; Yu-Lin Tian; San-Guang He

    2007-01-01

    AIM: To analyze the surgical management of adult primary retroperitoneal tumors (APRT) and the factors influencing the outcome after operation.METHODS: Data of 143 cases of APRT from 1990 to 2003 in the First Affiliated Hospital of China Medical University were evaluated retrospectively.RESULTS: A total of 143 cases of APRT were treated surgically. Among them, 122 (85.3%) underwent complete resection, 16 (11.2%) incomplete resection,and 3 (3%) surgical biopsies. Twenty-nine (20.2%)underwent tumor resection plus multiple organ resections. Ninety-five malignant cases were followed up for 1 mo to 5 years. The 1-year, 3-year, and 5-year survival rates of the patients subject to complete resection was 94.9%, 76.6% and 34.3% and that of patients with incomplete resection was 80.4%, 6.7%,and 0%, respectively (P < 0.001). The Cox multi-various regression analysis showed the completeness of tumor,sex and histological type were associated closely with local recurrence.CONCLUSION: Sufficient preoperative preparation and complete tumor resection play important roles in reducing recurrence and improving survival.

  17. Development of AR Surgical Navigation Systems for Multiple Surgical Regions.

    Science.gov (United States)

    Suzuki, Naoki; Hattori, Asaki; Iimura, Jiro; Otori, Nobuyoshi; Onda, Shinji; Okamoto, Tomoyoshi; Yanaga, Katsuhiko

    2014-01-01

    The purpose of our research is to develop surgical navigation systems to enhance surgical safety. Our systems make use of augmented reality technology to superimpose, on the surgery screen on a real time basis, patients' organ models reconstructed in 3D from their X-ray CT data taken before surgery. By doing so, the systems display anatomical risk materials, tumors and blood vessels which surgeons cannot see with their naked eyes. This will in turn lead to surgeons intuitively grasping the inner structures of the operational fields. We so far have been developing navigation systems that can conduct surgeries in various fields. The basic structure of the navigation systems are the same. The navigation systems uses different peripheral equipment and different methods to display navigation images which best meet the demands of each type of surgery. In this thesis, we report on our navigation systems for 2 types of surgery - endoscopic sinus surgery and hepatobilialy-pancreatic surgery.

  18. Radiation-induced bystander effects in vivo are sex specific

    Energy Technology Data Exchange (ETDEWEB)

    Koturbash, Igor; Kutanzi, Kristy; Hendrickson, Karl; Rodriguez-Juarez, Rocio; Kogosov, Dmitry [Department of Biological Sciences, University of Lethbridge, Alberta T1K 3M4 (Canada); Kovalchuk, Olga [Department of Biological Sciences, University of Lethbridge, Alberta T1K 3M4 (Canada)], E-mail: olga.kovalchuk@uleth.ca

    2008-07-03

    Ionizing radiation (IR) effects span beyond the area of direct exposure and can be observed in neighboring and distant naive cells and organs. This phenomenon is termed a 'bystander effect'. IR effects in directly exposed tissue in vivo are epigenetically mediated and distinct in males and females. Yet, IR-induced bystander effects have never been explored in a sex-specificity domain. We used an in vivo mouse model, whereby the bystander effects are studied in spleen of male and female animals subjected to head exposure when the rest of the body is protected by a medical-grade lead shield. We analyzed the induction of DNA damage and alterations in global DNA methylation. Molecular parameters were correlated with cellular proliferation and apoptosis levels. The changes observed in bystander organs are compared to the changes in unexposed animals and animals exposed to predicted and measured scatter doses. We have found the selective induction of DNA damage levels, global DNA methylation, cell proliferation and apoptosis in exposed and bystander spleen tissue of male and female mice. Sex differences were significantly diminished in animals subjected to a surgical removal of gonads. These data constitute the first evidence of sex differences in radiation-induced bystander effects in mouse spleen in vivo. We show the role of sex hormones in spleen bystander responses and discuss implications of the observed changes.

  19. A sex difference in the hypothalamic uncinate nucleus: relationship to gender identity.

    Science.gov (United States)

    Garcia-Falgueras, Alicia; Swaab, Dick F

    2008-12-01

    Transsexuality is an individual's unshakable conviction of belonging to the opposite sex, resulting in a request for sex-reassignment surgery. We have shown previously that the bed nucleus of the stria terminalis (BSTc) is female in size and neuron number in male-to-female transsexual people. In the present study we investigated the hypothalamic uncinate nucleus, which is composed of two subnuclei, namely interstitial nucleus of the anterior hypothalamus (INAH) 3 and 4. Post-mortem brain material was used from 42 subjects: 14 control males, 11 control females, 11 male-to-female transsexual people, 1 female-to-male transsexual subject and 5 non-transsexual subjects who were castrated because of prostate cancer. To identify and delineate the nuclei and determine their volume and shape we used three different stainings throughout the nuclei in every 15th section, i.e. thionin, neuropeptide Y and synaptophysin, using an image analysis system. The most pronounced differences were found in the INAH3 subnucleus. Its volume in thionin sections was 1.9 times larger in control males than in females (P INAH3 volume and number of neurons of male-to-female transsexual people is similar to that of control females. The female-to-male transsexual subject had an INAH3 volume and number of neurons within the male control range, even though the treatment with testosterone had been stopped three years before death. The castrated men had an INAH3 volume and neuron number that was intermediate between males (volume and number of neurons P > 0.117) and females (volume P > 0.245 and number of neurons P > 0.341). There was no difference in INAH3 between pre-and post-menopausal women, either in the volume (P > 0.84) or in the number of neurons (P INAH3 of male-to-female transsexuals was not due to estrogen treatment. We propose that the sex reversal of the INAH3 in transsexual people is at least partly a marker of an early atypical sexual differentiation of the brain and that the changes in

  20. The effect of antibiotic irrigation of surgical Incisions in prevention of Surgical Site Infection

    Directory of Open Access Journals (Sweden)

    Mirsharifi S R

    2008-05-01

    Full Text Available Background: surgical site infection is one of the most common post operative complications alongside with sepsis, cardiovascular, pulmonary and thromboembolic complications. The development of surgical site infection is related to three factors: the degree of microbial contamination of the wound during surgery, the duration of the procedure, and host factors such as diabetes, malnutrition, obesity, immune suppression, and a number of other underlying disease states. The purpose of this study was to evaluate the effects of topical cephazolin in controlling infection of the site of surgery after non-laparoscopic cholecystecomy.Methods: One hundred and two of patients referred to the outpatient clinic of Imam Khomeini Hospital from fall 2005 to fall 2006 non- laparoscopic cholecystectomy enrolled in a randomized clinical trial. All patients underwent the same procedure of anesthesia and surgery and they were randomly assigned into two groups of cases with irrigation of the site of surgery with 1g of topical Cephazolin prior to the termination of the operation- and controls. Cephazolin is a first generation cephalosporin which binds penicillin binding protein and is a potent cell wall synthesis inhibitor. The patients were followed up for six weeks for symptoms and signs of infection including discharge of the wound; and presence of pain, warmness, swelling and erythema of the wound.Results: There were no significant differences between two study groups regarding mean age, duration of operation, and sex. There was no significant difference in the incidence of infection of the site of surgery (11.8% in both groups with p=0.99 between two groups.Conclusion: Analyzing the collected data confirms that prophylactic use of topical cephazolin was unable to decrease the risk of infection of the site of surgery in patients undergoing non- laparascopic cheolecystectomy.

  1. Talk to Your Kids about Sex

    Science.gov (United States)

    ... Topic En español Talk to Your Kids about Sex Browse Sections The Basics Overview Bodies and Puberty ... healthy expectations for their relationships. Talk about opposite-sex and same-sex relationships. When you talk about ...

  2. Surgical and Nonsurgical Management of Bilateral Periapical ...

    African Journals Online (AJOL)

    Journal of Surgical Technique and Case Report | Jan-Jun 2011 | Vol-3 | Issue-1. 44. Surgical .... incisor and canine. Same was ... The operative field was isolated, and access preparation .... environment in which periapical healing can occur.

  3. Surgical intervention in patients with necrotizing pancreatitis

    NARCIS (Netherlands)

    Besselink, MG; de Bruijn, MT; Rutten, JP; Boermeester, MA; Hofker, HS; Gooszen, HG

    2006-01-01

    Background: This study evaluated the various surgical strategies for treatment of (suspected) infected necrotizing pancreatitis (INP) and patient referrals for this condition in the Netherlands. Methods: This retrospective study included all 106 consecutive patients who had surgical treatment for IN

  4. Sex Education: Talking to Your Teen about Sex

    Science.gov (United States)

    ... contraception and safe sex. The doctor may also stress the importance of routine human papillomavirus (HPV) vaccination, for both girls and boys, to help prevent genital warts as well as cancers of the cervix, anus, ...

  5. Sex in the brain: hormones and sex differences.

    Science.gov (United States)

    Marrocco, Jordan; McEwen, Bruce S

    2016-12-01

    Contrary to popular belief, sex hormones act throughout the entire brain of both males and females via both genomic and nongenomic receptors. Many neural and behavioral functions are affected by estrogens, including mood, cognitive function, blood pressure regulation, motor coordination, pain, and opioid sensitivity. Subtle sex differences exist for many of these functions that are developmentally programmed by hormones and by not yet precisely defined genetic factors, including the mitochondrial genome. These sex differences, and responses to sex hormones in brain regions and upon functions not previously regarded as subject to such differences, indicate that we are entering a new era in our ability to understand and appreciate the diversity of gender-related behaviors and brain functions.

  6. Surgical skin-marking techniques.

    Science.gov (United States)

    Granick, M S; Heckler, F R; Jones, E W

    1987-04-01

    Surgical skin-marking inks and dyes are in everyday use for designing and planning incisions in plastic and reconstructive surgery. We have traced the historical development of surgical skin-marking techniques from ancient times to the present. The biochemical characteristics of the commonly used marking agents are discussed. A three-part experiment utilizing a pig model was carried out to test the tissue inflammatory response to the various dyes and inks when used intradermally as tattoos, the persistence of such tattoos, and the ease of skin erasure for each of eight stains. Methylene blue and gentian violet are recommended as the best all-purpose marking agents. The use of proprietary inks is discouraged.

  7. Surgical considerations about amyloid goiter.

    Science.gov (United States)

    García Villanueva, Augusto; García Villanueva, María Jesús; García Villanueva, Mercedes; Rojo Blanco, Roberto; Collado Guirao, María Vicenta; Cabañas Montero, Jacobo; Beni Pérez, Rafael; Moreno Montes, Irene

    2013-05-01

    Amyloidosis is an uncommon syndrome consisting of a number of disorders having in common an extracellular deposit of fibrillary proteins. This results in functional and structural changes in the affected organs, depending on deposit location and severity. Amyloid infiltration of the thyroid gland may occur in 50% and up to 80% of patients with primary and secondary amyloidosis respectively. Amyloid goiter (AG) is a true rarity, usually found associated to secondary amyloidosis. AG may require surgical excision, usually because of compressive symptoms. We report the case of a patient with a big AG occurring in the course of a secondary amyloidosis associated to polyarticular onset juvenile idiopathic arthritis who underwent total thyroidectomy. Current literature is reviewed, an attempt is made to provide action guidelines, and some surgical considerations on this rare condition are given.

  8. Sushruta: Foundation for Surgical Practice

    Directory of Open Access Journals (Sweden)

    Siddharth P. Dubhashi

    2016-04-01

    Full Text Available Sushruta was an ancient Indian surgeon (600 B.C. who resided in Varanasi.The teachings and work of Sushruta is compiled in a treatise called Sushruta Samhita (Sushruta's compendium, which is believed to be a part of Atharvaveda. It contains 184 chapters, descriptions of 1,120 illnesses, 300 surgical procedures, classification of human surgery in 8 categories, over 120 surgical instruments and around 700 drugs of animal, plant and mineral origin. Sushruta was one of the earliest exponents of surgery as an art and science. Sushruta's principles and teachings took surgery in ancient India to a noteworthy pedestal, making it the Golden Age of Surgery. He is truly the “Father of Surgery” and “Father of Plastic Surgery”. It is extremely essential that we put his principles into practice, and preserve the dignity of our noble profession. That would be the ideal tribute to this legendary figure.

  9. Surgical training in the Netherlands.

    Science.gov (United States)

    Borel-Rinkes, Inne H M; Gouma, Dirk J; Hamming, Jaap F

    2008-10-01

    Surgical training in the Netherlands has traditionally been characterized by learning on the job under the classic master-trainee doctrine. Over the past decades, it has become regionally organized with intensive structural training courses, and a peer-based quality control system. Recently, the nationwide programme has been modernized further and now involves a systematic, competency-based education with structural training courses, formalized assessment and room for reflection by residents under the supervision of surgical teaching groups. To this end, a uniform web-based digital portfolio is being introduced to facilitate monitoring of the individual resident's progress. Though requiring inspirational leadership, commitment, and determination, this modernization has sparked enthusiasm among trainees and teachers.

  10. Surgical tools and medical devices

    CERN Document Server

    Jackson, Mark

    2016-01-01

    This new edition presents information and knowledge on the field of biomedical devices and surgical tools. The authors look at the interactions between nanotechnology, nanomaterials, design, modeling, and tools for surgical and dental applications, as well as how nanostructured surfaces can be created for the purposes of improving cell adhesion between medical devices and the human body. Each original chapter is revised in this second edition and describes developments in coatings for heart valves, stents, hip and knee joints, cardiovascular devices, orthodontic applications, and regenerative materials such as bone substitutes. There are also 8 new chapters that address: Microvascular anastomoses Inhaler devices used for pulmonary delivery of medical aerosols Surface modification of interference screws Biomechanics of the mandible (a detailed case study) Safety and medical devices The synthesis of nanostructured material Delivery of anticancer molecules using carbon nanotubes Nano and micro coatings for medic...

  11. [Surgical treatment of paralytic lagophthalmos].

    Science.gov (United States)

    Schrom, T; Bast, F

    2010-03-01

    Impairment of the peripheral or central part of the facial nerve causes an ipsilateral peripheral facial nerve paresis. It is quite a common syndrome and affects 20-35 persons per 100,000 per year in Western Europe and the United States. A possible complication of facial palsy is paralytic lagophthalmos with aesthetic and functional impairment for the patient. Beside primary nerve reconstructive procedures plastic-reconstructive procedures play a major role in correcting paralytic lagophthalmos. The eyebrow, upper and lower lids, medial and lateral lid angle as well as the lacrimal system need to be seen as functional units and can be corrected with local surgical procedures. Restoration of eye closure is the most important goal in treating the affected eye. Due to the significant aesthetic limitations and resultant psychological stress for the patient cosmetic aspects must be included in the surgical concept.

  12. Whose crazy investment in sex?

    Science.gov (United States)

    Mandlis, Lane R

    2011-01-01

    By probing the processes of exclusion of transsexuals from the political sphere, this article offers contributions to social and political theory through an examination of the processes of exclusion from the category "human." This article considers how the erasure of investment in their own embodied sex constructs a platform from which to blame others for sex/gender variance, as well as to justify that blaming. Bringing together Giorgio Agamben, Georges Bataille, Judith Butler, and Nikolas Rose with transphobia, medicalization in psychiatry, law, and ethopolitics, this article questions whose investment in sexed embodiment counts and why that investment might be seen as "crazy."

  13. A New Surgical Technique for Ingrown Toenail

    OpenAIRE

    Seyed Reza Mousavi; Jaledin Khoshnevice

    2012-01-01

    Background. Ingrowing toenails are a common condition which, when recurrent and painful, are often treated surgically. The aim of this study is to present a new simple surgical technique for ingrown toenails with good results. Method and Patients. The selected 250 patients with affected toes were surgically treated by our technique and observed from 1998 to 2004. Marginal nail elevation combined with surgical excision of the granulation tissue was more successful. For fixing the nail margin o...

  14. 68 INVITED Personalized surgical treatment for sarcoma

    National Research Council Canada - National Science Library

    Hohenberger, P

    2007-01-01

    ... belongtothemodernsurgicalapproachinthebattleagainstlocalisedand locallyadvancedprostatecancer. 67 INVITED Personalized surgical treatment for early breast cancer E.Rutgers. The Netherlands Cancer Institute, Department...

  15. Aesthetic Surgical Crown Lengthening Procedure

    OpenAIRE

    2015-01-01

    The aim of this case report was to describe the surgical sequence of crown lengthening to apically reposition the dentogingival complex, in addition to an esthetic restorative procedure. Many different causes can be responsible for short clinical crown. In these cases, the correct execution of a restorative or prosthetic rehabilitation requires an increasing of the crown length. According to the 2003 American Academy of Periodontology (Practice Profile Survey), crown lengthening is the most h...

  16. Surgical checklists: the human factor.

    LENUS (Irish Health Repository)

    O Connor, Paul

    2013-05-14

    BACKGROUND: Surgical checklists has been shown to improve patient safety and teamwork in the operating theatre. However, despite the known benefits of the use of checklists in surgery, in some cases the practical implementation has been found to be less than universal. A questionnaire methodology was used to quantitatively evaluate the attitudes of theatre staff towards a modified version of the World Health Organisation (WHO) surgical checklist with relation to: beliefs about levels of compliance and support, impact on patient safety and teamwork, and barriers to the use of the checklist. METHODS: Using the theory of planned behaviour as a framework, 14 semi-structured interviews were conducted with theatre personnel regarding their attitudes towards, and levels of compliance with, a checklist. Based upon the interviews, a 27-item questionnaire was developed and distribute to all theatre personnel in an Irish hospital. RESULTS: Responses were obtained from 107 theatre staff (42.6% response rate). Particularly for nurses, the overall attitudes towards the effect of the checklist on safety and teamworking were positive. However, there was a lack of rigour with which the checklist was being applied. Nurses were significantly more sensitive to the barriers to the use of the checklist than anaesthetists or surgeons. Moreover, anaesthetists were not as positively disposed to the surgical checklist as surgeons and nurse. This finding was attributed to the tendency for the checklist to be completed during a period of high workload for the anaesthetists, resulting in a lack of engagement with the process. CONCLUSION: In order to improve the rigour with which the surgical checklist is applied, there is a need for: the involvement of all members of the theatre team in the checklist process, demonstrated support for the checklist from senior personnel, on-going education and training, and barriers to the implementation of the checklist to be addressed.

  17. [Surgical anatomy of the nose].

    Science.gov (United States)

    Nguyen, P S; Bardot, J; Duron, J B; Jallut, Y; Aiach, G

    2014-12-01

    Thorough knowledge of the anatomy of the nose is an essential prerequisite for preoperative analysis and the understanding of surgical techniques. Like a tent supported by its frame, the nose is an osteo-chondral structure covered by a peri-chondroperiosteal envelope, muscle and cutaneous covering tissues. For didactic reasons, we have chosen to treat this chapter in the form of comments from eight key configurations that the surgeon should acquire before performing rhinoplasty.

  18. [Surgical options in ulcerative colitis].

    Science.gov (United States)

    Hultén, L; Ecker, K W

    1998-01-01

    Surgery is needed in every second patient with pancolitis. Historically four surgical options have been developed: conventional ileostomy, ileorectostomy, continent ileostomy (Kock's pouch) and ileo-anal pouch. However, in emergent or unclear situations subtotal colectomy, ileostomy and preservation of the rectum is the most suitable operation. After recovery and in elective indications proctectomy and proctocolectomy establish the general surgical standard. Today, in most cases ileo-pouch-anal anastomosis is performed instead of creation of an ileostomy. Both lowered frequency of defecation and acceptable continence contribute to a better quality of life. However, functional disturbances are not uncommon and result in most cases from complications of the demanding technique. Definitive cure of the colitis is in interference with the risk of pouchitis in about 30%. The cumulative probability to loose the pouch may rise to 15-20% in the long-term course. Thus, ileorectostomy may be considered as a first step of surgical treatment, since pelvic nerve damage is excluded, function is much better and persistent proctitis can be treated topically. The attractively is that ileo-anal pouch can be performed later on, when decreasing function and increasing risk of malignant change will eventually require proctectomy. A Kock-pouch is seldom considered, especially in patients with ileostomy wishing sure fecal control. But the continent reservoir becomes more and more interesting again since it can be reconstructed from a failed ileo-anal pouch without loss of bowel. Conventional ileostomy should be reserved for patients not suitable for reconstructive methods or those who consider pough operations risk. However, it is the safest procedure with absolute cure of disease. The optimal choice of method considers medical and surgical aspects as well as patients conception and desire.

  19. Towards MRI guided surgical manipulator.

    Science.gov (United States)

    Chinzei, K; Miller, K

    2001-01-01

    The advantages of surgical robots and manipulators are well recognized in the clinical and technical community. Precision, accuracy and the potential for telesurgery are the prime motivations in applying advanced robot technology in surgery. In this paper critical interactions between Magnetic Resonance Imaging equipment and mechatronic devices are discussed and a novel Magnetic Resonance compatible surgical robot is described. Experimental results of the effects from several passive (metallic materials) and active (ultrasound motors) mechanical elements are demonstrated. The design principles for Magnetic Resonance compatible robots are established and the compatibility of the proposed robot is assessed by comparing images taken with and without the robot's presence within Signa SP/I GE Medical Systems scanner. The results showed that, in principle, it is possible to construct precision mechatronic devices intended to operate inside MR scanner. Use of such a device will not cause image shift or significant degradation of signal-to-noise-ratio. An MR compatible surgical assist robot was designed and constructed. The robot is not affected by the presence of strong magnetic fields and is able to manoeuvre during imaging without compromising the quality of images. A novel image-guided robot control scheme was proposed. As a part of the control scheme, biomechanics-based organ deformation model was constructed and validated by in-vivo experiment. It has been recognised that for robust control of an image guided surgical robot the precise knowledge of the mechanical properties of soft organs operated on must be known. As an illustration, results in mathematical modelling and computer simulation of brain deformation are given. The novel MR compatible robot was designed to position and direct an axisymmetric tool, such as a laser pointer or a biopsy catheter. New Robot control system based on the prediction of soft organ deformation was proposed.

  20. Surgical smoke and ultrafine particles

    Directory of Open Access Journals (Sweden)

    Nowak Dennis

    2008-12-01

    Full Text Available Abstract Background Electrocautery, laser tissue ablation, and ultrasonic scalpel tissue dissection all generate a 'surgical smoke' containing ultrafine ( Methods To measure the amount of generated particulates in 'surgical smoke' during different surgical procedures and to quantify the particle number concentration for operation room personnel a condensation particle counter (CPC, model 3007, TSI Inc. was applied. Results Electro-cauterization and argon plasma tissue coagulation induced the production of very high number concentration (> 100000 cm-3 of particles in the diameter range of 10 nm to 1 μm. The peak concentration was confined to the immediate local surrounding of the production side. In the presence of a very efficient air conditioning system the increment and decrement of ultrafine particle occurrence was a matter of seconds, with accumulation of lower particle number concentrations in the operation room for only a few minutes. Conclusion Our investigation showed a short term very high exposure to ultrafine particles for surgeons and close assisting operating personnel – alternating with longer periods of low exposure.

  1. Ethical issues in surgical innovation.

    Science.gov (United States)

    Miller, Megan E; Siegler, Mark; Angelos, Peter

    2014-07-01

    Innovation is responsible for most advances in the field of surgery. Innovative approaches to solving clinical problems have significantly decreased morbidity and mortality for many surgical procedures, and have led to improved patient outcomes. While innovation is motivated by the surgeon's expectation that the new approach will be beneficial to patients, not all innovations are successful or result in improved patient care. The ethical dilemma of surgical innovation lies in the uncertainty of whether a particular innovation will prove to be a "good thing." This uncertainty creates challenges for surgeons, patients, and the healthcare system. By its very nature, innovation introduces a potential risk to patient safety, a risk that may not be fully known, and it simultaneously fosters an optimism bias. These factors increase the complexity of informed consent and shared decision making for the surgeon and the patient. Innovative procedures and their associated technology raise issues of cost and resource distribution in the contemporary, financially conscious, healthcare environment. Surgeons and institutions must identify and address conflicts of interest created by the development and application of an innovation, always preserving the best interest of the patient above the academic or financial rewards of success. Potential strategies to address the challenges inherent in surgical innovation include collecting and reporting objective outcomes data, enhancing the informed consent process, and adhering to the principles of disclosure and professionalism. As surgeons, we must encourage creativity and innovation while maintaining our ethical awareness and responsibility to patients.

  2. Surgical treatment for myelodysplastic clubfoot,

    Directory of Open Access Journals (Sweden)

    Alexandre Zuccon

    2014-12-01

    Full Text Available Objective:To analyze the results from surgical treatment of 69 cases of clubfoot in 43 patients with myelodysplasia according to clinical and radiographic criteria, at our institution between 1984 and 2004.Methods:This was a retrospective study involving analysis of medical files, radiographs and consultations relating to patients who underwent surgical correction of clubfoot. The surgical technique consisted of radical posteromedial and lateral release with or without associated talectomy.Results:The patients' mean age at the time of the surgery was four years and two months, and the mean length of postoperative follow-up was seven years and two months. Satisfactory results were achieved in 73.9% of the feet and unsatisfactory results in 26.1% (p < 0.0001.Conclusion:Residual deformity in the immediate postoperative period was associated with unsatisfactory results. Opening of the Kite (talocalcaneal angle in feet that only underwent posteromedial and lateral release, along with appropriate positioning of the calcaneus in cases that underwent talectomy, was the radiographic parameter that correlated with satisfactory results.

  3. Simulation-based surgical education.

    Science.gov (United States)

    Evgeniou, Evgenios; Loizou, Peter

    2013-09-01

    The reduction in time for training at the workplace has created a challenge for the traditional apprenticeship model of training. Simulation offers the opportunity for repeated practice in a safe and controlled environment, focusing on trainees and tailored to their needs. Recent technological advances have led to the development of various simulators, which have already been introduced in surgical training. The complexity and fidelity of the available simulators vary, therefore depending on our recourses we should select the appropriate simulator for the task or skill we want to teach. Educational theory informs us about the importance of context in professional learning. Simulation should therefore recreate the clinical environment and its complexity. Contemporary approaches to simulation have introduced novel ideas for teaching teamwork, communication skills and professionalism. In order for simulation-based training to be successful, simulators have to be validated appropriately and integrated in a training curriculum. Within a surgical curriculum, trainees should have protected time for simulation-based training, under appropriate supervision. Simulation-based surgical education should allow the appropriate practice of technical skills without ignoring the clinical context and must strike an adequate balance between the simulation environment and simulators.

  4. Control tower to surgical theater

    Directory of Open Access Journals (Sweden)

    Buccioli Matteo

    2016-09-01

    Full Text Available The main social priority is to reduce public debt and to streamline national health service (NHS costs. Consequently, health managers need to acquire operating methods within their managerial structures so that all available resources are better planned in terms of effectiveness and efficiency, without compromising patient safety. In order to identify the information categories needed to know the whole surgical process is necessary to divide these in two main categories, supply and demand. Demand Information Group (DIG contains the information that identify patients and its needs in terms of care. Instead Supply Information Group (SIG contains information about hospital resources in order to cover the supply. The surgical process analyzed in terms such as industrial production process has the goal of produce the “health product for the patient” and its central part is performed in the operating room by a surgical team. This does not mean that the precedent and subsequent phases of the operating room have minor importance, in fact to obtain a high quality “health product” and reduce to a minimum the clinical risks related to the patient it is necessary that each phase of the process is carried out in the right way. The implementation of a Control Tower Approach allows for the management of productive process, able to guide hospital managers to identify the best strategies and to improve the risk management of patient safety in response to the guidelines of the World Health Organization.

  5. Decision making in surgical oncology.

    Science.gov (United States)

    Lamb, B; Green, J S A; Vincent, C; Sevdalis, N

    2011-09-01

    Decisions in surgical oncology are increasingly being made by multi-disciplinary teams (MDTs). Although MDTs have been widely accepted as the preferred model for cancer service delivery, the process of decision making has not been well described and there is little evidence pointing to the ideal structure of an MDT. Performance in surgery has been shown to depend on non-technical skills, such as decision making, as well as patient factors and the technical skills of the healthcare team. Application of this systems approach to MDT working allows the identification of factors that affect the quality of decision making for cancer patients. In this article we review the literature on decision making in surgical oncology and by drawing from the systems approach to surgical performance we provide a framework for understanding the process of decision making in MDTs. Technical factors that affect decision making include the information about patients, robust ICT and video-conferencing equipment, a minimum dataset with expert review of radiological and pathological information, implementation and recording of the MDTs decision. Non-technical factors with an impact on decision making include attendance of team members at meetings, leadership, teamwork, open discussion, consensus on decisions and communication with patients and primary care. Optimising these factors will strengthen the decision making process and raise the quality of care for cancer patients.

  6. Surgical Treatment for Hepatocellular Carcinoma

    Directory of Open Access Journals (Sweden)

    Ahmad A Madkhali

    2015-01-01

    Full Text Available Hepatocellular carcinoma (HCC is an epithelial tumor derived from hepatocytes; it accounts for 80% of all primary liver cancers and ranks globally as the fourth leading cause of cancer-related deaths. HCC treatment is a multidisciplinary and a multimodal task, with surgery in the form of liver resection and liver transplantation (LT representing the only potentially curative modality. However, there are variable opinions and discussions about applying these surgical options and using other supporting treatments. This article is a narrative review that includes articles published from 1984 to 2013 located by searching scientific databases such as PubMed, SCOPUS, and Elsevier, with the main keyword of hepatocellular carcinoma in addition to other keywords such as liver transplantation, liver resection, transarterial chemoembolization, portal vein embolization, bridging therapy, and downstaging. In this review, we focus mainly on the surgical treatment options offered for HCC, in order to illustrate the current relevant data available in the literature to help in applying these surgical options and to use other supporting treatment modalities when appropriate.

  7. Career satisfaction of surgical specialties.

    Science.gov (United States)

    Deshpande, Satish P; Deshpande, Sagar S

    2011-05-01

    To examine the factors that impact career satisfaction for various surgical specialties. An acute shortage of surgeons is anticipated in the future. Career dissatisfaction can make this already difficult situation worse. It is important to understand and address factors that influence career satisfaction of surgeons to prolong tenure of existing surgeons and understand anticipated needs of future surgeons. The Center for Studying Health System Change 2008 Health Tracking Physician Survey data were used in this study. Regression analysis was done to examine the impact of various practice-related factors, compensation-related factors, practice location, extent of minority patient, and various demographics on career satisfaction of various surgical specialties (n = 762). Among practice related factors, although threat of malpractice had a significant negative impact on career satisfaction, ability to provide quality care to patients and time with patients had a significant positive impact on career satisfaction of surgical specialists. Among compensation related factors, income and financial incentives to expand services had a significant positive impact on career satisfaction. Among practice location factors, those who primarily worked in medical schools were significantly more satisfied with their careers than others. Among minority factors, those treating a large proportion of Hispanic patients were significantly less likely to be satisfied with their careers. Ability to provide quality care, time with patients, income, and financial incentives had a significant positive impact on career satisfaction. Similarly, threat of malpractice and high proportion of Hispanic patients had a negative impact on career satisfaction.

  8. Surgical smoke in dermatologic surgery.

    Science.gov (United States)

    Oganesyan, Gagik; Eimpunth, Sasima; Kim, Silvia Soohyun; Jiang, Shang I Brian

    2014-12-01

    Potential dangers associated with smoke generated during electrosurgery have been described. However, the use of smoke management in dermatology is unknown. There is no objective data showing the amount or the composition of the smoke generated in dermatologic surgeries. To assess the use of smoke management in dermatologic surgery and provide data on the amount and chemical composition of surgical smoke. A total of 997 surveys were sent to dermatologic surgeons across the United States to assess the use of smoke management. Amounts and concentrations of particulates and chemical composition were measured during electrosurgery using a particulate meter and the Environmental Protection Agency-standardized gas chromatography-mass spectrometry analysis. Thirty-two percent of the surgeons responded to the survey, and 77% of the respondents indicated no use of smoke management at all. Only approximately 10% of surgeons reported consistent use of smoke management. Active electrosurgery produced significant amounts of particulates. In addition, surgical smoke contained high concentrations of known carcinogens, such as benzene, butadiene, and acetonitrile. Surgical smoke contains toxic compounds and particulates. Most dermatologic surgeons do not use smoke management within their practices. Raising the awareness of the potential risks can help increase the use of smoke management.

  9. Surgical Treatment of Skin Tumors

    Directory of Open Access Journals (Sweden)

    Gonca

    2015-06-01

    Full Text Available When we mention about surgical treatment of any tumor residing on the skin independent of its benign or malignant nature, the first method we recall is excision. Elliptical excision is the mainstay of the dermatologic surgery. Each excision ends with a defect for which we are responsible to repair functionally and cosmetically. The diameter of the tumor we excised and the safety margin used for excision determine the diameter of the final defect. After achieving tumor free lateral and deep margins with the appropriate surgical method, we decide between the repair options of second intention healing, primary repair, flaps, full or split thickness grafts, considering the diameter and the anatomic localization of the defect, for the best functional and cosmetic result for that specific defect. This review overviews not only the most common dermatologic surgical methods, but also Mohs surgery which is a method rarely used in our country, although it is the treatment of choice for the treatment of high risk basal cell carcinoma (BCC and squamous cell carcinoma (SCC.

  10. [Surgical managment of retinal detachment].

    Science.gov (United States)

    Haritoglou, C; Wolf, A

    2015-05-01

    The detachment of the neurosensory retina from the underlying retinal pigment epithelium can be related to breaks of the retina allowing vitreous fluid to gain access to the subretinal space, to exudative changes of the choroid such as tumours or inflammatory diseases or to excessive tractional forces exerted by interactions of the collagenous vitreous and the retina. Tractional retinal detachment is usually treated by vitrectomy and exudative detachment can be addressed by treatment of the underlying condition in many cases. In rhegmatogenous retinal detachment two different surgical procedures, vitrectomy and scleral buckling, can be applied for functional and anatomic rehabilitation of our patients. The choice of the surgical procedure is not really standardised and often depends on the experience of the surgeon and other more ocular factors including lens status, the number of retinal breaks, the extent of the detachment and the amount of preexisting PVR. Using both techniques, anatomic success rates of over 90 % can be achieved. Especially in young phakic patients scleral buckling offers the true advantage to prevent the progression of cataract formation requiring cataract extraction and intraocular lens implantation. Therefore, scleral buckling should be considered in selected cases as an alternative surgical option in spite of the very important technical refinements in modern vitrectomy techniques. Georg Thieme Verlag KG Stuttgart · New York.

  11. Is surgical workforce diversity increasing?

    Science.gov (United States)

    Andriole, Dorothy A; Jeffe, Donna B; Schechtman, Kenneth B

    2007-03-01

    We sought to determine the extent to which recent increases in levels of gender and racial diversity in the overall resident-physician workforce were evident among core-surgical specialty resident workforces. Chi-square tests for trend assessed the importance of changes from 1996 to 2004 in proportions of women and African Americans in the surgery-resident workforce. Surgery-resident trends were compared with overall resident workforce trends using two-tailed t-tests to compare regression slopes that quantified rates of change over time. Chi-square tests assessed differences between proportions of women and African Americans in the current overall board-certified workforce and their proportions in the surgery board-certified workforce. From 1996 to 2004, proportions of women increased in all seven surgical specialties studied. Compared with the overall trend toward increasing proportions of women in the resident workforce, the trend in one surgical specialty was larger (obstetrics/gynecology, p 0.05), and two were smaller (each p 0.05). Proportions of African Americans decreased in three specialties (each p workforce, except obstetrics/gynecology, remained lower than in the overall board-certified workforce (each p workforces have persisted since 1996 and will likely perpetuate ongoing surgery board-certified workforce disparities.

  12. SURGICAL EXPERIENCE WITH INTRACARDIAC MYXOMAS

    Directory of Open Access Journals (Sweden)

    N. Safaei

    2007-08-01

    Full Text Available Cardiac myxoma is generally considered to be a surgical emergency. Surgical excision must be done as soon as possible after diagnosis because of the high risk of valve obstruction or systemic embolization. In this study we report the result of operation in patient with benign cardiac myxoma. From 2001 to 2006, 35 patients (15 men and 20 women between the ages of 26 and 82 years (mean of 52 ± 14 years were operated on for cardiac myxoma. In all of them cardiac myxoma was excised with large cuff of atrial septum. The postoperative mortality was 2.9% (1 patient. No patient was lost in 5 years follow up. Emergency operation was performed in 80% of the patients; in the remaining (20% of the patients, condition was stable and the clinical presentation was less worrying, so elective operation was done. Now as echocardiography can reveal smaller tumors in generally elderly patients, most cases of cardiac myxoma correspond to stable forms. With early diagnosis and surgical excision of atrial myxoma, 97.1% of patients survived post operatively and had an excellent short-term and long-term results leading to eventual cure of nonfamilial myxomas. However, familial myxomas retain a strong tendency to recur after excision.

  13. Fighting surgical site infections in small animals

    DEFF Research Database (Denmark)

    Verwilghen, Denis; Singh, Ameet

    2015-01-01

    A diverse array of pathogen-related, patient-related, and caretaker-related issues influence risk and prevention of surgical site infections (SSIs). The entire surgical team involved in health care settings in which surgical procedures are performed play a pivotal role in the prevention of SSIs...

  14. Crown lengthening: a surgical flap approach.

    Science.gov (United States)

    Lundergan, W; Hughes, W R

    1996-09-01

    In many instances it is not possible to place a restoration margin without encroaching on the periodontal attachment apparatus. A surgical crown-lengthening procedure can provide a good solution to this common clinical problem. This article discusses indication and contraindication for surgical crown-lengthening procedures and presents an appropriate surgical technique.

  15. Surgical electronic logbook: A step forward.

    Science.gov (United States)

    Gómez Díaz, Carlos Javier; Luna Aufroy, Alexis; Rebasa Cladera, Pere; Serra Pla, Sheila; Jurado Ruiz, Cristina; Mora López, Laura; Serra Aracil, Xavier; Navarro Soto, Salvador

    2015-12-01

    The surgical electronic logbook (surgical e-logbook) aims to: simplify registration of the training activities of surgical residents, and to obtain reliable and detailed reports about these activities for resident evaluation. The surgical e-logbook is a unique and shared database. Residents prospectively record their activities in 3 areas: surgical, scientific and teaching. We can access activity reports that are constantly updated. Study period using the surgical e-logbook: Between June 2011 and May 2013. Number of surgeries reported: 4,255. Number of surgical procedures reported: 11,907. Number of surgeries per resident per year reported: 250. Number of surgical procedures per resident per year reported: 700. Surgical activity as a primary surgeon during the first year of residency is primarily in emergency surgery (68,01%) and by laparotomy (97,73%), while during the fifth year of residency 51,27% is performed in elective surgery and laparoscopy is used in 23,10% of cases. During this period, residents participated in a total of 11 scientific publications, 75 conference presentations and 69 continuing education activities. The surgical e-logbook is a useful tool that simplifies the recording and analysis of data about surgical and scientific activities of the residents. It is a step forward in the evaluation of the training of surgical residents, however, is only an intermediate step towards the development of a larger Spanish registry. Copyright © 2014 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

  16. Inadvertent femoral artery "stripping": surgical management.

    Science.gov (United States)

    Liddicoat, J E; Bekassy, S M; Daniell, M B; De Bakey, M E

    1975-02-01

    Following "vein stripping" for varicosities, two patients were referred to our service for evaluation of arterial insufficiency of the lower extremities. Both patients had had surgical interruption of the femoral arterial system which required reconstruction. This paper emphasizes the importance of understanding surgical anatomy and presents the techniques of successful surgical management of both cases.

  17. Surgical versus non-surgical management for pleural empyema.

    Science.gov (United States)

    Redden, Mark D; Chin, Tze Yang; van Driel, Mieke L

    2017-03-17

    Empyema refers to pus in the pleural space, commonly due to adjacent pneumonia, chest wall injury, or a complication of thoracic surgery. A range of therapeutic options are available for its management, ranging from percutaneous aspiration and intercostal drainage to video-assisted thoracoscopic surgery (VATS) or thoracotomy drainage. Intrapleural fibrinolytics may also be administered following intercostal drain insertion to facilitate pleural drainage. There is currently a lack of consensus regarding optimal treatment. To assess the effectiveness and safety of surgical versus non-surgical treatments for complicated parapneumonic effusion or pleural empyema. We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (2016, Issue 9), MEDLINE (Ebscohost) (1946 to July week 3 2013, July 2015 to October 2016) and MEDLINE (Ovid) (1 May 2013 to July week 1 2015), Embase (2010 to October 2016), CINAHL (1981 to October 2016) and LILACS (1982 to October 2016) on 20 October 2016. We searched ClinicalTrials.gov and WHO International Clinical Trials Registry Platform for ongoing studies (December 2016). Randomised controlled trials that compared a surgical with a non-surgical method of management for all age groups with pleural empyema. Two review authors independently assessed trials for inclusion and risk of bias, extracted data, and checked the data for accuracy. We contacted trial authors for additional information. We assessed the quality of the evidence using the GRADE approach. We included eight randomised controlled trials with a total of 391 participants. Six trials focused on children and two on adults. Trials compared tube thoracostomy drainage (non-surgical), with or without intrapleural fibrinolytics, to either VATS or thoracotomy (surgical) for the management of pleural empyema. Assessment of risk of bias for the included studies was generally unclear for selection and blinding but low for attrition and reporting bias. Data analyses compared

  18. Congenital symbrachydactyly: outcomes of surgical treatment in 120 webs

    Institute of Scientific and Technical Information of China (English)

    LI Wen-jun; ZHAO Jun-hui; TIAN Wen; TIAN Guang-lei

    2013-01-01

    Background Symbrachydactyly is defined as a combination of short fingers with syndactyly.There are few published reports estimating the incidence of symbrachydactyly.The aim of this study was to investigate the clinical features and the outcome of surgical treatment for congenital symbrachydactyly.Methods One hundred and twenty webs of thirty-four patients of symbrachydactyly were involved in the study.The sex ratio was 21 males/13 females.The age ranged from 1 year to 8 years,average 2.6 years.Four cases had both hands involved and 30 patients had one hand involvement.Release of the syndactylous digits webs were completed by one surgical procedure in 14 cases and more than one surgical procedure in 20 cases; 3 to 6 months between the procedures.In the meantime,some of the associated hand deformities were treated.Results Postoperative follow-up time was 10 to 18 months,average 12 months.All the fingers involved in this study were separated successfully.However,6 fingers had scar tissue contracture and 8 had web scar adhesion.All complications needed further surgical treatment.Parents of 94.1% of the patients were satisfied with the overall function of the hand,and 76.5% were satisfied with the cosmetic appearance of hand.Conclusions The combination of syndactyly and brachydactyly is the main clinical feature in symbrachydactyly.Separation of the digital webs can greatly improve the function of the hand.However,more work needs to be done to improve the cosmetic appearance of the hand.

  19. Disentangling the benefits of sex.

    Science.gov (United States)

    Roze, Denis

    2012-01-01

    Understanding the evolutionary advantage of sexual reproduction remains one of the most fundamental questions in evolutionary biology. Most of the current hypotheses rely on the fact that sex increases genetic variation, thereby enhancing the efficiency of natural selection; an important body of theoretical work has defined the conditions under which sex can be favoured through this effect. Over the last decade, experimental evolution in model organisms has provided evidence that sex indeed allows faster rates of adaptation. A new study on facultatively sexual rotifers shows that increased rates of sex can be favoured during adaptation to new environmental conditions and explores the cause of this effect. The results provide support for the idea that the benefits of increasing genetic variation may compensate for the short-term costs of sexual reproduction.

  20. Same-Sex Partner Bereavement.

    Science.gov (United States)

    Patlamazoglou, Lefteris; Simmonds, Janette G; Snell, Tristan L

    2017-01-01

    The experience of same-sex-attracted people who have lost a partner is neglected in the existing literature on bereavement. Previous research on lesbian, gay, bisexual, transgender, intersex, queer and questioning (LGBTIQ) populations tends to focus on the loss of a partner to HIV-related causes, and there is scant research concerning non-HIV-related bereavement. The purpose of this article is to investigate the non-HIV-related bereavement experiences of same-sex partners and to address the potential complications of disenfranchised grief. Coping with the loss of a same-sex partner and the impact of bereavement on subsequent relationships are also discussed. Implications for counseling of bereaved same-sex-attracted individuals are drawn, and recommendations for future psychological research on the experience of bereavement are made.

  1. Why sex differences in schizophrenia?

    Institute of Scientific and Technical Information of China (English)

    Rena Li; Xin Ma; Gang Wang; Jian Yang; Chuanyue Wang

    2016-01-01

    Clinical observation shows that men and women are different in prevalence, symptoms, and responses to treatment of several psychiatric disorders, including schizophrenia. While the etiology of gender differences in schizophrenia is only partially understood, recent genetic studies suggest significant sex-specific pathways in the schizophrenia between men and women. More research is needed to understand the causal roles of sex differences in schizophrenia in order to ultimately develop sex-specific treatment of this seri-ous mental illness. In the present review, we will out-line the current evidence on the sex-related factors in-teraction with disease onset, symptoms and treatment of schizophrenia, and discuss the potential molecular mechanisms that may mediate their cooperative actions in schizophrenia pathogenesis.

  2. Sex and Sexuality and HIV

    Science.gov (United States)

    ... DO protect against HIV: abstinence (not having sex) male condom female condom Birth control options that DO NOT protect against HIV: oral contraceptive ("the pill") Depo-Provera (shot) emergency contraception ("morning- ...

  3. Sex Inversion Operations in China

    Institute of Scientific and Technical Information of China (English)

    1994-01-01

    IN July 1992, Dr. Xia Zhaoji, 58, and his assistants surprised the world by successfully completing the world’s first operation to partially replant human internal reproductive organs. BBC broadcast this 8-minute news story ten days later, followed by AP, Reuters and AFP, as well as some other domestic and international media. What is a sex inversion operation? Why should people change their sex? And how is it

  4. Surgical correction of cleft lip and palate.

    Science.gov (United States)

    Jayaram, Rahul; Huppa, Christoph

    2012-01-01

    Surgical cleft repair aims to restore function of the oro-nasal sphincter and oro-nasal soft tissues and re-establish the complex relationship between perioral and perinasal muscle rings without compromising subsequent mid-facial growth and development. Here we review the surgical anatomy of this region, optimal timing for surgical repair and current thinking on the use of surgical adjuncts. In addition, an overview of current surgical techniques available for the repair of cleft lip, cleft palate and velopharyngeal insufficiency is presented. Finally, we briefly discuss nasal revision surgery and the use of osteotomy, including distraction osteogenesis in the cleft patient.

  5. Surgical resection versus radiofrequency ablation in treatment of small hepatocellular carcinoma

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    HE Xiuting

    2013-08-01

    Full Text Available ObjectiveTo compare clinical efficacy and recurrence between surgical resection and radiofrequency ablation (RFA in the treatment of small hepatocellular carcinoma (HCC. MethodsThe clinical data of 97 patients with small HCC, who underwent surgical resection or RFA as the initial treatment in The First Hospital of Jilin University from January 2002 to December 2008, were collected. Sixty-three cases, who survived 2 years after treatment, were followed up; of the 63 cases, 34 underwent surgical resection, and 29 underwent RFA. The recurrence of these patients was analyzed retrospectively. The measurement data were analyzed by chi-square test. The Cox regression analysis was used for determining the risk factors for recurrence. The log-rank test was used for disease-free survival (DFS difference analysis. ResultsThe 3-month, 1-year, and 2-year intrahepatic recurrence rates for the patients who underwent surgical resection were 15%, 38%, and 64%, respectively, versus 21%, 35%, and 45% for those who underwent RFA, without significant differences between the two groups of patients. The intrahepatic recurrence after initial treatment was not significantly associated with treatment method, sex, age, Child-Pugh grade, tumor size, number of nodules, presence of cirrhosis, and alpha-fetoprotein level. There was no significant difference in DFS between the two groups of patients. ConclusionRFA produces a comparable outcome to that by surgical resection in the treatment of small HCC. RFA holds promise as a substitute for surgical resection.

  6. Sex differences in developmental programming models.

    Science.gov (United States)

    Aiken, Catherine E; Ozanne, Susan E

    2013-01-01

    The theory of developmental programming suggests that diseases such as the metabolic syndrome may be 'programmed' by exposure to adverse stimuli during early development. The developmental programming literature encompasses the study of a wide range of suboptimal intrauterine environments in a variety of species and correlates these with diverse phenotypic outcomes in the offspring. At a molecular level, a large number of variables have been measured and suggested as the basis of the programmed phenotype. The range of both dependent and independent variables studied often makes the developmental programming literature complex to interpret and the drawing of definitive conclusions difficult. A common, though under-explored, theme of many developmental programming models is a sex difference in offspring outcomes. This holds true across a range of interventions, including dietary, hypoxic, and surgical models. The molecular and phenotypic outcomes of adverse in utero conditions are often more prominent in male than female offspring, although there is little consideration given to the basis for this observation in most studies. We review the evidence that maternal energy investment in male and female conceptuses may not be equal and may be environment dependent. It is suggested that male and female development could be viewed as separate processes from the time of conception, with differences in both timing and outcomes.

  7. Giant choledochal calculosis: Surgical treatment

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    Hasan Bektas

    2014-01-01

    Full Text Available Context: Gallstone disease is one of the most common surgical pathologies. Choledocholithiasis may occur in some of these cases and require surgical intervention. Although there are relatively non-invasive procedures such as endoscopic retrograde cholangiopancreatography (ERCP, this technique is usually unsuccessful in patients with stones larger than 10 mm. In our case, we aimed to report a giant choledochal stone (15 cm × 4.5 cm, which is rare in surgical practice and our treatment with open surgery. Case Report: The patient was a 59-year-old woman. Magnetic resonance cholangiopancreatography (MRCP had showed a hydropic gallbladder with an excessively dilated CBD and a 110 mm × 41 mm stone. In the operation, an excessively dilated CBD was seen and after choledochotomy and a very large calculus that filled CBD completely. Choledochotomy incision was carried forward and a T-tube choledochostomy with choledochoduodenostomy (CD was performed. The patient was discharged without any complications on postoperative 8 th day. Conclusion: Benign gallstone disease is a multifactorial process, with risk factors such as obesity, hemolytic diseases, diabetes mellitus, and pregnancy. Risk factors for choledocholithiasis are similar to those for gallstone disease. MRCP is a non-invasive technique in detecting choledocholithiasis. The gold standard intervention for CBD stones is ERCP. Stones in CBD may reach very considerable dimensions without causing serious symptoms. The most common symptom is jaundice. During preoperative radiological examination, giant stones may be interfered with malignancies. Surgeons should obey conventional algorithms in diagnosis and open surgery must be kept in mind in earlier stages without being too insistent on endoscopic interventions.

  8. Disc degeneration: current surgical options

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    C Schizas

    2010-10-01

    Full Text Available Chronic low back pain attributed to lumbar disc degeneration poses a serious challenge to physicians. Surgery may be indicated in selected cases following failure of appropriate conservative treatment. For decades, the only surgical option has been spinal fusion, but its results have been inconsistent. Some prospective trials show superiority over usual conservative measures while others fail to demonstrate its advantages. In an effort to improve results of fusion and to decrease the incidence of adjacent segment degeneration, total disc replacement techniques have been introduced and studied extensively. Short-term results have shown superiority over some fusion techniques. Mid-term results however tend to show that this approach yields results equivalent to those of spinal fusion. Nucleus replacement has gained some popularity initially, but evidence on its efficacy is scarce. Dynamic stabilisation, a technique involving less rigid implants than in spinal fusion and performed without the need for bone grafting, represents another surgical option. Evidence again is lacking on its superiority over other surgical strategies and conservative measures. Insertion of interspinous devices posteriorly, aiming at redistributing loads and relieving pain, has been used as an adjunct to disc removal surgery for disc herniation. To date however, there is no clear evidence on their efficacy. Minimally invasive intradiscal thermocoagulation techniques have also been tried, but evidence of their effectiveness is questioned. Surgery using novel biological solutions may be the future of discogenic pain treatment. Collaboration between clinicians and basic scientists in this multidisciplinary field will undoubtedly shape the future of treating symptomatic disc degeneration.

  9. The surgical treatment of acromegaly.

    Science.gov (United States)

    Buchfelder, Michael; Schlaffer, Sven-Martin

    2017-02-01

    Surgical extraction of as much tumour mass as possible is considered the first step of treatment in acromegaly in many centers. In this article the potential benefits, disadvantages and limitations of operative acromegaly treatment are reviewed. Pertinent literature was selected to provide a review covering current indications, techniques and results of operations for acromegaly. The rapid reduction of tumour volume is an asset of surgery. To date, in almost all patients, minimally invasive, transsphenoidal microscopic or endoscopic approaches are employed. Whether a curative approach is feasible or a debulking procedure is planned, can be anticipated on the basis of preoperative magnetic resonance imaging. The radicality of adenoma resection essentially depends on localization, size and invasive character of the tumour. The normalization rates of growth hormone and IGF-1 secretion, respectively, depend on tumour-related factors such as size, extension, the presence or absence of invasion and the magnitude of IGF-1 and growth hormone oversecretion. However, also surgeon-related factors such as experience and patient load of the centers have been shown to strongly affect surgical results and the rate of complications. As compared to most medical treatments, surgery is relatively cheap since the costs occur only once and not repeatedly. There are several new technical gadgets which aid in the surgical procedure: navigation and variants of intraoperative imaging. For the mentioned reasons, current algorithms of acromegaly management suggest an initial operation, unless the patients are unfit for surgery, refuse an operation or only an unsatisfactory resection is anticipated. A few suggestions are made when a re-operation could be considered.

  10. Surgical Innovation in Sarcoma Surgery.

    Science.gov (United States)

    Jeys, L; Morris, G; Evans, S; Stevenson, J; Parry, M; Gregory, J

    2017-08-01

    The field of orthopaedic oncology relies on innovative techniques to resect and reconstruct a bone or soft tissue tumour. This article reviews some of the most recent and important innovations in the field, including biological and implant reconstructions, together with computer-assisted surgery. It also looks at innovations in other fields of oncology to assess the impact and change that has been required by surgeons; topics including surgical margins, preoperative radiotherapy and future advances are discussed. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

  11. Lesson plans in surgical training.

    Science.gov (United States)

    Lester, S E; Robson, A K R

    2007-06-01

    Lesson plans in surgery enable trainers and trainees to agree on goals that balance training needs with service commitments. Lesson plans are individualised to the trainee and encourage ownership of learning. They are based on SMART criteria and therefore have a sound educational footing. Most of the work in creating a lesson plan falls to the trainee. The total time for creation of each plan is approximately 20 min. Our use of lesson plans for surgical training has been met with favourable response from both trainer and trainees.

  12. Surgical packages for laparoscopic surgery

    Directory of Open Access Journals (Sweden)

    Bhattacharya K

    2005-01-01

    Full Text Available ′Packages′ are in fashion today for most surgical procedures in various corporate hospitals and this has included laparoscopic procedures too. A package system enables the hospitals to get cost settlements done more easily. Also, it is more convenient for the patients who are aware upfront of the charges. The principal disadvantages seems to be for the surgeon, who may face displeasure of the patient, hospital or insurance agencies apart from forfeiting his personal charges if (a he is a novice in laparoscopic surgery and takes extra time to complete a procedure, (b unforeseen problems occur during surgery, or (c new pathologies are discovered on exploration.

  13. Stereotactic limbic leucotomy: surgical technique

    Science.gov (United States)

    Richardson, Alan

    1973-01-01

    The requirements for modern psychosurgery are safety and accuracy. Stereotactic techniques give the geometric accuracy and stimulation gives physiological information, which is important in determining lesion sites or at least lesion symmetry. The process whereby focal brain destruction is produced is ideally by a freezing probe, but equally effectively by coagulation. A number of small lesions is thus required. This at present is unavoidable if side effects are to be obviated. Careful continuing assessment of results is necessary to validate any surgical procedure. ImagesFig. 1Fig. 2Fig. 3Fig. 4 PMID:4618905

  14. Surgical treatment of cleft lip

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    Mateus Domingues Miachon

    Full Text Available We performed a systematic review of the literature on the surgical treatment of cleft lip, emphasizing the prevalence, complications associated with the treatment and the points of disagreement between authors. We conducted a literature cross-sectional search that analyzed publications in books, articles and on the databases SciELO - Scientific Electronic Library Online, PubMed, of the National Center for Biotechnology Information. We conclude that: 1 the severity of the cleft will indicate the technique presenting more advantages; 2 the different approaches indicate that there is no consensus on the optimal technique; and 3 the surgeon experience contributes to choosing the best option.

  15. A Review of The Sex EDcyclopedia

    Science.gov (United States)

    Herman, Jeff; Andelloux, Megan

    2012-01-01

    While virtually all sex education books for teenagers focus on sexual health, Jo Langford's "The Sex EDcyclopedia" offers comprehensive and empowering information specifically for teen males about their sexuality and how it may be positively experienced. This review examines the strengths of "The Sex EDcyclopedia" as a sex education resource and…

  16. Sex trade among men: negotiating sex, bodies and identity categories

    Directory of Open Access Journals (Sweden)

    Murilo dos Santos Moscheta

    2013-01-01

    Full Text Available Commercial sex is a marginalized and highly stigmatized activity in Brazilian culture. In this article we aim at investigating the discursive strategies used by young men who trade sex in order to resist stigmatization and social exclusion. We interviewed 24 young men who trade sex in a medium sized city in Brazil. Discursive strategies used by the interviewees to avoid social stigma could be summarized as (1 a reduction of sexual activity to its commercial sense by employing a conceptualization of masculinity that focuses on moral values and disregards sexual intercourse, (2 an emphasis on the anatomic characteristics as a criterion to delimit sexual identification categories, and (3 a shifting of sexual systems from one based on sexual object choice to one based on sexual aim. The discussion highlights that the interviewees were actively negotiating with normative assumptions of sexuality and thus producing either its subversion or conservation.

  17. Surgical treatment of rhinophyma. Report of two cases

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    Bernaldo Canto Vidal

    2016-10-01

    Full Text Available Rhinophyma is a nose skin disease consisting on a hypertrophy of the local sebaceous glands which leads to a characteristic deformation. It presents with skin hypertrophy, chronic inflammation and increase of the vascular tissue, with multiple telangiectasias y comedones, all of which causes a deformed tip of the nose. It more often affects the male sex and can get to a malignancy. Two patients affected by rhinophyma are presented who were assisted at the maxillofacial service of the General Teaching Hospital Dr Gustavo Aldereguía Lima, Cienfuegos. The surgical technique used in both cases is described. It is a rare disease therefore it is considered of interest for study and dissemination.

  18. Surgical management of hepatocellular carcinoma

    Institute of Scientific and Technical Information of China (English)

    Tony CY Pang; Vincent WT Lam

    2015-01-01

    Hepatocellular carcinoma (HCC) is the second mostcommon cause of death from cancer worldwide.Standard potentially curative treatments are eitherresection or transplantation. The aim of this paper isto provide an overview of the surgical managementof HCC, as well as highlight current issues in hepaticresection and transplantation. In summary, due to therelationship between HCC and chronic liver disease,the management of HCC depends both on tumourrelatedand hepatic function-related considerations. Assuch, HCC is currently managed largely through nonsurgicalmeans as the criteria, in relation to the aboveconsiderations, for surgical management is still largelyrestrictive. For early stage tumours, both resectionand transplantation offer fairly good survival outcomes(5 years overall survival of around 50%). Selectiontherefore would depend on the level of hepatic functionderangement, organ availability and local expertise.Patients with intermediate stage cancers have limitedoptions, with resection being the only potential forcure. Otherwise, locoregional therapy with transarterialchemoembolization or radiofrequency ablation are viableoptions. Current issues in resection and transplantationare also briefly discussed such as laparoscopic resection,ablation vs resection, anatomical vs non-anatomicalresection, transplantation vs resection, living donor livertransplantation and salvage liver transplantation.

  19. BRACHYMETACARPIA: FEATURES AND SURGICAL TREATMENT

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    V. I. Zavarukhin

    2013-01-01

    Full Text Available The purpose - to study the morphofunctional changes of upper extremities in patients with brachymetacarpia. Material and methods. The results of the examination and surgical treatment by distraction osteosynthesis of six patients (10 hands, shortening of the 18-metacarpal bones with brachymetacarpia are presented. Results. All patients noted dissatisfaction with the cosmetic state of hands and tiredness during physical activities with the hand. IV ray was shortened in 50%, V ray - in 33% of cases and III ray - in 17%. Limitation of active flexion was noted in all patients, an average flexion was 58.9 ± 7,1°. After treatment flexion increased an average on 20.5 ° (22.7%. Complications were obtained in two patients on three hands. Conclusions. Brachymetacarpia is a rare disease, the etiology of which is still unknown and requires further study. In all cases of brachymetacarpia there is a restriction of active flexion of the MCP joint of the affected ray and the indications for treatment are caused not only by a cosmetic defect, but also functional impairment. Surgical treatment of brachymetacarpia by distraction osteosynthesis gives predictably good results. Complications during the treatment of brachymetacarpia are rare and mostly related to the appearance of contractures, in order to prevent which in the postoperative period should be used preventive conservative therapy.

  20. [Amebiasis. Surgical treatment in 1989].

    Science.gov (United States)

    Sigler Morales, L; Mier y Díaz, J; Melgoza Ortiz, C; Blanco Benavides, R; Medina González, E

    1989-01-01

    Even when the number of patients with invasive amebiasis has decreased, the internist and surgeon must be alert in case that the patient requires an operation. Amebic liver abscess is treated medically; percutaneous evacuation is rarely used and surgical drainage is made when there is not response to medical treatment or there is high risk of abscess rupture. Operation is mandatory when the abscess has ruptured to the abdominal cavity or through the pericardial sac. In fulminant colitis it is necessary to resect the diseased portion of the colon without primary anastomoses. Amebic apendicitis is difficult to diagnosis before an operation. It may be suspected in cases of apendicitis if the cecal wall is inflammed. Colon ameboma requires medical treatment except if it is associated with necrosis or perforation. In a four year period (1985-1988) 294 patients with diagnosis of invasive amebiasis were admitted to three hospitals of the Instituto Mexicano del Seguro Social in Mexico City. 218 had hepatic abscess, 45 required surgical drainage with four deaths (9%) and four not operated patients died. In this series only four patients had their abscess drained percutaneously. 31 patients with amebic colitis were treated; three required colonic resection with one death. Ameboma was seen in five patients and there were 11 cases of amebic apendicitis. No deaths occurred in these last two groups.

  1. SURGICAL PROCEDURES IN SUSHRUTA SAMHITA

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    Singh R.K

    2011-05-01

    Full Text Available The Sushruta Samhita is an Ayurvedic text, by the legendary Sushruta, foundational to Ayurvedic medicine (Indian traditional medicine, with innovative chapters mainly on surgery. There is a general impression that Sushruta Samhita is only an ancient Indian Ayurvedic text book of surgery. Sushruta Samhita contains 184 chapters and description of 1120 illnesses, 700 medicinal plants, a detailed study on anatomy, 64 preparations from mineral sources and 57 preparations based on animal sources. It still retains the land mark position in the field of surgical texts. In addition to his worldwide known work of historical significance on plastic surgery, he also made similar unique contributions on numerous aspects of medicine, such as fracture and dislocations, urinary stones, skin diseases including leprosy, Pancha Karma (Purification procedures, toxicology, pediatrics, eye diseases, psychiatry, obstetrics and gynaecology, etc. A very limited conceptual work has been performed on the selected chapters of Sushruta Samhita. Therefore a review conceptual study has been carried out on the various surgical concepts of Sushruta Samhita. Outcome of this study shows, Sushruta Samhita is written in the aphorism form and the techniques described in it are eminently in line with technical abilities of the times. It is need of the hour to explore the hidden truth by decoding the versions of the texts.

  2. The surgical management of spasticity.

    Science.gov (United States)

    Lazorthes, Y; Sol, J-C; Sallerin, B; Verdié, J-C

    2002-05-01

    Neurosurgery is only considered for severe spasticity following the failure of noninvasive management (adequate medical and physical therapy). The patients are carefully selected, based on rigorous multidisciplinary clinical assessment. In this we evaluate the contribution of the spasticity to the disability and any residual voluntary motor function. The goals for each patient are: (a) improvement of function and autonomy; (b) control of pain; and (c) prevention of orthopaedic disorders. To achieve these objectives, the surgical procedure must be selective and reduce the excessive hypertonia without suppressing useful muscle tone and limb functions. The surgical procedures are: (1) Classical neuro-ablative techniques (peripheral neurotomies, dorsal rhizotomies) and their modern modifications using microsurgery and intra-operative neural stimulation (dorsal root entry zone: DREZotomy). These techniques are destructive and irreversible, with the reduced muscle tone reflecting the nerve topography. It is mainly indicated when patients have localized spasticity without useful mobility. (2) Conservative techniques based on a neurophysiological control mechanism. These procedures are totally reversible. The methods involve chronic neurostimulation of the spinal cord or the cerebellum. There are only a few patients for whom this is indicated. Conversely, chronic intrathecal administration of baclofen, using an implantable pump, is well established in the treatment of diffuse spasticity of spinal origin. From reports in the literature, we critically review the respective indications in terms of function, clinical progression and the topographic extent of the spasticity.

  3. Surgical infections: a microbiological study

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    Santosh Saini

    Full Text Available Surgical infections are mostly polymicrobial, involving both aerobes and anaerobes. One hundred seventeen cases comprised of abscesses (n=51, secondary peritonitis (n=25, necrotizing fascitis (n=22 and wounds with devitalized tissues (n=19 were studied. The number of microorganisms isolated per lesion was highest in secondary peritonitis (2.32. The aerobe/ anaerobe ratio was 0.81 in secondary peritonitis and 1.8 in necrotizing fascitis. Most secondary peritonitis (80%, necrotizing fascitis (75% and wounds with devitalized tissues (66.7% were polymicrobial. Common microorganisms isolated in our study were E. coli, Staphylococcus aureus, Klebsiella spp., Pseudomonas aeruginosa, Bacteroides fragilis and Peptostreptococcus spp. The most effective antibiotics for S. aureus were clindamycin (79.1% and cefuroxime (70.8%. For Gram-negatives (Klebsiella spp., E. coli and Proteus spp., the most effective antibiotics were cefotaxime, ceftizoxime, amikacin and ciprofloxacin. Pseudomonas aeruginosa was maximally sensitive to amikacin (35.2% and ciprofloxacin (35.2%. The greatest degree of multidrug resistance to all the drugs was found in P. aeruginosa (52.9%, followed by Klebsiella spp. (33.3%, Proteus spp. (33.3%, E. coli (22.2%, and S. aureus (12.5%. All the anaerobes that we isolated were 100% sensitive to metronidazole and chloramphenicol, followed by clindamycin (95% to 100%. Apart from antibiotic therapy, non-antimicrobial methods, such as hyperbaric oxygen therapy and debridement also play an important role in the treatment of surgical infections.

  4. Surgical infections: a microbiological study

    Directory of Open Access Journals (Sweden)

    Santosh Saini

    2004-04-01

    Full Text Available Surgical infections are mostly polymicrobial, involving both aerobes and anaerobes. One hundred seventeen cases comprised of abscesses (n=51, secondary peritonitis (n=25, necrotizing fascitis (n=22 and wounds with devitalized tissues (n=19 were studied. The number of microorganisms isolated per lesion was highest in secondary peritonitis (2.32. The aerobe/ anaerobe ratio was 0.81 in secondary peritonitis and 1.8 in necrotizing fascitis. Most secondary peritonitis (80%, necrotizing fascitis (75% and wounds with devitalized tissues (66.7% were polymicrobial. Common microorganisms isolated in our study were E. coli, Staphylococcus aureus, Klebsiella spp., Pseudomonas aeruginosa, Bacteroides fragilis and Peptostreptococcus spp. The most effective antibiotics for S. aureus were clindamycin (79.1% and cefuroxime (70.8%. For Gram-negatives (Klebsiella spp., E. coli and Proteus spp., the most effective antibiotics were cefotaxime, ceftizoxime, amikacin and ciprofloxacin. Pseudomonas aeruginosa was maximally sensitive to amikacin (35.2% and ciprofloxacin (35.2%. The greatest degree of multidrug resistance to all the drugs was found in P. aeruginosa (52.9%, followed by Klebsiella spp. (33.3%, Proteus spp. (33.3%, E. coli (22.2%, and S. aureus (12.5%. All the anaerobes that we isolated were 100% sensitive to metronidazole and chloramphenicol, followed by clindamycin (95% to 100%. Apart from antibiotic therapy, non-antimicrobial methods, such as hyperbaric oxygen therapy and debridement also play an important role in the treatment of surgical infections.

  5. Sex determination using maxillary sinus

    Directory of Open Access Journals (Sweden)

    Ranjith Kumar Kanthem

    2015-01-01

    Full Text Available Background: Individual identification is a subtle concept and often one of the most important priorities in mass disasters, road accidents, air crashes, fires, and even in the investigation of criminal cases. Matching specific features detected on the cadaver with data recorded during the life of an individual is an important aspect in forensics, and can be performed by fingerprint analysis, deoxyribonucleic acid matching, anthropological methods, radiological methods and other techniques which can facilitate age and sex identification. Sinus radiography is one such method that has been used for determination of the sex of an individual. Hence, an attempt is being made to use the different dimensions of the maxillary sinus in the determination of sex using coronal and axial sections of plain computed tomography (CT scan. Materials and Methods: A total of 30 patients including 17 male and 13 female, visiting the Outpatient Department of the Mamata General Hospital were included as the study subjects. The dimensions of right and left maxillary sinuses of 30 subjects from plain CT were measured using SYNGO software and statistical analysis was done. Results: Sex determination using height, length, width, and volume of the maxillary sinus on both sides showed statistically significant results with a higher percentage of sexual dimorphism in the case of volume. Conclusion: Volume of the right maxillary sinus can be used as accurate diagnostic parameter for sex determination.

  6. A reconfiguration of the sex trade

    DEFF Research Database (Denmark)

    Elmes, Jocelyn; Skovdal, Morten; Nhongo, Kundai

    2017-01-01

    dispersed from the bars into the wider community, requiring female sex workers to employ different tactics to attract clients. Hyperinflation meant that sex workers had to accept new forms of payment, including sex-on-credit and commodities. Further impacting the demand for commercial sex work was a poverty...... and respond to the contribution of sex work to HIV transmission need to guard against unduly static definitions and consider the changing socioeconomic context and how this can cause shifts in behavior....

  7. Population consequences of environmental sex reversal.

    OpenAIRE

    Cotton, S.; Wedekind, C

    2009-01-01

    When sex determination in a species is predominantly genetic but environmentally reversible, exposure to (anthropogenic) changes in the environment can lead to shifts in a population's sex ratio. Such scenarios may be common in many fishes and amphibians, yet their ramifications remain largely unexplored. We used a simple model to study the (short-term) population consequences of environmental sex reversal (ESR). We examined the effects on sex ratios, sex chromosome frequencies, and populatio...

  8. Tackling the diversity of sex determination.

    Science.gov (United States)

    Wedekind, Claus; Stelkens, Rike B

    2010-02-23

    A workshop on 'The evolution of sex determination systems' was held at a remote place in the Swiss Alps from 17 to 20 June 2009. It brought together theoreticians and empiricists, the latter ranging from molecular geneticists to evolutionary ecologists, all trying to understand key aspects of sex determination. The topics discussed included the evolutionary origins of sex determination, the diversity of sex determination mechanisms in different taxa, and the transition from genotypic to environmental sex determination and vice versa.

  9. The Stability of Same-Sex Cohabitation, Different-Sex Cohabitation, and Marriage

    Science.gov (United States)

    Lau, Charles Q.

    2012-01-01

    This study contributes to the emerging demographic literature on same-sex couples by comparing the level and correlates of union stability among 4 types of couples: (a) male same-sex cohabitation, (b) female same-sex cohabitation, (c) different-sex cohabitation, and (d) different-sex marriage. The author analyzed data from 2 British birth cohort…

  10. Sex hormone binding globulin phenotypes

    DEFF Research Database (Denmark)

    Cornelisse, M M; Bennett, Patrick; Christiansen, M

    1994-01-01

    Human sex hormone binding globulin (SHBG) is encoded by a normal and a variant allele. The resulting SHBG phenotypes (the homozygous normal SHBG, the heterozygous SHBG and the homozygous variant SHBG phenotype) can be distinguished by their electrophoretic patterns. We developed a novel detection....... This method of detection was used to determine the distribution of SHBG phenotypes in healthy controls of both sexes and in five different pathological conditions characterized by changes in the SHBG level or endocrine disturbances (malignant and benign ovarian neoplasms, hirsutism, liver cirrhosis...... on the experimental values. Differences in SHBG phenotypes do not appear to have any clinical significance and no sex difference was found in the SHBG phenotype distribution....

  11. Oxytocin reverses osteoporosis in a sex dependent manner

    Directory of Open Access Journals (Sweden)

    Guillaume E Beranger

    2015-05-01

    Full Text Available The increase of life expectancy has led to the increase of age-related diseases such as osteoporosis. Osteoporosis is characterized by bone weakening promoting the occurrence of fractures with defective bone regeneration. Men aged over 50 have a prevalence for osteoporosis of 20% which is related to a decline in sex hormones occurring during andropause or surgical orchidectomy. As we previously demonstrated in a mouse model for menopause in women that treatment with the neurohypophyseal peptide hormone oxytocin (OT normalizes body weight and prevents the development of osteoporosis, herein we addressed the effects of OT in male osteoporosis.Thus, we treated orchidectomized mice, an animal model suitable for the study of male osteoporosis, for 8 weeks with OT and then analyzed trabecular and cortical bone parameters as well as fat mass using micro-computed tomography. Orchidectomized mice displayed severe bone loss, muscle atrophy accompanied by fat mass gain as expected in andropause. Interestingly, OT treatment in male mice normalized fat mass as it did in female mice. However, although OT treatment led to a normalization of bone parameters in ovariectomized mice, this did not happen in orchidectomized mice. Moreover, loss of muscle mass was not reversed in orchidectomized mice upon OT treatment. All of these observations indicate that OT acts on fat physiology in both sexes, but in a sex specific manner with regard to bone physiology.

  12. Factors predicting surgical site infection after posterior lumbar surgery

    Science.gov (United States)

    Wang, Tao; Wang, Hui; Yang, Da-Long; Jiang, Li-Qiang; Zhang, Li-Jun; Ding, Wen-Yuan

    2017-01-01

    Abstract This is a retrospective study. The purpose of this study is to explore incidence and risk factors for surgical site infection (SSI) after posterior lumbar surgery. SSI is a common complication after posterior lumbar surgery, bringing mental and physical pain and prolonging hospital stay. However, predisposing factors, as reported less, remain controversial. Patients who underwent posterior lumbar surgery at 3 centers between 2006 and 2016 were included. The possible factors include 3 aspects: demographic variables-age, sex, body mass index (BMI), waist-to-hip radio (WHR), hypertension, diabetes, heart disease, smoking, drinking, steroidal injection, surgical time between June and September, preoperative shower; blood test variables-white blood cell (WBC), neutrophil, red blood cell (RBC), hemoglobin (Hb), total protein (TP), albumin, albumin/globulin (A/G), C-reactive protein (CRP), procalcitonin (PCT), erythrocyte sedimentation rate (ESR) and surgical related variables-operation time, blood loss, operative level, instrumentation, incision length. Factors related with SSI were also performed by multivariate analysis. The prevalence of SSI was 3.00% (267 cases of 8879) had a postoperative wound infection. There were significant difference in WHR (0.92 vs 0.83), WBC (4.31 vs 6.69), TP (58.7 vs 65.2), albumin (36.9 vs 43.2), CRP (2.01 vs 0.57), PCT (0.097 vs 0.067), operation time (217.9 vs 195.7), blood loss (997.1 vs 915.3) and operative level (3.05 vs 2.45) and incision length (24.1 vs 20.0) between SSI group and non-SSI group. >60 years old, female, BMI 30.0, diabetes, male smoking, preoperative steroidal injection, surgical time between June and September, no preoperative shower, instrumentation surgery were risk factors for SSI after posterior lumbar surgery. Many factors, >60 years old, female, BMI, WHR, diabetes, male smoking, preoperative steroidal injection, surgical time between June and September, preoperative shower, WBC, TP, albumin, CRP, PCT

  13. Male sex predisposes the newborn surgical patient to parenteral nutrition-associated cholestasis and to sepsis

    NARCIS (Netherlands)

    Albers, MJIJ; de Gast-Bakker, DAH; van Dam, NAM; Madern, GC; Tibboel, D

    2002-01-01

    Hypothesis: Sepsis is an epiphenomenon of parenteral nutrition-associated cholestasis (PNAC) and not a causative factor, and the incidence of sepsis is not affected by the presence or absence of PNAC. Design: Observational cohort study. Setting: Pediatric surgery department in a tertiary referral ch

  14. Surgical safety checklists in developing countries.

    Science.gov (United States)

    Vivekanantham, Sayinthen; Ravindran, Rahul Prashanth; Shanmugarajah, Kumaran; Maruthappu, Mahiben; Shalhoub, Joseph

    2014-01-01

    The World Health Organization Surgical Safety Checklist (WHO SSC) has demonstrated efficacy in developed and developing countries alike. Recent increases in awareness of surgical morbidity in developing countries has placed greater emphasis on strategies to improve surgical safety in resource-limited settings. The implementation of surgical safety checklists in low-income countries has specific barriers related to resources and culture. Adapting and amending existing surgical safety checklists, as well as considering factors unique to developing countries, may allow the potential of this simple intervention to be fully harnessed in a wider setting. This review will address the benefits and challenges of implementation of surgical safety checklists in developing countries. Moreover, inspiration for the original checklist is revisited to identify areas that will be of particular benefit in a resource-poor setting. Potential future strategies to encourage the implementation of checklists in these countries are also discussed.

  15. Destabilising Sex work and Intimacy?

    DEFF Research Database (Denmark)

    Spanger, Marlene

    politikfelt prostitution. Undersøgelsen trækker på poststrukturalistisk feministisk teori og er baseret på interviews med kvindelige thailandske migranter, der sælger sex, og socialarbejdere samt deltagende observationer og diverse dokumenter. Afhandlingen falder i to dele. Den første del er rammen for de...... fire artikler, som består af en introduktion, en teoretisk ramme, metodeovervejelser og konklusion samt et overordnet forskningsspørgsmål: Hvordan destabiliserer og reproducerer kvindelige thailandske migranter, der sælger sex i Danmark, det danske prostitutionspolitikfelts kategorier ’sexarbejde’ og...

  16. SExSeg: SExtractor segmentation

    Science.gov (United States)

    Coe, Dan

    2015-08-01

    SExSeg forces SExtractor (ascl:1010.064) to run using a pre-defined segmentation map (the definition of objects and their borders). The defined segments double as isophotal apertures. SExSeg alters the detection image based on a pre-defined segmenation map while preparing your "analysis image" by subtracting the background in a separate SExtractor run (using parameters you specify). SExtractor is then run in "double-image" mode with the altered detection image and background-subtracted analysis image.

  17. Elusive Sex Acts: Pleasure and Politics in Norwegian Sex Education

    Science.gov (United States)

    Svendsen, Stine H. Bang

    2012-01-01

    While there is little political opposition towards sex education as such in Norway, recent attempts at reforming the subject reveal underlying heteronormative presumptions that seem resistant to reform. While a focus on homosexuality is included in the national curriculum at all levels of compulsory education, the sexual practices involved in…

  18. Learning about Sex: Resource Guide for Sex Educators. Revised Edition

    Science.gov (United States)

    Huberman, Barbara

    2011-01-01

    Whether you are someone new to the field of sex education, trying to start a library or resource center on adolescent sexual health, or an old pro, this guide should give you a basic orientation to what's available to support your work. These resources are important to advancing positive attitudes toward adolescent sexual health and the author…

  19. Sex Equity and Sexuality in College Level Sex Education Courses.

    Science.gov (United States)

    Myerson, Marilyn

    1987-01-01

    This article examines two relevant features in the historical development of sexology, the body of knowledge upon which sex education is based: its depoliticization of sexuality and its attempts to ground itself as scientific. Also examined are the sexual politics of sexology, via a content analysis of several college texts. (IAH)

  20. Elusive Sex Acts: Pleasure and Politics in Norwegian Sex Education

    Science.gov (United States)

    Svendsen, Stine H. Bang

    2012-01-01

    While there is little political opposition towards sex education as such in Norway, recent attempts at reforming the subject reveal underlying heteronormative presumptions that seem resistant to reform. While a focus on homosexuality is included in the national curriculum at all levels of compulsory education, the sexual practices involved in…

  1. Surgical Management of Fractures and Tendons.

    Science.gov (United States)

    Pentecost, Rebecca; Niehaus, Andrew J; Anderson, David E

    2016-11-01

    Long bone fractures and disorders of tendons and ligaments represent a significant proportion of surgical orthopedic cases presented to ruminant veterinarians. The presentation of these patients, their diagnostic work-up, surgical treatment, and expected outcome will be discussed. The outcome of these cases depends largely on the presenting problem; however, accurate diagnosis and prompt surgical intervention can greatly improve the outcome of many of these cases.

  2. Effects of art on surgical patients

    OpenAIRE

    Vetter, Diana; Barth, Jürgen; Uyulmaz, Sema; Uyulmaz, Semra; Vonlanthen, René; Belli, Giulio; Montorsi, Marco; Bismuth, Henri; Claudia M. Witt; Clavien, Pierre-Alain

    2015-01-01

    Objectives: The aim of the study was to assess the effect of art including ambient features such as music, interior design including visual art, and architectural features on health outcomes in surgical patients. Background: Healing environments can have a positive influence on many patients, but data focusing on art in surgical patients remain scarce. Methods: We conducted a systematic search following the PRISMA guidelines from January 2000 to October 2014 on art in surgical patients....

  3. Surgical treatment in cocaine body packers and body pushers.

    Science.gov (United States)

    Schaper, Andreas; Hofmann, Rainer; Bargain, Philippe; Desel, Herbert; Ebbecke, Martin; Langer, Claus

    2007-12-01

    Body packers smuggle cocaine by swallowing containers filled with the drugs, whilst body pushers conceal the containers in the rectum or vagina. In a collaborative effort between the Department of General Surgery, two major airports and Poisons Centre, we performed a retrospective study to develop an algorithm for the treatment of ruptured cocaine-filled containers. The data of all cocaine body packers and body pushers who were identified at the airports of Frankfurt and Paris from 1985 to 2002 were evaluated concerning incidence, demographics and surgical aspects. From 1985 to 2002, 312 body pushers and 4,660 body packers were identified. The sex ratio was 1:1. Sixty-four "mules" (1.4%) developed life-threatening symptoms of cocaine overdose after the rupture of a container. In 20 patients, an emergency laparotomy was performed and the containers were removed; all of these patients survived. Forty-four body packers died before surgical treatment could be performed. Only one body pusher required medical attention. Cocaine overdose can be life-threatening. If the cause is the rupture of a container in a body packer, the only possible treatment is immediate laparotomy for the removal of the container.

  4. [Financing and control of surgical training].

    Science.gov (United States)

    Schröder, W; Welcker, K

    2010-01-01

    The present analyses of different surgical training systems show that training of surgical residents significantly contributes to hospital costs. These are predominantly caused by prolonged operation times of residents with increased work load for other staff members in the operating room. In addition, the productivity of surgical residents is less compared to experienced surgeons. On the other hand, hospital managements save money by the lower standard wages paid to the residents. The amount of educational costs is difficult to determine because surgical training takes place as on the job training. Therefore, from an economic point of view, the two products patient care and surgical training are difficult to separate. There are no reliable cost analyses available for the German training system. At present surgical training is indirectly financed by the DRG (diagnosis-related groups) flat rates of the health insurance. Possible options of financing the surgical training are additional funding from the health department or redistribution with supplemental payment for those surgical departments which contribute significantly more to the residents' training. Statements of medical associations, health departments and health insurances demonstrate the difficulty to come to an agreement concerning the finances of the training system. Despite this controversial discussion it should be taken into consideration that there is no alternative to a high quality surgical training as this is the basis for an effective health system.

  5. Intraoperative OCT in Surgical Oncology

    Science.gov (United States)

    South, Fredrick A.; Marjanovic, Marina; Boppart, Stephen A.

    The global incidence of cancer is rising, putting an increasingly heavy burden upon health care. The need to effectively detect and treat cancer is one of the most significant problems faced in health care today. Effective cancer treatment typically depends upon early detection and, for most solid tumors, successful removal of the cancerous tumor tissue via surgical procedures. Difficulties arise when attempting to differentiate between normal and tumor tissue during surgery. Unaided visual examination of the tissue provides only superficial, low-resolution information and often with little visual contrast. Many imaging modalities widely used for cancer screening and diagnostics are of limited use in the operating room due to low spatial resolution. OCT provides cellular resolution allowing for more precise localization of the tumor tissue. It is also relatively inexpensive and highly portable, making it well suited for intraoperative applications.

  6. [Surgical therapy for entrapment neuropathy].

    Science.gov (United States)

    Tachibana, Shigekuni

    2012-01-01

    Entrapment neuropathy is not uncommon, and surgical treatment is followed by favorite result. Therefore, to obtain an accurate diagnosis based on precise knowledge of the peripheral nervous system is very important. The most popular and useful symptoms and signs of the entrapment neuropathy is paresthesia, dysesthesia and Tinel's like sign at the lesion site. Nerve conduction study is also valuable for the accurate diagnosis. For the last 30 years, the author operated on 1,399 lesions of entrapment neuropathy. They consist of 877 carpal tunnel syndrome (63%), 284 tarsal tunnel syndrome (20%), 135 ulnar neuropathy at the elbow (10%), 53 piriformis syndrome (4%), 15 thoracic outlet syndrome (1%), and others. From the pathophysiological point to view, except for the carpal tunnel syndrome, several locations and factors come into play producing the entrapment of the nerve. The author would like to stress that the entrapment neuropathy is not severe disease, though, it strongly insult the patient's quality of life.

  7. [Living donor transplantation. Surgical complications].

    Science.gov (United States)

    Karam, Georges

    2008-02-01

    Although nephrectomy by open surgery is the most used technique for the extraction of kidney transplants in the living donor, nephrectomy under laparaoscopy is increasingly practiced. Laparoscopic nephrectomy is less invasive and performed under videoscopy control, after insufflation of the peritoneal cavity. Three to four incisions are done in order to enter the surgical instruments. The kidney is extracted through a horizontal sus-pubic incision. The exposition is either exclusively transperitoneal, retroperitoneal or hand assisted. The advantages of laparoscopy are esthetical, financial due to a shorter hospitalisation and a quicker recovery, as well a confort for the donor. The disadvantages are a longer warm ischemia time and possibly a higher risk of delayed graft function. Randomised studies having compared laparoscopy and open surgery in the living donor have not find any significant difference regarding the per- and perioperative in the complications.

  8. [Surgical dilemmas. Sinus floor elevation].

    Science.gov (United States)

    ten Bruggenkate, C M; Schulten, E A J M; Zijderveld, S A

    2008-12-01

    Limited alveolar bone height prevents the placement of dental implants. Sinus floor elevation is an internal augmentation of the maxillary sinus that allows implants to be placed. The principle of this surgical procedure is the preparation of a 'top hinge door', that is raised together with the Schneiderian membrane in the cranial direction. The space which created under this lid is filled with a bone transplant. Autogenous bone is the standard transplant material, despite the fact that a second surgery site is necessary. Under certain circumstances bone substitutes can be used, with a longer healing phase. If sufficient alveolar bone height is available to secure implant stability, simultaneous implantation and sinus floor elevation are possible. Considering the significant anatomical variation in the region of the maxillary sinus, a sound knowledge of the anatomy is of great importance.

  9. Coccidioidomycosis: Surgical Issues and Implications.

    Science.gov (United States)

    Forrester, Joseph D; Guo, Haiwei Henry; Weiser, Thomas G

    2016-12-01

    Coccidioidomycosis, commonly called "valley fever," "San Joaquin fever," "desert fever," or "desert rheumatism," is a multi-system illness caused by infection with Coccidioides fungi (C. immitis or C. posadasii). This organism is endemic to the desert Southwest regions of the United States and Mexico and to parts of South America. The manifestations of infection occur along a spectrum from asymptomatic to mild self-limited fever to severe disseminated disease. Review of the English-language literature. There are five broad indications for surgical intervention in patients with coccidioidomycosis: Tissue diagnosis in patients at risk for co-existing pathology, perforation, bleeding, impingement on critical organs, and failure to resolve with medical management. As part of a multidisciplinary team, surgeons may be responsible for the care of infected patients, particularly those with severe disease. This review discusses the history, microbiology, epidemiology, pathology, diagnosis, and treatment of coccidioidomycosis, focusing on situations that may be encountered by surgeons.

  10. Surgical Craniotomy for Intracerebral Haemorrhage.

    Science.gov (United States)

    Mendelow, A David

    2015-01-01

    may improve the completeness of surgical evacuation and outcomes, regardless of which surgical technique is employed.

  11. Acromioclavicular motion after surgical reconstruction.

    Science.gov (United States)

    Motta, Pierorazio; Bruno, Laura; Maderni, Alberto; Tosco, Piermario; Mariotti, Umberto

    2012-06-01

    A retrospective long-term study was carried out to determine whether there was any correlation between the clinical motion of the acromioclavicular joint evaluated by a test we set up using 90° of abduction and 0° of external rotation against resistance [90°/0°RTest] and the cross arm test (compared to the healthy side) and full return to everyday activities after surgical repair. A clinical and radiographic evaluation was carried out on 51/80 subjects at a 5.4-year mean follow-up, treated for acromioclavicular joint dislocation with an extra-articular artificial loop, between 2000 and 2006. The 25 subjects with ossifications obtained a normal acromioclavicular joint motion, on both the horizontal and vertical planes. There was a correlation between the normal motion of the reconstructed acromioclavicular joint (compared to the healthy side) in these 25 patients and full clinical recovery, whilst there was no correlation between the Constant score, the simple shoulder test, the radiographic evaluation on one hand and the clinical motion of the joint on the other. Two patients had recurrent dislocation. Three had mobilization of the screws without reduction loss, or negative clinical outcome. A postoperative radiographic evaluation should be correlated with a clinical evaluation of the acromioclavicular joint motion (normal, hypermobile, unstable). Normal acromioclavicular joint motion was observed in subjects who developed significant ossifications. The study shows that the clinical evaluation of acromioclavicular joint motion is a simple and trustworthy method to assess the clinical result of a surgical repair. Diagnostic study investigating a diagnostic test, Level III.

  12. The Dutch surgical colorectal audit.

    Science.gov (United States)

    Van Leersum, N J; Snijders, H S; Henneman, D; Kolfschoten, N E; Gooiker, G A; ten Berge, M G; Eddes, E H; Wouters, M W J M; Tollenaar, R A E M; Bemelman, W A; van Dam, R M; Elferink, M A; Karsten, Th M; van Krieken, J H J M; Lemmens, V E P P; Rutten, H J T; Manusama, E R; van de Velde, C J H; Meijerink, W J H J; Wiggers, Th; van der Harst, E; Dekker, J W T; Boerma, D

    2013-10-01

    In 2009, the nationwide Dutch Surgical Colorectal Audit (DSCA) was initiated by the Association of Surgeons of the Netherlands (ASN) to monitor, evaluate and improve colorectal cancer care. The DSCA is currently widely used as a blueprint for the initiation of other audits, coordinated by the Dutch Institute for Clinical Auditing (DICA). This article illustrates key elements of the DSCA and results of three years of auditing. Key elements include: a leading role of the professional association with integration of the audit in the national quality assurance policy; web-based registration by medical specialists; weekly updated online feedback to participants; annual external data verification with other data sources; improvement projects. In two years, all Dutch hospitals participated in the audit. Case-ascertainment was 92% in 2010 and 95% in 2011. External data verification by comparison with the Netherlands Cancer Registry (NCR) showed high concordance of data items. Within three years, guideline compliance for diagnostics, preoperative multidisciplinary meetings and standardised reporting increased; complication-, re-intervention and postoperative mortality rates decreased significantly. The success of the DSCA is the result of effective surgical collaboration. The leading role of the ASN in conducting the audit resulted in full participation of all colorectal surgeons in the Netherlands. By integrating the audit into the ASNs' quality assurance policy, it could be used to set national quality standards. Future challenges include reduction of administrative burden; expansion to a multidisciplinary registration; and addition of financial information and patient reported outcomes to the audit data. Copyright © 2013 Elsevier Ltd. All rights reserved.

  13. Surgical treatment of cervical spine trauma: Our experience and results

    Science.gov (United States)

    Dobran, Mauro; Iacoangeli, Maurizio; Nocchi, Niccolò; Di Rienzo, Alessandro; di Somma, Lucia Giovanna Maria; Nasi, Davide; Colasanti, Roberto; Al-Fay, Mohuammad; Scerrati, Massimo

    2015-01-01

    Objective and Background: The objective of this study is to evaluate how the neurological outcome in patients operated for cervical spinal cord injury (SCI) is influenced by surgical timing, admission American Spinal Injury Association (ASIA) grading system, and age. Materials and Methods: From January 2004 to December 2011, we operated 110 patients with cervical SCI. Fifty-seven of them (44 males and 13 females) with preoperative neurological deficit, were included in this study with a complete follow-up. Age, sex, associated comorbidities (evaluated with Charlson comorbidity index [CCI]), mechanism of trauma, preoperative and follow-up ASIA score, time elapsed from injury to surgical treatment, preoperative cervical computed tomography scan or magnetic resonance imaging, type of fractures, and surgical procedure were evaluated for each patient. The patient population was divided into two groups related to the timing of surgery: Ultra-early surgery group (within 12 h from the trauma, 27 patients) and early surgery (within 12–72 h from the trauma, 30 patients). Statistical Analysis Used: The univariate analysis of data was carried out by the Chi-square test for discrete variables, the t-test for the continuous ones. Logistic regression was used for the multivariate analysis. Results: Neurological outcome was statistically better in ultra-early surgery group (<12 h) than in patient underwent surgery within 12–72 h (82.14% vs. 31%, multivariate analysis P = 0.005). The neurological improvement was also correlated with the age and the ASIA grade at admission in the univariate analysis (P = 0.006 and P = 0.017 respectively) and in the multivariate 1 (P = 0.037 and P = 0.006 respectively) while the CCI was correlated with the improvement only in the univariate analysis (P = 0.007). Conclusion: Nowadays, in patients with cervical SCI early surgery could be associated with improved outcome, most in case of young people with mild neurological impairment. PMID:26396608

  14. Surgical site infection--the authors' own prospective research.

    Science.gov (United States)

    Neuman, Danuta; Grzebieniak, Zygmunt

    2014-01-01

    Surgical site infection is a common complication in surgery, which increases treatment cost, extends hospitalization time and can lead to septic complications. The aim of the study was analysis of postoperative infections in own material and finding significant risk factors with preserving the obligatory procedures in the clinic. Prospective analysis of 270 consecutively operated patients aged from 18 to 101 was performed with observation of early infection until 7th day postoperatively. Factors judged included: age, sex, BMI, operation type: elective or urgent, physical preparation for surgery, antibiotic prophylaxis, length and type of surgery. Wound observation card was used. Data were analysed statistically (t-Student's test, chi2 test, U Mann Whitney test and logistic regression analysis). Wound infection was observed in 33 patients (12.22% of the entire group). In 24 (8.88%) it was a superficial infection and in 9 (3.33%) deep infection. Statistically significant risk factors were age, presence of diabetes, operation time and operations on large bowel. The average age of patients with present infection was 61.2. In the group without infection there were 6,3% patients with diabetes and 20.8% in the group with infection. In our study diabetes increased the risk of infection four times. The longer the operation time the higher was the risk of deep infection (without complications 76.2 minutes, superficial 94.9 minutes, deep 148.9 minutes). Operations on large bowel were performed in 11.9%of all study patients. In the group of 33 patients with surgical wound infection, 39.4% had colon surgery, 39.4% of all deep infections and 29.2% of all superficial infections. In own study material significant risk factors of surgical wound infection were: age, presence of diabetes, length of operation, large bowel surgery. In preoperative course risk factors should be identified to perform certain prophylactic procedures to lower the risk of infectious complications.

  15. Numerous transitions of sex chromosomes in Diptera.

    Science.gov (United States)

    Vicoso, Beatriz; Bachtrog, Doris

    2015-04-01

    Many species groups, including mammals and many insects, determine sex using heteromorphic sex chromosomes. Diptera flies, which include the model Drosophila melanogaster, generally have XY sex chromosomes and a conserved karyotype consisting of six chromosomal arms (five large rods and a small dot), but superficially similar karyotypes may conceal the true extent of sex chromosome variation. Here, we use whole-genome analysis in 37 fly species belonging to 22 different families of Diptera and uncover tremendous hidden diversity in sex chromosome karyotypes among flies. We identify over a dozen different sex chromosome configurations, and the small dot chromosome is repeatedly used as the sex chromosome, which presumably reflects the ancestral karyotype of higher Diptera. However, we identify species with undifferentiated sex chromosomes, others in which a different chromosome replaced the dot as a sex chromosome or in which up to three chromosomal elements became incorporated into the sex chromosomes, and others yet with female heterogamety (ZW sex chromosomes). Transcriptome analysis shows that dosage compensation has evolved multiple times in flies, consistently through up-regulation of the single X in males. However, X chromosomes generally show a deficiency of genes with male-biased expression, possibly reflecting sex-specific selective pressures. These species thus provide a rich resource to study sex chromosome biology in a comparative manner and show that similar selective forces have shaped the unique evolution of sex chromosomes in diverse fly taxa.

  16. Numerous transitions of sex chromosomes in Diptera.

    Directory of Open Access Journals (Sweden)

    Beatriz Vicoso

    2015-04-01

    Full Text Available Many species groups, including mammals and many insects, determine sex using heteromorphic sex chromosomes. Diptera flies, which include the model Drosophila melanogaster, generally have XY sex chromosomes and a conserved karyotype consisting of six chromosomal arms (five large rods and a small dot, but superficially similar karyotypes may conceal the true extent of sex chromosome variation. Here, we use whole-genome analysis in 37 fly species belonging to 22 different families of Diptera and uncover tremendous hidden diversity in sex chromosome karyotypes among flies. We identify over a dozen different sex chromosome configurations, and the small dot chromosome is repeatedly used as the sex chromosome, which presumably reflects the ancestral karyotype of higher Diptera. However, we identify species with undifferentiated sex chromosomes, others in which a different chromosome replaced the dot as a sex chromosome or in which up to three chromosomal elements became incorporated into the sex chromosomes, and others yet with female heterogamety (ZW sex chromosomes. Transcriptome analysis shows that dosage compensation has evolved multiple times in flies, consistently through up-regulation of the single X in males. However, X chromosomes generally show a deficiency of genes with male-biased expression, possibly reflecting sex-specific selective pressures. These species thus provide a rich resource to study sex chromosome biology in a comparative manner and show that similar selective forces have shaped the unique evolution of sex chromosomes in diverse fly taxa.

  17. Sex-biased gene expression at homomorphic sex chromosomes in emus and its implication for sex chromosome evolution.

    Science.gov (United States)

    Vicoso, Beatriz; Kaiser, Vera B; Bachtrog, Doris

    2013-04-16

    Sex chromosomes originate from autosomes. The accumulation of sexually antagonistic mutations on protosex chromosomes selects for a loss of recombination and sets in motion the evolutionary processes generating heteromorphic sex chromosomes. Recombination suppression and differentiation are generally viewed as the default path of sex chromosome evolution, and the occurrence of old, homomorphic sex chromosomes, such as those of ratite birds, has remained a mystery. Here, we analyze the genome and transcriptome of emu (Dromaius novaehollandiae) and confirm that most genes on the sex chromosome are shared between the Z and W. Surprisingly, however, levels of gene expression are generally sex-biased for all sex-linked genes relative to autosomes, including those in the pseudoautosomal region, and the male-bias increases after gonad formation. This expression bias suggests that the emu sex chromosomes have become masculinized, even in the absence of ZW differentiation. Thus, birds may have taken different evolutionary solutions to minimize the deleterious effects imposed by sexually antagonistic mutations: some lineages eliminate recombination along the protosex chromosomes to physically restrict sexually antagonistic alleles to one sex, whereas ratites evolved sex-biased expression to confine the product of a sexually antagonistic allele to the sex it benefits. This difference in conflict resolution may explain the preservation of recombining, homomorphic sex chromosomes in other lineages and illustrates the importance of sexually antagonistic mutations driving the evolution of sex chromosomes.

  18. Same Sex Marriage and the Perceived Assault on Opposite Sex Marriage

    OpenAIRE

    Alexis Dinno; Chelsea Whitney

    2013-01-01

    BACKGROUND: Marriage benefits both individuals and societies, and is a fundamental determinant of health. Until recently same sex couples have been excluded from legally recognized marriage in the United States. Recent debate around legalization of same sex marriage has highlighted for anti-same sex marriage advocates and policy makers a concern that allowing same sex couples to marry will lead to a decrease in opposite sex marriages. Our objective is to model state trends in opposite sex mar...

  19. Attitudes of Lebanese university students towards surgical hymen reconstruction.

    Science.gov (United States)

    Awwad, Johnny; Nassar, Anwar; Usta, Ihab; Shaya, Monique; Younes, Zeina; Ghazeeri, Ghina

    2013-11-01

    Many cultural and religious beliefs place virginity at a high level of social significance, in that women who lose their virginity before marriage may face humiliation, ostracism, divorce, and extreme violence. This led to an increase in the demand for virginity restoration through surgical hymen reconstruction among these cultures. However, data regarding the acceptance of hymenoplasty in societies that consider sexuality a taboo are scarce. In this cross-sectional study, we investigated the effects of gender and religion on sexual attitudes towards hymenoplasty, premarital sex, and virginity in a sample of 600 Lebanese university students. Our findings showed that approval of hymenoplasty was low among participants regardless of gender (25.7 % men vs. 19.1 % women) and religious affiliations (22.5 % Muslims vs. 22.3 % Christians). Arguments for rejection were rooted in moral ethics and personal convictions: "form of deceiving and cheating" (80.7 %) and "betrayal of honesty in the relationship" (80.4 %). Reasons for acceptance included: personal belief in "women's rights, autonomy, and freedom" (72.2 %) and "physical harm and death" (63.5 %).Male participants were more likely to approve premarital coital sex than females (61.0 vs. 27.3 %). Muslims were also more likely to reject marrying a non-virgin than Christians (39.9 vs. 18.0 %). Female participants expressed more tolerance towards marrying a non-virgin male partner (78.3 vs. 57.3 %). Low acceptance of hymenoplasty among Lebanese university students was found to be related to moral ethics and personal convictions independently from gender and religious affiliation. Differences in sexual attitudes towards premarital coital sex and virginity, however, were more significantly influenced by culture and religion.

  20. SURVIVAL OF CONTINUOUS AMBULATORY PERITONEAL DIALYSIS CATHETERS: AN EVALUATION OF SURGICAL AND NON-SURGICAL FACTORS (SINGLE CENTER STUDY

    Directory of Open Access Journals (Sweden)

    A. Keshvari

    2006-06-01

    Full Text Available Peritoneal dialysis is an established form of renal replacement therapy used in many patients with end-stage renal disease. The key to a successful chronic peritoneal dialysis is a permanent and safe access to the peritoneal cavity. This study was conducted in order to evaluate the catheter survival and its related factors in Imam Khomeini Hospital. A total of 80 catheters were inserted into 69 patients (52 men and 28 women with end-stage chronic renal failure during a period of 84 months. Retrospectively the correlation between catheter survival (overall and event free with demographic factors (sex and age, surgical factors (surgeons and surgical methods, nephrologic factors (the causes of peritoneal dialysis selection and the history of hemodialysis and peritonitis factors (the history and number of peritonitis has been evaluated. The mean age of the patients was 48.35 years (16 to 79 years. The overall survival of catheters or the probability of having a functioning catheter after one, two and three years was 53%, 41%, 22%, respectively. The event free survival of the catheter or the probability of having a functioning catheter without any problems after one year was 14%. It has been found out that among all factors in this study only history of hemodialysis had statistically significant effect on the overall survival of continuous ambulatory peritoneal dialysis catheter (P = 0.04. It seems that the overall survival of catheters is better when CAPD is started before any other attempts for hemodialysis.

  1. Sex differences in glucose levels

    DEFF Research Database (Denmark)

    Faerch, K; Borch-Johnsen, Knut; Vaag, A

    2010-01-01

    We aimed to examine whether sex differences in fasting plasma glucose (FPG), 2 h post-OGTT plasma glucose (2hPG) and HbA(1c) could be explained by differences in body size and/or body composition between men and women in a general non-diabetic Danish population. Moreover, we aimed to study to what...

  2. Sex and acute stroke presentation.

    Science.gov (United States)

    Labiche, Lise A; Chan, Wenyaw; Saldin, Kamaldeen R; Morgenstern, Lewis B

    2002-11-01

    We determine whether a sex difference exists for acute stroke emergency department presentation. The TLL Temple Foundation Stroke Project is a prospective observational study of acute stroke management that identified 1,189 validated strokes in nonurban community EDs from February 1998 to March 2000. Structured interview of the patient and the person with the patient at symptom onset identified the symptom or symptoms that prompted the patient to seek medical attention. Interview data were available for 1,124 (94%) patients. A physician blinded to sex classified the reported symptoms into 14 categories. Nontraditional stroke symptoms were reported by 28% of women and 19% of men (odds ratio 1.62; 95% confidence interval 1.2 to 2.2). Nontraditional stroke symptoms, pain (men 8%, women 12%) and change in level of consciousness (men 12%, women 17%), were more often reported by women. Traditional stroke symptoms, imbalance (men 20%, women 15%) and hemiparesis (men 24%, women 19%), were reported more frequently by men. Trends were also found for women to present with nonneurologic symptoms (men 17%, women 21%) and men to present with gait abnormalities (men 11%, women 8%). There was no sex difference in the mean number of symptoms reported by an individual patient. This study suggests that a sex difference exists in reporting of acute stroke symptoms. Women with validated strokes present more frequently with nontraditional stroke symptoms than men. Recognition of this difference might yield faster evaluation and management of female patients with acute stroke eligible for acute therapies.

  3. Sex differences in heart failure

    NARCIS (Netherlands)

    Meyer, Sven

    2016-01-01

    This thesis examined differences between men and women with heart failure. First, it was shown that biological sex is a strong modulator in the clinical expression of various cardiomyopathies. In the general population it was shown that men are more likely to develop heart failure with reduced eject

  4. Sex Education in Multicultural Norway

    Science.gov (United States)

    Bartz, Tiffany

    2007-01-01

    Scandinavia has long been admired by American liberals and sex education advocates who cite comparable rates of adolescent sexuality, yet lower rates of teenage pregnancy, sexually transmitted diseases and abortion in Scandinavia. The United States has, however, two variables with which Scandinavia in general, and Norway in particular, has not…

  5. Sex Bias in Counseling Materials

    Science.gov (United States)

    Harway, Michele

    1977-01-01

    This article reviews findings of bias in counseling materials and presents results of three original studies. Indications are that textbooks used by practitioners present the sexes in stereotypical fashion, and a greater proportion of college catalog context is devoted to men than to women. (Author)

  6. Children as Sex Offenders, Why?

    Science.gov (United States)

    Deranek, Traci; Gilman, David A.

    This study investigates juvenile sex offenders and the predetermining factors that are present in their lives, prior to their first offenses. This study will give an overview of theories, children's sexual behaviors ranging from normal to disturbed, and family dynamics of juvenile offenders. The treatment files of boys and young men, currently in…

  7. Facets: Sex and Language Features.

    Science.gov (United States)

    English Journal, 1983

    1983-01-01

    Presents (1) suggestions of a sex-related frequency variation in vocabulary, pronunciation, and grammar; (2) evidence of increased sensitivity to sexist language in the manuscripts submitted to the National Council of Teachers of English; (3) a proposed substitution of "Dear Reader" for "Gentlemen" in business correspondence; and (4) a description…

  8. Sex determination in the Hymenoptera

    NARCIS (Netherlands)

    Heimpel, George E.; de Boer, Jetske G.

    2008-01-01

    The dominant and ancestral mode of sex determination in the Hymenoptera is arrhenotokous parthenogenesis, in which diploid females develop from fertilized eggs and haploid males develop from unfertilized eggs. We discuss recent progress in the understanding of the genetic and cytoplasmic mechanisms

  9. Sex, Lies and Video Games

    Science.gov (United States)

    Kearney, Paul; Pivec, Maja

    2007-01-01

    Sex and violence in video games is a social issue that confronts us all, especially as many commercial games are now being introduced for game-based learning in schools, and as such this paper polls teenage players about the rules their parents and teachers may or may not have, and surveys the gaming community, ie, game developers to parents, to…

  10. Creativity and Psychopathology: Sex Matters

    Science.gov (United States)

    Martín-Brufau, Ramón; Corbalán, Javier

    2016-01-01

    The association between creativity and psychopathology has, for decades, been a focus of heated debate fuelled by contradictory findings. Nevertheless, the findings suggest complex associations between creativity and psychopathology. Other studies have investigated the association between creativity and sex, with inconsistent results. The aim of…

  11. Sex Education in Multicultural Norway

    Science.gov (United States)

    Bartz, Tiffany

    2007-01-01

    Scandinavia has long been admired by American liberals and sex education advocates who cite comparable rates of adolescent sexuality, yet lower rates of teenage pregnancy, sexually transmitted diseases and abortion in Scandinavia. The United States has, however, two variables with which Scandinavia in general, and Norway in particular, has not…

  12. Sex determination in flowering plants.

    Science.gov (United States)

    Dellaporta, S L; Calderon-Urrea, A

    1993-10-01

    In many ways, plants offer unique systems through which to study sex determination. Because the production of unisexual flowers has evolved independently in many plant species, different and novel mechanisms may be operational. Hence, there is probably not one unifying mechanism that explains sex determination in plants. Advances in our understanding of sex determination will come from the analysis of the genetics, molecular biology, and biochemistry of genes controlling sexual determination in plants. Several excellent model systems for bisexual floral development (Arabidopsis and Antirrhinum), monoecy (maize), and dioecy (Silene, asparagus, and mercury) are available for such analyses. The important questions that remain concern the mechanism of action of sex determination genes and their interrelationship, if any, with homeotic genes that determine the sexual identity of floral organ primordia. At the physiological level, the connection between hormone signaling and sexuality is not well understood, although significant correlations have been discovered. Finally, once the genes that regulate these processes are identified, cloned, and studied, new strategies for the manipulation of sexuality in plants should be forthcoming.

  13. Creativity and Psychopathology: Sex Matters

    Science.gov (United States)

    Martín-Brufau, Ramón; Corbalán, Javier

    2016-01-01

    The association between creativity and psychopathology has, for decades, been a focus of heated debate fuelled by contradictory findings. Nevertheless, the findings suggest complex associations between creativity and psychopathology. Other studies have investigated the association between creativity and sex, with inconsistent results. The aim of…

  14. Sex, Lies and Video Games

    Science.gov (United States)

    Kearney, Paul; Pivec, Maja

    2007-01-01

    Sex and violence in video games is a social issue that confronts us all, especially as many commercial games are now being introduced for game-based learning in schools, and as such this paper polls teenage players about the rules their parents and teachers may or may not have, and surveys the gaming community, ie, game developers to parents, to…

  15. Assessment of educational environment of surgical theatre at a teaching hospital of a saudi university: using surgical theatre educational environment measures.

    Science.gov (United States)

    Al-Qahtani, Mona Faisal; Al-Sheikh, Mona

    2012-05-01

    This study was aimed to determine how medical interns perceive the important factors of the learning environment the surgical theatre at the teaching hospital of the medical school, University of Dammam (UoD). The study also investigated the relationships between the learning environment and academic achievements. Finally, it determined the role and significance of gender on the above perceptions and relationships. The Surgical Theatre Educational Environment Measure (STEEM) was used to identify the perceptions of interns on the most important factors prevalent in the surgical theatre as an educational environment. STEEM was administered to all interns during the period of June-September 2009. Ninety-one out of 145 students completed the questionnaire representing a response rate of 63%. Non-parametric statistical analysis was performed using Statistical Package for the Social Sciences (SPSS) Version 17. The STEEM was shown to be internally consistent for the assessment of the overall educational environment in the surgical theatre of UoD. The overall STEEM mean score was 110. For male and female students, the mean scores were 114 and 107 respectively. There were statistically significant gender differences in the perceptions of "learning opportunities" and "teaching and training". Females rated these subscales lower than males. There were no significant associations between academic achievements and perceptions of the educational environment. The interns perceived the learning environment of the surgical theatre as less than satisfactory. In comparison with the males; the perception of the females was less positive, particularly in the areas of learning opportunities, and teaching and training. The study also revealed some other problematic areas in the learning environment of surgical theatre of the teaching hospital of UoD. The results imply that there is much room for improvement. They also indicate that equal opportunities for learning and training should be

  16. [Acute appendicitis. Surgical and non-surgical treatment].

    Science.gov (United States)

    Souza-Gallardo, Luis Manuel; Martínez-Ordaz, José Luis

    2017-01-01

    Appendicitis represents a common disease for the surgeon with a relative risk between 7-8%. It was thought that if more time passed between diagnosis and treatment, the risk for complications, such as perforation or abscess formation, was higher; nevertheless; the evolution is variable, making necessary the development of different strategies such as antibiotic use only, interval surgery or endoscopic treatment. The purpose of this study is to make a revision in the management of appendicitis comparing conservative and surgical treatment. It is known that traditional management of appendicitis is appendectomy with a complication rate of 2.5% to 48%. Nowadays, laparoscopy is the approach of choice by many surgeons and there have proposed new invasive techniques such as endoscopic treatment with the use of prosthesis and ambulatory surgery. Antibiotic use is essential in the management of appendicitis. Its use as the only strategy to treat this disease has the purpose of lowering costs and diminishing complications related to surgery or the resection of the organ. We conclude that the ideal management of appendicitis remains controversial and it will depend of the clinical characteristics of each patient and the resources available.

  17. Surgical learning activities for house officers: do they improve the surgical experience?

    Science.gov (United States)

    Maweni, R M; Foley, R W; Lupi, M; Shier, D; Ronan O'Connell, P; Vig, S

    2016-11-01

    To ascertain whether house officers (HOs) attain a more satisfactory surgical rotation experience when they perform basic surgical learning activities. We also sought to establish how many and which learning activities HOs achieve and the effect on their surgical experience. A questionnaire listing 20 learning activities and questions regarding satisfaction with an overall experience was disseminated to HOs in the UK and Ireland who had completed ≥3 months of surgical rotations. Satisfaction with surgical experience was dichotomised in order to perform logistic regression using R Studio software v0.98. The survey was completed by 150 respondents, with 26 % completing at least 10 basic surgical learning activities during their surgical rotation. On multivariate analysis, the completion of these learning activities was significantly associated with a satisfactory rotation experience (p learning activities (p = 0.003). Surgical HOs who were informed about potential basic surgical learning activities that can be performed during their rotations performed significantly more of these activities. And these activities were associated with a significantly greater satisfaction with surgical rotations. Therefore, we recommend facilitating HOs completion of these activities as this will ensure that basic surgical competencies are achieved and that HOs will be more satisfied with their surgical experience.

  18. Profile of Congenital Surgical Anomalies in Neonates Admitted to Tertiary Care Neonatal Intensive Care Unit of Saurashtra Region

    Directory of Open Access Journals (Sweden)

    Zalak Shah

    2016-06-01

    Full Text Available Background: Congenital surgical anomaly is a major indication for admission of a neonate to an intensive care unit. Profile of surgical conditions is variable by system affecting the neonate and outcomes of the individual conditions depending upon treatment and post surgical facilities. This study was undertaken to highlight the surgical conditions, their burden and their prognosis encountered in our newborn care unit. Methodology: This study is a cross sectional study. All information was collected from the case records of all neonates admitted in newborn care unit of our centre between 1st April, 2011 and 31st October, 2014 with congenital surgical conditions and the following information extracted: surgical condition, age, sex, maturity, birth weight, its treatment and outcome, and other associated features were studied. Result: A total of 9213 neonates were admitted in the study period, of which 328 neonates (3.6% had surgical conditions. Surgery was performed in 225 neonates. Commonest congenital surgical condition was of gastrointestinal tract (GIT. Commonest GIT anomalies were tracheo-oesophageal fistula (28.6%, intestinal obstruction (23.7%, anorectal malformation (17.9%, and omphalocoele (7%. The overall mortality in neonates with congenital surgical condition in this study was 51.2%. Significantly, more deaths occurred in preterm than in term neonates (P = 0.00003 and low birth weight babies more than normal weight (p=0.0002. Conclusion: High mortality is found in neonates suffering from surgical conditions. Commonest anomaly includes conditions of Gastrointestinal tract. Prematurity and low birth weight is a significant factor associated with high mortality. [Natl J Med Res 2016; 6(2.000: 168-170

  19. Contemporary Review of Grafting Techniques for the Surgical Treatment of Peyronie's Disease.

    Science.gov (United States)

    Hatzichristodoulou, Georgios; Osmonov, Daniar; Kübler, Hubert; Hellstrom, Wayne J G; Yafi, Faysal A

    2017-02-28

    Techniques for the Surgical Treatment of Peyronie's Disease. Sex Med Rev 2017;X:XX-XX. Copyright © 2017 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

  20. Surgical management of primary and recurrent melanoma.

    Science.gov (United States)

    Farma, Jeffrey M; Kulkarni, Nandini; Hsu, Cary

    2015-04-01

    Melanoma accounts for less than 2% of skin cancer cases but causes most skin cancer-related deaths. Surgery continues to be the cornerstone of treatment of melanoma and surgical principles are guided by data derived from clinical research. This article examines the evolution of surgical techniques for the diagnosis and treatment of primary and locally recurrent melanoma.

  1. Traumatic foot injuries in horses: surgical management.

    Science.gov (United States)

    Burba, Daniel J

    2013-01-01

    Managing traumatic foot wounds in horses may require surgical intervention. These wounds include coronary-band and heel-bulb lacerations, septic pedal osteitis, septic navicular bursitis, sepsis of the collateral cartilages, and hoof-wall injuries. This article provides a practical overview of the surgical management of these types of wounds.

  2. Surgical site infection in posterior spine surgery

    African Journals Online (AJOL)

    2016-03-20

    Mar 20, 2016 ... Background: Surgical site infections (SSIs) in spine surgery remain a significant cause of ... before postoperative day 5 were associated with an increase in the rate of SSI. .... Table 1: Patient characteristics and associated wound .... patients with superficial or deep surgical site infection after spinal surgery.

  3. Multimodal strategies to improve surgical outcome

    DEFF Research Database (Denmark)

    Kehlet, Henrik; Wilmore, Douglas W

    2002-01-01

    surgical procedures or require only 1 to 2 days of postoperative hospitalization. Reorganization of the perioperative team (anesthesiologists, surgeons, nurses, and physical therapists) will be essential to achieve successful fast track surgical programs. CONCLUSIONS: Understanding perioperative...... track" surgery programs represents the major challenge for the medical professionals working to achieve a "pain and risk free" perioperative course....

  4. Non-surgical embryo transfer in pigs

    NARCIS (Netherlands)

    Hazeleger, W.

    1999-01-01

    Embryo transfer in pigs has been performed surgically for a long time. However, a less invasive, non-surgical, procedure of embryo transfer could be a valuable tool for research (to study embryo survival and embryo-uterus interactions) and practical applications (export, prevention of

  5. SURGICAL ORTHODONTICS: LITERATURE REVIEW AND CASE REPORT

    OpenAIRE

    2013-01-01

    Orthognathic surgery is a surgical procedure largely practiced throughout the world for the correction of various maxillofacial deformities. The procedure for correcting a particular deformity will be done after proper evaluation, which includes cephalometric, dental model analysis and photographs. The patient undergoes pre-surgical orthodontic correction for dental compensation, after which surgery is planned. During the last few decades, the profession has witnessed ...

  6. Surgical management of pancreatic neuroendocrine tumors

    NARCIS (Netherlands)

    Jilesen, A.P.J.

    2015-01-01

    This thesis gives an overview of the surgical management and prognosis of patients with pancreatic neuroendocrine tumors (pNET). A systematic review including 2600 studies, was performed on complications and survival after different surgical procedures for pNETs. The overall pancreatic fistula rate

  7. Sex, Sexuality, Sexting, and SexEd: Adolescents and the Media

    Science.gov (United States)

    Brown, Jane D.; Keller, Sarah; Stern, Susannah

    2009-01-01

    The traditional media (television, radio, movies, magazines) and new, digital media (the Internet, Social Networking Sites such as Facebook and Myspace, and cell phones) have become important sex educators for adolescents. Adolescents in the United States spend six to seven hours a day with some form of media, often using more than one kind…

  8. Sex, Sexuality, Sexting, and SexEd: Adolescents and the Media

    Science.gov (United States)

    Brown, Jane D.; Keller, Sarah; Stern, Susannah

    2009-01-01

    The traditional media (television, radio, movies, magazines) and new, digital media (the Internet, Social Networking Sites such as Facebook and Myspace, and cell phones) have become important sex educators for adolescents. Adolescents in the United States spend six to seven hours a day with some form of media, often using more than one kind…

  9. Surgical Strategies for Cervical Spinal Neurinomas.

    Science.gov (United States)

    Ito, Kiyoshi; Aoyama, Tatsuro; Miyaoka, Yoshinari; Horiuchi, Tetsuyoshi; Hongo, Kazuhiro

    2015-01-01

    Cervical spinal neurinomas are benign tumors that arise from nerve roots. Based on their location, these tumors can also take the form of a dumbbell-shaped mass. Treatment strategies for these tumors have raised several controversial issues such as appropriate surgical indications and selection of surgical approaches for cervical dumbbell-shaped spinal neurinomas. In this report, we review previous literature and retrospectively analyze cervical spinal neurinoma cases that have been treated at our hospital. Surgical indications and approaches based on tumor location and severity are discussed in detail. Thus, with advances in neuroimaging and neurophysiological monitoring, we conclude that appropriate surgical approaches and intraoperative surgical manipulations should be chosen on a case-by-case basis.

  10. Disparities between industrial and surgical ergonomics.

    Science.gov (United States)

    Seagull, F Jacob

    2012-01-01

    A surgeon's work environment and working conditions are often harsher than those of an industrial worker. Accepted principles and regulations of ergonomics in manufacturing are largely ignored or absent in the medical/surgical domain. Examples include poor surgical tool handle design, awkward and stressful surgical postures, and prolonged standing without breaks and without a foot mat. In these and other areas, there are documented "best practices" for industrial hygiene and ergonomics that are not yet widely accepted for surgery. There is support in the literature for innovations in surgical ergonomics, yet adoption is not widespread. In the absence of these ergonomic principles, surgical repetitive strain injuries in minimally invasive surgery are reaching epidemic levels. As ergonomists, it falls upon us to understand why current solutions have not been widely adopted within this domain, and to derive solutions to the unique challenges of surgery.

  11. The effect of fasting on surgical performance

    DEFF Research Database (Denmark)

    Schefte, David Fenger; Rosenstock, Steffen Jais

    2016-01-01

    BACKGROUND: It is unknown whether fasting has any impact on surgical performance. This simulator-based study investigates whether fasting affects surgical performance. METHODS: Twelve healthy medical students [seven women, mean age 26.5 years (range 23-34)] with no prior experience with surgical...... simulators underwent a short course introduction to the LapSim(®) simulator. After having reached a predefined level, the participants performed five simulated salpingectomies on the LapSim(®) simulator 5-30 days after the initial introduction. The procedures took place at 9 a.m. and 2 p.m. after fasting...... in the longitudinal axis with the left hand. CONCLUSION: The simulator-based study suggests that 17 h of fasting does not deteriorate surgical performance. Further studies on the effect of fasting on surgical performance are needed....

  12. Early sexing techniques in Lophiosilurus alexandri (Steindachner, 1876), a freshwater carnivorous catfish.

    Science.gov (United States)

    Melillo Filho, Reinaldo; Gheller, Valentim Arabicano; Chaves, Glauco Vinício; de Souza E Silva, Walisson; Costa, Deliane Cristina; Figueiredo, Luis Gustavo; da Costa Julio, Gustavo Soares; Luz, Ronald Kennedy

    2016-10-01

    This study aimed to evaluate sexing techniques for juvenile Lophiosilurus alexandri. With this aim, we evaluated three techniques: coelioscopy, performed with the use of video surgery equipment; coeliotomy, a surgical procedure for direct visualization of the gonads; and sex determination using a urethral probe to compare the genital papillae. For coelioscopy, the survival rate was 100% 30 days after the procedure, and the fish restarted eating 10 days after surgery. This technique resulted in a 100% correct identification of individuals identified as females, whereas for males, it was 66.6%. There was no significant difference between males and females for anesthesia induction and recovery times. However, the procedure took longer for males because of the difficulty in observing the gonads, which can be attributed to the large amount of visceral fat in males. Coeliotomy also resulted in a 100% survival rate 30 days after surgery, and the efficiency of this technique was 96.3% for males and 93.9% for females. The fish restarted eating between 10 and 14 days after surgery, and there were no significant differences between males and females for anesthesia induction and recovery times for the surgical procedure to visualize the gonads (P > 0.05). The urethral probe technique was less efficient with an accuracy rate of 67.8% and 81.8% for males and females, respectively. We conclude that coeliotomy was more efficient for sexing both sexes of juvenile L. alexandri.

  13. How Will Cancer Affect My Sex Life?

    Science.gov (United States)

    ... Patients and Families How will cancer affect my sex life? Sexual feelings and attitudes vary greatly among ... Others find that they have less interest in sex because of the physical and emotional demands of ...

  14. Sex and Prevention Concerns for Positive People

    Science.gov (United States)

    ... with any comments or concerns. February 17, 2011 Sex and prevention concerns for positive people Facebook Twitter ... partner, and vice versa. The reality of safer sex You put yourself at risk for infections through ...

  15. Gambling, Sex, and…Parkinson's Disease?

    Science.gov (United States)

    ... spent, browse our financial information. Learn More Gambling, Sex, and…Parkinson's Disease? By Laura Marsh, M.D. ... and, in people with Parkinson's, most typically involve sex, gambling and abuse of anti-parkinsonian medications. Pathological ...

  16. Sex and the Man With Cancer

    Science.gov (United States)

    ... and Sexual Side Effects in People with Cancer Sex and the Man With Cancer In this guide, ... you and your partner some information about cancer, sex, and sexuality. We cannot answer every question, but ...

  17. Goals for Sex Equitable Sexuality Education.

    Science.gov (United States)

    Whatley, Mariamne H.

    1987-01-01

    This article presents an overview of issues related to sex equity in sexuality education. Goals which might represent sex equitable sexuality education include eliminating double standards, and redefining sexuality education. (IAH)

  18. Sex chromosome rearrangements in Polyphaga beetles.

    Science.gov (United States)

    Dutrillaux, A M; Dutrillaux, B

    2009-01-01

    The presence of a parachute sex chromosome bivalent (Xyp) at metaphase I of male meiosis is a well-known characteristic of Coleoptera, present in almost all families of this order and assumed to represent their ancestral sex chromosome formula. Sex chromosomes appear to be manifold more frequently involved in inter-chromosomal rearrangements than the average of the nine autosomal pairs usually forming their karyotype. This leads to various formulae such as neo-sex, multiple sex and perhaps unique sex chromosomes. These rearrangements alter the intimate association between sex chromosomes and nucleolar proteins, which are usual components of the Xyp. Different situations, selected in a series of 125 mitotic and meiotic cytogenetic studies of Polyphaga beetle species, are reported and discussed, with the aim to improve our knowledge on the mechanisms of sex chromosome rearrangements, the relationships with nucleoli and the consequences on dosage compensation and chromosome segregation.

  19. Sex and Prevention Concerns for Positive People

    Science.gov (United States)

    ... with any comments or concerns. February 17, 2011 Sex and prevention concerns for positive people Facebook Twitter ... partner, and vice versa. The reality of safer sex You put yourself at risk for infections through ...

  20. Sex Ratio at Birth in China

    Institute of Scientific and Technical Information of China (English)

    2004-01-01

    The demographic structure of populations,particularly age and sex, has profound consequences for harmonious and sustainable social and economic development. Furthermore, analyzing sex ratios of populations is important in analyzing the development of the status Of women and girls.

  1. The Teacher and Sex Role Stereotyping

    Science.gov (United States)

    Juhasz, Anne McCreary

    1974-01-01

    In this article, selected research findings are presented on sex role learning, sex role stereotyping, in general and in the school setting, the effect of such stereotyping on the student, and some suggestions for the teacher. (Author/JA)

  2. [Surgical treatment of chiasmal gliomas in children].

    Science.gov (United States)

    Helcl, F

    1997-03-01

    Chiasmal gliomas are rare brain tumors occurring especially in children. Their proper treatment is still controversial and consists of surgery, radiotherapy and chemotherapy. Surgical removal of these tumors can usually be only partial or subtotal and radiotherapy frequently follows. There are supporters of surgical approach, as well as its enemies. The author has been engaged in problems of optimal treatment of this entity for more than 10 years. He is offering a review of knowledge from the literature concerning surgical treatment of this disease in children. The great majority of articles in the literature are dealing with retrospective analysis of relatively small series of patients usually treated in single neurosurgical department and the surgical treatment is enclosed like a part of combined therapy. Articles dealing only with surgical treatment of chiasmal gliomas are few and reviews determining the contemporary role of surgery of this entity are also lacking. This was the main impulse for writing this compilation. The short history of surgical therapy is reviewed. Some new trends of this therapy are also mentioned (microsurgery, Cavitron Ultrasonic Surgical Aspirator and peroperative use of visual evoked potentials). Up to date criteria for surgical treatment of chiasmal gliomas in children are given-exploration of chiasmal region and performing a biopsy in all cases, radical surgery only in extrinsic gliomas of the chiasmal region and conservative surgical approach to intrinsic chiasmal gliomas. It is emphasized that the significance of obstructive hydrocephalus in this entity has not been fully estimated till now, as well as the role of shunting procedures. Surgical treatment remains, nevertheless, an important armamentarium in the management of chiasmal gliomas in children. (Ref. 20.)

  3. Quality of pharmaceutical care in surgical patients.

    Directory of Open Access Journals (Sweden)

    Monica de Boer

    Full Text Available BACKGROUND: Surgical patients are at risk for preventable adverse drug events (ADEs during hospitalization. Usually, preventable ADEs are measured as an outcome parameter of quality of pharmaceutical care. However, process measures such as QIs are more efficient to assess the quality of care and provide more information about potential quality improvements. OBJECTIVE: To assess the quality of pharmaceutical care of medication-related processes in surgical wards with quality indicators, in order to detect targets for quality improvements. METHODS: For this observational cohort study, quality indicators were composed, validated, tested, and applied on a surgical cohort. Three surgical wards of an academic hospital in the Netherlands (Academic Medical Centre, Amsterdam participated. Consecutive elective surgical patients with a hospital stay longer than 48 hours were included from April until June 2009. To assess the quality of pharmaceutical care, the set of quality indicators was applied to 252 medical records of surgical patients. RESULTS: Thirty-four quality indicators were composed and tested on acceptability and content- and face-validity. The selected 28 candidate quality indicators were tested for feasibility and 'sensitivity to change'. This resulted in a final set of 27 quality indicators, of which inter-rater agreements were calculated (kappa 0.92 for eligibility, 0.74 for pass-rate. The quality of pharmaceutical care was assessed in 252 surgical patients. Nearly half of the surgical patients passed the quality indicators for pharmaceutical care (overall pass rate 49.8%. Improvements should be predominantly targeted to medication care related processes in surgical patients with gastro-intestinal problems (domain pass rate 29.4%. CONCLUSIONS: This quality indicator set can be used to measure quality of pharmaceutical care and detect targets for quality improvements. With these results medication safety in surgical patients can be enhanced.

  4. The effect of cross-sex hormonal treatment on gender dysphoria individuals' mental health: a systematic review

    Directory of Open Access Journals (Sweden)

    Costa R

    2016-08-01

    Full Text Available Rosalia Costa,1 Marco Colizzi2 1Gender Identity Development Service, Tavistock and Portman NHS Foundation Trust, Tavistock Centre, 2Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK Abstract: Cross-sex hormonal treatment represents a main aspect of gender dysphoria health care pathway. However, it is still debated whether this intervention translates into a better mental well-being for the individual and which mechanisms may underlie this association. Although sex reassignment surgery has been the subject of extensive investigation, few studies have specifically focused on hormonal treatment in recent years. Here, we systematically review all studies examining the effect of cross-sex hormonal treatment on mental health and well-being in gender dysphoria. Research tends to support the evidence that hormone therapy reduces symptoms of anxiety and dissociation, lowering perceived and social distress and improving quality of life and self-esteem in both male-to-female and female-to-male individuals. Instead, compared to female-to-male individuals, hormone-treated male-to-female individuals seem to benefit more in terms of a reduction in their body uneasiness and personality-related psychopathology and an amelioration of their emotional functioning. Less consistent findings support an association between hormonal treatment and other mental health-related dimensions. In particular, depression, global psychopathology, and psychosocial functioning difficulties appear to reduce only in some studies, while others do not suggest any improvement in these domains. Results from longitudinal studies support more consistently the association between hormonal treatment and improved mental health. On the contrary, a number of cross-sectional studies do not support this evidence. This review provides possible biological explanation vs psychological explanation (direct effect vs indirect effect

  5. Temperature-dependent sex ratio in a bird

    National Research Council Canada - National Science Library

    Ann Göth; David T Booth

    2005-01-01

    ... smaller. Megapodes possess heteromorphic sex chromosomes like other birds, which eliminates temperature-dependent sex determination, as described for reptiles, as the mechanism behind the skewed sex ratios...

  6. Augmented reality in surgical procedures

    Science.gov (United States)

    Samset, E.; Schmalstieg, D.; Vander Sloten, J.; Freudenthal, A.; Declerck, J.; Casciaro, S.; Rideng, Ø.; Gersak, B.

    2008-02-01

    Minimally invasive therapy (MIT) is one of the most important trends in modern medicine. It includes a wide range of therapies in videoscopic surgery and interventional radiology and is performed through small incisions. It reduces hospital stay-time by allowing faster recovery and offers substantially improved cost-effectiveness for the hospital and the society. However, the introduction of MIT has also led to new problems. The manipulation of structures within the body through small incisions reduces dexterity and tactile feedback. It requires a different approach than conventional surgical procedures, since eye-hand co-ordination is not based on direct vision, but more predominantly on image guidance via endoscopes or radiological imaging modalities. ARIS*ER is a multidisciplinary consortium developing a new generation of decision support tools for MIT by augmenting visual and sensorial feedback. We will present tools based on novel concepts in visualization, robotics and haptics providing tailored solutions for a range of clinical applications. Examples from radio-frequency ablation of liver-tumors, laparoscopic liver surgery and minimally invasive cardiac surgery will be presented. Demonstrators were developed with the aim to provide a seamless workflow for the clinical user conducting image-guided therapy.

  7. Audit of Orthopaedic Surgical Documentation

    Directory of Open Access Journals (Sweden)

    Fionn Coughlan

    2015-01-01

    Full Text Available Introduction. The Royal College of Surgeons in England published guidelines in 2008 outlining the information that should be documented at each surgery. St. James’s Hospital uses a standard operation sheet for all surgical procedures and these were examined to assess documentation standards. Objectives. To retrospectively audit the hand written orthopaedic operative notes according to established guidelines. Methods. A total of 63 operation notes over seven months were audited in terms of date and time of surgery, surgeon, procedure, elective or emergency indication, operative diagnosis, incision details, signature, closure details, tourniquet time, postop instructions, complications, prosthesis, and serial numbers. Results. A consultant performed 71.4% of procedures; however, 85.7% of the operative notes were written by the registrar. The date and time of surgery, name of surgeon, procedure name, and signature were documented in all cases. The operative diagnosis and postoperative instructions were frequently not documented in the designated location. Incision details were included in 81.7% and prosthesis details in only 30% while the tourniquet time was not documented in any. Conclusion. Completion and documentation of operative procedures were excellent in some areas; improvement is needed in documenting tourniquet time, prosthesis and incision details, and the location of operative diagnosis and postoperative instructions.

  8. Surgical Treatment in Uveal Tumors

    Directory of Open Access Journals (Sweden)

    Kaan Gündüz

    2014-09-01

    Full Text Available Surgical treatment in uveal tumors can be done via iridectomy, partial lamellar sclerouvectomy (PLSU and endoresection. Iridectomy is done in iris tumors without angle and ciliary body involvement. PLSU is performed in tumors with ciliary body and choroidal involvement. For this operation, a partial thickness scleral flap is dissected, the intraocular tumor is excised, and the flap is sutured back in position. PLSU surgery is done in iridociliary and ciliary body tumors with less than 3 clock hours of iris and ciliary body involvement and in choroidal tumors with a base diameter less than 15 mm. However, it can be employed in any size tumor for biopsy purposes. Potential complications of PLSU surgery include vitreous hemorrhage, cataract, retinal detachment, and endophthalmitis. Endoresection is a technique whereby the intraocular tumor is excised using vitrectomy techniques. The rationale for performing endoresection is based on the fact that irradiated uveal melanomas may be associated with exudation and neovascular glaucoma and removing the dead tumor tissue may contribute to better visual outcome. There are some centers where endoresection is done without prior radiotherapy. Allegedly, avoidance of radiation retinopathy and papillopathy are the main advantages of using endoresection without prior radiotherapy. (Turk J Ophthalmol 2014; 44: Supplement 29-34

  9. [Surgical treatment of anal fistula].

    Science.gov (United States)

    Zeng, Xiandong; Zhang, Yong

    2014-12-01

    Anal fistula is a common disease. It is also quite difficult to be solved without recurrence or damage to the anal sphincter. Several techniques have been described for the management of anal fistula, but there is no final conclusion of their application in the treatment. This article summarizes the history of anal fistula management, the current techniques available, and describes new technologies. Internet online searches were performed from the CNKI and Wanfang databases to identify articles about anal fistula management including seton, fistulotomy, fistulectomy, LIFT operation, biomaterial treatment and new technology application. Every fistula surgery technique has its own place, so it is reasonable to give comprehensive individualized treatment to different patients, which may lead to reduced recurrence and avoidance of damage to the anal sphincter. New technologies provide promising alternatives to traditional methods of management. Surgeons still need to focus on the invention and improvement of the minimally invasive techniques. Besides, a new therapeutic idea is worth to explore that the focus of surgical treatment should be transferred to prevention of the formation of anal fistula after perianal abscess.

  10. Adoption by same-sex couples

    National Research Council Canada - National Science Library

    Ellen, Mary; Lopata, Casey

    2007-01-01

    ... of the child to deny adoption to same-sex couples? As with opposite sex couples, the answer depends on the particular child and the particular couple involved. And studies show that children in same-sex-headed families do just as well as those in opposite-sex-headed families, and better than children who remain un-adopted. MARY ELLEN and CASEY LOPATA Rocheste...

  11. Abnormal sex chromosome constitution and longitudinal growth

    DEFF Research Database (Denmark)

    Aksglaede, Lise; Skakkebaek, Niels E; Juul, Anders

    2008-01-01

    Growth is a highly complex process regulated by the interaction between sex steroids and the GH IGF-axis. However, other factors such as sex chromosome-related genes play independent roles.......Growth is a highly complex process regulated by the interaction between sex steroids and the GH IGF-axis. However, other factors such as sex chromosome-related genes play independent roles....

  12. Decreasing Human Trafficking through Sex Work Decriminalization.

    Science.gov (United States)

    Albright, Erin; D'Adamo, Kate

    2017-01-01

    In order to decrease human trafficking, health care workers should support the full decriminalization of prostitution. Similar to trafficking in other forms of labor, preventing trafficking in the sex trade requires addressing the different forms of marginalization that create vulnerable communities. By removing punitive laws that prevent reporting of exploitation and abuse, decriminalization allows sex workers to work more safely, thereby reducing marginalization and vulnerability. Decriminalization can also help destigmatize sex work and help resist political, social, and cultural marginalization of sex workers.

  13. Sex trafficking in Nepal: context and process

    OpenAIRE

    Hennink, Monique; Simkhada, Padam

    2004-01-01

    This study has developed a conceptual framework to provide a clearer understanding of the process and context of sex trafficking from Nepal. Quantitative data were analysed from case records of 202 sex-trafficked women at rehabilitation centres in Nepal. In-depth interviews with 42 sex trafficked women, mostly residing at rehabilitation centres in Kathmandu, provide contextual information on the process and circumstances of sex trafficking. The results of this study provide a clearer understa...

  14. Tackling the diversity of sex determination.

    OpenAIRE

    Wedekind, C; Stelkens, R. B.

    2010-01-01

    A workshop on ‘The evolution of sex determination systems’ was held at a remote place in the Swiss Alps from 17 to 20 June 2009. It brought together theoreticians and empiricists, the latter ranging from molecular geneticists to evolutionary ecologists, all trying to understand key aspects of sex determination. The topics discussed included the evolutionary origins of sex determination, the diversity of sex determination mechanisms in different taxa, and the transition from genotypic to envir...

  15. Sex Education Can't Wait

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    Teenagers have become sexually mature and active much earlier, leading to rising rates of premarital sex and juvenile pregnancies in China and around the world. As a lack of sex education will put young people in a position that is very vulnerable to sexually transmitted diseases, including HIV/AIDS, we must give them proper knowledge about sex and help them handle sex-related issues wisely.

  16. Climate-driven shifts in adult sex ratios via sex reversals: the type of sex determination matters.

    Science.gov (United States)

    Bókony, Veronika; Kövér, Szilvia; Nemesházi, Edina; Liker, András; Székely, Tamás

    2017-09-19

    Sex reversals whereby individuals of one genetic sex develop the phenotype of the opposite sex occur in ectothermic vertebrates with genetic sex-determination systems that are sensitive to extreme temperatures during sexual differentiation. Recent rises in global temperatures have led researchers to predict that sex reversals will become more common, resulting in the distortion of many populations' sex ratios. However, it is unclear whether susceptibility to climate-driven sex-ratio shifts depends on the type of sex determination that varies across species. First, we show here using individual-based theoretical models that XX/XY (male-heterogametic) and ZZ/ZW (female-heterogametic) sex-determination systems can respond differentially to temperature-induced sex reversals. Interestingly, the impacts of climate warming on adult sex ratio (ASR) depend on the effects of both genotypic and phenotypic sex on survival and reproduction. Second, we analyse the temporal changes of ASR in natural amphibian populations using data from the literature, and find that ASR shifted towards males in ZZ/ZW species over the past 60 years, but did not change significantly in XX/XY species. Our results highlight the fact that we need a better understanding of the interactions between genetic and environmental sex-determining mechanisms to predict the responses of ectotherms to climate change and the associated extinction risks.This article is part of the themed issue 'Adult sex ratios and reproductive decisions: a critical re-examination of sex differences in human and animal societies'. © 2017 The Author(s).

  17. Sexing the brain: the science and pseudoscience of sex differences.

    Science.gov (United States)

    Rogers, Lesley J

    2010-06-01

    A recent upsurge in unitary biological explanations for gender differences in behavior (i.e. that they are "hard-wired" in the genetic code), put forward not only in books written for a general audience but also in scientific papers, makes it important to examine the fallacies of these ideas. Such genetic and hormonal explanations of human behavior, formulated with little consideration of the influences of experience, and often without taking experience into account at all, are part of a new wave of genetic explanations for a broad range of human behavior, as explained in the paper. These ideas are far from new; moreover, they are pseudoscientific and are used for political influence under the guise of science. They are a conservative social force that maintains social and educational inequalities between women and men. This paper explains that causal explanations of differences between the sexes are of two completely different types: unitary (genetic determinist) versus interactive explanations. The false reasoning used to support genetic determinist explanations of sex differences in behavior is discussed. To illustrate what biology really tells us about gender differentiation, the paper discusses the interactive roles of genetic, hormonal and environmental influences on the development of gender differences. These interactions are illustrated using two model biological systems (e.g. the intertwined influences of genes, sex hormones and experience on the development of sex differences in behavior in rats, and sex differences in neuronal connections in chickens). There is plenty of scientific evidence to show the complex interactive, and ever changing, influences of experience and genes that take place as an organism develops and throughout its life. Malleability of brain and behavior can be shown clearly using animal models, and the processes involved apply also to the development of brain and behavior in humans. We diminish our understanding of the functions of

  18. Sexing the Brain: The Science and Pseudoscience of Sex Differences

    Directory of Open Access Journals (Sweden)

    Lesley J. Rogers

    2010-06-01

    Full Text Available A recent upsurge in unitary biological explanations for gender differences in behavior (i.e. that they are “hard-wired” in the genetic code, put forward not only in books written for a general audience but also in scientific papers, makes it important to examine the fallacies of these ideas. Such genetic and hormonal explanations of human behavior, formulated with little consideration of the influences of experience, and often without taking experience into account at all, are part of a new wave of genetic explanations for a broad range of human behavior, as explained in the paper. These ideas are far from new; moreover, they are pseudoscientific and are used for political influence under the guise of science. They are a conservative social force that maintains social and educational inequalities between women and men. This paper explains that causal explanations of differences between the sexes are of two completely different types: unitary (genetic determinist versus interactive explanations. The false reasoning used to support genetic determinist explanations of sex differences in behavior is discussed. To illustrate what biology really tells us about gender differentiation, the paper discusses the interactive roles of genetic, hormonal and environmental influences on the development of gender differences. These interactions are illustrated using two model biological systems (e.g. the intertwined influences of genes, sex hormones and experience on the development of sex differences in behavior in rats, and sex differences in neuronal connections in chickens. There is plenty of scientific evidence to show the complex interactive, and ever changing, influences of experience and genes that take place as an organism develops and throughout its life. Malleability of brain and behavior can be shown clearly using animal models, and the processes involved apply also to the development of brain and behavior in humans. We diminish our understanding

  19. Sex Differences in Assertiveness in College Students

    Science.gov (United States)

    Stebbins, Charles; And Others

    1977-01-01

    Validates the "College Self-Expression Scale." Shows that females are significantly more assertive, and that in one of the criterion situations each sex was significantly more assertive toward members of the same sex than members of the opposite sex. (RL)

  20. 77 FR 73558 - Sex Offender Registration Amendments

    Science.gov (United States)

    2012-12-11

    ... COLUMBIA 28 CFR Part 811 RIN 3225-AA10 Sex Offender Registration Amendments AGENCY: Court Services and... verification of registration information for sex offenders. The proposed rule, if finalized, would permit CSOSA to verify addresses of sex offenders by conducting home visits on its own accord and with its...