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Sample records for surgical specimen measured

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

    DEFF Research Database (Denmark)

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

    2011-01-01

    Recently, vacuum-based preservation of surgical specimens has been proposed as a safe alternative to formalin fixation at the surgical theater. The method seems feasible from a practical point of view, but no systematic study has examined the effect of vacuum sealing alone with respect to tissue...... preservation. In this study, we therefore subjected tissue samples from 5 different organs to treatments with and without vacuum sealing and cooling at 4°C to study the effect of vacuum sealing of surgical specimens with respect to tissue preservation and compare it with the effect of cooling. No preserving...... effect of vacuum sealing was observed with respect to cellular morphology, detection of immunohistochemical epitopes, or RNA integrity. In contrast, storage at 4°C was shown to preserve tissue to a higher degree than storage at room temperature for all included endpoints, independently of whether...

  2. Documentation of surgical specimens using digital video technology.

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    Melín-Aldana, Héctor; Carter, Barbara; Sciortino, Debra

    2006-09-01

    Digital technology is commonly used for documentation of specimens in anatomic pathology and has been mainly limited to still photographs. Technologic innovations, such as digital video, provide additional, in some cases better, options for documentation. To demonstrate the applicability of digital video to the documentation of surgical specimens. A Canon Elura MC40 digital camcorder was used, and the unedited movies were transferred to a Macintosh PowerBook G4 computer. Both the camcorder and specimens were hand-held during filming. The movies were edited using the software iMovie. Annotations and histologic photographs may be easily incorporated into movies when editing, if desired. The finished movies are best viewed in computers which contain the free program QuickTime Player. Movies may also be incorporated onto DVDs, for viewing in standard DVD players or appropriately equipped computers. The final movies are on average 2 minutes in duration, with a file size between 2 and 400 megabytes, depending on the intended use. Because of file size, distribution is more practical via CD or DVD, but movies may be compressed for distribution through the Internet (e-mail, Web sites) or through internal hospital networks. Digital video is a practical, easy, and affordable methodology for specimen documentation, permitting a better 3-dimensional understanding of the specimens. Discussions with colleagues, student education, presentation at conferences, and other educational activities can be enhanced with the implementation of digital video technology.

  3. Concordance of DNA methylation profiles between breast core biopsy and surgical excision specimens containing ductal carcinoma in situ (DCIS).

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    Chen, Youdinghuan; Marotti, Jonathan D; Jenson, Erik G; Onega, Tracy L; Johnson, Kevin C; Christensen, Brock C

    2017-08-01

    The utility and reliability of assessing molecular biomarkers for translational applications on pre-operative core biopsy specimens assume consistency of molecular profiles with larger surgical specimens. Whether DNA methylation in ductal carcinoma in situ (DCIS), measured in core biopsy and surgical specimens are similar, remains unclear. Here, we compared genome-scale DNA methylation measured in matched core biopsy and surgical specimens from DCIS, including specific DNA methylation biomarkers of subsequent invasive cancer. DNA was extracted from guided 2mm cores of formalin fixed paraffin embedded (FFPE) specimens, bisulfite-modified, and measured on the Illumina HumanMethylation450 BeadChip. DNA methylation profiles of core biopsies exhibited high concordance with matched surgical specimens. Within-subject variability in DNA methylation was significantly lower than between-subject variability (all Pcore biopsy and surgical specimens, 15%, and a pathway analysis of these CpGs indicated enrichment for genes related with wound healing. Our results indicate that DNA methylation measured in core biopsies are representative of the matched surgical specimens and suggest that DCIS biomarkers measured in core biopsies can inform clinical decision-making. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  4. HER2 testing on core needle biopsy specimens from primary breast cancers: interobserver reproducibility and concordance with surgically resected specimens

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    Yamamoto Sohei

    2010-10-01

    Full Text Available Abstract Background Accurate evaluation of human epidermal growth factor receptor type-2 (HER2 status based on core needle biopsy (CNB specimens is mandatory for identification of patients with primary breast cancer who will benefit from primary systemic therapy with trastuzumab. The aim of the present study was to validate the application of HER2 testing with CNB specimens from primary breast cancers in terms of interobserver reproducibility and comparison with surgically resected specimens. Methods A total of 100 pairs of archival formalin-fixed paraffin-embedded CNB and surgically resected specimens of invasive breast carcinomas were cut into sections. All 100 paired sections were subjected to HER2 testing by immunohistochemistry (IHC and 27 paired sections were subjected to that by fluorescence in situ hybridization (FISH, the results being evaluated by three and two observers, respectively. Interobserver agreement levels in terms of judgment and the concordance of consensus scores between CNB samples and the corresponding surgically resected specimens were estimated as the percentage agreement and κ statistic. Results In CNB specimens, the percentage interobserver agreement of HER2 scoring by IHC was 76% (κ = 0.71 for 3 × 3 categories (0-1+ versus 2+ versus 3+ and 90% (κ = 0.80 for 2 × 2 categories (0-2+ versus 3+. These levels were close to the corresponding ones for the surgically resected specimens: 80% (κ = 0.77 for 3 × 3 categories and 92% (κ = 0.88 for 2 × 2 categories. Concordance of consensus for HER2 scores determined by IHC between CNB and the corresponding surgical specimens was 87% (κ = 0.77 for 3 × 3 categories, and 94% (κ = 0.83 for 2 × 2 categories. Among the 13 tumors showing discordance in the mean IHC scores between the CNB and surgical specimens, the results of consensus for FISH results were concordant in 11. The rate of successful FISH analysis and the FISH positivity rate in cases with a HER2 IHC score of

  5. 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...

  6. 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...

  7. Measurements and Counts for Notacanthidae Specimens

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Taxonomic data were collected for specimens of deep-sea spiny eels (Notacanthidae) from the Hawaiian Ridge by Bruce C. Mundy. Specimens were collected off the north...

  8. Degenerative spine disease : pathologic findings in 985 surgical specimens.

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    Pytel, Peter; Wollmann, Robert L; Fessler, Richard G; Krausz, Thomas N; Montag, Anthony G

    2006-02-01

    A number of pathologic changes have been reported in spinal surgery specimens. The frequency of many of these is not well defined. We retrospectively reviewed the histologic features of 985 extradural spinal surgery specimens. Of the cases, 1.6% were identified clinically as synovial cysts. In addition, synovial tissue was seen in another 5.3% of cases, often embedded within disk material. Neovascularization of disk tissue was present in 8.1% of cases, chondrocyte clusters in 18.3%, and calcium pyrophosphate crystals in 2.8%, predominantly within disk material. With the exception of crystal deposits, all of these changes were significantly more common in the lumbar spine. A better understanding of cell-based degenerative changes will become essential with increasing research into cell-based therapies for spinal disk disease. We report data on the frequency of different pathologic changes and describe synovial metaplasia as a reactive change not previously reported.

  9. Can we measure surgical resilience?

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    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.

  10. MORPHOLOGICAL STUDY OF SURGICALLY OBTAINED HUMAN COCHLEAR SPECIMENS-TECHNICAL ASPECTS

    Institute of Scientific and Technical Information of China (English)

    LIU Wei; GUO Rui; Rask Andersen Helge

    2014-01-01

    Object To explore the procedures in per-operative harvesting and management of fresh human cochlear specimens for research. Methods During trans-cochlear surgery to remove large petro-clival meningiomas causing life-threatening compression on the brainstem, cochleae are normally destroyed and drilled away in order to reach the apical petrous and clivus region. Instead the cochlea can be dissected out after ethical per-mission was obtained from the local ethical committee (EPN) and allowance gained from the patients. Sur-gery is performed by a team consisting of oto-and neurosurgeons as a two-day procedure with total petro-sectomy in combination with an inferior re-routing of the facial nerve. Fixation of the cochleae was done in the operating room as soon as the specimens had been separated from the temporal bones. Decalcification began after hours’to overnight’s fixation for 4 weeks. Sectioning parallel to the modiolus (mid-modiolus) was performed with a cryostat microtome. The sections were subjected to immunofluorescence (IF). Results Using freshly prepared 4%paraformaldehyde (PFD) solution, adequate fixation of fine inner ear structures was achieved with hours’immersion of the cochlear specimens. Decalcification in 6.2% ethylene di-amine-tetracetic acid (EDTA) solution for 4 weeks yielded a thoroughly decalcified cochlea. Experiences in processing 14 human cochleae and analysing main landmarks in five human inner ear plastic/silicone casts showed that the oval window/stapes footplate are backward tilted, at an angle about 15 degrees, from the plane perpendicular to the modiolar axis. The distance from the modiolar apex to the anterior border of the oval window/footplate in these inner ear casts measured between 4 and 5 mm. High quality IF staining was obtained. Conclusion Surgically obtained human cochlear specimen, when properly processed, contains ide-ally preserved antigenicity for immunohistochemical study. Adequate orientation during sectioning helps

  11. Integration of Value Stream Map and Healthcare Failure Mode and Effect Analysis into Six Sigma Methodology to Improve Process of Surgical Specimen Handling

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    Sheng-Hui Hung

    2015-01-01

    Full Text Available Specimen handling is a critical patient safety issue. Problematic handling process, such as misidentification (of patients, surgical site, and specimen counts, specimen loss, or improper specimen preparation can lead to serious patient harms and lawsuits. Value stream map (VSM is a tool used to find out non-value-added works, enhance the quality, and reduce the cost of the studied process. On the other hand, healthcare failure mode and effect analysis (HFMEA is now frequently employed to avoid possible medication errors in healthcare process. Both of them have a goal similar to Six Sigma methodology for process improvement. This study proposes a model that integrates VSM and HFMEA into the framework, which mainly consists of define, measure, analyze, improve, and control (DMAIC, of Six Sigma. A Six Sigma project for improving the process of surgical specimen handling in a hospital was conducted to demonstrate the effectiveness of the proposed model.

  12. Integration of Value Stream Map and Healthcare Failure Mode and Effect Analysis into Six Sigma Methodology to Improve Process of Surgical Specimen Handling.

    Science.gov (United States)

    Hung, Sheng-Hui; Wang, Pa-Chun; Lin, Hung-Chun; Chen, Hung-Ying; Su, Chao-Ton

    2015-01-01

    Specimen handling is a critical patient safety issue. Problematic handling process, such as misidentification (of patients, surgical site, and specimen counts), specimen loss, or improper specimen preparation can lead to serious patient harms and lawsuits. Value stream map (VSM) is a tool used to find out non-value-added works, enhance the quality, and reduce the cost of the studied process. On the other hand, healthcare failure mode and effect analysis (HFMEA) is now frequently employed to avoid possible medication errors in healthcare process. Both of them have a goal similar to Six Sigma methodology for process improvement. This study proposes a model that integrates VSM and HFMEA into the framework, which mainly consists of define, measure, analyze, improve, and control (DMAIC), of Six Sigma. A Six Sigma project for improving the process of surgical specimen handling in a hospital was conducted to demonstrate the effectiveness of the proposed model.

  13. Recommendations for gross examination and sampling of surgical specimens of the spleen.

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    O'Malley, Dennis P; Louissaint, Abner; Vasef, Mohammad A; Auerbach, Aaron; Miranda, Roberto; Brynes, Russell K; Fedoriw, Yuri; Hudnall, S David

    2015-10-01

    This review examines handling and processing of spleen biopsies and splenectomy specimens with the aim of providing the pathologist with guidance in optimizing examination and diagnosis of splenic disorders. It also offers recommendations as to relevant reporting factors in gross examination, which may guide diagnostic workup. The role of splenic needle biopsies is discussed. The International Spleen Consortium is a group dedicated to promoting education and research on the anatomy, physiology, and pathology of the spleen. In keeping with these goals, we have undertaken to provide guidelines for gross examination, sectioning, and sampling of spleen tissue to optimize diagnosis (Burke). The pathology of the spleen may be complicated in routine practice due to a number of factors. Among these are lack of familiarity with lesions, complex histopathology, mimicry within several types of lesions, and overall rarity. To optimize diagnosis, appropriate handling and processing of splenic tissue are crucial. The importance of complete and accurate clinical history cannot be overstated. In many cases, significant clinical history such as previous lymphoproliferative disorders, hematologic disorders, trauma, etc, can provide important information to guide the evaluation of spleen specimens. Clinical information helps plan for appropriate processing of the spleen specimen. The pathologist should encourage surgical colleagues, who typically provide the specimens, to include as much clinical information as possible.

  14. Pathological assessment of tumor biopsy specimen and surgical sentinel lymph node dissection in patients with melanoma.

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    Nodiţi, Gheorghe; Nica, Cristian C; Petrescu, Horaţiu Pompiliu; Ivan, Codruţ; Crăiniceanu, Zorin Petrişor; Bratu, Tiberiu; Dema, Alis

    2014-01-01

    Actual trends of cutaneous malignant melanoma show a faster increase then other forms of cancer. Early detection and diagnosis, and accurate pathologic interpretation of the biopsy specimen is extremely important for the treatment and prognosis of clinically localized melanoma. The surgical approach to cutaneous melanoma patients with clinically uninvolved regional lymph nodes remains controversial. A retrospective study of melanoma cases was conducted in the "Casa Austria" Department of Plastic and Reconstructive Surgery, Emergency County Hospital, Timisoara, Romania. We have analyzed the medical records of 21 patients that underwent surgical treatment for different stages of melanoma in the period 2008-2012. For histopathological diagnosis of melanoma and the sentinel lymph node(s) status, tissular fragments were routinely processed. For the difficult cases, additional immunohistochemical investigation was done. A positive family history was noted in two cases. The presence of different sizes and localization of pigmented nevi was found in 38% of the cases. Different types of melanoma like superficial spreading melanoma, nodular melanoma or lentigo malignant melanoma and acral lentiginous melanoma was described. The surgical treatment consisted in all cases in wide excision of the primary tumor and prophylactic dissection of sentinel lymph node after lymphoscintigraphy examination. A positive biopsy of the sentinel lymph node was noted in 4.9% of the cases. The surgical treatment combining the wide excision of the primary tumor with respect to safe oncological limits with the prophylactic dissection of sentinel lymph node after lymphoscintigraphy examination had the confirmation done by the pathologic interpretation of the biopsy specimen showing that all the patients had a Breslow index more than 1.5 mm.

  15. Radial scars without atypia in percutaneous biopsy specimens: can they obviate surgical biopsy?

    Science.gov (United States)

    Mesa-Quesada, J; Romero-Martín, S; Cara-García, M; Martínez-López, A; Medina-Pérez, M; Raya-Povedano, J L

    2017-06-06

    To evaluate the need for surgical biopsy in patients diagnosed with radial scars without atypia by percutaneous biopsy. In this retrospective observational study, we selected patients with a histological diagnosis of radial scar in specimens obtained by percutaneous biopsy during an 8-year period. The statistical analysis was centered on patients with radial scar without atypia (we assessed the radiologic presentation, the results of the percutaneous biopsy, and their correlation with the results of surgical biopsy and follow-up) and we added the patients with atypia and cancer in the elaboration of the diagnostic indices. We identified 96 patients with radial scar on percutaneous biopsy; 54 had no atypia, 18 had atypia, and 24 had cancer. Among patients with radial scar without atypia, there were no statistically significant differences between patients who underwent imaging follow-up and those who underwent surgical biopsy (p>0.05). The rate of underdiagnosis for percutaneous biopsy in patients without atypia was 1.9%. The rates of diagnosis obtained with percutaneous biopsy in relation to follow-up and surgical biopsy in the 96 cases were sensitivity 92.3%, specificity 100%, positive predictive value 100%, negative predictive value 97.2%, and accuracy 97.9%. The area under the ROC curve was 0.96 (p<0.001), and the kappa concordance index was 0.95 (p<0.001) CONCLUSIONS: We consider that it is not necessary to perform surgical biopsies in patients with radial scars without atypia on percutaneous biopsies because the rate of underestimation is very low and the concordance between the diagnosis reached by percutaneous biopsy and the definitive diagnosis is very high. Copyright © 2017 SERAM. Publicado por Elsevier España, S.L.U. All rights reserved.

  16. Interobserver agreement of gleason score and modified gleason score in needle biopsy and in surgical specimen of prostate cancer

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    Sergio G. Veloso

    2007-10-01

    Full Text Available INTRODUCTION: Gleason score, which has a high interobserver variability, is used to classify prostate cancer. The most recent consensus valued the tertiary Gleason pattern and recommended its use in the final score of needle biopsies (modified Gleason score. This pattern is considered to be of high prognostic value in surgical specimens. This study emphasized the evaluation of the modified score agreement in needle biopsies and in surgical specimen, as well as the interobserver variability of this score MATERIALS AND METHODS: Three pathologists evaluated the slides of needle biopsies and surgical specimens of 110 patients, reporting primary, secondary and tertiary Gleason patterns and after that, traditional and modified Gleason scores were calculated. Kappa test (K assessed the interobserver agreement and the agreement between the traditional and modified scores of the biopsy and of the surgical specimen RESULTS: Interobserver agreement in the biopsy was K = 0.36 and K = 0.35, and in the surgical specimen it was K = 0.46 and K = 0.36, for the traditional and modified scores, respectively. The tertiary Gleason grade was found in 8%, 0% and 2% of the biopsies and in 8%, 0% and 13% of the surgical specimens, according to observers 1, 2 and 3, respectively. When evaluating the agreement of the traditional and modified Gleason scores in needle biopsy with both scores of the surgical specimen, a similar agreement was found through Kappa CONCLUSION: Contrary to what was expected, the modified Gleason score was not superior in the agreement between the biopsy score and the specimen, or in interobserver reproducibility, in this study.

  17. Isolation of stem cells using spheroids from fresh surgical specimen: an analytic mini-review.

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    Avital, Itzhak; Stojadinovic, Alexander; Wang, Hongjian; Mannion, Ciaran; Cho, Williams C S; Wang, Jinlian; Man, Yan Gao

    2014-01-01

    It is a commonly held belief that adult stem cells represent the "seeds" for normal cellular replenishment and also for carcinogenesis. The identification and characterization of stem cells for clinical therapeutic applications, however, is extremely challenging for a number of reasons. Recently, our group and others have attempted to isolate stem cells using spheroids from fresh surgical specimens and utilize them for in vitro and in vivo studies. This mini-review summarizes the major technical steps of these methods along with the primary findings. Besides, it critically analyzes the advantages and limitations of the concept and technical approaches. Finally, this mini-review presents our thoughts on the potential future directions of stem cell isolation and cancer stem cell-related research and clinical applications.

  18. A histopathologic, histobacteriologic, and radiographic study of periapical endodontic surgical specimens.

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    Block, R M; Bushell, A; Rodrigues, H; Langeland, K

    1976-11-01

    Data available on 230 periapical endodontic surgical specimens were studied. It was found that bacteria occurred in the periapical tissue very infrequently. In addition, there was no correlation between the presence of acute inflammatory cells and the presence or absence of pain. Granulomas with epithelium occurred in 61 out of 230 cases, while 14 of these were cysts. Of the 110 cases with radiographic follow-up data, 67 were classified as successful, 40 were uncertain, and 3 were unsuccessful according to a modification of Strindberg's criteria, whereas 107 would have been successes according to the criteria of Bender and Seltzer and their associates. No valid biologic or clinical basis for endodontic therapy as suggested by Bhaskar was found in this material.

  19. Measurement of thermal expansion coefficient of nonuniform temperature specimen

    Institute of Scientific and Technical Information of China (English)

    Jingmin Dai; Chunsuo Kin; Xiaowa He

    2008-01-01

    A new technique is developed to measure the longitudinal thermal expansion coefficient of C/C composite material at high temperature. The measuring principle and components of the apparatus are described in detail. The calculation method is derived from the temperature dependence of the thermal expansion coefficient. The apparatus mainly consists of a high temperature environmental chamber, a power circuit of heating, two high-speed pyrometers, and a laser scanning system. A long solid specimen is resistively heated to a steady high-temperature state by a steady electrical current. The temperature profile of the specimen surface is not uniform because of the thermal conduction and radiation. The temperature profile and the total expansion are measured with a high-speed scanning pyrometer and a laser slit scanning measuring system, respectively. The thermal expansion coefficient in a wide temperature range (1000 - 3800 K) of the specimen can therefore be obtained. The perfect consistency between the present and previous results justifies the validity of this technique.

  20. A Histomorphological Pattern Analysis of Pulmonary Tuberculosis in Lung Autopsy and Surgically Resected Specimens

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    Mamta Gupta

    2016-01-01

    Full Text Available Background. Tuberculosis (TB is a major cause of morbidity and mortality globally. Many cases are diagnosed on autopsy and a subset of patients may require surgical intervention either due to the complication or sequelae of TB. Materials and Methods. 40 cases of resected lung specimens following surgery or autopsy in which a diagnosis of pulmonary tuberculosis was made were included. Histopathological pattern analysis of pulmonary tuberculosis along with associated nonneoplastic changes and identification of Mycobacterium tuberculosis bacilli was done. Results. The mean age of diagnosis was 41 years with male predominance (92.5%. Tuberculosis was suspected in only 12.1% of cases before death. Seven cases were operated upon due to associated complications or suspicion of malignancy. Tubercular consolidation was the most frequent pattern followed by miliary tuberculosis. The presence of necrotizing granulomas was seen in 33 cases (82.5%. Acid fast bacilli were seen in 57.5% cases on Ziehl-Neelsen stain. Conclusion. Histopathology remains one of the most important methods for diagnosing tuberculosis, especially in TB prevalent areas. It should be considered in the differential diagnosis of all respiratory diseases because of its varied clinical presentations and manifestations.

  1. Minimally invasive surgical technique integrating multiple procedures with large specimen extraction via inguinal hernia orifice

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    Mani, Vishnu R.; Ahmed, Leaque

    2015-01-01

    While laparoscopic surgery can be performed using small skin incisions, any resected specimen must still be able to fit through these opening. For procedures, such as cholecystectomies and appendectomies, this is not usually a problem; however, for large specimens such as bowel or large tumors, this becomes problematic. Currently, the standard technique is to attempt piecemeal removal of the specimen or enlarge one of the laparoscopic incisions, effectively creating a mini laparotomy. Creatin...

  2. Can perineural invasion detected in prostate needle biopsy specimens predict surgical margin positivity in D’Amico low risk patients?

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    Ozgur Haki Yuksel

    2016-07-01

    Full Text Available Objectives: In this study, our aim was to estimate the value of perineural invasion (PNI in prostate needle biopsy (PNB specimens in the prediction of surgical margin positivity (SMP and its prognostic significance (upgrade Gleason Score in patients who had undergone radical retropubic prostatectomy (RRP with low risk prostate cancer according to D’Amico risk assessment. Materials and Methods: We retrospectively analyzed the data of 65 patients who were diagnosed as clinical stage T1c prostate cancer (PC and underwent RRP between January 2010 and June 2013. Pathological specimens of PNB and RRP were separately examined for the parameters of PNI, vascular invasion (VI, Gleason Score (GS and SMP. Results: The patients’ mean age was 63.65 ± 4.93 (range 47- 75 years. PNI in PNB specimens were identified in 12 of 65 patients and 11 of 12 patients showed SMP on RRP specimens. While 53 of 65 patients had not PNI on PNB, only 11 of them demonstrated SMP on RRP specimens. SMP was 30.64-fold more frequently encountered in PNB specimens obtained from PNI-positive patients relative to PNI-negative patients. In our study, PNI detected in PNB specimens was statistically significantly associated with SMP on RRP specimens (P = 0.0001. Conclusion: It is well known that higher PSA values and GS were independent predictors of SMP in clinically localized prostate cancer (CLPC. We think that PNI in PNB specimens may be a useful prognostic factor for predicting SMP in cases with CLPC.

  3. Minimally invasive surgical technique integrating multiple procedures with large specimen extraction via inguinal hernia orifice

    Science.gov (United States)

    Mani, Vishnu R.; Ahmed, Leaque

    2015-01-01

    While laparoscopic surgery can be performed using small skin incisions, any resected specimen must still be able to fit through these opening. For procedures, such as cholecystectomies and appendectomies, this is not usually a problem; however, for large specimens such as bowel or large tumors, this becomes problematic. Currently, the standard technique is to attempt piecemeal removal of the specimen or enlarge one of the laparoscopic incisions, effectively creating a mini laparotomy. Creating a larger incision adds many of the drawbacks of open laparotomy and should be avoided whenever possible. In this article, we present a new technique of combining the repair of an inguinal hernia, umbilical hernia with a duodenal tumor resection in order to extract the specimen through the inguinal hernia orifice. PMID:26703927

  4. Label-free reflectance hyperspectral imaging for tumor margin assessment: a pilot study on surgical specimens of cancer patients

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    Fei, Baowei; Lu, Guolan; Wang, Xu; Zhang, Hongzheng; Little, James V.; Patel, Mihir R.; Griffith, Christopher C.; El-Diery, Mark W.; Chen, Amy Y.

    2017-08-01

    A label-free, hyperspectral imaging (HSI) approach has been proposed for tumor margin assessment. HSI data, i.e., hypercube (x,y,λ), consist of a series of high-resolution images of the same field of view that are acquired at different wavelengths. Every pixel on an HSI image has an optical spectrum. In this pilot clinical study, a pipeline of a machine-learning-based quantification method for HSI data was implemented and evaluated in patient specimens. Spectral features from HSI data were used for the classification of cancer and normal tissue. Surgical tissue specimens were collected from 16 human patients who underwent head and neck (H&N) cancer surgery. HSI, autofluorescence images, and fluorescence images with 2-deoxy-2-[(7-nitro-2,1,3-benzoxadiazol-4-yl)amino]-D-glucose (2-NBDG) and proflavine were acquired from each specimen. Digitized histologic slides were examined by an H&N pathologist. The HSI and classification method were able to distinguish between cancer and normal tissue from the oral cavity with an average accuracy of 90%±8%, sensitivity of 89%±9%, and specificity of 91%±6%. For tissue specimens from the thyroid, the method achieved an average accuracy of 94%±6%, sensitivity of 94%±6%, and specificity of 95%±6%. HSI outperformed autofluorescence imaging or fluorescence imaging with vital dye (2-NBDG or proflavine). This study demonstrated the feasibility of label-free, HSI for tumor margin assessment in surgical tissue specimens of H&N cancer patients. Further development of the HSI technology is warranted for its application in image-guided surgery.

  5. Gigapixel surface imaging of radical prostatectomy specimens for comprehensive detection of cancer-positive surgical margins using structured illumination microscopy

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    Wang, Mei; Tulman, David B.; Sholl, Andrew B.; Kimbrell, Hillary Z.; Mandava, Sree H.; Elfer, Katherine N.; Luethy, Samuel; Maddox, Michael M.; Lai, Weil; Lee, Benjamin R.; Brown, J. Quincy

    2016-06-01

    Achieving cancer-free surgical margins in oncologic surgery is critical to reduce the need for additional adjuvant treatments and minimize tumor recurrence; however, there is a delicate balance between completeness of tumor removal and preservation of adjacent tissues critical for normal post-operative function. We sought to establish the feasibility of video-rate structured illumination microscopy (VR-SIM) of the intact removed tumor surface as a practical and non-destructive alternative to intra-operative frozen section pathology, using prostate cancer as an initial target. We present the first images of the intact human prostate surface obtained with pathologically-relevant contrast and subcellular detail, obtained in 24 radical prostatectomy specimens immediately after excision. We demonstrate that it is feasible to routinely image the full prostate circumference, generating gigapixel panorama images of the surface that are readily interpreted by pathologists. VR-SIM confirmed detection of positive surgical margins in 3 out of 4 prostates with pathology-confirmed adenocarcinoma at the circumferential surgical margin, and furthermore detected extensive residual cancer at the circumferential margin in a case post-operatively classified by histopathology as having negative surgical margins. Our results suggest that the increased surface coverage of VR-SIM could also provide added value for detection and characterization of positive surgical margins over traditional histopathology.

  6. A semiautomatic CT-based ensemble segmentation of lung tumors: comparison with oncologists’ delineations and with the surgical specimen

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    Velazquez, Emmanuel Rios; Aerts, Hugo J. W. L.; Gu, Yuhua; Goldgof, Dmitry B.; De Ruysscher, Dirk; Dekker, Andre; Korn, René; Gillies, Robert J.; Lambin, Philippe

    2013-01-01

    Purpose To assess the clinical relevance of a semiautomatic CT-based ensemble segmentation method, by comparing it to pathology and to CT/PET manual delineations by five independent radiation oncologists in non-small cell lung cancer (NSCLC). Materials and Methods For twenty NSCLC patients (stage Ib – IIIb) the primary tumor was delineated manually on CT/PET scans by five independent radiation oncologists and segmented using a CT based semi-automatic tool. Tumor volume and overlap fractions between manual and semiautomatic-segmented volumes were compared. All measurements were correlated with the maximal diameter on macroscopic examination of the surgical specimen. Imaging data is available on www.cancerdata.org. Results High overlap fractions were observed between the semi-automatically segmented volumes and the intersection (92.5 ± 9.0, mean ± SD) and union (94.2 ± 6.8) of the manual delineations. No statistically significant differences in tumor volume were observed between the semiautomatic segmentation (71.4 ± 83.2 cm3, mean ± SD) and manual delineations (81.9 ± 94.1 cm3; p = 0.57). The maximal tumor diameter of the semiautomatic-segmented tumor correlated strongly with the macroscopic diameter of the primary tumor (r = 0.96). Conclusion Semiautomatic segmentation of the primary tumor on CT demonstrated high agreement with CT/PET manual delineations and strongly correlated with the macroscopic diameter considered the “gold standard”. This method may be used routinely in clinical practice and could be employed as a starting point for treatment planning, target definition in multi-center clinical trials or for high throughput data mining research. This method is particularly suitable for peripherally located tumors. PMID:23157978

  7. International Society of Urological Pathology (ISUP) Consensus Conference on Handling and Staging of Radical Prostatectomy Specimens. Working group 5: surgical margins.

    NARCIS (Netherlands)

    Tan, P.H.; Cheng, L.; Srigley, J.R.; Griffiths, D.; Humphrey, P.A.; Kwast, T.H. van der; Montironi, R.; Wheeler, T.M.; Delahunt, B.; Egevad, L.; Epstein, J.I.; Hulsbergen- van de Kaa, C.A.

    2011-01-01

    The 2009 International Society of Urological Pathology Consensus Conference in Boston, made recommendations regarding the standardization of pathology reporting of radical prostatectomy specimens. Issues relating to surgical margin assessment were coordinated by working group 5. Pathologists agreed

  8. International Society of Urological Pathology (ISUP) Consensus Conference on Handling and Staging of Radical Prostatectomy Specimens. Working group 5: surgical margins.

    NARCIS (Netherlands)

    Tan, P.H.; Cheng, L.; Srigley, J.R.; Griffiths, D.; Humphrey, P.A.; Kwast, T.H. van der; Montironi, R.; Wheeler, T.M.; Delahunt, B.; Egevad, L.; Epstein, J.I.; Hulsbergen- van de Kaa, C.A.

    2011-01-01

    The 2009 International Society of Urological Pathology Consensus Conference in Boston, made recommendations regarding the standardization of pathology reporting of radical prostatectomy specimens. Issues relating to surgical margin assessment were coordinated by working group 5. Pathologists agreed

  9. Measuring temperature rise during orthopaedic surgical procedures.

    Science.gov (United States)

    Manoogian, Sarah; Lee, Adam K; Widmaier, James C

    2016-09-01

    A reliable means for measuring temperatures generated during surgical procedures is needed to recommend best practices for inserting fixation devices and minimizing the risk of osteonecrosis. Twenty four screw tests for three surgical procedures were conducted using the four thermocouples in the bone and one thermocouple in the screw. The maximum temperature rise recorded from the thermocouple in the screw (92.7±8.9°C, 158.7±20.9°C, 204.4±35.2°C) was consistently higher than the average temperature rise recorded in the bone (31.8±9.3°C, 44.9±12.4°C, 77.3±12.7°C). The same overall trend between the temperatures that resulted from three screw insertion procedures was recorded with significant statistical analyses using either the thermocouple in the screw or the average of several in-bone thermocouples. Placing a single thermocouple in the bone was determined to have limitations in accurately comparing temperatures from different external fixation screw insertion procedures. Using the preferred measurement techniques, a standard screw with a predrilled hole was found to have the lowest maximum temperatures for the shortest duration compared to the other two insertion procedures. Future studies evaluating bone temperature increase need to use reliable temperature measurements for recommending best practices to surgeons.

  10. Unavoidable Human Errors of Tumor Size Measurement during Specimen Attachment after Endoscopic Resection: A Clinical Prospective Study

    Science.gov (United States)

    Mori, Hirohito; Kobara, Hideki; Tsushimi, Takaaki; Nishiyama, Noriko; Fujihara, Shintaro; Masaki, Tsutomu

    2015-01-01

    Objective Objective evaluation of resected specimen and tumor size is critical because the tumor diameter after endoscopic submucosal dissection affects therapeutic strategies. In this study, we investigated whether the true tumor diameter of gastrointestinal cancer specimens measured by flexible endoscopy is subjective by testing whether the specimen is correctly attached to the specimen board after endoscopic submucosal dissection resection and whether the size differs depending on the endoscopist who attached the specimen. Methods Seventy-two patients diagnosed with early gastric cancer who satisfied the endoscopic submucosal dissection expanded-indication guideline were enrolled. Three endoscopists were randomly selected before every endoscopic submucosal dissection. Each endoscopist separately attached the same resected specimen, measured the maximum resection diameter and tumor size, and removed the lesion from the attachment board. Results The resected specimen diameters of the 3 endoscopists were 44.5±13.9 mm (95% Confidence Interval (CI): 23–67), 37.4±12.0 mm (95% CI: 18–60), and 41.1±13.3 mm (95% CI: 20–63) mm. Comparison among 3 groups (Kruskal Wallis H- test), there were significant differences (H = 6.397, P = 0.040), and recorded tumor sizes were 38.3±13.1 mm (95% CI: 16–67), 31.1±11.2 mm (95% CI: 12.5–53.3), and 34.8±12.8 (95% CI: 11.5–62.3) mm. Comparison among 3 groups, there were significant differences (H = 6.917, P = 0.031). Conclusions Human errors regarding the size of attached resected specimens are unavoidable, but it cannot be ignored because it affects the patient’s additional treatment and/or surgical intervention. We must develop a more precise methodology to obtain accurate tumor size. Trial Registration University hospital Medical Information Network UMIN No. 000012915 PMID:25856397

  11. Thermal Measurements of Resonant Ultrasonic Surgical Horn

    Science.gov (United States)

    Manandhar, Prakash; Gupta, Saurav V.; Kosenko, Igor V.; Cotter, Daniel J.

    Temperatures at the distal end of the tip in ultrasonic surgical instruments are of interest because this is the applied part to a patient. It is difficult to directly measure these temperatures using contacting temperature sensors due to high vibration levels. Non-contact infrared (IR) thermography could be an important tool to experimentally determine the tip temperature. However, the low emissivity and polished cylindrical geometry of the tips complicate accurate IR thermography. In this study, we use Cr2O3 high emissivity paint to coat the tip for increased accuracy in IR measurements. Temperature measurements are consistent with heat generation models based on mechanical quality factor of about 5000 for the titanium tip material. It was found that no heat is generated at the tip distal end where strain is low. Air cooling by aspiration is effective at keeping tip distal end temperatures at near ambient levels even with heat transfer by conduction from warmer parts of the tip.

  12. Method and Apparatus for Measuring Thermal Conductivity of Small, Highly Insulating Specimens

    Science.gov (United States)

    Miller, Robert A (Inventor); Kuczmarski, Maria A (Inventor)

    2013-01-01

    A method and apparatus for the measurement of thermal conductivity combines the following capabilities: 1) measurements of very small specimens; 2) measurements of specimens with thermal conductivity on the same order of that as air; and, 3) the ability to use air as a reference material. Care is taken to ensure that the heat flow through the test specimen is essentially one-dimensional. No attempt is made to use heated guards to minimize the flow of heat from the hot plate to the surroundings. Results indicate that since large correction factors must be applied to account for guard imperfections when specimen dimensions are small, simply measuring and correcting for heat from the heater disc that does not flow into the specimen is preferable.

  13. Analytical Measurement of Discrete Hydrogen Sulfide Pools in Biological Specimens

    OpenAIRE

    Shen, Xinggui; Peter, Elvis A.; Bir, Shyamal; Wang, Rui; Kevil, Christopher G.

    2012-01-01

    Hydrogen sulfide (H2S) is a ubiquitous gaseous signaling molecule that plays a vital role in numerous cellular functions and has become the focus of many research endeavors including pharmaco-therapeutic manipulation. Amongst the challenges facing the field is the accurate measurement of biologically active H2S. We have recently reported that the typically used methylene blue method and its associated results are invalid and do not measure bonafide H2S. The complexity of analytical H2S measur...

  14. Estimation of tumor size in breast cancer comparing clinical examination, mammography, ultrasound and MRI-correlation with the pathological analysis of the surgical specimen.

    Science.gov (United States)

    Cortadellas, Tomas; Argacha, Paula; Acosta, Juan; Rabasa, Jordi; Peiró, Ricardo; Gomez, Margarita; Rodellar, Laura; Gomez, Sandra; Navarro-Golobart, Alejandra; Sanchez-Mendez, Sonia; Martinez-Medina, Milagros; Botey, Mireia; Muñoz-Ramos, Carlos; Xiberta, Manel

    2017-08-01

    To evaluate the best method in our center to measure preoperative tumor size in breast tumors, using as reference the tumor size in the postoperative surgical specimen. We compared physical examination vs. mammography vs. resonance vs. ultrasound. There are different studies in the literature with disparate results. This is a retrospective study. All the included patients have been studied by clinical examination performed by gynecologist or surgeon specialists in senology, and radiological tests (mammography, ultrasound and magnetic resonance imaging). The correlation of mammary examination, ultrasound, mammography and resonance with pathological anatomy was studied using the Pearson index. Subsequently, the results of such imaging tests were compared with the tumor size of the infiltrating component measured by anatomopathological study using a student's t test for related variables. The level of significance was set at 95%. Statistical package R. was used. A total of 73 cases were collected from October 2015 to July 2016 with diagnosis of infiltrating breast carcinoma. Twelve cases of carcinoma in situ and seven cases of neoadjuvant carcinoma are excluded. Finally, a total of 56 cases were included in the analysis. The mean age of the patients is 57 years. The histology is of infiltrating ductal carcinoma in 46 patients (80.7%), lobular in 8 (14%) and other carcinomas in 3 cases (5.2%). We verified the relationship between preoperative tumor size by physical examination, mammography, ultrasound (US) and magnetic resonance imaging (MRI), and the final size of the surgical specimen by applying a Pearson correlation test. A strong correlation was found between the physical examination results 0.62 (0.43-0.76 at 95% CI), ultrasound 0.68 (0.51-0.8 at 95% CI), mammography 0.57 (0.36-0.72 at 95% CI) and RM 0.51 (0.29-0.68 at 95% CI) with respect to pathological anatomy. The mean tumor size of the surgical specimen was 16.1 mm. Mean of tumor size by physical examination

  15. Strain measurement based on laser mark automatic tracking line mark on specimen

    Science.gov (United States)

    Tian, Qiuhong; Sun, Zhengrong; Le, Zhongping; Liu, Yanna; Zhang, Lijian; Xie, Sendong

    2014-12-01

    Conventional video extensometers, using a measurement mark on specimen to obtain material strain, have a problem with deformation of the measurement mark. Therefore, the accurate position of the measurement mark is difficult to evaluate, and measurement accuracy is limited. To solve this problem, a strain measurement method based on a laser mark automatically tracking a line mark on the specimen is proposed. This method is using an undeformed laser mark to replace the line mark to calculate the specimen strain and eliminates the measurement error induced by the deformation of specimen marks. The positions of the laser mark and the line mark are achieved by using digital image processing. Automatic tracking is realized by means of an intelligent motor control. Also, the strain of the specimen is obtained by analyzing the movement trace of the laser mark. A video extensometer experimental setup based on the proposed method is constructed. Two experiments were carried out. The first experiment verified the validity and the repeatability of the method via tensile testing of the specimens of low-carbon steel and cast iron. The second one demonstrated the high measurement accuracy of the method by comparing with a clip-on extensometer.

  16. The challenge and importance of standardizing pre-analytical variables in surgical pathology specimens for clinical care and translational research.

    Science.gov (United States)

    Hicks, D G; Boyce, B F

    2012-01-01

    The introduction of targeted cancer therapies into clinical practice, in which patients are selected for novel treatments based on results of companion molecular testing of their tumor specimens, has created significant new challenges for the surgical pathology laboratory. These include standardization of tissue handling and sample preparation with accurate documentation to ensure optimal quality of clinical samples to reduce the risk of errors in molecular biology tests. The assay of tumor tissues for biomarkers that can provide predictive data for prognosis or treatment should enable selection of the most appropriate therapies (Yaziji et al. 2008, Hicks and Kulkarni 2008). Major advances have been made in the ability to profile clinical samples for research at the DNA, RNA and protein levels. To translate this new information into the clinical setting, however, the quality of the starting material, in this case the tumor tissue, determines the accuracy and reliability of companion diagnostic assay results and therefore optimal therapeutic strategies. Inaccurate results owing to compromised tissue quality can lead to false positive or false negative results with therapeutic consequences that can harm patients and affect their eventual outcome.

  17. Making mock-FNA smears from fresh surgical pathology specimens to improve smear preparation technique and to create cytohistological correlation series.

    Directory of Open Access Journals (Sweden)

    Tibor Mezei

    Full Text Available Fine needle aspiration (FNA cytology is a well-established diagnostic method based on the microscopic interpretation of often scant cytological material; therefore, experience, good technique and smear quality are equally important in obtaining satisfactory results.We studied the use of fresh surgical pathology specimens for making so-called mock-FNA smears with the potential of cytohistological correlation. Additionally, we studied how this process aids the improvement of preparation technique and smear quality.Cytological aspirates from 32 fresh biopsy specimens from various sites: lung (20, lymph nodes (6, and breast (6 were obtained, all with a clinical diagnosis of tumor. Aspiration was performed from grossly palpable tumors. 25 G needle and Cameco-type syringe holder was used with minimal or no suction.Unfixed surgical specimens provided sufficient cytological material that resulted in good quality smears. After standard processing of specimens into microscopic sections from paraffin embedded tissues, cytohistological case-series were created. No significant alteration was reported in tissue architecture on hematoxylin-eosin stained sections after the aspiration procedure. A gradual, but steady improvement was observed in smear quality just after a few preparations.Our study proved that surgical specimens may be used as a source of cytological material to create cytohistological correlation studies and also to improve FNA cytology skills. The use of very fine gauge needle (25 G, 0,6 mm diameter during the sampling process does not alter tissue architecture therefore the final histopathological diagnosis is not compromised. We conclude that by using fresh surgical specimens useful cytohistological collections can be created both as a teaching resource and as improving experience.

  18. Method and apparatus for measuring thermal conductivity of small, highly insulating specimens

    Science.gov (United States)

    Miller, Robert A. (Inventor); Kuczmarski, Maria A. (Inventor)

    2012-01-01

    A hot plate method and apparatus for the measurement of thermal conductivity combines the following capabilities: 1) measurements of very small specimens; 2) measurements of specimens with thermal conductivity on the same order of that as air; and, 3) the ability to use air as a reference material. Care is taken to ensure that the heat flow through the test specimen is essentially one-dimensional. No attempt is made to use heated guards to minimize the flow of heat from the hot plate to the surroundings. Results indicate that since large correction factors must be applied to account for guard imperfections when specimen dimensions are small, simply measuring and correcting for heat from the heater disc that does not flow into the specimen is preferable. The invention is a hot plate method capable of using air as a standard reference material for the steady-state measurement of the thermal conductivity of very small test samples having thermal conductivity on the order of air.

  19. Towards real-time metabolic profiling of a biopsy specimen during a surgical operation by 1H high resolution magic angle spinning nuclear magnetic resonance: a case report

    Directory of Open Access Journals (Sweden)

    Piotto Martial

    2012-01-01

    Full Text Available Abstract Introduction Providing information on cancerous tissue samples during a surgical operation can help surgeons delineate the limits of a tumoral invasion more reliably. Here, we describe the use of metabolic profiling of a colon biopsy specimen by high resolution magic angle spinning nuclear magnetic resonance spectroscopy to evaluate tumoral invasion during a simulated surgical operation. Case presentation Biopsy specimens (n = 9 originating from the excised right colon of a 66-year-old Caucasian women with an adenocarcinoma were automatically analyzed using a previously built statistical model. Conclusions Metabolic profiling results were in full agreement with those of a histopathological analysis. The time-response of the technique is sufficiently fast for it to be used effectively during a real operation (17 min/sample. Metabolic profiling has the potential to become a method to rapidly characterize cancerous biopsies in the operation theater.

  20. Comparison of bend angle measurements in fresh cryopreserved cartilage specimens after electromechanical reshaping

    Science.gov (United States)

    Karimi, Koohyar; Protsenko, Dimitry; Wu, Edward C.; Foulad, Allen; Manuel, Cyrus T.; Lim, Amanda; Wong, Brian J. F.

    2010-02-01

    Cryopreservation of cartilage has been investigated for decades and is currently an established protocol. However, the reliability and applicability of cartilage cryopreservation for the use in electromechanical reshaping (EMR) has not been studied exclusively. A system to cryopreserve large numbers of tissue specimens provides a steady source of cartilage of similar quality for experimentation at later dates. This will reduce error that may arise from different cartilage stock, and has the potential to maximize efficiency under time constraints. Our study utilizes a unique methodology to cryopreserve septal cartilage for use in EMR studies. Rabbit septal cartilage specimens were harvested and standardized to 20 x 8 x 1 mm, and placed in one of three solutions (normal saline, PBS, 10% DMSO in PBS) for four hours in a cold storage room at 4 degrees Celsius. Then, each cartilage specimen was vacuumed and sealed in an anti-frost plastic bag and stored in a freezer at -80 degrees Celsius for 1 to 3 weeks duration. EMR was performed using 2 and 6 volts for 2 minutes application time. Bend angle measurements of the cryopreserved cartilage specimens were compared to bend angles of fresh cartilage which underwent EMR using the same parameters. Results demonstrate that normal saline, phosphate buffered saline (PBS), and PBS with DMSO were effective in cryopreservation, and indicated no significant differences in bend angle measurements when compared to no cryopreservation. Our methodology to cryopreserve cartilage specimens provides a successful approach for use in conducting large-scale EMR studies.

  1. A J Integral Approach for Measuring Cohesive Laws Using a Modified DCB Sandwich Specimen

    DEFF Research Database (Denmark)

    Lundsgaard-Larsen, Christian; Berggreen, Christian; Sørensen, Bent F.

    2007-01-01

    mode mixities. The sandwich specimen consists of glass fiber faces and Divinycell H200 foam core. Arbitrary stiffening of the sandwich specimen with steel bars adhered to the faces reduces rotations and ensures that the method is useable for a wide range of materials. The J integral is employed...... and the opening of the pre-crack tip is recorded by a commercial digital photogrammetry measurement system. Cohesive laws are extracted by differentiating J with respect to the normal and tangential opening of the pre-crack tip. Some results are presented and discussed....

  2. Method for independent strain and temperature measurement in polymeric tensile test specimen using embedded FBG sensors

    DEFF Research Database (Denmark)

    Pereira, Gilmar Ferreira; McGugan, Malcolm; Mikkelsen, Lars Pilgaard

    2016-01-01

    A novel method to obtain independent strain and temperature measurements using embedded Fibre Bragg Grating (FBG) in polymeric tensile test specimens is presented in this paper. The FBG strain and temperature cross-sensitivity was decoupled using two single mode FBG sensors, which were embedded...... in the specimen material with a certain angle between them. It is demonstrated that, during temperature variation, both FBG sensors show the same signal response. However, for any applied load the signal response is different, which is caused by the different levels of strain acting in each sensor. Equations...... calibration procedure (temperature and strain) was performed to this material-sensor pair, where a calibration error

  3. Effect of out-of-plane specimen movement on the accuracy of the smallest specimen strain measurable using the digital image correlation technique

    Science.gov (United States)

    Poling, Joel; Desai, Niranjan

    2017-04-01

    This investigation determined the smallest strain accurately measurable by a state-of-the-art digital image correlation (DIC) - based tool used in structural health monitoring, in a specimen subjected to out-of-plane movement, building upon a study that concluded that out-of-plane specimen movement results in noise in DIC-based strain measurements. This study was motivated by initially undetected damage at low strains in connections of a real-world bridge, whose detection would have prevented its propagation, resulting in lower repair costs. The smallest strains accurately measurable using the state-of-the-art DIC tool, over a range of specimen out-of-plane displacement amplitudes, were determined.

  4. Evaluation of adherence to measures for the prevention of surgical site infections by the surgical team

    Directory of Open Access Journals (Sweden)

    Adriana Cristina de Oliveira

    2015-10-01

    Full Text Available AbstractOBJECTIVEEvaluate pre- and intraoperative practices adopted by medical and nursing teams for the prevention of surgical infections.METHODA prospective study carried out in the period of April to May 2013, in a surgical center of a university hospital in Belo Horizonte, Minas Gerais.RESULTS18 surgeries were followed and 214 surgical gloves were analyzed, of which 23 (10.7% had postoperative glove perforation detected, with 52.2% being perceived by users. Hair removal was performed on 27.7% of patients in the operating room, with the use of blades in 80% of the cases. Antibiotic prophylaxis was administered to 81.8% of patients up to 60 minutes prior to surgical incision. An average of nine professionals were present during surgery and the surgery room door remained open in 94.4% of the procedures.CONCLUSIONPartial adhesion to the recommended measures was identified, reaffirming a need for greater attention to these critical steps/actions in order to prevent surgical site infection.

  5. Percutaneous computed tomography-guided core needle biopsy of soft tissue tumors: results and correlation with surgical specimen analysis

    Energy Technology Data Exchange (ETDEWEB)

    Chojniak, Rubens; Grigio, Henrique Ramos; Bitencourt, Almir Galvao Vieira; Pinto, Paula Nicole Vieira; Tyng, Chiang J.; Cunha, Isabela Werneck da; Aguiar Junior, Samuel; Lopes, Ademar, E-mail: chojniak@uol.com.br [Hospital A.C. Camargo, Sao Paulo, SP (Brazil)

    2012-09-15

    Objective: To evaluate the efficacy of percutaneous computed tomography (CT)-guided core needle biopsy of soft tissue tumors in obtaining appropriate samples for histological analysis, and compare its diagnosis with the results of the surgical pathology as available. Materials and Methods: The authors reviewed medical records, imaging and histological reports of 262 patients with soft-tissue tumors submitted to CT-guided core needle biopsy in an oncologic reference center between 2003 and 2009. Results: Appropriate samples were obtained in 215 (82.1%) out of the 262 patients. The most prevalent tumors were sarcomas (38.6%), metastatic carcinomas (28.8%), benign mesenchymal tumors (20.5%) and lymphomas (9.3%). Histological grading was feasible in 92.8% of sarcoma patients, with the majority of them (77.9%) being classified as high grade tumors. Out of the total sample, 116 patients (44.3%) underwent surgical excision and diagnosis confirmation. Core biopsy demonstrated 94.6% accuracy in the identification of sarcomas, with 96.4% sensitivity and 89.5% specificity. A significant intermethod agreement about histological grading was observed between core biopsy and surgical resection (p < 0.001; kappa = 0.75). Conclusion: CT-guided core needle biopsy demonstrated a high diagnostic accuracy in the evaluation of soft tissue tumors as well as in the histological grading of sarcomas, allowing an appropriate therapeutic planning (author)

  6. Evaluation of conventional, dynamic contrast enhanced and diffusion weighted MRI for quantitative Crohn's disease assessment with histopathology of surgical specimens

    Energy Technology Data Exchange (ETDEWEB)

    Tielbeek, Jeroen A.W.; Ziech, Manon L.W.; Lavini, Cristina; Bipat, Shandra; Stoker, Jaap [University of Amsterdam, Academic Medical Center, Department of Radiology, Amsterdam (Netherlands); Li, Zhang [Delft University of Technology, Quantitative Imaging Group, Department of Imaging Science and Technology, Delft (Netherlands); Bemelman, Willem A. [University of Amsterdam, Academic Medical Center, Department of Surgery, Amsterdam (Netherlands); Roelofs, Joris J.T.H. [University of Amsterdam, Academic Medical Center, Department of Pathology, Amsterdam (Netherlands); Ponsioen, Cyriel Y. [University of Amsterdam, Academic Medical Center, Department of Gastroenterology and Hepatology, Amsterdam (Netherlands); Vos, Frans M. [University of Amsterdam, Academic Medical Center, Department of Radiology, Amsterdam (Netherlands); Delft University of Technology, Quantitative Imaging Group, Department of Imaging Science and Technology, Delft (Netherlands)

    2014-03-15

    To prospectively compare conventional MRI sequences, dynamic contrast enhanced (DCE) MRI and diffusion weighted imaging (DWI) with histopathology of surgical specimens in Crohn's disease. 3-T MR enterography was performed in consecutive Crohn's disease patients scheduled for surgery within 4 weeks. One to four sections of interest per patient were chosen for analysis. Evaluated parameters included mural thickness, T1 ratio, T2 ratio; on DCE-MRI maximum enhancement (ME), initial slope of increase (ISI), time-to-peak (TTP); and on DWI apparent diffusion coefficient (ADC). These were compared with location-matched histopathological grading of inflammation (AIS) and fibrosis (FS) using Spearman correlation, Kruskal-Wallis and Chi-squared tests. Twenty patients (mean age 38 years, 12 female) were included and 50 sections (35 terminal ileum, 11 ascending colon, 2 transverse colon, 2 descending colon) were matched to AIS and FS. Mural thickness, T1 ratio, T2 ratio, ME and ISI correlated significantly with AIS, with moderate correlation (r = 0.634, 0.392, 0.485, 0.509, 0.525, respectively; all P < 0.05). Mural thickness, T1 ratio, T2 ratio, ME, ISI and ADC correlated significantly with FS (all P < 0.05). Quantitative parameters from conventional, DCE-MRI and DWI sequences correlate with histopathological scores of surgical specimens. DCE-MRI and DWI parameters provide additional information. (orig.)

  7. Lessons learned from the comparative study between renal mass biopsy and the analysis of the surgical specimen.

    Science.gov (United States)

    Domínguez-Esteban, M; Villacampa-Aubá, F; Garcia-Muñóz, H; Tejido Sánchez, A; Romero Otero, J; de la Rosa Kehrmann, F

    2014-12-01

    The role of renal mass (RM) biopsy is currently under discussion. As a result of the progressive increase in the incidental diagnosis of RMs (which have a higher percentage of benignity and well-differentiated cancers), new approaches have emerged such as observation, especially with elderly patients or those with significant comorbidity. RM biopsy (RMB) should provide sufficient information for making this decision, but so far this has not been the case. We examine our prospective series of in-bench RMBs after surgery and compare them with the anatomy of the removed specimen. We obtained (prospectively, in-bench and with a 16-gauge needle) 4 biopsies of RMs operated on in our department from October 2008 to December 2009. These RMs were analyzed by 2 uropathologists and compared with the results of the specimen. We analyzed 188 biopsies (47 RMs); 12.75% were "not valid". The ability of biopsy to diagnose malignancy or benignity was 100%, and the coincidence in the histological type was 95%. The success in determining the tumor grade was 100% when the cancer was low-grade and 62% when high-grade. None of the analyzed data (necrosis, size, etc.) influenced the results in a statistically significant manner. RMB with a 16-G needle enables the differentiation between malignancy and benignity in 100% of cases, with a very similar diagnostic accuracy in the tumor type. Tumor grade is still the pending issue with renal mass biopsy. Copyright © 2014 AEU. Published by Elsevier Espana. All rights reserved.

  8. International Society of Urological Pathology (ISUP) Consensus Conference on Handling and Staging of Radical Prostatectomy Specimens. Working group 5: surgical margins.

    Science.gov (United States)

    Tan, Puay Hoon; Cheng, Liang; Srigley, John R; Griffiths, David; Humphrey, Peter A; van der Kwast, Theodore H; Montironi, Rodolfo; Wheeler, Thomas M; Delahunt, Brett; Egevad, Lars; Epstein, Jonathan I

    2011-01-01

    The 2009 International Society of Urological Pathology Consensus Conference in Boston, made recommendations regarding the standardization of pathology reporting of radical prostatectomy specimens. Issues relating to surgical margin assessment were coordinated by working group 5. Pathologists agreed that tumor extending close to the 'capsular' margin, yet not to it, should be reported as a negative margin, and that locations of positive margins should be indicated as either posterior, posterolateral, lateral, anterior at the prostatic apex, mid-prostate or base. Other items of consensus included specifying the extent of any positive margin as millimeters of involvement; tumor in skeletal muscle at the apical perpendicular margin section, in the absence of accompanying benign glands, to be considered organ confined; and that proximal and distal margins be uniformly referred to as bladder neck and prostatic apex, respectively. Grading of tumor at positive margins was to be left to the discretion of the reporting pathologists. There was no consensus as to how the surgical margin should be regarded when tumor is present at the inked edge of the tissue, in the absence of transected benign glands at the apical margin. Pathologists also did not achieve agreement on the reporting approach to benign prostatic glands at an inked surgical margin in which no carcinoma is present.

  9. Small lesion size measured by colposcopy may predict absence of cervical intraepithelial neoplasia in a large loop excision of the transformation zone specimen.

    Science.gov (United States)

    Munmany, M; Marimon, L; Cardona, M; Nonell, R; Juiz, M; Astudillo, R; Ordi, J; Torné, A; Del Pino, M

    2017-02-01

    To evaluate whether colposcopic measurement of the lesion size at diagnosis and/or human papillomavirus (HPV) genotyping can predict the absence of dysplasia in a large loop excision of the transformation zone (LLETZ) specimen in women treated for squamous intraepithelial lesions/cervical intraepithelial neoplasia (SIL/CIN). Prospective observational study. Tertiary university hospital. A cohort of 116 women who underwent LLETZ because of biopsy-proven low-grade SIL/CIN that had persisted for 2 years, or because of a high-grade SIL/CIN diagnosed in the referral visit and squamocolumnar junction completely visible (types 1 or 2, according to the International Federation of Cervical Pathology and Colposcopy, IFCPC). After LLETZ the women were classified by histology into the study group (absence of SIL/CIN in the surgical specimen, 28/116, 24.1%) and the control group (SIL/CIN in the LLETZ specimen, 88/116, 75.9%). The size of the lesion determined in the diagnostic colposcopy and the HPV genotype were evaluated in all women. The lesion size was significantly smaller in the study group (25.7 ± 37.8 versus 84.5 ± 81.7 mm(2) ; P size of ≤12 mm(2) and HPV types other than 16 or 18 were associated with an absence of SIL/CIN in the LLETZ specimen (P size of ≤12 mm(2) predicted the absence of SIL/CIN (odds ratio, OR 10.6; 95% confidence interval, 95% CI 3.6-30.6; P size of ≤12 mm(2) had a specificity of 90.9% (95% CI 83.0-95.3%) and a negative predictive value of 86.0% (95% CI 77.5-91.6%) to predict the absence of SIL/CIN in the surgical specimen. Small lesion size in diagnostic colposcopy could predict the absence of SIL/CIN in the LLETZ specimen. Colposcopy measurement of lesion size prior to LLETZ may avoid unnecessary treatment. Small lesion size in colposcopic evaluation might predict the absence of SIL/CIN in an LLETZ specimen. © 2016 Royal College of Obstetricians and Gynaecologists.

  10. Reactor Materials Program electrochemical potential measurements by ORNL with unirradiated and irradiated stainless steel specimens

    Energy Technology Data Exchange (ETDEWEB)

    Baumann, E.W.; Caskey, G.R. Jr.

    1993-07-01

    Effect of irradiation of stainless steel on electrochemical potential (ECP) was investigated by measurements in dilute HNO{sub 3} and H{sub 2}O{sub 2} solutions, conditions simulating reactor moderator. The electrodes were made from unirradiated/irradiated, unsensitized/sensitized specimens from R-reactor piping. Results were inconclusive because of budgetary restrictions. The dose rate may have been too small to produce a significant radiolytic effect. Neither the earlier CERT corrosion susceptibility tests nor the present ECP measurements showed a pronounced effect of irradiation on susceptibility of the stainless steel to IGSCC; this is confirmed by the absence in the stainless steel of the SRS reactor tanks (except for the C Reactor tank knuckle area).

  11. Neutron diffraction measurements for the determination of residual stresses in MMC tensile and fatigue specimens

    DEFF Research Database (Denmark)

    Fiori, F.; Girardin, E.; Giuliani, A.;

    2000-01-01

    , residual stresses are present in both the matrix and the particles microstructure, prior to any macroscopic loading. They vary with the temperature and with the type and level of loading imposed to the material, having a strong influence on the mechanical behaviour of MMCs. Neutron diffraction measurements...... have been performed at RISO (Roskilde, DK) and HMI-BENSC (Berlin, D), for the determination of residual stress in AA2124 + 17% SiCp and AA359 + 20% SiCp specimens, submitted to tensile and fatigue tests. For each of the investigated samples, the macrostress has been separated from the elastic...... and thermal mismatch microstresses. The results show that, in general, the main contribution to the stress state of both matrix and reinforcement is given by the thermal microstresses, already existing due to heat treatment prior to mechanical tests. (C) 2000 Elsevier Science B.V. All rights reserved....

  12. A photoelastic modulator-based birefringence imaging microscope for measuring biological specimens

    Science.gov (United States)

    Freudenthal, John; Leadbetter, Andy; Wolf, Jacob; Wang, Baoliang; Segal, Solomon

    2014-11-01

    The photoelastic modulator (PEM) has been applied to a variety of polarimetric measurements. However, nearly all such applications use point-measurements where each point (spot) on the sample is measured one at a time. The main challenge for employing the PEM in a camera-based imaging instrument is that the PEM modulates too fast for typical cameras. The PEM modulates at tens of KHz. To capture the specific polarization information that is carried on the modulation frequency of the PEM, the camera needs to be at least ten times faster. However, the typical frame rates of common cameras are only in the tens or hundreds frames per second. In this paper, we report a PEM-camera birefringence imaging microscope. We use the so-called stroboscopic illumination method to overcome the incompatibility of the high frequency of the PEM to the relatively slow frame rate of a camera. We trigger the LED light source using a field-programmable gate array (FPGA) in synchrony with the modulation of the PEM. We show the measurement results of several standard birefringent samples as a part of the instrument calibration. Furthermore, we show results observed in two birefringent biological specimens, a human skin tissue that contains collagen and a slice of mouse brain that contains bundles of myelinated axonal fibers. Novel applications of this PEM-based birefringence imaging microscope to both research communities and industrial applications are being tested.

  13. Load-displacement measurement and work determination in three-point bend tests of notched or precracked specimens

    Science.gov (United States)

    Buzzard, R. J.; Fisher, D. M.

    1978-01-01

    Suggestions for testing of notched or cracked three-point bend specimens are presented that (1) correct displacement measurement errors resulting from misalignment between the load applicator and specimen; (2) account for coincidental strains not associated with the work of crack extension; (3) simplify record analysis and processing; and (4) extend displacement gage range without sacrifice of sensitivity or accuracy. These testing details are particularly applicable to procedures in which the crack extension force J(I) is determined from the work done on the specimen.

  14. Measurement of Specimen Thickness by Using Electron Holography and Electron Dynamic Calculation with a Transmission Electron Microscope

    Institute of Scientific and Technical Information of China (English)

    王岩国; 刘红荣; 杨奇斌; 张泽

    2003-01-01

    A method of transmission-electron microscopy for accurate measurement of specimen thickness has been proposed based on off-axis electron holography along with the dynamic electron diffraction simulation. The phase shift of the exit object wave with respect to the reference wave in vacuum, resulting from the scattering within the specimen, has been simulated versus the specimen thickness by the dynamic electron diffraction formula. Offaxis electron holography in a field emission gun transmission-electron microscope has been used to determine the phase shift of the exit wave. The specimen thickness can be obtained by match of the experimental and simulated phase shift. Based on the measured phase shift of the [110] oriented copper foil, the thickness can be determined at a good level of accuracy with an error less than ~10%.

  15. Correction of constraint loss in fracture toughness measurement of PCVN specimens based on fracture toughness diagram

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Shin Beom; Kim, Young Jin [Sungkyunkwan University, Suwon (Korea, Republic of); Chang, Yoon-Suk [Kyung Hee University, Yongin (Korea, Republic of); Kim, Min Chul; Lee, Bong Sang [Korea Atomic Energy Reserch Institute, Daejeon (Korea, Republic of)

    2010-03-15

    The aim of this paper is to suggest an approach to generate master curves by using miniature specimens, especially pre-cracked Charpy V-notched (PCVN) specimen, made of SA508 carbon steel. Firstly, fracture toughness diagram is derived from comparing finite element analyses results with the fixed mesh size at crack tip between standard compact tension and PCVN specimens. To compensate the constraint effects from different geometry, further examination based on the fracture toughness diagram was performed. In this context, a scale factor to deal with specimen size effects is proposed by statistically manipulating the numerical analysis data. Finally, the proposed scale factor is applied to calculate reference temperature which affects on the master curve. We expect that the approach can be applicable to compensate the geometrical constraint effects on fracture toughness of SA508 carbon steel when the PCVN specimen is used

  16. Measurements of Sub and Super Harmonic Waves at the Interfaces of Fatigue-Cracked CT Specimen

    Energy Technology Data Exchange (ETDEWEB)

    Jeong Hyun Jo [Wonkwnag University, Iksan (Korea, Republic of); Barnard, Dan [Iowa State University, Ames (United States)

    2011-02-15

    Nonlinear harmonic waves generated at cracked interfaces are investigated both experimentally and theoretically. A compact tension specimen is fabricated and the amplitude of transmitted wave is analyzed as a function of position along the fatigued crack surface. In order to measure as many nonlinear harmonic components as possible a broadband Lithium Niobate (LiNbO{sub 3}) transducers are employed together with a calibration technique for making absolute amplitude measurements with fluid-coupled receiving transducers. Cracked interfaces are shown to generate high acoustic nonlinearities which are manifested as harmonics in the power spectrum of the received signal. The first subharmonic (f/2) and the second harmonic (2f) waves are found to be dominant nonlinear components for an incident toneburst signal of frequency f. To explain the observed nonlinear behavior a partially closed crack is modeled by planar half interfaces that can account for crack parameters such as crack opening displacement and crack surface conditions. The simulation results show reasonable agreements with the experimental results

  17. The effect of a Lean quality improvement implementation program on surgical pathology specimen accessioning and gross preparation error frequency.

    Science.gov (United States)

    Smith, Maxwell L; Wilkerson, Trent; Grzybicki, Dana M; Raab, Stephen S

    2012-09-01

    Few reports have documented the effectiveness of Lean quality improvement in changing anatomic pathology patient safety. We used Lean methods of education; hoshin kanri goal setting and culture change; kaizen events; observation of work activities, hand-offs, and pathways; A3-problem solving, metric development, and measurement; and frontline work redesign in the accessioning and gross examination areas of an anatomic pathology laboratory. We compared the pre- and post-Lean implementation proportion of near-miss events and changes made in specific work processes. In the implementation phase, we documented 29 individual A3-root cause analyses. The pre- and postimplementation proportions of process- and operator-dependent near-miss events were 5.5 and 1.8 (P < .002) and 0.6 and 0.6, respectively. We conclude that through culture change and implementation of specific work process changes, Lean implementation may improve pathology patient safety.

  18. Evaluation of adherence to measures for the prevention of surgical site infections by the surgical team

    OpenAIRE

    Adriana Cristina de Oliveira; Camila Sarmento Gama

    2015-01-01

    AbstractOBJECTIVEEvaluate pre- and intraoperative practices adopted by medical and nursing teams for the prevention of surgical infections.METHODA prospective study carried out in the period of April to May 2013, in a surgical center of a university hospital in Belo Horizonte, Minas Gerais.RESULTS18 surgeries were followed and 214 surgical gloves were analyzed, of which 23 (10.7%) had postoperative glove perforation detected, with 52.2% being perceived by users. Hair removal was performed on ...

  19. Gage for Measuring Decrease in Dimension of Test Specimen in Tensile Test.

    Science.gov (United States)

    respect to the frame member and provides an output signal proportional to displacement. Elastic bands are used to support the test gage on a tensile test machine which is used to apply a stress to the test specimen. (Author)

  20. Fatigue life determination by damage measuring in SAE 8620 specimens steel subjected to multiaxial experiments in neutral and corrosive environment

    Energy Technology Data Exchange (ETDEWEB)

    Silva, Luiz L. da; Filho, Nelson do N.A.; Gomes, Paulo de T.V.; Rabello, Emerson G.; Mansur, Tanius R., E-mail: silvall@cdtn.br, E-mail: nnaf@cdtn.br, E-mail: ptvg@cdtn.br, E-mail: egr@cdtn.br, E-mail: tanius@cdtn.br [Centro de Desenvolvimento da Tencologia Nuclear (CDTN/CNEN-MG), Belo Horizonte, MG (Brazil)

    2013-07-01

    Fatigue is the fail phenomenon of a material subjected to cyclic loads. This phenomenon affects any component under loads (forces, temperatures, etc.) that changes in time. When there is a combined load, originating multiaxial fatigue, which is the most of the real loads, worst is the situation. Before the component fail, the fatigue phenomenon produces damages to its material and this is a cumulative process that could not be reduced. In the continuum mechanic context, material damage is defined as a parameter that reduces the component resistance and this could cause its fail. The process of damage measuring by changes in electrical resistance is used in this work, and from experimental results of SAE 8620 steel specimens subjected to multiaxial fatigue in corrosive and neutral environment, the remaining specimen time life could be determined. Each specimen has its initial electrical resistance measured and after a certain number of fatigue cycles stopping points, its electrical resistance was measured again. In order to study multiaxial fatigue in specimens, a machine that induces simultaneously bending and torsional loads in the specimen was developed. Air at the temperature range of 18 deg C and 20 deg C was considered neutral environment. The corrosive environment was a NaCl solution with a concentration of 3,5% in weigh. The experimental results showed that the measuring fatigue damage using the changes in electrical resistance is efficient and that is possible to estimate the effect of a corrosive environment in the fatigue damage. (author)

  1. Spectrum of Gastroenteropancreatic NENs in Routine Histological Examinations of Bioptic and Surgical Specimen: A Study of 161 Cases Collected from 17 Departments of Pathology in the Czech Republic

    Directory of Open Access Journals (Sweden)

    Václav Mandys

    2014-01-01

    Full Text Available Objective. To characterize GEP-NENs in routine biopsies and surgical specimen in the Czech Republic and to evaluate how WHO Classification (2010 is acceptable in diagnostic practice. Methods. Paraffin-embedded blocks and bioptic reports were collected from 17 departments of pathology. Histologic slides were stained with H&E and immunohistologically for CgA, synaptophysin, and Ki-67. Results. Out of 28 gastric NENs, there were 22 NETs, G1, 5 NETs, G2, and 1 NEC. Ten duodenal NENs were NETs, G1. Among 27 NENs of jejunum and ileum, 23 were NETs, G1, 2 NETs, G2, and 1 NEC and 1 mixed adenoneuroendocrine carcinoma (MANEC. Among 42 appendiceal “incidentalomas”, 39 were NETs G1, 2 goblet cell carcinoids, and 1 MANEC. Out of 34 large intestinal NENs, 30 were NETs, G1, 3 NETs, G2, and 1 NEC. One small intestinal and 6 large bowel neoplasms were reclassified as poorly differentiated adenocarcinomas. In 12 pancreatic NENs, there were 7 NETs, G1, 3 NETs, G2, and 2 NECs. Conclusions. Our study demonstrates differences in GEP-NENs frequency in sites of origin in our region, comparing to other countries. Regarding routine bioptic diagnostics, we gave evidence that the WHO 2010 classification of NENs is fully acceptable for exact categorisation of tumours.

  2. Influence of specimen type and reinforcement on measured tension-tension fatigue life of unidirectional GFRP laminates

    DEFF Research Database (Denmark)

    Korkiakoski, Samuli; Brøndsted, Povl; Sarlin, Essi

    2016-01-01

    It is well known that standardised tension-tension fatigue test specimens of unidirectional (UD) glass-fibre-reinforced plastics (GFRP) laminates tend to fail at end tabs. The true fatigue life is then underestimated. The first objective of this study was to find for UD GFRP laminates a test...... specimen that fails in the gauge section. The second objective was to compare fatigue performance of two laminates, one having a newly developed UD powder-bound fabric as a reinforcement and the other having a quasi-UD stitched non-crimp fabric as a reinforcement. In the first phase, a rectangular specimen...... a significant effect on the failure mode and measured fatigue life of the laminates. A significantly higher fatigue life was measured for the laminate with the powder-bound fabric reinforcement when compared to the laminate with the stitched reinforcement....

  3. Comparison of refractometry and biuret assay for measurement of total protein concentration in canine abdominal and pleural fluid specimens.

    Science.gov (United States)

    Rose, Alexandra; Funk, Deborah; Neiger, Reto

    2016-04-01

    To compare total protein (TP) concentrations in canine pleural and abdominal fluid specimens as measured by refractometry and biuret assay. Diagnostic test evaluation. Data regarding 92 pleural and 148 abdominal fluid specimens from dogs with various diseases. TP concentrations in fluid specimens as measured by refractometry and biuret assay were recorded. Strength of association between sets of measurements was assessed by Spearman rank correlations and Bland-Altman plots. Optimal concentration cutoff for diagnostic discrimination between exudate and nonexudate was identified by construction of receiver operating characteristic curves. Median TP concentration in pleural fluid specimens was 2.7 g/dL (range, 0.3 to 4.8 g/dL) for refractometry and 2.9 g/dL (range, 0.7 to 5.8 g/dL) for biuret assay. Median TP concentration in abdominal fluid specimens was 3.5 g/dL (range, 0.1 to 6.0 g/dL) for refractometry and 3.5 g/dL (range, 0.6 to 5.7 g/dL) for biuret assay. Correlation was significant between refractometric and biuret results for pleural (ρ = 0.921) and abdominal (ρ = 0.908) fluid. Bland-Altman plots revealed bias of -0.18 g/dL for pleural fluid and -0.03 g/dL for abdominal fluid for refractometry versus biuret assay. With a TP concentration of ≥ 3 g/dL used to distinguish exudate from nonexudate, sensitivity of refractometry was 77% for pleural fluid and 80% for abdominal fluid. Specificity was 100% and 94%, respectively. Refractometry yielded acceptable results for measurement of TP concentration in canine pleural and abdominal fluid specimens, providing a more rapid and convenient method than biuret assay.

  4. Full Field Digital Mammography (FFDM) versus CMOS Technology, Specimen Radiography System (SRS) and Tomosynthesis (DBT) - Which System Can Optimise Surgical Therapy?

    Science.gov (United States)

    Schulz-Wendtland, R; Dilbat, G; Bani, M; Fasching, P A; Heusinger, K; Lux, M P; Loehberg, C R; Brehm, B; Hammon, M; Saake, M; Dankerl, P; Jud, S M; Rauh, C; Bayer, C M; Beckmann, M W; Uder, M; Meier-Meitinger, M

    2013-05-01

    Aim: This prospective clinical study aimed to evaluate whether it would be possible to reduce the rate of re-excisions using CMOS technology, a specimen radiography system (SRS) or digital breast tomosynthesis (DBT) compared to a conventional full field digital mammography (FFDM) system. Material and Method: Between 12/2012 and 2/2013 50 patients were diagnosed with invasive breast cancer (BI-RADS™ 5). After histological verification, all patients underwent breast-conserving therapy with intraoperative imaging using 4 different systems and differing magnifications: 1. Inspiration™ (Siemens, Erlangen, Germany), amorphous selenium, tungsten source, focus 0.1 mm, resolution 85 µm pixel pitch, 8 lp/mm; 2. BioVision™ (Bioptics, Tucson, AZ, USA), CMOS technology, photodiode array, flat panel, tungsten source, focus 0.05, resolution 50 µm pixel pitch, 12 lp/mm; 3. the Trident™ specimen radiography system (SRS) (Hologic, Bedford, MA, USA), amorphous selenium, tungsten source, focus 0.05, resolution 70 µm pixel pitch, 7.1 lp/mm; 4. tomosynthesis (Siemens, Erlangen, Germany), amorphous selenium, tungsten source, focus 0.1 mm, resolution 85 µm pixel pitch, 8 lp/mm, angular range 50 degrees, 25 projections, scan time > 20 s, geometry: uniform scanning, reconstruction: filtered back projection. The 600 radiographs were prospectively shown to 3 radiologists. Results: Of the 50 patients with histologically proven breast cancer (BI-RADS™ 6), 39 patients required no further surgical therapy (re-excision) after breast-conserving surgery. A retrospective analysis (n = 11) showed a significant (p < 0.05) increase of sensitivity with the BioVision™, the Trident™ and tomosynthesis compared to the Inspiration™ at a magnification of 1.0 : 2.0 or 1.0 : 1.0 (tomosynthesis) (2.6, 3.3 or 3.6 %), i.e. re-excision would not have been necessary in 2, 3 or 4 patients, respectively, compared to findings obtained with a standard

  5. Adherence to surgical care improvement project measures and post-operative surgical site infections.

    Science.gov (United States)

    Awad, Samir S

    2012-08-01

    Surgical site infection (SSI) is unequivocally morbid and costly. The estimated 300,000 SSIs annually in the United States represent the second most common infection among surgical patients, prolong hospitalization by 7-10 days, and have an estimated annual incremental cost of $1 billion. The mortality rate associated with SSI is 3%, with about three quarters of deaths being attributable directly to the infection. Prevention is possible for the most part, and concerted effort has been made to limit these infections, arguably to little effect. Review of pertinent English-language literature. Numerous risk factors for SSI and tactics for prevention have been described, but efforts to bundle these tactics into an effective, comprehensive prevention program have been disappointing. Numerous studies now demonstrate that the Surgical Care Improvement Program (SCIP), which focused on process improvement rather than outcomes, has been ineffective despite governmental support, financial penalties for non-compliance, and consequent widespread implementation. Required reporting has increased awareness of the problem of SSI, but just as the complexity of SSI risk, pathogenesis, and preventions reflects the complexity of the disease, many other factors must be taken into account, including the skill and knowledge of the surgical team and promulgation of a culture of quality and safety in surgical patient care.

  6. Minimizing errors during in vitro testing of multisegmental spine specimens: considerations for component selection and kinematic measurement.

    Science.gov (United States)

    Gédet, Philippe; Thistlethwaite, Paul A; Ferguson, Stephen J

    2007-01-01

    Apparatus-induced artifacts may invalidate standard spine testing protocols. Kinematic measurements may be compromised by the configuration of motion capture equipment. This study has determined: (1) the influence of machine design (component friction) on in vitro spinal kinetics; (2) the sensitivity of kinematic measurements to variations in the placement of motion capture markers. A spinal loading simulator has been developed to dynamically apply pure bending moments (three axes) with or without a simultaneous compressive preload. Two linear slider types with different friction coefficients, one with caged ball bearings and one with high-precision roller bearings on rails, were mounted and specimen response compared in sequential tests. Three different optoelectronic marker cluster configurations were mounted on the specimen and motion data was captured simultaneously from all clusters during testing. A polymer tube with a uniform bending stiffness approximately equivalent to a polysegmental lumbar spine specimen was selected to allow reproducible behavior over multiple tests. The selection of sliders for linear degrees of freedom had a marked influence on parasitic shear forces. Higher shear forces were recorded with the caged-bearing design than with the high-precision rollers and consequently a higher moment was required to achieve a given rotation. Kinematic accuracy varied with each marker configuration, but in general higher accuracy was achieved with larger marker spacings and situations where markers moved predominantly parallel to the camera's imaging plane. Relatively common alternatives in the mechanical components used in an apparatus for in vitro spine testing can have a significant influence on the measured kinematic and kinetics. Low-magnitude parasitic shear forces due to friction in sliders induces a linearly increasing moment along the length of the specimen, precluding the ideal of pure moment application. This effect is compounded in

  7. A linear laser scanner to measure cross-sectional shape and area of biological specimens during mechanical testing.

    Science.gov (United States)

    Vergari, Claudio; Pourcelot, Philippe; Holden, Laurène; Ravary-Plumioën, Bérangère; Laugier, Pascal; Mitton, David; Crevier-Denoix, Nathalie

    2010-10-01

    Measure of the cross-sectional area (CSA) of biological specimens is a primary concern for many biomechanical tests. Different procedures are presented in literature but besides the fact that noncontact techniques are required during mechanical testing, most of these procedures lack accuracy or speed. Moreover, they often require a precise positioning of the specimen, which is not always feasible, and do not enable the measure of the same section during tension. The objective of this study was to design a noncontact, fast, and accurate device capable of acquiring CSA of specimens mounted on a testing machine. A system based on the horizontal linear displacement of two charge-coupled device reflectance laser devices next to the specimen, one for each side, was chosen. The whole measuring block is mounted on a vertical linear guide to allow following the measured zone during sample tension (or compression). The device was validated by measuring the CSA of metallic rods machined with geometrical shapes (circular, hexagonal, semicircular, and triangular) as well as an equine superficial digital flexor tendon (SDFT) in static condition. We also performed measurements during mechanical testing of three SDFTs, obtaining the CSA variations until tendon rupture. The system was revealed to be very fast with acquisition times in the order of 0.1 s and interacquisition time of about 1.5 s. Measurements of the geometrical shapes yielded mean errors lower than 1.4% (n=20 for each shape) while the tendon CSA at rest was 90.29 ± 1.69 mm(2) (n=20). As for the tendons that underwent tension, a mean of 60 measures were performed for each test, which lasted about 2 min until rupture (at 20 mm/min), finding CSA variations linear with stress (R(2)>0.85). The proposed device was revealed to be accurate and repeatable. It is easy to assemble and operate and capable of moving to follow a defined zone on the specimen during testing. The system does not need precise centering of the sample

  8. Speckle-interferometric measurement system of 3D deformation to obtain thickness changes of thin specimen under tensile loads

    Science.gov (United States)

    Kowarsch, Robert; Zhang, Jiajun; Sguazzo, Carmen; Hartmann, Stefan; Rembe, Christian

    2017-06-01

    The analysis of materials and geometries in tensile tests and the extraction of mechanic parameters is an important field in solid mechanics. Especially the measurement of thickness changes is important to obtain accurate strain information of specimens under tensile loads. Current optical measurement methods comprising 3D digital image correlation enable thickness-change measurement only with nm-resolution. We present a phase-shifting electronic speckle-pattern interferometer in combination with speckle-correlation technique to measure the 3D deformation. The phase-shift for the interferometer is introduced by fast wavelength tuning of a visible diode laser by injection current. In a post-processing step, both measurements can be combined to reconstruct the 3D deformation. In this contribution, results of a 3Ddeformation measurement for a polymer membrane are presented. These measurements show sufficient resolution for the detection of 3D deformations of thin specimen in tensile test. In future work we address the thickness changes of thin specimen under tensile loads.

  9. Several methods applied to measuring residual stress in a known specimen

    Energy Technology Data Exchange (ETDEWEB)

    Prime, M.B.; Rangaswamy, P.; Daymond, M.R.; Abelin, T.G.

    1998-09-01

    In this study, a beam with a precisely known residual stress distribution provided a unique experimental opportunity. A plastically bent beam was carefully prepared in order to provide a specimen with a known residual stress profile. 21Cr-6Ni-9Mn austenitic stainless steel was obtained as 43 mm square forged stock. Several methods were used to determine the residual stresses, and the results were compared to the known values. Some subtleties of applying the various methods were exposed.

  10. Miniature Precracked Charpy Specimens for Measuring the Master Curve Reference Temperature of RPV Steels at Impact Loading Rates

    Energy Technology Data Exchange (ETDEWEB)

    Lucon, E.; Scibetta, M.; Puzzolante, L.

    2008-10-15

    In the framework of the 2006 Convention, we investigated the applicability of fatigue precracked miniature Charpy specimens of KLST type (MPCC - B = 3 mm, W = 4 mm and L = 27 mm) for impact toughness measurements, using the well-characterized JRQ RPV steel. In the ductile to-brittle transition region, MPCC tests analyzed using the Master Curve approach and compared to data previously obtained from PCC specimens had shown a more ductile behavior and therefore un conservative results. In the investigation presented in this report, two additional RPV steels have been used to compare the performance of impact-tested MPCC and PCC specimens in the transition regime: the low-toughness JSPS steel and the high-toughness 20MnMoNi55 steel. The results obtained (excellent agreement for 20MnMoNi55 and considerable differences between T0 values for JSPS) are contradictory and do not presently allow qualifying the MPCC specimens as a reliable alternative to PCC samples for impact toughness measurements.

  11. Pharmaceutical care in surgical patients: Tools for measurement and intervention

    NARCIS (Netherlands)

    de Boer, M.

    2015-01-01

    Assessing and improving the quality of pharmaceutical care is a major issue in hospitals nowadays. Medication safety strategies are being developed and widely introduced in hospitals to reduce medication-related harm. Surgical patients are at risk for medication-related harm, also called adverse

  12. Digital image measurement of specimen deformation based on CCD cameras and Image J software: an application to human pelvic biomechanics

    Science.gov (United States)

    Jia, Yongwei; Cheng, Liming; Yu, Guangrong; Lou, Yongjian; Yu, Yan; Chen, Bo; Ding, Zuquan

    2008-03-01

    A method of digital image measurement of specimen deformation based on CCD cameras and Image J software was developed. This method was used to measure the biomechanics behavior of human pelvis. Six cadaveric specimens from the third lumbar vertebra to the proximal 1/3 part of femur were tested. The specimens without any structural abnormalities were dissected of all soft tissue, sparing the hip joint capsules and the ligaments of the pelvic ring and floor. Markers with black dot on white background were affixed to the key regions of the pelvis. Axial loading from the proximal lumbar was applied by MTS in the gradient of 0N to 500N, which simulated the double feet standing stance. The anterior and lateral images of the specimen were obtained through two CCD cameras. Based on Image J software, digital image processing software, which can be freely downloaded from the National Institutes of Health, digital 8-bit images were processed. The procedure includes the recognition of digital marker, image invert, sub-pixel reconstruction, image segmentation, center of mass algorithm based on weighted average of pixel gray values. Vertical displacements of S1 (the first sacral vertebrae) in front view and micro-angular rotation of sacroiliac joint in lateral view were calculated according to the marker movement. The results of digital image measurement showed as following: marker image correlation before and after deformation was excellent. The average correlation coefficient was about 0.983. According to the 768 × 576 pixels image (pixel size 0.68mm × 0.68mm), the precision of the displacement detected in our experiment was about 0.018 pixels and the comparatively error could achieve 1.11\\perthou. The average vertical displacement of S1 of the pelvis was 0.8356+/-0.2830mm under vertical load of 500 Newtons and the average micro-angular rotation of sacroiliac joint in lateral view was 0.584+/-0.221°. The load-displacement curves obtained from our optical measure system

  13. Investigation of PVC physical ageing in field test specimens using ultrasonic and dielectric measurements

    NARCIS (Netherlands)

    Demcenko, A.; Ravanan, M.; Visser, Roy; Loendersloot, Richard; Akkerman, Remko

    2013-01-01

    Physical ageing in PVC is studied using two techniques: a) non-linear ultrasonic measurements based on the non-collinear wave interaction theory and b) dielectric measurements. The ultrasonic measurement results are compared with dielectric measurement results. The comparison shows that the used

  14. Measuring dynamic fracture toughness of cement rock using a short rod specimen

    Institute of Scientific and Technical Information of China (English)

    2002-01-01

    As Daqing Oilfield is developing oil layer with a big potential,the requirement for the quality of well cementation is higher than ever before.Cement rock is a brittle material containing a great number of microcracks and defects.In order to reduce the damage to cement ring and improve sealed cementing property at the interface,it is necessary to conduct research on the modification of the cement rock available.According to the principle of super mixed composite materials,various fillers are added to the ingredients of cement rock.Dynamic fracture toughness of cement rock will be changed under the influence of filler.In this paper,short rod specimens of cement rock are employed in the experiments to investigate the dynamic fracture toughness of cement rocks with different ingredients using split Hopkinson Pressure Bar,and partial experimental results are given.The results indicate that fiber reinforcement is an effective way to improve the impact resistance of cement rock.

  15. Effects of cutting and specimen size on neutron measurement of residual stresses

    Science.gov (United States)

    Law, M.; Luzin, V.; Kirstein, O.

    2010-11-01

    To perform neutron residual stress measurements it is often necessary to cut samples to a manageable size. The effects of cutting a girth welded pipe were investigated with analytical methods and finite element analysis. The effect of cutting on measured stresses was calculated. A simplified method of modelling residual stresses in welds, "chill modelling", is introduced. In ring slitting a cut is made in the axial direction and the deformation is maeesured. The change in elastic stress can be calculated and added to neutron diffraction measurements made on a cut ring to calculate the original stresses. Residual stress measurements were performed to validate the ring slitting correction using ANSTO's residual stress diffractometer Kowari.

  16. Measurement and prediction of residual stress in a bead-on-plate weld benchmark specimen

    Energy Technology Data Exchange (ETDEWEB)

    Ficquet, X.; Smith, D.J. [Department of Mechanical Engineering, University of Bristol, Queen' s Building, University Walk, Bristol BS8 1TR (United Kingdom); Truman, C.E. [Department of Mechanical Engineering, University of Bristol, Queen' s Building, University Walk, Bristol BS8 1TR (United Kingdom)], E-mail: c.e.truman@bristol.ac.uk; Kingston, E.J. [Veqter Ltd, University Gate East, Park Row, Bristol BS1 5UB (United Kingdom); Dennis, R.J. [Frazer-Nash Consultancy Limited, 1 Trinity Street, College Green, Bristol BS1 5TE (United Kingdom)

    2009-01-15

    This paper presents measurements and predictions of the residual stresses generated by laying a single weld bead on a flat, austenitic stainless steel plate. The residual stress field that is created is strongly three-dimensional and is considered representative of that found in a repair weld. Through-thickness measurements are made using the deep hole drilling technique, and near-surface measurements are made using incremental centre hole drilling. Measurements are compared to predictions at the same locations made using finite element analysis incorporating an advanced, non-linear kinematic hardening model. The work was conducted as part of an European round robin exercise, coordinated as part of the NeT network. Overall, there was broad agreement between measurements and predictions, but there were notable differences.

  17. Measurement of the dynamic fracture toughness with notched PMMA specimen under impact loading

    OpenAIRE

    2009-01-01

    International audience; In the present study three-point-bend impact experiments were conducted using an instrumented Charpy pendulum with a laser displacement measurement to better understand the correlation between impact velocity and the dynamic effects observed on the load-time curves. The experiments were performed at impact velocities ranging from 1 to 4 m/s. The aim of this work is to measure the dynamic fracture toughness at high impact velocities where the classical method is limited...

  18. Receptor Binding Sites for Substance P, but not Substance K or Neuromedin K, are Expressed in High Concentrations by Arterioles, Venules, and Lymph Nodules in Surgical Specimens Obtained from Patients with Ulcerative Colitis and Crohn Disease

    Science.gov (United States)

    Mantyh, Christopher R.; Gates, Troy S.; Zimmerman, Robert P.; Welton, Mark L.; Passaro, Edward P.; Vigna, Steven R.; Maggio, John E.; Kruger, Lawrence; Mantyh, Patrick W.

    1988-05-01

    Several lines of evidence indicate that tachykinin neuropeptides [substance P (SP), substance K (SK), and neuromedin K (NK)] play a role in regulating the inflammatory and immune responses. To test this hypothesis in a human inflammatory disease, quantitative receptor autoradiography was used to examine possible abnormalities in tachykinin binding sites in surgical specimens from patients with inflammatory bowel disease. Surgical specimens of colon were obtained from patients with ulcerative colitis (n = 4) and Crohn disease (n = 4). Normal tissue was obtained from uninvolved areas of extensive resections for carcinoma (n = 6). In all cases, specimens were obtained germinal center of lymph nodules, whereas the concentrations of SP and SK binding sites expressed by the external muscle layers are not altered significantly. These results demonstrate that receptor binding sites for SP, but not SK or NK, are ectopically expressed in high concentrations (1000-2000 times normal) by cells involved in mediating inflammatory and immune responses. These data suggest that SP may be involved in the pathophysiology of inflammatory bowel disease and might provide some insight into the interaction between the nervous system and the regulation of inflammation and the immune response in human inflammatory disease.

  19. Development of new and accurate measurement devices (TruSlice and TruSlice Digital) for use in histological dissection: an attempt to improve specimen dissection precision.

    Science.gov (United States)

    Orchard, G E; Shams, M; Nwokie, T; Bulut, C; D'Amico, C; Gabriel, J; Ramji, Z; Georgaki, A; Neichcial, A; Shams, F; Neesam, H; Haine, N; Brewer, C

    2015-01-01

    Histological dissection of human tissue has relied on conventional procedures, which have largely remained unchanged for decades. Practices to determine measurement parameters employed in these procedures have largely relied on the use of rulers and weighing scales. It is well documented in the scientific literature that both fixation and processing of tissue can significantly affect the viability of the of tissue sections both for tinctorial and immunocytochemical investigations. Both of these factors can be compounded in their negative effects by inappropriate sampling of tissue at histological cut up. There are five key factors to ensure good surgical grossing technique, flat uniformly perpendicular specimen cutting face, appropriate immobilisation of the tissue specimen during grossing, good visualisation of the cutting tissue face, sharp cutting knives and the grossing knife action. Meeting these factors implies the devices are fit for purpose. Here we describe an innovative approach to designing cut up devices to improve accuracy and precision, which take these five key requirements into consideration. The devices showed accuracy and precision, enabling tissue slices to be produced in a uniformly perpendicular fashion to within 2 mm in thickness and to enable consistency and reproducibility of performance across a series of tissue types. The application of a digital rule on one of these devices ensures accuracy and also enables quality control issues to be clearly assessed. As cellular pathology laboratories conform to ever increasing standards of compliance and performance in practice, the advent of assured precision and accuracy at cut up is awaited. Recommendations from accreditation bodies such as the United Kingdom Accreditation Service (UKAS) continue to push for improvements in this area of histological investigation. These newly designed devices may give the answers to these requirements and provide the impetus for a new generation of innovative

  20. A Method for Direct-Measurement of the Energy of Rupture of Impact Specimens

    Science.gov (United States)

    1953-01-01

    Existing principles of physics, optics and elec- tronics are utilized in this energy measuring system to provide sensing elements capable of producing...to perfect the elements of the over-all system and to integrate than into a full-scale working modelo 6 A program to aeoomplish this objective is

  1. A modified DCB sandwich specimen for measuring mixed-mode cohesive laws

    DEFF Research Database (Denmark)

    Lundsgaard-Larsen, Christian; Sørensen, Bent F.; Berggreen, Christian;

    2008-01-01

    A test method is described for measuring cohesive laws for interfaces in sandwich structures. It is proposed to increase the bending stiffness of the sandwich faces by adhering steel bars onto the sandwich faces. This stiffening reduces rotations and ensures that the method is applicable for thin...... which mixed-mode cohesive laws are extracted....

  2. Virtual Specimens

    Science.gov (United States)

    de Paor, D. G.

    2009-12-01

    Virtual Field Trips have been around almost as long as the Worldwide Web itself yet virtual explorers do not generally return to their desktops with folders full of virtual hand specimens. Collection of real specimens on fields trips for later analysis in the lab (or at least in the pub) has been an important part of classical field geoscience education and research for generations but concern for the landscape and for preservation of key outcrops from wanton destruction has lead to many restrictions. One of the author’s favorite outcrops was recently vandalized presumably by a geologist who felt the need to bash some of the world’s most spectacular buckle folds with a rock sledge. It is not surprising, therefore, that geologists sometimes leave fragile localities out of field trip itineraries. Once analyzed, most specimens repose in drawers or bins, never to be seen again. Some end up in teaching collections but recent pedagogical research shows that undergraduate students have difficulty relating specimens both to their collection location and ultimate provenance in the lithosphere. Virtual specimens can be created using 3D modeling software and imported into virtual globes such as Google Earth (GE) where, they may be linked to virtual field trip stops or restored to their source localities on the paleo-globe. Sensitive localities may be protected by placemark approximation. The GE application program interface (API) has a distinct advantage over the stand-alone GE application when it comes to viewing and manipulating virtual specimens. When instances of the virtual globe are embedded in web pages using the GE plug-in, Collada models of specimens can be manipulated with javascript controls residing in the enclosing HTML, permitting specimens to be magnified, rotated in 3D, and sliced. Associated analytical data may be linked into javascript and localities for comparison at various points on the globe referenced by ‘fetching’ KML. Virtual specimens open up

  3. Breast specimen shrinkage following formalin fixation

    Directory of Open Access Journals (Sweden)

    Horn CL

    2014-02-01

    Full Text Available Christopher L Horn, Christopher Naugler Department of Pathology and Laboratory Medicine, University of Calgary, and Calgary Laboratory Services, Calgary, AB, Canada Abstract: Accurate measurement of primary breast tumors and subsequent surgical margin assessment is critical for pathology reporting and resulting patient therapy. Anecdotal observations from pathology laboratory staff indicate possible shrinkage of breast cancer specimens due to the formalin fixation process. As a result, we conducted a prospective study to investigate the possible shrinkage effects of formalin fixation on breast cancer specimens. The results revealed no significant changes in tumor size, but there were significant changes in the distance to all surgical resection margins from the unfixed to fixed state. This shrinkage effect could interfere with the accuracy of determining distance to margin assessment and tumor-free margin assessment. Thus, changes in these measurements due to the formalin fixation process have the potential to alter treatment options for the patient. Keywords: breast margins, formalin, shrinkage, cancer

  4. Network analysis of surgical innovation: Measuring value and the virality of diffusion in robotic surgery.

    Science.gov (United States)

    Garas, George; Cingolani, Isabella; Panzarasa, Pietro; Darzi, Ara; Athanasiou, Thanos

    2017-01-01

    Existing surgical innovation frameworks suffer from a unifying limitation, their qualitative nature. A rigorous approach to measuring surgical innovation is needed that extends beyond detecting simply publication, citation, and patent counts and instead uncovers an implementation-based value from the structure of the entire adoption cascades produced over time by diffusion processes. Based on the principles of evidence-based medicine and existing surgical regulatory frameworks, the surgical innovation funnel is described. This illustrates the different stages through which innovation in surgery typically progresses. The aim is to propose a novel and quantitative network-based framework that will permit modeling and visualizing innovation diffusion cascades in surgery and measuring virality and value of innovations. Network analysis of constructed citation networks of all articles concerned with robotic surgery (n = 13,240, Scopus®) was performed (1974-2014). The virality of each cascade was measured as was innovation value (measured by the innovation index) derived from the evidence-based stage occupied by the corresponding seed article in the surgical innovation funnel. The network-based surgical innovation metrics were also validated against real world big data (National Inpatient Sample-NIS®). Rankings of surgical innovation across specialties by cascade size and structural virality (structural depth and width) were found to correlate closely with the ranking by innovation value (Spearman's rank correlation coefficient = 0.758 (p = 0.01), 0.782 (p = 0.008), 0.624 (p = 0.05), respectively) which in turn matches the ranking based on real world big data from the NIS® (Spearman's coefficient = 0.673;p = 0.033). Network analysis offers unique new opportunities for understanding, modeling and measuring surgical innovation, and ultimately for assessing and comparing generative value between different specialties. The novel surgical innovation metrics developed may

  5. Evaluation of DC electric field distribution of PPLP specimen based on the measurement of electrical conductivity in LN2

    Science.gov (United States)

    Hwang, Jae-Sang; Seong, Jae-Kyu; Shin, Woo-Ju; Lee, Jong-Geon; Cho, Jeon-Wook; Ryoo, Hee-Suk; Lee, Bang-Wook

    2013-11-01

    High temperature superconducting (HTS) cable has been paid much attention due to its high efficiency and high current transportation capability, and it is also regarded as eco-friendly power cable for the next generation. Especially for DC HTS cable, it has more sustainable and stable properties compared to AC HTS cable due to the absence of AC loss in DC HTS cable. Recently, DC HTS cable has been investigated competitively all over the world, and one of the key components of DC HTS cable to be developed is a cable joint box considering HVDC environment. In order to achieve the optimum insulation design of the joint box, analysis of DC electric field distribution of the joint box is a fundamental process to develop DC HTS cable. Generally, AC electric field distribution depends on relative permittivity of dielectric materials but in case of DC, electrical conductivity of dielectric material is a dominant factor which determines electric field distribution. In this study, in order to evaluate DC electric field characteristics of the joint box for DC HTS cable, polypropylene laminated paper (PPLP) specimen has been prepared and its DC electric field distribution was analyzed based on the measurement of electrical conductivity of PPLP in liquid nitrogen (LN2). Electrical conductivity of PPLP in LN2 has not been reported yet but it should be measured for DC electric field analysis. The experimental works for measuring electrical conductivity of PPLP in LN2 were presented in this paper. Based on the experimental works, DC electric field distribution of PPLP specimen was fully analyzed considering the steady state and the transient state of DC. Consequently, it was possible to determine the electric field distribution characteristics considering different DC applying stages including DC switching on, DC switching off and polarity reversal conditions.

  6. Surgical accuracy in high tibial osteotomy: coronal equivalence of computer navigation and gap measurement.

    Science.gov (United States)

    Schröter, S; Ihle, C; Elson, D W; Döbele, S; Stöckle, U; Ateschrang, A

    2016-11-01

    Medial opening wedge high tibial osteotomy (MOW HTO) is now a successful operation with a range of indications, requiring an individualised approach to the choice of intended correction. This manuscript introduces the concept of surgical accuracy as the absolute deviation of the achieved correction from the intended correction, where small values represent greater accuracy. Surgical accuracy is compared in a randomised controlled trial (RCT) between gap measurement and computer navigation groups. This was a prospective RCT conducted over 3 years of 120 consecutive patients with varus malalignment and medial compartment osteoarthritis, who underwent MOW HTO. All procedures were planned with digital software. Patients were randomly assigned into gap measurement or computer navigation groups. Coronal plane alignment was judged using the mechanical tibiofemoral angle (mTFA), before and after surgery. Absolute (positive) values were calculated for surgical accuracy in each individual case. There was no significant difference in the mean intended correction between groups. The achieved mTFA revealed a small under-correction in both groups. This was attributed to a failure to account for saw blade thickness (gap measurement) and over-compensation for weight bearing (computer navigation). Surgical accuracy was 1.7° ± 1.2° (gap measurement) compared to 2.1° ± 1.4° (computer navigation) without statistical significance. The difference in tibial slope increases of 2.7° ± 3.9° (gap measurement) and 2.1° ± 3.9° (computer navigation) had statistical significance (P osteotomy for individual cases. This work is clinically relevant because coronal surgical accuracy was not superior in either group. Therefore, the increased expense and surgical time associated with navigated MOW HTO is not supported, because meticulously conducted gap measurement yields equivalent surgical accuracy. I.

  7. Ligament strain on the iliofemoral, pubofemoral, and ischiofemoral ligaments in cadaver specimens: biomechanical measurement and anatomical observation.

    Science.gov (United States)

    Hidaka, Egi; Aoki, Mitsuhiro; Izumi, Tomoki; Suzuki, Daisuke; Fujimiya, Mineko

    2014-10-01

    The iliofemoral, pubofemoral, and ischiofemoral ligaments are major structures that stabilize the hip joint. We have sought evidence on which to base more effective hip stretching positions. The purpose of this study was to measure strains on these ligaments and to observe them. Eight fresh/frozen translumbar cadaver specimens were used. Clinically available stretching positions for these ligaments were adopted. Strain on each ligament was measured by a displacement sensor during passive torque to the hip joint. Hip motion was measured using an electromagnetic tracking device. The strained ligaments were captured on clear photographs. Significantly, high strains were imposed on the superior iliofemoral ligament by external rotation of the hip (3.48%); on the inferior iliofemoral ligament by maximal extension and 10° or 20° of external rotation with maximal extension (1.86%, 1.46%, 1.25%); on the pubofemoral ligament by maximal abduction and 10°, 20°, or 30° of external rotation with maximal abduction (3.18%, 3.28%, 3.11%, 2.99%); and on the ischiofemoral ligament by 10° or 20° of abduction with maximal internal rotation (7.11%, 7.83%). Fiber direction in each ligament was clearly identified. Significantly, high strains on hip ligaments corresponded with the anatomical direction of the ligament fibers. Positions were identified for each ligament that imposed maximal increase in strain on it.

  8. The quality of measurement of surgical wound infection as the basis for monitoring: a systematic review.

    Science.gov (United States)

    Bruce, J; Russell, E M; Mollison, J; Krukowski, Z H

    2001-10-01

    Comparison of postoperative surgical wound infection rates between institutions and over time is only valid if standard, valid and reliable definitions are used. The aim of this review was to assess evidence of validity and reliability of the definition and measurement of surgical wound infection. A systematic review was undertaken of prospective studies of surgical wound infection published over a seven-year period; 1993-1999. The information extracted from individual studies included: definition of surgical wound infection; details of wound assessment scale, scoring or grading scale systems; and evidence of assessment of validity, reliability and feasibility of identified definitions and grading systems. Two independent reviewers appraised 112 prospective studies, 90 of which were eligible for inclusion; eight studies assessed validity and/or reliability. Forty-one different definitions of surgical wound infection were identified, five of which were 'standard' definitions proposed by multi-disciplinary groups. Presence of pus was the most frequently used single component of any definition; the CDC definitions of 1988 and 1992 were the most widely implemented standard definitions; and the ASEPSIS wound assessment scale was the most frequently used quantitative grading tool. Only two formal validations of a definition were found, and six studies of reliability. This review highlights the extent of variation in definition of surgical wound infection used in clinical practice, and the need for validation of both content and organization of a surveillance system. However, realistically, there will have to be a balance between the quality of the measurement and the practicality of surveillance.

  9. Network analysis of surgical innovation: Measuring value and the virality of diffusion in robotic surgery

    Science.gov (United States)

    Cingolani, Isabella; Panzarasa, Pietro; Darzi, Ara; Athanasiou, Thanos

    2017-01-01

    Background Existing surgical innovation frameworks suffer from a unifying limitation, their qualitative nature. A rigorous approach to measuring surgical innovation is needed that extends beyond detecting simply publication, citation, and patent counts and instead uncovers an implementation-based value from the structure of the entire adoption cascades produced over time by diffusion processes. Based on the principles of evidence-based medicine and existing surgical regulatory frameworks, the surgical innovation funnel is described. This illustrates the different stages through which innovation in surgery typically progresses. The aim is to propose a novel and quantitative network-based framework that will permit modeling and visualizing innovation diffusion cascades in surgery and measuring virality and value of innovations. Materials and methods Network analysis of constructed citation networks of all articles concerned with robotic surgery (n = 13,240, Scopus®) was performed (1974–2014). The virality of each cascade was measured as was innovation value (measured by the innovation index) derived from the evidence-based stage occupied by the corresponding seed article in the surgical innovation funnel. The network-based surgical innovation metrics were also validated against real world big data (National Inpatient Sample–NIS®). Results Rankings of surgical innovation across specialties by cascade size and structural virality (structural depth and width) were found to correlate closely with the ranking by innovation value (Spearman’s rank correlation coefficient = 0.758 (p = 0.01), 0.782 (p = 0.008), 0.624 (p = 0.05), respectively) which in turn matches the ranking based on real world big data from the NIS® (Spearman’s coefficient = 0.673;p = 0.033). Conclusion Network analysis offers unique new opportunities for understanding, modeling and measuring surgical innovation, and ultimately for assessing and comparing generative value between different

  10. Optimization of high grade glioma cell culture from surgical specimens for use in clinically relevant animal models and 3D immunochemistry.

    Science.gov (United States)

    Hasselbach, Laura A; Irtenkauf, Susan M; Lemke, Nancy W; Nelson, Kevin K; Berezovsky, Artem D; Carlton, Enoch T; Transou, Andrea D; Mikkelsen, Tom; deCarvalho, Ana C

    2014-01-07

    Glioblastomas, the most common and aggressive form of astrocytoma, are refractory to therapy, and molecularly heterogeneous. The ability to establish cell cultures that preserve the genomic profile of the parental tumors, for use in patient specific in vitro and in vivo models, has the potential to revolutionize the preclinical development of new treatments for glioblastoma tailored to the molecular characteristics of each tumor. Starting with fresh high grade astrocytoma tumors dissociated into single cells, we use the neurosphere assay as an enrichment method for cells presenting cancer stem cell phenotype, including expression of neural stem cell markers, long term self-renewal in vitro, and the ability to form orthotopic xenograft tumors. This method has been previously proposed, and is now in use by several investigators. Based on our experience of dissociating and culturing 125 glioblastoma specimens, we arrived at the detailed protocol we present here, suitable for routine neurosphere culturing of high grade astrocytomas and large scale expansion of tumorigenic cells for preclinical studies. We report on the efficiency of successful long term cultures using this protocol and suggest affordable alternatives for culturing dissociated glioblastoma cells that fail to grow as neurospheres. We also describe in detail a protocol for preserving the neurospheres 3D architecture for immunohistochemistry. Cell cultures enriched in CSCs, capable of generating orthotopic xenograft models that preserve the molecular signatures and heterogeneity of GBMs, are becoming increasingly popular for the study of the biology of GBMs and for the improved design of preclinical testing of potential therapies.

  11. Value and Limits of Routine Histology Alone or Combined with Glutamine Synthetase Immunostaining in the Diagnosis of Hepatocellular Adenoma Subtypes on Surgical Specimens

    Directory of Open Access Journals (Sweden)

    Paulette Bioulac-Sage

    2013-01-01

    Full Text Available Immunohistochemistry is a valid method to classify hepatocellular adenoma (HCA. The aim was to test the performance of routine histology combined to glutamine synthetase (GS staining to identify the 2 major HCA subtypes: HNF1α inactivated (H-HCA and inflammatory HCA (IHCA. 114 surgical cases, previously classified by immunohistochemistry, were analysed. Group A comprised 45 H-HCAs, 44 IHCAs, and 9 β-catenin-activated IHCAs (b-IHCA, and group B, 16 b-HCA and unclassified HCA (UHCA. Steatosis was the hallmark of H-HCA. IHCA and b-IHCA were mainly characterized by inflammation, thick arteries, and sinusoidal dilatation; b-IHCA could not be differentiated from IHCA by routine histology. Group B was identified by default. A control set (91 cases was analyzed using routine and GS stainings (without knowing immunohistochemical results. Among the 45 H-HCAs and 27 IHCAs, 40 and 24 were correctly classified, respectively. Among the 10 b-IHCAs, 4 were identified as such using additional GS. Eight of the 9 HCAs that were neither H-HCA nor IHCA were correctly classified. Conclusion. Routine histology allows to diagnose >85% of the 2 major HCA subtypes. GS is essential to identify b-HCA. This study demonstrates that a “palliative” diagnostic approach can be proposed, when the panel of specific antibodies is not available.

  12. Design of a scale for measuring post-surgical complications in third molar surgery.

    Science.gov (United States)

    Aravena, P C; Astudillo, P; Manterola, C

    2014-08-01

    The aim of this study was to design a scale for measuring the extent and severity of post-surgical complications in third molar surgery. A multi-stage study using a quantitative methodology and qualitative interview strategy was employed. The degree of importance of signs and symptoms in the evaluation of post-surgical complications was initially observed using a self-report questionnaire administered to maxillofacial surgeons and surgical residents at the International Conference of Oral and Maxillofacial Surgeons in 2011. Then, using exploratory factor analysis, the items and components of the scale were established, with internal consistency determined using Cronbach's alpha. Finally, a group of experts performed a face validity analysis and provided conceptual definitions for the items and components. Thirty-six signs and symptoms were evaluated by 100 respondents, with the most relevant being 'suppuration' and 'abscess'. Factor analysis of the results identified three factors, defined as 'secondary complication', 'soft tissue infection', and 'osseous involvement' (Cronbach's alpha>0.7). Finally, a preliminary scale was designed comprised of these three components and 10 items. In this way, a preliminary scale for measuring post-surgical complications was designed to standardize the semiological concepts of post-surgical assessment. This scale will be assessed in a future investigation.

  13. Concordance between HER-2 status determined by qPCR in Fine Needle Aspiration Cytology (FNAC) samples compared with IHC and FISH in Core Needle Biopsy (CNB) or surgical specimens in breast cancer patients.

    Science.gov (United States)

    Rodriguez, Claudia; Suciu, Voichita; Poterie, Audrey; Lacroix, Ludovic; Miran, Isabelle; Boichard, Amélie; Delaloge, Suzette; Deneuve, Jacqueline; Azoulay, Sandy; Mathieu, Marie-Christine; Valent, Alexander; Michiels, Stefan; Arnedos, Monica; Vielh, Philippe

    2016-11-01

    Determining the status of HER2-neu amplification and overexpression in breast cancer is crucial for prognosis but mostly for treatment purposes. Standard techniques include the determination of IHC in combination with in situ hybridization techniques to confirm a HER2-neu amplification in case of IHC2+ using either a core-needle biopsy or a surgical specimen. qPCR has been also demonstrated to be able to determine HER2 status, mostly in core biopsies or in surgical specimens. Fine-needle aspiration is a reliable, quicker and less invasive technique that is widely used for diagnosis of invasive breast cancer. In this study, we assessed the performance of qPCR in invasive breast carcinomas to determine HER2-neu status by using fine-needle aspiration samples and comparing to standard IHC and FISH. From a total of 154 samples from patients who had nodular breast lesions and attended the 1-day-stop clinic at the Gustave Roussy from March 2013 to October 2014, qPCR was able to determine the HER2 status in a mean of 3.7 days (SD 3.1). The overall concordance with standard HER2-testing was very high: 97% (95% CI 0.94 to 0.99); sensitivity was 96% (0.87-1), specificity 98% (0.95-1) and positive and negative predictive values 88% (0.75-1) and 99% (0.98-1), respectively. In conclusion, our study demonstrates that qPCR performed using fine-needle aspiration samples from a primary tumour is a reliable and fast method to determine HER2/neu status in patients with early breast cancer.

  14. EGFR Mutations in Surgically Resected Fresh Specimens from 697 Consecutive Chinese Patients with Non-Small Cell Lung Cancer and Their Relationships with Clinical Features

    Directory of Open Access Journals (Sweden)

    Yuanyang Lai

    2013-12-01

    Full Text Available We aimed to reveal the true status of epidermal growth factor receptor (EGFR mutations in Chinese patients with non-small cell lung cancer (NSCLC after lung resections. EGFR mutations of surgically resected fresh tumor samples from 697 Chinese NSCLC patients were analyzed by Amplification Refractory Mutation System (ARMS. Correlations between EGFR mutation hotspots and clinical features were also explored. Of the 697 NSCLC patients, 235 (33.7% patients had tyrosine kinase inhibitor (TKIs sensitive EGFR mutations in 41 (14.5% of the 282 squamous carcinomas, 155 (52.9% of the 293 adenocarcinomas, 34 (39.5% of the 86 adenosquamous carcinomas, one (9.1% of the 11 large-cell carcinomas, 2 (11.1% of the 18 sarcomatoid carcinomas, and 2 (28.6% of the 7 mucoepidermoid carcinomas. TKIs sensitive EGFR mutations were more frequently found in female patients (p < 0.001, non-smokers (p = 0.047 and adenocarcinomas (p < 0.001. The rates of exon 19 deletion mutation (19-del, exon 21 L858R point mutation (L858R, exon 21 L861Q point mutation (L861Q, exon 18 G719X point mutations (G719X, including G719C, G719S, G719A were 43.4%, 48.1%, 1.7% and 6.8%, respectively. Exon 20 T790M point mutation (T790M was detected in 3 squamous carcinomas and 3 adenocarcinomas and exon 20 insertion mutation (20-ins was detected in 2 patients with adenocarcinoma. Our results show the rates of EGFR mutations are higher in all types of NSCLC in Chinese patients. 19-del and L858R are two of the more frequent mutations. EGFR mutation detection should be performed as a routine postoperative examination in Chinese NSCLC patients.

  15. Subtyping of Non-Small Cell Lung Carcinoma in Fine Needle Aspiration Specimens: A Study of 252 Patients with Surgical Correlations

    Directory of Open Access Journals (Sweden)

    Beyhan Varol Mollamehmetoğlu

    2016-12-01

    Full Text Available Objective: Fine-needle aspiration (FNA cytology performed by either transthoracic or transbronchial procedures is an important approach to obtain tumor tissue for histological diagnosis. We investigated the accuracy of FNA in differentiating NSCLCs of adenocarcinoma from squamous cell carcinoma histological types to correlate cytological findings with histological features and immunohistochemistry confirmation in some cases. Methods: From 2010 to 2015, a total of 635 transbronchial needle aspirations or transthoracic needle aspirations were performed. 332 cases were diagnosed as NSCLC, with or without an indication of a specific subtype, while 303 cases were not diagnosed as NSCLC. Out of 332 cases diagnosed as NSCLC, 252 had a histological follow-up. Subsequently, histological samples included 161 surgical resections and 91 biopsies. In cases with histopathological diagnosis accompanied by FNA cytology, an immunohistochemical study was carried out and the diagnostic results of the two methods were compared to each other. Results: The specific subtype of NSCLC was provided in 217 cases (86% based on cytomorphology which included 115 adenocarcinomas (46% and 102 squamous cell carcinomas (40%. The diagnosis NSCLC-NOS by FNA was set in 35 cases. At histology, 251 cases (99.6% were sub-classified: 122 adenocarcinomas (48%, 104 squamous cell carcinomas (41%, 11 large cell carcinomas (4% , and 14 adenosquamous carcinomas (6%. Agreement between cytological and histological typing was found in 181 of 197 cases (92% (K=0.837; p<0.001. Conclusion: Our study proved that most NSCLC can be sub-classified as adenocarcinoma or squamous cell carcinoma by FNA through cytomorphology and the application of immunocytochemistry.

  16. Novel Totally Laparoscopic Endolumenal Rectal Resection With Transanal Natural Orifice Specimen Extraction (NOSE) Without Rectal Stump Opening: A Modification of Our Recently Published Clean Surgical Technique in a Porcine Model.

    Science.gov (United States)

    Kvasha, Anton; Hadary, Amram; Biswas, Seema; Szvalb, Sergio; Willenz, Udi; Waksman, Igor

    2015-06-01

    Our group has recently described a novel technique for clean endolumenal bowel resection, in which abdominal and transanal approaches were used. In the current study, 2 modifications of this procedure were tested for feasibility in a porcine model. A laparoscopic approach to the peritoneal cavity was employed in rectal mobilization; this was followed by a transanal rectorectal intussusception and pull-through (IPT). IPT was established in a stepwise fashion. First, the proximal margin of resection was attached to the shaft of the anvil of an end-to-end circular stapler with a ligature around the rectum. Second, this complex was pulled transanally to produce IPT. Once IPT was established, a second ligature was placed around the rectum approximating the proximal and distal resection margins. This was followed by a purse string suture through 2 bowel walls, encircling the shaft of the anvil just proximal to the ligatures. The specimen was resected and extracted by making a full-thickness incision through the 2 bowel walls distal to the previously placed purse string suture and ligatures. The anastomosis was achieved by applying the stapler. The technique was found to be feasible. Peritoneal samples, collected after transanal specimen extraction, did not demonstrate bacterial growth. Although, this is a novel and evolving procedure, its minimally invasive nature, as well as aseptic bowel manipulation during endolumenal rectal resection, has the potential to limit the complications associated with abdominal wall incision and surgical site infection.

  17. Measurement of In-Plane Shear Strength of Carbon/Carbon Composites by Compression of Double-Notched Specimens

    Science.gov (United States)

    Yan, K. F.; Zhang, C. Y.; Qiao, S. R.; Song, C. Z.; Han, D.; Li, M.

    2012-01-01

    The compression of a double-notched specimen was used to determine the in-plane shear strength (IPSS) of a carbon/carbon composite in the paper. The effects of the notch distance ( L), thickness ( T), and notch width ( W) and supporting jig on the IPSS of the double-notched specimens were investigated numerically and experimentally. The fracture surfaces were examined by a scanning electron microscope. It was found that the IPSS varied with L. Thin specimen yielded low strength. W has little effect on IPSS. The main failure modes include the matrix shear cracking, delamination, fracture and pullout of fibers or fiber bundles. Meanwhile, a supporting jig can provide lateral support and prevent buckling, therefore lead to the failure in a shear mode.

  18. Use of Performance Measures to Evaluate, Document Competence and Deterioration of Advanced Surgical Skills Exposure for Trauma (ASSET) Surgical Skills

    Science.gov (United States)

    2015-03-01

    University, Melbourne , Australia; 3USUHS Bethesda USA; 4USAF C-STARS Baltimore Background: We developed surgical technical skills assessment metrics...scene.- He was initially taken to a small community hospital without an in- house surgeon where his blood pressure was 80/50 and his heart rate was...Bethesda USA, The Alfred Hospital and Swinburne University, Melbourne , Australia • 6) THE ASSETS OF ASSET: IMPROVING SURGICAL PERFROMANCE

  19. Patient-reported outcome measures after routine periodontal and implant surgical procedures.

    Science.gov (United States)

    Tan, Wah Ching; Krishnaswamy, Gita; Ong, Marianne M A; Lang, Niklaus P

    2014-06-01

    To compare patient-reported outcome measures (PROMs) after different dental surgical procedures over a 1-week post-surgical period and in relation to duration of the surgery, and periosteal releasing incisions. To evaluate the prevalence of post-surgical complications. Four hundred and sixty-eight healthy dental patients requiring surgeries, such as crown lengthening (CL), open flap debridement (OFD) and implant installation (IMP) in the National Dental Centre, Singapore (2009-2011), were consecutively recruited. PROMs on bleeding, swelling, pain and bruising were obtained using Visual Analogue Scales (VAS) on days 0, 3, 5 and 7 post-operatively. On the day of surgery, the IMP procedure gave the lowest median VAS for all four PROM parameters. After a week, OFD still had a significantly higher VAS for swelling, pain and bruising. Patients who underwent procedures lasting more than 60 min. had higher VAS for all parameters except bleeding. After considering other important confounders, type of surgery procedure was no longer associated with the VAS score for any of the parameters. Time after surgery, male gender and shorter surgery duration reduced post-operative VAS for one or more of the parameters. Longer surgeon experience helps reduce VAS scores only for bleeding. Prevalence for tenderness to palpation was 11.6%, 8.9% and 12.2% for IMP, CL and OFD, respectively, 1-week post-operatively. Swelling and suppuration occurred rarely. The median VAS scores for all PROM parameters were generally low and reduced to near zero over a week following all three surgical procedures tested. Time after surgery and shorter surgery duration were associated with lower VAS scores in all the PROM parameters in this cohort of patients. Surgery type was not associated significantly with VAS after adjustment with other important confounders. Low prevalences of post-surgical complications were reported. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  20. Plantar measurements to determine success of surgical correction of Stage IIb adult acquired flatfoot deformity.

    Science.gov (United States)

    Matheis, Erika A; Spratley, E Meade; Hayes, Curtis W; Adelaar, Robert S; Wayne, Jennifer S

    2014-01-01

    demonstrated that surgical treatment of adult acquired flatfoot deformity can be accurately assessed using patient-reported outcome measures and plantar pressures.

  1. Perioperative Care Coordination Measurement: A Tool to Support Care Integration of Pediatric Surgical Patients.

    Science.gov (United States)

    Ferrari, Lynne R; Ziniel, Sonja I; Antonelli, Richard C

    2016-03-01

    The relationship of care coordination activities and outcomes to resource utilization and personnel costs has been evaluated for a number of pediatric medical home practices. One of the first tools designed to evaluate the activities and outcomes for pediatric care coordination is the Care Coordination Measurement Tool (CCMT). It has become widely used as an instrument for health care providers in both primary and subspecialty care settings. This tool enables the user to stratify patients based on acuity and complexity while documenting the activities and outcomes of care coordination. We tested the feasibility of adapting the CCMT to a pediatric surgical population at Boston Children's Hospital. The tool was used to assess the preoperative care coordination activities. Care coordination activities were tracked during the interval from the date the patient was scheduled for a surgical or interventional procedure through the day of the procedure. A care coordination encounter was defined as any task, whether face to face or not, supporting the development or implementation of a plan of care. Data were collected to enable analysis of 5675 care coordination encounters supporting the care provided to 3406 individual surgical cases (patients). The outcomes of care coordination, as documented by the preoperative nursing staff, included the elaboration of the care plan through patient-focused communication among specialist, facilities, perioperative team, and primary care physicians in 80.5% of cases. The average time spent on care coordination activities increased incrementally by 30 minutes with each additional care coordination encounter for a surgical case. Surgical cases with 1 care coordination encounter took an average of 35.7 minutes of preoperative care coordination, whereas those with ≥4 care coordination encounters reported an average of 121.6 minutes. We successfully adapted and implemented the CCMT for a pediatric surgical population and measured nonface

  2. CT- and MRI-based volumetry of resected liver specimen: Comparison to intraoperative volume and weight measurements and calculation of conversion factors

    Energy Technology Data Exchange (ETDEWEB)

    Karlo, C., E-mail: christoph.karlo@usz.c [Institute of Diagnostic Radiology, Department of Radiology, University Hospital of Zurich, Raemistrasse 100, 8091 Zurich (Switzerland); Reiner, C.S.; Stolzmann, P. [Institute of Diagnostic Radiology, Department of Radiology, University Hospital of Zurich, Raemistrasse 100, 8091 Zurich (Switzerland); Breitenstein, S. [Department of Visceral Surgery, University Hospital of Zurich (Switzerland); Marincek, B. [Institute of Diagnostic Radiology, Department of Radiology, University Hospital of Zurich, Raemistrasse 100, 8091 Zurich (Switzerland); Weishaupt, D. [Institute for Radiology and Radiodiagnostics, City Hospital Triemli, Zurich (Switzerland); Frauenfelder, T. [Institute of Diagnostic Radiology, Department of Radiology, University Hospital of Zurich, Raemistrasse 100, 8091 Zurich (Switzerland)

    2010-07-15

    Objective: To compare virtual volume to intraoperative volume and weight measurements of resected liver specimen and calculate appropriate conversion factors to reach better correlation. Methods: Preoperative (CT-group, n = 30; MRI-group, n = 30) and postoperative MRI (n = 60) imaging was performed in 60 patients undergoing partial liver resection. Intraoperative volume and weight of the resected liver specimen was measured. Virtual volume measurements were performed by two readers (R1,R2) using dedicated software. Conversion factors were calculated. Results: Mean intraoperative resection weight/volume: CT: 855 g/852 mL; MRI: 872 g/860 mL. Virtual resection volume: CT: 960 mL(R1), 982 mL(R2); MRI: 1112 mL(R1), 1115 mL(R2). Strong positive correlation for both readers between intraoperative and virtual measurements, mean of both readers: CT: R = 0.88(volume), R = 0.89(weight); MRI: R = 0.95(volume), R = 0.92(weight). Conversion factors: 0.85(CT), 0.78(MRI). Conclusion: CT- or MRI-based volumetry of resected liver specimen is accurate and recommended for preoperative planning. A conversion of the result is necessary to improve intraoperative and virtual measurement correlation. We found 0.85 for CT- and 0.78 for MRI-based volumetry the most appropriate conversion factors.

  3. The role of radiographic measurements in the evaluation of congenital clubfoot surgical results

    Energy Technology Data Exchange (ETDEWEB)

    Fridman, Marcos W. [Sao Lucas Hospital, Orthopaedics, Porto Alegre, RS (Brazil); Sodre de Almeida Fialho, Henrique [UNIFESP, Pediatric Orthopaedics, Sao Paulo, SP (Brazil)

    2007-02-15

    A series of 50 patients with 71 clubfeet treated surgically was evaluated after exclusion of individuals with associated malformations, syndromes, neurological disorders, previous surgery and age over 30 months at the time of the surgical procedure. They underwent soft-tissue releases that addressed all the components of the deformity, including, when necessary, the calcaneocuboid joint. The age of the patients at the time of the surgery ranged from 6 to 26 months and the mean follow-up period was 77.03 months. The scores resulting from the application of the functional rating system designed by Laaveg and Ponseti were compared with several radiological parameters described in the medical literature to verify the degree of statistical association between these variables. The talo-first metatarsal angle, the calcaneal-second and fifth metatarsal angles were the only radiological measurements that correlated well with the functional score. (orig.)

  4. Estimation of Surface Temperature and Heat Flux by Inverse Heat Transfer Methods Using Internal Temperatures Measured While Radiantly Heating a Carbon/Carbon Specimen up to 1920 F

    Science.gov (United States)

    Pizzo, Michelle; Daryabeigi, Kamran; Glass, David

    2015-01-01

    The ability to solve the heat conduction equation is needed when designing materials to be used on vehicles exposed to extremely high temperatures; e.g. vehicles used for atmospheric entry or hypersonic flight. When using test and flight data, computational methods such as finite difference schemes may be used to solve for both the direct heat conduction problem, i.e., solving between internal temperature measurements, and the inverse heat conduction problem, i.e., using the direct solution to march forward in space to the surface of the material to estimate both surface temperature and heat flux. The completed research first discusses the methods used in developing a computational code to solve both the direct and inverse heat transfer problems using one dimensional, centered, implicit finite volume schemes and one dimensional, centered, explicit space marching techniques. The developed code assumed the boundary conditions to be specified time varying temperatures and also considered temperature dependent thermal properties. The completed research then discusses the results of analyzing temperature data measured while radiantly heating a carbon/carbon specimen up to 1920 F. The temperature was measured using thermocouple (TC) plugs (small carbon/carbon material specimens) with four embedded TC plugs inserted into the larger carbon/carbon specimen. The purpose of analyzing the test data was to estimate the surface heat flux and temperature values from the internal temperature measurements using direct and inverse heat transfer methods, thus aiding in the thermal and structural design and analysis of high temperature vehicles.

  5. Utility of Thyroglobulin measurement in fine-needle aspiration biopsy specimens of lymph nodes in the diagnosis of recurrent thyroid carcinoma

    Directory of Open Access Journals (Sweden)

    Baloch Zubair W

    2008-01-01

    Full Text Available Abstract Introduction The most common site for the metastasis of papillary carcinoma of the thyroid (PTC is regional lymph nodes. Ultrasound (US imaging may identify abnormal appearing lymph nodes, suspicious for PTC recurrence. Although fine needle aspiration biopsy (FNAB of abnormal lymph nodes is often diagnostic of recurrence, small or cystic lymph nodes may be non-diagnostic due to lack of tumor cells. The measurement of thyroglobulin (TG levels in FNAB specimens from lymph nodes suspicious for recurrent PTC can serve as an adjunct to the cytologic diagnosis. Materials and methods 115 abnormal appearing lymph nodes were aspirated under ultrasound guidance in 89 patients with history of thyroid carcinoma. In addition to obtaining material for cytologic interpretation, an additional aspirate was obtained by FNAB and rinsed in 1 ml of normal saline for TG level measurements. Results The cytologic diagnoses included: 35 (30% reactive lymph node, no tumor seen (NTS, 39 (34% PTC, 23 (20% inadequate for evaluation due to lack of lymphoid or epithelial cells (NDX 15 (13% atypical/suspicious for PTC, and 3 (3% other (e.g. paraganglioma, poorly differentiated carcinoma and carcinoma not otherwise specified. TG levels were markedly elevated (median 312 ng/ml; normal Conclusion The measurement of TG in FNAB specimens from lymph node in patients with history of PTC is useful in detecting recurrent disease, especially in cases when the specimen is known to be or likely to be inadequate for cytologic evaluation.

  6. 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

  7. Surgical site infections in dermatologic surgery: etiology, pathogenesis, and current preventative measures.

    Science.gov (United States)

    Saleh, Karim; Schmidtchen, Artur

    2015-05-01

    Surgical site infections (SSIs) after dermatologic surgery continue to represent undesirable complications that affect patients in several aspects. The etiology and pathogenesis of SSIs are not completely understood, and as a result, current preventative measures are debatable. To review and summarize the current available literature specific to SSIs in dermatologic surgery. The pathogenesis of SSIs, factors contributing to SSIs, current preventative guidelines, and evidence supporting their use are explored. A review of the medical literature. Most measures used to prevent SSIs in dermatologic surgery are based on studies of wounds in general surgery. Evidence specific to dermatologic surgery is scarce. More research related to the pathogenesis of SSIs is needed to establish effective preventative measures that are key to reducing incidences of SSIs.

  8. Activity analysis: measurement of the effectiveness of surgical training and operative technique.

    Science.gov (United States)

    Shepherd, J P; Brickley, M

    1992-11-01

    All surgical procedures are characterised by a sequence of steps and instrument changes. Although surgical efficiency and training in operative technique closely relate to this process, few studies have attempted to analyse it quantitatively. Because efficiency is particularly important in day surgery and lower third molar removal is a high-volume procedure, the need for which is responsible for particularly long waiting-lists in almost all UK health regions, this operation was selected for evaluation. A series of 80 consecutive procedures, carried out for 43 day-stay patients under general anaesthesia by seven junior staff (senior house officers and registrars: 39 procedures) and four senior staff (senior registrars and consultants: 41 procedures) were analysed. Median operating time for procedures which required retraction of periosteum was 9.5 min (range 2.7-23.3 min). Where these steps were necessary, median time for incision was 25 s (range 10-90 s); for retraction of periosteum, 79 s (range 5-340 s); for bone removal, 118 s (range 10-380 s); for tooth excision, 131 s (range 10-900 s); for debridement, 74 s (range 5-270 s); and for suture, 144 s (range 25-320 s). Junior surgeons could be differentiated from senior surgeons on the basis of omission, repetition and duration of these steps. Juniors omitted retraction of periosteum in 10% of procedures (seniors 23%) and suture in 13% (seniors 32%). Juniors repeated steps in 47% of operations; seniors, 14%. Junior surgeons took significantly more time than senior surgeons for incision, bone removal and tooth excision. No significant differences between junior and senior surgeons were found in relation to the incidence of altered lingual and labial sensation at 7 days. It was concluded that activity analysis may be a useful measure of the effectiveness of surgical training and the efficiency of operative technique.

  9. Urine culture - catheterized specimen

    Science.gov (United States)

    Culture - urine - catheterized specimen; Urine culture - catheterization; Catheterized urine specimen culture ... urinary tract infections may be found in the culture. This is called a contaminant. You may not ...

  10. Accurate assessment of breast volume: a study comparing the volumetric gold standard (direct water displacement measurement of mastectomy specimen) with a 3D laser scanning technique.

    Science.gov (United States)

    Yip, Jia Miin; Mouratova, Naila; Jeffery, Rebecca M; Veitch, Daisy E; Woodman, Richard J; Dean, Nicola R

    2012-02-01

    Preoperative assessment of breast volume could contribute significantly to the planning of breast-related procedures. The availability of 3D scanning technology provides us with an innovative method for doing this. We performed this study to compare measurements by this technology with breast volume measurement by water displacement. A total of 30 patients undergoing 39 mastectomies were recruited from our center. The volume of each patient's breast(s) was determined with a preoperative 3D laser scan. The volume of the mastectomy specimen was then measured in the operating theater by water displacement. There was a strong linear association between breast volumes measured using the 2 different methods when using a Pearson correlation (r = 0.95, P Scanner as a tool for assessment of breast volume.

  11. Assessment of patient-reported outcome measures in the surgical treatment of patients with gastric cancer.

    Science.gov (United States)

    Straatman, Jennifer; van der Wielen, Nicole; Joosten, Pieter J; Terwee, Caroline B; Cuesta, Miguel A; Jansma, Elise P; van der Peet, Donald L

    2016-05-01

    Gastric cancer is responsible for 10 % of all cancer-related deaths worldwide. With improved operative techniques and neo-adjuvant therapy, survival rates are increasing. Outcomes of interest are shifting to quality of life (QOL), with many different tools available. The aim of this study was to assess which patient-reported outcome measures (PROMs) are used to measure QOL after a gastrectomy for cancer. A comprehensive search was conducted for original articles investigating QOL after gastrectomy. Two authors independently selected relevant articles, conducted clinical appraisal and extracted data (P.J. and J.S.). Out of 3414 articles, 26 studies were included, including a total of 4690 patients. These studies included ten different PROMs, which could be divided into generic, symptom-specific and disease-specific questionnaires. The EORTC and the FACT questionnaires use an oncological overall QOL module and an organ-specific module. Only one validation study regarding the use of the EORTC after surgery for gastric cancer was available, demonstrating good psychometric properties and clinical validity. A great variety of PROMs are being used in the measurement of QOL after surgery for gastric cancer. A questionnaire with a general module along with a disease-specific module for the assessment of QOL seems most desirable, such as the EORTC and the FACT with their specific modules. Both are developed in different treatment modalities, such as in surgical patients. EORTC is the most widely used questionnaire and therefore allows for comparison of new studies to existing data. Future studies are needed to assess content validity in surgical gastric cancer patients.

  12. Traceable measurement and imaging of the complex permittivity of a multiphase mineral specimen at micron scales using a microwave microscope.

    Science.gov (United States)

    Gregory, A P; Blackburn, J F; Hodgetts, T E; Clarke, R N; Lees, K; Plint, S; Dimitrakis, G A

    2017-01-01

    This paper describes traceable measurements of the dielectric permittivity and loss tangent of a multiphase material (particulate rock set in epoxy) at micron scales using a resonant Near-Field Scanning Microwave Microscope (NSMM) at 1.2GHz. Calibration and extraction of the permittivity and loss tangent is via an image charge analysis which has been modified by the use of the complex frequency to make it applicable for high loss materials. The results presented are obtained using a spherical probe tip, 0.1mm in diameter, and also a conical probe tip with a rounded end 0.01mm in diameter, which allows imaging with higher resolution (≈10µm). The microscope is calibrated using approach-curve data over a restricted range of gaps (typically between 1% and 10% of tip diameter) as this is found to give the best measurement accuracy. For both tips the uncertainty of scanned measurements of permittivity is estimated to be±10% (at coverage factor k=2) for permittivity ⪝10. Loss tangent can be resolved to approximately 0.001. Subject to this limit, the uncertainty of loss tangent measurements is estimated to be±20% (at k=2). The reported measurements inform studies of how microwave energy interacts with multiphase materials containing microwave absorbent phases.

  13. [Blood Count Specimen].

    Science.gov (United States)

    Tamura, Takako

    2015-12-01

    The circulating blood volume accounts for 8% of the body weight, of which 45% comprises cellular components (blood cells) and 55% liquid components. We can measure the number and morphological features of blood cells (leukocytes, red blood cells, platelets), or count the amount of hemoglobin in a complete blood count: (CBC). Blood counts are often used to detect inflammatory diseases such as infection, anemia, a bleeding tendency, and abnormal cell screening of blood disease. This count is widely used as a basic data item of health examination. In recent years, clinical tests before consultation have become common among outpatient clinics, and the influence of laboratory values on consultation has grown. CBC, which is intended to count the number of raw cells and to check morphological features, is easily influenced by the environment, techniques, etc., during specimen collection procedures and transportation. Therefore, special attention is necessary to read laboratory data. Providing correct test values that accurately reflect a patient's condition from the laboratory to clinical side is crucial. Inappropriate medical treatment caused by erroneous values resulting from altered specimens should be avoided. In order to provide correct test values, the daily management of devices is a matter of course, and comprehending data variables and positively providing information to the clinical side are important. In this chapter, concerning sampling collection, blood collection tubes, dealing with specimens, transportation, and storage, I will discuss their effects on CBC, along with management or handling methods.

  14. Sampling variability of computer-aided fractal-corrected measures of liver fibrosis in needle biopsy specimens

    Institute of Scientific and Technical Information of China (English)

    Fabio Grizzi; Carlo Russo; Barbara Franceschini; Mariagrazia Di Rocco; Valter Torri; Emanuela Morenghi; Luigi Rainiero Fassati; Nicola Dioguardi

    2006-01-01

    AIM: To assess the sampling variability of computeraided, fractal-corrected measures of fibrosis in liver biopsies.METHODS: Samples were derived from six to eight different parts of livers removed from 12 patients with clinically and histologically proven cirrhosis undergoing orthotopic liver transplantation. Sirius red-stained sections with a thickness of 2 μm were digitized using a computer-aided image analysis system that automatically measures the surface of fibrosis, as well as its outline perimeter, fractal surface and outline dimensions,wrinkledness, and Hurst coefficient.RESULTS: We found a high degree of inter-sample variability in the measurements of the surface [coefficient of variation (CV) = 43% ± 13%] and wrinkledness (CV = 28% ± 9%) of fibrosis, but the inter-sample variability of Hurst's exponent was low (CV = 14% ± 2%).CONCLUSION: This study suggests that Hurst's exponent might be used in clinical practice as the best histological estimate of fibrosis in the whole organ,and evidences the fact that biopsy sections, which are fundamental for the qualitative diagnosis of chronic hepatitis, play a key role in the quantitative estimate of architectural changes in liver tissue.

  15. Combining the ASA Physical Classification System and Continuous Intraoperative Surgical Apgar Score Measurement in Predicting Postoperative Risk.

    Science.gov (United States)

    Jering, Monika Zdenka; Marolen, Khensani N; Shotwell, Matthew S; Denton, Jason N; Sandberg, Warren S; Ehrenfeld, Jesse Menachem

    2015-11-01

    The surgical Apgar score predicts major 30-day postoperative complications using data assessed at the end of surgery. We hypothesized that evaluating the surgical Apgar score continuously during surgery may identify patients at high risk for postoperative complications. We retrospectively identified general, vascular, and general oncology patients at Vanderbilt University Medical Center. Logistic regression methods were used to construct a series of predictive models in order to continuously estimate the risk of major postoperative complications, and to alert care providers during surgery should the risk exceed a given threshold. Area under the receiver operating characteristic curve (AUROC) was used to evaluate the discriminative ability of a model utilizing a continuously measured surgical Apgar score relative to models that use only preoperative clinical factors or continuously monitored individual constituents of the surgical Apgar score (i.e. heart rate, blood pressure, and blood loss). AUROC estimates were validated internally using a bootstrap method. 4,728 patients were included. Combining the ASA PS classification with continuously measured surgical Apgar score demonstrated improved discriminative ability (AUROC 0.80) in the pooled cohort compared to ASA (0.73) and the surgical Apgar score alone (0.74). To optimize the tradeoff between inadequate and excessive alerting with future real-time notifications, we recommend a threshold probability of 0.24. Continuous assessment of the surgical Apgar score is predictive for major postoperative complications. In the future, real-time notifications might allow for detection and mitigation of changes in a patient's accumulating risk of complications during a surgical procedure.

  16. Economic modeling of surgical disease: a measure of public health interventions.

    Science.gov (United States)

    Corlew, D Scott

    2013-07-01

    The measurement of the burden of disease and the interventions that address that burden can be done in various units. Reducing these measures to the common denominator of economic units (i.e., currency) enables comparison with other health entities, interventions, and even other fields. Economic assessment is complex, however, because of the multifactorial components of what constitutes health and what constitutes health interventions, as well as the coupling of those data to economic means. To perform economic modeling in a meaningful manner, it is necessary to: (1) define the health problem to be addressed; (2) define the intervention to be assessed; (3) define a measure of the effect of the health entity with and without the intervention (which includes defining the counterfactual); and (4) determine the appropriate method of converting the health effect to economics. This paper discusses technical aspects of how economic modeling can be done both of disease entities and of interventions. Two examples of economic modeling applied to surgical problems are then given.

  17. Pig model vs sheep model in undergraduate periodontal surgical training.

    OpenAIRE

    Larsen, Patryk Daniel; Tronsen, Eyvind; Bøen, Kim Reisæter

    2013-01-01

    Objective: The objective of this study was to further develop the sheep model for periodontal surgical training to undergraduate students, and compare it to the more commonly used pig model. Method: Periodontal measurements as pocket depth and gingival width were measured on a total number of 10 sheep and 9 pigs, and a pre-established list of surgical procedures were performed on both types of specimen in different areas of the dentition; gingivectomy, modified access flap w...

  18. 混凝土试件变形的光学测量与分析研究%Deformation analysis of a concrete specimen by optical measurement approach

    Institute of Scientific and Technical Information of China (English)

    李新换; 崔晨风; 蔡坤

    2014-01-01

    Brittle concrete has very small deformation before destruction,which is difficult to be measured by traditional methods,accu-rately.To overcome this difficulty and further to obtain more accurate physical and mechanical properties of concrete ,a new method,i.e., close-range photogrammetry approach,for deformation measurement of concrete specimen/structure is adopted in the present study.Nowa-days,close-range photogrammetry method is very popular for deformation measurement of varies of engineering structures because of such merits as non-contact,high efficiency and low cost.Computer controlled servo universal tester is used to apply compression on a cubic con-crete specimen.Before loading,the specimen is marked with many measurement points on one of its vertical sides.During loading,the de-formation data of the points are obtained by tester,digital camera and high-precision total station simultaneously.The structural deforma-tion of specimen can be calculated based on the theory of two-dimensional(2D) direct linear transformation.Results show that close-range photogrammetry can get high accurate(2D) deformation of the surface of concrete specimen.It is also found that the internal deformation is far from uniform.Compared with data obtained by using the total station,both the relative errors along horizontal and vertical directions of deformation obtained by digital camera are within 5%.%脆性混凝土试件在破坏前变形极小,传统测量方法测量获得的变形误差大。为了弥补传统混凝土变形测量方法的不足,进而获得混凝土更加真实的物理、力学性能,采用近景测量法进行混凝土试件/结构变形测量。近景摄影测量以其非接触式、高效性、低成本性、环境适应性强等优点广泛应用于工程结构变形测量中。采用微机控制万能试验机对立方体混凝土试件进行压缩试验。试验前在混凝土表面布置测点。加载期间,同时获取压力试验机及

  19. Hospital procedure volume should not be used as a measure of surgical quality.

    Science.gov (United States)

    LaPar, Damien J; Kron, Irving L; Jones, David R; Stukenborg, George J; Kozower, Benjamin D

    2012-10-01

    The Agency for Healthcare Research and Quality and the Leapfrog Group use hospital procedure volume as a quality measure for pancreatic resection (PR), abdominal aortic aneurysm (AAA) repair, esophageal resection (ER), and coronary artery bypass grafting (CABG). However, controversy exists regarding the strength and validity of the evidence for the volume-outcome association. The purpose of this study was to reevaluate the volume-outcome relationship for these procedures. Discharge data for 261,412 patients were extracted from the 2008 Nationwide Inpatient Sample. The relationship between hospital procedure volume and mortality was rigorously assessed using hierarchical general linear modeling with restricted cubic splines, adjusted for patient demographics, comorbid disease, and elective procedure status. Unadjusted mortality rates were PR (4.7%), AAA (12.7%), ER (5.8%), and CABG (2.2%), and the majority of operations were elective. Hospital procedure volume was not a statistically significant predictor of in-hospital mortality for any of the 4 procedures. Strong predictors of mortality included age, elective procedure status, renal failure, and malnutrition (P procedure volume is not a significant predictor of mortality for the performance of pancreatectomy, AAA repair, esophagectomy, or CABG. Procedure volume by itself should not be used as a proxy measure for surgical quality. Patient mortality risk is primarily attributable to patient-level characteristics such as age and comorbidity.

  20. Use of Performance Measures to Evaluate, Document Competence and Deterioration of ASSET Surgical Skills

    Science.gov (United States)

    2016-05-01

    fielding of data collection tool. 15. SUBJECT TERMS Performance evaluation, ASSET, vascular trauma , surgical training, medical education 16...33 Appendix 9: Management of Vascular Trauma by Senior Surgical Residents: Perception Does Not Equal Reality...69 Appendix 30: Perception Does Not Equal Reality for Resident Vascular Trauma

  1. Improved transoral surgical tool design by CT measurements of the oral cavity and pharynx.

    Science.gov (United States)

    Cox, Emily; Ghasemloonia, Ahmad; Nakoneshny, Steven C; Zareinia, Kourosh; Hudon, Mark; Lysack, John T; Sutherland, Garnette R; Dort, Joseph C

    2016-09-23

    The majority of head and neck cancers arise from the oral cavity and oropharynx. Many of these lesions will be amenable to surgical resection using transoral approaches including transoral robotic surgery (TORS). To develop and control TORS tools, precise dimensions of the oral cavity and pharynx are desirable. CT angiograms of 76 patients were analyzed. For the oral cavity, only the maximum length and width were measured, while for the pharynx, the width, length, and areas of the airway were all measured and the volume calculated. A prototype TORS tool was developed and tested based on the findings and dimensions. The design modification of the tool is in progress. The mean male oral cavity width and length were 93.3 ± 4.3 and 77.0 ± 7.2 mm, respectively, and the mean male pharyngeal width, length, area, and volume were 26.5 ± 7.2 mm, 16.2 ± 8.8 mm, 325 ± 149 mm(2), and 28,440 ± 14,100 mm(3), respectively, while the mean female oral cavity width and length were 84.5 ± 12.9 and 71.0 ± 6.3 mm, respectively, and the mean female pharyngeal width, length, area, and volume were 24.8 ± 5.6 mm, 13.7 ± 3.2 mm, 258 ± 98 mm(2), and 17,660 ± 7700 mm(3), respectively. The developed TORS tool was tested inside the oral cavity of an intubation mannequin. These data will also be used to develop an electronic no-go cone-shape tunnel to improve the safety of the surgical field. Reporting the oral cavity and pharyngeal dimensions is important for design of TORS tools and creating control zones for the workspace of the tool inside the oral cavity.

  2. Strain Measurements within Fibre Boards. Part II: Strain Concentrations at the Crack Tip of MDF Specimens Tested by the Wedge Splitting Method

    Directory of Open Access Journals (Sweden)

    Jörn Rathke

    2012-08-01

    Full Text Available This is the second part of an article series where the mechanical and fracture mechanical properties of medium density fiberboard (MDF were studied. While the first part of the series focused on internal bond strength and density profiles, this article discusses the fracture mechanical properties of the core layer. Fracture properties were studied with a wedge splitting setup. The critical stress intensity factors as well as the specific fracture energies were determined. Critical stress intensity factors were calculated from maximum splitting force and two-dimensional isotropic finite elements simulations of the specimen geometry. Size and shape of micro crack zone were measured with electronic laser speckle interferometry. The process zone length was approx. 5 mm. The specific fracture energy was determined to be 45.2 ± 14.4 J/m2 and the critical stress intensity factor was 0.11 ± 0.02 MPa.

  3. Strain Measurements within Fibre Boards. Part II: Strain Concentrations at the Crack Tip of MDF Specimens Tested by the Wedge Splitting Method

    Science.gov (United States)

    Sinn, Gerhard; Müller, Ulrich; Konnerth, Johannes; Rathke, Jörn

    2012-01-01

    This is the second part of an article series where the mechanical and fracture mechanical properties of medium density fiberboard (MDF) were studied. While the first part of the series focused on internal bond strength and density profiles, this article discusses the fracture mechanical properties of the core layer. Fracture properties were studied with a wedge splitting setup. The critical stress intensity factors as well as the specific fracture energies were determined. Critical stress intensity factors were calculated from maximum splitting force and two-dimensional isotropic finite elements simulations of the specimen geometry. Size and shape of micro crack zone were measured with electronic laser speckle interferometry. The process zone length was approx. 5 mm. The specific fracture energy was determined to be 45.2 ± 14.4 J/m2 and the critical stress intensity factor was 0.11 ± 0.02 MPa.

  4. Quantitative assessment of sensory functions after 3 surgical approaches for trigeminal neuralgia by current perception threshold measurement

    Institute of Scientific and Technical Information of China (English)

    Chen Ruoping; Ouyang Huoniu; Wang Bingyu; Ding Meixiu; Charles J. Hodge Jr.

    2008-01-01

    Objective: To quantitatively identify and grade trigeminal sensory functions after 3 major surgical procedures of trigeminal neuralgia using a newly developed quantitative sensory testing technique, current perception threshold measurement (CPTM). Methods: In the current study, there were 48 trigeminal neuralgia patients without history of prior surgical treatment. These patients received one of the following 3 surgical procedures, microvascular decompression (MVD), peripheral nerve block with alcohol (PNB), or percutaneous radiofrequency thermocoagulation (PRFT). The quantitative sensory testing measurement, CPTM, and conventional qualitative sensory testing measurements were performed preoperatively and postoperatively to evaluate and grade the trigeminal sensory functions.All 3 major cutaneous sensory fiber types, large myelinated fibers (A beta), small myelinated fibers (A delta) and unmyelinated fibers(C) were allowed to quantitatively evaluate and grade by CPTM. The results of the measurements were statistically analyzed using a one-way analysis of variance (single factor). Each subject was his/her own control for comparison of the preoperative to postoperative state on the asymptomatic and symptomatic sides. Subjects were tested 48 h preoperatively and 4 weeks postoperatively. Results: PNB with alcohol and PRFT caused significant sensory dysfunction postoperatively in every fiber type, indicating damage to all fibers. On the contrary, the sensory function in all 3 fiber types was unchanged after MVD management. Conclusion: Among the 3 major surgical procedures tested,only MVD preserves sensory function in trigeminal system. CPTM is of quantitative nature on the evaluation of sensory functions of nerve fibers

  5. Evaluation of DC electric field distribution of PPLP specimen based on the measurement of electrical conductivity in LN{sub 2}

    Energy Technology Data Exchange (ETDEWEB)

    Hwang, Jae-Sang; Seong, Jae-Kyu; Shin, Woo-Ju; Lee, Jong-Geon [Hanyang University, 408-2, 4th Engineering Bldg, Sa 3-dong, Sangrok-gu, Ansan 426-791 (Korea, Republic of); Cho, Jeon-Wook; Ryoo, Hee-Suk [Korea Electrotechnology Research Institute, Changwon, Gyungnam 641-120 (Korea, Republic of); Lee, Bang-Wook, E-mail: bangwook@hanyang.ac.kr [Hanyang University, 408-2, 4th Engineering Bldg, Sa 3-dong, Sangrok-gu, Ansan 426-791 (Korea, Republic of)

    2013-11-15

    Highlights: •The electrical conductivity of PPLP in LN{sub 2} was successfully measured. •Based on the measured value of PPLP, DC field analysis was performed. •The electric field distribution was altered according to the DC applying stages. •The maximum electric field was observed during polarity reversal situation. •DC field analysis is important to determine the optimum design of DC HTS devices. -- Abstract: High temperature superconducting (HTS) cable has been paid much attention due to its high efficiency and high current transportation capability, and it is also regarded as eco-friendly power cable for the next generation. Especially for DC HTS cable, it has more sustainable and stable properties compared to AC HTS cable due to the absence of AC loss in DC HTS cable. Recently, DC HTS cable has been investigated competitively all over the world, and one of the key components of DC HTS cable to be developed is a cable joint box considering HVDC environment. In order to achieve the optimum insulation design of the joint box, analysis of DC electric field distribution of the joint box is a fundamental process to develop DC HTS cable. Generally, AC electric field distribution depends on relative permittivity of dielectric materials but in case of DC, electrical conductivity of dielectric material is a dominant factor which determines electric field distribution. In this study, in order to evaluate DC electric field characteristics of the joint box for DC HTS cable, polypropylene laminated paper (PPLP) specimen has been prepared and its DC electric field distribution was analyzed based on the measurement of electrical conductivity of PPLP in liquid nitrogen (LN{sub 2}). Electrical conductivity of PPLP in LN{sub 2} has not been reported yet but it should be measured for DC electric field analysis. The experimental works for measuring electrical conductivity of PPLP in LN{sub 2} were presented in this paper. Based on the experimental works, DC electric

  6. Measuring Nontechnical Aspects of Surgical Clinician Development in an Otolaryngology Residency Training Program.

    Science.gov (United States)

    Shin, Jennifer J; Cunningham, Michael J; Emerick, Kevin G; Gray, Stacey T

    2016-05-01

    Surgical competency requires sound clinical judgment, a systematic diagnostic approach, and integration of a wide variety of nontechnical skills. This more complex aspect of clinician development has traditionally been difficult to measure through standard assessment methods. This study was conducted to use the Clinical Practice Instrument (CPI) to measure nontechnical diagnostic and management skills during otolaryngology residency training; to determine whether there is demonstrable change in these skills between residents who are in postgraduate years (PGYs) 2, 4, and 5; and to evaluate whether results vary according to subspecialty topic or method of administration. Prospective study using the CPI, an instrument with previously established internal consistency, reproducibility, interrater reliability, discriminant validity, and responsiveness to change, in an otolaryngology residency training program. The CPI was used to evaluate progression in residents' ability to evaluate, diagnose, and manage case-based clinical scenarios. A total of 248 evaluations were performed in 45 otolaryngology resident trainees at regular intervals. Analysis of variance with nesting and postestimation pairwise comparisons were used to evaluate total and domain scores according to training level, subspecialty topic, and method of administration. Longitudinal residency educational initiative. Assessment with the CPI during PGYs 2, 4, and 5 of residency. Among the 45 otolaryngology residents (248 CPI administrations), there were a mean (SD) of 5 (3) administrations (range, 1-4) during their training. Total scores were significantly different among PGY levels of training, with lower scores seen in the PGY-2 level (44 [16]) compared with the PGY-4 (64 [13]) or PGY-5 level (69 [13]) (P otolaryngology (mean [SD], 72 [14]) than in subspecialties (range, 55 [12], P = .003, to 56 [19], P < .001). Neither administering the examination with an electronic scoring system, rather than a

  7. Activity analysis: measurement of the effectiveness of surgical training and operative technique.

    OpenAIRE

    Shepherd, J P; Brickley, M.

    1992-01-01

    All surgical procedures are characterised by a sequence of steps and instrument changes. Although surgical efficiency and training in operative technique closely relate to this process, few studies have attempted to analyse it quantitatively. Because efficiency is particularly important in day surgery and lower third molar removal is a high-volume procedure, the need for which is responsible for particularly long waiting-lists in almost all UK health regions, this operation was selected for e...

  8. Contemporary update on pathology-related issues on routine workup of prostate biopsy: sectioning, tumor extent measurement, specimen orientation, and immunohistochemistry.

    Science.gov (United States)

    Montironi, Rodolfo; Lopez-Beltran, Antonio; Mazzucchelli, Roberta; Scarpelli, Marina; Galosi, Andrea B; Cheng, Liang

    2014-04-01

    While the prime goal of the needle biopsy is to diagnose prostatic adenocarcinoma (PCa), once PCa is detected further descriptive information regarding the type of cancer, amount of tumor, and grade in prostate needle cores forms the cornerstone for contemporary management of the patient and to assess the potential for local cure and the risk for distant metastasis. This review gives an update on selected pathology-related issues on routine workup of prostate biopsy with special references to adequate histologic sectioning necessary to maximize cancer yield, tumor extent measurements and methodologies, specimen orientation, and the role of immunohistochemistry in the evaluation of the prostate. Multiple factors influence the diagnostic yield of prostate biopsies. Many of these factors are fixed and uncontrollable. Other factors are controlled by the urologist, including number of cores obtained, method and location of biopsy, and amount of tissue obtained. The yield of cancer is also controlled by the pathologist and histotechnologist. It is necessary to report the number of cores submitted and the number of positive cores, thereby giving the fraction of positive cores. The percentage involvement by carcinoma with or without the linear extent of carcinoma of the single core with the greatest amount of tumor should also be provided. Using the marking technique, we can add a new pathological parameter: pathological orientation. Cancer or atypical lesions can be accurately located within the biopsy specimen and integrated to biopsy approach. Probably the most common use of immunohistochemistry in the evaluation of the prostate is for the identification of basal cells, which are absent with rare exception in adenocarcinoma of the prostate and in general positive in mimickers of prostate cancer. If a case is still considered atypical by a uropathology expert after negative basal cell staining, positive staining for alpha-methylacyl-CoA-racemase can help establish in 50

  9. 37 CFR 2.59 - Filing substitute specimen(s).

    Science.gov (United States)

    2010-07-01

    ... 37 Patents, Trademarks, and Copyrights 1 2010-07-01 2010-07-01 false Filing substitute specimen(s..., DEPARTMENT OF COMMERCE RULES OF PRACTICE IN TRADEMARK CASES Drawing § 2.59 Filing substitute specimen(s). (a... specimen(s), the applicant must: (1) For an amendment to allege use under § 2.76, verify by affidavit...

  10. Standardized Infection Ratio for Surgical Site Infection after Colon Surgery: Discord in Models Measuring Healthcare Quality.

    Science.gov (United States)

    Chinn, Raymond; Lempp, Jason M; Huang, Susan S; Murthy, Rekha; Torriani, Francesca J; Daley, Jacqueline; Dekker, Elaine; Goss-Bottorff, Barbara; Kaler, Wendy; Meyer, Karen; Myers, Frank; Nichols, Amy; Kathleen Quan; Birnbaum, David

    2016-11-01

    The government publishes 3 different public report surgical site infection (SSI) metrics, all called standardized infection ratios (SIRs), that impact perceived hospital quality. We conducted a non-random cross-sectional observational pilot study of 20 California hospitals that voluntarily submitted colon surgery and SSI data. Discordant SIR values, leading to contradictory conclusions, occurred in 35% of these hospitals. Infect Control Hosp Epidemiol 2016;1-5.

  11. Controlled Environment Specimen Transfer

    DEFF Research Database (Denmark)

    Damsgaard, Christian Danvad; Zandbergen, Henny W.; Hansen, Thomas Willum

    2014-01-01

    Specimen transfer under controlled environment conditions, such as temperature, pressure, and gas composition, is necessary to conduct successive complementary in situ characterization of materials sensitive to ambient conditions. The in situ transfer concept is introduced by linking an environme...

  12. Value of volume measurements in evaluating abdominal aortic aneurysms growth rate and need for surgical treatment

    Energy Technology Data Exchange (ETDEWEB)

    Kontopodis, Nikolaos, E-mail: kontopodisn@yahoo.gr [Department of Vascular Surgery, University of Crete Medical School, Heraklion (Greece); Metaxa, Eleni, E-mail: emmetaxa@gmail.com [Institute of Applied and Computational Mathematics, Foundation for Research and Technology-Hellas, Heraklion, Crete (Greece); Papaharilaou, Yannis, E-mail: yannisp@iacm.forth.gr [Institute of Applied and Computational Mathematics, Foundation for Research and Technology-Hellas, Heraklion, Crete (Greece); Georgakarakos, Efstratios, E-mail: efstratiosgeorg@gmail.com [Vascular Surgery Department, “Demokritus” University of Thrace Medical School, Alexandroupolis (Greece); Tsetis, Dimitris, E-mail: tsetis@med.uoc.gr [Interventional Radiology Unit, Department of Radiology, University of Crete Medical School, Heraklion, Crete (Greece); Ioannou, Christos V., E-mail: ioannou@med.uoc.gr [Department of Vascular Surgery, University of Crete Medical School, Heraklion (Greece)

    2014-07-15

    Purpose: To examine whether indices other than the traditionally used abdominal aortic aneurysm (AAA) maximum diameter, such as AAA volume, intraluminal thrombus (ILT) thickness and ILT volume, may be superior to evaluate aneurismal enlargement. Materials and methods: Thirty-four small AAAs (initially presenting a maximum diameter <5.5 cm which is the threshold for surgical repair) with an initial and a follow-up CT were examined. Median increase and percentile annual change of these variables was calculated. Correlation between growth rates as determined by the new indices under evaluation and those of maximum diameter were assessed. AAAs were divided according to outcome (surveillance vs. elective repair after follow-up which is based on the maximum diameter criterion) and according to growth rate (high vs. low) based on four indices. Contingency between groups of high/low growth rate regarding each of the four indices on one hand and those regarding need for surgical repair on the other was assessed. Results: A strong correlation between growth rates of maximum diameter and those of AAA and ILT volumes could be established. Evaluation of contingency between groups of outcome and those of growth rate revealed significant associations only for AAA and ILT volumes. Subsequently AAAs with a rapid volumetric increase over time had a likelihood ratio of 10 to be operated compared to those with a slower enlargement. Regarding increase of maximum diameter, likelihood ratio between AAAs with rapid and those with slow expansion was only 3. Conclusion: Growth rate of aneurysms regarding 3Dimensional indices of AAA and ILT volumes is significantly associated with the need for surgical intervention while the same does not hold for growth rates determined by 2Dimensional indices of maximum diameter and ILT thickness.

  13. 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. ...

  14. The impact of electronic health record implementation and use on performance of the Surgical Care Improvement Project measures.

    Science.gov (United States)

    Thirukumaran, Caroline Pinto; Dolan, James G; Reagan Webster, Patricia; Panzer, Robert J; Friedman, Bruce

    2015-02-01

    To examine the impact of electronic health record (EHR) deployment on Surgical Care Improvement Project (SCIP) measures in a tertiary-care teaching hospital. SCIP Core Measure dataset from the CMS Hospital Inpatient Quality Reporting Program (March 2010 to February 2012). One-group pre- and post-EHR logistic regression and difference-in-differences analyses. Statistically significant short-term declines in scores were observed for the composite, postoperative removal of urinary catheter and post-cardiac surgery glucose control measures. A statistically insignificant improvement in scores for these measures was noted 3 months after EHR deployment. The transition to an EHR appears to be associated with a short-term decline in quality. Implementation strategies should be developed to preempt or minimize this initial decline. © Health Research and Educational Trust.

  15. Comparison of margin status and lesional size between radioactive seed localized vs conventional wire localized breast lumpectomy specimens.

    Science.gov (United States)

    Rarick, Jason; Kimler, Bruce F; Tawfik, Ossama

    2016-04-01

    Despite the known benefits of the use of radioactive seed localization (RSL), few studies have looked at the resultant pathologic marginal status of these lumpectomy specimens, especially in regard to different definitions of close/positive margins. We compared the marginal status of lumpectomy specimens removed by either RSL or conventional wire localization (CWL) techniques. A total of 106 lumpectomy specimens including 62 by CWL and 44 by RSL for invasive ductal and lobular carcinomas were compared. Data on gross and microscopic surgical margin status, tumor type and grade, and demographic information were retrospectively collected. There was no difference between the techniques in terms of tumor characteristics including size, histologic grade, lymph node positivity, or age. Although the distributions are very similar between CWL and RSL specimens for final marginal assessments (P=.69), there is a (modest) statistically significant difference in the distribution for margin classifications based on gross assessments (P=.040), specifically more RSL specimens exhibiting tumor within 1mm of the closest margin. Concordance between gross and microscopic lesion measurements is highest for invasive ductal carcinoma grade 3 for both CWL and RSL lumpectomies (78.6% and 80.0%). This study shows that there were no significant marginal status differences between RSL and CWL lumpectomy specimens with invasive carcinoma. Rather, what was relevant is whether the entire specimen could be classified as having negative/close margins. Significant workflow challenges in surgical pathology laboratories are expected with the adoption of the RSL process.

  16. Retrieval of specimens in laparoscopy using reclosable zipper-type plastic bags: a simple, cheap, and useful method.

    Science.gov (United States)

    Weber, A; Vázquez, J A; Valencia, S; Cueto, J

    1998-12-01

    Surgical specimens must often be extracted during laparoscopic surgery. Although the technologic advances in this field are amazing, simple measures may sometimes work even better than very sophisticated instruments. This is true of the reclosable plastic bags with zipper-type closure that we use for retrieving surgical specimens from the abdominal cavity in order to protect it as well as the abdominal wall. The bags are cheap, offer no problems for sterilization, are easy to obtain, and are available in many sizes. They are very simple to handle, making it easy to slip in the specimen and then extract it from the abdominal cavity. We describe our experience with these bags and a technique for manipulating them.

  17. Genomics and museum specimens.

    Science.gov (United States)

    Nachman, Michael W

    2013-12-01

    Nearly 25 years ago, Allan Wilson and colleagues isolated DNA sequences from museum specimens of kangaroo rats (Dipodomys panamintinus) and compared these sequences with those from freshly collected animals (Thomas et al. 1990). The museum specimens had been collected up to 78 years earlier, so the two samples provided a direct temporal comparison of patterns of genetic variation. This was not the first time DNA sequences had been isolated from preserved material, but it was the first time it had been carried out with a population sample. Population geneticists often try to make inferences about the influence of historical processes such as selection, drift, mutation and migration on patterns of genetic variation in the present. The work of Wilson and colleagues was important in part because it suggested a way in which population geneticists could actually study genetic change in natural populations through time, much the same way that experimentalists can do with artificial populations in the laboratory. Indeed, the work of Thomas et al. (1990) spawned dozens of studies in which museum specimens were used to compare historical and present-day genetic diversity (reviewed in Wandeler et al. 2007). All of these studies, however, were limited by the same fundamental problem: old DNA is degraded into short fragments. As a consequence, these studies mostly involved PCR amplification of short templates, usually short stretches of mitochondrial DNA or microsatellites. In this issue, Bi et al. (2013) report a breakthrough that should open the door to studies of genomic variation in museum specimens. They used target enrichment (exon capture) and next-generation (Illumina) sequencing to compare patterns of genetic variation in historic and present-day population samples of alpine chipmunks (Tamias alpinus) (Fig. 1). The historic samples came from specimens collected in 1915, so the temporal span of this comparison is nearly 100 years.

  18. Effective cataract surgical coverage: An indicator for measuring quality-of-care in the context of Universal Health Coverage.

    Science.gov (United States)

    Ramke, Jacqueline; Gilbert, Clare E; Lee, Arier C; Ackland, Peter; Limburg, Hans; Foster, Allen

    2017-01-01

    To define and demonstrate effective cataract surgical coverage (eCSC), a candidate UHC indicator that combines a coverage measure (cataract surgical coverage, CSC) with quality (post-operative visual outcome). All Rapid Assessment of Avoidable Blindness (RAAB) surveys with datasets on the online RAAB Repository on April 1 2016 were downloaded. The most recent study from each country was included. By country, cataract surgical outcome (CSOGood, 6/18 or better; CSOPoor, worse than 6/60), CSC (operated cataract as a proportion of operable plus operated cataract) and eCSC (operated cataract and a good outcome as a proportion of operable plus operated cataract) were calculated. The association between CSC and CSO was assessed by linear regression. Gender inequality in CSC and eCSC was calculated. Datasets from 20 countries were included (2005-2013; 67,337 participants; 5,474 cataract surgeries). Median CSC was 53.7% (inter-quartile range[IQR] 46.1-66.6%), CSOGood was 58.9% (IQR 53.7-67.6%) and CSOPoor was 17.7% (IQR 11.3-21.1%). Coverage and quality of cataract surgery were moderately associated-every 1% CSC increase was associated with a 0.46% CSOGood increase and 0.28% CSOPoor decrease. Median eCSC was 36.7% (IQR 30.2-50.6%), approximately one-third lower than the median CSC. Women tended to fare worse than men, and gender inequality was slightly higher for eCSC (4.6% IQR 0.5-7.1%) than for CSC (median 2.3% IQR -1.5-11.6%). eCSC allows monitoring of quality in conjunction with coverage of cataract surgery. In the surveys analysed, on average 36.7% of people who could benefit from cataract surgery had undergone surgery and obtained a good visual outcome.

  19. Improving risk-adjusted measures of surgical site infection for the national healthcare safety network.

    Science.gov (United States)

    Mu, Yi; Edwards, Jonathan R; Horan, Teresa C; Berrios-Torres, Sandra I; Fridkin, Scott K

    2011-10-01

    The National Healthcare Safety Network (NHSN) has provided simple risk adjustment of surgical site infection (SSI) rates to participating hospitals to facilitate quality improvement activities; improved risk models were developed and evaluated. Data reported to the NHSN for all operative procedures performed from January 1, 2006, through December 31, 2008, were analyzed. Only SSIs related to the primary incision site were included. A common set of patient- and hospital-specific variables were evaluated as potential SSI risk factors by univariate analysis. Some ific variables were available for inclusion. Stepwise logistic regression was used to develop the specific risk models by procedure category. Bootstrap resampling was used to validate the models, and the c-index was used to compare the predictive power of new procedure-specific risk models with that of the models with the NHSN risk index as the only variable (NHSN risk index model). From January 1, 2006, through December 31, 2008, 847 hospitals in 43 states reported a total of 849,659 procedures and 16,147 primary incisional SSIs (risk, 1.90%) among 39 operative procedure categories. Overall, the median c-index of the new procedure-specific risk was greater (0.67 [range, 0.59-0.85]) than the median c-index of the NHSN risk index models (0.60 [range, 0.51-0.77]); for 33 of 39 procedures, the new procedure-specific models yielded a higher c-index than did the NHSN risk index models. A set of new risk models developed using existing data elements collected through the NHSN improves predictive performance, compared with the traditional NHSN risk index stratification.

  20. Developing a tool to measure pharmacoeconomic outcomes of post-surgical pain management interventions.

    Science.gov (United States)

    Keller, Deborah S; Smalarz, Amy; Haas, Eric M

    2016-01-01

    Financial pressures have limited the ability of providers to use medication that may improve clinical outcomes and patient satisfaction. New interventions are often fraught with resistance from individual cost centers. A value realization tool (VRT) is essential for separate cost centers to communicate and comprehend the overall financial and clinical implications of post-surgical pain management medication interventions (PSMI). The goal was to describe development of a VRT. An evaluation of common in-patient PSMI approaches, impacts, and costs was performed. A multidisciplinary task force guided development of the VRT to ensure appropriate representation and relevance to clinical practice. The main outcome was an Excel-based tool that communicates the overall cost/benefit of PSMI for the post-operative patient encounter. The VRT aggregated input data on costs, clinical impact, and nursing burden of PSMI assessment and monitoring into two high-level outcome reports: Overall Cost Impact and Nurse & Patient Impact. Costs included PSMI specific medication, equipment, professional placement, labor, overall/opioid-related adverse events, re-admissions, and length of stay. Nursing impact included level of practice interference, job satisfaction, and patient care metrics. Patient impact included pain scores, opioid use, PACU time, and satisfaction. Reference data was provided for individual institutions that may not collect all variables included in the VRT. The VRT is a valuable way for administrators to assess PSMI cost/benefits and for individual cost centers to see the overall value of individual interventions. The user-friendly, decision-support tool allows the end-user to use built-in referenced or personalized outcome data, increasing relevance to their institutions. This broad picture could facilitate communication across cost centers and evidence-based decisions for appropriate use and impacts of PSMI.

  1. Development of a single, practical measure of surgical site infection (SSI) for patient report or observer completion

    Science.gov (United States)

    Macefield, Rhiannon C; Reeves, Barnaby C; Milne, Thomas K; Nicholson, Alexandra; Blencowe, Natalie S; Calvert, Melanie; Avery, Kerry NL; Messenger, David E; Bamford, Richard; Pinkney, Thomas D; Blazeby, Jane M

    2017-01-01

    Background: Surgical site infections (SSIs) are the third most common hospital-associated infection and can lead to significant patient morbidity and healthcare costs. Identification of SSIs is key to surveillance and research but reliable assessment is challenging, particularly after hospital discharge when most SSIs present. Existing SSI measurement tools have limitations and their suitability for post-discharge surveillance is uncertain. Aims: This study aimed to develop a single measure to identify SSI after hospital discharge, suitable for patient or observer completion. Methods: A three-phase mixed methods study was undertaken: Phase 1, an analysis of existing tools and semi-structured interviews with patients and professionals to establish the content of the measure; Phase 2, development of questionnaire items suitable for patients and professionals; Phase 3, pre-testing the single measure to assess acceptability and understanding to both stakeholder groups. Interviews and pre-testing took place over 12 months in 2014–2015 with patients and professionals from five specialties recruited from two UK hospital Trusts. Findings: Analyses of existing tools and interviews identified 19 important domains for assessing SSIs. Domains were developed into provisional questionnaire items. Pre-testing and iterative revision resulted in a final version with 16 items that were understood and easily completed by patients and observers (healthcare professionals). Conclusion: A single patient and observer measure for post-discharge SSI assessment has been developed. Further testing of the validity, reliability and accuracy of the measure is underway.

  2. Biaxial Creep Specimen Fabrication

    Energy Technology Data Exchange (ETDEWEB)

    JL Bump; RF Luther

    2006-02-09

    This report documents the results of the weld development and abbreviated weld qualification efforts performed by Pacific Northwest National Laboratory (PNNL) for refractory metal and superalloy biaxial creep specimens. Biaxial creep specimens were to be assembled, electron beam welded, laser-seal welded, and pressurized at PNNL for both in-pile (JOYO reactor, O-arai, Japan) and out-of-pile creep testing. The objective of this test campaign was to evaluate the creep behavior of primary cladding and structural alloys under consideration for the Prometheus space reactor. PNNL successfully developed electron beam weld parameters for six of these materials prior to the termination of the Naval Reactors program effort to deliver a space reactor for Project Prometheus. These materials were FS-85, ASTAR-811C, T-111, Alloy 617, Haynes 230, and Nirnonic PE16. Early termination of the NR space program precluded the development of laser welding parameters for post-pressurization seal weldments.

  3. Validation of 3D Code KATRIN For Fast Neutron Fluence Calculation of VVER-1000 Reactor Pressure Vessel by Ex-Vessel Measurements and Surveillance Specimens Results

    Science.gov (United States)

    Dzhalandinov, A.; Tsofin, V.; Kochkin, V.; Panferov, P.; Timofeev, A.; Reshetnikov, A.; Makhotin, D.; Erak, D.; Voloschenko, A.

    2016-02-01

    Usually the synthesis of two-dimensional and one-dimensional discrete ordinate calculations is used to evaluate neutron fluence on VVER-1000 reactor pressure vessel (RPV) for prognosis of radiation embrittlement. But there are some cases when this approach is not applicable. For example the latest projects of VVER-1000 have upgraded surveillance program. Containers with surveillance specimens are located on the inner surface of RPV with fast neutron flux maximum. Therefore, the synthesis approach is not suitable enough for calculation of local disturbance of neutron field in RPV inner surface behind the surveillance specimens because of their complicated and heterogeneous structure. In some cases the VVER-1000 core loading consists of fuel assemblies with different fuel height and the applicability of synthesis approach is also ambiguous for these fuel cycles. Also, the synthesis approach is not enough correct for the neutron fluence estimation at the RPV area above core top. Because of these reasons only the 3D neutron transport codes seem to be satisfactory for calculation of neutron fluence on the VVER-1000 RPV. The direct 3D calculations are also recommended by modern regulations.

  4. Neonatal Intensive Care Unit Quality Initiative:  Identifying Preanalytical Variables Contributing to Specimen Hemolysis and Measuring the Impact of Evidence-Based Practice Interventions.

    Science.gov (United States)

    Tolan, Nicole V; Kaleta, Erin J; Fang, Jennifer L; Colby, Christopher E; Carey, William A; Karon, Brad S; Baumann, Nikola A

    2016-07-01

    Blood specimen hemolysis is a major cause of sample recollection in the neonatal intensive care unit. We aimed to reduce the hemolysis rate from 6.3% at baseline to less than 4% within the 9 months' duration of the study. Intravenous infusion of lipid emulsion during sample collection, sample collection site, and blood sample transportation methods were investigated as possible contributors to hemolysis. Subsequently, two practice improvements were implemented: pausing lipid emulsion infusion prior to collection and slowing withdrawal rates through arterial catheters. Samples were more likely to be hemolyzed if they were collected during lipid infusion and subsequently transported by pneumatic tube or collected through an arterial catheter. Retrospective analysis demonstrated a decreased number of tests cancelled due to specimen hemolysis (3.5%) after our interventions. We identified three variables contributing to hemolysis and instituted two clinical practice interventions to significantly reduce test cancellations due to hemolysis. © American Society for Clinical Pathology, 2016. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  5. Validation of 3D Code KATRIN For Fast Neutron Fluence Calculation of VVER-1000 Reactor Pressure Vessel by Ex-Vessel Measurements and Surveillance Specimens Results

    Directory of Open Access Journals (Sweden)

    Dzhalandinov A.

    2016-01-01

    Full Text Available Usually the synthesis of two-dimensional and one-dimensional discrete ordinate calculations is used to evaluate neutron fluence on VVER-1000 reactor pressure vessel (RPV for prognosis of radiation embrittlement. But there are some cases when this approach is not applicable. For example the latest projects of VVER-1000 have upgraded surveillance program. Containers with surveillance specimens are located on the inner surface of RPV with fast neutron flux maximum. Therefore, the synthesis approach is not suitable enough for calculation of local disturbance of neutron field in RPV inner surface behind the surveillance specimens because of their complicated and heterogeneous structure. In some cases the VVER-1000 core loading consists of fuel assemblies with different fuel height and the applicability of synthesis approach is also ambiguous for these fuel cycles. Also, the synthesis approach is not enough correct for the neutron fluence estimation at the RPV area above core top. Because of these reasons only the 3D neutron transport codes seem to be satisfactory for calculation of neutron fluence on the VVER-1000 RPV. The direct 3D calculations are also recommended by modern regulations.

  6. Impact of surgical training on the performance of proposed quality measures for hysterectomy for pelvic organ prolapse.

    Science.gov (United States)

    Adams-Piper, Emily R; Guaderrama, Noelani M; Chen, Qiaoling; Whitcomb, Emily L

    2017-06-01

    Recent healthcare reform has led to increased emphasis on standardized provision of quality care. Use of government- and organization-approved quality measures is 1 way to document quality care. Quality measures, to improve care and aid in reimbursement, are being proposed and vetted in many areas of medicine. We aimed to assess performance of proposed quality measures that pertain to hysterectomy for pelvic organ prolapse stratified by surgical training. The 4 quality measures that we assessed were (1) the documentation of offering conservative treatment of pelvic organ prolapse, (2) the quantitative assessment of pelvic organ prolapse (Pelvic Organ Prolapse-Quantification or Baden-Walker), (3) the performance of an apical support procedure, and (4) the performance of cystoscopy at time of hysterectomy. Patients who underwent hysterectomy for pelvic organ prolapse from January 1 to December 31, 2008, within a large healthcare maintenance organization were identified by diagnostic and procedural codes within the electronic medical record. Medical records were reviewed extensively for demographic and clinical data that included the performance of the 4 proposed quality measures and the training background of the primary surgeon (gynecologic generalist, fellowship-trained surgeon in Female Pelvic Medicine and Reconstructive Surgery, and "grandfathered" Female Pelvic Medicine and Reconstructive Surgery). Data were analyzed with the use of descriptive statistics. Inferential statistics with chi-squared tests were used to compare performance rates of quality measures that were stratified by surgical training. Probability values trained surgeons performed 302 hysterectomies for pelvic organ prolapse; grandfathered Female Pelvic Medicine and Reconstructive Surgery surgeons performed 98 hysterectomies, and gynecologic generalist surgeons performed 230 hysterectomies. Fellowship-trained surgeons had the highest performance rates for individual quality measures (91

  7. 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 ...

  8. Measurement of total and free urinary phenol and paraben concentrations over the course of pregnancy: assessing reliability and contamination of specimens in the Norwegian Mother and Child Cohort Study

    OpenAIRE

    Guidry, Virginia T.; Longnecker, Matthew P.; Aase, Heidi; Eggesbø, Merete Åse; Zeiner, Pål; Reichborn-Kjennerud, Ted; Knudsen,Gun Peggy; Bertelsen, Randi Jacobsen; Ye, Xiaoyun; Calafat, Antonia M.; Engel, Stephanie M.

    2015-01-01

    Background Exposures to environmental phenols and parabens may be harmful, especially in utero. Prior studies have demonstrated high within-person variability of urinary concentrations across pregnancy. Objectives We sought to measure phenol and paraben biomarker concentrations for the Norwegian Mother and Child Cohort (MoBa) study, assess within-person variability, and investigate any possible external phenol or paraben contamination of specimens. Methods We collected three spot urine sample...

  9. Measuring the surgical academic output of an institution: the "institutional" H-index.

    Science.gov (United States)

    Turaga, Kiran K; Gamblin, T Clark

    2012-01-01

    The Hirsch index is a novel index that combines the number of publications and citations in measuring the research output of researchers. We hypothesized that the h-index can be used to measure the academic success of an institution in a subject area (surgery) and compared this measure to previously published measures of ranking institutions. We identified the top 10 research medical schools as designated by the United States News and World Report 2010. The h-index for an institution was obtained in 3-year periods for articles published in surgery. Independent rankings from the NIH and other web sites were then used to compare with our newly generated rankings. The median h-index for institutions was 52.5 (46-54) for 2000-2002, 50 (44-52) for 2003-2005, 35.5 (33-40) for 2006-2008, and 15.5 (13-16) for 2009-2011. The percentage of self citations was the highest in publications from Harvard University (22.2%) and the lowest from Columbia University (10%) in the years 2009-11. Our ranking closely mirrored the United States News and World Report, and Harvard Medical School remains the top ranking in the field of surgery, although NIH funding-based ranking may suggest otherwise. The institutional h-index appears to be a viable indicator for the measure of academic success of institutions in a subject area. Despite limitations, it yields objective data regarding the citations and number of articles published by an institution in a subject area and could be used to measure performance. Copyright © 2012 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  10. Specimen Holder For Flammability Tests

    Science.gov (United States)

    Rucker, Michelle A.

    1992-01-01

    Fixture holds sheet specimens for flammability tests. Frame and clamps designed to minimize local overstress on specimen. Heat capacity of fixture low, interfering less with interpretation of results of test by drawing less heat away from specimen. Accepts films, fabrics, foams, and other sheets, rigid or flexible. Specimens thin or thick, or of variable thickness. Bent to accommodate curved rigid specimens. Also used for such other tests as particle-impact tests.

  11. Optical-mechanical measurements of biomechanical characteristics of lumbar spines after application of various surgical fixation methods

    Science.gov (United States)

    Keprt, Jiri; Bartonek, Ludek; Charamza, Jiri; Hrabalek, Lumir

    2001-03-01

    Special equipment was realized for measurement of biomechanical characteristics of samples of lower part of the spine that means the lumbar part L1-L5. The measuring was carried out on 3 spinal samples. At first on an intact spinal sample, on a destabilized spinal sample and on a stabilized spinal sample. The stabilization was carry out by cylindrical cages and fixation screws. Using force-meters each specimen was tested sequentially nondestructively in axial torsion, compression, flexion and extension and lateral bending. Stiffness of destabilized and stabilized samples were computed to that of intact spine. During straining and measurement of ht rigidity of the sample as a whole it is also necessary to observe the movement of individual parts of the sample. This movement is followed with the help of round targets connected to the appropriate vertebra to be observed. The detectional targets are lit with a lamp, in some cases with a laser, and are watched by two CCD cameras. An optical signal is brought into a computer and evaluated by the fast Fourier transformation method. The period and direction of interference fringes determine the size and the direction of the shift.

  12. 三轴试样径向变形激光量测系统的改进%IMPROVEMENT OF LASER MEASUREMENT SYSTEM FOR RADIAL DEFORMATION OF TRIAXIAL SPECIMENS

    Institute of Scientific and Technical Information of China (English)

    苗强强; 陈正汉; 孙树国; 任心志; 黄雪峰; 张磊

    2011-01-01

    利用激光光电检测技术和高精度位置敏感探测器(PSD)的优点,对三轴试样径向变形的激光量测系统进行相关改进.共做了3个方面的改进工作:(1)将圆形压力室改为方形压力室,可解决光垂直入射时发生的光线偏折现象.(2)由于原系统使用1个PSD,无法解决三轴剪切试验中试样容易发生偏心的问题,使用2个PSD分别对试样径向左右两侧进行量测,可提高量测的精度.(3)将控制传感器升降的微动机械控制单元的普通电机转换成由计算机指令控制的步进电机,每一行程都能回到同一初始位置.运用该套系统对标准件、压力室中的标准件和压力室加水的标准件进行标定,得出电信号变化与直径变化的函数关系,并对饱和含黏砂土试样进行固结试验,将测试结果同计算结果相比较,证明该套系统测试三轴试验试样的体变结果较为可靠.该系统可用于研究三轴试样的局部变形和端部约束等问题,并对当前土体本构关系中的应变局部化、剪切带形成以及非饱和土体变量测等方面也有比较广泛的应用前景.%Taking advantages of laser photoelectricity measurement technique and position sensing detector(PSD) with high precision, the laser measurement system for measuring radial deformation of triaxial specimens is improved.Three aspects of improvement have been done as follows: (1) In order to avoid the deflection of vertical incident light, the square pressure chamber is adopted instead of the circular one.(2) Two PSDs are used to measure radial deformation in left and right sides of specimen instead of one PSD in original system, which couldn't take into account the specimen eccentricity in triaxial shear tests.So the measuring precision would be enhanced.(3) A stepper motor of controlling transducer lift and down is used instead of common motor.It can ensure the transducer goes back to the same initial position.This system is used to

  13. Measures of right ventricular function after transcatheter versus surgical aortic valve replacement

    DEFF Research Database (Denmark)

    Grønlykke, Lars; Ihlemann, Nikolaj; Ngo, Anh Thuc

    2017-01-01

    OBJECTIVES: Describe changes in measures of right ventricular (RV) function in patients treated for aortic stenosis using open-chest surgery (SAVR) or transcatheter treatment (TAVR). METHODS: Patients in the Nordic Aortic Valve Intervention (NOTION) trial were randomized 1:1 to TAVR (n = 114......) or SAVR (n = 106). Echocardiography was performed at baseline and 3 and 12 months post-procedure. Tricuspid annular plane systolic excursion (TAPSE) and right ventricular fractional area change (RVFAC) were used as measures of longitudinal and transverse RV contraction. Left ventricular ejection fraction...... echocardiographic changes and NYHA class. CONCLUSIONS: TAPSE and AVPD lateral differed between TAVR and SAVR at 3 and 12 months follow-up, but these findings were not related to any changes in NYHA class. These observations indicate that following SAVR, echocardiographic changes may not reflect right ventricular...

  14. Measurement of breast volume is a useful supplement to select candidates for surgical breast reduction

    DEFF Research Database (Denmark)

    Ikander, Peder; Drejøe, Jennifer Berg; Lumholt, Pavia

    2014-01-01

    for breast reduction surgery, thus establishing a standard decision basis that can be shared by surgeons and departments to secure patients fair and equal treatment opportunities. MATERIAL AND METHODS: A total of 427 patients who were referred to three Danish public hospitals with breast hypertrophy...... in the period from January 2007 to March 2011 were included prospectively in the study. The patients' subjective complaints, height, weight and standard breast measurements were registered as well as the decision for or against surgery. Breast volume was measured using transparent plastic cups. RESULTS: Cut......-off values for breast volume were calculated based on whether or not the patients were offered reduction surgery. Most patients (93%) with a breast volume below 800 cc were not offered surgery, while most with a volume exceeding 900 cc were offered surgery (94%). In the grey zone between 800 and 900 cc...

  15. NASA Biological Specimen Repository

    Science.gov (United States)

    McMonigal, K. A.; Pietrzyk, R. A.; Sams, C. F.; Johnson, M. A.

    2010-01-01

    The NASA Biological Specimen Repository (NBSR) was established in 2006 to collect, process, preserve and distribute spaceflight-related biological specimens from long duration ISS astronauts. This repository provides unique opportunities to study longitudinal changes in human physiology spanning may missions. The NBSR collects blood and urine samples from all participating ISS crewmembers who have provided informed consent. These biological samples are collected once before flight, during flight scheduled on flight days 15, 30, 60, 120 and within 2 weeks of landing. Postflight sessions are conducted 3 and 30 days after landing. The number of in-flight sessions is dependent on the duration of the mission. Specimens are maintained under optimal storage conditions in a manner that will maximize their integrity and viability for future research The repository operates under the authority of the NASA/JSC Committee for the Protection of Human Subjects to support scientific discovery that contributes to our fundamental knowledge in the area of human physiological changes and adaptation to a microgravity environment. The NBSR will institute guidelines for the solicitation, review and sample distribution process through establishment of the NBSR Advisory Board. The Advisory Board will be composed of representatives of all participating space agencies to evaluate each request from investigators for use of the samples. This process will be consistent with ethical principles, protection of crewmember confidentiality, prevailing laws and regulations, intellectual property policies, and consent form language. Operations supporting the NBSR are scheduled to continue until the end of U.S. presence on the ISS. Sample distribution is proposed to begin with selections on investigations beginning in 2017. The availability of the NBSR will contribute to the body of knowledge about the diverse factors of spaceflight on human physiology.

  16. Modelling of Specimen Fracture

    Science.gov (United States)

    2013-09-23

    the plate center. An end load of 1.0 MPa was applied. 1 2 3 Modelling of Specimen Fracture – Final Report 11 TR-13-47 Figure 2.5: Crack Geometry Figure...Christopher Bayley DRDC Atlantic Dockyard Laboratory Pacific CFB Esquimalt, Building 199 PO Box 17000, Station Forces Victoria, British Columbia Canada...q The weighting function, q , can be any arbitrary function within the J-integral domain, and must be zero on the domain boundary . An easy function

  17. Labeling of Patient Specimens

    Science.gov (United States)

    2011-01-26

    noted during the event that the actu.al number of near miss incidmts reported monthly was low due to laboratory personnel performing rounds each...specimens never leaves label and if moved it is labeled), All orders in system and all near misses and errors reported to patient safety Purchase/Install...Meeting 14 Aug 09, 1400 in lab break room thru out Develop TICK sheet to track near misses .JDI Ms. Clark Clinics will provide toPS 1st working day of

  18. Measures and time points relevant for post-surgical follow-up in patients with inflammatory arthritis: a pilot study

    Directory of Open Access Journals (Sweden)

    Tägil Magnus

    2009-05-01

    Full Text Available Abstract Background Rheumatic diseases commonly affect joints and other structures in the hand. Surgery is a traditional way to treat hand problems in inflammatory rheumatic diseases with the purposes of pain relief, restore function and prevent progression. There are numerous measures to choose from, and a combination of outcome measures is recommended. This study evaluated if instruments commonly used in rheumatologic clinical practice are suitable to measure outcome of hand surgery and to identify time points relevant for follow-up. Methods Thirty-one patients (median age 56 years, median disease duration 15 years with inflammatory rheumatic disease and need for post-surgical occupational therapy intervention formed this pilot study group. Hand function was assessed regarding grip strength (Grippit, pain (VAS, range of motion (ROM (Signals of Functional Impairment (SOFI and grip ability (Grip Ability Test (GAT. Activities of daily life (ADL were assessed by means of Disabilities of the Arm, Shoulder and Hand Outcome (DASH and Canadian Occupational Performance Measure (COPM. The instruments were evaluated by responsiveness and feasibility; follow-up points were 0, 3, 6 and 12 months. Results All instruments showed significant change at one or more follow-up points. Satisfaction with activities (COPM showed the best responsiveness (SMR>0.8, while ROM measured with SOFI had low responsiveness at most follow-up time points. The responsiveness of the instruments was stable between 6 and 12 month follow-up which imply that 6 month is an appropriate time for evaluating short-term effect of hand surgery in rheumatic diseases. Conclusion We suggest a core set of instruments measuring pain, grip strength, grip ability, perceived symptoms and self-defined daily activities. This study has shown that VAS pain, the Grippit instrument, GAT, DASH symptom scale and COPM are suitable outcome instruments for hand surgery, while SOFI may be a more insensitive

  19. Continuous intraoperative temperature measurement and surgical site infection risk: analysis of anesthesia information system data in 1008 colorectal procedures.

    Science.gov (United States)

    Melton, Genevieve B; Vogel, Jon D; Swenson, Brian R; Remzi, Feza H; Rothenberger, David A; Wick, Elizabeth C

    2013-10-01

    To investigate the association between intraoperative temperature and surgical site infection (SSI) in colorectal surgery with anesthesia information system data. Continuously measured intraoperative anesthesia information system temperature data for adult abdominal colorectal surgery procedures at a large tertiary center for 1 year were linked to 30-day American College of Surgeons National Surgical Quality Improvement Program SSI outcomes. Univariable and multivariable analyses of SSI to descriptive temperature statistics, absolute and relative temperature threshold times, and other clinically relevant variables were performed. Overall, 1008 patients (48% female, median age: 53 years) underwent major colorectal procedures (7% emergent, 72% open, 173 ± 95 minutes mean procedure time) with median intraoperative temperature 36.0°C, using active rewarming in 92% and 1-hour presurgical antibiotic administration in 91%. Thirty-day overall and organ/space infection rates were 17.4% (175) and 8.5% (86). Maximum, minimum, ending, and median temperatures were similar for those with or without SSI (36.6°C vs 36.5°C, 34.9°C vs 35.0°C, 36.4°C vs 36.2°C, and 36.1°C vs 36.0°C, P = not significant) and percent minutes using incremental cutoffs failed to correlate SSI with temperature. Absolute minutes for higher temperature cutoffs correlated with SSI because of longer procedure times. On multivariable analysis, factors associated with SSI were preoperative diabetes [odds ratio: 1.81 (1.07-3.07), P = 0.022] and blood loss of more than 500 mL [odds ratio: 1.61 (1.01-2.58), P = 0.047]. Although active rewarming remains an accepted and valid process measure, highly granular anesthesia information system temperature data did not demonstrate a correlation between temperature measures and SSI. SSI prevention efforts should focus on more efficacious interventions as opposed to currently mandated publicly reported normothermia measures.

  20. [Transfontanellar Doppler ultrasound measurement of cerebral blood velocity before and after surgical treatment of hydrocephalus].

    Science.gov (United States)

    de Assis, M C; Machado, H R

    1999-09-01

    Twenty-seven children with hydrocephalus of different etiologies diagnosed by clinical examination, neurosonography and computerized brain tomography were submitted to transfontanellar US-Doppler evaluation for measurement of blood flow velocity and for the calculation of resistance index (RI) in the anterior and middle cerebral arteries and internal carotids. All children were submitted to evaluation before surgery and on the 1st, 30th and 60th postoperative days. We conclude that neurosonography and US-Doppler technique is useful for determination of hydrocephalus, indication and control of cerebrospinal fluid shunts and monitoring of changes in RI, comparing data obtained immediately before and after surgery and during the late postoperative period. The results obtained when comparing the RI values for the various arteries during the different stages of the study also permitted us to conclude that the anterior cerebral arteries are representative of the maximal alterations that occur in cerebral vascular resistance in pediatric patients with hydrocephalus.

  1. Vickers Microhardness Testing with Miniaturized Disk Specimens

    OpenAIRE

    Kurishita, Hiroaki; Kayano, Hideo

    1991-01-01

    The microhardness technique has been increasingly important for testing irradiated materials because of the necessity of small-scale specimen technology. In order to establish Vickers microhardness testing over a wide temperature range using miniaturized specimens such as transmission electron microscopy (TEM) disks, an apparatus that permits the measurements in the temperature range of well below liquid nitrogen temperature to well above room temperature is developed. Effects of indentation ...

  2. Type specimen studies in Pleurotus

    NARCIS (Netherlands)

    Petersen, Ronald H.; Krisai-Greilhuber, Irmgard

    1999-01-01

    An epitype specimen is designated for Pleurotus cornucopiae. Morphological examination of Mexican material and the type specimen of P. opuntiae showed that the distribution of this species includes North Africa and the highlands of Mexico. The type specimen of Lentinus (Pleurotus) eugrammus reveals

  3. Prospective Study of the Surgical Techniques Used in Primary Rhinoplasty on the Caucasian Nose and Comparison of the Preoperative and Postoperative Anthropometric Nose Measurements

    Directory of Open Access Journals (Sweden)

    Berger, Cezar Augusto Sarraf

    2014-12-01

    Full Text Available Introduction The knowledge and study of surgical techniques and anthropometric measurements of the nose make possible a qualitative and quantitative analysis of surgical results. Objective Study the main technique used in rhinoplasty on Caucasian noses and compare preoperative and postoperative anthropometric measurements of the nose. Methods A prospective study with 170 patients was performed at a private hospital. Data were collected using the Electronic System Integrated of Protocols software (Sistema Integrado de Protocolos Eletrônicos, SINPE©. The surgical techniques used in the nasal dorsum and tip were evaluated. Preoperative and 12-month follow-up photos as well as the measurements compared with the ideal aesthetic standard of a Caucasian nose were analyzed objectively. Student t test and standard deviation test were applied. Results There was a predominance of endonasal access (94.4%. The most common dorsum technique was hump removal (33.33%, and the predominance of sutures (24.76% was observed on the nasal tip, with the lateral intercrural the most frequent (32.39%. Comparison between preoperative and postoperative photos found statistically significant alterations on the anthropometric measurements of the noses. Conclusion The main surgical techniques on Caucasian noses were evaluated, and a great variety was found. The evaluation of anthropometric measurements of the nose proved the efficiency of the performed procedures.

  4. Prospective Study of the Surgical Techniques Used in Primary Rhinoplasty on the Caucasian Nose and Comparison of the Preoperative and Postoperative Anthropometric Nose Measurements

    Science.gov (United States)

    Berger, Cezar Augusto Sarraf; Freitas, Renato da Silva; Malafaia, Osvaldo; Pinto, José Simão de Paula; Macedo Filho, Evaldo Dacheux; Mocellin, Marcos; Fagundes, Marina Serrato Coelho

    2014-01-01

    Introduction The knowledge and study of surgical techniques and anthropometric measurements of the nose make possible a qualitative and quantitative analysis of surgical results. Objective Study the main technique used in rhinoplasty on Caucasian noses and compare preoperative and postoperative anthropometric measurements of the nose. Methods A prospective study with 170 patients was performed at a private hospital. Data were collected using the Electronic System Integrated of Protocols software (Sistema Integrado de Protocolos Eletrônicos, SINPE©). The surgical techniques used in the nasal dorsum and tip were evaluated. Preoperative and 12-month follow-up photos as well as the measurements compared with the ideal aesthetic standard of a Caucasian nose were analyzed objectively. Student t test and standard deviation test were applied. Results There was a predominance of endonasal access (94.4%). The most common dorsum technique was hump removal (33.33%), and the predominance of sutures (24.76%) was observed on the nasal tip, with the lateral intercrural the most frequent (32.39%). Comparison between preoperative and postoperative photos found statistically significant alterations on the anthropometric measurements of the noses. Conclusion The main surgical techniques on Caucasian noses were evaluated, and a great variety was found. The evaluation of anthropometric measurements of the nose proved the efficiency of the performed procedures. PMID:25992149

  5. Systematic review of patient-reported outcome measures in the surgical treatment of patients with esophageal cancer.

    Science.gov (United States)

    Straatman, J; Joosten, P J M; Terwee, C B; Cuesta, M A; Jansma, E P; van der Peet, D L

    2016-10-01

    Esophageal cancer is currently the eighth most common cancer worldwide. Improvements in operative techniques and neoadjuvant therapies have led to improved outcomes. Resection of the esophagus carries a high risk of severe complications and has a negative impact on health-related quality of life (QOL). The aim of this study was to assess which patient-reported outcome measures (PROMs) are used to measure QOL after esophagectomy for cancer. A comprehensive search of original articles was conducted investigating QOL after surgery for esophageal carcinoma. Two authors independently selected relevant articles, conducted clinical appraisal, and extracted data (PJ and JS). Out of 5893 articles, 58 studies were included, consisting of 41 prospective and 17 retrospective cohort studies, including a total of 6964 patients. These studies included 11 different PROMs. The existing PROMs could be divided into generic, symptom-specific, and disease-specific questionnaires. The European Organisation for Research and Treatment of Cancer (EORTC) QOL Questionnaire Core 30 (QLQ C-30) along with the EORTC QLQ-OESophagus module OES18 was the most widely used; in 42 and 32 studies, respectively. The EORTC and the Functional Assessment of Cancer Therapy (FACT) questionnaires use an oncological module and an organ-specific module. One validation study was available, which compared the FACT and EORTC, showing moderate to poor correlation between the questionnaires. A great variety of PROMs are being used in the measurement of QOL after surgery for esophageal cancer. A questionnaire with a general module along with a disease-specific module for assessment of QOL of different treatment modalities seem to be the most desirable, such as the EORTC and the FACT with their specific modules (EORTC QLQ-OES18 and FACT-E). Both are developed in different treatment modalities, such as in surgical patients. With regard to reproducibility of current results, the EORTC is recommended. © 2015

  6. Clinicopathological study of hysterectomised specimens

    Directory of Open Access Journals (Sweden)

    Saravana A.

    2016-12-01

    Full Text Available Background: Hysterectomy is the commonest major surgical procedure performed in gynecology. It can be done by abdominal or vaginal route and with the help of laparoscopy. Hysterectomy is an effective treatment option for many conditions like fibroid, abnormal uterine bleeding, endometriosis, adenomyosis, uterine prolapse, pelvic inflammatory disease and cancer of reproductive organ when other treatment options are contraindicated or have failed, or if the woman no longer wishes to retain her menstrual and reproductive. The aim and objective of the study was to correlate indications of hysterectomy with histopathological findings in hysterectomised patients. Methods: A retrospective study was carried on 113 hysterectomised cases over a period of one year from June 2015 to May 2016. The data regarding the patient’s age, parity, clinical diagnosis, type of hysterectomy and histopathological diagnosis were reviewed by the records and analyzed. Results: A total of 113 cases of hysterectomies were studied. Hysterectomies were distributed over a wide age ranging from 20 years to 75 years. Most common age group was 41-50 years. Among hystectomies majority were done through vaginal route 86 (76.1% and 26 (23% cases were done through abdominal route. Most common clinical diagnosis was fibroid uterus in 44(38.9% cases. Most of the hysterectomies were done for benign conditions. In final histopathological report most common diagnosis was fibroid uterus in 45(39.8% hysterectomy specimens. It was correlated well with clinical diagnosis. Next most common histopathological diagnosis was Adenomyosis. Conclusions: Histopathological analysis correlated well with preoperative clinical diagnosis in majority of cases. The commonest indication and histopathological finding in our study was fibroid uterus. Next most common histopathological finding was Adenomyosis. Most commonly hysterectomies were done through vaginal route in our study.

  7. Diferença entre hospitais privado e universitário na taxa de linfonodos de peça cirúrgica de câncer colorretal: o papel do patologista Difference between university and private hospitals on lymph nodes harvest of surgical colorectal cancer specimens: the role of the pathologist

    Directory of Open Access Journals (Sweden)

    Rodrigo Gomes da Silva

    2010-03-01

    Full Text Available Tem sido demonstrado que o número de linfonodos obtidos em peças cirúrgicas de câncer colorretal é fundamental para o adequado estadiamento da doença e, consequentemente, para a obtenção de melhores resultados oncológicos. A percepção de diferenças no número de linfonodos dissecados em peças cirúrgicas de câncer colorretal pelos mesmos cirurgiões em hospitais diferentes motivou este estudo. O objetivo do presente estudo foi avaliar se há diferença no número de linfonodos e em determinados parâmetros histopatológicos em peça cirúrgica de pacientes com câncer colorretal operados por dois cirurgiões que atuam tanto em hospital universitário, como em hospital privado. MÉTODO: Foram avaliados retrospectivamente 122 pacientes, obtendo-se dados relativos a tipo de instituição (universitária versus privada, aspectos demográficos, estadiamento, localização do tumor, tipo de operação, via de acesso (aberta versus laparoscópica , indicação de radioterapia, número de linfonodos dissecados, número de linfonodos positivos e negativos, assim como o tipo histológico, presença de invasões vascular, linfática e perineural e resposta linfocítica. RESULTADOS: Sessenta e cinco pacientes foram operados em instituição universitária e 57, em instituição privada. Não houve diferença entre os grupos quanto à idade, gênero, estadiamento, localização do tumor, indicação de radioterapia e tipo de operação. A via laparoscópica foi mais comum na instituição universitária. A mediana de linfonodos dissecados foi de 25 (P25-75: 15-34 na instituição universitária versus 15 (P25-75;12-17 (pIt has been demonstrated that lymph nodes harvest from surgical specimens of colorectal cancer is one of the most important features for appropriate staging of the disease and to plain the best treatment. The perception of differences in the number of harvest lymph nodes in surgical specimens of colorectal cancer by the same

  8. Strain Assessment in Surgically Resected Inflammatory and Neoplastic Bowel Lesions

    DEFF Research Database (Denmark)

    Havre, R F; Leh, S; Gilja, O H

    2014-01-01

    Purpose: To investigate whether ultrasound-based strain imaging can discriminate between colorectal adenocarcinomas and stenotic Crohn's lesions in newly resected surgical specimens.Materials and Methods: Resected surgical specimens from 27 patients electively operated for colorectal tumors...... or stenotic lesions from Crohn's disease were prospectively examined with ultrasonography using a Hitachi HV 900 US scanner with real-time elastography (RTE). Three different methods were applied to assess tissue strain: A four-level categorical visual classification, a continuous visual analog scale (VAS, 0...... - 100) and a strain ratio (SR) measurement between the lesion and surrounding reference tissue. The imaged sections were marked and subsequently examined by a pathologist. Results from RTE were evaluated according to diagnosis, degree of fibrosis, inflammatory parameters, tumor stage and grade...

  9. Measuring surgical outcomes in cervical spondylotic myelopathy patients undergoing anterior cervical discectomy and fusion: assessment of minimum clinically important difference.

    Directory of Open Access Journals (Sweden)

    Brenda M Auffinger

    Full Text Available OBJECT: The concept of minimum clinically important difference (MCID has been used to measure the threshold by which the effect of a specific treatment can be considered clinically meaningful. MCID has previously been studied in surgical patients, however few studies have assessed its role in spinal surgery. The goal of this study was to assess the role of MCID in patients undergoing anterior cervical discectomy and fusion (ACDF for cervical spondylotic myelopathy (CSM. METHODS: Data was collected on 30 patients who underwent ACDF for CSM between 2007 and 2012. Preoperative and 1-year postoperative Neck Disability Index (NDI, Visual-Analog Scale (VAS, and Short Form-36 (SF-36 Physical (PCS and Mental (MCS Component Summary PRO scores were collected. Five distribution- and anchor-based approaches were used to calculate MCID threshold values average change, change difference, receiver operating characteristic curve (ROC, minimum detectable change (MDC and standard error of measurement (SEM. The Health Transition Item of the SF-36 (HTI was used as an external anchor. RESULTS: Patients had a significant improvement in all mean physical PRO scores postoperatively (p<0.01 NDI (29.24 to 14.82, VAS (5.06 to 1.72, and PCS (36.98 to 44.22. The five MCID approaches yielded a range of values for each PRO: 2.00-8.78 for PCS, 2.06-5.73 for MCS, 4.83-13.39 for NDI, and 0.36-3.11 for VAS. PCS was the most representative PRO measure, presenting the greatest area under the ROC curve (0.94. MDC values were not affected by the choice of anchor and their threshold of improvement was statistically greater than the chance of error from unimproved patients. CONCLUSION: SF-36 PCS was the most representative PRO measure. MDC appears to be the most appropriate MCID method. When MDC was applied together with HTI anchor, the MCID thresholds were: 13.39 for NDI, 3.11 for VAS, 5.56 for PCS and 5.73 for MCS.

  10. Evaluation of stretching position by measurement of strain on the ilio-femoral ligaments: an in vitro simulation using trans-lumbar cadaver specimens.

    Science.gov (United States)

    Hidaka, Egi; Aoki, Mitsuhiro; Muraki, Takayuki; Izumi, Tomoki; Fujii, Misaki; Miyamoto, Shigenori

    2009-08-01

    The ilio-femoral ligament is known to cause flexion contracture of the hip joint. Stretching positioning is intended to elongate the ilio-femoral ligaments, however, no quantitative analysis to measure the effect of stretching positions on the ligament has yet been performed. Strains on the superior and inferior ilio-femoral ligaments in 8 fresh/frozen trans-lumbar cadaveric hip joints were measured using a displacement sensor, and the range of movement of the hip joints was recorded using a 3Space Magnetic Sensor. Reference length (L(0)) for each ligament was determined to measure strain on the ligaments. Hip positions at 10 degrees adduction with maximal external rotation, 20 degrees adduction with maximal external rotation, and maximal external rotation showed larger strain for the superior ilio-femoral ligament than the value obtained from L(0), and hip positions at 20 degrees external rotation with maximal extension and maximal extension had larger strain for the inferior ilio-femoral ligament than the value obtained from L(0) (pligaments exhibited positive strain values with specific stretching positions. Selective stretching for the ilio-femoral ligaments may contribute to achieve lengthening of the ligaments to treat flexion contracture of the hip joint.

  11. Strain Measurements within Fibreboard. Part III: Analyzing the Process Zone at the Crack Tip of Medium Density Fiberboards (MDF) Double Cantilever I-Beam Specimens

    Science.gov (United States)

    Rathke, Jörn; Müller, Ulrich; Konnerth, Johannes; Sinn, Gerhard

    2012-01-01

    This paper is the third part of a study dealing with the mechanical and fracture mechanical characterization of Medium Density Fiberboards (MDF). In the first part, an analysis of internal bond strength testing was performed and in the second part MDF was analyzed by means of the wedge splitting experiment; this part deals with the double cantilever I beam test, which is designed for measuring the fracture energy as well as stress intensity factor in Mode I. For a comparison of isotropic and orthotropic material behavior, finite element modeling was performed. In addition to the calculation of fracture energy the stress intensity factor was analyzed by means of finite elements simulation and calculation. In order to analyze strain deformations and the process zone, electronic speckle pattern interferometry measurements were performed. The results revealed an elongated process zone and lower results for KIC if compared to the wedge splitting experiment. The Gf numbers are higher compared to the wedge splitting results and can be explained by the thicker process zone formed during the crack propagation. The process zone width on its part is influenced by the stiff reinforcements and yields a similar crack surface as with the internal bond test.

  12. Strain Measurements within Fibreboard. Part III: Analyzing the Process Zone at the Crack Tip of Medium Density Fiberboards (MDF Double Cantilever I-Beam Specimens

    Directory of Open Access Journals (Sweden)

    Gerhard Sinn

    2012-11-01

    Full Text Available This paper is the third part of a study dealing with the mechanical and fracture mechanical characterization of Medium Density Fiberboards (MDF. In the first part, an analysis of internal bond strength testing was performed and in the second part MDF was analyzed by means of the wedge splitting experiment; this part deals with the double cantilever I beam test, which is designed for measuring the fracture energy as well as stress intensity factor in Mode I. For a comparison of isotropic and orthotropic material behavior, finite element modeling was performed. In addition to the calculation of fracture energy the stress intensity factor was analyzed by means of finite elements simulation and calculation. In order to analyze strain deformations and the process zone, electronic speckle pattern interferometry measurements were performed. The results revealed an elongated process zone and lower results for KIC if compared to the wedge splitting experiment. The Gf numbers are higher compared to the wedge splitting results and can be explained by the thicker process zone formed during the crack propagation. The process zone width on its part is influenced by the stiff reinforcements and yields a similar crack surface as with the internal bond test.

  13. Instrumented impact testing machine with reduced specimen oscillation effects

    Science.gov (United States)

    Rintamaa, R.; Ranka, K.; Wallin, K.; Ikonen, K.; Talja, H.; Kotilainen, H.; Sirkkola, E.

    1984-07-01

    A pendulum-type instrumented Charpy test apparatus based on inverted test geometry was developed. Geometry inversion reduces inertia load and specimen oscillation effects. Initial impact energy is double that of standard (300 J) impact testers, allowing the use of larger (10 x 20 x 110 mm) bend specimens than normal Charpy specimens. The rotation axis in the three point bending is nearly stationary, making COD-measurements possible. Inertia effects and specimen oscillations are compared with the conventional tester, and using an analytical finite element model for Charpy V-notch specimens. Better performance for the inverted geometry is reported.

  14. Measurement of Total and Free Urinary Phenol and Paraben Concentrations over the Course of Pregnancy: Assessing Reliability and Contamination of Specimens in the Norwegian Mother and Child Cohort Study

    Science.gov (United States)

    Longnecker, Matthew P.; Aase, Heidi; Eggesbø, Merete; Zeiner, Pål; Reichborn-Kjennerud, Ted; Knudsen, Gun P.; Bertelsen, Randi J.; Ye, Xiaoyun; Calafat, Antonia M.; Engel, Stephanie M.

    2015-01-01

    Background Exposures to environmental phenols and parabens may be harmful, especially in utero. Prior studies have demonstrated high within-person variability of urinary concentrations across pregnancy. Objectives We sought to measure phenol and paraben biomarker concentrations for the Norwegian Mother and Child Cohort (MoBa) study, assess within-person variability, and investigate any possible external phenol or paraben contamination of specimens. Methods We collected three spot urine samples at approximately 17, 23, and 29 weeks gestation in a hospital setting and added a preservative containing ethyl paraben. We measured urinary concentrations and within-person variability for phenols and parabens in a MoBa sample (n = 45), including a subgroup of 15 participants previously randomly selected for a bisphenol A (BPA) exposure study who had unusually high total BPA concentrations. Additionally, we compared reliability results for total, conjugated, and free concentrations of phenolic compounds. Results We detected total and free BPA, butyl paraben, propyl paraben, and methyl paraben in 100% of samples, total benzophenone-3 in 95% of samples, and infrequently detected free benzophenone-3 and total and free 2,4-dichlorophenol and 2,5-dichlorophenol. Intraclass correlation coefficients (ICCs) for total, conjugated, and free concentrations ranged from relatively low for BPA to moderate for propyl paraben. ICCs were generally similar overall and by subgroup. Conclusions Using conjugated concentrations improved reliability estimates only for BPA. Measuring total and free concentrations, an approach that may be useful for future studies, allowed us to identify likely BPA and butyl paraben contamination of archived MoBa urine specimens. Citation Guidry VT, Longnecker MP, Aase H, Eggesbø M, Zeiner P, Reichborn-Kjennerud T, Knudsen GP, Bertelsen RJ, Ye X, Calafat AM, Engel SM. 2015. Measurement of total and free urinary phenol and paraben concentrations over the course of

  15. Prospective comparison of (18)F-NaF PET/CT versus (18)F-FDG PET/CT imaging in mandibular extension of head and neck squamous cell carcinoma with dedicated analysis software and validation with surgical specimen. A preliminary study.

    Science.gov (United States)

    Lopez, Raphael; Gantet, Pierre; Salabert, Anne Sophie; Julian, Anne; Hitzel, Anne; Herbault-Barres, Beatrice; Fontan, Charlotte; Alshehri, Sarah; Payoux, Pierre

    2017-09-01

    The aim of this study is to propose a new method to quantify radioactivity with PET/CT imaging in mandibular extension in head and neck squamous cell carcinoma (HNSCC), using innovative software, and to compare results with microscopic surgical specimens. This prospective study enrolled 15 patients who underwent (18)F-NaF and (18)F-FDG PET/CT. We compared the delineations of bone invasions obtained with (18)F-NaF PET/CT and (18)F-FDG PET/CT with the results of histopathological analysis of mandibular resections (from right and left bone borders). A method for visualization and quantification of PET images was developed. For all patients, a significant difference (p = 0.032 for right limits and p = 0.011 for left limits) was observed between (18)F-FDG PET/CT imaging and histopathology results, and no significant difference (p = 0.88 for right limits and p = 0.55 for left limits) was observed between (18)F-NaF PET/CT imaging and histopathology results. The right limits were less than 10 mm in 93% of patients, and the left limits were less than 10 mm in 86% of patients. The dedicated software enabled the objective delineation of radioactivity within the bone. We can confirm that (18)F-NaF is a precise and specific bone marker for the assessment of intraosseous mandibular extensions of head and neck cancers. Therapeutic, III. Copyright © 2017 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  16. New WHO recommendations on preoperative measures for surgical site infection prevention : an evidence-based global perspective

    NARCIS (Netherlands)

    Allegranzi, Benedetta; Bischoff, Peter; de Jonge, Stijn; Kubilay, N Zeynep; Zayed, Bassim; Gomes, Stacey M; Abbas, Mohamed; Atema, Jasper J; Gans, Sarah; van Rijen, Miranda; Boermeester, Marja A; Egger, Matthias; Kluytmans, Jan; Pittet, Didier; Solomkin, Joseph S

    2016-01-01

    Surgical site infections (SSIs) are among the most preventable health-care-associated infections and are a substantial burden to health-care systems and service payers worldwide in terms of patient morbidity, mortality, and additional costs. SSI prevention is complex and requires the integration of

  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. Strain Measurement Technology for Corrosion Fatigue Specimen

    Institute of Scientific and Technical Information of China (English)

    ZHONG; Wei-hua; NING; Guang-sheng; ZHANG; Chang-yi; TONG; Zhen-feng; YANG; Wen

    2015-01-01

    Main pipeline is the key component of nuclear power plants(NPPs).Under the first loop water and low-cyclic load condition,the main pipeline may be induced to corrosion fatigue failure.Thus,it’s necessary to test and get the corrosion fatigue property of main pipeline material.During the corrosion fatigue test,the strain

  19. Pathology handling of pancreatoduodenectomy specimens: Approaches and controversies

    Institute of Scientific and Technical Information of China (English)

    María; del; Carmen; Gómez-Mateo; Luis; Sabater-Ortí; Antonio; Ferrández-Izquierdo

    2014-01-01

    Pancreatic cancer, with a 5% 5-year survival rate, is the fourth leading cause of cancer death in Western countries. Unfortunately, only 20% of all patients benefit from surgical treatment. The need to prolong survival has prompted pathologists to develop improved protocols to evaluate pancreatic specimens and their surgical margins. Hopefully, the new protocols will provide clinicians with more powerful prognostic indicators and accurate information to guide their therapeutic decisions. Despite the availability of several guidelines for the handling and pathology reporting of duodenopancreatectomy specimens and their continual updating by expert pathologists, there is no consensus on basic issues such as surgical margins or the definition of incomplete excision(R1) of pancreatic ductal adenocarcinoma. This article reviews the problems and controversies that dealing with duodenopancreatectomy specimens pose to pathologists, the various terms used to define resection margins or infiltration, and reports. After reviewing the literature, including previous guidelines and based on our own experience, we present our protocol for the pathology handling of duodenopancreatectomy specimens.

  20. Changes in surgical team performance and safety climate attitudes following expansion of perioperative services: a repeated-measures study.

    Science.gov (United States)

    Gillespie, Brigid M; Harbeck, Emma; Kang, Evelyn; Steel, Catherine; Fairweather, Nicole; Chaboyer, Wendy

    2017-08-10

    Objective The aim of the present study was to describe process changes in surgical team performance and team members' attitudes to safety culture following hospital relocation and expansion of perioperative services.Methods The study was a naturalistic study using structured observations and surveys to assess non-technical skills (NTS; i.e. communication, teamwork, situational awareness, decision making and leadership) in surgery. This interrupted time series design used mixed-linear regression models to examine the effect of phase (before and after hospital relocation) on surgical teams' NTS and their processes that may affect performance. Differences in self-reported teamwork and safety climate attitudes were also examined.Results In all, 186 procedures (100 before and 81 after hospital relocation) were observed across teams working in general, paediatric, orthopaedic and thoracic surgeries. Interobserver agreement ranged from 86% to 95%. An effect of phase was found, indicating that there were significant improvements after relocation in the use of NTS by the teams observed (P=0.020; 95% confidence interval 1.9-4.7).Conclusions The improvements seen in surgical teams' NTS performance and safety culture attitudes may be related to the move to a new state-of-the-art perioperative department.What is known about the topic? Patient safety in surgery relies on optimal team performance, underpinned by effective NTS.What does this paper add? The NTS of surgical teams may be improved through ergonomic innovations that promote teams' shared mental models.What are the implications for practitioners? Effective multidisciplinary teamwork relies on a combination of NTS and ergonomic factors, which inherently contribute to team performance and safety climate attitudes.

  1. 2003 Dead Bald Eagle Specimen

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — The specimen report states the Bald Eagle was found along the side of the I-95 by a motorist who contacted Santee National Wildlife Refuge. The Bald Eagle was taken...

  2. Manufacturing of Plutonium Tensile Specimens

    Energy Technology Data Exchange (ETDEWEB)

    Knapp, Cameron M [Los Alamos National Laboratory

    2012-08-01

    Details workflow conducted to manufacture high density alpha Plutonium tensile specimens to support Los Alamos National Laboratory's science campaigns. Introduces topics including the metallurgical challenge of Plutonium and the use of high performance super-computing to drive design. Addresses the utilization of Abaqus finite element analysis, programmable computer numerical controlled (CNC) machining, as well as glove box ergonomics and safety in order to design a process that will yield high quality Plutonium tensile specimens.

  3. 手术烟雾危害及防护措施研究进展%Research Progress on Harm and Protection Measures of Surgical Smoke

    Institute of Scientific and Technical Information of China (English)

    孙静

    2016-01-01

    It introduced the generation mechanism,damage and composition of surgical smoke,and suggests some preventive measures on establish a good emission system,use of surgical electrical equipment, aspirator system and personal protection.%本文从手术烟雾的产生机制、烟雾的成分及危害三个方面进行阐述。从手术室建立良好的排放系统、正确使用手术电设备、吸引系统、个人防护等方面提出对手术烟雾的防护措施。

  4. Identification of bacterial invasion in necrotizing enterocolitis specimens using fluorescent in situ hybridization

    NARCIS (Netherlands)

    Heida, F H; Harmsen, H J M; Timmer, A; Kooi, E M W; Bos, A F; Hulscher, J B F

    2016-01-01

    OBJECTIVE: Investigation of bacterial invasion into the intestinal wall in necrotizing enterocolitis (NEC) specimens. STUDY DESIGN: We compared 43 surgical NEC specimens with 43 age-matched controls. We used fluorescent in situ hybridization (FISH), a universal bacterial probe together with species-

  5. [International Society of Urological Pathology (ISUP) Consensus Conference on handling and staging of radical prostatectomy specimens].

    Science.gov (United States)

    Compérat, Eva; Camparo, Philippe; Srigley, John; Delahunt, Brett; Egevad, Lars

    2013-06-01

    The 2009 International Society of Urological Pathology (ISUP) consensus conference on handling and staging of radical prostatectomy specimens issued recommendations for standardization of pathology reporting of radical prostatectomy specimens. The conference addressed specimen handling, T2 substaging, prostate cancer volume, extraprostatic extension, lymphovascular invasion, seminal vesicle invasion, lymph node metastases and surgical margins. This review summarizes the conclusions and recommendations resulting from the consensus process. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  6. 73. Surgical site infection after CABG: Root cause analysis and quality measures recommendation SSI quality improvement project

    Directory of Open Access Journals (Sweden)

    A. Arifi

    2016-07-01

    Full Text Available Surgical site infection (SSI, is a preventable and devastating complication with significant morbidity after cardiac surgery. The reported SSI rate at our center, ranging from 3.4% to 11.2% (2007–2013. This rate is considered to be above the standardized rate recommended by the NHSN. Quality improvement project team to address the issue of SSI, (SCIP, where formed by the medical administration late 2014. The aim of the study was to identify SSI risk factors at our cardiac surgical unit, using evidence based practices while taking a local approach to problem solving. We performed Root Cause Analysis (RCA, and we applied other quality improvement tools to identify the area for potential improvement. Data include a Process Map of the pre-operative, intra-operative and post-operative factors that might contribute to SSI risk. We prospectively used the RCA form to investigate all the stages of the patient process map (pre, intra op, and post operatively. The data included the Patient related factors, the sterilization and the hygiene practice in the operating room, and the operating room traffic, and the compliance to the bundle of care. Figure represent the “Fishbone” diagram of the possible causes of SSI after cardiac surgery in our unit. Demographic features of patients with SSI were as follows: mean age-65 years; female 83%; time to infection (mean 101 days; range 1–36 days;. The root cause analysis identified a significant weakness in the compliance to the bundle of care to prevent SSI. Furthermore, the patient flow, the operating theatre cleaning and traffic was also identified as a contributing factor to SSI. Surgical site infection after cardiac surgery is a preventable complication. The application of the evidence based practice and structured way of thinking in problem solving, will help identify the potential risk factors. Focusing on solving the right patient process and visually represents the problem will help identifying the

  7. 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....

  8. A Technique of Deformed Specimen Grating Replication for In-Situ Measurement of Moiré Interferometry%云纹干涉法现场测量中的变形试件栅复制技术

    Institute of Scientific and Technical Information of China (English)

    邬柱; 戴福隆

    2002-01-01

    An in-situ measurement method of moiré interferometry is investigated in this paper. In the method, deformed specimen grating is replicated during an in-situ measurement.The replicated grating containing the load induced deformation. This deformation can be extracted easily by moiré interferometry. This practical method maintains all the advantages of moité interferometry but it make moiré interferometry extended to other application fields out of optical laboratories.%本文研究了云纹干涉法的现场测量技术.该方法在现场测量过程中复制变形的试件栅.试件栅上保留了载荷引起的变形信息,通过云纹干涉法可以得到这些变形信息.该方法不但具有云纹干涉法的所有优点,并且使云纹干涉法可以在光学实验室以外场合中应用.

  9. [The German Environmental Specimen Bank].

    Science.gov (United States)

    Schröter-Kermani, Christa; Gies, Andreas; Kolossa-Gehring, Marike

    2016-03-01

    The main objective of the German Environmental Specimen Bank (ESB) is the long-term storage of environmental and human samples under stable deep-freeze conditions for future research. The ESB is unique in providing a continuous historical record of environmental and human exposure to chemicals in Germany. ESB was started parallel to the development of the first German Chemicals Legislation in the late 1970s. In 1979, the ESB test operation began. After the Chemicals Law came into force in 1982, the ESB was established as a permanent facility in 1985. With the new European Chemicals Legislation, REACH, in 2007 responsibility for the safety of commercial chemicals and risk assessment was assigned to the industry. Since then, the ESB has become even more important in verifying the self-assessment of the industry, in evaluating the effectiveness of regulations, thus ensuring the protection of humans and the environment against adverse effects caused by exposure to chemicals. These objectives are pursued by the regular monitoring of contaminations and the assessment of temporal trends. Demonstrating the necessity of deriving exposure reduction measures, ESB results serve as key information for policy-makers. Information on preventing exposure to chemicals is available to the general public and to the public health services. The ESB is thus an important monitoring instrument of the Federal Ministry for the Environment, Nature Conservation, Building and Nuclear Safety. The Federal Environment Agency operates the ESB based on its own concepts, heads the scientific data evaluation and transfers results into the environmental policy arena and to the general public.

  10. Measuring the quality of melanoma surgery - Highlighting issues with standardization and quality assurance of care in surgical oncology.

    Science.gov (United States)

    Pasquali, S; Sommariva, A; Spillane, A J; Bilimoria, K Y; Rossi, C R

    2017-03-01

    In an attempt to ensure high standards of cancer care, there is increasing interest in determining and monitoring the quality of interventions in surgical oncology. In recent years, this has been particularly the case for melanoma surgery. The vast majority of patients with melanoma undergo surgery. Usually, this is with combinations of wide excision, sentinel lymph node biopsy and lymphadenectomy. The indications for these procedures evolved during a time when no effective systemic adjuvant therapy was available, and whilst the rationale has been sound, the justification for differences in extent and thoroughness has generally been supported by inadequate or low-level evidence. This has led to a substantial variation among melanoma centres or even among surgeons within a centre in how these procedures are done. With recent rapid progress in the efficacy of systemic treatments that are impacting on overall survival, the prospect of long-term survival in these previously high risk patients means that more than ever long-term locoregional control of melanoma is imperative. Furthermore, the understanding of effects of systemic therapy on locoregional disease will only be interpretable if surgeons use standardized, high quality techniques. This article focuses on standardization and evolution of quality indicators for melanoma surgery and how these might have a positive impact on patient care. Copyright © 2016 Elsevier Ltd, BASO ~ the Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.

  11. Rehydration of forensically important larval Diptera specimens.

    Science.gov (United States)

    Sanford, Michelle R; Pechal, Jennifer L; Tomberlin, Jeffery K

    2011-01-01

    Established procedures for collecting and preserving evidence are essential for all forensic disciplines to be accepted in court and by the forensic community at large. Entomological evidence, such as Diptera larvae, are primarily preserved in ethanol, which can evaporate over time, resulting in the dehydration of specimens. In this study, methods used for rehydrating specimens were compared. The changes in larval specimens with respect to larval length and weight for three forensically important blow fly (Diptera: Calliphoridae) species in North America were quantified. Phormia regina (Meigen), Cochliomyia macellaria (F.), and Chrysomya rufifacies (Macquart) third-instar larvae were collected from various decomposing animals and preserved with three preservation methods (80% ethanol, 70% isopropyl alcohol, and hot-water kill then 80% ethanol). Preservative solutions were allowed to evaporate. Rehydration was attempted with either of the following: 80% ethanol, commercial trisodium phosphate substitute solution, or 0.5% trisodium phosphate solution. All three methods partially restored weight and length of specimens recorded before preservation. Analysis of variance results indicated that effects of preservation, rehydration treatment, and collection animal were different in each species. The interaction between preservative method and rehydration treatment had a significant effect on both P. regina and C. macellaria larval length and weight. In addition, there was a significant interaction effect of collection animal on larval C. macellaria measurements. No significant effect was observed in C. rufifacies larval length or weight among the preservatives or treatments. These methods could be used to establish a standard operating procedure for dealing with dehydrated larval specimens in forensic investigations.

  12. Validation of an algorithm for planar surgical resection reconstruction

    Science.gov (United States)

    Milano, Federico E.; Ritacco, Lucas E.; Farfalli, Germán L.; Aponte-Tinao, Luis A.; González Bernaldo de Quirós, Fernán; Risk, Marcelo

    2012-02-01

    Surgical planning followed by computer-assisted intraoperative navigation in orthopaedics oncology for tumor resection have given acceptable results in the last few years. However, the accuracy of preoperative planning and navigation is not clear yet. The aim of this study is to validate a method capable of reconstructing the nearly planar surface generated by the cutting saw in the surgical specimen taken off the patient during the resection procedure. This method estimates an angular and offset deviation that serves as a clinically useful resection accuracy measure. The validation process targets the degree to which the automatic estimation is true, taking as a validation criterium the accuracy of the estimation algorithm. For this purpose a manually estimated gold standard (a bronze standard) data set is built by an expert surgeon. The results show that the manual and the automatic methods consistently provide similar measures.

  13. Can the Misinterpretation Amendment Rate Be Used as a Measure of Interpretive Error in Anatomic Pathology?: Implications of a Survey of the Directors of Anatomic and Surgical Pathology.

    Science.gov (United States)

    Parkash, Vinita; Fadare, Oluwole; Dewar, Rajan; Nakhleh, Raouf; Cooper, Kumarasen

    2017-03-01

    A repeat survey of the Association of the Directors of Anatomic and Surgical Pathology, done 10 years after the original was used to assess trends and variability in classifying scenarios as errors, and the preferred post signout report modification for correcting error by the membership of the Association of the Directors of Anatomic and Surgical Pathology. The results were analyzed to inform on whether interpretive amendment rates might act as surrogate measures of interpretive error in pathology. An analyses of the responses indicated that primary level misinterpretations (benign to malignant and vice versa) were universally qualified as error; secondary-level misinterpretations or misclassifications were inconsistently labeled error. There was added variability in the preferred post signout report modification used to correct report alterations. The classification of a scenario as error appeared to correlate with severity of potential harm of the missed call, the perceived subjectivity of the diagnosis, and ambiguity of reporting terminology. Substantial differences in policies for error detection and optimal reporting format were documented between departments. In conclusion, the inconsistency in labeling scenarios as error, disagreement about the optimal post signout report modification for the correction of the error, and variability in error detection policies preclude the use of the misinterpretation amendment rate as a surrogate measure for error in anatomic pathology. There is little change in uniformity of definition, attitudes and perception of interpretive error in anatomic pathology in the last 10 years.

  14. Echosonography and surgical therapy of facial skin tumors

    Directory of Open Access Journals (Sweden)

    Pešić Zoran U.

    2002-01-01

    Full Text Available In the second half of the 20 century, echosonography has been used in many medical specialties. In 1992 and 1993 highfrequencies echosonography was used in the examination of irritant and allergic skin lesions in order to examine the effects of different therapeuthical agents on the skin lesions [1-4]. Hoffmann used highfrequencies echosonography in the examination of healing of skin lesions [3]. By their incidence skin tumors are the largest group of newly discovered tumors, and their usual location is on the face [5-7]. By clinical examination it is not possible to precisely determine the depth of tumor border; therefore, the radically performed surgical excision is the only correct surgical treatment. The aim of this study was to estimate the results of preoperatively performed high frequencies echosonography in order to reduce the number of incorrectly performed surgical excisions of skin tumors. The group was composed of 40 patients with 45 tumors, who first underwent echosonographic diagnostic procedure (20 MHz, Hadsund electronic, Hadsund Technology, Denmark and then surgical excision; patients in control group (45 patients with 45 tumors were only subjected to surgical excision. Excised tumors were then pathohistologically analyzed, and measurements of tumor depth progression were performed. Margins of pathohistological specimen were controlled for the presence of tumor cells. Results of measurements of tumor depth obtained by echosonography and pathohistological measurements were compared. By Jate's modification of c2 test results regarding correct and incorrect surgical excision in patients and control group were compared. By linear regression analysis results of tumor depth obtained by echosonographic and pathohistologic examinations were compared. Hypoechogen zone echosonographic results were used like criteria for tumor expansion. Results of tumor depth measurements are presented in Table 1. Linear regression analysis showed (R = 0

  15. Specimen Collection and Submission Manual

    Science.gov (United States)

    2016-06-01

    a validated test algorithm . If there is insufficient specimen volume for testing, there may be delays, and the request may be referred to management...Additional guidance on packing and shipping infectious substances can be found through American Society for Microbiology: http://www.asm.org...images/pdf/Clinical/ pack -ship-7-15-2011.pdf TR-16-161 DISTRIBUTION STATEMENT A: Approved for public release; distribution is unlimited. UNCLASSIFIED

  16. Fungal contaminants in cytopathology specimens

    Directory of Open Access Journals (Sweden)

    Prashant Sharma

    2014-02-01

    Full Text Available A pseudo-epidemic of environmental fungi, most likely by Fusarium spp., leading to inappropriate investigations for disseminated systemic mycosis is described. Subtle diagnostic clues, including the specimens affected, the nature of the host response, and the type of fungal elements noted helped to determine the nature of contaminants. The potential pitfall can be avoided by the knowledge of pertinent disease biology, prompt consultation for infectious diseases, and investigations of the potential environmental sources followed by source control.

  17. Endoluminal surgical triangulation 2.0: A new flexible surgical robot. Preliminary pre-clinical results with colonic submucosal dissection.

    Science.gov (United States)

    Légner, András; Diana, Michele; Halvax, Péter; Liu, Yu-Yin; Zorn, Lucile; Zanne, Philippe; Nageotte, Florent; De Mathelin, Michel; Dallemagne, Bernard; Marescaux, Jacques

    2017-05-03

    Complex intraluminal surgical interventions of the gastrointestinal tract are challenging due to the limitation of existing instruments. Our group has developed a master-slave robotic flexible endoscopic platform that provides instrument triangulation in an endoluminal environment. Colonic endoscopic submucosal dissections (ESD) were carried out in eight pigs. The robot was introduced transanally. A combination of adapted tele-operated instruments was used. Specimens were inspected and measured. Out of 18 ESDs in total, 12 were successfully completed. Among the completed procedures, two perforations and one system failure occurred and were managed intraoperatively. There was no major bleeding. Mean size of the removed specimens was 18.2 ± 9.8 cm(2) and mean total procedure time was 73 ± 35.5 min. Experimental colorectal ESDs using the flexible surgical robot were feasible and reflected a short learning curve. After some technical improvements the system might allow for a wider adoption of complex endoluminal surgical procedures. Copyright © 2017 John Wiley & Sons, Ltd.

  18. Innovations in macroscopic evaluation of pancreatic specimens and radiologic correlation

    Directory of Open Access Journals (Sweden)

    Charikleia Triantopoulou

    2016-01-01

    Full Text Available The purpose of this study was to evaluate the feasibility of a novel dissection technique of surgical specimens in different cases of pancreatic tumors and provide a radiologic pathologic correlation. In our hospital, that is a referral center for pancreatic diseases, the macroscopic evaluation of the pancreatectomy specimens is performed by the pathologists using the axial slicing technique (instead of the traditional procedure with longitudinal opening of the main pancreatic and/or common bile duct and slicing along the plane defined by both ducts. The specimen is sliced in an axial plane that is perpendicular to the longitudinal axis of the descending duodenum. The procedure results in a large number of thin slices (3–4 mm. This plane is identical to that of CT or MRI and correlation between pathology and imaging is straightforward. We studied 70 cases of suspected different solid and cystic pancreatic tumors and we correlated the tumor size and location, the structure—consistency (areas of necrosis—hemorrhage—fibrosis—inflammation, the degree of vessels’ infiltration, the size of pancreatic and common bile duct and the distance from resection margins. Missed findings by imaging or pitfalls were recorded and we tried to explain all discrepancies between radiology evaluation and the histopathological findings. Radiologic-pathologic correlation is extremely important, adding crucial information on imaging limitations and enabling quality assessment of surgical specimens. The deep knowledge of different pancreatic tumors’ consistency and way of extension helps to improve radiologists’ diagnostic accuracy and minimize the radiological-surgical mismatching, preventing patients from unnecessary surgery.

  19. 论外科新上岗护士职业压力及应对措施%On occupational stresses of surgical new nurses and coping measures

    Institute of Scientific and Technical Information of China (English)

    徐文; 聂平

    2015-01-01

    本文分析了外科新上岗护士职业压力产生的原因,并从加强岗位培训、提高护理操作技能、定期予以心理辅导、加强法律法规知识培训等方面提出了缓解职业压力的措施,以保障外科新上岗护士的心身健康,确保医疗安全和护理质量。%In this paper the causes of occupational stresses of surgical new nurses are analyzed and measures relieving occupational stresses raised from the strengthen of on‐the‐job training , improvement of nursing manipulation skill , regular psychological counseling and the strengthen of laws and regulations knowledge training and so on in order to ensure psychosomatic health of surgical new employed nurses , medical safety and nursing quality .

  20. Effect of specimen geometry on tensile strength of cortical bone.

    Science.gov (United States)

    Feng, Liang; Jasiuk, Iwona

    2010-11-01

    We investigate the effect of specimen geometry on the ultimate tensile strength of cortical bone measured by a tensile test. This article is motivated by the fact that there is no clear consensus in the literature on a suitable specimen shape for cortical bone testing. We consider three commonly used tensile test specimen shapes: strip, dumbbell with sharp junctions, and dumbbell with rounded junctions. We conduct this study computationally, using a finite element method, and experimentally by testing porcine femurs. Our results show that local stress concentration factors in the specimen lead to reduced values in the measured tensile strength. The higher the stress concentrations are, the lower is the measured strength. We find that the strip specimens are not a good choice due to high stress concentrations. For the same reason, dumbbell specimens with sharp junctions between the grip and gage sections should also be avoided. The dumbbell shaped tensile test specimens with an arc transition and a maximized radius of fillet are a better choice because such geometry lowers stress concentrations.

  1. 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.

  2. Friction Compensation in the Upsetting of Cylindrical Test Specimens

    DEFF Research Database (Denmark)

    Christiansen, Peter; Martins, P. A. F.; Bay, Niels Oluf

    2016-01-01

    This manuscript presents a combined numerical andexperimental methodology for determining the stress-straincurve of metallic materials from the measurements of forceand displacement obtained in the axial compression of cylindrical test specimens with friction between the specimens and the platens...... model or combined friction models are utilized .Experimental results obtained from cylindrical and Rastegaev test specimens with different lubricants combined with the experimental determination of friction by means of ring compression tests allows compensating the effect of friction...... Appendix is provided for those readers interested in utilizing the associated numerical algorithm for determining the stress straincurves of metallic materials....

  3. Hydraulically Driven Grips For Hot Tensile Specimens

    Science.gov (United States)

    Bird, R. Keith; Johnson, George W.

    1994-01-01

    Pair of grips for tensile and compressive test specimens operate at temperatures up to 1,500 degrees F. Grips include wedges holding specimen inside furnace, where heated to uniform temperature. Hydraulic pistons drive wedges, causing them to exert clamping force. Hydraulic pistons and hydraulic fluid remain outside furnace, at room temperature. Cooling water flows through parts of grips to reduce heat transferred to external components. Advantages over older devices for gripping specimens in high-temperature tests; no need to drill holes in specimens, maintains constant gripping force on specimens, and heated to same temperature as that of specimen without risk of heating hydraulic fluid and acuator components.

  4. Routine pathology evaluation of hydrocele and spermatocele specimens is associated with significant costs and no identifiable benefit.

    Science.gov (United States)

    Shah, Viral S; Nepple, Kenneth G; Lee, Daniel K

    2014-10-01

    Hydrocelectomy and spermatocelectomy are routine scrotal surgeries. A significant number of the surgical specimens are sent for pathology analysis. However, to our knowledge no study has been done to examine outcomes and necessity, which results in significant potentially unnecessary costs to the patient and the health care system. We evaluated outcomes and surgical pathology analysis of hydroceles and spermatoceles. We performed a retrospective, single institution chart review of all patients who underwent initial surgery for hydrocele or spermatocele between January 2000 and August 2013. We determined the number of cases in which a surgical specimen was sent for pathology examination. The cost for each specimen was estimated at the department of pathology. A total of 264 routine scrotal cases were performed during the 14-year period. Surgical specimens were sent for pathology analysis in 102 hydrocelectomy cases (51%) and in 57 spermatocelectomy cases (90%). No pathology specimen showed any indication of malignancy. The estimated direct total cost of pathology analysis was $49,449 in this cohort. No malignancy was detected in 159 hydrocele and spermatocele specimens during the 14 study years, suggesting that the pathology analysis is of little clinical benefit. Forgoing surgical pathology analysis of these specimens would result in significant cost savings to the patient and the health care system. Copyright © 2014 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  5. Histological assessment of cholecystectomy specimens performed for symptomatic cholelithiasis: routine or selective?

    Science.gov (United States)

    de Silva, WMM

    2013-01-01

    Traditionally, all cholecystectomy specimens resected for symptomatic cholelithiasis were sent for histological evaluation. The objectives of such evaluation are to confirm the clinicoradiological diagnosis, identification of unsuspected findings including incidental gallbladder malignancy, audit and research purposes, and quality control issues. Currently, there is a developing trend to consider selective histological evaluation of surgical specimens removed for clinically benign disease. This article discusses the need for routine or selective histopathological evaluation of gallbladder specimens following cholecystectomy. Although several retrospective studies have suggested selective histological evaluation of cholecystectomy specimens performed for symptomatic cholelithiasis, the evidence is not adequate at present to recommend selective histological evaluation globally. However, it may be appropriate to consider selective histological evaluation on a regional basis in areas of extremely low incidence of gallbladder cancer only after unanimous agreement between the governing bodies of surgical and histopathological expertise. PMID:23838492

  6. The characteristic of unqualified specimens in clinical microbiology laboratory and its solution measures%临床微生物培养不合格标本的特点及解决对策

    Institute of Scientific and Technical Information of China (English)

    尹秀云; 陈建魁; 曾利军; 于农; 宋世平; 左向华; 金欣; 王淼

    2012-01-01

    目的 分析临床微生物检验标本中不合格标本产生的原因及其解决措施,以便为临床提供更有价值的结果.方法 统计该院2011年住院患者送检的微生物培养不合格标本的数量分布,并分析其中的原因.结果 全年24 006份微生物培养标本中,不合格标本数为311 份,不合格率为1.3%.微生物室不合格标本的主要类型是痰液、尿液、大便等.不合格的原因,标本留取质量不合格(59.2%)、申请信息不全或错误(19.3%)、容器使用错误(6.1%)等.结论加强微生物检验分析前的质量控制,加强与临床的联系与及时沟通,针对不合格标本发生原因定期向临床医护人员进行宣传、培训,减少不合格标本的发生;使其认识到合格的标本是整个检验质量的保证.%Objective To analyze the causes of the unqualified specimens in clinical microbiological laboratory and its solution methods, so as to provide more valuable results for the physician. Methods The quantity and the distribution of unqualified microbiological specimens of hospitalized patients in 2011 were calculated and analyzed. Results The number of unqualified specimens was 311 among the 24 006 samples in the year of 2011 unqualified rate was 1. 3%. The main types of unqualified specimens were sputum,urine and stool. The main reasons were inferior quality(59. 2%) , incomplete application or incorrect information(19. 3%) and the wrong container(6. 1%). Conclusion The preanalytical quality control should be strengthened in the microbiological laboratory. Timely discussion and communication should be made between the clinical workers(including physicians and nurses) and the microbiological laboratory staff. Microbiological laboratory technicians should train clinical medical workers to reduce the incidence of unqualified specimens on a regular basis,make them aware that qualified specimens was the basis of correct microbiological identification and drug sensitive tests.

  7. Effect of specimen size on the fracture toughness of V-4Cr-4Ti

    Energy Technology Data Exchange (ETDEWEB)

    Kurtz, R.J.; Jones, R.H. [Pacific Northwest National Laboratory, Richland, WA (United States); Li, Huaxin

    1996-04-01

    J-R curves were generated using the single specimen unload-compliance technique on four specimens of V-4Cr-4Ti to determine the effect of specimen dimensions on the fracture behavior. Ductile crack initiation and growth was observed in the 6.35 mm thick specimens but not in the 12.70 mm thick specimens. The J-R curves determined from these tests were not valid per ASTM validity criteria so quantitative measures of the resistance to ductile crack initiation and growth were not obtained. These data suggests that standard fracture toughness tests were performed with small-scale DCT specimens may also not be valid.

  8. Risk-adjusted morbidity in teaching hospitals correlates with reported levels of communication and collaboration on surgical teams but not with scale measures of teamwork climate, safety climate, or working conditions.

    Science.gov (United States)

    Davenport, Daniel L; Henderson, William G; Mosca, Cecilia L; Khuri, Shukri F; Mentzer, Robert M

    2007-12-01

    Since the Institute of Medicine patient safety reports, a number of survey-based measures of organizational climate safety factors (OCSFs) have been developed. The goal of this study was to measure the impact of OCSFs on risk-adjusted surgical morbidity and mortality. Surveys were administered to staff on general/vascular surgery services during a year. Surveys included multiitem scales measuring OCSFs. Additionally, perceived levels of communication and collaboration with coworkers were assessed. The National Surgical Quality Improvement Program was used to assess risk-adjusted morbidity and mortality. Correlations between outcomes and OCSFs were calculated and between outcomes and communication/collaboration with attending and resident doctors, nurses, and other providers. Fifty-two sites participated in the survey: 44 Veterans Affairs and 8 academic medical centers. A total of 6,083 surveys were returned, for a response rate of 52%. The OCSF measures of teamwork climate, safety climate, working conditions, recognition of stress effects, job satisfaction, and burnout demonstrated internal validity but did not correlate with risk-adjusted outcomes. Reported levels of communication/collaboration with attending and resident doctors correlated with risk-adjusted morbidity. Survey-based teamwork, safety climate, and working conditions scales are not confirmed to measure organizational factors that influence risk-adjusted surgical outcomes. Reported communication/collaboration with attending and resident doctors on surgical services influenced patient morbidity. This suggests the importance of doctors' coordination and decision-making roles on surgical teams in providing high-quality and safe care. We propose risk-adjusted morbidity as an effective measure of surgical patient safety.

  9. Fine Needle Aspiration Cytology of Thyroid Nodules: Correlation with Surgical Histopathology Histopathology

    Directory of Open Access Journals (Sweden)

    Nargess Ghazaleh

    2008-01-01

    Full Text Available Objective: Approximately 7% of people have thyroid nodules. The most important consideration in evaluating patients with thyroid nodules is whether the nodule is malignant. Fine needle aspiration (FNA biopsy is the best, safest, and most cost-effective measure for distinguishing malignancy, thus preventing unnecessary surgeries. In this survey, adequacy of smears, cytologic findings, histologic findings, and their concordance, have been studied. Materials and Methods: FNA biopsy was performed in 200 patients with palpable thyroid nodules in 2004-2005. Cytologic findings and adequacy of specimens were recorded. Of the 200 patients, 39 had surgery; postoperative histological results were compared with FNA biopsy results.Results: Of FNA smears, 88% were adequate; of these adequate smears, 57.2% were benign, 34.2% were suspicious for malignancy, and 8.6% were reported as malignant. When results of surgical pathology were compared with FNA cytology results, all benign surgical specimens also had benign cytology results, and all malignant surgical specimens had malignant results on cytology evaluation. In nodules with suspicious cytology, histopathology showed that 50% were malignant and 50% were benign.Conclusions: FNA is a simple and cost-effective procedure for identifying benign and malignant nodules. The incidence of malignant pathology in nodules with suspicious cytology was higher than other studies.Turk Jem 2008; 12: 73-4

  10. Evaluation of the VE1 Antibody in Thyroid Cytology Using Papillary Thyroid Carcinoma Specimens

    Directory of Open Access Journals (Sweden)

    Yon Hee Kim

    2016-01-01

    Full Text Available Background: Recently, VE1, a monoclonal antibody against the BRAFV600E mutant protein, has been investigated in terms of its detection of the BRAFV600E mutation. Although VE1 immunostaining and molecular methods used to assess papillary thyroid carcinoma in surgical specimens are in good agreement, evaluation of VE1 in thyroid cytology samples is rarely performed, and its diagnostic value in cytology has not been well established. In present study, we explored VE1 immunoexpression in cytology samples from ex vivo papillary thyroid carcinoma specimens in order to minimize limitations of low cellularity and sampling/targeting errors originated from thyroid fineneedle aspiration and compared our results with those obtained using the corresponding papillary thyroid carcinoma tissues. Methods: The VE1 antibody was evaluated in 21 cases of thyroid cytology obtained directly from ex vivo thyroid specimens. VE1 immunostaining was performed using liquid-based cytology, and the results were compared with those obtained using the corresponding tissues. Results: Of 21 cases, 19 classic papillary thyroid carcinomas had BRAFV600E mutations, whereas two follicular variants expressed wild-type BRAF. VE1 immunoexpression varied according to specimen type. In detection of the BRAFV600E mutation, VE1 immunostaining of the surgical specimen exhibited 100% sensitivity and 100% specificity, whereas VE1 immunostaining of the cytology specimen exhibited only 94.7% sensitivity and 0% specificity. Conclusions: Our data suggest that VE1 immunostaining of a cytology specimen is less specific than that of a surgical specimen for detection of the BRAFV600E mutation, and that VE1 immunostaining of a cytology specimen should be further evaluated and optimized for clinical use.

  11. 2013年外科手消毒管理成效分析及干预措施%Surgical Hand Disinfection Management Performance Analysis and Intervention Measures In 2013

    Institute of Scientific and Technical Information of China (English)

    翁秀英; 朱虹; 钱吉康

    2015-01-01

    In order to further standardize and unify hospital surgical hand disinfection operation and supervision and management.From March 2013 to April 2013 surgical hand disinfection standard implementation present situation was investigated,the problems in the execution of formulate corresponding management measures were summarized and analysed,it showed that our surgical hand disinfection there was not standard.Hospital infection administration through takes surgical hand disinfection activities,and surgical hand disinfection of employee training work,to improve the quality of hospital surgical hand disinfection,ensure the patients’ medical security.%为了进一步规范、统一外科手消毒操作与监督管理,对2013年3-4月笔者所在医院外科手消毒规范执行现状进行调查,将执行过程中存在问题进行汇总、分析,制定相应管理对策,发现笔者所在医院外科手消毒存在一定不规范。医院感染管理科通过开展外科手消毒活动,外科手消毒的全员培训工作,提高手术科室外科手消毒的质量,保障了患者医疗安全。

  12. Final Report: Posttest Analysis of Omega II Optical Specimens

    Energy Technology Data Exchange (ETDEWEB)

    Newlander, C D; Fisher, J H

    2007-01-30

    Preliminary posttest analyses have been completed on optical specimens exposed during the Omega II test series conducted on 14 July 2006. The Omega Facility, located at the Laboratory for Laser Energetics (LLE) at the University of Rochester was used to produce X-ray environments through the interaction of intense pulsed laser radiation upon germanium-loaded silica aerogels. The optical specimen testing was supported by GH Systems through experiment design, pre- and post-test analyses, specimen acquisition, and overall technical experience. The test specimens were fabricated and characterized by Surface Optics Corporation (SOC), San Diego, CA and were simple protected gold coatings on silica substrates. Six test specimens were exposed, five filtered with thin beryllium foil filters, and one unfiltered which was exposed directly to the raw environment. The experimental objectives were: (1) demonstrate that tests of optical specimens could be performed at the Omega facility; (2) evaluate the use and survivability of beryllium foil filters as a function of thickness; (3) obtain damage data on optical specimens which ranged from no damage to damage; (4) correlate existing thermal response models with the damage data; (5) evaluate the use of the direct raw environment upon the specimen response and the ability/desirability to conduct sensitive optical specimen tests using the raw environment; and (6) initiate the development of a protocol for performing optical coatings/mirror tests. This report documents the activities performed by GH Systems in evaluating and using the environments provided by LLNL, the PUFFTFT analyses performed using those environments, and the calculated results compared to the observed and measured posttest data.

  13. Assessment of pose repeatability and specimen repositioning of a robotic joint testing platform.

    Science.gov (United States)

    El Daou, H; Lord, B; Amis, A; Rodriguez Y Baena, F

    2017-09-01

    This paper describes the quantitative assessment of a robotic testing platform, consisting of an industrial robot and a universal force-moment sensor, via the design of fixtures used to hold the tibia and femur of cadaveric knees. This platform was used to study the contributions of different soft tissues and the ability of implants and reconstruction surgeries to restore normal joint functions, in previously published literature. To compare different conditions of human joints, it is essential to reposition specimens with high precision after they have been removed for a surgical procedure. Methods and experiments carried out to determine the pose repeatability and measure errors in repositioning specimens are presented. This was achieved using an optical tracking system (fusion Track 500, Atracsys Switzerland) to measure the position and orientation of bespoke rigid body markers attached to the tibial and femoral pots after removing and reinstalling them inside the rigs. The pose repeatability was then evaluated by controlling the robotic platform to move a knee joint repeatedly to/from a given pose while tracking the position and orientation of a rigid body marker attached to the tibial fixture. The results showed that the proposed design ensured a high repeatability in repositioning the pots with standard deviations for the computed distance and angle between the pots at both ends of the joint equal to 0.1mm, 0.01mm, 0.13° and 0.03° for the tibial and femoral fixtures respectively. Therefore, it is possible to remove and re-setup a joint with high precision. The results also showed that the errors in repositioning the robotic platform (that is: specimen path repeatability) were 0.11mm and 0.12°, respectively. Copyright © 2017. Published by Elsevier Ltd.

  14. Negative histology with surgically treated tubal ectopic pregnancies - A retrospective cohort study.

    Science.gov (United States)

    Farahani, Linda; Sinha, Anjita; Lloyd, Jilly; Islam, Melissa; Ross, Jackie A

    2017-06-01

    To determine the outcome of histological examinations of surgical specimens obtained from treatment of tubal ectopic pregnancy and to correlate with clinical findings, pre-operative ultrasound scans and the type of surgery. A retrospective cohort study of 941 women diagnosed with a tubal ectopic pregnancy in the Early Pregnancy Unit and having surgical treatment at King's College Hospital, London. Clinical and ultrasound data had been entered contemporaneously on our electronic early pregnancy database and hospital clinical records over an 11year period from 2004 to 2014. Demographic data, clinical history, ultrasound scan parameters, type of surgical management and histological diagnosis were recorded. The primary outcome measure was the presence or absence of chorionic villi in the surgical specimen. Data were analysed using Mann Whitney U test for non-parametric data, relative risk for categorical data and binomial logistic regression. A surgical specimen was obtained in 925 cases. Of these, 881/925 (95.2%) were positive for the presence of chorionic villi on histological examination. Patients with negative histology had a lower median gestational age, smaller ectopic pregnancies and lower serum human chorionic gonadotrophin levels. The relative risk of negative histology was significantly higher with a solid ectopic pregnancy on ultrasound (RR1.91, 95% CI 1.07-3.4) and with conservative surgery (RR 3.68, 95% CI 1.25-10.77). The relative risk was significantly lower with the presence of embryonic cardiac activity (RR 0.12, 95% CI 0.02-0.85). Only the serum hCG level was a significant predictor of negative histology on logistic regression analysis (p=0.048). In 39/44 women with negative histology, the human chorionic gonadotrophin level declined after surgery with no further intervention. Five of the 44 required a second surgical procedure as the ectopic pregnancy had been missed at the initial surgery and did not resolve. There is lack of histological

  15. Iliopsoas tendon insertion footprint with surgical implications in lesser trochanterplasty for treating ischiofemoral impingement: an anatomic study

    OpenAIRE

    Gómez-Hoyos, Juan; Schröder, Ricardo; Ian J. Palmer; Reddy, Manoj; Khoury, Anthony; Martin, Hal David

    2015-01-01

    The objective of this study was to describe the footprint location of the iliopsoas tendon on the lesser trochanter to clarify the surgical implications of the lesser trochanterplasty for treating ischiofemoral impingement. Ten non-matched, fresh-frozen, cadaveric hemipelvis specimens (average age, 62.4 years; range, 48–84 years; 7 male and 3 female) were included. Registered measures included bony parameters of the lesser trochanter (lesser trochanteric area, distances from the tip to the ba...

  16. Noninvasive, near infrared spectroscopic-measured muscle pH and PO2 indicate tissue perfusion for cardiac surgical patients undergoing cardiopulmonary bypass

    Science.gov (United States)

    Soller, Babs R.; Idwasi, Patrick O.; Balaguer, Jorge; Levin, Steven; Simsir, Sinan A.; Vander Salm, Thomas J.; Collette, Helen; Heard, Stephen O.

    2003-01-01

    OBJECTIVE: To determine whether near infrared spectroscopic measurement of tissue pH and Po2 has sufficient accuracy to assess variation in tissue perfusion resulting from changes in blood pressure and metabolic demand during cardiopulmonary bypass. DESIGN: Prospective clinical study. SETTING: Academic medical center. SUBJECTS: Eighteen elective cardiac surgical patients. INTERVENTION: Cardiac surgery under cardiopulmonary bypass. MEASUREMENTS AND MAIN RESULTS: A near infrared spectroscopic fiber optic probe was placed over the hypothenar eminence. Reference Po2 and pH sensors were inserted in the abductor digiti minimi (V). Data were collected every 30 secs during surgery and for 6 hrs following cardiopulmonary bypass. Calibration equations developed from one third of the data were used with the remaining data to investigate sensitivity of the near infrared spectroscopic measurement to physiologic changes resulting from cardiopulmonary bypass. Near infrared spectroscopic and reference pH and Po2 measurements were compared for each subject using standard error of prediction. Near infrared spectroscopic pH and Po2 at baseline were compared with values during cardiopulmonary bypass just before rewarming commenced (hypotensive, hypothermic), after rewarming (hypotensive, normothermic) just before discontinuation of cardiopulmonary bypass, and at 6 hrs following cardiopulmonary bypass (normotensive, normothermic) using mixed-model analysis of variance. Near infrared spectroscopic pH and Po2 were well correlated with the invasive measurement of pH (R2 =.84) and Po2 (R 2 =.66) with an average standard error of prediction of 0.022 +/- 0.008 pH units and 6 +/- 3 mm Hg, respectively. The average difference between the invasive and near infrared spectroscopic measurement was near zero for both the pH and Po2 measurements. Near infrared spectroscopic Po2 significantly decreased 50% on initiation of cardiopulmonary bypass and remained depressed throughout the bypass and

  17. Noninvasive, near infrared spectroscopic-measured muscle pH and PO2 indicate tissue perfusion for cardiac surgical patients undergoing cardiopulmonary bypass

    Science.gov (United States)

    Soller, Babs R.; Idwasi, Patrick O.; Balaguer, Jorge; Levin, Steven; Simsir, Sinan A.; Vander Salm, Thomas J.; Collette, Helen; Heard, Stephen O.

    2003-01-01

    OBJECTIVE: To determine whether near infrared spectroscopic measurement of tissue pH and Po2 has sufficient accuracy to assess variation in tissue perfusion resulting from changes in blood pressure and metabolic demand during cardiopulmonary bypass. DESIGN: Prospective clinical study. SETTING: Academic medical center. SUBJECTS: Eighteen elective cardiac surgical patients. INTERVENTION: Cardiac surgery under cardiopulmonary bypass. MEASUREMENTS AND MAIN RESULTS: A near infrared spectroscopic fiber optic probe was placed over the hypothenar eminence. Reference Po2 and pH sensors were inserted in the abductor digiti minimi (V). Data were collected every 30 secs during surgery and for 6 hrs following cardiopulmonary bypass. Calibration equations developed from one third of the data were used with the remaining data to investigate sensitivity of the near infrared spectroscopic measurement to physiologic changes resulting from cardiopulmonary bypass. Near infrared spectroscopic and reference pH and Po2 measurements were compared for each subject using standard error of prediction. Near infrared spectroscopic pH and Po2 at baseline were compared with values during cardiopulmonary bypass just before rewarming commenced (hypotensive, hypothermic), after rewarming (hypotensive, normothermic) just before discontinuation of cardiopulmonary bypass, and at 6 hrs following cardiopulmonary bypass (normotensive, normothermic) using mixed-model analysis of variance. Near infrared spectroscopic pH and Po2 were well correlated with the invasive measurement of pH (R2 =.84) and Po2 (R 2 =.66) with an average standard error of prediction of 0.022 +/- 0.008 pH units and 6 +/- 3 mm Hg, respectively. The average difference between the invasive and near infrared spectroscopic measurement was near zero for both the pH and Po2 measurements. Near infrared spectroscopic Po2 significantly decreased 50% on initiation of cardiopulmonary bypass and remained depressed throughout the bypass and

  18. Micropapillary urothelial carcinoma: Cytologic features in a retrospective series of urine specimens

    Directory of Open Access Journals (Sweden)

    Jonas John Heymann

    2013-01-01

    Full Text Available Background : The micropapillary variant of urothelial carcinoma (uPC is a rare variant of urothelial carcinoma that carries a poor prognosis. Definitive surgery may represent optimal management of low stage tumors. Urine cytology is indispensable in the screening and follow-up of urinary tract cancer. However, cytopathological criteria for diagnosis of uPC and its differentiation from conventional urothelial carcinoma (CUC are not well-defined. Materials and Methods : Twenty-five cases of histologically confirmed micropapillary uPC from 21 patients were compared to 25 cases of histologically confirmed high-grade CUC. Results : In uPC cases, cell clusters were identified in 13 of 25 specimens from 10 patients. Six of the 13 specimens containing cell clusters corresponded to surgical pathology specimens in which micropapillary carcinoma accounted for at least 50% of total carcinoma. In contrast, only 1 of the 12 urine specimens devoid of cell clusters corresponded to surgical specimens in which micropapillary carcinoma accounted for at least 50% of total carcinoma. Cytomorphologic features of urinary specimens from patients with histologically confirmed micropapillary carcinoma were generally similar to those from patients with high-grade CUC, making it difficult to distinguish these entities in exfoliative urine specimens. Conclusions and Summary : Further investigation of the core cytopathological characteristics of uPC is warranted to refine its diagnostic criteria by exfoliative urine cytology.

  19. The Value of Surgical Measurement of the Sphenoid Sinus with Sagittal CT%CT矢状位测量蝶窦外科径线的价值

    Institute of Scientific and Technical Information of China (English)

    邬海博; 袁慧书; 朱丽

    2011-01-01

    目的 探讨CT矢状位重组图像测量蝶窦外科径线的价值.资料与方法 在薄层CT矢状位重组图像上对173名成年健康自愿者(男91名,女82名)的343个蝶窦的部分径线进行测量.结果 除外部分特殊病例(如Onodi气房)外,从蝶窦口至前颅窝底及蝶窦下壁最低点的垂直距离分别平均为(9.54±2.5)mm及(12.64±3.7)mm.从蝶窦口至蝶窦后壁的水平距离平均为(18.13±1.6)mm或(28.9±2.5)mm.从蝶鞍最低点向前至蝶窦前壁的水平距离平均为(17.72±1.5)mm.除部分蝶骨小翼过度气化的病例外,沿前颅窝底从蝶窦的前壁至其后壁的水平距离为(9.08±4.3)mm.除部分斜坡过度气化病例外,从蝶窦后壁最远点向前至蝶窦前壁的水平距离平均为(21.82±7.4)mm.结论 CT矢状位重组可用以测量蝶窦的解剖径线,有助于避免外科手术时并发症的发生,但埘部分过度气化的蝶窦需个别对待.因此,术前蝶窦矢状位CT的观察至关重要.%Objective To discuss the value of the surgical measurement of sphenoid sinus with sagittal CT thin-slice reconstruction images.Materials and Methods 343 CT images of the sphenoid sinus from 173 healthy volunteers(91 males and 82 females) were measured with sagittal CT reconstruction images.Results Except for some special cases (such as Onodi cell) ,the mean vertical distance from the spheuoid ostium to the skull base,and to the lowest point of the bottom of the sphenoid sinus was 9.54 ± 2.5 and (12.64 ± 3.7 ) mm.The mean horizontal distance from sphenoid ostium to the nearest point of posterior wall of sphenoid sinus was ( 18.13 ± 1.6) mm or ( 28.9 ± 2.5 ) mm.The mean horizontal distance from the lowest point of sella to anterior wall of sphenoid sinus was ( 17.72 ± 1.5 ) mm.Except for eases that the pneumatization extends into the lesser wing, the mean horizontal distance from anterior wall to posterior wall of sphenoid sinus lining skull base was (9.20 ± 0.7 )mm.Except for clival

  20. Design and characterization of a digital image acquisition system for whole-specimen breast histopathology

    Energy Technology Data Exchange (ETDEWEB)

    Clarke, Gina M [Imaging Research Program, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, Ontario, M4N 3M5 (Canada); Peressotti, Chris [Imaging Research Program, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, Ontario, M4N 3M5 (Canada); Mawdsley, Gordon E [Imaging Research Program, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, Ontario, M4N 3M5 (Canada); Yaffe, Martin J [Imaging Research Program, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, Ontario, M4N 3M5 (Canada)

    2006-10-21

    We have developed a digital histopathology imaging system capable of producing a three-dimensional (3D) representation of histopathology from an entire lumpectomy specimen. The system has the potential to improve the accuracy of surgical margin assessment in the treatment of breast cancer by providing finer sampling and 3D visualization. A scanning light microscope was modified to allow digital photomicrography of a stack of large (up to 120 x 170 mm{sup 2}) histology slides cut serially through the entire specimen. The images are registered and displayed in 2D and 3D. The design of the system, which reduces or eliminates the appearance of 'tiling' and 'seam' artefacts inherent in the scanning method, is described and its resolution, contrast/noise and coverage properties are characterized through measurements of the modulation transfer function (MTF), depth of field (DOF) and signal difference to noise ratio (SDNR). The imaging task requires a lateral resolution of 5 {mu}m, an SDNR of 5 between relevant features, 'tiling artefact' at a level below the detectability threshold of the eye, and 'seam artefact' of less than 5-10 {mu}m. The tests demonstrate that the system is largely adequate for the imaging task, although further optimizations are required to reduce the degradation of coverage incurred by seam artefact.

  1. Design and characterization of a digital image acquisition system for whole-specimen breast histopathology

    Science.gov (United States)

    Clarke, Gina M.; Peressotti, Chris; Mawdsley, Gordon E.; Yaffe, Martin J.

    2006-10-01

    We have developed a digital histopathology imaging system capable of producing a three-dimensional (3D) representation of histopathology from an entire lumpectomy specimen. The system has the potential to improve the accuracy of surgical margin assessment in the treatment of breast cancer by providing finer sampling and 3D visualization. A scanning light microscope was modified to allow digital photomicrography of a stack of large (up to 120 × 170 mm2) histology slides cut serially through the entire specimen. The images are registered and displayed in 2D and 3D. The design of the system, which reduces or eliminates the appearance of 'tiling' and 'seam' artefacts inherent in the scanning method, is described and its resolution, contrast/noise and coverage properties are characterized through measurements of the modulation transfer function (MTF), depth of field (DOF) and signal difference to noise ratio (SDNR). The imaging task requires a lateral resolution of 5 µm, an SDNR of 5 between relevant features, 'tiling artefact' at a level below the detectability threshold of the eye, and 'seam artefact' of less than 5-10 µm. The tests demonstrate that the system is largely adequate for the imaging task, although further optimizations are required to reduce the degradation of coverage incurred by seam artefact.

  2. Significant Individual Variation Between Pathologists in the Evaluation of Colon Cancer Specimens After Complete Mesocolic Excision.

    Science.gov (United States)

    Munkedal, Ditte Louise E; Laurberg, Søren; Hagemann-Madsen, Rikke; Stribolt, Katrine J; Krag, Søren R P; Quirke, Philip; West, Nicholas P

    2016-10-01

    After the introduction of complete mesocolic excision, a new pathological evaluation of the resected colon cancer specimen was introduced. This concept has quickly gained acceptance and is often used to compare surgical quality. The grading of colon cancer specimens is likely to depend on both surgical quality and the training of the pathologist. The purpose of this study was to validate the principles of the pathological evaluation of colon cancer specimens. This was an exploratory study. The study was conducted in Aarhus, Denmark, and Leeds, United Kingdom. Colon cancers specimens were used. The agreement of gradings between participants was of interest. Four specialist GI pathologists and 2 abdominal surgeons evaluated 2 rounds of colon cancer specimens, each at 2 separate time points. Each round contained 50 specimens. After the first round, a protocol of detailed principles for the grading procedure was agreed on. Results from an experienced pathologist were considered as the reference results. In the first round, the distribution of gradings between participants showed substantial variation. In the second round, the variation was reduced. Intraobserver agreement was mostly fair to good, whereas interobserver agreement was frequently poor. This did not significantly change from round 1 to round 2. The small sample size of 100 specimens provided a very small number of specimens resected in the muscularis propria plane, which renders the evaluation of this group potentially unreliable. The evaluations were made on photos and not on fresh specimens. This study demonstrates significant variation in the pathological evaluation of colon cancer specimens. It demonstrates that it cannot be used in clinical studies, and care should be taken when comparing results between different hospitals.

  3. Microwave applications to rock specimen drying in laboratory

    Science.gov (United States)

    Park, Jihwan; Park, Hyeong-Dong

    2014-05-01

    Microwave heating is the process in which electromagnetic wave with 300 MHz - 300 GHz heats dielectric material. Although in the beginning microwave was mainly used in food industry to cook or heat the food, it soon became clear that microwave had a large potential for other applications. It was thus introduced in geological fields of investigation like mineral processing, oil sand and oil shale extraction, soil remediation, waste treatment. However, the drying techniques using microwave was rarely treated in geology field. According to the ISRM suggested methods, experimental rock specimens in laboratory test were dried in 105°C oven for a period of at least 24 hours. In this method, hot air transmits heats to material by means of thermal conduction, and the heat was transferred from the surface to the inside of the rock specimens. The thermal gradient and moisture gradient can deteriorate the specimens, and energy can be wasted in bulk heating the specimens. The aim of our study was to compare physical property, microstructural property, and energy efficiency between microwave drying method and conventional oven drying method, and to suggest new method for rock drying. Granite, basalt, and sandstone were selected as specimens and were made in cylinder shape with 54 mm diameter. To compare two different methods, one set of saturated specimens were dried in 105°C conventional oven and the other set of saturated specimens were dried in microwave oven. After dried, the specimens were cooled and saturated in 20°C water 48 hours. The saturation-drying were repeated 50 cycles, and the physical property and microstructural property were measured every 10 cycles. Absorption and elastic wave velocity were measured to investigate the change of physical property, and microscope image and X-ray computed tomography image were obtained to investigate the change of microstructural property of rock specimens. The electricity consumption of conventional oven and microwave oven

  4. Study of two tantalum Taylor impact specimens using experiments and stochastic polycrystal plasticity simulation

    Energy Technology Data Exchange (ETDEWEB)

    Tonks, Michael R [Los Alamos National Laboratory

    2008-01-01

    We compare the experimentally obtained response of two cylindrical tantalum Taylor impact specimens. The first specimen is manufactured using a powder metallurgy (P/M) process with a random initial texture and relatively equiaxed crystals. The second is sectioned from a roundcorner square rolled (RCSR) rod with an asymmetric texture and elongated crystals. The deformed P/M specimen has an axisymmetric footprint while the deformed RCSR projectile has an eccentric footprint with distinct corners. Also, the two specimens experienced similar crystallographic texture evolution, though the RCSR specimen experienced greater plastic deformation. Our simulation predictions mimic the texture and deformation data measured from the P/M specimen. However, our RCSR specimen simulations over-predict the texture development and do not accurately predict the deformation, though the deformation prediction is improved when the texture is not allowed to evolve. We attribute this discrepancy to the elongated crystal morphology in the RCSR specimen which is not represented in our mean-field model.

  5. Ideal number of biopsy tumor fragments for predicting HER2 status in gastric carcinoma resection specimens.

    Science.gov (United States)

    Ahn, Sangjeong; Ahn, Soomin; Van Vrancken, Michael; Lee, Minju; Ha, Sang Yun; Lee, Hyuk; Min, Byung-Hoon; Lee, Jun Haeng; Kim, Jae J; Choi, Sunkyu; Jung, Sin-Ho; Choi, Min Gew; Lee, Jun-Ho; Sohn, Tae Sung; Bae, Jae Moon; Kim, Sung; Kim, Kyoung-Mee

    2015-11-10

    Intratumoral heterogeneity of HER2 expression is common in gastric cancers and pose a challenge for identifying patients who would benefit from anti-HER2 therapy. The aim of this study is to compare HER2 expression in biopsy and resection specimens of gastric carcinoma by immunohistochemistry (IHC) and to find the ideal number of biopsy tumor fragments that can accurately predict HER2 overexpression in the corresponding surgically resected specimen. The HER2 IHC results of 702 paired biopsy and resection specimens of gastric cancer were compared.The mean number of biopsy fragments among all cases was 4.3 (range 1-11). HER2 was positive in 130 (18.5%) endoscopic biopsies and in 102 (14.5%) gastrectomy specimens. Intratumoral heterogeneity of HER2 was found in 80 (61.5%) biopsies and 70 (68.6%) resection specimens. Out of the 70 surgical specimens with intratumoral heterogeneity, 24 (34.3%) of the corresponding biopsies were categorized as negative (positive conversion). In the 86 (12.3%) discrepant cases, negative conversion was observed in 57 (66.3%) cases and positive conversion in 29 (33.7%). The fragment numbers were significantly correlated with the discrepancy of results and positive predictability (P = 0.0315 and P = 0.0052). ROC curve analysis and positive predictability showed that 4 fragments should be obtained to minimize the differences in HER2 scores between biopsy and resection specimen.In gastric carcinomas with discrepant HER2 results between biopsy and surgical resection specimens, intratumoral heterogeneity is common with most of them showing positive conversion. To predict HER2 status precisely, at least 4 biopsy fragments containing tumor cells are required.

  6. 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.

  7. Nondestructive DNA extraction from museum specimens.

    Science.gov (United States)

    Hofreiter, Michael

    2012-01-01

    Natural history museums around the world hold millions of animal and plant specimens that are potentially amenable to genetic analyses. With more and more populations and species becoming extinct, the importance of these specimens for phylogenetic and phylogeographic analyses is rapidly increasing. However, as most DNA extraction methods damage the specimens, nondestructive extraction methods are useful to balance the demands of molecular biologists, morphologists, and museum curators. Here, I describe a method for nondestructive DNA extraction from bony specimens (i.e., bones and teeth). In this method, the specimens are soaked in extraction buffer, and DNA is then purified from the soaking solution using adsorption to silica. The method reliably yields mitochondrial and often also nuclear DNA. The method has been adapted to DNA extraction from other types of specimens such as arthropods.

  8. 48. The value of CT scan and detection of telomerase activity in biopsy specimens for early diagnosis of lung carcinoma

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    Objective: To evaluate the diagnostic value of telomerase activity in the specimens of biopsy with bronchoscopy or cutting needle. Methods: Telomerase activity was measured in the biopsy apecimens taken from 52 patients suspected of having early lung cancer by CT scan. The PCR based silver staining telomeric repeat amplification protocol (TRAP) was used for detection of telomerase activity in 22 patients with early lung cancer (T1N0M0). Control study was made on the specimens taken from 24 patients with benign disease (cyst 3, TB 6, pseudtumor 5, pneumonjia 10). Results: The positive rates of telomerase activity were 86.45% (19/22) and 4.2% (1/24) in early lung cancers and benign lesions respectively (P<0.01). It was significantly higher in early lung cancers than in benign disease. All cases were diagnosed with surgical pathology and following for 2 years. Conclusion: Detecting telomerase activity in preoperative bronchoscope and cutting needle biopsy specimens may contribute to diagnosis of early lung cancer.

  9. An MRI-based assessment of standard and extralevator abdominoperineal excision specimens: time for a patient tailored approach?

    Science.gov (United States)

    How, Peter; West, Nicholas P; Brown, G

    2014-03-01

    The extralevator abdominoperineal excision (ELAPE) has been proposed as oncologically superior to standard abdominoperineal excision (SAPE). However, little is known regarding comparative margins achieved in ELAPE and SAPE. The purpose of this study was to compare patterns of tissue removal between these two groups that can aid patient selection. Twenty APE specimens, comprising 10 SAPEs and 10 ELAPEs, were selected randomly from a single UK centre. Transverse slices of pathological specimens were matched to corresponding axial MRI images obtained from conventional pelvic MRI imaging. Measurements from the muscularis propria to the resection margin [muscularis to margin (MTM) distance] were recorded by height (from anal verge) and quadrant for each surgical group. MTM distances achieved on histopathological assessment were also compared to MRI assessed distances necessary to achieve a clear CRM. ELAPE specimens had a greater mean MTM distance than for SAPE (7.75 vs. 5.61 mm, p = 0.02). ELAPE had significantly greater MTM distances in lateral and posterior quadrants (p CRM positivity. ELAPE appears to confer oncological benefit over SAPE but with notable exceptions, including tumours located above and below the puborectalis sling and anteriorly at the level of prostate where exenteration may be more appropriate.

  10. Making Durable Specimens For Electron Microscopy

    Science.gov (United States)

    Doychak, Joseph

    1989-01-01

    Consistent metal-oxide cross sections prepared quickly. New process makes TEM/STEM cross sections of metal/oxide interfaces. After specimen bars oxidized, placed in specially designed mold. Following encapsulation in zinc alloy, 3-mm-diameter specimen bar sliced into disks suitable for further preparation steps. Technique used to prepare 3-mm-diameter specimens of cross sections of oxides of alloys intended for use at temperatures greater than approximately 600 degree C.

  11. RSB: Research Specimen Banking across the Institution

    OpenAIRE

    Pense, Rick; Grose, Tim; Anderson, Lynn; Lee, H

    2001-01-01

    Research Specimen Banking (RSB) system is a component of the translational investigations infrastructure at Moffitt Cancer Center & Research Institute. It was implemented to provide specimen management functions to support basic science cancer research taking place in conjunction with caner clinical trials. RSB handles the receipt and distribution of clinical specimens to the research labs, with identifiers that both mask personal identity and enable linkage of clinical data to correlative re...

  12. STEM tomography for thick biological specimens

    Energy Technology Data Exchange (ETDEWEB)

    Aoyama, Kazuhiro [FEI Company Japan Ltd., Application Laboratory, NSS-II Building, 2-13-34 Kohnan, Minato-ku, Tokyo 108-0075 (Japan)], E-mail: kazuhiro.aoyama@fei.com; Takagi, Tomoko [FEI Company Japan Ltd., Application Laboratory, NSS-II Building, 2-13-34 Kohnan, Minato-ku, Tokyo 108-0075 (Japan); Laboratory of Electron Microscopy, Japan Women' s University, 2-8-1 Mejirodai, Bunkyo-ku, Tokyo 112-8681 (Japan); Hirase, Ai; Miyazawa, Atsuo [Bio-multisome Research Team, RIKEN SPring-8 Center, Harima Institute, 1-1-1 Kouto, Sayo, Hyogo 679-5148 (Japan); CREST, JST (Japan)

    2008-12-15

    Scanning transmission electron microscopy (STEM) tomography was applied to biological specimens such as yeast cells, HEK293 cells and primary culture neurons. These cells, which were embedded in a resin, were cut into 1-{mu}m-thick sections. STEM tomography offers several important advantages including: (1) it is effective even for thick specimens, (2) 'dynamic focusing', (3) ease of using an annular dark field (ADF) mode and (4) linear contrasts. It has become evident that STEM tomography offers significant advantages for the observation of thick specimens. By employing STEM tomography, even a 1-{mu}m-thick specimen (which is difficult to observe by conventional transmission electron microscopy (TEM)) was successfully analyzed in three dimensions. The specimen was tilted up to 73 deg. during data acquisition. At a large tilt angle, the specimen thicknesses increase dramatically. In order to observe such thick specimens, we introduced a special small condenser aperture that reduces the collection angle of the STEM probe. The specimen damage caused by the convergent electron beam was expected to be the most serious problem; however, the damage in STEM was actually smaller than that in TEM. In this study, the irradiation damage caused by TEM- and STEM-tomography in biological specimens was quantitatively compared.

  13. AGC-2 Specimen Post Irradiation Data Package Report

    Energy Technology Data Exchange (ETDEWEB)

    Windes, William Enoch [Idaho National Lab. (INL), Idaho Falls, ID (United States); Swank, W. David [Idaho National Lab. (INL), Idaho Falls, ID (United States); Rohrbaugh, David T. [Idaho National Lab. (INL), Idaho Falls, ID (United States); Cottle, David L. [Idaho National Lab. (INL), Idaho Falls, ID (United States)

    2015-08-01

    This report documents results of the post-irradiation examination material property testing of the creep, control, and piggyback specimens from the irradiation creep capsule Advanced Graphite Creep (AGC)-2 are reported. This is the second of a series of six irradiation test trains planned as part of the AGC experiment to fully characterize the neutron irradiation effects and radiation creep behavior of current nuclear graphite grades. The AGC-2 capsule was irradiated in the Idaho National Laboratory Advanced Test Reactor at a nominal temperature of 600°C and to a peak dose of 5 dpa (displacements per atom). One-half of the creep specimens were subjected to mechanical stresses (an applied stress of either 13.8, 17.2, or 20.7 MPa) to induce irradiation creep. All post-irradiation testing and measurement results are reported with the exception of the irradiation mechanical strength testing, which is the last destructive testing stage of the irradiation testing program. Material property tests were conducted on specimens from 15 nuclear graphite grades using a similar loading configuration as the first AGC capsule (AGC-1) to provide easy comparison between the two capsules. However, AGC-2 contained an increased number of specimens (i.e., 487 total specimens irradiated) and replaced specimens of the minor grade 2020 with the newer grade 2114. The data reported include specimen dimensions for both stressed and unstressed specimens to establish the irradiation creep rates, mass and volume data necessary to derive density, elastic constants (Young’s modulus, shear modulus, and Poisson’s ratio) from ultrasonic time-of-flight velocity measurements, Young’s modulus from the fundamental frequency of vibration, electrical resistivity, and thermal diffusivity and thermal expansion data from 100–500°C. No data outliers were determined after all measurements were completed. A brief statistical analysis was performed on the irradiated data and a limited comparison between

  14. Effect of surgical procedures on prostate tumor gene expression profiles

    Institute of Scientific and Technical Information of China (English)

    Jie Li; Zhi-Hong Zhang; Chang-Jun Yin; Christian Pavlovich; Jun Luo; Robert Getzenberg; Wei Zhang

    2012-01-01

    Current surgical treatment of prostate cancer is typically accomplished by either open radical prostatectomy (ORP) or robotic-assisted laparoscopic radical prostatectomy (RALRP).Intra-operative procedural differences between the two surgical approaches may alter the molecular composition of resected surgical specimens,which are indispensable for molecular analysis and biomarker evaluation.The objective of this study is to investigate the effect of different surgical procedures on RNA quality and genome-wide expression signature.RNA integrity number (RIN) values were compared between total RNA samples extracted from consecutive LRP (n=11 ) and ORP (n=24) prostate specimens.Expression profiling was performed using the Agilent human whole-genome expression microarrays.Expression differences by surgical type were analyzed by Volcano plot analysis and gene ontology analysis.Quantitative reverse transcription (RT)-PCR was used for expression validation in an independent set of LRP (n=8) and ORP (n=8) samples.The LRP procedure did not compromise RNA integrity.Differential gene expression by surgery types was limited to a small subset of genes,the number of which was smaller than that expected by chance.Unexpectedly,this small subset of differentially expressed genes was enriched for those encoding transcription factors,oxygen transporters and other previously reported surgery-induced stress-response genes,and demonstrated unidirectional reduction in LRP specimens in comparison to ORP specimens.The effect of the LRP procedure on RNA quality and genome-wide transcript levels is negligible,supporting the suitability of LRP surgical specimens for routine molecular analysis.Blunted in vivo stress response in LRP specimens,likely mediated by CO2 insufflation but not by longer ischemia time,is manifested in the reduced expression of stress-response genes in these specimens.

  15. Evaluation of specimen preservatives for DNA analyses of bees

    Science.gov (United States)

    Frampton, M.; Droege, S.; Conrad, T.; Prager, S.; Richards, M.H.

    2008-01-01

    Large-scale insect collecting efforts that are facilitated by the use of pan traps result in large numbers of specimens being collected. Storage of these specimens can be problematic if space and equipment are limited. In this study, we investigated the effects of various preservatives (alcohol solutions and DMSO) on the amount and quality of DNA extracted from bees (specifically Halictidae, Apidae, and Andrenidae). In addition, we examined the amount and quality of DNA obtained from bee specimens killed and stored at -80 degrees C and from specimens stored for up to 24 years in ethanol. DNA quality was measured in terms of how well it could be PCR-amplified using a set of mitochondrial primers that are commonly used in insect molecular systematics. Overall the best methods of preservation were ultra-cold freezing and dimethyl sulfoxide, but these are both expensive and in the case of ultra-cold freezing, somewhat impractical for field entomologists. Additionally, dimethyl sulfoxide was shown to have adverse effects on morphological characters that are typically used for identification to the level of species. We therefore recommend that the best alternative is 95% ethanol, as it preserves bee specimens well for both morphological and molecular studies.

  16. Friction Compensation in the Upsetting of Cylindrical Test Specimens

    DEFF Research Database (Denmark)

    Christiansen, Peter; Martins, P. A. F.; Bay, Niels Oluf

    2016-01-01

    This manuscript presents a combined numerical andexperimental methodology for determining the stress-straincurve of metallic materials from the measurements of forceand displacement obtained in the axial compression of cylindrical test specimens with friction between the specimens and the platens...... model or combined friction models are utilized .Experimental results obtained from cylindrical and Rastegaev test specimens with different lubricants combined with the experimental determination of friction by means of ring compression tests allows compensating the effect of friction...... in the determination of the material flow curve. Comparison with the flow curves determined without friction compensation shows the viability of the proposed methodology. The proposed methodology is a simple and effective alternative to other solutions available in the literature and the pseudo-code supplied inthe...

  17. 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.

  18. 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.

  19. Comparison between dog-bone and Gaussian specimens for size effect evaluation in gigacycle fatigue

    Directory of Open Access Journals (Sweden)

    A. Tridello

    2013-10-01

    Full Text Available Gigacycle fatigue properties of materials are strongly affected by the specimen risk volume (volume of material subjected to a stress amplitude larger than the 90% of the maximum stress. Gigacycle fatigue tests, performed with ultrasonic fatigue testing machines, are commonly carried out by using hourglass shaped specimens with a small risk volume. The adoption of traditional dog-bone specimens allows for increasing the risk volume, even if the increment is quite limited. In order to obtain larger risk volumes, a new specimen shape is proposed (Gaussian specimen. The dog-bone and the Gaussian specimens are compared through Finite Element Analyses and the numerical results are validated experimentally by means of strain gages measurements. The range of applicability of the two different specimens in terms of available risk volume and stress concentration effects due to the cross section variation is determined.

  20. Finite element simulations of electrostatic dopant potentials in thin semiconductor specimens for electron holography

    Energy Technology Data Exchange (ETDEWEB)

    Somodi, P.K.; Twitchett-Harrison, A.C.; Midgley, P.A. [Department of Materials Science and Metallurgy, University of Cambridge, Pembroke Street, Cambridge CB2 3QZ (United Kingdom); Kardynał, B.E. [Peter Grünberg Institute 9, Forschungszentrum Jülich, D-52425 Jülich (Germany); Barnes, C.H.W. [Department of Physics, University of Cambridge, Madingley Road, Cambridge CB3 0HE (United Kingdom); Dunin-Borkowski, R.E., E-mail: rafaldb@gmail.com [Ernst Ruska-Centre for Microscopy and Spectroscopy with Electrons and Peter Grünberg Institute 5, Forschungszentrum Jülich, D-52425 Jülich (Germany)

    2013-11-15

    Two-dimensional finite element simulations of electrostatic dopant potentials in parallel-sided semiconductor specimens that contain p–n junctions are used to assess the effect of the electrical state of the surface of a thin specimen on projected potentials measured using off-axis electron holography in the transmission electron microscope. For a specimen that is constrained to have an equipotential surface, the simulations show that the step in the projected potential across a p–n junction is always lower than would be predicted from the properties of the bulk device, but is relatively insensitive to the value of the surface state energy, especially for thicker specimens and higher dopant concentrations. The depletion width measured from the projected potential, however, has a complicated dependence on specimen thickness. The results of the simulations are of broader interest for understanding the influence of surfaces and interfaces on electrostatic potentials in nanoscale semiconductor devices. - Highlights: • Finite element simulations are performed to calculate electrostatic dopant potentials in TEM specimens that contain p–n junctions. • The effect of the electrical state of the specimen surface on the projected potential is assessed for equipotential specimen surfaces. • The step in projected potential is always found to be lower than the step in potential in the bulk device. • The step in projected potential is least sensitive to surface state energy for thicker specimens and higher dopant concentrations. • The depletion width measured from the projected potential has a complicated dependence on specimen thickness.

  1. 16 CFR Figure 3 to Part 1610 - Specimen Holder Supported in Specimen Rack

    Science.gov (United States)

    2010-01-01

    ... 16 Commercial Practices 2 2010-01-01 2010-01-01 false Specimen Holder Supported in Specimen Rack 3 Figure 3 to Part 1610 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION FLAMMABLE FABRICS ACT... Holder Supported in Specimen Rack ER25MR08.002...

  2. Reconstituted Charpy impact specimens. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Perrin, J.S.; Wullaert, R.A.; McConnell, P.; Server, W.L.; Fromm, E.O.

    1982-12-01

    The arc stud welding process was used to produce new, full size Charpy V-notch impact specimens from halves of Charpy specimens which had been previously tested. The apparatus was developed such that it could be used not only for unirradiated specimens, but also so that it could be adapted for in-cell use to produce new reconstituted specimens of irradiated material. The materials studied are of interest in nuclear applications. They include A533B, A36, A516-80, submerged arc weld metal (A508 base metal), HY80, cast duplex stainless steel, irradiated A533B, and irradiated submerged arc weld metal (A508 base metal). Both unirradiated and irradiated specimens were successfully produced and subsequently impact tested. In general, there was excellent agreement when comparing the original curves to the subsequent curves generated with reconstituted specimens. This program has shown that the arc stud welding process is well suited for producing reconstituted specimens at a reasonable cost using either unirradiated or irradiated material.

  3. Mode-II-Fracture Specimen And Holder

    Science.gov (United States)

    Buzzard, Robert J.; Ghosn, Louis; Succop, George

    1991-01-01

    Test specimen and loading frame developed for fatigue and fracture testing of materials under mode-II (sliding-mode) loading. Assembly placed in compression-testing machine. Loads directed oppositely along centerline cause self-similar crack to propagate. Enables consistently accurate alignment of specimens before insertion of specimen/frame assemblies into compression-testing machine. Makes design attractive for testing in hostile environments in which access to machine or furnace limited. Additional feature, with little or no modification, placed horizontally into impact testing machine and subjected to loading at high speeds.

  4. Significance and prognostic value of lysosomal enzyme activities measured in surgically operated adenocarcinomas of the gastroesophageal junction and squamous cell carcinomas of the lower third of esophagus

    Institute of Scientific and Technical Information of China (English)

    Aron Altorjay; Balazs Paal; Nicolette Sohar; Janos Kiss; Imre Szanto; Istvan Sohar

    2005-01-01

    AIM: To establish whether there are fundamental differences in the biochemistries of adenocarcinomas of the gastroesophageal junction (GEJ) and the squamous cell carcinomas of the lower third of the esophagus (LTE).METHODS: Between February 1, 1997 and February 1,2000, we obtained tissue samples at the moment of resection from 54 patients for biochemical analysis. The full set of data could be comprehensively analyzed in 47 of 54 patients' samples (81%). Of these, 29 were adenocarcinomas of the GEJ Siewert type Ⅰ (n = 8), type Ⅱ (n = 12), type Ⅲ (n = 9), and 18 presented as squamous cell carcinomas of the LTE. We evaluated the mean values of 11-lysosomal enzyme and 1-cytosol protease activities of the tumorous and surrounding mucosae as well as their relative activities, measured as the ratio of activity in tumor and normal tissues from the same patient.These data were further analyzed to establish the correlation with tumor localization, TNM stage (lymph-node involvement), histological type (papillary, signet-ring cell,tubular), state of differentiation (good, moderate, poor),and survival (≤24 or ≥24 mo).RESULTS: In adenocarcinomas, the activity of α-mannosidase (AMAN), cathepsin B (CB) and dipeptidyl-peptidase Ⅰ (DPP Ⅰ) increased significantly as compared to the normal gastric mucosa. In squamous cell carcinomas of the esophagus, we also found a significant difference in the activity of cathepsin L and tripeptidyl-peptidase I in addition to these three. There was a statistical correlation of AMAN,CB, and DPP Ⅰ activity between the level of differentiation of adenocarcinomas of the GEJ and lymph node involvement,because tumors with no lymph node metastases histologically confirmed as well-differentiated, showed a significantly lower activity. The differences in CB and DPP Ⅰ activity correlated well with the differences in survival rates, since the CB and DPP Ⅰ values of those who died within 24 mo following surgical intervention were

  5. Thick Concrete Specimen Construction, Testing, and Preliminary Analysis

    Energy Technology Data Exchange (ETDEWEB)

    Clayton, Dwight A. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Hoegh, Kyle [Univ. of Minnesota, Minneapolis, MN (United States); Khazanovich, Lev [Univ. of Minnesota, Minneapolis, MN (United States)

    2015-03-01

    The purpose of the U.S. Department of Energy Office of Nuclear Energy’s Light Water Reactor Sustainability (LWRS) Program is to develop technologies and other solutions that can improve the reliability, sustain the safety, and extend the operating lifetimes of nuclear power plants (NPPs) beyond 60 years. Since many important safety structures in an NPP are constructed of concrete, inspection techniques must be developed and tested to evaluate the internal condition. In-service containment structures generally do not allow for the destructive measures necessary to validate the accuracy of these inspection techniques. This creates a need for comparative testing of the various nondestructive evaluation (NDE) measurement techniques on concrete specimens with known material properties, voids, internal microstructure flaws, and reinforcement locations. A preliminary report detailed some of the challenges associated with thick reinforced concrete sections and prioritized conceptual designs of specimens that could be fabricated to represent NPP concrete structures for using in NDE evaluation comparisons. This led to the construction of the concrete specimen presented in this report, which has sufficient reinforcement density and cross-sectional size to represent an NPP containment wall. Details on how a suitably thick concrete specimen was constructed are presented, including the construction materials, final nominal design schematic, as well as formwork and rigging required to safely meet the desired dimensions of the concrete structure. The report also details the type and methods of forming the concrete specimen as well as information on how the rebar and simulated defects were embedded. Details on how the resulting specimen was transported, safely anchored, and marked to allow access for systematic comparative NDE testing of defects in a representative NPP containment wall concrete specimen are also given. Data collection using the MIRA Ultrasonic NDE equipment and

  6. New suoid specimens from Gebel Zelten, Libya

    Directory of Open Access Journals (Sweden)

    Pickford, M.

    2006-12-01

    Full Text Available A restricted collection of suoids from Gebel Zelten was made in the 1990’s by the Spanish-Libyan Palaeontology Expedition. Dr Dolores Soria filmed the specimens with a video camera and took measurements of the teeth with vernier calipers. This paper uses the images from the video, which, even though somewhat limited in terms of picture quality, are of interest because they represent the first known snout of the gigantic suid Megalochoerus khinzikebirus. The images reveal that it is basically an enlarged version of Libycochoerus massai, but with relatively small premolars. The sanithere specimens from the site were photographed with an Olympus 1.4 megapixel digital camera, and the image quality is better than from the video camera. These specimens throw light on the degree of sexual dimorphism exhibited by sanitheres, a feature that was previously inferred from isolated teeth, but which can now be confirmed on the basis of the two mandible fragments from Gebel Zelten. This paper is dedicated to the memory of Dr Soria. This paper takes into account a few undescribed suid post-cranial bones from Gebel Zelten housed in the Natural History Museum, London, collected during the 1960’s by R. Savage.Una limitada colección de suoideos procedentes de Gebel Zelten fue hecha a finales de los años 1990 por una expedición paleontológica internacional, con participación española y libia. La Dra. Dolores Soria filmó los ejemplares con una cámara de vídeo y tomó las medidas de los dientes con calibre. En este trabajo se utilizan las imágenes filmadas, que, aunque algo limitadas en términos de calidad fotográfica, son interesantes porque representan las primeras conocidas del rostro del suido gigante Megalochoerus khinzikebirus. Las imágenes revelan que básicamente es una versión agrandada de Libycochoerus massai, pero con premolares relativamente más pequeños. Los ejemplares de saniterios fueron fotografiados con una cámara digital Olympus

  7. Structure of Wet Specimens in Electron Microscopy

    Science.gov (United States)

    Parsons, D. F.

    1974-01-01

    Discussed are past work and recent advances in the use of electron microscopes for viewing structures immersed in gas and liquid. Improved environmental chambers make it possible to examine wet specimens easily. (Author/RH)

  8. Testing Biopsy and Cytology Specimens for Cancer

    Science.gov (United States)

    ... Your Diagnosis Exams and Tests for Cancer Testing Biopsy and Cytology Specimens for Cancer Waiting to hear ... who tell you whether the cells in your biopsy sample are cancer or not. How is cancer ...

  9. Structure of Wet Specimens in Electron Microscopy

    Science.gov (United States)

    Parsons, D. F.

    1974-01-01

    Discussed are past work and recent advances in the use of electron microscopes for viewing structures immersed in gas and liquid. Improved environmental chambers make it possible to examine wet specimens easily. (Author/RH)

  10. Effect of erodent particles on the erosion of metal specimens

    Science.gov (United States)

    Razzaque, M. Mahbubur; Alam, M. Khorshed; Khan, M. Ishak

    2016-07-01

    This paper presents the experimental results of the measurement of erosion rate of carbon steel specimens in sand water slurry system in a slurry pot tester. Sylhet sand has been sieved to get three sizes of erodent particles; namely, less than 250 micron, 250 to 590 micron and 590 to 1190 micron. Experiments are done with three sand concentrations (10%, 15% and 20%). The rate of erosion of the carbon steel specimens is measured as the loss of weight per unit surface area per unit time under the dynamic action of solid particles. The eroded surfaces of the specimens are examined using Scanning Electron Microscopy (SEM) to visualize the impact of the slurry of various conditions. It is seen that irrespective of the particle size the rate of erosion increases with the increase of slurry concentration. This increment of erosion rate at high concentration is high for large particles. High erosion rate is observed in case of large sand particles. In case of small and fine particles erosion rate is small because of low impact energy as well as the wastage of energy to overcome the hindrance of the finer particles before striking on the specimen surface.

  11. Microstructural changes of sandstone specimens during CO2 injection

    Science.gov (United States)

    Park, J. H.; Son, J.; Oh, M.; Park, H. D.

    2014-12-01

    Carbon dioxide capture and storage (CCS) is a technology to isolate CO2 from atmosphere, by capturing it from sources, transporting it to injection area, and injecting it into suitable geological formation, ocean, or mineral carbonation plant. Geological storage of carbon dioxide is the most effective and economical method, and until now a lot of demonstration projects were carried out successfully such as Sleipner, Weyburn, and In Salah. In Republic of Korea, small-scale CO2 injection demonstration project is now under investigation in offshore Pohang Basin with sandstone reservoir and the mudstone caprock. When CO2 is injected in target site, the rock around injection well can be deteriorated because of extreme change of temperature and pressure. In this study supercritical CO2 was injected in sandstone specimen and the initiation and propagation of fracture inside the specimens were observed using X-ray computed tomography (CT). X-ray CT method is a computer technology to observe inner density of target object in three dimensional image. Because of its non-destructivity and high resolution, it is suitable for consistent observation of the same specimen. Porosity and permeability of the specimens were measured using X-ray CT images and both of them were increased after injection. P- and S-wave velocity were also measured to assess the change of mechanical property and both of them were decreased after injection because of growth of inner fractures. The data from this research can be used as input data of CCS site.

  12. Impact of specimen adequacy on the assessment of renal allograft biopsy specimens.

    Science.gov (United States)

    Cimen, S; Geldenhuys, L; Guler, S; Imamoglu, A; Molinari, M

    2016-01-01

    The Banff classification was introduced to achieve uniformity in the assessment of renal allograft biopsies. The primary aim of this study was to evaluate the impact of specimen adequacy on the Banff classification. All renal allograft biopsies obtained between July 2010 and June 2012 for suspicion of acute rejection were included. Pre-biopsy clinical data on suspected diagnosis and time from renal transplantation were provided to a nephropathologist who was blinded to the original pathological report. Second pathological readings were compared with the original to assess agreement stratified by specimen adequacy. Cohen's kappa test and Fisher's exact test were used for statistical analyses. Forty-nine specimens were reviewed. Among these specimens, 81.6% were classified as adequate, 6.12% as minimal, and 12.24% as unsatisfactory. The agreement analysis among the first and second readings revealed a kappa value of 0.97. Full agreement between readings was found in 75% of the adequate specimens, 66.7 and 50% for minimal and unsatisfactory specimens, respectively. There was no agreement between readings in 5% of the adequate specimens and 16.7% of the unsatisfactory specimens. For the entire sample full agreement was found in 71.4%, partial agreement in 20.4% and no agreement in 8.2% of the specimens. Statistical analysis using Fisher's exact test yielded a P value above 0.25 showing that - probably due to small sample size - the results were not statistically significant. Specimen adequacy may be a determinant of a diagnostic agreement in renal allograft specimen assessment. While additional studies including larger case numbers are required to further delineate the impact of specimen adequacy on the reliability of histopathological assessments, specimen quality must be considered during clinical decision making while dealing with biopsy reports based on minimal or unsatisfactory specimens.

  13. Ultrasonic analysis of spherical composite test specimens

    Energy Technology Data Exchange (ETDEWEB)

    Brosey, W.D.

    1984-08-22

    Filament wound spherical test specimens have been examined ultrasonically as part of a program to determine the effectiveness of various nondestructive evaluation techniques for analysis of mechanical characteristics of a composite with enclosed geometry. The Kevlar-epoxy composite specimens contained simulated defect conditions which were located, and the extent of damage determined, using ultrasonic analysis. Effects of transducer frequency and signal parameters have been examined to determine optimum conditions for flaw detection. The data were displayed in rectangular and axonometric projection.

  14. Usefulness of liquid-based cytology in hormone receptor analysis of breast cancer specimens.

    Science.gov (United States)

    Nishimura, Rieko; Aogi, Kenjiro; Yamamoto, Tamami; Takabatake, Daisuke; Takashima, Seiki; Teramoto, Norihiro; Kagawa, Akihiro; Morita, Sachiko

    2011-02-01

    Immunohistochemical (IHC) analysis of the hormone receptor (HR) in breast cancer cytology is an important issue nowadays. Several studies have shown discrepancy in the HR status between the primary tumor and metastases. Cytology can be used for patients with metastatic disease. Although cytological assessment of HR is an excellent method, it has not been routinely used because of the difficulty in consistently preparing multiple good quality slides. Liquid-based cytology (LBC) preparation is considered as the key to resolving the aforementioned problem; however, few studies have reported the HR assessment in breast cancer using LBC. Therefore, the HR status of LBC slides from 82 breast cancers was compared with that of the corresponding surgical specimens. The HR assay in both the LBC slides and surgical specimens was conducted by IHC using an autostainer. For the IHC staining, the protocol recommended by the manufacturer for paraffin-embedded sections was used for both the cytology and histology specimens. The HR results of the cytology agreed with those of the histology in 80 of the 82 cases (accuracy rate, 98%) for estrogen receptor, and in 78 of the 82 cases (accuracy rate, 95%) for progesterone receptor. The overall accuracy of the HR status on the cytology and the histology was 99% in 81 of the 82 cases. In conclusion, in HR analysis of breast cancers, LBC followed by IHC using an autostainer was useful for the standard processing of cytological specimens and showed a good correlation with the results of analysis on the histology specimens.

  15. Accuracy of 3-Dimensional Transoesophageal Echocardiography in Assessment of Prosthetic Mitral Valve Dehiscence with Comparison to Anatomical Specimens

    Science.gov (United States)

    Brown, Martin R.; Javorsky, George; Platts, David G.

    2010-01-01

    The evolution of echocardiography from 2-Dimensional Transthoracic Echo through to real time 3-Dimensional Transoesophageal Echo has enabled more accurate visualisation and quantification of valvular disorders especially prosthetic mitral valve paravalvular regurgitation. However, validation of accuracy is rarely confirmed by surgical or post-mortem specimens. We present a case directly comparing different echocardiographic modality images to post mortem specimens in a patient with prosthetic mitral valve paravalvular regurgitation. PMID:20886015

  16. Clinicopathologic features of incidental prostatic adenocarcinoma in radical cystoprostatectomy specimens

    Directory of Open Access Journals (Sweden)

    Vuruskan Hakan

    2011-07-01

    Full Text Available Abstract Background The aim of this study is to review all features of incidentally discovered prostate adenocarcinoma in patients undergoing radical cystoprostatectomy for bladder cancer. Methods The medical charts of 300 male patients who underwent radical cystoprostatectomy for bladder cancer between 1997 and 2005 were retrospectively reviewed. The mean age of the patients was 62 (range 51-75 years. Results Prostate adenocarcinoma was present in 60 (20% of 300 specimens. All were acinar adenocarcinoma. Of these, 40 (66.7% were located in peripheral zone, 20 (33.3% had pT2a tumor, 12 (20% had pT2b tumor, 22(36.7% had pT2c and, 6 (10% had pT3a tumor. Gleason score was 6 or less in 48 (80% patients. Surgical margins were negative in 54 (90% patients, and tumor volume was less than 0.5 cc in 23 (38.3% patients. Of the 60 incidentally detected cases of prostate adenocarcinoma 40 (66.7% were considered clinically significant. Conclusion Incidentally detected prostate adenocarcinoma is frequently observed in radical cystoprostatectomy specimens. The majority are clinically significant.

  17. 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) ...

  18. 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). ...

  19. 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 / ...

  20. 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.

  1. 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 ...

  2. 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.

  3. Closeout of JOYO-1 Specimen Fabrication Efforts

    Energy Technology Data Exchange (ETDEWEB)

    ME Petrichek; JL Bump; RF Luther

    2005-10-31

    Fabrication was well under way for the JOYO biaxial creep and tensile specimens when the NR Space program was canceled. Tubes of FS-85, ASTAR-811C, and T-111 for biaxial creep specimens had been drawn at True Tube (Paso Robles, CA), while tubes of Mo-47.5 Re were being drawn at Rhenium Alloys (Cleveland, OH). The Mo-47.5 Re tubes are now approximately 95% complete. Their fabrication and the quantities produced will be documented at a later date. End cap material for FS-85, ASTAR-811C, and T-111 had been swaged at Pittsburgh Materials Technology, Inc. (PMTI) (Large, PA) and machined at Vangura (Clairton, PA). Cutting of tubes, pickling, annealing, and laser engraving were in process at PMTI. Several biaxial creep specimen sets of FS-85, ASTAR-811C, and T-111 had already been sent to Pacific Northwest National Laboratory (PNNL) for weld development. In addition, tensile specimens of FS-85, ASTAR-811C, T-111, and Mo-47.5 Re had been machined at Kin-Tech (North Huntington, PA). Actual machining of the other specimen types had not been initiated. Flowcharts 1-3 detail the major processing steps each piece of material has experienced. A more detailed description of processing will be provided in a separate document [B-MT(SRME)-51]. Table 1 lists the in-process materials and finished specimens. Also included are current metallurgical condition of these materials and specimens. The available chemical analyses for these alloys at various points in the process are provided in Table 2.

  4. Pooling Bio-Specimens in the Presence of Measurement Error and Non-Linearity in Dose-Response: Simulation Study in the Context of a Birth Cohort Investigating Risk Factors for Autism Spectrum Disorders

    Directory of Open Access Journals (Sweden)

    Karyn Heavner

    2015-11-01

    Full Text Available We sought to determine the potential effects of pooling on power, false positive rate (FPR, and bias of the estimated associations between hypothetical environmental exposures and dichotomous autism spectrum disorders (ASD status. Simulated birth cohorts in which ASD outcome was assumed to have been ascertained with uncertainty were created. We investigated the impact on the power of the analysis (using logistic regression to detect true associations with exposure (X1 and the FPR for a non-causal correlate of exposure (X2, r = 0.7 for a dichotomized ASD measure when the pool size, sample size, degree of measurement error variance in exposure, strength of the true association, and shape of the exposure-response curve varied. We found that there was minimal change (bias in the measures of association for the main effect (X1. There is some loss of power but there is less chance of detecting a false positive result for pooled compared to individual level models. The number of pools had more effect on the power and FPR than the overall sample size. This study supports the use of pooling to reduce laboratory costs while maintaining statistical efficiency in scenarios similar to the simulated prospective risk-enriched ASD cohort.

  5. Small peripheral lung carcinomas with five-year post-surgical follow-up: assessment by semi-automated volumetric measurement of tumour size, CT value and growth rate on TSCT

    Energy Technology Data Exchange (ETDEWEB)

    Sone, Shusuke [JA Nagano Azumi General Hospital, Ikeda, Nagano (Japan); Nagano Health Promotion Corporation, Inasato, Nagano (Japan); Hanaoka, Takaomi [JA Nagano Azumi General Hospital, Department of Chest Surgery, Ikeda, Nagano (Japan); Ogata, Hiroyuki [JA Nagano Azumi General Hospital, Division of Clinical Laboratory and Pathology, Ikeda, Nagano (Japan); Takayama, Fumiyoshi [JA Nagano Azumi General Hospital, Department of Radiology, Ikeda, Nagano (Japan); Ichinose Neurosurgery Hospital, Matsumoto, Nagano (Japan); Watanabe, Tomofumi [Iida Municipal Hospital, Iida, Nagano (Japan); Haniuda, Masayuki [Aichi Medical University, Division of Chest Surgery, Aichi (Japan); Kaneko, Kazuhiko [Shinshu University School of Medicine, Department of Surgery, Matsumoto (Japan); Okaya-Enrei Hospital, Okaya, Nagano (Japan); Kondo, Ryoichi [National Chushin Matsumoto Hospital, Matsumoto (Japan); Yoshida, Kazuo [Shinshu University School of Medicine, Department of Surgery, Matsumoto (Japan); Honda, Takayuki [Shinshu University School of Medicine, Department of Laboratory Medicine, Matsumoto (Japan)

    2012-01-15

    To retrospectively assess the utility of semi-automated measurements by stratification of CT values of tumour size, CT value and doubling time (DT) using thin-section computed tomography (CT) images. The post-surgical outcomes of favourable and problematic tumours (more advanced p stage than IA, post-surgical recurrence or mortality from lung cancer) were compared using the measured values. The computed DTs were compared with manually measured values. The study subjects comprised 85 patients (aged 33-80 years, 48 women, 37 men), followed-up for more than 5 years postoperatively, with 89 lung lesions, including 17 atypical adenomatous hyperplasias and 72 lung cancers. DTs were determined in 45 lesions. For problematic lesions, whole tumour diameter and density were >18 mm and >-400 HU, respectively. The respective values for the tumour core (with CT values of -350 to 150 HU) were >15 mm and >-70 HU. Analysis of tumour core DTs showed interval tumour progression even if little progress was seen by standard tumour volume DT (TVDT). Software-based volumetric measurements by stratification of CT values provide valuable information on tumour core and help estimate tumour aggressiveness and interval tumour progression better than standard manually measured 2D-VDTs. (orig.)

  6. Strength characterization of tubular ceramic materials by flexure of semi-cylindrical specimens

    DEFF Research Database (Denmark)

    Kwok, Kawai; Kiesel, Lutz; Frandsen, Henrik Lund;

    2014-01-01

    capable of loading multiple specimens in controlled environments. The stress field is analyzed in detail with finite element analyses. The validity of the test is found to depend on specimen dimensions and the valid range is established. The methodology is demonstrated by experimental measurements...

  7. Impact energy analysis of HSLA specimens after simulated welding thermal cycle

    Directory of Open Access Journals (Sweden)

    Samarždić, I.

    2008-04-01

    Full Text Available This paper presents impact energy results of specimens made from high strength fine grained steel TStE 420 after thermal cycle simulation. These results are obtained by examining Charpy specimens. Metallographic analysis is performed, hardness is measured and total impact energy is divided into ductile and brittle components.

  8. The Value of Agricultural Voucher Specimens

    OpenAIRE

    Barkworth,Mary; Wolf, Paul; Kinosian,Sylvia; Dyreson, Curtis; Pearse, Will; Brandt, Ben; Cobb,Neil

    2017-01-01

    Voucher specimens are the ultimate raw data of biodiversity studies because they document the interpretation of the names used in papers and reports resulting from such studies. The value of voucher specimens is increased by making their records web-accessible but they can be further enhanced by linking them to other online resources, particularly if the links are birectional.  In this presentation, we discuss the potential benefits of such links for a group of agricultural significance, the ...

  9. 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.

  10. Well-differentiated prostate cancer in core biopsy specimens may be associated with extraprostatic disease

    Directory of Open Access Journals (Sweden)

    José Cury

    Full Text Available CONTEXT AND OBJECTIVE: Accurate determination of the Gleason score in prostate core biopsy specimens is crucial in selecting the type of prostate cancer treatment, especially for patients with well-differentiated tumors (Gleason score 2 to 4. For such patients, an inaccurate biopsy score may result in a therapeutic intervention that is too conservative. We evaluate the role of Gleason score 2-4 in prostate core-needle biopsies for predicting the final pathological staging following radical prostatectomy. DESIGN AND SETTING: Retrospective study at Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo. METHODS: We analyzed the medical records of 120 consecutive patients who underwent radical retropubic prostatectomy to treat clinical localized prostate cancer at our institution between December 2001 and July 2006. Thirty-two of these patients presented well-differentiated tumors (Gleason score 2 to 4 in biopsy specimens and were included in the study. The Gleason scores of the core-needle biopsies were compared with the pathological staging of the surgical specimens. RESULTS: Sixteen of the 32 patients (50% presented moderately differentiated tumors (Gleason score 5 to 7 in surgical specimens. Eighteen patients (56% had tumors with involvement of the prostate capsule and ten (31% had involvement of adjacent organs. Evaluating the 16 patients that maintained Gleason scores of 2 to 4 in the pathological staging of the surgical specimens, 11 (68.7% had focal invasion of the prostate capsule and five (31.25% had organ-confined disease. CONCLUSION: Well-differentiated tumors (Gleason score 2 to 4 seen in biopsies are not predictive of organ-confined disease.

  11. 16 CFR Figure 6 to Subpart A of... - Dummy Specimen in Specimen Holder

    Science.gov (United States)

    2010-01-01

    ... 16 Commercial Practices 2 2010-01-01 2010-01-01 false Dummy Specimen in Specimen Holder 6 Figure 6 to Subpart A of Part 1209 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION CONSUMER PRODUCT SAFETY ACT REGULATIONS INTERIM SAFETY STANDARD FOR CELLULOSE INSULATION The Standard Pt. 1209, Subpt. A...

  12. Residual stress state in pipe cut ring specimens for fracture toughness testing

    Energy Technology Data Exchange (ETDEWEB)

    Damjanovic, Darko [J.J. Strossmayer Univ. of Osijek, Slavonski Brod (Croatia). Mechanical Engineering Faculty; Kozak, Drazan [Zagreb Univ. (Croatia). Dept. for Mechanical Design; Marsoner, Stefan [Materials Center, Leoben (Austria).; Gubeljak, Nenad [Maribor Univ. (Slovenia). Chair of Mechanics

    2017-07-01

    Thin-walled pipes are not suitable for measuring fracture toughness parameters of vital importance because longitudinal crack failure is the most common failure mode in pipes. This is due to the impossibility to manufacture standard specimens for measuring fracture toughness, such as SENB or CT specimens, from the thin wall of the pipe. Previous works noticed this problem, but until now, a good and convenient solution has not been found or developed. To overcome this problem, very good alternative solution was proposed, the so-called pipe ring notched bend specimen (PRNB) [1-5]. Until now, only the idealized geometry PRNB specimen is analyzed, i. e., a specimen which is not cut out from an actual pipe but produced from steel plate. Based on that, residual stresses are neglected along with the imperfections in geometry (elliptical and eccentricity). The aim of this research is to estimate the residual stress state(s) in real pipes used in the boiler industry produced by hot rolling technique. These types of pipes are delivered only in normalized condition, but not stress relieved. Therefore, there are residual stresses present due to the manufacturing technique, but also due to uneven cooling after the production process. Within this paper, residual stresses are estimated by three methods: the incremental hole drilling method (IHMD), X-ray diffraction (XRD) and the splitting method (SM). Knowing the residual stress state in the ring specimen, it is possible to assess their impact on fracture toughness measured on the corresponding PRNB specimen(s).

  13. 37 CFR 2.56 - Specimens.

    Science.gov (United States)

    2010-07-01

    ... indicate membership in the collective organization. (5) A certification mark specimen must show how a... of a union or other organization performed the work or labor on the goods or services. (c) A... be a digitized image in .jpg or .pdf format....

  14. The impact of intra-operative specimen radiographs on specimen weights for wide local excision of breast cancer.

    Science.gov (United States)

    Carmichael, A R; Ninkovic, G; Boparai, R

    2004-08-01

    The ultimate goal of breast conserving surgery (BCS) is to achieve survival and local control rates similar to those for mastectomy while providing improved cosmetic and functional results. The volume of breast tissue removed is the most significant determinant of the final cosmetic outcome of BCS. We hypothesised that intra-operative specimen radiograph (IOSR) during BCS may guide the surgeon to achieve clear radiographic and histological margins with minimum normal breast tissue excision, thus preserving cosmetic appearance. The aim of this study was to evaluate the effect of introducing the policy of IOSR on the weight of specimens of wide local excision of palpable invasive breast cancer. All consecutive patients who underwent therapeutic wide local excision for palpable invasive breast cancer from 01/01/02 to 31/03/03 were included in this study. A policy of IOSR was introduced in October 2002, thus all BCS done after 01/10/2002 underwent IOSR. The mean (S.D.) specimen weight for the no intra-operative specimen radiograph (NIOSR) group was 74 grams compared to 46 g in the IOSR group, (P = 0.0241, unpaired t-test with Welch's correction) and the mean tumour size for the NIOSR was 23(13)mm and for IOSR was 21(8)mm (P = ns, unpaired t-test with Welch's correction). A histologically clear circumferential margin rate in the IOSR group was 96% compared to 82% in the NIOSR group. Five patients in the IOSR group and 11 in NIOSR group had positive anterior or posterior margin. For these patients no further surgical excision was possible as BCS was performed from skin to pectoral fascia. Therefore a radiation boost was given to the site of excision. Only one patient in the IOSR group needed further breast surgery (mastectomy) for a positive inferior (toward nipple) margin for a mammographically occult tumour, while 11 patients in the NIOSR group required further breast surgery. In conclusion, IOSR is a simple, effective and economical way of assessing adequacy of

  15. Stress distribution in composite flatwise tension test specimens

    Science.gov (United States)

    Scott, Curtis A.; Pereira, J. Michael

    1993-01-01

    A finite element analysis was conducted to determine the stress distribution in typical graphite/epoxy composite flat wise tension (FWT) specimens under normal loading conditions. The purpose of the analysis was to determine the relationship between the applied load and the stress in the sample to evaluate the validity of the test as a means of measuring the out-of-plane strength of a composite laminate. Three different test geometries and three different material lay ups were modeled. In all cases, the out-of-plane component of stress in the test section was found to be uniform, with no stress concentrations, and very close to the nominal applied stress. The stress in the sample was found to be three-dimensional, and the magnitude of in-plane normal and shear stresses varied with the anisotropy of the test specimen. However, in the cases considered here, these components of stress were much smaller than the out-of-plane normal stress. The geometry of the test specimen had little influence on the results. It was concluded that the flat wise tension test provides a good measure of the out-of-plane strength for the representative materials that were studied.

  16. 外科患者常见心理分析及护理对策%The mental analysis and nursing counter measurement of surgical patients

    Institute of Scientific and Technical Information of China (English)

    朱如意; 贾国荣

    2009-01-01

    通过研究外科患者存在的心理问题,给患者提供相应的心理护理,观察心理护理与疾病康复之间的关系.应用发放调查问卷的研究方法,收集外科患者面对各种应激出现的心理反应.不同年龄、不同性别的外科患者存在着不同程度的负面心理反应,通过因地制宜地实施心理护理,患者满意度大幅度增加,生活质量显著提高.心理护理在外科患者的整个护理过程中起着重要的作用.%To supply corresponding mental nursing for patients by investigating their psychic mattem, and to observe the relationshiop between mental nursing and recovery from illness. We collect all kinds of psychic reac-lions of patients under various kinds stress by questionnaires, and next to analyse the results. Surgical patients in different sex and age have different negtive mental reactions,such as helplessnees,gloomy,horror,anger and despair et al. Results show us that satisfactional degree and quality of life of patients increased significantly after providing specific mental nursing to different patients with various mental matters compared with the groups who had not ob-tain enough mental nursing. Mental nursing play an important role in complete care program of surgical patients.

  17. Diagnosis of Desmoplastic Reaction by Immunohistochemical Analysis, in Biopsy Specimens of Early Colorectal Carcinomas, Is Efficacious in Estimating the Depth of Invasion

    Directory of Open Access Journals (Sweden)

    Hiroyuki Mitomi

    2013-06-01

    Full Text Available The aim of our study was to evaluate the diagnosis of desmoplastic reaction (DR by immunostaining for α-smooth muscle actin (αSMA and desmin, for predicting the depth of submucosal invasion in biopsy specimens of early colorectal carcinomas (CRCs. Thirty-eight cases of non-pedunculated early CRCs were included in this study. Positive for DR was defined as αSMA-positive and desmin-negative stroma in the CRC. The depth of submucosal invasion was measured in endoscopically or surgically resected specimens and the lesions were subsequently divided into two groups: Group A (carcinoma in situ/intramucosal carcinoma and submucosal invasive carcinoma with a depth <1000 μm and Group B (submucosal invasion with a depth ≥1000 μm. Twenty-one cases were DR-positive and 17 were DR-negative. No statistical significance was found between the DR with regard to tumor size, location and histological type. All DR-positive cases belonged to Group B whereas 14 (82.4% DR-negative lesions belonged to Group A (p < 0.001. The sensitivity, specificity, positive and negative predictive values and accuracy of DR positivity for diagnosis of Group B were 87.5%, 100%, 100%, 82.4% and 92.1%, respectively. Conclusively, detection of DR in biopsy specimens with ancillary immunohistochemistry (αSMA/desmin would help in preoperative diagnosis for the depth of submucosal invasion of early CRC.

  18. Surgical attire and the operating room: role in infection prevention.

    Science.gov (United States)

    Salassa, Tiare E; Swiontkowski, Marc F

    2014-09-01

    ➤ Although there is some evidence that scrubs, masks, and head coverings reduce bacterial counts in the operating room, there is no evidence that these measures reduce the prevalence of surgical site infection.➤ The use of gloves and impervious surgical gowns in the operating room reduces the prevalence of surgical site infection.➤ Operating-room ventilation plays an unclear role in the prevention of surgical site infection.➤ Exposure of fluids and surgical instruments to the operating-room environment can lead to contamination. Room traffic increases levels of bacteria in the operating room, although the role of this contamination in surgical site infection is unclear.

  19. 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.

  20. Computer assisted surgical anatomy mapping : applications in surgical anatomy research, tailor-made surgery and presonalized teaching

    NARCIS (Netherlands)

    A.L.A. Kerver (Anton)

    2017-01-01

    markdownabstractThis thesis presents a novel anatomy mapping tool named Computer Assisted Surgical Anatomy Mapping (CASAM). It allows researchers to map complex anatomy of multiple specimens and compare their location and course. Renditions such as safe zones or danger zones can be visualized,

  1. Computer assisted surgical anatomy mapping : applications in surgical anatomy research, tailor-made surgery and presonalized teaching

    NARCIS (Netherlands)

    A.L.A. Kerver (Anton)

    2017-01-01

    markdownabstractThis thesis presents a novel anatomy mapping tool named Computer Assisted Surgical Anatomy Mapping (CASAM). It allows researchers to map complex anatomy of multiple specimens and compare their location and course. Renditions such as safe zones or danger zones can be visualized, summa

  2. Differentiation of Metastatic and Non-Metastatic Mesenteric Lymph Nodes by Strain Elastography in Surgical Specimens

    DEFF Research Database (Denmark)

    Havre, R F; Leh, S M; Gilja, O H;

    2016-01-01

    Purpose: To investigate if strain elastography could differentiate between metastatic and non-metastatic mesenteric lymph nodes ex-vivo. Materials and Methods: 90 mesenteric lymph nodes were examined shortly after resection from 25 patients including 17 patients with colorectal cancer and 8 patie...

  3. Rapid and non-enzymatic in vitro retrieval of tumour cells from surgical specimens.

    Directory of Open Access Journals (Sweden)

    Brigitte Mack

    Full Text Available The study of tumourigenesis commonly involves the use of established cell lines or single cell suspensions of primary tumours. Standard methods for the generation of short-term tumour cell cultures include the disintegration of tissue based on enzymatic and mechanical stress. Here, we describe a simple and rapid method for the preparation of single cells from primary carcinomas, which is independent of enzymatic treatment and feeder cells. Tumour biopsies are processed to 1 mm(3 cubes termed explants, which are cultured 1-3 days on agarose-coated well plates in specified medium. Through incisions generated in the explants, single cells are retrieved and collected from the culture supernatant and can be used for further analysis including in vitro and in vivo studies. Collected cells retain tumour-forming capacity in xenotransplantation assays, mimic the phenotype of the primary tumour, and facilitate the generation of cell lines.

  4. Surgical site infection rates following laparoscopic urological procedures.

    Science.gov (United States)

    George, Arvin K; Srinivasan, Arun K; Cho, Jane; Sadek, Mostafa A; Kavoussi, Louis R

    2011-04-01

    Surgical site infections have been categorized by the Centers for Medicare and Medicaid Services as "never events". The incidence of surgical site infection following laparoscopic urological surgery and its risk factors are poorly defined. We evaluated surgical site infection following urological laparoscopic surgery and identified possible factors that may influence occurrence. Patients who underwent transperitoneal laparoscopic procedures during a 4-year period by a single laparoscopic surgeon were retrospectively reviewed. Surgical site infections were identified postoperatively and defined using the Centers for Disease Control criteria. Clinical parameters, comorbidities, smoking history, preoperative urinalysis and culture results as well as operative data were analyzed. Nonparametric testing using the Mann-Whitney U test, multivariable logistic regression and Spearman's rank correlation coefficient were used for data analysis. In 556 patients undergoing urological laparoscopic procedures 14 surgical site infections (2.5%) were identified at mean postoperative day 21.5. Of the 14 surgical site infections 10 (71.4%) were located at a specimen extraction site. Operative time, procedure type and increasing body mass index were significantly associated with the occurrence of surgical site infections (p = 0.007, p = 0.019, p = 0.038, respectively), whereas history of diabetes mellitus (p = 0.071) and intraoperative transfusion (p = 0.053) were found to trend toward significance. Age, gender, positive urine culture, steroid use, procedure type and smoking history were not significantly associated with surgical site infection. Body mass index and operative time remained significant predictors of surgical site infection on multivariate logistic regression analysis. Surgical site infection is an infrequent complication following laparoscopic surgery with the majority occurring at the specimen extraction site. Infection is associated with prolonged operative time and

  5. 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.

  6. Análise de 33 peças cirúrgicas de colectomias laparoscópicas para câncer, durante a curva de aprendizado inicial: margens oncológicas e número de linfonodos não diferem de colectomias abertas Analysis of 33 surgical specimens of laparoscopic resections for colorectal cancer in the early learning curve: margins and nodes harvest do not differ from open resections

    Directory of Open Access Journals (Sweden)

    Augusto Motta Neiva

    2010-03-01

    no início da experiência com colectomia laparoscópica, os critérios para ressecção oncológica podem ser preservados quando os procedimentos são realizados por cirurgiões especialistas trabalhando com equipe especializada em patologia gastrointestinal.INTRODUCTION: Colorectal laparoscopic surgery is considered a procedure with long learning curve. Despite surgeons with experience in laparoscopic surgery are able to achieve the same oncological results obtained in open procedures, it is important to evaluate if these good results are sustained during the learning curve. The aim of this study was to evaluate the adequacy of the margins and the lymph nodes harvest in early learning curve of laparoscopic colectomies performed by specialized surgeons compared to open colectomies. METHODS: Thirty-three surgical specimens of laparoscopic resections for colorectal cancer performed during the early learning curve were evaluated. The following data were analyzed: age, sex, tumor location, pathologic classification, lymph node harvest and proximal and distal margins. Data were compared to a control group of 45 open resections for colorectal cancer. RESULTS: Age, tumor location and Dukes classification of laparoscopic and open groups were similar. Laparoscopic group had more female patients. Distal margins were similar between the groups [mean of 7,15 cm (SD ± 9,98 for open and 8,26 cm (SD ± 11,5 for laparoscopic group, p=NS]. There was no difference in the lymph nodes harvest between the groups. The mean of lymph nodes harvest of open and laparoscopic groups were 19 (SD ± 19,41 and 21 (SD ± 14,73, respectively, (p=NS. CONCLUSION: Oncologic margins and lymph nodes harvest obtained during early learning curve of laparoscopic resections were similar to open procedures. Despite the natural difficulties faced during early learning curve, oncologic criteria can be achieved when laparoscopic colorectal resections are performed by specialized surgeons working with

  7. Measuring ERCC1 protein expression in cancer specimens

    DEFF Research Database (Denmark)

    Smith, David Hersi; Fiehn, Anne-Marie Kanstrup; Fogh, Louise

    2014-01-01

    Platinum chemotherapy remains part of standard therapies in the management of a variety of cancers. Severe side effects and a high degree of resistance to platinum drugs have led numerous researchers to search for predictive biomarkers, which could aid in identifying patients that are the most...... likely to respond to therapy. The ERCC1-ERCC4 endonuclease plays a critical role in the repair of platinum-DNA damage and has widely been studied in relation to sensitivity to platinum chemotherapy. The standard method to evaluate ERCC1 protein expression is through the use of immunohistochemistry...

  8. Acoustic Measurement of the Mechanical Properties of Thin Material Specimens

    Science.gov (United States)

    1992-05-15

    Principal Director, Mechanics and Materials Technology Center. Paul M. Propp was the project officer for the Mission-Oriented Investigation and...for the exchange and stimulation of ideas. MARTIN K. WILLIAMS, Capt, USAF PAUL M. PROPP Mgr, Space Systems Integration Wright Laboratory West Coast

  9. Measurements and Counts for Larval and Juvenile Bramidae Specimens

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Micronekton and plankton samples were collected at the Southeast (SE) Hancock Seamount in 1985-1987, and in the vicinity of Palmyra Atoll, Line Islands in 1990....

  10. Measurements and Counts for Larval and Juvenile Beryx Specimens

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Larval alfonsin (Beryx species) were collected in the vicinity of the Southeast Hancock Seamount. A three-net Tucker trawl (I m2 effective mouth opening and 0.333 mm...

  11. Measurements and Counts for Larval and Juvenile Pseudopentaceros Specimens

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Armorhead (Pseudopentaceros wheeleri) larvae and juveniles were collected in the vicinity of the Northwest and Southeast Hancock Seamounts During 1984 and 1985....

  12. Is routine histopathology of tonsil specimen necessary?

    Directory of Open Access Journals (Sweden)

    Agida S Adoga

    2011-01-01

    Full Text Available Background: Tonsillar diseases are common in paediatric and adult otolaryngological practice. These diseases require tonsillectomy. Specimens are subjected to histopathology routinely in my institution for fear of infections and tumour without consideration for risk factors. The financial burden is on the patients and waste of histopathologist′s man hour because other specimens are left un-attended. This study aims to find out the necessity of routine histopathology of tonsil specimens. Materials and Methods : A 2 year retrospective review of the histopathological results of two (paediatric and adult groups of 61 patients managed for tonsillar diseases at the ENT UNIT of Jos University Teaching Hospital from July 2005 to June, 2007. Data extracted included biodata, clinical features and histopathological diagnosis. Result : The 61 patients comprise 35 children and 26 adults. The youngest and oldest paediatric patients were 1 year and 3 months and 16 years respectively, a range of 1 year 3 months to 16 years. The youngest and oldest adults were 17 and 50 years with a range of 17-50 years. Groups mean ages were 5.1 and 28.5 years. The gender ratios were 1:2.7 and 1:1.9 respectively. One adult was HIV positive. The histopathological diagnosis were chronic nonspecific tonsillitis in 10(16.6%, follicular tonsillitis in 23(38.3%, chronic suppurative tonsillitis in 10(16.6%, lymphoid hyperplasia in 18(30.0% and lymphoma in 1(1.0% respectively. Conclusion : Histopathologic request for tonsillectomy specimens should be based on certain risk factors with consideration of the cost to patients and to spare the histopathologist′s man hour.

  13. SQA specimen paper 2013, national 5, French

    CERN Document Server

    SQA

    2013-01-01

    Practise for your exam on the offical National 5 specimen paper from the Scottish Qualifications Authority. Plus each book includes additional model papers and extra revision guidance, making them an essential purchase for any student.; Discover how to get your best grade with answers checked by senior examiners.; Prepare for your exams with study skills guidance sections.; Gain vital extra marks and avoid common mistakes with examiner tips

  14. Damage modeling in Small Punch Test specimens

    DEFF Research Database (Denmark)

    Martínez Pañeda, Emilio; Cuesta, I.I.; Peñuelas, I.

    2016-01-01

    Ductile damage modeling within the Small Punch Test (SPT) is extensively investigated. The capabilities ofthe SPT to reliably estimate fracture and damage properties are thoroughly discussed and emphasis isplaced on the use of notched specimens. First, different notch profiles are analyzed...... and constraint conditionsquantified. The role of the notch shape is comprehensively examined from both triaxiality and notchfabrication perspectives. Afterwards, a methodology is presented to extract the micromechanical-basedductile damage parameters from the load-displacement curve of notched SPT samples...

  15. 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.

  16. Incidental prostate cancer in radical cystoprostatectomy specimens

    Institute of Scientific and Technical Information of China (English)

    Xiao-Dong Jin; Zhao-Dian Chen; Bo Wang; Song-Liang Cai; Xiao-Lin Yao; Bai-Ye Jin

    2008-01-01

    Aim: To investigate the rates of prostate cancer (Pca) in radical cystoprostatectomy (RCP) specimens for bladder cancer in mainland China. To determine the follow-up outcome of patients with two concurrent cancers and identify whether prostate-specific antigen (PSA) is a useful tool for the detection of Pca prior to surgery. Methods: From January 2002 to January 2007, 264 male patients with bladder cancer underwent RCP at our center. All patients underwent digital rectal examination (DRE) and B ultrasound. Serum PSA levels were tested in 168 patients. None of the patients had any evidence of Pca before RCP. Entire prostates were embedded and sectioned at 5 mm intervals. Results: Incidental Pca was observed in 37 of 264 (14.0%) RCP specimens. Of these, 12 (32.4%) were clinically significant according to an accepted definition. The PSA levels were not significantly different between patients with Pca and those without Pca, nor between patients with significant Pca and those with insignificant Pca. Thirty-four patients with incidental Pca were followed up. During a mean follow-up period of 26 months, two patients with PSA > 4 ng/mL underwent castration. None of the patients died of Pca. Conclusion: The incidence of Pca in RCP specimens in mainland China is lower than that in most developed countries. PSA cannot identify asymptomatic Pca prior to RCP. In line with published reports, incidental Pca does not impact the prognosis of bladder cancer patients undergoing RCP.

  17. Preinjury and postinjury running analysis along with measurements of strength and tendon length in a patient with a surgically repaired Achilles tendon rupture.

    Science.gov (United States)

    Silbernagel, Karin Grävare; Willy, Richard; Davis, Irene

    2012-06-01

    Case report. The Achilles tendon is the most frequently ruptured tendon, and the incidence of Achilles tendon rupture has increased in the last decade. The rupture generally occurs without any preceding warning signs, and therefore preinjury data are seldom available. This case represents a unique opportunity to compare preinjury running mechanics with postinjury evaluation in a patient with an Achilles tendon rupture. A 23-year-old female sustained a right complete Achilles tendon rupture while playing soccer. Running mechanics data were collected preinjury, as she was a healthy participant in a study on running analysis. In addition, patient-reported symptoms, physical activity level, strength, ankle range of motion, heel-rise ability, Achilles tendon length, and running kinetics were evaluated 1 year after surgical repair. During running, greater ankle dorsiflexion and eversion and rearfoot abduction were noted on the involved side postinjury when compared to preinjury data. In addition, postinjury, the magnitude of all kinetics data was lower on the involved limb when compared to the uninvolved limb. The involved side displayed differences in strength, ankle range of motion, heel rise, and tendon length when compared to the uninvolved side 1 year after injury. Despite a return to normal running routine and reports of only minor limitations with running, considerable changes were noted in running biomechanics 1 year after injury. Calf muscle weakness and Achilles tendon elongation were also found when comparing the involved and uninvolved sides.

  18. An advanced digital image-capture computer system for gross specimens: a substitute for gross description.

    Science.gov (United States)

    Leong, A S; Visinoni, F; Visinoni, C; Milios, J

    2000-05-01

    The description of macroscopic appearances of surgically excised specimens together with the sites of specimen sampling form an important component in the documentation of a histopathology specimen. Unfortunately, accuracy of description depends on the vocabulary and descriptive prowess of the pathologist which means that the result can be variable. Transcription of the dictated word also takes time and involves typists. We developed a user-friendly, high-resolution image capture system that will supplement word description of macroscopic specimens and has the potential to replace it completely. It also provides the opportunity of revisiting traditional methods of documenting specimens with words, allowing the production of more relevant and user-friendly reports containing information relevant to clinical management and supplemented by high-resolution digital images. The accompanying Windows-based software has capabilities of generating the entire histopathology report and allows rapid retrospective searches through any one of several common search parameters. The stored images form a powerful database for teaching and research. Connection to remote transmission facilities allows teleconferencing and telepathology consultations.

  19. 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

  20. 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...

  1. 42 CFR 493.1232 - Standard: Specimen identification and integrity.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 5 2010-10-01 2010-10-01 false Standard: Specimen identification and integrity... Nonwaived Testing General Laboratory Systems § 493.1232 Standard: Specimen identification and integrity. The... optimum integrity of a patient's specimen from the time of collection or receipt of the specimen through...

  2. Specimen loading list for the varying temperature experiment

    Energy Technology Data Exchange (ETDEWEB)

    Qualls, A.L.; Sitterson, R.G. [Oak Ridge National Lab., TN (United States)

    1998-09-01

    The varying temperature experiment HFIR-RB-13J has been assembled and inserted in the reactor. Approximately 5300 specimens were cleaned, inspected, matched, and loaded into four specimen holders. A listing of each specimen loaded into the steady temperature holder, its position in the capsule, and the identification of the corresponding specimen loaded into the varying temperature holder is presented in this report.

  3. HMSRP Hawaiian Monk Seal Specimen Data (includes physical specimens, collection information, status, storage locations, and laboratory results associated with individual specimens)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This data set includes physical specimens, paper logs and Freezerworks database of all logged information on specimens collected from Hawaiian monk seals since 1975....

  4. Evaluations of the Irwin. beta. /sub Ic/ adjustment for small specimen fracture toughness data

    Energy Technology Data Exchange (ETDEWEB)

    Merkle, J.G.

    1983-01-01

    When small specimens are used to measure the cleavage fracture toughness of pressure vessel steels in the transition range of temperature, specimen thickness size effects and large amounts of data scatter are often observed. The size effects are manifested by an increase in the average value of fracture toughness with decreasing specimen thickness, eventually resulting in a change in fracture mode from cleavage to ductile tearing. It has been shown that a semiempirical adjustment for the interacting effects of specimen thickness, yield stress and toughness originally proposed by Irwin is capable of reducing the calculated values of toughness and data scatter to levels consistent with large specimen test data. This is true for dynamic as well as for static initiation toughness values. The nature of the size effect described by the Irwin ..beta../sub Ic/ equation is illustrated and specific cases are shown in which ..beta../sub Ic/ adjustment has eliminated size effects, for both static and dynamic fracture toughness data.

  5. The use of finger-stick blood to assess lactate in critically ill surgical patients.

    Science.gov (United States)

    Sabat, Joseph; Gould, Scott; Gillego, Ezra; Hariprashad, Anita; Wiest, Christine; Almonte, Shailyn; Lucido, David J; Gave, Asaf; Leitman, I Michael; Eiref, Simon D

    2016-09-01

    Using finger-stick capillary blood to assess lactate from the microcirculation may have utility in treating critically ill patients. Our goals were to determine how finger-stick capillary lactate correlates with arterial lactate levels in patients from the surgical intensive care unit, and to compare how capillary and arterial lactate trend over time in patients undergoing resuscitation for shock. Capillary whole blood specimens were obtained from finger-sticks using a lancet, and assessed for lactate via a handheld point-of-care device as part of an "investigational use only" study. Comparison was made to arterial blood specimens that were assessed for lactate by standard laboratory reference methods. 40 patients (mean age 68, mean APACHEII 18, vasopressor use 62%) were included. The correlation between capillary and arterial lactate levels was 0.94 (p < 0.001). Capillary lactate measured slightly higher on average than paired arterial values, with a mean difference 0.99 mmol/L. In patients being resuscitated for septic and hemorrhagic shock, capillary and arterial lactate trended closely over time: rising, peaking, and falling in tandem. Clearance of capillary and arterial lactate mirrored clinical improvement, normalizing in all patients except two that expired. Finger-stick capillary lactate both correlates and trends closely with arterial lactate in critically ill surgical patients, undergoing resuscitation for shock.

  6. National Surgical Quality Improvement Program-Pediatric (NSQIP) and the Quality of Surgical Care in Pediatric Orthopaedics.

    Science.gov (United States)

    Brighton, Brian K

    2015-01-01

    In recent years, the safety, quality, and value of surgical care have become increasingly important to surgeons and hospitals. Quality improvement in surgical care requires the ability to collect, measure, and act upon reliable and clinically relevant data. One example of a large-scale quality effort is the American College of Surgeons National Surgical Quality Improvement Program-Pediatric (ACS NSQIP-Pediatric), the only nationwide, risk-adjusted, outcomes-based program evaluating pediatric surgical care.

  7. Response of a PGNAA setup for pozzolan-based cement concrete specimens

    Energy Technology Data Exchange (ETDEWEB)

    Naqvi, A.A. [Department of Physics, King Fahd University of Petroleum and Minerals, Dhahran 31261 (Saudi Arabia)], E-mail: aanaqvi@kfupm.edu.sa; Garwan, M.A. [Department of Physics, King Fahd University of Petroleum and Minerals, Dhahran 31261 (Saudi Arabia); Maslehuddin, M. [Center for Engineering Research, Research Institute, King Fahd University of Petroleum and Minerals, Dhahran 31261 (Saudi Arabia); Nagadi, M.M. [Department of Physics, King Fahd University of Petroleum and Minerals, Dhahran 31261 (Saudi Arabia); Al-Amoudi, O.S.B. [Department of Civil Engineering, King Fahd University of Petroleum and Minerals, Dhahran 31261 (Saudi Arabia); Raashid, M. [Department of Physics, King Fahd University of Petroleum and Minerals, Dhahran 31261 (Saudi Arabia)

    2010-04-15

    Pozzolanic materials are added to Portland cement concrete to increase its durability, particularly corrosion-resistance. In this study the elemental composition of a pozzolanic cement concrete was measured non-destructively utilizing an accelerator-based Prompt Gamma Ray Neutron Activation Analysis (PGNAA) setup. The optimum size of the pozzolanic cement concrete specimen was obtained through Monte Carlo simulations. The simulation results were experimentally verified through the {gamma}-ray yield measurement from the pozzolanic cement concrete specimens as a function of their radii. The concentration of the pozzolanic material in the cement concrete specimens was evaluated by measuring {gamma}-ray yield for calcium and iron from pozzolanic cement concrete specimens containing 5-80 wt% pozzolan. A good agreement was noted between the experimental values and the Monte Carlo simulation results, indicating an excellent response of the KFUPM accelerator-based PGNAA setup for pozzolan based concrete.

  8. Response of a PGNAA setup for pozzolan-based cement concrete specimens.

    Science.gov (United States)

    Naqvi, A A; Garwan, M A; Maslehuddin, M; Nagadi, M M; Al-Amoudi, O S B; Raashid, M

    2010-01-01

    Pozzolanic materials are added to Portland cement concrete to increase its durability, particularly corrosion-resistance. In this study the elemental composition of a pozzolanic cement concrete was measured non-destructively utilizing an accelerator-based Prompt Gamma Ray Neutron Activation Analysis (PGNAA) setup. The optimum size of the pozzolanic cement concrete specimen was obtained through Monte Carlo simulations. The simulation results were experimentally verified through the gamma-ray yield measurement from the pozzolanic cement concrete specimens as a function of their radii. The concentration of the pozzolanic material in the cement concrete specimens was evaluated by measuring gamma-ray yield for calcium and iron from pozzolanic cement concrete specimens containing 5-80 wt% pozzolan. A good agreement was noted between the experimental values and the Monte Carlo simulation results, indicating an excellent response of the KFUPM accelerator-based PGNAA setup for pozzolan based concrete.

  9. Wildlife specimen collection, preservation, and shipment

    Science.gov (United States)

    White, C. LeAnn; Dusek, Robert J.; Franson, J. Christian; Friend, Milton; Gibbs, Samantha E.J.; Wild, Margaret A.

    2015-01-01

    Specimens are used to provide supporting information leading to the determination of the cause of disease or death in wildlife and for disease monitoring or surveillance. Commonly used specimens for wildlife disease investigations include intact carcasses, tissues from carcasses, euthanized or moribund animals, parasites, ingested food, feces, or environmental samples. Samples from live animals or the environment (e.g., contaminated feed) in the same vicinity as a mortality event also may be helpful. The type of specimen collected is determined by availability of samples and biological objectives. Multiple fresh, intact carcasses from affected species are the most useful in establishing a cause for a mortality event. Submission of entire carcasses allows observation of gross lesions and abnormalities, as well as disease testing of multiple tissues. Samples from live animals may be more appropriate when sick animals cannot be euthanized (e.g., threatened or endangered species) or for research and monitoring projects examining disease or agents circulating in apparently healthy animals or those not exhibiting clinical signs. Samples from live animals may include collections of blood, hair, feathers, feces, or ectoparasites, or samples obtained by swabbing lesions or orifices. Photographs and videos are useful additions for recording field and clinical signs and conveying conditions at the site. Collection of environmental samples (e.g., feces, water, feed, or soil) may be appropriate when animals cannot be captured for sampling or the disease agent may persist in the environment. If lethal collection is considered necessary, biologists should refer to the policies, procedures, and permit requirements of their institution/facility and the agency responsible for species management (U.S. Fish and Wildlife Service or State natural resource agency) prior to use in the field. If threatened or endangered species are found dead, or there is evidence of illegal take, field

  10. Histological evaluation of 400 cholecystectomy specimens

    Directory of Open Access Journals (Sweden)

    H Kumar

    2015-09-01

    Full Text Available Background: A majority of gallbladder specimens show changes associated with chronic cholecystitis; however few harbour a highly lethal carcinoma. This study was conducted to review the significant histopathological findings encountered in gallbladder specimens received in our laboratory.Materials and Methods: Four hundred cholecystectomy specimens were studied over a period of five years (May, 2002 to April, 2007 received at department of pathology, Kasturba Medical College, Mangalore, India. Results: Gallstones and associated diseases were more common in women in the 4th to 5th decade as compared to men with M: F ratio of 1:1.33. Maximum number of patients (28.25% being 41 to 50 years old. Histopathologically, the most common diagnosis was chronic cholecystitis (66.75%, followed by chronic active cholecystitis (20.25%, acute cholecystitis (6%, gangrenous cholecystitis (2.25%,xanthogranulomatous cholecystitis (0.50%, empyema (1%, mucocele (0.25%, choledochal cyst (0.25%, adenocarcinoma gallbladder (1.25% and  normal  gallbladders (1%.Conclusion: All lesions were found more frequently in women except chronic active cholecystitis. Gallstones were present in (80.25% cases, and significantly associated with various lesions (P value 0.009. Pigment stones were most common, followed by cholesterol stones and mixed stones. Adequate  sectioning  is  mandatory  in  all  cases  to  assess  epithelial changes arising from cholelithiasis and chronic cholecystitis as it has been known to progress to malignancy in some cases.

  11. 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.

  12. Isolation of Klebsiella terrigena from clinical specimens.

    Science.gov (United States)

    Podschun, R; Ullmann, U

    1992-04-01

    In a three-year survey conducted from 1988 to 1990 Klebsiella isolates from human clinical specimens were subjected to additional tests to identify any Klebsiella terrigena strains. Ten strains of Klebsiella terrigena (0.4%) were found among 2355 indole-negative Klebsiella isolates. Most of the isolates were recovered from the respiratory tract. In the API20EC system almost exclusively biotypes no. 1777771 and 1777671 were observed. Serotyping revealed capsule types K2, K5 and K18 in two strains each. In antibiotic susceptibility tests the strains were shown to be comparable in sensitivity to Klebsiella pneumoniae.

  13. 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.

  14. 胸外科手术后医院获得性肺炎的前瞻性监测与干预研究%Prospective monitoring of hospital acquired pneumonia in thoracic surgical patients and intervention measures

    Institute of Scientific and Technical Information of China (English)

    仝宇红; 钱雪松; 郑颖; 刘冰慧; 张金梁; 刘维伟; 田春风; 邢江涛

    2014-01-01

    Objective To study the prevention and control measures for hospital acquired pneumonia in thoracic surgical patients.Methods Using the prospective monitoring,morbidity rate of hospital acquired pneumonia in thoracic surgical patients was monitored.The cluster intervention measures were taken,such as education training,strictly disinfecting the respirator duct,raising up the patients'bedside 30°,conducting oral cavity nursing with hlorhexidine,making assessment everyday to determine the withdrawal of the respirator,and strict hand hygiene.Results By cluster intervention measures,the implementation of hand hygienc of the medical staff was significantly improved; intervention measures including raising up the patients' bedside 30°,conducting oral cavity nursing with hlorhexidine,making assessment everyday to determine the withdrawal of the respirator were enforced well.The morbidity rate of hospital acquired pneumonia in thoracic surgical patients fell from 25.87% to 9.02% (P <0.05).Conclusions It is a positive significance for the prevention and control of the hospital acquired pneumonia in thoracic surgical patients through cluster intervention measures.%目的 探讨胸外科手术后医院获得性肺炎的预防控制措施.方法 采用前瞻性监测方法,通过集束干预包括加强培训、呼吸机管路的严格消毒、床头抬高30°、洗必泰口腔护理、每天评估是否撤机、加强手卫生等综合措施,监测胸外科手术后医院获得性肺炎发病率.结果 通过集束干预措施,手卫生依从率明显提高,床头抬高30°、洗必泰口腔护理每2~6小时1次、每天评估是否撤机干预措施执行情况优于干预前,胸外科手术后医院获得性肺炎发病率由监测前的25.87%下降至9.02%,差异有统计学意义(x2 =44.956,P<0.05).结论 开展前瞻性监测,实施集束干预措施,对控制胸外科手术后医院获得性肺炎有积极意义,降低了手术后医院获得性肺炎的发病率.

  15. Occult cancer in specimens of reduction mammaplasty aimed at symmetrization. A multicentric study of 2718 patients.

    Science.gov (United States)

    Sorin, T; Fyad, J P; Delay, E; Rouanet, P; Rimareix, F; Houpeau, J L; Classe, J M; Garrido, I; Tunon De Lara, C; Dauplat, J; Bendavid, C; Houvenaeghel, G; Clough, K B; Sarfati, I; Leymarie, N; Trudel, M; Salleron, J; Guillemin, F; Oldrini, G; Brix, M; Dolivet, G; Simon, E; Verhaeghe, J L; Marchal, F

    2015-06-01

    Women who have undergone surgical treatment for breast cancer often benefit from a contralateral reduction mammaplasty (CRM) aimed at symmetrization of the contralateral breast unaffected by the initial cancer. In our 7-year multicentric study (12 centers) of 2718 patients, incidence of CRM cancers (CRMc) was 1.47% (n = 40) [95% CI 1.05%-2.00%]. The CRMc group had significantly more initial mammary cancers of invasive lobular carcinoma (ILC, 22.5% vs 12.0%) and ductal carcinoma in situ (DCIS, 35.0% vs 21.6%) types than the healthy CRM group (p = 0.017). 35.0% (n = 14) of patients had en bloc resection; 25.0% (n = 10) of surgical specimens were correctly oriented. En bloc resection and orientation of surgical specimens enable precise pinpointing of the CRMc. A salvage lumpectomy may be proposed as an option when margins are invaded. The histological distribution of the 40 CRMc (mean size 12.7 mm) was carcinoma in situ (CIS) 70%, ILC 12.5%, invasive ductal carcinoma (IDC) 12.5% and tubular carcinoma (TC) 5.0%. Copyright © 2015 Elsevier Ltd. All rights reserved.

  16. 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 ...

  17. 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....

  18. 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/ ...

  19. Generation of R-Curve from 4ENF Specimens: An Experimental Study

    Directory of Open Access Journals (Sweden)

    V. Alfred Franklin

    2014-01-01

    Full Text Available The experimental determination of the resistance to delamination is very important in aerospace applications as composite materials have superior properties only in the fiber direction. To measure the interlaminar fracture toughness of composite materials, different kinds of specimens and experimental methods are available. This article examines the fracture energy of four-point end-notched flexure (4ENF composite specimens made of carbon/epoxy and glass/epoxy. Experiments were conducted on these laminates and the mode II fracture energy, GIIC, was evaluated using compliance method and was compared with beam theory solution. The crack growth resistance curve (R-curve for these specimens was generated and the found glass/epoxy shows higher toughness values than carbon/epoxy composite. From this study, it was observed that R-curve effect in 4ENF specimens is quite mild, which means that the measured delamination toughness, GIIC, is more accurate.

  20. Molecular markers in the surgical margin of oral carcinomas

    DEFF Research Database (Denmark)

    Bilde, A.; Buchwald, C. von; Dabelsteen, E.;

    2009-01-01

    BACKGROUND: Local or regional lymph node recurrence is the most common pattern of treatment failure in oral squamous cell carcinoma (SCC). The local recurrence rate is 30% even when the surgical resection margin is diagnosed as tumour free. Accumulation of genetic changes in histologically normal...... epithelium in the surgical resection margin may explain the local recurrence rate. The purpose of this study is to investigate the presence of senescence markers, which may represent early malignant changes in the margin that in routine pathological evaluations are classified as histologically normal....... METHODS: Formalin-fixed, paraffin-embedded surgical specimens from 16 consecutive patients with oral SCC and a clear surgical margin were obtained. The margin was analysed by immunohistochemistry for p53, p16, Chk2, Laminin-5 and glycosylated oncofetal fibronectin. RESULTS: Two patterns of p53 expression...

  1. Mastoidectomy: anatomical parameters x surgical difficulty

    Directory of Open Access Journals (Sweden)

    Pereira Júnior, Anastácio Rodrigues

    2012-01-01

    Full Text Available Introduction: The lowered temporal meninges and/ or anterior sigmoid sinus are contiditions that can determine surgical difficulties in performing mastoidectomy. Objective: To correlate in the tomography the extent of the prolapse of the sigmoid sinus and of temporal meninges with the surgical difficulty in the mastoidectomy. Method: The tomographic measurements of prolapse sigmoid and of temporal meninges were correlated with the presence or non-presence of the surgical difficulty observed during the mastoidectomy procedure in patients with ostomatoiditis chronic (n=30. Form of study: Contemporary cohort transverse. Results: In 10 patients were observed surgical difficulty distributed as: due to prolapse of the sigmoid sinus (n = 2 or temporal meninges prolapse (n = 7 or both (n = 1. In patients in which the surgical difficulty was due to sigmoid sinus prolapse, the tomography distance of the anterior border of the sigmoid sinus to posterior wall of external auditory canal was lower than 9 mm. In patients in which surgical difficulty was due to temporal meninges prolapse, the tomographic distance to the upper plane of the petrous bone was 7 mm. Conclusion: The computerized tomography distance between the temporal meninges and the upper plane of the petrous bone 7 mm and the distance of the anterior border of the sigmoid sinus to posterior wall of external auditory canal was lower than 9 mm are predictive to the surgical difficulties to perform mastoidectomy.

  2. Do psychological variables affect early surgical recovery?

    Directory of Open Access Journals (Sweden)

    Michael N Mavros

    Full Text Available BACKGROUND: Numerous studies have examined the effect of psychological variables on surgical recovery, but no definite conclusion has been reached yet. We sought to examine whether psychological factors influence early surgical recovery. METHODS: We performed a systematic search in PubMed, Scopus and PsycINFO databases to identify studies examining the association of preoperative psychological variables or interventions with objectively measured, early surgical outcomes. RESULTS: We identified 16 eligible studies, 15 of which reported a significant association between at least one psychological variable or intervention and an early postoperative outcome. However, most studies also reported psychological factors not influencing surgical recovery and there was significant heterogeneity across the studies. Overall, trait and state anxiety, state anger, active coping, subclinical depression, and intramarital hostility appeared to complicate recovery, while dispositional optimism, religiousness, anger control, low pain expectations, and external locus of control seemed to promote healing. Psychological interventions (guided relaxation, couple support visit, and psychiatric interview also appeared to favor recovery. Psychological factors unrelated to surgical outcomes included loneliness, perceived social support, anger expression, and trait anger. CONCLUSION: Although the heterogeneity of the available evidence precludes any safe conclusions, psychological variables appear to be associated with early surgical recovery; this association could bear important implications for clinical practice. Large clinical trials and further analyses are needed to precisely evaluate the contribution of psychology in surgical recovery.

  3. Relationship between patient complaints and surgical complications

    Science.gov (United States)

    Murff, H J; France, D J; Blackford, J; Grogan, E L; Yu, C; Speroff, T; Pichert, J W; Hickson, G B

    2006-01-01

    Background Patient complaints are associated with increased malpractice risk but it is unclear if complaints might be associated with medical complications. The purpose of this study was to determine whether an association exists between patient complaints and surgical complications. Methods A retrospective analysis of 16 713 surgical admissions was conducted over a 54 month period at a single academic medical center. Surgical complications were identified using administrative data. The primary outcome measure was unsolicited patient complaints. Results During the study period 0.9% of surgical admissions were associated with a patient complaint. 19% of admissions associated with a patient complaint included a postoperative complication compared with 12.5% of admissions without a patient complaint (p = 0.01). After adjusting for surgical specialty, co‐morbid illnesses and length of stay, admissions with complications had an odds ratio of 1.74 (95% confidence interval 1.01 to 2.98) of being associated with a complaint compared with admissions without complications. Conclusions Admissions with surgical complications are more likely to be associated with a complaint than surgical admissions without complications. Further research is necessary to determine if patient complaints might serve as markers for poor clinical outcomes. PMID:16456204

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

    Directory of Open Access Journals (Sweden)

    Andersson Annette Erichsen

    2012-06-01

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

  5. Deginerative changes of femoral articular cartilage in the knee : comparative study of specimen sonography and pathology

    Energy Technology Data Exchange (ETDEWEB)

    Park, Ju Youn; Hong, Sung Hwan; Sohn, Jin Hee; Wee, Young Hoon; Chang, Jun Dong; Park, Hong Seok; Lee, Eil Seoung; Kang Ik Won [Hallym Univ. College of Medicine, Seoul (Korea, Republic of)

    2001-04-01

    To determine the sonographic findings of degenerative change in femoral articular cartilage of the knee by comparative study of specimen sonography and pathology. We obtained 40 specimens of cartilage of the femur (20 medial and 20 lateral condylar) from 20 patients with osteoarthritis of the knee who had undergone total knee replacement. The specimens were placed in a saline-filled container and sonography was performed using a 10-MHz linear transducer. Sonographic abnormalities were evaluated at the cartilage surface, within the cartilage, and at the bone-cartilage interface, and were compared with the corresponding pathologic findings. In addition, cartilage thickness was measured at a representative portion of each femoral cartilage specimen and was compared with the thickness determined by sonography. 'Dot' lesions, irregularity or loss of the hyperechoic line, were demonstrated by sonography at the saline-cartilage interface of 14 cartilages. Pathologic examination showed that these findings corresponded to cleft, detachment, erosion, and degeneration. Irregularities in the hyperechoic line at the bone-cartilage interface were revealed by sonography in eight cartilages and were related to irregularity or loss of tidemark, downward displacement of the cartilage, and subchondral callus formation. Dot lesions, corresponding to cleft and degeneration, were noted within one cartilage. Cartilage thickness measured on specimen and by sonography showed no significant difference (p=0.446). Specimen sonography suggested that articular cartilage underwent degenerative histopathological change. Cartilage thickness measured by sonography exactly reflected real thickness.

  6. Enzymatic detection of formalin-fixed museum specimens for DNA analysis and enzymatic maceration of formalin-fixed specimens

    DEFF Research Database (Denmark)

    Sørensen, Margrethe; Redsted Rasmussen, Arne; Simonsen, Kim Pilkjær

    2016-01-01

    % ethanol. The method was subsequently tested on wild-living preserved specimens and an archived specimen. The protease enzyme used was SavinaseH 16 L, Type EX from Novozymes A/S. The enzymatic screening test demands only simple laboratory equipment. The method is useful for natural history collections...... in museums where DNA analyses of archived specimens are performed. Wasted time and resources can be avoided through the detection of formalin-fixed specimens because these specimens yield low-quality, damaged DNA. In addition to the screening method, it is shown that formalin-preserved specimens can...

  7. Reheating of zinc-titanate sintered specimens

    Directory of Open Access Journals (Sweden)

    Labus N.

    2015-01-01

    Full Text Available The scope of this work was observing dimensional and heat transfer changes in ZnTiO3 samples during heating in nitrogen and air atmosphere. Interactions of bulk specimens with gaseous surrounding induce microstructure changes during heating. Sintered ZnTiO3 nanopowder samples were submitted to subsequent heating. Dilatation curves and thermogravimetric with simultaneous differential thermal analysis TGA/DTA curves were recorded. Reheating was performed in air and nitrogen atmospheres. Reheated samples obtained at different characteristic temperatures in air were analyzed by X-ray diffraction (XRD. Microstructures obtained by scanning electron microscopy (SEM of reheated sintered samples are presented and compared. Reheating in a different atmosphere induced different microstructures. The goal was indicating possible causes leading to the microstructure changes. [Projekat Ministarstva nauke Republike Srbije, br. OI172057 i br. III45014

  8. Dissolution of bulk specimens of silicon nitride

    Science.gov (United States)

    Davis, W. F.; Merkle, E. J.

    1981-01-01

    An accurate chemical characterization of silicon nitride has become important in connection with current efforts to incorporate components of this material into advanced heat engines. However, there are problems concerning a chemical analysis of bulk silicon nitride. Current analytical methods require the pulverization of bulk specimens. A pulverization procedure making use of grinding media, on the other hand, will introduce contaminants. A description is given of a dissolution procedure which overcomes these difficulties. It has been found that up to at least 0.6 g solid pieces of various samples of hot pressed and reaction bonded silicon nitride can be decomposed in a mixture of 3 mL hydrofluoric acid and 1 mL nitric acid overnight at 150 C in a Parr bomb. High-purity silicon nitride is completely soluble in nitric acid after treatment in the bomb. Following decomposition, silicon and hydrofluoric acid are volatilized and insoluble fluorides are converted to a soluble form.

  9. 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.

  10. 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.

  11. Tensile test of dumbbell-shaped specimen in thickness direction

    Science.gov (United States)

    Iizuka, Takashi

    2016-10-01

    Sheet metal forming is widely used in manufacturing shops, and evaluation of forming limit for sheet metal is important. However, specimen shape influences on the fracture of the sheet metal. As one of methods to decrease these effects, an uniaxial tensile test using specimen dumbbell-shaped in thickness direction had been examined using FEM analysis. In this study, actually specimen dumbbell-shaped in thickness direction was fabricated using a new incremental sheet forging method, and uniaxial tensile test was conducted. Load-stroke diagram, fracture morphologies, stress-strain curves and shape after fracture were investigated, and effects of specimen shape were considered. Elongation was larger as using specimen dumbbell-shaped in the width direction. Stress-strain curves until necking occurred were less influenced by specimen shape. However, yield stress decreased and local elongation increased as using specimen dumbbell-shaped in the width direction. The reasons why these tendencies showed were considered in the view of specimen shapes.

  12. A new specimen management system using RFID technology.

    Science.gov (United States)

    Shim, Hun; Uh, Young; Lee, Seung Hwan; Yoon, Young Ro

    2011-12-01

    The specimen management system with barcode needs to be improved in order to solve inherent problems in work performance. This study describes the application of Radio Frequency Identification (RFID) which is the solution for the problems associated with specimen labeling and management. A new specimen management system and architecture with RFID technology for clinical laboratory was designed. The suggested system was tested in various conditions such as durability to temperature and aspect of effective utilization of new work flow under a virtual hospital clinical laboratory environment. This system demonstrates its potential application in clinical laboratories for improving work flow and specimen management. The suggested specimen management system with RFID technology has advantages in comparison to the traditional specimen management system with barcode in the aspect of mass specimen processing, robust durability of temperature, humidity changes, and effective specimen tracking.

  13. A non-destructive DNA sampling technique for herbarium specimens.

    Science.gov (United States)

    Shepherd, Lara D

    2017-01-01

    Herbarium specimens are an important source of DNA for plant research but current sampling methods require the removal of material for DNA extraction. This is undesirable for irreplaceable specimens such as rare species or type material. Here I present the first non-destructive sampling method for extracting DNA from herbarium specimens. DNA was successfully retrieved from robust leaves and/or stems of herbarium specimens up to 73 years old.

  14. Drone Transport of Microbes in Blood and Sputum Laboratory Specimens.

    Science.gov (United States)

    Amukele, Timothy K; Street, Jeff; Carroll, Karen; Miller, Heather; Zhang, Sean X

    2016-10-01

    Unmanned aerial vehicles (UAVs) could potentially be used to transport microbiological specimens. To examine the impact of UAVs on microbiological specimens, blood and sputum culture specimens were seeded with usual pathogens and flown in a UAV for 30 ± 2 min. Times to recovery, colony counts, morphologies, and matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS)-based identifications of the flown and stationary specimens were similar for all microbes studied.

  15. The type specimen of Anoura geoffroyi lasiopyga (Chiroptera: Phyllostomidae)

    Science.gov (United States)

    Arroyo-Cabrales, Joaquin; Gardner, A.L.

    2003-01-01

    In 1868, Wilhelm Peters described Glossonycteris lasiopyga, based on a specimen provided by Henri de Saussure and collected in Mexico. The type specimen was presumed to be among those housed in the collections of the Zoologisches Museum of the Humboldt Universitat in Berlin, Germany. Our study of one of Saussure?s specimens from Mexico, discovered in the collections of the Museum d?Histoire Naturelle, Geneva, Switzerland, demonstrates that it and not one of the Berlin specimens is the holotype.

  16. Elastic-plastic analysis of the SS-3 tensile specimen

    Energy Technology Data Exchange (ETDEWEB)

    Majumdar, S. [Argonne National Lab., IL (United States)

    1998-09-01

    Tensile tests of most irradiated specimens of vanadium alloys are conducted using the miniature SS-3 specimen which is not ASTM approved. Detailed elastic-plastic finite element analysis of the specimen was conducted to show that, as long as the ultimate to yield strength ratio is less than or equal to 1.25 (which is satisfied by many irradiated materials), the stress-plastic strain curve obtained by using such a specimen is representative of the true material behavior.

  17. Dual-Energy CT of Rectal Cancer Specimens

    DEFF Research Database (Denmark)

    Al-Najami, Issam; Beets-Tan, Regina G H; Madsen, Gunvor

    2016-01-01

    BACKGROUND: An accurate method to assess malignant lymph nodes in the mesorectum is needed. Dual-energy CT scans simultaneously with 2 levels of energy and thereby provides information about tissue composition based on the known effective Z value of different tissues. Each point investigated...... is represented by a certain effective Z value, which allows for information on its composition. OBJECTIVE: We wanted to standardize a method for dual-energy scanning of rectal specimens to evaluate the sensitivity and specificity of benign versus malignant lymph node differentiation. Histopathological evaluation...... cancer. MAIN OUTCOME MEASURES: We measured accuracy of differentiating benign from malignant lymph nodes by investigating the following: 1) gadolinium, iodine, and water concentrations in lymph nodes; 2) dual-energy ratio; 3) dual-energy index; and 4) effective Z value. RESULTS: Optimal discriminations...

  18. Liability exposure for surgical robotics instructors.

    Science.gov (United States)

    Lee, Yu L; Kilic, Gokhan; Phelps, John Y

    2012-01-01

    Surgical robotics instructors provide an essential service in improving the competency of novice gynecologic surgeons learning robotic surgery and advancing surgical skills on behalf of patients. However, despite best intentions, robotics instructors and the gynecologists who use their services expose themselves to liability. The fear of litigation in the event of a surgical complication may reduce the availability and utility of robotics instructors. A better understanding of the principles of duty of care and the physician-patient relationship, and their potential applicability in a court of law likely will help to dismantle some concerns and uncertainties about liability. This commentary is not meant to discourage current and future surgical instructors but to raise awareness of liability issues among robotics instructors and their students and to recommend certain preventive measures to curb potential liability risks.

  19. 外科护理不良事件发生原因及防范措施分析%Causes and Preventive Measures of Nursing Adverse Events in Surgical Departments

    Institute of Scientific and Technical Information of China (English)

    成靖

    2016-01-01

    Objective To investigate and explore the causes and preventive measures of nursing adverse events in surgical departments. Methods From February 2013 to January 2016, 2 500 patients treated in our hospital were chosen, nursing adverse events during the surgical hospitalization of all patients were analyzed. Results There were 90 cases of nursing adverse events with the rate of 3.6%, including 40 cases of pressure sores, 20 cases of catheter loss, 20 cases of fall and 10 case of aspiration, which had been corrected after symptomatic treatment. Conclusion Surgical nursing adverse events of occurrence causes more has related to nursing management factors and the patient's own. so that nursing can obtain healthy, steady and sustainable development.%目的调查与探讨外科护理不良事件发生原因及防范措施。方法选取2013年2月~2016年1月我院外科进行诊治的2500例患者,记录所有患者在外科住院期间发生的护理不良事件,并分析其成因。结果发生护理不良事件90例,发生率为3.6%,其中压疮40例,导管脱落20例,跌倒20例,误吸10例,都经过对症处理后纠正。结论外科护理不良事件的发生原因多与护理管理因素和患者自身有关,外科护理不良事件的发生原因多与护理管理因素和患者自身有关,在临床上要积极管理,从而使护理工作健康、稳步、持续发展。

  20. Fixture For Hot Stress Tests Of Thin Specimens

    Science.gov (United States)

    Gates, Thomas S.

    1993-01-01

    Fixture designed to hold and heat thin, rectangular-cross-section specimen of composite material during hot lengthwise-stress test. Suitable for testing same specimen in either tension or compression. Clamps lightly onto specimen, providing both heat via thermal conduction and lateral support needed to prevent buckling during compression test.

  1. 49 CFR 219.205 - Specimen collection and handling.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 4 2010-10-01 2010-10-01 false Specimen collection and handling. 219.205 Section... § 219.205 Specimen collection and handling. (a) General. Urine and blood specimens must be obtained, marked, preserved, handled, and made available to FRA consistent with the requirements of this subpart...

  2. The CAS Bio-specimen Centers in Sound Progress

    Institute of Scientific and Technical Information of China (English)

    LI Liangqian; QIAO Gexia; YAO Yijian

    2010-01-01

    @@ Bio-specimen centers, including herbaria and zoological museums, are the most integrated places for the storage of specimens, which are real samples and the most important vouchers for taxonomic and biodiversity studies.The information carried by the specimens is of substantial reference for research on species distribution, history, status, phylogeny and evolution, etc.

  3. Adaptation of Museum Specimens for Use in Anatomical Teaching Aids

    Science.gov (United States)

    Harris, P. F.; And Others

    1977-01-01

    Color transparencies are prepared of a re-colored anatomical specimen after placing labels temporarily in position to indicate specific structures. The specimen is also radiographed to show skeletal and soft tissue structures. Cross-reference among the specimen, photographs, and radiographs is supplemented by examination and self-assessment…

  4. 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

  5. Problems of laser vibrometry of temporal bone specimens

    Science.gov (United States)

    Zahnert, Thomas; Vogel, Uwe; Hofmann, Gert; Huettenbrink, Karl-Bernd

    1996-08-01

    Laser vibrometry became a well-established method for vibration detection of solids. By the means of laser Doppler interferometry it is possible to obtain information about displacement and velocity of the system under test. This approach allows the non-contact measurement of small vibrations, and is therefore capable of investigating vibration response of the middle ear ossicles or tympanic membrane due to sound simulation. There have been investigated 20 fresh human temporal bone specimens. Various components related to the sound transmission due to acoustic or mechanic stimulation have been measured by a commercial laser vibrometer (OFV3000 + OFV302/Polytec). Data acquisition, signal processing and test signal generation have been provided by a signal analyzer B&K3550/Bruel&Kjaer or integrated into a Notebook PC. The samples became prepared to allow laser beam access to the regions of interest. Generally our experiments show the capability of laser vibration measurements of the temporal bone specimen for middle ear sound transmission investigations. But the complexity is limiting that method unfortunately. 1D detection could represent insufficient information about the acoustic transmission characteristics only. The request of possibly 3D scanning is limited by anatomic conditions, e.g., according to the narrowness of the tympanic cavity. Nevertheless, for specific problems, e.g., investigation of spatially resolved tympanic membrane vibration characteristics, laser vibrometry performs a unique and high-sensitive approach. After removing the external ear canal different, well-defined points of the tympanic membrane surface have been manually scanned by the open laser beam. Particular care has been taken of the problem of perpendicular beam incidence, in order to detect identical vector components of the vibration amplitude. Laser vibrometry becomes suitable for functional investigation of the vibrating system `ear' influenced by boundary condition changes too

  6. Utilization of speckle techniques at measurements of biomechanical characteristics of cadaverous human lumbar spine samples after application of various surgical fixation methods

    Science.gov (United States)

    Bartonek, Ludek; Keprt, Jiri, Sr.; Charamza, Jiri; Hrabalek, Lumir

    2003-10-01

    Special equipment was realized for testing of stabilization methods of samples of lower part of the spine (L1-L5). During straining and measurement of the rigidity of the sample as a whole it is also necessary to observe the movement of individual parts of the sample. This movement is non-contact followed with the help of round targets connected to the appropriate vertebra to be observed. The watched targets are lit with a lamp or laser, and are identified by two CCD cameras. An optical signal is brought into a computer and evaluated by the fast Fourier transformation method. The period and direction of interference fringes determine the size and the direction of the shift.

  7. 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...

  8. Reliability of 46,XX results on miscarriage specimens: a review of 1,222 first-trimester miscarriage specimens

    National Research Council Canada - National Science Library

    Lathi, Ruth B; Gustin, Stephanie L F; Keller, Jennifer; Maisenbacher, Melissa K; Sigurjonsson, Styrmir; Tao, Rosina; Demko, Zach

    2014-01-01

    To examine the rate of maternal contamination in miscarriage specimens. Retrospective review of 1,222 miscarriage specimens submitted for chromosome testing with detection of maternal cell contamination (MCC...

  9. Ductile fracture assessment using parameters from small specimens

    Energy Technology Data Exchange (ETDEWEB)

    Talja, H. [VTT Manufacturing Technology, Espoo (Finland)

    1998-12-31

    The topic of this thesis is the computational aspects in the assessment of ductile failure in metals. The first part briefly describes the micromechanics of ductile crack growth and methods for assessing it. The `classic` approach to describe material behaviour using fracture mechanics is summarised. The limitations of the one parameter approach based on the stress intensity factor K or the J- integral are described. Attempts to extend the application field of fracture mechanics parameters by introducing triaxility or constraint parameters are also presented. Different local approach methodologies are summarised. Special attention is paid to the modified Gurson model, which is based on micro-mechanical studies of void initiation, growth and coalescence. The main part of the work consists of numerical analyses with the modified Gurson model. The parameters of the model are first determined by matching tensile test results by finite element analysis, and then applied to J-R curve prediction. This methodology is applied to several reactor pressure vessel materials: A533B, 20 MnMoNi 5 5 and austenitic VVER 440 cladding. As a result, the applicability of different specimen types for the parameter determination of the modified Gurson model has been evaluated. Because a combination of experimental and numerical work is needed, it proved to be most feasible to use specimens which can be simulated with two-dimensional or axisymmetric finite element models. Further, a practical way to treat anisotropic material behaviour using the modified Gurson model by using separate parameter sets for different orientations has been proposed and verified. The correspondence between the observed scatters in tensile and fracture mechanical test results has been examined. Best agreement was obtained fitting the scatter of tensile tests by varying the values of initial parameters. Reasons for apparently higher ductility measured from sub-sized than standard size tensile specimens were

  10. Structured reporting ensures complete content and quick detection of essential data in pathology reports of oncological breast resection specimens.

    Science.gov (United States)

    Aumann, Konrad; Niermann, Kathrin; Asberger, Jasmin; Wellner, Ulrich; Bronsert, Peter; Erbes, Thalia; Hauschke, Dieter; Stickeler, Elmar; Gitsch, Gerald; Kayser, Gian; Werner, Martin

    2016-04-01

    There is increasing evidence that not only the way of data acquisition but also the design of data visualization (i.e., the format) has impact on the quality of pathology reports. Therefore, we investigated the correlation between the format of pathology reports and the amount as well as the detection time of transmitted data. All reports of oncological breast resection specimens referred to the Institute for Surgical Pathology, University Medical Center Freiburg, between 2003 and 2011 (n = 4181) were classified into descriptive reports (DR, n = 856), structured reports (SR, n = 2455), or template-based synoptic reports (TBSR, n = 870). The reports were screened regarding the content of nine organ-specific essential data. The amount of recorded essential data per report was summarized in an essential data score (EDS) and the format types were statistically compared regarding their EDS. Additionally, we measured the time a gynecologist needed to detect all nine essential data within a subset of reports and compared the format types regarding the detection times statistically. A full-score EDS of 9 was seen in 28.4 % of all reports, in 4 % of DRs, in 21.4 % of SRs, and in 72.3 % of TBSRs (p < 0.0001). Median EDS of DRs was 7, of SRs 8, and of TBSRs 9 (p < 0.0001). Data regarding tumor localization, tumor size, specific grading, angioinvasion, hormone receptor status, and additional findings were mentioned more frequently in TBSRs compared to other format type reports with a statistically highly significant difference (p < 0.0001). Mean data detection time decreased significantly from 26 to 20 and 14 s in DRs, SRs, and TBSRs, respectively. Our results clearly show that due to the use of TBSRs reporting of oncological breast resection specimens are improved regarding the content of essential data and the clarity of the data layout resulting in a rapid detection of essential data by clinicians.

  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. Enhancement of Neuromuscular Activity by Natural Specimens and Cultured Mycelia of Cordyceps sinensis in Mice

    Science.gov (United States)

    Singh, K. P.; Meena, H. S.; Negi, P. S.

    2014-01-01

    The present study was aimed to evaluate the effect of natural specimen and laboratory cultured mycelia of Cordyceps sinensis on neuromuscular activity in mice. The powder of natural specimen and laboratory cultured Cordyceps sinensis was orally administered at the dose rate of 100, 300 and 500 mg/kg for 30 days. Natural specimen and in vitro propagated Cordyceps sinensis showed significant (P<0.05) enhancement in neuromuscular endurance and antidepressant activity at 300 and 500 mg/kg as compared to the control group. However, the fungus did not proved to be as effective as fluoxetine in exhibiting antidepressant action. Muscular endurance was determined on a Rota rod apparatus while antidepressant (mood elevating) activity was measured on a photoactometer in Swiss albino mice. The effects produced by both natural specimens and laboratory cultured Cordyceps sinensis were comparable and showed almost equal potency. PMID:25425763

  14. Permittivity and permeability determination for high index specimens using partially filled shorted rectangular waveguides

    CERN Document Server

    Scott, Mark M; Bean, Jeffrey A; Allen, Kenneth W

    2016-01-01

    A method for determining the permittivity and permeability for specimens with high refractive index and variable shape is investigated. The method extracts the permeability and permittivity tensor elements from reflection measurements made with a partially-filled shorted rectangular waveguide on an electrically small specimen. Measurements are performed for two isotropic, heavily loaded coaxial magnetic composites. Supporting measurements from a stripline cavity and coaxial airline are used to validate the method. The results demonstrate the methods ability to handle frequency dispersive and high index materials.

  15. [A scale for measuring symptoms related to degenerative diseases of the cervical spine. A reference in determining indications and evaluating surgical outcome].

    Science.gov (United States)

    Koller, M; Kienapfel, H; Hinder, D; Sabau, E; Wingert, G; Pfeiffer, M; Griss, P; Lorenz, W

    1999-11-01

    A scale for measuring symptoms related to degenerative diseases of the cervical spine is presented. Twenty typical symptoms are listed, e. g., neck pain, dysesthesia, and reduced mobility. Responses are assessed via a 6-point scaling ("did not have symptom" - "had symptom and suffered very strongly".) The cervical spine scale was tested in three samples: patients having undergone cervical spine surgery (n = 70), patients with other orthopedic diagnoses (n = 104), and healthy students (n = 100). The single items of the scale were aggregated into four scores: total number of symptoms, degree of overall symptom distress, functional disability, and pain/psychological distress. Statistical analyses proved the high reliability (Cronbach's alpha = 0.85 to 0.95) and validity (content, convergent, discriminant) of all scores. The scale differs clearly between cervical spine patients, other orthopedic patients and healthy individuals, and between cervical spine patients with different subjective operative outcomes. For applied clinical purposes the cervical spine scale can be included in a quality of life profile (QL-profile); this allows for a readily understandable graphic depiction of individual patients' QL-status.

  16. Optimizing Surgical Margins in Breast Conservation

    Directory of Open Access Journals (Sweden)

    Preya Ananthakrishnan

    2012-01-01

    Full Text Available Adequate surgical margins in breast-conserving surgery for breast cancer have traditionally been viewed as a predictor of local recurrence rates. There is still no consensus on what constitutes an adequate surgical margin, however it is clear that there is a trade-off between widely clear margins and acceptable cosmesis. Preoperative approaches to plan extent of resection with appropriate margins (in the setting of surgery first as well as after neoadjuvant chemotherapy, include mammography, US, and MRI. Improvements have been made in preoperative lesion localization strategies for surgery, as well as intraoperative specimen assessment, in order to ensure complete removal of imaging findings and facilitate margin clearance. Intraoperative strategies to accurately assess tumor and cavity margins include cavity shave techniques, as well as novel technologies for margin probes. Ablative techniques, including radiofrequency ablation as well as intraoperative radiation, may be used to extend tumor-free margins without resecting additional tissue. Oncoplastic techniques allow for wider resections while maintaining cosmesis and have acceptable local recurrence rates, however often involve surgery on the contralateral breast. As systemic therapy for breast cancer continues to improve, it is unclear what the importance of surgical margins on local control rates will be in the future.

  17. Apparatus and method for magnetically processing a specimen

    Science.gov (United States)

    Ludtka, Gerard M; Ludtka, Gail M; Wilgen, John B; Kisner, Roger A; Jaramillo, Roger A

    2013-09-03

    An apparatus for magnetically processing a specimen that couples high field strength magnetic fields with the magnetocaloric effect includes a high field strength magnet capable of generating a magnetic field of at least 1 Tesla and a magnetocaloric insert disposed within a bore of the high field strength magnet. A method for magnetically processing a specimen includes positioning a specimen adjacent to a magnetocaloric insert within a bore of a magnet and applying a high field strength magnetic field of at least 1 Tesla to the specimen and to the magnetocaloric insert. The temperature of the specimen changes during the application of the high field strength magnetic field due to the magnetocaloric effect.

  18. Apparatus and method for magnetically processing a specimen

    Energy Technology Data Exchange (ETDEWEB)

    Ludtka, Gerard M; Ludtka, Gail M; Wilgen, John B; Kisner, Roger A; Jaramillo, Roger A

    2013-09-03

    An apparatus for magnetically processing a specimen that couples high field strength magnetic fields with the magnetocaloric effect includes a high field strength magnet capable of generating a magnetic field of at least 1 Tesla and a magnetocaloric insert disposed within a bore of the high field strength magnet. A method for magnetically processing a specimen includes positioning a specimen adjacent to a magnetocaloric insert within a bore of a magnet and applying a high field strength magnetic field of at least 1 Tesla to the specimen and to the magnetocaloric insert. The temperature of the specimen changes during the application of the high field strength magnetic field due to the magnetocaloric effect.

  19. A general mixed mode fracture mechanics test specimen: The DCB-specimen loaded with uneven bending moments

    DEFF Research Database (Denmark)

    Sørensen, Bent F.; Jørgensen, K.; Jacobsen, T.K.;

    2004-01-01

    A mixed mode specimen is proposed for fracture mechanics characterisation of adhesive joints, laminates and multilayers. The specimen is a double cantilever beam specimen loaded with uneven bending moments at the two free beams. By varying the ratiobetween the two applied moments, the full mode...

  20. Accuracy of non-invasive continuous total hemoglobin measurement by Pulse CO-Oximetry in severe traumatized and surgical bleeding patients.

    Science.gov (United States)

    Baulig, Werner; Seifert, Burkhardt; Spahn, Donat R; Theusinger, Oliver M

    2017-02-01

    The Masimo Radical-7 Pulse CO-Oximeter (Masimo Corp., USA) non-invasively computes hemoglobin concentration (SpHb). SpHb was compared to Co-Oximeter readings (CoOxHb) of arterial samples in surgery patients of the emergency department. Forty-six patients were enrolled. The Masimo R1 25L (revision F and G) adult adhesive sensor was attached to the ring finger of the arterially cannulated hand. Before start, every 30 min during surgery and in the case of severe bleeding SpHb and CoOxHb values were documented. SpHb and post hoc adjusted SpHb (AdSpHb) values were analyzed. Linear regression analysis and Bland-Altman plot for agreement were performed. The detection failure rate of SpHb was 24.5 %. CoOxHb and SpHb showed a strong correlation (r = +0.81), but agreement was moderate [bias (LOA) of -0.6 (-3.0; +1.9)] g/dl. Positive and negative predicted value was 0.49 and 0.69. Exclusion of changes of CoOxHb values ≤1 g/dl resulted in a positive and negative predictive value of 0.66 and 1.00. Post hoc adjustment of the SpHb (AdSpHb) improved linear correlation of CoOxHb and AdSpHb [r = +0.90 (p values and predicted decreases of CoOxHb only if changes of SpHb ≤ 1.0 g/dl were excluded. The detection failure rate of SpHb was high. At present, additional refinements of the current technology are necessary to further improve performance of non-invasive hemoglobin measurement in the clinical setting.

  1. Laparoscopic right-sided colonic resection with transluminal colonoscopic specimen extraction

    Institute of Scientific and Technical Information of China (English)

    Cuneyt; Kayaalp; Koray; Kutluturk; Mehmet; Ali; Yagci; Mustafa; Ates

    2015-01-01

    AIM: To study the transcolonic extraction of the proximally resected colonic specimens by colonoscopic assistance at laparoscopic colonic surgery. METHODS: The diagnoses of our patients were Crohn’s disease, carcinoid of appendix and adenocarcinoma of cecum. We preferred laparoscopic total mesocolic resections. Colon and terminal ileum were divided with endoscopic staplers. A colonoscope was placed per anal and moved proximally in the colon till to reach the colonic closed end under the laparoscopic guidance. The stump of the colon was opened with laparoscopic scissors. A snare of colonoscope was released and the intraperitoneal complete free colonic specimen was grasped. Specimen was moved in to the colon with the help of the laparoscopic graspers and pulled gently through the large bowel and extracted through the anus. The open end of the colon was closed again and the ileal limb and the colon were anastomosed intracorporeally with a 60-mm laparoscopic stapler. The common enterotomy orifice was closed in two layers with a running intracorporeal suture.RESULTS: There were three patients with laparoscopic right-sided colonic resections and their specimens were intended to remove through the remnant colon by colonoscopy but the procedure failed in one patient(adenocarcinoma) due to a bulky mass and the specimen extraction was converted to transvaginal route. All the patients had prior abdominal surgeries and had related adhesions. The operating times were 210, 300 and 500 min. The lengths of the specimenswere 13, 17 and 27 cm. In our cases, there were no superficial or deep surgical site infections or any other complications. The patients were discharged uneventfully within 4-5 d and they were asymptomatic after a mean 7.6 mo follow-up(ranged 4-12). As far as we know, there were only 12 cases reported yet on transcolonic extraction of the proximal colonic specimens by colonoscopic assistance after laparoscopic resections. With our cases, success rate of the

  2. Topographic mapping of biological specimens: flexure and curvature characterization

    Science.gov (United States)

    Baron, William S.; Baron, Sandra F.

    2004-07-01

    Shape quantification of tissue and biomaterials can be central to many studies and applications in bioengineering and biomechanics. Often, shape is mapped with photogrammetry or projected light techniques that provide XYZ point cloud data, and shape is quantified using derived flexure and curvature calculations based on the point cloud data. Accordingly, the accuracy of the calculated curvature depends on the properties of the point cloud data set. In this study, we present a curvature variability prediction (CVP) software model that predicts the distribution, i.e., the standard deviation, of curvature measurements associated with surface topography point cloud data properties. The CVP model point cloud data input variables include XYZ noise, sampling density, and map extent. The CVP model outputs the curvature variability statistic in order to assess performance in the curvature domain. Representative point cloud data properties are obtained from an automated biological specimen video topographer, the BioSpecVT (ver. 1.02) (Vision Metrics, Inc.,). The BioSpecVT uses a calibrated, structured light pattern to support automated computer vision feature extraction software for precisely converting video images of biological specimens, within seconds, into three dimensional point cloud data. In representative sample point cloud data obtained with the BioSpecVT, sampling density is about 11 pts/mm2 for an XYZ mapping volume encompassing about 16 mm x 13.5 mm x 18.5 mm, average XY per point variability is about +/-2 μm, and Z axis variability is about +/-40 μm (50% level) with a Gaussian distribution. A theoretical study with the CVP model shows that for derived point cloud data properties, curvature mapping accuracy increases, i.e. measurement variability decreases, when curvature increases from about 30 m-1 to 137 m-1. This computed result is consistent with the Z axis noise becoming less significant as the measured depth increases across an approximately fixed XY

  3. Impact energy analysis of quenched and tempered fine grain structural steel specimens after weld thermal cycle simulation

    Directory of Open Access Journals (Sweden)

    M. Dunđer

    2014-10-01

    Full Text Available The paper presents impact energy results of thermal cycle simulated specimens of quenched and tempered fine grain structural steel S960QL. These results are obtained by examining notched Charpy specimens. Upon performed metallographic analysis and measured hardness, total impact energy is separated into ductile and brittle components.

  4. Adequacy of urine cytology specimens: an assessment of collection techniques.

    Science.gov (United States)

    Hundley, Andrew F; Maygarden, Susan; Wu, Jennifer M; Visco, Anthony G; Connolly, AnnaMarie

    2007-09-01

    The objective of this study was to determine whether the method of urine collection impacts the adequacy and cell counts of cytology specimens in a low-risk population. Voided, post-cystometrogram (CMG), and bladder irrigant specimens were collected and evaluated for cytologic adequacy and average cell count by a single cytopathologist masked to the source of each sample. Data were analyzed to detect differences in specimen adequacy and cell counts based on method of collection. Both the voided and post-CMG specimens (97.3%, 93.7% respectively) were significantly more likely to be adequate compared to the bladder irrigant specimen (11.7%, p urine dipstick (p = 0.03). No cytologic abnormalities were diagnosed. Whereas both spontaneously voided and post-CMG specimens were consistently adequate for interpretation, spontaneous voided specimens were optimal with regard to maximizing cell count/hpf.

  5. Evaluation of hybrid composite materials in cylindrical specimen geometries

    Science.gov (United States)

    Liber, T.; Daniel, I. M.

    1976-01-01

    Static and fatigue properties of three composite materials and hybrids were examined. The materials investigated were graphite/epoxy, S-glass/epoxy, PRD-49 (Kevlar 49)/epoxy, and hybrids in angle-ply configurations. A new type of edgeless cylindrical specimen was developed. It is a flattened tube with two flat sides connected by curved sections and it is handled much like the standard flat coupon. Special specimen fabrication, tabbing, and tab region reinforcing techniques were developed. Axial modulus, Poisson's ratio, strength, and ultimate strain were obtained under static loading from flattened tube specimens of nine laminate configurations. In the case of graphite/epoxy the tubular specimens appeared to yield somewhat higher strength and ultimate strain values than flat specimens. Tensile fatigue tests were conducted with all nine types of specimens and S-N curves obtained. Specimens surviving 10 million cycles of tensile loading were subsequently tested statically to failure to determine residual properties.

  6. Recording and submitting specimen history data

    Science.gov (United States)

    Bodenstein, Barbara L.; Franson, J. Christian; Friend, Milton; Gibbs, Samantha E.J.; Wild, Margaret A.

    2016-06-14

    SummaryIn wildlife disease investigations, determining the history or background of a problem is the first significant step toward establishing a diagnosis and aiding agencies with management considerations. The diagnostic process and overall investigation is often greatly expedited by a chronological record accompanying specimens submitted for laboratory evaluation. Knowing where and when the outbreak is taking place, what the environmental conditions and species involved are, and clinical signs in sick animals, along with necropsy findings and diagnostic test results are important for understanding the natural history or epizootiology of disease outbreaks. It becomes increasingly difficult to retrospectively obtain all of the pertinent history as time passes. The most helpful information is that which is obtained at the time of the die-off event by perceptive field biologists and other observers. Significant events preceding morbidity and/or mortality also provide valuable information on which to base corrective actions. In this chapter, readers will find information regarding what type of information should be recorded, how it should be recorded and why it is relevant to a disease investigation. A thoughtful approach in providing as much information as possible surrounding the situation including about host species and the biotic and abiotic environment, greatly aids in determining the most likely causative agent(s).

  7. Molecular diagnosis of Raoultella planticola infection of a surgical site.

    Science.gov (United States)

    Wolcott, R; Dowd, S

    2010-08-01

    Raoultella planticola has been rarely diagnosed in clinical specimens. A case of a polymicrobial surgical site infection primarily caused by R. planticola in a 66-year-old Caucasian male with a fractured left tibia after an open reduction internal fixation of his left ankle is described and confirms this organism to be an opportunistic human pathogen. This pathogen was diagnosed with rapid clinical molecular pathogen diagnostic methods, which allowed an appropriate therapy to be implemented, thereby improving prognosis.

  8. MRI-Derived Restriction Spectrum Imaging Cellularity Index is Associated with High Grade Prostate Cancer on Radical Prostatectomy Specimens

    OpenAIRE

    Liss, Michael A.; White, Nathan S.; Parsons, J. Kellogg; Schenker-Ahmed, Natalie M.; Rakow-Penner, Rebecca; Kuperman, Joshua M.; Bartsch, Hauke; Choi, Hyung W.; Mattrey, Robert F.; Bradley, William G.; Shabaik, Ahmed; Huang, Jiaoti; Daniel J. A. Margolis; Raman, Steven S.; Marks, Leonard S.

    2015-01-01

    Purpose: We evaluate a novel magnetic resonance imaging (MRI) technique to improve detection of aggressive prostate cancer (PCa). Materials and Methods: We performed a retrospective analysis of pre-surgical prostate MRI scans using an advanced diffusion-weighted imaging technique called restriction spectrum imaging (RSI), which can be presented as a normalized z-score statistic. Scans were acquired prior to radical prostatectomy. Prostatectomy specimens were processed using whole-mount sec...

  9. Disc degeneration: current surgical options

    Directory of Open Access Journals (Sweden)

    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.

  10. Surgical anatomy of the larynx.

    Science.gov (United States)

    Friedrich, G; Lichtenegger, R

    1997-09-01

    Modern functionally oriented surgery of the larynx increasingly requires exact knowledge of the anatomy and landmarks of the endolaryngeal structures in relation to the laryngeal skeleton. Review of the literature reveals several opposing statements and controversial anatomical definitions regarding several clinically critical points. In order to obtain basic anatomical data morphological measurements were performed on a total of 50 laryngeal specimens. Measurements were taken on whole organs and on cuts in the horizontal and in the frontal plane, as well. The data were evaluated statistically, which resulted in the determination of average configurations and dimensions of cartilages and soft tissues of the larynx. In particular, the projection of the deeper structures on the surface and the distances and angles between the different structures were taken into consideration. In order to make these data clinically applicable a scale model has been developed that will allow a direct correlation and application for individual surgery.

  11. Analysis of the learning curve for pre-cut corneal specimens in preparation for lamellar transplantation: a prospective, single-centre, consecutive case series prepared at the Lions New South Wales Eye Bank.

    Science.gov (United States)

    Martin, Aifric Isabel; Devasahayam, Rajnesh; Hodge, Christopher; Cooper, Simon; Sutton, Gerard L

    2017-03-06

    This study is the first paper to establish a learning curve by a single technician. Preparation of pre-cut corneal endothelial grafts commenced at Lions New South Wales Eye Bank in December 2014. The primary objective of this study was to review the safety and reliability of the preparation method during the first year of production. This is a hospital-based, prospective case series. There were 234 consecutive donor corneal lenticules. Donor lenticules were prepared by a single operator using a linear cutting microkeratome. Immediately prior to cutting, central corneal thickness values were recorded. Measurements of the corneal bed were taken immediately following lenticule preparation. Outcomes were separated by blade sizes, and intended thickness was compared to actual thickness for each setting. Early specimens were compared to later ones to assess for a learning curve within the technique. The main parameter measured is the mean difference from intended lamellar cut thickness. The mean final cut thickness was 122.36 ± 20.35 μm, and the mean difference from intended cut was 30.17 ± 37.45 μm. No significant difference was found between results achieved with early specimens versus those achieved with later specimens (P = 0.425). Thin, reproducible endothelial grafts can routinely be produced by trained technicians at their respective eye banks without significant concerns for an extended learning curve. This service can reduce perioperative surgical complexity, required surgical paraphernalia and theatre times. The consistent preparation of single-pass, ultrathin pre-cut corneas may have additional advantages for surgeons seeking to introduce lamellar techniques. © 2017 Royal Australian and New Zealand College of Ophthalmologists.

  12. [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.

  13. [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.

  14. Mini-tensile specimen application for sheets characterization

    Science.gov (United States)

    Džugan, J.; Rund, M.; Prantl, A.; Konopík, P.

    2017-02-01

    There are many cases when there is a shortage of the experimental material for detailed analysis and then small size specimens techniques becomes essential. The current paper deals with investigations of mini-tensile tests (MTT) application to metal sheets characterization. In the case of metal sheets assessment the most common are tensile tests for Lankford parameters and strain hardening determination. As most of the processes are not quasi-static and constant strain rate processes, thus assessment of strain rate hardening is also crucial part of the characterization. Previously developed and verified testing procedure of M-TTs for bulk materials is applied here for steel sheet made of DC01 characterization. Tests under quasi-static and dynamic loading conditions are carried out in order to describe above mentioned properties at room temperature. Accurate strain measurement is carried out with digital image correlation systems and results obtained with M-TTs are going to be confronted with standard size specimens’ results.

  15. International Society of Urological Pathology (ISUP) consensus conference on handling and staging of radical prostatectomy specimens: rationale and organization.

    Science.gov (United States)

    Egevad, Lars; Srigley, John R; Delahunt, Brett

    2011-01-01

    The 2009 International Society of Urological Pathology consensus conference in Boston, made recommendations regarding the standardization of pathology reporting of radical prostatectomy specimens. The activities of the conference were coordinated through five workgroups. The results are presented in five separate reports covering (1) specimen handling, (2) T2 substaging and prostate cancer volume, (3) extraprostatic extension, lymphovascular invasion and locally advanced disease, (4) seminal vesicles and lymph node metastases and (5) surgical margins. In this introductory article we describe some novel features of the organization of the consensus process. Following the completion of a pre-meeting survey conference, participants discussed and voted on 43 specific issues of contention relating to the pathological reporting of radical prostatectomy specimens. Consensus, defined as agreement by at least 65% of participants present, was achieved for 30 questions.

  16. Surgical Treatment for 11 Cases of Penile Verrucous Carcinoma

    Science.gov (United States)

    Chuanyu, Sun; Ke, Xu; Jie, Zheng; Guowei, Xia; Zujun, Fang

    2011-01-01

    Penile verrucous carcinoma is a rare, well-differentiated and low-grade tumor. The surgeons are deficiently aware about the biological behavior and the clinicopathological characteristic of this disease, which raises difficulties during the treatment. In our present study, the clinical and pathological data of 11 patients with penile verrucous carcinoma, aged between 49 to 85 years was retrospectively analyzed. The tumors exhibited exophytic, papillary, caulifower-like or verrucose lesions of great dimensions measuring between 2 to 10 cm on the penises. The tumors were located at glans in 6 cases, invaded the coronoid sulcus in 4 cases and invaded the shaft of the penis in 1 case. Eight cases underwent partial penectomy, while the other 3 were treated with local excision. The diagnosis of penile verrucous carcinoma was confirmed by histopathologic examination of the specimens with the negative surgical margins in all the cases. Within the period of 12 to 60 months of follow-up, all the patients were disease-free with no case of recurrence and metastasis. The novel knowledge and experience of the treatment of penile verrucous carcinoma will be a useful clinical guide for surgeons in the future. PMID:22346275

  17. Assessment of viable bacteria and bacterial DNA in blood and bloodstain specimens stored under various conditions.

    Science.gov (United States)

    Hosokawa-Muto, Junji; Fujinami, Yoshihito; Mizuno, Natsuko

    2013-11-01

    Microbial forensic specimens that are collected at biocrime and bioterrorism scenes include blood, tissue, cloths containing biological fluids, swabs, water, soil, and aerosols. It is preferable that pathogens in such specimens are alive and kept in a steady state. Specimens may be stored for a prolonged period before analysis; therefore, it is important to understand the effect of the storage conditions on the pathogens contained within the specimens. In this study, we prepared blood and bloodstain specimens containing Gram-negative or -positive bacteria, stored the samples for 482 days under various conditions, and measured viable bacterial counts and total bacterial contents in the samples. Viable bacteria were preserved well in the samples stored at -30 and -80 °C, but were diminished or undetectable in the samples stored at 4 °C and room temperature. The total bacterial content was maintained in the blood samples stored at -30 and -80 °C and in the bloodstain samples stored under all temperature conditions, but decreased in the blood samples stored at 4 °C and room temperature. This study showed that the storage conditions affected viable bacteria and bacterial DNA and that freezing and drying were significant for their long-term storage. We provide important information for the storage of microbial forensic specimens.

  18. Effect of specimen thickness on Mode Ⅱ fracture toughness of rock

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    Anti-symmetric four-point bending specimens with different thickness, without and with guiding grooves, were used to conduct Mode Ⅱ fracture test and study the effect of specimen thickness on Mode Ⅱ fracture toughness of rock. Numerical calculations show that the occurrence of Mode Ⅱ fracture in the specimens without guiding grooves (when the inner and outer loading points are moved close to the notch plane) and with guiding grooves is attributed to a favorable stress condition created for Mode Ⅱ fracture, i.e. tensile stress at the notch tip is depressed to be lower than the tensile strength or to be compressive stress, and the ratio of shear stress to tensile stress at notch tip is very high. The measured value of Mode Ⅱ fracture toughness KⅡC decreases with the increase of the specimen thickness or the net thickness of specimen. This is because a thick specimen promotes a plane strain state and thus results in a relatively small fracture toughness.

  19. Double pituitary adenomas: six surgical cases.

    Science.gov (United States)

    Sano, T; Horiguchi, H; Xu, B; Li, C; Hino, A; Sakaki, M; Kannuki, S; Yamada, S

    1999-05-01

    While double pituitary adenomas have been found in approximately 1% of autopsy pituitaries, those in surgically resected material have been only rarely reported. We report herein 6 cases of double pituitary adenomas, which consisted of two histologically and/or immunohistochemically different areas among approximately 450 surgical specimens. Five out of 6 patients were men and the age was ranged between 18 and 61 years old. All these 6 patients presented acromegaly or acrogigantism and hyperprolactinemia was noted in 3 patients. In 2 patients (cases 1 and 2) the two adenomas belonged to different adenoma groups (GH-PRL-TSH group and FSH/LH group), while in the remaining 4 patients (cases 3-6) the two adenomas belonged to the same group (GH-PRL-TSH group). Thus, in all patients at least one of the two adenomas was GH-producing adenoma. Reasons for a high incidence of GH-producing adenomas in surgically resected double pituitary adenomas may include the presence of a variety of histologic subtypes among GH-producing adenomas and the advantage of cytokeratin immunostaining to distinguish these subtypes. In regard to pathogenesis of double pituitary adenomas, adenomas in cases 1 and 2 may be of multicentric occurrence, while those in cases 3-6 may occur through different clonal proliferation within originally one adenoma, resulting in diverse phenotypic expressions. Since there were patients with familial MEN 1 (case 2) and familial pituitary adenoma unrelated MEN 1 (case 3), genetic background should be also considered. Double pituitary adenomas in surgically resected material may not be so infrequent. Further molecular analysis will provide new insights into understanding the pathogenesis of pituitary adenomas and their mechanisms of multidirectional phenotypic diffrentiation.

  20. Recurrent periductal mastitis: Surgical treatment.

    Science.gov (United States)

    Taffurelli, Mario; Pellegrini, Alice; Santini, Donatella; Zanotti, Simone; Di Simone, Domenico; Serra, Margherita

    2016-12-01

    Recurrent periductal mastitis is a benign breast disorder that often features a mammary fistula that runs between periareolar skin and the ductal mammary system. Due to the high recurrence rate of this disease, its management is controversial. This study was designed to assess the efficacy of fistulectomy (Hadfield operation), particularly with regard to its long-term outcome. We reviewed all women with recurrent periductal mastitis who underwent the Hadfield operation in the Breast Center in S.Orsola-Malpighi Hospital (Bologna University) from 2005 to 2015. All but one of the patients were heavy smokers and presented with a recurrent periareolar abscess and a periareolar mammary fistula. Eighteen women underwent the Hadfield surgical treatment. Mean age at the time of presentation was 42 years; 17 of 18 women smoked >10 cigarettes/d. All patients had a breast ultrasonography or mammography. Half of the patients had undergone antibiotic therapy with one or more prior abscess drainages or another form of operative treatment. All patients who underwent operative treatment had no postoperative events and were satisfied with the cosmetic results. Squamous metaplasia was always present in the specimens. After a median follow-up of 36 months, 2 patients developed a recurrence after a few months; neither had stopped smoking. Based on our review of the literature and taking into account the results of this study, it seems clear that the best treatment involves a combined total excision of the affected duct and the fistulous tract. Due to the important role of smoking in this disease, it is important to encourage patients to stop smoking. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. Cataract surgical uptake among older adults in Ghana | Ackuaku ...

    African Journals Online (AJOL)

    ... measures and chi square for associations in categorical outcome measures. ... Regional differences in cataract surgical uptake existed; was less than 60% in all ten ... Further investigations to garner equity in national eye care efforts are ...

  2. Improving ED specimen TAT using Lean Six Sigma.

    Science.gov (United States)

    Sanders, Janet H; Karr, Tedd

    2015-01-01

    Lean and Six Sigma are continuous improvement methodologies that have garnered international fame for improving manufacturing and service processes. Increasingly these methodologies are demonstrating their power to also improve healthcare processes. The purpose of this paper is to discuss a case study for the application of Lean and Six Sigma tools in the reduction of turnaround time (TAT) for Emergency Department (ED) specimens. This application of the scientific methodologies uncovered opportunities to improve the entire ED to lab system for the specimens. This case study provides details on the completion of a Lean Six Sigma project in a 1,000 bed tertiary care teaching hospital. Six Sigma's Define, Measure, Analyze, Improve, and Control methodology is very similar to good medical practice: first, relevant information is obtained and assembled; second, a careful and thorough diagnosis is completed; third, a treatment is proposed and implemented; and fourth, checks are made to determine if the treatment was effective. Lean's primary goal is to do more with less work and waste. The Lean methodology was used to identify and eliminate waste through rapid implementation of change. The initial focus of this project was the reduction of turn-around-times for ED specimens. However, the results led to better processes for both the internal and external customers of this and other processes. The project results included: a 50 percent decrease in vials used for testing, a 50 percent decrease in unused or extra specimens, a 90 percent decrease in ED specimens without orders, a 30 percent decrease in complete blood count analysis (CBCA) Median TAT, a 50 percent decrease in CBCA TAT Variation, a 10 percent decrease in Troponin TAT Variation, a 18.2 percent decrease in URPN TAT Variation, and a 2-5 minute decrease in ED registered nurses rainbow draw time. This case study demonstrated how the quantitative power of Six Sigma and the speed of Lean worked in harmony to improve

  3. Characterization of aerosols produced by surgical procedures

    Energy Technology Data Exchange (ETDEWEB)

    Yeh, H.C.; Muggenburg, B.A.; Lundgren, D.L.; Guilmette, R.A.; Snipes, M.B.; Jones, R.K. [Inhalation Toxicology Research Institute, Albuquerque, NM (United States); Turner, R.S. [Lovelace Health Systems, Albuquerque, NM (United States)

    1994-07-01

    In many surgeries, especially orthopedic procedures, power tools such as saws and drills are used. These tools may produce aerosolized blood and other biological material from bone and soft tissues. Surgical lasers and electrocautery tools can also produce aerosols when tissues are vaporized and condensed. Studies have been reported in the literature concerning production of aerosols during surgery, and some of these aerosols may contain infectious material. Garden et al. (1988) reported the presence of papilloma virus DNA in the fumes produced from laser surgery, but the infectivity of the aerosol was not assessed. Moon and Nininger (1989) measured the size distribution and production rate of emissions from laser surgery and found that particles were generally less than 0.5 {mu}m diameter. More recently there has been concern expressed over the production of aerosolized blood during surgical procedures that require power tools. In an in vitro study, the production of an aerosol containing the human immunodeficiency virus (HIV) was reported when power tools were used to cut tissues with blood infected with HIV. Another study measured the size distribution of blood aerosols produced by surgical power tools and found blood-containing particles in a number of size ranges. Health care workers are anxious and concerned about whether surgically produced aerosols are inspirable and can contain viable pathogens such as HIV. Other pathogens such as hepatitis B virus (HBV) are also of concern. The Occupational Safety and Health funded a project at the National Institute for Inhalation Toxicology Research Institute to assess the extent of aerosolization of blood and other tissues during surgical procedures. This document reports details of the experimental and sampling approach, methods, analyses, and results on potential production of blood-associated aerosols from surgical procedures in the laboratory and in the hospital surgical suite.

  4. Characteristics of SIP Response for Rock Specimens in the Gagok Skarn Deposit, Korea

    Science.gov (United States)

    Kim, C.; Mi Kyung, P.; Park, S.; Shin, S.

    2012-12-01

    Spectral Induced Polarization (SIP) method was conducted to develop mineral exploration technique in the Gagok skarn deposit, Korea. The Gagok mine was once abandoned and recently reopened. The Gagok stratabound skarn deposit is originated from the Cretaceous granite intrusion into the Paleozoic limestone and slate formations. The ore minerals of the Gagok deposit include sulfide minerals such as sphalerite, pyrrhotite, galena, chalcopyrite, pyrite, arsenopyrite, etc. The characteristics of SIP response for the rock specimens were examined to re-evaluate mineral resources. Total 104 rock specimens were obtained from the mine shafts at the various elevations, and were modified in cylindrical shape for the measurement of SIP response, along with other physical properties such as porosity, density, DC electrical resistivity, magnetic susceptibility, and seismic velocity. The SIP measurement system consists of electrical current transmitter and receiver (model GDP-32 system, Zonge Co. USA), and measures amplitude for resistivity, and phase at 14 steps of frequencies ranging from 0.125 to 1,024 Hz. The results of the SIP measurement shows that the rock specimens from ore bodies accompanied with sulfide minerals such as sphalerite and pyrite produce large phase differences with frequencies applied. The results also show that the rock specimens at the lower elevation of the mine shaft have stronger SIP response and mineralization. The rock specimens with large phase differences of strong SIP response were classified into three phase curve types, based on the range of critical frequency from the SIP measurement. (1) Curve type 1: critical frequency of less than 1 Hz with decreasing phase curve (2) Curve type 2: critical frequency of 1 to 10 Hz with bell shape, (3) Curve type 3: critical frequency of larger than 10 Hz with mixture of curve type 1 and 2. It is believed that the graphitic components and sulfide minerals such as sphalerite and pyrite are dominant in the rock

  5. Improving the quality of colon cancer surgery through a surgical education program

    DEFF Research Database (Denmark)

    West, Nicholas P; Sutton, Kate M; Ingeholm, Peter

    2010-01-01

    Recent evidence has demonstrated the importance of dissection in the correct tissue plane for the resection of colon cancer. We have previously shown that meticulous mesocolic plane surgery yields better outcomes and that the addition of central vascular ligation produces an oncologically superior...... specimen compared with standard techniques. We aimed to assess the effect of surgical education on the oncological quality of the resection specimen produced....

  6. 石墨炉原子吸收法测定全血标本铅含量的3种前处理方法%Comparison of three specimen pretreatment methods for measuring lead content in whole blood by graphite furnace a-tomic absorption spectrometry

    Institute of Scientific and Technical Information of China (English)

    张斯恩; 张贝基; 谭红丽

    2014-01-01

    比较石墨炉原子吸收法测定全血标本中铅的3种前处理方法优劣,从中筛选一种更简便、准确、灵敏的方法,从而达到提高检测质量,降低工作强度的目的。方法采用酸脱蛋白法、混合基体改进剂法、微波消解法对无铅接触史的健康成年人全血标本进行前处理,分别用石墨炉原子吸收法检测,对检测结果进行统计分析,比较标准曲线线性、相关系数(r)、相对标准偏差(RSD%)、准确度等指标。结果3种方法标准曲线 r分别为0.9965、0.9942、0.9995;检出限分别为5.4、3.6、2.7μg/L ;RSD%分别为4.1、4.5、2.8;回收率分别为95.7%~103.3%、98.7%~104.5%、98.3%~102.3%。结论微波消解处理全血标本各项指标均令人满意,是测量血铅较好的前处理方法。%Objective To compare three specimen pretreatment methods for measuring lead content in whole blood by graphite furnace atomic absorption spectrometry .Methods Whole blood of healthy adults without lead ex‐posure history were pretreated by using acid deproteinized method ,mixed matrix modifier method ,and microwave di‐gestion method ,and then detected for lead content by using graphite furnace atomic absorption spectrometry .All re‐sults were statistically analyzed to compare indicators ,including standard curve′s linear ,correlation coefficient ,rela‐tive standard deviation (RSD% ) ,accuracy and so on .Results Correlation coefficients of standard curve of the three methods were 0 .996 5 ,0 .994 2 and 0 .999 5 ,the minimum detectable concentration were 5 .4 ,3 .6 and 2 .7 μg/L , RSD% were 4 .1 ,4 .5 and 2 .8 ,and the recovery rates were 95 .7% -103 .3% ,98 .7% -104 .5% and 98 .3% -102 .3% .Conclusion The evaluation indicators of microwave digestion method could be satisfactory ,which might be an ideal method for pretreatment of blood specimens for detection of lead content .

  7. An Experimental Study of Shear-Dominated Failure in the 2013 Sandia Fracture Challenge Specimen

    Energy Technology Data Exchange (ETDEWEB)

    Corona, Edmundo [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Deibler, Lisa Anne [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Reedlunn, Benjamin [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Ingraham, Mathew Duffy [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Williams, Shelley [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2015-04-01

    This report presents an experimental study motivated by results obtained during the 2013 Sandia Fracture Challenge. The challenge involved A286 steel, shear-dominated compression specimens whose load-deflection response contained a load maximum fol- lowed by significant displacement under decreasing load, ending with a catastrophic fracture. Blind numerical simulations deviated from the experiments well before the maximum load and did not predict the failure displacement. A series of new tests were conducted on specimens machined from the original A286 steel stock to learn more about the deformation and failure processes in the specimen and potentially improve future numerical simulations. The study consisted of several uniaxial tension tests to explore anisotropy in the material, and a set of new tests on the compression speci- men. In some compression specimen tests, stereo digital image correlation (DIC) was used to measure the surface strain fields local to the region of interest. In others, the compression specimen was loaded to a given displacement prior to failure, unloaded, sectioned, and imaged under the microscope to determine when material damage first appeared and how it spread. The experiments brought the following observations to light. The tensile tests revealed that the plastic response of the material is anisotropic. DIC during the shear- dominated compression tests showed that all three in-plane surface strain components had maxima in the order of 50% at the maximum load. Sectioning of the specimens revealed no signs of material damage at the point where simulations deviated from the experiments. Cracks and other damage did start to form approximately when the max- imum load was reached, and they grew as the load decreased, eventually culminating in catastrophic failure of the specimens. In addition to the steel specimens, a similar study was carried out for aluminum 7075-T651 specimens. These specimens achieved much lower loads and displacements

  8. Subsize specimen testing of nuclear reactor pressure vessel material

    Energy Technology Data Exchange (ETDEWEB)

    Kumar, A.S. [Missouri Univ., Rolla, MO (United States). Materials Research Center; Rosinski, S.T. [Sandia National Labs., Albuquerque, NM (United States); Cannon, N.S. [Westinghouse Hanford Co., Richland, WA (United States); Hamilton, M.L. [Pacific Northwest Lab., Richland, WA (United States)

    1991-12-31

    A new methodology is proposed to correlate the upper shelf energy (USE) of full size and subsize Charpy specimens of a nuclear reactor pressure vessel plate material, A533B. The methodology appears to be more satisfactory than the methodologies proposed earlier. USE of a notched-only specimen is partitioned into macro-crack initiation and crack propagation energies. USE of a notched and precracked specimen provides the crack propagation energy. {Delta}USE, the difference between the USE`s of notched-only and precracked specimens, is an estimate of the crack initiation energy. {Delta}USE was normalized by a factor involving the dimensions of the Charpy specimen and the stress concentration factor at the notch root. The normalized values of the {Delta}USE were found to be invariant with specimen size.

  9. Subsize specimen testing of nuclear reactor pressure vessel material

    Energy Technology Data Exchange (ETDEWEB)

    Kumar, A.S. (Missouri Univ., Rolla, MO (United States). Materials Research Center); Rosinski, S.T. (Sandia National Labs., Albuquerque, NM (United States)); Cannon, N.S. (Westinghouse Hanford Co., Richland, WA (United States)); Hamilton, M.L. (Pacific Northwest Lab., Richland, WA (United States))

    1991-01-01

    A new methodology is proposed to correlate the upper shelf energy (USE) of full size and subsize Charpy specimens of a nuclear reactor pressure vessel plate material, A533B. The methodology appears to be more satisfactory than the methodologies proposed earlier. USE of a notched-only specimen is partitioned into macro-crack initiation and crack propagation energies. USE of a notched and precracked specimen provides the crack propagation energy. [Delta]USE, the difference between the USE's of notched-only and precracked specimens, is an estimate of the crack initiation energy. [Delta]USE was normalized by a factor involving the dimensions of the Charpy specimen and the stress concentration factor at the notch root. The normalized values of the [Delta]USE were found to be invariant with specimen size.

  10. Fracture mechanics characterisation of medium-size adhesive joint specimens

    DEFF Research Database (Denmark)

    Sørensen, Bent F.; Jacobsen, T.K.

    2004-01-01

    Medium-size specimens (adhesive layer were tested in four point bending to determine their load carrying capacity. Specimens having different thickness were tested. Except for onespecimen, the cracking occurred as cracking...... along the adhesive layer; initially cracking occurred along the adhesive/laminate interface, but after some crack extension the cracking took place inside the laminate (for one specimen the later part of thecracking occurred unstably along the adhesive/ laminate interface). Crack bridging by fibres...

  11. 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.

  12. 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.

  13. 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.

  14. 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.

  15. Isokinetic muscle assessment after treatment of pectoralis major muscle rupture using surgical or non-surgical procedures

    Directory of Open Access Journals (Sweden)

    Anna Maria Fleury

    2011-01-01

    Full Text Available INTRODUCTION: Rupture of the pectoralis major muscle appears to be increasing in athletes. However, the optimal treatment strategy has not yet been established. OBJECTIVES: To compare the isokinetic shoulder performance after surgical treatment to that after non-surgical treatment for pectoralis major muscle rupture. METHODS: We assessed 33 pectoralis major muscle ruptures (18 treated non-surgically and 15 treated surgically. Horizontal abduction and adduction as well as external and internal rotation at 60 and 120 degrees/s were tested in both upper limbs. Peak torque, total work, contralateral deficiency, and the peak torque agonist-to-antagonist ratio were measured. RESULTS: Contralateral muscular deficiency did not differ between the surgical and non-surgical treatment modalities. However, the surgical group presented twice the number of athletes with clinically acceptable contralateral deficiency (<20% for internal rotators compared to the non-surgical group. The peak torque ratio between the external and internal rotator muscles revealed a similar deficit of the external rotation in both groups and on both sides (surgical, 61.60% and 57.80% and non-surgical, 62.06% and 54.06%, for the dominant and non-dominant sides, respectively. The peak torque ratio revealed that the horizontal adduction muscles on the injured side showed similar weakness in both groups (surgical, 86.27%; non-surgical, 98.61%. CONCLUSIONS: This study included the largest single series of athletes reported to date for this type of injury. A comparative analysis of muscular strength and balance showed no differences between the treatment modalities for pectoralis major muscle rupture. However, the number of significant clinical deficiencies was lower in the surgical group than in the non-surgical group, and both treatment modalities require greater attention to the rehabilitation process, especially for the recovery of muscle strength and balance.

  16. A new contrast agent for radiological and dissection studies of the arterial network of anatomic specimens.

    Science.gov (United States)

    Bulla, A; Casoli, C; Farace, F; Mazzarello, V; De Luca, L; Rubino, C; Montella, A

    2014-01-01

    The aim of the present study is to propose a new contrast agent that can be easily applied both to CT and dissection studies to replace lead oxide based formulas for comparative anatomical analyses of the vascularisation of cadaveric specimens. The infusion material was an epoxy resin, especially modified by the addition of barium sulphate to enhance its radiopacity. The final copolymer was toxicologically safe. To test the properties of the new material, several cadaveric limb injections were performed. The injected specimens were both CT scanned to perform 3D vascular reconstructions and dissected by anatomical planes. There was a perfect correspondence between the image studies and the dissections: even the smallest arteries on CT scan can be identified on the specimen and vice versa. The properties of the epoxy allowed an easy dissection of the vessels. The new imaging techniques available today, such as CT scan, can evaluate the vascular anatomy in high detail and 3D. This new contrast agent may help realising detailed vascular studies comparing CT scan results with anatomical dissections. Moreover, it may be useful for teaching surgical skills in the field of plastic surgery.

  17. Conceptual design of a biological specimen holding facility. [Life Science Laboratory for Space Shuttle

    Science.gov (United States)

    Jackson, J. K.; Yakut, M. M.

    1976-01-01

    An all-important first step in the development of the Spacelab Life Science Laboratory is the design of the Biological Specimen Holding Facility (BSHF) which will provide accommodation for living specimens for life science research in orbit. As a useful tool in the understanding of physiological and biomedical changes produced in the weightless environment, the BSHF will enable biomedical researchers to conduct in-orbit investigations utilizing techniques that may be impossible to perform on human subjects. The results of a comprehensive study for defining the BSHF, description of its experiment support capabilities, and the planning required for its development are presented. Conceptual designs of the facility, its subsystems and interfaces with the Orbiter and Spacelab are included. Environmental control, life support and data management systems are provided. Interface and support equipment required for specimen transfer, surgical research, and food, water and waste storage is defined. New and optimized concepts are presented for waste collection, feces and urine separation and sampling, environmental control, feeding and watering, lighting, data management and other support subsystems.

  18. 骨科手术患者切口感染的危险因素分析与预防对策%Analysis on risk factors and control measures for orthopedic surgical wound infections

    Institute of Scientific and Technical Information of China (English)

    杨群英; 杨园园; 陶树平; 陈红卫

    2014-01-01

    目的:调查分析骨科手术患者切口感染的主要影响因素,为骨科临床降低手术后感染率提供参考依据。方法选取2011年6月-2012年12月在医院骨科进行手术治疗的1816例患者,对其手术相关因素及术后感染情况进行统计分析,分析骨科无菌手术切口感染的危险因素,根据危险因素探讨防治切口感染的措施,采用SPSS 17.0软件包进行统计分析。结果1816例骨科手术患者中有16例发生切口感染,感染率为1.54%;老年患者、Ⅲ类手术切口、手术部位在腰腹以下、手术耗时长等因素可导致骨科手术患者切口感染,差异均有统计学意义(P<0.05)。结论导致骨科手术患者术后切口感染的影响因素较多,医护人员在对患者给予骨科手术治疗时,应综合评估患者自身情况、医院感染控制管理规范给予预防性的干预措施,尽可能减少骨科手术后切口感染的发生。%OBJECTIVE To analyze the risk factors for orthopedic surgical wound infections ,so as to provide refer-ence of reducing infection after orthopedic operation .METHODS A total of 1 816 cases with surgery from Jun . 2011 to Dec .2012 in our hospital were selected and statistically analyzed the operation-related factors and situation of postoperative infection .Risk factors of wound infections after aseptic orthopedic surgical were analyzed and based these factors to discuss about preventive measures .SPSS 17 .0 software was used for statistical analysis . RESULTS Among 1 816 patients with orthopedic surgery ,16 cases had wound infections ,accounting for 1 .54% . Elderly patients ,Ⅲ incision operation area ,surgery sites below the waist and abdomen ,long time-consuming operation were the factors that might cause wound infections after orthopedic surgery ,and the difference was sig-nificant (P<0 .05) .CONCLUSION Many factors can cause incision infections after the surgery ,the doctors and nurses

  19. Design Analysis of the Mixed Mode Bending Sandwich Specimen

    DEFF Research Database (Denmark)

    Quispitupa, Amilcar; Berggreen, Christian; Carlsson, Leif A.

    2010-01-01

    A design analysis of the mixed mode bending (MMB) sandwich specimen for face–core interface fracture characterization is presented. An analysis of the competing failure modes in the foam cored sandwich specimens is performed in order to achieve face–core debond fracture prior to other failure modes....... The analysis facilitates selection of the appropriate geometry for the MMB sandwich specimen to promote debond failure. An experimental study is performed using MMB sandwich specimens with a H100 PVC foam core and E-glass–polyester faces. The results reveal that debond propagation is successfully achieved...... for the chosen geometries and mixed mode loading conditions....

  20. A Debonded Sandwich Specimen Under Mixed Mode Bending (MMB)

    DEFF Research Database (Denmark)

    Quispitupa, Amilcar; Berggreen, Christian; Carlsson, Leif A.

    2008-01-01

    Face/core interface crack propagation in sandwich specimens is analyzed. A thorough analysis of the typical failure modes in sandwich composites was performed in order to design the MMB specimen to promote face/core debond fracture. Displacement, compliance and energy release rate expressions...... for the MMB specimen were derived from a superposition analysis. An experimental verification of the methodology proposed was performed using MMB sandwich specimens with H100 PVC foam core and E-glass/polyester non-crimp quadro-axial [0/45/90/-45]s DBLT-850 faces. Different mixed mode loadings were applied...

  1. A Debonded Sandwich Specimen Under Mixed Mode Bending (MMB)

    DEFF Research Database (Denmark)

    Quispitupa, Amilcar; Berggreen, Christian; Carlsson, Leif A.

    2008-01-01

    Face/core interface crack propagation in sandwich specimens is analyzed. A thorough analysis of the typical failure modes in sandwich composites was performed in order to design the MMB specimen to promote face/core debond fracture. Displacement, compliance and energy release rate expressions...... for the MMB specimen were derived from a superposition analysis. An experimental verification of the methodology proposed was performed using MMB sandwich specimens with H100 PVC foam core and E-glass/polyester non-crimp quadro-axial [0/45/90/-45]s DBLT-850 faces. Different mixed mode loadings were applied...

  2. High-frequency ultrasonic imaging of thickly sliced specimens

    Science.gov (United States)

    Miyasaka, Chiaki; Tittmann, Bernhard R.; Chandraratna, Premindra A. N.

    2003-07-01

    It has been reported that a mechanical scanning reflection acoustic microscope (hereinafter called simply "SAM"), using high frequency ultrasonic tone-burst waves, can form a horizontal cross-sectional image (i.e., c-scan image) showing a highly resolved cellular structure of biological tissue. However, the tissue prepared for the SAM has been mostly a thinly sectioned specimen. In this study, the SAM images of specimens thickly sectioned from the tissue were analyzed. Optical and scanning acoustic microscopies were used to evaluate tissues of human small intestine and esophagus. For preparing thin specimens, the tissue was embedded in paraffin, and substantially sectioned at 5-10μm by the microtome. For optical microscopy, the tissue was stained with hematoxylin and eosin, and affixed onto glass substrates. For scanning acoustic microscopy, two types of specimens were prepared: thinly sectioned specimens affixed on the glass substrate, wherein the specimens were deparaffinized in xylene, but not stained, and thickely sectioned specimens. Images of the thick specimens obtained with frequency at 200 MHz revealed cellular structures. The morphology was very similar to that seen in the thinly sectioned specimens with optical and scanning acoustic microscopy. In addition, scanning electron microscopy was used to compare the images of biological tissue. An acoustic lens with frequency at 200 MHz permitted the imaging of surface and/or subsurface of microstructures in the thick sections of small intestine and esophagus.

  3. 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.

  4. 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.

  5. Maternal screening for hypothyroidism and thyroiditis using filter paper specimens.

    Science.gov (United States)

    Foley, T P; Henry, J J; Hofman, L F; Thomas, R D; Sanfilippo, J S; Naylor, E W

    2013-11-01

    Hypothyroidism and autoimmune thyroiditis are more prevalent than previously considered in women during pregnancy and the postpartum, and are associated with adverse effects on the mother and her fetus. We determined the efficacy and accuracy of screening women for primary hypothyroidism and autoimmune thyroiditis by testing TSH and two thyroid antibodies (TAb): thyroperoxidase antibodies (TPOAb) and thyroglobulin antibodies (TgAb), in eluates of filter paper specimens collected during early pregnancy and the postpartum. We enrolled 494 first-trimester pregnant women with no exclusion criteria into a prospective study to detect primary hypothyroidism and autoimmune thyroiditis. Finger stick blood was applied to filter paper, dried in room air, eluted, and promptly tested for TSH and TAb. A total of 178 of the pregnant women (36%) were tested in the early postpartum. Women with abnormal results had confirmatory serum tests. It was found that 91 pregnant women (18.4%) and 43 postpartum women (24.2%) had abnormal TSH values (>4.0 mU/L) and/or positive TAb; 140 pregnant women (28.3%) had TSH values >2.5 mU/L. All subjects with TSH values >4.0 mU/L tested positive for TAb. Eighteen women (3.6%) who tested normal during pregnancy tested abnormal in the postpartum. This study confirms that TSH and TPOAb measured in eluates of blood-spotted filter paper specimens are excellent screening tests to detect primary hypothyroidism and autoimmune thyroiditis in pregnant and postpartum women. Results are very comparable to serum data in this population published in the literature.

  6. A Study on Mechanical behavior of Tensile Specimen Fabricated by Laser Cutting

    Energy Technology Data Exchange (ETDEWEB)

    Jin, Y. G.; Kim, G. S.; Baik, S. J.; Baek, S. Y. [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

    2016-10-15

    The mechanical testing data are required for the assessment of dry storage of the spent nuclear fuel. Laser cutting system could be useful tools for material processing such as cutting in radioactive environment due to non-contact nature, ease in handling and the laser cutting process is most advantageous, offering the narrow kerf width and heat affected zone by using small beam spot diameter. The feasibility of the laser cutting system was demonstrated for the fabrication of various types of the unirradiated cladding with and without oxide layer on the specimens. In the present study, the dimensional measurement and tensile test were conducted to investigate the mechanical behavior of the axial tensile test specimens depending on the material processing methods in a hot cell at IMEF (Irradiated Materials Examination Facility) of KAERI. Laser cutting system was used to fabricate the tensile test specimens, and the mechanical behavior was investigated using the dimensional measurement and tensile test. It was shown that the laser beam machining could be a useful tool to fabricate the specimens and this technique will be developed for the fabrication of various types of irradiated specimens in a hotcell.

  7. Comparative analysis of hospital and forensic laboratory ethanol concentrations: A 15 month investigation of antemortem specimens.

    Science.gov (United States)

    Saitman, Alec; Estrada, Julio; Fitzgerald, Robert L; McIntyre, Iain M

    2015-07-01

    Quantitative serum alcohol concentrations from regional hospitals (from specimens collected at time of hospital admission) were compared to results from whole blood (from specimens collected at the time of hospital admission) concentrations measured at the San Diego County Medical Examiner's Office (SDCMEO). Over a 15 month period (January 2012 to March 2013), the postmortem forensic toxicology laboratory analyzed a total of 2,321 cases. Of these, 280 were hospital cases (antemortem) representing 12% of the overall Medical Examiner toxicology casework. 59 of the 280 hospital cases (or 21%) screened positive for alcohol (ethanol). 39 of these 59 cases were included in the study based on available specimens for quantitative analyses. This investigation indicated that serum hospital ethanol concentrations correlated well (R(2) = 0.942) with ethanol values determined at SDCMEO (generally measured in whole blood). There was an observed negative bias with an average of -14.1%. A paired t-test was applied to the data and it was shown that this observed bias is statistically significant. These differences in ethanol concentrations could result from differences in specimen, analytical techniques, and/or calibration. The potential for specimen contamination is also discussed.

  8. Peculiarities of Specimen Preparation for the Investigation of Woven Structure Deformations using Image Analysis

    Directory of Open Access Journals (Sweden)

    Jovita DARGIENĖ

    2013-03-01

    Full Text Available The paper presents a method based on non – contact image analysis, which allows to simplify experimental process and increase measurement accuracy, identifying local deformations of woven material. Striving to gain accuracy of image analysis results, specimen preparation and deformation process fixation stages are of great importance. For the studies differently marked specimen groups were prepared. Their behaviour in process of tension was analysed using a special calibrated image acquisition system. Using digital images of deformed specimen the displacement of the marked surface elements - points and their shape changes were measured and material deformations in separate specimen parts (A and B were described. According the obtained results zones of uniform deformations were established and it confirmed that stretched specimen was deformed unevenly. Mild deformations obtained in part A and the highest values of deformation recorded in the centre of part B: local deformations in the transverse to tension direction were set up to -42.9 % and 27.6 % of local elongation along tension direction. Results of local deformation variation explain buckling phenomenon of bias stretched fabric. Particular local deformation values allow us to describe behaviour of deformed material, bring opportunities to perform experimental and modelling comparison of the results. The suggested methodology could be applied for the investigation of differently deformed material behaviour.DOI: http://dx.doi.org/10.5755/j01.ms.19.1.3830

  9. 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

  10. A Method Of Calculating Thermal Diffusivity And Conductivity For Irregularly Shaped Specimens In Laser Flash Analysis

    Directory of Open Access Journals (Sweden)

    Szałapak Jerzy

    2015-12-01

    Full Text Available The Low Temperature Joining Technique (LTJT using silver compounds enables to significantly increase the thermal conductivity between joined elements, which is much higher than for soldered joints. However, it also makes difficult to measure the thermal conductivity of the joint. The Laser Flash Analysis (LFA is a non-intrusive method of measuring the temperature rise of one surface of a specimen after excitation with a laser pulse of its other surface. The main limitation of the LFA method is its standard computer software, which assumes the dimensions of a bonded component to be similar to those of the substrate, because it uses the standard Parker’s formula dedicated for one-dimensional heat flow. In the paper a special design of measured specimen was proposed, consisting of two copper plates of different size joined with the sintered silver layer. It was shown that heat properties of these specimens can also be measured after modifying the LFA method. The authors adapted these specimens by masking the false heat signal sourced from the uncovered plate area. Another adaptation was introducing a correcting factor of the heat travel distance, which was calculated with heat-flow simulations and placed into the Parker’s formula. The heat-flow simulated data were compared with the real LFA measurement results, which enabled estimation of the joint properties, e.g. its porosity.

  11. Surgical management of traumatic brain injury

    DEFF Research Database (Denmark)

    Hartings, Jed A; Vidgeon, Steven; Strong, Anthony J;

    2014-01-01

    OBJECT: Mass lesions from traumatic brain injury (TBI) often require surgical evacuation as a life-saving measure and to improve outcomes, but optimal timing and surgical technique, including decompressive craniectomy, have not been fully defined. The authors compared neurosurgical approaches...... enrolled in the Co-Operative Studies on Brain Injury Depolarizations (COSBID) at King's College Hospital (KCH, n = 27) and Virginia Commonwealth University (VCU, n = 24) from July 2004 to March 2010. Subdural electrode strips were placed at the time of surgery for subsequent electrocorticographic...

  12. Evaluation of the effect of formalin fixation on skin specimens in dogs and cats

    Directory of Open Access Journals (Sweden)

    Jaimie L. Miller

    2014-03-01

    Full Text Available Skin and subcutaneous tissues are the origin of most common neoplasms affecting dogs, accounting for approximately one third of all tumors encountered in the species. Surgical excision is frequently the best chance for a cure; determining factors influencing the success of excision are vital for surgical management of cases. This work examined the shrinkage of skin of various lengths from three sites in formalin for both dogs and cats. Tissues were measured on the animal (initial measurement, at the time of excision (post-removal, and after formalin fixation (post-fixation. While shrinkage after tissue removal was found in samples from the thorax, abdomen, and rear leg in dogs and from the rear leg in cats, no significant shrinkage due to formalin fixation was detected in any sample except for the thoracic samples from the dog. Therefore, when determining where to make incisions to effect a surgical cure, initial measurements should take into account tissue shrinkage effects.

  13. 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.

  14. Contributors to Surgical In-patient Satisfaction—Development and Reliability of a Targeted Instrument

    Directory of Open Access Journals (Sweden)

    CSK Cheung

    2009-07-01

    Conclusions: The initial version of HK2Happ was reliable in assessing surgical patient satisfaction. The measure is now undergoing validity testing across different surgical patient populations for generalisation and generation of a short form of discriminant items.

  15. [Current possibilities to influence surgical site infection].

    Science.gov (United States)

    Bělina, F

    2017-01-01

    Infections associated with surgical procedures, also referred to as surgical site infections (SSIs), are the most common nosocomial infections (HAIs - Health Care-Associated Infections) in surgery departments. Although effectively preventable in most cases, they are still associated with significant morbidity and mortality, prolonged or repeated hospitalizations and increased treatment costs. Therefore, compliance with applicable procedures and guidelines is essential for SSI prevention, which was also shown in numerous EBM studies. Relevant procedures and clinical guidelines involve all phases of perioperative care, covering preoperative patient preparation, the course of the surgical procedure itself, as well as post-operative care. In order to effectively reduce the risk of postoperative infectious complications, these proven principles and procedures need to be implemented into daily practice with every single surgical patient. Continuous monitoring of compliance with these procedures, staff education, recording the incidence of SSI in individual departments with regular evaluation and presentation of results should form an integral part of these measures.Key words: surgical site infection - incidence - risk factors - prevention - guidelines.

  16. Measuring Work Functions Of "Dirty" Surfaces With A Vibrating Capacitive Probe

    Science.gov (United States)

    Yost, William T.

    1995-01-01

    Apparatus measures work function of possibly contaminated surface of specimen of metal or other electrically conductive material. Measures work function of specimen indirectly, by vibrating capacitive measurement of contact potential. Work function of specimen affected by microstructure and by contamination.

  17. Failed PCR of Ganoderma type specimens affects nomenclature.

    Science.gov (United States)

    Paterson, R R M; Lima, N

    2015-06-01

    The nomenclature of Ganoderma used as a Chinese medicine is debated. A group of researchers could not amplify the DNA of type specimens and concluded the DNA was degraded irreparably. New topotypes were used as the type specimens which was premature. The use of internal amplification controls is recommended to determine if other factors were involved as alternative explanations.

  18. 16 CFR Figure 7 to Subpart A of... - Specimen Tray

    Science.gov (United States)

    2010-01-01

    ... 16 Commercial Practices 2 2010-01-01 2010-01-01 false Specimen Tray 7 Figure 7 to Subpart A of Part 1209 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION CONSUMER PRODUCT SAFETY ACT... to Subpart A of Part 1209—Specimen Tray EC03OC91.037 ...

  19. 46 CFR 57.06-4 - Production testing specimen requirements.

    Science.gov (United States)

    2010-10-01

    ... plates three-fourths inch or less in thickness one reduced section tensile specimen and two free-bend... saw into as many portions of the thickness as necessary, as shown in Figure 57.06-4(f)(1)(ii) each of..., the specimen may be cut with a thin saw into as many portions of the thickness as necessary as shown...

  20. A cylindrical specimen holder for electron cryo-tomography

    Energy Technology Data Exchange (ETDEWEB)

    Palmer, Colin M., E-mail: cpalmer@mrc-lmb.cam.ac.uk; Löwe, Jan, E-mail: jyl@mrc-lmb.cam.ac.uk

    2014-02-01

    The use of slab-like flat specimens for electron cryo-tomography restricts the range of viewing angles that can be used. This leads to the “missing wedge” problem, which causes artefacts and anisotropic resolution in reconstructed tomograms. Cylindrical specimens provide a way to eliminate the problem, since they allow imaging from a full range of viewing angles around the tilt axis. Such specimens have been used before for tomography of radiation-insensitive samples at room temperature, but never for frozen-hydrated specimens. Here, we demonstrate the use of thin-walled carbon tubes as specimen holders, allowing the preparation of cylindrical frozen-hydrated samples of ribosomes, liposomes and whole bacterial cells. Images acquired from these cylinders have equal quality at all viewing angles, and the accessible tilt range is restricted only by the physical limits of the microscope. Tomographic reconstructions of these specimens demonstrate that the effects of the missing wedge are substantially reduced, and could be completely eliminated if a full tilt range was used. The overall quality of these tomograms is still lower than that obtained by existing methods, but improvements are likely in future. - Highlights: • The missing wedge is a serious problem for electron cryo-tomography. • Cylindrical specimens allow the missing wedge to be eliminated. • Carbon nanopipettes can be used as cylindrical holders for tomography of frozen-hydrated specimens. • Cryo-tomography of cylindrical biological samples demonstrates a reduction of deleterious effects associated with the missing wedge.

  1. Preparation of Articular Cartilage Specimens for Scanning Electron Microscopy.

    Science.gov (United States)

    Stupina, T A

    2016-08-01

    We developed and adapted a technology for preparation of articular cartilage specimens for scanning electron microscopy. The method includes prefixation processing, fixation, washing, and dehydration of articular cartilage specimens with subsequent treatment in camphene and air-drying. The technological result consists in prevention of deformation of the articular cartilage structures. The method is simpler and cheaper than the known technologies.

  2. The whereabouts of pre-nineteenth century bird specimens

    NARCIS (Netherlands)

    Steinheimer, F.D.

    2005-01-01

    The paper lists the whereabouts of surviving pre-nineteenth century bird collections containing altogether about 1500-3000 specimens. They are found in more than 50 institutions world-wide, with Berlin, Leiden, Paris, Stockholm, Tring and Vienna museums each holding more than 200 bird specimens from

  3. On a specimen of Lumbricus terrestris, L. with bifurcated tail

    NARCIS (Netherlands)

    Horst, R.

    1886-01-01

    In the last number of the »Annals and Magazine of Nat. History” (Dec. 1885), I find a notice of Prof. Jeffrey Bell about two Lumbrici with bifid hinder ends, one specimen belonging to L. terrestris, the other to L. foetidus; moreover he mentions a specimen, presenting a similar remarquable arrangeme

  4. The whereabouts of pre-nineteenth century bird specimens

    NARCIS (Netherlands)

    Steinheimer, F.D.

    2005-01-01

    The paper lists the whereabouts of surviving pre-nineteenth century bird collections containing altogether about 1500-3000 specimens. They are found in more than 50 institutions world-wide, with Berlin, Leiden, Paris, Stockholm, Tring and Vienna museums each holding more than 200 bird specimens from

  5. 40 CFR 792.51 - Specimen and data storage facilities.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 31 2010-07-01 2010-07-01 true Specimen and data storage facilities. 792.51 Section 792.51 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) TOXIC SUBSTANCES CONTROL ACT (CONTINUED) GOOD LABORATORY PRACTICE STANDARDS Facilities § 792.51 Specimen and data...

  6. 综合手术救治方舱X线辐射防护措施的评价%Evaluation of X-ray radioprotection measures in the comprehensive surgical cabinet

    Institute of Scientific and Technical Information of China (English)

    王猛; 梁明; 姚天明; 孙景阳; 邵会雨; 韩雅玲

    2013-01-01

    Objective The aim of this shirty was to determine the radiation from the c-ann X-ray machine in the comprehensive surgical cabinet and evaluate the radioprotection measures in order to adapt the measures to different conditions, especially the treatment of cardiovascular events or trauma in sudden natural disasters. Methods A radiation detector was used to detect the dose of radiation affecting the surgeons beside the c-ann X-ray machine in the surgical cabinet with or without lead-shade radioprotection. The radiation dose was determined in 9 perspective positions-anteroposterior, head, right shoulder, right anterior oblique, left shoulder, left anterior oblique, liver, spleen and foot. Results The radiation dose received by the surgeons with lead-shade protection was significantly lower than that received by those without protection in various positions (anteroposterior: [ 7. 89±0.19 vs 229. 80±1. 30 ] uGy/h, P<0.001; head: [ 16. 86±0.11 vs 255. 20±1. 30 ] uGy/h, P<0.001; right shoulder [ 32. 38±1. 38 vs 249. 00±1. 22 ] uGy/h, P<0.001; right anterior oblique: [ 37. 84±0.35 vs 134. 60±1. 52 ] uGy/h, P<0.001; left shoulder [ 38. 20±0.07 vs 282.40±1.14] uGy/h, P<0.001; left anterior oblique [ 26. 54±0.15 vs 276. 00±1. 22 ] uGy/h, P<0.001; liver [36. 50±0.19 vs 126. 00±1.22 ] uGy/h, P<0.001; spleen [ 34. 36±0.21 vs 261. 00±1. 00 ] uGy/h, P<0.001; foot [ 36. 44±0.22 vs 149.00±1.00] uGy/h, P<0.001). Conclusion The radioprotection measures in the surgical cabinet could prevent most of the radiation from the c-ann X-ray machine, but great importance should be attached to the unprotected area by improving radioprotection measures and observing operating regulations.%目的 为了适应不同环境,特别是突发自然灾害等情况下心血管事件及外伤的处理,开发研制了能够快速移动救治的方舱,文中通过对综合手术救治方舱C型臂X线机放射情况监测,评价其放射及防护情况.方法 采用辐射剂量检测仪,

  7. Comparison of Red Blood Cell Hemolysis Using Plasma and Serum Separation Tubes for Outpatient Specimens

    Science.gov (United States)

    Ko, Dae-Hyun; Won, Dahae; Jeong, Tae-Dong; Lee, Woochang; Chun, Sail

    2015-01-01

    Background To rapidly obtain outpatient results, we use plasma separation tubes (PST) for chemistry analysis. If lactate dehydrogenase measurement is required, serum separation tubes (SST) are used. There has been no evaluation of hemolysis with these tubes. We compared the hemolytic index (HI) obtained by using PST and SST and applied this for choosing appropriate tubes for clinical laboratories. Methods The HI of specimens obtained from outpatients visiting Asan Medical Center between July and December 2012 was analyzed. The HI was scored from 0 to 10 by using the Toshiba 200FR (Toshiba Medical Systems Co., Japan). HI was classified by sample tube type, and significant hemolysis was defined as a HI of 2 or more. For significant hemolysis cases, medical records were reviewed to identify the causes. Results Among 171,519 specimens, significant hemolysis was observed in 0.66% of specimens (0.68% of PST specimens, 0.46% of SST specimens). The mean HI in PST was 0.18 (SD: 0.43) and that in SST was 0.14 (SD: 0.37). The proportion of significant hemolysis was significantly higher in PST than in SST (P=0.001). The cause of significant hemolysis was identified as chemotherapy and prosthetic valve in 48.1% of specimens. Complex sampling errors may have caused significant hemolysis in the remaining 51.9% of specimens. Conclusions The incidence of hemolysis was slightly higher for PST than SST, although both were sample volume, and less risk of random errors due to fibrin strands. PMID:25729720

  8. Design and validation of bending test method for characterization of miniature pediatric cortical bone specimens.

    Science.gov (United States)

    Albert, Carolyne I; Jameson, John; Harris, Gerald

    2013-02-01

    Osteogenesis imperfecta is a genetic disorder of bone fragility; however, the effects of this disorder on bone material properties are not well understood. No study has yet measured bone material strength in humans with osteogenesis imperfecta. Small bone specimens are often extracted during routine fracture surgeries in children with osteogenesis imperfecta. These specimens could provide valuable insight into the effects of osteogenesis imperfecta on bone material strength; however, their small size poses a challenge to their mechanical characterization. In this study, a validated miniature three-point bending test is described that enables measurement of the flexural material properties of pediatric cortical osteotomy specimens as small as 5 mm in length. This method was validated extensively using bovine bone, and the effect of span/depth aspect ratio (5 vs 6) on the measured flexural properties was examined. The method provided reasonable results for both Young's modulus and flexural strength in bovine bone. With a span/depth ratio of 6, the median longitudinal modulus and flexural strength results were 16.1 (range: 14.4-19.3)GPa and 251 (range: 219-293)MPa, respectively. Finally, the pilot results from two osteotomy specimens from children with osteogenesis imperfecta are presented. These results provide the first measures of bone material strength in this patient population.

  9. Tumor characterization and treatment monitoring of postsurgical human breast specimens using harmonic motion imaging (HMI).

    Science.gov (United States)

    Han, Yang; Wang, Shutao; Hibshoosh, Hanina; Taback, Bret; Konofagou, Elisa

    2016-05-09

    High-intensity focused ultrasound (HIFU) is a noninvasive technique used in the treatment of early-stage breast cancer and benign tumors. To facilitate its translation to the clinic, there is a need for a simple, cost-effective device that can reliably monitor HIFU treatment. We have developed harmonic motion imaging (HMI), which can be used seamlessly in conjunction with HIFU for tumor ablation monitoring, namely harmonic motion imaging for focused ultrasound (HMIFU). The overall objective of this study was to develop an all ultrasound-based system for real-time imaging and ablation monitoring in the human breast in vivo. HMI was performed in 36 specimens (19 normal, 15 invasive ductal carcinomas, and 2 fibroadenomas) immediately after surgical removal. The specimens were securely embedded in a tissue-mimicking agar gel matrix and submerged in degassed phosphate-buffered saline to mimic in vivo environment. The HMI setup consisted of a HIFU transducer confocally aligned with an imaging transducer to induce an oscillatory radiation force and estimate the resulting displacement. 3D HMI displacement maps were reconstructed to represent the relative tissue stiffness in 3D. The average peak-to-peak displacement was found to be significantly different (p = 0.003) between normal breast tissue and invasive ductal carcinoma. There were also significant differences before and after HMIFU ablation in both the normal (53.84 % decrease) and invasive ductal carcinoma (44.69 % decrease) specimens. HMI can be used to map and differentiate relative stiffness in postsurgical normal and pathological breast tissues. HMIFU can also successfully monitor thermal ablations in normal and pathological human breast specimens. This HMI technique may lead to a new clinical tool for breast tumor imaging and HIFU treatment monitoring.

  10. Effect of hydrogen sulfide emissions on cement mortar specimens

    Energy Technology Data Exchange (ETDEWEB)

    Idriss, A. F. [Alberta Environment, Science and Technology Branch, Edmonton, AB (Canada); Negi, S. C.; Jofriet, J. C.; Haywoard, G. L. [Guelph Univ., Guelph, ON (Canada)

    2001-07-01

    Six different cement mortar specimens used in animal buildings, where they were exposed to hydrogen sulfide generated from anaerobic fermentation of manure during a period of one year, were investigated. Primary interest was on comparing the corrosion resistance of different cement mortar specimens under long term exposure to hydrogen sulfide. The impressed voltage technique was used to test the specimens in the laboratory. Results revealed that test specimens made with eight per cent silica fume cement replacement performed best and similar Portland cement mortar specimens with a water-cement ratio of 0.55 (PC55) the poorest. All other treatments, (Portland cement with a water to cement ratio of 045, Portland cement Type 50, Portland cement with fibre mesh and Portland cement Type 10 coated with linseed oil) all with water-cement ratios of 0.45, were less effective in preventing corrosion than silica fume replacement.

  11. Study of patina formation on bronze specimens

    Energy Technology Data Exchange (ETDEWEB)

    Oliveira, F.J.R. de [Instituto de Quimica, Universidade Federal do Rio de Janeiro, Centro de Tecnologia, Bloco A, Sala 634A, Cidade Universitaria, Ilha do Fundao, CEP 21941-909, Rio Janeiro, RJ (Brazil); Lago, D.C.B.; Senna, L.F. [Instituto de Quimica da Universidade do Estado do Rio de Janeiro, Rua Sao Francisco Xavier, 524, Pavilhao Haroldo Lisboa da Cunha, Sala 427, CEP 20559-013, Rio Janeiro, RJ (Brazil); Miranda, L.R.M. de [Programa de Engenharia Metalurgica e de Materiais da Universidade Federal do Rio de Janeiro, Caixa postal 68563, CEP 21945-970, Rio Janeiro, RJ (Brazil); D' Elia, E., E-mail: eliane@iq.ufrj.br [Instituto de Quimica, Universidade Federal do Rio de Janeiro, Centro de Tecnologia, Bloco A, Sala 634A, Cidade Universitaria, Ilha do Fundao, CEP 21941-909, Rio Janeiro, RJ (Brazil)

    2009-06-15

    In this study, bronze samples (94.059% Cu; 0.023% Zn; 0.077% Pb and 5.801% Sn, w/w) were exposed for 8 months to a marine atmosphere (splash zone) at Barra of Tijuca Beach, Rio de Janeiro. X-ray diffraction analysis (XRD) was used to identify the composition of the corrosion products formed on the samples. The electrochemical properties were analyzed using potential and electrochemical impedance measurements. These analyses and measurements were obtained from periodically removed samples, and compared to those exposed to laboratory tests (total and alternating immersion) in 10{sup -2} mol L{sup -1} NaCl solution. The corrosion potential results, allied to XRD analysis, showed that the chemical nature of the films obtained on the surface of the field test samples was very similar to that obtained in the alternating immersion test. The main products identified were cuprite and atacamite. However, the film formed during the total immersion (TI) test was primarily composed of cuprite with nantokite traces, which was not observed in either the field or in alternating tests. The electrochemical impedance measurements obtained in laboratory and field test samples showed the formation of films with a porous structure. The thermodynamic evaluation was also consistent with the corrosion products formed.

  12. Phantom-based evaluation method for surgical assistance devices in minimally invasive cochlear implantation

    Science.gov (United States)

    Lexow, G. Jakob; Kluge, Marcel; Majdani, Omid; Lenarz, Thomas; Rau, Thomas S.

    2017-03-01

    Several research groups have proposed individual solutions for surgical assistance devices to perform minimally invasive cochlear implantation. The main challenge is the drilling of a small bore hole from the surface of the skull to the inner ear at submillimetric accuracy. Each group tested the accuracy of their device in their respective test bench or in a small number of temporal bone specimens. This complicates the comparison of the different approaches. Thus, a simple and inexpensive phantom based evaluation method is proposed which resembles clinical conditions. The method is based on half-skull phantoms made of bone-substitute material - optionally equipped with an artificial skin replica to include skin incision within the evaluation procedure. Anatomical structures of the temporal bone derived from segmentations using clinical imaging data are registered into a computer tomographic scan of the skull phantom and used for the planning of the drill trajectory. Drilling is performed with the respective device under conditions close to the intraoperative setting. Evaluation of accuracy can either be performed through postoperative imaging or by means of added targets on the inside of the skull model. Two different targets are proposed: simple reference marks only for measuring the accuracy of the device and a target containing a scala tympani model for evaluation of the complete workflow including the insertion of the electrode carrier. Experiments using the presented method take place under reproducible conditions thus allowing the comparison of the different approaches. In addition, artificial phantoms are easier to obtain and handle than human specimens.

  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. Face/core debond fatigue crack growth characterization using the sandwich mixed mode bending specimen

    DEFF Research Database (Denmark)

    Manca, Marcello; Quispitupa, Amilcar; Berggreen, Christian;

    2012-01-01

    Face/core fatigue crack growth in foam-cored sandwich composites is examined using the mixed mode bending (MMB) test method. The mixed mode loading at the debond crack tip is controlled by changing the load application point in the MMB test fixture. Sandwich specimens were manufactured using H45...... critical load, at load ratios of R=0.1 and 0.2. The crack length was determined during fatigue testing using the analytical compliance expression and verified by visual measurements. Fatigue crack growth results revealed higher crack growth rates for mode I dominated loading. For specimens with H45 core...

  16. Surgical data science: the new knowledge domain

    Directory of Open Access Journals (Sweden)

    Vedula S. Swaroop

    2017-04-01

    Full Text Available Healthcare in general, and surgery/interventional care in particular, is evolving through rapid advances in technology and increasing complexity of care, with the goal of maximizing the quality and value of care. Whereas innovations in diagnostic and therapeutic technologies have driven past improvements in the quality of surgical care, future transformation in care will be enabled by data. Conventional methodologies, such as registry studies, are limited in their scope for discovery and research, extent and complexity of data, breadth of analytical techniques, and translation or integration of research findings into patient care. We foresee the emergence of surgical/interventional data science (SDS as a key element to addressing these limitations and creating a sustainable path toward evidence-based improvement of interventional healthcare pathways. SDS will create tools to measure, model, and quantify the pathways or processes within the context of patient health states or outcomes and use information gained to inform healthcare decisions, guidelines, best practices, policy, and training, thereby improving the safety and quality of healthcare and its value. Data are pervasive throughout the surgical care pathway; thus, SDS can impact various aspects of care, including prevention, diagnosis, intervention, or postoperative recovery. The existing literature already provides preliminary results, suggesting how a data science approach to surgical decision-making could more accurately predict severe complications using complex data from preoperative, intraoperative, and postoperative contexts, how it could support intraoperative decision-making using both existing knowledge and continuous data streams throughout the surgical care pathway, and how it could enable effective collaboration between human care providers and intelligent technologies. In addition, SDS is poised to play a central role in surgical education, for example, through objective

  17. Surgical data science: The new knowledge domain.

    Science.gov (United States)

    Vedula, S Swaroop; Hager, Gregory D

    2017-04-01

    Healthcare in general, and surgery/interventional care in particular, is evolving through rapid advances in technology and increasing complexity of care with the goal of maximizing quality and value of care. While innovations in diagnostic and therapeutic technologies have driven past improvements in quality of surgical care, future transformation in care will be enabled by data. Conventional methodologies, such as registry studies, are limited in their scope for discovery and research, extent and complexity of data, breadth of analytic techniques, and translation or integration of research findings into patient care. We foresee the emergence of Surgical/Interventional Data Science (SDS) as a key element to addressing these limitations and creating a sustainable path toward evidence-based improvement of interventional healthcare pathways. SDS will create tools to measure, model and quantify the pathways or processes within the context of patient health states or outcomes, and use information gained to inform healthcare decisions, guidelines, best practices, policy, and training, thereby improving the safety and quality of healthcare and its value. Data is pervasive throughout the surgical care pathway; thus, SDS can impact various aspects of care including prevention, diagnosis, intervention, or post-operative recovery. Existing literature already provides preliminary results suggesting how a data science approach to surgical decision-making could more accurately predict severe complications using complex data from pre-, intra-, and post-operative contexts, how it could support intra-operative decision-making using both existing knowledge and continuous data streams throughout the surgical care pathway, and how it could enable effective collaboration between human care providers and intelligent technologies. In addition, SDS is poised to play a central role in surgical education, for example, through objective assessments, automated virtual coaching, and robot

  18. The importance of tissue handling of surgically removed breast cancer for an accurate assessment of the Ki-67 index

    Science.gov (United States)

    Arima, Nobuyuki; Nishimura, Reiki; Osako, Tomofumi; Nishiyama, Yasuyuki; Fujisue, Mamiko; Okumura, Yasuhiro; Nakano, Masahiro; Tashima, Rumiko; Toyozumi, Yasuo

    2016-01-01

    Aim Insufficient attention for the Ki-67 immunohistochemistry has been given to the importance of tissue handling for surgical breast cancer specimens. We sought to investigate the effect of fixation status on the Ki-67. Methods We examined the effect of fixative, time to and duration of fixation using surgical specimens, and finally, compared the paired Ki-67 index in the tumour between core needle and surgical specimen. Results The Ki-67 was significantly higher when 10% neutral buffered formalin was used (p=0.0276). Insufficient fixation caused a drastic reduction in the Ki-67 index (p=0.0177), but not significant in oestrogen receptor (ER) and human epidermal growth factor receptor 2 (HER2). Sixteen hours delayed time to fixation also caused a reduction of the Ki-67 (p=0.0284), but not significant in ER. Prolonged fixation significantly led to a gradual reduction in the Ki-67 in a time-dependent manner, but not in both ER and HER2. Finally, cutting the tumour before fixation improved fixation status and consequently caused an increased level of the Ki-67 index (p=0.0181), which resulted in a strong correlation of the Ki-67 between core needle and surgical specimen (r=0.8595). Conclusions Tissue handling of surgical specimen is critical for assessing the Ki-67 compared with ER and HER2. We should pay more attention to tissue fixation status for the standard assessment of the Ki-67 index. PMID:26420767

  19. Axial-torsional fatigue: A study of tubular specimen thickness effects

    Science.gov (United States)

    Bonacuse, Peter J.; Kalluri, Sreeramesh

    1990-01-01

    A room-temperature experimental program was conducted on AISI type 316 stainless steel to determine the effect of wall thickness on the cyclic deformation behavior and fatigue life of thin-wall, tubular, axial-torsional fatigue specimens. The following experimental variables were examined in this study: the depth of the surface work-hardened layer produced in specimen machining, and the effects of strain range and axial-torsional strain phasing. Tubular fatigue specimens were fabricated with wall thicknesses of 1.5, 2.0, and 2.5 mm. One as-fabricated specimen from each wall thickness was sectioned for microstructural examination and microhardness measurement. A specimen of each wall thickness was tested at each of three conditions - high strain range in-phase, low strain range in-phase, and low strain range out-of-phase - for a total of nine axial-torsional fatigue experiments. The machining-induced work-hardened zone, as a percentage of the gage section material, was found to have a minimal effect on both deformation behavior and fatigue life. Also, little or no variation in fatigue life or deformation behavior as a function of wall thickness was observed. Out-of-phase fatigue tests displayed shorter fatigue lives and more cyclic hardening than in-phase tests.

  20. Axial-torsional fatigue - A study of tubular specimen thickness effects

    Science.gov (United States)

    Bonacuse, Peter J.; Kalluri, Sreeramesh

    1993-01-01

    Experiments were carried out at room temperature on AISI type 316 stainless steel to determine the effect of wall thickness on the cyclic deformation behavior and fatigue life of thin-wall tubular axial-torsional fatigue specimens. The experimental variables examined included the depth of the surface work-hardened layer produced in specimen machining, and the effects of strain range and axial-torsional strain phasing. Tubular fatigue specimens had wall thicknesses of 1.5, 2.0, and 2.5 mm. One as-fabricated specimen from each wall thickness was sectioned for microstructural examination and microhardness measurement. A specimen of each wall thickness was tested in axial-torsional fatigue experiments for each of the three conditions: high strain range in-phase, low strain range in-phase, and low strain range out-of-phase. The machining-induced work-hardened zone, as a percentage of the gage section material, was found to have a minimal effect on both deformation behavior and fatigue life. Out-of-phase fatigue tests displayed shorter fatigue lives and more cyclic hardening than in-phase tests.

  1. Offset-sparsity decomposition for automated enhancement of color microscopic image of stained specimen in histopathology

    Science.gov (United States)

    Kopriva, Ivica; Hadžija, Marijana Popović; Hadžija, Mirko; Aralica, Gorana

    2015-07-01

    We propose an offset-sparsity decomposition method for the enhancement of a color microscopic image of a stained specimen. The method decomposes vectorized spectral images into offset terms and sparse terms. A sparse term represents an enhanced image, and an offset term represents a "shadow." The related optimization problem is solved by computational improvement of the accelerated proximal gradient method used initially to solve the related rank-sparsity decomposition problem. Removal of an image-adapted color offset yields an enhanced image with improved colorimetric differences among the histological structures. This is verified by a no-reference colorfulness measure estimated from 35 specimens of the human liver, 1 specimen of the mouse liver stained with hematoxylin and eosin, 6 specimens of the mouse liver stained with Sudan III, and 3 specimens of the human liver stained with the anti-CD34 monoclonal antibody. The colorimetric difference improves on average by 43.86% with a 99% confidence interval (CI) of [35.35%, 51.62%]. Furthermore, according to the mean opinion score, estimated on the basis of the evaluations of five pathologists, images enhanced by the proposed method exhibit an average quality improvement of 16.60% with a 99% CI of [10.46%, 22.73%].

  2. Ophiomusium acuferum (Ophiolepididae and Ophiomisidium pulchellum (Ophiuridae (Ophiuroidea: Echinodermata, redescription based on the Brazilian specimens

    Directory of Open Access Journals (Sweden)

    Michela Borges

    2011-04-01

    Full Text Available Ophiomusium (Ophiolepididae and Ophiomisidium (Ophiuridae are similar, but differ in features such as size of the adult, number of disc dorsal plates, length of the arms, shape of the first ventral arm plates and number of the tentacle. In this contribution, a large number of specimens of Ophiomusium acuferum Lyman, 1869 and Ophiomisidium pulchellum (Wyville Thomson, 1878 were sampled from southeastern and southern Brazilian at depths ranging from 46 to 1300 m. A close analysis has shown that specimens identified as Ophiomisidium pulchellum (C.W. Thomson, 1877 in several Brazilian museums are actually Ophiomusium acuferum Lyman, 1875. A total of 2330 individuals were examined: 2046 specimens of Ophiomusium acuferum ('Evaluation of the sustainable potential of living resources from the Brazilian Economic Exclusive Zone/Score South - Benthos' - REVIZEE; 'Rational usage of coastal ecosystems from the Brazilian Tropical Region: São Paulo State - Integrated Project/Subproject Benthos' - INTEGRADO; and the MD55/Brazil and 284 of Ophiomisidium pulchellum (MD55/Brazil. The disc diameter of each individual was measured and the specimens were digitally photographed. The samples studied are deposited in the Museum of Zoology of the University of Campinas and Institute of Biology at the Federal University of Rio de Janeiro. The specimens from the MD55 are deposited at the Paris Museum National d'Histoire Naturelle. An identification key to these species is provided here. A detailed morphological analysis and redescription of both species, comparisons, and their geographic distribution in Brazil are discussed.

  3. In-line phase contrast micro-CT reconstruction for biomedical specimens.

    Science.gov (United States)

    Fu, Jian; Tan, Renbo

    2014-01-01

    X-ray phase contrast micro computed tomography (micro-CT) can non-destructively provide the internal structure information of soft tissues and low atomic number materials. It has become an invaluable analysis tool for biomedical specimens. Here an in-line phase contrast micro-CT reconstruction technique is reported, which consists of a projection extraction method and the conventional filter back-projection (FBP) reconstruction algorithm. The projection extraction is implemented by applying the Fourier transform to the forward projections of in-line phase contrast micro-CT. This work comprises a numerical study of the method and its experimental verification using a biomedical specimen dataset measured at an X-ray tube source micro-CT setup. The numerical and experimental results demonstrate that the presented technique can improve the imaging contrast of biomedical specimens. It will be of interest for a wide range of in-line phase contrast micro-CT applications in medicine and biology.

  4. A novel biaxial specimen for inducing residual stresses in thermoset polymers and fibre composite material

    DEFF Research Database (Denmark)

    Jakobsen, Johnny; Andreasen, Jens Henrik; Jensen, Martin

    2015-01-01

    engineers when they challenge the material limits in present and future thermoset and composite component. In addition to the new specimen configuration, this paper presents an analytical solution for the residual stress state in the specimen. The analytical solution assumes linear elastic and isotropic......A new type of specimen configuration with the purpose of introducing a well-defined biaxial residual (axisymmetric) stress field in a neat thermoset or a fibre composite material is presented. The ability to experimentally validate residual stress predictions is an increasing need for design...... material behaviour. Experimental strain release measurements and the analytical solution determine the residual stress state present in the material. A demonstration on neat epoxy is conducted and residual stress predictions of high accuracy and repeatability have been achieved. The precise determination...

  5. Obtaining parotid saliva specimens after major surgery.

    Science.gov (United States)

    Good, Marion; Wotman, Stephen; Anderson, Gene Cranston; Ahn, Sukhee; Cong, Xiaomei

    2004-10-01

    The purpose of this study was to develop and test a standard method of collecting saliva from postoperative patients. Saliva was collected from patients following major abdominal surgery from both parotid glands in intraoral cups and measured in milliliters. Trained research nurses stimulated saliva production with lemon juice and collected saliva at 4 time points on postoperative day 2. Collection time was measured with a stopwatch, and flow rate was calculated by dividing the amount in milliliters by collection time in minutes. Attrition was 9% due to ineligibility after enrollment and 1 withdrawal. In participating patients (n = 68), there were 272 tests planned and 28% were missing. The reasons were postoperative health problems, hospital discharge, and not wanting to be bothered. When saliva collection attempts were made, three-fourths were successful, but the remainder resulted in "dry mouth." Milliliters, minutes, and flow rate were calculated with and without those with dry mouth. Mean flow rates were 0.23 to 0.33 ml/min excluding those with dry mouth and 0.17 to 0.24 ml/min including those with dry mouth. Saliva variables were correlated with antihypertension medications, opioids, opioid side effects, and length of surgery, but statistically significant correlations were not found consistently at all 4 time points. The findings suggest that nurse-researchers studying biological markers can successfully collect saliva from postoperative patients if they recognize the difficulties and make efforts to minimize and control for them.

  6. 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.

  7. Quality assessment and preservation of RNA from biobank tissue specimens: a systematic review.

    Science.gov (United States)

    Caixeiro, Nicole Joaquim; Lai, Ken; Lee, Cheok Soon

    2016-03-01

    It is well recognised that genomic, proteomic and biomarker studies require properly annotated and well-characterised biospecimens. Consequently, this necessitates biobanks to collect, store and distribute biospecimens under stringent quality control and assurance measures. However, despite this realisation, there remains a lack of standardisation in quality management among biobanks and consensus as to which quality indicators provide the optimal molecular diagnostic performance tools and information for biospecimens. In an attempt to identify key factors that predict tissue specimen integrity and quality, this systematic review investigated the measures reported in the literature, which characterised the collection, processing and storage of high-quality tissue specimens. Our findings demonstrated RNA integrity, alone, may not be an effective measure of tissue quality. Furthermore, the frequently reported parameters related to biospecimen integrity, such as storage time, temperature, time to cryopreservation and tissue morphology were also not effective indicators of quality control and assurance. These findings suggest that it is unlikely that a single marker will provide the optimal diagnostic and performance information for biospecimens, but rather, a panel of markers assessing the molecular integrity of the lifespan of the biospecimen is required. Further work is needed to identify which factors predict specimen integrity and quality in biobanked tissue specimens. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  8. Incidental parasitic infestations in surgically removed appendices: a retrospective analysis

    Directory of Open Access Journals (Sweden)

    Aydin Özgür

    2007-05-01

    Full Text Available Abstract Background Appendiceal parasites can cause symptoms of appendiceal pain, independent of microscopic evidence of acute inflammation. The diagnosis of a parasitic infestation is generally achieved only after the pathologic examination of the resected appendices. Patients/Methods Pathology department records were reviewed for all patients who required an operation for symptoms of acute appendicitis between 2000 and 2006. The specimens which were pathologically diagnosed to contain parasites were reevaluated for features of acute inflamation, and parasite type. The medical records were reviewed in detail to achieve a diagnostic score(Eskelinen. Radiologic imaging findings were correlated, if present. Results Of the 190 appendectomies performed, 6 specimens (3,15% were found to contain parasites(4 Enterobius vermicularis, 2 Taenia subspecies. Appendectomies with Taenia showed acute inflamation, while acute inflamation was absent in the ones with Enterobius vermicularis. The Eskelinen score was higher than the treshold in two cases with an acute inflamation, and in two without. Ultrasound scans, and a computed tomography scan were performed in 5 patients. In 3 of 4 bland appendices, results favored acute appendicitis. Conclusion The diagnosis of gastrointestinal parasites is not only made by examining the stool but the diagnosis can be made by histology from surgical specimens. Timely diagnosis and appropriate therapy might prevent probable future complications that may necessitate surgical procedures, at least in some of the patients. The clinical management of these infections is different from that for classical appendicitis.

  9. The Assessment and Validation of Mini-Compact Tension Test Specimen Geometry and Progress in Establishing Technique for Fracture Toughness Master Curves for Reactor Pressure Vessel Steels

    Energy Technology Data Exchange (ETDEWEB)

    Sokolov, Mikhail A. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Nanstad, Randy K. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States)

    2016-09-01

    Small specimens are playing the key role in evaluating properties of irradiated materials. The use of small specimens provides several advantages. Typically, only a small volume of material can be irradiated in a reactor at desirable conditions in terms of temperature, neutron flux, and neutron dose. A small volume of irradiated material may also allow for easier handling of specimens. Smaller specimens reduce the amount of radioactive material, minimizing personnel exposures and waste disposal. However, use of small specimens imposes a variety of challenges as well. These challenges are associated with proper accounting for size effects and transferability of small specimen data to the real structures of interest. Any fracture toughness specimen that can be made out of the broken halves of standard Charpy specimens may have exceptional utility for evaluation of reactor pressure vessels (RPVs) since it would allow one to determine and monitor directly actual fracture toughness instead of requiring indirect predictions using correlations established with impact data. The Charpy V-notch specimen is the most commonly used specimen geometry in surveillance programs. Assessment and validation of mini-CT specimen geometry has been performed on previously well characterized HSST Plate 13B, an A533B class 1 steel. It was shown that the fracture toughness transition temperature measured by these Mini-CT specimens is within the range of To values that were derived from various large fracture toughness specimens. Moreover, the scatter of the fracture toughness values measured by Mini-CT specimens perfectly follows the Weibull distribution function providing additional proof for validation of this geometry for the Master Curve evaluation of rector pressure vessel steels. Moreover, the International collaborative program has been developed to extend the assessment and validation efforts to irradiated weld metal. The program is underway and involves ORNL, CRIEPI, and EPRI.

  10. 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.

  11. Post-deformation examination of specimens subjected to SCC testing

    Energy Technology Data Exchange (ETDEWEB)

    Gussev, Maxim N. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Field, Kevin G. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Busby, Jeremy T. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Leonard, Keith J. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States)

    2016-09-01

    This report details the results of post-radiation and post-deformation characterizations performed during FY 2015–FY 2016 on a subset of specimens that had previously been irradiated at high displacement per atom (dpa) damage doses. The specimens, made of commercial austenitic stainless steels and alloys, were subjected to stress-corrosion cracking tests (constant extension rate testing and crack growth testing) at the University of Michigan under conditions typical of nuclear power plants. After testing, the specimens were returned to Oak Ridge National Laboratory (ORNL) for further analysis and evaluation.

  12. Small Specimen Data from a High Temperature HFIR Irradiation Experiment

    Energy Technology Data Exchange (ETDEWEB)

    Burchell, Timothy D [ORNL; McDuffee, Joel Lee [ORNL; Thoms, Kenneth R [ORNL

    2014-01-01

    The HTV capsule is a High Flux Isotope Reactor (HFIR) target-rod capsule designed to operate at very high temperatures. The graphite containing section of the capsule (in core) is approximately 18 inches (457.2 mm) long and is separated into eight temperature zones. The specimen diameters within each zone are set to achieve the desired gas gap and hence design temperature (900 C, 1200 C or 1500 C). The capsule has five zones containing 0.400 inch (10.16 mm) diameter specimens, two zones containing 0.350 inch (8.89 mm) diameter specimens and one zone containing 0.300 inch (7.62 mm) diameter specimens. The zones have been distributed within the experiment to optimize the gamma heating from the HFIR core as well as minimize the axial heat flow in the capsule. Consequently, there are two 900 C zones, three 1200 C zones, and three 1500 C zones within the HTV capsule. Each zone contains nine specimens 0.210 0.002 inches (5.334 mm) in length. The capsule will be irradiated to a peak dose of 3.17 displacements per atom. The HTV specimens include samples of the following graphite grades: SGL Carbon s NBG-17 and NBG-18, GrafTech s PCEA, Toyo Tanso s IG-110, Mersen s 2114 and the reference grade H-451 (SGL Carbon). As part of the pre-irradiation program the specimens were characterized using ASTM Standards C559 for bulk density, and ASTM C769 for approximate Young s modulus from the sonic velocity. The probe frequency used for the determination of time of flight of the ultrasonic signal was 2.25 MHz. Marked volume (specimen diameter) effects were noted for both bulk density (increased with increasing specimen volume or diameter) and Dynamic Young s modulus (decreased with increasing specimen volume or diameter). These trends are extended by adding the property vs. diameter data for unirradiated AGC-1 creep specimens (nominally 12.5 mm-diameter x 25.4 mm-length). The relatively large reduction in Dynamic Young s Modulus was surprising given the trend for increasing density

  13. Cost-effective framework for basic surgical skills training.

    Science.gov (United States)

    Jiang, Deng-Jin; Wen, Chan; Yang, Ai-Jun; Zhu, Zhi-Li; Lei, Yan; Lan, Yang-Jun; Huang, Qing-Yuan; Hou, Xiao-Yu

    2013-06-01

    The importance of basic surgical skills is entirely agreed among surgical educators. However, restricted by ethical issues, finance etc, the basic surgical skills training is increasingly challenged. Increasing cost gives an impetus to the development of cost-effective training models to meet the trainees' acquisition of basic surgical skills. In this situation, a cost-effective training framework was formed in our department and introduced here. Each five students were assigned to a 'training unit'. The training was implemented weekly for 18 weeks. The framework consisted of an early, a transitional, an integrative stage and a surgical skills competition. Corresponding training modules were selected and assembled scientifically at each stage. The modules comprised campus intranet databases, sponge benchtop, nonliving animal tissue, local dissection specimens and simulating reality operations. The training outcomes used direct observation of procedural skills as an assessment tool. The training data of 50 trainees who were randomly selected in each year from 2006 to 2011 year, were retrospectively analysed. An excellent and good rate of the surgical skills is from 82 to 88%, but there is no significant difference among 6 years (P > 0.05). The skills scores of the contestants are markedly higher than those of non-contestants (P < 0.05). The average training cost per trainee is about $21.85-34.08. The present training framework is reliable, feasible, repeatable and cost-effective. The skills competition can promote to improve the surgical skills level of trainees. © 2012 The Authors. ANZ Journal of Surgery © 2012 Royal Australasian College of Surgeons.

  14. 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.

  15. 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

  16. 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.

  17. 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.

  18. ARCTOS: a relational database relating specimens, specimen-based science, and archival documentation

    Science.gov (United States)

    Jarrell, Gordon H.; Ramotnik, Cindy A.; McDonald, D.L.

    2010-01-01

    Data are preserved when they are perpetually discoverable, but even in the Information Age, discovery of legacy data appropriate to particular investigations is uncertain. Secure Internet storage is necessary but insufficient. Data can be discovered only when they are adequately described, and visibility increases markedly if the data are related to other data that are receiving usage. Such relationships can be built within (1) the framework of a relational database, or (1) they can be built among separate resources, within the framework of the Internet. Evolving primarily around biological collections, Arctos is a database that does both of these tasks. It includes data structures for a diversity of specimen attributes, essentially all collection-management tasks, plus literature citations, project descriptions, etc. As a centralized collaboration of several university museums, Arctos is an ideal environment for capitalizing on the many relationships that often exist between items in separate collections. Arctos is related to NIH’s DNA-sequence repository (GenBank) with record-to-record reciprocal linkages, and it serves data to several discipline-specific web portals, including the Global Biodiversity Information Network (GBIF). The University of Alaska Museum’s paleontological collection is Arctos’s recent extension beyond the constraints of neontology. With about 1.3 million cataloged items, additional collections are being added each year.

  19. Examination of the fatigue life under combined loading of specimens

    Directory of Open Access Journals (Sweden)

    Fojtík F.

    2008-11-01

    Full Text Available This contribution describes experimental results under combined loading of specimens manufactured from common construction steel 11523. Specimens were gradually loaded by amplitude of the torque, then by combination of torque and tension prestress. The last set of specimens was loaded in combination of torque and inner overpressure. To obtain the required input values the stress-strain analysis of specimens by finite element method in software Ansys was performed within the last experiment. For evaluation of the results the Fuxa's criterion was applied. The performed experiments and their results embody a good agreement with bellow mentioned conjugated strength criterion. The experiments were performed on reconstructed testing machine equipped by pressure chamber.

  20. Application of subsize specimens in nuclear plant life extension

    Energy Technology Data Exchange (ETDEWEB)

    Rosinski, S.T. [Sandia National Labs., Albuquerque, NM (United States); Kumar, A.S. [Missouri Univ., Rolla, MO (United States); Cannon, S.C. [Westinghouse Hanford Co., Richland, WA (United States); Hamilton, M.L. [Pacific Northwest Lab., Richland, WA (United States)

    1991-12-31

    The US Department of Energy is sponsoring a research effort through Sandia National Laboratories and the University of Missour-Rolla to test a correlation for the upper shelf energy (USE) values obtained from the impact testing of subsize Charpy V-notch specimens to those obtained from the testing of full size samples. The program involves the impact testing of unirradiated and irradiated full, half, and third size Charpy V-notch specimens. To verify the applicability of the correlation on LWR materials unirradiated and irradiated full, half, and third size Charpy V-notch specimens of a commercial pressure vessel steel (ASTM A533 Grade B) will be tested. This paper will provide details of the program and present results obtained from the application of the developed correlation methodology to the impact testing of the unirradiated full, half, and third size A533 Grade B Charpy V-notch specimens.

  1. Application of subsize specimens in nuclear plant life extension

    Energy Technology Data Exchange (ETDEWEB)

    Rosinski, S.T. (Sandia National Labs., Albuquerque, NM (United States)); Kumar, A.S. (Missouri Univ., Rolla, MO (United States)); Cannon, S.C. (Westinghouse Hanford Co., Richland, WA (United States)); Hamilton, M.L. (Pacific Northwest Lab., Richland, WA (United States))

    1991-01-01

    The US Department of Energy is sponsoring a research effort through Sandia National Laboratories and the University of Missour-Rolla to test a correlation for the upper shelf energy (USE) values obtained from the impact testing of subsize Charpy V-notch specimens to those obtained from the testing of full size samples. The program involves the impact testing of unirradiated and irradiated full, half, and third size Charpy V-notch specimens. To verify the applicability of the correlation on LWR materials unirradiated and irradiated full, half, and third size Charpy V-notch specimens of a commercial pressure vessel steel (ASTM A533 Grade B) will be tested. This paper will provide details of the program and present results obtained from the application of the developed correlation methodology to the impact testing of the unirradiated full, half, and third size A533 Grade B Charpy V-notch specimens.

  2. Simulation Analysis of Standard Metal Specimen Tension Experiment by Fem

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    <正>Some standard metal rod-shaped, plate-shaped or pipe-shaped specimens usually are used to be tensioned to acquire the material properties such as tensional ductility, contractibility ratio on breaking section,

  3. North Mississippi Refuges Complex Dragonfly Vouchered Specimens 2005

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — Report contains a list of dragonflies and photographs of them collected in 2005 from the refuge complex. These were verified by Steve Krotzer and specimens retained...

  4. Description of Specimens in the Marine Mammal Osteology Reference Collection

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The NMFS Alaska Fisheries Science Center National Marine Mammal Laboratory (NMML) Marine Mammal Osteology Collection consists of approximately 2500 specimens (skulls...

  5. Pathologic diagnoses of appendectomy specimens: a 10-year review.

    African Journals Online (AJOL)

    Pathologic diagnoses of appendectomy specimens: a 10-year review. ... Annals of Biomedical Sciences ... Materials and methods: Records of resected appendices with a clinical diagnosis of acute appendicitis submitted to histopathology ...

  6. Surgical Team Stability and Risk of Sharps-Related Blood and Body Fluid Exposures During Surgical Procedures.

    Science.gov (United States)

    Myers, Douglas J; Lipscomb, Hester J; Epling, Carol; Hunt, Debra; Richardson, William; Smith-Lovin, Lynn; Dement, John M

    2016-05-01

    To explore whether surgical teams with greater stability among their members (ie, members have worked together more in the past) experience lower rates of sharps-related percutaneous blood and body fluid exposures (BBFE) during surgical procedures. A 10-year retrospective cohort study. A single large academic teaching hospital. Surgical teams participating in surgical procedures (n=333,073) performed during 2001-2010 and 2,113 reported percutaneous BBFE were analyzed. A social network measure (referred to as the team stability index) was used to quantify the extent to which surgical team members worked together in the previous 6 months. Poisson regression was used to examine the effect of team stability on the risk of BBFE while controlling for procedure characteristics and accounting for procedure duration. Separate regression models were generated for percutaneous BBFE involving suture needles and those involving other surgical devices. RESULTS The team stability index was associated with the risk of percutaneous BBFE (adjusted rate ratio, 0.93 [95% CI, 0.88-0.97]). However, the association was stronger for percutaneous BBFE involving devices other than suture needles (adjusted rate ratio, 0.92 [95% CI, 0.85-0.99]) than for exposures involving suture needles (0.96 [0.88-1.04]). Greater team stability may reduce the risk of percutaneous BBFE during surgical procedures, particularly for exposures involving devices other than suture needles. Additional research should be conducted on the basis of primary data gathered specifically to measure qualities of relationships among surgical team personnel.

  7. Quantitative sensing of corroded steel rebar embedded in cement mortar specimens using ultrasonic testing

    Science.gov (United States)

    Owusu Twumasi, Jones; Le, Viet; Tang, Qixiang; Yu, Tzuyang

    2016-04-01

    Corrosion of steel reinforcing bars (rebars) is the primary cause for the deterioration of reinforced concrete structures. Traditional corrosion monitoring methods such as half-cell potential and linear polarization resistance can only detect the presence of corrosion but cannot quantify it. This study presents an experimental investigation of quantifying degree of corrosion of steel rebar inside cement mortar specimens using ultrasonic testing (UT). A UT device with two 54 kHz transducers was used to measure ultrasonic pulse velocity (UPV) of cement mortar, uncorroded and corroded reinforced cement mortar specimens, utilizing the direct transmission method. The results obtained from the study show that UPV decreases linearly with increase in degree of corrosion and corrosion-induced cracks (surface cracks). With respect to quantifying the degree of corrosion, a model was developed by simultaneously fitting UPV and surface crack width measurements to a two-parameter linear model. The proposed model can be used for predicting the degree of corrosion of steel rebar embedded in cement mortar under similar conditions used in this study up to 3.03%. Furthermore, the modeling approach can be applied to corroded reinforced concrete specimens with additional modification. The findings from this study show that UT has the potential of quantifying the degree of corrosion inside reinforced cement mortar specimens.

  8. Analysis of crack propagation in nuclear graphite using three-point bending of sandwiched specimens

    Energy Technology Data Exchange (ETDEWEB)

    Shi Li; Li Haiyan; Zou Zhenmin [School of Mechanical, Aerospace and Civil Engineering, University of Manchester, P.O. Box 88, Sackville Street, Manchester M60 1QD (United Kingdom); Fok, Alex S.L. [School of Mechanical, Aerospace and Civil Engineering, University of Manchester, P.O. Box 88, Sackville Street, Manchester M60 1QD (United Kingdom)], E-mail: alex.fok@manchester.ac.uk; Marsden, Barry J. [School of Mechanical, Aerospace and Civil Engineering, University of Manchester, P.O. Box 88, Sackville Street, Manchester M60 1QD (United Kingdom); Hodgkins, Andrew; Mummery, Paul M.; Marrow, James [School of Materials, University of Manchester, Grosvenor St., Manchester M1 7HS (United Kingdom)

    2008-01-31

    The aim of this paper was to assess the suitability of the sandwiched beam in three-point bending as a technique for determining fracture toughness and R-curve behaviour of nuclear graphite using small beam specimens. Surface displacements of the cracked beam specimen were measured using Electronic Speckle Pattern Interferometry (ESPI) and Image Correlation in order to accurately monitor crack propagation and frictional contact between the test specimen and the sandwiching beams. The results confirmed that solutions based on the simple beam theory could overestimate the fracture toughness of graphite. Finite element analysis using a Continuum Damage Mechanics failure model indicated that both friction and shape of the notch played an important part in providing resistance to crack growth. Inclusion of these factors and the use of more accurate load vs. crack length curves derived from the FE model would provide a satisfactory measure of fracture toughness in small beam specimens under such a loading configuration. The particular graphite tested, IG-110, showed a decrease in fracture toughness with increasing crack length.

  9. Stress Analysis of a Secondary-Bending Specimen

    Science.gov (United States)

    1993-11-01

    Control Office Ansett Airlines of Australia, Library 0 Qantas Airways Limited Hawker de Havilland Aust Pty Ltd, Victoria, Library Hawker de Havilland...MELBOURNE, VICTORIA Technical Note 58 STRESS ANALYSIS OF A SECONDARY-BENDING SPECIMEN 0 by R.L. EVANS M. HELLER Approved for public release C) COMMONWEALTH...AND TECHNOLOGY ORGANISATION AERONAUTICAL RESEARCH LABORATORY Technical Note 58 0 STRESS ANALYSIS OF A SECONDARY-BENDING SPECIMEN by R.L. EVANS 0 M

  10. Innovation for reducing blood culture contamination: initial specimen diversion technique.

    Science.gov (United States)

    Patton, Richard G; Schmitt, Timothy

    2010-12-01

    We hypothesized that diversion of the first milliliter of venipuncture blood-the initial specimen diversion technique (ISDT)-would eliminate incompletely sterilized fragments of skin from the culture specimen and significantly reduce our blood culture contamination rate (R). We studied our hypothesis prospectively beginning with our control culture (C) definition: one venipuncture with two sequentially obtained specimens, 10 ml each, the first specimen (M1) for aerobic and the second (M2) for anaerobic media. The test ISDT culture (D) was identical, with the exception that each was preceded by diverting a 1-ml sample (DS) from the same venipuncture. During the first of two sequential 9-month periods, we captured D versus C data (n=3,733), where DMXR and CMXR are R for D and C specimens. Our hypothesis predicted DS would divert soiled skin fragments from DM1, and therefore, CM1R would be significantly greater than DM1R. This was confirmed by CM1R (30/1,061 [2.8%]) less DM1R (37/2,672 [1.4%]; P=0.005), which equals 1.4%. For the second 9-month follow-up period, data were compiled for all cultures (n=4,143), where ADMXR is R for all (A) diversion specimens, enabling comparison to test ISDT. Our hypothesis predicted no significant differences for test ISDT versus all ISDT. This was confirmed by DM1R (37/2,672 [1.4%]) versus ADM1R (42/4,143 [1.0%]; P=0.17) and DM2R (21/2,672 [0.80%]) versus ADM2R (39/4,143 [0.94%]; P=0.50). We conclude that our hypothesis is valid: venipuncture needles soil blood culture specimens with unsterilized skin fragments and increase R, and ISDT significantly reduces R from venipuncture-obtained blood culture specimens.

  11. Progress Report on Alloy 617 Notched Specimen Testing

    Energy Technology Data Exchange (ETDEWEB)

    McMurtrey, Michael David [Idaho National Lab. (INL), Idaho Falls, ID (United States); Wright, Richard Neil [Idaho National Lab. (INL), Idaho Falls, ID (United States); Lillo, Thomas Martin [Idaho National Lab. (INL), Idaho Falls, ID (United States)

    2016-08-01

    Creep behavior of Alloy 617 has been extensively characterized to support the development of a draft Code Case to qualify Alloy 617 in Section III division 5 of the ASME Boiler and Pressure Vessel Code. This will allow use of Alloy 617 in construction of nuclear reactor components at elevated temperatures and longer periods of time (up to 950°C and 100,000 hours). Prior to actual use, additional concerns not considered in the ASME code need to be addressed. Code Cases are based largely on uniaxial testing of smooth gage specimens. In service conditions, components will generally be under multi axial loading. There is also the concern of the behavior at discontinuities, such as threaded components. To address the concerns of multi axial creep behavior and at geometric discontinuities, notched specimens have been designed to create conditions representative of the states that service components experience. Two general notch geometries have been used for these series of tests: U notch and V notch specimens. The notches produce a tri axial stress state, though not uniform across the specimen. Characterization of the creep behavior of the U notch specimens and the creep rupture behavior of the V notch specimens provides a good approximation of the behavior expected of actual components. Preliminary testing and analysis have been completed and are reported in this document. This includes results from V notch specimens tested at 900°C and 800°C. Failure occurred in the smooth gage section of the specimen rather than at the root of the notch, though some damage was present at the root of the notch, where initial stress was highest. This indicates notch strengthening behavior in this material at these temperatures.

  12. Specimen Sample Preservation for Cell and Tissue Cultures

    Science.gov (United States)

    Meeker, Gabrielle; Ronzana, Karolyn; Schibner, Karen; Evans, Robert

    1996-01-01

    The era of the International Space Station with its longer duration missions will pose unique challenges to microgravity life sciences research. The Space Station Biological Research Project (SSBRP) is responsible for addressing these challenges and defining the science requirements necessary to conduct life science research on-board the International Space Station. Space Station will support a wide range of cell and tissue culture experiments for durations of 1 to 30 days. Space Shuttle flights to bring experimental samples back to Earth for analyses will only occur every 90 days. Therefore, samples may have to be retained for periods up to 60 days. This presents a new challenge in fresh specimen sample storage for cell biology. Fresh specimen samples are defined as samples that are preserved by means other than fixation and cryopreservation. The challenge of long-term storage of fresh specimen samples includes the need to suspend or inhibit proliferation and metabolism pending return to Earth-based laboratories. With this challenge being unique to space research, there have not been any ground based studies performed to address this issue. It was decided hy SSBRP that experiment support studies to address the following issues were needed: Fixative Solution Management; Media Storage Conditions; Fresh Specimen Sample Storage of Mammalian Cell/Tissue Cultures; Fresh Specimen Sample Storage of Plant Cell/Tissue Cultures; Fresh Specimen Sample Storage of Aquatic Cell/Tissue Cultures; and Fresh Specimen Sample Storage of Microbial Cell/Tissue Cultures. The objective of these studies was to derive a set of conditions and recommendations that can be used in a long duration microgravity environment such as Space Station that will permit extended storage of cell and tissue culture specimens in a state consistent with zero or minimal growth, while at the same time maintaining their stability and viability.

  13. Potential usefulness of mucin immunohistochemical staining of preoperative pancreatic biopsy or juice cytology specimens in the determination of treatment strategies for intraductal papillary mucinous neoplasm.

    Science.gov (United States)

    Hisaka, Toru; Horiuchi, Hiroyuki; Uchida, Shinji; Ishikawa, Hiroto; Kawahara, Ryuichi; Kawashima, Yusuke; Akashi, Masanori; Mikagi, Kazuhiro; Ishida, Yusuke; Okabe, Yoshinobu; Nakayama, Masamichi; Naito, Yoshiki; Yano, Hirohisa; Taira, Tomoki; Kawahara, Akihiko; Kage, Masayoshi; Kinoshita, Hisafumi; Shirozu, Kazuo

    2013-11-01

    We classified resected intraductal papillary mucinous neoplasms (IPMNs) into four subtypes (gastric, intestinal, pancreatobiliary and oncocytic) according to their morphological features and mucin expression, determined their clinicopathological characteristics and investigated the possibility of preoperatively diagnosing these subtypes. Sixty resected tumors, 4 preoperative tumor biopsies and 10 preoperative pancreatic juice cytology specimens were analyzed. The gastric and intestinal types accounted for the majority of IPMNs. Non-gastric type IPMNs were of high-grade malignancy. Many of the pancreatobiliary-type IPMNs were in an advanced stage and were associated with a poor prognosis. The results of mucin immunohistochemical staining of preoperative biopsy and surgically resected specimens were in agreement with each other, and in close agreement with those for pancreatic juice cytology specimens obtained from 10 patients during endoscopic retrograde cholangiopancreatography (ERCP). The immunostaining of preoperative biopsy specimens and ERCP-obtained pancreatic juice cytology specimens may be useful in the differential diagnosis of gastric and intestinal types of IPMN. If such techniques enable the preoperative diagnosis of IPMN subtypes, their use in combination with conventional preoperative imaging modalities may lead to surgical treatment best suited for the biological characteristics of the four subtypes.

  14. Study and analysis of the stress state in a ceramic, button-head, tensile specimen

    Energy Technology Data Exchange (ETDEWEB)

    Jenkins, M.G.; Ferber, M.K.; Martin, R.L.; Jenkins, V.T.; Tennery, V.J.

    1991-09-01

    The final results are reported for a study to identify and correct the causes of nongage-section failures (notably button-head failures) in ceramic tensile specimens observed in several laboratories. Numerical modeling of several candidate specimen gripping systems has shown inherent stress concentrations near the specimen button head at which the maximum stress may approach 75 to 100% of the gage-section stress for certain grip conditions. Empirical comparisons of both tapered- and straight-collet gripping systems revealed compromises in both systems. The straight-collet system, with deformable collets, is simpler to use but produces statistically significant greater average percent bending for all tests than those produced for the tapered-collet system, which is slightly more difficult to use. Empirical tensile tests of {approximately}50 aluminium oxide and {approximately}50 silicon nitride specimens were conducted to evaluate the loading capability of both gripping systems, the percent bending in each system, and the potential of consistently producing successful test results. These tests revealed that, due to variations in individuals specimens or the individual specimen/grip interfaces, neither of the gripping systems can consistently produce bending of less than 3 to 4% at failure although occasional values of {approximately}0.5% bending were attained. Refinements of grinding procedures and dimensional measurement techniques have shown critical details in both the practices and consistency of machining necessary for achieving the dimensional tolerances while minimizing subsurface damage. Numerical integration techniques indicate that up to a consistent 5.0% bending during fast- fracture tests can be tolerated before large influences are detected in the determination of the Weibull modulus and the Weibull characteristic strength.

  15. Difference between actual vs. pathology prostate weight in TURP and radical robotic-assisted prostatectomy specimen

    Directory of Open Access Journals (Sweden)

    Szilveszter Lukacs

    2014-12-01

    Full Text Available Introduction To investigate and highlight the effect of formaldehyde induced weight reduction in transurethral resection of prostate (TURP and radical robotically-assisted prostatectomy (RALP specimen as a result of standard chemical fixation. Materials and Methods 51 patients were recruited from January 2013 to June 2013 who either underwent a TURP (n=26 or RALP (n=25. Data was collected prospectively by the operating surgeon who measured the native, unfixed histology specimen directly after operation. The specimens were fixed in 10% Formaldehyde Solution BP and sent to the pathology laboratory where after sufficient fixation period was re-weighed. Results Overall mean age 64.78 years, TURP mean age 68.31 years RALP mean age 61.12years. We found that the overall prostatic specimen (n=51 weight loss after fixation was a mean of 11.20% (3.78 grams (p≤0.0001. Subgroup analysis of the native TURP chips mean weight was 16.15 grams and formalin treated mean weight was 14.00 grams (p≤0.0001. Therefore, TURP chips had a mean of 13.32 % (2.15 grams weight loss during chemical fixation. RALP subgroup unfixed specimen mean weight was 52.08 grams and formalin treated mean weight was 42.60 grams (p≤0.0001, a 19.32 % (9.48grams mean weight reduction. Conclusion It has not been known that prostatic chips and whole human radical prostatectomy specimen undergo a significant weight reduction. The practical significance of the accurate prostate weight in patient management may be limited, however, it is agreed that this should be recorded correctly, as data is potential interest for research purposes and vital for precise documentation.

  16. Determination of the J integral for laminated double cantilever beam specimens: The curvature approach

    OpenAIRE

    Rask, Morten; Sørensen, Bent F

    2012-01-01

    A new approach is proposed for measuring the J integral (and thus the fracture resistance) of interface cracks in multiply laminates. With this approach the J integral is found from beam curvatures and applied moments. Knowledge of ply layup and stiffness is not required. In order to test the accuracy of the proposed approach, double cantilever beam specimen loaded with uneven bending moments (DCB-UBM) specimens were tested and analysed using the curvature approach and a method based on lamin...

  17. Targeted Treatment and Psychological Nursing Measures for Common Surgical Wounds%外科常见伤口的针对性治疗方法及心理护理措施

    Institute of Scientific and Technical Information of China (English)

    陈洪芳

    2015-01-01

    Objective To explore the targeted treatment and psychological nursing measures for common surgical wounds.Methods A retrospective review was conducted for the clinical data of 82 patients receiving dressing treatment in our community health service center, and random grouping method was adopted. Routine treatment was offered to the 41 patients in the control group, 41 patients in the observation group, psychological nursing was provided in addition to routine treatment.Results The wounds in patients in both the observation group and the control group were al healed, with the anxiety and pain scores in the observation group significantly lower than those of the control group,P 0.05.Conclusion Psychological nursing taken on the basis of conventional treatment can relieve anxiety and pain in patients.%目的:外科常见伤口的针对性治疗方法及心理护理措施。方法选择在我社区换药治疗的82例患者的临床资料进行回顾性总结,采用随机分组法。对照组的41例患者我们只采取常规治疗方法,在常规治疗方法的基础上,观察组采用心理护理。结果6观察组和对照组患者的伤口均愈合,观察组的焦虑评分及疼痛评分低于对照组,P<0.01,两组伤口的愈合时间相比差异无统计学意义,P>0.05。结论对外科常见的伤口采取常规治疗的基础上采用心理护理,可以缓解患者的焦虑情绪,减轻疼痛感。

  18. The International Environmental Specimen Banks--let's get visible.

    Science.gov (United States)

    Küster, Anette; Becker, Paul R; Kucklick, John R; Pugh, Rebecca S; Koschorreck, Jan

    2015-02-01

    Environmental specimen banks (ESBs) are facilities that archive samples from the environment for future research and monitoring purposes. In addition, the long-term preservation of representative specimens is an important complement to environmental research and monitoring. Today, environmental specimen banking is experiencing a renaissance due to an increase in regulatory interest in ESB biota standards and trend data. The International Environmental Specimen Bank Group (IESB) promotes the worldwide development of techniques and strategies of environmental specimen banking and the international cooperation and collaboration among national ESBs. In order to provide a current and comprehensive overview on international environmental specimen banking activities, a questionnaire was sent to the national ESBs and asked for detailed information on the respective ESBs. The results show the rich diversity of national sampling programs, including more detailed information on archived samples, sampling strategies, and studies that have already been performed in the respective countries. All ESBs completing the survey expressed a strong interest in cooperating with other ESBs on a collaborative project. The collected information of national ESBs is intended to be made publicly available.

  19. ROLE OF SCALE FACTOR DURING TENSILE TESTING OF SMALL SPECIMENS

    Energy Technology Data Exchange (ETDEWEB)

    Gussev, Maxim N [ORNL; Busby, Jeremy T [ORNL; Field, Kevin G [ORNL; Sokolov, Mikhail A [ORNL; Gray, Mr. Sean [University of Michigan

    2014-01-01

    The influence of scale factor (tensile specimen geometry and dimensions) on mechanical test results was investigated for different widely used types of small specimens (SS-1, SS-2, SS-3, and SS-J3) and a set of materials. It was found that the effect of scale factor on the accurate determination of yield stress, ultimate tensile stress, and uniform elongation values was weak; however, clear systematic differences were observed and should be accounted for during interpretation of results. In contrast, total elongation values were strongly sensitive to variations in specimen geometry. Modern experimental methods like digital image correlation allow the impact of scale factor to be reduced. Using these techniques, it was shown that true stress true strain curves describing strain-hardening behavior were very close for different specimen types. The limits of miniaturization are discussed, and an ultra-miniature specimen concept was suggested and evaluated. This type of specimen, as expected, may be suitable for SEM and TEM in situ testing.

  20. Compatibility of reduced activation ferritic/martensitic steel specimens with liquid Na and NaK in irradiation rig of IFMIF

    OpenAIRE

    2005-01-01

    In the high flux region of the International Fusion Materials Irradiation Facility (IFMIF), the neutron irradiation damage for iron-based alloys will exceed 20 dpa/ year. An accurate specimen temperature measurement under a large amount of nuclear heating is a key issue but the change of heat transfer of gap between irradiation specimens and specimen holder during irradiation test is inevitable, if gap is filled with an inert gas and temperature is monitored by a thermocouple buried in the sp...

  1. 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.

  2. 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

  3. 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.

  4. 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

  5. Experimental study on variations in Charpy impact energies of low carbon steel, depending on welding and specimen cutting method

    Energy Technology Data Exchange (ETDEWEB)

    Yang, Zhaorui; Kang, Hansaem; Lee, Young Seog [Chung-Ang University, Seoul (Korea, Republic of)

    2016-05-15

    This paper presents an experimental study that examines variations of Charpy impact energy of a welded steel plate, depending upon the welding method and the method for obtaining the Charpy specimens. Flux cored arc welding (FCAW) and Gas tungsten arc welding (GTAW) were employed to weld an SA516 Gr. 70 steel plate. The methods of wire cutting and water-jet cutting were adopted to take samples from the welded plate. The samples were machined according to the recommendations of ASTM SEC. II SA370, in order to fit the specimen dimension that the Charpy impact test requires. An X-ray diffraction (XRD) method was used to measure the as-weld residual stress and its redistribution after the samples were cut. The Charpy impact energy of specimens was considerably dependent on the cutting methods and locations in the welded plate where the specimens were taken. The specimens that were cut by water jet followed by FCAW have the greatest resistance-to-fracture (Charpy impact energy). Regardless of which welding method was used, redistributed transverse residual stress becomes compressive when the specimens are prepared using water-jet cutting. Meanwhile, redistributed transverse residual stress becomes tensile when the specimens are prepared using wire cutting.

  6. [Histologic discrepancy between gastric biopsy and resection specimen in the era of endoscopic treatment for early gastric cancer].

    Science.gov (United States)

    Joo, Mee; Kim, Kyoung-Mee

    2014-11-01

    Endoscopic resection (ER) is accepted as a treatment option for early gastric cancer in patients with negligible risk of lymph node metastasis. Determination of histologic differentiation of adenocarcinoma based on pretreatment endoscopic biopsy is critical in deciding the treatment strategy of ER versus surgical resection. However, discrepancies are frequent between pretreatment biopsies and ER specimens, which may result in an additional gastrectomy after ER. In this context, a review on possible factors contributing to the diagnostic discrepancy in the histologic difference between the pretreatment biopsy and ER is necessary. Two major factors are significantly associated with this discrepancy: pathologic characteristics of the tumor itself, i.e. histologic heterogeneity (tumor factor), and diagnostic procedure performed by endoscopists or pathologists (human factor). In this review, we focus on pathologic report of pretreatment biopsy specimens and its clinical significance.

  7. Assessment of fresh breast tissue specimens with confocal strip-mosaicking microscopy in an emulated pathology setting (Conference Presentation)

    Science.gov (United States)

    Abeytunge, Sanjeewa; Larson, Bjorg A.; Peterson, Gary; Rajadhyaksha, Milind; Murray, Melissa

    2017-02-01

    Confocal microscopy is in clinical use to diagnose skin cancers in the United States and in Europe. Potentially, this technology may provide bed-side pathology in breast cancer surgery during tumor removal. Initial studies have described major findings of invasive breast cancers as seen on fluorescence confocal microscopy. In many of these studies the region of interest (ROI) used in the analysis was user-selected and small (typically 15 square-mm). Although these important findings open exploration into rapid pathology, further development and implementation in a surgical setting will require examination of large specimens in a blinded fashion that will address the needs of typical surgical settings. In post surgery pathology viewing, pathologists inspect the entire pathology section with a low (2X) magnification objective lens initially and then zoomed in to ROIs with higher magnification lenses (10X to 40X) magnifications to further investigate suspected regions. In this study we explore the possibility of implementation in a typical surgical setting with a new microscope, termed confocal strip-mosaicking microscope (CSM microscope), which images an area of 400 square-mm (2 cm x 2 cm) of tissue with cellular level resolution in 10 minutes. CSM images of 34 human breast tissue specimens from 18 patients were blindly analyzed by a board-certified pathologist and correlated with the corresponding standard fixed histopathology. Invasive tumors and benign tissue were clearly identified in CSM images. Thirty specimens were concordant for images-to-histopathology correlation while four were discordant. Preliminary results from on-going work to molecularly target tumor margin will also be presented.

  8. Rapid full-field OCT assessment of clinical tissue specimens (Conference Presentation)

    Science.gov (United States)

    Dalimier, Eugénie; Harms, Fabrice; Brossollet, Charles; Benoit, Emilie; Martins, Franck; Boccara, Claude A.

    2016-03-01

    FFOCT (Full Field Optical Coherence Tomography) is a novel optical technology that gives access to very high resolution tomography images of biological tissues within minutes, non-invasively. This makes it an attractive tool to bridge the gap between medical imaging modalities (MRI, ultrasound, CT) used for cancer lesion identification or targeting and histological diagnosis. Clinical tissue specimens, such as surgical cancer margins or biopsies, can potentially be assessed rapidly, by the clinician, in the aim to help him decide on the course of action. A fast FFOCT prototype was built, that provides 1cm2 images with 1 µm resolution in 1 minute, and can accommodate samples up to 50mm diameter. Specific work was carried out to implement a large sample holder, high-speed image acquisition system, optimized scanning, and accelerated GPU tiles stitching. Results obtained on breast, urology, and digestive tissues show the efficiency of the technique for the detection of cancer on clinical tissue specimens, and reinforce the clinical relevance of the technique. The technical and clinical results show that the fast FFOCT system can successfully be used for a fast assessment of cancer excision margins or biopsies providing a very valuable tool in the clinical environment.

  9. Fast full-field OCT assessment of clinical tissue specimens (Conference Presentation)

    Science.gov (United States)

    Dalimier, Eugénie; Harms, Fabrice; Brossolet, Charles; Benoit, Emilie; Martins, Franck; Boccara, Claude

    2016-03-01

    Full-field optical coherence tomography (FFOCT) offers a non-invasive method of obtaining images of biological tissues at ultrahigh resolution (1µm in all 3 directions) approaching traditional histological sections. Previous clinical studies have shown the high efficiency of this imaging technique for the detection of cancer on various organs. This promises great potential of the technique for an ex-vivo quick analysis of surgical resections or biopsy specimens, in the aim to help the surgeon/radiologist decide on the course of action. Here we will present some of the latest technical developments on a FFOCT system which can produce 1cm2 images with 1 µm resolution in 1 minute. Larger samples, up to 50mm diameter, can also be imaged. Details on the large sample handling, high-speed image acquisition, optimized scanning, and accelerated GPU tiles stitching will be given. Results on the clinical applications for breast, urology, and digestive tissues will also be given. They highlight the relevance of the system characteristics for the detection of cancer on ex-vivo specimens. FFOCT now appears clearly as a very fast and non-destructive imaging technique that provides a quick assessment of the tissue morphology. With the benefit of both new technical developments and clinical validation, it turned into a mature technique to be implemented in the clinical environment. In particular, the technique holds potential for the fast ex-vivo analysis of excision margins or biopsies in the operating room.

  10. Incidental Prostate Cancer in Transurethral Resection of the Prostate Specimens in the Modern Era

    Directory of Open Access Journals (Sweden)

    Brandon Otto

    2014-01-01

    Full Text Available Objectives. To identify rates of incidentally detected prostate cancer in patients undergoing surgical management of benign prostatic hyperplasia (BPH. Materials and Methods. A retrospective review was performed on all transurethral resections of the prostate (TURP regardless of technique from 2006 to 2011 at a single tertiary care institution. 793 men (ages 45–90 were identified by pathology specimen. Those with a known diagnosis of prostate cancer prior to TURP were excluded (n=22 from the analysis. Results. 760 patients had benign pathology; eleven (1.4% patients were found to have prostate cancer. Grade of disease ranged from Gleason 3+3=6 to Gleason 3+4=7. Nine patients had cT1a disease and two had cT1b disease. Seven patients were managed by active surveillance with no further events, one patient underwent radiation, and three patients underwent radical prostatectomy. Conclusions. Our series demonstrates that 1.4% of patients were found to have prostate cancer, of these 0.5% required treatment. Given the low incidental prostate cancer detection rate, the value of pathologic review of TURP specimens may be limited depending on the patient population.

  11. Full-field optical coherence tomography for the analysis of fresh unstained human lobectomy specimens

    Directory of Open Access Journals (Sweden)

    Manu Jain

    2013-01-01

    Full Text Available Background: Full-field optical coherence tomography (FFOCT is a real-time imaging technique that generates high-resolution three-dimensional tomographic images from unprocessed and unstained tissues. Lack of tissue processing and associated artifacts, along with the ability to generate large-field images quickly, warrants its exploration as an alternative diagnostic tool. Materials and Methods: One section each from the tumor and from adjacent non-neoplastic tissue was collected from 13 human lobectomy specimens. They were imaged fresh with FFOCT and then submitted for routine histopathology. Two blinded pathologists independently rendered diagnoses based on FFOCT images. Results: Normal lung architecture (alveoli, bronchi, pleura and blood vessels was readily identified with FFOCT. Using FFOCT images alone, the study pathologists were able to correctly identify all tumor specimens and in many cases, the histological subtype of tumor (e.g., adenocarcinomas with various patterns. However, benign diagnosis was provided with high confidence in roughly half the tumor-free specimens (others were diagnosed as equivocal or false positive. Further analysis of these images revealed two major confounding features: (a Extensive lung collapse and (b presence of smoker′s macrophages. On a closer inspection, however, the smoker′s macrophages could often be identified as distinct from tumor cells based on their relative location in the alveoli, size and presence of anthracosis. We posit that greater pathologist experience, complemented with morphometric analysis and color-coding of image components, may help minimize the contribution of these confounders in the future. Conclusion: Our study provides evidence for the potential utility of FFOCT in identifying and differentiating lung tumors from non-neoplastic lung tissue. We foresee its potential as an adjunct to intra-surgical frozen section analysis for margin assessment, especially in limited lung

  12. 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.

  13. Reliability of quantitative real-time PCR for bacterial detection in cystic fibrosis airway specimens.

    Directory of Open Access Journals (Sweden)

    Edith T Zemanick

    Full Text Available The cystic fibrosis (CF airway microbiome is complex; polymicrobial infections are common, and the presence of fastidious bacteria including anaerobes make culture-based diagnosis challenging. Quantitative real-time PCR (qPCR offers a culture-independent method for bacterial quantification that may improve diagnosis of CF airway infections; however, the reliability of qPCR applied to CF airway specimens is unknown. We sought to determine the reliability of nine specific bacterial qPCR assays (total bacteria, three typical CF pathogens, and five anaerobes applied to CF airway specimens. Airway and salivary specimens from clinically stable pediatric CF subjects were collected. Quantitative PCR assay repeatability was determined using triplicate reactions. Split-sample measurements were performed to measure variability introduced by DNA extraction. Results from qPCR were compared to standard microbial culture for Pseudomonas aeruginosa, Staphylococcus aureus, and Haemophilus influenzae, common pathogens in CF. We obtained 84 sputa, 47 oropharyngeal and 27 salivary specimens from 16 pediatric subjects with CF. Quantitative PCR detected bacterial DNA in over 97% of specimens. All qPCR assays were highly reproducible at quantities≥10(2 rRNA gene copies/reaction with coefficient of variation less than 20% for over 99% of samples. There was also excellent agreement between samples processed in duplicate. Anaerobic bacteria were highly prevalent and were detected in mean quantities similar to that of typical CF pathogens. Compared to a composite gold standard, qPCR and culture had variable sensitivities for detection of P. aeruginosa, S. aureus and H. influenzae from CF airway samples. By reliably quantifying fastidious airway bacteria, qPCR may improve our understanding of polymicrobial CF lung infections, progression of lung disease and ultimately improve antimicrobial treatments.

  14. Angle-beam shear wave scattering from buried crack-like defects in bonded specimens

    Science.gov (United States)

    Maki, Carson T.; Michaels, Jennifer E.; Weng, Yu; Michaels, Thomas E.

    2017-02-01

    Ultrasonic wavefield imaging, which refers to the measurement of wave motion on a 2-D rectilinear grid resulting from a fixed source, has been previously applied to angle-beam shear wave propagation in simple plates with through-holes and far-surface notches. In this prior work, scattered waves were analyzed using baseline subtraction of wavefields acquired before and after a notch was introduced. In practice, however, defects of interest often occur between bonded layers and it is generally not possible to record data from the same specimen in both the undamaged and damaged states, even in the laboratory. Direct baseline subtraction of wavefields thus becomes impractical as a tool for analyzing scattering. This present work considers measurement and analysis of angle-beam waves in bonded specimens with and without buried defects originating from fastener holes. Data from fastener holes with and without simulated damage in the form of notches are compared, and it is shown that wavefield baseline subtraction, even after correcting for misalignment between scans, is ineffective for isolating scattering from the notch. A combination of frequency-wavenumber filtering and spatial windowing is proposed and implemented as an alternative approach to quantify scattering from damage. Despite unavoidable deviations from specimen-to-specimen caused by factors such as variations in bonding, transducer mounting, and fastener hole machining, it is shown that scattering from buried notches can be clearly visualized in recorded wavefield data of bonded plates containing a buried defect as opposed to "baseline" wavefield data taken from a nominally similar specimen with no defect present. Backscattering is further quantified in the form of scattering patterns at different scattering frames to quantify the effect of the notch on the total backscattered wavefield.

  15. International Society of Urological Pathology (ISUP) Consensus Conference on Handling and Staging of Radical Prostatectomy Specimens. Working group 1: specimen handling.

    Science.gov (United States)

    Samaratunga, Hemamali; Montironi, Rodolfo; True, Lawrence; Epstein, Jonathan I; Griffiths, David F; Humphrey, Peter A; van der Kwast, Theo; Wheeler, Thomas M; Srigley, John R; Delahunt, Brett; Egevad, Lars

    2011-01-01

    The 2009 International Society of Urological Pathology Consensus Conference in Boston made recommendations regarding the standardization of pathology reporting of radical prostatectomy specimens. Issues relating to the handling and processing of radical prostatectomy specimens were coordinated by working group 1. Most uropathologists followed similar procedures for fixation of radical prostatectomy specimens, with 51% of respondents transporting tissue in formalin. There was also consensus that the prostate weight without the seminal vesicles should be recorded. There was consensus that the surface of the prostate should be painted. It was agreed that both the prostate apex and base should be examined by the cone method with sagittal sectioning of the tissue sample. There was consensus that the gland should be fully fixed before sectioning. Both partial and complete embedding of prostates was considered to be acceptable as long as the method of partial embedding is stated. No consensus was determined regarding the necessity of weighing and measuring the length of the seminal vesicles, the preparation of whole mounts rather than standardized blocks and the methodology for sampling of fresh tissue for research purposes, and it was agreed that these should be left to the discretion of the working pathologist.

  16. Intraoperative ultrasound control of surgical margins during partial nephrectomy.

    Science.gov (United States)

    Alharbi, Feras M; Chahwan, Charles K; Le Gal, Sophie G; Guleryuz, Kerem M; Tillou, Xavier P; Doerfler, Arnaud P

    2016-01-01

    To evaluate a simple and fast technique to ensure negative surgical margins on partial nephrectomies, while correlating margin statuses with the final pathology report. This study was conducted for patients undergoing partial nephrectomy (PN) with T1-T2 renal tumors from January 2010 to the end of December 2015. Before tumor removal, intraoperative ultrasound (US) localization was performed. After tumor removal and before performing hemostasis of the kidney, the specimens were placed in a saline solution and a US was performed to evaluate if the tumor's capsule were intact, and then compared to the final pathology results. In 177 PN(s) (147 open procedures and 30 laparoscopic procedures) were performed on 147 patients. Arterial clamping was done for 32 patients and the mean warm ischemia time was 19 ± 6 min. The mean US examination time was 41 ± 7 s. The US analysis of surgical margins was negative in 172 cases, positive in four, and in only one case it was not possible to conclude. The final pathology results revealed one false positive surgical margin and one false negative surgical margin, while all other margins were in concert with US results. The mean tumor size was 3.53 ± 1.43 cm, and the mean surgical margin was 2.8 ± 1.5 mm. The intraoperative US control of resection margins in PN is a simple, efficient, and effective method for ensuring negative surgical margins with a small increase in warm ischemia time and can be conducted by the operating urologist.

  17. Standard practice for preparation and use of Bent-Beam stress-corrosion test specimens

    CERN Document Server

    American Society for Testing and Materials. Philadelphia

    2011-01-01

    1.1 This practice covers procedures for designing, preparing, and using bent-beam stress-corrosion specimens. 1.2 Different specimen configurations are given for use with different product forms, such as sheet or plate. This practice applicable to specimens of any metal that are stressed to levels less than the elastic limit of the material, and therefore, the applied stress can be accurately calculated or measured (see Note 1). Stress calculations by this practice are not applicable to plastically stressed specimens. Note 1—It is the nature of these practices that only the applied stress can be calculated. Since stress-corrosion cracking is a function of the total stress, for critical applications and proper interpretation of results, the residual stress (before applying external stress) or the total elastic stress (after applying external stress) should be determined by appropriate nondestructive methods, such as X-ray diffraction (1). 1.3 Test procedures are given for stress-corrosion testing by ex...

  18. Variations in Feulgen stainability of epithelial parenchymal cells extracted from paraffin-embedded salivary gland specimens.

    Science.gov (United States)

    Schimmelpenning, H; Falkmer, U G; Hamper, K; Seifert, G; Auer, G U

    1990-01-01

    The variations of Feulgen stainability of cells extracted from paraffin-embedded archival specimens for DNA assessment by means of image cytometry (ICM) were investigated in normal salivary gland parenchyma. The Feulgen stainability of the deparaffinized, rehydrated, and disaggregated preparations was found to exhibit variations of up to 300%, expressed by the mean of integrated optical density (IOD), when a routine procedure was applied to a first series of Cytospin preparations of disaggregated specimens. When measured in nondisaggregated tissue sections, only negligible variations were observed. After minimization of the mechanical strains to the cellular material in the Cytospin preparations in a second series, the variations in Feulgen stainability were found to be considerably lower. The findings indicate that the main reason for variations in the Feulgen stainability of extracted cells is, most likely, the disaggregation procedure itself. Factors such as initial treatment of the specimens, duration and kind of formalin fixation, and length of storage time periods seem to be of minor importance. Retrospective studies on paraffin-embedded specimens require a carefully controlled tissue type-adapted disaggregation procedure. In addition, we concluded that the interpretation of histograms, obtained by means of ICM DNA assessments in Cytospin preparations of archival material, requires a well-defined internal specific standard.

  19. Xanthogranulomatous appendicitis in interval appendectomy specimens of children

    Directory of Open Access Journals (Sweden)

    Yusuf Hakan Çavuşoğlu

    2016-05-01

    Full Text Available Xanthogranulomatous inflammation is common in interval appendectomy specimens in adults, but it is unusual in children. Histopathologic specimens of interval appendectomy, within an 8-year period, were reevaluated to assess the true incidence. A computer search of the hospital database of all appendectomies was performed between January 2008 and June 2015 to identify all interval appendectomy cases. A total of 2694 patients underwent appendectomies. Of these, 13 were interval appendectomies. After pathologic evaluation, 2 (15.4% of the specimens were reported as xanthogranulomatous appendicitis (XA. Histopathologic examination of these interval appendectomy specimens, granulomas (59%, xanthogranulomatous inflammation (36% and Crohn-like changes (50% were common in adults. However, XA is a particularly rare clinical entity among children. Two cases of XA were reported in children in the English literature. One was a 12-year old boy that underwent interval appendectomy 6 weeks after an episode of acute appendicitis. The other was an 11-year old boy with acute (non-interval appendicitis, but the complete blood count was suggestive of an acute suppurative inflammation. These two cases are the 3rd and 4th cases of XA reported in children in the English literature, and both were managed by interval appendectomy. Thus, XA may be encountered in interval appendectomy specimens and association with IBD has to be ruled out.

  20. Standard Guide for Reconstitution of Irradiated Charpy-Sized Specimens

    CERN Document Server

    American Society for Testing and Materials. Philadelphia

    2007-01-01

    1.1 This guide covers procedures for the reconstitution of ferritic pressure boundary steels used in nuclear power plant applications, Type A Charpy (Test Methods E 23) specimens and specimens suitable for testing in three point bending in accordance with Test Methods E 1921 or E 1820. Materials from irradiation programs (principally broken specimens) are reconstituted by welding end tabs of similar material onto remachined specimen sections that were unaffected by the initial test. Guidelines are given for the selection of suitable specimen halves and end tab materials, for dimensional control, and for avoidance of overheating the notch area. A comprehensive overview of the reconstitution methodologies can be found in Ref (1). 1.2 The values stated in SI units are to be regarded as the standard. The values given in parentheses are for information only. This standard does not purport to address all of the safety concerns, if any, associated with its use. It is the responsibility of the user of this standard...