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Sample records for surgisis anal plug

  1. Initial experience of treating anal fistula with the Surgisis anal fistula plug.

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    Chan, S; McCullough, J; Schizas, A; Vasas, P; Engledow, A; Windsor, A; Williams, A; Cohen, C R

    2012-06-01

    Complex anal fistulas remain a challenge for the colorectal surgeon. The anal fistula plug has been developed as a simple treatment for fistula-in-ano. We present and evaluate our experience with the Surgisis anal fistula plug from two centres. Data were prospectively collected and analysed from consecutive patients undergoing insertion of a fistula plug between January 2007 and October 2009. Fistula plugs were inserted according to a standard protocol. Data collected included patient demographics, fistula characteristics and postoperative outcome. Forty-four patients underwent insertion of 62 plugs (27 males, mean age 45.6 years), 25 of whom had prior fistula surgery. Mean follow-up was 10.5 months Twenty-two patients (50%) had successful healing following the insertion of plug with an overall success rate of 23 out of 62 plugs inserted (35%). Nineteen out of 29 patients healed following first-time plug placement, whereas repeated plug placement was successful in 3 out of 15 patients (20%; p = 0.0097). There was a statistically significant difference in the healing rate between patients who had one or less operations prior to plug insertion (i.e. simple fistulas) compared with patients who needed multiple operations (18 out of 24 patients vs. 4 out of 20 patients; p = 0.0007). Success of treatment with the Surgisis anal fistula plug relies on the eradication of sepsis prior to plug placement. Plugs inserted into simple tracts have a higher success rate, and recurrent insertion of plugs following previous plug failure is less likely to be successful. We suggest the fistula plug should remain a first-line treatment for primary surgery and simple tracts.

  2. Successful closure of gastrocutaneous fistulas using the Surgisis(®) anal fistula plug.

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    Darrien, J H; Kasem, H

    2014-05-01

    Gastrocutaneous fistulas remain an uncommon complication of upper gastrointestinal surgery. Less common but equally problematic are gastrocutaneous fistulas secondary to non-healing gastrostomies. Both are associated with considerable morbidity and mortality. Surgical repair remains the gold standard of care. For those unfit for surgical intervention, results from conservative management can be disappointing. We describe a case series of seven patients with gastrocutaneous fistulas who were unfit for surgical intervention. These patients were managed successfully in a minimally invasive manner using the Surgisis(®) (Cook Surgical, Bloomington, IN, US) anal fistula plug. Between September 2008 and January 2009, seven patients with gastrocutaneous fistulas presented to Wishaw General Hospital. Four gastrocutaneous fistulas represented non-healing gastrostomies, two followed an anastomotic leak after an oesophagectomy and one following an anastomotic leak after a distal gastrectomy. All patients had poor nutritional reserve with no other identifiable reason for failure to heal. All were deemed unfit for surgical intervention. Five gastrocutaneous fistulas were closed successfully using the Surgisis(®) anal fistula plug positioned directly into the fistula tract under local anaesthesia and two gastrocutaneous fistulas were closed successfully using the Surgisis(®) anal fistula positioned endoscopically using a rendezvous technique. For the five patients with gastrocutaneous fistulas closed directly under local anaesthesia, oral alimentation was reinstated immediately. Fistula output ceased on day 12 with complete epithelialisation occurring at a median of day 26. For the two gastrocutaneous fistulas closed endoscopically using the rendezvous technique, oral alimentation was reinstated on day 5 with immediate cessation of fistula output. Follow-up upper gastrointestinal endoscopy confirmed re-epithelialisation at eight weeks. In none of the cases has there been

  3. Successful closure of gastrocutaneous fistulas using the Surgisis® anal fistula plug

    Science.gov (United States)

    Kasem, H

    2014-01-01

    Introduction Gastrocutaneous fistulas remain an uncommon complication of upper gastrointestinal surgery. Less common but equally problematic are gastrocutaneous fistulas secondary to non-healing gastrostomies. Both are associated with considerable morbidity and mortality. Surgical repair remains the gold standard of care. For those unfit for surgical intervention, results from conservative management can be disappointing. We describe a case series of seven patients with gastrocutaneous fistulas who were unfit for surgical intervention. These patients were managed successfully in a minimally invasive manner using the Surgisis® (Cook Surgical, Bloomington, IN, US) anal fistula plug. Methods Between September 2008 and January 2009, seven patients with gastrocutaneous fistulas presented to Wishaw General Hospital. Four gastrocutaneous fistulas represented non-healing gastrostomies, two followed an anastomotic leak after an oesophagectomy and one following an anastomotic leak after a distal gastrectomy. All patients had poor nutritional reserve with no other identifiable reason for failure to heal. All were deemed unfit for surgical intervention. Five gastrocutaneous fistulas were closed successfully using the Surgisis® anal fistula plug positioned directly into the fistula tract under local anaesthesia and two gastrocutaneous fistulas were closed successfully using the Surgisis® anal fistula positioned endoscopically using a rendezvous technique. Results For the five patients with gastrocutaneous fistulas closed directly under local anaesthesia, oral alimentation was reinstated immediately. Fistula output ceased on day 12 with complete epithelialisation occurring at a median of day 26. For the two gastrocutaneous fistulas closed endoscopically using the rendezvous technique, oral alimentation was reinstated on day 5 with immediate cessation of fistula output. Follow-up upper gastrointestinal endoscopy confirmed re-epithelialisation at eight weeks. In none of the

  4. Efficacy of an anal fistula plug for fistulas-in-Ano in children.

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    Kouchi, Katsunori; Takenouchi, Ayao; Matsuoka, Aki; Yabe, Kiyoaki; Korai, Mashahiro; Nakata, Chikako

    2017-08-01

    In children, perianal abscesses have a good prognosis and often heal with age. However, some perianal abscesses are refractory to treatment and remain as fistulas-in-Ano. Treatment with a Surgisis Anal Fistula Plug® has been reported as a new method of treatment for fistulas. In adults, the plug has been reported to cause little pain and have a high cure rate, but there have been no reported cases of its use in children. This study was designed to analyze the efficacy of the plug for closure of refractory fistulas in children. Since the plug has not been approved as a medical device in Japan, application for its use was submitted to the ethics committee of our university, and approval was granted, marking the first use of the plug in Japan. We classified refractory fistulas as those treated for 6months or longer and remaining unhealed, even after 1year of age, despite continued conservative treatment. The plug was used in 11 refractory fistulas in 8 children. Eight of 11 fistulas (72.7%) were successfully treated. Three fistulas recurred, and fistulectomies were performed. No sequelae were observed after AFP treatment. The plug was effective even for closure of refractory fistulas without sequelae in children. Treatment Study, Level IV. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. The anal fistula plug in Crohn's disease patients with fistula-in-ano: a systematic review.

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    Nasseri, Y; Cassella, L; Berns, M; Zaghiyan, K; Cohen, J

    2016-04-01

    This study aimed to review, consolidate and analyse the findings of studies investigating the efficacy of anal fistula plugs (AFPs) in treating fistula-in-ano in patients with Crohn's disease. A literature review was conducted via Pubmed, Embase, Medline, Scopus and the Cochrane Library for the period 1995-2015. Articles were selected and reviewed based on specific inclusion and exclusion criteria. A total of 16 studies were extracted, of which 12 were included in the systematic review. In total, 84 patients (n = 1-20 per study) with a median age of 45 (18-72) years and a median follow-up time of 9 (3-24) months were analysed. The total success rate, defined as closure of the fistula tract, was 49/84 (58.3%, 95% CI 47-69). Success in patients with recurrent anal fistulae was 2/5 (40%, 95% CI 5-85). Overall, the success rates of Surgisis and GORE BIO-A brand plugs were 48/80 (60%, 95% CI 48-71) and 1/4 (25%, 95% CI 1-81). The recurrence rate of fistula-in-ano in the five studies that reported recurrence was 3/22 (13.6%). In two comparative studies, inferior overall success rates were found in patients who received preoperative immunomodulators vs. those who did not [3/11 (27.3%) vs. 17/23 (73.9%)]. The studies suggest that the use of an AFP in patients with Crohn's disease is a safe procedure with reasonable success, little morbidity and a low risk of incontinence. The current literature is limited by a number of factors, including small study cohorts, grouping of fistulae in Crohn's disease with other types of anal fistula, short and highly variable follow-up times and multiple confounding factors such as number of fistula tracts, use of preoperative steroids or immunosuppressants, previous use of setons and variation in surgical technique. Colorectal Disease © 2016 The Association of Coloproctology of Great Britain and Ireland.

  6. Treating anal fistula with the anal fistula plug: case series report of 12 patients

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    Saba, Reza Bagherzadeh; Tizmaghz, Adnan; Ajeka, Somar; Karami, Mehdi

    2016-01-01

    Introduction Recurrent and complex high fistulas remain a surgical challenge. This paper reports our experience with the anal fistula plug in patients with complex fistulas. Methods Data were collected prospectively and analyzed from consecutive patients undergoing insertion of a fistula plug from January 2011 through April 2014 at Hazrat-e-Rasoul Hospital in Tehran. We ensured that sepsis had been eradicated in all patients prior to placement of the plug. During surgery, a conical shaped col...

  7. Long-term outcome of the anal fistula plug for anal fistula of cryptoglandular origin.

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    Tan, K-K; Kaur, G; Byrne, C M; Young, C J; Wright, C; Solomon, M J

    2013-12-01

    This study aimed to evaluate the long-term outcome of the anal fistula plug in the treatment of anal fistula of cryptoglandular origin. A review of all patients who had at least one anal fistula plug inserted from March 2007 to August 2008 was performed. Only anal fistulae of cryptoglandular origin were included. Success was defined as the closure of the external opening with no further purulent discharge or collection. Thirty anal fistula plugs were inserted in 26 patients [median age 40 (26-70) years]. Twenty-six of the fistulae were transsphincteric and three were suprasphincteric. One patient had a high intersphincteric fistula, which was the only fistula that did not have a seton inserted. The median duration between seton insertion and the plug procedure was 12 (4-28) weeks. The median length of the fistula tract was 3 (1-7.5) cm. After a median follow-up of 59 (13-97) weeks, 26 (86.7%) fistulae recurred. Of the 26 failures, the median time to failure was 8 (2-54) weeks. Subsequent surgical interventions were performed in 20 of the failures. The role of the fistula plug in the management of anal fistula of cryptoglandular origin remains debatable and warrants further evaluation. © 2013 The Authors. Colorectal Disease © 2013 The Association of Coloproctology of Great Britain and Ireland.

  8. Treating anal fistula with the anal fistula plug: case series report of 12 patients.

    Science.gov (United States)

    Saba, Reza Bagherzadeh; Tizmaghz, Adnan; Ajeka, Somar; Karami, Mehdi

    2016-04-01

    Recurrent and complex high fistulas remain a surgical challenge. This paper reports our experience with the anal fistula plug in patients with complex fistulas. Data were collected prospectively and analyzed from consecutive patients undergoing insertion of a fistula plug from January 2011 through April 2014 at Hazrat-e-Rasoul Hospital in Tehran. We ensured that sepsis had been eradicated in all patients prior to placement of the plug. During surgery, a conical shaped collagen plug was pulled through the fistula tract. Twelve patients were included in this case study. All patients had previously undergone failed surgical therapy to cure their fistula and had previously-placed Setons. There were eight males and four females with an average age of 44 who were treated for complex fistulas. At a median time of follow-up of 22.7 months, 10 of the 12 patients had healed (83.3%). One patient developed an abscess that was noted on the sixth postoperative day, and there was one recurrence during follow-up. Fistula plugs are effective for the long-term closure of complex anal fistulas. Success of treatment with the fistula plug depends on the eradication of sepsis prior to plug placement.

  9. The Anal Fistula Plug versus the mucosal advancement flap for the treatment of Anorectal Fistula (PLUG trial

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    Janssen Lucas WM

    2008-06-01

    Full Text Available Abstract Background Low transsphincteric fistulas less than 1/3 of the sphincter complex are easy to treat by fistulotomy with a high success rate. High transsphincteric fistulas remain a surgical challenge. Various surgical procedures are available, but recurrence rates of these techniques are disappointingly high. The mucosal flap advancement is considered the gold standard for the treatment of high perianal fistula of cryptoglandular origin by most colorectal surgeons. In the literature a recurrence rate between 0 and 63% is reported for the mucosal flap advancement. Recently Armstrong and colleagues reported on a new biologic anal fistula plug, a bioabsorbable xenograft made of lyophilized porcine intestinal submucosa. Their prospective series of 15 patients with high perianal fistula treated with the anal fistula plug showed promising results. The anal fistula plug trial is designed to compare the anal fistula plug with the mucosal flap advancement in the treatment of high perianal fistula in terms of success rate, continence, postoperative pain, and quality of life. Methods/design The PLUG trial is a randomized controlled multicenter trial. Sixty patients with high perianal fistulas of cryptoglandular origin will be randomized to either the fistula plug or the mucosal advancement flap. Study parameters will be anorectal fistula closure-rate, continence, post-operative pain, and quality of life. Patients will be followed-up at two weeks, four weeks, and 16 weeks. At the final follow-up closure rate is determined by clinical examination by a surgeon blinded for the intervention. Discussion Before broadly implementing the anal fistula plug results of randomized trials using the plug should be awaited. This randomized controlled trial comparing the anal fistula plug and the mucosal advancement flap should provide evidence regarding the effectiveness of the anal fistula plug in the treatment of high perianal fistulas. Trial registration ISRCTN

  10. Prospective multicenter study of a synthetic bioabsorbable anal fistula plug to treat cryptoglandular transsphincteric anal fistulas.

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    Stamos, Michael J; Snyder, Michael; Robb, Bruce W; Ky, Alex; Singer, Marc; Stewart, David B; Sonoda, Toyooki; Abcarian, Herand

    2015-03-01

    Although interest in sphincter-sparing treatments for anal fistulas is increasing, few large prospective studies of these approaches have been conducted. The study assessed outcomes after implantation of a synthetic bioabsorbable anal fistula plug. A prospective, multicenter investigation was performed. The study was conducted at 11 colon and rectal centers. Ninety-three patients (71 men; mean age, 47 years) with complex cryptoglandular transsphincteric anal fistulas were enrolled. Exclusion criteria included Crohn's disease, an active infection, a multitract fistula, and an immunocompromised status. Draining setons were used at the surgeon's discretion. Patients had follow-up evaluations at 1, 3, 6, and 12 months postoperatively. The primary end point was healing of the fistula, defined as drainage cessation plus closure of the external opening, at 6 and 12 months. Secondary end points were fecal continence, duration of drainage from the fistula, pain, and adverse events during follow-up. Thirteen patients were lost to follow-up and 21 were withdrawn, primarily to undergo an alternative treatment. The fistula healing rates at 6 and 12 months were 41% (95% CI, 30%-52%; total n = 74) and 49% (95% CI, 38%-61%; total n = 73). Half the patients in whom a previous treatment failed had healing. By 6 months, the mean Wexner score had improved significantly (p = 0.0003). By 12 months, 93% of patients had no or minimal pain. Adverse events included 11 infections/abscesses, 2 new fistulas, and 8 total and 5 partial plug extrusions. The fistula healed in 3 patients with a partial extrusion. The study was nonrandomized and had relatively high rates of loss to follow-up. Implantation of a synthetic bioabsorbable fistula plug is a reasonably efficacious treatment for complex transsphincteric anal fistulas, especially given the simplicity and low morbidity of the procedure.

  11. Gore Bio-A® Fistula Plug: a new sphincter-sparing procedure for complex anal fistula.

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    Ratto, C; Litta, F; Parello, A; Donisi, L; Zaccone, G; De Simone, V

    2012-05-01

    The surgical treatment of a complex anal fistula remains controversial, although 'sphincter-saving' operations are desirable. The Gore Bio-A® Fistula Plug is a new bioprosthetic plug that has been proposed for the treatment of complex anal fistula. This study reports preliminary data following implantation of this plug. Eleven patients with a complex anal fistula underwent insertion of Gore Bio-A® Fistula Plugs. The disc diameter and number of tubes in the plug were adapted to the fistula to allow accommodation of the disc into a submucosal pocket, and the excess tubes were trimmed. During the follow-up period, patients underwent clinical and physical examinations and three-dimensional endoanal ultrasound. Fistulas were high anterior transphincteric in five patients and high posterior transphincteric in six patients. All patients had a loose seton placement before plug insertion. Two, three and four tubes were inserted into the fistula plug in seven, three and one patient, respectively. The median follow-up period was 5 months. No patient reported any faecal incontinence. There was no case of early plug dislodgement. Treatment success was noted for eight (72.7%) of 11 patients at the last follow-up appointment. Implanting a Gore Bio-A® Fistula Plug is a simple, minimally invasive, safe and potentially effective procedure to treat complex anal fistula. Patient selection is fundamental for success. © 2012 The Authors. Colorectal Disease © 2012 The Association of Coloproctology of Great Britain and Ireland.

  12. Anal plugs and retrograde colonic irrigation are helpful in fecal incontinence or constipation

    Institute of Scientific and Technical Information of China (English)

    Marcel Cazemier; Richelle JF Felt-Bersma; Chris JJ Mulder

    2007-01-01

    AIM: To evaluate the feasibility, clinical effect and predicting factors for favorable outcome of treatment with anal plugs in fecal incontinence and retrograde colonic irrigation (RCI) in patients with fecal incontinence or constipation.METHODS: Patients who received treatment with an anal plug or RCI between 1980 and 2005 were investigated with a questionnaire.RESULTS: Of the 201 patients (93 adults, 108 children), 101 (50%) responded. Adults: anal plugs (8), five stopped immediately, one stopped after 20 mo and two used it for 12-15 mo. RCI (40, 28 fecal incontinence, 12 constipation), 63% are still using it (mean 8.5 years), 88% was satisfied. Younger adults (< 40 years) were more satisfied with RCI (94 % vs 65%, P = 0.05). Children: anal plugs (7), 5 used it on demand for an average of 2.5 years with satisfactory results, one stopped immediately and one after 5 years. RCI (26 fecal incontinence, 22 constipation), 90% are still using it (mean time 6.8 years) and felt satisfied. Children tend to be more satisfied (P = 0.001). Besides age, no predictive factors for success were found. There was no difference in the outcome between patients with fecal incontinence or constipation.CONCLUSION: RCI is more often applied than anal plugs and is helpful in patients with fecal incontinence or constipation, especially for younger patients. Anal plugs can be used incidentally for fecal incontinence, especially in children.

  13. Randomized clinical trial comparing collagen plug and advancement flap for trans-sphincteric anal fistula.

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    Bondi, J; Avdagic, J; Karlbom, U; Hallböök, O; Kalman, D; Šaltytė Benth, J; Naimy, N; Øresland, T

    2017-08-01

    The role of a collagen plug for treating anal fistula is not well established. A randomized prospective multicentre non-inferiority study of surgical treatment of trans-sphincteric cryptogenic fistulas was undertaken, comparing the anal fistula plug with the mucosal advancement flap with regard to fistula recurrence rate and functional outcome. Patients with an anal fistula were evaluated for eligibility in three centres, and randomized to either mucosal advancement flap surgery or collagen plug, with clinical follow-up at 3 and 12 months. The primary outcome was the fistula recurrence rate. Anal pain (visual analogue scale), anal incontinence (St Mark's score) and quality of life (Short Form 36 questionnaire) were also reported. Ninety-four patients were included; 48 were allocated to the plug procedure and 46 to advancement flap surgery. The median follow-up was 12 (range 9-24) months. The recurrence rate at 12 months was 66 per cent (27 of 41 patients) in the plug group and 38 per cent (15 of 40) in the flap group (P = 0·006). Anal pain was reduced after operation in both groups. Anal incontinence did not change in the follow-up period. Patients reported an increased quality of life after 3 months. There were no differences between the groups with regard to pain, incontinence or quality of life. There was a considerably higher recurrence rate after the anal fistula plug procedure than following advancement flap repair. Registration number: NCT01021774 (http://www.clinicaltrials.gov). © 2017 BJS Society Ltd Published by John Wiley & Sons Ltd.

  14. Modified plug repair with limited sphincter sparing fistulectomy in the treatment of complex anal fistulas.

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    Köckerling, Ferdinand; von Rosen, Thomas; Jacob, Dietmar

    2014-01-01

    New technical approaches involving biologically derived products have been used to treat complex anal fistulas in order to avoid the risk of fecal incontinence. The least invasive methods involve filling out the fistula tract with fibrin glue or introduction of an anal fistula plug into the fistula canal following thorough curettage. A review shows that the new techniques involving biologically derived products do not confer any significant advantages. Therefore, the question inevitably arises as to whether the combination of a partial or limited fistulectomy, i.e., of the extrasphincteric portion of the fistula, and preservation of the sphincter muscle by repairing the section of the complex anal fistula running through the sphincter muscle and filling it with a fistula plug produces better results. A modified plug technique was used, in which the extrasphincteric portion of the complex anal fistula was removed by means of a limited fistulectomy and the remaining section of the fistula in the sphincter muscle was repaired using the fistula plug with fixing button. Of the 52 patients with a complex anal fistula, who had undergone surgery using a modified plug repair with limited fistulectomy of the extrasphincteric part of the fistula and use of the fistula plug with fixing button, there are from 40 patients (follow-up rate: 77%) some kind of follow-up informations, after a mean of 19.32 ± 6.9 months. Thirty-two were men and eight were women, with a mean age of 52.97 ± 12.22 years. Surgery was conducted to treat 36 transsphincteric, 1 intersphincteric, and 3 rectovaginal fistulas. In 36 of 40 patients (90%), the complex anal fistulas or rectovaginal fistulas were completely healed without any sign of recurrence. None of these patients complained about continence problems. A modification of the plug repair of complex anal fistulas with limited fistulectomy of the extrasphincteric part of the fistula and use of the plug with fixing button seems to

  15. Modified Plug Repair with Limited Sphincter Sparing Fistulectomy in the Treatment of Complex Anal Fistulas

    Science.gov (United States)

    Köckerling, Ferdinand; von Rosen, Thomas; Jacob, Dietmar

    2014-01-01

    Purpose: New technical approaches involving biologically derived products have been used to treat complex anal fistulas in order to avoid the risk of fecal incontinence. The least invasive methods involve filling out the fistula tract with fibrin glue or introduction of an anal fistula plug into the fistula canal following thorough curettage. A review shows that the new techniques involving biologically derived products do not confer any significant advantages. Therefore, the question inevitably arises as to whether the combination of a partial or limited fistulectomy, i.e., of the extrasphincteric portion of the fistula, and preservation of the sphincter muscle by repairing the section of the complex anal fistula running through the sphincter muscle and filling it with a fistula plug produces better results. Methods: A modified plug technique was used, in which the extrasphincteric portion of the complex anal fistula was removed by means of a limited fistulectomy and the remaining section of the fistula in the sphincter muscle was repaired using the fistula plug with fixing button. Results: Of the 52 patients with a complex anal fistula, who had undergone surgery using a modified plug repair with limited fistulectomy of the extrasphincteric part of the fistula and use of the fistula plug with fixing button, there are from 40 patients (follow-up rate: 77%) some kind of follow-up informations, after a mean of 19.32 ± 6.9 months. Thirty-two were men and eight were women, with a mean age of 52.97 ± 12.22 years. Surgery was conducted to treat 36 transsphincteric, 1 intersphincteric, and 3 rectovaginal fistulas. In 36 of 40 patients (90%), the complex anal fistulas or rectovaginal fistulas were completely healed without any sign of recurrence. None of these patients complained about continence problems. Conclusion: A modification of the plug repair of complex anal fistulas with limited fistulectomy of the extrasphincteric part of the fistula and use of the

  16. Acceptable results using plug for the treatment of complex anal fistulas

    DEFF Research Database (Denmark)

    Kleif, Jakob; Hagen, Kikke; Wille-Jørgensen, Peer

    2011-01-01

    The management of complex fistula-in-ano remains a surgical challenge. Previously published studies on the treatment of fistula-in-ano with the anal fistula plug (AFP) have reported a success rate reaching 35-87%. The aim of this study was to assess the results of the AFP procedure in a group...

  17. Fistula plug versus conventional surgical treatment for anal fistulas. A system review and meta-analysis.

    Science.gov (United States)

    Pu, Yu-Wei; Xing, Chun-Gen; Khan, Imran; Zhao, Kui; Zhu, Bao-Song; Wu, Yong

    2012-09-01

    To evaluate the recurrence and fecal incontinence of anal fistula plug versus conventional surgical treatment for anal fistulas. This meta-analysis was carried out in the General Surgery Department of the Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China. We searched the Medline, EMBASE, and Cochrane Library from June 2011 to April 2012. The literature searches were carried out using medical subject headings and free-text word: anal fistula, fibrin adhesive, fibrin sealant, and fistula plug. Two randomized controlled trials and 3 retrospective controlled studies were included. A total of 428 patients were included in our study. The recurrence rate was higher in those patients who accept fistula plug treatment (62.1% versus 47%) (p=0.004). Anal fistula plug has a moderate probability of success with little risk of incontinence, but the recurrence rate is significantly higher than the conventional surgical treatment. This treatment is minimally invasive, repeatable, and sphincter-sparing. This meta-analysis failed to find a statistically significant difference in incontinence rate between conservative treatment and conventional surgical treatment.

  18. An outcome and cost analysis of anal fistula plug insertion vs endorectal advancement flap for complex anal fistulae.

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    Fisher, O M; Raptis, D A; Vetter, D; Novak, A; Dindo, D; Hahnloser, D; Clavien, P-A; Nocito, A

    2015-07-01

    The study aimed to compare the rate of success and cost of anal fistula plug (AFP) insertion and endorectal advancement flap (ERAF) for anal fistula. Patients receiving an AFP or ERAF for a complex single fistula tract, defined as involving more than a third of the longitudinal length of of the anal sphincter, were registered in a prospective database. A regression analysis was performed of factors predicting recurrence and contributing to cost. Seventy-one patients (AFP 31, ERAF 40) were analysed. Twelve (39%) recurrences occurred in the AFP and 17 (43%) in the ERAF group (P = 1.00). The median length of stay was 1.23 and 2.0 days (P analysis, postoperative complications, underlying inflammatory bowel disease and fistula recurring after previous treatment were independent predictors of de novo recurrence. It also showed that length of hospital stay ≤ 1 day to be the most significant independent contributor to lower cost (P = 0.023). Anal fistula plug and ERAF were equally effective in treating fistula-in-ano, but AFP has a mean cost saving of €2518 per procedure compared with ERAF. The higher cost for ERAF is due to a longer median length of stay. Colorectal Disease © 2014 The Association of Coloproctology of Great Britain and Ireland.

  19. Acceptable results using plug for the treatment of complex anal fistulas

    DEFF Research Database (Denmark)

    Kleif, Jakob; Hagen, Kikke; Wille-Jørgensen, Peer

    2011-01-01

    The management of complex fistula-in-ano remains a surgical challenge. Previously published studies on the treatment of fistula-in-ano with the anal fistula plug (AFP) have reported a success rate reaching 35-87%. The aim of this study was to assess the results of the AFP procedure in a group...... of Danish patients with complex fistulas, and to analyse if the results were compatible with previous international findings....

  20. [A multicenter randomized controlled clinical trial of Ligation of the Intersphincteric Fistula Tract Plus Bioprosthetic Anal Fistula Plug in the treatment of chronic anal fistula].

    Science.gov (United States)

    Zheng, Yi; Wang, Zhenjun; Yang, Xinqing; Cui, Jinjie; Chen, Chaowen; Zhang, Xuebin; Wang, Xiaoqiang; Zhang, Xiling; Che, Xiangming; Chen, Jincai; Cui, Feibo; Song, Weiliang; Chen, Yuzhuo

    2015-11-10

    To evaluate the effectiveness and safety of Ligation of the Intersphincteric Fistula Tract Plus Bioprosthetic Anal Fistula Plug (LIFT-plug) in the treatment of chronic anal fistula. A total of 239 patients (199 males, 40 females) with chronic anal fistula were recruited from 5 hospitals between March 2011 and April 2013. These patients were randomly assigned to the experimental group (n=119) treated with LIFT-plug or the control group (n=120) treated with LIFT. The follow-up period was 180 days. The collected data included healing rate, the median healing time, the recurrence rate, the Visual Analogue Scale (VAS), the incontinence rate, and the safety indicators associated with the anal fistula plug. The healing rate of the experimental group was better than the control group (96.5% vs 83.7%, Panal fistula plug in the experimental group. LIFT-plug is simple, less invasive, and with shorter healing time and more satisfactory healing rate in treating chronic anal fistula compared with LIFT.

  1. Ligation of the intersphincteric fistula tract plus a bioprosthetic anal fistula plug (LIFT-Plug): a new technique for fistula-in-ano.

    Science.gov (United States)

    Han, J G; Yi, B Q; Wang, Z J; Zheng, Y; Cui, J J; Yu, X Q; Zhao, B C; Yang, X Q

    2013-05-01

    Ligation of the intersphincteric fistula tract and reinforcement with a bioprosthetic graft are two recently reported procedures that have shown promise in the treatment of anal fistula. This study was undertaken to validate combining ligation of the intersphincteric fistula tract plus bioprosthetic anal fistula plug and report our preliminary results and experience. Twenty-one patients with transsphincteric anal fistula were treated with ligation of the intersphincteric fistula tract plus concurrent bioprosthetic plug of the anal fistula. We evaluated healing time, fistula closure rate and postoperative anal function according to the Wexner continence score. No mortality or major complications were observed. Median operative time was 20 (range 15-40) min. After a median follow-up of 14 (range 12-15) months, the overall success rate was 95% (20/21), with a median healing time of 2 (range 2-3) weeks for external anal fistula opening and 4 (range 3-7) weeks for intersphincteric groove incision. Only 1 (5%) patient reported rare incontinence for gas postoperatively (Wexner score 1). Ligation of the intersphincteric fistula tract plus a bioprosthetic anal fistula plug is an easy, safe, effective and useful alternative in the management of anal fistula. Further randomized controlled studies are necessary to better evaluate long-term results. © 2012 The Authors. Colorectal Disease © 2012 The Association of Coloproctology of Great Britain and Ireland.

  2. A Newly Designed Anal Fistula Plug: Clinicopathological Study in an Experimental Iatrogenic Fistula Model

    Science.gov (United States)

    Aikawa, Masayasu; Miyazawa, Mitsuo; Okada, Katsuya; Akimoto, Naoe; Koyama, Isamu; Yamaguchi, Shigeki; Ikada, Yoshito

    2013-01-01

    We report on a clinicopathologic study in an animal model of treatment with a new bioabsorbable polymer plug (BAPP). Over a 2-week period, 6 porcine models, which each had 4 anal fistulae, were created using Blake drains. The pigs were divided into 2 groups: the BAPP-treatment group (n = 12 fistulae) and the control group (n = 12 fistulae). Two weeks later, the pigs were humanely killed, and the perianal sites were excised and examined with gross and pathologic studies. Each fistula in the BAPP group was completely cured. In the pathologic study, the treatment sites had little disarray, few defects in the muscular layer, and small numbers of inflammatory cells. The control group had a significantly greater number of inflammatory cells and microabscesses than the BAPP group. The newly developed BAPP reduced the infection and induced good healing in anal fistulae. The BAPP may be a useful new device for the clinical treatment of anal fistulae. PMID:23701146

  3. Comparison of an anal fistula plug and mucosa advancement flap for complex anal fistulas: a meta-analysis.

    Science.gov (United States)

    Xu, Yansong; Tang, Weizhong

    2016-12-01

    The aim of this analysis was to compare the advantages of the anal fistula plug (AFP) with the mucosa advancement flap (MAF) for complex anal fistulas. Comparative studies of the efficacy of AFP and MAF were included. Two independent reviewers selected articles for inclusion. After information collection, a meta-analysis was performed using data on overall healing rates, complications, incontinences and recurrences. The quality of postoperative life and cost were also included with the clinical results. Ten studies included 778 patients who were divided into AFP and MAF groups in this meta-analysis. During the follow-up period, no significant difference in healing rates, complications and recurrences were found (P = 0.55, P = 0.78 and P = 0.23, respectively). The incontinence rate of AFP was lower than that of MAF (P = 0.04). The postoperative quality of life of AFP patients was superior to that of MAF patients. The AFP patients had less persistent pain of a shorter duration and shortened healing time and hospital stay. The treatment cost of AFP patient was lower than that of MAF. Compared to the MAF procedure, the AFP procedure has some advantages for complex anal fistulas, but more and large randomized clinical trials comparing the two procedures for fistula management need to be conducted. © 2016 Royal Australasian College of Surgeons.

  4. Treatment of recurrent anal fistula using an autologous cartilage plug: a pilot study.

    Science.gov (United States)

    Ozturk, E

    2015-05-01

    The aim of the present study was to assess a novel autologous cartilage plug technique used to treat anal fistula in ten patients. All ten patients had undergone at least two prior operations for recurrent fistulas. The plugs were prepared using the patients' own cartilage, which was obtained from either the nose or the ear, diced into pieces, and wrapped with oxidized regenerated cellulose. During the same session, fistula tracts were curetted using cytology brushes, and then, the cartilage plug was inserted into the tract. Routine postoperative examinations were performed at 2, 4, 8, 12, and 24 weeks after surgery. Magnetic resonance imaging was performed before surgery and at 3 and 6 months postoperatively. Relief of symptoms, radiological healing, recurrence, and continence were evaluated. The ten patients included six males and four females, with a median age of 39 years (range 25-70 years) and a median of three previous fistula operations (range 2-7 operations). Nine patients had cryptoglandular abscess, and one patient had Crohn's disease. The majority of the patients had transsphincteric fistulas with substantial anal sphincter involvement. The cartilage donor site was the nose for one patient and the ear for nine patients. The median follow-up time was 24 months (range 10-32 months). Of the ten patients, nine had fistula treatment without any short-term complications. The fistula failed to heal in one patient. Among the nine patients whose operations were initially successful, two late recurrences were observed. The cartilage plug seems to be a promising alternative for anal fistula treatment.

  5. Results of collagen plug occlusion of anal fistula: a multicentre study of 126 patients.

    Science.gov (United States)

    Blom, J; Husberg-Sellberg, B; Lindelius, A; Gustafsson, U-M; Carlens, S; Oppelstrup, H; Bragmark, M; Yin, L; Nyström, P-O

    2014-08-01

    The Biodesign(®) anal fistula plug was introduced as a means of obliterating the fistula tract and promoting healing through biocompatibility. The results demonstrated unexplained variations from good to bad. This report analysed the results of a retrospective multicentre study. All plug procedures performed in four Stockholm hospitals between June 2006 and June 2010 were identified and studied using a common protocol. The outcome after the first plug-insertion procedure was assessed by chart review performed a minimum of 8 months after plug insertion. Cox proportional-hazards models were used to assess the associations of various factors with fistula healing. One-hundred and twenty-six patients (mean age 47 years) were deemed suitable for the plug procedure. Eighty-five per cent of fistulae were cryptoglandular, 64% of patients were male and a mean of 2.9 previous fistulae procedures had been performed. All patients, except four, had an indwelling seton at the time of the plug procedure, which was performed in accordance with previously established principles of day surgery. After a median of 13 months, 30 (24%) fistulae had closed with no discomfort or secretion reported. The outcome in the four hospitals varied from 13% to 33% with similar numbers of patients in each hospital. A success rate of 12% was observed for patients with anterior fistula compared with 32% for those with posterior tracks [hazard ratio (HR) for successful healing = 2.98; 95% CI: 1.01-8.78) and 41% for those with a lateral internal opening (HR = 3.76; 95% CI: 1.03-13.75). Age, sex and number of previous procedures were not associated with healing. Four independent patient groups showed low success rates after the first plug-insertion procedure. Anterior fistulae were much less likely to heal compared with fistulae in other locations. Colorectal Disease © 2014 The Association of Coloproctology of Great Britain and Ireland.

  6. Results of the Gore Bio-A fistula plug implantation in the treatment of anal fistula: a multicentre study.

    Science.gov (United States)

    Herold, A; Ommer, A; Fürst, A; Pakravan, F; Hahnloser, D; Strittmatter, B; Schiedeck, T; Hetzer, F; Aigner, F; Berg, E; Roblick, M; Bussen, D; Joos, A; Vershenya, S

    2016-08-01

    The aim of this prospective study was to determine the efficiency of the Gore Bio-A synthetic plug in the treatment of anal fistulas. A synthetic bioabsorbable anal fistula plug was implanted in 60 patients. All fistulas were transsphincteric and cryptoglandular in origin. The healing rate after 1 year of follow-up was 52 % (31 out of 60 patients). No patient was lost to follow-up. The treatment had no effect on the incontinence score. The plug dislodgement rate was 10 % (6 out of 60 patients). Thirty-four per cent of the patients (16 out of 47) required reoperation. The average operating time was 32 ± 10.2 min, and the average length of hospital stay was 3.3 ± 1.8 days. Synthetic plugs may be an alternative to bioprosthetic fistula plugs in the treatment of transsphincteric anal fistulas. This method might have better success rates than treatment with bioprosthetic fistula plugs.

  7. Anal fistula plug: a prospective evaluation of success, continence and quality of life in the treatment of complex fistulae.

    Science.gov (United States)

    Adamina, M; Ross, T; Guenin, M O; Warschkow, R; Rodger, C; Cohen, Z; Burnstein, M

    2014-07-01

    Curing complex anal fistula without compromising continence can be extremely challenging. This study investigated the healing rate, continence and quality of life of patients after treatment of complex anal fistula of cryptoglandular origin with a bioprosthetic plug. Consecutive patients were prospectively followed in four referral centres. Following seton conditioning, a bioprosthetic plug was inserted into the fistula and sutured to the anal sphincter. Clinical evaluation was performed at 10 days, 6 weeks and 6 months after surgery, and was completed by telephone interviews. Anal continence and quality of life were evaluated using the Fecal Incontinence Score Index and the Short Form-36 Health Survey, version 2 (SF-36 v2) questionnaire. Forty-six patients presenting with a complex anal fistula and a median of three previous fistula surgeries were included. The 6-month recurrence rate was 30.7% (95% CI: 15.9-42.8%), increasing to 48.0% (95% CI: 30.6-61.1%) after 2 years. Follow up was continued for a median of 68.1 months, and 26 (56.5%) recurrences were identified. Anal continence improved from a median of 19 points to 12 points at 6 months of follow up (P = 0.008). Quality of life markedly improved in all scales. The physical summary score increased from 47.2 to 56.2 (P fistula plug demonstrated a healing rate close to 50% in complex cryptoglandular fistula. Also, it markedly improved anal continence and quality of life. These data support the use of a bioprosthetic plug as first-line therapy for complex fistula instead of more aggressive and potentially debilitating surgical options. Colorectal Disease © 2014 The Association of Coloproctology of Great Britain and Ireland.

  8. 括约肌外侧切开肛瘘栓填塞--一种改良的肛瘘栓技术%Extrasphincteric Incision and Anal Fistula Plug Repair:a Modified Technique of Anal Fistula Plugging

    Institute of Scientific and Technical Information of China (English)

    于锦利; 鹿雅镜; 段宏岩; 蔡姮婧

    2015-01-01

    2014年10月,对2例括约肌上型肛瘘患者,术前不进行挂线治疗,在括约肌外侧瘘管转折处切断瘘管,将瘘管分为两部分,分别填塞1枚肛瘘栓并缝合固定,通畅引流。2例全部治愈,术后无并发症,肛门功能良好,外口愈合时间12、13 d,肛缘伤口愈合时间50、45 d。随访8个月,无复发。%[Summary] Two cases of suprasphincteric anal fistula were treated in October 2014.Without preoperative seton insertion, the fistula was cut off at the turning point outside the sphincter muscle and filled with 1 piece of anal fistula plug at both end respectively. Adequate drainage was utilized.The 2 cases were all cured, without complications after the operation.The anal function was normal. The healing time of the external opening was 12 and 13 days, while the healing time of the anal margin wound was 50 and 45 days.No recurrence happened during a follow-up for 8 months.

  9. Ligation of Intersphincteric Fistula Tract vs Ligation of the Intersphincteric Fistula Tract Plus a Bioprosthetic Anal Fistula Plug Procedure in Patients With Transsphincteric Anal Fistula: Early Results of a Multicenter Prospective Randomized Trial.

    Science.gov (United States)

    Han, Jia Gang; Wang, Zhen Jun; Zheng, Yi; Chen, Chao Wen; Wang, Xiao Qiang; Che, Xiang Ming; Song, Wei Liang; Cui, Jin Jie

    2016-12-01

    The purpose of this study was to compare the ligation of intersphincteric fistula tract (LIFT) with an additional plug (LIFT-plug) in the treatment of transsphincteric anal fistula. Both LIFT and LIFT-plug are recently reported effective alternatives of transsphincteric anal fistula. This multicenter prospective randomized study (NCT01478139) was conducted at 5 university hospitals throughout China. A total of 235 patients were randomly assigned to undergo LIFT (118 patients) or LIFT-plug (117 patients) between March 2011 and April 2013. The primary outcome measured was primary healing rate at 6 months postoperatively and healing time. Secondary outcomes included recurrence rate, postoperative pain, and incontinence rate. The LIFT procedure showed shorter operative time than the LIFT-plug procedure (26.7 min vs 28.5 min, P = 0.03). Median healing time was 22 days in LIFT-plug group vs 30 days in LIFT group (P anal fistulas, both LIFT-plug and LIFT are simple, safe, and effective procedures. LIFT-plug has the advantage of a higher healing rate, less healing time, and a lower early postoperative pain score.

  10. Anal fistula plug vs mucosa advancement flap in complex fistula-in-ano: A meta-analysis

    Science.gov (United States)

    Leng, Qiang; Jin, Hei-Ying

    2012-01-01

    AIM: To investigate the efficacy of the anal fistula plug (AFP) compared to the mucosa advancement flap (MAF), considered the best procedure for patients with a complex anal fistula. METHODS: The literature search included PubMed, EMBASE, Cochrane Library and OVID original studies on the topic of AFP compared to MAF for complex fistula-in-ano that had a deadline for publication by April 2011. Randomized controlled trials, controlled clinical trials and prospective cohort studies were included in the review. After information collection, a meta-analysis was performed using data on overall success rates as well as incidence of incontinence and morbidity. The quality of postoperative life was also included with the clinical results. RESULTS: Six studies involving 408 patients (AFP = 167, MAF = 241) were included in the meta-analysis. The differences in the overall success rates and incidence of fistula recurrence were not statistically significant between the AFP and MAF [risk difference (RD) = -0.12, 95%CI: -0.39 - 0.14; RD = 0.13; 95%CI: -0.18 - 0.43, respectively]. However, for the AFP, the risk of postoperative impaired continence was lower (RD = -0.08, 95%CI: -0.15 - -0.02) as was the incidence of other complications (RD = -0.06, 95%CI: -0.11 - -0.00). The postoperative quality of life, for patients treated using the AFP was superior to that of the MAF patients. Patients treated with the AFP had less persistent pain of a shorter duration and the healing time of the fistula and hospital stay were also reduced. CONCLUSION: The AFP is an effective procedure for patients with a complex anal fistula; it has the same success rate but a lower risk of complications than the MAF and may also be associated with an improved postoperative quality of life. Additional evidence is needed to confirm these findings. PMID:23494149

  11. Gore BioA Fistula Plug in the treatment of high anal fistulas--initial results from a German multicenter-study.

    Science.gov (United States)

    Ommer, A; Herold, A; Joos, A; Schmidt, C; Weyand, G; Bussen, D

    2012-01-01

    Treatment of high anal fistulas may be associated with a high risk of continence disorders. Beside traditional procedure of flap-reconstruction the occlusion of the fistula tract using fistula-plugs offers a new sphincter-saving treatment option. In this study for the first time results from Germany are described. 40 patients (30 male, 10 female, age 51 ± 12 years) underwent closure of a high trans-sphincteric (n = 28) or supra-sphincteric (n = 12) fistula with Gore BioA Fistula Plug(®) in three surgical departments. The surgical procedures had been performed by five colorectal surgeons. Four patients had Crohn's disease. Preoperatively 33 patients were completely continent; seven patients complained of minor continence disorders. Treatment of the patients was performed on a intent-to-treat basis and evaluation of the results was retrospective using pooled data from each center. Postoperatively one patient developed an abscess, which had to be managed surgically. In two patients the plug had fallen out within the first two weeks postoperatively. Six months after surgery the fistula has been healed in 20 patients (50.0%). Three additional fistulas healed after 7, 9 rsp. 12 months. The overall healing-rate was 57.5% (23/40). The healing rate differs considerably between the surgeons from 0 to 75% and depends on the number of previous interventions. In patients having only drainage of the abscess success occurred in 63.6% (14/22) whereas in patients after one or more flap fistula reconstruction the healing rate decreased slightly to 50% (9/18). No patient complained about any impairment of his preoperative continence status. By occlusion of high anal fistulas with a plug technique definitive healing could be achieved in nearly every second patients. Previous surgery seems to have a negative impact on success rate. We have not observed any negative impact on anal continence. From that point of view anal fistula plugs might be discussed as a treatment option for high

  12. Gore BioA Fistula Plug in the treatment of high anal fistulas – initial results from a German multicenter-study [Gore BioA Fistel Plug zur Behandlung hoher Analfisteln – erste Ergebnisse einer deutschen Multicenter-Studie

    Directory of Open Access Journals (Sweden)

    Ommer, A.

    2012-09-01

    Full Text Available [english] Background: Treatment of high anal fistulas may be associated with a high risk of continence disorders. Beside traditional procedure of flap-reconstruction the occlusion of the fistula tract using fistula-plugs offers a new sphincter-saving treatment option. In this study for the first time results from Germany are described.Patients and method: 40 patients (30 male, 10 female, age 51±12 years underwent closure of a high trans-sphincteric (n=28 or supra-sphincteric (n=12 fistula with Gore BioA Fistula Plug in three surgical departments. The surgical procedures had been performed by five colorectal surgeons. Four patients had Crohn’s disease. Preoperatively 33 patients were completely continent; seven patients complained of minor continence disorders. Treatment of the patients was performed on a intent-to-treat basis and evaluation of the results was retrospective using pooled data from each center.Results: Postoperatively one patient developed an abscess, which had to be managed surgically. In two patients the plug had fallen out within the first two weeks postoperatively. Six months after surgery the fistula has been healed in 20 patients (50.0%. Three additional fistulas healed after 7, 9 rsp. 12 months. The overall healing-rate was 57.5% (23/40. The healing rate differs considerably between the surgeons from 0 to 75% and depends on the number of previous interventions. In patients having only drainage of the abscess success occurred in 63.6% (14/22 whereas in patients after one or more flap fistula reconstruction the healing rate decreased slightly to 50% (9/18. No patient complained about any impairment of his preoperative continence status.Conclusion: By occlusion of high anal fistulas with a plug technique definitive healing could be achieved in nearly every second patients. Previous surgery seems to have a negative impact on success rate. We have not observed any negative impact on anal continence. From that point of view

  13. Surgisis acellular collagen matrix in aesthetic and reconstructive plastic surgery soft tissue applications.

    Science.gov (United States)

    Centeno, Robert F

    2009-04-01

    Tissue engineering in aesthetic and reconstructive plastic surgery remains an elusive goal. The advent of Surgisis extracellular collagen matrix and its performance characteristics suggest that the use of a bioengineered tissue substitute can meet some of our reconstructive requirements. Incorporation and replacement by host tissue with minimal allergic or immune response seems to be achievable today. The ability to engineer the device, the ready availability of substrate, and its cost effectiveness support the use of Surgisis in aesthetic and reconstructive plastic surgery applications. Future product innovations and engineering seem promising. The permanent role of Surgisis in aesthetic and reconstructive plastic surgery will be determined by its documented long-term performance.

  14. New Techniques for Treating an Anal Fistula

    OpenAIRE

    Song, Kee Ho

    2012-01-01

    Surgery for an anal fistula may result in recurrence or impairment of continence. The ideal treatment for an anal fistula should be associated with low recurrence rates, minimal incontinence and good quality of life. Because of the risk of a change in continence with conventional techniques, sphincter-preserving techniques for the management complex anal fistulae have been evaluated. First, the anal fistula plug is made of lyophilized porcine intestinal submucosa. The anal fistula plug is exp...

  15. Use of Surgisis for Treatment of Anterior and Posterior Vaginal Prolapse

    Directory of Open Access Journals (Sweden)

    Sara Armitage

    2012-01-01

    Full Text Available Aim. To evaluate the anatomical success and complication rate of Surgisis in the repair of anterior and posterior vaginal wall prolapse. Methods. A retrospective review of 65 consecutive Surgisis prolapse repairs, involving the anterior and/or posterior compartment, performed between 2003 and 2009, including their objective and subjective success rates using the pelvic organ prolapse quantification (POPQ system. Results. The subjective success rate (no symptoms and no bulge beyond the hymen was 92%, and the overall objective success rate (no subsequent prolapse in any compartment was 66% (43 of 65. The overall reoperation rate for de novo and recurrent prolapse was 7.7% with 3 women undergoing repeat surgery at the same site (anterior compartment. No long-term complications occurred. Conclusions. Surgisis has a definite role in the surgical treatment of prolapse. It may decrease recurrences seen with native tissue repair and long-term complications of synthetic mesh. Its use in posterior compartment repair in particular is promising.

  16. Anal Itching

    Science.gov (United States)

    Diseases and Conditions Anal itching By Mayo Clinic Staff Anal itching is a common condition. The itch, situated in or around your anus, ... a strong urge to scratch. You may find anal itching to be embarrassing and uncomfortable. Also called ...

  17. [Perianal fistula and anal fissure].

    Science.gov (United States)

    Heitland, W

    2012-12-01

    CRYPTOGLANDULAR ANAL FISTULA: Perianal abscesses are caused by cryptoglandular infections. Not every abscess will end in a fistula. The formation of a fistula is determined by the anatomy of the anal sphincter and perianal fistulas will not heal on their own. The therapy of a fistula is oriented between a more aggressive approach (operation) and a conservative treatment with fibrin glue or a plug. Definitive healing and the development of incontinence are the most important key points. ANAL FISSURES: Acute anal fissures should be treated conservatively by topical ointments, consisting of nitrates, calcium channel blockers and if all else fails by botulinum toxin. Treatment of chronic fissures will start conservatively but operative options are necessary in many cases. Operation of first choice is fissurectomy, including excision of fibrotic margins, curettage of the base and excision of the sentinel pile and anal polyps. Lateral internal sphincterotomy is associated with a certain degree of incontinence and needs critical long-term observation.

  18. Plugging mud

    Energy Technology Data Exchange (ETDEWEB)

    Rogoza, Z.I.; Bulla, Yu.A.; Fedorov, V.V.; Isakova, Ye.F.

    1983-01-01

    A plugging mud is proposed which includes cement, water and hydrolyzed polyacronitrile. In order to reduce water output, it additionally contains iron sulfate and sodium sulfate with the following ratio of components, % by mass: cement 68.665.42; hydrolyzed polyacronitrile 0.07-0.21; iron sulfate 0.03-0.07; sodium sulfate 0.34-1.40; water--the rest.

  19. Cryptoglandular anal fistula.

    Science.gov (United States)

    de Parades, V; Zeitoun, J-D; Atienza, P

    2010-08-01

    Fistula arising from the glands of the anal crypts is the most common form of anoperineal sepsis. It is characterized by a primary internal orifice in the anal canal, a fistulous tract, and an abscess and/or secondary perineal orifice with purulent discharge. Antibiotics are not curative. The treatment of an abscess is urgent and consists, whenever possible, of incision and drainage under local anesthesia. Definitive treatment of the fistulous tract can await a second stage. The primary aim is to control infection without sacrificing anal continence. Fistulotomy is the basis for all treatments but the specific technique depends on the height of the fistula in relation to the sphincteric mechanism. Overall results of fistulotomy are excellent but there is some risk of anal incontinence. This explains the growing interest in sphincter sparing techniques such as the mucosal advancement flap, the injection of fibrin glue, and the plug procedure. However, results of these procedures are not yet good enough and leave much room for improvement.

  20. Modern management of anal fistula.

    Science.gov (United States)

    Limura, Elsa; Giordano, Pasquale

    2015-01-07

    Ideal surgical treatment for anal fistula should aim to eradicate sepsis and promote healing of the tract, whilst preserving the sphincters and the mechanism of continence. For the simple and most distal fistulae, conventional surgical options such as laying open of the fistula tract seem to be relatively safe and therefore, well accepted in clinical practise. However, for the more complex fistulae where a significant proportion of the anal sphincter is involved, great concern remains about damaging the sphincter and subsequent poor functional outcome, which is quite inevitable following conventional surgical treatment. For this reason, over the last two decades, many sphincter-preserving procedures for the treatment of anal fistula have been introduced with the common goal of minimising the injury to the anal sphincters and preserving optimal function. Among them, the ligation of intersphincteric fistula tract procedure appears to be safe and effective and may be routinely considered for complex anal fistula. Another technique, the anal fistula plug, derived from porcine small intestinal submucosa, is safe but modestly effective in long-term follow-up, with success rates varying from 24%-88%. The failure rate may be due to its extrusion from the fistula tract. To obviate that, a new designed plug (GORE BioA®) was introduced, but long term data regarding its efficacy are scant. Fibrin glue showed poor and variable healing rate (14%-74%). FiLaC and video-assisted anal fistula treatment procedures, respectively using laser and electrode energy, are expensive and yet to be thoroughly assessed in clinical practise. Recently, a therapy using autologous adipose-derived stem cells has been described. Their properties of regenerating tissues and suppressing inflammatory response must be better investigated on anal fistulae, and studies remain in progress. The aim of this present article is to review the pertinent literature, describing the advantages and limitations of

  1. Defensive anality and anal narcissism.

    Science.gov (United States)

    Shengold, L

    1985-01-01

    This paper aims at demonstrating a currently beleaguered assumption: the central importance, the continuing vitality, and the appropriate complexity of Freud's theory of the drives and of his idea of the primacy of the body ego. It is not enough to consider man a thinking machine or a social being; his animal nature must be given a central place in psychology. The paper postulates that 'anal or sphincter defensiveness' is one of the precursors of the repression barrier. Anality has been comparatively neglected in recent psychoanalytic literature, and so has its explorer, Karl Abraham. The paper's thesis is that there is a special defensive importance to anal erogeneity and libido, and to those aspects of ego and superego that are functionally operative (as the 'sadistic-anal organization' (Freud, 1917)) during the so-called 'sadistic-anal' developmental phase. Any of the psychic danger situations can evoke regression to manifestations of 'anal narcissim'--an attempt to master overwhelming feeling by a kind of emotional sphincter action, narrowing down the world to the controllable and the predictable. The basic assumption here is Fliess's idea that the attainment of anal sphincter control functions--with, as-it-were, 'psychic resonance'--as a means to master primal (murderous, cannibalistic) affect. For optimal psychic development, a proper balance must be attained between anal control of, and anal expression of, instinctual derivatives--especially of affect laden with aggression.

  2. Anal fissure

    Science.gov (United States)

    ... split or tear in the thin moist tissue ( mucosa ) lining the lower rectum (anus). Causes Anal fissures ... Chronic Constipation in infants and children Crohn disease Mucosa Review Date 5/24/2016 Updated by: Mary ...

  3. Anal Cancer

    Science.gov (United States)

    ... has just been diagnosed with anal cancer, this short, simple guide can help. More Resources Read more Cancer Basics Read more Finding Treatment Centers Read more Online Support Communities News & Stories Read More Latest Cancer News Read More Stories ...

  4. New techniques for treating an anal fistula.

    Science.gov (United States)

    Song, Kee Ho

    2012-02-01

    Surgery for an anal fistula may result in recurrence or impairment of continence. The ideal treatment for an anal fistula should be associated with low recurrence rates, minimal incontinence and good quality of life. Because of the risk of a change in continence with conventional techniques, sphincter-preserving techniques for the management complex anal fistulae have been evaluated. First, the anal fistula plug is made of lyophilized porcine intestinal submucosa. The anal fistula plug is expected to provide a collagen scaffold to promote tissue in growth and fistula healing. Another addition to the sphincter-preserving options is the ligation of intersphincteric fistula tract procedure. This technique is based on the concept of secure closure of the internal opening and concomitant removal of infected cryptoglandular tissue in the intersphincteric plane. Recently, cell therapy for an anal fistula has been described. Adipose-derived stem cells have two biologic properties, namely, ability to suppress inflammation and differentiation potential. These properties are useful for the regeneration or the repair of damaged tissues. This article discusses the rationales for, the estimated efficacies of, and the limitations of new sphincter-preserving techniques for the treatment of anal fistulae.

  5. New Techniques for Treating an Anal Fistula

    Science.gov (United States)

    2012-01-01

    Surgery for an anal fistula may result in recurrence or impairment of continence. The ideal treatment for an anal fistula should be associated with low recurrence rates, minimal incontinence and good quality of life. Because of the risk of a change in continence with conventional techniques, sphincter-preserving techniques for the management complex anal fistulae have been evaluated. First, the anal fistula plug is made of lyophilized porcine intestinal submucosa. The anal fistula plug is expected to provide a collagen scaffold to promote tissue in growth and fistula healing. Another addition to the sphincter-preserving options is the ligation of intersphincteric fistula tract procedure. This technique is based on the concept of secure closure of the internal opening and concomitant removal of infected cryptoglandular tissue in the intersphincteric plane. Recently, cell therapy for an anal fistula has been described. Adipose-derived stem cells have two biologic properties, namely, ability to suppress inflammation and differentiation potential. These properties are useful for the regeneration or the repair of damaged tissues. This article discusses the rationales for, the estimated efficacies of, and the limitations of new sphincter-preserving techniques for the treatment of anal fistulae. PMID:22413076

  6. Anal herpes

    National Research Council Canada - National Science Library

    Andre Goulart; Jose Pinto; Pedro Leão

    2017-01-01

    ... that irradiated to the buttocks and the physical examination revealed red bumps with ulceration ( figure 1 ). Anal herpes was suspected and the patient was treated with an antiviral (brivudine) and carbamazepine for symptomatic relief. Seven days after treatment the patient had complete resolution of his symptoms and there were no cut...

  7. Anal acoustic reflectometry

    DEFF Research Database (Denmark)

    Mitchell, Peter J; Klarskov, Niels; Telford, Karen J

    2011-01-01

    Anal acoustic reflectometry is a new technique of assessing anal sphincter function. Five new variables reflecting anal canal function are measured: the opening and closing pressure, the opening and closing elastance, and hysteresis.......Anal acoustic reflectometry is a new technique of assessing anal sphincter function. Five new variables reflecting anal canal function are measured: the opening and closing pressure, the opening and closing elastance, and hysteresis....

  8. Anal acoustic reflectometry

    DEFF Research Database (Denmark)

    Mitchell, Peter J; Klarskov, Niels; Telford, Karen J;

    2011-01-01

    Anal acoustic reflectometry is a new technique of assessing anal sphincter function. Five new variables reflecting anal canal function are measured: the opening and closing pressure, the opening and closing elastance, and hysteresis.......Anal acoustic reflectometry is a new technique of assessing anal sphincter function. Five new variables reflecting anal canal function are measured: the opening and closing pressure, the opening and closing elastance, and hysteresis....

  9. Plug Load Data

    Data.gov (United States)

    National Aeronautics and Space Administration — We provide MATLAB binary files (.mat) and comma separated values files of data collected from a pilot study of a plug load management system that allows for the...

  10. Anal Abscess/Fistula

    Science.gov (United States)

    ... to determine if antibiotics are indicated. TREATMENT OF ANAL FISTULA Currently, there is no medical treatment available for ... surgery is almost always necessary to cure an anal fistula. If the fistula is straightforward (involving minimal sphincter ...

  11. Anal fissure - slideshow

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/presentations/100154.htm Anal fissure - series—Normal anatomy To use the sharing ... rectum through which passes stool during defecation. The anal sphincter is a critical mechanism for control of ...

  12. Anal and Rectal Disorders

    Science.gov (United States)

    ... switch to the Professional version Home Digestive Disorders Anal and Rectal Disorders Overview of the Anus and ... This Article Medical Dictionary Also of Interest (Quiz) Anal Fissure (Video) Overview of Celiac Disease (News) Another ...

  13. Anal Health Care Basics

    Science.gov (United States)

    Chang, Jason; McLemore, Elisabeth; Tejirian, Talar

    2016-01-01

    Despite the fact that countless patients suffer from anal problems, there tends to be a lack of understanding of anal health care. Unfortunately, this leads to incorrect diagnoses and treatments. When treating a patient with an anal complaint, the primary goals are to first diagnose the etiology of the symptoms correctly, then to provide an effective and appropriate treatment strategy. The first step in this process is to take an accurate history and physical examination. Specific questions include details about bowel habits, anal hygiene, and fiber supplementation. Specific components of the physical examination include an external anal examination, a digital rectal examination, and anoscopy if appropriate. Common diagnoses include pruritus ani, anal fissures, hemorrhoids, anal abscess or fistula, fecal incontinence, and anal skin tags. However, each problem presents differently and requires a different approach for management. It is of paramount importance that the correct diagnosis is reached. Common errors include an inaccurate diagnosis of hemorrhoids when other pathology is present and subsequent treatment with a steroid product, which is harmful to the anal area. Most of these problems can be avoided by improving bowel habits. Adequate fiber intake with 30 g to 40 g daily is important for many reasons, including improving the quality of stool and preventing colorectal and anal diseases. In this Special Report, we provide an overview of commonly encountered anal problems, their presentation, initial treatment options, and recommendations for referral to specialists. PMID:27723447

  14. Anal Health Care Basics.

    Science.gov (United States)

    Chang, Jason; Mclemore, Elisabeth; Tejirian, Talar

    2016-01-01

    Despite the fact that countless patients suffer from anal problems, there tends to be a lack of understanding of anal health care. Unfortunately, this leads to incorrect diagnoses and treatments. When treating a patient with an anal complaint, the primary goals are to first diagnose the etiology of the symptoms correctly, then to provide an effective and appropriate treatment strategy.The first step in this process is to take an accurate history and physical examination. Specific questions include details about bowel habits, anal hygiene, and fiber supplementation. Specific components of the physical examination include an external anal examination, a digital rectal examination, and anoscopy if appropriate.Common diagnoses include pruritus ani, anal fissures, hemorrhoids, anal abscess or fistula, fecal incontinence, and anal skin tags. However, each problem presents differently and requires a different approach for management. It is of paramount importance that the correct diagnosis is reached. Common errors include an inaccurate diagnosis of hemorrhoids when other pathology is present and subsequent treatment with a steroid product, which is harmful to the anal area.Most of these problems can be avoided by improving bowel habits. Adequate fiber intake with 30 g to 40 g daily is important for many reasons, including improving the quality of stool and preventing colorectal and anal diseases.In this Special Report, we provide an overview of commonly encountered anal problems, their presentation, initial treatment options, and recommendations for referral to specialists.

  15. O uso de telas Parietex® e Surgisis® na correção de defeitos produzidos na parede abdominal de coelhos The repair of abdominal defects in rabbits with Parietex® and Surgisis® meshes abdominal wall

    Directory of Open Access Journals (Sweden)

    João Batista Baroncello

    2008-12-01

    Full Text Available RACIONAL: Na cirurgia geral, as correções das hérnias da parede abdominal ocupam lugar de destaque e, cada vez mais, as indicações e usos de telas têm aumentado devido aos melhores resultados. OBJETIVO: Comparar as correções de orifícios produzidos em parede abdominal com telas Parietex® e Surgisis® em contato direto com as vísceras abdominais. MÉTODO: Para os experimentos foram utilizadas 16 coelhas adultas jovens e produção de defeitos triangulares de 2 cm de base por 2,5 cm de altura, comprometendo os planos músculo-aponeurótico-peritoniais da parede abdominal, nos flancos, simétricos à linha média que foram corrigidos com telas retangulares de 3 cm de base por 3,5 cm de altura. No lado direito usou-se tela Parietex® (poliéster/colágeno-polietilenoglicol-glicerol e no lado esquerdo tela Surgisis® (submucosa intestinal suína. Na avaliação utilizaram-se parâmetros clínico-cirúrgicos, histológicos e imunoistoquímicos. Oito coelhas foram submetidas a eutanásia em 30 dias e as 8 restantes, em 60. Comparou-se a eficiência das duas telas. RESULTADOS: As duas telas provocaram erosões de pele e não ocorreu nenhum caso de hérnia incisional. As aderências ocorreram em todas as telas no primeiro mês e em menor grau e intensidade, no segundo mês; a retração delas foi de 1/3 do tamanho original; a Parietex® provocou menor processo inflamatório; não houve diferença significante de deposição de entre as duas telas; a deposição do colágeno tipo III foi mais intensa no segundo mês em ambas; na remodelação do colágeno a produção da enzima MMP8 foi maior na tela Parietex® no primeiro mês e a enzima MMP13 aumentou no segundo mês em ambas as telas, porém com significância apenas na Parietex®. CONCLUSÃO: As duas telas foram eficientes na correção de hérnias incisionais e com resultados semelhantes, sendo que a Parietex® apresentou menor processo inflamatório, maior quantidade de metaloproteinases

  16. Playing with Plug-ins

    Science.gov (United States)

    Thompson, Douglas E.

    2013-01-01

    In today's complex music software packages, many features can remain unexplored and unused. Software plug-ins--available in most every music software package, yet easily overlooked in the software's basic operations--are one such feature. In this article, I introduce readers to plug-ins and offer tips for purchasing plug-ins I have…

  17. Vascular plugs - A key companion to Interventionists - 'Just Plug it'.

    Science.gov (United States)

    Ramakrishnan, Sivasubramanian

    2015-01-01

    Vascular plugs are ideally suited to close extra-cardiac, high flowing vascular communications. The family of vascular plugs has expanded. Vascular plugs in general have a lower profile and the newer variants can be delivered even through a diagnostic catheter. These features make them versatile and easy to use. The Amplatzer vascular plugs are also used for closing intracardiac defects including coronary arterio-venous fistula and paravalvular leakage in an off-label fashion. In this review, the features of currently available vascular plugs are reviewed along with tips and tricks of using them in the cardiac catheterization laboratory.

  18. Kirurgisk behandling af anale fistler ved Crohns sygdom

    DEFF Research Database (Denmark)

    Heyckendorff-Diebold, Tina; Maeda, Yasuko; Buntzen, Steen;

    2012-01-01

    The treatment of transsphincteric anal fistulas in Crohn's disease is a balance between the elimination of the sepsis and the functional outcome. Loose setons can be used as a preoperative drainage or chronic treatment. Fibrin glue and the anal fistula plug are methods with excellent functional...... outcomes, but the success rate varies. The endorectal advancement flap is considered to be the gold standard. Ligation of the intersphincteric fistula tract is promising. Proctectomy or proctocolectomy in combination with transposition flaps may be necessary. A success rate of 66-70% has been reported....

  19. Anal abscess and fistula.

    Science.gov (United States)

    Sneider, Erica B; Maykel, Justin A

    2013-12-01

    Benign anorectal diseases, such as anal abscesses and fistula, are commonly seen by primary care physicians, gastroenterologists, emergency physicians, general surgeons, and colorectal surgeons. It is important to have a thorough understanding of the complexity of these 2 disease processes so as to provide appropriate and timely treatment. We review the pathophysiology, presentation, diagnosis, and treatment options for both anal abscesses and fistulas.

  20. Providing free autopoweroff plugs

    DEFF Research Database (Denmark)

    Jensen, Carsten Lynge; Hansen, Lars Gårn; Fjordbak, Troels

    2012-01-01

    on metered electricity consumption for different types of households. We find effects for single men and couples without children, while we find no effect for single women and households with children. We suggest that this could be because of differences in saving potential (e.g. some households do not have...... appliances where using a plug is relevant), differences in the skills relevant for installing the technology and differences in the willingness to spend time and effort on installation. We conclude that targeting interventions at more responsive households, and tailoring interventions to target groups, can...

  1. Anal cancer; Cancer du canal anal

    Energy Technology Data Exchange (ETDEWEB)

    Fesneau, M.; Champeaux-Orange, E. [Service de radiotherapie, Centre regional universitaire de cancerologie Henry-S.-Kaplan CHU de Tours, Hopital Bretonneau, 37 - Tours (France); Champeaux-Orange, E. [Service d' oncologie-radiotherapie, Centre hospitalier regional d' Orleans, 45 - Orleans (France); Hennequin, C. [Service de cancerologie-radiotherapie, hopital Saint-Louis, 75 - Paris (France)

    2010-07-01

    Anal canal epidermoid carcinomas represent 1.2% of digestive cancers and 6% of ano-rectal cancers. For localized diseases, the treatment is based on radiotherapy with or without chemotherapy (5-FU and cisplatin or mitomycin), according to tumour and nodal extension. The recommended treatment dose is 45 Gy in the anal canal, the mesorectum, para-rectal lymph nodes, and inguinal lymph nodes. An additional dose of 15 to 20 Gy is delivered in the initial tumour for good responders. Salvage surgery is necessary in case of poor response. The organs at risk to be considered are bladder, femur heads, small intestine and vulva. The objective of this work is to summarize the epidemiological and radio-anatomic and prognostic characteristics of this tumour. The conformal radiotherapy technique is illustrated by a case report. (authors)

  2. Mechanics Model of Plug Welding

    Science.gov (United States)

    Zuo, Q. K.; Nunes, A. C., Jr.

    2015-01-01

    An analytical model has been developed for the mechanics of friction plug welding. The model accounts for coupling of plastic deformation (material flow) and thermal response (plastic heating). The model predictions of the torque, energy, and pull force on the plug were compared to the data of a recent experiment, and the agreements between predictions and data are encouraging.

  3. Static Gas-Charging Plug

    Science.gov (United States)

    Indoe, William

    2012-01-01

    A gas-charging plug can be easily analyzed for random vibration. The design features two steeped O-rings in a radial configuration at two different diameters, with a 0.050-in. (.1.3-mm) diameter through-hole between the two O-rings. In the charging state, the top O-ring is engaged and sealing. The bottom O-ring outer diameter is not squeezed, and allows air to flow by it into the tank. The inner diameter is stretched to plug the gland diameter, and is restrained by the O-ring groove. The charging port bushing provides mechanical stop to restrain the plug during gas charge removal. It also prevents the plug from becoming a projectile when removing gas charge from the accumulator. The plug can easily be verified after installation to ensure leakage requirements are met.

  4. HIV-associated anal cancer

    OpenAIRE

    Newsom-Davis, Thomas; Bower, Mark

    2010-01-01

    HIV-associated anal carcinoma, a non-AIDS-defining cancer, is a human papillomavirus-associated malignancy with a spectrum of preinvasive changes. The standardized incidence ratio for anal cancer in patients with HIV/AIDS is 20-50. Algorithms for anal cancer screening include anal cytology followed by high-resolution anoscopy for those with abnormal findings. Outpatient topical treatments for anal intraepithelial neoplasia include infrared coagulation therapy, trichloroacetic acid, and imiqui...

  5. Relationship Among Anal Sphincter Injury, Patulous Anal Canal, and Anal Pressures in Patients with Anorectal Disorders

    Science.gov (United States)

    Prichard, David; Harvey, Doris M.; Fletcher, Joel G.; Zinsmeister, Alan R.; Bharucha, Adil E.

    2015-01-01

    Background & Aims The anal sphincters and puborectalis are routinely imaged with an endoanal magnetic resonance imaging (MRI) coil, which does not assess co-aptation of the anal canal at rest. Using a MRI torso coil, we identified a patulous anal canal in some patients with anorectal disorders. We aimed to evaluate the relationship between anal sphincter and puborectalis injury, a patulous anal canal, and anal pressures. Methods We performed a retrospective analysis of data from 119 patients who underwent MRI and manometry analysis of anal anatomy and pressures, respectively, from February 2011 through March 2013 at the Mayo Clinic. Anal pressures were determined by high-resolution manometry, anal sphincter and puborectalis injury was determined by endoanal MRI, and anal canal integrity was determined by torso MRI. Associations between manometric and anatomical parameters were evaluated with univariate and multivariate analyses. Results Fecal incontinence (55 patients, 46%) and constipation (36 patients. 30%) were the main indications for testing; 49 patients (41%) had a patulous anal canal, which was associated with injury to more than 1 muscle (all P≤.001) and internal sphincter (Panal resting pressure. A patulous anal canal was the only significant predictor (Panal squeeze pressure increment. Conclusions Patients with anorectal disorders commonly have a patulous anal canal, associated with more severe anal injury, anal resting pressure, and squeeze pressure increment. It is therefore important to identify patulous anal canal because it appears to be a marker of not only anal sphincter injury but disturbances beyond sphincter injury, such as damage to the anal cushions or anal denervation. PMID:25869638

  6. Obstetric anal sphincter injuries

    Institute of Scientific and Technical Information of China (English)

    Remon Keriakos; Deepa Gopinath

    2015-01-01

    Obstetric anal sphincter injuries can be associated with significant short and long term consequences causing devastating impacts on the quality of lives of young, otherwise healthy women. The major consequence is anal incontinence which may be short or long term and vary in severity. The other consequences include pain, infection, dyspareunia and sexual dysfunction. This may in turn result in considerable economic burden to health care providers and patients. It also has an implication on future deliveries. Although it can never be eliminated, it can be reduced by improving practice, training and provision of high quality multidisciplinary care in order to reduce long-term morbidity. Obstetric anal sphincter injuries are also a source of litigation which can be distressing to both patients and clinicians. The aim of this review article is to explore the available evidence on epidemiology, strategies for preventions, prognosis and also how to deal with governance issues.

  7. Pharmacotherapy of Anal Cancer.

    Science.gov (United States)

    Rogers, Jane E; Eng, Cathy

    2017-08-02

    Anal squamous cell carcinoma (SCCA), among other malignancies, is associated with the human papillomavirus (HPV) and its incidence continues to rise. Anal SCCA will likely remain an existing healthcare concern given compliance issues with the HPV vaccination seen in the US. Localized disease is predominantly treated with standard of care (SOC) definitive chemoradiation that has remained unchanged for decades. Clinical and molecular prognostic factors have emerged to characterize patients unresponsive to SOC, revealing the need for an alternate approach. Metastatic disease is an extremely small subset and understudied population due to its rarity. Recent prospective trials and mutational analysis have opened treatment options for this subset in need. Our review details the pharmacotherapeutic treatment in localized and metastatic anal SCCA chronologically, while also describing future outlooks.

  8. Obstetric anal sphincter injuries

    Directory of Open Access Journals (Sweden)

    Remon Keriakos

    2015-10-01

    Full Text Available Obstetric anal sphincter injuries can be associated with significant short and long term consequences causing devastating impacts on the quality of lives of young, otherwise healthy women. The major consequence is anal incontinence which may be short or long term and vary in severity. The other consequences include pain, infection, dyspareunia and sexual dysfunction. This may in turn result in considerable economic burden to health care providers and patients. It also has an implication on future deliveries. Although it can never be eliminated, it can be reduced by improving practice, training and provision of high quality multidisciplinary care in order to reduce long-term morbidity. Obstetric anal sphincter injuries are also a source of litigation which can be distressing to both patients and clinicians. The aim of this review article is to explore the available evidence on epidemiology, strategies for preventions, prognosis and also how to deal with governance issues.

  9. 49 CFR 230.59 - Fusible plugs.

    Science.gov (United States)

    2010-10-01

    ..., DEPARTMENT OF TRANSPORTATION STEAM LOCOMOTIVE INSPECTION AND MAINTENANCE STANDARDS Boilers and Appurtenances Fusible Plugs § 230.59 Fusible plugs. If boilers are equipped with fusible plugs, the plugs shall be removed and cleaned of scale each time the boiler is washed but not less frequently than during every...

  10. Anal itching -- self-care

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000689.htm Anal itching - self-care To use the sharing features on this page, please enable JavaScript. Anal itching occurs when the skin around your anus ...

  11. [Cryptoglandular anal fistulas].

    Science.gov (United States)

    de Parades, Vincent; Zeitoun, Jean-David; Bauer, Pierre; Atienza, Patrick

    2008-10-31

    Cryptoglandular anal fistulae are the most frequently occurring form of perianal sepsis. Characteristically they have an endoanal primary opening, a fistula track and an abscess and/or an external purulent opening. Antibiotic therapy is not of use in initial management except in special cases. Treatment of an abscess, if present, is required urgently and when possible, consists of its incision under local anaesthesia. Treating the fistula track occurs afterwards and aims to dry up the purulent discharge and avoid recurrence of the abscess by means of surgical fistulotomy. These techniques are very effective in terms of eradication of the problem but there is sometimes a risk of anal incontinence. This explains the increasing interest in sphincter preserving techniques using the advancement of a covering flap of rectal mucosa and the injection of fibrin glue.

  12. Treatment of fistula-in-ano with fistula plug – A Review under special consideration of the technique

    Directory of Open Access Journals (Sweden)

    Ferdinand eKöckerling

    2015-10-01

    Full Text Available IntroducationIn a recent Cochrane review the authors concluded that there is an urgent need for well-powered, well-conducted randomized controlled trials comparing various modes of treatment of fistula-in-ano. Ten randomized controlled trials were available for analyses: There were no significant differences in recurrence rates or incontinuence rates in any of the studied comparisons. The following article reviews all studies available for treatment of fistula-in-ano with a fistula plug.Material and MethodsPubMed, Medline, Embase and the Cochrane medical database were searched up to December 2014. 47 articles were relevant for this review.ResultsHealing rates of 50 – 60 % can be expected for treatment of complex anal fistula with a fistula plug, with a plug-extrusion rate of 10 – 20 %. Such results can be achieved not only with plugs made of porcine intestinal submucosa, but also those made of other biological mesh materials, such as acellular dermal matrix. Important technical steps in the performance of a complex anal fistula plug repair need to be followed.SummaryTreatment of a complex fistula-in-ano with a fistula plug is an option with a success rate of 50 – 60 % with low complication rate. Further improvements in technique and better studies

  13. Biomaterials in the Treatment of Anal Fistula: Hope or Hype?

    Science.gov (United States)

    Scoglio, Daniele; Walker, Avery S.; Fichera, Alessandro

    2014-01-01

    Anal fistula (AF) presents a chronic problem for patients and colorectal surgeons alike. Surgical treatment may result in impairment of continence and long-term risk of recurrence. Treatment options for AFs vary according to their location and complexity. The ideal approach should result in low recurrence rates and minimal impact on continence. New technical approaches involving biologically derived products such as biological mesh, fibrin glue, fistula plug, and stem cells have been applied in the treatment of AF to improve outcomes and decrease recurrence rates and the risk of fecal incontinence. In this review, we will highlight the current evidence and describe our personal experience with these novel approaches. PMID:25435826

  14. Why do we have so much trouble treating anal fistula?

    Institute of Scientific and Technical Information of China (English)

    Haig Dudukgian; Herand Abcarian

    2011-01-01

    Anal fistula is among the most common illnesses af-fecting man. Medical literature dating back to 400 BC has discussed this problem. Various causative factors have been proposed throughout the centuries, but it appears that the majority of fistulas unrelated to spe-cific causes (e.g. Tuberculosis, Crohn's disease) result from infection (abscess) in anal glands extending from the intersphincteric plane to various anorectal spaces. The tubular structure of an anal fistula easily yields itself to division or unroofing (fistulotomy) or excision (fistulectomy) in most cases. The problem with this single, yet effective, treatment plan is that depending on the thickness of sphincter muscle the fistula trans-gresses, the patient will have varying degrees of fecal incontinence from minor to total. In an attempt to pre-serve continence, various procedures have been pro-posed to deal with the fistulas. These include: (1) sim-ple drainage (Seton); (2) closure of fistula tract using fibrin sealant or anal fistula plug; (3) closure of prima-ry opening using endorectal or dermal flaps, and more recently; and (4) ligation of intersphincteric fistula tract (LIFT). In most complex cases (i.e. Crohn's disease), a proximal fecal diversion offers a measure of symptom-atic relief. The fact remains that an "ideal" procedure for anal fistula remains elusive. The failure of each sphincter-preserving procedure (30%-50% recurrence) often results in multiple operations. In essence, the price of preservation of continence at all cost is multi-ple and often different operations, prolonged disability and disappointment for the patient and the surgeon. Nevertheless, the surgeon treating anal fistulas on an occasional basis should never hesitate in referring the patient to a specialist. Conversely, an expert colorectal surgeon must be familiar with many different opera-tions in order to selectively tailor an operation to the individual patient.

  15. Why do we have so much trouble treating anal fistula?

    Science.gov (United States)

    Dudukgian, Haig; Abcarian, Herand

    2011-07-28

    Anal fistula is among the most common illnesses affecting man. Medical literature dating back to 400 BC has discussed this problem. Various causative factors have been proposed throughout the centuries, but it appears that the majority of fistulas unrelated to specific causes (e.g. Tuberculosis, Crohn's disease) result from infection (abscess) in anal glands extending from the intersphincteric plane to various anorectal spaces. The tubular structure of an anal fistula easily yields itself to division or unroofing (fistulotomy) or excision (fistulectomy) in most cases. The problem with this single, yet effective, treatment plan is that depending on the thickness of sphincter muscle the fistula transgresses, the patient will have varying degrees of fecal incontinence from minor to total. In an attempt to preserve continence, various procedures have been proposed to deal with the fistulas. These include: (1) simple drainage (Seton); (2) closure of fistula tract using fibrin sealant or anal fistula plug; (3) closure of primary opening using endorectal or dermal flaps, and more recently; and (4) ligation of intersphincteric fistula tract (LIFT). In most complex cases (i.e. Crohn's disease), a proximal fecal diversion offers a measure of symptomatic relief. The fact remains that an "ideal" procedure for anal fistula remains elusive. The failure of each sphincter-preserving procedure (30%-50% recurrence) often results in multiple operations. In essence, the price of preservation of continence at all cost is multiple and often different operations, prolonged disability and disappointment for the patient and the surgeon. Nevertheless, the surgeon treating anal fistulas on an occasional basis should never hesitate in referring the patient to a specialist. Conversely, an expert colorectal surgeon must be familiar with many different operations in order to selectively tailor an operation to the individual patient.

  16. Complex anal fistula remains a challenge for colorectal surgeon.

    Science.gov (United States)

    Cadeddu, F; Salis, F; Lisi, G; Ciangola, I; Milito, G

    2015-05-01

    Anal fistula is a common proctological problem to both patient and physician throughout surgical history. Several surgical and sphincter-sparing approaches have been described for the management of fistula-in-ano, aimed to minimize the recurrence and to preserve the continence. We aimed to systematically review the available studies relating to the surgical management of anal fistulas. A Medline search was performed using the PubMed, Ovid, Embase, and Cochrane databases to identify articles reporting on fistula-in-ano management, aimed to find out the current techniques available, the new technologies, and their effectiveness in order to delineate a gold standard treatment algorithm. The management of low anal fistulas is usually straightforward, given that fistulotomy is quite effective, and if the fistula has been properly evaluated, continence disturbance is minimal. On the contrary, high complex fistulas are challenging, because cure and continence are directly competing priorities. Conventional fistula surgery techniques have their place, but new technologies such as fibrin glues, dermal collagen injection, the anal fistula plugs, and stem cell injection offer alternative approaches whose long-term efficacy needs to be further clarified in large long-term randomized trials.

  17. Anal anatomy and normal histology.

    Science.gov (United States)

    Pandey, Priti

    2012-12-01

    The focus of this article is the anatomy and histology of the anal canal, and its clinical relevance to anal cancers. The article also highlights the recent histological and anatomical changes to the traditional terminology of the anal canal. The terminology has been adopted by the American Joint Committee on Cancer, separating the anal region into the anal canal, the perianal region and the skin. This paper describes the gross anatomy of the anal canal, along with its associated blood supply, venous and lymphatic drainage, and nerve supply. The new terminology referred to in this article may assist clinicians and health care providers to identify lesions more precisely through naked eye observation and without the need for instrumentation. Knowledge of the regional anatomy of the anus will also assist in management decisions.

  18. The NAHIF* Plug-in-Magnet

    CERN Multimedia

    CERN Audiovisual Unit

    1981-01-01

    * North Area High Intensity Facility of the CERN SPS. The beamlines with target stations and the plug-in magnets - The plug-in magnet to be removed for repair - The lifting bar and tool for the vacuum connector - The control stand - Controls for vacuum connector tool - The plug-in vacuum connector - Liftingbar with the automatic pins for magnets - The gravitational automatic pin - The plug-in kit in action.

  19. Anal cancer – a review

    Science.gov (United States)

    Salati, Sajad Ahmad; Al Kadi, Azzam

    2012-01-01

    Anal cancer accounts for only 1.5% of gastrointestinal malignancies but this disease has shown a steady increase in incidence particularly in HIV positive males. The understanding of pathophysiology and treatment of anal cancer has changed radically over last thirty years. Risk factors have been identified and organ preservation by chemoradiotherapy has become a standard. This article aims to review the clinical presentation, diagnostic evaluation, and treatment options for anal cancer in the light of current literature. PMID:23580899

  20. Anal squamous intraepithelial neoplasia.

    Science.gov (United States)

    Bejarano, Pablo A; Boutros, Marylise; Berho, Mariana

    2013-12-01

    Diagnosis, follow up, and treatment of anal intraepithelial neoplasia are complex and not standardized. This may be partly caused by poor communication of biopsy and cytology findings between pathologists and clinicians as a result of a disparate and confusing terminology used to classify these lesions. This article focuses on general aspects of epidemiology and on clarifying the current terminology of intraepithelial squamous neoplasia, its relationship with human papilloma virus infection, and the current methods that exist to diagnose and treat this condition. Copyright © 2013 Elsevier Inc. All rights reserved.

  1. Hypertrophied anal papillae and fibrous anal polyps, should they be removed during anal fissure surgery?

    Institute of Scientific and Technical Information of China (English)

    Pravin J. Gupta

    2004-01-01

    AIM: Hypertrophied anal papillae and fibrous anal polyps are not given due importance in the proctology practice.They are mostly ignored being considered as normal structures. The present study was aimed to demonstrate that hypertrophied anal papillae and fibrous anal polyps could cause symptoms to the patients and that they should be removed in treatment of patients with chronic fissure in anus.METHODS: Two groups of patients were studied. A hundred patients were studied in group A in which the associated fibrous polyp or papillae were removed by radio frequency surgical device after a lateral subcutaneous sphincterotomy for relieving the sphincter spasm. Another group of a hundred patients who also had papillae or fibrous polyps, were treated by lateral sphincterotomy alone. They were followed up for one year.RESULTS: Eighty-nine percent patients from group A expressed their satisfaction with the treatment in comparison to only 64% from group B who underwent sphincterotomy alone with the papillae or anal polyps left untreated. Group A patients showed a marked reduction with regard to pain and irritation during defecation (P= 0.0011),pricking or foreign body sensation in the anus (P = 0.0006)and pruritus or wetness around the anal verge (P = 0.0008).CONCLUSION: Hypertrophied anal papillae and fibrous anal polyps should be removed during treatment of chronic anal fissure. This would add to effectiveness and completeness of the procedure.

  2. Screening for Anal Cancer in Women

    Science.gov (United States)

    Moscicki, Anna-Barbara; Darragh, Teresa M.; Berry-Lawhorn, J. Michael; Roberts, Jennifer Margaret; Khan, Michelle J.; Boardman, Lori A.; Chiao, Elizabeth; Einstein, Mark H.; Goldstone, Stephen E.; Jay, Naomi; Likes, Wendy M.; Stier, Elizabeth A.; Welton, Mark Lane; Wiley, Dorothy J.; Palefsky, Joel M.

    2015-01-01

    Objective The incidence of anal cancer is higher in women than men in the general population and has been increasing for several decades. Similar to cervical cancer, most anal cancers are associated with human papillomavirus (HPV) and it is believed that anal cancers are preceded by anal high-grade squamous intraepithelial lesions (HSIL). Our goal was to summarize the literature on anal cancer, HSIL and HPV infection in women, and provide screening recommendations in women. Methods A group of experts convened by the ASCCP and the International Anal Neoplasia Society reviewed the literature on anal HPV infection, anal SIL and anal cancer in women. Results Anal HPV infection is common in women but is relatively transient in most. The risk of anal HSIL and cancer varies considerably by risk group, with HIV-infected women and those with a history of lower genital tract neoplasia (LGTN) at highest risk compared with the general population. Conclusions While there are no data yet to demonstrate that identification and treatment of anal HSIL leads to reduced risk of anal cancer, women in groups at the highest risk should be queried for anal cancer symptoms and have digital anorectal examinations to detect anal cancers. HIV-infected women and women with LGTN, may be considered for screening with anal cytology with triage to treatment if HSIL is diagnosed. Healthy women with no known risk factors or anal cancer symptoms do not need to be routinely screened for anal cancer or anal HSIL. PMID:26103446

  3. Management of Complex Anal Fistulas

    Science.gov (United States)

    Bubbers, Emily J.; Cologne, Kyle G.

    2016-01-01

    Complex anal fistulas require careful evaluation. Prior to any attempts at definitive repair, the anatomy must be well defined and the sepsis resolved. Several muscle-sparing approaches to anal fistula are appropriate, and are often catered to the patient based on their presentation and previous repairs. Emerging technologies show promise for fistula repair, but lack long-term data. PMID:26929751

  4. SAMI Automated Plug Plate Configuration

    CERN Document Server

    Lorente, Nuria P F; Goodwin, Michael

    2012-01-01

    The Sydney-AAO Multi-object Integral field spectrograph (SAMI) is a prototype wide-field system at the Anglo-Australian Telescope (AAT) which uses a plug-plate to mount its 13 x 61-core imaging fibre bundles (hexabundles) in the optical path at the telescope's prime focus. In this paper we describe the process of determining the positions of the plug-plate holes, where plates contain three or more stacked observation configurations. The process, which up until now has involved several separate processes and has required significant manual configuration and checking, is now being automated to increase efficiency and reduce error. This is carried out by means of a thin Java controller layer which drives the configuration cycle. This layer controls the user interface and the C++ algorithm layer where the plate configuration and optimisation is carried out. Additionally, through the Aladin display package, it provides visualisation and facilitates user verification of the resulting plates.

  5. Halliburton Composite Bridge Plug Assembly

    Energy Technology Data Exchange (ETDEWEB)

    Starbuck, J.M.; Luttrell, C.R.; Aramayo, G.

    2005-01-15

    The overall objectives of this CRADA were to assist Halliburton in analyzing a composite bridge plug and to determine why their original design was failing in the field. In Phase 1, finite element analyses were done on the original composite slip design and several alternative designs. The composite slip was the component in the bridge plug that was failing. The finite element code ABAQUS was used for these calculations and I-DEAS was used as the pre- and post-processor in the analyses. Several different designs and materials were analyzed and recommendations were made towards improving the design. In Phase 2, the objective was to develop finite element models that would accurately represent the deformations in the entire all-composite 4-1/2' diameter bridge plug assembly. The finite element code LS-DYNA was used and the results from this effort were intended to expand Halliburton's composite design and analysis capabilities with regard to developing future composite components for downhole tools. In addition to the finite element modeling, this effort involved the utilization of micromechanics to determine the necessary composite material properties that were needed as input for finite element codes.

  6. [Surgical treatment of anal fistula].

    Science.gov (United States)

    Zeng, Xiandong; Zhang, Yong

    2014-12-01

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

  7. Plug Load Behavioral Change Demonstration Project

    Energy Technology Data Exchange (ETDEWEB)

    Metzger, I.; Kandt, A.; VanGeet, O.

    2011-08-01

    This report documents the methods and results of a plug load study of the Environmental Protection Agency's Region 8 Headquarters in Denver, Colorado, conducted by the National Renewable Energy Laboratory. The study quantified the effect of mechanical and behavioral change approaches on plug load energy reduction and identified effective ways to reduce plug load energy. Load reduction approaches included automated energy management systems and behavioral change strategies.

  8. Electrocautery for Precancerous Anal Lesions

    Science.gov (United States)

    Results from a randomized clinical trial conducted in Amsterdam suggest that electrocautery is better than topical imiquimod or fluorouracil at treating potentially precancerous anal lesions in HIV-positive men who have sex with men.

  9. Anal fistula. Past and present

    National Research Council Canada - National Science Library

    Zubaidi, Ahmad M

    2014-01-01

    Anal fistula is a common benign condition that typically describes a miscommunication between the anorectum and the perianal skin, which may present de novo, or develop after acute anorectal abscess...

  10. Multimeediaetendus : Opera Gets Plugged / Eve Arpo

    Index Scriptorium Estoniae

    Arpo, Eve

    2008-01-01

    Eesti Muusika- ja Teatriakadeemia lühiooperite õhtul "Opera Gets Plugged" etendunud lavastustest - Monika Mattieseni "DMeeter" ja Age Hirve "Tuleloitsija": Mõlema lavastaja ja projektijuht Liis Kolle

  11. Multimeediaetendus : Opera Gets Plugged / Eve Arpo

    Index Scriptorium Estoniae

    Arpo, Eve

    2008-01-01

    Eesti Muusika- ja Teatriakadeemia lühiooperite õhtul "Opera Gets Plugged" etendunud lavastustest - Monika Mattieseni "DMeeter" ja Age Hirve "Tuleloitsija": Mõlema lavastaja ja projektijuht Liis Kolle

  12. Comparative study of anal acoustic reflectometry and anal manometry in the assessment of faecal incontinence

    DEFF Research Database (Denmark)

    Hornung, B R; Mitchell, P J; Carlson, G L;

    2012-01-01

    Anal acoustic reflectometry (AAR) is a reproducible technique providing a novel physiological assessment of anal sphincter function. It may have advantages over conventional anal manometry. The aims of this study were to determine the ability of AAR and anal manometry to identify changes in anal...

  13. Novel biological strategies in the management of anal fistula.

    Science.gov (United States)

    Lewis, R; Lunniss, P J; Hammond, T M

    2012-12-01

    The mostly widely studied biomaterials for the sphincter sparing treatment of anal fistulas are fibrin glue and the anal fistula plug (AFP). However their overall mean clinical success is only 50-60%. As the understanding of the pathology of anal fistula, wound healing and the host response to materials has improved, so new biological sphincter-sparing strategies have been developed. The aim of this review is to assess the safety and efficacy of these novel techniques. PubMed, the Cochrane database and EMBASE were independently searched. All studies that investigated the potential of a biomaterial (defined as any synthetic or biologically derived substance in contact with host tissue) to augment the healing of anal fistula without sphincter division were included. Studies solely describing the role of fibrin glue or an AFP were excluded. Data extraction included type of material, fistula aetiology, treatment of the primary tract, fistula healing, incontinence, duration of follow-up and any specific complications. Systematic quality assessment of the included articles was performed. Twenty-three articles were finally selected for review. These included a variety of biological and synthetic systems that were employed to deliver selected components of the extracellular matrix, growth factors, cytokines, stem cells or drugs to the fistula tract. To date no study matches fistulotomy with regard to long-term fistula eradication rate. This is probably due to implant extrusion, inadequate track preparation or an unsuitable material. Future techniques need to address all these issues to ensure success. Success should be validated by MRI or long-term follow-up. © 2012 The Authors. Colorectal Disease © 2012 The Association of Coloproctology of Great Britain and Ireland.

  14. Vascular plugs – A key companion to Interventionists – ‘Just Plug it’

    Science.gov (United States)

    Ramakrishnan, Sivasubramanian

    2015-01-01

    Vascular plugs are ideally suited to close extra-cardiac, high flowing vascular communications. The family of vascular plugs has expanded. Vascular plugs in general have a lower profile and the newer variants can be delivered even through a diagnostic catheter. These features make them versatile and easy to use. The Amplatzer vascular plugs are also used for closing intracardiac defects including coronary arterio-venous fistula and paravalvular leakage in an off-label fashion. In this review, the features of currently available vascular plugs are reviewed along with tips and tricks of using them in the cardiac catheterization laboratory. PMID:26304581

  15. Mastering Eclipse plug-in development

    CERN Document Server

    Blewitt, Alex

    2014-01-01

    If you are a Java developer who is familiar with the Eclipse plug-in environment, this book covers the advanced concepts that you need to know to achieve true expertise. Prior experience in creating Eclipse plug-ins is assumed for this book.

  16. Tension free femoral hernia repair with plug

    Directory of Open Access Journals (Sweden)

    Milivoje Vuković

    2013-01-01

    Conclusions: The technique of closing the femoral canal with plug a simple. The plug is made from monofilament material and is easily formed. This technique allows the reduction of recurrence and can be used safely, quickly and easily in elective and emergency situations.

  17. Mapping nanocavities in plugged SBA-15 with confined silver nanostructures

    NARCIS (Netherlands)

    De Lima Oliveira, Rafael; Shakeri, Mozaffar; Meeldijk, Johannes D.; de Jong, Krijn P.; de Jongh, Petra E.

    2015-01-01

    Silver nanostructures inside the pores of SBA-15 and plugged SBA-15 were synthesized and imaged, providing for the first time quantitative information about the nanocavity dimensions and plug distributions in plugged SBA-15.

  18. Plug-in Hybrid Initiative

    Energy Technology Data Exchange (ETDEWEB)

    Goodman, Angie; Moore, Ray; Rowden, Tim

    2013-09-27

    Our main project objective was to implement Plug-in Electric Vehicles (PEV) and charging infrastructure into our electric distribution service territory and help reduce barriers in the process. Our research demonstrated the desire for some to be early adopters of electric vehicles and the effects lack of education plays on others. The response of early adopters was tremendous: with the initial launch of our program we had nearly 60 residential customers interested in taking part in our program. However, our program only allowed for 15 residential participants. Our program provided assistance towards purchasing a PEV and installation of Electric Vehicle Supply Equipment (EVSE). The residential participants have all come to love their PEVs and are more than enthusiastic about promoting the many benefits of driving electric.

  19. Plug into 'the modernizing machine'!

    DEFF Research Database (Denmark)

    Krejsler, John B.

    2013-01-01

    ‘The modernizing machine’ codes individual bodies, things and symbols with images from New Public Management, neoliberal and Knowledge Economy discourses. Drawing on Deleuze & Guattari’s concept of machines, this article explores how ‘the modernizing machine’ produces neo-liberal modernization...... of the public sector. Taking its point of departure in Danish university reform, the article explores how the university is transformed by this desiring-producing machine. ‘The modernizing machine’ wrestles with the so-called ‘democratic-Humboldtian machine’. The University Act of 2003 and the host of reforms...... bodies and minds simultaneously produce academic subjectivities by plugging into these transformative machinic forces and are produced as they are traversed by them. What is experienced as stressful closures vis-à-vis new opportunities depends to a great extent upon how these producing...

  20. Internal anal sphincter: Clinical perspective.

    Science.gov (United States)

    Kumar, Lalit; Emmanuel, Anton

    2017-08-01

    To summarise current knowledge of Internal anal sphincter. The internal anal sphincter (IAS) is the involuntary ring of smooth muscle in the anal canal and is the major contributor to the resting pressure in the anus. Structural injury or functional weakness of the muscle results in passive incontinence of faeces and flatus. With advent of new assessment and treatment modalities IAS has become an important topic for surgeons. This review was undertaken to summarise our current knowledge of internal anal sphincter and highlight the areas that need further research. The PubMed database was used to identify relevant studies relating to internal anal sphincter. The available evidence has been summarised and advantages and limitations highlighted for the different diagnostic and therapeutic techniques. Our understanding of the physiology and pharmacology of IAS has increased greatly in the last three decades. Additionally, there has been a rise in diagnostic and therapeutic techniques specifically targeting the IAS. Although these are promising, future research is required before these can be incorporated into the management algorithm. Copyright © 2016 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved.

  1. Fibrin glue in the treatment of anal fistula: a systematic review

    Directory of Open Access Journals (Sweden)

    Covarelli Piero

    2009-11-01

    Full Text Available Abstract Background New sphincter-saving approaches have been applied in the treatment of perianal fistula in order to avoid the risk of fecal incontinence. Among them, the fibrin glue technique is popular because of its simplicity and repeatability. The aim of this review is to compare the fibrin glue application to surgery alone, considering the healing and complication rates. Methods We performed a systematic review searching for published randomized and controlled clinical trials without any language restriction by using electronic databases. All these studies were assessed as to whether they compared conventional surgical treatment versus fibrin glue treatment in patients with anal fistulas, in order to establish both the efficacy and safety of each treatment. We used Review Manager 5 to conduct the review. Results The healing rate is higher in those patients who underwent the conventional surgical treatment (P = 0,68, although the treatment with fibrin glue gives no evidence of anal incontinence (P = 0,08. Furthermore two subgroup analyses were performed: fibrin glue in combination with intra-adhesive antibiotics versus fibrin glue alone and anal fistula plug versus fibrin glue. In the first subgroup there were not differences in healing (P = 0,65. Whereas in the second subgroup analysis the healing rate is statistically significant for the patients who underwent the anal fistula plug treatment instead of the fibrin glue treatment (P = 0,02. Conclusion In literature there are only two randomized controlled trials comparing the conventional surgical management versus the fibrin glue treatment in patients with anal fistulas. Although from our statistical analysis we cannot find any statistically significant result, the healing rate remains higher in patients who underwent the conventional surgical treatment (P = 0,68, and the anal incontinence rate is very low in the fibrin glue treatment group (P = 0,08. Anyway the limited collected data do

  2. Friction pull plug welding: dual chamfered plate hole

    Science.gov (United States)

    Coletta, Edmond R. (Inventor); Cantrell, Mark A. (Inventor)

    2001-01-01

    Friction Pull Plug Welding (FPPW) is a solid state repair process for defects up to one inch in length, only requiring single sided tooling (OSL) for usage on flight hardware. Early attempts with FPPW followed the matching plug/plate geometry precedence of the successful Friction Push Plug Welding program, however no defect free welds were achieved due to substantial plug necking and plug rotational stalling. The dual chamfered hole has eliminated plug rotational stalling, both upon initial plug/plate contact and during welding. Also, the necking of the heated plug metal under a tensile heating/forging load has been eliminated through the usage of the dual chamfered plate hole.

  3. Anal fistula. Past and present.

    Science.gov (United States)

    Zubaidi, Ahmad M

    2014-09-01

    Anal fistula is a common benign condition that typically describes a miscommunication between the anorectum and the perianal skin, which may present de novo, or develop after acute anorectal abscess. Athough anal fistulae are benign, the condition can still negatively influence a patient's quality of life by causing minor pain, social hygienic embarrassment, and in severe cases, frank sepsis. Despite its long history and prevalence, anal fistula management remains one of the most challenging and controversial topics in colorectal surgery today. The end goals of treatment include draining the local infection, eradicating the fistulous tract, and minimizing recurrence and incontinence rates. The goal of this review is to ensure surgeons and physicians are aware of the different imaging and treatment choices available, and to report expected outcomes of the various surgical modalities so they may select the most suitable treatment. 

  4. Experimental model of anal fistula in rats

    OpenAIRE

    Arakaki, Mariana Sousa; Santos,Carlos Henrique Marques dos; Falcão, Gustavo Ribeiro; Cassino,Pedro Carvalho; Nakamura, Ricardo Kenithi; Gomes,Nathália Favero; Santos,Ricardo Gasparin Coutinho dos

    2013-01-01

    INTRODUCTION: the management of anal fistula remains debatable. The lack of a standard treatment free of complications stimulates the development of new options. OBJECTIVE: to develop an experimental model of anal fistula in rats. METHODS: to surgically create an anal fistula in 10 rats with Seton introduced through the anal sphincter musculature. The animals were euthanized for histological fistula tract assessment. RESULTS: all ten specimens histologically assessed had a lumen and surroundi...

  5. Modular, Plug and Play, Distributed Avionics Project

    Data.gov (United States)

    National Aeronautics and Space Administration — The objective of this SBIR effort was to prove the viability of an Ethernet version of the MicroSat Systems, Inc. (MSI) modular, plug and play (PnP) spacecraft...

  6. PLUGGING AND UNPLUGGING OF WASTE TRANSFER PIPELINES

    Energy Technology Data Exchange (ETDEWEB)

    M.A. Ebadian, Ph.D.

    1999-01-01

    This project, which began in FY97, involves both the flow loop research on plugging and unplugging of waste transfer pipelines, and the large-scale industrial equipment test of plugging locating and unplugging technologies. In FY98, the related work was performed under the project name ''Mixing, Settling, and Pipe Unplugging of Waste Transfer Lines.'' The mixing, settling, and pipeline plugging and unplugging are critical to the design and maintenance of a waste transfer pipeline system, especially for the High-Level Waste (HLW) pipeline transfer. The major objective of this work is to recreate pipeline plugging conditions for equipment testing of plug locating and removal and to provide systematic operating data for modification of equipment design and enhancement of performance of waste transfer lines used at DOE sites. As the waste tank clean-out and decommissioning program becomes active at the DOE sites, there is an increasing potential that the waste slurry transfer lines will become plugged and unable to transport waste slurry from one tank to another or from the mixing tank to processing facilities. Transfer systems may potentially become plugged if the solids concentration of the material being transferred increases beyond the capability of the prime mover or if upstream mixing is inadequately performed. Plugging can occur due to the solids' settling in either the mixing tank, the pumping system, or the transfer lines. In order to enhance and optimize the slurry's removal and transfer, refined and reliable data on the mixing, sampling, and pipe unplugging systems must be obtained based on both laboratory-scale and simulated in-situ operating conditions.

  7. Hybrid and Plug-in Electric Vehicles

    Energy Technology Data Exchange (ETDEWEB)

    None

    2014-05-20

    Hybrid and plug-in electric vehicles use electricity either as their primary fuel or to improve the efficiency of conventional vehicle designs. This new generation of vehicles, often called electric drive vehicles, can be divided into three categories: hybrid electric vehicles (HEVs), plug-in hybrid electric vehicles(PHEVs), and all-electric vehicles (EVs). Together, they have great potential to reduce U.S. petroleum use.

  8. Recurrent obstetric anal sphincter injury and the risk of long term anal incontinence

    DEFF Research Database (Denmark)

    Jangö, Hanna; Langhoff-Roos, Jens; Rosthøj, Susanne

    2017-01-01

    BACKGROUND: Women with an obstetric anal sphincter injury are concerned about the risk of recurrent obstetric anal sphincter injury in their second pregnancy. Existing studies have failed to clarify whether recurrence of obstetric anal sphincter injury affects the risk of anal- and fecal incontin......BACKGROUND: Women with an obstetric anal sphincter injury are concerned about the risk of recurrent obstetric anal sphincter injury in their second pregnancy. Existing studies have failed to clarify whether recurrence of obstetric anal sphincter injury affects the risk of anal- and fecal...... incontinence at long term follow up. OBJECTIVE: To evaluate whether recurrent obstetric anal sphincter injury influenced the risk of anal- and fecal incontinence more than 5 years after the second vaginal delivery. STUDY DESIGN: We performed a secondary analysis of data from a postal questionnaire study...

  9. Electrical stimulation of anal sphincter or pudendal nerve improves anal sphincter pressure.

    Science.gov (United States)

    Damaser, Margot S; Salcedo, Levilester; Wang, Guangjian; Zaszczurynski, Paul; Cruz, Michelle A; Butler, Robert S; Jiang, Hai-Hong; Zutshi, Massarat

    2012-12-01

    Stimulation of the pudendal nerve or the anal sphincter could provide therapeutic options for fecal incontinence with little involvement of other organs. The goal of this project was to assess the effects of pudendal nerve and anal sphincter stimulation on bladder and anal pressures. Ten virgin female Sprague Dawley rats were randomly allocated to control (n = 2), perianal stimulation (n = 4), and pudendal nerve stimulation (n = 4) groups. A monopolar electrode was hooked to the pudendal nerve or placed on the anal sphincter. Aballoon catheter was inserted into the anus to measure anal pressure, and a catheter was inserted into the bladder via the urethra to measure bladder pressure. Bladder and anal pressures were measured with different electrical stimulation parameters and different timing of electrical stimulation relative to spontaneous anal sphincter contractions. Increasing stimulation current had the most dramatic effect on both anal and bladder pressures. An immediate increase in anal pressure was observed when stimulating either the anal sphincter or the pudendal nerve at stimulation values of 1 mA or 2 mA. No increase in anal pressure was observed for lower current values. Bladder pressure increased at high current during anal sphincter stimulation, but not as much as during pudendal nerve stimulation. Increased bladder pressure during anal sphincter stimulation was due to contraction of the abdominal muscles. Electrical stimulation caused an increase in anal pressures with bladder involvement only at high current. These initial results suggest that electrical stimulation can increase anal sphincter pressure, enhancing continence control.

  10. Image Spectrum of Anal Ultrasound in Patients with Peri Anal Disease

    Energy Technology Data Exchange (ETDEWEB)

    Jeon, Hae Jeong; Kim, Young Jun; ParK, Hee Sun; Jung, Sung Il; Park, Sang Woo; Choi, Young Chil; Shin, Hyun Joon; Park, Uug Chae [Konkuk University School of Medicine, Seoul (Korea, Republic of); Jin, Yong Hyun [Sung Ae General Hospital, Seoul (Korea, Republic of)

    2009-12-15

    Endoanal ultrasonography has recently emerged as a popular diagnostic modality for mapping and imaging the anal sphincter. This procedure can be performed as an outpatient procedure: it is relatively quick and virtually painless. The imaging typically is performed in a proximal to distal manner with defining a variety of levels of the anal canal as it progresses. Anal ultrasound can provide a detailed image of the anal sphincter musculature. The internal anal sphincter appears endosonographically as a hypoechoic circular band that is most prominently seen at the level of the mid-anal canal. The external anal sphincter appears as a thicker circular mixed echogenic band outside of the hypoechoic internal sphincter. Anal ultrasound can be used to evaluate patients with anal fistulas with or without abscess. Imaging is performed and the fistulous tracts or abscesses are identified by hypoechogenicity within the external sphincter muscle or the ischiorectal fossa. Its ability to clearly image the anal sphincters has allowed its use for the evaluation of anal fistulas. Moreover, anal ultrasound has emerged as the technique of choice for imaging the anal sphincters and for evaluating incontinence. Each of the individual physiologic tests offers valuable information that is relevant to the continence mechanism, and the ultrasound yields results that are complementary to other tests. Ultrasound serves as a surveillance tool to monitor the results after sphincterplasty. We illustrate the endo-anal sonographic features of various anal diseases and the ultrasound-anatomic correlation for the anus

  11. Underwater connect and disconnect plug and receptacle

    Science.gov (United States)

    Dodier, Paul J.

    1989-06-01

    A plug and receptacle combination is transformer coupled. There are no exposed contacts to the environment at any time, whether the plug and receptacle combination are mated or separated from each other. By encapsulating the primary winding and secondary winding separately in a respective plug and receptacle, mating and unmating can be accomplished while submerged in water. The inventive device is useful in any underwater activity in which a diver must attach a power cable to a power driven tool, light, pump, etc., while submerged. In addition submarines could have the receptacles installed outboard of the pressure hull to be used in the event it became disabled at a depth attainable by a diver. A diver could descend with cables and plug them into the receptacles providing power and communications to the stranded crew awaiting rescue. The inventions could also be used in the home as a safety device where no voltage would be exposed. Either the plug or the receptacle shown could be built into the wall. Whichever items is built into the wall would receive the power source and have the primary winding.

  12. Anal incontinence in women with recurrent obstetric anal sphincter rupture

    DEFF Research Database (Denmark)

    Bøgeskov, Reneé; Nickelsen, Carsten Nahne Amtoft; Secher, Niels Jørgen

    2015-01-01

    UNLABELLED: Abstract Objectives: To determine the risk of recurrent anal sphincter rupture (ASR), and compare the risk of anal incontinence (AI) after recurrent ASR, with that seen in women with previous ASR who deliver by caesarean section or vaginally without sustaining a recurrent ASR. METHODS...... uncomplicated vaginal delivery or caesarean section. RESULTS: There were 93 437 vaginal deliveries. ASR occurred in 5.5% (n = 2851) of the nulliparous and 1.5% (n = 608) of the multiparous women. Recurrent ASR occurred in 8% (n = 49) of whom 50% reported symptoms of AI. We found no difference in the occurrence...... of AI between women with recurrent ASR, and those who delivered vaginally without repeat ASR (p = 0.37; OR = 2.0) or by caesarean section (p = 0.77; OR = 1.3). CONCLUSION: Women with a past history of ASR have an 8% risk of recurrence. AI affects half of the women with recurrent ASR. Larger studies...

  13. Recurrent obstetric anal sphincter injury and the risk of long-term anal incontinence.

    Science.gov (United States)

    Jangö, Hanna; Langhoff-Roos, Jens; Rosthøj, Susanne; Sakse, Abelone

    2017-06-01

    Women with an obstetric anal sphincter injury are concerned about the risk of recurrent obstetric anal sphincter injury in their second pregnancy. Existing studies have failed to clarify whether the recurrence of obstetric anal sphincter injury affects the risk of anal and fecal incontinence at long-term follow-up. The objective of the study was to evaluate whether recurrent obstetric anal sphincter injury influenced the risk of anal and fecal incontinence more than 5 years after the second vaginal delivery. We performed a secondary analysis of data from a postal questionnaire study in women with obstetric anal sphincter injury in the first delivery and 1 subsequent vaginal delivery. The questionnaire was sent to all Danish women who fulfilled inclusion criteria and had 2 vaginal deliveries 1997-2005. We performed uni- and multivariable analyses to assess how recurrent obstetric anal sphincter injury affects the risk of anal incontinence. In 1490 women with a second vaginal delivery after a first delivery with obstetric anal sphincter injury, 106 had a recurrent obstetric anal sphincter injury. Of these, 50.0% (n = 53) reported anal incontinence compared with 37.9% (n = 525) of women without recurrent obstetric anal sphincter injury. Fecal incontinence was present in 23.6% (n = 25) of women with recurrent obstetric anal sphincter injury and in 13.2% (n = 182) of women without recurrent obstetric anal sphincter injury. After adjustment for third- or fourth-degree obstetric anal sphincter injury in the first delivery, maternal age at answering the questionnaire, birthweight of the first and second child, years since first and second delivery, and whether anal incontinence was present before the second pregnancy, the risk of flatal and fecal incontinence was still increased in patients with recurrent obstetric anal sphincter injury (adjusted odds ratio, 1.68 [95% confidence interval, 1.05-2.70), P = .03, and adjusted odds ratio, 1.98 [95% confidence interval, 1

  14. Anal fistula: Intraoperative difficulties and unexpected findings

    Institute of Scientific and Technical Information of China (English)

    Ahmed A Abou-Zeid

    2011-01-01

    Anal fistula surgery is a commonly performed procedure. The diverse anatomy of anal fistulae and their proximity to anal sphincters make accurate preoperative diagnosis essential to avoid recurrence and fecal incontinence. De-spite the fact that proper preoperative diagnosis can be reached in the majority of patients by simple clinical ex-amination, endoanal ultrasound or magnetic resonance imaging, on many occasions, unexpected findings can be encountered during surgery that can make the oper-ation difficult and correct decision-making crucial. In this article we discuss the difficulties and unexpected find-ings that can be encountered during anal fistula sur-gery and how to overcome them.

  15. Anal fistula: intraoperative difficulties and unexpected findings.

    Science.gov (United States)

    Abou-Zeid, Ahmed A

    2011-07-28

    Anal fistula surgery is a commonly performed procedure. The diverse anatomy of anal fistulae and their proximity to anal sphincters make accurate preoperative diagnosis essential to avoid recurrence and fecal incontinence. Despite the fact that proper preoperative diagnosis can be reached in the majority of patients by simple clinical examination, endoanal ultrasound or magnetic resonance imaging, on many occasions, unexpected findings can be encountered during surgery that can make the operation difficult and correct decision-making crucial. In this article we discuss the difficulties and unexpected findings that can be encountered during anal fistula surgery and how to overcome them.

  16. Neuromyogenic properties of the internal anal sphincter: therapeutic rationale for anal fissures.

    Science.gov (United States)

    Bhardwaj, R; Vaizey, C J; Boulos, P B; Hoyle, C H

    2000-06-01

    Lateral sphincterotomy diminishes internal anal sphincter hypertonia and thereby reduces anal canal pressure. This improves anal mucosal blood flow and promotes the healing of anal fissures. However, sphincterotomy can be associated with long term disturbances of sphincter function. The optimal treatment for an anal fissure is to induce a temporary reduction of anal canal resting pressure to allow healing of the fissure without permanently disrupting normal sphincter function. Broader understanding of the intrinsic mechanisms controlling smooth muscle contraction has allowed pharmacological manipulation of anal sphincter tone. We performed an initial Medline literature search to identify all articles concerning "internal anal sphincter" and "anal fissures". This review is based on these articles and on additional publications obtained by manual cross referencing. Internal anal smooth muscle relaxation can be inhibited by stimulation of non-adrenergic non-cholinergic enteric neurones, parasympathetic muscarinic receptors, or sympathetic beta adrenoceptors, and by inhibition of calcium entry into the cell. Sphincter contraction depends on an increase in cytoplasmic calcium and is enhanced by sympathetic adrenergic stimulation. Currently, the most commonly used pharmacological agent in the treatment of anal fissures is topical glyceryl trinitrate, a nitric oxide donor. Alternative agents that exhibit a similar effect via membrane Ca2+ channels, muscarinic receptors, and alpha or beta adrenoceptors are also likely to have a therapeutic potential in treating anal fissures.

  17. Plug-in hybrid electric vehicle R&D plan

    Energy Technology Data Exchange (ETDEWEB)

    None, None

    2007-06-01

    FCVT, in consultation with industry and other appropriate DOE offices, developed the Draft Plug-In Hybrid Electric Vehicle R&D Plan to accelerate the development and deployment of technologies critical for plug-in hybrid vehicles.

  18. Jet noise suppression by porous plug nozzles

    Science.gov (United States)

    Bauer, A. B.; Kibens, V.; Wlezien, R. W.

    1982-01-01

    Jet noise suppression data presented earlier by Maestrello for porous plug nozzles were supplemented by the testing of a family of nozzles having an equivalent throat diameter of 11.77 cm. Two circular reference nozzles and eight plug nozzles having radius ratios of either 0.53 or 0.80 were tested at total pressure ratios of 1.60 to 4.00. Data were taken both with and without a forward motion or coannular flow jet, and some tests were made with a heated jet. Jet thrust was measured. The data were analyzed to show the effects of suppressor geometry on nozzle propulsive efficiency and jet noise. Aerodynamic testing of the nozzles was carried out in order to study the physical features that lead to the noise suppression. The aerodynamic flow phenomena were examined by the use of high speed shadowgraph cinematography, still shadowgraphs, extensive static pressure probe measurements, and two component laser Doppler velocimeter studies. The different measurement techniques correlated well with each other and demonstrated that the porous plug changes the shock cell structure of a standard nozzle into a series of smaller, periodic cell structures without strong shock waves. These structures become smaller in dimension and have reduced pressure variations as either the plug diameter or the porosity is increased, changes that also reduce the jet noise and decrease thrust efficiency.

  19. Mass transport through defected bentonite plugs

    Energy Technology Data Exchange (ETDEWEB)

    Oscarson, D.W.; Dixon, D.A.; Hume, H.B

    1996-07-01

    Compacted bentonite-based materials are important barriers in many waste containment strategies. To function as effective barriers, however, these materials must maintain their low water permeability and molecular diffusivity for long periods of time under a variety of environmental conditions. Here we examine the permeability and diffusivity of compacted bentonite plugs that were either slotted, to mimic fractures, parallel to the direction of mass flow or heated at 150 and 250{sup o}C for several weeks at various moisture contents before testing. The dry density of the plugs ranged from about 0.9 to 1.3 Mg/m{sup 3}. The results show that the saturated hydraulic conductivity and diffusivity (for I{sup -} and Cs{sup +}) of the treated or 'defected' bentonite plugs are essentially the same as those of untreated plugs at similar densities. This provides confidence that compacted bentonitic materials can function effectively as barriers for long periods of time under a range of environmental conditions. (author)

  20. Feasibility of Upper Port Plug tube handling

    NARCIS (Netherlands)

    Koning, J.F.; Elzendoorn, B.S.Q.; Ronden, D.M.S.; Klinkhamer, J.F.F.; Biel, W.; Krasikov, Y.; Walker, C.I.

    2011-01-01

    Central, retractable tubes are proposed in several Upper Port Plugs (UPPs) designs for ITER, to enable fast exchange of specific components of diagnostics housed in these UPPs. This paper investigates into possible designs to enable the efficient handling of tubes. The feasibility of tube handling i

  1. Bond strength of cementitious borehole plugs in welded tuff

    Energy Technology Data Exchange (ETDEWEB)

    Akgun, H.; Daemen, J.J.K. [Arizona Univ., Tucson, AZ (USA). Dept. of Mining and Geological Engineering

    1991-02-01

    Axial loads on plugs or seals in an underground repository due to gas, water pressures and temperature changes induced subsequent to waste and plug emplacement lead to shear stresses at the plug/rock contact. Therefore, the bond between the plug and rock is a critical element for the design and effectiveness of plugs in boreholes, shafts or tunnels. This study includes a systematic investigation of the bond strength of cementitious borehole plugs in welded tuff. Analytical and numerical analysis of borehole plug-rock stress transfer mechanics is performed. The interface strength and deformation are studied as a function of Young`s modulus ratio of plug and rock, plug length and rock cylinder outside-to-inside radius ratio. The tensile stresses in and near an axially loaded plug are analyzed. The frictional interface strength of an axially loaded borehole plug, the effect of axial stress and lateral external stress, and thermal effects are also analyzed. Implications for plug design are discussed. The main conclusion is a strong recommendation to design friction plugs in shafts, drifts, tunnels or boreholes with a minimum length to diameter ratio of four. Such a geometrical design will reduce tensile stresses in the plug and in the host rock to a level which should minimize the risk of long-term deterioration caused by excessive tensile stresses. Push-out tests have been used to determine the bond strength by applying an axial load to cement plugs emplaced in boreholes in welded tuff cylinders. A total of 130 push-out tests have been performed as a function of borehole size, plug length, temperature, and degree of saturation of the host tuff. The use of four different borehole radii enables evaluation of size effects. 119 refs., 42 figs., 20 tabs.

  2. An optimal design for millimeter-wide facture plugging zone

    Directory of Open Access Journals (Sweden)

    Yili Kang

    2015-01-01

    Full Text Available Lost circulation control in millimeter-wide fractures has been a challenge in well drilling all the time. Low pressure-bearing capacity of a plugging zone will result in excessive consumption of lost circulation materials (LCMs and extra down time. In this study, laboratory experiments were conducted on the plugging of millimeter-wide fractures to evaluate the plugging effects of different types of LCM including rigid granules, elastic particles and fiber. Maximum plugging pressure, total loss volume before sealing and plugging time were taken as the evaluation index of the LCM plugging effect. According to the experimental results, the synergistic plugging mechanisms of different LCM combinations were also analyzed. Experimental results showed that the total loss volume of the plugging zone formed by rigid and elastic particle combination was generally greater than 400 mL, and the maximum plugging pressure of the plugging zone formed by elastic particle and fiber combination was generally less than 6 MPa. In contrast, the plugging zone formed by the combination of the three types of LCMs has the maximum plugging pressure of up to 13 MPa and total loss volume before sealing of 75 mL. In the synergistic plugging process, rigid granules form a frame with high pressure-bearing capacity in the narrower parts of the fractures; elastic particles generate elastic force through elastic deformation to increase the friction between a fracture and a plugging zone to make the plugging zone more stable; fibers filling in the pore space between the particles increase the tightness and integrity of the plugging zone. The experimental results can provide guidance for the optimal design of LCMs used in the field.

  3. Anal self-massage in the treatment of acute anal fissure: a randomized prospective study.

    Science.gov (United States)

    Gaj, Fabio; Biviano, Ivano; Candeloro, Laura; Andreuccetti, Jacopo

    2017-01-01

    An anal fissure (AF) is a tear in the epithelial lining of the anal canal. This is a very common condition, but the choice of treatment is unclear. The use of anal dilators is effective, economic, and safe. The aim of the study was to compare the efficacy of two conservative treatments, the use of anal dilators or a finger for anal dilatation, in reducing anal pressure and resolving anal fissures. Fifty patients with a clinical diagnosis of AF were randomly assigned to one of the treatments, self-massage of the anal sphincter (group A, 25 patients) or passive dilatation using dilators (group B, 25 patients). All patients were evaluated at baseline, at the end of treatment, and after 12 weeks and 6 months. Pain was measured using a visual analog scale. After the treatment, 60% of patients treated with dilators and 80% of patients treated with anal self-massage using a finger showed disappearance of their anal fissures. A comparison between signs and symptoms reported by the patients in the two groups showed a statistically significant reduction in anal pain (group A, P=0.0001; group B, P=0.0001) and bleeding after defecation (group A, P=0.001, group B, P=0.001). At 6 months after treatment, a significantly greater reduction in anal pain was observed in Group A compared to Group B (P=0.02). The use of anal self-massage with a finger appears to induce a better resolution of acute anal fissure than do anal dilators, and in a shorter time.

  4. How the anal gland orifice could be found in anal abscess operations

    OpenAIRE

    Shahram Paydar; Ahmad Izadpanah; Leila Ghahramani; Seyed Vahid Hosseini; Alimohammad Bananzadeh; Salar Rahimikazerooni; Faranak Bahrami

    2015-01-01

    Background: On an average 30-50% of patients who undergo incision and drainage (I and D) of anal abscess will develop recurrence or fistula formation. It is claimed that finding the internal orifice of anal abscess to distract the corresponding anal gland duct; will decline the rate of future anal fistula. Surgeons supporting I and D alone claim that finding the internal opening is hazardous. This study is conducted to assess short-term results of optional method to manage patients with anal ...

  5. Anal intraepithelial neoplasia in HIV+ men

    NARCIS (Netherlands)

    Richel, O.

    2014-01-01

    In this thesis we investigated several aspects of anal intraepithelial neoplasia (AIN) in HIV+ men who have sex with men (MSM). This condition has gained clinical interest because of the impressive increase of the anal cancer incidence in HIV+ MSM since the introduction of combination antiretroviral

  6. Neuronal hyperplasia in the anal canal

    DEFF Research Database (Denmark)

    Fenger, C; Schrøder, H D

    1990-01-01

    In a consecutive series of minor surgical specimens from the anal canal, neuronal hyperplasia was found in nine of 56 haemorrhoidectomy specimens and in four of 23 fibrous polyps. In an additional series of 14 resections of the anal canal, neuronal hyperplasia was present in six cases, of which...

  7. Anal intraepithelial neoplasia in HIV+ men

    NARCIS (Netherlands)

    Richel, O.

    2014-01-01

    In this thesis we investigated several aspects of anal intraepithelial neoplasia (AIN) in HIV+ men who have sex with men (MSM). This condition has gained clinical interest because of the impressive increase of the anal cancer incidence in HIV+ MSM since the introduction of combination antiretroviral

  8. Nocturnal faecal soiling and anal masturbation.

    OpenAIRE

    Clark, A. F.; Tayler, P J; Bhate, S R

    1990-01-01

    Two cases of late onset faecal soiling as a result of anal masturbation in children who were neither mentally handicapped nor psychotic were studied. The role of soiling in aiding the young person and his family to avoid separating and maturing is highlighted. We suggest that the association of anal masturbation and resistant nocturnal soiling may be unrecognised.

  9. O Proceso analítico

    OpenAIRE

    Yebra Biurrun, María del Carmen

    2013-01-01

    Esta unidade didáctica enfócase de maneira que permita proporcionar unha visión global da Química Analítica e a súa terminoloxía básica, mostrando a importancia da Química Analítica para a resolución de problemas de diversos ámbitos. Este enfoque faise sobre o esquema do proceso analítico como medio de resolución dunha determinada problemática analítica real. Deste xeito, partindo dun esquema sinxelo, explícase o obxectivo e as distintas etapas do proceso analítico: definición do problema...

  10. Synchronous rectal adenocarcinoma and anal canal adenocarcinoma

    Institute of Scientific and Technical Information of China (English)

    GU Jin; LI Jiyou; YAO Yunfeng; LU Aiping; WANG Hongyi

    2007-01-01

    It is difficult to distinguish a tectal carcinoma with anal metastases from coexistent synchronous anorectal carcinomas.The therapeutic strategy for rectal and anal carcinoma is so different that it should be clearly identified.Here,we report on the case of a 63-year-old man who presented with an upper-third rectal adenocarcinoma.Five months after resection,he developed an adenocarcinoma in the anal canal.The histological slides of both tumors were reviewed and immunohistochemical studies for cytokeratins(CKs)7 and 20 were performed.The index tumor demonstrated CK 7-/CK 20+and the second showed CK7+/CK20+.For this reason,we believe the present case had synchronous adenocarcinomas arising from anal canal and the rectum separately.It is very important to difierentiate the anorectal lesions pathologically because of the impact on the therapeutic options available,especially for the lesion arising in the anal canal.

  11. Increased anal basal pressure in chronic anal fissures may be caused by overreaction of the anal-external sphincter continence reflex

    NARCIS (Netherlands)

    van Meegdenburg, Maxime M.; Trzpis, Monika; Heineman, Erik; Broens, Paul M. A.

    2016-01-01

    Chronic anal fissure is a painful disorder caused by linear ulcers in the distal anal mucosa. Even though it counts as one of the most common benign anorectal disorders, its precise etiology and pathophysiology remains unclear. Current thinking is that anal fissures are caused by anal trauma and pai

  12. Increased anal basal pressure in chronic anal fissures may be caused by overreaction of the anal-external sphincter continence reflex

    NARCIS (Netherlands)

    van Meegdenburg, Maxime M.; Trzpis, Monika; Heineman, Erik; Broens, Paul M. A.

    Chronic anal fissure is a painful disorder caused by linear ulcers in the distal anal mucosa. Even though it counts as one of the most common benign anorectal disorders, its precise etiology and pathophysiology remains unclear. Current thinking is that anal fissures are caused by anal trauma and

  13. Viscoelastic assessment of anal canal function using acoustic reflectometry

    DEFF Research Database (Denmark)

    Mitchell, Peter J; Klarskov, Niels; Telford, Karen J;

    2012-01-01

    Anal acoustic reflectometry is a new reproducible technique that allows a viscoelastic assessment of anal canal function. Five new variables reflecting anal canal function are measured: the opening and closing pressure, opening and closing elastance, and hysteresis.......Anal acoustic reflectometry is a new reproducible technique that allows a viscoelastic assessment of anal canal function. Five new variables reflecting anal canal function are measured: the opening and closing pressure, opening and closing elastance, and hysteresis....

  14. Outcomes after operations for anal fistula: results of a prospective, multicenter, regional study.

    Science.gov (United States)

    Hall, Jason F; Bordeianou, Liliana; Hyman, Neil; Read, Thomas; Bartus, Christine; Schoetz, David; Marcello, Peter W

    2014-11-01

    There are various surgical techniques used treat anal fistulas. The adoption and success rates of newer techniques have not been clearly established. The purpose of this study was to determine the healing rate after operations for anal fistulas in New England colorectal surgery practices. We conducted a retrospective review of a prospectively collected database. The study was conducted at colorectal surgery practices in New England. A prospective, multicenter registry was created by the New England Society of Colon and Rectal Surgeons. Surgeons were invited to collect data prospectively regarding patients operated on for anal fistulas between January 1, 2011, and August 1, 2013. Fistula classification, surgical intervention, continence scores, and healing were determined by the treating surgeon. Operation for anal fistula was performed. We measured the proportion of patients with healed fistulas at 3 months. Sixteen surgeons submitted data regarding 240 operations for fistula with curative intent. Mean patient age was 45 ± 14 years. A total of 158 patients (66%) were men, and 110 (46%) had undergone an anorectal operation. Twenty-nine (12%) had Crohn's disease. The healing rates of fistulotomy, advancement flap, and fistula plugs at 3 months were 94% (95% CI, 89-97), 60% (95% CI, 33-77), and 20% (95% CI, 5-50). The healing rate of the ligation of intersphincteric fistula tract procedure at 3 months was 79% (95% CI, 65-88). Hospital site was the only variable associated with healing (p fistula tract procedures had higher healing rates at 3 months (p anal fistulas in our region. Fistulotomy continues to have excellent results. There has been enthusiastic early adoption of the ligation of intersphincteric fistula tract technique. Early healing rates after the ligation of intersphincteric fistula tract procedure appear to be excellent.

  15. Tension free femoral hernia repair with plug

    Institute of Scientific and Technical Information of China (English)

    Milivoje Vukovi; Neboja Moljevi; Sinia Crnogorac

    2013-01-01

    Objective: To investigate the conventional technique involves treatment of femoral hernia an approximation inguinal ligament to pectineal ligament. In technique which uses mesh closure for femoral canal without tissue tension. Method: A prospective study from January 01. 2007-May 30. 2009. We analyzed 1 042 patients with inguinal hernia, of which there were 83 patients with 86 femoral hernia. Result: Femoral hernias were present in 7.96% of cases. Males were 13 (15.66%) and 70 women (84.34%). The gender distribution of men: women is 1:5.38. Urgent underwent 69 (83%), and the 14 election (17%) patients. Average age was 63 years, the youngest patient was a 24 and the oldest 86 years. Ratio of right: left hernias was 3.4:1. With bilateral femoral hernias was 3.61% of cases. In 7 patients (8.43%) underwent femoral hernia repair with 9 Prolene plug. Conclusions: The technique of closing the femoral canal with plug a simple. The plug is made from monofilament material and is easily formed. This technique allows the reduction of recurrence and can be used safely, quickly and easily in elective and emergency situations.

  16. Anal cancer and intraepithelial neoplasia screening: Areview

    Institute of Scientific and Technical Information of China (English)

    2016-01-01

    This review focuses on the early diagnosis of anal cancer and its precursor lesions through routine screening. Anumber of risk-stratification strategies as well as screeningtechniques have been suggested, and currently littleconsensus exists among national societies. Much ofthe current clinical rationale for the prevention of analcancer derives from the similar tumor biology of cervicalcancer and the successful use of routine screening toidentify cervical cancer and its precursors early in thedisease process. It is thought that such a strategy ofidentifying early anal intraepithelial neoplasia will reducethe incidence of invasive anal cancer. The low prevalenceof anal cancer in the general population prevents theuse of routine screening. However, routine screeningof selected populations has been shown to be a morepromising strategy. Potential screening modalities includedigital anorectal exam, anal Papanicolaou testing, humanpapilloma virus co-testing, and high-resolution anoscopy.Additional research associating high-grade dysplasiatreatment with anal cancer prevention as well as directcomparisons of screening regimens is necessary todevelop further anal cancer screening recommendations.

  17. Prevalence of Anal HPV and Anal Dysplasia in HIV-Infected Women From Johannesburg, South Africa.

    Science.gov (United States)

    Goeieman, Bridgette J; Firnhaber, Cynthia S; Jong, Eefje; Michelow, Pam; Kegorilwe, Patricia; Swarts, Avril; Williamson, Anna-Lise; Allan, Bruce; Smith, Jennifer S; Wilkin, Timothy J

    2017-07-01

    Anal cancer is a relatively common cancer among HIV-infected populations. There are limited data on the prevalence of anal high-risk human papillomavirus (HR-HPV) infection and anal dysplasia in HIV-infected women from resource-constrained settings. A cross-sectional study of HIV-infected women aged 25-65 years recruited from an HIV clinic in Johannesburg, South Africa. Cervical and anal swabs were taken for conventional cytology and HR-HPV testing. Women with abnormal anal cytology and 20% of women with negative cytology were seen for high-resolution anoscopy with biopsy of visible lesions. Two hundred women were enrolled. Anal HR-HPV was found in 43%. The anal cytology results were negative in 51 (26%); 97 (49%) had low-grade squamous intraepithelial lesions (SIL), 32 (16%) had atypical squamous cells of unknown significance, and 19 (9.5%) had high-grade SIL or atypical squamous cells suggestive of high-grade SIL. On high-resolution anoscopy, 71 (36%) had atypia or low-grade SIL on anal histology and 17 (8.5%) had high-grade SIL. Overall, 31 (17.5%) had high-grade SIL present on anal cytology or histology. Abnormal cervical cytology was found in 70% and cervical HR-HPV in 41%. We found a significant burden of anal HR-HPV infection, abnormal anal cytology, and high-grade SIL in our cohort. This is the first study of the prevalence of anal dysplasia in HIV-infected women from sub-Saharan Africa. Additional studies are needed to define the epidemiology of these conditions, as well as the incidence of anal cancer, in this population.

  18. Anal erogeneity: the goose and the rat.

    Science.gov (United States)

    Shengold, L

    1982-01-01

    A case is presented in which the patient's traumatically derived intense anal erogeneity (associated with traumatic anxiety as well as with castration anxiety) inhibited his phallic sensations and potency and also his power to sustain productive thought. His passive cravings were disguised and reacted against in his compulsive-exhibitionistically phallic role of a Don Juan. He described at least two levels of anal feelings: a dangerous but exciting, tolerable or even pleasurable tension associated with the imago of the goose; and an unbearable, terrifying overcharged level embodied in the imago of the rat. (He had read of, and had felt himself identified with, Freud's Rat Man.) Contrasts are presented with François Rabelais' account of the instinctual development and anal training of Gargantua, in which the connotations of the goose lead to a happy anal, phallic and intellectual control. Generalizations are ventured about the crucial attainment of command over the anal sphincter for the taming of 'primal affect'(Fliess). With early psychopathology there is a defensive overcathexis of anal control (and of anal mechanisms and character traits) to try to contain over-stimulation. In contrast true anal mastery contributes to the acquisition of optimal genital feelings and functioning and to the capacity for sustaining integrative thinking so necessary for 'owning' one's affects and impulses, and therefore for a feeling of identity. Finally, some remarks of Freud on Rabelais are reviewed in relation to levels of urethral erogeneity, seen as developmental way stations between the anal and the phallic, and partaking of both.

  19. Tratamento dos datos analíticos

    OpenAIRE

    Yebra Biurrun, María del Carmen

    2008-01-01

    Esta unidade didáctica é a primeira toma de contacto do alumnado co estudo do tratamento dos datos analíticos e a comprobación da súa calidade. Este estudo poderase completar máis adiante dentro do programa desta materia cando se presente o resto dos parámetros de calidade dos métodos analíticos. A importancia deste tema radica en que unha vez obtidos os datos analíticos, o primeiro aspecto que se ten que considerar é a verificación da calidade dos mesmos en termos de exactitude e precisió...

  20. Design progress on ITER port plug test facility

    Energy Technology Data Exchange (ETDEWEB)

    Levesy, B., E-mail: bruno.levesy@iter.org [ITER Organization, Route de Vinon sur Verdon, 13115 Saint Paul Lez Durance (France); Beaumont, B. [ITER Organization, Route de Vinon sur Verdon, 13115 Saint Paul Lez Durance (France); Bruno, L.; Cerisier, T. [CNIM, Z.I de Bregaillon, 83507 La Seyne sur Mer (France); Cordier, J.J.; Dammann, A.; Giancarli, L.; Henderson, M. [ITER Organization, Route de Vinon sur Verdon, 13115 Saint Paul Lez Durance (France); Romannikov, A. [ITER Agency, Russian Research Center ' Kurchatov Institute' , pl. Kurchatova I., 1, Moscow 123182 (Russian Federation); Rumyantsev, Y. [JSC ' Cryogenmash' , 143907 Moscow reg., Balashikha (Russian Federation); Udintsev, V.S. [ITER Organization, Route de Vinon sur Verdon, 13115 Saint Paul Lez Durance (France)

    2012-08-15

    To achieve the overall ITER machine availability target, the availability of diagnostics and heating port plugs shall be as high as 99.5%. To fulfill these requirements, it is mandatory to test the port plugs at operating temperature before installation on the machine and after refurbishment. The ITER port plug test facility (PPTF) provides the possibility to test upper and equatorial port plugs before installation on the machine. The port plug test facility is composed of several test stands. These test stands are first used in the domestic agencies and on the ITER Organization site to test the port plugs at the end of manufacturing. Two of these stands are installed later in the ITER hot cell facility to test the port plugs after refurbishment. The port plugs to be tested are the Ion Cyclotron (IC) heating and current drive antennas, Electron Cyclotron (EC) heating and current drive launchers, diagnostics and test blanket modules port plugs. Test stands shall be capable to perform environmental and functional tests. The test stands are composed of one vacuum tank (3.3 m in diameter, 5.6 m long) and the associated heating, vacuum and control systems. The vacuum tank shall achieve an ultimate pressure of 1 Multiplication-Sign 10{sup -5} Pa at 100 Degree-Sign C containing a port plug. The heating system shall provide water at 240 Degree-Sign C and 4.4 MPa to heat up the port plugs. Openings are provided on the back of the vacuum tank to insert probes for the functional tests. This paper describes the tests to be performed on the port plugs and the conceptual design of the port plug test facility. The configuration of the standalone test stands and the integration in the hot cell facility are presented.

  1. VAAFT - Videoassisted anal fistula treatment: a new approach for anal fistula

    OpenAIRE

    Mendes,Carlos Ramon Silveira; FERREIRA, Luciano Santana de Miranda; Sapucaia,Ricardo Aguiar; LIMA, Meyline Andrade; Araujo, Sergio Eduardo Alonso

    2014-01-01

    INTRODUCTION: Anal fistula is an epithelised path between the rectum or anal canal and the perianal region. The use of laparoscopic surgery with a minimally invasive procedure has led to the development of video-assisted surgical treatment of anal fistula.OBJECTIVE: To describe the surgical technique VAAFT as a new approach to fistula.CONCLUSION: This is a safe and reproducible procedure. It enables the study of the entire fistula, obtaining the identification of accessory paths, cavitations ...

  2. How the anal gland orifice could be found in anal abscess operations

    Directory of Open Access Journals (Sweden)

    Shahram Paydar

    2015-01-01

    Full Text Available Background: On an average 30-50% of patients who undergo incision and drainage (I and D of anal abscess will develop recurrence or fistula formation. It is claimed that finding the internal orifice of anal abscess to distract the corresponding anal gland duct; will decline the rate of future anal fistula. Surgeons supporting I and D alone claim that finding the internal opening is hazardous. This study is conducted to assess short-term results of optional method to manage patients with anal abscess and fitula-in-ano at the same time. Materials and Methods: In this cross-sectional descriptive study 49 from 77 patients with anal abscess whose internal orifice was not identified by pressing on the abscess, diluted hydrogen peroxide (2% and methylene blue was injected into the abscess cavity and the anal canal was inspected to find out the internal opening. Once the opening was distinguished, an incision was given from the anal verge to the internal opening. Results: The internal orifice was identified in 44 out of 49 patients (90% who underwent this new technique. Up to 18 months during follow-up, only 2.5% of patients with primary fistulotomy developed fistula on the site of a previous abscess. Conclusion: Conventional method to seek the internal orifice of anal abscesses is successful in about one-third of cases. By applying this new technique, surgeons would properly find the internal opening in >90% of patients. Needless to say, safe identification of the anal gland orifice in anal abscess disease best helps surgeons to do primary fistulotomy and in turn it would significantly decrease the rate of recurrence in anal abscess and fistula formation.

  3. Anal Cancer: What Happens After Treatment?

    Science.gov (United States)

    ... see the section Understanding Recurrence . For patients with colostomies Most people treated for anal cancer don’t ... APR, you will need to have a permanent colostomy. If you have a colostomy, follow-up is ...

  4. Treatment of non-IBD anal fistula

    National Research Council Canada - National Science Library

    Lundby, Lilli; Hagen, Kikke; Christensen, Peter; Buntzen, Steen; Thorlacius-Ussing, Ole; Andersen, Jens; Krupa, Marek; Qvist, Niels

    2015-01-01

    The course of the fistula tract in relation to the anal sphincter is identified by clinical examination under general anaesthesia using a fistula probe and injection of fluid into the external fistula opening...

  5. A plug with infinite order and some exotic 4-manifolds

    CERN Document Server

    Tange, Motoo

    2012-01-01

    Every exotic pair in 4-dimension is obtained each other by twisting a {\\it cork} or {\\it plug} which are codimension 0 submanifolds embedded in the 4-manifolds. The twist was an involution on the boundary of the submanifold. We define cork (or plug) with order $p\\in {\\Bbb N}\\cup \\{\\infty\\}$ and show there exists a plug with infinite order. Furthermore we show twisting $(P,\\varphi^2)$ gives to enlargements of $P$ compact exotic manifolds with boundary.

  6. The trophoblast plug during early pregnancy: a deeper insight

    OpenAIRE

    Weiss, Gregor; Sundl, Monika; Glasner, Andreas; Huppertz, Berthold; Moser, Gerit

    2016-01-01

    During the first trimester of pregnancy, foetal endovascular trophoblasts invade into maternal spiral arteries, accumulate and form plugs in the lumen of the vessels. These plugs only allow blood plasma to seep through. Hence, during the first trimester of pregnancy, a first flow of fluids through the placental intervillous space is established, resulting in a physiological oxygen gradient between mother and foetus. The trophoblast plugs block spiral arteries until the beginning of the second...

  7. SpaceWire Plug and Play

    Science.gov (United States)

    Rakow, Glenn; McGuirk, Patrick; Kimmery, Clifford; Jaffe, Paul

    2006-01-01

    The ability to rapidly deploy inexpensive satellites to meet tactical goals has become an important goal for military space systems. In fact, Operationally Responsive Space (ORS) has been in the spotlight at the highest levels. The Office of the Secretary of Defense (OSD) has identified that the critical next step is developing the bus standards and modular interfaces. Historically, satellite components have been constructed based on bus standards and standardized interfaces. However, this has not been done to a degree, which would allow the rapid deployment of a satellite. Advancements in plug-and-play (PnP) technologies for terrestrial applications can serve as a baseline model for a PnP approach for satellite applications. Since SpaceWire (SpW) has become a de facto standard for satellite high-speed (greater than 200Mbp) on-board communications, it has become important for SpW to adapt to this Plug and Play (PnP) environment. Because SpW is simply a bulk transport protocol and lacks built-in PnP features, several changes are required to facilitate PnP with SpW. The first is for Host(s) to figure out what the network looks like, i.e., how pieces of the network, routers and nodes, are connected together; network mapping, and to receive notice of changes to the network. The second is for the components connected to the network to be understood so that they can communicate. The first element, network topology mapping & change of status indication, is being defined (topic of this paper). The second element describing how components are to communicate has been defined by ARFL with the electronic data sheets known as XTEDS. The first element, network mapping, is recent activities performed by Air Force Research Lab (ARFL), Naval Research Lab (NRL), NASA and US industry (Honeywell, Clearwater, FL, and others). This work has resulted in the development of a protocol that will perform the lower level functions of network mapping and Change Of Status (COS) indication

  8. Electric powered vehicle: Tulip without direct plug

    Energy Technology Data Exchange (ETDEWEB)

    Anon.

    1995-05-01

    Here is described the electric powered vehicle, called Tulip (for Urban Transport, free, Individual and Public) developed by PSA Peugeot Citroen, french automobile company. Its electric characteristics are based on induction. The refill system, by induction allows to the subscriber not to be concerned about it. On arriving to the relay station, it only takes to position the vehicle on the centre which puts in relation a captor with the inductor coupled to a generator plugged into the mains. The cadmium-nickel battery offers a 9.6 Kw power and gives a range longer than 60 kilometers. (N.C.). 1 fig., 1 photo.

  9. Testing and plugging power plant heat exchangers

    Energy Technology Data Exchange (ETDEWEB)

    Sutor, F. [Expando Seal Tools, Inc., Montgomeryville, PA (United States)

    1994-12-31

    Heat Exchanger tubes fail for any number of reasons including but certainly not limited to the cumulative effects of corrosion, erosion, thermal stress and fatigue. This presentation will attempt to identify the most common techniques for determining which tubes are leaking and then introduce the products in use to plug the leaking tubes. For the sake of time I will limit the scope of this presentation to include feedwater heaters and secondary system heat exchangers such as Hydrogen Coolers, Lube Oil Coolers, and nuclear Component Cooling Water, Emergency Cooling Water, Regenerative Heat Recovery heat exchangers.

  10. Plug ‘n’ Play with DNA

    DEFF Research Database (Denmark)

    Lund, Anne Mathilde; Andreasen, Elisa W.; Korgaard, Jaide V.;

    Synthetic biology has evolved dramatically within the past decade, which calls for a revolution of the Standard Assembly method that makes the foundation of BioBricks. We believe that iGEM should be about fast assembly of BioBricks, where any thinkable part, device or existing BioBrick can be com...... be combined for any type of organism within one day. Therefore, we have designed a new BioBrick Kit based on a novel assembly standard; called “Plug 'n' Play with DNA”....

  11. Knowledge-Based System to Support Plug Load Management

    Data.gov (United States)

    National Aeronautics and Space Administration — Electrical plug loads comprise an increasingly larger share of building energy consumption as improvements have been made to Heating, Ventilation, and Air...

  12. Deep Space Habitat Wireless Smart Plug

    Science.gov (United States)

    Morgan, Joseph A.; Porter, Jay; Rojdev, Kristina; Carrejo, Daniel B.; Colozza, Anthony J.

    2014-01-01

    NASA has been interested in technology development for deep space exploration, and one avenue of developing these technologies is via the eXploration Habitat (X-Hab) Academic Innovation Challenge. In 2013, NASA's Deep Space Habitat (DSH) project was in need of sensors that could monitor the power consumption of various devices in the habitat with added capability to control the power to these devices for load shedding in emergency situations. Texas A&M University's Electronic Systems Engineering Technology Program (ESET) in conjunction with their Mobile Integrated Solutions Laboratory (MISL) accepted this challenge, and over the course of 2013, several undergraduate students in a Capstone design course developed five wireless DC Smart Plugs for NASA. The wireless DC Smart Plugs developed by Texas A&M in conjunction with NASA's Deep Space Habitat team is a first step in developing wireless instrumentation for future flight hardware. This paper will further discuss the X-Hab challenge and requirements set out by NASA, the detailed design and testing performed by Texas A&M, challenges faced by the team and lessons learned, and potential future work on this design.

  13. Innovative cement plug setting process reduces risk and lowers NPT

    Energy Technology Data Exchange (ETDEWEB)

    Marriott, T.; Rogers, H.; Lloyd, S.; Quinton, C. [Halliburton Energy Services, Calgary, AB (Canada); Tetrault, N. [Apache Canada, Calgary, AB (Canada)

    2006-07-01

    With increased drilling in mature fields and unconventional reservoirs, Canadian operators are experiencing a higher rate of lost circulation events. When drilling into lower fracture-gradient zones, operators face the risk of drilling through shallower depleted zones. The unique challenges associated with setting cement plugs in such open hole wells were described. The best solution to address lost circulation events is a properly designed cement slurry where cement can be squeezed into the lost circulation zones to strengthen the wellbore when set. The cement plug is drilled through, leaving the residual cement setting inside the problem zones. Since cement plugs are used for a wide range of reasons, such as healing losses, abandonment, and directional drilling, it is important that a competent cement plug is placed the first time. This paper presented a newly developed tool and a special process designed to meet the challenges associated with setting cement plugs. It is based on a tubing-release tool (TRT) in which a sacrificial tubing is placed into the lost circulation zone to balance the cement plug. The sacrificial tubing is released from the drillstring and remains in the wellbore. The TRT has been used as a plug-setting aid for lost-circulation plugs; shallow-water shut-off; kick-off plug placement; and multizone plugs to abandon. An overview of the TRT features was presented. The tool and process has been used by more than 20 operating companies around the world to successfully place cement plugs downhole on the first attempt. The disconnect has been used successfully in more than 120 wells throughout North and South America, Europe, the Middle East, and Australia. It has proven to lower the risk and non-productive time associated with drilling in mature fields and unconventional reservoirs. 7 refs., 5 figs.

  14. Quality of life with anal fistula.

    Science.gov (United States)

    Owen, H A; Buchanan, G N; Schizas, A; Cohen, R; Williams, A B

    2016-05-01

    Anal fistula affects people of working age. Symptoms include abscess, pain, discharge of pus and blood. Treatment of this benign disease can affect faecal continence, which may, in turn, impair quality of life (QOL). We assessed the QOL of patients with cryptoglandular anal fistula. Newly referred patients with anal fistula completed the St Mark's Incontinence Score, which ranges from 0 (perfect continence) to 24 (totally incontinent), and Short form 36 (SF-36) questionnaire at two institutions with an interest in anal fistula. The data were examined to identify factors affecting QOL. Data were available for 146 patients (47 women), with a median age of 44 years (range 18-82 years) and a median continence score of 0 (range 0-23). Versus population norms, patients had an overall reduction in QOL. While those with recurrent disease had no difference on continence scores, QOL was worse on two of eight SF-36 domains (pfistula patients, 19.4% of patients experienced urgency versus 36.3% of those with recurrent fistulas. Patients with anal fistula had a reduced QOL, which was worse in those with recurrent disease, secondary extensions and urgency. Loose seton had no impact on QOL.

  15. Plug and Play Process Control of a District Heating System

    DEFF Research Database (Denmark)

    Trangbaek, Klaus; Knudsen, Torben; Skovmose Kallesøe, Carsten

    2009-01-01

    The main idea of plug and play process control is to initialise and reconfigure control systems automatically. In this paper these ideas are applied to a scaled laboratory model of a district heating pressure control system.  First of all this serves as a concrete example of plug and play control...

  16. Hybrid and Plug-In Electric Vehicles (Brochure)

    Energy Technology Data Exchange (ETDEWEB)

    2014-05-01

    Hybrid and plug-in electric vehicles use electricity as their primary fuel or to improve the efficiency of conventional vehicle designs. These vehicles can be divided into three categories: hybrid electric vehicles (HEVs), plug-in hybrid electric vehicles (PHEVs), all-electric vehicles (EVs). Together, they have great potential to cut U.S. petroleum use and vehicle emissions.

  17. Plug-in hybrid electric vehicles in dynamical energy markets

    NARCIS (Netherlands)

    Kessels, J.T.B.A.; Bosch, P.P.J. van den

    2008-01-01

    The plug-in hybrid electric vehicle allows vehicle propulsion from multiple internal power sources. Electric energy from the grid can be utilized by means of the plug-in connection. An on-line energy management (EM) strategy is proposed to minimize the costs for taking energy from each power source.

  18. Developing quality standards for physical properties of mineral wool plugs

    NARCIS (Netherlands)

    Blok, C.; Berg, van den C.C.; Winkel, van A.

    2014-01-01

    The KIWA certification guidelines for mineral wool products contain standards for slabs and blocks. Propagators would like to introduce quality standards for mineral wool plugs as well. Main concerns were effects of too dense plugs on plant growth, and handling problems with too fluffy or broken

  19. National Plug-In Electric Vehicle Infrastructure Analysis

    Energy Technology Data Exchange (ETDEWEB)

    Eric Wood, Clément Rames, Matteo Muratori, Sesha Raghavan, and Marc Melaina

    2017-09-15

    This report addresses the fundamental question of how much plug-in electric vehicle (PEV) charging infrastructure—also known as electric vehicle supply equipment (EVSE)—is needed in the United States to support both plug-in hybrid electric vehicles (PHEVs) and battery electric vehicles (BEVs).

  20. Plug-in hybrid electric vehicles in dynamical energy markets

    NARCIS (Netherlands)

    Kessels, J.T.B.A.; Bosch, P.P.J. van den

    2008-01-01

    The plug-in hybrid electric vehicle allows vehicle propulsion from multiple internal power sources. Electric energy from the grid can be utilized by means of the plug-in connection. An on-line energy management (EM) strategy is proposed to minimize the costs for taking energy from each power source.

  1. California Statewide Plug-In Electric Vehicle Infrastructure Assessment

    Energy Technology Data Exchange (ETDEWEB)

    Melaina, Marc; Helwig, Michael

    2014-05-01

    The California Statewide Plug-In Electric Vehicle Infrastructure Assessment conveys to interested parties the Energy Commission’s conclusions, recommendations, and intentions with respect to plug-in electric vehicle (PEV) infrastructure development. There are several relatively low-risk and high-priority electric vehicle supply equipment (EVSE) deployment options that will encourage PEV sales and

  2. [Colo-anal anastomosis. Our experience].

    Science.gov (United States)

    Morlino, A; Tramutola, G; Rossi, M T; Scutari, F

    2009-03-01

    The aim of study is to report the results of our experience about ultra-low rectum carcinomas treated with anterior resection and colo-anal anastomosis. The surgery still represents the treatment of choice for the cancer of the rectum. The problems concern the conservation of the sphincter functions (anal and urethral), and sexual function and the reduction of the locoregional recurrences. From 2005 to 2007, 33 patients underwent surgery for low and ultralow rectal carcinoma (30 treated with neoadjuvant radio-chemotherapy, and 3 only with surgery). In 16 of these we have performed a colo-anal anastomosis, in 11 an ultralow colorectal anastomosis and in 7 a Miles resection. We report our updated results.

  3. Experimental plug and play quantum coin flipping

    Science.gov (United States)

    Pappa, Anna; Jouguet, Paul; Lawson, Thomas; Chailloux, André; Legré, Matthieu; Trinkler, Patrick; Kerenidis, Iordanis; Diamanti, Eleni

    2014-04-01

    Performing complex cryptographic tasks will be an essential element in future quantum communication networks. These tasks are based on a handful of fundamental primitives, such as coin flipping, where two distrustful parties wish to agree on a randomly generated bit. Although it is known that quantum versions of these primitives can offer information-theoretic security advantages with respect to classical protocols, a demonstration of such an advantage in a practical communication scenario has remained elusive. Here we experimentally implement a quantum coin flipping protocol that performs strictly better than classically possible over a distance suitable for communication over metropolitan area optical networks. The implementation is based on a practical plug and play system, developed by significantly enhancing a commercial quantum key distribution device. Moreover, we provide combined quantum coin flipping protocols that are almost perfectly secure against bounded adversaries. Our results offer a useful toolbox for future secure quantum communications.

  4. Plugging criteria for WWER SG tubes

    Energy Technology Data Exchange (ETDEWEB)

    Papp, L.; Wilam, M. [Vitkovice NPP Services (Switzerland); Herman, M. [Vuje, Trnava (Slovakia)

    1997-12-31

    At operated Czech and Slovak nuclear power plants the 80 % criteria for crack or other bulk defect depth is used for steam generator heat exchanging tubes plugging. This criteria was accepted as the recommendation of designer of WWER steam generators. Verification of this criteria was the objective of experimental program performed by Vitkovice, J.S.C., UJV Rez, J.S.C. and Vuje Trnava, J.S.C .. Within this program the following factors were studied: (1) Influence of secondary water chemistry on defects initiation and propagation, (2) Statistical evaluation of corrosion defects progression at operated SG, and (3) Determination of critical pressure for tube rupture as a function of eddy current indications. In this presentation items (2) and (3) are considered.

  5. Borehole plugging by compaction process. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Fernandez, R.; MacGowan, C.; Nolan, E.; Morey, R.; Palty, A.

    1976-08-01

    The requirements of an overall program to preserve the integrity of a repository formation are documented. The repository is intended to be in stable earth stratum used as a safe and permanent storage area for nuclear waste material. These wastes represent an environmental hazard for a period of up to 200,000 years. An engineering analysis, a reliability and quality-assurance program, and a development program for borehole plugging by compaction process, using natural earthen materials, are presented. Part 1 provides the engineering analysis of downhole compaction methods and related instrumentation along with a recommended development plan from concept through a pilot in-situ experiment. Part 2 provides a reliability and quality-assurance program from laboratory testing of materials through an in-situ experiment.

  6. Mitigation of Syngas Cooler Plugging and Fouling

    Energy Technology Data Exchange (ETDEWEB)

    Bockelie, Michael J. [Reaction Engineering International, Salt Lake City, UT (United States)

    2015-06-29

    This Final Report summarizes research performed to develop a technology to mitigate the plugging and fouling that occurs in the syngas cooler used in many Integrated Gasification Combined Cycle (IGCC) plants. The syngas cooler is a firetube heat exchanger located downstream of the gasifier. It offers high thermal efficiency, but its’ reliability has generally been lower than other process equipment in the gasification island. The buildup of ash deposits that form on the fireside surfaces in the syngas cooler (i.e., fouling) lead to reduced equipment life and increased maintenance costs. Our approach to address this problem is that fouling of the syngas cooler cannot be eliminated, but it can be better managed. The research program was funded by DOE using two budget periods: Budget Period 1 (BP1) and Budget Period 2 (BP2). The project used a combination of laboratory scale experiments, analysis of syngas cooler deposits, modeling and guidance from industry to develop a better understanding of fouling mechanisms and to develop and evaluate strategies to mitigate syngas cooler fouling and thereby improve syngas cooler performance. The work effort in BP 1 and BP 2 focused on developing a better understanding of the mechanisms that lead to syngas cooler plugging and fouling and investigating promising concepts to mitigate syngas cooler plugging and fouling. The work effort focused on the following: • analysis of syngas cooler deposits and fuels provided by an IGCC plant collaborating with this project; • performing Jet cleaning tests in the University of Utah Laminar Entrained Flow Reactor to determine the bond strength between an ash deposit to a metal plate, as well as implementing planned equipment modifications to the University of Utah Laminar Entrained Flow Reactor and the one ton per day, pressurized Pilot Scale Gasifier; • performing Computational Fluid Dynamic modeling of industrially relevant syngas cooler configurations to develop a better

  7. Malignant transformation in an anal condyloma acuminatum.

    Science.gov (United States)

    Ejeckam, G C; Idikio, H A; Nayak, V; Gardiner, J P

    1983-03-01

    A 61-year-old man had malignant transformation of an anal condyloma acuminatum, demonstrated by light and electron microscopic studies. Intranuclear virus-like particles were seen in the benign condylomatous koilocytotic cells but these were absent in the malignant cells. Multinucleation, syncytial giant cells and nuclear atypia in a condyloma acuminatum are considered features of in-situ carcinomatous change. Anal condyloma acuminatum requires wide excision and thorough examination of anorectal canal in order to exclude hidden disease, which will predispose to recurrence. Homosexuality is considered a predisposing factor. The authors stress the importance of histopathologic examination of all anorectal warts to exclude malignant change.

  8. Arthroscopic meniscal allograft transplantation without bone plugs.

    Science.gov (United States)

    Alentorn-Geli, Eduard; Seijas Vázquez, Roberto; García Balletbó, Montserrat; Álvarez Díaz, Pedro; Steinbacher, Gilbert; Cuscó Segarra, Xavier; Rius Vilarrubia, Marta; Cugat Bertomeu, Ramón

    2011-02-01

    Partial or total meniscectomy are common procedures performed at Orthopedic Surgery departments. Despite providing a great relief of pain, it has been related to early onset knee osteoarthritis. Meniscal allograft transplantation has been proposed as an alternative to meniscectomy. The purposes of this study were to describe an arthroscopic meniscal allograft transplantation without bone plugs technique and to report the preliminary results. All meniscal allograft transplantations performed between 2001 and 2006 were approached for eligibility, and a total of 35 patients (involving 37 menisci) were finally engaged in the study. Patients were excluded if they had ipsilateral knee ligament reconstruction or cartilage repair surgery before meniscal transplantation or other knee surgeries after the meniscal transplantation. Scores on Lysholm, Subjective IKDC Form, and Visual Analogue Scale (VAS) scale for pain were obtained at a mean follow-up of 38.6 months and compared to pre-operative data. Data on chondral lesions were obtained during the arthroscopic procedure and through imaging (radiographs and MRI) studies pre-operatively. Two graft failures out of 59 transplants (3.4%) were found. Daily life accidents were responsible for all graft failures. Significant improvements for Lysholm, Subjective IKDC Form, and VAS for pain scores following the meniscal allograft transplantation were found (P lesion, there was no significant interactions for Lysholm (n.s.), Subjective IKDC Form (n.s.), and VAS for pain scores (n.s.). This study demonstrated that an arthroscopic meniscal allograft transplantation without bone plugs improved knee function and symptoms after a total meniscectomy. Improvements were observed independently of the degree of chondral lesion.

  9. Strategies for Controlling Plug Loads. A Tool for Reducing Plug Loads in Commercial Buildings

    Energy Technology Data Exchange (ETDEWEB)

    Torcellini, Paul [National Renewable Energy Lab. (NREL), Golden, CO (United States); Bonnema, Eric [National Renewable Energy Lab. (NREL), Golden, CO (United States); Sheppy, Michael [National Renewable Energy Lab. (NREL), Golden, CO (United States); Pless, Shanti [National Renewable Energy Lab. (NREL), Golden, CO (United States)

    2015-09-01

    Plug loads are often not considered as part of the energy savings measures in Commercial Buildings; however, they can account for up to 50% of the energy used in the building. These loads are numerous and often scattered throughout a building. Some of these loads are purchased by the owner and some designed into the building or the tenant finishes for a space. This document provides a strategy and a tool for minimizing these loads.

  10. Sphincter-saving surgery for complex anal fistula%复杂性肛瘘保留括约肌手术的治疗进展

    Institute of Scientific and Technical Information of China (English)

    孙薛亮; 林秋; 杨柏霖

    2011-01-01

    目前复杂性肛瘘的治疗普遍存在复发率高、肛门功能保护不足的现状.传统的肛瘘切开术和切割挂线术损伤肛门括约肌,易致肛门失禁,已逐渐被保留括约肌术式,如推移瓣、肛瘘栓、经括约肌问瘘管结扎术等所取代.本文将对复杂性肛瘘保留括约肌手术治疗进展作一综述.%At present, the treatments for complex anal fistula are often associated with high recurrence and insufficient protection of anal function. Fis-tulotomy and cutting seton often lead to damage to the anal sphincters, increasing the risk of incontinence. Recently, they have been replaced gradually by sphincter-saving measures, such as advancement flap, anal fistula plug and ligation of intersphincteric fistula tract. In this article, we will review the recent advances in sphincter-saving surgical treatment of complex anal fistula.

  11. Chronic anal fissure: morphometric analysis of the anal canal at 3.0 Tesla MR imaging.

    Science.gov (United States)

    Erden, Ayşe; Peker, Elif; Gençtürk, Zeynep Bıyıklı

    2017-02-01

    OBJECTıVE: To compare the morphometric data relating to the muscular structures of the anal canal, in patients with chronic anal fissure and in control group, examined at a 3.0 Tesla MR system. Forty-seven consecutive patients with chronic anal fissure and randomly selected 40 patients who had no claims for perianal disease during their life time were included in the study. T2-weighted sagittal, high-resolution (HR) T2-weighted, and contrast-enhanced fat-suppressed T1-weighted oblique axial and oblique coronal images were retrospectively analyzed by two observers in consensus. Thickness of sphincteric muscles, anal canal length, anorectal angle, thickness of anococcygeal ligament, depth of Minor triangle, width between subcutaneous sphincters, vascularity of posterior commissure, visibility of posterosuperior projection of external sphincter, and angle between the distal anal canal and posterosuperior projection of external sphincter (H angle) in patients and in controls were compared and analyzed using t test, Mann-Whitney U test, and Spearman correlation. The patients with chronic anal fissure had longer anal canal (51.50 mm ± 0.91 vs. 44.11 mm ± 0.71; p = 0.000), thicker internal anal sphincter muscle at mid-anal level (4.18 ± 0.15 vs. 3.39 ± 0.07; p = 0.007), and wider space between subcutaneous external sphincters (11.39 ± 0.50 vs. 6.89 ± 0.22; p = 0.000). In patients, there was a positive correlation between H angle and external sphincter thickness at proximal (r = 0.347; p = 0.021), middle (r = 0427; p = 0.000), and distal (r = 0.518; p = 0.000)) levels of the anal canal. CONCLUSıON: 3.0 Tesla MR imaging provides detailed information about the morphometric changes in the anal sphincter muscles in patients with chronic anal fissure.

  12. Seoseid loov kunstiteose analüüs / Anneli Porri

    Index Scriptorium Estoniae

    Porri, Anneli, 1980-

    2013-01-01

    Kunstiteose analüüsi seosest riikliku õppekavaga, ülevaade kunstiteose analüüsimeetoditest kunstiteaduses ning metoodilistest tähelepanekutest kunsti ja visuaalkultuuri kujutiste vaatamise kohta gümnaasiumi kunstitunnis

  13. Anal sphincter responses after perianal electrical stimulation

    DEFF Research Database (Denmark)

    Pedersen, Ejnar; Klemar, B; Schrøder, H D

    1982-01-01

    By perianal electrical stimulation and EMG recording from the external anal sphincter three responses were found with latencies of 2-8, 13-18 and 30-60 ms, respectively. The two first responses were recorded in most cases. They were characterised by constant latency and uniform pattern, were...

  14. KRAS and BRAF mutations in anal carcinoma

    DEFF Research Database (Denmark)

    Serup-Hansen, Eva; Linnemann, Dorte; Høgdall, Estrid

    2015-01-01

    the frequency and the prognostic value of KRAS and BRAF mutations in a large cohort of patients with anal cancer. One hundred and ninety-three patients with T1-4N0-3M0-1 anal carcinoma were included in the study. Patients were treated with curative (92%) or palliative intent (8%) between January 2000...... and January 2010. KRAS mutations were detected using Therascreen(®)KRAS real-time PCR assay (Qiagen) and V600E or V600D/K BRAF mutations were uncovered using Pyrosequencing. The frequency of KRAS and BRAF mutations was low; KRAS mutations were detected in 1.6% and BRAF mutations in 4.7% of the biopsies....... No impact of KRAS or BRAF status on survival was found. In conclusion, both KRAS and BRAF mutations are rare in anal cancer. The low frequency of KRAS mutations support protocols exploring EGFR-targeted therapy in patients with metastatic anal cancer, while treatment with BRAF inhibitors might be relevant...

  15. [Diagnostics and conservative treatment of anal incontinence].

    Science.gov (United States)

    Geile, Dorothea; Osterholzer, Georg; Rosenberg, Robert

    2004-01-01

    Anal incontinence is diagnosed primarily by clinical and proctologic examination. Etiological factors of the disease are found in 85% of the patients by additional examinations. Motility dysfunction of colon and rectum has to be excluded (stenosis, dyschezia, internal hernias). Because anal incontinence is a multifactorial disease as a rule, the single compounds have to be diagnosed and have to undergo therapy. Accordingly, useful investigations are: endorectal ultrasound (defect of muscle, inflammatory or tumour infiltration), manometry (alteration of either anal resting pressure and/or anal squeezing pressure) and surface electromyography (ability of contraction, duration of contraction, strength). Neurophysiological examinations are: needle electromyography, pudendal nerve latency time measurement (PNLT). The occurrence of nerve damage determines the outcome of operative intervention! Conservative treatment is indicated in 80 to 90% of all patients, even higher when one includes all patients in the perioperative period. Possible therapy modalities are: nutrition consultation, physiotherapy, pelvic floor training, biofeedback training of pelvic floor and sphincter muscles, electrostimulation and the combination of both (EMG-triggered electrostimulation). Short-term results are satisfying in up to 85% of patients, but later, successful results depend on the patient's willingness or ability to continue training, and on his/her age.

  16. Treatment of non-IBD anal fistula

    DEFF Research Database (Denmark)

    Lundby, Lilli; Hagen, Kikke; Christensen, Peter

    2015-01-01

    The course of the fistula tract in relation to the anal sphincter is identified by clinical examination under general anaesthesia using a fistula probe and injection of fluid into the external fistula opening. In the event of a complex fistula or in the case of fistula recurrence, this should...

  17. Treatment of non-IBD anal fistula

    DEFF Research Database (Denmark)

    Lundby, Lilli; Hagen, Kikke; Christensen, Peter;

    2015-01-01

    The course of the fistula tract in relation to the anal sphincter is identified by clinical examination under general anaesthesia using a fistula probe and injection of fluid into the external fistula opening. In the event of a complex fistula or in the case of fistula recurrence, this should be ...

  18. Do We Know What Causes Anal Cancer?

    Science.gov (United States)

    ... cells are more likely to become cancerous. Lowered immunity When the body is less able to fight off infections, viruses like HPV can become more active, which might trigger the development of anal cancer. HIV, the virus that causes AIDS, weakens the ...

  19. Introducing the operation method for curing anal fistula by laser

    Science.gov (United States)

    Ji, Bingzhi

    1993-03-01

    The key to the treatment of anal fistula lies in scavenging the infected anal gland thoroughly, which is the source of anal fistula infection. The fistula tract at the internal orifice of the anal fistula is cut 1 cm using laser with the infectious source completely degenerated and the wound gassified and scanned. The residual distal fistula softens and disappears upon the action of organic fibrinolysin.

  20. W-plug via electromigration in CMOS process

    Institute of Scientific and Technical Information of China (English)

    Zhao Wenbin; Chen Haifeng; Xiao Zhiqiang; Li Leilei; Yu Zongguang

    2009-01-01

    We analyze the failure mechanism of W-plug via electromigration made in a 0.5-μm CMOS SPTM process. Failure occurs at the top or bottom of a W-plug via. We design a series of via chains, whose size ranges from 0.35 to 0.55 μm. The structure for the via electromigration test is a long via chain, and the layer in the via is Ti/TiN/W/TiN. Using a self-heated resistor to raise the temperature of the via chain allows the structure to be stressed at lower current densities, which does not cause significant joule heating in the plugs. This reduces the interaction between the plug and the plug contact resistance and the time-to-failure for the via chain. The lifetime of a W-plug via electromigration is on the order of 3 × 107 s, i.e., far below the lifetime of metal electromigration. The study on W-plug via electromigraion in this paper is beneficial for wafer level reliability monitoring of the ultra-deep submicron CMOS multilayer metal interconnect process.

  1. Mechanical and thermo-mechanical analyses of the tapered plug for plugging of deposition tunnels. A feasibility study

    Energy Technology Data Exchange (ETDEWEB)

    Faelth, Billy (Clay Technology AB, Lund (Sweden)); Gatter, Patrik (Vattenfall Power Consultant AB, Stockholm (Sweden))

    2009-09-15

    This report presents results from a study that was carried out in order to examine the applicability of the tapered plug concept for plugging of deposition tunnels in the deep repository for spent nuclear fuel. The report presents results from mechanical and thermo-mechanical models of the tapered plug. The models were analyzed with 3DEC. The models included a portion of a deposition tunnel and its intersection with a main tunnel. In the deposition tunnel, a tapered concrete plug was installed. The plug was subjected to the combined load from the swelling backfill material and from pore pressure inside the deposition tunnel. The thermo-mechanical effects due to the heat generation in the spent fuel were also included in the analyses. Generic material parameter values for the concrete were used. The following items were studied: - Stresses and displacements in the plug. - Shear stresses and shear displacements in the rock-concrete interface. - Stress additions in the rock due to the loads. The sensitivity of the results to changes of constitutive models, to changes of the plug geometry and to pore water pressure in the rock-concrete interface was examined. The results indicate that the displacements in the plug will be within reasonable ranges but the stresses may locally be high enough that they exceed acceptable levels. However, they can be reduced by choice of advantageous plug geometry and by having a good rock-concrete bond. The results also show that the stress additions in the rock due to the thermal load may yield stresses that locally exceed the spalling strength of the rock. At most locations, however, the rock stresses will amount at lower levels. It was concluded that, with choice of an appropriate design, the tapered plug seems to be an applicable concept for plugging of deposition tunnels. It was also concluded that further studies of the tapered plug concept should use material properties parameter values for low-pH concrete. Further, they should also

  2. Video-assisted anal fistula treatment: a new concept of treating anal fistulas.

    Science.gov (United States)

    Meinero, Piercarlo; Mori, Lorenzo; Gasloli, Giorgio

    2014-03-01

    The surgical treatment of complex anal fistulas is very challenging because of the incidence of incontinence and recurrence after traditional approaches. Video-assisted anal fistula treatment is a novel endoscopic sphincter-saving technique. The aim of this article is to evaluate the results of treating complex anal fistulas from the inside and to focus on the rationale and the advantages of this innovative approach. This is a retrospective observational study. The study was conducted at a tertiary care public hospital in Italy. From February 2006 to February 2012, video-assisted anal fistula treatment was performed on 203 patients (124 men and 79 women; median age, 42 years; range, 21-77 years) who had complex anal fistulas. One hundred forty-nine had undergone previous anal fistula surgery. Video-assisted anal fistula treatment has 2 phases: diagnostic and operative. The fistuloscope is introduced through the external opening to identify the main tract, possible secondary tracts or abscess cavities, and the internal opening. With the use of an electrode, the fistula and its branches are destroyed under direct vision and cleaned. The internal opening is closed by a stapler or a flap. Half a milliliter of synthetic cyanoacrylate is used for suture reinforcement. Successful healing of the fistula was assessed with clinical evaluation. Continence was evaluated by using patient self-reports of the presence/absence of postdefecation soiling. Follow-up was at 2, 4, 6, 12, and 24 months. The 6-month cumulative probability of freedom from fistula estimated according to a Kaplan-Meier analysis is 70% (95%CI, 64%-76%). No major complications occurred. No patients reported a reduction in their postoperative continence score. The limitations of this study included potential single-institution bias, lack of anorectal manometry, and potential selection bias. Video-assisted anal fistula treatment is effective and safe for the treatment of fistula-in-ano.

  3. Teaching Men's Anal Pleasure: Challenging Gender Norms with "Prostage" Education

    Science.gov (United States)

    Branfman, Jonathan; Ekberg Stiritz, Susan

    2012-01-01

    To help students critique sex/gender norms, sexuality educators should address men's anal pleasure. Men's anal receptivity blurs accepted binaries like male/female, masculine/feminine, and straight/queer. By suppressing men's receptivity, the taboo against men's anal pleasure helps legitimize hegemonic sex/gender beliefs--and the sexism,…

  4. Anal human papillomavirus DNA in women at a colposcopy clinic.

    NARCIS (Netherlands)

    Hauwers, K.W.M. d'

    2012-01-01

    OBJECTIVES: To describe the type-specific prevalence of anal and cervical human papillomavirus (HPV) infections and the cytology in HIV-negative women without a history of cervical cancer, attending a colposcopy clinic. To examine if an HPV positive anal smear is related to anal pathology and

  5. Anal fistulas : New perspectives on treatment and pathogenesis

    NARCIS (Netherlands)

    R.S. van Onkelen (Robbert)

    2015-01-01

    markdownabstractAbstract The objective of modern anal fistula treatment is healing of the fistula without diminished fecal continence. Sphincter saving techniques have been developed for anal fistulas, for which fistulotomy is not suitable. Treatment of these anal fistulas remains challenging

  6. Anal human papillomavirus DNA in women at a colposcopy clinic.

    NARCIS (Netherlands)

    Hauwers, K.W.M. d'

    2012-01-01

    OBJECTIVES: To describe the type-specific prevalence of anal and cervical human papillomavirus (HPV) infections and the cytology in HIV-negative women without a history of cervical cancer, attending a colposcopy clinic. To examine if an HPV positive anal smear is related to anal pathology and conseq

  7. Update on Anal Fistulae: Surgical Perspectives for the Gastroenterologist

    Directory of Open Access Journals (Sweden)

    Helena Tabry

    2011-01-01

    Full Text Available Anal fistulae are common and debilitating; they are characterized by severe pain and discharge. They arise following infection near the anal canal, or as a primary event from an abscess in the abdomen, fistulating into the vagina or perianal skin. The term ‘cryptoglandular’ is given to abscesses arising from the anal glands.

  8. Anal fistulas : New perspectives on treatment and pathogenesis

    NARCIS (Netherlands)

    R.S. van Onkelen (Robbert)

    2015-01-01

    markdownabstractAbstract The objective of modern anal fistula treatment is healing of the fistula without diminished fecal continence. Sphincter saving techniques have been developed for anal fistulas, for which fistulotomy is not suitable. Treatment of these anal fistulas remains challenging and

  9. Postpartum two‐ and three‐dimensional ultrasound evaluation of anal sphincter complex in women with obstetric anal sphincter injury

    National Research Council Canada - National Science Library

    Ros, C; Martínez‐Franco, E; Wozniak, M. M; Cassado, J; Santoro, G. A; Elías, N; López, M; Palacio, M; Wieczorek, A. P; Espuña‐Pons, M

    2017-01-01

    ...) in detecting residual defects after primary repair of obstetric anal sphincter injuries (OASIS). Methods External (EAS) and internal (IAS) anal sphincters were evaluated by the four ultrasound modalities in women with repaired OASIS...

  10. A Genre Classification Plug-in for Data Collection

    DEFF Research Database (Denmark)

    Lehn-Schiøler, Tue; Arenas-García, Jerónimo; Petersen, Kaare Brandt;

    2006-01-01

    This demonstration illustrates how the methods developed in the MIR community can be used to provide real-time feedback to music users. By creating a genre classifier plug-in for a popular media player we present users with relevant information as they play their songs. The plug-in can furthermor...... be used as a data collection platform. After informed consent from a selected set of users the plug-in will report on music consumption behavior back to a central server....

  11. [Preliminary efficacy of video-assisted anal fistula treatment for complex anal fistula].

    Science.gov (United States)

    Liu, Hailong; Xiao, Yihua; Zhang, Yong; Pan, Zhihui; Peng, Jian; Tang, Wenxian; Li, Ajian; Zhou, Lulu; Yin, Lu; Lin, Moubin

    2015-12-01

    To evaluate the preliminary efficacy of video-assisted anal fistula treatment (VAAFT) for complex anal fistula. Clinical data of 11 consecutive patients with complex anal fistula undergoing VAAFT in our department from May to July 2015 were reviewed. VAAFT was performed to manage the fistula under endoscope without cutting or resection. VAAFT was successfully performed in all the 11 patients. The internal ostium was closed using mattress suture in 10 cases, and Endo-GIA stapler in 1 case. The mean operative time was (42.0±12.4) min, mean hospital stay was (4.1±1.5) d. Complication included bleeding and perianal infection in 1 case respectively. After 1 to 3.2 months follow-up, success rate was 72.7%(8/11), and no fecal incontinence was observed. Video-assisted anal fistula treatment is an effective, safe and minimally invasive surgical procedure for complex anal fistula with preservation of anal sphincter function.

  12. Mode of delivery after obstetric anal sphincter injury and the risk of long-term anal incontinence

    DEFF Research Database (Denmark)

    Jangö, Hanna; Langhoff-Roos, Jens; Rosthøj, Susanne

    2016-01-01

    BACKGROUND: Primiparous women have an increased risk of obstetric anal sphincter injury; because most of these patients deliver again, there are major concerns about mode of delivery: the risk of recurrent obstetric anal sphincter injury and the risk of long-term symptoms of anal incontinence...

  13. Risk Factors for Anal HPV Infection and Anal Precancer in HIV-Infected Men Who Have Sex With Men

    OpenAIRE

    Schwartz, Lauren M.; Castle, Philip E.; Follansbee, Stephen; Borgonovo, Sylvia; Fetterman, Barbara; Tokugawa, Diane; Lorey, Thomas S.; Sahasrabuddhe, Vikrant V.; Luhn, Patricia; Gage, Julia C; Darragh, Teresa M.; Wentzensen, Nicolas

    2013-01-01

    Background. Carcinogenic human papillomaviruses (HPVs) cause a large proportion of anal cancers. Human immunodeficiency virus (HIV)–infected men who have sex with men (MSM) are at increased risk of HPV infection and anal cancer compared with HIV-negative men. We evaluated risk factors for HPV infection and anal precancer in a population of HIV-infected MSM.

  14. SI Engine with repetitive NS spark plug

    Science.gov (United States)

    Pancheshniy, Sergey; Nikipelov, Andrey; Anokhin, Eugeny; Starikovskiy, Andrey; Laplase Team; Mipt Team; Pu Team

    2013-09-01

    Now de-facto the only technology for fuel-air mixtures ignition in IC engines exists. It is a spark discharge of millisecond duration in a short discharge gap. The reason for such a small variety of methods of ignition initiation is very specific conditions of the engine operation. First, it is very high-pressure of fuel-air mixture - from 5-7 atmospheres in old-type engines and up to 40-50 atmospheres on the operating mode of HCCI. Second, it is a very wide range of variation of the oxidizer/fuel ratio in the mixture - from almost stoichiometric (0.8-0.9) at full load to very lean (φ = 0.3-0.5) mixtures at idle and/or economical cruising mode. Third, the high velocity of the gas in the combustion chamber (up to 30-50 m/s) resulting in a rapid compression of swirling inlet flow. The paper presents the results of tests of distributed spark ignition system powered by repetitive pulse nanosecond discharge. Dynamic pressure measurements show the increased pressure and frequency stability for nanosecond excitation in comparison with the standard spark plug. Excitation by single nanosecond high-voltage pulse and short train of pulses was examined. In all regimes the nanosecond pulsed excitation demonstrate a better performance.

  15. [Pay attention to the imaging diagnosis of complex anal fistula].

    Science.gov (United States)

    Zhou, Zhiyang

    2015-12-01

    The diagnosis and treatment of complex anal fistula has been a significant challenge. Unwise incision and excessive exploration will lead to the secondary branch, sinus and perforation. A simple fistula may become a surgical problem and result in disastrous consequences. Preoperative accurate diagnosis of anal fistula, including in the internal opening, primary track and location of the fistula, extensions and abscess, is important for anal fistula treatment. In the diagnosis of anal fistula, imaging examination, especially MRI plays a crucial role. Localization and demarcation of anal fistula and the relationship with sphincter are important. MRI has been an indispensable confirmatory imaging examination.

  16. Engaging Tenants in Reducing Plug Load Energy Use

    Energy Technology Data Exchange (ETDEWEB)

    Schantz, Marta; Langner, Rois

    2016-08-26

    Plug and Process Loads (PPLs) account for an increasingly large percentage of commercial building energy use in the U.S. due to the rising number of energy intensive plug-in devices. In addition, buildings are becoming more and more efficient and plug load energy use has become an increasingly pertinent component to achieving aggressive energy targets and netzero energy status. For multi-tenant buildings, controlling plug loads in tenant spaces can be a significant challenge. Luckily, there are a number of PPL reduction strategies, best practices, and lessons learned from numerous commercial real estate and higher education leaders who have successfully engaged building occupants and tenants in reducing PPL energy use. This paper provides actionable PPL reduction strategies and best practices that building owners and managers can immediately apply to their own buildings.

  17. Rotary plug device for use in LMFBR type reactors

    Energy Technology Data Exchange (ETDEWEB)

    Azuma, Kazuhiko; Imayoshi, Sho.

    1988-02-23

    Purpose: To prevent adhesion of sodium in the rotational gap of a rotational plug. Constitution: One of the walls of a cylindrical gap formed between the outer circumference of a small rotary plug and a large rotary plug that constitute a double rotary plug is cooled to lower than the sodium coagulation temperature, while a stater of a linear motor in a cylindrical shape and wound with linear coils around the iron core is attached to the inside of the other of the walls. Then, one of the walls of the gap to which sodium adheres is cooled to less than sodium coagulation temperature, so that sodium is or tends to be deposited to the wall. Then, eddy currents are resulted to sodium by the current supplied to the stater of the linear motor attached to the other of the walls, to produce thrusting force. Sodium on the wall surface is scraped off by this. (Yoshihara, H.).

  18. Application of Inductive Monitoring System to Plug Load Anomaly Detection

    Data.gov (United States)

    National Aeronautics and Space Administration — NASA Ames Research Center’s Sustainability Base is a new 50,000 sq. ft. LEED Platinum office building. Plug loads are expected to account for a significant portion...

  19. Frictional Fluid Dynamics and Plug Formation in Multiphase Millifluidic Flow

    Science.gov (United States)

    Dumazer, Guillaume; Sandnes, Bjørnar; Ayaz, Monem; Mâløy, Knut Jørgen; Flekkøy, Eirik Grude

    2016-07-01

    We study experimentally the flow and patterning of a granular suspension displaced by air inside a narrow tube. The invading air-liquid interface accumulates a plug of granular material that clogs the tube due to friction with the confining walls. The gas percolates through the static plug once the gas pressure exceeds the pore capillary entry pressure of the packed grains, and a moving accumulation front is reestablished at the far side of the plug. The process repeats, such that the advancing interface leaves a trail of plugs in its wake. Further, we show that the system undergoes a fluidization transition—and complete evacuation of the granular suspension—when the liquid withdrawal rate increases beyond a critical value. An analytical model of the stability condition for the granular accumulation predicts the flow regime.

  20. Microstructure Formation and Degradation Mechanism of Cementitious Plugging Agent Slurries

    Institute of Scientific and Technical Information of China (English)

    YAN Peiyu; ZHOU Yongxiang; YANG Zhenjie; QIN Jian

    2007-01-01

    The hydration products and microstructure of class G oil well cement and a newly developed plugging agent (YLD) slurries cured in the simulated temperature and pressure environment, which was of similar temperature and pressure with those at the bottom of oil well in a normal depth, were investigated using XRD, TG and SEM. Severe leakage is confirmed at the interface between hardened slurries and steel tube during the dynamically curing process, which induces the quick loss of cementing property of slurries. This should be the dominating cause of degradation of class G oil well cement slurry. A secondary hydration process can take place at the eroded interface of hardened YLD plugging agent slurry. Newly formed C-S-H gel has a self-healing effect to repair the damaged interface, which unceasingly maintains the cementing property of the YLD plugging agent slurry. Therefore, the effective using period of YLD plugging agent can be prolonged.

  1. Waste isolation pilot plant (WIPP) borehole plugging program description

    Energy Technology Data Exchange (ETDEWEB)

    Christensen, C.L.; Hunter, T.O.

    1979-08-01

    The tests and experiments described attempt to provide a mix of borehole (with limited access) and in-mine (with relatively unlimited access) environments in which assessment of the various issues involved can be undertaken. The Bell Canyon Test provides the opportunity to instrument and analyze a plug in a high pressure region. The Shallow Hole Test permits application of best techniques for plugging and then access to both the top and bottom of the plug for further analysis. The Diagnostic Test Hole permits recovery of bench scale size samples for analysis and establishes an in-borehole laboratory in which to conduct testing and analysis in all strata from the surface into the salt horizon. The additional in mine experiments provide the opportunity to investigate in more detail specific effects on plugs in the salt region and allows evaluation of instrumentation systems.

  2. Mechanical Properties of Plug Welds after Micro-Jet Cooling

    Directory of Open Access Journals (Sweden)

    Hadryś D.

    2016-12-01

    Full Text Available New technology of micro-jet welding could be regarded as a new way to improve mechanical properties of plug welds. The main purpose of that paper was analyzing of mechanical properties of plug welds made by MIG welding method with micro-jet cooling. The main way for it was comparison of plug welds made by MIG welding method with micro-jet cooling and plug welds made by ordinary MIG welding method. It is interesting for steel because higher amount of acicular ferrite (AF in weld metal deposit (WMD is obtained in MIG welding method with micro-jet cooling in relation to ordinary MIG welding method. This article presents the influence of the cooling medium and the number of micro-jet streams on mechanical properties of the welded joint. Mechanical properties were described by force which is necessary to destroy weld joint.

  3. Prevalence of anal symptoms in general practice: a prospective study.

    Science.gov (United States)

    Tournu, Géraldine; Abramowitz, Laurent; Couffignal, Camille; Juguet, Frédéric; Sénéjoux, Agnès; Berger, Stéphane; Wiart, Anne-Laure; Bernard, Marc; Provost, Françoise; Pillant-Le Moult, Hélène; Bouchard, Dominique; Aubert, Jean-Pierre

    2017-08-03

    Anal disorders are largely underestimated in general practice. Studies have shown patients conceal anal symptoms leading to late diagnosis and treatment. Management by general practitioners is poorly described. The aim of this study is to assess the prevalence of anal symptoms and their management in general practice. In this prospective, observational, national study set in France, all adult patients consulting their general practitioner during 2 days of consultation were included. Anal symptoms, whether spontaneously revealed or not, were systematically collected and assessed. For symptomatic patients, the obstacles to anal examination were evaluated. The general practitioner's diagnosis was collected and a proctologist visit was systematically proposed in case of anal symptoms. If the proctologist was consulted, his or her diagnosis was collected. From October 2014 to April 2015, 1061 patients were included by 57 general practitioners. The prevalence of anal symptoms was 15.6% (95% CI: 14-18). However, 85% of these patients did not spontaneously share their symptoms with their doctors, despite a discomfort rating of 3 out of 10 (range 1-5). Although 65% of patients agreed to an anal examination, it was not proposed in 45% of cases with anal symptoms. Performing the examination was associated with a significantly higher diagnosis rate of 76% versus 20% (p anal symptoms are significant in general practice despite the impact on quality of life. Anal examination is seldom done. Improved training of general practitioners is required to break the taboo.

  4. Engineering activities on the ITER representative diagnostic equatorial port plug

    Energy Technology Data Exchange (ETDEWEB)

    Meunier, L. [Association Euratom CEA, CEA/DSM/IRFM (France)], E-mail: lmeunier@cea.fr; Doceul, L.; Salasca, S.; Martins, J.-P.; Jullien, F.; Dechelle, Christian; Bidaud, Pierre; Pilard, Vincent; Terra, Alexis; Ogea, Mathieu [Association Euratom CEA, CEA/DSM/IRFM (France); Ciattaglia, Emanuela [EFDA CSU, Garching (Germany); Walker, Christopher [ITER International Organisation (France)

    2009-06-15

    Most of ITER diagnostic systems are integrated in port plugs, which are water cooled stainless steel structures inserted into the vacuum vessel ports. The port plug must provide basic functions such as neutron and gamma shielding, supporting the first wall armour (BSM), closing the vacuum vessel ports, while supporting the diagnostic equipments. ITER diagnostic port plug must resist a severe environment like high temperature due to neutron interaction with the structures and high electromechanical loading during disruptions events. CEA has contributed to the design and integration tasks in the frame of the representative equatorial port plug EQ no. 01, in particular on the engineering, structural and thermal finite element analysis. These detailed analyses have highlighted some design issues which were worked out through different solutions. This paper contains a description of the engineering activities performed such as: -The static mechanical calculations of the top plate closure system under disruption load. -The static mechanical calculations of the BSM attachment to the port plug. These two first studies led to design changes proposals which significantly improved the behaviour of the structures but also showed that the safety margin with respect to design limits is quite low. -The design of a Diagnostic Shield Module (DSM) integrated inside the port plug and a proposition of attachment scheme, with respect to disruption loads. The manufacturing of the DSM has been taken into account, as well as diagnostic integration inside the structure and maintenance aspects. -The thermal assessment of the port plug under neutronic load during normal operation, with the optimization of the cooling system. The maximum temperature calculated in normal operation has been reduced from 900 deg. C to less than 400 deg. C in the front plate; and the cooling arrangement at the back of the port plug has been simplified without important temperature increase.

  5. Anal incontinence after two vaginal deliveries without obstetric anal sphincter rupture.

    Science.gov (United States)

    Persson, Lisa K G; Sakse, Abelone; Langhoff-Roos, Jens; Jangö, Hanna

    2017-06-01

    To evaluate prevalence and risk factors for long-term anal incontinence in women with two prior vaginal deliveries without obstetric anal sphincter injury (OASIS) and to assess the impact of anal incontinence-related symptoms on quality of life. This is a nation-wide cross-sectional survey study. One thousand women who had a first vaginal delivery and a subsequent delivery, both without OASIS, between 1997 and 2008 in Denmark were identified in the Danish Medical Birth Registry. Women with more than two deliveries in total till 2012 were excluded at this stage. Of the 1000 women randomly identified, 763 were eligible and received a questionnaire. Maternal and obstetric data were retrieved from the national registry. The response rate was 58.3%. In total, 394 women were included for analysis after reviewing responses according to previously defined exclusion criteria. Median follow-up time was 9.8 years after the first delivery and 6.4 years after the second. The prevalence of flatal incontinence, fecal incontinence and fecal urgency were 11.7, 4.1, and 12.3%, respectively. Overall, 20.1% had any degree of anal incontinence and/or fecal urgency. In 6.3% these symptoms affected their quality of life. No maternal or obstetric factors including episiotomy and vacuum extraction were consistently associated with altered risk of anal incontinence in the multivariable analyses. Anal incontinence and fecal urgency is reported by one fifth of women with two vaginal deliveries without OASIS at long-term follow-up. Episiotomy or vacuum extraction did not alter the risk of long-term anal incontinence.

  6. Treatment of anal fistula and abscess.

    Science.gov (United States)

    Pigot, F

    2015-04-01

    The glands of Hermann and Desfosses, located in the thickness of the anal canal, drain into the canal at the dentate line. Infection of these anal glands is responsible for the formation of abscesses and/or fistulas. When this presents as an abscess, emergency drainage of the infected cavity is required. At the stage of fistula, treatment has two sometimes conflicting objectives: effective drainage and preservation of continence. These two opposing constraints explain the existence of two therapeutic concepts. On one hand the laying-open of the fistulous tract (fistulotomy) in one or several operative sessions remains the treatment of choice because of its high cure rates. On the other hand surgical closure with tract ligation or obturation with biological components preserves sphincter function but suffers from a higher failure rate. Copyright © 2014. Published by Elsevier Masson SAS.

  7. Squamous cell carcinoma of the anal canal.

    LENUS (Irish Health Repository)

    Martin, F T

    2012-01-31

    Squamous cell carcinoma ofthe anal canal represents 1.5% of all malignancies affectingthe gastrointestinal tract. Over the past 20 years dramatic changes have been seen in both the epidemiological distribution of the disease and in the therapeutic modalities utilised to manage it. CLINICAL MANAGEMENT: Historically abdominoperineal resection had been the treatment of choice with local resection reserved for early stage disease. Work by Nigro et al. has revolutionised how we currently manage carcinoma of the anal canal, demonstrating combined modality chemoradiotherapy as an appropriate alternative to surgical resection with the benefit of preserving sphincter function. Surgery is then reserved for recurrent disease with salvage abdominoperineal resection. This article reviews current literature and highlights the changing therapeutic modalities with selected clinical cases

  8. Correlação entre a incompetência esfincteriana anal e a prática de sexo anal em homossexuais do sexo masculino Correlation between anal sphincter incompetence and anal sex practice in male homosexual

    Directory of Open Access Journals (Sweden)

    Maíra Costa Ferreira

    2010-03-01

    Full Text Available INTRODUÇÃO: a incontinência anal (IA é uma disfunção de origem multifatorial com impacto significativo na qualidade de vida do indivíduo. Dentre as diversas etiologias para IA encontra-se a traumática, provocada pela penetração de objetos no canal anal. A inclusão do ânus na atividade sexual, já vem sendo descrita, principalmente entre homossexuais do sexo masculino. A partir desta premissa, questionou-se nesta pesquisa a possibilidade da penetração do pênis no ânus se enquadrar como etiologia traumática da incontinência anal. OBJETIVO: verificar a possível correlação entre a incontinência anal e a prática de sexo anal utilizando variáveis como idade, tempo de prática e a freqüência semanal de sexo anal. Métodos: 100 homossexuais masculinos passivos responderam um questionário elaborado pelas pesquisadoras e um Índice de Incontinência Anal. RESULTADOS: a incontinência anal estava presente em 62%, sendo que a perda de gases foi considerada a mais significativa. Contudo, as correlações propostas não se apresentaram estatisticamente significantes. CONCLUSÃO: a maioria dos homossexuais apresentou algum grau de incontinência anal, provavelmente em decorrência da prática do sexo anal.INTRODUCTION: the anal incontinence (AI is a disfunction of multifactorial origin with significant impact in thequality of life of the individual. Amongst the diverse etiologies for AI meets it traumatic, provoked for the object penetration inthe anal canal. The inclusion of the anus in the sexual activity, already comes being described, mainly between homosexuals ofthe masculine sex. From this premise, the possibility of the penetration of the penis in the anus was questioned in this researchif to fit as traumatic etiology of the anal incontinence. OBJECTIVE: to verify the possible correlation between changeable the analincontinence and the practical one of anal sex being used as age, practical time of and the weekly frequency of

  9. Management of Anal Squamous Intraepithelial Lesions

    OpenAIRE

    Pineda, Carlos E.; Welton, Mark L.

    2009-01-01

    Anal squamous intraepithelial lesions include both low-grade squamous intraepithelial lesions (LSIL) and high-grade squamous intraepithelial lesions (HSIL) and are caused by chronic infection with the human papillomavirus (HPV). The disease is increasing in both incidence and prevalence, especially among patients with the following risk factors: homosexual men, acquired or iatrogenic immunosuppression, and presence of other HPV-related diseases. Although the natural history of the disease is ...

  10. [Combined radio- and chemotherapy of anal cancer].

    Science.gov (United States)

    Dobrowsky, W

    1986-05-30

    The treatment regime in anal carcinoma is changing from being a mainly surgical problem. Combined radio-chemotherapy is of increasing interest as treatment of choice. The new treatment modality, including chemotherapy with Mitomycin C and 5-fluorouracil combined with percutaneous and interstitial radiotherapy is presented. The treatment regimes performed at the University Department for Radiotherapy and Radiobiology Vienna is discussed with regard to tolerance, side effects and local control.

  11. High quality new type spark plug pressure sensor; Koseino plug gata shiatsu sensor ni tsuite

    Energy Technology Data Exchange (ETDEWEB)

    Urakawa, H.; Yanagihara, S.; Kawa, T. [Tsukasa Sokken Co. Ltd., Tokyo (Japan); Enomoto, Y. [Musashi Institute of Technology, Tokyo (Japan); Sato, T. [Dai Ichi Institute of Technology, Kagoshima (Japan); Gotthard, E.

    1998-05-01

    Investigations were made on a spark plug type pressure sensor using GaPO4 piezoelectric material developed recently by AVL Corporation. This sensor has the ignition electrode installed decentered to assure the installing position for the pressure sensor, where the small pressure sensor with a diameter of 4.4 mm, model GU12P is installed on the side. Experiments were performed on this sensor, a water cooled sensor for comparison, and a cooling-free type sensor for reference. The engine was operated at an outlet cooling water temperature maintained constant at 80 degC, and experimented in a normal combustion condition with full load at 2000 rpm and 4000 rpm, in a knocking condition with full load at 2000 rpm, and in a transient condition from full load at 4000 rpm to no load at 1300 rpm. As a result, it was made clear that the spark plug type pressure sensor showed an output of the same level as that with the water cooled sensor in the normal combustion pressure. Load change drift under the transient condition was found as good as 2.5% FS at maximum. No effect of columnar vibration was discovered, and a knocking waveform of 14 kHz was observed. 6 refs., 12 figs., 1 tab.

  12. Anal intraepitelial neoplasia: a narrative review

    Directory of Open Access Journals (Sweden)

    Garazi Elorza

    2016-01-01

    Full Text Available Anal intraepitelial neoplasia (AIN constitutes a major health problem in certain risk groups, such as patients with immunosuppression of varied origin, males who have sexual relations with other males, and females with a previous history of vaginal or cervical abnormalities in cytology. Its relationship with the human papillomavirus (HPV infection has been well documented; however, many of the factors involved in the progression and regression of the viral infection to dysplasia and anal carcinoma are unknown. AIN can be diagnosed through cytology of the anal canal or biopsy guided by high-resolution anoscopy. However, the need for these techniques in high-risk groups remains controversial. Treatment depends on the risk factors and given the high morbidity and high recurrence rates the utility of the different local treatments is still a subject of debate. Surgical biopsy is justified only in the case of progression suggesting lesions. The role of the vaccination in high-risk patients as primary prevention has been debated by different groups. However, there is no general consensus on its use or on the need for screening this population.

  13. Premalignant Lesions of the Anal Canal and Squamous Cell Carcinoma of the Anal Canal

    Science.gov (United States)

    Poggio, Juan Lucas

    2011-01-01

    Squamous cell carcinoma of the anus (SCCA) is a rare tumor. However, its incidence has been increasing in men and women over the past 25 years worldwide. Risk factors associated with this cancer are those behaviors that predispose individuals to human papillomavirus (HPV) infection and immunosuppression. Anal cancer is generally preceded by high-grade anal intraepithelial neoplasia (HGAIN), which is most prevalent in human immunodeficiency virus-positive men who have sex with men. High-risk patients may benefit from screening. The most common presentation is rectal bleeding, which is present in nearly 50% of patients. Twenty percent of patients have no symptoms at the time of presentation. Clinical staging of anal cancer requires a digital rectal exam and a positron emission tomography/computed tomography scan of the chest, abdomen, and pelvis. Endorectal/endoanal ultrasound appears to add more-specific staging information when compared with digital rectal examination alone. Treatment of anal cancer prior to the 1970s involved an abdominoperineal resection. However, the current standard of care for localized anal cancer is concurrent chemoradiation therapy, primarily because of its sphincter-saving and colostomy-sparing potential. Studies have addressed alternative chemoradiation regimens to improve the standard protocol of fluorouracil, misogynic, and radiation, but no alternative regimen has proven superior. Surgery is reserved for those patients with residual disease or recurrence. PMID:22942800

  14. Video-Assisted Anal Fistula Treatment (VAAFT) for Complex Anal Fistula: A Preliminary Evaluation in China.

    Science.gov (United States)

    Jiang, Hui-Hong; Liu, Hai-Long; Li, Zhen; Xiao, Yi-Hua; Li, A-Jian; Chang, Yi; Zhang, Yong; Lv, Liang; Lin, Mou-Bin

    2017-04-30

    BACKGROUND Although many attempts have been made to advance the treatment of complex anal fistula, it continues to be a difficult surgical problem. This study aimed to describe the novel technique of video-assisted anal fistula treatment (VAAFT) and our preliminary experiences using VAAFT with patients with complex anal fistula. MATERIAL AND METHODS From May 2015 to May 2016, 52 patients with complex anal fistula were treated with VAAFT at Yangpu Hospital of Tongji University School of Medicine, and the clinical data of these patients were reviewed. RESULTS VAAFT was performed successfully in all 52 patients. The median operation time was 55 minutes. Internal openings were identified in all cases. 50 cases were closed with sutures, and 2 were closed with staplers. Complications included perianal sepsis in 3 cases and bleeding in another 3 cases. Complete healing without recurrence was achieved in 44 patients (84.6%) after 9 months of follow-up. No fecal incontinence was observed. Furthermore, a significant improvement in Gastrointestinal Quality of Life Index (GIQLI) score was observed from preoperative baseline (mean, 85.5) to 3-month follow-up (mean, 105.4; panal fistula with preservation of anal sphincter function.

  15. Prevalence of anal human papillomavirus infection and anal HPV-related disorders in women: a systematic review

    Science.gov (United States)

    Stier, Elizabeth A.; Sebring, Meagan C.; Mendez, Audrey E.; Ba, Fatimata S.; Trimble, Debra D.; Chiao, Elizabeth Y.

    2015-01-01

    Objective The aim of this study was to systematically review the findings of publications addressing the epidemiology of anal HPV infection, anal intraepithelial neoplasia and anal cancer in women. Data Sources We conducted a systematic review among publications published from January 1, 1997 to September 30, 2013 in order to limit to publications from the combined antiretroviral therapy (cART) era. Three searches were performed of the National Library of Medicine PubMed database using the following search terms: “women and anal HPV”, “women anal intraepithelial neoplasia”, and “women and anal cancer.” Study Eligibility Criteria Publications were included in the review if they addressed any of the following outcomes: (1) prevalence, incidence, or clearance of anal HPV infection, (2) prevalence of anal cytological or histological neoplastic abnormalities, or (3) incidence or risk of anal cancer. Thirty-seven publications addressing anal HPV infection and anal cytology remained after applying selection criteria, and 23 anal cancer publications met the selection criteria. Results Among HIV-positive women, prevalence of HR-HPV in the anus was 16-85%. Among HIV-negative women, prevalence of anal HR-HPV infection ranged from 4 - 86%. The prevalence of anal HR- HPV in HIV-negative women with HPV-related pathology of the vulva, vagina and cervix compared with women with no known HPV-related pathology, varied from 23-86%, and 5-22%, respectively. Histologic anal HSIL (AIN 2+) was found in 3-26% of the women living with HIV, 0-9% among women with lower genital tract pathology, and 0-3% for women who are HIV-negative without known lower genital tract pathology. The incidence of anal cancer among HIV-infected women ranged from 3.9-30 per 100,000. Among women with a history of cervical cancer or CIN 3, the IR of anal cancer ranged from 0.8-63.8/100,000 person-years, and in the general population, the IRs ranged from 0.55-2.4/100,000 person-years. Conclusions This

  16. Methodology for physical modeling of melter electrode power plug

    Energy Technology Data Exchange (ETDEWEB)

    Heath, W.O.

    1984-09-01

    A method is presented for building and testing a one-third scale model of an electrode power plug used to supply up to 3000 amperes to a liquid fed ceramic melter. The method describes how a one-third scale model can be used to verify the ampacity of the power plug, the effectiveness of the power plug cooling system and the effect of the high amperage current on eddy current heating of rebar in the cell wall. Scale-up of the test data, including cooling air flow rate and pressure drop, temperature profiles, melter water jacket heat duty and electrical resistance is covered. The materials required to build the scale model are specified as well as scale surface finish and dimensions. The method for designing and testing a model power plug involves developing a way to recreate the thermal conditions including heat sources, sinks and boundary temperatures on a scale basis. The major heat sources are the molten glass in contact with the electrode, joule heat generation within the power plug, and eddy current heating of the wall rebar. The melting cavity heat source is modelled using a plate heater to provide radiant heat transfer to a geometrically similar, one-third scale electrode housed in a scale model of a melting cavity having a thermally and geometrically similar wall and floor. The joule heat generation within the power plug is simulated by passing electricity through the model power plug with geometrically similar rebar positioned to simulate the eddy heating phenomenon. The proposed model also features two forced air cooling circuits similar to those on the full design. The interaction of convective, natural and radiant heat transfer in the wall cooling circuit are considered. The cell environment and a melter water jacket, along with the air cooling circuits, constitute the heat sinks and are also simulated.

  17. Reduced-dimension model of liquid plug propagation in tubes

    Science.gov (United States)

    Fujioka, Hideki; Halpern, David; Ryans, Jason; Gaver, Donald P.

    2016-09-01

    We investigate the flow resistance caused by the propagation of a liquid plug in a liquid-lined tube and propose a simple semiempirical formula for the flow resistance as a function of the plug length, the capillary number, and the precursor film thickness. These formulas are based on computational investigations of three key contributors to the plug resistance: the front meniscus, the plug core, and the rear meniscus. We show that the nondimensional flow resistance in the front meniscus varies as a function of the capillary number and the precursor film thickness. For a fixed capillary number, the flow resistance increases with decreasing precursor film thickness. The flow in the core region is modeled as Poiseuille flow and the flow resistance is a linear function of the plug length. For the rear meniscus, the flow resistance increases monotonically with decreasing capillary number. We investigate the maximum mechanical stress behavior at the wall, such as the wall pressure gradient, the wall shear stress, and the wall shear stress gradient, and propose empirical formulas for the maximum stresses in each region. These wall mechanical stresses vary as a function of the capillary number: For semi-infinite fingers of air propagating through pulmonary airways, the epithelial cell damage correlates with the pressure gradient. However, for shorter plugs the front meniscus may provide substantial mechanical stresses that could modulate this behavior and provide a major cause of cell injury when liquid plugs propagate in pulmonary airways. Finally, we propose that the reduced-dimension models developed herein may be of importance for the creation of large-scale models of interfacial flows in pulmonary networks, where full computational fluid dynamics calculations are untenable.

  18. Cáncer anal en la era del VIH: papel de la citología anal Anal cancer in the HIV era

    Directory of Open Access Journals (Sweden)

    Juan Carlos Cataño Correa

    2004-09-01

    Full Text Available El cáncer anal solía ser una neoplasia infrecuente que afectaba principalmente a mujeres y personas mayores de 65 años, pero recientemente su incidencia ha venido en aumento debido a la pandemia de VIH, fenómeno que tiende a empeorar porque la terapia antirretroviral altamente activa (HAART, por su sigla en inglés no solo alarga la vida de los pacientes, sino que al mismo tiempo hace posible una prolongada evolución de las lesiones precancerosas que conducen a cáncer anal; además, está plenamente demostrado que la HAART no evita la evolución de las lesiones intraepiteliales escamosas hacia cáncer anal. La citología anal ha demostrado ser una prueba de tamización poblacional útil y costoefectiva para el diagnóstico de las lesiones precancerosas producidas por Papilomavirus humano en el canal anal de hombres homosexuales y bisexuales, principalmente de aquellos positivos para VIH. Esta revisión tiene como objetivo llamar la atención sobre la creciente incidencia de cáncer anal en la población de pacientes VIH positivos, y sobre la utilidad del diagnóstico temprano utilizando la citología anal en este grupo de pacientes de riesgo. Anal cancer used to be an uncommon neoplasia that affected mainly women and people aged over 65 years, but recently its incidence has been growing, mostly due to the HIV pandemic, and it will become worse because highly active antiretroviral therapy (HAART at the same time that lengthens life expectancy in HIV positive subjects, will increase the possibility to develop anal cancer; it has already been demonstrated that HAART does not prevent the evolution of intraepithelial squamous lesions to anal cancer. Anal cytology has demonstrated to be an useful and cost-effective screening tool for detection of precancerous lesions associated with human Papillomavirus (HPV infection in the anal canal of homosexual and bisexual men, specially in those that are HIV positive. This article is an update of the

  19. Report on electric cars and plug-in hybrid cars; Redegoerelse - elbiler og plug-in hybridbiler

    Energy Technology Data Exchange (ETDEWEB)

    Elkjaer Toennesen, A.; Winther, K.; Noerregaard, K. (Teknologisk Institut, Taastrup (Denmark)); Larsen, Esben; Christensen, Linda; Kveiborg, O. (Danmarks Teknologiske Univ., Kgs. Lyngby (DTU) (Denmark))

    2010-04-15

    The Center for Green Transport at the Danish Transport Authority has prepared this statement in order to uncover driving technical aspects, user expectations and needs, and the environmental consequences of using electric and plug-in hybrid cars. An electric car is defined as a car driven by an electric motor that has a battery that can be charged with power from the grid. A plug-in hybrid car is defined as a car that combines gasoline or diesel engine with an electric motor with a battery which can be recharged with power from the grid. From an overall consideration related to the transport sector electric cars and plug-in hybrid cars have the major advantage that negative impacts on environment and climate from traffic can be reduced while the high mobility is maintained. Through an increased use of electric cars and plug-in hybrid cars, the many advantages attached to the car as an individual transportation form is maintained, while CO{sub 2} emissions etc. are reduced. Electric cars and plug-in hybrid cars is one of the technologies that are considered to have particularly great prospects in the medium term when it comes to promoting new technologies in transport. Another advantage of using electric vehicles is the power supply factor. An increased use of electricity in transport will reduce the need for and dependence on fossil fuels in the sector. Both electric cars and plug-in hybrid cars are expected to be used for storage of wind power, a possibility which is hardly available today. The plug-in hybrid car could meet some of the challenges facing the pure electric car, because it also can use conventional fuel. The report presents analyses based on three focus areas: a) Users' needs, expectations and economics in relation to vehicles; b) The technology - and hence the manufacturers' opportunities and challenges; c) Connection to the power grid. (ln)

  20. Plug-in electric vehicles integrating fluctuating renewable electricity

    Energy Technology Data Exchange (ETDEWEB)

    Dallinger, David

    2013-11-01

    This paper examines a method to model plug-in electric vehicles as part of the power system and presents results for the contribution of plug-in electric vehicles to balance the fluctuating electricity generation of renewable energy sources. The scientific contribution includes: - A novel approach to characterizing fluctuating generation. This allows the detailed comparison of results from energy analysis and is the basis to describe the effect of electricity from renewable energy sources and plug-in electric vehicles on the power system. - The characterization of mobile storage, which includes the description of mobility behavior using probabilities and battery discharging costs. - The introduction of an agent-based simulation approach, coupling energy markets and distributed grids using a price-based mechanism design. - The description of an agent with specific driving behavior, battery discharging costs and optimization algorithm suitable for real plug-in vehicles and simulation models. - A case study for a 2030 scenario describing the contribution of plug-in electric vehicles to balance generation from renewable energy sources in California and Germany.

  1. Damage Tolerance Assessment of Friction Pull Plug Welds

    Science.gov (United States)

    McGill, Preston; Burkholder, Jonathan

    2012-01-01

    Friction stir welding is a solid state welding process developed and patented by The Welding Institute in Cambridge, England. Friction stir welding has been implemented in the aerospace industry in the fabrication of longitudinal welds in pressurized cryogenic propellant tanks. As the industry looks to implement friction stir welding in circumferential welds in pressurized cryogenic propellant tanks, techniques to close out the termination hole associated with retracting the pin tool are being evaluated. Friction pull plug welding is under development as a one means of closing out the termination hole. A friction pull plug weld placed in a friction stir weld results in a non-homogenous weld joint where the initial weld, plug weld, their respective heat affected zones and the base metal all interact. The welded joint is a composite, plastically deformed material system with a complex residual stress field. In order to address damage tolerance concerns associated with friction plug welds in safety critical structures, such as propellant tanks, nondestructive inspection and proof testing may be required to screen hardware for mission critical defects. The efficacy of the nondestructive evaluation or the proof test is based on an assessment of the critical flaw size in the test or service environments. Test data relating residual strength capability to flaw size in two aluminum alloy friction plug weld configurations is presented.

  2. Squamous cell carcinoma of the anal sacs in three dogs.

    Science.gov (United States)

    Mellett, S; Verganti, S; Murphy, S; Bowlt, K

    2015-03-01

    Anal sac squamous cell carcinoma is rare in dogs. Five cases have been previously reported, treatment of which involved surgery alone. This report describes three further cases of canine anal sac squamous cell carcinoma which underwent medical (meloxicam) management alone, resulting in survival of up to seven months. No metastases were identified. Squamous cell carcinoma, although extremely uncommon, should be considered as a possible differential diagnosis when a dog is presented for investigation of an anal sac mass.

  3. Anal intraepithelial neoplasia: A review of diagnosis and management.

    Science.gov (United States)

    Roberts, Joseph R; Siekas, Lacey L; Kaz, Andrew M

    2017-02-15

    Anal intraepithelial neoplasia (AIN) is a premalignant lesion of the anal mucosa that is a precursor to anal cancer. Although anal cancer is relatively uncommon, rates of this malignancy are steadily rising in the United States, and among certain high risk populations the incidence of anal cancer may exceed that of colon cancer. Risk factors for AIN and anal cancer consist of clinical factors and behaviors that are associated with the acquisition and persistence of human papilloma virus (HPV) infection. The strongest HPV-associated risk factors are HIV infection, receptive anal intercourse, and high risk sexual behavior. A history of HPV-mediated genital cancer, which suggests infection with an oncogenic HPV strain, is another risk factor for AIN/anal cancer. Because progression of AIN to anal cancer is known to occur in some individuals over several years, screening for AIN and early anal cancer, as well as treatment of advanced AIN lesions, is reasonable in certain high-risk populations. Although randomized controlled trials evaluating screening and treatment outcomes are lacking, experts support routine screening for AIN in high risk populations. Screening is performed using anal cytological exams, similar to those performed in cervical cancer screening programs, along with direct tissue evaluation and biopsy via high resolution anoscopy. AIN can be treated using topical therapies such as imiquimod, 5-flurouracil, and trichloroacetic acid, as well as ablative therapies such as electrocautery and laser therapy. Reductions in AIN and anal cancer rates have been shown in studies where high-risk populations were vaccinated against the oncogenic strains of HPV. Currently, the CDC recommends both high-risk and average-risk populations be vaccinated against HPV infection using the quadrivalent or nonavalent vaccines. It is important for clinicians to be familiar with AIN and the role of HPV vaccination, particularly in high risk populations.

  4. Update on anal fistulae: Surgical perspectives for the gastroenterologist

    OpenAIRE

    Helena Tabry; Farrands, Paul A

    2011-01-01

    Anal fistulae are common and debilitating; they are characterized by severe pain and discharge. They arise following infection near the anal canal, or as a primary event from an abscess in the abdomen, fistulating into the vagina or perianal skin. The term ‘cryptoglandular’ is given to abscesses arising from the anal glands.For many years, the treatment of choice was to lay open the fistula; however, this risks causing incontinence with potentially devastating consequences. Alternative surgic...

  5. Anal intraepithelial neoplasia: A review of diagnosis and management

    Science.gov (United States)

    Roberts, Joseph R; Siekas, Lacey L; Kaz, Andrew M

    2017-01-01

    Anal intraepithelial neoplasia (AIN) is a premalignant lesion of the anal mucosa that is a precursor to anal cancer. Although anal cancer is relatively uncommon, rates of this malignancy are steadily rising in the United States, and among certain high risk populations the incidence of anal cancer may exceed that of colon cancer. Risk factors for AIN and anal cancer consist of clinical factors and behaviors that are associated with the acquisition and persistence of human papilloma virus (HPV) infection. The strongest HPV-associated risk factors are HIV infection, receptive anal intercourse, and high risk sexual behavior. A history of HPV-mediated genital cancer, which suggests infection with an oncogenic HPV strain, is another risk factor for AIN/anal cancer. Because progression of AIN to anal cancer is known to occur in some individuals over several years, screening for AIN and early anal cancer, as well as treatment of advanced AIN lesions, is reasonable in certain high-risk populations. Although randomized controlled trials evaluating screening and treatment outcomes are lacking, experts support routine screening for AIN in high risk populations. Screening is performed using anal cytological exams, similar to those performed in cervical cancer screening programs, along with direct tissue evaluation and biopsy via high resolution anoscopy. AIN can be treated using topical therapies such as imiquimod, 5-flurouracil, and trichloroacetic acid, as well as ablative therapies such as electrocautery and laser therapy. Reductions in AIN and anal cancer rates have been shown in studies where high-risk populations were vaccinated against the oncogenic strains of HPV. Currently, the CDC recommends both high-risk and average-risk populations be vaccinated against HPV infection using the quadrivalent or nonavalent vaccines. It is important for clinicians to be familiar with AIN and the role of HPV vaccination, particularly in high risk populations. PMID:28255426

  6. De mundejarismo de los Anales Toledanos Segundos

    Directory of Open Access Journals (Sweden)

    Felipe MAÍLLO SALGADO

    2009-12-01

    Full Text Available Como es sabido los Anales Toledanos (Primeros, Segundos y Terceros, compuestos en su mayor parte durante el siglo XIII en distintos momentos y por diferentes manos, son piezas importantes de la historiografía medieval hispánica, tanto por recoger gran cantidad de noticias —por más que éstas sean escuetas— cuanto por estar todas ellas rigurosamente fechadas; de ahí que sean de gran utilidad para el historiador.De estos tres anales, los Segundos (A.T.II tienen unas peculiaridades que los distinguen fuertemente de los otros; sin embargo, en una primera hojeada el lector poco avisado vería que, por su aspecto formal, nada difieren de otros escritos del mismo género, un género éste cuya condición esencial radica en la consignación del evento fechado, esto es, se presenta en párrafos que comienzan o terminan —como es aquí el caso— con una fecha determinada. Nuestro imaginario lector, por otra parte, se encontraría con las peladas noticias típicas del género analístico, a saber: una serie de referencias que dan cuenta de fenómenos naturales (como son las sequías prolongadas o las excesivas lluvias, las heladas intempestivas, los terremotos, los eclipses..., que informan de las épocas de hambre o carestía, de los precios de los artículos, de prodigios, de acontecimientos locales, etc.; el todo amalgamado con noticias de carácter político-militar.

  7. Psychological stress in patients with anal fistula.

    Science.gov (United States)

    Cioli, V M; Gagliardi, G; Pescatori, M

    2015-08-01

    Psychological stress is known to affect the immunologic system and the inflammatory response. The aim of this study was to assess the presence of psychological stress, anxiety, and depression in patients with anal fistula. Consecutive patients with anal fistula, hemorrhoids, and normal volunteers were studied prospectively. Stressful life events were recorded and subjects were asked to complete the state-trait anxiety inventory (STAI), a depression scale, and three different reactive graphic tests (RGT). Seventy-eight fistula patients, 73 patients with grade III-IV hemorrhoids, and 37 normal volunteers were enrolled. Of the fistula patients, 65 (83 %) reported one or more stressful events in the year prior to diagnosis, compared to 16 (22 %) of the hemorrhoid patients (P = 0.001). There were no significant differences in the percentage of subjects with abnormal trait anxiety (i.e., proneness for anxiety) and depression scores between fistula patients, hemorrhoid patients, and controls. Fistula patients had significantly higher (i.e., better) scores compared to hemorrhoid patients in two of three RGT and significantly lower (i.e., worse) scores in all three RGT compared to healthy volunteers. Of 37 patients followed up for a median of 28 months (range 19-41 months) after surgery, 8 (21.6 %) had persistent or recurrent sepsis. There was no significant difference in depression, STAI, and RGT scores between patients with sepsis and patients whose fistula healed. Our results suggest that an altered emotional state plays an important role in the pathogenesis of anal fistula and underline the importance of psychological screening in patients with anorectal disorders.

  8. Efficacy of LIFT for recurrent anal fistula.

    Science.gov (United States)

    Lehmann, J-P; Graf, W

    2013-05-01

    Ligation of the intersphincteric fistula tract (LIFT) is a novel sphincter-preserving technique for anal fistula. This pilot study was designed to evaluate the results in patients with a recurrent fistula. Seventeen patients [nine men; median age 49 (range, 30-76) years] with a recurrent trans-sphincteric fistula were treated with a LIFT procedure between June 2008 and February 2011. All were followed prospectively for a median of 16 (range, 5-27) weeks with clinical examination. Fifteen followed for 13.5 (range, 8-26) months by clinical examination also had three-dimensional (3D) anal ultrasound. The duration of the procedure was 35 (range, 18-70) min. One patient developed a small local haematoma and one had a subcutaneous infection, but otherwise there was no morbidity. At follow up, 11 (65%) patients had a successful closure, two (12%) had a remaining sinus and four (23%) had a persistent fistula. The incidence of persistent or recurrent fistulae at 13.5 months was six (40%) of 15 patients. No de novo faecal incontinence was reported. LIFT is a safe procedure for patients with recurrent anal fistula, with healing at short-term and medium-term follow-up comparable with or superior to that of other sphincter-preserving techniques. Larger studies with a longer follow up are needed to define the ultimate role of LIFT in patients with recurrence. © 2013 The Authors. Colorectal Disease © 2013 The Association of Coloproctology of Great Britain and Ireland.

  9. Comentarios sobre dibujo analítico

    OpenAIRE

    Mata Botella, Elena

    2004-01-01

    Cuaderno de apoyo a la docencia del DIBUJO DE ARQUITECTURA que pretende hacer reflexionar al alumno (de primero o segundo de carrera) sobre un tipo de dibujo que aquí se ha llamado “dibujo analítico”. Un dibujo que a través de operaciones gráficas y conceptuales como la esquematización y la selección de información, tiende a alejarse de la descripción del objeto arquitectónico para adentrarse en determinados aspectos o dimensiones que subyacen en el proyecto arquitectónico. Unas notas intr...

  10. Comentarios sobre dibujo analítico

    OpenAIRE

    Mata Botella, Elena

    2004-01-01

    Cuaderno de apoyo a la docencia del DIBUJO DE ARQUITECTURA que pretende hacer reflexionar al alumno (de primero o segundo de carrera) sobre un tipo de dibujo que aquí se ha llamado “dibujo analítico”. Un dibujo que a través de operaciones gráficas y conceptuales como la esquematización y la selección de información, tiende a alejarse de la descripción del objeto arquitectónico para adentrarse en determinados aspectos o dimensiones que subyacen en el proyecto arquitectónico. Unas notas intr...

  11. Treatment of non-IBD anal fistula

    DEFF Research Database (Denmark)

    Lundby, Lilli; Hagen, Kikke; Christensen, Peter;

    2015-01-01

    The course of the fistula tract in relation to the anal sphincter is identified by clinical examination under general anaesthesia using a fistula probe and injection of fluid into the external fistula opening. In the event of a complex fistula or in the case of fistula recurrence, this should...... be supplemented with an endoluminal ultrasound scan and/or an MRI scan. St. Mark's fistula chart should be used for the description. Simple fistulas are amenable to fistulotomy, whereas treatment of complex fistulas requires special expertise and management of all available treatment modalities to tailor...

  12. Treatment of non-IBD anal fistula

    DEFF Research Database (Denmark)

    Lundby, Lilli; Hagen, Kikke; Christensen, Peter

    2015-01-01

    be supplemented with an endoluminal ultrasound scan and/or an MRI scan. St. Mark's fistula chart should be used for the description. Simple fistulas are amenable to fistulotomy, whereas treatment of complex fistulas requires special expertise and management of all available treatment modalities to tailor......The course of the fistula tract in relation to the anal sphincter is identified by clinical examination under general anaesthesia using a fistula probe and injection of fluid into the external fistula opening. In the event of a complex fistula or in the case of fistula recurrence, this should...

  13. [The anal fistula disease and abscess].

    Science.gov (United States)

    Strittmatter, Bernhard

    2004-01-01

    There are two forms of anal fistulas arising from its pathogenesis: the acute stage is the abscess, whereas the chronic stage is the fistula in ano. The classification of the fistula in ano is named after Parks. Pathogenesis and classification are explained. For complete cure, every abscess needs precise examination to be able to show the course and shape of the fistula. The surgical procedure depends on the fistula tract. Most fistulas can be operated by means of a fistulotomy or fistulectomy. Recovery depends on locating the total fistula tract.

  14. Interaction of clay and concrete plugs - Plugging of 5 m deep hole KA1621G01 at Aespoe

    Energy Technology Data Exchange (ETDEWEB)

    Pusch, Roland [Drawrite AB, Lund (Sweden); Luleaa Technical Univ., Luleaa (Sweden); Ramqvist, Gunnar [Eltekno AB, Figeholm (Sweden)

    2011-11-15

    Sealing of deep boreholes in repository rock is planned to be made by installing dense smectite clay plugs where the rock is low-permeable and casting concrete where the holes intersect water-bearing fracture zones. Such zones have to be stabilized before sealing starts because fragments of rock can otherwise fall off and make it difficult to bring equipment for concrete casting and clay plug units down. These parts of the holes are filled with concrete and clay plugs are then inserted up to the nearest fracture zone where concrete is filled to the required level etc. The role of the concrete in the hole and in the closest part of the surrounding fracture zone is to provide stable parts that are sufficiently fine-porous to prevent clay particles from contacting clay plugs to migrate into the fractures and be lost by erosion. While the larger parts of long clay plugs are believed to stay largely intact chemically for hundreds of thousands of years, the parts adjacent to concrete plugs may undergo changes and so can the concrete plugs themselves. The objective of the presently reported project was to identify the detailed processes and quantify associated changes in physical properties by investigating samples of clay and concrete from a 2.5 m long plug of clay over which an equally long concrete plug had been cast and left to rest for 3 years. The outcome of the investigations was that significant chemically induced changes in mineralogy and physical performance had occurred within a few centimetres distance from the clay/concrete contact but that virtually no changes had taken place at larger distance. A comprehensive laboratory study including X-ray diffraction (XRD), X-ray fluorescence (XRF) and electron microscopy study (SEM and TEM) on the sample material was performed including also dual beam (combined ion and electron) microscopy. It was found that the clay had infiltrated the contacting concrete plug after filling of the borehole since clay was detected both

  15. Flexible Plug Repair for Shuttle Wing Leading Edge

    Science.gov (United States)

    Camarda, Charles J.; Sikora, Joseph; Smith, Russel; Rivers, H.; Scotti, Stephen J.; Fuller, Alan M.; Klacka, Robert; Reinders, Martin; Schwind, Francis; Sullivan, Brian; hide

    2012-01-01

    In response to the Columbia Accident Investigation Board report, a plug repair kit has been developed to enable astronauts to repair the space shuttle's wing leading edge (WLE) during orbit. The plug repair kit consists of several 17.78- cm-diameter carbon/silicon carbide (C/SiC) cover plates of various curvatures that can be attached to the refractory carbon-carbon WLE panels using a TZM refractory metal attach mechanism. The attach mechanism is inserted through the damage in the WLE panel and, as it is tightened, the cover plate flexes to conform to the curvature of the WLE panel within 0.050 mm. An astronaut installs the repair during an extravehicular activity (EVA). After installing the plug repair, edge gaps are checked and the perimeter of the repair is sealed using a proprietary material, developed to fill cracks and small holes in the WLE.

  16. Susceptibility-matched plugs for microcoil NMR probes

    Science.gov (United States)

    Kc, Ravi; Gowda, Yashas N.; Djukovic, Danijel; Henry, Ian D.; Park, Gregory H. J.; Raftery, Daniel

    2010-07-01

    For mass-limited samples, the residual sample volume outside the detection coil is an important concern, as is good base line resolution. Here, we present the construction and evaluation of magnetic susceptibility-matched plugs for microcoil NMR sample cells which address these issues. Mixed-epoxy glue and ultem tube plugs that have susceptibility values close to those of perfluorocarbon FC-43 (fluorinert) and copper were used in small volume (0.5-2 μL) and larger volume (15-20 μL) thin glass capillary sample cells. Using these plugs, the sample volume efficiency (i.e. ratio of active volume to total sample volume in the microcoil NMR cell) was improved by 6-12-fold without sensitivity and resolution trade-offs. Comparison with laser etched or heat etched microcoil sample cells is provided. The approaches described are potentially useful in metabolomics for biomarkers detection in mass limited biological samples.

  17. Reliability assessment of reserved water disposal with erodible fuse plug

    Directory of Open Access Journals (Sweden)

    Kosichenko Yuriy Mikhaylovich

    Full Text Available Water disposal constructions are one of the most responsible constructions of reservoir hydrosystem, that’s why the a lot of attention was always paid to the problems of estimating and providing their reliability and safety. The most important function of such objects is providing reliability and safety of other hydraulic constructions and economic assets in afterbay and water head. The authors offer estimation method for reliability and faultless performance of reserved water disposal with erodible fuse plug on low-head water development. In order to estimate the reliability of reserved water disposal with erodible fuse plug the Bayesian treatment was used. The calculation of diagnoses (states of reserved water disposal isoffered in case of diagnostic properties k 1 and k 2. One of the main demands placed onreserved water disposals is erosion of soil plug in case of flood discharge exeedance over the estimated frequency with the full opening of the waste sluice.

  18. Susceptibility-matched plugs for microcoil NMR probes.

    Science.gov (United States)

    Kc, Ravi; Gowda, Yashas N; Djukovic, Danijel; Henry, Ian D; Park, Gregory H J; Raftery, Daniel

    2010-07-01

    For mass-limited samples, the residual sample volume outside the detection coil is an important concern, as is good base line resolution. Here, we present the construction and evaluation of magnetic susceptibility-matched plugs for microcoil NMR sample cells which address these issues. Mixed-epoxy glue and ultem tube plugs that have susceptibility values close to those of perfluorocarbon FC-43 (fluorinert) and copper were used in small volume (0.5-2 microL) and larger volume (15-20 microL) thin glass capillary sample cells. Using these plugs, the sample volume efficiency (i.e. ratio of active volume to total sample volume in the microcoil NMR cell) was improved by 6-12-fold without sensitivity and resolution trade-offs. Comparison with laser etched or heat etched microcoil sample cells is provided. The approaches described are potentially useful in metabolomics for biomarkers detection in mass limited biological samples.

  19. Eddy Current Minimizing Flow Plug for Use in Flow Conditioning and Flow Metering

    Science.gov (United States)

    England, John Dwight (Inventor); Kelley, Anthony R. (Inventor)

    2015-01-01

    An eddy-current-minimizing flow plug has open flow channels formed between the plug's inlet and outlet. Each open flow channel includes (i) a first portion that originates at the inlet face and converges to a location within the plug that is downstream of the inlet, and (ii) a second portion that originates within the plug and diverges to the outlet. The diverging second portion is approximately twice the length of the converging first portion. The plug is devoid of planar surface regions at its inlet and outlet, and in fluid flow planes of the plug that are perpendicular to the given direction of a fluid flowing therethrough.

  20. Condyloma Acuminatum, Anal Intraepithelial Neoplasia, and Anal Cancer in the Setting of HIV: Do We Really Understand the Risk?

    Science.gov (United States)

    Fazendin, Edward A; Crean, Alexander J; Fazendin, Jessica M; Kucejko, Robert J; Gill, Harkenwar S; Poggio, Juan L; Stein, David E

    2017-10-01

    The gold standard for surveillance of patients with anal lesions is unclear. The aim of this study was to stratify patients for risk of progression of disease and to determine appropriate intervals for surveillance of patients with anal disease. This was a retrospective chart review for patients treated for anal lesions between 2007 and 2014. Only patients with ≥1 year of follow-up from index evaluation, pathology, documented physical examination, and anoscopy findings were included for analysis. The study was conducted at an urban university hospital. HIV-positive patients with anal lesions treated with excision and fulguration were included. Recurrence of anal lesions, progression of disease, and progression to cancer were measured. Ninety-one patients met inclusion criteria. The mean age was 41.6 years, and mean follow-up was 38.6 months (range, 11.0-106.0 mo). On initial pathology, 8 patients (8.8%) had a diagnosis of condyloma acuminatum without dysplasia, 20 patients (22%) had anal intraepithelial neoplasia I, 32 (35.2%) had anal intraepithelial neoplasia II, and 31 (34.1%) had anal intraepithelial neoplasia III. Sixty-nine patients (75.8%) had repeat procedures. Seven (87.5%) of 8 patients with condyloma and 6 (30%) of 20 patients with anal intraepithelial neoplasia I progressed to high-grade lesions. Five (15.6%) of 32 patients progressed from anal intraepithelial neoplasia II to III, and 2 patients with anal intraepithelial neoplasia III (6.5%) developed squamous cell carcinoma (2.3% for the entire cohort). This was a single institution study. High-resolution anoscopy was not used. All of the HIV-positive patients with condyloma or anal intraepithelial neoplasia, regardless of the presence of dysplasia, should be surveyed at equivalent 3-month time intervals, because their risk of progression of disease is high. Video Abstract at http://links.lww.com/DCR/A389.

  1. Varying nanoparticle pseudostationary phase plug length during capillary electrophoresis†

    Science.gov (United States)

    Subramaniam, Varuni; Griffith, Lindsay; Haes, Amanda J.

    2016-01-01

    Capillary electrophoresis based separations of the hypothesized Parkinson’s disease biomarkers dopamine, epinephrine, pyrocatechol, L-3,4-dihydroxyphenylalanine (L-DOPA), glutathione, and uric acid are performed in the presence of a 1 nM 11-mercaptoundecanoic acid functionalized gold (Au@MUA) nanoparticle pseudostationary phase plug. Au@MUA nanoparticles are monitored in the capillary and remain stable in the presence of electrically-driven flow. Migration times, peak areas, and relative velocity changes (vs. no pseudostationary) are monitored upon varying (1) the Au@MUA nanoparticle pseudostationary phase plug length at a fixed separation voltage and (2) the separation voltage for a fixed Au@MUA nanoparticle pseudostationary phase plug length. For instance, the migration times of positively charged dopamine and epinephrine increase slightly as the nanoparticle pseudostationary phase plug length increases with concomitant decreases in peak areas and relative velocities as a result of attractive forces between the positively charged analytes and the negatively charged nanoparticles. Migration times for neutral pyrocatechol and slightly negative L-DOPA did not exhibit significant changes with increasing nanoparticle pseudostationary plug length; however, reduction in peak areas for these two molecules were evident and attributed to non-specific interactions (i.e. hydrogen bonding and van der Waals interactions) between the biomarkers and nanoparticles. Moreover, negatively charged uric acid and glutathione displayed progressively decreasing migration times and peak areas and as a result, increased relative velocities with increasing nanoparticle pseudostationary phase plug length. These trends are attributed to partitioning and exchanging with 11-mercaptoundecanoic acid on nanoparticle surfaces for uric acid and glutathione, respectively. Similar trends are observed when the separation voltage decreased thereby suggesting that nanoparticle-biomarker interaction

  2. Plug and Play PV Systems for American Homes

    Energy Technology Data Exchange (ETDEWEB)

    Hoepfner, Christian [Fraunhofer USA, Inc., Boston, MA (United States)

    2016-12-22

    The core objectives of the Plug & Play PV Systems Project were to develop a PV system that can be installed on a residential rooftop for less than $1.50/W in 2020, and in less than 10 hours (from point of purchase to commissioning). The Fraunhofer CSE team’s approach to this challenge involved a holistic approach to system design – hardware and software – that make Plug & Play PV systems: • Quick, easy, and safe to install • Easy to demonstrate as code compliant • Permitted, inspected, and interconnected via an electronic process Throughout the three years of work during this Department of Energy SunShot funded project, the team engaged in a substantive way with inspectional services departments and utilities, manufacturers, installers, and distributors. We received iterative feedback on the system design and on ideas for how such systems can be commercialized. This ultimately led us to conceiving of Plug & Play PV Systems as a framework, with a variety of components compatible with the Plug & Play PV approach, including string or microinverters, conventional modules or emerging lightweight modules. The framework enables a broad group of manufacturers to participate in taking Plug & Play PV Systems to market, and increases the market size for such systems. Key aspects of the development effort centered on the system hardware and associated engineering work, the development of a Plug & Play PV Server to enable the electronic permitting, inspection and interconnection process, understanding the details of code compliance and, on occasion, supporting applications for modifications to the code to allow lightweight modules, for example. We have published a number of papers on our testing and assessment of novel technologies (e.g., adhered lightweight modules) and on the electronic architecture.

  3. Versatile Friction Stir Welding/Friction Plug Welding System

    Science.gov (United States)

    Carter, Robert

    2006-01-01

    A proposed system of tooling, machinery, and control equipment would be capable of performing any of several friction stir welding (FSW) and friction plug welding (FPW) operations. These operations would include the following: Basic FSW; FSW with automated manipulation of the length of the pin tool in real time [the so-called auto-adjustable pin-tool (APT) capability]; Self-reacting FSW (SRFSW); SR-FSW with APT capability and/or real-time adjustment of the distance between the front and back shoulders; and Friction plug welding (FPW) [more specifically, friction push plug welding] or friction pull plug welding (FPPW) to close out the keyhole of, or to repair, an FSW or SR-FSW weld. Prior FSW and FPW systems have been capable of performing one or two of these operations, but none has thus far been capable of performing all of them. The proposed system would include a common tool that would have APT capability for both basic FSW and SR-FSW. Such a tool was described in Tool for Two Types of Friction Stir Welding (MFS- 31647-1), NASA Tech Briefs, Vol. 30, No. 10 (October 2006), page 70. Going beyond what was reported in the cited previous article, the common tool could be used in conjunction with a plug welding head to perform FPW or FPPW. Alternatively, the plug welding head could be integrated, along with the common tool, into a FSW head that would be capable of all of the aforementioned FSW and FPW operations. Any FSW or FPW operation could be performed under any combination of position and/or force control.

  4. Warning: safety risk with some Apple AC Wall Plug Adapters

    CERN Multimedia

    CERN IT department

    2016-01-01

    Dear Mac and iOS Users, Apple has determined that some of its two prong Apple AC wall plug adapters may break and create a risk of electrical shock.   CERN users can now exchange their affected Apple wall plug adapters at the Service Desk. To find out if your adapter is affected and for any further information concerning the procedure to follow to exchange it, please check the following URL: https://cern.service-now.com/service-portal/view-outage.do?n=OTG0028639.

  5. Implantation of the AMPLATZER™ Cardiac Plug: tips and tricks.

    Science.gov (United States)

    Park, Jai-Wun

    2013-03-01

    The AMPLATZER™ Cardiac Plug device is designed for percutaneous occlusion of the left atrial appendage (LAA) for stroke prophylaxis in patients with atrial fibrillation (AF) who are contraindicated or intolerant to oral anticoagulation. While updated guidelines start to refer to this therapy (Camm A, Eur Heart J, doi:10.1093/eurheartj/ehs253, 2012) and operators gain experience with this relatively new technique, continuing efforts are focused on maximizing the safety of the implantation procedure. This paper is aimed at explaining and illustrating the distinct steps and specific considerations related to the implantation of the AMPLATZER™ Cardiac Plug.

  6. Benign anal lesions, inflammatory bowel disease and risk for high-risk human papillomavirus-positive and -negative anal carcinoma.

    OpenAIRE

    Frisch, M; Glimelius, B; van den Brule, A. J.; Wohlfahrt, J; Meijer, C. J.; Walboomers, J M; Adami, H. O.; Melbye, M.

    1998-01-01

    A central role in anal carcinogenesis of high-risk types of human papillomaviruses (hrHPV) was recently established, but the possible role of benign anal lesions has not been addressed in hrHPV-positive and -negative anal cancers. As part of a population-based case-control study in Denmark and Sweden, we interviewed 417 case patients (93 men and 324 women) diagnosed during the period 1991-94 with invasive or in situ anal cancer, 534 patients with adenocarcinoma of the rectum and 554 populatio...

  7. Elektromagnetická analýza

    OpenAIRE

    Kolofík, Josef

    2012-01-01

    Tato práce se zabývá problematikou elektromagnetické analýzy a aplikací elektromagnetického postranního kanálu. První a druhá část práce popisují základy kryptografie, funkci kryptografického modulu a útoky vedené postranními kanály. Třetí část práce rozebírá možnosti elektromagnetické analýzy, konstrukci sondy, popis laboratorního pracoviště, elektromagnetickou emisi PIC16F84A, algoritmus AES a přípravu na laboratorní měření. Čtvrtá část práce popisuje konkrétní laboratorní měření a extrakci...

  8. Management of anal squamous intraepithelial lesions.

    Science.gov (United States)

    Pineda, Carlos E; Welton, Mark L

    2009-05-01

    Anal squamous intraepithelial lesions include both low-grade squamous intraepithelial lesions (LSIL) and high-grade squamous intraepithelial lesions (HSIL) and are caused by chronic infection with the human papillomavirus (HPV). The disease is increasing in both incidence and prevalence, especially among patients with the following risk factors: homosexual men, acquired or iatrogenic immunosuppression, and presence of other HPV-related diseases. Although the natural history of the disease is unknown, there is significant evidence that untreated HSIL progresses to squamous cell carcinoma in 11% of patients and in up to 50% of patients with extensive disease and immunosuppression. Anal cytology and reflex HPV DNA testing are used to screen for disease, particularly among patients with the aforementioned risk factors. Evaluation of the patient should include physical examination and high-resolution anoscopy (HRA) to evaluate for disease above and below the dentate line. Intervention is warranted and this can be achieved in many ways. The treatment option associated with the best outcomes is ablation directed with HRA, which can be performed in the office or in the operating room with minimal morbidity. This strategy is effective in patients with both low-volume and high-volume disease and is associated with a malignant progression rate of 0.4% in patients with treated HSIL.

  9. PLUG: A FORTRAN program for the analysis of PLUG flow reactors with gas-phase and surface chemistry

    Energy Technology Data Exchange (ETDEWEB)

    Larson, R.S.

    1996-01-01

    This manual describes the structure and usage of the computer program PLUG, which simulates the behavior of plug flow chemical reactors. More specifically, the code is designed to model the non-dispersive one-dimensional flow of a chemically reacting ideal gas mixture in a conduit of essentially arbitrary geometry. The code makes use of the CHEMKIN and SURFACE CHEMKIN software packages to handle gas-phase and heterogeneous kinetics as well as thermodynamic properties. In addition, the standard implicit code DASSL is used to solve the set of differential/algebraic equations describing the reactor. These equations are briefly discussed here, after which the procedures for running PLUG are described in some detail. Input and output files for a sample problem involving chemical vapor deposition are given.

  10. Fiber types in the striated urethral and anal sphincters

    DEFF Research Database (Denmark)

    Schrøder, H D; Reske-Nielsen, E

    1983-01-01

    Seven normal human striated urethral and anal sphincters obtained by autopsy were examined using histochemical techniques. In both the urethral sphincter and the subcutaneous (s.c.) and superficial part of the anal sphincter a characteristic pattern with two populations of muscle fibers, abundant...... contractions and to react in stress conditions with fast increase in tension....

  11. Sotsiaalvõrgustike analüüs / Innar Liiv

    Index Scriptorium Estoniae

    Liiv, Innar, 1982-

    2005-01-01

    Sotsiaalvõrgustike analüüs (social network analys - SNA) on tehnikate, meetodite ning vahendite kogum, mis aitab avastada mustreid sotsiaalsetes struktuurides. Analüüsi kasutamisest energeetikaettevõtte Enron ja kohalike ettevõtete võrgustike näitel. Skeemid

  12. Knowledge and Acceptability of Anal Cytology Screening Among Women.

    Science.gov (United States)

    Blankenship, Stephanie A; Debnath, Priyanka; Szlachta-McGinn, Alec W; Maguire, Karla; Garcia, Jorge J; Aserlind, Alexandra; Lipshultz, Emma; Potter, JoNell E

    2016-01-01

    Medical providers have initiated anal cytology screening among women to detect anal neoplasia early. Lack of knowledge of the human papillomavirus (HPV) and anticipated screening discomfort may limit patient acceptance. This study investigates attitudes toward anal cytology screening among women. Women seen for gynecologic care at an urban university medical center were invited to complete an anonymous survey assessing their understanding of HPV and interest in anal cytology screening. Subjects reported the level of pain, discomfort, and embarrassment they expected from screening on a 100-mm visual analog scale. Four hundred four women with mean (SD) age 36 (13) years met criteria for participation. Three hundred thirty-five women reported their race: 52% were white and 36% were African American. Three hundred forty-eight women reported their ethnicities: 76% were Hispanic and 12% were Haitian. Twenty-two percent had never heard of HPV, 57% were not familiar with anal cytology screening, 67% acknowledged that screening was very helpful in detecting anal neoplasia early, and 28% were very interested in undergoing screening. Mean (SD) level of anticipated pain, discomfort, and embarrassment during screening was 62 (32), 68 (30), and 58 (34) mm, respectively. Level of familiarity with anal cytology screening (p cytology screening among at-risk women to familiarize them with the procedure, describe its role in detecting anal neoplasia, and address expectations surrounding pain to increase its acceptability.

  13. Survey of anal sphincter dysfunction using anal manometry in patients with fecal incontinence: a possible guide to therapy

    Science.gov (United States)

    Mandaliya, Rohan; DiMarino, Anthony J.; Moleski, Stephanie; Rattan, Satish; Cohen, Sidney

    2015-01-01

    Background Despite the surge of new medical and surgical approaches to treat fecal incontinence, the types of sphincter abnormalities in patients with incontinence have not been well characterized. We aimed to categorize anal sphincter dysfunction using anorectal manometry in patients with fecal incontinence as a potential guide for improved treatment. Methods A retrospective review of 162 consecutive patients with fecal incontinence referred for anorectal manometry was performed. Resting anal pressure and maximal squeeze pressure were considered as measures of internal anal sphincter and external anal sphincter function respectively. Results Mean age of the patients was 63 years (13-89); females (81.5%) and males (18.5%). 74% of the patients had sphincter dysfunction on anorectal manometry. Internal anal sphincter dysfunction was present in 62% patients vs. external anal sphincter dysfunction present in 44% patients. 80% females had abnormal manometry vs. 44% in males (P<0.0001). Internal anal sphincter dysfunction was present in 68% females vs. 37% in males (P=0.0026). Conclusions Overall, abnormal anorectal manometry studies revealed that internal anal sphincter dysfunction is the most common finding, alone or in combination with external anal sphincter dysfunction. We suggest that anorectal manometry may be important to delineate anal sphincter function prior to using newer therapeutic mechanical devices. Future studies using pharmacological agents to increase internal anal sphincter tone may be of clinical importance. Finally, the classification of fecal incontinence based on the type of sphincter dysfunction may be an improved guide in the selection of newer agents in treating fecal incontinence. PMID:26423466

  14. Plug-In Electric Vehicle Handbook for Fleet Managers (Brochure)

    Energy Technology Data Exchange (ETDEWEB)

    2012-04-01

    Plug-in electric vehicles (PEVs) are entering the automobile market and are viable alternatives to conventional vehicles. This guide for fleet managers describes the basics of PEV technology, PEV benefits for fleets, how to select the right PEV, charging a PEV, and PEV maintenance.

  15. PIXASTIC: STEGANOGRAPHY BASED ANTI-PHISHING BROWSER PLUG-IN

    Directory of Open Access Journals (Sweden)

    P.Thiyagarajan

    2012-04-01

    Full Text Available In spite of existence of many standard security mechanisms for ensuring secure e- Commerce business, users still fall prey for onlin e attacks. One such simple but powerful attack is ‘Phishing’. Phishing is the most alarming threat in the e-Commerce world and effective anti-phishing technique is the need of the hour. This paper focuses on a novel anti-phishing browser plug-in which uses information hiding technique - Steganography. A Robust Message based Image Steganography (RMIS algorithm has been proposed. The same has been incorporated in the form of a browser plug-in (safari called Pixastic. Pixastic is tested in an online banking scenario and it is compared with other well-known anti-phishing plug-in methods in practice. Various parameters such as robustness, usability and its behavior on various attacks have been analysed. From experimental results, it is ev ident that our method Pixastic performs well compared to other anti-phishing plug-ins.

  16. Nuclear determination of saturation profiles in core plugs. Status report

    Energy Technology Data Exchange (ETDEWEB)

    Sletsgaard, J. [DTU, Inst. for Automation (Denmark)

    1996-01-01

    A method to determine liquid saturations in core plugs during flooding is of importance when the relative permeability and capillary pressure function are to be determined. This part of the EFP-93 project uses transmission of {gamma}-radiation to determine these saturations. In {gamma}-transmission measurements, the electron density of the given substance is measured. This is an advantage as compared to methods that use electric conductivity, since neither oil nor gas conducts electricity. At the moment a single {sup 137}Cs-source is used, but a theoretical investigation of whether it is possible to determine three saturations, using two radioactive sources with different {gamma}-energies, has been performed. Measurements were made on three core plugs. To make sure that the measurements could be reproduced, all the plugs had a point of reference, i.e. a mark so that it was possible to place the plug same way every time. Two computer programs for calculation of saturation and porosity and the experimental setup are listed. (EG).

  17. Plug-In Electric Vehicle Handbook for Consumers (Brochure)

    Energy Technology Data Exchange (ETDEWEB)

    2011-09-01

    Plug-in electric vehicles (PEVs) are entering the automobile market and are viable alternatives to conventional vehicles. This guide for consumers describes the basics of PEV technology, PEV benefits, how to select the right PEV, charging a PEV, and PEV maintenance.

  18. A Rotating Plug Model of Friction Stir Welding Heat Transfer

    Science.gov (United States)

    Raghulapadu J. K.; Peddieson, J.; Buchanan, G. R.; Nunes, A. C.

    2006-01-01

    A simplified rotating plug model is employed to study the heat transfer phenomena associated with the fiction stir welding process. An approximate analytical solution is obtained based on this idealized model and used both to demonstrate the qualitative influence of process parameters on predictions and to estimate temperatures produced in typical fiction stir welding situations.

  19. Occlusion of pulmonary arteriovenous malformations by use of vascular plug

    DEFF Research Database (Denmark)

    Andersen, P E; Kjeldsen, A D

    2007-01-01

    Pulmonary arteriovenous malformations are commonly treated by embolization with coils or balloons to prevent cerebral complications and to raise the oxygenation of the blood. The Amplatzer vascular plug is a new occlusive device made of a self-expanding cylindrical nitinol mesh. It is fast and safe...

  20. Anal metastasis originating from colorectal cancer: Report of two cases

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jae Min; Lim, Joon Seok; Choi, Jin Young; Park, Mi Suk; Kim, Myeong Jin [Dept. of Radiology and Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul (Korea, Republic of); Chung, Taek; Kim, Ho Guen [Dept. of Pathology, Severance Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2016-12-15

    Anal metastasis from colorectal cancer rarely occurs, but it severely impairs the patient's quality of life, often requiring wide resection including the anal sphincter with permanent colostomy. This lesion can be misdiagnosed as a perianal fistula or an abscess, and it can be overlooked at the time of surgery because it is not included in the routine surgical extent of low anterior resection. We report two rare cases of anal metastasis from colorectal cancer. In both cases, perianal nodules with an internal solid portion were detected on preoperative rectal magnetic resonance imaging and additional local excisions of the anal lesions were performed during the process of treatment. Anal metastasis was pathologically confirmed by histology and immunohistochemical staining.

  1. Risk factors for anal fistula: a case-control study.

    Science.gov (United States)

    Wang, D; Yang, G; Qiu, J; Song, Y; Wang, L; Gao, J; Wang, C

    2014-07-01

    The aim of our study was to identify potential risk factors for anal fistula in order to improve prevention and treatment of anal fistula. A retrospective case-control study for anal fistula was conducted at our unit. Logistic regression analyses were carried out to identify associated risk factors for anal fistula. The final model obtained by the stepwise forward logistic regression analysis method identified the following items as independent risk factors: body mass index of >25.0 kg/m(2), high daily salt intake, history of diabetes, hyperlipidemia, dermatosis, anorectal surgery, history of smoking and alcohol intake, sedentary lifestyle, excessive intake of spicy/greasy food, very infrequent participation in sports and prolonged sitting on the toilet for defecation. Our results indicate that lifestyle factors and certain medical conditions increase an individual's risk of developing anal fistula.

  2. Fiscal Year 1993 Well Plugging and Abandonment Program Summary Report Y-12 Plant, Oak Ridge, Tennessee

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1994-09-01

    This report is a synopsis of the progress of the well plugging and abandonment program at the Y-12 Plant, Oak Ridge, Tennessee, from October 1993 through August 1994. A total of 57 wells and borings were plugged and abandoned during the period of time covered in this report. All wells and borings were plugged and abandoned in accordance with the Monitoring Well Plugging and Abandonment Plan for the U.S. Department of Energy, Y-12 Plant, Oak Ridge, Tennessee.

  3. Fiscal year 1993 well plugging and abandonment program, Y-12 Plant, Oak Ridge, Tennessee

    Energy Technology Data Exchange (ETDEWEB)

    1993-09-01

    This report is a synopsis of the progress of the well plugging and abandonment program at the Y-12 Plant, Oak Ridge, Tennessee, from December 1992 through August 20, 1993. A total of 70 wells and borings were plugged and abandoned during the period of time covered in this report. All wells and borings were plugged and abandoned in accordance with the Monitoring Well Plugging and Abandonment Plan for the US Department of Energy, Y-12 Plant, Oak Ridge, Tennessee (HSW, Inc. 1991).

  4. Chronic anal fissure: new approaches to chemical sphincterotomy

    Directory of Open Access Journals (Sweden)

    Mohammad hassan Emami

    2008-06-01

    Full Text Available

    • An anal fissure is a split in the mucosa extending from the anal verge towards the dentate line. It currently affects 10% of patients attending proctology clinics. Recent studies have highlighted the role of increased internal anal sphincter pressure and decreased anodermal blood flow in the pathogenesis of chronic anal fissures. Acute fissures usually heal with conservative management. Fissures lasting greater than two months with features of chronicity, are unlikely to heal with conservative management. Lateral internal sphincterotomy has been the treatment of choice for chronic anal fissures. Because of the disability associated with surgery for healing anal fissure and the risk of incontinence, medical alternatives for surgery have been sought. Among different chemical agents, Glyceryl trinitrate (GTN has been shown to be the first line treatment for chronic anal fissure but the transient sphincteric relaxation effect of pharmacologic agents such as GTN, makes them less effective than surgery. Although we have different forms of GTN products, they do not show a long acting effect on relaxing and enhancing the perfusion of anal sphincter, because they are soon metabolized. Most difficulties with current usage of drugs are due to poor compliance of patients. It can be taken into consideration that new formulation and novel combination of GTN with other treatments, in slow releasing forms may lead to acceptable strategies in the management of chronic anal fissure. As authors’ experience in this field, other clinical trials on the drug combination and slow releasing formulations are warranted to generate new data on the subject.
    • Key word: chronic anal fissure, review, chemical sphincterotomy 

  5. Sumario analítico / Analytic Summary

    Directory of Open Access Journals (Sweden)

    José URRUTIKOETXEA LIZARRAGA

    2010-02-01

    Full Text Available Los estudios sobre demografía histórica en el marco de la historiografía vasca han experimentado algunos cambios notables en los últimos decenios. Hacer un balance de los mismos, por un lado, y profundizar en el análisis de espacios y de ámbitos hasta hace poco tiempo desconocidos o marginados en este territorio histórico, por otro, son los retos que se plantean en este artículo. Las herramientas analíticas y metodológicas empleadas permiten al autor concluir sobre el vigor y los déficits de la demografía histórica vasca, las líneas centrales de investigación y los nuevos temas de análisis.

  6. Treatment of non-IBD anal fistula.

    Science.gov (United States)

    Lundby, Lilli; Hagen, Kikke; Christensen, Peter; Buntzen, Steen; Thorlacius-Ussing, Ole; Andersen, Jens; Krupa, Marek; Qvist, Niels

    2015-05-01

    The course of the fistula tract in relation to the anal sphincter is identified by clinical examination under general anaesthesia using a fistula probe and injection of fluid into the external fistula opening. In the event of a complex fistula or in the case of fistula recurrence, this should be supplemented with an endoluminal ultrasound scan and/or an MRI scan. St. Mark's fistula chart should be used for the description. Simple fistulas are amenable to fistulotomy, whereas treatment of complex fistulas requires special expertise and management of all available treatment modalities to tailor the right operation to the individual patient. The given levels of evidence and grades of recommendations are according to the Oxford Centre for Evidence-based Medicine (www.cemb.net).

  7. Alternate tube plugging criteria for steam generator tubes

    Energy Technology Data Exchange (ETDEWEB)

    Cueto-Felgueroso, C.; Aparicio, C.B. [Tecnatom, S.A., Madrid (Spain)

    1997-02-01

    The tubing of the Steam Generators constitutes more than half of the reactor coolant pressure boundary. Specific requirements governing the maintenance of steam generator tubes integrity are set in Plant Technical Specifications and in Section XI of the ASME Boiler and Pressure Vessel Code. The operating experience of Steam Generator tubes of PWR plants has shown the existence of some types of degradatory processes. Every one of these has an specific cause and affects one or more zones of the tubes. In the case of Spanish Power Plants, and depending on the particular Plant considered, they should be mentioned the Primary Water Stress Corrosion Cracking (PWSCC) at the roll transition zone (RTZ), the Outside Diameter Stress Corrosion Cracking (ODSCC) at the Tube Support Plate (TSP) intersections and the fretting with the Anti-Vibration Bars (AVBs) or with the Support Plates in the preheater zone. The In-Service Inspections by Eddy Currents constitutes the standard method for assuring the SG tubes integrity and they permit the monitoring of the defects during the service life of the plant. When the degradation reaches a determined limit, called the plugging limit, the SG tube must be either repaired or retired from service by plugging. Customarily, the plugging limit is related to the depth of the defect. Such depth is typically 40% of the wall thickness of the tube and is applicable to any type of defect in the tube. In its origin, that limit was established for tubes thinned by wastage, which was the predominant degradation in the seventies. The application of this criterion for axial crack-like defects, as, for instance, those due to PWSCC in the roll transition zone, has lead to an excessive and unnecessary number of tubes being plugged. This has lead to the development of defect specific plugging criteria. Examples of the application of such criteria are discussed in the article.

  8. Polysaccharides and bacterial plugging. Final report, 1992--1993

    Energy Technology Data Exchange (ETDEWEB)

    Fogler, H.S.

    1995-02-01

    In situ core plugging experiments and transport experiments, using the model bacteria Leuconostoc m., have been conducted. Results demonstrated that cellular polysaccharide production increases cell distribution in porous media and caused an overall decrease in media permeability. Further, a parallel core plugging experiment was conducted and showed the feasibility of this system to divert injection fluid from high permeability zones into low permeability zones within porous media as is needed for profile modification. To implement this type of application, however, controlled placement of cells and rates of polymer production are needed. Therefore, kinetic studies were performed. A kinetic model was subsequently developed for Leuconostoc m. bacteria. This model is based on data generated from batch growth experiments and allows for the prediction of saccharide utilization, cell generation, and dextran production. These predictions can be used to develop injection strategies for field implementation. Transport and in situ growth micromodel experiments have shown how dextran allow cells to remain as clusters after cell division which enhanced cell capture and retention in porous media. Additional Damkohler experiments have been performed to determine the effects of the nutrient injection rate and nutrient concentration on the rate of porous media plugging. As shown experimentally and as predicted by a model for in situ growth, an increase in nutrient concentration and/or its injection rate will result in a faster rate of porous media plugging. Through continuum model simulations, it has been shown that the initial cell profiles play a key role on the core plugging rate. Controlling the location of the inoculating cells is thus another key factor in using bacteria for profile modification.

  9. Oscillation of an isolated liquid plug inside a dry capillary

    Science.gov (United States)

    Srinivasan, Vyas; Kumar, Siddhartha; Asfer, Mohammed; Khandekar, Sameer

    2017-06-01

    The present work reports an experimental study on the dynamics of partially wetting isolated liquid plug (DI water), which is made to oscillate inside a square, glass capillary tube (1 mm × 1 mm; 60 mm length). The liquid plug is made to oscillate pneumatically at two different frequencies (0.25 and 0.35 Hz), using a cam-follower mechanism. Bright field imaging is used to visualize the three-phase contact line behavior, while, micro-Particle Imaging Velocimetry (PIV) apparatus is used to discern the nature of flow inside the oscillating liquid plug. During a cycle, due to the partial wetting nature of DI water, the three-phase contact line at the menisci gets pinned at the extreme end of each stroke, where the dynamic apparent contact angle gets drastically altered before the initiation of the next stroke. The difference between the apparent contact angle of the front and rear meniscus are seen to be a function of the oscillating frequency; the difference increasing with increasing frequency. The flow inside the liquid plug reveals unique non-Poiseuille flow features near the meniscus, due to free-slip boundary condition, which leads to formation of distinct vortex pairs behind it. The vortices too change their direction during each stroke of the oscillation, eventually leading to an alternating recirculation pattern inside the plug. The results clearly indicate that improved mathematical models are required for predicting transport parameters in such flows, which are important in engineering systems such as pulsating heat pipes, lab-on-chip devices and PEM fuel cells.

  10. 30 CFR 250.1715 - How must I permanently plug a well?

    Science.gov (United States)

    2010-07-01

    ... effective back-pressure control set 50 to 100 feet above the casing shoe, and a cement plug that extends at...-pressure control set 50 to 100 feet above the top of the perforated interval, and a cement plug that.... (7) A subsea well with unsealed annulus A cutter to sever the casing, and you must set a stub plug...

  11. A Case of Randall's Plugs Associated to Calcium Oxalate Dihydrate Calculi

    Directory of Open Access Journals (Sweden)

    Felix Grases

    2016-07-01

    Full Text Available A case of a patient who developed multiple calcium oxalate dihydrate calculi, some of them connected to intratubular calcifications (Randall's plugs, is presented. Randall's plugs were isolated and studied. The mechanism of Randall's plug development is also suggested.

  12. Test Confessions: A Study of Testing Practices for Plug-in Systems

    NARCIS (Netherlands)

    Greiler, M.; Van Deursen, A.; Storey, M-A.

    2011-01-01

    Testing plug-in-based systems is challenging due to complex interactions among many different plug-ins, and variations in version and configuration. The objective of this paper is to increase our understanding of what testers and developers think and do when it comes to testing plug-inbased systems.

  13. Strangulated bowel obstruction resulting from mesh plug migration after open inguinal hernioplasty:case report

    Institute of Scientific and Technical Information of China (English)

    LIANG Xiao; CAI Xiu-jun; YU Hong; WANG Yi-fan

    2008-01-01

    @@ The use of mesh plug in hernioplasty was introduced by Shulman et al 1 in 1990 as a"rolled plug"fixed with two stitches to close the internal inguinal ring.Robbins and Rutkow 2 described their mesh plug technique in 1993.

  14. 40 CFR 144.62 - Cost estimate for plugging and abandonment.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 22 2010-07-01 2010-07-01 false Cost estimate for plugging and... Waste Injection Wells § 144.62 Cost estimate for plugging and abandonment. (a) The owner or operator must prepare a written estimate, in current dollars, of the cost of plugging the injection well...

  15. Trends in incidence of anal cancer and high-grade anal intraepithelial neoplasia in Denmark, 1978-2008

    DEFF Research Database (Denmark)

    Nielsen, Ann; Plum, Christian Edinger Munk; Kjaer, Susanne K

    2012-01-01

    The aim of the study was to determine the incidences of anal cancer and high-grade anal intraepithelial neoplasia (AIN2/3) over time in Danish women and men. Describing the burden of anal cancer and AIN may be valuable in future evaluations of the human papillomavirus (HPV) vaccine. We included all......-associated histological types levelled out or even declined during the 30 years of observation. In women, the increase in HPV-associated cancers was more pronounced among those under 60 years of age. Our findings indicate that vaccines against HPV might play an important role in the prevention of anal cancer and its...... cases of AIN2/3 during the study period. The average annual percentage change of 5% between 1998 and 2008 represents a steep increase in the incidence of AIN in both genders. Furthermore, the incidence rate of HPV-associated anal cancers increased significantly, whereas that of non-HPV...

  16. Strategická analýza Citibank a. s.

    OpenAIRE

    Boháčová, Michaela

    2007-01-01

    Bakalářská práce si za svůj cíl vytyčila problematiku strategické analýzy, která je důležitou součástí tvorby strategie. Výstupem strategické analýzy je SWOT analýza. Na závěr práce jsou uvedeny a zhodnoceny používané strategie, které utváří rámec hospodaření Citibank a. s. Stručný obsah: 1. Strategická analýza 1.1. Externí analýza 1.2. Interní analýza 1.3. SWOT analýza 2. Vize a poslání Citibank 3. Zhodnocení zvolené strategie 3.1. Konkurenční strategie 3.2. Investiční strategie 3.3. Strateg...

  17. Endoanal ultrasound in benign anal disorders: findings and usefulness

    Energy Technology Data Exchange (ETDEWEB)

    Heo, Tae Haeng; Shin, Hyun Joon; Cho, Young Kwon; Park, Dong Rib; Jeon, Hae Jeong; Park, Jeong Hee; Choi, Yong Chil; Park, Ung Chae; Choi, Jin Yong [Konkuk Univ. College of Medicine, Seoul (Korea, Republic of)

    1997-09-01

    To evaluate the usefulness of endoanal ultrasonography and to determine the imaging features of patients with fecal incontinence, anal abscess or anal fistula. Twenty five patients underwent endoanal ultrasonography between October 1995 and July 1996. Ten of these were fecal incontinence cases, eight had an anal abscess, and seven, an anal fistula. The incontinence grading scale (IGS) was used for clinical grading of fecal incontinence and pudendal nerve terminal motor latency (PNTML) for pudendal nerve injury. Endoanal ultrasonographic features and operative findings were retrospectively reviewed. Endoanal ultrasonography revealed defective sphincteric muscles in all three patients with myogenic fecal incontinence, but in six of seven cases with neurogenic fecal incontinence, these muscles were not difective. Myogenic and neurogenic incontience showed different findings (p=3D0.033). In comparison with surgical findings, endoanal ultrasonography was 88% accurate in anal abscess cases and 86% accurate in those of anal fistula. Endoanal ultrasonography in conjunction with PNTML was very useful for the detection of the site and severity of sphincteric muscle defect and diagnosis of the etiology of fecal incontinence. Through analysis of the site and type of lesion, the procedure can also serve as a guide to the surgical treatment of patients with anal abscess or fistula.=20.

  18. Conservative treatment of the anal carcinoma. Retrospective results - radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Dobrowsky, W.

    1987-09-01

    The results of primary radiotherapy in anal carcinoma are reported in a retrospective study. Fourteen patients have been treated by primary radiotherapy between 1970 and 1982. The three-year survival rate is 11/14 (corrected 11/12). Among eleven patients followed up, ten have a normal anal function. The importance of radio-oncology as a therapy of choice in conservative, function-preserving treatment of the anal carcinoma is discussed regarding the retrospective results as well as possible combinations of radiotherapy and chemotherapy.

  19. [Conservative treatment of anal cancer. Retrospective results--radiotherapy].

    Science.gov (United States)

    Dobrowsky, W

    1987-09-01

    The results of primary radiotherapy in anal carcinoma are reported in a retrospective study. Fourteen patients have been treated by primary radiotherapy between 1970 and 1982. The three-year survival rate is 11/14 (corrected: 11/12). Among eleven patients followed up, ten have a normal anal function. The importance of radio-oncology as a therapy of choice in conservative, function-preserving treatment of the anal carcinoma is discussed regarding the retrospective results as well as possible combinations of radiotherapy and chemotherapy.

  20. Anal transition zone in the surgical management of ulcerative colitis

    Institute of Scientific and Technical Information of China (English)

    Jennifer Holder-Murray; Alessandro Fichera

    2009-01-01

    Preservation of the anal transition zone has long been a significant source of controversy in the surgical management of ulcerative colitis. The two techniques for restorative proctocolectomy and ileal pouch anal anastomosis (RPC IPAA) in common practice are a stapled anastomosis and a handsewn anastomosis;these techniques differ in the amount of remaining rectal mucosa and therefore the presence of the anal transition zone following surgery. Each technique has advantages and disadvantages in long-term functional outcomes, operative and postoperative complications, and risk of neoplasia. Therefore, we propose a selective approach to performing a stapled RPC IPAA based on the presence of dysplasia in the preoperative endoscopic evaluation.

  1. DO CHANGES IN ANAL SPHINCTER ANATOMY CORRELATE WITH ANAL FUNCTION IN WOMEN WITH A HISTORY OF VAGINAL DELIVERY?

    Directory of Open Access Journals (Sweden)

    Sthela Maria MURAD-REGADAS

    2014-09-01

    Full Text Available Objectives To evaluate anal sphincter anatomy using three-dimensional ultrasonography (3-DAUS in incontinent women with vaginal delivery, correlate anatomical findings with symptoms of fecal incontinence and determine the effect of vaginal delivery on anal canal anatomy and function. Methods Female with fecal incontinence and vaginal delivery were assessed with Wexner’s score, manometry, and 3DAUS. A control group comprising asymptomatic nulliparous was included. Anal pressure, the angle of the defect and length of the external anal sphincter (EAS, the anterior and posterior internal anal sphincter (IAS, the EAS + puborectal and the gap were measured and correlated with score. Results Of the 62, 49 had fecal incontinence and 13 were asymptomatic. Twenty five had EAS defects, 8 had combined EAS+IAS defects, 16 had intact sphincters and continence scores were similar. Subjects with sphincter defects had a shorter anterior EAS, IAS and longer gap than women without defects. Those with a vaginal delivery and intact sphincters had a shorter anterior EAS and longer gap than nulliparous. We found correlations between resting pressure and anterior EAS and IAS length in patients with defects. Conclusions Avaliar a anatomia do esfíncter anal usando ultra-sonografia tridimensional (3D-US em mulheres incontinentes com parto vaginal, correlacionar os achados anatômicos com sintomas de incontinência fecal e, determinar o efeito do parto vaginal sobre a anatomia e função do canal anal.

  2. Processing of nanolitre liquid plugs for microfluidic cell-based assays

    Directory of Open Access Journals (Sweden)

    Junji Fukuda, Shintaro Takahashi, Tatsuya Osaki, Naoto Mochizuki and Hiroaki Suzuki

    2012-01-01

    Full Text Available Plugs, i.e. droplets formed in a microchannel, may revolutionize microfluidic cell-based assays. This study describes a microdevice that handles nanolitre-scale liquid plugs for the preparation of various culture setups and subsequent cellular assays. An important feature of this mode of liquid operation is that the recirculation flow generated inside the plug promotes the rapid mixing of different solutions after plugs are merged, and it keeps cell suspensions homogeneous. Thus, serial dilutions of reagents and cell suspensions with different cell densities and cell types were rapidly performed using nanolitres of solution. Cells seeded through the plug processing grew well in the microdevice, and subsequent plug processing was used to detect the glucose consumption of cells and cellular responses to anticancer agents. The plug-based microdevice may provide a useful platform for cell-based assay systems in various fields, including fundamental cell biology and drug screening applications.

  3. Polymer grouts for plugging lost circulation in geothermal wells.

    Energy Technology Data Exchange (ETDEWEB)

    Galbreath, D. (Green Mountain International, Waynesvile, NC); Mansure, Arthur James; Bauer, Stephen J.

    2004-12-01

    We have concluded a laboratory study to evaluate the survival potential of polymeric materials used for lost circulation plugs in geothermal wells. We learned early in the study that these materials were susceptible to hydrolysis. Through a systematic program in which many potential chemical combinations were evaluated, polymers were developed which tolerated hydrolysis for eight weeks at 500 F. The polymers also met material, handling, cost, and emplacement criteria. This screening process identified the most promising materials. A benefit of this work is that the components of the polymers developed can be mixed at the surface and pumped downhole through a single hose. Further strength testing is required to determine precisely the maximum temperature at which extrusion through fractures or voids causes failure of the lost circulation plug.

  4. Plug and Process Loads Capacity and Power Requirements Analysis

    Energy Technology Data Exchange (ETDEWEB)

    Sheppy, M.; Gentile-Polese, L.

    2014-09-01

    This report addresses gaps in actionable knowledge that would help reduce the plug load capacities designed into buildings. Prospective building occupants and real estate brokers lack accurate references for plug and process load (PPL) capacity requirements, so they often request 5-10 W/ft2 in their lease agreements. Limited initial data, however, suggest that actual PPL densities in leased buildings are substantially lower. Overestimating PPL capacity leads designers to oversize electrical infrastructure and cooling systems. Better guidance will enable improved sizing and design of these systems, decrease upfront capital costs, and allow systems to operate more energy efficiently. The main focus of this report is to provide industry with reliable, objective third-party guidance to address the information gap in typical PPL densities for commercial building tenants. This could drive changes in negotiations about PPL energy demands.

  5. Strength and stability of microbial plugs in porous media

    Energy Technology Data Exchange (ETDEWEB)

    Sarkar, A.K. [NIPER/BDM-Oklahoma, Inc., Bartlesville, OK (United States); Sharma, M.M.; Georgiou, G. [Univ. of Texas, Austin, TX (United States)

    1995-12-31

    Mobility reduction induced by the growth and metabolism of bacteria in high-permeability layers of heterogeneous reservoirs is an economically attractive technique to improve sweep efficiency. This paper describes an experimental study conducted in sandpacks using an injected bacterium to investigate the strength and stability of microbial plugs in porous media. Successful convective transport of bacteria is important for achieving sufficient initial bacteria distribution. The chemotactic and diffusive fluxes are probably not significant even under static conditions. Mobility reduction depends upon the initial cell concentrations and increase in cell mass. For single or multiple static or dynamic growth techniques, permeability reduction was approximately 70% of the original permeability. The stability of these microbial plugs to increases in pressure gradient and changes in cell physiology in a nutrient-depleted environment needs to be improved.

  6. Migrated Mesh Plug Masquerading as a Bladder Tumor

    Science.gov (United States)

    Dajani, Daoud; Aron, Monish

    2017-01-01

    Abstract Background: The purpose of this case presentation is to demonstrate how erosion of mesh into the bladder can initially present with the same symptoms as bladder malignancy. Case Presentation: A 62-year-old Hispanic male presented with 2 years of hematuria along with imaging concerning for a bladder tumor. The patient underwent cystoscopy with biopsy of a lesion at the anterior bladder. It was ultimately determined that a mesh plug from a prior hernia repair had migrated into the bladder. The mesh plug was excised using the Da Vinci Si robot, which allowed for efficient mobilization of the bladder and other anatomic structures, as well as rapid recovery. Conclusion: Our case demonstrates the need to consider mesh erosion as a cause of hematuria and, furthermore, shows how the robotic approach can help facilitate excision of migrated mesh into the bladder. PMID:28164159

  7. Flow induced vibration studies on PFBR control plug components

    Energy Technology Data Exchange (ETDEWEB)

    Prakash, V., E-mail: prakash@igcar.gov.in [Fast Reactor Technology Group, Indira Gandhi Centre for Atomic Research, Kalpakkam, Tamilnadu (India); Kumar, P. Anup; Anandaraj, M.; Thirumalai, M.; Anandbabu, C.; Rajan, K.K. [Fast Reactor Technology Group, Indira Gandhi Centre for Atomic Research, Kalpakkam, Tamilnadu (India)

    2012-09-15

    Highlights: Black-Right-Pointing-Pointer Flow induced vibration studies on Prototype Fast Breeder Reactor control plug model carried out. Black-Right-Pointing-Pointer Velocity similitude was followed for the study. Black-Right-Pointing-Pointer Frequencies and amplitude of vibrations of various control plug components measured. Black-Right-Pointing-Pointer Overall values of vibration are well within permissible limits. - Abstract: The construction of Prototype Fast Breeder Reactor (PFBR), a 500 MWe liquid sodium cooled reactor, is in progress at Kalpakkam in India. Control plug (CP) is located right above the core subassemblies in the hot pool. Control plug is an important component as many of the critical reactor parameters are sensed and controlled by the components housed in the control plug assembly. In PFBR primary circuit, components are basically thin walled, slender shells with diameter to thickness ratio ranging from 100 to 650. These components are prone to flow induced vibrations. The existence of free liquid (sodium) surfaces, which is the source of sloshing phenomenon and the operation of primary sodium pump in the primary pool are other potential sources of vibration of reactor components. Control plug is a hollow cylindrical shell structure and provides passages and support for 12 absorber rod drive mechanisms (ARDM) which consists of 9 control and safety rods and 3 diverse safety rods, 210 thermo wells to measure the sodium temperature at the exit of various fuel subassemblies, three failed fuel localization modules (FFLM) and acoustic detectors. It consists of a core cover plate (CCP), which forms the bottom end, two intermediate supports plate, i.e. lower stay plate (LSP) and upper stay plate (USP) and an outer shell. The CCP is located at a distance of 1.3 m from the core top. With such a gap, there will be long free hanging length of the thermocouple sleeves, Delayed neutron detector (DND) sampling tubes and ARDM shroud tubes and hence they are

  8. A Rigorous Methodology for Analyzing and Designing Plug-Ins

    DEFF Research Database (Denmark)

    Fasie, Marieta V.; Haxthausen, Anne Elisabeth; Kiniry, Joseph

    2013-01-01

    . This paper addresses these problems by describing a rigorous methodology for analyzing and designing plug-ins. The methodology is grounded in the Extended Business Object Notation (EBON) and covers informal analysis and design of features, GUI, actions, and scenarios, formal architecture design, including...... behavioral semantics, and validation. The methodology is illustrated via a case study whose focus is an Eclipse environment for the RAISE formal method's tool suite....

  9. Maturity Assessment of Space Plug-and-Play Architecture

    Science.gov (United States)

    2013-03-01

    EPC ) to convert the standard bus voltage to the necessary component voltages. In light of these voltage requirements, SPA introduced a standard...to the developers to decide how to implement those functions. Assessing software maturity for contractor -developed software will be difficult at...Comtech AA) and Seakr are two of the Advanced Plug-and-Play Technology (APT) contractors . Comtech AA demonstrated a full system utilizing SPA

  10. Plug-In Electric Vehicle Handbook for Workplace Charging Hosts

    Energy Technology Data Exchange (ETDEWEB)

    None

    2013-08-01

    Plug-in electric vehicles (PEVs) have immense potential for increasing the country's energy, economic, and environmental security, and they will play a key role in the future of U.S. transportation. By providing PEV charging at the workplace, employers are perfectly positioned to contribute to and benefit from the electrification of transportation. This handbook answers basic questions about PEVs and charging equipment, helps employers assess whether to offer workplace charging for employees, and outlines important steps for implementation.

  11. Experimental Investigation of Near-Borehole Crack Plugging with Bentonite

    Science.gov (United States)

    Upadhyay, R. A.; Islam, M. N.; Bunger, A.

    2015-12-01

    The success of the disposal of nuclear waste in a deep borehole (DBH) is determined by the integrity of the components of the borehole plug. Bentonite clay has been proposed as a key plugging material, and its effectiveness depends upon its penetration into near-borehole cracks associated with the drilling process. Here we present research aimed at understanding and maximizing the ability of clay materials to plug near-borehole cracks. A device was constructed such that the borehole is represented by a cylindrical chamber, and a near-borehole crack is represented by a slot adjacent to the center chamber. The experiments consist of placing bentonite clay pellets into the center chamber and filling the entire cavity with distilled water so that the pellets hydrate and swell, intruding into the slot because the cell prohibits swelling in the vertical direction along the borehole. Results indicate that the bentonite clay pellets do not fully plug the slot. We propose a model where the penetration is limited by (1) the free swelling potential intrinsic to the system comprised of the bentonite pellets and the hydrating fluid and (2) resisting shear force along the walls of the slot. Narrow slots have a smaller volume for the clay to fill than wider slots, but wider slots present less resistive force to clay intrusion. These two limiting factors work against each other, leading to a non-monotonic relationship between slot width and intrusion length. Further experimental results indicate that the free swelling potential of bentonite clay pellets depends on pellet diameter, "container" geometry, and solution salinity. Smaller diameter pellets possess more relative volumetric expansion than larger diameter pellets. The relative expansion of the clay also appears to decrease with the container size, which we understand to be due to the increased resistive force provided by the container walls. Increasing the salinity of the solution leads to a dramatic decrease in the clay

  12. National Plug-In Electric Vehicle Infrastructure Analysis

    Energy Technology Data Exchange (ETDEWEB)

    Wood, Eric W [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Rames, Clement L [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Muratori, Matteo [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Srinivasa Raghavan, Seshadri [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Melaina, Marc W [National Renewable Energy Laboratory (NREL), Golden, CO (United States)

    2017-09-15

    This document describes a study conducted by the National Renewable Energy Laboratory quantifying the charging station infrastructure required to serve the growing U.S. fleet of plug-in electric vehicles (PEVs). PEV sales, which include plug-in hybrid electric vehicles (PHEVs) and battery electric vehicles (BEVs), have surged recently. Most PEV charging occurs at home, but widespread PEV adoption will require the development of a national network of non-residential charging stations. Installation of these stations strategically would maximize the economic viability of early stations while enabling efficient network growth as the PEV market matures. This document describes what effective co-evolution of the PEV fleet and charging infrastructure might look like under a range of scenarios. To develop the roadmap, NREL analyzed PEV charging requirements along interstate corridors and within urban and rural communities. The results suggest that a few hundred corridor fast-charging stations could enable long-distance BEV travel between U.S. cities. Compared to interstate corridors, urban and rural communities are expected to have significantly larger charging infrastructure requirements. About 8,000 fast-charging stations would be required to provide a minimum level of coverage nationwide. In an expanding PEV market, the total number of non-residential charging outlets or 'plugs' required to meet demand ranges from around 100,000 to more than 1.2 million. Understanding what drives this large range in capacity requirements is critical. For example, whether consumers prefer long-range or short-range PEVs has a larger effect on plug requirements than does the total number of PEVs on the road. The relative success of PHEVs versus BEVs also has a major impact, as does the number of PHEVs that charge away from home. This study shows how important it is to understand consumer preferences and driving behaviors when planning charging networks.

  13. Mesh Plug Repair of Inguinal Hernia; Single Surgeon Experience

    Directory of Open Access Journals (Sweden)

    Ahmet Serdar Karaca

    2013-10-01

    Full Text Available Aim: Mesh repair of inguinal hernia repairs are shown to be an effective and reliable method. In this study, a single surgeon%u2019s experience with plug-mesh method performs inguinal hernia repair have been reported. Material and Method: 587 patients with plug-mesh repair of inguinal hernia, preoperative age, body / mass index, comorbid disease were recorded in terms of form. All of the patients during the preoperative and postoperative hernia classification of information, duration of operation, antibiotics, perioperative complications, and later, the early and late postoperative complications, infection, recurrence rates and return to normal daily activity, verbal pain scales in terms of time and postoperative pain were evaluated. Added to this form of long-term pain ones. The presence of wound infection was assessed by the presence of purulent discharge from the incision. Visual analog scale pain status of the patients was measured. Results: 587 patients underwent repair of primary inguinal hernia mesh plug. One of the patients, 439 (74% of them have adapted follow-ups. Patients%u2019 ages ranged from 18-86. Was calculated as the mean of 47±18:07. Follow-up period of the patients was found to be a minimum of 3 months, maximum 55 months. Found an average of 28.2±13.4 months. Mean duration of surgery was 35.07±4.00 min (min:22mn-max:52mn, respectively. When complication rates of patients with recurrence in 2 patients (0.5%, hematoma development (1.4% in 6 patients, the development of infection in 11 patients (2.5% and long-term groin pain in 4 patients (0.9% appeared. Discussion: In our experience, the plug-mesh repair of primary inguinal hernia repair safe, effective low recurrence and complication rates can be used.

  14. PIXASTIC: STEGANOGRAPHY BASED ANTI-PHISHING BROWSER PLUG-IN

    OpenAIRE

    P.Thiyagarajan; G.Aghila; V. Prasanna Venkatesan

    2012-01-01

    In spite of existence of many standard security mechanisms for ensuring secure e- Commerce business, users still fall prey for onlin e attacks. One such simple but powerful attack is ‘Phishing’. Phishing is the most alarming threat in the e-Commerce world and effective anti-phishing technique is the need of the hour. This paper focuses on a novel anti-phishing browser plug-in which uses information hiding technique - Steganography. A Robust Message based Im...

  15. Pixastic: Steganography based Anti-Phihsing Browser Plug-in

    OpenAIRE

    P.Thiyagarajan; G.Aghila; Venkatesan, V. Prasanna

    2012-01-01

    In spite of existence of many standard security mechanisms for ensuring secure e-Commerce business, users still fall prey for online attacks. One such simple but powerful attack is 'Phishing'. Phishing is the most alarming threat in the e-Commerce world and effective anti-phishing technique is the need of the hour. This paper focuses on a novel anti-phishing browser plug-in which uses information hiding technique - Steganography. A Robust Message based Image Steganography (RMIS) algorithm has...

  16. Nuclear analysis of ITER Test Blanket Module Port Plug

    Energy Technology Data Exchange (ETDEWEB)

    Villari, Rosaria, E-mail: rosaria.villari@enea.it [ENEA, Fusion Technical Unit, Nuclear Technologies Laboratory, Via Enrico Fermi 45, 00044 Frascati, Rome (Italy); Kim, Byoung Yoon; Barabash, Vladimir; Giancarli, Luciano; Levesy, Bruno; Loughlin, Michael; Merola, Mario [ITER Organization, Route de Vinon-sur-Verdon, CS 90 046, 13067 Saint Paul-lez-Durance Cedex (France); Moro, Fabio [ENEA, Fusion Technical Unit, Nuclear Technologies Laboratory, Via Enrico Fermi 45, 00044 Frascati, Rome (Italy); Pascal, Romain [ITER Organization, Route de Vinon-sur-Verdon, CS 90 046, 13067 Saint Paul-lez-Durance Cedex (France); Petrizzi, Luigino [European Commission, DG Research & Innovation G5, CDMA 00/030, B-1049 Brussels (Belgium); Polunovsky, Eduard; Van Der Laan, Jaap G. [ITER Organization, Route de Vinon-sur-Verdon, CS 90 046, 13067 Saint Paul-lez-Durance Cedex (France)

    2015-10-15

    Highlights: • 3D nuclear analysis of the ITER TBM Port Plug (PP). • Calculations of neutron fluxes, nuclear heating, damage and He-production in TBM PP components. • Shutdown dose rate assessment with Advanced D1S method considering different configurations. • Potential design improvements to reduce the shutdown dose rate in the port interspace. - Abstract: Nuclear analyses have been performed for the ITER Test Blanket Module Port Plug (TBM PP) using the MCNP-5 Monte Carlo Code. A detailed 3D model of the TBM Port Plug with dummy TBM has been integrated into the ITER MCNP model (B-lite v.3). Neutron fluxes, nuclear heating, helium production and neutron damage have been calculated in all the TBM PP components. Global shutdown dose rate calculations have also been performed with Advanced D1S method for different configurations of the TBM PP system. This paper presents the results of these analyses and discusses potential design improvements aiming to further reduce the shutdown dose rate in the port interspace.

  17. Selecting a Control Strategy for Plug and Process Loads

    Energy Technology Data Exchange (ETDEWEB)

    Lobato, C.; Sheppy, M.; Brackney, L.; Pless, S.; Torcellini, P.

    2012-09-01

    Plug and Process Loads (PPLs) are building loads that are not related to general lighting, heating, ventilation, cooling, and water heating, and typically do not provide comfort to the building occupants. PPLs in commercial buildings account for almost 5% of U.S. primary energy consumption. On an individual building level, they account for approximately 25% of the total electrical load in a minimally code-compliant commercial building, and can exceed 50% in an ultra-high efficiency building such as the National Renewable Energy Laboratory's (NREL) Research Support Facility (RSF) (Lobato et al. 2010). Minimizing these loads is a primary challenge in the design and operation of an energy-efficient building. A complex array of technologies that measure and manage PPLs has emerged in the marketplace. Some fall short of manufacturer performance claims, however. NREL has been actively engaged in developing an evaluation and selection process for PPLs control, and is using this process to evaluate a range of technologies for active PPLs management that will cap RSF plug loads. Using a control strategy to match plug load use to users' required job functions is a huge untapped potential for energy savings.

  18. Plug and Play Integration through Space Object Standardization

    Science.gov (United States)

    Boyce, Leslye; Meyers, Gary; Rigsbee, Emmett; Branch, William; Shaw, Jeffrey; Poole, David

    1999-01-01

    Plug and play is an industry standard promoted by Intel and Microsoft, and others that allows users to add and remove various input and output devices without making specific customizations to their systems. The idea behind concept is that using standard products eases integration of components and promotes capabilities of conforming products. The concept works because vendors comply with a standard specification. This paper reports the development of a reference architecture for the mission control domain, which is leveraging off this revolutionary concept. Standards are being developed at the application layer, which enable "plug and play" of mission software products. A Mission Control, reference architecture has been defined. For each sub-domain, the interfaces are modeled in Interface Definition Language (IDL). A subset of the IDL has been developed within both commercial off-the-shelf (COTS) and government (GOTS) products. Selected vendors have agreed to modify their products to be compatible with the defined IDL. The plug and play integration of these different products has been validated in a demonstration testbed.

  19. Radiotherapy of epidermoid anal canal cancer.

    Science.gov (United States)

    Dobrowsky, W

    1989-01-01

    Forty-eight patients with anal canal cancers were treated with surgery and irradiation or irradiation alone during the period 1970-1982. All cases were treated by external megavoltage equipment. The overall 5-year survival was 50%, and the local recurrence rate 33%. According to the therapy, four major groups were analysed: radical surgery followed by post-operative irradiation (5-year survival 43%, local recurrence rate 38%), incomplete major surgery and post-operative irradiation with very inferior prognosis (none of the patients surviving beyond 52 months). Two groups of patients had sphincter-saving procedures: local surgery followed by irradiation (5-year survival 78%, local recurrence rate 22%) and primary irradiation (5-year survival 57%, local recurrence rate 14%). Lymph node positive patients showed a median survival of 24.5 months against 52 months in N0 cases (5-year survival 21% against 50%). Side-effects of radiotherapy were transient and mild, and no late severe sequelae were seen. The data indicate that post-operative external radiotherapy seems insufficient and unable to decrease the local recurrence rate, especially when surgery is incomplete. Both spincter-saving surgery and radiotherapy, as well as primary irradiation, are effective treatment modalities. These data are analysed and future aspects considering combined radiochemotherapy are discussed.

  20. Technická analýza

    OpenAIRE

    Kosek, Lukáš

    2014-01-01

    Diplomová práce se zabývá problematikou technické analýza a jejího využití při tvorbě automatických obchodních systémů. V teoretické části práce jsou vysvětleny základní principy fungování měnového trhu (Forex) a technických identifikátorů. Výstupem práce je portfolio strategií, které je aplikováno na měnové páry Euro/Americký dolar a Britská libra/Americký dolar. Obchodní strategie jsou navrhnuté v programu Adaptrade Builder pomocí genetických algoritmů a následně otestované v obchodní platf...

  1. Video-assisted anal fistula treatment.

    Science.gov (United States)

    Kochhar, Gaurav; Saha, Sudipta; Andley, Manoj; Kumar, Ashok; Saurabh, Gyan; Pusuluri, Rahul; Bhise, Vikas; Kumar, Ajay

    2014-01-01

    Fistula in ano is a common disease seen in the surgical outpatient department. Many procedures are advocated for the treatment of fistula in ano. However, none of the procedures is considered the gold standard. The latest addition to the list of treatment options is video-assisted anal fistula treatment (VAAFT). It is a minimally invasive, sphincter-saving procedure with low morbidity. The aim of our study was to compare the results with a premier study done previously. The procedure involves diagnostic fistuloscopy and visualization of the internal opening, followed by fulguration of the fistulous tract and closure of the internal opening with a stapling device or suture ligation. The video equipment (Karl Storz, Tuttlingen, Germany) was connected to an illuminating source. The study was conducted from July 2010 to March 2014. Eighty-two patients with fistula in ano were operated on with VAAFT and were followed up according to the study protocol. The recurrence rate was 15.85%, with recurrences developing in 13 cases. Postoperative pain and discomfort were minimal. VAAFT is a minimally invasive procedure performed under direct visualization. It enables visualization of the internal opening and secondary branches or abscess cavities. It is a sphincter-saving procedure and offers many advantages to patients. Our initial results with the procedure are quite encouraging.

  2. Sphincter preservation in anal cancer: A brief review

    Directory of Open Access Journals (Sweden)

    Divya Khosla

    2013-01-01

    Full Text Available Management of anal cancer is a challenge. The goal of treatment is to eradicate tumor without sacrificing the anal sphincters. The idea of organ preservation emerged following the discovery of a high complete response rate from preoperative combined chemoradiation (CRT prior to abdominoperineal resection.CRT is widely accepted as the standard therapy for treating anal squamous cell cancer. The combination of external beam radiotherapy with interstitial brachytherapy increases the dose to the tumor volume and decreases dose to normal tissues. The current goal is to avoid colostomy, and surgery has become a salvage or secondary therapy. In this article, we review the non-surgical management of anal cancer with special emphasis on CRT, role of intensity modulated radiation therapy and brachytherapy.

  3. What Are the Risk Factors for Anal Cancer?

    Science.gov (United States)

    ... may have few or no known risk factors. Human papilloma virus (HPV) infection Most squamous cell anal cancers seem to be linked to infection by the human papilloma virus (HPV), the same virus that causes cervical ...

  4. Tubulovillous adenoma of anal canal: A case report

    Institute of Scientific and Technical Information of China (English)

    Bhupinder S Anand; Gordana Verstovsek; George Cole

    2006-01-01

    Tumors arising from the anal canal are usually of epithelial origin and are mostly squamous cell carcinoma or basal cell carcinoma. We present a case of benign anal adenomas arising from the anus, an extremely rare diagnosis. A 78-year-old white man presented with rectal bleeding of several months duration. Examination revealed a 4 cm friable mass attached to the anus by a stalk. At surgery, the mass was grasped with a Babcock forceps and was resected using electrocautery.Microscopic examination revealed a tubulovillus adenoma with no areas of high grade dysplasia or malignant transformation. The squamocolumnar junction was visible at the edges of the lesion confirming the anal origin of the tumor. We believe the tubulovillus adenoma arose from either an anal gland or its duct that opens into the anus. Although seen rarely, it is important to recognize and treat these tumors at an early stage because of their potential to transform into adenocarcinoma.

  5. Fecal Continence Revisited : The Anal External Sphincter Continence Reflex

    NARCIS (Netherlands)

    Broens, Paul M. A.; Penninckx, Freddy M.; Boix Ochoa, Jose

    2013-01-01

    BACKGROUND: None of the current theories on fecal incontinence can explain fecal continence adequately. OBJECTIVE: This study aims to evaluate the mechanism controlling fecal continence. DESIGN: Anal electrosensitivity, anorectal pressures, and rectal pressure volumetry tests were performed in 17

  6. Softwarová podpora analýzy rizik

    OpenAIRE

    Psota, Michal

    2013-01-01

    Tato práce se zabývá teoretickým popisem možností řízení rizik především v oblasti informačních technologií a popisuje metody sloužící k analýze rizik. Rozebrané metody jsou analýza stromu událostí, analýza stromu poruch, FMEA, HAZOP a Markovova analýza. Praktická část práce zahrnuje návrh a implementaci aplikace, která vizualizuje rozhodovací stromy a určuje pravděpodobnosti jednotlivých prvků. This thesis focuses on the theoretical description of risk management options related to inform...

  7. Rectocele and anal sphincter defect – surgical anatomy and ...

    African Journals Online (AJOL)

    muscle wall is repaired first, anal sphincter repair is facilitated. The nature and pathology of .... A literature search of anatomy and pathology textbooks yielded no data on the .... The defect mainly involves the deep part of the external sphincter.

  8. Reflexo pudendo-anal em mulheres normais Pudendo-anal reflex in normal women

    Directory of Open Access Journals (Sweden)

    Geraldo de Aguiar Cavalcanti

    2004-09-01

    Full Text Available São descritas observações do registro do reflexo pudendo-anal em mulheres sem queixas de incontinência urinária. Foram estudadas 31 voluntárias adultas, com estimulação elétrica bilateral e independente do clitóris e registros de superfície em ambos os lados do músculo esfíncter externo do ânus (EEA. As respostas foram obtidas com pulsos duplos de 0,2 ms de duração e intervalos de 5 ms, aplicados a uma freqüência menor que 0,5 Hz. Foram medidas as latências iniciais das respostas. Não foram evidenciadas diferenças entre as respostas obtidas de cada lado do EEA e nem entre os lados, com relação aos estímulos. Uma das voluntárias não apresentou respostas após estimulação de um dos lados. Não foram observadas diferenças relacionadas a paridade total e nem com a presença de partos vaginais. A idade e o índice de massa corpórea não se correlacionaram com as respostas. Em 12% das respostas, a medida das latências foi dificultada pela baixa relação sinal-ruído.The pudendo-anal reflex was studied in a sample of 31 normal women. Responses were obtained after bilateral independent stimulation of the clitoris, with surface recordings from both sides of the external anal sphincter. Reponses were elicited with double-pulses of 0,2 ms duration with a interstimulus interval of 5 ms, frequency of stimulation was lower than 0,5 Hz. A minimal of four responses were recorded after supramaximal stimulation. In one volunteer no response was recorded after unilateral stimulation. Latencies of the responses from the right and left sides of the anal sfincter after right and left stimulation were 36.35±6.37, 36.28±6.23, 35.88±4.68, 36.44±4.45ms, respectively. No relation was detected between latencies and age, body mass index and parity (considering either total parity or vaginal delivery only. In 12% of the recordings uncertainty was introduced in the latency measurements related to a poor signal-noise ratio.

  9. Colitis amebiasis with symptom of occasional dripped anal bleeding.

    Science.gov (United States)

    Wandono, Hadi

    2007-01-01

    Colitis amebiasis is usually characterized by bloody and mucous diarrhea, abdominal pain and anal discomfort. However, there is unusual manifestation of colitis amebiasis, such as occasional dripped anal bleeding, which sometimes spouted. Therefore, we often do not suspect such symptoms for colitis amebiasis. Laboratory examination includes complete laboratory test, coagulation and hematologic test, ICT TBC and colonoscopy. The pathology anatomy examination reveals positive results of trophozoites. Treatment by using metronidazole tablet provides good result for this disease.

  10. Direct and indirect costs for anal fistula in Sweden.

    Science.gov (United States)

    Lundqvist, Adam; Ahlberg, Ida; Hjalte, Frida; Ekelund, Mats

    2016-11-01

    Anal fistula is an abnormal tract with an external and internal opening that cause leakage, discomfort, and occasionally pain. Surgery is standard treatment, but recurrence and anal incontinence is common. The objective of the study was to analyze resource use, costs and sick leave for newly diagnosed patients with anal fistula in Sweden. The study was based on register data from linkages between Swedish population-based registers including patients treated for anal fistula in Västra Götaland County, Sweden. Health care resource use, costs and sick leave were estimated. The sample included 362 patients of which 27% had no surgery, 37% had one surgery and 36% had multiple surgeries. Patients with multiple surgeries underwent over four surgeries on average. Approximately 67% of the contacts occurred during the first year after diagnosis. Estimated mean sick leave was 10.4 full-time equivalent days per patient. Total discounted costs were €5,561 per patient where approximately 80% were direct costs. To our knowledge this is the first study of resource use, costs and sick leave related to anal fistulas. The study indicates that anal fistula is a condition that is costly for society and that the burden of anal fistula in terms of health care resources and sick leave is especially high for patients experiencing multiple surgeries. Anal fistula is a condition that is costly for society and there is an unmet need for the group of patients with multiple surgeries to find appropriate treatment interventions. Copyright © 2016 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

  11. Anal sphincter EMG in the diagnosis of parkinsonian syndromes

    DEFF Research Database (Denmark)

    Winge, K; Jennum, Poul Jørgen; Løkkegaard, Annemette;

    2010-01-01

    The role of electromyography (EMG) recorded from the external anal sphincter (EAS) in the diagnosis of atypical parkinsonian syndromes is a matter for continuous debate. Most studies addressing this issue are retrospective.......The role of electromyography (EMG) recorded from the external anal sphincter (EAS) in the diagnosis of atypical parkinsonian syndromes is a matter for continuous debate. Most studies addressing this issue are retrospective....

  12. Rare case of gastrointestinal stromal tumor of the anal canal

    Directory of Open Access Journals (Sweden)

    Madhu Kumar

    2013-01-01

    Full Text Available Gastrointestinal stromal tumor (GIST is a rare mesenchymal neoplasm of the gastrointestinal tract. GIST of anal canal is very rare representing only 3% of all anorectal mesenchymal tumors. We report an extremely rare case of GIST of the anal canal in 60-years-old man with history of irregular bowel habits with dark colored stool mixed with blood and constipation from 6 month. Diagnosis was made on the basis of histomorphological and immunohistochemical examination.

  13. Optimal control of a repowered vehicle: Plug-in fuel cell against plug-in hybrid electric powertrain

    Energy Technology Data Exchange (ETDEWEB)

    Tribioli, L., E-mail: laura.tribioli@unicusano.it; Cozzolino, R. [Dept. of Industrial Engineering, University of Rome Niccolo’ Cusano (Italy); Barbieri, M. [Engineering Dept., University of Naples Parthenope, Centro Direzionale-Isola C4, 80143 Naples (Italy)

    2015-03-10

    This paper describes two different powertrain configurations for the repowering of a conventional vehicle, equipped with an internal combustion engine (ICE). A model of a mid-sized ICE-vehicle is realized and then modified to model both a parallel plug-in hybrid electric powertrain and a proton electrolyte membrane (PEM) fuel cell (FC) hybrid powertrain. The vehicle behavior under the application of an optimal control algorithm for the energy management is analyzed for the different scenarios and results are compared.

  14. Anal sphincter injury in vaginal deliveries complicated by shoulder dystocia.

    Science.gov (United States)

    Hehir, Mark P; Rubeo, Zachary; Flood, Karen; Mardy, Anne H; O'Herlihy, Colm; Boylan, Peter C; D'Alton, Mary E

    2017-05-18

    Shoulder dystocia is an obstetric emergency that occurs in 0.2-3% of all cephalic vaginal deliveries. We hypothesized that because of the difficult nature of deliveries complicated by shoulder dystocia, the condition may be associated with anal sphincter injury. We sought to identify risk factors for obstetric anal sphincter injury in women with shoulder dystocia. This retrospective analysis included all cases of shoulder dystocia from 2007 to 2011 at two large tertiary referral centers, in the USA and Ireland. Details of maternal demographics, intrapartum characteristics, and delivery outcomes in cases of shoulder dystocia were analyzed. Univariate and multivariate analyses were used to describe the association between shoulder dystocia and anal sphincter injury. There were 685 cases of shoulder dystocia, and the rate of shoulder dystocia was similar at both institutions. The incidence of anal sphincter injury was 8.8% (60 out of 685). The rate was 14% (45 out of 324) in nulliparas and 4.2% (15 out of 361) in multiparas. Women with sphincter injury were more likely to be nulliparous (75% [45 out of 60] vs 45% [279 out of 625]; p anal sphincter injury is 9%. Risk factors include nulliparity, operative vaginal delivery, and use of internal maneuvers, whereas episiotomy was found to have a protective effect against anal sphincter injury during cases of shoulder dystocia.

  15. Botulinum toxin A in the treatment of anal fissure

    Directory of Open Access Journals (Sweden)

    Stanković Nebojša

    2004-01-01

    Full Text Available Background. This paper presents our first experience in the treatment of primary anal fissure by injection of botulinum A toxin into the internal sphincter. Methods. The study group of the retrospective study included 12 outpatients (8 females and 4 males, mean age 42 (range 18-60. During the period 2000-2003, after unsuccessful conservative treatment, patients were treated with the injections of botulinum A toxin, 100 units on both sides of the anal fissure laterally into the internal anal sphincter (50 units on either side. The patients were clinically evaluated 3, 7, and 30 days, and 3 and 6 months after the treatment. Results. Three fissures had healed after a month, and seven after 3 months. Two remained unhealed, but asymptomatic. There was no incontinence of flatus or faeces after 3 months of the treatment. After temporary healing, two fissures relapsed after 6 months, and these patients had the adequate tonus of the anal sphincter muscles. Except for the temporary incontinence, there were neither other side-efects, nor serious complications. Conclusion. Injection of botulinum A toxin achieved good results in the treatment of anal fissure. The appropriate use makes this method safe as an alternative to surgical treatment of anal fissure.

  16. Is routine endoanal ultrasound useful in anal fistulas?

    Directory of Open Access Journals (Sweden)

    I. Pascual Migueláñez

    Full Text Available Objective: to evaluate the effectiveness of endoanal ultrasound with hydrogen peroxide enhancement in the assessment of anal fistula (tract and internal opening, and to value the utility of this examination for anal or perianal suppuration when performed by a colorectal surgeon trained in this technique. Patients: endoanal ultrasound was performed in 103 patients with anal or perianal suppuration. Twenty patients were excluded: 9 had the external opening closed, and 11 had cryptoglandular abscesses. All ultrasound scans were performed by the same explorer using a B&K Diagnostic Ultrasound System with a 7 MHz endoprobe. The examination was based on the identification of the three anal planes, then hydrogen peroxide was infused and the procedure was repeated. Results: out of 83 patients included, 11 had a perianal sinus and 72 an anal fistula. In all fistulas the main tract was found: 24 were inter-sphinteric (33.33%, 33 trans-sphincteric (45.83%, 3 supra-sphincteric (4.17%, and 12 extra-sphincteric (16.67%. An internal opening was identified in 69 (95.83%. Conclusions: endoanal ultrasound with hydrogen peroxide enhancement is an effective examination to visualize fistulous tracts and internal openings. We think it is highly useful for anal or perianal suppuration to identify abscesses, to recognize a perianal sinus, to check the sphincteric condition, and to plan subsequent surgery.

  17. Commercializing light-duty plug-in/plug-out hydrogen-fuel-cell vehicles: "Mobile Electricity" technologies and opportunities

    Science.gov (United States)

    Williams, Brett D.; Kurani, Kenneth S.

    Starting from the premise that new consumer value must drive hydrogen-fuel-cell-vehicle (H 2FCV) commercialization, a group of opportunities collectively called "Mobile Electricity" is characterized. Mobile Electricity (Me-) redefines H 2FCVs as innovative products able to import and export electricity across the traditional vehicle boundary. Such vehicles could provide home recharging and mobile power, for example for tools, mobile activities, emergencies, and electric-grid-support services. This study integrates and extends previous analyses of H 2FCVs, plug-in hybrids, and vehicle-to-grid (V2G) power. Further, it uses a new electric-drive-vehicle and vehicular-distributed-generation model to estimate zero-emission-power versus zero-emission-driving tradeoffs, costs, and grid-support revenues for various electric-drive vehicle types and levels of infrastructure service. By framing market development in terms of new consumer value flowing from Me-, this study suggests a way to move beyond the battery versus fuel-cell zero-sum game and towards the development of integrated plug-in/plug-out hybrid platforms. As one possible extension of this Me- product platform, H 2FCVs might supply clean, high-power, and profitable Me- services as the technologies and markets mature.

  18. [Epithelium and anal glands in rectal pouches and fistula. Histologic studies of swine with congenital anal atresia].

    Science.gov (United States)

    Lambrecht, W; Kluth, D; Lierse, W

    1989-02-01

    The epithelial coating of the rectal pouch and fistula was studied morphologically in 33 newborn piglets with high and low forms of anal atresia and was found to be similar to the epithelial coating of the anal canal in normal piglets: the typical epithelium of the rectum changed its character into transitional epithelium at the region of the internal sphincter which surrounded the fistulae in all animals. In the caudal part of the fistula the transitional epithelium was followed by squamous epithelium. Only in male piglets with deformities and recto-urethral fistulae no squamous epithelium was found. In these cases transitional epithelium covered all parts of the fistula and the region of the internal sphincter. Anal glands were found in all animals, with or without anorectal malformations. They always invaded the internal sphincter. According to our morphological studies the fistula in anorectal malformations represents an ectopic anal canal.

  19. A phase II clinical study to assess the feasibility of self and partner anal examinations to detect anal canal abnormalities including anal cancer.

    Science.gov (United States)

    Nyitray, Alan G; Hicks, Joseph T; Hwang, Lu-Yu; Baraniuk, Sarah; White, Margaret; Millas, Stefanos; Onwuka, Nkechi; Zhang, Xiaotao; Brown, Eric L; Ross, Michael W; Chiao, Elizabeth Y

    2017-08-23

    Anal cancer is a common cancer among men who have sex with men (MSM); however, there is no standard screening protocol for anal cancer. We conducted a phase II clinical trial to assess the feasibility of teaching MSM to recognise palpable masses in the anal canal which is a common sign of anal cancer in men. A clinician skilled in performing digital anorectal examinations (DARE) used a pelvic manikin to train 200 MSM, aged 27-78 years, how to do a self-anal examination (SAE) for singles or a partner anal examination (PAE) for couples. The clinician then performed a DARE without immediately disclosing results, after which the man or couple performed an SAE or PAE, respectively. Percentage agreement with the clinician DARE in addition to sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated for the SAE, PAE and overall. Men had a median age of 52 years, 42.5% were African American and 60.5% were HIV positive. DARE detected abnormalities in 12 men while the men's SAE/PAEs detected 9 of these. A total of 93.0% of men classified the health of their anal canal correctly (95% CI 89.5 to 96.5). Overall percentage agreement, sensitivity and specificity were 93.0%, 75.0% and 94.2%, respectively, while PPV and NPV were 45.0% and 98.3%, respectively. The six men who detected the abnormality had nodules/masses ≥3 mm in size. More than half of men (60.5%) reported never checking their anus for an abnormality; however, after performing an SAE/PAE, 93.0% said they would repeat it in the future. These results suggest that tumours of ≥3 mm may be detectable by self or partner palpation among MSM and encourage further investigation given literature suggesting a high cure rate for anal cancer tumours ≤10 mm. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  20. [Effectiveness of human papillomavirus genotyping for detection of high-grade anal intraepithelial neoplasia compared to anal cytology].

    Science.gov (United States)

    Padilla-España, Laura; Repiso-Jiménez, Juan Bosco; Fernández-Sánchez, Fernando; Pereda, Teresa; Rivas-Ruiz, Francisco; Fernández-Morano, Teresa; de la Torre-Lima, Javier; Palma, Fermín; Redondo, Maximino; de Troya-Martín, Magdalena

    2016-01-01

    The incidence of high-grade anal intraepithelial neoplasia (HGAIN) -with an aetiological based on high-risk types of human papillomavirus- is increasing in some high-risk groups. Screening for HGAIN includes routine anal cytology and, more recently, HPV genotyping. The main objective of this study was to determine the sensitivity and specificity of anal cytology and HPV genotyping for the detection of HGAIN. This is a study to determine the correlation of cytological and microbiological findings with anal biopsy findings in a cohort of patients at high risk of developing AIN referred to the department of sexually transmitted infections of the Hospital Costa del Sol, Spain, between January 2008 and December 2014. Of the 151 patients subjected to screening, a total of 92 patients, all of them with the result of three screening test (anal cytology, genotyping and biopsy) were included in the study. Just under two-thirds (62%) of them were HIV-positive. The sensitivity and specificity of anal cytology to detect HGAIN were 52.8 and 85.7%, respectively (k: 0.328), and 78 and 62.8% to detect two or more HPV oncogenic genotypes (k: 0.417). The detection of oncogenic HPV genotypes allowed the identification of 23 new cases of HGAIN that had been underdiagnosed with anal cytology, with 14 cases containing at least three high-risk genotypes. Anal cytology did not show enough sensitivity in HGAIN screening. HPV genotyping has shown to be a useful tool to detect HGAIN cases, although it could lead to an over-diagnosis as a solitary screening procedure. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

  1. Anal dysplasia screening: an evidence-based analysis.

    Science.gov (United States)

    2007-01-01

    This review considered the role of the anal Pap test as a screening test for anal dysplasia in patients at high risk of anal SCC. The screening process is now thought to be improved with the addition of testing for the human papillomavirus (HPV) in high-risk populations. High-resolution anoscopy (a method to view the rectal area, using an anoscope, a lighted instrument inserted into the rectum) rather than routine anoscopy-guided biopsy, is also now considered to be the diagnostic standard. TARGET POPULATION AND CONDITION Anal cancer, like cervical cancer, is a member of a broader group of anogenital cancers known to be associated with sexually transmitted viral HPV infection. Human papillomavirus is extremely prevalent, particularly in young, sexually active populations. Sexual practices involving receptive anal intercourse lead to significantly elevated risk for anal dysplasia and cancer, particularly in those with immune dysfunctions. Anal cancer is rare. It occurs at a rate of about 1 to 2 per 100,000 in the general population. It is the least common of the lower gastrointestinal cancers, representing about 4% of them, in contrast to colorectal cancers, which remain the third most commonly diagnosed malignancy. Certain segments of the population, however, such as HIV-positive men and women, other chronic immune-suppressed patients (e.g., after a transplant), injection drug users, and women with genital dysplasia /cancer, have a high susceptibility to anal cancer. Those with the highest identified risk for anal cancer are HIV-positive homosexual and bisexual men, at a rate of 70 per 100,000 men. The risk for anal cancer is reported to be increasing dramatically in HIV-positive males and females, particularly since the introduction of highly active antiretroviral therapy in the mid-1990s. The introduction of effective viral therapy has been said to have transformed the AIDS epidemic in developed countries into a chronic disease state of long

  2. Current treatment options for management of anal intraepithelial neoplasia

    Science.gov (United States)

    Weis, Stephen E

    2013-01-01

    Anal squamous cell cancer is an uncommon malignancy caused by infection with oncogenic strains of Human papilloma virus. Anal cancer is much more common in immunocompromised persons, including those infected with Human immunodeficiency virus. High-grade anal intraepithelial neoplasia (HGAIN), the precursor of anal cancer, is identified by clinicians providing care for patients with anorectal disease, and is increasingly being identified during screening of immunosuppressed patients for anal dysplasia. The traditional treatment for HGAIN has been excision of macroscopic disease with margins. This approach is effective for patients with small unifocal HGAIN lesions. Patients with extensive multifocal HGAIN frequently have recurrence of HGAIN after excision, and may have postoperative complications of anal stenosis or fecal incontinence. This led to the suggestion by some that treatment for HGAIN should be delayed until patients developed anal cancer. Alternative approaches in identification and treatment have been developed to treat patients with multifocal or extensive HGAIN lesions. High-resolution anoscopy combines magnification with anoscopy and is being used to identify HGAIN and determine treatment margins. HGAIN can then be ablated with a number of modalities, including infrared coagulation, CO2 laser, and electrocautery. These methods for HGAIN ablation can be performed with local anesthesia on outpatients and are relatively well tolerated. High-resolution anoscopy-directed HGAIN ablation is evolving into a standard approach for initial treatment and then subsequent monitoring of a disease which should be expected to be recurrent. Another treatment approach for HGAIN is topical treatment, principally with 5-fluorouracil or imiquimod. Topical therapies have the advantage of being nonsurgical and are well suited for treating widespread multifocal disease. Topical treatments have the disadvantage of requiring extended treatment courses and causing a symptomatic

  3. Erosion on spark plug electrodes; Funkenerosion an Zuendkerzenelektroden

    Energy Technology Data Exchange (ETDEWEB)

    Rager, J.

    2006-07-01

    Durability of spark plugs is mainly determined by spark gap widening, caused by electrode wear. Knowledge about the erosion mechanisms of spark plug materials is of fundamental interest for the development of materials with a high resistance against electrode erosion. It is therefore crucial to identify those parameters which significantly influence the erosion behaviour of a material. In this work, a reliable and reproducible testing method is presented which produces and characterizes electrode wear under well-defined conditions and which is capable of altering parameters specifically. Endurance tests were carried out to study the dependence of the wear behaviour of pure nickel and platinum on the electrode temperature, gas, electrode gap, electrode diameter, atmospheric pressure, and partial pressure of oxygen. It was shown that erosion under nitrogen is negligible, irrespective of the material. This disproves all common mechanism discussed in the literature explaining material loss of spark plug electrodes. Based on this observation and the variation of the mentioned parameters a new erosion model was deduced. This relies on an oxidation of the electrode material and describes the erosion of nickel and platinum separately. For nickel, electrode wear is caused by the removal of an oxide layer by the spark. In the case of platinum, material loss occurs due to the plasma-assisted formation and subsequent evaporation of volatile oxides in the cathode spot. On the basis of this mechanism a new composite material was developed whose erosion resistance is superior to pure platinum. Oxidation resistant metal oxide particles were added to a platinum matrix, thus leading to a higher erosion resistance of the composite. However, this can be decreased by a side reaction, the separation of oxygen from the metal oxides, which effectively assists the oxidation of the matrix. This reaction can be suppressed by using highly stable oxides, characterized by a large negative Gibbs

  4. Plugging of a model rock system by using starved bacteria.

    Science.gov (United States)

    Macleod, F A; Lappin-Scott, H M; Costerton, J W

    1988-06-01

    The effects of starvation on bacterial penetration through artificial rock cores were examined. Klebsiella pneumoniae was starved in a simple salts solution for a duration of up to 4 weeks. These cell suspensions were injected into sintered glass bead cores, and the resulting reductions in core permeabilities were recorded. Vegetative cell cultures of K. pneumoniae grown in a sodium citrate medium were injected into other, similar cores, and the reductions in core permeabilities were recorded. The starved cell suspensions did not completely block the core pores, whereas the vegetative cultures reduced core permeability to less than 1%. Scanning electron microscopy of core sections infiltrated with either vegetative or starved cells showed that the former produced shallow "skin" plugs and copious amounts of glycocalyx at the inlet face, whereas the latter produced very little glycocalyx and the cells were distributed evenly throughout the length of the core. The use of a DNA assay to produce a cell distribution profile showed that, compared with the vegetative cells, starved bacteria were able to penetrate deeper into the cores. This was due to the smaller size of the cells and the reduction in biofilm production. This ability of starved bacteria to penetrate further into cores than the normal-size vegetative cells can be usefully applied to selective plugging for enhanced oil recovery. To further test the suitability of starved cells for use in selective plugging, the activities of starved cells present within cores were monitored before and after nutrient stimulation. Our data indicate that with nutrient stimulation, the starved cells lose their metabolic dormancy and produce reductions in core permeability due to cell growth and polymer production.

  5. Relationship of nutritional factors to the cause, dissolution, and prevention of feline uroliths and urethral plugs.

    Science.gov (United States)

    Osborne, C A; Polzin, D J; Kruger, J M; Lulich, J P; Johnston, G R; O'Brien, T D

    1989-05-01

    Feline lower urinary tract disease is often associated with uroliths and urethral plugs. Uroliths and urethral plugs are composed of variable quantities of matrix and a variety of minerals (including struvite, calcium oxalate, ammonium urate, calcium phosphate, and cystine). Knowledge of nutritional factors associated with the pathophysiology of uroliths and urethral plugs facilitates the modification of diets for the dissolution of several minerals contained within them.

  6. Plugging wells for abandonment: a state-of-the-art study and recommended procedures

    Energy Technology Data Exchange (ETDEWEB)

    Herndon, J.; Smith, D.K.

    1976-09-01

    The state-of-the-art of borehole plugging of abandoned oil wells and the tools and materials used are discussed. Special problems encountered are considered and several case studies are outlined. The special procedures which must be followed if the plugged borehole is to be considered as a repository for radioactive wastes are discussed and special recommendations are made. A state-by-state summary is given of the regulatory requirements for borehole plugging. (JSR)

  7. Microscopic Evaluation of Friction Plug Welds- Correlation to a Processing Analysis

    Science.gov (United States)

    Rabenberg, Ellen M.; Chen, Poshou; Gorti, Sridhar

    2017-01-01

    Recently an analysis of dynamic forge load data from the friction plug weld (FPW) process and the corresponding tensile test results showed that good plug welds fit well within an analytically determined processing parameter box. There were, however, some outliers that compromised the predictions. Here the microstructure of the plug weld material is presented in view of the load analysis with the intent of further understanding the FPW process and how it is affected by the grain structure and subsequent mechanical properties.

  8. Plug in electric vehicles in smart grids charging strategies

    CERN Document Server

    Rajakaruna, Sumedha; Ghosh, Arindam

    2014-01-01

    This book covers the recent research advancements in the area of charging strategies that can be employed to accommodate the anticipated high deployment of Plug-in Electric Vehicles (PEVs) in smart grids. Recent literature has focused on various potential issues of uncoordinated charging of PEVs and methods of overcoming such challenges. After an introduction to charging coordination paradigms of PEVs, this book will present various ways the coordinated control can be accomplished. These innovative approaches include hierarchical coordinated control, model predictive control, optimal control

  9. Plug-In Hybrid Electric Vehicle Penetration Scenarios

    Energy Technology Data Exchange (ETDEWEB)

    Balducci, Patrick J.

    2008-04-03

    This report examines the economic drivers, technology constraints, and market potential for plug-in hybrid electric vehicles (PHEVs) in the U.S. A PHEV is a hybrid vehicle with batteries that can be recharged by connecting to the grid and an internal combustion engine that can be activated when batteries need recharging. The report presents and examines a series of PHEV market penetration scenarios. Based on input received from technical experts and industry representative contacted for this report and data obtained through a literature review, annual market penetration rates for PHEVs are presented from 2013 through 2045 for three scenarios. Each scenario is examined and implications for PHEV development are explored.

  10. A study on thimble plug removal for PWR plants

    Energy Technology Data Exchange (ETDEWEB)

    Song, Dong Soo; Lee, Chang Sup; Lee, Jae Yong; Jun, Hwang Yong [Korea Electric Power Research Institute, Taejon (Korea, Republic of)

    1997-12-31

    The thermal-hydraulic effects of removing the RCC guide thimble plugs are evaluated for 8 Westinghouse type PWR plants in Korea as a part of feasibility study: core outlet loss coefficient, thimble bypass flow, and best estimate flow. It is resulted that the best estimate thimble bypass flow increases about by 2% and the best estimate flow increases approximately by 1.2%. The resulting DNBR penalties can be covered with the current DNBR margin. Accident analyses are also investigated that the dropped rod transient is shown to be limiting and relatively sensitive to bypass flow variation. 8 refs., 5 tabs. (Author)

  11. Plug in electric vehicles in smart grids energy management

    CERN Document Server

    Rajakaruna, Sumedha; Ghosh, Arindam

    2014-01-01

    This book highlights the cutting-edge research on energy management within smart grids with significant deployment of Plug-in Electric Vehicles (PEV). These vehicles not only can be a significant electrical power consumer during Grid to Vehicle (G2V) charging mode, they can also be smartly utilized as a controlled source of electrical power when they are used in Vehicle to Grid (V2G) operating mode. Electricity Price, Time of Use Tariffs, Quality of Service, Social Welfare as well as electrical parameters of the network are all different criteria considered by the researchers when developing

  12. Plug in electric vehicles in smart grids integration techniques

    CERN Document Server

    Rajakaruna, Sumedha; Ghosh, Arindam

    2014-01-01

    This book focuses on the state of the art in worldwide research on applying optimization approaches to intelligently control charging and discharging of batteries of Plug-in Electric Vehicles (PEVs) in smart grids. Network constraints, cost considerations, the number and penetration level of PEVs, utilization of PEVs by their owners, ancillary services, load forecasting, risk analysis, etc. are all different criteria considered by the researchers in developing mathematical based equations which represent the presence of PEVs in electric networks. Different objective functions can be defined an

  13. The viscoelastic properties of the cervical mucus plug

    DEFF Research Database (Denmark)

    Bastholm, Sara K.; Becher, Naja; Stubbe, Peter Reimer;

    2014-01-01

    ObjectiveTo characterize the viscoelastic properties of cervical mucus plugs (CMPs) shed during labor at term. DesignExperimental research. SettingDepartment of Obstetrics and Gynecology, Aarhus University Hospital, Denmark. Population/SampleSpontaneously shed CMPs from 18 healthy women in active...... labor. MethodsViscoelastic properties of CMPs were investigated with a dynamic oscillatory rheometer using frequency and stress sweep experiments within the linear viscoelastic region. Main outcome measuresThe rheological variables obtained were as follows: elastic modulus (G), viscous modulus (G...

  14. Plug-In Hybrid Electric Vehicle Penetration Scenarios

    Energy Technology Data Exchange (ETDEWEB)

    Balducci, Patrick J.

    2008-04-03

    This report examines the economic drivers, technology constraints, and market potential for plug-in hybrid electric vehicles (PHEVs) in the U.S. A PHEV is a hybrid vehicle with batteries that can be recharged by connecting to the grid and an internal combustion engine that can be activated when batteries need recharging. The report presents and examines a series of PHEV market penetration scenarios. Based on input received from technical experts and industry representative contacted for this report and data obtained through a literature review, annual market penetration rates for PHEVs are presented from 2013 through 2045 for three scenarios. Each scenario is examined and implications for PHEV development are explored.

  15. Chronic eosinophilic pneumonia with mucous plugs: case report

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    @@ Chronic eosinophilic pneumonia (CEP), a rare eosinophilic lung disease of unknown etiology, is characterized by peripheral blood eosinophilia, chest radiograph infiltrates, and prompt response to corticosteroid therapy.1 The first detailed description of CEP was described by Carrington et al 2 in 1969. The usual symptoms are cough, dyspnea, fever, and weight loss. It is most often seen in middle aged woman and has a subacute onset.1 We report a case of CEP presenting with right lower lung infiltrates and mucus plugging that causing bronchus obstruction.

  16. Plug-In Hybrid Vehicle Analysis (Milestone Report)

    Energy Technology Data Exchange (ETDEWEB)

    Markel, T.; Brooker, A.; Gonder, J.; O' Keefe, M.; Simpson, A.; Thornton, M.

    2006-11-01

    NREL's plug-in hybrid electric vehicle (PHEV) analysis activities made great strides in FY06 to objectively assess PHEV technology, support the larger U.S. Department of Energy PHEV assessment effort, and share technical knowledge with the vehicle research community and vehicle manufacturers. This report provides research papers and presentations developed in FY06 to support these efforts. The report focuses on the areas of fuel economy reporting methods, cost and consumption benefit analysis, real-world performance expectations, and energy management strategies.

  17. A Plug and Produce Framework for Industrial Collaborative Robots

    DEFF Research Database (Denmark)

    Schou, Casper; Madsen, Ole

    2016-01-01

    Collaborative robots are today ever more interesting in response to the increasing need for agile manufacturing equipment. Contrary to traditional industrial robots, collaborative robots are intended for working in dynamic environments alongside the production staff. To cope with the dynamic...... environment and workflow, new configuration and control methods are needed compared to those of traditional industrial robots. The new methods should enable shop floor operators to reconfigure the robot. This paper presents a plug and produce framework for industrial collaborative robots. The paper focuses...... of the framework through a series of reconfigurations performed on a modular collaborative robot....

  18. Compact Fluorescent Plug-In Ballast-in-a-Socket

    Energy Technology Data Exchange (ETDEWEB)

    Rebecca Voelker

    2001-12-21

    The primary goal of this program was to develop a ballast system for plug-in CFLs (compact fluorescent lamps) that will directly replace standard metal shell, medium base incandescent lampholders (such as Levition No. 6098) for use with portable lamp fixtures, such as floor, table and desk lamps. A secondary goal was to identify a plug-in CFL that is optimized for use with this ballast. This Plug-in CFL Ballastin-a-Socket system will allow fixture manufacturers to easily manufacture CFL-based high-efficacy portable fixtures that provide residential and commercial consumers with attractive, cost-effective, and energy-efficient fixtures for use wherever portable incandescent fixtures are used today. The advantages of this proposed system over existing CFL solutions are that the fixtures can only be used with high-efficacy CFLs, and they will be more attractive and will have lower life-cycle costs than screw-in or adapter-based CFL retrofit solutions. These features should greatly increase the penetration of CFL's into the North American market. Our work has shown that using integrated circuits it is quite feasible to produce a lamp-fixture ballast of a size comparable to the current Edison-screw 3-way incandescent fixtures. As for price points for BIAS-based fixtures, end-users polled by the Lighting Research Institute at RPI indicated that they would pay as much as an additional $10 for a lamp containing such a ballast. The ballast has been optimized to run with a 26 W amalgam triple biax lamp in the base-down position, yet can accept non-amalgam versions of the lamp. With a few part alterations, the ballast can be produced to support 32 W lamps as well. The ballast uses GE's existing L-Comp[1] power topology in the circuit so that the integrated circuit design would be a design that could possibly be used by other CFL and EFL products with minor modifications. This gives added value by reducing cost and size of not only the BIAS, but also possibly other

  19. Electric and plug-in hybrid vehicles advanced simulation methodologies

    CERN Document Server

    Varga, Bogdan Ovidiu; Moldovanu, Dan; Iclodean, Calin

    2015-01-01

    This book is designed as an interdisciplinary platform for specialists working in electric and plug-in hybrid electric vehicles powertrain design and development, and for scientists who want to get access to information related to electric and hybrid vehicle energy management, efficiency and control. The book presents the methodology of simulation that allows the specialist to evaluate electric and hybrid vehicle powertrain energy flow, efficiency, range and consumption. The mathematics behind each electric and hybrid vehicle component is explained and for each specific vehicle the powertrain

  20. Sonographic appearance of anal cushions of hemorrhoids

    Science.gov (United States)

    Aimaiti, Adilijiang; A Ba Bai Ke Re, Ma Mu Ti Jiang; Ibrahim, Irshat; Chen, Hui; Tuerdi, Maimaitituerxun; Mayinuer

    2017-01-01

    . Arteriovenous fistulas and venous dilatation were obvious in the anal cushion of hemorhoidal tissues. After pathological results with arteriovenous fistulas were taken as the standard reference, we evaluated the compatibility between the two methods according to the Cohen’s kappa co-efficiency calculation. The compatibility (Cohein kappa co-efficiency value) between “mosaic pattern” in the TPUS and arteriovenous fistula in pathology was very good (ĸ = 0.8939). When compared between different groups, TRUS presented the advantage that the mosaic pattern could be confirmed in more patients, especially for group A. There was a statistical difference when comparing group A with group B or C (P fistula in pathology. There are clearly different hemorrhoid structures shown by sonography. “Mosaic pattern” may be a parameter for surgical indication of grades III and IV hemorrhoids. PMID:28611519

  1. Current treatment options for management of anal intraepithelial neoplasia

    Directory of Open Access Journals (Sweden)

    Weis SE

    2013-06-01

    Full Text Available Stephen E Weis1,2 1Division of Dermatology, Department of Internal Medicine, University of North Texas Health Science Center at Fort Worth, 2Preventive Medicine Clinic, Tarrant County Public Health, Fort Worth, TX, USA Abstract: Anal squamous cell cancer is an uncommon malignancy caused by infection with oncogenic strains of Human papilloma virus. Anal cancer is much more common in immunocompromised persons, including those infected with Human immunodeficiency virus. High-grade anal intraepithelial neoplasia (HGAIN, the precursor of anal cancer, is identified by clinicians providing care for patients with anorectal disease, and is increasingly being identified during screening of immunosuppressed patients for anal dysplasia. The traditional treatment for HGAIN has been excision of macroscopic disease with margins. This approach is effective for patients with small unifocal HGAIN lesions. Patients with extensive multifocal HGAIN frequently have recurrence of HGAIN after excision, and may have postoperative complications of anal stenosis or fecal incontinence. This led to the suggestion by some that treatment for HGAIN should be delayed until patients developed anal cancer. Alternative approaches in identification and treatment have been developed to treat patients with multifocal or extensive HGAIN lesions. High-resolution anoscopy combines magnification with anoscopy and is being used to identify HGAIN and determine treatment margins. HGAIN can then be ablated with a number of modalities, including infrared coagulation, CO2 laser, and electrocautery. These methods for HGAIN ablation can be performed with local anesthesia on outpatients and are relatively well tolerated. High-resolution anoscopy-directed HGAIN ablation is evolving into a standard approach for initial treatment and then subsequent monitoring of a disease which should be expected to be recurrent. Another treatment approach for HGAIN is topical treatment, principally with 5

  2. Heterosexual Women's Anal Sex Attitudes and Motivations: A Focus Group Study.

    Science.gov (United States)

    McBride, Kimberly R

    2017-08-10

    Focus group methods were used to explore heterosexual women's receptive anal sex attitudes and motivations. Behaviors under investigation included penile-anal intercourse (PAI), manual-anal stimulation, oral-anal contact, and the use of sex toys. A total of 33 self-identified heterosexual women ages 18 to 30 recruited from two metropolitan areas in the Midwestern United States participated in one of six focus groups. The findings suggest that women viewed heterosexual anal sex as an emerging norm. Attitudes and motivations were complex and varied by behavior. Dominant themes included curiosity, pain, pleasure, and stigma. Relational factors, including acquiescence, coercion, and consent, were also salient among participants. Factors that influence anal sexual behaviors may not be entirely distinct from those that influence other sexual behaviors; however, factors that influence anal intercourse may be distinct from those that influence nonintercourse anal sex. Improved understanding will allow scientists to better understand the integration of anal sex behaviors into the broader sexual repertoire.

  3. The Anal Pap Smear: Cytomorphology of squamous intraepithelial lesions

    Directory of Open Access Journals (Sweden)

    Arain Shehla

    2005-01-01

    Full Text Available Abstract Background Anal smears are increasingly being used as a screening test for anal squamous intraepithelial lesions (ASILs. This study was undertaken to assess the usefulness and limitations of anal smears in screening for ASILs. Methods The cytomorphological features of 200 consecutive anal smears collected in liquid medium from 198 patients were studied and findings were correlated with results of surgical biopsies and/or repeat smears that became available for 71 patients within six months. Results Adequate cellularity was defined as an average of 6 or more nucleated squamous cells/hpf. A glandular/transitional component was not required for adequacy. Dysplastic cells, atypical parakeratotic cells and bi/multinucleated cells were frequent findings in ASIL while koilocytes were infrequent. Smears from LSIL cases most frequently showed mildly dysplastic and bi/multinucleate squamous cells followed by parakeratotic cells (PK, atypical parakeratotic cells (APK, and koilocytes. HSIL smears contained squamous cells with features of moderate/severe dysplasia and many APKs. Features of LSIL were also found in most HSIL smears. Conclusions In this study liquid based anal smears had a high sensitivity (98% for detection of ASIL but a low specificity (50% for predicting the severity of the abnormality in subsequent biopsy. Patients with cytologic diagnoses of ASC-US and LSIL had a significant risk (46–56% of HSIL at biopsy. We suggest that all patients with a diagnosis of ASC-US and above be recommended for high resolution anoscopy with biopsy.

  4. The Anal Pap Smear: Cytomorphology of squamous intraepithelial lesions.

    Science.gov (United States)

    Arain, Shehla; Walts, Ann E; Thomas, Premi; Bose, Shikha

    2005-02-16

    BACKGROUND: Anal smears are increasingly being used as a screening test for anal squamous intraepithelial lesions (ASILs). This study was undertaken to assess the usefulness and limitations of anal smears in screening for ASILs. METHODS: The cytomorphological features of 200 consecutive anal smears collected in liquid medium from 198 patients were studied and findings were correlated with results of surgical biopsies and/or repeat smears that became available for 71 patients within six months. RESULTS: Adequate cellularity was defined as an average of 6 or more nucleated squamous cells/hpf. A glandular/transitional component was not required for adequacy. Dysplastic cells, atypical parakeratotic cells and bi/multinucleated cells were frequent findings in ASIL while koilocytes were infrequent. Smears from LSIL cases most frequently showed mildly dysplastic and bi/multinucleate squamous cells followed by parakeratotic cells (PK), atypical parakeratotic cells (APK), and koilocytes. HSIL smears contained squamous cells with features of moderate/severe dysplasia and many APKs. Features of LSIL were also found in most HSIL smears. CONCLUSIONS: In this study liquid based anal smears had a high sensitivity (98%) for detection of ASIL but a low specificity (50%) for predicting the severity of the abnormality in subsequent biopsy. Patients with cytologic diagnoses of ASC-US and LSIL had a significant risk (46-56%) of HSIL at biopsy. We suggest that all patients with a diagnosis of ASC-US and above be recommended for high resolution anoscopy with biopsy.

  5. All's Well That Ends Well: Shakespeare's treatment of anal fistula.

    Science.gov (United States)

    Cosman, B C

    1998-07-01

    Textual and contextual evidence suggests that the French king's fistula, a central plot device in Shakespeare's play All's Well That Ends Well, is a fistula-in-ano. Anal fistula was known to the lay public in Shakespeare's time. In addition, Shakespeare may have known of the anal fistula treatise of John Arderne, an ancestor on Shakespeare's mother's side. Shakespeare's use of anal fistula differs from all previous versions of the story, which first appeared in Boccaccio's Decameron and from its possible historical antecedent, the fistula of Charles V of France. This difference makes sense given the conventions of Elizabethan comedy, which included anal humor. It is also understandable when one looks at what wounds in different locations mean in European legend. In this light, it is not surprising that subsequent expurgations treat Boccaccio's and Shakespeare's fistulas differently, censoring only Shakespeare's. This reading has implications for the staging of All's Well That Ends Well, and for our view of the place of anal fistulas in cultural history.

  6. Pathogenesis and persistence of cryptoglandular anal fistula: a systematic review.

    Science.gov (United States)

    Sugrue, Jeremy; Nordenstam, Johan; Abcarian, Herand; Bartholomew, Amelia; Schwartz, Joel L; Mellgren, Anders; Tozer, Philip J

    2017-06-01

    Anal fistulas continue to be a problem for patients and surgeons alike despite scientific advances. While patient and anatomical characteristics are important to surgeons who are evaluating patients with anal fistulas, their development and persistence likely involves a multifaceted interaction of histological, microbiological, and molecular factors. Histological studies have shown that anal fistulas are variably epithelialized and are surrounded by dense collagen tissue with pockets of inflammatory cells. Yet, it remains unknown if or how histological differences impact fistula healing. The presence of a perianal abscess that contains gut flora commonly leads to the development of anal fistula. This implies a microbiological component, but bacteria are infrequently found in chronic fistulas. Recent work has shown an increased expression of proinflammatory cytokines and epithelial to mesenchymal cell transition in both cryptoglandular and Crohn's perianal fistulas. This suggests that molecular mechanisms may also play a role in both fistula development and persistence. The aim of this study was to examine the histological, microbiological, molecular, and host factors that contribute to the development and persistence of anal fistulas.

  7. [A case of primary carcinoma associated with anal fistula].

    Science.gov (United States)

    Nushijima, Youichirou; Nakano, Katsutoshi; Sugimoto, Keishi; Nakaguchi, Kazunori; Kan, Kazuomi; Maruyama, Hirohide; Doi, Sadayuki; Okamura, Shu; Murata, Kohei

    2014-11-01

    A 47-year-old man with no history of anal fistula was admitted to our hospital with a complaint of perianal pain. Computed tomography (CT) imaging revealed perianal abscess. Incision and drainage were performed under spinal anesthesia. Ten months after drainage, magnetic resonance imaging revealed anal fistula on the left side of the anus. Subsequently, core-out and seton procedures were performed for ischiorectalis type III anal fistula. Pathological examination of the resected specimen of anal fistula revealed a moderately differentiated adenocarcinoma, leading to the diagnosis of carcinoma associated with anal fistula. No distant metastases or enlarged lymph nodes were observed on positron emission tomography (PET)/CT. We performed abdominoperineal resection with wide resection of ischiorectalis fat tissue. The pathology results were tub2, A, ly0, v0, n0, PM0, DM0, RM0, H0, P0, M0, Stage II. Negative pressure wound therapy was performed for perineum deficiency, after which rapid wound healing was observed. Left inguinal lymph node recurrence was detected 8 months after surgery, for which radiotherapy was administered. Distant metastasis was detected 11 months after surgery. The patient died 21 months after surgery.

  8. A new plug-in software architecture applied for a portable molecular structure browser.

    Science.gov (United States)

    Ueno, Y; Asai, K

    1997-01-01

    A new software configuration method using plug-in style components was established for the tool with the incremental development of software used in protein structural study. Our memory database provides the interface of data and functions among plug-in modules and its host program. A molecular structure browser program was developed together with several plug-in modules on our programming library that maintains graphics portability and user interfaces. This plug-in software architecture is generally useful for large-scale software development and for prototyping parts of the system.

  9. Transport of Wetting and Nonwetting Liquid Plugs in a T-shaped Microchannel

    Institute of Scientific and Technical Information of China (English)

    YONG Yumei; LI Sha; YANG Chao; YIN Xiaolong

    2013-01-01

    The transport of liquid plugs in microchannels is very important for many applications such as in medical treatments in airways and in extraction of oil from porous rocks.A plug of wetting and non-wetting liquids driven by a constant pressure difference through a T-shaped microchannel is studied numerically with lattice Boltzmann (LB) method.A two-phase flow LB model based on field mediators is built.Three typical flow patterns (blocking,rupture and splitting flow) of plug flow are obtained with different driving pressures.It is found that it becomes difficult for a plug with short initial plug length to leave the microchannel; the flow pattern of plug transport varies with the contact angle,especially from wetting to nonwetting; with the increase of interracial tension,the front interface of plug moves faster; the front and rear interfaces of the plug with small viscosity ratio move faster in the microchannel than those of the plug with large viscosity ratio.The study is helpful to provide theoretical data for the design and scale-up of liquid-liquid reactors and separators.

  10. Borehole plugging of man-made accesses to a basalt repository: a preliminary study

    Energy Technology Data Exchange (ETDEWEB)

    Taylor, C.L.; Anttonen, G.J.; O' Rourke, J.E.; Niccum, M.R.

    1979-09-01

    This report describes the status of work currently in progress for the Basalt Borehole Plugging Program (BBPP). The primary objectives of the BBPP outlined in this report have been met during this first phase of work. These objectives included: (1) the preparation of a preliminary list of candidate plug materials; (2) a description of available machinery capable of placing candidate plug materials; and (3) the development of physical and geochemical testing programs to help evaluate the chemical stability and physical properties of candidate plug materials. The most significant finding from work to date is that given reasonable regulatory criteria, nothing has been identified which would prevent design of a plug system to seal manmade openings leading to a nuclear waste repository in Columbia River basalt for significantly long periods of time (on the order of thousands of years). Work accomplished to date indicates that this plug system can be designed using both natural and manufactured materials and can be emplaced with existing placement machinery and modifications of that machinery. The objectives of Task II are to conduct laboratory tests to evaluate the suitability of preferred candidate materials for plugging boreholes in the proposed repository, select plug system(s), initiate preconceptual machinery design for the placement of materials in plug system(s), and prepare a preliminary Task II report. As with Task I project organization, Task II is divided into subtasks that are identified by written subtask work summaries.

  11. Fiscal year 1996 well plugging and abandonment program Y-12 Plant, Oak Ridge, Tennessee

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1997-04-01

    This report is a synopsis of the progress of the well plugging and abandonment program at the Oak Ridge Y-12 Plant, Oak Ridge, Tennessee, from August 1995 through August 1996. A total of 27 wells, piezometers, and borings were plugged and abandoned during the period of time covered in this report. All wells and borings were plugged and abandoned in accordance with the Monitoring Well Plugging and Abandonment Plan for the U.S. Department of Energy, Y-12 Plant, Oak Ridge, Tennessee (HSW, Inc. 1991).

  12. A Novel Dual-Electrode Plug to Achieve Intensive Electric Field for High Performance Ignition

    Directory of Open Access Journals (Sweden)

    Chih-Lung Shen

    2013-01-01

    Full Text Available A thorough analysis of electric field is carried out so as to verify that a novel dual-electrode plug can build intensive electric field and can improve the main drawbacks of feeble electric field and low ignition efficiency of the traditional plug. With intensive electric field, the proposed novel plug can achieve high performance ignition, resulting in fuel saving and exhaust reduction. Gauss law is applied for electric field analysis to show that intensive electric field can be built by the novel plug. Then, according to Faraday law a lower-voltage ignition feature accomplished by the plug is discussed. Compared with traditional plug, the novel dual-electrode plug has the following advantages. (1 Much higher energy density is built between the plug electrodes, lowering ignition voltage requirement. (2 Electromagnetic interference (EMI problem caused by high ignition voltage is readily resolved. (3 Ignition time delay can be improved. (4 The feature to save fuel consuming is achieved. (5 The exhaust of CO and HC is reduced significantly. Practical measurements are fulfilled to validate the electric field analysis and to demonstrate the features of the proposed dual-electrode plug.

  13. Manometric asymmetry of the anal sphincter: anatomic evidence and clinical application

    Institute of Scientific and Technical Information of China (English)

    XIAO Yuan-hong; LIU Gui-lin

    2005-01-01

    Background Manometric pressure asymmetry of the anal sphincter exists in the anal canal. There are reports about the anatomy of the anal sphincter, but the relationship between the configuration and the pressure asymmetry of the anal sphincter is not clear. This study is to investigate the anatomic evidence and clinical application of anal sphincter pressure asymmetry. Methods PC polygram HR at the state of relaxing and squeezing was used in 27 normal children and 12 abnormal ones with fecal incontinence.Results In normal children, longitudinal pressure gradients existed at eight channels in the anal canal, and the maximal pressure 1 cm from the anal verge. Longitudinal pressure asymmetry changes of eight channels also existed in the anal canal, from 3 cm to 2 cm to 1 cm from the anal verge. The high pressure distribution changed from the posterior to the anterior anal canal. Anteriorly, 1 cm from the anal verge, the maximal pressure was formed in the anal canal. However, neither longitudinal pressure gradients nor longitudinal pressure asymmetry changes were seen in patients with fecal incontinence. Conclusion The configuration and function of the striated muscle complex possibly contribute to the formation of the pressure asymmetry of the anal sphincter, which is essential to anal control.

  14. Development and application of microbial selective plugging processes

    Energy Technology Data Exchange (ETDEWEB)

    Jenneman, G.E. [Phillips Petroleum Co., Bartlesville, OK (United States); Gevertz, D.; Davey, M.E. [Agouron Institute, La Jolla, CA (United States)] [and others

    1995-12-31

    Phillips Petroleum Company recently completed a microbial selective plugging (MSP) pilot at the North Burbank Unit (NBU), Shidler, Oklahoma. Nutrients were selected for the pilot that could stimulate indigenous microflora in the reservoir brine to grow and produce exopolymer. It was found that soluble corn starch polymers (e.g., maltodextrins) stimulated the indigenous bacteria to produce exopolymer, whereas simple sugars (e.g., glucose and sucrose), as well as complex media (e.g., molasses and Nutrient Broth), did not. Injection of maltodextrin into rock cores in the presence of indigenous NBU bacteria resulted in stable permeability reductions (> 90%) across the entire length, while injection of glucose resulted only in face plugging. In addition, it was found that organic phosphate esters (OPE) served as a preferable source of phosphorus for the indigenous bacteria, since orthophosphates and condensed phosphates precipitated in NBU brine at reservoir temperature (45{degrees}C). Injection of maltodextrin and ethyl acid phosphate into a producing well stimulated an increase in maltodextrin utilizing bacteria (MUB) in the back-flowed, produced fluid. Additional screens of indigenous and nonindigenous bacteria yielded several nonindigenous isolates that could synthesize polymer when growing in brine containing 6% NaCl at 45{degrees}C.

  15. "Plug-and-go" strategy to manipulate streptavidin valencies.

    Science.gov (United States)

    Sun, Xun; Montiel, Daniel; Li, Hao; Yang, Haw

    2014-08-20

    The streptavidin-biotin set is one of the most widely utilized conjugation pairs in biotechnological applications. The tetravalent nature of streptavidin and its homologues, however, tends to result in such undesirable complications as cross-linking or ill-defined stoichiometry. Here, we describe a mutagenesis-free strategy to manipulate the valencies of wild-type streptavidin that only requires commercially available reagents. The basic idea is simple: one obtains the desired streptavidin valency by blocking off unwanted binding sites using ancillary biotin ("plug"); this way, the extraordinary fM-biotin-binding affinity is fully retained for the remaining sites in streptavidin. In the present implementation, the ancillary biotin is attached to an auxiliary separation handle, negatively charged DNA or His-tagged protein, via a photochemically or enzymatically cleavable linker. Mixing streptavidin with the ancillary biotin construct produces a distribution of streptavidin valencies. The subsequent chromatographic separation readily isolates the construct of desired streptavidin valency, and the auxiliary handles are easily removed afterward ("go"). We demonstrate how this "plug-and-go" strategy allows a precise control for the compositions of streptavidin-biotin conjugates at the single-molecule level. This low-entry-barrier protocol could further expand the application scope of the streptavidin technology.

  16. The anal personality: self-disclosure, negativism, self-esteem, and superego severity.

    Science.gov (United States)

    Fischer, R E; Juni, S

    1982-02-01

    Psychoanalytic implications of anal characterology were operationalized, and an experimental situation devised to test hypotheses of various aspects of interpersonal behavior. Subjects selected for the study had been found to score either high or low on Kline's (Ai3) Anality Scale. Self-disclosure and disclosure reciprocity were shown to be negative functions of anality: productivity and superego measures were also shown to be functions of anality. Self-esteem and socio-economic status did not relate to anality levels, while the hypothesis linking anality with negativism was only partially confirmed. Implications for psychoanalytic and social psychology research are discussed.

  17. KRONİK ANAL FİSSÜR OLGULARINDA CERRAHİ TEDAVİ

    OpenAIRE

    ERSAN, Yılmaz; YAVUZ, Nihat; KUŞASLAN, Ramazan; ÇİÇEK, YUSUF; ERGÜNEY, Sabri

    2014-01-01

    Background.- Chronic anal fissure (Chronic fissure in ano) is a longitudinal or pear-shaped defect of the anal canal mucosa extending usually from the dentate line to the external verge of the anal canal. Circular fibers of the internal anal sphincter are visible on the floor of the fissure and secondary changes; such as a sentinel tag, hypertrophied anal papilla and a degree of anal stenosis frequently accompany chronic fissures. A fissure in ano may occur at any age, but is most common betw...

  18. Anal Cancer debuting as Cancer of Unknown Primary

    DEFF Research Database (Denmark)

    Sveistrup, Joen; Loft, Annika; Engelholm, Svend Aage

    2011-01-01

    Anal cancer usually presents with a visible or palpable tumour. In this case we describe a 54-year old man diagnosed with Cancer of Unknown Primary (CUP) with a single inguinal node as the only finding. Thorough examination failed to identify any primary tumour. The patient was treated with lymph...... node dissection and not until nearly two years after initial diagnosis, was the primary tumour found, and the patient was diagnosed with anal cancer. The patient was treated with chemoradiotherapy and 45 months after initial diagnosis there is still no sign of relapse. This case illustrates, that anal...... cancer can metastasise before the primary tumour is detectable. Furthermore, it demonstrates the necessity of thorough clinical follow-up after treatment of CUP since the primary tumour was found later. Finally this is a case of a long-term survivor following treatment for metastatic inguinal lymph nodes...

  19. Squamous cell carcinoma of the anal sac in five dogs.

    Science.gov (United States)

    Esplin, D G; Wilson, S R; Hullinger, G A

    2003-05-01

    Tumors of the perianal area of dogs are common and include multiple tumor types. Whereas perianal adenomas occur often, adenocarcinomas of the apocrine glands of the anal sac occur less frequently. A review of the literature revealed no reports of squamous cell carcinomas arising from the epithelial lining of the anal sac. Squamous cell carcinomas originating from the lining of the anal sac were diagnosed in five dogs. Microscopically, the tumors consisted of variably sized invasive nests and cords of epithelial cells displaying squamous differentiation. Four of the five dogs were euthanatized because of problems associated with local infiltration by the tumors. In the fifth dog, there was no evidence of tumor 7 months after surgical removal, but further follow up was not available.

  20. [Management of complications in anal and transanal tumor surgery].

    Science.gov (United States)

    Sailer, M; Eisoldt, S; Möllmann, C

    2015-08-01

    Anal and transanal tumor operations are safe and are associated with a very low morbidity. Perianal and anal lesions as well as low rectal tumors can be excised by direct exposure using an anal retractor. For lesions situated in the middle or upper third of the rectum, special instrumentation, such as transanal endoscopic microsurgery (TEM) and transanal endoscopic operation (TEO) should be used to avoid unnecessary R1 resections. Fatal complications are extremely rare and most complications, such as urinary retention or temporary subfebrile temperatures, are minor. Suture line dehiscences are usually clinically unremarkable. Major complications comprise significant hemorrhage and opening of the peritoneal cavity. The latter must be recognized intraoperatively and can usually be managed by primary suturing. Infections, abscess formation, rectovaginal fistula, injury of the prostate or even urethra are extremely rare complications.

  1. Anal carcinoma and HIV infection: is it time for screening?

    Science.gov (United States)

    Herranz-Pinto, P; Sendagorta-Cudós, E; Bernardino-de la Serna, J I; Peña-Sánchez de Rivera, J M

    2014-03-01

    A 38-year-old white man had a 10-year history of human immunodeficiency virus (HIV) infection (A3), with no episodes of opportunistic diseases and in good immunologic recovery (CD4 cell count: 450 and indetectable HIV viral load) while on HAART. He presented with a two-month history of mild anal symptoms, including pruritus and episodic bleeding. He referred past episodes of anal warts, self-treated with several topical compounds, all proven unsuccessful. Perianal examination showed erythema and scratching. A 0.5cm sized tumor, with infiltration at the base was detected on digital exam, located at 15mm from the anal margin. Local biopsy driven by high-resolution anuscopy (AAR) yielded a final diagnosis of infiltrative epidermoid carcinoma. Might that neoplasia have been prevented? Copyright © 2013 Elsevier España, S.L. All rights reserved.

  2. Treatment of peri-anal fistula in Crohn's disease.

    Science.gov (United States)

    Sica, Giuseppe S; Di Carlo, Sara; Tema, Giorgia; Montagnese, Fabrizio; Del Vecchio Blanco, Giovanna; Fiaschetti, Valeria; Maggi, Giulia; Biancone, Livia

    2014-10-07

    Anal fistulas are a common manifestation of Crohn's disease (CD). The first manifestation of the disease is often in the peri-anal region, which can occur years before a diagnosis, particularly in CD affecting the colon and rectum. The treatment of peri-anal fistulas is difficult and always multidisciplinary. The European guidelines recommend combined surgical and medical treatment with biologic drugs to achieve best results. Several different surgical techniques are currently employed. However, at the moment, none of these techniques appear superior to the others in terms of healing rate. Surgery is always indicated to treat symptomatic, simple, low intersphincteric fistulas refractory to medical therapy and those causing disabling symptoms. Utmost attention should be paid to correcting the balance between eradication of the fistula and the preservation of fecal continence.

  3. Can Anal Sphincter Defects Be Identified by Palpation?

    Science.gov (United States)

    Shek, Ka Lai; Atan, Ixora Kamisan; Dietz, Hans Peter

    The aim of this study was to correlate clinical findings of anal sphincter defects and function with a sonographic diagnosis of significant sphincter defects. This is an observational cross-sectional study on women seen 6 to 10 weeks after primary repair of obstetric anal sphincter injuries (OASIs). All patients underwent a standardized interview including the St Mark incontinence score, a digital rectal examination, and 3-/4-dimensional transperineal ultrasound imaging. Two hundred forty-five patients were seen after primary repair of OASIs. Mean age was 29 (17-43) years. They were assessed at a median of 58 (15-278) days postpartum. One hundred fifty-seven (64%) delivered normal vaginally, 72 (29%) delivered by vacuum, and 16 (7%) delivered by forceps. A comparison of external anal sphincter (EAS) and internal anal sphincter ultrasound volume data and palpation was possible in 220 and 212 cases, respectively. Sphincter defects at rest and on contraction were both detected clinically in 17 patients. Significant abnormalities of the EAS were diagnosed on tomographic ultrasound imaging in 99 cases (45%), and significant abnormalities of the internal anal sphincter were diagnosed in 113 cases (53%). Agreement between digital and sonographic findings of sphincter defect was poor (k = 0.03-0.08). Women with significant EAS defects on ultrasound were found to have a lower resistance to digital insertion (P = 0.018) and maximum anal squeeze (P = 0.009) on a 6-point scale. The difference was however small. Digital rectal examination does not seem to be sufficiently sensitive to diagnose residual sphincter defects after primary repair of OASIs. Imaging is required for the evaluation of sphincter anatomy after repair.

  4. Fistulotomy or seton in anal fistula: a decisional algorithm.

    Science.gov (United States)

    Cariati, Andrea

    2013-09-01

    Fistula in ano is a common proctological disease. Several authors stated that internal and external anal sphincters preservation is in the interest of continence maintenance. The aim of the present study is to report our experience using a decisional algorithm on sphincter saving procedures that achieved us to obtain good results with low rate of complications. From 2008 to 2011, 206 patients underwent surgical treatment for anal fistula; 28 patients underwent perianal abscess drainage plus seton placement of trans-sphincteric or supra-sphincteric fistula (13.6 %), 41 patients underwent fistulotomy for submucosal or low inter-sphincteric or low trans-sphincteric anal fistula (19.9 %) and 137 patients underwent partial fistulectomy or partial fistulotomy (from cutaneous plan to external sphincter muscle plan) and cutting seton placement without internal sphincterotomy for trans-sphincteric anal fistula (66.50 %). Healing rates have been of 100 % and healing times ranged from 1 to 6 months in 97 % of patients treated by setons. Transient fecal soiling was reported by 19 patients affected by trans-sphincteric fistula (11.5 %) for 4-6 months and then disappeared or evolved in a milder form of flatus occasional incontinence. No major incontinence has been reported also after fistulotomy. Fistula recurred in five cases of trans-sphincteric fistula treated by seton placement (one with abscess) (1/28) (3.5 %) and four with trans-sphincteric fistula (4/137) (3 %). Our algorithm permitted us to reduce to 20 % sphincter cutting procedures without reporting postoperative major anal incontinence; it seems to open an interesting way in the treatment of anal fistula.

  5. Computational modeling of unsteady surfactant-laden liquid plug propagation in neonatal airways

    Science.gov (United States)

    Olgac, Ufuk; Muradoglu, Metin

    2013-07-01

    Surfactant-free and surfactant-laden liquid plug propagation in neonatal airways in various generations representing the upper and lower airways are investigated computationally using a finite-difference/front-tracking method. Emphasis is placed on the unsteady surfactant-laden plug propagation as a model for Surfactant Replacement Therapy (SRT) and airway reopening. The numerical method is designed to solve the evolution equations of the interfacial and bulk surfactant concentrations coupled with the incompressible Navier-Stokes equations. Available experimental data for surfactant Survanta are used to relate surface tension coefficient to surfactant concentration at the interface. It is found that, for the surfactant-free case, the trailing film thickness is in good agreement with Taylor's law for plugs with plug length greater than the airway width. Mechanical stresses that could be injurious to epithelial cells such as pressure and shear stress and their gradients are maximized on the front and rear menisci with increasing magnitudes in the lower generations. These mechanical stresses, especially pressure and pressure gradient, are diminished with the introduction of surfactants. Surfactant is absorbed onto the trailing film and thickens it, eventually leading to either plug rupture or, if totally consumed prior to rupture, to steadily propagating plug. In the upper airways, initially small plugs rupture rapidly and plugs with comparable initial plug length with the airway width persist and propagate steadily. For a more effective SRT treatment, we recommend utilization of plugs with initial plug length greater than the airway width. Increasing surfactant strength or increasing the initially instilled surfactant concentration is found to be ineffective.

  6. The copulatory plug delays ejaculation by rival males and affects sperm competition outcome in house mice.

    Science.gov (United States)

    Sutter, A; Lindholm, A K

    2016-08-01

    Females of many species mate with multiple males (polyandry), resulting in male-male competition extending to post-copulation (sperm competition). Males adapt to such post-copulatory sexual selection by altering features of their ejaculate that increase its competitiveness and/or by decreasing the risk of sperm competition through female manipulation or interference with rival male behaviour. At ejaculation, males of many species deposit copulatory plugs, which are commonly interpreted as a male adaptation to post-copulatory competition and are thought to reduce or delay female remating. Here, we used a vertebrate model species, the house mouse, to study the consequences of copulatory plugs for post-copulatory competition. We experimentally manipulated plugs after a female's first mating and investigated the consequences for rival male behaviour and paternity outcome. We found that even intact copulatory plugs were ineffective at preventing female remating, but that plugs influenced the rival male copulatory behaviour. Rivals facing intact copulatory plugs performed more but shorter copulations and ejaculated later than when the plug had been fully or partially removed. This suggests that the copulatory plug represents a considerable physical barrier to rival males. The paternity share of first males increased with a longer delay between the first and second males' ejaculations, indicative of fitness consequences of copulatory plugs. However, when males provided little copulatory stimulation, the incidence of pregnancy failure increased, representing a potential benefit of intense and repeated copulation besides plug removal. We discuss the potential mechanisms of how plugs influence sperm competition outcome and consequences for male copulatory behaviour.

  7. Fistula Plug in Fistulising Ano-Perineal Crohn's Disease: a Randomised Controlled Trial.

    Science.gov (United States)

    Senéjoux, A; Siproudhis, L; Abramowitz, L; Munoz-Bongrand, N; Desseaux, K; Bouguen, G; Bourreille, A; Dewit, O; Stefanescu, C; Vernier, G; Louis, E; Grimaud, J C; Godart, B; Savoye, G; Hebuterne, X; Bauer, P; Nachury, M; Laharie, D; Chevret, S; Bouhnik, Y

    2016-02-01

    Anal fistula plug [AFP] is a bioabsorbable bioprosthesis used in ano-perineal fistula treatment. We aimed to assess efficacy and safety of AFP in fistulising ano-perineal Crohn's disease [FAP-CD]. In a multicentre, open-label, randomised controlled trial we compared seton removal alone [control group] with AFP insertion [AFP group] in 106 Crohn's disease patients with non- or mildly active disease having at least one ano-perineal fistula tract drained for more than 1 month. Patients with abscess [collection ≥ 3mm on magnetic resonance imaging or recto-vaginal fistulas were excluded. Randomisation was stratified in simple or complex fistulas according to AGA classification. Primary end point was fistula closure at Week 12. In all, 54 patients were randomised to AFP group [control group 52]. Median fistula duration was 23 [10-53] months. Median Crohn's Disease Activity Index at baseline was 81 [45-135]. Fistula closure at Week 12 was achieved in 31.5% patients in the AFP group and in 23.1 % in the control group (relative risk [RR] stratified on AGA classification: 1.31; 95% confidence interval: 0.59-4.02; p = 0.19). No interaction in treatment effect with complexity stratum was found; 33.3% of patients with complex fistula and 30.8% of patients with simple fistula closed the tracts after AFP, as compared with 15.4% and 25.6% in controls, respectively [RR of success = 2.17 in complex fistula vs RR = 1.20 in simple fistula; p = 0.45]. Concerning safety, at Week 12, 17 patients developed at least one adverse event in the AFP group vs 8 in the controls [p = 0.07]. AFP is not more effective than seton removal alone to achieve FAP-CD closure. Copyright © 2015 European Crohn’s and Colitis Organisation (ECCO). Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.

  8. Steinert's syndrome presenting as anal incontinence: a case report

    Directory of Open Access Journals (Sweden)

    Uzum Ayse

    2011-08-01

    Full Text Available Abstract Introduction Myotonic dystrophy (MD or Steinert's syndrome is a rare cause of chronic diarrhea and anal incontinence. In the presence of chronic diarrhea and fecal incontinence with muscle weakness, neuromuscular disorders such as myotonic dystrophy should be considered in the differential diagnosis. Case Presentation We present the case of a 45-year-old Turkish man with Steinert's syndrome, who was not diagnosed until the age of 45. Conclusions In clinical practice, the persistence of diarrhea and fecal incontinence with muscle weakness should suggest that the physician perform an anal manometric study and electromyography. Neuromuscular disorders such as myotonic dystrophy should be considered in the differential diagnosis.

  9. Correlação entre a incompetência esfincteriana anal e a prática de sexo anal em homossexuais do sexo masculino Correlation between anal sphincter incompetence and anal sex practice in male homosexual

    OpenAIRE

    Maíra Costa Ferreira; Tatiana Pereira Braz; Ana Maria Oliveira Machado; Gabriel Ribeiro; Rosana Cristina Pererira de Andrade

    2010-01-01

    INTRODUÇÃO: a incontinência anal (IA) é uma disfunção de origem multifatorial com impacto significativo na qualidade de vida do indivíduo. Dentre as diversas etiologias para IA encontra-se a traumática, provocada pela penetração de objetos no canal anal. A inclusão do ânus na atividade sexual, já vem sendo descrita, principalmente entre homossexuais do sexo masculino. A partir desta premissa, questionou-se nesta pesquisa a possibilidade da penetração do pênis no ânus se enquadrar como etiolog...

  10. Use of Anal Acoustic Reflectometry in the Evaluation of Men With Passive Fecal Leakage.

    Science.gov (United States)

    Hornung, Benjamin R; Telford, Karen J; Carlson, Gordon L; Mitchell, Peter J; Klarskov, Niels; Kiff, Edward S

    2017-05-01

    Men with passive fecal leakage represent a distinct clinical entity in which the pathophysiology remains unclear. Standard anorectal investigations fail to demonstrate consistent abnormalities in this group. Anal acoustic reflectometry is a new test of anal sphincter function with greater sensitivity and discriminatory ability than conventional anal manometry. The aim of this study was to determine whether men with fecal leakage have an abnormality in anal sphincter function that is detectable by anal acoustic reflectometry. This was an age-matched study of continent and incontinent men. The study was conducted at a university teaching hospital. Male patients with isolated symptoms of fecal leakage were recruited. Anal acoustic reflectometry, followed by conventional anal manometry, was performed. Results were then compared with those from an age-matched group of men with no symptoms of anal incontinence or anorectal pathology. Variables measured with anal acoustic reflectometry and anal manometry in the incontinent and continent men were compared. Thirty subjects were recruited, of whom 15 were men with fecal leakage and 15 were continent men. There was a significantly higher incidence of previous anorectal surgery in the men with leakage. The anal acoustic reflectometry variables of opening and closing pressure were significantly lower in leakers compared with continent subjects (p = 0.003 and p = 0.001). Hysteresis was significantly greater in the male leaker group (p = 0.026). No difference was seen in anal manometry. With a larger sample size, the effect of previous anorectal surgery and the presence of an anal sphincter defect could be clarified. Anal acoustic reflectometry is a sensitive test of anal sphincter function and, unlike anal manometry, can discriminate male leakers from continent subjects. An identifiable abnormality has been detected using anal acoustic reflectometry, which may further our understanding of the pathogenesis in this group.

  11. Unified theory on the pathogenesis of Randall's plaques and plugs.

    Science.gov (United States)

    Khan, Saeed R; Canales, Benjamin K

    2015-01-01

    Kidney stones develop attached to sub-epithelial plaques of calcium phosphate (CaP) crystals (termed Randall's plaque) and/or form as a result of occlusion of the openings of the Ducts of Bellini by stone-forming crystals (Randall's plugs). These plaques and plugs eventually extrude into the urinary space, acting as a nidus for crystal overgrowth and stone formation. To better understand these regulatory mechanisms and the pathophysiology of idiopathic calcium stone disease, this review provides in-depth descriptions of the morphology and potential origins of these plaques and plugs, summarizes existing animal models of renal papillary interstitial deposits, and describes factors that are believed to regulate plaque formation and calcium overgrowth. Based on evidence provided within this review and from the vascular calcification literature, we propose a "unified" theory of plaque formation-one similar to pathological biomineralization observed elsewhere in the body. Abnormal urinary conditions (hypercalciuria, hyperoxaluria, and hypocitraturia), renal stress or trauma, and perhaps even the normal aging process lead to transformation of renal epithelial cells into an osteoblastic phenotype. With this de-differentiation comes an increased production of bone-specific proteins (i.e., osteopontin), a reduction in crystallization inhibitors (such as fetuin and matrix Gla protein), and creation of matrix vesicles, which support nucleation of CaP crystals. These small deposits promote aggregation and calcification of surrounding collagen. Mineralization continues by calcification of membranous cellular degradation products and other fibers until the plaque reaches the papillary epithelium. Through the activity of matrix metalloproteinases or perhaps by brute physical force produced by the large sub-epithelial crystalline mass, the surface is breached and further stone growth occurs by organic matrix-associated nucleation of CaOx or by the transformation of the outer layer

  12. Study on plasma parameters and dust charging in an electrostatically plugged multicusp plasma device

    Science.gov (United States)

    Kakati, B.; Kausik, S. S.; Saikia, B. K.; Bandyopadhyay, M.

    2011-06-01

    The effect of the electrostatic confinement potential on the charging of dust grains and its relationship with the plasma parameters has been studied in an electrostatically plugged multicusp dusty plasma device. Electrostatic plugging is implemented by biasing the electrically isolated magnetic multicusp channel walls. The experimental results show that voltage applied to the channel walls can be a controlling parameter for dust charging.

  13. The Status of USITER Diagnostic Port Plug Neutronics Analysis Using Attila

    Energy Technology Data Exchange (ETDEWEB)

    Feder, Russell [1; Youssef, Mahamoud [2; Klabacha, Jonathan [1

    2013-11-01

    USITER is one of seven partner domestic agencies (DA) contributing components to the ITER project. Four diagnostic port plug packages (two equatorial ports and two upper ports) will be engineered and fabricated by Princeton Plasma Physics Lab (PPPL). Diagnostic port plugs as illustrated in Fig. 1 are large primarily stainless steel structures that serve several roles on ITER. The port plugs are the primary vacuum seal and tritium confinement barriers for the vessel. The port plugs also house several plasma diagnostic systems and other machine service equipment. Finally, each port plug must shield high energy neutrons and gamma photons from escaping and creating radiological problems in maintenance areas behind the port plugs. The optimization of the balance between adequate shielding and the need for high performance, high throughput diagnostics systems is the focus of this paper. Neutronics calculations are also needed for assessing nuclear heating and nuclear damage in the port plug and diagnostic components. Attila, the commercially available discrete-ordinates software package, is used for all diagnostic port plug neutronics analysis studies at PPPL.

  14. 40 CFR 147.3108 - Plugging Class I, II, and III wells.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 22 2010-07-01 2010-07-01 false Plugging Class I, II, and III wells... Certain Oklahoma Indian Tribes § 147.3108 Plugging Class I, II, and III wells. In addition to the... well: (a) For Class I and III wells: (1) The well shall be filled with mud from the bottom of the...

  15. Effects of inertia and gravity on liquid plug splitting at a bifurcation.

    Science.gov (United States)

    Zheng, Y; Fujioka, H; Grotberg, J C; Grotberg, J B

    2006-10-01

    Liquid plugs may form in pulmonary airways during the process of liquid instillation or removal in many clinical treatments. During inspiration the plug may split at airway bifurcations and lead to a nonuniform final liquid distribution, which can adversely affect treatment outcomes. In this paper, a combination of bench top experimental and theoretical studies is presented to study the effects of inertia and gravity on plug splitting in an airway bifurcation model to simulate the liquid distributions in large airways. The splitting ratio, Rs, is defined as the ratio of the plug volume entering the upper (gravitationally opposed) daughter tube to the lower (gravitationally favored) one. Rs is measured as a function of parent tube Reynolds number, Rep; gravitational orientations for roll angle, phi, and pitch angle, gamma; parent plug length LP; and the presence of pre-existing plug blockages in downstream daughter tubes. Results show that increasing Rep causes more homogeneous splitting. A critical Reynolds number Rec is found to exist so that when Rep water, glycerin, and LB-400X. A theoretical model based on entrance flow for the plug in the daughters is developed and predicts Rs versus Rep. The frictional pressure drop, as a part of the total pressure drop, is estimated by two fitting parameters and shows a linear relationship with Rep. The theory provides a good prediction on liquid plug splitting and well simulates the liquid distributions in the large airways of human lungs.

  16. Plug and Play Process Control Applied to a District Heating System

    DEFF Research Database (Denmark)

    Knudsen, Torben; Trangbæk, Klaus; Kallesøe, Carsten Skovmose

    2008-01-01

    The general ideas within plug and play process control (PTC) are to initialize and reconfigure control systems just by plug and play. In this paper these ideas are applied to a district heating pressure control problem. First of all this serves as a concrete example of PTC, secondly some of the f...

  17. Chinese Standards on Refractories Purging Plugs and Well Blocks for Refining Ladle

    Institute of Scientific and Technical Information of China (English)

    Zhang Xiaohui

    2009-01-01

    @@ 1 Scope This standard specifies the classification,technical requirements,test methods,inspection rules,marking,packing,transportation,storage and quality certificate of purging plugs and well blocks for refining ladle. This standard is applicable to the directional slit purging plugs and well blocks for refining ladle.

  18. Conceptual design of the ITER upper port plug for charge exchange diagnostic

    NARCIS (Netherlands)

    Sadakov, S.; Baross, T.; Biel, W.; Borsuk, V.; Hawkes, N.; Hellermann, M. von; Gille, P.; Kiss, G.; Koning, J.; Knaup, M.; Klinkhamer, J.F.F.; Krasikov, Yu.; Litnovsky, A.; Neubauer, O.; Panin, A.

    2009-01-01

    A plug for the ITER core charge exchange recombination spectroscopy (core CXRS) is located in the upper port 3. It transfers the light emitted by interaction of plasma ions with the diagnostic neutral beam (DNB). The plug consists of a main shell, a shielding cassette and a retractable tube. The tub

  19. Control and assessment of plugging of mesopores in SBA-15 materials

    NARCIS (Netherlands)

    Shakeri, M; Klein Gebbink, R.J.M.; de Jongh, P.E.; de Jong, K.P.

    2013-01-01

    Plugged SBA-15 materials consist of mesoporous channels constricted along the central axis by windows. Tailoring and measurement of physical properties, particularly the window sizes, of plugged SBA-15 materials are crucial for potential host–guest applications. In this paper we report a synthesis p

  20. Analysis and methodology for measuring oxygen concentration in liquid sodium with a plugging meter

    Energy Technology Data Exchange (ETDEWEB)

    Nollet, B. K.; Hvasta, M.; Anderson, M. [Univ. of Wisconsin-Madison, 1500 Engineering Dr., Madison, WI 53706 (United States)

    2012-07-01

    Oxygen concentration in liquid sodium is a critical measurement in assessing the potential for corrosion damage in sodium-cooled fast reactors (SFRs). There has been little recent work on sodium reactors and oxygen detection. Thus, the technical expertise dealing with oxygen measurements within sodium is no longer readily available in the U.S. Two methods of oxygen detection that have been investigated are the plugging meter and the galvanic cell. One of the overall goals of the Univ. of Wisconsin's sodium research program is to develop an affordable, reliable galvanic cell oxygen sensor. Accordingly, attention must first be dedicated to a well-known standard known as a plugging meter. Therefore, a sodium loop has been constructed on campus in effort to develop the plugging meter technique and gain experience working with liquid metal. The loop contains both a galvanic cell test section and a plugging meter test section. Consistent plugging results have been achieved below 20 [wppm], and a detailed process for achieving effective plugging has been developed. This paper will focus both on an accurate methodology to obtain oxygen concentrations from a plugging meter, and on how to easily control the oxygen concentration of sodium in a test loop. Details of the design, materials, manufacturing, and operation will be presented. Data interpretation will also be discussed, since a modern discussion of plugging data interpretation does not currently exist. (authors)

  1. Mobotware – A Plug-in Based Framework For Mobile Robots

    DEFF Research Database (Denmark)

    Beck, Anders Billesø; Andersen, Nils Axel; Andersen, Jens Christian

    2010-01-01

    integration of sensors, fast porting to new robots and core system stability and maintainability in an undisciplined programming environment. Real-time performance is assured by using RTAI-Linux; core stability is obtained by using plug-ins for user developed modules. The plug-in based module structure...

  2. Empaatia kogemus kunstiteoses kujutatud subjekti suhtes: fenomenoloogiline analüüs / Marge Paas

    Index Scriptorium Estoniae

    Paas, Marge, 1976-

    2015-01-01

    Analüüsitakse vaataja esteetilist kogemust kunstiteose suhtes. Autor tugineb Edith Steini empaatia kogemuse uurimusele ja fenomenoloogilisele uurimismeetodile. Vaataja empaatia kogemuse analüüs Maarit Murka maalisarjas "Hairpower" kujutatud subjekti suhtes

  3. Empaatia kogemus kunstiteoses kujutatud subjekti suhtes: fenomenoloogiline analüüs / Marge Paas

    Index Scriptorium Estoniae

    Paas, Marge, 1976-

    2015-01-01

    Analüüsitakse vaataja esteetilist kogemust kunstiteose suhtes. Autor tugineb Edith Steini empaatia kogemuse uurimusele ja fenomenoloogilisele uurimismeetodile. Vaataja empaatia kogemuse analüüs Maarit Murka maalisarjas "Hairpower" kujutatud subjekti suhtes

  4. HIV infection connected to rising anal cancer rates in men in the U.S.

    Science.gov (United States)

    Human immunodeficiency virus (HIV) infection contributes substantially to the epidemic of anal cancer in men, but not women in the United States, according to new research from NCI. Chart shows overall incidence rates of anal cancers in general population

  5. Modifiable risk factors of obstetric anal sphincter injury in primiparous women

    DEFF Research Database (Denmark)

    Jango, Hanna; Langhoff-Roos, Jens; Rosthøj, Susanne

    2014-01-01

    To determine modifiable risk factors and incidence of obstetric anal sphincter injury (OASIS) in primiparous women.......To determine modifiable risk factors and incidence of obstetric anal sphincter injury (OASIS) in primiparous women....

  6. [Anal abscess with a tuberculous origin: report of two cases and review of the literature].

    Science.gov (United States)

    Romelaer, Charlotte; Abramowitz, Laurent

    2007-01-01

    Gastrointestinal tuberculosis represents 1% of extrapulmonary tuberculoses and only sporadic cases of anal tuberculosis have been reported in the literature. We report two cases of tuberculous anal abscess and a review of the literature for diagnosis and treatment.

  7. Preparation and Performance of an Adsorption Type Gel Plugging Agent as Enhanced Oil Recovery Chemical

    Directory of Open Access Journals (Sweden)

    Xiaoping Qin

    2015-01-01

    Full Text Available A novel adsorption type gel plugging agent (ATGPA was prepared using acrylamide (AM, acrylic acid (AA, diallyl dimethyl ammonium chloride (DMDAAC, 2-acrylamido-2-methylpropanesulfonate (AMPS, formaldehyde (HCHO, resorcinol (C6H6O2, and thiocarbamide (CH4N2S as raw materials under mild conditions. ATGPA was characterized by infrared (IR spectroscopy, elemental analysis, and scanning electron microscope (SEM. It was found that ATGPA exhibited higher elastic modulus (G′ and viscous modulus (G′′ than AM/AA gel plugging agent (AAGPA under the same scanning frequency. It was also found that ATGPA had moderate temperature resistance and salt tolerance. Core plugging tests results indicated that ATGPA could achieve up to higher plugging rate (PR than AAGPA (97.2% versus 95.7% at 65°C. In addition, ATGPA possessed stronger antiscouring ability by core plugging experiments at 65°C.

  8. Analýza vybrané firmy

    OpenAIRE

    ZAVORALOVÁ, Eva

    2012-01-01

    Diplomová práce je zaměřena na analýzu realitní společnosti M&M reality holding, a.s.. V rámci mapování společnosti se zaměřuji na rozbor oborového okolí pomocí PEST analýzy, Porterův model pěti konkurenčních sil, SWOT analýzu a finanční analýzu. V závěru práce navrhuji doporučení, která by měla vést ke zlepšení současné situace. The master´s thesis is focused on the analysis of real estate company M&M reality holding, a.s.. The mapping of the analysis focuses on the professional environme...

  9. Aspectos funcionales de la psicoterapia analítico funcional.

    Directory of Open Access Journals (Sweden)

    Javier Virués Ortega

    2003-01-01

    Full Text Available Se considera una nueva psicoterapia de orientación conductual: la Psicoterapia Analítico Funcional. Se describen brevemente sus fundamentos teóricos, metodológicos y aplicados. Se discuten sus aspectos funcionales desde un punto de vista contextual.

  10. The Danish anal sphincter rupture questionnaire: Validity and reliability

    DEFF Research Database (Denmark)

    Due, Ulla; Ottesen, Marianne

    2008-01-01

    offered pelvic floor muscle examination and instruction by a specialist physiotherapist. In relation to that, a non-validated questionnaire about anal and urinary incontinence was to be answered six months after childbirth. Method. The original questionnaire was revised and a pilot test was performed...

  11. Primary radiation therapy in the treatment of anal carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Cantril, S.T. (Children' s Hospital of San Francisco, CA); Green, J.P.; Schall, G.L.; Schaupp, W.C.

    1983-09-01

    From 1966 to 1981, 47 patients with a diagnosis of anal carcinoma were irradiated. This group was composed of 23 males and 24 females, with age ranging from 38 to 84 years (average 64.4 years). Five patients were treated preoperatively and 34 were treated definitively with cancericidal doses of irradiation. Acute radiation reactions requiring a rest-break were noted in 28% of patients, but all were managed as outpatients without untoward chronic sequelae. Chronic complications were noted in 13 patients, including two patients who required colostomy for severe anal stenosis and two who required A-P resection for large painful ulcers. Twenty-eight of 35 patients (80%) treated with irradiation alone have remained locally controlled without further treatment. An additional four have been salvaged by surgery. Only three patients had interstitial implants as part of their treatment course. Actuarial survival at five years for the N/sub 0/ patients and the group as a whole are 95.6 and 79.3%, respectively. It is concluded that external beam irradiation alone, properly fractionated to cancericidal doses, can control anal carcinoma with acceptable morbidity rates and without the use of either chemotherapy or interstitial implants in most cases. There is also a strong correlation suggesting that anal intercourse and male homosexuality play a significant role in the etiology of this disease.

  12. Aspectos funcionales de la psicoterapia analítico funcional.

    OpenAIRE

    Javier Virués Ortega; Alberto Descalzo Quero; José Fernando Venceslá Martínez

    2003-01-01

    Se considera una nueva psicoterapia de orientación conductual: la Psicoterapia Analítico Funcional. Se describen brevemente sus fundamentos teóricos, metodológicos y aplicados. Se discuten sus aspectos funcionales desde un punto de vista contextual.

  13. Anal endosonographic findings in women after vaginal delivery

    Energy Technology Data Exchange (ETDEWEB)

    Kolodziejczak, Malgorzata [Department of Proctology, Hospital at Solec, Warsaw (Poland); Sudol-Szopinska, Iwona, E-mail: iwsud@ciop.pl [Department of Proctology, Hospital at Solec, Warsaw (Poland); Department of Diagnostic Imaging, Second Faculty of Warsaw Medical University, Warsaw (Poland); Stefanski, Robert [Department of Proctology, Hospital at Solec, Warsaw (Poland); Department of Diagnostic Imaging, Second Faculty of Warsaw Medical University, Warsaw (Poland); Panorska, Anna K. [Department of Mathematics and Statistics, University of Nevada, Reno (United States); Gardyszewska, Agnieszka [Second Clinic of Obstetrics and Gynecology, Warsaw (Poland); Krasnodebski, Ireneusz [Department of General and Gastroenterological Surgery and Nutrition, Medical University, Warsaw (Poland)

    2011-04-15

    Objective: To estimate a frequency of obstetric anal sphincters defects in women after vaginal delivery. Methods: The study included 102 women, aged from 16 to 40 years (mean age 28.6 years). 28 women had perineal lacerations of 3rd and 4th degree. 22 women had instrumental delivery. Anal endosonography was performed on all participants using BK Medical scanner Pro focus with a 3D endoprobe during the first week after delivery. Starck's classification was used to score sphincters defects. Results: The endosonographic images were abnormal in 8 out of 102 women (7.8%). Follow-up examinations after 6 weeks confirmed defects in 6 out of 102 women (5.8%). Five women had external anal sphincter torn, and 1 woman had both sphincters, internal and external, defected. Discordance between endosonographic diagnosis of defect and clinical assessment of sphincters continuity was demonstrated in 6 (5.9%) out of 8 initially found, including 2 (1.9%) false endosonographic results and 4 (3.9%) false clinical diagnosis (occult sphincter defects). The endosonography sensitivity and accuracy in sphincter defect diagnostic amounted to 100% and 98%, respectively. Conclusions: (1) Anal sphincters' tears in symptomatic women are not as frequent as it was believed. (2) The defect diagnosis in the first week after delivery should be verified by a follow-up endosonography in 6 weeks, after regression of the edema and hematoma.

  14. Internal sphincterotomy versus topical nitroglycerin ointment for chronic anal fissure

    Directory of Open Access Journals (Sweden)

    Muhammad I. Aslam

    2014-01-01

    Conclusion: This quasi-experimental study demonstrates that open partial lateral internal sphincterotomy is superior to topical 0.2% nitroglycerin application in the treatment of chronic anal fissure, with good symptomatic relief, high rate of healing, fewer side effects, and a very low rate of early continence disturbances.

  15. Aspectos funcionales de la psicoterapia analítico funcional.

    OpenAIRE

    2003-01-01

    Se considera una nueva psicoterapia de orientación conductual: la Psicoterapia Analítico Funcional. Se describen brevemente sus fundamentos teóricos, metodológicos y aplicados. Se discuten sus aspectos funcionales desde un punto de vista contextual.

  16. Usefulness and limitations of CT examinations for deep anal fistulas

    Energy Technology Data Exchange (ETDEWEB)

    Suzuki, Shinichiro; Matsumoto, Akihiko (Yokohama City Univ. (Japan). Faculty of Medicine); Kono, Kazuo (and others)

    1990-05-01

    Preoperative CT examination was performed on 30 cases of deep anal fistula and one case with an anal fistular carcinoma, and its usefulness and the limit of applicability were investigated. The deep anal fistula was recognized as a funicular or tumorous shadow on CT image. The differentiation of tumorous shadow and carcinoma was performed by biopsy under CT observation. While, there were also unidentifiable cases including three out of eight cases (37.5%) in II HC type and one out of 11 cases (9.1%) in II HC and III B types. Particularly, patients with a rectostenosis as the madn lesion could not be identified on CT images. The benefits of CT examination in deep anal fistula were compared with transrectal ultrasonography to establish a procedure for image diagnosis. Transrectal ultrasonography is performed as a routine test and CT examination is added when a lesion waving diameter of more than one cm is observed. Furthermore, active biopsy for patients with suspected carcinoma is planned under CT observation. (author).

  17. Anovestibular fistula with normal anal opening: Is it always congenital?

    Directory of Open Access Journals (Sweden)

    Jain Prashant

    2008-01-01

    Full Text Available Aim: To review 12 cases of anovestibular fistula with normal anal opening. Methods: Retrospective analysis of 12 children with anovestibular fistula and normal anal opening were treated between the years 2000 and 2007. Of these, 11 patients were diagnosed as having acquired anovestibular fistula with normal anal opening and were managed by conservative management. Results: Most of them presented with diarrhea and labial redness. One patient was considered to have fistula of congenital origin and was managed surgically. Eleven patients presented between the ages of 1.5-11 months and were considered as cases of acquired anovestibular fistula and only two of them required surgical management in the form of colostomy and fistula excision. Others were successfully managed by conservative treatment; the fistulous output and labial redness decreased gradually within a period of 5-19 (average 11.5 days. Conclusions: Not all presentations of anovestibular fistula with normal anal opening can be considered as congenital. Presence of inflammation, paramedian fistula, and a favourable response to conservative management/colostomy suggest acquired etiology. Trial of conservative management should be given in the acquired variety.

  18. Organisation og tidlige operationsresultater efter ileo-pouch-anal-anastomose

    DEFF Research Database (Denmark)

    Ljungmann, Ken; Bendixen, Anette; Laurberg, Søren;

    2008-01-01

    INTRODUCTION: Restorative proctocolectomy and ileal pouch-anal anastomosis (IPAA) has become the operation of choice for patients with ulcerative colitis and familial polyposis. However, the procedure is complex with a long learning curve, and carries a risk of both early and late complications...

  19. Hafnia-plugged microcavities for thermal stability of selective emitters

    Science.gov (United States)

    Lee, Heon-Ju; Smyth, Katherine; Bathurst, Stephen; Chou, Jeffrey; Ghebrebrhan, Michael; Joannopoulos, John; Saka, Nannaji; Kim, Sang-Gook

    2013-06-01

    Two-dimensional arrays of micro-cavities effectively control photon motion and selectively emit radiation tailored to the preferred bandgap of photovoltaic (PV) cells, thus enhancing the efficiency of thermophotovoltaic energy conversion. At the high operating temperatures, however, the micro- and nano-patterned structures of the selective emitters quickly lose their integrity--obliterating the tight tolerances required for precise spectral control. Even if oxidation, recrystallization, and grain growth could be avoided with single-crystal tungsten (W) selective emitters with vacuum packaging, surface diffusion, evaporation, and re-condensation are not avoidable in long-term operation at high temperatures. The concept of a planar array of plugged micro-cavities to suppress the curvature-dependent thermal degradation modes is proposed and tested. Based on scale-accelerated failure tests of silicon devices, the lifetime of W selective emitters operating at 1100 K is estimated to be at least 30 yr.

  20. Plug-in electric vehicle (PEV) smart charging module

    Energy Technology Data Exchange (ETDEWEB)

    Harper, Jason; Dobrzynski, Daniel S.

    2017-09-12

    A smart charging system for charging a plug-in electric vehicle (PEV) includes an electric vehicle supply equipment (EVSE) configured to supply electrical power to the PEV through a smart charging module coupled to the EVSE. The smart charging module comprises an electronic circuitry which includes a processor. The electronic circuitry includes electronic components structured to receive electrical power from the EVSE, and supply the electrical power to the PEV. The electronic circuitry is configured to measure a charging parameter of the PEV. The electronic circuitry is further structured to emulate a pulse width modulated signal generated by the EVSE. The smart charging module can also include a first coupler structured to be removably couple to the EVSE and a second coupler structured to be removably coupled to the PEV.

  1. Plug-and-Play Control – Modifying Control Systems Online

    DEFF Research Database (Denmark)

    Bendtsen, Jan Dimon; Trangbæk, K; Stoustrup, Jakob

    2013-01-01

    Often, when new sensor or actuator hardware be- comes available for use in a control system, it is desirable to retain the existing control system and apply the new control capabilities in a gradual fashion rather than decommissioning the entire existing system and replacing it with an altogether...... new control system. However, this requires that the existing controller remains in action, and the new control law component is added to the existing system. This paper formally introduces the concept of Plug-and-Play control and proposes two different methods of introducing new control components...... in a smooth manner, providing stability guarantees during the transition phase as well as retaining the original control structure. The applicability of the methods is illustrated on two different practical example systems, a livestock stable climate control system and a laboratory-scale model of a district...

  2. Battery Test Manual For Plug-In Hybrid Electric Vehicles

    Energy Technology Data Exchange (ETDEWEB)

    Jeffrey R. Belt

    2010-09-01

    This battery test procedure manual was prepared for the United States Department of Energy (DOE), Office of Energy Efficiency and Renewable Energy (EERE), Vehicle Technologies Program. It is based on technical targets established for energy storage development projects aimed at meeting system level DOE goals for Plug-in Hybrid Electric Vehicles (PHEV). The specific procedures defined in this manual support the performance and life characterization of advanced battery devices under development for PHEV’s. However, it does share some methods described in the previously published battery test manual for power-assist hybrid electric vehicles. Due to the complexity of some of the procedures and supporting analysis, a revision including some modifications and clarifications of these procedures is expected. As in previous battery and capacitor test manuals, this version of the manual defines testing methods for full-size battery systems, along with provisions for scaling these tests for modules, cells or other subscale level devices.

  3. Battery Test Manual For Plug-In Hybrid Electric Vehicles

    Energy Technology Data Exchange (ETDEWEB)

    Jeffrey R. Belt

    2010-12-01

    This battery test procedure manual was prepared for the United States Department of Energy (DOE), Office of Energy Efficiency and Renewable Energy (EERE), Vehicle Technologies Program. It is based on technical targets established for energy storage development projects aimed at meeting system level DOE goals for Plug-in Hybrid Electric Vehicles (PHEV). The specific procedures defined in this manual support the performance and life characterization of advanced battery devices under development for PHEV’s. However, it does share some methods described in the previously published battery test manual for power-assist hybrid electric vehicles. Due to the complexity of some of the procedures and supporting analysis, a revision including some modifications and clarifications of these procedures is expected. As in previous battery and capacitor test manuals, this version of the manual defines testing methods for full-size battery systems, along with provisions for scaling these tests for modules, cells or other subscale level devices.

  4. Amplatzer vascular plug for rapid vessel occlusion in interventional neuroradiology.

    Science.gov (United States)

    Banfield, Jillian C; Shankar, Jai Jai Shiva

    2016-02-01

    The purpose of this paper is to report different uses of endovascular Amplatzer vascular plug (AVP) treatment for rapid vessel occlusion in the field of interventional neuroradiology. We retrospectively reviewed our interventional neuroradiology database from November 2010 to July 2015 and found nine patients who were treated with endovascular AVP. AVP was used for rapid vessel occlusion of common carotid artery (1 patient), internal carotid artery (5 patients), vertebral artery (2 patients), and internal jugular vein (1 patient). A median of three AVPs were used with almost immediate occlusion and no thromboembolic complications. Use of AVP is feasible, safe, rapid, and potentially cost-effective method for rapid occlusion of larger size vessels in the head and neck region for different indications.

  5. A Plug and Produce Framework for Industrial Collaborative Robots

    DEFF Research Database (Denmark)

    Schou, Casper; Madsen, Ole

    2017-01-01

    into agents and thus supports the software sharing of the robot operating system community. A clear separation of the hardware agents and the higher level task control is achieved through standardization of the functional interface, a standardization maintaining the possibility of specialized function......Collaborative robots are today ever more interesting in response to the increasing need for agile manufacturing equipment. Contrary to traditional industrial robots, collaborative robots are intended for working in dynamic environments alongside the production staff. To cope with the dynamic...... environment and workflow, new configuration and control methods are needed compared to those of traditional industrial robots. The new methods should enable shop floor operators to reconfigure the robot. This article presents a plug and produce framework for industrial collaborative robots. The article...

  6. Hydrotransport plugging study. FY 1980-1981 progress report

    Energy Technology Data Exchange (ETDEWEB)

    Eyler, L.L.; Lombardo, NJ.; Barnhart, J.S.

    1982-09-01

    Large-particle hydrotransport flow phenomena are analyzed. These include particle suspension mechanisms, relative in situ slip between phases, and shear between separated solid/liquid flow regions. These phenomena are related to the mechanistic force balance modeling approach to predicting nominal and minimum horizontal pipeline transport conditions. Results of four series of tests in a 35 m-long, 0.165 m-diameter plexiglass pipeline are presented. These tests were designed to investigate isolated flow phenomena related to lower limits of operation of large-particle transport. They included measurements of the particle size dependence and flow geometry dependence on interfacial friction factors, initiation of plug flow motion, and plugging tendencies of flow through upward-turning elbows. Numerous flow phenomena and parameter dependencies are included in analysis of predictions made using the force balance modeling approach. Comparisons with data are made where possible and a step-by-step solution procedure is presented. Results show agreement with some data sets and disagreement with others. Most available data, however, are neither extensive enough nor accurate enough to form complete conclusions as to the minimum operating conditions predicted with the force balance modeling approach. Additional data from a systematic experimental program in a once-through pipeline system are necessary to further verify the modeling approach. A limited qualitative analysis of methods proposed to unplug large particle pipelines is presented. Methods assessed include pulsed air injection, vibration augmentation, friction reducing surfactant injection, and mechanical or hydraulic boring machinery. Advantages and disadvantages of each method are assessed qualitatively. Laboratory and field testing are required to determine applications.

  7. Gastrotomy closure using bioabsorbable plugs in a canine model.

    Science.gov (United States)

    Cios, Theodore J; Reavis, Kevin M; Renton, David R; Hazey, Jeffrey W; Mikami, Dean J; Narula, Vimal K; Allemang, Matthew T; Davis, S Scott; Melvin, W Scott

    2008-04-01

    The repair of gastric perforation commonly involves simple suture closure using an open or laparoscopic approach. An endolumenal approach using prosthetic materials may be beneficial. The role of bioprosthetics in this instance has not been thoroughly investigated, thus the authors evaluated the feasibility of gastric perforation repair using a bioabsorbable device and quantified gross and histological changes at the injury site. Twelve canines were anesthetized and underwent open gastrotomy. A 1-cm-diameter perforation was created in the anterior wall of the stomach and plugged with a bioabsorbable device. Intralumenal pH was recorded. Canines were sacrificed at one, four, six, eight, and 12 weeks. The stomach was explanted followed by gross and histological examination. The injury site was examined. The relative ability of the device to seal the perforation was recorded, as were postoperative changes. Tissue samples were analyzed for gross and microscopic tissue growth and compared to normal gastric tissue in the same animal as an internal control. A scoring system of -2 to +2 was used to measure injury site healing (-2= leak, -1= no leak and minimal ingrowth, 0= physiologic healing, +1= mild hypertrophic tissue, +2= severe hypertrophic tissue). In all canines, the bioprosthesis successfully sealed the perforation without leak under ex vivo insufflation. At one week, the device maintained its integrity but there was no tissue ingrowth. Histological healing score was -1. At 4-12 weeks, gross examination revealed a healed injury site in all animals. The lumenal portion of the plug was completely absorbed. The gross and histological healing score ranged from -1 to +1. The application of a bioabsorbable device results in durable closure of gastric perforation with physiologic healing of the injury site. This method of gastrotomy closure may aid in the evolution of advanced endoscopic approaches to perforation closure of hollow viscera.

  8. Mechanistic Understanding of Microbial Plugging for Improved Sweep Efficiency

    Energy Technology Data Exchange (ETDEWEB)

    Steven Bryant; Larry Britton

    2008-09-30

    Microbial plugging has been proposed as an effective low cost method of permeability reduction. Yet there is a dearth of information on the fundamental processes of microbial growth in porous media, and there are no suitable data to model the process of microbial plugging as it relates to sweep efficiency. To optimize the field implementation, better mechanistic and volumetric understanding of biofilm growth within a porous medium is needed. In particular, the engineering design hinges upon a quantitative relationship between amount of nutrient consumption, amount of growth, and degree of permeability reduction. In this project experiments were conducted to obtain new data to elucidate this relationship. Experiments in heterogeneous (layered) beadpacks showed that microbes could grow preferentially in the high permeability layer. Ultimately this caused flow to be equally divided between high and low permeability layers, precisely the behavior needed for MEOR. Remarkably, classical models of microbial nutrient uptake in batch experiments do not explain the nutrient consumption by the same microbes in flow experiments. We propose a simple extension of classical kinetics to account for the self-limiting consumption of nutrient observed in our experiments, and we outline a modeling approach based on architecture and behavior of biofilms. Such a model would account for the changing trend of nutrient consumption by bacteria with the increasing biomass and the onset of biofilm formation. However no existing model can explain the microbial preference for growth in high permeability regions, nor is there any obvious extension of the model for this observation. An attractive conjecture is that quorum sensing is involved in the heterogeneous bead packs.

  9. Anal function after ligation of the intersphincteric fistula tract.

    Science.gov (United States)

    Tsunoda, Akira; Sada, Haruki; Sugimoto, Takuya; Nagata, Hiroshi; Kano, Nobuyasu

    2013-07-01

    Although the ligation of the intersphincteric fistula tract is a promising anal sphincter-saving procedure for fistula-in-ano, the objective assessment of the sphincter preservation remains unknown. The primary end point was to measure the anal function before and after this procedure. The secondary end point measured was cure of the disease. This study is a prospective observational study. This study was conducted at the Department of Surgery, Kameda Medical Center, Japan, from March 2010 to August 2012. Twenty patients with transsphincteric or complex fistulas were evaluated. All patients underwent the ligation of the intersphincteric fistula tract with a loose seton for anal fistulas. Anal manometric study was performed before and 3 months after the procedure. Fecal incontinence was evaluated by using the fecal incontinence severity index. Failure was defined as nonhealing of the surgical wound or fistula. The median operation time was 42 minutes. No intraoperative complications were documented. The median follow-up duration was 18 (3-32) months. No patients reported any incontinence postoperatively. The median score of the fecal incontinence severity index before and 3 months after the procedure was 0. The median maximum resting pressure measured before and after operation were 125 (71-175) cm H2O and 133 (95-169) cm H2O. The median maximum squeeze pressure measured before and after operation were 390 (170-815) cm H2O and 432 (200-902) cm H2O. There were no significant postoperative changes in either the resting pressure or the squeeze pressure. Primary healing was observed in 19 (95%) patients, and the median healing time was 7 weeks; 1 wound remained incompletely healed. Short-term follow-up may not justify the use of the term definitive cure. The ligation of the intersphincteric fistula tract with a loose seton showed no postoperative deterioration on anal sphincter function with favorable healing rates.

  10. Cause-Specific Colostomy Rates After Radiotherapy for Anal Cancer: A Danish Multicentre Cohort Study

    DEFF Research Database (Denmark)

    Sunesen, Kåre G; Nørgaard, Mette; Lundby, Lilli

    2011-01-01

    In anal cancer, colostomy-free survival is a measure of anal sphincter preservation after treatment with radiotherapy or chemoradiotherapy. Failure to control anal cancer and complications of treatment are alternative indications for colostomy. However, no data exist on cause-specific colostomy...

  11. Relation between anal electrosensitivity and rectal filling sensation and the influence of age

    NARCIS (Netherlands)

    Broens, PMA; Penninckx, FM

    PURPOSE: The aim of this study was to assess the effect of age and sex on the rectal filling sensation and anal electrosensitivity and to explore the relation between anal electrosensitivity and the parameters of the rectal filling sensation. METHODS: Anal mucosal electrosensitivity and anorectal

  12. Relation between anal electrosensitivity and rectal filling sensation and the influence of age

    NARCIS (Netherlands)

    Broens, PMA; Penninckx, FM

    2005-01-01

    PURPOSE: The aim of this study was to assess the effect of age and sex on the rectal filling sensation and anal electrosensitivity and to explore the relation between anal electrosensitivity and the parameters of the rectal filling sensation. METHODS: Anal mucosal electrosensitivity and anorectal ma

  13. Patterns of surface burrow plugging in a colony of black-tailed prairie dogs occupied by black-footed ferrets

    Science.gov (United States)

    Eads, David E.; Biggins, Dean E.

    2012-01-01

    Black-tailed prairie dogs (Cynomys ludovicianus) can surface-plug openings to a burrow occupied by a black-footed ferret (Mustela nigripes). At a coarse scale, surface plugs are more common in colonies of prairie dogs occupied by ferrets than in colonies without ferrets. However, little is known about spatial and temporal patterns of surface plugging in a colony occupied by ferrets. In a 452-ha colony of black-tailed prairie dogs in South Dakota, we sampled burrow openings for surface plugs and related those data to locations of ferrets observed during spotlight surveys. Of 67,574 burrow openings in the colony between June and September 2007, 3.7% were plugged. In a colony-wide grid of 80 m × 80 m cells, the occurrence of surface plugging (≥1 opening plugged) was greater in cells used by ferrets (93.3% of cells) than in cells not observably used by ferrets (70.6%). Rates of surface plugging (percentages of openings plugged) were significantly higher in cells used by ferrets (median = 3.7%) than in cells without known ferret use (median = 3.2%). Also, numbers of ferret locations in cells correlated positively with numbers of mapped surface plugs in the cells. To investigate surface plugging at finer temporal and spatial scales, we compared rates of surface plugging in 20-m-radius circle-plots centered on ferret locations and in random plots 1–4 days after observing a ferret (Jun–Oct 2007 and 2008). Rates of surface plugging were greater in ferret-plots (median = 12.0%) than in random plots (median = 0%). For prairie dogs and their associates, the implications of surface plugging could be numerous. For instance, ferrets must dig to exit or enter plugged burrows (suggesting energetic costs), and surface plugs might influence microclimates in burrows and consequently influence species that cannot excavate soil (e.g., fleas that transmit the plague bacterium Yersinia pestis).

  14. Patterns of surface burrow plugging in a colony of black-tailed prairie dogs occupied by black-footed ferrets

    Science.gov (United States)

    Eads, D.A.; Biggins, D.E.

    2012-01-01

    Black-tailed prairie dogs (Cynomys ludovicianus) can surface-plug openings to a burrow occupied by a black-footed ferret (Mustela nigripes). At a coarse scale, surface plugs are more common in colonies of prairie dogs occupied by ferrets than in colonies without ferrets. However, little is known about spatial and temporal patterns of surface plugging in a colony occupied by ferrets. In a 452-ha colony of black-tailed prairie dogs in South Dakota, we sampled burrow openings for surface plugs and related those data to locations of ferrets observed during spotlight surveys. Of 67,574 burrow openings in the colony between June and September 2007, 3.7% were plugged. In a colony-wide grid of 80 m × 80 m cells, the occurrence of surface plugging (≥1 opening plugged) was greater in cells used by ferrets (93.3% of cells) than in cells not observably used by ferrets (70.6%). Rates of surface plugging (percentages of openings plugged) were significantly higher in cells used by ferrets (median = 3.7%) than in cells without known ferret use (median = 3.2%). Also, numbers of ferret locations in cells correlated positively with numbers of mapped surface plugs in the cells. To investigate surface plugging at finer temporal and spatial scales, we compared rates of surface plugging in 20-m-radius circle-plots centered on ferret locations and in random plots 1–4 days after observing a ferret (Jun–Oct 2007 and 2008). Rates of surface plugging were greater in ferret-plots (median = 12.0%) than in random plots (median = 0%). For prairie dogs and their associates, the implications of surface plugging could be numerous. For instance, ferrets must dig to exit or enter plugged burrows (suggesting energetic costs), and surface plugs might influence microclimates in burrows and consequently influence species that cannot excavate soil (e.g., fleas that transmit the plague bacterium Yersinia pests).

  15. Sexual behavior, cannibalism, and mating plugs as sticky traps in the orb weaver spider Leucauge argyra (Tetragnathidae).

    Science.gov (United States)

    Aisenberg, Anita; Barrantes, Gilbert

    2011-07-01

    Unpublished field observations in Leucauge argyra, a tropical orb weaver spider, suggest the occurrence of conspicuous mating plugs that could reduce or prevent remating attempts. Otherwise, the sexual behavior of this species remains unknown. The aims of this study were to describe the courtship behavior and copulation in L. argyra and investigate mating plug formation in this species. Fourteen virgin females and 12 plugged females were exposed to up to three males and checked for mating plug formation. Of the 12 virgins that copulated, nine produced plugs (five immediately after copulation), and the five plugged females that copulated produced another mating plug immediately after copulation. We did not detect the transfer of any male substance during copulation but observed a whitish liquid emerging from female genital ducts. Plug formation was positively associated with male twanging during courtship. One virgin and four plugged females cannibalized males. In seven trials with virgins and in three trials with plugged females, the male's palp adhered to a substance that emerged from female genital ducts and spread on her genital plate. The male had to struggle energetically to free his glued palp; two of these males were cannibalized while trying to release their palps. Females seem to determine copulation duration by altering the timing of mating plug formation and through sexual cannibalism. This is the first case reported of a mating plug as a sticky trap for males.

  16. Miniature plug connectors for photovoltaics integrated into the building; Miniatur-Steckverbinder fuer Bauwerk-integrierte Photovoltaik

    Energy Technology Data Exchange (ETDEWEB)

    Schamber, Andreas [Phoenix Contact GmbH and Co. KG, Blomberg (Germany)

    2012-09-15

    In the photovaltics integrated into the building, the plug connector should not only transmit the electric power safely and reliably over its lifetime. Plug connectors should also be easily tailored and fit well especially in the cable channel. Sunclix miniature plug connectors are one solution.

  17. Fuel-electricity mix and efficiency in Dutch plug-in and range-extender vehicles on the road

    NARCIS (Netherlands)

    Ligterink, N.E.; Smokers, R.T.M.; Bolech, M.

    2013-01-01

    For the Dutch Ministry for Infrastructure and the Environment data of plug-in vehicles was collected. Data concerning fueling and charging of plug-in vehicles is collected from lease companies, a fuel-pass company, and the charging infrastruture organisation. More than 10% of the total Dutch plug-in

  18. Comparative Study of Tailor-made Mesh Plug Herniorrhaphy Versus Lichtenstein Herniorrhaphy Versus Bassini Operation: A Prospective Clinical Trial

    Directory of Open Access Journals (Sweden)

    Phatchara Horharin

    2006-04-01

    Conclusion: Tailor-made mesh plug herniorrhaphy is a safe operation. The mesh plug material (Mersilene was cheap. The recurrence rate was lower with tailor-made mesh plug herniorrhaphy than with the Bassini operation, but equal to that with Lichtenstein herniorrhaphy. Postoperative complications did not differ among all operations.

  19. An experience with video-assisted anal fistula treatment (VAAFT) with new insights into the treatment of anal fistulae.

    Science.gov (United States)

    Seow-En, I; Seow-Choen, F; Koh, P K

    2016-06-01

    The aim of this retrospective study was to assess our experience of 41 patients with anal fistulae treated with video-assisted anal fistula treatment (VAAFT). Forty-one consecutive patients with cryptoglandular anal fistulae were included. Patients with low intersphincteric anal fistulae or those with gross perineal abscess were excluded. Eleven (27 %) patients had undergone prior fistula surgery with 5 (12 %) having had three or more previous operations. All patients underwent the diagnostic phase as well as diathermy and curettage of the fistula tracts during VAAFT. Primary healing rate was 70.7 % at a median follow-up of 34 months. Twelve patients recurred or did not heal and underwent a repeat VAAFT procedure utilising various methods of dealing with the internal opening. There was a secondary healing rate of 83 % with two recurrences. Overall, stapling of the internal opening had a 22 % recurrence rate, while anorectal advancement flap had a 75 % failure rate. There was no recurrence seen in six cases after using the over-the-scope-clip (OTSC(®)) system to secure the internal opening. VAAFT is useful in the identification of fistula tracts and enables closure of the internal opening. Adequate closure is essential with the method used to close large or fibrotic internal openings being the determining factor for success or failure. The OTSC system delivered the most consistent result without leaving a substantial perianal wound. Ensuring thorough curettage and drainage of the tract during VAAFT is also important to facilitate healing. We believe that this understanding will bring about a decrease in the high recurrence rates currently seen in many series of anal fistulae.

  20. Low-pH concrete plug for sealing the KBS-3V deposition tunnels

    Energy Technology Data Exchange (ETDEWEB)

    Malm, Richard (Vattenfall Power Consultant AB (Sweden))

    2012-01-15

    In SKB's main alternative for final repository of radioactive material, KBS-3V, the backfilled deposition tunnels will be separated from the remaining tunnel system with concrete plugs. These concrete plugs will be designed for a life span of 100 years and their function shall maintain until the transport tunnels outside the plug are backfilled and the natural geohydrological conditions have been restored. The purpose of this report is to document the results and the evaluation from this project and motivate the choice of the most appropriate design for closing the deposition tunnels in the spent fuel repository. The purpose has also been to investigate and present the loads acting on the plug system and determine the load capacity of the concrete plug. This report is the result of a project conducted between 2009-01-01 - 2010-12-31 and the project group has made its assessment based on the conditions and requirements that are present today. The entire design of the plug system is part of this project, where the plug system consists of a filter, a bentonite seal and a cast-in-place concrete plug. Two different conceptual design alternatives for the concrete plug have been studied in this report, one long tapered plug and one dome shaped plug. The results in this report focus on the choice of the conceptual design for the concrete plug and its possibility to assist the entire plug system to satisfy its requirements. It is a complicated task to dispose the radioactive waste and it sets high technical requirements on the design and the production of the backfill and the closing of the deposition tunnels. The aim of this project is to design and develop a plug system suitable for production. This is done by the means of numerical calculations and analyses. The primary function of the concrete plug is to act as a resistance to the external loads originated from the axial expansion of the backfill and the water pressure. However, the entire plug system has a

  1. Botulinum toxin A injection for chronic anal fissures and anal sphincter spasm improves quality of life in recessive dystrophic epidermolysis bullosa

    Directory of Open Access Journals (Sweden)

    Cassandra Chaptini, MBBS

    2015-12-01

    Full Text Available We report a 20-year-old female with generalized, severe, recessive dystrophic epidermolysis bullosa who developed secondary chronic anal fissures. This resulted in anal sphincter spasm and severe, disabling pain. She was treated with five botulinum toxin A injections into the internal anal sphincter over a period of 2 years and gained marked improvement in her symptoms. This case demonstrates the successful use of botulinum toxin A injections to relieve anal sphincter spasm and fissuring, with long-term improvement.

  2. New "all-in-one" device for mesh plug hernioplasty: the Trabucco repair.

    Science.gov (United States)

    Gossetti, Francesco; Massa, Salvatore; Abbonante, Francesco; Calabria, Michele; Ceci, Francesca; Viarengo, Maria Antonietta; Manzi, Emy; D'Amore, Linda; Negro, Paolo

    2015-01-01

    Sebbene la tecnica Mesh Plug rappresenti una procedura di indubbia efficacia nel trattamento dell’ernia inguinale, tuttora permangono dubbi in relazione alla storia naturale del plug. In particolare, il plug può andare incontro a coartazione (shrinkage) con formazione di un “meshoma” responsabile di una sintomatologia dolorosa cronica. Più raramente, il plug può migrare e provocare erosione delle strutture anatomiche circostanti. Nel passato sono stati proposti alcuni devices per cercare di risolvere il problema della migrazione; nessuno di questi, tuttavia, ha raggiunto la popolarità dei plug conici o a forma di fiore. Il presente lavoro riporta i risultati di uno studio pilota condotto con l’impiego di un nuovo device tridimensionale, il NeT Plug & Patch. I risultati dopo 12 mesi di follow-up, hanno dimostrato una ridotta incidenza di dolore postoperatorio e cronico, senza rischio di migrazione. Inoltre è stata registrata una compliance soddisfacente sia dei pazienti che degli operatori. La protesi NeT Plug & Patch ha dimostrato di poter realizzare un’ernioplastica semplice ed efficace per la riparazione dell’ernia inguinale.

  3. Preconceptual systems and equipment for plugging of man-made accesses to a repository in basalt

    Energy Technology Data Exchange (ETDEWEB)

    Taylor, C.L.; O' Rourke, J.E.; Allirot, D.; O' Connor, K.

    1980-09-01

    This report presents results of a study leading to preconceptual designs for plugging boreholes, shafts, and tunnels to a nuclear waste repository in basalt. Beginning design criteria include a list of preferred plug materials and plugging machines that were selected to suit the environmental conditions, and depths, diameters, and orientations of the accesses to a nuclear waste repository in the Columbia River basalts located in eastern Washington State. The environmental conditions are described. The fiscal year 1979-1980 Task II work is presented in two parts: preliminary testing of materials for plugging of man-made accesses to a repository in basalt (described in a separate report); and preconceptual systems and equipment for plugging of man-made accesses to a repository in basalt (described in this report). To fulfill the scope of the Task II work, Woodward-Clyde Consultants (WCC) was requested to: provide preconceptual systems for plugging boreholes, tunnels, and shafts in basalt; describe preconceptual borehole plugging equipment for placing the selected materials in man-made accesses; utilize the quality assurance program, program plan and schedule, and work plans previously developed for Task II; and prepare a preliminary report.

  4. Analysis of Spark Plug Gap on Flame Development using Schlieren Technique and Image Processing

    Science.gov (United States)

    Hii Shu-Yi, Paul; Khalid, Amir; Mohamad, Anuar; Manshoor, Bukhari; Sapit, Azwan; Zaman, Izzuddin; Hashim, Akasha

    2016-11-01

    Gasoline spark ignition system in cars remains one of the main consumption of fuel in the world nowadays. During combustion process, spark plug is one important key features in a gasoline engine. The incompatibility of spark plug gap width and the fuel used causing backfire and knocking in the combustion engine. Thus, the spark plug gap was studied with focussing in controlling the combustion process to improve the performance of the engine. The main purpose of this research is to investigate the effect of spark plug air gap on flame development. The parameters studied in this research include spark plug air gap width (1.0 mm, 1.2 mm, 1.4 mm, 1.6 mm and 1.8 mm), injection pressure (0.3 MPa, 0.4 MPa, 0.5 MPa and 0.6 MPa) and flame characteristics such as flame front area and the flame intensity. The flame front area of different spark plug gap and injection pressure were investigated through Schlieren photography method. The Schlieren images taken were analysed with the time changes. The experiment results proved that the increase of spark plug gap width will led to better flame development in shorter time while increased the chance of misfire.

  5. Diffuse large B cell lymphoma presenting as a peri-anal abscess.

    Science.gov (United States)

    Jayasekera, Hasanga; Gorissen, Kym; Francis, Leo; Chow, Carina

    2014-06-04

    A non-healing peri-anal abscess can be difficult to manage and is often attributed to chronic disease. This case documents a male in his seventh decade who presented with multiple peri-anal collections. The abscess cavity had caused necrosis of the internal sphincter muscles resulting in faecal incontinence. Biopsies were conclusive for diffuse large B-cell lymphoma. A de-functioning colostomy was performed and the patient was initiated on CHOP-R chemotherapy. Anal lymphoma masquerading as a peri-anal abscess is rare. A high degree of suspicion must be maintained for an anal abscess which does not resolve with conservative management.

  6. Regenerating the Anal Sphincter: Cytokines, Stem Cells, or Both?

    Science.gov (United States)

    Sun, Li; Xie, Zhuojun; Kuang, Mei; Penn, Marc; Damaser, Margot S; Zutshi, Massarat

    2017-04-01

    Healing of an anal sphincter defect at a time distant from injury is a challenge. We aimed to investigate whether re-establishing stem cell homing at the site of an anal sphincter defect when cytokine expression has declined using a plasmid engineered to express stromal derived factor 1 with or without mesenchymal stem cells can improve anatomic and functional outcome. This was a randomized animal study. Thirty-two female age- and weight-matched Sprague Dawley rats underwent 50% excision of the anal sphincter complex. Three weeks after injury, 4 interventions were randomly allocated (n = 8), including no intervention, 100-μg plasmid, plasmid and 800,000 cells, and plasmid with a gelatin scaffold mixed with cells. The differences in anal sphincter resting pressures just before and 4 weeks after intervention were used for functional analysis. Histology was analyzed using Masson staining. One-way ANOVA followed by the Tukey post hoc test was used for pressure and histological analysis. All 3 of the intervention groups had a significantly greater change in resting pressure (plasmid p = 0.009; plasmid + cells p = 0.047; plasmid + cells in scaffold p = 0.009) compared with the control group. The plasmid-with-cells group showed increased organization of muscle architecture and increased muscle percentage, whereas the control group showed disorganized architecture at the site of the defect. Histological quantification revealed significantly more muscle at the site of defect in the plasmid-plus-cells group compared with the control group, which had the least muscle. Quantification of connective tissue revealed significantly less fibrosis at the site of defect in the plasmid and plasmid-plus-cells groups compared with the control group. Midterm evaluation and muscle morphology were not defined. At this midterm follow-up, local delivery of a stromal derived factor 1 plasmid with or without local mesenchymal stem cells enhanced anal sphincter muscle regeneration long after an

  7. Mating plugs in polyandrous giants: which sex produces them, when, how and why?

    Directory of Open Access Journals (Sweden)

    Matjaž Kuntner

    Full Text Available BACKGROUND: Males usually produce mating plugs to reduce sperm competition. However, females can conceivably also produce mating plugs in order to prevent unwanted, superfluous and energetically costly matings. In spiders-appropriate models for testing plugging biology hypotheses-mating plugs may consist of male genital parts and/or of amorphous covers consisting of glandular or sperm secretions. In the giant wood spider Nephila pilipes, a highly sexually dimorphic and polygamous species, males are known to produce ineffective embolic plugs through genital damage, but nothing is known about the origin and function of additional conspicuous amorphous plugs (AP covering female genitals. METHODOLOGY: We tested alternative hypotheses of the nature and function of AP in N. pilipes by staging mating trials with varying degrees of polyandry. No APs were ever formed during mating trials, which rules out the possibility of male AP formation. Instead, those females that oviposited produced the AP from a liquid secreted during egg sac formation. Polyandrous females were more likely to lay eggs and to produce the AP, as were those that mated longer and with more total insertions. Our further tests revealed that, in spite of being a side product of egg sac production, AP, when hardened, prevented any subsequent copulation. CONCLUSIONS: We conclude that in the giant wood spider (Nephila pilipes, the amorphous mating plugs are not produced by the males, that repeated copulations (most likely polyandrous are necessary for egg fertilization and AP formation, and that the AP represents a female adaptation to sexual conflict through prevention of unwanted, excessive copulations. Considering the largely unknown origin of amorphous plugs in spiders, we predict that a similar pattern might be detected in other clades, which would help elucidate the evolutionary interplay of various selection pressures responsible for the origin and maintenance of mating plugs.

  8. Small-Scale Spray Releases: Orifice Plugging Test Results

    Energy Technology Data Exchange (ETDEWEB)

    Mahoney, Lenna A.; Gauglitz, Phillip A.; Blanchard, Jeremy; Kimura, Marcia L.; Kurath, Dean E.

    2012-09-01

    One of the events postulated in the hazard analysis at the Waste Treatment and Immobilization Plant (WTP) and other U.S. Department of Energy (DOE) nuclear facilities, is a breach in process piping that produces aerosols with droplet sizes in the respirable range. The current approach for predicting the size and concentration of aerosols produced in a spray leak involves extrapolating from correlations published in the literature. These correlations are based on results obtained from small engineered spray nozzles using pure liquids with Newtonian fluid behavior. The narrow ranges of physical properties on which the correlations are based do not cover the wide range of slurries and viscous materials present in the WTP and across processing facilities in the DOE complex. Two key technical areas were identified where testing results were needed to improve the technical basis by reducing the uncertainty introduced by extrapolating existing literature results. The first technical need was to quantify the role of slurry particles in small breaches in which the slurry particles may plug and result in substantially reduced, or even negligible, respirable fraction formed by high pressure sprays. The second technical need was to determine the aerosol droplet size distribution and volume from prototypic breaches and fluids, specifically including sprays from larger breaches with slurries where data from the literature are largely absent. To address these technical areas, small- and large-scale test stands were constructed and operated with simulants to determine the aerosol release fractions and aerosol generation rates from a range of breach sizes and geometries. The properties of the simulants represented the range of properties expected in the WTP process streams and included water, sodium salt solutions, slurries containing boehmite or gibbsite, and a hazardous chemical simulant. The effect of anti-foam agents (AFA) was assessed with most of the simulants. Orifices

  9. What role do bacteria play in persisting fistula formation in idiopathic and Crohn's anal fistula?

    Science.gov (United States)

    Tozer, P J; Rayment, N; Hart, A L; Daulatzai, N; Murugananthan, A U; Whelan, K; Phillips, R K S

    2015-03-01

    The aetiology of Crohn's disease-related anal fistula remains obscure. Microbiological, genetic and immunological factors are thought to play a role but are not well understood. The microbiota within anal fistula tracts has never been examined using molecular techniques. The present study aimed to characterize the microbiota in the tracts of patients with Crohn's and idiopathic anal fistula. Samples from the fistula tract and rectum of patients with Crohn's and idiopathic anal fistula were analysed using fluorescent in situ hybridization, Gram staining and scanning electron microscopy were performed to identify and quantify the bacteria present. Fifty-one patients, including 20 with Crohn's anal fistula, 18 with idiopathic anal fistula and 13 with luminal Crohn's disease and no anal fistula, were recruited. Bacteria were not found in close association with the luminal surface of any of the anal fistula tracts. Anal fistula tracts generally do not harbour high levels of mucosa-associated microbiota. Crohn's anal fistulas do not seem to harbour specific bacteria. Alternative explanations for the persistence of anal fistula are needed. Colorectal Disease © 2014 The Association of Coloproctology of Great Britain and Ireland.

  10. Simulation on friction taper plug welding of AA6063-20Gr metal matrix composite

    Science.gov (United States)

    Hynes, N. Rajesh Jesudoss; Nithin, Abeyram M.

    2016-05-01

    Friction taper plug welding a variant of friction welding is useful in welding of similar and dissimilar materials. It could be used for joining of composites to metals in sophisticated aerospace applications. In the present work numerical simulation of friction taper plug welding process is carried out using finite element based software. Graphite reinforced AA6063 is modelled using the software ANSYS 15.0 and temperature distribution is predicted. Effect of friction time on temperature distribution is numerically investigated. When the friction time is increased to 30 seconds, the tapered part of plug gets detached and fills the hole in the AA6063 plate perfectly.

  11. The chemical-in-plug bacterial chemotaxis assay is prone to false positive responses

    Directory of Open Access Journals (Sweden)

    Ward Mandy J

    2010-03-01

    Full Text Available Abstract Background Chemical-in-plug assays are commonly used to study bacterial chemotaxis, sometimes in the absence of stringent controls. Results We report that non-chemotactic and non-motile mutants in two distinct bacterial species (Shewanella oneidensis and Helicobacter pylori show apparent zones of accumulation or clearing around test plugs containing potential attractants or repellents, respectively. Conclusions Our results suggest that the chemical-in-plug assay should be used with caution, that non-motile or non-chemotactic mutants should be employed as controls, and that results should be confirmed with other types of assays.

  12. Association Between Smoking and Size of Anal Warts in HIV-infected Women

    Science.gov (United States)

    Luu, HN; Amirian, ES; Beasley, RP; Piller, L; Chan, W; Scheurer, ME

    2015-01-01

    While the association between smoking and HPV infection, cervical cancer, and anal cancer has been well studied, evidence on the association between cigarette smoking and anal warts is limited. The purpose of this study was to investigate if cigarette smoking status influences the size of anal warts over time in HIV-infected women in a sample of 976 HIV-infected women from the Women’s Interagency HIV Study (WIHS). A linear mixed model was used to determine the effect of smoking on anal wart size. Even though women who were currently smokers had larger anal warts at baseline and slower growth rate of anal wart size after each visit than women who were not current smokers, there was no association between size of anal wart and current smoking status over time. Further studies on the role of smoking and interaction between smoking and other risk factors, however, should be explored. PMID:23155099

  13. Plug-in Electric Vehicle Policy Effectiveness: Literature Review

    Energy Technology Data Exchange (ETDEWEB)

    Zhou, Yan [Argonne National Lab. (ANL), Argonne, IL (United States); Levin, Todd [Argonne National Lab. (ANL), Argonne, IL (United States); Plotkin, Steven E. [Argonne National Lab. (ANL), Argonne, IL (United States)

    2016-05-01

    The U.S. federal government first introduced incentives for plug-in electric vehicles (PEVs) through the American Clean Energy and Security Act of 2009, which provided a tax credit of up to $7,500 for a new PEV purchase. Soon after, in December 2010, two mass-market PEVs were introduced, the plug-in hybrid electric vehicle (PHEV) Chevrolet Volt and the battery electric vehicle (BEV) Nissan LEAF. Since that time, numerous additional types of PEV incentives have been provided by federal and regional (state or city) government agencies and utility companies. These incentives cover vehicle purchases as well as the purchase and installation of electric vehicle supply equipment (EVSE) through purchase rebates, tax credits, or discounted purchase taxes or registration fees. Additional incentives, such as free high-occupancy vehicle (HOV) lane access and parking benefits, may also be offered to PEV owners. Details about these incentives, such as the extent to which each type is offered by region, can be obtained from the U.S. Department of Energy (DOE) Alternative Fuel Data Center (http://www.afdc.energy.gov/). In addition to these incentives, other policies, such as zero-emission vehicle (ZEV) mandates,1 have also been implemented, and community-scale federal incentives, such as the DOE PEV Readiness Grants, have been awarded throughout the country to improve PEV market penetration. This report reviews 18 studies that analyze the impacts of past or current incentives and policies that were designed to support PEV adoption in the U.S. These studies were selected for review after a comprehensive survey of the literature and discussion with a number of experts in the field. The report summarizes the lessons learned and best practices from the experiences of these incentive programs to date, as well as the challenges they face and barriers that inhibit further market adoption of PEVs. Studies that make projections based on future policy scenarios and those that focus solely

  14. The importance of ultrasound findings in the study of anal pain Importancia de los hallazgos ecográficos en el dolor anal

    Directory of Open Access Journals (Sweden)

    A. M. Vieira

    2010-05-01

    Full Text Available Objective: endoanal ultrasonography can detect organic causes of anal pain without pathology on physical examination. The aim of this study is to evaluate the importance of endoanal ultrasonography in the diagnosis and therapeutic management of idiopathic and functional anal pain. Material and methods: retrospective study, between 15 March 2005 and 15 June 2008, of all patients with proctalgia and normal examination or with alterations not responsible for anal pain at proctologic exam that have undergone an endoanal ultrasonography. Results: a total of 90 patients were analyzed, with a mean age of 50.5 years, 58% were female. Twenty-three patients had functional anal pain clinic criteria. Endoanal ultrasonography revealed alterations in 49% of patients. The primary findings were changes in sphincters in 14 patients, followed by anal sepsis in 12 patients, anal fissure in 10 patients, perirectal lesions in 6 patients and ulcer of the anal canal in 2 patients. Of the patients with sphincter defects, 5 patients had criteria of chronic anal pain. In this group of patients, no differences were found in manometric and defecographic results between the different ultrasound abnormalities. Conclusions: the endoanal ultrasonography detected occult organic lesions to proctologic examination, in half the patients with anal pain. Ultrasound abnormalities were found in 22% of patients with functional anal pain. However, there was no correlation between ultrasound findings and physiological studies, and therefore could not find etiological or pathogenic factors of functional anal pain.Objetivo: la ecografía endoanal puede detectar causas orgánicas en el dolor anal sin patología en la exploración física. El objetivo de este estudio es evaluar la importancia de la ecografía endoanal en el diagnóstico y en el abordaje terapéutico del dolor anal idiopática y funcional. Material y métodos: estudio retrospectivo realizado entre el 15 de marzo de 2005 y el

  15. Anal metastasis from recurrent breast lobular carcinoma: A case report

    Institute of Scientific and Technical Information of China (English)

    Maria Puglisi; Emanuela Varaldo; Michela Assalino; Gianluca Ansaldo; Giancarlo Torre; Giacomo Borgonovo

    2009-01-01

    We report a case of isolated gastrointestinal metastasis from breast lobular carcinoma, which mimicked primary anal cancer. In July 2000, an 88-year-old woman presented with infiltrating lobular cancer (pT1/G2/N2). The patient received postoperative radiotherapy and hormonal therapy. Four years later,she presented with an anal polypoid lesion. The mass was removed for biopsy. Immunohistochemical staining suggested a breast origin. Radiotherapy was chosen for this patient, which resulted in complete regression of the lesion. The patient died 3 years after the first manifestation of gastrointestinal metastasis.According to the current literature, we consider the immunohistochemistry features that are essential to support the suspicion of gastrointestinal breast metastasis, and since we consider the gastrointestinal involvement as a sign of systemic disease, the therapy should be less aggressive and systemic.

  16. Anal high-risk human papillomavirus infection and high-grade anal intraepithelial neoplasia detected in women and heterosexual men infected with human immunodeficiency virus

    Directory of Open Access Journals (Sweden)

    Gandra S

    2015-01-01

    Full Text Available Sumanth Gandra, Aline Azar, Mireya WessolosskyDivision of Infectious Disease and Immunology, University of Massachusetts Medical School, Worcester, MA, USABackground: Although anal high-risk human papillomavirus (HR-HPV infection and anal cytological abnormalities are highly prevalent among human immunodeficiency virus (HIV-infected men who have sex with men (MSM, there are insufficient data on these abnormalities among HIV-infected heterosexual men (HSM and women. In this study, we evaluated the prevalence of anal HR-HPV, cytological abnormalities, and performance of these screening tests in detecting high-grade anal intraepithelial neoplasia (AIN2+ among our cohort of HIV-infected MSM and non-MSM (HSM and women.Methods: A single-center, retrospective cohort study was conducted with HIV-infected individuals who underwent anal cancer screening with anal cytology and HR-HPV testing from January 2011 to January 31, 2013.Results: Screening of 221 HIV-infected individuals for both HR-HPV and anal cytology showed the presence of HR-HPV in 54% (abnormal anal cytology 48% of MSM, 28% (abnormal anal cytology 28% of HSM, and 27% (abnormal anal cytology 34% of women. Among 117 (53% individuals with abnormal results (HR-HPV-positive and/or cytology was atypical squamous cells of undetermined significance or above, 67 underwent high resolution anoscopy. Of these 67 individuals, 22 individuals had AIN2+ (17 MSM, four women, and one HSM. HR-HPV correlated better with AIN2+ than with anal cytology on biopsy in both MSM (r=0.29 versus r=0.10; P=0.05 versus P=0.49 and non-MSM (r=0.36 versus r=-0.34; P=0.08 versus P=0.09.Conclusion: Given the presence of AIN2+ in screened HIV-infected HSM and women, routine anal cancer screening in all HIV-infected individuals should be considered. HR-HPV merits further evaluation for anal cancer screening among non-MSM.Keywords: human immunodeficiency virus, anal human papillomavirus, heterosexual men, women, anal cancer

  17. The impact of anal sphincter injury on perceived body image.

    Science.gov (United States)

    Iles, David; Khan, Rabia; Naidoo, Kristina; Kearney, Rohna; Myers, Jenny; Reid, Fiona

    2017-05-01

    Obstetric anal sphincter injury is common but the effect on body image is unreported. The aim of this study was to explore patient perceived changes in body image and other psychological aspects in women attending a perineal follow-up clinic. This retrospective study analysed women's responses to a self-reported questionnaire. Consecutive women with anal sphincter injury who attended a United Kingdom Maternity Hospital perineal follow-up clinic between January 1999 and January 2012 were identified and the records obtained and reviewed. Multivariate regression analyses were performed to examine variables influencing self-reported change in body image. Questionnaires and operation notes were analysed from 422 women who attended at a median of four months after delivery. 222 (53%) reported a change in body image with 80 (19%) reporting lower self-esteem and 75 (18%) a change in their personality due to the change in body image. 248 (59%) perceived an anatomical change due to the delivery. Factors associated with increased likelihood of reporting a change in body image were reporting a perceived change in anatomy due to the delivery, adjusted OR 6.11 (3.56-10.49), anal incontinence, OR 1.97 (1.16-3.36), and delivery by forceps, OR 2.59 (1.23-5.43). This is the first study to quantify body image changes in women after anal sphincter injury sustained in childbirth. These were found to be very common, affecting up to 50% of women. The study has several limitations but it does highlight the significant psychosocial problems of negative self-esteem and personality changes associated with a perceived change in body image that has not previously been reported. It also outlines the further research questions that need to be addressed. Copyright © 2017 Elsevier B.V. All rights reserved.

  18. Pelvic floor ultrasound and anal incontinence in primiparous women

    DEFF Research Database (Denmark)

    Sakse, Abelone Elisabeth

    2010-01-01

    Afhandlingen havde til formål at undersøge muskulære forandringer på bækkenbundsmuskulaturen i relation til første fødsel, med særligt fokus på anal inkontinens. Forsvaret fandt sted d. 10. september 2010 kl. 14:00 i Auditoriet på Hvidovre Hospital.   ...

  19. Analysis of the Cuban journal Bibliotecas: Anales de Investigacion

    OpenAIRE

    2016-01-01

    The objective of this article is to describe the academic impact, the editorial process quality, and the editorial and visibility strategies of Bibliotecas. Anales de Investigacion (BAI), a scientific Cuban journal edited by National Library of Cuba Jose Marti. The academic impact is determined through a citation analysis, which considers Google Scholar database as reference source. The bibliometric indicators applied are: citation per year, citation vs. self-citation, citable journals vs. no...

  20. Long-term outcome after surgery for Crohn's anal fistula.

    Science.gov (United States)

    Graf, W; Andersson, M; Åkerlund, J-E; Börjesson, L

    2016-01-01

    Treatment of Crohn's anal fistula remains challenging and little is known about factors associated with healing. The aim of this study was to assess the rate of healing after surgical treatment and analyse clinical variables related to healing. A total of 119 patients [63 women, mean age 36 (±13.7) years] with histopathologically verified Crohn's disease underwent a surgical procedure for anal fistula at four main referral centres in Sweden, January 1998 to December 2009. Baseline and treatment-related variables were recorded and analysed for correlation with fistula healing at a final follow-up after a mean of 7.2 (median 7.1, 1.0-17.5) years. Of the 119 patients 62 (52%) were healed at final follow-up. Fourteen healed after one procedure and the remaining 48 healed after a further median of 4.0 (2-20) procedures. Ten (8%) patients were subjected to a proctectomy. Final healing was more common in patients operated with a procedure aiming at eradicating the fistula (P = 0.0001), without proctitis (P = 0.02) and a shorter duration of Crohn's disease (P = 0.0019). Long-term healing of a Crohn's anal fistula can be expected in about half of the patients, usually after repeated surgical treatment. The probability for cure was higher when a curative operation was performed in a patient without proctitis and with a shorter duration of Crohn's disease. An attempt to close a Crohn's anal fistula is thus often worthwhile. Colorectal Disease © 2015 The Association of Coloproctology of Great Britain and Ireland.

  1. A entrada do chiste na cena analítica

    Directory of Open Access Journals (Sweden)

    Luciana Balbo

    Full Text Available O artigo se utiliza do dito espirituoso freudiano para refletir sobre algumas questões do ato analítico. O exemplo clínico apresentado se presta a uma ilustração prática de uma possível estrutura chistosa do ato analítico. De forma sintética discute-se os pontos de interesse da compreensão freudiana sobre os chistes para uma aproximação da noção de ato analítico. O caso clínico é retomado, com o intuito de funcionar como uma espécie de linha, que vai costurando os aportes teóricos apresentados ao longo do texto. Lacan é mencionado, no sentido de ampliar a visão sobre os chistes e incluir a noção de chiste como um ato de sentido.

  2. Obstetrics anal sphincter injury and repair technique: a review.

    Science.gov (United States)

    Temtanakitpaisan, Teerayut; Bunyacejchevin, Suvit; Koyama, Masayasu

    2015-03-01

    The Urogynecology Committee of the Asia and Oceania Federation of Obstetrics and Gynaecology (AOFOG) has held seminars and workshops on various urogynecological problems in each country in the Asia-Oceania area in order to encourage young obstetricians and gynecologists. In 2013, we organized the operative seminar for obstetrical anal sphincter injuries (OASIS) in which we prepared porcine models to educate young physicians in a hands-on workshop at the 23rd Asian and Oceanic Congress of Obstetrics and Gynaecology in Bangkok, Thailand. Laceration of the anal sphincter mostly occurs during vaginal delivery and it can develop into anal sphincter deficiency, which causes fecal incontinence, if an appropriate suture is not performed. OASIS has become an important issue, especially in developing countries. The prevalence of OASIS of more than the third degree is around 5% in primary parous women and the frequency is higher when detected by ultrasonographic evaluation. Several risk factors, such as macrosomia, instrumental labor, perineal episiotomy and high maternal age, have been recognized. In a society where pregnant women are getting older, OASIS is becoming a more serious issue. An intrapartum primary appropriate stitch is important, but the 1-year outcome of a delayed operation after 2 weeks postpartum is similar. A randomized controlled study showed that overlapping suture of the external sphincter is better than that of end-to-end surgical repair. The Urogynecology Committee of the AOFOG would like to continue with educative programs about the appropriate therapy for OASIS.

  3. Carcinoma of the anal sac glands in ranch mink.

    Science.gov (United States)

    Hadlow, W J

    1985-05-01

    During a 14-year period, carcinoma of the anal sac apocrine glands was found in 52 pastel and 8 sapphire mink (Mustela vison) kept for studies on slow viral diseases. The pastel mink varied in age from 72 to 135 months (mean age 108 months), the sapphire mink from 63 to 100 months (mean age 81 months). All but one pastel mink were females. The primary tumor varied in size from masses that caused bulges in the perineum to those that were found only after microscopic examination of the anal sac glands. Although the primary tumor grew mainly by expansion with little local infiltration, 41 of the 60 tumors had metastasized to the regional lymph nodes and sometimes also to more distant sites. The striking propensity of the carcinoma to metastasize while still small, even microscopic, often resulted in massive secondary growths, notably in the iliac lymph nodes. Hypercalcemia did not accompany the carcinoma. Its varied microscopic appearance included solid, glandular, squamous cell, and spindle or round cell components. Combinations of them formed mixed or complex histologic patterns, no doubt largely attributable to neoplastic proliferation of myoepithelial cells and squamous metaplasia of the apocrine gland epithelium. Although its cause remains obscure, the carcinoma appeared to arise from small foci of hyperplastic apocrine glands, sometimes in relation to both anal sacs. The tumor is a common and distinctive expression of neoplasia in older ranch mink.

  4. Screening, Surveillance, and Treatment of Anal Intraepithelial Neoplasia

    Science.gov (United States)

    Long, Kevin C.; Menon, Raman; Bastawrous, Amir; Billingham, Richard

    2016-01-01

    The prevalence of anal intraepithelial neoplasia has been increasing, especially in high-risk patients, including men who have sex with men, human immunodeficiency virus positive patients, and those who are immunosuppressed. Several studies with long-term follow-up have suggested that rate of progression from high-grade squamous intraepithelial lesions to invasive anal cancer is ∼ 5%. This number is considerably higher for those at high risk. Anal cytology has been used to attempt to screen high-risk patients for disease; however, it has been shown to have very little correlation to actual histology. Patients with lesions should undergo history and physical exam including digital rectal exam and standard anoscopy. High-resolution anoscopy can be considered as well, although it is of questionable time and cost–effectiveness. Nonoperative treatments include expectant surveillance and topical imiquimod or 5-fluorouracil. Operative therapies include wide local excision and targeted ablation with electrocautery, infrared coagulation, or cryotherapy. Recurrence rates remain high regardless of treatment delivered and surveillance is paramount, although optimal surveillance regimens have yet to be established. PMID:26929753

  5. Computational analysis on plug-in hybrid electric motorcycle chassis

    Science.gov (United States)

    Teoh, S. J.; Bakar, R. A.; Gan, L. M.

    2013-12-01

    Plug-in hybrid electric motorcycle (PHEM) is an alternative to promote sustainability lower emissions. However, the PHEM overall system packaging is constrained by limited space in a motorcycle chassis. In this paper, a chassis applying the concept of a Chopper is analysed to apply in PHEM. The chassis 3dimensional (3D) modelling is built with CAD software. The PHEM power-train components and drive-train mechanisms are intergraded into the 3D modelling to ensure the chassis provides sufficient space. Besides that, a human dummy model is built into the 3D modelling to ensure the rider?s ergonomics and comfort. The chassis 3D model then undergoes stress-strain simulation. The simulation predicts the stress distribution, displacement and factor of safety (FOS). The data are used to identify the critical point, thus suggesting the chassis design is applicable or need to redesign/ modify to meet the require strength. Critical points mean highest stress which might cause the chassis to fail. This point occurs at the joints at triple tree and bracket rear absorber for a motorcycle chassis. As a conclusion, computational analysis predicts the stress distribution and guideline to develop a safe prototype chassis.

  6. The water intensity of the plugged-in automotive economy.

    Science.gov (United States)

    King, Carey W; Webber, Michael E

    2008-06-15

    Converting light-duty vehicles from full gasoline power to electric power, by using either hybrid electric vehicles or fully electric power vehicles, is likely to increase demand for water resources. In the United States in 2005, drivers of 234 million cars, lighttrucks, and SUVs drove approximately 2.7 trillion miles and consumed over 380 million gallons of gasoline per day. We compare figures from literature and government surveys to calculate the water usage, consumption, and withdrawal, in the United States during petroleum refining and electricity generation. In displacing gasoline miles with electric miles, approximately 2-3 [corrected] times more water is consumed (0.24 [corrected] versus 0.07--0.14 gallons/mile) and over 12 [corrected] times more water is withdrawn (7.8 [corrected] versus 0.6 gallons/mile) primarily due to increased water cooling of thermoelectric power plants to accommodate increased electricity generation. Overall, we conclude that the impact on water resources from a widespread shift to grid-based transportation would be substantial enough to warrant consideration for relevant public policy decision-making. That is not to say that the negative impacts on water resources make such a shift undesirable, but rather this increase in water usage presents a significant potential impact on regional water resources and should be considered when planning for a plugged-in automotive economy.

  7. Endobronchial closure of bronchopleural fistulas with Amplatzer vascular plug.

    Science.gov (United States)

    Fruchter, Oren; Bruckheimer, Elchanan; Raviv, Yael; Rosengarten, Dror; Saute, Milton; Kramer, Mordechai R

    2012-01-01

    Bronchopulmonary fistula (BPF) is a severe complication following lobectomy or pneumonectomy and is associated with a high rate of morbidity and mortality. We have developed a novel minimally invasive method of central BPF closure using Amplatzer vascular plug (AVP) device that was originally designed for the transcatheter closure of vascular structures in patients with small BPF. Patients with BPFs were treated under conscious sedation by bronchoscopic closure of BPFs using AVP. After locating the fistula using bronchography, the self-expanding nitinol made AVP occluder to be delivered under direct bronchoscopic guidance over a loader wire into the fistula followed by bronchography to assure correct device positioning and sealing of the BPF. Six AVPs were placed in five patients, four males and one female, with a mean age of 62.3 years (range: 51-82 years). The underlying disorders and etiologies for BPF development were lobectomy (two patients), pneumonectomy for lung cancer (one patient), lobectomy due to necrotizing pneumonia (one patient), and post-tracheostomy tracheo-pleural fistula (one patient). In all the patients, the bronchoscopic procedure was successful and symptoms related to BPF disappeared following closure by the AVP. The results were maintained over a median follow-up of 9 months (range: 5-34 months). Endobronchial closure using the AVP is a safe and effective method for treatment of small postoperative BPF. The ease of their implantation by bronchoscopy under conscious sedation adds this novel technique to the armatorium of minimally invasive modalities for the treatment of small BPF.

  8. Analysis of plug-in hybrid electric vehicle utility factors

    Science.gov (United States)

    Bradley, Thomas H.; Quinn, Casey W.

    Plug-in hybrid electric vehicles (PHEVs) are hybrid electric vehicles that can be fueled from both conventional liquid fuels and grid electricity. To represent the total contribution of both of these fuels to the operation, energy use, and environmental impacts of PHEVs, researchers have developed the concept of the utility factor. As standardized in documents such as SAE J1711 and SAE J2841, the utility factor represents the proportion of vehicle distance travelled that can be allocated to a vehicle test condition so as to represent the real-world driving habits of a vehicle fleet. These standards must be used with care so that the results are understood within the context of the assumptions implicit in the standardized utility factors. This study analyzes and derives alternatives to the standard utility factors from the 2001 National Highway Transportation Survey, so as to understand the sensitivity of PHEV performance to assumptions regarding charging frequency, vehicle characteristics, driver characteristics, and means of defining the utility factor. Through analysis of these alternative utility factors, this study identifies areas where analysis, design, and policy development for PHEVs can be improved by alternative utility factor calculations.

  9. Plug-and-play, single-chip photoplethysmography.

    Science.gov (United States)

    Chandrasekar, Deepak; Arnetz, Bengt; Levy, Philip; Basu, Amar S

    2012-01-01

    Remote patient monitoring (RPM) relies on low-cost, low-power, wearable sensors for continuous physiological assessment. Photoplethysmographic (PPG) sensors generally require >10 components, occupy an area >300 mm(2), consume >10 mW power, and cost >$20 USD. Although the principle of PPG sensing is straightforward, in practice, a robust implementation requires a careful design including optical alignment, analog circuits, ambient light cancellation, and power management. This paper reports the first use of digital optical proximity sensors (OPS) for "plug-and-play" PPG. OPS have traditionally been used for distance sensing in smartphones and factory automation. Here we show that a digital OPS can perform PPG functions in a single 4×4 mm package which also provides a direct digital interface to a microcontroller. By exploiting its key features, a digital OPS can provide substantial performance advantages over existing state-of-the-art PPGs, including: i) 10X lower power consumption (200 µW) due to pulse operation; ii) high signal to noise ratio (>90), as a result of built-in optical barriers, filters, and ambient light cancellation; iii) 10X lower cost ($2 USD); and iv) 12X smaller area. We show single wavelength PPG measurements in multiple anatomical locations, including fingertips and earlobes. The results suggest that a digital OPS can provide an elegant solution for battery-powered, wearable physiological monitors. To the authors' knowledge, this is the smallest and lowest power PPG sensor reported to date.

  10. Engineering estimates of impurity fluxes on the ITER port plugs

    Science.gov (United States)

    Kotov, Vladislav

    2016-10-01

    Predictions of impurity fluxes are required for design analysis of the ITER optical diagnostics. In the present paper a simplified model is proposed for calculation of the neutral impurity fluxes on the recessed surfaces which are not in direct contact with plasma. The method is based on the Monte-Carlo simulation of the neutral particles transport in prescribed and fixed plasma background. The plasma parameters are projected from experimental observations, scalings and ITER modelling results. Blobs are approximated as stationary hot species. Results of 2D simulations with toroidally uniform wall and of the ‘2.5D model’ are presented. In this latter the 3D geometry of ports is implemented, but details of the incident ion flux distribution on the first wall panels are neglected. The calculated worst case gross deposition rate of Be in the middle of the port plug faces reaches almost 0.1 nm s-1. At the same time, the obtained Be erosion to deposition ratio at those locations is always larger than 5, indicating high probability of net erosion conditions there.

  11. Episodic air quality impacts of plug-in electric vehicles

    Science.gov (United States)

    Razeghi, Ghazal; Carreras-Sospedra, Marc; Brown, Tim; Brouwer, Jack; Dabdub, Donald; Samuelsen, Scott

    2016-07-01

    In this paper, the Spatially and Temporally Resolved Energy and Environment Tool (STREET) is used in conjunction with University of California Irvine - California Institute of Technology (UCI-CIT) atmospheric chemistry and transport model to assess the impact of deploying plug-in electric vehicles and integrating wind energy into the electricity grid on urban air quality. STREET is used to generate emissions profiles associated with transportation and power generation sectors for different future cases. These profiles are then used as inputs to UCI-CIT to assess the impact of each case on urban air quality. The results show an overall improvement in 8-h averaged ozone and 24-h averaged particulate matter concentrations in the South Coast Air Basin (SoCAB) with localized increases in some cases. The most significant reductions occur northeast of the region where baseline concentrations are highest (up to 6 ppb decrease in 8-h-averaged ozone and 6 μg/m3 decrease in 24-h-averaged PM2.5). The results also indicate that, without integration of wind energy into the electricity grid, the temporal vehicle charging profile has very little to no effect on urban air quality. With the addition of wind energy to the grid mix, improvement in air quality is observed while charging at off-peak hours compared to the business as usual scenario.

  12. Progress on the ITER TBM port plug design

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Byoung-Yoon, E-mail: byoungyoon.kim@iter.org [ITER Organization, Route de Vinon-sur-Verdon, CS 90 046, 13067 St. Paul Lez Durance Cedex (France); Marconi, Matteo [LTCalcoli, Piazza Prinetti 26/B, 23807 Merate (Italy); Neviere, Jean-Christophe [Comex Nucléaire, 13115 Saint Paul Lez Durance (France); Merola, Mario; Giancarli, Luciano M. [ITER Organization, Route de Vinon-sur-Verdon, CS 90 046, 13067 St. Paul Lez Durance Cedex (France); Lucca, Flavio [LTCalcoli, Piazza Prinetti 26/B, 23807 Merate (Italy); Gicquel, Stefan [ITER Organization, Route de Vinon-sur-Verdon, CS 90 046, 13067 St. Paul Lez Durance Cedex (France)

    2015-10-15

    Highlights: • ITER TBM PP design progress with two Dummy TBMs was outlined. • Attachment of Dummy TBMs in TBM Frame was assessed to investigate mechanical and sealing performance. • Implementation of cover plates was described and the preliminary maintenance sequence was developed. • Clearance between TBM Frame and Dummy TBMs were reduced to have better shielding performance. • Cooling layout and castellation design were updated to minimize thermal induced stress. - Abstract: In three of the ITER equatorial ports, tritium breeding blanket concepts will be validated and tested using mock-up breeding blankets called test blanket modules (TBM). In these ports, two TBM-Sets are mechanically attached in a TBM Frame to form a TBM port plug (TBM PP). The ITER Organization is responsible for the design and manufacture of both this TBM Frame and the Dummy TBMs which will fill them. As a part of this development, in 2013, a conceptual design review (CDR) of TBM PP with two dummy TBMs revealed the need for improvement of design performance, interfaces and maintainability. This paper presents the main design improvements after the CDR as well as associated feasibility analysis of the improved design focusing on the attachment. Finally the work plan for the Preliminary Design phase is summarized.

  13. Câncer ano-reto-cólico - aspectos atuais: I - câncer anal Anal canal and colorectal cancer - current features: I - anal canal cancer

    Directory of Open Access Journals (Sweden)

    Júlio César M. Santos Jr.

    2007-06-01

    Full Text Available A inclusão do tema - câncer anal - nessa revisão, apesar de sua relativa raridade, responde, em parte, ao propósito de chamar atenção para o significativo aumento dessa lesão e sua estreita relação com doenças sexualmente transmissíveis, principalmente causadas pelo vírus do papiloma humano (HPV; seus aspectos nosológicos, sua epidemiologia, sua etiologia multifatorial, seus fatores de riscos, sua prevenção e, em parte, para revelar a definição atual do tratamento.The inclusion of the theme - anal cancer - in this revision, in spite of its relative rarity, it answers, partly, to the purpose of calling attention for the significant increase of that lesion and its narrow relationship with sexually transmissible diseases mainly caused by the human papilloma virus (HPV; its nosologic aspects, epidemiology, etiology, and the multifactorial nature of risk that is associated to the disease, its prevention, and, partly, to reveal the current definition of the treatment.

  14. Plug-and-Play Compatibility for CubeSat Attitude Determination and Control Systems Project

    Data.gov (United States)

    National Aeronautics and Space Administration — The development of Plug-and-play Compatibility for CubeSat Attitude Determination and Control Systems (ADACS) is proposed. Existing Maryland Aerospace (MAI) ADACS...

  15. APPLICATION OF EXOTHERMIC PLUGS AT PRODUCTION OF STEEL CASTING IS THE WAY TO ECONOMY

    Directory of Open Access Journals (Sweden)

    V. M. Gatsuro

    2008-01-01

    Full Text Available It is shown that application of exothermic plugs allows to decrease steel intensity of casting mold, labor intensiveness for trim, expenses for melting of 1 ton of good casting, material expenses for burden materials.

  16. Interaction of backfilling techniques and MTA plugs with additives: Fracture strength and adaptation analyses.

    Science.gov (United States)

    Yilmaz, Zeliha; Küçükkaya Eren, Selen; Uzunoğlu, Emel; Görduysus, Melahat; Görduysus, Mehmet Ömer

    2017-08-25

    The aims were to evaluate the effects of different additives on the adaptation of mineral trioxide aggregate (MTA) plugs before and after different backfilling techniques and analyze the interference of filling procedures on the fracture resistance of simulated immature teeth. The apical parts of 60 teeth were filled with MTA mixed with distilled water (DW), propylene glycol (PG) or calcium chloride (CaCl2) and backfilled with cold lateral condensation (CLC) or warm vertical compaction (WVC). The specimens were subjected to adaptation analysis and fracture testing. CaCl2 addition resulted in poor marginal adaptation, while PG addition significantly decreased the fracture values (pMTA-CaCl2 plugs and decreased the fracture values of teeth with MTA-PG plugs (pMTA with DW can be recommended as apical plug when the remaining root canal space is going to be filled with either CLC or WVC techniques.

  17. Flow-to-fracture transition in a volcanic mush plug may govern normal eruptions at Stromboli

    Science.gov (United States)

    Suckale, J.; Keller, T.; Cashman, K. V.; Persson, P.-O.

    2016-12-01

    Stromboli is a model volcano for studying eruptions driven by degassing. The current paradigm posits that Strombolian eruptions represent the bursting of gas slugs ascending through melt-filled conduits, but petrological observations show that magma at shallow depth is crystalline enough to form a three-phase plug consisting of crystals, bubbles, and melt. We combine a 1-D model of gas flushing a crystalline mush with a 3-D stress model. Our results suggest that localized gas segregation establishes hot conduits of mobile magma within a stagnant plug. The plug is prone to tensile failure controlled by gas overpressure and tectonic stress, with failure most likely beneath the observed vent locations. We hence argue that Strombolian eruptions are related to plug failure rather than flow. Our proposed three-phase model of the shallow plumbing system may provide a promising framework for integrating geophysical, petrological, and morphological observations at Stromboli and in open-system volcanism more generally.

  18. Plug-Load Control and Behavioral Change Research in GSA Office Buildings

    Energy Technology Data Exchange (ETDEWEB)

    Metzger, I.; Cutler, D.; Sheppy, M.

    2012-10-01

    The U.S. General Services Administration (GSA) owns and leases over 354 million square feet (ft2) of space in over 9,600 buildings [1]. GSA is a leader among federal agencies in aggressively pursuing energy efficiency (EE) opportunities for its facilities and installing renewable energy (RE) systems to provide heating, cooling, and power to these facilities. According to several energy assessments of GSA's buildings conducted by the National Renewable Energy Laboratory (NREL), plug-loads account for approximately 21% of the total electricity consumed within a standard GSA Region 3 office building. This study aims to provide insight on how to effectively manage plug-load energy consumption and attain higher energy and cost savings for plug-loads. As GSA improves the efficiency of its building stock, plug-loads will become an even greater portion of its energy footprint.

  19. Plug-and-Play Star Sensor for Rapid Spacecraft Integration Project

    Data.gov (United States)

    National Aeronautics and Space Administration — Microcosm, with partners Space Micro and HRP Systems, will design, build, and test a plug-and play (PnP) star sensor for small satellites, achieving TRL 6 at the...

  20. Ongoing Technology and Developing Trend of Ar-blowing Purging Plug

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    An introduction of the ongoing technology of ar-gon-blowing purging plugs in China was presented in this work.Gel powders were used as starting materials to enhance the high temperature mechanical properties of the purging plugs.Composite purging plug adopting ex-trusion formed gas-purging bar and slit had its surface structural design improved,which enhanced the resist-ances to thermal shock and molten steel penetration,prolonging the service life.In addition,the safety Was greatly improved by upgrading the framework and pro-duction process,enhancing the resistance to breakout.It is indicated that the developing trend is to produce pur-ging plugs of longer service life and better gas purging rate with different starting materials and structure de-signs to meet the requirements of various metallurgical processes.

  1. Comparison of Al electromigration in conventional Al alloy and W-plug contacts to silicon

    Science.gov (United States)

    Oates, A. S.; Martin, E. P.; Alugbin, D.; Nkansah, F.

    1993-06-01

    We examine the impact of the presence of a W plug on electromigration-induced voiding of the Al alloy layer of contacts to silicon. By comparing conventional Al alloy and W-plug contacts we show that the presence of the plug does not significantly improve the intrinsic susceptibility of contacts to Al voiding despite the elimination of the Al step coverage problem. Both the conventional Al alloy and W-plug contacts degrade by drift of the Al layer with a velocity that is not influenced by the contact structure. The sheet resistance of the underlayer material of multilayer conductors plays an important role in influencing failure times since it determines the rate of resistance increase due to electromigration.

  2. CLINICAL TRIALS FOR VAS DEFERENS OCCLUSION BY PERCUTANEOUS INJECTION OF POLYURETHANE ELASTOMER TO FORM PLUGS

    Institute of Scientific and Technical Information of China (English)

    ZHAOSheng-Cai; etal.

    1989-01-01

    A non-incision method of vss occlusion based on the percutaneous injection of polyurethane elastomer solution to form a plug is described. The procedure was conducted under aseptic procedure and local fidocaine anaesthesia. Two different kinds of

  3. Dispersion of a suspension plug in oscillatory pressure-driven flow

    Science.gov (United States)

    Cui, Francis R.; Howard, Amanda A.; Maxey, Martin R.; Tripathi, Anubhav

    2017-09-01

    We investigate the dispersion of finite lengths of concentrated suspended particles, or suspension plugs, in a microcapillary as they are sheared in an oscillating pressure-driven flow. In the experiments, plugs of neutrally buoyant, noncolloidal particles (90-μ m mean diameter) suspended in viscous fluid at low and high concentrations are observed for various values of applied strain of this cyclic shearing flow. No significant increase in the overall plug length is seen near the centerline after numerous cycles. However, significant streamwise particle migration was observed near the walls of the capillary, becoming more pronounced with increasing strain amplitude. Related numerical simulations for a suspension plug sheared in a planar channel show similar results and elucidate the dynamics for this strongly inhomogeneous flow and the anomalous particle fluxes that develop.

  4. Cultural Resource Survey of Proposed Ditch Plugs Near Troublesome Creek in Marion County, Missouri

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — A phase I cultural resource survey was conducted for the US Department of the Interior, Fish and Wildlife Service, of three proposed ditch plugs to be constructed...

  5. Investigation of Thrust and Drag Characteristics of a Plug-type Exhaust Nozzle

    Science.gov (United States)

    Hearth, Donald P; Gorton, Gerald C

    1954-01-01

    An investigation was conducted in the 8- by 6-foot supersonic wind tunnel on the external and internal characteristics of a plug-type exhaust nozzle. Two positions of the center plug, one simulating a convergent nozzle and the other a convergent-divergent nozzle, were investigated. Data were obtained at free-stream Mach numbers of 0.1, 0.6, 1.6, and 2.0 over a pressure-ratio range of 1 to 20 and angles of attack of zero and 8 degrees. Results of this investigation indicated that the plug nozzle had thrust-minus-drag performance over the entire pressure-ratio range comparable with equivalent conventional nozzles. The effect of the exhaust jet on the external aerodynamics was similar to results observed for conventional nozzles. In addition, the thrust characteristics were generally insensitive to external flow and good agreement was noted with data obtained on comparable plug nozzles in quiescent air.

  6. Pilot Study of a Plug Load Management System: Preparing for Sustainability Base

    Data.gov (United States)

    National Aeronautics and Space Administration — NASA Ames Research Center’s Sustainability Base is a new 50,000 sq. ft. high-performance office building targeting a LEED Platinum rating. Plug loads are expected to...

  7. Plug-and-Play Star Sensor for Rapid Spacecraft Integration Project

    Data.gov (United States)

    National Aeronautics and Space Administration — Microcosm, with Space Micro., and HRP Systems will design a plug-and-play (PnP) star sensor for small satellites. All three companies are well experienced in...

  8. Simultaneous bioassays in a microfluidic channel on plugs of different magnetic particles.

    Science.gov (United States)

    Bronzeau, Sandrine; Pamme, Nicole

    2008-02-18

    Magnetic particles coated with specific biomolecules are often used as solid supports for bioassays but conventional test tube based techniques are time consuming and labour intensive. An alternative is to work on magnetic particle plugs immobilised inside microfluidic channels. Most research so far has focussed on immobilising one type of particle to perform one type of assay. Here we demonstrate how several assays can be performed simultaneously by flushing a sample solution over several plugs of magnetic particles with different surface coatings. Within a microchannel, three plugs of magnetic particles were immobilised with external magnets. The particles featured surface coatings of glycine, streptavidin and protein A, respectively. Reagents were then flushed through the three plugs. Molecular binding occurred between matching antigens and antibodies in continuous flow and was detected by fluorescence. This first demonstration opens the door to a quicker and easier technique for simultaneous bioassays using magnetic particles.

  9. Straight ileo-anal anastomosis with myectomy as an alternative to ileal pouch-anal anastomosis in restorative proctocolectomy.

    Science.gov (United States)

    Landi, E; Landa, L; Fianchini, A; Marmorale, C; Piloni, V

    1994-04-01

    Restorative proctocolectomy with various types of reservoir is widely used in the elective surgery of ulcerative colitis and familial adenomatous polyposis. Both, advantages and disadvantages of this procedure are well known and documented. Straight ileo-anal anastomosis (IAA) yields unsatisfactory clinical results due to the lack of storage capacity of the distal ileum and the frequency of bowel movements related to high pressure ileal waves. In an attempt to create an alternative to the above procedures, we have performed a straight ileo-anal anastomosis with two rectangular (10 cm x 1 cm) myectomies down to 2 cm, above the anastomotic line. The two myectomies are spaced at 120 degrees to each other and to the mesenteric border of the ileal loop. The rationale of this approach is to reduce the peristaltic drive of the ileum by weakening the muscular wall. This study presents the results in three patients operated on with this new method in the last year.

  10. Identifying the best therapy for chronic anal fissure

    Institute of Scientific and Technical Information of China (English)

    Mariusz; H; Madalinski

    2011-01-01

    Chronic anal fissure(CAF)is a painful tear or crack which occurs in the anoderm.The optimal algorithm of therapy for CAF is still debated.Lateral internal sphincterotomy(LIS)is a surgical treatment,considered as the’gold standard’therapy for CAF.It relieves CAF symptoms with a high rate of healing.Chemical sphincterotomy(CS)with nitrates,calcium blockers or botulinum toxin(BTX)is safe,with the rapid relief of pain,mild sideeffects and no risk of surgery or anesthesia,but is a statistically less effective therapy for CAF than LIS.This article considers if aggressive treatment should only be offered to patients who fail pharmacological sphincterotomy.Aspects of anal fissure etiology,epidemiology and pathophysiology are considered with their meaning for further management of CAF.A molecular model of chemical interdependence significant for the chemistry of CAF healing is examined.Its application may influence the development of optimal therapy for CAF.BTX is currently considered the most effective type of CS and discussion in this article scrutinizes this method specifically.Although the effectiveness of BTXvs LIS has been discussed,the essential focus of the article concerns identifying the best therapy application for anal fissure.Elements are presented which may help us to predict CAF healing.They provide rationale for the expansion of the CAF therapy algorithm.Ethical and economic factors are also considered in brief.As long as the patient is willing to accept the potential risk of fecal incontinence,we have grounds for the’gold standard’(LIS)as the first-line treatment for CAF.The author concludes that,when the diagnosis of the anal fissure is established,CS should be considered for both ethical and economic reasons.He is convinced that a greater understanding and recognition of benign anal disorders by the GP and a proactive involvement at the point of initial diagnosis would facilitate the consideration of CS at an earlier,more practical stage with

  11. The effect of topical anal captopril on resting anal pressure in healthy volunteers: the first human pilot study.

    Science.gov (United States)

    Khaikin, M; Bashankaev, B; Sands, D; Weiss, E G; Zbar, A; Wexner, S D

    2014-01-01

    Previous laboratory studies have shown that angiotensin II is produced locally in the rat internal anal sphincter causing potent contraction. The aim of this first human study was to evaluate the safety and manometric effects of topical application of captopril (an ACE inhibitor) on the resting anal pressure in healthy adult volunteers. Ten volunteers, mean age 32.5 years (range, 19-48 years), underwent anorectal manometric evaluation of the mean anal resting pressure (MRAP) and the length of the high-pressure zone (HPZ) before 20 and 60 min after topical application of captopril (0.28 %) cream. Cardiovascular variables (systolic blood pressure, diastolic blood pressure and pulse) were measured before and for up to 1 h after cream application. Side effects were recorded. Adverse events and patient comfort after the cream application were evaluated within a 24-h period by completing a questionnaire. There was no significant change overall in MRAP following captopril administration, although in half the patients, there were reductions in MRAP after treatment. Half the patients had a reduction in the mean resting HPZ length; however, there was no overall difference between pre- and post-treatment values. There was no effect on basic cardiovascular parameters and no correlation between manometric and cardiovascular variables. Topical application of captopril cream may result in a reduction in MRAP in volunteers without anorectal disease. Its use is associated with minimal side effects. It may be a new potential therapeutic option in the treatment of anal fissure. Further studies are required to determine the optimal concentration, dose and frequency of application.

  12. Hybrid and Plug-In Electric Vehicles (Spanish Version); Clean Cities, Energy Efficiency & Renewable Energy (EERE)

    Energy Technology Data Exchange (ETDEWEB)

    None

    2015-08-01

    This is a Spanish-language brochure about hybrid and plug-in electric vehicles, which use electricity as their primary fuel or to improve the efficiency of conventional vehicle designs. These vehicles can be divided into three categories: hybrid electric vehicles (HEVs), plug-in hybrid electric vehicles (PHEVs), all-electric vehicles (EVs). Together, they have great potential to cut U.S. petroleum use and vehicle emissions.

  13. Ford Plug-In Project: Bringing PHEVs to Market Demonstration and Validation Project

    Energy Technology Data Exchange (ETDEWEB)

    D' Annunzio, Julie [Ford Motor Company, Dearborn, MI (United States); Slezak, Lee [U.S. DOE Office of Energy Efficiency & Renewable Energy, Washington, DC (United States); Conley, John Jason [National Energy Technology Lab. (NETL), Albany, OR (United States)

    2014-03-26

    This project is in support of our national goal to reduce our dependence on fossil fuels. By supporting efforts that contribute toward the successful mass production of plug-in hybrid electric vehicles, our nation’s transportation-related fuel consumption can be offset with energy from the grid. Over four and a half years ago, when this project was originally initiated, plug-in electric vehicles were not readily available in the mass marketplace. Through the creation of a 21 unit plug-in hybrid vehicle fleet, this program was designed to demonstrate the feasibility of the technology and to help build cross-industry familiarity with the technology and interface of this technology with the grid. Ford Escape PHEV Demonstration Fleet 3 March 26, 2014 Since then, however, plug-in vehicles have become increasingly more commonplace in the market. Ford, itself, now offers an all-electric vehicle and two plug-in hybrid vehicles in North America and has announced a third plug-in vehicle offering for Europe. Lessons learned from this project have helped in these production vehicle launches and are mentioned throughout this report. While the technology of plugging in a vehicle to charge a high voltage battery with energy from the grid is now in production, the ability for vehicle-to-grid or bi-directional energy flow was farther away than originally expected. Several technical, regulatory and potential safety issues prevented progressing the vehicle-to-grid energy flow (V2G) demonstration and, after a review with the DOE, V2G was removed from this demonstration project. Also proving challenging were communications between a plug-in vehicle and the grid or smart meter. While this project successfully demonstrated the vehicle to smart meter interface, cross-industry and regulatory work is still needed to define the vehicle-to-grid communication interface.

  14. Plug-in de procesado visual (OpenCV) en OpenDomo OS

    OpenAIRE

    Herrera Castro, Alexander

    2015-01-01

    Este proyecto consiste en el diseño y desarrollo de un plug-in que permita usar el sistema de procesado de imagen OpenCV desde el sistema operativo OpenDomo OS. Aquest projecte consisteix en el disseny i desenvolupament d'un plug-in que permeti utilitzar el sistema de processament d'imatge OpenCV des del sistema operatiu OpenDomo OS. Master thesis for the Free Software program.

  15. Coil-On-Plug Ignition for LOX/Methane Liquid Rocket Engines in Thermal Vacuum Environments

    Science.gov (United States)

    Melcher, John C.; Atwell, Matthew J.; Morehead, Robert L.; Hurlbert, Eric A.; Bugarin, Luz; Chaidez, Mariana

    2017-01-01

    A coil-on-plug ignition system has been developed and tested for Liquid Oxygen (LOX) / liquid methane rocket engines operating in thermal vacuum conditions. The igniters were developed and tested as part of the Integrated Cryogenic Propulsion Test Article (ICPTA), previously tested as part of the Project Morpheus test vehicle. The ICPTA uses an integrated, pressure-fed, cryogenic LOX/methane propulsion system including a reaction control system (RCS) and a main engine. The ICPTA was tested at NASA Glenn Research Center's Plum Brook Station in the Spacecraft Propulsion Research Facility (B-2) under vacuum and thermal vacuum conditions. In order to successfully demonstrate ignition reliability in the vacuum conditions and eliminate corona discharge issues, a coil-on-plug ignition system has been developed. The ICPTA uses spark-plug ignition for both the main engine igniter and the RCS. The coil-on-plug configuration eliminates the conventional high-voltage spark plug cable by combining the coil and the spark-plug into a single component. Prior to ICPTA testing at Plum Brook, component-level reaction control engine (RCE) and main engine igniter testing was conducted at NASA Johnson Space Center (JSC), which demonstrated successful hot-fire ignition using the coil-on-plug from sea-level ambient conditions down to 10(exp.-2) torr. Integrated vehicle hot-fire testing at JSC demonstrated electrical and command/data system performance. Lastly, Plum Brook testing demonstrated successful ignitions at simulated altitude conditions at 30 torr and cold thermal-vacuum conditions at 6 torr. The test campaign successfully proved that coil-on-plug technology will enable integrated LOX/methane propulsion systems in future spacecraft.

  16. [APPLICATION OF FISTULA PLUG WITH THE FIBRIN ADHESIVE IN TREATMENT OF RECTAL FISTULAS].

    Science.gov (United States)

    Aydinova, P R; Aliyev, E A

    2015-05-01

    Results of surgical treatment of 21 patients, suffering high transsphincteric and extrasphincteric rectal fistulas, were studied. In patients of Group I the fistula passage was closed, using fistula plug obturator; and in patients of Group II--by the same, but preprocessed by fibrin adhesive. The fistula aperture germeticity, prophylaxis of rude cicatrices development in operative wound zone, promotion of better fixation of bioplastic material were guaranteed, using fistula plug obturator with preprocessing, using fibrin adhesive.

  17. Cystine Plug and Other Novel Mechanisms of Large Mechanical Stability in Dimeric Proteins

    Science.gov (United States)

    Sikora, Mateusz; Cieplak, Marek

    2012-11-01

    We identify three dimeric proteins whose mechanostability is anisotropic and should exceed 1 nN along some directions. They come with distinct mechanical clamps: either shear-based, or involving a cystine slipknot, or due to dragging of a cystine plug through a cystine ring. The latter two mechanisms are topological in nature; the cystine plug mechanism has not yet been discussed but it turns out to provide the largest resistance to stretching. Its possible applications in elastomers are discussed.

  18. City of Las Vegas Plug-in Hybrid Electric Vehicle Demonstration Program

    Energy Technology Data Exchange (ETDEWEB)

    None

    2013-12-31

    The City of Las Vegas was awarded Department of Energy (DOE) project funding in 2009, for the City of Las Vegas Plug-in Hybrid Electric Vehicle Demonstration Program. This project allowed the City of Las Vegas to purchase electric and plug-in hybrid electric vehicles and associated electric vehicle charging infrastructure. The City anticipated the electric vehicles having lower overall operating costs and emissions similar to traditional and hybrid vehicles.

  19. Ford Plug-In Project: Bringing PHEVs to Market Demonstration and Validation Project

    Energy Technology Data Exchange (ETDEWEB)

    None

    2013-12-31

    This project is in support of our national goal to reduce our dependence on fossil fuels. By supporting efforts that contribute toward the successful mass production of plug-in hybrid electric vehicles, our nation’s transportation-related fuel consumption can be offset with energy from the grid. Over four and a half years ago, when this project was originally initiated, plug-in electric vehicles were not readily available in the mass marketplace. Through the creation of a 21 unit plug-in hybrid vehicle fleet, this program was designed to demonstrate the feasibility of the technology and to help build cross-industry familiarity with the technology and interface of this technology with the grid. Ford Escape PHEV Demonstration Fleet 3 March 26, 2014 Since then, however, plug-in vehicles have become increasingly more commonplace in the market. Ford, itself, now offers an all-electric vehicle and two plug-in hybrid vehicles in North America and has announced a third plug-in vehicle offering for Europe. Lessons learned from this project have helped in these production vehicle launches and are mentioned throughout this report. While the technology of plugging in a vehicle to charge a high voltage battery with energy from the grid is now in production, the ability for vehicle-to-grid or bi-directional energy flow was farther away than originally expected. Several technical, regulatory and potential safety issues prevented progressing the vehicle-to-grid energy flow (V2G) demonstration and, after a review with the DOE, V2G was removed from this demonstration project. Also proving challenging were communications between a plug-in vehicle and the grid or smart meter. While this project successfully demonstrated the vehicle to smart meter interface, cross-industry and regulatory work is still needed to define the vehicle-to-grid communication interface.

  20. [Dampness in an electric plug as a cause of electricity failure in an operation theatre].

    Science.gov (United States)

    Andersen, C; Pold, R; Nielsen, H D

    2000-02-07

    Two cases of electricity failure in an operation theatre during open heart surgery are discussed. The fuse for the patient monitor, ventilator, surgery instruments and heart lung machine was blown. Short-circuit was established because of humidity in the plug of the heater for fluid and blood. We recommend sealed or founded plugs and that anaesthesia equipment should not be used as an electrical supply for other electronic apparatus.

  1. The epidemiology of anal human papillomavirus infection among women and men having sex with women.

    Science.gov (United States)

    Nyitray, Alan G

    2012-12-01

    The goal of this review is to summarise epidemiological data that support an understanding of the natural history of anal human papillomavirus (HPV) among women and men having sex with women (MSW). HPV is a common infection of the anal canal among women and MSW. Although there have been a limited number of studies to date, both oncogenic and nononcogenic HPV genotypes commonly occur among these populations even when individuals do not report receptive anal sex. Genotype distribution is quite diverse, with recent studies typically detecting more than two dozen genotypes in the anal canal in samples of women and MSW. Factors most consistently associated with HPV in the anal canal among both women and MSW are lifetime number of sexual partners and detection of HPV at the genitals. The common finding of genotypic concordance between the genitals and anal canal in women and MSW, and the infectious nature of HPV, in addition to a limited number of studies offering empirical evidence of anal-to-genital self-inoculation and evidence of HPV hand carriage, may help explain the detection of HPV in the anal canal outside the context of receptive anal sex. HPV vaccination has been shown to reduce anal HPV infection among women and is also a promising prevention strategy among MSW.

  2. Conceptualizations of heterosexual anal sex and HIV risk in five East African communities.

    Science.gov (United States)

    Duby, Zoe; Colvin, Christopher

    2014-01-01

    Heterosexual anal sex is underresearched and little understood, particularly in the African context. Existing prevalence data indicate that heterosexual anal sex is a widespread practice, yet little is known about the way in which it is conceptualized and understood. Describing findings from qualitative research conducted in Kenya, Tanzania, and Uganda, we shed light on conceptualizations of heterosexual anal sex and its relation to human immunodeficiency virus (HIV). These findings suggest that penile-anal sex is practiced by men and women in Africa for a range of reasons, including virginity maintenance, contraception, fulfillment of male pleasure, relationship security, menstruation, in the presence of vaginal complications, financial gain, fidelity, and prestige. Despite anal sex being the most efficient way to transmit HIV sexually, there is widespread lack of knowledge about its risks. These findings describe the ways in which anal sex is conceptualized in five East African communities, highlighting how penile-anal intercourse is often not considered "sex" and how the omission of anal sex in safe-sex messaging is interpreted as meaning that anal sex is safe. In light of its frequency and risks, greater attention must be paid to heterosexual anal sex in Africa to ensure a comprehensive approach to HIV prevention.

  3. Anal squamous carcinoma: a new AIDS-defining cancer? Case report and literature review

    Directory of Open Access Journals (Sweden)

    Marcelo Corti

    2012-12-01

    Full Text Available Squamous anal cell carcinoma is a rare malignancy that represents the 1.5% to 2% of all the lower digestive tract cancers. However, an increased incidence of invasive anal carcinoma is observed in HIV-seropositive population since the widespread of highly active antiretroviral therapy. Human papillomavirus is strongly associated with the pathogenesis of anal cancer. Anal intercourse and a high number of sexual partners appear to be risk factors to develop anal cancer in both sexes. Anal pain, bleeding and a palpable lesion in the anal canal are the most common clinical features. Endo-anal ultrasound is the best diagnosis method to evaluate the tumor size, the tumor extension and the infiltration of the sphincter muscle complex. Chemoradiotherapy plus antiretroviral therapy are the recommended treatments for all stages of localized squamous cell carcinoma of the anal canal in HIV-seropositive patients because of its high rate of cure. Here we present an HIV patient who developed a carcinoma of the anal canal after a long time of HIV infection under highly active antiretroviral therapy with a good virological and immunological response.

  4. A novel artificial anal sphincter system based on transcutaneous energy transmission

    Institute of Scientific and Technical Information of China (English)

    Zan Peng; Yan Guozheng; Liu Hua

    2008-01-01

    For controlling anal incontinence, a new artificial anal sphincter system (AASS) with sensor feedback based on transcutaneous energy transmission is developed. The device mainly comprises an artificial anal sphincter (AAS), a wireless power supply subsystem, and a communication subsystem. The artificial anal sphincter comprises a front cuff and a sensor cuff placed around the rectum, a reservoir sited in abdominal cavity and a micropump controlling inflation and deflation of the front cuff. There are two pressure sensors in the artificial anal sphincter. One can measure the pressure in the front cuff to clamp the rectum, the other in the sensor cuff can measure the pressure of the rectum. Wireless power supply subsystem includes a resonance transmit coil to transmit an alternating magnetic field and a secondary coil to receive the power. Wireless communication subsystem can transmit the pressure information of the artificial anal sphincter to the monitor, or send the control commands to the artificial anal sphincter. A prototype is designed and the basic function of the artificial anal sphincter system has been tested through experiments. The results demonstrate that the artificial anal sphincter system can control anal incontinence effectively.

  5. Anal metastasis of rectal cancer-adenocarcinoma of squamous cells: a case report and literature review.

    Science.gov (United States)

    Sasaki, Shun; Sugiyama, Masahiko; Nakaji, Yu; Nakanishi, Ryota; Nakashima, Yuichiro; Saeki, Hiroshi; Oki, Eiji; Oda, Yoshinao; Maehara, Yoshihiko

    2017-12-01

    Anal metastasis of colorectal cancer is very rare and is usually associated with a history of anal disease, including anal fistula, fissure, hemorrhoidectomy, and anastomotic injury. We report a case of rectal cancer with a synchronous anal metastasis consisting of adenocarcinoma of squamous cells without a history of anal disease. A 60-year-old woman had a chief complaint of melena. She had a 1.5-cm anal tumor on the perianal skin, and a Bollman type 2 rectal tumor on the Ra portion was found on colonoscopy. Biopsy of both tumors revealed a similar histology of well- to moderately differentiated adenocarcinoma. There was no sign of metastases in lymph nodes or other organs. For the purpose of diagnosis and treatment, transperineal local resection of the anal tumor was performed, and it was histologically identified as adenocarcinoma of squamous cells with no invasion to muscles, lymph ducts, or microvessels. The pathological margin was free. Then, to achieve radical cure, laparoscopic low anterior resection (LAR) with D3 lymphadenectomy was performed. The histological diagnosis of the anal tumor was adenocarcinoma of squamous cells without invasion to muscles, lymph ducts, or vessels. The surgical margin was completely free. Immunohistochemical analysis of both tumors revealed similar staining patterns, and the final diagnosis was rectal cancer with metastasis to the anal skin. The patient received no postoperative therapy, and no recurrences have been observed 12 months after surgery. We expect that our sphincter-preserving surgical strategy provided a good prognosis for the synchronous rectal cancer and anal metastasis. This is a rare report of a case with an anal metastasis of colorectal cancer on perianal squamous cells without a history of anal disease that was resected while preserving anal function.

  6. Gripping tool for the ITER upper port plug RH extraction/insertion

    Energy Technology Data Exchange (ETDEWEB)

    Rosa, Elena V., E-mail: elena.rosa@ciemat.es; Ríos, Luis, E-mail: luis.rios@ciemat.es

    2014-10-15

    Highlights: •The gripping tool is based on only one gripping point centred at the plug bottom. •The gripping tool should allow the relative displacement in the gripping point to absorb the misalignment between plug and tractor. •The gripping tool needs to withstand around 100/30 kN during the plug extraction/insertion. •The gripping tool should rely on visual control and it has to avoid force feed-back. •The comparison between the features of several gripping tool concepts is assessed. -- Abstract: The conceptual design of several gripping tools and their mechanical interfaces is being carried out for the ITER ECH UPP within the WP10-GOTRH programme. EFDA finances the GOT RH (Goal Oriented Training Programme for Remote Handling). The purpose of this paper is to introduce new concepts of gripping tools for the plug extraction/insertion in the upper port of ITER. All these gripping tools are designed according to IO input data and geometrical constraints. The gripping tools have to be able to extract/insert the plug in the scenario of maximum misalignment between the plug and the tractor. The paper also defines the functional requirements the gripping tools need to comply with. The requirements and input data are verified and validated through 3D simulation with Catia mock-ups of the gripping tools. The strengths and weaknesses of each gripping tool model are compared.

  7. Real-Time Occupant Based Plug-in Device Control Using ICT in Office Buildings

    Directory of Open Access Journals (Sweden)

    Woo-Bin Bae

    2016-03-01

    Full Text Available The purpose of this study is to reduce the unnecessary plug loads used by computers, monitors, and computer peripheral devices, all of which account for more than 95% of the entire plug loads of an office building. To this end, an occupant-based plug-in device control (OBC-P software was developed. The OBC-P software collects real-time information about the presence or absence of occupants who are connected to the access point through the Wifi and controls the power of monitors or computers, while a standby power off device controls computer peripheral devices. To measure the plug load saving of the occupant-based plug-in device control, an experiment was conducted, targeting 10 occupants of three research labs of the graduate school, for two weeks. The experiment results showed that it could save the plug loads of monitors and computer peripheral devices by 15% in the Awake mode, and by 26% in the Sleep mode.

  8. Study of borehole plugging in bedded salt domes by earth melting technology

    Energy Technology Data Exchange (ETDEWEB)

    Black, D.L.

    1975-06-01

    The intent of this program is to define the most viable Melted In situ Rock salt Plug (MIRP) System options, these options being addressed primarily from the downhole subsystem perspective, with a conventional drill rig as the basis for the surface part of the MIRP System. Preliminary experiments had indicated that it is possible to backfill the open penetrations in the domed salt deposits with a melted in situ rocksalt plug such that in time the melted rock salt plug effectively duplicates the parent virgin salt. The programmatic assumption for the requirement of duplicating the virgin salt with a MIRP provides the basis for this study. A system functional analysis was performed to establish the requirements for the performance of the overall MIRP System. A similar functional analysis was conducted for the salt plug that would be formed by the MIRP System. Based on the analyses of the material, thermal, and structural behavior of the salt plug, the requirements for the formation of an acceptable salt plug were determined. From the functional analysis a determination was made of the operation of the hardware for the downhole portion of the MIRP System. From that perspective several design concepts were formulated. For these design concepts a technology roadmap was developed. The pertinent aspects, results, conclusions and recommendations of the above are summarized in the sections that follow.

  9. Fiscal year 1995 well plugging and abandonment program Y-12 Plant, Oak Ridge, Tennessee

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-09-01

    This report is a synopsis of the progress of the well plugging and abandonment program at the Y-12 Plant, Oak Ridge, Tennessee, from September 1994 through August 1995. A total of 67 wells, piezometers, and borings were plugged and abandoned during the period of time covered in this report. All wells and borings were plugged and abandoned if (1) its construction did not meet current standards (substandard construction); (2) it was irreparably damaged or had deteriorated beyond practical repair; (3) its location interfered with or otherwise impeded site operations, construction, or closure activities; or (4) special circumstances existed as defined on a case-by-case basis and approved by the Y-12 Plant Groundwater Protection Program (GWPP) Manager. This summary report contains: general geologic setting of the Y-12 Plant and vicinity; discussion of well plugging and abandonment methods, grouting procedures, and waste management practices (a Waste Management Plan for Drilling Activities is included in Appendix C); summaries of plugging and abandonment activities at each site; and quality assurance/quality control (QA/QC) and health and safety protocols used during the FY 1995 Plugging and Abandonment Program.

  10. Quantum well infrared photodetectors (QWIP) with selectively regrown N-GaAs plugs

    Science.gov (United States)

    Matsukura, Yusuke; Nishino, Hironori; Tanaka, Hitoshi; Fujii, Toshio

    2001-10-01

    We fabricated the GaAs/AlGaAs Quantum Well Infrared Photo detector (QWIP) focal plane array with selectively re-grown N- GaAs interconnection plugs and demonstrated its device operation, in order to establish the technology to obtain both complex device functions and device manufacturability. MBE (Molecular Beam Epitaxy) grown QWIP MQW wafers were covered with SiON and SiNx mask films to obtain selectivity of the re-growth process. N-GaAs plugs were re-grown selectively with low-pressure MOCVD (Metal-Organic Chemical Vapor Deposition) with AsH3 and Dimethylgalliumchloride as precursors, only on the bottom surfaces of the holes for the interconnection to extract the electrodes from the underlying epilayer. Cross- sectional SEM observation revealed that the feature of the re- grown N-GaAs plugs was triangular, rather than rectangular as expected. The reason for this discrepancy is not yet clear. The electrical contact between the epilayer and re-grown N- GaAs plug was 'ohmic-like,' without any trace of interfacial barrier. The Current-Voltage characteristics of the fabricated QWIP device showed no tangible leakage current between the N- GaAs plug and device structure, indicating that electrical insulation between the N-GaAs plugs and device structure was sufficient. Fabricated devices were successfully operated as a hybrid focal plane array, indicating the selective re-growth was a promising technique to realize complex QWIP based devices.

  11. Blood plasma separation in a long two-phase plug flowing through disposable tubing.

    Science.gov (United States)

    Sun, Meng; Khan, Zeina S; Vanapalli, Siva A

    2012-12-21

    We report a simple technique to separate plasma from blood in a flowing immiscible plug. We investigate the effect of various control parameters such as blood dilution, injection flow rate, observation time and fluid properties on plasma separation. We find that the technique works best for diluted blood samples at low plug velocities and long observation times. We postulate that the main mechanism responsible for efficient separation is the sedimentation of blood cells in the plug and their subsequent collection by the moving plug causing a significant accumulation of cells at the rear of the plug. We discuss the time scales determining the sedimentation, advection and collection of a blood cell in the immiscible plug and propose a phase diagram that is able to predict the operating space for effective plasma separation. We demonstrate that the technique allows for the extraction of more than 60% of the plasma by volume from 1 μL of diluted blood. We show the practical significance of this method by compartmentalizing the separated plasma into discrete microfluidic droplets and detecting cholesterol. This technique features low consumption of blood (nL-scale) and low shear rate (∼1 s(-1)). It is inexpensive, easy to use, and has the potential to be developed as an efficient point-of-care device for blood diagnostics in resource-poor environments. More advanced applications could also be envisioned by integrating our plasma separation method into existing microfluidic drop manipulation techniques.

  12. Comprehensive Review of the Literature on Existing Punctal Plugs for the Management of Dry Eye Disease.

    Science.gov (United States)

    Jehangir, Naz; Bever, Greg; Mahmood, S M Jafar; Moshirfar, Majid

    2016-01-01

    Numerous designs of punctal and canalicular plugs are available on the market. This variety presents challenges to ophthalmologists when choosing punctal plugs for the management of various ocular conditions. The aim of this literature review is to provide a classification system for lacrimal occlusive devices based on their location and duration of action as well as to identify different characteristics of each one of them. We want to give a comprehensive overview on punctal and canalicular plugs including their manufacturing companies, indications, and complications that have been reported in various articles. PubMed and Google Scholar were used to identify articles written in English as well as few articles written in Japanese, Chinese, Slovak, and Spanish that had abstracts in English. Nine different companies that manufacture punctal and canalicular plugs were identified and their plugs were included in this review. Punctal and canalicular plugs are used in the management of various ocular conditions including dry eye disease and punctal stenosis as well as in ocular drug delivery. Although they are a relatively safe option, associated complications have been reported in the literature such as infection, allergic reaction, extrusion, and migration.

  13. Comprehensive Review of the Literature on Existing Punctal Plugs for the Management of Dry Eye Disease

    Directory of Open Access Journals (Sweden)

    Naz Jehangir

    2016-01-01

    Full Text Available Numerous designs of punctal and canalicular plugs are available on the market. This variety presents challenges to ophthalmologists when choosing punctal plugs for the management of various ocular conditions. The aim of this literature review is to provide a classification system for lacrimal occlusive devices based on their location and duration of action as well as to identify different characteristics of each one of them. We want to give a comprehensive overview on punctal and canalicular plugs including their manufacturing companies, indications, and complications that have been reported in various articles. PubMed and Google Scholar were used to identify articles written in English as well as few articles written in Japanese, Chinese, Slovak, and Spanish that had abstracts in English. Nine different companies that manufacture punctal and canalicular plugs were identified and their plugs were included in this review. Punctal and canalicular plugs are used in the management of various ocular conditions including dry eye disease and punctal stenosis as well as in ocular drug delivery. Although they are a relatively safe option, associated complications have been reported in the literature such as infection, allergic reaction, extrusion, and migration.

  14. Progression of anal high-grade squamous intraepithelial lesions to invasive anal cancer among HIV-infected men who have sex with men.

    Science.gov (United States)

    Berry, J Michael; Jay, Naomi; Cranston, Ross D; Darragh, Teresa M; Holly, Elizabeth A; Welton, Mark L; Palefsky, Joel M

    2014-03-01

    The incidence of anal cancer is elevated in human immunodeficiency virus (HIV)-infected men-who-have-sex-with-men (MSM) compared to the general population. Anal high-grade squamous intraepithelial lesions (HSIL) are common in HIV-infected MSM and the presumed precursors to anal squamous cell cancer; however, direct progression of HSIL to anal cancer has not been previously demonstrated. The medical records were reviewed of 138 HIV-infected MSM followed up at the University of California, San Francisco, who developed anal canal or perianal squamous cancer between 1997 and 2011. Men were followed up regularly with digital anorectal examination (DARE), high-resolution anoscopy (HRA) and HRA-guided biopsy. Although treatment for HSIL and follow-up were recommended, not all were treated and some were lost to follow-up. Prevalent cancer was found in 66 men. Seventy-two HIV-infected MSM developed anal cancer while under observation. In 27 men, anal cancer developed at a previously biopsied site of HSIL. An additional 45 men were not analyzed in this analysis due to inadequate documentation of HSIL in relation to cancer location. Of the 27 men with documented progression to cancer at the site of biopsy-proven HSIL, 20 men progressed from prevalent HSIL identified when first examined and seven men from incident HSIL. Prevalent HSIL progressed to cancer over an average of 57 months compared to 64 months for incident HSIL. Most men were asymptomatic, and cancers were detected by DARE. Anal HSIL has clear potential to progress to anal cancer in HIV-infected MSM. Early diagnosis is facilitated by careful follow-up. Carefully controlled studies evaluating efficacy of screening for and treatment of HSIL to prevent anal cancer are needed. © 2013 UICC.

  15. Obstetrical Anal Sphincter Injuries (OASIS): Prevention, Recognition, and Repair.

    Science.gov (United States)

    Harvey, Marie-Andrée; Pierce, Marianne; Alter, Jens-Erik W; Chou, Queena; Diamond, Phaedra; Epp, Annette; Geoffrion, Roxana; Harvey, Marie-Andrée; Larochelle, Annick; Maslow, Kenny; Neustaedter, Grace; Pascali, Dante; Pierce, Marianne; Schulz, Jane; Wilkie, David; Sultan, Abdul; Thakar, Ranee

    2015-12-01

    Objectif : Analyser les données probantes traitant des lésions obstétricales du sphincter anal (LOSA) en ce qui concerne leur diagnostic, les techniques visant leur réparation et les résultats de l’intervention. Formuler des recommandations permettant d’éclairer les conseils offerts aux patientes ayant connu des LOSA en ce qui a trait à la voie d’accouchement à privilégier dans le cadre des grossesses subséquentes. Options : Les fournisseurs de soins obstétricaux qui comptent des patientes ayant connu des LOSA disposent de l’option de réparer le sphincter anal en faisant appel à la méthode de suture « bout à bout » (end-to-end) ou à la méthode « en paletot » (overlapping). Ils pourraient également être appelés à conseiller des femmes ayant déjà connu des LOSA en ce qui a trait à la voie d’accouchement à privilégier pour les grossesses subséquentes. Issues : Le critère d’évaluation était la continence anale à la suite d’une réparation primaire de LOSA et à la suite d’un accouchement subséquent. Résultats : La littérature publiée a été récupérée par l’intermédiaire de recherches menées dans Medline, EMBASE et The Cochrane Library en mai 2011 au moyen d’un vocabulaire contrôlé (p. ex. anal canal, obstetrics, obstetric labour complication, pregnancy complication, treatment outcome, surgery, quality of life) et de mots clés (p. ex. obstetrical anal sphincter injur*, anus sphincter, anus injury, delivery, obstetrical care, surgery, suturing method, overlap, end-to-end, feces incontinence) appropriés. Les résultats ont été restreints aux analyses systématiques, aux études observationnelles et aux essais comparatifs randomisés / essais cliniques comparatifs. Aucune restriction n’a été imposée en matière de date ou de langue. Les recherches ont été mises à jour de façon régulière et intégrées à la directive clinique jusqu’en septembre 2014. La littérature grise (non

  16. Experiences from the design and construction of plug II in the Prototype Repository

    Energy Technology Data Exchange (ETDEWEB)

    Dahlstroem, Lars-Olof (NCC Teknik (Sweden))

    2009-12-15

    The intention with this document is to summarise the comprehensive documentation and experience that was gained during the design and construction of the temporary plugs in the Prototype Repository experiment at Aespoe HRL. The Prototype Repository experiment was designed to in full scale test the engineered barriers and their function, including the plug that separate the deposition tunnel from the temporary access- and transportation tunnels that are at atmospheric pressure. This plug is designed and constructed as a concrete plug with a spherical front side and a flat pressurised side. This report presents the processes and operations that were considered when developing the 'plug', design, construction and verification. In the Prototype Repository the demand of leakage control is very high and the maximum length of the plugs is constrained due to available clearance space, experimental set-up and configuration. Therefore a typical 'friction plug' normally used to block waterways in connection with hydropower plants, is not suitable. Instead a plug constructed as an 'arch plug' with abutments was considered. In order to minimize the Excavation Disturbed Zone (EDZ) the abutments, in which the plug is inserted, was excavated by seam drilling with coring technique. The steel formwork was pre-assembled at the ground surface before taken down to the tunnel. The steel was bolted and welded together and crossbars and plywood were mounted on top. Before taken down to the tunnel, the formwork was separated into smaller pieces that were easier to transport down the tunnel but easy to assembly at the Prototype Repository experiment. Before assembling the formwork, a retaining wall was installed to resist the earth and compaction pressure developed from the backfill material. The retaining wall consists of pre-fabricated concrete beams that were installed parallel with the installation of the backfill. Reinforcement was cut and bent at the

  17. Kansas Consortium Plug-in Hybrid Medium Duty

    Energy Technology Data Exchange (ETDEWEB)

    None, None

    2012-03-31

    On September 30, 2008, the US Department of Energy (DoE), issued a cooperative agreement award, DE-FC26-08NT01914, to the Metropolitan Energy Center (MEC), for a project known as “Kansas Consortium Plug-in Hybrid Medium Duty Certification” project. The cooperative agreement was awarded pursuant to H15915 in reference to H. R. 2764 Congressionally Directed Projects. The original agreement provided funding for The Consortium to implement the established project objectives as follows: (1) to understand the current state of the development of a test protocol for PHEV configurations; (2) to work with industry stakeholders to recommend a medium duty vehicle test protocol; (3) to utilize the Phase 1 Eaton PHEV F550 Chassis or other appropriate PHEV configurations to conduct emissions testing; (4) and to make an industry PHEV certification test protocol recommendation for medium duty trucks. Subsequent amendments to the initial agreement were made, the most significant being a revised Scope of Project Objectives (SOPO) that did not address actual field data since it was not available as originally expected. This project was mated by DOE with a parallel project award given to the South Coast Air Quality Management District (SCAQMD) in California. The SCAQMD project involved designing, building and testing of five medium duty plug-in hybrid electric trucks. SCAQMD had contracted with the Electric Power Research Institute (EPRI) to manage the project. EPRI provided the required match to the federal grant funds to both the SCAQMD project and the Kansas Consortium project. The rational for linking the two projects was that the data derived from the SCAQMD project could be used to validate the protocols developed by the Kansas Consortium team. At the same time, the consortium team would be a useful resource to SCAQMD in designating their test procedures for emissions and operating parameters and determining vehicle mileage. The years between award of the cooperative

  18. Plug-In Hybrid Urban Delivery Truck Technology Demonstration

    Energy Technology Data Exchange (ETDEWEB)

    Miyasato, Matt [South Coast Air Quality Management District Building Corporation, Diamond Bar, CA (United States); Impllitti, Joseph [South Coast Air Quality Management District Building Corporation, Diamond Bar, CA (United States); Pascal, Amar [South Coast Air Quality Management District Building Corporation, Diamond Bar, CA (United States)

    2015-07-31

    The I-710 and CA-60 highways are key transportation corridors in the Southern California region that are heavily used on a daily basis by heavy duty drayage trucks that transport the cargo from the ports to the inland transportation terminals. These terminals, which include store/warehouses, inland-railways, are anywhere from 5 to 50 miles in distance from the ports. The concentrated operation of these drayage vehicles in these corridors has had and will continue to have a significant impact on the air quality in this region whereby significantly impacting the quality of life in the communities surrounding these corridors. To reduce these negative impacts it is critical that zero and near-zero emission technologies be developed and deployed in the region. A potential local market size of up to 46,000 trucks exists in the South Coast Air Basin, based on near- dock drayage trucks and trucks operating on the I-710 freeway. The South Coast Air Quality Management District (SCAQMD), California Air Resources Board (CARB) and Southern California Association of Governments (SCAG) — the agencies responsible for preparing the State Implementation Plan required under the federal Clean Air Act — have stated that to attain federal air quality standards the region will need to transition to broad use of zero and near zero emission energy sources in cars, trucks and other equipment (Southern California Association of Governments et al, 2011). SCAQMD partnered with Volvo Trucks to develop, build and demonstrate a prototype Class 8 heavy-duty plug-in hybrid drayage truck with significantly reduced emissions and fuel use. Volvo’s approach leveraged the group’s global knowledge and experience in designing and deploying electromobility products. The proprietary hybrid driveline selected for this proof of concept was integrated with multiple enhancements to the complete vehicle in order to maximize the emission and energy impact of electrification. A detailed review of all

  19. Transcatheter closure of small ductus arteriosus with amplatzer vascular plug

    Directory of Open Access Journals (Sweden)

    Eunhyun Cho

    2013-09-01

    Full Text Available Purpose: The purpose of this study was to share our experience of transcatheter closure of small patent ductus arteriosus (PDA by using an Amplatzer vascular plug (AVP.&lt;br&gt; Methods: We reviewed the medical records of 20 patients who underwent transcatheter closure at Samsung Medical Center and Sejong General Hospital from January 2008 to August 2012. The size and shape of the PDAs were evaluated by performing angiograms, and the PDA size and the AVP devices size were compared.&lt;br&gt;Results: The mean age of the patients was 54.9±45.7 months old. The PDAs were of type C (n=5, type D (n=12 and type E (n=3. The mean pulmonary end diameter of the PDA was 1.7±0.6 mm, and the aortic end diameter was 3.6±1.4 mm. The mean length was 7.3±1.8 mm. We used 3 types of AVP devices: AVP I (n=5, AVP II (n=7, and AVP IV (n=8. The ratio of AVP size to the pulmonary end diameter was 3.37±1.64, and AVP size/aortic end ratio was 1.72±0.97. The aortic end diameter was significantly larger in those cases repaired with AVP II than in the others (P =0.002. The AVP size did not significantly correlate with the PDA size, but did correlate with smaller ratio of AVP size to aortic end diameter (1.10±0.31, P =0.032. &lt;br&gt;Conclusion: Transcatheter closure of small PDA with AVP devices yielded satisfactory outcome. AVP II was equally effective with smaller size of device, compared to others.

  20. A Plug-and-Play Duct System Evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Beach, Robert [IBACOS, Inc., Pittsburgh, PA (United States); Dickson, Bruce [IBACOS, Inc., Pittsburgh, PA (United States); Grisolia, Anthony [IBACOS, Inc., Pittsburgh, PA (United States); Poerschke, Andrew [IBACOS, Inc., Pittsburgh, PA (United States); Rapport, Ari [IBACOS, Inc., Pittsburgh, PA (United States)

    2017-07-10

    This report describes an air distribution system composed of a series of uniformly-sized ducts that terminate in rooms throughout the home and return to a central manifold, similar in fashion to a “home-run” cross-linked polyethylene plumbing system. With a well-designed manifold, each duct receives an equal static pressure potential for airflow from the air handling unit, and the number of needed ducts for each room are simply attached to fittings located on the manifold; in this sense, the system is plug-and-play (PnP). As indicated, all ducts in the PnP system are identical in size and small enough to fit in the ceiling and wall cavities of a house (i.e., less than 3.5-in. outer diameter). These ducts are also more appropriately sized for the lower airflow requirements of modern, energy-efficient homes; therefore, the velocity of the air moving through the duct is between that of conventional duct systems (approximately 700 ft/min) and high-velocity systems (more than 1,500 ft/min) on the market today. The PnP duct system uses semi-rigid plastic pipes, which have a smooth inner wall and are straightforward to install correctly, resulting in a system that has minimal air leakage. However, plastic ducts are currently not accepted by code for use in residential buildings; therefore, the project team considered other duct materials for the system that are currently accepted by code, such as small-diameter, wirehelix, flexible ductwork.