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Sample records for techniques treatment procedures

  1. Endovascular stroke treatment now and then-procedural and clinical effectiveness and safety of different mechanical thrombectomy techniques over time.

    Science.gov (United States)

    von Gadow, Niels; Nikoubashman, Omid; Freiherr, Jessica; Block, Frank; Reich, Arno; Fesl, Gunther; Wiesmann, Martin

    2017-02-01

    The most essential development in endovascular stroke treatment (EST) was the shift from intra-arterial thrombolysis to endovascular thrombectomy with dedicated thrombectomy devices, most notably the introduction of stent-retrievers. We evaluated procedural and clinical effectiveness and safety of different EST techniques over time. We retrospectively analyzed EST cases that were treated by the same interventionalist before (n=36) and after (n=50) stent-retrievers were established as the treatment device of first choice. EST techniques in the first cohort comprised intra-arterial thrombolysis (n=24), manual thrombus aspiration (n=15), the use of the Penumbra thrombectomy system (n=13) and the Phenox clot retriever (n=3), intracranial stenting (n=10), and EST with stent-retrievers as a salvage procedure (n=11). In the second cohort, EST with stent-retrievers was the treatment option of first choice (n=47). Intra-arterial thrombolysis (n=15) and stenting of the occluded vessel (n=1) were performed, whenever EST with stent-retrievers failed. In both cohorts, revascularization rates (TICI ≥2b) were high (91.7% and 86.0%, respectively). A significantly lower number of interventional techniques per case were required in the second cohort (mean ± SD, 1.4±0.5 vs. 2.1±0.9, P<0.001). Recanalization was achieved almost twice as fast in the second cohort (85 vs. 163 minutes on average, P<0.001). The rate of patients achieving good functional outcome (mRS ≤2) was higher in the second cohort (40.0% vs. 22.2%, P=0.083). Our findings imply that when stent-retrievers were established as first-line the treatment device a significantly lower number of interventional techniques per case were required and recanalization was achieved almost twice as fast.

  2. Extended Resin Composite Restorations: Techniques and Procedures

    NARCIS (Netherlands)

    Loomans, B.A.C.; Hilton, T.

    2016-01-01

    This article gives an overview of the state of the art of different restorative treatment procedures and techniques needed for placing extended posterior resin composite restorations. Clinical aspects related to the procedure are discussed and reviewed based on the current literature, such as the

  3. IC Treatment: Surgical Procedures

    Science.gov (United States)

    ... Complicated IC Cases Promising IC Diagnostic Tests Wrong Diagnosis IC Treatment Guideline IC Treatments IC Diet & Self Management Physical Therapy Antidepressants Antihistamines Pentosan Polysulfate Sodium Bladder Instillations Immunosuppresants ...

  4. Expanded eggshell procedure combined with closing-opening technique (a modified vertebral column resection) for the treatment of thoracic and thoracolumbar angular kyphosis.

    Science.gov (United States)

    Liu, Xinyu; Yuan, Suomao; Tian, Yonghao; Wang, Lianlei; Zheng, Yanping; Li, Jianmin

    2015-07-01

    The purpose of this study was to determine the efficacy of a modified vertebral column resection for the treatment of thoracolumbar angular kyphosis. A total of 13 patients (8 male, 5 female) with thoracolumbar kyphosis (kyphotic angle > 60°) were included in this study (Group A). There were 3 patients with failure of spinal formation (Type 1 deformity), 6 patients with old thoracic or lumbar compression fracture, and 4 patients with old spinal tuberculosis (including 1 case of T3-5 vertebral malunion). The average preoperative kyphotic angle was 67.3° (range 62°-75°). Each patient underwent an expanded eggshell procedure combined with the closing-opening technique for the treatment of thoracolumbar angular kyphosis. Sixteen patients who were previously treated with a closing-opening wedge osteotomy in the same spine classification group (kyphotic angle > 60°) were used as a control group (Group B). In Group A, the average (± SD) operative time was 400 ± 60 minutes, and the average blood loss was 960 ± 120 ml. There were no surgery-related complications observed during or after the operations. The average local kyphotic angle was 20.3° (range 18°-24.5°), and the average correction rate was 68.7%. In Group B, the average operative time was 470 ± 90 minutes, and the average blood loss was 2600 ± 1600 ml (range 1200-8200 ml). There were segmental vessels and spinal canal venous plexus injury in 1 case, spinal cord injury in 1 case, dural tearing in 2 cases, pleural rupture in 2 cases, and hemothorax and pneumothorax in 1 case. Each patient had more than 2 years of follow-up. At the latest follow-up examination, the average regional kyphotic angle was 19.9° ± 9.1° (range 19°-34°), and there was no significant loss of correction (p > 0.05). There was greater blood loss and a higher complication rate in Group B than in Group A (p < 0.05). An expanded eggshell procedure combined with the closing-opening technique for the treatment of thoracolumbar

  5. Techniques and Materials Used by General Dentists during Root Canal Treatment Procedures: Findings from the National Dental Practice-Based Research Network

    Science.gov (United States)

    Eleazer, Paul D.; Gilbert, Gregg H.; Funkhouser, Ellen; Reams, G.J.; Law, A.S.; Benjamin, Paul L.

    2015-01-01

    Background Little is known about which materials and techniques general dentists (GDs) use during root canal procedures. The objectives were to: (1) quantify GD’s use of specific endodontic armamentarium; (2) quantify inappropriate use; and (3) ascertain if inappropriate use is associated with dentists’ practice characteristics. Methods GDs in the National Dental Practice-Based Research Network reported in a questionnaire materials and techniques they use during root canal procedures. Results 1,490 (87%) of eligible GDs participated. Most (93%; n=1,383) used sodium hypochlorite to irrigate. The most commonly used sealers were zinc oxide-eugenol (43%) and resin (40%), followed by calcium hydroxide (26%). A majority (62%; n=920) used a compaction obturation technique; 36% (n=534) used a carrier-based method. Most (96%; n=1,423) used gutta percha as a filler; 5% used paste fillers. Few used irrigants (n=46), sealers (n=4), techniques (n=49) or fillers (n=10) that investigators classified as ‘inappropriate’. Conclusions GDs use a broad range of endodontic techniques and materials, often adapting to newer technologies as they become available. Few GDs use armamentarium that the investigators classified as inappropriate. Practical Implications GDs use many types of endodontic techniques and materials, but only a very small percentage is not appropriate. PMID:26562726

  6. Cardiovascular procedures/diagnostic techniques and therapeutic procedures

    Energy Technology Data Exchange (ETDEWEB)

    Tilkian, A.G.; Daily, E.K.

    1986-01-01

    This book covers the technical and therapeutic aspects of cardiovascular procedures in immense detail. There are large and appropriate diagrams and tables. The topics of the chapters are tools for catheterization, venous access, arterial access, hemodynamic monitoring, cardiac catheterization and coronary arteriography, ergonovine provocation testing for coronary artery spasm, pulmonary angiography, endomyocredial biopsy, electrophysiologic studies, pericardiocentesis and drainage, intraaortic balloon pumping, direct current cardioversion and defibrilaltion, pacemaker implantation of the automatic implantable cardioverter/defibrillator, coronary angioplasty, thrombolytic therapy, transluminal catheter extraction and resolution of intracardiac catheter knots, cardiopulmonary resuscitation, contrast media toxicity and allergic reactions, radiation hazards, and medicolegal concerns. An appendix and index follow these chapters. In general, each chapter covers historical aspects, indications, complications, techniques, and preoperative and postoperative care.

  7. Children Procedures and Treatment (Fertility Issues)

    Medline Plus

    Full Text Available Oncofertility Consortium Children Procedures and Treatment Share My Story Share my story! Children Procedures and Treatment Is ovarian tissue cryopreservation available to girls under 18? How can ...

  8. Children Procedures and Treatment (Fertility Issues)

    Medline Plus

    Full Text Available Oncofertility Consortium Children Procedures and Treatment Share My Story Share my story! Children Procedures and Treatment Is ovarian tissue cryopreservation available to girls under 18? How can ...

  9. Chipless RFID design procedure and detection techniques

    CERN Document Server

    Rezaiesarlak, Reza

    2015-01-01

    This book examines the design of chipless RFID systems. The authors begin with the historical development of wireless identification systems and finally arrive at a representation of the chipless RFID system as a block diagram illustration. Chapter 2 is devoted to the theoretical bases for the design of chipless RFID tags and detection techniques in the reader. A rigorous mathematical formulation is presented based on the singularity expansion method (SEM) and characteristic mode theory (CMT) in order to study the scattered fields from an object in a general form. Th e authors attempt to explain some physical concepts behind the mathematical descriptions of the theories in this chapter. In Chapter 3, two design procedures based on complex natural resonance and CMT are presented for the design of the chipless RFID tag. By studying the effects of structural parameters on radiation and resonant behaviors of the tag, some design conclusions are presented in this chapter. Chapter 4 is dedicated to the time-frequen...

  10. Levels of evidence in nursing techniques and procedures

    Directory of Open Access Journals (Sweden)

    Montserrat Solís Muñoz

    2008-07-01

    Full Text Available Objective: To analyze the levels of scientific evidence on nursing techniques and procedures.Selection of nursing techniques: According to the frequency of daily use, increase in scientific production in the last years, and variability in practise.Sources and data searching: 1. Books and manuals in Specialised libraries and using the Online Point Access Catalog (OPAC. 2. Clinical practise guidelines and protocols from hospitals taking part in the Evidence-Based Medicine network. 3. On-line manuals, clinical practise guidelines and protocols, using different searching strategies and specific language of PubMed, Cochrane Library, CINAHL, IBECS, and others.Revision method: 1. To retrieve the sources of information containing the techniques and procedures. 2. Their identification and description. 3. Assessment of the level of evidence of the studies cited in the sources through critical appraisal, by two observers. If disagreement, a third reviewer will assess the study. 4. Analysis of scientific evidence of techniques and procedures, applying specific criteria and using the highest level of evidence supporting them. 5. Assignment of the level of recommendation for the technique depending on the level of evidence.Analysis and data treatment: With a reference manager databases with sources and references will be created and related to each other.

  11. SU-F-T-647: Linac-Based Stereotactic Radiosurgery (SRS) in the Treatment of Trigeminal Neuralgia: Detailed Description of SRS Procedural Technique and Reported Clinical Outcomes

    Energy Technology Data Exchange (ETDEWEB)

    Pokhrel, D; Sood, S; Badkul, R; Jiang, H; Stepp, T; Camarata, P; Wang, F [University of Kansas Hospital, Kansas City, KS (United States)

    2016-06-15

    Purpose: SRS is an effective non-invasive alternative treatment modality with minimal-toxicity used to treat patients with medically/surgically refractory trigeminal neuralgia root(TNR) or those who may not tolerate surgical intervention. We present our linac-based SRS procedure for TNR treatment and simultaneously report our clinical outcomes. Methods: Twenty-eight TNR-patients treated with frame-based SRS at our institution (2009–2015) with a single-fraction point-dose of 60-80Gy to TNR were included in this IRB-approved study. Experienced neurosurgeon and radiation oncologist delineated the TNR on 1.0mm thin 3D-FIESTA-MRI that was co-registered with 0.7mm thin planning-CT. Treatment plans were generated in iPlan (BrainLAB) with a 4-mm diameter cone using 79 arcs with differential-weighting for Novalis-TX 6MV-SRS(1000MU/min) beam and optimized to minimize brainstem dose. Winston-Lutz test was performed before each treatment delivery with sub-millimeter isocenter accuracy. Quality assurance of frame placement was maintained by helmet-bobble-measurement before simulation-CT and before patient setup at treatment couch. OBI-CBCT scan was performed for patient setup verification without applying shifts. On clinical follow up, treatment response was assessed using Barrow Neurological Institute Pain Intensity Score(BNI-score:I–V). Results: 26/28 TNR-patients (16-males/10-females) who were treated with following single-fraction point-dose to isocenter: 80Gy(n=22),75Gy(n=1),70Gy(n=2) and 60Gy(n=1, re-treatment) were followed up. Median follow-up interval was 8.5-months (ranged:1–48.5months). Median age was 70-yr (ranged:43–93-yr). Right/left TNR ratio was 15/11. Delivered total # of average MUs was 19034±1204. Average beam-on-time: 19.0±1.3min. Brainstem max-dose and dose to 0.5cc were 13.3±2.4Gy (ranged:8.1–16.5Gy) and 3.6±0.4Gy (ranged:3.0–4.9Gy). On average, max-dose to optic-apparatus was ≤1.2Gy. Mean value of max-dose to eyes/lens was 0.26Gy/0.11Gy

  12. Children Procedures and Treatment (Fertility Issues)

    Medline Plus

    Full Text Available ... Story Share my story! Children Procedures and Treatment Is ovarian tissue cryopreservation available to girls under 18? ... fertility preservation with their cancer-stricken child? How is the Oncofertility Consortium addressing the fertility preservation needs ...

  13. Report on COTECH test procedure and characterization techniques

    DEFF Research Database (Denmark)

    Islam, Mohammad Aminul

    This deliverable report describes in detail the test steps that need to be executed in order to certify the final COTECH demonstrators for the specific application areas like health, biomedical, automotive, energy and information technology. It also defines and lists the capabilities and properties...... and material characterization techniques  Characterization techniques of the COTECH demonstrators  Functionality and lifecycle testing of the COTECH demonstrators Besides the general introduction and conclusion each section of the report is dedicated to the characterization techniques and test procedure.......Characterization techniques and test procedure requirements for innovative self-ligating dental brackets (EO) Section 5.Characterization techniques and test procedure requirements for smart diagnostic chips comprising a microfluidic channel system (GBO) Section 6.Characterization techniques and test procedure...

  14. Role of Malabsorptive Endoscopic Procedures in Obesity Treatment

    Science.gov (United States)

    Park, Jae Myung

    2017-01-01

    The incidence of obesity is increasing, and more definitive treatment modalities are needed. Endoluminal procedures, including restrictive endoscopic procedures, endoscopic gastroplasty, and malabsorptive endoscopic procedures, can reduce weight in obese patients and control obesity-related comorbidities. Malabsorptive endoscopic interventions also offer the potential for an ambulatory procedure that may be safer and more cost-effective compared with laparoscopic surgery. Malabsorptive endoscopic intervention can induce weight reduction and improve obesity-related metabolic parameters, despite complications such as device migration, obstruction, and abdominal pain. Improvement in technique will follow the development of new devices. PMID:28147470

  15. TECHNIQUE OF ESTIMATION OF ERROR IN THE REFERENCE VALUE OF THE DOSE DURING THE LINEAR ACCELERATOR RADIATION OUTPUT CALIBRATION PROCEDURE. Part 2. Dependence on the characteristics of collimator, optical sourse-distance indicator, treatment field, lasers and treatment couch

    Directory of Open Access Journals (Sweden)

    Y. V. Tsitovich

    2016-01-01

    Full Text Available To ensure the safety of radiation oncology patients needed to provide consistent functional characteristics of the medical linear accelerators, which affect the accuracy of dose delivery. To this end, their quality control procedures, which include the calibration of radiation output of the linac, the error in determining the dose reference value during which must not exceed 2 %, is provided. The aim is to develop a methodology for determining the error (difference between a measured value of quantity and its true value in determining this value, depending on the characteristics of the collimator, the source to surface distance pointer, lasers, radiation field and treatment table. To achieve the objectives have been carried out dosimetric measurements of Trilogy S/N 3567 linac dose distributions, on the basis of which dose errors depending on the accuracy setting the zero position of the collimator, the deviation of the collimator rotation isocenter, the sourcesurface distance pointer accuracy, field size accuracy, the accuracy of lasers and treatment table positioning were obtained. It was found that the greatest impact on the value of the error has the error in the optical SSD indication and the error in the lasers position in the plane perpendicular to the plane of incidence of the radiation beam (up to 3.64 % for the energy of 6 MV. Dose errors caused by error in the field size were different for two photon energies, and reached 2.54 % for 6 MeV and 1.33% for 18 MeV. Errors caused by the rest of the characteristic do not exceed 1 %. Thus, it is possible to express the results of periodic quality control of these devices integrated in linac in terms of dose and use them to conduct a comprehensive assessment of the possibility of clinical use of a linear accelerator for oncology patients irradiation on the basis of the calibration of radiation output in case of development of techniques that allow to analyze the influence dosimetric

  16. Heat Treatment Procedure Qualification -- Final Technical Report

    Energy Technology Data Exchange (ETDEWEB)

    Robert C. Voigt

    2004-10-15

    Heat treatment practices used by steel foundries have been carefully studied as part of comprehensive heat treatment procedure development trials. These studies highlight the relationships between critical heat treatment process control parameters and heat treatment success. Foundry heat treatment trials to develop heat treatment procedure qualification have shed light on the relationship between heat treatment theory and current practices. Furnace load time-temperature profiles in steel foundries exhibit significant differences depending on heat treatment equipment, furnace loading practice, and furnace maintenance. Time-temperature profiles of the furnace control thermocouples can be very different from the time-temperature profiles observed at the center of casting loads in the furnace. Typical austenitrization temperatures and holding times used by steel foundries far exceed what is required for transformation to austenite. Quenching and hardenability concepts were also investigated. Heat treatment procedure qualification (HTPQ) schema to demonstrate heat treatment success and to pre-qualify other alloys and section sizes requiring lesser hardenability have been developed. Tempering success is dependent on both tempering time and temperature. As such, furnace temperature uniformity and control of furnace loading during tempering is critical to obtain the desired mechanical properties. The ramp-up time in the furnace prior to the establishment of steady state heat treatment conditions contributes to the extent of heat treatment performed. This influence of ramp-up to temperature during tempering has been quantified.

  17. Heat Treatment Procedure Qualification for Steel Castings

    Energy Technology Data Exchange (ETDEWEB)

    Mariol Charles; Nicholas Deskevich; Vipin Varkey; Robert Voigt; Angela Wollenburg

    2004-04-29

    Heat treatment practices used by steel foundries have been carefully studied as part of comprehensive heat treatment procedure qualification development trials. These studies highlight the relationships between critical heat treatment process control parameters and heat treatment success. Foundry heat treatment trials to develop heat treatment procedure qualifications have shed light on the relationship between heat treatment theory and current practices. Furnace load time-temperature profiles in steel foundries exhibit significant differences depending on heat treatment equipment, furnace loading practice, and furnace maintenance. Time-temperature profiles of furnace control thermocouples can be very different from the time-temperature profiles observed at the center of casting loads in the furnace. Typical austenitization temperatures and holding times used by steel foundries far exceed what is required for transformation to austenite. Quenching and hardenability concepts were also investigated. Heat treatment procedure qualification (HTPQ) schema to demonstrate heat treatment success and to pre-qualify other alloys and section sizes requiring lesser hardenability have been developed. Tempering success is dependent on both tempering time and temperature. As such, furnace temperature uniformity and control of furnace loading during tempering is critical to obtain the desired mechanical properties. The ramp-up time in the furnace prior to the establishment of steady state heat treatment conditions contributes to the extent of heat treatment performed. This influence of ramp-up to temperature during tempering has been quantified.

  18. The Gandhi Technique: A New Procedure for Intractable Problems.

    Science.gov (United States)

    Schiff, Neil P.; Belson, Richard

    1988-01-01

    Notes problem of treating clients with intractable difficulties. Presents Gandhi Technique as simple, dramatic and seemingly effective procedure to resolve intractable difficulties. Describes technique and its application in different cases. Discusses several theories which may account for the efficacy of the technique. Proposes that Gandhi…

  19. Impact of 3D Rotational Angiography on Liver Embolization Procedures: Review of Technique and Applications

    Energy Technology Data Exchange (ETDEWEB)

    Lucatelli, Pierleone, E-mail: pierleone.lucatelli@gmail.com; Corona, Mario, E-mail: mario.corona68@gmail.com; Argirò, Renato, E-mail: renato.argiro@gmail.com; Anzidei, Michele, E-mail: michele.anzidei@gmail.com [Sapienza University of Rome, Vascular and Interventional Radiology Unit, Department of Radiological, Oncological and Anatomo-Pathological Sciences (Italy); Vallati, Giulio, E-mail: vallati@ifo.it [Istituto Nazionale Tumori, Regina Elena, Department of Angiography and Interventional Radiology (Italy); Fanelli, Fabrizio, E-mail: fabrizio.fanelli@uniroma1.it; Bezzi, Mario, E-mail: mario.bezzi@uniroma1.it; Catalano, Carlo, E-mail: carlo.catalano@uniroma1.it [Sapienza University of Rome, Vascular and Interventional Radiology Unit, Department of Radiological, Oncological and Anatomo-Pathological Sciences (Italy)

    2015-06-15

    In the last years, the interest into interventional applications of C-arm cone-beam CT (CBCT) progressively raised, widening its clinical application from the original field of interventional neuroradiology to the field of peripheral procedures. Liver embolization procedures, due to their complexity and potential treatment-related life-threatening complications, represent one of the main clinical applications of this novel angiographic technique. CBCT has been demonstrated to render procedures safer and technically easier, and to predict outcome as well as to avoid major complications in different treatment scenarios (trans-arterial embolization, trans-arterial chemoembolization, selective internal radiation therapy, percutaneous portal vein embolization). This review summarizes all technical, dosimetric and procedural aspects of CBCT techniques, underlying all its potential clinical advantages in the field of liver embolization procedures. Moreover, the paper provides all the instructions to obtain the best diagnostic performance out of this novel angiographic technique.

  20. Arthroscopically assisted Sauvé-Kapandji procedure: an advanced technique for distal radioulnar joint arthritis.

    Science.gov (United States)

    Luchetti, Riccardo; Khanchandani, Prakash; Da Rin, Ferdinando; Borelli, Pierpaolo P; Mathoulin, Christophe; Atzei, Andrea

    2008-12-01

    Osteoarthritis of distal radioulnar joint (DRUJ) leads to chronic wrist pain, weakness of grip strength, and limitation of motion, all of which affect the quality of life of the patient. Over the years, several procedures have been used for the treatment of this condition; however, this condition still remains a therapeutic challenge for the hand surgeons. Many procedures such as Darrach procedure, Bower procedure, Sauvé-Kapandji procedure, and ulnar head replacement have been used. Despite many advances in wrist arthroscopy, arthroscopy has not been used for the treatment of arthritis of the DRUJ. We describe a novel technique of arthroscopically assisted Sauvé-Kapandji procedure for the arthritis of the DRUJ. The advantages of this technique are its less invasive nature, preservation of the extensor retinaculum, more anatomical position of the DRUJ, faster rehabilitation, and a better cosmesis.

  1. A review of the regenerative endodontic treatment procedure

    Directory of Open Access Journals (Sweden)

    Bin-Na Lee,

    2015-08-01

    Full Text Available Traditionally, apexification has been used to treat immature permanent teeth that have lost pulp vitality. This technique promotes the formation of an apical barrier to close the open apex so that the filling materials can be confined to the root canal. Because tissue regeneration cannot be achieved with apexification, a new technique called regenerative endodontic treatment was presented recently to treat immature permanent teeth. Regenerative endodontic treatment is a treatment procedure designed to replace damaged pulp tissue with viable tissue which restores the normal function of the pulp-dentin structure. After regenerative endodontic treatment, continued root development and hard tissue deposition on the dentinal wall can occur under ideal circumstances. However, it is difficult to predict the result of regenerative endodontic treatment. Therefore, the purpose of this study was to summarize multiple factors effects on the result of regenerative endodontic treatment in order to achieve more predictable results. In this study, we investigated the features of regenerative endodontic treatment in comparison with those of other pulp treatment procedures and analyzed the factors that have an effect on regenerative endodontic treatment.

  2. Hepatic cystic echinococcosis:Percutaneous treatment as an outpatient procedure

    Institute of Scientific and Technical Information of China (English)

    Mert Krolu; Okan Akhan; Bekir Erol; Cemil Grses; Bar Trkbey; Cem Yunus Ba; Ahmetkr Alparslan; Banu Kale Krolu; clal Erdem Toslak; Blenteki

    2014-01-01

    Objective:To demonstrate utility and safety of the puncture aspiration injection and reaspiration (PAIR) technique for outpatients.Methods:Percutaneous treatment withUS guidance was applied to33 patients for44 cysts.Patients treated with thePAIR technique, were outpatients. PAIR and catheterization technique were evaluated for efficacy and safety of procedure and complication rates.Results:Thirty-five of44 cysts were treated with thePAIR and9 of44 were treated with the catheterization technique.The success rate of the cystsGharbi type1(CE1) and type2(CE3a) treated with thePAIR technique was100%.In the follow up of9 cysts treated with the catheterization technique,2 of them(22%) developed cyst infection and1(11%) developed a biliary fistula.Conclusions:ThePAIR technique was found to be an effective and safe approach in order to treatGharbi type1 and type2 cysts percutaneously for outpatients.It has a very low complication rate in comparison with the catheterization technique.So every effort should be made to finish the treatment withPAIR technique.

  3. Modification of the Nuss Procedure: The Single-incision Technique

    Directory of Open Access Journals (Sweden)

    Tetsushi Aizawa, MD

    2014-11-01

    Full Text Available Summary: The Nuss procedure is a prevalent minimally invasive surgery for pectus excavatum. Although the Nuss procedure has the advantage of leaving less obtrusive scars, the standard technique requires at least 3 skin incisions to insert several instruments. We experienced 7 cases of the modified Nuss procedure using a single incision during a 7-year period. To facilitate passing of the bar, a traction guide was created according to our unique method. There was no need for a bar stabilizer, and no severe intraoperative complications occurred. All patients exhibited satisfactory short-term results; however, 1 patient suffered from bar rotation and required repeat surgery for fixation. Two patients underwent bar removal via the same single incision without any difficulties.

  4. [Nonpharmacological treatment procedures for Parkinson's disease].

    Science.gov (United States)

    Witt, K; Kalbe, E; Erasmi, R; Ebersbach, G

    2017-03-01

    Nonpharmacological treatment strategies in Parkinson' disease include heterogeneous treatment modalities, such as physiotherapy, occupational therapy, speech therapy, cognitive training and deep brain stimulation as well as noninvasive brain stimulation strategies. Even in the early stages of Parkinson's disease nonpharmacological interventions, such as active exercise therapy and speech therapy can be indicated taking the individual symptoms of a patient into account. Mild cognitive deficits are frequently detected in the course of the disease and progression of these disorders to dementia in the advanced stages of the disease is not uncommon. The starting point for a cognitive training, training strategy and training frequency is unknown and currently under investigation. Deep brain stimulation is an established treatment modality, which should be considered when motor fluctuations cannot be adequately controlled by pharmacological treatment. This therapeutic option depends on patient-specific needs and has to be managed by a multiprofessional team. Non-invasive neurostimulation techniques, such as transcranial magnetic stimulation and transcranial direct current stimulation are experimental tools and cannot currently be recommended for general use.

  5. Free Nipple Graft Technique to Correct Nipple and Areola Malposition after Breast Procedures

    Directory of Open Access Journals (Sweden)

    Mario Rietjens, MD

    2013-11-01

    Full Text Available Summary: Secondary correction of nipple areola complex (NAC malposition represents a major concern after breast reconstructive procedures. It is frequently requested by patients complaining about asymmetric areolas impairing the whole reconstructive procedure and asking for improved cosmetic outcomes. Several methods have been described to achieve a good symmetry between the 2 areolas, either natural or reconstructed. We describe our correction technique with free NAC graft. A total of 16 patients were treated with free NAC grafts between April 2010 and April 2013 at the European Institute of Oncology, Milan, Italy. This series focused on the surgical technique and its postoperative outcomes. Three cases of partial graft loss (18% were observed in the postoperative period. No total NAC necrosis occurred. No infection was observed. All the complications were managed with a conservative treatment, not requiring any further surgery. NAC malposition following breast reconstructive procedures can be corrected using the technique of free NAC graft with reliable and satisfactory results.

  6. Gingival augmentation procedure prior to fixed orthodontic treatment

    Directory of Open Access Journals (Sweden)

    Surekha Bhedasgoankar

    2011-01-01

    Full Text Available Patients seek orthodontic treatment for correction of malocclusion and aesthetic improvement. A strong correlation between labially placed teeth and gingival recession has been found. If such cases are left untreated with or without orthodontic therapy, it may lead to an increase in the severity of the disease. A similar case of a 21-year-old male patient with gingival recession in the mandibular anterior region is reported. The patient was successfully treated using a free gingival graft technique. This technique not only improves the aesthetic aspect but also avoids future attachment loss and thus makes the patient more stable for further orthodontic treatment. The aim behind the treatment of gingival recession is not only to cover the exposed root surface, but also to improve aesthetics and reduce dentinal hypersensitivity. Different soft tissue-grafting procedures have been proposed for the treatment of gingival recession, of which free gingival graft is the most reliable one. The purpose of this case report is to illustrate the importance of root coverage prior to orthodontic treatment and to describe the planning for successful treatment which will improve the overall periodontal status of the patient.

  7. Vulvar procedures: biopsy, bartholin abscess treatment, and condyloma treatment.

    Science.gov (United States)

    Mayeaux, Edward J; Cooper, Danielle

    2013-12-01

    Several benign, premalignant, and malignant lesions may arise on the vulva, and multiple types of procedures may be used to diagnose and treat these conditions. Punch and shave biopsies may be used to diagnose most vulvar conditions, but lesions suspected of being melanomas may best be diagnosed with narrow-margin excisional biopsies. Bartholin gland cysts and abscesses may be treated with several different treatment modalities, the most common of which are fistulization and marsupialization. Genital warts may be treated with several medical and surgical modalities to relieve symptoms.

  8. A biological treatment technique for wool textile

    Directory of Open Access Journals (Sweden)

    Yu Xiao-Wei

    2005-09-01

    Full Text Available A biological treatment technique for wool textile was carried out by enzymes degradation coupled with H2O2 oxidation. The results demonstrated that the technique had ideal effects on wool textile such as better softness, plump and less loss of bursting stress. Because of mild reaction conditions, less textile damage and less environmental pollution, this technique for wool textile treatment could have promising prospect.

  9. Literature Review of Cosmetic Procedures in Men: Approaches and Techniques are Gender Specific.

    Science.gov (United States)

    Cohen, Brandon E; Bashey, Sameer; Wysong, Ashley

    2017-02-01

    The proportion of men receiving non-surgical cosmetic procedures has risen substantially in recent years. Various physiologic, anatomic, and motivational considerations differentiate the treatments for male and female patients. Nevertheless, research regarding approaches to the male cosmetic patient is scarce. We sought to provide an overview and sex-specific discussion of the most popular cosmetic dermatologic procedures pursued by men by conducting a comprehensive literature review pertaining to non-surgical cosmetic procedures in male patients. The most common and rapidly expanding non-surgical interventions in men include botulinum toxin, filler injection, chemical peels, microdermabrasion, laser resurfacing, laser hair removal, hair transplantation, and minimally invasive techniques for adipose tissue reduction. Important sex-specific factors associated with each of these procedures should be considered to best serve the male cosmetic patient.

  10. Extraction treatment using Invisalign Technique.

    Science.gov (United States)

    Giancotti, Aldo; Greco, Mario; Mampieri, Gianluca

    2006-01-01

    The Invisalign method is gaining an increasing interest as an alternative treatment option in adult patients and in difficult orthodontic cases. The aim of this work is to show a class II malocclusion with severe crowding in the upper and lower arches treated with the extraction of the upper first premolars performed by means of Invisalign. The alignment phase was successfully completed but the space closure achieved with crown tipping and without correct root inclination making a further fixed appliance phase necessary.

  11. A new technique in the surgical treatment of Hangman's fractures: Neurospinal Academy (NSA) technique

    OpenAIRE

    Sedat Dalbayrak; Onur Yaman; Mesut Yilmaz

    2013-01-01

    Context: Treatment of Hangman′s fractures is still controversial. Hangman′s fractures Type II and IIA are usually treated with surgical procedures. Aim: This study aims at describing the Neurospinal Academy (NSA) technique as an attempt to achieve an approximation of the fracture line to the axis body, which may be used for Type II and IIA patients with severe displacement and angulation. Settings and Design: NSA technique both pars or pedicle screws are placed bicortically to ensure that ant...

  12. [Intraluminal/endoscopic procedures in the treatment of obesity].

    Science.gov (United States)

    Martínez-Ortega, Antonio Jesús; Aliaga-Verdugo, Alberto; Pereira-Cunill, José Luis; Jiménez-Varo, Ignacio; Romero-Lluch, Ana R; Sobrino-Rodríguez, Salvador; Belda-Laguna, Ovidio; García-Luna, Pedro Pablo

    2014-05-01

    Few effective therapeutic tools are currently available to fight the increasing prevalence of obesity and its associated comorbidities. Bariatric surgery is the only treatment with proven long-term effectiveness, but is associated to a high surgical risk and significant economic costs because of its technical complexity and the characteristics of patients. This is leading to development of new endoscopic procedures with less clinical risks and economic costs, while maintaining the benefits in terms of morbidity and mortality, which could even serve as a bridging element before surgery in cases where this is unavoidable, allowing for preoperative weight loss and control of comorbidities in order to improve anesthetic risks and possible complications. The purpose of this review was to analyze the most relevant and promising endoscopic techniques currently available. Copyright © 2013 SEEN. Published by Elsevier Espana. All rights reserved.

  13. Modified pediatric Bentall procedure: A novel technique in a rare case

    Directory of Open Access Journals (Sweden)

    Gananjay G Salve

    2016-01-01

    Full Text Available Aneurysms of ascending aorta are rarely seen in pediatric age group. Only few cases with Marfans syndrome have been reported in the literature. Preferred treatment for these children has been the standard Bentall procedure (aortic root replacement with composite graft prosthesis. We report a 4-year-old male child with huge aneurysm of ascending aorta and aortic root dilation with severe aortic regurgitation, having phenotypic features of Loeys-Dietz syndrome type I. He underwent Bentall procedure with a novel modification (medial trap-door technique for coronary reimplantation. Short-term result of this procedure is encouraging and he is asymptomatic for the last 14 months of follow-up.

  14. Children Procedures and Treatment (Fertility Issues)

    Medline Plus

    Full Text Available ... approach the subject of fertility preservation with their cancer-stricken child? How is the Oncofertility Consortium addressing the fertility preservation needs of children? How do cancer and cancer treatment affect a child's fertility? Why ...

  15. Children Procedures and Treatment (Fertility Issues)

    Medline Plus

    Full Text Available ... approach the subject of fertility preservation with their cancer-stricken child? How is the Oncofertility Consortium addressing the fertility preservation needs of children? How do cancer and cancer treatment affect a child's fertility? Why ...

  16. Children Procedures and Treatment (Fertility Issues)

    Medline Plus

    Full Text Available ... and Treatment Is ovarian tissue cryopreservation available to girls under 18? How can a parent approach the ... parents, patients, and their families? What can a girl's cancer doctor do to protect her fertility? What ...

  17. Children Procedures and Treatment (Fertility Issues)

    Medline Plus

    Full Text Available ... cryopreservation differ for children and adults? Why is it important to discuss fertility preservation with a child? ... fractionation? What is the difference between leukemia and its treatments in children v. adults? What are the ...

  18. Children Procedures and Treatment (Fertility Issues)

    Medline Plus

    Full Text Available ... does ovarian tissue cryopreservation differ for children and adults? Why is it important to discuss fertility preservation ... between leukemia and its treatments in children v. adults? What are the general rules surrounding parental consent? ...

  19. Open palm technique in Dupuytren's disease treatment

    Directory of Open Access Journals (Sweden)

    Marcio Carpi Malta

    2013-06-01

    Full Text Available OBJECTIVE: To evaluate the results of the open palm technique for the treatment of Dupuytren's disease. METHOD: The authors used the technique described by McCash. Twelve patients (13 hands were surgically treated, between october 2002 and september 2011. RESULTS: The wounds healed in a medium of 25 days (variation of 17 to 30 days. There were no complications, such as infection, haematoma formation, skin necrosis, residual edema. CONCLUSION: The open palm technique remains a safe alternative for the treatment of Dupuytren's disease, with satisfactory results and low risk of complications.

  20. Children Procedures and Treatment (Fertility Issues)

    Medline Plus

    Full Text Available ... preservation needs of children? How do cancer and cancer treatment affect a child's fertility? Why should fertility preservation be a priority for my child? How does ovarian tissue cryopreservation differ for children ... What can a girl's cancer doctor do to protect her fertility? What can ...

  1. Children Procedures and Treatment (Fertility Issues)

    Science.gov (United States)

    ... approach the subject of fertility preservation with their cancer-stricken child? How is the Oncofertility Consortium addressing the fertility preservation needs of children? How do cancer and cancer treatment affect a child's fertility? Why should fertility preservation be a priority ...

  2. Update on procedure-related risks for prenatal diagnosis techniques

    DEFF Research Database (Denmark)

    Tabor, Ann; Alfirevic, Zarko

    2010-01-01

    Introduction: As a consequence of the introduction of effective screening methods, the number of invasive prenatal diagnostic procedures is steadily declining. The aim of this review is to summarize the risks related to these procedures. Material and Methods: Review of the literature. Results: Data...... from randomised controlled trials as well as from systematic reviews and a large national registry study are consistent with a procedure-related miscarriage rate of 0.5-1.0% for amniocentesis as well as for chorionic villus sampling (CVS). In single-center studies performance may be remarkably good due...... not be performed before 15 + 0 weeks' gestation. CVS on the other hand should not be performed before 10 weeks' gestation due to a possible increase in risk of limb reduction defects. Discussion: Experienced operators have a higher success rate and a lower complication rate. The decreasing number of prenatal...

  3. European wind turbine procedure development blade test methods and techniques

    Energy Technology Data Exchange (ETDEWEB)

    Bulder, B.H.; Dam, J.J.D. van; Delft, D.R.V. van [and others

    1999-03-01

    In this paper the preliminary results obtained by performing the second task of the `European Wind Turbine Testing Procedure Development` project are presented. This project is performed within and with financial support of the Standards, Measurements and Testing programme of the European Commission. (au)

  4. Monoplane 3D Overlay Roadmap versus Conventional Biplane 2D Roadmap Technique for Neurointervenional Procedures

    Science.gov (United States)

    Jang, Dong-Kyu; Stidd, David A.; Schafer, Sebastian; Chen, Michael; Moftakhar, Roham

    2016-01-01

    Purpose We investigated whether a 3D overlay roadmap using monoplane fluoroscopy offers advantages over a conventional 2D roadmap using biplane fluoroscopy during endovascular aneurysm treatment. Materials and Methods A retrospective chart review was conducted for 131 consecutive cerebral aneurysm embolizations by three neurointerventionalists at a single institution. Allowing for a transition period, the periods from January 2012 to August 2012 (Time Period 1) and February 2013 to July 2013 (Time Period 2) were analyzed for radiation exposure, contrast administration, fluoroscopy time, procedure time, angiographic results, and perioperative complications. Two neurointerventionalists (Group 1) used a conventional 2D roadmap for both Time Periods, and one neurointerventionalist (Group 2) transitioned from a 2D roadmap during Time Period 1 to a 3D overlay roadmap during Time Period 2. Results During Time Period 2, Group 2 demonstrated reduced fluoroscopy time (p<0.001), procedure time (P=0.023), total radiation dose (p=0.001), and fluoroscopy dose (P=0.017) relative to Group 1. During Time Period 2, there was no difference of immediate angiographic results and procedure complications between the two groups. Through the transition from Time Period 1 to Time Period 2, Group 2 demonstrated decreased fluoroscopy time (p< 0.001), procedure time (p=0.022), and procedure complication rate (p=0.041) in Time Period 2 relative to Time Period 1. Conclusion The monoplane 3D overlay roadmap technique reduced fluoroscopy dose and fluoroscopy time during neurointervention of cerebral aneurysms with similar angiographic occlusions and complications rate relative to biplane 2D roadmap, which implies possible compensation of limitations of monoplane fluoroscopy by 3D overlay technique. PMID:27621947

  5. Arts and technology - Mosaic new techniques and procedures

    Science.gov (United States)

    Papiu, G. A.; Suciu, N.

    2017-05-01

    The relationship between art and technique has been along the time one that is inseparable and systematic, artists appealing to various technologies, tools and practices that help them stimulate their imagination. Today there is a new category of artists, coming from a technical or scientific field, that are being 'trapped’ in this ‘game of art”. The mosaic, even if it is an old technique, responded to the social requirements and it evolved over time, being constantly related to aesthetic and artistic thinking, discoveries of science, assimilating permanent new techniques and technologies, diversifying its artistic forms of expression and methods of transposition. Not being bound any more to a religious institution, which was its birth place, today, she migrated to all public spaces. Works of art in public space have become today an active factor in reshaping the urban aesthetic landscape.

  6. Single port robotic hysterectomy technique improving on multiport procedure

    Directory of Open Access Journals (Sweden)

    John R Lue

    2012-01-01

    Full Text Available The benefits of laparoscopic surgery over conventional abdominal surgery have been well documented. Reducing postoperative pain, decreasing postoperative morbidity, hospital stay duration, and postoperative recovery time have all been demonstrated in recent peer-review literature. Robotic laparoscopy provides the added dimension of increased fine mobility and surgical control. With new single port surgical techniques, we have the added benefit of minimally invasive surgery and greater patient aesthetic satisfaction, as well as all the other benefits laparoscopic surgery offers. In this paper, we report a successful single port robotic hysterectomy and the simple process by which this technique is performed.

  7. Update on procedure-related risks for prenatal diagnosis techniques

    DEFF Research Database (Denmark)

    Tabor, Ann; Alfirevic, Zarko

    2010-01-01

    from randomised controlled trials as well as from systematic reviews and a large national registry study are consistent with a procedure-related miscarriage rate of 0.5-1.0% for amniocentesis as well as for chorionic villus sampling (CVS). In single-center studies performance may be remarkably good due...... to very skilled operators, but these figures cannot be used for general counselling. Amniocentesis performed prior to 15 weeks had a significantly higher miscarriage rate than CVS and mid-trimester amniocentesis, and also increased the risk of talipes equinovarus. Amniocentesis should therefore...

  8. Persistent type I endoleak after endovascular treatment with Chimney technique

    Directory of Open Access Journals (Sweden)

    Ana Isabel Azevedo

    2016-09-01

    Full Text Available Thoracic endovascular aortic repair (TEVAR is increasingly used in the treatment of acute type B aortic dissection. Type Ia endoleaks are a common complication of the procedure, but its clinical significance as well as the best treatment strategy remain poorly defined. We present a case of a type Ia endoleak following TEVAR in the treatment of acute type B aortic dissection. Chimney technique approach was used in an attempt to seal the endoleak. Although technical success was suboptimal, the patient remained clinically stable and event free. Data regarding the natural course and management of type Ia endoleaks following TEVAR for aortic dissection are sparse. Future research is required to establish the clinical and technical determinants of the need to treat these endoleaks as well as the best treatment strategy.

  9. Multimodality Image Fusion-Guided Procedures: Technique, Accuracy, and Applications

    Energy Technology Data Exchange (ETDEWEB)

    Abi-Jaoudeh, Nadine, E-mail: naj@mail.nih.gov [National Institutes of Health, Radiology and Imaging Sciences (United States); Kruecker, Jochen, E-mail: jochen.kruecker@philips.com [Philips Research North America (United States); Kadoury, Samuel, E-mail: samuel.kadoury@polymtl.ca [Ecole Polytechnique de Montreal, Department of Computer and Software Engineering, Institute of Biomedical Engineering (Canada); Kobeiter, Hicham, E-mail: hicham.kobeiter@gmail.com [CHU Henri Mondor, UPEC, Departments of Radiology and d' imagrie medicale (France); Venkatesan, Aradhana M., E-mail: VenkatesanA@cc.nih.gov; Levy, Elliot, E-mail: levyeb@cc.nih.gov; Wood, Bradford J., E-mail: bwood@cc.nih.gov [National Institutes of Health, Radiology and Imaging Sciences (United States)

    2012-10-15

    Personalized therapies play an increasingly critical role in cancer care: Image guidance with multimodality image fusion facilitates the targeting of specific tissue for tissue characterization and plays a role in drug discovery and optimization of tailored therapies. Positron-emission tomography (PET), magnetic resonance imaging (MRI), and contrast-enhanced computed tomography (CT) may offer additional information not otherwise available to the operator during minimally invasive image-guided procedures, such as biopsy and ablation. With use of multimodality image fusion for image-guided interventions, navigation with advanced modalities does not require the physical presence of the PET, MRI, or CT imaging system. Several commercially available methods of image-fusion and device navigation are reviewed along with an explanation of common tracking hardware and software. An overview of current clinical applications for multimodality navigation is provided.

  10. Desert Operations Tactics, Techniques, and Procedures. Southwest Asia Focus

    Science.gov (United States)

    1990-11-01

    identify and/or kill the snake. Take it to medical personnel for inspection / identification. TREAT ALL SNAKEBITES AS POISONOUS . The treatment prescribed...Reconnaissance .......................................................................... 5-1 BATTLEFIELD AREA OF EVALUATION ...weather, and may be seen coiled in shady spots during the day. DON’T PLAY WITH SNAKES! PIT POISON SAC FANGS EYE EYE Viper Cobra 1-3 ChapterI - The Area

  11. Diagnostic and treatment procedures induced by cervical cancer screening

    NARCIS (Netherlands)

    M. van Ballegooijen (Marjolein); M.A. Koopmanschap (Marc); G.J. van Oortmarssen (Gerrit); J.D.F. Habbema (Dik); N. van der Lubbe (Nils); H.M.A. van Agt (H. M A)

    1990-01-01

    markdownabstractAbstract The amount of diagnostic and treatment procedures induced by cervical cancer screening has been assessed prospectively and related to mortality reduction. Assumptions are based on data from Dutch screening programmes and on a scenario for future developments. With 5 invita

  12. Quality assurance of a conformal treatment technique

    Energy Technology Data Exchange (ETDEWEB)

    Kroes, A.P.G.; Bruinvis, I.A.D.; Lanson, J.H.; Uiterwaal, G.J. [Nederlands Kanker Inst. `Antoni van Leeuwenhoekhuis`, Amsterdam (Netherlands)

    1995-12-01

    For a parotid gland irradiation technique with a pair of oblique wedged photon beams the target coverage near the surface was investigated. The planning target volume extends to 5 millimetres under the skin; a minimum target dose of 95% is required when the dose at the centre is set to 100%. The treatment technique was simulated on a water phantom with a beam of 45 degree gantry angle, 55 degree wedge, 8 x 10 cm{sup 2} field size and the isocentre at 2 cm depth. Beam energies of 4, 6 and 8 MV were used. The dose distributions were measured in two orthogonal planes through the isocentre perpendicular to the water surface with p-type silicon diodes along lines through the isocentre every 45 degrees. Dose distributions were calculated in these planes with our 3-D planning system (U-Mplan, University of Michigan planning system), with model parameters are fitted to depth dose curves and profiles of open and wedged normally incident beams. The location of the 95% isodose was determined in five points near the surface. For 4, 6 and 8 MV the depths of the 95% isodose were 6.0, 10.3 and 11.0 mm, respectively. The depths of the 95% points of single normally incident open fields were 6.0, 9.0 and 11.5 mm, respectively. The treatment planning system (TPS) calculated the 95% isodose for the parotid technique at 5.5, 7.3 and 11.5 mm depths, for 4, 6 and 8 MV, respectively. Thus for 6 MV the 95% was 3 mm deeper than calculated by the TPS; 2 mm were caused by the inaccuracy of the open field depth dose curve fit in the build-up region. The depth near the surface of the 95% isodose for this treatment technique can be estimated from single open field depth dose curves with acceptable accuracy. This result is not obvious because the effects of the wedge and oblique incidence on the dose distribution are also involved. The TPS performed well for the 4 and 8 MV beams, but for treatments with 6 MV target under dosage could have remained undetected. (Abstract Truncated)

  13. Percutaneous Procedures for the Treatment of Trigeminal Neuralgia.

    Science.gov (United States)

    Bender, Matthew T; Bettegowda, Chetan

    2016-07-01

    Three major percutaneous procedures are currently used to treat trigeminal neuralgia (TN). Percutaneous balloon compression, glycerol rhizotomy, and radiofrequency thermocoagulation interrupt afferent pain fibers by injury to the trigeminal nerve root or ganglion. Each is capable of offering immediate and durable pain relief. Each is associated with relatively low, but variable rates of complications. Patient heterogeneity, technical variation, and nonstandard outcomes plague the existing outcomes literature and limit comparisons of treatments. Rendering treatment selection a function of individual physician preference and practice patterns. Randomized, prospective trials are needed; in the meantime, percutaneous rhizotomy remains an excellent treatment for selected patients.

  14. Tension-free procedures in the treatment of groin hernias

    OpenAIRE

    2003-01-01

    Hernia repair is one of the most common surgical procedures performed in the United States, with 700,000 operations performed each year. Improvements in surgical technique, together with the development of new prosthetic materials and a better understanding of how to use them, have significantly improved outcomes for many patients. These improvements have occurred most notably in centers specializing in hernia surgery, with some institutions reporting failure rates of less than 1%. In contras...

  15. Reinforcement procedure in the treatment of reluctant speech.

    Science.gov (United States)

    Morin, C; Ladouceur, R; Cloutier, R

    1982-06-01

    The efficacy of a positive reinforcement contingency procedure was evaluated in the treatment of a 6-year old boy with reluctant speech. The intervention was conducted in the kindergarten classroom and the teacher served as therapist. Using an ABABB' single case experimental design, positive reinforcement was found to be effective for increasing the child's verbal responsiveness. At a 1-year follow-up, therapeutic benefits were maintained at an optimal level. The present results bring support to the use of reinforcement procedures in the case of reluctant speech.

  16. Tension-free procedures in the treatment of groin hernias

    Directory of Open Access Journals (Sweden)

    Milić Dragan J.

    2003-01-01

    patch repair the PerFix plug and patch repair, the Prolene Hernia System bilayer patch repair and Trabucco’s sutureless preshaped hernioraphy. General surgeons today have access to a wider and more sophisticated range of synthetic biomaterials for use in hernia repair than ever before. The advantages and disadvantages of each of these devices must be understood however, before surgeons select any of these implants. Meanwhile, a 1997 study of various biomaterials used in abdominal wall hernia repair further reported that the risk of infection, seroma formation biomaterial-related intestinal obstructions, and other complications can be minimized or eliminated by understanding the process underlying these problems and taking proper precautions. The surgeon's choice of the prosthesis used in hernia repair is based on a combination of factors, including patient characteristics; clinical experience, training, interest, and skill; understanding of the range of products available and the clinical studies that may have been performed on each; and the surgeon's familiarity with a particular product and/or surgical approach. Innovations in technique and product design will no doubt continue to spur advances in hernia repair, and it is hoped that they will continue to improve outcomes. The availability of these outcomes data, along with the ongoing accumulation of clinical experience with a broad range of materials and techniques, will help surgeons to better identify the most appropriate prosthesis for the clinician and the patient. It appears that herniology will remain in the realm of the surgeon, since it is doubtful that any medical measures will replace the operative treatment for abdominal wall hernias. Although operative procedures are not yet ideal important advances have been made in herniorrhaphy resulting in improved outcomes: The use of local techniques has maximized the safety of anesthesia time needed for care has been minimized, with most procedures now being done

  17. Alveolar antral artery isolation during sinus lift procedure with the double window technique

    National Research Council Canada - National Science Library

    Maridati, Paolo; Stoffella, Enrico; Speroni, Stefano; Cicciu, Marco; Maiorana, Carlo

    2014-01-01

    The sinus lift technique, introduced in 1976 by Tatum and subsequently described by Boyne in 1980, is nowadays considered a safe and reliable procedure for the rehabilitation of the atrophic upper posterior maxilla...

  18. "Non-filling" procedures for lip augmentation: a systematic review of contemporary techniques and their outcomes.

    Science.gov (United States)

    Moragas, Joan San Miguel; Vercruysse, Herman Junior; Mommaerts, Maurice Y

    2014-09-01

    Ideal lip augmentation techniques have good longevity, low complication rates, and optimal functional and aesthetic results. No systematic review is currently available regarding the efficacy of lip augmentation techniques. This review will focus only on non-filling procedures for lip augmentation (NFPLAs). Current databases Elsevier Science Direct, PubMed, HighWire Press, Springer Standard Collection, SAGE, DOAJ, Sweetswise, Free E-Journals, Ovid Lippincott Williams & Wilkins, Willey Online Library Journals and Cochrane Plus were scrutinized and relevant article reference sections were studied for additional publications. The search heading sequence used was ("Lip" or "Mouth" or "Perioral" or "Nasolabial") and ("Augmentation" or "Enhancement" or "Surgery" or "Lift" or "V-Y" or "Corner"). Exclusion criteria applied to 6436 initial keyword-search retrievals yielded 12 articles. Eight more articles were retrieved from reference sections, for a total of 18 papers assessed. Only one article made a direct comparison of efficacy between two surgical techniques for lip augmentation, and none directly compared complications associated with different NFPLAs. Although this systematic review revealed a lack of quality data in comparing the efficacy and complications among different NFPLAs, it is important to review and pool the existing studies to better suggest proper treatment to patients. Copyright © 2014 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  19. Minimally Invasive Procedures - Direct and Video-Assisted Forms in the Treatment of Heart Diseases

    Energy Technology Data Exchange (ETDEWEB)

    Castro, Josué Viana Neto, E-mail: jvcn@uol.com.br [Instituto do Coração do Nordeste (INCONE), Fortaleza, CE (Brazil); Universidade de Fortaleza (UNIFOR), Fortaleza, CE (Brazil); Melo, Emanuel Carvalho; Silva, Juliana Fernandes [Instituto do Coração do Nordeste (INCONE), Fortaleza, CE (Brazil); Rebouças, Leonardo Lemos; Corrêa, Larissa Chagas; Germano, Amanda de Queiroz [Universidade de Fortaleza (UNIFOR), Fortaleza, CE (Brazil); Machado, João José Aquino [Instituto do Coração do Nordeste (INCONE), Fortaleza, CE (Brazil)

    2014-03-15

    Minimally invasive cardiovascular procedures have been progressively used in heart surgery. To describe the techniques and immediate results of minimally invasive procedures in 5 years. Prospective and descriptive study in which 102 patients were submitted to minimally invasive procedures in direct and video-assisted forms. Clinical and surgical variables were evaluated as well as the in hospital follow-up of the patients. Fourteen patients were operated through the direct form and 88 through the video-assisted form. Between minimally invasive procedures in direct form, 13 had aortic valve disease. Between minimally invasive procedures in video-assisted forms, 43 had mitral valve disease, 41 atrial septal defect and four tumors. In relation to mitral valve disease, we replaced 26 and reconstructed 17 valves. Aortic clamp, extracorporeal and procedure times were, respectively, 91,6 ± 21,8, 112,7 ± 27,9 e 247,1 ± 20,3 minutes in minimally invasive procedures in direct form. Between minimally invasive procedures in video-assisted forms, 71,6 ± 29, 99,7 ± 32,6 e 226,1 ± 42,7 minutes. Considering intensive care and hospitalization times, these were 41,1 ± 14,7 hours and 4,6 ± 2 days in minimally invasive procedures in direct and 36,8 ± 16,3 hours and 4,3 ± 1,9 days in minimally invasive procedures in video-assisted forms procedures. Minimally invasive procedures were used in two forms - direct and video-assisted - with safety in the surgical treatment of video-assisted, atrial septal defect and tumors of the heart. These procedures seem to result in longer surgical variables. However, hospital recuperation was faster, independent of the access or pathology.

  20. A new technique in the surgical treatment of Hangman′s fractures: Neurospinal Academy (NSA technique

    Directory of Open Access Journals (Sweden)

    Sedat Dalbayrak

    2013-01-01

    Full Text Available Context: Treatment of Hangman′s fractures is still controversial. Hangman′s fractures Type II and IIA are usually treated with surgical procedures. Aim: This study aims at describing the Neurospinal Academy (NSA technique as an attempt to achieve an approximation of the fracture line to the axis body, which may be used for Type II and IIA patients with severe displacement and angulation. Settings and Design: NSA technique both pars or pedicle screws are placed bicortically to ensure that anterior surface of C2 vertebral body will be crossed 1-2 mm. A rod is prepared in suitable length and curve to connect the two screws. For placing the rod, sufficient amount of bone is resected from the C2 spinous process. C2 vertebral body is pulled back by means of the screws that crossed the anterior surface of C2 vertebral body. Materials and Methods: Hangman II and IIA patient are treated with NSA technique. Result: Angulated and tilted C2 vertebral body was pulled back and approximated to posterior elements. Conclusions: In Hangman′s fractures Type II and IIA with severe vertebral body and pedicle displacement, NSA technique is an effective and reliable treatment alternative for the approximation of posterior elements to the C2 vertebral body, which is tilted, angulated, and dislocated.

  1. Comparison of the pain perception in children using comfort control syringe and a conventional injection technique during pediatric dental procedures

    Directory of Open Access Journals (Sweden)

    M Langthasa

    2012-01-01

    Full Text Available Objective: To evaluate and compare the pain perception by the pediatric patients, while experiencing computerized injection device comfort control syringe (CCS and the conventional injection technique during dental clinical procedures. Materials and Methods: Fifty children (31 boys and 19 girls aged 6-14 years requiring local anaesthesia on both sides of the dental arch for various treatment procedures were selected for this study. The patients served as their own control, and on the appointed day CCS was used on one side of the dental arch and on the subsequent appointment, i.e., the very next day conventional injection technique was used. Visual analogue scale (VAS and faces pain rating scale (FRS were used to assess the child′s pain perception to each of the techniques immediately after the injection. Various physiological parameters were measured before, during and after the two injection procedures and compared for statistical variation. Results : Paired t-test revealed a statistically significant difference in the pain perception by children using VAS and FRS between computerized and conventional technique. No statistically significant difference was observed when physiological parameters (heart rate, blood pressure and temperature were compared at various intervals between the computerized and the conventional technique. Conclusion: Computerized injection device (CCS provides less painful injections when compared to the conventional injection technique.

  2. Techniques of endoscopic airway tumor treatment.

    Science.gov (United States)

    Guibert, Nicolas; Mhanna, Laurent; Droneau, Sylvain; Plat, Gavin; Didier, Alain; Mazieres, Julien; Hermant, Christophe

    2016-11-01

    Interventional bronchoscopy has a predominant role in the management of both early and advanced-stage airway tumors. Given the very poor prognosis of lung cancer, there is a need for new tools to improve early detection and bronchoscopic treatment of endo-bronchial precancerous lesions. In more advanced stages, interventional bronchoscopy plays an important role, as nearly a third of lung cancers lead to proximal airway obstruction. This will cause great discomfort or even life-threatening symptoms related to local extension, such as dyspnea, post-obstructive pneumonia, and hemoptysis. Surgery for very locally advanced disease is only effective for a limited number of patients and the effects of conventional antitumor therapies, like radiation therapy or chemotherapy, are inconstant and are too delayed in a palliative context. In this review, we aim to provide pulmonologists with an exhaustive technical overview of (I) the bronchoscopic management of benign endobronchial lesions; (II) the bronchoscopic management of malignant tumors, including the curative treatment of localized lesions and palliative management of malignant proximal airway stenosis; and (III) descriptions of the emerging endoscopic techniques used to treat peripheral lung tumors.

  3. Increasing spelling achievement: an analysis of treatment procedures utilizing an alternating treatments design.

    OpenAIRE

    Ollendick, T. H.; Matson, J L; Esveldt-Dawson, K; Shapiro, E S

    1980-01-01

    Two studies which examine the effectiveness of spelling remediation procedures are reported. In both studies, an alternating treatment design was employed. In the first study, positive practice overcorrection plus positive reinforcement was compared to positive practice alone and a no-remediation control condition. In the second study, positive practice plus positive reinforcement was compared to a traditional corrective procedure plus positive reinforcement and a traditional procedure when u...

  4. INVO Procedure: Minimally Invasive IVF as an Alternative Treatment Option for Infertile Couples

    Directory of Open Access Journals (Sweden)

    Elkin Lucena

    2012-01-01

    Full Text Available Intravaginal culture (IVC, also called INVO (intravaginal culture of oocytes, is an assisted reproduction procedure where oocyte fertilization and early embryo development are carried out within a gas permeable air-free plastic device, placed into the maternal vaginal cavity for incubation. In the present study we assessed the outcome of the INVO procedure, using the recently designed INVOcell device, in combination with a mild ovarian stimulation protocol. A total of 125 cycles were performed. On average 6.5 oocytes per cycle were retrieved, and a mean of 4.2 were placed per INVOcell device. The cleavage rate obtained after the INVO culture was 63%. The procedure yielded 40%, 31.2%, and 24% of clinical pregnancy, live birth, and single live birth rates per cycle, respectively. Our results suggest that the INVO procedure is an effective alternative treatment option in assisted reproduction that shows comparable results to those reported for existing IVF techniques.

  5. Surgical Treatment of Canine Glaucoma: Filtering and End-Stage Glaucoma Procedures.

    Science.gov (United States)

    Maggio, Federica; Bras, Dineli

    2015-11-01

    Canine glaucoma is a common cause of vision loss associated with raised intraocular pressure, and leads to damage of the retina and optic nerve head. In most cases, medical treatment alone cannot provide long-term management of intraocular pressure control and preservation of vision. Surgical intervention is usually recommended to either decrease aqueous humor production, or increase its outflow. Among the current available procedures, filtering techniques are aimed at increasing aqueous humor outflow. Proper surgical timing and a combination of cyclodestructive and filtering procedures have been recently suggested to improve the long-term success of surgical treatment in dogs. Bleb fibrosis and surgical failure are still common occurrences in filtration surgery with relapse of glaucoma and vision loss. End stage procedures, such as enucleation, evisceration with intrascleral prosthesis, and chemical ablation of the ciliary bodies are then recommended to address chronic discomfort in buphthalmic and blind eyes.

  6. Monoplane 3D Overlay Roadmap versus Conventional Biplane 2D Roadmap Technique for Neurointervenional Procedures.

    Science.gov (United States)

    Jang, Dong-Kyu; Stidd, David A; Schafer, Sebastian; Chen, Michael; Moftakhar, Roham; Lopes, Demetrius K

    2016-09-01

    We investigated whether a 3D overlay roadmap using monoplane fluoroscopy offers advantages over a conventional 2D roadmap using biplane fluoroscopy during endovascular aneurysm treatment. A retrospective chart review was conducted for 131 consecutive cerebral aneurysm embolizations by three neurointerventionalists at a single institution. Allowing for a transition period, the periods from January 2012 to August 2012 (Time Period 1) and February 2013 to July 2013 (Time Period 2) were analyzed for radiation exposure, contrast administration, fluoroscopy time, procedure time, angiographic results, and perioperative complications. Two neurointerventionalists (Group 1) used a conventional 2D roadmap for both Time Periods, and one neurointerventionalist (Group 2) transitioned from a 2D roadmap during Time Period 1 to a 3D overlay roadmap during Time Period 2. During Time Period 2, Group 2 demonstrated reduced fluoroscopy time (poverlay roadmap technique reduced fluoroscopy dose and fluoroscopy time during neurointervention of cerebral aneurysms with similar angiographic occlusions and complications rate relative to biplane 2D roadmap, which implies possible compensation of limitations of monoplane fluoroscopy by 3D overlay technique.

  7. Evaluation of patient perceptions after labial frenectomy procedure: A comparison of diode laser and scalpel techniques

    Directory of Open Access Journals (Sweden)

    Kalakonda Butchibabu

    2014-01-01

    Full Text Available Background: Frenectomy is the complete excision of the frenum along with its attachment to the underlying bone. It can be done by conventional technique, electrosurgery or soft tissue lasers. Aim: To evaluate the effects of diode laser and scalpel technique on degree of post-operative pain and discomfort experienced by patients on the 1 st , 3 rd and the 7 th post-operative days after frenectomy. Materials and Methods: Ten patients who required frenectomy were randomly assigned to undergo treatment with diode laser or scalpel. The data were analyzed with paired t-test and intragroup comparison was determined by ANOVA. Results: Intergroup comparison of the mean VAS scores for discomfort and pain for both the groups showed significant difference. The VAS scores of pain and discomfort within scalpel group between 1 st and 3 rd day did not show any significant difference, however between 7 th day versus 3 rd and 1 st day difference was highly significant. The VAS scores of pain and discomfort within laser group between all the days showed significant difference. Conclusion: Taking into consideration the clinical outcome, the diode laser is a dependable alternative as it is an efficient and satisfactory option for procedures like frenectomy.

  8. Milk as Desensitizing Agent for Treatment of Dentine Hypersensitivity Following Periodontal Treatment Procedures

    Science.gov (United States)

    Sabir, Mohammad

    2015-01-01

    Background Dentinal hypersensitivity is a commonly observed problem after periodontal treatment procedures in periodontal patients. This further complicates preventive oral hygiene procedures by patients which jeopardize periodontal treatment, or even may aid in periodontal treatment failure. Aims and Objectives The aims and objectives of present study were to assess the problem of dentine hypersensitivity after non-surgical periodontal treatment and selection of cases for evaluation of commercially available milk at room temperature as mouth rinse for the treatment of dentinal hypersensitivity caused by periodontal treatment. Materials and Methods Patients were selected randomly for nonsurgical periodontal treatment and then were assessed for dentine hypersensitivity. Those having dentine hypersensitivity were assigned in two groups. Group one patients were advised to rinse with commercially available milk at room temperature, group two patients were advised to rinse with luke warm water as control. A four point Verbal Rating Score (VRS) was designed to record the numerical value of dentine hypersensitivity. Results The results show incidence of 42.5% and prevalence of 77.5% for dentine hypersensitivity after periodontal treatment procedures. After rinsing with milk following periodontal treatment procedures, there was found a significant reduction of dentine hypersensitivity with probability by unpaired t-test as 0.0007 and 0.0001 at tenth and fifteenth day post periodontal treatment procedures respectively. Conclusion This study demonstrated that the milk rinse is a suitable, cheaper, fast acting, home-use and easily available solution to the problem of dentine hypersensitivity after non-surgical periodontal treatment. Milk can be used as desensitizing agent and rinsing with milk for few days is effective in quick reduction of dentine hypersensitivity due to periodontal treatment procedures. PMID:26674005

  9. UV transmittance during the crosslinking procedure: tunable treatment

    Science.gov (United States)

    Lincoln, Victor A. C.; Mello, Marcio M.; Ventura, Liliane

    2014-02-01

    The transmittance of UVA light through the in vitro human cornea over the thickness of 400um during the corneal collagen cross-linking procedure has been measured using an optical fiber (600 μm core diameter) fixed just before the cornea and attached to Spectrophotometer. The 10 corneas, (average of 6 days post-mortem) were washed with saline and cross-linked with the currently used protocol. To enhance absorption of UV radiation, Riboflavin solution (0.1% and 400 mOsm) was applied prior to and during exposure. The UVA beam - 365nm +/- 5nm at 3mW/cm2 +/- 0.003mW/cm2 - was focused directly onto the corneal stroma. The measured average transmittance of the cornea without Riboflavin was 64.1%. Preceding the irradiation but after 6 applications of Riboflavin at 5min intervals (total of 30min) transmittance decreased to 21.1%. The 30min of irradiation were then accompanied by an additional 6 applications of Riboflavin at 5min intervals (for a total of treatment time of 1h), resulting in a further decrease in transmittance to 12.2%, which is in agreement with current literature. The average transmittance in terms of energy during the 30 minutes irradiation procedure fluctuated from 0.63 to 0.37 mW/cm2. These results indicate different levels of UV transmittance during treatment, leading to consider a new personalized treatment with tunable UV power irradiation.

  10. The Bristow-Latarjet procedure, a historical note on a technique in comeback.

    Science.gov (United States)

    van der Linde, J A; van Wijngaarden, R; Somford, M P; van Deurzen, D F P; van den Bekerom, M P J

    2016-02-01

    The Bristow-Latarjet procedure is a well-known surgical technique designed to treat shoulder instability. In this procedure, the coracoid process is transferred to the glenoid rim, to serve as augmentation of an associated bony defect. Because long-term results following a soft tissue procedure (Bankart repair) reveal that up to 21 and 33 % of the patients might experience recurrent instability and with the advent of the arthroscopic coracoid transfer, there is renewed interest in this procedure to treat shoulder instability. The aim of this study is to provide a historical overview, with emphasis on the original inventors Bristow and Latarjet, the complications and following modifications regarding the surgical approach, the coracoid transfer and the arthroscopic technique. Level of evidence V.

  11. Anesthesia for ex utero intrapartum treatment: renewed insight on a rare procedure.

    Science.gov (United States)

    Marques, Miguel Vieira; Carneiro, João; Adriano, Marta; Lança, Filipa

    2015-01-01

    The ex utero intrapartum treatment is a rare surgical procedure performed in cases of expected postpartum fetal airway obstruction. The technique lies on a safe establishment of a patent airway during labor in anticipation of a critical respiratory event, without interrupting maternal-fetal circulation. Anesthetic management is substantially different from that regarding standard cesarean delivery and its main goals include uterine relaxation, fetal anesthesia and preservation of placental blood flow. We present the case of an ex utero intrapartum treatment procedure performed on a fetus with a large cervical lymphangioma and prenatal evidence of airway compromise. Modifications to the classic ex utero intrapartum treatment management strategies were successfully adopted and will be discussed in the following report. Copyright © 2013 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.

  12. [Anesthesia for ex utero intrapartum treatment: renewed insight on a rare procedure].

    Science.gov (United States)

    Marques, Miguel Vieira; Carneiro, João; Adriano, Marta; Lança, Filipa

    2015-01-01

    The ex utero intrapartum treatment is a rare surgical procedure performed in cases of expected postpartum fetal airway obstruction. The technique lies on a safe establishment of a patent airway during labor in anticipation of a critical respiratory event, without interrupting maternal-fetal circulation. Anesthetic management is substantially different from that regarding standard cesarean delivery and its main goals include uterine relaxation, fetal anesthesia and preservation of placental blood flow. We present the case of an ex utero intrapartum treatment procedure performed on a fetus with a large cervical lymphangioma and prenatal evidence of airway compromise. Modifications to the classic ex utero intrapartum treatment management strategies were successfully adopted and will be discussed in the following report. Copyright © 2013 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

  13. Anesthesia for ex utero intrapartum treatment: renewed insight on a rare procedure

    Directory of Open Access Journals (Sweden)

    Miguel Vieira Marques

    2015-12-01

    Full Text Available The ex utero intrapartum treatment is a rare surgical procedure performed in cases of expected postpartum fetal airway obstruction. The technique lies on a safe establishment of a patent airway during labor in anticipation of a critical respiratory event, without interrupting maternal-fetal circulation. Anesthetic management is substantially different from that regarding standard cesarean delivery and its main goals include uterine relaxation, fetal anesthesia and preservation of placental blood flow. We present the case of an ex utero intrapartum treatment procedure performed on a fetus with a large cervical lymphangioma and prenatal evidence of airway compromise. Modifications to the classic ex utero intrapartum treatment management strategies were successfully adopted and will be discussed in the following report.

  14. [Modified arthroscopic Latarjet procedure for the treatment of anterior shoulder instability].

    Science.gov (United States)

    Wu, G; Jiang, C Y; Lu, Y; Zhu, Y M; Li, F L; Li, X

    2015-04-18

    To present the surgical technique and to evaluate the results of the modified arthroscopic Latarjet procedure. Arthroscopic Latarjet procedure has proven to be a reliable method of treatment for difficult anteroinferior instability of the shoulder joint. However, there is no anterior capsule reattachment and too much subscapularis damage for the classic procedure. From February 2013, we modified the classic procedure with reattachment of anterior joint capsule and muscle-tendon junction splitting of subscapularis. Coracoid graft position was evaluated using CT scanning. From March 2012 to August 2014, 51 modified Latarjet procedures were successfully performed arthroscopically for patients with anterior shoulder instability. According to the CT scanning at the final follow up, the graft was flush with the glenoid in 94.1%, and medially placed in 5.9%. Vertical positioning was perfect in 96.0% (2 to 5 o'clock), too high in 2.0%, and too low in 2.0%. There were no cases of recurrent dislocation or subluxation. The modified arthroscopic Latarjet procedure has shown satisfactory results with good graft positioning. It is a minimal invasive and accurate approach, which combines the advantages of the open procedure.

  15. Mathematical Optimization Techniques for Multi-Phase Radiation Treatment Design

    OpenAIRE

    Sonderman, David

    1983-01-01

    A mathematical model for optimal external beam radiotherapy treatment design over multiple treatment phases is presented. The solution procedure is discussed and illustrated on a case of boost treatment for lung cancer. The models are integrated with current radiobiological software to produce an optimal design over both phases of treatment displayed by means of computer graphics.

  16. Transvaginal Hybrid NOTES Procedure for Treatment of Gallstone Ileus

    Directory of Open Access Journals (Sweden)

    Takuya Shiraishi

    2016-01-01

    Full Text Available Gallstone ileus is a rare mechanical bowel obstruction, and previously reported cases have been treated laparoscopically with good results. Although transvaginal hybrid NOTES without a minilaparotomy has been reported to decrease the incidence of surgical wound complications, to our knowledge, this procedure has not been used previously to treat gallstone ileus. We present a case of a 63-year-old woman who underwent transvaginal hybrid NOTES procedure for treatment of gallstone ileus. This case was admitted to our hospital following acute-onset abdominal pain and vomiting. We diagnosed gallstone ileus with cholecystoduodenal fistula by computed tomography and performed totally laparoscopic surgery using only three 5 mm abdominal ports with transvaginal specimen extraction and enterectomy. The patient’s postoperative course was uneventful, and laparoscopic cholecystectomy and fistula repair were performed 8 months after the initial surgery. The patient experienced additional pain relief and good cosmetic outcomes. In conclusion, using transvaginal hybrid NOTES may become a future option to minimize the invasiveness of other laparoscopic procedures.

  17. Transvaginal Hybrid NOTES Procedure for Treatment of Gallstone Ileus

    Science.gov (United States)

    Tomizawa, Naoki; Andoh, Tatsumasa; Arakawa, Kazuhisa; Enokida, Yasuaki; Ozawa, Naoya

    2016-01-01

    Gallstone ileus is a rare mechanical bowel obstruction, and previously reported cases have been treated laparoscopically with good results. Although transvaginal hybrid NOTES without a minilaparotomy has been reported to decrease the incidence of surgical wound complications, to our knowledge, this procedure has not been used previously to treat gallstone ileus. We present a case of a 63-year-old woman who underwent transvaginal hybrid NOTES procedure for treatment of gallstone ileus. This case was admitted to our hospital following acute-onset abdominal pain and vomiting. We diagnosed gallstone ileus with cholecystoduodenal fistula by computed tomography and performed totally laparoscopic surgery using only three 5 mm abdominal ports with transvaginal specimen extraction and enterectomy. The patient's postoperative course was uneventful, and laparoscopic cholecystectomy and fistula repair were performed 8 months after the initial surgery. The patient experienced additional pain relief and good cosmetic outcomes. In conclusion, using transvaginal hybrid NOTES may become a future option to minimize the invasiveness of other laparoscopic procedures. PMID:27429831

  18. What is a Bristow-Latarjet procedure? A review of the described operative techniques and outcomes.

    Science.gov (United States)

    Cowling, P D; Akhtar, M A; Liow, R Y L

    2016-09-01

    A variety of operative techniques have been described as under the term 'Bristow-Latarjet' procedure. This review aims to define the original procedure, and compare the variation in techniques described in the literature, assessing any effect on clinical outcomes. A systematic review of 24 studies was performed to compare specific steps of the technique (coracoid osteotomy site, subscapularis approach, orientation and position of coracoid graft fixation and fixation method, additional labral and capsular repair) and detect any effect this variability had on outcomes. Overall recurrence rate was 5.36% (2.94% to 43%). Half of the studies performed the procedure for recurrent shoulder instability, with only five studies documenting glenoid bone loss as an indication: 12 studies used the procedure as the primary surgical intervention for recurrent instability. No change in outcome was noted when examining variation in the coracoid osteotomy site, the fixation site on the scapular neck, the fixation method or whether a capsular repair was also performed. Performing a horizontal split in subscapularis may preserve external rotation compared with performing a tenotomy. This is the first review to examine various operative techniques of the Bristow-Latarjet procedure, and their effect on outcome. We found that other than the approach through subscapularis, outcome was independent of the surgical technique, and depended more on patient selection. We would commend future publications on this procedure to provide a detailed description of the surgical technique, and as a minimum present rates of recurrence as an outcome measure. Cite this article: Bone Joint J 2016;98-B:1208-14. ©2016 The British Editorial Society of Bone & Joint Surgery.

  19. Review of procedures involving separation and preconcentration for the determination of cadmium using spectrometric techniques

    Energy Technology Data Exchange (ETDEWEB)

    Ferreira, Sergio L.C. [Instituto de Quimica, Campus Universitario Ondina, Universidade Federal da Bahia, Salvador, Bahia 40170-290 (Brazil)]. E-mail: slcf@ufba.br; Andrade, Jailson B. de [Instituto de Quimica, Campus Universitario Ondina, Universidade Federal da Bahia, Salvador, Bahia 40170-290 (Brazil); Korn, Maria das Gracas A. [Instituto de Quimica, Campus Universitario Ondina, Universidade Federal da Bahia, Salvador, Bahia 40170-290 (Brazil); Pereira, Madson de G. [Departamento de Ciencias Exatas e da Terra Campus 1-Cabula, Universidade do Estado da Bahia, Salvador, Bahia 41195-001 (Brazil); Lemos, Valfredo A. [Laboratorio de Quimica Analitica, Campus de Jequie, Universidade Estadual do Sudoeste da Bahia, Jequie, Bahia 45200-190 (Brazil); Santos, Walter N.L. dos [Departamento de Ciencias Exatas e da Terra Campus 1-Cabula, Universidade do Estado da Bahia, Salvador, Bahia 41195-001 (Brazil); Rodrigues, Frederico de Medeiros [Instituto de Quimica, Campus Universitario Ondina, Universidade Federal da Bahia, Salvador, Bahia 40170-290 (Brazil); Empresa Baiana de Desenvolvimento Agricola S.A., Avenida Dorival Caymmi 15649, Itapoan, Salvador, Bahia 41635-150 (Brazil); Souza, Anderson S. [Instituto de Quimica, Campus Universitario Ondina, Universidade Federal da Bahia, Salvador, Bahia 40170-290 (Brazil); Instituto Multidisciplinar em Saude, Campus AnisioTeixeira, Universidade Federal da Bahia, Vitoria da Conquista, Bahia 45055-090 (Brazil); Ferreira, Hadla S. [Instituto de Quimica, Campus Universitario Ondina, Universidade Federal da Bahia, Salvador, Bahia 40170-290 (Brazil); Silva, Erik G.P. da [Instituto de Quimica, Campus Universitario Ondina, Universidade Federal da Bahia, Salvador, Bahia 40170-290 (Brazil)

    2007-07-16

    Spectrometric techniques for the analysis of trace cadmium have developed rapidly due to the increasing need for accurate measurements at extremely low levels of this element in diverse matrices. This review covers separation and preconcentration procedures, such as electrochemical deposition, precipitation, coprecipitation, solid phase extraction, liquid-liquid extraction (LLE) and cloud point extraction (CPE), and consider the features of the their application with several spectrometric techniques.

  20. Solution Procedure for Transport Modeling in Effluent Recharge Based on Operator-Splitting Techniques

    Directory of Open Access Journals (Sweden)

    Shutang Zhu

    2008-01-01

    Full Text Available The coupling of groundwater movement and reactive transport during groundwater recharge with wastewater leads to a complicated mathematical model, involving terms to describe convection-dispersion, adsorption/desorption and/or biodegradation, and so forth. It has been found very difficult to solve such a coupled model either analytically or numerically. The present study adopts operator-splitting techniques to decompose the coupled model into two submodels with different intrinsic characteristics. By applying an upwind finite difference scheme to the finite volume integral of the convection flux term, an implicit solution procedure is derived to solve the convection-dominant equation. The dispersion term is discretized in a standard central-difference scheme while the dispersion-dominant equation is solved using either the preconditioned Jacobi conjugate gradient (PJCG method or Thomas method based on local-one-dimensional scheme. The solution method proposed in this study is applied to the demonstration project of groundwater recharge with secondary effluent at Gaobeidian sewage treatment plant (STP successfully.

  1. Anatomic and Biomechanical Comparison of the Classic and Congruent-Arc Techniques of the Latarjet Procedure.

    Science.gov (United States)

    Montgomery, Scott R; Katthagen, J Christoph; Mikula, Jacob D; Marchetti, Daniel Cole; Tahal, Dimitri S; Dornan, Grant J; Dahl, Kimi D; Brady, Alex W; Turnbull, Travis Lee; Millett, Peter J

    2017-05-01

    The Latarjet procedure is commonly performed using either the classic or the congruent-arc technique. Each technique has potential clinical advantages and disadvantages. However, data on the anatomic and biomechanical effects, benefits, and limitations of each technique are limited. Hypothesis/Purpose: To compare the anatomy and biomechanical fixation strength (failure load) between the 2 techniques. It was hypothesized that the classic technique would have superior initial fixation when compared with the congruent-arc technique and that this would be affected by sex and coracoid size. Controlled laboratory study. A biomechanical cadaver study was performed with 20 pairs of male and female shoulders. One of each pair of shoulders was randomly assigned to receive the classic or congruent-arc technique. Coracoid and glenoid anatomic measurements were collected before biomechanical testing. A tensile force was applied through the conjoined tendon to replicate forces experienced by the coracoid graft in the early postoperative period, and the failure load was determined for each specimen. The mean ± SD surface area available for fixation was 263 ± 63 mm(2) in the classic technique compared with 177 ± 63 mm(2) in the congruent-arc group ( P Latarjet procedure provided a greater surface area for healing to the glenoid and superior initial fixation when compared with the congruent-arc technique. The congruent-arc technique allowed restoration of a larger glenoid defect. The classic and congruent-arc techniques of coracoid transfer have anatomic and biomechanical advantages and disadvantages that should be considered when choosing between the 2 techniques.

  2. New surface treatment techniques against ice formation and growth

    Energy Technology Data Exchange (ETDEWEB)

    Megateli, R. [TechnoCentre eolien Gaspesie-les Iles, Murdochville, PQ (Canada). Centre CORUS

    2007-07-01

    The average wind speed in Murdochville, Quebec is 9 m/s, making it one of Canada's richest wind resource regions. As such, it is the site of a natural laboratory for the CORUS Center to study the North American climate and wind energy extraction. This presentation outlined research initiatives at CORUS, with particular reference to innovative treatments against ice accretion on wind turbine blades. Ice changes the aerodynamic profile of turbine blades, overloads the structure, increases vibrations and causes component wear. This results in loss of energy production, frequent failures, reduced service life and increased operating and maintenance costs. CORUS has been working on reducing ice accretion on blade surfaces without affecting the manufacturing process using ion implantation and UV rays irradiation. The ions used in the process are hydrogen, fluorine and argon. The technique modifies the surface chemical properties at the nano-scale depth level. This presentation provided details of the ion implantation procedure and the UV rays exposure procedure. An evaluation of wetting and water contact angles on blade samples was provided. Preliminary results showed that the high hysteresis of the non-treated samples had favourable conditions to ice adhesion. Argon implantation reduced the water contact angles and particularly hysteresis. Hydrogen implantation slightly increased the water contact angles and reduced the hysteresis. The process was beneficial in terms of service life. UV irradiation increased the hysteresis. figs.

  3. A Technique of Distal Clavicle Fracture Fixation Using The Tightrope Procedure

    Directory of Open Access Journals (Sweden)

    CJ Soh

    2011-11-01

    Full Text Available We present here a technique of fracture stabilization using the Tightrope procedure in a patient with a widely displaced Neer type IIB distal clavicle fracture. The Tightrope system, typically used for stabilization of acromioclavicular joint dislocation, has not been widely described for distal clavicle fractures. The patient achieved satisfactory results after surgery; we feel that this technique is appealing as it is simple, reproducible and avoids the complications associated with extensive metalwork. This technique may also appeal to the arthroscopic surgeon.

  4. Treatment Options: Biological Basis of Regenerative Endodontic Procedures

    Science.gov (United States)

    Hargreaves, Kenneth M.; Diogenes, Anibal; Teixeira, Fabricio B.

    2013-01-01

    Dental trauma occurs frequently in children and often can lead to pulpal necrosis. The occurrence of pulpal necrosis in the permanent but immature tooth represents a challenging clinical situation since the thin and often short roots increase the risk of subsequent fracture. Current approaches for treating the traumatized immature tooth with pulpal necrosis do not reliably achieve the desired clinical outcomes, consisting of healing of apical periodontitis, promotion of continued root development and restoration of the functional competence of pulpal tissue. An optimal approach for treating the immature permanent tooth with a necrotic pulp would be to regenerate functional pulpal tissue. This review summarizes the current literature supporting a biological rationale for considering regenerative endodontic treatment procedures in treating the immature permanent tooth with pulp necrosis. PMID:23439043

  5. Coracoid bone graft osteolysis after Latarjet procedure: A comparison study between two screws standard technique vs mini-plate fixation.

    Science.gov (United States)

    Giacomo, Giovanni Di; Costantini, Alberto; de Gasperis, Nicola; De Vita, Andrea; Lin, Bernard K H; Francone, Marco; Beccaglia, Mario A Rojas; Mastantuono, Marco

    2013-01-01

    One of the reason for Latarjet procedure failure may be coracoid graft osteolysis. In this study, we aimed to understand if a better compression between the coracoid process and the glenoid, using a mini-plate fixation during the Latarjet procedure, could reduce the amount of coracoid graft osteolysis. A computed tomography scan analysis of 26 prospectively followed-up patients was conducted after modified Latarjet procedure using mini-plate fixation technique to determine both the location and the amount of coracoid graft osteolysis in them. We then compared our current results with results from that of our previous study without using mini-plate fixation to determine if there is any statistical significant difference in terms of corcacoid bone graft osteolysis between the two surgical techniques. The most relevant osteolysis was represented by the superficial part of the proximal coracoid, whereas the deep part of the proximal coracoid graft is least involved in osteolysis and has best bone healing. The current study showed a significant difference only for the deep part of the distal coracoid with our previous study (P Latarjet procedure. Our study suggests that there is a significant difference only for the deep part of the distal coracoid in terms of osteolysis. At clinical examination, this difference did not correspond with any clinical findings. Level 4. Prospective case series, Treatment study.

  6. Reviewing efficacy of alternative water treatment techniques.

    Science.gov (United States)

    Hambidge, A

    2001-06-01

    synergistic effect in the inactivation of coliphage MS-2 and poliovirus. Other techniques: There are a number of other techniques. We have conducted trials of most of these in the control of Legionella sp., but these fall out of the scope of this article, and as such less emphasis has been placed on them here. Ozonation: Ozone [O3] is an oxidising gas, generated electrically from oxygen [O2]. L. pneumophila can be killed at ozone [Edelstien et al 1982]. Muraca et al [1987] found that 1-2 mg/L of continuous ozone over a six hour contact time, produced a 5 logarithm decrease of L. pneumophila. The effectiveness of ozone treatment against a range of bacteria and coliphages has been studied Botzenhart et al [1993]. E. coli was least resistant to ozone, followed by MS 2-coliphage and PhiX 174-coliphage, with L. pneumophila and Bacillus subtilis spores being the most resistant. (ABSTRACT TRUNCATED)

  7. Surrogate motherhood as a medical treatment procedure for women's infertility.

    Science.gov (United States)

    Jovic, Olga S

    2011-03-01

    The content of this work is conceived on the research of the consequences of surrogate motherhood as a process of assisted procreation, which represent a way of parenthood in cases when it is not possible to realize parenthood through a natural way. Surrogate motherhood is a process in which a woman (surrogate mother) agrees to carry a pregnancy with the intent to give the child to the couple with whom she has made a contract on surrogate maternity after the birth. This process of conception and birth makes the determination of the child's origin on its mother's side hard to determine, because of the distinction of the genetic and gestation phases of the two women. The concept of surrogate motherhood is to appear in two forms, depending on the existence or the non-existence of the genetic link between the surrogate mother and the child she gives birth to. There are gestation (full) and genetic (partial) surrogates each with different modalities and legal and ethical implications. In Serbia, Infertility Treatment and the Bio-medically Assisted Procreation Act from 2009 explicitly forbids surrogate motherhood, despite the fact that an infertile couple decides to use it, as a rule, after having tried all other treatment procedures, in cases when there is a diagnosis but the conventional treatment applied has not produced the desired results. Given the fact that no one has the right to ignore the sufferings of people who cannot procreate naturally, the medical practice and legal science in our country plead for a formulation of a legal framework in which to apply surrogate motherhood as an infertility treatment, under particular conditions.

  8. Comparison of the Sauvé-Kapandji procedure and the Darrach procedure for the treatment of rheumatoid wrists.

    Science.gov (United States)

    Nakagawa, Natsuko; Abe, Shuji; Kimura, Hiroshi; Imura, Shigeaki; Nishibayashi, Yasuro; Yoshiya, Sinichi

    2003-09-01

    Abstract In surgical treatment of the rheumatoid wrist, the Darrach procedure combined with synovectomy has been the treatment of choice in the past. However, owing to the significant ulnar carpal shift observed after the Darrach procedure, the Sauvé-Kapandji (S-K) procedure has become increasingly popular. The purpose of this study was to compare the clinical results of the S-K and Darrach procedures. Thirty-two wrists in the S-K-procedure group and 31 wrists in Darrach-procedure group were examined. Before and after surgery, clinical evaluations of pain, swelling, range of motion, grip strength, and radiological findings were performed and the results were compared. Both procedures resulted in decreased pain and swelling, as well as improved rotatory motion of the forearm. The S-K procedure was shown to be superior to the Darrach procedure in reducing ulnar carpal migration and improving grip strength. On the other hand, the prevention of carpal bone destruction could not be completely achieved in either procedure.

  9. Procedural guidance using advance imaging techniques for percutaneous edge-to-edge mitral valve repair.

    Science.gov (United States)

    Quaife, Robert A; Salcedo, Ernesto E; Carroll, John D

    2014-02-01

    The complexity of structural heart disease interventions such as edge-to edge mitral valve repair requires integration of multiple highly technical imaging modalities. Real time imaging with 3-dimensional (3D) echocardiography is a relatively new technique that first, allows clear volumetric imaging of target structures such as the mitral valve for both pre-procedural diagnosis and planning in patients with degenerative or functional mitral valve regurgitation. Secondly it provides intra-procedural, real-time panoramic volumetric 3D view of structural heart disease targets that facilitates eye-hand coordination while manipulating devices within the heart. X-ray fluoroscopy and RT 3D TEE images are used in combination to display specific targets and movement of catheter based technologies in 3D space. This integration requires at least two different image display monitors and mentally fusing the individual datasets by the operator. Combined display technology such as this, allow rotation and orientation of both dataset perspectives necessary to define targets and guidance of structural disease device procedures. The inherently easy concept of direct visual feedback and eye-hand coordination allows safe and efficient completion of MitraClip procedures. This technology is now merged into a single structural heart disease guidance mode called EchoNavigator(TM) (Philips Medical Imaging Andover, MA). These advanced imaging techniques have revolutionized the field of structural heart disease interventions and this experience is exemplified by a cooperative imaging approach used for guidance of edge-to-edge mitral valve repair procedures.

  10. Neonatal cholestasis – differential diagnoses, current diagnostic procedures and treatment

    Directory of Open Access Journals (Sweden)

    Thomas eGötze

    2015-06-01

    Full Text Available Cholestatic jaundice in early infancy is a complex diagnostic problem. Misdiagnosis of cholestasis as physiologic jaundice delays the identification of severe liver diseases. In the majority of infants it may represent benign cases of breast milk jaundice, but few among them are masked and caused by neonatal cholestasis that requires a prompt diagnosis and treatment. Therefore, a prolonged neonatal jaundice longer than two weeks after birth must always be scrutinized because an early diagnosis is essential for appropriate management. To rapidly identify the cholestatic cases, the conjugated bilirubin needs to be determined in any infant presenting with prolonged jaundice at 14 days of age with or without depigmented stool. Once neonatal cholestasis is confirmed, a systematic approach is the key to reliably achieve the diagnosis in order to promptly initiate the specific, and in many cases, life saving therapy. This strategy is most important to promptly identify and treat infants with biliary atresia, the most common cause of neonatal cholestasis that requires a hepatoportoenterostomy as soon as possible.Here, we provide a detailed work-up approach including initial treatment recommendations and a clinically oriented overview of possible differential diagnoses in order to facilitate an early recognition and a timely diagnosis. This warrants a broad spectrum of diagnostic procedures and investigations including new methods that are described in this review.

  11. A Novel Technique of Impression Procedure in a Hemimaxillectomy Patient with Microstomia

    Directory of Open Access Journals (Sweden)

    Suryakant C. Deogade

    2012-01-01

    Full Text Available A restricted mouth opening in hemimaxillectomy patient can create a significant problem with the insertion and the removal of the obturator prosthesis. Even it poses a problem in impression making due to small oral opening. A modification of the standard impression procedure is often necessary to accomplish an acceptable impression in the fabrication of a successful prosthesis. Sectional trays are a good option for such patients. This paper describes a novel technique of impression procedure and a method of fabricating a sectional tray with the anterior and the posterior locking mechanism for a hemimaxillectomy patient with limited oral opening.

  12. A novel technique of impression procedure in a hemimaxillectomy patient with microstomia.

    Science.gov (United States)

    Deogade, Suryakant C

    2012-01-01

    A restricted mouth opening in hemimaxillectomy patient can create a significant problem with the insertion and the removal of the obturator prosthesis. Even it poses a problem in impression making due to small oral opening. A modification of the standard impression procedure is often necessary to accomplish an acceptable impression in the fabrication of a successful prosthesis. Sectional trays are a good option for such patients. This paper describes a novel technique of impression procedure and a method of fabricating a sectional tray with the anterior and the posterior locking mechanism for a hemimaxillectomy patient with limited oral opening.

  13. 40 CFR 142.46 - Alternative treatment techniques.

    Science.gov (United States)

    2010-07-01

    ... grant a variance from any treatment technique requirement of a national primary drinking water... 40 Protection of Environment 22 2010-07-01 2010-07-01 false Alternative treatment techniques. 142... PROGRAMS (CONTINUED) NATIONAL PRIMARY DRINKING WATER REGULATIONS IMPLEMENTATION Variances Issued by the...

  14. Application of minimally invasive technique in surgical treatment of pancreatic diseases

    Directory of Open Access Journals (Sweden)

    ZHANG Yixi

    2015-05-01

    Full Text Available In recent years, with the rapid development of minimally invasive concept, from laparoscopic operation to three-dimension laparoscopic technique and to robotic surgical system, treatment modalities have changed a lot. Pancreatic diseases, including multiple lesions, have different prognoses. An appropriate surgical procedure should be selected while ensuring the radical treatment of disease, so as to minimize the injury to patients and the impairment of organ function. Minimally invasive technique is of great significance in the surgical treatment of pancreatic diseases.

  15. Adult bipolar diathermy circumcision and related procedures in adults – a safe and efficient technique

    Directory of Open Access Journals (Sweden)

    Nalavenkata S

    2014-06-01

    Full Text Available Sunny Nalavenkata, Matthew Winter, Rachel Kour, Nam-Wee Kour, Paul RuljancichDepartment of Urology, Eastern Health, Box Hill Hospital, Box Hill, VIC, AustraliaObjectives: To present our novel technique and step-by-step approach to bipolar diathermy circumcision and related procedures in adult males.Methods: We reviewed our technique of bipolar circumcision and related procedures in 54 cases over a 22-month period at our day procedure center. Bipolar diathermy cutting and hemostasis was performed using bipolar forceps with a Valleylab machine set at 15. Sleeve circumcision was used. A dorsal slit was made, followed by frenulum release and ventral slit, and was completed with bilateral circumferential cutting. Frenuloplasties released the frenulum. Preputioplasties used multiple 2–3 mm longitudinal cuts to release the constriction, with frenulum left intact. All wounds were closed with interrupted 4/0 Vicryl Rapide™.Results: A total of 54 nonemergency bipolar circumcision procedures were carried out from November 2010–August 2012 (42 circumcisions, eight frenuloplasties, and four preputioplasties. Patients were aged 18–72 years (mean, 34 years. There was minimal to no intraoperative bleeding in all cases, allowing for precise dissection. All patients were requested to attend outpatient reviews; three frenuloplasty and two circumcision patients failed to return. Of the remaining 49, mean interval to review was 49 days, with a range of 9–121 days. Two circumcision patients reported mild bleeding with nocturnal erections within a week postoperatively, but they did not require medical attention. Two others presented to family practitioners with possible wound infections which resolved with oral antibiotics. All 49 patients had well-healed wounds.Conclusion: The bipolar diathermy technique is a simple procedure, easily taught, and reproducible. It is associated with minimal bleeding, is safe and efficient, uses routine operating equipment and

  16. Wide brick tunnel randomization - an unequal allocation procedure that limits the imbalance in treatment totals.

    Science.gov (United States)

    Kuznetsova, Olga M; Tymofyeyev, Yevgen

    2014-04-30

    In open-label studies, partial predictability of permuted block randomization provides potential for selection bias. To lessen the selection bias in two-arm studies with equal allocation, a number of allocation procedures that limit the imbalance in treatment totals at a pre-specified level but do not require the exact balance at the ends of the blocks were developed. In studies with unequal allocation, however, the task of designing a randomization procedure that sets a pre-specified limit on imbalance in group totals is not resolved. Existing allocation procedures either do not preserve the allocation ratio at every allocation or do not include all allocation sequences that comply with the pre-specified imbalance threshold. Kuznetsova and Tymofyeyev described the brick tunnel randomization for studies with unequal allocation that preserves the allocation ratio at every step and, in the two-arm case, includes all sequences that satisfy the smallest possible imbalance threshold. This article introduces wide brick tunnel randomization for studies with unequal allocation that allows all allocation sequences with imbalance not exceeding any pre-specified threshold while preserving the allocation ratio at every step. In open-label studies, allowing a larger imbalance in treatment totals lowers selection bias because of the predictability of treatment assignments. The applications of the technique in two-arm and multi-arm open-label studies with unequal allocation are described.

  17. Development of Radiation Technique for Environmental Treatment

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Myun Joo; Kuk, Il Hiun; Jin, Joon Ha (and others)

    2007-02-15

    The purpose of this research is to development of technologies for 1) the removal of toxic organic chemicals in sewage sludges and the volume reduction of the sewage sludge 2) the recycling/reuse of sewage sludge 3) the reconvey of resource from fishery waste by using radiation technologies. This research project focused on the study of treatment, disposal, and recycling/reuse of sewage sludge by radiation technology, and recovery of highly value-added resources from the wastes. As basic studies with a radiation technology, an enhancement of dewaterbilities of sewage sludge, development of dewatering conditioner, reduction of trace toxic organic chemicals, and the toxicities of the byproducts were studied. Based on the basic experimental results, we developed the pilot-scale system with the continuous e-beam and dewatering unit and the advanced treatment system with the use of carbon source recovered from sewage sludge.

  18. The Application of Six Sigma Techniques in the Evaluation of Enzyme Measurement Procedures in China.

    Science.gov (United States)

    Zhang, Chuanbao; Zhao, Haijian; Wang, Jing; Zeng, Jie; Wang, Zhiguo

    2015-01-01

    Recently, Six Sigma techniques have been adopted by clinical laboratories to evaluate laboratory performance. Measurement procedures in laboratories can be categorized as "excellent", "good", and "improvement needed" based on sigma (σ) metrics of σ ≥ 6, 3 ≤ σ 1.2 indicates that the trueness of the procedure needs to be improved; 0.8 ≤ QGI ≤ 1.2 indicates that both the precision and trueness of the procedure need to be improved. Fresh frozen sera containing seven enzymes (ALT, ALP, AMY, AST, CK, GGT, and LDH) were sent to 78 clinical laboratories in China. The biases for measurement procedures in each laboratory (Bias) were calculated based on the target values assigned by 18 laboratories performing IFCC (International Federation of Clinical Chemistry and Laboratory medicine) recommended reference methods. The imprecision of each measurement procedure was represented by coefficient variations (CV) calculated based on internal quality control (IQC) data. The σ and QGI values were calculated as follows: σ = (TEa-Bias)/CV; QGI = Bias/(1.5 x CV). TEa is allowable total error for each enzyme derived from biological variation. Our study indicated that 7.9% (6/76, ALP) to 31.0% (18/58, AMY) of the participating laboratories were scored as "excellent" (σ ≥ 6), 21.1% (16/76, ALP) to 41.3% (31/75, CK) of the laboratories were scored as "good" (3 ≤ σ Six Sigma techniques still suggested that approximately 31.1% to 71.0% of the laboratories need to improve their enzyme measurement procedures, either in terms of precision, trueness, or both.

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

    OpenAIRE

    Mani, Vishnu R.; Ahmed, Leaque

    2015-01-01

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

  20. [Treatment of atherosclerosis. New percutaneous intraluminal techniques].

    Science.gov (United States)

    Lablanche, J M

    1990-10-06

    Balloon-catheter angioplasty was introduced by Gruntzig in 1977 and has since proved effective, but 3 problems are still encountered: immediate reobstruction, restenosis during the first 3 months and extension of the procedure to a greater number of cases. In an attempt to solve these problems, other percutaneous/technics, associated or not with balloon angioplasty, have been devised. They are: (1) intraluminal stents which perfectly keep the vessel open after balloon angioplasty; (2) vaporization of atheromatous plaques by laser, and notably excimer laser which results in immediate recanalization, later completed by balloon angioplasty; (3) heating balloons which stick dissections and improve the immediate success rate; (4) atheroma-cutting and storing systems, such as Simpson's atherocath, cutting and aspirating systems, such as Stack's transluminal extraction catheter, or erasing systems, such as Auth's rotablator; (5) other sources of energy, such as ultrasounds, microwaves and radiofrequencies, will perhaps, be used in the near future. None of these new technics has solved the restenosis problem, but all have proved effective in suppressing the obstacle, there by giving hopes of reducing immediate complications and gradually widening the indications of percutaneous revascularization.

  1. Modified Sauve-Kapandji procedure for disorders of the distal radioulnar joint in patients with rheumatoid arthritis. Surgical technique.

    Science.gov (United States)

    Fujita, Satoru; Masada, Kazuhiro; Takeuchi, Eiji; Yasuda, Masataka; Komatsubara, Yoshio; Hashimoto, Hideo

    2006-03-01

    The Sauvé-Kapandji procedure has become popular for the treatment of disorders of the distal radioulnar joint in patients with rheumatoid arthritis, but this procedure is impossible to perform in patients with poor bone quality in the distal part of the ulna. We have modified the procedure for patients with poor bone quality in the distal part of the ulna. The modified procedure involves resecting the distal part of the ulna, making a drill-hole in the ulnar cortex of the distal part of the radius, rotating the resected portion of the ulna 90 degrees, inserting it into the distal part of the radius, and fixing it at that site with use of an AO cancellous-bone screw. In the present report, we describe the new operative technique and report the results after a minimum duration of follow-up of three years. This operation was performed in fifty-six patients (sixty-six wrists) with rheumatoid arthritis. The mean age at the time of the operation was 59.3 years. The mean duration of follow-up was forty-eight months. Patients were evaluated in terms of wrist pain, grip strength, and range of motion. Radiographic evaluation included calculation of the carpal translation index to assess the extent of ulnar translation of the carpus. Osseous union was achieved in all cases. Wrist pain resolved or decreased in all patients. The mean total range of forearm rotation increased from 144 degrees preoperatively to 167 degrees at the time of the most recent follow-up (p Kapandji procedure results in rigid fixation of the grafted bone. The technique provides sufficient osseous support of the carpus even in patients with rheumatoid arthritis and poor bone quality in the distal part of the ulna.

  2. Adapted Cuing Technique for Use in Treatment of Dyspraxia.

    Science.gov (United States)

    Klick, Susan L.

    1985-01-01

    The Adapted Cuing Technique (ACT) was created to accompany oral stimulus presentation in treatment of dyspraxia. ACT is consistent with current treatment theory, emphasizing patterns of articulatory movement, manner of production, and multimodality facilitation. A case study describes the use of ACT in the treatment of a five-year-old child.…

  3. Microextraction Techniques Used in the Procedures for Determining Organomercury and Organotin Compounds in Environmental Samples

    Directory of Open Access Journals (Sweden)

    Małgorzata Rutkowska

    2014-06-01

    Full Text Available Due to human activities, the concentrations of organometallic compounds in all parts of the environment have increased in recent decades. The toxicity and some biochemical properties of mercury and tin present in the environment depend on the concentration and chemical form of these two elements. The ever-increasing demand for determining compounds at very low concentration levels in samples with complex matrices requires the elimination of interfering substances, the reduction of the final extract volume, and analyte enrichment in order to employ a detection technique, which is characterised by high sensitivity at low limits of quantification. On the other hand, in accordance with current trends, the analytical procedures should aim at the miniaturisation and simplification of the sample preparation step. In the near future, more importance will be given to the fulfilment of the requirements of Green Chemistry and Green Analytical Chemistry in order to reduce the intensity of anthropogenic activities related to analytical laboratories. In this case, one can consider the use of solvent-free/solvent-less techniques for sample preparation and microextraction techniques, because the use of the latter leads to lowering the quantity of reagents used (including solvents due to the reduction of the scale of analysis. This paper presents an overview of microextraction techniques (SPME and LPME used in the procedures for determining different chemical forms of mercury and tin.

  4. The "bony Bankart bridge" procedure: a new arthroscopic technique for reduction and internal fixation of a bony Bankart lesion.

    Science.gov (United States)

    Millett, Peter J; Braun, Sepp

    2009-01-01

    Arthroscopic treatment of bony Bankart lesions can be challenging. We present a new easy and reproducible technique for arthroscopic reduction and suture anchor fixation of bony Bankart fragments. A suture anchor is placed medially to the fracture on the glenoid neck, and its sutures are passed around the bony fragment through the soft tissue including the inferior glenohumeral ligament complex. The sutures of this anchor are loaded in a second anchor that is placed on the glenoid face. This creates a nontilting 2-point fixation that compresses the fragment into its bed. By use of the standard technique, additional suture anchors are used superiorly and inferiorly to the bony Bankart piece to repair the labrum and shift the joint capsule. We call this the "bony Bankart bridge" procedure.

  5. Comparison of Bristow procedure and Bankart arthroscopic method as the treatment of recurrent shoulder instability

    Directory of Open Access Journals (Sweden)

    Abolghasem Zarezade

    2014-01-01

    Full Text Available Background: Anterior shoulder dislocation is the most common major joint dislocation. In patients with recurrent shoulder dislocation, surgical intervention is necessary. In this study, two methods of treatment, Bankart arthroscopic method and open Bristow procedure, were compared. Materials and Methods: This clinical trial survey had been done in the orthopedic department of Alzahra and Kashani hospitals of Isfahan during 2008-2011. Patients with recurrent anterior shoulder dislocation who were candidates for surgical treatment were randomly divided into two groups, one treated by Bankart arthroscopic technique and the other treated by Bristow method. All the patients were assessed after the surgery using the criteria of ROWE, CONSTANT, UCLA, and ASES. Data were analyzed by SPSS software. Results: Six patients (16.22% had inappropriate condition with ROWE score (score less than 75; of them, one had been treated with Bristow and five with Bankart (5.26 vs. 27.78. Nine patients (24.32% had appropriate condition, which included six from Bristow group and three treated by Bankart technique (31.58 vs. 16.67. Finally, 22 patients (59.46% showed great improvement with this score, which included 12 from Bristow and 10 from Bankart groups (63.16 vs. 55.56. According to Fisher′s exact test, there were no significant differences between the two groups (P = 0.15. Conclusion: The two mentioned techniques did not differ significantly, although some parameters such as level of performance, pain intensity, use of analgesics, and range of internal rotation showed more improvement in Bristow procedure. Therefore, if there is no contraindication for Bristow procedure, it is preferred to use this method.

  6. Modified Arthroscopic Latarjet Procedure With Coracoid Exteriorization for Treatment of Anterior Glenohumeral Instability

    Science.gov (United States)

    Ranne, Juha O.; Kainonen, Terho U.; Lehtinen, Janne T.; Heinonen, Olli J.

    2013-01-01

    The Latarjet procedure for treating anterior glenohumeral instability includes transfer of the coracoid and biceps tendon to the anterior glenoid. A modified method for the arthroscopic procedure was developed to facilitate the procedure and minimize the risk of injury to the brachial plexus. The detached coracoid was exteriorized through the anteroinferior portal for drilling and shaping. A Coracoid Drill Guide (Arthrex, Naples, FL) was used to help cut the coracoid to the desired size and make 2 drill holes in the coracoid for fixation to the glenoid. The Coracoid Transfer Instrument (Acierart, Masku, Finland) was designed to facilitate coracoid transfer and serve as a pin guide for fixation. Ten patients with severe anterior glenohumeral instability were treated with this technique. They had only mild to moderate postoperative pain. There were no postoperative infections or recurrent dislocations. The safety of this operation was similar to that of other operations on the coracoid process in the proximity of the brachial plexus. The modified arthroscopic Latarjet procedure may be applied successfully to the treatment of anterior glenohumeral instability, with good patient satisfaction and functional outcome. PMID:24400183

  7. Percutaneous vertebroplasty: optimizing the procedure after treatment of 250 vertebral levels under fluoroscopic guidance.

    Science.gov (United States)

    Pedicelli, A; Rollo, M; Piano, M; Grattacaso, G; Colosimo, C; Bonomo, L

    2009-10-01

    Percutaneous vertebroplasty (PVP) is a minimally invasive treatment for symptomatic vertebral compression fractures (VCFs). The aim of this study was to assess the effectiveness, complications and progress of results of PVP optimized in terms of technique, costs, time and strategic protocol after 3 years of procedures performed under fluoroscopic guidance alone. We treated 250 VCFs in 120 consecutive patients after assessing clinical and radiological indications. The effectiveness of the procedure was determined by statistical analysis of numerical scores for pain, mobility and drug consumption before and after treatment. No major complications and only three minor complications occurred. Clinically relevant improved mobility and reduction of pain and analgesics were observed, with overall significant results (p<0.0001) in all patients at 24 h after PVP and in 83 available patients at 6 months. A total of five asymptomatic refractures of cemented vertebrae and 14 new symptomatic vertebral fractures at different levels were observed between 1 and 10 months after the procedure. PVP is a safe, rapid, effective and costeffective therapy for VCFs, requiring only brief hospital admission and with long-lasting clinical results, when performed under good-quality radiological guidance, when correct indications are respected and when it is associated with rehabilitation therapy in the follow-up. It is a valid alternative to conservative therapy, which is burdened by high healthcare costs and often requires long-term immobilisation of frail and elderly patients at risk of clinical complications.

  8. The Differential Outcomes Procedure Enhances Adherence to Treatment: A Simulated Study with Healthy Adults

    Science.gov (United States)

    Molina, Michael; Plaza, Victoria; Fuentes, Luis J.; Estévez, Angeles F.

    2015-01-01

    Memory for medical recommendations is a prerequisite for good adherence to treatment, and therefore to ameliorate the negative effects of the disease, a problem that mainly affects people with memory deficits. We conducted a simulated study to test the utility of a procedure (the differential outcomes procedure, DOP) that may improve adherence to treatment by increasing the patient’s learning and retention of medical recommendations regarding medication. The DOP requires the structure of a conditional discriminative learning task in which correct choice responses to specific stimulus–stimulus associations are reinforced with a particular reinforcer or outcome. In two experiments, participants had to learn and retain in their memory the pills that were associated with particular disorders. To assess whether the DOP improved long-term retention of the learned disorder/pill associations, participants were asked to perform two recognition memory tests, 1 h and 1 week after completing the learning phase. The results showed that compared with the standard non-differential outcomes procedure, the DOP produced better learning and long-term retention of the previously learned associations. These findings suggest that the DOP can be used as a useful complementary technique in intervention programs targeted at increasing adherence to clinical recommendations. PMID:26913010

  9. Clinical effectiveness and costs of the Sugarbaker procedure for the treatment of pseudomyxoma peritonei.

    Science.gov (United States)

    Bryant, J; Clegg, A J; Sidhu, M K; Brodin, H; Royle, P; Davidson, P

    2004-02-01

    This systematic review examines the clinical and cost-effectiveness of the Sugarbaker procedure for treating pseudomyxoma peritonei (PMP) and the costs of the procedure in the UK. Electronic databases, bibliographies of related papers and experts in the field were used as sources for English language studies available up to September 2002. Evidence of the clinical effectiveness of the Sugarbaker procedure for PMP was synthesised through a narrative review with full tabulation of results of all included studies. The economic modelling used a Monte-Carlo simulation model populated with UK price data to estimate likely UK costs. Five retrospective case-series reports assessing the Sugarbaker procedure met the inclusion criteria for the review, although they were found to be of poor quality when judged against standard criteria for assessing methodological standard. There appears to be some benefit for people with PMP who undergo treatment with the Sugarbaker procedure. Commonly reported complications of the Sugarbaker procedure were anastomotic leaks, fistula formation, wound infection, small bowel perforations/obstructions and pancreatitis. One costing study of poor methodological quality and set in the USA was found. This study, together with UK unit price data and expert advice, was used to populate a Monte-Carlo simulation model to estimate the marginal cost of operating a service to provide treatment for PMP using the Sugarbaker technique rather than standard treatment. The results of the Monte-Carlo simulation model showed that the cost for one patient over a maximum of 5 years would be about 9700 British pounds, with a standard deviation of about 1300 British pounds (although costs incurred in setting up the specific service or training the staff were not included). The US study showed a ten-fold higher cost. The Monte-Carlo analysis showed that the variation around the mean was not very high. The most likely factor influencing the variation of the costs was

  10. Coracoid bone graft osteolysis after Latarjet procedure: A comparison study between two screws standard technique vs mini-plate fixation

    Directory of Open Access Journals (Sweden)

    Giovanni Di Giacomo

    2013-01-01

    Full Text Available Aims: One of the reason for Latarjet procedure failure may be coracoid graft osteolysis. In this study, we aimed to understand if a better compression between the coracoid process and the glenoid, using a mini-plate fixation during the Latarjet procedure, could reduce the amount of coracoid graft osteolysis. Materials and Methods: A computed tomography scan analysis of 26 prospectively followed-up patients was conducted after modified Latarjet procedure using mini-plate fixation technique to determine both the location and the amount of coracoid graft osteolysis in them. We then compared our current results with results from that of our previous study without using mini-plate fixation to determine if there is any statistical significant difference in terms of corcacoid bone graft osteolysis between the two surgical techniques. Results: The most relevant osteolysis was represented by the superficial part of the proximal coracoid, whereas the deep part of the proximal coracoid graft is least involved in osteolysis and has best bone healing. The current study showed a significant difference only for the deep part of the distal coracoid with our previous study (P < 0.01. Discussion: To our knowledge, there are no studies in literature that show the causes of coracoid bone graft osteolysis after Latarjet procedure. Conclusion: Our study suggests that there is a significant difference only for the deep part of the distal coracoid in terms of osteolysis. At clinical examination, this difference did not correspond with any clinical findings. Level of Evidence: Level 4. Clinical Relevance: Prospective case series, Treatment study.

  11. Treatment of a Developmental Groove and Supernumerary Root Using Guided Tissue Regeneration Technique

    Directory of Open Access Journals (Sweden)

    Zahra Alizadeh Tabari

    2016-01-01

    Full Text Available Introduction. The radicular groove is a developmental groove which is usually found on the palatal or lateral aspects of the maxillary incisor teeth. The present case is a maxillary lateral incisor with a small second root and a deep radicular groove. The developmental groove caused a combined periodontal-endodontic lesion. Methods. Case was managed using a combined treatment procedure involving nonsurgical root canal therapy and surgical periodontal treatment. After completion of root canal treatment, guided tissue regeneration (GTR was carried out using decalcified freeze dried bone allograft (DFDBA and a bioabsorbable collagenous membrane. Tooth also was splinted for two months. Results. After 12 months the tooth was asymptomatic. The periapical radiolucency disappeared and probing depth did not exceed 3 mm. Conclusion. Combined treatment procedure involving nonsurgical root canal therapy and surgical periodontal regenerative treatment can be a predictable technique in treating combined endodontic-periodontal lesions caused by radicular groove.

  12. Treatment of a Developmental Groove and Supernumerary Root Using Guided Tissue Regeneration Technique.

    Science.gov (United States)

    Alizadeh Tabari, Zahra; Homayouni, Hamed; Pourseyediyan, Tahere; Arvin, Armita; Eiland, Derrick; Moradi Majd, Nima

    2016-01-01

    Introduction. The radicular groove is a developmental groove which is usually found on the palatal or lateral aspects of the maxillary incisor teeth. The present case is a maxillary lateral incisor with a small second root and a deep radicular groove. The developmental groove caused a combined periodontal-endodontic lesion. Methods. Case was managed using a combined treatment procedure involving nonsurgical root canal therapy and surgical periodontal treatment. After completion of root canal treatment, guided tissue regeneration (GTR) was carried out using decalcified freeze dried bone allograft (DFDBA) and a bioabsorbable collagenous membrane. Tooth also was splinted for two months. Results. After 12 months the tooth was asymptomatic. The periapical radiolucency disappeared and probing depth did not exceed 3 mm. Conclusion. Combined treatment procedure involving nonsurgical root canal therapy and surgical periodontal regenerative treatment can be a predictable technique in treating combined endodontic-periodontal lesions caused by radicular groove.

  13. Treatment of a Developmental Groove and Supernumerary Root Using Guided Tissue Regeneration Technique

    Science.gov (United States)

    Alizadeh Tabari, Zahra; Pourseyediyan, Tahere; Eiland, Derrick

    2016-01-01

    Introduction. The radicular groove is a developmental groove which is usually found on the palatal or lateral aspects of the maxillary incisor teeth. The present case is a maxillary lateral incisor with a small second root and a deep radicular groove. The developmental groove caused a combined periodontal-endodontic lesion. Methods. Case was managed using a combined treatment procedure involving nonsurgical root canal therapy and surgical periodontal treatment. After completion of root canal treatment, guided tissue regeneration (GTR) was carried out using decalcified freeze dried bone allograft (DFDBA) and a bioabsorbable collagenous membrane. Tooth also was splinted for two months. Results. After 12 months the tooth was asymptomatic. The periapical radiolucency disappeared and probing depth did not exceed 3 mm. Conclusion. Combined treatment procedure involving nonsurgical root canal therapy and surgical periodontal regenerative treatment can be a predictable technique in treating combined endodontic-periodontal lesions caused by radicular groove. PMID:27965900

  14. Surgical Treatment of Epiphrenic Diverticulum: Technique and Controversies.

    Science.gov (United States)

    Andolfi, Ciro; Wiesel, Ory; Fisichella, P Marco

    2016-11-01

    The goal of this article is to illustrate the current minimal invasive approaches to patients with epiphrenic diverticulum in terms of preoperative evaluation, surgical technique, and outcomes. Two techniques will be presented: a laparoscopic and a video-assisted thoracic repair. Indications for each technique will be discussed as well as proper patient selection and management. Current controversies in the treatment of patients with this rare disease will be addressed.

  15. Endodontic filling removal procedure: an ex vivo comparative study between two rotary techniques

    Directory of Open Access Journals (Sweden)

    Monica Sampaio do Vale

    2013-12-01

    Full Text Available In this study, we compared the ex vivo removal capacity of two endodontic rotary techniques and determined whether there was a significant quantitative difference in residual material when comparing root thirds. Forty extracted molars were used. The palatal roots were selected, and the canals were prepared using a step-back technique and filled using a lateral condensation technique with gutta-percha points and Endofill sealer. After two weeks of storage in a 0.9% saline solution at 37ºC in an oven, the specimens were divided into 2 groups of 20, with group 1 samples subjected to Gates-Glidden drills and group 2 samples subjected to the ProTaper retreatment System. Hedstroem files and eucalyptol solvent were used in both groups to complete the removal procedure. Then, the roots thirds were radiographed and the images were submitted to the NIH ImageJ program to measure the residual filling material in mm. Each root third was related to the total area of the root canals. The data were analyzed using Student's t test. There was a statistically significant difference between the two techniques as more filling material was removed by technique 2 (ProTaper than technique 1 (Gates-Glidden drills, p < 0.05. The apical third had a greater amount of residual filling material than the cervical and middle thirds, and the difference was statistically significant (p < 0.05. None of the selected techniques removed all filling material, and the material was most difficult to remove from the apical third. The ProTaper files removed more material than the Gates-Glidden drills

  16. Surgical treatment of idiopathic syringomyelia: Silastic wedge syringosubarachnoid shunting technique

    Directory of Open Access Journals (Sweden)

    Teck M Soo

    2014-01-01

    Conclusions: Shunting procedures for the syringomyelia disease spectrum have been criticized due to the inconsistent long-term outcomes. This surgical technique used to treat symptomatic idiopathic syringomyelia has been devised based on our intraoperative experience, surgical outcomes, and evaluation of the literature. The purpose of the wedges is to preserve patency of the communication between the syrinx cavity and the expanded subarachnoid space by preventing healing of the myelotomy edges and by maintaining an artificial conduit between the syrinx cavity and the subarachnoid space. Although short-term results are promising, continued long-term follow up is needed to determine the ultimate success of the silastic wedge shunting procedure.

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

    Science.gov (United States)

    Mani, Vishnu R.; Ahmed, Leaque

    2015-01-01

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

  18. The ex utero intrapartum treatment procedure: Looking back at the EXIT.

    Science.gov (United States)

    Hirose, Shinjiro; Farmer, Diana L; Lee, Hanmin; Nobuhara, Kerilyn K; Harrison, Michael R

    2004-03-01

    The ex utero intrapartum treatment (EXIT) procedure was developed originally for management of airway obstruction after fetal surgery, and indications have continued to expand for a variety of fetal anomalies. The authors review their single-institution experience with EXIT. Retrospective review of all patients who underwent an EXIT procedure from 1993 to 2003 (n = 52) was performed. Variables evaluated include indication for EXIT, gender, gestational age at EXIT, birth weight, maternal blood loss, operative complications, operative time, and survival rate. Technique, personnel, and anesthesic management were reviewed. Long-term follow-up was available for all patients. Fifty-one of 52 patients were born alive; currently, 27 of 52 patients (52%) are alive. All deaths have been in patients with congenital diaphragmatic hernia. Forty-five patients underwent EXIT for reversal of tracheal occlusion for congenital diaphragmatic hernia. Of these patients, 30 underwent tracheal clip removal. Two patients had repair of tracheal injury from clipping at EXIT. Fifteen patients underwent bronchoscopy and tracheal balloon removal. Five patients underwent EXIT procedure for neck masses. Tracheostomy was performed in 3 of these patients. One patient was intubated successfully, and 1 patient underwent resection of the neck mass while on placental support. Two patients underwent EXIT procedure and tracheostomy for congenital high-airway obstruction syndrome. Average gestational age at delivery was 31.95 +/- 2.55 weeks. Average birth weight was 1,895 +/- 653 g. Average maternal blood loss was 970 +/- 510 mL. Average operating time on placental support was 45 +/- 25 minutes with a maximum of 150 minutes. EXIT procedures can be performed with minimal maternal morbidity and with good outcomes. It is an excellent strategy for establishing an airway in a controlled manner, avoiding "crash" intubation or tracheostomy. Longer procedures on placental support allowing for definitive

  19. Force reconstruction using the sum of weighted accelerations technique -- Max-Flat procedure

    Energy Technology Data Exchange (ETDEWEB)

    Carne, T.G.; Mayes, R.L.; Bateman, V.I.

    1993-12-31

    Force reconstruction is a procedure in which the externally applied force is inferred from measured structural response rather than directly measured. In a recently developed technique, the response acceleration time-histories are multiplied by scalar weights and summed to produce the reconstructed force. This reconstruction is called the Sum of Weighted Accelerations Technique (SWAT). One step in the application of this technique is the calculation of the appropriate scalar weights. In this paper a new method of estimating the weights, using measured frequency response function data, is developed and contrasted with the traditional SWAT method of inverting the mode-shape matrix. The technique uses frequency response function data, but is not based on deconvolution. An application that will be discussed as part of this paper is the impact into a rigid barrier of a weapon system with an energy-absorbing nose. The nose had been designed to absorb the energy of impact and to mitigate the shock to the interior components.

  20. The Effectiveness of Two Grammar Treatment Procedures for Children with SLI: A Randomized Clinical Trial

    Science.gov (United States)

    Smith-Lock, Karen M.; Leitão, Suze; Prior, Polly; Nickels, Lyndsey

    2015-01-01

    Purpose: This study compared the effectiveness of two grammar treatment procedures for children with specific language impairment. Method: A double-blind superiority trial with cluster randomization was used to compare a cueing procedure, designed to elicit a correct production following an initial error, to a recasting procedure, which required…

  1. Pulmonary angiography: a safe procedure with modern contrast media and technique

    Energy Technology Data Exchange (ETDEWEB)

    Nilsson, T.; Maare, K. [Department of Radiology, Huddinge University Hospital, Huddinge (Sweden); Carlsson, A. [Department of Internal Medicine, Danderyd Hospital, Danderyd (Sweden)

    1998-02-01

    Pulmonary angiography (PA) for decades has been accepted as the gold standard for the diagnosis of pulmonary embolism (PE). Apprehensions that the procedure is expensive, invasive and thus associated with both fatal and non-fatal complications has more or less limited its use to patients presenting a non-diagnostic lung scan. However, this opinion originates from earlier studies. Increasing clinical demands for faster and safer diagnostics, together with improved techniques and safer contrast media, has led to an increased use of PA. In order to evaluate the complication rate, we retrospectively studied the case records of 707 consecutive patients who had undergone PA. During 1990-1994, 728 patients underwent PA at Danderyd and Huddinge University Hospital. Selective pulmonary angiography (cine or digital subtraction angiography), non-ionic, low-osmolar contrast media and modern pigtail catheters were used. Standard volumes were 40 ml at 2 s for each injection. Pressure measurements were made in 376 patients. A test injection was made in all patients in order to assess the flow rate. Experienced radiologists as well as residents performed the examinations and a total of 707 angiography protocols and clinical records were available for review in search of complications associated with the procedure. No deaths occurred. One major non-fatal complication (bleeding in the groin requiring surgery) was reported in one case. Moderate/minor complications (i. e. transient angina and cardiac failure, minor haematomas, urticaria) occurred in 10 patients (1.4 %). With modern contrast media and technique, pulmonary angiography is a safe procedure. (orig.) 19 refs.

  2. Arthroscopic Latarjet and Capsular Shift (ALCS) procedure: a new "freehand" technique for anterior shoulder instability associated with significant bone defects.

    Science.gov (United States)

    Bhatia, Deepak N

    2015-03-01

    Anterior shoulder instability associated with significant bone loss has been described as "bony-instability," and this condition is usually treated with an anterior glenoid bone grafting procedure (Latarjet procedure). The Latarjet procedure involves transfer of the horizontal limb of the coracoid process along with the conjoint tendon to the anterior glenoid rim, and is traditionally performed as an open surgical procedure. Recently, an arthroscopic technique for the Latarjet procedure has been described; the technique necessitates the use of specialized instrumentation and involves excision of the entire anterior capsule to facilitate coracoid fixation. We describe a new "freehand" arthroscopic technique for the Latarjet procedure, and, in addition, a simultaneous capsular shift to further optimize mid and end range stability. This technique eliminates the use of additional instrumentation and can be done using routine arthroscopic instruments. Preliminary experience with this technique suggests that the arthroscopic Latarjet and capsular shift is a technically demanding procedure. Glenohumeral capsule can be preserved, and this should be attempted wherever possible to optimize stability. Additional specialized instrumentation would probably reduce surgical time; however, the procedure can be performed with routine instruments.

  3. Dragging technique versus blanching technique for endometrial ablation with the Nd:YAG laser in the treatment of chronic menorrhagia.

    Science.gov (United States)

    Lomano, J M

    1988-07-01

    Endometrial ablation performed with the Nd:YAG laser was developed to treat patients with chronic menorrhagia as an alternative to hysterectomy. The original dragging technique may result in an obscured operating field and fluid overload. This study compares results of endometrial ablation performed in 62 patients. The first 17 procedures were performed by use of the dragging technique; the last 45 procedures were performed with a blanching technique. Both procedures were performed at the same institution and by the same surgeon. Sixty-five percent of patients undergoing the blanching technique became amenorrheic after the procedure versus 12% of those undergoing the dragging technique. Moreover, the blanching technique required less time, fewer joules of energy, and resulted in less fluid absorption by the patient. The blanching technique is apparently more effective, easier to accomplish, and safer for the patient than the dragging technique.

  4. ARTHROSCOPIC TREATMENT OF ACROMIOCLAVICULAR JOINT DISLOCATION BY TIGHT ROPE TECHNIQUE (ARTHREX®)

    Science.gov (United States)

    GÓmez Vieira, Luis Alfredo; Visco, Adalberto; Daneu Fernandes, Luis Filipe; GÓmez Cordero, Nicolas Gerardo

    2015-01-01

    Presenting the arthroscopic treatment by Tight Rope - Arthrex® system for acute acromioclavicular dislocation and to evaluate results obtained with this procedure. Methods: Between August 2006 and May 2007, 10 shoulders of 10 patients with acute acromioclavicular dislocation were submitted to arthroscopic repair using the Tight Rope - Arthrex® system. Minimum follow-up was 12 months, with a mean of 15 months. Age ranged from 26 to 42, mean 34 years. All patients were male. Radiology evaluation was made by trauma series x-ray. The patients were assisted in the first month weekly and after three months after the procedure. Clinical evaluation was based on the University of California at Los Angeles (UCLA) criteria. Results: All patients were satisfied after the arthroscopic procedure and the mean UCLA score was 32,5. Conclusion: The arthroscopic treatment by Tight Rope – Arthrex® system for acute acromioclavicular dislocation showed to be an efficient technique. PMID:26998453

  5. Comparison between two perineal procedures for treatment of rectal prolaps

    Directory of Open Access Journals (Sweden)

    Ahmed Mohamed Abozid, Nabila Mohamed A. Shams, , Yahia Hassan

    2001-09-01

    Full Text Available The optimal surgical procedures for the management of rectal prolapse is still under debate so comparison between two operations were done in our series. Eighteen patients with complete rectal prolaps were treated surgically through the perineum they were divided into two groups. First group were treated by recto-segmoidectomy and levatroplasty to fortify the pelvic floor, the second group were treated by rectopexy using prolene mesh and levetroplasty to fortify the pelvic floor, the mesh was inserted between the rectum and sacrum and fixed through perineal incision. The recurrence rate !""#$$!%$ &significant difference in hospital stay among both groups. Also there were no other cases of postoperative complications such as anastomotic leak or stricture, affection of the bladder dysfunction in both groups. Aim of work The aim of this work was to compare the short-term outcome of two different perineal operative procedures in patients with full thickness rectal prolaps.

  6. Minimally invasive surgical procedures for the treatment of lumbar disc herniation

    Directory of Open Access Journals (Sweden)

    Raspe, Heiner

    2005-11-01

    Full Text Available Introduction: In up to 30% of patients undergoing lumbar disc surgery for herniated or protruded discs outcomes are judged unfavourable. Over the last decades this problem has stimulated the development of a number of minimally-invasive operative procedures. The aim is to relieve pressure from compromised nerve roots by mechanically removing, dissolving or evaporating disc material while leaving bony structures and surrounding tissues as intact as possible. In Germany, there is hardly any utilisation data for these new procedures – data files from the statutory health insurances demonstrate that about 5% of all lumbar disc surgeries are performed using minimally-invasive techniques. Their real proportion is thought to be much higher because many procedures are offered by private hospitals and surgeries and are paid by private health insurers or patients themselves. So far no comprehensive assessment comparing efficacy, safety, effectiveness and cost-effectiveness of minimally-invasive lumbar disc surgery to standard procedures (microdiscectomy, open discectomy which could serve as a basis for coverage decisions, has been published in Germany. Objective: Against this background the aim of the following assessment is: * Based on published scientific literature assess safety, efficacy and effectiveness of minimally-invasive lumbar disc surgery compared to standard procedures. * To identify and critically appraise studies comparing costs and cost-effectiveness of minimally-invasive procedures to that of standard procedures. * If necessary identify research and evaluation needs and point out regulative needs within the German health care system. The assessment focusses on procedures that are used in elective lumbar disc surgery as alternative treatment options to microdiscectomy or open discectomy. Chemonucleolysis, percutaneous manual discectomy, automated percutaneous lumbar discectomy, laserdiscectomy and endoscopic procedures accessing the disc

  7. Minimally invasive surgical procedures for the treatment of lumbar disc herniation

    Science.gov (United States)

    Lühmann, Dagmar; Burkhardt-Hammer, Tatjana; Borowski, Cathleen; Raspe, Heiner

    2005-01-01

    Introduction In up to 30% of patients undergoing lumbar disc surgery for herniated or protruded discs outcomes are judged unfavourable. Over the last decades this problem has stimulated the development of a number of minimally-invasive operative procedures. The aim is to relieve pressure from compromised nerve roots by mechanically removing, dissolving or evaporating disc material while leaving bony structures and surrounding tissues as intact as possible. In Germany, there is hardly any utilisation data for these new procedures – data files from the statutory health insurances demonstrate that about 5% of all lumbar disc surgeries are performed using minimally-invasive techniques. Their real proportion is thought to be much higher because many procedures are offered by private hospitals and surgeries and are paid by private health insurers or patients themselves. So far no comprehensive assessment comparing efficacy, safety, effectiveness and cost-effectiveness of minimally-invasive lumbar disc surgery to standard procedures (microdiscectomy, open discectomy) which could serve as a basis for coverage decisions, has been published in Germany. Objective Against this background the aim of the following assessment is: Based on published scientific literature assess safety, efficacy and effectiveness of minimally-invasive lumbar disc surgery compared to standard procedures. To identify and critically appraise studies comparing costs and cost-effectiveness of minimally-invasive procedures to that of standard procedures. If necessary identify research and evaluation needs and point out regulative needs within the German health care system. The assessment focusses on procedures that are used in elective lumbar disc surgery as alternative treatment options to microdiscectomy or open discectomy. Chemonucleolysis, percutaneous manual discectomy, automated percutaneous lumbar discectomy, laserdiscectomy and endoscopic procedures accessing the disc by a posterolateral or

  8. Endovascular treatment of traumatic carotid cavernous fistula with trapping technique

    Directory of Open Access Journals (Sweden)

    Benny Young

    2013-08-01

    Full Text Available Conventional endovascular treatment for carotid cavernous fistula (CCF involves a direct delivery of either coils, detachable balloon or both to the fistula with end point of CCF resolution and carotid artery preservation. But in few cases with severe laceration of carotid artery, the feasible endovascular technique applicable is by blocking the filling of fistula from cerebral circulation. This method known as trapping technique which implicates carotid artery occlusion, was performed in our present case with good result. (Med J Indones. 2013;22:178-82. doi: 10.13181/mji.v22i3.588Keywords: Carotid cavernous fistula (CCF, carotid occlusion, trapping technique

  9. Percutaneous left atrial appendage closure: procedural techniques and outcomes.

    Science.gov (United States)

    Saw, Jacqueline; Lempereur, Mathieu

    2014-11-01

    Percutaneous left atrial appendage closure technology for stroke prevention in patients with atrial fibrillation has significantly advanced in the past 2 decades. Several devices are under clinical investigation, and a few have already received Conformité Européene (CE)-mark approval and are available in many countries. The WATCHMAN device (Boston Scientific, Natick, Massachusetts) has the most supportive data and is under evaluation by the U.S. Food and Drug Administration for warfarin-eligible patients. The Amplatzer Cardiac Plug (St. Jude Medical, Plymouth, Minnesota) has a large real-world experience over the past 5 years, and a randomized trial comparing Amplatzer Cardiac Plug with the WATCHMAN device is anticipated in the near future. The Lariat procedure (SentreHEART Inc., Redwood City, California) has also gained interest lately, but early studies were concerning for high rates of serious pericardial effusion and major bleeding. The current real-world experience predominantly involves patients who are not long-term anticoagulation candidates or who are perceived to have high bleeding risks. This pattern of practice is expected to change when the U.S. Food and Drug Administration approves the WATCHMAN device for warfarin-eligible patients. This paper reviews in depth the procedural techniques, safety, and outcomes of the current leading devices. Copyright © 2014 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  10. Radiofrequency ablation of chondroblastoma: procedure technique, clinical and MR imaging follow up of four cases

    Energy Technology Data Exchange (ETDEWEB)

    Christie-Large, M.; Evans, N.; Davies, A.M.; James, S.L.J. [Royal Orthopaedic Hospital Foundation Trust, Department of Radiology, Birmingham (United Kingdom)

    2008-11-15

    The aim of this study is to describe the procedure technique, clinical and imaging outcomes of patients treated with radiofrequency ablation for chondroblastoma. Four patients (female/male, 3:1; mean age, 13 years; age range; 9-16 years) underwent the procedure. All had pre-operative magnetic resonance imaging (MRI) and symptomatic, biopsy-proven chondroblastomas (two proximal femur, two proximal tibia). The lesion size ranged from 1.5 to 2.5 cm in maximal dimension (mean size, 1.8 cm). Bone access was gained with a Bonopty biopsy needle system (mean number of radiofrequency needle placements, 5; mean ablation time, 31 min). Clinical and MRI follow-up was available in all cases (mean, 12.25 months; range, 5-18 months). All patients reported resolution of symptoms at 2-6 weeks post ablation. At their most recent clinical follow-up, three patients remained completely asymptomatic with full return to normal activities and one patient had minor local discomfort (different pain pattern) that was not limiting activity. All four patients' follow-up MRI studies demonstrated resolution of the oedema pattern around the lesion and temporal evolution of the internal signal characteristics with fatty replacement. Radiofrequency ablation for chondroblastoma provides an alternative to surgical curettage, and we have demonstrated both a clinical improvement in symptoms and the follow-up MRI appearances. (orig.)

  11. Treatment of petroleum-contaminated water resources: modern techniques

    Science.gov (United States)

    Pogharnitskaya, O. V.; Konovalov, V. V.; Dmitrieva, N. V.; Belozerova, D. S.; Strelnikova, A. B.

    2016-09-01

    The article deals with the issue of petroleum-contaminated water resources. The authors have analyzed the dynamics of oil spills, including the world's largest ones, and claimed the issue to be global. The modern methods of mitigating oil spill effects have been studied, as well as the modern techniques of water resource treatment. The particular attention is paid to peat sorbent production, which is considered a promising trend of petroleum- contaminated water treatment.

  12. Treatment of petroleum-contaminated water resources: modern techniques

    OpenAIRE

    Pozharnitskaya, Olga Vyacheslavovna; Konovalov, Vyacheslav Vasilievich; N. V. Dmitrieva; Belozerova, D. S.; Strelnikova, A. B.

    2016-01-01

    The article deals with the issue of petroleum-contaminated water resources. The authors have analyzed the dynamics of oil spills, including the world's largest ones, and claimed the issue to be global. The modern methods of mitigating oil spill effects have been studied, as well as the modern techniques of water resource treatment. The particular attention is paid to peat sorbent production, which is considered a promising trend of petroleum- contaminated water treatment.

  13. Efficacy of needle-placement technique in radiofrequency ablation for treatment of lumbar facet arthropathy

    Directory of Open Access Journals (Sweden)

    Loh JT

    2015-10-01

    Full Text Available Jeffrey T Loh,1 Andrea L Nicol,1 David Elashoff,2 F Michael Ferrante,1 1Department of Anesthesiology, David Geffen School of Medicine, 2Department of Biomathematics, University of California Los Angeles, Los Angeles, CA, USA Background: Many studies have assessed the efficacy of radiofrequency ablation to denervate the facet joint as an interventional means of treating axial low-back pain. In these studies, varying procedural techniques were utilized to ablate the nerves that innervate the facet joints. To date, no comparison studies have been performed to suggest superiority of one technique or even compare the prevalence of side effects and complications. Materials and methods: A retrospective chart review was performed on patients who underwent a lumbar facet denervation procedure. Each patient's chart was analyzed for treatment technique (early versus advanced Australian, preprocedural visual numeric scale (VNS score, postprocedural VNS score, duration of pain relief, and complications. Results: Pre- and postprocedural VNS scores and change in VNS score between the two groups showed no significant differences. Patient-reported benefit and duration of relief was greater in the advanced Australian technique group (P=0.012 and 0.022, respectively. The advanced Australian technique group demonstrated a significantly greater median duration of relief (4 months versus 1.5 months, P=0.022. Male sex and no pain-medication use at baseline were associated with decreased postablation VNS scores, while increasing age and higher preablation VNS scores were associated with increased postablation VNS scores. Despite increasing age being associated with increased postablation VNS scores, age and the advanced Australian technique were found to confer greater patient self-reported treatment benefit. Conclusion: The advanced Australian technique provides a significant benefit over the early Australian technique for the treatment of lumbar facet pain, both in

  14. The Per Oral Endoscopic Myotomy (POEM) technique: how many preclinical procedures are needed to master it?

    Science.gov (United States)

    Hernández Mondragón, Oscar Víctor; Rascón Martínez, Dulce Maria; Muñoz Bautista, Aracely; Altamirano Castañeda, Maria Lourdes; Blanco-Velasco, Gerardo; Blancas Valencia, Juan Manuel

    2015-01-01

    Background and study aim: Per oral endoscopic myotomy (POEM) is a complex technique used in achalasia. Preclinical training is essential but little is known about the number of procedures needed. The aim of this study was to determine the number of procedures required to master POEM in an animal model. Patients and methods: This prospective comparative study was conducted in two swine models at a single institution in Mexico City between November 2012 and October 2014: Group 1 (G1) = 30 ex vivo and Group 2 (G2) = 20 live swine models. POEM was mastered after finishing the five steps without complications. Time, characteristics, and complications were recorded. Velocity of tunnelization and myotomy (VTM) was determined. Ex vivo analysis was done in G1 immediately after finishing POEM and at day 30 in G2. Results: A total of 50 POEM were done in both groups (G1 = 30, G2 = 20). The mean times were 90.17 min (G1) and 89.50 min (G2) (P = 0.92). Myotomy was faster in G2 (21.10 vs 27.97 min; P = 0.009) with a slightly slower tunnelization (40.35 vs 41.13 min; P = 0.86). Myotomy was longer in G2 (9.25 vs 8.83 cm; P = 0.26). VTM between the groups was similar (G1 = 0.159 vs G2 = 0.157 cm/min; P = 0.925). Complications were: mucosotomy (G1 = 18 %, G2 = 8 %; P = 0.430), mediastinal perforation (G1 = 12 %, G2 = 8 %; P = 1.0), and perforation at the gastroesophageal junction (GEJ) level (G1 = 16 %, G2 = 4 %; P = 0.149). Seven models in G2 presented minor bleeding and there was one death not attributed to the procedure. Mastery was obtained after 26 cases. Conclusions: We suggest that centers interested in learning POEM consider 26 procedures in animal models to master it before performing it in patients with achalasia. PMID:26716112

  15. Treatment of recalcitrant warts with the carbon dioxide laser using an excision technique.

    Science.gov (United States)

    Oni, Georgette; Mahaffey, Peter J

    2011-10-01

    Recalcitrant warts remain a challenging problem to treat, with considerable morbidity for patients. Our technique uses the carbon dioxide (CO2) laser as a bloodless scalpel to excise and treat recalcitrant warts. This paper reviews the results of patients with recalcitrant warts treated by the senior author using this technique. A retrospective case note review and questionnaire-based survey of patients treated by this technique. Seventy-one recalcitrant warts treated in 22 patients, all as day case procedures. A total of 54.5% of patients had complete remission after one treatment and the average length of follow-up was 71.5 months. Recurrence occurred on average 5.29 months following treatment. Of those patients, 90% were successfully retreated, giving an overall rate of 95.5%. In total, 46.7% of patients were left with scarring, but all felt this was acceptable given the benefits of the treatment, and 80.0% of patients would have the procedure again. Four patients had spontaneous regression of warts at other body sites not treated with the CO2 laser. This study illustrates the efficacy of our technique with a favourable outcome comparable to published studies. Recurrence occurred within 12 months; therefore, we would recommend this as a minimum follow-up period. In addition, the disappearance of warts at distant sites suggests that the effects of the CO2 laser therapy modulate the immune system, thereby extending it beyond simple excision or ablation.

  16. Technical Description of the Use of Selective Perfusion Techniques During the Norwood Procedure for Hypoplastic Left Heart Syndrome

    Science.gov (United States)

    Chabot, David Leonard; Polimenakos, Anastasios C.

    2011-01-01

    Abstract: Since the introduction of the Norwood procedure for surgical palliation of hypoplastic left heart syndrome in 1983, refinements have been made to the original procedure to improve patient outcomes while still accomplishing the original goals of the procedure. One of these refinements has been the introduction of regional selective perfusion to limit the duration of circulatory arrest times and optimize the regional flow distribution. In this paper we describe our technique for performing selective cerebral and lower body perfusion during the Norwood procedure. PMID:22416608

  17. Treatment of 58 Cases of Tonsillitis by Pricking Technique

    Institute of Scientific and Technical Information of China (English)

    SUN Yu; ZHANG Zhi-gang; MIAO Hong; LI Wei; HUANG Guo-qi

    2003-01-01

    Ashi point (tonsil) in combination of the pricking and bleeding technique on Shaoshang (LU 11 )and Shangyang (LI 1) were used to treat 58 outpatients of acute tonsillitis. The results showed cure in 38 cases,remarkable effect in 17 cases and failure in 3 cases by one treatment, and the total effective rate in 95%.

  18. J-tube technique for double-j stent insertion during laparoscopic upper urinary tract surgical procedures.

    Science.gov (United States)

    Kim, Hyung Suk; Lee, Byung Ki; Jung, Jin-Woo; Lee, Jung Keun; Byun, Seok-Soo; Lee, Sang Eun; Jeong, Chang Wook

    2014-11-01

    Double-J stent insertion has been generally performed during laparoscopic upper urinary tract (UUT) surgical procedures to prevent transient urinary tract obstruction and postoperative flank pain from ureteral edema and blood clots. Several restrictive conditions that make this procedure difficult and time consuming, however, include the coiled distal ends of the flexible Double-J stent and the limited bending angle of the laparoscopic instruments. To overcome these limitations, we devised a Double-J stent insertion method using the new J-tube technique. Between July 2011 and May 2013, Double-J stents were inserted using the J-tube technique in 33 patients who underwent a laparoscopic UUT surgical procedure by a single surgeon. The mean stent placement time was 4.8±2.7 minutes, and there were no intraoperative complications. In conclusion, the J-tube technique is a safe and time-saving method for Double-J stent insertion during laparoscopic surgical procedures.

  19. Microelectrode-guided Technique for Treatment of Parkinson's Diseases

    Institute of Scientific and Technical Information of China (English)

    陈坚; 杨正明; 郭东生; 牛洪泉

    2002-01-01

    From May, 2000 to June, 2001, 27 patients with Parkinson disease (PD), including 10cases of rigidity, 13 cases of tremor, 4 cases of rigidity and tremor, were treated by microelectrodeguided technique. Among them, phlebotomy was carried out in 17 cases and thalamotomy in 10 cases. All the targets of lesion were anatomically located by using MR and neurophysiological signals on microelectrode. Our results showed that the efficiency of microelectrode-guided technique for treatment of PD was 98 %. The postoperative unified parkinson disease rating scale were 12.3+ 9.1 and 13. 2± 8. 9 respectively, which significantly improved as compared with those before operation. It was concluded that by recognizing special electrical signals in neurons microelectrode-guided neuropsychological techniques can locate target at cellular level, which overcomes the individual difference in anatomy and function, and allow more accuracy, safety and efficiency of operation. This is especially true of PD patients who fail to respond to medical treatment.

  20. Treatment procedures and referral patterns of general dentists in Lithuania

    Directory of Open Access Journals (Sweden)

    Vilija Berlin

    2015-11-01

    Conclusions: There is a clear need for Lithuanian dental practitioners to refer patients to all types of dental specialists. Undergraduate dental education program and postgraduate training should be more directed toward the extraction of teeth and roots, treatment of young children and provision of dental prostheses to patients.

  1. Complicated Crown-Root Fracture Treated Using Reattachment Procedure: A Single Visit Technique

    Directory of Open Access Journals (Sweden)

    Akhil Rajput

    2011-01-01

    Full Text Available Complicated crown-root fracture of maxillary central and lateral incisors is common in case of severe trauma or sports-related injury. It happens because of their anterior positioning in oral cavity and protrusive eruptive pattern. On their first dental visit, these patients are in pain and need emergency care. Because of impaired function, esthetics, and phonetics, such patients are quite apprehensive during their emergency visit. Successful pain management with immediate restoration of function, esthetics and phonetics should be the prime objective while handling such cases. This paper describes immediate treatment of oblique crown root fracture of maxillary right lateral incisor with reattachment procedure using light transmitting fiber post. After two and half years, the reattached fragment still has satisfying esthetics and excellent function.

  2. The Darrach procedure defended: technique redefined and long-term follow-up.

    Science.gov (United States)

    Tulipan, D J; Eaton, R G; Eberhart, R E

    1991-05-01

    Thirty-three patients with pain and decreased range of motion after traumatic derangement of the distal radioulnar and ulna-carpal joint were treated with a modified Darrach distal ulnar resection. Their ages ranged from 22 to 75 years (average, 50 years). Twenty-seven patients had Colles' or other distal radius fractures. Seven patients had ulnar resection for treatment of distal ulnar-carpal derangement. Follow-up averaged 54.4 months. The patients showed an average increase in extension of 58% and flexion increased by 40% (p less than 0.01). Pronation increased by 40% and supination increased by 60% (p less than 0.01). Average grip strength increased by 38% (p less than 0.05). Ninety-one percent good or excellent results were achieved with this procedure. The Darrach resection can predictably provide pain relief while improving strength and motion when attention is paid to minimal bony resection and meticulous soft tissue reconstruction.

  3. Evaluation of Patient Perceptions After Vestibuloplasty Procedure: A Comparison of Diode Laser and Scalpel Techniques.

    Science.gov (United States)

    Kalakonda, Butchibabu; Farista, Sana; Koppolu, Pradeep; Baroudi, Kusai; Uppada, Udaykiran; Mishra, Ashank; Savarimath, Abhishek; Lingam, Amara Swapna

    2016-05-01

    Inadequate vestibular depth results in poor plaque control owing to an insufficient width of keratinized gingiva. Vestibuloplasty provides the necessary vestibular depth and can be performed either with a scalpel, electrocautery or lasers. To evaluate the patient perceptions related to pain and discomfort on the 1(st), 3(rd) and the 7(th) day post vestibuloplasty and also assess the healing outcomes related to the treatment of inadequate vestibular depth either with the diode laser or the scalpel. Twenty patients who had inadequate vestibular depth and required vestibuloplasty were assigned randomly to undergo the procedure either with the scalpel or the laser. The data obtained was analysed for intergroup comparison with an independent paired t-test and intragroup comparison was determined by a paired t-test. Intragroup comparison within the laser group for VAS scores of pain and discomfort within all the reported days exhibited a significant difference (pvestibuloplasty performed with the scalpel.

  4. Effect of precipitation procedure and detection technique on particle size distribution of CaCO 3

    Science.gov (United States)

    Martos, C.; Coto, B.; Peña, J. L.; Rodríguez, R.; Merino-Garcia, D.; Pastor, G.

    2010-09-01

    The deposition of inorganic salts ("scales") such as calcium carbonate is an important flow assurance problem during crude oil production. The knowledge of the features of the precipitated solids, mainly the particle size and morphology, is crucial to understand the nature of the solids and to avoid or reduce the effect of their deposition. For instance, the use of additives is one of the most usual procedures to mitigate this problem. Additives interact with scale-forming substances either by increasing the induction time, or by inhibiting crystal growth, changing the morphology of solids. In this work, CaCO 3 was precipitated by two different experimental methods: by mixing sodium carbonate and calcium chloride at 25 °C (method 1), and by changing the pH (method 2). Precipitated solids were analyzed by means of the following techniques: laser diffraction (LD), focused-beam reflectance measurement (FBRM), scanning electron microscopy (SEM), and X-ray diffraction (XRD), in order to select a method for the determination of particle size of solids similar to scales, in order to study these deposits at the beginning of their formation and to evaluate the effect of additives in the scales particle size. Results were compared to those of scale deposits extracted from crude oil pipelines. SEM and XRD characterization showed that both the precipitation methods lead to calcium carbonate as a mixture of calcite, aragonite and vaterite, with rhombohedral morphology for method 1 and spherical for method 2. The effects of temperature, kinetics and Mg 2+ presence in the morphology of CaCO 3 were evaluated. Thus, the solids obtained by static bottle test and real scales are mainly formed by long needle-shaped aragonite. The comparison of the several particle size characterization methods determinates that an LD is a fast and sensitive technique for spherical and non-spherical solids, and it is a convenient technique for the analysis of scales extracted from oil pipelines.

  5. Slightly modified technique of the original essed plication procedure for congenital penile deviation

    Directory of Open Access Journals (Sweden)

    C Van Der Horst

    2003-08-01

    Full Text Available PURPOSE: The Schroeder-Essed plication procedure is a standard technique for the correction of penile curvature. In a retrospective analysis we compared functional results and quality of life (LQ of the original technique with inverted sutures as described by Schroeder-Essed and our slight modification consisting of horizontal incisions into the tunica albuginea. MATERIALS AND METHODS: Twenty-six patients with congenital penis deviation were treated for penile deviation by the original Schroeder-Essed plication with inverted sutures (11 patients and by the described modification (15 patients. In case of modified technique, horizontal and parallel incisions 4 mm to 6 mm apart and about 8 mm - 10 mm long were made through the tunica albuginea. The outer edges of the incisions were then approximated with permanent inverted sutures (Gore-Tex® 3-0. Mean age was 21.6 years in the first group and 23.2 years in the second group. Average follow-up was 28 months and 13 months, respectively. The preoperative penile deviation angle was > 25º in all patients without difference between the 2 groups. RESULTS: All patients in both groups reported an improvement in their quality of life and full ability to engage in sexual intercourse. Nine patients (88% in the first group and 14 patients (93% in the second group were satisfied with the cosmetic result. In contrast, 10 patients (91% of the first and 13 patients (87% of the second group complained of penile shorting. Recurrence of deviation was only noticed in 2 males in the first group (18%. CONCLUSIONS: Our results indicate that this simple modification of the Schroeder-Essed plication offers good functional and cosmetic results. Most patients were satisfied with the penile angle correction results.

  6. Percutaneous treatment of insufficiency fractures. Principles, technique and review of literature

    Energy Technology Data Exchange (ETDEWEB)

    Beall, Douglas P. [University of Oklahoma Health Science Center, Oklahoma City, OK (United States); Clinical Radiology of Oklahoma, Edmond, OK (United States); Oklahoma City, OK (United States); Datir, Abhijit [Royal National Orthopaedic Hospital, Department of Radiology, Middlesex (United Kingdom); D' Souza, Sharon L.; D' Souza, Logan S.; Gunda, Divya; Morelli, John; Johnson, Michael Brandon; Nabavizadeh, Nima [University of Oklahoma Health Science Center, Oklahoma City, OK (United States)

    2010-02-15

    Insufficiency fractures of the pelvis, sacrum, spine, and long bones are painful, debilitating, and are common consequences of osteoporosis. Conventional treatment for these fractures varies from conservative therapy to surgery with plate and screw fixation. The former fails to address the underlying problem of fracture and frequently does not alleviate symptoms, while the latter is invasive and not always possible in older populations with low bone density and numerous co-morbidities. Osseous augmentation with polymethylmethacrylate (PMMA) has been used for over two decades to treat fractures related to osteoporosis, but has not been commonly used to treat fractures outside of the vertebral bodies. Osseous augmentation with PMMA is an image-guided procedure and various techniques have been utilized to treat fracture in different locations. We describe various techniques for image-guided osseous augmentation and treatment of insufficiency fractures with bothPMMA and allograft bone for fractures of the pelvis including sacrum, acetabulum, pubic symphysis, pubic rami ilium; appendicular skeleton including distal radius, proximal femur, and vertebral body. We also describe the potential risks and complications associated with percutaneous treatment of insufficiency fractures and techniques to avoid the pitfalls of the various procedures. We will present the process for patient follow-up and data regarding the pre- and postprocedure pain response in patients undergoing treatment for pelvic insufficiency fractures. (orig.)

  7. Treatment of MSW fly ashes using the electrodialytic remediation technique

    DEFF Research Database (Denmark)

    Ferreira, Celia; Ribeiro, Alexandra B.; Ottosen, Lisbeth M.

    2004-01-01

    In the present work the electrodialytic remediation technique is applied for the treatment of fly ash, a hazardous by-product resulting from the incineration of municipal solid waste. Results are presented for an experiment conducted for 40 days at 38 mA, with a continuously stirred cell...... extraction tests and during the electrodialytic treatment. This substance was found to perform well for pH below 6 and above 9, although extractions are better in the acidic region. Other relevant observations include the retention of significant amounts of heavy metals on the cation-exchange membrane...... separating chambers III and IV and the dissolution of a large percentage of sample during the treatment. 39% of zinc, 14% of lead, 18% of copper and 60% of cadmium were removed from fly ash using the electrodialytic technique and these results are compared with previously reported experiments on similar...

  8. Treatment of ingrown toenails using a new conservative method: a prospective study comparing brace treatment with Emmert's procedure.

    Science.gov (United States)

    Harrer, Jörg; Schöffl, Volker; Hohenberger, Werner; Schneider, Ignaz

    2005-01-01

    Ingrown toenails cause incapacitation and pain for the patient and lost time from work. Many different conservative and surgical treatment methods have been described. European chiropodists and podologists have long treated ingrown toenails with orthonyxia, which consists of implantation of a small metal brace or plate onto the dorsum of the nail. To determine whether orthonyxia is an acceptable alternative to surgery, we compared the VHO-Osthold brace (VHO-Osthold-Spange GmbH, Deisenhofen, Germany), a new method of orthonyxia, with Emmert's procedure, a standard surgical method that is virtually identical to the Winograd-type procedure, in a prospective study of 41 patients (21 in the brace group and 20 in the Emmert procedure group). Pain due to treatment was significantly lower in the brace group than in the Emmert procedure group, and patients in the brace group could wear regular shoes again without appreciable pain much earlier than those in the Emmert procedure group. In the brace group, there were four recurrences, and one patient was still receiving treatment at the end of follow-up; in the Emmert procedure group, there were three recurrences. None of the patients in the brace group had to take time off from work, whereas in the Emmert procedure group, working patients were off from work for an average of 14.7 days. Brace treatment proved to be a good conservative alternative to operative procedures.

  9. Skin Treatments and Dermatological Procedures to Promote Youthful Skin

    OpenAIRE

    Sator, Paul G

    2006-01-01

    The skin, the largest organ of the body, is the organ in which changes associated with aging are most visible. With increasing frequency, patients are requesting information and treatments that improve the appearance of their skin. Corresponding to this trend, there is an increasing number of products and methods available that claim to aid this pursuit. First, a change of the patient's lifestyle (eg, sun behavior, nicotine abuse, and nutrition) must take place. Only then may other methods be...

  10. Surgical techniques for the treatment of ankyloglossia in children: a case series.

    Science.gov (United States)

    Junqueira, Marina Azevedo; Cunha, Nayara Nery Oliveira; Costa e Silva, Lidiane Lucas; Araújo, Leandro Borges; Moretti, Ana Beatriz Silveira; Couto Filho, Carlos Eduardo Gomes; Sakai, Vivien Thiemy

    2014-06-01

    This paper reports a series of clinical cases of ankyloglossia in children, which were approached by different techniques: frenotomy and frenectomy with the use of one hemostat, two hemostats, a groove director or laser. Information on the indications, contraindications, advantages and disadvantages of the techniques was also presented. Children diagnosed with ankyloglossia were subjected to different surgical procedures. The choice of the techniques was based on the age of the patient, length of the frenulum and availability of the instruments and equipment. All the techniques presented are successful for the treatment of ankyloglossia and require a skilled professional. Laser may be considered a simple and safe alternative for children while reducing the amount of local anesthetics needed, the bleeding and the chances of infection, swelling and discomfort.

  11. Surgical techniques for the treatment of ankyloglossia in children: a case series

    Directory of Open Access Journals (Sweden)

    Marina Azevedo JUNQUEIRA

    2014-06-01

    Full Text Available This paper reports a series of clinical cases of ankyloglossia in children, which were approached by different techniques: frenotomy and frenectomy with the use of one hemostat, two hemostats, a groove director or laser. Information on the indications, contraindications, advantages and disadvantages of the techniques was also presented. Children diagnosed with ankyloglossia were subjected to different surgical procedures. The choice of the techniques was based on the age of the patient, length of the frenulum and availability of the instruments and equipment. All the techniques presented are successful for the treatment of ankyloglossia and require a skilled professional. Laser may be considered a simple and safe alternative for children while reducing the amount of local anesthetics needed, the bleeding and the chances of infection, swelling and discomfort.

  12. Development of dose audits for complex treatment techniques in radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Stefanic, A. M.; Molina, L.; Vallejos, M.; Montano, G.; Zaretzky, A.; Saravi, M., E-mail: stefanic@cae.cnea.gov.ar [Centro Regional de Referencia con Patrones Secundarios para Dosimetria - CNEA, Presbitero Juan Gonzalez y Aragon 15, B1802AYA Ezeiza (Argentina)

    2014-08-15

    This work was performed in the frame of a Coordinated Research Project (CRP) with IAEA whose objective was to extend the scope of activities carried out by national TLD-based networks from dosimetry audit for rectangular radiation fields to irregular and small fields relevant to modern radiotherapy. External audit is a crucial element in QA programmes for clinical dosimetry in radiotherapy, therefore a methodology and procedures were developed and were made available for dose measurement of complex radiotherapy parameters used for cancer treatment. There were three audit steps involved in this CRP: TLD based dosimetry for irregular MLC fields for conformal radiotherapy, dosimetry in the presence of heterogeneities and 2D MLC shaped fields relevant to stereotactic radiotherapy and applicable to dosimetry for IMRT. In addition, a new development of film-based 2D dosimetry for testing dose distributions in small field geometry was included. The plan for each audit step involved a pilot study and a trial audit run with a few local hospitals. The pilot study focused on conducting and evaluation of the audit procedures with all participants. The trial audit run was the running of the audit procedures by the participants to test them with a few local radiotherapy hospitals. This work intends to provide audits which are much nearer clinical practice than previous audits as they involve significant testing of Tps methods, as well as verifications to determinate whether hospitals can correctly calculate dose delivery in radiation treatments. (author)

  13. Treatment of pectus excavatum recurring after open surgery using Nuss procedure: A case report

    Directory of Open Access Journals (Sweden)

    Yucel Akkas

    2016-12-01

    Full Text Available We would like to report a 14-year-old male patient with pectus excavatum that recurred 10 years later after Ravitch surgery who was successfully operated using Nuss procedure. The patient underwent pectus excavatum surgery using Nuss procedure. The patient was discharged from the hospital at post-operative 5.day. The bar is planned to be removed in post-operative 3.year. In conclusion, surgery of pectus excavatum that recurred after open surgery is risky. Nuss procedure, which is a minimally-invasive technique, is a safe procedure that can be successfully applied in recurring cases due to short time of surgery and minimal blood loss.

  14. Laser tracheobronchoplasty: a novel technique for the treatment of symptomatic tracheobronchomalacia.

    Science.gov (United States)

    Castellanos, Paul; Mk, Manjunath; Atallah, Ihab

    2017-03-01

    The management of tracheobronchomalacia is a very challenging problem with few treatment options. This study aims to evaluate the outcomes of a novel surgical treatment for membranous tracheobronchomalacia. A consecutive series of patients with tracheobronchomalacia were treated with two to three holmium laser scarring surgeries of the hyperdynamic tracheal and bronchial walls for the purpose of stiffening them through fibrosis. Patients filled out a Dyspnea Index questionnaire before and after treatment. Ten patients were treated for their tracheobronchomalacia with a mean age of 54 years. Symptoms included severe dyspnea, dry cough, recurrent pulmonary infections, and respiratory failure. Fifty percent of patients presented with wheezing refractory to traditional treatment. Tracheobronchomalacia was associated with gastroesophageal reflux disease (n = 8), obstructive sleep apnea (n = 5), and tracheal stenosis (n = 3). Only 50 % of patients presented with morbid obesity. All cases showed significant improvement of their respiratory symptoms with a mean postoperative difference of 22.3 out of a maximum impairment score of 40 (P < 0.01) on the Dyspnea Index. The mean number of procedures was 2.3 per patient with the average laser energy delivered per procedure of 1600 J. Laser tracheobronchoplasty is a safe, easy to adopt, and effective technique for the treatment of membranous tracheobronchomalacia. It presents a simple alternative to the commonly used procedures like endoluminal stenting and open tracheobronchoplasty.

  15. [Breast augmentation with autologous fat - experience of 96 procedures with the BEAULI-technique].

    Science.gov (United States)

    Münch, D P

    2013-04-01

    Over the past 30 years, interest in the use of autologous fat for aesthetic body contouring, especially for breast augmentation has been continuously on the rise. The benefits of an autologous fat transplant include the absence of any inflammatory reaction to a foreign body, its harmonious appearance and a natural feeling. In earlier years, complications such as necrosis, infections or the formation of cysts, poor resorption rates as well as the difficulty of harvesting large amounts of fat within a reasonable amount of time provided grounds for criticism of the methodology of autologous fat transplantation. With the advent of the so-called BEAULI method, since 2007 a procedure is available for the efficient harvesting and processing of larger quantities of transplantable fat. The aim of the study is to describe the technique in detail and reproducibly and to present a detailed overview of autologous fat transfer due to the basis of our own clinical experience. Between 1 September 2010 and 30 June 2012 the author performed 96 fat transfer procedures on 84 patients. Patients aged 18-60 with a desire for a moderate augmentation of volume and shape of the breasts were selected for the procedure. The fat was harvested using water jet-assisted liposuction (Bodyjet) to flush out the fat cells and subsequent separation of the fat components with the Lipo-Collector. There were no occurrences of post-operative complications in any of the cases. The results were evaluated in the context of a check-up, a photographic comparison and with the completion of a questionnaire. With regard to the increase in size and/or shape enhancement of the breasts, 31% of the patients were very happy with the results, 45% indicated they were satisfied, 23% would have liked more volume, while 1% were dissatisfied. This study indicates that the autologous fat transplant into the female breast using the BEAULI method represents an excellent, safe method for the achievement of a moderate and

  16. Abdominal aortic aneurysm: Treatment options, image visualizations and follow-up procedures

    Institute of Scientific and Technical Information of China (English)

    Zhong-Hua Sun

    2012-01-01

    Abdominal aortic aneurysm is a common vascular disease that affects elderly population.Open surgical repair is regarded as the gold standard technique for treatment of abdominal aortic aneurysm,however,endovaseular aneurysm repair has rapidly expanded since its first introduction in 1990s.As a less invasive technique,endovascular aneurysm repair has been confirmed to be an effective alternative to open surgical repair,especially in patients with co-morbid conditions.Computed tomography (CT) angiography is currently the preferred imaging modality for both preoperative planning and post-operative follow-up.2D CT images are complemented by a number of 3D reconstructions which enhance the diagnostic applications of CT angiography in both planning and follow-up of endovascular repair.CT has the disadvantage of high cummulative radiation dose,of particular concern in younger patients,since patients require regular imaging follow-ups after endovascular repair,thus,exposing patients to repeated radiation exposure for life.There is a trend to change from CT to ultrasound surveillance of endovascular aneurysm repair.Medical image visualizations demonstrate excellent morphological assessment of aneurysm and stent-grafts,but fail to provide hemodynamic changes caused by the complex stent-graft device that is implanted into the aorta.This article reviews the treatment options of abdominal aortic aneurysm,various image visualization tools,and follow-up procedures with use of different modalities including both imaging and computational fluid dynamics methods.Future directions to improve treatment outcomes in the follow-up of endovascular aneurysm repair are outlined.

  17. Parent caregiver self-efficacy and child reactions to pediatric cancer treatment procedures.

    Science.gov (United States)

    Peterson, Amy M; Harper, Felicity W K; Albrecht, Terrance L; Taub, Jeffrey W; Orom, Heather; Phipps, Sean; Penner, Louis A

    2014-01-01

    This study examined how parents' sense of self-efficacy specific to caregiving for their child during cancer treatment procedures affected children's distress and cooperation during procedures. Potential correlates of caregiver self-efficacy (ie, demographics, child clinical characteristics, parent dispositional attributes, and social support) were also examined. Participants were 119 children undergoing cancer treatment procedures and their parents. Parents' self-efficacy about 6 procedure-specific caregiver tasks was measured. Parents, children, nurses, and observers rated child distress and parents, nurses and observers rated child cooperation during procedures. Higher parent self-efficacy about keeping children calm during procedures predicted lower child distress and higher child cooperation during procedures. Parent dispositional attributes (eg, enduring positive mood, empathy) and social support predicted self-efficacy. Parent caregiver self-efficacy influences child distress and cooperation during procedures and is associated with certain parent attributes. Findings suggest the utility of identifying parents who would benefit from targeted interventions to increase self-efficacy about caregiving during treatment procedures.

  18. Development of Layered Treatment Technique for Multiple Heavy Oil Reservoirs

    Institute of Scientific and Technical Information of China (English)

    Hu Zhimian; Wu Dehua

    1995-01-01

    @@ In order to solve the problems that there is steam absorbing inhomogeneity in various layers of well in heavy oil reservoirs during steam injection, and upperlayers and high permeability layers repeat steam absorption, as well as middle or low permeability layers absorb little steam or no steam, we have studied and developed seperate-layer treatment techniques for huff and puff wells in recent years. By test and application,these techniques have been proved successful in increasing steam stimulated effect and recovery efficiency in the period of cyclic steam stimulations of oil wells in multilayer heavy oil reservoirs.

  19. Influence of polishing procedures on the surface roughness of dental ceramics made by different techniques.

    Science.gov (United States)

    Oliveira-Junior, Osmir Batista; Buso, Leonardo; Fujiy, Fábio Hiroshi; Lombardo, Geraldo Henrique Leao; Campos, Fernanda; Sarmento, Hugo Ramalho; Souza, Rodrigo Othavio Assuncao

    2013-01-01

    The aim of this study was to evaluate the influence of 2 different surface polishing procedures-glazing and manual polishing-on the roughness of ceramics processed by computer-aided design/computer-aided manufacturing (CAD/CAM) and conventional systems (stratification technique). Eighty ceramic discs (diameter: 8 mm, thickness: 1 mm) were prepared and divided among 8 groups (n = 10) according to the type of ceramic disc and polishing method: 4 GZ and 4 MP. Specimens were glazed according to each manufacturer's recommendations. Two silicone polishing points were used on the ceramic surface for manual polishing. Roughness was measured using a surface roughness tester. The roughness measurements were made along a distance of 2 mm on the sample surface and the speed of reading was 0.1 mm/s. Three measurements were taken for each sample. The data (μm) were statistically analyzed using analysis of variance (ANOVA) and Tukey's test (α = 0.05). Qualitative analysis was performed using scanning electron microscopy (SEM). The mean (± SD) roughness values obtained for GZ were: 1.1 ± 0.40 μm; 1.0 ± 0.31 μm; 1.6 ± 0.31 μm; and 2.2 ± 0.73 μm. For MP, the mean values were: 0.66 ± 0.13 μm; 0.43 ± 0.14 μm; 1.6 ± 0.55 μm; and 2.0 ± 0.63 μm. The mean roughness values were significantly affected by the ceramic type (P = 0.0001) and polishing technique (P = 0.0047). The SEM images confirmed the roughness data. The manually polished glass CAD/CAM ceramics promoted lower surface roughness than did the glazed feldspathic dental ceramics.

  20. Re-implant of the right coronary artery: a surgical technique for the treatment of ostial lesions

    Directory of Open Access Journals (Sweden)

    Bongiovani Hércules Lisboa

    2002-01-01

    Full Text Available Previously described surgical treatment for ostial coronary artery stenosis relied on either venous or arterial bypasses or ostial patch angioplasty. These surgical procedures are performed with bovine pericardium, saphenous vein or internal thoracic artery. We describe a technique of right coronary artery re-implantation into the aorta. The procedure was performed in four patients with right coronary artery ostial stenosis along with other left coronary artery lesions.

  1. Legal, ethical, and procedural bases for the use of aseptic techniques to implant electronic devices

    Science.gov (United States)

    Mulcahy, Daniel M.

    2013-01-01

    The popularity of implanting electronic devices such as transmitters and data loggers into captive and free-ranging animals has increased greatly in the past two decades. The devices have become smaller, more reliable, and more capable (Printz 2004; Wilson and Gifford 2005; Metcalfe et al. 2012). Compared with externally mounted devices, implanted devices are largely invisible to external viewers such as tourists and predators; exist in a physically protected, thermally stable environment in mammals and birds; and greatly reduce drag and risk of entanglement. An implanted animal does not outgrow its device or attachment method as can happen with collars and harnesses, which allows young animals to be more safely equipped. However, compared with mounting external devices, implantation requires greater technical ability to perform the necessary anesthesia, analgesia, and surgery. More than 83% of publications in the 1990s that used radiotelemetry on animals assumed that there were no adverse effects on the animal (Godfrey and Bryant 2003). It is likely that some studies using implanted electronic devices have not been published due to a high level of unexpected mortality or to aberrant behavior or disappearance of the implanted animals, a phenomenon known as the “file drawer” problem (Rosenthal 1979; Scargle 2000). The near absence of such studies from the published record may be providing a false sense of security that procedures being used are more innocuous than they actually are. Similarly, authors sometimes state that it was unlikely that device implantation was problematic because study animals appeared to behave normally, or authors state that previous investigators used the same technique and saw no problems. Such statements are suppositions if no supporting data are provided or if the animals were equipped because there was no other way to follow their activity. Moreover, such suppositions ignore other adverse effects that affect behavior indirectly, and

  2. Priority of surgical treatment techniques of full cartilage defects of knee joint

    Directory of Open Access Journals (Sweden)

    Андрій Вікторович Літовченко

    2015-10-01

    Full Text Available Aim. Surgical treatment of chondromalacia of knee joint cartilage is an actual problem of the modern orthopedics because the means of conservative therapy can be realized at an initial stage only and almost exhausted at the further ones. Imperfections of palliative surgical techniques are the short-term clinical effect and pathogenetic baselessness because surgical procedure is not directed on reparation of cartilaginous tissue. For today there are a lot of transplantation techniques that are used for biological renewal of articular surface with formation of hyaline or at least hyaline-like cartilage. The deep forage of cartilage defect bottom to the medullary canal is a perspective and priority technique.Methods. The results of treatment of 61 patients with chondromalacia of knee joint of 3-4 degree according to R. Outerbridge are the base of the work. 20 patients of every group underwent microfracturization of cartilage defect bottom and subchondral forage of defect zone. 21 patients underwent the deep forage of defect zone of knee joint according to an offered technique.Result. The results of treatment with microfracturization, subchondral forage and deep forage of defect zone indicate the more strong clinical effect especially in the last clinical group where good and satisfactory results ratios in the term of observation 18 and 24 month remain stable.Conclusions. Deep forage of cartilage defects zone is the most adequate reparative technique of the surgical treatment of local knee joint cartilage defects. Owing to this procedure the number of cells of reparative chondrogenesis predecessors is realized

  3. [Non-fusion techniques for treatment of pediatric scoliosis].

    Science.gov (United States)

    Ridderbusch, K; Rupprecht, M; Kunkel, P; Stücker, R

    2013-12-01

    The primary goal of treatment in children with early onset scoliosis (EOS) is to control the deformity and to allow spinal and chest wall growth to continue and improve pulmonary function. In skeletally immature children spondylodesis leads to fusion of the instrumented segments with associated nonsymmetrical growth and pulmonary insufficiency. Non-fusion, techniques such as growing rods, vertical expandable prosthetic titanium rib® (VEPTR) and staples have evolved over the past years. Each technique has its different spectrum of indications which the surgeon has to follow accurately to prevent the patient from developing complications. A new trend started by using magnetically controlled growing rods to avoid the need for anesthesia and open surgery during adaptive growth. The intention of this article is to give the reader a synopsis about the three most important non-fusion techniques based on own experience and the current literature.

  4. Water jet dissection in neurosurgery: an update after 208 procedures with special reference to surgical technique and complications.

    Science.gov (United States)

    Keiner, Doerthe; Gaab, Michael R; Backhaus, Vanessa; Piek, Juergen; Oertel, Joachim

    2010-12-01

    Water jet dissection represents a promising technique for precise brain tissue dissection with preservation of blood vessels. In the past, the water jet dissector has been used for various pathologies. A detailed report of the surgical technique is lacking. The authors present their results after 208 procedures with a special focus on surgical technique, intraoperative suitability, advantages, and disadvantages. Between March 1997 and April 2009, 208 patients with various intracranial neurosurgical pathologies were operated on with the water jet dissector. Handling of the device and its usefulness and extent of application were assessed. The pressures encountered, potential risks, and complications were documented. The patients were followed 1 to 24 months postoperatively. A detailed presentation of the surgical technique is given. Differences and limitations of the water jet dissection device in the various pathologies were evaluated. The water jet dissector was intensively used in 127 procedures (61.1%), intermittently used in 56 procedures (26.9%), and scarcely used in 25 procedures (12%). The device was considered to be very helpful in 166 procedures (79.8%) and helpful to some extent in 33 procedures (15.9%). In 8 (3.8%) procedures, it was not helpful, and in 1 procedure (0.5%), the usefulness was not documented by the surgeon. The water jet dissector can be applied easily and very safely. Precise tissue dissection with preservation of blood vessels and no greater risk of complications are possible. However, the clinical consequences of the described qualities need to be demonstrated in a randomized clinical trial.

  5. Chronic Generalized Parodontitis. Part II. Modern Treatment and Prevention Techniques

    OpenAIRE

    Lukinykh L.M.; Kruglova N.V.

    2011-01-01

    To optimize a therapeutic process due to technological development in dentistry there have appeared new progressive technologies that allow improving life quality of patients with periodontal inflammatory diseases. Modern techniques of a complex etiopathogenic treatment of periodontal inflammatory diseases including conservative, orthopedic, orthodontic and surgical measures have been presented. There has been proved the use of preparations of systemic and local effect to treat chronic ge...

  6. Primary effect of dual growing rod technique for the treatment of severe scoliosis in young children

    Institute of Scientific and Technical Information of China (English)

    LI Qi-yi; WENG Xi-sheng; ZHANG Jian-guo; QIU Gui-xing; WANG Yi-peng; SHEN Jian-xiong; ZHAO Yu; LI Shu-gang; YU Bin; WANG Xi

    2010-01-01

    Background Treatment of rapidly progressing scoliosis in young children is a challenge for spine surgeons. Some surgeons had begun to use dual growing rod technique for treatment of rapidly progressing scoliosis in young children and had achieved acceptable results. The aim of this study was to determine the primary results and complications of this new technique in China. Methods Eleven children suffering from rapidly progressing scoliosis were treated with dual growing rod technique between November 2004 and March 2009 at Peking Union Medical College Hospital (PUMCH). There were 10 females and 1 male in the group with Risser sign of 0 grade. The mean age at initial surgery was 6.1 years (range, 2.1-10.9 years). Ten patients were diagnosed as congenital scoliosis and 1 patient neuromuscular scoliosis. All the patients had 1-4 lengthening procedures (mean, 1.8 procedures) after the initial surgeries. The radiographic results of all the patients were investigated. Results The coronal Cobb angle of scoliosis improved from (67.64±11.43)° to (34.64±8.26)° after initial surgery with the correction rate observed at (47.15±16.48)%. The coronal trunk shift improved from (2.00±1.73) cm to (1.49±1.31) cm after initial surgery. The T1-S1 height increased from (25.47±6.16) cm to (28.84±5.69) cm after initial surgery. The coronal Cobb angle of scoliosis was (36.82±11.76)° and the coronal trunk shift was (1.11 ±1.29) cm after the most recent lengthening procedure with the most recent correction rate observed at (44.73±19.43)%. The T1-S1 height was (31.29±4.50) cm after the most recent lengthening procedure with an average T1-S1 length increase of 1.6 (range, 1.0-2.7) cm per year during the lengthening period. The sagittal balance was maintained. Five of the total patients (45.5%) had complications including: hook displacement, pedical screw loosening, and broken rod. We performed revision surgeries with simultaneous lengthening procedures in all 5 cases with

  7. Implementation of Treatment Integrity Procedures An Analysis of Outcome Studies of Youth Interventions Targeting Externalizing Behavioral Problems

    NARCIS (Netherlands)

    Goense, Pauline; Boendermaker, Leonieke; van Yperen, Tom; Stams, Geert-Jan; van Laar, Jose

    2014-01-01

    This systematic review evaluates the implementation of treatment integrity procedures in outcome studies of youth interventions targeting behavioral problems. The Implementation of Treatment Integrity Procedures Scale (ITIPS), developed by Perepletchikova, Treat, and Kazdin (2007), was adapted

  8. Implementation of treatment integrity procedures: an analysis of outcome studies of youth interventions targeting externalizing behavioral problems

    NARCIS (Netherlands)

    Goense, P.; Boendermaker, L.; van Yperen, T.; Stams, G.J.; van Laar, J.

    2014-01-01

    This systematic review evaluates the implementation of treatment integrity procedures in outcome studies of youth interventions targeting behavioral problems. The Implementation of Treatment Integrity Procedures Scale (ITIPS), developed by Perepletchikova, Treat, and Kazdin (2007), was adapted

  9. Combined treatment of conventional techniques and acupressure in laryngectomized patients

    Directory of Open Access Journals (Sweden)

    Leonor Mora Yero

    2015-07-01

    Full Text Available Background: the use of traditional medicine techniques, specifically acupressure, along with established techniques, is widely used in developed countries for the rehabilitation of the laryngectomized patients.Objective: to describe the effectiveness of the combination of conventional techniques and those using acupressure in laryngectomized patients seen at the department of speech and phoniatrics of Ernesto Guevara Hospital from January, 2013 to December, 2014.Methods: a quasi-experimental study was carried out on a sample of 24 patients who had undergone laryngectomy and presented voluntarily or were referred for voice rehabilitation in the period and place herein mentioned. The sample was divided into two groups of 12 each. The first group was treated by the conventional method and the second group was treated with a combination of the traditional method and acupressure.Results: in the group of patients that received a conventional treatment a 50 % achieved rehabilitation. In the group where conventional techniques were combined with acupressure, rehabilitation of a 91,6 % was achieved. No adverse effects were manifested.Conclusions: the unit of the conventional technique with acupressure reduced the time for the rehabilitation of patients and increased the number of patients rehabilitated.

  10. Surgical technique for treatment of recalcitrant adductor longus tendinopathy.

    Science.gov (United States)

    Gill, Thomas J; Carroll, Kaitlin M; Makani, Amun; Wall, Andrew J; Dumont, Guillaume D; Cohn, Randy M

    2014-04-01

    Chronic groin pain in the athlete can be a difficult problem to manage. Adductor dysfunction is the most common cause of groin pain in athletes, with the adductor longus being the tendon most commonly involved. The most reproducible finding for adductor longus tendinopathy is tenderness along the tendon with passive abduction and resisted hip adduction in extension. Magnetic resonance imaging and injection of a corticosteroid and anesthetic into the proximal muscle-tendon junction are both helpful in confirming the diagnosis. Nonoperative treatment may consist of protected weight bearing, ice application, ultrasonography, electrical stimulation, and gentle stretching with progressive strengthening. However, nonoperative management is not always successful. In these instances, surgical treatment can be quite effective. We present the indications, surgical technique, and rehabilitation protocol of adductor tenotomy for chronic tendinopathy. This can prove a useful tool for the treatment of recalcitrant groin pain attributable to the adductor longus.

  11. Randomized clinical trial comparing ultrasound-guided procedure with the Seldinger's technique for placement of implantable venous ports.

    Science.gov (United States)

    Miao, Jianzhong; Ji, Lijun; Lu, Jianjun; Chen, Jianqing

    2014-09-01

    The aim of this randomized controlled study was to compare ultrasound-guided procedure with the Seldinger's technique for placement of implantable venous ports. A total of 214 patients were randomized to receive TIAP placement by either ultrasound-guided procedure or the Seldinger's technique. Complications and pain perception were compared between these two groups. No severe perioperative or periinterventional complication occurred. Significantly (P venous thrombosis, fever of unknown origin, skin necrosis, and sepsis. In conclusion, both techniques, the TIAP implantation via ultrasound-guided jugular vein puncture and via Seldinger's technique subclavian vein puncture, are feasible and safe. Regarding intrainterventional pain perception and implantation-related complications, the jugular vein puncture under ultrasound guidance seems to be advantageous.

  12. Embryonic NOTES thoracic sympathectomy for palmar hyperhidrosis: results of a novel technique and comparison with the conventional VATS procedure.

    Science.gov (United States)

    Zhu, Li-Huan; Chen, Long; Yang, Shengsheng; Liu, Daoming; Zhang, Jixue; Cheng, Xianjin; Chen, Weisheng

    2013-11-01

    To avoid the disadvantages of chronic pain and chest wall paresthesia associated with video-assisted thoracic surgery (VATS) procedures, we developed a novel surgical technique for performing sympathectomy by embryonic natural orifice transumbilical endoscopic surgery (E-NOTES) with a flexible endoscope. In this study, we compared the outcomes of E-NOTES with conventional VATS thoracic sympathectomy on palmar hyperhidrosis. From January 2010 to April 2011, a total of 66 patients with severe palmar hyperhidrosis were treated with thoracic sympathectomy in our department. Thirty-four transumbilical thoracic sympathectomies were performed via a 5-mm umbilicus incision with ultrathin gastroscope, then compared with 32 conventional needlescopic thoracic sympathectomies. Retrospective statistical analysis of a prospectively collected group of patients was performed. There was no significant difference with regard to gender, mean age, body mass index, and length of hospital stay between the two groups. The operative time for E-NOTES thoracic sympathectomy was longer than that of VATS thoracic sympathectomy (56.4 ± 10.8 vs. 40.3 ± 6.5 min, p sympathectomy reported successful treatment of their palmar hyperhidrosis. Compensatory hyperhidrosis was noticed in 7 (20.1 %) and 6 (18.8 %) patients in the E-NOTES and VATS groups, respectively (p > 0.05). Postoperative pain and paresthesia were significantly reduced in the E-NOTES group at each time interval, and the aesthetic effect of the incision was superior in the E-NOTES group. Transumbilical-diaphragmatic thoracic sympathectomy is a safe and efficacious alternative to the conventional approach. This novel procedure can further reduce postoperative pain and chest wall paresthesia as well as afford maximum cosmetic benefits by hiding the surgical incision in the umbilicus.

  13. Reestablishment of second hepatic hilum: a new technique for the treatment of Budd-Chiari syndrome

    Institute of Scientific and Technical Information of China (English)

    杨建勇; 张翎; 余深平; 陈伟; 庄文权; 冯敢生; 梁惠民

    2003-01-01

    Objective To assess a new intervention for reestablishing the second hepatic hilum by means of puncturing and stenting the liver tissue between the intrahepatic vena cava and a hepatic vein for the treatment of Budd-Chiari syndrome (BCS).Methods Two patients with BCS, in which no second hepatic hilum structure was found in transhepatic venography, underwent an interventional procedure of canalizing and stenting the parenchyma tract between the intrahepatic vena cava and a hepatic vein. The procedures were performed in the percutaneous transhepatic and right jugular vein, respectively. A metallic stent with a 10 mm diameter was implanted to maintain tract patency. Results The free hepatic vein pressure (FHVP) of both patients decreased from 37 mm Hg to 5 mm Hg and from 28 mm Hg to 4 mm Hg, respectively, after the procedure. The complication of hemorrhage due to puncture was observed in one patient. Both patients maintained hepatic improvements in 3-year follow-up. Both clinical conditions and laboratory values were significantly improved after the procedure. Furthermore, the stented canals (the reestablished second hepatic hilum) maintained patent with normal FHVP, which was confirmed by control venography.Conclusion The new technique provides a simple, safe, effective, and relatively inexpensive treatment of Budd-Chiari syndrome. Long-lasting effectiveness is expected.

  14. [Treatment of Poland syndrome thorax deformity with the lipomodeling technique: about ten cases].

    Science.gov (United States)

    La Marca, S; Delay, E; Toussoun, G; Ho Quoc, C; Sinna, R

    2013-02-01

    The correct management, with the classic techniques, of the thoracic deformity in Poland's syndrome is difficult, with often insatisfactory results. The current surgical treatment involves the use of prothetic material and/or different flaps with their own complications and scares. The experience of our team with fat grafting (we named lipomodeling) in breast reconstruction helped us to propose the correction of the thoracic and mammary deformity by repeated fat transfer sessions. Fat grafting is commonly used in our team since 1998 in various indication of breast surgery. We reviewed retrospectively our ten first cases of thoracic deformity in Poland's syndrome treated with only fat grafting. Patients had repeated procedures until obtaining a satisfactory result. The fat was harvested from the thigh, buttocks, and abdomen. There were young patients with a mean age of 16years old (from 12 to 24). The mean follow-up was 51months. An average of 2.9 procedures (1 to 5) with 255cm(3) of fat injection at each procedure was needed to obtain symetry. Hundred percent of the patients were satisfied. No complication was noted. As reported, the reconstruction of the thoracic deformity and the mammary shape can be obtained by fat grafting. The absence of a flap donor site sequelae and the absence an implant allow this technique to be simple, reproductible, and without great complication. These criteria match well the surgical management of this deformity, which is mainly aesthetic. Moreover, the secondary benefit of liposuction of disgracious steatomery helps the acceptance of the procedure. Therefore in our hands, fat grafting to the breast (lipomodeling) is now our first choice treatment in thoracic Poland syndrome deformity. Given the rarity of this syndrome, we recommend a treatment by an operator who makes the learning curve of lipomodeling, and who often deals with Poland syndrome.

  15. Hypnosis as an Adjunct Treatment for Distress Associated with Pediatric Cancer Procedures.

    Science.gov (United States)

    White, Jerre Lee

    This paper reviews research literature pertaining to the pain and anxiety associated with pediatric cancer and the use of hypnosis as an adjunct treatment. It is noted that pain and anxiety are most often associated with the procedural treatment of cancer, and that the literature suggests that both pain and anxiety are multi-faceted constructs.…

  16. Defining Prolonged Dwell Time: When Are Advanced Inferior Vena Cava Filter Retrieval Techniques Necessary? An Analysis in 762 Procedures.

    Science.gov (United States)

    Desai, Kush R; Laws, James L; Salem, Riad; Mouli, Samdeep K; Errea, Martin F; Karp, Jennifer K; Yang, Yihe; Ryu, Robert K; Lewandowski, Robert J

    2017-06-01

    Despite growth in placement of retrievable inferior vena cava filters, retrieval rates remain low. Filters with extended implantation times present a challenge to retrieval, where standard techniques often fail. The development of advanced retrieval techniques has positively impacted retrieval of retrievable inferior vena cava filters with prolonged dwell times; however, there is no precise definition of the time point when advanced techniques become necessary. We aim to define prolonged retrievable inferior vena cava filters dwell time by determining the inflection point when the risk of standard retrieval technique failure increases significantly, necessitating advanced retrieval techniques to maintain overall technical success of retrieval. From January 2009 to April 2015, 762 retrieval procedures were identified from a prospectively acquired database. We assessed patient age/sex, filter dwell time, procedural technical success, the use of advanced techniques, and procedure-related adverse events. Overall retrieval success rate was 98% (n=745). When standard retrieval techniques failed, advanced techniques were used; this was necessary 18% of the time (n=138). Logistic regression identified that dwell time was the only risk factor for failure of standard retrieval technique (odds ratio, 1.08; 95% confidence interval, 1.05-1.10; Ptechnique failure was 40.9%. Adverse events occurred at a rate of 2% (n=18; 15 minor and 3 major). The necessity of advanced techniques to maintain technical success of retrieval increases with dwell time. Patients with retrievable inferior vena cava filters in place beyond 7 months may benefit from referral to centers with expertise in advanced filter retrieval. © 2017 American Heart Association, Inc.

  17. [Metatarsus primus double osteotomy, a logical and non-disabling surgical technique for treatment of hallux valgus].

    Science.gov (United States)

    Osterwalder, A; Maestretti, G

    1993-09-01

    The procedure known as the Metatarsus Primus Double Osteotomy ("L'ostéotomie métatarsienne bipolaire" of Schnepp-Carret) for the treatment of the hallux valgus is a logical, efficient and non-mutilating procedure. The technique consists in reducing the hallux valgus deformity by a subcapital bone wedge resection of the metatarsus primus. The bone wedge is then pinched into a second proximal osteotomy of the metatarsus primus, correcting the varus deformity in a valgus direction. This procedure is little known and is not even mentioned in the classic orthopedic literature of German and English language.

  18. Hippocampal sparing radiotherapy for pediatric medulloblastoma: impact of treatment margins and treatment technique

    DEFF Research Database (Denmark)

    Brodin, N. Patrik; af Rosenschold, Per Munck; Blomstrand, Malin

    2014-01-01

    BackgroundWe investigated how varying the treatment margin and applying hippocampal sparing and proton therapy impact the risk of neurocognitive impairment in pediatric medulloblastoma patients compared with current standard 3D conformal radiotherapy.MethodsWe included 17 pediatric medulloblastoma...... boost. Neurocognitive impairment risk was estimated based on dose-response models from pediatric CNS malignancy survivors and compared among different margins and treatment techniques.ResultsMean hippocampal dose and corresponding risk of cognitive impairment were decreased with decreasing treatment...

  19. A Simple Technique to Facilitate Treatment of Urethral Strictures with Optical Internal Urethrotomy

    Directory of Open Access Journals (Sweden)

    Konstantinos Stamatiou

    2014-01-01

    Full Text Available Urethral stricture is a common condition that can lead to serious complications such as urinary infections and renal insufficiency secondary to urinary retention. Treatment options include catheterization, urethroplasty, endoscopic internal urethrotomy, and dilation. Optical internal urethrotomy offers faster recovery, minimal scarring, and less risk of infection, although recurrence is possible. However, technical difficulties associated with poor visualization of the stenosis or of the urethral lumen may increase procedural time and substantially increase the failure rates of internal urethrotomy. In this report we describe a technique for urethral catheterization via a suprapubic, percutaneous approach through the urinary bladder in order to facilitate endoscopic internal urethrotomy.

  20. Retrospective evaluation of conservative treatment for 140 ingrown toenails with a novel taping procedure.

    Science.gov (United States)

    Watabe, Akiko; Yamasaki, Kenshi; Hashimoto, Akira; Aiba, Setsuya

    2015-09-01

    The aim of this study is retrospectively to review the efficacy of a taping procedure for treating ingrown toe-nails or for supporting other conservative treatments of ingrown toenails. A total of 140 ingrown toenails treated at the Dermatology Clinic in Tohoku University Hospital were retrospectively reviewed for demographic characteristics, association with granulation tissue or infection, treatment modalities and their outcomes, and classified according the treatment modalities. All the ingrown toe-nails were treated with a novel taping procedure, "slit tape-strap procedure" alone or in conjunction with other conservative treatments. The mean?±?SD duration until pain relief and until cure of the ingrown toenail were 4.8?±?4.7 days, range 0-24 and 21.0?±?11.2 weeks, range 4-56, respectively. All of the treatments were all effective, although 18 cases recurred after treatment. The "slit tape-strap procedure" is effective in treating ingrown toenails, either as a monotherapy or as a supportive therapy for other conservative treatments.

  1. Endobutton technique for the treatment of acute acromioclavicular joint dislocations

    Directory of Open Access Journals (Sweden)

    Raif Özden

    2014-06-01

    Full Text Available Objective: Acromioclavicular (AC joint dislocation is a common injury frequently affecting young athletes. The aim of this study is to evaluate postoperative functional results in cases diagnosed with acute AC joint dislocation stabilized with endobutton system. Methods: This fixation procedure has been applied on 10 patients. Indications of the technique included: a grade V AC joint dislocation (7 patients, and grade III AC joint dislocation (3 patient according to Rockwood classification. The coracoclavicular (CC interval and AC joint were reduced using two endobuttons. One endobutton was fitted on the clavicle and the second was placed at the undersurface of the coracoid. Outcomes were assessed with the Constant shoulder score and visual analog pain scale. Results: All the patients had powerful intraoperative fixation. Immediately after surgery, and 6 weeks, and 1 year postoperative radiographs showed adequate reduction of the CC distance and the AC joint. The mean Constant shoulder score was 89 (88–92 in the injured shoulder and 90 (88–93 in the uninjured shoulder. There was no statically significant difference between the injured and normal shoulder in terms of Constant shoulder score and there was no complication during the process. Conclusion: This technique is a safe and effective method for providing fixation for the AC joint.

  2. Comparative study of novel endovascular treatment techniques for intracranial aneurysms

    Science.gov (United States)

    Cantón, Gádor; Lasheras, Juan C.; Levy, David I.; Sparks, Steven R.

    2002-11-01

    Intracranial aneurysms are life-threatening vascular lesions, which are potentially treatable to avoid the consequences of their rupture. Current treatments, either surgical or endovascular, are all guided to reduce the hemodynamic forces acting on the aneurysm wall in an effort to minimize the risk of rupture. Surgical clipping is still the most used technique to treat this type of aneurysm but there is a continued demand for less invasive approaches. This has led to the development of several endovascular techniques. We report here a comparative study of the reduction in the hemodynamic stresses and the modification of the flow in the parent vessel resulting from the use of three different techniques. The first one consists of endosaccular packing with platinum coils (GDC, Target Therapeutics), which is already widely used but its long-term efficacy has not yet been determined. The second one consists of the embolization of the aneurismal sac with Onyx, a polymer which hardens when in contact with the blood (being developed by Micro Therapeutics, Inc.). The third one involves the packing of the sac with hydrocoils, platinum wires coated with a gel which quickly hydrates when in contact with blood (developed by MicroVention). A Digital Particle Image Velocimetry (DPIV) system is used to measure in vitro the velocity field inside a model of an ACOM aneurysm (an aneurysm forming in the anterior communicating artery). Physiological accurate pulsatile flow conditions are input to the arterial model through a programmable pump. The measurements show that although all treatment techniques lead to a reduction in both normal and tangential shear stresses on the aneurismal sac, each one of them also leads to different modifications of the flow in the parent vessel which may have consequences related to potential for clotting. Comparison of the untreated aneurysm with the above three treated cases also showed that the characteristics of the wall shear stresses on the parent

  3. Endoscopic treatment of calcaneal spur syndrome: A comprehensive technique.

    Science.gov (United States)

    Blanco, C E; Leon, H O; Guthrie, T B

    2001-05-01

    We describe a comprehensive approach to the endoscopic treatment of calcaneal spur syndrome developed by the Arthroscopic Group of the Orthopedic Service of Hospital Hermanos Ameijeiras in Havana, Cuba. The surgical technique involves treatment of the heel spur and plantar fasciitis commonly found in calcaneal spur syndrome, but it also addresses adjacent calcaneal periostitis and allows decompression of the nerve to the abductor digiti quinti. Medial endoscopy and lateral instrumentation are used in a sequential approach with exposure and debridement of the posterior roof of the calcaneal arch, followed by removal of the calcaneal spur, lateral to medial release of the medial 75% of the plantar fascia, and if necessary, debridement of the calcaneal tuberosity periosteum. This technique was used in a prospective case series from June 1997 to May 1998 to treat a select group of 38 feet in 30 patients who reported unacceptable levels of pain despite 5 months of conservative treatment, which included an aggressive 8-week physical therapy program prescribed by the treating physician. Good to excellent results were obtained at 3 months postoperatively in all patients with regard to pain relief and return to normal activity, although 5 patients required a short course of physical therapy to resolve symptoms brought on by sports, trauma, or impact loading before 1-year follow-up, at which time all patients reported good to excellent results. Complications included 3 superficial wound infections cured by oral antibiotics and 2 transient lateral paresthesias that resolved with rest and nonsteroidal inflammatory medications. The described technique may provide a useful method for treating refractory heel spur syndrome and warrants further study.

  4. Sertl shelf arthroplasty (BOP procedure) in the treatment of canine hip dysplasia.

    Science.gov (United States)

    Jensen, D J; Sertl, G O

    1992-05-01

    The BOP/Sertl shelf arthroplasty procedure is not difficult or lengthy. It uses minimal metallic fixation. It is quite physiological with minimal morbidity because there is no change in the bony anatomic pelvis except to create an extension of the lateral rim of the acetabulum. The animal is able to walk the day after surgery. The procedure can be performed bilaterally the same day, thus creating good bony stability and decreasing stretching of the joint capsule, which in turn prevents further subluxation and pain in the hip joint. The aim of this procedure is to return the animal to a satisfactory lifestyle through an effective but less complicated surgical procedure as compared to other available options. This procedure is straightforward and can be done by a surgeon who is familiar with orthopedic surgical techniques and has been trained in this procedure. To date, more than 150 veterinarians have had hands-on training to perform this operation. We are not claiming that this procedure is a cure for CHD; rather, it is a procedure that dramatically slows down the progress of this malady and allows the dog to lead a more normal lifestyle and avoids euthanasia. After 51 months, our study of 200 hips has had a success rate of 99% on the animals available for follow-up as evidenced by returning those animals to a satisfactory lifestyle with stable hips.

  5. Interventional techniques in managing persistent pain after vertebral augmentation procedures: a retrospective evaluation.

    Science.gov (United States)

    Georgy, Bassem A

    2007-09-01

    Based on systematic reviews, it appears that at least 10% of patients may continue to suffer with residual or persistent pain after successful vertebral or sacral augmentation procedures. To report and evaluate the incidence and prevalence of different spinal injections in patients who received vertebroplasty, kyphoplasty, and sacroplasty procedures for both benign and malignant compression fractures. A retrospective case review. Retrospective review of all cases of vertebroplasty, sacroplasty, and kyphoplasty performed in a 12-month period in a single outpatient setting of interventional radiology was conducted. In a 12-month period starting from October 2005 to September 2006, 144 patients underwent cement augmentation procedures. Of the 144, 34 patients required a spinal injection procedure for residual or persistent pain within a 1-year period after the augmentation procedure. Twenty-four patients required epidural steroid injections, 6 patients required intercostal nerve blocks, 5 patients required trigger point injections, 5 patients required sacroiliac joint injections, and 1 patient required facet joint injections. Nine patients who required lumbar epidural steroid injections and all patients who required intercostal nerve blocks and had underwent a thoracic cement augmentation procedure. A small proportion of patients undergoing percutaneous cement augmentation for vertebral compression fractures or sacral insufficiency fractures potentially require spinal injections to treat residual pain after the procedure.

  6. Surgical treatment of scoliosis: a review of techniques currently applied

    Directory of Open Access Journals (Sweden)

    Maruyama Toru

    2008-04-01

    Full Text Available Abstract In this review, basic knowledge and recent innovation of surgical treatment for scoliosis will be described. Surgical treatment for scoliosis is indicated, in general, for the curve exceeding 45 or 50 degrees by the Cobb's method on the ground that: 1 Curves larger than 50 degrees progress even after skeletal maturity. 2 Curves of greater magnitude cause loss of pulmonary function, and much larger curves cause respiratory failure. 3 Larger the curve progress, more difficult to treat with surgery. Posterior fusion with instrumentation has been a standard of the surgical treatment for scoliosis. In modern instrumentation systems, more anchors are used to connect the rod and the spine, resulting in better correction and less frequent implant failures. Segmental pedicle screw constructs or hybrid constructs using pedicle screws, hooks, and wires are the trend of today. Anterior instrumentation surgery had been a choice of treatment for the thoracolumbar and lumbar scoliosis because better correction can be obtained with shorter fusion levels. Recently, superiority of anterior surgery for the thoracolumbar and lumbar scoliosis has been lost. Initial enthusiasm for anterior instrumentation for the thoracic curve using video assisted thoracoscopic surgery technique has faded out. Various attempts are being made with use of fusionless surgery. To control growth, epiphysiodesis on the convex side of the deformity with or without instrumentation is a technique to provide gradual progressive correction and to arrest the deterioration of the curves. To avoid fusion for skeletally immature children with spinal cord injury or myelodysplasia, vertebral wedge ostetomies are performed for the treatment of progressive paralytic scoliosis. For right thoracic curve with idiopathic scoliosis, multiple vertebral wedge osteotomies without fusion are performed. To provide correction and maintain it during the growing years while allowing spinal growth for

  7. Treatment of ruptured Achilles tendon: Operative or non-operative procedure?

    Science.gov (United States)

    Cukelj, Fabijan; Bandalovic, Ante; Knezevic, Josip; Pavic, Arsen; Pivalica, Bozen; Bakota, Bore

    2015-11-01

    The aim of this study was to compare the efficiency of non-operative and surgical procedures in the treatment of ruptured Achilles tendon in athletes (professional and amateur). Ninety professional or amateur athletes with rupture of the Achilles tendon were included in the study between 1998 and 2013. The athletes were aged between 25 and 40 years (mean 34.83±4.65). A total of 30 athletes underwent an open procedure, 30 were treated with a percutaneous method and 30 were treated non-operatively. All operated patients were tested one year after the surgical procedure. An isokinetic dynamometer was used to compare the open and percutaneous methods. The results for the patients who were treated using the percutaneous method were 15% better than those for the patients who underwent the open procedure; the results for the group treated conservatively were 20% better than those for the group treated percutaneously. The percutaneous method was easier technically than the open method. Time spent in hospital was 14.5 times shorter with the percutaneous procedure compared with the open procedure (percutaneous procedure: range 0.5-2 days, mean 0.79±0.36; open procedure: range 10-24 days, mean 11.46±2.70; pAchilles tendon in the group treated with the percutaneous procedure. One patient in the group treated with the open procedure had postoperative infection (4.2%). In the non-surgical (conservatively treated) group, there were three reruptures of the Achilles tendon within one year, and one patient developed adhesions that resulted in loss of function and had to undergo an operation. The percutaneous method is the best method of surgical treatment for Achilles tendon rupture. Copyright © 2015 Elsevier Ltd. All rights reserved.

  8. The Bristow and Latarjet procedures: why these techniques should not be considered synonymous.

    Science.gov (United States)

    Giles, Joshua W; Degen, Ryan M; Johnson, James A; Athwal, George S

    2014-08-20

    Recurrent shoulder instability is commonly associated with glenoid bone defects. Coracoid transfer procedures, such as the Bristow and Latarjet procedures, are frequently used to address these bone deficiencies. Despite the frequent synonymous labeling of these transfers as the "Bristow-Latarjet" procedure, their true equivalence has not been demonstrated. Therefore, our purpose was to compare the biomechanical effects of these two procedures. Eight cadaveric specimens were tested on a custom shoulder simulator capable of loading nine muscle groups and of accurately orienting the joint throughout shoulder motion. The specimens were tested in the intact state, following Bristow and Latarjet reconstructions of a capsulolabral injury (0% glenoid defect), and following each procedure after creation of 15% and 30% glenoid bone defects. The reconstruction order was randomized. In each condition, joint stiffness (anterior stability) and occurrence of dislocation were assessed in shoulder adduction and abduction with neutral and external rotation. No significant differences (p Latarjet reconstructions for the 0% glenoid defect in any joint position. However, substantially greater joint stiffness occurred following the Latarjet procedure, as compared with the Bristow procedure, for the 15% and 30% glenoid bone-loss conditions in adduction with neutral rotation, adduction with external rotation, and abduction with external rotation (average across the three joint positions: 8.6 ± 4.4 N/mm versus 3.9 ± 1.26.7 N/mm [p = 0.034] with 15% bone loss and 7.5 ± 4.4 N/mm versus 3.4 ± 1.5 N/mm [p = 0.045] with 30% bone loss). The Latarjet reconstruction restored the stiffness that had been measured in the intact state in eleven of the twelve tested conditions, whereas the Bristow procedure was successful in only four of the twelve conditions. In addition, during instability testing, three more specimens dislocated following the Bristow reconstruction, compared with the Latarjet

  9. Salvage of the unstable Sauvé-Kapandji procedure: a new technique.

    Science.gov (United States)

    Ross, Mark; Thomas, James; Couzens, Gregory; Coleman, Stephen

    2007-03-01

    The Sauvé-Kapandji procedure has been commonly performed in the setting of posttraumatic osteoarthritis of the distal radioulnar joint. A recognized complication is instability of the proximal ulnar stump, which may occur in up to 33% of cases. Salvage of the failed Sauvé-Kapandji procedure in this setting is difficult and can sometimes involve sacrifice of forearm rotation. We report the results of 3 cases of a new salvage procedure in this setting. The radioulnar pseudarthrosis was taken down; ulnar continuity was restored with an intercalary graft; and forearm rotation was restored with matched hemiresection and interposition arthroplasty at the site of previous radioulnar fusion. Postoperatively, all patients achieved good forearm rotation (mean supination, 60 degrees; mean pronation, 65 degrees), had no symptoms of instability, and were satisfied with the results of the procedure. Disabilities of the Arm, Shoulder and Hand scores improved from preoperative mean of 55 to postoperative mean of 18.

  10. Electrochemical Techniques in Textile Processes and Wastewater Treatment

    Directory of Open Access Journals (Sweden)

    Mireia Sala

    2012-01-01

    Full Text Available The textile industry uses the electrochemical techniques both in textile processes (such as manufacturing fibers, dyeing processes, and decolorizing fabrics and in wastewaters treatments (color removal. Electrochemical reduction reactions are mostly used in sulfur and vat dyeing, but in some cases, they are applied to effluents discoloration. However, the main applications of electrochemical treatments in the textile sector are based on oxidation reactions. Most of electrochemical oxidation processes involve indirect reactions which imply the generation of hypochlorite or hydroxyl radical in situ. These electrogenerated species are able to bleach indigo-dyed denim fabrics and to degrade dyes in wastewater in order to achieve the effluent color removal. The aim of this paper is to review the electrochemical techniques applied to textile industry. In particular, they are an efficient method to remove color of textile effluents. The reuse of the discolored effluent is possible, which implies an important saving of salt and water (i.e., by means of the “UVEC Cell”.

  11. [Orthotopic liver transplant in rats. Surgical technique, complications and treatment].

    Science.gov (United States)

    Lausada, Natalia R; Gondolesi, G E; Ortiz, E; Dreizzen, E; Raimondi, J C

    2002-01-01

    The orthotopic rat liver transplant model is a widely used technique in transplantation research. It has many advantages over other animal transplant models because of its availability and low cost. However, it must be emphasized that success with the rat model requires thorough training. The aim of this paper is to describe the microsurgical technique involved in 60 rat liver transplants and to discuss the complications and their treatments. Forty-nine liver transplants were performed at the Experimental Laboratory of the University Hospital, Ontario, Canada (ELUH) and 11 were performed at the Laboratorio de Trasplante de Organos de la Facultad de Ciencias Médicas de La Plata, Buenos Aires. Argentina (LTO). Among the transplants performed at the ELUH, the observed complications were haemorrhage (n = 4), pneumothorax (n = 1), anastomotic failure (n = 15), bile leak (n = 3), and bile duct necrosis (n = 9). The remaining 17 rats at the ELUH were healthy at day 7 after surgery. Animal survival immediately postop, at 24 hours postop and at 7 days postop was achieved with the 9th, 20th and 21st transplants respectively. At the LTO, 3 rats died as a result of anaesthetic complications. Seven-day animal survival was achieved with the 11th transplant. We beleive that the description of the orthotopic rat liver transplantation technique, as well as the discussion regarding complications and their management, can be useful for researchers interested in performing liver transplantation in rats.

  12. Novel technique for placement of hemodialysis catheters using a combined open procedure with the Seldinger micropuncture technique.

    Science.gov (United States)

    Maa, J; Gosnell, J E; Chuter, T A M

    2005-03-01

    Percutaneous placement of large-diameter dialysis catheters via the Seldinger technique can be technically challenging in patients with coagulopathy, difficult anatomy, or several previous central line insertions. We describe a method for achieving safer access by combining an open approach to delineate the venous anatomy of the chest wall, with a micropuncture device and smaller diameter guidewire to gain intravascular access to the cephalic vein or its major tributaries. Serial dilation of otherwise unusable vessels can then permit successful and safer hemodialysis catheter insertion in these difficult cases.

  13. Antegrade scrotal sclerotherapy of internal spermatic veins for varicocele treatment: technique, complications, and results

    Directory of Open Access Journals (Sweden)

    Alessandro Crestani

    2016-01-01

    Full Text Available Varicocele repair is mainly indicated in young adult patients with clinical palpable varicocele and abnormal semen parameters. Varicocele treatment is associated with a significant improvement in sperm concentration, motility, morphology, and pregnancy rate. Antegrade scrotal sclerotherapy (ASS represented one of the main alternatives to the traditional inguinal or suprainguinal surgical ligation. This article reviews the use of ASS for varicocele treatment. We provide a brief overview of the history of the procedure and present our methods used in ASS. In addition, we review complication and success of ASS, including our own retrospective data of treating 674 patients over the last 17 years. Herein, we analyzed step by step the ASS technique and described our results with an original modified technique with a long follow-up. Between December 1997 and December 2014, we performed 674 ASS. Mean operative time was 14 min (range 9 to 50 min. No significant intraoperative complications were reported. Within 90 days from the procedure, postoperative complications were recorded in overall 49 (7.2% patients. No major complications were recorded. A persistent/recurrent varicocele was detected in 40 (5.9% cases. In 32/40 (80% cases, patients showed preoperative grade III varicoceles. In patients with a low sperm number before surgery, sperm count improved from 13 × 10 6 to 21 × 10 6 ml−1 (P < 0.001. The median value of the percentage of progressive motile forms at 1 h improved from 25% to 45% (P < 0.001. Percentage of normal forms increased from 17% before surgery to 35% 1 year after the procedure (P < 0.001. In the subgroup of the 168 infertile patients, 52 (31% fathered offspring at a 12-month-minimum follow-up. Therefore, ASS is an effective minimal invasive treatment for varicocele with low recurrence/persistence rate.

  14. Performance assessment techniques for groundwater recovery and treatment systems

    Energy Technology Data Exchange (ETDEWEB)

    Kirkpatrick, G.L. [Environmental Resources Management, Inc., Exton, PA (United States)

    1993-03-01

    Groundwater recovery and treatment (pump and treat systems) continue to be the most commonly selected remedial technology for groundwater restoration and protection programs at hazardous waste sites and RCRA facilities nationwide. Implementing a typical groundwater recovery and treatment system includes the initial assessment of groundwater quality, characterizing aquifer hydrodynamics, recovery system design, system installation, testing, permitting, and operation and maintenance. This paper focuses on methods used to assess the long-term efficiency of a pump and treat system. Regulatory agencies and industry alike are sensitive to the need for accurate assessment of the performance and success of groundwater recovery systems for contaminant plume abatement and aquifer restoration. Several assessment methods are available to measure the long-term performance of a groundwater recovery system. This paper presents six assessment techniques: degree of compliance with regulatory agency agreement (Consent Order of Record of Decision), hydraulic demonstration of system performance, contaminant mass recovery calculation, system design and performance comparison, statistical evaluation of groundwater quality and preferably, integration of the assessment methods. Applying specific recovery system assessment methods depends upon the type, amount, and quality of data available. Use of an integrated approach is encouraged to evaluate the success of a groundwater recovery and treatment system. The methods presented in this paper are for engineers and corporate management to use when discussing the effectiveness of groundwater remediation systems with their environmental consultant. In addition, an independent (third party) system evaluation is recommended to be sure that a recovery system operates efficiently and with minimum expense.

  15. Monitoring Therapeutic Treatments against Burkholderia Infections Using Imaging Techniques

    Directory of Open Access Journals (Sweden)

    Tiffany M. Mott

    2013-05-01

    Full Text Available Burkholderia mallei, the etiologic agent of glanders, are Category B select agents with biothreat potential, and yet effective therapeutic treatments are lacking. In this study, we showed that CpG administration increased survival, demonstrating protection in the murine glanders model. Bacterial recovery from infected lungs, liver and spleen was significantly reduced in CpG-treated animals as compared with non-treated mice. Reciprocally, lungs of CpG-treated infected animals were infiltrated with higher levels of neutrophils and inflammatory monocytes, as compared to control animals. Employing the B. mallei bioluminescent strain CSM001 and the Neutrophil-Specific Fluorescent Imaging Agent, bacterial dissemination and neutrophil trafficking were monitored in real-time using multimodal in vivo whole body imaging techniques. CpG-treatment increased recruitment of neutrophils to the lungs and reduced bioluminescent bacteria, correlating with decreased bacterial burden and increased protection against acute murine glanders. Our results indicate that protection of CpG-treated animals was associated with recruitment of neutrophils prior to infection and demonstrated, for the first time, simultaneous real time in vivo imaging of neutrophils and bacteria. This study provides experimental evidence supporting the importance of incorporating optimized in vivo imaging methods to monitor disease progression and to evaluate the efficacy of therapeutic treatment during bacterial infections.

  16. Pain relief following thoracic surgical procedures: A literature review of the uncommon techniques.

    Science.gov (United States)

    Alzahrani, Tariq

    2017-01-01

    Thoracic surgical procedures can be either thoracotomy or thoracoscopy. In thoracotomy, the incision could be either muscle-cutting or muscle-sparing incision. The posterolateral thoracotomy incision is used for most general thoracic surgical procedures. This incision, which involves division of the latissimus dorsi and serratus anterior muscles, affords excellent exposure of the thoracic cavity. However, it is associated with significant morbidity, including impaired pulmonary function, postoperative chest pain, and restricted arm and shoulder movement. Various muscle-sparing incisions have been proposed to decrease the morbidity. Postthoracotomy pain originates from pleural and muscular damage, costovertebral joint disruption, and intercostal nerve damage during surgery. Inadequate pain relief after surgery affects the quality of patient's recovery and exposes the patients to postoperative morbidities. There is a tendency nowadays among thoracic surgeons and anesthesiologists toward the area of enhanced recovery after thoracic surgery which requires careful titration of the anesthetic drugs in awake patients undergoing thoracoscopic procedures. There is a common feeling among thoracic anesthesiologists that potthoracoscopy procedures produce less pain intensity versus thoracotomy which is partially true. However, effective management of acute pain following either thoracotomy/thoracoscopy is needed and may prevent these complications and reduce the likelihood of developing chronic pain. In this report, we are going to review the newly introduced postthoracotomy/thoracoscopy pain relief modalities with special reference to the new tendency of awake thoracic surgical procedures and its impact on enhanced recovery after surgery.

  17. Pain relief following thoracic surgical procedures: A literature review of the uncommon techniques

    Directory of Open Access Journals (Sweden)

    Tariq Alzahrani

    2017-01-01

    Full Text Available Thoracic surgical procedures can be either thoracotomy or thoracoscopy. In thoracotomy, the incision could be either muscle-cutting or muscle-sparing incision. The posterolateral thoracotomy incision is used for most general thoracic surgical procedures. This incision, which involves division of the latissimus dorsi and serratus anterior muscles, affords excellent exposure of the thoracic cavity. However, it is associated with significant morbidity, including impaired pulmonary function, postoperative chest pain, and restricted arm and shoulder movement. Various muscle-sparing incisions have been proposed to decrease the morbidity. Postthoracotomy pain originates from pleural and muscular damage, costovertebral joint disruption, and intercostal nerve damage during surgery. Inadequate pain relief after surgery affects the quality of patient's recovery and exposes the patients to postoperative morbidities. There is a tendency nowadays among thoracic surgeons and anesthesiologists toward the area of enhanced recovery after thoracic surgery which requires careful titration of the anesthetic drugs in awake patients undergoing thoracoscopic procedures. There is a common feeling among thoracic anesthesiologists that potthoracoscopy procedures produce less pain intensity versus thoracotomy which is partially true. However, effective management of acute pain following either thoracotomy/thoracoscopy is needed and may prevent these complications and reduce the likelihood of developing chronic pain. In this report, we are going to review the newly introduced postthoracotomy/thoracoscopy pain relief modalities with special reference to the new tendency of awake thoracic surgical procedures and its impact on enhanced recovery after surgery.

  18. Robert's uterus: modern imaging techniques and ultrasound-guided hysteroscopic treatment without laparoscopy or laparotomy.

    Science.gov (United States)

    Ludwin, A; Ludwin, I; Martins, W P

    2016-10-01

    Robert's uterus is a unique malformation, described as a septate uterus with a non-communicating hemicavity, consisting of a blind uterine horn usually with unilateral hematometra, a contralateral unicornuate uterine cavity and a normally shaped external uterine fundus. The main symptom in affected young women is pelvic pain that becomes intensified near menses. We describe the case of a 22-year-old woman who was referred for diagnostic assessment and treatment of a congenital uterine anomaly. We used three-dimensional sonohysterography with volume-contrast imaging, HDLive rendering mode and automatic volume calculation (SonoHysteroAVC) for the diagnosis, surgical planning and postoperative evaluation. These imaging techniques provided a complete understanding of the internal and external uterine structures, enabling us to perform a minimally invasive hysteroscopic metroplasty, guided by transrectal ultrasound, and therefore avoiding the need for laparotomy/laparoscopy. The outcome of treatment was considered satisfactory; menstruation ceased to be painful and, after two hysteroscopic procedures, the communicating 0.3-cm(3) hemicavity was visualized as a 3.6-cm(3) normalized uterine cavity using the same imaging techniques. The findings of this case report raise questions about the embryological origin of Robert's uterus, the suitability of current classification systems, and the role of more invasive approaches (laparoscopy/laparotomy) and surgical procedures (horn resection/endometrectomy) that do not aim to improve uterine cavity shape and volume in women with this condition. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd.

  19. Treatment of multiple gingival recessions adopting modified tunnel subepithelial connective tissue graft technique

    Directory of Open Access Journals (Sweden)

    Jagmohan Singh

    2014-01-01

    Full Text Available Gingival recession related to periodontal disease or developmental problems can result in root sensitivity, root caries, and esthetically unacceptable root exposures. In the past, multiple surgical procedures have been proposed to obtain root coverage on exposed buccal root surfaces. There has been great interest in the treatment of gingival recession defects, especially with subepithelial connective-tissue grafting (SCTG. Recent advances have focused on SCTG by the tunnel technique. This article highlights the esthetic results obtained by adopting a modification of the tunnel technique using a single vertical incision along with autologous SCTG in the management of multiple adjacent Miller Class-II gingival recessions. A single vertical incision was used along with tunnel preparation for the facile placement of SCTG into the prepared tunnel. After 6 months of follow-up, the clinical condition was stable with satisfactory root coverage outcome. An excellent esthetical outcome was achieved and the patient was satisfied with the result.

  20. EFSUMB Guidelines on Interventional Ultrasound (INVUS), Part III - Abdominal Treatment Procedures (Short Version)

    DEFF Research Database (Denmark)

    Dietrich, C F; Lorentzen, T; Appelbaum, L

    2016-01-01

    are presented covering indications, contraindications, safety and efficacy of the broad variety of these techniques. In particular, drainage of abscesses and fluid collections, interventional tumor ablation techniques, interventional treatment of symptomatic cysts and echinococcosis, percutaneous transhepatic...... cholangiography and drainage, percutaneous gastrostomy, urinary bladder drainage, and nephrostomy are addressed (short version; a long version is published online)....

  1. Endoscopic treatment for vesicoureteral reflux: how important is technique?

    Science.gov (United States)

    Watters, Sean T; Sung, Jennifer; Skoog, Steven J

    2013-12-01

    Endoscopic dextranomer/hyaluronic acid (Dx/HA) injection by subureteric transurethral injection (STING) or hydrodistention implantation technique (HIT) for treatment of vesicoureteral reflux (VUR) has variable results with HIT reporting better outcomes. We determined outcomes with each technique comparing reflux resolution rates and evaluating predictors of treatment success and failure. Univariate and multivariate analysis compared 163 patients (246 ureters) who underwent a single endoscopic Dx/HA injection from December 2001 to April 2010. Data on pre, peri, and post-operative variables were prospectively collected. Resolution was defined as no reflux on voiding cystourethrogram (VCUG) at 3 month follow up. Calculated ellipsoid volume (CEV) of Dx/HA mounds was defined as (4/3π(height/2) × (length/2) × (width/2)) based on post-operative ultrasound dimensions. Ureter resolution was 79.75% and 80.84% for STING and HIT, respectively (p = 0.86). Patient resolution was 70.0% and 74.3% for STING and HIT, respectively (p = 0.57). Multivariate ureter analysis revealed lower pre-operative grade (p = 0.004) and injected Dx/HA volume 0.80-1.00 mL (p = 0.039) as predictors of success. CEV <0.20 mL (p = 0.002) and CEV/injected-volume <25% (p = 0.006) were predictors of failure. Volcano morphology (p = 0.004) and lower pre-op grade (p = 0.015) were predictors of success for STING and HIT, respectively. We found no differences in ureter or patient resolution between endoscopic Dx/HA injection techniques STING or HIT. Lower pre-operative grade and moderated Dx/HA volume were predictors of success regardless of technique. Copyright © 2013 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

  2. Role of Imaging Techniques in Percutaneous Treatment of Mitral Regurgitation.

    Science.gov (United States)

    Li, Chi-Hion; Arzamendi, Dabit; Carreras, Francesc

    2016-04-01

    Mitral regurgitation is the most prevalent valvular heart disease in the United States and the second most prevalent in Europe. Patients with severe mitral regurgitation have a poor prognosis with medical therapy once they become symptomatic or develop signs of significant cardiac dysfunction. However, as many as half of these patients are inoperable because of advanced age, ventricular dysfunction, or other comorbidities. Studies have shown that surgery increases survival in patients with organic mitral regurgitation due to valve prolapse but has no clinical benefit in those with functional mitral regurgitation. In this scenario, percutaneous repair for mitral regurgitation in native valves provides alternative management of valvular heart disease in patients at high surgical risk. Percutaneous repair for mitral regurgitation is a growing field that relies heavily on imaging techniques to diagnose functional anatomy and guide repair procedures. Copyright © 2016 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

  3. [Two cases of congenital airway obstruction managed with ex utero intrapartum treatment procedures: anesthetic implications].

    Science.gov (United States)

    Manrique, S; Blasco, J; Munar, F; Andreu, E; Mateo, M D; Suescun, M C; López Gil, M V

    2007-01-01

    An ex utero intrapartum treatment (EXIT) procedure provides sufficient time to gain control of the potentially obstructed fetal upper airway while uterine placental circulation is maintained during cesarean section. We report 2 cases in which fetal congenital upper airway obstruction was managed without complications during EXIT procedures. We also discuss general considerations concerning the obstetric patient and the performance of intramuscular fetal anesthesia. Before the hysterotomy, sevoflurane at 1.5 minimum alveolar concentration was administered to assure sufficient uterine relaxation during EXIT. The 2 parturients remained hemodynamically stable during the procedure and uterine and placental perfusion was adequate. Nasotracheal intubation was possible in 1 fetus after a cervical mass was dissected. In the other, a tracheostomy was created. After the umbilical cord was clamped, the concentration of sevoflurane anesthetic gas was reduced and oxytocin and methylergometrine were administered to induce adequate uterine contractions within a few minutes. Both neonates survived the EXIT procedure with no complications.

  4. Barriers to Implementing Treatment Integrity Procedures in School Psychology Research: Survey of Treatment Outcome Researchers

    Science.gov (United States)

    Sanetti, Lisa M. Hagermoser; DiGennaro Reed, Florence D.

    2012-01-01

    Treatment integrity data are essential to drawing valid conclusions in treatment outcome studies. Such data, however, are not always included in peer-reviewed research articles in school psychology or related fields. To gain a better understanding of why treatment integrity data are lacking in the school psychology research, we surveyed the…

  5. Barriers to Implementing Treatment Integrity Procedures in School Psychology Research: Survey of Treatment Outcome Researchers

    Science.gov (United States)

    Sanetti, Lisa M. Hagermoser; DiGennaro Reed, Florence D.

    2012-01-01

    Treatment integrity data are essential to drawing valid conclusions in treatment outcome studies. Such data, however, are not always included in peer-reviewed research articles in school psychology or related fields. To gain a better understanding of why treatment integrity data are lacking in the school psychology research, we surveyed the…

  6. Arthroscopic Remplissage and Open Latarjet Procedure for the Treatment of Anterior Glenohumeral Instability With Severe Bipolar Bone Loss.

    Science.gov (United States)

    Katthagen, J Christoph; Anavian, Jack; Tahal, Dimitri S; Millett, Peter J

    2016-10-01

    Bipolar bone loss in patients with anterior glenohumeral instability is challenging to treat. The goal of the treatment is to restore stability by ensuring that the humeral head remains within the glenoid vault. This can be achieved either with the combination of an arthroscopic Bankart procedure and remplissage (glenoid bone loss Latarjet procedure (glenoid bone loss >25%). In cases with more severe bipolar bone loss of both the glenoid and the humeral head, the conventional approach has been to lengthen the articular arc of the glenoid and to ignore the Hill-Sachs lesion. However, it has recently been shown that this can still lead to an "off-track" situation with persistent shoulder instability from engagement of the Hill-Sachs on the anterior glenoid. In these cases, the combination of a Hill-Sachs remplissage and the Latarjet procedure can be effective in preventing persistent instability. In this technical note, the surgical technique of an arthroscopic Hill-Sachs remplissage in combination with an open Latarjet procedure is presented.

  7. Congenital vertical talus: Treatment by reverse ponseti technique

    Directory of Open Access Journals (Sweden)

    Bhaskar Atul

    2008-01-01

    Full Text Available Background: The surgery for idiopathic congenital vertical talus (CVT can lead to stiffness, wound complications and under or over correction. There are sporadic literature on costing with mixed results. We describe our early experience of reverse ponseti technique. Materials and methods: Four cases (four feet of idiopathic congenital vertical talus (CVT which presented one month after birth were treated by serial manipulation and casting, tendoachilles tenotomy and percutaneous pinning of talonavicular joint. An average of 5.2 (range - four to six plaster cast applications were required to correct the forefoot deformity. Once the talus and navicular were aligned based on the radiographic talus-first metatarsal axis, percutaneous fixation of the talo-navicular joint with a Kirschner wire, and percutaneous tendoachilles tenotomy under anesthesia was performed following which a cast was applied with the foot in slight dorsiflexion. Results: The mean follow-up period for the four cases was 8.5 months (6-12 months. At the end of the treatment all feet were supple and plantigrade but still using ankle foot orthosis (AFO. The mean talocalcaneal angle was 70 degrees before treatment and this reduced to 31 degrees after casting. The mean talar axis first metatasal base angle (TAMBA angle was 60° before casting and this improved to 10.5°. Conclusion: Although our follow-up period is small, we would recommend early casting for idiopathic CVT along the same lines as the Ponseti technique for clubfoot except that the forces applied are in reverse direction. This early casting method can prevent extensive surgery in the future, however, a close vigil is required to detect any early relapse.

  8. Dosimetric trade-offs in breast treatment with VMAT technique.

    Science.gov (United States)

    Fogliata, Antonella; Seppälä, Jan; Reggiori, Giacomo; Lobefalo, Francesca; Palumbo, Valentina; De Rose, Fiorenza; Franceschini, Davide; Scorsetti, Marta; Cozzi, Luca

    2017-02-01

    Breast planning with volumetric modulated arc therapy (VMAT) has been explored, especially for left-sided breast treatments, with the primary intent of lowering the heart dose and improving target dose homogeneity. As a trade-off, larger healthy tissue volumes would receive low dose levels, with the potential risk of increasing late toxicities and secondary cancer induction, although no clinical data are available today to confirm the risk level. The scope of this work is to explore the dosimetric trade-offs using two different VMAT plans. Two planning strategies for dual-partial-arc VMAT, RA_avoid and RA_full, with and without avoidance sectors, were explored in a cohort of 20 patients, for whole left breast irradiation for 40.05 Gy to the mean target dose in 15 fractions. Common dose objectives included a stringent dose homogeneity, mean dose to the heart <5 Gy, ipsilateral lung (Ilung) <8 Gy, contralateral lung (Clung) <2 Gy and contralateral breast (Cbreast) <3 Gy. RA_full showed a better dose conformity, lower high-dose spillage in the healthy tissue and lower skin dose. RA_avoid presented a reduction of the mean doses for all critical structures: 51% to the heart, 12% to the Ilung, 81% to the Clung and 73% to the Cbreast. All differences were significant with p < 0.0001. The adaptation of VMAT options to planning objectives reduced significantly the healthy tissue dose levels at the price of some high-dose spillage. Evaluation of the trade-offs for application to the different critical structures should drive in improving the usage of the VMAT technique for breast cancer treatment. Advances in knowledge: Different planning strategies in the same VMAT technique could give significant variations in dose distributions. The choice of the trade-offs would affect the possible future late toxicity and secondary cancer induction risk.

  9. EFSUMB Guidelines on Interventional Ultrasound (INVUS), Part III - Abdominal Treatment Procedures (Long Version)

    DEFF Research Database (Denmark)

    Dietrich, Christoph F; Lorentzen, T.; Appelbaum, L.

    2016-01-01

    The third part of the European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB) Guidelines on Interventional Ultrasound (INVUS) assesses the evidence for ultrasound-guided and assisted interventions in abdominal treatment procedures. Recommendations for clinical practice ar...... transhepatic cholangiography and drainage, percutaneous gastrostomy, urinary bladder drainage, and nephrostomy are addressed (long version)....

  10. THE TIKHOFF-LINBERG PROCEDURE IN THE TREATMENT OF SARCOMAS OF THE SHOULDER GIRDLE

    NARCIS (Netherlands)

    HAM, SJ; HOEKSTRA, HJ; EISMA, WH; KOOPS, HS; OLDHOFF, J

    The majority of patients with soft tissue or bone sarcomas of the upper extremity can be treated today with limb-saving procedures using combined modality therapies. For patients with a tumor in the shoulder area, sometimes an interscapulothoracic amputation is the only radical surgical treatment.

  11. Surgical treatment of gingival recessions using Emdogain gel : Clinical procedure and case reports

    NARCIS (Netherlands)

    Abbas, F; Wennstrom, J; Van der Weijden, F; Schneiders, T; Van der Velden, U

    2003-01-01

    This article describes the clinical procedure and outcome of surgical treatment of gingival recessions with the adjunctive use of Emdogain gel, an enamel matrix derivative bioactive material for periodontal reconstructive surgery. Six cases with gingival recession on maxillary canines are presented

  12. Optimized evaporation technique for leachate treatment: Small scale implementation.

    Science.gov (United States)

    Benyoucef, Fatima; Makan, Abdelhadi; El Ghmari, Abderrahman; Ouatmane, Aziz

    2016-04-01

    This paper introduces an optimized evaporation technique for leachate treatment. For this purpose and in order to study the feasibility and measure the effectiveness of the forced evaporation, three cuboidal steel tubs were designed and implemented. The first control-tub was installed at the ground level to monitor natural evaporation. Similarly, the second and the third tub, models under investigation, were installed respectively at the ground level (equipped-tub 1) and out of the ground level (equipped-tub 2), and provided with special equipment to accelerate the evaporation process. The obtained results showed that the evaporation rate at the equipped-tubs was much accelerated with respect to the control-tub. It was accelerated five times in the winter period, where the evaporation rate was increased from a value of 0.37 mm/day to reach a value of 1.50 mm/day. In the summer period, the evaporation rate was accelerated more than three times and it increased from a value of 3.06 mm/day to reach a value of 10.25 mm/day. Overall, the optimized evaporation technique can be applied effectively either under electric or solar energy supply, and will accelerate the evaporation rate from three to five times whatever the season temperature. Copyright © 2016. Published by Elsevier Ltd.

  13. Cyclodialysis Cleft Treatment Using a Minimally Invasive Technique

    Directory of Open Access Journals (Sweden)

    João Pinheiro-Costa

    2015-02-01

    Full Text Available Purpose: To report a case of a cyclodialysis cleft that was successfully managed with gas endotamponade and cyclocryotherapy. Methods: A 37-year-old male victim of a severe blunt ocular trauma was referred to our service for evaluation and treatment of a left eye hypotony. Clinical examination revealed an intraocular pressure of 2 mm Hg, a cyclodialysis cleft extending from the 11 to 1 o'clock positions and a hypotonic maculopathy. Left eye best corrected visual acuity (BCVA was 3/10. The patient failed to respond to conservative treatment with atropine 1%, so a single bubble of 16% C2F6 was injected into the vitreous cavity, followed by superior quadrant transconjunctival cyclocryotherapy. Results: After gas absorption, the intraocular pressure increased to 11 mm Hg and became steady during the 24 months of follow-up. His hypotonic maculopathy resolved, and the BCVA improved to 9/10. Complete closure of the cyclodialysis cleft was documented with ultrasound biomicroscopy. Conclusion: Cryotherapy associated with gas endotamponade is a minimally invasive technique that could be considered for patients with cyclodialysis clefts that fail to respond to medical therapy.

  14. Proceedings of the National Conference on Energy Resource Management. Volume 1: Techniques, Procedures and Data Bases

    Science.gov (United States)

    Brumfield, J. O. (Editor); Schiffman, Y. M. (Editor)

    1982-01-01

    Topics dealing with the integration of remotely sensed data with geographic information system for application in energy resources management are discussed. Associated remote sensing and image analysis techniques are also addressed.

  15. Continuation of Development and Application of Data Processing Techniques and Analytic Procedures to Cloud Physics Data.

    Science.gov (United States)

    1976-07-30

    aircraft is fully explained. Practical applications of various mathematical techniques (such as: Newton’s forward formula, least square curve fitting, Pappus-Guldinus Theorem etc) are fully delineated. (Author)

  16. Economics of wastewater treatment in GTL plant using spray technique

    Directory of Open Access Journals (Sweden)

    G.C. Enyi, G.G. Nasr, M. Burby

    2013-01-01

    Full Text Available In a Gas-to-liquid (GTL plant, significant quantities of CO2 and reaction water are produced and various chemicals are used as intermediate treatment chemicals. The reaction water is contaminated by these chemicals which impair the pH and the related properties of the water. The pH has to be controlled in the effluent treatment unit before the water is re-used or released to the environment. The overall aim of this investigation is to create a novel technique to address the problem of waste water treatment in GTL plants which will assist in the reduction of greenhouse gas (CO2 emissions into the atmosphere. A laboratory-scale effluent neutralisation unit for pH control utilising gas injectors was designed and built. The unit used the CO2 produced as a by-product of GTL process as wastewater treatment chemical instead of the conventional Sulphuric acid. The quality of wastewater after treatment with CO2 met the standards set by the state regulatory agency. The economics of the new process shows a better payout period of 3.6 years for capital investment of $1,645 Million compared to 4.7 years for an existing plant layout with capital investment of $1,900 Million. The effects of increase in plant capacity showed a lower payback back of 2.8 years for plant capacity of 140,000 barrels/day (22258 m3/day, 3.6 years for 34,000 barrels/day and 6.0 years for 12,500 barrels/day (1987 m3/day plant capacity. The sensitivity analysis using crystal ball simulator with ‘Microsoft Excel’ shows that the annual revenue has the greatest effects on the NPV of the plant than the CAPEX and inflation rate. Apart from the environmental benefits the process generates by reducing CO2 emissions into the atmosphere, the study also concludes that the replacement of conventional Sulphuric acid (H2SO4 unit with CO2 improves the economics of the plant.

  17. Economics of wastewater treatment in GTL plant using spray technique

    Energy Technology Data Exchange (ETDEWEB)

    Enyi, G.C.; Nasr, G.G.; Burby, M. [University of Salford, Manchester, M5 4WT (United Kingdom)

    2013-07-01

    In a Gas-to-liquid (GTL) plant, significant quantities of CO2 and reaction water are produced and various chemicals are used as intermediate treatment chemicals. The reaction water is contaminated by these chemicals which impair the pH and the related properties of the water. The pH has to be controlled in the effluent treatment unit before the water is re-used or released to the environment. The overall aim of this investigation is to create a novel technique to address the problem of waste water treatment in GTL plants which will assist in the reduction of greenhouse gas (CO2) emissions into the atmosphere. A laboratory-scale effluent neutralisation unit for pH control utilising gas injectors was designed and built. The unit used the CO2 produced as a by-product of GTL process as wastewater treatment chemical instead of the conventional Sulphuric acid. The quality of wastewater after treatment with CO2 met the standards set by the state regulatory agency. The economics of the new process shows a better payout period of 3.6 years for capital investment of $1,645 Million compared to 4.7 years for an existing plant layout with capital investment of $1,900 Million. The effects of increase in plant capacity showed a lower payback back of 2.8 years for plant capacity of 140,000 barrels/day (22258 m3/day), 3.6 years for 34,000 barrels/day and 6.0 years for 12,500 barrels/day (1987 m3/day) plant capacity. The sensitivity analysis using crystal ball simulator with 'Microsoft Excel' shows that the annual revenue has the greatest effects on the NPV of the plant than the CAPEX and inflation rate. Apart from the environmental benefits the process generates by reducing CO2 emissions into the atmosphere, the study also concludes that the replacement of conventional Sulphuric acid (H2SO4) unit with CO2 improves the economics of the plant.

  18. Sediment remediation treatment techniques for the Venice industrial canals

    Energy Technology Data Exchange (ETDEWEB)

    Pippa, R.; Scanferla, P.; Cammarata, F.; Zampieri, L.; Carlon, C. [Consorzio Venezia Ricerche (Italy); Pavoni, B. [Ca' Foscari University of Venice (Italy). Dept. of Environmental Sciences; Pannocchia, G. [Venezia Technologie SpA, Venice (Italy); Hreglich, S. [Stazione Sperimentale del Vetro, Venice (Italy); Avezzu, F. [Depuracque Impianti srl, Venice (Italy)

    2003-07-01

    The main objective of SeRTech project (Sediment Remediation Technologies) is to develop an integrated cost-effective treatment system to address heterogeneous contamination and matrixes, such as those of Venice lagoon dredged materials. Seven treatment techniques, selected over a large array, have been tested: Thermal Desorption. A preliminary set of isothermal treatments at different temperatures was performed to evaluated the losses of organic and the most volatile metals (such as Pb and As). An almost full volatilisation of organic compounds was observed at temperatures ranging between 200 and 300 C. Chemical stabilization-solidification. Depuracque Impianti srl process uses innovative patented additives (polimers and superplasticizers) to immobilize heavy metals into cement pellets. Solvent extraction. Organic contaminants such as PAHs and PCBs were extracted from sediments by using ethyl acetate. The results showed that solvent extraction obtained high efficiency in removal of PAHs and other organic contaminants. Immobilization of heavy metals employing sulfate-reducing bacteria. High Gradient Magnetic Separation (HGMS). Sulfate reducing bacteria (SBR) produce an iron sulfide containing biomass with a high capability to adsorbe hevy metals and some organic compounds. This biomass can be separated through a high gradient magnetic field removing a substantial fraction of contaminants. Vitrification. Sediment was mixed with other inorganic wastes (glass cullet, feldsphatic tailings) and low amounts of row material to obtain an inert glass, which in turn can be recycled into other useful products, for example glass fibres, foam glass and glass ceramics. Phytoremediation. Phragmites australis (Cav.), Trin; Juncus Iacustrus, Arthrocnmemum fruticosum, Spartina maritima, Helianthus annuus L., Zea mais L., Brassica napus L., Brassica juncea L. have been selected to verify limit and efficiency of phytoextraction for heavy metals (Zn, Pb, Hg, Cd, As, Ni). Not only

  19. Rolling technique for treatment of left displacement of the large colon in horses: 11 cases (2004-2009

    Directory of Open Access Journals (Sweden)

    P.A. Canola

    2013-04-01

    Full Text Available The left displacement of the large colon, a condition that commonly occurs in horses, has two clinical manifestations. Different treatments including medical treatment, rolling the horse under general anesthesia or surgical correction have been recommended. The diagnosis can often be made by rectal examination and confirmed by percutaneous ultrasonography. During the period between 2004 and 2009, 11 horses were treated for left displacement of the large colon by rolling the horses under general anesthesia, using a slightly different technique than the ones previously described. The clinical case selection was based on rectal palpation confirmed with ultrasonogram. Nine animals were successfully treated and two had to be submitted to surgery after three attempts of rolling. No short or long term complications were observed after the procedure. Only one animal had a recurrence of the clinical manifestation 10 months after the first treatment and was successfully rolled once again. Despite a bit different from the other rolling procedures, this also proved to be an effective procedure. Rolling a horse even when attempted more than once showed to be a safe procedure, however, we reinforce the need for special attention following the procedure in order to establish proper emergency procedures in case complications occur.

  20. Tent-shape technique: another procedure to repair P2 of posterior leaflet of mitral valve.

    Science.gov (United States)

    Kassem, Samer; Moasis, Ghassan A; Biglioli, Paolo

    2011-06-01

    In this report, we describe a new procedure to repair the prolapsing high mid-scallop of the mitral valve (MV) posterior leaflet (P2) with detailed consideration of the anatomy and physiology of the MV. A new artificial chord is implanted in the body of the P2 at the same height of non-prolapsing P1 and P3, and the remaining part of the prolapsing P2 is anchored to the artificial chord taking the shape of a tent.

  1. Assessment of Competence in EVAR Procedures: A Novel Rating Scale Developed by the Delphi Technique.

    Science.gov (United States)

    Strøm, M; Lönn, L; Bech, B; Schroeder, T V; Konge, L

    2017-07-01

    To develop a procedure specific global rating scale for assessment of operator competence in endovascular aortic repair (EVAR). A Delphi approach was used to achieve expert consensus. A panel of 32 international experts (median 300 EVAR procedures, range 200-3000) from vascular surgery (n = 21) and radiology (n = 11) was established. The first Delphi round was based on a review of endovascular skills assessment papers, stent graft instructions for use, and structured interviews. It led to a primary pool of 83 items that were formulated as global rating scale items with tentative anchors. Iterative Delphi rounds were executed. The panellists rated the importance of each item on a 5 point Likert scale. Consensus was defined as 80% of the panel rating an item 4 or 5 in the primary round and 90% in subsequent rounds. Consensus on the final assessment tool was defined as Cronbach's alpha > .8 after a minimum of three rounds. Thirty-two of 35 invited experts participated. Three rounds of surveys were completed with a completion rate of 100% in the first two rounds and 91% in round three. The 83 primary assessment items were supplemented with five items suggested by the panel and reduced to seven pivotal assessment items that reached consensus, Cronbach's alpha = 0.82. The seven item rating scale covers key elements of competence in EVAR stent placement and deployment. Each item has well defined grades with explicit anchors at unacceptable, acceptable, and superior performance on a 5 point Likert scale. The Delphi methodology allowed for international consensus on a new procedure specific global rating scale for assessment of competence in EVAR. The resulting scale, EndoVascular Aortic Repair Assessment of Technical Expertise (EVARATE), represents key elements in the procedure. EVARATE constitutes an assessment tool for providing structured feedback to endovascular operators in training. Copyright © 2017 European Society for Vascular Surgery. Published by Elsevier

  2. The National Criminal Justice Treatment Practices survey: multilevel survey methods and procedures.

    Science.gov (United States)

    Taxman, Faye S; Young, Douglas W; Wiersema, Brian; Rhodes, Anne; Mitchell, Suzanne

    2007-04-01

    The National Criminal Justice Treatment Practices (NCJTP) survey provides a comprehensive inquiry into the nature of programs and services provided to adult and juvenile offenders involved in the justice system in the United States. The multilevel survey design covers topics such as the mission and goals of correctional and treatment programs; organizational climate and culture for providing services; organizational capacity and needs; opinions of administrators and staff regarding rehabilitation, punishment, and services provided to offenders; treatment policies and procedures; and working relationships between correctional and other agencies. The methodology generates national estimates of the availability of programs and services for offenders. This article details the methodology and sampling frame for the NCJTP survey, response rates, and survey procedures. Prevalence estimates of juvenile and adult offenders under correctional control are provided with externally validated comparisons to illustrate the veracity of the methodology. Limitations of the survey methods are also discussed.

  3. Monitoring techniques and alarm procedures for CMS Services and Sites in WLCG

    Science.gov (United States)

    Molina-Perez, J.; Bonacorsi, D.; Gutsche, O.; Sciabà, A.; Flix, J.; Kreuzer, P.; Fajardo, E.; Boccali, T.; Klute, M.; Gomes, D.; Kaselis, R.; Du, R.; Magini, N.; Butenas, I.; Wang, W.

    2012-12-01

    The CMS offline computing system is composed of roughly 80 sites (including most experienced T3s) and a number of central services to distribute, process and analyze data worldwide. A high level of stability and reliability is required from the underlying infrastructure and services, partially covered by local or automated monitoring and alarming systems such as Lemon and SLS; the former collects metrics from sensors installed on computing nodes and triggers alarms when values are out of range, the latter measures the quality of service and warns managers when service is affected. CMS has established computing shift procedures with personnel operating worldwide from remote Computing Centers, under the supervision of the Computing Run Coordinator at CERN. This dedicated 24/7 computing shift personnel is contributing to detect and react timely on any unexpected error and hence ensure that CMS workflows are carried out efficiently and in a sustained manner. Synergy among all the involved actors is exploited to ensure the 24/7 monitoring, alarming and troubleshooting of the CMS computing sites and services. We review the deployment of the monitoring and alarming procedures, and report on the experience gained throughout the first two years of LHC operation. We describe the efficiency of the communication tools employed, the coherent monitoring framework, the proactive alarming systems and the proficient troubleshooting procedures that helped the CMS Computing facilities and infrastructure to operate at high reliability levels.

  4. New Procedure for Treatment of Atrial Fibrillation in Patients with Valvular Heart Disease

    Directory of Open Access Journals (Sweden)

    Naser Safaie

    2010-09-01

    Full Text Available "nPatients with valvular heart disease suffer from atrial fibrillation for more than 12 months after valve surgery and have a low probability of remaining in sinus rhythm. We performed an intra-operative procedure similar to surgical maze ІІІ procedure for conversion of this arrhythmia to sinus rhythm. We did this study to evaluate the efficacy of this procedure to restore the sinus rhythm in patients with valvular heart disease. 28 patients with valvular heart disease and chronic persistent atrial fibrillation underwent different combinations of valve surgery and concomitant reduction of left and right atrial size and resection of both atrial auricles in Shahid Madani cardiothoracic center from September 2004 to October 2008. The procedure for atrial fibrillation treatment was performed with cardiopulmonary bypass and after mitral valve replacement. There was one in-hospital death postoperatively because of respiratory failure, but no other complication till 6 months after the operation. Out of 28 patients, 23 were in sinus rhythm one week after the operation, one patient had junctional rhythm after the operation that restored to sinus rhythm and 4 patients had persistent atrial fibrillation. During the 12-month follow up, atrial fibrillation was corrected in 82.14%. Doppler echocardiography in these patients with sinus rhythm demonstrated good atrial contractility. This procedure on both atria is effective and less invasive than the original maze procedure to eliminate the atrial fibrillation, and can be performed in patients with valvular heart disease without increasing the risk of operation.

  5. New Procedure for Treatment of Atrial Fibrillation in Patients with Valvular Heart Disease

    Directory of Open Access Journals (Sweden)

    Naser Safaie

    2010-10-01

    Full Text Available Patients with valvular heart disease suffer from atrial fibrillation for more than 12 months after valve surgery and have a low probability of remaining in sinus rhythm. We performed an intra-operative procedure similar to surgical maze ІІІ procedure for conversion of this arrhythmia to sinus rhythm. We did this study to evaluate the efficacy of this procedure to restore the sinus rhythm in patients with valvular heart disease. 28 patients with valvular heart disease and chronic persistent atrial fibrillation underwent different combinations of valve surgery and concomitant reduction of left and right atrial size and resection of both atrial auricles in Shahid Madani cardiothoracic center from September 2004 to October 2008. The procedure for atrial fibrillation treatment was performed with cardiopulmonary bypass and after mitral valve replacement. There was one in-hospital death postoperatively because of respiratory failure, but no other complication till 6 months after the operation. Out of 28 patients, 23 were in sinus rhythm one week after the operation, one patient had junctional rhythm after the operation that restored to sinus rhythm and 4 patients had persistent atrial fibrillation. During the 12-month follow up, atrial fibrillation was corrected in 82.14%. Doppler echocardiography in these patients with sinus rhythm demonstrated good atrial contractility. This procedure on both atria is effective and less invasive than the original maze procedure to eliminate the atrial fibrillation, and can be performed in patients with valvular heart disease without increasing the risk of operation.

  6. New procedure for treatment of atrial fibrillation in patients with valvular heart disease.

    Science.gov (United States)

    Safaie, Naser; Maghamipour, Nasrollah; Jodati, Ahmad Reza; Mahmoodpoor, Ata; Dashtaki, Leila; Hakimzadeh, Masoud

    2010-01-01

    Patients with valvular heart disease suffer from atrial fibrillation for more than 12 months after valve surgery and have a low probability of remaining in sinus rhythm. We performed an intra-operative procedure similar to surgical maze ІІІ procedure for conversion of this arrhythmia to sinus rhythm. We did this study to evaluate the efficacy of this procedure to restore the sinus rhythm in patients with valvular heart disease. 28 patients with valvular heart disease and chronic persistent atrial fibrillation underwent different combinations of valve surgery and concomitant reduction of left and right atrial size and resection of both atrial auricles in Shahid Madani cardiothoracic center from September 2004 to October 2008. The procedure for atrial fibrillation treatment was performed with cardiopulmonary bypass and after mitral valve replacement. There was one in-hospital death postoperatively because of respiratory failure, but no other complication till 6 months after the operation. Out of 28 patients, 23 were in sinus rhythm one week after the operation, one patient had junctional rhythm after the operation that restored to sinus rhythm and 4 patients had persistent atrial fibrillation. During the 12-month follow up, atrial fibrillation was corrected in 82.14%. Doppler echocardiography in these patients with sinus rhythm demonstrated good atrial contractility. This procedure on both atria is effective and less invasive than the original maze procedure to eliminate the atrial fibrillation, and can be performed in patients with valvular heart disease without increasing the risk of operation.

  7. Lateral Decubitus All-Arthroscopic Latarjet Procedure for Treatment of Shoulder Instability.

    Science.gov (United States)

    Lewington, Matthew R; Urquhart, Nathan; Wong, Ivan H

    2015-06-01

    Shoulder instability can be a challenging condition to treat when it becomes refractory to soft-tissue procedures or when bone loss exceeds 25% to 27% of the glenoid. The Bristow-Latarjet procedure has been developed and popularized to deal with these concerns. Traditionally, the procedure has been performed as an open approach; however, this has been recently supplanted by novel arthroscopic techniques. We present a technique for the procedure performed with the patient in a semi-lateral decubitus position that assists with optimal graft placement on the native glenoid. We use the cannulated Bristow-Latarjet Instability Shoulder System (DePuy Mitek, Raynham, MA). After a diagnostic arthroscopic evaluation, we use multiple arthroscopic anterior portals to debride the rim of the glenoid. The coracoid is prepared and taken down arthroscopically, and the cannulated guide is attached and advanced through an arthroscopically created subscapularis split. With the shoulder held in a reduced position, we are then able to drill and anchor the graft to the native glenoid. The patient is able to begin gentle range-of-motion exercises immediately postoperatively.

  8. Lateral Decubitus All-Arthroscopic Latarjet Procedure for Treatment of Shoulder Instability

    Science.gov (United States)

    Lewington, Matthew R.; Urquhart, Nathan; Wong, Ivan H.

    2015-01-01

    Shoulder instability can be a challenging condition to treat when it becomes refractory to soft-tissue procedures or when bone loss exceeds 25% to 27% of the glenoid. The Bristow-Latarjet procedure has been developed and popularized to deal with these concerns. Traditionally, the procedure has been performed as an open approach; however, this has been recently supplanted by novel arthroscopic techniques. We present a technique for the procedure performed with the patient in a semi-lateral decubitus position that assists with optimal graft placement on the native glenoid. We use the cannulated Bristow-Latarjet Instability Shoulder System (DePuy Mitek, Raynham, MA). After a diagnostic arthroscopic evaluation, we use multiple arthroscopic anterior portals to debride the rim of the glenoid. The coracoid is prepared and taken down arthroscopically, and the cannulated guide is attached and advanced through an arthroscopically created subscapularis split. With the shoulder held in a reduced position, we are then able to drill and anchor the graft to the native glenoid. The patient is able to begin gentle range-of-motion exercises immediately postoperatively. PMID:26258032

  9. KAPANDJI TECHNIQUE AS AMINIMALLY INVASIVE PROCEDURE FOR SELECTED PATIENTS WITH TWO- AND THREE-PART FRACTURES OF THE PROXIMAL HUMERUS.

    Science.gov (United States)

    Chamseddine, Ali Hassan; Abdallah, Amer Camille; Zein, Hadi Khaled

    2016-01-01

    Current algorithms for decision making in proximal humerus fractures consider the fracture pattern along with the patient characteristics and surgeon’s experience. Minimally invasive techniques for reduction and internal fixation of many types of these fractures have recently been widely promoted, especially with the use of the newly developed locking plate systems. Intramedullary flexible nailing is one of the oldest techniques using minimally invasive reduction and fixation of proximal humerus fractures. Kapandji technique uses the “Deltoid V” landmark as entry point for intramedullary insertion of the flexible nails into the humeral head. The authors report their experience with this procedure in twenty-six, relatively young patients with good bone quality, presenting with displaced 2- or 3-part extra-articular fracture of the proximal humerus, treated with percutaneous reduction and intramedullary flexible nailing as described by Kapandji. Nineteen medical records were available for this retrospective review, with 9 to 12 months follow-up. There were 15 excellent and 1 good results when patients were assessed for pain, function and range of motion of the shoulder. The authors submit that Kapandji technique is a valuable procedure for management of extra-articular displaced 2- and 3- part proximal humerus fractures in young patients with good bone quality.

  10. Whole-procedure clinical accuracy of Gamma Knife treatments of large lesionsa).

    Science.gov (United States)

    Ma, Lijun; Chuang, Cynthia; Descovich, Martina; Petti, Paula; Smith, Vernon; Verhey, Lynn

    2008-11-01

    The mechanical accuracy of Gamma Knife radiosurgery based on single-isocenter measurement has been established to within 0.3mm. However, the full delivery accuracy for Gamma Knife treatments of large lesions has only been estimated via the quadrature-sum analysis. In this study, the authors directly measured the whole-procedure accuracy for Gamma Knife treatments of large lesions to examine the validity of such estimation. The measurements were conducted on a head-phantom simulating the whole treatment procedure that included frame placement, computed tomography imaging, treatment planning, and treatment delivery. The results of the measurements were compared with the dose calculations from the treatment planning system. Average agreements of 0.1-1.6mm for the isodose lines ranging from 25% to 90% of the maximum dose were found despite potentially large contributing uncertainties such as 3-mm imaging resolution, 2-mm dose grid size, 1-mm frame registration, multi-isocenter deliveries, etc. The results of our measurements were found to be significantly smaller (>50%) than the calculated value based on the quadrature-sum analysis. In conclusion, Gamma Knife treatments of large lesions can be delivered much more accurately than predicted from the quadrature-sum analysis of major sources of uncertainties from each step of the delivery chain. © 2008 American Association of Physicists in Medicine.

  11. [Tension-free procedures in the surgical treatment of groin hernias].

    Science.gov (United States)

    Milić, Dragan J; Pejić, Miljko A

    2003-01-01

    Fix plug and patch repair, the Prolene Hernia System bilayer patch repair and Trabucco's sutureless preshaped herniography. General surgeons today have access to a wider and more sophisticated range of synthetic biomaterials for use in hernia repair than ever before. The advantages and disadvantages of each of these devices must be understood, however, before surgeons select any of these implants. Meanwhile, a 1997 study of various biomaterials used in abdominal wall hernia repair further reported that the risk of infection, seroma formation, biomaterial-related intestinal obstructions, and other complications can be minimized or eliminated by understanding the process underlying these problems and taking proper precautions. The surgeon's choice of the prosthesis used in hernia repair is based on a combination of factors, including patient characteristics; clinical experience, training, interest, and skill; understanding of the range of products available and the clinical studies that may have been performed on each; and the surgeon's familiarity with a particular product and/or surgical approach. Innovations in technique and product design will no doubt continue to spur advances in hernia repair, and it is hoped that they will continue to improve outcomes. The availability of these outcomes data, along with the ongoing accumulation of clinical experience with a broad range of materials and techniques, will help surgeons to better identify the most appropriate prosthesis for the clinician and the patient. It appears that herniology will remain in the realm of the surgeon, since it is doubtful that any medical measures will replace the operative treatment for abdominal wall hernias. Although operative procedures are not yet ideal, important advances have been made in herniorrhaphy resulting in improved outcomes: The use of local techniques has maximized the safety of anesthesia; time needed for care has been minimized, with most procedures now being done on an outpatient

  12. Mini-invasive impression techniques in fixed prothesis: an alternative to traditional procedures

    Science.gov (United States)

    BONINO, M.; DE VICO, G.; SPINELLI, D.; CONTI, I.; OTTRIA, L.; BARLATTANI, A.

    2010-01-01

    SUMMARY The object of our work is the illustration of an alternative technique in the impress survey in fixed prosthesis. This method conceived from Doctor Casartelli, allowed us to utilize this technology in the day-to-day activity eliminating also the anaesthetic use, so give the possibility to operate patients with anticoagulant therapy. Moreover the mini-invasive techniques allow a lowering recessions, best tolerability from the patients, less pain and postoperative inflammation, “restitutio ad integrum” of tissue without morphological modifications. PMID:23285382

  13. Improved outcomes with direct percutaneous CT guided lumbar synovial cyst treatment: advanced approaches and techniques.

    Science.gov (United States)

    Ortiz, A Orlando; Tekchandani, Leena

    2014-12-01

    To determine if lumbar synovial cyst rupture in symptomatic patients results in improved clinical outcome when using direct tandem and/or coaxial percutaneous CT guided techniques. 20 patients with unilateral lower extremity radiculopathy and/or low back pain underwent CT guided percutaneous treatment for their symptomatic lumbar synovial cysts. Cysts were identified with the use of a low osmolar non-ionic contrast agent via facet joint injection or through direct injection. Cyst rupture, using a direct tandem and/or coaxial technique, was attempted in all patients using an 18 gauge guide needle and a 22 gauge insert needle. Following attempted cyst aspiration, cyst rupture was performed using 1-3 mL of a mixture of methylprednisolone (2 mL, 80 mg) and bupivacaine (3 mL, 0.5%). All patients were followed-up in clinic for a minimum of 6 months after their procedures and up to a maximum of 24 months. 11 patients were male and nine were female, with an average age of 65.6 years. 17 patients presented with severe unilateral lower extremity radiculopathy and three patients were experiencing low back pain. One of the patients had two synovial cysts, and therefore a total of 21 lumbar synovial cysts were treated in this group of patients. Direct cyst puncture was achieved using a tandem technique in nine patients, a coaxial interlaminar approach in seven patients, a coaxial transforaminal approach in two patients, and a coaxial trans-facet approach in three patients. Cyst rupture was documented in all cases, as evidenced by CT confirmation of cyst decompression and contrast agent extravasation into the epidural space. The mean surveillance period in these patients was 18 months. Six patients experienced their usual radicular pain within 2 months of their treatment. Four of these patients were re-treated for recurrent smaller cysts. These patients have not had a recurrence at 24 months of follow up. Two of these six patients elected to undergo open

  14. Laboratory procedures and data reduction techniques to determine rheologic properties of mass flows

    Science.gov (United States)

    Holmes, R.R.; Huizinga, R.J.; Brown, S.M.; Jobson, H.E.

    1993-01-01

    Determining the rheologic properties of coarse- grained mass flows is an important step to mathematically simulate potential inundation zones. Using the vertically rotating flume designed and built by the U.S. Geological Survey, laboratory procedures and subsequent data reduction have been developed to estimate shear stresses and strain rates of various flow materials. Although direct measurement of shear stress and strain rate currently (1992) are not possible in the vertically rotating flume, methods were derived to estimate these values from measurements of flow geometry, surface velocity, and flume velocity.

  15. Procedure for studying population genetic aspects of marine organisms using biochemical techniques

    Digital Repository Service at National Institute of Oceanography (India)

    Menezes, M.R.

    .1.1.44); and general protein (PROT). Staining procedures ofenzymes and proteins (Menezes and Taniguchi, 1988) 1. NADP+ dependent Each mixture ofsubstrate staining solution is added with: Nicotinamide-adenine dinucleotide phosphate (NADP) 6mg Phenazine methosulphate... is added with: Nicotinamide-adenine dinucleotide (NAD) 6mg Phenazine methosulphate (PMS) 1mg 189 NBDBlDBTSponsored TraJnbrion T/UU)nOlrlJ, Genet/cs IUld Gene BanJdni ofCoastaJ and Marine BlorDO,m:es, elF£, MwnbaI --Nitro blue tetrazolium (NBT) of 1...

  16. An improved brain image classification technique with mining and shape prior segmentation procedure.

    Science.gov (United States)

    Rajendran, P; Madheswaran, M

    2012-04-01

    The shape prior segmentation procedure and pruned association rule with ImageApriori algorithm has been used to develop an improved brain image classification system are presented in this paper. The CT scan brain images have been classified into three categories namely normal, benign and malignant, considering the low-level features extracted from the images and high level knowledge from specialists to enhance the accuracy in decision process. The experimental results on pre-diagnosed brain images showed 97% sensitivity, 91% specificity and 98.5% accuracy. The proposed algorithm is expected to assist the physicians for efficient classification with multiple key features per image.

  17. Commander’s Guide to Money as a Weapons System: Tactics, Techniques, and Procedures

    Science.gov (United States)

    2009-04-01

    events, diffuse potential unrest, and foster relations and stability with the local Afghan people. Provincial reconstruction teams (PRT) and...more advanced techniques such as reverse osmosis . The distribution of drinking water is accomplished via municipal water systems or as bottled water

  18. Proceedings of the National Conference on Energy Resource Management. Volume 1: Techniques, Procedures and Data Bases

    Energy Technology Data Exchange (ETDEWEB)

    Brumfield, J.O.; Schiffman, Y.M.

    1982-01-01

    Topics dealing with the integration of remotely sensed data with geographic information system for application in energy resources management are discussed. Associated remote sensing and image analysis techniques are also addressed. For individual titles, see N83-26156 through N83-26175.

  19. Giant and complex aneurysms treatment with preservation of flow via bypass technique.

    Science.gov (United States)

    Thines, L; Proust, F; Marinho, P; Durand, A; van der Zwan, A; Regli, L; Lejeune, J-P

    2016-02-01

    Due to their anatomical characteristics and the complexity of the procedures required to obtain their complete occlusion, the treatment of giant intracranial aneurysms is a real challenge. Direct reconstructive strategies, whether by interventional neuroradiology (coils, stents) or microsurgical (clipping) means, are not always applicable and, in patients that would not tolerate parent or collateral artery sacrifice, the adjunction of a revascularization procedure using a bypass technique might be necessary. Cerebral arterial bypasses can be classified according to their function (3 types: flow replacement, flow reversal or protective), the branching mode of the graft used (3 types: pedicled, interpositional or in situ), the sites of anastomosis (2 types: extracranial-intracranial or intracranial-intracranial) and the class of flow they are supposed to provide (3 types: low-, intermediate- or high-flow). In this article, the authors review the different aspects in the management of patients with a giant intracranial aneurysm using a bypass: preoperative work-up, types of bypass and indications, surgical techniques and results.

  20. Pain and nurses' emotion work in a paediatric clinic: treatment procedures and nurse-child alignments.

    Science.gov (United States)

    Rindstedt, Camilla

    2013-01-01

    In the treatment of cancer in children, treatment procedures have been reported to be one of the most feared elements, as more painful than the illness as such. This study draws on a video ethnography of routine needle procedure events, as part of fieldwork at a paediatric oncology clinic documenting everyday treatment negotiations between nurses and young children. On the basis of detailed transcriptions of verbal and nonverbal staff-child interaction, the analyses focus on ways in which pain and anxiety can be seen as phenomena that are partly contingent on nurses' emotion work. The school-age children did not display fear. In the preschool group, though, pain and fear seemed to be phenomena that were greatly reduced through nurses' emotion work. This study focuses on three preschoolers facing potentially painful treatment, showing how the nurses engaged in massive emotion work with the children, through online commentaries, interactive formats (delegation of tasks, consent sequences, collaborative 'we'-formats), as well as solidarity-oriented moves (such as praise and endearment terms). Even a young toddler would handle the distress of needle procedures, when interacting with an inventive nurse who mobilized child participation through skilful emotion work.

  1. The Manchester procedure versus vaginal hysterectomy in the treatment of uterine prolapse

    DEFF Research Database (Denmark)

    Tolstrup, Cæcilie Krogsgaard; Lose, Gunnar; Klarskov, Niels

    2017-01-01

    INTRODUCTION AND HYPOTHESIS: Uterine prolapse is a common health problem and the number of surgical procedures is increasing. No consensus regarding the surgical strategy for repair of uterine prolapse exists. Vaginal hysterectomy (VH) is the preferred surgical procedure worldwide, but uterus......-preserving alternatives including the Manchester procedure (MP) are available. The objective was to evaluate if VH and the MP are equally efficient treatments for uterine prolapse with regard to anatomical and symptomatic outcome, quality of life score, functional outcome, re-operation and conservative re......-intervention rate, complications and operative outcomes. METHODS: We systematically searched Embase, PubMed, the Cochrane databases, Clinicaltrials and Clinical trials register using the MeSh terms "uterine prolapse", "uterus prolapse", "vaginal prolapse" "pelvic organ prolapse", "prolapsed uterus", "Manchester...

  2. Impact of Technique-Specific Operative Videos on First-Year Dental Students' Performance of Restorative Procedures.

    Science.gov (United States)

    Patel, Shalizeh A; Barros, Juliana A; Clark, Christina M; Frey, Gary N; Streckfus, Charles F; Quock, Ryan L

    2015-09-01

    The aim of this study was to examine the impact of psychomotor operative video demonstrations on first-year dental students who are performing specific procedures for the first time in a preclinical setting. The class was randomly divided into two groups, and three restorative procedures were selected. On the date on which each procedure was to be performed in the preclinical laboratory for the first time, one group (experimental, n=50) was shown a technique video for that specific procedure immediately before commencing the exercise; the control cohort (n=50) did not view the video. Technical performance on procedures was evaluated by students and two calibrated and blinded examiners. The students' perceptions of the experience were also collected in a survey. All first-year students participated in the study, for a 100% response rate. A Mann-Whitney U test did not show any group differences in technical performance (mean values on preparation: 77.1 vs. 77.8; amalgam: 82.7 vs. 82.8; composite: 79.7 vs. 78.0). A Spearman rho test revealed a significantly higher correlation in 13 out of 25 evaluation categories between student self-assessment and blinded examiner assessment for the experimental group. A chi-square test of questionnaire responses revealed a positive student perception of administering these videos for the preparation (X(2)=4.8, pstudent performance on preclinical operative procedures, but they were well received by students and augmented self-assessment ability. These findings suggest that videos can be a useful teaching aid in a preclinical environment, especially regarding comprehension of concepts.

  3. Prioritization governmental insurance company according to BSC procedure by AHP group technique

    Directory of Open Access Journals (Sweden)

    Amene Kiarazm

    2014-05-01

    Full Text Available Insurance industry is one of the industries that have special importance and validity in modern economy, domestic and foreign trade. Performance evaluation and grading the insurance company in addition to determining the general position of agency in industry, market and informing the beneficiaries, cause increase in competition, dynamism in industry, and development in community. On the other hand, organization strategic performance evaluation is always one the first and most basic prerequisites for compiling improvement programs in organizations and it has a high importance. One of the strategic efficient models in this aspect is BSC that equally analyses all aspects of organization. The statistical population in this research is consists of four governmental insurance (Iran, Asia, Dana and Alborz. For collecting data, haphazard sampling procedure was used. Study tool is questionnaire whose reliability was measured by consistency ratio and whose validity was measured by content-construct method by acquiring the opinions of experts and some managers in this field of study and the results showed appropriate reliability and validity. In analysis data section, the group integrative procedures AHP and BSC were used. The results showed that the D insurance company had the higher final score than the other companies. After that the C, A and B insurance companies were respectively.

  4. Development of a technique for environmental treatment by radiation

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Myun Joo; Jin, J. H.; Jung, Y. D. and others

    2000-04-01

    This study was carried out for the development of pilot plant which can produce industrial water from effluent of sewage treatment plant by irradiation. As a basic study, the characteristics on decomposition of organic compounds, decoloration and sterilization of bacteria were evaluated. An additive mainly composed by sponge type of TiO{sub 2} was developed for reduction of irradiation dose and enhancement of removal efficiency of organic compounds. The optimum pilot plant was composed of sysem with gamma irradiation/ozone/additive/ion exchange. The effluent with BOD 20 ppm, COD 25 ppm and color 25 ADMI could be treated to less than 5 ppm and 5 ADMI under the irradiation of 5 kGy. The disinfection of microorganism also could be done perfectively under the same irradiation. A small amount of heavy metal ions and inorganic ions, nitrogen, contained in effluent were removed by ion exchanger. From the operation of pilot plant it could be concluded that irradiation technique can be a good method for the produce of industrial water from effluent.

  5. Coiling vs. clipping. Hospital stay and procedure time in intracranial aneurysm treatment

    Energy Technology Data Exchange (ETDEWEB)

    Brunken, Martin; Kehler, U. [Abt. fuer Neurochirurgie, Asklepios-Klinik Altona (Germany); Fiehler, J. [Neuroradiology, Universitaetskrankenhaus Hamburg-Eppendorf (Germany); Leppien, A.; Eckert, B. [Fachbereich Neuroradiologie, Asklepios-Klinik Altona (Germany)

    2009-10-15

    Purpose: evaluation of hospital resource allocation in intracranial aneurysm treatment in a medium-volume neurovascular center. Materials and methods: retrospective data analysis included 653 procedures performed on 598 patients with 667 aneurysms (A) from 1990 to 2004. 515 treatments were carried out in ruptured A (clip: n = 370; coil: n = 145) and 138 procedures in non-ruptured A (clip: n = 51, coil: n = 87). Patient management data included procedure time (min), length of stay in the intensive care unit (days), total length of hospital stay (days), and discharge to home ratio. Results: clinical admission grade (rupt. A: Hunt and Hess grade 1-3: clip: 73% coil: 72%) and clinical outcome at discharge (good neurological outcome/mortality rate: rupt. A: clip: 51.1/13.8% coil: 45.5/10.3% non-rupt. A: 88.2/0% coil: 88.5/1.3%) were similar for both treatment modes. The coil procedure time was found to be significantly shorter (rupt. A: coil: 145 min; clip: 203 min; p < 0.01; non-rupt. A: coil: 164 min, clip: 200 min; p < 0.01). Coiling reduced the length of stay in the ICU (rupt. A: coil: 5.3 d; clip: 6d, p < 0.01; non-rupt. A: coil: 1.5d; clip: 2d; p = 0.21) and coiling significantly reduced the length of hospital stay (rupt. A: coil: 21.4d; clip: 26.8 d, p < 0.01; non-rupt. A: coil: 9.2d; clip: 17.5d; p = 0.01). The discharge to home ratio did not differ (rupt. A: clip: 31.6% coil: 29.7% nonrupt. A: clip: 74.5% coil: 80.5%). Conclusion: in a medium-volume neurovascular center, coiling significantly reduced the procedure time, the stay in the ICU, and the length of hospital stay suggesting favorable resource allocation in endovascular therapy. (orig.)

  6. Video-assisted anal fistula treatment (VAAFT): a novel sphincter-saving procedure for treating complex anal fistulas.

    Science.gov (United States)

    Meinero, P; Mori, L

    2011-12-01

    Video-assisted anal fistula treatment (VAAFT) is a novel minimally invasive and sphincter-saving technique for treating complex fistulas. The aim of this report is to describe the procedural steps and preliminary results of VAAFT. Karl Storz Video Equipment is used. Key steps are visualization of the fistula tract using the fistuloscope, correct localization of the internal fistula opening under direct vision, endoscopic treatment of the fistula and closure of the internal opening using a stapler or cutaneous-mucosal flap. Diagnostic fistuloscopy under irrigation is followed by an operative phase of fulguration of the fistula tract, closure of the internal opening and suture reinforcement with cyanoacrylate. From May 2006 to May 2011, we operated on 136 patients using VAAFT. Ninety-eight patients were followed up for a minimum of 6 months. No major complications occurred. In most cases, both short-term and long-term postoperative pain was acceptable. Primary healing was achieved in 72 patients (73.5%) within 2-3 months of the operation. Sixty-two patients were followed up for more than 1 year. The percentage of the patients healed after 1 year was 87.1%. The main feature of the VAAFT technique is that the procedure is performed entirely under direct endoluminal vision. With this approach, the internal opening can be found in 82.6% of cases. Moreover, fistuloscopy helps to identify any possible secondary tracts or chronic abscesses. The VAAFT technique is sphincter-saving, and the surgical wounds are extremely small. Our preliminary results are very promising.

  7. Diagnostic procedures in tularaemia with special focus on molecular and immunological techniques.

    Science.gov (United States)

    Splettstoesser, W D; Tomaso, H; Al Dahouk, S; Neubauer, H; Schuff-Werner, P

    2005-08-01

    Tularaemia is a severe bacterial zoonosis caused by the highly infectious agent Francisella tularensis. It is endemic in countries of the northern hemisphere ranging from North America to Europe, Asia and Japan. Very recently, Francisella-like strains causing disease in humans were described from tropical northern Australia. In the last decade, efforts have been made to develop sensitive and specific immunological and molecular techniques for the laboratory diagnosis of tularaemia and also for the definite identification of members of the species F. tularensis and its four subspecies. Screening for the keyword 'Francisella' a Medline search over the last decade was performed and articles describing diagnostic methods for tularaemia and its causative agent were selected. Besides classical microbiological techniques (cultivation, biochemical profiling, susceptibility testing) several new immunological and molecular approaches to identify F. tularensis have been introduced employing highly specific antibodies and various polymerase chain reaction (PCR)-based methods. Whereas direct antigen detection by enzyme-linked immunosorbent assay (ELISA) or immunofluorescence might allow early presumptive diagnosis of tularaemia, these methods--like all PCR techniques--still await further evaluation. Therefore, diagnosis of tularaemia still relies mainly on the demonstration of specific antibodies in the host. ELISA and immunoblot methods started to replace the standard tube or micro-agglutination assays. However, the diagnostic value of antibody detection in the very early clinical phase of tularaemia is limited. Francisella tularensis is regarded as a 'highest priority' biological agent (category 'A' according to the CDC, Atlanta, GA, USA), thus rapid and reliable diagnosis of tularaemia is required not only for a timely onset of therapy, the handling of outbreak investigations but also for the surveillance of endemic foci. Only very recently, evaluated test kits for

  8. Choosing a treatment procedure for early stuttering: issues and future directions.

    Science.gov (United States)

    Onslow, M

    1992-10-01

    The new responsibility of speech-language pathologists to provide direct, early intervention for stuttering creates a further responsibility for them to choose justifiable treatment procedures for that intervention. This paper has two purposes. The first is to encourage clinicians to evaluate the conceptual and practical aspects of the treatments they use for early stuttering. The second purpose of the paper is to overview available early intervention procedures and consider the advantages, disadvantages, and prominent issues associated with each. The procedures considered are environment manipulation, prolonged speech, and response-contingent stimulation. It is concluded that clinicians have no cause to be satisfied with any currently available early intervention procedure. Further, it is concluded that (a) although anticipatory struggle theories have made a useful contribution to scholarship, their line of theoretical reasoning is questionable for clinical practice; (b) although theoretically sound for the purpose, variants of prolonged speech pose prohibitive conceptual and practical shortcomings if they are used to treat very young stuttering children; (c) despite its disadvantages, response contingent stimulation is the most conceptually and practically justifiable method for early intervention with stuttering.

  9. Monitoring techniques and alarm procedures for CMS services and sites in WLCG

    CERN Document Server

    Molina-Perez, Jorge Amando

    2012-01-01

    The CMS offline computing system is composed of roughly 80 sites (including most experienced T3s) and a number of central services to distribute, process and analyze data worldwide. A high level of stability and reliability is required from the underlying infrastructure and services, partially covered by local or automated monitoring and alarming systems such as Lemon and SLS; the former collects metrics from sensors installed on computing nodes and triggers alarms when values are out of range, the latter measures the quality of service and warns managers when service is affected. CMS has established computing shift procedures with personnel operating worldwide from remote Computing Centers, under the supervision of the Computing Run Coordinator on duty at CERN. This dedicated 24/7 computing shift personnel is contributing to detect and react timely on any unexpected error and hence ensure that CMS workflows are carried out efficiently and in a sustained manner. Synergy among all the involved actors is explo...

  10. A Novel Technique of Uterine Manipulation in Laparoscopic Pelvic Oncosurgical Procedures: “The Uterine Hitch Technique”

    Directory of Open Access Journals (Sweden)

    S. P. Puntambekar

    2010-01-01

    Full Text Available Aim. To describe a new technique of uterine manipulation in laparoscopic management of pelvic cancers. Material and Methods. We used a novel uterine hitch technique in 23 patients from May 2008 to October 2008. These patients underwent pelvic oncologic surgery including laparoscopic radical hysterectomy (n=7, laparoscopic anterior resection (n=4, laparoscopic abdominoperineal resection (n=3, laparoscopic posterior exenteration (n=4, or laparoscopic anterior exenteration (n=5. The uterus was hitched to the anterior abdominal.wall by either a single suture in the fundus or by sutures through the round ligaments. Results. The uterine hitch technique was successfully accomplished in all procedures. It was performed in less than 5 minutes in all cases. It obviated the need for vaginal manipulation. An extra port for retraction could be avoided. There were no intraoperative complications. Conclusion. A practical, cheap and reproducible method for uterine manipulation, during pelvic oncologic surgery is described. It improves the stability of the uterus and also obviates the need for keeping an additional assistant for vaginal manipulation in any of the procedures.

  11. [Therapeutic effect of the latest extracorporal elimination procedure (Prometheus treatment) in acute liver failure caused by intoxication].

    Science.gov (United States)

    Bakos, Agnes; Rikker, Csaba; Tóvárosi, Szilveszter; Kárteszi, Mihály

    2007-10-21

    Despite intensive therapy the mortality of acute liver failure without organ transplantation is 60-90%. Because of organ shortage in liver transplantation, a significant number of patients dies while being on the waiting list. In order to diminish the mortality, various trials were introduced to remove the albumin-bound and water-soluble toxins in liver failure with the aim to support the spontaneous regeneration of the liver and maintaining the patients alive until liver transplantation. Prometheus treatment is a relatively new technique combining Fractionated Plasma Separation and Adsorption (FPSA) with a high-flux dialysis. During the procedure the patient's own separated albumin-rich plasma passes through special adsorbents making possible the elimination of albumin-bound toxins, while hemodialysis gets rid of water-soluble toxins. The authors' intention was to demonstrate the efficiency of Prometheus treatment in acute liver failure caused by intoxication. Prometheus treatment was indicated in three patients who suffered from severe intoxication with paracetamol, potassium permanganate and Amanita phalloides, which resulted in a hepatic failure incurable with conservative therapy. Ten treatments were performed in the three female patients. No serious complication was observed. Due to the treatment the albumin-bound (indirect bilirubin p = 0.048; bile acid p = 0.001) and water-soluble (direct bilirubin p = 0.002; creatinine p = 0.007) toxins were significantly decreased. The level of ammonia, urea nitrogen, fibrinogen and antithrombin III did not change significantly. All the three patients were cured without liver transplantation. Prometheus treatment removes efficiently the accumulating toxins in acute liver failure. It is a safe elimination technique. In cases untreatable with conservative therapy it makes possible maintaining the patients alive until the liver regenerates spontaneously, or liver transplantation is feasible.

  12. Surgical treatment of chronic pancreatitis using Frey's procedure: a Brazilian 16-year single-centre experience.

    Science.gov (United States)

    Gestic, Martinho Antonio; Callejas-Neto, Francisco; Chaim, Elinton Adami; Utrini, Murillo Pimentel; Cazzo, Everton; Pareja, Jose Carlos

    2011-04-01

    Surgical treatment of chronic pancreatitis is indicated for intractable pain. Frey's procedure is an accepted treatment for this disease. The aim of the present study was to describe a single-centre experience in the treatment of chronic pancreatitis using Frey's procedure. A retrospective analysis of 73 patients who underwent a Frey's procedure between 1991 to 2007 and had at least 1 year of follow-up. Demographics, indication for surgery, peri-operative complications and late outcomes were analysed. The median age was 39.9 years. Seventy out of the 73 (95.8%) patients were male. The median pre-operative body mass index (BMI) was 19.1 kg/m(2). All patients had abdominal pain, 34 (46.6%) of them daily and 13 (17.8%) weekly, with moderate or severe intensity in 98.6% (n= 72). The aetiology was secondary to alcohol in 70 patients (95.9%), with a median consumption of 278 g per day. The surgical morbidity rate was 28.7%; there were no deaths. Median post-operative follow-up was 77.0 months; 64 patients (91.4%) had complete pain relief and post-operative BMI was 22.4 kg/m(2) (P<0.001). All patients with pre-operative endocrine and exocrine insufficiencies showed no reversal of the situation. New onset insufficiencies appeared late. Frey's procedure was a safe and effective therapeutic option for the surgical treatment of patients with intractable pain caused by chronic pancreatitis. © 2011 International Hepato-Pancreato-Biliary Association.

  13. CONTEMPORARY PRINCIPLES FOR CHOLECYSTITIS TREATMENT WITH LAPAROSCOPIC TECHNIQUE

    Directory of Open Access Journals (Sweden)

    Slobodan Aranđelović

    2016-03-01

    Full Text Available The first laparoscopic cholecystectomy (LC was performed in France in 1987 by a French surgeon (P. Mouret, and it rapidly became accepted until the end of the nineties in Europe and America as a "gold standard" in the treatment of the gallbladder. "There are just a few examples in the history of surgery, where the advantage of some surgical techniques is so quickly imposed, as it is in the case of laparoscopic cholecystectomy" (Cusshieri. Assuming the present of a surgical skill and experience, welltrained team and the specific technical equipment, the main advantages of this surgical method are less operative trauma and postoperative pain, faster recovery and a shorter hospital stay. The percentage of conversion to open cholecystectomy is 2%-20% and it is caused by certain conditions, such as older age, morbid obesity, and expressed inflammation of gallbladder and biliary anatomical anomalies. Male gender, anatomical variations, previous abdominal operations and technical problems, were rarer causes of conversion. Non-compliance and non-recognition of these risk factors can lead to complications, most notably the common bile duct injuries. At the Surgical Clinic in Nis, in the period of 3 years (January 2010 to November 2013 1.389 patients with symptomatic cholelithiasis underwent surgery, 626 (45,1% using standard techniques of laparoscopic method. Most patients, 60,10%, were female and 39,90% were male. Chronic calculous cholecystitis was an indication of the 86,20%, 8,50% in the acute, gallbladder polyp 5,30%. Conversion was forced out in 28 patients (4.47%. There have been no lethal operative outcomes in observed period, intraoperative lesions of vascular structures were not notified, total specific morbidity was about 2,07%. The technical aspect is still dominant at laparoscopic cholecystectomy (LC. Outstanding results at our clinic and in the world, impose the need for further development of this method, education of surgeons and staff

  14. Vascular dynamics of a shape memory polymer foam aneurysm treatment technique.

    Science.gov (United States)

    Ortega, Jason; Maitland, Duncan; Wilson, Tom; Tsai, William; Savaş, Omer; Saloner, David

    2007-11-01

    The vascular dynamics of a shape memory polymer foam aneurysm treatment technique are assessed through the simulated treatment of a generic basilar aneurysm using coupled fluid dynamics and heat transfer calculations. The shape memory polymer foam, which expands to fill the aneurysm when heated, is modeled at three discrete stages of the treatment procedure. To estimate an upper bound for the maximum amount of thermal damage due to foam heating, a steady velocity is specified through the basilar artery, corresponding to a minimum physiological flow velocity over a cardiac cycle. During expansion, the foam alters the flow patterns within the aneurysm by shielding the aneurysm dome from a confined jet that issues from the basilar artery. The time scales for thermal damage to the artery walls and surrounding blood flow are computed from the temperature field. The flow through the post-treatment bifurcation is comprised of two counter-rotating vortex tubes that are located beneath the aneurysm neck and extend downstream into the outlet arteries. Beneath the aneurysm neck, a marked increase in the wall shear stress is observed due to the close proximity of the counter-rotating vortex tubes to the artery wall.

  15. Paul Tessier's technique in the treatment of paralytic lagophthalmos by lengthening of the levator muscle: evaluation of 29 cases.

    Science.gov (United States)

    Guillou-Jamard, Marie-Reine; Labbé, Daniel; Bardot, Jacques; Benateau, Hervé

    2011-12-01

    Lagophthalmos is the major functional complication of facial paralysis because, in the absence of treatment, it can lead to corneal scarring and blindness. This disorder can be treated in a number of ways, including levator lengthening by aponeurosis interposition, a technique developed by Paul Tessier. We assessed the benefits of this technique, and compared the results to those with other techniques, in particular, the use of gold implants. A total of 29 patients were operated by the same surgeon using levator lengthening by aponeurosis interposition as described by Paul Tessier. Aesthetic and functional results were assessed according to predefined criteria during patient consultation at 1 year and by the patients themselves (questionnaire). We reviewed other surgical techniques used to treat lagophthalmos and compared findings with previous international studies. The use of a gold plate implant remains the most widely used technique for the treatment of lagophthalmos. Although the functional results are good, the implant is always visible, leading to the disappearance of the superior palpebral fold and a risk of exposure and therefore of infection. Levator lengthening, a technique developed by Paul Tessier, allows identical functional results to be obtained, but conserves a natural appearance of the upper eyelid. It is a simple surgical procedure associated with a low morbidity rate. The lengthening of the levator by aponeurosis interposition is a simple, reliable, and easily reproducible technique allowing treatment of paralytic lagophthalmos with good results, in terms of both function and aesthetics.

  16. The ultrasound guided psoas-compartment-block fundamentals and technique for a new regional anaesthetic procedure

    CERN Document Server

    Kirchmair, L P M

    2001-01-01

    Ultrasound (US) has proven to be an useful adjunct during the performance of peripheral nerve blocks. This study is the first dealing with the application of US guidance for the psoas-compartment-block which is used to achieve lumbar plexus blockades. A pilot study was carried out to establish the US anatomy of the lumbar paravertebral region and its blood vessels. Moreover, suitable transducers and US frequencies were assessed. The feasibility of US imaging of the psoas-compartment was studied on healthy volunteers (N=21) of varying body types (normal weight: N= 13; overweight: N=5; obese: N=3) in a first volunteer study. Additionally, the skin-plexus distances were measured. A second volunteer study (N=21) was carried out to investigate the US anatomy of the paravertebral blood vessels by means of power Doppler sonography. The technique of an US guided approach to the psoas-compartment was tested on embalmed cadavers (N=10) at the levels L2/L3, L3/L4 and L4/L5. Accuracy and safety of this technique were ver...

  17. Evaluation of the Effects of Standard Rescue Procedure on Severe Trauma Treatment in China

    Institute of Scientific and Technical Information of China (English)

    Xiao-Feng Yin; Tian-Bing Wang; Pei-Xun Zhang; Yu-Hui Kou; Dian-Ying Zhang; Kai Yu; De-Cheng Lyu

    2015-01-01

    Background:This study aimed to evaluate the effects of standard rescue procedure (SRP) in improving severe trauma treatments in China.Methods:This study was conducted in 12 hospitals located in geographically and industrially different cities in China.A standard procedure on severe trauma rescue was established as a general rule for staff training and patient treatment.A regional network (system) efficiently integrating prehospital rescue,emergency room treatments,and hospital specialist treatments was built under the rule for information sharing and improving severe trauma treatments.Treatment outcomes were compared between before and I year after the implementation of the SRP.Results:The outcomes of a total of 74,615 and 12,051 trauma cases were collected from 12 hospitals before and after the implementation of the SRP.Implementation of the SRP led to efficient cooperation and information sharing of different treatment services.The emergency response time,prehospital transit time,emergency rescue time,consultation call time,and mortality rate of patients were 24.24 ± 4.32 min,45.69 ± 3.89 min,6.38 ± 1.05 min,17.53 ± 0.72 min,and 33.82% ± 3.87% (n =441),respectively,before the implementation of the standardization and significantly reduced to 10.11 ± 3.21 min,22.39 ± 4.32 min,3.26 ± 0.89 min,3.45 ± 0.45 min,and 20.49% ± 3.11%,separately (n =495,P < 0.05) after that.Conclusions:Staff training and SRP can significantly improve the efficiency of severe trauma treatments in China.

  18. Parent-Implemented Procedural Modification of Escape Extinction in the Treatment of Food Selectivity in a Young Child with Autism

    Science.gov (United States)

    Tarbox, Jonathan; Schiff, Averil; Najdowski, Adel C.

    2010-01-01

    Fool selectivity is characterized by the consumption of an inadequate variety of foods. The effectiveness of behavioral treatment procedures, particularly nonremoval of the spoon, is well validated by research. The role of parents in the treatment of feeding disorders and the feasibility of behavioral procedures for parent implementation in the…

  19. Highly efficient sparse-matrix inversion techniques and average procedures applied to collisional-radiative codes

    CERN Document Server

    Poirier, M

    2009-01-01

    The behavior of non-local thermal-equilibrium (NLTE) plasmas plays a central role in many fields of modern-day physics, such as laser-produced plasmas, astrophysics, inertial or magnetic confinement fusion devices, or X-ray sources. The proper description of these media in stationary cases requires to solve linear systems of thousands or more rate equations. A possible simplification for this arduous numerical task may lie in some type of statistical average, such as configuration or superconfiguration average. However to assess the validity of this procedure and to handle cases where isolated lines play an important role, it may be important to deal with detailed levels systems. This involves matrices with sometimes billions of elements, which are rather sparse but still involve thousands of diagonals. We propose here a numerical algorithm based on the LU decomposition for such linear systems. This method turns out to be orders of magnitude faster than the traditional Gauss elimination. And at variance with ...

  20. Evaluation of the Prevalence of Different Treatment Failure Modes after Crown Lengthening Surgical Procedures

    Directory of Open Access Journals (Sweden)

    Amirreza Babaloo

    2016-07-01

    and a lack of sufficient keratinized gingiva around the tooth was the most frequent reason for early failures of such procedures.   Key words: Crown lengthening surgical procedures; treatment failure; keratinized gingiva;

  1. Comparison of surgical procedures for vascular and airway anastomoses that utilize a modified non-suture external cuff technique for experimental lung transplantation in rats.

    Science.gov (United States)

    Mizobuchi, Teruaki; Sekine, Yasuo; Yasufuku, Kazuhiro; Fujisawa, Takehiko; Wilkes, David S

    2004-07-01

    Lung transplantation in rats is technically difficult and results may vary. The non-suture cuff technique (non-suture [NS]), which involves using a cuff for anastomoses of vessels and airways, is commonly utilized to perform transplant procedures. However, the standard bronchial cuff may occlude the lumen, resulting in diminished graft survival. In contrast, the non-suture cuff technique for vascular anastomoses with bronchial suturing (bronchial suture [BS]), although more technically difficult, is known to have prolonged bronchial patency. We developed a "modified" NS technique that uses a larger and longer cuff for anastomoses and compared the efficacy of this procedure to the BS technique for lung transplantation. The BS procedure was performed in 146 transplant procedures. The modified NS procedure, which uses a larger cuff than the standard NS procedure, was performed in 113 procedures. Although total ischemic times were comparable, the total operation time in the NS group was significantly shorter than in the BS group (p technique is widely acknowledged to provide prolonged patency of bronchial anastomosis, graft survival in the NS group was observed up 17 months post-transplant. These data show that the NS technique, which is less technically difficult, results in shorter operative times compared with the BS procedure, and results in durable anastomoses of lung grafts.

  2. Endovascular Treatment of the Huge Dissecting Aneurysms Involving the Basilar Artery by the Internal Trapping Technique: Technical Note

    Directory of Open Access Journals (Sweden)

    Shi-Qing Mu

    2015-01-01

    Full Text Available Background: The endovascular strategy of the huge dissecting aneurysms involving the basilar artery (BA is controversial and challenging. This study was to investigate the clinical and angiographic outcomes of the treatment of the huge dissecting aneurysms involving the BA by the internal trapping (IT technique. Methods: We retrospectively studied 15 patients with the huge dissecting aneurysms involving the BA treated by the IT technique between September 2005 and September 2014 in Department of Interventional Neuroradiology of Beijing Tiantan Hospital. Clinical and angiographic data were reviewed and evaluated. Results: All patients were treated by the IT technique. That meant the dissecting artery and aneurysm segments were completed occlusion. After the procedure, the angiography demonstrated that all the dissecting artery and aneurysm segments were completed occlusion. Follow-up angiography was performed at 3-6 months or 12-18 months after the endovascular treatment (median 8 months, 14 patients had a good recovery. Re-canalization occurred in one patient whose aneurysm involved in bilateral vertebral arteries and the two third of the middle-lower BA. After the second treatment, the patient died by the ventricular tachycardia. Conclusions: The IT technique is a technically feasible and safe alternative for the treatment of BA dissecting aneurysms, but it is not necessarily the safest or most definitive treatment modality. The ideal treatment of the huge dissecting aneurysms involving the BA remains debatable and must be investigated on a case-by-case basis.

  3. Endovascular Treatment of the Huge Dissecting Aneurysms Involving the Basilar Artery by the Internal Trapping Technique: Technical Note

    Institute of Scientific and Technical Information of China (English)

    Shi-Qing Mu; Xin-Jian Yang; You-Xiang Li; Chu-Han Jiang; Zhong-Xue Wu

    2015-01-01

    Background:The endovascular strategy of the huge dissecting aneurysms involving the basilar artery (BA) is controversial and challenging.This study was to investigate the clinical and angiographic outcomes of the treatment of the huge dissecting aneurysms involving the BA by the internal trapping (IT) technique.Methods:We retrospectively studied 15 patients with the huge dissecting aneurysms involving the BA treated by the IT technique between September 2005 and September 2014 in Department of lnterventional Neuroradiology of Beijing Tiantan Hospital.Clinical and angiographic data were reviewed and evaluated.Results:All patients were treated by the IT technique.That meant the dissecting artery and aneurysm segments were completed occlusion.After the procedure,the angiography demonstrated that all the dissecting artery and aneurysm segments were completed occlusion.Follow-up angiography was performed at 3-6 months or 12-18 months after the endovascular treatment (median 8 months),14 patients had a good recovery.Re-canalization occurred in one patient whose aneurysm involved in bilateral vertebral arteries and the two third of the middle-lower BA.After the second treatment,the patient died by the ventricular tachycardia.Conclusions:The IT technique is a technically feasible and safe alternative for the treatment of BA dissecting aneurysms,but it is not necessarily the safest or most definitive treatment modality.The ideal treatment of the huge dissecting aneurysms involving the BA remains debatable and must be investigated on a case-by-case basis.

  4. Endovascular Treatment of the Huge Dissecting Aneurysms Involving the Basilar Artery by the Internal Trapping Technique: Technical Note.

    Science.gov (United States)

    Mu, Shi-Qing; Yang, Xin-Jian; Li, You-Xiang; Jiang, Chu-Han; Wu, Zhong-Xue

    2015-07-20

    The endovascular strategy of the huge dissecting aneurysms involving the basilar artery (BA) is controversial and challenging. This study was to investigate the clinical and angiographic outcomes of the treatment of the huge dissecting aneurysms involving the BA by the internal trapping (IT) technique. We retrospectively studied 15 patients with the huge dissecting aneurysms involving the BA treated by the IT technique between September 2005 and September 2014 in Department of Interventional Neuroradiology of Beijing Tiantan Hospital. Clinical and angiographic data were reviewed and evaluated. All patients were treated by the IT technique. That meant the dissecting artery and aneurysm segments were completed occlusion. After the procedure, the angiography demonstrated that all the dissecting artery and aneurysm segments were completed occlusion. Follow-up angiography was performed at 3-6 months or 12-18 months after the endovascular treatment (median 8 months), 14 patients had a good recovery. Re-canalization occurred in one patient whose aneurysm involved in bilateral vertebral arteries and the two third of the middle-lower BA. After the second treatment, the patient died by the ventricular tachycardia. The IT technique is a technically feasible and safe alternative for the treatment of BA dissecting aneurysms, but it is not necessarily the safest or most definitive treatment modality. The ideal treatment of the huge dissecting aneurysms involving the BA remains debatable and must be investigated on a case-by-case basis.

  5. Efficacy of Preventive Dental Treatment Procedures on Oral Tissues in Naval Personnel.

    Science.gov (United States)

    The study is an attempt to evaluate new and current clinical methods, agents and techniques employed for the treatment of dental caries, periodontal ...supragingival calculus in relation to the composition of serum and saliva , respectively; (d) study the calculus-tooth structure interface with the

  6. A systematic review of tongue base suspension techniques as an isolated procedure or combined with uvulopalatopharyngoplasty in obstructive sleep apnea.

    Science.gov (United States)

    Bostanci, Asli; Turhan, Murat

    2016-10-01

    We aimed to evaluate existing research into the effectiveness and safety of two tongue base suspension (TBS) techniques (Repose(®) system and modified TBS) with or without uvulopalatopharyngoplasty (UPPP) in obstructive sleep apnea. The literature review was performed using PubMed database. Searched terms used included the keywords "sleep apnea", "surgery", "tongue", "tongue base", "suspension", "Repose", "uvulopalatopharyngoplasty", and "hypopharynx". Levels of evidences and grades of recommendations were determined according to the hierarchy proposed by Oxford Centre for Evidence-based Medicine. Seven studies including 113 patients met the eligibility criteria for TBS as a stand-alone procedure. Four of seven studies including 62 patients used the Repose(®), and three studies including 51 patients used the modified TBS. The success rates were higher in the studies that used modified technique (74.5 %) than those that used the Repose(®) (25.8 %), (p data of 413 patients were compared, the modified TBS was found to be associated with significantly higher success rates (73.7 vs. 56.7 %, p techniques with or without UPPP; although there is a trend toward improved outcome with modified technique.

  7. Calcaneo-stop procedure in the treatment of the juvenile symptomatic flatfoot.

    Science.gov (United States)

    Pavone, Vito; Costarella, Luciano; Testa, Gianluca; Conte, Giorgio; Riccioli, Maria; Sessa, Giuseppe

    2013-01-01

    Flexible flatfoot is the most prevalent condition seen in pediatric orthopedic clinics. It is characterized by an absence of the medial arch and a valgus position of the calcaneus. The purpose of the present study was to report on the results obtained in children treated using the calcaneo-stop procedure. A total of 410 flatfeet in 242 consecutive patients were treated using the calcaneo-stop procedure from January 1999 to March 2010 (10 years, 3 months) and were followed up to February 2012. The mean age at surgery was 11 (range 7 to 14) years, and the mean follow-up duration was 88 (range 14 to 157) months. A clinical evaluation, podoscopic examination, and radiologic assessment were performed in the participating patients preoperatively and at 6 months postoperatively. Of the 242 patients, 168 (69.42%) underwent bilateral foot surgery and 74 (30.58%) unilateral intervention, involving 33 right (44.6%) and 41 left (55.4%) feet. At follow-up, the outcome was satisfactory in 397 feet (96.83%); heel valgus was observed in only 12 feet (2.92%), and the footprint was normalized in 328 feet (80%). The calcaneo-stop procedure is a simple, reliable, and minimally invasive procedure for the treatment of pediatric flexible flatfoot. It allows alignment of the talus and calcaneus, restoring a proper foot arch.

  8. "The missing LINX" for gastroesophageal reflux disease: Operative techniques video for the Linx magnetic sphincter augmentation procedure.

    Science.gov (United States)

    Kuckelman, John P; Barron, Morgan R; Martin, Matthew J

    2017-05-01

    In 2012 the FDA approved a magnetic sphincter augmentation (MSA) device (LINX, Torax Medical, Inc) for placement around the lower esophageal sphincter as an alternative approach to fundoplication for gastroesophageal reflux disease (GERD). This is a relatively new procedure and there is not widespread familiarization with the standard indications and techniques of device placement. We present two operative videos to highlight the standard surgical technique and technical points needed for successful LINX placement. First will be placement in a standard indications setting of uncomplicated GERD with no hiatal hernia. Second will be placement with complicated anatomy due to alterations from prior gastric surgery and a hiatal hernia. Our experience has revealed that the LINX device can be placed safely in patients with normal or significantly altered anatomy but requires adherence to several key principles and technical points. This procedure offers a new option that is anatomically and physiologically unique compared to standard fundoplication, and that offers highly effective control of GERD with a less invasive approach. Published by Elsevier Inc.

  9. Shaeer’s Technique: A Minimally Invasive Procedure for Monsplasty and Revealing the Concealed Penis

    Science.gov (United States)

    2016-01-01

    Background: A concealed penis is a condition where part of the penis is invisible below the surface of the prepubic skin. Dermolipectomy can correct this condition, although it involves a long abdominal crease incision, or infrapubic incision around the base of the penis, and a possibility for genital lymphedema. This study describes Shaeer’s technique, a minimally invasive method for revealing the concealed penis. Methods: A 1- to 2-cm-long incision was cut over the anterior superior iliac spine (ASIS) on either side. A long curved blunt forceps was inserted from one incision, down to the base of the penis and then up to the contralateral ASIS. A 5-mm wide nonabsorbable tape was picked up by the forceps from 1 incision and pulled through to emerge from the other. Pulling on the tape cephalad pulled the mons pubis and revealed the penis. The tape was sutured to the periosteum overlying the ASIS on either side. Patients were followed up for 18 months for penile length, complications, and overall satisfaction. Results: Twenty patients were operated upon. Preoperatively, flaccid visible length was 3 ± 0.9 cm, and erect visible length was 8 ± 4.6 cm. Postoperatively, the flaccid visible length was 7.1 ± 2.1 cm, with a 57.9% improvement in length (P penis. PMID:27622092

  10. Corticotomies as a surgical procedure to accelerate tooth movement during orthodontic treatment: A systematic review

    Science.gov (United States)

    Fernández-Ferrer, Laura; Montiel-Company, José-María; Candel-Martí, Eugenia; Almerich-Silla, José-Manuel; Peñarrocha-Diago, Miguel

    2016-01-01

    Background One of the main aims of orthodontists is to reduce the treatment time as much as possible, particularly in view of the rise in demand for orthodontic treatment among adult patients. The objective of this systematic review was to examine the effectiveness of corticotomy as a surgical procedure that accelerates orthodontic tooth movement, together with its possible adverse effects. Material and Methods A systematic review of articles in 4 databases, Pubmed, Cochrane, Scopus and Embase, complemented by a manual search, identified 772 articles. The duplicates were eliminated and a critical reading of titles and abstracts led to the rejection of articles that did not meet the objectives of the review, leaving 69. After reading the full text of these articles, 49 were excluded because they did not meet the inclusion criteria. On applying the CONSORT criteria as a quality filter, a further 4 were eliminated due to low quality. Finally, 16 articles (4 systematic reviews and 12 controlled trials) were reviewed. Results All the studies agree that corticotomy prior to orthodontic treatment accelerates dental movement, reducing the treatment time. With regard to side-effects, no periodontal damage was found, although this was only studied in the short term. Conclusions The evidence regarding the results of corticotomy is limited, given the small number of quality clinical studies available. Before this procedure is included as a routine practice in dental surgeries, studies of higher methodological quality are required, studying a greater number of individuals and examining the possible long-term adverse effects and the cost/benefit of the procedure. Key words:Corticotomy, orthodontics, adults, accelerated tooth movement, osteotomy. PMID:27475698

  11. A Guide for Developing Standard Operating Job Procedures for the Tertiary Chemical Treatment - Lime Precipitation Process Wastewater Treatment Facility. SOJP No. 6.

    Science.gov (United States)

    Petrasek, Al, Jr.

    This guide describes the standard operating job procedures for the tertiary chemical treatment - lime precipitation process of wastewater treatment plants. Step-by-step instructions are given for pre-start up, start-up, continuous operation, and shut-down procedures. In addition, some theoretical material is presented along with some relevant…

  12. Can miniature pulpotomy procedure improve treatment outcomes of direct pulp capping?

    Science.gov (United States)

    Asgary, Saeed; Ahmadyar, Maryam

    2012-02-01

    Dental pulp exposure is a common incident during dental treatment. If there are clinical signs of pulp vitality, it is recommended to carry out direct pulp capping (DPC) using appropriate pulp covering agents (PCA). The main objectives are maintenance of pulp vitality/healing along with the formation of a calcified bridge beneath the PCA. Our proposed hypothesis is based on consideration of biologic principles in order to achieve improved treatment outcomes of DPC for cariously exposed pulp using miniature pulpotomy procedure (MPP). MPP will result in improved treatment outcomes of DPC by improved maintenance of a clean surgical pulp wound; removal of infected dentin chips/damaged pulp tissue specially injured odontoblast cells; improved proximity/interaction of PCA to undifferentiated mesenchymal/stem cells; better control of bleeding; and creating an improved seal using PCA.

  13. Validation of a new photogrammetric technique to monitor the treatment effect of Botulinum toxin in synkinesis.

    Science.gov (United States)

    Mabvuure, N T; Hallam, M-J; Venables, V; Nduka, C

    2013-07-01

    To validate a new photogrammetric technique for quantifying eye surface area and using this to quantify the degree of improvement in symmetry in patients with oral-ocular synkinesis following Botulinum toxin injection. Feasibility study and retrospective outcomes analysis Ten patients' photographs were chosen from a photographic database. Their eye surface areas were measured independently by two raters using a graphics tablet. One rater repeated the procedure after 15 days. Bland-Altman plots were computed, ascertaining inter-rater and intra-rater variability. The eye surface areas of 19 patients were then derived from photographs taken before and after Botulinum toxin injections. Paired t-tests were used to analyse the significance of the difference in pre- and post-treatment symmetry. Ninety per cent of eye surface areas derived from the two raters were within a coefficient of variation of 0.1 (95% CI: 0.05-0.15). Similarly, 90% of eye surface areas derived from one rater had a coefficient of variation of 0.08 (95% CI: 0.04-0.12). Botulinum toxin significantly reduced synkinesis resulting from lip puckering, Mona Lisa smiling and Hollywood smiling (P<0.05). We have proposed a clinically valid tool for quantifying the effects of Botulinum toxin treatment for oral-ocular synkinesis. We recommend this method be used to monitor the response of such patients when receiving Botulinum toxin treatment.

  14. Loop electrosurgical excision procedure for the treatment of cervical intraepithelial neoplasia: how much excision is enough?

    Science.gov (United States)

    Le, T; El-Sugi, R; Hicks-Boucher, W; Weberpals, J; Faught, W

    2013-08-01

    This is a retrospective observational study to compare outcomes in patients with cervical intraepithelial neoplasia (CIN) treated with loop electrosurgical excision procedure (LEEP) using combined ectocervical/endocervical resection vs ectocervical resection alone. We demonstrated that additional endocervical resection during loop electrosurgical excision procedure did not significantly lower the risk of subsequent recurrence compared with ectocervical resection alone, in the treatment of CIN. With current published data supporting subsequent increased adverse effects of LEEP on future obstetrical outcomes, endocervical excision should be applied selectively. We recommend that additional endocervical excision should be reserved only for patients with a strong suspicion of underlying endocervical canal involvement based on colposcopic assessment or in patients with unsatisfactory colposcopy, where it is essential to evaluate the endocervical canal.

  15. The primary Sauve-Kapandji procedure--for treatment of comminuted distal radius and ulnar fractures.

    Science.gov (United States)

    Horii, E; Ohmachi, T; Nakamura, R

    2005-02-01

    We have performed primary Sauve-Kapandji procedures on four patients with severe open comminuted fractures of both the distal radius and ulna. The fragmented distal ulna was fixed to the sigmoid notch in order to stabilize the ulnar side of the carpus, and a proximal pseudoarthrosis was maintained for forearm rotation. All the distal radial fractures united without major complications. The mean wrist flexion/extension arc was 76 degrees , the mean pronation/supination arc was 135 degrees, and grip strength was 64% of the contralateral side. All patients returned to their work or daily activities within short time period without any additional surgical treatment, except for removal of implants in three patients. The primary Sauve-Kapandji procedure is effective for the reconstruction of severely combined distal radius and ulnar fractures.

  16. A treatment procedure for Gemini North/NIFS data cubes: application to NGC 4151

    CERN Document Server

    Menezes, R B; Ricci, T V

    2014-01-01

    We present a detailed procedure for treating data cubes obtained with the Near-Infrared Integral Field Spectrograph (NIFS) of the Gemini North telescope. This process includes the following steps: correction of the differential atmospheric refraction, spatial re-sampling, Butterworth spatial filtering, 'instrumental fingerprint' removal and Richardson-Lucy deconvolution. The clearer contours of the structures obtained with the spatial re-sampling, the high spatial-frequency noise removed with the Butterworth spatial filtering, the removed 'instrumental fingerprints' (which take the form of vertical stripes along the images) and the improvement of the spatial resolution obtained with the Richardson-Lucy deconvolution result in images with a considerably higher quality. An image of the Br{\\gamma} emission line from the treated data cube of NGC 4151 allows the detection of individual ionized-gas clouds (almost undetectable without the treatment procedure) of the narrow-line region of this galaxy, which are also ...

  17. The Manchester procedure versus vaginal hysterectomy in the treatment of uterine prolapse: a review.

    Science.gov (United States)

    Tolstrup, Cæcilie Krogsgaard; Lose, Gunnar; Klarskov, Niels

    2017-01-01

    Uterine prolapse is a common health problem and the number of surgical procedures is increasing. No consensus regarding the surgical strategy for repair of uterine prolapse exists. Vaginal hysterectomy (VH) is the preferred surgical procedure worldwide, but uterus-preserving alternatives including the Manchester procedure (MP) are available. The objective was to evaluate if VH and the MP are equally efficient treatments for uterine prolapse with regard to anatomical and symptomatic outcome, quality of life score, functional outcome, re-operation and conservative re-intervention rate, complications and operative outcomes. We systematically searched Embase, PubMed, the Cochrane databases, Clinicaltrials and Clinical trials register using the MeSh terms "uterine prolapse", "uterus prolapse", "vaginal prolapse" "pelvic organ prolapse", "prolapsed uterus", "Manchester procedure" and "vaginal hysterectomy". No limitations regarding language, study design or methodology were applied. In total, nine studies published from 1966 to 2014 comparing the MP to VH were included. The anatomical recurrence rate for the middle compartment was 4-7 % after VH, whereas recurrence was very rare after the MP. The re-operation rate because of symptomatic recurrence was higher after VH (9-13.1 %) compared with MP (3.3-9.5 %) and more patients needed conservative re-intervention (14-15 %) than after MP (10-11 %). After VH, postoperative bleeding and blood loss tended to be greater, bladder lesions and infections more frequent and the operating time longer. This review is in favour of the MP, which seems to be an efficient and safe treatment for uterine prolapse. We suggest that the MP might be considered a durable alternative to VH in uterine prolapse repair.

  18. Hybrid procedure in the treatment of thoracoabdominal aortic aneurysms: Case report

    Directory of Open Access Journals (Sweden)

    Davidović Lazar B.

    2013-01-01

    Full Text Available Introduction. Treatment of thoracoabdominal aortic aneurysms is a major problem in vascular surgery. Conventional open repair is associated with significant rates of mortality and morbidity and therefore, there is a need for better solutions. One of them is a hybrid procedure that includes visceral debranching. This paper presents the first such case performed in Serbia, with a brief overview on all published procedures worldwide. Case Outline. A 57-year-old woman was admitted to the hospital because of thoracoabdominal aneurysms type V by Crawford-Safi classifications. Because of the significant comorbidities it was concluded that conventional treatment would bear unacceptably high perioperative risk, and that the possible alternative could be the hybrid procedure in two stages. In the first stage aortobiliacal reconstruction with bifurcated Dacron graft (16×8 mm and visceral debranching with hand made tailored branched graft was done. In the second act, the thoracoabdominal aneurysm was excluded with implantation of the endovascular Valiant stent graft, 34×150 mm (Medtronic, Santa Rosa, CA. Control MSCT angiography showed a proper visceral branch patency and positioning of the stent graft without endoleaks. Nine months after the procedure the patient was symptom-free, with no aneurysm, diameter change and no graft-related complication. All visceral branches were patent. Conclusion. So far about 500 cases of visceral debranching have been published with the aim of treating thoracoabdominal aneurysms, and still we have no valid guidelines concerning this method. However, in carefully selected high-risk patients this is an excellent alternative to open surgery of thoracoabdominal aneurysms.

  19. A fuzzy approach to evaluation and management of therapeutic procedure in diabetes mellitus treatment

    Directory of Open Access Journals (Sweden)

    Tadić Danijela

    2010-01-01

    Full Text Available In this paper a new fuzzy model (FMOTPD2 is developed and by this model the measures of beliefs are determined so that one of the groups of possible therapeutic procedures is optimal for each patient of type 2 diabetes on hospital treatment. The choice of therapeutic procedure on individual level, which is one of the demands of modern medicine, means that each therapeutic procedure is to be evaluated by multiple and different criteria. In this paper, evaluation criteria are classified into two groups: (1 common criteria by which medicines used by the type 2 diabetes patients are being evaluated and (2 specific criteria, by which the patients' 1h state of health with type 2 diabetes mellitus is being estimated. Generally, the relative importance and values of these criteria are different. It is assumed that (a the relative importance of evaluation criteria is defined by a team of medical experts and described by linguistic expressions and (b the values of evaluation criteria are determined by evidence data, anamnesis and a diagnostic process. They can be crisp or uncertain. The most often used linguistic expressions describing the relative importance of evaluation criteria are modeled by triangular fuzzy numbers. The rest of uncertainties, which exist in developed model are described by discrete fuzzy numbers. A new algorithm for determining a unified fuzzy portrait of treated therapeutic procedures for each patient is given. It enables calculation of the measures of beliefs that some therapeutic procedures are more optimal than the others. The developed model is illustrated by examples with real word data collected in a hospital.

  20. Vestibuloplasty by modified Kazanjian technique in treatment with dental implants.

    Science.gov (United States)

    Ponzoni, Daniela; Jardim, Ellen Cristina Gaetti; de Carvalho, Paulo Sérgio Perri

    2013-07-01

    Dentists are often faced with extensively resorbed mandibular ridges with shallow buccal vestibule and high insertion of the mentalis muscle in relation to the crest of the ridge, causing the displacement of the prosthesis. Vestibuloplasty techniques aim at eliminating the muscle insertions, reposition the mucosa, and increase the area chapeável, giving more stability to the prosthesis. Among the techniques to deepen the vestibule are submucosal vestibuloplasties by secondary epithelialization and with mucosal and skin grafts. We will discuss vestibuloplasty by secondary epithelialization with emphasis on the so-called modified Kazanjian technique. This technique provides an appropriate result and does not require hospitalization, additional surgery at the donor, or prolonged periods without the use of prosthesis.

  1. Spray cryotherapy (SCT): institutional evolution of techniques and clinical practice from early experience in the treatment of malignant airway disease

    Science.gov (United States)

    Turner, J. Francis; Parrish, Scott

    2015-01-01

    Background Spray cryotherapy (SCT) was initially developed for gastroenterology (GI) endoscopic use in the esophagus. In some institutions where a device has been utilized by GI, transition to use in the airways by pulmonologists and thoracic surgeons occurred. Significant differences exist, however, in the techniques for safely using SCT in the airways. Methods We describe the early experience at Walter Reed National Military Medical Center from 2011 to 2013 using SCT in patients with malignant airway disease and the evolution of our current techniques and clinical practice patterns for SCT use in patients. In November 2013 enrollment began in a multi-institutional prospective SCT registry in which we are still enrolling and will be reported on separately. Results Twenty-seven patients that underwent 80 procedures (2.96 procedures/patient). The average age was 63 years with a range of 20 to 87 years old. The average Eastern Cooperative Oncology Group (ECOG) status was 1.26. All malignancies were advanced stage disease. All procedures were performed in the central airways. Other modalities were used in combination with SCT in 31 (39%) of procedures. Additionally 45 of the 80 (56%) procedures were performed in proximity to a silicone, hybrid, or metal stent. Three complications occurred out of the 80 procedures. All three were transient hypoxia that limited continued SCT treatments. These patients were all discharged from the bronchoscopy recovery room to their pre-surgical state. Conclusions SCT can be safely used for treatment of malignant airway tumor (MAT) in the airways. Understanding passive venting of the nitrogen gas produced as the liquid nitrogen changes to gas is important for safe use of the device. Complications can be minimized by adopting strict protocols to maximize passive venting and to allow for adequate oxygenation in between sprays. PMID:26807288

  2. Treatment of a horizontal root-fractured tooth with decoronation procedure: case report

    Directory of Open Access Journals (Sweden)

    Selen Esin Yoldaş

    2016-05-01

    Full Text Available INTRODUCTION: Early loss of permanent anterior teeth due to trauma can cause esthetic and functional problems for young patients. In such cases, replacement of the missing tooth with traditional approaches is possible; however such approaches will reduce the chance of the patient to receive an esthetic and consistent treatment in the future. CASE REPORT: A 12-year-old male patient referred to our clinic with a history of trauma. Complicated crown fracture in tooth no.11 and horizontal root fracture in tooth no. 21 was detected. Following root canal treatment, tooth no. 11 was restored with a fiber post and a strip crown. To avoid alveolar bone loss due to early tooth extraction, decoronation procedure, an alternative approach, was applied to tooth no. 21. This procedure consisted of leaving the root fragment inside the alveolar socket following the removal of the crown. For the rehabilitation of the missing crown, a partial removable prosthesis was implemented. The patient was recalled in 6., 12. and 18. months. Within the follow-up period, no reduction in the alveolar bone level was seen. No sign of infection was evident. The remaining root fragment kept on resorbing. Tooth no. 11 remained symptom-free as well. The patient is still being followed. CONCLUSION: Decoronation is essentially a treatment choice for preventing alveolar bone loss in ankylosed teeth considered for extraction. In this case report, decoronation was shown to be a suitable alternative also for a fractured, non-ankylosed tooth.

  3. [Diagnosis and treatment of varicose veins: part 2: therapeutic procedures and results].

    Science.gov (United States)

    Nüllen, H; Noppeney, T

    2010-12-01

    This is the second of two articles on the diagnosis and treatment of varicose veins. Primary varicosis is a congenital degenerative disease of the peripheral venous system of the lower extremities. Treatment is carried out according to an individualized concept which takes the incurability and progression of the disease into consideration. Conservative treatment with compression bandages is an option for all forms of varicosis and the accompanying complications. Veins can be specifically ablated by sclerotherapy of varices. In addition to high ligation and stripping mini-phlebectomy and subfascial endoscopic perforator surgery (SEPS) can also be performed. The indications in cases of SEPS should be extremely limited because of possible severe complications. Radiofrequency ablation (RFO) and endovenous laser therapy (ELT) are also available as endovenous therapy options. Information in the literature on recurrence rates of the various procedures is extremely variable and the reasons for recurrent varicosis are the subject of controversy. The data relating to the results of RFO and ELT are relatively good and both procedures show a significant improvement in quality of life and the venous clinical severity score (VCSS).

  4. A new on-board imaging treatment technique for palliative and emergency treatments in radiation oncology

    Energy Technology Data Exchange (ETDEWEB)

    Held, Mareike

    2016-03-23

    and reconstruction corrections. Consequently, multiple image value-to-density calibration curves are necessary for accurate dose calculation. UCSF has implemented the new technique clinically for emergency treatments on their patients who stand to benefit from the fast simulation to treatment time frame that is achieved through this on-board imaging workflow.

  5. The impact of loop electrosurgical excision procedure (LEEP) for CIN 2,3 on spontaneous preterm delivery in twin pregnancies by assisted reproductive technique: preliminary data.

    Science.gov (United States)

    Ciavattini, Andrea; Stortoni, Piergiorgio; Mancioli, Francesca; Puglia, Danila; Tranquilli, Andrea Luigi; Liverani, Carlo Antonio

    2014-07-01

    The objective of this study was to compare the frequency of spontaneous preterm delivery before 35 weeks in 7 dichorionic twin pregnancies obtained after loop electrosurgical excision procedure (LEEP) for cervical intraepithelial neoplasia (CIN) 2,3 with respect to 21 twin pregnancies without previous cervical treatment. All the pregnancies were obtained after assisted reproduction techniques (ART). Same age at delivery was observed between two groups (p = 0.81) and none of our twin pregnancies after LEEP had a threatened preterm labor while four controls (19%) underwent a spontaneous preterm delivery (p = 0.35). These preliminary data seem to indicate that LEEP may not be responsible of spontaneous preterm delivery in twin pregnancies subsequent to ART.

  6. Comparison of surgical techniques in the treatment of laryngeal polypoid degeneration.

    Science.gov (United States)

    Lumpkin, S M; Bishop, S G; Bennett, S

    1987-01-01

    Surgical excision has been the accepted treatment of laryngeal polypoid degeneration, or chronic polypoid corditis. We report on 29 women with polypoid degeneration who received one of three surgical treatments: vocal fold stripping, carbon dioxide laser obliteration, or the Hirano technique. The duration of postoperative dysphonia was longest with the laser removal and shortest with the Hirano technique. A combination of vocal hygiene management and the Hirano technique of removal provided the most efficacious treatment.

  7. [The dispute and prospect of sedation and analgesia treatments in outpatient dental procedures].

    Science.gov (United States)

    Cong, Yu

    2015-12-01

    The topic of eliminating the fear or pain of patients during dental therapy is gaining increasing attention from dentists across the country. The field of painless dental therapeutics involves a wide range of subjects, including stomatology, anesthesiology, and hospital management. We summarized the characteristics of sedation and analgesia technology in outpatient oral therapy, reviewed the common sedative and analgesic treatments, and discussed the disputes on the use of sedation and analgesia in dental procedures. We also reviewed the trends and breakthroughs in this area on the basis of our own clinica experiences.

  8. Surgical Procedures of the Distal Limb for Treatment of Sepsis in Cattle.

    Science.gov (United States)

    Anderson, David E; Desrochers, André; van Amstel, Sarel R

    2017-07-01

    With a thorough knowledge of the anatomy of the foot, and basic surgical instruments, digit surgery can be performed in field situations. Sepsis of the distal interphalangeal and proximal interphalangeal joints should be treated surgically because conservative treatment is often ineffective. Most of the diseases described in this article are chronic and often the animals have been suffering for some time. Perioperative analgesia is important to alleviate the pain of those animals. All those procedures should be performed under local or regional anesthesia. Copyright © 2017 Elsevier Inc. All rights reserved.

  9. Sportsmen’s Groin—Diagnostic Approach and Treatment With the Minimal Repair Technique

    Science.gov (United States)

    Muschaweck, Ulrike; Berger, Luise Masami

    2010-01-01

    Context: Sportsmen’s groin, also called sports hernia and Gilmore groin, is one of the most frequent sports injuries in athletes and may place an athletic career at risk. It presents with acute or chronic groin pain exacerbated with physical activity. So far, there is little consensus regarding pathogenesis, diagnostic criteria, or treatment. There have been various attempts to explain the cause of the groin pain. The assumption is that a circumscribed weakness in the posterior wall of the inguinal canal, which leads to a localized bulge, induces a compression of the genital branch of the genitofemoral nerve, considered responsible for the symptoms. Methods: The authors developed an innovative open suture repair—the Minimal Repair technique—to fit the needs of professional athletes. With this technique, the circumscribed weakness of the posterior wall of the inguinal canal is repaired by an elastic suture; the compression on the nerve is abolished, and the cause of the pain is removed. In contrast with that of common open suture repairs, the defect of the posterior wall is not enlarged, the suture is nearly tension free, and the patient can return to full training and athletic activity within a shorter time. The outcome of patients undergoing operations with the Minimal Repair technique was compared with that of commonly used surgical procedures. Results: The following advantages of the Minimal Repair technique were found: no insertion of prosthetic mesh, no general anesthesia required, less traumatization, and lower risk of severe complications with equal or even faster convalescence. In 2009, a prospective cohort of 129 patients resumed training in 7 days and experienced complete pain relief in an average of 14 days. Professional athletes (67%) returned to full activity in 14 days (median). Conclusion: The Minimal Repair technique is an effective and safe way to treat sportsmen’s groin. PMID:23015941

  10. Comparison of two different gingivectomy techniques for gingival cleft treatment.

    Science.gov (United States)

    Malkoc, Siddik; Buyukyilmaz, Tamer; Gelgor, Ibrahim; Gursel, Mihtikar

    2004-06-01

    Interdental clefts or invaginations contribute to orthodontic relapse and poor periodontal health in extraction cases. These clefts or invaginations can be removed both by electrosurgical or conventional surgical gingivectomy techniques. This study investigates and compares the efficacy of two different techniques to remove gingival clefts with respect to periodontal health and patient tolerance. Twenty-two patients (mean age, 15.7 years) with bilateral gingival clefts participated in this study. In each patient, the gingival invaginations were removed by gingivectomy using electrosurgery on one side and conventional surgery on the contralateral side. The length and depth of the invaginations, the gingival index of the adjacent teeth, and the changes in visual analogue scale scores were recorded before and after the operation for both groups. Mann-Whitney U-test and Wilcoxon tests were used to analyze the data statistically. The results showed significant improvement in invagination depth and length and gingival index scores for both techniques. There were no statistical differences between the two gingivectomy techniques with respect to gingival health and patient tolerance. Both techniques can be used to remove the gingival invaginations efficiently.

  11. Comparison Of Lateral Mass Screw Fixation Technique And Hartshill Rectangle Technique In The Treatment Of Sub-Axial Cervical Spine Fractures

    Directory of Open Access Journals (Sweden)

    Mohit KM

    2012-11-01

    Full Text Available INTRODUCTION: Cervical injury in a polytrauma patient is one of the most critical injuries. The aim of this study was to compare the lateral mass screw technique with the Hartshill rectangle technique for treatment of such cases. MATERIALS AND METHODS: This prospective study consisted of 40 patients. Both groups were followed for three years clinically and radiologically. RESULTS: In the lateral mass technique, there were no cases of vertebral artery injury, radiculopathy, screw pullout, dural tears, residual kyphosis or persistent pain. In the Hartshill technique 3 patients experienced intra- operative dural tears, 1 case of wire breakage at the six months follow up, 6 patients with persistent neck pain and 1 with worsening neurological status. One hundred per cent fusion was achieved in both groups. There was significant radiation exposure in the lateral mass group. Post-operative immobilisation was required only in the Hartshill. CONCLUSION: Lateral mass screw technique is definitely a relatively better procedure. But Hartshill rectangle still stands out in certain practical situations.

  12. Standard procedures of endovascular treatment for vascular access stenosis in our facility - clinical usefulness of ultrasonography.

    Science.gov (United States)

    Sato, Takashi; Tsuboi, Masato; Onogi, Takeshi; Miwa, Naofumi; Sakurai, Hiroshi; Ookubo, Kentarou; Matsubara, Chieko; Kasuga, Hirotake

    2015-11-01

    In Japan, the number of patients receiving dialysis is 314,180 at the end of 2013 and 97% are treated with hemodialysis. And the mean age of patients and the percentage of diabetes have been increasing. For this reason, preparations of a new vascular access (VA) and its long-term maintenance have become difficult. In the guidelines by the Japanese Society for Dialysis Therapy (JSDT), endovascular treatment (ET) is positioned as the first line for VA stenosis. The procedure of ET itself is very simple. The revision of Japanese health insurance set an expensive technical fee for ET in 2012. It also added a restriction by which the claims for both technical and material fees would be denied, if the treatment was performed within 3 months after a previous treatment. This makes determination of best treatment timing more important. The functional evaluation using ultrasonography (US) is a useful monitoring index for determination of the ET timing for patients with stenosis. We investigated the cumulative relative frequency of flow volume (FV) and resistant index (RI) of brachial artery in arteriovenous graft (AVG) and arteriovenous fistula (AVF) cases with access failures. As a result, the cut-off values of FV and RI in AVG were 480 mL/min and 0.57, and in AVF were 354 mL/min and 0.61, respectively. Therefore we determine the treatment timing based on these results. Since 2012, active monitoring using US could have decreased the number of treatment patients by 100 per year. This meant that objective evaluation by US enabled treatments at a more suitable time to promote the proper use of medical expenses for EV treatment.

  13. SU-E-T-402: Y-90 Microspheres (SIR Spheres) for Treatment of Liver Metastasis : Technique

    Energy Technology Data Exchange (ETDEWEB)

    Nair, M

    2014-06-01

    Purpose: The purpose of this presentation is to discuss the radiation safety and dosimetric technique used for the therapeutic procedure using Y-90 microspheres through intra -arterial administration on patients with liver metastasis Methods: The radiation dosimetry, technique and safety aspects of 14 patients with primary and metastatic liver cancer, treated with Y-90 microsphere (SIR spheres) are discussed. The liver and tumor volumes were determined using the CT and MR scans . The images were imported into the treatment planning system and the liver and tumor volumes and the volume of the liver affected were outlined and the volume calculation was performed using the software. The lung shunt fraction (LSF) and tumor to liver uptake ratio (TLR) were determined using the nuclear medicine SPECT imaging with Tc-99m MAA. The absorbed dose to the target volume in liver was calculated using the following equation:Dose ? (Gy) = C x E? x 5.92 x 10-6 (Gy/s) x T(1/2)(days) x 1.44 x 8.64 x 104 (s) The distribution of activity in the tumor bed was confirmed by post Y-90 administration imaging using the Bremsstrahlung peak at 30% window. The patient and the procedure room were surveyed and radiation safety instructions were given to the patient Results: The tumor volume ranged from 77 cc to 700 cc, tumor to liver uptake ranged from 3 to 12. The lung shunt fraction varied from 1.08% to 9.0%. The activity administered ranged from 1.0GBq to 2.5 GBq, . The radiation survey in contact with the patient ranged from 1.8 mR/hr to 2.5 mR/hr and reading at 1 meter was less than 0.2 mR/hr Conclusion: The technique for radiation dosimetry and radiation safety for Y-90 microsphere therapy is established. The post treatment imaging helped to confirm the distribution of Y-90 microspheres inside the tumor bed.

  14. Treatment of 320 Cases of Infantile Diarrhea by Needling Technique of Setting Fire on Mountains

    Institute of Scientific and Technical Information of China (English)

    BO Li-ya; ZHANG Hui-ling; WU Chun-sheng; HUANG Guo-qi

    2003-01-01

    In the treatment of 320 cases of infantile diarrhea by the needling technique of setting fire on mountains, with Zusanli (ST 36) and Changqiang (GV 1)as the main acupoints, all cases were cured after 1-3 treatments.

  15. A treatment procedure for Gemini North/NIFS data cubes: application to NGC 4151

    Science.gov (United States)

    Menezes, R. B.; Steiner, J. E.; Ricci, T. V.

    2014-03-01

    We present a detailed procedure for treating data cubes obtained with the Near-Infrared Integral Field Spectrograph (NIFS) of the Gemini North telescope. This process includes the following steps: correction of the differential atmospheric refraction, spatial re-sampling, Butterworth spatial filtering, `instrumental fingerprint' removal and Richardson-Lucy deconvolution. The clearer contours of the structures obtained with the spatial re-sampling, the high spatial-frequency noise removed with the Butterworth spatial filtering, the removed `instrumental fingerprints' (which take the form of vertical stripes along the images) and the improvement of the spatial resolution obtained with the Richardson-Lucy deconvolution result in images with a considerably higher quality. An image of the Brγ emission line from the treated data cube of NGC 4151 allows the detection of individual ionized-gas clouds (almost undetectable without the treatment procedure) of the narrow-line region of this galaxy, which are also seen in an [O III] image obtained with the Hubble Space Telescope. The radial velocities determined for each one of these clouds seem to be compatible with models of biconical outflows proposed by previous studies. Considering the observed improvements, we believe that the procedure we describe in this work may result in more reliable analysis of data obtained with this instrument.

  16. Modified steel basket technique for the treatment of equine cervical vertebral stenotic myelopathy - a case report

    Directory of Open Access Journals (Sweden)

    Frederico Fernandes Araújo

    2015-08-01

    Full Text Available Cervical vertebral stenotic myelopathy (CVSM, also known as cervical ataxia or wobbler syndrome, is caused by the narrowing of the medullary canal due to a malformation of the cervical vertebrae, resulting in compression of the spinal cord and neurological alterations such as ataxia, hypermetria, weakness, and abnormal stance. The treatment options can be conservative or surgical, with varied effectiveness. The most appropriate surgical technique in the majority of cases is arthrodesis, providing quick and efficient decompression of the spinal cord. The goal of this case report is to present an equine patient with CVSM that was surgically treated using a new modified cage model. The diagnosis was based on history, clinical signs and radiographic evidence of spinal cord compression between the C3 and C4 vertebrae, after ruling out possible infectious agents. The surgical procedure for the decompression and stabilization of the point of stenosis was performed using a modified Cloward’s technique and a new cage model fixed with two screws. Evidence of fusion was obtained by periodic radiographs over six months of postoperative care. The new cage model used in this surgery proved to be efficient for the decompression and stabilization of the vertebrae, allowing arthrodesis development and remission of the clinical signs. Fixation of the cage with screws reduces the risk of migration of the implant.

  17. Fundamental aspects of oily waters treatment from the mineral industries by electrolytic techniques

    Energy Technology Data Exchange (ETDEWEB)

    Merma, A.G.; Gonzales, L.V.; Torem, M.L. [Pontifical Catholic Univ. of Rio de Janeiro, Rio de Janeiro (Brazil). Dept. of Materials Engineering

    2010-07-01

    There is an immediate need to develop innovative and more effective techniques for treatment of wastewaters as regulations on effluent wastewater discharge are becoming increasingly prevalent. The mining and metallurgical industries generate wastewaters that contain stable oil-in-water emulsions, arising from residues of liquid streams that serve the purpose of lubrication, cooling, cleaning and corrosion prevention in the equipment used in those industries. Chemically stabilized oil-water emulsions produced in the mineral industries can be treated using an electrocoagulation technique that considers the effects of operating parameters such as initial pH, current density, reaction time, electrode area/liquid volume ratio and electrode materials on the separation of oil as measured by the chemical oxygen demand. The paper discussed electrocoagulation as well as the materials and methods for the study, including oil in water emulsions; the experimental apparatus; and the experimental procedure. It was concluded that the electrolysis of this kind of oil in water emulsions with aluminum electrodes resulted in pH neutralization regardless of the initial pH tested. 18 refs., 4 figs.

  18. The advent of non-thermal, non-tumescent techniques for treatment of varicose veins.

    Science.gov (United States)

    Bootun, Roshan; Lane, Tristan R A; Davies, Alun H

    2016-02-01

    Varicose veins are common and their management has undergone a number of changes over the years. Surgery has been the traditional treatment option, but towards the 21st century, new endovenous thermal ablation techniques, namely, radiofrequency ablation and endovenous laser ablation, were introduced which have revolutionised the way varicose veins are treated. These minimally invasive techniques are associated with earlier return to normal activity and less pain, as well as enabling procedures to be carried out as day cases. They are, however, also known to cause a number of side-effects and involve infiltration of tumescent fluid which can cause discomfort. Non-thermal, non-tumescent methods are believed to be the answer to these unwelcome effects. Ultrasound-guided foam sclerotherapy is one such non-thermal, non-tumescent method and, despite a possible lower occlusion, has been shown to improve the quality of life of patients. The early results of two recently launched non-thermal, non-tumescent methods, mechanochemical ablation and cyanoacrylate glue, are promising and are discussed.

  19. Procedures for identifying evidence-based psychological treatments for older adults.

    Science.gov (United States)

    Yon, Adriana; Scogin, Forrest

    2007-03-01

    The authors describe the methods used to identify evidence-based psychological treatments for older adults in this contribution to the special section. Coding teams were assembled to review the literature on several problems relevant to mental health and aging. These teams used the manual developed by the Committee on Science and Practice of the Society for Clinical Psychology (Division 12) of the American Psychological Association that provided definitions of key constructs used in coding. The authors provide an overview of the process followed by the review teams and of some of the issues that emerged to illustrate the steps involved in the coding procedure. Identifying evidence-based treatments is a fundamental aspect of promoting evidence-based practice with older adults; such practice is advocated by most health care disciplines, including psychology.

  20. Advanced modeling techniques in application to plasma pulse treatment

    Science.gov (United States)

    Pashchenko, A. F.; Pashchenko, F. F.

    2016-06-01

    Different approaches considered for simulation of plasma pulse treatment process. The assumption of a significant non-linearity of processes in the treatment of oil wells has been confirmed. Method of functional transformations and fuzzy logic methods suggested for construction of a mathematical model. It is shown, that models, based on fuzzy logic are able to provide a satisfactory accuracy of simulation and prediction of non-linear processes observed.

  1. The canalith repositioning procedure for the treatment of benign paroxysmal positional vertigo: a randomized controlled trial.

    Science.gov (United States)

    Froehling, D A; Bowen, J M; Mohr, D N; Brey, R H; Beatty, C W; Wollan, P C; Silverstein, M D

    2000-07-01

    To compare the canalith repositioning procedure (CRP) with a sham maneuver for the treatment of benign paroxysmal positional vertigo. We recruited 50 patients with a history of positional vertigo and unilateral positional nystagmus on physical examination (Dix-Hallpike maneuver). Patients were randomized to either the CRP (n = 24) or a sham maneuver (n = 26). Measured outcomes included resolution of vertigo and positional nystagmus at follow-up examination. The mean duration of follow-up was 10 days for both groups. Resolution of symptoms was reported by 12 (50%) of the 24 patients in the CRP group and by 5 (19%) of the 26 patients in the sham group (P = .02). The results of the Dix-Hallpike maneuver were negative for positional nystagmus in 16 (67%) of 24 patients in the CRP group and in 10 (38%) of 26 patients in the sham group (P = .046). The CRP is effective treatment of benign paroxysmal positional vertigo, and this procedure can be performed by general internists on outpatients with this disorder.

  2. A treatment procedure for VLT/SINFONI data cubes: application to NGC 5643

    CERN Document Server

    Menezes, R B; Ricci, T V; Steiner, J E; May, D; Borges, B W

    2015-01-01

    In this second paper of a series, we present a treatment procedure for data cubes obtained with the Spectrograph for Integral Field Observations in the Near Infrared of the Very Large Telescope. We verified that the treatment procedure improves significantly the quality of the images of the data cubes, allowing a more detailed analysis. The images of the Br$\\gamma$ and H$_2 \\lambda 21218$ emission lines from the treated data cube of the nuclear region of NGC 5643 reveal the existence of ionized and molecular-gas clouds around the nucleus, which cannot be seen clearly in the images from the non-treated data cube of this galaxy. The ionized-gas clouds represent the narrow-line region, in the form of a bicone. We observe a good correspondence between the positions of the ionized-gas clouds in the Br$\\gamma$ image and in an [O III] image, obtained with the Hubble Space Telescope, of the nuclear region of this galaxy convolved with an estimate of the point-spread function of the data cube of NGC 5643. The morpholo...

  3. Comparison of hybrid volumetric modulated arc therapy (VMAT technique and double arc VMAT technique in the treatment of prostate cancer

    Directory of Open Access Journals (Sweden)

    Amaloo Christopher

    2015-09-01

    Full Text Available Background. Volumetric modulated arc therapy (VMAT has quickly become accepted as standard of care for the treatment of prostate cancer based on studies showing it is able to provide faster delivery with adequate target coverage and reduced monitor units while maintaining organ at risk (OAR sparing. This study aims to demonstrate the potential to increase dose conformality with increased planner control and OAR sparing using a hybrid treatment technique compared to VMAT.

  4. S2 Alar-iliac Fixation: A Powerful Procedure for the Treatment of Kyphoscoliosis.

    Science.gov (United States)

    Liu, Zhen; Qiu, Yong; Yan, Huang; Hu, Zong-shan; Zhu, Feng; Qiao, Jun; Xu, Lei-lei; Wang, Bin; Yu, Yang; Qian, Bang-ping; Zhu, Ze-zhang

    2016-02-01

    The purpose of this study was to introduce a powerful technique for the treatment of kyphoscoliosis. There are currently multiple techniques for sacropelvic fixation, including trans-iliac bars and iliac and iliosacral screws. Several studies have documented the use of these instrumentation techniques; however, a ubiquitous problematic issue concerns the need for separate incisions for the use of offset connectors, which add to surgical time and morbidity. Any additional dissection of the skin, subcutaneous tissue or muscle in this area is believed to increase the incidence of complications of wound healing. However, as stated above, the above-mentioned techniques require separate incisions for the use of offset connectors, which add to surgical time and morbidity. The novel technique of S2 alar-iliac (S2AI) pelvic fixation has been developed to address some of these issues. However, a technique for achieving correction of kyphoscoliosis with pelvic obliquity in adult patients with spinal deformity has not previously been described. Our entry point is based on the S1 foramen and is typically up to 5 mm caudal and 2 to 3 mm lateral to that foramen. Once the S1 foramen has been identified, a blunt instrument can be used to probe the alar ridge. The screw trajectory is 40°-50° from horizontal and 20°-30° caudal, aimed toward the greater trochanter and rostral to the sciatic notch. A 36-year-old female patient presented with a 3-year history of low back pain, and progressive thoracolumbar kyphoscoliosis. In this typical case, we performed S2AI fixation with transforaminal lumbar interbody fusion and hemivertebra resection technique to treat her lumbosacral kyphoscoliosis. Satisfactory improvement in her preoperative lumbar kyphoscoliosis was found at 3-month follow-up. © 2016 Chinese Orthopaedic Association and John Wiley & Sons Australia, Ltd.

  5. Comparing Limberg Flap Technique and Phenol Treatment Methods in Treatment of Pilonidal Disease

    Directory of Open Access Journals (Sweden)

    Ulas Urganci

    2016-01-01

    Full Text Available Aim: Although pilonidal disease is experienced commonly, there is no definitive algorithm. Our purpose is to contribute in determining treatment algorithm by comparing the conservative phenol treatment (PT method with limberg flap technique (LFT used frequently for pilonidal disease surgery.Material and Method: Patients diagnosed with pilonidal sinus and treated with PT and LFT between February 2011 and September 2014 in Buca Seyfi Demirsoy State Hospital General Surgery service are retrospectively enrolled in the study. Patients are contacted with the help of their files and included in the study. Patients are compared in terms of age, gender, pain-free walking and start date for going back to work, complications, success and relapse ratios. Results: 73 (81.1% of the cases were male, 17 (18.9% were female and their average age was 24±8.4(14-55. No statistically significant difference was detected between patients who have undergone LFT and PT in terms of success and relapse (p>0,05. Hospitalization period was average 1.55±0.9 days for patients who have undergone LFT. FT was applied as outpatient treatment for all patients. A statistically significant difference was determined in favor of PT as a result of comparing postoperative complications, pain-free walking and start date for going back to work (p=0,00. Discussion: In our study, we have proven that LFT, which is a method used frequently with recognized success is not superior to PT in terms of success and relapse ratios (p>0.05. On the contrary, when compared in terms of postoperative complication, pain-free walking time and start date for going back to work, we observed that PT is more advantageous than LFT (p=0,00. We consider that PT can be prefered treatment method due to its acceptable relapse ratio, low postoperative complication ratio, good postoperative patient comfort, capability of performing repeated applications and constant availability of operation option.

  6. Study on different pre-treatment procedures for metal determination in Orujo spirit samples by ICP-AES

    Energy Technology Data Exchange (ETDEWEB)

    Barciela, Julia; Vilar, Manuela; Garcia-Martin, Sagrario [Departamento de Quimica Analitica, Nutricion y Bromatologia, Facultad de Ciencias, Universidad de Santiago de Compostela, Campus de Lugo, 27002 Lugo (Spain); Pena, Rosa M. [Departamento de Quimica Analitica, Nutricion y Bromatologia, Facultad de Ciencias, Universidad de Santiago de Compostela, Campus de Lugo, 27002 Lugo (Spain)], E-mail: qarosa@lugo.usc.es; Herrero, Carlos [Departamento de Quimica Analitica, Nutricion y Bromatologia, Facultad de Ciencias, Universidad de Santiago de Compostela, Campus de Lugo, 27002 Lugo (Spain)], E-mail: cherrero@lugo.usc.es

    2008-10-17

    In this work several pre-treatment methods were studied for metal (Na, K, Mg, Cu and Ca) determination in Orujo spirit samples using inductively coupled plasma atomic emission spectrometry (ICP-AES). Dilution, digestion, evaporation, and cryogenic desolvatation techniques were comparatively evaluated. Because of their analytical characteristics, digestion and evaporation with nitrogen current were found to be appropriate procedures for the determination of metals in alcoholic spirit samples. Yet, if simplicity and application time are to be considered, the latter-evaporation in a water bath with a nitrogen current-stands out as the optimum procedure for any further determinations in Orujo samples by ICP-AES. Low detection levels and wide linear ranges (sufficient to determine these metals in the samples studied) were achieved for each metal. The recoveries (in the 97.5-100.5% range) and the precision (R.S.D. lower than 5.6%) obtained were also satisfactory. The selected procedure was applied to determine the content of metals in 80 representative Galician Orujo spirit samples with and without a Certified Brand of Origin (CBO) which had been produced using different distillation systems. The metal concentrations ranged between 0.37 and 79.7 mg L{sup -1} for Na,

  7. Clinical evaluation of guided tissue regeneration procedure in the treatment of grade II mandibular molar furcations.

    Science.gov (United States)

    Prathibha, P K; Faizuddin, M; Pradeep, A R

    2002-01-01

    The management of furcation defects remains a challenge in periodontal therapy, Traditionally, furcation therapy involved scaling, rootplaning, furcation plasty and resective techniques. The purpose of this study was to clinically evaluate the potential of guided tissue regeneration in the treatment of mandibular molar grade II furcations using a nonresorbable barrier, TefGen-GTR and compare it with open flap debridement alone. Ten patients with similar bilateral grade II furcation lesions participated in the study. TefGen-GTR was placed in the experimental sites while the contralateral sites served as controls. Treatment effects were evaluated at six months reentry. Both groups showed gain in vertical and horizontal open probing attachment and defect depth reduction when compared to baseline values, with experimental sites showing statistically significant improvement over the controls. The results suggest that the nonresorbable Teflon barrier, TefGen-GTR, may be used as an alternative for treatment of grade II furcation invasions.

  8. Intravascular ultrasound guidance of percutaneous coronary intervention in ostial chronic total occlusions: a description of the technique and procedural results.

    Science.gov (United States)

    Ryan, Nicola; Gonzalo, Nieves; Dingli, Philip; Cruz, Oscar Vedia; Jiménez-Quevedo, Pilar; Nombela-Franco, Luis; Nuñez-Gil, Ivan; Trigo, María Del; Salinas, Pablo; Macaya, Carlos; Fernandez-Ortiz, Antonio; Escaned, Javier

    2017-02-14

    Inability to cross the lesion with a guidewire is the most common reason for failure in percutaneous revascularization (PCI) of chronic total occlusions (CTOs). An ostial or stumpless CTO is an acknowledged challenge for CTO recanalization due to difficulty in successful wiring. IVUS imaging provides the opportunity to visualize the occluded vessel and to aid guidewire advancement. We review the value of this technique in a single-centre experience of CTO PCI. This series involves 22 patients who underwent CTO-PCI using IVUS guidance for stumpless CTO wiring at our institution. CTO operators with extensive IVUS experience in non-CTO cases carried out all procedures. Procedural and outcome data was prospectively entered into the institutional database and a retrospective analysis of clinical, angiographic and technical data performed. 17 (77%) of the 22 procedures were successful. The mean age was 59.8 ± 11.5 years, and 90.9% were male. The most commonly attempted lesions were located in the left anterior descending 36.4% (Soon et al. in J Intervent Cardiol 20(5):359-366, 2007) and Circumflex artery (LCx) 31.8% (Mollet et al. in Am J Cardiol 95(2):240-243, 2005). Mean JCTO score was 3.09 ± 0.75 (3.06 ± 0.68, 3.17 ± 0.98 in the successful and failed groups respectively p = 0.35). The mean contrast volume was 378.7 ml ± 114.7 (389.9 ml ± 130.5, 349.2 ml ± 52.2 p = 0.3 in the successful and failed groups respectively). There was no death, coronary artery bypass grafting or myocardial infarction requiring intervention in this series. When the success rates were analyzed taking into account the date of adoption of this technique, the learning curve had no significant impact on CTO-PCI success. This series describes a good success rate in IVUS guided stumpless wiring of CTOs in consecutive patients with this complex anatomical scenario.

  9. Changes in group treatment procedures of Danish finishers and its influence on the amount of administered antimicrobials

    DEFF Research Database (Denmark)

    Fertner, Mette Ely; Boklund, Anette; Dupont, Nana Hee

    2016-01-01

    antimicrobials between the years was significantly different in Cohort Change when compared to both Cohort Water and Cohort Feed. Results from this study demonstrate that farms changing their procedure of group treatment from feed administration to water administration may increase their overall use......When treating groups of pigs orally, antimicrobials can be administered through either feed or water. During the last decade, the group treatment procedure for finishers has shifted from feed to water administration. We hypothesized that farms implementing this change in treatment procedure would...... increase their total amount of administered antimicrobials. Based on Danish national register data, we performed a retrospective cohort study with three groups. The cohort of primary interest (Cohort Change) consisted of 50 finisher farms which changed their group treatment procedure from feed...

  10. Technique of Arthroscopic Treatment of Impingement After Total Ankle Arthroplasty.

    Science.gov (United States)

    Gross, Christopher E; Neumann, Julie A; Godin, Jonathan A; DeOrio, James K

    2016-04-01

    Rates of medial and/or lateral gutter impingement after total ankle replacement are not insignificant. If impingement should occur, it typically arises an average of 17 months after total ankle replacement. Our patient underwent treatment for right ankle medial gutter bony impingement with arthroscopic debridement 5 years after her initial total ankle replacement. Standard anteromedial and anterolateral portals and a 30° 2.7-mm-diameter arthroscope were used. An aggressive soft-tissue and bony resection was performed using a combination of curettes, a 3.5-mm shaver, a 5.5-mm unsheathed burr, a drill, and a radiofrequency ablator. This case shows that arthroscopic treatment is an effective and potentially advantageous alternative to open treatment of impingement after total ankle replacement. In addition, symptoms of impingement often improve in a short amount of time after arthroscopic debridement of the medial and/or lateral gutter.

  11. Preliminary Assessment of the Nutrient Film Technique for Wastewater Treatment

    Science.gov (United States)

    1982-03-01

    of an experiment conducted at CRREL to de- tween an NFT system and a hydroponic plant system termine the feasibility of using the nutrient film tech...umre) Hydroponics Thin films Wastes (Sanitary engineering) \\Waslewater \\I MArWIASSACr a m evemww sb N nem y., d idenif, by block nm,6...) An experiment...was conducted to determine the feasibility of using a solar powered, self-regenerating plant growth system, called the nutrient film technique ( NFT

  12. Two-micron (thulium) laser resection of the prostate-tangerine technique: a new method for BPH treatment

    Institute of Scientific and Technical Information of China (English)

    Shu-Jie Xia

    2009-01-01

    Two-micron (thulium) laser resection of the prostate-tangerine technique (TmLRP-TT) is a transurethral pro-cedure that uses a thulium laser fiber to dissect whole prostatic lobes off the surgical capsule, similar to peeling a tangerine. We recently reported the primary results. Here we introduce this procedure in detail. A 70-W, 2-μm (thulium) laser was used in continuous-wave mode. We joined the incision by making a transverse cut from the level of the verumontanum to the bladder neck, making the resection sufficiently deep to reach the surgical capsule, and resected the prostate into small pieces, just like peeling a tangerine. As we resected the prostate, the pieces were vaporized, sufficiently small to be evacuated through the resectoscope sheath, and the use of the mechanical tissue morcellator was not required. The excellent hemostasis of the thulium laser ensured the safety of TmLRP-TT. No patient required blood transfusion. Saline irrigation was used intraoperatively, and no case of transurethral resec-tion syndrome was observed. The bladder outlet obstruction had clearly resolved after catheter removal in all cases. We designed the tangerine technique and proved it to be the most suitable procedure for the use of thulium laser in the treatment of benign prostatic hyperplasia (BPH). This procedure, which takes less operative time than standard techniques, is safe and combines efficient cutting and rapid organic vaporization, thereby showing the great superi-ority of the thulium fiber laser in the treatment of BPH. It has been proven to be as safe and efficient as transurethral resection of the prostate (TURP) during the 1-year follow-up.April 2009.

  13. Percutaneous endovascular stent-graft treatment of aortic aneurysms and dissections: new techniques and initial experience

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Do Yun; Choi, Dong Hoon; Kang, Sung Gwon; Lee, Kwang Hoon; Won, Jong Yun [Yonsei University College of Medicine, Seoul (Korea, Republic of); Kang, Sung Gwon [Chosun University College of Medicine, Gwangju (Korea, Republic of); Won, Je Whan [Aju University College of Medicine, Suwon (Korea, Republic of); Song, Ho Young [Ulsan University College of Medicine, Seoul (Korea, Republic of)

    2003-01-01

    To evaluate the feasibility, safety and effectiveness of a newly designed percutaneously implanted separate stent-graft (SSG) for the treatment of aortic aneurysms and dissections. Using a percutaneous technique, SSG placement (in the descending thoracic aorta in 26 cases and infrarenal abdominal aorta in 24) was attempted in 50 patients with aortic aneurysms (n=27) or dissection (n=23). All SSGs were individually constructed using self-expandable nitinol stents and a Dacron graft, and were introduced through a 12 F sheath and expanded to a diameter of 20-34 mm. In all cases, vascular access was through the femoral artery. The clinical status of each patient was monitored, and postoperative CT was performed within one week of the procedure and at 3-6 month intervals afterwards. Endovascular stent-graft deployment was technically successful in 49 of 50 patients (98%). The one failure was due to torsion of the unsupported graft during deployment. Successful exclusion of aneurysms and the primary entry tears of dissections was achieved in all but three patients with aortic dissection. All patients in whom technical success was achieved showed complete thrombosis of the thoracic false lumen or aneurysmal sac, and the overall technique success rate was 92%. In addition, sixteen patients demonstrated complete resolution of the dissected thoracic false lumen (n=9) or aneurysmal sac (n=7). Immediate post-operative complications occurred at the femoral puncture site in one patient with an arteriovenous fistula, and in two, a new saccular aneurysm developed at the distal margin of the stent. No patients died, and there was no instance of paraplegia, stroke, side-branch occlusion or infection during the subsequent mean follow-up period of 9.4 (range, 2 to 26) months. In patients with aortic aneurysm and dissection, treatment with a separate percutaneously inserted stent-graft is technically feasible, safe, and effective.

  14. Congenital penile curvature: long-term results of operative treatment using the plication procedure

    Institute of Scientific and Technical Information of China (English)

    S.-S.Lee; E.Meng; E-RChuang; C.-Y.Yen; S.-Y.Chang; D.-S.Yu; G.-H.Sun

    2004-01-01

    Aim: To determine the long-term outcome, effectiveness and patient satisfaction of congenital penile curvature correction by plication of tunica albuginea. Methods: From January 1992 to January 2002, 106 young patients underwent surgical correction of congenital penile curvature by corporeal plication. Indications for operation were difficult or impossible vaginal penetration and cosmetic problems. The technique of corporeal plication consists of placing longitudinal plication sutures of 2-zero braided polyester on the convex side of the curvature until the curvature is corrected when erection is artificially induced. Results of this procedure were obtained by retrospective chart reviews and questionnaires via mail. Long-term follow-up ranged from 11 to 132 (mean 69.3) months and data were available for 68 patients. Results: Penile straightening was excellent in 62 patients (91%) and good with less than 15 degree of residual curvature in 6 patients (9 %). Sixty-seven patients reported no change in erectile rigidity or maintenance postoperatively, while 1 described early detumescence. Shortening of the penis without functional problems was noted by 26 patients (38 %). Thirty-Five patients (51%) reported feeling palpable indurations (suture knots) on the penis. Temporary numbness of glans penis was described in 3 patients. Overall, 60 patients were very satisfied, 6 satisfied, 2 unsatisfied. Conclusion: Corporeal plication is an effective and durable procedure with a high rate of patient satisfaction. (Asian J Androl 2004 Sep; 6: 273-276)

  15. Congenital penile curvature: long-term results of operative treatment using the plication procedure.

    Science.gov (United States)

    Lee, S-S; Meng, E; Chuang, F-P; Yen, C-Y; Chang, S-Y; Yu, D-S; Sun, G-H

    2004-09-01

    To determine the long-term outcome, effectiveness and patient satisfaction of congenital penile curvature correction by plication of tunica albuginea. From January 1992 to January 2002, 106 young patients underwent surgical correction of congenital penile curvature by corporeal plication. Indications for operation were difficult or impossible vaginal penetration and cosmetic problems. The technique of corporeal plication consists of placing longitudinal plication sutures of 2-zero braided polyester on the convex side of the curvature until the curvature is corrected when erection is artificially induced. Results of this procedure were obtained by retrospective chart reviews and questionnaires via mail. Long-term follow-up ranged from 11 to 132 (mean 69.3) months and data were available for 68 patients. Penile straightening was excellent in 62 patients (91 %) and good with less than 15 degree of residual curvature in 6 patients (9 %). Sixty-seven patients reported no change in erectile rigidity or maintenance postoperatively, while 1 described early detumescence. Shortening of the penis without functional problems was noted by 26 patients (38 %). Thirty-Five patients (51 %) reported feeling palpable indurations (suture knots) on the penis. Temporary numbness of glans penis was described in 3 patients. Overall, 60 patients were very satisfied, 6 satisfied, 2 unsatisfied. Corporeal plication is an effective and durable procedure with a high rate of patient satisfaction.

  16. Visceral hybrid reconstruction of thoracoabdominal aortic aneurysm after open repair of type a aortic dissection by the Bentall procedure with the elephant trunk technique: A case report

    Directory of Open Access Journals (Sweden)

    Marjanović Ivan

    2014-01-01

    Full Text Available Introduction. Reconstruction of chronic type B dissection and thoracoabdominal aortic aneurysm (TAAA remaining after the emergency reconstruction of the ascending thoracic aorta and aortic arch for acute type A dissection represents one of the major surgical challenges. Complications of chronic type B dissection are aneurysmal formation and rupture of an aortic aneurysm with a high mortality rate. We presented a case of visceral hybrid reconstruction of TAAA secondary to chronic dissection type B after the Bentall procedure with the elephant trunk technique due to acute type A aortic dissection in a high-risk patient. Case report. A 62 year-old woman was admitted to our institution for reconstruction of Crawford type I TAAA secondary to chronic dissection. The patient had had an acute type A aortic dissection 3 years before and undergone reconstruction by the Bentall procedure with the elephant trunk technique with valve replacement. On admission the patient had coronary artery disease (myocardial infarction, two times in the past 3 years, congestive heart disease with ejection fraction of 25% and chronic obstructive pulmonary disease. On computed tomography (CT of the aorta TAAA was revealed with a maximum diameter of 93 mm in the descending thoracic aorta secondary to chronic dissection. All the visceral arteries originated from the true lumen with exception of the celiac artery (CA, and the end of chronic dissection was below the origin of the superior mesenteric artery (SMA. The patient was operated on using surgical visceral reconstruction of the SMA, CA and the right renal artery (RRA as the first procedure. Postoperative course was without complications. Endovascular TAAA reconstruction was performed as the second procedure one month later, when the elephant trunk was used as the proximal landing zone for the endograft, and distal landing zone was the level of origin of the RRA. Postoperatively, the patient had no neurological deficit and

  17. 40 CFR 141.403 - Treatment technique requirements for ground water systems.

    Science.gov (United States)

    2010-07-01

    ....403 Treatment technique requirements for ground water systems. (a) Ground water systems with significant deficiencies or source water fecal contamination. (1) The treatment technique requirements of this... requirements of this section. (3) When a significant deficiency is identified at a Subpart H public...

  18. 40 CFR 141.111 - Treatment techniques for acrylamide and epichlorohydrin.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 22 2010-07-01 2010-07-01 false Treatment techniques for acrylamide....111 Treatment techniques for acrylamide and epichlorohydrin. Each public water system must certify annually in writing to the State (using third party or manufacturer's certification) that when acrylamide...

  19. 40 CFR 141.404 - Treatment technique violations for ground water systems.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 22 2010-07-01 2010-07-01 false Treatment technique violations for ground water systems. 141.404 Section 141.404 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS (CONTINUED) NATIONAL PRIMARY DRINKING WATER REGULATIONS Ground Water Rule § 141.404 Treatment technique violations for...

  20. Treatment of adolescents with morbid obesity with bariatric procedures and anti-obesity pharmacological agents

    Directory of Open Access Journals (Sweden)

    Um SS

    2011-12-01

    Full Text Available Scott S Um1, Wendelin Slusser2, Daniel A DeUgarte11Department of Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA; 2Department of Pediatrics, David Geffen School of Medicine at UCLA, Los Angeles, CA, USAAbstract: Adolescent obesity is a growing health concern that can have immense physical and psychological impact. Treatment of morbidly obese adolescents should include a multidisciplinary team to address medical comorbidities, diet, physical activity, mental health, and behavior modification. Anti-obesity pharmacologic agents have a limited role in the treatment of adolescents because of concerns with side effects, safety, and efficacy. Orlistat (GlaxoSmithKline, Moon Township, PA is the only approved medication for weight-loss in adolescents. However, it is associated with gastrointestinal side effects and its long-term efficacy is unknown. Bariatric surgery is the most effective therapy to treat morbid obesity. However, adolescents must meet rigorous criteria and have appropriate cognitive, psychological, and social clearance before being considered for surgical intervention. Gastric bypass remains the gold standard bariatric operation. The adjustable gastric band is not FDA-approved for use in patients under 18 years of age. Sleeve gastrectomy is a promising procedure for adolescents because it avoids an intestinal bypass and the implantation of a foreign body. Prospective longitudinal assessment of bariatric surgery procedures is required to determine long-term outcomes. In this manuscript, we review the treatment options, efficacy, and impact on quality of life for morbidly obese adolescents.Keywords: bariatric surgery, morbid obesity, weight loss, adolescent

  1. Modern techniques in treatment of chest and extremity polytraumas

    Directory of Open Access Journals (Sweden)

    Khmara Т.G.

    2012-12-01

    Full Text Available The article presents a review of Russian and foreign literature on polytrauma. It touches upon the following points: statistic data of the pathology occurrence, mortality and disability from injuries, classification and methods of diagnostics and treatment of multiple traumas and polytraumas.

  2. Molecular Genetics Techniques to Develop New Treatments for Brain Cancers

    Energy Technology Data Exchange (ETDEWEB)

    Fox, Jacob; Fathallan-Shaykh, Hassan

    2006-09-22

    The objectives of this report are: (1) to devise novel molecular gene therapies for malignant brain tumors, (2) advance our understanding of the immune system in the central nervous system; and (3) apply genomics to find molecular probes to diagnose brain tumors, predict prognosis, biological behavior and their response to treatment.

  3. Surgical treatment of complex aneurysms and thoracic aortic dissections with the Frozen Elephant Trunk technique

    Directory of Open Access Journals (Sweden)

    Ricardo Ribeiro Dias

    2015-04-01

    Full Text Available AbstractObjective:Report initial experience with the Frozen Elephant Trunk technique.Methods:From July 2009 to October 2013, Frozen Elephant Trunk technique was performed in 21 patients (66% male, mean age 56 ±11 years. They had type A aortic dissection (acute 9.6%, chronic 57.3%, type B (14.3%, all chronic and complex aneurysms (19%. It was 9.5% of reoperations and 38% of associated procedures (25.3% miocardial revascularization, 25.3% replacement of aortic valve and 49.4% aortic valved graft. Aortic remodeling was evaluated comparing preoperative and most recent computed tomography scans. One hundred per cent of complete follow-up, mean time of 28 months.Results:In-hospital mortality of 14.2%, being 50% in acute type A aortic dissection, 8.3% in chronic type A aortic dissection, 33.3% in chronic type B aortic dissection and 0% in complex aneurysms. Mean times of cardiopulmonary bypass (152±24min, myocardial ischemia (115±31min and selective cerebral perfusion (60±15min. Main complications were bleeding (14.2%, spinal cord injury (9.5%, stroke (4.7%, prolonged mechanical ventilation (4.7% and acute renal failure (4.7%. The need for second-stage operation was 19%. False-lumen thrombosis was obtained in 80%.Conclusion:Frozen Elephant Trunk is a feasible technique and should be considered. The severity of the underlying disease justifies high mortality rates. The learning curve is a reality. This approach allows treatment of more than two segments at once. Nonetheless, if a second stage is made necessary, it is facilitated.

  4. Nanomaterial characterization through image treatment, 3D reconstruction and AI techniques

    Science.gov (United States)

    Lopez de Uralde Huarte, Juan Jose

    Nanotechnology is not only the science of the future, but it is indeed the science of today. It is used in all sectors, from health to energy, including information technologies and transport. For the present investigation, we have taken carbon black as a use case. This nanomaterial is mixed with a wide variety of materials to improve their properties, like abrasion resistance, tire and plastic wear or tinting strength in pigments. Nowadays, indirect methods of analysis, like oil absorption or nitrogen adsorption are the most common techniques of the nanomaterial industry. These procedures measure the change in the physical state while adding oil and nitrogen. In this way, the superficial area is estimated and related with the properties of the material. Nevertheless, we have chosen to improve the existent direct methods, which consist in analysing microscopy images of nanomaterials. We have made progress in the image processing treatments and in the extracted features. In fact, some of them have overcome the existing features in the literature. In addition, we have applied, for the first time in the literature, machine learning to aggregate categorization. In this way, we identify automatically their morphology, which will determine the final properties of the material that is mixed with. Finally, we have presented an aggregate reconstruction genetic algorithm that, with only two orthogonal images, provides more information than a tomography, which needs a lot of images. To summarize, we have improved the state of the art in direct analysing techniques, allowing in the near future the replacement of the current indirect techniques.

  5. Venous leakage treatment revisited: pelvic venoablation using aethoxysclerol under air block technique and Valsalva maneuver

    Directory of Open Access Journals (Sweden)

    Ralf Herwig

    2015-03-01

    Full Text Available Objective: We evaluated the effectiveness of pelvic vein embolization with aethoxysclerol in aero-block technique for the treatment of impotence due to venous leakage in men using sildenafil for intercourse. The aim of the procedure was to reduce the use of sildenafil. Methods: A total of 96 patients with veno-occlusive dysfunction, severe enough for the need of PDE5 inhibitors for vaginal penetration, underwent pelvic venoablation with aethoxysclerol. The mean patient age was 53.5 years. Venous leaks were identified by Color Doppler Ultrasound after intracavernous alprostadil injection. Under local anesthesia a 20-gauge needle was inserted into the deep dorsal penile vein. The pelvic venogram was obtained through deep dorsal venography. Aethoxysclerol 3% as sclerosing agent was injected after air-block under Valsalva manoeuver. Success was defined as the ability to achieve vaginal insertion without the aid of any drugs, vasoactive injections, penile prosthesis, or vacuum device. Additionally, a pre- and post- therapy IIEF score and a digital overnight spontaneous erections protocol (OSEP with the NEVA™-system was performed. Results: At 3 month follow-up 77 out of 96 patients (80.21% reported to have erections sufficient for vaginal insertion without the use of any drug or additional device. Four (4.17% patients did not report any improvement. Follow up with color Doppler ultrasound revealed a new or persistent venous leakage in 8 (8.33% of the patients. No serious complications occurred. Conclusions: Our new pelvic venoablation technique using aethoxysclerol in air-block technique was effective, minimally invasive, and cost-effective. All patients were able to perform sexual intercourse without the previously used dosage of PDE5 inhibitor. This new method may help in patients with contra-indications against PDE5 inhibitors, in patients who cannot afford the frequent usage of expensive oral medication or those who do not fully respond to PDE5

  6. Quality of Life Shift after Aortic Valve Replacement in the Era of TAVI: Single-Center Class Comparison Study Between Different Procedural Techniques.

    Science.gov (United States)

    Blehm, Alexander; Sorokin, Vitaly A; Hartman, Mikael; Wai, Khin Lay; Schmitz, Karoline; Lichtenberg, Artur

    2015-09-01

    The health-related quality of life (QOL) is one of the most important outcome indicators for elderly people undergoing aortic valve interventions, and should be assessed across different interventions, including emerging percutaneous techniques. The study aim was to assess the change in QOL after different procedures for aortic valve replacement (AVR). QOL was assessed using the Short Form-36 questionnaire (SF-36) for 59 patients after conventional AVR; of these patients, 28 had AVR via a J-sternotomy, a transapical approach was used in 20 patients, and a transfemoral approach in 34. The early mortality during hospitalization was not significantly different among all four groups. The inverse probability weighted propensity scores adjusted Kaplan-Meier curve revealed that the transapical group had the lowest survival rate. The treatment effect analysis was most prominent in the transfemoral transcatheter aortic valve implantation (TAVI) group across all domains for QOL. The multivariate hierarchical linear mixed final fitted model shows that the transapical TAVI procedure and NYHA class (III-IV) had a significant negative effect on the physical domain and overall QOL score. Changes in QOL after interventions on the aortic valve were determined by the patient's preoperative status and the surgical intervention. The transcatheter intervention, even in 'sicker' patients, provided a gain in QOL comparable with that after an open-heart procedure. Transfemoral TAVI was shown to have advantages over transapical TAVI in terms of QOL improvement at three months and six months, and should be considered the first choice for patients in the high-risk surgical group.

  7. Short clinical crowns (SCC) – treatment considerations and techniques

    OpenAIRE

    Sharma, Ashu; Rahul, G. R.; Poduval, Soorya T.; Shetty, Karunakar

    2012-01-01

    When the clinical crowns of teeth are dimensionally inadequate, esthetically and biologically acceptable restoration of these dental units is difficult. Often an acceptable restoration cannot be accomplished without first surgically increasing the length of the existing clinical crowns; therefore, successful management requires an understanding of both the dental and periodontal parameters of treatment. The complications presented by teeth with short clinical crowns demand a comprehensive tre...

  8. Short clinical crowns (SCC) – treatment considerations and techniques

    OpenAIRE

    Sharma, Ashu; G. R. Rahul; Poduval, Soorya T.; Shetty, Karunakar

    2012-01-01

    When the clinical crowns of teeth are dimensionally inadequate, esthetically and biologically acceptable restoration of these dental units is difficult. Often an acceptable restoration cannot be accomplished without first surgically increasing the length of the existing clinical crowns; therefore, successful management requires an understanding of both the dental and periodontal parameters of treatment. The complications presented by teeth with short clinical crowns demand a comprehensive tre...

  9. The Cost Differential Between Warfarin Versus Aspirin Treatment After a Fontan Procedure.

    Science.gov (United States)

    Schilling, Chris; Dalziel, Kim; Iyengar, Ajay J; d'Udekem, Yves

    2017-08-01

    The use of aspirin versus warfarin for treatment of patients after a Fontan procedure remains contentious. Current preference-based models of treatment across Australia and New Zealand show variation in care that is unlikely to reflect patient differences and/or clinical risk. We combine data from the Australian and New Zealand Fontan Registry and a home INR (International Normalised Ratio) monitoring program (HINRMP) from the Royal Children's Hospital (RCH) Melbourne, to estimate the cost difference for Fontan recipients receiving aspirin versus warfarin for 2015. We adopt a societal perspective to costing which includes cost to the health system (e.g. medical consults, pathology tests) and costs to patients and carers (e.g. travel and time), but excludes costs of adverse events. Costs are presented in Australian 2015 dollars; any costs from previous years have been inflated using appropriate rates from the Australian Bureau of Statistics. We find that warfarin patients face additional costs of $825 per annum, with the majority ($584 or 71%) of those borne by the patient or family. If aspirin is as clinically as effective as warfarin, Fontan recipients could be enjoying far less costly, invasive and time-consuming treatment. While achieving such clinical consensus can be difficult, economics shows us that there are large costs associated with a failure to achieve it. Copyright © 2017. Published by Elsevier B.V.

  10. BPH Procedural Treatment: The Case for Value-Based Pay for Performance

    Directory of Open Access Journals (Sweden)

    Mark Stovsky

    2008-01-01

    Full Text Available The concept of “pay for performance” (P4P applied to the practice of medicine has become a major foundation in current public and private payer reimbursement strategies for both institutional and individual physician providers. “Pay for performance” programs represent a substantial shift from traditional service-based reimbursement to a system of performance-based provider payment using financial incentives to drive improvements in the quality of care. P4P strategies currently embody rudimentary structure and process (as opposed to outcomes metrics which set relatively low-performance thresholds. P4P strategies that align reimbursement allocation with “free market” type shifts in cognitive and procedural care using evidence-based data and positive reinforcement are more likely to produce large-scale improvements in quality and cost efficiency with respect to clinical urologic care. This paper reviews current paradigms and, using BPH procedural therapy outcomes, cost, and reimbursement data, makes the case for a fundamental change in perspective to value-based pay for performance as a reimbursement system with the potential to align the interests of patients, physicians, and payers and to improve global clinical outcomes while preserving free choice of clinically efficacious treatments.

  11. Multiservice Tactics, Techniques, and Procedures for Treatment of Chemical Agent Casualties and Conventional Military Chemical Injuries

    Science.gov (United States)

    2007-09-01

    bromide, peptic ulcer disease , and low serum acetylcholinesterase. (5) Personnel who are self-administering PB while handling or working around...be used with caution in individuals with hyperthyroidism, sensitivity to bromide, peptic ulcer disease , and low serum acetylcholinesterase. (6) If... acid (HF) may suffer lingering chronic lung disease . Burns may take a long time to heal and may result in severe scarring, persistent pain and bone

  12. Endoscopic third ventriculostomy is a safe and effective procedure for the treatment of Blake's pouch cyst

    Directory of Open Access Journals (Sweden)

    Carlos Vicente Brusius

    2013-08-01

    Full Text Available OBJECTIVE: Blake's pouch cyst (BPC is a midline cystic malformation of the posterior fossa, within Dandy-Walker's complex (DWC, often associated with hydrocephalus. Endoscopic third ventriculostomy (ETV has been an alternative to conventional methods for BPC treatment. This study aimed at reporting our experience with ETV in a series of patients with BPC. METHODS: Of 33 patients diagnosed with midline posterior fossa cyst, 26 met the protocol criteria for DWC, and eight subjects with BPC were selected (aged one month to two years old. All cases were treated with ETV. RESULTS: Five patients were male; and three were prenatally diagnosed. They had hydrocephalus and motor deficiencies. Motor assessment at a five-year follow-up yielded normal findings. All patients improved, and only one had residual cognitive dysfunction, despite overall neurological improvement. There were no complications. CONCLUSIONS: ETV was a safe and effective procedure, reducing risks and morbidity associated with open surgery and shunt-related problems.

  13. Concomitant percutaneous treatment of aortic coarctation and associated intercostal aneurysms: pre-procedural recognition is key.

    Science.gov (United States)

    Batlivala, Sarosh P; Rome, Jonathan J

    2016-02-01

    Intercostal aneurysms are associated with aortic coarctation. Their aetiology is not well-understood but may be related to intrinsic vascular pathology and altered flow dynamics through the intercostal artery. We present the cases of two patients with coarctation and intercostal aneurysms. The aneurysms were recognised on pre-catheterisation imaging studies and were selectively occluded during the same procedure to treat the coarctation. There were no complications; both the patients have no residual coarctation at the most recent follow-up. Intercostal aneurysms associated with coarctation can have significant consequences including late rupture, paralysis, and even death. These aneurysms are common with an incidence of up to 40% with adult-diagnosed coarctation; one treatment plan is to treat both the coarctation and aneurysm during a single catheterisation. Pre-catheterisation CT or MRI may play a role in this strategy.

  14. The Shouldice technique for the treatment of inguinal hernia

    Directory of Open Access Journals (Sweden)

    Chan Chin

    2006-01-01

    Full Text Available The Shouldice repair has been refined over several decades and is the gold standard for the prosthesis-free treatment of inguinal hernias. A recurrence rate around 1% has been consistently demonstrated over the years. The objective of this paper is to outline and highlight the key principles, including the dedicated pre-operative preparation, the use of local anesthesia, a complete inguinal dissection and the eponymous four-layered reconstruction. A knowledge and understanding of inguinal hernia anatomy and the patho-physiology of recurrence are vital to achieving a long-term success and patient satisfaction for a pure tissue repair.

  15. Comparison of intraoperative blood loss between four different surgical procedures in the treatment of bimaxillary protrusion.

    Science.gov (United States)

    Tseng, Yu-Chuan; Ting, Chun-Chan; Kao, Yu-Hsun; Chen, Chun-Ming

    2017-01-01

    This study was aimed at investigating the correlation between intraoperative blood loss and operation-related factors in the treatment of bimaxillary protrusion with four different procedures. Ninety-four patients were separated into the following four surgical groups: group 1: anterior subapical osteotomy of the maxilla (ASO Mx) + bilateral parasymphyseal osteotomy of the mandible (BPsO Md) + genioplasty (GeP); group 2: ASO Mx + BPsO Md; group 3: ASO Mx + ASO Md + GeP; and group 4: ASO Mx + ASO Md. Patient- and operation-related factors (age, intraoperative blood loss, operation time, and preoperative and postoperative blood parameters) were compared among the four groups. The mean operation time and intraoperative blood loss were 438.7 minutes and 369.9 mL in group 1; 432.5 minutes and 356.5 mL in group 2; 393.3 minutes and 387.3 mL in group 3; and 353.5 minutes and 289.5 mL in group 4. Intergroup differences in intraoperative blood loss were not significant. A significant correlation between intraoperative blood loss and operation time was found in group 4 but not in the other groups. No significant differences in blood loss were found among the four different surgical procedures in the treatment of bimaxillary protrusion. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. Short clinical crowns (SCC) – treatment considerations and techniques

    Science.gov (United States)

    Rahul, G. R.; Poduval, Soorya T.; Shetty, Karunakar

    2012-01-01

    When the clinical crowns of teeth are dimensionally inadequate, esthetically and biologically acceptable restoration of these dental units is difficult. Often an acceptable restoration cannot be accomplished without first surgically increasing the length of the existing clinical crowns; therefore, successful management requires an understanding of both the dental and periodontal parameters of treatment. The complications presented by teeth with short clinical crowns demand a comprehensive treatment plan and proper sequencing of therapy to ensure a satisfactory result. Visualization of the desired result is a prerequisite of successful therapy. This review examines the periodontal and restorative factors related to restoring teeth with short clinical crowns. Modes of therapy are usually combined to meet the biologic, restorative, and esthetic requirements imposed by short clinical crowns. In this study various methods for treating short clinical crowns are reviewed, the role that restoration margin location play in the maintenance of periodontal and dental symbiosis and the effects of violation of the supracrestal gingivae by improper full-coverage restorations has also been discussed. Key words:Short clinical crown, surgical crown lengthening, forced eruption, diagnostic wax up, alveoloplasty, gingivectomy. PMID:24558561

  17. "Heidelberg standard examination" and "Heidelberg standard procedures" - Development of faculty-wide standards for physical examination techniques and clinical procedures in undergraduate medical education.

    Science.gov (United States)

    Nikendei, C; Ganschow, P; Groener, J B; Huwendiek, S; Köchel, A; Köhl-Hackert, N; Pjontek, R; Rodrian, J; Scheibe, F; Stadler, A-K; Steiner, T; Stiepak, J; Tabatabai, J; Utz, A; Kadmon, M

    2016-01-01

    The competent physical examination of patients and the safe and professional implementation of clinical procedures constitute essential components of medical practice in nearly all areas of medicine. The central objective of the projects "Heidelberg standard examination" and "Heidelberg standard procedures", which were initiated by students, was to establish uniform interdisciplinary standards for physical examination and clinical procedures, and to distribute them in coordination with all clinical disciplines at the Heidelberg University Hospital. The presented project report illuminates the background of the initiative and its methodological implementation. Moreover, it describes the multimedia documentation in the form of pocketbooks and a multimedia internet-based platform, as well as the integration into the curriculum. The project presentation aims to provide orientation and action guidelines to facilitate similar processes in other faculties.

  18. [Professor LAI Xinsheng's treatment experience of infertility by Tongyuan needling technique].

    Science.gov (United States)

    Li, Yuemei; Meng, Zhenzhen; Wang, Ranran

    2015-03-01

    Professor LAI Xinsheng's treatment experience of infertility mainly by Tongyuan needling technique for both females and males is summarized. Tongyuan needling technique is a treatment method of leading qi to its primordial location mainly through viscera back-shu points that can dredge the governor vessel and tonify the spirit and conception vessel points in abdomen and abdominal front-mu points, and according to state of illness acupoints for opening the 4 gates or five shu points are combined; reinforcing and reducing manipulations of acupuncture are applied for reference. With the method of listing cases, professor LAI Xinsheng's Tongyuan needling technique is detailedly introduced in different aspects, such as the treatment of polycystic ovary syndrome infertility and male infertility and improving the success rate of test-tube baby, and the manipulation of Tongyuan needling technique is summarized, indicating that Tongyuan needling technique is worth vigorously prompting in clinical treatment of infertility.

  19. Dosimetric Comparison of Two Craniospinal Radiotherapy Techniques for Treatment Optimization

    Directory of Open Access Journals (Sweden)

    Hamidreza Baghani

    2010-06-01

    Full Text Available Introduction: Orthogonal radial fields are those in which the central axes are perpendicular to each other. An example of these orthogonal fields is the set of craniospinal orthogonal fields that are used for radiotherapy of medulloblastoma. Craniospinal radial fields consist of two parallel-opposed fields for brain exposure and one or two posterior spinal fields for spinal cord exposure. The main problem in using these combinative fields is the overlap of radial fields, where they adjoin. Therefore, adjusting radial fields in craniospinal radiotherapy is of remarkable significance and can outstandingly affect the reduction of the side effects due to radiotherapy. In doing so, two different setups were used for craniospinal radiotherapy, and by using dosimetry in each adjustment in the junction region between brain and upper spine fields and in organs at risk, the results of the two adjustments were compared. Materials and Methods: Each one of these two setups was separately performed on a Rando phantom. In the first setup, the arrangement of radial fields was performed without the rotation of the treatment bed and the collimators of the brain fields. In the second setup, the arrangement of radial fields was performed using the rotation of the treatment bed and the collimators of brain fields. For dosimetry, GR-200 TLDs were used. For radiotherapy, a varian linac (2100 C/D Model was used. Results: The results of dosimetry in the brain CTV, junction of brain and upper spine fields, thyroid and heart in the first setup were equal to 105, 168, 46 and 44 cGy, respectively, and in second setup, 106, 140, 48 and 44 cGy, respectively. Absorbed dose to the testes in both setups was negligible.  Discussion and Conclusion: The results of dosimetry in both setups showed that angling the bed and the collimators for the brain fields prevents the overlap of radial fields and reduces the side effects due to radiotherapy.

  20. [Tibial defects and infected non-unions : Treatment results after Masquelet technique].

    Science.gov (United States)

    Moghaddam, A; Ermisch, C; Fischer, C; Zietzschmann, S; Schmidmaier, G

    2017-03-01

    The treatment of non-unions with large bone defects or osteitis is a major challenge in orthopedic and trauma surgery. A new concept of therapy is a two-step procedure: Masquelet technique according to the diamond concept. Between February 2010 and June 2014, 55 patients with tibia non-unions or infections were treated in a two-step Masquelet technique in our center. The patients' average age was 48 (median 50; minimum 15-maximum 72) with an average BMI (body mass index) of 28 (27; 18-52). There were 10 (18 %) female and 45 (82 %) male patients in the group. All study patients went through a follow up. Bone healing and clinical functional data were collected, as well as data according to subjective patient statements about pain and everyday limitations. In 42 cases (76.4 %) the outcome was a sufficient bony consolidation. On average, the time to heal was 10.3 (8, 5; 3-40) months, defect gaps were 4 cm (3 cm; 0,6-26 cm), and on average the patients had had 6 (median 4; range 1-31) previous operations . In all cases patients received osteosynthesis as well as a defect filling with RIA (reamer-irrigator-aspirator), and growth factor BMP-7 (bone morphogenetic protein-7). In 13 cases (23.6 %) there was no therapeutic success. In the evaluation of the SF12 questionnaire the mental health score increased from 47.4 (49.1; 27.6-65.7) to 49.8 (53.0; 28.7-69.4) and the well-being score from 32.7 (32.7;16.9-55.7) to 36.6 (36.5; 24.6-55.9). The two-step bone grafting method in the Masquelet technique used for tibia non-unions according to the diamond concept is a promising treatment option. Its application for tibia shaft non-unions with large bone defects or infections means a high degree of safety for the patient.

  1. Raman Spectra of Nanodiamonds: New Treatment Procedure Directed for Improved Raman Signal Marker Detection

    Directory of Open Access Journals (Sweden)

    Raoul R. Nigmatullin

    2013-01-01

    Full Text Available Detonation nanodiamonds (NDs have shown to be promising agents in several industries, ranging from electronic to biomedical applications. These NDs are characterized by small particle size ranging from 3 to 6 nm, while having a reactive surface and a stable inert core. Nanodiamonds can exhibit novel intrinsic properties such as fluorescence, high refractive index, and unique Raman signal making them very attractive imaging agents. In this work, we used several nanodiamond preparations for Raman spectroscopic studies. We exposed these nanodiamonds to increasing temperature treatments at constant heating rates (425–575°C aiding graphite release. We wanted to correlate changes in the nanodiamond surface and properties with Raman signal which could be used as a detection marker. These observations would hold potential utility in biomedical imaging applications. First, the procedure of optimal linear smoothing was applied successfully to eliminate the high-frequency fluctuations and to extract the smoothed Raman spectra. After that we applied the secondary Fourier transform as the fitting function based on some significant set of frequencies. The remnant noise was described in terms of the beta-distribution function. We expect this data treatment to provide better results in biomolecule tracking using nanodiamond base Raman labeling.

  2. How to optimize excisional procedures for the treatment of CIN? The role of colposcopy.

    Science.gov (United States)

    Grisot, Céline; Mancini, Julien; Giusiano, Sophie; Houvenaeghel, Gilles; Agostini, Aubert; d'Ercole, Claude; Boubli, Léon; Prendiville, Walter; Carcopino, Xavier

    2012-05-01

    To evaluate the value of colposcopy during excisional treatment of cervical intraepithelial neoplasia (CIN). Data from 469 women who underwent excisional treatment for CIN in three different hospitals between January 2005 and December 2009 were reviewed. Margins status and surgical specimen dimensions were analyzed according to the use of colposcopy during procedure. The rate of negative margins was not significantly different between women who had excision performed without colposcopic examination, with colposcopy immediately before excision and with direct colposcopic vision (DCV): 74 (62.2%), 186 (72.9%) and 25 (67.6%), respectively (p = 0.107). DCV allowed for significantly higher probability to achieve both negative margins and depth of specimen of less than 10 mm: 22 (18.5%) versus 70 (27.5%) versus 14 (37.8%), respectively (p = 0.039). In multivariate analysis, compared to women who had excision without any use of colposcopy, DCV allowed for significant and independent reduction in both depth (ß: -2.46; 95%CI: -4.45 to -0.47; p = 0.015) and diameter (ß: -4.80; 95%CI: -7.14 to -2.47; p CIN, allows for smaller surgical specimen without jeopardizing the margins status.

  3. Clinical evaluation of techniques used in the surgical treatment of progressive hemifacial atrophy

    NARCIS (Netherlands)

    R. Roddi (Roberto); E. Riggio (Egidio); P.M. Gilbert (Philip); S.E.R. Hovius (Steven); J. Michiel Vaandrager (J.); J.C.H.M. van der Meulen (Jacques)

    1994-01-01

    textabstractWe critically review 13 patients with progressive hemifacial atrophy treated with three basic surgical procedures (free flap transplantation, alloplastic implants, micro-fat injections ‘lipofilling’) and further ancillary techniques. In spite of the satisfactory results achieved with the

  4. Surgical treatment of varicose vein using the tumescent technique of local anesthesia

    Directory of Open Access Journals (Sweden)

    Bjelanović Zoran

    2011-01-01

    Full Text Available Background/Aim. Tumescent local anesthesia (TLA is a technique for local and regional anesthesia of the skin and the subcutaneous tissue, using infiltration of large amounts of a diluted solution of local anesthetic. This technique is applied in plastic surgery, liposuction as well as in dermatology for the entire series of dermatocosmetic procedures. The purpose of this study was to determine efficiency of surgical treatment of varicose vein using TLA as an alternative method to a conventional treatment for varicose vein. Methods. Seventy-two patients with varicose vein were enrolled in the study. All of them were operated on applying TLA, from April 2008 to November 2009. TLA solution consisted of local anesthetics was used. TLA solutions used were: 1% prilocaine-chloride with adrenaline supplement, and 2% lidocaine-chloride and adrenaline in concentration of 0.1%-0.4%. Results. Out of 72 patients, we stripped great saphenous vein from 60 patient and did varicectomy as well as ligation of insufficiently perforating veins. In 12 patients we did partial varicectomy and ligation of perforating veins. There were not any patients with the need for continued surgery, as well as bringing patient to the general anesthesia due to pain during the surgery. One patient came for postoperative opening wound in the groin, one for infection of the wound and one for the formation of seroma in the groin. There were not any allergic reactions or systemic complications in the operations as well as postoperative period. Postoperatively, all the patients were treated with compressive elastic bandage during the period of 6 weeks as well as anticoagulation prophylaxis in the duration of 5 days. Conclusion. Surgery of varicose veins with implementation of TLA is easy and safe method with very low percentage of complications and unwanted effects. It is a good alternative method to classic surgery of varicose veins. The economic aspect is a very important component

  5. Transobturator tension-free “inside-to-out” suburethral sling procedure for the treatment of stress urinary incontinence

    Directory of Open Access Journals (Sweden)

    Laketić Darko

    2012-01-01

    Full Text Available Introduction. Stress urinary incontinence is an involuntary leakage of urine on a sudden increase of intra-abdominal pressure by physical activity, exercise, coughing, sneezing or laughing. Objective. To assess symptoms, functional and anatomical status of voiding function, complications and short term success of a novel procedure, tension-free vaginal tape obturator technique (TVT-O in the treatment of stress urinary incontinence. Methods. A prospective study was performed on 40 female patients who underwent the TVT-O suburethral sling at the Urology Department of the Health Centre in Prokuplje and Urology Hospital in Niš between May 2009 and February 2010. The mean patients’ age was 58 years (range 34-84 years. Preoperative evaluation included a detailed history and gynaecologic examination including urodynamic testing and voiding studies.UDI-6 and UIQ-7 score testing was performed before, and six months after surgery. All patients who demonstrated stress urinary incontinence with a Q-tip test-angle during maximal straining were included into the study. Postoperatively, outcomes evaluation included voiding function, anatomical parameters, complications, as well as subjective success rates. Results. In 30 patients surgery was performed under spinal and in ten under general anaesthesia. The average intraoperative blood loss during the TVT-O was minimal (<50 ml. There were no vascular, bladder, bowel, and neurological injuries. Thirty-eight patients (95% were discharged voiding satisfactorily. There was a statistically significant difference in symptoms between UDI-6 and UIQ-7 before and after surgery. Conclusion. Initial experience with TVT-O suburethral sling is promising. The TVT-O differs from retropubic procedures by resulting in lower postoperative morbidity, intraoperative and postoperative complications.

  6. A heat treatment procedure to produce fine-grained lamellar microstructures in a P/M titanium aluminide alloy

    Science.gov (United States)

    Au, Peter

    A process for fabricating advanced aerospace titanium aluminide alloys starting from metal powders (the hot isostatically consolidated P/M process) is presented in this thesis. This process does not suffer the difficulties of chemical inhomogeneities and coarse grain structure of castings. In addition heat treatments which take advantage of the refined structure of HIP processed materials are developed to achieve microstructure control and subsequent mechanical property control. It is shown that a better "property balance" is possible after the heat treatment of HIP consolidated materials than it is with alternative processing. It is well understood that the standard microstructures (near-gamma, duplex, nearly lamellar, and fully lamellar) do not have the balanced mechanical properties (tensile, yield, creep and fatigue strength, ductility and fracture toughness) necessary for optimal performance in aero engine and automotive applications. In this work a fine-grained fully lamellar (FGFL) microstructure is developed for property control and in particular for achieving a much improved property balance. A heat treatment procedure for this purpose which consists of cyclic processing in the alpha transus temperature region to achieve an FGFL structure with grain sizes in the range of 50 mum to 150 mum is presented. Compared with conventional duplex structured materials, the minimum creep rate is an order of magnitude lower with only a 10% loss in tensile yield strength. Moreover, a three-fold increase in tensile elongation is possible by converting to an FGFL structure with only a 30% loss in minimum creep rate. These are attractive trade-offs when considering the use of these alloys for aerospace purposes. A thorough literature review of the mechanisms of formation of standard microstructures and their deformation under mechanical loading is contained in the thesis. In addition, conventional techniques to produce FGFL microstructures in wrought and cast materials are

  7. LIFT术在肛瘘治疗中的应用%Clinical Application of LIFT Procedure in Treatment of Anal Fistula

    Institute of Scientific and Technical Information of China (English)

    陈敏; 张涛; 龚旭晨

    2012-01-01

    目的 探讨结扎括约肌间瘘管术(LIFT)对肛瘘的临床疗效.方法 对50例肛瘘管患者行LIFT术,并结合术中所见以及术后随访对LIFT术的疗效进行评价.结果 经LIFT术治疗的肛瘘患者,随访3~6个月,仅3例出现复发,术后未发生肛门失禁.结论 LIFT术操作简便,疗效显著,不损伤括约肌功能,是治疗肛瘘的有效方法.%Objective To investigate the clinical effect of LIFT procedure in treatment of anal fistula. Methods LIFT procedure was done to 50 patients with anal fistula. The finding in operation and follow-up was used to estimate the effect of LIFT procedure. Results Only 3 of the 50 patients have been found recrudescence after follow-up of 3 to 6 months. There were no anal incontinence in all the patients after the operation. Conclusion LIFT procedure as a simplified technique has notable curative effect,which does no harm to the sphincter muscle,thas is an effective treatment for anal fistula.

  8. [External canthopexy using the Edgerton-Montandon procedure in lagophthalmos of leprosy patients. Technique and indications. Apropos of 30 cases].

    Science.gov (United States)

    Grauwin, M Y; Saboye, J; Cartel, J L

    1996-08-01

    This paper deals with the results observed in 21 ancient leprosy patients suffering from lagophthalmos (13 of whom suffered from bilateral lagophthalmos) and treated by the Edgerton-Montandon surgical procedure which associates lateral canthopexy and tarsorraphy. Eighteen of the 21 treated patients were reviewed at one month after the procedure and, overall, results could be evaluated for 30 eyes. Improvement was noted in all of the 30 eyes and, globally, the residual palpebral fissure (during voluntary closing of the eyes by the patient) decreased from 6.7 mm before the procedure to 1.8 after the procedure. The following recommendations may be proposed. For young patients with intact corneal sensation, the Gillies procedure remains the procedure of choice to correct lagophthalmos. For older patients with corneal anesthesia, at high risk of blindness, the Edgerton-Montandon procedure should be recommended.

  9. Office-Based Procedures for the Diagnosis and Treatment of Laryngeal Pathology.

    Science.gov (United States)

    Wellenstein, David J; Schutte, Henrieke W; Takes, Robert P; Honings, Jimmie; Marres, Henri A M; Burns, James A; van den Broek, Guido B

    2017-09-18

    Since the development of distal chip endoscopes with a working channel, diagnostic and therapeutic possibilities in the outpatient clinic in the management of laryngeal pathology have increased. Which of these office-based procedures are currently available, and their clinical indications and possible advantages, remains unclear. Review of literature on office-based procedures in laryngology and head and neck oncology. Flexible endoscopic biopsy (FEB), vocal cord injection, and laser surgery are well-established office-based procedures that can be performed under topical anesthesia. These procedures demonstrate good patient tolerability and multiple advantages. Office-based procedures under topical anesthesia are currently an established method in the management of laryngeal pathology. These procedures offer medical and economic advantages compared with operating room-performed procedures. Furthermore, office-based procedures enhance the speed and timing of the diagnostic and therapeutic process. Copyright © 2017 The Voice Foundation. All rights reserved.

  10. Endovascular procedures in the treatment of obstructive lesions of brachiocephalic arteries

    Directory of Open Access Journals (Sweden)

    Sagić Dragan

    2002-01-01

    Full Text Available Background. To assess the early effects, possible risks, and long term results of percutaneous transluminal angioplasty (PTA of brachiocephalic trunk (BT and subclavian arteries (SA. Methods. During the period of 11 years, in 92 patients (57 males - 62%, mean age 53,5 ± 7,8 years 93 PTA of SA/BT were performed; 70 (75% lesions were stenosis, while 23 (25% lesions were occlusions with mean diameter stenosis percent of 83,1 ± 6,2%. Clinical indications were: vertebrobasilar insufficiency (n=57, upper limb ischemia (n=40, coronary steal syndrome (n=4 and scheduled aorto-coronary bypass, using internal thoracic artery (ITA (n=4 asymptomatic patients. Mean lesion length was 22 ± 8 mm. Results. Eighty one (87% out of 93 lesions were successfully dilated; all of 12 (13% failures were due to unsuccessful recanalisation of occluded arteries. In 10 patients 10 stents were implanted (2 in BT and 8 in left SA. There were 6 (6.5% procedural complications: 1 dissection, 1 thrombosis of the left SA, transient ischemic attack in 2 patients, and 2 cases of dislocation of atheromatous plaque from the right SA into the right common carotid artery. During the follow-up of 48 ± 3 months, 16 (20% restenoses were treated by PTA (n=7 or operatively (n=9. Primary and secondary patency for all lesions treated during 11 years was 87% and 80%, respectively (stenosis: 97% and 89%; occlusions: 58% and 58%. Conclusion. PTA with or without stenting was relatively simple, efficient and safe procedure. It required short hospitalization with low treatment costs. If any of suboptimal results or chronic occlusions were present, the implantation of endovascular stents should have been considered.

  11. Recurrent Anterior Shoulder Instability With Combined Bone Loss: Treatment and Results With the Modified Latarjet Procedure.

    Science.gov (United States)

    Yang, Justin S; Mazzocca, Augustus D; Cote, Mark P; Edgar, Cory M; Arciero, Robert A

    2016-04-01

    Recurrent anterior glenohumeral dislocation in the setting of an engaging Hill-Sachs lesion is high. The Latarjet procedure has been well described for restoring glenohumeral stability in patients with >25% glenoid bone loss. However, the treatment for patients with combined humeral head and mild (Latarjet for patients with combined humeral and glenoid defects and compares the results for patients with ≤25% glenoid bone loss versus patients with >25% glenoid bone loss. The hypothesis was that the 2 groups would have equivalent subjective outcomes and recurrence rates. Cohort Study; Level of evidence, 3. Modified Latarjet was performed in 40 patients with recurrent anterior shoulder instability, engaging Hill-Sachs by examination confirmed with arthroscopy, and ≤25% anterior glenoid bone loss (group A). A second group of 12 patients were identified to have >25% glenoid bone loss with an engaging Hill-Sachs lesion (group B). The mean follow-up time was 3.5 years. All patients were assessed for their risk of recurrence using the Instability Severity Index score and Beighton score and had preoperative 3-dimensional imaging to assess humeral and glenoid bone loss. Single Assessment Numeric Evaluation (SANE), Western Ontario Shoulder Instability Index (WOSI), recurrence rate, radiographs, range of motion, and dynamometer strength were used to assess outcomes. A multivariate analysis was performed. Glenoid bone loss averaged 15% in group A compared with 34% in group B. Both groups had comparable WOSI scores (356 vs 475; P = .311). In multivariate analysis, the number of previous surgeries and Beighton score were directly correlated with WOSI score in Latarjet patients. The SANE score was better in group A (86 vs 77; P = .02). Group B experienced more loss of external rotation (9.2° vs 15.8°; P = .0001) and weaker thumbs-down abduction and external rotation strength (P .999) were similar for both groups. The complication rate was 25% for both groups. The modified

  12. Treatment of Pica Using a Pica Exchange Procedure with Increasing Response Effort

    Science.gov (United States)

    Carter, Stacy L.

    2009-01-01

    The effects of a pica exchange procedure were evaluated on the pica of a female with severe mental retardation. A BAB design revealed that the pica exchange procedure was effective at reducing the occurrence of pica. In addition, the pica exchange procedure was effective throughout six increasingly more difficult response effort conditions.…

  13. Intensity modulated radiation therapy for squamous cell carcinoma of the vulva: Treatment technique and outcomes

    Directory of Open Access Journals (Sweden)

    Yuan James Rao, MD

    2017-04-01

    Conclusions: IMRT for vulvar cancer is associated with high rates of LRC in the postoperative setting and limited radiation-related toxicity. Durable LRC of disease after definitive IMRT remains challenging, and several refinements to our treatment technique are suggested.

  14. Endovascular treatment for hemothorax via contralateral internal thoracic artery branch after Nuss procedure – A case report

    Directory of Open Access Journals (Sweden)

    Daisuke Kanamori

    2017-02-01

    Full Text Available The Nuss procedure is performed widely as a standard surgical treatment for pectus excavatum. Compared to conventional methods, the Nuss procedure excels in cosmetic terms and involves fewer complications. A 14-year-old boy developed right hemothorax with a sudden shock one month after the Nuss procedure. We identified the bleeding from left internal thoracic artery (ITA branch and achieved hemostasis by endovascular coil embolization. To the best of our knowledge, this is the first to report that the ITA on the contralateral side of the hemothorax was responsible for the bleeding.

  15. Surgical treatment of uterine prolapse in women with bladder exstrophy: report of two cases with modified Prolift procedure

    NARCIS (Netherlands)

    Bartelink, L.R.; Feitz, W.F.J.; Kluivers, K.B.; Withagen, M.I.J.; Vierhout, M.E.

    2011-01-01

    The incidence of pelvic organ prolapse is 18% in women with bladder exstrophy. A vaginal technique to correct the prolapse may be preferable in these women with multiple abdominal operations in their histories. We have performed a modified Prolift procedure for the repair of severe uterine prolapse

  16. DETERMINING AND MONITORING OF THE THERAPY PROCEDURES BY APPLICATION OF THE ARTIFICIAL INTELLIGENCE METHODS RELEVANT FOR ACQUIRING OF THE QUALITY EXCELLENCE IN THE PROCESSES OF THE MEDICAL TREATMENT

    Directory of Open Access Journals (Sweden)

    Danijela Tadić

    2009-09-01

    Full Text Available In this paper, short retrospection of the multi criteria mathematical models and fuzzy expert systems from available literature for support of the decision processes in medical treatment is presented. The significance of the application of methods and techniques of artificial intelligence, primarily the theory of fuzzy sets in modeling of clinical uncertainties and ranking of the possible solutions is demonstrated. Special attention is focused to possibility of the application of medical expert systems in the process of determination and monitoring of the optimal therapy procedure for individuals. Summary of the possibilities for application of the medical expert systems in the republic of Serbia is presented.

  17. Combined thoracoscopic and laparoscopic robotic-assisted minimally invasive esophagectomy using a four-arm platform: experience, technique and cautions during early procedure development.

    Science.gov (United States)

    Sarkaria, Inderpal S; Rizk, Nabil P; Finley, David J; Bains, Manjit S; Adusumilli, Prasad S; Huang, James; Rusch, Valerie W

    2013-05-01

    This study reports an early, single-institution experience of combined thoracoscopic and laparoscopic robotic-assisted minimally invasive esophagectomy (RAMIE) using a four-arm robotic platform, with special attention given to the pitfalls and complications during procedure development. We conducted a prospective, single-cohort, observational study of patients undergoing RAMIE at a single institution. A total of 21 patients (median age, 62 years [range, 37-83 years]) underwent RAMIE with a four-arm robotic platform (17 by Ivor Lewis and 4 by McKeown). Of the patients, 17 (81%) had a complete (R0) resection, and 16 (76%) received induction treatment, the majority (14/21 [67%]) with combined chemoradiation. The median operative time was 556 min (range, 395-807 min), which decreased to 414 min (range, 405-543 min) for the last 5 cases in the series. The median estimated blood loss was 307 cm(3) (range, 200-500 cm(3)), and the median length of hospital stay was 10 days (range, 7-70 days). The median number of lymph nodes resected was 20 (range, 10-49). Five (24%) patients were converted to open procedures. Five patients (24%) had major complications. One (5%) died of complications on postoperative Day 70, and 3 (14%) had clinically significant anastomotic leaks (Grade II or greater, by Common Terminology Criteria for Adverse Events version 3.0). Three patients (14%) in this early experience developed airway fistulas. While four-arm RAMIE may offer advantages over standard minimally invasive esophagectomy approaches, its adoption in a structured program, with critical evaluation of adverse events and subsequent adjustment of technique, is paramount to maximize patient safety, minimize complications and improve the conduct of operation early in the learning curve. Particular technical consideration should be given to prevention of airway complications.

  18. Office-based procedures for diagnosis and treatment of esophageal pathology.

    Science.gov (United States)

    Wellenstein, David J; Schutte, Henrieke W; Marres, Henri A M; Honings, Jimmie; Belafsky, Peter C; Postma, Gregory N; Takes, Robert P; van den Broek, Guido B

    2017-09-01

    Diagnostic and therapeutic office-based procedures under topical anesthesia are emerging in the daily practice of laryngologists and head and neck surgeons. Since the introduction of the transnasal esophagoscope, office-based procedures for the esophagus are increasingly performed. We conducted a systematic review of literature on office-based procedures under topical anesthesia for the esophagus. Transnasal esophagoscopy is an extensively investigated office-based procedure. This procedure shows better patient tolerability and equivalent accuracy compared to conventional transoral esophagoscopy, as well as time and cost savings. Secondary tracheoesophageal puncture, esophageal dilatation, esophageal sphincter injection, and foreign body removal are less investigated, but show promising results. With the introduction of the transnasal esophagoscope, an increasing number of diagnostic and therapeutic office-based procedures for the esophagus are possible, with multiple advantages. Further investigation must prove the clinical feasibility and effectiveness of the therapeutic office-based procedures. © 2017 Wiley Periodicals, Inc.

  19. Historic overview of treatment techniques for rib fractures and flail chest

    NARCIS (Netherlands)

    Bemelman, M.; Poeze, M.; Blokhuis, T. J.; LEENEN, LPH

    2010-01-01

    Introduction From the beginning of the twentieth century till the current time, an overview is presented of the surgical treatment for rib fractures and flail chest. Methods Many techniques have been used to stabilize the thorax wall. There has been no follow-up for the most described techniques and

  20. New technical procedure involving Achilles tendon rupture treatment through transcutaneous suture.

    Science.gov (United States)

    TarniŢă, DănuŢ Nicolae; TarniŢă, Daniela; Grecu, Dan Cristian; Calafeteanu, Dan Marian; Căpitănescu, Bogdan

    2016-01-01

    The Achilles tendon is the widest tendon of the human body. Achilles tendon belongs to the extrasynovial tendons group and this allows it a faster recovery, thanks to local hematoma from the peritenon, necessary for the scarification. We concluded that in Achilles tendon rupture treatment it is essential to maintain the tendon covering skin integrity, the peritendinous integrity, to maintain the local hematoma formed during and after tendon rupture, reattaching the ruptured tendon heads and maintain them in this position by suturing them and by relaxing the sural triceps muscle. The percutaneous suture requires five pairs of mirror micro-incisions (5 mm) on one side and the other of the tendon. It is necessary for one of the pairs to be placed to the rupture level. With a surgical needle, we arm the proximal and distal heads of the tendon by different threads. By traction and muscular relaxation, we bring in contact the two ruptured heads and then we knot together the arming threads. The inferior member was cast immobilized in relaxing position for the sural triceps muscle for a 45 days period. Using this technique, we have operated 15 cases in our Clinic. In all the cases, we obtained a healing by first intention of the tegument micro-incisions. After the cast immobilization suppression, during 30 days the patients were in a recovery program. At the end of this program, they have recovered completely the dorsal and plantar flexion and the walking. In four months after the surgery, the esthetic of the area is completely restored, this technique being the only surgical technique that realizes this recovery.

  1. Ultrasound in the diagnosis and treatment of developmental dysplasia of the hip. Evaluation of a selective screening procedure

    DEFF Research Database (Denmark)

    Strandberg, C.; Konradsen, L.A.; Ellitsgaard, N.

    2008-01-01

    INTRODUCTION: With the intention of reducing the treatment frequency of Developmental Dysplasia of the Hip (DDH), two hospitals in Copenhagen implemented a screening and treatment procedure based on selective referral to ultrasonography of the hip (US). This paper describes and evaluates...... 0.03%. No relationship was seen between morphological parameters at the first US and the outcome of hips classified as minor dysplastic or not fully developed (NFD). A statistically significant relationship was seen between the degree of dysplasia and the time until US normalization of the hips (p......= 0.02). There was no relapse of dysplasia after treatment. The median duration of treatment was six, eight and nine weeks for mild, moderate and severe dysplasia respectively. CONCLUSION: The procedure resulted in a low rate of treatment and a small number of late diagnosed cases. Prediction...

  2. The feasibility of using Pareto fronts for comparison of treatment planning systems and delivery techniques

    DEFF Research Database (Denmark)

    Ottosson, Rickard O; Engstrom, Per E; Sjöström, David

    2008-01-01

    of a treatment planning system (TPS), treatment strategy or delivery technique, Pareto fronts for a given case are likely to differ. The aim of this study was to investigate the feasibility of using Pareto fronts as a comparative tool for TPSs, treatment strategies and delivery techniques. In order to sample...... Pareto fronts, multiple treatment plans with varying target conformity and dose sparing of OAR were created for a number of prostate and head & neck IMRT cases. The DVHs of each plan were evaluated with respect to target coverage and dose to relevant OAR. Pareto fronts were successfully created for all...... may be used to evaluate a number of parameters within radiotherapy. Examples are TPS optimization algorithms, the variation between accelerators or delivery techniques and the degradation of a plan during the treatment planning process. The issue of designing a model for unbiased comparison...

  3. Review of deep inspiration breath-hold techniques for the treatment of breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Latty, Drew, E-mail: drew.latty@health.nsw.gov.au [Crown Princess Mary Cancer Centre, Westmead Hospital, Sydney, New South Wales (Australia); Stuart, Kirsty E [Crown Princess Mary Cancer Centre, Westmead Hospital, Sydney, New South Wales (Australia); Westmead Breast Cancer Institute, Sydney, New South Wales (Australia); Wang, Wei [Crown Princess Mary Cancer Centre, Westmead Hospital, Sydney, New South Wales (Australia); Westmead Breast Cancer Institute, Sydney, New South Wales (Australia); Nepean Cancer Care Centre, Sydney, New South Wales (Australia); Ahern, Verity [Crown Princess Mary Cancer Centre, Westmead Hospital, Sydney, New South Wales (Australia)

    2015-03-15

    Radiation treatment to the left breast is associated with increased cardiac morbidity and mortality. The deep inspiration breath-hold technique (DIBH) can decrease radiation dose delivered to the heart and this may facilitate the treatment of the internal mammary chain nodes. The aim of this review is to critically analyse the literature available in relation to breath-hold methods, implementation, utilisation, patient compliance, planning methods and treatment verification of the DIBH technique. Despite variation in the literature regarding the DIBH delivery method, patient coaching, visual feedback mechanisms and treatment verification, all methods of DIBH delivery reduce radiation dose to the heart. Further research is required to determine optimum protocols for patient training and treatment verification to ensure the technique is delivered successfully.

  4. SU-E-J-162: Quality Assurance Procedures for MR Guided Focused Ultrasound Treatment of Bone Metastasis

    Energy Technology Data Exchange (ETDEWEB)

    Chen, L; Chen, X; Wang, B; Gupta, R; Ma, C [Fox Chase Cancer Center, Philadelphia, PA (United States)

    2014-06-01

    Purpose: The purpose of this work is to develop and verify our quality assurance (QA) procedures to ensure the safety and efficacy of MR-guided focused ultrasound (MRgFUS) treatment of bone metastases. Methods: A practical QA program was developed. Monthly and daily QA (DQA) procedures were performed. The major QA items included the checks of the machine hardware, software and patient safety features. Briefly, these checks/tests include: 1) the cooling system reservoir and treatment table; 2) power to the treatment table; 3) the MR coil; 4) the transducer position with MRI; 5) image display on the treatment work station; 6) the effective focal spot in 3 directions using MR thermometry; and 7) all the safety devices including a sonication lamp, and the emergency stop-sonication switches. In order to avoid patient skin burn, it is important to remove gas bubbles in the interfaces between the treatment table and the gel pad, and the gel pad and patients skin during the patient setup. Our QA procedures have been verified and evaluated through patient treatments. Seven patients with scapula, humeral head, sacrum, ilium, pubic ramus and acetabular bone metastases were treated using MRgFUS. Results: Our study showed that all seven patients tolerated the MRgFUS treatment well. No skin toxicity or other complications were observed. The pain score (0–10) using the visual analog scale (VAS) was significantly reduced from 8.0 ± 1.1 before treatment to 4.7 ± 3.0, 3.0 ± 1.5, 3.2 ± 2.8 and 3.4 ± 1.5 at one day, one month, two months and three months after the MRgFUS treatment, respectively. Conclusion: We demonstrated that with the appropriate QA procedures, MRgFUS is a safe, effective and noninvasive treatment modality for palliation of bone metastases.

  5. Results of a bone splint technique for the treatment of lower limb deformities in children with type I osteogenesis imperfecta

    Directory of Open Access Journals (Sweden)

    Dasheng Lin

    2013-01-01

    Full Text Available Background: Children with osteogenesis imperfecta (OI can suffer from frequent fractures and limb deformities, resulting in impaired ambulation. Osteopenia and thin cortices complicate orthopedic treatment in this group. This study evaluates the clinical results of a bone splint technique for the treatment of lower limb deformities in children with type I OI. The technique consists of internal plating combined with cortical strut allograft fixation. Materials and Methods: We prospectively followed nine children (five boys, four girls with lower limb deformities due to type I OI, who had been treated with the bone splint technique (11 femurs, four tibias between 2003 and 2006. The fracture healing time, deformity improvement, ambulation ability and complications were recorded to evaluate treatment effects. Results: At the time of surgery the average age in our study was 7.7 years (range 5-12 years. The average length of followup was 69 months (range 60-84 months. All patients had good fracture healing with an average healing time of 14 weeks (range 12-16 weeks and none experienced further fractures, deformity, or nonunion. The fixation remained stable throughout the procedure in all cases, with no evidence of loosening or breakage of screws and the deformity and mobility significantly improved after surgery. Of the two children confined to bed before surgery, one was able to walk on crutches and the other needed a wheelchair. The other seven patients could walk without walking aids or support like crutches. Conclusions: These findings suggest that the bone splint technique provides good mechanical support and increases the bone mass. It is an effective treatment for children with OI and lower limb deformities.

  6. Treatment of atrophic femoral non-unions according to the diamond concept: Results of one- and two-step surgical procedure.

    Science.gov (United States)

    Moghaddam, Arash; Thaler, Benjamin; Bruckner, Thomas; Tanner, Michael; Schmidmaier, Gerhard

    2017-03-01

    The treatment of non-unions in long bones poses a great challenge, particularly in cases of infection or large osseous defects. This article evaluates the use of the diamond concept in the treatment of femoral non-unions in a one-step or two-step procedure according to the Masquelet technique. Between February 2010 and March 2014, 88 patients with atrophic femoral non-unions were included in our study. The treatment was performed in one step (Group G1) on 41 patients and in two-step Masquelet technique (Group G2) on 47 patients, according to the diamond concept. In 72 cases it was decided to apply the growth factor BMP-7. The mean age of patients was 49.9 ± 15.3. The data were analysed after following up all patients for at least 12 months after surgery. 74% of patients achieved consolidation in an average of 9.3 months. Positive bacterial cultures were found in 16 cases (18%). The consolidation rate in G2 was dependent on the non-union localisation and the osteosynthesis method applied. 83% of patients treated by intramedullary reaming achieved consolidation, while this was the case for only 60% of patients with osteosynthesis plates. Smokers in G2 had a larger average osseous defect and a lower consolidation rate. The quality of life as assessed with the SF-12 questionnaire had improved in both groups, with no significant differences between G1 and G2 one year after surgery. One-step therapy is a suitable method of treatment for aseptic femoral non-unions with small osseous defects, using BMP-7 and RIA in the case of primarily failed atrophic non-union treatment. The Masquelet technique is an efficient means of eradicating infections in non-unions. In combination with intramedullary nailing, this technique is the method of choice for the treatment of femoral shaft non-unions with large defects.

  7. Waste treatment in NUCEF facility with silver mediated electrochemical oxidation technique

    Energy Technology Data Exchange (ETDEWEB)

    Umeda, M.; Sugikawa, S. [Tokai Establishment, Japan Atomic Energy Research Institute, Tokai-Mura, Naka-Gun, Ibaraki-Ken (Japan)

    2000-07-01

    Silver mediated electrochemical oxidation technique has been considered one of promising candidates for alpha-bearing waste treatment. Destruction tests of organic compounds, such as insoluble tannin, TBP and dodecane, were carried out by this technique and the experimental data such as destruction rates, current efficiencies and intermediates were obtained. These compounds could be completely mineralized without the formation of reactive organic nitrate associated to safety hazards. On the basis of these results, the applicability of silver mediated electrochemical oxidation technique to waste treatment in NUCEF was evaluated. (authors)

  8. Laparoscopic treatment of colovesical fistulas: technique and review of the literature.

    Science.gov (United States)

    Tsivian, Alexander; Kyzer, Shlomo; Shtricker, Avraham; Benjamin, Shalva; Sidi, Abraham Ami

    2006-05-01

    Colovesical fistula is an uncommon complication of diverticulitis. We present our technique of a laparoscopic approach for treatment of vesicosigmoid fistulas and review the available published literature. We believe that a laparoscopic approach is a feasible and advantageous alternative for the treatment of colovesical fistulas, with low morbidity and short hospital stay.

  9. Curative effects of two new endometrial ablation procedures using radiofrequency thermocoagulation for the treatment of severe abnormal uterine bleeding.

    Science.gov (United States)

    Yin, Geping; Li, Juan; Zhu, Tongyu; Chen, Ming

    2013-07-01

    Severe Abnormal Uterine Bleeding (SAUB) is a common gynecological disorder. The clinical characteristics include disordered menstrual cycle and massive bleeding that can cause anemia or secondary infection. Current treatment mainly relies on drug therapy or surgical removal of the uterus, each having its significant disadvantages. How to preserve the uterus, reduce the pain from surgery, and achieve better treatment effects have been well known but remaining as unresolved issues. This study aims at evaluating two types of radiofrequency (RF) thermocoagulation procedures for the treatment of SAUB: the RF-A procedure group included 25 SAUB patients ≥45 years of age treated for amenorrhea; the RF-B procedure group included 51 patients at bleeding. Post-treatment ratings of menstrual satisfaction and pre-/post-treatment menstrual scores-pictorial blood loss assessment chart (PBAC)-and hemoglobin levels were collected; and the mean length of follow-up was 72 months. Also, 38 SAUB patients treated with standard drug regimens served as a control group. The results of the study showed that following RF treatment, the average long-term patient menstrual satisfaction was greater than 92 %. In both the RF groups, PBAC scores and hemoglobin levels were significantly improved from baseline (p < .05). Compared with the control group, PBAC scores and hemoglobin levels were also significantly better for the RF groups at 6-24-month post-operation. Patients experienced no hysterectomy in association with the RF procedures. In conclusion, this pilot study suggests that the novel RF procedures are both safe and effective in treating patients with SAUB. Further investigation is necessary to evaluate their application in broader clinical indication.

  10. A clinical study to assess the effectiveness of a hyaluronic acid-based procedure for treatment of premature ejaculation

    OpenAIRE

    Littara, A; Palmieri, B.; Rottigni, V.; Iannitti, T

    2013-01-01

    Premature ejaculation is a sexual debilitating condition affecting a large number of men worldwide and leading to important dysfunctions influencing the patients' affective and emotional life. Hyaluronic acid is a natural and safe compound that has been widely used not only in the aesthetic medicine clinic, but also for treatment of osteoarthritis. The present study shows the effectiveness of a hyaluronic acid-based procedure for treatment of premature ejaculation. A hundred and ten male pati...

  11. Acute biliary pancreatitis and cholecystolithiasis in a child:one time treatment with laparoendoscopic "Rendez-vous" procedure

    Institute of Scientific and Technical Information of China (English)

    Gaetano La Greca; Michele Di Blasi; Francesco Barbagallo; Manuela Di Stefano; Saverio Latteri; Domenico Russello

    2006-01-01

    Acute biliary pancreatitis (ABP) is rare in childhood and endoscopic sphincterotomy should be avoided in the child due to the risk of both early and late complications but, when necessary, the optimal timing between endoscopic procedure and cholecystectomy is still uncertain.A nine years old child with acute biliary pancreatitis underwent successfull laparo-endoscopic "Rendez-Vous" procedure in which endoscopic drainage of the common bile duct and laparoscopic cholecystectomy were performed simultaneously. This is the first case reported of laparo-endoscopic Rendez-Vous in a child. The excellent outcome of this patient and the review of the literature concerning other available options for the treatment of such cases suggest that this procedure offers great advantages, especially in children, of reducing the required number of treatments, the risk of ineffectiveness, the number of anaesthesia, the length of hospital stay and the risk of iatrogenic morbidity.

  12. The Maxillary Sinus Membrane Elevation Procedure: Augmentation of Bone around Dental Implants without Grafts—A Review of a Surgical Technique

    Directory of Open Access Journals (Sweden)

    Christopher Riben

    2012-01-01

    Full Text Available Background. Long-term edentulism may in many cases result in resorption of the alveolar process. The sinus lift procedure aims to create increased bone volume in the maxillary sinus in order to enable installation of dental implants in the region. The method is over 30 years old, and initially autogenous bone grafts were used and later also different bone substitutes. Since 1997, a limited number of studies have explored the possibility of a graftless procedure where the void under the sinus membrane is filled with a blood clot that enables bone formation. Aim. To describe the evolution of the sinus-lift technique and to review the literature related to the technique with a focus on long-term studies related to the graft-less technique. Methods. The electronic database PubMed was searched, and a systematic review was conducted regarding relevant articles. Results. A relatively few long-term studies using the described technique were found. However, the technique was described as reliable considering the outcome of the existing studies. Conclusion. All investigated studies show high implant survival rates for the graftless technique. The technique is considered to be cost-effective, less time-consuming, and related to lower morbidity since no bone harvesting is needed.

  13. 40 CFR Appendix E to Part 63 - Monitoring Procedure for Nonthoroughly Mixed Open Biological Treatment Systems at Kraft Pulp...

    Science.gov (United States)

    2010-07-01

    ... constant, L/g mixed liquor volatile suspended solids (MLVSS)-hr KL=Liquid-phase mass transfer coefficient, m/s Ks=Monod biorate constant at half the maximum rate, g/m3 III. Test Procedure for Determination... of the open biological treatment unit. An appropriate value of the biorate constant, Ks,...

  14. A Guide for Developing Standard Operating Job Procedures for the Tertiary Multimedia Filtration Process Wastewater Treatment Facility. SOJP No. 7.

    Science.gov (United States)

    Petrasek, Al, Jr.

    This guide describes the standard operating job procedures for the tertiary multimedia filtration process of wastewater treatment plants. The major objective of the filtration process is the removal of suspended solids from the reclaimed wastewater. The guide gives step-by-step instructions for pre-start up, start-up, continuous operation, and…

  15. Elastic suture (shoelace technique) for fasciotomy closure after treatment of compartmental syndrome associated to tibial fracture.

    Science.gov (United States)

    Branco, Paulo Sergio Martins Castelo; Cardoso Junior, Mauricio; Rotbande, Isaac; Ciraudo, José Antonio Fraga; Silva, Celso Ricardo Correa de Melo; Leal, Paulo Cesar Dos Santos

    2017-01-01

    This article reports the use of elastic suture as an adjuvant in surgical wound closure caused by decompressive fasciotomy after compartment syndrome associated with a compound fracture of the tibia. Widely used in other medico-surgical specialties, this technique is unusual in orthopedics surgery, but the simplicity of the procedure and the successful outcome observed in this case allows for its consideration as indicated for situations similar to that presented in this study.

  16. Treatment of gingival hyperpigmentation with rotary abrasive, scalpel, and laser techniques: A case series

    OpenAIRE

    Murthy, M Bhanu; Kaur, Jasjit; Das, Rupali

    2012-01-01

    Melanin pigmentation often occurs in the gingiva as a result of an abnormal deposition of melanin, due to which the gums may appear black, but the principles, techniques, and management of the problems associated with gingival melanin pigmentation are still not fully established. Depigmentation procedures such as scalpel surgery, gingivectomy with free gingival autografting, electrosurgery, cryosurgery, chemical agents such as 90% phenol and 95% alcohol, abrasion with diamond bur, Nd: YAG las...

  17. Endovascular techniques for the treatment of ruptured abdominal aortic aneurysms: 7-year intention-to-treat results.

    Science.gov (United States)

    Dalainas, Ilias; Nano, Giovanni; Bianchi, Paolo; Stegher, Silvia; Casana, Renato; Malacrida, Giovanni; Tealdi, Domenico G

    2006-10-01

    The purpose of this single-institution study was to describe our 7-year intention-to-treat results, obtained with the use of endovascular techniques for the treatment of ruptured abdominal aortic aneurysms (rAAA). From October 1998 until March 2005, a total of 28 patients were admitted or transferred to our department with an rAAA. They were all treated according to a management protocol of intention-to-treat with endovascular techniques. Twenty of the patients received endovascular treatment and the remaining 8 underwent an open surgery procedure. The mortality rate of the endovascularly treated patients was 40% (8 in 20), whereas of the 8 surgical patients 3 survived (mortality = 62.5%). The overall mortality rate of the 28 patients admitted with an rAAA was 46.4% (13 of 28 patients). In our experience the intension-to-treat protocol for rAAA offered acceptable results in terms of mortality rates. Multi-center studies are necessary to establish the role of endovascular treatment in patients with rAAA.

  18. Calcium sulfate combined with guided tissue regeneration: A novel technique in treatment of gingival recessions

    Directory of Open Access Journals (Sweden)

    Arnav Mukherji

    2016-01-01

    Full Text Available The presence of mucogingival problem around anterior teeth is a challenge to the clinician as not only biological and functional aspects has to be addressed but esthetic aspirations of the patient have to be met. The use of guided tissue regeneration (GTR procedures for the treatment of gingival recession has shown encouraging results and is gaining clinical acceptance. However, maintenance of space under the membrane remains a problem for clinicians. Hence, this case study was an innovative attempt to evaluate the effect of adjunctive calcium sulfate placement along with collagen membrane GTR-based root coverage procedure.

  19. Calcium sulfate combined with guided tissue regeneration: A novel technique in treatment of gingival recessions.

    Science.gov (United States)

    Mukherji, Arnav

    2016-01-01

    The presence of mucogingival problem around anterior teeth is a challenge to the clinician as not only biological and functional aspects has to be addressed but esthetic aspirations of the patient have to be met. The use of guided tissue regeneration (GTR) procedures for the treatment of gingival recession has shown encouraging results and is gaining clinical acceptance. However, maintenance of space under the membrane remains a problem for clinicians. Hence, this case study was an innovative attempt to evaluate the effect of adjunctive calcium sulfate placement along with collagen membrane GTR-based root coverage procedure.

  20. Treatment of urinary stress incontinence: laparoscopic Burch colposuspension versus transobturator tape procedure

    Directory of Open Access Journals (Sweden)

    Samiee H

    2009-12-01

    Full Text Available "n Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Arial; mso-bidi-theme-font:minor-bidi;} Background: Stress incontinence is the most common type of urinary incontinence which has been treated by different surgical techniques. The objectives of our study were to compare the laparoscopic Burch colposuspension with Trans- obturator Tape (TOT procedure."n"nMethods: This randomized clinical trial was conducted on 40 patients with stress incontinence referred to Arash hospital from 2007 to 2009. All patients were randomly divided in two groups (laparoscopic Burch and TOT. Patient information was using obtained demographic, I-QOL (Which contained 22 questions, UDI-6 (urinary symptoms, ISI (Severity of urinary incontinence questionnaires and urodynamic test."n"nResults: The data collected from 19 patients in TOT group and 16 patients in laparoscopic Burch groups. The objective cure rate which was determined by no urinary leakage during stress and were analyzed urodynamic evaluation was 75% in laparoscopic and 84.2% in TOT (p=0.53. Result of ISI questionnaire with showing the subjective cure rate following surgery had no significant difference between two groups (p=0.23. UDI-6 questionnaire was used to compare the result of both groups before and after surgery and showed that the improvement in Urgency was

  1. The technique of «Subliminal verbal suggestion for the treatment of [pseudo]obsessions»

    Directory of Open Access Journals (Sweden)

    N. V. Danilevska

    2016-03-01

    Full Text Available [Pseudo]obsessions therapy in patients with endogenous diseases of schizophrenic round accompanied with difficulties, caused by both psycho etio pathogenetic features of the disease. Disadvantages of the existing methods of therapy are associated with therapeutic conflict between two nosologies. Aim: to develop and test etiopsychopathogenetic technique "Subliminal verbal suggestion for the treatment of [pseudo]obsessions" as a subsidiary method of treatment of schizophrenia patients with [pseudo] obsessions in the structure of the disease. Methods and results. 137 patients who underwent hospital treatment 65 schizophrenia patients (F20 with the [pseudo]obsessive symptoms in the structure of the disease were examined on the basis of Public Health Institution «Regional clinical mental hospital» of the Zaporizhzhian regional council. 30 patients received standard pharmacotherapy (antipsychotic drugs according to clinical protocols that was combined with proposed technique "Subliminal verbal suggestion for the treatment of [pseudo]obsessions". The comparison group consisted of 35 patients treated with the use of standard pharmacotherapy: antipsychotic drugs. The next methods were used: medical history assessment, follow-up, clinical-psychopathological, psychodiagnostic. "Subliminal verbal suggestion for the treatment of [pseudo]obsessions" technique was developed. This technique is a combination of suggestion in the waking state and neurolinguistic programming, implemented with specially compiled auditory complex listening. The main therapeutic component s realized through the subthreshold perception of the verbal formulas that are unavailable to awareness. The technique consists of two components – primary and secondary, and three stages. The methodology was tested, its therapeutic efficacy was confirmed. Conclusion. "Subliminal verbal suggestion for the treatment of [pseudo]obsessions" technique was developed as a subsidiary method of the

  2. Piriformis syndrome: implications of anatomical variations, diagnostic techniques, and treatment options.

    Science.gov (United States)

    Cassidy, Lindsey; Walters, Andrew; Bubb, Kathleen; Shoja, Mohammadali M; Tubbs, R Shane; Loukas, Marios

    2012-08-01

    Details of piriformis syndrome, including the proper diagnosis and most effective form of treatment, continue to be controversial. While the cause, diagnosis, and treatment of piriformis syndrome remain elusive, many studies have been conducted to investigate newly developed diagnostic techniques as well as various treatment options for piriformis-induced sciatica. Despite the quantity of literature, few studies have demonstrated statistically significant results that support one form of treatment over another. Thus, despite the evidence supporting the newer treatment methodologies for piriformis syndrome, research should continue. It is important not only to evaluate treatment outcomes based on associated pain relief, but also to investigate the functional and anatomical return that patients experience from these studied treatments in order to fully explore the most effective form of therapy for piriformis syndrome.

  3. Usefulness of lower extremity MR venography in 2D TOF sequence with fat suppression techniques and MTC, and study of different warming procedures

    Energy Technology Data Exchange (ETDEWEB)

    Higashida, Mitsuji; Yamazaki, Masaru; Sahara, Tomohiro; Motozuka, Masayasu [Osaka City Univ. (Japan). Hospital

    2001-03-01

    We evaluated the effect of fat suppression techniques (fatsat) and magnetization transfer contrast (MTC) for MR venography (MRV) using the 2D TOF sequence in the lower extremities. In addition, the improvement of vessel conspicuity resulting from three different warming procedures was evaluated. Three combinations of fatsat and MTC were performed. Both the signal intensity ratio (SIR) and contrast-to-noise ratio (CNR) were measured at ROIs of vein, fat, and muscle in knee. The vessel conspicuity of MIP was evaluated by three radiologists. The experimental results indicated that MTC pulses did not affect fatsat. The combination techniques of fatsat and MTC improved SIR ({approx_equal}13%) and CNR ((applox =)5%) of the vein compared with techniques using fatsat only. The continuous warming procedure was better than temporary warming in terms of vessel conspicuity. We conclude that the combined techniques of fatsat and MTC with the continuous warming procedure were clearly useful for MRV using the 2D TOF sequence in the lower extremities. (author)

  4. Comparison of wedge resection (Winograd procedure) and wedge resection plus complete nail plate avulsion in the treatment of ingrown toenails.

    Science.gov (United States)

    Huang, Jia-Zhang; Zhang, Yi-Jun; Ma, Xin; Wang, Xu; Zhang, Chao; Chen, Li

    2015-01-01

    The present retrospective study compared the efficacy of wedge resection (Winograd procedure) and wedge resection plus complete nail plate avulsion for the treatment of ingrown toenails (onychocryptosis). Two surgical methods were performed in 95 patients with a stage 2 or 3 ingrown toenail. Each patient was examined weekly until healing and then at 1, 6, and 12 months of follow-up. The outcomes measured were surgical duration, healing time, recurrence rate, the incidence of postoperative infection, and cosmetic appearance after surgery. Of the 95 patients (115 ingrown toenails) included in the present study, 39 (41.1%) underwent wedge resection (Winograd procedure) and 56 (59%), wedge resection plus complete nail plate avulsion. The mean surgical duration for wedge resection (Winograd procedure) and wedge resection plus complete nail plate avulsion was 14.9 ± 2.4 minutes and 15.1 ± 3.2 minutes, respectively (p = .73). The corresponding healing times were 2.8 ± 1.2 weeks and 2.7 ± 1.3 weeks (p = .70). Recurrence developed in 3 (3.2%) patients after wedge resection (Winograd procedure) and in 4 (4.2%) after wedge resection plus complete nail plate avulsion. In addition, postoperative infection occurred in 3 (3.2%) patients after wedge resection (Winograd procedure) and 2 (2.1%) after wedge resection plus complete nail plate avulsion. Both of the surgical procedures were practical and appropriate for the treatment of ingrown toenails, being simple and associated with low morbidity and a high success rate. However, cosmetically, wedge resection (Winograd procedure) would be the better choice because the nail plate remains intact.

  5. CONSIDERATIONS FOR THE TREATMENT OF COMPUTERIZED PROCEDURES IN HUMAN RELIABILITY ANALYSIS

    Energy Technology Data Exchange (ETDEWEB)

    Ronald L. Boring; David I. Gertman

    2012-07-01

    Computerized procedures (CPs) are an emerging technology within nuclear power plant control rooms. While CPs have been implemented internationally in advanced control rooms, to date no US nuclear power plant has implemented CPs in its main control room. Yet, CPs are a reality of new plant builds and are an area of considerable interest to existing plants, which see advantages in terms of easier records management by omitting the need for updating hardcopy procedures. The overall intent of this paper is to provide a characterization of human reliability analysis (HRA) issues for computerized procedures. It is beyond the scope of this document to propose a new HRA approach or to recommend specific methods or refinements to those methods. Rather, this paper serves as a review of current HRA as it may be used for the analysis and review of computerized procedures.

  6. The "Lantern" Procedure to Simplify Treatment of Retrograde Type A Dissection After Thoracic Endograft Stenting.

    Science.gov (United States)

    Tsai, Chung-Lin

    2016-04-01

    The emergency repair of retrograde type A aortic dissection after thoracic endovascular aortic repair is a complex and challenging surgical procedure and carries a surgical challenge. Previous studies have reported a significant mortality in the complex repair of retrograde type A aortic dissection after thoracic endovascular aortic repair. We devised a simplified hybrid method-the "Lantern" procedure-to solve this retrograde type A aortic dissection complication.

  7. Center-blocked field technique for treatment of extensive chest wall disease

    Energy Technology Data Exchange (ETDEWEB)

    Podgorsak, E.B.; Pla, M.; Kim, T.H.; Freeman, C.R.

    1981-10-01

    Our treatment technique for patients with extensive chest wall disese is presented. A rotational center-blocked radiation field is used to cover the large tumor volume to a dose with +/- 10% while sparing the lungs and the spinal cord. The center block is tapered to match both the patient's mediastinal slope in the sagittal plane and the outline of the lungs in the coronal plane. Ten patients treated with this technique to a tumor dose of 50 Gy tolerated the treatment well, despite a high integral dose. The local responses were excellent, particularly in view of the initial extent of the disease.

  8. A comparative study on EDTA and coronaliy advanced flap technique in the treatment of human gingival recessions

    Directory of Open Access Journals (Sweden)

    Khoshkhoo Nejad AA

    2003-08-01

    Full Text Available Statement of Problem: Treatment of gingival recession defect and covering denuded root surfaces is one of the goals in periodontal therapy and several surgical techniques have been suggested in this field."nPurpose: The aim of this study was to perform a comparison on coronaliy repositioned flap procedure with and without the use of ethylenediaminoteraacetic acid (EDTA. 24%, pH=7 in the treatment of"nrecession defects."nMaterial and Methods: In this randomized clinical trial study, 16 patients, aged 17-60 years, with a total of 27 miller class 1 isolated buccal gingival recession type defects of at least 2mm depth, and based"non special criteria were investigated. After initial therapy, surgical recession coverage was performed as coronaliy advanced flap technique and EDTA gel conditioning (test or coronaliy advanced flap alone"n(control. Clinical examination including assessments of oral hygiene, recession depth (RD, recession width (RW, width of keratinized tissue (KT, probing depth (PD and probing attachment level (PAL"nwere performed before and 1, 2, 3 months after surgical treatment."nResults: The mean of initial RD, RW, KT, PT and PAL in the test group was 2.73, 3.17, 3.13, 1.1 and 3.83mm respectively and in the control group was 2.56, 3.03, 3.67, 1.25, 3.92mm respectively. The mean of these parameters 3 months after treatment in the test group were changed to 0.46, 1.97, 2.65, 0.67, 1.1 mm, corresponding figures for control teeth were 0.85, 2.98, 2.75, 1, 1.94, respectively. At 3 months after treatment the mean root coverage amounted to 83% (test and 67% (control which was a statistically significant difference (P=0.0067. Although a significant clinical difference was observed regarinding root coverage level, all other clinical variables were not statistically different, with the exception of probing attachment level (P=0.005."nConclusion: It was suggested that EDTA gel (24%, PLT=7 for 3 minutes as root conditioner and the coronaliy

  9. [Application progress of minimally invasive technique in treatment of calcaneus fractures].

    Science.gov (United States)

    Yu, Tao; Yang, Yunfeng; Yu, Guangrong

    2013-02-01

    To review the application progress of minimally invasive technique in the treatment of calcaneus fractures and to analyze the advantages and disadvantages of each method as well as to predict the trend of development in the field. Domestic and abroad literature concerning the minimally invasive technique applied in calcaneus fractures in recent years was reviewed extensively and analyzed thoroughly. There are both advantages and limitations of each minimally invasive technique including percutaneous reduction and fixation, limited incision, external fixator, arthroscopic assisted reduction, and balloon expansion reduction. But every technique is developing rapidly and becoming more and more effective. A variety of minimally invasive technique can not only be used independently but also can be applied jointly to complement one another. It needs further study how to improve the effectiveness and expand the indications. And the theoretical basis of evidence-based medicine needs to be provided more.

  10. CLINICAL OBSERVATION ON THE TREATMENT OF KNEE OSTEOARTHRITIS BY ACUPUNCTURE IN BA-HE TECHNIQUE

    Institute of Scientific and Technical Information of China (English)

    LIANG Yun-wu; TAN Yuan-sheng; ZHOU Jun

    2005-01-01

    Objective:To observe the clinical therapeutic effect of Ba-He technique of acupuncture in the treatment of knee osteoarthritis. Methods: A total of 90 cases of knee osteoarthritis were evenly randomized into Ba-He technique group (observation group) and common technique group (control group), with 45 cases in each group. Zusanli (足三里 ST 36), Heding (鹤顶 EX-LE 2) and Dubi (犊鼻 ST 35) were punctured respectively in Ba-He technique and common technique in the two groups. The therapeutic effects of the two groups were compared after one course of treatment (10 sessions) in accordance with Japanese assessment criteria for knee-joint functions. Results: Aftertreatment, among the 74 and 71 affected knees in the observation and control groups, the therapeutic effect was excellent in 42 (56.8%) and 26 (36.6%) knees, fine in 14 (18.9%) and 20 (28.2%), OK in 10 (13.5%) and 11 (15.5%), and poor in 8 (10.8%) and 14 (19.7%) respectively. The therapeutic effect of the observation group was significantly better than that of control group (P<0.01). Conclusion: The Ba-He technique of acupuncture applied to the above-mentioned three acupoints exerted remarkable therapeutic effect for knee osteoarthritis, which is obviously better than that of the common needling technique.

  11. Calcium sulfate combined with guided tissue regeneration: A novel technique in treatment of gingival recessions

    OpenAIRE

    Arnav Mukherji

    2016-01-01

    The presence of mucogingival problem around anterior teeth is a challenge to the clinician as not only biological and functional aspects has to be addressed but esthetic aspirations of the patient have to be met. The use of guided tissue regeneration (GTR) procedures for the treatment of gingival recession has shown encouraging results and is gaining clinical acceptance. However, maintenance of space under the membrane remains a problem for clinicians. Hence, this case study was an innovative...

  12. CdS thin films obtained by thermal treatment of cadmium(II) complex precursor deposited by MAPLE technique

    Energy Technology Data Exchange (ETDEWEB)

    Rotaru, Andrei [INFLPR - National Institute for Laser, Plasma and Radiation Physics, PPAM - Lasers Department, 409 Atomistilor Bvd., Magurele RO-077125, Bucharest (Romania); Mietlarek-Kropidlowska, Anna [Gdansk University of Technology, Chemistry Faculty, 11/12 G. Narutowicza Str., PL-90-233 Gdansk (Poland); Constantinescu, Catalin, E-mail: catalin.constantinescu@inflpr.ro [INFLPR - National Institute for Laser, Plasma and Radiation Physics, PPAM - Lasers Department, 409 Atomistilor Bvd., Magurele RO-077125, Bucharest (Romania); Scarisoreanu, Nicu; Dumitru, Marius [INFLPR - National Institute for Laser, Plasma and Radiation Physics, PPAM - Lasers Department, 409 Atomistilor Bvd., Magurele RO-077125, Bucharest (Romania); Strankowski, Michal [Gdansk University of Technology, Chemistry Faculty, 11/12 G. Narutowicza Str., PL-90-233 Gdansk (Poland); Rotaru, Petre [University of Craiova, Faculty of Physics, 13 A.I. Cuza St., Craiova RO-200585, Dolj (Romania); Ion, Valentin [INFLPR - National Institute for Laser, Plasma and Radiation Physics, PPAM - Lasers Department, 409 Atomistilor Bvd., Magurele RO-077125, Bucharest (Romania); Vasiliu, Cristina [INOE 2000 - National Institute for Optoelectronics, 1 Atomistilor Bvd., Magurele RO-077125, Bucharest (Romania); Becker, Barbara [Gdansk University of Technology, Chemistry Faculty, 11/12 G. Narutowicza Str., PL-90-233 Gdansk (Poland); Dinescu, Maria [INFLPR - National Institute for Laser, Plasma and Radiation Physics, PPAM - Lasers Department, 409 Atomistilor Bvd., Magurele RO-077125, Bucharest (Romania)

    2009-05-15

    Thin films of [Cd{l_brace}SSi(O-Bu{sup t}){sub 3}{r_brace}(S{sub 2}CNEt{sub 2})]{sub 2}, precursor for semiconducting CdS layers, were deposited on silicon substrates by Matrix-Assisted Pulsed Laser Evaporation (MAPLE) technique. Structural analysis of the obtained films by Fourier transform infrared spectroscopy (FTIR) confirmed the viability of the procedure. After the deposition of the coordination complex, the layers are manufactured by appropriate thermal treatment of the system (thin film and substrate), according to the thermal analysis of the compound. Surface morphology of the thin films was investigated by atomic force microscopy (AFM) and spectroscopic-ellipsometry (SE) measurements.

  13. Different imaging techniques for investigation of treatment effects on various substrate surfaces

    OpenAIRE

    Chmela, O.

    2015-01-01

    The different imaging techniques were used for measurement of the properties changes on substrate surfaces. In this paper we report about testing various treatment on different substrates following investigation and characterization of the advantages/disadvantages of these methods for future applications. We usually used flexible materials such as polyethylene terephthalate (PET) and poly-carbonate (PC) for treatment. We also used glass substrate and aluminum oxide (Al2O3) to determine the ...

  14. Prenatal Diagnosis Procedures and Techniques to Obtain a Diagnostic Fetal Specimen or Tissue: Maternal and Fetal Risks and Benefits.

    Science.gov (United States)

    Wilson, R Douglas; Gagnon, Alain; Audibert, François; Campagnolo, Carla; Carroll, June; Brock, Jo-Ann; Chong, Karen; Johnson, Jo-Ann; MacDonald, William; Okun, Nanette; Pastuck, Melanie; Vallee-Pouliot, Karine

    2015-07-01

    Objectif : Offrir aux fournisseurs de soins de maternité et à leurs patientes des lignes directrices factuelles contemporaines en ce qui concerne les services de counseling traitant des risques et des avantages maternels propres à la tenue des interventions diagnostiques prénatales orientées par échographie (et/ou des techniques permettant l’établissement d’un diagnostic génétique) nécessaires dans les cas où il a été établi pendant la période prénatale que la grossesse serait exposée à des risques, ainsi qu’en ce qui concerne la prise de décisions subséquentes quant à la prise en charge de la grossesse (questions abordant des aspects tels que le niveau du fournisseur de soins obstétricaux, la surveillance prénatale, le lieu où devraient se dérouler les soins et l’accouchement, et la décision de poursuivre ou d’interrompre la grossesse). La présente directive clinique se limite aux services de counseling traitant des risques et des avantages maternels, et aux décisions en matière de prise en charge de la grossesse pour les femmes qui nécessitent (ou qui envisagent) la mise en œuvre d’une intervention ou d’une technique effractive orientée par échographie aux fins de l’établissement d’un diagnostic prénatal. Population de patientes : Femmes enceintes identifiées, à la suite de la mise en œuvre de protocoles établis de dépistage prénatal (taux sériques maternels ± imagerie, résultats d’analyse de l’ADN acellulaire indiquant des risques élevés, résultats anormaux au moment de l’imagerie fœtale diagnostique ou antécédents familiaux de troubles héréditaires), comme étant exposées à un risque accru d’anomalie génétique fœtale. Ces femmes pourraient nécessiter ou demander des services de counseling au sujet des risques et des avantages pour la grossesse de la tenue d’une intervention effractive orientée par échographie visant à déterminer l’étiologie, le diagnostic, et/ou la

  15. Recanalization strategy for chronic total occlusions with tapered and stiff-tip guidewire. The results of CTO new techniQUE for STandard procedure (CONQUEST) trial.

    Science.gov (United States)

    Mitsudo, Kazuaki; Yamashita, Takehiro; Asakura, Yasushi; Muramatsu, Toshiya; Doi, Osamu; Shibata, Yoshisato; Morino, Yoshihiro

    2008-11-01

    The success rate of percutaneous coronary intervention (PCI) for chronic total coronary occlusion (CTO) lesions varies depending on the guidewire manipulation skills of the operator. The standardization of guidewire technique is very important. A new technique with a new tapered wire (Conquest, Confianza Pro) was tested to verify effectiveness for higher initial success rates and standardization of PCI for CTO. A prospective, multicenter registry was conducted at 6 investigational sites. In the CONQUEST trial, The CTO lesions were treated by using an intermediate guidewire to cross the lesion. If it did not cross, the guidewire was changed to the Conquest guidewire. If it did not cross, "seesaw-wiring" or the "parallel-wire technique" was performed. The primary endpoint was the initial procedural success rate. A total of 110 patients representing 116 CTO lesions were treated from July 2003 through March 2004. The procedural success rate was 86.2% on the first try, and 88.8% on the second try, respectively. The guidewire success rate on the second try was 90.5% during the hospital stay; no deaths, or acute myocardial infarctions were confirmed. Two patients deteriorated into tamponade, and surgical or percutaneous drainage was performed in each patient without any sequelae. A guidewire technique in PCI for CTOs that starts with the intermediate guidewire and moves to the Confianza Pro tapered guidewire, either alone or by performing a see-saw or parallel-wire technique, can achieve a high initial success rate with an acceptably low major complication rate.

  16. Tratamiento periodontal quirúrgico: Revisión. Conceptos. Consideraciones. Procedimientos. Técnicas Periodontal surgical therapy: Review. Concepts. Considerations. Procedures. Techniques

    Directory of Open Access Journals (Sweden)

    R. Matos Cruz

    2011-12-01

    considered as an adjunct to cause-related periodontal therapy. The kind of surgery performed, the number of sites included and the moment at which it should performed is decided after evaluating for the initial cause-related therapy results. The ultimate objective of periodontal surgical treatment is the long term preservation of the periodontium. Periodontal surgery can contribute to this end creating accessibility for an adequate scaling and root planning therefore restoring the gingival morphology which facilitates the automatic plaque control of the patient. Developed surgical techniques must be evaluated on the basis of their potential to facilitate the elimination of subgingival deposits, as well as facilitate plaque control and thus improve the long term preservation of the periodontium. In the present article the authors review the basis of surgical periodontal treatment as well as related concepts and considerations, objectives, indications and contraindications, procedures and factors that determine the selection of one or the other surgical technique.

  17. A modified procedure for velopharyngeal sphincteroplasty in primary cleft palate repair and secondary velopharyngeal incompetence treatment and its preliminary results.

    Science.gov (United States)

    Cheng, Ningxin; Zhao, Min; Qi, Kemin; Deng, Hui; Fang, Zeng; Song, Ruyao

    2006-01-01

    During cleft repair, velopharyngeal sphincter reconstruction is still a challenge to plastic surgeons. To improve the surgical treatment for cleft palate and secondary velopharyngeal incompetence (VPI), a carefully designed modified procedure for primary palatoplasty and secondary VPI was presented. Fifty-six patients (48 for primary cleft palate repair and eight for secondary VPI of previously repaired clefts) underwent this procedure from 1988 to 2001. The modified procedure is a combination of the tunnelled palatopharyngeus myomucosal flap for dynamic circular reconstruction of the pharyngeal element of the velopharyngeal sphincter and the double-reversing Z-plasty with levator velo palatini muscles reposition in the velar element of the sphincter. The satisfactory velopharyngeal competence (complete velopharyngeal closure and marginal velopharyngeal closure) was achieved in 23 of 25 patients with primary cleft palate repair examined by nasendoscopy and the nasality, speech articulation and intelligibility are also assessed in 25 primary cleft palate repaired patients with 92% satisfactory result (normal speech and speech with mild VPI) in single word test and 88% in continuous speech evaluation. Based on our experience, we believe that this modified procedure is a reasonable choice for primary cleft repair and secondary VPI treatment because it is in accord with normal physiology and anatomy of the velopharyngeal sphincter, can lengthen the soft palate, decrease the enlarged velopharynx, augment the posterior pharyngeal wall, and enhance the relationship between the muscles of velopharyngeal sphincter which results in a dynamic neo-sphincter in palatopharyngoplasty. Further study of the procedure is needed. The theoretical basis, operative highlights, velopharyngeal function, advantages and disadvantages of the modified procedure were discussed.

  18. Suppression test in the follow-up of antithyroidal treatment: Rebirth of an in-vivo radioisotopic procedure

    Energy Technology Data Exchange (ETDEWEB)

    Reiners, C.; Becker, W.; Boerner, W.

    1985-06-01

    Measurements of thyroidal suppressibility by thyroid hormones belong to the diagnostic program in nuclear medicine for more than 30 years. Suppression tests are used in follow-up of antithydroidal treatment of predict remission or relapse of hyperthyroidism. Recently, the number of publications dealing with suppression tests has been increasing. Apparently, non-suppressibility of the thyroid after antithydroidal treatment for about 1 year corresponds to a rate of relapse of about 70% whereas in the case of a positive suppression test, the relapse rate amounts to about 20% only. The diagnostic procedures described in the litearature are different with respect to radiopharmaceuticals, activity doses, thyroid hormone suppression and, above all, to the time of uptake measurements. After a critical discussion of the literature, a modern diagnostic procedure for the suppression test is proposed using /sup 123/I or sup(99m)Tc and a computer-assisted gamma camera.

  19. The incidence of secondary vertebral fracture of vertebral augmentation techniques versus conservative treatment for painful osteoporotic vertebral fractures: a systematic review and meta-analysis.

    Science.gov (United States)

    Song, Dawei; Meng, Bin; Gan, Minfeng; Niu, Junjie; Li, Shiyan; Chen, Hao; Yuan, Chenxi; Yang, Huilin

    2015-08-01

    field that vertebral augmentation procedures may increase the incidence of secondary fractures, we found no differences in the incidence of secondary fractures between vertebral augmentation techniques and conservative treatment for patients with OVCFs. © The Foundation Acta Radiologica 2014.

  20. Treatment of physeal fractures of the distal radius by volar intrafocal Kapandji method: surgical technique.

    Science.gov (United States)

    Rubin, Guy; Orbach, Hagay; Chezar, Avi; Rozen, Nimrod

    2017-01-01

    Distal radial physeal fractures with volar displacement are rare. Several methods of operative treatment include volar plate without inserting distal screws, percutaneous technique using two anterior skin incisions and reversed Kapandji technique with pins introduced through a posterior approach and locked at the anterior cortex of the fracture. We report three cases along with a literature review of the surgical techniques described in the past and a novel surgical technique for this uncommon fracture termed "Volar Kapandji". All patients had anatomic reduction at the last follow-up radiography, and all patients had a full range of motion and VAS 0 at the last follow-up. No complications were recorded. This case study presents the minimally invasive option for treating rare cases of physeal distal radius fractures with volar displacement. V.

  1. Comparison of online IGRT techniques for prostate IMRT treatment: Adaptive vs repositioning correction

    Energy Technology Data Exchange (ETDEWEB)

    Thongphiew, Danthai; Wu, Q. Jackie; Lee, W. Robert; Chankong, Vira; Yoo, Sua; McMahon, Ryan; Yin Fangfang [Department of Radiation Oncology, Duke University Medical Center, P.O. Box 3295, Durham, North Carolina 27710 (United States); Department of Electrical Engineering and Computer Science, Case Western Reserve University, Cleveland, Ohio 44106 (United States); Department of Radiation Oncology, Duke University Medical Center, P.O. Box 3295, Durham, North Carolina 27710 (United States)

    2009-05-15

    This study compares three online image guidance techniques (IGRT) for prostate IMRT treatment: bony-anatomy matching, soft-tissue matching, and online replanning. Six prostate IMRT patients were studied. Five daily CBCT scans from the first week were acquired for each patient to provide representative ''snapshots'' of anatomical variations during the course of treatment. Initial IMRT plans were designed for each patient with seven coplanar 15 MV beams on a Eclipse treatment planning system. Two plans were created, one with a PTV margin of 10 mm and another with a 5 mm PTV margin. Based on these plans, the delivered dose distributions to each CBCT anatomy was evaluated to compare bony-anatomy matching, soft-tissue matching, and online replanning. Matching based on bony anatomy was evaluated using the 10 mm PTV margin (''bone10''). Soft-tissue matching was evaluated using both the 10 mm (''soft10'') and 5 mm (''soft5'') PTV margins. Online reoptimization was evaluated using the 5 mm PTV margin (''adapt''). The replanning process utilized the original dose distribution as the basis and linear goal programming techniques for reoptimization. The reoptimized plans were finished in less than 2 min for all cases. Using each IGRT technique, the delivered dose distribution was evaluated on all 30 CBCT scans (6 patientsx5CBCT/patient). The mean minimum dose (in percentage of prescription dose) to the CTV over five treatment fractions were in the ranges of 99%-100%(SD=0.1%-0.8%), 65%-98%(SD=0.4%-19.5%), 87%-99%(SD=0.7%-23.3%), and 95%-99%(SD=0.4%-10.4%) for the adapt, bone10, soft5, and soft10 techniques, respectively. Compared to patient position correction techniques, the online reoptimization technique also showed improvement in OAR sparing when organ motion/deformations were large. For bladder, the adapt technique had the best (minimum) D90, D50, and D30 values for 24, 17

  2. The feasibility of using Pareto fronts for comparison of treatment planning systems and delivery techniques.

    Science.gov (United States)

    Ottosson, Rickard O; Engstrom, Per E; Sjöström, David; Behrens, Claus F; Karlsson, Anna; Knöös, Tommy; Ceberg, Crister

    2009-01-01

    Pareto optimality is a concept that formalises the trade-off between a given set of mutually contradicting objectives. A solution is said to be Pareto optimal when it is not possible to improve one objective without deteriorating at least one of the other. A set of Pareto optimal solutions constitute the Pareto front. The Pareto concept applies well to the inverse planning process, which involves inherently contradictory objectives, high and uniform target dose on one hand, and sparing of surrounding tissue and nearby organs at risk (OAR) on the other. Due to the specific characteristics of a treatment planning system (TPS), treatment strategy or delivery technique, Pareto fronts for a given case are likely to differ. The aim of this study was to investigate the feasibility of using Pareto fronts as a comparative tool for TPSs, treatment strategies and delivery techniques. In order to sample Pareto fronts, multiple treatment plans with varying target conformity and dose sparing of OAR were created for a number of prostate and head & neck IMRT cases. The DVHs of each plan were evaluated with respect to target coverage and dose to relevant OAR. Pareto fronts were successfully created for all studied cases. The results did indeed follow the definition of the Pareto concept, i.e. dose sparing of the OAR could not be improved without target coverage being impaired or vice versa. Furthermore, various treatment techniques resulted in distinguished and well separated Pareto fronts. Pareto fronts may be used to evaluate a number of parameters within radiotherapy. Examples are TPS optimization algorithms, the variation between accelerators or delivery techniques and the degradation of a plan during the treatment planning process. The issue of designing a model for unbiased comparison of parameters with such large inherent discrepancies, e.g. different TPSs, is problematic and should be carefully considered.

  3. Endoluminal brachytherapy in the treatment of oesophageal cancer: technique description, case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Luisa Castilla

    2015-07-01

    Full Text Available Endoesophageal brachytherapy is a useful technique for the palliative treatment of dysphagia in advanced oesophageal cancer. This technique offers good results on dysphagia control and quality of life. We report the case of a patient treated with this technique presenting complete response to the dysphagia. We describe endoesophageal brachyterapy technique and we comment on the literature.

  4. Treatment of gingival hyperpigmentation with rotary abrasive, scalpel, and laser techniques: A case series.

    Science.gov (United States)

    Murthy, M Bhanu; Kaur, Jasjit; Das, Rupali

    2012-10-01

    Melanin pigmentation often occurs in the gingiva as a result of an abnormal deposition of melanin, due to which the gums may appear black, but the principles, techniques, and management of the problems associated with gingival melanin pigmentation are still not fully established. Depigmentation procedures such as scalpel surgery, gingivectomy with free gingival autografting, electrosurgery, cryosurgery, chemical agents such as 90% phenol and 95% alcohol, abrasion with diamond bur, Nd: YAG laser, semiconductor diode laser, and CO2 laser have been employed for removal of melanin hyper pigmentation. The following case series describes three different surgical depigmentation techniques: scalpel surgery, abrasion with rotary abrasive, and a diode laser. Better results of depigmentation were achieved with diode laser than conventional scalpel and with rotary abrasion with respect to esthetics. The results point out that lasers are an effective and a safe means to removal of hyperpigmentation from the gingiva. Healing was uneventful and no repigmentation occurred.

  5. A review of 105 consecutive uniport endoscopic plantar fascial release procedures for the treatment of chronic plantar fasciitis.

    Science.gov (United States)

    Morton, Troy N; Zimmerman, Jeffrey P; Lee, Michael; Schaber, John D

    2013-01-01

    Plantar fasciitis is a common cause of heel pain in the U.S. Army soldier, resulting in a significant loss of man hours. Given the heavy operations tempo of the U.S. military, successful treatment options need to be considered and used as quickly as possible. Plantar fasciitis can be successfully treated in up to 90% of patients using conservative measures. Operative intervention might need to be considered for those in whom conservative measures have failed. The present report is a review of 105 consecutive uniport endoscopic plantar fascial release procedures performed by the principal investigator during a 9-year period. The following data were collected and analyzed: gender, age, weight, height, body mass index, medical treatment facility, procedure laterality, preoperative pain levels, postoperative pain levels at 3 months, first ambulatory day in the controlled ankle motion boot, return to activity as tolerated, and complications. Three major points were of interest: evidence of improvement in chronic plantar fasciitis when treated with uniport endoscopic procedures; the patient attributes associated with self-reported pain levels 90 days postoperatively; and the patient attributes associated with the average time until patients were able to return to activities as tolerated in a controlled ankle motion boot. It was noted that 44.5% of those with a body mass index of 29.80 kg/m(2) or greater reported a postoperative pain level of 0; and 96.3% of those with a body mass index of 25.53 kg/m(2) or less reported postoperative pain levels of 0. The analyzed data were used to characterize the clinical outcomes of the procedure, identify changes in outcome with surgeon experience, and identify whether certain patient subgroups have better outcomes, allowing surgeons to identify which patient might be the best candidates for an endoscopic release procedure.

  6. Diagnosis and treatment of anteroinferior capsular redundancy associated with anterior shoulder instability using an open Latarjet procedure and capsulorrhaphy.

    Science.gov (United States)

    Ropars, Mickaël; Cretual, Armel; Kaila, Rajiv; Bonan, Isabelle; Hervé, Anthony; Thomazeau, Hervé

    2016-12-01

    There is a paucity of data detailing management of anterior capsular redundancy (ACR) when using the Latarjet procedure for unidirectional instability. This study aimed to describe the surgical management and to assess the clinical profile of patients presenting with anterior capsular redundancy [ACR(+)] with anterior shoulder instability. Seventy-seven patients who had a Latarjet procedure were followed for a 55-month period. Per-operative ACR was assessed during surgery. ACR was considered present if the inferior capsular flap of a Neer T-shaft capsulorrhaphy was able to cover the superior capsular flap with the arm in the neutral position. Patients with ACR(+) received an additional Neer capsulorrhaphy, while patients with ACR(-) did not. This per-operative finding was correlated with demographics, clinical, radiological pre-operative data and surgical outcome. Patients presenting with a per-operative ACR(+) were significantly associated with a sulcus sign (P 4 (P 85°. Open standard Latarjet procedures with Neer capsulorrhaphy in ACR(+) patients showed excellent or good results and stability rate of 95 %. All patients except four who presented with a new dislocation after surgery were satisfied with their outcome. Thirteen patients (16 %) had a persistent apprehension sign at the last follow-up. ACR(+) and ACR(-) groups did not show significant difference in the mean values of Rowe, Walch-Duplay and Constant-Murley scores. ACR correlated with a sulcus sign, Beighton score and instability history. In anterior shoulder instability associated with ACR, the Latarjet procedure with a Neer capsulorrhaphy appears a satisfactory treatment alternative to arthroscopic or open capsular shift. It decreased apprehension in comparison with Latarjet procedures without capsular repair. Cases series, treatment study, Level IV.

  7. Bariatric Surgery Procedures

    Science.gov (United States)

    ... Center Access to Care Toolkit EHB Access Toolkit Bariatric Surgery Procedures Bariatric surgical procedures cause weight loss by ... Bariatric procedures also often cause hormonal changes. Most weight loss surgeries today are performed using minimally invasive techniques (laparoscopic ...

  8. A new procedure for treatment of oily slurry using geotextile filters.

    Science.gov (United States)

    Mendonça, M B; Cammarota, M C; Freire, D D C; Ehrlich, M

    2004-07-05

    A new procedure to mitigate the environmental impacts and reduce the cost of disposal of oil slurry is present in this paper. Waste from the petroleum industry has a high environmental impact. Systems for oil-water separation have been used to mitigate the contamination potential of these types of effluents. At the outlet of these systems, the oil is skimmed-off the surface, while the slurry is removed from the base. Due to the high concentration of contaminants, the disposal of this slurry is an environmentally hazardous practice. Usually this type of waste is disposed of in tanks or landfills after removal from the industrial plant. Basically, the proposed procedure utilizes drying beds with geotextile filters to both reduce the water content in the slurry and obtain a less contaminated effluent. Laboratory tests were carried out to simulate the drying system. Four types of filters were analyzed: two non-woven geotextiles, one woven geotextile, and a sand filter.

  9. Light-force technique for the early treatment of an ectopic tooth.

    Science.gov (United States)

    Cozzani, Mauro; Lupini, Daniela; Siciliani, Giuseppe

    2005-01-01

    Free crown tipping can be useful when teeth do not erupt in their physiologic sequence and a real intraosseous migration and eruption of a single tooth into a distant ectopic position can be observed. This article presents a case of an ectopic mandibular lateral incisor treated early, with the light-force technique and uncontrolled forces, and finished with the bidimensional edgewise appliance. A Caucasian female patient, 10 years 10 months of age, had a mandibular left lateral incisor displacement, with the lateral incisor crown positioned mesial to left second primary molar. An early treatment was planned to correct the mandibular left lateral incisor displacement and to allow proper eruption of the mandibular left canine and first premolar. A second phase of treatment, in permanent dentition, was planned for the dental Class II subdivision on the right and deep bite correction. Phase 1 treatment was completed after 10 months; phase 2 treatment was initiated in the permanent dentition and lasted 18 months. Treatment achieved the following outcomes: (1) mandibular lateral incisor in corrected position; (2) full canine and molar Class I relationship; (3) overjet and overbite within the normal limits; (4) symmetric arches; and (5) a balanced profile. The radiograph evaluation revealed good root parallelism and mandibular left lateral incisor light root resorption. The light-force technique is not only a possible alternative but the ideal appliance for treatment in the mixed dentition, when the permanent teeth should be controlled.

  10. Táticas e técnicas endovasculares para retirada de corpos estranhos intravenosos Endovascular techniques and procedures, methods for removal of intravascular foreign bodies

    Directory of Open Access Journals (Sweden)

    Joaquim Maurício da Motta-Leal Filho

    2010-06-01

    malfunction is the most likely signal of embolization, since patients are usually asymptomatic. OBJECTIVE: To report the method of removing intravascular foreign bodies, catheters with the use of various endovascular techniques and procedures. METHODS: This is a two-year retrospective study of 12 patients: seven women and five men. The average age was 29 years (ranging from two months to 65 years. RESULTS: Technical performance was 100% successful. Ten port-a-caths, one intra-cath and one PICC were extracted. The most common sites for the lodging of one of the ends of the intravascular foreign bodies were the right atrium (41.6% and the right ventricle (33.3%. In 100% of the cases, only one venous access was used for extraction of foreign bodies, and in 91.6% of the cases (11 catheters the femoral access was used. The loop-snare was used in 10 cases (83.3%. The most common cause of intravascular foreign body insertion was a catheter fracture, which occurred in 66.6% of the cases (eight cases. One major complication, the atrial fibrillation, occurred (8.3%, which was related to the intravascular foreign body extraction. The mortality rate in 30 days was zero. CONCLUSION: Percutaneous retrieval of intravascular foreign bodies is considered gold standard treatment because it is a minimally invasive, relatively simple, safe procedure, with low complication rates compared to conventional surgical treatment

  11. Choice of a General Anesthesia Technique in the Surgical Treatment of Postinfarct Left Ventricular Aneurysms

    Directory of Open Access Journals (Sweden)

    N. A. Karpun

    2005-01-01

    Full Text Available Objective. To choose the optimum technique of general anesthesia in the surgical treatment of patients with postinfarct left ventricular aneurysms (PLVA.Materials and methods. Fifty-four patients operated on for PLVA were examined. They were divided into 4 groups according to the basic technique of general anesthesia: 1 intravenous anesthesia based on propofol and fentanyl; 2 inhalation sevoflurane anesthesia with fentanyl enhancement of the analgesic component; 3 inhalation isoflurane anesthesia with fentanyl enhancement of the analgesic component; 4 general anesthesia in combination with epidural blockade. Central hemodynamics was investigated by the thermodilution technique and the perioperative period was also studied.Results and discussion. None of the general anesthesia techniques affected the development of perioperative complications. However, with decreased myocardial reserves, high thoracic epidural anesthesia should be applied with caution as it causes a significant desympathization, which may lead to impairments of the autoregulatory mechanisms of coronary blood flow and aggravate existing contractile disorders. Intravenous and inhalation anesthesia techniques provide a fair hemodynamic stability at all stages of surgical treatment. Inhalation anesthesia has a number of advantages: less cost and the possibility of rapid activation of patients in the early postoperative period.

  12. What is the best fixation technique for the treatment of supracondylar humerus fractures in children?

    Science.gov (United States)

    Patriota, Gyoguevara Sol Queiroz Andrade; Assunção Filho, Carlos Alberto; Assunção, Carlos Alberto

    2017-01-01

    To define the best technique for the surgical treatment of supracondylar fracture of the humerus (SFH) in children, evaluating percutaneous pinning with side wires vs. cross-pinning. Randomized controlled trials using the Medline, CAPES, and BIREME. The criteria for inclusion of articles criteria were: (1) randomized controlled trials (RCTs) comparing percutaneous wire fixation techniques, (2) SFH Gartland II B, III, and IV, and (3) children aged 1-14 years. The following were used as main variables: incidence of iatrogenic injury to the ulnar nerve and loss reduction. Eight studies were selected (521 patients) comparing surgical treatment with pinning in supracondylar fracture of the humerus in children Gartland II type B, III or IV. Iatrogenic injury to the ulnar nerve was greater with the cross-pinning technique, with RR 0.28 and p = 0.03, while the mini-open technique presented RR 0.14 and p = 0.2. A statistically significant greater loss of reduction in the lateral pinning was observed in FSU Gartland III and IV(p = 0.04). Based upon this meta-analysis of prospective randomized clinical trials, the following is recommended: (1) percutaneous pinning with lateral wires in supracondylar fractures of the humerus in children classified as Gartland II type B; (2) use of crossed wires for Gartland type III or IV, using the mini-open technique for the medial wire.

  13. Percutaneous Management of Accidentally Retained Foreign Bodies During Image-Guided Non-vascular Procedures: Novel Technique Using a Large-Bore Biopsy System.

    Science.gov (United States)

    Cazzato, Roberto Luigi; Garnon, Julien; Ramamurthy, Nitin; Tsoumakidou, Georgia; Caudrelier, Jean; Thénint, Marie-Aude; Rao, Pramod; Koch, Guillaume; Gangi, Afshin

    2016-07-01

    To describe a novel percutaneous image-guided technique using a large-bore biopsy system to retrieve foreign bodies (FBs) accidentally retained during non-vascular interventional procedures. Between May 2013 and October 2015, five patients underwent percutaneous retrieval of five iatrogenic FBs, including a biopsy needle tip in the femoral head following osteoblastoma biopsy and radiofrequency ablation (RFA); a co-axial needle shaft within a giant desmoid tumour following cryoablation; and three post-vertebroplasty cement tails within paraspinal muscles. All FBs were retrieved immediately following original procedures under local or general anaesthesia, using combined computed tomography (CT) and fluoroscopic guidance. The basic technique involved positioning a 6G trocar sleeve around the FB long axis and co-axially advancing an 8G biopsy needle to retrieve the FB within the biopsy core. Retrospective chart review facilitated analysis of procedures, FBs, technical success, and complications. Mean FB size was 23 mm (range 8-74 mm). Four FBs were located within 10 mm of non-vascular significant anatomic structures. The basic technique was successful in 3 cases; 2 cases required technical modifications including using a stiff guide-wire to facilitate retrieval in the case of the post-cryoablation FB; and using the central mandrin of the 6G trocar to push a cement tract back into an augmented vertebra when initial retrieval failed. Overall technical success (FB retrieval or removal to non-hazardous location) was 100 %, with no complications. Percutaneous image-guided retrieval of iatrogenic FBs using a large-bore biopsy system is a feasible, safe, effective, and versatile technique, with potential advantages over existing methods.

  14. A clinical study to assess the effectiveness of a hyaluronic acid-based procedure for treatment of premature ejaculation

    Science.gov (United States)

    Littara, A; Palmieri, B; Rottigni, V; Iannitti, T

    2013-01-01

    Premature ejaculation is a sexual debilitating condition affecting a large number of men worldwide and leading to important dysfunctions influencing the patients' affective and emotional life. Hyaluronic acid is a natural and safe compound that has been widely used not only in the aesthetic medicine clinic, but also for treatment of osteoarthritis. The present study shows the effectiveness of a hyaluronic acid-based procedure for treatment of premature ejaculation. A hundred and ten male patients were treated with hyaluronic acid injections in the deep dermis of their glans penis to increase the volume and the circumference of their penis to prevent male premature ejaculation and improve the patients' and their partners' sexual satisfaction. The intravaginal ejaculation latency time increased significantly from a baseline value of 88.34±3.14 s to 293.14±8.16 s after 6 months from the procedure. Maximal glandular circumference increased from 98.51±0.71 mm to 114.35±0.66 mm after 6 months from the procedure. At 6-month follow-up, patients' self-rated satisfaction was 5.3±0.07 (range: 4–6). At the follow-up, partners' self-rated satisfaction was 5.1±0.09 (range: 3–6). The present clinical study showed that hyaluronic acid injection is a promising treatment for premature ejaculation. The effect of the procedure in the long-term follow-up needs to be clarified. PMID:23552577

  15. Assessment and Treatment of Severe Behavior Problems Using Choice-Making Procedures.

    Science.gov (United States)

    Harding, Jay W.; Wacker, David P.; Berg, Wendy K.; Barretto, Anjali; Rankin, Barbara

    2002-01-01

    Choice-making produces were used to identify response-reinforcer relations during assessment and treatment phases with two children (ages 4-6) with pervasive development disorders who displayed severe behavioral problems. Results were used to develop preliminary treatment packages in which access to positive reinforcement was contingent on…

  16. Nine Months of Multicomponent Behavioral Treatment for ADHD and Effectiveness of MTA Fading Procedures

    Science.gov (United States)

    Arnold, L. Eugene; Chuang, Shirley; Davies, Mark; Abikoff, Howard B.; Conners, C. Keith; Elliott, Glen R.; Greenhill, Laurence L.; Hechtman, Lily; Hinshaw, Stephen P.; Hoza, Betsy; Jensen, Peter S.; Kraemer, Helena C.; Langworthy-Lam, Kristen S.; March, John S.; Newcorn, Jeffrey H.; Pelham, William E.; Severe, Joanne B.; Swanson, James M.; Vitiello, Benedetto; Wells, Karen C.; Wigal, Timothy

    2004-01-01

    We examined 9-month data from the 14-month NIMH Multimodal Treatment Study of Children with ADHD (the MTA) as a further check on the relative effect of medication (MedMgt) and behavioral treatment (Beh) for attention-deficit/hyperactivity disorder (ADHD) while Beh was still being delivered at greater intensity than at 14-month endpoint, and…

  17. Facilitating endoscopic submucosal dissection: the suture-pulley method significantly improves procedure time and minimizes technical difficulty compared with conventional technique: an ex vivo study (with video)

    Science.gov (United States)

    Aihara, Hiroyuki; Kumar, Nitin; Ryou, Marvin; Abidi, Wasif; Ryan, Michele B.; Thompson, Christopher C.

    2015-01-01

    Background The lack of countertraction in endoscopic submucosal dissection (ESD) results in increased technical demand and procedure time. Although the suture-pulley method for countertraction has been reported, its effectiveness compared with the traditional ESD technique remains unclear. Objective To objectively analyze efficacy of countertraction using the suture-pulley method for ESD. Design Prospective ex vivo animal study. Setting Animal laboratory. Interventions Twenty simulated gastric lesions were created in porcine stomachs by using a standard circular template 30 mm in diameter. In the control arm (n = 10), ESD was performed by using the standard technique. In the suture-pulley arm (N = 10), a circumferential incision was made, and an endoscopic suturing device was used to place the suture pulley. Main Outcome Measurements The primary outcome of this study was total procedure time. Results The median total procedure time with the suture-pulley method was significantly shorter than the traditional ESD technique (median, 25% to 75%, interquartile range [IQR]: 531 seconds [474.3–549.3 seconds] vs 845 seconds [656.3–1547.5 seconds], P < .001). The median time (IQR) for suture-pulley placement was 160.5 seconds (150.0–168.8 seconds). Although there was a significantly longer procedure time for proximal versus middle/lower stomach lesions with traditional ESD (median, 1601 seconds; IQR, 1547.5–1708.8 seconds vs median, 663 seconds; IQR, 627.5–681.8 seconds; P =.01), there was no significant difference in procedure time for lesions of various locations when using the suture-pulley method. Compared with traditional ESD, the suture-pulley method was less demanding in all categories evaluated by the NASA Task Load Index. Limitations Ex vivo study. Conclusions The suture-pulley method facilitates direct visualization of the submucosal layer during ESD and significantly reduces procedure time and technical difficulty. In addition, the benefit of the suture

  18. Treatment of recurrent traumatic carotid cavernous fistula via endovascular embo lism technique

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    @@Endovascular embolism technique has been demonstrated to be the best initial option for treatment of carotid cavernous fistula (CCF). Several large series re ports have shown that most CCFs can be successfully occluded via transarterial or transvenous endovascular approach.1-6 This paper reports a case of C CF recurred after endovascular occlusion of internal carotid artery (ICA) proxim al to the fistula. A new technique has been described for transarterial emboliza tion with tungsten microcoils via surgical exposure to ICA, which has not been r eported previously in the literatures.

  19. Various techniques for the surgical treatment of common bile duct stones: a meta review.

    Science.gov (United States)

    Shojaiefard, Abolfazl; Esmaeilzadeh, Majid; Ghafouri, Ali; Mehrabi, Arianeb

    2009-01-01

    Common bile duct stones (CBDSs) may occur in up to 3%-14.7% of all patients for whom cholecystectomy is preformed. Patients presenting with CBDS have symptoms including: biliary colic, jaundice, cholangitis, pancreatitis or may be asymptomatic. It is important to distinguish between primary and secondary stones, because the treatment approach varies. Stones found before, during, and after cholecystectomy had also differing treatments. Different methods have been used for the treatment of CBDS but the suitable therapy depends on conditions such as patient' satisfaction, number and size of stones, and the surgeons experience in laparoscopy. Endoscopic retrograde cholangiopancreatography with or without endoscopic biliary sphincterotomy, laparoscopic CBD exploration (transcystic or transcholedochal), or laparotomy with CBD exploration (by T-tube, C-tube insertion, or primary closure) are the most commonly used methods managing CBDS. We will review the pathophysiology of CBDS, diagnosis, and different techniques of treatment with especial focus on the various surgical modalities.

  20. Various Techniques for the Surgical Treatment of Common Bile Duct Stones: A Meta Review

    Directory of Open Access Journals (Sweden)

    Abolfazl Shojaiefard

    2009-01-01

    Full Text Available Common bile duct stones (CBDSs may occur in up to 3%–14.7% of all patients for whom cholecystectomy is preformed. Patients presenting with CBDS have symptoms including: biliary colic, jaundice, cholangitis, pancreatitis or may be asymptomatic. It is important to distinguish between primary and secondary stones, because the treatment approach varies. Stones found before, during, and after cholecystectomy had also differing treatments. Different methods have been used for the treatment of CBDS but the suitable therapy depends on conditions such as patient' satisfaction, number and size of stones, and the surgeons experience in laparoscopy. Endoscopic retrograde cholangiopancreatography with or without endoscopic biliary sphincterotomy, laparoscopic CBD exploration (transcystic or transcholedochal, or laparotomy with CBD exploration (by T-tube, C-tube insertion, or primary closure are the most commonly used methods managing CBDS. We will review the pathophysiology of CBDS, diagnosis, and different techniques of treatment with especial focus on the various surgical modalities.

  1. Strategies and techniques to enhance constructed wetland performance for sustainable wastewater treatment.

    Science.gov (United States)

    Wu, Haiming; Fan, Jinlin; Zhang, Jian; Ngo, Huu Hao; Guo, Wenshan; Liang, Shuang; Hu, Zhen; Liu, Hai

    2015-10-01

    Constructed wetlands (CWs) have been used as an alternative to conventional technologies for wastewater treatment for more than five decades. Recently, the use of various modified CWs to improve treatment performance has also been reported in the literature. However, the available knowledge on various CW technologies considering the intensified and reliable removal of pollutants is still limited. Hence, this paper aims to provide an overview of the current development of CW strategies and techniques for enhanced wastewater treatment. Basic information on configurations and characteristics of different innovations was summarized. Then, overall treatment performance of those systems and their shortcomings were further discussed. Lastly, future perspectives were also identified for specialists to design more effective and sustainable CWs. This information is used to inspire some novel intensifying methodologies, and benefit the successful applications of potential CW technologies.

  2. Procedure of Forecasting Operational and Extremal State of Critical Systems of the Rocket Technique Under Repeated Thermo-Force Loading

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    Shevchenko Yu.M.

    2015-09-01

    Full Text Available The mathematical model for investigation of the thermoelastoplastic stress-strain state and the strength of the rocket technique systems under the repeated starting is proposed. The thermal conductivity equation and constitutive equations of thermoplasticity for the repeated elastic-plastic deformation processes of isotropic materials along small-curvature paths, the strength and low-cyclic fatigue criteria, numerical methods for solving the boundary-value heat conduction problems and corresponding computer software are used.

  3. The Double-Row Suture Technique: A Better Option for the Treatment of Haglund Syndrome.

    Science.gov (United States)

    Jiang, Yiqiu; Li, Yang; Tao, Tianqi; Li, Wang; Zhang, Kaibin; Gui, Jianchao; Ma, Yong

    2016-01-01

    Purpose. The purpose of this study is to investigate whether double-row suture technique is a better option for the treatment of Haglund syndrome than single-row suture technique regarding the surgical outcomes. Methods. Thirty-two patients with Haglund syndrome were recruited in this study. Patients were divided into Group 1 (treated with single-row suture technique) and Group 2 (treated with double-row suture technique). There were 16 patients in each group. The AOFAS-ankle-hindfoot scale, VISA-A scores, and Arner-Lindholm standard were used to assess the clinical outcomes. The pre- and postoperative X-rays were used to assess the radiological outcome. Results. Both AOFAS-ankle-hindfoot scale score and VISA-A score had varying degrees of improvement in both groups. In latest follow-up assessment, the Arner-Lindholm standard investigation showed there were 7 excellent, 7 good, and 2 bad outcomes in Group 1 and 12 excellent and 4 good outcomes in Group 2. In Group 2 patients, there were no more posterosuperior bony prominence of the calcaneum in post-op X-rays and there were no recurrent cases. The ankle-related scale score was statistically significantly higher in Group 2 than in Group 1 (P = 0.029). Conclusion. The double-row suture technique seems to be a better option to treat Haglund syndrome than single-row suture technique.

  4. The Double-Row Suture Technique: A Better Option for the Treatment of Haglund Syndrome

    Directory of Open Access Journals (Sweden)

    Yiqiu Jiang

    2016-01-01

    Full Text Available Purpose. The purpose of this study is to investigate whether double-row suture technique is a better option for the treatment of Haglund syndrome than single-row suture technique regarding the surgical outcomes. Methods. Thirty-two patients with Haglund syndrome were recruited in this study. Patients were divided into Group 1 (treated with single-row suture technique and Group 2 (treated with double-row suture technique. There were 16 patients in each group. The AOFAS-ankle-hindfoot scale, VISA-A scores, and Arner-Lindholm standard were used to assess the clinical outcomes. The pre- and postoperative X-rays were used to assess the radiological outcome. Results. Both AOFAS-ankle-hindfoot scale score and VISA-A score had varying degrees of improvement in both groups. In latest follow-up assessment, the Arner-Lindholm standard investigation showed there were 7 excellent, 7 good, and 2 bad outcomes in Group 1 and 12 excellent and 4 good outcomes in Group 2. In Group 2 patients, there were no more posterosuperior bony prominence of the calcaneum in post-op X-rays and there were no recurrent cases. The ankle-related scale score was statistically significantly higher in Group 2 than in Group 1 (P=0.029. Conclusion. The double-row suture technique seems to be a better option to treat Haglund syndrome than single-row suture technique.

  5. Dermal fillers for the treatment of tear trough deformity: A review of anatomy, treatment techniques, and their outcomes

    Directory of Open Access Journals (Sweden)

    Jaishree Sharad

    2012-01-01

    Full Text Available Tear trough deformity is a major concern in a lot of individuals seeking periorbital rejuvenation. A prominent tear trough deformity is characterised by a sunken appearance of the eye that results in the casting of a dark shadow over the lower eyelid, giving the patient a fatigued appearance despite adequate rest, and is refractory to attempts at cosmetic concealment. The tear trough deformity is a natural consequence of the anatomic attachments of the periorbital tissues. A variety of techniques have evolved to address this cosmetic issue. Traditional techniques relied on surgical excision of skin, muscle, and fat as well as chemical peels. Treatment is now tailored towards specific anatomic abnormalities and often employs multiple modalities including surgery, botulinum toxin, and replacement of volume. Various original research articles, text book publications and review articles were studied. Data specific to the historical aspect and anatomy of tear trough have been enumerated. Techniques of different authors were analysed and their results and complications have been summarised. The technique of the author has also been described here.

  6. Minimally Invasive Laminate Veneers: Clinical Aspects in Treatment Planning and Cementation Procedures

    Science.gov (United States)

    Morita, R. K.; Hayashida, M. F.; Berger, G.; Reggiani, R. D.; Betiol, E. A. G.

    2016-01-01

    When a definitive aesthetic treatment is determined, it is crucial to grant the patient's wish with the necessary dental treatment. Thus, conservative treatments that are the solution to aesthetic problems involving morphologic modifications and provide the result that the patient expects should always be the first therapeutic option. In this context, ceramic laminate veneers, also known as “contact lens,” are capable of providing an extremely faithful reproduction of the natural teeth with great color stability and periodontal biocompatibility. Minimal or no preparation veneers are heavily advertised as the answer to our patients' cosmetic needs, which they can be if they are used correctly in the appropriate case. This report is about ultraconservative restorations to achieve functional and aesthetic rehabilitation through treatment planning. Thus, clinicians should be aware that the preparation for laminate veneers remains within enamel, to ensure the bond strength and avoid or minimize the occurrence of postoperative sensitivity. PMID:28070427

  7. Apexogenesis and revascularization treatment procedures for two traumatized immature permanent maxillary incisors: a case report.

    Science.gov (United States)

    Forghani, Maryam; Parisay, Iman; Maghsoudlou, Amir

    2013-08-01

    Traumatic injuries to an immature permanent tooth may result in cessation of dentin deposition and root maturation. Endodontic treatment is often complicated in premature tooth with an uncertain prognosis. This article describes successful treatment of two traumatized maxillary central incisors with complicated crown fracture three months after trauma. The radiographic examination showed immature roots in maxillary central incisors of a 9-year-old boy with a radiolucent lesion adjacent to the right central incisor. Apexogenesis was performed for the left central incisor and revascularization treatment was considered for the right one. In 18-month clinical and radiographic follow-up both teeth were asymptomatic, roots continued to develop, and periapical radiolucency of the right central incisor healed. Considering the root development of these contralateral teeth it can be concluded that revascularization is an appropriate treatment method in immature necrotic teeth.

  8. Minimally Invasive Laminate Veneers: Clinical Aspects in Treatment Planning and Cementation Procedures

    Directory of Open Access Journals (Sweden)

    R. K. Morita

    2016-01-01

    Full Text Available When a definitive aesthetic treatment is determined, it is crucial to grant the patient’s wish with the necessary dental treatment. Thus, conservative treatments that are the solution to aesthetic problems involving morphologic modifications and provide the result that the patient expects should always be the first therapeutic option. In this context, ceramic laminate veneers, also known as “contact lens,” are capable of providing an extremely faithful reproduction of the natural teeth with great color stability and periodontal biocompatibility. Minimal or no preparation veneers are heavily advertised as the answer to our patients’ cosmetic needs, which they can be if they are used correctly in the appropriate case. This report is about ultraconservative restorations to achieve functional and aesthetic rehabilitation through treatment planning. Thus, clinicians should be aware that the preparation for laminate veneers remains within enamel, to ensure the bond strength and avoid or minimize the occurrence of postoperative sensitivity.

  9. Application of osteopathic manipulative technique in the treatment of back pain during pregnancy.

    Science.gov (United States)

    Majchrzycki, Marian; Wolski, Hubert; Seremak-Mrozikiewicz, Agnieszka; Lipiec, Joanna; Marszałek, Sławomir; Mrozikiewicz, Przemysław M; Klejewski, Andrzej; Lisiński, Przemyslaw

    2015-03-01

    Changes in body posture, musculoskeletal disorders and somatic dysfunctions are frequently observed during pregnancy especially ligament, joint and myofascial impairment. The aim of the paper is to present the use of osteopathic manipulative treatment (OMT) for back and pelvic pain in pregnancy on the basis of a review of the available literature. MEDLINE and Cochrane Library were searched in January 2014 for relevant reports, randomized controlled trials, clinical and case studies of OMT use in pregnant women. Each eligible source was verified and analyzed by two independent reviewers. OMT procedures appear to be effective and safe for pelvic and spinal pain management in the lumbosacral area in pregnant women.

  10. [Successful treatment of a cervical heterotopic pregnancy following an in vitro fertilization procedure].

    Science.gov (United States)

    Elena, Hernán E; Elena, Alfredo F; Miola, Anselmo; Glujovsky, Demian; Sueldo, Carlos E

    2016-01-01

    A 37-year-old nulligravida infertile female had a cervical heterotopic pregnancy following an in vitro fertilization procedure. Early intervention on the 6th week of gestation with a manual vacuum aspirator reached to remove the cervical pregnancy. Ligation of the descending cervical branches of the uterine arteries and a cervical cerclage, were placed before the aspiration, for prevention of possible hemorrhage. Successful removal of the cervical pregnancy was achieved with only mild bleeding. An intrauterine pregnancy progressed to viability without complications, resulting in a vaginal delivery of a preterm live-birth at 35.4 weeks, of a male that weighted 2740 g.

  11. Antegrade bowel intussusception after remote Whipple and Puestow procedures for treatment of pancreas divisum

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    To date, antegrade intussusception involving a Roux-en-Y reconstruction has been reported only once. We report a case of acute bowel obstruction due to an intussusception involving two Roux-en-Y limbs in a 40-year-old woman with a history of chronic pancreatitis due to pancreas divisum. Four years preceding this event, the patient had undergone a Whipple procedure, and three years prior to that, a Puestow operation. The patient was successfully treated with bowel resection and a side-to-side anastomosis between the most distal aspect of the bowel and the most distal Roux-en-Y reconstruction, which preserved both Roux-en-Y reconstructions.

  12. A Comparative Study of Two Techniques of Cryotherapy in the Treatment of Seborrheic Kreatosis

    Directory of Open Access Journals (Sweden)

    Meltem Uslu

    2008-09-01

    Full Text Available Objective: Seborrheic keratosis is a benign epidermal tumour that is generally pigmented and develop from the proliferation of epidermal keratinocytes. In this study, two different techniques, spray or probe applications used cryotherapy during the treatment of seborrheic keratosis were compared in terms of efficiency and undesired effects. By this way, it is aimed to find the most suitable technique in seborrheic keratosis treatment. Method: Eighty lesions were included in the study with the diagnosis of seborrheic keratosis. These 80 lesions were divided randomly into two groups of 40; to one of which spray cryotherapy to the second cryotherapy with probe were applied. If clinical improvement were seen treatment was accepted as successful. The patiens were evaluated 2 and 4 months after the therapy for the comparison of two treatment. The patients in both groups scored their pain from 1 to 10 during the cryotherapy.Results: In the study, great success was achieved in the treatment of seborrheic keratosis by using different cryotherapy methods. All the patients in both groups were diagnosed with hipopigmentation. They were found to continue hipopigmentation in the second and fourth months. It was found that the intensity of the pain which those in the probe cryotherapy group suffered was significantly greater statistically.Conclusion: It was concluded that spray cryotherapy should be preferred since it was less painful and required less equipment than probe cryotherapy.

  13. Determining quantitative road safety targets by applying statistical prediction techniques and a multi-stage adjustment procedure.

    Science.gov (United States)

    Wittenberg, P; Sever, K; Knoth, S; Sahin, N; Bondarenko, J

    2013-01-01

    Due to substantial progress made in road safety in the last ten years, the European Union (EU) renewed the ambitious agreement of halving the number of persons killed on the roads within the next decade. In this paper we develop a method that aims at finding an optimal target for each nation, in terms of being as achievable as possible, and with the cumulative EU target being reached. Targets as an important component in road safety policy are given as reduction rate or as absolute number of road traffic deaths. Determination of these quantitative road safety targets (QRST) is done by a top-down approach, formalized in a multi-stage adjustment procedure. Different QRST are derived under consideration of recent research. The paper presents a method to break the national target further down to regional targets in case of the German Federal States. Generalized linear models are fitted to data in the period 1991-2010. Our model selection procedure chooses various models for the EU and solely log-linear models for the German Federal States. If the proposed targets for the EU Member States are attained, the sum of fatalities should not exceed the total value of 15,465 per year by 2020. Both, the mean level and the range of mortality rates within the EU could be lowered from 28-113 in 2010 to 17-41 per million inhabitants in 2020. This study provides an alternative to the determination of safety targets by political commitments only, taking the history of road fatalities trends and population into consideration.

  14. Extremities--indications and techniques for treatment of extremity vascular injuries.

    Science.gov (United States)

    Doody, O; Given, M F; Lyon, S M

    2008-11-01

    Traumatic vascular injuries involving the extremity are rare and penetrating trauma accounts for the majority of such injuries. The remaining arterial injuries are as a result of either blunt or iatrogenic injuries. The rapid detection, localisation and characterisation of vascular injuries in patients who have a traumatic extremity injury is essential for the effective management and treatment of such injuries. This review will discuss the expanding role of multi-detector computed tomography angiography in diagnosing vascular injuries and its implications on conventional diagnostic angiography. The roles of other non-invasive imaging modalities are reviewed. The presentation and types of vascular injuries in blunt and penetrating injuries are discussed. While surgery remains the gold standard in the management of vascular extremity injuries it has significant morbidity rates. Endovascular techniques are increasingly being used for the treatment of vascular traumatic injuries and various techniques including balloon occlusion, embolisation and stent/stent graft placement are discussed.

  15. [Combined endoscopic-laparoscopic techniques for one-stage treatment of concomitant cholelithiasis and choledocholithiasis].

    Science.gov (United States)

    Wu, Junzheng; Xu, Xiaofei; Liu, Hao; Li, Guoxin

    2013-11-01

    To assess the clinical effects of combined endoscopic-laparoscopic technique for one-stage treatment of cholelithiasis with concomitant choledocholithiasis. A retrospective analysis was conducted of the clinical data of 30 patients (Group A) with cholelithiasis and choledocholithiasis receiving one-stage laparoscopic cholecystectomy (LC) combined with intraoperative encoscopic retrograde cholangio-pancreatography (ERCP) and 32 patients (Group B) receiving LC combined with 1aparoscopic common bile duct exploration. The operative time, blood loss, conversion to open surgery rate, time to postoperative ambulation, calculi residual rate, hospitalization cost and length of hospital stay were analyzed comparatively. There were statistically differences between the two groups in hospitalization cost and length of hospital stay (P0.05). Combined endoscopic-laparoscopic techniques can be a safe and feasible option for one-stage treatment of concomitant cholelithiasis and choledocholithiasis to allow rapid postoperative recovery with a shortened hospital stay.

  16. Congenital pseudoarthrosis of the tibia – results of treatment by free fibular transfer and associated procedures – preliminary study.

    Science.gov (United States)

    Iamaguchi, Raquel B; Fucs, Patricia M M B; Carlos da Costa, Antonio; Chakkour, Ivan; Gomes, Mogar D

    2011-09-01

    We evaluated 16 children with congenital pseudoarthrosis of the tibia treated with contralateral fibular graft, with the aim to report the difficulties and clinical results in the affected limb after consolidation. Sixty-three percent of the children had characteristics of neurofibromatosis. Consolidation was achieved after the main surgery in 37%of patients, and the remainder, after multiple procedures. Consolidation time was longer for male patients. Refracture was observed in six patients and recurrence of the anterior bowing in six; four of these patients were submitted to correction. Four patients presented femur overgrowth. The average shortening of the affected leg was 3.6 cm. The proposed procedure leads to a long treatment course with many reoperations for correction of possible complications.

  17. Investigating VMAT planning technique to reduce rectal and bladder dose in prostate cancer treatment plans

    Directory of Open Access Journals (Sweden)

    Suresh B Rana

    2013-01-01

    Full Text Available Background: RapidArc is a volumetric modulated arc therapy (VMAT technique that can deliver conformal dose distribution to the target while minimizing dose to critical structures. The main purpose of this study was to compare dosimetric quality of full double arc (full DA, full single arc (full SA, and partial double arc (partial DA techniques in RapidArc planning of prostate cancer. Materials and Methods: Twelve cases of prostate cancer involving seminal vesicles were selected for this retrospective study. For each case, RapidArc plans were created using full DA (two full arcs, full SA (one full arc, and partial DA (two partial arcs with anterior and posterior avoidance sectors techniques. For planning target volume (PTV, the maximum and mean doses, conformity, and inhomogeneity indices were evaluated. For bladder and rectum, volumes that received 70, 50, 40, and 20 Gy (V 70Gy , V 50Gy , V 40Gy and V 20Gy , respectively, and mean dose were compared. For femoral heads, V 40Gy , V 20Gy , and mean dose were evaluated. Additionally, an integral dose and monitor units (MUs were compared for each treatment plan. Results: In comparison to full DA and full SA techniques, the partial DA technique was better in sparing of rectum and bladder but delivered higher femoral head dose, which was nonetheless within the planning criteria. No clear dosimetric differences were found between full DA and partial DA plans for dose conformity and target homogeneity. The number of MUs and integral dose were largest with the partial DA technique and lowest with the full SA technique. Conclusion: The partial DA technique provides an alternative RapidArc planning approach for low risk prostate cancer.

  18. An indirect veneer technique for simple and esthetic treatment of anterior hypoplastic teeth

    Directory of Open Access Journals (Sweden)

    Amit Khatri

    2010-01-01

    Full Text Available This study describes a technique for treating anterior hypoplastic teeth using indirect nanocomposite veneer restoration. The prime advantage of an indirect veneer technique is that it provides an esthetic and conservative result. One of the most frequent reasons that patients seek dental care is discolored anterior teeth. Although treatment options such as removal of surface stains, bleaching, microabrasion or macroabrasion, veneering, and placement of porcelain crowns are available, conservative approach such as veneer preserves the natural tooth as much as possible. Full veneers are recommended for the restoration of localized defects or areas of intrinsic discoloration, which are caused by deeper internal stains or enamel defects. Indirectly fabricated veneers are much less sensitive compared to a operator′s technique and if multiple teeth are to be veneered, indirect veneers can be usually placed much more expeditiously. Indirect veneers last much longer than the direct veneers. Therefore, indirectly fabricated veneers are more advantageous than directly fabricated veneers in many cases.

  19. Treatment of failed Sauvé-Kapandji procedures with a spherical ulnar head prosthesis.

    Science.gov (United States)

    Fernandez, Diego L; Joneschild, Elizabeth S; Abella, Diego M

    2006-04-01

    Radioulnar convergence is a painful complication after a Sauvé-Kapandji procedure, with a reported incidence of 13% to 39%. We evaluated 10 patients with painful radioulnar convergence treated with a spherical ulnar head prosthesis proximal to the radioulnar fusion mass. At a mean follow-up of 2.6 years, patients were evaluated clinically and radiographically to determine whether an ulnar head replacement could restore forearm stability, prevent radioulnar convergence, and reduce pain. Postoperatively, no patient had subjective complaints of radioulnar convergence or clinical signs of distal ulnar instability. Pain had improved in all patients. Grip strength, expressed as a percentage of the uninjured hand, improved on average from 27% to 55%. Range of motion improved in seven patients, worsened in two and remained the same in one. Nine of 10 patients returned to their previous occupation with an average working capacity of 76%. The prosthesis was stable radiographically in all patients. Complications included two fractures of the radioulnar fusion mass and the development of painful periprosthetic calcifications in one patient. Placement of a spherical ulnar head prosthesis after a Sauvé-Kapandji procedure provides adequate early results for patients with painful radioulnar convergence. Therapeutic study, level IV (case series).

  20. BRIEF REVIEW ON DIAGNOSTIC TECHNIQUE AND NOVEL MOLECULES IN CLINICAL TRIALS FOR TREATMENT OF BREAST CANCER

    Directory of Open Access Journals (Sweden)

    VISHAL KUMAR S. MODI

    2015-01-01

    Full Text Available Breast cancer is the most common cancer in women in both developed and undeveloped countries, and the second most frequent cause of cancer deaths after lung cancer. Although there have been many chemotherapeutic agents like 5-fluorouracil, taxol, tamoxifen, doxorubicin, cisplatin, and camptothecin and hormones are used to treat breast cancer. This review focuses on the causes of breast cancer, latest diagnostic techniques and various molecules under clinical trials for the treatment of breast cancer.

  1. Criteria and techniques for three-dimensional treatment planning with pions

    Energy Technology Data Exchange (ETDEWEB)

    Berardo, P.; Zink, S.; Paciotti, M.; Bradbury, J.

    1981-01-01

    The ability to predict a pion dose distribution in a patient is a major objective of the clinical trials at LAMPF. Accurate predictions are essential for evaluation of pion therapy. But accuracy must be in the context of clinical utility. That is, reasonable approximations must be made in calculational methods so that treatment planning can proceed in a timely and efficient manner. A few of the techniques and current developments used to achieve that objective are presented here.

  2. Endoscopic treatment of complete bladder neck obstruction by transurethral Seldinger technique.

    Science.gov (United States)

    Aygün, C; Peskircioglu, L; Tekin, M I; Dirim, A; Ozkardes, H

    2001-08-01

    Bladder neck contracture is usually a complication of prostatectomy and the treatment of choice in such a condition should be endoscopic surgery. However, in a few patients the bladder neck may be completely obstructed preventing retrograde access into the bladder. A case is presented of complete bladder neck obstruction occurring after transurethral resection of prostate, which was treated after an access was provided by using transurethral Seldinger technique.

  3. A single-field integrated boost treatment planning technique for spot scanning proton therapy

    OpenAIRE

    Zhu, Xiaorong Ronald; Poenisch, Falk; LI, Heng; Zhang, Xiaodong; Sahoo, Narayan; Richard Y. Wu; Li, Xiaoqiang; Lee, Andrew K.; Chang, Eric L.; Choi, Seungtaek; Pugh, Thomas; Steven J. Frank; Gillin, Michael T.; Mahajan, Anita; Grosshans, David R.

    2014-01-01

    Purpose Intensity modulated proton therapy (IMPT) plans are normally generated utilizing multiple field optimization (MFO) techniques. Similar to photon based IMRT, MFO allows for the utilization of a simultaneous integrated boost in which multiple target volumes are treated to discrete doses simultaneously, potentially improving plan quality and streamlining quality assurance and treatment delivery. However, MFO may render plans more sensitive to the physical uncertainties inherent to partic...

  4. Bristow-Latarjet Technique in the Treatment of Anterior Shoulder Instability.

    Directory of Open Access Journals (Sweden)

    Isidro Jiménez

    2016-02-01

    Full Text Available Objetives In the treatment of anterior shoulder instability there are have been described many surgical techniques, all of them with advantages and disadvantages. Our goal is to study the half term results on patients that underwent open Bristow-Latarjet surgery considering the preoperative ISIS value. Method This is a retrospective study of 33 patients that underwent open Bristow-Latarjet surgery in our center between 2005 and 2012. Average age of 33 (21-68 years and follow up of 6 (2-9 years. Results were taken by Rowe and Constant scores, DASH questionnaire and we also recorded a subjective assessment of the result by each patient. Results No recurrence was reported. No reoperations. Mean Rowe score was 74.6 (15-100 points and mean Constant score was 70 (32-98 points. In the disability questionnaire (DASH, the mean value was 22.9 (0-73 points. Seventy-nine percent of patients were satisfied with surgery result. The migration of a screw occurred in one patient Conclusions We believe that Bristow-Latarjet technique is a reliable technique, with few complications and with an low rate of recurrence in treatment of chronic shoulder instability as reported in literature. We believe, therefore, that it should be used as primary surgery in some cases and the preoperative ISIS is an excellent and simple guide to select correctly the surgical technique for each patient.

  5. Entire papilla preservation technique in the regenerative treatment of deep intrabony defects: 1-Year results.

    Science.gov (United States)

    Aslan, Serhat; Buduneli, Nurcan; Cortellini, Pierpaolo

    2017-09-01

    This study evaluates the clinical outcomes of a novel tunnel-like surgical technique in the treatment of isolated deep intrabony defects. Twelve patients presenting with at least one isolated deep intrabony defect received regenerative periodontal treatment with "entire papilla preservation (EPP)" technique. Access to the intrabony defect for debridement was provided by a bevelled vertical releasing incision positioned in the buccal gingiva of the neighbouring inter-dental space. Following the elevation of a buccal flap, an inter-dental tunnel was prepared undermining the defect-associated papilla. Granulation tissue was removed, root surfaces were carefully debrided and bone substitutes and enamel matrix derivative were applied. Microsurgical suturing technique was used for optimal wound closure. Early healing was uneventful in all cases, and 100% wound closure was maintained during the entire healing period. At 1-year, there was significant attachment gain of 6.83±2.51 mm (p<0.001). The 7±2.8 mm reduction in probing depth was also significant (p<0.001), which was associated with minimal increase in gingival recession (0.16±0.38 mm, p=0.166). Tunnel-like "EPP" technique may limit the risk of wound failure particularly in the early healing phase, thereby preventing exposure of regenerative biomaterials, possibly enhancing stabilization of blood clot in deep intrabony defects and leading to optimal clinical outcomes. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  6. Treatment of alumina refinery waste (red mud) through neutralization techniques: A review.

    Science.gov (United States)

    Rai, Suchita; Wasewar, K L; Agnihotri, A

    2017-06-01

    In the Bayer process of extraction of alumina from bauxite, the insoluble product generated after bauxite digestion with sodium hydroxide at elevated temperature and pressure is known as 'red mud' or 'bauxite residue'. This alumina refinery waste is highly alkaline in nature with a pH of 10.5-12.5 and is conventionally disposed of in mostly clay-lined land-based impoundments. The alkaline constituents in the red mud impose severe and alarming environmental problems, such as soil and air pollution. Keeping in view sustainable re-vegetation and residue management, neutralization/treatment of red mud using different techniques is the only alternative to make the bauxite residue environmentally benign. Hence, neutralization techniques, such as using mineral acids, acidic waste (pickling liquor waste), coal dust, superphosphate and gypsum as amenders, CO2, sintering with silicate material and seawater for treatment of red mud have been studied in detail. This paper is based upon and emphasizes the experimental work carried out for all the neutralization techniques along with a comprehensive review of each of the processes. The scope, applicability, limitations and feasibility of these processes have been compared exhaustively. Merits and demerits have been discussed using flow diagrams. All the techniques described are technically feasible, wherein findings obtained with seawater neutralization can be set as a benchmark for future work. Further studies should be focused on exploring the economical viability of these processes for better waste management and disposal of red mud.

  7. Dual-wavelength photoacoustic technique for monitoring tissue status during thermal treatments

    Science.gov (United States)

    Hsiao, Yi-Sing; Wang, Xueding; Deng, Cheri X.

    2013-06-01

    Photoacoustic (PA) techniques have been exploited for monitoring thermal treatments. However, PA signals depend not only on tissue temperature but also on tissue optical properties which indicate tissue status (e.g., native or coagulated). The changes in temperature and tissue status often occur simultaneously during thermal treatments, so both effects cause changes to PA signals. A new dual-wavelength PA technique to monitor tissue status independent of temperature is performed. By dividing the PA signal intensities obtained at two wavelengths at the same temperature, a ratio, which only depends on tissue optical properties, is obtained. Experiments were performed with two experimental groups, one with untreated tissue samples and the other with high-intensity focused ultrasound treated tissue samples including thermal coagulated lesion, using ex vivo porcine myocardium specimens to test the technique. The ratio of PA signal intensities obtained at 700 and 800 nm was constant for both groups from 25 to 43°C, but with distinct values for the two groups. Tissue alteration during thermal treatment was then studied using water bath heating of tissue samples from 35 to 60°C. We found that the ratio stayed constant before it exhibited a marked increase at around 55°C, indicating tissue changes at this temperature.

  8. Liver hydatidosis: reasoned indications of surgical treatment. Comparison between conservative and radical techniques Retrospective study.

    Science.gov (United States)

    Salamone, Giuseppe; Tutino, Roberta; Atzeni, Jenny; Licari, Leo; Falco, Nicola; Orlando, Giuseppina; Gulotta, Gaspare

    2014-01-01

    Liver hydatidosis is a focal benign parasitic disease that still cause high rate of morbidity particularly in the Mediterranean area. A retrospective study comparing conservative and radical techniques in a General and Urgent Surgery operative unit was carried out in order to find signs of its surgical treatment. A total of 50 patients, 24 men and 26 women, who experienced a surgical treatment from 2000 to 2011, participated, and through the Fisher's Exact Test characteristics of the cysts, post-operative complications and relapse were compared. As a result, 29 patients undertook conservative surgery, while 21 radical surgery. There was a relationship between characteristics of the cysts and the technique chosen, (pcase (p<0.14). In conclusion, in a non hepato-bilio-pancreatic center a radical surgery including liver resection is suggested for left lobe's cysts, while a conservative technique tends to be more effective for right lobe's cysts mainly if complex. Consequently, patients with complicated presentation could explain why conservative treatment causes higher rate of morbidity.

  9. Investigations into the Optimization of Multi-Source Strength Brachytherapy Treatment Procedures

    CERN Document Server

    Henderson, D L; Yoo, S

    2002-01-01

    The goal of this project is to investigate the use of multi-strength and multi-specie radioactive sources in permanent prostate implant brachytherapy. In order to fulfill the requirement for an optimal dose distribution, the prescribed dose should be delivered to the target in a nearly uniform dose distribution while simultaneously sparing sensitive structures. The treatment plan should use a small number of needles and sources while satisfying the treatment requirements. The hypothesis for the use of multi-strength and/or multi-specie sources is that a better treatment plan using fewer sources and needles could be obtained than by treatment plans using single-strength sources could reduce the overall number of sources used for treatment. We employ a recently developed greedy algorithm based on the adjoint concept as the optimization search engine. The algorithm utilizes and ''adjoint ratio'', which provides a means of ranking source positions, as the pseudo-objective function. It ha s been shown that the gre...

  10. Endoscopy-assisted surgery for the management of benign breast tumors: technique, learning curve, and patient-reported outcome from preliminary 323 procedures.

    Science.gov (United States)

    Lai, Hung-Wen; Lin, Hui-Yu; Chen, Shu-Ling; Chen, Shou-Tung; Chen, Dar-Ren; Kuo, Shou-Jen

    2017-01-11

    Endoscopy-assisted breast surgery (EABS), a technique that optimizes cosmetic outcome because it is performed through small wounds hidden in inconspicuous areas, could be an alternative surgical technique for benign breast tumors. In this study, we report the preliminary results of 323 EABS procedures performed at our institution for the management of benign breast tumors. The medical records of patients who underwent EABS for benign breast lesions during the periods August 2010 to December 2015 were collected from the Changhua Christian Hospital EABS database. Data on clinicopathologic characteristics, type of surgery, hospital stay, and complications were analyzed to determine the effectiveness of the procedure for benign breast tumors. The operating time with the number of procedure performed was analyzed for learning curve evaluation. Patient satisfaction with cosmetic outcome was evaluated with a self-report questionnaire. A total of 323 EABS procedures were performed in 286 patients with benign breast lesions, including 249 (90.5%) patients with unilateral lesions. The mean age was 36 years, the mean tumor size was 2.2 cm, and the mean distance from the nipple to the tumor was 5.2 cm. Most (93.8%, 303/323) of these tumors were excised through a transareolar wound, 2.4% (8/323) through an axillary wound, and 0.3% (1/323) through the infra-mammary fold. Histopathologic analysis revealed that 63.5% (202/318) of the tumors were fibroadenoma-related lesions. The mean operative time was 81.4 min (59~89 min), which was decreased with experience increased. The overall rate of complications was 6.5%, and all were minor and wound-related. Among the 110 patients who participated in the self-report cosmetic outcome evaluation, 85.4% reported being satisfied with the cosmetic result, and almost all were satisfied with breast symmetry. Of the patients interviewed, 92.7% reported that they would choose the same procedure if they had to undergo the operation again. Our

  11. Interventional procedures in the chest.

    Science.gov (United States)

    Vollmer Torrubiano, I; Sánchez González, M

    2016-05-01

    Many thoracic conditions will require an interventional procedure for diagnosis and/or treatment. For this reason, radiologists need to know the indications and the technique for each procedure. In this article, we review the various interventional procedures that radiologists should know and the indications for each procedure. We place special emphasis on the potential differences in the diagnostic results and complications between fine-needle aspiration and biopsy. We also discuss the indications for radiofrequency ablation of lung tumors and review the concepts related to the drainage of pulmonary abscesses. We devote special attention to the management of pleural effusion, covering the indications for thoracocentesis and when to use imaging guidance, and to the protocol for pleural drainage. We also discuss the indications for percutaneous treatment of pericardial effusion and the possible complications of this treatment. Finally, we discuss the interventional management of mediastinal lesions and provide practical advice about how to approach these lesions to avoid serious complications.

  12. Hepatic artery pseudoaneurysm after surgical treatment for pancreatic cancer: Minimally invasive angiographic techniques as the preferred treatment

    Directory of Open Access Journals (Sweden)

    Sucandy Iswanto

    2014-01-01

    Full Text Available Background: Delayed intra-abdominal bleeding related to hepatic artery pseudoaneurysm is a potentially lethal complication after pancreaticoduodenectomy for pancreatic cancer. Locally advanced tumors, which result in vessel erosion or extensive operative skeletonization, may contribute to weakness of the arterial wall. Reoperation is often technically difficult with high rate of mortality; therefore, alternative less invasive options are ideal. Aims: The study was to present an alternative endovascular treatment of a large hepatic artery pseudoaneurysm after pancreatic resection for locally advanced multicystic adenocarcinoma. Materials and Methods: Transcatheteric mesenteric angiography with deployment of detachable coils in the pseudoaneurysm sac was utilized to manage the hepatic artery pseudoaneurysm. Results: Completion angiography confirmed cessation of contrast enhancement in the pseudoaneurysm sac with preservation of normal antegrade hepatic artery flow. Conclusion: Minimally invasive angiographic technique is the preferred treatment for hepatic artery pseudoaneurysm after pancreatic resections.

  13. Intensity modulated radiotherapy (IMRT) for patients of the Brazilian unified health system (SUS): an analysis of 508 treatments two years after the technique implementation

    Energy Technology Data Exchange (ETDEWEB)

    Oliveira, Harley Francisco de; Trevisan, Felipe Amstalden; Bighetti, Viviane Marques; Guimaraes, Flavio da Silva; Amaral, Leonardo Lira; Barbi, Gustavo Lazaro; Borges, Leandro Federiche; Peria, Fernanda Maris, E-mail: harley@fmrp.usp.br [Universidade de Sao Paulo (FMRP/USP), Ribeirao Preto, SP (Brazil). Faculdade de Medicina

    2014-11-15

    Objective: the offering of high-technology radiotherapy to the population assisted by the Brazilian unified health system (SUS) is limited since it is not included in the system’s list of procedures and, many times, because of the insufficient installed capacity and lack of specialized human resources. Thus the access to intensity-modulated radiotherapy (IMRT) is restricted to few centers in Brazil. The present study is aimed at presenting the characteristics of the first 508 cases treated with IMRT during the first years after the technique implementation in a university hospital. Materials and methods: the first consecutive 508 cases of IMRT treatment completed in the period from May/2011 to September/2013 were reviewed. Static multi leaf was the technique employed. Results: amongst 4,233 treated patients, 12.5% were submitted to IMRT. Main indications for the treatment included cancers located in the skull, head and neck and prostate. Intensity modulated radiotherapy was utilized in about 30% of cranial and 50% of prostate treatments. Treatment toxicity was observed in 4% of the patients. Conclusion: because of restricted access to radiotherapy in addition to lack of coverage for the procedure, IMRT indications for SUS patients should be based on institutional clinical protocols, with special attention to the reduction of toxicity. (author)

  14. [The new treatment procedure of the German statutory accident insurance: From the perspective of a community hospital].

    Science.gov (United States)

    Bonnaire, F; Goepel, M; Bula, P

    2016-11-01

    The requirements of the German statutory accident insurance (DGUV) for the new treatment procedure were presented on 1 January 2013 in a new catalogue. The implementation of the certification of hospitals for the very severe injury procedure (SAV) by the DGUV should have been completed by 2014. These requirements placed high demands on trauma-oriented hospitals because of the high structural and personnel prerequisites. The background to the new organization was the wish of the DGUV for quality improvement in patient treatment in hospitals for patients with very severe occupational and occupation-related trauma by placement in qualified centers with high case numbers. No increase in income was planned for the hospitals to cope with the necessary improvements in quality. After 2 years of experience with the SAV we can confirm for a community hospital that the structural requirements could be improved (e.g. establishment of departments of neurosurgery, plastic surgery and thoracic surgery) but the high requirements for qualification and attendance of physicians on duty are a continuous problem and are also costly. The numbers of severely injured trauma patients have greatly increased, particularly in 2015. The charges for the complex treatment are not adequately reflected in the German diagnosis-related groups system and no extra flat rate funding per case is explicitly planned in the DRG remuneration catalogue. The invoicing of a center surcharge in addition to the DRG charges has not been introduced.

  15. Evaluation of an ablative and non-ablative laser procedure in the treatment of striae distensae

    Directory of Open Access Journals (Sweden)

    Sule Gungor

    2014-01-01

    Full Text Available Background: Striae distensae or stretch marks are atrophic linear dermal scars with epidermal atrophy. There are many therapeutic options for management, but no consistently effective modality is available yet. Objective: We compared the efficacy of 1064 nm long pulse (LP Nd: YAG laser and 2940 nm variable square pulse (VSP erbium: YAG laser in the treatment of striae distensae. Methods: Twenty female volunteers (Fitzpatrick skin types II-V aged between 20 and 40 years with striae (3 patients with the rubra type and 17 with the alba type were enrolled in the study. The duration of striae ranged from 4 months to 12 years. Lesions were located on the abdomen in all patients except one patient who had striae on the arms and two patients with striae in the lumbar region. Treatments were randomly allocated to both sides of the body in each patient, one side being treated with VSP erbium: YAG laser and the opposite side with LP Nd: YAG laser. All subjects were treated monthly for a total of three treatments. Two 3-mm punch biopsies were obtained from six subjects, both of the same striae, one before the first treatment and one 4 weeks after the last session. Results: Response was evaluated clinically by photographic comparison and was found to be poor in 17 subjects, both on the LP Nd: YAG laser treated side and VSP erbium YAG laser treated side. All these patients had mature lesions (striae distensae alba. Three subjects had a moderate response on both sides; these patients′ striae were immature (striae distensae rubra. Histologically, elastic fibers were slightly increased in post-treatment samples compared with pretreatment skin biopsies. Conclusion: We observed no satisfactory clinical improvement in striae distensae alba lesions although histopathological changes were seen. We suggest that variable square pulse Er: YAG and long pulse Nd: YAG lasers are not useful in the treatment of striae distensae alba.

  16. Treatment failure following excision therapy of CIN: the impact of direct colposcopic vision during procedure.

    Science.gov (United States)

    Heineman, Mellie; Mancini, Julien; Villeret, Julia; Agostini, Aubert; Houvenaeghel, Gilles; Boubli, Léon; Carcopino, Xavier

    2016-04-01

    To assess whether the use of direct colposcopic vision during excision therapy of cervical intraepithelial neoplasia (CIN) has an impact on the risk of treatment failure. Data from 285 patients who had had excision therapy with proven CIN at specimen histological analysis were reviewed. Primary endpoint was the occurrence of post-treatment failure defined by the histological diagnosis of CIN 2-3 during follow-up. Data were analysed according to the use of colposcopy at the time of initial therapy of CIN. The use of direct colposcopic vision (DCV) resulted in a significant reduction in the mean height (p = 0.008) and diameter (p treatment failure. Compared to excisions performed without any use of colposcopy, DCV was not found to have any significant impact on the risk of treatment failure (HR: 0.58; 95 % CI 0.16-2.13, p = 0.412), neither when compared to excisions performed immediately after colposcopy (HR: 0.91; 95 % CI 0.47-1.79; p = 0.794). The only factors found to have a significant impact on the risk of treatment failure was the identification of clear margins (HR: 0.36; 95 %CI 0.19-0.69; p = 0.002) and the diameter of the surgical specimen (HR: 0.94; 95 %CI 0.89-0.99; p = 0.040). Although the use of DCV during excision therapy of CIN was associated with a significant reduction in the dimensions of the excised cervical specimen, it did not result in a significant change in the risk of treatment failure.

  17. Effects of surface treatments of galvanized steels on projection welding procedure

    Institute of Scientific and Technical Information of China (English)

    王敏; 王宸煜

    2003-01-01

    A group of projection welding experiments and joints tension-shear tests are carried out for cold-rolled steel sheets, galvanized steel sheets (GSS) without treatment, GSS with phosphating and GSS with surface greasing, respectively. The experimental results are regressively analyzed on the computers, then the projection welded joint tension-shear strength curve and the perfect welding currents range of each material are obtained. The results show that surface treatments of galvanized steels have effects on their spot weldabilities. Among the four kinds of materials, GSS with surface greasing have the worst spot weldability, for they need higher welding current and have a narrow welding current range.

  18. A procedure for estimating Bacillus cereus spores in soil and stream-sediment samples - A potential exploration technique

    Science.gov (United States)

    Watterson, J.R.

    1985-01-01

    The presence of bacterial spores of the Bacillus cereus group in soils and stream sediments appears to be a sensitive indicator of several types of concealed mineral deposits, including vein-type gold deposits. The B. cereus assay is rapid, inexpensive, and inherently reproducible. The test, currently under investigation for its potential in mineral exploration, is recommended for use on a research basis. Among the aerobic spore-forming bacilli, only B. cereus and closely related strains produce an opaque zone in egg-yolk emulsion agar. This characteristic, also known as the Nagler of lecitho-vitellin reaction, has long been used to rapidly indentify and estimate presumptive B. cereus. The test is here adapted to permit rapid estimation of B. cereus spores in soil and stream-sediment samples. Relative standard deviation was 10.3% on counts obtained from two 40-replicate pour-plate determinations. As many as 40 samples per day can be processed. Enough procedural detail is included to permit investigation of the test in conventional geochemical laboratories using standard microbiological safety precautions. ?? 1985.

  19. Successful treatment for acute aortic dissection in pregnancy---bentall procedure concomitant with cesarean section

    Directory of Open Access Journals (Sweden)

    Xu Demin

    2011-10-01

    Full Text Available Abstract Acute aortic type A dissection is a life-threatening disease that requires immediate surgical intervention. When dissection occurs during pregnancy, it is of high risk for both the mother and the fetus. In this study, we reported two cases of acute aortic dissection in late pregnancy at 28 weeks and 32 weeks of gestation respectively. After the two patients underwent a cesarean section and delivered a baby, we performed composite graft replacement of the aortic valve, aortic root and ascending aorta, with re-implantation of the coronary arteries into the graft (Bentall procedure instead of repairing the arch with deep hypothermia and circulation arrest. Both mothers and children survived and recovered well.

  20. A Hybrid IMRT/VMAT Technique for the Treatment of Nasopharyngeal Cancer

    Directory of Open Access Journals (Sweden)

    Nan Zhao

    2015-01-01

    Full Text Available Hybrid IMRT/VMAT technique which combined intensity modulated radiotherapy (IMRT and volumetric modulated arc therapy (VMAT was developed for the treatment of nasopharyngeal cancer (NPC. Two-full-arc VMAT (2ARC-VMAT, 9-field IMRT (9F-IMRT, and Hybrid IMRT/VMAT plans for NPC were compared in terms of the dosimetric quality, sparing of organs at risk (OARs, and delivery efficiency. The Hybrid IMRT/VMAT technique can improve the target dose homogeneity and conformity compared with 9F-IMRT and 2ARC-VMAT. It can reduce the dose delivered to the TMJ, mandible, temporal lobe, and unspecified tissue with fewer MUs compared with 9F-IMRT and dose delivered to parotids, brainstem, and spinal cord compared with 2ARC-VMAT technique. The mean delivery time of Hybrid plans was shorter than that of 9F-IMRT plans (408 s versus 812 s; P=0.00 and longer than that of 2ARC-VMAT plans (408 s versus 179 s; P=0.00. Hybrid IMRT/VMAT technique could be a viable radiotherapy technique with better plan quality.

  1. A hybrid IMRT/VMAT technique for the treatment of nasopharyngeal cancer.

    Science.gov (United States)

    Zhao, Nan; Yang, Ruijie; Jiang, Yuliang; Tian, Suqing; Guo, Fuxin; Wang, Junjie

    2015-01-01

    Hybrid IMRT/VMAT technique which combined intensity modulated radiotherapy (IMRT) and volumetric modulated arc therapy (VMAT) was developed for the treatment of nasopharyngeal cancer (NPC). Two-full-arc VMAT (2ARC-VMAT), 9-field IMRT (9F-IMRT), and Hybrid IMRT/VMAT plans for NPC were compared in terms of the dosimetric quality, sparing of organs at risk (OARs), and delivery efficiency. The Hybrid IMRT/VMAT technique can improve the target dose homogeneity and conformity compared with 9F-IMRT and 2ARC-VMAT. It can reduce the dose delivered to the TMJ, mandible, temporal lobe, and unspecified tissue with fewer MUs compared with 9F-IMRT and dose delivered to parotids, brainstem, and spinal cord compared with 2ARC-VMAT technique. The mean delivery time of Hybrid plans was shorter than that of 9F-IMRT plans (408 s versus 812 s; P=0.00) and longer than that of 2ARC-VMAT plans (408 s versus 179 s; P=0.00). Hybrid IMRT/VMAT technique could be a viable radiotherapy technique with better plan quality.

  2. A Hybrid IMRT/VMAT Technique for the Treatment of Nasopharyngeal Cancer

    Science.gov (United States)

    Zhao, Nan; Yang, Ruijie; Jiang, Yuliang; Tian, Suqing; Guo, Fuxin; Wang, Junjie

    2015-01-01

    Hybrid IMRT/VMAT technique which combined intensity modulated radiotherapy (IMRT) and volumetric modulated arc therapy (VMAT) was developed for the treatment of nasopharyngeal cancer (NPC). Two-full-arc VMAT (2ARC-VMAT), 9-field IMRT (9F-IMRT), and Hybrid IMRT/VMAT plans for NPC were compared in terms of the dosimetric quality, sparing of organs at risk (OARs), and delivery efficiency. The Hybrid IMRT/VMAT technique can improve the target dose homogeneity and conformity compared with 9F-IMRT and 2ARC-VMAT. It can reduce the dose delivered to the TMJ, mandible, temporal lobe, and unspecified tissue with fewer MUs compared with 9F-IMRT and dose delivered to parotids, brainstem, and spinal cord compared with 2ARC-VMAT technique. The mean delivery time of Hybrid plans was shorter than that of 9F-IMRT plans (408 s versus 812 s; P = 0.00) and longer than that of 2ARC-VMAT plans (408 s versus 179 s; P = 0.00). Hybrid IMRT/VMAT technique could be a viable radiotherapy technique with better plan quality. PMID:25688371

  3. Comparison of the pain levels of computer-controlled and conventional anesthesia techniques in prosthodontic treatment

    Directory of Open Access Journals (Sweden)

    Murat Yenisey

    2009-10-01

    Full Text Available OBJECTIVE: The objective of this study was to compare the pain levels on opposite sides of the maxilla at needle insertion during delivery of local anesthetic solution and tooth preparation for both conventional and anterior middle superior alveolar (AMSA technique with the Wand computer-controlled local anesthesia application. MATERIAL AND METHODS: Pain scores of 16 patients were evaluated with a 5-point verbal rating scale (VRS and data were analyzed nonparametrically. Pain differences at needle insertion, during delivery of local anesthetic, and at tooth preparation, for conventional versus the Wand technique, were analyzed using the Mann-Whitney U test (p=0.01. RESULTS: The Wand technique had a lower pain level compared to conventional injection for needle insertion (p0.05. CONCLUSIONS: The AMSA technique using the Wand is recommended for prosthodontic treatment because it reduces pain during needle insertion and during delivery of local anaesthetic. However, these two techniques have the same pain levels for tooth preparation.

  4. Application of Self Nulling Eddy Current Probe Technique to the Detection of Fatigue Crack Initiation and Control of Test Procedures

    Science.gov (United States)

    Namkung, M.; Nath, S.; Wincheski, B.; Fulton, J. P.

    1994-01-01

    A major part of fracture mechanics is concerned with studying the initiation and propagation of fatigue cracks. This typically requires constant monitoring of crack growth during fatigue cycles and the knowledge of the precise location of the crack tip at any given time. One technique currently available for measuring fatigue crack length is the Potential Drop method. The method, however, may be inaccurate if the direction of crack growth deviates considerably from what was assumed initially or the curvature of the crack becomes significant. Another popular approach is to optically view the crack using a high magnification microscope, but this entails a person constantly monitoring it. The present proposed technique uses an automated scheme, in order to eliminate the need for a person to constantly monitor the experiment. Another technique under development elsewhere is to digitize an optical image of the test specimen surface and then apply a pattern recognition algorithm to locate the crack tip. A previous publication showed that the self nulling eddy current probe successfully tracked a simulated crack in an aluminum sample. This was the impetus to develop an online real time crack monitoring system. An automated system has been developed which includes a two axis scanner mounted on the tensile testing machine, the probe and its instrumentation and a personal computer (PC) to communicate and control all the parameters. The system software controls the testing parameters as well as monitoring the fatigue crack as it propagates. This paper will discuss the experimental setup in detail and demonstrate its capabilities. A three dimensional finite element model is utilized to model the magnetic field distribution due to the probe and how the probe voltage changes as it scans the crack. Experimental data of the probe for different samples under zero load, static load and high cycle fatigue load will be discussed. The final section summarizes the major accomplishments

  5. The optimization of essential oils supercritical CO2 extraction from Lavandula hybrida through static-dynamic steps procedure and semi-continuous technique using response surface method.

    Science.gov (United States)

    Kamali, Hossein; Aminimoghadamfarouj, Noushin; Golmakani, Ebrahim; Nematollahi, Alireza

    2015-01-01

    The aim of this study was to examine and evaluate crucial variables in essential oils extraction process from Lavandula hybrida through static-dynamic and semi-continuous techniques using response surface method. Essential oil components were extracted from Lavandula hybrida (Lavandin) flowers using supercritical carbon dioxide via static-dynamic steps (SDS) procedure, and semi-continuous (SC) technique. Using response surface method the optimum extraction yield (4.768%) was obtained via SDS at 108.7 bar, 48.5°C, 120 min (static: 8×15), 24 min (dynamic: 8×3 min) in contrast to the 4.620% extraction yield for the SC at 111.6 bar, 49.2°C, 14 min (static), 121.1 min (dynamic). The results indicated that a substantial reduction (81.56%) solvent usage (kg CO2/g oil) is observed in the SDS method versus the conventional SC method.

  6. [Application of molecular diagnostic techniques in precision medicine of personalized treatment for colorectal cancer].

    Science.gov (United States)

    Fu, Ji; Lin, Guole

    2016-01-01

    Precision medicine is to customize the treatment options for individual patient based on the personal genome information. Colorectal cancer (CRC) is one of the most common cancer worldwide. Molecular heterogeneity of CRC, which includes the MSI phenotype, hypermutation phenotype, and their relationship with clinical preferences, is believed to be one of the main factors responsible for the considerable variability in treatment response. The development of powerful next-generation sequencing (NGS) technologies allows us to further understand the biological behavior of colorectal cancer, and to analyze the prognosis and chemotherapeutic drug reactions by molecular diagnostic techniques, which can guide the clinical treatment. This paper will introduce the new findings in this field. Meanwhile we integrate the new progress of key pathways including EGFR, RAS, PI3K/AKT and VEGF, and the experience in selective patients through associated molecular diagnostic screening who gain better efficacy after target therapy. The technique for detecting circulating tumor DNA (ctDNA) is introduced here as well, which can identify patients with high risk for recurrence, and demonstrate the risk of chemotherapy resistance. Mechanism of tumor drug resistance may be revealed by dynamic observation of gene alteration during treatment.

  7. Treatment of Multiply Controlled Problem Behavior with Procedural Variations of Differential Reinforcement

    Science.gov (United States)

    Neidert, Pamela L.; Iwata, Brian A.; Dozier, Claudia L.

    2005-01-01

    We describe the assessment and treatment of 2 children with autism spectrum disorder whose problem behaviors (self-injury, aggression, and disruption) were multiply controlled. Results of functional analyses indicated that the children's problem behaviors were maintained by both positive reinforcement (attention) and negative reinforcement (escape…

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

    Science.gov (United States)

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

    2017-02-28

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

  9. [Bacteriospermia in Assisted Reproductive Techniques: effects of bacteria on spermatozoa and seminal plasma, diagnosis and treatment].

    Science.gov (United States)

    Boitrelle, F; Robin, G; Lefebvre, C; Bailly, M; Selva, J; Courcol, R; Lornage, J; Albert, M

    2012-04-01

    The presence of bacteria in semen could induce impairment of sperm morphology, alteration of sperm function and mechanical or functional obstruction of the seminal tract. The term of bacteriospermia does not signify infection. Bacteriospermia and male accessory gland infection (MAGI) have indeed to be distinguished. They may lead both to male infertility but their diagnosis and treatment options differ. This review summarizes effects of bacteria and leucocytospermia on sperm parameters and functions. Then, indications, benefits and risks of treatment of bacteriospermia and MAGI, in assisted reproductive techniques (ART) will be discussed. For bacteria commonly observed in semen, this review aims at defining some thresholds above which a treatment is required. These thresholds were established according to literature, according to French microbiology society and in function of our usual practice. This review should help practitioners of reproductive medicine to take care of bacteriospermia in semen.

  10. A Modified Stoppa (Technique Approach for Treatment of Pediatric Acetabular Fractures

    Directory of Open Access Journals (Sweden)

    Mehmet Elmadag

    2013-01-01

    Full Text Available Pediatric acetabular fractures are rare, and anterior column fractures are even rarer. Generally, conservative treatment is applied. If there is displacement of more than 2 mm or findings of instability or fragments within the joint, then surgical treatment is applied. Anterior and posterior approaches may be used in surgical treatment. With pediatric patients, even greater care should be taken in the choice of surgery to be performed according to the fracture pattern to avoid postoperative triradiate cartilage damage. Therefore, minimally invasive surgery is more appropriate. We herein present a case of an acetabulum anterior column posterior hemitransverse fracture following a traffic accident, which was treated surgically using a modified Stoppa (technique approach.

  11. Clinical evaluation of a two-incision fistula technique for the treatment of oral ranulas.

    Science.gov (United States)

    Wang, Shaoyi; Zhang, Zhiyuan; Yang, Chi

    2016-01-01

    Oral ranulas are caused by extravasation of mucus from the sublingual glands, and the preferred treatment varies. We have developed a two-incision fistula operation for their treatment, and in this clinical study we have evaluated the efficacy and safety of this approach. Twelve patients with oral ranulas confirmed by fine needle aspiration cytology were enrolled and gave their consent to be treated by our new technique. The clinical outcomes and complications were evaluated during a period that ranged from 8-24 months. Nine ranulas became smaller and gradually disappeared, and there were no complications or injury to Wharton's duct. Three ranulas recurred, but disappeared after a second operation. The two-incision fistula operation can be effective and safe as an initial treatment for oral ranulas, and the method may become the preferred management for retention cysts.

  12. Investigations into the Optimization of Multi-Source Strength Brachytherapy Treatment Procedures

    Energy Technology Data Exchange (ETDEWEB)

    D. L. Henderson; S. Yoo; B.R. Thomadsen

    2002-09-30

    The goal of this project is to investigate the use of multi-strength and multi-specie radioactive sources in permanent prostate implant brachytherapy. In order to fulfill the requirement for an optimal dose distribution, the prescribed dose should be delivered to the target in a nearly uniform dose distribution while simultaneously sparing sensitive structures. The treatment plan should use a small number of needles and sources while satisfying the treatment requirements. The hypothesis for the use of multi-strength and/or multi-specie sources is that a better treatment plan using fewer sources and needles could be obtained than by treatment plans using single-strength sources could reduce the overall number of sources used for treatment. We employ a recently developed greedy algorithm based on the adjoint concept as the optimization search engine. The algorithm utilizes and ''adjoint ratio'', which provides a means of ranking source positions, as the pseudo-objective function. It ha s been shown that the greedy algorithm can solve the optimization problem efficiently and arrives at a clinically acceptable solution in less than 10 seconds. Our study was inclusive, that is there was no combination of sources that clearly stood out from the others and could therefore be considered the preferred set of sources for treatment planning. Source strengths of 0.2 mCi (low), 0.4 mCi (medium), and 0.6 mCi (high) of {sup 125}I in four different combinations were used for the multi-strength source study. The combination of high- and medium-strength sources achieved a more uniform target dose distribution due to few source implants whereas the combination of low-and medium-strength sources achieved better sparing of sensitive tissues including that of the single-strength 0.4 mCi base case. {sup 125}I at 0.4 mCi and {sup 192}Ir at 0.12 mCi and 0.25 mCi source strengths were used for the multi-specie source study. This study also proved inconclusive , Treatment

  13. Diagnostic procedures and treatment of eleven dogs with peritoneal infections caused by Mesocestoides spp.

    Science.gov (United States)

    Crosbie, P R; Boyce, W M; Platzer, E G; Nadler, S A; Kerner, C

    1998-12-01

    An 8-year-old spayed Schnauzer with a distended abdomen was examined because of straining to urinate and suspected urinary tract infection. Abdominal radiography revealed a ground-glass appearance, and ultrasonography revealed numerous cystic structures in the peritoneal cavity. Examination of an aspirate of abdominal fluid revealed tissues consistent with metacestodes. Tissues were definitively identified as Mesocestoides spp on the basis of polymerase chain reaction amplification of restriction fragment length polymorphisms. The dog required several courses of treatment with fenbendazole to eliminate the infection. This was 1 of 11 dogs infected with Mesocestoides metacestodes. Treatment involving the use of praziquantel and albendazole were ineffective, but fenbendazole successfully cleared Mesocestoides infections in 5 of 6 dogs.

  14. Pain treatment after craniotomy: where is the (procedure-specific) evidence? A qualitative systematic review

    DEFF Research Database (Denmark)

    Hansen, M.S; Brennum, Jannick; Moltke, Finn B;

    2011-01-01

    Pain following craniotomy has been demonstrated to be frequent and moderate-to-severe in nature. In recent years, the focus on the challenges in treatment of postoperative pain following craniotomy has increased. Fear of using opioids because of their wide array of side-effects has led to the sea...... to the search for alternative analgesic options. The objective of this systematic review was to evaluate current evidence about analgesic therapy following craniotomy....

  15. [Imaging of the lumbosacral plexus : Diagnostics and treatment planning with high-resolution procedures].

    Science.gov (United States)

    Jengojan, S; Schellen, C; Bodner, G; Kasprian, G

    2017-03-01

    Technical advances in magnetic resonance (MR) and ultrasound-based neurography nowadays facilitate the radiological assessment of the lumbosacral plexus. Anatomy and imaging of the lumbosacral plexus and diagnostics of the most common pathologies. Description of the clinically feasible combination of magnetic resonance imaging (MRI) and ultrasound diagnostics, case-based illustration of imaging techniques and individual advantages of MRI and ultrasound-based diagnostics for various pathologies of the lumbosacral plexus and its peripheral nerves. High-resolution ultrasound-based neurography (HRUS) is particularly valuable for the assessment of superficial structures of the lumbosacral plexus. Depending on the examiner's experience, anatomical variations of the sciatic nerve (e. g. relevant in piriformis syndrome) as well as more subtle variations, for example as seen in neuritis, can be sonographically depicted and assessed. The use of MRI enables the diagnostic evaluation of more deeply located nerve structures, such as the pudendal and the femoral nerves. Modern MRI techniques, such as peripheral nerve tractography allow three-dimensional depiction of the spatial relationship between nerves and local tumors or traumatic alterations. This can be beneficial for further therapy planning. The anatomy and pathology of the lumbosacral plexus can be reliably imaged by the meaningful combination of MRI and ultrasound-based high resolution neurography.

  16. Operating Procedures of the Electrochemotherapy for Treatment of Tumor in Dogs and Cats

    Science.gov (United States)

    Tozon, Natasa; Lampreht Tratar, Ursa; Znidar, Katarina; Sersa, Gregor; Teissie, Justin; Cemazar, Maja

    2016-01-01

    Electrochemotherapy (ECT) is a local approach which is used for treating solid tumors of different histologies. Its mechanism is based on cell membrane permeabilization by means of "electroporation". To achieve the "electroporation" of the cells, electric pulses are generated by a generator and delivered to the target tissue by the use of electrodes. Electroporation is a physical method which is used to introduce molecules, like cytostatic drugs, into the cells that could not pass the cell membrane on their own. In electrochemotherapy, currently, cisplatin and bleomycin are clinically used. Electrochemotherapy antitumor effectiveness is high, for example up to 100% complete response of canine mast cell tumors smaller than 2 cm3 was achieved. Additionally, electrochemotherapy can be used for the treatment of inoperable tumors. One of the important characteristics of electrochemotherapy is that it can be effective as a one-time treatment only. However, in the case of failure or partial tumor response it can be repeated several times with equal or improved effectiveness. Electrochemotherapy is already a standard treatment for cutaneous and subcutaneous tumors of various histologies in human and veterinary oncology. Furthermore, several clinical studies exploiting electrochemotherapy for deep-seated tumors are on-going. PMID:27805594

  17. Technical success, technique efficacy and complications of minimally-invasive imaging-guided percutaneous ablation procedures of breast cancer: A systematic review and meta-analysis.

    Science.gov (United States)

    Mauri, Giovanni; Sconfienza, Luca Maria; Pescatori, Lorenzo Carlo; Fedeli, Maria Paola; Alì, Marco; Di Leo, Giovanni; Sardanelli, Francesco

    2017-08-01

    To systematically review studies concerning imaging-guided minimally-invasive breast cancer treatments. An online database search was performed for English-language articles evaluating percutaneous breast cancer ablation. Pooled data and 95% confidence intervals (CIs) were calculated. Technical success, technique efficacy, minor and major complications were analysed, including ablation technique subgroup analysis and effect of tumour size on outcome. Forty-five studies were analysed, including 1,156 patients and 1,168 lesions. Radiofrequency (n=577; 50%), microwaves (n=78; 7%), laser (n=227; 19%), cryoablation (n=156; 13%) and high-intensity focused ultrasound (HIFU, n=129; 11%) were used. Pooled technical success was 96% (95%CI 94-97%) [laser=98% (95-99%); HIFU=96% (90-98%); radiofrequency=96% (93-97%); cryoablation=95% (90-98%); microwave=93% (81-98%)]. Pooled technique efficacy was 75% (67-81%) [radiofrequency=82% (74-88); cryoablation=75% (51-90); laser=59% (35-79); HIFU=49% (26-74)]. Major complications pooled rate was 6% (4-8). Minor complications pooled rate was 8% (5-13%). Differences between techniques were not significant for technical success (p=0.449), major complications (p=0.181) or minor complications (p=0.762), but significant for technique efficacy (p=0.009). Tumour size did not impact on variables (p>0.142). Imaging-guided percutaneous ablation techniques of breast cancer have a high rate of technical success, while technique efficacy remains suboptimal. Complication rates are relatively low. • Imaging-guided ablation techniques for breast cancer are 96% technically successful. • Overall technique efficacy rate is 75% but largely inhomogeneous among studies. • Overall major and minor complication rates are low (6-8%).

  18. Determination of the ideal sampling technique to reduce repeated procedures:a comparative study including 393 fine-needle aspirations for thyroid nodules.

    Science.gov (United States)

    Uzunkaya, Fatih; Özden, Ahmet

    2017-02-27

    Fine-needle aspiration biopsy is an established method for the evaluation of thyroid nodules, but it has not been standardized worldwide yet. Adequacy of the aspirations is affected by several factors. The aim of this study is to determine the main factors affecting the adequacy and to suggest a procedural technique expected to reduce repeated procedures. A total of 393 aspiration procedures performed using either 22-gauge or 27-gauge needles were included in the study. The samplings were classified as inadequate or adequate according to the cytopathological reports, and results were compared. The rate of adequate samplings was higher in the 27-gauge group and the difference was statistically significant. Neither the size of nodules nor the number of slides used for smearing affected the adequacy. There was not a statistically significant relation between the needle size and the nodule size or the number of slides in terms of adequacy. Needle size is an important factor that affects the adequacy of samplings. The nodule size and the number of slides do not affect the adequacy. However, bloody and thicker smears are difficult for pathologists to evaluate and result in inadequacy.

  19. Current status of full-endoscopic techniques in the surgical treatment of disk herniations and spinal canal stenosis

    Institute of Scientific and Technical Information of China (English)

    Ruetten S; Komp M; Oezdemir S

    2014-01-01

    Degenerative constrictions of the spinal canal with compression of neural elements arise as a result of bony, disk, capsular or ligament structures. The most frequent causes are disk herniations and spinal stenoses. The lumbar and cervical spine is the most prominent cause. After conservative treatments have been exhausted, surgical intervention may be necessary. Today, microsurgical or microscopically-assisted decompression is regarded as the standard procedure for disk herniation and spinal stenosis in the lumbar region, while in the cervical spine, microsurgical or microscopically-assisted anterior decompression and fusion are standard. Both procedures demonstrate good clinical results but present problems associated with the operation. Decompressions in the area of the spine must be carried out under continuous visualization and must entail the possibility of adequate bone resection. Taking this into account, completely new endoscopes and instrument sets has been developed for full-endoscopic operations in tandem with the development of the lateral transforaminal and interlaminar approaches for the lumbar spine and the posterior, contralateral and anterior approaches for the cervical spine. The possibilities and results of comparable and established standard procedures have been used as a benchmark in the course of clinical validation. The development of surgically created approaches and the new rod lens endoscopes combined with appropriate instrument sets have laid the technical foundations for full-endoscopic operation in the lumbar spine on all primary and recurrent disk herniations inside and outside the spinal canal and on spinal stenoses. This development has also permitted resection of soft disk herniations in the cervical spine. The use of the relevant approaches depends on anatomical and pathological inclusion and exclusion criteria. The clinical results of standard procedures are achieved, which must be regarded as a minimum criterion for the

  20. Comparative clinical study of the effect of LLLT in the immediate and late treatments of hypoesthesia due to surgical procedures

    Science.gov (United States)

    Ladalardo, Thereza C.; Brugnera, Aldo, Jr.; Pinheiro, Antonio L. B.; Castanho Garrini, Ana E.; Bologna, Elisangela D.; Takamoto, Marcia; Siqueira, Jose T.; Dias, Pedro; Campos, Roberto A. d. C.

    2002-06-01

    We evaluated the effect of LLLT in 68 patients who presented hypoesthesia due to odontological surgery procedures: dental implant surgeries (N=51); extraction of impacted lower third molars (N=10); endodontics in lower first molars (N=7). Lesions treated within 30 days after the nerve injury had occurred were part of the immediate group, and lesions with more than 30 days from the occurrence of the injury were part of the late group. Treatments were carried out with an infrared diode laser of 40 mW-830nm, continuous wave emission, spot size 3 mm2, and a total dosage of 18 joules per session in a contact mode of application, 20 sessions altogether. The efficacy of laser therapy in peripheral nerve regeneration is also related to the degree of the peripheral nerve lesion, and not only to the lesion duration. LLLT resulted in neurosensory functional improvement in both immediate and late treatments of hypoesthesia.

  1. EXPERIENCE OF THE LATARJET PROCEDURE FOR RECURRENT ANTERIOR SHOULDER DISLOCATION TREATMENT

    Directory of Open Access Journals (Sweden)

    E. A. Belyak

    2014-01-01

    Full Text Available We have the experience of open Latarjet procedures which were perfomed to 18 patients since 2011 to 2014 in the orthopaedic department Moscow city hospital № 12, among them 14 male (77,8% and 4 female (22,2% with anterior shoulder instability. Mean age of the group was 24,3 years. The mean follow-up was 16±4 months (from 6 to 26 months. Mean range of motion increased after 1 year post-op: flexion 178°±2° (from 170° to 180, increased at 2.4°. There was no post-op recurrent dislocation. The patients felt no subluxation or disturbance in operated shoulder. For functional scores, WOSI pre-op was 49,8, one year post-op decreased to 30,3. DASH-score pre-op was 16,5, post-op - 5,2. The results were defined as excellent in 12 patients, good in 6 patients, we had no bad or moderate results. All patients returned to normal life and sport activity.

  2. Optimization Correction Strength Using Contra Bending Technique without Anterior Release Procedure to Achieve Maximum Correction on Severe Adult Idiopathic Scoliosis

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    Ahmad Jabir Rahyussalim

    2016-01-01

    Full Text Available Adult scoliosis is defined as a spinal deformity in a skeletally mature patient with a Cobb angle of more than 10 degrees in the coronal plain. Posterior-only approach with rod and screw corrective manipulation to add strength of contra bending manipulation has correction achievement similar to that obtained by conventional combined anterior release and posterior approach. It also avoids the complications related to the thoracic approach. We reported a case of 25-year-old male adult idiopathic scoliosis with double curve. It consists of main thoracic curve of 150 degrees and lumbar curve of 89 degrees. His curve underwent direct contra bending posterior approach using rod and screw corrective manipulation technique to achieve optimal correction. After surgery the main thoracic Cobb angle becomes 83 degrees and lumbar Cobb angle becomes 40 degrees, with 5 days length of stay and less than 800 mL blood loss during surgery. There is no complaint at two months after surgery; he has already come back to normal activity with good functional activity.

  3. Clinical application of axonal repair technique for treatment of peripheral nerve injury

    Institute of Scientific and Technical Information of China (English)

    陈亮; 顾玉东; 徐雷

    2004-01-01

    Objective: To evaluate the efficacy of axonal repair technique for treatment of peripheral nerve injury clinically.Methods: In 1998, the authors applied axonal repair technique to treat peripheral nerve injuries in 12 patients with 13 nerves. It consists of four steps, ie, stumps of the nerve being soaked in a modified Collins fluid, freezed,trimmed, and coapted with glue, making the injured nerve repaired at the axonal level.Results: The patients were followed up for an average of 13 months. Results showed that in 4 cases of first-stage contraiateral C7 transfer, regenerating axons reached to the sternoclavicular joint or axilla at 4 to 7 months, offering the timing for performing the second-stage contralateral C7 transfer. In 5 cases of accessory nerve transferred to the suprascapular nerve, the abduction of the shoulder was 40° on average. In the other 3 patients with four different nerves repaired, results were also satisfactory.Conclusions: This technique is promising in the treatment of peripheral nerve injury.

  4. RESULTS OF THE USE OF PEEK CAGES IN THE TREATMENT OF BASILAR INVAGINATION BY GOEL TECHNIQUE

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    Luís Eduardo Carelli Teixeira da Silva

    2016-03-01

    Full Text Available ABSTRACT Objective: Analysis of the use of polyetheretherketone (PEEK cages for atlantoaxial facet realignment and distraction for treatment of basilar invagination by Goel technique. Method: Retrospective descriptive statistical analysis of the neurological status, pain, presence of subsidence and bone fusion with the use of PEEK cages in 8 atlantoaxial joints of 4 patients with basilar invagination. All patients were treated with atlantoaxial facet distraction and realignment and subsequent arthrodesis C1-C2 by the technique of Goel modified by the use of PEEK cage. Results: All patients showed improvement in Nurick neurological assessment scale and Visual Analogue Scale (VAS of pain. There were no cases of subsidence, migration, or damage to the vertebral artery during the insertion of the cage. All joints evolved with bone fusion, assessed by dynamic radiographs, and computed tomography. Two patients developed neuropathic pain in dermatome of C2 and one patient had unilateral vertebral artery injury during C2 instrumentation treated with insertion of pedicle screw to control the bleeding. Conclusion: The results of the treatment of basilar invagination by the Goel technique with the use of PEEK cages shown to be effective and safe although further studies are needed to confirm this use.

  5. Relationship between periodontics and restorative procedures: surgical treatment of the restorative alveolar interface (rai)--case series.

    Science.gov (United States)

    Almeida, A L P F; Esper, L A; Sbrana, M C; Cunha, M J S; Greghi, S L A; Carrilho, G P B; Pegoraro, L F

    2013-12-01

    Maintenance of a healthy periodontium is fundamental for the long term success of prosthetic restorations. Thus, prosthetic procedures with subgingival margins may affect the periodontal health if the distances between the junctional epithelium and supracrestal connective tissue attachment aren't respected, or if there is insufficient space to maintain the health of the interproximal tissues, leading to gingival inflammation, connective tissue attachment loss and bone resorption. The restorative alveolar interface (RAI) technique was described as the portion of the root surface extending from the alveolar crest apically to the restorative margin coronally. RAI consists of modifying the restorative margin position into a healthier environment, respecting the biological width and therefore allowing effective plaque control. This paper describes four clinical cases with indication for the RAI technique for maintenance of periodontal health. The cases were associated with prostheses. All cases were evaluated at 90 days and exhibited a healthy periodontal tissue. Successful outcomes were observed in the different indications for the RAI technique.

  6. Comparison of different breast planning techniques and algorithms for radiation therapy treatment.

    Science.gov (United States)

    Borges, C; Cunha, G; Monteiro-Grillo, I; Vaz, P; Teixeira, N

    2014-03-01

    This work aims at investigating the impact of treating breast cancer using different radiation therapy (RT) techniques--forwardly-planned intensity-modulated, f-IMRT, inversely-planned IMRT and dynamic conformal arc (DCART) RT--and their effects on the whole-breast irradiation and in the undesirable irradiation of the surrounding healthy tissues. Two algorithms of iPlan BrainLAB treatment planning system were compared: Pencil Beam Convolution (PBC) and commercial Monte Carlo (iMC). Seven left-sided breast patients submitted to breast-conserving surgery were enrolled in the study. For each patient, four RT techniques--f-IMRT, IMRT using 2-fields and 5-fields (IMRT2 and IMRT5, respectively) and DCART - were applied. The dose distributions in the planned target volume (PTV) and the dose to the organs at risk (OAR) were compared analyzing dose-volume histograms; further statistical analysis was performed using IBM SPSS v20 software. For PBC, all techniques provided adequate coverage of the PTV. However, statistically significant dose differences were observed between the techniques, in the PTV, OAR and also in the pattern of dose distribution spreading into normal tissues. IMRT5 and DCART spread low doses into greater volumes of normal tissue, right breast, right lung and heart than tangential techniques. However, IMRT5 plans improved distributions for the PTV, exhibiting better conformity and homogeneity in target and reduced high dose percentages in ipsilateral OAR. DCART did not present advantages over any of the techniques investigated. Differences were also found comparing the calculation algorithms: PBC estimated higher doses for the PTV, ipsilateral lung and heart than the iMC algorithm predicted.

  7. Influence of different treatment techniques on radiation dose to the LAD coronary artery

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    Molls Michael

    2007-06-01

    Full Text Available Abstract Background The purpose of this proof-of-principle study was to test the ability of an intensity-modulated radiotherapy (IMRT technique to reduce the radiation dose to the heart plus the left ventricle and a coronary artery. Radiation-induced heart disease might be a serious complication in long-term cancer survivors. Methods Planning CT scans from 6 female patients were available. They were part of a previous study of mediastinal IMRT for target volumes used in lymphoma treatment that included 8 patients and represent all cases where the left anterior descending coronary artery (LAD could be contoured. We compared 6 MV AP/PA opposed fields to a 3D conformal 4-field technique and an optimised 7-field step-and-shoot IMRT technique and evaluated DVH's for several structures. The planning system was BrainSCAN 5.21 (BrainLAB, Heimstetten, Germany. Results IMRT maintained target volume coverage but resulted in better dose reduction to the heart, left ventricle and LAD than the other techniques. Selective dose reduction could be accomplished, although not to the degree initially attempted. The median LAD dose was approximately 50% lower with IMRT. In 5 out of 6 patients, IMRT was the best technique with regard to heart sparing. Conclusion IMRT techniques are able to reduce the radiation dose to the heart. In addition to dose reduction to whole heart, individualised dose distributions can be created, which spare, e.g., one ventricle plus one of the coronary arteries. Certain patients with well-defined vessel pathology might profit from an approach of general heart sparing with further selective dose reduction, accounting for the individual aspects of pre-existing damage.

  8. Treatment of congential vascular disorders: classification, step program, and therapeutic procedures

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    Philipp, Carsten M.; Poetke, Margitta; Engel-Murke, Frank; Waldschmidt, J.; Berlien, Hans-Peter

    1994-02-01

    Because of the different step programs concerning the preoperative diagnostic and the onset of therapy for the various types of congenital vascular disorders (CVD) a clear classification is important. One has to discern the vascular malformations, including the port wine stain, from the real hemangiomas which are vascular tumors. As former classification, mostly based on histological findings, showed little evidence to a clinical step program, we developed a descriptive classification which allows an early differentiation between the two groups of CVD. In most cases this can be done by a precise medical history of the onset and development of the disorder, a close look to the clinical signs and by Duplex-Ultrasound and MRI-diagnostic. With this protocol and the case adapted use of different lasers and laser techniques we have not seen any severe complications as skin necrosis or nerve lesions.

  9. The use of PTC and RFA as treatment alternatives with low procedural morbidity in non-small cell lung cancer.

    Science.gov (United States)

    Choe, Yeong Hun; Kim, So Ri; Lee, Kyung Sun; Lee, Ka Young; Park, Seoung Ju; Jin, Gong Yong; Lee, Yong Chul

    2009-07-01

    Minimally invasive percutaneous ablative therapies for treating lung cancers are currently being studied as treatment alternatives. This present study investigated the efficacies of percutaneous thoracic cryotherapy (PTC) and radiofrequency ablation (RFA) on clinical courses of pulmonary malignant tumours, especially in the setting of non-surgical candidates. Sixty-five patients with lung malignancy underwent sixty-seven sessions of RFA and nine sessions of PTC. We evaluated the results of RFA and PTC including efficacies, local progression rate, survival rate, and complications. Twenty-nine patients (43.3%) treated with RFA and six patients (66.7%) with PTC attained complete ablation. In small-sized lung mass (3 cm), complete ablation rate of RFA and PTC was increased to 76.2% and 85.7%, respectively. Additionally, we have found that the complete ablation group had significantly higher survival duration and progression free survival duration compared with the partial ablation group. Moreover, the complication profile was acceptable and the pain associated with the procedures disappeared within 1 day; 42 patients (62.7%) after RFA and all patients after PTC. This study provides evidence for the use of PTC and RFA as treatment alternatives with low procedural morbidity in the management of inoperable pulmonary malignant tumours, although the current study is limited by the small sample size and the short follow-up period.

  10. Treatment of high grade cervical intraepithelial neoplasia by photodynamic therapy using hexylaminolevulinate may be costeffective compared to conisation procedures due to decreased pregnancy-related morbidity.

    Science.gov (United States)

    Soergel, Philipp; Makowski, Lars; Makowski, Efthimia; Schippert, Cordula; Hertel, Hermann; Hillemanns, Peter

    2011-09-01

    Standard treatments of high-grade Cervical intraepithelial neoplasia (CIN) are conisation procedures. Theses methods have proven effectiveness but are associated with an increased risk of subsequent pregnancy complications. Recently, photodynamic therapy (PDT) of CIN using hexylaminolevulinate (HAL) may represent an alternative treatment without the risk of cervical insufficiency or scaring. This study aims to evaluate the economical aspect of CIN treatment including associated pregnancy complications by comparing both methods. We developed model treatment pathways for both conisation procedures and PDT using HAL. Thereafter, we calculated total costs for both treatment pathways including necessary re-treatments or alternative treatments. The estimated impact of conisation-related cervical insufficiency, prematurity, perinatal morbidity and life-long disability were determined. The total additional costs per conisation due to perinatal morbidity were calculated. The total cost of treatment for CIN with a conisation procedure alone was 1,473 €, whereas the PDT procedure alone accounted for 1,386 €, based of assumptions of a 50% re-PDT rate, a 70% response rate and costs of 500 € for the PDT intervention itself. We computed 71, 144 and 545 newborns born prematurely due to conisation procedures treatment with PDT given the above-mentioned assumptions were 1,558 €. For Germany, PDT has the potential to be a cost-effective treatment for high-grade CIN compared to conisation procedure. Most important, the increased perinatal morbidity, perinatal mortality and associated costs after conisation procedures are significant and may be reduced by the implementation of PDT in CIN treatment. Copyright © 2011 Wiley-Liss, Inc.

  11. Purification and Functionalization of Single-Walled Carbon Nanotubes through Different Treatment Procedures

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    Peir-An Tsai

    2013-01-01

    Full Text Available Single-walled carbon nanotubes (SWCNTs were purified by the combined use of ultrasonic- and microwave-assisted acid digestion. The results show that the method efficiently eliminates impurities, reduces solvent consumption, and prevents damage to the structure of the SWCNTs. The purified SWCNTs were given functionalization treatments with a nitric acid/sulfuric acid mixture. These acid-treated SWCNTs (A-SWCNTs were then grafted with 3-isocyanatopropyl triethoxysilane (A-SWCNTs-Si. The A-SWCNTs and A-SWCNTs-Si were used to improve interfacial interactions with polymers and to produce a well-dispersed SWCNT composite.

  12. Does the Papilla Preservation Flap Technique Induce Soft Tissue Modifications over Time in Endodontic Surgery Procedures?

    Science.gov (United States)

    Taschieri, Silvio; Del Fabbro, Massimo; Francetti, Luca; Perondi, Isabella; Corbella, Stefano

    2016-08-01

    The aim of the present controlled clinical trial was to compare 2 incision techniques, papilla base incision (PBI) and sulcular incision (IS), evaluating changes in papilla and recession height over a 12-month period. A total of 24 subjects requiring endodontic surgery on a single tooth were enrolled. PBI was used in 1 group and IS in the other group. The primary outcomes were changes in gingival recession of the tooth affected by periapical lesions and the mesial and distal teeth and the mesial and distal papilla height using the treated tooth as the reference. Outcome variables were assessed at baseline and 12 months after the surgical intervention. Statistical analysis was performed by a blinded operator through appropriate tests, with significance set at a P value equal to .05. In the PBI group, the papilla height at the 12-month follow-up in the mesial and distal aspect decreased 0.10 ± 0.32 mm and 0.10 ± 0.32 mm, respectively, and 0.23 ± 0.68 mm and 0.25 ± 0.40 mm, respectively, in the IS group without any significant differences. There were no differences found for recession change values between groups. The PBI and IS approaches in endodontic surgery showed similar results in terms of papilla height preservation and recession changes. Copyright © 2016 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  13. Treatment of congenital thoracic scoliosis with associated rib fusions using VEPTR expansion thoracostomy: a surgical technique.

    Science.gov (United States)

    Dayer, Romain; Ceroni, Dimitri; Lascombes, Pierre

    2014-07-01

    Untreated growing patients with congenital scoliosis and fused ribs will develop finally thoracic insufficiency syndrome. The technique of expansion thoracoplasty with implantation of a vertical expandable prosthetic titanium rib (VEPTR) was introduced initially to treat these children. This article attempts to provide an overview of the surgical technique of opening-wedge thoracostomy and VEPTR instrumentation in children with congenital thoracic scoliosis and fused ribs. Our modification of the surgical approach using a posterior midline incision rather than the modified thoracotomy incision initially described could potentially help to diminish wound dehiscence and secondary infection, while preserving a more acceptable esthetic appearance of the back. Vertical expandable prosthetic titanium rib-based treatments should be undertaken only with a good knowledge of its numerous specific complications. Every aspect of the treatment should be oriented to minimize these complications. At the same time it should be kept in mind that the ultimate step of this long-term fusionless treatment strategy will be a technically demanding spine fusion.

  14. [Legal aspects and the treatment procedure of gender dysphoria in Hungary].

    Science.gov (United States)

    Kórász, Krisztián

    2015-07-26

    The legal process of gender transition in Hungary had previously been more developed as in most European countries, as the law enabled transsexual people to change their name and gender before or without a medical treatment, which was unique at the time. Over the years, however, lots of European countries developed legal frameworks and accepted international standards of care for the treatment of gender dysphoria that Hungary did not follow. Currently in Hungary there is no consistent legal framework of gender transition, there is no official regulation or guidelines regarding gender transition process, no institution with the obligation to accommodate the process, and there is no nominated specialist in the state health care system whose remit included dealing with transsexual patients. The information on gender transition options both to the professionals and to the patients is limited and incoherent. This paper reviews the legal aspects and clinical management process of gender dysphoria in Hungary. Some issues regarding the Hungarian practice and possible solutions based on examples from the United Kingdom are addressed within the paper.

  15. Persistent Human Chorionic Gonadotropin After Methotrexate Treatment and an Emergency Surgical Procedure for Ectopic Pregnancy.

    Science.gov (United States)

    Kurt-Mangold, Michelle; Van Voorhis, Bradley J; Krasowski, Matthew D

    2015-01-01

    The case study is a 33-year-old white female with persistently elevated serum human chorionic gonadotropin (hCG) levels following methotrexate treatment and emergency surgery for ectopic pregnancy. At the time of the first methotrexate dose, the serum hCG concentration was 27,995 IU/L. The laboratory was consulted 3.5 months after the surgery, because serum hCG levels had stopped declining and had leveled off to around 80 to 90 IU/L but with negative urine pregnancy tests. Laboratory studies ruled out heterophile antibody interference and hook effect by multiple methods including analysis by different serum hCG assays, treatment with heterophile antibody blocking agents, and dilution studies. Three additional doses of methotrexate over six months were required for serum hCG concentrations to decline to undetectable levels. This case illustrates challenges that may arise with serum hCG measurements in management of ectopic pregnancies. Close collaboration between the laboratory and clinical service is key for optimal patient care.

  16. Absolute absorbed dose measurements with an array of ionization chambers as part of a routine procedure of quality control for the VMAT technique; Medidas de dosis absorbida absoluta con un array de camaras de ionizacion como parte de un procedimiento rutinario de control de calidad para la tecnica VMAT

    Energy Technology Data Exchange (ETDEWEB)

    Clemente Gutierrez, F.; Cabello Murillo, E.; Ramirez Ros, J. C.; Casa de Julian, M. A. de la

    2011-07-01

    Arcotheraphy techniques volumetric modulated (VMAT) treatments involve continuous variation of the gantry rotation speed, positions of the sheets and dose rate. Since all treatments are administered by continuous arcs, these techniques require quality control procedures to ensure quick and easy constancy of the calibration factor (total absorbed dose) for any gantry angle. We report here a simple method of quality control for the measurement of the calibration factor using an array of ionization chambers. The measurements were performed on a unit of 6 MV Elekta Synergy with VMAT, belonging to the Radiation Oncology service of the Defense Central Hospital Gomez Ulla.

  17. Combined manual therapy techniques for the treatment of women with infertility: a case series.

    Science.gov (United States)

    Kramp, Mary Ellen

    2012-10-01

    Current management options for infertility, including hormone therapy, intrauterine insemination, and in vitro fertilization, tend to be expensive, are not necessarily covered by insurance, and carry different levels of short-term and long-term health risks. Many of the issues that contribute to infertility can be traced to scar tissue, fascial restriction, and lymphatic congestion in the pelvic region. Manual therapy techniques exist to release fascial restrictions, to mobilize tight ligaments, and to drain congested lymphatics, all of which can be applied to the reproductive system. In this case series, 10 infertile women were treated with 1 to 6 sessions of manual therapy applied to the pelvic region. Techniques included muscle energy, lymphatic drainage, and visceral manipulation. Six of the 10 women conceived within 3 months of the last treatment session, and all 6 of those women delivered at full term.

  18. [Discoveries and techniques that have contributed to improving the treatment of pancreatic diseases].

    Science.gov (United States)

    Navarro, Salvador

    2015-05-01

    Due to its retroperitoneal location, the pancreas has historically been a mysterious organ that is difficult to examine and which complicates treatment. The discovery of anesthesia and asepsis in the mid-19th century allowed laparotomic diagnosis, which was previously only possible at autopsy. The expectations of surgery were improved by the detection of blood groups, vitamin K synthesis, and the development of intensive care units. In addition, high levels of presurgical diagnosis and an unquestionable improvement of its results were enabled by advances in laboratory methods (serum quantification of amylase and lipase, tumoral markers, genetics, and techniques for measuring exocrine pancreatic function), imaging and endoscopic modalities, and fine tuning of surgical techniques. In this article, we review the history of the main milestones that have allowed progress in all these aspects. Copyright © 2014 Elsevier España, S.L.U. and AEEH y AEG. All rights reserved.

  19. Magnetic Resonance Techniques Applied to the Diagnosis and Treatment of Parkinson’s Disease

    Science.gov (United States)

    de Celis Alonso, Benito; Hidalgo-Tobón, Silvia S.; Menéndez-González, Manuel; Salas-Pacheco, José; Arias-Carrión, Oscar

    2015-01-01

    Parkinson’