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

Science.gov (United States)

Dalbayrak, Sedat; Yaman, Onur; Yılmaz, Mesut

2013-07-01

Treatment of Hangman's fractures is still controversial. Hangman's fractures Type II and IIA are usually treated with surgical procedures. 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. 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. Hangman II and IIA patient are treated with NSA technique. Angulated and tilted C2 vertebral body was pulled back and approximated to posterior elements. 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.

All-Arthroscopic Revision Eden-Hybinette Procedure for Failed Instability Surgery: Technique and Preliminary Results.

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Giannakos, Antonios; Vezeridis, Peter S; Schwartz, Daniel G; Jany, Richard; Lafosse, Laurent

2017-01-01

To describe the technique of an all-arthroscopic Eden-Hybinette procedure in the revision setting for treatment of a failed instability procedure, particularly after failed Latarjet, as well as to present preliminary results of this technique. Between 2007 and 2011, 18 shoulders with persistent instability after failed instability surgery were treated with an arthroscopic Eden-Hybinette technique using an autologous bicortical iliac crest bone graft. Of 18 patients, 12 (9 men, 3 women) were available for follow-up. The average follow-up was 28.8 months (range, 15 to 60 months). A Latarjet procedure was performed as an index surgery in 10 patients (83%). Two patients (17%) had a prior arthroscopic Bankart repair. Eight patients (67%) obtained a good or excellent result, whereas 4 patients (33%) reported a fair or poor result. Seven patients (58%) returned to sport activities. A positive apprehension test persisted in 5 patients (42%), including 2 patients (17%) with recurrent subluxations. The Rowe score increased from 30.00 to 78.33 points (P Instability Index score showed a good result of 28.71% (603 points). The average anterior flexion was 176° (range, 150° to 180°), and the average external rotation was 66° (range, 0° to 90°). Two patients (16.67%) showed a progression of glenohumeral osteoarthritic changes, with each patient increasing by one stage in the Samilson-Prieto classification. All 4 patients (33%) with a fair or poor result had a nonunion identified on postoperative computed tomography scan. An all-arthroscopic Eden-Hybinette procedure in the revision setting for failed instability surgery, although technically demanding, is a safe, effective, and reproducible technique. Although the learning curve is considerable, this procedure offers all the advantages of arthroscopic surgery and allows reconstruction of glenoid defects and restoration of shoulder stability in this challenging patient population. In our hands, this procedure yields good

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

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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

The "All-Inside" Arthroscopic Broström Procedure Augmented With a Proximal Suture Anchor: An Innovative Technique.

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Cottom, James M; Richardson, Phillip E

Arthroscopic treatments of chronic lateral ankle stability have been reported in the literature. The authors report on an innovative technique augmenting the "All- Inside" Arthroscopic Broström procedure with an additional suture anchor. Copyright © 2016 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

Orthodontic treatment of an anterior openbite with the aid of corticotomy procedure: Case report.

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Aljhani, Ali S; Aldrees, Abdullah M

2011-04-01

This case report illustrates the orthodontic treatment combined with the corticotomy technique in an adult patient to accelerate tooth movement and shorten the treatment time. The patient was a 22-year-old woman with an anterior open bite and flared and spaced upper and lower incisors. First, fixed orthodontic appliances (bidimensional edgewise brackets) were bonded, and a week later buccal and lingual corticotomy with alveolar augmentation procedure in the maxillary arch from the first molar to the contralateral first molar, and from canine to canine in the mandibular arch was performed. Orthodontic therapy proceeded with frequent activation of the appliances to retract the incisors every 2 weeks. The total treatment time was 5 months and no adverse effects were observed at the end of active treatment. The addition of the decortication procedure to the conventional orthodontic therapy decreased the duration of treatment significantly. Successful closure of the anterior open bite with adequate overbite and interdigitation of the teeth were achieved.

Percutaneous Treatment of Simple Hepatic Cysts: The Long-Term Results of PAIR and Catheterization Techniques as Single-Session Procedures

International Nuclear Information System (INIS)

Akhan, Okan; Islim, Filiz; Balci, Sinan; Erbahceci, Aysun; Akpınar, Burcu; Ciftci, Turkmen; Akinci, Devrim

2016-01-01

PurposeThe purpose of our study is to evaluate results of percutaneous aspiration with alcohol sclerotherapy in symptomatic patients with simple hepatic cysts by employing single-session techniques either by a needle or a catheter.Materials and MethodsWe retrospectively included 39 simple hepatic cysts in 35 patients treated via percutaneous aspiration and single-session alcohol sclerotherapy between years 1993 and 2012. Indications were pain (n = 28) or ruling out cystic echinococcus (CE) disease (n = 7). 29 cysts in 26 patients were treated by needle technique (Group A) and ten cysts in nine patients were treated by single-session catheter technique (Group B). Patients were followed for 4–173 months (median: 38 months).ResultsAll patients were successfully treated. Before procedure, cyst volumes were 21–676 cc (median: 94 cc). Post-procedure cyst volumes at last follow-up were 0-40 cc (median: 1 cc). The mean decrease in cyst volume was 95.92 ± 2.86 % in all patients (95.96 ± 3.26 % in Group A and 95.80 ± 6.20 % in Group B). There was no statistically significant difference between the volume reduction rates of Group A and Group B. Only one patient, in Group B, developed a major complication, an abscess. Hospitalization period was 1 day for all patients.ConclusionsFor patients with symptomatic simple hepatic cysts smaller than 500 cc in volume by using puncture, aspiration, injection, and reaspiration (PAIR) technique with only needle, single-session alcohol sclerotherapy of 10 min is a safe and effective procedure with high success rate.

Percutaneous Treatment of Simple Hepatic Cysts: The Long-Term Results of PAIR and Catheterization Techniques as Single-Session Procedures

Energy Technology Data Exchange (ETDEWEB)

Akhan, Okan, E-mail: akhano@tr.net [Hacettepe University Faculty of Medicine, Department of Radiology (Turkey); Islim, Filiz, E-mail: fislim@yahoo.com [Istanbul Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Department of Radiology (Turkey); Balci, Sinan, E-mail: snnbalci@gmail.com [Hacettepe University Faculty of Medicine, Department of Radiology (Turkey); Erbahceci, Aysun, E-mail: aysunerbahceci@yahoo.com [Istanbul Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Department of Radiology (Turkey); Akpınar, Burcu, E-mail: burcu-akpinar@yahoo.com; Ciftci, Turkmen, E-mail: turkmenciftci@yahoo.com; Akinci, Devrim, E-mail: akincid@hotmail.com [Hacettepe University Faculty of Medicine, Department of Radiology (Turkey)

2016-06-15

PurposeThe purpose of our study is to evaluate results of percutaneous aspiration with alcohol sclerotherapy in symptomatic patients with simple hepatic cysts by employing single-session techniques either by a needle or a catheter.Materials and MethodsWe retrospectively included 39 simple hepatic cysts in 35 patients treated via percutaneous aspiration and single-session alcohol sclerotherapy between years 1993 and 2012. Indications were pain (n = 28) or ruling out cystic echinococcus (CE) disease (n = 7). 29 cysts in 26 patients were treated by needle technique (Group A) and ten cysts in nine patients were treated by single-session catheter technique (Group B). Patients were followed for 4–173 months (median: 38 months).ResultsAll patients were successfully treated. Before procedure, cyst volumes were 21–676 cc (median: 94 cc). Post-procedure cyst volumes at last follow-up were 0-40 cc (median: 1 cc). The mean decrease in cyst volume was 95.92 ± 2.86 % in all patients (95.96 ± 3.26 % in Group A and 95.80 ± 6.20 % in Group B). There was no statistically significant difference between the volume reduction rates of Group A and Group B. Only one patient, in Group B, developed a major complication, an abscess. Hospitalization period was 1 day for all patients.ConclusionsFor patients with symptomatic simple hepatic cysts smaller than 500 cc in volume by using puncture, aspiration, injection, and reaspiration (PAIR) technique with only needle, single-session alcohol sclerotherapy of 10 min is a safe and effective procedure with high success rate.

Study on assembly techniques and procedures for ITER tokamak device

International Nuclear Information System (INIS)

Obara, Kenjiro; Kakudate, Satoshi; Shibanuma, Kiyoshi; Sago, Hiromi; Ue, Koichi; Shimizu, Katsusuke; Onozuka, Masanori

2006-06-01

The International Thermonuclear Experimental Reactor (ITER) tokamak is mainly composed of a doughnut-shaped vacuum vessel (VV), four types of superconducting coils such as toroidal field coils (TF coils) arranged around the VV, and in-vessel components, such as blanket and divertor. The dimensions and weight of the respective components are around a few ten-meters and several hundred-tons. In addition, the whole tokamak assembly, which are composed of these components, are roughly estimated, 26 m in diameter, 18 m in height and over 16,500 tons in total weight. On the other hand, as for positioning and assembly tolerances of the VV and the TF coil are required to be a high accuracy of ±3 mm in spite of large size and heavy weight. The assembly procedures and techniques of the ITER tokamak are therefore studied, taking account of the tolerance requirements as well as the configuration of the tokamak with large size and heavy weight. Based on the above backgrounds, the assembly procedures and techniques, which are able to assemble the tokamak with high accuracy, are described in the present report. The tokamak assembly operations are categorized into six work break down structures (WBS), i.e., (1) preparation for assembly operations, (2) sub-assembly of the 40deg sector composed of 40deg VV sector, two TF coils and thermal shield between VV and TF coil at the assembly hall, (3) completion of the doughnut-shaped tokamak assembly composed of nine 40deg sectors in the cryostat at the tokamak pit, (4) measurement of positioning and accuracy after the completion of the tokamak assembly, (5) installation of the ex-vessel components, and (6) installation of in-vessel components. In the present report, two assembly operations of (2) and (3) in the above six WBS, which are the most critical in the tokamak assembly, are mainly described. The report describes the following newly developed tokamak assembly procedures and techniques, jigs and tools for assembly and metrology

SYSTEMATIC SCANNING ELECTRON MICROSCOPY TECHNIQUE FOR EVALUATING COMBINED BIOLOIGCAL/GRANULAR ACTIVATED CARBON TREATMENT PROCESSES

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A systematic scanning election microscope analytical technique has been developed to examine granular activated carbon used a a medium for biomass attachment in liquid waste treatment. The procedure allows for the objective monitoring, comparing, and trouble shooting of combined ...

Treatment of intervertebral disc degenerative disease using percutaneous nucleotomy–an overview of less invasive procedures

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Miran Jeromel

2014-04-01

Full Text Available Background: Less invasive treatment methods for intervertebral disc disease and decompression of neural structures as a consequence of contained disc herniation represent an alternative to surgical procedure. Percutaneus nucleotomy uses a percutaneous approach to the intervertebral disc. The article presents the evolution of numerous procedureds in clinical practice.Methods: Percutaneous nucleoplasty is a fluoroscopy-guided procedure which enables controlled and safe entrance into the intervertebral disc. The procedure is performed under strict aseptic conditions, using a local anaesthesia with the patient under analgosedation. Based on the principle of therapeutic intradiscal action, the procedures can be divided into three groups: chemical (chemonucleolysis with chimopapain, alcohol, ozone, mechanical (automated percutaneous lumbar discectomy – APLD, arthroscopic discectomy and thermical methods (laser, radiofrequency ablation, intradiscal electrothermal annuloplasty – IDET, Coblation®.Results: Percutaneous nucleotomy by the majority of the mentioned procedures results in a therapeutic effect (reduction of pain and decompression of neural structures. Fast recovery represents a major advantage of less invasive treatment.Conclusions: Less invasive method (nucleotomy using different procedures represents a successful alternative approach to surgical discectomy. Proper patient selection and safe technique are mandatory in order to achieve a good clinical outcome.

Treatment of Wide-Neck Bifurcation Aneurysm Using "WEB Device Waffle Cone Technique".

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Mihalea, Cristian; Caroff, Jildaz; Rouchaud, Aymeric; Pescariu, Sorin; Moret, Jacques; Spelle, Laurent

2018-05-01

The endovascular treatment of wide-neck bifurcation aneurysms can be challenging and often requires the use of adjunctive techniques and devices. We report our first experience of using a waffle-cone technique adapted to the Woven Endoluminal Bridge (WEB) device in a large-neck basilar tip aneurysm, suitable in cases where the use of Y stenting or other techniques is limited due to anatomic restrictions. The procedure was complete, and angiographic occlusion of the aneurysm was achieved 24 hours post treatment, as confirmed by digital subtraction angiography. No complications occurred. The case reported here was not suitable for Y stenting or deployment of the WEB device alone, due to the small caliber of both posterior cerebral arteries and their origin at the neck level. The main advantage of this technique is that both devices have a controlled detachment system and are fully independent. To our knowledge, this technique has not been reported previously and this modality of treatment has never been described in the literature. Copyright © 2018 Elsevier Inc. All rights reserved.

IMPAIRED MOBILITY OF VOCAL FOLDS – DIAGNOSTIC PROCEDURES AND TREATMENT, part 2

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Karlo Pintarić

2015-09-01

Full Text Available Paresis or paralysis of one or both vocal cords affects phonation, swallowing and breathing. The major cause for reduced mobility or even immobility is innervation damage, less often mechanical disorder.The main procedures in the diagnostics of disordered vocal fold mobility are indirect laryngoscopy and videoendostroboscopy. Different imaging techniques (especially computerized tomography are of great value in searching for a cause of the impaired mobility.In unilateral vocal fold immobility, the treatment is focused on the improvement of voice quality and the prevention of aspiration during swallowing. In bilateral paralysis, it is crucial to find a balance between effective breathing and sufficient voice quality. The treatment of unilateral paralysis is started with voice therapy and swallowing rehabilitation. If these procedures are not enough surgical treatment for the medialization of the paralyzed vocal fold is applied. In the case of breathing difficulties in bilateral vocal fold immobility there is a possibility of surgical lateralization of one or both folds or a surgical excision of a part or the entire vocal fold. Surgical reinnervation, functional electrostimulation of certain laryngeal muscles and gene therapy are developing treatment modalities.

Increasing nursing treatment for pediatric procedural pain.

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Bice, April A; Gunther, Mary; Wyatt, Tami

2014-03-01

Procedural pain management is an underused practice in children. Despite the availability of efficacious treatments, many nurses do not provide adequate analgesia for painful interventions. Complementary therapies and nonpharmacologic interventions are additionally essential to managing pain. Owing to the increasing awareness of inadequate nursing utilization of pharmacologic measures for procedural pain, this paper focuses only on analgesic treatments. The aim of this review was to examine how varying degrees of quality improvement affect nursing utilization of treatments for routine pediatric procedural pain. A comprehensive search of databases including Cinahl, Medline/Pubmed, Web of Science, Google Scholar, Psycinfo, and Cochrane Library was performed. Sixty-two peer-reviewed research articles were examined. Ten articles focusing on quality improvement in pediatric pain management published in English from 2001 to 2011 were included. Three themes emerged: 1) increasing nursing knowledge; 2) nursing empowerment; and 3) protocol implementation. Research critique was completed with the use of guidelines and recommendations from Creswell (2009) and Garrard (2011). The literature reveals that nurses still think that pediatric pain management is essential. Quality improvement increases nursing utilization of procedural pain treatments. Although increasing nursing knowledge improves pediatric pain management, it appears that nursing empowerment and protocol implementation increase nursing compliance more than just education alone. Nurses providing pain management can enhance their individual practice with quality improvement measures that may increase nursing adherence to institutional and nationally recommended pediatric procedural pain management guidelines. Copyright © 2014 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

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

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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.

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

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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.

Monti’s procedure as an alternative technique in complex urethral distraction defect

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Jalil Hosseini

2010-06-01

Full Text Available PURPOSE: Pelvic fracture urethral distraction defect is usually managed by the end to end anastomotic urethroplasty. Surgical repair of those patients with post-traumatic complex posterior urethral defects, who have undergone failed previous surgical treatments, remains one of the most challenging problems in urology. Appendix urinary diversion could be used in such cases. However, the appendix tissue is not always usable. We report our experience on management of patients with long urethral defect with history of one or more failed urethroplasties by Monti channel urinary diversion. MATERIALS AND METHODS: From 2001 to 2007, we evaluated data from 8 male patients aged 28 to 76 years (mean age 42.5 in whom the Monti technique was performed. All cases had history of posterior urethral defect with one or more failed procedures for urethral reconstruction including urethroplasty. A 2 to 2.5 cm segment of ileum, which had a suitable blood supply, was cut. After the re-anastomosis of the ileum, we closed the opened ileum transversely surrounding a 14-16 Fr urethral catheter using running Vicryl sutures. The newly built tube was used as an appendix during diversion. RESULTS: All patients performed catheterization through the conduit without difficulty and stomal stenosis. Mild stomal incontinence occurred in one patient in the supine position who became continent after adjustment of the catheterization intervals. There was no dehiscence, necrosis or perforation of the tube. CONCLUSION: Based on our data, Monti’s procedure seems to be a valuable technique in patients with very long complicated urethral defect who cannot be managed with routine urethroplastic techniques.

[Interventional radiology procedures for malignancies of the liver treatment: Intraarterial procedures].

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Cristina, V; Pracht, M; Lachenal, Y; Adib, S; Boubaker, A; Prior, J; Senys, A; Wagner, A D; Bize, P

2014-05-21

Intraarterial procedures such as chemoembolization and radioembolization aim for the palliative treatment of advanced hepatocellular carcinoma (stage BCLC B and C with tumoral portal thrombosis). The combination of hepatic intraarterial chemotherapy and systemic chemotherapy can increase the probability of curing colorectal cancer with hepatic metastases not immediately accessible to surgical treatment or percutaneous ablation.

Endoscopic sutured gastroplasty: procedure evolution from first-in-man cases through current technique.

Science.gov (United States)

Kumar, Nitin; Abu Dayyeh, Barham K; Lopez-Nava Breviere, Gontrand; Galvao Neto, Manoel P; Sahdala, Nicole P; Shaikh, Sohail N; Hawes, Robert H; Gostout, Christopher J; Goenka, Mahesh K; Orillac, Jorge R; Alvarado, Alonso; Jirapinyo, Pichamol; Zundel, Natan; Thompson, Christopher C

2018-04-01

Endoscopic sutured gastroplasty (ESG) has evolved over time. With the advent of full-thickness endoscopic suturing, an efficient technique for ESG was developed and refined. This prospective first-in-man trial started in April 2012 and represents the first use of full-thickness endoscopic suturing for primary obesity therapy. The trial focused on procedure development, reproducibility, safety, and short-term efficacy. The trial was performed at centers in five countries, in three phases. Phase I was evaluation of safety and technical feasibility of various procedure techniques; stitch patterns and sequences were assessed for efficiency, safety, and feasibility. Phase II entailed continued procedure refinement to establish a standardized technique. Phase III entailed evaluation of technical feasibility and weight loss outcomes in 77 patients; the procedure was performed using the standardized technique, and there was no procedure development. Data were prospectively collected into a registry. In Phase I, the procedure was created and modified to improve time efficiency. Safety and technical feasibility were established, and short-term weight loss was demonstrated. In Phase II, a number of stitch patterns were attempted, and the stitch pattern was modified and finalized. 22 patients were included, and 1-year total weight loss was 17.3 ± 2.6%. In Phase III, conformity with the final technique was high. 77 patients were included, with a mean BMI of 36.1 ± 0.6 kg/m 2 . Mean weight loss was 16.0 ± 0.8% at 6 months and 17.4 ± 1.2% at 12 months (n = 44). Postprocedural nausea, vomiting, and epigastric pain were frequently reported; there were no reported significant adverse events post-procedure or during the follow-up period. Following a methodical procedure development phase, ESG demonstrated safety and short-term efficacy in this trial. The procedure also achieved meaningful weight loss during the follow-up period.

Clinical study of treatment of cerebral hemorrhage: remove the intracranial hematoma with a minimal invasive procedure

International Nuclear Information System (INIS)

Ke Dongfeng; He Yunguang; Hu Wen; Lin Yang; Yang Danyang; Chen Shaokai; Ma Shaobing

2004-01-01

Objective: To study the feasibility and factors of minimal invasive intracranial hematoma removing procedure as a treatment of cerebral hemorrhage. Methods: From May, 2000 to September, 2003, 33 patients with intracerebral hemorrhage underwent minimal invasive intracranial hematoma removing procedure and from May, 1997 to September, 2000, 27 patients with cerebral hemorrhage received conservative treatments. Two groups were compared and analyzed. The quantity of hemorrhage and the indication of procedure were also studied. Results: State of an illness has no significant difference between the two groups (P<0.05). The rate of recovery were higher in the group undergoing the procedure (57.6%) than in the control group (14.8%) (P<0.05). The rate of handicap were lower in the procedure group (24.0%) than in the control group (60.0%) (P<0.05). The mortality were also lower in the procedure group (24.2%) than in the control group (63.0%) (P<0.01). In the control group no patient with a hematoma larger than 70 ml survived. In the procedure group patients with hematoma larger than 70 ml had less chance of survival than the other patients (P<0.01). The mortality rate were respectively 50%, 5.6%, 33.3% when the procedure was done in super early, early, delayed stage. The mortality rate was higher in the super early stage than in early stage (P<0.05). Conclusion: The minimal invasive intracranial hematoma removing procedure has a better clinical outcome than the conservative treatment. The procedure reduces obviously mortality rate and increase the quality of survival. Multiple puncturing and draining or craniotomy are recommended to remove huge hematoma. The earlier treatment brings better clinical effects. This technique is simple, less invasive and provides good clinical outcome, which is worth recommendation

Anaerobic treatment techniques

International Nuclear Information System (INIS)

Boehnke, B.; Bischofsberger, W.; Seyfried, C.F.

1993-01-01

This practical and theoretical guide presents the current state of knowledge in anaerobic treatment of industrial effluents with a high organic pollutant load and sewage sludges resulting from the treatment of municipal and industrial waste water. Starting from the microbiological bases of anaerobic degradation processes including a description and critical evaluation of executed plants, the book evolves the process-technical bases of anaerobic treatment techniques, derives relative applications, and discusses these with reference to excuted examples. (orig./UWA). 232 figs [de

Rendezvous cannulation technique reduces post-ERCP pancreatitis: a prospective nationwide study of 12,718 ERCP procedures.

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Swahn, Fredrik; Nilsson, Magnus; Arnelo, Urban; Löhr, Matthias; Persson, Gunnar; Enochsson, Lars

2013-04-01

The aim of this study was to investigate if intraoperative rendezvous cannulation reduces the risk of post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP) because there is no universal consensus on the optimal treatment of common bile duct stones. We performed a nationwide case-control study, nested within the cohort of ERCP procedures reported to the Swedish Registry for Gallstone Surgery and ERCP (GallRiks), between 2007 and 2009. Data were collected prospectively from a web-based registry of ERCP procedures that includes variables such as patient characteristics, indication, cannulation technique, diagnostic findings, therapeutic measures, and complications. The primary outcome was PEP. The registry included 12,718 ERCP procedures performed on patients without a history of previous ERCP. The risk of PEP when using the rendezvous technique compared with those who were cannulated by conventional means was reduced from 3.6 to 2.2% (odds ratio (OR) 0.5, 95% confidence interval 0.2-0.9, P=0.02). Although a significant reduction there are overall relatively few cases with PEP and the calculated numbers needed to treat to avoid one case of PEP is as high as 71. Other factors associated with increased risk of PEP were young age, prolonged procedure time, and elective ERCP. Rendezvous bile duct cannulation during ERCP reduces the risk of PEP from 3.6 to 2.2% compared with conventional biliary cannulation.

Modification of the Nuss Procedure: The Single-incision Technique

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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.

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

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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.

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

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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.

Evaluation of nuclear power plant operating procedures classifications and interfaces: Problems and techniques for improvement

International Nuclear Information System (INIS)

Barnes, V.E.; Radford, L.R.

1987-02-01

This report presents activities and findings of a project designed to evaluate current practices and problems related to procedure classification schemes and procedure interfaces in commercial nuclear power plants. The phrase ''procedure classification scheme'' refers to how plant operating procedures are categorized and indexed (e.g., normal, abnormal, emergency operating procedures). The term ''procedure interface'' refers to how reactor operators are instructed to transition within and between procedures. The project consisted of four key tasks, including (1) a survey of literature regarding problems associated with procedure classifications and interfaces, as well as techniques for overcoming them; (2) interviews with experts in the nuclear industry to discuss the appropriate scope of different classes of operating procedures and techniques for managing interfaces between them; (3) a reanalysis of data gathered about nuclear power plant normal operating and off-normal operating procedures in a related project, ''Program Plan for Assessing and Upgrading Operating Procedures for Nuclear Power Plants''; and (4) solicitation of the comments and expert opinions of a peer review group on the draft project report and on proposed techniques for resolving classification and interface issues. In addition to describing these activities and their results, recommendations for NRC and utility actions to address procedure classification and interface problems are offered

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

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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.

The Jejunal Serosal Patch Procedure: A Successful Technique for ...

African Journals Online (AJOL)

Background: The selection of the most appropriate technique for the repair of peptic ulcer perforations, especially when the initial attempt of closure has failed have been the concern of many surgeons. Since the experimental report regarding the jejunal serosal patch procedure by Koboldin in 1963, authors have reported its ...

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

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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.

Retrospective Study on Laser Treatment of Oral Vascular Lesions Using the "Leopard Technique": The Multiple Spot Irradiation Technique with a Single-Pulsed Wave.

Science.gov (United States)

Miyazaki, Hidetaka; Ohshiro, Takafumi; Romeo, Umberto; Noguchi, Tadahide; Maruoka, Yutaka; Gaimari, Gianfranco; Tomov, Georgi; Wada, Yoshitaka; Tanaka, Kae; Ohshiro, Toshio; Asamura, Shinichi

2018-06-01

This study aimed to retrospectively evaluate the efficacy and safety of laser treatment of oral vascular lesions using the multiple spot irradiation technique with a single-pulsed wave. In laser therapy for vascular lesions, heat accumulation induced by excessive irradiation can cause adverse events postoperatively, including ulcer formation, resultant scarring, and severe pain. To prevent heat accumulation and side effects, we have applied a multiple pulsed spot irradiation technique, the so-called "leopard technique" (LT) to oral vascular lesions. This approach was originally proposed for laser treatment of nevi. It can avoid thermal concentration at the same spot and spare the epithelium, which promotes smooth healing. The goal of the study was to evaluate this procedure and treatment outcomes. The subjects were 46 patients with 47 oral vascular lesions treated with the LT using a Nd:YAG laser (1064 nm), including 24 thick lesions treated using a combination of the LT and intralesional photocoagulation. All treatment outcomes were satisfactory without serious complications such as deep ulcer formation, scarring, bleeding, or severe swelling. Laser therapy with the LT is a promising less-invasive treatment for oral vascular lesions.

Patient use of social media to evaluate cosmetic treatments and procedures.

Science.gov (United States)

Schlichte, Megan J; Karimkhani, Chante; Jones, Trevor; Trikha, Ritika; Dellavalle, Robert P

2015-04-16

With a growing sphere of influence in the modern world, online social media serves as a readily accessible interface for communication of information. Aesthetic medicine is one of many industries increasingly influenced by social media, as evidenced by the popular website, "RealSelf," an online community founded in 2006 that compiles ratings, reviews, photographs, and expert physician commentary for nearly 300 cosmetic treatments. To investigate the current preferences of patients regarding cosmetic non-surgical, surgical, and dental treatments on RealSelf and in the documented medical literature. On a single day of data collection, all cosmetic treatments or procedures reviewed on the RealSelf website were tabulated, including name, percent "worth it" rating, total number of reviews, and average cost. Patient satisfaction rates documented in the current medical literature for each cosmetic treatment or procedure were also recorded. Statistical t-testingcomparing RealSelf ratings and satisfaction rates in the literature was performed for each category-non-surgical, surgical, and dental. The top ten most-commonly reviewed non-surgical treatments, top ten most-commonly reviewed surgical procedures, and top 5 most-commonly reviewed dental treatments, along with documented satisfaction rates in the medical literature for each treatment or procedure were recorded in table format and ranked by RealSelf "worth it" rating. Paired t-testing revealed that satisfaction rates documented in the literature were significantly higher than RealSelf "worth it" ratings for both non-surgical cosmetic treatments (p=0.00076) and surgical cosmetic procedures (p=0.00056), with no statistically significant difference for dental treatments. For prospective patients interested in cosmetic treatments or procedures, social media sites such as RealSelf may offer information helpful to decision-making as well enable cosmetic treatment providers to build reputations and expand practices. "Worth

Combined use of ultrasonic liposuction with the pull-through technique for the treatment of gynecomastia.

Science.gov (United States)

Hammond, Dennis C; Arnold, Jame F; Simon, Amy M; Capraro, Philippe A

2003-09-01

The authors present a method of treatment for gynecomastia that combines the use of two techniques of soft-tissue contouring. This method uses ultrasonic liposuction in conjunction with the pull-through technique of direct excision to effectively remove the fibrofatty tissue of the male breast and the fibrous breast bud through a single 1-cm incision. Fifteen patients were treated in this fashion, and each patient demonstrated a smooth, masculine breast contour with a well-concealed scar, which eliminates the stigma of breast surgery. The procedure is technically straightforward and provides consistent results. It is offered as an additional option for the treatment of gynecomastia.

An overview of anesthetic procedures, tools, and techniques in ambulatory care

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Messieha Z

2015-01-01

Full Text Available Zakaria Messieha Department of Anesthesiology, University of Illinois at Chicago, Chicago, IL, USA Abstract: Ambulatory surgical and anesthesia care (ASAC, also known as Same Day Surgery or Day Care in some countries, is the fastest growing segment of ambulatory surgical and anesthesia care. Over 50 million ambulatory surgical procedures are conducted annually comprising over 60% of all anesthesia care with an impressive track record of safety and efficiency. Advances in ambulatory anesthesia care have been due to newer generation of inhalation and intravenous anesthetics as well as airway management technology and techniques. Successful ambulatory anesthesia care relies on patient selection, adequate facilities, highly trained personnel and quality improvement policies and procedures. Favoring one anesthetic technique over the other should be patient and procedure-specific. Effective management of post-operative pain as well as nausea and vomiting are the final pieces in assuring success in ambulatory anesthesia care. Keywords: ambulatory anesthesia, out-patient anesthesia, Day-Care anesthesia

Modified PAIR Technique for Percutaneous Treatment of High-Risk Hydatid Cysts

Energy Technology Data Exchange (ETDEWEB)

Gabal, Abdelwahab M., E-mail: gabalrad@yahoo.com [King Fahad Hospital, Department of Radiology (Saudi Arabia); Khawaja, Fazal I. [King Fahad Hospital, Department of Gastroenterology and Gastrointestinal Endoscopy (Saudi Arabia); Mohammad, Ghanem A. [Al-azhar University Medical Center, Department of Chest Diseases (Egypt)

2005-04-15

Purpose: This paper presents a modification of the known method for percutaneous treatment of hydatid cyst, the PAIR technique. It aimed to achieve safe aspiration of large symptomatic cysts and cysts with a danger of impending rupture. Methods: We designed a coaxial catheter system to achieve concomitant evacuation of cyst contents while infusing scolicidal agent. Hypertonic saline is used to wash out cyst contents and to kill protoscolices. This was followed by injection of a sclerosant (ethyl alcohol 95%) into the residual cyst cavity to prevent formation of a cyst collection after the procedure. Seventeen cysts in 14 patients were successfully aspirated. Follow-up plain radiographs, ultrasonography and CT were performed weekly in the first 4 weeks and then at 3, 6 and 12 months for all patients. Seven patients (9 drained cysts) were followed up for 2 years and 1 patient for 3 years. Results: All cysts were successfully aspirated. The following morphologic changes were noticed: a gradual decrease in cyst size (17 cysts, 100%), thickening and irregularity of the cyst wall due to separation of endocyst from pericyst (7 cysts, 41%), development of a heterogeneous appearance of the cyst components (8 cysts, 47%) and development of pseudotumor (2 cysts, 12%). None of the treated cysts disappeared completely. No significant procedure-related complications were encountered. Conclusion: This modified PAIR technique is a reliable method for percutaneous treatment of risky and symptomatic hydatid cysts.

Modified PAIR Technique for Percutaneous Treatment of High-Risk Hydatid Cysts

International Nuclear Information System (INIS)

Gabal, Abdelwahab M.; Khawaja, Fazal I.; Mohammad, Ghanem A.

2005-01-01

Purpose. This paper presents a modification of the known method for percutaneous treatment of hydatid cyst, the PAIR technique. It aimed to achieve safe aspiration of large symptomatic cysts and cysts with a danger of impending rupture. Methods. We designed a coaxial catheter system to achieve concomitant evacuation of cyst contents while infusing scolicidal agent. Hypertonic saline is used to wash out cyst contents and to kill protoscolices. This was followed by injection of a sclerosant (ethyl alcohol 95%) into the residual cyst cavity to prevent formation of a cyst collection after the procedure. Seventeen cysts in 14 patients were successfully aspirated. Follow-up plain radiographs, ultrasonography and CT were performed weekly in the first 4 weeks and then at 3, 6 and 12 months for all patients. Seven patients (9 drained cysts) were followed up for 2 years and 1 patient for 3 years. Results. All cysts were successfully aspirated. The following morphologic changes were noticed: a gradual decrease in cyst size (17 cysts, 100%), thickening and irregularity of the cyst wall due to separation of endocyst from pericyst (7 cysts, 41%), development of a heterogeneous appearance of the cyst components (8 cysts, 47%) and development of pseudotumor (2 cysts, 12%). None of the treated cysts disappeared completely. No significant procedure-related complications were encountered. Conclusion. This modified PAIR technique is a reliable method for percutaneous treatment of risky and symptomatic hydatid cysts

Percutaneous Treatment of Intrahepatic Biliary Leak: A Modified Occlusion Balloon Technique

Energy Technology Data Exchange (ETDEWEB)

Nasser, Felipe; Rocha, Rafael Dahmer, E-mail: rafaeldrocha@gmail.com; Falsarella, Priscila Mina; Motta-Leal-Filho, Joaquim Maurício da; Azevedo, André Arantes; Valle, Leonardo Guedes Moreira; Cavalcante, Rafael Noronha; Garcia, Rodrigo Gobbo; Affonso, Breno Boueri; Galastri, Francisco Leonardo [Hospital Israelita Albert Einstein, Department of Interventional Radiology (Brazil)

2016-05-15

PurposeTo report a novel modified occlusion balloon technique to treat biliary leaks.MethodsA 22-year-old female patient underwent liver transplantation with biliary-enteric anastomosis. She developed thrombosis of the common hepatic artery and extensive ischemia in the left hepatic lobe. Resection of segments II and III was performed and a biliary-cutaneous leak originating at the resection plane was identified in the early postoperative period. Initial treatment with percutaneous transhepatic drainage was unsuccessful. Therefore, an angioplasty balloon was coaxially inserted within the biliary drain and positioned close to the leak.ResultsThe fistula output abruptly decreased after the procedure and stopped on the 7th day. At the 3-week follow-up, cholangiography revealed complete resolution of the leakage.ConclusionThis novel modified occlusion balloon technique was effective and safe. However, greater experience and more cases are necessary to validate the technique.

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...

A Technique of Distal Clavicle Fracture Fixation Using The Tightrope Procedure

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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.

Comparative study of 2 commissural dorsal flap techniques for the treatment of congenital syndactyly.

Science.gov (United States)

Mallet, Cindy; Ilharreborde, Brice; Jehanno, Pascal; Litzelmann, Estelle; Valenti, Philippe; Mazda, Keyvan; Penneçot, Georges-François; Fitoussi, Franck

2013-03-01

Many commissural reconstruction techniques have been described for the treatment of syndactyly. This study is the first to compare long-term results of 2 commissural dorsal flap procedures (T-flap and omega-flap). Fifty-nine web-spaces in 39 patients, operated on between 1991 and 2008, were retrospectively analyzed. Thirty-six T-flap and 23 omega-flap procedures were performed using full-thickness skin graft in every case for digital resurfacing. Factors that could affect the long-term outcome were collected, including development of web-creep, clinodactyly, and flexion contracture. Patients were reviewed with a mean follow-up of 5 years and 8 months. Preoperative complexity of syndactyly influenced the development of clinodactyly and flexion contracture. Among the patients who developed clinodactyly, 96% had surgery for complex syndactyly. No difference was found between the 2 flap methods concerning digital deformation and mobility. However, web-creep occurred more frequently after T-flap than after omega-flap procedures (17% vs. 5%). The combination of either dorsal commissural T-flaps or omega-flaps with full-thickness graft to resurface digits is a reliable technique for the treatment of syndactyly with satisfactory functional and cosmetic results. Long-term results are not influenced by the type of flap. Nevertheless, the omega-flap technique, using 2 triangular lateral-palmar flaps, avoids use of skin graft to cover lateral-palmar aspects of the new commissure, consequently reducing the incidence of web-creep. In cases of syndactyly, the primary prognostic factor is whether the patient has simple or complex syndactyly. In complex syndactyly, the risk of long-term unfavorable results is higher. When complex complicated syndactyly is involved, postoperative complication rates increase. Level III.

Absolute absorbed dose measurements with an array of ionization chambers as part of a routine procedure of quality control for the VMAT technique

International Nuclear Information System (INIS)

Clemente Gutierrez, F.; Cabello Murillo, E.; Ramirez Ros, J. C.; Casa de Julian, M. A. de la

2011-01-01

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.

Implementation of BNCT treatment planning procedures

International Nuclear Information System (INIS)

Capala, J.; Ma, R.; Diaz, A.Z.; Chanana, A.D.; Coderre, J.A.

2001-01-01

Estimation of radiation doses delivered during boron neutron capture therapy (BNCT) requires combining data on spatial distribution of both the thermal neutron fluence and the 10 B concentration, as well as the relative biological effectiveness of various radiation dose components in the tumor and normal tissues. Using the treatment planning system created at Idaho National Engineering and Environmental Laboratory and the procedures we had developed for clinical trials, we were able to optimize the treatment position, safely deliver the prescribed BNCT doses, and carry out retrospective analyses and reviews. In this paper we describe the BNCT treatment planning process and its implementation in the ongoing dose escalation trials at Brookhaven National Laboratory. (author)

Comparison of Clinical Outcomes of Scarf and Chevron Osteotomies and the McBride Procedure in the Treatment of Hallux Valgus Deformity

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Mohammad Fakoor

2014-03-01

Full Text Available Background:   Hallux valgus deformity is a common chronic problem in middle age and elderly. Different surgical procedures have been introduced so far with their proposed indications for each. This study aimed to compare three   current procedures namely Chevron osteotomy, Scarf osteotomy and McBride technique.     Methods:   In this study, 44 patients were included from 2010 to 2013. All patients had been undergone one of the three current procedures including Chevron, Scarf or McBride techniques. Preoperative and follow-up radiographies     were evaluated in terms of hallux valgus and intermetatarsal angles. Foot Ankle Disability Index was filled to assess the functional. A Visual Analogue Scale evaluated pain. Also, satisfaction, aesthetic and the rate of recurrence were evaluated. Results:   Functional score, aesthetic and satisfaction level were higher in Scarf technique rather than Chevron and McBride techniques. Also, pain score and recurrence rate were lower in Scarf Technique rather the other two techniques.     Conclusions:   With respect to better results with Scarf osteotomy in this study, we recommend Scarf osteotomy as   a first choice for treatment of moderate hallux valgus deformity.

The differential outcomes procedure enhances adherence to treatment: A simulated study with healthy adults

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Michael eMolina

2015-11-01

Full Text Available 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 hour and 1 week after completing the learning phase. The results showed that compared with the standard non-differential outcomes procedure (NOP, 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.

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. Copyright © 2013 John Wiley & Sons, Ltd.

A 3D technique for simulation of irregular electron treatment fields using a digital camera

International Nuclear Information System (INIS)

Bassalow, Roustem; Sidhu, Narinder P.

2003-01-01

Cerrobend inserts, which define electron field apertures, are manufactured at our institution using perspex templates. Contours are reproduced manually on these templates at the simulator from the field outlines drawn on the skin or mask of a patient. A previously reported technique for simulation of electron treatment fields uses a digital camera to eliminate the need for such templates. However, avoidance of the image distortions introduced by non-flat surfaces on which the electron field outlines were drawn could only be achieved by limiting the application of this technique to surfaces which were flat or near flat. We present a technique that employs a digital camera and allows simulation of electron treatment fields contoured on an anatomical surface of an arbitrary three-dimensional (3D) shape, such as that of the neck, extremities, face, or breast. The procedure is fast, accurate, and easy to perform

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

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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.

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

International Nuclear Information System (INIS)

Castro, Josué Viana Neto; Melo, Emanuel Carvalho; Silva, Juliana Fernandes; Rebouças, Leonardo Lemos; Corrêa, Larissa Chagas; Germano, Amanda de Queiroz; Machado, João José Aquino

2014-01-01

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

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

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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.

[Balloon osteoplasty as reduction technique in the treatment of tibial head fractures].

Science.gov (United States)

Freude, T; Kraus, T M; Sandmann, G H

2015-10-01

Tibial plateau fractures requiring surgery are severe injuries of the lower extremities. Depending on the fracture pattern, the age of the patient, the range of activity and the bone quality there is a broad variation in adequate treatment.  This article reports on an innovative treatment concept to address split depression fractures (Schatzker type II) and depression fractures (Schatzker type III) of the tibial head using the balloon osteoplasty technique for fracture reduction. Using the balloon technique achieves a precise and safe fracture reduction. This internal osteoplasty combines a minimal invasive percutaneous approach with a gently rise of the depressed area and the associated protection of the stratum regenerativum below the articular cartilage surface. This article lights up the surgical procedure using the balloon technique in tibia depression fractures. Using the balloon technique a precise and safe fracture reduction can be achieved. This internal osteoplasty combines a minimally invasive percutaneous approach with a gentle raising of the depressed area and the associated protection of the regenerative layer below the articular cartilage surface. Fracture reduction by use of a tamper results in high peak forces over small areas, whereas by using the balloon the forces are distributed over a larger area causing less secondary stress to the cartilage tissue. This less invasive approach might help to achieve a better long-term outcome with decreased secondary osteoarthritis due to the precise and chondroprotective reduction technique.

Medial to posterior release procedure after failure of functional treatment in clubfoot: a prospective study.

Science.gov (United States)

Bocahut, Nicolas; Simon, Anne-Laure; Mazda, Keyvan; Ilharreborde, Brice; Souchet, Philippe

2016-04-01

Two conservative techniques for clubfoot treatment are still being debated and depend upon the institution's expertise. For >40 years, the current institution has been a pioneer in the development of the physiotherapy method; however, some severe deformities remain resistant to this method which causes pain, sprains, and difficulties wearing shoes. Therefore, a surgical approach was developed simultaneously for the treatment of these residual or recurring clubfeet. The procedure reproduces the same chronological steps by performing forefoot derotation before correcting hindfoot equinus. The aim of the current study was to assess the results of this surgical technique. All clubfeet undergoing surgery between October 1995 and February 2009 were prospectively included. Initial severity was based on Dimeglio's classification and final outcomes on the International Clubfoot Study Group (ICFSG) outcome evaluation system. Last follow-up results were assessed by physical examination and radiographs. A total of 137 patients with severe clubfeet (mean Dimeglio score 12.0) underwent surgery. At the mean follow-up of 10.8 years, mean ICFSG score was 4.3 (range 0-23), and 12 % required revision surgery. The rate of undercorrection and overcorrection was low (17 pes-plano-valgus ft and 11 ft with undercorrection). Eight feet had a fixed deformity. Severe deformities are more resistant to conservative techniques even for institutions with large experience. These deformities require further treatment, including surgery if necessary. The medial to posterior soft-tissue release is a valuable technique with stable results. Level IV.

Evaluation procedure for radioactive waste treatment processes

International Nuclear Information System (INIS)

Whitty, W.J.

1979-11-01

An aspect of the Los Alamos Scientific Laboratory's nuclear waste management R and D programs has been to develop an evaluation procedure for radioactive waste treatment processes. This report describes the process evaluation method. Process worth is expressed as a numerical index called the Figure-of-Merit (FOM), which is computed using a hierarchial, linear, additive, scoring model with constant criteria weights and nonlinear value functions. A numerical example is used to demonstrate the procedure and to point out some of its strengths and weaknesses. Potential modifications and extensions are discussed, and an extensive reference list is included

Technique of radiotherapeutic treatment of breast cancer with scarcity means

International Nuclear Information System (INIS)

Velazquez M, S.; Carrera M, F.; Bayo L, E.; Gutierrez B, L.; Gomez-Millan B, J.

1998-01-01

The objective of this work is to show the particularities in the treatment simulation localization, in the volume selection and in the main planning strategies motive by our scarcity means during the first year of performance. It was utilized a computerized tomograph, an X-ray equipment with tele commanded table. Also it was utilized a radio opaque lattice of marked center and knowing space and also a magnetic pointer for indicating 80 cm length between focus-skin. Putting the patient on an inclined plane of self design and manufacture, it was realized three cuts at different levels over what are limited the clinical target volume (CTV) and it is optimized the isocenter through its determined localization by equations. It was employed equations for the radiobiological prediction about fibrosis and dermatitis. It was utilized another techniques or procedures for planning such as personnel wedges or the dose equilibrium in three points of the breast. It was evaluated toxicities (EORTC-RTOG). The results were as follow: Acute dermatitis (grade 1: 23 %; grade 2: 59 %; grade 3: 18 %). Acute pneumonitis (grade 1: 4.3 %); acute pharyngitis (grade 1: 11 %; grade 2: 3.7 %. In conservator treatment of breast it was obtained excellent aesthetic results in 15 %; good 72 %; moderate 11 %; and bad 3 %. The good aesthetic results by the combined use of the optimization techniques in clinical dosimetry, personnel wedges, isocenter therapy and computerized planning in the radiotherapeutic treatment of the breast cancer. (Author)

Significance of MR imaging determining the suitability of patients with metastatic changes in the liver for treatment procedures

International Nuclear Information System (INIS)

Jaruszewska-Orlicka, K.; Czyszkowski, P.; Lasek, W.; Szylberg, T.

2004-01-01

Liver resection is the preferred method of treatment of hepatic metastases. Unfortunately, only 10-20% of patients can be qualified for surgery. One of the alternative palliative methods of treatment is percutaneous alcoholisation of metastatic foci (PEIT). The treatment procedure is determined primarily by the progression of the process in the liver, assessed with non-invasive imaging techniques. Assessment of diagnostic value of MR for patients with focal changes in the liver, an attempt to establish the algorithm of diagnostic and therapeutic procedure, and determination of the criteria qualifying for PEIT. The patients (after USG and BAC) due for liver resection because of liver metastases were subjected to MRI performed with a GYROSCAN NT apparatus with 1T field using a 'body' type solenoid in T2-weighted sequences and STIR/LONG and T1-weighted ones, before and after intravenous administration of a contrast medium in arterial and venous phase, in transversal and frontal planes. MR examination changed the procedure of treatment as a result of larger number and size of metastatic foci found by MRI than by USG. The results of MR examination caused a decrease in the number of patients qualified for liver resection, with a rise in the number of patients referred for PEIT. The application of another diagnostic method (e.g. MR) after USG examination is necessary for patients due for liver resection. MR examination of the liver allows a precise assessment of the operability criteria of hepatic metastases and significantly influences the treatment procedure in patients with metastatic changes in the liver. (author)

Calculation and experimental technique of determination of rolling procedure for cold-rolling tube mills

International Nuclear Information System (INIS)

Igoshin, V.F.; Aleshin, V.A.; Khoroshikh, Yu.G.; Bogatov, A.A.; Mizhiritskij, O.I.

1983-01-01

Calculation and experimental technique of determination of tube cold rolling procedure has been developed. Rolling procedure based on the usage of regression equation epsilon=1.24 psi, where psi is the relative reduction of area, delta-permissible reduction during rolling, has been tested on 08Kh18N10T steel. The effect of tube geometry, tool calibration parameters, lubrication conditions etc. on metal deformability in taking into account experimentally. The use of the technique proposed has allowed to shorten the time of mastering of the production of tubes from different steels

Development of radioactive waste treatment technique

International Nuclear Information System (INIS)

Kikuchi, Makoto; Amamiya, Shigeru; Yusa, Hideo.

1984-01-01

The techniques of radioactive waste treatment are generally reviewed, placing emphasis on volume reduction and solidification techniques. After a brief description on the general process of radioactive waste treatment, some special technologies being developed by Hitachi Ltd. are explained. From the viewpoints of the volume reduction, long term management and final disposal of wastes, the pelletization of dried waste and the solidification with inorganic substances are considered. One of the features of the pelletization system is to treat various kinds of wastes such as concentrated liquid wastes and used resins by the same system. The flow diagram of the system and its special features are shown. The volume reduction achieved by this system as compared to the conventional method is about 1/7. The first commercial plant for the treatment of concentrated liquid waste is scheduled to begin operation in June, 1984. As for the solidification technique for waste disposal, the use of cement glass is considered. The solidification system being developed is shortly described. (Aoki, K.)

A critical analysis of penile enhancement procedures for patients with normal penile size: surgical techniques, success, and complications.

Science.gov (United States)

Vardi, Yoram; Har-Shai, Yaron; Harshai, Yaron; Gil, Tamir; Gruenwald, Ilan

2008-11-01

Most men who request surgical penile enhancement have a normal-sized and fully functional penis but visualize their penises as small (psychological dysmorphism). The aim of this review is to describe the various reported techniques and to provide the available scientific data on the success and complication rates of penile enhancement procedures. We performed an extensive systematic review based on a search of the MEDLINE database for articles published between 1965 and 2008. The following key words were used: penis, enhancement, enlargement, phalloplasty, reconstruction, girth, lengthening, and augmentation. Only English-language articles that were related to penile surgery and dysmorphobia were sought. We excluded articles in which fewer than five cases were described and articles in which the type of surgical treatment and the outcome were not clear. Of the 176 papers found, 34 were selected and critically analyzed. We found only a small number of well-designed and comprehensive studies, and most of the published articles reported data that were obtained from small cohorts of patients. The more recently published studies presented better methodologies and descriptions of the surgical techniques than did the older publications. In general, penile enhancement surgery can cause a 1-2-cm increase in penile length and a 2.5-cm augmentation of penile girth. Unwanted outcomes and complications, namely penile deformity, paradoxical penile shortening, disagreeable scarring, granuloma formation, migration of injected material, and sexual dysfunction were reported frequently in these studies. Disappointing short- and long-term patient satisfaction rates following these procedures were also reported in most studies. To date, the use of cosmetic surgery to enlarge the penis remains highly controversial. There is a lack of any standardization of all described procedures. Indications and outcome measures are poorly defined, and the reported complications are unacceptably high

New Technique for the Treatment of Buried Penis in Children.

Science.gov (United States)

Liu, Feng; Lin, Tao; He, Dawei; Wei, Guanghui; Liu, Junhong; Liu, Xing; Hua, Yi; Zhang, Deying; Lu, Peng; Wu, Shengde; Li, Xuliang

2016-02-01

To present our treatment experience of buried penis, which has no consensus therapeutic technique for all cases of buried penis, by using a new technique for the repair of this condition, in which the approach is through the ventral penile root. We performed a retrospective review of 153 patients (median age: 6.5 years) who underwent repair of a buried penis between March 2005 and March 2013. The technique involves the creation of a wedge-shaped cut of the ventral penile skin, followed by fixation of the subcutaneous penile skin at the base of the degloved penis to the Buck fascia at the 2- and 10-o'clock positions. The ventral outer preputial skin is split down the midline, and the dorsal inner preputial skin is cut with oblique incision. All patients were followed for an average of 12 months after repair. Other than 2 cases (1.3%) of trapped penis with a ring of scar tissue, which required subsequent excision, there were no complications and the cosmetic appearance was satisfactory. The described ventral penile approach is a simple and effective procedure with good cosmetic outcomes and few complications. Copyright © 2016 Elsevier Inc. All rights reserved.

Antegrade jj stenting after percutaneous renal procedures: The 'pull and push' technique.

Science.gov (United States)

Ratkal, Jaideep M; Sharma, Elias

2015-06-01

A JJ stent is inserted antegradely after percutaneous renal procedures like percutaneous nephrolithotomy (PCNL) for renal calculus disease, and for endopyelotomy for pelvi-ureteric junction obstruction. We describe a technique for antegrade stent insertion after PCNL.

Treatment of celiac artery stenosis with interventional techniques

International Nuclear Information System (INIS)

Wang Maoqiang; Wang Zhijun; Liu Fengyong; Wang Zhongpu

2005-01-01

Objective: To present two cases of celiac artery (CA) stenosis treated successfully by interventional technique. Methods: Two patients characterised by chronic upper abdominal pain after eating, associated with weight loss and an epigastric bruit were treated with interventional procedure. The diagnosis was suggested by color Doppler imaging of the celiac axis and confirmed by aortography. One patient possessed the classic triad of median arcuate ligament syndrome (MALS). Arteriosclerosis was found to be responsible for the CA stenosis in another one. The interventional technique consisted of conventional PTA and stent placement in the CA. Results: Abdominal arteriograms in both patients showed severe stenosis (>90%) of CA. The stenotic segments were dilated and stented during the same session. One patient with balloon expandable Palmaz stent placed in the proximal celiac artery, another with 2 wallstents deployed in the CA trunk. The post procedural arteriograms showed good dilation of the lesions with immediate improvement of CA blood flow. Follow-up Doppler ultrasound scans showed normal flow patterns in the CA. Three months after the procedures, their upper gastrointestinal symptoms had resolved and regained body weights. They remained well and free of symptoms, at 16 months and 26 months follow-up, respectively, after the procedure. Conclusions: CA stenosis can successfully be treated with angioplasty and stenting. (authors)

Comparison of bone tunnel and suture anchor techniques in the modified Broström procedure for chronic lateral ankle instability.

Science.gov (United States)

Hu, Chang-Yong; Lee, Keun-Bae; Song, Eun-Kyoo; Kim, Myung-Sun; Park, Kyung-Soon

2013-08-01

angle. The bone tunnel and suture anchor techniques of the modified Broström procedure showed similar good functional and radiographic outcomes. Both techniques appear to be effective and reliable methods for the treatment of chronic lateral ankle instability.

High-speed technique based on a parallel projection correlation procedure for digital image correlation

Science.gov (United States)

Zaripov, D. I.; Renfu, Li

2018-05-01

The implementation of high-efficiency digital image correlation methods based on a zero-normalized cross-correlation (ZNCC) procedure for high-speed, time-resolved measurements using a high-resolution digital camera is associated with big data processing and is often time consuming. In order to speed-up ZNCC computation, a high-speed technique based on a parallel projection correlation procedure is proposed. The proposed technique involves the use of interrogation window projections instead of its two-dimensional field of luminous intensity. This simplification allows acceleration of ZNCC computation up to 28.8 times compared to ZNCC calculated directly, depending on the size of interrogation window and region of interest. The results of three synthetic test cases, such as a one-dimensional uniform flow, a linear shear flow and a turbulent boundary-layer flow, are discussed in terms of accuracy. In the latter case, the proposed technique is implemented together with an iterative window-deformation technique. On the basis of the results of the present work, the proposed technique is recommended to be used for initial velocity field calculation, with further correction using more accurate techniques.

Procedure for the determination of gap and base ground surface configurations beneath the bottom plate of storage tanks using neutron gauging inspection techniques : including radiation safety procedure and emergency procedure

International Nuclear Information System (INIS)

Jaafar Abdullah

1993-01-01

The procedure is intended for the neutron gauging inspection of gap between the bottom plate and the foundation of bulk storage tanks, which potentially exhibit uneven sinking of the bottom plate and the foundation. Its describes the requirements for the performance of neutron back scattered inspection techniques (or radiometric non-destructive evaluation techniques), using an isotopic neutron source associated with neutron detecting systems, to detect and size the gap between the bottom plate and the foundations as well as to quantify the presence of hydrogenous materials (e.g. oil or water) underneath the bottom plate. This procedure is not only outline the requirements for the neutron gauging inspection, but also describes the requirements which shall be taken into account in formulating the radiation safety and emergency procedures for the neutron gauging inspection works

Diagnostic and corrective procedures for TL analysis using the pre-dose technique

International Nuclear Information System (INIS)

Haskell, E.H.

1985-01-01

The high sensitivity of the pre-dose TL technique using fired quartz grains with relatively low doses makes it the only TL technique that is generally suitable for retrospective environmental dosimetry. The use of this technique for dose measurements of less than 0.2 Gy has been the focus of research at the Utah laboratory, while the extension of the useful range of the pre-dose technique to doses in excess of 5 Gy has been the aim of the Durham laboratory. Certain characteristics of the pre-dose phenomenon, if not properly diagnosed, can lead to erroneous dose estimates at both extremes. This paper describes the procedures used at both laboratories to diagnose such problems and recently developed methods for their circumvention. (author)

[Knapp procedure and modified Knapp procedure with Foster suture for the treatment of double elevator palsy].

Science.gov (United States)

Li, Y P; Zhang, W; Ding, J; Ma, H Z; Zhao, K X

2017-12-11

Objective: To investigate the efficacy of Knapp procedure and modified Knapp procedure with Foster suture in the treatment of double elevator palsy(DEP). Methods: Retrospective study. Twenty-two patients with congenital DEP were underwent Knapp procedure ( n= 15) and modified Knapp procedure( n= 7). The clinical data were retrospectively analyzed, including the preoperative and postoperative vertical deviation in the primary position, ocular motility, and binocular vision. Results: The average vertical deviation in the primary position was (34.7±8.6) prism diopters(PD) before surgery and (6.5±6.5) PD after surgery ( t= 30.41, P= 0.00) in the group underwent Knapp procedure. The mean preoperative and postoperative deviations of the group underwent modified procedure were respectively (38.6±14.6) PD and (5.7±9.3)PD ( t= 15.33, P= 0.00). The mean corrected vertical deviation of the latter (32.8±5.7) PD was greater than that of the former (28.1±3.6) PD( t=- 2.39, P= 0.03). The mean improved upgaze in the modified group (2.6±0.5) was more obvious than that in the Knapp group (1.9±0.6) ( t= 2.41, P= 0.02). There is no significant difference in the surgical effect on downgaze between two groups ( U =43.00, P= 0.54). Seven patients having binocular vision with abnormal head posture (AHP) before surgery obtained binocular single vision in the primary position and reading position after operations. AHP disappeared or reduced to less than 5°. The surgical outcomes were satisfied in 72.7% patients. But the patients with ≥40 PD preoperative vertical deviation were under-corrected and needed the further operations. Conclusions: Knapp procedure and modified Knapp procedure with Foster suture were the efficient procedures for treatment of DEP without restriction of ipsilateral inferior rectus. Both procedures can obviously correct the vertical deviation and improve upgaze without remarkable limitation of downgaze, which is good to obtain the binocular single vision in

Pain related to cancer treatments and diagnostic procedures: a no man's land?

Science.gov (United States)

Ripamonti, C I; Bossi, P; Santini, D; Fallon, M

2014-06-01

While guidelines are available for the management of cancer-related pain, little attention is given to the assessment and treatment of pain caused by treatments and diagnostic procedures in cancer patients. We evaluated the literature on pain related to cancer treatment and diagnostic procedures within a critical analysis. The data available are sparse, suggesting that little attention has been directed at this important aspect of oncology. This points to potentially suboptimal patient management. Appropriate studies are necessary in order to understand the incidence and appropriate management of pain, both during and/or after oncological treatments and diagnostic procedures. At the same time, Health Care Professionals should have heightened awareness of the causes and treatment of pain with the aim of anticipating and managing pain most appropriately for each individual patient. This is clearly an important component of holistic patient care before, during, and after oncological treatment. © The Author 2014. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: journals.permissions@oup.com.

"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.

Rendezvous procedure for the treatment of bile leaks and injury following segmental hepatectomy.

Science.gov (United States)

Nasr, John Y; Hashash, Jana G; Orons, Philip; Marsh, Wallis; Slivka, Adam

2013-05-01

Endoscopic retrograde cholangiopancreatography is a minimally invasive procedure used for the evaluation and management of biliary injuries. At times, ERCP fails and percutaneous modalities may be required. Rendezvous procedures are combined endoscopic and percutaneous techniques that have been used to restore anatomic continuity and biliary drainage in cases where retrograde and/or transhepatic access alone has failed either due to anatomic variation or traumatic injury with biloma formation. To assess if the Rendezvous technique plays a role in establishing biliary continuity in patients with a bile leak after segmental hepatectomy. We herby present a series of 3 patients who had complex bile leaks after segmental liver resection and underwent a combined percutaneous and endoscopic Rendezvous procedure to establish biliary continuity. This technique was successful in restoring biliary continuity and avoiding hepaticojejunostomy in 2 of the 3 patients. The Rendezvous technique may play a role in establishing biliary continuity in patients with biliary leak secondary to hepatic surgery. Copyright © 2013 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

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.

Surgical techniques for treatment of gastroesophageal reflux disease

Directory of Open Access Journals (Sweden)

Carlos Édder de Mello Cardoso Lima

2015-12-01

Full Text Available Gastroesophageal reflux is one of the most frequently gastrointestinal tract diseases currently found, having a great impact on the patient's quality of life. Purpose: to analyze the main surgical techniques used in the treatment of this pathology, their indications, advantages and disadvantages. Methods: this is a literature review. Thirteen articles published between 1998 and 2013 in the Lilacs, Bireme e Scielo databases, addressing different surgical techniques for the treatment of gastroesophageal reflux were selected. Results: Five hundred and thirty-eight total fundoplications and 466 partial fundoplications were performed. Conclusion: The findings of this review show that total fundoplication is the most commonly used technique in the treatment of gastroesophageal reflux disease.

Evaluation and treatment of failed shoulder instability procedures.

Science.gov (United States)

Ho, Anthony G; Gowda, Ashok L; Michael Wiater, J

2016-09-01

Management of the unstable shoulder after a failed stabilization procedure can be difficult and challenging. Detailed understanding of the native shoulder anatomy, including its static and dynamic restraints, is necessary for determining the patient's primary pathology. In addition, evaluation of the patient's history, physical exam, and imaging is important for identifying the cause for failure after the initial procedure. Common mistakes include under-appreciation of bony defects, failure to recognize capsular laxity, technical errors, and missed associated pathology. Many potential treatment options exist for revision surgery, including open or arthroscopic Bankart repair, bony augmentation procedures, and management of Hill Sachs defects. The aim of this narrative review is to discuss in-depth the common risk factors for post-surgical failure, components for appropriate evaluation, and the different surgical options available for revision stabilization. Level of evidence Level V.

Antegrade jj stenting after percutaneous renal procedures: The ‘pull and push’ technique

Science.gov (United States)

Ratkal, Jaideep M.; Sharma, Elias

2014-01-01

A JJ stent is inserted antegradely after percutaneous renal procedures like percutaneous nephrolithotomy (PCNL) for renal calculus disease, and for endopyelotomy for pelvi-ureteric junction obstruction. We describe a technique for antegrade stent insertion after PCNL. PMID:26413327

THD Doppler procedure for hemorrhoids: the surgical technique

OpenAIRE

Ratto, C.

2013-01-01

Transanal hemorrhoidal dearterialization (THD) is an effective treatment for hemorrhoidal disease. The ligation of hemorrhoidal arteries (called “dearterialization”) can provide a significant reduction of the arterial overflow to the hemorrhoidal piles. Plication of the redundant rectal mucosa/submucosa (called “mucopexy”) can provide a repositioning of prolapsing tissue to the anatomical site. In this paper, the surgical technique and perioperative patient management are illustrated. Followi...

Treatment of unicameral bone cyst: surgical technique.

Science.gov (United States)

Hou, Hsien-Yang; Wu, Karl; Wang, Chen-Ti; Chang, Shun-Min; Lin, Wei-Hsin; Yang, Rong-Sen

2011-03-01

There is a variety of treatment modalities for unicameral bone cysts, with variable outcomes reported in the literature. Although good initial outcomes have been reported, the success rate has often changed with longer-term follow-up. We introduce a novel, minimally invasive treatment method and compare its clinical outcomes with those of other methods of treatment of this lesion. From February 1994 to April 2008, forty patients with a unicameral bone cyst were treated with one of four techniques: serial percutaneous steroid and autogenous bone-marrow injection (Group 1, nine patients); open curettage and grafting with a calcium sulfate bone substitute either without instrumentation (Group 2, twelve patients) or with internal instrumentation (Group 3, seven patients); or minimally invasive curettage, ethanol cauterization, disruption of the cystic boundary, insertion of a synthetic calcium sulfate bone-graft substitute, and placement of a cannulated screw to provide drainage (Group 4, twelve patients). Success was defined as radiographic evidence of a healed cyst or of a healed cyst with some defect according to the modified Neer classification, and failure was defined as a persistent or recurrent cyst that needed additional treatment. Patients who sustained a fracture during treatment were also considered to have had a failure. The outcome parameters included the radiographically determined healing rate, the time to solid union, and the total number of procedures needed. The follow-up time ranged from eighteen to eighty-four months. Group-4 patients had the highest radiographically determined healing rate. Healing was seen in eleven of the twelve patients in that group compared with three of the nine in Group 1, eight of the twelve in Group 2, and six of the seven in Group 3. Group-4 patients also had the shortest mean time to union: 3.7 ± 2.3 months compared with 23.4 ± 14.9, 12.2 ± 8.5, and 6.6 ± 4.3 months in Groups 1, 2, and 3, respectively. This new

A Simple Technique of Supine Craniospinal Irradiation

International Nuclear Information System (INIS)

Munshi, Anusheel; Jalali, Rakesh

2008-01-01

We describe a simple procedure of craniospinal irradiation in supine position. The procedure was carried out with a 100-cm isocenter linear accelerator and compatible simulator. Treatment was with a 1 or 2 posteroanterior (PA)-directed spinal fields abutting lateral-directed cranial fields. Abutment of the fields was established by placement of markers on the neck of the patient, which provided a measure of the divergence of the spinal field. The precision and reproducibility of this technique, including the placement of junctions, appeared to be as good as for treatment in the prone position. The same could be verified with port films. We conclude that this new technique of supine craniospinal treatment is a simple and convenient alternative to traditional treatment in the prone position

Toward automated selective retina treatment (SRT): an optical microbubble detection technique

Science.gov (United States)

Seifert, Eric; Park, Young-Gun; Theisen-Kunde, Dirk; Roh, Young-Jung; Brinkmann, Ralf

2018-02-01

Selective retina therapy (SRT) is an ophthalmological laser technique, targeting the retinal pigment epithelium (RPE) with repetitive microsecond laser pulses, while causing no thermal damage to the neural retina, the photoreceptors as well as the choroid. The RPE cells get damaged mechanically by microbubbles originating, at the intracellular melanosomes. Beneficial effects of SRT on Central Serous Retinopathy (CSR) and Diabetic Macula Edema (DME) have already been shown. Variations in the transmission of the anterior eye media and pigmentation variation of RPE yield in intra- and inter- individual thresholds of the pulse energy required for selective RPE damage. Those selective RPE lesions are not visible. Thus, dosimetry-systems, designed to detect microbubbles as an indicator for RPE cell damage, are demanded elements to facilitate SRT application. Therefore, a technique based on the evaluation of backscattered treatment light has been developed. Data of 127 spots, acquired during 10 clinical treatments of CSR patients, were assigned to a RPE cell damage class, validated by fluorescence angiography (FLA). An algorithm has been designed to match the FLA based information. A sensitivity of 0.9 with a specificity close to 1 is achieved. The data can be processed within microseconds. Thus, the process can be implemented in existing SRT lasers with an automatic pulse wise increasing energy and an automatic irradiation ceasing ability to enable automated treatment close above threshold to prevent adverse effects caused by too high pulse energy. Alternatively, a guidance procedure, informing the treating clinician about the adequacy of the actual settings, is possible.

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...

A simple technique to facilitate treatment of urethral strictures with optical internal urethrotomy.

Science.gov (United States)

Stamatiou, Konstantinos; Papadatou, Aggeliki; Moschouris, Hippocrates; Kornezos, Ioannis; Pavlis, Anargiros; Christopoulos, Georgios

2014-01-01

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.

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.

Enhancing photogrammetric 3d city models with procedural modeling techniques for urban planning support

International Nuclear Information System (INIS)

Schubiger-Banz, S; Arisona, S M; Zhong, C

2014-01-01

This paper presents a workflow to increase the level of detail of reality-based 3D urban models. It combines the established workflows from photogrammetry and procedural modeling in order to exploit distinct advantages of both approaches. The combination has advantages over purely automatic acquisition in terms of visual quality, accuracy and model semantics. Compared to manual modeling, procedural techniques can be much more time effective while maintaining the qualitative properties of the modeled environment. In addition, our method includes processes for procedurally adding additional features such as road and rail networks. The resulting models meet the increasing needs in urban environments for planning, inventory, and analysis

New perineal injection technique for pudendal nerve infiltration in diagnostic and therapeutic procedures

NARCIS (Netherlands)

Weinschenk, Stefan; Hollmann, Markus W.; Strowitzki, Thomas

2016-01-01

Pudendal nerve injection is used as a diagnostic procedure in the vulvar region and for therapeutic purposes, such as in vulvodynia. Here, we provide a new, easy-to-perform perineal injection technique. We analyzed 105 perineal injections into the pudendal nerve with a local anesthetic (LA),

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

[Ureteral realignment with the rendezvous procedure in complex ureteral injuries - aspects of technique and our experience].

Science.gov (United States)

Brandt, Alexander Sascha; von Rundstedt, F-C; Lazica, D A; Roth, S

2010-07-01

The rendezvous procedure for re-establishing ureteral continuity after complex ureteral injuries is introduced and we present our experience with this technique. Aspects of the technique are described in a detailed step-by-step instruction using intraoperative radiographs. We evaluated our patient data from 1998 until 2009 for cases in which the rendezvous procedure was attempted. The rendezvous procedure was used in a total of 11 patients. Realignment was successful in 10 cases (90.9 %) and the initial nephrostomy could be removed. In 3 of 7 cases postoperative removal of the JJ ureteric stent was successful. In 7 patients the final surgical ureter reconstruction was performed after a medium period of 7 months. 5 cases of ureteroneocystostomy and 2 cases of reconstruction of the ureter either with colon or ileum segments were accomplished. In 1 patient a permanent maintenance of the DJ ureteral stent was necessary. Ureteral realignment with the rendezvous procedure enables disposition of the ureteral stent in many cases, exclusively antegrade or retrograde procedures failed. By this means nephrostomy could be spared as a temporary or permanent solution and a better chance of restitutio ad integrum could be realised. Georg Thieme Verlag KG Stuttgart * New York.

The first successful laparoscopic Whipple procedure at Hat Yai Hospital: surgical technique and a case report.

Science.gov (United States)

Khaimook, Araya; Borkird, Jumpot; Alapach, Sakda

2010-09-01

Whipple procedure is the most complex abdominal surgical procedure to treat periampullary carcinoma. With the benefit of minimally invasive approach, many institutes attempt to do Whipple procedure laparoscopically. However, only 146 cases of laparoscopic Whipple procedure have yet been reported in the literature worldwide between 1994 and 2008. The authors reported the first laparoscopic Whipple procedure at Hat Yai Hospital in December 2009. The patient was a 40-year-old, Thai-Muslim female, with the diagnosis of ampullary carcinoma. The operating time was 685 minutes. The patient was discharged on postoperative day 14 without serious complication. The surgical technique and postoperative progress of the patient were described.

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

Science.gov (United States)

Browning, Robert; Turner, J Francis; Parrish, Scott

2015-12-01

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. 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. 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. 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.

A Methods and procedures to apply probabilistic safety Assessment (PSA) techniques to the cobalt-therapy process. Cuban experience

International Nuclear Information System (INIS)

Vilaragut Llanes, J.J.; Ferro Fernandez, R.; Lozano Lima, B; De la Fuente Puch, A.; Dumenigo Gonzalez, C.; Troncoso Fleitas, M.; Perez Reyes, Y.

2003-01-01

This paper presents the results of the Probabilistic Safety Analysis (PSA) to the Cobalt Therapy Process, which was performed as part of the International Atomic Energy Agency's Coordinated Research Project (CRP) to Investigate Appropriate Methods and Procedures to Apply Probabilistic Safety Assessment (PSA) Techniques to Large Radiation Sources. The primary methodological tools used in the analysis were Failure Modes and Effects Analysis (FMEA), Event Trees and Fault Trees. These tools were used to evaluate occupational, public and medical exposures during cobalt therapy treatment. The emphasis of the study was on the radiological protection of patients. During the course of the PSA, several findings were analysed concerning the cobalt treatment process. In relation with the Undesired Events Probabilities, the lowest exposures probabilities correspond to the public exposures during the treatment process (Z21); around 10-10 per year, being the workers exposures (Z11); around 10-4 per year. Regarding to the patient, the Z33 probabilities prevail (not desired dose to normal tissue) and Z34 (not irradiated portion to target volume). Patient accidental exposures are also classified in terms of the extent to which the error is likely to affect individual treatments, individual patients, or all the patients treated on a specific unit. Sensitivity analyses were realised to determine the influence of certain tasks or critical stages on the results. As a conclusion the study establishes that the PSA techniques may effectively and reasonably determine the risk associated to the cobalt-therapy treatment process, though there are some weaknesses in its methodological application for this kind of study requiring further research. These weaknesses are due to the fact that the traditional PSA has been mainly applied to complex hardware systems designed to operate with a high automation level, whilst the cobalt therapy treatment is a relatively simple hardware system with a

Experience with the vacuum assisted closure negative pressure technique in the treatment of non-healing diabetic and dysvascular wounds.

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Clare, Michael P; Fitzgibbons, Timothy C; McMullen, Scott T; Stice, R Colleen; Hayes, Dennis F; Henkel, Loree

2002-10-01

The purpose of this study is to report our experience with the Vacuum Assisted Closure (VAC) negative pressure technique in patients with non-healing wounds of the foot, ankle, and lower limb. We retrospectively reviewed 17 patients with non-healing wounds of the lower extremity who underwent treatment using the Vacuum Assisted Closure (VAC) device. Thirteen of 17 (76%) had diabetes mellitus, nine of whom were insulin-dependent, and 10 of whom had associated peripheral neuropathy. Eight of 17 (47%) had severe peripheral vascular disease. All had failed previous management with serial wound debridements and dressing changes; 15 of 17 (88%) had previously completed at least one course of oral antibiotics. Thirteen of 17 (76%) had previously undergone operative irrigation and debridement of the wounds; six of 17 (35%) had previously undergone revascularization procedures of the involved extremity. Five of 17 (29%) had wounds necessitating an amputation procedure prior to the present treatment; seven of 17 (41%) had failed treatment with local growth factors prior to the present treatment. Average length of treatment with the VAC device was 8.2 weeks. Fourteen of 17 (82%) wounds successfully healed; four underwent split-thickness skin grafting for wound closure; four were briefly treated with local growth factors; six were treated with only dressing changes following VAC treatment. Three of 17 (18%) wounds failed VAC treatment; all three patients had diabetes and had wounds located in the midfoot or forefoot; two of three had severe peripheral vascular disease. Our results indicate that the Vacuum Assisted Closure negative pressure technique is emerging as an acceptable option for wound care of the lower extremity. Not all patients are candidates for such treatment; those patients with severe peripheral vascular disease or smaller forefoot wounds may be best treated by other modalities. Larger wounds seem to be better suited for skin grafting or two-stage primary

Longitudinal study of parent caregiving self-efficacy and parent stress reactions with pediatric cancer treatment procedures

Science.gov (United States)

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

2013-01-01

Background Pain/distress during pediatric cancer treatments has substantial psychosocial consequences for children and families. We examined relationships between parents’ caregiving self-efficacy, parents’ affect in response to their children’s cancer-related treatment procedures, and parents’ symptoms of post-traumatic stress at follow-up. Methods Participants were 75 pediatric cancer patients and parents. On the day of each of three procedures (i.e., port-start, lumbar puncture, or bone marrow aspiration), parents rated their self-efficacy for six caregiving goals. Parents also self-reported their negative affect (i.e., state anxiety, negative mood, and distress) in response to each procedure. Three months after the last procedure, parents reported their level of post-traumatic stress symptoms (PTSS). Results Higher parent self-efficacy about keeping children calm before treatment and/or keeping children calm during the procedure was associated with lower state anxiety. Self-efficacy for keeping the child calm during procedures was significantly correlated with distress in parents at the time of procedures, and self-efficacy for keeping the child calm before procedures was significantly correlated with PTSS. All three negative affect measures significantly mediated the effects of parents’ caregiving self-efficacy for both goals on parents’ PTSS 3 months later. Conclusions Parents’ caregiving self-efficacy influences their immediate and longer-term distress reactions to their children’s treatment procedures. These findings provide a more nuanced understanding of how parents’ cognitions contribute to their ability to cope with their children’s treatment and suggest the benefit of an intervention that targets parents’ procedure-specific caregiver self-efficacy. PMID:23034930

Reoperative reimplantation procedure after previous remodeling in a patient with Marfan syndrome.

Science.gov (United States)

Hechadi, Jawad; De Kerchove, Laurent; Vohra, Hunaid A; El Khoury, Gebrine

2013-05-01

A 43-year-old man with Marfan syndrome presented with recurrent aortic root dilatation and aortic regurgitation at ten years after a remodeling (Yacoub) procedure. Herein is described a reoperative valve-sparing procedure employing the reimplantation technique (David procedure) used in the treatment of this patient.

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.

Whole-procedure clinical accuracy of Gamma Knife treatments of large lesions

International Nuclear Information System (INIS)

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

2008-01-01

The mechanical accuracy of Gamma Knife radiosurgery based on single-isocenter measurement has been established to within 0.3 mm. 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 0.1-1.6 mm 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.

40 CFR 141.111 - Treatment techniques for acrylamide and epichlorohydrin.

Science.gov (United States)

2010-07-01

... (CONTINUED) WATER PROGRAMS (CONTINUED) NATIONAL PRIMARY DRINKING WATER REGULATIONS Treatment Techniques § 141.111 Treatment techniques for acrylamide and epichlorohydrin. Each public water system must certify... and epichlorohydrin are used in drinking water systems, the combination (or product) of dose and...

Can a Drill Guide Improve the Coracoid Graft Placement During the Latarjet Procedure? A Prospective Comparative Study With the Freehand Technique.

Science.gov (United States)

Barth, Johannes; Boutsiadis, Achilleas; Neyton, Lionel; Lafosse, Laurent; Walch, Gilles

2017-10-01

One of the factors that can affect the success of the Latarjet procedure is accurate coracoid graft (CG) placement. The use of a guide can improve placement of the CG and screw positioning in the sagittal and axial planes as compared with the classic open ("freehand") technique. Cohort study; Level of evidence, 2. A total of 49 patients who underwent a Latarjet procedure for the treatment of recurrent anterior shoulder instability were prospectively included; the procedure was performed with the freehand technique in 22 patients (group 1) and with use of a parallel drill guide during screw placement in 27 patients (group 2). All patients underwent a postoperative computed tomography scan with the same established protocol. The scans were used to evaluate and compare the position of the CG in the sagittal and axial planes, the direction of the screws (α angle), and overall contact of the graft with the anterior surface of the glenoid after the 2 surgical techniques. The CG was placed >60% below the native glenoid equator in 23 patients (85.2%) in group 2, compared with 14 patients (63.6%) in group 1 ( P = .004). In the axial plane, the position of the CG in group 2 patients was more accurate (85.2% and 88.9% flush) at the inferior and middle quartiles of the glenoid surface ( P = .012 and .009), respectively. Moreover, with the freehand technique (group 1), the graft was in a more lateral position in the inferior and middle quartiles ( P = .012 and .009, respectively). No differences were found between groups 1 and 2 regarding the mean α angle of the superior (9° ± 4.14° vs 11° ± 6.3°, P = .232) and inferior (9.5° ± 6° vs 10° ± 7.5°, P = .629) screws. However, the mean contact angle (angle between the posterior coracoid and the anterior glenoid surface) with the freehand technique (3.8° ± 6.8°) was better than that of the guide (8.55° ± 8°) ( P = .05). Compared with the classic freehand operative technique, the parallel drill guide can ensure

Treatment of Moya Moya disease using indirect surgery technique

Directory of Open Access Journals (Sweden)

Cezary Grochowski

2016-08-01

Conclusion: Presented technique is preferred among children suffering from moya moya disease because of the safety of the technique and good treatment effects. There is no need to perform by-pass surgery which is also considered as big advantage of presented technique.

Chronic total coronary occlusion: treatment results.

Science.gov (United States)

Kirk Christensen, Martin; Freeman, Phillip Fischer; Rasmussen, Jeppe Groendal; Villadsen, Anton Boel; Raungaard, Bent; Eggert Jensen, Svend; Thuesen, Leif

2017-08-01

To describe the clinical and procedural coronary chronic total occlusion (CTO) treatment results in a Nordic PCI centre during the implementation of a CTO treatment program. In a retrospective registry study, we assessed; (1) indication for the procedure, (2) Canadian Cardiovascular Society angina pectoris score (CCS)/New York Heart Association (NYHA) heart failure score, (3) lesion complexity and (4) adverse events during hospital stay and three months following the index procedure. The study cohort included 503 patients (594 lesions). From 2010 to 2013 96% of procedures were performed with antegrade wire-escalation technique and 4% performed using retrograde techniques, from 2013-2016 the corresponding numbers were 83% and 17.0%. The procedural success rate was 69%, increasing from 64% before to 72% (p = .06) after routinely using the retrograde approach. No individual patient characteristic, lesion variable or score was strongly associated with procedural success or failure. There were 4% serious procedure related complications. In patients with PCI of a CTO lesion only, 87% were in CCS or NYHA functional class ≥2 before the index procedure vs. 22% at follow-up. Routine use of retrograde techniques tended to increase the procedural success rate. Clinical results after three months were acceptable, but the complication rate was higher than for non-CTO PCI. Individual patient and lesion characteristics had a low predictability for procedural success. Therefore, clinical symptoms, objective signs of myocardial ischemia and procedural risk should be focus points in coronary chronic total occlusion treatment strategies.

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

International Nuclear Information System (INIS)

Ferreira, Sergio L.C.; Andrade, Jailson B. de; Korn, Maria das Gracas A.; Pereira, Madson de G.; Lemos, Valfredo A.; Santos, Walter N.L. dos; Rodrigues, Frederico de Medeiros; Souza, Anderson S.; Ferreira, Hadla S.; Silva, Erik G.P. da

2007-01-01

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

Laparoscopic extended cardiomyotomy in children: an effective procedure for the treatment of esophageal achalasia.

Science.gov (United States)

Tannuri, Ana Cristina Aoun; Tannuri, Uenis; Velhote, Manoel Carlos Prieto; Romão, Rodrigo Luiz Pinto

2010-07-01

Achalasia of the esophagus is characterized by aperistalsis and incomplete relaxation of the lower esophageal sphincter in response to swallowing. The objective of the present study is to present the experience of a modified Heller myotomy via a laparoscopic approach for the treatment of children who had this condition. A retrospective review of medical records of all patients who underwent this procedure from 2000 to 2009 was performed. The procedure consisted of an extended esophagomyotomy beginning on the lower part of the lower esophageal sphincter and continuing 5 to 6 cm above on the lower third of the esophagus, and then extended 3 to 4 cm below to the stomach, associated with an anterior 180-degree hemi-fundoplication according to Dor's technique. Fifteen patients were included in the study. There were 8 female and 7 male patients. Mean operating time was 190 minutes with no intraoperative complications and 1 conversion to open surgery because of difficulty in dissecting an inflamed distal esophagus. In a mean follow-up period of 32.3 months, 2 patients had recurrence of mild dysphagia that disappeared spontaneously, and 1 required a single botulinum toxin injection with complete resolution of symptoms. We conclude that the laparoscopic extended Heller myotomy with Dor fundoplication is a safe and effective method for the treatment for achalasia in the pediatric population even in advanced cases. Copyright 2010 Elsevier Inc. All rights reserved.

Integration technique of digital I and C replacement and its Critical Digital Review procedure

International Nuclear Information System (INIS)

Huang, Hui-Wen; Yang, Wen-Long

2013-01-01

Highlights: ► A digital I and C replacement integration technique have been developed. ► Establishment of Nuclear Power Plant Digital Replacement Integration Guideline. ► Preliminary Investigation on I and C System Digitalization. ► Evaluation on I and C System Digitalization. ► Establishment of I and C System Digitalization Architectures. -- Abstract: Institute of Nuclear Energy Research (INER) developed a digital Instrumentation and Control (I and C) replacement integration technique on the basis of requirement of the three existing nuclear power plants (NPPs), which are Chin–Shan (CS) NPP, Kuo–Sheng (KS) NPP, and Maanshan (MS) NPP, in Taiwan, and also developed the related Critical Digital Review (CDR) procedure. The digital I and C replacement integration technique includes: (1) Establishment of Nuclear Power Plant Digital Replacement Integration Guideline, (2) Preliminary Investigation on I and C System Digitalization, (3) Evaluation on I and C System Digitalization, and (4) Establishment of I and C System Digitalization Architectures. These works can be a reference for performing I and C system digital replacement integration of the three existing NPPs of Taiwan Power Company (TPC). A CDR is the review for a critical system digital I and C replacement. The major reference of this procedure is EPRI TR-1011710 (2005) “Handbook for Evaluating Critical Digital Equipment and Systems” which was published by the Electric Power Research Institute (EPRI). With this document, INER developed a TPC-specific CDR procedure. Currently, CDR becomes one of the policies for digital I and C replacement in TPC. The contents of this CDR procedure include: Scope, Responsibility, Operation Procedure, Operation Flow Chart, CDR review items. The CDR review items include the comparison of the design change, Software Verification and Validation (SV and V), Failure Mode and Effects Analysis (FMEA), Evaluation of Diversity and Defense-in-depth (D3), Evaluation of

The Selection of Procedures in One-stage Urethroplasty for Treatment of Coexisting Urethral Strictures in Anterior and Posterior Urethra.

Science.gov (United States)

Lv, XiangGuo; Xu, Yue-Min; Xie, Hong; Feng, Chao; Zhang, Jiong

2016-07-01

To explore selection of the procedures in one-stage urethroplasty for treatment of coexisting urethral strictures in the anterior and posterior urethra. Between 2008 and 2014, a total of 27 patients with existing strictures simultaneously at anterior urethra and posterior urethra were treated in our hospital. Two types of procedures were selected for treatment of the anterior urethral strictures. A penile skin flap and the lingual mucosa were used for augmented urethroplasty in 20 and 7 cases, respectively. Three types of procedures, namely, non-transecting end-to-end urethral anastomosis (n = 3), traditional end-to-end urethral anastomosis (n = 17), other grafts substitution urethroplasty, including pedicle scrotal skin urethroplasty (n = 2), and lingual mucosal graft urethroplasty (n = 5), were utilized in the treatment of posterior urethral strictures. The patients were mean followed up 30 months with an overall success rate of 88.9%. The majority of the patients exhibited wide patent urethras on retrograde urethrography and the patients' urinary peak flow ranged from 14.2 to 37.9 ml/s. Complications developed in 3 patients (11.1%). Of the 17 patients who underwent traditional urethral end-to-end anastomosis, urethral strictures occurred in 2 patients at 4 and 6 months after the operation. These patients achieved a satisfactory voiding function after salvage pedicle scrotal skin urethroplasty. A urethral pseudodiverticulum was observed in another patient 9 months after pedicle penile flap urethroplasty; and after a salvage procedure, he regained excellent voiding function. Synchronous anterior and posterior strictures can be successfully reconstructed with a combination of substitution and anastomotic urethroplasty techniques. Copyright © 2016 Elsevier Inc. All rights reserved.

Special set-up and treatment techniques for the radiotherapy of pediatric malignancies

International Nuclear Information System (INIS)

Martinez, A.; Donaldson, S.S.; Bagshaw, M.A.

1977-01-01

The prevention of serious and long term complications of treatment have become as important a consideration in the therapy of children with malignant disease as the goal of tumor control. This balance requires meticulous treatment planning and attention to the treatment preparation and immobilization techniques when radiotherapy is administered to children. Accurate localization of tumor volume and daily reproducibility is essential for delivering precise irradiation. Four special set-up and treatment techniques which have a specific usefulness in radiotherapy for pediatric malignancies are defined and illustrated with the aid of clinical cases. They include the three point set-up, the split beam technique, the isocentric technique, and the strinking field technique

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…

PENILE ENHANCEMENT PROCEDURES: UROLOGICAL AND ETHICOLEGAL ISSUES

OpenAIRE

Marco Vella

2012-01-01

Phalloplasty procedures for most men requiring penile augmentation surgery are cosmetic procedures; generally the patients have a normal-sized and fully functional penis but they think that their penis is too small. There are not well defined indications for penile enhancement surgery and, except for the treatment of “micropenis”, there are not established guidelines and the outcome measures for success are still unclear. All penile enhancement techniques often do not reach the...

Talar anchor placement for modified Brostrom lateral ankle stabilization procedure.

Science.gov (United States)

Angirasa, Arush K; Barrett, Michael J

2008-01-01

The modified Brostrom procedure has been a proven procedure with excellent utility in the treatment of lateral ankle instability within limitation. Multiple variations of the original technique have been described in the literature to date. Included in these variations are differences in anchor placement, suture technique, or both. In this research study, we propose placing a bone screw anchor into the lateral shoulder of the talus rather than the typical placement at the lateral malleolus for anatomic reconstruction of the lateral ankle ligaments.

MDCT evaluation of pulmonary embolism in children and young adults following a lateral tunnel Fontan procedure: optimizing contrast-enhancement techniques

International Nuclear Information System (INIS)

Prabhu, Sanjay P.; Mahmood, Soran; Sena, Laureen; Lee, Edward Y.

2009-01-01

Pulmonary embolism (PE) is a life-threatening thromboembolic complication in patients who have undergone a Fontan procedure for augmenting pulmonary blood flow in the setting of single-ventricle physiology. In patients following a Fontan procedure, lack of proper contrast agent mixing in the right atrium and sluggish, low-velocity blood flow within the Fontan circulation often results in suboptimal contrast enhancement within the pulmonary artery for evaluating PE. Unfortunately, there is a paucity of information describing the optimal contrast-enhancement technique with multidetector CT (MDCT) for evaluating PE in children and young adults following a Fontan procedure. We illustrate the MDCT imaging findings of suboptimal contrast enhancement within the pulmonary artery, which can be mistaken for PE, in patients following a lateral Fontan procedure, and we discuss MDCT techniques to optimize contrast enhancement within the pulmonary artery in these patients for evaluating PE. The MDCT imaging findings in pediatric and young adult patients following a lateral Fontan procedure and with clinically suspected PE are illustrated. We describe intravenous contrast agent injection techniques that can be used to optimize the contrast enhancement in the pulmonary artery in patients following a lateral Fontan procedure. The use of a suboptimal contrast-enhancement technique led to initial misdiagnosis and incomplete evaluation of PE in the three patients following a lateral Fontan procedure. Imaging in two patients showed that optimal evaluation of thrombosis in the Fontan pathway and PE in the pulmonary arteries can be successfully achieved with simultaneous upper- and lower-limb injections of contrast agent. This series demonstrates that suboptimal contrast enhancement can result in misdiagnosis or incomplete evaluation of PE in children and young adults following a lateral Fontan procedure. Careful attention to optimizing contrast enhancement during MDCT examination for

Utilization of two different surgical techniques in gingival recession treatment: A comparative study

Directory of Open Access Journals (Sweden)

Bajić Miljan

2014-01-01

Full Text Available Introduction. Gingival recession is a displacement of gingival margin apically to cementenamel junction. Objective. The aim of this study was to compare the results achieved with two different surgical procedures used in gingival recession treatment. Methods. Ten patients with bilateral buccal recession on maxillary canines or premolars were included in the study. Professional teeth cleaning was performed before surgery. Recession on the experimental side was treated with connective tissue graft in combination with coronally advanced, split thickness flap (tunnel technique. Control side recession was treated with connective tissue graft in combination with trapezoidal coronally advanced, full thickness flap. Coin toss was used for side decision. The following parameters were evaluated before surgery and 6 months post-op: Vertical Recession Dimension, Clinical Attachment Level, Apico-coronal width of the keratinized tissue, Healing index (Laundry, RES index, and Patient evaluation of esthetic results. Student’s t-test was used for statistical analysis. Results. Six months after surgery, mean root coverage was 91.5±14.1% and 90.1±14.6% on the experimental and on the control side, respectively. RES index, Healing index (Laundry and Patient Subjective evaluation of esthetic results showed significantly better results (p≤0.05. Conclusion. Both surgical procedures produce highly successful clinical results based on evaluated parameters, but this tunnel technique provides significantly better esthetic results. [Projekat Ministarstva nauke Republike Srbije, br. III 41008: Interakcija etiopatogenetskih mehanizama parodontopatije i periimplantitisa sa sistemskim bolestima današnjice

[Single procedure treatment of complex nephrolithiasis: about a modern series of anatrophic nephrolithotomy].

Science.gov (United States)

Lunardi, P; Timsit, M O; Roumiguie, M; Dariane, C; N'Guyen, K; Beauval, J B; Leroux, S

2015-02-01

Advances in endourology have significantly reduced indications of open surgery in the treatment of staghorn calculi. However, in our experience, open surgery is still the treatment of choice in some cases. This study presents the results of a series of selected patients and discusses the results in terms of efficacy and morbidity. A cohort of 26 patients underwent anatrophic nephrolithotomy by lombotomy to treat a complex staghorn calculus. The mean stone size was 68,5mm, 70% were complete staghorn calculi. The operative time was 100minutes. Blood loss was 225mL, with a postoperative transfusion rate of 15.4%. The hospital stay was 8.4 days. The stone free rate following the procedure was 92%. The creatinine clearance (MDRD) at 3 months was improved from 5.9mL/min/m(2) on average over the entire series. There are clearly still indications for open surgery in staghorn stones management, with good results in this contemporary series on both stone removal and nephronic preservation. Yet, it appears that this technique is no longer taught. 5. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

Techniques for preparing flowchart-format emergency operating procedures: Background (Sections 1.0-9.0)

International Nuclear Information System (INIS)

Barnes, V.E.; Moore, C.J.; Wieringa, D.R.; Isakson, C.S.; Kono, B.K.; Gruel, R.L.

1989-01-01

This two-volume report describes the activities, findings, and recommendations of a project entitled ''Techniques for Presenting Flowchart-Format Emergency Operating Procedures.'' The project team surveyed the literature pertaining to flowcharts, reviewed existing flowchart emergency operating procedures (EOPs), interviewed consultants who produced flowcharts, and interviewed reactor operator licensing examiners about the use of flowcharts in nuclear power plants. This document, and Volume 1 of this report, discusses the use of flowchart-format EOPs in nuclear power plants and presents issue to be addressed in the design and implementation of flowchart EOPs. 66 refs., 76 figs., 2 tabs

Two Procedures for Relaxation as Self-Control in the Treatment of Communication Apprehension

Science.gov (United States)

Deffenbacher, Jerry L.; Payne, Dennis M.

1977-01-01

An in vivo procedure for relaxation as self-control and a procedure for self-control modification of desensitization were compared to a no-treatment control. Results showed modified desensitization, compared to the control, significantly decreased communication anxiety and fear of negative evaluation and significantly increased assertiveness.…

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)

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.

Gaining Insights on Nasopharyngeal Carcinoma Treatment Outcome Using Clinical Data Mining Techniques.

Science.gov (United States)

Ghaibeh, A Ammar; Kasem, Asem; Ng, Xun Jin; Nair, Hema Latha Krishna; Hirose, Jun; Thiruchelvam, Vinesh

2018-01-01

The analysis of Electronic Health Records (EHRs) is attracting a lot of research attention in the medical informatics domain. Hospitals and medical institutes started to use data mining techniques to gain new insights from the massive amounts of data that can be made available through EHRs. Researchers in the medical field have often used descriptive statistics and classical statistical methods to prove assumed medical hypotheses. However, discovering new insights from large amounts of data solely based on experts' observations is difficult. Using data mining techniques and visualizations, practitioners can find hidden knowledge, identify interesting patterns, or formulate new hypotheses to be further investigated. This paper describes a work in progress on using data mining methods to analyze clinical data of Nasopharyngeal Carcinoma (NPC) cancer patients. NPC is the fifth most common cancer among Malaysians, and the data analyzed in this study was collected from three states in Malaysia (Kuala Lumpur, Sabah and Sarawak), and is considered to be the largest up-to-date dataset of its kind. This research is addressing the issue of cancer recurrence after the completion of radiotherapy and chemotherapy treatment. We describe the procedure, problems, and insights gained during the process.

Energetic soft-tissue treatment technologies: an overview of procedural fundamentals and safety factors

NARCIS (Netherlands)

van de Berg, N. J.; van den Dobbelsteen, J. J.; Jansen, F. W.; Grimbergen, C. A.; Dankelman, J.

2013-01-01

Energy administered during soft-tissue treatments may cauterize, coagulate, seal, or otherwise affect underlying structures. A general overview of the functionality, procedural outcomes, and associated risks of these treatments, however, is not yet generally available. In addition, literature is

Detour technique, Dipping technique, or IIeal bladder flap technique for surgical correction of uretero-ileal anastomotic stricture in orthotopic ileal neobladder

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Mohamed Wishahi

2015-08-01

Full Text Available ABSTRACTBackground:Uretero-ileal anastomotic stricture (UIAS is a urological complication after ileal neobladder, the initial management being endourological intervention. If this fails or stricture recurs, surgical intervention will be indicated.Design and Participants:From 1994 to 2013, 129 patients were treated for UIAS after unsuccessful endourological intervention. Unilateral UIAS was present in 101 patients, and bilateral in 28 patients; total procedures were 157. The previous ileal neobladder techniques were Hautmann neobladder, detubularized U shape, or spherical shape neobladder.Surgical procedures:Dipping technique was performed in 74 UIAS. Detour technique was done in 60 renal units. Ileal Bladder flap was indicated in 23 renal units. Each procedure ended with insertion of double J, abdominal drain, and indwelling catheter.Results:Follow-up was done for 12 to 36 months. Patency of the anastomosis was found in 91.7 % of cases. Thirteen patients (8.3% underwent antegrade dilatation and insertion of double J.Conclusion:After endourological treatment for uretero-ileal anastomotic failure, basically three techniques may be indicated: dipping technique, detour technique, and ileal bladder flap. The indications are dependent on the length of the stenotic/dilated ureteral segment. Better results for long length of stenotic ureter are obtained with detour technique; for short length stenotic ureter dipping technique; when the stenotic segment is 5 cm or more with a short ureter, the ileal tube flap is indicated. The use of double J stent is mandatory in the majority of cases. Early intervention is the rule for protecting renal units from progressive loss of function.

Pelvic denervation procedures for dysmenorrhea.

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Ramirez, Christina; Donnellan, Nicole

2017-08-01

Chronic pelvic pain and dysmenorrhea are common conditions affecting reproductive-age women. Surgical pelvic denervation procedures may be a treatment option for women with midline dysmenorrhea, in which medical management is declined by the patient, ineffective at managing symptoms, or medically contraindicated. This review describes the surgical techniques and complications associated with pelvic denervation procedures as well as the current evidence for these procedures in women with primary dysmenorrhea and dysmenorrhea secondary to endometriosis. Presacral neurectomy is the preferred pelvic denervation procedure in patients with primary dysmenorrhea and midline chronic pelvic pain associated with endometriosis. In patients with endometriosis presacral neurectomy is a useful adjunct to excision or ablation of all endometrial lesions to improve postoperative pain relief. There is no additional patient benefit of performing combined presacral neurectomy and uterine nerve ablation procedures. Pelvic denervation procedures can be performed safely and quickly with a low risk of complication if the surgeon is knowledgeable and skilled in operating in the presacral space. Patients should be adequately counseled on expected success rates and potential complications associated with pelvic denervation procedures.

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

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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

Modified duval procedure for small-duct chronic pancreatitis without head dominance.

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Oida, Takatsugu; Aramaki, Osamu; Kano, Hisao; Mimatsu, Kenji; Kawasaki, Atsushi; Kuboi, Youichi; Fukino, Nobutada; Kida, Kazutoshi; Amano, Sadao

2011-01-01

In the case of small-duct chronic pancreatitis, surgery for pain relief is broadly divided into resection and drainage procedures. These procedures should be selected according to the location of dominant lesion, diameter of the pancreatic duct and extent of the disease. The appropriate procedure for the treatment of small-duct chronic pancreatitis, especially small-duct chronic pancreatitis without head dominance, remains controversial. We developed the modified Duval procedure for the treatment of small-duct chronic pancreatitis without head dominance and determined the efficacy of this procedure. We retrospectively studied 14 patients who underwent surgical drainage with or without pancreatic resection for chronic pancreatitis with small pancreatic duct (Puestow procedure group and the modified Duval procedure group. No complications occurred in the modified Duval group. In the modified Puestow procedure group, complete and partial pain relief were observed in 62.5%, and 37.5% of patients respectively. In contrast, complete pain relief was observed in all the patients in the modified Duval procedure group. Our modified Duval procedure is useful and should be considered the appropriate surgical technique for the treatment of small-duct chronic pancreatitis without head dominance.

Interventional neuroradiology techniques in interventional radiology

CERN Document Server

Murphy, Kieran; Robertson, Fergus; Watkinson, Anthony

2013-01-01

This book provides accessible technique-specific information on interventional radiology procedures, in a format suitable for reference in the IR treatment room or as a carry-around guide. Offers step-by-step points, key point summaries and illustrations.

Characteristics, treatment, and outcomes of periprocedural cerebrovascular accidents during electrophysiologic procedures.

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Harb, Serge C; Thomas, George; Saliba, Walid I; Nakhoul, Georges N; Hussein, Ayman A; Duarte, Valeria E; Bhargava, Mandeep; Baranowski, Bryan; Tchou, Patrick; Dresing, Thomas; Callahan, Thomas; Kanj, Mohamed; Natale, Andrea; Lindsay, Bruce D; Wazni, Oussama M

2013-06-01

We sought to identify the characteristics, treatment, and outcomes of periprocedural cerebrovascular accident (PCVA) during electrophysiologic (EP) procedures. Periprocedural cerebrovascular accident is one of the most feared complications during EP procedures with very few data regarding its characteristics, management, and outcomes. Between January 1998 and December 2008, we reviewed 30,032 invasive EP procedures for PCVA occurrence and characteristics. Management and outcomes were also determined. Thirty-eight CVAs were identified. Twenty (53 %) were intraprocedural and 18 (47 %) postprocedural. Thirty-two (84 %) were classified as strokes and six (16 %) as transient ischemic attacks. All CVAs except one (37, 97 %) were ischemic and the vast majority occurred during ablation procedures (36, 95 %). Among the 31 patients with ischemic stroke, 11 (35 %) were treated with reperfusion (eight catheter-based therapy and three intravenous t-PA) of whom five (46 %) had complete recovery, three (27 %) had partial recovery, and three (27 %) had no recovery. No hemorrhagic transformations occurred. Periprocedural cerebrovascular accident during EP procedures is rare and is almost always ischemic. It occurs more frequently during ablation procedures. Reperfusion therapy is feasible and safe.

Results of a minimally invasive technique for treatment of unicameral bone cysts.

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Mik, Gökçe; Arkader, Alexandre; Manteghi, Alexander; Dormans, John P

2009-11-01

Unicameral bone cysts are benign bone lesions commonly seen in pediatric patients. Several treatment methods have been described with variable results and high recurrence rates. We previously reported short-term success of a minimally invasive technique that includes combining percutaneous decompression and grafting with medical-grade calcium sulfate pellets. The purpose of this study was to review the additional long-term results with a minimum followup of 24 months (average, 37 months; range, 24-70 months). We identified 55 patients with an average age of 10.8 years (range, 1.3-18 years). Forty-one of 55 lesions occurred in the humerus and femur. Forty-four of 55 (80%) patients had a partial or complete response after initial surgery; of these, seven obtained a partial or complete response after a repeat surgery (cumulative healing rate, 94%). Two patients underwent a third surgery (cumulative healing rate, 98%). One underwent a third repeat surgery (cumulative healing rate, 100%). There were no major complications associated with the procedure. Two patients had a superficial infection that resolved with oral antibiotics. Although some patients required a repeat procedure, complete or partial response at a minimum 24 months' followup was achieved in all patients. Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

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)

Paediatric minor oral surgical procedures under inhalation sedation and general anaesthetic: a comparison of variety and duration of treatment.

Science.gov (United States)

Foley, J

2008-03-01

To develop baseline data in relation to paediatric minor oral surgical procedures undertaken with both general anaesthesia and nitrous oxide inhalation sedation within a Hospital Dental Service. Data were collected prospectively over a three-year period from May 2003 to June 2006 for patients attending the Departments of Paediatric Dentistry, Dundee Dental Hospital and Ninewells Hospital, NHS Tayside, Great Britain, for all surgical procedures undertaken with either inhalation sedation or general anaesthetic. Both operator status and the procedure being undertaken were noted. In addition, the operating time was recorded. Data for 166 patients (F: 102; M: 64) with a median age of 12.50 (inter-quartile range 10.00, 14.20) years showed that 195 surgical procedures were undertaken. Of these 160 and 35 were with general anaesthetic and sedation respectively. The surgical removal of impacted, carious and supernumerary unit(s) accounted for 53.8% of all procedures, whilst the exposure of impacted teeth and soft tissue surgery represented 34.9% and 11.3% of procedures respectively. The median surgical time for techniques undertaken with sedation was 30.00 (inter-quartile range 25.00, 43.50) minutes whilst that for general anaesthetic was similar at 30.00 (inter-quartile range 15.25, 40.00) minutes (not statistically significant, (Mann Whitney U, W = 3081.5, P = 0.331). The majority of paediatric minor oral surgical procedures entail surgical exposure or removal of impacted teeth. The median treatment time for most procedures undertaken with either general anaesthetic or nitrous oxide sedation was 30 minutes.

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.…

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

Automated synthesis of image processing procedures using AI planning techniques

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Chien, Steve; Mortensen, Helen

1994-01-01

This paper describes the Multimission VICAR (Video Image Communication and Retrieval) Planner (MVP) (Chien 1994) system, which uses artificial intelligence planning techniques (Iwasaki & Friedland, 1985, Pemberthy & Weld, 1992, Stefik, 1981) to automatically construct executable complex image processing procedures (using models of the smaller constituent image processing subprograms) in response to image processing requests made to the JPL Multimission Image Processing Laboratory (MIPL). The MVP system allows the user to specify the image processing requirements in terms of the various types of correction required. Given this information, MVP derives unspecified required processing steps and determines appropriate image processing programs and parameters to achieve the specified image processing goals. This information is output as an executable image processing program which can then be executed to fill the processing request.

New techniques in lamellar keratoplasty.

Science.gov (United States)

Alio, Jorge L; Shah, Sunil; Barraquer, Carmen; Bilgihan, Kamil; Anwar, Mohammed; Melles, Gerrit R J

2002-08-01

In the past years, several lamellar keratoplasty surgical techniques have been developed, modified or improved in the past years, including microkeratome assisted anterior and posterior lamellar keratoplasty, anterior lamellar keratoplasty using air-dissection or visco-dissection, sutureless posterior lamellar keratoplasty, LASIK for postkeratoplasty astigmatism, and excimer laser assisted keratophakia for keratoconus or to manage complications after LASIK. These procedures may continue to gain interest as alternative procedures for a penetrating keratoplasty in the treatment of various corneal disorders.

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.

Endovascular treatment for extrahepatic portal vein bifurcation stenosis after a Whipple procedure using the kissing stents technique.

Science.gov (United States)

Zhang, Wen-guang; Liu, Dong-mei; Li, Zhen; Wang, Yan-Li; Ding, Peng-xu; Zhou, Peng-li; Wang, Zhong-gao; Han, Xin-wei

2014-01-01

A 57-year-old man presented with a rare extrahepatic portal vein bifurcation scar stenosis involving the proximal splenic vein and superior mesenteric vein after a Whipple procedure. He was treated with endovascular coil embolization for the gastroesophageal varices and kissing stents for the portal vein bifurcation stenosis. This case illustrates a rarely seen complication after the Whipple procedure and a novel management strategy that can be considered in the management of this complex disease. Copyright © 2014 Elsevier Inc. All rights reserved.

Inner tubing technique used for the treatment of anastomotic aneurism.

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Gaspar, Márcio Teodoro da Costa; de Mattos, Bruno Vinicius Hortences; Sofia, Milena Cristina Dias; Mulatti, Grace Carvajal; Lederman, Alex

2016-01-01

The authors report the case of a 66-year-old male patient diagnosed with a pseudoaneurysm of the distal aorto-aortic anastomosis treated with the inner tubing technique. The patient had been operated on 1 year before when he had an aortic prosthesis implanted as treatment for a ruptured abdominal aortic aneurysm. The inner tubing technique was developed to facilitate the treatment in bifurcated vascular lesions, where endovascular conventional prosthesis is not available.

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

International Nuclear Information System (INIS)

Barciela, Julia; Vilar, Manuela; Garcia-Martin, Sagrario; Pena, Rosa M.; Herrero, Carlos

2008-01-01

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 -1 for Na, -1 for K, 0.02-4.83 mg L -1 for Mg content, -1 for Cu and 0.03-13.10 mg L -1 for Ca

If additional shielding required for the linear accelerator room when modern treatment techniques are intensively used

International Nuclear Information System (INIS)

Miller, Albert V.; Atkocius, Vydmantas; Aleknavicius, Eduardas

2001-01-01

are different and should be considered separately. Additionally, in theory, the workloads for all energies in use have to be calculated. In practice, however, the shielding calculation needs to be performed only for the highest energy used for the particular technique. In our case it was 25 MV X-rays. Results - The primary barrier thickness is calculated with the use of direct workload value. Direct workload in our case is the sum of conventional workload, conformal workload and TBI workload. For the secondary barrier thickness calculation the leakage and scatter workloads are used. Leakage workload is determined as total number of monitor units accumulated per week. For the conventional treatment leakage workload the factor of 1cGy/MU is used to convert from direct workload. For conformal technique, however, additional factor of approximately 2 is required. This factor is about 10 for our TBI technique. Scatter workload we found less or equal to the direct workload. Further, we assumed about 40% of patients receive conformal therapy on the accelerator and in average one patient per week receive TBI. The leakage workload in this situation will be 1.6 of the direct workload. It will increase the secondary barrier thickness by approximately 0.18 of tenth value layer. Conclusion - When intensive use of conformal therapy and TBI is planned on linear accelerator one should consider increasing secondary barrier thickness for the treatment room. The calculation procedure is quite simple and does not require any additional data or measurements. (author)

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

Science.gov (United States)

Brodin, N Patrik; Munck af Rosenschöld, Per; Blomstrand, Malin; Kiil-Berthlesen, Anne; Hollensen, Christian; Vogelius, Ivan R; Lannering, Birgitta; Bentzen, Søren M; Björk-Eriksson, Thomas

2014-04-01

We 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. We included 17 pediatric medulloblastoma patients to represent the variability in tumor location relative to the hippocampal region. Treatment plans were generated using 3D conformal radiotherapy, hippocampal sparing intensity-modulated radiotherapy, and spot-scanned proton therapy, using 3 different treatment margins for the conformal tumor boost. Neurocognitive impairment risk was estimated based on dose-response models from pediatric CNS malignancy survivors and compared among different margins and treatment techniques. Mean hippocampal dose and corresponding risk of cognitive impairment were decreased with decreasing treatment margins (P < .05). The largest risk reduction, however, was seen when applying hippocampal sparing proton therapy-the estimated risk of impaired task efficiency (95% confidence interval) was 92% (66%-98%), 81% (51%-95%), and 50% (30%-70%) for 3D conformal radiotherapy, intensity-modulated radiotherapy, and proton therapy, respectively, for the smallest boost margin and 98% (78%-100%), 90% (60%-98%), and 70% (39%-90%) if boosting the whole posterior fossa. Also, the distance between the closest point of the planning target volume and the center of the hippocampus can be used to predict mean hippocampal dose for a given treatment technique. We estimate a considerable clinical benefit of hippocampal sparing radiotherapy. In choosing treatment margins, the tradeoff between margin size and risk of neurocognitive impairment quantified here should be considered.

Biodegradable Magnesium Stent Treatment of Saccular Aneurysms in a Rat Model - Introduction of the Surgical Technique.

Science.gov (United States)

Nevzati, Edin; Rey, Jeannine; Coluccia, Daniel; D'Alonzo, Donato; Grüter, Basil; Remonda, Luca; Fandino, Javier; Marbacher, Serge

2017-10-01

The steady progess in the armamentarium of techniques available for endovascular treatment of intracranial aneurysms requires affordable and reproducable experimental animal models to test novel embolization materials such as stents and flow diverters. The aim of the present project was to design a safe, fast, and standardized surgical technique for stent assisted embolization of saccular aneurysms in a rat animal model. Saccular aneurysms were created from an arterial graft from the descending aorta.The aneurysms were microsurgically transplanted through end-to-side anastomosis to the infrarenal abdominal aorta of a syngenic male Wistar rat weighing >500 g. Following aneurysm anastomosis, aneurysm embolization was performed using balloon expandable magnesium stents (2.5 mm x 6 mm). The stent system was retrograde introduced from the lower abdominal aorta using a modified Seldinger technique. Following a pilot series of 6 animals, a total of 67 rats were operated according to established standard operating procedures. Mean surgery time, mean anastomosis time, and mean suturing time of the artery puncture site were 167 ± 22 min, 26 ± 6 min and 11 ± 5 min, respectively. The mortality rate was 6% (n=4). The morbidity rate was 7.5% (n=5), and in-stent thrombosis was found in 4 cases (n=2 early, n=2 late in stent thrombosis). The results demonstrate the feasibility of standardized stent occlusion of saccular sidewall aneurysms in rats - with low rates of morbidity and mortality. This stent embolization procedure combines the opportunity to study novel concepts of stent or flow diverter based devices as well as the molecular aspects of healing.

Sci-Fri PM: Radiation Therapy, Planning, Imaging, and Special Techniques - 06: Patient-specific QA Procedure for Gated VMAT SABR Treatments using 10x Beam in Flattening-Filter Free Mode

Energy Technology Data Exchange (ETDEWEB)

Mestrovic, Ante; Chitsazzadeh, Shadi; Wells, Derek M.; Gray, Stephen [University of Calgary, Tom Baker Cancer Centre, Tom Baker Cancer Centre (Canada)

2016-08-15

Purpose: To develop a highly sensitive patient specific QA procedure for gated VMAT stereotactic ablative radiotherapy (SABR) treatments. Methods: A platform was constructed to attach the translational stage of a Quasar respiratory motion phantom to a pinpoint ion chamber insert and move the ion chamber inside the ArcCheck. The Quasar phantom controller uses a patient-specific breathing pattern to translate the ion chamber in a superior-inferior direction inside the ArcCheck. With this system the ion chamber is used to QA the correct phase of the gated delivery and the ArcCheck diodes are used to QA the overall dose distribution. This novel approach requires a single plan delivery for a complete QA of a gated plan. The sensitivity of the gating QA procedure was investigated with respect to the following parameters: PTV size, exhale duration, baseline drift, gating window size. Results: The difference between the measured dose to a point in the penumbra and the Eclipse calculated dose was under 2% for small residual motions. The QA procedure was independent of PTV size and duration of exhale. Baseline drift and gating window size, however, significantly affected the penumbral dose measurement, with differences of up to 30% compared to Eclipse. Conclusion: This study described a highly sensitive QA procedure for gated VMAT SABR treatments. The QA outcome was dependent on the gating window size and baseline drift. Analysis of additional patient breathing patterns is currently undergoing to determine a clinically relevant gating window size and an appropriate tolerance level for this procedure.

A Fuzzy PROMETHEE Approach for Breast Cancer Treatment Techniques

Directory of Open Access Journals (Sweden)

Dilber Uzun Ozsahin

2018-05-01

Full Text Available Breast tumor is a growth that occur in the healthy breast tissue, whereby abnormal cells undergo division in an uncontrolled manner. It comes in different types and stages and the ability to metastasize and infect distant tissues. Several studies have showed that one in eight women in the US have develop breast cancer during their life time. Therefore, early diagnosis and treatment is widely approved as being essential to effectively alleviate the disease. The aim of this study is to comparatively analyze certain breast cancer treatment procedures which include surgery, hormone therapy, chemotherapy, and radiation therapy. Fuzzy PROMETHEE (preference ranking organization method for enrichment of evaluations a multi-criteria decision-making process was used to evaluate the treatments on factors that include side effects, overall survival rate, cost of treatment and treatment time.

Calibration and verification of surface contamination meters --- Procedures and techniques

International Nuclear Information System (INIS)

Schuler, C; Butterweck, G.; Wernli, C.; Bochud, F.; Valley, J.-F.

2007-03-01

A standardised measurement procedure for surface contamination meters (SCM) is presented. The procedure aims at rendering surface contamination measurements to be simply and safely interpretable. Essential for the approach is the introduction and common use of the radionuclide specific quantity 'guideline value' specified in the Swiss Radiation Protection Ordinance as unit for the measurement of surface activity. The according radionuclide specific 'guideline value count rate' can be summarized as verification reference value for a group of radionuclides ('basis guideline value count rate'). The concept can be generalized for SCM of the same type or for SCM of different types using he same principle of detection. A SCM multi source calibration technique is applied for the determination of the instrument efficiency. Four different electron radiation energy regions, four different photon radiation energy regions and an alpha radiation energy region are represented by a set of calibration sources built according to ISO standard 8769-2. A guideline value count rate representing the activity per unit area of a surface contamination of one guideline value can be calculated for any radionuclide using instrument efficiency, radionuclide decay data, contamination source efficiency, guideline value averaging area (100 cm 2 ), and radionuclide specific guideline value. n this way, instrument responses for the evaluation of surface contaminations are obtained for radionuclides without available calibration sources as well as for short-Iived radionuclides, for which the continuous replacement of certified calibration sources can lead to unreasonable costs. SCM verification is based on surface emission rates of reference sources with an active area of 100 cm 2 . The verification for a given list of radionuclides is based on the radionuclide specific quantity guideline value count rate. Guideline value count rates for groups of radionuclides can be represented within the maximum

Guide of external radiotherapy procedures 2007

International Nuclear Information System (INIS)

Anon.

2008-01-01

This work aims at participating in the permanent optimization of the returned medical service and the ratio profit-risk. This first version of the guide of external radiotherapy procedures 2007 processes only techniques of external radiotherapy, by opposition to the techniques of brachytherapy which use radioactive sources (iridium 192 , iodine 125 , cesium 137 ) placed in the contact of the tumor to be irradiated. Only, also, will be considered the irradiations of the most frequent cunning(malignant) tumors with the exception of the radiotherapy of the mild pathologies and the re-irradiations after a first radiotherapy. The first part is shared in eight chapters as follow: introduction, the steps of a treatment by radiotherapy, infrastructure, equipment and human resources, radiobiology mechanism of action of ionising radiations in radiotherapy, dose in radiotherapy, quality of treatment and radiation protection of patients in radiotherapy, prevention and risk management in radiotherapy, quality assurance and radiation protection for the pediatrics cancers and the case of pregnant women. The second part gives the tumoral localizations and the procedures; the third part is a glossary and different annexes such regulations and legislative texts. (N.C.)

SU-E-J-162: Quality Assurance Procedures for MR Guided Focused Ultrasound Treatment of Bone Metastasis

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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.

SU-E-J-162: Quality Assurance Procedures for MR Guided Focused Ultrasound Treatment of Bone Metastasis

International Nuclear Information System (INIS)

Chen, L; Chen, X; Wang, B; Gupta, R; Ma, C

2014-01-01

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

Aortic arch/elephant trunk procedure with Sienna(TM) graft and endovascular stenting of thoraco-abdominal aorta for treatment of complex chronic dissection.

Science.gov (United States)

Wong, Randolph H L; Baghai, Max; Yu, Simon C H; Underwood, Malcolm J

2013-05-01

Aneurismal dilatation of the remaining thoracic aorta after ascending aortic interposition grafting for type 'A' aortic dissection is not uncommon. For such complex cases, one treatment option is total arch replacement and elephant trunk procedure with the Sienna(TM) collared graft (Vascutek, Inchinnan, UK) technique followed by a staged thoracic endovascular aortic repair (TEVAR). The video illustrates our technique in a 56-year-old man with an extensive aortic arch and descending thoracic aortic dissecting aneurysm. For the 'open' procedure femoral arterial and venous cannulation was used along with systemic cooling and circulatory arrest at 22 °C. Upon circulatory arrest, the aortic arch was incised and antegrade cerebral perfusion achieved via selective cannulation to the right brachiocephalic and left common carotid artery, keeping flow rates at 10-15 mL/kg/min and perfusion pressure at 50-60 mmHg. Arch replacement with an elephant trunk component was then performed and after completion of the distal aortic anastomosis antegrade perfusion via a side-arm in the graft was started and the operation completed using a variation of the 'sequential' clamping technique to maximize cerebral perfusion. The second endovascular stage was performed two weeks after discharge. Two covered stents were landing from the elephant trunk to the distal descending thoracic aorta, to secure the distal landing a bare stent of was placed to cover the aorta just distal to the origin of the celiac axis. The left subclavian artery was embolised with fibre coils. Post TEVAR angiogram showed no endoleak Although re-operative total arch replacement and elephant trunk procedure and subsequent TEVAR remained a challenging procedure, we believe excellent surgical outcome can be achieved with carefully planned operative strategy.

Dosimetric comparison of metastatic spinal photon treatment techniques

Energy Technology Data Exchange (ETDEWEB)

Ewing, Marvene M., E-mail: mewing@iuhealth.org [Department of Radiation Oncology, Indiana University School of Medicine, Indianapolis, IN (United States); Carnes, Samuel M.; Henderson, Mark A.; Das, Indra J. [Department of Radiation Oncology, Indiana University School of Medicine, Indianapolis, IN (United States)

2012-01-01

Traditional palliative treatment of metastatic cancer to the vertebral bodies often results in doses to the spinal cord that are higher than the dose prescribed to the target, or gross tumor volume (GTV). This study compares traditional techniques of spine palliation with intensity-modulated radiation therapy (IMRT). The purpose of the study is 2-fold: first, the study demonstrates the benefits of using IMRT to lower the dose to the organs at risk (OAR), particularly for the spinal cord and other nonspecified normal tissues; second, the article provides information regarding the advantages and disadvantages of commonly used conventional techniques for treating the vertebral bodies based on patient anatomy. Because the use of IMRT or other advanced techniques may be prohibitive because of insurance issues, treatment plans were created that compared optimal coverage vs. optimal sparing for single-field, wedged-pair, and opposed-beam arrangements. Fifty-five patients were selected and divided by location of target (cervical, thoracic, and lumbar spine) and also by the measured separation between the anterior and posterior surface of the patient at the level of mid-GTV. Within each anatomic category the patients again were divided into the categories of small, medium, and large based on separation. The patient dataset that most closely represented the average separation within each category was selected, resulting in a total of 9 patients, and the appropriate treatment plan techniques were calculated for each of the 9 patients. The results of the study do show that the use of IMRT is far superior when compared with other techniques, both for coverage and for sparing of the surrounding tissue, regardless of patient size and the section of spine being treated. Based on a combination of both target coverage and sparing of normal tissues, the conventional plan of choice may vary by both the section of spine to be treated and by the size of the patient.

Waste treatment in NUCEF facility with silver mediated electrochemical oxidation technique

International Nuclear Information System (INIS)

Umeda, M.; Sugikawa, S.

2000-01-01

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)

Trends in preconcentration procedures for metal determination using atomic spectrometry techniques

International Nuclear Information System (INIS)

Godoi Pereira, M. de; Arruda, M.A.Z.

2003-01-01

Methods for metal preconcentration are often described in the literature. However, purposes are often different, depending on whether the methods are applied in environmental, clinical or technological fields. The respective method needs to be efficient, give high sensitivity, and ideally also is selective which is useful when used in combination with atomic spectroscopy. This review presents the actual tendencies in metal preconcentration using techniques such as flame atomic absorption spectrometry (FAAS), electrothermal atomic absorption spectrometry (ETAAS), hydride generation atomic absorption spectrometry (HGAAS), inductively coupled plasma optical emission spectrometry (ICP OES) and inductively coupled plasma mass spectrometry (ICP-MS). Procedures based on related to electrochemical, coprecipitation/precipitation, liquid-liquid and solid-liquid extraction and atom trapping mechanisms are presented. (author)

Use of potassium titanyl phosphate (KTP) laser Dermastat in the treatment of recurrent anterior epistaxis - a new technique.

Science.gov (United States)

Jain, A; Frampton, S J; Sachidananda, R; Jain, P K

2016-09-01

To evaluate the short- to medium-term effectiveness of potassium titanyl phosphate (KTP) laser Dermastat in patients with recurrent anterior epistaxis. Fifty-eight patients presenting with recurrent anterior epistaxis were treated using potassium titanyl phosphate laser Dermastat. Those with recurrent epistaxis arising from prominent vessels in Little's area, and/or those for whom treatment with silver nitrate cautery failed, were included. The main outcome measure was resolution of epistaxis at two months. Fifty-eight patients were treated; 27 were under 18 years old. Thirty patients had prominent vessels. Thirty-one patients had undergone previous cautery treatment. Thirty-eight patients had treatment to the left side, 19 to the right and 1 to both. At two months, 74 per cent reported resolution of epistaxis with no complications. This increased to 78 per cent at further follow up. Our technique is a successful, safe treatment for recurrent anterior epistaxis in an otherwise treatment-resistant group. A single procedure is effective. The handpiece and tip are reusable and sterilisable, resulting in cost-effectiveness.

Identification of inhaler technique errors with a routine procedure in Portuguese community pharmacy

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Castel-Branco MM

2017-12-01

Full Text Available Background: A correct selection of drugs prescribed, but also the choice of the appropriate inhaler device, is crucial for the control of respiratory diseases. Objective: To evaluate the inhaler technique and identify potential errors of patients when treated with inhalers by testing a routinary procedure to be implemented in any community pharmacy. Methods: Adults with asthma/COPD and under inhalation therapy were invited to demonstrate how they use their inhalers. After direct observation it was registered whether all the sequential steps included in the summary of product characteristics (SmPC were performed. Results: The study involved 67 patients from 4 community pharmacies (Portugal central region: 34 (50.7% males, 65.4 (SD=18.28 years old, 42 (62.7% with COPD, and 23 (34.3% using more than one inhaler. The 67 patients used 95 inhalers, comprising: 57 (60.0% multiple dose DPI (dry powder inhalers, 18 (18.9% single dose DPI, 16 (16.8% pMDI (pressurized metered dose inhalers, 2 (2.1% pMDI+spacer and 2 (2.1% SMI (soft mist inhalers. No errors were made only by 9 (13.4% patients. In the 75 DPIs techniques, the most frequent errors were ‘no previous forced expiration’ (46=61.3% and ‘no 10s apnea after inhalation’ (51=68.0%; in the 16 pMDIs techniques common errors were ‘lack of hand-lung coordination’ (7=43.8 %, ‘no previous forced exhalation’ (8=50.0% and ‘no apnea after inhalation’ (10=62.5%. After inhaling from 56 devices containing corticosteroids, 34 (60.7% of the patients did not wash their mouth. Conclusion: The study demonstrated the possibility of performing this procedure routinely in Portuguese community pharmacies and also its utility, since 58 (87% of patients had at least one error during the inhalers use.

Iatrogenic Damage to the Periodontium Caused by Orthodontic Treatment Procedures: An Overview

Science.gov (United States)

Rafiuddin, Syed; YG, Pradeep Kumar; Biswas, Shriparna; Prabhu, Sandeep S; BM, Chandrashekar; MP, Rakesh

2015-01-01

In orthodontic treatment, teeth are moved in to new positions and relationships and the soft tissue and underlying bone are altered to accommodate changes in esthetics and function. Function is more important than esthetics. The speciality of orthodontics has in addition to its benefits, complications as well as risks associated with its procedures. However the benefits outweigh the risks & complications in most of the treatment cases. Few of the unwanted side effects associated with treatment are tooth discolorations, enamel decalcification, periodontal complications like open gingival embrasures, root resorption, allergic reactions to nickel & chromium as well as treatment failure in the form of relapse. PMID:26312093

Human factoring administrative procedures

International Nuclear Information System (INIS)

Grider, D.A.; Sturdivant, M.H.

1991-01-01

In nonnuclear business, administrative procedures bring to mind such mundane topics as filing correspondence and scheduling vacation time. In the nuclear industry, on the other hand, administrative procedures play a vital role in assuring the safe operation of a facility. For some time now, industry focus has been on improving technical procedures. Significant efforts are under way to produce technical procedure requires that a validated technical, regulatory, and administrative basis be developed and that the technical process be established for each procedure. Producing usable technical procedures requires that procedure presentation be engineered to the same human factors principles used in control room design. The vital safety role of administrative procedures requires that they be just as sound, just a rigorously formulated, and documented as technical procedures. Procedure programs at the Tennessee Valley Authority and at Boston Edison's Pilgrim Station demonstrate that human factors engineering techniques can be applied effectively to technical procedures. With a few modifications, those same techniques can be used to produce more effective administrative procedures. Efforts are under way at the US Department of Energy Nuclear Weapons Complex and at some utilities (Boston Edison, for instance) to apply human factors engineering to administrative procedures: The techniques being adapted include the following

[Multiple colonic anastomoses in the surgical treatment of short bowel syndrome. A new technique].

Science.gov (United States)

Robledo-Ogazón, Felipe; Becerril-Martínez, Guillermo; Hernández-Saldaña, Víctor; Zavala-Aznar, Marí Luisa; Bojalil-Durán, Luis

2008-01-01

Some surgical pathologies eventually require intestinal resection. This may lead to an extended procedure such as leaving 30 cm of proximal jejunum and left and sigmoid colon. One of the most important consequences of this type of resection is "intestinal failure" or short bowel syndrome. This complex syndrome leads to different metabolic and water and acid/base imbalances, as well as nutritional and immunological challenges along with the problem accompanying an abdomen subjected to many surgical procedures and high mortality. Many surgical techniques have been developed to improve quality of life of patients. We designed a non-transplant surgical approach and performed the procedure on two patients with postoperative short bowel syndrome with work can be performed by a large number of surgeons. The procedure has a low morbimortality rate and offers the opportunity for better control of metabolic and acid/base balance, intestinal transit and proper nutrition. We consider that this technique offers a new alternative for the complex management required by patients with short bowel syndrome and facilitates their long-term nutritional control.

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. Experim......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...

Clinical treatment planning in gynecologic cancer

International Nuclear Information System (INIS)

Brady, L.W.; Markoe, A.M.; Micaily, B.; Damsker, J.I.; Karlsson, U.L.; Amendola, B.E.

1987-01-01

Treatment planning in gynecologic cancer is a complicated and difficult procedure. It requires an adequate preoperative assessment of the true extent of the patient's disease process and oftentimes this can be achieved not only by conventional studies but must employ surgical exploratory techniques in order to truly define the extent of the disease. However, with contemporary sophisticated treatment planning techniques that are now available in most contemporary departments of radiation oncology, radiation therapy is reemerging as an important and major treatment technique in the management of patients with gynecologic cancer

Microsurgical techniques in temporal lobe epilepsy.

Science.gov (United States)

Alonso Vanegas, Mario A; Lew, Sean M; Morino, Michiharu; Sarmento, Stenio A

2017-04-01

Temporal lobe resection is the most prevalent epilepsy surgery procedure. However, there is no consensus on the best surgical approach to treat temporal lobe epilepsy. Complication rates are low and efficacy is very high regarding seizures after such procedures. However, there is still ample controversy regarding the best surgical approach to warrant maximum seizure control with minimal functional deficits. We describe the most frequently used microsurgical techniques for removal of both the lateral and mesial temporal lobe structures in the treatment of medically intractable temporal lobe epilepsy (TLE) due to mesial temporal sclerosis (corticoamygdalohippocampectomy and selective amygdalohippocampectomy). The choice of surgical technique appears to remain a surgeon's preference for the near future. Meticulous surgical technique and thorough three-dimensional microsurgical knowledge are essentials for obtaining the best results. Wiley Periodicals, Inc. © 2017 International League Against Epilepsy.

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,

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.

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.

[Robot assisted Frykman-Goldberg procedure. Case report].

Science.gov (United States)

Zubieta-O'Farrill, Gregorio; Ramírez-Ramírez, Moisés; Villanueva-Sáenz, Eduardo

2017-12-01

Rectal prolapse is defined as the protrusion of the rectal wall through the anal canal; with a prevalence of less than 0.5%. The most frequent symptoms include pain, incomplete defecation sensation with blood and mucus, fecal incontinence and/or constipation. The surgical approach can be perineal or abdominal with the tendency for minimal invasion. Robot-assisted procedures are a novel option that offer technique advantages over open or laparoscopic approaches. 67 year-old female, who presented with rectal prolapse, posterior to an episode of constipation, that required manual reduction, associated with transanal hemorrhage during defecation and occasional fecal incontinence. A RMI defecography was performed that reported complete rectal and uterine prolapse, and cystocele. A robotic assisted Frykman-Goldberg procedure wass performed. There are more than 100 surgical procedures for rectal prolapse treatment. We report the first robot assisted procedure in Mexico. Robotic assisted surgery has the same safety rate as laparoscopic surgery, with the advantages of better instrument mobility, no human hand tremor, better vision, and access to complicated and narrow areas. Robotic surgery as the surgical treatment is a feasible, safe and effective option, there is no difference in recurrence and function compared with laparoscopy. It facilitates the technique, improves nerve preservation and bleeding. Further clinical, prospective and randomized studies to compare the different minimal invasive approaches, their functional and long term results for this pathology are needed. Copyright © 2016 Academia Mexicana de Cirugía A.C. Publicado por Masson Doyma México S.A. All rights reserved.

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.

Simultaneous Delorme's procedure and inter-sphinteric prosthetic implant for the treatment of rectal prolapse and faecal incontinence: preliminary experience and literature review.

Science.gov (United States)

Cavazzoni, Emanuel; Rosati, Emanuele; Zavagno, Valentina; Graziosi, Luigina; Donini, Annibale

2015-02-01

Rectal prolapse is a distressing condition affecting mostly elderly patients and females. Delorme's procedure is frequently performed since it offers good results and is burdened by a particularly low morbidity. Faecal Incontinence is associated with prolapse in a large percentage of patients, due to the sphincter damage caused by the prolapsed rectum through the anal canal. Prolapse resection is often ineffective in treating incontinence, and further specific procedures are frequently required. At present, no data are available on combined Delorme's procedure with the implant of Bulking Agents for the simultaneous treatment of rectal prolapse and faecal incontinence. Three patients affected by complete external rectal prolapse underwent simultaneous Delorme's procedure with application of six polyacrylonitrile prosthetic cylinders in the inter-sphinteric space (Gate Keeper™, THD, Correggio Italy). Follow up was at 3,6 and 12 months. Gate Keeper procedure required a short operative time; no morbidity or complications were experienced. Prolapse was successfully treated in all patients and the mean Vaizey's incontinence score value dropped from pre-operative 19.3 to 9.3 after 3 months. All patients experienced a reduction of incontinence episodes and an improvement in daily activities and lifestyle. Gate Keeper implant is feasible and safe when associated to surgical procedures like Delorme's prolapse resection. Preliminary results are positive even if a study with a larger numbers of patients is needed to confirm the efficacy. A simultaneous treatment of faecal incontinence should be always considered when performing surgery for rectal prolapse. The present manuscript describes a simultaneous combination of two surgical techniques to treat rectal prolapse and faecal incontinence. To date, there are no published data on a similar approach. The paper underlies the importance of treating faecal incontinence when performing surgery for rectal prolapse. Copyright �

Kyphoplasty: indications, contraindications and technique

International Nuclear Information System (INIS)

Masala, Salvatore; Fiori, Roberto; Massari, Francesco; Simonetti, Giovanni

2005-01-01

Purpose. Percutaneous Kyphoplasty is an emerging Interventional Radiology technique consisting in injecting polymethylmethacrylate (PMMA) into collapsed vertebral bodies under fluoroscopic guidance, after compaction of the cancellous bone with two dedicated balloon catheters. The purpose of our study was to assess the indications, contraindications, technique and results of our initial study. Materials and methods. Between January and May 2003 we treated 11 patients (5 men, 6 women) with vertebral collapse occurred up to three months earlier and osteoporosis or myeloma (mean age: 68.9), with pain refractory to medical therapy. All patients underwent treatment on a single vertebra (1 D7; 1 D8; 2 D12; 3 L1; 3 L2; 1 l4). Patient selection was based on clinical and instrumental criteria: conventional radiography, CT and MR were performed on all patients before the procedure. The Visual Analogue scale (VAS) for pain assessment was used to evaluate the post-procedure results. Results. All patients showed an increase in the height of the collapsed vertebral body, associated with partial or complete pain relief (VAS score decreasing from a pre-treatment score of 8 to a score of 2 after treatment). No complications related to the procedure were recorded. Conclusions. The indications for kyphoplasty include recent vertebral compression fractures due to osteoporosis, myeloma, metastasis and vertebral angioma with intractable pain and with no neurological symptoms. The main contraindications are coagulation disorders, unstable fractures or complete vertebral collapse (vertebra plana). Kyphoplasty proved to be a safe and effective method for the treatment of intractable pain due to vertebral collapse that allows for shorter hospital stays and an immediate improvement in the patient's quality of life [it

Worldwide enucleation techniques and materials for treatment of retinoblastoma: an international survey.

Directory of Open Access Journals (Sweden)

Daphne L Mourits

Full Text Available To investigate the current practice of enucleation with or without orbital implant for retinoblastoma in countries across the world.A digital survey identifying operation techniques and material used for orbital implants after enucleation in patients with retinoblastoma.We received a response of 58 surgeons in 32 different countries. A primary artificial implant is routinely inserted by 42 (72.4% surgeons. Ten (17.2% surgeons leave the socket empty, three (5.2% decide per case. Other surgeons insert a dermis fat graft as a standard primary implant (n=1, or fill the socket in a standard secondary procedure (n=2; one uses dermis fat grafts and one artificial implants. The choice for porous implants was more frequent than for non-porous implants: 27 (58.7% and 15 (32.6%, respectively. Both porous and non-porous implant types are used by 4 (8.7% surgeons. Twenty-five surgeons (54.3% insert bare implants, 11 (23.9% use separate wrappings, eight (17.4% use implants with prefab wrapping and two insert implants with and without wrapping depending on type of implant. Attachment of the muscles to the wrapping or implant (at various locations is done by 31 (53.4% surgeons. Eleven (19.0% use a myoconjunctival technique, nine (15.5% suture the muscles to each other and seven (12.1% do not reattach the muscles. Measures to improve volume are implant exchange at an older age (n=4, the use of Restylane SQ (n=1 and osmotic expanders (n=1. Pegging is done by two surgeons.No (worldwide consensus exists about the use of material and techniques for enucleation for the treatment of retinoblastoma. Considerations for the use of different techniques are discussed.

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

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.

Completion of Gamma Knife radiosurgery for AVM treatment after unplanned interruption-technical note.

Science.gov (United States)

Raman, Hari S; Santanam, Lakshmi; Vellimana, Ananth K; Drzymala, Robert E; Tsien, Christina I; Zipfel, Gregory J

2018-02-17

Gamma Knife radiosurgery is an established technique for non-urgent treatment of various intracranial pathologies. Intra-procedural dislodgement of the stereotactic frame is an uncommon occurrence that could lead to abortion of ongoing treatment and necessitate more invasive treatment strategies. In this case report, we describe a novel method for resumption of Gamma Knife treatment after an unplanned intra-procedural interruption. The case example involves a radiosurgical treatment of a Spetzler-Martin grade I arteriovenous malformation. Our technique involves integration of scans and coordinate systems from two imaging sessions using the composite isodose line to resolve translational differences, thereby limiting delivery of remaining shots to the untreated region of the lesion. MRI follow-up at 13 months showed a reduction in the nidus size with no evidence of any radiation injury to the surrounding brain parenchyma. We believe this technique will allow care teams to effectively salvage interrupted Gamma Knife procedures and reduce progression to more invasive treatment options.

Evaluating Referral, Screening, and Assessment Procedures for Middle School Trauma/Grief-Focused Treatment Groups

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Grassetti, Stevie N.; Williamson, Ariel A.; Herres, Joanna; Kobak, Roger; Layne, Christopher M.; Kaplow, Julie B.; Pynoos, Robert S.

2018-01-01

There is a need to delineate best practices for referring, assessing, and retaining students suspected of posttraumatic stress (PTS) and maladaptive grief (MG) in school-based treatment. Evidence-based risk-screening procedures should accurately include students who are appropriate for group treatment and exclude students who do not require…

Treatment of critical lower limb ischemia using a hybrid technique

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Ricardo Wagner da Costa Moreira

2014-09-01

Full Text Available Critical ischemia of a lower limb is a condition that threatens its viability and must be treated promptly to avoid major amputation. Revascularization is the most effective treatment method and is performed using surgical or endovascular techniques. For patients with thoracoabdominal aortic aneurysms, combining these two approaches into a "hybrid technique" makes it possible to treat patients who could not be adequately treated by either technique in isolation. We report on a case of lower limb critical ischemia treated using a combination of surgery and endovascular techniques, in an application of the hybrid technique in a different arterial bed.

Modified technique of the treatment for proximal tibiofibular joint dislocation

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Gvozdenović Nemanja

2017-01-01

Full Text Available Introduction. Dislocation of the proximal tibiofibular joint (PTFJ is a rare injury. The diagnosis requires an accurate history of the mechanism and symptoms of the injury, and adequate clinical and radiographic evaluation of both knees. In the literature there is no larger series, only several cases of PTFJ dislocation treated by different methods have been published so far. The aim of the study was to present a modified technique for the treatment of the unstable PTFJ that results in faster recovery of the patient. Case report. A 24-year-old football player was injured at the beginning of training; when tackling the ball he felt a sharp pain in his right knee. He was immediately brought to the Emergency Center of Vojvodina and diagnosed with anterolateral dislocation of the PTFJ. Close reduction in general anesthesia was tried but we failed and then open reduction and internal fixation (ORIF were performed with a single three cortical screw. We preferred not to immobilise the knee after the procedure and immediately employed passive and active exercises in the knee, without bearing weight to the injured leg. After 6 weeks we removed the screw and gave full weight support to the leg and continued physical treatment. Conclusion. In case of acute PTFJ dislocation, the first method of choice is closed reduction in sedation or general anesthesia. If closed reduction fails, ORIF must be performed. ORIF without immobilization and early start of physical therapy lead to the rapid return to sports activities

Management of Chronic Recurrent Dislocation of Temporomandibular Joint Using 'U' Shaped Graft: A New Restrictive Technique.

Science.gov (United States)

Gadre, Kiran; Singh, Divya; Gadre, Pushkar; Halli, Rajshekhar

2017-06-01

Numerous procedures have been described for the treatment of chronic recurrent dislocation of the temporo-mandibular joint (TMJ), either in the form of enhancement or restriction of the condylar movement, with their obvious merits and demerits. We present a new technique of using U shaped iliac bone graft to restrict the condylar movement and its advantages over the conventional techniques.We have used this technique successfully in 8 cases where Dautrey's procedure had failed with follow up period of 2 years. No patient complained of recurrent dislocation postoperatively. This a very simple and effective technique where other procedures have failed.

Machine-Specific Magnetic Resonance Imaging Quality Control Procedures for Stereotactic Radiosurgery Treatment Planning.

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Fatemi, Ali; Taghizadeh, Somayeh; Yang, Claus Chunli; R Kanakamedala, Madhava; Morris, Bart; Vijayakumar, Srinivasan

2017-12-18

Purpose Magnetic resonance (MR) images are necessary for accurate contouring of intracranial targets, determination of gross target volume and evaluation of organs at risk during stereotactic radiosurgery (SRS) treatment planning procedures. Many centers use magnetic resonance imaging (MRI) simulators or regular diagnostic MRI machines for SRS treatment planning; while both types of machine require two stages of quality control (QC), both machine- and patient-specific, before use for SRS, no accepted guidelines for such QC currently exist. This article describes appropriate machine-specific QC procedures for SRS applications. Methods and materials We describe the adaptation of American College of Radiology (ACR)-recommended QC tests using an ACR MRI phantom for SRS treatment planning. In addition, commercial Quasar MRID 3D and Quasar GRID 3D phantoms were used to evaluate the effects of static magnetic field (B 0 ) inhomogeneity, gradient nonlinearity, and a Leksell G frame (SRS frame) and its accessories on geometrical distortion in MR images. Results QC procedures found in-plane distortions (Maximum = 3.5 mm, Mean = 0.91 mm, Standard deviation = 0.67 mm, >2.5 mm (%) = 2) in X-direction (Maximum = 2.51 mm, Mean = 0.52 mm, Standard deviation = 0.39 mm, > 2.5 mm (%) = 0) and in Y-direction (Maximum = 13. 1 mm , Mean = 2.38 mm, Standard deviation = 2.45 mm, > 2.5 mm (%) = 34) in Z-direction and < 1 mm distortion at a head-sized region of interest. MR images acquired using a Leksell G frame and localization devices showed a mean absolute deviation of 2.3 mm from isocenter. The results of modified ACR tests were all within recommended limits, and baseline measurements have been defined for regular weekly QC tests. Conclusions With appropriate QC procedures in place, it is possible to routinely obtain clinically useful MR images suitable for SRS treatment planning purposes. MRI examination for SRS planning can benefit from the improved localization and planning

Procedure generation and verification

International Nuclear Information System (INIS)

Sheely, W.F.

1986-01-01

The Department of Energy has used Artificial Intelligence of ''AI'' concepts to develop two powerful new computer-based techniques to enhance safety in nuclear applications. The Procedure Generation System, and the Procedure Verification System, can be adapted to other commercial applications, such as a manufacturing plant. The Procedure Generation System can create a procedure to deal with the off-normal condition. The operator can then take correct actions on the system in minimal time. The Verification System evaluates the logic of the Procedure Generator's conclusions. This evaluation uses logic techniques totally independent of the Procedure Generator. The rapid, accurate generation and verification of corrective procedures can greatly reduce the human error, possible in a complex (stressful/high stress) situation

The treatment of tubal pregnancy by interventional technique through uterine artery

International Nuclear Information System (INIS)

Li Lizhao; Zhang Yonghui; Chen Zhu; Ge Xiaobing; Li Jiehua

2004-01-01

Objective: To study the feasibility and the clinical effect of the treatment of tubule pregnancy by using interventional technique through selective uterine artery. Methods: By using seldinger's method, 48 cases received interventional treatment, followed by perfusion of methotrexate (MTX) 100 mg through Tube 4-5 F. The concentration of serum β-HCG, the changes of pelvic cavity, and the open condition of amnion by ultrasonic examination. Results: The cure rate of 47 cases was 97.92%. No serious reaction. After treatment, the mean time that the serum β-HCG concentration returned to normal was 14-28 days and the mean time was 18 days. Conclusion: The treatment of tubule pregnancy by interventional technique proved no harmful effect to reproductive organs and quick recovery. It is worth spreading

Procedural wound geometry and blood flow generation for medical training simulators

Science.gov (United States)

Aras, Rifat; Shen, Yuzhong; Li, Jiang

2012-02-01

Efficient application of wound treatment procedures is vital in both emergency room and battle zone scenes. In order to train first responders for such situations, physical casualty simulation kits, which are composed of tens of individual items, are commonly used. Similar to any other training scenarios, computer simulations can be effective means for wound treatment training purposes. For immersive and high fidelity virtual reality applications, realistic 3D models are key components. However, creation of such models is a labor intensive process. In this paper, we propose a procedural wound geometry generation technique that parameterizes key simulation inputs to establish the variability of the training scenarios without the need of labor intensive remodeling of the 3D geometry. The procedural techniques described in this work are entirely handled by the graphics processing unit (GPU) to enable interactive real-time operation of the simulation and to relieve the CPU for other computational tasks. The visible human dataset is processed and used as a volumetric texture for the internal visualization of the wound geometry. To further enhance the fidelity of the simulation, we also employ a surface flow model for blood visualization. This model is realized as a dynamic texture that is composed of a height field and a normal map and animated at each simulation step on the GPU. The procedural wound geometry and the blood flow model are applied to a thigh model and the efficiency of the technique is demonstrated in a virtual surgery scene.

The results of treatment of children with acute non-lymphoblastic leukemia using a modified BFM-87 procedure

International Nuclear Information System (INIS)

Popa, A.V.; Mayakova, S.A.; Kurmashov, V.I.

1997-01-01

Efficiency of the treatment of children with acute non-lymphoblastic leukemia using modified BFM-87 procedure was studied. Intensive modified BFM-87 procedure was applied to 32 patients and considered of remission induction (8 days), remission consolidation (57 days), chemoradio prophylaxis of neuroleukosis, supporting therapy during remission. Efficiency of the used treatment program was proved (complete remission - 90% of patients, 5 year survival time - 47%)

Electrochemical Techniques in Textile Processes and Wastewater Treatment

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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”.

Experience in treatment of hyperthyroidism with I-131 diagnosis, patient preparation and therapeutic procedure

International Nuclear Information System (INIS)

Zhongyun, Pan

2003-01-01

Treatment of hyperthyroidism with I-131 diagnosis is being performed after clinical diagnosis of thyrotoxicosis based on clinical manifestations of hypermetabolic state, serumT3 and T4 determination; medical preparation of patients and therapeutic procedure is obtained for better efficacy, relieve symptoms and prevent aggravation of thyrotoxicosis after I-131 treatment

Contemporary treatment of patients with chronic total occlusion: critical appraisal of different state-of-the-art techniques and devices.

Science.gov (United States)

García-García, Héctor M; Kukreja, Neville; Daemen, Joost; Tanimoto, Shuzou; van Mieghem, Carlos; Gonzalo, Nieves; van Weenen, Sander; van der Ent, Martin; Sianos, Georgios; de Feyter, Pim; Serruys, Patrick W

2007-08-01

graft was used; the remaining cases were treated either via collaterals or the septal branches. The treatment of CTOs requires the use of a high number of guiding catheters and guidewires, as well as the use of sophisticated devices. The procedure must be carefully planned in advance as far as possible, as well as considering a prompt change in approach during the performance of the procedure to prevent complications derived from long procedures by using specific techniques such as parallel wire, see-saw, anchoring balloon, etc.

Improvement of the technique in treatment of internal hemorrhoids with Nd:YAG laser

Science.gov (United States)

Bao, Xiao-qing; Zhu, Jing; Shi, Hong-Min

2005-07-01

Objective: To observe and study the improvement of the technique in treatment of internal hemorrhoids with Nd:YAG laser and evaluate the effective rate. Methods: 60 patients of internal hemorrhoids were treated with Nd:YAG laser (10-15mw) irradiating on the mucosa of the lesions. Results: Among 60 patients, 57 patients were primarily cured with one treatment, 3 patients were primarily cured with two treatments. The effective rate was 95% with one treatment, and it reached to 100% with two treatments. Conclusions: the improvement of the technique in treatment of internal hemorrhoids with Nd:YAG laser is effective and easy to operate.

Analgesic techniques in minor painful procedures in neonatal units: a survey in northern Italy.

Science.gov (United States)

Codipietro, Luigi; Bailo, Elena; Nangeroni, Marco; Ponzone, Alberto; Grazia, Giuseppe

2011-01-01

The aim of this survey was to evaluate the current practice regarding pain assessment and pain management strategies adopted in commonly performed minor painful procedures in Northern Italian Neonatal Intensive Care Units (NICUs). A multicenter survey was conducted between 2008 and 2009 in 35 NICUs. The first part of the survey form covered pain assessment tools, the timing of analgesics, and the availability of written guidelines. A second section evaluated the analgesic strategies adopted in commonly performed painful procedures. The listed analgesic procedures were as follows: oral sweet solutions alone, non-nutritive sucking (NNS) alone, a combination of sweet solutions and NNS, breast-feeding where available, and topical anesthetics. Completed questionnaires were returned from 30 neonatal units (85.7% response rate). Ten of the 30 NICUs reported using pain assessment tools for minor invasive procedures. Neonatal Infant Pain Scale was the most frequently used pain scale (60%). Twenty neonatal units had written guidelines directing pain management practices. The most frequently used procedures were pacifiers alone (69%), followed by sweet-tasting solutions (58%). A 5% glucose solution was the most frequently utilized sweet-tasting solution (76.7%). A minority of NICUs (16.7%) administered 12% sucrose solutions for analgesia and the application of topical anesthetics was found in 27% of NICUs while breast-feeding was performed in 7% of NICUs. This study found a low adherence to national and international guidelines for analgesia in minor procedures: the underuse of neonatal pain scales (33%), sucrose solution administration before heel lance (23.3%), topical anesthetics before venipuncture, or other analgesic techniques. The presence of written pain control guidelines in these regions of Northern Italy increased in recent years (from 25% to 66%). © 2010 World Institute of Pain.

Congenital high airway obstruction syndrome in the breech presentation managed by ex utero intrapartum treatment procedure after intraoperative external cephalic version.

Science.gov (United States)

Miwa, Ichiro; Sase, Masakatsu; Nakamura, Yasuhiko; Hasegawa, Keiko; Kawasaki, Masahiro; Ueda, Kazuyuki

2012-05-01

Congenital high airway obstruction syndrome (CHAOS) caused by laryngeal atresia was diagnosed by prenatal ultrasound in a male fetus at 26 weeks of gestation. Findings included massive ascites, subcutaneous edema, enlarged hyperechogenic lungs with diaphragmatic inversion, dilated trachea, polyhydramnios, and breech presentation. Those findings of CHAOS spontaneously returned to normal by 33 weeks of gestation. However, the placenta was localized to the anterior uterine wall. In addition, the fetal position had been breech until delivery. At 36 weeks of gestation, a planned ex utero intrapartum treatment (EXIT) procedure was performed following intraoperative external cephalic version (ECV) in which the fetus was approached from the posterior wall of the uterus. Laryngoscopy revealed the predicted laryngeal obstruction, and tracheostomy was placed. Intraoperative ECV may be a useful technique in breech presentation before EXIT procedure. © 2012 The Authors. Journal of Obstetrics and Gynaecology Research © 2012 Japan Society of Obstetrics and Gynecology.

PENILE ENHANCEMENT PROCEDURES: UROLOGICAL AND ETHICOLEGAL ISSUES

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Marco Vella

2012-04-01

Full Text Available Phalloplasty procedures for most men requiring penile augmentation surgery are cosmetic procedures; generally the patients have a normal-sized and fully functional penis but they think that their penis is too small. There are not well defined indications for penile enhancement surgery and, except for the treatment of “micropenis”, there are not established guidelines and the outcome measures for success are still unclear. All penile enhancement techniques often do not reach the expected result and the grade of patient’s satisfaction is frequently poor. Phalloplasty procedures for psychological dysmorfism are not approved by any scientific society and the majority of these procedures are performed in private settings. The ethical and medicolegal problems resulting from a penis enhancement can be various and numerous, but few of them are reported in literature. After phalloplasty an attribution of professional responsibility and request of reimbursement is not rare. In this contribution the authors summarize a panorama of several urological and medico-legal aspects related to phalloplasty procedures.

Verification of the helioseismology travel-time measurement technique and the inversion procedure for sound speed using artificial data

Energy Technology Data Exchange (ETDEWEB)

Parchevsky, K. V.; Zhao, J.; Hartlep, T.; Kosovichev, A. G., E-mail: akosovichev@solar.stanford.edu [Stanford University, HEPL, Stanford, CA 94305 (United States)

2014-04-10

We performed three-dimensional numerical simulations of the solar surface acoustic wave field for the quiet Sun and for three models with different localized sound-speed perturbations in the interior with deep, shallow, and two-layer structures. We used the simulated data generated by two solar acoustics codes that employ the same standard solar model as a background model, but utilize different integration techniques and different models of stochastic wave excitation. Acoustic travel times were measured using a time-distance helioseismology technique, and compared with predictions from ray theory frequently used for helioseismic travel-time inversions. It is found that the measured travel-time shifts agree well with the helioseismic theory for sound-speed perturbations, and for the measurement procedure with and without phase-speed filtering of the oscillation signals. This testing verifies the whole measuring-filtering-inversion procedure for static sound-speed anomalies with small amplitude inside the Sun outside regions of strong magnetic field. It is shown that the phase-speed filtering, frequently used to extract specific wave packets and improve the signal-to-noise ratio, does not introduce significant systematic errors. Results of the sound-speed inversion procedure show good agreement with the perturbation models in all cases. Due to its smoothing nature, the inversion procedure may overestimate sound-speed variations in regions with sharp gradients of the sound-speed profile.

Verification of the helioseismology travel-time measurement technique and the inversion procedure for sound speed using artificial data

International Nuclear Information System (INIS)

Parchevsky, K. V.; Zhao, J.; Hartlep, T.; Kosovichev, A. G.

2014-01-01

We performed three-dimensional numerical simulations of the solar surface acoustic wave field for the quiet Sun and for three models with different localized sound-speed perturbations in the interior with deep, shallow, and two-layer structures. We used the simulated data generated by two solar acoustics codes that employ the same standard solar model as a background model, but utilize different integration techniques and different models of stochastic wave excitation. Acoustic travel times were measured using a time-distance helioseismology technique, and compared with predictions from ray theory frequently used for helioseismic travel-time inversions. It is found that the measured travel-time shifts agree well with the helioseismic theory for sound-speed perturbations, and for the measurement procedure with and without phase-speed filtering of the oscillation signals. This testing verifies the whole measuring-filtering-inversion procedure for static sound-speed anomalies with small amplitude inside the Sun outside regions of strong magnetic field. It is shown that the phase-speed filtering, frequently used to extract specific wave packets and improve the signal-to-noise ratio, does not introduce significant systematic errors. Results of the sound-speed inversion procedure show good agreement with the perturbation models in all cases. Due to its smoothing nature, the inversion procedure may overestimate sound-speed variations in regions with sharp gradients of the sound-speed profile.

Cocaine choice procedures in animals, humans, and treatment-seekers: Can we bridge the divide?

Science.gov (United States)

Moeller, Scott J.; Stoops, William W.

2015-01-01

Individuals with cocaine use disorder chronically self-administer cocaine to the detriment of other rewarding activities, a phenomenon best modeled in laboratory drug-choice procedures. These procedures can evaluate the reinforcing effects of drugs versus comparably valuable alternatives under multiple behavioral arrangements and schedules of reinforcement. However, assessing drug-choice in treatment-seeking or abstaining humans poses unique challenges: for ethical reasons, these populations typically cannot receive active drugs during research studies. Researchers have thus needed to rely on alternative approaches that approximate drug-choice behavior or assess more general forms of decision-making, but whether these alternatives have relevance to real-world drug-taking that can inform clinical trials is not well-understood. In this mini-review, we (A) summarize several important modulatory variables that influence cocaine choice in nonhuman animals and non-treatment seeking humans; (B) discuss some of the ethical considerations that could arise if treatment-seekers are enrolled in drug-choice studies; (C) consider the efficacy of alternative procedures, including non-drug-related decision-making and ‘simulated’ drug-choice (a choice is made, but no drug is administered) to approximate drug choice; and (D) suggest opportunities for new translational work to bridge the current divide between preclinical and clinical research. PMID:26432174

Potential applications of plasma science techniques for water treatment systems

International Nuclear Information System (INIS)

Pavlik, D.

1994-01-01

The historical evolution of water treatment techniques and their impact on man and his environment are presented. Ancient man recognized the relationship between good water and good health. However, it was not until the late 1800's that man's own contribution to the pollution of water via biological and chemical contamination of the water stream was recognized as having adverse affects on water quality. Since that time virtually every nation has adopted laws and regulations to ensure that safe sources of unpolluted water are available to its citizens. In the United States, water quality is governed by the Clean Water Act of 1972 administered at the federal level by the Environmental Protection Agency (EPA). Further, each state has established its equivalent agency which administers its own laws and regulations. Different biological and chemical biohazards present in the water system are discussed. Biological contaminants include various types of viruses, bacteria, fungii, molds, yeasts, algae, amoebas, and parasites. Chemical contaminates include elemental heavy metals and other organic and inorganic compounds which interfere with normal biological functions. Conventional water treatments for both consumption and sewage effluent commonly employ four different principals: mechanical filtration, quiescent gravity settling, biological oxidation, and chemical treatment. Although these techniques have greatly reduced the incidence of water-borne disease recent studies suggest that more effective means of eliminating biohazards are needed. Regulatory requirements for more aggressive treatment and elimination of residual contaminants present a significant opportunity for the application of various forms of electromagnetic radiation techniques. A comparison between conventional techniques and more advanced methods using various forms of electromagnetic radiation is discussed

Spasticity: its physiology and management. Part IV. Current and projected treatment procedures for spasticity.

Science.gov (United States)

Bishop, B

1977-04-01

Today's prescriptions for treating spasticity may include pharmacological, surgical, or physical procedures. All derive their rationale from the classical concepts of decerebrate rigidity and of brain organization as discussed in Part I. This paper describes the advantages and disadvantages of these current treatment procedures and proposes that recent discoveries about the "recovery" capabilities of the central nervous system may influence the means for managing spasticity in the future.

Pretreatment procedures

International Nuclear Information System (INIS)

Anon.

1989-01-01

It is frequently in the patient's best interest that radiation treatments are initiated soon after the decision to treat is made. However, it is essential to good radiation therapy that the patient's treatment course be planned and beam-modifying devices be fabricated with utmost care prior to treatment. The objectives of the treatment, along with the treatment parameters and techniques necessary to achieve these objectives, must be discussed prior to initiating planning procedures. Determination of the target volume is made by the radiation oncologist; this is based on knowledge of the history of the tumor, the patterns of spread of the disease, and on diagnostic findings during the work-up of each patient. It is then necessary to obtain several measurements of the patient and also to identify the position of the target volume and of adjacent normal organs with respect to known external skin marks before the actual treatment planning is begun. Such localization can be done through several methods. The two most commonly used methods are radiographic and computed tomography (CT), both of which are discussed in this chapter. The measurements often include contours of the patient's external surface, usually in the axial plane of the central axis of the beam, and often in multiple levels within the region to be treated. Three dimensional localization and treatment planning requires thorough understanding of geometry as well as of patient positioning and immobilization. This chapter attempts to clarify some of these complicated but essential preparations for treatment

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...

EFSUMB Guidelines on Interventional Ultrasound (INVUS), Part III - Abdominal Treatment Procedures (Short 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 assesses the evidence for ultrasound-guided and assisted interventions in abdominal treatment procedures. Recommendations for clinical practice are presen...

Spinal Cord Ischemia after Thoracoabdominal Aortic Procedures

Directory of Open Access Journals (Sweden)

Rupesh George

2015-01-01

Full Text Available Overall prevalence of Thoraco abdominal aneurysm has increased due to widespread use of imaging techniques and aging population. Surgical aneurysm repair and endovascular stent graft repair have refined as successful treatment modalities in preventing aneurysm progression and rupture. Since spinal cord depends on branches of thoracoabdominal aorta for blood supply ,spinal cord ischaemia is a dreadful complication of these procedures. However recent animal experiments and surgical series thrown light in tackling this anatomical obstructions by physiologic means. The adoption of techniques for avoiding hypovolumea, hypotension, CSF pressure has reduced this complication rate from 23% to 2-6%.

Treatment of unicameral bone cyst: a comparative study of selected techniques.

Science.gov (United States)

Hou, Hsien-Yang; Wu, Karl; Wang, Chen-Ti; Chang, Shun-Min; Lin, Wei-Hsin; Yang, Rong-Sen

2010-04-01

There is a variety of treatment modalities for unicameral bone cysts, with variable outcomes reported in the literature. Although good initial outcomes have been reported, the success rate has often changed with longer-term follow-up. We introduce a novel, minimally invasive treatment method and compare its clinical outcomes with those of other methods of treatment of this lesion. From February 1994 to April 2008, forty patients with a unicameral bone cyst were treated with one of four techniques: serial percutaneous steroid and autogenous bone-marrow injection (Group 1, nine patients); open curettage and grafting with a calcium sulfate bone substitute either without instrumentation (Group 2, twelve patients) or with internal instrumentation (Group 3, seven patients); or minimally invasive curettage, ethanol cauterization, disruption of the cystic boundary, insertion of a synthetic calcium sulfate bone-graft substitute, and placement of a cannulated screw to provide drainage (Group 4, twelve patients). Success was defined as radiographic evidence of a healed cyst or of a healed cyst with some defect according to the modified Neer classification, and failure was defined as a persistent or recurrent cyst that needed additional treatment. Patients who sustained a fracture during treatment were also considered to have had a failure. The outcome parameters included the radiographically determined healing rate, the time to solid union, and the total number of procedures needed. The follow-up time ranged from eighteen to eighty-four months. Group-4 patients had the highest radiographically determined healing rate. Healing was seen in eleven of the twelve patients in that group compared with three of the nine in Group 1, eight of the twelve in Group 2, and six of the seven in Group 3. Group-4 patients also had the shortest mean time to union: 3.7 +/- 2.3 months compared with 23.4 +/- 14.9, 12.2 +/- 8.5, and 6.6 +/- 4.3 months in Groups 1, 2, and 3, respectively. This new

Three-dimensional conformal pancreas treatment: comparison of four- to six-field techniques

International Nuclear Information System (INIS)

Higgins, Patrick D.; Sohn, Jason W.; Fine, Robert M.; Schell, Michael C.

1995-01-01

Purpose: We compare practical conformal treatment approaches to pancreatic cancer using 6 and 18 MV photons and contrast those approaches against standard techniques. Methods and Materials: A four-field conformal technique for treating pancreas cancer has been developed using nonopposed 18 MV photons. This approach has been extended to 6 MV photon application by the addition of one to two fields. These techniques have been optimized to increase sparing of normal liver and bowel, compared with opposed-field methods, to improve patient tolerance of high doses. In this study we compare these techniques in a simulated tumor model in a cylindrical phantom. Dose-volume analysis is used to quantify differences between the conformal, nonopposed techniques with conformal, opposed field methods. This model is also used to evaluate the effect of 1-2 cm setup errors on dose-volume coverage. Results: Dose-volume analysis demonstrates that five-to-six field conformal treatments using 6 MV photons provides similar or better dose coverage and normal tissue sparing characteristics as an optimized 18 MV, four-field approach when 1-2 cm margins are included for setup uncertainty. All approaches using nonopposed beam geometry provide significant reduction in the volume of tissue encompassed by the 30-50% isodose surfaces, as compared with four-field box techniques. Conclusions: Three-dimensional (3D) conformal treatments can be designed that significantly improve dose-volume characteristics over conventional treatment designs without costing unacceptable amounts of machine time. Further, deep intraabdominal sites can be adequately accessed and treated on intermediate energy machines with a relatively moderate increase in machine time

New techniques for the treatment of uranium ores

International Nuclear Information System (INIS)

Renaud, J.; Boutonnet, G.

1977-01-01

The growth in nuclear power programmes since 1970 has led to an increasing demand for uranium, and tenders have been invited from all parts of the world for the construction of new treatment plants. What types of plant could be suggested. The diversity of ores and sites, even more stringent safety requirements, greater care for the environment and economic facts called for numerous, if not basic, reviews of the conventional techniques. Two examples illustrate this point. In the case of a plant to treat a refractory ore situated in a desert area with limited water resources, Pechiney Ugine Kuhlmann studied and applied a new technique of leaching by sulphuric acid pulping, which gives a considerable saving of sulphuric acid and water in comparison with conventional leaching techniques. In dealing with a problem which arose at a plant situated in a mountainous region of touristic interest, where a tailings settling tank could not be installed, Pechiney Ugine Kuhlmann studied and developed techniques involving the use of band filters for solid-liquid separation and pulp washing. Apart from lowering investment costs by about 15% in comparison with the techniques used so far, this technique produces the tailings in solid form so that they do not require a settling tank for storage. (author)

Computer-assisted preoperative simulation for positioning and fixation of plate in 2-stage procedure combining maxillary advancement by distraction technique and mandibular setback surgery.

Science.gov (United States)

Suenaga, Hideyuki; Taniguchi, Asako; Yonenaga, Kazumichi; Hoshi, Kazuto; Takato, Tsuyoshi

2016-01-01

Computer-assisted preoperative simulation surgery is employed to plan and interact with the 3D images during the orthognathic procedure. It is useful for positioning and fixation of maxilla by a plate. We report a case of maxillary retrusion by a bilateral cleft lip and palate, in which a 2-stage orthognathic procedure (maxillary advancement by distraction technique and mandibular setback surgery) was performed following a computer-assisted preoperative simulation planning to achieve the positioning and fixation of the plate. A high accuracy was achieved in the present case. A 21-year-old male patient presented to our department with a complaint of maxillary retrusion following bilateral cleft lip and palate. Computer-assisted preoperative simulation with 2-stage orthognathic procedure using distraction technique and mandibular setback surgery was planned. The preoperative planning of the procedure resulted in good aesthetic outcomes. The error of the maxillary position was less than 1mm. The implementation of the computer-assisted preoperative simulation for the positioning and fixation of plate in 2-stage orthognathic procedure using distraction technique and mandibular setback surgery yielded good results. Copyright © 2016 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Effect of platelet-rich plasma and microfracture reparative technique combined in chondral lesions treatment

OpenAIRE

Pietro Zedde; Sebastiano Cudoni; Pietro Lisai; Mario Fadda; Andrea Fabio Manunta

2015-01-01

The microfracture surgery introduced by Stedman despite limitations still represents the most common procedure to repair chondral defects. In recent years other regeneration techniques, such as the implantation of platelet-rich plasma (PRP), have been adopted in combination to boost and promote successful outcomes. This study aimed at evaluating clinical and functional results in 60 patients affected by chondral lesions and treated only using the microfracture procedure or in combination with...

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

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…

Vertical mammaplasty associated with accelerated partial breast radiotherapy: how oncoplastic surgery techniques associated with modern techniques of radiotherapy can improve the aesthetic outcome in selected patients

International Nuclear Information System (INIS)

Couto, Henrique Lima; Amorim, Washington Cancado; Guimaraes, Rodrigo

2014-01-01

Breast cancer is the second most common type of cancer in the world, being the most common among women, responsible for 22% of new cases each year. It's surgical and radiation treatment evolved from radical procedures (Halsted radical mastectomy and total external breast radiotherapy) to less radical and more conservative procedures. With the use of modern oncoplastic surgery techniques and accelerated partial breast radiotherapy, selected patients can benefit with better aesthetic results, fewer side effects, and more comfortable and brief treatments. (author)

Vertical mammaplasty associated with accelerated partial breast radiotherapy: how oncoplastic surgery techniques associated with modern techniques of radiotherapy can improve the aesthetic outcome in selected patients

Energy Technology Data Exchange (ETDEWEB)

Couto, Henrique Lima, E-mail: enriquecouto@hotmail.com [Santa Fe Women' s and Maternity Hospital, Belo Horizonte, MG (Brazil); Amorim, Washington Cancado; Guimaraes, Rodrigo [Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG (Brazil). Hospital Geral; Ramires, Leandro Cruz; Castilho, Marcus Simoes [Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG (Brazil). Fac. de Medicina; Dominguez, Lorena Lima Coto [Universidade Estacio de Sa (UNESA), Rio de Janeiro, EJ (Brazil)

2014-07-15

Breast cancer is the second most common type of cancer in the world, being the most common among women, responsible for 22% of new cases each year. It's surgical and radiation treatment evolved from radical procedures (Halsted radical mastectomy and total external breast radiotherapy) to less radical and more conservative procedures. With the use of modern oncoplastic surgery techniques and accelerated partial breast radiotherapy, selected patients can benefit with better aesthetic results, fewer side effects, and more comfortable and brief treatments. (author)

Treatment of Necrotic Calcified Tooth Using Intentional Replantation Procedure

Directory of Open Access Journals (Sweden)

Nima Moradi Majd

2014-01-01

Full Text Available Introduction. If the teeth are impacted by a chronic irritant, the pulp space possibly will undergo calcific changes that may impede access opening during root canal treatment. In such cases that conventional endodontic treatment is impossible or impractical, intentional replantation may be considered as a last solution to preserve the tooth. Methods. After failing to perform conventional root canal therapy for a necrotic calcified right mandibular second premolar, the tooth was gently extracted. The root apex was resected and the root end cavity was prepared and filled with calcium enriched mixture (CEM cement. Then, the extracted tooth was replanted in its original position. Results. After a year the tooth was asymptomatic, and the size of periapical radiolucency was remarkably reduced and no clinical sign of ankylosis was observed. Conclusion. Intentional replantation of the necrotic calcified teeth could be considered as an alternative to teeth extraction, especially for the single-rooted teeth and when nonsurgical and surgical endodontic procedures seem impossible.

Effect of episodic and working memory impairments on semantic and cognitive procedural learning at alcohol treatment entry.

Science.gov (United States)

Pitel, Anne Lise; Witkowski, Thomas; Vabret, François; Guillery-Girard, Bérengère; Desgranges, Béatrice; Eustache, Francis; Beaunieux, Hélène

2007-02-01

Chronic alcoholism is known to impair the functioning of episodic and working memory, which may consequently reduce the ability to learn complex novel information. Nevertheless, semantic and cognitive procedural learning have not been properly explored at alcohol treatment entry, despite its potential clinical relevance. The goal of the present study was therefore to determine whether alcoholic patients, immediately after the weaning phase, are cognitively able to acquire complex new knowledge, given their episodic and working memory deficits. Twenty alcoholic inpatients with episodic memory and working memory deficits at alcohol treatment entry and a control group of 20 healthy subjects underwent a protocol of semantic acquisition and cognitive procedural learning. The semantic learning task consisted of the acquisition of 10 novel concepts, while subjects were administered the Tower of Toronto task to measure cognitive procedural learning. Analyses showed that although alcoholic subjects were able to acquire the category and features of the semantic concepts, albeit slowly, they presented impaired label learning. In the control group, executive functions and episodic memory predicted semantic learning in the first and second halves of the protocol, respectively. In addition to the cognitive processes involved in the learning strategies invoked by controls, alcoholic subjects seem to attempt to compensate for their impaired cognitive functions, invoking capacities of short-term passive storage. Regarding cognitive procedural learning, although the patients eventually achieved the same results as the controls, they failed to automate the procedure. Contrary to the control group, the alcoholic groups' learning performance was predicted by controlled cognitive functions throughout the protocol. At alcohol treatment entry, alcoholic patients with neuropsychological deficits have difficulty acquiring novel semantic and cognitive procedural knowledge. Compared with

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)

Development of dose audits for complex treatment techniques in radiotherapy

International Nuclear Information System (INIS)

Stefanic, A. M.; Molina, L.; Vallejos, M.; Montano, G.; Zaretzky, A.; Saravi, M.

2014-08-01

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)

Electrochemical procedures in the treatment of the spent nuclear fuel

International Nuclear Information System (INIS)

Oliveira Forbicini, Christina Aparecida L.G. de.

1994-01-01

Taking into account the advantages of the electrochemical technique and operational features of contactors, type mixer-settler, a new electrolytic extraction equipment is presented. Preliminary studies on electrochemical reduction behavior were carried out with a single stage prototype to set the reliable parameters for the final multistage mixer-settler design (MIRELE). Titanium was the housing material (cathode) and platinum the anode. MIRELE was designed and manufactured at IPEN workshop. After operational tests, the equipment was installed in a glove-box and U/Pu electrochemical partitioning studies were accomplished. The influences of parameters, as hydrazine as scavenger agent in nitric acid medium, current density control in each transference unit and organic and aqueous flow rate on the process efficiency were verified. An uranium separation higher than 99,5% has been achieved. Based on these studies, a flowsheet for spent nuclear fuel treatment was performed, including: an U-Pu co-extraction and scrubbing step, a partial partitioning, followed by final partitioning both using electrochemical Pu reduction, and an uranium reextraction as last step. The product with Pu/U ratio 2,2 times higher than the initial one, with suitable composition for the MOX fuel re-fabrication, has been achieved, showing an important application of the equipment in the new concept of fuel recycling. Also, waste volume reduction, one of the important aspects of the process, has been obtained. Concluding the works, an electrochemical procedure for residual hydrazine decomposition, present in the plutonium product solution, was used to provide a safety operation during the concentration step. (author). 94 refs., 44 figs., 15 tabs

Dosimetric comparison of treatment techniques IMRT and VMAT for breast cancer

International Nuclear Information System (INIS)

Urbina, G. L.; Garcia, B. G.

2015-10-01

In this study the dosimetric distribution was compared in the different treatment techniques such as Volumetric Modulated Arc Therapy (VMAT) and Intensity Modulated Radiation Therapy (IMRT) in female patients with breast cancer with stage II-B and III-A, 6 cases (both calculated on VMAT and IMRT) were studied, comparison parameter that are taken into account are: compliance rate, homogeneity index, monitor units, volume dose 50 Gy (D-50%) and 5 Gy (D-5%) volume dose. Comparisons are made in primary tumor volume to optimize treatment in patients with breast cancer, with IMRT using Step, Shoot and VMAT Monte Carlo algorithm, in addition to the organs at risk; the concern to make this work is due to technological advances in radiotherapy and the application of new treatment techniques, that increase the accuracy allowing treatment dose climbing delivering a higher dose to the patient. (Author)

CT-image based conformal high-dose rate brachytherapy boost in the conservative treatment of stage I - II breast cancer - introducing the procedure

International Nuclear Information System (INIS)

Kubaszewska, M.; Skowronek, J.; Chichel, A.; Kanikowski, M.; Dymnicka, M.

2008-01-01

Aim: Breast-conserving surgery (BCS) followed by radiotherapy (RT) has become the standard treatment for the majority of patients with early breast cancer. With regard to boost technique some disagreements are found between groups that are emphasizing the value of electron boost treatment and groups pointing out the value of interstitial brachytherapy (BT) boost treatment. We present the preliminary results in treating selected patients with early-stage breast cancer using high-dose-rate brachytherapy (HD R-BT) as a boost after breast conservation therapy (BCT). Materials/Methods: Between January 2006 and August 2007, a total of 58 female patients with first and second stage breast cancer underwent BCT. This therapeutic procedure involves BCS, whole breast radiation therapy (WBRT) and additional irradiation to the tumour bed (boost) using interstitial HDR-BT via flexible implant tubes. A 10 Gy boost dose was received by all patients. The treatment planning was based on CT-guided 3D (three-dimensional) reconstruction of the surgical clips, implant tubes and critical structures localization (skin and ribs). The accuracy of tumour bed localization, the conformity of planning target volume and treated volume were analyzed. Results: The evaluations of implant parameters involved the use of: dose volume histogram (DVH), the volume encompassed by the 100% reference isodose surface (V100%), the high dose volumecalculation (V150%, V200%, V300%), the dose non-uniformity ratio (DNR), and the conformity index (COIN). Our results were as follows: the mean PTV volume, the mean high dose volume (V150%; V200%; V300%), the DNR and COIN mean value were estimated at 57.38, 42.98, 21.38, 7.90, 0.52 and 0.83 respectively. Conclusions: CT-guided 3D HDR-BT is most appropriate for planning the boost procedure after BT especially in large breast volume, in cases with a deep seated tumour bed, as well as in patients with high risk for local recurrences. This technique reduces the

Mutagenic treatments towards increasing the frequency of day-neutral mutations and standardization of procedures for tissue culture, in potato

International Nuclear Information System (INIS)

Upadhya, M.D.; Chandra, R.; Abraham, M.J.

1976-01-01

Various chemical mutagens and gamma radiation have been used on single dormant eyes and true seeds with a view to finding effective mutagenic treatment for the induction of day-length neutral mutants in potato using an effective screening technique for the isolation of day-length neutral mutants. Sodium meta bisulphite (SMS) was found to be an efficient mutagen in inducing mutations for this trait in true seeds although the same concentrations, when used for treating the single tuber eyes proved lethal. Pre-soaking the seeds for 24 hrs prior to treatment with 0.0025M SMS gave highest frequency of the mutants followed by 48 hrs presoaking, indicating a sensitive stage during the cell cycle in true seeds. Other mutagen treatments gave different frequencies of mutations. The highest frequency of day-length neutral mutants was observed when seeds irradiated with 40 Kr of gamma radiation were treated with 0.05M hydrazinium dichloride solution. Screening procedures have also been standardised with the development of synethetic media for the isolation of biochemical mutants at the true seed level. Initial efforts have yielded mutants resistant to LD 100 doses of ethionine. Another aspect of the study was to develop a proper potato callus culture technique. A medium has been developed to produce and maintain callus from potato leaf strips. Efforts on the regeneration of shoot and roots from callus, have so far lead to differentiation of callus to form roots. The ultimate aim of these studies is to develop plantlets from single cell which would form the units of mutation induction and isolation. (author)

Electron/photon matched field technique for treatment of orbital disease

International Nuclear Information System (INIS)

Arthur, Douglas W.; Zwicker, Robert D.; Garmon, Pamela W.; Huang, David T.; Schmidt-Ullrich, Rupert K.

1997-01-01

Purpose: A number of approaches have been described in the literature for irradiation of malignant and benign diseases of the orbit. Techniques described to date do not deliver a homogeneous dose to the orbital contents while sparing the cornea and lens of excessive dose. This is a result of the geometry encountered in this region and the fact that the target volume, which includes the periorbital and retroorbital tissues but excludes the cornea, anterior chamber, and lens, cannot be readily accommodated by photon beams alone. To improve the dose distribution for these treatments, we have developed a technique that combines a low-energy electron field carefully matched with modified photon fields to achieve acceptable dose coverage and uniformity. Methods and Materials: An anterior electron field and a lateral photon field setup is used to encompass the target volume. Modification of these fields permits accurate matching as well as conformation of the dose distribution to the orbit. A flat-surfaced wax compensator assures uniform electron penetration across the field, and a sunken lead alloy eye block prevents excessive dose to the central structures of the anterior segment. The anterior edge of the photon field is modified by broadening the penumbra using a form of pseudodynamic collimation. Direct measurements using film and ion chamber dosimetry were used to study the characteristics of the fall-off region of the electron field and the penumbra of the photon fields. >From the data collected, the technique for accurate field matching and dose uniformity was generated. Results: The isodose curves produced with this treatment technique demonstrate homogeneous dose coverage of the orbit, including the paralenticular region, and sufficient dose sparing of the anterior segment. The posterior lens accumulates less than 40% of the prescribed dose, and the lateral aspect of the lens receives less than 30%. A dose variation in the match region of ±12% is confronted when

Repeated rendezvous treatment of PTBD and ERCP in patients with recurrent obstructive jaundice.

Science.gov (United States)

Liu, Yingdi; Meng, Jianyun; Wang, Jianhua; Wang, Zhiqiang; Wang, Xiangdong; Linghu, Enqiang; Li, Wen; Yang, Yunsheng

2010-01-01

Repeated applications of rendezvous technique combining percutaneous transhepatic biliary drainage (PTBD) with endoscopic retrograde cholangiopancreatography (ERCP) (PE) in patients with recurrent obstructive jaundice have not been reported. The present study aimed to evaluate treatment effects of this technique in patients who previously received the same rendezvous treatment. Repeated PE rendezvous procedure was performed in 27 patients who received the same procedure previously and had recurrent obstructive jaundice. Twenty-two patients were treated by second-time rendezvous procedure and five patients by third-time. The clinical characteristics and therapeutic effects were retrospectively analyzed. By means of repeated rendezvous technique, 26 patients gained access to the bile duct and were successfully implanted new stents, only one failed with stent implantation. Total serum bilirubin level decreased within one week from 221.89 +/- 64.70 micromol/L to 156.0 +/- 32.2 micromol/L in patients with second-time treatment and from 297.07 +/- 109.12 micromol/L to 238.77 +/- 36.81 micromol/L in patients with third-time treatment. There was no severe complications observed that are associated with repeated PE procedure. Rendezvous procedure of PTBD and ERCP could be used repeatedly and effectively for patients who present recurrent obstructive jaundice after ERCP failure.

Technique of Antireflux Procedure without Creating Submucosal Tunnel for Surgical Correction of Vesicoureteric Reflux during Bladder Closure in Exstrophy.

Science.gov (United States)

Sunil, Kanoujia; Gupta, Archika; Chaubey, Digamber; Pandey, Anand; Kureel, Shiv Narain; Verma, Ajay Kumar

2018-01-01

To report the clinical application of the new surgical technique of antireflux procedure without creating submucosal tunnel for surgical correction of vesicoureteric reflux during bladder closure in exstrophy. Based on the report of published experimental technique, the procedure was clinically executed in seven patients of classic exstrophy bladder with small bladder plate with polyps, where the creation of submucosal tunnel was not possible, in last 18 months. Ureters were mobilized. A rectangular patch of bladder mucosa at trigone was removed exposing the detrusor. Mobilized urteres were advanced, crossed and anchored to exposed detrusor parallel to each other. Reconstruction included bladder and epispadias repair with abdominal wall closure. The outcome was measured with the assessment of complications, abolition of reflux on cystogram and upper tract status. At 3-month follow-up cystogram, reflux was absent in all. Follow-up ultrasound revealed mild dilatation of pelvis and ureter in one. The technique of extra-mucosal ureteric reimplantation without the creation of submucosal tunnel is simple to execute without risk and complications and effectively provides an antireflux mechanism for the preservation of upper tract in bladder exstrophy. With the use of this technique, reflux can be prevented since the very beginning of exstrophy reconstruction.

Computed tomography after radical pancreaticoduodenectomy (Whipple's procedure)

International Nuclear Information System (INIS)

Smith, S.L.; Hampson, F.; Duxbury, M.; Rae, D.M.; Sinclair, M.T.

2008-01-01

Whipple's procedure (radical pancreaticoduodenectomy) is currently the only curative option for patients with periampullary malignancy. The surgery is highly complex and involves multiple anastomoses. Complications are common and can lead to significant postoperative morbidity. Early detection and treatment of complications is vital, and high-quality multidetector computed tomography (MDCT) is currently the best method of investigation. This review outlines the surgical technique and illustrates the range of normal postoperative appearances together with the common complications

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. ((c) 2007 APA, all rights reserved).

Pediatric interventional radiology: Indications, techniques, and management

International Nuclear Information System (INIS)

Towbin, R.B.; Ball, W.S. Jr.

1987-01-01

This course develops a practical approach to pediatric interventional radiology. Radiologic intervention in the pediatricage group is possible by attending to the care and special needs of the child. The authors also emphasize their approach to patient preparation, sedation and anesthesia, nursing care, monitoring of the patient during the procedure, and follow-up care. The course is divided into nonvascular and vascular sections. The discussion of nonvascular procedures focus on the chest and the GU and GI systems. Biopsy techniques and drainage of effusions and abscesses within the chest are discussed. A variety of GU procedures are presented including insertion of a nephrostomy tube and percutaneous tract dilation for placement of internal stents, percutaneous stone removal, and percutaneous surgery for pyeloplasty. The authors approach to percutaneous pyeloplasty is briefly discussed. Intervention within the GI system includes percutaenous aspiration, drainage, and biopsies. Emphasis is placed on the selection of embolic agents and catheter delivery systems, techniques, and current treatment concepts. The authors describe experience with embolization of vascular malformations, renovascular disease, uncontrollable hemorrhage, and selected neoplastic processes. Comments on the indications for and techniques of transluminal angioplasty and fibrinolytic therapy in children conclude the lecture

Pediatric Endoscopic Pilonidal Sinus Treatment, a Revolutionary Technique to Adopt in Children with Pilonidal Sinus Fistulas: Our Preliminary Experience.

Science.gov (United States)

Esposito, Ciro; Izzo, Serena; Turrà, Francesco; Cerulo, Mariapina; Severino, Giovanni; Settimi, Alessandro; Iannazzone, Marta; Masieri, Lorenzo; Cortese, Giuseppe; Escolino, Maria

2018-03-01

This study aimed to report our preliminary experience with pediatric endoscopic pilonidal sinus treatment (PEPSiT). We retrospectively reviewed the reports of 15 patients, 6 girls and 9 boys, with an average age of 16 years (range 13-18) with noninfected pilonidal sinus disease who underwent PEPSiT in our institution over an 18-month period. Four cases were redo-procedures, for recurrence of disease after open excision repair. Surgical outcomes of sinus healing, recurrence of disease, postoperative pain, hospital stay, analgesic requirements, and patient satisfaction levels were evaluated and a comparison analysis with classic open repair was performed. All procedures were performed under subarachnoid spinal anesthesia. We always adopted a fistuloscope, an endoscopic forceps, and a monopolar electrode to remove the hairs and to heal the fistula. The average length of surgery was 28.5 minutes (range 26-41). No intraoperative or postoperative complications were reported. The average pain score evaluated using Visual Analogue Scale (VAS) pain scale during the first 48 postoperative hours was 3.2 (range 2-5). The average analgesic requirement was 22 hours (range 16-28). The average hospital stay length was 28 hours (range 22-48). They changed dressing daily, by applying a topical solution of eosin 2% and a silver sulfadiazine spray. At 1 month postoperatively, the external openings were closed in all patients and no recurrence was recorded at a mean follow-up of 6 month. PEPSiT was associated with a significantly shorter, painless, and better outcome compared to open technique. On the basis of our preliminary experience, we believe that PEPSiT is a promising technique for surgical treatment of pilonidal sinus in children. It is technically easy and quick to perform, with a short and painless hospital stay, without recurrences in our series. It allows operated patients an early return to full daily activities without restrictions that happen for the classic treatment.

Percutaneous mechanical atherectomy for treatment of peripheral arterial occlusive disease

International Nuclear Information System (INIS)

Buecker, A.; Minko, P.; Massmann, A.; Katoh, M.

2010-01-01

Peripheral arterial occlusive disease (PAOD) is still an extremely important politico-economic disease. Diverse treatment procedures exist but the pillars of therapy are changes in lifestyle, such as nicotine abstinence and walking exercise as well as drug therapy. Further therapy options are considered after conventional procedures have been exhausted. These further options consist of improvement of the blood supply by surgical or minimally invasive procedures. The latter therapy options include balloon dilatation and stenting as the most widely used techniques. More recent techniques also used are cryoplasty, laser angioplasty, drug-coated stents or balloons as well as brachytherapy or atherectomy, whereby this list makes no claims to completeness. The multitude of different treatment methods emphatically underlines the fact that no resounding success can be achieved with one single method. The long-term results of both balloon dilatation and stenting techniques show a need for improvement, which elicited the search for additional methods for the treatment of PAOD. Atherectomy represents such an alternative method for treatment of PAOD. Basically, the term atherectomy means the removal of atheroma tissue. For percutaneous atherectomy, in contrast to surgical procedures, it is not necessary to create surgically access to the vessel but accomplishes the atherectomy by means of dedicated systems via a minimally invasive access. There are two basic forms of mechanical atherectomy: directional and rotational systems. (orig.) [de

Brine treatment, smoking and storage techniques: their effects on the ...

African Journals Online (AJOL)

Journal of Food Technology in Africa ... Brine treatment, smoking and storage techniques: their effects on the microbial quality of smoked mackerel. ... off odour development, softening of the fish and positively affected personal preference.

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.

No-Drain Single Incision Liposuction Pull-Through Technique for Gynecomastia.

Science.gov (United States)

Khalil, Ashraf A; Ibrahim, Amr; Afifi, Ahmed M

2017-04-01

Several different methods have been proposed for treatment of gynecomastia, depending on the amount of breast enlargement and skin redundancy. The liposuction pull-through technique has been proposed as an efficacious treatment for many gynecomastia cases. This work aims to study the outcome of this technique when applied as an outpatient procedure, without the use of drains and through a single incision. Fifty-two patients with bilateral gynecomastia without significant skin excess were included in this study. The liposuction pull-through technique was performed through a single incision just above the inframammary fold and without the use of drains. Patients were followed up for 6 months. The proposed technique was able to treat the gynecomastia in all patients, with a revision rate of 1.9% to remove residual glandular tissues. There were no seromas, hematomas, nipple distortion, permanent affection of nipple sensation or wound healing problems. The liposuction pull-through technique is an effective treatment for gynecomastia without significant skin redundancy. It combines the benefits of the direct excision of glandular tissues, with the minimally invasive nature of liposuction. Performing the procedure through a single incision without the use of drains and without general anesthesia is a safe alternative. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors http://www.springer.com/00266 .

Bronchoscopic techniques in the management of patients with tuberculosis

Directory of Open Access Journals (Sweden)

Michele Mondoni

2017-11-01

Full Text Available Tuberculosis (TB is one of the leading causes of morbidity and mortality worldwide. Early diagnosis and treatment are key to prevent Mycobacterium tuberculosis transmission. Bronchoscopy can play a primary role in pulmonary TB diagnosis, particularly for suspected patients with scarce sputum or sputum smear negativity, and with endobronchial disease. Bronchoscopic needle aspiration techniques are accurate and safe means adopted to investigate hilar and mediastinal lymph nodes in cases of suspected TB lymphadenopathy. Tracheobronchial stenosis represents the worst complication of endobronchial tuberculosis. Bronchoscopic procedures are less invasive therapeutic strategies than conventional surgery to be adopted in the management of TB-related stenosis.We conducted a non-systematic review aimed at describing the scientific literature on the role of bronchoscopic techniques in the diagnosis and therapy of patients with TB.We focused on three main areas of interventions: bronchoscopic diagnosis of smear negative/sputum scarce TB patients, endobronchial TB diagnosis and treatment and needle aspiration techniques for intrathoracic TB lymphadenopathy. We described experiences on bronchoalveolar lavage, bronchial washing, and biopsy techniques for the diagnosis of patients with tracheobronchial and pulmonary TB; furthermore, we described the role played by conventional and ultrasound-guided transbronchial needle aspiration in the diagnosis of suspected hilar and mediastinal TB adenopathy. Finally, we assessed the role of the bronchoscopic therapy in the treatment of endobronchial TB and its complications, focusing on dilation techniques (such as balloon dilation and airway stenting and ablative procedures (both heat and cold therapies. Keywords: Bronchoscopy, Tuberculosis, Endoscopic ultrasound-guided fine needle aspiration, Tracheobronchial stenosis

The Effect of a Multiple Treatment Program and Maintenance Procedures on Smoking Cessation.

Science.gov (United States)

Powell, Don R.

The efficacy of a multiple treatment smoking cessation program and three maintenance strategies was evaluated. Phases I and II of the study involved 51 subjects who participated in a five-day smoking cessation project consisting of lectures, demonstrations, practice exercises, negative smoking, and the teaching of self-control procedures. At the…

Minimally invasive myotomy for the treatment of esophageal achalasia: evolution of the surgical procedure and the therapeutic algorithm.

Science.gov (United States)

Bresadola, Vittorio; Feo, Carlo V

2012-04-01

Achalasia is a rare disease of the esophagus, characterized by the absence of peristalsis in the esophageal body and incomplete relaxation of the lower esophageal sphincter, which may be hypertensive. The cause of this disease is unknown; therefore, the aim of the therapy is to improve esophageal emptying by eliminating the outflow resistance caused by the lower esophageal sphincter. This goal can be accomplished either by pneumatic dilatation or surgical myotomy, which are the only long-term effective therapies for achalasia. Historically, pneumatic dilatation was preferred over surgical myotomy because of the morbidity associated with a thoracotomy or a laparotomy. However, with the development of minimally invasive techniques, the surgical approach has gained widespread acceptance among patients and gastroenterologists and, consequently, the role of surgery has changed. The aim of this study was to review the changes occurred in the surgical treatment of achalasia over the last 2 decades; specifically, the development of minimally invasive techniques with the evolution from a thoracoscopic approach without an antireflux procedure to a laparoscopic myotomy with a partial fundoplication, the changes in the length of the myotomy, and the modification of the therapeutic algorithm.

Development of residual stress analysis procedure for fitness-for-service assessment of welded structure

International Nuclear Information System (INIS)

Kim, Jong Sung; Jin, Tae Eun; Dong, P.; Prager, M.

2003-01-01

In this study, a state of art review of existing residual stress analysis techniques and representative solutions is presented in order to develop the residual stress analysis procedure for Fitness-For-Service(FFS) assessment of welded structure. Critical issues associated with existing residual stress solutions and their treatments in performing FFS are discussed. It should be recognized that detailed residual stress evolution is an extremely complicated phenomenon that typically involves material-specific thermomechanical/metallurgical response, welding process physics, and structural interactions within a component being welded. As a result, computational procedures can vary significantly from highly complicated numerical techniques intended only to elucidate a small part of the process physics to cost-effective procedures that are deemed adequate for capturing some of the important features in a final residual stress distribution. Residual stress analysis procedure for FFS purposes belongs to the latter category. With this in mind, both residual stress analysis techniques and their adequacy for FFS are assessed based on both literature data and analyses performed in this investigation

Treatment and disposal techniques of dangerous municipal solid wastes

International Nuclear Information System (INIS)

Beone, G.; Carbone, A.I.; Zagaroli, M.

1989-01-01

This paper describes the qualitative and quantitative features of the different types of dangerous municipal solid wastes, according to Italian law. In the second part the impact on environment and man health is presented. This impact should be minimized by suitable controlled disposal techniques, which differ from other municipal waste treatments. Finally, the paper deals with the most appropriate systems for treatment and disposal of such kind of waste. Particularly, some research activities in the field of metal recovery from used batteries, sponsored by ENEA, and carrying out by private companies, are described. (author)

Reduction of radiation doses in leg lengthening procedures by means of audit and computed tomography scanogram techniques

International Nuclear Information System (INIS)

Romanowski, C.A.J.; Sprigg, A.; Underwood, A.C.

1994-01-01

Children with congenital bone dysplasias may benefit from leg lengthening procedures. Such procedures, by necessity, require frequent and regular imaging. It is necessary to minimize the total radiation dose to these patients, and particularly the dose to the gonads. In the present study, the films of 13 patients who had completed leg lengthening procedures were reviewed. The number of films was assessed together with the use of appropriate gonad shielding. In a second part of the study, thermoluminescent dosemeter measurements of radiation doses to a phantom were made for both plain radiographs (with and without gonad protection) and computed tomography (CT) scanograms. The results show that audit plays an important role in assessing radiographic practice with respect to accurate placement of gonad protection and confirm that a significant dose reduction can be accomplished by careful use of this lead shielding. Dose reduction can also be achieved by using alternative radiographic techniques such as CT scanograms. (author)

SU-G-TeP1-13: Reclined Total Skin Electron Treatment Technique

Energy Technology Data Exchange (ETDEWEB)

Mathew, D; Gerbi, B [University of Minnesota, Minneapolis, MN (United States)

2016-06-15

Purpose: The purpose is to describe a new reclined technique for treatment of weakened patients that require total skin electron irradiation. Methods: This technique is a modification of a previously published reclined technique differing in that all six patient positions are treated with the gantry angled 60° from vertically down. The patient is located at a treatment distance of 330 cm SSD along the CA of the beam. The 3/8′ thick Lexan beam spoiler is placed 25 cm from the most proximal surface of the patient for all patient treatment positions. To produce a flat, uniform field of ∼190 cm length, the patient was moved longitudinally by an experimentally determined distance. Kodak EDR2 and EBT3 Radiochromic film were placed around the periphery of the phantom, and OSLs were placed every 30° around the phantom periphery to determine output and surface dose uniformity. A piece of Kodak EDR2 was sandwiched between the two slabs of the 30 cm diameter phantom to determine beam penetration. Results: Field uniformity shifting the patient ±75 cm was ±5% over a treatment span of 190 cm. The dose variation around the periphery of the 30 cm diameter phantom varied by <±5% with the maximum values observed at the 0°-300°, 60° locations with the minimum values at the 30°-330°, 60° locations. Results obtained using Kodak EDR2, EBT3 Radiochromic film, and OSLs agreed to within ±5%. Conclusion: This technique provides a very efficient and convenient means by which to treat the entire skin surface of patients incapable of standing for treatment. It provides a treatment field that is both large and uniform enough for adults along with a convenient way to treat four of the six patient treatment positions. The beam spoiler lies to the side of the patient allowing easy access for patient positioning.

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.

Development of quality control procedures for mass produced and released Bactrocera Philippinensis (Diptera: Tephritidae) for sterile insect technique programs

International Nuclear Information System (INIS)

Resilva, S.; Obra, G.; Zamora, N.; Gaitan, E.

2007-01-01

Quality control procedures for Bactrocera philippinensis Drew and Hancock 1994 (Diptera: Tephritidae) used in sterile insect technique (SIT) programs were established in the mass rearing facility at the Philippine Nuclear Research Institute. Basic studies on pupal irradiation, holding/packaging systems, shipping procedures, longevity, sterility studies, and pupal eye color determination in relation to physiological development at different temperature regimes were investigated. These studies will provide baseline data for the development of quality control protocols for an expansion of B. philippinensis field programs with an SIT component in the future. (author) [es

Monaldi's technique for treatment of pulmonary abscesses

International Nuclear Information System (INIS)

Fuentes Valdes, Edelberto

2010-01-01

The pulmonary abscesses are usually treated with antibiotics and postural drainage. However, some patients don't improve with conservative measures or have contraindications for conventional surgical treatment. The aim of present paper was the presentation of three cases underwent percutaneous drainage of pulmonary abscesses. The technique used for tube insertion, complications and postoperative course of patients were described. In such cases operation was successful without mortality and with a bronchopleural cutaneous fistula like the only complication requiring a further intervention (pneumonectomy). The percutaneous drainage of pulmonary abscesses was safe and effective in our patients. (author)

Procedural mishaps with trephine-based intraosseous anesthesia.

Science.gov (United States)

Small, Joel C; Witherspoon, David E; Regan, John D; Hall, Ellen

2011-01-01

Failure to achieve profound anesthesia during dental treatment can be a significant problem for dental clinicians, especially for endodontic procedures on teeth in the mandibular arch with irreversible pulpitis. A number of supplemental local anesthesia techniques exist, the most effective of which may be the intraosseous injection. Two cases are presented demonstrating the dangers associated with the use of the intraosseous anesthesia technique. While the technique can provide profound anesthesia in otherwise difficult to anesthetize cases, care must be taken during its administration. Both cases show the damage done to the root and overlying bone by the injudicious use of the trephine. It is incumbent on the clinician to fully consider the anatomy in the area prior to insertion of the trephine. Intraosseous anesthesia techniques are a valuable addition to the clinicians' armamentarium. However careless administration can result in problems of endodontic or periodontal nature that may be difficult to rectify.

Imaging guided interventional procedures in paediatric uroradiology--a case based overview

Energy Technology Data Exchange (ETDEWEB)

Riccabona, M. E-mail: michael.riccabona@kfunigraz.ac.at; Sorantin, E.; Hausegger, K

2002-08-01

Objective: To describe the potential and application of interventional image guided procedures in the paediatric urinary tract. Patients and methods: The different techniques are illustrated using case reports. The examples comprise established indications such as percutaneous nephrostomy for compromised kidneys in obstructive uropathy and infection, sonographic guided renal biopsy including monitoring or treatment of complications after biopsy, and evaluation and balloon dilatation of childhood renal artery stenosis. There are new applications such as treatment of stenosis in cutaneous ureterostomy or sonographically guided catheterism for deployment of therapeutic agents. Results: Generally, the procedures are safe and successful. However, complications may occur, and peri-/post-interventional monitoring is mandatory to insure early detection and adequate management. Sometimes additional treatment such as percutaneous embolisation of a symptomatic post biopsy arterio-venous fistula, or a second biopsy for recurrent disease may become necessary. Conclusion: Imaging guided interventional procedures are performed successfully in a variety of diseases of the paediatric urinary tract. They can be considered a valuable additional modality throughout infancy and childhood.

Imaging guided interventional procedures in paediatric uroradiology--a case based overview

International Nuclear Information System (INIS)

Riccabona, M.; Sorantin, E.; Hausegger, K.

2002-01-01

Objective: To describe the potential and application of interventional image guided procedures in the paediatric urinary tract. Patients and methods: The different techniques are illustrated using case reports. The examples comprise established indications such as percutaneous nephrostomy for compromised kidneys in obstructive uropathy and infection, sonographic guided renal biopsy including monitoring or treatment of complications after biopsy, and evaluation and balloon dilatation of childhood renal artery stenosis. There are new applications such as treatment of stenosis in cutaneous ureterostomy or sonographically guided catheterism for deployment of therapeutic agents. Results: Generally, the procedures are safe and successful. However, complications may occur, and peri-/post-interventional monitoring is mandatory to insure early detection and adequate management. Sometimes additional treatment such as percutaneous embolisation of a symptomatic post biopsy arterio-venous fistula, or a second biopsy for recurrent disease may become necessary. Conclusion: Imaging guided interventional procedures are performed successfully in a variety of diseases of the paediatric urinary tract. They can be considered a valuable additional modality throughout infancy and childhood

Performance evaluation of a hybrid-passive landfill leachate treatment system using multivariate statistical techniques

Energy Technology Data Exchange (ETDEWEB)

Wallace, Jack, E-mail: jack.wallace@ce.queensu.ca [Department of Civil Engineering, Queen’s University, Ellis Hall, 58 University Avenue, Kingston, Ontario K7L 3N6 (Canada); Champagne, Pascale, E-mail: champagne@civil.queensu.ca [Department of Civil Engineering, Queen’s University, Ellis Hall, 58 University Avenue, Kingston, Ontario K7L 3N6 (Canada); Monnier, Anne-Charlotte, E-mail: anne-charlotte.monnier@insa-lyon.fr [National Institute for Applied Sciences – Lyon, 20 Avenue Albert Einstein, 69621 Villeurbanne Cedex (France)

2015-01-15

the five criteria parameters (set as dependent variables), on a statistically significant level: conductivity, dissolved oxygen (DO), nitrite (NO{sub 2}{sup −}), organic nitrogen (N), oxidation reduction potential (ORP), pH, sulfate and total volatile solids (TVS). The criteria parameters and the significant explanatory parameters were most important in modeling the dynamics of the passive treatment system during the study period. Such techniques and procedures were found to be highly valuable and could be applied to other sites to determine parameters of interest in similar naturalized engineered systems.

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...

Laparoscopic intestinal derotation: original technique.

Science.gov (United States)

Valle, Mario; Federici, Orietta; Tarantino, Enrico; Corona, Francesco; Garofalo, Alfredo

2009-06-01

The intestinal derotation technique, introduced by Cattel and Valdoni 40 years ago, is carried out using a laparoscopic procedure, which is described here for the first time. The method is effective in the treatment of malign lesions of the III and IV duodenum and during laparoscopic subtotal colectomy with anastomosis between the ascending colon and the rectum. Ultimately, the procedure allows for the verticalization of the duodenal C and the anterior positioning of the mesenteric vessels, facilitating biopsy and resection of the III and IV duodenal portions and allowing anastomosis of the ascending rectum, avoiding both subtotal colectomy and the risk of torsion of the right colic loop. Although the procedure calls for extensive experience with advanced video-laparoscopic surgery, it is both feasible and repeatable. In our experience we have observed no mortality or morbidity.

Techniques of treatment or conditioning for waste arising from 131I production

International Nuclear Information System (INIS)

Dellamono, J.C.

1989-07-01

Distillation, evaporation/crystallization, direct immobilization and some chemical like precipitation and reduction were studied as techniques of treatment or conditioning for waste arising from 131 I production. The description of all techniques studied, as well as evaluation and discussion of the results are presented. (author) [pt

Frey procedure combined with biliary diversion in chronic pancreatitis.

Science.gov (United States)

Merdrignac, Aude; Bergeat, Damien; Rayar, Michel; Harnoy, Yann; Turner, Kathleen; Courtin-Tanguy, Laetitia; Boudjema, Karim; Meunier, Bernard; Sulpice, Laurent

2016-11-01

The Frey procedure has become the standard operative treatment in chronic painful pancreatitis. Biliary diversion could be combined when associated with common bile duct obstruction. The aim of the present study was to evaluate the impact of the type of biliary diversion combined with the Frey procedure on late morbidity. The data from consecutive patients undergoing the Frey procedure and having a minimum follow-up of 2 years were extracted from a maintained prospective database. The mean endpoint was the rate of secondary biliary stricture after the Frey procedure combined with biliary diversion (bilioenteric anastomosis or common bile duct reinsertion in the resection cavity). Between 2006 and 2013, 55 consecutive patients underwent the Frey procedure. Twenty-nine patients had common bile duct obstruction (52.7%). The technique of biliary diversion resulted in bilioenteric anastomosis in 19 patients (65.5%) and common bile duct reinsertion in 10 patients (34.5%). Preoperative characteristics and early surgical outcomes were comparable. Pain control was similar. There was significantly more secondary biliary stricture after common bile duct reinsertion than after bilioenteric anastomosis (60% vs 11%, P = .008). Combined bilioenteric anastomosis during the Frey procedure is an efficient technique for treating common bile duct obstruction that complicates chronic painful pancreatitis. Bilioenteric anastomosis was associated with less secondary biliary stricture than common bile duct reinsertion in the pancreatic resection cavity. Copyright © 2016 Elsevier Inc. All rights reserved.

Procedural Media Representation

OpenAIRE

Henrysson, Anders

2002-01-01

We present a concept for using procedural techniques to represent media. Procedural methods allow us to represent digital media (2D images, 3D environments etc.) with very little information and to render it photo realistically. Since not all kind of content can be created procedurally, traditional media representations (bitmaps, polygons etc.) must be used as well. We have adopted an object-based media representation where an object can be represented either with a procedure or with its trad...

Comparing imaging procedures: techniques and examples. Gastroenterology

International Nuclear Information System (INIS)

Malmud, L.S.

1982-01-01

The distinct advantages of nuclear medicine procedures, in comparison to radiography, contrast studies, computerized tomography and ultrasound, are emphasized. Scintigraphic methods offer quantitative data regarding function which competing imaging modalities are unable to provide, and make them the studies of choice in the evaluation of gastrointestinal physiology and functional abnormalities

Electromyographic evaluation in children orthodontically treated for skeletal Class II malocclusion: Comparison of two treatment techniques.

Science.gov (United States)

Ortu, Eleonora; Pietropaoli, Davide; Adib, Fray; Masci, Chiara; Giannoni, Mario; Monaco, Annalisa

2017-11-16

Objective To compare the clinical efficacy of two techniques for fabricating a Bimler device by assessing the patient's surface electromyography (sEMG) activity at rest before treatment and six months after treatment. Methods Twenty-four patients undergoing orthodontic treatment were enrolled in the study; 12 formed the test group and wore a Bimler device fabricated with a Myoprint impression using neuromuscular orthodontic technique and 12 formed the control group and were treated by traditional orthodontic technique with a wax bite in protrusion. The "rest" sEMG of each patient was recorded prior to treatment and six months after treatment. Results The neuromuscular-designed Bimler device was more comfortable and provided better treatment results than the traditional Bimler device. Conclusion This study suggests that the patient group subjected to neuromuscular orthodontic treatment had a treatment outcome with more relaxed masticatory muscles and better function versus the traditional orthodontic treatment.

To compare effects of maitland and mulligan mobilization techniques in the treatment of frozen shoulder

International Nuclear Information System (INIS)

Haider, R.; Ahmad, A.

2014-01-01

To compare the role of Maitland mobilization and Mulligan's mobilization techniques in treatment of frozen shoulder and its possible effect in early gaining of ROM and Pain management. Methods: This was a randomized control trial conducted at Department of Physiotherapy ana Orthopedics unit I, KEMU / Mayo Hospital, Lahore. There were two group of patients each group contained 30 patients. Patients were treated with Mulligan's technique in Group - A and with Maitland manual therapy technique in Group - B. Patients in both treatment groups were followed till 6 weeks and improvement in range of motion parameters were recorded at every follow up visit of the patients. SPSS was used for data entry and analysis. Results: In the study 60 patients were enrolled. Mean age of Group - A patients was 46.23 ± 9.71 years, and mean age of Group - B patients was 47 ± 9.21 years. In Group - A 14 patients duration of onset was 8 weeks, 4 patients duration of onset was 10 weeks and 12 patients duration of onset was 12 weeks. In Group - B 14 patients duration of onset was 8 weeks, 8 patients duration of onset was 10 weeks and 12 weeks each respectively. It was observed that patients who were treated with Mulligan technique their abduction and flexion was improved greatly as compared to those who were treated with Maitland technique. Patients who were treated with Mulligan technique their flex- ion was improved greatly as compared to those who were treated with Maitland technique. At 6th week mean extension in Maitland's treatment group was 52.50 ± 8.66 where as that Mulligan's treatment group was 52.00 ± 7.58. It was observed that patients in both treatment groups had same improvement in extension and it was statistically same. In both treatment groups patients had same improvement in medial rotation and it was statistically same. At 6th week mean lateral rotation in both treatment groups was 42.65 ± 24.47 and 53.50 ± 23.03. It was observed that patients in

[Diverticular disease of the large bowel - surgical treatment].

Science.gov (United States)

Levý, M; Herdegen, P; Sutoris, K; Simša, J

2013-07-01

Surgical treatment, despite the rapid development of the numerous modern miniinvasive intervention techniques, remains essential in the treatment of complicated diverticular disease. The aim of this work is to summarize indications for surgical treatment in both acute and elective patients suffering from diverticular disease of the large bowel. Review of the literature and recent findings concerning indications for surgical intervention in patients with diverticulosis of the colon. The article describes indications, types of procedures, techniques and postoperative care in patients undergoing surgical intervention for diverticular disease.

Treatment of a case of subacute lumbar compartment syndrome using the Graston technique.

Science.gov (United States)

Hammer, Warren I; Pfefer, Mark T

2005-01-01

To discuss subacute lumbar compartment syndrome and its treatment using a soft tissue mobilization technique. A patient presented with low back pain related to exercise combined with prolonged flexion posture. The symptoms were relieved with rest and lumbar extension. The patient had restrictive lumbar fascia in flexion and rotation and no neurological deficits. The restrictive lumbar posterior fascial layers and adjoining restrictive fascia (thoracic, gluteal, hamstring) were treated with a form of instrument-assisted soft tissue mobilization called the Graston technique. Restoration of fascial extensibility and resolution of the complaint occurred after 6 treatment visits. The posterior spinal fascial compartments may be responsible for intermittent lower back pain. Functional clinical tests can be employed to determine whether the involved fascia is abnormally restrictive. Treatment directed at the restrictive fascia using this soft tissue technique may result in improved fascial functional testing and reduction of symptoms.

Comparison of online IGRT techniques for prostate IMRT treatment: Adaptive vs repositioning correction

International Nuclear Information System (INIS)

Thongphiew, Danthai; Wu, Q. Jackie; Lee, W. Robert; Chankong, Vira; Yoo, Sua; McMahon, Ryan; Yin Fangfang

2009-01-01

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, and 15 fractions out of 30 total fractions, while it also had the best D90, D50, and D30 values for

Surgical techniques for the treatment of carpal ligament injury in the athlete.

Science.gov (United States)

Paci, Gabrielle M; Yao, Jeffrey

2015-01-01

Treatment of intercarpal ligament injuries in the athlete requires special attention due to several practical and biomechanical considerations. Optimally, the athlete will maintain as much function and range of motion as possible with return to high-impact and load-bearing activity in a timely fashion. Several cutting-edge techniques have arisen in treatment. This article discusses injury patterns in the athlete with scapholunate injury, lunotriquetral injury, scaphotrapezial-trapezoidal injury, and extrinsic ligamentous injury, and the various approaches to addressing these injuries, with a review of the classic as well as newer, innovative techniques. Copyright © 2015 Elsevier Inc. All rights reserved.

Frontier of Advanced Accelerator Applications and Medical Treatments Using Nuclear Techniques. Abstract

International Nuclear Information System (INIS)

2015-01-01

To address the challenges of research-based practice, developing advanced accelerator applications, and medical treatments using nuclear tecniqoes, researchers from Rajamakala University of Technology Lanna, Office of Atoms for Peace, and Chiang Mai University have joined in hosting this conference. Nuclear medicine, amedical specialty, diagnoses and treats diseases in a safe and painless way. Nuclear techniques can determine medical information that may otherwise be unavailable, require surgery, or necessitate more expensive and invasive diagnostic tests. Advance in nuclear techniques also offer the potential to detect abnormalities at earlier stages, leasding to earlier treatment and a more successful prognosis.

Use of the Boomerang catalyst advantage closure device to facilitate complex multistaged percutaneous revascularization procedures for the treatment of critical limb ischemia.

Science.gov (United States)

Garcia, Joel A; Casserly, Ivan P

2009-07-01

An increasing spectrum of complex peripheral arterial disease may be successfully treated using percutaneous revascularization techniques. A pair of challenging peripheral revascularization procedures in patients with critical limb ischemia is presented, where an array of interventional tools and techniques were required, and the off-label use of the Boomerang catalyst system closure device was important in managing a variety of complex arterial access issues and ultimately allowing procedural success. Copyright 2009 Wiley-Liss, Inc.

Classification of radiological procedures

International Nuclear Information System (INIS)

1989-01-01

A classification for departments in Danish hospitals which use radiological procedures. The classification codes consist of 4 digits, where the first 2 are the codes for the main groups. The first digit represents the procedure's topographical object and the second the techniques. The last 2 digits describe individual procedures. (CLS)

A single-gradient junction technique to replace multiple-junction shifts for craniospinal irradiation treatment

International Nuclear Information System (INIS)

Hadley, Austin; Ding, George X.

2014-01-01

Craniospinal irradiation (CSI) requires abutting fields at the cervical spine. Junction shifts are conventionally used to prevent setup error–induced overdosage/underdosage from occurring at the same location. This study compared the dosimetric differences at the cranial-spinal junction between a single-gradient junction technique and conventional multiple-junction shifts and evaluated the effect of setup errors on the dose distributions between both techniques for a treatment course and single fraction. Conventionally, 2 lateral brain fields and a posterior spine field(s) are used for CSI with weekly 1-cm junction shifts. We retrospectively replanned 4 CSI patients using a single-gradient junction between the lateral brain fields and the posterior spine field. The fields were extended to allow a minimum 3-cm field overlap. The dose gradient at the junction was achieved using dose painting and intensity-modulated radiation therapy planning. The effect of positioning setup errors on the dose distributions for both techniques was simulated by applying shifts of ± 3 and 5 mm. The resulting cervical spine doses across the field junction for both techniques were calculated and compared. Dose profiles were obtained for both a single fraction and entire treatment course to include the effects of the conventional weekly junction shifts. Compared with the conventional technique, the gradient-dose technique resulted in higher dose uniformity and conformity to the target volumes, lower organ at risk (OAR) mean and maximum doses, and diminished hot spots from systematic positioning errors over the course of treatment. Single-fraction hot and cold spots were improved for the gradient-dose technique. The single-gradient junction technique provides improved conformity, dose uniformity, diminished hot spots, lower OAR mean and maximum dose, and one plan for the entire treatment course, which reduces the potential human error associated with conventional 4-shifted plans

Comparing Treatment and Control Groups on Multiple Outcomes: Robust Procedures for Testing a Directional Alternative Hypothesis

Science.gov (United States)

Lix, Lisa M.; Deering, Kathleen N.; Fouladi, Rachel T.; Manivong, Phongsack

2009-01-01

This study considers the problem of testing the difference between treatment and control groups on m [greater than or equal to] 2 measures when it is assumed a priori that the treatment group will perform better than the control group on all measures. Two procedures are investigated that do not rest on the assumptions of covariance homogeneity or…

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...

Handbook of laboratory techniques

International Nuclear Information System (INIS)

2002-01-01

The Nuclear Regulatory Authority in Argentina have laboratories of support to regulations functions on radiological and nuclear safety, safeguards and physical protection, that have a surface of 2950 m 2 in the Ezeiza Atomic Center. The manual describes in seven chapters the different techniques developed and applied in the laboratories along four decades of existence. The chapter 1: Dedicated to the treatment of environmental samples, described the procedures associated with the different types of samples: deposits, waters, sediments, vegetables, milk, fish and diet. The chapter 2: Details 48 radiochemical techniques associated to the measurements of americium 241, carbon 16, strontium 90, iodine 129, plutonium, radium 226, radon, uranium, nickel and actinides. The chapter 3: Describes the measurements techniques of alpha and gamma spectrometry. The different techniques of biological and physical dosimetry are described in the chapters 5 and 6 respectively. The final chapter is dedicated the techniques of external and internal contamination. It s important to emphasize that this manual contains the standardized technologies that the Nuclear Regulatory Authority of Argentina submits regularly to international comparisons

Treatment for retained [corrected] common bile duct stones during laparoscopic cholecystectomy: the rendezvous technique.

Science.gov (United States)

Borzellino, Giuseppe; Rodella, Luca; Saladino, Edoardo; Catalano, Filippo; Politi, Leonardo; Minicozzi, Annamaria; Cordiano, Claudio

2010-12-01

To determine the feasibility and efficacy of the laparoscopic intraoperative rendezvous technique for common bile duct stones (CBDS). Case series. Verona University Hospital, Verona, Italy. A total of 110 patients were enrolled in the study; 47 had biliary colic; 39, acute cholecystitis; 19, acute biliary pancreatitis; and 5, acute biliary pancreatitis with associated acute cholecystitis. In all patients, CBDS diagnosis was reached by intraoperative cholangiography. Intraoperative endoscopy with rendezvous performed during laparascopic cholecystectomy for confirmed CBDS; for such a procedure, a transcystic guide wire was positioned into the duodenum. Intraoperative endoscopy with rendezvous was performed for retrieved CBDS during a laparoscopic cholecystectomy. Laparoscopic rendezvous feasibility, morbidity, postprocedure pancreatitis, and mortality. The laparoscopic rendezvous proved to be feasible in 95.5% (105 of 110 patients). The rendezvous failed in 3 cases of successfully performed laparoscopic cholecystectomy, and a conversion of the laparoscopy was needed in 2 cases of successful rendezvous. Two major complications and 2 cases of bleeding were registered after sphincterotomy was successfully performed with rendezvous, and severe acute pancreatitis complicated a traditional sphincterotomy performed after a failed rendezvous. Rendezvous is a feasible option for treatment of CBDS; it allows one to perform only 1 stage of treatment, even in acute cases such as cholecystitis and pancreatitis. Positioning of the guide wire may allow reduced complications secondary to papilla cannulation but not those of the endoscopic sphincterotomy.

[New guidelines on chronic pancreatitis : interdisciplinary treatment strategies].

Science.gov (United States)

Lerch, M M; Bachmann, K A; Izbicki, J R

2013-02-01

Chronic pancreatitis is a common disorder associated with significant morbidity and mortality. Interdisciplinary consensus guidelines have recently updated the definitions and diagnostic criteria for chronic pancreatitis and provide a critical assessment of therapeutic procedures. Diagnostic imaging relies on endoscopic ultrasound (EUS) as the most sensitive technique, whereas computed tomography (CT) and magnetic resonance imaging (MRI)/magnetic resonance cholangiopancreatography (MRCP) remain a frequent preoperative requirement. Endoscopic retrograde cholangiopancreatography (ERCP) is now used mostly as a therapeutic procedure except for the differential diagnosis of autoimmune pancreatitis. Complications of chronic pancreatitis, such as pseudocysts, duct stricture and intractable pain can be treated with endoscopic interventions as well as open surgery. In the treatment of pseudocysts endoscopic drainage procedures now prevail while pain treatment has greater long-term effectiveness following surgical procedures. Currently, endocopic as well as surgical treatment of chronic pancreatitis require an ever increasing degree of technical and medical expertise and are provided increasingly more often by interdisciplinary centres. Surgical treatment is superior to interventional therapy regarding the outcome of pain control and duodenum-preserving pancreatic head resection is presently the surgical procedure of choice.

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.

Ultrasound-guided procedures around the wrist and hand: How to do

International Nuclear Information System (INIS)

Orlandi, Davide; Corazza, Angelo; Silvestri, Enzo; Serafini, Giovanni; Savarino, Edoardo Vincenzo; Garlaschi, Giacomo; Mauri, Giovanni; Cimmino, Marco Amedeo; Sconfienza, Luca Maria

2014-01-01

Ultrasound has emerged as a low-cost, radiation-free and effective imaging technique to detect joint abnormalities and to guide percutaneous procedures. Being superficial, wrist and hand tendons and joints represent a good target to perform such procedures using ultrasound guidance. This kind of approach allows for a clear and real-time visualization of the needles during their whole path. In this setting, the knowledge of technical aspects and tips is essential to act in the most accurate way on target tissues that can be as small as a few millimetres. The aim of this review is to summarize the local treatments of inflammatory and degenerative disease described in literature (such as treatment of De Quervain's tenosynovitis, trigger finger, trapezio-metacarpal joint osteoarthritis, etc.), emphasizing precautions and tricks based on day-by-day experience that may help to improve the outcome of percutaneous ultrasound-guided procedures around the wrist and hand

Ultrasound-guided procedures around the wrist and hand: How to do

Energy Technology Data Exchange (ETDEWEB)

Orlandi, Davide; Corazza, Angelo [Scuola di Specializzazione in Radiodiagnostica, Università degli Studi di Genova, Via L.B. Alberti 4, 16132 Genova (Italy); Silvestri, Enzo [Diagnostica per Immagini, Ospedale Evangelico Internazionale, Corso Solferino 29A, 16100 Genova (Italy); Serafini, Giovanni [Dipartimento di Diagnostica per Immagini, Ospedale Santa Corona, Via XXV Aprile 38, 17037 Pietra Ligure, Savona (Italy); Savarino, Edoardo Vincenzo [Dipartimento di Scienze Chirurgiche, Oncologiche e Gastroenterologiche, Università degli Studi di Padova, Via Giustiniani, Padova (Italy); Garlaschi, Giacomo [Dipartimento di Scienze per la Salute, Università degli Studi di Genova, Via L.B. Alberti 4, 16132 Genova (Italy); Mauri, Giovanni [Servizio di Radiologia, IRCCS Policlinico San Donato, Piazza Malan 2, San Donato Milanese, Milano (Italy); Cimmino, Marco Amedeo [Dipartimento di Medicina Interna, Università degli Studi di Genova, Via L.B. Alberti 4, 16132 Genova (Italy); Sconfienza, Luca Maria, E-mail: io@lucasconfienza.it [Servizio di Radiologia, IRCCS Policlinico San Donato, Piazza Malan 2, San Donato Milanese, Milano (Italy); Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Piazza Malan 2, San Donato Milanese, Milano (Italy)

2014-07-15

Ultrasound has emerged as a low-cost, radiation-free and effective imaging technique to detect joint abnormalities and to guide percutaneous procedures. Being superficial, wrist and hand tendons and joints represent a good target to perform such procedures using ultrasound guidance. This kind of approach allows for a clear and real-time visualization of the needles during their whole path. In this setting, the knowledge of technical aspects and tips is essential to act in the most accurate way on target tissues that can be as small as a few millimetres. The aim of this review is to summarize the local treatments of inflammatory and degenerative disease described in literature (such as treatment of De Quervain's tenosynovitis, trigger finger, trapezio-metacarpal joint osteoarthritis, etc.), emphasizing precautions and tricks based on day-by-day experience that may help to improve the outcome of percutaneous ultrasound-guided procedures around the wrist and hand.

New procedure for the control of the treatment of industrial effluents to remove volatile organosulfur compounds.

Science.gov (United States)

Boczkaj, Grzegorz; Makoś, Patrycja; Fernandes, André; Przyjazny, Andrzej

2016-10-01

We present a new procedure for the determination of volatile organosulfur compounds in samples of industrial effluents using dispersive liquid-liquid microextraction and gas chromatography with flame photometric detection. Initially, the extraction parameters were optimized. These included: type and volume of extraction solvent, volume of disperser solvent, salting out effect, pH, time and speed of centrifugation as well as extraction time. The procedure was validated for 30 compounds. The developed procedure has low detection limits of 0.0071-0.49 μg/L and a good precision (relative standard deviation values of 1.2-5.0 and 0.6-4.1% at concentrations of 1 and 10 μg/L, respectively). The procedure was used to determine the content of volatile organosulfur compounds in samples of effluents from the production of bitumens before and after chemical treatment, in which six compounds were identified, including 2-mercaptoethanol, thiophenol, thioanisole, dipropyl disulfide, 1-decanethiol, and phenyl isothiocyanate at concentrations ranging from 0.47 to 8.89 μg/L. Problems in the determination of organosulfur compounds related to considerable changes in composition of the effluents, increase in concentration of individual compounds and appearance of secondary pollutants during effluent treatment processes are also discussed. © 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Evaluation of some resonance self-shielding procedures employed in high conversion light water reactor design

International Nuclear Information System (INIS)

Patino, N.E.; Abbate, M.J.; Sbaffoni, M.M.

1990-01-01

The procedures employed in the treatment of the resonance shielding effect have been identified as one of the causes of the large discrepancies found in the neutronic calculation of high conversion light water reactors (HCLWRs), indicating the need for a revision of the self-shielding procedures employed. In this work some well known techniques applied in HCLWR self-shielding calculations are evaluated; the study involves the comparison of methods for the generation of group constants, the analysis of the impact of considering some isotopes as infinitely diluted and the evaluation of the usual approximations utilized for the treatment of heterogeneities

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

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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.

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.

A simple technique for an accurate shielding of the lungs during total body irradiation

Directory of Open Access Journals (Sweden)

Hana Mekdash

2017-09-01

Conclusion: This new technique succeeded in reducing the length of the overall treatment session of the conventional TBI procedure and hence reduced patient discomfort while ensuring accurate shielding of the lungs.

Percutaneous Management of Accidentally Retained Foreign Bodies During Image-Guided Non-vascular Procedures: Novel Technique Using a Large-Bore Biopsy System

Energy Technology Data Exchange (ETDEWEB)

Cazzato, Roberto Luigi, E-mail: gigicazzato@hotmail.it; Garnon, Julien, E-mail: juleiengarnon@gmail.com [Hôpitaux Universitaires de Strasbourg, HUS, Department of Interventional Radiology, Nouvel Hôpital Civil (France); Ramamurthy, Nitin, E-mail: nitin-ramamurthy@hotmail.com [Norfolk and Norwich University Hospital, Department of Radiology (United Kingdom); Tsoumakidou, Georgia, E-mail: georgia.tsoumakidou@chru-strasbourg.fr; Caudrelier, Jean, E-mail: jean.caudrelier@chru-strasbourg.fr; Thénint, Marie-Aude, E-mail: marie-aude.thenint@chru-strasbourg.fr; Rao, Pramod, E-mail: pramodrao@me.com; Koch, Guillaume, E-mail: guillaume.koch@chru-strasbourg.fr; Gangi, Afshin, E-mail: gangi@unistra.fr [Hôpitaux Universitaires de Strasbourg, HUS, Department of Interventional Radiology, Nouvel Hôpital Civil (France)

2016-07-15

ObjectiveTo 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.Materials and MethodsBetween 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.ResultsMean 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.ConclusionPercutaneous 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.

Efficiency and Safety of One-Step Procedure Combined Laparoscopic Cholecystectomy and Eretrograde Cholangiopancreatography for Treatment of Cholecysto-Choledocholithiasis: A Randomized Controlled Trial.

Science.gov (United States)

Liu, Zhiyi; Zhang, Luyao; Liu, Yanling; Gu, Yang; Sun, Tieliang

2017-11-01

We aimed to evaluate the efficiency and safety of one-step procedure combined endoscopic retrograde cholangiopancreatography (ERCP) and laparoscopic cholecystectomy (LC) for treatment of patients with cholecysto-choledocholithiasis. A prospective randomized study was performed on 63 consecutive cholecysto-choledocholithiasis patients during 2008 and 2011. The efficiency and safety of one-step procedure was assessed by comparing the two-step LC with ERCP + endoscopic sphincterotomy (EST). Outcomes including intraoperative features, postoperative features (length of stay and postoperative complications) were evaluated. One- or two-step procedure of LC with ERCP + EST was successfully performed in all patients, and common bile duct stones were completely removed. Statistical analyses showed that length of stay and pulmonary infection rate were significantly lower in the test group compared with that in the control group (P 0.05). The one-step procedure of LC with ERCP + EST is superior to the two-step procedure for treatment of patients with cholecysto-choledocholithiasis regarding to the reduced hospital stay and inhibited occurrence of pulmonary infections. Compared with two-step procedure, one-step procedure of LC with ERCP + EST may be a superior option for cholecysto-choledocholithiasis patients treatment regarding to hospital stay and pulmonary infections.

'Boomerang' technique: an improved method for conformal treatment of locally advanced nasopharyngeal cancer.

Science.gov (United States)

Corry, June; Hornby, Colin; Fisher, Richard; D'Costa, Ieta; Porceddu, Sandro; Rischin, Danny; Peters, Lester J

2004-06-01

The primary aim of the present study was to assess radiation dosimetry and subsequent clinical outcomes in patients with locally advanced nasopharyngeal cancer using a novel radiation technique termed the 'Boomerang'. Dosimetric comparisons were made with both conventional and intensity modulated radiation therapy (IMRT) techniques. This is a study of 22 patients treated with this technique from June 1995 to October 1998. The technique used entailed delivery of 36 Gy in 18 fractions via parallel opposed fields, then 24 Gy in 12 fractions via asymmetric rotating arc fields for a total of 60 Gy in 30 fractions. Patients also received induction and concurrent chemotherapy. The radiation dosimetry was excellent. Dose-volume histograms showed that with the arc fields, 90% of the planning target volume received 94% of the prescribed dose. Relative to other conventional radiation therapy off-cord techniques, the Boomerang technique results in a 27% greater proportion of the prescribed dose being received by 90% of the planning target volume. This translates into an overall 10% greater dose received for the same prescribed dose. At 3 years, the actuarial loco-regional control rate, the failure-free survival rate and the overall survival rate were 91, 75 and 91%, respectively. At 5 years, the actuarial loco-regional control rate, the failure-free survival rate and the overall survival rate were 74, 62 and 71%, respectively. The Boomerang technique provided excellent radiation dosimetry with correspondingly good loco-regional control rates (in conjunction with chemotherapy) and very acceptable acute and late toxicity profiles. Because treatment can be delivered with conventional standard treatment planning and delivery systems, it is a validated treatment option for centres that do not have the capability or capacity for IMRT. A derivative of the Boomerang technique, excluding the parallel opposed component, is now our standard for patients with locally advanced

Social Learning Family Therapy and the Treatment of Conduct Disorder in Early Childhood: Premise, Procedures and Prospects.

Science.gov (United States)

Mpofu, Elias

1997-01-01

Discusses social learning family therapy hypotheses on the development and sustenance of conduct disorder in early childhood, together with treatment approaches that use parents as the primary agents of change. Reviews research showing that parent training procedures hold much promise for the treatment of conduct disorder in childhood. (JPB)

Is the stripping technique a tissue-sparing procedure in large simple ovarian cysts in children?

Science.gov (United States)

Arena, Francesco; Romeo, Carmelo; Castagnetti, Marco; Scalfari, GianFranco; Cimador, Marcello; Impellizzeri, Pietro; Villari, Daniela; Zimbaro, Fabrizio; DeGrazia, Enrico

2008-07-01

Stripping of the cystic wall is performed by gynecologists to treat large ovarian cysts. Information in the pediatric population is poor. We prospectively evaluated the pathologic specimens of large ovarian cyst to determine whether the stripping technique is a tissue-sparing procedure even in this age. We evaluated 5 patients. Samples were taken from the intermediate part of the cystic wall and from the layer covering the cyst during excision. The presence of ovarian tissue adjacent to the cyst wall, and the morphological features of the surrounding tissue were both evaluated. Pelvic ultrasound follow-up was also performed. Patients' mean age was 4.5 years (7 days to 12 years). All cysts were removed because all were symptomatic. The mean diameter was 86.6 mm (74-100 mm). Cysts were follicular in 2 cases, serous in other two, and endometriotic in 1 case. Adjacent ovarian tissue was present in 1 of 5 specimens and was approximately 1 to 2 mm in thickness. The layer adjacent to the cystic wall always appeared as normal ovarian tissue. Ultrasound scans at follow-up revealed presence of ovarian tissue. The stripping procedure for large ovarian cyst excision allows to spare the adjacent normal ovarian tissue even in pediatric age because ovarian tissue is rarely excised with the cyst wall during the procedure.

[Intestinal lengthening techniques: an experimental model in dogs].

Science.gov (United States)

Garibay González, Francisco; Díaz Martínez, Daniel Alberto; Valencia Flores, Alejandro; González Hernández, Miguel Angel

2005-01-01

To compare two intestinal lengthening procedures in an experimental dog model. Intestinal lengthening is one of the methods for gastrointestinal reconstruction used for treatment of short bowel syndrome. The modification to the Bianchi's technique is an alternative. The modified technique decreases the number of anastomoses to a single one, thus reducing the risk of leaks and strictures. To our knowledge there is not any clinical or experimental report that studied both techniques, so we realized the present report. Twelve creole dogs were operated with the Bianchi technique for intestinal lengthening (group A) and other 12 creole dogs from the same race and weight were operated by the modified technique (Group B). Both groups were compared in relation to operating time, difficulties in technique, cost, intestinal lengthening and anastomoses diameter. There were no statistical difference in the anastomoses diameter (A = 9.0 mm vs. B = 8.5 mm, p = 0.3846). Operating time (142 min vs. 63 min) cost and technique difficulties were lower in group B (p anastomoses (of Group B) and intestinal segments had good blood supply and were patent along their full length. Bianchi technique and the modified technique offer two good reliable alternatives for the treatment of short bowel syndrome. The modified technique improved operating time, cost and technical issues.

The Technique of Endovascular Intracranial Revascularization

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John J. Connors

2014-11-01

Full Text Available Intracranial atherosclerosis was traditionally believed to carry a risk of stroke of 8% to 22% per annum. The annualized stroke rate in the recent Stenting and Aggressive Medical Management for Preventing Stroke in Intracranial Stenosis trial medical management arm was 12.2%. This trial was halted due to excessive periprocedural events in the stent arm. This stroke rate Is still Unacceptably high and a treatment strategy is still needed. SAMMPRIS has no bearing on angioplasty alone. Angioplasty alone has always been our primary intervention for intracranial atherosclerosis and remains so to this day due to its relative simplicity, low complication rate, and efficacy. We have, however, made adjustments to our patient management regimen based on the results of SAMMPRIS. This paper outlines our current patient selection, procedural technique, and post-procedure management. The complications we have encountered while developing our technique are described along with how to avoid them and how to manage them. Our most recent results (since previous publications are also discussed.

Rendezvous technique for recanalization of long-segmental chronic total occlusion above the knee following unsuccessful standard angioplasty.

Science.gov (United States)

Cao, Jun; Lu, Hai-Tao; Wei, Li-Ming; Zhao, Jun-Gong; Zhu, Yue-Qi

2016-04-01

To assess the technical feasibility and efficacy of the rendezvous technique, a type of subintimal retrograde wiring, for the treatment of long-segmental chronic total occlusions above the knee following unsuccessful standard angioplasty. The rendezvous technique was attempted in eight limbs of eight patients with chronic total occlusions above the knee after standard angioplasty failed. The clinical symptoms and ankle-brachial index were compared before and after the procedure. At follow-up, pain relief, wound healing, limb salvage, and the presence of restenosis of the target vessels were evaluated. The rendezvous technique was performed successfully in seven patients (87.5%) and failed in one patient (12.5%). Foot pain improved in all seven patients who underwent successful treatment, with ankle-brachial indexes improving from 0.23 ± 0.13 before to 0.71 ± 0.09 after the procedure (P rendezvous technique is a feasible and effective treatment for chronic total occlusions above the knee when standard angioplasty fails. © The Author(s) 2015.

Comparative study of the effects of treatment techniques on the ...

African Journals Online (AJOL)

This paper reports the effects of some fibre treatment techniques namely: mercerization, acetylation and semi-carbonisation on the performance of Kenaf fibres. The treated kenaf fibres which are considered biodegradable, cost effective, renewable and user friendly have been used as a possible base friction material for ...

A brief review on the efficacy of different possible and nonpharmacological techniques in eliminating discomfort of local anesthesia injection during dental procedures

Science.gov (United States)

Davoudi, Amin; Rismanchian, Mansour; Akhavan, Ali; Nosouhian, Saeid; Bajoghli, Farshad; Haghighat, Abbas; Arbabzadeh, Farahnaz; Samimi, Pouran; Fiez, Atiyeh; Shadmehr, Elham; Tabari, Kasra; Jahadi, Sanaz

2016-01-01

Dental anxiety and fear of needle injection is one of the most common problems encountered by dental practitioners, especially in the pediatric patient. In consequences, it might affect the patient's quality of life. Several methods are suggested to lower the discomfort of local anesthesia injection during dental procedures. Desensitization of injection site is one of the recommended strategies. Among chemical anesthetic topical agents that are effective but might have allergic side effects, using some nonpharmacological and safe techniques might be useful. This study aimed to overview the efficacy of using cooling techniques, mostly by ice or popsicles, warming or pH buffering of drug, and using modern devices to diminish the discomfort of local anesthesia injection during dental procedures. PMID:26957683

Effect of platelet-rich plasma and microfracture reparative technique combined in chondral lesions treatment

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Pietro Zedde

2015-11-01

Full Text Available The microfracture surgery introduced by Stedman despite limitations still represents the most common procedure to repair chondral defects. In recent years other regeneration techniques, such as the implantation of platelet-rich plasma (PRP, have been adopted in combination to boost and promote successful outcomes. This study aimed at evaluating clinical and functional results in 60 patients affected by chondral lesions and treated only using the microfracture procedure or in combination with intra-articular PRP infiltration. Patients were sub-divided in 2 groups: 30 were treated with microfracture reparative technique and the remaining 30 microfractures were treated with 3 platelet-rich plasma intra-articular injections. All patients were postoperatively evaluated based on the visual along scale, International Knee Documentation Committee, subjective knee function, and Lysholm knee scoring scale. The evaluation results for each follow-up showed an improvement of all evaluation scores compared to the preoperative phase and a variable and progressive deterioration registered at 24, 36 and 48-month follow-up visits, more pronounced in patients treated with microfracture alone. Instead, more successful outcomes in terms of pain symptomatology and functional recovery were reported during all follow-up visits and based on all scoring scales for the 30 patients treated with a combination of both techniques. The combination of the micro fracture reparative technique and the platelet-rich plasma implantation favoured a faster resolution of pain symptomatology and a quicker functional recovery with favourable results maintained over time.

State of affairs on pollutants and syngas removal techniques stemming from thermal treatment of waste by gasification. Extended abstract

International Nuclear Information System (INIS)

Megret, O.; Bequet, L.

2011-10-01

The aim of the current study is to outline the state of affairs related to pollutants and slaughtering techniques of syngas that result both from waste thermal treatment by gasification. The study starts by a review permitting to classify the gasification techniques applied to waste thermal treatment. This review leads to distinguish between auto-thermal and allo-thermal equipments. Furthermore, are described, in this first part, the general principles and parameters of functioning and adjustment of the factors characterizing the thermal treatment in reducing atmosphere. It is also about the composition of the syngas products according to the different driving behaviours of gasifiers. Finally, we state succinctly, on one hand, the possible promotion procedures in the frame of syngas development and, on the other hand, the thresholds that we ought to reach in order to make this promotion achievable. The second part of the study deals with the characteristics of the pollutants located in the syngas. This description took the shape of a detailed index card where pollutants are classified into minority components (including those of pollutants, those of gaseous and those of particulates) according to their concentrations, to their driving behaviours and to their thermochemical conditions of formation (temperature, pressure, response-type agents, atmosphere...). In the last part, we discuss the current and the considered types of slaughtering devices in reducing atmosphere in relation with their performance in slaughtering and regarding the departure point of syngas promotion ways. Finally, are exposed the key postures and the barricades within those technologies. Hereupon, research axes are proposed. (authors)

Transforaminal Percutaneous Endoscopic Discectomy using Transforaminal Endoscopic Spine System technique: Pitfalls that a beginner should avoid.

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Kapetanakis, Stylianos; Gkasdaris, Grigorios; Angoules, Antonios G; Givissis, Panagiotis

2017-12-18

Transforaminal Percutaneous Endoscopic Discectomy (TPED) is a minimally invasive technique mainly used for the treatment of lumbar disc herniation from a lateral approach. Performed under local anesthesia, TPED has been proven to be a safe and effective technique which has been also associated with shorter rehabilitation period, reduced blood loss, trauma, and scar tissue compared to conventional procedures. However, the procedure should be performed by a spine surgeon experienced in the specific technique and capable of recognizing or avoiding various challenging conditions. In this review, pitfalls that a novice surgeon has to be mindful of, are reported and analyzed.

Technique for the Laparoscopic Removal of Essure Microinserts.

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Mahmoud, Mohamad S

2016-01-01

To describe our technique for the laparoscopic removal of Essure microinserts (Bayer HealthCare Pharmaceuticals Inc., Whippany, NJ). Step-by-step explanation of the procedure using video (Canadian Task Force classification III). Hysteroscopic sterilization using tubal microinsert devices has generally been reported to be well tolerated in terms of procedure-related pain. Persistent pelvic pain requiring microinsert removal has been described in a few case reports and series and was estimated at 0.16% of cases (7 cases [49/4,274]) in a large retrospective study. Removal is usually performed at the patient's request and/or because of persistent pelvic pain unresponsive to other treatments with no other etiologies found. In general, the pain starts at the initial insertion and persists thereafter. Both laparoscopic and hysteroscopic removal approaches have been described in the few cases reported. In this video, we describe our technique for the surgical management of pelvic pain resulting from Essure microinserts. We performed laparoscopic removal of bilateral Essure microinserts in a 30-year-old G3P3 (Gravida 3 Para 3) with bilateral Essure devices placed 2 years before the procedure; hysterosalpingogram confirmed appropriate placement. The patient was suffering from bilateral sharp pelvic pain since insertion that was related to positional change and movements but unrelated to periods along with menorrhagia. A pelvic ultrasound showed a small intramural uterine leiomyoma. She failed a trial of treatment of her symptoms with a levonorgestrel intrauterine device. The patient requested removal of her Essure microinserts and endometrial ablation. She underwent laparoscopic bilateral Essure microinsert removal and bilateral salpingectomy along with hysteroscopic removal of the levonorgestrel intrauterine device and endometrial ablation. Her surgery was uneventful, and she was discharged the day of the surgery. Her symptoms resolved completely after the procedure

The Modified Kimura's Technique for the Treatment of Duodenal Atresia

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Biagio Zuccarello

2009-01-01

Full Text Available Background/Purpose. Kimura's diamond-shaped-duodenoduodenostomy (DSD is a known technique for the correction of congenital intrinsic duodenal obstruction. We present a modification of the technique and review the advantages of this new technique. Methods. From 1992 to 2006, 14 newborns were treated for duodenal atresia. We inverted the direction of the duodenal incisions: a longitudinal incision was made in the proximal duodenum while the distal was opened by transverse incision. Results. Our “inverted-diamond-shaped-duodenoduodenostomy” (i-DSD allowed postoperative oral feeding to start on days 2 to 3, peripheral intravenous fluids discontinuity on days 3 to 8 (median values 3.6; time to achieve full oral feeds on days 8 to 12 (median values 9.4; the length of hospitalisation ranged from 10 and 14 days (median value 11.2. No complications related to the anastomosis, by Viz leakage, dehiscence, biliary stasis, or stenosis were observed. Conclusions. The i-DSD provides a safe procedure to protect the ampulla of Vater from injury and avoids any formation of a blind loop. The results show that patients who have i-DSD achieve full oral feeds in a very short time period and, consequently, the length of hospitalisation is also significantly reduced.

Development of spent solvent treatment process by a submerged combustion technique

International Nuclear Information System (INIS)

Uchiyama, Gunzo; Maeda, Mitsuru; Fujine, Sachio; Amakawa, Masayuki; Uchida, Katsuhide; Chida, Mitsuhisa

1994-01-01

An experimental study using a bench-scale equipment of 1 kg-simulated spent solvents per hour has been conducted in order to evaluate the applicability of a submerged combustion technique to the treatment of spent solvents contaminated with TRU elements. This report describes the experimental results on the combustion characteristics of the simulated spent solvents of tri-n-butyl phosphate and/or n-dodecane, and on the distribution behaviors of combustion products such as phosphoric acid, Ru, I, Zr and lanthanides as TRU simulants in the submerged combustion process. Also the experimental results of TRU separation from phosphoric acid solution by co-precipitation using bismuth phosphate are reported. It was shown that the submerged combustion technique was applicable to the treatment of spent solvents including the distillation residues of the solvent. Based on the experimental data, a new treatment process of spent solvent was proposed which consisted of submerged combustion, co-precipitation using bismuth phosphate, ceramic membrane filtration, cementation of TRU lean phosphate, and vitrification of TRU rich waste. (author)

The TVT-obturator surgical procedure for the treatment of female stress urinary incontinence: a clinical update.

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Waltregny, David; de Leval, Jean

2009-03-01

Six years ago, the inside-out transobturator tape TVT-O procedure was developed for the surgical treatment of female stress urinary incontinence (SUI) with the aim of minimizing the risk of urethra and bladder injuries and ensuring minimal tissue dissection. Initial feasibility and efficacy studies suggested that the TVT-O procedure is associated with high SUI cure rates and low morbidity at short term. A recent analysis of medium-term results indicated that the TVT-O procedure is efficient, with maintenance, after a 3-year minimum follow-up, of cure rates comparing favorably with those reported for TVT. No late complications were observed. As of July 2008, more than 35 clinical papers, including ten randomized trials and two national registries, have been published on the outcome of the TVT-O surgery. Results from these studies have confirmed that the TVT-O procedure is safe and as efficient as the TVT procedure, at least in the short/medium term.

utilization of adsorption and/or liquid membranes techniques in treatment of some hazardous substances

International Nuclear Information System (INIS)

Hussin, L.M.S.

2011-01-01

environmental pollution, as a consequence of the industrialization process, is one of the major problems that has to be solved and controlled. The most important treatment processes for metals and dyes contaminated waste streams include chemical precipitation, membrane, filtration, ion exchange, carbon adsorption and coprecipitation/adsorption. However, all these techniques have their inherent advantages and limitations in applications. These processes usually need expensive facility and high maintenance cost. Therefore, there is a need for more economical alternative technologies for the treatment of metals and dyes contaminated waste streams. The aim of present work is to study the treatment of some hazardous substances such as heavy metals e.g. ( lead, cobalt and strontium) and dyes e.g. ( acid red 73, and acid blue 74 ) using either adsorption or liquid emulsion membrane techniques. The experimental part deals with the application of adsorption and liquid emulsion membrane techniques for removal of some hazardous substances such as metal ions ( lead, cobalt and strontium) and dyes (acid red 73 and acid blue 74). All the apparatus and techniques employed were described.

Recession wedge trochleoplasty as an additional procedure in the surgical treatment of patellar instability with major trochlear dysplasia: early results.

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Thaunat, M; Bessiere, C; Pujol, N; Boisrenoult, P; Beaufils, P

2011-12-01

The importance of a dysplastic trochlea as a component of patellar instability has long been recognized. An original trochleoplasty technique consisting in retro-trochlear recession wedge osteotomy was described by Goutallier et al. The aim is not to fashion a groove but to reduce the bump without modifying patellofemoral congruence. This retrospective study reports the operative technique and short-term outcomes of a consecutive case series of 17 patients (19 knees) who underwent recession wedge trochleoplasty for patellofemoral instability associated with severe trochlear dysplasia. Other contributing factors of patellar instability were also corrected as part of the surgical procedure: tibial tuberosity transfer (n=18), MPFL reconstruction (n=8). Minimum follow-up was 12 months (mean, 34 months; range, 12 to 71 months). The trochlear prominence was reduced from a mean 4.8mm (range, 0 to 8mm) to -0.8mm (range, -8 to 6mm). Patellar tilt was reduced from a mean 14° (range, 6° to 26°) to 6° (range, -1° to 24°). Two cases showed recurrent patellofemoral instability. Mean Kujala, KOOS and IKDC score were respectively 80 (± 17), 70 (± 18) and 67 (± 17) at last follow-up. Three patients required further operations, apart from removal of metal screws: arthroscopic arthrolysis for stiffness (n=1), revision for tibial tuberosity non-union (n=1), and supratrochlear exostosectomy (n=1). Recession wedge trochleoplasty is a feasible additional procedure addressing bony trochlear abnormality in the surgical treatment of patellar instability. Our attitude is to perform it never in isolation but associated to realignment of the extensor apparatus according to the à la carte surgery concept. It seems to be effective in preventing future patellar dislocation and reducing anterior knee pain in case of painful patellofemoral instability with a major dysplastic trochlea, or in revision cases when other realignment procedures have failed. Copyright © 2011 Elsevier Masson SAS

Incompressible Navier-Stokes and parabolized Navier-Stokes solution procedures and computational techniques

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Rubin, S. G.

1982-01-01

Recent developments with finite-difference techniques are emphasized. The quotation marks reflect the fact that any finite discretization procedure can be included in this category. Many so-called finite element collocation and galerkin methods can be reproduced by appropriate forms of the differential equations and discretization formulas. Many of the difficulties encountered in early Navier-Stokes calculations were inherent not only in the choice of the different equations (accuracy), but also in the method of solution or choice of algorithm (convergence and stability, in the manner in which the dependent variables or discretized equations are related (coupling), in the manner that boundary conditions are applied, in the manner that the coordinate mesh is specified (grid generation), and finally, in recognizing that for many high Reynolds number flows not all contributions to the Navier-Stokes equations are necessarily of equal importance (parabolization, preferred direction, pressure interaction, asymptotic and mathematical character). It is these elements that are reviewed. Several Navier-Stokes and parabolized Navier-Stokes formulations are also presented.

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

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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.

Robotic pancreas drainage procedure for chronic pancreatitis: robotic lateral pancreaticojejunostomy (Puestow procedure).

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Khan, Adeel S; Siddiqui, Imran; Vrochides, Dionisios; Martinie, John B

2018-01-01

Lateral pancreaticojejunostomy (LPJ), also known as the Puestow procedure, is a complex surgical procedure reserved for patients with refractory chronic pancreatitis (CP) and a dilated pancreatic duct. Traditionally, this operation is performed through an open incision, however, recent advancements in minimally invasive techniques have made it possible to perform the surgery using laparoscopic and robotic techniques with comparable safety. Though we do not have enough data yet to prove superiority of one over the other, the robotic approach appears to have an advantage over the laparoscopic technique in better visualization through 3-dimensional (3D) imaging and availability of wristed instruments for more precise actions, which may translate into superior outcomes. This paper is a description of our technique for robotic LPJ in patients with refractory CP. Important principles of patient selection, preoperative workup, surgical technique and post-operative management are discussed. A short video with a case presentation and highlights of the important steps of the surgery is included.

Exploitation of Clustering Techniques in Transactional Healthcare Data

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Naeem Ahmad Mahoto

2014-03-01

Full Text Available Healthcare service centres equipped with electronic health systems have improved their resources as well as treatment processes. The dynamic nature of healthcare data of each individual makes it complex and difficult for physicians to manually mediate them; therefore, automatic techniques are essential to manage the quality and standardization of treatment procedures. Exploratory data analysis, patternanalysis and grouping of data is managed using clustering techniques, which work as an unsupervised classification. A number of healthcare applications are developed that use several data mining techniques for classification, clustering and extracting useful information from healthcare data. The challenging issue in this domain is to select adequate data mining algorithm for optimal results. This paper exploits three different clustering algorithms: DBSCAN (Density-Based Clustering, agglomerative hierarchical and k-means in real transactional healthcare data of diabetic patients (taken as case study to analyse their performance in large and dispersed healthcare data. The best solution of cluster sets among the exploited algorithms is evaluated using clustering quality indexes and is selected to identify the possible subgroups of patients having similar treatment patterns

Development Procedure in Mutation Induction and Tracer Technique for Good Agriculture Practices for Under used Crops

International Nuclear Information System (INIS)

Faiz Ahmad; Rusli Ibrahim; Khairuddin Abdul Rahim

2015-01-01

Under used crops are those crop species which have high potential value in the supply of important raw material for secondary economy sector in food processing. The yield production of new Under used crops varieties can be used as an important input in food production process for export products. The optimum production cost can be minimized since the price of raw material supplied from agriculture sector is cheaper compared with the international markets. Agriculture output can be increased through the development of Under used crops using radiation mutagenesis and tracer technique for good agricultural practices. This paper work will discuss the development procedure of mutation induction method which includes irradiation of samples such as seeds of groundnut and in vitro shoots of banana using gamma rays and application of N-15 for nutrient use efficiency and screening of potential mutant lines with high yield and resistance to drought. These management practices using established procedures of water and nutrient use efficiency will be recommended to the growers. (author)

The comparison of an inexpensive-modified transobturator vaginal tape versus TVT-O procedure for the surgical treatment of female stress urinary incontinence.

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Zhang, Yan; Jiang, Min; Tong, Xiao-Wen; Fan, Bo-Zhen; Li, Huai-Fang; Chen, Xin-Liang

2011-09-01

To compare the safety and efficacy of an inexpensive-modified transobturator vaginal tape procedure with the transobturator tension-free vaginal tape (TVT-O) procedure for the surgical treatment of female stress urinary incontinence (SUI). Patients with SUI were randomly allocated to either the test group receiving the inexpensive-modified transobturator vaginal tape procedure or the control group receiving the GYNECARE TVT-O procedure. Treatment outcomes and Quality-of-life scores were recorded and analyzed between two groups. A total of 156 patients were enrolled in this trial. Eighty patients underwent the modified transobturator vaginal tape procedure. Among them 75(93.8%) were cured and 5(6.2%) were improved. The rest of the 76 patients underwent the GYNECARE TVT-O procedure with a 92% (70 of 76) cure rate and an 8% (6 of 76) improvement rate. No inefficient or aggravated cases occurred in both groups. The success rates between groups had no significant statistic difference (p > 0.05). The operative time, blood loss, hospital stay, and medical cost were significantly lower in the test group (p < 0.01); the increases in Quality-of-life scores were comparable between groups. The modified transobturator vaginal tape procedure is an efficacious and economic surgical treatment for female SUI. Copyright © 2011. Published by Elsevier B.V.

Peroral endoscopic myotomy: An emerging minimally invasive procedure for achalasia

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Vigneswaran, Yalini; Ujiki, Michael B

2015-01-01

Peroral endoscopic myotomy (POEM) is an emerging minimally invasive procedure for the treatment of achalasia. Due to the improvements in endoscopic technology and techniques, this procedure allows for submucosal tunneling to safely endoscopically create a myotomy across the hypertensive lower esophageal sphincter. In the hands of skilled operators and experienced centers, the most common complications of this procedure are related to insufflation and accumulation of gas in the chest and abdominal cavities with relatively low risks of devastating complications such as perforation or delayed bleeding. Several centers worldwide have demonstrated the feasibility of this procedure in not only early achalasia but also other indications such as redo myotomy, sigmoid esophagus and spastic esophagus. Short-term outcomes have showed great clinical efficacy comparable to laparoscopic Heller myotomy (LHM). Concerns related to postoperative gastroesophageal reflux remain, however several groups have demonstrated comparable clinical and objective measures of reflux to LHM. Although long-term outcomes are necessary to better understand durability of the procedure, POEM appears to be a promising new procedure. PMID:26468336

A new technique for endoscopic treatment of gastric phytobezoars: fragmentation using guidewire.

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Senturk, O; Hulagu, S; Celebi, A; Korkmaz, U; Duman, A E; Dindar, G; Bozkurt, N; Yilmaz, H; Ozturkler, M; Can, B; Batman, A

2014-12-01

Bezoars result from accumulation of indigestible materials in the gastrointestinal tract and often occur in the stomach. In this study, we evaluated the use of guidewires in patients with gastric phytobezoars (PBs) as a new method for PB removal and examined the safety of the procedure. Between February 2009 and January 2013, we analyzed data from 11 patients with gastric PBs. We fitted a transparent cap to a standard endoscope (EG450WR5, Fujinon), and a 0.025 inch guidewire was passed through the standart endoscope. PBs were surrounded by a loop in the guidewire and destroyed. After 2 weeks of treatment, patients were re-evaluated for effectiveness. PB fragmentation time was 5-11 minutes. In five patients with a history of gastric surgery, we needed an additional 16-28 minutes for removal of the fragments. In six patients additionally treated with enzymatic degradation after the breaking procedure, PBs completely disappeared within 2 weeks. There were no complications during the procedure. The guidewire and fragmentation procedure for PBs is an efficient and reliable method. When combined with enzymatic degradation, PBs can be managed quickly and effectively.

Superselective intra-arterial chemotherapy (SIC) by using the Seldinger technique as the treatment strategy for maxillary sinus carcinoma

International Nuclear Information System (INIS)

Yoshida, Tomoyuki; Nakamura, Kazuhiro; Tukahara, Kiyoaki; Ito, Hiroyuki; Shimizu, Akira; Takata, Daisuke; Okamoto, Isaku; Kondo, Takahito

2010-01-01

conducted salvage operation as additional treatment. Adverse events of chemotherapy and SIC combined with radiotherapy were completed as scheduled. The treatment response was evaluated at 1 month based on macroscopic, imaging, and histopathological findings. In total, the Seldinger technique was performed 73 times in 40 patients. The mean number of feeding vessels used for treatment was 2.3. Follow-up of adverse events revealed Grade 3 or higher stomatitis in 45% of patients; although it often led to anorexia or dysphagia, it was reversible in all cases. Five patients needed granulocyte-colony stimulating factor (G-CSF) administration for leukocytopenia. Grade 3 or higher renal dysfunction related to CDDP administration was observed in 6 patients. Three patients underwent hemodialysis for Grade 4 renal dysfunction and all could discontinue hemodialysis. All adverse events were reversible and non-serious except for 3 patients with suspected symptoms of transient cerebral ischemia. Primary treatment response was complete response (CR) in 50.0% and partial response (PR) in 25.0% at 40 Gy, with a response rate of 75.0%. Thirty patients received surgery after intra-arterial chemotherapy. Of these, 10 patients rated as CR before surgery were all pathological CR. Of 10 patients who achieved PR in their primary treatment response after SIC combined with radiotherapy, 5 patients were pathological CR in the postoperative pathological evaluation. The final CR rate was 62.5%. These results suggest that adverse events of this therapy are relatively minor and within an acceptable range. In terms of local control, SIC may avoid invasive surgical procedures. (author)

Management of odontogenic cysts by endonasal endoscopic techniques: A systematic review and case series.

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Marino, Michael J; Luong, Amber; Yao, William C; Citardi, Martin J

2018-01-01

Odontogenic cysts and tumors of the maxilla may be amendable to management by endonasal endoscopic techniques, which may reduce the morbidity associated with open procedures and avoid difficult reconstruction. To perform a systematic review that evaluates the feasibility and outcomes of endoscopic techniques in the management of different odontogenic cysts. A case series of our experience with these minimally invasive techniques was assembled for insight into the technical aspects of these procedures. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses was used to identify English-language studies that reported the use of endoscopic techniques in the management of odontogenic cysts. Several medical literature data bases were searched for all occurrences in the title or abstract of the terms "odontogenic" and "endoscopic" between January 1, 1950, and October 1, 2016. Publications were evaluated for the technique used, histopathology, complications, recurrences, and the follow-up period. A case series of patients who presented to a tertiary rhinology clinic and who underwent treatment of odontogenic cysts by an endoscopic technique was included. A systematic review identified 16 case reports or series that described the use of endoscopic techniques for the treatment of odontogenic cysts, including 45 total patients. Histopathologies encountered were radicular (n = 16) and dentigerous cysts (n = 10), and keratocystic odontogenic tumor (n = 12). There were no reported recurrences or major complications for a mean follow-up of 29 months. A case series of patients in our institution identified seven patients without recurrence for a mean follow-up of 10 months. Endonasal endoscopic treatment of various odontogenic cysts are described in the literature and are associated with effective treatment of these lesions for an average follow-up period of >2 years. These techniques have the potential to reduce morbidity associated with the resection of these

The Norwood procedure: in favor of the RV-PA conduit.

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Barron, David J

2013-01-01

Evolution of the Norwood procedure has culminated in there currently being three treatment strategies available for initial management: the 'classical' Norwood (utilizing a Blalock-Taussig shunt), the Norwood with right-ventricle to pulmonary artery (RV-PA) conduit, and the 'hybrid' Norwood procedure utilizing bilateral pulmonary artery banding and ductal stenting. Each variant has its potential advantages and disadvantages, and this paper looks to examine the evidence in favor of each strategy, with emphasis on the supportive data for the RV-PA conduit. The 'classical' procedure has the benefit of the greatest accumulated surgical experience and avoids any incision into the ventricle. However, the diastolic run-off of the Blalock-Taussig shunt can cause hemodynamic instability and unpredictable coronary steal phenomenon. The RV-PA conduit has the advantage of maintaining diastolic pressure with a more stable postoperative course, but at the cost of a ventriculotomy that may have detrimental long-term sequelae. The 'hybrid' procedure has the advantage of avoiding cardiopulmonary bypass, but does not always secure coronary blood flow and has a high inter-stage morbidity and reintervention rate. The evidence shows that each technique may have its place in future management, and that treatment algorithms could emerge that direct the choice of procedure for specific patient groups. Copyright © 2013 Elsevier Inc. All rights reserved.

Technique, Complication, and Long-Term Outcome for Endovascular Treatment of Iliac Artery Occlusion

International Nuclear Information System (INIS)

Ozkan, Ugur; Oguzkurt, Levent; Tercan, Fahri

2010-01-01

The aim of this study was to report technical details, procedure-related complications, and results of endovascular treatment in chronic iliac artery occlusion. Between 2001 and 2008, endovascular treatments of 127 chronic iliac artery occlusions in 118 patients (8 women and 110 men; mean age, 59 years) were retrospectively reviewed. The study was based on Ad Hoc Committee on Reporting Standards (Society for Vascular Surgery/International Society for Cardiovascular Surgery Standards). All occlusions were treated with stent placement with or without preliminary balloon angioplasty. Kaplan-Meier estimators were used to determine patency rates. Univariate and multivariate analyses were performed to determine variables affecting successful recanalization, major complications, early stent thrombosis (≤30 days), and primary and secondary patency rates. Initial technical success was achieved in 117 (92%) procedures. Successful recanalization was obtained by antegrade approach in 69 of 77 (90%) procedures and by retrograde approach in 52 of 105 (50%) procedures (p < 0.001). Complications were encountered in 28 (24%) patients [minor in 7 patients (6%) and major in 22 patients (19%)]. One death occurred in the operative period secondary to iliac artery rupture. Early stent thrombosis was seen in eight (7%) patients. Presence of critical limb ischemia (p = 0.03), subintimal recanalization (p = 0.03), and major complication (p = 0.02) were the independent predictors of early stent thrombosis on multivariate analysis. Primary and secondary patency rates at 5 years were 63 and 93%, respectively. Presence of critical limb ischemia, TASC type C iliac lesions, combined occlusions of both common and external iliac arteries, and major complications were associated with decreased patency rates on univariate analysis, whereas these factors were not independent predictors of stent patency on multivariate analysis. In conclusion, endovascular treatment of iliac artery occlusion has a

Randomized, Split-Face/Décolleté Comparative Trial of Procedure Enhancement System for Fractional non-Ablative Laser Resurfacing Treatment.

Science.gov (United States)

Robinson, Deanne Mraz; Frulla, Ashton P

2017-07-01

INTRODUCTION: A topical proprietary procedural enhancement system (PES) containing a combination of active ingredients including a tripeptide and hexapeptide (TriHex Technology™, Alastin Procedure Enhancement Invasive System, ALASTIN Skincare™, Inc., Carlsbad, CA) has been used successfully to aid in healing and improve symptomatology following resurfacing procedures. METHODS: PES (Gentle Cleanser, Regenerating Skin Nectar with TriHex Technology™, Ultra Nourishing Moisturizer with TriHex Technology™, Soothe + Protect Recovery Balm, Broad Spectrum 30+ Sunscreen) was compared to a basic regimen (Aquaphor™, Cerave™ cleanser, Vanicream™, Alastin Broad Spectrum 30+ Sunscreen) in a split face/ décolleté trial following fractional non-ablative thulium-doped resurfacing treatment to the face or décolleté. The skin was pre-conditioned and treated during and after the procedure using the two regimens. RESULTS: A blinded investigator rated the PES statistically superior to the basic regimen on healing post-laser treatment on day 4 based on lentigines, texture, and Global Skin Quality. Subjects also reported 'better looking and feeling' skin on the PES side. CONCLUSION: PES appears to improve healing post-non ablative thulium-doped resurfacing treatment to the face/décolleté in comparison with standard of care. J Drugs Dermatol. 2017;16(7):707-710..

Evaluation of the results from surgical treatment of fractures of the lateral extremity of the clavicle, using the double ligature technique

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Alberto Naoki Miyazaki

2015-04-01

Full Text Available OBJECTIVE: To evaluate the incidence of consolidation in surgical treatment of fractures of the lateral extremity of the clavicle using the double subcoracoid ligature technique, with nonabsorbable No. 5 thread.METHODS: Between May 1993 and June 2013, the Shoulder and Elbow Group of our service surgically treated 116 patients (116 shoulders with fractures of the lateral extremity of the clavicle. Among these, we were able to reassess 65 cases. The surgical technique used consisted of double subcoracoid ligature with two nonabsorbable threads. In two patients classified as type III, we had to combine this technique with use of an interfragmentary screw for fixation of the intra-articular portion of the acromioclavicular joint.RESULTS: We achieved fracture consolidation in 90%. Fourteen cases (21% evolved with major complications: four cases of pseudarthrosis, five of adhesive capsulitis, two of delayed consolidation and three of loss of reduction. Two cases (3% evolved with minor complications of skin granuloma.CONCLUSION: The double ligature technique for fractures of the lateral extremity of the clavicle promotes the stabilization needed for consolidation to take place, without the need for synthesis using metal components. It avoids reoperation for the synthesis material to be removed. Moreover, it is a low-cost procedure with good reproducibility and preservation of the acromioclavicular joint.

Painful procedures in children with cancer: comparison of moderate sedation and general anesthesia for lumbar puncture and bone marrow aspiration.

Science.gov (United States)

Iannalfi, Alberto; Bernini, Gabriella; Caprilli, Simona; Lippi, Alma; Tucci, Fabio; Messeri, Andrea

2005-12-01

The study was conducted to compare moderate sedation (MS) with general anesthesia (GA) in the management of frequently performed lumbar puncture or bone marrow aspiration (BMA) during the treatment of childhood cancer. The MS (14 patients for 30 procedures) was managed by non-anesthesiologists (combined nitrous oxide-midazolam +/- non-pharmacological techniques). The GA was managed by anesthesiologists (17 patients for 30 procedures). A neutral observer recorded side effects, use of sedative antagonists, recovery time, oncologist's evaluation, procedure behaviors check list (PBCL); subjective perceptions during the procedure with a questionnaire administered to children (>6 years) and their parents; drugs costs and professional resources. P-values compliance and cost-effectiveness as it relies on the contribution of non-pharmacological techniques. 2005 Wiley-Liss, Inc.

Whole lung lavage with intermittent double lung ventilation. A modified technique for managing pulmonary alveolar proteinosis

International Nuclear Information System (INIS)

Ahmed, Raees; Iqbal, Mobeen; Kashef, Sayed H.; Almomatten, Mohammed I.

2005-01-01

Whole lung lavage is still the most effective treatment for pulmonary alveolar proteinosis. We report a 21-year-old male diagnosed with pulmonary alveolar proteinosis by open lung biopsy and who underwent whole lung lavage with a modified technique. He showed significant improvement in clinical and functional parameters. The technique of intermittent double lung ventilation during lavage procedure keeps the oxygen saturation in acceptable limits in patients at risk for severe hypoxemia and allows the procedure to be completed in a single setting. (author)

'Boomerang' technique: an improved method for conformal treatment of locally advanced nasopharyngeal cancer

International Nuclear Information System (INIS)

Corry, June; D'Costa, Leta; Porceddu, Sandro; Peters, Lester J.; Hornby, Colin; Fisher, Richard; Rischin, Danny

2004-01-01

The primary aim of the present study was to assess radiation dosimetry and subsequent clinical outcomes in patient: with locally advanced nasopharyngeal cancer using a novel radiation technique termed the 'Boomerang'. Dosimetric comparisons were made with both conventional and intensity modulated radiation therapy (IMRT) techniques. Thi; is a study of 22 patients treated with this technique from June 1995 to October 1998. The technique used entailec delivery of 36 Gy in 18 fractions via parallel opposed fields, then 24 Gy in 12 fractions via asymmetric rotating arc field' for a total of 60 Gy in 30 fractions. Patients also received induction and concurrent chemotherapy. The radiation dosimetry was excellent. Dose-volume histograms showed that with the arc fields, 90% of the planning target volume received 94% of the prescribed dose. Relative to other conventional radiation therapy off-cord techniques, the Boomerang technique results in a 27% greater proportion of the prescribed dose being received by 90% of the planning target volume. This translates into an overall 10% greater dose received for the same prescribed dose. At 3 years, the actuarial loco-regional control rate, the failure-free survival rate and the overall survival rate were 91, 75 and 91%, respectively. At 5 years, the actuarial loco-regional control rate, the failure-free survival rate and the overall survival rate were 74, 62 and 71%, respectively. The Boomerang technique provided excellent radiation dosimetry with correspondingly good loco-regional control rates (in conjunction with chemotherapy) and very acceptable acute and late toxicity profiles. Because treatment can be delivered with conventional standard treatment planning and delivery systems, it is a validated treatment option for centres that do not have the capability or capacity for IMRT. A derivative of the Boomerang technique, excluding the parallel opposed component, is now our standard for patients with locally advanced

Aesthetic procedures in office practice.

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Small, Rebecca

2009-12-01

Since the approval of botulinum toxin, dermal fillers, and lasers for cosmetic use, minimally invasive aesthetic procedures have rapidly become the treatments of choice for age-related facial changes. In the past 10 years, aesthetic procedures have increased nearly five-fold. Of the 10.2 million aesthetic treatments performed in 2008, 83 percent were minimally invasive procedures. Botulinum toxin and dermal filler injections, laser hair reduction, chemical peels, laser skin resurfacing, microdermabrasion, and intense pulsed light photorejuvenation were the most commonly performed procedures in 2008. These procedures are effective and associated with minimal discomfort, and they have a low incidence of adverse effects and short recovery times. High patient and physician satisfaction have contributed to their growing popularity and availability in the primary care setting. As patient demand for aesthetic treatments increases, family physicians should be familiar with common minimally invasive aesthetic procedures when advising patients or incorporating aesthetic care into office practice.

Modified Kidner procedure utilizing a Mitek bone anchor.

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Dawson, D M; Julsrud, M E; Erdmann, B B; Jacobs, P M; Ringstrom, J B

1998-01-01

The recent development of small bone suture anchors has created several potential applications in reconstructive surgery of the foot. Mitek bone anchors are simple to insert, require less aggressive dissection and surgical time than reefing of the redundant posterior tibial tendon, and are a reliable method of tendon-to-bone fixation. Mitek bone anchors are an excellent technique for the treatment of redundant tibialis posterior tendon following a modified Kidner procedure. In modified Kidner procedures involving an excessively large os tibiale externum, Mitek anchoring of the redundant tibialis posterior tendon to the navicular bone is an excellent means for secure plication of the posterior tibial tendon in cases involving intraoperative tendon laxity. A description of the Mitek Anchor System and technique of application in a modified Kinder procedure is presented. The purpose of this study was to describe patient satisfaction and long-term clinical outcomes of the modified Kinder procedure with and without the Mitek bone anchoring system. A retrospective study of the modified Kinder procedure was performed with 13 patients being evaluated, seven with Mitek anchoring and six without. The University of Maryland 100-point Painful Foot Center Scoring System was modified to be more specific to the modified Kinder procedure for assessment of subjective long-term results. Patient overall satisfaction was rated good to excellent by 85.6% of patients in the Mitek group and by 100% of patients in the non-Mitek group. Use of the Mitek anchor allowed for quicker postoperative recovery to resumption of ambulation without assistive devices (average of 3 weeks vs. 4.42 weeks) and a quicker return to pain-free ambulation in normal shoegear (average of 4 weeks vs. 6 weeks). Mitek anchoring of the tibialis posterior tendon, theoretically, increases medial arch support as evidenced by 14% of the Mitek group and 67% of the non-Mitek group requiring postoperative orthotics.

Autologous chondrocyte implantation for cartilage injury treatment in Chiang Mai University Hospital: a case report.

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Wongtriratanachai, Prasit; Pruksakorn, Dumnoensun; Pothacharoen, Peraphan; Nimkingratana, Puwapong; Pattamapaspong, Nuttaya; Phornphutkul, Chanakarn; Setsitthakun, Sasiwariya; Fongsatitkul, Ladda; Phrompaet, Sureeporn

2013-11-01

Autologous chondrocyte implantation (ACI) has become one of the standard procedures for articular cartilage defect treatment. This technique provides a promising result. However the procedural process requires an approach of several steps from multidisciplinary teams. Although the success of this procedure has been reported from Srinakharinvirot University since 2007, the application of ACI is still limited in Thailand due to the complexity of processes and stringent quality control. This report is to present the first case of the cartilage defect treatment using the first generation-ACI under Chiang Mai University's (CMU) own facility and Ethics Committee. This paper also reviews the process of biotechnology procedures, patient selection, surgical, and rehabilitation techniques. The success of the first case is an important milestone for the further development of the CMU Human Translational Research Laboratory in near future.

Sedation as a technique to aid in the supportive examination for children with special needs

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Risti Saptarini Primarti

2007-03-01

Full Text Available Undergoing medical procedures often extremely distress people, especially patients with special needs. Supportive examinations, such as radiographic and laboratory examinations, as a part of medical procedure sometimes are impossible to be done in those patients, while we demand those tests for diagnostic and treatment reasons. A variety of techniques are available to the dental and medical professional to aid in the management of these patients regarding medical procedures, one of them is sedation. By eliminating patient’s fear and anxiety throughout sedation, all medical procedure including taking a supportive examination may be successfully completed. This paper will report the role of sedation as a technique to aid in the supportive examination for special needs child (Down’s syndrome in Hasan Sadikin General Hospital, Bandung, West Java Indonesia.

Chiropractic treatment of lateral epicondylitis: a case report utilizing active release techniques.

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Gliedt, Jordan A; Daniels, Clinton J

2014-06-01

The purpose of this report is to describe the chiropractic management of a case of lateral epicondylitis with active release techniques (ART). A 48-year-old white man presented to a chiropractic clinic with a complaint of left lateral elbow pain that began 2 years previous with insidious onset. The patient reported an inability to play 18 consecutive holes of golf due to the pain. Treatment consisted of 5 sessions of ART (a soft tissue technique that is applied to muscles, fascia, tendons, ligaments, and nerves) applied to the left elbow soft tissue over a duration of 3 weeks. The patient reported an absence of pain and ability to consistently play 18 consecutive holes of golf up to 3 times per week at 4 and 8 weeks post-treatment. This patient with lateral epicondylitis responded favorably to chiropractic treatment using the application of ART, as demonstrated by reduced pain and increased functional outcomes.

Air Treatment Techniques for Abatement of Emissions from Intensive Livestock Production

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Melse, R.W.; Ogink, N.W.M.; Rulkens, W.H.

2009-01-01

Intensive livestock production is connected with a number of environmental effects, including emissions of ammonia (NH3), greenhouse gases (CH4 and N2O), odour, and particulate matter (PM10 and PM2.5). Possible strategies for emission reduction include feed management, adaptation of housing design, and, in case of mechanically ventilated animal houses, the application of end-of-pipe air treatment, viz acid scrubbers and bioscrubbers. Air treatment techniques can achieve very high emission red...

Analgesia, nil or placebo to babies, in trials that test new analgesic treatments for procedural pain.

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Bellieni, Carlo V; Johnston, C Celeste

2016-02-01

This review assessed how often neonates in control groups experienced unnecessary pain during clinical trials involving procedural pain. We retrieved 45 studies in the 30 months up to June 2015 and found that in 29 (64%) the control babies received either placebos or no treatment. Placebos were used in 15/25 (60%) studies involving heel pricks and in 6/8 (75%) involving venepuncture. Despite international guidelines, neonates included in control groups during painful procedures do not receive analgesia in the majority of cases. Several historical reasons can explain this, but in the light of present knowledge, this should not continue. Ethical committees are thereof invited since now to not permit clinical trials that do not explicitly rule out pain during treatments and journals are invited to not publish them. ©2015 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

Surgical treatment of choanal atresia with transnasal endoscopic approach with stentless single side-hinged flap technique: 5 year retrospective analysis

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Carmelo Saraniti

Full Text Available Abstract Introduction: Choanal atresia is a rare congenital malformation of the nasal cavity characterized by the complete obliteration of the posterior choanae. In 67% of cases choanal atresia is unilateral, affecting mainly (71% the right nasal cavity. In contrast to the unilateral form, bilateral choanal atresia is a life-threatening condition often associated with respiratory distress with feeding and intermittent cyanosis exacerbated by crying. Surgical treatment remains the only therapeutic option. Objective: To report our experience in the use of a transnasal endoscopic approach with stentless single side-hinged flap technique for the surgical management of choanal atresia. Methods: A 5 year retrospective analysis of surgical outcomes of 18 patients treated for choanal atresia with a transnasal technique employing a single side-hinged flap without stent placement. All subjects were assessed preoperatively with a nasal endoscopy and a Maxillofacial computed tomography scan. Results: Ten males and eight females with a mean age at the time of surgery of 20.05 ± 11.32 years, underwent surgery for choanal atresia. Fifteen subjects (83.33% had a bony while 3 (26.77% a mixed bony-membranous atretic plate. Two and sixteen cases suffered from bilateral and unilateral choanal atresia respectively. No intra- and/or early postoperative complications were observed. Between 2 and 3 months after surgery two cases (11.11% of partial restenosis were found. Only one of these presented a relapse of the nasal obstruction and was subsequently successfully repaired with a second endoscopic procedure. Conclusion: The surgical technique described follows the basic requirements of corrective surgery and allows good visualization, evaluation and treatment of the atretic plate and the posterior third of the septum, in order to create the new choanal opening. We believe that the use of a stent is not necessary, as recommended in case of other surgical techniques

Computed tomography after radical pancreaticoduodenectomy (Whipple's procedure)

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Smith, S.L. [Department of Radiology, Ipswich Hospital, Ipswich IP4 5PD (United Kingdom)], E-mail: simon.smith@ipswichhospital.nhs.uk; Hampson, F. [Department of Radiology, Addenbrooke' s Hospital NHS Trust, Cambridge (United Kingdom); Duxbury, M. [Department of Surgery, Royal Infirmary of Edinburgh, Little France, Edinburgh EH16 4SU (United Kingdom); Rae, D.M.; Sinclair, M.T. [Department of Pancreaticobiliary surgery, Ipswich Hospital, Ipswich IP4 5PD (United Kingdom)

2008-08-15

Whipple's procedure (radical pancreaticoduodenectomy) is currently the only curative option for patients with periampullary malignancy. The surgery is highly complex and involves multiple anastomoses. Complications are common and can lead to significant postoperative morbidity. Early detection and treatment of complications is vital, and high-quality multidetector computed tomography (MDCT) is currently the best method of investigation. This review outlines the surgical technique and illustrates the range of normal postoperative appearances together with the common complications.

'Cupid and Psyche': a novel technique for robotic hysterosacropexy in the treatment of pelvic organ prolapse.

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Dal Moro, Fabrizio; Calpista, Arturo; Mancini, Mariangela

2016-01-01

The purpose of any surgical repair of pelvic organ prolapse (POP) is to restore pelvic anatomy, preserving urinary, intestinal and sexual functions while avoiding complications. We present a novel robotic approach to hysterosacropexy (HSP) in the treatment of POP. In our technique (named 'Cupid and Psyche', recalling as it does the famous sculpture by Canova), the two branches of the MESH encircle the uterus from behind, lifting and supporting it.The aim of this technique is to resolve POP, minimizing the risk of vaginal erosion: the posterior 'embrace' of the uterus limits the direct contact of the mesh with the vagina, thus reducing any risk of erosion/extrusion at this level. We performed 10 cases of robotic HSP. All procedures are completed robotically. Median operative time (skin-to-skin) is 125 min [interquartile range (IQR) 85-145], including port placement, robot docking and console time. We have never had any cases of intraoperative or postoperative complications.With regard to short-term follow-up, analysis of outcomes is limited; in any case, we have never had any cases of MESH erosion or other complications, and no sexually active woman complained of dyspareunia. Maintaining sufficient motility of the vagina is another advantage of 'Cupid and Psyche', avoiding as it does any negative effects on patients' later sexual activity, granting more natural motility of both uterus and vagina but resolving the prolapse.Further prospective studies comparing the long-term functional outcomes of the various HSP techniques are needed to confirm these findings.

Sportsmen's Groin-Diagnostic Approach and Treatment With the Minimal Repair Technique: A Single-Center Uncontrolled Clinical Review.

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Muschaweck, Ulrike; Berger, Luise Masami

2010-05-01

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. 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. 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). The Minimal Repair technique is an effective and safe way to treat sportsmen's groin.

Morel-Lavallée lesion: diagnosis and treatment with imaging techniques.

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Martel Villagrán, J; Díaz Candamio, M J; Bueno Horcajadas, A

We aim to review the characteristics of Morel-Lavallée lesions and to evaluate their treatment. We retrospectively reviewed 17 patients (11 men and 6 women; mean age, 56.1 years, range 25-81 years) diagnosed with Morel-Lavallée lesions in two different departments. All patients underwent ultrasonography, 5 underwent computed tomography, and 9 underwent magnetic resonance imaging. Percutaneous treatment with fine-needle aspiration and/or drainage with a 6F-8F catheter was performed in 13 patients. Two patients required percutaneous sclerosis with doxycycline. All patients responded adequately to percutaneous treatment, although it was necessary to repeat the procedure in 4 patients. Radiologists need to be familiar with this lesion that can be treated percutaneously in the ultrasonography suite when it is not associated with other entities. Copyright © 2018 SERAM. Publicado por Elsevier España, S.L.U. All rights reserved.

A randomized clinical trial comparing cervical dysplasia treatment with cryotherapy vs loop electrosurgical excision procedure in HIV-seropositive women from Johannesburg, South Africa.

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Smith, Jennifer S; Sanusi, Busola; Swarts, Avril; Faesen, Mark; Levin, Simon; Goeieman, Bridgette; Ramotshela, Sibongile; Rakhombe, Ntombiyenkosi; Williamson, Anna L; Michelow, Pam; Omar, Tanvier; Hudgens, Michael G; Firnhaber, Cynthia

2017-08-01

Mortality associated with cervical cancer is a public health concern for women, particularly in HIV-seropositive women in resource-limited countries. HIV-seropositive women are at a higher risk of high-grade cervical precancer, which can eventually progress to invasive carcinoma as compared to HIV-seronegative women. It is imperative to identify effective treatment methods for high-grade cervical precursors among HIV-seropositive women. Randomized controlled trial data are needed comparing cryotherapy vs loop electrosurgical excision procedure treatment efficacy in HIV-seropositive women. Our primary aim was to compare the difference in the efficacy of loop electrosurgical excision procedure vs cryotherapy for the treatment of high-grade cervical intraepithelial neoplasia (grade ≥2) among HIV-seropositive women by conducting a randomized clinical trial. HIV-seropositive women (n = 166) aged 18-65 years with histology-proven cervical intraepithelial neoplasia grade ≥2 were randomized (1:1) to cryotherapy or loop electrosurgical excision procedure treatment at a government hospital in Johannesburg. Treatment efficacy was compared using 6- and 12-month cumulative incidence posttreatment of: (1) cervical intraepithelial neoplasia grade ≥2; (2) secondary endpoints of histologic cervical intraepithelial neoplasia grade ≥3 and grade ≥1; and (3) high-grade and low-grade cervical cytology. The study was registered (ClinicalTrials.govNCT01723956). From January 2010 through August 2014, 166 participants were randomized (86 loop electrosurgical excision procedure; 80 cryotherapy). Cumulative cervical intraepithelial neoplasia grade ≥2 incidence was higher for cryotherapy (24.3%; 95% confidence interval, 16.1-35.8) than loop electrosurgical excision procedure at 6 months (10.8%; 95% confidence interval, 5.7-19.8) (P = .02), although by 12 months, the difference was not significant (27.2%; 95% confidence interval, 18.5-38.9 vs 18.5%; 95% confidence interval, 11

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

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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;

Alternative practices of achieving anaesthesia for dental procedures: a review.

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Angelo, Zavattini; Polyvios, Charalambous

2018-04-01

Managing pain and anxiety in patients has always been an essential part of dentistry. To prevent pain, dentists administer local anaesthesia (LA) via a needle injection. Unfortunately, anxiety and fear that arise prior to and/or during injection remains a barrier for many children and adults from receiving dental treatment. There is a constant search for techniques to alleviate the invasive and painful nature of the needle injection. In recent years, researchers have developed alternative methods which enable dental anaesthesia to be less invasive and more patient-friendly. The aim of this review is to highlight the procedures and devices available which may replace the conventional needle-administered local anaesthesia. The most known alternative methods in providing anaesthesia in dentistry are: topical anaesthesia, electronic dental anaesthesia, jet-injectors, iontophoresis, and computerized control local anaesthesia delivery systems. Even though these procedures are well accepted by patients to date, it is the authors' opinion that the effectiveness practicality of such techniques in general dentistry is not without limitations.

Effect of brachytherapy technique and patient characteristics on cervical cancer implant dosimetry

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Anker, Christopher J., E-mail: chris.anker@hci.utah.edu [Department of Radiation Oncology, Huntsman Cancer Hospital, University of Utah, Salt Lake City, UT (United States); O' Donnell, Kristen [Department of Radiation Oncology, The University of Arizona, Tucson, AZ (United States); Boucher, Kenneth M. [Department of Oncological Sciences, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT (United States); Gaffney, David K. [Department of Radiation Oncology, Huntsman Cancer Hospital, University of Utah, Salt Lake City, UT (United States)

2013-01-01

Our purpose was to evaluate the relationship between brachytherapy technique and patient characteristics on dose to organs-at-risk (OARs) in patients undergoing high dose rate (HDR) brachytherapy for cervical cancer. From 1998 to 2008, 31 patients with cervical cancer with full dosimetric data were identified who received definitive external-beam radiation and HDR brachytherapy with tandem and ovoid applicators. Doses were recorded at point A, the International Commission on Radiation Units and Measurements (ICRU)-38 rectal point, the ICRU-38 bladder point, the vaginal surface, and the pelvic sidewall. Generalized estimating equations were used to determine the significance of changes in OAR to point A dose ratios with differences in brachytherapy technique or patient characteristics. Patients underwent a median of 5 brachytherapy procedures (range, 3 to 5), with a total of 179 procedures for 31 patients. For all brachytherapy treatments, the average ratios between the doses for the rectal, bladder, vaginal surface, and pelvic sidewall reference points to those at point A were 0.49, 0.59, 1.15, and 0.17, respectively. In general, decreased OAR dose was associated with a lower stage, younger age, increased ovoid size, increased tandem length, and earlier implant number. Increased tandem curvature significantly increased bladder dose and decreased rectal dose. Intravenous anesthesia usage was not correlated with improved dosimetry. This study allowed identification of patient and procedure characteristics influencing OAR dosing. Although the advent of 3-dimensional (3D) image-guided brachytherapy will bring new advances in treatment optimization, the actual technique involved at the time of the brachytherapy implant procedure will remain important.

Direct versus indirect revascularization procedures for moyamoya disease: a comparative effectiveness study.

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Macyszyn, Luke; Attiah, Mark; Ma, Tracy S; Ali, Zarina; Faught, Ryan; Hossain, Alisha; Man, Karen; Patel, Hiren; Sobota, Rosanna; Zager, Eric L; Stein, Sherman C

2017-05-01

OBJECTIVE Moyamoya disease (MMD) is a chronic cerebrovascular disease that can lead to devastating neurological outcomes. Surgical intervention is the definitive treatment, with direct, indirect, and combined revascularization procedures currently employed by surgeons. The optimal surgical approach, however, remains unclear. In this decision analysis, the authors compared the effectiveness of revascularization procedures in both adult and pediatric patients with MMD. METHODS A comprehensive literature search was performed for studies of MMD. Using complication and success rates from the literature, the authors constructed a decision analysis model for treatment using a direct and indirect revascularization technique. Utility values for the various outcomes and complications were extracted from the literature examining preferences in similar clinical conditions. Sensitivity analysis was performed. RESULTS A structured literature search yielded 33 studies involving 4197 cases. Cases were divided into adult and pediatric populations. These were further subdivided into 3 different treatment groups: indirect, direct, and combined revascularization procedures. In the pediatric population at 5- and 10-year follow-up, there was no significant difference between indirect and combination procedures, but both were superior to direct revascularization. In adults at 4-year follow-up, indirect was superior to direct revascularization. CONCLUSIONS In the absence of factors that dictate a specific approach, the present decision analysis suggests that direct revascularization procedures are inferior in terms of quality-adjusted life years in both adults at 4 years and children at 5 and 10 years postoperatively, respectively. These findings were statistically significant (p indirect and combination procedures may offer optimal results at long-term follow-up.

Maze Procedures for Atrial Fibrillation, From History to Practice.

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Kik, Charles; Bogers, Ad J J C

2011-10-01

Atrial fibrillation may result in significant symptoms, (systemic) thrombo-embolism, as well as tachycardia-induced cardiomyopathy with cardiac failure, and consequently be associated with significant morbidity and mortality. Nowadays symptomatic atrial fibrillation can be treated with catheter-based ablation, surgical ablation or hybrid approaches. In this setting a fairly large number of surgical approaches and procedures are described and being practised. It should be clear that the Cox-maze procedure resulted from building up evidence and experience in different steps, while some of the present surgical approaches and techniques are being based only on technical feasibility with limited experience, rather than on a process of consequent methodology. Some of the issues still under debate are whether or not the maze procedure can be limited to the left atrium or even to isolation of the pulmonary veins or that bi-atrial procedures are indicated, whether or not cardiopulmonary bypass is to be applied and which route of exposure facilitates an optimal result. In addition, maze procedures are not procedures guide by electrophysiological mapping. At least in theory not in all patients all lesions of the maze procedures are necessary. A history and aspects of current practise in surgical treatment of atrial fibrillation is presented.

[Debridement- crucial procedure in the treatment of chronic wounds].

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Huljev, Dubravko

2013-10-01

Debridement is the process of removing dead tissue from the wound bed. Devitalized tissue can obstruct or completely stop healing of the wound. The aim of debridement is to transform a chronic wound into an acute wound and to initiate the process of healing. Debridement is the basis of each wound treatment and it has to be repeated, depending on the necrotic tissue formation. There are several types of debridement, as follows: mechanical, autolytic, chemical, enzymatic, biological, and new debridement techniques. With advances in technology, new types of debridement have been introduced. Besides standard methods, methods of pulsed lavage debridement (hydro-surgery, water-jet) and ultrasound-assisted wound treatment are ever more frequently introduced. The method of debridement the clinician will choose depends on the amount of necrotic (devitalized) tissue in the wound bed, size and depth of the wound, underlying disease, possible comorbidity, and the patient general condition. Frequently, the methods of debridement are combined in order to achieve better removal of devitalized tissue. In addition, debridement significantly reduces bacterial burden.

Adaptive algebraic reconstruction technique

International Nuclear Information System (INIS)

Lu Wenkai; Yin Fangfang

2004-01-01

Algebraic reconstruction techniques (ART) are iterative procedures for reconstructing objects from their projections. It is proven that ART can be computationally efficient by carefully arranging the order in which the collected data are accessed during the reconstruction procedure and adaptively adjusting the relaxation parameters. In this paper, an adaptive algebraic reconstruction technique (AART), which adopts the same projection access scheme in multilevel scheme algebraic reconstruction technique (MLS-ART), is proposed. By introducing adaptive adjustment of the relaxation parameters during the reconstruction procedure, one-iteration AART can produce reconstructions with better quality, in comparison with one-iteration MLS-ART. Furthermore, AART outperforms MLS-ART with improved computational efficiency

Early and medium term results of the sleeve valve-sparing procedure for aortic root ectasia.

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Gamba, Amando; Tasca, Giordano; Giannico, Floriana; Lobiati, Elisabetta; Skouse, Douglas; Galanti, Andrea; Martino, Antonello Stefano; Triggiani, Michele

2015-04-01

The aim of this retrospective study was to evaluate our experience of using a simplified aortic valve sleeve procedure to treat aortic root ectasia and aneurysms with or without aortic regurgitation. In experienced hands, 2 aortic valve-sparing procedures, ie, Yacoub and David, have yielded excellent long-term results in the treatment of aortic root aneurysms, with or without aortic regurgitation. However, these techniques are demanding and not widely used. Recently, a new and simplified valve-sparing technique, named "sleeve procedure," has been proposed, and has yielded encouraging early results. Ninety consecutive patients with aortic root aneurysms underwent sleeve procedures from October 2006 to October 2012. Follow-up data (clinical 100% complete and echocardiographic 93% complete) were acquired from our outpatient clinic or from the referring cardiologist. The mean age of the patients was 61.5 ± 12.5 years, 79% were male, 16 (18%) had a bicuspid valve, 3 had Marfan syndrome, and 2 had aortic dissection. Over a mean clinical follow-up of 34 ± 19 months, 2 patients died from noncardiac causes and 1 was reoperated on for the recurrence of aortic regurgitation. On follow-up echocardiography after a mean of 18 ± 9 months, aortic regurgitation was absent/negligible, mild or moderate in 62%, 37%, and 1% of patients, respectively, and the diameters of the annulus, Valsalva sinuses, and sinotubular junction were 27.3 + 2.2, 37.0 + 3.4, and 30.6 + 3.1 mm, respectively. Our encouraging early and medium term results suggest that the sleeve procedure is a safe and effective aortic valve-sparing technique for the treatment of aortic root ectasia and aneurysm. However, longer follow-up is needed in order to draw definitive conclusions. Copyright © 2015 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Differentiating intraparenchymal hemorrhage from contrast extravasation on post-procedural noncontrast CT scan in acute ischemic stroke patients undergoing endovascular treatment

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Payabvash, Seyedmehdi [Zeenat Qureshi Stroke Institute, Minneapolis, MN (United States); University of Minnesota, Department of Radiology, Minneapolis, MN (United States); Qureshi, Mushtaq H.; Khan, Shayaan M.; Khan, Mahnoor; Majidi, Shahram; Pawar, Swaroop; Qureshi, Adnan I. [Zeenat Qureshi Stroke Institute, Minneapolis, MN (United States)

2014-09-15

This study aimed to identify the imaging characteristics that can help differentiate intraparenchymal hemorrhage from benign contrast extravasation on post-procedural noncontrast CT scan in acute ischemic stroke patients after endovascular treatment. We reviewed the clinical and imaging records of all acute ischemic stroke patients who underwent endovascular treatment in two hospitals over a 3.5-year period. The immediate post-procedural CT scan was evaluated for the presence of hyperdense lesion(s). The average attenuation of the lesion(s) was measured. Intraparenchymal hemorrhage was defined as a persistent hyperdensity visualized on follow-up CT scan, 24 h or greater after the procedure. Of the 135 patients studied, 74 (55 %) patients had hyperdense lesion(s) on immediate post-procedural CT scan. Follow-up scans confirmed the diagnosis of intraparenchymal hemorrhage in 20 of these 74 patients. A receiver operating characteristic analysis showed that the average attenuation of the most hyperdense lesion can differentiate intraparenchymal hemorrhage from contrast extravasation with an area under the curve of 0.78 (p = 0.001). An average attenuation of <50 Hounsfield units (HU) in the most visually hyperattenuating hyperdense lesion had 100 % specificity and 56 % sensitivity for identification of contrast extravasations. Petechial hyperdensity was seen in 46/54 (85 %) patients with contrast extravasation versus 9/20 (45 %) patients with intraparenchymal hemorrhage on the immediate post-procedural CT scan (p < 0.001). An average attenuation <50 HU of the most hyperattenuating hyperdense parenchymal lesion on immediate post-procedural CT scan was very specific for differentiating contrast extravasation from intraparenchymal hemorrhage in acute ischemic stroke patients after endovascular treatment. (orig.)

Differentiating intraparenchymal hemorrhage from contrast extravasation on post-procedural noncontrast CT scan in acute ischemic stroke patients undergoing endovascular treatment

International Nuclear Information System (INIS)

Payabvash, Seyedmehdi; Qureshi, Mushtaq H.; Khan, Shayaan M.; Khan, Mahnoor; Majidi, Shahram; Pawar, Swaroop; Qureshi, Adnan I.

2014-01-01

This study aimed to identify the imaging characteristics that can help differentiate intraparenchymal hemorrhage from benign contrast extravasation on post-procedural noncontrast CT scan in acute ischemic stroke patients after endovascular treatment. We reviewed the clinical and imaging records of all acute ischemic stroke patients who underwent endovascular treatment in two hospitals over a 3.5-year period. The immediate post-procedural CT scan was evaluated for the presence of hyperdense lesion(s). The average attenuation of the lesion(s) was measured. Intraparenchymal hemorrhage was defined as a persistent hyperdensity visualized on follow-up CT scan, 24 h or greater after the procedure. Of the 135 patients studied, 74 (55 %) patients had hyperdense lesion(s) on immediate post-procedural CT scan. Follow-up scans confirmed the diagnosis of intraparenchymal hemorrhage in 20 of these 74 patients. A receiver operating characteristic analysis showed that the average attenuation of the most hyperdense lesion can differentiate intraparenchymal hemorrhage from contrast extravasation with an area under the curve of 0.78 (p = 0.001). An average attenuation of <50 Hounsfield units (HU) in the most visually hyperattenuating hyperdense lesion had 100 % specificity and 56 % sensitivity for identification of contrast extravasations. Petechial hyperdensity was seen in 46/54 (85 %) patients with contrast extravasation versus 9/20 (45 %) patients with intraparenchymal hemorrhage on the immediate post-procedural CT scan (p < 0.001). An average attenuation <50 HU of the most hyperattenuating hyperdense parenchymal lesion on immediate post-procedural CT scan was very specific for differentiating contrast extravasation from intraparenchymal hemorrhage in acute ischemic stroke patients after endovascular treatment. (orig.)

Palatal approach of anterior superior alveolar injection technique may not be potentially useful in periodontal procedures

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Pragathi Raghavendra Bhat

2016-01-01

Full Text Available Background: The palatal approach of anterior superior alveolar (P-ASA using WAND injection was reported to effectively provide a profound bilateral maxillary anesthesia of the soft tissue of anterior one-third of the palate and facial gingivae extending from canine to canine which lasted for more than an hour thus making it ideal for scaling root planing and minor periodontal procedures in the anterior maxilla. Our study suggests that the conventional P-ASA injection is of very short duration and the extent of anesthesia was not profound and consistent. This has not been reported earlier in the literature. Materials and Methods: Thirty-five cases (20 males and 15 females, who underwent scaling, root planing and minor periodontal surgical procedures such as abscess drainage, gingivectomy, and frenectomy in the maxillary anterior region in the age range of 19–45 years was assessed for the efficacy of the P-ASA injection. After the administration of the P-ASA injection, the subjective and the objective symptoms were used to evaluate the extent and duration of the anesthesia at 10, 15, and 20 min. Results: This study suggests that the conventional P-ASA injection technique does not provide anesthesia for more than 20 min. Wilcoxon matched pairs test was used to compare the effect of anesthesia at the different time intervals and the results were found to be statistically significant (P < 0.05. Conclusions: The conventional P-ASA injection technique is of very short duration and does not demonstrate effectiveness in periodontal surgery of the anterior maxilla.

Power-assisted liposuction and the pull-through technique for the treatment of gynecomastia.

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Lista, Frank; Ahmad, Jamil

2008-03-01

Gynecomastia is a common condition affecting many adolescent and adult males. Surgical techniques utilizing a variety of incisions, excisions, suction-assisted lipectomy, ultrasound-assisted liposuction, power-assisted liposuction, or some combination of these methods have been used in the treatment of gynecomastia. This article describes the authors' method of using power-assisted liposuction and the pull-through technique to treat gynecomastia. This technique involves the use of power-assisted liposuction to remove fatty breast tissue. The pull-through technique is then performed utilizing several instruments to sever the subdermal attachments of fibroglandular breast tissue; this tissue is removed through the incision used for liposuction. Finally, power-assisted liposuction is performed again to contour the remaining breast tissue. A chart review of 99 consecutive patients (197 breasts) treated between January of 2003 and November of 2006 was performed. Ninety-six patients (192 breasts) were successfully treated using this technique. Power-assisted liposuction was performed in all cases, and the average volume aspirated per breast was 459 ml (range, 25 to 1400 ml). Using the pull-through technique, the authors were able to remove between 5 and 70 g of tissue per breast. Complications were minimal (1.0 percent of breasts), and no revisions were required. Since January of 2003, the authors have used this technique to successfully treat 97 percent of their gynecomastia patients. Combining power-assisted liposuction and the pull-through technique has proven to be a versatile approach for the treatment of gynecomastia and consistently produces a naturally contoured male breast while resulting in a single inconspicuous scar.

Successful treatment of recurrent stoma prolapse after Hartmann’s procedure through ileorectal anastomosis: A case report

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Noriya Takayama

Full Text Available Introduction: Treatment strategy for recurrent stoma prolapse has not been well-established because of the rarity and complexity of the condition. We report a case of recurrent stoma prolapse that was successfully managed using unique surgical treatments. Presentation of case: A 72-year-old man with a history of Parkinson's disease presented with transverse (T3N0M0 and sigmoid (T3N0M0 colon cancer. Considering the status of large bowel obstruction, Hartmann's procedure was indicated. Four months after surgery, stoma prolapse occurred, which became irreducible. Six months after surgery, local resection of the prolapsed bowel was performed. The patient continued to receive laxatives for bowel movement control and his abdomen remained distended. Ten months later, stoma prolapse recurred with evident bowel dilatation. Initially, we planned Hartmann’s reversal. However, as the patient had intractable constipation secondary to Parkinson’s disease, resection of the proximal colon and ileorectal anastomosis were considered as the treatment choices. Therefore, we performed right colectomy with ileorectal anastomosis. At 1.5 years after the last surgery, complications such as small bowel obstruction, difficulty in defecation, or fecal incontinence were not detected. Discussion: The cause of stoma prolapse is generally ascribed to various anatomical factors such as redundant intestine, high intra-abdominal pressure, and intraperitoneal route. Stoma prolapse is also influenced by other factors, including old age, obesity, and the severity of illness that necessitated stoma creation. In this case, the decision regarding surgical management was complicated by colonic motility disorder with concomitant Parkinson’s disease. Conclusion: We suggest that ileorectal anastomosis may be an optimal surgical treatment for patients with recurrent stoma prolapse and concomitant colonic motility disorder who have undergone Hartmann’s procedure. Keywords: Stoma

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

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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.

FIRST METATARSOPHALANGEAL JOINT OSTEOARTHRITIS: PERCUTANEOUS SURGERY, CHOICE OF A SURGICAL PROCEDURE, CLINICAL AND RADIOGRAPHIC CLASSIFICATION

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S. Yu. Berezhnoy

2017-01-01

Full Text Available Introduction. Hallux rigidus is observed in approximately 2.5% of the adult population. Until now neither a unified classification of hallux rigidus appears to exist nor any clear principles to choose the surgical method. The variety of clinical and radiological signs explains the difficulties in establishing a comprehensive classification system and in selection of the criteria for surgical procedure. There are few published reports about hallux rigidus percutaneous surgical treatment. Existing papers are dedicated to a limited number of percutaneous techniques.The purpose of this study was to evaluate the efficacy of percutaneous techniques for surgical treatment of the first metatarsophalangeal joint osteoarthritis; to specify factors determining the choice of procedure; to develop a grading system of the hallux rigidus severity which will help in selection of surgery. Materials and methods. Based on 156 surgeries (107 patients the author demonstrated the possibilities of percutaneous techniques in the surgical treatment of hallux rigidus of different stages as well as provided a brief description of used surgical techniques.Results. The mean age of patients was 48.8 years (ranged from 18 to 73. The mean follow-up was 7 months (ranged from 3 to 54. At the specified time the treatment outcomes of 103 patients (150 feet were analyzed. Mean hospital stay was 0.78 days (ranged from 0 to 1. No infectious or wound-healing problems were observed. Overall, the patients were completely satisfied with the outcomes of 89 surgical treatment, qualified satisfaction was reported with patients in respect of outcomes of 57 surgeries. Four unsatisfactory outcomes were observed. The role of the relatively long first metatarsal in the development of hallux rigidus was confirmed. Conclusion. Percutaneous techniques provide successful treatment for all stages of hallux rigidus. The choice of a specific surgical technique may be challenging and requires

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

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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.

Transvaginal mesh procedures for pelvic organ prolapse.

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Walter, Jens-Erik

2011-02-01

To provide an update on transvaginal mesh procedures, newly available minimally invasive surgical techniques for pelvic floor repair. The discussion is limited to minimally invasive transvaginal mesh procedures. PubMed and Medline were searched for articles published in English, using the key words "pelvic organ prolapse," transvaginal mesh," and "minimally invasive surgery." Results were restricted to systematic reviews, randomized control trials/controlled clinical trials, and observational studies. Searches were updated on a regular basis, and articles were incorporated in the guideline to May 2010. Grey (unpublished) literature was identified through searching the websites of health technology assessment and health technology assessment-related agencies, clinical practice guideline collections, clinical trial registries, and national and international medical specialty societies. The quality of evidence was rated using the criteria described in the Report of the Canadian Task Force on the Preventive Health Care. Recommendations for practice were ranked according to the method described in that report (Table 1). Counselling for the surgical treatment of pelvic organ prolapse should consider all benefits, harms, and costs of the surgical procedure, with particular emphasis on the use of mesh. 1. Patients should be counselled that transvaginal mesh procedures are considered novel techniques for pelvic floor repair that demonstrate high rates of anatomical cure in uncontrolled short-term case series. (II-2B) 2. Patients should be informed of the range of success rates until stronger evidence of superiority is published. (II-2B) 3. Training specific to transvaginal mesh procedures should be undertaken before procedures are performed. (III-C) 4. Patients should undergo thorough preoperative counselling regarding (a) the potential serious adverse sequelae of transvaginal mesh repairs, including mesh exposure, pain, and dyspareunia; and (b) the limited data available

A computer-controlled conformal radiotherapy system. III: graphical simulation and monitoring of treatment delivery

International Nuclear Information System (INIS)

Kessler, Marc L.; McShan, Daniel L.; Fraass, Benedick A.

1995-01-01

Purpose: Safe and efficient delivery of radiotherapy using computer-controlled machines requires new procedures to design and verify the actual delivery of these treatments. Graphical simulation and monitoring techniques for treatment delivery have been developed for this purpose. Methods and Materials: A graphics-based simulator of the treatment machine and a set of procedures for creating and manipulating treatment delivery scripts are used to simulate machine motions, detect collisions, and monitor machine positions during treatment. The treatment delivery simulator is composed of four components: a three-dimensional dynamic model of the treatment machine; a motion simulation and collision detection algorithm, user-interface widgets that mimic the treatment machine's control and readout devices; and an icon-based interface for creating and manipulating treatment delivery scripts. These components are used in a stand-alone fashion for interactive treatment delivery planning and integrated with a machine control system for treatment implementation and monitoring. Results: A graphics-based treatment delivery simulator and a set of procedures for planning and monitoring computer-controlled treatment delivery have been developed and implemented as part of a comprehensive computer-controlled conformal radiotherapy system. To date, these techniques have been used to design and help monitor computer-controlled treatments on a radiotherapy machine for more than 200 patients. Examples using these techniques for treatment delivery planning and on-line monitoring of machine motions during therapy are described. Conclusion: A system that provides interactive graphics-based tools for defining the sequence of machine motions, simulating treatment delivery including collision detection, and presenting the therapists with continual visual feedback from the treatment machine has been successfully implemented for routine clinical use as part of an overall system for computer

Hysteroscopic myomectomy: techniques and preoperative assessment.

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Casadio, Paolo; Guasina, Francesca; Morra, Ciro; Talamo, Maria T; Leggieri, Concetta; Frisoni, Jessica; Seracchioli, Renato

2016-04-01

Even if usually asymptomatic, uterine myomas have been associated with a number of clinical issues such as abnormal uterine bleeding (AUB), heavy menstrual bleeding (HMB), infertility, recurrent pregnancy loss, especially when these masses are submucous. Golden standard treatment for symptomatic submucous fibroids has long been considered their laparotomic removal or a total hysterectomy. The development of endoscopy has made these fibroids accessible and removable from the inner surface of uterus. Hysteroscopy arose as a diagnostic technique, but then it also became an alternative surgical technique for many diseases, offering therapeutic and irreplaceable possibilities of treatment, avoiding major surgery on the one hand, and allowing the correction of pathologies specifically related to female fertility, on the other hand. Excision by slicing has been described as traditional resectoscopic submucosal myomectomy, but today there are new procedures among which the operator can choose, that allow overcoming the initial limitations of the traditional resectoscopic myomectomy in clinical practice.

The treatment of muscle tension dysphonia: a comparison of two treatment techniques by means of an objective multiparameter approach.

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Van Lierde, Kristiane M; De Bodt, Marc; Dhaeseleer, Evelien; Wuyts, Floris; Claeys, Sofie

2010-05-01

The purpose of the present study is to measure the effectiveness of two treatment techniques--vocalization with abdominal breath support and manual circumlaryngeal therapy (MCT)--in patients with muscle tension dysphonia (MTD). The vocal quality before and after the two treatment techniques was measured by means of the dysphonia severity index (DSI), which is designed to establish an objective and quantitative correlate of the perceived vocal quality. The DSI is based on the weighted combination of the following set of voice measurements: maximum phonation time (MPT), highest frequency, lowest intensity, and jitter. The repeated-measures analysis of variance (ANOVA) revealed a significant difference between the objective overall vocal quality before and after MCT. No significant differences were measured between the objective overall vocal quality before and after vocalization with abdominal breath support. This study showed evidence that MCT is an effective treatment technique for patients with elevated laryngeal position, increased laryngeal muscle tension, and MTD. The precise way in which MCT has an effect on vocal quality has not been addressed in this experiment, but merits study. Further research into this topic could focus on electromyography (EMG) recordings in relation to vocal improvements with larger sample of subjects. (c) 2010 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

Virtual reality in the treatment of pain

OpenAIRE

Botella Arbona, Cristina; García Palacios, Azucena; Baños Rivera, Rosa María; Quero Castellano, Soledad; Bretón-López, Juana

2008-01-01

Many medical procedures produce acute pain that in most cases is quite disturbing for the individual. Medication is the treatment of choice for acute pain. However, given the involvement of psychological aspects in the experience of pain, psychological techniques are being used as an effective adjunct to alleviate pain related to medical procedures. In the last years a new technology is demonstrating an enormous potential in this field: Virtual Reality (VR) distraction. In this ar...

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

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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

Towards a standard protocol for antimony intralesional infiltration technique for cutaneous leishmaniasis treatment

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Rosiana Estéfane da Silva

Full Text Available BACKGROUND Despite its recognised toxicity, antimonial therapy continues to be the first-line drug for cutaneous leishmaniasis (CL treatment. Intralesional administration of meglumine antimoniate (MA represents an alternative that could reduce the systemic absorption of the drug and its side effects. OBJECTIVES This study aims to validate the standard operational procedure (SOP for the intralesional infiltration of MA for CL therapy as the first step before the assessment of efficacy and safety related to the procedure. METHODS The SOP was created based on 21 trials retrieved from the literature, direct monitoring of the procedure and consultation with experts. This script was submitted to a formal computer-aided inspection to identify readability, clarity, omission, redundancy and unnecessary information (content validation. For criterion and construct validations, the influence of critical condition changes (compliance with the instructions and professional experience on outcome conformity (saturation status achievement, tolerability (pain referred and safety (bleeding were assessed. FINDINGS The median procedure length was 12 minutes and in 72% of them, patients classified the pain as mild. The bleeding was also classified as mild in 96.6% of the procedures. Full compliance with the SOP was observed in 66% of infiltrations. Despite this, in 100% of the inspected procedures, lesion saturation was observed at the end of infiltration, which means that it tolerates some degree of modification in its execution (robustness without prejudice to the result. CONCLUSIONS The procedure is reproducible and can be used by professionals without previous training with high success and safety rates.

Towards a standard protocol for antimony intralesional infiltration technique for cutaneous leishmaniasis treatment.

Science.gov (United States)

Silva, Rosiana Estéfane da; Carvalho, Janaína de Pina; Ramalho, Dario Brock; Senna, Maria Camilo Ribeiro De; Moreira, Hugo Silva Assis; Rabello, Ana; Cota, Erika; Cota, Gláucia

2018-02-01

BACKGROUND Despite its recognised toxicity, antimonial therapy continues to be the first-line drug for cutaneous leishmaniasis (CL) treatment. Intralesional administration of meglumine antimoniate (MA) represents an alternative that could reduce the systemic absorption of the drug and its side effects. OBJECTIVES This study aims to validate the standard operational procedure (SOP) for the intralesional infiltration of MA for CL therapy as the first step before the assessment of efficacy and safety related to the procedure. METHODS The SOP was created based on 21 trials retrieved from the literature, direct monitoring of the procedure and consultation with experts. This script was submitted to a formal computer-aided inspection to identify readability, clarity, omission, redundancy and unnecessary information (content validation). For criterion and construct validations, the influence of critical condition changes (compliance with the instructions and professional experience) on outcome conformity (saturation status achievement), tolerability (pain referred) and safety (bleeding) were assessed. FINDINGS The median procedure length was 12 minutes and in 72% of them, patients classified the pain as mild. The bleeding was also classified as mild in 96.6% of the procedures. Full compliance with the SOP was observed in 66% of infiltrations. Despite this, in 100% of the inspected procedures, lesion saturation was observed at the end of infiltration, which means that it tolerates some degree of modification in its execution (robustness) without prejudice to the result. CONCLUSIONS The procedure is reproducible and can be used by professionals without previous training with high success and safety rates.

An overview of periodontal regenerative procedures for the general dental practitioner

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M. Siaili

2018-01-01

Full Text Available The complete regeneration of the periodontal tissues following periodontal disease remains an unmet challenge, and has presented clinicians with a remarkably difficult clinical challenge to solve given the extensive research in this area and our current understanding of the biology of the periodontal tissues. In particular as clinicians we look for treatments that will improve the predictability of the procedure, improve the magnitude of the effect of treatment, and perhaps most importantly in the long term would extend the indications for treatment beyond the need for single enclosed bony defects to allow for suprabony regeneration, preferably with beneficial effects on the gingival soft tissues. A rapid development in both innovative methods and products for the correction of periodontal deficiencies have been reported during the last three decades. For example, guided tissue regeneration with or without the use of bone supplements has been a well-proven treatment modality for the reconstruction of bony defects prior to the tissue engineering era. Active biomaterials have been subsequently introduced to the periodontal community with supporting dental literature suggesting that certain factors should be taken into consideration when undertaking periodontal regenerative procedures. These factors as well as a number of other translational research issues will need to be addressed, and ultimately it is vital that we do not extrapolate results from pre-clinical and animal studies without conducting extensive randomized clinical trials to substantiate outcomes from these procedures. Whatever the outcomes, the pursuit of regeneration of the periodontal tissues remains a goal worth pursuing for our patients. The aim of the review, therefore is to update clinicians on the recent advances in both materials and techniques in periodontal regenerative procedures and to highlight the importance of both patient factors and the technical aspects of

Osteoid osteoma: percutaneous treatment with CT guidance

International Nuclear Information System (INIS)

Velan, Osvaldo; Ayzaguer, Alejandro H.; Endara Bustos, Olinda; Lambertini, Roberto G.

2004-01-01

Purpose: The osteoid osteoma (OO) is a benign bone tumor characterized by causing severe and constant pain at night, and for that reason it requires a surgical excision. Although for years the treatment of choice has been surgery, the development of CT-guided percutaneous procedures, such as percutaneous resection with trephine (PR), and more recently the radiofrequency ablation (RF), it is possible to remove the core of the lesion and therefore relieve the symptoms in a considerably less invasive way. Material and methods: Between January 1990 and February 2004, 65 lesions in 60 patients with a presumptive diagnosis of osteoid osteoma were treated. 49 PRs and 16 RFs were performed. Of the 49 PRs, 5 required curettage and one required an ethanol injection. The procedures were guided by CT imaging under general or spinal anesthesia with 24 hr hospitalization. Tumor samples were taken for anatomical pathology analysis (AP). The absence of symptoms and late complications was verified 30 days after the procedure. Results: All lesions were accessed successfully. In 5 of them it was necessary to broaden the resection due to a possible insufficient margin. In 38 of the 65 lesions (58,5%) AP confirmed the OO diagnosis; in 6/65 (9.2%) of them AP found other specific lesions, such as enostoma (n=2), bone cyst (n=1), inclusion cyst (n=1), chondroma (n=1), and chronic osteitis (n=1), and in the rest of the cases the findings were unspecified. All patients (60/60) showed no pain within 24-48 hours of the procedure, and 5/60 (8,3%) received further treatment due to recurring symptoms. Conclusion: The percutaneous procedure has shown to be an effective technique for the treatment of OO. Compared to surgical excision, the percutaneous technique is less invasive, it requires less anesthesia and hospitalization time, and it allows an earlier return to active life. The PR is less expensive than the RF, but it requires a wider bone incision. However, both techniques are equally

Radiographic comparison of apical root resorption after orthodontic treatment between bidimensional and Roth straight-wire techniques.

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Zawawi, Khalid H; Malki, Ghadah A

2014-10-01

The aim of this study was to compare the amount of root resorption after orthodontic treatment between the bidimensional and the Roth straight-wire techniques. Another objective was to compare the amount of root resorption in the whole sample studied and record the prevalence of root resorption. The sample consisted of 40 patients (age ranged between 11 and 18 years) with Angle Class II division 1 malocclusions, treated nonextraction. Twenty patients were treated with bidimensional technique and 20 with a 0.018-inch Roth straight-wire technique. Root lengths of the maxillary incisors were measured on pre- and post-treatment periapical radiographs. The results demonstrated that the bidimensional and Roth straight-wire groups showed significant root resorption after treatment, 1.11 (0.17) and 0.86 (0.05), respectively, P root shortening between the bidimensional and Roth straight-wire groups, there was no significant difference between the mean change from pre- to post-treatment between bidimensional group (mean = 1.00 ± 1.34) and Roth straight-wire group (mean = 0.88 ± 0.86), P = 0.63. Considering the whole sample, there was no root resoprtion in 32.5% of the analysed teeth. There was only mild resorption in 56.2%, moderate in 8.8% and severe in only 2.5% of the teeth. Treatment with the bidimensional technique did not produce an increase in the amount of root resorption. The prevalence and amount of root resorption was similar between bidimensional and Roth straight-wire techniques.

An ecological study of skin biopsies and skin cancer treatment procedures in the United States Medicare population, 2000 to 2015.

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Wang, David M; Morgan, Frederick C; Besaw, Robert J; Schmults, Chrysalyne D

2018-01-01

Analyses of skin cancer procedures adjusted for population changes are needed. To describe trends in skin cancer-related biopsies and procedures in Medicare beneficiaries. An ecological study of Medicare claims for skin biopsies and skin cancer procedures in 2000 to 2015. Biopsies increased 142%, and skin cancer procedures increased 56%. Mohs micrographic surgery (MMS) utilization increased on the head/neck, hands/feet, and genitalia (increasing from 11% to 27% of all treatment procedures) but was low on the trunk/extremities (increasing from 1% to 4%). Adjusted for increased Medicare enrollment (+36%) between 2000 and 2015, the number of biopsies and MMS procedures performed per 1000 beneficiaries increased (from 56 to 99 and from 5 to 15, respectively), whereas the number of excisions and destructions changed minimally (from 18 to 16 and from 19 to 18, respectively). Growth in biopsies and MMS procedures slowed between each time period studied: 4.3 additional biopsies per year and 0.9 additional MMS procedures per year per 1000 beneficiaries between 2000 and 2007, 2.2 and 0.5 more between 2008 and 2011, and 0.5 and 0.3 more between 2012 and 2015, respectively. Medicare claims-level data do not provide patient-level or nonsurgical treatment information. The increased number of skin cancer procedures performed was largely the result of Medicare population growth over time. MMS utilization increased primarily on high- and medium-risk and functionally and cosmetically significant locations where tissue sparing and maximizing cure are critical. Copyright © 2017 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

Why are mini-implants lost: the value of the implantation technique!

Science.gov (United States)

Romano, Fabio Lourenço; Consolaro, Alberto

2015-01-01

The use of mini-implants have made a major contribution to orthodontic treatment. Demand has aroused scientific curiosity about implant placement procedures and techniques. However, the reasons for instability have not yet been made totally clear. The aim of this article is to establish a relationship between implant placement technique and mini-implant success rates by means of examining the following hypotheses: 1) Sites of poor alveolar bone and little space between roots lead to inadequate implant placement; 2) Different sites require mini-implants of different sizes! Implant size should respect alveolar bone diameter; 3) Properly determining mini-implant placement site provides ease for implant placement and contributes to stability; 4) The more precise the lancing procedures, the better the implant placement technique; 5) Self-drilling does not mean higher pressures; 6) Knowing where implant placement should end decreases the risk of complications and mini-implant loss.

Why are mini-implants lost: The value of the implantation technique!

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Fabio Lourenço Romano

2015-02-01

Full Text Available The use of mini-implants have made a major contribution to orthodontic treatment. Demand has aroused scientific curiosity about implant placement procedures and techniques. However, the reasons for instability have not yet been made totally clear. The aim of this article is to establish a relationship between implant placement technique and mini-implant success rates by means of examining the following hypotheses: 1 Sites of poor alveolar bone and little space between roots lead to inadequate implant placement; 2 Different sites require mini-implants of different sizes! Implant size should respect alveolar bone diameter; 3 Properly determining mini-implant placement site provides ease for implant placement and contributes to stability; 4 The more precise the lancing procedures, the better the implant placement technique; 5 Self-drilling does not mean higher pressures; 6 Knowing where implant placement should end decreases the risk of complications and mini-implant loss.

The synthesis of radioactive polymeric microspheres for SPECT imaging during embolization procedures

International Nuclear Information System (INIS)

Carvalheira, Luciana; Pinto, José C.C.S.; Souza, Marcio N. de

2017-01-01

Vascular embolization is an important clinical procedure, frequently used to reduce the size of a tumor, to facilitate the removal of a tumor during surgery or to define a treatment of tumor malformation. In addition, imaging is an important component for the evaluation and care of patients undergoing vascular embolization. Nowadays, during the embolization procedure, the radiologist uses the Angiography or Fluoroscopy (X-Ray images) technique to estimate devascularization, since only pathological examinations are able to show the exact location of the blockade and microspheres. SPECT imaging is widely used in Brazil and provides images of superior quality to the mentioned techniques. Therefore, radioactive polymeric microspheres can be used as radioembolization agents for SPECT imaging. This technique can improve the resolution of images and, consequently, the embolization procedure efficacy of uterine fibroids for example, by allowing the track of particles distribution in the veins and tumor, the homogeneity of this distribution and the end of the embolization procedure. In this work, we evaluate the copolymerization of 4-vinylphenol and vinyl acetate as a synthesis route for a new radioembolization agent. GPC analysis results showed that this comonomer presence improved the molar mass distribution. In addition, bulk polymerization tests and kinetic studies showed that the selected comonomer retards the reaction time, but does not decrease the conversion percentage. Indeed, this result points out the necessity of a comonomer chemical modification to improve yield results. (author)

The synthesis of radioactive polymeric microspheres for SPECT imaging during embolization procedures

Energy Technology Data Exchange (ETDEWEB)

Carvalheira, Luciana; Pinto, José C.C.S.; Souza, Marcio N. de, E-mail: luciana@ien.gov.br, E-mail: nele@eq.ufrj.br [Instituto de Engenharia Nuclear (IEN/CNEN-RJ), Rio de Janeiro, RJ (Brazil); Coordenacao de Pos-Graduacao e Pesquisa de Engenharia (PEQ/COPPE/UFRJ), Rio de Janeiro, RJ (Brazil)

2017-07-01

Vascular embolization is an important clinical procedure, frequently used to reduce the size of a tumor, to facilitate the removal of a tumor during surgery or to define a treatment of tumor malformation. In addition, imaging is an important component for the evaluation and care of patients undergoing vascular embolization. Nowadays, during the embolization procedure, the radiologist uses the Angiography or Fluoroscopy (X-Ray images) technique to estimate devascularization, since only pathological examinations are able to show the exact location of the blockade and microspheres. SPECT imaging is widely used in Brazil and provides images of superior quality to the mentioned techniques. Therefore, radioactive polymeric microspheres can be used as radioembolization agents for SPECT imaging. This technique can improve the resolution of images and, consequently, the embolization procedure efficacy of uterine fibroids for example, by allowing the track of particles distribution in the veins and tumor, the homogeneity of this distribution and the end of the embolization procedure. In this work, we evaluate the copolymerization of 4-vinylphenol and vinyl acetate as a synthesis route for a new radioembolization agent. GPC analysis results showed that this comonomer presence improved the molar mass distribution. In addition, bulk polymerization tests and kinetic studies showed that the selected comonomer retards the reaction time, but does not decrease the conversion percentage. Indeed, this result points out the necessity of a comonomer chemical modification to improve yield results. (author)

Technique of radiotherapeutic treatment of breast cancer with scarcity means; Tecnica de tratamiento radioterapico del cancer de mama con escasez de medios

Energy Technology Data Exchange (ETDEWEB)

Velazquez M, S.; Carrera M, F.; Bayo L, E.; Gutierrez B, L.; Gomez-Millan B, J. [Hospital Juan Ramon Jimenez, Ronda Norte s/n, 21005 Huelva (Spain)

1998-12-31

The objective of this work is to show the particularities in the treatment simulation localization, in the volume selection and in the main planning strategies motive by our scarcity means during the first year of performance. It was utilized a computerized tomograph, an X-ray equipment with tele commanded table. Also it was utilized a radio opaque lattice of marked center and knowing space and also a magnetic pointer for indicating 80 cm length between focus-skin. Putting the patient on an inclined plane of self design and manufacture, it was realized three cuts at different levels over what are limited the clinical target volume (CTV) and it is optimized the isocenter through its determined localization by equations. It was employed equations for the radiobiological prediction about fibrosis and dermatitis. It was utilized another techniques or procedures for planning such as personnel wedges or the dose equilibrium in three points of the breast. It was evaluated toxicities (EORTC-RTOG). The results were as follow: Acute dermatitis (grade 1: 23 %; grade 2: 59 %; grade 3: 18 %). Acute pneumonitis (grade 1: 4.3 %); acute pharyngitis (grade 1: 11 %; grade 2: 3.7 %. In conservator treatment of breast it was obtained excellent aesthetic results in 15 %; good 72 %; moderate 11 %; and bad 3 %. The good aesthetic results by the combined use of the optimization techniques in clinical dosimetry, personnel wedges, isocenter therapy and computerized planning in the radiotherapeutic treatment of the breast cancer. (Author)

Study and economic analysis in the treatment of vinasse; Estudios y analisis economico en el tratamiento de vinazas

Energy Technology Data Exchange (ETDEWEB)

Lopez-Perez, L.; Perez-Baez, S. O.; Susial, P. [Universidad de Las Palmas de Gran Canarias (Spain)

2001-07-01

Different techniques to control and treatment wastewater from distillation alcohol plants are reviewed and a non conventional procedure in vinasses treatment obtained like stillage from fermented and distilled sugar cane juice is presented. Tests of coagulation-flocculation made with jar test equipment shows that a clear effluent verified by NTU is obtained, despite the rate of diminution of the DBO{sub 5} was smaller of 40%, reason why the designed technique needs to be combined with an oxidation pos treatment, after as the industrial wastewater satisfies the normative parameters. A comparative analysis of the coagulation-flocculation technique with respect to the conventional procedure anaerobic+aerobic treatment is made in economic terms. The obtained result shows that in small plants is viable a physical+chemical treatment, whenever the volume of vinasse to be treated must be smaller than 15 m''3/day. (Author) 30 refs.

The effect of varying incubation times for hypotonic treatment of lymphocytes in dicentric assay technique

International Nuclear Information System (INIS)

Noraisyah Yusof; Noriah Jamal; Rahimah Abdul Rahim; Juliana Mahamad Napiah

2010-01-01

The International Atomic Energy Agency (IAEA) has recommended that incubation time for the hypotonic treatment of lymphocytes in dicentric assay technique to be between 15 to 20 minutes. Incubation time will effect the hypotonic treatment of lymphocytes and thus, the breakage of cytoplasmic membrane. The objective of this study is to examine the effect of varying incubation times for hypotonic treatment of lymphocytes in dicentric assay technique. In this study, we choose to use our standard protocol for dicentric assay technique. However, for the hypotonic treatment of lymphocytes, the incubation times were varied from 10, 15, 20, 25 and 30 minutes respectively. Lymphocytes were then fixed and stained with Giemsa. The cells were then analyzed for clear background that indicates good metaphases. We found that incubation time of 30 minutes gives the best metaphase images. This incubation time is longer than what has been recommended by the IAEA. This maybe explained by the fact that our country's climate is of higher humidity compared with the European countries. (author)

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.

Covering techniques for severe burn treatment: lessons for radiological burn accidents

International Nuclear Information System (INIS)

Carsin, H.; Stephanazzi, J.; Lambert, F.; Curet, P.M.; Gourmelon, P.

2002-01-01

Covering techniques for severe burn treatment: lessons for radiological burn accidents. After a severe burn, the injured person is weakened by a risk of infection and a general inflammation. The necrotic tissues have to be removed because they are toxic for the organism. The injured person also needs to be covered by a cutaneous envelope, which has to be done by a treatment centre for burned people. The different techniques are the following: - auto grafts on limited burned areas; - cutaneous substitutes to cover temporary extended burned areas. Among them: natural substitutes like xenografts (pork skin, sheep skin,..) or allografts (human skin), - treated natural substitutes which only maintain the extracellular matrix. Artificial skins belong to this category and allow the development of high quality scars, - cell cultures in the laboratory: multiplying the individual cells and grafting them onto the patient. This technique is not common but allows one to heal severely injured patients. X-ray burns are still a problem. Their characteristics are analysed: intensive, permanent, antalgic resistant pain. They are difficult to compare with heat burns. In spite of a small number of known cases, we can give some comments and guidance on radio necrosis cures: the importance of the patients comfort, of ending the pain, of preventing infection, and nutritional balance. At the level of epidermic inflammation and phlyctena (skin blisters), the treatment may be completed by the use of growth factors. At the level of necrosis, after a temporary cover, an auto graft can be considered only if a healthy basis is guaranteed. The use of cellular cultures in order to obtain harmonious growth factors can be argued. (author)

HOLISTIC PROCEDURE WORK ORGANIZATION AND LABOR SKILLS

Directory of Open Access Journals (Sweden)

Marianela Bermejo-Salmon

2016-01-01

Full Text Available The purpose of this article is the development of a procedure with a holistic focus for the treatment of the elements that conform the profile of work organization in the United of Base Enterprise Mastor of the Telex Company of Santiago de Cuba. Different methods and techniques are used such as: historical-logical, analysis and synthesis, induction and deduction, the Delphi method, functional analysis, integrated focus or ¨Holistic¨, experts’ approach, briefcase or portfolio of evidences, surveys, and observation of the acting, among others. The procedure establishes two key moments for the study of the process given by the level of competitions and its profile. The competence tasks were identified and the rules and standards tasks from which a direct link between the performances evaluations and formations action is established, in correspondence with the elements that integrate the process of work organization with an integrative character. 

A new technique of single portal endoscopic carpal tunnel release.

Science.gov (United States)

Ip, Wing-Yuk Josephine; Sweed, Tamer Ahmed; Fung, Kwok Keung Boris; Tipoe, George L; Pun, Tze Shing

2012-03-01

Since the first description of endoscopic carpal tunnel release (ECTR) in 1987 by Okutsu many endoscopic techniques have been developed, but the majority of the literature on ECTR has dealt with the Chow and Agee techniques. ECTR is indicated for carpal tunnel syndrome that is not responding to conservative treatment for 6 months. This new technique of ECTR is a single-portal technique using instruments originally designed for endoscopic cubital tunnel release, with no disposable instruments used. It also has the advantage of performing the release with the median nerve protected under direct vision. Ten cases were operated with this technique after performing the procedure on 8 hands of 4 fresh frozen cadavers. There were no neurovascular or tendon injuries with this technique and patients were satisfied with the results.

The Cox-maze IV procedure in its second decade: still the gold standard?

Science.gov (United States)

Ruaengsri, Chawannuch; Schill, Matthew R; Khiabani, Ali J; Schuessler, Richard B; Melby, Spencer J; Damiano, Ralph J

2018-04-01

Atrial fibrillation (AF) is the most common cardiac arrhythmia and the treatment options include medical treatment and catheter-based or surgical interventions. AF is a major cause of stroke, and its prevalence is increasing. The surgical treatment of AF has been revolutionized over the past 2 decades through surgical innovation and improvements in endoscopic imaging, ablation technology and surgical instrumentation. The Cox-maze (CM) procedure, which was developed by James Cox and introduced clinically in 1987, is a procedure in which multiple incisions are created in both the left and the right atria to eliminate AF while allowing the sinus impulse to reach the atrioventricular node. This procedure became the gold standard for the surgical treatment of AF. Its latest iteration is termed the CM IV and was introduced in 2002. The CM IV replaced the previous cut-and-sew method (CM III) by replacing most of the incisions with a combination of bipolar radiofrequency and cryoablation. The use of ablation technologies, made the CM IV technically easier, faster and more amenable to minimally invasive approaches. The aims of this article are to review the indications and preoperative planning for the CM IV, to describe the operative technique and to review the literature including comparisons of the CM IV with the previous cut-and-sew method. Finally, this review explores future directions for the surgical treatment of patients with AF.

Current Techniques of Teaching and Learning in Bariatric Surgical Procedures: A Systematic Review.

Science.gov (United States)

Kaijser, Mirjam; van Ramshorst, Gabrielle; van Wagensveld, Bart; Pierie, Jean-Pierre

The gastric sleeve resection and gastric bypass are the 2 most commonly performed bariatric procedures. This article provides an overview of current teaching and learning methods of those techniques in resident and fellow training. A database search was performed on Pubmed, Embase, and the Education Resources Information Center (ERIC) to identify the methods used to provide training in bariatric surgery worldwide. After exclusion based on titles and abstracts, full texts of the selected articles were assessed. Included articles were reviewed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system. In total, 2442 titles were identified and 14 full text articles met inclusion criteria. Four publications described an ex vivo training course, and 6 focused on at least 1 step of the gastric bypass procedure. Two randomized controlled trials (RCT) provided high-quality evidence on training aspects. Surgical coaching caused significant improvement of Bariatric Objective Structured Assessment of Technical Skills (BOSATS) scores (3.60 vs. 3.90, p = 0.017) and reduction of technical errors (18 vs. 10, p = 0.003). A preoperative warm-up increased global rating scales (GRS) scores on depth perception (p = 0.02), bimanual dexterity (p = 0.01), and efficiency of movements (p = 0.03). Stepwise education, surgical coaching, warming up, Internet-based knowledge modules, and ex vivo training courses are effective in relation to bariatric surgical training of residents and fellows, possibly shortening their learning curves. Copyright © 2018 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Osteosynthesis techniques used for mandibular sagittal split osteotomy – history of orthognathic procedures and modern practice.

Science.gov (United States)

Nowak, Rafał; Trybek, Grzegorz

Choosing an appropriate fixation technique after maxillary or mandibular osteotomy is one of the key factors affecting the success of orthognathic surgery. In line with the development of new surgical methods and techniques, the surgeons’ approach to the fixation of bone fragments has evolved accordingly, varying from non-fusion to different osteosynthesis techniques. Advances in medical sciences and medical technologies, have changed our attitudes to bone fragment reduction in orthopaedics and traumatology, and also in maxillofacial surgery. The pivotal underlying principle which determines bone healing – that is proper positioning so as to ensure appropriate contact area and immobilisation so as to ensure osteosynthesis – has remained unchanged for centuries. However, over the years, patient comfort and the predictability of treatment outcomes have vastly improved. The paper provides an overview of the techniques and methods used for the fixation of osteotomized fragments after bilateral sagittal split osteotomy since its introduction by Hugo Obwegeser up to the present day.

[Laparoscopic treatment of ovarian cysts. Indications, techniques, results. Apropos of 650 cases].

Science.gov (United States)

Bruhat, M A; Mage, G; Bagory, G; Canis, M; Pouly, J L; Wattiez, A; Chapron, C; Laberge, P

1991-01-01

Laparoscopic management of annexes is now accepted as alternative to classical management by laparotomy. However, a careful pre-operative evaluation, including clinical and ultrasonographic examination is of ut most importance in order to exclude malignant lesion which should be treated by laparotomy. The laparoscopic treatment includes several procedures: intra-peritoneal cystectomy, extra-abdominal cystectomy, oaphorectomy and adnexectomy. These procedures and used according to the laparoscopic diagnosis. About 652 cases managed by laparoscopy, we can concluded: laparoscopic diagnosis of benign lesion is reliable (positive predictive value 100%); most of benign ovarian cysts can be treated by laparoscopy, from 89 to 97% of the benign adnexal cysts; complications are uncommon (8 cases out of 616 patients); the recurrence risk appears to be low (only 2.7% in patients treated for a non endometriotic adnexal cysts).

Computer-assisted preoperative simulation for positioning and fixation of plate in 2-stage procedure combining maxillary advancement by distraction technique and mandibular setback surgery

Directory of Open Access Journals (Sweden)

Hideyuki Suenaga

2016-01-01

Conclusion: The implementation of the computer-assisted preoperative simulation for the positioning and fixation of plate in 2-stage orthognathic procedure using distraction technique and mandibular setback surgery yielded good results.

Outcome of endodontic treatment of teeth filled using lateral condensation versus vertical compaction (Schilder's technique).

Science.gov (United States)

Aqrabawi, Jamal A

2006-02-15

The purpose of this prospective clinical and radiographic investigation was to assess the treatment results following endodontic therapy of teeth filled with lateral condensation versus teeth filled with vertical compaction of warm gutta-percha. A total of 290 patients were treated using the standardized step-back technique for canal preparation, which were filled with either lateral condensation or vertical compaction in one single session. Five years later, the treatment results were assessed clinically and radiographically and related to the type of the obturation technique using Chi-square analysis. Of the 340 teeth that were reexamined, 160 teeth were filled with lateral condensation, and 180 teeth were filled with vertical condensation. The results showed a significantly higher success rate for the vertical compaction versus the lateral condensation technique of teeth presented with preoperative periapical lesions P<0.04. Regardless of the preoperative periapical status of the teeth, no statistically significant difference was found between the two techniques. The overall success rate of both filling techniques was 80.3%.

Treatment Using the SpyGlass Digital System in a Patient with Hepatolithiasis after a Whipple Procedure.

Science.gov (United States)

Harima, Hirofumi; Hamabe, Kouichi; Hisano, Fusako; Matsuzaki, Yuko; Itoh, Tadahiko; Sanuki, Kazutoshi; Sakaida, Isao

2018-05-23

An 89-year-old man was referred to our hospital for treatment of hepatolithiasis causing recurrent cholangitis. He had undergone a prior Whipple procedure. Computed tomography demonstrated left-sided hepatolithiasis. First, we conducted peroral direct cholangioscopy (PDCS) using an ultraslim endoscope. Although PDCS was successfully conducted, it was unsuccessful in removing all the stones. The stones located in the B2 segment were difficult to remove because the endoscope could not be inserted deeply into this segment due to the small size of the intrahepatic bile duct. Next, we substituted the endoscope with an upper gastrointestinal endoscope. After positioning the endoscope, the SpyGlass digital system (SPY-DS) was successfully inserted deep into the B2 segment. Upon visualizing the residual stones, we conducted SPY-DS-guided electrohydraulic lithotripsy. The stones were disintegrated and completely removed. In cases of PDCS failure, a treatment strategy using the SPY-DS can be considered for patients with hepatolithiasis after a Whipple procedure.

An independent check of treatment plan, prescription and dose calculation as a QA procedure

International Nuclear Information System (INIS)

Duggan, Lisa; Kron, Tomas; Howlett, Stephen; Skov, Annette; O'Brien, Peter

1997-01-01

In many radiotherapy centres where planning for external beam treatments is performed by radiation therapists, the treatment sheet and its calculations are independently checked by staff from a different educational background, typically a radiotherapy physicist. The benefits of this practice were evaluated in a radiotherapy department with two linear accelerators, one combined superficial-orthovoltage unit and one telecaesium unit. Within the 19 months of the investigation period, 2328 checks were performed on the treatment sheets of 1579 patients. In six cases, errors in excess of 5% were detected, which if uncorrected, could potentially have affected local tumour control or caused normal tissue complications. It was found that an independent check of treatment sheets assists in keeping these errors as low as can be achievable in clinical practice, and suggests that treatment sheet checking and in vivo dosimetry play a complementary role in this aim. Independent treatment sheet checking is an important quality assurance (QA) activity, with additional advantages such as improved communication in the department, education of staff and in vivo dosimetry targeting. Therefore the advantages of the procedure seem to outweigh the additional workload of approximately 0.3 full-time staff per 1000 patients per year

Revisiting renovascular imaging for renal sympathetic denervation: current techniques and applications

Energy Technology Data Exchange (ETDEWEB)

Pua, Uei; Tan, Cher Heng [Tan Tock Seng Hospital, Department of Diagnostic Radiology, Singapore (Singapore); Ho, Hee Hwa; Tan, Julian Ko Beng; Ong, Paul Jau Leong [Tan Tock Seng Hospital, Department of Cardiology, Singapore (Singapore)

2014-08-28

Renal sympathetic denervation (RDN) is an emerging technique in the treatment of resistant hypertension, most commonly performed using an endovascular approach. Clinical and anatomical criteria for RDN are well established and imaging plays an integral role in selecting patients with suitable anatomy, procedural planning and device selection. Nevertheless, the current body of literature surrounding imaging related to RDN remains limited. The purpose of this article is to illustrate the expectations and limitations of various imaging techniques, including Doppler ultrasound, CT angiography, MR angiography and newer techniques such as non-contrast MR angiography, in the context of RDN. (orig.)

Revisiting renovascular imaging for renal sympathetic denervation: current techniques and applications

International Nuclear Information System (INIS)

Pua, Uei; Tan, Cher Heng; Ho, Hee Hwa; Tan, Julian Ko Beng; Ong, Paul Jau Leong

2015-01-01

Renal sympathetic denervation (RDN) is an emerging technique in the treatment of resistant hypertension, most commonly performed using an endovascular approach. Clinical and anatomical criteria for RDN are well established and imaging plays an integral role in selecting patients with suitable anatomy, procedural planning and device selection. Nevertheless, the current body of literature surrounding imaging related to RDN remains limited. The purpose of this article is to illustrate the expectations and limitations of various imaging techniques, including Doppler ultrasound, CT angiography, MR angiography and newer techniques such as non-contrast MR angiography, in the context of RDN. (orig.)

Acne Scar Treatment: A Multimodality Approach Tailored to Scar Type.

Science.gov (United States)

Zaleski-Larsen, Lisa A; Fabi, Sabrina G; McGraw, Timothy; Taylor, Mark

2016-05-01

Acne scarring can be classified into atrophic icepick, boxcar, and rolling scars in addition to keloidal and hypertrophic scars. Additionally, these scars can be erythematous, hyperpigmented, and/or hypopigmented. Each scar type has a different structural cause warranting a customized approach. Many cosmetic options exist to address these changes individually, but little literature exists about the safety and efficacy of combining such procedures and devices. A Medline search was performed on combination treatments because it relates to facial acne scarring, and results are summarized. Practical applications for these combinations of procedures are also discussed. Studies examining the efficacy and safety of ablative, nonablative, fractionated, and nonfractionated lasers, dermabrasion, chemical peels, needling, subcision, radiofrequency, stem cell therapy, fat transplantation, platelet-rich plasma, and hyaluronic acid dermal fillers for acne scars were found. The authors review their experience in combining these techniques. Review of the literature revealed multiple single options for facial acne scarring treatment with minimal evidence in the literature found on the safety and efficacy of combining such procedures and devices. The authors' experience is that combining acne scar treatment techniques can be performed safely and synergistically with optimal patient outcomes.

Treatment of postradiation structure of the rectum by the modified Duhamel procedure

Energy Technology Data Exchange (ETDEWEB)

Starr, D.S.; Lawrie, G.M.; Morris, G.C. Jr.

1979-06-01

Benign rectosigmoid stenosis secondary to pelvic radiation presents a difficult problem in management and is usually treated by permanent colostomy with its attendant discomfort and inconvenience. Other approaches include low anterior resection or even transsacral resection of the affected area of rectosigmoid, but they involve risk to rectal, bladder, and sexual function. The Martin modification of the Duhamel procedure is specifically designed to avoid these problems and was used successfully in the present case for treatment of rectosigmoid stenosis. The patient has been followed up 8 years and reports normal sensation and function of bladder and rectum and no disturbance of sexual function.

Difference in temporal lobe dose between two radiotherapy techniques in the treatment of NPC with anterior nasal involvement

International Nuclear Information System (INIS)

Wu, V.W.C.; Luk, J.H.Y.; Wong, S.F.T.; Lam, E.C.H.; Fung, M.C.Y.; Tong, S.M.; Ku, I.K.M.

1997-01-01

Nasopharyngeal carcinoma with anterior extension are treated with special radiotherapy techniques. The purpose of this study is to investigate the difference of temporal lobe dose between two radiotherapy techniques (A and B) which are commonly used in the treatment of such condition in Hong Kong. The study is carried out by performing radiation treatments to a humanoid phantom under simulated conditions of the two techniques. The dose measurement is done by thermoluminescent dosimeters (TLD) which are placed inside the phantom. Both techniques employ a '3-field' arrangement: a heavy-weighted anterior facial fields with two lateral opposing facial fields. The main difference lies in the anterior facial field in which technique A uses electron beam throughout while technique B uses a mixture of photon and electron beams. The results demonstrates that technique A delivers higher dose to temporal lobe than technique B. In a course of radical external beam radiotherapy (66 Gy), the mean dose to inferior temporal lobe are 59.29 Gy in technique A and 34.06 Gy in technique B respectively (p < 0.0001). Furthermore, it is found that the temporal lobe dose difference between the two techniques is mainly due to their phase I treatment. (p < 0.0001 for phase I and p = 0.078 for phase II). (authors)

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

Advances in Aesthetic Therapies: Plasma-Rich Protein Procedure for the Treatment of Alopecia.

Science.gov (United States)

Harrison, Jeanine

Predominance of aesthetic options is growing and evolving to include procedures that have traditionally been much more invasive and fiscally challenging for the average patient. It is not uncommon now for the Canadian consumers to begin to look for lesser invasive options that show results significant enough to improve their appearance but that may not fall under the traditional health care coverage. One area that is evolving quickly is the nonsurgical treatment of hair loss. This is not a new condition, but generally the methods of treatment are not under the current health coverage; therefore, consumers are paying out of pocket to reduce or replace their hair loss. Recently, more options have evolved, and utilizing platelet-rich plasma has become more prevalent as a method to support hair growth and prevent hair loss.

Interventional spine procedures

Energy Technology Data Exchange (ETDEWEB)

Kelekis, A.D. [Attikon University Hospital, 2nd Radiology Department, University of Athens, Rimini 1, 124 61 Athens (Greece)]. E-mail: akelekis@cc.uoa.gr; Somon, T. [Geneva University Hospital, Department of Radiology, Neuroradiology, 24, Rue Micheli-du-Crest, 1211 Geneva 14 (Switzerland); Yilmaz, H. [Geneva University Hospital, Department of Radiology, Neuroradiology, 24, Rue Micheli-du-Crest, 1211 Geneva 14 (Switzerland); Bize, P. [Geneva University Hospital, Department of Radiology, Neuroradiology, 24, Rue Micheli-du-Crest, 1211 Geneva 14 (Switzerland); Brountzos, E.N. [Attikon University Hospital, 2nd Radiology Department, University of Athens, Rimini 1, 124 61 Athens (Greece); Lovblad, K. [Geneva University Hospital, Department of Radiology, Neuroradiology, 24, Rue Micheli-du-Crest, 1211 Geneva 14 (Switzerland); Ruefenacht, D. [Geneva University Hospital, Department of Radiology, Neuroradiology, 24, Rue Micheli-du-Crest, 1211 Geneva 14 (Switzerland); Martin, J.B. [Clinique Generale Beaulieu 12 chemin Beau Soleil 1206 Geneva (Switzerland)]. E-mail: jbmartin@beaulieu.ch

2005-09-01

Minimally invasive techniques for the treatment of some spinal diseases are percutaneous treatments, proposed before classic surgery. By using imaging guidance, one can significantly increase accuracy and decrease complication rates. This review report physiopathology and discusses indications, methods, complications and results of performing these techniques on the spine, including different level (cervical, thoracic, lumbar and sacroiliac) and different kind of treatments (nerve block, disc treatment and bone treatment). Finally the present article also reviews current literature on the controversial issues involved.

A New Sacroiliac Joint Injection Technique and Its Short-Term Effect on Chronic Sacroiliac Region Pain.

Science.gov (United States)

Do, Kyung Hee; Ahn, Sang Ho; Jones, Rodney; Jang, Sung Ho; Son, Su Min; Lee, Dong Gyu; Cho, Hee Kyung; Choi, Gyu Sik; Cho, Yun-Woo

2016-10-01

Sacroiliac joint (SIJ) injections have been used to provide short-term relief of SIJ pain. In this study, the authors investigated a new technique using a superior approach. Twenty four patients with chronic SI joint paint were recruited. Each patient was treated with a single SIJ intra-articular injection plus a periarticular injection of local anesthetic and corticosteroid in one procedure. Technical accuracy of the intra-articular procedure was determined by having 2 independent observers review and rate the quality of arthrograms obtained. Treatment effects were evaluated using a numerical rating scale, the Oswestry disability index (ODI) and global perceived effect (GPE). Both independent observers agreed that satisfactory arthrograms were obtained in all patients. Pain scores and disability were significantly reduced at 2 weeks and 4 weeks after treatment. Nineteen patients (79%) reported satisfaction with treatment. No serious adverse effects were encountered. The superior approach consistently achieves good access to the SI joint, and achieves outcomes that are compatible with those of other techniques. The superior approach constitutes an alternative to other techniques for injections into the SI joint. © 2016 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Radiographic changes in the operative treatment of acute acromioclavicular joint dislocation – tight rope technique vs. K-wire fixation

International Nuclear Information System (INIS)

Horst, Klemens; Dienstknecht, Thomas; Andruszkow, Hagen; Gradl, Gertraud; Kobbe, Philipp; Pape, Hans-Christoph

2013-01-01

Operative treatment of higher degree acromioclavicular joint luxation is common. A new option is made available by the tight rope technique. It claims to provide adequate outcome with the use of a minimally invasive technique. First clinical studies justified its medical use, but the equivalence to established surgical methods remains unclear. We therefore analyzed radiographic data from patients that were treated with the tight rope system (TR) and compared them to those treated with K-wires (KW) fixation. Retrospective study with inclusion criteria: surgery for acromioclavicular joint luxation between 2004 and 2011, classified as Rockwood type III, no concomitant injury, first event injury. We compared pre- and post-operative X-rays with those taken at the end of treatment. Clinical data from follow-ups and radiographic data were evaluated. The main outcome variable was the remaining distance between the acromion and clavicle (ACD), as well as the coracoid process and clavicle (CCD). 27 patients (TR: n=16; KW: n=11) with comparable demographics and injury severity were included. Surgery reduced ACD (TR: p=0.002; KW: p<0.001) and CCD (TR: p=0.001; KW: p=0.003). Heterotopic ossification or postoperative osteolysis was not significantly associated with either one of the procedures. Three patients (18.75%) in the TR group showed impaired wound healing, migrating K-wires were recorded in 2 patients (18.2%) and impingement syndrome occurred in 1 patient (9.1%) with K-wires. Posttraumatic arthritis was not seen. There was a loss of reduction in 2 cases within the TR-group (12.51%) and 1 in the KW-group (9.1%). At last follow up, ACD and CCD were wider in both groups compared to the healthy side. This study shows that the Tight rope system is an effective alternative in the treatment of higher degree acromioclavicular luxation and comparable to the established methods

A technique to obtain a multiparameter radar rainfall algorithm using the probability matching procedure

International Nuclear Information System (INIS)

Gorgucci, E.; Scarchilli, G.

1997-01-01

The natural cumulative distributions of rainfall observed by a network of rain gauges and a multiparameter radar are matched to derive multiparameter radar algorithms for rainfall estimation. The use of multiparameter radar measurements in a statistical framework to estimate rainfall is resented in this paper, The techniques developed in this paper are applied to the radar and rain gauge measurement of rainfall observed in central Florida and central Italy. Conventional pointwise estimates of rainfall are also compared. The probability matching procedure, when applied to the radar and surface measurements, shows that multiparameter radar algorithms can match the probability distribution function better than the reflectivity-based algorithms. It is also shown that the multiparameter radar algorithm derived matching the cumulative distribution function of rainfall provides more accurate estimates of rainfall on the ground in comparison to any conventional reflectivity-based algorithm

Office-based procedures for diagnosis and treatment of esophageal pathology.

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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.

Treatment of complex electroplating waste by 'zero discharge' technique

International Nuclear Information System (INIS)

Khattak, B.Q.; Ram Sankar, P.; Jain, A.K.

2009-01-01

Surface treatment processes generate lot of liquid waste, which contains toxic substances and are potentially harmful to the living beings. It is extremely difficult to treat the pollutants where processes and frequencies are not fixed. In Chemical Treatment Facility of RRCAT, surface treatment processes are user dependent and makes the electroplating waste very complicated. Initially the waste was treated by simple chemical transformation technique in which heavy metal ions are converted to hydroxide precipitates. Non metallic ions that contribute much to the plating waste could not be treated by this process. To remove maximum possible pollutants, many experiments were conducted on the laboratory scale. Based on those results, a pilot ion exchange plant of various resins was introduced in the process to achieve disposal quality effluent. Anionic load of Phosphate, Nitrate and fluoride caused frequent anionic bed exhaustions and polymeric network damaging. To avoid this phenomenon a new setup was designed. This pre treatment has the capacity to treat 500 litres per hour connected to a platter with clarifier followed by high pressure carbon and pebbles filters. Analysis of these ions was carried out on the advanced ion chromatography system and is found free of toxic metals, phosphate and fluoride. This effluent can be reused by adding a reverse osmosis system followed by ion exchange system to produce good quality de mineralized water needed for surface treatment activities. In this paper we describe the existing status of effluent treatment facility and future plans for achieving 'zero discharge'. (author)

Fiberoptic endoscopic-assisted diverticulotomy: a novel technique for the management of Zenker's diverticulum.

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Altman, Jason I; Genden, Eric M; Moche, Jason

2005-05-01

Endoscopic diverticulotomy is rapidly becoming the procedure of choice for treatment of Zenker's diverticulum. The endoscopic approach has resulted in significant decreases in patient morbidity, time to resumption of oral intake, and overall cost as compared with open treatment. However, a small but significant patient population is unable to accommodate the rigid laryngoscope and therefore requires open treatment. We present a novel technique, flexible fiberoptic endoscopic-assisted diverticulotomy, for the management of patients who are unable to undergo rigid endoscopy.

A novel technique for presurgical nasoalveolar molding using computer-aided reverse engineering and rapid prototyping.

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Yu, Quan; Gong, Xin; Wang, Guo-Min; Yu, Zhe-Yuan; Qian, Yu-Fen; Shen, Gang

2011-01-01

To establish a new method of presurgical nasoalveolar molding (NAM) using computer-aided reverse engineering and rapid prototyping technique in infants with unilateral cleft lip and palate (UCLP). Five infants (2 males and 3 females with mean age of 1.2 w) with complete UCLP were recruited. All patients were subjected to NAM before the cleft lip repair. The upper denture casts were recorded using a three-dimensional laser scanner within 2 weeks after birth in UCLP infants. A digital model was constructed and analyzed to simulate the NAM procedure with reverse engineering software. The digital geometrical data were exported to print the solid model with rapid prototyping system. The whole set of appliances was fabricated based on these solid models. Laser scanning and digital model construction simplified the NAM procedure and estimated the treatment objective. The appliances were fabricated based on the rapid prototyping technique, and for each patient, the complete set of appliances could be obtained at one time. By the end of presurgical NAM treatment, the cleft was narrowed, and the malformation of nasoalveolar segments was aligned normally. We have developed a novel technique of presurgical NAM based on a computer-aided design. The accurate digital denture model of UCLP infants could be obtained with laser scanning. The treatment design and appliance fabrication could be simplified with a computer-aided reverse engineering and rapid prototyping technique.

A PILOT PROJECT FOR THE DEVELOPMENT OF EDUCATIONAL RESEARCH TECHNIQUES AND PROCEDURES SUITABLE FOR THE MEASUREMENT OF INSTITUTIONAL STABILITY AND CHANGE.

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TURNEY, DAVID T.

THE PROBLEM INVESTIGATED IN THIS STUDY INVOLVED THE DEVELOPMENT OF TECHNIQUES AND PROCEDURES THAT COULD YIELD MEASURES OF INSTITUTIONAL STABILITY AND CHANGE ALONG A TIME CONTINUUM. THE STUDY FOCUSED ON THE PUPILS AND TEACHERS IN THE UNIVERSITY SCHOOL OF KENT STATE UNIVERSITY (658 PUPILS IN KINDERGARTEN CLASSES THROUGH GRADE 12 AND 29 INSTRUCTORS).…

The relationship between parental catastrophizing about child pain and distress in response to medical procedures in the context of childhood cancer treatment: a longitudinal analysis.

Science.gov (United States)

Caes, Line; Goubert, Liesbet; Devos, Patricia; Verlooy, Joris; Benoit, Yves; Vervoort, Tine

2014-08-01

Children with leukemia frequently undergo invasive medical procedures, such as lumbar punctures (LPs) and bone marrow aspirations (BMAs). To date, cross-sectional evidence indicates that LP/BMA procedures continue to elicit distress over the course of treatment in children and parents. The current study used prospective analyses investigating in 28 children diagnosed with leukemia, the course of parental and child distress when confronted with consecutive LP/BMA procedures and potential moderation by catastrophic thinking. Parents' level of catastrophic thoughts was assessed before the first treatment-related LP/BMA, while child and parent distress was reported on after each LP/BMA procedure. Whereas parental distress decreased over time among low catastrophizing parents, LP/BMA procedures remained highly distressing for high catastrophizing parents. Child distress during LP/BMA procedures increased over time and was positively related with parental distress. These findings stress the importance of targeting child and parent distress as early as possible in treatment. © The Author 2014. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Tests for qualitative treatment-by-centre interaction using a 'pushback' procedure.

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Ciminera, J L; Heyse, J F; Nguyen, H H; Tukey, J W

1993-06-15

In multicentre clinical trials using a common protocol, the centres are usually regarded as being a fixed factor, thus allowing any treatment-by-centre interaction to be omitted from the error term for the effect of treatment. However, we feel it necessary to use the treatment-by-centre interaction as the error term if there is substantial evidence that the interaction with centres is qualitative instead of quantitative. To make allowance for the estimated uncertainties of the centre means, we propose choosing a reference value (for example, the median of the ordered array of centre means) and converting the individual centre results into standardized deviations from the reference value. The deviations are then reordered, and the results 'pushed back' by amounts appropriate for the corresponding order statistics in a sample from the relevant distribution. The pushed-back standardized deviations are then restored to the original scale. The appearance of opposite signs among the destandardized values for the various centres is then taken as 'substantial evidence' of qualitative interaction. Procedures are presented using, in any combination: (i) Gaussian, or Student's t-distribution; (ii) order-statistic medians or outward 90 per cent points of the corresponding order statistic distributions; (iii) pooling or grouping and pooling the internally estimated standard deviations of the centre means. The use of the least conservative combination--Student's t, outward 90 per cent points, grouping and pooling--is recommended.

Evaluation of improved techniques for the removal of 90Sr and 137Cs from process wastewater and groundwater: Chabazite zeolite baseline study

International Nuclear Information System (INIS)

Bostick, D.T.; Arnold, W.D. Jr.; Taylor, P.A.; McTaggart, D.R.; Burgess, M.W.; Guo, B.

1995-04-01

Standard waste treatment procedures for the removal of 90 Sr and 137 Cs from contaminated groundwater and process wastewaters generate large volumes of secondary contaminated wastes. Several new sorbent materials, ion exchangers, and other processes hold the promise of treating large volumes of contaminated water while minimizing the generation of secondary low-level radioactive wastes. As part of the Efficient Separations/Processes-Integrated Program (ESPIP), these new treatment techniques will be compared with standard processes to define their effectiveness for the removal of radioactive strontium (Sr) and cesium (Cs), as well as to gauge the quantity of secondary radioactive waste generated by the new processes. This report summarizes the efforts made to design standardized testing procedures to evaluate the sorption characteristics of a baseline wastewater treatment technique. Definition of the experimental procedures, as well as a summary of the benchmark sorption technique, will provide the framework with which to compare newly evolving treatment technologies. Accomplishments include selecting the feed strewn to the Process Waste Treatment Plant (PWTP) at Oak Ridge National Laboratory as representative of the prototypical contaminated wastewater of many DOE sites. Samples from the PWTP feed stream were collected and analyzed for metals, anions, total Sr and Cs, radioactive Sr and Cs, alkalinity, pH, and density. The cumulative sample data were used to formulate a simulant that will be used as a standard waste surrogate for comparative testing of selected treatment methods

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

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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

Comparison between suture anchor and transosseous suture for the modified-Broström procedure.

Science.gov (United States)

Cho, Byung-Ki; Kim, Yong-Min; Kim, Dong-Soo; Choi, Eui-Sung; Shon, Hyun-Chul; Park, Kyoung-Jin

2012-06-01

This prospective, randomized study was conducted to compare clinical outcomes of the modified Broström procedure using suture anchor or transosseous suture technique for chronic ankle instability. Forty patients were followed for more than 2 years after modified Broström procedure. Twenty procedures using a suture anchor and 20 procedures using a transosseous suture were performed by one surgeon. The clinical evaluation consisted of the Karlsson scale and the Sefton grading system. Talar tilt and anterior talar translation were measured on anterior and varus stress radiographs. The Karlsson scale had improved significantly to 90.8 points in the suture anchor group, and to 89.2 points in the transosseous suture group. According to Sefton grading system, 18 patients (90%) in suture anchor group and 17 patients (85%) in transosseous suture group achieved satisfactory results. The talar tilt angle and anterior talar translation improved significantly to 5.9 degrees and 4.2 mm in suture anchor group, and to 5.4 degrees and 4.1 mm in transosseous suture group, respectively. No significant differences existed in clinical and functional outcomes between the two techniques for ligament reattachment. Both modified Broström procedures using the suture anchor and transosseous suture seem to be effective treatment methods for chronic lateral ankle instability.

Radiological protection in a patient during a total body irradiation procedure

International Nuclear Information System (INIS)

Hernandez O, J. O.; Hinojosa G, J.; Gomez M, E.; Balam de la Vega, J. A.; Deheza V, J. C.

2010-09-01

A technique used in the Service of Radiotherapy of the Cancer Center of the American British Cowdray Medical Center (ABC) for the bone marrow transplantation, is the total body irradiation. It is known that the dose calculation, for this irradiation type, is old, since the dosimetric calculation is carried out by hand and they exist infinity of techniques for the patients irradiation and different forms of protecting organs of risk, as well as a great uncertainty in the given dose. In the Cancer Center of the ABC Medical Center, was carried out an irradiation procedure to total body with the following methodology: Computerized tomography of the patient total body (two vacuum mattresses in the following positions: dorsal and lateral decubitus), where is combined the two treatment techniques anterior-posterior and bilateral, skin delineate and reference volumes, dose calculation with the planning system Xi O of CMS, dose determination using an ionization chamber and a lung phantom IMRT Thorax Phantom of the mark CIRS and dosimetry in vivo. In this work is presented the used treatment technique, the results, statistics and the actualization of the patient clinical state. (Author)

The feasibility of using Pareto fronts for comparison of treatment planning systems and delivery techniques

International Nuclear Information System (INIS)

Ottosson, Rickard O.; Sjoestroem, David; Behrens, Claus F.; Karlsson, Anna; Engstroem, Per E.; Knoeoes, 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 and 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

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.

A new procedure for the treatment of an industrial waste containing flotation reagents

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Milosavljević Milutin M.

2014-01-01

Full Text Available Flotation reagents can be transformed to industrial waste if they are stored for a long period of time. Also, if synthesis or drying process is not performed under defined conditions in industrial plants, which produce flotation reagents, batch of waste may arise and be stored as a waste. The chemical composition of this waste depends on the phase in which it was created, but typically includes: unreacted alkali hydroxide, solvent - alcohol and trithiocarbonate and oxidation product - dixanthogenate. In this paper a new laboratory procedure for the treatment of such wastes is described. The identification and separation of industrial waste components is also included. From the separated dixantogenate and xanthate a laboratory synthesis of thioncarbamates is given. In addition, a semi-industrial treatment of waste xanthate is presented. Synthesis of N-alkyl and N,N-dialkyl-O-isobutylthioncarbamates were obtained from the filtrate obtained in the first step. As a by-product, sodium thioglycolate was produced. This by-product is transformed to a thioglycolic acid by the addition of an acid. Also, the synthesis of thioncarbamates from dixanthogenates, isolated from industrial waste as a cake, is desribed. Described waste treatment is additionally interesting due to the production of sulphur as another by-product. Laboratory synthesis gave thioncarbamates in yields from 69.7 to 87.7 %, while the semi-industrial process for the selected batches produced thioncarbamates in yields from 74.2 to 80.5 %. Taking into account the importance of the synthesized compounds as selective flotation reagents, a new procedure of their synthesis from industrial waste is characterized by good yields and purity of the obtained compounds, the simplicity of process, low environmental impact and short reaction times of synthesis. [Projekat Ministarstva nauke Republike Srbije, br. III 43007

Research on monitoring and management information integration technique in waste treatment and management

International Nuclear Information System (INIS)

Kong Jinsong; Yu Ren; Mao Wei

2013-01-01

The integration of the waste treatment process and the device status monitoring information and management information is a key problem required to be solved in the information integration of the waste treatment and management. The main content of the monitoring and management information integration is discussed in the paper. The data exchange techniques, which are based on the OPC, FTP and data push technology, are applied to the different monitoring system respectively, according to their development platform, to realize the integration of the waste treatment process and device status monitoring information and management information in a waste treatment center. (authors)

Current status of laparoendoscopic rendezvous in the treatment of cholelithiasis with concomitant choledocholithiasis.

Science.gov (United States)

Baloyiannis, Ioannis; Tzovaras, George

2015-06-25

The current evidence in favor of the laparoendoscopic rendezvous is promising and demonstrates the main advantages of this technique in regard to shorter hospital stay and selective cannulation of the common bile duct (CBD), avoiding thus the inadvertent cannulation of the pancreatic duct. In addition, in the rendezvous technique the contrast medium is not injected retrogradely as during the traditional endoscopic retrograde cholangiopancreatography (ERCP), when the medium accidentally could be injected under pressure into the pancreatic duct. The RV technique minimizes that risk. Both these main advantages of the RV technique over the classic ERCP, are related with a significant lower incidence of hyperamylasemia and post-ERCP pancreatitis, compared with the traditional two stage procedure. Choledocholithiasis is present in 10% to 15% of patients undergoing cholecystectomy. To date, the ideal management of CBD stones remains controversial. Prospective randomized trials have shown that laparoscopic management of the CBD stones, as a single stage procedure, is the most efficient and cost effective method of treatment. Laparoendoscopic rendezvous has been proposed as an alternative single stage approach. Several studies have shown the effective use of this technique in the treatment of CBD stones by improving patient compliance and clinical results including shorter hospital stay, higher success rate and less cost. The current evidence about the use of this technique presented in this review article is promising and demonstrates the main advantages of the procedure.

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

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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

Anesthesia for radiologic procedures

International Nuclear Information System (INIS)

Forestner, J.E.

1987-01-01

Anesthetic techniques for neurodiagnostic studies and radiation therapy have been recently reviewed, but anesthetic involvement in thoracic and abdominal radiology has received little attention. Patient reactions to radiologic contrast media may be of concern to the anesthesiologist, who is often responsible for injecting these agents during diagnostic procedures, and thus is included in this discussion. Finally, the difficulties of administering anesthesia for magnetic resonance imaging (MRI) scans are outlined, in an effort to help anesthesiologist to anticipate problems with this new technologic development. Although there are very few indications for the use of general anesthesia for diagnostic radiologic studies in adults, most procedures performed with children, the mentally retarded, or the combative adult require either heavy sedation or general anesthesia. In selecting an anesthetic technique for a specific procedure, both the patient's disease process and the requirements of the radiologist must be carefully balanced

Reverse waffle cone technique in management of stent dislodgement into intracranial aneurysms.

Science.gov (United States)

Luo, Chao-Bao; Lai, Yen-Jun; Teng, Michael Mu-Huo; Chang, Feng-Chi; Lin, Chung-Jung; Guo, Wan-Yuo

2013-09-01

Stent-assisted coil embolization (SACE) is a common method to manage intracranial wide-neck aneurysm. Using this technique, a stent must be successfully deployed into the parent artery to cross the aneurysm neck. We describe the reverse waffle cone technique in management of intra-procedural stent dislodgement during SACE of internal carotid artery (ICA) wide-neck aneurysms. Two patients with unruptured wide-neck ICA aneurysms underwent SACE. Intra-procedural forward stent migration occurred during catheterization with proximal stent dislodgement and migration into the aneurysm sac. Navigation of a second stent to bridge the aneurysm neck failed in one patient because the second stent was impeded by the dislodged stent. Using the reverse waffle cone technique, a microcatheter was navigated into the aneurysm sacs. Coils were safely detached into each aneurysm sac without any device assistance. The two wide-neck aneurysms were successfully treated with preservation of flow to the internal carotid arteries. The complication of intra-procedural distal stent migration and dislodgement, with proximal stent prolapse into an aneurysm sac, may not result in a failure to coil the aneurysm. The reverse waffle cone technique provides an effective treatment in the management of this complication. Copyright © 2013 Elsevier Ltd. All rights reserved.

Transobturator tension-free “inside-to-out” suburethral sling procedure for the treatment of stress urinary incontinence

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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.

ECSPECT prospective multicentre registry for single-port laparoscopic colorectal procedures

DEFF Research Database (Denmark)

Weiss, Helmut; Zorron, R; Vestweber, K-H

2017-01-01

BACKGROUND: The international multicentre registry ECSPECT (European Consensus of Single Port Expertise in Colorectal Treatment) was established to evaluate the general feasibility and safety of single-port colorectal surgery with regard to preoperative risk assessment. METHODS: Consecutive...... patients undergoing single-port colorectal surgery were enrolled from 11 European centres between March 2010 and March 2014. Data were analysed to assess patient-, technique- and procedure-dependent parameters. A validated sex-adjusted risk chart was developed for prediction of single-port colorectal...

Fabrication techniques to eliminate postweld heat treatment

International Nuclear Information System (INIS)

Lochhead, J.C.

1978-01-01

Postweld heat treatments to reduce residual stresses (stress relief operations) have been a common practice in the pressure vessel industry for a large number of years. A suitable heat treatment operation can, in particular for low alloy steels, have additional beneficial effects, i.e. a reduction in peak hardness values in the heat-affected zone, an improvement in weld metal properties, and a lowering of the adverse effects of the welding process on the mechanical properties of the parent material adjacent to the weld metal. However, continuing studies in the field of brittle fracture, improved parent materials, and more sophisticated nondestructive testing techniques have led to the elimination of such a practice in ever-increasing thickness ranges and types of material. For instance, the recently issued BS 5500 compared with BS 1113 (1969) lifts the thickness limit requiring stress relief in certain circumstances from 19 to 35mm for C steels. With respect to materials the CEGB has stated that as a result of successful operational experience it will no longer be necessary to postweld heat treat butt welds in 2 1/4 Cr-1Mo tubes of certain dimensions. Despite this trend, over a period of years a number of instances have arisen where, because of some factor, postweld heat treatment, although perhaps desirable, is not possible. This Paper describes several such examples. It must be noted that the examples quoted consist of relatively important and major items. It has been necessary within the confines of this Paper to condense the reports. It is hoped that no significant factors have been omitted. (author)

Difference in temporal lobe dose between two radiotherapy techniques in the treatment of NPC with anterior nasal involvement

Energy Technology Data Exchange (ETDEWEB)

Wu, V.W.C.; Luk, J.H.Y.; Wong, S.F.T.; Lam, E.C.H.; Fung, M.C.Y.; Tong, S.M.; Ku, I.K.M. [Hong Kong Polytechnic University, Hong Kong, (Hong Kong). Department of Radiography and Optometry

1997-04-01

Nasopharyngeal carcinoma with anterior extension are treated with special radiotherapy techniques. The purpose of this study is to investigate the difference of temporal lobe dose between two radiotherapy techniques (A and B) which are commonly used in the treatment of such condition in Hong Kong. The study is carried out by performing radiation treatments to a humanoid phantom under simulated conditions of the two techniques. The dose measurement is done by thermoluminescent dosimeters (TLD) which are placed inside the phantom. Both techniques employ a `3-field` arrangement: a heavy-weighted anterior facial fields with two lateral opposing facial fields. The main difference lies in the anterior facial field in which technique A uses electron beam throughout while technique B uses a mixture of photon and electron beams. The results demonstrates that technique A delivers higher dose to temporal lobe than technique B. In a course of radical external beam radiotherapy (66 Gy), the mean dose to inferior temporal lobe are 59.29 Gy in technique A and 34.06 Gy in technique B respectively (p < 0.0001). Furthermore, it is found that the temporal lobe dose difference between the two techniques is mainly due to their phase I treatment. (p < 0.0001 for phase I and p = 0.078 for phase II). (authors). 14 refs., 3 tabs., 6 figs.

Treatment of alumina refinery waste (red mud) through neutralization techniques: A review.

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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, CO 2 , 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.

Surgery without papilla incision: tunneling flap procedures in plastic periodontal and implant surgery.

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Zuhr, Otto; Rebele, Stephan F; Cheung, Stefani L; Hürzeler, Markus B

2018-06-01

Diverse clinical advancements, together with some relevant technical innovations, have led to an increase in popularity of tunneling flap procedures in plastic periodontal and implant surgery in the recent past. This trend is further promoted by the fact that these techniques have lately been introduced to a considerably expanded range of indications. While originally described for the treatment of gingival recession-type defects, tunneling flap procedures may now be applied successfully in a variety of clinical situations in which augmentation of the soft tissues is indicated in the esthetic zone. Potential clinical scenarios include surgical thickening of thin buccal gingiva or peri-implant mucosa, alveolar ridge/socket preservation and implant second-stage surgery, as well as soft-tissue ridge augmentation or pontic site development. In this way, tunneling flap procedures developed from a technique, originally merely intended for surgical root coverage, into a capacious surgical conception in plastic periodontal and implant surgery. The purpose of this article is to provide a comprehensive overview on tunneling flap procedures, to introduce the successive development of the approach along with underlying ideas on surgical wound healing and to present contemporary clinical scenarios in step-by-step photograph-illustrated sequences, which aim to provide clinicians with guidance to help them integrate tunneling flap procedures into their daily clinical routine. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Efficacy of Manual Therapy Including Neurodynamic Techniques for the Treatment of Carpal Tunnel Syndrome: A Randomized Controlled Trial.

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Wolny, Tomasz; Saulicz, Edward; Linek, Paweł; Shacklock, Michael; Myśliwiec, Andrzej

2017-05-01

The purpose of this randomized trial was to compare the efficacy of manual therapy, including the use of neurodynamic techniques, with electrophysical modalities on patients with mild and moderate carpal tunnel syndrome (CTS). The study included 140 CTS patients who were randomly assigned to the manual therapy (MT) group, which included the use of neurodynamic techniques, functional massage, and carpal bone mobilizations techniques, or to the electrophysical modalities (EM) group, which included laser and ultrasound therapy. Nerve conduction, pain severity, symptom severity, and functional status measured by the Boston Carpal Tunnel Questionnaire were assessed before and after treatment. Therapy was conducted twice weekly and both groups received 20 therapy sessions. A baseline assessment revealed group differences in sensory conduction of the median nerve (P < .01) but not in motor conduction (P = .82). Four weeks after the last treatment procedure, nerve conduction was examined again. In the MT group, median nerve sensory conduction velocity increased by 34% and motor conduction velocity by 6% (in both cases, P < .01). There was no change in median nerve sensory and motor conduction velocities in the EM. Distal motor latency was decreased (P < .01) in both groups. A baseline assessment revealed no group differences in pain severity, symptom severity, or functional status. Immediately after therapy, analysis of variance revealed group differences in pain severity (P < .01), with a reduction in pain in both groups (MT: 290%, P < .01; EM: 47%, P < .01). There were group differences in symptom severity (P < .01) and function (P < .01) on the Boston Carpal Tunnel Questionnaire. Both groups had an improvement in functional status (MT: 47%, P < .01; EM: 9%, P < .01) and a reduction in subjective CTS symptoms (MT: 67%, P < .01; EM: 15%, P < .01). Both therapies had a positive effect on nerve conduction, pain reduction, functional status, and subjective symptoms in

Robotic-assisted transperitoneal nephron-sparing surgery for small renal masses with associated surgical procedures: surgical technique and preliminary experience.

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Ceccarelli, Graziano; Codacci-Pisanelli, Massimo; Patriti, Alberto; Ceribelli, Cecilia; Biancafarina, Alessia; Casciola, Luciano

2013-09-01

Small renal masses (T1a) are commonly diagnosed incidentally and can be treated with nephron-sparing surgery, preserving renal function and obtaining the same oncological results as radical surgery. Bigger lesions (T1b) may be treated in particular situations with a conservative approach too. We present our surgical technique based on robotic assistance for nephron-sparing surgery. We retrospectively analysed our series of 32 consecutive patients (two with 2 tumours and one with 4 bilateral tumours), for a total of 37 robotic nephron-sparing surgery (RNSS) performed between June 2008 and July 2012 by a single surgeon (G.C.). The technique differs depending on tumour site and size. The mean tumour size was 3.6 cm; according to the R.E.N.A.L. Nephrometry Score 9 procedures were considered of low, 14 of moderate and 9 of hight complexity with no conversion in open surgery. Vascular clamping was performed in 22 cases with a mean warm ischemia time of 21.5 min and the mean total procedure time was 149.2 min. Mean estimated blood loss was 187.1 ml. Mean hospital stay was 4.4 days. Histopathological evaluation confirmed 19 cases of clear cell carcinoma (all the multiple tumours were of this nature), 3 chromophobe tumours, 1 collecting duct carcinoma, 5 oncocytomas, 1 leiomyoma, 1 cavernous haemangioma and 2 benign cysts. Associated surgical procedures were performed in 10 cases (4 cholecystectomies, 3 important lyses of peritoneal adhesions, 1 adnexectomy, 1 right hemicolectomy, 1 hepatic resection). The mean follow-up time was 28.1 months ± 12.3 (range 6-54). Intraoperative complications were 3 cases of important bleeding not requiring conversion to open or transfusions. Regarding post-operative complications, there were a bowel occlusion, 1 pleural effusion, 2 pararenal hematoma, 3 asymptomatic DVT (deep vein thrombosis) and 1 transient increase in creatinine level. There was no evidence of tumour recurrence in the follow-up. RNSS is a safe and feasible technique

Basic science and surgical treatment options for articular cartilage injuries of the knee.

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Tetteh, Elizabeth S; Bajaj, Sarvottam; Ghodadra, Neil S

2012-03-01

The complex structure of articular cartilage allows for diverse knee function throughout range of motion and weight bearing. However, disruption to the structural integrity of the articular surface can cause significant morbidity. Due to an inherently poor regenerative capacity, articular cartilage defects present a treatment challenge for physicians and therapists. For many patients, a trial of nonsurgical treatment options is paramount prior to surgical intervention. In instances of failed conservative treatment, patients can undergo an array of palliative, restorative, or reparative surgical procedures to treat these lesions. Palliative methods include debridement and lavage, while restorative techniques include marrow stimulation. For larger lesions involving subchondral bone, reparative procedures such as osteochondral grafting or autologous chondrocyte implantation are considered. Clinical success not only depends on the surgical techniques but also requires strict adherence to rehabilitation guidelines. The purpose of this article is to review the basic science of articular cartilage and to provide an overview of the procedures currently performed at our institution for patients presenting with symptomatic cartilage lesions.

Urethral bulking agents versus other surgical procedures for the treatment of female stress urinary incontinence: a systematic review and meta-analysis.

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Leone Roberti Maggiore, Umberto; Bogani, Giorgio; Meschia, Michele; Sorice, Paola; Braga, Andrea; Salvatore, Stefano; Ghezzi, Fabio; Serati, Maurizio

2015-06-01

Bulking agents provide an alternative option in the management of women with stress urinary incontinence and they seem to have an important role in the management flow chart of SUI. However, evidence on this issue is scanty. The most important aspect is to understand whether bulking agents are comparable with the other first-line anti-incontinence surgical procedure (MUS, Burch colposuspension and pubovaginal slings). Hence, the primary aim of the current review was to assess the objective and subjective outcomes of bulking agents in comparison with the other surgical procedures for the treatment of SUI. PubMed and Medline were systematically searched and we included studies evaluating the use of bulking agents in comparison with other surgical approaches for either primary or recurrent treatment of female SUI. Three studies meeting the inclusion criteria were identified. Two of these studies were RCTs evaluating the use of bulking agents versus other surgical procedures for the treatment of primary female SUI; the remnant article was a retrospective cohort study that compared the effectiveness and safety of repeat midurethral sling with urethral bulking after failed midurethral sling. The combined results of all analyses showed that the objective recurrence rate of peri- or trans-urethral injections is significantly higher in comparison with the other surgical procedures. Similar findings were observed when considering separately the treatment for primary or recurrent SUI. Furthermore, lower subjective recurrence rate was observed among patients undergoing other surgical treatment in comparison with those undergoing bulking agents; however, this trend was not statistically significant. Moreover, patients undergoing injection of bulking agents experienced a lower rate of voiding dysfunctions in comparison to the control group. According to current evidence, bulking agents should not be proposed as first-line treatment in those women seeking permanent cure for both

Radiosurgical fistulotomy; an alternative to conventional procedure in fistula in ano.

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Gupta, Pravin J

2003-01-01

Most surgeons continue to prefer the classic lay open technique [fistulotomy] as the gold standard of treatment in anal fistula. In this randomized study, a comparison is made between conventional fistulotomy and fistulotomy performed by a radio frequency device. One hundred patients of low anal fistula posted for fistulotomy were randomized prospectively to either a conventional or radio frequency technique. Parameters measured included time taken for the procedure, amount of blood loss, postoperative pain, return to work, and recurrence rate. The patient demographic was comparable in 2 groups. The radio frequency fistulotomy was quicker as compared to a conventional one [22 versus 37 minutes, p = 0.001], amount of bleeding was significantly less [47 ml versus 134 ml, p = 0.002], and hospital stay was less when patient was operated by radio frequency method [37 hours versus 56 hours in conventional method, p = 0.001]. The postoperative pain in the first 24 hours was more in conventional group [2 to 5 versus 0 to 3 on visual analogue scale]. The patients from radio frequency group resumed their duties early with a reduced healing period of the wounds [47 versus 64 days, p = 0.01]. The recurrence or failure rates were comparable in the radio frequency and conventional groups [2% versus 6%]. Fistulotomy procedure using a radio frequency technique has significant advantages over a conventional procedure with regard to operation time, blood loss, return to normal activity, and healing time of the wound.

Treatment of edentulism: optimizing outcomes with tissue management and impression techniques.

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Salinas, Thomas J

2009-02-01

Significant numbers of patients throughout the world seek treatment for edentulism. The trend toward tissue-integrated prostheses has been a monumental step in restoring edentulous patients to function; however, this treatment can be out of reach for those who fail to qualify or those who do not have sufficient resources to afford it. In these cases, conventional dentures remain an important primary course of treatment. Attention to detail when diagnosing, treatment planning, and performing treatment for these patients is still a prime consideration for the best possible outcome. In particular, many experienced denture wearers are afflicted with chronically inflamed denture-bearing mucosa. Clinicians must recognize the need for tissue conditioning, choices of impression materials, and accepted fabrication techniques that can have favorable outcomes when matched with patients who are philosophical and realistic in their expectations. The purpose of this article is to review impression philosophies, associated materials, and methods of tissue conditioning. Retention and stability of the denture bases can be augmented by the routine use of denture adhesive, and indications for use of denture adhesive will be discussed.

RECONSTRUCTION OF ATROPHIC MAXILLA BY ANTERIOR ILIAC CREST BONE GRAFTING VIA NEUROAXIAL BLOCKADE TECHNIQUE: A CASE REPORT

Directory of Open Access Journals (Sweden)

Erol CANSIZ

2017-01-01

Full Text Available Anterior iliac crest bone grafting is a well-established modality in the treatment of alveolar bone deficiencies. However, this procedure may also have considerable postoperative morbidity which is mostly related to general anesthesia. Postoperative pain-related complications can be managed by neuroaxial blockade techniques which provide adequate surgical analgesia and reduce postoperative pain. This clinical report describes the reconstruction of a severely atrophic maxilla with anterior iliac crest bone grafting using combined spinal epidural anesthesia. Neuroaxial blockade techniques may be a useful alternative to eliminate general anesthesia related challenges of anterior iliac crest bone grafting procedures.