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Sample records for techniques treatment procedures

  1. Extended Resin Composite Restorations: Techniques and Procedures

    NARCIS (Netherlands)

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

    2016-01-01

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

  2. Core calculational techniques and procedures

    International Nuclear Information System (INIS)

    Romano, J.J.

    1977-10-01

    Described are the procedures and techniques employed by B and W in core design analyses of power peaking, control rod worths, and reactivity coefficients. Major emphasis has been placed on current calculational tools and the most frequently performed calculations over the operating power range

  3. Comparison between primary closure with karydakis's technique versus open procedure in treatment of pilonidal sinus in terms of frequency of postoperative wound infection

    International Nuclear Information System (INIS)

    Nafees, A.U.A.; Ahmed, M.

    2013-01-01

    Objective: The purpose of this study is to compare between primary closure with Karydakis's technique versus open procedure in treatment of pilonidal sinus in terms of frequency of postoperative wound infection. Study Design: Randomized Clinical Trials (RCT). Place and Duration of Study: This study was carried out at Department of Surgery, CMH, Kharian over a period of 2 years from Sept 2010 to Oct 2012. Patients and Methods: Sixty patients were selected out of which 30 patients underwent open excision and secondary healing and 30 patients underwent Karydakis procedure. Post operatively these patients were observed for wound infection on date of discharge and weeks 1, 2 and 3. Results of both groups were compared for wound infection by applying chi-square test. Results: There was no statistically significant difference in the frequency of infection between the two groups when calculated during the complete course of study. Conclusion: Primary closure with Karydakis's technique and open procedure are satisfactory surgical procedures for pilonidal sinus disease in terms of post-operative wound infection. (author)

  4. Laboratory rat procedural techniques: manual and DVD

    National Research Council Canada - National Science Library

    Bogdanske, John J

    2011-01-01

    .... The manual contains handouts with color illustrations and descriptive text for each technique, including the purpose and application of the procedure, recommended skills, and necessary supplies...

  5. Laboratory mouse procedural techniques: manual and DVD

    National Research Council Canada - National Science Library

    Bogdanske, John J

    2011-01-01

    .... The manual contains handouts with color illustrations and descriptive text for each technique, including the purpose and application of the procedure, recommended skills, and necessary supplies...

  6. Techniques of Wastewater Treatment

    Indian Academy of Sciences (India)

    need and importance of wastewater treatment and conven- tional methods of treatment. Currently the need is to develop low power consuming and yet effective techniques to handle complex wastes. As a result, new and ... ered as supplying energy to make an active oxidizable species of the pollutants. Generally speaking ...

  7. Techniques of Wastewater Treatment

    Indian Academy of Sciences (India)

    Home; Journals; Resonance – Journal of Science Education; Volume 5; Issue 12. Techniques of Wastewater Treatment - Future Technologies. Amol A Kulkarni Mugdha ... Chemical Engineering Division, University Department of Chemical Technology, Nathalal Parik Marg, Matunga, Mumbai 400 019, India. Chemical ...

  8. Commissioning of radiotherapy treatment planning systems: Testing for typical external beam treatment techniques. Report of the Coordinated Research Project (CRP) on Development of Procedures for Quality Assurance of Dosimetry Calculations in Radiotherapy

    International Nuclear Information System (INIS)

    2008-01-01

    users at the hospitals. Commissioning is one of the most important parts of the entire QA programme for both the RTPS and the planning process. Commissioning involves testing of system functions, documentation of the different capabilities and verification of the ability of the dose calculation algorithms to reproduce measured dose calculations. The current report is limited to treatment simulation tests for external high-energy photon beams that are performed prior to clinical use of RTPS. The report deals with the verification of the dose calculations through commissioning tests that cover typical treatment techniques only. This report also summarizes the results of a pilot study of the clinical commissioning recommendations that was performed by the participants of the Coordinated Research Project at their home institutions. The summary of the pilot study is available to medical physicists as an example of the implementation of the clinical commissioning procedures for RTPSs at their hospitals. Issues related to intensity modulated radiation therapy (IMRT) or other specialized techniques such as stereotactic radiosurgery are not addressed in this clinical commissioning report. While recognizing the specific scope of this report, this publication is useful to the purchasers of RTPSs in any country although they may have to perform tests beyond those described in this report to meet the needs of specialized techniques that have not been addressed here

  9. 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.

  10. Report on COTECH test procedure and characterization techniques

    DEFF Research Database (Denmark)

    Islam, Mohammad Aminul

    .Characterization techniques and test procedure requirements for innovative self-ligating dental brackets (EO) Section 5.Characterization techniques and test procedure requirements for smart diagnostic chips comprising a microfluidic channel system (GBO) Section 6.Characterization techniques and test procedure...... requirements for multifunctional integrated lighting rear lamp for cars (CRP) Section 7.Characterization techniques and test procedure requirements for micro-fresnel lenses for cell phone flash lights (HEPTAGON) Section 8.Characterization techniques and test procedure requirements for 5 Pin Ric Connector...

  11. 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...

  12. On-site inspection: Procedures and techniques

    International Nuclear Information System (INIS)

    Krioutchenkov, V.

    1999-01-01

    This presentation describes the procedures and techniques of on-site inspection (OSI) which is the main task of OSI Division of the CTBTO Prep Com. This is the integral part of the Comprehensive Test Ban Treaty (CTBT) verification regime which should be conducted with view of obtaining scientific evidence to clarify whether an ambiguous event is a nuclear explosion. The Provisional Technical Secretariat of the CTBTO Prep Com in cooperation with national OSI experts develops the OSI methodology with a concept of operations and an operational manual as basic elements of this development. This includes identification of detection levels and binding requirements for available technologies (gamma monitoring, multi spectral imaging, environmental radioactive and non radioactive sampling) as well as identification and development o detailed equipment specifications for unique technologies

  13. Techniques of Wastewater Treatment

    Indian Academy of Sciences (India)

    emerging effluent treatment methods. What is an Effluent? Liquid, solid and gaseous waste materials are often generated during the manufacturing of almost all the chemical and other industrial products. .... mass during the effluent treatment to oxidise the biologically oxidizable pollutants and for their own sustenance.

  14. Newer techniques for intravascular and intraoperative neurointerventional procedures

    International Nuclear Information System (INIS)

    Higashida, R.T.; Halbach, V.V.; Hieshima, G.B.; Yang, P.

    1987-01-01

    A videotape demonstrating newer techniques used in intravascular and intraoperative embolization procedures will be presented. The authors discuss the use of some of the newer embolic agents, real-time digital subtraction angiography, roadmapping techniques, and the use of microcatheters and steerable micro guide wires, which has greatly facilitated neurovascullar embolization procedures and enhanced patient safety. A number of actual intraoperative and intravascular cases will be shown demonstrating treatment of vascular malformations of the brain and spinal cord, carotid cavernous sinus fistulas, aneurysms and dural arteriovenous malformations. The indications for treatment, patient selection, technical preparation and newer methodologies and approaches to complex vascular lesions of the brain and spinal cord are discussed in detail

  15. Techniques of Wastewater Treatment

    Indian Academy of Sciences (India)

    By now the reader must have got an idea about the importance of wastewater treatment. Today, biological method (aerobic) is the most widely used method because of its simplicity and relatively low cost but is less successful when the effluent contains highly toxic organic pollutants. It occupies a large space and this could.

  16. 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

  17. 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

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

    Directory of Open Access Journals (Sweden)

    Y. V. Tsitovich

    2016-01-01

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

  19. Non contingent distraction procedure effects in pediatric dentistry treatment

    OpenAIRE

    Leatrice Palieraqui Pereira da Silva; Antonio Bento Alves de Moraes; Gustavo Sattolo Rolim

    2008-01-01

    The aim of the study was to investigate if a non-contingent distraction procedure, during the treatment, would facilitate behavior management increasing the children’s cooperation. In this study, two four-year old children, presenting non-compliance to the treatment were evaluated. The distraction technique carried out in dental chair, during the session, involved questions and answers based in pictures. Correct answers were socially reinforced through chips and prizes. Thirteen sessions were...

  20. 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

  1. Minimum (minimal) invasive techniques in early colorectal cancer treatment

    International Nuclear Information System (INIS)

    Slezak, V.

    2007-01-01

    Minimally invasive non-operating techniques for treatment of early tumors of colon present a convenient approach for the patient. At most times they can be performed on outpatient basis or with minimal hospital stay. They are non-demanding procedures for the patient and can be used even in patients with high surgical risk. These techniques include classical polypectomy and endoscopic mucosal resection. Other methods used include argon plasma coagulation and laser therapy, if available. These techniques are indicated in findings limited to muscularis mucosa. Risk of complication during and after procedure is low. Endoscopic ultrasound is recommended prior procedure in large size or high-risk polyps. (author)

  2. Procedural techniques and multicenter postmarket experience using minimally invasive convective radiofrequency thermal therapy with Rezūm system for treatment of lower urinary tract symptoms due to benign prostatic hyperplasia

    Directory of Open Access Journals (Sweden)

    Darson MF

    2017-08-01

    Full Text Available Micheal F Darson,1 Erik E Alexander,1 Zvi J Schiffman,2 Michael Lewitton,2 Robert A Light,2 Mark A Sutton,2 Carlos Delgado-Rodriguez,2 Ricardo R Gonzalez2 1Arizona Urology Specialists, Scottsdale, AZ, 2Houston Metro Urology, Houston, TX, USA Objective: This report evaluates clinical experience with the Rezūm system after US Food and Drug Administration clearance in consecutive cases accrued by multiple community urologists for the treatment of lower urinary tract symptoms (LUTS associated with benign prostatic hyperplasia (BPH. Treatment techniques for transurethral convective radiofrequency water-vapor thermal therapy and outcomes with up to 12 months’ follow-up are presented. Materials and methods: A total of 131 patients with moderate–severe LUTS were included in a retrospective analysis of BPH procedures with the Rezūm system. Pre- and postprocedure assessments included International Prostate Symptom Score (IPSS, quality of life, peak urinary flow rate, voided volume, and postvoid residual urine volume. Urologists used their own discretion for patient selection, with variable prostate sizes, LUTS severity, urinary retention, or presence of an obstructing median lobe. Safety signals and surgical retreatment rates were monitored prospectively. Results: Men aged 47–96 years with prostates 13–183 cm3 showed significant improvement in IPSS, quality of life, and postvoid residual volume durable through 12 months after thermal therapy. Patients with either moderate (IPSS 8–19 or severe (IPSS 20–35 symptoms achieved significantly improved scores. Postprocedure adverse events normally anticipated and related to endoscopic instrumentation were transient and mild–moderate in nature. No de novo erectile or ejaculatory dysfunction was reported. Conclusion: This study corroborates prior published pilot and randomized controlled trial results indicating significant relief of urinary symptoms and reproducibility of responses to thermal

  3. 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 ...

  4. IMPROVING THE STUDENTS’ READING SKILL THROUGH CLOZE PROCEDURE TECHNIQUE

    OpenAIRE

    HENDRA EKA PUTRA

    2016-01-01

    Lack of ability in comprehending English texts is students’ big problem nowadays. They fail in comprehending or grasping information from reading materials. As a result, their motivation decreases which in turn can inhibit their reading comprehension. In reading comprehension class, those difficulties faced by the students may be caused by many factors such as, reading materials, teaching method, media used and so forth. Related to the problem, cloze procedure technique can be used as an alte...

  5. The Kiricuta procedure in reconstructive surgical treatment of the breast

    International Nuclear Information System (INIS)

    Lopez, J.F.; Bouchet, Y.; Dupre, A.

    1990-01-01

    A series of 50 patients with carcinoma of the breast underwent omental transposition. This palliative procedure is indicated for recurrences after conservative treatment, radiation necrosis and Stage III or IV ulcerated tumors. The operative technique is described in detail. Omentoplasties were performed upon 33 right and 17 left mammary areas. Forty-five right pedicled flaps and only four left areas were used. One patient died on the fourth postoperative day because of massive pulmonary embolus. Local repair was satisfactory in 76 per cent of the patients. Four patients presented with herniation of the abdominal wall at the site of omental tunneling. In three, the treatment consisted of sectioning the vascular pedicle and reinforcing the parietal closure with Dacron (polyester fiber) mesh

  6. 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

  7. A new surgical procedure for hallux limitus treatment

    Science.gov (United States)

    Valero, José; Moreno, Manuel; Gallart, José; González, David; Salcini, Jose L.; Gordillo, Luis; Deus, Javier; Lahoz, Manuel

    2017-01-01

    Abstract The purpose of this study was to evaluate the effectiveness of the new Double-V osteotomy of the first metatarsophalangeal joint (1stMPJ) in patients with hallux limitus (HL). A study of 66 patients was performed, 33 patients were treated Cheilectomy and 33 were treated Double-V. All patients underwent an assessment of the passive mobility of the 1stMPJ before the procedure, reevaluated 12 months later evaluating dorsiflexion, plantarflexion, and patients status using both the American Orthopaedic Foot and Ankle Society (AOFAS) for Hallux Metatarsophalangeal–Interphalangeal Scale. In comparing the improvement achieved regarding the increase of mobility obtained with surgical treatment, the feet operated with procedure Double-V gained significant degrees of movement increased in all analyzed parameters (P < .05). We achieved 13.33° more than average in dorsiflexion motion and 2.12° more than average in plantarflexion with regard to the feet that were operated with Cheilectomy procedure. Double-V scores on the AOFAS scale improved significantly (P = .000) 91.48 points postoperative, while with the following Cheilectomy only 79.30 points. This new surgical technique, easy to perform and with low complexity in surgical execution and a minimum of complications, produces better clinical and functional results that Cheilectomy alone. PMID:28953644

  8. ANTERIOR PERCUTANEOUS CERVICAL DISCECTOMY. TWO-YEAR FOLLOW-UP OF A BLUNT TECHNIQUE PROCEDURE

    Directory of Open Access Journals (Sweden)

    Jorge Felipe Ramírez León

    Full Text Available ABSTRACT Objective: To report the outcomes of non-endoscopic percutaneous cervical discectomy by anterior blunt approach for the treatment of degenerative disc disease. Methods: A review of the medical records of patients with axial cervical pain resulting from degenerative disc disease and treated with discectomy and percutaneous nucleoplasty by anterior blunt approach with radiofrequency source was carried out. The data were evaluated according to modified MacNab and pre- and postoperative VAS criteria at 3, 12 and 24 months. Results: Sixty-two procedures were performed in 48 patients between 2008 and 2014. The mean age of the population was 52.4 years. MacNab results were 84.6%, 92.3%, and 89.2% improvement (excellent and good results at 3, 12 and 24 months, respectively. The VAS changed from 7.4 to 2.3 two years after the procedure, showing a statistically significant difference (p=0.000. There were no major complications or re-interventions related to the technique. Conclusions: Anterior non-endoscopic discectomy and nucleoplasty for the treatment of discogenic axial cervical pain may be an effective alternative to open surgery. In the two-year follow-up, our blunt technique proved to be a safe procedure with no approach-related complications, and provided outcomes comparable to those reported using the original needle technique.

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

    Science.gov (United States)

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

    2014-05-01

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

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

    Directory of Open Access Journals (Sweden)

    Gananjay G Salve

    2016-01-01

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

  11. [Urinary lithiasis treatment by laparoscopy. Combined techniques.

    Science.gov (United States)

    Fernández González, Inmaculada; Brime Menendez, Ricardo; Celada Luis, Guillermo; Acosta Reveles, Marco Antonio; Albers Acosta, Eduardo Mariano; Mejía Celemin, Pilar; San José Manso, Luis Alberto; Casado Varela, Javier

    2017-01-01

    Over the last 30 years, the treatment of urinary lithiasis has changed dramatically. With the advent of extracorporeal lithotripsy and the advances on ureterorenoscopy and percutaneous nephrolithotomy, the need to turn to open and laparoscopic/robotic surgery has diminished. The objective of this article is to review the different indications for open and/or laparoscopic treatment of urinary lithiasis, to achieve its complete elimination with the less invasive possible means and trying to minimize the number of secondary procedures as well as complications.

  12. Brine treatment, smoking and storage techniques

    African Journals Online (AJOL)

    Voi. 6 No. 2. The Journal of Food Technology in Africa. Brine treatment, smoking and storage techniques: their effects on the microbial quality of smoked mackerel. Eyabi Eyabi G. D. Research Station for Fisheries and Marine Science of the Institute of Agriculture Research for Development (IRAD). PMB77 Limbe, Cameroon.

  13. Practical techniques for reducing radiation exposure during cerebral angiography procedures.

    Science.gov (United States)

    Pearl, Monica S; Torok, Collin; Wang, Jiangxia; Wyse, Emily; Mahesh, Mahadevappa; Gailloud, Philippe

    2015-02-01

    DSA remains the gold standard imaging method for the evaluation of many cerebrovascular disorders, in particular cerebral aneurysms and vascular malformations. The purpose of this study was to demonstrate the effect of modifying DSA frame rate, fluoroscopic and roadmap pulse rates, and flat panel detector (FPD) position on the radiation dose delivered during routine views for a cerebral angiogram in a phantom model. Adult skull and abdomen/pelvis anthropomorphic phantoms were used to compare the radiation dose metrics Ka,r (in mGy), PKA (in μGym(2)), and fluoroscopy time (in minutes) after modification of fluoroscopic pulses per second (p/s), DSA frames per second (f/s), and FPD position and collimation in three components of a cerebral angiogram: (1) femoral artery access, (2) roadmap guidance, and (3) biplane cerebral DSA. For femoral artery access, DSA protocols resulted in significantly higher doses than those utilizing fluoroscopy alone (p=0.007). Roadmaps using 3 p/s or 4 p/s delivered significantly less dose than higher pulse rates (p=0.008). The ranges of delivered doses for biplane cerebral DSA were 347.3-1188.5 mGy and 3914.54-9518.78 μGym(2). The lowest radiation doses were generated by the variable frame rate DSA protocols. Replacing femoral arterial access evaluations by DSA with fluoroscopy, utilizing lower pulse rates during fluoroscopy and roadmap guidance, and choosing variable frame rates for DSA are simple techniques that may be considered by operators in their clinical practices to lower radiation dose during cerebral angiography procedures. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  14. 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...... invasive procedures calls for quality assurance and monitoring of operators' performance....

  15. Non contingent distraction procedure effects in pediatric dentistry treatment

    Directory of Open Access Journals (Sweden)

    Leatrice Palieraqui Pereira da Silva

    2008-12-01

    Full Text Available The aim of the study was to investigate if a non-contingent distraction procedure, during the treatment, would facilitate behavior management increasing the children’s cooperation. In this study, two four-year old children, presenting non-compliance to the treatment were evaluated. The distraction technique carried out in dental chair, during the session, involved questions and answers based in pictures. Correct answers were socially reinforced through chips and prizes. Thirteen sessions were recorded and the behaviors analyzed in each 15 seconds intervals. Indicative uncooperative behaviors expressed by high crying frequency (PI:1s-74% and 7s-35%, PII:1s-94% and 6s-40% suggests that this non-contingent distraction was not effective in reducing children’s uncooperative behaviors. However, children’s distraction task was improved during the treatment (PI:2s-29% and 7s-100% of correct answers, PII:2s-25% and 6s-100% of correct answers. Among the subjects of this study, distraction did not modify non-cooperative behavior, but allowed children to participate of the distraction planned task, which was not incompatible with non-cooperation responses. The child learned other behaviors at the same time as being exposed to aversive conditions.   Keywords: behavior management; distraction; pediatric dentistry.

  16. 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...... are presented covering indications, contraindications, and safe and effective performance of the broad variety of these techniques. In particular, drainage of abscesses and fluid collections, interventional tumor ablation techniques, interventional treatment of symptomatic cysts and echinococcosis, percutaneous...

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

    Directory of Open Access Journals (Sweden)

    Ana Isabel Azevedo

    2016-09-01

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

  18. 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...

  19. Generating consistent buildings: A semantic approach for integrating procedural techniques

    NARCIS (Netherlands)

    Tutenel, T.; Smelik, R.M.; Lopes, R.; Kraker, K.J. de; Bidarra, R.

    2011-01-01

    Computer games often take place in extensive virtual worlds, attractive for roaming and exploring. Unfortunately, current virtual cities can strongly hinder this kind of gameplay, since the buildings they feature typically have replicated interiors, or no interiors at all. Procedural content

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1999-03-01

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

  1. 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)

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2012-10-15

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

  3. Orthodontics treatment open byte with fixed Damon technique

    Directory of Open Access Journals (Sweden)

    Pavlović Jasna

    2016-01-01

    Full Text Available The complexity of the open bite is attributed to the combination of the skeletal, dental and soft tissue elements. Depending on the etiology there are different approaches in their solution from conventional to surgical orthodontic treatment. In boys, aged 15 years, was found anterior open bite. After diagnostic procedures and growth assessment, the Demon nonsurgical orthodontic treatment technique was performed. The use of mild force, low friction and early use of intraoral elastics, arterior vertikal and class II in the area of the side teeth, have enabled us to take advantage of favorable growth type maxillofacial complex by which we have achieved a satisfactory therapeutic effect and close the open bite.

  4. 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)

  5. 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

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

    Directory of Open Access Journals (Sweden)

    Milić Dragan J.

    2003-01-01

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

  7. 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......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 presented covering indications, contraindications, safety and efficacy of the broad variety of these techniques. In particular, drainage of abscesses and fluid collections, interventional tumor ablation techniques, interventional treatment of symptomatic cysts and echinococcosis, percutaneous transhepatic...

  8. 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)

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2014-03-15

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

  11. Urethral advancement procedure in the treatment of primary distal ...

    African Journals Online (AJOL)

    Introduction: Distal hypospadias is the most common genital anomaly, occurring in almost 65% of all hypospadias cases. Although there are several surgical techniques for the treatment of distal hypospadias, it is clear that none can be used to correct all forms of hypospadias. The aim of the study was to evaluate urethral ...

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

    Directory of Open Access Journals (Sweden)

    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.

  13. Endoscopic treatment of Haglund's syndrome with a three portal technique.

    Science.gov (United States)

    Wu, Ziying; Hua, Yinghui; Li, Yunxia; Chen, Shiyi

    2012-08-01

    The purpose of our study is to make a retrospective evaluation of endoscopic treatment of Haglund's syndrome using a new three portal technique. All 23 patients (25 heels) with a mean age of 27.7 years were evaluated pre-operatively and postoperatively with parallel pitch lines, the American Orthopaedic Foot and Ankle Society (AOFAS) score and the Ogilvie Harris score. The mean follow-up was 41 months (range, 30-59 months). There were no obvious complications in our study. In 22 heels, postoperative lateral radiographs showed the achievement of negative parallel pitch lines. The average AOFAS score improved from 63.3 ± 11.9 points pre-operatively to 86.8 ± 10.1 points at final follow-up. There were 14 excellent results, seven good results, two fair results and two poor results. For the Ogilvie Harris score, there were 15 excellent, seven good, one fair, and two poor results. An endoscopic procedure using the three portal technique seemed to be a safe and efficacious option for surgical treatment of Haglund's syndrome.

  14. 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.

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

    Science.gov (United States)

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

    2016-09-01

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

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

    Science.gov (United States)

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

    2016-02-01

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

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

    Science.gov (United States)

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

    2015-01-01

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

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

    Science.gov (United States)

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

    2015-01-01

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

  19. Brine treatment, smoking and storage techniques

    African Journals Online (AJOL)

    Pseudotolithus typus) in FAO. Rep. 467:58-64. The Journal of Food Technology in Africa mackerel. Eyabi Eyabi, G.D. (1998) Techniques for fish handling, marketing and smoking in Cameroon in. FAO Fisheries Report 574. Eyabi Eyabi, G.D. (2000) ...

  20. Transvaginal Hybrid NOTES Procedure for Treatment of Gallstone Ileus

    Directory of Open Access Journals (Sweden)

    Takuya Shiraishi

    2016-01-01

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

  1. Illustrated techniques for performing the Cox-Maze IV procedure through a right mini-thoracotomy.

    Science.gov (United States)

    Robertson, Jason O; Saint, Lindsey L; Leidenfrost, Jeremy E; Damiano, Ralph J

    2014-01-01

    The Cox-Maze IV procedure has replaced the "cut-and-sew" technique of the original Cox-Maze operation with lines of ablation created using bipolar radiofrequency (RF) and cryothermal energy devices. In select patients, this procedure can be performed through a right mini-thoracotomy. This illustrated review is the first to detail the complete steps of the Cox-Maze IV procedure performed through a right mini-thoracotomy with careful attention paid to operative anatomy and advice. Pre- and post-operative management and outcomes are also discussed. This should be a practical guide for the practicing cardiac surgeon.

  2. 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

  3. [Application of ultrasonography in central venous catheterization; access sites and procedure techniques].

    Science.gov (United States)

    Czyzewska, Dorota; Ustymowicz, Andrzej; Klukowski, Mark

    2016-08-05

    Central venous catheterization is commonly performed in clinical practice. Traditional procedural technique is based on anatomical landmarks, but is associated with a high risk of failure and complications. To decrease their incidence European and American societies recommend application of ultrasonography. Preliminary ultrasonographic examination allows for assessment of local anatomical relations as well as vessel morphology (diameter, patency), while real-time ultrasonography increases chances of successful needle insertion. This paper presents the most common venous access sites and procedure techniques. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

  4. 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

  5. Development of Radiation Technique for Environmental Treatment

    International Nuclear Information System (INIS)

    Lee, Myun Joo; Kuk, Il Hiun; Jin, Joon Ha

    2007-02-01

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

  6. Development of Radiation Technique for Environmental Treatment

    Energy Technology Data Exchange (ETDEWEB)

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

    2007-02-15

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

  7. Er:YAG laser: the promising procedure for caries treatment

    Science.gov (United States)

    Ishikawa, Isao; Aoki, Akira; Watanabe, Hisashi; Ando, Yoshinori; Yamada, Toshimoto; Otsuki, Masayuki; Tagami, Junji

    1996-04-01

    The effectiveness of the Er:YAG laser for caries removal was evaluated in vitro and in vivo. As the in vitro study, thirty-two extracted human teeth with cervical root caries were used. An axially divided half of each caries lesion was treated with the Er:YAG laser, and the other was removed with round steel burs mounted on a micromotor or was left untreated as a control. Laser irradiation was performed in contact and non-contact mode at 145 mJ/pulse (51.3 J/cm2/pulse) and 10 pps under water spray. Conventional micromotor treatment was performed at 10,000 rpm using some different size of round steel burs. Measurement of time required for caries removal, histological observation of decalcified serial sections, SEM observation and hardness measurement of the cavity floor dentin were conducted with both laser and conventional treatments. In addition to the above in vitro study, the usefulness of root caries treatment with the Er:YAG laser was assessed in vivo as a clinical trial. The results indicated that removal of carious dentin using the Er:YAG laser was completed effectively to the same extent as the conventional treatment and thermal damage of the lased cavity was minimum. The Er:YAG laser treatment diminished unpleasant sound and vibration, when compared with the conventional rotary technique. We conclude that the Er:YAG laser possesses the promising characteristics for caries removal.

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

    Science.gov (United States)

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

    2017-05-01

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

  9. 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.

  10. 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),

  11. An Experimental Test of a Craving Management Technique for Adolescents in Substance-Abuse Treatment

    Science.gov (United States)

    Florsheim, Paul; Heavin, Sarah; Tiffany, Stephen; Colvin, Peter; Hiraoka, Regina

    2008-01-01

    This paper describes an experiment designed to test an imagery-based craving management technique with a sample of adolescents diagnosed with substance-use disorders. Seventy adolescents between the ages of 14 and 18 (41 males) were recruited through two substance-abuse treatment programs. The experimental procedure involved stimulating craving…

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

    Directory of Open Access Journals (Sweden)

    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

  13. Irradiation techniques for the breast cancer treatment

    International Nuclear Information System (INIS)

    Varon T, C.F.; Rojas C, E.L.

    2007-01-01

    The radiotherapy is a cancer treatment way based on the radiation employment. It acts on the tumor, destroying the wicked cells and impeding that this it grows and reproduce. With the radiotherapy the probability of cure of some types of cancer; among them the one of breast, it increases. The investigations in oncology have allowed to develop new technologies with which is possible, for example, to locate the tumors accurately and to adapt the irradiation fields to their form. This has allowed to improve the treatments since it can destroy the tumor applying an intense radiation dose without producing irreversible damages to other organs and healthy tissues of the body. In the underdeveloped countries or in development as Mexico, and almost all those of Latin America, it is not still possible to have several of these technologies in the main oncological centers of the country by their high cost. It is expected that their cost go lowering and that its going to develop technologies more cheap so that they can be applied in more general way to the population that suffers of this suffering. (Author)

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

    Directory of Open Access Journals (Sweden)

    ZHANG Yixi

    2015-05-01

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

  15. Ex-vivo investigations on endoluminal vein treatment procedures

    Science.gov (United States)

    Sroka, R.; Burgmeier, C.; Meissner, Oliver; Hunger, Katrin; Barbaryka, Gregor; Beyer, W.; Beck, T.; Steckmeier, B.; Schmedt, C.

    2007-02-01

    An ex-vivo model was developed for experimental evaluation of endoluminal thermal procedures for the occlusion of saphenous veins. The model consists of the subcutaneous foot vein from freshly slaughtered cows. Using this model primary and acute effects and initial mechanisms on vein vessel could be studied. In this study different energy sources (laser and radiofrequency generator), different energy application parameters (velocity, fluence, fluence rate, temperature) were compared. The dependency of using bare fibre and cylindrical diffusors could be investigated with respect to the induced effects on the vessels wall. Contraction of the vessels were measured and investigated macroscopically and microscopically as well as by means of optical coherence tomography. As a result an optimized treatment protocol could be developed and discussed with respect to the induced effects.

  16. [Surgical treatment of the GER with Boix-Ochoa technique. Long term results].

    Science.gov (United States)

    Hernández-Orgaz, A; López-Alonso, M

    2004-07-01

    The Boix-Ochoa technique enable hipercorrection of the gastroesophageal reflux (GER), avoiding the disphagia and allowing the eructing capability as a consequence of the fundoplication procedure. During the last decade 102 children were surgically treated using the Boix-Ochoa technique. The age range was 4.93 +/- 3.80 years. All patients have previously been studied with Xray, esophageal manometry, pHmetry during 24 h, and eventually with medical treatment. Failure of the medical treatment lead to the surgical treatment with the Boix-Ochoa technique. After surgery, 24 h controls of esophageal pHmetry showed reflux indexes greater than 5 in six patients. Two of them had neurological pathology and one of them suffered peptic stenosis previously treated by means of mechanical dilatation. The rest of patients showed normal value of reflux indexes after surgery. Excluding the esophageal atresia and caustic stenosis, the Boix-Ochoa technique is the best choice for the surgical treatment of GER.

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

    Science.gov (United States)

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

    2013-01-01

    Aims: One of the reason for Latarjet procedure failure may be coracoid graft osteolysis. In this study, we aimed to understand if a better compression between the coracoid process and the glenoid, using a mini-plate fixation during the Latarjet procedure, could reduce the amount of coracoid graft osteolysis. Materials and Methods: A computed tomography scan analysis of 26 prospectively followed-up patients was conducted after modified Latarjet procedure using mini-plate fixation technique to determine both the location and the amount of coracoid graft osteolysis in them. We then compared our current results with results from that of our previous study without using mini-plate fixation to determine if there is any statistical significant difference in terms of corcacoid bone graft osteolysis between the two surgical techniques. Results: The most relevant osteolysis was represented by the superficial part of the proximal coracoid, whereas the deep part of the proximal coracoid graft is least involved in osteolysis and has best bone healing. The current study showed a significant difference only for the deep part of the distal coracoid with our previous study (P Latarjet procedure. Conclusion: Our study suggests that there is a significant difference only for the deep part of the distal coracoid in terms of osteolysis. At clinical examination, this difference did not correspond with any clinical findings. Level of Evidence: Level 4. Clinical Relevance: Prospective case series, Treatment study. PMID:23858288

  18. The Effectiveness of Distraction as Procedural Pain Management Technique in Pediatric Oncology Patients: A Meta-analysis and Systematic Review.

    Science.gov (United States)

    Bukola, Ibitoye M; Paula, Dawson

    2017-10-01

    Diagnostic tests and treatment regimens for pediatric cancers involve invasive and painful procedures. Effective management of such pain has been shown to be suboptimal in many parts of the world, often because of the cost and limited availability of appropriate medications. Current evidence suggests that distraction (a relatively low-cost technique) is a promising intervention for procedural pain management. There is, however, limited evidence demonstrating its effectiveness in pediatric oncology patients. A systematic review was conducted to ascertain the effectiveness of distraction as a procedural pain management technique in pediatric oncology patients. Using a comprehensive search strategy, MEDLINE, PsycINFO, Cochrane Library, AMED, CINAHL, Web of Science, and EMBASE electronic databases were searched for studies comparing distraction techniques to standard care/any intervention. Using the selected studies, a systematic review and meta-analysis of randomized controlled trials was conducted. Two hundred ninety-nine studies were identified, with seven randomized control trials identified as eligible for inclusion. Pain was assessed using self-report, observer-report, and physiological measures. A meta-analysis of four studies showed distraction as effective in reducing procedural pain, based on self-reported pain. A meta-analysis of three studies, based on pulse rates, demonstrated similar results. For observer-reported pain, limited evidence supported the effectiveness of distraction. This systematic review demonstrates that distraction is a promising intervention for procedural pain. Future research should assess effectiveness of distraction in varied populations, to explore evidence of cultural influences on pain expression, measurement, and management approaches. Copyright © 2017 American Academy of Hospice and Palliative Medicine. All rights reserved.

  19. 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.

  20. 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

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

    Directory of Open Access Journals (Sweden)

    Suryakant C. Deogade

    2012-01-01

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

  2. 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)

  3. Alternative procedure to improve the stability of mandibular complete dentures: a modified neutral zone technique.

    Science.gov (United States)

    Rehmann, Peter; Zenginel, Martha; Wostmann, Bernd

    2012-01-01

    The aim of this report is to describe an alternative technique to record the neutral zone. An acrylic resin base with posterior occlusal rims was applied using a thermoplastic denture adhesive. After being worn for 2 days, the base was transferred into an acrylic resin complete denture. Most patients reported an improvement in denture stability and a reduction of pressure sores. This procedure seems to be helpful to improve denture function, especially in the mandible, in patients who cannot be treated with implants. However, because of its complexity, this neutral zone technique cannot be recommended for routine clinical use.

  4. Inner tubing technique used for the treatment of anastomotic aneurism.

    Science.gov (United States)

    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.

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

    Directory of Open Access Journals (Sweden)

    Nalavenkata S

    2014-06-01

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

  6. Significantly reduced radiation exposure to operators during kyphoplasty and vertebroplasty procedures: methods and techniques.

    Science.gov (United States)

    Ortiz, A O; Natarajan, V; Gregorius, D R; Pollack, S

    2006-05-01

    Vertebroplasty and kyphoplasty can be associated with significant radiation exposure to the operator. We compared the exposure levels to an operator performing vertebral fracture augmentation with vertebroplasty and kyphoplasty, to assess a cement injection and a monitoring technique designed to reduce this exposure. A neuroradiologist performed 189 consecutive vertebral augmentation procedures in 135 patients with osteoporotic compression fractures by using a bilateral approach with biplane pulse fluoroscopy at 7.5 pulses/second. Cement delivery was performed with intermittent fluoroscopy with kyphoplasty and vertebroplasty by using syringes or continuous fluoroscopic monitoring with a cement delivery system (CDS). Data collection included time and operator exposure parameters. A total of 87 kyphoplasty procedures, 82 vertebroplasty procedures with a CDS (VP-CDS), and 20 vertebroplasty procedures with syringes (VP-S) were safely performed. Mean fluoroscopy time for device positioning was 4.3 minutes for each procedure type. Mean fluoroscopy time (minutes) for cement delivery was significantly different for the 3 procedure types; 2.1 for kyphoplasty, 3.7 for VP-CDS, and 1.5 for VP-S (P exposure rates (microsieverts/minute) were 0.8 for kyphoplasty, 1.1 for VP-CDS, and 0.3 for VP-S during device-positioning and 1.7 for kyphoplasty, 2.9 for VP-CDS, and 0.2 for VP-S during cement injection (P technique and intermittent fluoroscopy with kyphoplasty and vertebroplasty with syringes results in a significantly lower operator exposure rate compared with vertebroplasty with a CDS.

  7. Local Anesthesia for Surgical Procedures of the Upper Eyelid Using Filling Cannula: Our Technique

    Directory of Open Access Journals (Sweden)

    Maria Trapasso, MD

    2014-05-01

    Full Text Available Summary: Sometimes, after local anesthetic injection for surgical procedures of the upper eyelid, it is possible to observe superficial preseptal hematomas or excessive lid swelling that may distort the tissues and obscure surgical landmarks. We present a technique to perform local anesthesia of the upper eyelids, using a 27-gauge needle and a 26-gauge filling cannula, that may decrease the incidence of hematomas and bruising.

  8. 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 QGIs were further calculated. Based on QGI values, 8.6% (5/58, AMY) to 35.9% (28/78, LDH) of the laboratories (QGI < 0.8) need to improve the precision of the procedures, 8.0% (6/75, CK) to 52.6% (40/76, ALP) of the laboratories (QGI ≤ 1.2) need to improve the trueness of the procedures; and 2.7% (2/75, AST) to 16.3% (8/49, GGT) of the laboratories (0.8 ≤ QGI ≤ 1.2) need to improve both the precision and trueness of the procedures. Even though rapid progress has been made to standardize serum enzyme measurements in China in recent years, our study using Six Sigma techniques still suggested that

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

    Directory of Open Access Journals (Sweden)

    Zahra Alizadeh Tabari

    2016-01-01

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

  10. Treatment of excessive gingival display using a modified lip repositioning technique.

    Science.gov (United States)

    Ribeiro-Júnior, Noé Vital; Campos, Thiago Veiga de Souza; Rodrigues, Jefferson Guilherme; Martins, Thiago Modolo Azevedo; Silva, Cléverson O

    2013-01-01

    Excessive gingival display during smiling ("gummy smile") is an esthetic issue that affects a considerable part of the population. The hyperactivity of the elevator muscle of the upper lip is one of the main causes of a gummy smile, and several techniques have been proposed for its treatment. The aim of this report is to describe a modification of the lip repositioning technique to achieve stable and significant outcomes through a more conservative procedure. Two patients complaining about a gummy smile were treated with the proposed technique and presented, after a 6-month follow-up, significant improvement in the amount of gingival exposure and esthetic satisfaction.

  11. Techniques of WasteWater Treatment-Introduction to Effluent ...

    Indian Academy of Sciences (India)

    Home; Journals; Resonance – Journal of Science Education; Volume 5; Issue 11. Techniques of WasteWater Treatment - Introduction to Effluent Treatment and Industrial Methods. Amol A Kulkarni Mugdha Deshpande A B Pandit. General Article Volume 5 Issue 11 November 2000 pp 56-68 ...

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

    Directory of Open Access Journals (Sweden)

    Małgorzata Rutkowska

    2014-06-01

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

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

    Directory of Open Access Journals (Sweden)

    Abolghasem Zarezade

    2014-01-01

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

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

    Science.gov (United States)

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

    2013-01-01

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

  15. Loop electrosurgical excision procedure in vulvar intraepithelial neoplasia treatment.

    Science.gov (United States)

    Vlastos, Anne-Thérèse; Levy, Larry B; Malpica, Anais; Follen, Michele

    2002-10-01

    OBJECTIVE.: Our objective was to compare by response rate the therapeutic options of loop electrosurgical excision procedure (LEEP), laser therapy, and wide local excision in managing high-grade vulvar intraepithelial neoplasia in a pilot study for a randomized clinical trial. MATERIALS AND METHODS.: Between 1995 and 1999, 109 patients presenting with vulvar lesions were registered at a comprehensive cancer center and 2 associated colposcopy clinics. From these 109, we identified 74 patients with lesions histologically proven to be vulvar intraepithelial neoplasia who underwent treatment with CO2 laser, wide local excision, or LEEP. Clinical and pathological features were reviewed retrospectively. Wilcoxon rank sum test and life table analyses were used to compare groups. Response rates for this retrospective study will be used to calculate the sample size for a prospective clinical trial. RESULTS.: Our population was similar to others reported in the literature in age, range of diagnoses, and follow-up. Only 1 of 74 patients (1%) had invasive cancer. In a subset of 62 patients treated for the first time, LEEP and wide local excision were equal in their ability to achieve complete response. Laser ablation was the least successful of all methods (10/20 with laser, 3/20 with LEEP, and 2/22 with wide local excision experienced recurrences [p = .04]). No statistically significant differences among the 3 were noted in time to recurrence (p = .24). Age, age at first intercourse, and number of sexual partners were not correlated with recurrence and did not confound the results. Using a chi approximation, an alpha error of 0.05, and a power of 0.80, researchers should enroll 25 patients per arm if improvement over standard therapy is expected to be 40%, 45 if expected to be 30%, and 95 if expected to be 20%. CONCLUSIONS.: Because of differences in recurrence rate and length of hospital stay and indications of potential differences in cost found in this pilot, LEEP merits

  16. 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.

  17. Independent technique of verifying high-dose rate (HDR) brachytherapy treatment plans

    International Nuclear Information System (INIS)

    Saw, Cheng B.; Korb, Leroy J.; Darnell, Brenda; Krishna, K. V.; Ulewicz, Dennis

    1998-01-01

    Purpose: An independent technique for verifying high-dose rate (HDR) brachytherapy treatment plans has been formulated and validated clinically. Methods and Materials: In HDR brachytherapy, dwell times at respective dwell positions are computed, using an optimization algorithm in a HDR treatment-planning system to deliver a specified dose to many target points simultaneously. Because of the variability of dwell times, concerns have been expressed regarding the ability of the algorithm to compute the correct dose. To address this concern, a commercially available low-dose rate (LDR) algorithm was used to compute the doses at defined distances, based on the dwell times obtained from the HDR treatment plans. The percent deviation between doses computed using the HDR and LDR algorithms were reviewed for HDR procedures performed over the last year. Results: In this retrospective study, the difference between computed doses using the HDR and LDR algorithms was found to be within 5% for about 80% of the HDR procedures. All of the reviewed procedures have dose differences of less than 10%. Conclusion: An independent technique for verifying HDR brachytherapy treatment plans has been validated based on clinical data. Provided both systems are available, this technique is universal in its applications and not limited to either a particular implant applicator, implant site, or implant type

  18. 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)

  19. Ultrasound-Guided Interventional Procedures About the Shoulder: Anatomy, Indications, and Techniques.

    Science.gov (United States)

    Pourcho, Adam M; Colio, Sean W; Hall, Mederic M

    2016-08-01

    Chronic and acute shoulder pain and dysfunction are common complaints among patients. Shoulder pain may be the result of abnormality involving the rotator cuff, subacromial-subdeltoid bursa, biceps tendon, glenoid labrum, glenohumeral joint, acromioclavicular joint, sternoclavicular joint, or glenohumeral joint capsule. Ultrasound-guided (USG) procedures of the shoulder are well established for interventional management. Ultrasound provides the advantages of excellent soft tissue resolution, injection accuracy, low cost, accessibility, portability, lack of ionizing radiation, and the ability to perform real-time image-guided procedures. The purpose of this article is to review common indications and effective techniques for USG injections about the shoulder. Copyright © 2016 Elsevier Inc. All rights reserved.

  20. 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.

  1. 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

  2. Endoscope-assisted treatment of scaphocephaly: report of a case and new surgical technique

    Directory of Open Access Journals (Sweden)

    Domagoj Jugović

    2015-10-01

    Full Text Available The most common craniosynostosis, scaphocephaly, is the consequence of premature closure of the sagittal suture. Craniosynostosis does not just pose a cosmetic problem, but it can also lead to the permanent neurological deficits. Therefore early diagnosis and treatment are crucial for good outcome. Open surgery with large skin incision is currently the standard procedure. We present our first endoscope-assisted surgical procedure for scaphocephaly. The infant did not need transfusion or intensive therapy after the surgery and skin incision was minimal. This minimal invasive, new surgical technique and its development were described.  

  3. Constraint treatment techniques and parallel algorithms for multibody dynamic analysis. Ph.D. Thesis

    Science.gov (United States)

    Chiou, Jin-Chern

    1990-01-01

    Computational procedures for kinematic and dynamic analysis of three-dimensional multibody dynamic (MBD) systems are developed from the differential-algebraic equations (DAE's) viewpoint. Constraint violations during the time integration process are minimized and penalty constraint stabilization techniques and partitioning schemes are developed. The governing equations of motion, a two-stage staggered explicit-implicit numerical algorithm, are treated which takes advantage of a partitioned solution procedure. A robust and parallelizable integration algorithm is developed. This algorithm uses a two-stage staggered central difference algorithm to integrate the translational coordinates and the angular velocities. The angular orientations of bodies in MBD systems are then obtained by using an implicit algorithm via the kinematic relationship between Euler parameters and angular velocities. It is shown that the combination of the present solution procedures yields a computationally more accurate solution. To speed up the computational procedures, parallel implementation of the present constraint treatment techniques, the two-stage staggered explicit-implicit numerical algorithm was efficiently carried out. The DAE's and the constraint treatment techniques were transformed into arrowhead matrices to which Schur complement form was derived. By fully exploiting the sparse matrix structural analysis techniques, a parallel preconditioned conjugate gradient numerical algorithm is used to solve the systems equations written in Schur complement form. A software testbed was designed and implemented in both sequential and parallel computers. This testbed was used to demonstrate the robustness and efficiency of the constraint treatment techniques, the accuracy of the two-stage staggered explicit-implicit numerical algorithm, and the speed up of the Schur-complement-based parallel preconditioned conjugate gradient algorithm on a parallel computer.

  4. Alternative technique for class V resin composite restorations with minimum finishing/polishing procedures.

    Science.gov (United States)

    Perez, Cesar Reis

    2010-01-01

    Class V restorations are a very common occurrence in clinics. Some reasons include an increase in non-carious cervical lesions (NCCL), root caries and the elderly population. Unfortunately, Class V restorations also represent one of the less durable types of restorations and have a high index of loss of retention, marginal excess and secondary caries. Some causes for these problems include difficulties in isolation, insertion, contouring, finishing and polishing procedures. This technique demonstrates an alternative isolation and insertion method using photocured gingival barrier in association with a flowable resin and hybrid resin composite to recreate the gingival wall with minimum or no excess.

  5. Multiple-frequency holography and synthetic-aperture-focusing-technique-(SAFT) procedures in ultrasound testing

    Science.gov (United States)

    Kutzner, J.; Wuestenberg, H.; Erhard, A.

    1986-05-01

    The reconstruction formulations of multiple-frequency-holography (MFH) and SAFT procedures used in ultrasonic NDE are investigated analytically and shown to be closely related, and experimental measurements on a steel block with a 6-mm-diameter 45.5-mm hole are reported. The results are presented in graphs and shown to be in good agreement with the theoretical models proposed. The limitations of these methods in discriminating the nonlinear upper edge of the hole are indicated, and it is suggested that simpler methods such as the shadow-holography technique described by Kutzner and Zimpfer (1977) may be more useful in some cases.

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

    Science.gov (United States)

    Vale, Mônica Sampaio do; Moreno, Melinna dos Santos; Silva, Priscila Macêdo França da; Botelho, Thereza Cristina Farias

    2013-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Monica Sampaio do Vale

    2013-12-01

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

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

    OpenAIRE

    Jagmohan Singh; Vipin Bharti

    2014-01-01

    Gingival recession related to periodontal disease or developmental problems can result in root sensitivity, root caries, and esthetically unacceptable root exposures. In the past, multiple surgical procedures have been proposed to obtain root coverage on exposed buccal root surfaces. There has been great interest in the treatment of gingival recession defects, especially with subepithelial connective-tissue grafting (SCTG). Recent advances have focused on SCTG by the tunnel technique. This ar...

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1993-12-31

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

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

    Science.gov (United States)

    Loh, Jeffrey T; Nicol, Andrea L; Elashoff, David; Ferrante, F Michael

    2015-01-01

    Many studies have assessed the efficacy of radiofrequency ablation to denervate the facet joint as an interventional means of treating axial low-back pain. In these studies, varying procedural techniques were utilized to ablate the nerves that innervate the facet joints. To date, no comparison studies have been performed to suggest superiority of one technique or even compare the prevalence of side effects and complications. A retrospective chart review was performed on patients who underwent a lumbar facet denervation procedure. Each patient's chart was analyzed for treatment technique (early versus advanced Australian), preprocedural visual numeric scale (VNS) score, postprocedural VNS score, duration of pain relief, and complications. Pre- and postprocedural VNS scores and change in VNS score between the two groups showed no significant differences. Patient-reported benefit and duration of relief was greater in the advanced Australian technique group (P=0.012 and 0.022, respectively). The advanced Australian technique group demonstrated a significantly greater median duration of relief (4 months versus 1.5 months, P=0.022). Male sex and no pain-medication use at baseline were associated with decreased postablation VNS scores, while increasing age and higher preablation VNS scores were associated with increased postablation VNS scores. Despite increasing age being associated with increased postablation VNS scores, age and the advanced Australian technique were found to confer greater patient self-reported treatment benefit. The advanced Australian technique provides a significant benefit over the early Australian technique for the treatment of lumbar facet pain, both in magnitude and duration of pain relief.

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

    Science.gov (United States)

    Loh, Jeffrey T; Nicol, Andrea L; Elashoff, David; Ferrante, F Michael

    2015-01-01

    Background Many studies have assessed the efficacy of radiofrequency ablation to denervate the facet joint as an interventional means of treating axial low-back pain. In these studies, varying procedural techniques were utilized to ablate the nerves that innervate the facet joints. To date, no comparison studies have been performed to suggest superiority of one technique or even compare the prevalence of side effects and complications. Materials and methods A retrospective chart review was performed on patients who underwent a lumbar facet denervation procedure. Each patient’s chart was analyzed for treatment technique (early versus advanced Australian), preprocedural visual numeric scale (VNS) score, postprocedural VNS score, duration of pain relief, and complications. Results Pre- and postprocedural VNS scores and change in VNS score between the two groups showed no significant differences. Patient-reported benefit and duration of relief was greater in the advanced Australian technique group (P=0.012 and 0.022, respectively). The advanced Australian technique group demonstrated a significantly greater median duration of relief (4 months versus 1.5 months, P=0.022). Male sex and no pain-medication use at baseline were associated with decreased postablation VNS scores, while increasing age and higher preablation VNS scores were associated with increased postablation VNS scores. Despite increasing age being associated with increased postablation VNS scores, age and the advanced Australian technique were found to confer greater patient self-reported treatment benefit. Conclusion The advanced Australian technique provides a significant benefit over the early Australian technique for the treatment of lumbar facet pain, both in magnitude and duration of pain relief. PMID:26504407

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

    Directory of Open Access Journals (Sweden)

    Loh JT

    2015-10-01

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

  13. 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 ...

  14. 40 CFR 142.46 - Alternative treatment techniques.

    Science.gov (United States)

    2010-07-01

    ....46 Section 142.46 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER... Administrator Under Section 1415(a) of the Act § 142.46 Alternative treatment techniques. The Administrator may... lowering the level of the contaminant with respect to which such requirements was prescribed. A variance...

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1998-02-01

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

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

    Science.gov (United States)

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

    2015-01-01

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

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

    Science.gov (United States)

    Bhatia, Deepak N

    2015-03-01

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

  18. 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

  19. ANTIMICROBIAL TREATMENT BEFORE DENTAL PROCEDURES IN PATIENTS WITH BACTERIAL ENDOCARDITIS

    Directory of Open Access Journals (Sweden)

    Adriana Krasteva

    2010-12-01

    Full Text Available Infective endocarditis is a rare condition with significant morbidity and mortality. It may arise following bacteraemia in a patient with a predisposing cardiac lesion. In an attempt to prevent this disease, over the past 50 years, at-risk patients have been given antibiotic prophylaxis before dental procedures.

  20. Endovascular treatment of intracranial aneurysms: diversity in treatment techniques of varying anatomical presentations.

    Science.gov (United States)

    Putu, Patriawan; Firman, Sitanggang; Ismail, Mohd Redzuan; Nik-Ismail, Nik Azuan; Yaacob, Nur Yazmin; Muda, Ahmad Sobri

    2014-01-01

    We discuss and illustrate various endovascular treatment options for intracranial aneurysms, to reflect common technique used in endovascular treatment of brain aneurysm. We select five cases of various aneurysm types to show assortments of endovascular treatment (EVT) are performed. Selective catheterization of the intracranial aneurysms and endovascular treatments are technically feasible, offering a viable alternative to the surgical approach. We discuss the radiographic features, clinical presentation, and strategies of endovascular treatment of intracranial aneurysms.

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

    Directory of Open Access Journals (Sweden)

    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.

  2. Treating the Initial Physical Reflex of Misophonia With the Neural Repatterning Technique: A Counterconditioning Procedure

    Directory of Open Access Journals (Sweden)

    Thomas H. Dozier

    2015-10-01

    Full Text Available Misophonia is a condition in which a person has an acute emotional response of anger or disgust to a commonly occurring innocuous auditory or visual stimulus referred to as a trigger. This case details the effective treatment of misophonia in a young woman that included a counterconditioning treatment called the Neural Repatterning Technique (NRT, which combines a continuous positive stimulus and a reduced intensity, intermittent trigger. The treatment was delivered via the Misophonia Trigger Tamer smartphone app and all treatments were conducted independently by the patient. In this patient, the trigger elicited a physical reflex of contraction of the flexor digitorum profundus, which caused her to clench her fist. To enhance the effect of the NRT treatment, Progressive Muscle Relaxation was incorporated to increase her ability to deliberately relax the affected muscle during treatment. During NRT treatment sessions, the patient experienced a weak physical reflex to the reduced trigger stimulus but no emotional response. Her emotional response of misophonia was not treated, but when the physical reflex extinguished, the emotional response also extinguished. This case indicates that the misophonic response includes a Pavlovian-conditioned physical reflex. It is proposed that the trigger elicited the physical reflex and the physical reflex then elicited the conditioned emotional response that is characteristic of misophonia. Because of the conditioned reflex nature of misophonia, it is proposed that a more appropriate name for this disorder would be Conditioned Aversive Reflex Disorder.

  3. 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

  4. Diagnosis and treatment procedure for intractable liver ascites

    Directory of Open Access Journals (Sweden)

    FAN Zhidong

    2015-03-01

    Full Text Available Ascites is a common complication of liver cirrhosis. Liver ascites may occur repeatedly, which increases the therapeutic difficulty. This paper reviews the definition of intractable liver ascites, general treatment measures, and current treatment of common complications such as spontaneous bacterial peritonitis and hepatorenal syndrome, as well as the advances in conventional, unconventional, and surgical treatment of intractable liver ascites. It is pointed out that abdominocentesis for excessive drainage and active preparation for liver transplantation are the preferred approach to the treatment of intractable liver ascites.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2010-02-15

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

  6. 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)

  7. 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)

  8. Common Operative Procedural Errors and Clinical Factors Associated with Root Canal Treatment

    OpenAIRE

    Estrela, Carlos; Pécora, Jesus Djalma; Estrela, Cyntia R.A.; Guedes, Orlando A.; Silva, Brunno S.F.; Soares, Carlos José; Sousa-Neto, Manoel Damião

    2017-01-01

    Abstract Operative procedural errors must be well analyzed in order to avoid influence negatively the root canal treatment (RCT) prognosis. The successful RCT prevents tooth loss and avoids pain and apical periodontitis. This review aimed to categorize common operative procedure errors and clinical factors associated with RCT. Based on this, will be approached common errors of procedures within the clinical operative sequence: endodontic treatment planning, pulp and periapical disease diagnos...

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

    Directory of Open Access Journals (Sweden)

    Marina Azevedo JUNQUEIRA

    2014-06-01

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

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

    Science.gov (United States)

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

    2014-06-01

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

  11. Ultrasound-guided implantation techniques in treatment of prostate cancer

    International Nuclear Information System (INIS)

    Carter, S.S.; Torp-Pedersen, S.T.; Holm, H.H.

    1989-01-01

    Percutaneous ultrasound-guided interstitial radiotherapy is an attractive and elegant technique for the administration of high-dose local radiotherapy to the prostate. The complications of seed implantation are those associated with the radiation rather than with the technique of implantation. However, radiotherapy has not provided impressive local control of the disease or prolonged survival. The poor disease control was not attributed to poor seed placement, but rather to the inadequacy of 125 I in controlling the cancer. The essence of nonsurgical treatment for prostate cancer is the use of effective imaging. Experience in the field of minimally invasive surgery has shown that ultrasound is the ideal imaging system for targeting treatments because of its ease of use and the absence of adverse effects. As the newer techniques of implantation come to be accepted, it is hoped that the complications of rectal and bladder radiation injury will decrease and the therapeutic benefits increase. The clinical trials required to define the precise role of each of the modalities of treatment must take nodal staging into account and must be compared with the gold standard of radical prostatectomy in the treatment of early confined disease

  12. Biofeedback therapy technique for treatment of urinary incontinence.

    Science.gov (United States)

    O'Donnell, P D; Doyle, R

    1991-05-01

    Biofeedback treatment of urinary incontinence is a management method that has low risk and therapeutic efficacy for selected patients. Biofeedback therapy techniques vary widely and have not been well described or standardized. A technique for biofeedback therapy is described that allows accurate signal monitoring and assures appropriate biofeedback to the patient. External anal sphincter electromyographic performance is presented to the patient as a color line graph with pitch variable audio feedback. The method has complete flexibility in providing biofeedback training according to patient performance level and is one that can be easily interpreted by patients who have voiding dysfunctions.

  13. 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

  14. Corneal collagen cross-linking (CXL) combined with refractive procedures for the treatment of corneal ectatic disorders: CXL plus.

    Science.gov (United States)

    Kymionis, George D; Grentzelos, Michael A; Portaliou, Dimitra M; Kankariya, Vardhaman P; Randleman, J Bradley

    2014-08-01

    To discuss current combined corneal collagen cross-linking (CXL) and refractive surgical techniques (herein termed "CXL plus") for the treatment of corneal ectatic disorders to improve functional visual acuity in addition to corneal stability from CXL alone. Literature review. Efficacious combined treatments with CXL include: photorefractive keratectomy, transepithelial phototherapeutic keratectomy, intrastromal corneal ring segments implantation, phakic intraocular lens implantation, and multiple combined procedures. Some uncertainty remains as to the optimal strategies for each patient. A decision tree is proposed to facilitate optimal patient management. With multiple adjuvant techniques, CXL plus is likely to benefit many patients with corneal ectatic disorders. The appropriate combined procedure will depend on multiple factors, such as refraction, corneal thickness, and degree of irregular astigmatism. Copyright 2014, SLACK Incorporated.

  15. Round block technique is a useful oncoplastic procedure for multicentric fibroadenomas.

    Science.gov (United States)

    Lai, Hung-Wen; Kuo, Yao-Lung; Su, Chin-Chen; Chen, Chih-Jung; Kuo, Sou-Jen; Chen, Shou-Tung; Chen, Dar-Ren

    2016-02-01

    Multicentric fibroadenomas, defined as multiple fibroadenomas located at different quadrants of the breast, occur in 10-20% of women with fibroadenoma. The surgical management of multicentric fibroadenomas may be troublesome for surgeons and patients. In this study, we report our preliminary experience using the "round block technique" in the management of women with multicentric fibroadenomas of the breast. Records of patients with breast diseases managed with the round block technique were searched for in the Changhua Christian Hospital oncoplastic breast surgery database. The patients' clinicopathologic characteristics, type of surgery, operation time, blood loss, and complications were recorded. The cosmetic outcome was evaluated by the patient and operating surgeon two months after the surgery. Twenty patients with multicentric fibroadenomas managed by the round block technique comprised the current study cohort. The mean age of the subjects was 36.5 ± 10.4 years. Twelve (60%) patients had tumors on one side of the breast, and eight (40%) had bilateral breast lesions. The average number of tumors removed was 3.3 ± 1.2 (range 2-6) per breast, and mean tumor size was 2.2 ± 0.5 cm. Three (15%) patients developed mild ecchymosis of the breast undergoing operation, which resolved spontaneously. One (5%) patient had partial nipple ischemia/necrosis due to 2 tumors excised near the nipple-areolar complex. The aesthetic results were evaluated as good in 19 (95%) patients and fair in 1 (5%). The round block technique is a useful oncoplastic procedure for the management of multicentric fibroadenomas excised at the same time. Copyright © 2014 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved.

  16. 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)

  17. Efficacy of different techniques of sinonasal irrigation after modified Lothrop procedure.

    Science.gov (United States)

    Beule, Achim; Athanasiadis, Theodore; Athanasiadis, Emmanuel; Field, John; Wormald, Peter-John

    2009-01-01

    Postoperative irrigation after endoscopic sinus surgery and endoscopic modified Lothrop procedure is used to remove nasal crusts and to improve wound healing. To evaluate the optimal application protocol for irrigation of the frontal sinus, a prospective cadaver study was performed. An endoscopic modified Lothrop procedure and complete sphenoethmoidectomy were performed in 19 heads. Each was irrigated with a 1.5% solution of water and different colors using nasal spray and a squeeze bottle filled with 50, 100, and 200 mL. Intensity of local staining and percentage of area were documented using standardized videoendoscopy after irrigation in "bending over the sink" or "vertex to floor" position. Grading was performed by two independent observers for 23 anatomic regions, including the stained circumference of maxillary and frontal ostia. To evaluate the influence of the anatomy, acoustic rhinometry was performed. ANOVA was used to evaluate effects of application methods and head positions using GenStat 8.2 (Lawes Agricultural Trust, Rothamsted Experimental Station, Harpenden, U.K.) using an appropriate block structure. With regard to the frontal sinus, we were able to show clear superiority of the squeeze bottle technique filled with 200 mL and applied in the "vertex to floor position." In a relatively fit and flexible patient the vertex to floor position using a squeeze bottle technique is advocated. There may be some patients, however, for whom this position is not feasible. In these patients "bending over the sink," while inferior to the "vertex to floor" position, still ensures some irrigation of the frontal sinus.

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

    Directory of Open Access Journals (Sweden)

    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.

  19. Role of Restrictive Endoscopic Procedures in Obesity Treatment

    OpenAIRE

    Lee, Hang Lak

    2017-01-01

    It is well recognized that obesity is a big problem and it can induce large economic burden. Obesity affects about 40% people in the America alone and obesity also is the worldwide problem, with about 400 million obese adults. Moreover, another problem of obesity is the increasing prevalence of overweight children. Though bariatric surgery remains the gold treatment modality in the obesity treatment, endoluminal approaches may have the meaningful role for weight control. Endoscopists should h...

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2008-11-15

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

  1. 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)

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

    Science.gov (United States)

    Saw, Jacqueline; Lempereur, Mathieu

    2014-11-01

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

  3. A new surgical procedure for hallux limitus treatment

    OpenAIRE

    Valero, José; Moreno, Manuel; Gallart, José; González, David; Salcini, Jose L.; Gordillo, Luis; Deus, Javier; Lahoz, Manuel

    2017-01-01

    Abstract The purpose of this study was to evaluate the effectiveness of the new Double-V osteotomy of the first metatarsophalangeal joint (1stMPJ) in patients with hallux limitus (HL). A study of 66 patients was performed, 33 patients were treated Cheilectomy and 33 were treated Double-V. All patients underwent an assessment of the passive mobility of the 1stMPJ before the procedure, reevaluated 12 months later evaluating dorsiflexion, plantarflexion, and patients status using both the Americ...

  4. Numerical treatment of experimental data in calibration procedures

    International Nuclear Information System (INIS)

    Moreno, C.

    1993-06-01

    A discussion of a numerical procedure to find the proportionality factor between two measured quantities is given in the framework of the least-squares method. Variable, as well as constant, amounts of experimental uncertainties are considered for each variable along their measured range. The variance of the proportionality factor is explicitly given as a closed analytical expression valid for the general case. Limits of the results obtained here have been studied allowing comparisons with those obtained using classical least-squares expressions. Analytical and numerical examples are also discussed. (author). 11 refs, 1 fig., 1 tab

  5. 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)

  6. 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

    separating chambers III and IV and the dissolution of a large percentage of sample during the treatment. 39% of zinc, 14% of lead, 18% of copper and 60% of cadmium were removed from fly ash using the electrodialytic technique and these results are compared with previously reported experiments on similar......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....... Experimental parameters monitored include voltage drop, pH and electrolyte's volumes. Evolution of heavy metal concentration with time in the different compartments is analysed. The performance of sodium gluconate for heavy metals extraction from fly ash in different pH conditions is evaluated in batch...

  7. Surgical techniques for the treatment of temporal lobe epilepsy.

    Science.gov (United States)

    Al-Otaibi, Faisal; Baeesa, Saleh S; Parrent, Andrew G; Girvin, John P; Steven, David

    2012-01-01

    Temporal lobe epilepsy (TLE) is the most common form of medically intractable epilepsy. Advances in electrophysiology and neuroimaging have led to a more precise localization of the epileptogenic zone within the temporal lobe. Resective surgery is the most effective treatment for TLE. Despite the variability in surgical techniques and in the extent of resection, the overall outcomes of different TLE surgeries are similar. Here, we review different surgical interventions for the management of TLE.

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

    Science.gov (United States)

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

    2015-12-01

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

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

    Directory of Open Access Journals (Sweden)

    Bongiovani Hércules Lisboa

    2002-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Vilija Berlin

    2015-11-01

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

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

    Directory of Open Access Journals (Sweden)

    C Van Der Horst

    2003-08-01

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

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

    Science.gov (United States)

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

    2010-09-01

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

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

    Directory of Open Access Journals (Sweden)

    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.

  14. 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.

  15. Skin Treatments and Dermatological Procedures to Promote Youthful Skin

    OpenAIRE

    Sator, Paul G

    2006-01-01

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

  16. 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

    2017-10-12

    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 © 2017 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  17. 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.

  18. Noninvasive fetal electrocardiography: an overview of the signal electrophysiological meaning, recording procedures, and processing techniques.

    Science.gov (United States)

    Agostinelli, Angela; Grillo, Marla; Biagini, Alessandra; Giuliani, Corrado; Burattini, Luca; Fioretti, Sandro; Di Nardo, Francesco; Giannubilo, Stefano R; Ciavattini, Andrea; Burattini, Laura

    2015-07-01

    Noninvasive fetal electrocardiography (fECG), obtained positioning electrodes on the maternal abdomen, is important in safeguarding the life and the health of the unborn child. This study aims to provide a review of the state of the art of fECG, and includes a description of the parameters useful for fetus clinical evaluation; of the fECG recording procedures; and of the techniques to extract the fECG signal from the abdominal recordings. The fetus clinical status is inferred by analyzing growth parameters, supraventricular arrhythmias, ST-segment variability, and fetal-movement parameters from the fECG signal. This can be extracted from an abdominal recording obtained using one of the following two electrode-types configurations: pure-abdominal and mixed. Differently from the former, the latter also provides pure maternal ECG tracings. From a mathematical point of view, the abdominal recording is a summation of three signal components: the fECG signal (i.e., the signal of interest to be extracted), the abdominal maternal ECG (amECG), and the noise. Automatic extraction of fECG includes noise removal by abdominal signal prefiltration (0.5-45 Hz bandpass filter) and amECG cancellation. Differences among methods rely on different techniques used to extract fECG. If pure abdominal electrode configurations are used, fECG is extracted directly from the abdominal recording using independent component analysis or template subtraction. Eventually, if mixed electrode configurations are used, the fECG can be extracted using the adaptive filtering fed with the maternal ECG recorded by the electrodes located in the woman thorax or shoulder. © 2015 Wiley Periodicals, Inc.

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

    Science.gov (United States)

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

    2014-01-01

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

  20. Parent Caregiver Self-Efficacy and Child Reactions to Pediatric Cancer Treatment Procedures

    Science.gov (United States)

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

    2014-01-01

    This study examined how parents’ sense of self-efficacy specific to caregiving for their child during cancer treatment procedures affected children’s distress and cooperation during procedures. Potential correlates of caregiver self-efficacy (ie, demographics, child clinical characteristics, parent dispositional attributes, and social support) were also examined. Participants were 119 children undergoing cancer treatment procedures and their parents. Parents’ self-efficacy about 6 procedure-specific caregiver tasks was measured. Parents, children, nurses, and observers rated child distress and parents, nurses and observers rated child cooperation during procedures. Higher parent self-efficacy about keeping children calm during procedures predicted lower child distress and higher child cooperation during procedures. Parent dispositional attributes (eg, enduring positive mood, empathy) and social support predicted self-efficacy. Parent caregiver self-efficacy influences child distress and cooperation during procedures and is associated with certain parent attributes. Findings suggest the utility of identifying parents who would benefit from targeted interventions to increase self-efficacy about caregiving during treatment procedures. PMID:24378818

  1. Skin treatments and dermatological procedures to promote youthful skin.

    Science.gov (United States)

    Sator, Paul G

    2006-01-01

    The skin, the largest organ of the body, is the organ in which changes associated with aging are most visible. With increasing frequency, patients are requesting information and treatments that improve the appearance of their skin. Corresponding to this trend, there is an increasing number of products and methods available that claim to aid this pursuit. First, a change of the patient's lifestyle (eg, sun behavior, nicotine abuse, and nutrition) must take place. Only then may other methods be used. This article reflects on the following topics: topical retinoids, peels, botulinum neurotoxin, soft tissue fillers, lasers, topical and systemic endocrinological therapies, and phytohormones. A thorough knowledge of the properties (benefits, limitations, and complications) of the expanding array of possibilities for rejuvenation of the skin is essential for any physician treating patients with cosmetic complaints.

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

    Science.gov (United States)

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

    2001-05-01

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

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

    Science.gov (United States)

    Mulcahy, Daniel M.

    2013-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Raif Özden

    2014-06-01

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

  5. [New techniques for the treatment of salivary lithiasis: sialoendoscopy and extracorporal lithotripsy: 1773 cases].

    Science.gov (United States)

    Katz, Ph

    2004-06-01

    Salivary lithiasis is a relatively common medical problem. Treatment by invasive endoscopy, intracorporeal lithotripsy, and extracorporeal lithotripsy has been developing worldwide as an alternative to open surgical procedures. We hypothesized that treatment of salivary gland duct stones with endoscopic ductal intervention and extracorporeal lithotripsy could eliminate ductal stones while exposing the patient to less morbidity. In the current study, we analyzed a large clinical series to determine the success of the new techniques and develop an algorithm for comprehensive treatment of salivary stones. Retrospective chart study of 1773 treated salivary ductal pathology cases. Treatment of salivary lithiasis using either duct endoscopy with instrumentation and/or intracorporeal laser lithotripsy or electromagnetic extracorporeal shock wave lithotripsy was undertaken for 1773 lithitic glands between 1988 and 2002. A total of 1105 endoscopies were performed on pathologic glands. 668 therapeutic extracorporeal lithotripsies were conducted. Stones were eliminated endoscopically in 96% of patients. Lithotripsy completely destroyed the stones in 63% of the lithotriptor cases; and an additional 35% of these procedures resulted in stone fragmentation with spontaneous expulsion or ancillary endoscopic removal. There were no major complications such as nerve or tooth damage. Early in the endoscopic series, one patient required surgical removal of a lodged wire-basket snare. TIssue effects such as edema, swelling bleeding or infection were temporary and treated as necessary. Four percent of the endoscopic cases and 2% of the lithotriptor cases ultimately required gland excision to remove the stone. The treatment algorithm for salivary stones, which once contained only conventional open surgery, may now include endoscopic instrumentation and extracorporeal lithotripsy. Both techniques are particularly valuable for stones located in the major salivary ducts. This series

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

    Science.gov (United States)

    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.

  7. Assisted reproductive techniques after fertility-sparing treatments in gynaecological cancers.

    Science.gov (United States)

    Zapardiel, Ignacio; Cruz, Maria; Diestro, Maria D; Requena, Antonio; Garcia-Velasco, Juan A

    2016-04-01

    The trend toward late childbearing has made fertility preservation a major issue for women who face gynecological cancer. New techniques in assisted reproductive medicine enable conception after primary treatment of these cancers. Here, we aimed to review the efficacy and safety of assisted reproductive techniques (ART) after fertility-preserving treatment of gynaecological cancers. We conducted a systematic literature review of both prospective and retrospective studies in the PubMed, EMBASE, CENTRAL and SciSearch databases. In the retrieved studies, we evaluated live births, clinical pregnancies, overall survival and disease-free survival. We identified many prospective and retrospective studies on this topic, but no relevant randomized clinical trials. Fertility-sparing treatments with safe oncological outcomes are feasible in endometrial, cervical and ovarian cancer cases. After cancer treatment, ART seem safe and show variable obstetrical outcomes. After fertility-preserving treatment for gynaecological cancers, ART can enable pregnancy to be achieved with apparent oncological safety. The success of such procedures should directly impact clinical practice and management of those patients who require fertility-sparing treatment. © The Author 2016. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  8. Geometric error of cervical point A calculated through traditional reconstruction procedures for brachytherapy treatment.

    Science.gov (United States)

    Chang, Liyun; Ho, Sheng-Yow; Yeh, Shyh-An; Lee, Tsair-Fwu; Chen, Pang-Yu

    2015-09-08

    Brachytherapy used in local cervical cancer is still widely based on 2D standard dose planning with the prescription to point A, which is invisible on imaging and located at a high-dose gradient. In this study, the geometric location error of point A was investigated. It is traditionally reconstructed in the treatment planning system after carefully digitizing the point marks that were previously drawn on the orthogonal radiographs into the system. Two Cartesian coordinates of point A were established and compared. One was built up based on the geometric definition of point A and would be taken as the true coordinate, while the other was built up through traditional clinical treatment procedures and named as the practical coordinate. The orthogonal-film reconstruction technique was used and the location error between the practical and the true coordinate introduced from the variations of, first, the angle between the tandem and the simulator gantry-rotation-axis, and second, the interval between the tandem flange and the simulator isocenter, was analyzed. The location error of point A was higher if the tandem was rotated away from the gantry-rotation-axis or if the location of the tandem flange was set away from the isocenter. If a tandem with a 30-degree curvature was rotated away from the gantry-rotation-axis 10 degrees in the anterior-posterior (AP) view, and there was an 8.7 cm interval between the flange and the isocenter, the location error of point A would be greater than 3 mm without including other errors from simulator calibration, data input, patient setup and movements. To reduce the location error of point A calculated for traditional reconstruction procedures, it is suggested to move the couch or patient to make the mid-point of two points A near the isocenter and the tandem in the AP view parallel to the gantry-rotation-axis as much as possible.

  9. 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

    . Experimental parameters monitored include voltage drop, pH and electrolyte's volumes. Evolution of heavy metal concentration with time in the different compartments is analysed. The performance of sodium gluconate for heavy metals extraction from fly ash in different pH conditions is evaluated in batch...... extraction tests and during the electrodialytic treatment. This substance was found to perform well for pH below 6 and above 9, although extractions are better in the acidic region. Other relevant observations include the retention of significant amounts of heavy metals on the cation-exchange membrane...... separating chambers III and IV and the dissolution of a large percentage of sample during the treatment. 39% of zinc, 14% of lead, 18% of copper and 60% of cadmium were removed from fly ash using the electrodialytic technique and these results are compared with previously reported experiments on similar...

  10. Treatment of acute liver failure with hemodetoxification techniques.

    Science.gov (United States)

    Splendiani, G; Tancredi, M; Daniele, M; Giammaria, U

    1990-06-01

    The exact pathogenesis of hepatic coma is unknown and this fact has stimulated research in the field of hemodetoxification treatment. We studied 31 patients (19 M and 12 F) with acute hepatic failure and used different detoxification techniques such as hemodialysis, hemoperfusion, hemofiltration and plasmaferesis. We evaluated blood tests, degree of coma and serum levels of middle-molecular weight substances (by gel-chromatography) for each patient. Our results show that there was an improvement of consciousness and general clinical state in 40% of patients who underwent HD, in 50% of patients treated with HP, in 37.5% of those treated with PF and 78% of patients treated with HF. Unfortunately, the improvement did not last long. In conclusion we can say that artificial support improves hepatic coma and state of consciousness. This improvement could be due to the better regeneration possibilities of hepatic cells. For this reason hemodetoxification treatment should be started as soon as possible.

  11. 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.

  12. [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.

  13. Electrochemical Techniques in Textile Processes and Wastewater Treatment

    Directory of Open Access Journals (Sweden)

    Mireia Sala

    2012-01-01

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

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

    Science.gov (United States)

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

    2017-06-01

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

  15. Procedural complications of endovascular treatment in patients with aneurysmal subarachnoid haemorrhage treated at a single centre.

    Science.gov (United States)

    Alanen, Mikko; Pyysalo, Liisa; Jalava, Iiro; Snicker, Oona; Pienimäki, Juha-Pekka; Öhman, Juha; Ronkainen, Antti

    2018-03-01

    We present a single-centre experience of procedural complications suffered by patients undergoing endovascular treatment for a ruptured saccular intracranial aneurysm at Tampere University Hospital, Finland, between 2000 and 2014. From 2000 to 2014, we treated 1,253 patients with aneurysmal subarachnoid haemorrhage, 491 of whom received endovascular treatment. Clinical data were collected retrospectively from the hospital's aneurysm database. A procedural complication was defined as having occurred whenever there was a documented new event in the patient's medical records or a note of a technical complication written by an interventionist after endovascular treatment. Procedural complications could be with or without clinical symptoms. Nearly 40% (491/1253) of the patients were treated with the endovascular method. Procedural complications occurred in 11.4% (56/491) of cases. The morbidity rate was 4.5% (22/491) and the mortality rate was 0.2% (1/491). Of the 56 complications, ischaemic complications occurred in 52% (29/56), haemorrhagic complications occurred in 27% (15/56) and technical complications occurred in 21% (12/56) of cases. In 61% (34/56) of the cases, the procedural complication did not cause any clinical symptoms. The total risk for procedural complications leading to postoperative disability or death at our institute was 4.7%. The complication frequency is in accordance with previous reports. Endovascular treatment of ruptured intracranial aneurysms is a safe treatment method when patient selection is carefully performed.

  16. Recommended procedures and techniques for the petrographic description of bituminous coals

    Science.gov (United States)

    Chao, E.C.T.; Minkin, J.A.; Thompson, C.L.

    1982-01-01

    Modern coal petrology requires rapid and precise description of great numbers of coal core or bench samples in order to acquire the information required to understand and predict vertical and lateral variation of coal quality for correlation with coal-bed thickness, depositional environment, suitability for technological uses, etc. Procedures for coal description vary in accordance with the objectives of the description. To achieve our aim of acquiring the maximum amount of quantitative information within the shortest period of time, we have adopted a combined megascopic-microscopic procedure. Megascopic analysis is used to identify the distinctive lithologies present, and microscopic analysis is required only to describe representative examples of the mixed lithologies observed. This procedure greatly decreases the number of microscopic analyses needed for adequate description of a sample. For quantitative megascopic description of coal microlithotypes, microlithotype assemblages, and lithotypes, we use (V) for vitrite or vitrain, (E) for liptite, (I) for inertite or fusain, (M) for mineral layers or lenses other than iron sulfide, (S) for iron sulfide, and (X1), (X2), etc. for mixed lithologies. Microscopic description is expressed in terms of V representing the vitrinite maceral group, E the exinite group, I the inertinite group, and M mineral components. volume percentages are expressed as subscripts. Thus (V)20(V80E10I5M5)80 indicates a lithotype or assemblage of microlithotypes consisting of 20 vol. % vitrite and 80% of a mixed lithology having a modal maceral composition V80E10I5M5. This bulk composition can alternatively be recalculated and described as V84E8I4M4. To generate these quantitative data rapidly and accurately, we utilize an automated image analysis system (AIAS). Plots of VEIM data on easily constructed ternary diagrams provide readily comprehended illustrations of the range of modal composition of the lithologic units making up a given coal

  17. Concussion Treatment Using Massage Techniques: a Case Study.

    Science.gov (United States)

    Burns, Sylvia L

    2015-06-01

    Concussion, its recognition, diagnosis, and treatment is a growing public health issue. Massage practitioners who specialize in rehabilitation deal with a variety of injury cases that involve concussion, including those incurred by falls, motor vehicle incidents, and sports injuries. This case study presents a unique massage therapy approach to concussion trauma treatment. Male 23-year-old intramural soccer player diagnosed with postconcussion syndrome resulting from a fall. Assessment and treatment were completed in two sessions of 45 minutes spaced two days apart. Massage therapy techniques were applied to injury areas by a Licensed Massage Practitioner. Using the Balance Error Scoring System (BESS) and self-report, the outcome measures showed diminished concussion symptoms and regained ease in range of motion in the cervical area. Positive results for this case highlight the potential importance of massage therapy work to reduce headache, dizziness, and nausea in concussion recovery. In the presence of such outcomes, massage therapy may also have a supportive role in a person's return to function after concussion.

  18. Monitoring Therapeutic Treatments against Burkholderia Infections Using Imaging Techniques

    Directory of Open Access Journals (Sweden)

    Tiffany M. Mott

    2013-05-01

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

  19. Radiofrequency Atrial Fibrillation Ablation Technique in Patients with Mitral Valve Surgery and Left Atrial Reduction Procedures

    Directory of Open Access Journals (Sweden)

    Pouya Nezafati1

    2015-10-01

    Full Text Available Background: About half of all patients who undergo mitral valve surgery suffer from atrial fibrillation (AF. Cox described the surgical cut-and-sew Maze procedure, which is an effective surgical method but has some complications. This study was designed to evaluate the efficacy of a substitution method of radiofrequency ablation (RFA for patients undergoing mitral valve surgery with AF.Methods: We evaluated 50 patients, comprising 40 men and 10 women at a mean age of 61.8 ± 7.5 years, who underwent mitral valve surgery with RFA between March 2010 and August 2013. All the patients had permanent AF with an enlarged left atrium (LA. The first indication for surgery was underlying organic lesions. Mitral valve replacement or repair was performed in the patients as a single procedure or in combination with aortic valve replacement or coronary artery bypass grafting. Radiofrequency energy was used to create continuous endocardial lesions mimicking most incisions and sutures. We evaluated the pre- and postoperative LA size, duration of aortic cross-clamping, cardiopulmonary bypass time, intensive care unit stay, and total hospital stay.Results: The mean preoperative and postoperative LA sizes were 7.5 ± 1.4 cm and 4.3 ± 0.7 cm (p value = 0.0001, respectively. The mean cardiopulmonary bypass time and the aortic cross-clamping time were 134.3 ± 33.7 minand 109.0 ± 28.4 min, respectively. The average stay at the intensive care unit was 2.1 ± 1.2 days, and the total hospital stay was 8.3 ± 2.4 days. Rebleeding was the only complication, found in one patient. There was no early or late mortality. Eighty-two percent of the patients were discharged in normal sinus rhythm. Five other patients had normal sinus rhythm at 6months' follow-up, and the remaining 4 patients did not have a normal sinus rhythm after 6 months.Conclusion: Radiofrequency ablation, combined with LA reduction, is an effective option for the treatment of permanent AF concomitant with

  20. The importance of the right focusing technique. At-a-glance information on focusing techniques in X-ray procedures

    International Nuclear Information System (INIS)

    Lichte-Wichmann, M.

    1993-01-01

    Sharp pictures providing all the information relevant to a particular case obviate repeat exposures, help to keep the radiation dose to a minimum and prevent false diagnoses. In her book, the author gives practical guidance on focusing techniques that is equally valuable to beginners and experienced investigators or medical X-ray assistants and physicians. A substantial part of the book is devoted to detailed instructions on how an object is brought into focus as well as on the criteria of proper focusing and the possibilities of identifying and avoiding false focusing techniques. The problems arising when uncommon X-ray pictures have to be taken are explained by diagrammatic representations. (orig.) [de

  1. [Treatment of urolithiasis in children and adolescents with extracorporeal lithotripsy and adjuvant urologic procedures].

    Science.gov (United States)

    Cueva Martínez, A; Braun, P M; Martínez Portillo, F J; Hoang-Böhm, J; Jünemann, K P; Alken, P; Köhrmann, K U

    2001-01-01

    To determine the efficacy of ESWL treatment in children and the need for auxiliary urological procedures. In a retrospective analysis we investigated the number of auxiliary procedures and the stone-free rate in children after ESWL treatment. 28 girls and 21 boys with a total of 56 stones were treated from January 1990 to January 1999. ESWL was carried out on either the Lithostar Plus or the Modulith SL20/SLX. Auxiliary procedures were subdivided into curative (ureterorenoscopy, percutaneous nephrolitholapaxy) and adjuvant (urethral stent, nephrostomy). 34.7% of the children were stone-free after the first ESWL treatment; 40.8% of the children were discharged with residual stone particles ready for spontaneous passage; 24.5% underwent re-ESWL treatment. Auxiliary urological procedures were required in 28.6% of the cases (adjuvant 18.3%, curative 10.3%). Extracorporeal shock wave lithotripsy is also a highly effective method of treatment for urolithiasis in children. However, curative or adjuvant auxiliary urological measures are required. In order to achieve high success rates, it is advisable to perform this method of treatment in centers with broad experience in ESWL and endourological procedures in children.

  2. 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…

  3. 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.…

  4. Spinal and sacroiliac assessment and treatment techniques used by osteopathic physicians in the United States

    Science.gov (United States)

    Fryer, Gary; Morse, Christopher M; Johnson, Jane C

    2009-01-01

    Background Osteopathic manipulative medicine texts and educators advocate a range of approaches for physical assessment and treatment, but little is known about their use by osteopathic physicians in the United States. Methods A web-based survey using a 5-point Likert scale was developed and e-mailed to 777 practicing osteopathic physician members of the American Academy of Osteopathy. Responses in the "frequently" and "always" categories were combined for reporting purposes. Friedman tests were used to analyze the reported usage of each item. The effect of gender was analyzed using Mann-Whitney tests. Results One hundred seventy-one osteopathic physicians completed the survey (22%). For the assessment of spinal somatic dysfunction, paraspinal tissue texture (98%), transverse process asymmetry (89%), and tenderness (85%) were most commonly reported. Myofascial release (78%), soft tissue technique (77%), and patient self-stretches (71%) were most commonly used for treatment of the spine. For assessment of pelvic landmark asymmetry, the anterior superior iliac spine (ASIS, 87%), sacral base (82%), posterior superior iliac spine (81%), sacral sulci (78%), iliac crests (77%), and inferior lateral angle of the sacrum (74%) were commonly palpated. For assessment of sacroiliac joint motion, ASIS compression (68%) was most commonly used. Sacroiliac pain provocation tests were also employed although their use was less common than asymmetry or motion tests. Muscle energy (70%), myofascial release (67%), patient self-stretches (66%), osteopathy in the cranial field (59%), muscle strengthening exercises (58%), soft tissue technique (58%), and articulatory technique (53%) were most commonly used for treatment of the pelvis and sacroiliac. The effect of gender was significant for many of the treatment procedures, with females using more soft tissue and muscle energy and males more high-velocity techniques. The majority of respondents document the types of osteopathic

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

    Science.gov (United States)

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

    2016-04-01

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

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

    Directory of Open Access Journals (Sweden)

    Alessandro Crestani

    2016-01-01

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

  7. Estimation of the effective doses for interventional employees in three common interventional diagnosis and treatment procedures

    International Nuclear Information System (INIS)

    Zhang Lin; Zhu Jianguo; Min Nan; Lu Feng; Chen Yue

    2011-01-01

    Objective: To study and estimate the effective dose of interventional employees in the common cerebral vascular, cardiovascular and liver interventional diagnosis and treatment. Methods: The absorbed doses of tissue or organ of anthropomorphic phantom in these three procedures were estimated by the anthropomorphic phantom experiment. The effective doses were calculated by the tissue weight factor which was given by International Commission on Radiological Protection publication 103. Results: The effective doses to high, medium and low group were 24.0, 9.7, 6.8 μSv for cerebral vascular interventional diagnosis and treatment, and 36.3, 29.3, 17.8 μSv for cardiovascular interventional diagnosis and treatment, and 23.9, 11.3, 5.5 μ Sv for liver interventional diagnosis and treatment, respectively. Conclusions: The effective doses of high, medium and low group of interventional employees in cardiovascular interventional procedure are higher than those of cerebral vascular and liver interventional procedures. (authors)

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

    Directory of Open Access Journals (Sweden)

    Jagmohan Singh

    2014-01-01

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

  9. 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

  10. Congenital vertical talus: Treatment by reverse ponseti technique

    Directory of Open Access Journals (Sweden)

    Bhaskar Atul

    2008-01-01

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

  11. SNODGRASS Procedure – A Versatile Technique for Various Types of Hypospadias Repair

    Directory of Open Access Journals (Sweden)

    Hombalkar N. N.

    2013-07-01

    Full Text Available There are about 156 operations described forhypospadias. The sheer number of proceduresindicates that no single procedure is standardfor hypospadias. We report our series of 20patients operated for hypospadias by Snodgrassprocedure. The technical details of the proce-dure and post-operative management protocolis discussed.

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

    Science.gov (United States)

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

    2016-04-01

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

  13. Procedure and technique critique for tritium enrichment by electrolysis at the IAEA Laboratory (effective November 1976)

    International Nuclear Information System (INIS)

    1976-01-01

    This publication gives a detailed description of the experimental and calculation procedures for tritium enrichment. Most descriptive sections are divided into 2 parts: Section A describes the procedure in the IAEA laboratory; section B discusses the reasons behind the various procedures, and may indicate alternative acceptable, or in some cases even better, procedures. The description of the equipment focuses on electrolysis cells, cooling system and power supply. Routine procedures are discussed including handling and checking of samples after receipt, 'spike' and blank water, initial sample distillation, preparation of cells and samples for electrolysis, electrolysis and completion of electrolysis (weighing of cells, neutralisation and distillation) and precautions against contaminations (prevention, detection and cure). A list of equipment required for electrolytic enrichment of tritium is provided

  14. 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

  15. Sediment remediation treatment techniques for the Venice industrial canals

    Energy Technology Data Exchange (ETDEWEB)

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

    2003-07-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2013-07-01

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

  17. 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.

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

    Science.gov (United States)

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

    2014-08-20

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

  19. Improved arthroscopic one-piece excision technique for the treatment of symptomatic discoid medial meniscus.

    Science.gov (United States)

    Wang, Hong-De; Li, Tong; Gao, Shi-Jun

    2017-10-30

    Discoid medial meniscus is an extremely rare abnormality of the knee. During arthroscopic meniscectomy for symptomatic discoid medial meniscus, it is difficult to remove the posterior portion of the meniscus because of the confined working space within the compartment and the obstruction caused by the anterior cruciate ligament and the tibial intercondylar eminence. To overcome these problems, we describe an improved arthroscopic technique for one-piece excision of symptomatic discoid medial meniscus through three unique portals. Three improved portals were made in the injured knee: a standard anteromedial portal, a central transpatellar tendon portal, and a high anterolateral portal. The anterior side of the discoid medial meniscus was cut 7 mm from the periphery of the meniscus. Next, the anterior portion of the free discoid meniscus fragment was pulled in the anterolateral direction with tension. A curve-shaped cut was made along the longitudinal tear to the posterior horn using basket forceps through the standard anteromedial portal. Then, the anterior portion of the free discoid meniscus was pulled in the anteromedial direction. Pulling the fragment under tension made it easier to cut the posterior side of the discoid meniscus. The posterior side of the discoid meniscus was cut 7 mm from the periphery of the meniscus with straight scissors or basket forceps through the central transpatellar tendon portal. This technique resulted in satisfactory results. Excellent visualization of the posterior part of the discoid medial meniscus was gained during the procedure, and it was easy to cut the posterior part of the discoid medial meniscus. No recurrent symptoms were found. This improved arthroscopic one-piece excision technique for the treatment of symptomatic discoid medial meniscus enables the posterior part of the meniscus to be cut satisfactorily. Moreover, compared with previous techniques, this novel technique causes less formation of foreign bodies and less

  20. 40 CFR 141.404 - Treatment technique violations for ground water systems.

    Science.gov (United States)

    2010-07-01

    ....404 Treatment technique violations for ground water systems. (a) A ground water system with a... ground water system is in violation of the treatment technique requirement if, within 120 days (or...) before or at the first customer for a ground water source is in violation of the treatment technique...

  1. 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

  2. A Guide for Developing Standard Operating Job Procedures for the Pump Station Process Wastewater Treatment Facility. SOJP No. 3.

    Science.gov (United States)

    Perley, Gordon F.

    This is a guide for standard operating job procedures for the pump station process of wastewater treatment plants. Step-by-step instructions are given for pre-start up inspection, start-up procedures, continuous routine operation procedures, and shut-down procedures. A general description of the equipment used in the process is given. Two…

  3. Comparison between three mini-sling surgical procedures and the traditional transobturator vaginal tape technique for female stress urinary incontinence.

    Science.gov (United States)

    Leanza, V; Intagliata, E; Leanza, A; Ferla, F; Leanza, G; Vecchio, R

    2014-01-01

    To compare mini-sling and traditional tension-free operations for female stress urinary incontinence. A systematic review of articles in the Literature published between 2002 and 2012, was conducted. A Pubmed search was performed. Primary outcomes were subjective and objective cure rates at 12 months comparing the three single-incision mini-slings techniques (TVT-Secur, MiniArc and Monarc systems) with the standard midurethral sling procedure TOT (Transobturator Vaginal Tape). Secondary outcomes included peri-operative (vaginal and/or bladder perforation, urine retention, urinary tract infection, bleeding, pain) and post-operative (mesh exposure, de novo urgency, and dyspareunia) complications. In term of objective cure rate at 12 month after surgery, it is evident that TOT at first, and MiniArc are the most effective procedures. The incidence of post-operative urgency and UTI was lower in TOT technique, while vaginal perforation was described in equal frequency both in TOT and in MiniArc procedures. The advantages of the three above described mini-invasive techniques seem to consist into lower cases of urinary retention, pain and bleeding. Furthermore, bladder perforation and bleeding are not described in the Literature for TVT-Secur and Monarc systems. Some single-incision slings look promising and as effective as conventional sub-urethral slings at short term evaluation. However, at this moment a clear statement in favor of the widespread use of single-incision slings cannot be made. More studies must define the efficacy of these techniques.

  4. A minimally invasive technique for surgical treatment of hallux valgus: simple, effective, rapid, inexpensive (SERI).

    Science.gov (United States)

    Giannini, Sandro; Faldini, Cesare; Nanni, Matteo; Di Martino, Alberto; Luciani, Deianira; Vannini, Francesca

    2013-09-01

    Several bony and soft tissue procedures have been described for the treatment of hallux valgus, and currently mini-invasive surgical techniques are preferred in order to reduce surgical trauma, complications, time of surgery and to allow an earlier recovery. The aim of this study is to analyse a series of 1,000 consecutive cases of hallux valgus, surgically treated by the minimally invasive SERI technique, reporting results at mid-term follow-up. We prospectively studied 641 patients (1,000 feet) with symptomatic hallux valgus surgically treated by SERI osteotomy. Inclusion criteria were: age between 20 and 65 years, reducible mild or moderate hallux valgus, HVA ≤ 40°, IMA ≤ 20°, and arthritis of the first metatarsophalangeal joint up to grade 2 according to the Regnauld classification. The American Orthopaedic Foot and Ankle Society (AOFAS) score rose from 46.8 ±  6.7 preoperatively to 89 ± 10.3 at last follow-up. Radiographic control at follow-up showed a complete healing of the osteotomy and remodelling of the metatarsal bone. Low rate of complication has been reported. This study demonstrated that the SERI technique is effective in treating mild to moderate hallux valgus in terms of relief from symptoms and functional improvement. This technique allowed correction of the main parameters of the deformity, with durable clinical and radiographic results at a mid-term follow-up.

  5. Treatment and outcome of coronary artery perforations using a dual guiding catheter technique.

    Science.gov (United States)

    Röther, J; Tröbs, M; Ludwig, J; Achenbach, S; Schlundt, C

    2015-12-15

    To evaluate the success rate and outcome of coronary artery perforation treatment using a dual guiding catheter technique. Coronary artery perforation is a rare but severe complication during percutaneous coronary intervention (PCI) with high mortality. The use of a second guiding catheter is a helpful technique to minimize hemorrhage through the perforation during interventional repair. We screened all patients between March 2004 and December 2014 who underwent PCI in our department for the occurrence of peri-interventional coronary perforation that was treated using a dual catheter technique. Patient and lesion characteristics as well as outcome were determined. We identified 8 patients who experienced coronary artery perforations (Ellis grade III) during coronary intervention and were treated using a dual guiding catheter approach. The procedure was technically successful (placement of covered stent and sealing of perforation) in 6 patients. Pericardiocentesis was required in 3 patients (38%). Total mortality was 12% (n=1). No coronary or peripheral vascular access complication occurred due to the use of a second guiding catheter. We suggest that the dual guiding catheter technique is a useful and alternative approach to treat severe Ellis grade III coronary artery perforations that occur in the context of percutaneous coronary interventions. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  6. Technique for verifying treatment fields using portal images with diagnostic quality.

    Science.gov (United States)

    Shiu, A S; Hogstrom, K R; Janjan, N A; Fields, R S; Peters, L J

    1987-10-01

    The image quality of portal films for megavoltage photon beams, when using the double-exposure technique, is poor compared to diagnostic quality, X ray images. A technique is described to record on a single film a megavoltage portal image superimposed upon a diagnostic X ray image, which provides the radiotherapist with "diagnostic quality" portal images. The technique uses a commercially available X ray tube mounted on the head of a 60Co unit. The alignment procedure, which uses a leveling device to ensure that the X ray focal spot and 60Co source are at the same location for each exposure, is confirmed by registering on film the image of an alignment marker. An evaluation of film-screen combination showed therapy verification film in a rare earth intensifying screen cassette to be best suited for this technique. The relationship between off-axis dose and the penumbral region of the portal image has been evaluated and should be useful in the interpretation of portal verification film relative to the treatment volume.

  7. Development of a technique for environmental treatment by radiation

    International Nuclear Information System (INIS)

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

    2000-04-01

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

  8. Development of a technique for environmental treatment by radiation

    Energy Technology Data Exchange (ETDEWEB)

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

    2000-04-01

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

  9. Radiation treatment planning techniques for lymphoma of the stomach

    International Nuclear Information System (INIS)

    Della Biancia, Cesar; Hunt, Margie; Furhang, Eli; Wu, Elisa; Yahalom, Joachim

    2005-01-01

    Purpose: Involved-field radiation therapy of the stomach is often used in the curative treatment of gastric lymphoma. Yet, the optimal technique to irradiate the stomach with minimal morbidity has not been well established. This study was designed to evaluate treatment planning alternatives for stomach irradiation, including intensity-modulated radiation therapy (IMRT), to determine which approach resulted in improved dose distribution and to identify patient-specific anatomic factors that might influence a treatment planning choice. Methods and Materials: Fifteen patients with lymphoma of the stomach (14 mucosa-associated lymphoid tissue lymphomas and 1 diffuse large B-cell lymphoma) were categorized into 3 types, depending on the geometric relationship between the planning target volume (PTV) and kidneys. AP/PA and 3D conformal radiation therapy (3DCRT) plans were generated for each patient. IMRT was planned for 4 patients with challenging geometric relationship between the PTV and the kidneys to determine whether it was advantageous to use IMRT. Results: For type I patients (no overlap between PTV and kidneys), there was essentially no benefit from using 3DCRT over AP/PA. However, for patients with PTVs in close proximity to the kidneys (type II) or with high degree of overlap (type III), the 4-field 3DCRT plans were superior, reducing the kidney V 15Gy by approximately 90% for type II and 50% for type III patients. For type III, the use of a 3DCRT plan rather than an AP/PA plan decreased the V 15Gy by approximately 65% for the right kidney and 45% for the left kidney. In the selected cases, IMRT led to a further decrease in left kidney dose as well as in mean liver dose. Conclusions: The geometric relationship between the target and kidneys has a significant impact on the selection of the optimum beam arrangement. Using 4-field 3DCRT markedly decreases the kidney dose. The addition of IMRT led to further incremental improvements in the left kidney and liver

  10. Distal soft tissue procedure in hallux valgus surgery: biomechanical background and technique.

    Science.gov (United States)

    Schneider, Wolfgang

    2013-09-01

    The distal soft tissue procedure has evolved into an indispensable additional surgical procedure to increase the corrective effect in hallux valgus surgery. Considering the biomechanical development of hallux valgus deformity, degenerative changes of the soft tissues around the first metatarsophalangeal joint contribute much more to the deformity than changes in the bony structures which can rather be seen as degenerative changes secondary to the deformity. Thus the principles in hallux valgus correction should aim to reverse all pathogenetic steps leading to deformity: release of the contracted lateral soft tissue structures, tightening of the torn-out medial structures and reduction and rebalancing the first metatarsal head onto the sesamoid complex. The scientific discussion over the last decades has clarified the impact of different surgical steps and methods on the efficacy of the lateral release, the risk of creating overcorrection or instability of the joint and the risk of avascular necrosis of the first metatarsal head. According to anatomical and clinical data, a lateral soft tissue release can be combined with a distal metatarsal osteotomy, provided that the osteotomy is performed in a defined safe zone without increasing the risk for avascular necrosis of the first metatarsal head. Transecting the lateral metatarsosesamoid suspensory ligament is the key to a successful lateral release in hallux valgus surgery. Release of the deep transverse metatarsal ligament and the adductor hallucis muscle does not contribute to hallux valgus correction. The lateral short sesamophalangeal ligament and the plantar attachment of the articular capsule should be preserved to avoid possible joint instability. Thus today, the distal soft tissue procedure cannot be seen only as a supplementary surgical procedure in cases where the bony procedure needs additional correction, but rather is an indispensable procedure to restore the physiological situation and function of the

  11. A model treatment refusal procedure for defendants found incompetent to stand trial in the ninth circuit.

    Science.gov (United States)

    Epson, Martin; Rodol, Liban; Bloom, Joseph D

    2012-01-01

    Pretrial detainees have a constitutionally protected right to refuse medical treatment in most circumstances; however, individuals found incompetent to stand trial (IST) due to a mental disorder can be treated involuntarily by clinicians who adhere to careful medical and legal procedures. The process of involuntary treatment of IST pretrial detainees begins with categorization into particular legal and medical groups. These different categories affect the individual's access to treatment. In this article, we review the relevant case law for the jurisdiction of the Ninth Circuit and place the medical-legal debate regarding these procedures in the context of recent cases. To address the medical-legal disjunction, we propose and discuss a model for managing treatment refusal in pretrial detainees found IST.

  12. 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

  13. 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.

  14. Radiation exposure to patients from image guidance procedures and techniques to reduce the imaging dose.

    Science.gov (United States)

    Ding, George X; Munro, Peter

    2013-07-01

    To compare imaging doses from MV images, kV radiographs, and kV-CBCT and describe methods to reduce the dose to patient's organs using existing on-board imaging devices. Monte Carlo techniques were used to simulate kV X-ray sources. The kV image doses to a variety of patient anatomies were calculated by using the simulated realistic sources to deposit dose in patient CT images. For MV imaging, the doses for the same patients were calculated using a commercial treatment planning system. Portal imaging results in the largest dose to anatomic structures, followed by Varian OBI CBCT, Varian TrueBeam CBCT and then kV radiographs. The imaging doses for the 50% volume from the DVHs, D50, to the eyes for representative head images are 4.3-4.8cGy; 0.05-0.06cGy; 0.04-0.05cGy; and, 0.12cGy; D50 to the bladder for representative pelvis images are 3.3cGy; 1.6cGy; 1.0cGy; and, 0.07cGy; while D50 to the heart for representative thorax images are 3.5cGy; 0.42cGy; 0.2cGy; and, 0.07cGy; when using portal imaging, OBI kV-CBCT scans, TrueBeam kV-CBCT scans and kV radiographs, respectively. The orientation of the kV beam can affect organ dose. For example, D50 to the eyes can be reduced from 0.12cGy using AP and right lateral radiographs to 0.008-0.017cGy when using PA and right lateral radiographs. In addition, organ exposures can be further reduced to 15-70% of their original values with the use of a full-fan, bow-tie filter for kV radiographs. In contrast, organ doses increase by a factor of ∼2-4 if bow-tie filters are not used during kV-CBCT acquisitions. Current on-board kV imaging devices result in much lower imaging doses compared to MV imagers even taking into account of higher bone dose from kV X-rays. And a variety of approaches are available to significantly reduce the image doses. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  15. A two step linear statistical technique using leaps and bounds procedure for retrieval of geophysical parameters from microwave radiometric data

    Science.gov (United States)

    Kakar, R. K.; Pandey, P. C.

    1983-01-01

    A linear statistical technique using a 'leaps and bounds' procedure (Furnival and Wilson, 1974) is developed for retrieving geophysical parameters from remote measurements. It is used for retrieving sea surface temperatures from the Scaning Multichannel Microwave Radiometer (SMMR) on Seasat. The technique uses an efficient algorithm to select the best fixed-size subset of the 10 SMMR channels for linearly retrieving a given geophysical parameter. The 5-channel subset (6.6V, 6.6H 10H, 18V, 21H), where V and H refer to, respectively, the vertical and horizontal polarizations and the numbers are the channel frequencies in gigahertz, gives the minimum rms error in estimating the sea surface temperature. A comparison with ground truth indicates that the algorithm infers the temperature with an rms accuracy of better than 1.5 K under most environmental conditions. A quality control procedure which is seen as holding promise for further improving the accuracy is proposed.

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

    OpenAIRE

    Vale, Monica Sampaio do; Moreno, Melinna dos Santos; Silva, Priscila Macedo Franca da; Botelho, Thereza Cristina Farias

    2013-01-01

    In this study, we compared the ex vivo removal capacity of two endodontic rotary techniques and determined whether there was a significant quantitative difference in residual material when comparing root thirds. Forty extracted molars were used. The palatal roots were selected, and the canals were prepared using a step-back technique and filled using a lateral condensation technique with gutta-percha points and Endofill sealer. After two weeks of storage in a 0.9% saline solution at 37ºC...

  17. 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.

  18. Diagnostic procedures and treatment of childhood obesity by pediatricians: 'The Dutch Approach'

    NARCIS (Netherlands)

    Schwiebbe, L.; Talma, H.; van Mil, E.G.; Fetter, W.P.F.; Hirasing, R.A.; Renders, C.M.

    2013-01-01

    Child Public Health professionals in the Netherlands refer obese children to a pediatrician to check for underlying causes and comorbidity. What happens to these children in terms of diagnostics and treatment when they visit a pediatrician? To get an overview of the diagnostic procedures and

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

    NARCIS (Netherlands)

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

    2003-01-01

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

  20. CONTEMPORARY PRINCIPLES FOR CHOLECYSTITIS TREATMENT WITH LAPAROSCOPIC TECHNIQUE

    Directory of Open Access Journals (Sweden)

    Slobodan Aranđelović

    2016-03-01

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

  1. 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.

  2. 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.

  3. [Treatment of complex hand injuries by stable osteosynthesis using a "multiple pinning" technique].

    Science.gov (United States)

    Le Nen, D; Hu, W; Genestet, M; Liot, M; Tran Quan, J; Dos Remédios, C; Mener, G

    2004-04-01

    The multiple pinning technique has been reported by the authors as an effective method for the treatment of comminuted osteo-articular fractures of the digits. This procedure can be performed rapidly, offers good stability and thereby allows early post-operative physiotherapy. The aim of this type of management is to offer the patient recovery of thumb to digit pinch by restoring two functional joints (MCP, PIP) or at least one functional joint (MCP), particularly as far as the radial digits are concerned. After performing reduction, very small diameter pins are introduced and the bone fragments are reconstructed like a puzzle. The very small calibre of the pins allows multiple pinning and simultaneously permits them to be easily orientated. The pins being multiple, and parallel or diverging are responsible for the stability of the construct. The ends of the pins are either bent over or more frequently, just cut flush with the surface of the bone. Comminuted fractures, even the most severe, respond very nicely to this management. The multiple pinning technique offers remarkable stability, allowing early post-operative physiotherapy. This technique is particularly effective when faced with the difficulties of treating open fractures of the metacarpals and phalanges. Moreover, this technique avoids performing an extensive skin incision. The stability of this multiple pinning technique could be related to the following factors: the shortness of the pins offering more rigidity and less flexibility, the proper fixation of the pins within the cortical bone, especially in the diaphysis and the large number of pins offering more strength. The disadvantage of this technique is the possibility of pin migration.

  4. Evaluation of superficial dosimetry between treatment planning system and measurement for several breast cancer treatment techniques

    Energy Technology Data Exchange (ETDEWEB)

    Akino, Yuichi; Das, Indra J.; Bartlett, Gregory K.; Zhang Hualin; Thompson, Elizabeth; Zook, Jennifer E. [Department of Radiation Oncology, Indiana University School of Medicine, Indianapolis, Indiana 46202 (United States) and Department of Radiation Oncology, Osaka University Graduate School of Medicine, Suita, Osaka 565-0871 (Japan); Department of Radiation Oncology, Indiana University School of Medicine, Indianapolis, Indiana 46202 (United States)

    2013-01-15

    Purpose: Dosimetric accuracy in radiation treatment of breast cancer is critical for the evaluation of cosmetic outcomes and survival. It is often considered that treatment planning systems (TPS) may not be able to provide accurate dosimetry in the buildup region. This was investigated in various treatment techniques such as tangential wedges, field-in-field (FF), electronic compensator (eComp), and intensity-modulated radiotherapy (IMRT). Methods: Under Institutional Review Board (IRB) exemption, radiotherapy treatment plans of 111 cases were retrospectively analyzed. The distance between skin surface and 95% isodose line was measured. For measurements, Gafchromic EBT2 films were used on a humanoid unsliced phantom. Multiple layers of variable thickness of superflab bolus were placed on the breast phantom and CT scanned for planning. Treatment plans were generated using four techniques with two different grid sizes (1 Multiplication-Sign 1 and 2.5 Multiplication-Sign 2.5 mm{sup 2}) to provide optimum dose distribution. Films were placed at different depths and exposed with the selected techniques. A calibration curve for dose versus pixel values was also generated on the same day as the phantom measurement was conducted. The DICOM RT image, dose, and plan data were imported to the in-house software. On axial plane of CT slices, curves were drawn at the position where EBT2 films were placed, and the dose profiles on the lines were acquired. The calculated and measured dose profiles were separated by check points which were marked on the films before irradiation. The segments of calculated profiles were stretched to match their resolutions to that of film dosimetry. Results: On review of treatment plans, the distance between skin and 95% prescribed dose was up to 8 mm for plans of 27 patients. The film measurement revealed that the medial region of phantom surface received a mere 45%-50% of prescribed dose. For wedges, FF, and eComp techniques, region around the

  5. 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.

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

    Science.gov (United States)

    Bonino, M; DE Vico, G; Spinelli, D; Conti, I; Ottria, L; Barlattani, A

    2010-04-01

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

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

    Science.gov (United States)

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

    2017-07-01

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

  8. Parallel side-docking technique for gynecologic procedures utilizing the da Vinci robot.

    Science.gov (United States)

    Silverman, Suzanne; Orbuch, Laurence; Orbuch, Iris

    2012-09-01

    Minimally invasive approaches to gynecologic surgery have quickly gained favor. The da Vinci surgical system robot as an option for minimally invasive surgery offers many advantages. As the placement of the system between the legs can be prohibitive, we propose a modification of the standard docking procedure by aligning the system parallel to the operating room table. Our experience is that parallel side-docking allows access to the perineum without compromising docking time and range of motion.

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

    Energy Technology Data Exchange (ETDEWEB)

    Molina-Perez, J. [UC, San Diego; Bonacorsi, D. [Bologna U.; Gutsche, O. [Fermilab; Sciaba, A. [CERN; Flix, J. [Madrid, CIEMAT; Kreuzer, P. [CERN; Fajardo, E. [Andes U., Bogota; Boccali, T. [INFN, Pisa; Klute, M. [MIT; Gomes, D. [Rio de Janeiro State U.; Kaselis, R. [Vilnius U.; Du, R. [Beijing, Inst. High Energy Phys.; Magini, N. [CERN; Butenas, I. [Vilnius U.; Wang, W. [Beijing, Inst. High Energy Phys.

    2012-01-01

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

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

    Science.gov (United States)

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

    2015-01-01

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

  11. Procedure for Changing an Impella Device while Maintaining Guide Wire Access: A Novel Technique

    Directory of Open Access Journals (Sweden)

    Tigran Khachatryan

    2016-01-01

    Full Text Available We describe a novel technique to exchange an Impella over a guide-wire, preserving the arteriotomy access and to lower the risks of vascular complications. We describe this technique in the context of two interesting cases. The first case is of a young man with myocarditis and cardiogenic shock from a previously undiagnosed systemic lupus erythematous. The second case is of a woman with ST elevation myocardial infarction and cardiogenic shock requiring complex percutaneous intervention. The implantation of Impella CP served as circulatory support in these cases as myocardium recovered but was complicated by access site bleeding. We were able to remove the Impella device while maintaining the access sheath to allow for adequate hemostasis prior to sheath removal. We believe the readers of the journal will find these images and technique interesting and useful in their own practice.

  12. 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.

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

    Science.gov (United States)

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

    2016-10-01

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

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

    Science.gov (United States)

    Milić, Dragan J; Pejić, Miljko A

    2003-01-01

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

  15. 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.

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

    Directory of Open Access Journals (Sweden)

    Shi-Qing Mu

    2015-01-01

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

  17. A Survey of the Practices, Procedures, and Techniques in Undergraduate Organic Chemistry Teaching Laboratories

    Science.gov (United States)

    Martin, Christopher B.; Schmidt, Monica; Soniat, Michael

    2011-01-01

    A survey was conducted of four-year institutions that teach undergraduate organic chemistry laboratories in the United States. The data include results from over 130 schools, describes the current practices at these institutions, and discusses the statistical results such as the scale of the laboratories performed, the chemical techniques applied,…

  18. 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.

  19. Electropyroelectric technique: A methodology free of fitting procedures for thermal effusivity determination in liquids.

    Science.gov (United States)

    Ivanov, R; Marin, E; Villa, J; Gonzalez, E; Rodríguez, C I; Olvera, J E

    2015-06-01

    This paper describes an alternative methodology to determine the thermal effusivity of a liquid sample using the recently proposed electropyroelectric technique, without fitting the experimental data with a theoretical model and without having to know the pyroelectric sensor related parameters, as in most previous reported approaches. The method is not absolute, because a reference liquid with known thermal properties is needed. Experiments have been performed that demonstrate the high reliability and accuracy of the method with measurement uncertainties smaller than 3%.

  20. Neonatal paracetamol treatment reduces long-term nociceptive behaviour after neonatal procedural pain in rats.

    Science.gov (United States)

    van den Hoogen, N J; Tibboel, D; Honig, W M M; Hermes, D; Patijn, J; Joosten, E A

    2016-09-01

    Pain from skin penetrating procedures (procedural pain) during infancy in the neonatal intensive care unit (NICU) may result in changes of nociceptive sensitivity in later life. This supports the need for pain management during such vulnerable periods in life. This study, therefore, analyses the short- and long-term consequences of neonatal paracetamol (acetaminophen) treatment on pain behaviour in an experimental rat model of neonatal procedural pain. A repetitive needle-prick model was used, in which neonatal rats received four needle pricks into the left hind paw per day from postnatal day 0 to day 7 (P0-P7). Paracetamol (50 mg/kg/day s.c.) was administered daily (P0-P7), and sensitivity to mechanical stimuli was compared with a needle-prick/saline-treated group and to a tactile control group. At 8 weeks of age, all animals underwent an ipsilateral paw-incision, modelling postoperative pain, and the duration of hypersensitivity was assessed. Neonatal paracetamol administration had no effect upon short-term mechanical hypersensitivity during the first postnatal week or upon long-term baseline sensitivity from 3 to 8 weeks. However, neonatal paracetamol administration significantly reduced the postoperative mechanical hypersensitivity in young adults, caused by repetitive needle pricking. Paracetamol administration during neonatal procedural pain does not alter short-term or long-term effects on mechanical sensitivity, but does reduce the duration of increased postoperative mechanical hypersensitivity in a clinically relevant neonatal procedural pain model. Paracetamol can be used safely in neonatal rats. Neonatal paracetamol treatment had no effect upon short-term mechanical hypersensitivity during the first postnatal week, nor upon long-term baseline sensitivity from 3 to 8 weeks. Paracetamol treatment during the first postnatal week significantly reduced the postoperative mechanical hypersensitivity in young adult rats. © 2016 European Pain Federation

  1. The micro-electrolysis technique in waste water treatment

    International Nuclear Information System (INIS)

    Jiti Zhou; Weihen Yang; Fenglin Yang; Xuemin Xiang; Yulu Wang

    1997-01-01

    The micro-electrolysis is one of the efficient methods to treat some kinds of waste water. The experiments have shown its high efficiency in sewage treatment and some kinds of industrial waste water. It is suitable for pre-treatment of high concentrated waste water and deep treatment of waste water for reuse purpose. The disadvantage of micro-electrolysis is its high energy consumption in case of high electrolyte concentration. (author) 2 figs., 11 tabs., 2 refs

  2. The micro-electrolysis technique in waste water treatment

    Energy Technology Data Exchange (ETDEWEB)

    Jiti Zhou; Weihen Yang; Fenglin Yang; Xuemin Xiang; Yulu Wang [Dalian Univ. of Technology, Dalian (China)

    1997-12-31

    The micro-electrolysis is one of the efficient methods to treat some kinds of waste water. The experiments have shown its high efficiency in sewage treatment and some kinds of industrial waste water. It is suitable for pre-treatment of high concentrated waste water and deep treatment of waste water for reuse purpose. The disadvantage of micro-electrolysis is its high energy consumption in case of high electrolyte concentration. (author) 2 figs., 11 tabs., 2 refs.

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

    Energy Technology Data Exchange (ETDEWEB)

    Held, Mareike

    2016-03-23

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

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

    Directory of Open Access Journals (Sweden)

    S. P. Puntambekar

    2010-01-01

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

  5. 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.

  6. The First Simultaneous Intraoperative Hyperthermia and Radiotherapy Procedure: Dog Experiment and Technique

    Science.gov (United States)

    Ashayeri, Ebrahim; Halyard, Michele; Goldson, Alfred L.; Cruz, Leon; Nibhanupudy, J. Rao; DeWitty, Robert; Galal, Fathy; Marquis, Bernard; Slaughter, Lynnard; Landes, Fred

    1987-01-01

    The Department of Radiation Therapy of Howard University Hospital was the first to revive (1976) the use of intraoperative radiotherapy, or direct view irradiation, using electron beam (IORTe−) in the United States. Since that time, this pioneering effort has gained both national and international acceptance. Now, many leading centers employ this investigational treatment modality. Recently, a new mode of cancer therapy has been gaining acceptance, namely hyperthermia (the treatment of cancer by heat). Hyperthermia has been shown, both experimentally and clinically, to improve the rate of local control (thermal enchancement ratio [TER]) when combined with radiation therapy in the treatment of cancer. Maximal TER has been observed with simultaneous or immediate application of radiation and hyperthermia for both tumor and normal tissues. Therefore, to achieve maximum therapeutic gain, selective, intraoperative, simultaneous heating and irradiation of the tumor with mechanical retraction of the normal and sensitive structures from the treatment field seems a promising alternative. There have been no published reports, to the authors' knowledge, on the combination of simultaneous IORTe− with intraoperative hyperthermia (IOHT). To employ this combination in human subjects, several questions must be answered first using animal models, including the technical and practical feasibility, the toxicity and morbidity, as well as the pathologic changes that may arise. The technical aspects of the first animal case, using a mongrel dog, applying simultaneous IORTe− and IOHT are presented. PMID:3112416

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

    Science.gov (United States)

    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.

  8. 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

  9. 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.

  10. Procedures and techniques for closure of near surface disposal facilities for radioactive waste

    International Nuclear Information System (INIS)

    2001-12-01

    The overall objective of this report is to provide Member States with guidance on planning and implementation of closure of near surface disposal facilities for low and intermediate level radioactive waste. The specific objectives are to review closure concepts, requirements, and components of closure systems; to discuss issues and approaches to closure, including regulatory, economic, and technical aspects; and to present major examples of closure techniques used and/or considered by Member States. Some examples of closure experience from Member States are presented in the Appendix and were indexed separately

  11. Application of response surface techniques to helicopter rotor blade optimization procedure

    Science.gov (United States)

    Henderson, Joseph Lynn; Walsh, Joanne L.; Young, Katherine C.

    1995-01-01

    In multidisciplinary optimization problems, response surface techniques can be used to replace the complex analyses that define the objective function and/or constraints with simple functions, typically polynomials. In this work a response surface is applied to the design optimization of a helicopter rotor blade. In previous work, this problem has been formulated with a multilevel approach. Here, the response surface takes advantage of this decomposition and is used to replace the lower level, a structural optimization of the blade. Problems that were encountered and important considerations in applying the response surface are discussed. Preliminary results are also presented that illustrate the benefits of using the response surface.

  12. 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

  13. Emerging minimally invasive procedures for focal treatment of organ-confined prostate cancer.

    Science.gov (United States)

    Habibian, David J; Katz, Aaron E

    2016-11-01

    Prostate cancer is the most common malignancy amongst American men. However, the majority of prostate cancer diagnoses are of low risk, organ-confined disease. Many men elect to undergo definitive treatment, but may benefit from focal therapy to maintain continence and potency. This review reports the mechanism of action and outcomes of emerging focal therapies for prostate cancer. We report the mechanism of action of focal cryotherapy, high intensity focused ultrasound, focal laser ablation, and irreversible electroporation. In addition, we reviewed the largest studies available reporting rates of urinary incontinence, erectile dysfunction, biochemical recurrence-free survival (ASTRO), and post-operative adverse events for each procedure. Each treatment modality stated has a unique mechanism in the ablation of cancerous cells. Genito-urinary symptoms following these studies report incontinence and erectile dysfunction rates ranging from 0-15% and 0-53%, respectively. Biochemical disease-free survival was reported using the ASTRO definition. Some treatment modalities lack the necessary follow-up to determine effectiveness in cancer control. No focal therapy studies reported serious adverse events. These minimally invasive procedures are feasible in a clinical setting and show promising functional and disease control results with short to medium-term follow-up. However, each treatment requires additional robust prospective studies as well as its own unique domain to determine biochemical recurrence free survival to properly determine their role in treatment of organ-confined prostate cancer.

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

    CERN Document Server

    Kirchmair, L P M

    2001-01-01

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

  15. Procedures and Techniques for the PSA of Digital I and C System

    International Nuclear Information System (INIS)

    Kang, Hyun Gook; Eom, Heung Sup; Jang, Seung Cheol

    2006-01-01

    UCN 5 and 6 nuclear units (OPR-1000) are being constructed and the Korean Next Generation Reactor (APR-1400) is being designed by using digital I and C equipment for the safety functions such as a reactor protection system, an engineered safety feature actuation system, and a safety equipment control system. Even though the use of digital equipment for safety-related functions provides many advantageous features, there are still many arguable safety issues remaining. Design, configuration management and maintenance are important application areas for the probabilistic safety assessment (PSA). Digital I and C systems are natural candidates for PSA applications. From the viewpoint of the PSA, the digital techniques are very different from the conventional techniques of analog I and C systems because of some unique features. This article aims at giving an overview for the important issues of digital system PSA and at presenting the current status of technology development for each issue. Korea Atomic Energy Research Institute (KAERI) has performed an initiative research in order to meet risk information needs for digitalized safety-critical systems in Korea. The technologies presented in this article especially focusing on those developed in the KAERI

  16. 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

  17. Influence of treatment techniques on Cu leaching and different organic fractions in MSWI bottom ash leachate.

    Science.gov (United States)

    Arickx, S; Van Gerven, T; Knaepkens, T; Hindrix, K; Evens, R; Vandecasteele, C

    2007-01-01

    The leaching of heavy metals, such as copper, from municipal solid waste incinerator (MSWI) bottom ash is of concern in many countries and may inhibit the beneficial reuse of this secondary material. Previous studies have focused on the role of dissolved organic carbon (DOC) on the leaching of copper. Recently, a study of the Energy Research Centre of The Netherlands (ECN) showed fulvic acid-type components to exist in the MSWI bottom ash leachates and to be likely responsible for the generally observed enhanced copper leaching. These findings were verified for a MSWI bottom ash (slashed circle 0.1-2 mm) fraction from an incinerator in Flanders. The filtered leachates were subjected to the IHSS fractionation procedure to identify and quantify the fractions of humic acid (HA), fulvic acid (FA) and hydrophilic organic carbon (Hi). The possible complexation of fulvic acid with other heavy metals (e.g., lead) was also investigated. The identified role of fulvic acids in the leaching of copper and other heavy metals can be used in the development of techniques to improve the environmental quality of MSWI bottom ash. Thermal treatment and extraction with a 0.2 M ammonium-citrate solution were optimized to reduce the leaching of copper and other heavy metals. The effect of these techniques on the different fractions of organic matter (HA, FA, Hi) was studied. However, due to the obvious drawbacks of the two techniques, research is focused on finding other (new) techniques to treat MSWI bottom ash. In view of this, particle size-based separation was performed to evaluate its effect on heavy metal leaching and on HA, FA and Hi in MSWI bottom ash leachates.

  18. 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.

  19. 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

  20. Radiation exposure during the lateral lumbar interbody fusion procedure and techniques to reduce radiation dosage.

    Science.gov (United States)

    Tatsumi, Robert L

    2012-01-01

    Fluoroscopy is widely used in spine surgery to assist with graft and hardware placement. Previous studies have not measured radiation exposure to a surgeon during minimally invasive lateral lumbar spine surgery for single-level discectomy and interbody cage insertion. This study was performed to model and measure radiation exposure to a surgeon during spine surgery using the direct lateral lumbar procedure. The study was performed using a mannequin substituting for the surgeon and a cadaver substituting for the patient. Radiation was measured with dosimeters attached to 6 locations on the mannequin using a OEC Medical Systems 9800 C-arm fluoroscope (OEC Medical Systems, Salt Lake City, Utah). Three different fluoroscopy setups were tested: a standard imaging setup, a standard setup using pulsed-mode fluoroscopy, and a reversed setup. The experiment was tested 5 times per setup, and the dosimeters' values were recorded. The highest amount of radiation exposure occurred when obtaining an anteroposterior view of the spine in the standard setup. Compared with the standard setup, the pulsed-mode setting decreased the radiation exposure to the mannequin by a factor of 6 times (P exposure to the mannequin by a factor of 6 times (P exposure to the eye level (P exposure. Radiation exposure to the surgeon can be greatly minimized by using either a pulsed imaging mode or the reversed setup. The reversed setup has the lowest amount of radiation exposure to the eye level.

  1. Refinement procedures of hydrogen and hydration structures of proteins by neutron diffraction technique

    International Nuclear Information System (INIS)

    Chatake, Toshiyuki; Morimoto, Yukio

    2007-01-01

    Neutrons have a unique role to play in determining the structure and dynamics of proteins and their complexes. Water molecules surrounding a protein play important roles in maintaining its structural stability. However, the hydration structures of most proteins are not known well at an atomic level because x-ray protein crystallography has difficulties to localize the position of hydrogen atoms, while neutron crystallography has not problem in determining the position of hydrogen atoms with high accuracy. A software suite, called Crystallography and NMR System (CNS), has been developed for macromolecular structure determinations by x-ray crystallography or solution nuclear magnetic resonance spectroscopy by A.T. Brunger et al. The software CNS is highly flexible, and is applied for neutron diffraction measurements after some modifications of parameters used in the software. The fundamental modifications are the followings; D atoms in replace of H atoms, and the substitution of neutron scattering lengths for x-ray scattering factors. Moreover, in neutron diffraction data analysis, an important problem rests on the introduction of hydrogen atoms into the software of x-ray crystallography without hydrogen atoms. After the above procedures, the software modified is applied to determine the molecular structure of histidine residue associated with hydrogen atoms. (author)

  2. 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.

  3. 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…

  4. Determination of nitrogen in coal macerals using electron microprobe technique-experimental procedure

    Science.gov (United States)

    Mastalerz, Maria; Gurba, L.W.

    2001-01-01

    This paper discusses nitrogen determination with the Cameca SX50 electron microprobe using PCO as an analyzing crystal. A set of conditions using differing accelerating voltages, beam currents, beam sizes, and counting times were tested to determine parameters that would give the most reliable nitrogen determination. The results suggest that, for the instrumentation used, 10 kV, current 20 nA, and a counting time of 20 s provides the most reliable nitrogen determination, with a much lower detection limit than the typical concentration of this element in coal. The study demonstrates that the electron microprobe technique can be used to determine the nitrogen content of coal macerals successfully and accurately. ?? 2001 Elsevier Science B.V. All rights reserved.

  5. Treatment of Some Hazardous Industrial Pollutants by Simple Oxidation Techniques

    International Nuclear Information System (INIS)

    Abd El-Rahman, N.M.

    1999-01-01

    Central treatment of Industrial wastewater requires pretreatment of some specific pollutants which may be not effectively degraded in down stream processes in central treatment unit. Some of the hazardous pollutants in industrial wastewater including acrylonitrile, pesticides and some commonly used dyes (active and acid dyes) have been subjected individually to oxidation using hydrogen peroxide catalyzed by ferrous ions in acidic solution. Treatment efficiency was monitored by chemical oxygen demand (COD) removal using a specially developed concentration/COD curves. Initial concentrations (in terms of COD) were 910 PPM, 1348 and 530 ppm and the respective COD reductions were 91, 98 and 99%, for the pesticide, acrylonitrile and the reactive dye. Oxidative degradation of polared and acid green also reduced COD by 99 and 100% respectively. The obtained results confirm the appropriateness of oxidative degradation as a pretreatment for some hazardous pollutants prior to treatment in central facilities or municipal activated sludge stations

  6. treatment of idiopathic clubfoot by ponseti technique of

    African Journals Online (AJOL)

    GB

    2012-07-02

    Jul 2, 2012 ... test. RESULTS: The average number of casts applied before full correction was 4.9. The duration of casts for more than 85% feet was <7 weeks. ... of cases by using his technique of manipulation, casting, and limited surgery (2). Cooper and Dietz reviewed Ponseti's cases, with an average of 30 years of ...

  7. a novel technique in the treatment of small bowel atresia

    African Journals Online (AJOL)

    pouch and oblique anastomosis of the resultant window with a longitudinally incised posterior wall of the distal bowel. Results This technique was used in seven successive neonates, four female and three male, in 1 year. Their ages at operation ranged between 2 and 30 days. (median 3 days). Six neonates recovered well ...

  8. Concussion Treatment Using Massage Techniques: a Case Study

    OpenAIRE

    Burns, Sylvia L.

    2015-01-01

    Background Concussion, its recognition, diagnosis, and treatment is a growing public health issue. Massage practitioners who specialize in rehabilitation deal with a variety of injury cases that involve concussion, including those incurred by falls, motor vehicle incidents, and sports injuries. Purpose This case study presents a unique massage therapy approach to concussion trauma treatment. Participant Male 23-year-old intramural soccer player diagnosed with postconcussion syndrome resulting...

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

    Directory of Open Access Journals (Sweden)

    Mohit KM

    2012-11-01

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

  10. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    Ulas Urganci

    2016-01-01

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

  13. Research and development of treatment techniques for LLW from decommissioning: Decontamination and volume reduction techniques

    International Nuclear Information System (INIS)

    Hirabayashi, T.; Kameo, Y.; Nakashio, N.

    2001-01-01

    For the purpose of reducing the amount and/or volume of low-level radioactive waste (LLW) arising from decommissioning of nuclear reactor, the Japan Atomic Energy Research Institute (JAERI) has been developing four decontamination techniques. They are: (a) Gas-carrying abrasive method, (b) In-situ remote electropolishing method for pipe system before dismantling, (c) Bead reaction - thermal shock method, and (d) Laser induced chemical method for components after dismantling. JAERI in developing techniques are also carrying out melting tests of metal and non-metal. Melting was confirmed to be effective in reducing the volume, homogenizing, and furthermore stabilizing non-metallic wastes. (author)

  14. Effective music therapy techniques in the treatment of nonfluent aphasia.

    Science.gov (United States)

    Tomaino, Concetta M

    2012-04-01

    In music therapy for nonfluent aphasia patients who have difficulty producing meaningful words, phrases, and sentences, various benefits of singing have been identified: strengthened breathing and vocal ability, improved articulation and prosody of speech, and increased verbal and nonverbal communicative behaviors. This paper will introduce these various techniques used in clinical music therapy, and summarize findings based on our recent study to illustrate the strength of different techniques emphasizing rhythm, pitch, memory, and vocal/oral motor components dealing with different symptoms. The efficacy of each component is enhanced or diminished by the choice of music and the way it is interactively delivered. This indicates that neural mechanisms underlying speech improvement vary greatly with available acoustic and social cues in aphasic brain. © 2012 New York Academy of Sciences.

  15. Comparison of two different debonding techniques in orthodontic treatment.

    Science.gov (United States)

    Piccoli, Luca; Migliau, Guido; Besharat, Laith Konstantinos; Di Carlo, Stefano; Pompa, Giorgio; Di Giorgio, Roberto

    2017-01-01

    The purpose of this research is to investigate whether and how the adhesive bond failure site varied in relation to the material used for the orthodontic bonding and debonding technique applied. Two different methods of orthodontic debonding were included in our survey; cutters for orthodontics and debonding plier. Three different materials for the adhesion of the bracket: composite light curing, self-curing composite and glass ionomer cement. The remaining amount of adhesive on the tooth surface is an important parameter that gives information on how the location of the posting site varied during the debonding. 60 dental elements, maxillary and mandibular, previously extracted for orthodontic reasons, as well as periodontal, were included in our research. We investigated a possible significant correlation between different variables (debonding technique and materials for membership) and the ARI index. The use of orthodontic cutters or debonding pliers does not affect the adhesive bond failure site and both techniques have a tendency to leave a significant amount of adhesive on the surface enamel. In the resin-reinforced glass ionomer cements, detachment occurs at the interface enamel-adhesive and this pattern of detachment increases the risk of the enamel damage during debonding. In both types of composite resins (photopolymerizable or self-curing), the detachment occurs at the interface bracketing adhesive. In this case the amount of remaining adhesive material on the tooth must be removed with further methods, which in addition, increase the risk of iatrogenic injury as well as the working hours.

  16. 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…

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

    Energy Technology Data Exchange (ETDEWEB)

    Fox, Jacob; Fathallan-Shaykh, Hassan

    2006-09-22

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

  18. Distraction Osteogenesis Technique for the Treatment of Nonsyndromic Sagittal Synostosis

    OpenAIRE

    Johns, Dana; Blagg, Ross; Kestle, John R. W.; Riva-Cambrin, Jay K.; Siddiqi, Faizi; Gociman, Barbu

    2015-01-01

    Background Historically, surgical treatment of children with a delayed presentation of cranial synostosis required complex cranial vault reconstruction. Recently, less invasive options for surgical correction, such as internal distraction osteogenesis, have been explored. In this study, we describe the successful management of delayed presentation of sagittal synostosis using distraction osteogenesis. Methods A bicoronal incision was made and 2 large rectangular osteotomies were performed bil...

  19. Some techniques used in the treatment of phenolic waters residual

    International Nuclear Information System (INIS)

    Alzate S, Rafael A.; Botero, Carlos Andre

    2000-01-01

    The current state of the diverse processes of treatment of phenolic waters residual is presented, beginning with the methods traditionally employees, until finishing with those but recent innovations, which have been derived of the necessity of increasing the removal of these pollutants without increasing the costs of such processes in excessive form

  20. Surface adsorption technique for the treatment of textile wastewaters ...

    African Journals Online (AJOL)

    Reductions in color and pH variation of the effluent were monitored through absorbance and pH measurements throughout the process. Concentration levels of Ni2+ in the wastewater ranged ... for treated samples to be employed for domestic purposes. Key Words: Effluents Treatment, Nickel, Chromium, Surface adsorption ...

  1. Reconstruction techniques in the treatment of vertebral neoplasms.

    Science.gov (United States)

    Biagini, R; Boriani, S; Casadei, R; Bandiera, S; De Iure, F; Campanacci, L; Demitri, S; Orsini, U; Di Fiore, M

    1997-01-01

    The authors present a new system for the topographical description of vertebral neoplasms. The general criteria of reconstruction after curettage or vertebral resection are evaluated. The literature is reviewed in terms of the use of prostheses, bone grafts, cement and stabilization systems in the treatment of tumors of the spine. Indications for the different methods are discussed.

  2. [Carefully conducted preanalytic and postanalytic procedures for urine samples. Often neglected in urolithiasis treatment].

    Science.gov (United States)

    Laube, N; Berg, W

    2014-01-01

    Particularly in the urological consultation sessions collection of 24 h urine samples is required to evaluate the metabolic risk factors for urolith formation. To ensure a yield from urinalysis of sufficiently high quality and to minimize the number of potential error sources, correctly performed preanalytical procedures are required. If certain basic quality criteria for the collection procedures are not being followed false data can be determined and the clinical interpretation based on that analysis will result in a wrong rating of the true metabolic status of patients. This article provides practical, feasible and proven solutions in an encouraging, motivating and clear way to ensure that at least the most important steps for a correct urine collection are being taken. The preanalytical requirements for the determination of other urinary parameters which are not in the direct focus of urolithiasis treatment will not be covered by this article.

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

    Science.gov (United States)

    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

  4. Using of new minimally invasive procedures in diagnostic, treatment and prevention of acute pericarditis

    Directory of Open Access Journals (Sweden)

    Григорий Николаевич Урсол

    2015-05-01

    Full Text Available This study proves satisfactorily the effectiveness of using two new methods of minimally invasive procedures for possibility of accurate diagnosis, appropriative and intense medical treatment of acute pericarditis in long term period.Aim – presentation of two new methods of minimally invasive procedures, which are performed with pericardioscopy and are assigned for effective diagnostic and treatment of pericarditis: introducing of micro drainage into pericardium; Performing pericardioscopy with following drainage using pericardioscope without using large discission.Materials and methods. This study includes results of 571 patients with acute pericarditis diagnosed since 1990 till 2014. Due to the etiology of pericarditis all the patients were divided into six groups: Viral, Bacterial, Tuberculous, Autologous-Reactive, Uremic, Tumoral. Main group included patient with viral acute pericarditis. Study includes 339 males and 232 females. Male’s main group was with viral pericarditis, female’s – patients with autologous-reactive acute pericarditis.In this study were used: assessment of clinical signs, ECG, chest X-Ray, echocardiogram, pericardium puncture, pericardiocentesis.Results. Results of using both methods are presented in clinical case, which illustrates opportunities of accurate diagnosis, appropriative and intense medical treatment of acute pericarditis. In 11-years follow-up patient has no clinically significant changes in chest organs, no exacerbations were diagnosed, thus, the effectiveness of proposed method for long-term period was proved.Conclusion. 1. Using of the method «Introducing of micro drainage into pericardium», allows to determine diagnosis during 24 hours in 90% of all cases, to prevent complications related to acute pericarditis and in some ways to neutralize the acute condition of the disease.2. In case when diagnosis is not verified in 48 hour another method is used: «Performing pericardioscopy with following

  5. Three technique for non coplanar conformal field radiation treatment of breast cancer

    International Nuclear Information System (INIS)

    Perez, Lourdes; Napoles, Misleidys; Alert, Jose; Larrinaga, Eduardo; Yanez, Yaima

    2009-01-01

    The radiation treatment of the breast is a challenge for radio therapists and physicists, because of the proximity of organs at risk such as lung and heart. For many years tangential irradiation technique has been the technique of choice in these cases. A novel technique described by the group Cancer Institute's work of Italian Switzerland, has been employed by us, good results. (Author)

  6. 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

  7. Technique for fabrication of an "instant total-contact cast" for treatment of neuropathic diabetic foot ulcers.

    Science.gov (United States)

    Armstrong, David G; Short, Brian; Espensen, Eric H; Abu-Rumman, Patricia L; Nixon, Brent P; Boulton, Andrew J M

    2002-01-01

    Addressing pressure reduction in the treatment of diabetic foot wounds is a critical component of therapy. The total-contact cast has proven to be the gold standard of treatment because of its ability to reduce pressure and facilitate patient adherence to the off-loading regimen. Removable cast walkers have proven to be as effective as total-contact casts in pressure reduction, but this has not translated into equivalent time to healing. A simple technique to convert the removable cast walker into a device that is not as easily detached from the lower extremity, thereby encouraging the use of this device over a 24-hour period, is presented in this article. The procedure involves wrapping the cast walker with cohesive bandage or plaster of Paris. In the authors' opinion, this technique addresses many of the disadvantages of the total-contact cast, resulting in an adequate compromise in this aspect of care.

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

    Directory of Open Access Journals (Sweden)

    Tadić Danijela

    2010-01-01

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

  9. Partial lateral facetectomy plus Insall's procedure for the treatment of isolated patellofemoral osteoarthritis: survival analysis.

    Science.gov (United States)

    Montserrat, Ferran; Alentorn-Geli, Eduard; León, Vicente; Ginés-Cespedosa, Alberto; Rigol, Pau

    2014-01-01

    The purpose of this study was to report the survival analysis of partial lateral facetectomy and Insall's procedure in patients with isolated patellofemoral osteoarthritis, and to assess the risk and protective factors for failure of this procedure. From 1992 to 2004, all subjects with isolated patellofemoral osteoarthritis who met the inclusion criteria and underwent this procedure were enrolled. Risk and protective factors for failure (failure considered as the need for total knee arthroplasty) were assessed by comparing obtained baseline data between failed and non-failed cases. Eighty-seven cases (mean (SD) age 61.8 (7.7) years, mean (SD) follow-up 9.6 (3.2) years) were included. Twenty-three failed cases were found. Mean (SD) survival time was 13.6 (0.5) years. At 13 years (last failure case), the cumulative survival was 59.3 %. Baseline medial tibiofemoral pain, genu flexum, and worst grade of tibiofemoral osteoarthritis were significant risk factors for failure (p < 0.0001, p = 0.02, p < 0.0001, respectively). In contrast, higher anatomical (p = 0.02) and total (p = 0.03) knee society score (KSS) scores, absence of knee effusion (p = 0.03), higher value of the Caton-Deschamps index (p = 0.03), and lateral position of the patella (p = 0.01) were all protective factors against failure. The treatment for isolated patellofemoral osteoarthritis through partial lateral facetectomy and Insall's procedure demonstrated good long-term survival. The presence of preoperative medial tibiofemoral pain, genu flexum, and incipient tibiofemoral osteoarthritis increased the risk of failure of this procedure. In contrast, higher anatomical and total KSS scores, absence of knee effusion, higher value of the Caton-Deschamps index, and lateral position of the patella were found to protect against failure.

  10. Novel Electromagnetic - Ultrasound Synergistic Technique for Treatment of Cancer

    Science.gov (United States)

    2013-11-01

    that was designed and assembled in-house. The matrix consists of two custom SP16T solid-state switching matrices and a cascaded pair of Miniciruits...associated coagu- lative necrosis (Hill and ter Haar , 1995). Two principal mechanisms, direct absorption of the transmitted pressure wave and acoustic...as HIFU becomes an accepted modal- ity for treatment (ter Haar and Coussios, 2007). Focused HIFU energy is sufficient to induce thermal coagulation

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

    Directory of Open Access Journals (Sweden)

    Ralf Herwig

    2015-03-01

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

  12. 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.

  13. Technique of treatment of prostatic cancer with scarcity means

    International Nuclear Information System (INIS)

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

    1998-01-01

    To show the particularities in the treatment simulation-localization, in the volume delimitation and in the main planning strategies motive by our scarcity means during the first year of performance (absence of physical simulator, planning system 2D). It was utilized a computerized tomograph, an X-ray equipment with tele commanded table and another with ceiling telescopic suspension. 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. In the CT it was took spaced cuts starting from the central, at coincident distances with lattice lines, contouring the clinical target volume (CTV), what subsequently it was removed to the simulation plate. The volume to be irradiated, or PTV (planning target volume), it was determined adding a margin to CTV. The irradiation to itself it was realized with a minimum of 3 fields in the first phase. From 16 patients evaluated, the 100 % normalize the PSA ciphers at 6 months. 25 % patients, rectal-intestinal toxicity grade 1 and 18.7 % grade 2. Acute vesicle toxicity grade 1 in a 31.2 % patients, grade 2 in 12.5 % and grade 3 in 6.5 %. A 25 % patients presented dermatitis grade 1 and 18 % grade 2 and grade 3. Under no case it was necessary the treatment interruption for the toxicity normalization. Maximum local control with absence of chronic toxicity. The low toxicity presented could must be to the utilization of conformations in the lateral plates. According to our experience, we believe that it is not necessary to renounce at this type of treatments if it is lacking of high energies, such as succeed in some installations if it is utilized 3 or more fields in the first phase and individualized conformations. (Author)

  14. Flow Diversion versus Standard Endovascular Techniques for the Treatment of Unruptured Carotid-Ophthalmic Aneurysms.

    Science.gov (United States)

    Di Maria, F; Pistocchi, S; Clarençon, F; Bartolini, B; Blanc, R; Biondi, A; Redjem, H; Chiras, J; Sourour, N; Piotin, M

    2015-12-01

    Over the past few years, flow diversion has been increasingly adopted for the treatment of intracranial aneurysms, especially in the paraclinoid and paraophthalmic carotid segment. We compared clinical and angiographic outcomes and complication rates in 2 groups of patients with unruptured carotid-ophthalmic aneurysms treated for 7 years by either standard coil-based techniques or flow diversion. From February 2006 to December 2013, 162 unruptured carotid-ophthalmic aneurysms were treated endovascularly in 138 patients. Sixty-seven aneurysms were treated by coil-based techniques in 61 patients. Flow diverters were deployed in 95 unruptured aneurysms (77 patients), with additional coiling in 27 patients. Complication rates, clinical outcome, and immediate and long-term angiographic results were retrospectively analyzed. No procedure-related deaths occurred. Four procedure-related thromboembolic events (6.6%) leading to permanent morbidity in 1 case (1.6%) occurred in the coiling group. Neurologic complications were observed in 6 patients (7.8%) in the flow-diversion group, resulting in 3.9% permanent morbidity. No statistically significant difference was found between complication (P = .9) and morbidity rates (P = .6). In the coiling group (median follow-up, 31.5 ± 24.5 months), recanalization occurred at 1 year in 23/50 (54%) aneurysms and 27/55 aneurysms (50.9%) at the latest follow-up, leading to retreatment in 6 patients (9%). In the flow-diversion group (mean follow-up, 13.5 ± 10.8 months), 85.3% (35/41) of all aneurysms were occluded after 12 months, and 74.6% (50/67) on latest follow-up. The retreatment rate was 2.1%. Occlusion rates between the 2 groups differed significantly at 12 months (P < .001) and at the latest follow-up (P < .005). Our retrospective analysis shows better long-term occlusion of carotid-ophthalmic aneurysms after use of flow diverters compared with standard coil-based techniques, without significant differences in permanent morbidity

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

    Science.gov (United States)

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

    2012-01-01

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

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

    Science.gov (United States)

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

    2012-10-01

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

  17. Learning and Recall of Medical Treatment-Related Information in Older Adults Using the Differential Outcomes Procedure

    Directory of Open Access Journals (Sweden)

    Victoria Plaza

    2018-02-01

    Full Text Available It has recently been reported that the differential outcomes procedure (DOP might be one of the therapeutical techniques focused at promoting autonomy in the elderly to deal with their medical issues. Molina et al. (2015 found that a group of healthy young adults improved their learning and long-term retention of six disorder/pill associations when each relationship to be learned was associated with a particular reinforcer (the differential outcomes condition compared to when they were randomly administered (the non-differential outcomes condition. In the present study, we extend these findings to older adults who usually show difficulties to remember to take their medications as prescribed. Participants were asked to learn the association between three pills and the specific time at the day when they had to take each medication. Two memory tests were also performed 1 h and 1 week after completing the training phase. Results showed a faster learning of the task and long-term retention of the previously learned associations (pill/time of day when differential outcomes were used. Furthermore, the older adults’ performance in the learning and memory phases did not differ from that of the younger adults in the DOP condition. These findings demonstrate that this procedure can help elderly people to ameliorate not only their learning, but also their long-term memory difficulties, suggesting the potential for the DOP to promote adherence to treatment in this population.

  18. Pain perception and procedural tolerance with computer controlled and conventional local anesthetic technique: An in vivo comparative study

    Directory of Open Access Journals (Sweden)

    Rahul Goyal

    2014-01-01

    Full Text Available Aim: The aim of this study was to evaluate and compare the Pain Perception and Procedural Tolerance (PPPT by the pediatric patients, while experiencing ′Computer Controlled Local Anesthetic Technique′ (CCLAD, Wand and ′Conventional local anesthetic technique′. Material and Methods: Fifteen subjects, of age 8-10 years requiring local anesthesia on both sides of the dental arch for the purpose of extraction were selected for this study. In this cross-over design study, randomization was done to allocate the type of local anesthetic technique to be used first, children who received CCLAD (Wand during ′First Anesthetic Exposure′ (FAE visit subsequently received ′Conventional anesthetic technique′ during ′Second Anesthetic Exposure′ (SAE visit and vice versa. Behavior assessment using ′Frankel′s Behavior Rating Scale′ (FBRS and anxiety assessment using ′Faces Version of Modified Child′s Dental Anxiety Scale′ (MCDAS f were done prior to the anesthetic exposure. ′Wong Baker′s Facial Pain Scale′ (WBFPS was used to assess the child′s pain perception to each of the two techniques, immediately after the injection. Various physiological parameters like ′Heart Rate′(HR, ′Respiratory Rate′(RR, and ′Oxygen Saturation′ were measured during pre-operative phase, LA-phase, post LA-phase, Extraction phase and post Extraction phase, during FAE and SAE. Results: Paired t-test revealed a very highly significant (P = 0.001 difference between CCLAD (Wand and conventional during SAE. Non-significant difference was observed when physiological parameters were compared at various intervals between the two anesthetic techniques. Conclusion: CCLAD (Wand provides lesser pain perception as compared to conventional local anesthetic technique.

  19. Physical quantities, their role and treatment in gasflow measurement techniques

    International Nuclear Information System (INIS)

    Narjes, L.

    1977-06-01

    We begin by taking a closer look at the concepts physical quantity, dimension and unit of measurement. Then a survey is given of the physical quantities applied in gasflow measurement techniques. Here the volume-, as well as the mass-flow rate, as derived quantities are of particular interest. The application of these quantities in relation to the legal units of measurement is specifically described. In addition the quantity equation and further the quantity equation adapted to the use of suitable units and their modes of application are compared. In the appendix four examples clarify these modes. Special attention is paid to the quantity equation adapted to practically oriented units. The applications of this type of equation in VDI regulations, standards and other technical guidelines for measurement of flow are mentioned. Moreover, the meaning of the standard state for the comparison of flows of gaseous fluids is illustrated. The difficulties concerning an international agreement on uniform standard temperature are explained. Starting from there, the advantages of the fundamental quantity 'amount of substance' applied to the measurement of flow are described. The use of this quantity for the thermodynamic state of ideal and real gases, respectively gas mixtures, is demonstrated in the appendix by an example. (orig.) [de

  20. 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).

  1. CdS thin films obtained by thermal treatment of cadmium(II) complex precursor deposited by MAPLE technique

    International Nuclear Information System (INIS)

    Rotaru, Andrei; Mietlarek-Kropidlowska, Anna; Constantinescu, Catalin; Scarisoreanu, Nicu; Dumitru, Marius; Strankowski, Michal; Rotaru, Petre; Ion, Valentin; Vasiliu, Cristina; Becker, Barbara; Dinescu, Maria

    2009-01-01

    Thin films of [Cd{SSi(O-Bu t ) 3 }(S 2 CNEt 2 )] 2 , precursor for semiconducting CdS layers, were deposited on silicon substrates by Matrix-Assisted Pulsed Laser Evaporation (MAPLE) technique. Structural analysis of the obtained films by Fourier transform infrared spectroscopy (FTIR) confirmed the viability of the procedure. After the deposition of the coordination complex, the layers are manufactured by appropriate thermal treatment of the system (thin film and substrate), according to the thermal analysis of the compound. Surface morphology of the thin films was investigated by atomic force microscopy (AFM) and spectroscopic-ellipsometry (SE) measurements.

  2. A Finite Element Procedure with Poisson Iteration Method Adopting Pattern Approach Technique for Near-Incompressible Rubber Problems

    Directory of Open Access Journals (Sweden)

    Young-Doo Kwon

    2014-08-01

    Full Text Available A finite element procedure is presented for the analysis of rubber-like hyperelastic materials. The volumetric incompressibility condition of rubber deformation is included in the formulation using the penalty method, while the principle of virtual work is used to derive a nonlinear finite element equation for the large displacement problem that is presented in a total-Lagrangian description. The behavior of rubber deformation is represented by hyperelastic constitutive relations based on a generalized Mooney-Rivlin model. The proposed finite element procedure using analytic differentiation exhibited results that matched very well with those from the well-known commercial packages NISA II and ABAQUS. Furthermore, the convergence of equilibrium iteration is quite slow or frequently fails in the case of near-incompressible rubber. To prevent such phenomenon even for the case that Poisson's ratio is very close to 0.5, Poisson's ratio of 0.49000 is used, first, to get an approximate solution without any difficulty; then the applied load is maintained and Poisson's ratio is increased to 0.49999 following a proposed pattern and adopting a technique of relaxation by monitoring the convergence rate. For a given Poisson ratio near 0.5, with this approach, we could reduce the number of substeps considerably.

  3. 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)

  4. 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,

  5. [Techniques and complementary techniques. Complementary treatments: nitric oxide, prone positioning and surfactant].

    Science.gov (United States)

    Martos Sánchez, I; Vázquez Martínez, J L; Otheo de Tejada, E; Ros, P

    2003-11-01

    The management of hypoxic respiratory failure is based on oxygen delivery and ventilatory support with lung-protective ventilation strategies. Better understanding of acute lung injury have led to new therapeutic approaches that can modify the outcome of these patients. These adjunctive oxygenation strategies include inhaled nitric oxide and surfactant delivery, and the use of prone positioning. Nitric oxide is a selective pulmonary vasodilator that when inhaled, improves oxygenation in clinical situations such as persistent pulmonary hypertension of the newborn, pulmonary hypertension associated with congenital heart disease, and acute respiratory distress syndrome (ARDS). When applied early in ARDS, prone positioning improves distribution of ventilation and reduces the intrapulmonary shunt. The surfactant has dramatically decreased mortality caused by hyaline membrane disease in premature newborns, although the results have been less successful in ARDS. Greater experience is required to determine whether the combination of these treatments will improve the prognosis of these patients.

  6. A Guide for Developing Standard Operating Job Procedures for the Grit Removal Process Wastewater Treatment Facility. SOJP No. 2.

    Science.gov (United States)

    Deal, Gerald A.; Montgomery, James A.

    This guide describes standard operating job procedures for the grit removal process of wastewater treatment plants. Step-by-step instructions are given for pre-start up inspection, start-up, continuous operation, and shut-down procedures. A description of the equipment used in the process is given. Some theoretical material is presented. (BB)

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

    Science.gov (United States)

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

    2017-03-01

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

  8. [Surgical treatment of hallux valgus with new method: operative technique and review of 100 cases].

    Science.gov (United States)

    Lucijanić, Ivica; Bićanić, Goran; Pećina, Tatjana Cicvara; Pećina, Marko

    2011-01-01

    We present the operative technique and treatment results for a new three-dimensional method for hallux valgus correction. Lucijanić procedure was developed at the Department of Orthopaedic Surgery, General Hospital Karlovac, where patients enrolled in this study were treated from 2001 to 2008. Clinical and radiological evaluation was performed in 100 cases with a mean follow-up of 4.5 years. Mean American Orthopaedic Foot and Ankle Society score improved from 48.56 preoperatively to 92.34 points postoperatively. Average recovery time and return to work was 7.7 weeks. Result was excellent or good in 93%, fair in 5% and poor in 2% of feet. On the average hallux valgus angle decreased from 29.7 degrees to 9.3 degrees and on the average intermetatarsal angle decreased from 12.5 degrees to 5.2 degrees. First metatarsal inclination angle on average increased 5.3 degrees. First metatarsophalangeal joint congruence and tibial sesamoid position were corrected. The new method allows for correction of hallux valgus deformity in all three planes and for metatarsalgia attenuation.

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

    Directory of Open Access Journals (Sweden)

    Marjanović Ivan

    2014-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Um SS

    2011-12-01

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

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

    Science.gov (United States)

    2007-09-01

    or both. Some pain may occur in the lower thorax and salivation increases. Secretions may be thick, sticky, and persistent. If postural drainage...often with fever, chills, and cyanosis, may develop two to six weeks after the initial exposure. Crackles are present; chest radiography may

  12. 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 the proc......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...... the procedure. MATERIALS AND METHODS: The procedure defines procedures for referral, diagnosis, treatment and follow-up of DDH. From 1998 to 2003 children with risk factors or with positive Ortolanis or Barlows test were referred to US. RESULTS: The treatment rate was 0.47%, and the rate of late diagnosed cases...... of the outcome of minor dysplastic/NFD hips must be based on a minimum of two US. An individualization of the treatment length was possible, and treatment length could be shortened in many cases. Compared with the incidence of DDH in Gentofte Hospital before the use of US, we suggest that this selective...

  13. Modified Boytchev procedure for treatment of recurrent anterior dislocation of shoulder

    Directory of Open Access Journals (Sweden)

    Anant Kumar Garg

    2011-01-01

    Full Text Available Background: More than 200 different operations have been described for the treatment of recurrent anterior dislocation of shoulder. The Modified Boytchev procedure employs rerouting of the detached tip of coracoid process with its attached conjoined tendon (short head of biceps and coracobrachialis deep to subscapularis and reattaches to its anatomical location. We conducted a study on evaluation of long-term effect of modified Boytchev procedure and to compare our results with other studies published in literature. Materials and Methods: Since June 2002, modified Boytchev procedure was performed on 48 patients, who presented with recurrent anterior dislocation. 45 were men and 3 were women and were in the age group of 18-40 years (mean 27.83±4.95 years. Forty patients were affected on the dominant side and rest on the non-dominant side. The mean number of dislocations in these patients was 18.22±12.08. The mean followup period was 58.13±19.06 months (range 18-96 months. The patients were evaluated by visual analogue score, modified American Shoulder and Elbow Surgeon′s Score (ASES, and Single Assessment Numeric Evaluation (SANE score at the last followup. Results: All the patients regained almost preoperative range of forward flexion at the last followup. In the preoperative period the mean external rotation deficit at 0° and at 90° of abduction was 13.22°±5.16° and 18.06°±6.50°, respectively. At the last followup, the mean external rotation deficit at 0° and at 90° of abduction was 8.06°±2.47° and 8.95°±2.07°, respectively. This improvement in external rotation deficit was statistically significant (P<.05. Preoperative scores were compared with the most recent followup scores for all variables with use of a paired t test. All patients had significant improvement in visual analogue score, modified American Shoulder and Elbow Surgeon′s Score (ASES, and Single Assessment Numeric Evaluation (SANE score at the last followup

  14. 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

  15. An efficient CT-simulation procedure for breast treatment using tangent beams

    International Nuclear Information System (INIS)

    Lu, H.-M.; Cheng Pan; Lee, Chin; Svensson, Goran; Harris, Jay

    1997-01-01

    Purpose:Breast treatment planning using CT-simulations provides a number of advantages, but presents several unique problems. One concern is the ability to evaluate coverage of the external target volume, since CT scanners cannot provide field light projections on skin. Another is whether treatment portals can be marked on a patient as in a regular simulation, so that the usual level of setup accuracy can be achieved without additional effort at the treatment unit. Finally, the planning procedure must be performed with efficiency, so that it could be used routinely for most or all patients. To address these issues, we report our CT-simulation procedure for breast treatment using tangent beams, which includes, all in one session, CT data acquisition, field determination, external target volume evaluation, and the marking of treatment portals on the patient. Methods and Materials: A General Electric CT scanner and a virtual simulation software package 'Advantage-Sim' were used to perform the simulations. We have developed two tools to assist the simulation process. One is a digitization system consisting of multimedia software interacting with a sonic digitizer that can capture the coordinates of a point in space with the standard deviation of 1.4 mm. Given the planned beam geometry, the system can establish a virtual beam projection on the patient's body in real space, so that for any digitized point on the skin, its position relative to the field can be calculated and shown in a beam's eye view display. With convenient audio and visual signals, the system allows one to see if any skin area of concern is included in the field with sufficient margin, or to rapidly locate field borders or marking points by cruising the digitizer probe on patient skin. The accuracy of the system has been studied by using a breast phantom. The other is a breast planning software tool which augments the virtual simulation software to speed up the generation of tangent beam pairs

  16. Treatment of empty sella associated with visual impairment: a systematic review of chiasmapexy techniques.

    Science.gov (United States)

    Barzaghi, Lina Raffaella; Donofrio, Carmine Antonio; Panni, Pietro; Losa, Marco; Mortini, Pietro

    2018-02-01

    Chiasmapexy is a poorly described surgical procedure adopted to correct the downward displacement of suprasellar visual system (SVS) into an empty sella (ES) causing visual worsening. The aim of our study is to define the indications for extradural and intradural chiasmapexy. A systematic literature review has been performed on MEDLINE database (US National Library of Medicine), including only articles that depicted cases of surgically treated patients affected by ES and progressive delayed visual worsening. Moreover, we have reported three cases of secondary ES syndrome (SESS) with visual worsening treated in our Department with transsphenoidal (TS) microsurgical intradural approach. Finally, we have compared the results of extradural and intradural chiasmapexy described in literature. The etiology of visual impairment is different in primary and secondary ESS. In primary ESS (PESS) the only predisposing factor is a dehiscence of diaphragma sellae, and the anatomical distortion caused by displacement of optic chiasm or traction of pituitary stalk and infundibulum may determine a direct injury of neural fibers and ischemic damage of SVS. In PESS the mechanical elevation of SVS performed through extradural approach is sufficient to resolve the main pathologic mechanism. In SESS, arachnoidal adhesions play an important role in addition to downward herniation of SVS. Consequently, the surgical technique should provide elevation of SVS combined to intradural release of scar tissue and arachnoidal adhesions. In treatment of SESS, the intradural approaches result to be more effective, guaranteeing the best visual outcomes with the lowest complications rates. The intradural chiasmapexy is indicated in treatment of SESS, instead the extradural approaches are suggested for surgical management of PESS.

  17. Intensity modulated radiation therapy for squamous cell carcinoma of the vulva: Treatment technique and outcomes

    Directory of Open Access Journals (Sweden)

    Yuan James Rao, MD

    2017-04-01

    Conclusions: IMRT for vulvar cancer is associated with high rates of LRC in the postoperative setting and limited radiation-related toxicity. Durable LRC of disease after definitive IMRT remains challenging, and several refinements to our treatment technique are suggested.

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

    Directory of Open Access Journals (Sweden)

    Mark Stovsky

    2008-01-01

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

  19. Validity of using backward Lagrangian Stochastic technique in measuring trace gas emission from treatment lagoon

    Science.gov (United States)

    This study evaluates the accuracy of measuring trace gas emission from treatment lagoons using backward Lagrangian stochastic (bLs) technique. The bLs technique was originally developed for relatively homogeneous terrains without any obstacles causing significant windflow disturbance. The errors ass...

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

    Directory of Open Access Journals (Sweden)

    Carlos Vicente Brusius

    2013-08-01

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

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

    Science.gov (United States)

    Batlivala, Sarosh P; Rome, Jonathan J

    2016-02-01

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

  2. Review of deep inspiration breath-hold techniques for the treatment of breast cancer

    International Nuclear Information System (INIS)

    Latty, Drew; Stuart, Kirsty E; Wang, Wei; Ahern, Verity

    2015-01-01

    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

  3. Review of deep inspiration breath-hold techniques for the treatment of breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Latty, Drew, E-mail: drew.latty@health.nsw.gov.au [Crown Princess Mary Cancer Centre, Westmead Hospital, Sydney, New South Wales (Australia); Stuart, Kirsty E [Crown Princess Mary Cancer Centre, Westmead Hospital, Sydney, New South Wales (Australia); Westmead Breast Cancer Institute, Sydney, New South Wales (Australia); Wang, Wei [Crown Princess Mary Cancer Centre, Westmead Hospital, Sydney, New South Wales (Australia); Westmead Breast Cancer Institute, Sydney, New South Wales (Australia); Nepean Cancer Care Centre, Sydney, New South Wales (Australia); Ahern, Verity [Crown Princess Mary Cancer Centre, Westmead Hospital, Sydney, New South Wales (Australia)

    2015-03-15

    Radiation treatment to the left breast is associated with increased cardiac morbidity and mortality. The deep inspiration breath-hold technique (DIBH) can decrease radiation dose delivered to the heart and this may facilitate the treatment of the internal mammary chain nodes. The aim of this review is to critically analyse the literature available in relation to breath-hold methods, implementation, utilisation, patient compliance, planning methods and treatment verification of the DIBH technique. Despite variation in the literature regarding the DIBH delivery method, patient coaching, visual feedback mechanisms and treatment verification, all methods of DIBH delivery reduce radiation dose to the heart. Further research is required to determine optimum protocols for patient training and treatment verification to ensure the technique is delivered successfully.

  4. Theory and practice of irradiation and other treatment procedures for conservation of cultural heritage

    International Nuclear Information System (INIS)

    Ponta, C.C.

    1998-01-01

    Promotional activities were developed for applications of the Romanian Multipurpose Irradiation Facility in various fields. Among these, the conservation of cultural heritage by irradiation is one of the targets taken into consideration from the design stage. A dedicated laboratory is part of the facility. The preparations for cultural heritage conservation already started. They included acquiring of theoretical and practical experience in this field and many contacts were done with museum and archive specialists in restoration and conservation. Being a quasi new borderline between the humanistic and technical areas, the conservation of cultural heritage needs pluri-disciplinary synthesis. Our work, mainly bibliographical, covers this complex picture focusing on conservation from different points of view: sources of degradation, technical conservation alternatives with pros and contras, cost/benefit and other aspects that must be taken into account when a conservation procedure is chosen. The paper aim is to assemble the abilities of those implicated in execution and decision. - The conservator perspective is the most important one. He has the privilege and responsibility in choosing the disinfestation procedure. His perspective is based on the knowledge of the material structure, of the specific way of material deterioration and of the biology of the aggressors. - The conservation procedures must have in view the protection of the persons that use the treated objects (museum custodian, archivist, archive researcher, visitor), i.e., the need for an ecologically friendly technology to ensure the protection of human beings and environment. This trend imposed the abandonment of fumigation with toxic vapours (persisting in treated items and slowly being released in museum and archives) giving credits to new clean methods, like irradiation. - The perspective of the operator that applies the conservation procedure is governed by technical and financial elements. Having

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

    Science.gov (United States)

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

    2016-01-01

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

  6. 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)

  7. Execution techniques for high level radioactive waste disposal. 7. Handling and emplacement procedure of waste, and backfilling procedure of disposal facility

    International Nuclear Information System (INIS)

    Shiozaki, Isao; Ogata, Nobuhide; Kanagawa, Tadashi; Deguchi, Akira; Takahashi, Yoshiaki; Takao, Hajime; Awano, Toshihiko; Kawamura, Hideki

    1999-01-01

    Based on the principle of radiation protection, we studied the handling and emplacement procedure of waste and buffer material. We showed the handling flow diagram, conceptual drawings of handling and emplacement facility in two cases of emplacement; vertical emplacement in pit and horizontal emplacement in tunnel. The procedure and material for backfilling and plugging have been studied and the optimum method of current technologies is selected. Regarding the tunnel supporting, the removal of concrete supporting mainly was studied. Finally, we showed our view of monitoring before and after the close of disposal facility. (author)

  8. 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)

  9. 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.

  10. Rapid prototyping and inclined plane technique in the treatment of maxillofacial malformations in a fox

    Science.gov (United States)

    Freitas, Elisangela P.; Rahal, Sheila C.; Teixeira, Carlos R.; Silva, Jorge V.L.; Noritomi, Pedro Y.; Villela, Carlos H.S.; Yamashita, Seizo

    2010-01-01

    An approximately 9-month-old fox (Pseudalopex vetulus) was presented with malocclusion and deviation of the lower jaw to the right side. Orthodontic treatment was performed using the inclined plane technique. Virtual 3D models and prototypes of the head were based on computed tomography (CT) image data to assist in diagnosis and treatment. PMID:20514249

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

    Directory of Open Access Journals (Sweden)

    Raoul R. Nigmatullin

    2013-01-01

    Full Text Available Detonation nanodiamonds (NDs have shown to be promising agents in several industries, ranging from electronic to biomedical applications. These NDs are characterized by small particle size ranging from 3 to 6 nm, while having a reactive surface and a stable inert core. Nanodiamonds can exhibit novel intrinsic properties such as fluorescence, high refractive index, and unique Raman signal making them very attractive imaging agents. In this work, we used several nanodiamond preparations for Raman spectroscopic studies. We exposed these nanodiamonds to increasing temperature treatments at constant heating rates (425–575°C aiding graphite release. We wanted to correlate changes in the nanodiamond surface and properties with Raman signal which could be used as a detection marker. These observations would hold potential utility in biomedical imaging applications. First, the procedure of optimal linear smoothing was applied successfully to eliminate the high-frequency fluctuations and to extract the smoothed Raman spectra. After that we applied the secondary Fourier transform as the fitting function based on some significant set of frequencies. The remnant noise was described in terms of the beta-distribution function. We expect this data treatment to provide better results in biomolecule tracking using nanodiamond base Raman labeling.

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

    Directory of Open Access Journals (Sweden)

    Laketić Darko

    2012-01-01

    Full Text Available Introduction. Stress urinary incontinence is an involuntary leakage of urine on a sudden increase of intra-abdominal pressure by physical activity, exercise, coughing, sneezing or laughing. Objective. To assess symptoms, functional and anatomical status of voiding function, complications and short term success of a novel procedure, tension-free vaginal tape obturator technique (TVT-O in the treatment of stress urinary incontinence. Methods. A prospective study was performed on 40 female patients who underwent the TVT-O suburethral sling at the Urology Department of the Health Centre in Prokuplje and Urology Hospital in Niš between May 2009 and February 2010. The mean patients’ age was 58 years (range 34-84 years. Preoperative evaluation included a detailed history and gynaecologic examination including urodynamic testing and voiding studies.UDI-6 and UIQ-7 score testing was performed before, and six months after surgery. All patients who demonstrated stress urinary incontinence with a Q-tip test-angle during maximal straining were included into the study. Postoperatively, outcomes evaluation included voiding function, anatomical parameters, complications, as well as subjective success rates. Results. In 30 patients surgery was performed under spinal and in ten under general anaesthesia. The average intraoperative blood loss during the TVT-O was minimal (<50 ml. There were no vascular, bladder, bowel, and neurological injuries. Thirty-eight patients (95% were discharged voiding satisfactorily. There was a statistically significant difference in symptoms between UDI-6 and UIQ-7 before and after surgery. Conclusion. Initial experience with TVT-O suburethral sling is promising. The TVT-O differs from retropubic procedures by resulting in lower postoperative morbidity, intraoperative and postoperative complications.

  13. Pre-endodontic Post and Core Technique for Endodontic and Prosthodontic Treatment.

    Science.gov (United States)

    Sasaki, Keita; Yamamoto, Takatsugu; Ikawa, Tomoko; Shigeta, Yuko; Shigemoto, Shuji; Ando, Eriko; Ogawa, Takumi; Ihara, Keisuke

    2018-01-01

    Displacement of provisional fixed prostheses may result in undesirable and embarrassing outcomes in dental treatments, especially in endodontic treatment. Development of certain counter measures has been necessary to avoid such discomforts. The aim of this report was to propose a pre-endodontic post and core technique to achieve smooth progress of the treatment. The patient was a 59-year-old male diagnosed with an infraocclusion caused by wear of his teeth. He received full mouth provisional fixed restorations for a complete oral rehabilitation. Displacement and fracture of the restorations frequently occurred during the observation period for the function of the restorations. Therefore, the pre-endodontic post and core technique was applied to the abutment teeth before their endodontic treatments were started. The technique consisted of three steps as follows: Step 1: Caries removal and dowel preparation were performed for the abutment teeth having apical periodontitis. Composite cores were indirectly fabricated, which had access holes for endodontic treatment. Step 2: The cores were bonded to the teeth. In endodontic treatment, rubber dam appliances were easily placed owing to the core, and proper tooth isolation was accomplished. Step 3: Fiberposts were bonded to the dowel holes through the access holes after the root canal filling. During endodontic treatment, displacement and/or fracture of the provisional restorations did not occur. The pre-endodontic post and core technique was effective in obtaining improved retention of provisional restoration, appropriate isolation for endodontic treatment, and sufficient retention of the post and core. The pre-endodontic post and core technique is useful for avoiding the discomforts in dental treatments, namely, a smooth transition from endodontic to prosthodontic treatment can be achieved.

  14. The evolution of the sentinel node procedure in the treatment of breast cancer.

    Science.gov (United States)

    Tvedskov, Tove Filtenborg

    2017-10-01

    This thesis is based on 10 original articles, of which 3 were previously included in the PhD thesis "Staging of women with breast cancer after introduction of sentinel node guided axillary dissection". In the PhD thesis is was shown that the introduction of sentinel lymph node dissection (SLND) in the treatment of breast cancer in Denmark has resulted in an increased identification of patients with micrometastases or isolated tumor cells (ITC) in the lymph nodes. Not all these small metastases are likely to disseminate to non-sentinel nodes. This thesis provides evidence that a previous surgical excision of a breast tumor is likely to lead to iatrogenic displacement of tumor cells resulting in a nearly four-fold increased risk of ITC in the sentinel node. These tumor cells are not associated with non-sentinel node metastases. Especially ITC, but also micrometastases and some macrometastases, are not identified on perioperative frozen sections, but found postoperatively at the conventional histopathological examination. These patients are offered an axillary lymph node dissection (ALND) as a second procedure. It has been suggested that this two-stage procedure reduces the number of lymph nodes removed, because of fibroses from previous surgery. In this thesis it was shown that a two-stage procedure does not result in a clinically relevant impairment of the number of lymph nodes removed by ALND. Based on patient, tumor, and sentinel node characteristics from the Danish Breast Cancer Group database, two predictive models for non-sentinel node metastases, when only micrometastases or ITC are found in the sentinel node, were developed, as a part of the PhD thesis. These two models have now been internally validated, and a cross-validation in a Finnish patient material has been performed in cooperation with researchers from Helsinki. The model for patients with micrometastases proved to be robust under internal as well as external validation and could be used to identify

  15. A Comparison of the Bariatric Procedures that Are Performed in the Treatment of Super Morbid Obesity.

    Science.gov (United States)

    Uno, Kohei; Seki, Yosuke; Kasama, Kazunori; Wakamatsu, Kotaro; Umezawa, Akiko; Yanaga, Katsuhiko; Kurokawa, Yoshimochi

    2017-10-01

    We have experienced numerous cases of super morbid obesity (SMO), defined by a BMI of ≥50 kg/m 2 , in which laparoscopic sleeve gastrectomy (LSG) was not able to achieve a sufficient weight loss effect. However, the most appropriate procedure for the treatment of SMO has not yet been established. The subjects included 248 successive patients who underwent surgery at our hospital from June 2006 to December 2012. We divided the subjects into an SMO group (BMI, 50 to <70 kg/m 2 ) and a morbid obesity (MO) group (BMI, 35 to <50 kg/m 2 ). The subjects underwent LSG, LSG with duodenojejunal bypass (LSG/DJB), or laparoscopic Roux-en-Y gastric bypass (LRYGB). The weight loss effects, safety of surgery, and metabolic profile changes were compared. Sixty-two subjects were classified into the SMO group (25%). The percent excess weight loss (%EWL) after LSG among the patients in the SMO group was not significantly different from that of patients who underwent other procedures. LSG was associated with a significantly lower success rate in terms of weight loss (%EWL ≥ 50%), in comparison to the weight loss at 1 year after LRYGB and at 2 years after LSG/DJB and LRYGB. Among the patients in the MO group, the %EWL and the rate of successful weight loss did not differ to a statistically significant extent. This study demonstrated that in patients with SMO, LSG/DJB and LRYGB can achieve superior weight loss effects in comparison to LSG.

  16. Endovascular procedures in the treatment of obstructive lesions of brachiocephalic arteries

    Directory of Open Access Journals (Sweden)

    Sagić Dragan

    2002-01-01

    Full Text Available Background. To assess the early effects, possible risks, and long term results of percutaneous transluminal angioplasty (PTA of brachiocephalic trunk (BT and subclavian arteries (SA. Methods. During the period of 11 years, in 92 patients (57 males - 62%, mean age 53,5 ± 7,8 years 93 PTA of SA/BT were performed; 70 (75% lesions were stenosis, while 23 (25% lesions were occlusions with mean diameter stenosis percent of 83,1 ± 6,2%. Clinical indications were: vertebrobasilar insufficiency (n=57, upper limb ischemia (n=40, coronary steal syndrome (n=4 and scheduled aorto-coronary bypass, using internal thoracic artery (ITA (n=4 asymptomatic patients. Mean lesion length was 22 ± 8 mm. Results. Eighty one (87% out of 93 lesions were successfully dilated; all of 12 (13% failures were due to unsuccessful recanalisation of occluded arteries. In 10 patients 10 stents were implanted (2 in BT and 8 in left SA. There were 6 (6.5% procedural complications: 1 dissection, 1 thrombosis of the left SA, transient ischemic attack in 2 patients, and 2 cases of dislocation of atheromatous plaque from the right SA into the right common carotid artery. During the follow-up of 48 ± 3 months, 16 (20% restenoses were treated by PTA (n=7 or operatively (n=9. Primary and secondary patency for all lesions treated during 11 years was 87% and 80%, respectively (stenosis: 97% and 89%; occlusions: 58% and 58%. Conclusion. PTA with or without stenting was relatively simple, efficient and safe procedure. It required short hospitalization with low treatment costs. If any of suboptimal results or chronic occlusions were present, the implantation of endovascular stents should have been considered.

  17. Recurrent Anterior Shoulder Instability With Combined Bone Loss: Treatment and Results With the Modified Latarjet Procedure.

    Science.gov (United States)

    Yang, Justin S; Mazzocca, Augustus D; Cote, Mark P; Edgar, Cory M; Arciero, Robert A

    2016-04-01

    Recurrent anterior glenohumeral dislocation in the setting of an engaging Hill-Sachs lesion is high. The Latarjet procedure has been well described for restoring glenohumeral stability in patients with >25% glenoid bone loss. However, the treatment for patients with combined humeral head and mild (Latarjet for patients with combined humeral and glenoid defects and compares the results for patients with ≤25% glenoid bone loss versus patients with >25% glenoid bone loss. The hypothesis was that the 2 groups would have equivalent subjective outcomes and recurrence rates. Cohort Study; Level of evidence, 3. Modified Latarjet was performed in 40 patients with recurrent anterior shoulder instability, engaging Hill-Sachs by examination confirmed with arthroscopy, and ≤25% anterior glenoid bone loss (group A). A second group of 12 patients were identified to have >25% glenoid bone loss with an engaging Hill-Sachs lesion (group B). The mean follow-up time was 3.5 years. All patients were assessed for their risk of recurrence using the Instability Severity Index score and Beighton score and had preoperative 3-dimensional imaging to assess humeral and glenoid bone loss. Single Assessment Numeric Evaluation (SANE), Western Ontario Shoulder Instability Index (WOSI), recurrence rate, radiographs, range of motion, and dynamometer strength were used to assess outcomes. A multivariate analysis was performed. Glenoid bone loss averaged 15% in group A compared with 34% in group B. Both groups had comparable WOSI scores (356 vs 475; P = .311). In multivariate analysis, the number of previous surgeries and Beighton score were directly correlated with WOSI score in Latarjet patients. The SANE score was better in group A (86 vs 77; P = .02). Group B experienced more loss of external rotation (9.2° vs 15.8°; P = .0001) and weaker thumbs-down abduction and external rotation strength (P .999) were similar for both groups. The complication rate was 25% for both groups. The modified

  18. Endoscopic treatment of multilocular walled-off pancreatic necrosis with the multiple transluminal gateway technique.

    Science.gov (United States)

    Jagielski, Mateusz; Smoczyński, Marian; Adrych, Krystian

    2017-06-01

    The development of minimally invasive techniques allowed access to the necrotic cavity through transperitoneal, retroperitoneal, transmural and transpapillary routes. The choice of access to walled-off pancreatic necrosis (WOPN) should depend not only on the spread of necrosis, but also on the experience of the clinical center. Herein we describe treatment of a patient with multilocular symptomatic walled-off pancreatic necrosis using minimally invasive techniques. The single transmural access (single transluminal gateway technique - SGT) to the necrotic collection of the patient was ineffective. The second gastrocystostomy was performed using the same minimally invasive technique as an extra way of access to the necrosis (multiple transluminal gateway technique - MTGT). In the described case the performance of the new technique consisting in endoscopic multiplexing transmural access (MTGT) was effective enough and led to complete recovery of the patient.

  19. Paving the way for a gold standard of care for infertility treatment: improving outcomes through standardization of laboratory procedures.

    Science.gov (United States)

    Schoolcraft, William; Meseguer, Marcos

    2017-10-01

    Infertility affects over 70 million couples globally. Access to, and interest in, assisted reproductive technologies is growing worldwide, with more couples seeking medical intervention to conceive, in particular by IVF. Despite numerous advances in IVF techniques since its first success in 1978, almost half of the patients treated remain childless. The multifactorial nature of IVF treatment means that success is dependent on many variables. Therefore, it is important to examine how each variable can be optimized to achieve the best possible outcomes for patients. The current approach to IVF is fragmented, with various protocols in use. A systematic approach to establishing optimum best practices may improve IVF success and live birth rates. Our vision of the future is that technological advancements in the laboratory setting are standardized and universally adopted to enable a gold standard of care. Implementation of best practices for laboratory procedures will enable clinicians to generate high-quality gametes, and to produce and identify gametes and embryos of maximum viability and implantation potential, which should contribute to improving take-home healthy baby rates. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  20. Quality assurance procedures based on dosimetric, gamma analysis as a fast reliable tool for commissioning brachytherapy treatment planning systems

    Directory of Open Access Journals (Sweden)

    Zwierzchowski Grzegorz

    2017-11-01

    Full Text Available Fast and easily repeatable methods for commissioning procedures for brachytherapy (BT treatment planning systems (TPS are needed. Radiochromic film dosimetry with gamma analysis is widely used in external beam quality assurance (QA procedures and planar film dosimetry is also increasingly used for verification of the dose distribution in BT applications. Using the gamma analysis method for comparing calculated and measured dose data could be used for commissioning procedures of the newly developed TG-186 and MBDCA calculation algorithms. The aim of this study was dosimetric verification of the calculation algorithm used in TPS when the CT/MRI ring applicator is used.

  1. A novel minimally invasive technique for the treatment of high-grade isthmic spondylolisthesis using a posterior transsacral rod.

    Science.gov (United States)

    Shedid, Daniel; Weil, Alexander G; Lieberman, Isidore

    2014-04-01

    Case report of 3 patients with high-grade isthmic spondylolisthesis treated using a novel minimally invasive technique using a posterior transsacral rod. To assess the efficacy, safety, and advantages of this approach in the treatment of high-grade L5-S1 spondylolisthesis. Surgical treatment of high-grade isthmic spondylolisthesis at the L5-S1 level is technically demanding. The most commonly used procedure is posterior spinal fusion. In this report, we present a new minimally invasive technique for the treatment high-grade isthmic spondylolisthesis in 3 patients with sagittally balanced spines. Three patients with high-grade L5-S1 spondylolisthesis underwent L4-S1 fusion with percutaneous pedicle screw fixation supplemented with a transsacral rod implanted through a tubular retractor. We report technical details, clinical, and radiologic results at follow-up. All 3 patients suffered from grade 3 or 4 L5-S1 spondylolisthesis. All patients had neutral sagittal balance on preoperative imaging. There were no postoperative complications and all 3 patients were discharged within 48 hours. At final follow-up (range, 13-18 mo), all patients were pain free off all narcotic pain medication and fusion was observed in all 3 patients. We have shown the technical feasibility of anterior and posterior fusion for severe L5-S1 spondylolisthesis using a minimally invasive percutaneous technique through a transsacral approach. The main advantage of a posterior transsacral axial rod fixation is that it creates a structurally sound anterior column support, thus eliminating the problems related to bone grafts and eliminating the complications associated with an anterior approach. Our preliminary results suggest that this technique is feasible and seems to be associated with favorable outcome, although larger studies are warranted to verify these findings.

  2. Combined thoracoscopic and laparoscopic robotic-assisted minimally invasive esophagectomy using a four-arm platform: experience, technique and cautions during early procedure development.

    Science.gov (United States)

    Sarkaria, Inderpal S; Rizk, Nabil P; Finley, David J; Bains, Manjit S; Adusumilli, Prasad S; Huang, James; Rusch, Valerie W

    2013-05-01

    This study reports an early, single-institution experience of combined thoracoscopic and laparoscopic robotic-assisted minimally invasive esophagectomy (RAMIE) using a four-arm robotic platform, with special attention given to the pitfalls and complications during procedure development. We conducted a prospective, single-cohort, observational study of patients undergoing RAMIE at a single institution. A total of 21 patients (median age, 62 years [range, 37-83 years]) underwent RAMIE with a four-arm robotic platform (17 by Ivor Lewis and 4 by McKeown). Of the patients, 17 (81%) had a complete (R0) resection, and 16 (76%) received induction treatment, the majority (14/21 [67%]) with combined chemoradiation. The median operative time was 556 min (range, 395-807 min), which decreased to 414 min (range, 405-543 min) for the last 5 cases in the series. The median estimated blood loss was 307 cm(3) (range, 200-500 cm(3)), and the median length of hospital stay was 10 days (range, 7-70 days). The median number of lymph nodes resected was 20 (range, 10-49). Five (24%) patients were converted to open procedures. Five patients (24%) had major complications. One (5%) died of complications on postoperative Day 70, and 3 (14%) had clinically significant anastomotic leaks (Grade II or greater, by Common Terminology Criteria for Adverse Events version 3.0). Three patients (14%) in this early experience developed airway fistulas. While four-arm RAMIE may offer advantages over standard minimally invasive esophagectomy approaches, its adoption in a structured program, with critical evaluation of adverse events and subsequent adjustment of technique, is paramount to maximize patient safety, minimize complications and improve the conduct of operation early in the learning curve. Particular technical consideration should be given to prevention of airway complications.

  3. 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.

  4. Missing data treatments matter: an analysis of multiple imputation for anterior cervical discectomy and fusion procedures.

    Science.gov (United States)

    Ondeck, Nathaniel T; Fu, Michael C; Skrip, Laura A; McLynn, Ryan P; Cui, Jonathan J; Basques, Bryce A; Albert, Todd J; Grauer, Jonathan N

    2018-04-09

    event, severe adverse events, and hospital readmission. Multiple imputation is a rigorous statistical procedure that is being increasingly used to address missing values in large datasets. Utilizing this technique for ACDF avoided the loss of cases that may have affected the representativeness and power of the study and led to different results than complete case analysis. Multiple imputation should be considered for future spine studies. Copyright © 2018 Elsevier Inc. All rights reserved.

  5. [Combined procedure for the treatment of ankle and foot deformities secondary to spina bifida].

    Science.gov (United States)

    Jiao, Shao-Feng; Qin, Si-He; Ren, Long-Xi; Ge, Jian-Zhong; Wu, Hong-Fei; Wang, Zhen-Jun; Zheng, Xue-Jian

    2012-03-01

    To study surgical strategies for ankle and foot deformities secondary to spina bifida and treatment methods for different types of deformities. From January 1990 and July 2009, 107 patients with ankle and foot deformities secondary to spina bifida were retrospectively analyzed. There were 44 males and 63 females, with an average age of 17.7 years (rangd from 1.3 to 52 years). Among the patients, 58 patients had double ankle deformities, 49 patients had unilateral deformities (22 cases on the left side, 27 cases on the right). Ninety-nine patients with equinus deformities were treated by achilles tendon lengthening and tendon transfering; 25 patients with talipes were treated by release of anterior tendon of ankle and tendon transfer; 17 patients with valgus and varus deformities were treated by tendon transfer and calcaneal osteotomy; 15 patients with flail deformities were managed treated by bone fusion between calcaneus and talus and shortening of achilles tendon; 9 patients with claw toe deformities were treated by bone fusion of interphalangeal joint or Ilizarovs distraction. AOFAS (American Orthopaedic Foot & Ankle Society) comprehensive scoring system was used to evaluate subjective pain and objective functional. Seventy-nine (127 feet) of 107 patients were followed up, and the duration ranged from 48 to 180 months (averaged, 64 months). According to AOFAS scoring system, the results were rated as excellent in 89 feet, good in 26 feet, moderate in 9 feet and poor in 3 feet. Treatment strategies for ankle-foot deformities mainly included four principles, deformity correction, muscular balance, joint stability and reservation of foot elasticity. Different combined procedure was applied for different foot deformities and received good therapeutic effects.

  6. Brazilian demand for Iodine-125 seeds in cancer treatment after a decade of medical procedures

    Energy Technology Data Exchange (ETDEWEB)

    Costa, Osvaldo L. da; Souza, Daiane C.B. de; Feher, Anselmo; Moura, João A.; Souza, Carla D.; Oliveira, Henrique B. de; Peleiras Junior, Fernando S.; Zeituni, CArlos A.; Rostelaro, Maria E.C.M., E-mail: olcosta@ipen.br [Instituto de Pesquisas Energeticas e Nucleares (IPEN/CNEN-SP), Sao Paulo, SP (Brazil)

    2017-07-01

    Iodine-125 and palladium-103 are radionuclides employed to made medical devices used in cancer treatment known as brachytherapy seeds. These radioactive sealed sources are applied in brain and ophthalmic cancer as a temporary implant to irradiate the tumor and in permanent implants to prostatic cancer. Brazilian Nuclear Energy Commission (CNEN) has the monopoly in Brazil of iodine-125 brachytherapy seeds distribution which is executed for Nuclear and Energy Research Institute (IPEN-CNEN/SP). Along a decade of use in Brazil more than 240 thousand seeds were implanted in patients or used to treat cancer tumors. In this article the Brazilian demand for iodine-125 brachytherapy seeds is analyzed. The demand behavior along a decade of using loose, strand, ophthalmic and brain brachytherapy seeds are shown. The annual quantity of seeds demanded by Brazil has dropped since 2012. The loose seeds which represented until 30% from total brachytherapy seeds used in Brazil decreased to less than 3%. The brain brachytherapy seeds had low demand along the decade and presented zero demand in several years. Concurrent treatment techniques are listed and main trends are discussed. The influence of Brazilian economic crisis and the demand behavior of the main hospitals and clinics that use Iodine-125 brachytherapy are shown. (author)

  7. 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

  8. A new technique of laparoscopic implantation of stimulation electrode to the pudendal nerve for treatment of refractory fecal incontinence and/or overactive bladder with urinary incontinence.

    Science.gov (United States)

    Possover, Marc

    2014-01-01

    To show a new technique of laparoscopic implantation of electrodes for stimulation of the pudendal nerve for treatment of fecal incontinence and/or overactive bladder with urinary incontinence. Step-by-step explanation of the technique using videos and pictures (educative video). Hyperactivity of the bladder with urinary incontinence, in particular the non-neurogenic form of the condition, but also fecal incontinence may affect millions of women worldwide without any comorbidities and in particular without any neurologic disorders or prolapsed organs. First-line conservative treatments do not always result in sufficient improvement of symptoms and are often associated with disabling adverse effects leading to treatment failure. Electrical stimulation of the pelvic nerves has emerged as an alternative and attractive treatment in refractory cases. A novel technique of implantation of an electrode to the pudendal nerve has been developed for treatment of fecal incontinence and of hyperactivity of the bladder with urinary incontinence. The laparoscopic approach is the only technique that enables placement of an electrode in direct contact with the endopelvic portion of the pudendal nerve within the protection of the pelvis. Laparoscopic transperitoneal implantation of a stimulation electrode to the endopelvic portion of the pudendal nerve. This technique of transperitoneal placement of an electrode to the endopelvic portion of the pudendal nerve is an effective, safe, and reproducible day procedure for treatment of intractable hyperactive bladder, urinary incontinence, fecal incontinence, and a combination of both forms of incontinence. Copyright © 2014 AAGL. Published by Elsevier Inc. All rights reserved.

  9. Treatment of unilateral giant fibroadenoma by breast reduction skin incision: the inverted "T" technique.

    Science.gov (United States)

    Achebe, J U; Njeze, G E; Okwesili, O R

    2014-01-01

    Giant fibroadenoma (GFA) has been defined as fibroadenoma greater than 5 cm in it's the widest diameter and/or weighing more than 500 g. A benign lesion, its size also raises the possibility of malignancy requiring differentiation from a malignant breast disease. When unilateral GFA presents with a severe breast asymmetry, due to its size, it is not correctable by simple enucleation alone. Postoperative asymmetry from volume and ptosis disparity results, which needs to be addressed at the primary surgery. The inverted "T" technique, which is effective in volume reduction and ptosis correction in breast hypertrophy, can be applied in the treatment of unilateral GFA. This is a retrospective review of all GFA treated by inverted "T" method. A retrospective review was carried out on all patients with GFA treated by inverted "T" skin pattern method over a period of 20 years (January 1988 to December 2007). The procedures were carried out at the University of Nigeria Teaching Hospital and the National Orthopedic Hospital, Enugu. Information, which included patients' demographics, pre-operative assessment, operative findings and outcome of surgery were obtained from the case files of the patients. The degree of ptosis was recorded for each patient. Diagnosis of GFA was made after clinical evaluation and pre-operative tissue biopsy. Immediate results of treatment were based on the patients' satisfaction, visual assessment of symmetry of size of breasts, correction of ptosis and position of nipple areola complex (NAC). A total of 27 patients underwent inverted "T" technique for excision of GFA in their breasts. Their average age was 17.5 years (range 12-25 years) delay in presentation ranged from 2 months to 15 months. In 16 patients (59.2%), the left breast was involved in GFA whilst the tumor occurred on the right breast in 11 (40.7%). The tumor weighed on the average 1500 g (range 655-2200 g). Average diameter of the tumor was 15 cm (range 12-20 cm). All quadrants of the

  10. 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

  11. Geometric parameter analysis to predetermine optimal radiosurgery technique for the treatment of arteriovenous malformation

    International Nuclear Information System (INIS)

    Mestrovic, Ante; Clark, Brenda G.

    2005-01-01

    Purpose: To develop a method of predicting the values of dose distribution parameters of different radiosurgery techniques for treatment of arteriovenous malformation (AVM) based on internal geometric parameters. Methods and Materials: For each of 18 previously treated AVM patients, four treatment plans were created: circular collimator arcs, dynamic conformal arcs, fixed conformal fields, and intensity-modulated radiosurgery. An algorithm was developed to characterize the target and critical structure shape complexity and the position of the critical structures with respect to the target. Multiple regression was employed to establish the correlation between the internal geometric parameters and the dose distribution for different treatment techniques. The results from the model were applied to predict the dosimetric outcomes of different radiosurgery techniques and select the optimal radiosurgery technique for a number of AVM patients. Results: Several internal geometric parameters showing statistically significant correlation (p < 0.05) with the treatment planning results for each technique were identified. The target volume and the average minimum distance between the target and the critical structures were the most effective predictors for normal tissue dose distribution. The structure overlap volume with the target and the mean distance between the target and the critical structure were the most effective predictors for critical structure dose distribution. The predicted values of dose distribution parameters of different radiosurgery techniques were in close agreement with the original data. Conclusions: A statistical model has been described that successfully predicts the values of dose distribution parameters of different radiosurgery techniques and may be used to predetermine the optimal technique on a patient-to-patient basis

  12. 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.

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

    Science.gov (United States)

    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.

  14. Implications of the Declarative/Procedural Model for Improving Second Language Learning: The Role of Memory Enhancement Techniques

    Science.gov (United States)

    Ullman, Michael T.; Lovelett, Jarrett T.

    2018-01-01

    The declarative/procedural (DP) model posits that the learning, storage, and use of language critically depend on two learning and memory systems in the brain: declarative memory and procedural memory. Thus, on the basis of independent research on the memory systems, the model can generate specific and often novel predictions for language. Till…

  15. Case Report: ‘Z’ osteotomy - a novel technique of treatment in Blount’s disease [version 1; referees: 2 approved

    Directory of Open Access Journals (Sweden)

    Raju Karuppal

    2015-11-01

    Full Text Available Blount’s disease is a progressive form of genu varum due to asymmetrical inhibition of the postero medial portion of the proximal tibial epiphysis. The surgical treatments involved in correction of Blount’s disease are often technically demanding, complicated procedures.  These procedures can lead to prolonged recovery times and poor patient compliance. In such a context we are suggesting “fibulectomy with Z osteotomy” of the proximal tibia, a relatively simple and highly effective technique. This technique is based on correcting the mechanical axis of the lower limb thereby restoring growth from the medial physis of proximal tibia. We have used a new surgical technique, which includes fibulectomy followed by a Z-shaped osteotomy. We have used this simple technique in a 5 year-old boy with unilateral Blount’s disease. The femoro-tibial angle was corrected from 18.2° of varus to 4.2° of valgus. The angular correction obtained after operation was 22°. There were no postoperative complications. This technique has the advantages of correcting both angular and rotational deformities simultaneously.  The purpose of this case study is to introduce a new surgical technique in the treatment of Blount’s disease.

  16. [Application progress of minimally invasive technique in treatment of calcaneus fractures].

    Science.gov (United States)

    Yu, Tao; Yang, Yunfeng; Yu, Guangrong

    2013-02-01

    To review the application progress of minimally invasive technique in the treatment of calcaneus fractures and to analyze the advantages and disadvantages of each method as well as to predict the trend of development in the field. Domestic and abroad literature concerning the minimally invasive technique applied in calcaneus fractures in recent years was reviewed extensively and analyzed thoroughly. There are both advantages and limitations of each minimally invasive technique including percutaneous reduction and fixation, limited incision, external fixator, arthroscopic assisted reduction, and balloon expansion reduction. But every technique is developing rapidly and becoming more and more effective. A variety of minimally invasive technique can not only be used independently but also can be applied jointly to complement one another. It needs further study how to improve the effectiveness and expand the indications. And the theoretical basis of evidence-based medicine needs to be provided more.

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

    DEFF Research Database (Denmark)

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

    2014-01-01

    BackgroundWe investigated how varying the treatment margin and applying hippocampal sparing and proton therapy impact the risk of neurocognitive impairment in pediatric medulloblastoma patients compared with current standard 3D conformal radiotherapy.MethodsWe included 17 pediatric medulloblastoma...

  18. 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)

  19. A comparative examination of sample treatment procedures for ICAP-AES analysis of biological tissue

    Science.gov (United States)

    De Boer, J. L. M.; Maessen, F. J. M. J.

    The objective of this study was to contribute to the evaluation of existing sample preparation procedures for ICAP-AES analysis of biological material. Performance characteristics were established of current digestion procedures comprising extraction, solubilization, pressure digestion, and wet and dry ashing methods. Apart from accuracy and precision, a number of criteria of special interest for the analytical practice was applied. As a test sample served SRM bovine liver. In this material six elements were simultaneously determined. Results showed that every procedure has its defects and advantages. Hence, unambiguous recommendation of standard digestion procedures can be made only when taking into account the specific analytical problem.

  20. Design of a technique for the radiotherapy treatment of patients of prostate with bilateral prosthetic hip

    International Nuclear Information System (INIS)

    Camacho, C.; Perez-Alija, J.; Olivares, S.; Loscos, S.; Pedro, A.

    2013-01-01

    The design of the plan of treatment of patients who have to undergo radical radiotherapy of prostate and that incorporate some sort of hip prosthesis is usually complex. the case of a patient's prostatic bed with bilateral hip prosthesis to assess radical radiotherapy to the 70Gy in bed. The objective of this paper is to present the chosen technique designed for this treatment. (Author)

  1. The Maxillary Sinus Membrane Elevation Procedure: Augmentation of Bone around Dental Implants without Grafts—A Review of a Surgical Technique

    Directory of Open Access Journals (Sweden)

    Christopher Riben

    2012-01-01

    Full Text Available Background. Long-term edentulism may in many cases result in resorption of the alveolar process. The sinus lift procedure aims to create increased bone volume in the maxillary sinus in order to enable installation of dental implants in the region. The method is over 30 years old, and initially autogenous bone grafts were used and later also different bone substitutes. Since 1997, a limited number of studies have explored the possibility of a graftless procedure where the void under the sinus membrane is filled with a blood clot that enables bone formation. Aim. To describe the evolution of the sinus-lift technique and to review the literature related to the technique with a focus on long-term studies related to the graft-less technique. Methods. The electronic database PubMed was searched, and a systematic review was conducted regarding relevant articles. Results. A relatively few long-term studies using the described technique were found. However, the technique was described as reliable considering the outcome of the existing studies. Conclusion. All investigated studies show high implant survival rates for the graftless technique. The technique is considered to be cost-effective, less time-consuming, and related to lower morbidity since no bone harvesting is needed.

  2. A comparison of different three-dimensional treatment planning techniques for localized radiotherapy of prostate cancer

    International Nuclear Information System (INIS)

    Koswig, S.; Dinges, S.; Buchali, A.; Boehmer, D.; Salk, J.; Rosenthal, P.; Harder, C.; Schlenger, L.; Budach, V.

    1999-01-01

    Purpose: Four different three-dimensional planning techniques for localized radiotherapy of prostate cancer were compared with regard to dose homogeneity within the target volume and dose to organs at risk, dependent upon tumor stage. Patients and Methods: Six patients with stage T1, 7 patients with stage T2 and 4 patients with stage T3 were included in this study. Four different 3D treatment plans (rotation, 4-field, 5-field and 6-field technique) were calculated for each patient. Dose was calculated with the reference point at the isocenter (100%). The planning target volume was encompassed within the 95% isodose surface. All the techniques used different shaped portal for each beam. Dose volume histograms were created and compared for the planning target volume and the organs at risk (33%, 50%, 66% volume level) in all techniques. Results: The 4 different three-dimensional planning techniques revealed no differences concerning dose homogeneity within the planning target volume. The dose volume distribution at organs at risk show differences between the calculated techniques. In our study the best protection for bladder and rectum in stage T1 and T2 was achieved by the 6-field technique. A significant difference was achieved between 6-field and 4-field technique only in the 50% volume of the bladder (p=0.034), between the 6-field and rotation technique (all volume levels) and between 5-field and rotation technique (all volume levels). In stage T1, T2 6-field and 4-field technique in 50% (p-0.033) and 66% (p=0.011) of the rectum volume. In stage T3 a significant difference was not observed between the 4 techniques. The best protection of head of the femur was achieved by the rotation technique. Conclusion: In the localized radiotherapy of prostate cancer in stage T1 or T2 the best protection for bladder and rectum was achieved by a 3D-planned conformal 6-field technique. If the seminal vesicles have been included in the target volume and in the case of large

  3. Electronic endoscope insertion into a thoracic drainage tube is a new technique in the treatment and diagnosis of pleural diseases.

    Science.gov (United States)

    Wang, Zhi-Tian; Wang, Lu-Ming; Li, Sun; Jian, Hu

    2009-07-01

    Pleural disease remains a commonly encountered clinical problem for both physician and surgeon. This study describes a new way to better diagnose and treat pleural diseases (hemothorax, empyema, and pleural effusion) using an electronic endoscope (gastroscope or bronchoscope). We conducted a retrospective study of the use of an electronic endoscope in the treatment and diagnosis of pleural diseases. From November 2006 to February 2008, a total of 17 patients (3 women, 14 men; mean age = 41.8 years; range = 18-62 years) underwent procedures for thoracic empyema (13 patients), traumatic clotted hemothorax (3 patients), and undiagnosed pleural effusion (1 patient). The electronic endoscope was inserted via the thoracic drainage tube for the treatment or diagnosis of pleural diseases after regular treatments, including thoracentesis, tube thoracostomy, and biopsy, failed. All patients were cured and discharged from hospital and were followed up for 6 months. The patients recovered well and there was no recurrence. The technique of inserting an electronic endoscope into the thoracic drainage tube for diagnosis and treatment of pleural diseases is simple, effective, minimally invasive, and cost-effective.

  4. 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.

  5. Prospective evaluation of antibiotic treatment for urological procedure in patients presenting with neurogenic bladder.

    Science.gov (United States)

    Weglinski, L; Rouzaud, C; Even, A; Bouchand, F; Davido, B; Duran, C; Salomon, J; Perronne, C; Denys, P; Chartier-Kastler, E; Dinh, A

    2016-09-01

    Patients presenting with neurogenic bladder often require urological procedures (urodynamic testing and botulinum toxin injections) and a preventive antibiotic therapy. We aimed to assess the efficacy of this little known strategy in a cohort of patients. All patients presenting with neurogenic bladder who underwent urological procedure were included in the study. They received an antibiotic therapy in accordance with the urine cytobacteriological examination results. The antibiotic therapy was initiated two days before the procedure and prolonged up until two days after the procedure if the culture was positive. Patients were treated with a single dose of fosfomycin-trometamol in case of a negative culture. The main study outcome was the occurrence of urinary tract infection (UTI), defined by a positive urine culture and symptoms, up until 14 days after the procedure. A total of 80 urological procedures were performed. Mean patient age was 47±13.1 years (sex ratio 1.22); 59 (73.8%) presented with asymptomatic bacteriuria before the procedure. Nine (11.1%) UTIs were recorded on Day 14, of which one (1.2%) was febrile. Two patients required an additional curative antibiotic therapy. No patient was hospitalized. Overall, 77.8% of UTIs were cured without antibiotic therapy. Screening and treating asymptomatic bacteriuria before urological procedures seems unnecessary and vainly exposes this population at high risk of infectious diseases to antibiotic therapies. This data should be confirmed by a randomized clinical trial. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  6. SU-G-BRB-07: Developing a QA Procedure for Gated VMAT SABR Treatments Using 10 MV Beam in Flattening-Filter Free Mode

    Energy Technology Data Exchange (ETDEWEB)

    Chitsazzadeh, S [University of Victoria, Victoria, British Columbia (Canada); Wells, D [British Columbia Cancer Agency, Victoria, British Columbia (Canada); Mestrovic, A [British Columbia Cancer Agency, Vancouver, British Columbia (Canada)

    2016-06-15

    Purpose: To develop a QA procedure for gated VMAT stereotactic ablative radiotherapy (SABR) treatments. Methods: An interface 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 an ArcCheck diode array. The Quasar phantom controller used a patient specific breathing pattern to translate the ion chamber in a superior-inferior direction inside the ArcCheck. An amplitude-based RPM tracking system was specified to turn the beam on during the exhale phase of the breathing pattern. SABR plans were developed using Eclipse for liver PTVs ranging in size from 3-12 cm in diameter using a 2-arc VMAT technique. Dose was measured in the middle of the penumbra region, where the high dose gradient allowed for sensitive detection of any inaccuracies in gated dose delivery. The overall fidelity of the dose distribution was confirmed using ArcCheck. The sensitivity of the gating QA procedure was investigated with respect to the following four parameters: PTV size, duration of exhale, baseline drift, and 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 will be required to determine a clinically relevant gating window size and an appropriate tolerance level for this procedure.

  7. Safety and clinical performance of kyphoplasty and SpineJack(®) procedures in the treatment of osteoporotic vertebral compression fractures: a pilot, monocentric, investigator-initiated study.

    Science.gov (United States)

    Noriega, D C; Ramajo, R H; Lite, I S; Toribio, B; Corredera, R; Ardura, F; Krüger, A

    2016-06-01

    Clinical performance and safety of two percutaneous vertebral cement augmentation (VA) procedures (SpineJack® and Kyphx Xpander® balloon) were compared in patients with osteoporotic compression fractures. Both techniques were safe, efficient, and led to a rapid and marked improvement in clinical signs; nevertheless, SpineJack showed better restoration of vertebral heights and angles, maintained over time. In patients with osteoporotic vertebral compression fractures (VCFs), both SpineJack® (SJ) and balloon kyphoplasty (BKP) led to a rapid and marked improvement in clinical signs. This pilot, monocentric, investigator-initiated, prospective study aimed to compare two percutaneous vertebral augmentation procedures in the painful osteoporotic VCF treatment. Thirty patients were randomized to receive SJ (n = 15) or BKP (n = 15). Analgesic consumption, back pain intensity (visual analog scale (VAS)), and Oswestry Disability Index (ODI) scores were recorded preoperatively, at 5 days and 1, 3, 6, and 12 months post-surgery. Quality of life (EQ-VAS score) was evaluated at 1, 3, 6, and 12 months. Spine X-rays were taken 48 h prior to procedure and 5 days and 6 and 12 months after. SpineJack® led to a significantly shorter intervention period (23 vs 32 min; p SpineJack® procedure has a higher potential for vertebral body height restoration and maintenance over time.

  8. A Guide for Developing Standard Operating Job Procedures for the Sludge Conditioning & Dewatering Process Wastewater Treatment Facility. SOJP No. 11.

    Science.gov (United States)

    Schwing, Carl M.

    This guide describes standard operating job procedures for the sludge conditioning and dewatering process of wastewater treatment facilities. In this process, sludge is treated with chemicals to make the sludge coagulate and give up its water more easily. The treated sludge is then dewatered using a vacuum filter. The guide gives step-by-step…

  9. A Guide for Developing Standard Operating Job Procedures for the Primary Sedimentation Process Wastewater Treatment Facility. SOJP No. 4.

    Science.gov (United States)

    Charles County Community Coll., La Plata, MD.

    This guide describes standard operating job procedures for the primary sedimentation process of wastewater treatment plants. The primary sedimentation process involves removing settleable and suspended solids, in part, from wastewater by gravitational forces, and scum and other floatable solids from wastewater by mechanical means. Step-by-step…

  10. A Guide for Developing Standard Operating Job Procedures for the Screening & Grinding Process Wastewater Treatment Facility. SOJP No. 1.

    Science.gov (United States)

    Deal, Gerald A.; Montgomery, James A.

    This guide describes standard operating job procedures for the screening and grinding process of wastewater treatment facilities. The objective of this process is the removal of coarse materials from the raw waste stream for the protection of subsequent equipment and processes. The guide gives step-by-step instructions for safety inspection,…

  11. A Guide for Developing Standard Operating Job Procedures for the Sludge Thickening Process Wastewater Treatment Facility. SOJP No. 9.

    Science.gov (United States)

    Schwing, Carl M.

    This guide describes standard operating job procedures for the screening and grinding process of wastewater treatment facilities. The objective of this process is the removal of coarse materials from the raw waste stream for the protection of subsequent equipment and processes. The guide gives step-by-step instructions for safety inspection,…

  12. A Guide for Developing Standard Operating Job Procedures for the Tertiary Multimedia Filtration Process Wastewater Treatment Facility. SOJP No. 7.

    Science.gov (United States)

    Petrasek, Al, Jr.

    This guide describes the standard operating job procedures for the tertiary multimedia filtration process of wastewater treatment plants. The major objective of the filtration process is the removal of suspended solids from the reclaimed wastewater. The guide gives step-by-step instructions for pre-start up, start-up, continuous operation, and…

  13. A Guide for Developing Standard Operating Job Procedures for the Digestion Process Wastewater Treatment Facility. SOJP No. 10.

    Science.gov (United States)

    Schwing, Carl M.

    This guide describes standard operating job procedures for the digestion process of wastewater treatment facilities. This process is for reducing the volume of sludge to be treated in subsequent units and to reduce the volatile content of sludge. The guide gives step-by-step instructions for pre-startup, startup, continuous operating, shutdown,…

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

    International Nuclear Information System (INIS)

    Mathew, D; Gerbi, B

    2016-01-01

    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.

  15. Surgical Treatment of Corneal Ectasia with Motowa's Trephine and Selective Suturing Technique.

    Science.gov (United States)

    Al-Motowa, Saeed; Al-Harby, Mosa

    2016-01-01

    A 40-year-old male presented with bilateral ectasia, contact lens intolerance, and astigmatism >10 D in both eyes. The patient had end-stage pellucid marginal degeneration that warranted surgical treatment. We present a unique surgical technique to stabilize the cornea, minimize astigmatism, improve vision and corneal status, and avoid penetrating keratoplasty.

  16. A general numerical procedure for the treatment of moving interfaces in implicit continuous Eulerian (ICE) hydrodynamics

    International Nuclear Information System (INIS)

    Smith, B.L.

    1988-10-01

    The implicit continuous Eulerian (ICE) finite difference method in hydrodynamic computations has proven very successful when applied to flow situations in which there are excessive fluid distortions. Code logic becomes exceedingly complex, however, if the boundaries of the fluid domain are material interfaces whose orientations with respect to the Eulerian grid evolve during the calculation. It is shown in this article that within the ICE methodology it is possible to express the discrete mass conservation condition in an identical form for all computational cells, even those containing, or close to, moving fluid boundaries. From this basis a generalized ICE algorithm is built up alleviating many of the difficulties associated with complicated configurations of free and structure boundaries. In particular, an effective treatment of slug impact with fluid-structure interaction is readily formulated. To illustrate the technique in practical situations, the method has been incorporated into a version of the coupled fluid-structure code SEURBNUK-EURDYN, used for LMFBR safety analysis, and a number of fluid-gas, fluid-structure situations are analyzed. Results are compared with analytic solutions, experimental measurement, and/or other code predictions, as appropriate. Two oblique, slug impact situations are included. (author) 37 refs., 24 figs

  17. [Application of digital design and three-dimensional printing technique on individualized medical treatment].

    Science.gov (United States)

    Qin, Mian; Liu, Yaxiong; He, Jiankang; Wang, Ling; Lian, Qin; Li, Dichen; Jin, Zhongmin; He, Sanhu; Li, Gang; Liu, Yanpu; Wang, Zhen

    2014-03-01

    To summarize the latest research development of the application of digital design and three-dimensional (3-D) printing technique on individualized medical treatment. Recent research data and clinical literature about the application of digital design and 3-D printing technique on individualized medical treatment in Xi'an Jiaotong University and its cooperation unit were summarized, reviewed, and analyzed. Digital design and 3-D printing technique can design and manufacture individualized implant based on the patient's specific disease conditions. And the implant can satisfy the needs of specific shape and function of the patient, reducing dependence on the level of experience required for the doctor. So 3-D printing technique get more and more recognition of the surgeon on the individualized repair of human tissue. Xi'an Jiaotong University is the first unit to develop the commercial 3-D printer and conduct depth research on the design and manufacture of individualized medical implant. And complete technological processes and quality standards of product have been developed. The individualized medical implant manufactured by 3-D printing technique can not only achieve personalized match but also meet the functional requirements and aesthetic requirements of patients. In addition, the individualized medical implant has the advantages of accurate positioning, stable connection, and high strength. So 3-D printing technique has broad prospects in the manufacture and application of individualized implant.

  18. Consensus of Leaders in Plastic Surgery: Identifying Procedural Competencies for Canadian Plastic Surgery Residency Training Using a Modified Delphi Technique.

    Science.gov (United States)

    Knox, Aaron D C; Shih, Jessica G; Warren, Richard J; Gilardino, Mirko S; Anastakis, Dimitri J

    2018-03-01

    Transitioning to competency-based surgical training will require consensus regarding the scope of plastic surgery and expectations of operative ability for graduating residents. Identifying surgical procedures experts deemed most important in preparing graduates for independent practice (i.e., "core" procedures), and those that are less important or deemed more appropriate for fellowship training (i.e., "noncore" procedures), will focus instructional and assessment efforts. Canadian plastic surgery program directors, the Canadian Society of Plastic Surgeons Executive Committee, and peer-nominated experts participated in an online, multiround, modified Delphi consensus exercise. Over three rounds, panelists were asked to sort 288 procedural competencies into five predetermined categories within core and noncore procedures, reflecting increasing expectations of ability. Eighty percent agreement was chosen to indicate consensus. Two hundred eighty-eight procedures spanning 13 domains were identified. Invitations were sent to 49 experts; 37 responded (75.5 percent), and 31 participated (83.8 percent of respondents). Procedures reaching 80 percent consensus increased from 101 (35 percent) during round 1, to 159 (55 percent) in round 2, and to 199 (69 percent) in round 3. The domain "burns" had the highest rate of agreement, whereas "lower extremity" had the lowest agreement. Final consensus categories included 154 core, essential; 23 core, nonessential; three noncore, experience; and 19 noncore, fellowship. This study provides clarity regarding which procedures plastic surgery experts deem most important for preparing graduates for independent practice. The list represents a snapshot of expert opinion regarding the current training environment. As our specialty grows and changes, this information will need to be periodically revisited.

  19. Advantages of ultrasonic Time of Flight Diffraction (TOFD) technique and R6 structural integrity assessment procedure for nuclear power plant components

    International Nuclear Information System (INIS)

    Dukic, P.; Dukic, I.

    2000-01-01

    In service inspection (ISI) of aged power plant parts has a delicate task to provide information on presence, position, orientation and size of defects in material. As far as results of ISI are just a starting point for elaborate procedure of structural integrity assessment, the accuracy and reliability of these results are particularly important. Time of Flight Diffraction (TOFD) technique is regarded as superior ultrasonic technique capable to fulfil required goals. In Slovenia TOFD is approved in nowadays routine inspection of components of conventional power plants. As there were no practical use of TOFD in Slovenian NPP yet, some experience from Slovenian conventional thermal power plants are presented. Results of TOFD inspections of turbine rotor and turbine inlet casing are shown. Simplified integrity assessment procedure (Nuclear Electric R6 procedure) can satisfy needs for assessing integrity of components in conventional PP, instead of detailed 3-D finite element simulation. Example of application of R6 procedure in conventional PP is shown in this paper . Although R6 results are relatively conservative, this relatively simple to use procedure could meet requirements for assessing safety margins in domestic Nuclear power plant too. (author)

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

    Science.gov (United States)

    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.

  1. A non-surgical uterine lavage technique in large cats intended for treatment of uterine infection-induced infertility.

    Science.gov (United States)

    Hildebrandt, T B; Göritz, F; Boardman, W; Strike, T; Strauss, G; Jewgenow, K

    2006-10-01

    This paper presents the successful use of a non-surgical, transcervical uterine lavage technique for the treatment of uterine infection-induced infertility in three female large cats. We developed a non-surgical uterine lavage technique, which allowed repeated flushing of the uterine lumen and installation of therapeutic antibiotics. The entire procedure was performed under general anaesthesia (duration of anesthesia ranged from 40 to 70 min). It was successfully applied in a Sumatran tiger (Panthera tigris sumatrae), a Corbett tiger (Panthera tigris corbetti) and an Amur leopard (Panthera pardus orientalis). The tigers were treated only once, whereas the leopard received four uterine treatments, due to re-infection after mating. Decisions to conduct uterine treatments were based on detection of uterine fluid during previous transrectal ultrasound examinations. The catheter was guided into the vagina, with the aid of an endoscope, passing the urethra, and then into the uterus, with the aid of transrectal ultrasonography. Both uterine horns were separately flushed with approximately 300 mL of cell medium M199, followed by an antibiotic infusion. Upon ultrasonographic re-examination, the topical uterine treatments resulted in an apparent decline in the inflammatory and/or degenerative processes. The Corbett tiger had the most severe uterine alterations, in addition to an aseptic pyometra. As a result, she was treated 1 month prior to ovariohysterectomy (in order to reduce the surgical risk). The Sumatran tiger was artificially inseminated twice after hormone-induced estrus, and the Amur leopard expressed a spontaneous estrus and re-initiated mating behaviour.

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

    DEFF Research Database (Denmark)

    Ottosson, Rickard O; Engstrom, Per E; Sjöström, David

    2008-01-01

    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...

  3. Adjustable patella grapple versus cannulated screw and cable technique for treatment of transverse patellar fractures.

    Science.gov (United States)

    Yan, Ning; Yang, Anli; Liu, Xiaodong; Cai, Feng; Liu, Liang; Chang, Shimin

    2014-03-01

    Although the cannulated screw and cable (CSC) tension band technique is an effective method for fixation of transverse patellar fractures, it has shortcomings, such as extensive soft tissue damage, osseous substance damage, and complex manipulation. We conducted a retrospective comparison of the adjustable patella grapple (APG) technique and the CSC tension band technique. We retrospectively reviewed 78 patients with transverse patellar fractures (45 in the APG group and 33 in the CSC group). Follow-up was 18 months. Comparison criteria were operation time, fracture reduction, fracture healing time, the knee injury and osteoarthritis outcome score for knee function, and complications. The APG group showed shorter operation time and equal fracture reduction, fracture healing time, and knee function compared with the CSC group. Eleven patients in the APG group experienced skin irritation generated by implants. There was no complication in the CSC group. The APG technique should be considered as an alternative method for treatment of transverse patellar fractures.

  4. 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

  5. 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

  6. 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.

  7. The incidence of secondary vertebral fracture of vertebral augmentation techniques versus conservative treatment for painful osteoporotic vertebral fractures: a systematic review and meta-analysis.

    Science.gov (United States)

    Song, Dawei; Meng, Bin; Gan, Minfeng; Niu, Junjie; Li, Shiyan; Chen, Hao; Yuan, Chenxi; Yang, Huilin

    2015-08-01

    field that vertebral augmentation procedures may increase the incidence of secondary fractures, we found no differences in the incidence of secondary fractures between vertebral augmentation techniques and conservative treatment for patients with OVCFs. © The Foundation Acta Radiologica 2014.

  8. Aortic aneurysm endovascular treatment with the parallel graft technique from the aortic arch to the iliac axis.

    Science.gov (United States)

    Fadda, Gian F; Marino, Mario; Kasemi, Holta; DI Angelo, Costantino L; Dionisi, Carlo P; Cammalleri, Valeria; Setacci, Carlo

    2017-05-26

    The chimney technique has been developed for the treatment of complex aortic aneurysms. We analyzed the midterm to long-term outcomes of this approach from a single- centre experience. From October 2008 to July 2016, 58 patients underwent endovascular aortic aneurysm repair using the chimney technique. Indications for treatment were thoracic aortic aneurysm (TAA) (n = 11), thoracoabdominal aortic aneurysm (TAAA) (n = 2), pararenal aortic aneurysm (PAAA) (n= 15), aortoiliac/isolated hypogastric artery aneurysm (n = 25), type I endoleak after previous TEVAR/EVAR (n=4), proximal pseudoaneurysm after AAA open repair (n = 1). Elective (82.8%) and emergent (17.2%) procedures were included. The immediate technical success was 100%. Single, double and triple chimneys were performed in 46, 10 and 2 patients, respectively. Overall, 61 target vessels (3 left common carotid arteries, 8 left subclavian arteries, 3 celiac trunks, 3 superior mesenteric arteries, 19 renal arteries and 25 hypogastric arteries) were involved. Post-operative mortality was 0. No neurologic complications were registered. Primary patency rate of the chimney stent/stent graft was 98.3%. Low flow type I endoleak was observed in 4 patients (6.9%). Post-operative chimney graft re-intervention rate was 1.7%. The median follow up was 32±20 months (range 3- 96 months). Overall estimated survival at 12, 50 and 80 months was 100%, 89% and 44%, respectively. Estimated freedom from endoleak at 1, 12, 24 and 36 months was 96.5%, 95%, 95% and 93%, respectively. One HA stent graft occluded at the 3rd month of follow up. No reintervention was performed. Our experience with the chimney technique for aortic aneurysms from the aortic arch to the iliac axis shows promising and durable mid- and long term results. Endograft oversizing, associated with the chimney graft diameter and length choice remain fundamental to reduce the risk of the most frequent procedure complications: type I endoleak and CG occlusion.The wider

  9. Endoluminal brachytherapy in the treatment of oesophageal cancer: technique description, case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Luisa Castilla

    2015-07-01

    Full Text Available Endoesophageal brachytherapy is a useful technique for the palliative treatment of dysphagia in advanced oesophageal cancer. This technique offers good results on dysphagia control and quality of life. We report the case of a patient treated with this technique presenting complete response to the dysphagia. We describe endoesophageal brachyterapy technique and we comment on the literature.

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

    Science.gov (United States)

    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.

  11. Comparison of wedge resection (Winograd procedure) and wedge resection plus complete nail plate avulsion in the treatment of ingrown toenails.

    Science.gov (United States)

    Huang, Jia-Zhang; Zhang, Yi-Jun; Ma, Xin; Wang, Xu; Zhang, Chao; Chen, Li

    2015-01-01

    The present retrospective study compared the efficacy of wedge resection (Winograd procedure) and wedge resection plus complete nail plate avulsion for the treatment of ingrown toenails (onychocryptosis). Two surgical methods were performed in 95 patients with a stage 2 or 3 ingrown toenail. Each patient was examined weekly until healing and then at 1, 6, and 12 months of follow-up. The outcomes measured were surgical duration, healing time, recurrence rate, the incidence of postoperative infection, and cosmetic appearance after surgery. Of the 95 patients (115 ingrown toenails) included in the present study, 39 (41.1%) underwent wedge resection (Winograd procedure) and 56 (59%), wedge resection plus complete nail plate avulsion. The mean surgical duration for wedge resection (Winograd procedure) and wedge resection plus complete nail plate avulsion was 14.9 ± 2.4 minutes and 15.1 ± 3.2 minutes, respectively (p = .73). The corresponding healing times were 2.8 ± 1.2 weeks and 2.7 ± 1.3 weeks (p = .70). Recurrence developed in 3 (3.2%) patients after wedge resection (Winograd procedure) and in 4 (4.2%) after wedge resection plus complete nail plate avulsion. In addition, postoperative infection occurred in 3 (3.2%) patients after wedge resection (Winograd procedure) and 2 (2.1%) after wedge resection plus complete nail plate avulsion. Both of the surgical procedures were practical and appropriate for the treatment of ingrown toenails, being simple and associated with low morbidity and a high success rate. However, cosmetically, wedge resection (Winograd procedure) would be the better choice because the nail plate remains intact. Copyright © 2015 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  12. 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.

  13. Percutaneous Sacroiliac Screw Placement: A Prospective Randomized Comparison of Robot-assisted Navigation Procedures with a Conventional Technique

    Directory of Open Access Journals (Sweden)

    Jun-Qiang Wang

    2017-01-01

    Conclusions: Accuracy of the robot-assisted technique was superior to that of the freehand technique. Robot-assisted navigation is safe for unstable posterior pelvic ring stabilization, especially in S1, but also in S2. SI screw insertion with robot-assisted navigation is clinically feasible.

  14. 'Sandwich' technique in the treatment of large and complex incisional hernias.

    Science.gov (United States)

    Martín-Cartes, Juan Antonio; Tamayo-López, María Jesús; Bustos-Jiménez, Manuel

    2016-05-01

    Reconstruction of large, complex abdominal wall hernias is an interesting challenge. Primary closure of those hernias is often not possible. There is little agreement about the most appropriate technique or prosthetic to repair these defects, in spite the fact of the prevalence of ventral hernias. Sometimes despite being contaminated surgical fields, we are often faced to reinforce with bio-prosthetic meshes. The component separation technique (CST) is a practical option; however, recurrence rates remain unacceptably high. In an attempt to reduce recurrences, we frequently added a biologic underlay mesh and a lightweight polypropylene on-lay mesh to the traditional CST. Our objective was to determine biologic mesh practice patterns of reconstructive surgeons with regard to indications, most appropriate technique, choice of prosthetics and experience with complications in order to work those hernias out. Thirty consecutive patients who underwent abdominal wall reconstruction by means of a component separations associated with non-cross-linked porcine dermal scaffolds (NCPDS) or a synthetic tissue scaffold (STS) reinforcement between October 2009 and December 2011 were retrospectively reviewed. Analysis of demographics, indications for NCPDS or STS placement, surgical technique, complications and follow-up data were performed. They underwent a 'sandwich' procedure with a biologic underlay mesh and a lightweight polypropylene on-lay mesh added to the traditional CST. We chose NCPDS or STS underlay mesh according to the fact of the presence or absence of a contaminated field. A 'sandwich' procedure was used for abdominal wall repair in 30 patients. In all of them, NCPDS or STS was positioned using an intraperitoneal technique associated to a lightweight polypropylene on-lay mesh and the CST. At a mean follow-up time of 30.1 months, most patients had successful outcomes. Occurrences included seroma, recurrence and infection. One of our patients died from multi

  15. Choice of a General Anesthesia Technique in the Surgical Treatment of Postinfarct Left Ventricular Aneurysms

    Directory of Open Access Journals (Sweden)

    N. A. Karpun

    2005-01-01

    Full Text Available Objective. To choose the optimum technique of general anesthesia in the surgical treatment of patients with postinfarct left ventricular aneurysms (PLVA.Materials and methods. Fifty-four patients operated on for PLVA were examined. They were divided into 4 groups according to the basic technique of general anesthesia: 1 intravenous anesthesia based on propofol and fentanyl; 2 inhalation sevoflurane anesthesia with fentanyl enhancement of the analgesic component; 3 inhalation isoflurane anesthesia with fentanyl enhancement of the analgesic component; 4 general anesthesia in combination with epidural blockade. Central hemodynamics was investigated by the thermodilution technique and the perioperative period was also studied.Results and discussion. None of the general anesthesia techniques affected the development of perioperative complications. However, with decreased myocardial reserves, high thoracic epidural anesthesia should be applied with caution as it causes a significant desympathization, which may lead to impairments of the autoregulatory mechanisms of coronary blood flow and aggravate existing contractile disorders. Intravenous and inhalation anesthesia techniques provide a fair hemodynamic stability at all stages of surgical treatment. Inhalation anesthesia has a number of advantages: less cost and the possibility of rapid activation of patients in the early postoperative period.

  16. 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%.

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

    Science.gov (United States)

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

    2018-03-09

    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.

  18. Apical wiring technique in surgical treatment of adolescent idiopathic scoliosis: the intermediate outcomes between Lenke types.

    Science.gov (United States)

    Chaiyamongkol, Weera; Klineberg, Eric O; Gupta, Munish C

    2013-02-01

    Retrospective cohort study of apical wiring technique for surgical treatment of adolescent idiopathic scoliosis patients. To evaluate the intermediate outcome of adolescent idiopathic scoliosis patients treated with apical wiring technique. Regarding surgical treatment for adolescent idiopathic scoliosis, there are reports of the superiority of coronal plane correction using all-screw constructs compared with all-hook or hybrid constructs. Major limitations of all-screw constructs are thoracic hypokyphosis and increased proximal junctional kyphosis. There are few reports about apical wiring technique outcomes and no reports of this surgical technique comparing Lenke types. Consecutive adolescent idiopathic scoliosis patients treated with apical wiring technique were analyzed. Inclusion criteria were patient 21 years old or younger, who underwent a posterior only surgical correction with a follow-up of at least 2 years. Radiographic data were analyzed according to the criteria given by Lenke and colleagues. The radiographic parameters included global balance, Cobb angle, curve flexibility, apical vertebral translation, tilt angle of lower instrumented vertebra, angle of caudal disk to the lower instrumented vertebra, thoracic kyphosis, lumbar lordosis, and proximal junctional angle preoperatively and postoperatively. There was a significant improvement of Cobb angle in every Lenke type with an average correction of 74.6%. At latest follow-up, the average loss of correction was 3.5% (1.9 degrees). The greatest loss of correction for the minor curve of Lenke 2 was 14.1% (5.8 degrees). There was an improvement of thoracic kyphosis in hypokyphosis group (1.9-21.1 degrees; Pwiring technique for surgical treatment of adolescent idiopathic scoliosis provides an average correction of 71.1% at 3.4 years of average follow-up with harmonious sagittal plane correction even with preexisting abnormal thoracic kyphosis.

  19. Remediation of textile effluents by membrane based treatment techniques: a state of the art review.

    Science.gov (United States)

    Dasgupta, Jhilly; Sikder, Jaya; Chakraborty, Sudip; Curcio, Stefano; Drioli, Enrico

    2015-01-01

    The textile industries hold an important position in the global industrial arena because of their undeniable contributions to basic human needs satisfaction and to the world economy. These industries are however major consumers of water, dyes and other toxic chemicals. The effluents generated from each processing step comprise substantial quantities of unutilized resources. The effluents if discharged without prior treatment become potential sources of pollution due to their several deleterious effects on the environment. The treatment of heterogeneous textile effluents therefore demands the application of environmentally benign technology with appreciable quality water reclamation potential. These features can be observed in various innovative membrane based techniques. The present review paper thus elucidates the contributions of membrane technology towards textile effluent treatment and unexhausted raw materials recovery. The reuse possibilities of water recovered through membrane based techniques, such as ultrafiltration and nanofiltration in primary dye houses or auxiliary rinse vats have also been explored. Advantages and bottlenecks, such as membrane fouling associated with each of these techniques have also been highlighted. Additionally, several pragmatic models simulating transport mechanism across membranes have been documented. Finally, various accounts dealing with techno-economic evaluation of these membrane based textile wastewater treatment processes have been provided. Copyright © 2014 Elsevier Ltd. All rights reserved.

  20. Treatment of axillary hyperhidrosis: combination of the starch-iodine test with the tumescent liposuction technique.

    Science.gov (United States)

    Swinehart, J M

    2000-04-01

    To evaluate and permanently improve axillary hyperhidrosis. Excessive sweating of the axillae is a common problem for which patients frequently seek dermatologic advice and therapy. Many treatments, including aluminum chloride, topical and systemic anticholinergic agents, tranquilizers, iontophoresis, direct surgical excision, botulinum toxin injection, and thoracic sympathectomy, have been employed to control this problem. All have drawbacks of one sort or another. The starch-iodine technique for delineation of preoperative and postoperative axillary sweating is described in detail. A method of sweat gland removal utilizing tumescent liposuction is discussed. The combination of the starch-iodine technique and tumescent liposuction is safe and effective for therapy of axillary hyperhidrosis.

  1. [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).

  2. 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

  3. Technical aspects of the deep inspiration breath-hold technique in the treatment of thoracic cancer

    International Nuclear Information System (INIS)

    Mah, Dennis; Hanley, Joseph; Rosenzweig, Kenneth E.; Yorke, Ellen; Braban, Louise; Ling, C. Clifton; Leibel, Stephen A.; Mageras, Gikas

    2000-01-01

    Purpose: The goal of this paper is to describe our initial experience with the deep inspiration breath-hold (DIBH) technique in conformal treatment of non-small-cell lung cancer with particular emphasis on the technical aspects required for implementation. Methods and Materials: In the DIBH technique, the patient is verbally coached through a modified slow vital capacity maneuver and brought to a reproducible deep inspiration breath-hold level. The goal is to immobilize the tumor and to expand normal lung out of the high-dose region. A physicist or therapist monitors and records patient breathing during simulation, verification, and treatment using a spirometer with a custom computer interface. Examination of internal anatomy during fluoroscopy over multiple breath holds establishes the reproducibility of the DIBH maneuver for each patient. A reference free-breathing CT scan and DIBH planning scan are obtained. To provide an estimate of tumor motion during normal tidal breathing, additional scan sets are obtained at end inspiration and end expiration. These are also used to set the spirometer action levels for treatment. Patient lung inflation is independently verified over the course of treatment by comparing the distance from the isocenter to the diaphragm measured from the DIBH digitally reconstructed radiographs to the distance measured on the portal films. Patient breathing traces obtained during treatment were examined retrospectively to assess the reproducibility of the technique. Results: Data from the first 7 patients, encompassing over 250 treatments, were analyzed. The inferred displacement of the centroid of gross tumor volume from its position in the planning scan, as calculated from the spirometer records in over 350 breath holds was 0.02 ± 0.14 cm (mean and standard deviation). These data are consistent with the displacements of the diaphragm (-0.1 ± 0.4 cm; range, from -1.2 to 1.1 cm) relative to the isocenter, as measured on the (92) portal films

  4. Two Suturing Techniques for the Prevention and Treatment of Nasal Valve Collapse After Mohs Micrographic Surgery.

    Science.gov (United States)

    Miladi, Anis; McGowan, Joseph W; Donnelly, Heidi B

    2017-03-01

    Tumor extirpation of nonmelanoma skin cancer (NMSC) adjacent to the alar groove, using Mohs micrographic surgery (MMS), may risk causing internal nasal valve (INV) collapse, resulting in reduced airflow during inspiration. There are many surgical options described in the literature to repair INV collapse as a postoperative corrective procedure, but few exist as an intra-operative preventative procedure. The authors present 2 distinct methods to prevent and treat INV collapse during the repair of a perialar surgical defect caused by MMS. A 3-point stitch method or a modified suspension suture technique was used to prevent INV collapse during the repair of MMS defects overlying the alar groove, for nonmelanoma skin cancers. The 3-point stitch was used with a complex repair. The modified suspension suture was used with flap reconstruction. The 3-point stitch and the modified suspension suture are simple, single-stage surgical solutions for perialar defects with collapse of the INV caused by loss of subcutaneous tissue during MMS. Once executed, patients experienced immediate subjective airflow improvement which was also supported by clinical examination. Patients were followed at 1 week and at 3 months postoperatively. Thirty-four of 35 patients reported good functional and cosmetic results and were satisfied with the final outcome. The 3-point stitch and the modified suspension suture techniques are easy and simple methods that can be incorporated into reconstruction after MMS for defects of variable depth covering any multisubunit perialar region to prevent or correct INV collapse.

  5. 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)

  6. The influence of three different instrumentation techniques on the incidence of postoperative pain after endodontic treatment.

    Science.gov (United States)

    Gambarini, Gianluca; Testarelli, Luca; De Luca, Massimo; Milana, Valerio; Plotino, Gianluca; Grande, Nicola Maria; Rubini, Alessio Giansiracusa; Al Sudani, Dina; Sannino, Gianpaolo

    2013-01-01

    Apical extrusion of infected debris to the periradicular tissues is one of the principal causes of postoperative pain and discomfort. Recent researches have shown that reciprocating instrumentation techniques seem to significantly increase the amount of debris extruded beyond the apex and, consequently, the risk of postoperative pain. The goal of the present study was to evaluate and compare postoperative pain using three different nickel-titanium instrumentation techniques: a rotary crown-down technique using TF instruments (SybronEndo, Orange, Ca), a reciprocating single-file technique using WaveOne instruments (Maillefer DEntsply, Baillagues, CH), and a novel instrumentation technique (TF Adaptive, SybronEndo, Orange, Ca), using a unique, proprietary movement, combining reciprocation and continuous rotation. Ninety patients requiring endodontic treatment on permanent premolar and molar teeth with non vital pulps preoperatively were included in the study. The patients were assigned into three groups of 30 patients each, trying to make the groups very similar, concerning the number of root canals, presence of initial pain and periapical lesions. The teeth in group 1 (n = 30) were instrumented with a crown-down technique using TF instruments, whilst those in group 2 (n = 30) were instrumented with a single-file technique using Waveone 08 25. The third group (n = 30) used the 3-file Tf Adaprtive sequence. All techniques were performed following manufacturers' instructions and all canals were shaped, cleaned and obturated in a single-visit by the same operator. The assessment of postoperative pain was carried out at 3 days by using a visual analogue scale. VAS pain scores were compared using one-way ANOVA post hoc Tukey test. A value of p < 0.05 was required for statistical significance. Results for VAS pain scores showed a statistically significant difference was found between the WaveOne (p=0,021) technique and the other two techniques. No statistical significant

  7. [Combined endoscopic-laparoscopic techniques for one-stage treatment of concomitant cholelithiasis and choledocholithiasis].

    Science.gov (United States)

    Wu, Junzheng; Xu, Xiaofei; Liu, Hao; Li, Guoxin

    2013-11-01

    To assess the clinical effects of combined endoscopic-laparoscopic technique for one-stage treatment of cholelithiasis with concomitant choledocholithiasis. A retrospective analysis was conducted of the clinical data of 30 patients (Group A) with cholelithiasis and choledocholithiasis receiving one-stage laparoscopic cholecystectomy (LC) combined with intraoperative encoscopic retrograde cholangio-pancreatography (ERCP) and 32 patients (Group B) receiving LC combined with 1aparoscopic common bile duct exploration. The operative time, blood loss, conversion to open surgery rate, time to postoperative ambulation, calculi residual rate, hospitalization cost and length of hospital stay were analyzed comparatively. There were statistically differences between the two groups in hospitalization cost and length of hospital stay (P0.05). Combined endoscopic-laparoscopic techniques can be a safe and feasible option for one-stage treatment of concomitant cholelithiasis and choledocholithiasis to allow rapid postoperative recovery with a shortened hospital stay.

  8. A Proposed Model for Selecting Measurement Procedures for the Assessment and Treatment of Problem Behavior.

    Science.gov (United States)

    LeBlanc, Linda A; Raetz, Paige B; Sellers, Tyra P; Carr, James E

    2016-03-01

    Practicing behavior analysts frequently assess and treat problem behavior as part of their ongoing job responsibilities. Effective measurement of problem behavior is critical to success in these activities because some measures of problem behavior provide more accurate and complete information about the behavior than others. However, not every measurement procedure is appropriate for every problem behavior and therapeutic circumstance. We summarize the most commonly used measurement procedures, describe the contexts for which they are most appropriate, and propose a clinical decision-making model for selecting measurement produces given certain features of the behavior and constraints of the therapeutic environment.

  9. Transforaminal Endoscopic Discectomy for Treatment of Central Disc Herniation: Surgical Techniques and Clinical Outcome.

    Science.gov (United States)

    Wang, Yapeng; Zhang, Wei; Lian, Lichao; Xu, Jiaxin; Ding, Wenyuan

    2018-03-01

    Though transforaminal endoscopic discectomy has achieved a satisfactory clinical outcome in the treatment of paracentral disc herniation, it has a high failure rate for treating central disc herniation. To explore the surgical techniques of transforaminal endoscopic discectomy in treating central disc herniation and the clinical outcome based on 2-year follow-up. A retrospective study. The Department of Spinal Surgery at the Third Hospital of Hebei Medical University in China. Sixty-nine consecutive patients (male:female = 14:9, mean age 38.8 ± 10.5 years) were enrolled in the study, all of whom underwent transforaminal endoscopic discectomy due to central disc herniation. The rod adjustment technique, apex technique, and posterior longitudinal ligament detection technique were adopted for intraoperative individualization. All of the patients were followed up for 24 months to assess the visual analog scale (VAS), Japanese Orthopaedic Association (JOA), and Oswestry Disability Index (ODI) scores. The postoperative segmental instability and recurrence were observed during the follow-up period as well. MacNab criteria scores were recorded both intraoperatively and at the final follow-up; postoperative complications and the surgical outcome and safety were also evaluated. The herniated disc tissues were successfully removed for all patients, without revision by open surgery. Twenty-one cases (30.43%) were rated excellent, 44 (63.77%) good, 4 (5.80%) fair, and 0 (0.00%) poor upon the final follow-up, with an overall excellent-to-good rate of 86.96%. The VAS scores of low back and leg pain were all significantly lower at 3, 6, 12, and 24 months postoperatively compared to preoperatively (all P disc herniations. Intraoperative individualized application of rod adjustment technique, apex technique, or posterior longitudinal ligament detection technique is the key to satisfactory clinical outcome. Central disc herniation, rod adjustment technique, transforaminal endoscopy

  10. An indirect veneer technique for simple and esthetic treatment of anterior hypoplastic teeth

    Directory of Open Access Journals (Sweden)

    Amit Khatri

    2010-01-01

    Full Text Available This study describes a technique for treating anterior hypoplastic teeth using indirect nanocomposite veneer restoration. The prime advantage of an indirect veneer technique is that it provides an esthetic and conservative result. One of the most frequent reasons that patients seek dental care is discolored anterior teeth. Although treatment options such as removal of surface stains, bleaching, microabrasion or macroabrasion, veneering, and placement of porcelain crowns are available, conservative approach such as veneer preserves the natural tooth as much as possible. Full veneers are recommended for the restoration of localized defects or areas of intrinsic discoloration, which are caused by deeper internal stains or enamel defects. Indirectly fabricated veneers are much less sensitive compared to a operator′s technique and if multiple teeth are to be veneered, indirect veneers can be usually placed much more expeditiously. Indirect veneers last much longer than the direct veneers. Therefore, indirectly fabricated veneers are more advantageous than directly fabricated veneers in many cases.

  11. Treatment comfort, time perception, and preference for conventional and digital impression techniques: A comparative study in young patients.

    Science.gov (United States)

    Burhardt, Lukasz; Livas, Christos; Kerdijk, Wouter; van der Meer, Wicher Joerd; Ren, Yijin

    2016-08-01

    The aim of this crossover study was to assess perceptions and preferences for impression techniques in young orthodontic patients receiving alginate and 2 different digital impressions. Thirty-eight subjects aged 10 to 17 years requiring impressions for orthodontic treatment were randomly allocated to 3 groups that differed in the order that an alginate impressions and 2 different intraoral scanning procedures were administered. After each procedure, the patients were asked to score their perceptions on a 5-point Likert scale for gag reflex, queasiness, difficulty to breathe, uncomfortable feeling, perception of the scanning time, state of anxiety, and use of a powder, and to select the preferred impression system. Chairside time and maximal mouth opening were also registered. More queasiness (P = 0.00) and discomfort (P = 0.02) during alginate impression taking of the maxilla were perceived compared with the scans with the CEREC Omnicam (Sirona Dental Systems, Bensheim, Germany). There were no significant differences in perceptions between the alginate impressions and the Lava C.O.S. (3M ESPE, St Paul, Minn) and between the 2 scanners. Chairside times for the alginate impressions (9.7 ± 1.8 minutes) and the CEREC Omnicam (10.7 ± 1.8 minutes) were significantly lower (P Digital impressions were favored by 51% of the subjects, whereas 29% chose alginate impressions, and 20% had no preference. Regardless of the significant differences in the registered times among the 3 impression-taking methods, the distributions of the Likert scores of time perception and maximal mouth opening were similar in all 3 groups. Young orthodontic patients preferred the digital impression techniques over the alginate method, although alginate impressions required the shortest chairside time. Copyright © 2016 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

  12. BRIEF REVIEW ON DIAGNOSTIC TECHNIQUE AND NOVEL MOLECULES IN CLINICAL TRIALS FOR TREATMENT OF BREAST CANCER

    OpenAIRE

    VISHAL KUMAR S. MODI; TARASHANKAR BASURI; VIRAG A. SHAH; ISHVAR PARMAR; SIDDIQUE SHABABANO

    2015-01-01

    Breast cancer is the most common cancer in women in both developed and undeveloped countries, and the second most frequent cause of cancer deaths after lung cancer. Although there have been many chemotherapeutic agents like 5-fluorouracil, taxol, tamoxifen, doxorubicin, cisplatin, and camptothecin and hormones are used to treat breast cancer. This review focuses on the causes of breast cancer, latest diagnostic techniques and various molecules under clinical trials for the treatment of breast...

  13. Bristow-Latarjet Technique in the Treatment of Anterior Shoulder Instability.

    Directory of Open Access Journals (Sweden)

    Isidro Jiménez

    2016-02-01

    Full Text Available Objetives In the treatment of anterior shoulder instability there are have been described many surgical techniques, all of them with advantages and disadvantages. Our goal is to study the half term results on patients that underwent open Bristow-Latarjet surgery considering the preoperative ISIS value. Method This is a retrospective study of 33 patients that underwent open Bristow-Latarjet surgery in our center between 2005 and 2012. Average age of 33 (21-68 years and follow up of 6 (2-9 years. Results were taken by Rowe and Constant scores, DASH questionnaire and we also recorded a subjective assessment of the result by each patient. Results No recurrence was reported. No reoperations. Mean Rowe score was 74.6 (15-100 points and mean Constant score was 70 (32-98 points. In the disability questionnaire (DASH, the mean value was 22.9 (0-73 points. Seventy-nine percent of patients were satisfied with surgery result. The migration of a screw occurred in one patient Conclusions We believe that Bristow-Latarjet technique is a reliable technique, with few complications and with an low rate of recurrence in treatment of chronic shoulder instability as reported in literature. We believe, therefore, that it should be used as primary surgery in some cases and the preoperative ISIS is an excellent and simple guide to select correctly the surgical technique for each patient.

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

    Science.gov (United States)

    Rai, Suchita; Wasewar, K L; Agnihotri, A

    2017-06-01

    In the Bayer process of extraction of alumina from bauxite, the insoluble product generated after bauxite digestion with sodium hydroxide at elevated temperature and pressure is known as 'red mud' or 'bauxite residue'. This alumina refinery waste is highly alkaline in nature with a pH of 10.5-12.5 and is conventionally disposed of in mostly clay-lined land-based impoundments. The alkaline constituents in the red mud impose severe and alarming environmental problems, such as soil and air pollution. Keeping in view sustainable re-vegetation and residue management, neutralization/treatment of red mud using different techniques is the only alternative to make the bauxite residue environmentally benign. Hence, neutralization techniques, such as using mineral acids, acidic waste (pickling liquor waste), coal dust, superphosphate and gypsum as amenders, 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.

  15. Accordion technique combined with minimally invasive percutaneous decortication for the treatment of bone non-union.

    Science.gov (United States)

    Zhang, Qun; Zhang, Wei; Zhang, Zhuo; Tang, Peifu; Zhang, Lihai; Chen, Hua

    2017-10-01

    A variety of approaches have been used to treat oligotrophic or atrophic non-union. Conventional methods are often associated with great operative trauma, increased blood loss, a risk of re-infection, higher medical costs, and complications at the donor site. This study aimed to assess the clinical efficacy of the accordion technique combined with Minimally Invasive Percutaneous Decortication (MIPD) for these types of bone non-union. From January 2010 to December 2015, 20 patients with long bone aseptic non-unions of the lower extremities without bone defects who were treated with the accordion technique combined with MIPD. The limb-length discrepancy (LLD) was less than 2cm in all patients. None of the patients received autogenous bone grafts during follow-up. All surgeries were performed by the same surgeon, and the modified Application of methods of Ilizarov (ASAMI) criteria were used to evaluate the operative effectiveness. A total of 20 patients were included in this study, and 1 patient was lost during follow-up. Fifteen of these patients presented with oligotrophic non-unions, and 5 patients presented with atrophic non-unions. The average follow-up period in these patients was 12.1 months (range: 8-42 months). The alternative compression and distraction procedure was repeated 1-3 times. Blood loss was 30 to 250ml during surgery. Ultimately, bone union was achieved in 19 patients and failed in 1 patient. The fractures healed within 4-8 months (average time: 5.9 months), and fracture healing was considered excellent in 19 patients and poor in 1 patient. Postoperative function was evaluated as excellent in 9 patients, good in 6 patients, fair in 4 patients, and poor in 1 patient. The accordion technique combined with MIPD, which is a simple, minimally invasive procedure that does not require autologous bone grafting, resulted in a high bone union rate and good postoperative function. Copyright © 2017 Elsevier Ltd. All rights reserved.

  16. Pomeroy technique or Filshie clips for postpartum sterilisation? Retrospective study on comparison between Pomeroy procedure and Filshie clips for a tubal occlusion at the time of Caesarean section.

    Science.gov (United States)

    Oligbo, Nicholas; Revicky, Vladimir; Udeh, Rebecca

    2010-06-01

    To compare the failure rate (pregnancies) of a Pomeroy procedure and Filshie clips tubal occlusion at the time of Caesarean section. This is a retrospective observational study done in a district general hospital in the UK. There were 290 sterilisations performed at the time of Caesarean section over the period of 1994-2007. Studied population included 203 Pomeroy procedures and 87 Filshie clips applications. Follow-up period ranged from 2 to 15 years. A birth register and an operating theatre database were used to identify patients who underwent Caesarean section with a tubal occlusion. These patients' names were checked against the antenatal booking database, the early pregnancy assessment unit database, the operating theatre database in case of ectopic pregnancies, and a termination of pregnancy database to recognise failed sterilisation. There was no failure of tubal occlusion with a Pomeroy procedure (0/203). The failure rate of Filshie clips tubal occlusion was 1.15% (1/87) (p = 0.3). The length of the follow-up period ranged from 2 to 15 years (for Pomeroy procedure, median was 9 years and inter-quartile range (IQR) was 7; for Filshie clip, median was 8 years and IQR was 7). Pomeroy technique appears to carry a lower risk of a failed sterilisation than Filshie clips tubal occlusion at the time of Caesarean section. However, Pomeroy procedure needs to be balanced against the speed and simplicity of Filshie clips tubal occlusion.

  17. Pre-optimization of radiotherapy treatment planning: an artificial neural network classification aided technique

    International Nuclear Information System (INIS)

    Hosseini-Ashrafi, M.E.; Bagherebadian, H.; Yahaqi, E.

    1999-01-01

    A method has been developed which, by using the geometric information from treatment sample cases, selects from a given data set an initial treatment plan as a step for treatment plan optimization. The method uses an artificial neural network (ANN) classification technique to select a best matching plan from the 'optimized' ANN database. Separate back-propagation ANN classifiers were trained using 50, 60 and 77 examples for three groups of treatment case classes (up to 21 examples from each class were used). The performance of the classifiers in selecting the correct treatment class was tested using the leave-one-out method; the networks were optimized with respect their architecture. For the three groups used in this study, successful classification fractions of 0.83, 0.98 and 0.93 were achieved by the optimized ANN classifiers. The automated response of the ANN may be used to arrive at a pre-plan where many treatment parameters may be identified and therefore a significant reduction in the steps required to arrive at the optimum plan may be achieved. Treatment planning 'experience' and also results from lengthy calculations may be used for training the ANN. (author)

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

    Science.gov (United States)

    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.

  19. 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

  20. Forward treatment planning techniques to reduce the normalization effect in Gamma Knife radiosurgery.

    Science.gov (United States)

    Cheng, Hao-Wen; Lo, Wei-Lun; Kuo, Chun-Yuan; Su, Yu-Kai; Tsai, Jo-Ting; Lin, Jia-Wei; Wang, Yu-Jen; Pan, David Hung-Chi

    2017-11-01

    In Gamma Knife forward treatment planning, normalization effect may be observed when multiple shots are used for treating large lesions. This effect can reduce the proportion of coverage of high-value isodose lines within targets. The aim of this study was to evaluate the performance of forward treatment planning techniques using the Leksell Gamma Knife for the normalization effect reduction. We adjusted the shot positions and weightings to optimize the dose distribution and reduce the overlap of high-value isodose lines from each shot, thereby mitigating the normalization effect during treatment planning. The new collimation system, Leksell Gamma Knife Perfexion, which contains eight movable sectors, provides an additional means to reduce the normalization effect by using composite shots. We propose different techniques in forward treatment planning that can reduce the normalization effect. Reducing the normalization effect increases the coverage proportion of higher isodose lines within targets, making the high-dose region within targets more uniform and increasing the mean dose to targets. Because of the increase in the mean dose to the target after reducing the normalization effect, we can set the prescribed marginal dose at a higher isodose level and reduce the maximum dose, thereby lowering the risk of complications. © 2017 Shuang Ho Hospital-Taipei Medical University. Journal of Applied Clinical Medical Physics published by Wiley Periodicals, Inc. on behalf of American Association of Physicists in Medicine.

  1. Different techniques recently used for the treatment of textile dyeing effluents: a review

    International Nuclear Information System (INIS)

    Altaf, A.; Noor, S.; Sharif, Q.M.; Najeebullah, M.

    2010-01-01

    Industrial textile processing comprises the operation of pretreatment dyeing printing and finishing. These production processes produce a substantial amount of chemical pollution. Textile finishing's wastewater, especially dye house effluent, contain different classes of organic dyes, chemicals and auxiliaries. They are colored and have extreme pH, COD and BOD values, and contain different salts, surfactants heavy metals and mineral oils. Therefore, dye bath effluents have to be treated before being discharge into the environment or municipal wastewater reservoir. This paper presents the review of different techniques currently used for the treatment of textile effluent, which are based on carbon adsorption, filtration, chemical precipitation, photo degradation, biodegradation and electrolytic chemical treatment. Membrane Technology has also been applied with the objective of recovering dyes and water. Biological processes could be adopted as a pretreatment decolorization step, combined with conventional treatment system (eg. coagulation flocculation, adsorption on activated carbon) to reduce the COD and BOD, an effective alternative for use by the textile dyeing industries. Electrochemical oxidation is an efficient process for the removal of colour and total organic carbon in reactive dyes textile wastewater. The ozonation is effective for decolorization of several dyes of different classes. Practical application of this process is feasible by treating industrial textile effluent after biological treatment. Processes using membranes technique, very interesting possibilities of separating hydrolyzed dyestuffs, dyeing auxiliaries and reuse treated wastewater in different finishing operation of textile industries. (author)

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

    Science.gov (United States)

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

    2017-10-01

    Techniques for the Surgical Treatment of Peyronie's Disease. Sex Med Rev 2017;5:544-552. Copyright © 2017 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

  3. A Modified Stoppa (Technique Approach for Treatment of Pediatric Acetabular Fractures

    Directory of Open Access Journals (Sweden)

    Mehmet Elmadag

    2013-01-01

    Full Text Available Pediatric acetabular fractures are rare, and anterior column fractures are even rarer. Generally, conservative treatment is applied. If there is displacement of more than 2 mm or findings of instability or fragments within the joint, then surgical treatment is applied. Anterior and posterior approaches may be used in surgical treatment. With pediatric patients, even greater care should be taken in the choice of surgery to be performed according to the fracture pattern to avoid postoperative triradiate cartilage damage. Therefore, minimally invasive surgery is more appropriate. We herein present a case of an acetabulum anterior column posterior hemitransverse fracture following a traffic accident, which was treated surgically using a modified Stoppa (technique approach.

  4. Treatment effects of various prescriptions and techniques for fixed orthodontic appliances : A systematic review.

    Science.gov (United States)

    Mousoulea, Sophia; Papageorgiou, Spyridon N; Eliades, Theodore

    2017-09-01

    Although several prescriptions and techniques exist for comprehensive fixed appliance treatment, their treatment effects have not yet been adequately assessed in an evidence-based manner. The aim of this systematic review was to assess the therapeutic and adverse effects of various prescriptions or techniques for orthodontic appliances from randomized clinical trials on human patients. Eight databases were searched up to July 2016 for randomized trials assessing any orthodontic prescriptions or techniques in human patients. After elimination of duplicate studies, data extraction, and risk of bias assessment according to the Cochrane guidelines, random effects meta-analyses with mean differences (MD) and their 95% confidence intervals (CIs) were performed. Compared to Roth preadjusted appliances, both Begg and modified Begg appliances were associated with statistically significantly worse occlusal outcome assessed with Peer Assessment Review (PAR) scores (1 trial, MD 3.1 points, 95% CI 1.9-4.3 points and 1 trial, MD 2.4 points, 95% CI 1.2-3.6 points, respectively) with low quality of evidence, due to bias and imprecision. Compared to a partially programmed fixed orthodontic appliance, a fully programmed appliance was associated with a statistically significant, but clinically irrelevant increase in treatment duration (1 trial, MD 2.4 months, 95% CI 0.6-4.2 months), supported by high quality of evidence. However, caution is needed in the interpretation of these results as only a limited number of small trials with methodological issues were available. Based on existing trials, there is limited evidence to support any robust clinical recommendation regarding the prescriptions or techniques for fixed orthodontic appliances. Registration: PROSPERO (CRD42016042727). None.

  5. 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)

  6. Early response of local steroid injection versus mini incision technique in treatment of carpal tunnel syndrome

    International Nuclear Information System (INIS)

    Awan, A.S.; Khan, A.; Afridi, S.A.; Khan, R.S.

    2015-01-01

    Carpal tunnel syndrome Carpal tunnel syndrome (CTS) is one of the commonest peripheral neuropathies which effects mainly middle aged women. Different techniques are being tried to decrease the post-operative pain in patients operated for CTS. The objective of this study was to compare effectiveness of local injection of steroid and mini incision technique in the treatment of carpal tunnel syndrome. Methods: This randomized control trial was conducted at department of Orthopedics and department of Neurosurgery, Ayub Teaching Hospital, Abbottabad from Aug 2011 to Feb 2013. A total of 116 patients of CTS were randomly allocated to either of the two groups. Fifty-eight Patient in Group A were subjected to local steroid injection and the same number of patient in Group B underwent mini incision technique. All patients of were advised to report to the OPD after one month to determine intervention effectiveness in terms of improvement in at least one grade of pain. Results: In this study mean age of the patients was 32.8 ± 5.1 years. Female gender was in dominance with 99 (86.3%) cases. In this study we compared the effectiveness of local steroid injection and mini incision technique in the treatment of carpel tunnel syndrome. We found out that the steroid injection was effective in 69.0% cases while mini incision technique was effective in 56.9% cases. The difference being statistically insignificant with a p-value of 0.17. Conclusion: The difference in pain after 1 month of the intervention was not statistically significant. (author)

  7. A new procedure for treatment of oily slurry using geotextile filters.

    Science.gov (United States)

    Mendonça, M B; Cammarota, M C; Freire, D D C; Ehrlich, M

    2004-07-05

    A new procedure to mitigate the environmental impacts and reduce the cost of disposal of oil slurry is present in this paper. Waste from the petroleum industry has a high environmental impact. Systems for oil-water separation have been used to mitigate the contamination potential of these types of effluents. At the outlet of these systems, the oil is skimmed-off the surface, while the slurry is removed from the base. Due to the high concentration of contaminants, the disposal of this slurry is an environmentally hazardous practice. Usually this type of waste is disposed of in tanks or landfills after removal from the industrial plant. Basically, the proposed procedure utilizes drying beds with geotextile filters to both reduce the water content in the slurry and obtain a less contaminated effluent. Laboratory tests were carried out to simulate the drying system. Four types of filters were analyzed: two non-woven geotextiles, one woven geotextile, and a sand filter.

  8. Diagnosis and treatment of anteroinferior capsular redundancy associated with anterior shoulder instability using an open Latarjet procedure and capsulorrhaphy.

    Science.gov (United States)

    Ropars, Mickaël; Cretual, Armel; Kaila, Rajiv; Bonan, Isabelle; Hervé, Anthony; Thomazeau, Hervé

    2016-12-01

    There is a paucity of data detailing management of anterior capsular redundancy (ACR) when using the Latarjet procedure for unidirectional instability. This study aimed to describe the surgical management and to assess the clinical profile of patients presenting with anterior capsular redundancy [ACR(+)] with anterior shoulder instability. Seventy-seven patients who had a Latarjet procedure were followed for a 55-month period. Per-operative ACR was assessed during surgery. ACR was considered present if the inferior capsular flap of a Neer T-shaft capsulorrhaphy was able to cover the superior capsular flap with the arm in the neutral position. Patients with ACR(+) received an additional Neer capsulorrhaphy, while patients with ACR(-) did not. This per-operative finding was correlated with demographics, clinical, radiological pre-operative data and surgical outcome. Patients presenting with a per-operative ACR(+) were significantly associated with a sulcus sign (P 4 (P 85°. Open standard Latarjet procedures with Neer capsulorrhaphy in ACR(+) patients showed excellent or good results and stability rate of 95 %. All patients except four who presented with a new dislocation after surgery were satisfied with their outcome. Thirteen patients (16 %) had a persistent apprehension sign at the last follow-up. ACR(+) and ACR(-) groups did not show significant difference in the mean values of Rowe, Walch-Duplay and Constant-Murley scores. ACR correlated with a sulcus sign, Beighton score and instability history. In anterior shoulder instability associated with ACR, the Latarjet procedure with a Neer capsulorrhaphy appears a satisfactory treatment alternative to arthroscopic or open capsular shift. It decreased apprehension in comparison with Latarjet procedures without capsular repair. Cases series, treatment study, Level IV.

  9. Táticas e técnicas endovasculares para retirada de corpos estranhos intravenosos Endovascular techniques and procedures, methods for removal of intravascular foreign bodies

    Directory of Open Access Journals (Sweden)

    Joaquim Maurício da Motta-Leal Filho

    2010-06-01

    malfunction is the most likely signal of embolization, since patients are usually asymptomatic. OBJECTIVE: To report the method of removing intravascular foreign bodies, catheters with the use of various endovascular techniques and procedures. METHODS: This is a two-year retrospective study of 12 patients: seven women and five men. The average age was 29 years (ranging from two months to 65 years. RESULTS: Technical performance was 100% successful. Ten port-a-caths, one intra-cath and one PICC were extracted. The most common sites for the lodging of one of the ends of the intravascular foreign bodies were the right atrium (41.6% and the right ventricle (33.3%. In 100% of the cases, only one venous access was used for extraction of foreign bodies, and in 91.6% of the cases (11 catheters the femoral access was used. The loop-snare was used in 10 cases (83.3%. The most common cause of intravascular foreign body insertion was a catheter fracture, which occurred in 66.6% of the cases (eight cases. One major complication, the atrial fibrillation, occurred (8.3%, which was related to the intravascular foreign body extraction. The mortality rate in 30 days was zero. CONCLUSION: Percutaneous retrieval of intravascular foreign bodies is considered gold standard treatment because it is a minimally invasive, relatively simple, safe procedure, with low complication rates compared to conventional surgical treatment

  10. 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.

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

    International Nuclear Information System (INIS)

    Cazzato, Roberto Luigi; Garnon, Julien; Ramamurthy, Nitin; Tsoumakidou, Georgia; Caudrelier, Jean; Thénint, Marie-Aude; Rao, Pramod; Koch, Guillaume; Gangi, Afshin

    2016-01-01

    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.

  12. Simplified field-in-field technique for a large-scale implementation in breast radiation treatment

    International Nuclear Information System (INIS)

    Fournier-Bidoz, Nathalie; Kirova, Youlia M.; Campana, Francois; Dendale, Rémi; Fourquet, Alain

    2012-01-01

    We wanted to evaluate a simplified “field-in-field” technique (SFF) that was implemented in our department of Radiation Oncology for breast treatment. This study evaluated 15 consecutive patients treated with a simplified field in field technique after breast-conserving surgery for early-stage breast cancer. Radiotherapy consisted of whole-breast irradiation to the total dose of 50 Gy in 25 fractions, and a boost of 16 Gy in 8 fractions to the tumor bed. We compared dosimetric outcomes of SFF to state-of-the-art electronic surface compensation (ESC) with dynamic leaves. An analysis of early skin toxicity of a population of 15 patients was performed. The median volume receiving at least 95% of the prescribed dose was 763 mL (range, 347–1472) for SFF vs. 779 mL (range, 349–1494) for ESC. The median residual 107% isodose was 0.1 mL (range, 0–63) for SFF and 1.9 mL (range, 0–57) for ESC. Monitor units were on average 25% higher in ESC plans compared with SFF. No patient treated with SFF had acute side effects superior to grade 1-NCI scale. SFF created homogenous 3D dose distributions equivalent to electronic surface compensation with dynamic leaves. It allowed the integration of a forward planned concomitant tumor bed boost as an additional multileaf collimator subfield of the tangential fields. Compared with electronic surface compensation with dynamic leaves, shorter treatment times allowed better radiation protection to the patient. Low-grade acute toxicity evaluated weekly during treatment and 2 months after treatment completion justified the pursuit of this technique for all breast patients in our department.

  13. SUBJECTIVE CURE RATES AFTER TVT PROCEDURE FOR TREATMENT OF FEMALE URINARY INCONTINENCE – A QUESTIONNAIRE BASED STUDY

    Directory of Open Access Journals (Sweden)

    Igor But

    2003-12-01

    Full Text Available Background. The aim of this study was to assess the subjective cure rate after the tension-free vaginal tape (TVT procedure in patients with stress (SUI and mixed (MUI urinary incontinence.Methods. This is a questionnaire based study done in 43 patients with SUI and 52 patients with MUI. In the assessement of the subjective cure rate the visual analogue scale and the symptom assessment index (SAI were used. Data were analyzed using nonparametric statistics.Results. The subjective cure rate assessed 19.6 months after TVT amounted to 89.3%. Urinary incontinence after TVT procedure was noted in 26 patients (27.4% and the majority of these women (73.1% were diagnosed with MUI. In patients with SUI and postoperative stable bladder a higher success rate was observed (96.7%. In 18.6% patients with SUI, de novo overactive bladder symptoms occurred. These patients estimated a significantly (p = 0.027 lower cure rate (81.9% after TVT procedure. In patients with MUI, the cure rate after TVT amounted to 85.6%. The subjective cure rate was lower (79.4% in case of persistent overactive bladder symptoms. However, it was significantly higher (97.5% in case of a postoperatively stable bladder (p = 0.016. In the group of MUI patients, the symptoms of overactive bladder disease resolved spontaneously in 17 patients (32.7% postoperatively. The patients were satisfied with TVT and 92.6% would recommend this procedure to others.Conclusions. The TVT procedure is a very effective method of treatment for stress as well as mixed urinary incontinence. The success rate of the procedure is high, however, it is influenced by bladder activity.

  14. Feasibility of three-dimensional magnetic resonance angiography-fluoroscopy image fusion technique in guiding complex endovascular aortic procedures in patients with renal insufficiency.

    Science.gov (United States)

    Schwein, Adeline; Chinnadurai, Ponraj; Shah, Dipan J; Lumsden, Alan B; Bechara, Carlos F; Bismuth, Jean

    2017-05-01

    Three-dimensional image fusion of preoperative computed tomography (CT) angiography with fluoroscopy using intraoperative noncontrast cone-beam CT (CBCT) has been shown to improve endovascular procedures by reducing procedure length, radiation dose, and contrast media volume. However, patients with a contraindication to CT angiography (renal insufficiency, iodinated contrast allergy) may not benefit from this image fusion technique. The primary objective of this study was to evaluate the feasibility of magnetic resonance angiography (MRA) and fluoroscopy image fusion using noncontrast CBCT as a guidance tool during complex endovascular aortic procedures, especially in patients with renal insufficiency. All endovascular aortic procedures done under MRA image fusion guidance at a single-center were retrospectively reviewed. The patients had moderate to severe renal insufficiency and underwent diagnostic contrast-enhanced magnetic resonance imaging after gadolinium or ferumoxytol injection. Relevant vascular landmarks electronically marked in MRA images were overlaid on real-time two-dimensional fluoroscopy for image guidance, after image fusion with noncontrast intraoperative CBCT. Technical success, time for image registration, procedure time, fluoroscopy time, number of digital subtraction angiography (DSA) acquisitions before stent deployment or vessel catheterization, and renal function before and after the procedure were recorded. The image fusion accuracy was qualitatively evaluated on a binary scale by three physicians after review of image data showing virtual landmarks from MRA on fluoroscopy. Between November 2012 and March 2016, 10 patients underwent endovascular procedures for aortoiliac aneurysmal disease or aortic dissection using MRA image fusion guidance. All procedures were technically successful. A paired t-test analysis showed no difference between preimaging and postoperative renal function (P = .6). The mean time required for MRA-CBCT image

  15. Outcomes of arthroscopic treatment of osteochondritis dissecans of the capitellum and description of the technique.

    Science.gov (United States)

    Koehler, Steven M; Walsh, Amanda; Lovy, Andrew J; Pruzansky, Jason S; Shukla, Dave R; Hausman, Michael R

    2015-10-01

    We hypothesize that a technique for all-arthroscopic fixation of capitellum osteochondritis dissecans (OCD) lesions using suture fixation and autogenous iliac crest bone grafting offers a successful alternative to open internal fixation techniques as shown by 2-year validated patient-reported outcomes. Our technique uses arthroscopic all-inside suture fixation with iliac crest autogenous bone grafting. The procedure was performed on 4 elite-level, adolescent athletes presenting with 5 unstable capitellum OCD lesions resulting in elbow pain, limited range of motion, and decreased ability to play. Magnetic resonance imaging showed an unstable OCD lesion, which was correlated with arthroscopy. Postoperatively, patients were evaluated by the short version of the Disabilities of the Arm, Shoulder and Hand questionnaire; Oxford Elbow and Mayo Elbow scores; visual analog scale; postoperative range of motion; and return to play. Three female patients and one male patient aged 13 to 15 years underwent the procedure. The mean final follow-up period was 2.8 years. Union was achieved in all patients, as seen on magnetic resonance imaging at a mean of 3 months. At follow-up, the mean loss of extension was 2°. Mean flexion was 153°. There was no loss of supination or pronation. The mean score on the short version of the Disabilities of the Arm, Shoulder and Hand questionnaire was 11. The mean Mayo Elbow score was 88. The mean Oxford Elbow score was 42. The mean visual analog scale score was 2. The mean time to return to play was 4 months. All patients continued to compete at an elite level. There were no infections or cases of fixation failure, and no patients required conversion to open surgery or needed revision surgery. Arthroscopic all-inside fixation of unstable OCD lesions is a successful technique, facilitating athletes to return to an elite level of play. Copyright © 2015 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights

  16. Surgical treatment of complex proximal humeral fractures with a technique of nail and osteosuture: "NOS".

    Science.gov (United States)

    Garret, J; Houdré, H; Cievet-Bonfils, M; Godenèche, Arnaud; Duparc, Fabrice; Roussignol, Xavier

    2017-04-01

    Open reduction and internal fixation of complex proximal humeral fracture represents a surgical challenge. The main objective of this procedure is to anatomically reduce the tuberosities. We propose a standardized and reproducible technique that we apply to all complex displaced 3- and 4-part fractures of patients under 50 years. We use an antero-lateral trans-deltoid approach; the humeral head and the tuberosities are reduced under fluoroscopic control. The tuberosities are stabilized with an inter-tuberosity osteosuture, and we then introduce a thin and straight intra-medullary nail (Telegraph IV FH Orthopedics) at the hinge point of the humeral head. The osteosynthesis of the tuberosities is completed by 3- or 4-self-stable divergent screws in the nail. A dynamic distal locking stabilizes the humeral shaft in rotation and facilitates consolidation thanks to micro movements. The removal of the nail with an arthroscopic shoulder arthrolysis in case of stiffness is possible secondarily.

  17. RESULTS OF THE USE OF PEEK CAGES IN THE TREATMENT OF BASILAR INVAGINATION BY GOEL TECHNIQUE

    Directory of Open Access Journals (Sweden)

    Luís Eduardo Carelli Teixeira da Silva

    2016-03-01

    Full Text Available ABSTRACT Objective: Analysis of the use of polyetheretherketone (PEEK cages for atlantoaxial facet realignment and distraction for treatment of basilar invagination by Goel technique. Method: Retrospective descriptive statistical analysis of the neurological status, pain, presence of subsidence and bone fusion with the use of PEEK cages in 8 atlantoaxial joints of 4 patients with basilar invagination. All patients were treated with atlantoaxial facet distraction and realignment and subsequent arthrodesis C1-C2 by the technique of Goel modified by the use of PEEK cage. Results: All patients showed improvement in Nurick neurological assessment scale and Visual Analogue Scale (VAS of pain. There were no cases of subsidence, migration, or damage to the vertebral artery during the insertion of the cage. All joints evolved with bone fusion, assessed by dynamic radiographs, and computed tomography. Two patients developed neuropathic pain in dermatome of C2 and one patient had unilateral vertebral artery injury during C2 instrumentation treated with insertion of pedicle screw to control the bleeding. Conclusion: The results of the treatment of basilar invagination by the Goel technique with the use of PEEK cages shown to be effective and safe although further studies are needed to confirm this use.

  18. Outcomes and treatments of mal fractures caused by the split-crest technique in the mandible.

    Science.gov (United States)

    Shibuya, Yasuyuki; Yabase, Akiko; Ishida, Suguru; Kobayashi, Masaki; Komori, Takahide

    2014-09-26

    In this study, we investigated cases of mal fracture occurring during the split-crest procedure. In all subjects (six patients), the free cortical bone segment caused by the mal fracture was carefully maintained in the lateral position without fixation using a titanium plate or screw. On pre- and postoperative multiplanar reconstruction CT, the average total alveolar increase was 5.0 mm in the lower portion 1 mm from the top of the alveolar ridge, and the average total alveolar increase in the lower portion 11 mm from the top of the alveolar ridge was 2.2 mm. A total of 11 dental implants were placed immediately at the same time as the split-crest procedure, while three dental implants were placed after a waiting period of 4-11 months from bone augmentation. During an average follow-up of 27.8 months, there were no complications or cases of failed implants. Consequently, among the patients who experienced mal fracture during the split-crest technique, a sufficient volume of alveolar bone was obtained without the need for rigid fixation of the free bone segment, and the dental implants placed within the area of the mal fracture showed a good prognosis.

  19. Endovascular treatment of diabetic foot syndrome: results from a single center prospective registry using mixed coronary and peripheral techniques and equipment.

    Science.gov (United States)

    Cardaioli, Paolo; Rigatelli, Gianluca; Dell'avvocata, Fabio; Giordan, Massimo; Lisato, Giovanna; Mollo, Francesco; Vassilev, Dobrin; Nanjundappa, Aravinda

    2011-12-01

    To assess the long-term results of interventional treatment of diabetic foot using mixed coronary and peripheral equipments and techniques. The interventional diabetic foot syndrome treatment is rapidly becoming the therapy of choice in such patients, but proper materials and techniques are still debated. From January 2006 to December 2010, we prospectively enrolled 220 diabetic patients (78.5 ± 15.8 years, 107 females, all with Fontaine III or IV class), referred to our center for diabetic foot syndrome and severe limb ischemia. Mixed coronary and peripheral guidewires and balloons techniques were used. Doppler ultrasonography and foot transcutaneous oxygen pressure (TCPO2) before and after the procedure were calculated as well as the amputation rate. The preferred approach was ipsilateral femoral antegrade in 170/220 patients (77.7%), contralateral cross-over in 40/220 patients (18.8%), and popliteal retrograde + femoral antegrade in 10/220 patients (4.5%). The techniques included combined use of coronary and dedicated peripheral guidewires and coronary and peripheral dedicated balloons. Balloon angioplasty was performed in 252 legs (32 patients with bilateral disease): the procedure was successful in 239/252 legs with an immediate success rate of 94.8% and a significant improvement in TCPO2 and ankle-brachial index with ulcer healing in 233/252 legs (92.4%). The freedom from major amputation was 82.8% at a mean follow-up of 3.1 ± 1.8 years (range 1 to 5 years). The endovascular diabetic foot syndrome treatment using mixed coronary and peripheral materials and techniques seems to lead to high immediate success and limb salvage rates compared to historical series. ©2011, Wiley Periodicals, Inc.

  20. Ridge augmentation with soft tissue procedures in aesthetic dentistry: first clinical results measured with a new kind of moire technique

    Science.gov (United States)

    Studer, Stephan P.; Bucher, Andreas; Mueller, Felix

    1993-09-01

    The oral health of the Swiss population was significantly improved by the successful prevention of dental caries and periodontitis. Along with the healthy dentition the demand for aesthetic dentistry is increasing. Removable partial dentures are becoming less accepted. Therefore, to substitute lost teeth by permanent fixed partial prosthesis (bridges), the often deformed alveolar ridge has to be operated, either to improve the aesthetic appearance or to make it possible to restore the missing teeth by a fixed cemented bridge. The aim of this paper is (1) to evaluate whether the moire technique is an appropriate and handy method, and (2) to validate the precision of the new method. The measuring system consisted of a moire projector with an integrated phase shift device and a moire viewer with a CCD video camera, connected to a frame grabber in a personal computer. a highly versatile software was allowed to control the system as well as to grab the moire images using the four-phase shift technique in order to compute the phase image of the actual object. The new technique was validated with one solid test object measured by a 3D coordination, high precision measuring machine.

  1. [Short term effect of multiple stents parallel placement and reconstruction technique for the treatment of giant fusiform vertebrobasilar dissecting aneurysms].

    Science.gov (United States)

    Li, Baomin; Liang, Yongping; Liu, Xinfeng; Wang, Jun; Li, Sheng; Cao, Xiangyu; Ge, Aili; Feng, Huimin

    2015-08-01

    To investigate the feasibility,safety and follow-up results of multiple stents parallel placement and reconstruction technique for treating giant vertebrobasilar dissecting aneurysms. Five consecutive patients with giant fusiform vertebrobasilar dissecting aneurysms in Department of Neurology,Chinese People's Liberation Army General Hospital were retrospectively reviewed from April 2011 to October 2013. All patients were diagnosed vertebrobasilar dissecting aneurysms by MRI and digital subtraction angiography (DSA), the aneurysm size ranged 8.2-15.0 mm. All patients were treated by multiple stents parallel placement and reconstruction technique under general anesthesia. In the endovascular treatment process, 2-3 Solitaire or Neuroform self-expandable stents were parallel implanted in the maximum extension segment of the aneurysms to reconstruct the cavity of the aneurysm and solved the problem that the diameter of the intracranial stent is less than the diameter of the aneurysms. Multiple stents parallel placement can keep the stents stable in the cavity. The parallel stent can close the dissection as well as strengthen the aneurysm walls to alleviate the vessel pulsative compression of the brain stem. Furthermore, one of the parallel stents was selected for the main blood flow channel. Based on the main channel, telescope technique was used to completely covering the dissection. It can not only prevent the progress of dissection to normal regions, but also be helpful for blood flow channel reconstruction to reduce the hemodynamic disorders. All Patients received routine antiplatelet therapy before and after endovascular treatment. The operative procedures were succeeded in all patients. Five patients were implanted 18 stents (3 stents in 3 patients; 4 stents in 1 patient; 5 stents in 1 patient; parallel 3 stents in 2 patients; parallel 2 stents in 3 patients). The signs and symptoms of brain stem and posterior group of cranial nerves improved significantly. All

  2. Occupational exposure to nitrous oxide during procedural pain control in children: a comparison of different inhalation techniques and scavenging systems.

    Science.gov (United States)

    Messeri, Andrea; Amore, Elena; Dugheri, Stefano; Bonari, Alessandro; Pompilio, Ilenia; Arcangeli, Giulio; Rizzo, Giuliana

    2016-09-01

    Nitrous oxide (N2 O 50% in oxygen) is commonly used for painful procedures in children. Potential negative health effects associated with chronic workplace exposure limit its use. Safe occupational N2 O exposure concentrations are below 25 ppm environmental concentration as a time-weighted average (TWA) and below 200 ppm as a short-time exposure level (STEL) of 15 min. The aim was to assess occupational exposure of staff during nitrous oxide administration to children using different inhalation delivery devices and scavenging systems. Staff nitrous oxide exposure during use of a double face mask (DFM) with or without a demand valve (DV) was compared with a conventional single face mask (FM). We also compared exposure using the hospital central scavenging system with a portable evacuation system. N2 O concentrations, representing exposure values, were monitored within proximity to staff. Urine N2 O concentration was measured in staff administering the N2 O at the end of the procedural session. The mean and median values of TWA and STEL within the working area were lower than recommended values in the DFM (10.8, 11.6 ppm for TWA; 13.9, 11.0 ppm for STEL) and DFM-DV groups (2.3, 2.8 ppm for TWA; 4.4, 3.5 ppm for STEL) using the portable evacuation system. The N2 O urine exposure in DFM-DV group was lower than DFM group: a mean difference of 9.56 ppm (95% CI 2.65-16.46). Staff N2 O urinary concentrations were within safe biological limits in both the DFM and DFM-DV groups. High exposure concentrations to N2 O were recorded in all FM and FM-DV environmental and biological samples. The DFM system, with or without a DV, connected to a portable evacuation system during N2 O administration to children for painful procedures kept N2 O levels within the local environment below recommended limits. © 2016 John Wiley & Sons Ltd.

  3. Impact of geometric uncertainties on evaluation of treatment techniques for prostate cancer

    International Nuclear Information System (INIS)

    Craig, Tim; Wong, Eugene; Bauman, Glenn; Battista, Jerry; Van Dyk, Jake

    2005-01-01

    Purpose: To assess the impact of patient repositioning and internal organ motion on prostate treatment plans using three-dimensional conformal and intensity-modulated radiotherapy. Methods and materials: Four-field, six-field, and simplified intensity-modulated arc therapy plans were generated for 5 prostate cancer patients. The planning target volume was created by adding a 1-cm margin to the clinical target volume. A convolution model was used to estimate the effect of random geometric uncertainties during treatment. Dose statistics, tumor control probabilities, and normal tissue complication probabilities were compared with and without the presence of uncertainty. The impact of systematic uncertainties was also investigated. Results: Compared with the planned treatments, the delivered dose distribution with random geometric uncertainties displayed an increase in the apparent minimal dose to the prostate and seminal vesicles and a decrease in the rectal volume receiving a high dose. This increased the tumor control probabilities and decreased the normal tissue complication probabilities. Changes were seen in the percentage of prostate volume receiving 100% and 95% of the prescribed dose, and the minimal dose and tumor control probabilities for the target volume. In addition, the volume receiving at least 65 Gy, the minimal dose, and normal tissue complication probabilities changed considerably for the rectum. The simplified intensity-modulated arc therapy technique was the most sensitive to systematic errors, especially in the anterior-posterior and superior-inferior directions. Conclusion: Geometric uncertainties should be considered when evaluating treatment plans. Contrary to the widely held belief, increased conformation of the dose distribution is not always associated with increased sensitivity to random geometric uncertainties if a sufficient planning target volume margin is used. Systematic errors may have a variable effect, depending on the treatment

  4. Water dissection technique of Toth for the treatment of hypertensive intracerebral putamen hemorrhage

    International Nuclear Information System (INIS)

    Wu Jiandong; Qian Surong; Lin Liqing; Wang Chenqiu; Wang Jianren; Wang Chen; Ying Guangzhong; Hui Guozhen

    2008-01-01

    Objective: To investige the possibility of water dissection technique of Toth for craniotomy with small bone flap through lateral fissure approach for the treatment of hypertensive intracerebral putamen hemorrhage. Methods: Twenty consecutive patients with hypertensive intracerebral putamen hemorrhage were treated by making a incision on sclap long about 6 cm across sylvian fissure, making a small bone flap about 3 cm x 3 cm, After opening dual, we injected water under microscopic control by a handheld syringe with a blunt needle applying repeated injection of physiological saline into the sylvian fissure to open it, opening the insular cortex, evacuation of intracerebral hematoma. Results: There was no further mortality. Patients who returned to ADL 1 and 2 (good recovery) after surgical treatment were 10, ADL 3 were 5, ADL 4 were 4, ADL 5 were 1. Conclusion: A method of water dissection technique of Toth for craniotomy with small bone flap through lateral fissure approach for the treatment of hypertensive intracerebral putamen hemorrhage is a method of convenient, safe, and with effective result. (authors)

  5. Cerclage handling for improved fracture treatment. A biomechanical study on the twisting procedure.

    Science.gov (United States)

    Wähnert, D; Lenz, M; Schlegel, U; Perren, S; Windolf, M

    2011-01-01

    Twisting is clinically the most frequently applied method for tightening and maintaining cerclage fixation. The twisting procedure is controversially discussed. Several factors during twisting affect the mechanical behaviour of the cerclage. This in vitro study investigated the influence of different parameters of the twisting procedure on the fixation strength of the cerclage in an experimental setup with centripetal force application. Cortical half shells of the femoral shaft were mounted on a testing fixture. 1.0 mm, 1.25 mm and 1.5 mm stainless ste- el wire cerclages as well as a 1.0mm cable cerclage were applied to the bone. Pretension of the cerclage during the installation was measured during the locking procedure. Subsequently, cyclic testing was performed up to failure. Higher pretension could be achieved with increasing wire diameter. However, with larger wire diameter the drop of pre- tension due to the bending and cutting the twist also increased. The cable cerclage showed the highest pretension after locking. Cerclages twisted under traction revealed significantly higher initial cerclage tension. Plastically deformed twists offered higher cerclage pretension compared to twists which were deformed in the elastic region of the material. Cutting the wire within the twist caused the highest loss of cerclage tension (44% initial tension) whereas only 11 % was lost when cutting the wire ends separately. The bending direction of the twist significantly influenced the cerclage pretension. 45% pretension was lost in forward bending of the twist, 53% in perpendicular bending and 90% in backward bending. Several parameters affect the quality of a cerclage fixation. Adequate installation of cerclage wires could markedly improve the clinical outcome of cerclage.

  6. Modified Latarjet Procedure Without Capsulolabral Repair for the Treatment of Failed Previous Operative Stabilizations in Athletes.

    Science.gov (United States)

    Ranalletta, Maximiliano; Rossi, Luciano A; Bertona, Agustin; Tanoira, Ignacio; Maignon, Gastón D; Bongiovanni, Santiago L

    2018-02-03

    To analyze time to return to sport, functional outcomes, and recurrences of the modified Latarjet procedure without capsulolabral repair in athletes with recurrent anterior shoulder instability after a failed previous operative stabilization. We included athletes with recurrent anterior shoulder instability with a previous failed operative stabilization treated with the modified Latarjet procedure without capsulolabral repair with a minimum of 2-year follow-up. Return to sports, range of motion, the Rowe score, a visual analog scale for pain in sport activity, and the Athletic Shoulder Outcome Scoring System were used to assess functional outcomes. Recurrences were also evaluated. The postoperative bone block position and consolidation were assessed with computed tomography. Between June 2008 and June 2015, 68 athletes were treated with the modified Latarjet procedure without capsulolabral reconstruction for recurrent shoulder instability after a previous failed stabilization surgery. The mean follow-up was 44 months (range, 24-108 months), and the mean age at the time of operation was 26.8 years (range, 17-35 years). All the patients returned to sports, and 95% returned to the same sport they practiced before the surgery, all to the same level. No significant difference in shoulder range of motion was found between preoperative and postoperative results. The Rowe score, visual analog scale, and Athletic Shoulder Outcome Scoring System showed statistical improvement after operation (P Latarjet without capsulolabral repair produced excellent functional outcomes with most athletes returning to sport at the same level they had before the surgery without recurrences. Level IV, therapeutic, case series study. Copyright © 2017 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    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

  8. [Discoveries and techniques that have contributed to improving the treatment of pancreatic diseases].

    Science.gov (United States)

    Navarro, Salvador

    2015-05-01

    Due to its retroperitoneal location, the pancreas has historically been a mysterious organ that is difficult to examine and which complicates treatment. The discovery of anesthesia and asepsis in the mid-19th century allowed laparotomic diagnosis, which was previously only possible at autopsy. The expectations of surgery were improved by the detection of blood groups, vitamin K synthesis, and the development of intensive care units. In addition, high levels of presurgical diagnosis and an unquestionable improvement of its results were enabled by advances in laboratory methods (serum quantification of amylase and lipase, tumoral markers, genetics, and techniques for measuring exocrine pancreatic function), imaging and endoscopic modalities, and fine tuning of surgical techniques. In this article, we review the history of the main milestones that have allowed progress in all these aspects. Copyright © 2014 Elsevier España, S.L.U. and AEEH y AEG. All rights reserved.

  9. Magnetic resonance techniques applied to the diagnosis and treatment of Parkinson’s disease

    Directory of Open Access Journals (Sweden)

    Benito eDe Celis Alonso

    2015-07-01

    Full Text Available Parkinson’s disease affects at least 10 million people worldwide. It is a neurodegenerative disease which is currently diagnosed by neurological examination. No neuroimaging investigation or blood biomarker is available to aid diagnosis and prognosis. Most effort toward diagnosis using magnetic resonance has been focused on the use of structural/anatomical neuroimaging and diffusion tensor imaging. However, deep brain stimulation, a current strategy for treating Parkinson’s disease, is guided by magnetic resonance imaging. For clinical prognosis, diagnosis and follow-up investigations, blood oxygen level–dependent magnetic resonance imaging, diffusion tensor imaging, spectroscopy and transcranial magnetic stimulation have been used. These techniques represent the state of the art in the last five years. Here, we focus on magnetic resonance techniques for the diagnosis and treatment of Parkinson’s disease.

  10. Experience with the Nuss technique for the treatment of Pectus Excavatum in Spanish Thoracic Surgery Departments.

    Science.gov (United States)

    Fibla, Juan J; Molins, Laureano; Moradiellos, Javier; Rodríguez, Pedro; Heras, Félix; Canalis, Emili; Bolufer, Sergio; Martínez, Pablo; Aragón, Javier; Arroyo, Andrés; Pérez, Javier; León, Pablo; Canela, Mercedes

    2016-01-01

    Although the Nuss technique revolutionized the surgical treatment of pectus excavatum, its use has not become widespread in our country. The aim of this study was to analyze the current use of this technique in a sample of Thoracic Surgery Departments in Spain. Observational rectrospective multicentric study analyzing the main epidemiological aspects and clinical results of ten years experience using the Nuss technique. Between 2001 and 2010 a total of 149 patients were operated on (mean age 21.2 years), 74% male. Initial aesthetic results were excellent or good in 93.2%, mild in 4.1% and bad in 2.7%. After initial surgery there were complications in 45 patients (30.6%). The most frequent were wound seroma, bar displacement, stabilizer break, pneumothorax, haemothorax, wound infection, pneumonia, pericarditis and cardiac tamponade that required urgent bar removal. Postoperative pain appeared in all patients. In 3 cases (2%) it was so intense that it required bar removal. After a mean follow-up of 39.2 months, bar removal had been performed in 72 patients (49%), being difficult in 5 cases (7%). After a 1.6 year follow-up period good results persisted in 145 patients (98.7%). Nuss technique in adults has had good results in Spanish Thoracic Surgery Departments, however its use has not been generalized. The risk of complications must be taken into account and its indication must be properly evaluated. The possibility of previous conservative treatment is being analyzed in several departments at present. Copyright © 2015 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

  11. 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)

  12. Fetal Oropharyngeal and Neck Tumors: Determination of the Need for Ex-Utero Intrapartum Treatment Procedure

    Directory of Open Access Journals (Sweden)

    Fatma Tuncay Özgünen

    2015-06-01

    Full Text Available Background: The aim of this study was to assess the ex-utero intrapartum therapy (EXIT applied to 3 of the 7 cases with oropharyngeal or neck masses and review the indicators of the need for an EXIT procedure. Case Report: Prenatal presentation, size and localization of the masses, existence of fetal hydrops and associated findings such as polyhydramnios, intraoperative managements, complications, and maternal and neonatal outcomes were evaluated through a retrospective analysis. Four cases had neck masses and three cases had oropharyngeal masses. Prenatal sonography was used as the main diagnostic tool for all patients. The median gestational age was 34.5 weeks at the time of diagnosis and 36 weeks at delivery. Polyhydramnios was observed in three of the seven cases and they were delivered prematurely. Interventions such as endotracheal intubation or tracheostomy were performed to provide patency of the airway during delivery by the EXIT procedure in three cases. Hemangioma was found in two cases, teratoma in two cases, lymphangioma in two cases and hamartoma in one case following pathological examination of the masses. Conclusion: The localization of mass, its characteristics, invasion (if it exists, and relation to the airway are the main factors used to determine the need for EXIT. The presence of polyhydramnios may be an important indicator to predict both the need for EXIT and fetal outcomes.

  13. A Two-stage procedure for the treatment of a neglected posterolateral knee dislocation: Gradual reduction with an Ilizarov external fixator followed by arthroscopic anterior and posterior cruciate ligament reconstruction.

    Science.gov (United States)

    Polyzois, Vasilios D; Stathopoulos, Ioannis P; Benetos, Ioannis S; Pneumaticos, Spyros G

    2016-01-01

    Neglected knee dislocations are extremely uncommon and their management cannot be evidence-based since only a few case reports have been published describing different treatment methods. We present the case of a young man with a neglected posterolateral knee dislocation and a concomitant sciatic nerve injury. A two-stage treatment strategy with gradual reduction using the Ilizarov technique and subsequent arthroscopic anterior and posterior cruciate ligament reconstruction was followed. The two-stage treatment approach led to a satisfactory clinical outcome. At the latest follow-up evaluation the patient was fully ambulatory and the knee was painless with no anteroposterior instability. In neglected knee dislocations treatment optios are guided by the severity of the concomitant injuries and the status of articulating surfaces. Gradual reduction with the Ilizarov technique and subsequent arthroscopic ligamentous reconstruction is a reliable alternative to open surgical procedures. Copyright © 2015 Elsevier B.V. All rights reserved.

  14. Efficacy of the combined treatment of medulloblastoma depending on the irradiation techniques

    International Nuclear Information System (INIS)

    Ragajshene, V.N.; Tiknyavichus, K.P.

    1980-01-01

    The paper is concerned with the results of the combined treatment of medulloblastoma using the spatial radiation dose distribution technique. Biological tumor characteristics necessitates total prophylactic irradiation of the central nervous system (CNS) in medulloblastoma. Long-term results, i.e. the duration of life of patients treated by different methods, are used as a yardstick of therapeutic efficacy. To show statistical significance the authors used a simple and reliable mathematical method which demonstrates obvious advantages of prophylactic irradiation of the CNS in medulloblastoma

  15. Apicoectomies with the erbium laser: a complementary technique for retrograde endodontic treatment.

    Science.gov (United States)

    Angiero, Francesca; Benedicenti, Stefano; Signore, Antonio; Parker, Steven; Crippa, Rolando

    2011-12-01

    The purpose of this study was to evaluate the efficacy of erbium lasers for retrograde endodontic treatment, in terms of clinical outcome and therapeutic success. Apicoectomy with retrograde filling is a well-established surgical procedure to treat teeth affected by persistent periapical lesions. The apical root end is generally removed with burs, and the adjacent periapical tissue curetted, or alternatively treated with ultrasound or laser. Between 2000 and 2010, 65 apicoectomies were performed on necrotic teeth that presented apical lesions (29 men, 36 women). The lasers used in the study were the erbium:yttrium-aluminum-garnet (Er:YAG) laser, wavelength 2940 nm, and the erbium,chromium-doped:yttrium-scandium-gallium-garnet (Er,Cr:YSGG) laser, wavelength 2780 nm. Of the 65 teeth in the study, failure only occurred in 9 CASES, MANIFESTING AFTER DIFFERENT TIMES. THE REMAINING PATIENTS, 86.15%, experienced no complications, and their treatment followed a positive course. Laser-assisted surgery increases the range of therapeutic approaches in the sphere of retrograde endodontic treatment. The results of this study show that the erbium laser, used for apicoectomy, results in a high success rate with considerable benefit in terms of clinical outcome and therapeutic success.

  16. Investigations into the Optimization of Multi-Source Strength Brachytherapy Treatment Procedures

    CERN Document Server

    Henderson, D L; Yoo, S

    2002-01-01

    The goal of this project is to investigate the use of multi-strength and multi-specie radioactive sources in permanent prostate implant brachytherapy. In order to fulfill the requirement for an optimal dose distribution, the prescribed dose should be delivered to the target in a nearly uniform dose distribution while simultaneously sparing sensitive structures. The treatment plan should use a small number of needles and sources while satisfying the treatment requirements. The hypothesis for the use of multi-strength and/or multi-specie sources is that a better treatment plan using fewer sources and needles could be obtained than by treatment plans using single-strength sources could reduce the overall number of sources used for treatment. We employ a recently developed greedy algorithm based on the adjoint concept as the optimization search engine. The algorithm utilizes and ''adjoint ratio'', which provides a means of ranking source positions, as the pseudo-objective function. It ha s been shown that the gre...

  17. ViPS (Viabahn Padova Sutureless) technique: preliminary results in the treatment of peripheral arterial disease.

    Science.gov (United States)

    Ferretto, Luca; Piazza, Michele; Bonvini, Stefano; Battocchio, Piero; Grego, Franco; Ricotta, Joseph J

    2012-01-01

    To describe early results of a novel technique (ViPS, Viabahn Padova Sutureless) that connects a vascular prosthetic graft to a target artery in a sutureless fashion. A consecutive series of five patients with peripheral arterial occlusive disease (Rutherford class IV and V) underwent six ViPS procedures (one bilateral) for limb revascularization. Angiography in all cases demonstrated complete superficial femoral artery (SFA) occlusion with reconstitution of a circumferentially calcified above-knee popliteal artery. Ultrasonography revealed no adequate vein for autogenous bypass creation. In all cases, a previous attempt of SFA endovascular recanalization was unsuccessful. A Viabahn (W.L. Gore, Flagstaff, AZ) endoprosthesis was partially deployed, and its proximal end was sutured to a polytetrafluoroethylene graft. After surgical exposure, the circumferentially calcified popliteal artery, which could not be safely sutured, was transected and the undeployed distal portion of the Viabahn was inserted into the popliteal artery supported by a stiff guidewire. The distal portion of the Viabahn graft was then deployed 2.5 cm into the popliteal artery with optimal apposition. The proximal end of the polytetrafluoroethylene graft was then sutured to the common femoral artery. The distal portion of the Viabahn was ballooned to ensure apposition with the popliteal artery. The mean time for surgical modification of the device was 6.6 minutes with a mean time for ViPS anastomosis deployment of 7 seconds. Mean operative time for ViPS procedure was 61 minutes (range: 48-74). Completion angiogram in all cases demonstrated a patent graft with no sign of dissection. The patients' symptoms resolved in all cases, with complete ulcer healing occurring in five patients within 3 weeks. Follow-up imaging (mean = 2.6 months, range: 1-5) with eco-color-Doppler and computed tomography angiogram demonstrated a patent graft with no loss of device integrity in all cases. The ViPS technique is

  18. Endoscopy-assisted surgery for the management of benign breast tumors: technique, learning curve, and patient-reported outcome from preliminary 323 procedures.

    Science.gov (United States)

    Lai, Hung-Wen; Lin, Hui-Yu; Chen, Shu-Ling; Chen, Shou-Tung; Chen, Dar-Ren; Kuo, Shou-Jen

    2017-01-11

    Endoscopy-assisted breast surgery (EABS), a technique that optimizes cosmetic outcome because it is performed through small wounds hidden in inconspicuous areas, could be an alternative surgical technique for benign breast tumors. In this study, we report the preliminary results of 323 EABS procedures performed at our institution for the management of benign breast tumors. The medical records of patients who underwent EABS for benign breast lesions during the periods August 2010 to December 2015 were collected from the Changhua Christian Hospital EABS database. Data on clinicopathologic characteristics, type of surgery, hospital stay, and complications were analyzed to determine the effectiveness of the procedure for benign breast tumors. The operating time with the number of procedure performed was analyzed for learning curve evaluation. Patient satisfaction with cosmetic outcome was evaluated with a self-report questionnaire. A total of 323 EABS procedures were performed in 286 patients with benign breast lesions, including 249 (90.5%) patients with unilateral lesions. The mean age was 36 years, the mean tumor size was 2.2 cm, and the mean distance from the nipple to the tumor was 5.2 cm. Most (93.8%, 303/323) of these tumors were excised through a transareolar wound, 2.4% (8/323) through an axillary wound, and 0.3% (1/323) through the infra-mammary fold. Histopathologic analysis revealed that 63.5% (202/318) of the tumors were fibroadenoma-related lesions. The mean operative time was 81.4 min (59~89 min), which was decreased with experience increased. The overall rate of complications was 6.5%, and all were minor and wound-related. Among the 110 patients who participated in the self-report cosmetic outcome evaluation, 85.4% reported being satisfied with the cosmetic result, and almost all were satisfied with breast symmetry. Of the patients interviewed, 92.7% reported that they would choose the same procedure if they had to undergo the operation again. Our

  19. Modeling of precipitation and Cr depletion profiles of Inconel 600 during heat treatments and LSM procedure

    Energy Technology Data Exchange (ETDEWEB)

    Bao Gang [Department of Mechanical System Engineering, Hiroshima University, 1-4-1 Higashi-Hiroshima, Hiroshima (Japan); Shinozaki, Kenji [Department of Mechanical System Engineering, Hiroshima University, 1-4-1 Higashi-Hiroshima, Hiroshima (Japan)]. E-mail: kshino@hiroshima-u.ac.jp; Inkyo, Muneyuki [Department of Mechanical System Engineering, Hiroshima University, 1-4-1 Higashi-Hiroshima, Hiroshima (Japan); Miyoshi, Tomohisa [Department of Mechanical System Engineering, Hiroshima University, 1-4-1 Higashi-Hiroshima, Hiroshima (Japan); Yamamoto, Motomichi [Department of Mechanical System Engineering, Hiroshima University, 1-4-1 Higashi-Hiroshima, Hiroshima (Japan); Mahara, Yoichi [Babcock-Hitachi K.K., 3-36 Takara-machi, Kure, Hiroshima (Japan); Watanabe, Hiroshi [Babcock-Hitachi K.K., 3-36 Takara-machi, Kure, Hiroshima (Japan)

    2006-08-10

    A model based on the thermodynamic and kinetic was conducted to simulate the Cr depletion profiles near the grain boundary in Inconel 600 during the heat treatments and laser surface melting (LSM) process using Thermo-Calc and Dictra code. Based on the good agreement of Cr concentration distribution during heat treatments measured by experiments, the microsegregation of Cr induced by cellular microstructure formed during the LSM process was also modeled. The Cr depletion profile was evaluated using the Cr depletion area below the critical Cr concentration for intergranular cracking/intergranular stress corrosion cracking (IGC/IGSCC) susceptibility (8 mass%). Comparing with the result of Streicher test, the Cr depletion area calculated showed good coherence with the IGC/IGSCC susceptibility. The sample after SR + LTS treatment with the largest Cr depletion area showed the worst IGC/IGSCC resistance, while, the sample after LSM process with the smaller Cr depletion area showed the excellent IGC/IGSCC resistance.

  20. Endotoxin exposure in sewage treatment workers: investigation of exposure variability and comparison of analytical techniques.

    Science.gov (United States)

    Spaan, Suzanne; Smit, Lidwien A M; Eduard, Wijnand; Larsson, Lennart; Arts, Huib J J M; Wouters, Inge M; Heederik, Dick J J

    2008-01-01

    Objectives were to give an overview of endotoxin exposure and its determinants in sewage treatment workers, and to study exposure to culturable and non-culturable microorganisms and the applicability of the LAL assay in this work environment. In 43 Dutch sewage treatment plants 470 full-shift, 123 task-based personal and 54 stationary inhalable dust samples were collected. Endotoxin concentration was determined with the LAL-assay. Mixed effects models were used to investigate possible determinants of exposure. Simultaneous parallel filter samples, impinger samples and viable total bacteria and Gram-negative bacterial samples were taken to compare analytical techniques. Filter and impinger samples were analyzed with the LAL-assay, gas chromatography-mass spectrometry (GC-MS) and fluorescence microscopy. Endotoxin exposure levels were moderate to low (geometric mean personal exposure 27 EU/m(3), stationary 33 EU/m(3), task-based 64 EU/m(3)), yet differences between jobs and sources and some determinants of exposure were identified. Exposure varied more from day to day than between workers. Concentrations in filter samples were higher and more consistent than in impinger samples. Fungi and Gram-positive bacteria were found in higher levels than Gram-negative bacteria. The LAL assay and GC-MS showed comparable endotoxin levels. Endotoxin exposure in Dutch sewage treatment workers was relatively low. Comparison of sampling and analytical techniques suggests that the LAL-assay did not result in much exposure misclassification. It thus seems justified to perform filter measurements in combination with the LAL-assay to measure endotoxin exposure in sewage treatment plants.

  1. Double innominate osteotomy and the Smith-Petersen technique in the treatment of developmental hip disorder.

    Science.gov (United States)

    Brdar, R; Petronic, I; Abramovic, D; Nikolic, D; Lukac, M; Cirovic, D

    2011-01-01

    The purpose of our study was to present results of different surgical orthopaedic approaches in the treatment of children with developmental hip disorder. At the University Childrens Hospital in Belgrade, 21 young adults diagnosed with developmental hip disorder were treated with double osteotomy and with a modified Smith-Peterson approach during a period of 10 years, from 1997 to 2007. All patients were clinically and radiographically evaluated. We were successful with 23 hips in 20 patients, since some patients underwent surgery of both hips. The evaluation of improvement was done according to the Merle d'Aubigne and Postel system which indicated very satisfied outcome in five patients, satisfied in 8, fair in 7 and poor in one patient. In this paper we discuss the advantages and disadvantages of double osteotomy procedures compared with others that are used in the correction of developmental hip disorder. The best solution is adequate and timely diagnosis with proper correction of the deformity.

  2. Significant improvement of mouse cloning technique by treatment with trichostatin A after somatic nuclear transfer

    International Nuclear Information System (INIS)

    Kishigami, Satoshi; Mizutani, Eiji; Ohta, Hiroshi; Hikichi, Takafusa; Thuan, Nguyen Van; Wakayama, Sayaka; Bui, Hong-Thuy; Wakayama, Teruhiko

    2006-01-01

    The low success rate of animal cloning by somatic cell nuclear transfer (SCNT) is believed to be associated with epigenetic errors including abnormal DNA hypermethylation. Recently, we elucidated by using round spermatids that, after nuclear transfer, treatment of zygotes with trichostatin A (TSA), an inhibitor of histone deacetylase, can remarkably reduce abnormal DNA hypermethylation depending on the origins of transferred nuclei and their genomic regions [S. Kishigami, N. Van Thuan, T. Hikichi, H. Ohta, S. Wakayama. E. Mizutani, T. Wakayama, Epigenetic abnormalities of the mouse paternal zygotic genome associated with microinsemination of round spermatids, Dev. Biol. (2005) in press]. Here, we found that 5-50 nM TSA-treatment for 10 h following oocyte activation resulted in more efficient in vitro development of somatic cloned embryos to the blastocyst stage from 2- to 5-fold depending on the donor cells including tail tip cells, spleen cells, neural stem cells, and cumulus cells. This TSA-treatment also led to more than 5-fold increase in success rate of mouse cloning from cumulus cells without obvious abnormality but failed to improve ES cloning success. Further, we succeeded in establishment of nuclear transfer-embryonic stem (NT-ES) cells from TSA-treated cloned blastocyst at a rate three times higher than those from untreated cloned blastocysts. Thus, our data indicate that TSA-treatment after SCNT in mice can dramatically improve the practical application of current cloning techniques

  3. Pain treatment after craniotomy: where is the (procedure-specific) evidence? A qualitative systematic review

    DEFF Research Database (Denmark)

    Hansen, M.S; Brennum, Jannick; Moltke, Finn B

    2011-01-01

    Pain following craniotomy has been demonstrated to be frequent and moderate-to-severe in nature. In recent years, the focus on the challenges in treatment of postoperative pain following craniotomy has increased. Fear of using opioids because of their wide array of side-effects has led...

  4. Papilla preservation technique combined with Emdogain in the treatment of intrabony defects: a novel treatment regimen for chronic periodontitis.

    Science.gov (United States)

    Miliauskaite, Asta; Selimovic, Denis; Hassan, Mohamed; Nagano, Futami; Soell, Martine; Sano, Hidehiko; Puriene, Alina

    2008-01-01

    Regenerative therapy with enamel matrix proteins derivative (EMD) was shown to induce periodontal regeneration in intrabony defects. However, the contribution of papilla preservation technique (PPT), to the clinical outcome of regenerative therapy is still not clarified. Therefore, we conducted the present study to evaluate clinically measurable results of a combined therapy by PPT and EMD in the treatment of isolated intrabony defects. Sixty isolated intrabony defects in 25 patients were surgically assessed with EMD and PPT. The clinical parameters: clinical attachment level (CAL), probing depth (PD) and gingival recession (GR) were evaluated at baseline and at three years. The primary outcome variable was CAL. The sites treated with enamel matrix proteins demonstrated mean CAL change from 6.6+/-1.2 mm to 3.4+/-1.3 mm (p<0.001) and the mean PD was reduced from 5.9+/-1.0 mm to 2.7+/-0.8 mm (p<0.001) after three years. The mean GR decreased from 0.71+/-1.2 mm to 0.64+/-1.1 mm (p<0.821). The results of the present case cohort study indicate that PPT combined with EMD resulted in significant improvement of the clinical parameters in the treatment of intrabony defects in chronic periodontitis.

  5. Prescription procedures in medication for relapse prevention after inpatient treatment for alcohol use disorders in Switzerland.

    Science.gov (United States)

    Buri, Caroline; Moggi, Franz; Giovanoli, Anna; Strik, Werner

    2007-01-01

    In randomized controlled trials with high internal validity, pharmacotherapy using acamprosate, naltrexone, and, to a somewhat lesser extent, disulfiram has proved effective in preventing relapse in patients with alcohol use disorders (AUD). There remains, however, a paucity of studies with sufficient external validity in which the effectiveness of pharmacotherapy in clinical practice is investigated. This study aimed to make a contribution to close this gap in research. In this naturalistic, prospective study, a comparison on indices of substance use, psychiatric symptoms, and treatment service utilization was carried out using samples of 92 patients who received pharmacotherapy and 323 patients who did not receive pharmacotherapy following discharge from 12 residential AUD programmes (index stay). Patients that received pharmacotherapy were more likely to use alcohol during the index stay and at the 1-year follow-up. Moreover, this patient group more readily utilized treatment services during a 2-year period prior to and a 1-year period following index stay than patients who were not given pharmacotherapy. Nevertheless, when pharmacotherapy was prescribed before first post-treatment alcohol use, it was associated with delay of alcohol use, fewer relapses, and a reduced need for inpatient treatment. In many cases, however, medication was not prescribed until alcohol use and relapse had occurred. The length of time to first alcohol use was longer, and the cumulative abstinence rate higher, for disulfiram than for acamprosate, the latter being generally prescribed for more severely alcohol-dependent patients. There is a need for further studies to probe the reasons why medication for relapse prevention is not prescribed upon discharge from residential treatment and for less severely alcohol-dependent patients.

  6. Journal of Special Operations Medicine. Training Supplement: Tactics, Techniques, and Procedures, Volume 8 Edition 4, Fall 2008

    Science.gov (United States)

    2008-01-01

    Ward beds 13 plus 4 isolation ward beds Dental operatories 1 Ancillary Lab, X-ray 3. Amphibious transport dock ( LSD ) a. Whidbey Island, Harpers Ferry...Civil War, where Confederate General Albert Sydney Johnston was killed in the battle of Shiloh from a gunshot wound to the popliteal artery. He bled...Hypothermia Prevention and Treatment,” February 16, 2006. A.S. Wolberg, Z.H. Meng, D.M. Monroe III, and M. Hoffman , “A Systematic Evaluation of the

  7. Rules of meridians and acupoints selection in treatment of Parkinson's disease based on data mining techniques.

    Science.gov (United States)

    Li, Zhe; Hu, Ying-Yu; Zheng, Chun-Ye; Su, Qiao-Zhen; An, Chang; Luo, Xiao-Dong; Liu, Mao-Cai

    2018-01-15

    To help selecting appropriate meridians and acupoints in clinical practice and experimental study for Parkinson's disease (PD), the rules of meridians and acupoints selection of acupuncture and moxibustion were analyzed in domestic and foreign clinical treatment for PD based on data mining techniques. Literature about PD treated by acupuncture and moxibustion in China and abroad was searched and selected from China National Knowledge Infrastructure and MEDLINE. Then the data from all eligible articles were extracted to establish the database of acupuncture-moxibustion for PD. The association rules of data mining techniques were used to analyze the rules of meridians and acupoints selection. Totally, 168 eligible articles were included and 184 acupoints were applied. The total frequency of acupoints application was 1,090 times. Those acupoints were mainly distributed in head and neck and extremities. Among all, Taichong (LR 3), Baihui (DU 20), Fengchi (GB 20), Hegu (LI 4) and Chorea-tremor Controlled Zone were the top five acupoints that had been used. Superior-inferior acupoints matching was utilized the most. As to involved meridians, Du Meridian, Dan (Gallbladder) Meridian, Dachang (Large Intestine) Meridian, and Gan (Liver) Meridian were the most popular meridians. The application of meridians and acupoints for PD treatment lay emphasis on the acupoints on the head, attach importance to extinguishing Gan wind, tonifying qi and blood, and nourishing sinews, and make good use of superior-inferior acupoints matching.

  8. The godoy & godoy cervical stimulation technique in the treatment of primary congenital lymphedema.

    Science.gov (United States)

    de Godoy, José Maria Pereira; de Godoy, Ana Carolina Pereira; Guimarães, Tânia Dias; de Godoy, Maria de Fátima Guerreiro

    2012-07-31

    THE AIM OF THE CURRENT STUDY IS TO REPORT ON THE TREATMENT OF PRIMARY LYMPHEDEMA USING A NEW FORM OF THERAPY: cervical stimulation. In a prospective cohort study, 9 boys and 5 girls with primary congenital lymphedema were evaluated over two years. Age ranged from two months to 8.5 years. After diagnosis, all mothers were trained in the new technique. The Godoy & Godoy cervical stimulation technique consists of between 20 to 30 stimuli per minute using light movements in the cervical region. All the children were submitted to perimetric evaluations of the feet and legs; however, in this study only two points, 3 and 6 cm from the base of the big toe nail, were used. The two-tailed t-test was used for statistical analysis with an alpha error of 5% (P<0.05) considered acceptable. The size of the lymphedematous feet was reduced and even normalized (P<0.0001) for all treated children. Cervical stimulation is a new option in the treatment of primary congenital lymphedema; its association with compression stockings has a synergistic effect in reducing the volume of lymphedema.

  9. The Godoy & Godoy cervical stimulation technique in the treatment of primary congenital lymphedema

    Directory of Open Access Journals (Sweden)

    Jose Maria Pereira de Godoy

    2012-10-01

    Full Text Available The aim of the current study is to report on the treatment of primary lymphedema using a new form of therapy: cervical stimulation. In a prospective cohort study, 9 boys and 5 girls with primary congenital lymphedema were evaluated over two years. Age ranged from two months to 8.5 years. After diagnosis, all mothers were trained in the new technique. The Godoy & Godoy cervical stimulation technique consists of between 20 to 30 stimuli per minute using light movements in the cervical region. All the children were submitted to perimetric evaluations of the feet and legs; however, in this study only two points, 3 and 6 cm from the base of the big toe nail, were used. The two-tailed t-test was used for statistical analysis with an alpha error of 5% (P<0.05 considered acceptable. The size of the lymphedematous feet was reduced and even normalized (P<0.0001 for all treated children. Cervical stimulation is a new option in the treatment of primary congenital lymphedema; its association with compression stockings has a synergistic effect in reducing the volume of lymphedema.

  10. Investigations into the Optimization of Multi-Source Strength Brachytherapy Treatment Procedures

    International Nuclear Information System (INIS)

    Henderson, D. L.; Yoo, S.; Thomadsen, B.R.

    2002-01-01

    The goal of this project is to investigate the use of multi-strength and multi-specie radioactive sources in permanent prostate implant brachytherapy. In order to fulfill the requirement for an optimal dose distribution, the prescribed dose should be delivered to the target in a nearly uniform dose distribution while simultaneously sparing sensitive structures. The treatment plan should use a small number of needles and sources while satisfying the treatment requirements. The hypothesis for the use of multi-strength and/or multi-specie sources is that a better treatment plan using fewer sources and needles could be obtained than by treatment plans using single-strength sources could reduce the overall number of sources used for treatment. We employ a recently developed greedy algorithm based on the adjoint concept as the optimization search engine. The algorithm utilizes and ''adjoint ratio'', which provides a means of ranking source positions, as the pseudo-objective function. It ha s been shown that the greedy algorithm can solve the optimization problem efficiently and arrives at a clinically acceptable solution in less than 10 seconds. Our study was inclusive, that is there was no combination of sources that clearly stood out from the others and could therefore be considered the preferred set of sources for treatment planning. Source strengths of 0.2 mCi (low), 0.4 mCi (medium), and 0.6 mCi (high) of 125 I in four different combinations were used for the multi-strength source study. The combination of high- and medium-strength sources achieved a more uniform target dose distribution due to few source implants whereas the combination of low-and medium-strength sources achieved better sparing of sensitive tissues including that of the single-strength 0.4 mCi base case. 125 I at 0.4 mCi and 192 Ir at 0.12 mCi and 0.25 mCi source strengths were used for the multi-specie source study. This study also proved inconclusive , Treatment plans using a combination of two 0

  11. Investigations into the Optimization of Multi-Source Strength Brachytherapy Treatment Procedures

    Energy Technology Data Exchange (ETDEWEB)

    D. L. Henderson; S. Yoo; B.R. Thomadsen

    2002-09-30

    The goal of this project is to investigate the use of multi-strength and multi-specie radioactive sources in permanent prostate implant brachytherapy. In order to fulfill the requirement for an optimal dose distribution, the prescribed dose should be delivered to the target in a nearly uniform dose distribution while simultaneously sparing sensitive structures. The treatment plan should use a small number of needles and sources while satisfying the treatment requirements. The hypothesis for the use of multi-strength and/or multi-specie sources is that a better treatment plan using fewer sources and needles could be obtained than by treatment plans using single-strength sources could reduce the overall number of sources used for treatment. We employ a recently developed greedy algorithm based on the adjoint concept as the optimization search engine. The algorithm utilizes and ''adjoint ratio'', which provides a means of ranking source positions, as the pseudo-objective function. It ha s been shown that the greedy algorithm can solve the optimization problem efficiently and arrives at a clinically acceptable solution in less than 10 seconds. Our study was inclusive, that is there was no combination of sources that clearly stood out from the others and could therefore be considered the preferred set of sources for treatment planning. Source strengths of 0.2 mCi (low), 0.4 mCi (medium), and 0.6 mCi (high) of {sup 125}I in four different combinations were used for the multi-strength source study. The combination of high- and medium-strength sources achieved a more uniform target dose distribution due to few source implants whereas the combination of low-and medium-strength sources achieved better sparing of sensitive tissues including that of the single-strength 0.4 mCi base case. {sup 125}I at 0.4 mCi and {sup 192}Ir at 0.12 mCi and 0.25 mCi source strengths were used for the multi-specie source study. This study also proved inconclusive , Treatment

  12. Limitations of the bowel bag contouring technique in the definitive treatment of cervical cancer.

    Science.gov (United States)

    Dominello, Michael M; Nalichowski, Adrian; Paximadis, Peter; Kaufman, Isaac; McSpadden, Erin; Joiner, Michael; Miller, Steven; Konski, Andre

    2014-01-01

    Incidence of acute grade 3 and 4 small bowel toxicity in the definitive treatment of cervical cancer is approximately 15%. Given uncertainties in position of the bowel at time of treatment, techniques including the contouring of a bowel bag have been suggested. The purpose of this study is to describe interfraction variability in bowel location for the female pelvis with intact reproductive organs and to characterize the ability of the bowel bag technique, as described in the Radiation Therapy Oncology Group pelvic normal tissue contouring guidelines, to account for organ motion in this specific clinical setting. Bowel position was assessed for 45 computed tomographic scans used in treatment planning for 9 consecutive cervical cancer patients. After a single operator contoured bowel loops, most superior, anterior, posterior, and inferior positions of bowel were recorded. Mixed effects models were used to assess significance of interfraction variability. Frequency of bowel loop migration outside of the bowel bag was then considered for each patient given all potential bowel bag volumes. Standardized scoring was used to determine additional margins that would be required to account for 95%, 90%, and 85% of significant bowel motion. Interfraction variability in the inferior-most bowel position was significant (P = .002). Median maximum variation in the inferior bowel position was 2.1 cm (range, 0.9 cm-4.8 cm). When applying the bowel bag technique, 100% of bowel motion was accounted for as the bowel translated laterally, anteriorly, posteriorly, and superiorly, though accounted for just 70.3% of motion in the inferior direction. A 4-cm inferior margin was required to account for 90% of motion in the inferior direction. In the intact female pelvis, the bowel bag technique is successful in accounting for most interfraction variability in bowel position but underestimates inferior motion. Until an improved approach to predicting small bowel motion can be routinely

  13. Percutaneous Treatment of a Primary Pancreatic Hydatid Cyst Using a Catheterization Technique

    Energy Technology Data Exchange (ETDEWEB)

    Karaman, Bulent; Ustunsoz, Bahri; Ugurel, Sahin [Gulhane Military Medical School, Ankara (Turkmenistan)

    2012-03-15

    Primary pancreatic hydatid cysts are rare and its percutaneous treatment and catheterization technique has, to the best of our knowledge, not been published in literature. A 33-year-old male patient who presented with abdominal pain was evaluated by ultrasonography (US) and computed tomography examinations. Both examinations revealed a cyst in the neck of the pancreas. After the administration of albendazole chemoprophylaxis, the patient underwent diagnostic puncture showing high pressure spring water which harbored the scoleces and was treated percutaneously by the catheterization technique. In this technique, first the cyst was punctured, the fluid content aspirated, the radiocontrast material injected to see possible fistulisation, and then re-aspirated. The 20% hypertonic saline solution was injected and re-aspiration was performed to the best of our abilities, followed by the insertion of a catheter for drainage of the remaining non-aspiratable fluid content. At follow-up examination, the cyst was not visible on US after 6 months. There was no evidence of cyst recurrence or dissemination after 18 months at serologic and imaging follow-up.

  14. Impact of radiation technique upon the outcome of treatment for medulloblastoma

    International Nuclear Information System (INIS)

    Halperin, Edward C.

    1996-01-01

    Craniospinal irradiation (CSI) is an essential component of the therapy of medulloblastoma. Because medulloblastoma disseminates via the cerebrospinal fluid (CSF), CSI technique involves the irradiation of all CSF-bearing areas which are at risk for tumor seeding. Underdosing with radiation because of inadequacies in CSI technique will produce dose 'cold spots' which have the potential of serving as a nidus for tumor recurrence. A simple mathematic model of subclinical disease in medulloblastoma based on the available data concerning the radiosensitivity of medulloblastoma cell lines as well as the known clinical dose-response relationships support the hypothesis that for most cases of medulloblastoma, the radiotherapist is working in a range of doses arrayed on the steep portion of the tumor control probability curve. Underdosing of CSF-bearing areas because of technical problems at the junction of the cranial and spinal fields of irradiation, placement of shielding blocks in the cribiform plate-sub frontal region, and/or anatomic errors in the design of the caudal end of the CSI fields may lead to significant risks of tumor relapse. One may debate the necessity of a posterior fossa boost encompassing the entire anatomic posterior fossa rather than the primary tumor volume with a margin. This review critically evaluates the potential impact of CSI technique upon the outcome of treatment for medulloblastoma, and suggests future areas of inquiry

  15. Treatment of PVC using an alternative low energy ion bombardment procedure

    Science.gov (United States)

    Rangel, Elidiane C.; dos Santos, Nazir M.; Bortoleto, José Roberto R.; Durrant, Steven F.; Schreiner, Wido H.; Honda, Roberto Y.; Rangel, Rita de Cássia C.; Cruz, Nilson C.

    2011-12-01

    In many applications, polymers have progressively substituted traditional materials such as ceramics, glasses, and metals. Nevertheless, the use of polymeric materials is still limited by their surface properties. Frequently, selective modifications are necessary to suit the surface to a given application. Amongst the most common treatments, plasma immersion ion implantation (PIII) has attracted the attention of many researchers owing to its versatility and practicality. This method, however, requires a power supply to provide high voltage (tens of kV) negative pulses, with a controlled duty cycle, width and frequency. Owing to this, the implementation of PIII on the industrial scale can become economically inviable. In this work, an alternative plasma treatment that enables low energy ion bombardment without the need of a high voltage pulse generator is presented. To evaluate the efficiency of the treatment of polymers, polyvinylchloride, PVC, specimens were exposed to 5 Pa argon plasmas for 3600 s, at excitation powers, P, of between 10 and 125 W. Through contact angle and atomic force microscopy data, the influence of P on the wettability, surface free energy and roughness of the samples was studied. Surface chemical composition was measured by X-ray photoelectron spectroscopy, XPS. To evaluate the effect of aging under atmospheric conditions, contact angle and XPS measurements were performed one and 1334 days after the treatment. The plasma potential and ion density around the driven electrode were determined from Langmuir probe measurements while the self-bias potential was derived with the aid of an oscilloscope. From these data it was possible to estimate the mean energy of ions bombarding the PVC surface. Chlorine, carbon and oxygen contamination were detected on the surface of the as-received PVC. Upon exposure to the plasma, the proportion of chlorine was observed to decrease while that of oxygen increased. Consequently, the wettability and surface energy

  16. Machine-specific quality assurance procedure for stereotactic treatments with dynamic couch rotations.

    Science.gov (United States)

    Wilson, Byron; Gete, Ermias

    2017-12-01

    We present a method in which the treatment couch's accuracy is measured using the electronic portal imaging device (EPID) and a phantom of our own construction. Using this phantom, we were able to quantify the treatment couch walkout, and the rotation angle accuracy for both static and dynamic couch treatments. These measurements were used to provide an accurate measure of the treatment couch isocenter as well as to verify the couch rotation angle recorded in the trajectory log. The phantom was constructed using a polystyrene slab in which five ball bearings of 4 mm diameter are placed on the same plane at varying radii (0, 2.8, 4.4, 5.6, and 6.7 cm). The couch was rotated through its full extent (-90, 90 degrees) while MV images were acquired continuously. The couch rotational accuracy was calculated using a least squares minimization which fit the locations of the BBs to their expected locations relative to reference setup conditions. Using this approach, rotation angle and isocenter walkout was calculated in three dimensions. These measurements were used to quantify the accuracy of the couch as well as to validate the Varian TrueBeam trajectory logs. Additionally, a method for an EPID-based couch star-shot measurement was developed and compared with the traditional film-based method. The measured couch center of rotation consisted of a cloud of points clustered around the room isocenter within 0.7 mm distance. The trajectory log couch angle values agreed with those recorded in the DICOM header of the EPID images to the third significant digit and the couch rotation angles recorded in the trajectory log and DICOM header agreed with the calculated values to 0.08 degrees. Comparison of couch star-shot measurement developed in this study with film-based star-shot measurements gave an agreement to within 0.2 mm. We have developed a quality assurance method for the treatment couch which is simple, accurate, and enables the user to access a multitude of consistent data

  17. Technical success, technique efficacy and complications of minimally-invasive imaging-guided percutaneous ablation procedures of breast cancer: A systematic review and meta-analysis.

    Science.gov (United States)

    Mauri, Giovanni; Sconfienza, Luca Maria; Pescatori, Lorenzo Carlo; Fedeli, Maria Paola; Alì, Marco; Di Leo, Giovanni; Sardanelli, Francesco

    2017-08-01

    To systematically review studies concerning imaging-guided minimally-invasive breast cancer treatments. An online database search was performed for English-language articles evaluating percutaneous breast cancer ablation. Pooled data and 95% confidence intervals (CIs) were calculated. Technical success, technique efficacy, minor and major complications were analysed, including ablation technique subgroup analysis and effect of tumour size on outcome. Forty-five studies were analysed, including 1,156 patients and 1,168 lesions. Radiofrequency (n=577; 50%), microwaves (n=78; 7%), laser (n=227; 19%), cryoablation (n=156; 13%) and high-intensity focused ultrasound (HIFU, n=129; 11%) were used. Pooled technical success was 96% (95%CI 94-97%) [laser=98% (95-99%); HIFU=96% (90-98%); radiofrequency=96% (93-97%); cryoablation=95% (90-98%); microwave=93% (81-98%)]. Pooled technique efficacy was 75% (67-81%) [radiofrequency=82% (74-88); cryoablation=75% (51-90); laser=59% (35-79); HIFU=49% (26-74)]. Major complications pooled rate was 6% (4-8). Minor complications pooled rate was 8% (5-13%). Differences between techniques were not significant for technical success (p=0.449), major complications (p=0.181) or minor complications (p=0.762), but significant for technique efficacy (p=0.009). Tumour size did not impact on variables (p>0.142). Imaging-guided percutaneous ablation techniques of breast cancer have a high rate of technical success, while technique efficacy remains suboptimal. Complication rates are relatively low. • Imaging-guided ablation techniques for breast cancer are 96% technically successful. • Overall technique efficacy rate is 75% but largely inhomogeneous among studies. • Overall major and minor complication rates are low (6-8%).

  18. The effect of drawing and writing technique on the anxiety level of children undergoing cancer treatment.

    Science.gov (United States)

    Altay, Naime; Kilicarslan-Toruner, Ebru; Sari, Çigdem

    2017-06-01

    To determine the effect of the drawing and writing technique on the anxiety level of children undergoing cancer treatment in hospital. Research was conducted in the haematology-oncology clinic of a university hospital, using a quasi-experimental design (pre-and-post intervention evaluations of a single group). The sample comprised 30 hospitalised children aged 9-16 years. Data were collected with Socio-demographic form, clinical data form, and the State Anxiety Inventory. The institution gave written approval for the study and parents provided written consent. Drawing, writing and mutual story-telling techniques were used as part of a five-day programme. Children were asked to draw a picture of a hospitalised child and write a story about this drawing. After drawing and writing, mutual storytelling were used to more constructive story with positive feelings. The drawing, writing techniques was implemented on the first and third days of the programme and mutual storytelling was implemented on the second and fourth days. Data were reported as percentages and frequencies and the intervention effect analysed with the Wilcoxon test. The average age of children was 12.56 years ± 2.67 and 76.7% were girls. The mean age diagnosis and mean treatment duration were 11.26 years ± 3.17 and 16.56 months ± 20.75 respectively. Most of the children (50%) had leukaemia and were receiving chemotherapy (66.7%). In most cases (76.7%) the mother was the primary caregiver. Scores on the State Anxiety Inventory were lower-indicating lower anxiety-after the intervention (36.86 ± 4.12 than before it (40.46 ± 4.51) (p < 0.05). The therapeutic intervention reduced children's state anxiety. Copyright © 2017 Elsevier Ltd. All rights reserved.

  19. Triangular Fixation Technique for Bicolumn Restoration in Treatment of Distal Humerus Intercondylar Fracture.

    Science.gov (United States)

    Jung, Sung-Weon; Kang, Seung-Hoon; Jeong, Min; Lim, Hae-Seong

    2016-03-01

    Distal humerus intercondylar fractures are intra-articular and comminuted fractures involving soft tissue injury. As distal humerus is triangle-shaped, parallel plating coupled with articular fixation would be suitable for bicolumn restoration in treatment of distal humerus intercondylar fracture. This study included 38 patients (15 males and 23 females) who underwent olecranon osteotomy, open reduction and internal fixation with the triangle-shaped cannulated screw and parallel locking plates (triangular fixation technique). Functional results were assessed with the visual analog scale (VAS) scores, Mayo elbow performance (MEP) scores and Disabilities of the Arm, Shoulder and Hand (DASH) questionnaires. Anteroposterior and lateral elbow radiographs were assessed for reduction, alignment, fracture union, posttraumatic arthrosis, and heterotopic ossification, and computed tomography (CT) scans were used to obtain more accurate measurements of articular discrepancy. All fractures healed primarily with no loss of reduction. The mean VAS, MEP, and DASH scores of the affected elbow were not significantly different from those of the unaffected elbow (p = 0.140, p = 0.090, and p = 0.262, respectively). The mean degree of flexion was significantly lower in the affected elbow than in the unaffected elbow, but was still considered as functional (p = 0.001, > 100° in 33 of 38 patients). Two cases of articular step-offs (> 2 mm) were seen on follow-up CT scans, but not significantly higher in the affected elbow than in the unaffected elbow (p = 0.657). Binary logistic regression analysis revealed that only Association for Osteosynthesis (AO) type C3 fractures correlated with good/excellent functional outcome (p = 0.012). Complications occurred in 12 of the 38 patients, and the overall reoperation rate for complications was 10.5% (4 of 38 patients). Triangular fixation technique for bicolumn restoration was an effective and reliable method in treatment of distal humerus

  20. Involved-Node Radiotherapy and Modern Radiation Treatment Techniques in Patients With Hodgkin Lymphoma

    International Nuclear Information System (INIS)

    Paumier, Amaury; Ghalibafian, Mithra; Beaudre, Anne; Ferreira, Ivaldo; Pichenot, Charlotte; Messai, Taha; Lessard, Nathalie Athalie; Lefkopoulos, Dimitri; Girinsky, Theodore

    2011-01-01

    Purpose: To assess the clinical outcome of the involved-node radiotherapy (INRT) concept using modern radi