Sample records for terrane suture chugach

  1. Contrasting styles of sedimentation and deformation in the Chugach Terrane accretionary complex, south-central Alaska (United States)

    Amato, J. M.; Pavlis, T. L.; Worthman, C.; Kochelek, E.; Day, E. M.; Clift, P. D.; Hecker, J.


    In southeast Alaska the Chugach terrane represents an accretionary complex associated with several arcs active at 200-65 Ma. This lithostratigraphic unit consists of blueschists with Early Jurassic metamorphic ages and uncertain depositional ages; the Jurassic-Cretaceous McHugh Complex; and the Late Cretaceous Valdez Group. Detrital zircon ages from densely sampled transects reveals patterns in the assembly of the complex. Blueschists are almost totally barren of zircon, suggesting protoliths derived from mafic-intermediate volcanic protoliths far from a continental source. There is an age gap between the blueschists and the McHugh complex interpreted to be caused by an episode of tectonic erosion. The McHugh Complex is two separate units that are lithologically and geochronologically distinct. The older McHugh is a melange is dominated by stratally disrupted volcanic rocks, chert, and argillite. The oldest McHugh rocks have maximum depositional ages (MDA) of 177-150 Ma at Seldovia and 157-145 Ma at Turnagain Arm; the lack of older rocks at Turnagain Arm suggests removal of structural section by faulting. The MDAs of the older McHugh rocks do not decrease progressively away from the arc. There is a 45 m.y. gap in MDA between the older McHugh and the Late Cretaceous McHugh rocks. The younger McHugh rocks are dominated by volcanogenic sandstone and coarse conglomerate and MDA decreases from 100 Ma near the boundary with the older McHugh mesomelange to 85 Ma near the Valdez Group. The Valdez Group consists of coherently bedded turbidites with a MDA range of 85-60 Ma that decreases progressively outboard of the arc source. A sample from the Orca Group of the Prince William terrane is lithologically similar to the Valdez Group and there is no gap in MDA between Valdez and Orca Groups. 55 Ma dikes cut the McHugh and Valdez Groups in the western Chugach and Kenai Mountains. The oldest units of the Chugach terrane are the most deformed, with deformation and metamorphism

  2. Grenvillean sutures zones in the northern portion of the Cuyania terrane, Republica Argentina. geophysical evidence

    International Nuclear Information System (INIS)

    Chernicoff, C.; Vujovich, G.


    In the northern portion of the Cuyania terrane there is geophysical evidence for the ocurrence of two ancient WNW suture zones, corresponding to the Guandacol and Vinchina lineaments. The location of these sutures is consistent with analogous structures in Laurentia, in the Ouachita embayment region, where the Grenvillean orogen trends WNW. It is argued that the WNW transform faults pertaining to the Ouachita rift would have developed as a result of a reactivation of compressional structures of identical orientation associated to the accretion of Grenvillean terranes. The Guandacol and Vinchina lineaments would have been in physical continuity with analogous megastructures in the Ouachita embayment region, and they both would have originated as compressional structures, later reactivated as transcurrent fault zones during the late Proterozoic early Paleozoic. The interpretation of the Guandacol and Vinchina lineaments as Grenvillean suture zones would add more complexity to the Cuyania terrane, with respect to what has been described up to now; they could precede the amalgamation of the Pie de Palo and Precordillera terranes (constituents of the Cuyania composite terrane) [es

  3. Gondwanan/peri-Gondwanan origin for the Uchee terrane, Alabama and georgia: Carolina zone or Suwannee terrane(?) and its suture with Grenvillian basement of the Pine Mountain window (United States)

    Steltenpohl, M.G.; Mueller, P.M.; Heatherington, A.L.; Hanley, T.B.; Wooden, J.L.


    The poorly known, suspect, Uchee terrane occupies a critical tectonic position with regard to how and when peri-Gondwanan (Carolina) and Gondwanan (Suwannee) terranes were sutured to Laurentia. It lies sandwiched between Laurentian(?) continental basement exposed in the Pine Mountain window and adjacent buried Gondwanan crust of the Suwannee terrane. The Uchee terrane has been proposed as both a septum of Piedmont rocks that once was continuous across the erosionally breached Pine Mountain window or part of the Carolina zone. To help resolve this issue, we conducted U-Pb (SHRIMP-RG) (sensitive high-resolution ion microprobe-reverse geometry) zircon studies and whole-rock isotopic analyses of principal metasedimentary and metaplutonic units. U-Pb ages for zircons from the Phenix City Gneiss suggest igneous crystallization at ca. 620 Ma, inheritance ca. 1000 to ca. 1700 Ma, and a ca. 300 Ma (Alleghanian) overprint recorded by zircon rims. Zircons from the metasedimentary/metavolcaniclastic Moffits Mill Schist yield bimodal dates at ca. 620 and 640 Ma. The 620 to 640 Ma dates make these rocks age-equivalent to the oldest parts of the Carolina slate belt (Virgilina and Savannah River) and strongly suggest a Gondwanan (Pan-African and/or Trans-Brasiliano) origin for the Uchee terrane. Alternatively, the Uchee terrane may be correlative with metamorphic basement of the Suwannee terrane. The ca. 300 Ma overgrowths on zircons are compatible with previously reported 295 to 288 Ma 40Ar/39Ar hornblende dates on Uchee terrane rocks, which were interpreted to indicate deep tectonic burial of the Uchee terrane contemporaneous with the Alleghanian orogeny recorded in the foreland. Temperature-time paths for the Uchee terrane are similar to that of the Pine Mountain terrane, indicating a minimum age of ca. 295 Ma for docking. In terms of tectono-metamorphic history of the Uchee terrane, it is important to note that no evidence for intermediate "Appalachian" dates (e.g, Acadian or

  4. Evidence From Detrital Zircon U-Pb Analysis for Suturing of Pre-Mississippian Terranes in Arctic Alaska (United States)

    Moore, T. E.; Potter, C. J.; O'Sullivan, P. B.; Aleinikoff, J. N.


    900 Ma and 1200-1450 Ma that are not seen in the Neroukpuk sample, as well as a cluster of ages at 320-390 Ma. This sample indicates that the Neroukpuk is not the only source of zircons for Mississippian strata in the northeast Brooks Range. The samples from the northeastern Brooks Range contain zircon distributions similar to those reported from autochthonous North American strata in east-central Alaska and are strikingly different from those in western and southern parts of the Arctic Alaska terrane. Peaks at ~1.8 Ga are subdued or missing in the latter samples and 1.5-1.6 Ga grains, a magmatic gap in Laurentia, are present in the Lisburne Peninsula and North Slope samples. In view of these data, field and seismic evidence for significant Devonian deformation in northern Alaska, and likely plate configurations for that time, northern Alaska probably records early to mid-Paleozoic closing of the Iapatus Ocean and collisional suturing of non-Laurentian continental blocks with northwestern North America. This suggests that Devonian deformation in Arctic Alaska represents an important, northern element of the Caledonian deformational system that probably once linked up with Caledonian structures in the Canadian Arctic Islands and adjacent continental margin region.

  5. Geochronology of plutonic rocks and their tectonic terranes in Glacier Bay National Park and Preserve, southeast Alaska: Chapter E in Studies by the U.S. Geological Survey in Alaska, 2008-2009 (United States)

    Brew, David A.; Tellier, Kathleen E.; Lanphere, Marvin A.; Nielsen, Diane C.; Smith, James G.; Sonnevil, Ronald A.


    We have identified six major belts and two nonbelt occurrences of plutonic rocks in Glacier Bay National Park and Preserve and characterized them on the basis of geologic mapping, igneous petrology, geochemistry, and isotopic dating. The six plutonic belts and two other occurrences are, from oldest to youngest: (1) Jurassic (201.6–145.5 Ma) diorite and gabbro of the Lituya belt; (2) Late Jurassic (161.0–145.5 Ma) leucotonalite in Johns Hopkins Inlet; (3) Early Cretaceous (145.5–99.6 Ma) granodiorite and tonalite of the Muir-Chichagof belt; (4) Paleocene tonalite in Johns Hopkins Inlet (65.5–55.8 Ma); (5) Eocene granodiorite of the Sanak-Baranof belt; (6) Eocene and Oligocene (55.8–23.0 Ma) granodiorite, quartz diorite, and granite of the Muir-Fairweather felsic-intermediate belt; (7) Eocene and Oligocene (55.8–23.0 Ma) layered gabbros of the Crillon-La Perouse mafic belt; and (8) Oligocene (33.9–23.0 Ma) quartz monzonite and quartz syenite of the Tkope belt. The rocks are further classified into 17 different combination age-compositional units; some younger belts are superimposed on older ones. Almost all these plutonic rocks are related to Cretaceous and Tertiary subduction events. The six major plutonic belts intrude the three southeast Alaska geographic subregions in Glacier Bay National Park and Preserve, from west to east: (1) the Coastal Islands, (2) the Tarr Inlet Suture Zone (which contains the Border Ranges Fault Zone), and (3) the Central Alexander Archipelago. Each subregion includes rocks assigned to one or more tectonic terranes. The various plutonic belts intrude different terranes in different subregions. In general, the Early Cretaceous plutons intrude rocks of the Alexander and Wrangellia terranes in the Central Alexander Archipelago subregion, and the Paleogene plutons intrude rocks of the Chugach, Alexander, and Wrangellia terranes in the Coastal Islands, Tarr Inlet Suture Zone, and Central Alexander Archipelago subregions.

  6. Preferential rifting of continents - A source of displaced terranes (United States)

    Vink, G. E.; Morgan, W. J.; Zhao, W.-L.


    Lithospheric rifting, while prevalent in the continents, rarely occurs in oceanic regions. To explain this preferential rifting of continents, the total strength of different lithospheres is compared by integrating the limits of lithospheric stress with depth. Comparisons of total strength indicate that continental lithosphere is weaker than oceanic lithosphere by about a factor of three. Also, a thickened crust can halve the total strength of normal continental lithosphere. Because the weakest area acts as a stress guide, any rifting close to an ocean-continent boundary would prefer a continental pathway. This results in the formation of small continental fragments or microplates that, once accreted back to a continent during subduction, are seen as displaced terranes. In addition, the large crustal thicknesses associated with suture zones would make such areas likely locations for future rifting episodes. This results in the tendency of new oceans to open along the suture where a former ocean had closed.

  7. Mechanics of Suture Joints (United States)

    Li, Yaning; Song, Juha; Ortiz, Christine; Boyce, Mary; Ortiz Group/DMSE/MIT Team; Boyce Group/ME/MIT Team


    Biological sutures are joints which connect two stiff skeletal or skeletal-like components. These joints possess a wavy geometry with a thin organic layer providing adhesion. Examples of biological sutures include mammalian skulls, the pelvic assembly of the armored fish Gasterosteus aculeatus (the three-spined stickleback), and the suture joints in the shell of the red-eared slider turtle. Biological sutures allow for movement and compliance, control stress concentrations, transmit loads, reduce fatigue stress and absorb energy. In this investigation, the mechanics of the role of suture geometry in providing a naturally optimized joint is explored. In particular, analytical and numerical micromechanical models of the suture joint are constructed. The anisotropic mechanical stiffness and strength are studied as a function of suture wavelength, amplitude and the material properties of the skeletal and organic components, revealing key insights into the optimized nature of these ubiquitous natural joints.

  8. Gravity signatures of terrane accretion (United States)

    Franco, Heather; Abbott, Dallas


    In modern collisional environments, accreted terranes are bracketed by forearc gravity lows, a gravitational feature which results from the abandonment of the original trench and the initiation of a new trench seaward of the accreted terrane. The size and shape of the gravity low depends on the type of accreted feature and the strength of the formerly subducting plate. Along the Central American trench, the accretion of Gorgona Island caused a seaward trench jump of 48 to 66 km. The relict trench axes show up as gravity lows behind the trench with minimum values of -78 mgal (N of Gorgona) and -49 mgal (S of Gorgona) respectively. These forearc gravity lows have little or no topographic expression. The active trench immediately seaward of these forearc gravity lows has minimum gravity values of -59 mgal (N of Gorgona) and -58 mgal (S of Gorgona), respectively. In the north, the active trench has a less pronounced gravity low than the sediment covered forearc. In the Mariana arc, two Cretaceous seamounts have been accreted to the Eocene arc. The northern seamount is most likely a large block, the southern seamount may be a thrust slice. These more recent accretion events have produced modest forearc topographic and gravity lows in comparison with the topographic and gravity lows within the active trench. However, the minimum values of the Mariana forearc gravity lows are modest only by comparison to the Mariana Trench (-216 mgal); their absolute values are more negative than at Gorgona Island (-145 to -146 mgal). We speculate that the forearc gravity lows and seaward trench jumps near Gorgona Island were produced by the accretion of a hotspot island from a strong plate. The Mariana gravity lows and seaward trench jumps (or thrust slices) were the result of breaking a relatively weak plate close to the seamount edifice. These gravity lows resulting from accretion events should be preserved in older accreted terranes.

  9. Suture Coding: A Novel Educational Guide for Suture Patterns. (United States)

    Gaber, Mohamed; Abdel-Wahed, Ramadan


    This study aims to provide a helpful guide to perform tissue suturing successfully using suture coding-a method for identification of suture patterns and techniques by giving full information about the method of application of each pattern using numbers and symbols. Suture coding helps construct an infrastructure for surgical suture science. It facilitates the easy understanding and learning of suturing techniques and patterns as well as detects the relationship between the different patterns. Guide points are fixed on both edges of the wound to act as a guideline to help practice suture pattern techniques. The arrangement is fixed as 1-3-5-7 and a-c-e-g on one side (whether right or left) and as 2-4-6-8 and b-d-f-h on the other side. Needle placement must start from number 1 or letter "a" and continue to follow the code till the end of the stitching. Some rules are created to be adopted for the application of suture coding. A suture trainer containing guide points that simulate the coding process is used to facilitate the learning of the coding method. (120) Is the code of simple interrupted suture pattern; (ab210) is the code of vertical mattress suture pattern, and (013465)²/3 is the code of Cushing suture pattern. (0A1) Is suggested as a surgical suture language that gives the name and type of the suture pattern used to facilitate its identification. All suture patterns known in the world should start with (0), (A), or (1). There is a relationship between 2 or more surgical patterns according to their codes. It can be concluded that every suture pattern has its own code that helps in the identification of its type, structure, and method of application. Combination between numbers and symbols helps in the understanding of suture techniques easily without complication. There are specific relationships that can be identified between different suture patterns. Coding methods facilitate suture patterns learning process. The use of suture coding can be a good

  10. Geochemical Constraints for Mercury's PCA-Derived Geochemical Terranes (United States)

    Stockstill-Cahill, K. R.; Peplowski, P. N.


    PCA-derived geochemical terranes provide a robust, analytical means of defining these terranes using strictly geochemical inputs. Using the end members derived in this way, we are able to assess the geochemical implications for Mercury.

  11. Circum-North Pacific tectonostratigraphic terrane map (United States)

    Nokleberg, Warren J.; Parfenov, Leonid M.; Monger, James W.H.; Baranov, Boris B.; Byalobzhesky, Stanislav G.; Bundtzen, Thomas K.; Feeney, Tracey D.; Fujita, Kazuya; Gordey, Steven P.; Grantz, Arthur; Khanchuk, Alexander I.; Natal'in, Boris A.; Natapov, Lev M.; Norton, Ian O.; Patton, William W.; Plafker, George; Scholl, David W.; Sokolov, Sergei D.; Sosunov, Gleb M.; Stone, David B.; Tabor, Rowland W.; Tsukanov, Nickolai V.; Vallier, Tracy L.; Wakita, Koji


    The companion tectonostratigraphic terrane and overlap assemblage of map the Circum-North Pacific presents a modern description of the major geologic and tectonic units of the region. The map illustrates both the onshore terranes and overlap volcanic assemblages of the region, and the major offshore geologic features. The map is the first collaborative compilation of the geology of the region at a scale of 1:5,000,000 by geologists of the Russian Far East, Japanese, Alaskan, Canadian, and U.S.A. Pacific Northwest. The map is designed to be a source of geologic information for all scientists interested in the region, and is designed to be used for several purposes, including regional tectonic analyses, mineral resource and metallogenic analyses (Nokleberg and others, 1993, 1994a), petroleum analyses, neotectonic analyses, and analyses of seismic hazards and volcanic hazards. This text contains an introduction, tectonic definitions, acknowledgments, descriptions of postaccretion stratified rock units, descriptions and stratigraphic columns for tectonostratigraphic terranes in onshore areas, and references for the companion map (Sheets 1 to 5). This map is the result of extensive geologic mapping and associated tectonic studies in the Russian Far East, Hokkaido Island of Japan, Alaska, the Canadian Cordillera, and the U.S.A. Pacific Northwest in the last few decades. Geologic mapping suggests that most of this region can be interpreted as a collage of fault-bounded tectonostratigraphic terranes that were accreted onto continental margins around the Circum-

  12. Continuation, south of Oaxaca City (southern Mexico) of the Oaxaca-Juarez terrane boundary and of the Oaxaca Fault. Based in MT, gravity and magnetic studies (United States)

    Campos-Enriquez, J. O.; Corbo, F.; Arzate-Flores, J.; Belmonte-Jimenez, S.; Arango-Galván, C.


    The Oaxaca Fault represents Tertiary extensional reactivation of the Juarez shear zone constituting the boundary-suture between the Oaxaca and Juarez terranes (southern Mexico). South of Oaxaca City, the fault trace disappears and there are not clear evidences for its southward continuation at depth. The crust in southern México has been studied through seismic refraction, and seismological and magnetotelluric (MT) studies. The refraction studies did not image the Oaxaca Fault. However, previous regional MT studies suggest that the Oaxaca-Juarez terrane boundary lies to the east of the Zaachila and Mitla sub-basins, which implies sinistral displacement along the Donaji Fault. Campos-Enriquez et al. (2009) established the shallow structure of the Oaxaca-Juarez terrane boundary based in detailed gravity and magnetic studies. This study enabled: 1) to establish the shallow structure of the composite depression comprising three N-S sub-basins: the northern Etla and southern Zaachila sub-basins separated by the Atzompa sub-basin. According to the Oaxaca-Juarez terrane boundary is displaced sinistrally ca. 20 km along the E-W Donají Fault, which defines the northern boundary of the Zaachila sub-basin. At the same time,, the Oaxaca Fault may either continue unbroken southwards along the western margin of a horst in the Zaachila sub-basin or be offset along with the terrane boundary. This model implies that originally the suture was continuous south of the Donaji Fault. A constraint for the accreation of the Oaxaca and Juarez terranes. Thirty MT soundings were done in the area of the Central Valleys, Oaxaca City (southern Mexico). In particular we wanted to image the possible southward continuation of the Oaxaca Fault. 22 Mt sounding are located along two NE-SW profiles to the northern and to the south of the City of Oaxaca. To the north of Oaxaca City, the electrical resistivity distribution obtained show a clear discontinuity across the superficial trace of the Oaxaca

  13. The Apuseni Mountains, Romania, a Variscan Collage of Ordovician Gondwanan Terranes (United States)

    Balintoni, I. C.; Balica, C.; Zaharia, L.; Chen, F.; Cliveti, M.; Hann, H. P.; Ghergari, L.


    The basement of the Apuseni Mountains, Romania, consists of three pre-Variscan terranes, sutured during an Early Variscan amalgamation around 351 Ma (Balintoni et al., this volume). The northern Someş Terrane (ST) is predominantly gneissic, while the southern Baia de Arieş Terrane (BAT) is dominated by the presence of large carbonate lenses, although metagranites and other types of orthogneisses can be found. These two terranes are sutured through the Biharia terrane, probably an accreted island arc. LA-ICP-MS datings on zircons extracted from orthogneisses and metagranites were performed in order to constrain the age of ST and BAT. A number of previously CL-imaged crystals were ablated at the China's University of Geosciences, Wuhan. From ST we dated an orthogneiss occurring in structurally lowermost position, a metatuff situated in the upper strongly retrogressed part and a twenty detrital crystal population sampled from a metasandstone. The 206Pb/238U apparent ages were projected using the weighted average plots.A magmatic crystallization age of 472.8±5.0 Ma (Upper Early Ordovician) resulted for one of the orthogneiss samples, besides several older ages at 505.7, 566.3 and 708.2 Ma corresponding to inherited cores. Another sample from the same rock appeared strongly affected by lead loss during a later thermotectonic event, most of the apparent ages grouping around 352±14 Ma. This age is similar with the age of the suture between ST and BT (Balintoni et al., this volume). The main zircon population of one metatuff sample furnished an averaged age of 423±7.2 Ma, also found in two additional samples, but their significance is obscure for the moment. Two primary magmatic ages arise at 464.2 and 473.8 Ma, an older value of 758.7 Ma corresponding to an inherited core. Detrital zircon ages range between 534.8 and 2596.8 Ma. The younger value represents an upper age constraint for the protolith age of ST-rocks. From BAT we dated the Lupşa metaporphyroid and the

  14. Geology and metallogeny of the Ar Rayn terrane, eastern Arabian shield: Evolution of a Neoproterozoic continental-margin arc during assembly of Gondwana within the East African orogen (United States)

    Doebrich, J.L.; Al-Jehani, A. M.; Siddiqui, A.A.; Hayes, T.S.; Wooden, J.L.; Johnson, P.R.


    characteristics of the Ar Rayn terrane are analogous to the Andean continental margin of Chile, with opposite subduction polarity. The Ar Rayn terrane represents a continental margin arc that lay above a west-dipping subduction zone along a continental block represented by the Afif composite terrane. The concentration of epithermal, porphyry Cu and IOCG mineral systems, of central arc affiliation, along the AAF suggests that the AAF is not an ophiolitic suture zone, but originated as a major intra-arc fault that localized magmatism and mineralization. West-directed oblique subduction and ultimate collision with a land mass from the east (East Gondwana?) resulted in major transcurrent displacement along the AAF, bringing the eastern part of the arc terrane to its present exposed position, juxtaposed across the AAF against a back-arc basin assemblage represented by the Abt schist of the Ad Dawadimi terrane. Our findings indicate that arc formation and accretionary processes in the Arabian shield were still ongoing into the latest Neoproterozoic (Ediacaran), to about 620-600 Ma, and lead us to conclude that evolution of the Ar Rayn terrane (arc formation, accretion, syn- to postorogenic plutonism) defines a final stage of assembly of the Gondwana supercontinent along the northeastern margin of the East African orogen. ?? 2007 Elsevier B.V. All rights reserved.

  15. Cenozoic extensional tectonics of the Western Anatolia Extended Terrane, Turkey

    International Nuclear Information System (INIS)

    Cemen, I; Catlos, E J; Gogus, O; Diniz, E; Hancer, M


    The Western Anatolia Extended Terrane in Turkey is located on the eastern side of the Aegean Extended Terrane and contains one of the largest metamorphic core complexes in the world, the Menderes massif. It has experienced a series of continental collisions from the Late Cretaceous to the Eocene during the formation of the Izmir-Ankara-Erzincan suture zone. Based our field work and monazite ages, we suggest that the north-directed postcollisional Cenozoic extension in the region is the product of three consecutive stages, triggered by three different mechanisms. The first stage was initiated about 30 Ma ago, in the Oligocene by the Orogenic Collapse the thermally weakened continental crust along the north-dipping Southwest Anatolian shear zone. The shear zone was formed as an extensional simple-shear zone with listric geometry at depth and exhibits predominantly normal-slip along its southwestern end. But, it becomes a high-angle oblique-slip shear zone along its northeastern termination. Evidence for the presence of the shear zone includes (1) the dominant top to the north-northeast shear sense indicators throughout the Menderes massif, such as stretching lineations trending N10E to N30E; and (2) a series of Oligocene extensional basins located adjacent to the shear zone that contain only carbonate and ophiolitic rock fragments, but no high grade metamorphic rock fragments. During this stage, erosion and extensional unroofing brought high-grade metamorphic rocks of the Central Menderes massif to the surface by the early Miocene. The second stage of the extension was triggered by subduction roll-back and associated back-arc extension in the early Miocene and produced the north-dipping Alasehir and the south-dipping Bueyuek Menderes detachments of the central Menderes massif and the north-dipping Simav detachment of the northern Menderes massif. The detachments control the Miocene sedimentation in the Alasehir, Bueyuek Menderes, and Simav grabens, containing high

  16. Precambrian terranes of African affinities in the southeastern part of Brazil and Uruguay

    International Nuclear Information System (INIS)

    Basei, M.A.S; Junior, Siga; Harara, O.M; Preciozzi, F; Sato, K; Kaufuss, G


    distinct, representing the main suture that separates the terranes of African and South-American affinities. As observed in figure 1, it is considered in this article that the region of African affinity is constituted by the terrains located east of the Major Gercino-Sierra Ballena suture zone, being represented by two major units: the Granite Belt - outcropping along the whole eastern portion of the Brazilian southern region, and the Punta del Este terrain (PET) south-easternmost of Uruguay. The Punta del Este Terrane (PET) is composed of a series of gneisses and migmatites formed in the 1000-900 Ma interval, according to Preciozzi et al. (1999; Basei et al 2000), intensely reworked during the Rio Doce orogeny (600-500 Ma). These authors proposed that the terranes situated east of the Alferes-Cordilheira Shear Zone should not integrate the Granite Belt, suggesting that this crustal segment represent in South America terranes related to the Namaqua Belt recognized in the southwestern portion of the African continent. Similar terranes have not been recognized in Brazil and Argentina. In PET, three major tectonic units can be characterized: a gneissic-migmatitic basement, a low-grade metasedimentary cover (Rocha Group) and a post-tectonic series that includes alkaline granitoids and acid volcanic rocks. Considering that the PET basement correlates with the Namaqua Complex gneisses, the Rocha Group was tentatively correlated with the Gariep Group supracrustal units (au)

  17. Geological and Geophysical Integration Regarding a Structural Evolution Modelling of a Suture Zone Controlled by a Cratonic Buttress - The Case of Dom Feliciano Orogenic Belt, SSE Brazil, Implications for Western Gondwana Assembly (United States)

    Bruno, H.; Almeida, J.; Heilbron, M. C. P. L.; Salomão, M.


    The matters surrounding the amalgamation of tectonic blocks during the Brasiliano / Pan-African orogeny have been the main subject of study of several works in recent years. The main objective of this work is the hierarchy and discrimination of the boundaries between the known tectonic blocks, integrating geological and geophysical data. The geology of the study area is dominated by Precambrian terranes; Luís Alves Terrane, the vulcanosedimentary sequences of the Itajaí and Campo Alegre Basins, the metasedimentary sequences of the Brusque and Paranaguá Terranes and their granitic suites besides the granitoids of the Florianópolis Terrane. The shear zones and faults that separate these crustal blocks were developed during the Brasiliano / Pan-African orogenic cycle that led to the formation of the supercontinent Gondwana. These tectonic boundaries generally separate blocks of different rheology and crustal thickness. The integration of geological and geophysical data allowed the identification of important structural lineaments and crustal boundaries. The presented geodynamic model suggests that the suture between the block composed of the Brusque, Paranaguá and Florianópolis Terranes and the block composed by the Luís Alves Terrane is the Itajaí Perimbó Shear Zone, and not the Major Gercino Shear Zone as previously suggested. Considering the Itajaí Perimbó Shear Zone as the suture zone, the metassediments of the Brusque Terrane were deposited on the basement of the Florianópolis Terrane, hereby declared as part of the Angola Craton, and are correlated to the metassediments of the Paranaguá Terrane as a passive margin that in approximately ca. 650 My became active margin, functioning as a forearc basin. The oblique collision between the blocks would have occurred with the development of a dextral transpression in the Itajaí Perimbó Shear Zone, separating the Luís Alves Terrane from the Brusque Terrane, a sinistral transcurrence represented by the

  18. North America as an exotic terrane'' and the origin of the Appalachian--Andean Mountain system

    Energy Technology Data Exchange (ETDEWEB)

    Dalziel, I.W.D; Gahagan, L.M. (Univ. of Texas, Austin, TX (United States). Inst. for Geophysics); Dalla Salda, L.H. (Univ. Nacional de La Plata, La Plata (Argentina). Centro de Investigaciones Geologicas)


    North America was sutured to Gondwana in the terminal Alleghanian event of Appalachian orogenesis, thus completing the late Paleozoic assembly of Pangea. The suggestion that the Pacific margins of East Antarctica-Australia and Laurentia may have been juxtaposed during the Neoproterozoic prompts reevaluation of the widely held assumptions that the ancestral Appalachian margin rifted from northwestern Africa during the earliest Paleozoic opening of Iapetus, and remained juxtaposed to that margin, even though widely separated from it at times, until the assembly of Pangea. The lower Paleozoic carbonate platform of northwestern Argentina has been known for a long time to contain Olenellid trilobites of the Pacific or Columbian realm. Although normally regarded as some kind of far-travelled terrane that originated along the Appalachian margin of Laurentia, it has recently been interpreted as a fragment detached from the Ouachita embayment of Laurentia following Taconic-Famatinian collision with Gondwana during the Ordovician. The Oaxaca terrane of Mexico, on the other hand, contains a Tremadocian trilobite fauna of Argentine-Bolivian affinities, and appears to have been detached from Gondwana following the same collision. The Wilson cycle'' of Iapetus ocean basin opening and closing along the Appalachian and Andean orogens may have involved more than one such continental collision during clockwise drift of Laurentia around South America following late Neoproterozoic to earliest Cambrian separation. Together with the collisions of baltic and smaller terranes with Laurentia, this could explain the protracted Paleozoic orogenic history of both the Appalachian and proto-Andean orogens.

  19. The history of barbed sutures. (United States)

    Ruff, Gregory L


    Ligatures have been used for millennia to close wounds. Sterilization and synthetic polymers that degrade in a commensurate fashion with wound healing have been the most significant improvements in these age-old devices. However, the constricting loop of a traditional suture and subsequent ischemia ("approximate, don't strangulate") still account for the most common cause of wound dehiscence-necrosis. Inspired by the quill of the North American porcupine, I envisioned a bidirectional array of barbs that could secure tissue without relying on constricting loops. One set of barbs could anchor the other. In this article, I document the development process of these barbed sutures from concept to patent to manufacture and US Food and Drug Administration approval. Knotless, strong, and easy to place, barbed sutures could foreseeably supplant conventional sutures, particularly as endoscopic procedures become more common. They also offer the intriguing potential to suspend ptotic tissues without surgical intervention.

  20. Geophysical modeling of the northern Appalachian Brompton-Cameron, Central Maine, and Avalon terranes under the New Jersey Coastal Plain (United States)

    Maguire, T.J.; Sheridan, R.E.; Volkert, R.A.


    A regional terrane map of the New Jersey Coastal Plain basement was constructed using seismic, drilling, gravity and magnetic data. The Brompton-Cameron and Central Maine terranes were coalesced as one volcanic island arc terrane before obducting onto Laurentian, Grenville age, continental crust in the Taconian orogeny [Rankin, D.W., 1994. Continental margin of the eastern United States: past and present. In: Speed, R.C., (Ed.), Phanerozoic Evolution of North American Continent-Ocean Transitions. DNAG Continent-Ocean Transect Volume. Geological Society of America, Boulder, Colorado, pp. 129-218]. Volcanic island-arc rocks of the Avalon terrane are in contact with Central Maine terrane rocks in southern Connecticut where the latter are overthrust onto the Brompton-Cameron terrane, which is thrust over Laurentian basement. Similarities of these allochthonous island arc terranes (Brompton-Cameron, Central Maine, Avalon) in lithology, fauna and age suggest that they are faulted segments of the margin of one major late Precambrian to early Paleozoic, high latitude peri-Gondwana island arc designated as "Avalonia", which collided with Laurentia in the early to middle Paleozoic. The Brompton Cameron, Central Maine, and Avalon terranes are projected as the basement under the eastern New Jersey Coastal Plain based on drill core samples of metamorphic rocks of active margin/magmatic arc origin. A seismic reflection profile across the New York Bight traces the gentle dipping (approximately 20 degrees) Cameron's Line Taconian suture southeast beneath allochthonous Avalon and other terranes to a 4 sec TWTT depth (approximately 9 km) where the Avalonian rocks are over Laurentian crust. Gentle up-plunge (approximately 5 degrees) projections to the southwest bring the Laurentian Grenville age basement and the drift-stage early Paleozoic cover rocks to windows in Burlington Co. at approximately 1 km depth and Cape May Co. at approximately 2 km depths. The antiformal Shellburne

  1. Linking Tengchong Terrane in SW Yunnan with Lhasa Terrane in southern Tibet through magmatic correlation (United States)

    Xie, Jincheng; Zhu, Dicheng; Dong, Guochen; Zhao, Zhidan; Wang, Qing


    New zircon U-Pb data, along with the data reported in the literature, reveal five phases of magmatic activity in the Tengchong Terrane since the Early Paleozoic with spatial and temporal variations summarized as: Cambrian-Ordovician (500-460 Ma) to the eastern, minor Triassic (245-206 Ma) in the eastern and western, abundant Early Cretaceous (131-114 Ma) in the eastern, extensive Late Cretaceous (77-65 Ma) in the central, and Paleocene-Eocene (65-49 Ma) in the central and western Tengchong Terrane, in which the Cretaceous-Eocene magmatism was migrated from east to west (Xu et al., 2012). The increased zircon eHf(t) of the Early Cretaceous granitoids from -12.3 to -1.4 at ca. 131-122 Ma to -4.6 to +7.1 at ca. 122-114 Ma identified for the first time in this study and the magmatic flare-up at ca. 53 Ma in the central and western Tengchong Terrane (Wang et al., 2014, Ma et al., 2015) indicate the increased contributions from mantle- or juvenile crust-derived components. The spatial and temporal variations and changing magmatic compositions with time in the Tengchong Terrane closely resemble the Lhasa Terrane in southern Tibet. Such similarities, together with the data of stratigraphy and paleobiogeography (Zhang et al., 2013), enable us to propose that the Tengchong Terrane in SW Yunnan is most likely linked with the Lhasa Terrane in southern Tibet, both of which experience similar tectonomagmatic histories since the Early Paleozoic. References Ma, L.Y., Wang, Y.J., Fan, W.M., Geng, H.Y., Cai, Y.F., Zhong, H., Liu, H.C., Xing, X.W., 2014. Petrogenesis of the early Eocene I-type granites in west Yingjiang (SW Yunnan) and its implication for the eastern extension of the Gangdese batholiths. Gondwana Research 25, 401-419. Wang, Y.J., Zhang, L.M., Cawood, P.A., Ma, L.Y., Fan, W.M., Zhang, A.M., Zhang, Y.Z., Bi, X.W., 2014. Eocene supra-subduction zone mafic magmatism in the Sibumasu Block of SW Yunnan: Implications for Neotethyan subduction and India-Asia collision

  2. Constraints of detrital zircon U-Pb ages and Hf isotopes on the provenance of the Triassic Yidun Group and tectonic evolution of the Yidun Terrane, Eastern Tibet (United States)

    Wang, Bai-Qiu; Wang, Wei; Chen, Wei Terry; Gao, Jian-Feng; Zhao, Xin-Fu; Yan, Dan-Ping; Zhou, Mei-Fu


    Eastern Tibet to the west of the Yangtze Block consists of the Yidun and Songpan-Ganzi Terranes, separated by the Ganzi-Litang suture zone. The Yidun Terrane includes the Zhongza Massif to the west, but the eastern part of the Yidun terrane is covered by the Yidun Group extending from the south (Shangri-La region) to the north (Changtai region). The Yidun Group, from the base upward, includes the Lieyi, Qugasi, Tumugou and Lanashan formations, which are mainly composed of volcanic-flysch successions. Based on the ages of volcanic interlayers and plutonic intrusions, depositional ages of the Qugasi and Tumugou formations are considered to be slightly older than 230 Ma and ca. 220-230 Ma respectively, which are prominently older than the previous estimates. The Yidun Group in the Changtai region has two prominent detrital zircon age peaks at 400-480 and 880-980 Ma and a minor peak at 2.45-2.50 Ga. This pattern suggests a detritus source from the Zhongza Massif, which was a micro-continent separated from the western Yangtze Block. In contrast, the Yidun Group in the Shangri-La region has various zircon age spectra among different formations. The Qugasi Formation in this region has detrital zircon age patterns similar to the Yidun Group in the Changtai region. However, the overlying Tumugou Formation shows distinct age peaks at Triassic (220-240 Ma), Neoproterozoic (~ 720-880 Ma), and Paleoproterozoic (~ 1.75-1.90 Ga). This age pattern is similar to that of the Xikang Group of the Songpan-Ganzi Terrane to the east. The detrital zircon age difference between the Qugasi and Tumugou formations in this region indicates a transition of sedimentary sources from the Zhongza Massif to locally distributed Triassic magmatic rocks at ~ 230 Ma. It is thus suggested that the Songpan-Ganzi Terrane may have been connected to or collided with the southern part of the Yidun Terrane during the Late Triassic, whereas the Songpan-Ganzi Terrane and the northern part of the Yidun Terrane

  3. Tectonostratigraphic terranes of the frontier circum-Pacific region

    Energy Technology Data Exchange (ETDEWEB)

    Howell, D.G.; Jones, D.L.; Schermer, E.R.


    Many major exploration frontiers around the Pacific are in regions where complex geologic relations reflect plate-tectonic processes, crustal mobility, and accretion of exotic terranes. The destruction of the proto-Pacific ocean (Panthalassa) involved accretion of terranes to cratonal regions such as Gondwana and Laurasia. Terranes in southwestern New Zealand and eastern Antarctica were also probably accreted during the Paleozoic. The southern margin of Siberia, extending into China, underwent a protracted period of accretion from the late Precambrian through the early Mesozoic. Mid-Paleozoic accretion is reflected in the Innuitian foldbelt of the Arctic Ocean, the Black Clastic unit of the northern Rocky Mountains, and the Antler orogeny of the western US cordillera. The Mesozoic breakup of Pangaea and the acceleration of subduction aided in the rifting and dispersal of terranes from equatorial paleolatitudes. Fragments of these terranes now compose much of the continental margins of the Pacific basin, including New Zealand, Indochina, southern China, southeast Siberia, the North American cordillera, and South America. Some terranes are presently being further fragmented by post-accretionary dispersion processes such as strike-slip faulting in western North America and Japan. Although the character and distribution of terranes in the western US are fairly well documented, details are needed for other terranes around the Pacific basin. Interpretation of structure and stratigraphy at depth will be aided by more data on the timing of accretion and the nature of deformation associated with accretion and dispersion. Such data are needed for further define specific exploration targets in the circum-Pacific region.

  4. Torsion of monofilament and polyfilament sutures under tension decreases suture strength and increases risk of suture fracture.

    LENUS (Irish Health Repository)

    Hennessey, D B


    A continuous running suture is the preferential method for abdominal closure. In this technique the suture is secured with an initial knot and successive tissue bites are taken. At each tissue bite, the needle is rotated through the tissue; in doing so, the suture can twist around the knot which acts as an anchor.

  5. [Laparoscopic suture or open suture in perforated duodenal ulcer]. (United States)

    Nicolau, A E; Ionescu, G; Iordache, F; Mehic, R; Spătaru, A


    Between Nov. 1994-Jan. 2001 we performed laparoscopic suture with omentoplasty of perforated duodenal ulcer (PDU) in 51 patients out of 56 it was intended (this constituted the laparoscopic group--LG). The selection criteria were young patients, age < 40 years, no associated diseases, onset of the operation under 12 hours from the occurrence of the perforation, absence of clear ulcer history. In the same period, we performed an open suture based on the same criteria in 105 patients (open group--OP). The results showed a difference between needed analgesia (2.8 days for LG vs. 5.2 days for OG) and a hospital stay of 6.1 days in LG vs. 7.7 days in OG. The incidence of postoperative complications was 5.88% in the LG and 7.61% in the OG with 1.96% and respective 1.90% reoperation rate. In conclusion laparoscopic suture of PDU with associated postoperative modern therapy of ulcer disease could be the treatment of choice in young patients.

  6. Syn- and Post-Accretionary Structures in the Neoproterozoic Central Allaqi-Heiani Suture Zone, Southeastern Egypt (United States)

    Abdeen, M. M.; Abdelghaffar, A. A.


    The Allaqi-Heiani suture (AHS) is the western part of the main Allaqi-Heiani-Gerf-Onib-Sol Hamed-Yanbu suture and represents one of the Neoproterozoic, arc-arc sutures in the Arabian-Nubian Shield (ANS). It separates the ca. 750 Ma South Eastern Desert terrane in the north from the ca. 830-720 Ma Gabgaba terrane in the south. The AHS is a deformed belt of ophiolitic rocks, syn-tectonic granitoids and metasediments. The central AHS zone is divided into three structural domains. The western domain (Ι) is characterized by NNE low thrusts and SSW-vergent folds. The central domain (ΙΙ) includes upright tight to isoclinal NNW-SSE oriented folds and transpressional faults. The eastern domain (ΙΙΙ) shows NNW-SSE oriented open folds. Structural analysis indicates that the area has a poly-phase deformation history involving at least two events. Event D1 was an N-S to NNE-SSW regional shortening generating the SSW-verging folds and the NNE dipping thrusts. Event D2 was an ENE-WSW shortening producing NNW-SSE oriented folds in the central and eastern parts of the study area and reactivating older thrusts with oblique-slip reverse fault movement. The tectonic evolution of the area involves two episodes of collision: an early collision between the South Eastern Desert terrane and the Gabgaba terrane along the AHS after the consumption of a basin floored by oceanic crust above a north-dipping subduction zone; and a later collision between East- and West-Gondwanas at ca. 750-650 Ma, leading to the closure of the Mozambique Ocean. This collision deformed the AHS along N-S trending shortening zones and produced NW-SE and NE-SW oriented sinistral and dextral transpressional faults, respectively. The early collision episode is related to the terrane accretion during the early Pan-African orogen, while the later phase is related to a late Pan-African or Najd orogen.

  7. [Bases and methods of suturing]. (United States)

    Vogt, P M; Altintas, M A; Radtke, C; Meyer-Marcotty, M


    If pharmaceutic modulation of scar formation does not improve the quality of the healing process over conventional healing, the surgeon must rely on personal skill and experience. Therefore a profound knowledge of wound healing based on experimental and clinical studies supplemented by postsurgical means of scar management and basic techniques of planning incisions, careful tissue handling, and thorough knowledge of suturing remain the most important ways to avoid abnormal scarring. This review summarizes the current experimental and clinical bases of surgical scar management.

  8. [Suture simulator - Cleft palate surgery]. (United States)

    Devinck, F; Riot, S; Qassemyar, A; Belkhou, A; Wolber, A; Martinot Duquennoy, V; Guerreschi, P


    Cleft palate requires surgery in the first years of life, furthermore repairing anatomically the soft and hard palate is complex on a surgical level because of the fine tissues and the local intraoral configuration. It is valuable to train first on simulators before going to the operating room. However, there is no material dedicated to learning how to perform intraoral sutures in cleft palate surgery. We made one, in an artisanal manner, in order to practice before the real surgical gesture. The simulator was designed based on precise anatomical data. A steel pipe, fixed on a rigid base represented the oral cavity. An adapted split spoon represented the palate. All pieces could be removed in order to apply a hydrocellular dressing before training for sutures. Our simulator was tested by 3 senior surgeons in our department in close to real-life conditions in order to evaluate its anatomical accuracy. It is valuable to have a simulator to train on cleft palate sutures within teaching university hospitals that manage this pathology. Our simulator has a very low cost, it is easy to make and is anatomically accurate. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  9. The suspension (Frost) suture: experience and applications. (United States)

    Connolly, Karen L; Albertini, John G; Miller, Christopher J; Ozog, David M


    The Frost suture is a well-known surgical technique for providing upward tension on the lower lid to prevent or correct ectropion after surgical interventions in the periorbital area. Despite its relatively common use, comprehensive information on executing this technique is not readily available. To review eyelid anatomy, indications, and proper technique for performing the Frost suture, as well as potential complications. A review of the literature on Frost sutures was performed. Cadaveric dissection was performed to demonstrate placement of the Frost suture. The Frost suture is a useful method to reduce the risk of ectropion after surgery near the lower eyelid. Downward pull on the lid can occur with normal wound contracture even if ectropion is not present with the initial repair, reinforcing the need for preventive measures. Potential complications of this technique include superficial skin erosion of the upper lid, corneal abrasion, and blockage of the field of vision while the suture is in place.

  10. Accretionary history of the Altai-Mongolian terrane: perspectives from granitic zircon U-Pb and Hf-isotope data (United States)

    Cai, Keda; Sun, Min; Xiao, Wenjiao


    The Central Asian Orogenic Belt (CAOB) consists of many tectonic terranes with distinct origin and complicated evolutionary history. Understanding of individual block is crucial to reconstruct the geodynamic history of the gigantic accetionary collage. This study presents zircon U-Pb ages and Hf isotopes for the granitoid rocks in the Russian Altai mountain range (including Gorny Altai, Altai-Mongolian terrane and CTUS suture zone between them), in order to clarify the timing of granitic magmatism, source nature, continental crustal growth and tectonic evolution. Our dating results suggest that granitic magmatism of the Russian Altai mountain range occurred in three major episodes including 445~429 Ma, 410~360 Ma and ~241 Ma. Most of the zircons within the Paleozoic granitoids present comparable positive ɛHf(t) values and Neoproterozoic crustal model ages, which favor the interpretation that the juvenile crustal materials produced in the early stage of CAOB were probably dominant sources for the Paleozoic magmatism in the region. The inference is also supported by widespread occurrence of short-lived juvenile materials including ophiolites, seamount relics and arc assemblages in the north CAOB. Consequently, the Paleozoic massive granitic rocks maybe not represent continental crustal growth at the time when they were emplaced, but rather record reworking of relatively juvenile Proterozoic crustal rocks although mantle-derived mafic magma was possibly involved to sever as heat engine during granitic magma generation. The Early Triassic granitic intrusion may be product in an intra-plate environment, as the case of same type rocks in the adjacent areas. The positive ɛHf(t) values (1.81~7.47) and corresponding Hf model ages (0.80~1.16 Ga) together with evidence of petrology are consistent with the interpretation that the parental magma of the Triassic granitic intrusion was produced from enriched mantle-derived sources under an usually high temperature condition

  11. Gravity and magnetic survey of the Oaxaca city region: Cenozoic horst-and-graben structure superimposed on the Oaxaca-Juarez terrane boundary, southern Mexico (United States)

    Campos-Enríquez, J. O.; Belmonte-Jiménez, S. I.; Keppie, J. D.; Ortega-Gutiérrez, F.; Arzate, J. A.; Martínez-Silva, J.; Martínez-Serrano, R. G.


    A geophysical survey of the Oaxaca Fault along the north-trending Etla and Zaachila valleys area, southern Mexico, shows a series of NNW-SSE Bouguer and magnetic anomalies with steeper gradients towards the east. The Oaxaca Fault represents Tertiary extensional reactivation of the Juarez shear zone that constitutes the boundary between the Oaxaca and Juárez terranes. Cooperative interpretation of six combined gravity and magnetic NE-SW profiles perpendicular to the valleys indicates the presence of a composite depression comprising three N-S sub-basins: the northern Etla and southern Zaachila sub-basins separated by the Atzompa sub-basin. The Etla sub-basin is bounded by the moderately E-dipping, Etla Fault and the more steeply W-dipping Oaxaca Fault, which together constitute a graben that continues southwards into the Atzompa graben. The deeper Zaachila sub-basin, south of Oaxaca city, is a wide V-shaped graben with a horst in the middle. The new geophysical data suggest that the Oaxaca-Juarez terrane boundary is displaced sinistrally ca. 20 km along the E-W Donají Fault, which defines the northern boundary of the Zaachila sub-basin. On the other hand, the Oaxaca Fault may either continue unbroken southwards along the western margin of the horst in the Zaachila sub-basin or be offset along with the terrane boundary. The sinistral movement may have taken place either during the Late Mesozoic-Early Cenozoic, Laramide Orogeny as a lateral ramp in the thrust plane or under Miocene-Pliocene, NE-SW extension. The former suggests that the Donají Fault is a transcurrent fault, whereas the latter implies that it is a transfer fault. The models imply that originally the suture was continuous south of the Donaji Fault and provide a constraint for the accretion of the Oaxaca and Juarez terranes.

  12. Comparison between suture anchor and transosseous suture for the modified-Broström procedure. (United States)

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


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

  13. Mesozoic and Cenozoic tectonics of the eastern and central Alaska Range: Progressive basin development and deformation in a suture zone

    Energy Technology Data Exchange (ETDEWEB)

    Ridgway, K.D.; Trop, J.M.; Nokleberg, W.J.; Davidson, C.M.; Eastham, K.R. [Purdue University, W. Lafayette, IN (United States). Dept. of Earth & Atmospheric Science


    Analysis of late Mesozoic and Cenozoic sedimentary basins, metamorphic rocks, and major faults in the eastern and central Alaska Range documents the progressive development of a suture zone that formed as a result of collision of an island-arc assemblage (the Wrangellia composite terrane) with the former North American continental margin. New basin-analysis, structural, and geochronologic data indicate the following stages in the development of the suture zone: (1) Deposition of 3-5 km of Upper Jurassic-Upper Cretaceous marine strata (the Kahiltna assemblage) recorded the initial collision of the island-arc assemblage with the continental margin. (2) Metamorphism of submarine-fan deposits of the Kahiltna basin, located near the leading edge of the island-arc assemblage, occurred at ca. 74 Ma, as determined from a new U-Pb zircon age for a synkinematic sill. (3) Shortening and exhumation of the suture zone peaked from 65 to 60 Ma on the basis of metamorphic and geochronologic data. (4) From 60 to 54 Ma, about 3 km of volcanic strata were deposited over deformed sedimentary strata of the Cantwell basin, and several granitic plutons (the McKinley sequence) were emplaced along the suture zone. (5) Following igneous activity, strike-slip displacement occurred from ca. 54 to 24 Ma along the Denali fault system, which had developed in the existing suture zone. (6) Regional transpressive shortening characterized the suture zone from ca. 24 Ma to the present. Regional subsidence resulted in Miocene coal seams up to 20 m thick and well-developed lacustrine deposits. Overlying the Miocene deposits are about 1.2 km of Pliocene and Holocene conglomeratic deposits. These mapping relationships provide evidence that regional shortening continues to the present in the eastern and central Alaska Range.

  14. Post thyroidectomy suture granuloma: a cytological diagnosis. (United States)

    Javalgi, Anita P; Arakeri, Surekha U


    There are known post thyroidectomized complications, a suture granuloma being less frequent, with its late complication mimicking recurrent thyroid cancer. A suture granuloma is a benign, granulomatous inflammatory reaction that occurs due to the use of non absorbable suture. It constitutes one of the late complications which altogether make up less than 2% of its incidence. A suture granuloma is similar to a foreign body reaction and it usually develops slowly as a painless, palpable asymptomatic mass over the years. It mimics a cancer recurrence or a lymph node metastasis. Here, we are reporting a case of a post thyroidectomy suture granuloma in a 46 years old lady who presented with a painless swelling in the lateral neck, with a past history of thyroidectomy 5 years back.

  15. Mesozoic and Cenozoic tectonics of the eastern and central Alaska Range: Progressive basin development and deformation in a suture zone (United States)

    Ridgway, K.D.; Trop, J.M.; Nokleberg, W.J.; Davidson, C.M.; Eastham, K.R.


    Analysis of late Mesozoic and Cenozoic sedimentary basins, metamorphic rocks, and major faults in the eastern and central Alaska Range documents the progressive development of a suture zone that formed as a result of collision of an island-arc assemblage (the Wrangellia composite terrane) with the former North American continental margin. New basin-analysis, structural, and geochronologic data indicate the following stages in the development of the suture zone: (1) Deposition of 3-5 km of Upper Jurassic-Upper Cretaceous marine strata (the Kahiltna assemblage) recorded the initial collision of the island-arc assemblage with the continental margin. The Kahiltna assemblage exposed in the northern Talkeetna Mountains represents a Kimmeridgian-Valanginian backarc basin that was filled by northwestward-flowing submarine-fan systems that were transporting sediment derived from Mesozoic strata of the island-arc assemblage. The Kahiltna assemblage exposed in the southern Alaska Range represents a Valanginian-Cenomanian remnant ocean basin filled by west-southwestward-flowing submarine-fan systems that were transporting sediment derived from Paleozoic continental-margin strata uplifted in the along-strike suture zone. A belt of retrograde metamorphism and a regional anticlinorium developed along the continental margin from 115 to 106 Ma, roughly coeval with the end of widespread deposition in the Kahiltna sedimentary basins. (2) Metamorphism of submarine-fan deposits of the Kahiltna basin, located near the leading edge of the island-arc assemblage, occurred at ca. 74 Ma, as determined from a new U-Pb zircon age for a synkinematic sill. Coeval with metamorphism of deposits of the Kahiltna basin in the southern part of the suture zone was development of a thrust-top basin, the Cantwell basin, in the northern part of the suture zone. Geologic mapping and compositional data suggest that the 4 km of Upper Cretaceous nonmarine and marginal marine sedimentary strata in this basin

  16. Geophysical constraints for terrane boundaries in southern Mongolia (United States)

    Guy, Alexandra; Schulmann, Karel; Munschy, Marc; Miehe, Jean-Marc; Edel, Jean-Bernard; Lexa, Ondrej; Fairhead, Derek


    The Central Asian Orogenic Belt (CAOB) is a typical accretionary orogen divided into numerous lithostratigraphic terranes corresponding to magmatic arcs, back arcs, continental basement blocks, accretionary wedges and metamorphic blocks. These terranes should be in theory characterized by contrasting magnetic and gravity signatures thanks to their different petrophysical properties. To test this hypothesis, the stratigraphically defined terranes in southern Mongolia were compared with potential field data to constrain their boundaries and extent. The existence of terranes in southern Mongolia cannot be attested by the uniform geophysical fabrics due to the lack of systematic correspondence between the high/low amplitude and high/low frequency geophysical domains and major terranes. Processed magnetic and gravity grids show that both gravity and magnetic lineaments are E-W trending in the west and correlate with direction of some geological units. In the east, both magnetic and gravity lineaments are disrupted by NE-SW trending heterogeneities resulting in complete blurring of the geophysical pattern. Correlation of magnetic signal with geological map shows that the magnetic highs coincide with late Carboniferous-early Permian volcanic and plutonic belts. The matched-filtering shows good continuity of signal to the depth located along the boundaries of these high magnetic anomalies which may imply presence of deeply rooted tectono-magmatic zones. The axes of high density bodies in the western and central part of the studied CAOB are characterized by periodic alternations of NW-SE trending high frequency and high amplitude gravity anomalies corresponding to late Permian to Triassic cleavage fronts up to 20 km wide. The matched-filtering analysis shows that the largest deformation zones are deeply rooted down to 20 km depth. Such a gravity signal is explained by the verticalization of high density mantle and lower crustal rocks due to localized vertical shearing

  17. A multicenter randomized controlled trial comparing absorbable barbed sutures versus conventional absorbable sutures for dermal closure in open surgical procedures. (United States)

    Rubin, J Peter; Hunstad, Joseph P; Polynice, Alain; Gusenoff, Jeffrey A; Schoeller, Thomas; Dunn, Raymond; Walgenbach, Klaus J; Hansen, Juliana E


    Barbed sutures were developed to reduce operative time and improve security of wound closure. The authors compare absorbable barbed sutures (V-Loc, Covidien, Mansfield, Massachusetts) with conventional (smooth) absorbable sutures for soft tissue approximation. A prospective multicenter randomized study comparing barbed sutures with smooth sutures was undertaken between August 13, 2009, and January 31, 2010, in 241 patients undergoing abdominoplasty, mastopexy, and reduction mammaplasty. Each patient received barbed sutures on 1 side of the body, with deep dermal sutures eliminated or reduced. Smooth sutures with deep dermal and subcuticular closure were used on the other side as a control. The primary endpoint was dermal closure time. Safety was assessed through adverse event reporting through a 12-week follow-up. A total of 229 patients were ultimately treated (115 with slow-absorbing polymer and 114 with rapid-absorbing polymer). Mean dermal closure time was significantly quicker with the barbed suture compared with the smooth suture (12.0 vs 19.2 minutes; P<.001), primarily due to the need for fewer deep dermal sutures. The rapid-absorbing barbed suture showed a complication profile equivalent to the smooth suture, while the slow-absorbing barbed suture had a higher incidence of minor suture extrusion. Barbed sutures enabled faster dermal closure quicker than smooth sutures, with a comparable complication profile. 1.

  18. Suture slippage in knotless suture anchors resulting in subacromial-subdeltoid bursitis. (United States)

    Hayeri, Mohammad Reza; Keefe, Daniel T; Chang, Eric Y


    Rotator cuff repair using a suture bridge and knotless suture anchors is a relatively new, but increasingly used technique. The suture bridge technique creates an anatomically similar and more secure rotator cuff repair compared with conventional arthroscopic techniques and the use of knotless anchors eliminates the challenges associated with knot tying during arthroscopic surgery. However, previous in vitro biomechanical tests have shown that the hold of the suture in a knotless suture anchor is far lower than the pullout strength of the anchor from bone. Up until now slippage has been a theoretical concern. We present a prospectively diagnosed case of in vivo suture loosening after rotator cuff repair using a knotless bridge technique resulting in subacromial-subdeltoid bursitis.

  19. On the roentgenomorphological correlations of cranial sutures

    International Nuclear Information System (INIS)

    Verkhoglyadova, T.P.; Koval', G.Yu.; Shuaa, T.I.


    The authors explain the essence of the zone of excessive transparence along the cranial sutures visualized on the X-ray pictures during the first year of life by presence of large number of rough-fiber bone in the marginal regions. The zone of ''physiological sclerosis'' is postulated as a result of summation of the bone margin shadows consisting of compact substance (osteones). Microscopic examination of skull in brain tumors revealed a delay in the formation of bone margins in the suture region with an excessive amount of connective and osteoid tissue while in craniostenosis closure of cranial sutures being with intensive bone formation as well as by closure of the bone margins by newly formed bone tissue around the vessels of the connective layer of the suture

  20. Aeromagnetic signatures of Precambrian shield and suture zones of Peninsular India

    Directory of Open Access Journals (Sweden)

    Mita Rajaram


    Full Text Available In many Precambrian provinces the understanding of the tectonic history is constrained by limited exposure and aeromagnetic data provide information below the surface cover of sediments, water, etc. and help build a tectonic model of the region. The advantage of using the aeromagnetic data is that the data set has uniform coverage and is independent of the accessibility of the region. In the present study, available reconnaissance scale aeromagnetic data over Peninsular India are analyzed to understand the magnetic signatures of the Precambrian shield and suture zones thereby throwing light on the tectonics of the region. Utilizing a combination of differential reduction to pole map, analytic signal, vertical and tilt derivative and upward continuation maps we are able to identify magnetic source distribution, tectonic elements, terrane boundaries, suture zones and metamorphic history of the region. The magnetic sources in the region are mainly related to charnockites, iron ore and alkaline intrusives. Our analysis suggests that the Chitradurga boundary shear and Sileru shear are terrane boundaries while we interpret the signatures of Palghat Cauvery and Achankovil shears to represent suture zones. Processes like metamorphism leave their signatures on the magnetic data: prograde granulites (charnockites and retrograde eclogites are known to have high susceptibility. We find that charnockites intruded by alkali plutons have higher magnetization compared to the retrogressed charnockites. We interpret that the Dharwar craton to the north of isograd representing greenschist to amphibolite facies transition, has been subjected to metamorphism under low geothermal conditions. Some recent studies suggest a plate tectonic model of subduction–collision–accretion tectonics around the Palghat Cauvery shear zone (PCSZ. Our analysis is able to identify several west to east trending high amplitude magnetic anomalies with deep sources in the region from

  1. Early Jurassic Volcanism in the South Lhasa Terrane, Southern Tibet: Record of Back-arc Extension in the Active Continental Margin (United States)

    Wei, Y.; Zhao, Z.; Zhu, D. C.; Wang, Z.; Liu, D.; Mo, X.


    Indus-Yarlung Zangbo Suture Zone (IYZSZ) represents the Mesozoic remnants of the Neo-Tethyan Ocean lithosphere after its northward subduction beneath the Lhasa Terrane. The evolution of the Neo-Tethyan Ocean prior to India-Asia collision remains unclear. To explore this period of history, we investigate zircon U-Pb geochronology, geochemistry and Nd-Hf isotopes of the Early Jurassic bimodal-like volcanic sequence around Dagze area, south Tibet. The volcanic sequence comprises calc-alkaline basalts to rhyolites whereas intermediate components are volumetrically restricted. Zircons from a basaltic andesite yielded crystallization age of 178Ma whereas those from 5 silicic rocks were dated at 183-174Ma, which suggest that both the basaltic and the silicic rocks are coeval. The basaltic rocks are enriched in LREE and LILE, and depleted in HFSE, with Epsilon Nd(t) of 1.6-4.0 and zircon Epsilon Hf(t) of 0.7-11.8, which implies that they were derived from a heterogenetic mantle source metasomatized by subduction components. Trace element geochemistry shows that the basaltic rocks are compositionally transitional from normal mid-ocean ridge basalts (N-MORB) to island arc basalts (IAB, e.g. Zedong arc basalts of ~160-155Ma in the south margin of Lhasa Terrane), with the signature of immature back-arc basin basalts. The silicic rocks display similar Nd-Hf isotopic features of the Gangdese batholith with Epsilon Nd(t) of 0.9-3.4 and zircon Epsilon Hf(t) of 2.4-17.7, indicating that they were possibly generated by anatexis of basaltic juvenile lower crust, instead of derived from the basaltic magma. These results support an Early to Middle Jurassic (183-155Ma) model that the back-arc extension tectonic setting were existing in the active continental margin in the south Lhasa Terrane.

  2. Modified method for bronchial suture by Ramirez Gama compared to separate stitches suture: experimental study

    Directory of Open Access Journals (Sweden)

    Vitor Mayer de Moura

    Full Text Available OBJECTIVE: To experimentally compare two classic techniques described for manual suture of the bronchial stump. METHODS: We used organs of pigs, with isolated trachea and lungs, preserved by refrigeration. We dissected 30 bronchi, which were divided into three groups of ten bronchi each, of 3mm, 5mm, and 7mm, respectively. In each, we performed the suture with simple, separated, extramucosal stitches in five other bronchi, and the technique proposed by Ramirez and modified by Santos et al in the other five. Once the sutures were finished, the anastomoses were tested using compressed air ventilation, applying an endotracheal pressure of 20mmHg. RESULTS: the Ramirez Gama suture was more effective in the bronchi of 3, 5 and 7 mm, and there was no air leak even after subjecting them to a tracheal pressure of 20mmHg. The simple interrupted sutures were less effective, with extravasation in six of the 15 tested bronchi, especially in the angles of the sutures. These figures were not significant (p = 0.08. CONCLUSION: manual sutures of the bronchial stumps were more effective when the modified Ramirez Gama suture was used in the caliber bronchi arms when tested with increased endotracheal pressure.

  3. A randomized clinical trial of knotless barbed suture vs conventional suture for closure of the uterine incision at cesarean delivery. (United States)

    Peleg, David; Ahmad, Ronan Said; Warsof, Steven L; Marcus-Braun, Naama; Sciaky-Tamir, Yael; Ben Shachar, Inbar


    Knotless barbed sutures are monofilament sutures with barbs cut into them. These sutures self-anchor, maintaining tissue approximation without the need for surgical knots. The hypothesis of this study was that knotless barbed suture could be used on the myometrium to close the hysterotomy at cesarean delivery. The objective was to compare uterine closure time, need for additional sutures, and blood loss between this and a conventional suture. This was a prospective, unblinded, randomized controlled trial conducted at the Ziv Medical Center, Zefat, Israel. The primary outcome was the length of time needed to close the uterine incision, which was measured from the start of the first suture on the uterus until obtaining uterine hemostasis. To minimize provider bias, women were randomized by sealed envelopes that were opened in the operating room just prior to uterine closure with either a bidirectional knotless barbed suture or conventional suture. Secondary outcomes included the number of additional hemostatic sutures needed and blood loss during incision closure. Patients were enrolled from August 2016 until March 2017. One hundred two women were randomized. Fifty-one had uterine closure with knotless barbed suture and 51 with conventional suture. The groups were similar for demographics as well as number of previous cesarean deliveries. Uterine closure time using the knotless barbed suture was significantly shorter than the conventional suture by a mean of 1 minute 43 seconds (P barbed sutures were associated with a lower need for hemostatic sutures (median 0 vs 1, P barbed suture is a reasonable alternative to conventional sutures because it reduced the closure time of the uterine incision. There was also less need for additional hemostatic sutures and slightly reduced estimated blood loss. Copyright © 2018 Elsevier Inc. All rights reserved.

  4. Siberia, the wandering northern terrane, and its changing geography through the Palaeozoic (United States)

    Cocks, L. Robin M.; Torsvik, Trond H.


    The old terrane of Siberia occupied a very substantial area in the centre of today's political Siberia and also adjacent areas of Mongolia, eastern Kazakhstan, and northwestern China. Siberia's location within the Early Neoproterozoic Rodinia Superterrane is contentious (since few if any reliable palaeomagnetic data exist between about 1.0 Ga and 540 Ma), but Siberia probably became independent during the breakup of Rodinia soon after 800 Ma and continued to be so until very near the end of the Palaeozoic, when it became an integral part of the Pangea Supercontinent. The boundaries of the cratonic core of the Siberian Terrane (including the Patom area) are briefly described, together with summaries of some of the geologically complex surrounding areas, and it is concluded that all of the Palaeozoic underlying the West Siberian Basin (including the Ob-Saisan Surgut area), Tomsk Terrane, Altai-Sayan Terranes (including Salair, Kuznetsk Alatau, Batenov, Kobdin and West Sayan), Ertix Terrane, Barguzin Terrane, Tuva-Mongol Terrane, Central Mongolia Terrane Assemblage, Gobi Altai and Mandalovoo Terranes, Okhotsk Terrane and much of the Verkhoyansk-Kolyma region all formed parts of peri-Siberia, and thus rotated with the main Siberian Craton as those areas were progressively accreted to the main Siberian Terrane at various times during the latest Neoproterozoic and Palaeozoic. The Ertix Terrane is a new term combining what has been termed the "Altay Terrane" or "NE Xinjiang" area of China, and the Baytag, Baaran and Bidz terranes of Mongolia. The Silurian Tuvaella brachiopod fauna is restricted only to today's southern parts of peri-Siberia. Thus, allowing for subsequent rotation, the fauna occurs only in the N of the Siberian Terrane, and, as well as being a helpful indicator of what marginal terranes made up peri-Siberia, is distinctive as being the only Silurian fauna known from northern higher latitudes globally. In contrast, the other terranes adjacent to peri

  5. Cauterization technique for suture erosion in transscleralfixation of intraocular lenses

    Directory of Open Access Journals (Sweden)

    Xu-Ting Hu


    Full Text Available Transscleral suturing is a commonly applied technique to fix intraocular implants in the sulcus. A major problem after transscleral implantation is suture erosion that normally happens in the late post-surgery period and may result in an increased incidence of endophthalmitis. Here we describe an original cauterization method by using a glass rod to melt the exposed suture end without damaging the suture knot in the sclera to avoid suture exposure in sclera-fixed IOL implantation. This is a simple, quick and effective technique that can be performed without conjunctiva incisions and will help to reduce suture erosion related complications.

  6. Characterization of the bending strength of craniofacial sutures. (United States)

    Maloul, Asmaa; Fialkov, Jeffrey; Whyne, Cari M


    The complex, thin and irregular bones of the human craniofacial skeleton (CFS) are connected together through bony articulations and connective tissues. These articulations are known as sutures and are commonly divided into two groups, facial and cranial sutures, based on their location in the CFS. CFS sutures can exhibit highly variable degrees of interdigitation and complexity and are believed to play a role in accommodating the mechanical demands of the skull. This study aimed to evaluate the mechanical behavior of CFS bone samples with and without sutures and to determine the effect of sutural interdigitations on mechanical strength. Sagittal, coronal, frontozygomatic and zygomaticotemporal sutures along with adjacent bone samples not containing sutures were excised from six fresh-frozen cadaveric heads. The interdigitation of the sutures was quantified through μCT based analysis. Three-point bending to failure was performed on a total of 29 samples. The bending strength of bone samples without sutures demonstrated a non-significant increase of 14% as compared to samples containing sutures (P=0.2). The bending strength of bones containing sutures was positively correlated to the sutural interdigitation index (R=0.701, P=0.002). The higher interdigitation indices found in human cranial vs. facial sutures may be present to resist bending loads as a functional requirement in protecting the brain. Copyright © 2012 Elsevier Ltd. All rights reserved.

  7. Comparison of suture types in the closure of scalp wounds.

    LENUS (Irish Health Repository)

    Bonham, Joseph


    Innovation in practice can benefit patients and healthcare providers but must be evidence based. This article describes a quantitative study of whether absorbable sutures are as beneficial as non-absorbable sutures in the management of simple scalp lacerations in adults. The results suggest that absorbable sutures can provide the same cosmetic and functional results as non-absorbable sutures. Their use can also reduce patient returns and save money and resources.

  8. 21 CFR 878.4830 - Absorbable surgical gut suture. (United States)


    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Absorbable surgical gut suture. 878.4830 Section 878.4830 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... surgical gut suture. (a) Identification. An absorbable surgical gut suture, both plain and chromic, is an...

  9. Tutoring Trainees to Suture: An Alternative Method for Learning How to Suture and a Way to Compensate for a Lack of Suturing Cases. (United States)

    Wongkietkachorn, Apinut; Rhunsiri, Peera; Boonyawong, Pangpoom; Lawanprasert, Attaporn; Tantiphlachiva, Kasaya


    Tutoring in suturing was developed to compensate for a shortage of suturing cases. The objective of this study was to compare ideal suturing score (ISS; 9 points), suturing time (min:sec), and suture placement error (mm) between medical students completing the suturing tutoring program and medical students attending ordinary medical school training program. Participants consisted of 2 groups of medical students who had never performed suturing. The study group had the role of suturing tutor to teach interested high school students. The control group consisted of volunteers from the ordinary medical school program. Skills measurement was performed by having students from both the groups perform 3 vertical mattress sutures on a model. The study group was tested at weeks 1, 9, and 10 to assess improvement. Both the groups were tested at week 10 to compare final learning outcome. There were 41 and 40 participants in the study group and the control group, respectively. ISS was significantly improved in the study group from week 1-week 10 (7.0 ± 1.3 vs. 8.2 ± 0.9, p = 0.01). At week 10, the study group had a higher mean ISS than the control group (8.2 ± 0.9 vs. 7.8 ± 1.1, p = 0.68). Mean suturing time and mean placement error were also lower in the study group at the end of suturing training (5:1 ± 1:0 vs. 5:2 ± 1:2, p = 0.13; 7.4 ± 7.4 vs. 8.0 ± 10.8, p = 0.44). Tutoring trainees to suture can improve a student's ability to learn how to suture. Copyright © 2016 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  10. Comparison of barbed unidirectional suture with figure-of-eight standard sutures in vaginal cuff closure in total laparoscopic hysterectomy. (United States)

    Karacan, Tolga; Ozyurek, Eser; Usta, Taner; Odacilar, Eylem; Hanli, Ulviye; Kovalak, Ebru; Dayan, Huseyin


    The aim of the study was to compare postoperative vaginal cuff complications due to the use of barbed sutures (V-Loc™ 180 unidirectional suture; Covidien, Mansfield, MA) and standard braided sutures (Vicryl ® ; Ethicon Inc., Somerville, MA) during vaginal cuff closure of patients undergoing a total laparoscopic hysterectomy (TLH) due to benign diseases. Eighty-nine patients were in the standard suture group and 208 patients were included in the barbed suture group. Vaginal cuff dehiscence was identified in only three (3.3%) patients within the standard suture group and none in the barbed suture group. Five (5.6%) patients in the standard suture group and two (0.9%) patients in the barbed suture group developed postoperative cuff infection/cellulitis. Duration of the surgery was significantly shorter in the barbed suture group than in the standard suture group (p barbed suture, which is used during TLH for vaginal cuff closure, is an applicable, safe and tolerable alternative to a standard suture. IMPACT STATEMENT What is already known on this subject: Barbed sutures are a relatively new type of suture that include sharp barbs inserted on monofilament material in various configurations, and are used for approximating tissues without any need for surgical knotting. They have increasingly been used in obstetrics and gynaecology in recent years, particularly in total laparoscopic hysterectomy and laparoscopic myomectomy. At present, there are a limited number of studies of V-Loc™ suture in the literature. What the results of this study add: We demonstrated that barbed sutures used for enabling vaginal cuff integrity did not cause major morbidity and mortality for the patient. We suggest that V-Loc™ 180 barbed sutures offer a practical, safe and tolerable alternative for surgeons because they are easy to use, do not cause a significant increase in vaginal cuff complications, and shorten the operating time. Our study with V-Loc™ 180 unidirectional barbed

  11. Automatic Detection of Wild-type Mouse Cranial Sutures

    DEFF Research Database (Denmark)

    Ólafsdóttir, Hildur; Darvann, Tron Andre; Hermann, Nuno V.

    , automatic detection of the cranial sutures becomes important. We have previously built a craniofacial, wild-type mouse atlas from a set of 10 Micro CT scans using a B-spline-based nonrigid registration method by Rueckert et al. Subsequently, all volumes were registered nonrigidly to the atlas. Using......, the observer traced the sutures on each of the mouse volumes as well. The observer outperforms the automatic approach by approximately 0.1 mm. All mice have similar errors while the suture error plots reveal that suture 1 and 2 are cumbersome, both for the observer and the automatic approach. These sutures can...

  12. Current manufacturing processes of drug-eluting sutures. (United States)

    Champeau, Mathilde; Thomassin, Jean-Michel; Tassaing, Thierry; Jérôme, Christine


    Drug-eluting sutures represent the next generation of surgical sutures since they fulfill their mechanical functions but also deliver the drug in their vicinity after implantation. These implants are produced by a variety of manufacturing processes. Drug-eluting sutures represent the next generation of surgical sutures since they fulfill their mechanical functions but also deliver the drug in their vicinity after implantation. These implants are produced by a variety of manufacturing processes. Two general approaches can be followed: (i) the ones that add the API into the material during the manufacturing process of the suture and (ii) the ones that load the API to an already manufactured suture. Areas covered: This review provides an overview of the current manufacturing processes for drug-eluting suture production and discusses their benefits and drawbacks depending on the type of drugs. The mechanical properties and the drug delivery profile of drug-eluting sutures are highlighted since these implants must fulfill both criteria. Expert opinion: For limited drug contents, melt extrusion and electrospinning are the emerging processes since the drug is added during the suture manufacture process. Advantageously, the drug release profile can be tuned by controlling the processing parameters specific to each process and the composition of the drug-containing polymer. If high drug content is targeted, the coating or grafting of a drug layer on a pre-manufactured suture allows for preservation of the tensile strength requirements of the suture.

  13. Feasibility of pure EFTR using an innovative new endoscopic suturing device: the Double-arm-bar Suturing System (with video). (United States)

    Mori, Hirohito; Kobara, Hideki; Fujihara, Shintaro; Nishiyama, Noriko; Rafiq, Kazi; Oryu, Makoto; Fujiwara, Masao; Suzuki, Yasuyuki; Masaki, Tsutomu


    Endoscopic full-thickness resection (EFTR) requires a reliable full-thickness suturing device and an endoscopic counter-traction device to prevent the collapse of the digestive tract. The present study aimed to assess the reliability of newly developed flexible endoscopy suturing devices and the feasibility of pure EFTR. A total of 30 EFTRs were performed and allocated to three groups (N = 10 for each group). The full-thickness sutures were placed using over-the-scope clips (OTSCs), hand-sewn sutures, or the Double-arm-bar Suturing System (DBSS). Air leak tests were conducted in the three groups. The times required for the placement of one OTSC suture and single-stitch simple interrupted sutures (hand-sewn and DBSS sutures, respectively) were also compared. All 30 full-thickness sutures were completely and successfully placed. Regarding the air leak tests, the Mann-Whitney U test showed significant differences between OTSC and hand-sewn sutures (p = 0.003). There was also a significant difference between OTSC and DBSS sutures (p = 0.023). There was no significant difference between hand-sewn and DBSS sutures (p = 0.542). A significant difference was found in the suture time for single-stitch simple interrupted sutures among the OTSC, hand-sewn, and DBSS sutures. The Mann-Whitney U test revealed a significant difference between OTSC and hand-sewn sutures (p = 0.0001). There was no significant difference between OTSC and DBSS sutures (p = 0.533), while a significant difference was found between hand-sewn and DBSS sutures (p = 0.0001). Pure EFTR is feasible if the mechanical counter traction system is used to expand a small operative field and DBSS is used to make full-thickness sutures. The high safety of full-thickness resection and full-thickness suturing allows for clinical applications of this method.

  14. Fiber from ramie plant (Boehmeria nivea): A novel suture biomaterial

    Energy Technology Data Exchange (ETDEWEB)

    Kandimalla, Raghuram; Kalita, Sanjeeb; Choudhury, Bhaswati [Drug discovery laboratory, Institute of Advanced Study in Science and Technology, Guwahati, Assam 781035 (India); Devi, Dipali [Seri biotech laboratory, Institute of Advanced Study in Science and Technology, Guwahati, Assam 781035 (India); Kalita, Dhaneswar [Government Ayurvedic College and Hospital, Jalukbari, Guwahati, Assam 781014 (India); Kalita, Kasturi [Department of Pathology, Hayat Hospital, Guwahati, Assam 781034 (India); Dash, Suvakanta [Girijananda Chowdhury Institute of pharmaceutical science, Azara, Guwahati, Assam 781017 (India); Kotoky, Jibon, E-mail: [Drug discovery laboratory, Institute of Advanced Study in Science and Technology, Guwahati, Assam 781035 (India)


    The quest for developing an ideal suture material prompted our interest to develop a novel suture with advantageous characters to market available ones. From natural origin only silk, cotton and linen fibers are presently available in market as non-absorbable suture biomaterials. In this study, we have developed a novel, cost-effective, and biocompatible suture biomaterial from ramie plant, Boehmeria nivea fiber. Field emission scanning electron microscopy (FE-SEM), energy-dispersive X-ray spectroscopy (EDX), attenuated total reflection Fourier transform infrared spectroscopy (ATR-FTIR) and thermo gravimetric analysis (TGA) results revealed the physicochemical properties of raw and degummed ramie fiber, where the former one showed desirable characteristics for suture preparation. The braided multifilament ramie suture prepared from degummed fiber exhibited excellent tensile strength. The suture found to be biocompatible towards human erythrocytes and nontoxic to mammalian cells. The fabricated ramie suture exhibited significant antibacterial activity against Escherichia coli, Bacillus subtilis and Staphylococcus aureus; which can be attributed to the inherent bacteriostatic ability of ramie plant fiber. In vivo wound closure efficacy was evaluated in adult male wister rats by suturing the superficial wound incisions. Within seven days of surgery the wound got completely healed leaving no rash and scar. The role of the ramie suture in complete wound healing was supported by the reduced levels of serum inflammatory mediators. Histopathology studies confirmed the wound healing ability of ramie suture, as rapid synthesis of collagen, connective tissue and other skin adnexal structures were observed within seven days of surgery. Tensile properties, biocompatibility and wound closure efficacy of the ramie suture were comparable with market available BMSF suture. The outcome of this study can drive tremendous possibility for the utilization of ramie plant fiber for

  15. Fiber from ramie plant (Boehmeria nivea): A novel suture biomaterial

    International Nuclear Information System (INIS)

    Kandimalla, Raghuram; Kalita, Sanjeeb; Choudhury, Bhaswati; Devi, Dipali; Kalita, Dhaneswar; Kalita, Kasturi; Dash, Suvakanta; Kotoky, Jibon


    The quest for developing an ideal suture material prompted our interest to develop a novel suture with advantageous characters to market available ones. From natural origin only silk, cotton and linen fibers are presently available in market as non-absorbable suture biomaterials. In this study, we have developed a novel, cost-effective, and biocompatible suture biomaterial from ramie plant, Boehmeria nivea fiber. Field emission scanning electron microscopy (FE-SEM), energy-dispersive X-ray spectroscopy (EDX), attenuated total reflection Fourier transform infrared spectroscopy (ATR-FTIR) and thermo gravimetric analysis (TGA) results revealed the physicochemical properties of raw and degummed ramie fiber, where the former one showed desirable characteristics for suture preparation. The braided multifilament ramie suture prepared from degummed fiber exhibited excellent tensile strength. The suture found to be biocompatible towards human erythrocytes and nontoxic to mammalian cells. The fabricated ramie suture exhibited significant antibacterial activity against Escherichia coli, Bacillus subtilis and Staphylococcus aureus; which can be attributed to the inherent bacteriostatic ability of ramie plant fiber. In vivo wound closure efficacy was evaluated in adult male wister rats by suturing the superficial wound incisions. Within seven days of surgery the wound got completely healed leaving no rash and scar. The role of the ramie suture in complete wound healing was supported by the reduced levels of serum inflammatory mediators. Histopathology studies confirmed the wound healing ability of ramie suture, as rapid synthesis of collagen, connective tissue and other skin adnexal structures were observed within seven days of surgery. Tensile properties, biocompatibility and wound closure efficacy of the ramie suture were comparable with market available BMSF suture. The outcome of this study can drive tremendous possibility for the utilization of ramie plant fiber for

  16. Some contrasting biostratigraphic links between the Baker and Olds Ferry Terranes, eastern Oregon (United States)

    Nestell, Merlynd K.; Blome, Charles D.


    New stratigraphic and paleontologic data indicate that ophiolitic melange windows in the Olds Ferry terrane of eastern Oregon contain limestone blocks and chert that are somewhat different in age than those present in the adjacent Baker terrane melange. The melange windows in the Olds Ferry terrane occur as inliers in the flyschoid Early and Middle Jurassic age Weatherby Formation, which depositionally overlies the contact between the melange-rich Devonian to Upper Triassic rocks of the Baker terrane on the north, and Upper Triassic and Early Jurassic volcanic arc rocks of the Huntington Formation on the south. The Baker terrane and Huntington Formation represent fragments of a subduction complex and related volcanic island arc, whereas the Weatherby Formation consists of forearc basin sedimentary deposits. The tectonic blocks in the melange windows of the Weatherby Formation (in the Olds Ferry terrane) are dated by scarce biostratigraphic evidence as Upper Pennsylvanian to Lower Permian and Upper Triassic. In contrast, tectonic blocks of limestone in theBaker terrane yield mostly fusulinids and small foraminifers of Middle Pennsylvanian Moscovian age at one locality.Middle Permian (Guadalupian) Tethyan fusulinids and smaller foraminifers (neoschwagerinids and other Middle Permian genera) are present at a few other localities. Late Triassic conodonts and bryozoans are also present in a few of the Baker terrane tectonic blocks. These limestone blocks are generally embedded in Permian and Triassic radiolarian bearing chert or argillite. Based on conodont, radiolarian and fusulinid data, the age limits of the meange blocks in the Weatherby Formation range from Pennsylvanian to Late Triassic.

  17. An exotic terrane in the Sulu UHP region, China (United States)

    Chu, W.; Zhang, R.; Tsujimori, T.; Liou, J. G.


    The Haiyangsuo region of about 15 km2 along the coast in the NE part of the Triassic Sulu UHP terrane occurs three major rock types: amphibolitized metagabbro, gneiss and granitic dikes. Three different gneisses were observed in the field: A) Light color felsic gneiss is the dominant country rock and contains Qtz, Pl, Ms and Bi. B) Dark color plagioclase-amphibole gneiss occurs as thin layers within country rock; C) Granulite facies rock occurs as discontinuous lens. The amphibolitized metagabbros intrude into the gneisses as massive bodies (several m to hundreds of m in size) and thin dikes. Both metamorphic intrusives and gneisses are cross-cut by granitic dikes. The amphibolitized metagabbro was divided into three types: coronal metagabbro, transitional rock and garnet amphibolite: 1) Coronal metagabbro preserves gabbroic texture and primary assemblage of Opx+Cpx+Pl+Amp+Ilm. Most pyroxene grains are partially rimmed by thin corona of Amp+Ab+Qtz. Garnet occurs as fine-grained coronas at interface between plagioclase, pyroxene or ilmenite. 2) Transitional rocks contain similar assemblage and texture but most orthopyroxenes were partially or totally replaced by Amp+Qtz; garnet increases in content and size. Some gabbroic textures are preserved, but calcic plagioclase was replaced by zoisite, albite and muscovite. 3) Garnet amphibolite occurs at the margins of intrusive bodies and boudins where only minor relict clinopyroxenes preserve. Garnet coronal chains are not clear any more. Granitic dikes show pronounced deformation with mylonitic texture and contain 40-50% quartz porphyroclasts. Zircon separates from 2 metagabbros, 4 gneisses and 1 granitic rock were dated by using Stanford SHRIMP-RG. Metagabbroic zircons are angular and fractured shapes. The upper-intercept ages of gneisses rang from 1730 to about 2400 Ma, indicating variable protoith age. The 2 garnet amphibolites have upper-intercept ages 1734±5Ma and 1735±21Ma respectively. They are much older than

  18. Achondroplasia and multiple-suture craniosynostosis. (United States)

    Albino, Frank P; Wood, Benjamin C; Oluigbo, Chima O; Lee, Angela C; Oh, Albert K; Rogers, Gary F


    Genetic mutations in the fibroblast growth factor receptor 3 gene may lead to achondroplasia or syndromic forms of craniosynostosis. Despite sharing a common genetic basis, craniosynostosis has rarely been described in cases of confirmed achondroplasia. We report an infant with achondroplasia who developed progressive multiple-suture craniosynostosis to discuss the genetic link between these clinical entities and to describe the technical challenges associated with the operative management.

  19. Far-travelled permian chert of the North Fork terrane, Klamath mountains, California (United States)

    Mankinen, E.A.; Irwin, W.P.; Blome, C.D.


    Permian chert in the North Fork terrane and correlative rocks of the Klamath Mountains province has a remanent magnetization that is prefolding and presumably primary. Paleomagnetic results indicate that the chert formed at a paleolatitude of 8.6?? ?? 2.5?? but in which hemisphere remains uncertain. This finding requires that these rocks have undergone at least 8.6?? ?? 4.4?? of northward transport relative to Permian North America since their deposition. Paleontological evidence suggests that the Permian limestone of the Eastern Klamath terrane originated thousands of kilometers distant from North America. The limestone of the North Fork terrane may have formed at a similar or even greater distance as suggested by its faunal affinity to the Eastern Klamath terrane and more westerly position. Available evidence indicates that convergence of the North Fork and composite Central Metamorphic-Eastern Klamath terranes occurred during Triassic or Early Jurassic time and that their joining together was a Middle Jurassic event. Primary and secondary magnetizations indicate that the new composite terrane containing these and other rocks of the Western Paleozoic and Triassic belt behaved as a single rigid block that has been latitudinally concordant with the North American craton since Middle Jurassic time.

  20. Cranial suture biology of the Aleutian Island inhabitants. (United States)

    Cray, James; Mooney, Mark P; Siegel, Michael I


    Research on cranial suture biology suggests there is biological and taxonomic information to be garnered from the heritable pattern of suture synostosis. Suture synostosis along with brain growth patterns, diet, and biomechanical forces influence phenotypic variability in cranial vault morphology. This study was designed to determine the pattern of ectocranial suture synostosis in skeletal populations from the Aleutian Islands. We address the hypothesis that ectocranial suture synostosis pattern will differ according to cranial vault shape. Ales Hrdlicka identified two phenotypes in remains excavated from the Aleutian Island. The Paleo-Aleutians, exhibiting a dolichocranic phenotype with little prognathism linked to artifacts distinguished from later inhabitants, Aleutians, who exhibited a brachycranic phenotype with a greater amount of prognathism. A total of 212 crania representing Paleo-Aleuts and Aleutian as defined by Hrdlicka were investigated for suture synostosis pattern following standard methodologies. Comparisons were performed using Guttmann analyses. Results revealed similar suture fusion patterns for the Paleo-Aleut and Aleutian, a strong anterior to posterior pattern of suture fusion for the lateral-anterior suture sites, and a pattern of early termination at the sagittal suture sites for the vault. These patterns were found to differ from that reported in the literature. Because these two populations with distinct cranial shapes exhibit similar patterns of suture synostosis it appears pattern is independent of cranial shape in these populations of Homo sapiens. These findings suggest that suture fusion patterns may be population dependent and that a standardized methodology, using suture fusion to determine age-at-death, may not be applicable to all populations. Copyright © 2011 Wiley-Liss, Inc.

  1. Ultramafic rocks of the western Idaho suture zone: Asbestos Peak and Misery Ridge

    Energy Technology Data Exchange (ETDEWEB)

    Godchaux, M.M. (Mount Holyoke Coll., South Hadley, MA (United States). Dept. of Geology); Bonnichsen, B. (Univ. of Idaho, Moscow, ID (United States))


    The Western Idaho Ultramafic Belt extends northward from the town of Weiser to the northern end of Dworshak Reservoir; in its northern portion most of the ultramafic bodies are localized along the suture zone where the Mesozoic oceanic accreted terranes meet the continental craton. Of the twenty bodies investigated, all are small, all are in fault contact with their metavolcanic and metasedimentary host rocks, all have been metamorphosed, and all display deformational fabrics in at least some portion of the outcrop area, suggesting that deformation continued after peak metamorphism. The degree of metamorphism ranges from incipient serpentinization to attainment of equilibrium in the upper amphibolite facies. Some bodies have been intruded by granitic dikes or pegmatite veins after emplacement, and have locally undergone contact metasomatism. Two particularly complex bodies, Asbestos Peak and Misery Ridge, were chosen for detailed petrographic and chemical study. Asbestos Peak is composed mostly of decussate anthophyllite-talc rock containing isolated patches of harzburgite protolith, and has blackwall border zones. Misery Ridge is composed mostly of coarse-grained sheared tremolite-talc schist without remnant protolith, and lacks true blackwall zones. Both bodies exhibit an unusual and enigmatic hornblende-poikiloblastic garnet-green spinel-skeletal ilmenite assemblage, present in some places as well-defined border zones and in other places as cross-cutting bodies.

  2. Subcuticular Suture Technique: Alternative to Frost Suture to Prevent Ectropion After Transcutaneous Incision of Lower Eyelid. (United States)

    Kudva, Adarsh; Kamath, Abhay; Cariappa, K M; Gadicherla, Srikanth; Dhara, B Vasantha


    An ectropion is a complication that can arise from reconstruction in the infraorbital region. Often, this complication occurs despite proper positioning of the lower lid at the time of closure. Various transcutaneous approaches to orbit skeleton have investigated in view of complication arising from them. A subtarsal approach with a postoperative Frost suture gives an advantage to reduce the occurrence of ectropion especially after treatment of orbital floor fractures. This case describes a method of subcuticular suturing technique for subtarsal incision of lower lid which can be used to support the lid during healing period, thus decreasing the rate of ectropion. The technique described here is an alterative method for frost suturing with certain advantages.

  3. Bidirectional Barbed Sutures for Wound Closure: Evolution and Applications (United States)

    Paul, Malcolm D.


    Traditionally, wound closure sutures have in common the need to tie knots with the inherent risk of extrusion, palpability, microinfarcts, breakage, and slippage. Bidirectional barbed sutures have barbs arrayed in a helical fashion in opposing directions on either side of an unbarbed midsegment. This suture is inserted at the midpoint of a wound and pulled through till resistance is encountered from the opposing barbs; each half of the suture is then advanced to the lateral ends of the wound. This design provides a method of evenly distributing tension along the incision line, a faster suture placement and closure time with no need to tie knots, and the possibility of improved cosmesis. Bidirectional barbed sutures, which are available in both absorbable and nonabsorbable forms, can be used for simple closures, multilayered closures, and closure of high-tension wounds in a variety of surgical settings. PMID:24527114

  4. The frontosphenoidal suture: fetal development and phenotype of its synostosis

    Energy Technology Data Exchange (ETDEWEB)

    Mathijssen, Irene M.J.; Meulen, Jacques J.N.M. van der; Adrichem, Leon N.A. van; Vaandrager, J.M.; Vermeij-Keers, Christl [Erasmus MC, University Medical Centre, Department of Plastic and Reconstructive Surgery, Rotterdam (Netherlands); Hulst, Rene R.W.J. van der [University Hospital Maastricht, Department of Plastic and Reconstructive Surgery, Maastricht (Netherlands); Lequin, Maarten H. [Erasmus MC, University Medical Centre, Department of Radiology, Rotterdam (Netherlands)


    Isolated synostosis of the frontosphenoidal suture is very rare and difficult to diagnose. Little has been reported on the clinical presentation and fetal development of this suture. To understand the development of the frontosphenoidal suture and the outcome of its synostosis. We studied the normal fetal development of the frontosphenoidal suture in dry human skulls and the clinical features of four patients with isolated synostosis of the frontosphenoidal suture. The frontosphenoidal suture develops relatively late during the second trimester of pregnancy, which explains the mild phenotype when there is synostosis. This rare craniosynostosis results in a deformity that causes recession of the lateral part of the frontal bone and supraorbital rim, with minimal facial asymmetry. Three-dimensional CT is the best examination to confirm the diagnosis. Isolated frontosphenoidal synostosis should be considered in patients with unilateral flattening of the forehead at birth that does not improve within the first few months of life. (orig.)

  5. A technique for introducing looped sutures in flexor tendon repair

    Directory of Open Access Journals (Sweden)

    Kamath B


    Full Text Available Stronger flexor tendon repairs facilitate early active motion therapy protocols. Core sutures using looped suture material provide 1 ½ to twice the strength of Kessler′s technique (with four strand and six strand Tsuge technique respectively. The technique is well-described and uses preformed looped sutures (supramid. This is not available in many countries and we describe a technique whereby looped sutures can be introduced in flexor tendon repair by the use of 23 G hypodermic needle and conventional 4.0 or 5.0 sutures. This is an alternative when the custom made preformed sutures are not available. This can be practiced in zone 3 to zone 5 repairs. Technical difficulties limit its use in zone 2 repairs.

  6. Sutural simplification in Physodoceratinae (Aspidoceratidae, Ammonitina

    Directory of Open Access Journals (Sweden)

    Checa, A.


    Full Text Available The estructural analysis of the shell septum interrelationship in sorne Jurassic ammonites allows us to conclude that sutural simplifications occurred throughout the phylogeny, were originated by alterations in the external morphology of the shell. In the case of Physodoceratinae the simplification observed in the morphology of the septal suture may have a double origin. First, an increase in the size of periumbilical tubercles may determine a shallowing of sutural elements and a shortening of saddle and lobe frilling. In other cases, shallowing is determined by a decrease in the whorl expansion rate, an apparent shortening of secondary branching not being observed.El análisis estructural de la interrelación concha-septo en algunos ammonites del Jurásico superior lleva a concluir que las simplificaciones suturales aparecidas a lo largo de la filogenia fueron originadas por alteraciones ocurridas en la morfología externa de la concha. En el caso concreto de la subfamilia Physodoceratinae, la simplificación observada en la morfología de la sutura puede tener un doble origen. En primer lugar, un incremento en el tamaño de los tubérculos periumbilicales puede determinar una pérdida de profundidad de los elementos de la sutura. siempre acompañada de una disminución en las indentaciones (frilling de sillas y lóbulos. En otros casos el acortamiento en profundidad está determinado por una disminución de la tasa de expansión de la espira, sin que se observe un acortamiento aparente de las ramificaciones secundarias.

  7. Cebollati group, Nico Perez terrane: Definition and age

    International Nuclear Information System (INIS)

    Gaucher, C; Chemale, F.; Bossi, J.; Castiglioni, E.; Castiglioni, E.


    The Cebollati Group (Nico Perez Terrane) is formally erected in this work to include a meta sedimentary succession informally known as L as Teta s Complex . It is shown that the stratigraphy of the unit can be reconstructed at a number of sections between Minas and Zapicìn, using sedimentary structures and stromatolites as geo petal indicators. The basement of the group is represented by metamorphic rocks and granitoids of the La China Complex, for which a new U-Pb zircon age of 3.029 ± 54 Ma is presented. The Cebollatií Group comprises, from base to top, three formations: the Arroyo Ma lo Formation (sandstones and petites), Cerro de Valuable Formation (dolostones, partly stromatolitic, and p elites) and the Cerro del Diamant e Formation (p elites, BIF, quartz-pebble conglomerates and sandstones). The mean thickness of the Cebollatií Group is ca. 2 km, being greatest in the south and diminishing to the north. Available ages for the unit suggested a Neoarchean depositional age of 2.75 Ga. However, in this work 12 Nd model ages are presented for sedimentary rocks of the Cebollatí Group, which are mostly younger than 2.75 Ga, the youngest being 1.64 Ga. These ages call into question the Neoarchean age accepted for the unit, suggesting a Meso proterozoic depositional age. The evidence supporting both views is discussed in view of the new data. The minimum age of the Cebollatí Group is 1.3 Ga on the basis of carbon isotope ratios of dolostones and deformational ages consistently around 1.25 Ga

  8. Midwives conducting perineal repair: The Danish Suture Trial

    DEFF Research Database (Denmark)

    Kindberg, Sara


    Midwives conducting perineal repair: The Danish Suture Trial.     Background Suture techniques and materials for repair of 2nd degree perineal lacerations and episiotomies have been tested in several clinical trials. Danish midwives and obstetricians have developed a new, simple and time-efficien......Midwives conducting perineal repair: The Danish Suture Trial.     Background Suture techniques and materials for repair of 2nd degree perineal lacerations and episiotomies have been tested in several clinical trials. Danish midwives and obstetricians have developed a new, simple and time...

  9. Visual Measurement of Suture Strain for Robotic Surgery

    Directory of Open Access Journals (Sweden)

    John Martell


    Full Text Available Minimally invasive surgical procedures offer advantages of smaller incisions, decreased hospital length of stay, and rapid postoperative recovery to the patient. Surgical robots improve access and visualization intraoperatively and have expanded the indications for minimally invasive procedures. A limitation of the DaVinci surgical robot is a lack of sensory feedback to the operative surgeon. Experienced robotic surgeons use visual interpretation of tissue and suture deformation as a surrogate for tactile feedback. A difficulty encountered during robotic surgery is maintaining adequate suture tension while tying knots or following a running anastomotic suture. Displaying suture strain in real time has potential to decrease the learning curve and improve the performance and safety of robotic surgical procedures. Conventional strain measurement methods involve installation of complex sensors on the robotic instruments. This paper presents a noninvasive video processing-based method to determine strain in surgical sutures. The method accurately calculates strain in suture by processing video from the existing surgical camera, making implementation uncomplicated. The video analysis method was developed and validated using video of suture strain standards on a servohydraulic testing system. The video-based suture strain algorithm is shown capable of measuring suture strains of 0.2% with subpixel resolution and proven reliability under various conditions.

  10. Comparison of Arterial Repair through the Suture, Suture with Fibrin or Cyanoacrylate Adhesive in Ex-Vivo Porcine Aortic Segment

    Directory of Open Access Journals (Sweden)

    Marcus Vinicius H. de Carvalho

    Full Text Available Abstract Introduction: Tissue adhesives can be used as adjacent to sutures to drop or avoid bleeding in cardiovascular operations. Objective: To verify the efficiency of fibrin and cyanoacrylate adhesive to seal arterial sutures and if the adhesives penetrate through suture line to the inner of arteries. Methods: 20 abdominal aorta segments of pigs were divided into two groups according to the adhesive which would be used as adjacent to the suture. In every arterial segment an arteriotomy was done, followed by a conventional artery closure. Afterwards a colloidal fluid was injected inside the arterial segment with a simultaneous intravascular pressure monitoring up to a fluid leakage through the suture. This procedure was repeated after application of one of the adhesives on the suture in order to check if the bursting pressure increases. The inner aorta segments also were analyzed in order to check if there was intraluminal adhesive penetration. Results: In Suture 1 group, the mean arterial pressure sustained by the arterial suture reached 86±5.35 mmHg and after the fibrin adhesive application reached 104±11.96 (P<0.002. In the Suture 2 group, the mean arterial pressure sustained by the suture reached 83±2.67 mmHg and after the cyanoacrylate adhesive application reached 152±14.58 mmHg (P<0.002. Intraluminal adhesive penetration has not been noticed. Conclusion: There was a significant rise in the bursting pressure when tissue adhesives were used as adjacent to arterial suture, and this rise was higher if the cyanoacrylate adhesive was used. In addition, the adhesives do not penetrate through the suture line into the arteries.

  11. The Khida terrane - Geology of Paleoproterozoic rocks in the Muhayil area, eastern Arabian Shield, Saudi Arabia (United States)

    Stoeser, D.B.; Whitehouse, M.J.; Stacey, J.S.


    The bulk of the Arabian Shield of Saudi Arabia is underlain by Neoproterozoic terranes of oceanic affinity that were accreted during Pan-African time (about 680- 640Ma). Geologicalmappingandisotopicinvestigations during the 1980’s,however, provided the first evidence for Paleoproterozoic continental crust within the east- central part of the shield in Saudi Arabia. These studies delineated an older basement domain, herein referred to as the Khida terrane (Fig. l), which is defined as that part of the southern Afif composite terrane underlain by Paleoproterozoicto Archean continental crust (Stoeser and Stacey, 1988). The isotopic and geochronologic work to support our current studies within the Khida terrane are discussed in a companion abstract (Whitehouse et al., this volume). The regional geology and geochronology of the region has been summarized in detail by Johnson (1996). The current study is based on the continued use of samples previously collected in the Khida area by the authors and others as well as new field work conducted by us in 1999. This work further defines the occurrence of late Paleoproterozoic rocks at Jabal Muhayil, which is located at the eastern margin of the exposed terrane (Fig. 1). Our isotopic work is at an early stage and this abstract partly relates geologic problems that remain to be resolved. 


    Directory of Open Access Journals (Sweden)



    Full Text Available PURPOSE: The aim of study is to compare Continuous technique with non - absorbable sutures, Interrupted technique with non - absorbable sutures and Continuous technique with slowly absorbable sutures Focusing mainly on incidence of incisional hernias, burst abdomen, wound infections, chronic wound pain, suture sinus, stitch granuloma, time for rectus closure. METHODOLOGY : Study was conducted for a period of one year on 271 randomized patients with primary elective midline laparotomy in our hospital . patients are divided into group I includes 102 patients with continuous technique using non absorbable polypropylene, group II includes 91 patients with interrupted technique using non absorbable polypropylene and group III includes 78 patients with continuous slowly absorbable polyhydroxybutyrate. RESULTS: No significant difference observed in incidence of wound infections and burst abdomen in all the 3 groups but relatively higher incidence of wound infections in noted our hospital. Incidence of stich granuloma suture sinus and chronic wound pain is more with interrupted technique than continuous technique and are more with non - absor bable suture material. CONCLUSION: Incidence of incisional hernias, suture complications like suture sinus, stitch granuloma can be more effectively reduced with slowly absorbable continuous sutures.

  13. Geophysical exploration of the Kalahari Suture Zone (United States)

    Brett, J. S.; Mason, R.; Smith, P. H.


    Fancamp Resources Limited of Montreal, Canada, commenced exploration of the Kalahari Suture Zone in southwest Botswana in 1996, following the interpretation of airborne magnetic surveys covering 400 km of strike along the Kalahari Suture Zone. Initial focus was on mafic/ultramafic intrusions associated with the Tshane Complex as potential targets for CuNiPGM mineralization, but these targets are now considered to be too deeply buried (> 700 m) to be of economic significance at this time. The exploration focus has been redirected to several prospective large coincident magnetic/gravity anomalies. These are considered prospective targets for Olympic Dam-type CuCo mineralisation associated with alkaline intrusive complexes, and/or NiCuCoPGM mineralisation associated with basic intrusive complexes. The two most important and prospective targets are the so-called 'Great Red Spot' and Tsetseng Complex. Additional ground geophysical surveys and deep drilling are planned for the next phase of exploration. These large targets are of high priority and represent tremendous potential for mineral development in the sparsely populated area of western Botswana.

  14. Tensile strength and failure load of sutures for robotic surgery. (United States)

    Abiri, Ahmad; Paydar, Omeed; Tao, Anna; LaRocca, Megan; Liu, Kang; Genovese, Bradley; Candler, Robert; Grundfest, Warren S; Dutson, Erik P


    Robotic surgical platforms have seen increased use among minimally invasive gastrointestinal surgeons (von Fraunhofer et al. in J Biomed Mater Res 19(5):595-600, 1985. doi: 10.1002/jbm.820190511 ). However, these systems still suffer from lack of haptic feedback, which results in exertion of excessive force, often leading to suture failures (Barbash et al. in Ann Surg 259(1):1-6, 2014. doi: 10.1097/SLA.0b013e3182a5c8b8 ). This work catalogs tensile strength and failure load among commonly used sutures in an effort to prevent robotic surgical consoles from exceeding identified thresholds. Trials were thus conducted on common sutures varying in material type, gauge size, rate of pulling force, and method of applied force. Polydioxanone, Silk, Vicryl, and Prolene, gauges 5-0 to 1-0, were pulled till failure using a commercial mechanical testing system. 2-0 and 3-0 sutures were further tested for the effect of pull rate on failure load at rates of 50, 200, and 400 mm/min. 3-0 sutures were also pulled till failure using a da Vinci robotic surgical system in unlooped, looped, and at the needle body arrangements. Generally, Vicryl and PDS sutures had the highest mechanical strength (47-179 kN/cm 2 ), while Silk had the lowest (40-106 kN/cm 2 ). Larger diameter sutures withstand higher total force, but finer gauges consistently show higher force per unit area. The difference between material types becomes increasingly significant as the diameters decrease. Comparisons of identical suture materials and gauges show 27-50% improvement in the tensile strength over data obtained in 1985 (Ballantyne in Surg Endosc Other Interv Tech 16(10):1389-1402, 2002. doi: 10.1007/s00464-001-8283-7 ). No significant differences were observed when sutures were pulled at different rates. Reduction in suture strength appeared to be strongly affected by the technique used to manipulate the suture. Availability of suture tensile strength and failure load data will help define software safety

  15. Characterization of craniofacial sutures using the finite element method. (United States)

    Maloul, Asmaa; Fialkov, Jeffrey; Wagner, Diane; Whyne, Cari M


    Characterizing the biomechanical behavior of sutures in the human craniofacial skeleton (CFS) is essential to understand the global impact of these articulations on load transmission, but is challenging due to the complexity of their interdigitated morphology, the multidirectional loading they are exposed to and the lack of well-defined suture material properties. This study aimed to quantify the impact of morphological features, direction of loading and suture material properties on the mechanical behavior of sutures and surrounding bone in the CFS. Thirty-six idealized finite element (FE) models were developed. One additional specimen-specific FE model was developed based on the morphology obtained from a µCT scan to represent the morphological complexity inherent in CFS sutures. Outcome variables of strain energy (SE) and von Mises stress (σvm) were evaluated to characterize the sutures' biomechanical behavior. Loading direction was found to impact the relationship between SE and interdigitation index and yielded varied patterns of σvm in both the suture and surrounding bone. Adding bone connectivity reduced suture strain energy and altered the σvm distribution. Incorporating transversely isotropic material properties was found to reduce SE, but had little impact on stress patterns. High-resolution µCT scanning of the suture revealed a complex morphology with areas of high and low interdigitations. The specimen specific suture model results were reflective of SE absorption and σvm distribution patterns consistent with the simplified FE results. Suture mechanical behavior is impacted by morphologic factors (interdigitation and connectivity), which may be optimized for regional loading within the CFS. © 2013 Elsevier Ltd. All rights reserved.

  16. The Athabasca Granulite Terrane and Evidence for Dynamic Behavior of Lower Continental Crust (United States)

    Dumond, Gregory; Williams, Michael L.; Regan, Sean P.


    Deeply exhumed granulite terranes have long been considered nonrepresentative of lower continental crust largely because their bulk compositions do not match the lower crustal xenolith record. A paradigm shift in our understanding of deep crust has since occurred with new evidence for a more felsic and compositionally heterogeneous lower crust than previously recognized. The >20,000-km2 Athabasca granulite terrane locally provides a >700-Myr-old window into this type of lower crust, prior to being exhumed and uplifted to the surface between 1.9 and 1.7 Ga. We review over 20 years of research on this terrane with an emphasis on what these findings may tell us about the origin and behavior of lower continental crust, in general, in addition to placing constraints on the tectonic evolution of the western Canadian Shield between 2.6 and 1.7 Ga. The results reveal a dynamic lower continental crust that evolved compositionally and rheologically with time.

  17. Bridge Suture for Successful McDonald Emergency Cerclage. (United States)

    Tanaka, Masaaki; Hori, Yoshiaki; Shirafuji, Aya; Kato, Mitsunori; Kato, Jyun; Kobayashi, Hiroto; Tsuchida, Toru; Fukae, Tsukasa


    To create awareness about a surgical technique termed bridge suture, which is performed as a pretreatment before a McDonald cerclage is performed on an emergency to treat severe cervical insufficiency. Procedures for bridge suture were reviewed in detail and outcomes of 16 patients treated with bridge suture followed by McDonald cerclage were evaluated retrospectively. Using the bridge suture, the edges of uterine cervix were temporarily sutured and the external uterine os was closed, while the hourglass-shaped fetal membranes were concomitantly confined within the cervix; subsequently, a McDonald cerclage was performed. Over a 22-year period, 16 patients with a dilated cervix and bulging fetal membranes were treated using the technique of bridge suture followed by an emergency cerclage. The mean gestational age at cerclage was 22.5 weeks; the mean gestational age at delivery was 30.7 weeks; and the mean interval between cerclage and delivery was 8.2 weeks. In 15 out of 16 cases, cerclage was performed without encountering any complications. No maternal complications, including cervical laceration, were observed. The mean body weight of 17 neonates, including that of a twin, was 1,516 g and of them, 15 neonates survived. The important outcome of bridge suture is the replacement of fetal membranes back into the uterine cavity before McDonald's cerclage is performed. Pretreatment with bridge suture may facilitate the performance of a successful emergency cerclage and contribute to good maternal and neonatal outcomes. © 2016 S. Karger AG, Basel.

  18. Arthroscopic Hip Labral Repair: The Iberian Suture Technique


    Stubbs, Allston J.; Andersen, Jason S.; Mannava, Sandeep; Wooster, Benjamin M.; Howse, Elizabeth A.; Winter, S. Bradley


    Arthroscopic hip labral repair has beneficial short-term outcomes; however, debate exists regarding ideal surgical labral repair technique. This technical note presents an arthroscopic repair technique that uses intrasubstance labral suture passage to restore the chondrolabral interface. This “Iberian suture technique” allows for an anatomic repair while posing minimal risk of damage to the labral and chondral tissues.

  19. Robot-assisted bronchoplasty using continuous barbed sutures. (United States)

    Sarsam, Omar Matthieu; Dunning, Joel; Pochulu, Bruno; Baste, Jean-Marc


    We describe in this article our bronchoplastic robot-assisted techniques. This consists of using continuous barbed sutures. Our aim is to show the feasibility and the interest of using robotics and this kind of suture material for complex bronchial procedures. We report four cases in France and the UK, two wedge bronchoplasties and two sleeve bronchoplasties for central pulmonary tumors.

  20. Mechanical model of suture joints with fibrous connective layer (United States)

    Miroshnichenko, Kateryna; Liu, Lei; Tsukrov, Igor; Li, Yaning


    A composite model for suture joints with a connective layer of aligned fibers embedded in soft matrix is proposed. Based on the principle of complementary virtual work, composite cylinder assemblage (CCA) approach and generalized self-consistent micro-mechanical models, a hierarchical homogenization methodology is developed to systematically quantify the synergistic effects of suture morphology and fiber orientation on the overall mechanical properties of sutures. Suture joints with regular triangular wave-form serve as an example material system to apply this methodology. Both theoretical and finite element mechanical models are developed and compared to evaluate the overall normal stiffness of sutures as a function of wavy morphology of sutures, fiber orientation, fiber volume fraction, and the mechanical properties of fibers and matrix in the interfacial layer. It is found that generally due to the anisotropy-induced coupling effects between tensile and shear deformation, the effective normal stiffness of sutures is highly dependent on the fiber orientation in the connective layer. Also, the effective shear modulus of the connective layer and the stiffness ratio between the fiber and matrix significantly influence the effects of fiber orientation. In addition, optimal fiber orientations are found to maximize the stiffness of suture joints.

  1. Suture associated corneal abscess three years after cataract surgery ...

    African Journals Online (AJOL)

    The abscess was carefully removed on slit lamp using blunt tipped forceps without breaking the thin membrane covering it. There was a deep corneal depression at the bottom of which was found a loose 10/0 nylon corneoscleral suture. Another loose suture was present at the 12 o'clock position surrounded by stromal ...

  2. Relationships between the Brook Street Terrane and Median Tectonic Zone (Median Batholith) : evidence from Jurassic conglomerates

    International Nuclear Information System (INIS)

    Tulloch, A.J.; Kimbrough, D.L.; Landis, C.A.; Mortimer, N.; Johnston, M.R.


    U-Pb zircon ages of 237-180 Ma and c. 280 Ma of seven granitoid clasts from the Rainy River Conglomerate which lies within the eastern Median Tectonic Zone (Median Batholith) in Nelson, and the Barretts Formation of the Brook Street Terrane in Southland, constrain the depositional ages of both units to be no older than c. 180-200 Ma (Early Jurassic). The minimum age of the Rainy River Conglomerate is constrained by the 147 +2 -1 Ma (Latest Jurassic) emplacement age of the One Mile Gabbronorite (new name: previously western Buller Diorite). The ages and chemistry of five of the granitoid clasts are broadly compatible with derivation from rocks that are now represented by Triassic plutons of the Median Tectonic Zone (Median Batholith), although ages as young as 180 Ma are slightly outside the range of the latter as currently exposed in New Zealand. The age (273-290 Ma, 237 +/- 3 Ma) and chemistry of the other two clasts (one each from Rainy River Conglomerate and Barretts Formation) suggest derivation from the Brook Street Terrane. Similarity in stratigraphic age, depositional characteristics, granitoid clast ages and composition between Rainy River Conglomerate and Barretts Formation suggests that they are broadly correlative and collectively overlapped a combined Brook Street Terrane - Median Batholith (MTZ) before the Late Jurassic (147 +2 -1 Ma). Sedimentary overlap may also have continued across to Middle Jurassic conglomeratic strata in the Murihiku Terrane to the east of the Brook Street Terrane. A U-Pb zircon age of 261 +/- 2 Ma is reported for Pourakino Trondhjemite of the Brook Street Terrane. (author). 56 refs., 10 figs., 4 tabs

  3. Chronologic constraints on the tectonic evolution of the Wilson Lake terrane of the Grenville Province, Canada

    DEFF Research Database (Denmark)

    Reno II, Barry Len; Korhonen, F.J.; Stout, J.H.

    the Grenville Orogen in North America. Many of these terranes record evidence of two orogenies: the Labradorian Orogeny at ca. 1710-1600 Ma, and the Grenville Orogeny at ca. 1080-980 Ma. The rocks in the Wilson Lake terrane are interpreted to have been subjected to peak pressures of ~0.95 GPa......) monazite exhibits distinct core and rim zoning in yttrium X-ray compositional maps, and occurs predominately in the melanosome of the rocks, and 2) a population of smaller (up to ~50 µm) unzoned monazite rarely occurs in quartz-rich layers of the rocks. In a majority of the melanosome-hosted monazite, (U...

  4. Discovery of the early Jurassic Gajia mélange in the Bangong-Nujiang suture zone: Southward subduction of the Bangong-Nujiang Ocean? (United States)

    Lai, Wen; Hu, Xiumian; Zhu, Dicheng; An, Wei; Ma, Anlin


    Mélange records a series of geological processes associated with oceanic subduction and continental collision. This paper reports for the first time the presence of Early Jurassic mélange from NW Nagqu in the southern margin of the Bangong-Nujiang suture zone, termed as the Gajia mélange. It shows typically blocks-in-matrix structure with matrix of black shale and siliceous mudstone, and several centimeters to several meters sized blocks of sandstone, silicalite, limestone and basalt. The sandstone blocks consist of homologous sandstone and two types of exotic sandstone, with different modal compositions. The Group 1 of exotic sandstone blocks consists of mainly of feldspar and quartz, whereas the Group 2 is rich in volcanic detritus. The Group 3 of homologous sandstone blocks is rich in feldspar and volcanic detritus with rare occurrence of quartz. U-Pb age data and in situ Hf isotopic compositions of detrital zircons from sandstone blocks are similar to those from the Lhasa terrane, suggesting that the sandstone blocks in the Gajia mélange most probably came from the Lhasa terrane. The YC1σ(2+) age of homologous sandstone blocks is 177 ± 2.4 Ma, suggesting an Early Jurassic depositional age for the sandstones within the Gajia mélange. The Gajia mélange likely records the southward subduction of the Bangong-Nujiang Ocean during the Early Jurassic.

  5. New Geochronology and Radiometric Age Dates Improve the Definition and Continuity of Accreted Tectonic Terranes of Northern Venezuela and the Lesser Antilles (United States)

    Baquero, M.; Mann, P.; Audemard, F. A.


    We use new and compiled geochronology and radiometric dates from the area of Venezuela to Tobago to define the following crustal provinces: 1) Guyana shield forms a sub-circular area of Pan-African rocks against which all younger terranes have collided and partially assumed its rounded shape: ages for the Guyana Shield range from >3.4 Ga to 1.8 Ga; 2) accreted Paleozoic rocks form a sub-circular, largely buried province that surround the Guiana Shield to the north and west; the El Pilar strike-slip fault forms the abrupt, northern limit of the Precambrian-Paleozoic craton in Venezuela characterized by crustal thicknesses of 40-50 km; 3) the Early to Late Cretaceous Great Arc of the Caribbean forms a continuous basement high that can be traced from northern Colombia, through the ABC Islands to La Blanquilla Island, and north along the Aves Ridge to the Greater Antilles; ages of the GAC generally are in the range of Late Cretaceous to early Eocene and have geochemistry consistent with intra-oceanic island arcs or oceanic plateau rocks with the exception of La Orchila Island with a Paleozoic intrusive age; the GAC collided from west to east with the passive margin of South America from Paleocene in western Venezuela to Plio-Pleistocene in the Trinidad area and marks the west to east passage of the Caribbean plate past the South American plate; 4) a post-GAC rifting event affected the GAC-South America suture from late Eocene to middle Miocene time in the Falcón Basin of western Venezuela with ages on intrusive and volcanic from 34 to 15.4 Ma; these ages are coeval with intrusive ages from the southernmost Lesser Antilles on Los Frailes and Los Testigos Islands and range from 35.7±2.6 to 36.4±0.5 Ma; the age of the intervening basin, the Bonaire basin, is poorly known but may be coeval with the Oligocene-Miocene extension that extended the suture zone in western Venezuela and extended the Lesser Antilles arc in early Middle Miocene time to form the Lesser Antilles

  6. The Paleozoic-Mesozoic recycling of the Rakaia Terrane, South Island, New Zealand : sandstone clast and sandstone petrology, geochemistry, and geochronology

    International Nuclear Information System (INIS)

    Wandres, A.M.; Bradshaw, J.D.; Ireland, T.


    The Torlesse terranes - part of the New Zealand Eastern Province - are accretionary complexes that comprise an enormous volume of quartzofeldspathic sandstones and mudstones with subsidiary conglomerates plus minor oceanic assemblages. Two terranes are recognised in the South Island - the Permian to Late Triassic Rakaia Terrane and the Late Jurassic to Early Cretaceous Pahau Terrane. Sandstone clasts from two Rakaia Terrane and two Pahau Terrane conglomerates were collected. We present the first combined detailed information on petrography and geochemistry of Torlesse conglomerate sandstone clasts and use our own and published U-Pb SHRIMP detrital zircon age data to demonstrate the recycling of the Rakaia Terrane into Rakaia strata itself and into Pahau Terrane strata. Sandstone clast major and trace element chemical data largely support petrographic observations derived from thin-section analysis. The similarities of petrographic and geochemical data between sandstone clasts from the Rakaia Terrane and Rakaia sandstones suggest that clasts in the Permian Te Moana and Late Triassic Lake Hill Conglomerates were derived by autocannibalistic reworking of older, consolidated, Rakaia sediments. Data from sandstone clasts from the Pahau Terrane suggest that uplift of the Rakaia Terrane continued into the Cretaceous. These Pahau Terrane clasts indicate that at the time of the Pahau sedimentation Permian to early Late Triassic Rakaia rocks were exposed and recycled into the Pahau Basin. (author). 57 refs., 8 figs., 3 tables

  7. Complications with mechanical suture use in colorectal surgery

    International Nuclear Information System (INIS)

    Bruno, G.; Ruso, L.; Gatti, A.; Quiros, F.; Balboa, O.


    The great development of mechanical suture and its qualitative impact in colorectal surgery has not been able to avoid persistent mortality due to suture failure which is still about 5% and rectal stenosis, which is significantly higher than with manual sutures.The present paper analyses 63 cases of colorrectal anastomosis performed of coordination with mechanical suture at CASMU, in a period of four years (1991-1995).There were 51 rectum resections and colorrectal anastomosis and 12 reconstruction of intestinal transit.There were 28 females and 35 males with and average age of 66 years.Three patients died (4,7%), 20 (31,7%) suffered various complications among which some are pointed out in relation to mechanical suture to suture failures(3,1%) who died and 8 rectal stenosis(12,9%)with favourable evolution after dilations.The authors analyse the issues that incide on the production of complications in colorrectal surgery and conclude that the incidence of global complications in their series is elevated, although mortality, suture failure and rectal stenosis figures are comparable to those in international literature analysed.The incidence of machine width proximal ostomies and radiotherapy on the development of stenosis in our milieu require a multicentric studie with a greater number of patients

  8. Ectocranial suture fusion in primates: pattern and phylogeny. (United States)

    Cray, James; Cooper, Gregory M; Mooney, Mark P; Siegel, Michael I


    Patterns of ectocranial suture fusion among Primates are subject to species-specific variation. In this study, we used Guttman Scaling to compare modal progression of ectocranial suture fusion among Hominidae (Homo, Pan, Gorilla, and Pongo), Hylobates, and Cercopithecidae (Macaca and Papio) groups. Our hypothesis is that suture fusion patterns should reflect their evolutionary relationship. For the lateral-anterior suture sites there appear to be three major patterns of fusion, one shared by Homo-Pan-Gorilla, anterior to posterior; one shared by Pongo and Hylobates, superior to inferior; and one shared by Cercopithecidae, posterior to anterior. For the vault suture pattern, the Hominidae groups reflect the known phylogeny. The data for Hylobates and Cercopithecidae groups is less clear. The vault suture site termination pattern of Papio is similar to that reported for Gorilla and Pongo. Thus, it may be that some suture sites are under larger genetic influence for patterns of fusion, while others are influenced by environmental/biomechanic influences. Copyright © 2013 Wiley Periodicals, Inc.

  9. A tectonic reconstruction of accreted terranes along the paleo-Pacific margin of Gondwana (United States)

    Bammel, Brandon

    The southern oceanic margin of Gondwana was nearly 40,000 km long or 24,854.8 miles. The southern margin was the result of the Terra Australis orogen. Spanning 18,000 km or 11,184.7 miles and is proposed as one of the largest and longest lived orogens in Earth history. The paleo-Pacific margin of Gondwana consisted of segments of the Australian-Antarctic craton, southern South America (modern Argentina and Chile), southern South Africa, Marie Byrdland, New Zealand and its adjacent continental shelf, the Ellsworth Mountains, and the Transantarctic Mountains. The process of terrane accretion has played a substantial part in the assembly of the continents as they look today. The paleo-Pacific margin of Gondwana was an active region of terrane accretion from the Neoproterozoic to the Late Mesozoic. This research study examines the accretion of terranes across the paleo-Pacific Gondwana margin to provide a comprehensive reconstruction. A paleogeographic basemap was created using PALEOMAP Project maps and the geology data was provided by the School of Geoscience from the University of Witwatersrand of South Africa. Location and data analyzed for terranes were collected building a PDF library of journal articles across numerous geological publications.

  10. Basic hypabissal, gondwanic magmatism: a new contribution for tecto no-stratigraphic terranes recognition in Uruguay

    International Nuclear Information System (INIS)

    Bossi, J.


    The possibility of having sufficient structural, geochronologic and geochemical data about the dykes and sills of Cuaro formation and the Corral de Piedra dyke swarm allowed to suggest the nature of the Mantle source and the injection process of each filonian set. Three units injected in the Gondwana continent were recognized: not outcropping Cuaro formation, at Piedra Alta Terrane; outcropping Cuaro Fm. in the Nico Perez Terrane, and the Corral de Piedra dyke swarm in the Cuchilla Dionisio terrane It was found different behavior in several important parameters in each one of them: mantelic source , melting percentage and crustal contamination. It may be concluded that Mantle nature and crust thickness and composition are different in each block, what supports. the idea that continental socle was constructed by amalgamation of different units of allocton provenence. When heat loss became difficult by the mega-continent consolidation, each fragment acted of different way. This represents a very strong argument favoring terrane Cuchilla Dionisio alloctony leaned to 525 Ma as regional geological mapping indicated

  11. Late Ordovician palaeogeography and the positions of the Kazakh terranes through analysis of their brachiopod faunas (United States)

    Popov, Leonid E.; Cocks, Robin M.


    Detailed biogeographical and biofacies analyses of the Late Ordovician brachiopod faunas with 160 genera, grouped into 94 faunas from individual lithotectonic units within the Kazakh Orogen strongly support an archipelago model for that time in that area. The Kazakh island arcs and microcontinents within several separate clusters were located in the tropics on both sides of the Equator. Key units, from which the Late Ordovician faunas are now well known, include the Boshchekul, Chingiz-Tarbagatai, and Chu-Ili terranes. The development of brachiopod biogeography within the nearly ten million year time span of the Late Ordovician from about 458 to 443 Ma (Sandbian, Katian, and Hirnantian), is supported by much new data, including our revised identifications from the Kazakh Orogen and elsewhere. The Kazakh archipelago was west of the Australasian segment of the Gondwana Supercontinent, and relatively near the Tarim, South China and North China continents, apart from the Atashu-Zhamshi Microcontinent, which probably occupied a relatively isolated position on the south-western margin of the archipelago. Distinct faunal signatures indicate that the Kazakh terranes were far away from Baltica and Siberia throughout the Ordovician. Although some earlier terranes had joined each other before the Middle Ordovician, the amalgamation of Kazakh terranes into the single continent of Kazakhstania by the end of the Ordovician is very unlikely. The Late Ordovician brachiopods from the other continents are also compared with the Kazakh faunas and global provincialisation statistically determined.

  12. The ophiolitic North Fork terrane in the Salmon River region, central Klamath Mountains, California (United States)

    Ando, C.J.; Irwin, W.P.; Jones, D.L.; Saleeby, J.B.


    The North Fork terrane is an assemblage of ophiolitic and other oceanic volcanic and sedimentary rocks that has been internally imbricated and folded. The ophiolitic rocks form a north-trending belt through the central part of the region and consist of a disrupted sequence of homogeneous gabbro, diabase, massive to pillowed basalt, and interleaved tectonitic harzburgite. U-Pb zircon age data on a plagiogranite pod from the gabbroic unit indicate that at least this part of the igneous sequence is late Paleozoic in age.The ophiolitic belt is flanked on either side by mafic volcanic and volcaniclastic rocks, limestone, bedded chert, and argillite. Most of the chert is Triassic, including much of Late Triassic age, but chert with uncertain stratigraphic relations at one locality is Permian. The strata flanking the east side of the ophiolitic belt face eastward, and depositional contacts between units are for the most part preserved. The strata on the west side of the ophiolitic belt are more highly disrupted than those on the east side, contain chert-argillite melange, and have unproven stratigraphic relation to either the ophiolitic rocks or the eastern strata.Rocks of the North Fork terrane do not show widespread evidence of penetrative deformation at elevated temperatures, except an early tectonitic fabric in the harzburgite. Slip-fiber foliation in serpentinite, phacoidal foliation in chert and mafic rocks, scaly foliation in argillite, and mesoscopic folds in bedded chert are consistent with an interpretation of large-scale anti-formal folding of the terrane about a north-south hinge found along the ophiolitic belt, but other structural interpretations are tenable. The age of folding of North Fork rocks is constrained by the involvement of Triassic and younger cherts and crosscutting Late Jurassic plutons. Deformation in the North Fork terrane must have spanned a short period of time because the terrane is bounded structurally above and below by Middle or Late

  13. Bacterial adhesion to suture material in a contaminated wound model: Comparison of monofilament, braided, and barbed sutures. (United States)

    Dhom, Jonas; Bloes, Dominik A; Peschel, Andreas; Hofmann, Ulf K


    Contaminated suture material plays an important role in the physiopathology of surgical site infections. Recently, suture material has been developed characterized by barbs projecting from a monofilament base. Claimed advantages for barbed sutures are a shortened wound closure time and reduced maximum wound tension. It has also been suggested that these sutures would be advantageous microbiologically. The aim of this study was to test the microbiological characteristics of the barbed Quill in comparison to the monofilament Ethilon II and the braided sutures Vicryl and triclosan-coated Vicryl Plus. In our study, sutures were cultivated on color-change agar with Staphylococcus aureus, Staphylococcus epidermidis, Enterococcus faecium, Escherichia coli, and Pseudomonas aeruginosa and the halo size was measured. In a second study arm with longer cultivation bacterial growth was followed by antibiotic treatment. Ethilon II and Quill showed good comparable results, whereas large halos were found around Vicryl. Vicryl Plus results depended on triclosan sensitivity. After longer bacterial cultivation and antibiotic treatment, halos were up to 3.6 times smaller on Quill than on Vicryl (p barbs on Quill. From a microbiological perspective, barbed sutures can be recommended in aseptic surgery, but should only be used carefully in septic surgery. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:925-933, 2017. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

  14. MonoMax Suture: A New Long-Term Absorbable Monofilament Suture Made from Poly-4-Hydroxybutyrate

    Directory of Open Access Journals (Sweden)

    Erich K. Odermatt


    Full Text Available A long-term absorbable monofilament suture was developed using poly-4-hydroxybutyrate (P4HB made from a biosynthetically produced homopolymer of the natural metabolite 4-hydroxybutyrate. The suture, called MonoMax, has prolonged strength retention. At 12 weeks, a size 3-0 MonoMax suture retains approximately 50% of its initial tensile strength in vivo and is substantially degraded in one year with minimal tissue reaction. In contrast, PDS II monofilament suture (Ethicon, Inc., Somerville, NJ has no residual strength in vivo after 12 weeks. In vivo, the MonoMax suture is hydrolyzed primarily by bulk hydrolysis, and is then degraded via the Krebs cycle. MonoMax is substantially more compliant than other monofilament sutures, and incorporates an element of elasticity. Its tensile modulus of 0.48 GPa is approximately one-third of the value of the PDS II fiber providing an exceptionally flexible and pliable fiber with excellent knot strength and security. These features are further enhanced by the fiber's elasticity, which also improves knot security and may help prevent wound dehiscence. Because of its performance advantages, this suture may find clinical utility in applications where prolonged strength retention, and greater flexibility are required, particularly in procedures like abdominal wall closure where wound dehiscence is still a significant post-surgical complication.

  15. Lithospheric electrical structure of the middle Lhasa terrane in the south Tibetan plateau (United States)

    Liang, Hongda; Jin, Sheng; Wei, Wenbo; Gao, Rui; Ye, Gaofeng; Zhang, Letian; Yin, Yaotian; Lu, Zhanwu


    The Lhasa terrane in southern Tibetan plateau is a huge tectono-magmatic belt and an important metallogenic belt. Its formation evolution process and mineralization are affected by the subduction of oceanic plate and subsequent continental collision. However, the evolution of Lhasa terrane has been a subject of much debate for a long time. The Lithospheric structure records the deep processes of the subduction of oceanic plate and continental collision. The magnetotelluric (MT) method can probe the sub-surface electrical conductivity, newly dense broadband and long period magnetotelluric data were collected along a south-north trending profile that across the Lhasa terrane at 88°-89°E. Dimensionality analyses demonstrated that the MT data can be interpreted using two-dimensional approaches, and the regional strike direction was determined as N110°E.Based on data analysis results, a two-dimensional (2-D) resistivity model of crust and upper mantle was derived from inversion of the transverse electric mode, transverse magnetic mode and vertical magnetic field data. Inversion model shows a large north-dipping resistor that extended from the upper crust to upper mantle beneath the Himalaya and the south of Lhasa Terrane, which may represent the subducting Indian continental lithosphere. The 31°N may be an important boundary in the Lhasa Terrane, the south performs a prominent high-conductivity anomaly from the lower crust to upper mantle which indicates the existence of asthenosphere upwelling, while the north performs a higher resistivity and may have a reworking ancient basement. The formation of the ore deposits in the study area may be related to the upwelling of the mantle material triggered by slab tearing and/or breaking off of the Indian lithosphere, and the mantle material input also contributed the total thickness of the present-day Tibetan crust. The results provide helpful constrains to understand the mechanism of the continent-continent collision and

  16. Origin and tectonic evolution of early Paleozoic arc terranes abutting the northern margin of North China Craton (United States)

    Zhou, Hao; Pei, Fu-Ping; Zhang, Ying; Zhou, Zhong-Biao; Xu, Wen-Liang; Wang, Zhi-Wei; Cao, Hua-Hua; Yang, Chuan


    The origin and tectonic evolution of the early Paleozoic arc terranes abutting the northern margin of the North China Craton (NCC) are widely debated. This paper presents detrital zircon U-Pb and Hf isotopic data of early Paleozoic strata in the Zhangjiatun arc terrane of central Jilin Province, northeast (NE) China, and compares them with the Bainaimiao and Jiangyu arc terranes abutting the northern margin of the NCC. Detrital zircons from early Paleozoic strata in three arc terranes exhibit comparable age groupings of 539-430, 1250-577, and 2800-1600 Ma. The Paleoproterozoic to Neoarchean ages and Hf isotopic composition of the detrital zircons imply the existence of the Precambrian fragments beneath the arc terranes. Given the evidences from geology, igneous rocks, and detrital zircons, we proposed that the early Paleozoic arc terranes abutting the northern margin of the NCC are a united arc terrane including the exotic Precambrian fragments, and these fragments shared a common evolutionary history from Neoproterozoic to early-middle Paleozoic.

  17. Crustal structure of norther Oaxaca terrane; The Oaxaca and caltepec faults, and the Tehuacan Valley. A gravity study. (United States)

    Campos-Enriquez, J. O.; Alatorre-Zamora, M. A.; Ramón, V. M.; Belmonte, S.


    Northern Oaxaca terrane, southern Mexico, is bound by the Caltepec and Oaxaca faults to the west and east, respectively. These faults juxtapose the Oaxaca terrane against the Mixteca and Juarez terranes, respectively. The Oaxaca Fault also forms the eastern boundary of the Cenozoic Tehuacan depression. Several gravity profiles across these faults and the Oaxaca terrane (including the Tehuacan Valley) enables us to establish the upper crustal structure of this region. Accordingly, the Oaxaca terrane is downward displaced to the east in two steps. First the Santa Lucia Fault puts into contact the granulitic basamental rocks with Phanerozoic volcanic and sedimentary rocks. Finally, the Gavilan Fault puts into contact the Oaxaca terrane basement (Oaxaca Complex) into contact with the volcano-sedimentary infill of the valley. This gravity study reveals that the Oaxaca Fault system gives rise to a series of east tilted basamental blocks (Oaxaca Complex?). A structural high at the western Tehuacan depression accomadates the east dipping faults (Santa Lucia and Gavilan faults) and the west dipping faults of the Oaxaca Fault System. To the west of this high structural we have the depper depocenters. The Oaxaca Complex, the Caltepec and Santa Lucia faults continue northwestwards beneath Phanerozoic rocks. The faults are regional tectonic structures. They seem to continue northwards below the Trans-Mexican Volcanic Belt. A major E-W to NE-SW discontinuity on the Oaxaca terrane is inferred to exist between profiles 1 and 2. The Tehuacan Valley posses a large groundwater potential.

  18. Outcome of Strabismus Surgery by Nonadjustable Suture among ...

    African Journals Online (AJOL)


    years old with strabismus seen ... adult with nonadjustable suture is safe and effective procedure with low risk of ... Strabismus or misalignment of the eyes is a condition that ... with Log MAR, type of refractive error, auto-refraction,.

  19. Outcome of strabismus surgery by nonadjustable suture among ...

    African Journals Online (AJOL)

    Outcome of strabismus surgery by nonadjustable suture among adults attending a ... postoperative residual deviation, 83 patients (86%) had defective vision with amblyopia. ... Conclusion: Surgical treatment of strabismus in Saudi adult with ...

  20. Integral Suture-Handling Techniques for Arthroscopic Sliding Knots


    Kanchanatawan, Wichan; Kongtharvonskul, Jatupon; Dorjiee, Gem; Suppauksorn, Sunikom; Pornvoranunt, Umpire; Karchana, Pongsakorn


    In arthroscopic tissue repair, the final step is achieving adequate tissue approximation with a secure knot. The sliding knot is widely preferred over the nonsliding knot, with numerous publications describing knot configurations. However, in the literature there are few published descriptions of suture-handling techniques, even though they are fundamental to arthroscopic knot tying. We describe integral suture-handling techniques for arthroscopic sliding knots to improve the surgeon's perfor...

  1. Experimental evaluation of horse hair as a nonabsorbable monofilament suture

    Directory of Open Access Journals (Sweden)

    Swati R Yedke


    Full Text Available Background: Success of surgery depends on wound closure and healing. Ancients had coated many suture materials from plant and animal origin. As the quest for natural nonabsorbable, monofilament surgical suture continues, horsehair has been taken for study, which is mentioned in ancient literature. Objectives: Aim of the study was to evaluate detail mechanical and biophysical properties of horsehair. Materials and Methods: Physical properties, that are diameter, straight pull and knot pull tensile strength, bioburden, sterility tests were performed. Visual and histological wound healing parameters were studied in experimental Wistar rat incision wound model. Two experimental wounds about 5 cm long were created on each side of dorsal midline. Each animal received two sutures-Horsehair 4-0 and Ethilon 4-0. The sutured areas were grossly examined on 3 rd and 7 th days for visual observations like congestion, edema, infection, wound disruption, and impression of suture material on healed wound and then subjected for histological study. Results: Revealed that horsehair has got diameter of 0.19 mm which complies with the 4-0 size USP standard. Straight pull tensile strength was found 0.5851 ± 0.122 kg and knot pull tensile strength was 0.3998 ± 0.078 kg, which complies with the standards of United State Pharmacopia for class II nonabsorbable suture materials. In vivo study revealed that there was no evidence of edema, congestion, and discharge in both the groups. Wounds healed with minimum impressions of suture material with minimum scar mark. Mean histological scoring shows very mild tissue reaction. Conclusion: Horsehair has got properties of standard suture material except low tensile strength and hence can be used in reconstructive, plastic surgeries, and ophthalmic surgeries.


    Directory of Open Access Journals (Sweden)

    Jafar Nader


    Full Text Available plastic adhesives, normal butyl cyanoacrylate monomer, isobutyl cyanoacrylate monomer and methyl 2 _ cyaooacrylate monomer, have been utilized in a comparative study with 5-{ silk suture in the repair of transected carotid arteries. Follow _ up arteriog ramS indicate isobutyl cyanoacrylate monomer and normal butyl cyanoacrylate monomer as having the most impressive rerults with only tWO thrombosis each. The silk suture had three thromboses and the adhesive methyl 2 _ cyanoacrylate monomer had nine, one of which a delayed

  3. Fixation of the Achilles tendon insertion using suture button technology. (United States)

    Fanter, Nathan J; Davis, Edward W; Baker, Champ L


    In the operative treatment of Achilles insertional tendinopathy, no guidelines exist concerning which form of fixation of the Achilles tendon insertion is superior. Transcalcaneal drill pin passage does not place any major plantar structures at risk, and the addition of a Krackow stitch and suture button to the fixation technique provides a significant increase in ultimate load to failure in Achilles tendon insertional repairs. Controlled laboratory study. The Achilles tendon insertions in 6 fresh-frozen cadaveric ankles were detached, and transcalcaneal drill pins were passed. Plantar dissection took place to evaluate the drill pin relationship to the plantar fascia, lateral plantar nerve and artery, flexor digitorum longus tendon, and master knot of Henry. The Achilles tendons were then repaired with a double-row suture anchor construct alone or with a suture button and Krackow stitch added to the double-row suture anchor construct. The repairs were then tested to maximum load to failure at 20 mm/min. The mode of failure was recorded, and the mean maximum load to failure was assessed using the Student t test for distributions with equal variance. Transcalcaneal drill pin passage did not place any selected anatomic structures at risk. The mean maximum load to failure for the suture bridge group was 239.2 N; it was 391.4 N for the group with the suture button (P = .014). The lateral plantar artery was the structure placed at greatest risk from drill pin placement, with a mean distance of 22.7 mm (range, 16.5-29.2 mm) between the pin and artery. In this laboratory study, transcalcaneal drill pin passage appeared to be anatomically safe, and the use of suture button technology with a Krackow stitch for Achilles tendon insertional repair significantly increased repair strength. Achilles tendon insertional repair with suture button fixation and a Krackow stitch may facilitate the earlier institution of postoperative rehabilitation and improve clinical outcomes.

  4. The Efficacy of Polydioxanone Monofilament Absorbable Suture for Tracheal Anastomosis


    Kawahara, Katsunobu; Yamasaki, Naoya; Yamamoto, Satoshi; Nagayasu, Takeshi; Kusano, Hiroyuki; Akamine, Shinji; Takahashi, Takao; Tomita, Masao


    To evaluate the efficacy of polydioxanon absorbable suture for tracheal anastomoses, we performed an experimental study using dose. Eight adult mongrel dogs underwent sleeve resection of the mediastinal trachea. A length of ten to twelve cartilage rings was resected. An end-to-end anastomosis was performed using either interrupted or continuous running 4-0 polydioxanone (PDS) suture. There was no detectable difference bronchoscopically, microangiografically, or histologically, in tracheal ana...

  5. A comparison of lateral ankle ligament suture anchor strength. (United States)

    Barber, F Alan; Herbert, Morley A; Crates, John M


    Lateral ankle ligament repairs increasingly use suture anchors instead of bone tunnels. Our purpose was to compare the biomechanical properties of a knotted and knotless suture anchor appropriate for a lateral ankle ligament reconstruction. In porcine distal fibulae, 10 samples of 2 different PEEK anchors were inserted. The attached sutures were cyclically loaded between 10N and 60N for 200 cycles. A destructive pull was performed and failure loads, cyclic displacement, stiffness, and failure mode recorded. PushLock 2.5 anchors failed before 200 cycles. PushLock 100 cycle displacement was less than Morphix 2.5 displacement (panchors completing 200 cycles was 86.5N (PushLock) and 252.1N (Morphix) (panchor breaking and suture breakage. The knotted Morphix demonstrated more displacement and greater failure strength than the knotless PushLock. The PushLock failed consistently with suture breaking. The Morphix anchor failed both by anchor breaking and by suture breaking. Copyright © 2012 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.

  6. A combination of subcuticular suture and sterile Micropore tape compared with conventional interrupted sutures for skin closure. A controlled trial. (United States)

    Taube, M.; Porter, R. J.; Lord, P. H.


    We have conducted a controlled trial to compare skin closure using conventional interrupted sutures with a combination of subcuticular suture and sterile Micropore tape in 169 patients undergoing appendicectomy, inguinal herniorrhaphy, or saphenofemoral ligation. We have found that the combination technique consistently gives a better cosmetic result and that the tape acts well as a dressing, is convenient, and is well tolerated by patients. Images Fig. 1 Fig. 2 Fig. 3 Fig. 4 PMID:6344732

  7. Craniosynostosis of coronal suture in Twist1+/- mice occurs through endochondral ossification recapitulating the physiological closure of posterior frontal suture

    Directory of Open Access Journals (Sweden)

    Bjorn eBehr


    Full Text Available Craniosynostosis, the premature closure of cranial suture, is a pathologic condition that affects 1/2000 live births. Saethre-Chotzen syndrome is a genetic condition characterized by craniosynostosis. The Saethre-Chotzen syndrome, which is defined by loss-of-function mutations in the TWIST gene, is the second most prevalent craniosynostosis. Although much of the genetics and phenotypes in craniosynostosis syndromes is understood, less is known about the underlying ossification mechanism during suture closure. We have previously demonstrated that physiological closure of the posterior frontal (PF suture occurs through endochondral ossification. Moreover, we revealed that antagonizing canonical Wnt signaling in the sagittal suture leads to endochondral ossification of the suture mesenchyme and sagittal synostosis, presumably by inhibiting Twist1. Classic Saethre-Chotzen syndrome is characterized by coronal synostosis, and the haploinsufficient Twist1+/- mice represents a suitable model for studying this syndrome. Thus, we seeked to understand the underlying ossification process in coronal craniosynostosis in Twist1+/- mice. Our data indicate that coronal suture closure in Twist1+/- mice occurs between postnatal day 9 to 13 by endochondral ossification, as shown by histology, gene expression analysis and immunohistochemistry. In conclusion, this study reveals that coronal craniosynostosis in Twist1+/- mice occurs through endochondral ossification. Moreover, it suggests that haploinsufficency of Twist1 gene, a target of canonical Wnt-signaling, and inhibitor of chondrogenesis, mimics conditions of inactive canonical Wnt-signaling leading to craniosynostosis.

  8. Biomechanical characteristics of single-row repair in comparison to double-row repair with consideration of the suture configuration and suture material


    Baums, M. H.; Buchhorn, G. H.; Spahn, G.; Poppendieck, B.; Schultz, W.; Klinger, H.-M.


    The aim of the study was to evaluate the time zero mechanical properties of single- versus double-row configuration for rotator cuff repair in an animal model with consideration of the stitch technique and suture material. Thirty-two fresh-frozen sheep shoulders were randomly assigned to four repair groups: suture anchor single-row repair coupled with (1) braided, nonabsorbable polyester suture sized USP No. 2 (SRAE) or (2) braided polyblend polyethylene suture sized No. 2 (SRAH). The double-...

  9. Unusual central Nevada geologic terranes produced by Late Devonian Antler orogeny and Alamo impact (United States)

    Poole, Forrest G.; Sandberg, Charles


    This Special Paper is the product of nearly 25 years of geologic investigations. It is an exposition of two small areas, both less than 25 km east of the Mississippian Roberts Mountains allochthon, but each displaying a different, unique geologic terrane, previously undocumented in Nevada and perhaps in North America. One area, the Bisoni-McKay, at the south end of the Fish Creek Range, displays an olistostrome, shed eastward during the late Late Devonian (early Famennian) from a migrating Antler orogenic forebulge. The other, the Warm Springs–Milk Spring, at the south end of the Hot Creek Range, displays a deeper marine terrane affected by the early Late Devonian (middle Frasnian) Alamo impact.

  10. [Treatment of calcaneal avulsion fractures with twinfix suture anchors fixation]. (United States)

    Zhao, Bin-xiu; Wang, Kun-zheng; Wang, Chun-sheng; Xie, Yue; Dai, Zhi-tang; Liu, Gang; Liu, Wei-dong


    For the calcaneal avulsion fracture, the current method is more commonly used screws or Kirschner wire to fix fracture fragment. This article intended to explore the feasibility and clinical efficacy for the treatment of avulsion fractures with TwinFix suture anchors. From July 2007 to November 2010, 21 patients were reviewed, including 15 males and 6 females, ranging in age from 49 to 65 years,with a mean of 58.7 years. Twelve patients had nodules in the right heel and 9 patients had nodules in the left heel. All the patients had closed fractures. The typical preoperative symptoms of the patients included pain in the upper heel and weak in heel lift. Body examination results: palpable sense of bone rubbing in the back of the heel, and swelling in the heel. Surgery treatment with TwinFix suture anchors performed as follows : to fix TwinFix suture anchors into the calcaneal body, then to drill the fracture block, to make the double strand suture through the fracture holes, to knot the suture eachother to fix the block, and to use stitch to fix the remaining suture in the Achilles tendon in order to improve the block fixation. The criteria of the AOFAS Foot and Ankle Surgery by the United States Association of ankle-rear foot functional recovery was used to evaluate the Achilles tendon. Total average score was (95.5 +/- 3.12) points, including pain items of(38.5 +/- 2.18) points,the average score of functional items of (49.5 +/- 3.09) points,and power lines of 10 points in all patients. Twenty-one patients got an excellent result, 16 good and 5 poor. The methods of treatment for the calcaneal avulsion fractures with TwinFix suture anchors is a simple operation, and have excellent clinical effect, which is worthy of promotion.

  11. Thermochronology of the Sulu ultrahigh-pressure metamorphic terrane: Implications for continental collision and lithospheric thinning (United States)

    Liu, Li-Ping; Li, Zheng-Xiang; Danišík, Martin; Li, Sanzhong; Evans, Noreen; Jourdan, Fred; Tao, Ni


    The thermal history of the Dabie-Sulu orogenic belt provides important constraints on the collision process between the South China and North China blocks during the Mesozoic, and possible lithospheric thinning event(s) in the eastern North China Block. This study reports on the thermal evolution of the Sulu ultrahigh-pressure metamorphic (UHP) terrane using zircon U-Pb geochronology and multiple thermochronology methods such as mica and hornblende 40Ar/39Ar, zircon and apatite fission track, and zircon and apatite (U-Th)/He dating. 40Ar/39Ar and zircon (U-Th)/He data show that the UHP terrane experienced accelerated cooling during 180-160 Ma. This cooling event could be interpreted to have resulted from extensional unroofing of an earlier southward thrusting nappe, or, more likely, an episode of northward thrusting of the UHP rocks as a hanging wall. A subsequent episode of exhumation took place between ca. 125 Ma and 90 Ma as recorded by zircon (U-Th)/He data. This event was more pronounced in the northwest section of the UHP terrane, whereas in the southeast section, the zircon (U-Th)/He system retained Jurassic cooling ages of ca. 180-160 Ma. The mid-Cretaceous episode of exhumation is interpreted to have resulted from crustal extension due to the removal of thickened, enriched mantle. A younger episode of exhumation was recorded by apatite fission track and apatite (U-Th)/He ages at ca. 65-40 Ma. Both latter events were linked to episodic thinning of lithosphere along the Sulu UHP terrane in an extensional environment, likely caused by the roll-back of the Western Pacific subduction system.

  12. Zircon U-Pb ages of Guyana greenstone-gneiss terrane

    Energy Technology Data Exchange (ETDEWEB)

    Gibbs, A.K. (Cornell Univ., Ithaca, NY (USA)); Olszewski, W.J. Jr. (New Hampshire Univ., Durham (USA))


    Isotopic U-Pb studies of zircons collected from weathered metagreywackes of the Barama-Mazaruni Supergroup of northern Guyana, South America, demonstrate an age of origin of ca. 2250 Ma. This is the best estimate for the age of the associated metavolcanic rocks. Zircons from weathered gneiss of the Bartica complex, adjacent to the volcanic-sedimentary belts, yield a similar age. The contiguous greenstone-gneiss terrane of eastern Venezuela is also of similar age and comparable greenstone-gneiss terranes of eastern Suriname and French Guiana are probably also of this age. Continental crust formation of a style closely comparable to that of the Canadian Archean occurred on a very widespread scale in the Lower Proterozoic of the Guiana shield. The lead losses from the weathered zircons are comparable to those from zircons from fresh rock from the adjacent terrane of Venezuela, and the advantages of field concentration from numerous saprolite exposures warrant use of such material in future geochronological studies of the region.

  13. Detrital zircon ages in Buller and Takaka terranes, New Zealand : constraints on early Zealandia history

    International Nuclear Information System (INIS)

    Adams, C.J.; Mortimer, N.; Campbell, H.J.; Griffin, W.L.


    Detrital zircon ages are presented for 34 early Palaeozoic sandstones from Buller and Takaka terranes, New Zealand, and formerly adjacent parts of Australia-Antarctica. The Buller-Takaka datasets always have two major groups: Ordovician-late Neoproterozoic, 444-700 Ma (but mainly 540-700 Ma), termed 'Gondwana Assembly' (GA), and early Neoproterozoic-Mesoproterozoic, 700-1600 Ma (but mainly 900-1200 Ma), termed 'Rodinia Assembly' (RA). In both terranes, significant age components within these groups are strikingly similar and also have RA/GA ratios, 0.6-1.8. The Cambrian volcanic arc of the Takaka Terrane has contributed little to the zircon patterns. Proportions of Late Cambrian-Early Ordovician zircons, characteristic of granitoid sources in the Ross-Delamerian Orogen are low. The zircons are predominantly reworked with contemporary zircons only evident in a few Buller datasets. The zircon patterns suggest that two major sources (late Mesoproterozoic and late Neoproterozoic), enduring over 120 Ma, were widely distributed and it is postulated they form Precambrian basement beneath southern Zealandia. (author).

  14. Local Delivery of Growth Factors Using Coated Suture Material

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    T. F. Fuchs


    Full Text Available The optimization of healing processes in a wide range of tissues represents a central point for surgical research. One approach is to stimulate healing processes with growth factors. These substances have a short half-life and therefore it seems useful to administer these substances locally rather than systemically. One possible method of local delivery is to incorporate growth factors into a bioabsorbable poly (D, L-lactide suspension (PDLLA and coat suture material. The aim of the present study was to establish a procedure for the local delivery of growth factors using coated suture material. Sutures coated with growth factors were tested in an animal model. Anastomoses of the colon were created in a rat model using monofilament sutures. These were either untreated or coated with PDLLA coating alone or coated with PDLLA incorporating insulin—like growth factor-I (IGF-I. The anastomoses were subjected to biomechanical, histological, and immunohistochemical examination. After 3 days the treated groups showed a significantly greater capacity to withstand biomechanical stress than the control groups. This finding was supported by the results of the histomorphometric. The results of the study indicate that it is possible to deliver bioactive growth factors locally using PDLLA coated suture material. Healing processes can thus be stimulated locally without subjecting the whole organism to potentially damaging high systemic doses.

  15. Selective laser vaporization of polypropylene sutures and mesh (United States)

    Burks, David; Rosenbury, Sarah B.; Kennelly, Michael J.; Fried, Nathaniel M.


    Complications from polypropylene mesh after surgery for female stress urinary incontinence (SUI) may require tedious surgical revision and removal of mesh materials with risk of damage to healthy adjacent tissue. This study explores selective laser vaporization of polypropylene suture/mesh materials commonly used in SUI. A compact, 7 Watt, 647-nm, red diode laser was operated with a radiant exposure of 81 J/cm2, pulse duration of 100 ms, and 1.0-mm-diameter laser spot. The 647-nm wavelength was selected because its absorption by water, hemoglobin, and other major tissue chromophores is low, while polypropylene absorption is high. Laser vaporization of ~200-μm-diameter polypropylene suture/mesh strands, in contact with fresh urinary tissue samples, ex vivo, was performed. Non-contact temperature mapping of the suture/mesh samples with a thermal camera was also conducted. Photoselective vaporization of polypropylene suture and mesh using a single laser pulse was achieved with peak temperatures of 180 and 232 °C, respectively. In control (safety) studies, direct laser irradiation of tissue alone resulted in only a 1 °C temperature increase. Selective laser vaporization of polypropylene suture/mesh materials is feasible without significant thermal damage to tissue. This technique may be useful for SUI procedures requiring surgical revision.


    Directory of Open Access Journals (Sweden)

    Fırat SELVİ


    Full Text Available Purpose: The purpose of this study was to investigate the healing differences in between four different widely used suture materials in the oral surgery practice, including silk (Perma- Hand; Ethicon, INC., Somerville, NJ, USA, polypropylene (Prolene; Ethicon, INC., Somerville, NJ, USA, coated polyglactin 910 (Ethicon, INC., Somerville, NJ, USA. and polyglecaprone 25 (Ethicon, INC., Somerville, NJ, USA . Materials and Methods: 20 male rats were randomly allocated into two groups depending on their sacrification days (post-operative 1st and the 7th days. Four longitudinal incision wounds, each 1cm in size, were created on the dorsum of each animal which were then primarily closed with four different types of sutures. Results: The effects of these suture materials on soft tissue healing were compared histopathologically, by means of density of the cells, necrosis, fibrosis, foreign body reaction, the presence of cells of acute and chronic infection. No statistically significant difference was observed between the groups regarding the density of the cells, necrosis, fibrosis, foreign body reaction, and the presence of the cells of acute & chronic infections. Of note, propylene showed slightly less tissue reaction among the other materials. Conclusion: The results of our study showed that there is no only one ideal suture material for surgical practice. The factors related to the patient, the type of the surgery and the quality of the tissue are important to decide an appropriate suture material.

  17. Mechanical Behavior of Bio-inspired Model Suture Joints (United States)

    Li, Yaning; Lin, Erica; Ortiz, Christine; Boyce, Mary


    Suture joints of varying degrees of geometric complexity are prevalent throughout nature as a means of joining structural elements while providing locally tailored mechanical performance. Here, micromechanical models of general trapezoidal waveforms of varying hierarchy are formulated to reveal the role of geometric complexity in governing stiffness, strength, toughness and corresponding deformation and failure mechanisms. Physical constructs of model composite suture systems are fabricated via multi-material 3D printing (Object Connex500). Tensile tests are conducted on samples covering a range in geometry, thus providing quantitative measures of stiffness, strength, and failure. The experiments include direct visualization of the deformation and failure mechanisms and their progression, as well as their dependence on suture geometry, showing the interplay between shear and tension/compression of the interfacial layers and tension of the skeletal teeth and the transition in failure modes with geometry. The results provide quantitative guidelines for the design and tailoring of suture geometry to achieve the desired mechanical properties and also facilitate understanding of suture growth and fusion, and evolutionary phenotype.

  18. Water-tight knee arthrotomy closure: comparison of a novel single bidirectional barbed self-retaining running suture versus conventional interrupted sutures. (United States)

    Nett, Michael; Avelar, Rui; Sheehan, Michael; Cushner, Fred


    Standard medial parapatellar arthrotomies of 10 cadaveric knees were closed with either conventional interrupted absorbable sutures (control group, mean of 19.4 sutures) or a single running knotless bidirectional barbed absorbable suture (experimental group). Water-tightness of the arthrotomy closure was compared by simulating a tense hemarthrosis and measuring arthrotomy leakage over 3 minutes. Mean total leakage was 356 mL and 89 mL in the control and experimental groups, respectively (p = 0.027). Using 8 of the 10 knees (4 closed with control sutures, 4 closed with an experimental suture), a tense hemarthrosis was again created, and iatrogenic suture rupture was performed: a proximal suture was cut at 1 minute; a distal suture was cut at 2 minutes. The impact of suture rupture was compared by measuring total arthrotomy leakage over 3 minutes. Mean total leakage was 601 mL and 174 mL in the control and experimental groups, respectively (p = 0.3). In summary, using a cadaveric model, arthrotomies closed with a single bidirectional barbed running suture were statistically significantly more water-tight than those closed using a standard interrupted technique. The sample size was insufficient to determine whether the two closure techniques differed in leakage volume after suture rupture.

  19. Isotopic provenance analysis and terrane tectonics: a warning about sediment transport distances

    International Nuclear Information System (INIS)

    Bassett, K.N.


    Full text: In the last 10 years the field of provenance analysis has undergone a revolution with the development of single-crystal isotopic dating techniques, the most common being U/Pb zircon and 40Ar/39Ar techniques. These have allowed age determination of single crystals thus providing more detail about probable provenance of each individual grain rather than an averaged population of grains. The usefulness for resolving complex terrane accretion and translation histories was immediately obvious and there have been many studies in many different regions aimed at tracking terrane motions by provenance of individual grains upward through the stratigraphy of a basin. Recent research in the North American Cordilleran terranes and in the New Zealand Torlesse Superterrane show how widely used and powerful these provenance analysis techniques are. However, isotopic provenance analysis has often been presented as key information to resolve controversies around terrane translation histories with very little discussion of the context of sedimentary facies and sediment transport mechanisms. An example is the recent use of U/Pb detrital zircon ages as the supposedly controversy-ending evidence for the amount of lateral translation of the Insular Superterrane in British Columbia (Baja BC) (Mahoney et al., 1999). The zircon grains were separated from fine-grained turbidite deposits and could easily have been transported over very large distances by a variety of mechanisms; yet they were presented as definitively resolving the Baja BC controversy. Modern examples illustrate the problem of using the provenance of fine grained sediment to constrain terrane tectonics. Sediment in the tip of the Bengal submarine fan was transported ∼3000 km from source, first by fluvial processes then by sediment gravity flow in the submarine fan. The detrital isotopic ages of single grains are the same as the depositional ages indicating a very rapid unroofing and transport rate with minimal


    Directory of Open Access Journals (Sweden)



    Full Text Available AIM: To evaluate the outcome of adjustable suture technique in ptosis surgery. INTRODUCTION : Surgical management of blepharoptosis is indicated in multiple situations and the post - operative outcomes can be as variable as the indications for surgery. Adjustable suture techniques in ptosis repair have been introduced and variable efficacies have been reported. MATERIALS AND METHODS: A retrospective case review of medical records from June 2010 to May 2011 (12 months of 5 eyes of 5 consecutive patients operated by a single surgeon at a Tertiary Eye care center in South India were reviewed. The clinical profile of patients included was r ecorded and results of adjustable suture technique described by Borman and collegues for these patients was reported. RESULTS: 5 eyes of 5 patients underwent adjustable suture ptosis repair in the study duration. 4 patients with moderate and 1 with severe ptosis, all having good levator function were diagnosed to have c ongenital ptosis in 3 cases and a cquired involutional ptosis in 2 cases. All 5 cases had a satisfactory outcome at day 4 post - operative after adjustment of lid height in the out - patient clini c. 1 patient with acquired involutional ptosis, identified with levator dehiscence intra - operatively had overcorrection at 6 months warranting re - surgery while the other 4 patients had satisfactory cosmetic lid height and functional outcome at 6 months fol low up after the adjustable suture technique for ptosis repair. CONCLUSION: Use of adjustable sutures in ptosis surgery can eliminate the intraoperative lid factors that can lead to unpredictable results. The technique described is easy to adapt and perfor m and can give repeatable and well acceptable results in the properly selected cases

  1. A reusable suture anchor for arthroscopy psychomotor skills training. (United States)

    Tillett, Edward D; Rogers, Rainie; Nyland, John


    For residents to adequately develop the early arthroscopy psychomotor skills required to better learn how to manage the improvisational situations they will encounter during actual patient cases, they need to experience sufficient practice repetitions within a contextually relevant environment. Unfortunately, the cost of suture anchors can be a practice repetition-limiting factor in learning arthroscopic knot-tying techniques. We describe a technique for creating inexpensive reusable suture anchors and provide an example of their application to repair the anterior glenoid labrum during an arthroscopy psychomotor skills laboratory training session.

  2. Effect of robotic manipulation on unidirectional barbed suture integrity: evaluation of tensile strength and sliding force. (United States)

    Kaushik, Dharam; Clay, Kevin; Hossain, S G M; Park, Eugene; Nelson, Carl A; LaGrange, Chad A


    One of the more challenging portions of robot-assisted radical prostatectomy (RARP) is the urethrovesical anastomosis. Because of this, a unidirectional absorbable barbed suture (V-Loc(™)) has been used to complete the anastomosis with better efficiency and less tension. The effect of robotic needle driver manipulation on barbed suture is unknown. Therefore, the aim of this study is to determine whether robotic manipulation decreases the tensile strength and peak sliding force of V-Loc barbed suture. Fifty-six V-Loc sutures were compared with 56 Maxon sutures. All sutures were 3-0 caliber. Half of the sutures in each group were manipulated with a da Vinci(®) robot large needle driver five times over a 5 cm length of suture. The other half was not manipulated. Breaking force was determined by placing sutures in a Bose ElectroForce load testing device. For sliding force testing, 28 V-Loc sutures were manipulated in the same fashion and compared with 28 nonmanipulated V-Loc sutures. Peak force needed to make the suture slip backward in porcine small intestine was determined to be the sliding force. Scanning electron microscopy of the barbs before and after robotic manipulation was also performed. The mean difference in breaking forces for manipulated vs nonmanipulated Maxon sutures was 4.52 N (P=0.004). The mean difference in breaking forces for manipulated vs nonmanipulated V-Loc sutures was 1.30 N (P=0.046). The manipulated V-Loc group demonstrated a lower peak sliding force compared with the nonmanipulated group (0.76 vs 0.88 N, P=0.199). Electron microscopy revealed minor structural damage to the barbs and suture. Tensile strength and peak sliding force of V-Loc suture is decreased by robotic manipulation. This is likely because of structural damage to the suture and barbs. This structural damage, however, is likely not clinically significant.

  3. Interrupted or continuous-intradermal suturing? Statistical analysis of postoperative scars

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    Elif Sarı


    Full Text Available Background and Design: Postoperative scar development is an important problem for patients treated in plastic surgery clinics. Most patients think that continuous intradermal suturing is superior to interrupted suturing because they assume that it creates less scarring. We evaluated scars that form following intradermal and interrupted suturing. This article presents our controlled study that objectively compared the scars on patients' faces using a wound evaluation scale. Materials and Methods: Thirty-five patients, who had undergone operations on the bilateral cheeks, were included in this study. Thirty patients were female; five patients were male. Their mean age was 40.05 years. The average scar evaluation time after surgery was 9.05 months. Elliptical excisions were made on the lesions under local anesthesia. The incisions on the right cheeks were sutured with 6/0 monofilament nonabsorbable sutures using the continuous intradermal suturing technique. The left cheek incisions were sutured with same sutures using the interrupted suturing method. Results: The patients were evaluated 7–11 months after operation (mean: 9.05 months using the Stony Brook Scar Evaluation Scale. A Related Samples T-test was used for statistical evaluation of the differences between the suturing techniques. No significant differences were noted in scar formation between the two suturing methods (p>0.05. Conclusion: We found no differences in scar formation between the two frequently used suturing techniques studied here. We believe that the suturing technique is a less important determinant of scar formation than are other factors.

  4. The Svalbard Caledonides - a collage of Laurentian, Timanian and exotic terranes assembled by Silurian - Late (?) Devonian transcurrent faulting. (United States)

    Andresen, Arild; Gasser, Deta


    New field and geochronological data from NE Greenland and Svalbard indicate that most of the sub-terranes making up the Svalbard Caledonides (Eastern, Northwestern and Southwestern Terranes) are derived from Laurentias eastern margin. The Neoproterozoic deposits of the Eastern Terrane (Nordaustlandet) show an almost one to one correlation with the Late Neoproterozoic Eleonore Bay Supergroup in NE Greenland. Great similarities also exist between the substratum to the Neoproterozoic deposits in the two areas. The "Barentsian plate/continent" is interpreted to be derived from Laurentias eastern margin Lithologic similarities also exist between parts of the Northwestern Terrane and NE Greenland. The geologic evolution of Svalbard`s Southwestern Terrane, with subduction complexes and Late Neoproterozoic intrusives (Timanian ?) is poorly understood. It will, however, be argued that there is no need to invoke considerable right lateral strike-slip movement of the Motalefjellet subduction complex and related rocks from a position in Arctic Canada to their present position within the Southwestern Terrane, as proposed by some authors. The structural grain of the Svalbard Caledonides, oblique to East Greenland and Scandinavian Caledonides, as well as the Ellesmerian Orogen, is interpreted to be due to counter-clockwise rotation (c. 45o) of the Caledonian trend. A counter-clockwise rotation is to be expected when the northward moving terranes reached the E-W trending Franklinian Basin north of Greenland/Laurentia, which in Early Devonian time had not yet started to close. The model predicts that there should be a dramatic change in the Caledonian structural grain somewhere south of Bjørnøya. It is furthermore speculated that the fan-shaped orientation of Late Paleozoic rift basins in the Western Barents Sea is controlled by reactivation of the rotated structural trend (e.g. Billefjorden Fault Zone and Billefjorden Trough).

  5. Absorbable Polydioxanone (PDS) suture provides fewer wound complications than polyester (ethibond) suture in acute Tendo-Achilles rupture repair

    LENUS (Irish Health Repository)

    Baig, M N


    We prospectively studied acute Achilles tendon rupture in patients over a two 2-year period and reviewed the causes, outcome and complications. There were 53 patients included with acute Achilles rupture with minimum follow up period of 6 months. We compared the outcomes including infection rate and Boyden score between the two groups repaired by Polydioxanone and Polyester respectively. All infected cases had a suture repair using the polyester suture. The difference in the infection rate was highly significant between the 2 groups (p=0.001). All 34 patients (100%) in the PDS group had good \\/ excellent results based on the Boyden clinical assessment. Conversely, only 16 patients 9(68.4%) had good or excellent results IN Polyester repair group. Patients treated with a non- absorbable suture (ethibond) material for repair had a higher incidence infection and worse Boyden scores than the absorbable PDS group.

  6. Distribution and Diversity of Carboniferous and Permian Colonial Rugose Coral Faunas in Western North America: Clues for Placement of Allochthonous Terranes

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    Calvin H. Stevens


    Full Text Available Colonial rugose corals are common in western cratonal North America and in some of the allochthonous terranes, now amalgamated against its western margin. Throughout the Late Paleozoic, the coral faunas in these two different settings were significantly different. Comparisons of these faunas suggest that during the Mississippian the Alexander terrane probably was southwest of Arctic Alaska and the Stikine terrane probably lay west of the southern part of the North American craton. The Cache Creek terrane lay far out in the Paleopacific Ocean. The Pennsylvanian faunas suggest that the Quesnellia and Eastern Klamath terranes were situated southwest of Arctic Alaska and the Alexander terrane was somewhat farther southwest and farther from cratonal North America. The Stikine terrane continued to be positioned west of the southern part of the North American craton. During the Early Permian, terranes with a cratonal faunal aspect may have lain 2000–3000 km west of cratonal North America and latitudinally generally southwest of their present positions. In the Middle Permian these terranes were carried southward relative to the North American craton. Simultaneously the Tethyan Realm expanded eastward.

  7. Biomechanical Comparison of Modified Suture Bridge Using Rip-Stop versus Traditional Suture Bridge for Rotator Cuff Repair

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    ZiYing Wu


    Full Text Available Purpose. To compare the biomechanical properties of 3 suture-bridge techniques for rotator cuff repair. Methods. Twelve pair-matched fresh-frozen shoulder specimens were randomized to 3 groups of different repair types: the medially Knotted Suture Bridge (KSB, the medially Untied Suture Bridge (USB, and the Modified Suture Bridge (MSB. Cyclic loading and load-to-failure test were performed. Parameters of elongation, stiffness, load at failure, and mode of failure were recorded. Results. The MSB technique had the significantly greatest load to failure (515.6±78.0 N, P=0.04 for KSB group; P<0.001 for USB group, stiffness (58.0±10.7 N/mm, P=0.005 for KSB group; P<0.001 for USB group, and lowest elongation (1.49±0.39 mm, P=0.009 for KSB group; P=0.001 for USB group among 3 groups. The KSB repair had significantly higher ultimate load (443.5±65.0 N than USB repair (363.5±52.3 N, P=0.024. However, there was no statistical difference in stiffness and elongation between KSB and USB technique (P=0.396 for stiffness and P=0.242 for elongation, resp.. The failure mode for all specimens was suture pulling through the cuff tendon. Conclusions. Our modified suture bridge technique (MSB may provide enhanced biomechanical properties when compared with medially knotted or knotless repair. Clinical Relevance. Our modified technique may represent a promising alternative in arthroscopic rotator cuff repair.

  8. Achondroplasia with multiple-suture craniosynostosis: a report of a new case of this rare association

    NARCIS (Netherlands)

    Bessenyei, Beáta; Nagy, Andrea; Balogh, Erzsébet; Novák, László; Bognár, László; Knegt, Alida C.; Oláh, Eva


    We report on a female patient with an exceedingly rare combination of achondroplasia and multiple-suture craniosynostosis. Besides the specific features of achondroplasia, synostosis of the metopic, coronal, lambdoid, and squamosal sutures was found. Series of neurosurgical interventions were

  9. [Subluxation of scleral-fixated PC IOL caused by polypropylene suture degradation--case report]. (United States)

    Kanigowska, Krystyna; Grałek, Mirosława; Czarnowska, Elzbieta; Zajaczkowska, Agnieszka


    The purpose of the study is to evaluate factors related to late-onset of lens subluxation in transscleral sutured posterior chamber IOL. We report a child, which required surgical treatment for dislocation of a scleral-sutured PC IOL. 11 years earlier the secondary lens implantation with scleral fixation was performed in 4 years old boy. The first surgical procedure included an anterior victrectomy and suturing a single- piece PMMA IOL under the scleral flaps with a 10-0 polipropylene suture. The second--included explantation of the dislocated lens. Optic and scanning electron microscopy was used to analyze the surface of the explanted remnants of the breakage suture. Microscopic findings indicate that the late suture breakage and subluxation of suture-fixated PC IOL was due to the degradation of polypropylene suture.

  10. Lower precambrian of the Keivy Terrane, Northeastern Baltic Shield: A stratigraphic succession or a collage of tectonic sheets? (United States)

    Balagansky, V. V.; Raevsky, A. B.; Mudruk, S. V.


    The Keivy Terrane in the northeastern Baltic Shield appreciably differs from the adjacent tectonic blocks. In the northwestern part of this terrane (the Serpovidny Range), an outlier of Paleoproterozoic supracrustal rocks called the Serpovidny structure is surrounded by Archean (?) Keivy high-alumina paraschists. As follows from structural and magnetic data, the Paleoproterozoic rocks are deformed into a tight sheath fold 8 × 2 km in size at the surface and 5 km in length along the sheath axis. Faults parallel to the boundaries of the layers and locally cutting them off at an acute angle are involved in folding as well. The outer boundaries of the Serpovidny structure are tectonic. This structure is complementary to a larger tectonic lens composed of the Keivy mica schists. It is concluded that all of the supracrustal rocks of the Serpovidny Range are in fact tectonic sheets and lenses deformed into sheath folds. The literature data show that kilometer-scale sheath folds occur throughout the Keivy paraschist belt and most likely were formed owing to thrusting of the Murmansk Craton onto the Keivy Terrane in the south-southwestern direction. Foliation and lineation related to thrusting have been established in the Archean silicic metavolcanics and peralkaline granites occupying the most part of the terrane. In contrast, the granitoids and gabbroanorthosites of the Archean basement, which form a block 90 × 20 km in the southwestern Keivy Terrane, were not affected by Paleoproterozoic deformation. In other words, a detached assembly of tectonic sheets composed of the upper and middle crustal rocks that underwent deformation at the initial stage of the Paleoproterozoic Lapland-Kola Orogeny and the Archean basement, which is free of this deformation, are distinguished. The depth of detachment is estimated at 20-25 km. The detachment of the upper and middle crust in the Keivy Terrane and its position in the structure of the Baltic Shield are consistent with a

  11. Two possibilities for New Siberian Islands terrane tectonic history during the Early Paleozoic based on paleomagnetic data (United States)

    Metelkin, Dmitry V.; Chernova, Anna I.; Vernikovsky, Valery A.; Matushkin, Nikolay Yu.


    The New Siberian Islands (NSI), located in the East Siberian Sea in the junction region of various structural elements, are a key target for deciphering the tectonic evolution of the Eastern Arctic. In recent years, we went on several expeditions and gathered an extensive geological material for this territory. Among other things, we could prove that the basement of the De Long and Anjou archipelagos structures is Precambrian and the overlying Paleozoic sections formed within the same terrane. The form of the boundaries of the NSI terrane are actively debated and are probably continued from the Lyakhovsky islands in the south-west to the southern parts of the submerged Mendeleev Ridge, for which there is increasing evidence of continental crust. Today there are several models that interpret the Paleozoic-Mesozoic tectonic history and structural affiliation of the NSI terrane. Some propose that the Paleozoic sedimentary section formed in a passive margin setting of the Siberian paleocontinent. Others compare its history with marginal basins of the Baltica and Laurentia continents or consider the NSI terrane as an element of the Chukotka-Alaska microplate. These models are mainly based on results of paleobiogeographical and lithological-facies analyses, including explanations of probable sources for detrital zircons. Our paleomagnetic research on sedimentary, volcanogenic-sedimentary and igneous rocks of the Anjou (Kotelny and Bel'kovsky islands) and De Long (Bennett, Jeannette and Henrietta islands) archipelagos let us calculate an apparent polar wander path for the early Paleozoic interval of geological history, which allows us to conclude that the NSI terrane could not have been a part of the continental plates listed above, but rather had active tectonic boundaries with them. Our paleomagnetic data indicate that the NSI terrane drifted slowly and steadily in the tropical and subtropical regions no higher than 40 degrees. However, the main uncertainty for the

  12. Low palaeoelevation of the northern Lhasa terrane during late Eocene: Fossil foraminifera and stable isotope evidence from the Gerze Basin. (United States)

    Wei, Yi; Zhang, Kexin; Garzione, Carmala N; Xu, Yadong; Song, Bowen; Ji, Junliang


    The Lhasa terrane is a key region for understanding the paleoelevation of the southern Tibetan Plateau after India-Asia collision. The Gerze Basin, located in the northern part of the Lhasa terrane, is a shortening-related basin. We discovered Lagena laevis (Bandy) fossils in upper Eocene strata of the Gerze Basin. This type of foraminifera is associated with lagoon and estuarine environments, indicating that the northern part of the Lhasa terrane was near sea level during the late Eocene. We speculate that these foraminifera were transported inland by storm surges to low elevation freshwater lakes during times of marine transgressions. This inference is consistent with the relatively positive δ(18)O values in carbonate from the same deposits that indicate low palaeoelevations close to sea level. Considering the palaeoelevation results from the nearby Oligocene basins at a similar latitude and the volcanic history of the Lhasa terrane, we infer that large-magnitude surface uplift of the northern Lhasa terrane occurred between late Eocene and late Oligocene time.

  13. Healing of the suture line in the irradiated small intestine

    International Nuclear Information System (INIS)

    Da Costa, S.A.


    With the help of data from literature the author goes more deeply into the aetiology, treatment and possible prevention of lesions of the small intestine related to preceding irradiation. In a clinical retrospective study at twenty patients who, after irradiation of the abdominal and pelvic areas, have been submitted to abdominal surgery, the relation is studied between predistion factors for gastrointestinal complications after irradiation, the surgeries applied in case of small-intestine problems and postoperative complications. The third part of the thesis covers an experimental part in which the healing process of suture line in the terminal ileum has been studied after resection and reanastomosis in previously irradiated bowel of the rat. It was investigated whether differences occurred in the healing process of suture line after various periods - 4, 10 and 40 weeks, after irradiation. Also comparison took place with a control group which underwent a similar procedure with the exception of the radiation treatment, which was simulated in this group. In a second experiment it was investigated if the healing process of suture line depends on the type of anastomosis. An end-to-end anastomosis was chosen versus side-to-side anastomosis. Also in this experiment an irradiated group was compared with a control group. Furthermore a method was developed for performing micro-angiographies of the rat intestine in order to demonstrate obliteration of blood vessels in irradiated intestine and to assess neovascularization in the intestinal wall at the suture line. (author). 84 refs.; 18 figs.; 27 tabs

  14. Comparison of Subcuticular Suture Materials in Cesarean Skin Closure

    Directory of Open Access Journals (Sweden)

    Pınar Solmaz Hasdemir


    Full Text Available Aim. Comparison of the rate of wound complications, pain, and patient satisfaction based on used subcuticular suture material. Methods. A total of 250 consecutive women undergoing primary and repeat cesarean section with low transverse incision were prospectively included. The primary outcome was wound complication rate including infection, dehiscence, hematoma, and hypertrophic scar formation within a 6-week period after operation. Secondary outcomes were skin closure time, the need for use of additional analgesic agent, pain score on numeric rating scale, cosmetic score, and patient scar satisfaction scale. Results. Absorbable polyglactin was used in 108 patients and nonabsorbable polypropylene was used in 142 patients. Wound complication rates were similar in primary and repeat cesarean groups based on the type of suture material. Skin closure time is longer in nonabsorbable suture material group in both primary and repeat cesarean groups. There was no difference between groups in terms of postoperative pain, need for additional analgesic use, late phase pain, and itching at the scar. Although the cosmetic results tended to be better in the nonabsorbable group in primary surgery patients, there was no significant difference in the visual satisfaction of the patients. Conclusions. Absorbable and nonabsorbable suture materials are comparable in cesarean section operation skin closure.

  15. non absorbable sutures in the urinary bladder resulting

    African Journals Online (AJOL)

    The vesical calculus. Urol Clin North AM. 2000, 27:333-346. 3. Evans JW, Chapple CR, Ralph DJ, Millory EJ: Bladder calculus formation as a complication of the Stamey procedure. Br J Urol 1990,. 65:580-582. 4. Sheng-Tsun Su, He-Fu Haung, Shu-Fen. Chang. Encrusted Bladder stone on Non- absorbable sutures after a ...

  16. Polymeric Medical Sutures: An Exploration of Polymers and Green Chemistry (United States)

    Knutson, Cassandra M.; Schneiderman, Deborah K.; Yu, Ming; Javner, Cassidy H.; Distefano, Mark D.; Wissinger, Jane E.


    With new K-12 national science standards emerging, there is an increased need for experiments that integrate engineering into the context of society. Here we describe a chemistry experiment that combines science and engineering principles while introducing basic polymer and green chemistry concepts. Using medical sutures as a platform for…

  17. Suture supported P C IOL in a homocystinuric child.

    Directory of Open Access Journals (Sweden)

    Bhatti S


    Full Text Available A homocystinuric child presented with a secondary pupillary block glaucoma due to anteriorly subluxated lens. After removal of the subluxated lens, a suture supported posterior chamber IOL was implanted. Postoperative complication of cerebral venous thrombosis following general anaesthesia was managed with high doses of pyridoxine special diet and drugs.

  18. Single-suture scleral fixation of subluxated foldable intraocular lenses. (United States)

    Yarangumeli, Alper; Alp, Mehmet Numan; Kural, Gulcan


    To evaluate the results of single-suture scleral fixation of subluxated foldable intraocular lenses (IOL) in eyes with sufficient residual capsular support. The results of IOL repositioning by single-suture scleral fixation in 6 eyes of 6 patients with IOL subluxation were included. All subluxated IOLs were single-piece hydrophilic acrylic. Subluxation resulted from posterior capsule tears in 3 eyes, zonular dialyses in 2 eyes, and zonular dialysis with a capsulorhexis tear in 1 eye. A similar technique was used in all eyes in which one haptic was externalized through a superior clear corneal incision and tied with a Pair-PAK 10-0 polypropylene suture, and was finally retracted and fixated behind the iris close to the ciliary sulcus at the 12:00 meridian. All patients were followed up for at least 6 months. Best-corrected visual acuities ranged between finger counting and 20/70 (mean logMAR 1.02±0.64) preoperatively, and between 20/100 and 20/20 (mean logMAR 0.22±0.26) at the final postoperative visit. All IOLs remained centered and no significant postoperative complications were encountered except for an IOL tilt which resulted in a considerable oblique astigmatism in one eye. Subluxated foldable IOLs may safely be repositioned and secured with a single scleral fixation suture in selected cases with adequate amount of capsular remnants.

  19. Hyperammonemic encephalopathy due to suture line breakdown after bladder operation. (United States)

    Boogerd, W; Zoetmulder, F A; Moffie, D


    A patient is described with a severe encephalopathy and hyperammonemia in absence of liver dysfunction, attributed to urine absorption into the systemic circulation due to suture line breakdown after bladder dome resection. At autopsy characteristic Alzheimer type II astrocytes were found in the basal ganglia.

  20. A Simple Suturing Technique for Laparoscopic Ligation of Vascular Pedicles

    Directory of Open Access Journals (Sweden)

    Keith A. Aqua


    Full Text Available We report on the performance of 348 adnexectomies and 35 uterine artery ligations for both benign and malignant disease using a simple laparoscopic suturing technique. Only 5-mm ports are required, and there was no morbidity directly associated with this approach. The procedure can be performed quickly, is relatively inexpensive, and allows hysterectomy and oophorectomy to be performed without bipolar electrocautery.

  1. Stress-Softening and Residual Strain Effects in Suture Materials

    Directory of Open Access Journals (Sweden)

    Alex Elías-Zúñiga


    Full Text Available This work focuses on the experimental characterization of suture material samples of MonoPlus, Monosyn, polyglycolic acid, polydioxanone 2–0, polydioxanone 4–0, poly(glycolide-co-epsilon-caprolactone, nylon, and polypropylene when subjected to cyclic loading and unloading conditions. It is found that all tested suture materials exhibit stress-softening and residual strain effects related to the microstructural material damage upon deformation from the natural, undistorted state of the virgin suture material. To predict experimental observations, a new constitutive material model that takes into account stress-softening and residual strain effects is developed. The basis of this model is the inclusion of a phenomenological nonmonotonous softening function that depends on the strain intensity between loading and unloading cycles. The theory is illustrated by modifying the non-Gaussian average-stretch, full-network model to capture stress-softening and residual strains by using pseudoelasticity concepts. It is shown that results obtained from theoretical simulations compare well with suture material experimental data.

  2. Seismic signatures of the Pan-African orogeny: implications for southern Indian high-grade terranes (United States)

    Rai, Abhishek; Gaur, V. K.; Rai, S. S.; Priestley, K.


    We present the results of a study designed to investigate and compare the seismic characteristics of the once contiguous terranes of eastern Gondwanaland, now incorporated in five separated continental masses, which, during the Neoproterozoic (~600Ma) Pan-African orogeny, suffered a high degree of thermal stress and deformation. Receiver functions and surface wave data from stations located in East Antarctica, Sri Lanka, the southern-Indian high-grade terranes, Madagascar and the Tanzania-Mozambique belt, were used to determine the shear-wave velocity structure, Moho depth and VP/VS values of the respective crustal segments. This study provides an additional dimension to the otherwise well-documented characteristic petrology of their surface exposures and other geological signatures such as their extensive granulitization and gem formation during the Pan-African event. Analysis of the receiver functions and surface wave data for these seismic stations located on their present day widely distributed continental fragments have been made. It is observed that with the exception of KOD (at Kodaikanal hill), situated on the southern Indian granulites having the thickest crust (~43.5 km), most of the Pan-African granulitic terranes have a crustal thicknesses of ~37 +/- 0.8km, with a transition to higher velocity at mid-crustal depths, and that their bulk composition is felsic. Average crustal VP/VS values (1.704 +/- 0.03) and thicknesses (37.8 +/- 0.8km), for four stations (SYO, PALK, TRV and ABPO), now located in East Antarctica, Sri Lanka, India and Madagascar, respectively, show remarkable similarity, indicating that the Pan-African orogeny was extensive enough to reorder the crustal structure of a wide region with a broadly similar stamp.

  3. Paleomagnetic Constraints on the Tectonic History of the Mesozoic Ophiolite and Arc Terranes of Western Mexico (United States)

    Boschman, L.; Van Hinsbergen, D. J. J.; Langereis, C. G.; Molina-Garza, R. S.; Kimbrough, D. L.


    The North American Cordillera has been shaped by a long history of accretion of arcs and other buoyant crustal fragments to the western margin of the North American Plate since the Early Mesozoic. Accretion of these terranes resulted from a complex tectonic history interpreted to include episodes of both intra-oceanic subduction within the Panthalassa/Pacific Ocean, as well as continental margin subduction along the western margin of North America. Western Mexico, at the southern end of the Cordillera, contains a Late Cretaceous-present day long-lived continental margin arc, as well as Mesozoic arc and SSZ ophiolite assemblages of which the origin is under debate. Interpretations of the origin of these subduction-related rock assemblages vary from far-travelled exotic intra-oceanic island arc character to autochthonous or parautochthonous extended continental margin origin. We present new paleomagnetic data from four localities: (1) the Norian SSZ Vizcaíno peninsula Ophiolite; (2) its Lower Jurassic sedimentary cover; and (3) Barremian and (4) Aptian sediments derived from the Guerrero arc. The data show that the Mexican ophiolite and arc terranes have a paleolatitudinal plate motion history that is equal to that of the North American continent. This suggests that these rock assemblages were part of the overriding plate and were perhaps only separated from the North American continent by temporal fore- or back-arc spreading. These spreading phases resulted in the temporal existence of tectonic plates between the North American and Farallon Plates, and upon closure of the basins, in the growth of the North American continent without addition of any far-travelled exotic terranes.

  4. Nonsuturing or Skin Adhesives versus Suturing of the Perineal Skin After Childbirth: A Systematic Review

    NARCIS (Netherlands)

    Seijmonsbergen-Schermers, A.E.; Sahami, S.; Lucas, C.; de Jonge, A.


    Background: Suturing of perineal trauma after childbirth can cause problems such as pain, discomfort because of tight sutures, the need for suture removal, and dyspareunia. It is unclear whether leaving the perineal skin unsutured or using skin adhesives might prevent these problems. Methods:

  5. Nonsuturing or Skin Adhesives versus Suturing of the Perineal Skin After Childbirth: A Systematic Review

    NARCIS (Netherlands)

    Seijmonsbergen-Schermers, Anna E.; Sahami, Saloomeh; Lucas, Cees; Jonge, Ank de


    Suturing of perineal trauma after childbirth can cause problems such as pain, discomfort because of tight sutures, the need for suture removal, and dyspareunia. It is unclear whether leaving the perineal skin unsutured or using skin adhesives might prevent these problems. CENTRAL, MEDLINE, EMBASE,

  6. Nickel-Titanium Wire as Suture Material: A New Technique for the Fixation of Skin. (United States)

    Li, Haidong; Song, Tao


    To introduce nickel-titanium wire as suture material for closure of incisions in cleft lip procedures. Closure of skin incisions using nickel-titanium wire as suture material, with postoperative follow-up wound evaluation. There was excellent patient satisfaction and good cosmetic outcome. Nickel-titanium wire is an excellent alternative for suture closure of cleft lip surgical incisions.

  7. Development of a penetration friction apparatus (PFA) to measure the frictional performance of surgical suture

    NARCIS (Netherlands)

    Zhang, Gangqiang; Ren, Tianhui; Lette, Walter; Zeng, Xiangqiong; van der Heide, Emile


    Nowadays there is a wide variety of surgical sutures available in the market. Surgical sutures have different sizes, structures, materials and coatings, whereas they are being used for various surgeries. The frictional performances of surgical sutures have been found to play a vital role in their

  8. Piedra lata terrane of Uruguay: Rb-Sr geochronological data of two new paleoproterozoic (transamazonian) granitoids

    International Nuclear Information System (INIS)

    Cingolani, C; Bossi, J; Varela, R; Maldonado, S.; Pineyro, D.; Schipilov, A


    The Precambrian basement of Uruguay consists of three major terranes separated and crosscut by wide NE-striking subvertical transcurrent shear zones. The western terrane as a part of the Rio de la Plata Craton is known as the Piedra Alta Terrane (PAT). This is separated from the Nico Perez Terrane by the Sarandi del Yi-Piri olis subvertical shear zone (Bossi et al., 1993). A mafic dykes complex intruded the PAT at 1.8 Ga and was not later deformed. The PAT has equivalent rocks in the igneous-metamorphic basement of Tandilia region and the Martin Garcia Island, Buenos Aires Province, Argentina (Dalla Salda et al., 1988; Cingolani and Dalla Salda, 2000). The PAT shows no evidence of the Neoproterozoic orogenies and is considered a best preserved Paleoproterozoic block (Transamazonian Cycle). It contains three E-W trending belts of volcano-sedimentary rocks with low grade metamorphism. These are from south to north: Pando, San Jose and Andresito belts (Bossi et al., 1996). Associated with them, three granitic-gneissic zones he Ecilda Paullier, Florida and Feliciano- were recognized with magmatic intrusives emplaced at different crustal levels. The San Jose belt is the largest supracrustal unit and contains abundant volcanic and volcaniclastic rocks of low grade metamorphic (Paso Severino Fm.) with sheets of granitic rocks intercalated (Mutti et al., 1996; Bossi et al., 1996). The associated granitic rocks are of large areal extension, mostly granodiorites and tonalites, and minor monzogranite and gabbro (e.g. Cerro Rospide region), including xenoliths from Paso Severino Fm. Towards the north of the San Jose belt an important Florida granitized zone is developed in the central part of the PAT, where the Pintos massif was recognized. The main purpose of this contribution is to offer new Rb-Sr geochronological data from two granitoid units, The Cerro Rospide intrusive in Paso Severino Fm. and Pintos massif included in medium grade migmatic-metamorphic complex and its

  9. Caudal Septal Stabilization Suturing Technique to Treat Crooked Noses. (United States)

    Baykal, Bahadir; Erdim, Ibrahim; Guvey, Ali; Oghan, Fatih; Kayhan, Fatma Tulin


    To rotate the nasal axis and septum to the midline using an L-strut graft and a novel caudal septal stabilization suturing technique to treat crooked noses. Thirty-six patients were included in the study. First, an L-strut graft was prepared by excising the deviated cartilage site in all patients. Second, multiple stabilization suturing, which we describe as a caudal septal stabilization suturing technique with a "fishing net"-like appearance, was applied between the anterior nasal spine and caudal septum in all patients. This new surgical technique, used to rotate the caudal septum, was applied to 22 I-type and 14 C-type crooked noses. Correction rates for the crooked noses were compared between the 2 inclination types with angular estimations. Deviation angles were measured using the AutoCAD 2012 software package and frontal (anterior) views, with the Frankfurt horizontal line parallel to the ground. Nasal axis angles showing angle improvement graded 4 categories as excellent, good, acceptable, and unsuccessful for evaluations at 6 months after surgery in the study. The success rate in the C-type nasal inclination was 86.7% (±21.9) and 88% (±16.7) in the I-type. The overall success rate of L-strut grafting and caudal septal stabilization suturing in crooked nose surgeries was 87.5% (±18.6). "Unsuccessful" results were not reported in any of the patients. L-strut grafting and caudal septal stabilization suturing techniques are efficacious in crooked noses according to objective measurement analysis results. However, a longer follow-up duration in a larger patient population is needed.

  10. Treatment of chronic deltoid ligament injury using suture anchors. (United States)

    Wang, Xu; Ma, Xin; Zhang, Chao; Wang, Chen; Huang, Jia-zhang


    To explore the efficacy of overlapping suture-anchor fixation for treatment of chronic deltoid ligament injury. Seventeen patients (11 men, 6 women of mean age 32.1 years [range, 18-58 years]) who had undergone surgery for chronic deltoid ligament injury from January 2007 to December 2011 were retrospectively analyzed. Preoperatively, they had undergone bilateral weight-bearing posterior-anterior radiographs, (MRI) and ultrasound examinations of the ankle. Ankle arthroscopy was performed to confirm the diagnosis, followed by surgery to clear intra-articular proliferating synovial tissues and remove cartilage debris and scar tissue. The deep layer of the deltoid ligament was sutured onto the tip of the medial malleolus and its superficial layer sutured onto its periosteum and fixed with suture anchors. American Orthopedic Foot and Ankle Society (AOFAS) scoring system for the ankle-hindfoot was used to evaluate the ankles pre- and post-operatively. The 17 patients were followed up for 12-34 months (mean 20.1 months). The angle between the long axes of the talus and first metatarsal and the hindfoot angle measured in a hindfoot alignment view (as described by Saltzman) were reduced from 5.4° ± 1.8° and 8.2° ± 2.6° preoperatively to 4.0° ± 0.9° and 5.3° ± 1.3° postoperatively, respectively. The mean AOFAS ankle-hindfoot score was 76.8 ± 7.0 preoperatively and 94.1 ± 3.3 at the last follow-up visit. Ten patients were scored as excellent, six as good, and one as fair. Pain was relieved in all patients and no patients had recurrent deltoid ligament injury. Using suture anchors to treat chronic deltoid ligament injury has relatively satisfactory outcomes. © 2014 Chinese Orthopaedic Association and Wiley Publishing Asia Pty Ltd.

  11. Arthroscopic repair of lateral ankle ligament complex by suture anchor. (United States)

    Wang, Jingwei; Hua, Yinghui; Chen, Shiyi; Li, Hongyun; Zhang, Jian; Li, Yunxia


    Arthroscopic repair of the lateral ligament complex with suture anchors is increasingly used to treat chronic ankle instability (CAI). Our aims are (1) to analyze and evaluate the literature on arthroscopic suture anchor repair of the anterior talofibular ligament and (2) to conduct a systematic review of the clinical evidence on the reported outcomes and complications of treating CAI with this technique. We performed a systematic review of the literature using PubMed, Ovid, Elsevier ScienceDirect, Web of Science-Conference Proceedings Citation Index, and the Cochrane Database of Systematic Reviews from 1987 to September 2013. Clinical studies using the arthroscopic suture anchor technique to treat CAI were included. Outcome measures consisted of clinical assessment of postoperative ligament stability and complications. In addition, the methodologic quality of the included studies was assessed by use of the modified Coleman Methodology Score. After reviewing 371 studies, we identified 6 studies (5 retrospective case series and 1 prospective case series, all Level IV) that met the inclusion criteria, with a mean Coleman Methodology Score of 71.8 ± 7.52 (range, 63 to 82). In these studies 178 patients (179 ankles) underwent arthroscopic suture anchor repair of the anterior talofibular ligament with a mean follow-up period of 38.9 months (range, 6 to 117.6 months). All patients were reported to have subjective improvement of their ankle instability, with complications in 31 cases. Studies of arthroscopic suture anchor technique to treat CAI are sparse, with moderate mean methodologic quality. The included studies suggest that the arthroscopic technique is a feasible procedure to restore ankle stability; however, on the basis of our review, this technique seems to be associated with a relatively high complication rate. Extensive cadaveric studies, clinical trials, and comparative studies comparing arthroscopic and open repair should be performed in the future. Level

  12. Cryogenian alkaline magmatism in the Southern Granulite Terrane, India: Petrology, geochemistry, zircon U-Pb ages and Lu-Hf isotopes (United States)

    Santosh, M.; Yang, Qiong-Yan; Ram Mohan, M.; Tsunogae, T.; Shaji, E.; Satyanarayanan, M.


    The Southern Granulite Terrane (SGT) in India preserves the records of the formation and recycling of continental crust from Mesoarchean through Paleoproterozoic to Neoproterozoic and Cambrian, involving multiple subduction-accretion-collision associated with major orogenic cycles. A chain of unmetamorphosed and undeformed alkaline magmatic intrusions occurs along the northern margin of the SGT aligned along paleo-suture zones. Here we investigate two representative plutons from this suite, the Angadimogar syenite (AM) and the Peralimala alkali granite (PM) through field, petrological, geochemical, zircon U-Pb and Lu-Hf studies. Magma mixing and mingling textures and mineral assemblages typical of alkaline rocks are displayed by these plutons. The whole-rock major and trace element data characterize their alkaline nature. In trace element discrimination diagrams, the AM rocks straddle between the VAG (volcanic-arc granites) and WPG (within plate granites) fields with most of the samples confined to the VAG field, whereas the PM rocks are essentially confined to the WPG field. The diversity in some of the geochemical features between the two plutons is interpreted to be the reflection of source heterogeneities. Most zircon grains from the AM and PM plutons display oscillatory zoning typical of magmatic crystallization although some grains, particularly those from the PM pluton, show core-rim structures with dark patchy zoned cores surrounded by irregular thin rims resulting from fluid alteration. The weighted mean 206Pb/238U ages of the magmatic zircons from three samples of the AM syenite are in the range of 781.8 ± 3.8 Ma to 798 ± 3.6 Ma and those from two samples of the PM alkali granite yield ages of 797.5 ± 3.7 Ma and 799 ± 6.2 Ma. A mafic magmatic enclave from the AM pluton shows weighted mean 206Pb/238U age of 795 ± 3.3 Ma. The AM and PM plutons also carry rare xeneocrystic zircons which define upper intercept concordia ages of 3293 ± 13 Ma and 2530

  13. Interpretation of gravity profiles across the northern Oaxaca terrane, its boundaries and the Tehuacán Valley, southern Mexico (United States)

    Campos-Enríquez, J. O.; Alatorre-Zamora, M. A.; Keppie, J. D.; Belmonte-Jiménez, S. I.; Ramón-Márquez, V. M.


    A gravity study was conducted across the northern Oaxaca terrane and its bounding faults: the Caltepec and Oaxaca Faults to the west and east, respectively. These faults juxtapose the Oaxaca terrane against the Mixteca and Juarez terranes, respectively. The Oaxaca Fault also forms the eastern boundary of the Cenozoic Tehuacán depression. On the west, at depth, the Tehuacán valley is limited by the normal buried Tehuacán Fault. This gravity study reveals that the Oaxaca Fault system gives rise to a series of east tilted basamental blocks (Oaxaca Complex). The tectonic depression is filled with Phanerozoic rocks and has a deeper depocenter to the west. The gravity data also indicate that on the west, the Oaxaca Complex, the Caltepec and Santa Lucia faults continue northwestwards beneath Phanerozoic rocks. A major E-W to NE-SW discontinuity is inferred to exist between profiles 1 and 2.

  14. The Incidence and Topographic Distribution of Sutures Including Wormian Bones in Human Skulls. (United States)

    Cirpan, Sibel; Aksu, Funda; Mas, Nuket


    The Wormian Bones are accessory bones located within the cranial sutures and fontanelles. The present article examines the incidence of Wormian Bones and compares the number and topographic distribution between the sutures including Wormian Bones in skulls of West Anatolian Population. One hundred fifty crania were examined. The parameters evaluated in the present study were as follows: the rate of skulls including Wormian Bones; the topographic distribution and frequencies of the sutures including Wormian Bones; the number of these sutures for each skull; the name and number of sutures that were bilaterally and symmetrically located on the right and left side of skull (paired sutures) and which coincidentally had Wormian Bones for each skull; the differences of frequencies between the paired sutures including Wormian Bones. The rate of skulls including Wormian Bones was determined as 59.3%. The maximum and minimum numbers of sutures, including Wormian Bones, were 6 in 1 skull and 1 in each of 30 skulls, respectively. The maximum and minimum rates of sutures that had Wormian Bones were found in left lambdoid 40.7% and right occipitomastoid 1.3% sutures, respectively. There was only a significant difference between the rate of right and left squamous sutures (P = 0.04). Forty-five skulls were including 55 pairs of bilaterally and symmetrically located sutures that coincidentally had Wormian Bones in each pair. Each of 35 skulls had 1 pair of sutures including Wormian Bones and each of 10 skulls had 2 pairs. In the present study, the rate of Wormian Bones was determined as 59.3% in West Anatolian Population. This incidence rate is considerably lower than the other reports, and it may be as a result of racial variations. These divergent bones were more frequently found in left lambdoid sutures (40.7%) and less frequently in right occipitomastoid sutures (1.3%). This study may guide the investigators dealing with the neurosurgery, orthopedy, radiology, anatomy, and

  15. Shallow magnetic inclinations in the Cretaceous Valle Group, Baja California: remagnetization, compaction, or terrane translation? (United States)

    Smith, Douglas P.; Busby, Cathy J.


    Paleomagnetic data from Albian to Turonian sedimentary rocks on Cedros Island, Mexico (28.2° N, 115.2° W) support the interpretation that Cretaceous rocks of western Baja California have moved farther northward than the 3° of latitude assignable to Neogene oblique rifting in the Gulf of California. Averaged Cretaceous paleomagnetic results from Cedros Island support 20 ± 10° of northward displacement and 14 ± 7° of clockwise rotation with respect to cratonic North America. Positive field stability tests from the Vizcaino terrane substantiate a mid-Cretaceous age for the high-temperature characteristic remanent magnetization in mid-Cretaceous strata. Therefore coincidence of characteristic magnetization directions and the expected Quaternary axial dipole direction is not due to post mid-Cretaceous remagnetization. A slump test performed on internally coherent, intrabasinal slump blocks within a paleontologically dated olistostrome demonstrates a mid-Cretaceous age of magnetization in the Valle Group. The in situ high-temperature natural remanent magnetization directions markedly diverge from the expected Quaternary axial dipole, indicating that the characteristic, high-temperature magnetization was acquired prior to intrabasinal slumping. Early acquisition of the characteristic magnetization is also supported by a regional attitude test involving three localities in coherent mid-Cretaceous Valle Group strata. Paleomagnetic inclinations in mudstone are not different from those in sandstone, indicating that burial compaction did not bias the results toward shallow inclinations in the Vizcaino terrane.

  16. Terrane accumulation and collapse in central Europe: seismic and rheological constraints (United States)

    Meissner, R.


    An attempt is made to compare the tectonic units and their evolution in central Europe with the deep seismic velocity structure and patterns of reflectivity. Caledonian and Variscan terrane accretion and orogenic collapse dominate the tectonic development in central and western Europe and have left their marks in a distinct velocity structure and crustal thickness as well as in the various reflectivity patterns. Whereas the memory of old collisional structures is still preserved in the rigid upper crust, collapse processes have formed and modified the lower crust. They have generally created rejuvenated, thin crusts with shallow Mohos. In the Variscan internides, the center of collision and post-orogenic heat pulses, the lower crust developed strong and thick seismic lamellae, the (cooler) externides show a thrust and shear pattern in the whole crust, and the North German Basin experienced large mafic intrusions in the lower crust and developed a high-velocity structure with only very thin lamellae on top of the Moho. The various kinds of reflectivity patterns in the lithosphere can be explained by a thermo-rheological model from terrane collision, with crustal thickening to collapse in a hot, post-orogenic setting.

  17. Tectonic superposition of the Kurosegawa Terrane upon the Sanbagawa metamorphic belt in eastern Shikoku, southwest Japan

    International Nuclear Information System (INIS)

    Suzuki, Hisashi; Isozaki, Yukio; Itaya, Tetsumaru.


    Weakly metamorphosed pre-Cenozoic accretionary complex in the northern part of the Chichibu Belt in Kamikatsu Town, eastern Shikoku, consists of two distinct geologic units; the Northern Unit and Southern Unit. The Northern Unit is composed mainly of phyllitic pelites and basic tuff with allochthonous blocks of chert and limestone, and possesses mineral paragenesis of the glaucophane schist facies. The Southern Unit is composed mainly of phyllitic pelites with allochthonous blocks of sandstone, limestone, massive green rocks, and chert, and possesses mineral paragenesis of the pumpellyite-actinolite facies. The Southern Unit tectonically overlies the Northern Univ by the south-dipping Jiganji Fault. K-Ar ages were dated for the recrystallized white micas from 11 samples of pelites and basic tuff in the Northern Unit, and from 6 samples of pelites in the Southern Unit. The K-Ar ages of the samples from the Northern Unit range in 129-112 Ma, and those from the Southern Unit in 225-194 Ma. In terms of metamorphic ages, the Northern Unit and Southern Unit are referred to the constituents of the Sanbagawa Metamorphic Belt, and to those of the Kurosegawa Terrane, respectively. Thus, tectonic superposition of these two units in the study area suggests that the Kurosegawa Terrane occurs in a higher structural position over the Sanbagawa Metamorphic Belt in eastern Shikoku. (author)

  18. Development of a penetration friction apparatus (PFA) to measure the frictional performance of surgical suture. (United States)

    Zhang, Gangqiang; Ren, Tianhui; Lette, Walter; Zeng, Xiangqiong; van der Heide, Emile


    Nowadays there is a wide variety of surgical sutures available in the market. Surgical sutures have different sizes, structures, materials and coatings, whereas they are being used for various surgeries. The frictional performances of surgical sutures have been found to play a vital role in their functionality. The high friction force of surgical sutures in the suturing process may cause inflammation and pain to the person, leading to a longer recovery time, and the second trauma of soft or fragile tissue. Thus, the investigation into the frictional performance of surgical suture is essential. Despite the unquestionable fact, little is actually known on the friction performances of surgical suture-tissue due to the lack of appropriate test equipment. This study presents a new penetration friction apparatus (PFA) that allowed for the evaluation of the friction performances of various surgical needles and sutures during the suturing process, under different contact conditions. It considered the deformation of tissue and can realize the puncture force measurements of surgical needles as well as the friction force of surgical sutures. The developed PFA could accurately evaluate and understand the frictional behaviour of surgical suture-tissue in the simulating clinical conditions. The forces measured by the PFA showed the same trend as that reported in literatures. Copyright © 2017 Elsevier Ltd. All rights reserved.

  19. Timing of ectocranial suture activity in Gorilla gorilla as related to cranial volume and dental eruption. (United States)

    Cray, James; Cooper, Gregory M; Mooney, Mark P; Siegel, Michael I


    Research has shown that Pan and Homo have similar ectocranial suture synostosis patterns and a similar suture ontogeny (relative timing of suture fusion during the species ontogeny). This ontogeny includes patency during and after neurocranial expansion with a delayed bony response associated with adaptation to biomechanical forces generated by mastication. Here we investigate these relationships for Gorilla by examining the association among ectocranial suture morphology, cranial volume (as a proxy for neurocranial expansion) and dental development (as a proxy for the length of time that it has been masticating hard foods and exerting such strains on the cranial vault) in a large sample of Gorilla gorilla skulls. Two-hundred and fifty-five Gorilla gorilla skulls were examined for ectocranial suture closure status, cranial volume and dental eruption. Regression models were calculated for cranial volumes by suture activity, and Kendall's tau (a non-parametric measure of association) was calculated for dental eruption status by suture activity. Results suggest that, as reported for Pan and Homo, neurocranial expansion precedes suture synostosis activity. Here, Gorilla was shown to have a strong relationship between dental development and suture activity (synostosis). These data are suggestive of suture fusion extending further into ontogeny than brain expansion, similar to Homo and Pan. This finding allows for the possibility that masticatory forces influence ectocranial suture morphology. © 2011 The Authors. Journal of Anatomy © 2011 Anatomical Society of Great Britain and Ireland.

  20. Randomized clinical trial comparing manual suture and different models of mechanical suture in the mimicking of bariatric surgery in swine

    Directory of Open Access Journals (Sweden)

    Fernandes MA


    Full Text Available Marcos AP Fernandes,1 Bruno MT Pereira,2 Sandra M Guimarães,1 Aline Paganelli,3 Carlos Manoel CT Pereira,1 Claudio Sergio Batista4 1Institute of Obesity and Advanced Video Laparoscopic Surgery of Petropolis, Rio de Janeiro, Brazil; 2Division of Trauma, University of Campinas, São Paulo, Brazil; 3Laboratório de Patologia Micron Cell Diagnóstico, Rio de Janeiro, Brazil; 4Department of Gynecology and Obstetrics, Faculty of Medicine of Petropolis, Rio de Janeiro, Brazil Context and objective: Variations in the ability of surgeons served as motivation for the development of devices that, overcoming individual differences, allow the techniques to be properly performed, and of which the end result was the best possible. Every technique must be reproduced reliably by the majority of surgeons for their results to be adopted and recognized as effective. The aim of this study was to compare the results, from the point of view of anatomic pathology, of manual sutures versus mechanical sutures using different models of linear mechanical staplers, in the procedure of gastroenteroanastomosis and enteroanastomosis in swine. Methods: Thirty-six healthy, adult, male Sus scrofa domesticus pigs, weighing between 20.7 and 25.5 kg, were used. The swine were randomly divided into four groups of nine pigs, according to the type of suture employed: group A, manual suture with Polysorb® 3-0 wire; group B, 80-shear linear stapler (Covidien® Gia 8038-S; group C, 75-shear linear stapler (Ethicon® Tlc 75; and group D, 75-shear linear stapler (Resource® Yq 75-3. A temporal study was established on the seventh postoperative day for histopathological analysis, and the degree of inflammation, fibrosis, and newly formed vessels, as well as the presence or absence of granulation tissue, foreign body granuloma, and necrosis were all evaluated qualitatively and semiquantitatively. The results were analyzed statistically. Results: Observations during the histopathological

  1. Efficacy of b-lynch brace suture in postpartum haemorrhage

    International Nuclear Information System (INIS)

    Tarique, S.; Wazir, S.; Moeen, G.


    Massive uncontrolled haemorrhage after childbirth is the leading cause of maternal death in developing countries. Postpartum haemorrhage is traditionally defined as blood loss of more than 500 ml after vaginal delivery and more than 1000 ml after caesarean section, but intraoperative estimation of blood loss is inaccurate. Uterine atony alone accounts for 75 - 90% of PPH. To estimate the effectiveness and safety of B-Lynch brace Suture in the management of primary postpartum haemorrhage (PPH). (author)

  2. Suture, synthetic, or biologic in contaminated ventral hernia repair. (United States)

    Bondre, Ioana L; Holihan, Julie L; Askenasy, Erik P; Greenberg, Jacob A; Keith, Jerrod N; Martindale, Robert G; Roth, J Scott; Liang, Mike K


    Data are lacking to support the choice between suture, synthetic mesh, or biologic matrix in contaminated ventral hernia repair (VHR). We hypothesize that in contaminated VHR, suture repair is associated with the lowest rate of surgical site infection (SSI). A multicenter database of all open VHR performed at from 2010-2011 was reviewed. All patients with follow-up of 1 mo and longer were included. The primary outcome was SSI as defined by the Centers for Disease Control and Prevention. The secondary outcome was hernia recurrence (assessed clinically or radiographically). Multivariate analysis (stepwise regression for SSI and Cox proportional hazard model for recurrence) was performed. A total of 761 VHR were reviewed for a median (range) follow-up of 15 (1-50) mo: there were 291(38%) suture, 303 (40%) low-density and/or mid-density synthetic mesh, and 167(22%) biologic matrix repair. On univariate analysis, there were differences in the three groups including ethnicity, ASA, body mass index, institution, diabetes, primary versus incisional hernia, wound class, hernia size, prior VHR, fascial release, skin flaps, and acute repair. The unadjusted outcomes for SSI (15.1%; 17.8%; 21.0%; P = 0.280) and recurrence (17.8%; 13.5%; 21.5%; P = 0.074) were not statistically different between groups. On multivariate analysis, biologic matrix was associated with a nonsignificant reduction in both SSI and recurrences, whereas synthetic mesh associated with fewer recurrences compared to suture (hazard ratio = 0.60; P = 0.015) and nonsignificant increase in SSI. Interval estimates favored biologic matrix repair in contaminated VHR; however, these results were not statistically significant. In the absence of higher level evidence, surgeons should carefully balance risk, cost, and benefits in managing contaminated ventral hernia repair. Copyright © 2016 Elsevier Inc. All rights reserved.

  3. Subgaleal Retention Sutures: Internal Pressure Dressing Technique for Dolenc Approach. (United States)

    Burrows, Anthony M; Rayan, Tarek; Van Gompel, Jamie J


    Extradural approach to the cavernous sinus, the "Dolenc" approach recognizing its developing Dr. Vinko Dolenc, is a critically important skull base approach. However, resection of the lateral wall of the cavernous sinus, most commonly for cavernous sinus meningiomas, results commonly in a defect that often cannot be reconstructed in a water-tight fashion. This may result in troublesome pseudomeningocele postoperatively. To describe a technique designed to mitigate the development of pseudomeningocele. We found the Dolenc approach critical for resection of cavernous lesions. However, a number of pseudomeningoceles were managed with prolonged external pressure wrapping in the early cohort. Therefore, we incorporated subgaleal to muscular sutures, which were designed to close this potential space and retrospectively analyzed our results. Twenty-one patients treated with a Dolenc approach and resection of the lateral wall of the cavernous sinus over a 2-year period were included. Prior to incorporation of this technique, 12 patients were treated and 3 (25%) experienced postoperative pseudomeningoceles requiring multiple clinic visits and frequent dressing. After incorporation of subgaleal retention sutures, no patient (0%) experienced this complication. Although basic, subgaleal to temporalis muscle retention sutures likely aid in eliminating this potential dead space, thereby preventing patient distress postoperatively. This technique is simple and further emphasizes the importance of dead space elimination in complex closures. Copyright © 2017 by the Congress of Neurological Surgeons

  4. A Comfortable Solution To Tracheal Anastomosis Protection: Tracheal Retention Sutures. (United States)

    Karapolat, Sami; Turkyilmaz, Atila; Seyis, Kubra Nur; Tekinbas, Celal


    Fixation of the chin to the anterior chest wall is the most commonly used method of reducing anastomotic tension following a segmental resection of the trachea and reconstruction with primary anastomosis. However, the sutures required for this method may lead to various organic and psychological problems. In five patients who underwent tracheal resection and primary anastomosis, retention sutures were placed on the proximal and distal-lateral edges of the anastomotic line rather than placing a Guardian chin stitch. All patients were mobilised in the early postoperative period and were able to perform their routine daily activities without restrictions. During their average 14.4 months of follow-up, no complications were found in their anastomotic lines during their clinical, radiological, and bronchoscopic assessments. The placement of tracheal retention sutures proved an inexpensive and reliable method to reduce anastomotic tension without additional surgical burden, and was effective in terms of patient comfort. Copyright © 2017 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.

  5. Traction suture modification to tongue-in-groove caudal septoplasty. (United States)

    Indeyeva, Y A; Lee, T S; Gordin, E; Chan, D; Ducic, Y


    Caudal septal deviation leads to unfavorable esthetic as well as functional effects on the nasal airway. A modification to the tongue-in-groove (TIG) technique to correct these caudal septal deformities is described. With placement of a temporary suspension suture to the caudal septum, manual traction is applied, assuring that the caudal septum remains in the midline position while it is being secured with multiple through-and-through, trans-columellar and trans-septal sutures. From 2003 to 2016, 148 patients underwent endonasal septoplasty using this modified technique, with excellent functional and cosmetic outcomes and a revision rate of 1.4%. This modified TIG technique replaces the periosteal suture that secures the caudal septum to the midline nasal crest in the original TIG technique. This simplifies the procedure and minimizes the risk of securing the caudal septum off-midline when used in endonasal septoplasty. Copyright © 2017 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  6. Paleoproterozoic (ca. 1.8 Ga) arc magmatism in the Lützow-Holm Complex, East Antarctica: Implications for crustal growth and terrane assembly in erstwhile Gondwana fragments (United States)

    Takahashi, Kazuki; Tsunogae, Toshiaki; Santosh, M.; Takamura, Yusuke; Tsutsumi, Yukiyasu


    lithological data from the region, suggest that the LHC can be divided into three units: Neoarchean (ca. 2.5 Ga) unit in the southern LHC (Shirase Orthogneiss or "Shirase microcontinent"), Neoproterozoic (ca. 1.0 Ga) unit in the northern LHC, and supracrustal unit in the central LHC with fragments of Paleoproterozoic (ca. 1.8 Ga) and minor Neoarchean (ca. 2.5 Ga) and Neoproterozoic (ca. 1.0 Ga) magmatic arcs. The 1.8 Ga arc magmatism inferred in this study has also been reported from adjacent Gondwana fragments such as the Highland Complex in Sri Lanka, and the Trivandrum and Nagercoil Blocks in southern India. Although the ca. 1.8 Ga arc-magmatic event is coeval in these regions, the Paleoproterozoic supracrustal unit in the central LHC may not be contiguous with those in the Highland Complex of Sri Lanka because recent studies have shown that the Vijayan Complex in Sri Lanka and the ca. 1.0 Ga northern LHC possibly were part of a single crustal unit (northern Lützow-Holm-Vijayan Complex) within the Kalahari Block. The supracrustal unit possibly marks part of a discrete suture formed by the collision of the ca. 2.5 Ga southern LHC (Shirase microcontinent) and the ca. 1.0 Ga northern Lützow-Holm-Vijayan Complex during the latest Neoproterozoic-Cambrian Gondwana amalgamation, which might be coeval with the collision of the Vijayan and Wanni Complexes and the formation of the Highland Complex in Sri Lanka. Our study provides new insights on crustal growth and terrane assembly in the ancient continental blocks of Gondwana.

  7. What can the Cretaceous-to-present latitude history of the Lhasa terrane tell us about plate-scale deformation in the Tibetan-Himalayan orogen? (Invited) (United States)

    Lippert, P. C.; Van Hinsbergen, D. J.; Dupont-Nivet, G.; Huang, W.


    Published paleomagnetic data from well-dated sedimentary and volcanic rocks from the Lhasa terrane have been re-evaluated in a statistically consistent framework to assess the latitude history of southern Tibet from ~110 Ma to the present. We apply a methodology similar to the one used by the Time-Averaged geomagnetic Field Initiative to each paleomagnetic data set to establish coherency within and between paleomagnetic data from Tibet (see Session T023 for more details). Moreover, we use only sedimentary data that have been evaluated for and, where necessary, corrected for sedimentary inclination shallowing. The resulting apparent polar wander path (APWP) shows that the southern margin of the Lhasa terrane at the longitudes of Nepal remained at 20×4°N latitude from ~110 to at least 50 Ma and subsequently drifted northward to its present latitude of 29°N. This latitude history provides a paleomagnetically-determined collision age between the Tibetan Himalaya and the southern margin of Asia that is 49.5×4.5 Ma at 21×4° N latitude. The paleomagnetic age and latitude of this collision may be a few millions of years earlier and ~2° lower if estimates for shortening within the suture zone are considered. When compared to the global APWP of Torsvik et al. (2012) in Eurasian coordinates, the Lhasa APWP indicates that at most 1100×560 km of post-50 Ma India-Asia convergence was partitioned into Asian lithosphere. The lower bound of these paleomagnetic estimates is consistent with the magnitude of upper crustal shortening within Asia calculated from orogen-scale geological reconstructions. An implication is that 1700×560 km or more post-50 Ma India-Asia convergence was partitioned into Greater India. Paleomagnetic data from the Tibetan Himalaya are consistent with >2000 km of extension of Greater Indian lithosphere after break-up from Gondwana but prior to collision with the southern margin of Asia. Cenozoic subduction of this Cretaceous extensional basin following

  8. Gamma-ray spectrometry of granitic suites of the Paranaguá Terrane, Southern Brazil (United States)

    Weihermann, Jessica Derkacz; Ferreira, Francisco José Fonseca; Cury, Leonardo Fadel; da Silveira, Claudinei Taborda


    The Paranaguá Terrane, located in the coastal portion of the states of Santa Catarina, Paraná and São Paulo in Southern Brazil is a crustal segment constituted mainly by an igneous complex, with a variety of granitic rocks inserted into the Serra do Mar ridge. The average altitude is approximately 1200 m above sea level, with peaks of up to 1800 m. Due to the difficulty of accessing the area, a shortage of outcrops and the thick weathering mantle, this terrane is understudied. This research aims to evaluate the gamma-ray spectrometry data of the granitic suites of the Paranaguá Terrane, in correspondence with the geological, petrographical, lithogeochemical, relief and mass movement information available in the literature. Aerogeophysical data were acquired along north-south lines spaced at 500 m, with a mean terrain clearance of 100 m. These data cover potassium (K, %), equivalent in thorium (eTh, ppm) and equivalent in uranium (eU, ppm). After performing a critical analysis of the data, basic (K, eU, eTh) and ternary (R-K/G-eTh/B-eU) maps were generated and then superimposed on the digital elevation model (DEM). The investigation of the radionuclide mobility across the relief and weathering mantle consisted of an analysis of the schematic profiles of elevation related with each radionuclide; a comparison of the K, eU and eTh maps with their 3D correspondents; and the study of mass movements registered in the region. A statistical comparison of lithogeochemical (K, U, Th) and geophysical (K, eU, eTh) data showed consistency in all the granitic suites studied (Morro Inglês, Rio do Poço and Canavieiras-Estrela). Through gamma-ray spectrometry, it was possible to establish relationships between scars (from mass movements) and the gamma-ray responses as well as the radionuclide mobility and the relief and to map the granitic bodies.

  9. Cretaceous–Eocene provenance connections between the Palawan Continental Terrane and the northern South China Sea margin

    NARCIS (Netherlands)

    Shao, Lei; Cao, Licheng; Qiao, Peijun; Zhang, Xiangtao; Li, Qianyu; van Hinsbergen, Douwe J.J.


    The plate kinematic history of the South China Sea opening is key to reconstructing how the Mesozoic configuration of Panthalassa and Tethyan subduction systems evolved into today's complex Southeast Asian tectonic collage. The South China Sea is currently flanked by the Palawan Continental Terrane

  10. Paleozoic subduction complex and Paleozoic-Mesozoic island-arc volcano-plutonic assemblages in the northern Sierra terrane (United States)

    Hanson, Richard E.; Girty, Gary H.; Harwood, David S.; Schweickert, Richard A.


    This field trip provides an overview of the stratigraphic and structural evolution of the northern Sierra terrane, which forms a significant part of the wall rocks on the western side of the later Mesozoic Sierra Nevada batholith in California. The terrane consists of a pre-Late Devonian subduction complex (Shoo Fly Complex) overlain by submarine arc-related deposits that record the evolution of three separate island-arc systems in the Late Sevonian-Early Mississippian, Permian, and Late Triassic-Jurassic. The two Paleozoic are packages and the underlying Shoo Fly Complex have an important bearing on plate-tectonic processes affecting the convergent margin outboard of the Paleozoic Cordilleran miogeocline, although their original paleogeographic relations to North America are controversial. The third arc package represents an overlap assemblage that ties the terrane to North America by the Late Triassic and helps constrain the nature and timing of Mesozoic orogenesis. Several of the field-trip stops examine the record of pre-Late Devonian subduction contained in the Shoo Fly Complex, as well as the paleovolcanology of the overlying Devonian to Jurassic arc rocks. Excellent glaciated exposures provide the opportunity to study a cross section through a tilted Devonian volcano-plutonic association. Additional stops focus on plutonic rocks emplaced during the Middle Jurassic arc magmatism in the terrane, and during the main pulse of Cretaceous magmatism in the Sierra Nevada batholith to the east.

  11. Tissue reactions of abdominal integuments to surgical sutures in sonography

    Directory of Open Access Journals (Sweden)

    Andrzej Smereczyński


    Full Text Available Classical abdominal surgeries usually require long incisions of the abdominal integuments followed by tight closure with adequate suturing material. Nonabsorbable sutures may cause various reactions, including granuloma reactions, both sterile and inflammatory. The aim of the study was to analyze prospective ultrasound examinations of the abdominal integuments in order to detect tissue reactions to surgical sutures. Material and methods: For 10 years, ultrasound examinations of the abdominal integuments involved the assessment of surgical scars in all patients who underwent open or closed surgeries for various reasons (in total 2254 patients. Ultrasound examinations were performed only with the use of linear probes with the frequency ranging from 7 to 12 MHz. Each scar in the abdominal integuments was scanned in at least two planes. When a lesion was detected, the image was enlarged and the transducer was rotated by approximately 180° in order to capture the dimensions of the granuloma and the most characteristic image of the suture. Moreover, vascularization of the lesion was also assessed with the use of color Doppler mode set to detect the lowest flows. Results: All granulomas (19 lesions, two in one patient created hypoechoic oval or round nodules, were relatively well-circumscribed and their size ranged from 8 × 4 mm to 40 × 14 mm. In the center of the lesion, it was possible to notice a thread that was coiled to various degrees and presented itself as a double, curved hyperechoic line. In 9 out of 19 granulomas, slight peripheral vascularization was observed. The substantial majority of the lesions (n = 15 were in contact with the fascia. In seven patients, compression with the transducer induced known local pain (n = 4 or intensified pain that had already been present (n = 3; all of these granulomas infiltrated the fascia and showed slight peripheral vascularization. Cutaneous fistulae developed in two patients with purulent

  12. Optimal suture anchor direction in arthroscopic lateral ankle ligament repair. (United States)

    Yoshimura, Ichiro; Hagio, Tomonobu; Noda, Masahiro; Kanazawa, Kazuki; Minokawa, So; Yamamoto, Takuaki


    In this study, the distance between the insertion point of the suture anchors and posterior surface of the fibula during arthroscopic lateral ankle ligament repair was investigated on computed tomography (CT) images. The hypothesis of this study was that there is an optimal insertional direction of the suture anchor to avoid anchor-related complications. One hundred eleven ankles of 98 patients who had undergone three-dimensional CT scans for foot or ankle disorders without deformity of the fibula were assessed (59 males, 52 females; median age 25.5 years; age range 12-78 years). The shortest distance from the insertion point of the suture anchor to the deepest point of the fossa/top of the convex aspect of the fibula was measured on the axial plane, tilting from the longitudinal axis of the fibula at 90°, 75°, 60°, and 45°. The distance from the insertion point of the suture anchor to the posterior surface of the fibula was also measured in a direction parallel to the sagittal plane of the lateral surface of the talus on the axial plane, tilting from the longitudinal axis of the fibula at 90°, 75°, 60°, and 45°. The posterior fossa was observed in all cases on the 90° and 75° images. The distance from the insertion point to the posterior surface of the fibula in the parallel direction was 15.0 ± 3.4 mm at 90°, 17.5 ± 3.2 mm at 75°, 21.7 ± 3.3 mm at 60°, and 25.7 ± 3.6 mm at 45°. The posterior points in the parallel direction were located on the posterior fossa in 36.0% of cases at 90°, in 12.6% at 75°, and in 0.0% at 60° and 45°. The suture anchor should be directed from anterior to posterior at an angle of <45° to the longitudinal axis of the fibula, parallel to the lateral surface of the talus, to avoid passing through the fibula. Cohort study, Level III.

  13. Laser tissue welding in genitourinary reconstructive surgery: assessment of optimal suture materials. (United States)

    Poppas, D P; Klioze, S D; Uzzo, R G; Schlossberg, S M


    Laser tissue welding in genitourinary reconstructive surgery has been shown in animal models to decrease operative time, improve healing, and decrease postoperative fistula formation when compared with conventional suture controls. Although the absence of suture material is the ultimate goal, this has not been shown to be practical with current technology for larger repairs. Therefore, suture-assisted laser tissue welding will likely be performed. This study sought to determine the optimal suture to be used during laser welding. The integrity of various organic and synthetic sutures exposed to laser irradiation were analyzed. Sutures studied included gut, clear Vicryl, clear polydioxanone suture (PDS), and violet PDS. Sutures were irradiated with a potassium titanyl phosphate (KTP)-532 laser or an 808-nm diode laser with and without the addition of a light-absorbing chromophore (fluorescein or indocyanine green, respectively). A remote temperature-sensing device obtained real-time surface temperatures during lasing. The average temperature, time, and total energy at break point were recorded. Overall, gut suture achieved significantly higher temperatures and withstood higher average energy delivery at break point with both the KTP-532 and the 808-nm diode lasers compared with all other groups (P welding appears to be between 60 degrees and 80 degrees C. Gut suture offers the greatest margin of error for KTP and 808-nm diode laser welding with or without the use of a chromophore.

  14. Evaluation of a novel suture material for closure of intestinal anastomoses in canine cadavers. (United States)

    Hansen, Lane A; Monnet, Eric L


    To compare leakage and maximum intraluminal pressures for a novel suture material with pressures for comparable suture material when used in closure of intestinal anastomoses in canine cadavers. Healthy intestines from cadavers of dogs euthanized for reasons unrelated to the study. 18 anastomoses were performed on intestinal sections within 72 hours after dogs were euthanized and intestinal samples collected. Anastomoses were performed with a simple continuous suture pattern. Leakage and maximum intraluminal pressures were measured and recorded for 6 control segments and 18 anastomosed sections. A barbed glycomer 631 suture (size 4-0 United States Pharmacopeia [USP]) was compared with glycomer 631 sutures (sizes 3-0 and 4-0 USP). Results for leakage and maximum intraluminal pressures were compared via an ANOVA. The barbed glycomer 631 suture material leaked at a significantly higher pressure than did the comparable glycomer 631 suture materials. Maximum intraluminal pressures were not significantly different among the suture materials. Barbed glycomer 631 4-0 USP suture material was as effective as glycomer 631 suture materials and may be a safe alternative for use in closure of enterectomies in dogs.

  15. Skull morphometry and vault sutures of Myrmecophaga tridactyla and Tamandua tetradactyla

    Directory of Open Access Journals (Sweden)

    Camila M. de S. Hossotani


    Full Text Available ABSTRACT This study aimed to examine the relationship between skull size and the level of cranial vault suture closure. A total of 50 Myrmecophaga tridactyla Linnaeus, 1758 and 178 Tamandua tetradactyla Linnaeus, 1758 skulls were analyzed in relation to 18 skull dimensions. The skulls were grouped into three levels of suture closure: no sutures closed (level 0, one or all the fallowing sutures closed: interfrontalis, sagitalis and coronalis (level 1 and all sutures closed (level 2. The results indicated that among the 18 variables measured, 17 showed significant differences (p ≤ 0.01 between level 0 and level 1 skulls of T. tetradactyla; as well as between level 0 and level 1, and level 0 and level 2 skulls of M. tridactyla. M. tridactyla level 1 and level 2 had no significant difference among any of the 18 dimensions. The foramen magnum height in both species showed no significant difference (p > 0.05 among any suture categories. In principle, suture closure level and cranial dimensions are related. The specimens with larger cranial dimensions showed greater number of cranial vault sutures closed for both species of anteaters. Tamandua tetradactyla and M. tridactyla specimens with none of the cranial vault suture closed have a foramen magnum height similar to those with cranial vault suture closed.

  16. Glue versus suture for mesh fixation in inguinal hernia repair. (United States)

    Chandrasekar, Shruthi; Jeyakumar, S; Ganapathy, Tharun


    Inguinal hernia is one of the most common surgical problem presenting to the surgical OPD. Surgery is the mainstay of treatment for inguinal hernia today. Surgery for inguinal hernia has undergone a great evolution over a period of several centuries. Lichenstein's tension free hernioplasty is the one of the first surgeries taught to a surgical resident. The main aim of surgeries in this era is to give the best possible results with the least possible pain, scar and time. This has given rise to so many modifications to the classical Lichenstein's procedure and also to laparoscopic hernioplasty. Pain after inguinal hernia surgery is found to be debilitating and altering the quality of life in several patients, which has been attributed to the traumatic fixation of the mesh with sutures. This has paved way to the development of various atraumatic methods of fixation, tissue glue is one such development. Hence this study, to compare traumatic and atraumatic methods of mesh fixation in inguinal hernia repair. The aim of this study was to compare suture fixation versus tissue glue fixation of the mesh in inguinal hernia repair. Primary objective was to compare the immediate and chronic post-operative pain. Secondary objective was to compare the time taken for the procedure by the two methods in use and also to compare the presence of any complications. and methodology: This study was done in the General Surgery department of XXX hospital, medical college and research centre, kattangulathur after Ethics committee clearance. It is a single blinded study. The study was done on 51 patients consenting for the study and meeting the inclusion criterias from the period of March 2016 to August 2017 out of which 26 were selected for glue mesh fixation and 25 for suture mesh fixation according to simple randomization. The suture group patients underwent classical Lichenstein's tension free hernioplasty and the glue group underwent Lichenstein's hernioplasty with glue where dots of

  17. Microprobe monazite constraints for and early (ca. 790 Ma) Braziliano orogeny: The Embu Terrane, southeastern Brazil

    International Nuclear Information System (INIS)

    Vlach, Silvio R.F


    The evolution of the Mantiqueira Orogenetic System, Southeastern Brazil, comprises discrete episodes of tectonic collage and docking of remnants of Rodinia break-up in the borders of the Sao Francisco Craton. This system is related to the closure of the Adamastor ocean and assemblage of the western Gondwana super-continent during Neoproterozoic times (ca. 610-530 Ma, Brito Neves et al., 1999; Campos Neto, 2000). This report presents monazite microprobe dating results for metassediments from the Embu Complex, an important lithological unit from the Ribeira Belt, currently included in the Juiz de Fora terrane, a unit added to the Sao Francisco Craton at ca. 600-580 Ma. (Campos Neto, 2000). The age results unravel a main metamorphic episode and related orogeny at ca. 790 Ma and bring new insights concerning the agglutination of Gondwana in this region during the Neoproterozoic (au)

  18. Paleointensity determination on Neoarchaean dikes within the Vodlozerskii terrane of the Karelian craton (United States)

    Shcherbakova, V. V.; Lubnina, N. V.; Shcherbakov, V. P.; Zhidkov, G. V.; Tsel'movich, V. A.


    The results of paleomagnetic studies and paleointensity determinations from two Neoarchaean Shala dikes with an age of 2504 Ma, located within the Vodlozerskii terrane of the Karelian craton, are presented. The characteristic components of primary magnetization with shallow inclinations I = -5.7 and 1.9 are revealed; the reliability of the determinations is supported by two contact tests. High paleointensity values are obtained by the Thellier-Coe and Wilson techniques. The calculated values of the virtual dipole moment (11.5 and 13.8) × 1022 A m2 are noticeably higher than the present value of 7.8 × 1022 A m2. Our results, in combination with the previous data presented in the world database, support the hypothesized existence of a period of high paleointensity in the Late Archaean-Early Proterozoic.

  19. kepler's dark worlds: A low albedo for an ensemble of Neptunian and Terran exoplanets (United States)

    Jansen, Tiffany; Kipping, David


    Photometric phase curves provide an important window onto exoplanetary atmospheres and potentially even their surfaces. With similar amplitudes to occultations but far longer baselines, they have a higher sensitivity to planetary photons at the expense of a more challenging data reduction in terms of long-term stability. In this work, we introduce a novel non-parametric algorithm dubbed phasma to produce clean, robust exoplanet phase curves and apply it to 115 Neptunian and 50 Terran exoplanets observed by kepler. We stack the signals to further improve signal-to-noise, and measure an average Neptunian albedo of Ag greenhouse effect, our work implies that kepler's solid planets are unlikely to resemble cloudy Venusian analogs, but rather dark Mercurian rocks.

  20. Bundles of spider silk, braided into sutures, resist basic cyclic tests: potential use for flexor tendon repair.

    Directory of Open Access Journals (Sweden)

    Kathleen Hennecke

    Full Text Available Repair success for injuries to the flexor tendon in the hand is often limited by the in vivo behaviour of the suture used for repair. Common problems associated with the choice of suture material include increased risk of infection, foreign body reactions, and inappropriate mechanical responses, particularly decreases in mechanical properties over time. Improved suture materials are therefore needed. As high-performance materials with excellent tensile strength, spider silk fibres are an extremely promising candidate for use in surgical sutures. However, the mechanical behaviour of sutures comprised of individual silk fibres braided together has not been thoroughly investigated. In the present study, we characterise the maximum tensile strength, stress, strain, elastic modulus, and fatigue response of silk sutures produced using different braiding methods to investigate the influence of braiding on the tensile properties of the sutures. The mechanical properties of conventional surgical sutures are also characterised to assess whether silk offers any advantages over conventional suture materials. The results demonstrate that braiding single spider silk fibres together produces strong sutures with excellent fatigue behaviour; the braided silk sutures exhibited tensile strengths comparable to those of conventional sutures and no loss of strength over 1000 fatigue cycles. In addition, the braiding technique had a significant influence on the tensile properties of the braided silk sutures. These results suggest that braided spider silk could be suitable for use as sutures in flexor tendon repair, providing similar tensile behaviour and improved fatigue properties compared with conventional suture materials.

  1. Are turtleback fault surfaces common structural elements of highly extended terranes? (United States)

    Çemen, Ibrahim; Tekeli, Okan; Seyitoğlu, Gűrol; Isik, Veysel


    The Death Valley region of the U.S.A. contains three topographic surfaces resembling the carapace of a turtle. These three surfaces are well exposed along the Black Mountain front and are named the Badwater, Copper Canyon, and Mormon Point Turtlebacks. It is widely accepted that the turtlebacks are also detachment surfaces that separate brittlely deformed Cenozoic volcanic and sedimentary rocks of the hanging wall from the strongly mylonitic, ductilely deformed pre-Cenozoic rocks of the footwall. We have found a turtleback-like detachment surface along the southern margin of the Alasehir (Gediz) Graben in western Anatolia, Turkey. This surface qualifies as a turtleback fault surface because it (a) is overall convex-upward and (b) separates brittlely deformed hanging wall Cenozoic sedimentary rocks from the ductilely to brittlely deformed, strongly mylonitic pre-Cenozoic footwall rocks. The surface, named here Horzum Turtleback, contains striations that overprint mylonitic stretching lineations indicating top to the NE sense of shear. This suggests that the northeasterly directed Cenozoic extension in the region resulted in a ductile deformation at depth and as the crust isostatically adjusted to the removal of the rocks in the hanging wall of the detachment fault, the ductilely deformed mylonitic rocks of the footwall were brought to shallower depths where they were brittlely deformed. The turtleback surfaces have been considered unique to the Death Valley region, although detachment surfaces, rollover folds, and other extensional structures have been well observed in other extended terranes of the world. The presence of a turtleback fault surface in western Anatolia, Turkey, suggests that the turtleback faults may be common structural features of highly extended terranes.

  2. Effects of silicate weathering on water chemistry in forested, upland, felsic terrane of the USA

    International Nuclear Information System (INIS)

    Stauffer, R.E.; Wittchen, B.D.


    The authors use data from the US EPA National Surface Water Survey (NSWS), the USGS Bench-Mark Station monitoring program, and the National Acid Deposition Program (NADP) to evaluate the role of weathering in supplying base cations to surface waters in forested, upland, felsic terrane of the northeastern, northcentral, and northwestern (Idaho batholith) US. Multivariate regression reveals differential effects of discharge on individual base cations and silica, but no secular trend in the Ca/Na denudation rate over 24 yr (1965-1988) for the Wild River catchment in the White Mountains. Because the turn-over time for Na in the soil-exchange complex is only ca. 1.5 yr, the long-term behavior of the ratios Ca/Na and Si/Na in waters leaving this catchment indicates that weathering is compensating for base cation export. In every subregion, Ca and Mg concentrations in lakes are statistically linked to nonmarine Na, but the median Ca/Na ratio is greater than the ratio in local plagioclase. The authors attribute this inequality to nonstoichiometric weathering of calcium in juvenile (formerly glaciated) terrane, not to leaching of exchangeable cations by So 4 because intraregional and cross-regional statistical analysis reveals no effect of atmospherically derived sulfate ion. The median base cation denudation rates (meq m -2 yr -1 ) for these American lake regions are: Maine granites (108); western Adirondack felsic gneiss (85); Vermilion batholith (42); Idaho batholith (52). The regional rates are high enough to compensate for present wet deposition of acidifying anions except in some vulnerable lake watersheds in the western Adirondacks

  3. Age and duration of eclogite-facies metamorphism, North Qaidam HP/UHP terrane, Western China (United States)

    Mattinson, C.G.; Wooden, J.L.; Liou, J.G.; Bird, D.K.; Wu, C.L.


    Amphibolite-facies para-and orthogneisses near Dulan, at the southeast end of the North Qaidam terrane, enclose minor eclogite and peridotite which record ultra-high pressure (UHP) metamorphism associated with the Early Paleozoic continental collision of the Qilian and Qaidam microplates. Field relations and coesite inclusions in zircons from paragneiss suggest that felsic, mafic, and ultramafic rocks all experienced UHP metamorphism and a common amphibolite-facies retrogression. SHRIMP-RG U-Pb and REE analyses of zircons from four eclogites yield weighted mean ages of 449 to 422 Ma, and REE patterns (flat HREE, no Eu anomaly) and inclusions of garnet, omphacite, and rutile indicate these ages record eclogite-facies metamorphism. The coherent field relations of these samples, and the similar range of individual ages in each sample suggests that the ???25 m.y. age range reflects the duration of eclogite-facies conditions in the studied samples. Analyses from zircon cores in one sample yield scattered 433 to 474 Ma ages, reflecting partial overlap on rims, and constrain the minimum age of eclogite protolith crystallization. Inclusions of Th + REE-rich epidote, and zircon REE patterns are consistent with prograde metamorphic growth. In the Lu??liang Shan, approximately 350 km northwest in the North Qaidam terrane, ages interpreted to record eclogite-facies metamorphism of eclogite and garnet peridotite are as old as 495 Ma and as young as 414 Ma, which suggests that processes responsible for extended high-pressure residence are not restricted to the Dulan region. Evidence of prolonged eclogite-facies metamorphism in HP/UHP localities in the Northeast Greenland eclogite province, the Western Gneiss Region of Norway, and the western Alps suggests that long eclogite-facies residence may be globally significant in continental subduction/collision zones.

  4. High resolution crustal structure for the region between the Chilenia and Cuyania terrane above the Pampean flat slab of Argentina from local receiver function and petrological analyses (United States)

    Ammirati, J. B.; Alvarado, P. M.; Pérez, S. B.; Beck, S. L.; Porter, R. C.; Zandt, G.


    Jean-Baptiste Ammirati 1,Sofía Perez 1, Patricia Alvarado 1, Susan L. Beck 2, Ryan Porter 3 and George Zandt 2(1) CIGEOBIO-CONICET, Universidad Nacional de San Juan, Argentina (2) The University of Arizona, USA (3) Northern Arizona University, USA At ~31ºS, The subduction of the Nazca plate under the South American plate presents along-strike variations of its dip angle referred to the Chilean-Pampean flat slab. Geological observations suggest that the regional crustal structure is inherited from the accretion of different terranes at Ordovician times and later reactivated during Andean compression since Miocene. Geophysical observations confirmed that the structure is extending in depth with décollement levels that accommodate crustal shortening in the region. In order to get a better insight on the shallow tectonics we computed high frequency local receiver functions from slab seismicity (~100 km depth). Local earthquakes present a higher frequency content that permits a better vertical resolution. Using a common conversion point (CCP) stacking method we obtained cross sections showing high-resolution crustal structure in the western part of the Pampean flat slab region, at the transition between the Precordillera and the Frontal Cordillera. Our results show a well-defined structure and their lateral extent for both units down to 80 km depth. In good agreement with previous studies, our higher resolution images better identify very shallow discontinuities putting more constraints on the relationships with the regional structural geology. Recent petrological analyses combined with RF high-resolution structure also allow us to better understand the regional crustal composition. Interestingly, we are able to observe a shifting structure beneath the Uspallata-Calingasta Valley, highlighting the differences in terms of crustal structure between the Precordillera and the Frontal Cordillera. Previously determined focal mechanisms in the region match well this

  5. A simple suture-retrieval device for the placement of u-stitches during laparoscopic gastrostomy. (United States)

    Mattei, Peter


    During minimally invasive operations, it is sometimes necessary to retrieve the end of a suture or a suture needle and bring it out through the abdominal wall. Using a standard needle and a length of suture, we have developed a simple device that allows the retrieval of a suture end during minimally invasive operations that require the placement of U-or stay stitches. The author has used the device described during more than 100 laparoscopic gastrostomy placement procedures and other operations involving the placement of U- or stay stitches with excellent results and no complications. Using a beveled hollow-bore needle and a loop of polypropylene suture, one can construct a simple device that allows the retrieval of a suture from within a body cavity during minimally invasive surgery, making the placement of U- and stay stitches easier and more precise.

  6. A simple method to take urethral sutures for neobladder reconstruction and radical prostatectomy

    Directory of Open Access Journals (Sweden)

    B Satheesan


    Full Text Available For the reconstruction of urethra-vesical anastamosis after radical prostatectomy and for neobladder reconstruction, taking adequate sutures to include the urethral mucosa is vital. Due to the retraction of the urethra and unfriendly pelvis, the process of taking satisfactory urethral sutures may be laborious. Here, we describe a simple method by which we could overcome similar technical problems during surgery using Foley catheter as the guide for the suture.

  7. Effects of suture position on left ventricular fluid mechanics under mitral valve edge-to-edge repair. (United States)

    Du, Dongxing; Jiang, Song; Wang, Ze; Hu, Yingying; He, Zhaoming


    Mitral valve (MV) edge-to-edge repair (ETER) is a surgical procedure for the correction of mitral valve regurgitation by suturing the free edge of the leaflets. The leaflets are often sutured at three different positions: central, lateral and commissural portions. To study the effects of position of suture on left ventricular (LV) fluid mechanics under mitral valve ETER, a parametric model of MV-LV system during diastole was developed. The distribution and development of vortex and atrio-ventricular pressure under different suture position were investigated. Results show that the MV sutured at central and lateral in ETER creates two vortex rings around two jets, compared with single vortex ring around one jet of the MV sutured at commissure. Smaller total orifices lead to a higher pressure difference across the atrio-ventricular leaflets in diastole. The central suture generates smaller wall shear stresses than the lateral suture, while the commissural suture generated the minimum wall shear stresses in ETER.

  8. Surgical sutures filled with adipose-derived stem cells promote wound healing.

    Directory of Open Access Journals (Sweden)

    Ann Katharin Reckhenrich

    Full Text Available Delayed wound healing and scar formation are among the most frequent complications after surgical interventions. Although biodegradable surgical sutures present an excellent drug delivery opportunity, their primary function is tissue fixation. Mesenchymal stem cells (MSC act as trophic mediators and are successful in activating biomaterials. Here biodegradable sutures were filled with adipose-derived mesenchymal stem cells (ASC to provide a pro-regenerative environment at the injured site. Results showed that after filling, ASCs attach to the suture material, distribute equally throughout the filaments, and remain viable in the suture. Among a broad panel of cytokines, cell-filled sutures constantly release vascular endothelial growth factor to supernatants. Such conditioned media was evaluated in an in vitro wound healing assay and showed a significant decrease in the open wound area compared to controls. After suturing in an ex vivo wound model, cells remained in the suture and maintained their metabolic activity. Furthermore, cell-filled sutures can be cryopreserved without losing their viability. This study presents an innovative approach to equip surgical sutures with pro-regenerative features and allows the treatment and fixation of wounds in one step, therefore representing a promising tool to promote wound healing after injury.

  9. Biomechanical testing of new meniscal repair techniques containing ultra high-molecular weight polyethylene suture. (United States)

    Barber, F Alan; Herbert, Morley A; Schroeder, F Alexander; Aziz-Jacobo, Jorge; Sutker, Michael J


    To evaluate the biomechanical characteristics of current meniscal repair techniques containing ultra high-molecular weight polyethylene (UHMWPE) suture with and without cyclic loading. Vertical longitudinal cuts made in porcine menisci were secured with a single repair device. Noncycled and cycled (500 cycles) biomechanical tests were performed on the following groups: group 1, No. 2-0 Mersilene vertical suture (Ethicon, Somerville, NJ); group 2, No. 2-0 Orthocord vertical suture (DePuy Mitek, Westwood, MA); group 3, No. 0 Ultrabraid vertical suture (Smith & Nephew Endoscopy, Andover, MA); group 4, No. 2-0 FiberWire vertical suture (Arthrex, Naples, FL); group 5, vertically oriented mattress suture by use of an Ultra FasT-Fix device (Smith & Nephew Endoscopy) with No. 0 Ultrabraid; group 6, vertically oriented mattress suture by use of a RapidLoc A2 device (DePuy Mitek) with No. 2-0 Orthocord suture; group 7, vertically oriented stitch by use of a MaxFire device with MaxBraid PE suture (Biomet Sports Medicine, Warsaw, IN); and group 8, an obliquely oriented stitch of No. 0 UHMWPE suture inserted by use of a CrossFix device (Cayenne Medical, Scottsdale, AZ). Endpoints were failure loads, failure modes, stiffness, and cyclic displacement. Mean single-pull loads were calculated for Ultra FasT-Fix (121 N), FiberWire (110 N), MaxFire (130 N), Mersilene (84 N), Orthocord (124 N), RapidLoc A2 (86 N), CrossFix (77 N), and Ultrabraid (109 N). After 500 cyclic loads, the Orthocord (222 N) repair was stronger than the others: Ultra FasT-Fix (110 N), FiberWire (117 N), MaxFire (132 N), Mersilene (89 N), RapidLoc A2 (108 N), CrossFix (95 N), and Ultrabraid (126 N) (P Fix, RapidLoc A2, and MaxFire) were comparable to the isolated UHMWPE-containing suture repairs on single-failure load testing. UHMWPE-containing suture repairs are stronger than braided polyester suture repairs, but pure UHMWPE suture (Ultrabraid) elongated more during cycling. Orthocord suture is significantly

  10. Rhinoplasty: a simplified, three-stitch, open tip suture technique. Part I: primary rhinoplasty. (United States)

    Daniel, R K


    Tip suture techniques offer a reliable and dramatic method of tip modification without needing to interrupt the alar rim strip or add tip grafts. The present simplified three-stitch technique consists of the following: (1) a strut suture to fix the columella strut between the crura, (2) bilateral domal creation sutures to create tip definition, and (3) a domal equalization suture to narrow and align the domes. If required, columella septal sutures can be added; either a dorsal rotational suture or a transfixion projection suture can be used. This simplified method represents a refinement based on more than 13 years of experience with tip suture techniques. It does not require a complex operative sequence or specialized sutures. Primary indications are moderate tip deformities of inadequate definition and excessive width and certain specific tip deformities, including the parenthesis tip and nostril/tip disproportion. The primary contraindications are for patients with minor tip deformities that are best done through a closed approach and those with severe tip deformities requiring an open structure graft. The technique is simple, efficacious, and easily learned.

  11. Ureteroscopic holmium laser cutting for inadvertently sutured drainage tube (report of five cases). (United States)

    Gao, Xu; Lu, Xin; Ren, Shancheng; Xu, Chuanliang; Sun, Yinghao


    The aim of this paper is to report a simple solution for inadvertently sutured drainage tube after urological surgery and discuss the different managements according to different types of this embarrassing complication. From September 2001 to January 2007, five inadvertently sutured drainage tubes were treated with ureteroscopic holmium laser cutting for the suture. All drainage tubes were removed after the operation without other complications. Holmium laser cutting via ureteroscope is a simple solution for the embarrassing problem of inadvertently sutured drainage tube. It can save the patient from undergoing another open surgery.

  12. Elasticity and breaking strength of synthetic suture materials incubated in various equine physiological and pathological solutions. (United States)

    Kearney, C M; Buckley, C T; Jenner, F; Moissonnier, P; Brama, P A J


    Selection of suture material in equine surgery is often based on costs or subjective factors, such as the surgeon's personal experience, rather than objective facts. The amount of objective data available on durability of suture materials with regard to specific equine physiological conditions is limited. To evaluate the effect of various equine physiological and pathological fluids on the rate of degradation of a number of commonly used suture materials. In vitro material testing. Suture materials were exposed in vitro to physiological fluid, followed by biomechanical analysis. Three absorbable suture materials, glycolide/lactide copolymer, polyglactin 910 and polydioxanone were incubated at 37°C for 7, 14 or 28 days in phosphate-buffered saline, equine serum, equine urine and equine peritoneal fluid from an animal with peritonitis. Five strands of each suture material type were tested to failure in a materials testing machine for each time point and each incubation medium. Yield strength, strain and Young's modulus were calculated, analysed and reported. For all suture types, the incubation time had a significant effect on yield strength, percentage elongation and Young's modulus in all culture media (Ptype was also shown significantly to influence changes in each of yield strength, percentage elongation and Young's modulus in all culture media (Ptype of fluid have significant effects on the biomechanical properties of various suture materials. These findings are important for evidence-based selection of suture material in clinical cases. © 2013 EVJ Ltd.

  13. Extrusion of bone anchor suture following flexor digitorum profundus tendon avulsion injury repair.

    LENUS (Irish Health Repository)

    Tiong, William H C


    Flexor digitorum profundus (FDP) zone I tendon avulsion injury is traditionally repaired with a pullout suture technique. More recently, bone anchor sutures have been used as a viable alternative and have largely replaced areas in hand surgery where pullout suture technique was once required. To date, there have been very few complications reported related to bone anchor suture use in FDP tendon reattachment to the bone. We report a very unusual case of extrusion of bone anchor through the nailbed, 6 years after zone I FDP tendon avulsion injury repair and a brief review of literature.

  14. Effects of diode laser welding with dye-enhanced glue on tensile strength of sutures commonly used in urology. (United States)

    Kirsch, A J; Chang, D T; Kayton, M L; Libutti, S K; Connor, J P; Hensle, T W


    Tissue welding using laser-activated protein solders may soon become an alternative to sutured tissue approximation. In most cases, approximating sutures are used both to align tissue edges and provide added tensile strength. Collateral thermal injury, however, may cause disruption of tissue alignment and weaken the tensile strength of sutures. The objective of this study was to evaluate the effect of laser welding on the tensile strength of suture materials used in urologic surgery. Eleven types of sutures were exposed to diode laser energy (power density = 15.9 W/cm2) for 10, 30, and 60 seconds. Each suture was compared with and without the addition of dye-enhanced albumin-based solder. After exposure, each suture material was strained (2"/min) until ultimate breakage on a tensometer and compared to untreated sutures using ANOVA. The strength of undyed sutures were not significantly affected; however, violet and green-dyed sutures were in general weakened by laser exposure in the presence of dye-enhanced glue. Laser activation of the smallest caliber, dyed sutures (7-0) in the presence of glue caused the most significant loss of tensile strength of all sutures tested. These results indicate that the thermal effects of laser welding using our technique decrease the tensile strength of dyed sutures. A thermally resistant suture material (undyed or clear) may prevent disruption of wounds closed by laser welding techniques.

  15. Assessing suturing techniques using a virtual reality surgical simulator. (United States)

    Kazemi, Hamed; Rappel, James K; Poston, Timothy; Hai Lim, Beng; Burdet, Etienne; Leong Teo, Chee


    Advantages of virtual-reality simulators surgical skill assessment and training include more training time, no risk to patient, repeatable difficulty level, reliable feedback, without the resource demands, and ethical issues of animal-based training. We tested this for a key subtask and showed a strong link between skill in the simulator and in reality. Suturing performance was assessed for four groups of participants, including experienced surgeons and naive subjects, on a custom-made virtual-reality simulator. Each subject tried the experiment 30 times using five different types of needles to perform a standardized suture placement task. Traditional metrics of performance as well as new metrics enabled by our system were proposed, and the data indicate difference between trained and untrained performance. In all traditional parameters such as time, number of attempts, and motion quantity, the medical surgeons outperformed the other three groups, though differences were not significant. However, motion smoothness, penetration and exit angles, tear size areas, and orientation change were statistically significant in the trained group when compared with untrained group. This suggests that these parameters can be used in virtual microsurgery training.

  16. Suture anchor tenodesis in repair of distal Achilles tendon injuries. (United States)

    Kiliçoğlu, Onder; Türker, Mehmet; Yildız, Fatih; Akalan, Ekin; Temelli, Yener


    Distal Achilles tendon avulsions are in the form of either bony and nonbony avulsion of Achilles tendon from its calcaneal insertion. Four patients with distal Achilles tendon avulsions or ruptures which were treated with tendon to bone repair using suture anchors are presented here. Operated leg was immobilized in above-knee cast for 4 weeks while the patient walked non-weight-bearing. Then, cast was changed to below knee, and full weight-bearing was allowed. Patients underwent gait analysis minimum at first postoperative year. Mean American Orthopedics Foot Ankle Society ankle/hindfoot score of patients at last visit was 88.75 (range 85-100), and Achilles tendon total rupture score was 77.75 (range 58-87). Mean passive dorsiflexion of injured ankles (14° ± 5°) was lower than uninjured ankles (23° ± 9°). All the kinematic parameters of gait analysis were comparable to the uninjured side. Maximum plantar flexion power of injured ankle was 1.40 W/kg, and this was significantly lower than the contralateral side value 2.38 W/kg; (P = 0.0143). There were no visually altered gait or problems in daily life. Suture anchor tenodesis technique of distal Achilles tendon avulsions was successful in achieving durable osteotendinous repairs.

  17. Subluxation of suture-fixated posterior chamber intraocular lenses a clinicopathologic study. (United States)

    Parekh, Parag; Green, W Richard; Stark, Walter J; Akpek, Esen Karamursel


    To report the occurrence of subluxation of suture-fixated posterior chamber (PC) intraocular lenses (IOL) and elucidate the mechanisms involved. Prospective clinicopathologic study. A single 10-0 Prolene suture explanted from a patient who experienced subluxation of his PC-IOL, 11.5 years after placement. Furthermore, multiple 10-0 Prolene sutures and PC-IOLs used for iris fixation were studied as controls. Scanning electron microscopy (SEM) was used to analyze the surface of the explanted suture. In addition, randomly selected 10-0 Prolene sutures cut with Vannas scissors and cut with the positioning holes of a randomly selected PC-IOL identical to that implanted in the patient's eye were examined as controls. Finally, the positioning holes of several randomly selected, iris-fixated PC-IOLs were studied using SEM with particular attention to surface quality and edge finish. Presence of any signs of suture degradation, the character of the cut edge of the suture, as well as the characteristics of the positioning holes of the PC-IOLs. Scanning electron microscopy of the explanted suture revealed sharply cut edges, without significant degradation of the suture, and no intact loop. Scanning electron microscopy of the control suture cut with a PC-IOL demonstrated a similarly cut edge. The positioning holes of the examined PC-IOLs had a sharp edge, and some also had an imperfect finish. We conclude that the surface properties of the positioning holes lead to cutting of the suture, and subsequent subluxation of the PC-IOL.

  18. Paleomagnetic contributions to the Klamath Mountains terrane puzzle-a new piece from the Ironside Mountain batholith, northern California (United States)

    Mankinen, Edward A.; Gromme, C. Sherman; Irwin, W. Porter


    We obtained paleomagnetic samples from six sites within the Middle Jurassic Ironside Mountain batholith (~170 Ma), which constitutes the structurally lowest part of the Western Hayfork terrane, in the Klamath Mountains province of northern California and southern Oregon. Structural attitudes measured in the coeval Hayfork Bally Meta-andesite were used to correct paleomagnetic data from the batholith. Comparing the corrected paleomagnetic pole with a 170-Ma reference pole for North America indicates 73.5° ± 10.6° of clockwise rotation relative to the craton. Nearly one-half of this rotation may have occurred before the terrane accreted to the composite Klamath province at ~168 Ma. No latitudinal displacement of the batholith was detected.

  19. Punta del este terrane: meso proterozoic basement and neo proterozoic cover

    International Nuclear Information System (INIS)

    Preciozzi, F.; Sanchez Bettucci, L.; Basei, M.; Peel, E.; Oyhantcabal, P.; Cordani, U.


    Full text: Eastern basement of Uruguay consists of Meso and Neoproterozoic rocks. Mesoproterozoic basement had been deformed by pre-Brasiliano and Brasiliano events. Regional variations in this basement and in the Neoproterozoic cover show equivalent deformation styles and intensities. Models proposed for tectonic evolution have been scarce and confusing. Specially, the ones that concern the moment of collision and/or juxtaposition of blocks. The Punta del Este Terrane (PET) is composed of gneisses and migmatites formed between 1000 Ma to 900 Ma (Preciozzi et al., 2001). These rocks had been strongly reworked during Brasiliano and Rio Doce orogenesis (ca. 900-500 Ma). This crustal segment represents a high grade metamorphic terrane, which is correlated to some gneissic complexes southwest of Africa. Particularly, it is correlated to Kibaran-Namaqua Belt in Namibia. U-Pb ages between 1000 Ma and 900 Ma, obtained in zircons from tonalitic granitoids, are interpreted as indicative of their crystallization (Fig. 1). Besides, anatectic fluids related to migmatites leucosomes yielded ages of ca. 520 to 540 Ma. This denotes that superimposed metamorphic conditions during Brasiliano orogenesis reached, at least, lower amphibolite facies. PET basement gneisses present Sm-Nd model ages (TDM) between 2.4 to 1.8 Ga, showing long crustal residence, corroborated by the very negative εNd values of –1.3 and –14.3. During Brazilian orogenesy they were affected by deformation processes and anatexis. Metasedimentary PET cover occurs near La Paloma and Rocha towns. It is represented by a siliciclastic metasedimentary succession corresponding to the Rocha formation. In La Pedrera town recognized three sedimentary facies were (1-3): (1) sandstones and pelites; (2) green pelites; and (3) rhytmites. The transition from facies (1) to facies (3) shows the passage from fluvial environment with tidal influence to tidal flat with predominance of sub tidal deposits (Pazos and S

  20. Lithospheric discontinuities beneath the U.S. Midcontinent - signatures of Proterozoic terrane accretion and failed rifting (United States)

    Chen, Chen; Gilbert, Hersh; Fischer, Karen M.; Andronicos, Christopher L.; Pavlis, Gary L.; Hamburger, Michael W.; Marshak, Stephen; Larson, Timothy; Yang, Xiaotao


    Seismic discontinuities between the Moho and the inferred lithosphere-asthenosphere boundary (LAB) are known as mid-lithospheric discontinuities (MLDs) and have been ascribed to a variety of phenomena that are critical to understanding lithospheric growth and evolution. In this study, we used S-to-P converted waves recorded by the USArray Transportable Array and the OIINK (Ozarks-Illinois-Indiana-Kentucky) Flexible Array to investigate lithospheric structure beneath the central U.S. This region, a portion of North America's cratonic platform, provides an opportunity to explore how terrane accretion, cratonization, and subsequent rifting may have influenced lithospheric structure. The 3D common conversion point (CCP) volume produced by stacking back-projected Sp receiver functions reveals a general absence of negative converted phases at the depths of the LAB across much of the central U.S. This observation suggests a gradual velocity decrease between the lithosphere and asthenosphere. Within the lithosphere, the CCP stacks display negative arrivals at depths between 65 km and 125 km. We interpret these as MLDs resulting from the top of a layer of crystallized melts (sill-like igneous intrusions) or otherwise chemically modified lithosphere that is enriched in water and/or hydrous minerals. Chemical modification in this manner would cause a weak layer in the lithosphere that marks the MLDs. The depth and amplitude of negative MLD phases vary significantly both within and between the physiographic provinces of the midcontinent. Double, or overlapping, MLDs can be seen along Precambrian terrane boundaries and appear to result from stacked or imbricated lithospheric blocks. A prominent negative Sp phase can be clearly identified at 80 km depth within the Reelfoot Rift. This arrival aligns with the top of a zone of low shear-wave velocities, which suggests that it marks an unusually shallow seismic LAB for the midcontinent. This boundary would correspond to the top of a

  1. Biomechanical comparison of an all-soft suture anchor with a modified Broström-Gould suture repair for lateral ligament reconstruction. (United States)

    Brown, Christopher A; Hurwit, Daniel; Behn, Anthony; Hunt, Kenneth J


    Anatomic repair is indicated for patients who have recurrent lateral ankle instability despite nonoperative measures. There is no difference in repair stiffness, failure torque, or failure angle between specimens repaired with all-soft suture anchors versus the modified Broström-Gould technique with sutures only. Controlled laboratory study. In 10 matched pairs of human cadaveric ankles, the anterior talofibular ligament (ATFL) was incised from its origin on the fibula. After randomization, 1 ankle was repaired to its anatomic insertion using two 1.4-mm JuggerKnot all-soft suture anchors; the other ankle was repaired with a modified Broström-Gould technique using 2-0 FiberWire. All were augmented using the inferior extensor retinaculum. All ankles were mounted to the testing machine in 20° of plantar flexion and 15° of internal rotation and loaded to failure after the repair. Stiffness, failure torque, and failure angle were recorded and compared using a paired Student t test with a significance level set at P anchors pulled out of bone. The primary mode of failure was pulling through the ATFL tissue. There was no statistical difference in strength or stiffness between a 1.4-mm all-soft suture anchor and a modified Broström-Gould repair with 2-0 FiberWire. The primary mode of failure was at the tissue level rather than knot failure or anchor pullout. The particular implant choice (suture only, tunnel, anchor) in repairing the lateral ligament complex may not be as important as the time to biological healing. The suture-only construct as described in the Broström-Gould repair was as strong as all-soft suture anchors, and the majority of the ankles failed at the tissue level. For those surgeons whose preference is to use anchor repair, this novel all-soft suture anchor may be an alternative to other larger anchors, as none failed by pullout.

  2. Terrane Boundary Geophysical Signatures in Northwest Panay, Philippines: Results from Gravity, Seismic Refraction and Electrical Resistivity Investigations

    Directory of Open Access Journals (Sweden)

    Jillian Aira S. Gabo


    Full Text Available Northwest Panay consists of two terranes that form part of the Central Philippine collision zone: Buruanga Peninsula and Antique Range. The Buruanga Peninsula consists of a Jurassic chert-clastic-limestone sequence, typical of oceanic plate stratigraphy of the Palawan Micro-continental Block. The Antique Range is characterized by Antique Ophiolite Complex peridotites and Miocene volcanic and clastic rocks, representing obducted oceanic crust that serves as the oceanic leading edge of the collision with the Philippine Mobile Belt. The Nabas Fault is identified as the boundary between the two terranes. This study employed the gravity method to characterize the Northwest Panay subsurface structure. Results indicate higher Bouguer anomaly values for Buruanga Peninsula than those for Antique Range, separated by a sudden decrease in gravity values toward the east-southeast (ESE direction. Forward gravity data modeling indicates the presence of an underlying basaltic subducted slab in the Buruanga Peninsula. Furthermore, the Nabas Fault is characterized as an east-dipping thrust structure formed by Buruanga Peninsula basement leading edge subduction beneath Antique Range. Additional geophysical constraints were provided by shallow seismic refraction and electrical resistivity surveys. Results from both methods delineated the shallow subsurface signature of the Nabas Fault buried beneath alluvium deposits. The gravity, seismic refraction and electrical resistivity methods were consistent in identifying the Nabas Fault as the terrane boundary between the Buruanga Peninsula and the Antique Range. The three geophysical methods helped constrain the subsurface configuration in Northwest Panay.

  3. Genipin crosslinker releasing sutures for improving the mechanical/repair strength of damaged connective tissue. (United States)

    Sundararaj, Sharath; Slusarewicz, Paul; Brown, Matt; Hedman, Thomas


    The most common mode of surgical repair of ruptured tendons and ligaments involves the use of sutures for reattachment. However, there is a high incidence of rerupture and repair failure due to pulling out of the suture material from the damaged connective tissue. The main goal of this research was to achieve a localized delivery of crosslinking agent genipin (GP) from rapid-release biodegradable coatings on sutures, for strengthening the repair of ruptured connective tissue. Our hypothesis is that GP released from the suture coating will lead to exogenous crosslinking of native connective tissue resulting in beneficial effects on clinically relevant mechanical parameters such as tear resistance, tissue strength, and energy required to rupture the tissue (toughness). Sutures were successfully coated with a biodegradable polymer layer loaded with the crosslinking agent genipin, without compromising the mechanical properties of the suture. The rapid-release of genipin was achieved under both in vitro and ex vivo conditions. Exogenous crosslinking using these genipin releasing sutures was demonstrated using equine tendons. The tendons treated with genipin releasing sutures showed significant improvement in failure load, energy required for pull-out failure, and stiffness. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 105B: 2199-2205, 2017. © 2016 Wiley Periodicals, Inc.

  4. Critical Anatomy Relative to the Sacral Suture: A Postoperative Imaging Study After Robotic Sacrocolpopexy. (United States)

    Crisp, Catrina C; Herfel, Charles V; Pauls, Rachel N; Westermann, Lauren B; Kleeman, Steven D


    This study aimed to characterize pertinent anatomy relative to the sacral suture placed at time of robotic sacrocolpopexy using postoperative computed tomography and magnetic resonance imaging. A vascular clip was placed at the base of the sacral suture at the time of robotic sacrocolpopexy. Six weeks postoperatively, subjects returned for a computed tomography scan and magnetic resonance imaging. Ten subjects completed the study. The middle sacral artery and vein coursed midline or to the left of midline in all the subjects. The left common iliac vein was an average of 26 mm from the sacral suture. To the right of the suture, the right common iliac artery was 18 mm away. Following the right common iliac artery to its bifurcation, the right internal iliac was on average 10 mm from the suture. The bifurcations of the inferior vena cava and the aorta were 33 mm and 54 mm further cephalad, respectively.The right ureter, on average, was 18 mm from the suture. The thickness of the anterior longitudinal ligament was 2 mm.The mean angle of descent of the sacrum was 70 degrees. Lastly, we found that 70% of the time, a vertebral body was directly below the suture; the disc was noted in 30%. We describe critical anatomy surrounding the sacral suture placed during robotic sacrocolpopexy. Proximity of both vascular and urologic structures within 10 to 18 mm, as well as anterior ligament thickness of only 2 mm highlights the importance of adequate exposure, careful dissection, and surgeon expertise.

  5. Early secondary suture versus healing by second intention of incisional abscesses

    DEFF Research Database (Denmark)

    Hermann, G G; Bagi, P; Christoffersen, I


    A controlled trial was set up to compare the treatment of wound abscesses, occurring after laparotomy, with either early secondary suture combined with cefuroxime and metronidazole given intravenously or by healing by second intention. The secondary suture was performed two days after wound...... drainage and resulted in a significant reduction (p less than 0.01) in healing time without complications. No reinfections occurred....

  6. Antibacterial-Coated Suture in Reducing Surgical Site Infection in Breast Surgery: A Prospective Study

    Directory of Open Access Journals (Sweden)

    Enora Laas


    Full Text Available Background. To reduce the incidence of microbial colonization of suture material, Triclosan- (TC-coated suture materials have been developed. The aim of this study was to assess the incidence of suture-related complications (SRC in breast surgery with and without the use of TC-coated sutures. Methods. We performed a study on two consecutive periods: 92 patients underwent breast surgery with conventional sutures (Group 1 and 98 with TC-coated sutures (Group 2. We performed subgroups analyses and developed a model to predict SRC in Group 1 and tested its clinical efficacy in Group 2 using a nomogram-based approach. Results. The SRC rates were 13% in Group 1 and 8% in Group 2. We found that some subgroups may benefit from TC-coated sutures. The discrimination obtained from a logistic regression model developed in Group 1 and based on multifocality, age and axillary lymphadenectomy was 0.88 (95% CI 0.77–0.95 (. There was a significant difference in Group 2 between predicted probabilities and observed percentages (. The predicted and observed proportions of complications in the high-risk group were 38% and 13%, respectively. Conclusion. This study used individual predictions of SRC and showed that using TC-coated suture may prevent SRC. This was particularly significant in high-risk patients.

  7. Interactive Virtual Suturing Simulations: Enhancement of Student Learning in Veterinary Medicine (United States)

    Staton, Amy J.; Boyd, Christine B.


    This capstone addresses an instructional gap in the Morehead State University Veterinary Technology Program and in other similar programs around the globe. Students do not retain the knowledge needed to proficiently complete suture patterns nor do students receive sufficient instructional time during the year to master each suture pattern that is…

  8. A novel technique of rotator cuff repair using spinal needle and suture loop

    Directory of Open Access Journals (Sweden)

    Muzaffar Nasir


    Full Text Available Abstract Background We present a simple technique of arthroscopic rotator cuff repair using a spinal needle and suture loop. Methods With the arthroscope laterally, a spinal needle looped with PDS is inserted percutaneously into the shoulder posteriorly and penetrated through the healthy posterior cuff tear margin. Anteriorly, another spinal needle loaded with PDS is inserted percutaneously to engage the healthy tissue at the anterior tear margin. The suture in the anterior needle is then delivered into the suture loop of the posterior needle using a suture retriever. The posterior needle and loop are then pulled out carrying the anterior suture with it. The two limbs of this suture are then retrieved through a cannula for knotting. The same procedure is then repeated for additional suturing. Suture anchors placed over the greater tuberosity are used to complete the repair. Conclusion This is an easy method of rotator cuff repair using simple instruments and lesser time, hence can be employed at centers with less equipment and at reduced cost to the patient.

  9. Comparison of clinical outcomes of multi-point umbrella suturing and single purse suturing with two-point traction after procedure for prolapse and hemorrhoids (PPH) surgery. (United States)

    Jiang, Huiyong; Hao, Xiuyan; Xin, Ying; Pan, Youzhen


    To compare the clinical outcomes of multipoint umbrella suture and single-purse suture with two-point traction after procedure for prolapse and hemorrhoids surgery (PPH) for the treatment of mixed hemorrhoids. Ninety patients were randomly divided into a PPH plus single-purse suture group (Group A) and a PPH plus multipoint umbrella suture (Group B). All operations were performed by an experienced surgeon. Operation time, width of the specimen, hemorrhoids retraction extent, postoperative pain, postoperative bleeding, and length of hospitalization were recorded and compared. Statistical analysis was conducted by t-test and χ2 test. There were no significant differences in sex, age, course of disease, and degree of prolapse of hemorrhoids between the two groups. The operative time in Group A was significantly shorter than that in Group B (P hemorrhoid core retraction were significantly lower in Group B (P  0.05 for all comparisons) was observed. The multipoint umbrella suture showed better clinical outcomes because of its targeted suture according to the extent of hemorrhoid prolapse. Copyright © 2017. Published by Elsevier Ltd.

  10. Post-peak metamorphic evolution of the Sumdo eclogite from the Lhasa terrane of southeast Tibet (United States)

    Cao, Dadi; Cheng, Hao; Zhang, Lingmin; Wang, Ke


    A reconstruction of the pressure-temperature-time (P-T-t) path of high-pressure eclogite-facies rocks in subduction zones may reveal important information about the tectono-metamorphic processes that occur at great depths along the plate interface. The majority of studies have focused on prograde to peak metamorphism of these rocks, whereas after-peak metamorphism has received less attention. Herein, we present a detailed petrological, pseudosection modeling and radiometric dating study of a retrograded eclogite sample from the Sumdo ultrahigh pressure belt of the Lhasa terrane, Tibet. Mineral chemical variations, textural discontinuities and thermodynamic modeling suggest that the eclogite underwent an exhumation-heating period. Petrographic observations and phase equilibria modeling suggest that the garnet cores formed at the pressure peak (∼2.5 GPa and ∼520 °C) within the lawsonite eclogite-facies and garnet rims (∼1.5 GPa and spans an interval of ∼7 million years, which is a minimum estimate of the duration of the eclogite-facies metamorphism of the Sumdo eclogite.

  11. UTE park group and other meso proterozoic units of the Nico Perez terrane: Rodina connecting

    International Nuclear Information System (INIS)

    Gaucher, C; Chemale, F.; Bossi, J.; Sial, A.; Chiglino, L.


    The Parque UTE Group is a volcano sedimentary succession metamorphosed in green schist facies, comprising (from base to top): the Canada Espinillo Formation (prasinites, pelites, andesite s), the Mina Valencia Formation (dolostones, limestones, marls) and the Cerro del Mast il Formation (black pelites, limestones, acid tuffs). Thickness of the GPU exceeds 2.5 km; base and top are not exposed. U-Pb zircon ages for basic magmatic rocks at the base and rhyolites at the top yielded 1492±4 and 1429±21 Ma, respectively. 13C values of carbonates of the Pug are characterized by a plateau at +1‰ VPDB, bracketed between two negative excursions.These values are consistent with an early Mesoproterozoic depositional age. Detrital zircon age spectra show that the source area of the GPU was the Nico Perez Terrane, being thus native to the Rio de la Plata Craton (Rpc). A Mesoproterozoic tectonic event at 1.25 Ga, recorded at both sides of the Sarandi del Yi mega shear, is discussed. New U-Pb zircon ages are presented for the La China Complex at its type area, where a schistosity N60W cuts the metamorphic banding and is parallel to thrusts dated K-Ar at 1253±32 Ma. The ages obtained are: 3096±45 Ma (main metamorphic event) and 1252 Ma (lower intercept). These data confirm the occurrence of a Grenvillian-aged tectonic event in Uruguay, suggesting that the RPC was part of the super continent Rodinia

  12. SR and LR Union Suture for the Treatment of Myopic Strabismus Fixus: Is Scleral Fixation Necessary?

    Directory of Open Access Journals (Sweden)

    Carol P. S. Lam


    Full Text Available Purpose. To evaluate and compare the effectiveness of scleral fixation SR and LR union suture and nonscleral fixation union suture for the treatment of myopic strabismus fixus. Methods. Retrospective review of 32 eyes of 22 patients with myopic strabismus fixus who had undergone union suture of superior rectus (SR and lateral rectus (LR with or without scleral fixation, and follow-up longer than 6 months at Hong Kong Eye Hospital from 2006 to 2013. Surgical techniques and outcomes in terms of ocular alignment are analyzed. Results. There is significant overall improvement both in postoperative angle of esodeviation (P0.05. Conclusions. Union suture of SR and LR is an effective procedure in correcting myopic strabismus fixus. Fixation of the union suture to the sclera does not improve surgical outcome.

  13. Sutures coated with antiseptic pomade to prevent bacterial colonization: a randomized clinical trial. (United States)

    Cruz, Fernando; Leite, Fabiola; Cruz, Gustavo; Cruz, Silvia; Reis, Juarez; Pierce, Matthew; Cruz, Mauro


    The aim of this study was to assess if an antiseptic pomade could reduce the bacterial colonization on multifilament sutures. A randomized clinical trial was conducted with 40 volunteer patients of both sexes aged 18-70, randomly separated into experimental (n = 20) and control (n = 20) groups. The experimental group received pomade-coated sutures (iodoform + calendula) and the control group uncoated sutures. Two millimeters of the suture was harvested from each patient from the 1st to the 15th postoperative day. The bacteria that had adhered to them were cultured. The number of colony-forming units per milliliter (CFU/mL) was determined and the groups were compared using the Mann-Whitney statistical test (P antiseptic pomade was effective in reducing bacterial colonization on silk braided sutures. Copyright © 2013 Elsevier Inc. All rights reserved.

  14. Nonabsorbable-Suture-Induced Osteomyelitis: A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Cheng Hong Yeo


    Full Text Available We are reporting a case of nonabsorbable suture-induced osteomyelitis in patient who had an open rotator cuff repair with nonabsorbable Ethibond anchor suture. Patient in this case presented with very subtle clinical features of osteomyelitis of the left proximal humerus 15 years after initial rotator cuff repair surgery. Literature had shown that deep infection following rotator cuff repairs, although rare, can be easily missed and can cause severe complications. Absorbable suture had been demonstrated to be more superior, in terms of rate of deep infection, as compared to nonabsorbable suture when used in rotator cuff repair surgery. Both absorbable and nonabsorbable suture had been demonstrated to have similar mechanical properties by several different studies. The case demonstrated that initial presentation of deep infection can be subtle and easily missed by clinicians and leads to further complications.

  15. The primary factor for suture configuration at rotator cuff repair: Width of mattress or distance from tear edge

    Directory of Open Access Journals (Sweden)

    Onur Hapa


    Conclusion: Bite size from the edge of the tendon seems to be more important than the width of the mattress. The curve of the suture passing device may also have an effect on the strength of the suture tendon interface.

  16. Novel Technique to Overcome the Nonavailability of a Long Needle 9-0 Polypropylene Suture for Sutured Scleral Fixation of the Posterior Chamber Intraocular Lens Using a Single Fisherman’s Knot

    Directory of Open Access Journals (Sweden)

    Yong Un Shin


    Full Text Available Purpose. To describe a method to overcome the nonavailability of a long needle 9-0 polypropylene suture for sutured scleral fixation of the posterior chamber intraocular lens (PC-IOL using a single fisherman’s knot (SFK. Methods. First, a 10-0 polypropylene suture was passed from the sclera to the ciliary sulcus using a long needle. A 9-0 suture was tied to the unpassed portion of the 10-0 suture with an SFK. We pulled the 10-0 suture to pass the SFK through the sclera, and then we cut the knot and removed the 10-0 suture. IOL fixation with 9-0 sutures used the conventional techniques used for sutured scleral-fixated IOL. Preoperative and postoperative visual acuity, corneal astigmatism, and endothelial cell count and intraoperative/postoperative complications were evaluated. Results. An SFK joining the two sutures was passed through the sclera without breakage or slippage. A total of 35 eyes from 35 patients who underwent sutured scleral fixation of the IOL. An intraoperative complication (minor intraocular hemorrhage was recorded in four cases. Knot exposure, IOL dislocation, subluxation, and retinal detachment were not observed. Conclusions. The SFK offers the opportunity to use 9-0 sutures for the long-term safety and may not require the surgeon to learn any new technique.

  17. Novel Technique to Overcome the Nonavailability of a Long Needle 9-0 Polypropylene Suture for Sutured Scleral Fixation of the Posterior Chamber Intraocular Lens Using a Single Fisherman's Knot. (United States)

    Shin, Yong Un; Seong, Mincheol; Cho, Hee Yoon; Kang, Min Ho


    To describe a method to overcome the nonavailability of a long needle 9-0 polypropylene suture for sutured scleral fixation of the posterior chamber intraocular lens (PC-IOL) using a single fisherman's knot (SFK). First, a 10-0 polypropylene suture was passed from the sclera to the ciliary sulcus using a long needle. A 9-0 suture was tied to the unpassed portion of the 10-0 suture with an SFK. We pulled the 10-0 suture to pass the SFK through the sclera, and then we cut the knot and removed the 10-0 suture. IOL fixation with 9-0 sutures used the conventional techniques used for sutured scleral-fixated IOL. Preoperative and postoperative visual acuity, corneal astigmatism, and endothelial cell count and intraoperative/postoperative complications were evaluated. An SFK joining the two sutures was passed through the sclera without breakage or slippage. A total of 35 eyes from 35 patients who underwent sutured scleral fixation of the IOL. An intraoperative complication (minor intraocular hemorrhage) was recorded in four cases. Knot exposure, IOL dislocation, subluxation, and retinal detachment were not observed. The SFK offers the opportunity to use 9-0 sutures for the long-term safety and may not require the surgeon to learn any new technique.

  18. Load response and gap formation in a single-row cruciate suture rotator cuff repair. (United States)

    Huntington, Lachlan; Richardson, Martin; Sobol, Tony; Caldow, Jonathon; Ackland, David C


    Double-row rotator cuff tendon repair techniques may provide superior contact area and strength compared with single-row repairs, but are associated with higher material expenses and prolonged operating time. The purpose of this study was to evaluate gap formation, ultimate tensile strength and stiffness of a single-row cruciate suture rotator cuff repair construct, and to compare these results with those of the Mason-Allen and SutureBridge repair constructs. Infraspinatus tendons from 24 spring lamb shoulders were harvested and allocated to cruciate suture, Mason-Allen and SutureBridge repair groups. Specimens were loaded cyclically between 10 and 62 N for 200 cycles, and gap formation simultaneously measured using a high-speed digital camera. Specimens were then loaded in uniaxial tension to failure, and construct stiffness and repair strength were evaluated. Gap formation in the cruciate suture repair was significantly lower than that of the Mason-Allen repair (mean difference = 0.6 mm, P = 0.009) and no different from that of the SutureBridge repair (P > 0.05). Both the cruciate suture repair (mean difference = 15.7 N/mm, P = 0.002) and SutureBridge repair (mean difference = 15.8 N/mm, P = 0.034) were significantly stiffer than that of the Mason-Allen repair; however, no significant differences in ultimate tensile strength between repair groups were discerned (P > 0.05). The cruciate suture repair construct, which may represent a simple and cost-effective alternative to double-row and double-row equivalent rotator cuff repairs, has comparable biomechanical strength and integrity with that of the SutureBridge repair, and may result in improved construct longevity and tendon healing compared with the Mason-Allen repair. © 2017 Royal Australasian College of Surgeons.

  19. Pullout strength of cement-augmented and wide-suture transosseous fixation in the greater tuberosity. (United States)

    Shi, Brendan Y; Diaz, Miguel; Belkoff, Stephen M; Srikumaran, Uma


    Obtaining strong fixation in low-density bone is increasingly critical in surgical repair of rotator cuff tears because of the aging population. To evaluate two new methods of improving pullout strength of transosseous rotator cuff repair in low-density bone, we analyzed the effects of 1) using 2-mm suture tape instead of no. 2 suture and 2) augmenting the lateral tunnel with cement. Eleven pairs of osteopenic or osteoporotic cadaveric humeri were identified by dual-energy x-ray absorptiometry. One bone tunnel and one suture were placed in the heads of 22 specimens. Five randomly selected pairs were repaired with no. 2 suture; the other six pairs were repaired with 2-mm suture tape. One side of each pair received lateral tunnel cement augmentation. Specimens were tested to suture pullout. Data were fitted to multivariate models that accounted for bone mineral density and other specimen characteristics. Two specimens were excluded because of knot-slipping during testing. Use of suture tape versus no. 2 suture conferred a 75-N increase (95% CI: 37, 113) in pullout strength (PCement augmentation conferred a 42-N improvement (95% CI: 10, 75; P=0.011). Other significant predictors of pullout strength were age, sex, and bone mineral density. We show two methods of improving the fixation strength of transosseous rotator cuff repairs in low-density bone: using 2-mm suture tape instead of no. 2 suture and augmenting the lateral tunnel with cement. These methods may improve the feasibility of transosseous repairs in an aging patient population. Copyright © 2017 Elsevier Ltd. All rights reserved.

  20. Sequential selective same-day suture removal in the management of post-keratoplasty astigmatism. (United States)

    Fares, U; Mokashi, A A; Elalfy, M S; Dua, H S


    In a previous study, we proposed that corneal topography performed 30-40 min after the initial suture removal can identify the next set of sutures requiring removal, for the treatment of post-keratoplasty astigmatism. The aim of this study was to evaluate the effect of removing subsequent sets of sutures at the same sitting. 10/0 nylon interrupted sutures were placed, to secure the graft-host junction, at the time of keratoplasty. Topography was performed using Pentacam (Oculus) before suture removal. The sutures to be removed in the steep semi-meridians were identified and removed at the slit-lamp biomicroscope. Topography was repeated 30-40 min post suture removal, the new steep semi-meridians determined, and the next set of sutures to be removed were identified and removed accordingly. Topography was repeated 4-6 weeks later and the magnitude of topographic astigmatism was recorded. A paired-samples t-test was used to evaluate the impact of selective suture removal on reducing the magnitude of topographic and refractive astigmatism. Twenty eyes of 20 patients underwent sequential selective same-day suture removal (SSSS) after corneal transplantation. This study showed that the topographic astigmatism decreased by about 46.7% (3.68 D) and the refractive astigmatism decreased by about 37.7% (2.61 D) following SSSS. Vector calculations also show a significant reduction of both topographic and refractive astigmatism (P<0.001). SSSS may help patients to achieve satisfactory vision more quickly and reduce the number of follow-up visits required post keratoplasty.

  1. Pectoralis Major Repair With Unicortical Button Fixation And Suture Tape. (United States)

    Sanchez, Anthony; Ferrari, Marcio B; Frangiamore, Salvatore J; Sanchez, George; Kruckeberg, Bradley M; Provencher, Matthew T


    Although injuries of the pectoralis major muscle are generally uncommon, ruptures of the pectoralis major are occasionally seen in younger, more active patients who participate in weightlifting activities. These injuries usually occur during maximal contraction of the muscle, while in extension and external rotation. In the case of a rupture, operative treatment is advocated especially in young, active patients regardless of the chronicity of the injury. Various surgical techniques for reattachment of the avulsed tendon have been described, but bone tunnel and suture anchor repair techniques are most widely used. In this Technical Note, we present our preferred technique for acute pectoralis major rupture repair involving use of cortical buttons for tendon stump-to-bone fixation.

  2. Application analysis on different suture of scleral flap in trabeculectomy

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    Ning Liu


    Full Text Available AIM: To research the application of scleral flap suture in trabeculectomy. METHODS: Totally 114 primary angle-closure glaucoma patients, aged from 36-72 years old, were selected as the objects, and randomly divided into research group and control group. The two groups received different administration methods. Traditional sewing method of sclera flap was used in research group and improved sewing method of sclera flap was used in control group. RESULTS: There was statistical differences between postoperative intraocular pressure of the patients in the observation group and the control group after 1d; 2wk; 1, 3mo(PPP>0.05.CONCLUSION: It is safe and effective that the improved sewing method of sclera flap for trabeculectomy of acute angle-closure glaucoma, and it is a better method to avoid the occurrence of shallow anterior chamber than the traditional sewing method in the early stage after operation.

  3. Automatically rating trainee skill at a pediatric laparoscopic suturing task. (United States)

    Oquendo, Yousi A; Riddle, Elijah W; Hiller, Dennis; Blinman, Thane A; Kuchenbecker, Katherine J


    Minimally invasive surgeons must acquire complex technical skills while minimizing patient risk, a challenge that is magnified in pediatric surgery. Trainees need realistic practice with frequent detailed feedback, but human grading is tedious and subjective. We aim to validate a novel motion-tracking system and algorithms that automatically evaluate trainee performance of a pediatric laparoscopic suturing task. Subjects (n = 32) ranging from medical students to fellows performed two trials of intracorporeal suturing in a custom pediatric laparoscopic box trainer after watching a video of ideal performance. The motions of the tools and endoscope were recorded over time using a magnetic sensing system, and both tool grip angles were recorded using handle-mounted flex sensors. An expert rated the 63 trial videos on five domains from the Objective Structured Assessment of Technical Skill (OSATS), yielding summed scores from 5 to 20. Motion data from each trial were processed to calculate 280 features. We used regularized least squares regression to identify the most predictive features from different subsets of the motion data and then built six regression tree models that predict summed OSATS score. Model accuracy was evaluated via leave-one-subject-out cross-validation. The model that used all sensor data streams performed best, achieving 71% accuracy at predicting summed scores within 2 points, 89% accuracy within 4, and a correlation of 0.85 with human ratings. 59% of the rounded average OSATS score predictions were perfect, and 100% were within 1 point. This model employed 87 features, including none based on completion time, 77 from tool tip motion, 3 from tool tip visibility, and 7 from grip angle. Our novel hardware and software automatically rated previously unseen trials with summed OSATS scores that closely match human expert ratings. Such a system facilitates more feedback-intensive surgical training and may yield insights into the fundamental

  4. Biomechanical advantages of triple-loaded suture anchors compared with double-row rotator cuff repairs. (United States)

    Barber, F Alan; Herbert, Morley A; Schroeder, F Alexander; Aziz-Jacobo, Jorge; Mays, Matthew M; Rapley, Jay H


    To evaluate the strength and suture-tendon interface security of various suture anchors triply and doubly loaded with ultrahigh-molecular weight polyethylene-containing sutures and to evaluate the relative effectiveness of placing these anchors in a single-row or double-row arrangement by cyclic loading and then destructive testing. The infraspinatus muscle was reattached to the original humeral footprint by use of 1 of 5 different repair patterns in 40 bovine shoulders. Two single-row repairs and three double-row repairs were tested. High-strength sutures were used for all repairs. Five groups were studied: group 1, 2 triple-loaded screw suture anchors in a single row with simple stitches; group 2, 2 triple-loaded screw anchors in a single row with simple stitches over a fourth suture passed perpendicularly ("rip-stop" stitch); group 3, 2 medial and 2 lateral screw anchors with a single vertical mattress stitch passed from the medial anchors and 2 simple stitches passed from the lateral anchors; group 4, 2 medial double-loaded screw anchors tied in 2 mattress stitches and 2 push-in lateral anchors capturing the medial sutures in a "crisscross" spanning stitch; and group 5, 2 medial double-loaded screw anchors tied in 2 mattress stitches and 2 push-in lateral anchors creating a "suture-bridge" stitch. The specimens were cycled between 10 and 180 N at 1.0 Hz for 3,500 cycles or until failure. Endpoints were cyclic loading displacement (5 and 10 mm), total displacement, and ultimate failure load. A single row of triply loaded anchors was more resistant to stretching to a 5- and 10-mm gap than the double-row repairs with or without the addition of a rip-stop suture (P row repair (P row created by 2 medial double-loaded suture anchors and 2 lateral push-in anchors stretched more than any other group (P row repairs with either crossing sutures or 4 separate anchor points were more likely to fail (5- or 10-mm gap) than a single-row repair loaded with 3 simple sutures

  5. Combined U-Pb SHRIMP and Hf isotope study of the Late Paleozoic Yaminué Complex, Rio Negro Province, Argentina: Implications for the origin and evolution of the Patagonia composite terrane

    Directory of Open Access Journals (Sweden)

    Carlos J. Chernicoff


    Combining geological and isotope data, as well as geophysical models, we identify the Yaminué Complex within the La Esperanza-Yaminué crustal block flanked by two other, distinct crustal blocks: the Eastern block which forms part of the Patagonia terrane sensu stricto, located in the eastern Patagonian region, and the Western block forming part of the Southern Patagonia terrane. Their origins and timing of amalgamation to form the Patagonia composite terrane are also discussed.

  6. Biomechanical characteristics of single-row repair in comparison to double-row repair with consideration of the suture configuration and suture material. (United States)

    Baums, M H; Buchhorn, G H; Spahn, G; Poppendieck, B; Schultz, W; Klinger, H-M


    The aim of the study was to evaluate the time zero mechanical properties of single- versus double-row configuration for rotator cuff repair in an animal model with consideration of the stitch technique and suture material. Thirty-two fresh-frozen sheep shoulders were randomly assigned to four repair groups: suture anchor single-row repair coupled with (1) braided, nonabsorbable polyester suture sized USP No. 2 (SRAE) or (2) braided polyblend polyethylene suture sized No. 2 (SRAH). The double-row repair was coupled with (3) USP No. 2 (DRAE) or (4) braided polyblend polyethylene suture No. 2 (DRAH). Arthroscopic Mason-Allen stitches were used (single-row) and combined with medial horizontal mattress stitches (double-row). Shoulders were cyclically loaded from 10 to 180 N. Displacement to gap formation of 5- and 10-mm at the repair site, cycles to failure, and the mode of failure were determined. The ultimate tensile strength was verified in specimens that resisted to 3,000 cycles. DRAE and DRAH had a lower frequency of 5- (P = 0.135) and 10-mm gap formation (P = 0.135). All DRAE and DRAH resisted 3,000 cycles while only three SRAE and one SRAH resisted 3,000 cycles (P row specimens was significantly higher than in others (P 0.05). Double-row suture anchor repair with arthroscopic Mason-Allen/medial mattress stitches provides initial strength superior to single-row repair with arthroscopic Mason-Allen stitches under isometric cyclic loading as well as under ultimate loading conditions. Our results support the concept of double-row fixation with arthroscopic Mason-Allen/medial mattress stitches in rotator cuff tears with improvement of initial fixation strength and ultimate tensile load. Use of new polyblend polyethylene suture material seems not to increase the initial biomechanical aspects of the repair construct.

  7. Recognition of the Kaweka Terrane in northern South Island, New Zealand : preliminary evidence from Rb-Sr metamorphic and U-Pb detrital zircon ages

    International Nuclear Information System (INIS)

    Adams, C.J.; Mortimer, N.; Campbell, H.J.; Griffin, W.L.


    Detrital zircon U-Pb ages and Rb-Sr metamorphic ages from low-grade Torlesse Supergroup metasedimentary rocks from North Canterbury and Marlborough provide preliminary evidence for a continuation of the Kaweka Terrane of the central North Island into the Torlesse Composite Terrane of the South Island. This would extend from the south side of the Wairau Fault in the upper Wairau River valley southwards to the Lake Tennyson and Lake Sumner areas, and as far as Hawarden. Rb-Sr ages indicate Jurassic metamorphism, 170±24 Ma, with initial 87 Sr/ 86 Sr ratios at that time 0.7073 ± 0.0007 i.e. similar to their North Island counterparts. These Kaweka Terrane rocks have detrital zircon ages that follow the distinctive pattern of the Torlesse rocks in general, i.e. substantial (>30%) Permian-Triassic and Precambrian-Early Palaeozoic groupings, but they also have minor youngest age components c. 175-165 Ma which constrain a maximum Early-Middle Jurassic depositional age. In detail, significant, older zircon components are Late Permian-Early Triassic (260-240 Ma) and Late Triassic (220-210 Ma), but the Precambrian-Early Palaeozoic detrital zircon ages are more scattered. The Kaweka Terrane thus forms a linear belt (c. 500 km) along the length of the Torlesse Composite Terrane in both North and South Islands. In the South Island it coincides with the Esk Head Belt, i.e. east of the Rakaia Terrane (Triassic-Late Permian) and west of the Pahau Terrane (Early Cretaceous-Late Jurassic). (author). 61 refs., 4 figs., 2 tabs.

  8. Effectiveness of ultrasonographic evaluation of the cranial sutures in children with suspected craniosynostosis

    Energy Technology Data Exchange (ETDEWEB)

    Simanovsky, Natalia; Hiller, Nurith; Koplewitz, Benjamin; Rozovsky, Katya [Hadassah Hebrew University Medical Center, Department of Medical Imaging, Mount, Scopus, P.O. Box 24035, Jerusalem (Israel)


    Computed tomography (CT) is the 'gold standard' for evaluation of the cranial sutures. While prenatal cranial suture evaluation with ultrasound (US) is common, US has not been established as a postnatal screening tool. We evaluated the effectiveness of US for diagnosis of craniosynostosis (CS). During 2006, 24 infants with questionable CS were assessed with US of the sagittal, metopic, and bilateral coronal and lambdoid sutures. US findings and clinical records were reviewed retrospectively. Sixteen boys and eight girls (ages 1-11 months, mean 4.3) underwent US. The correct diagnosis was provided in 23 (95%), with equivocal findings in one patient. Cranial sutures appeared normal in 15 infants, who had normal clinical presentation at mean 5.8 months follow-up; CT confirmation was obtained in two. In eight children, US identified premature closure of one or more cranial sutures. Three-dimensional CT was performed as a preparation for surgery in four, with classical CS findings. In one case with inconclusive US findings, CT showed narrow but open sutures. Sonographic examination of cranial sutures may serve as a first imaging tool for evaluation of craniosynostosis. CT may be reserved for children with abnormal or equivocal ultrasound and for preoperative planning. (orig.)

  9. Effectiveness of ultrasonographic evaluation of the cranial sutures in children with suspected craniosynostosis

    International Nuclear Information System (INIS)

    Simanovsky, Natalia; Hiller, Nurith; Koplewitz, Benjamin; Rozovsky, Katya


    Computed tomography (CT) is the 'gold standard' for evaluation of the cranial sutures. While prenatal cranial suture evaluation with ultrasound (US) is common, US has not been established as a postnatal screening tool. We evaluated the effectiveness of US for diagnosis of craniosynostosis (CS). During 2006, 24 infants with questionable CS were assessed with US of the sagittal, metopic, and bilateral coronal and lambdoid sutures. US findings and clinical records were reviewed retrospectively. Sixteen boys and eight girls (ages 1-11 months, mean 4.3) underwent US. The correct diagnosis was provided in 23 (95%), with equivocal findings in one patient. Cranial sutures appeared normal in 15 infants, who had normal clinical presentation at mean 5.8 months follow-up; CT confirmation was obtained in two. In eight children, US identified premature closure of one or more cranial sutures. Three-dimensional CT was performed as a preparation for surgery in four, with classical CS findings. In one case with inconclusive US findings, CT showed narrow but open sutures. Sonographic examination of cranial sutures may serve as a first imaging tool for evaluation of craniosynostosis. CT may be reserved for children with abnormal or equivocal ultrasound and for preoperative planning. (orig.)

  10. FGFR2c-mediated ERK-MAPK activity regulates coronal suture development (United States)

    Pfaff, Miles J.; Xue, Ke; Li, Li; Horowitz, Mark C.; Steinbacher, Derek M.; Eswarakumar, Jacob V.P.


    Fibroblast growth factor receptor 2 (FGFR2) signaling is critical for proper craniofacial development. A gain-of-function mutation in the 2c splice variant of the receptor’s gene is associated with Crouzon syndrome, which is characterized by craniosynostosis, the premature fusion of one or more of the cranial vault sutures, leading to craniofacial maldevelopment. Insight into the molecular mechanism of craniosynostosis has identified the ERK-MAPK signaling cascade as a critical regulator of suture patency. The aim of this study is to investigate the role of FGFR2c-induced ERK-MAPK activation in the regulation of coronal suture development. Loss-of-function and gain-of-function Fgfr2c mutant mice have overlapping phenotypes, including coronal synostosis and craniofacial dysmorphia. In vivo analysis of coronal sutures in loss-of-function and gain-of-function models demonstrated fundamentally different pathogenesis underlying coronal suture synostosis. Calvarial osteoblasts from gain-of-function mice demonstrated enhanced osteoblastic function and maturation with concomitant increase in ERK-MAPK activation. In vitro inhibition with the ERK protein inhibitor U0126 mitigated ERK protein activation levels with a concomitant reduction in alkaline phosphatase activity. This study identifies FGFR2c-mediated ERK-MAPK signaling as a key mediator of craniofacial growth and coronal suture development. Furthermore, our results solve the apparent paradox between loss-of-function and gain-of-function FGFR2c mutants with respect to coronal suture synostosis. PMID:27034231

  11. Anatomy-Based navigation for ventriculostomy: Nasion-coronal suture distance measurement

    Directory of Open Access Journals (Sweden)

    Mevci Özdemir


    Full Text Available Objective: In this study we aimed to determine a landmark that can be measured through the skin with nasal mid-point (bregma to coronal suture, and additionally an average value was calculated. We report, to our knowledge, the distance between the nasion-coronal sutures is reported for the first time in Turkish population. Methods: The study included 30 craniums and 30 frontal bones. Each skull from midline nasal suture to coronal suture curved up at the distance was measured with tape measure. Results: Mean values were determined. Nasal suture between coronal suture distance average 12,2 cm (min10,3 cm, up to 13,5 cm were detected. Conclusion: Nasal suture is an easily palpable area through the skin. A small incision is carried down through skin to bone at the spot 12 cm back from the nasion 3 cm lateral to the midline for ventricular drainage operation. This data provide practical information for neurosurgeon and is available everywhere. J Clin Exp Invest 2014; 5 (3: 368-370

  12. Radiological assessment of skull base changes in children with syndromic craniosynostosis: role of ''minor'' sutures

    International Nuclear Information System (INIS)

    Calandrelli, Rosalinda; D'Apolito, Gabriella; Gaudino, Simona; Stefanetti, Mariangela; Colosimo, Cesare; Massimi, Luca; Di Rocco, Concezio


    This study aims to identify the premature synostosis of ''major'' and ''minor'' sutures of the four ''sutural arches'' of the skull and to perform a morphometric analysis in children with syndromic craniosynostosis in order to evaluate changes in the skull base linked with premature suture synostosis. We reviewed multiplanar high-resolution CT images, implemented with 3D reconstructions, from 18 patients with complex syndromic craniosynostosis and compared them with 18 age-matched healthy subjects. We assessed the calvarial sutures and their extension to the skull base, and then we correlated specific types of synostosis with the size, shape and symmetry of the cranial fossae. We found a marked asymmetry of the skull base growth in all patients. The synostotic involvement around the coronal ring caused a reduction in the growth of the anterior and middle fossae. The size of the posterior cranial fossa was related not only to ''major'' but also to ''minor'' suture synostosis of the lambdoid and parieto-squamosal arches. Changes in the skull base and craniofacial axis symmetry are due to structural and functional relationships between ''major'' and ''minor'' skull sutures, suggesting a structural and functional relationship between the neurocranium and basicranium. The early recognition of prematurely closed skull base sutures may help clinicians and neurosurgeons to establish correct therapeutic approaches. (orig.)

  13. Immunostimulatory sutures that treat local disease recurrence following primary tumor resection

    Energy Technology Data Exchange (ETDEWEB)

    Intra, Janjira; Zhang Xueqing; Salem, Aliasger K [Division of Pharmaceutics, College of Pharmacy, University of Iowa, Iowa City, IA 52242 (United States); Williams, Robin L; Zhu Xiaoyan [Department of Surgery, Roy J and Lucille Carver College of Medicine, University of Iowa, Iowa City, IA 52242 (United States); Sandler, Anthony D, E-mail: [Department of Surgery and Center for Cancer and Immunology Research, Children' s National Medical Center, Washington DC 20010 (United States)


    Neuroblastoma is a common childhood cancer that often results in progressive minimal residual disease after primary tumor resection. Cytosine-phosphorothioate-guanine oligonucleotides (CpG ODN) have been reported to induce potent anti-tumor immune responses. In this communication, we report on the development of a CpG ODN-loaded suture that can close up the wound following tumor excision and provide sustained localized delivery of CpG ODN to treat local disease recurrence. The suture was prepared by melt extruding a mixture of polylactic acid-co-glycolic acid (PLGA 75:25 0.47 dL g{sup -1}) pellets and CpG ODN 1826. Scanning electron microscopy images showed that the sutures were free of defects and cracks. UV spectrophotometry measurements at 260 nm showed that sutures provide sustained release of CpG ODN over 35 days. Syngeneic female A/J mice were inoculated subcutaneously with 1 x 10{sup 6} Neuro-2a murine neuroblastoma wild-type cells and tumors were grown between 5 to 10 mm before the tumors were excised. Wounds from the tumor resection were closed using CpG ODN-loaded sutures and/or polyglycolic acid Vicryl suture. Suppression of neuroblastoma recurrence and mouse survival were significantly higher in mice where wounds were closed using the CpG ODN-loaded sutures relative to all other groups. (communication)

  14. Popularity of suture materials among residents and faculty members of a postdoctoral periodontology program. (United States)

    Maksoud, Mohamed; Koo, Samuel; Barouch, Kasumi; Karimbux, Nadeem


    The aim of the present study was to determine the favoritism of suture materials among a group of clinicians at a teaching institution. The surveys included 11 absorbable and nine non-absorbable sutures. The surveyor was asked to select his or her suture preferences when it comes to using it in 13 different, commonly-performed surgical procedures. The surveys showed overall preferences for non-absorbable versus absorbable sutures. Chromic Gut with a 4-0 diameter thread reverse cutting FS2 needle was the most favored suture. For periodontal bone grafts and hard tissue ridge augmentation, polytetrafluoroethylene with a 4-0 thread and FS2 needle was preferred. For autogenous gingival grafts, gingival allografts, connective tissue grafts, frenectomy and frenoplasty, Chromic Gut with 5-0 diameter thread reverse cutting P3 needle was favored. For extraction socket preservation, soft tissue canine exposure, ridge augmentation, and dental implants, Chromic Gut with 4-0 diameter thread reverse cutting FS2 needle was preferred, and for sinus augmentation, Vicryl with a 4-0 diameter thread reverse cutting FS2 needle was favored. Absorbable sutures were preferred in the majority of periodontal procedures; however, non-absorbable sutures were favored in procedures that required longer healing or better stability of the flap edges in cases of periodontal and ridge augmentation. © 2013 Wiley Publishing Asia Pty Ltd.

  15. Basic interrupted versus continuous suturing techniques in bronchial anastomosis following sleeve lobectomy in dogs. (United States)

    Bayram, Ahmet Sami; Erol, Mehmet Muharrem; Salci, Hakan; Ozyiğit, Ozgür; Görgül, Sacit; Gebitekin, Cengiz


    Sleeve resection with or without lung resection is a valid conservative operation for patients with benign or malignant tumors; it enables the preservation of lung parenchyma. The aim of this prospective randomized study was to compare complications, operating time, and bronchial healing between the techniques of interrupted and continuous suturing for bronchial anastomosis in dogs. Twenty adult mongrel dogs each weighing 18-22 kg (average: 20 kg) were divided into two groups according to the anastomosis technique performed: group A, interrupted suturing and group B, continuous suturing. Each group comprised of 10 dogs. Following right thoracotomy, sleeve resection of the right cranial lobe was performed in all dogs. Basic interrupted sutures using 4/0 Vicryl (Ethicon, USA) were used in group A, and continuous sutures were used in group B. The median anastomosis time was 15.2 min (range: 13-21 min) in group A and 9.6 min (range: 8-13 min) in group B. In all dogs, the anastomosis line was resected via right pneumonectomy for histopathological investigation 1 month after sleeve resection. Histopathological examination revealed that the healing of the anastomosis was not affected by the suturing technique applied. One dog from each group died on the fourth postoperative day; Fisher's exact test, p=0.763. Our research revealed that the healing of the anastomosis was not affected by the suturing technique performed.

  16. Introduction of a New Suture Method in Repair of Peripheral Nerves Injured with a Sharp Mechanism

    Directory of Open Access Journals (Sweden)

    Alireza Saied


    Full Text Available Background: The standard method for repair of an injured peripheal nerve is epineural repair with separate sutures. Herein we describe a method in which the nerve is sutured with continous sutures. In fact this method has not been utilized for nerve repair previously and our purpose was to compare it to the standard method. If it proved to be successful it would replace the standard method in certain circumstances. Methods: The proposal of the clinical trial was given a reference number form the ethics comitee. 25 dogs in which the scaitic nerve was cut by a sharp blade under genaeral anesthesia were divided randomly into three groups: control (5 dogs, repair of sciatic nerve with simple sutures (10 and repair with continous sutures (10. In the control group the nerve was not repaired at all. After 6 weeks the dogs were killed and the nerve was studied by light and electronic microscopes. The amount of consumed suture material, time of repair, myelin thickness and axon diiameter were examined. Ultrastructural studies were performed to assess degeneration and regeneration findings. Results: Time of repair and the amount of consumed suture material were significantly lower in the continous group (P

  17. [An experimental assessment of methods for applying intestinal sutures in intestinal obstruction]. (United States)

    Akhmadudinov, M G


    The results of various methods used in applying intestinal sutures in obturation were studied. Three series of experiments were conducted on 30 dogs--resection of the intestine after obstruction with the formation of anastomoses by means of double-row suture (Albert--Shmiden--Lambert) in the first series (10 dogs), by a single-row suture after V. M. Mateshchuk [correction of Mateshuku] in the second series, and bu a single-row stretching suture suggested by the author in the third series. The postoperative complications and the parameters of physical airtightness of the intestinal anastomosis were studied in dynamics in the experimental animals. The results of the study: incompetence of the anastomosis sutures in the first series 6, in the second 4, and in the third series one. Adhesions occurred in all animals of the first and second series and in 2 of the third series. Six dogs of the first series died, 4 of the second, and one of the third. Study of the dynamics of the results showed a direct connection of the complications with the parameters of the physical airtightness of the anastomosis, and the last-named with the method of the intestinal suture. Relatively better results were noted in formation of the anastomosis by means of our suggested stretshing continuous suture passed through the serous, muscular, and submucous coats of the intestine.

  18. Normal Development of Sutures and synchondroses in the central skull base : CT study

    International Nuclear Information System (INIS)

    Roh, Hong Gee; Kim, Hyung Jin; Kang, Jee Hee; Lee, Kyung Hee; Lim, Myung Kwan; Cho, Young Kuk; Ok, Cheol Su; Suh, Chang Hae


    To evaluate the developmental patterns of the sutures and synchondroses in the central skull base. We evaluated the CT scans of 109 children (age range 29 days to 15 years) with no skull base abnormality who had undergone axial CT of the skull base with 1-mm collimation. Using a five-tier scheme, we analyzed the developmental patterns of the 18 sutures and synchondroses related to the sphenoid and occipital bones. Fusion of the sutures and synchondroses related to the sphenoid bone progressed rapidly during the first two years. Thereafter, changes in the sphenoid bone were dominated by pneumatization of the sphenoid sinus. Fusion of the synchondroses within the sphenoid body, including intersphenoidal, intrapresphenoidal, intrapostsphenoidal synchondrosis occurred early and in most cases was graded ≥3D4. Fusion of the sphenosquamosal, sphenoethmoidal, and frontosphenoidal sutures was delayed, and residual sclerosis was a common finding. Except for Kerckring-supraoccipital synchondrosis, fusion of the six sutures and synchondroses related to the occipital bone occurred more gradually than that of those related to the sphenoid bone. Among these, fusion of the occipitomastoidal suture and petro-occipital synchondrosis was the last to occur. A knowledge of the developmental patterns of sutures and synchondroses can help differentiate normal conditions from those such as fracture, osseous dysplasia, or congenital malformation, which are abnormal. Our results provide certain basic information about skull base maturity in children. (author)

  19. Park Volcanics, Murihiku Terrane, New Zealand : petrology, petrochemistry, and tectonic significance

    International Nuclear Information System (INIS)

    Coombs, D.S.; Cook, N.D.J.; Kawachi, Y.; Johnstone, R.D.; Gibson, I.L.


    The Late Triassic to Early Jurassic Park Volcanics Group comprises minor shallow intrusive and extrusive bodies emplaced during mainly marine sedimentation of the Murihiku Terrane, southern New Zealand. Gowan Andesite in western Southland and Glenham Porphyry andesites in eastern Southland are high-K andesites. Glassy examples have commonly lost K during alteration. Orthoclase contents of Or 3.6-3.7 in plagioclase phenocrysts at An 50 confirm the high-K nature of the melts at the time of phenocryst crystallisation. The Gowan andesites have higher Fe/Mg than the Glenham and related differences in minor element chemistry suggesting lower ∫O 2 during fractionation of the parent magma. Pinney Volcanics in western Southland are mostly high-K trachydacites but, like Glenham Porphyry, include minor rhyolite. Barnicoat Andesite in the Nelson area is medium-K olivine andesite, marginally tholeiitic in terms of its FeO*/MgO versus SiO 2 behaviour, but otherwise is typically calc-alkaline, as are the Gowan, Glenham, and Pinney. Analyses of pyroxenes (augites, orthopyroxenes, reaction rim and groundmass pigeonites) reveal xenocrysts recording an early stage of magma fractionation, slight iron enrichment in the andesite stage, and lowered Fe/Mg and increased Ca contents in augites of the most felsic rocks. Titanian tschermakite and titanian magnesio-tschermakite of deep-seated origin participated in fractionation leading to the Pinney Volcanics, and magnesio-hornblende, edenite, and biotite crystallised as minor late stage minerals following high-level emplacement of Gowan Andesite and siliceous Glenham Porphyry members. Low 87 Sr/ 86 Sr ratios (c. 0.7034-0.7037), REE and multi-element distribution patterns, and the mineralogical features collectively suggest fractionation of the andesites from parental basalt originating in an enriched mantle wedge above a subduction zone, with minimal contamination by continental crust. High-K andesites appear to be unknown in clearly

  20. Precambrian Terranes of African affinities in the southeastern part of Brazil and Uruguay

    International Nuclear Information System (INIS)

    Preciozzi, F.; Basei, M.; Siga Junior, H.; Sato, K.; Kaufuss, G.


    The interest in correlating terranes at opposite margins of the South Atlantic Ocean reflects a natural curiosity of both researchers who work in the eastern South-America and who study southwestern Africa. On a large scale scenario the geology of this region is characterized by a central portion composed of Neoproterozoic-Cambrian belts (Dom Feliciano, Kao ko, Damara, Gariep, Saldania) having on each side old gneissic-migmatitic terrains on both continents (Luis Alves, Rio de La Plata, Kalahari and Congo). In South America the Neoproterozoic Dom Feliciano Belt (DFB) predominates in the eastern part of the region and is internally organized according to three different crustal segments characterized, from southeast to northwest, by a Granite belt (deformed I-type medium to high calc-alkaline granites and alkaline granitoid rocks; a Schist belt (volcano-sedimentary rocks metamorphosed from green schist to amphibolite facies and intrusive granitoids), and a Fore land basin (anchimetamorphic sedimentary and volcanic rocks), the latter situated between the Schist belt and the Archean-Paleoproterozoic fore land. Despite discontinuously covered by younger sediments, the NS continuity of these three crustal segments is suggested by similar lithotypes, structural characteristics, ages and isotopic signature, as well as by the gravimetric data. The Major Gercino, Cordilheira, and Sierra Ballena shear zones are part of the major NE-SW lineaments that affect all southern Brazilian and Uruguayan Precambrian terrains. They separate the Dom Feliciano Schist Belt (supra crustal rocks of the Brusque-Porongos and Lavalleja groups), to the West, from the granitoids of the Granite belt, to the East. The shear zones are characterized by a regional NE trend and a resultant oblique direction of movement where ductile-brittle structures predominate

  1. Ameloblastin inhibits cranial suture closure by modulating MSX2 expression and proliferation.

    Directory of Open Access Journals (Sweden)

    Phimon Atsawasuwan

    Full Text Available Deformities of cranial sutures such as craniosynostosis and enlarged parietal foramina greatly impact human development and quality of life. Here we have examined the role of the extracellular matrix protein ameloblastin (Ambn, a recent addition to the family of non-collagenous extracellular bone matrix proteins, in craniofacial bone development and suture formation. Using RT-PCR, western blot and immunohistochemistry, Ambn was localized in mouse calvarial bone and adjacent condensed mesenchyme. Five-fold Ambn overexpression in a K14-driven transgenic mouse model resulted in delayed posterior frontal suture fusion and incomplete suture closure. Moreover, Ambn overexpressor skulls weighed 13.2% less, their interfrontal bones were 35.3% thinner, and the width between frontal bones plus interfrontal suture was 14.3% wider. Ambn overexpressing mice also featured reduced cell proliferation in suture blastemas and in mesenchymal cells from posterior frontal sutures. There was a more than 2-fold reduction of Msx2 in Ambn overexpressing calvariae and suture mesenchymal cells, and this effect was inversely proportionate to the level of Ambn overexpression in different cell lines. The reduction of Msx2 expression as a result of Ambn overexpression was further enhanced in the presence of the MEK/ERK pathway inhibitor O126. Finally, Ambn overexpression significantly reduced Msx2 down-stream target gene expression levels, including osteogenic transcription factors Runx2 and Osx, the bone matrix proteins Ibsp, ColI, Ocn and Opn, and the cell cycle-related gene CcnD1. Together, these data suggest that Ambn plays a crucial role in the regulation of cranial bone growth and suture closure via Msx 2 suppression and proliferation inhibition.

  2. Influence of suture technique and suture material selection on the mechanics of end-to-end and end-to-side anastomoses. (United States)

    Baumgartner, N; Dobrin, P B; Morasch, M; Dong, Q S; Mrkvicka, R


    Experiments were performed in dogs to evaluate the mechanics of 26 end-to-end and 42 end-to-side artery-vein graft anastomoses constructed with continuous polypropylene sutures (Surgilene; Davis & Geck, Division of American Cyanamid Co., Danbury, Conn.), continuous polybutester sutures (Novafil; Davis & Geck), and interrupted stitches with either suture material. After construction, the grafts and adjoining arteries were excised, mounted in vitro at in situ length, filled with a dilute barium sulfate suspension, and pressurized in 25 mm Hg steps up to 200 mm Hg. Radiographs were obtained at each pressure. The computed cross-sectional areas of the anastomoses were compared with those of the native arteries at corresponding pressures. Results showed that for the end-to-end anastomoses at 100 mm Hg the cross-sectional areas of the continuous Surgilene anastomoses were 70% of the native artery cross-sectional areas, the cross-sectional areas of the continuous Novafil anastomoses were 90% of the native artery cross-sectional areas, and the cross-sectional areas of the interrupted anastomoses were 107% of the native artery cross-sectional areas (p anastomoses demonstrated no differences in cross-sectional areas or compliance for the three suture techniques. This suggests that, unlike with end-to-end anastomoses, when constructing an end-to-side anastomosis in patients any of the three suture techniques may be acceptable.

  3. Interfascicular suture with nerve autografts for median, ulnar and radial nerve lesions. (United States)

    Pluchino, F; Luccarelli, G


    Interfascicular nerve suture with autografts is the operation of choice for repairing peripheral nerve injuries because it ensures more precise alignment of the fasciculi and so better chances of reinnervation of the sectioned nerve. The procedure as described by Millesi et al has been used at the Istituto Neurologico di Milano in 30 patients with traumatic lesions of the median, ulnar and radial nerves. All have been followed up for 2 to 7 years since operation. The results obtained are compared with those of other series obtained with interfascicular suture and with epineural suture. Microsurgery is essential. The best time to operate is discussed.

  4. Brief communication: age and fractal dimensions of human sagittal and coronal sutures

    DEFF Research Database (Denmark)

    Lynnerup, Niels; Jacobsen, Jens Christian Brings


    The fractal dimensions of human sagittal and coronal sutures were calculated on 31 complete skulls from the Terry Collection. The aim was to investigate whether the fractal dimension, relying on the whole sutural length, might yield a better description of age-related changes in sutural morphology......, as opposed to other methods of quantification, which generally rely on more arbitrary scoring systems. However, the fractal dimension did not yield better age correlations than other previously described methods. At best, the results reflected the general observation that young adults below age 40 years...

  5. Identification of thermotectonics events by 40Ar/39Ar methodology, in Jauru, Pontes e Lacerda and Rio Alegre Terrane - southwest portion of Amazon Craton

    International Nuclear Information System (INIS)

    Paulo, Valeria Guimaraes de


    The southwest portion of Amazon Craton, subject of these work, correspond to the southwest region of Mato Grosso State and is inserted on Rio Negro-Juruena, Rondoniana-San Ignacio and Sunsas-Aguapei geochronologic Provinces. This region is surrounded by three big terranes: Jauru, Pontes e Lacerda and Rio Alegre. The main aim of this study is to use the ages of termochronologic events obtained by 40 Ar/ 39 Ar methodology, including data of literature, to contribute with the study of the geotectonic evolution on this region. Twenty samples were analyzed and 40 Ar/ 39 Ar ages found for the Jauru Terrane vary of 1539 ± 3 Ma to 1338 ± 3 Ma, for the Pontes e Lacerda Terrane the interval obtained was of 946,1 ± 0,8 Ma to 890 ± 2 Ma and for Rio Alegre Terrane the ages are between 1407 ± 3 Ma to 1321 ± 2 Ma. U/Pb, Rb/Sr and Sm/Nd data from previous works, together with 40 Ar/ 39 Ar results allowed to obtain cooling average rates to each terrane. The Jauru Terrane units cooling age is equivalent to 1,52 Ga. The cooling average rates found to Alto Jauru Greenstone belt rocks is 2,4 deg C - 1,0 Ma and to Magmatic Arc Cachoeirinha is 10,8 deg C - 1,0 Ma. Stabilization age obtained for Pontes and Lacerda Terrane is about 900 Ma coherent with the cooling age of the Sunsas Aguapei Event (1,0 - 0,9 Ga) and cooling average rates calculate were the lower, equivalent to 1,0 deg C - 1,0 Ma. Cooling age found in Rio Alegre Terrane was 1,35 Ga, possibility correspond to collision age these terrane with Amazonian protoCraton and cooling average rates of 5,0 deg C - 1,0 Ma. Finally, younger age found of 900 Ma, coherent to the Sunsas - Aguapei Event, probably represent the last regional event that affected these rocks, characterizing the stabilization period of the southwest portion of Amazon Craton. (author)

  6. Celastrol nanoparticles inhibit corneal neovascularization induced by suturing in rats

    Directory of Open Access Journals (Sweden)

    Li ZR


    Full Text Available Zhanrong Li1, Lin Yao1, Jingguo Li2, Wenxin Zhang1, Xianghua Wu1, Yi Liu1, Miaoli Lin1, Wenru Su1, Yongping Li1, Dan Liang11State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, 2School of Chemistry and Chemical Engineering, Sun Yat-Sen University, Guangzhou, People's Republic of ChinaPurpose: Celastrol, a traditional Chinese medicine, is widely used in anti-inflammation and anti-angiogenesis research. However, the poor water solubility of celastrol restricts its further application. This paper aims to study the effect of celastrol nanoparticles (CNPs on corneal neovascularization (CNV and determine the possible mechanism.Methods: To improve the hydrophilicity of celastrol, celastrol-loaded poly(ethylene glycol-block-poly(ε-caprolactone nanopolymeric micelles were developed. The characterization of CNPs was measured by dynamic light scattering and transmission electron microscopy analysis. Celastrol loading content and release were assessed by ultraviolet-visible analysis and high performance liquid chromatography, respectively. In vitro, human umbilical vein endothelial cell proliferation and capillary-like tube formation were assayed. In vivo, suture-induced CNV was chosen to evaluate the effect of CNPs on CNV in rats. Immunohistochemistry for CD68 assessed the macrophage infiltration of the cornea on day 6 after surgery. Real-time quantitative reverse transcription-polymerase chain reaction and enzyme-linked immunosorbent assay were used to evaluate the messenger ribonucleic acid and protein levels, respectively, of vascular endothelial growth factor, matrix metalloproteinase 9, and monocyte chemoattractant protein 1 in the cornea.Results: The mean diameter of CNPs with spherical shape was 48 nm. The celastrol loading content was 7.36%. The release behavior of CNPs in buffered solution (pH 7.4 showed a typical two-phase release profile. CNPs inhibited the proliferation of human umbilical vein endothelial

  7. The intra-oceanic Cretaceous (~ 108 Ma) Kata-Rash arc fragment in the Kurdistan segment of Iraqi Zagros suture zone: Implications for Neotethys evolution and closure (United States)

    Ali, Sarmad A.; Ismail, Sabah A.; Nutman, Allen P.; Bennett, Vickie C.; Jones, Brian G.; Buckman, Solomon


    The Kata-Rash arc fragment is an allochthonous thrust-bound body situated near Penjween, 100 km northeast of Sulymannia city, Kurdistan Region, within the Iraqi portion of the Zagros suture zone. It forms part of the suprasubduction zone 'Upper Allochthon' terranes (designated as the Gimo-Qandil Group), which is dominated by calc-alkaline andesite and basaltic-andesite, rhyodacite to rhyolite, crosscut by granitic, granodioritic, and dioritic dykes. Previously, rocks of the Kata-Rash arc fragment were interpreted as a part of the Eocene Walash volcanic group. However, SHRIMP zircon U-Pb dates on them of 108.1 ± 2.9 Ma (Harbar volcanic rocks) and 107.7 ± 1.9 Ma (Aulan intrusion) indicate an Albian-Cenomanian age, which is interpreted as the time of igneous crystallisation. The Aulan intrusion zircons have initial εHf values of + 8.6 ± 0.2. On a Nb/Yb-Th/Yb diagram, all Kata-Rash samples fall within the compositional field of arc-related rocks, i.e. above the mid-ocean-ridge basalt (MORB)-ocean island basalt (OIB) mantle array. Primitive-mantle-normalised trace-element patterns for the Kata-Rash samples show enrichment in the large ion lithophile elements and depletion in the high-field-strength elements supporting their subduction-related character. Low Ba/La coupled with low La/Yb and Hf/Hf* 3000 km continuity of Cretaceous arc activity (Oman to Cyprus), that consumed Neotethyian oceanic crust between Eurasia and the Gondwanan fragment Arabia.

  8. A rare case of persistent metopic suture in an elderly individual: Incidental autopsy finding with clinical implications

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    S Vikram


    Full Text Available Metopic suture is a dense fibrous joint extending from the nasion to the bregma. Normally, closure of this suture takes place between 1-8 years of age. Failure of this closure beyond 8 years leads to persistent metopic suture. A rare case of persistent metopic suture in a 60-year-old male is documented, who committed suicide by alleged consumption of organophosphorous compound at District Govt. Wenlock Hospital, Mangalore, Karnataka, India. Metopic suture may mimic skull fracture and may mislead an inexperienced forensic expert. Neurosurgeon should also be aware of this anatomical variation while performing frontal craniotomy, as the persistent metopic suture may mimic vertical fracture of the skull. Hence, in this case report, the clinical and medico-legal implications of the persistent metopic sutures have been discussed.

  9. Fixation in laparoscopic incisional hernia repair: Suture versus tacks

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    Adil Bangash


    Full Text Available Aims and Objectives: To compare the frequency of complications of laparoscopic repair of incisional hernia using fixation of mesh with transabdominal sutures tacks. Materials and Methods: This study was conducted as part of an interventional multicenter trial at the Rehman Medical Institute, Peshawar, Peshawar Institute of Medical Sciences, and Pakistan Institute of Medical Science, Islamabad, from the 1 st of November 2008 till 31 st October 2011. The frequency of complications was calculated as the measure of comparing two methods of fixation in laparoscopic repair of incisional hernia using the IPOM technique. These patients were admitted via the outpatient department and their demographic data were collected on a pro forma basis. Forty-five patients were alternately placed in either group, and group I comprised patients with a ventral hernia that was fixed using spiral tacks whereas the other group was fixed with transabdominal sutures. A polytetraflouroethylene (Dual R mesh was applied in all cases. All data were collected onthe individual pro forma of each patient and was loaded on the SPSS R version 13.0. Results: The BMI in both groups was similar (P=0.94 The mean hospital stay was higher in the PTFE mesh group but the values were not significant (P=1.22.No perioperative death was observed in either group. One patient (2.2% from group I was readmitted with varying complaints and was diagnosed as having subacute intestinal obstruction (P>0.05. A higher but insignificant recurrence rate was observed in the polyester group over a one-year period of follow-up. Three patients (6.6% were diagnosed with recurrences in group I. Instead the PTFE group had a similar recurrence rate recurrence (P=1.00. Conclusion: The rate of recurrence in this study showed no significant difference by either mode of fixation. But statistically significant pain scores and increased operative time to fixation favors the use of tacks that limits to the few inner

  10. Overcoming the learning curve of single-port total laparoscopic hysterectomy with barbed suture: a single surgeon's initial experience. (United States)

    Lee, Yoon Hee; Chong, Gun Oh; Kim, Mi Ju; Gy Hong, Dae; Lee, Yoon Soon


    Single-port total laparoscopic hysterectomy (TLH) has not been widely used because of its technical difficulty and steep learning curve, especially the laparoscopic suturing of the vaginal stump. Barbed suturing is a new technology that has the potential to greatly facilitate laparoscopic suturing. To compare surgical outcomes and vaginal vault healing between barbed sutures and traditional sutures in the repair of the vaginal vault during single-port TLH. Between August 2013 and June 2015, we performed single-port TLH in 85 consecutive patients for benign or premalignant gynecological conditions. The first 48 patients underwent single-port TLH with traditional interrupted sutures, and the next 37 patients underwent single-port TLH with absorbable unidirectional knotless barbed sutures for repair of the vaginal vault. The patient characteristics (age, body mass index), procedures performed, uterine weight, and uterine disease were similar between the groups. There were no differences in blood loss, hemoglobin change, length of hospital stay, or perioperative complications. Operative time and the time required for vaginal cuff suturing were significantly shorter in the barbed suture group than in the traditional suture group (57.8 ±13.5 vs. 80.1 ±18.7 min, p < 0.001; 5.5 ±1.7 vs. 12.9 ±3.5 min, p < 0.001). Moreover, the use of barbed sutures significantly reduced the incidence of vaginal granulation tissue formation (2.7% vs. 35.4%, p < 0.001). Use of barbed sutures in single-port TLH reduced the operative time, suturing time of the vaginal vault, and formation of vaginal granulation tissue. Barbed suturing may help overcome surgical difficulties and vaginal cuff complications.

  11. A geologic guide to Wrangell-Saint Elias National Park and Preserve, Alaska; a tectonic collage of northbound terranes (United States)

    Winkler, Gary R.; with contributions by MacKevett, E. M.; Plafker, George; Richter, D.H.; Rosenkrans, D.S.; Schmoll, H.R.


    Wrangell-Saint Elias National Park and Preserve, the largest unit in the U.S. National Park System, encompasses near 13.2 million acres of geological wonderments. This geologic guide presents history of exploration and Earth-science investigation; describes the complex geologic makeup; characterizes the vast college of accretion geologic terranes in this area of Alaska's continental margin; recapitulates the effects of earthquakes, volcanoes, and glaciers; characterizes the copper and gold resources of the parklands; and describes outstanding locales within the park and preserve area. A glossary of geologic terms and a categorized list of additional sources of information complete this report.

  12. Late Cretaceous tectonothermal evolution of the southern Lhasa terrane, South Tibet: Consequence of a Mesozoic Andean-type orogeny (United States)

    Dong, Xin; Zhang, Ze-ming; Klemd, Reiner; He, Zhen-yu; Tian, Zuo-lin


    The Lhasa terrane of the southern Tibetan Plateau participated in a Mesozoic Andean-type orogeny caused by the northward subduction of the Neo-Tethyan oceanic lithosphere. However, metamorphic rocks, which can unravel details of the geodynamic evolution, are rare and only exposed in the south-eastern part of the Lhasa terrane. Therefore, we conducted a detailed petrological, geochemical and U-Pb zircon geochronological study of the late Cretaceous metamorphic rocks and associated gabbros from the Nyemo inlier of the southern Lhasa terrane. The Nyemo metamorphic rocks including gneisses, schists, marbles and calc-silicate rocks, experienced peak amphibolite-facies contact metamorphism under P-T conditions of 3.5-4.0 kbar and 642-657 °C with a very high geothermal gradient of 45-50 °C/km, revealing a distinct deflection from the steady-state geotherm during low-pressure metamorphism. Inherited magmatic zircon cores from the metamorphic rocks yielded protolith ages of 197-194 Ma, while overgrowth zircon rims yielded metamorphic ages of ca. 86 Ma. Whole-rock chemistry and zircon Hf isotopes suggest that the protoliths of the gneisses and schists are andesites and tuffs of the early Jurassic Sangri Group, which were derived from a depleted mantle source of a continental arc affinity. The coeval intimately-associated gabbro (ca. 86 Ma) crystallized under P-T conditions of 3.5-5.3 kbar and 914-970 °C, supplying the heat flux high enough to cause the contact metamorphism of the Sangri Group rock types. We propose that the intrusion of the gabbro and a simultaneous pressure increase of up to 4.0 kbar, which is related to crustal thickening due to crustal overthrusting and the intrusion of mafic material, resulted in the late Cretaceous metamorphism of the early Jurassic Sangri Group during an Andean-type orogeny. Furthermore the Nyemo metamorphic rocks, which have previously been considered to represent slivers of the Precambrian metamorphic basement of the Lhasa terrane

  13. Shyok Suture Zone, N Pakistan: late Mesozoic Tertiary evolution of a critical suture separating the oceanic Ladakh Arc from the Asian continental margin (United States)

    Robertson, Alastair H. F.; Collins, Alan S.


    The Shyok Suture Zone (Northern Suture) of North Pakistan is an important Cretaceous-Tertiary suture separating the Asian continent (Karakoram) from the Cretaceous Kohistan-Ladakh oceanic arc to the south. In previously published interpretations, the Shyok Suture Zone marks either the site of subduction of a wide Tethyan ocean, or represents an Early Cretaceous intra-continental marginal basin along the southern margin of Asia. To shed light on alternative hypotheses, a sedimentological, structural and igneous geochemical study was made of a well-exposed traverse in North Pakistan, in the Skardu area (Baltistan). To the south of the Shyok Suture Zone in this area is the Ladakh Arc and its Late Cretaceous, mainly volcanogenic, sedimentary cover (Burje-La Formation). The Shyok Suture Zone extends northwards (ca. 30 km) to the late Tertiary Main Karakoram Thrust that transported Asian, mainly high-grade metamorphic rocks southwards over the suture zone. The Shyok Suture Zone is dominated by four contrasting units separated by thrusts, as follows: (1). The lowermost, Askore amphibolite, is mainly amphibolite facies meta-basites and turbiditic meta-sediments interpreted as early marginal basin rift products, or trapped Tethyan oceanic crust, metamorphosed during later arc rifting. (2). The overlying Pakora Formation is a very thick (ca. 7 km in outcrop) succession of greenschist facies volcaniclastic sandstones, redeposited limestones and subordinate basaltic-andesitic extrusives and flow breccias of at least partly Early Cretaceous age. The Pakora Formation lacks terrigenous continental detritus and is interpreted as a proximal base-of-slope apron related to rifting of the oceanic Ladakh Arc; (3). The Tectonic Melange (ocean ridge-type volcanics and recrystallised radiolarian cherts, interpreted as accreted oceanic crust. (4). The Bauma-Harel Group (structurally highest) is a thick succession (several km) of Ordovician and Carboniferous to Permian-Triassic, low

  14. Comparison of surgical time and complication rate of subcutaneous and skin closure using barbed suture or traditional knotted suture in dogs. (United States)

    Nutt, Laura K; Wilson, Megan L; Sakals, Sherisse


    This prospective study evaluated the handling, intraoperative and postoperative complication rates of a barbed knotless suture for closure of subcutaneous tissue and skin in 17 client-owned dogs (group A) following a tibial plateau leveling osteotomy procedure. Clinical characteristics, surgical time, and complication rates were compared to a control group of 17 client-owned dogs (group B) with subcutaneous tissue and skin closure using traditional suture material. Signalment was not significantly different between groups and did not have an effect on complication rates. Surgical times were not significantly different for subcutaneous tissue or skin closure between the 2 groups. There were significantly more intraoperative complications in the barbed suture group (A: 4/17; B: 0/17; P = 0.033) but no difference in minor or major postoperative complication rates (minor A: 2/16; B: 1/14; P = 0.626, major A: 2/16; B: 0/14; P = 0.171).

  15. The suture provides a niche for mesenchymal stem cells of craniofacial bones (United States)

    Zhao, Hu; Feng, Jifan; Ho, Thach-Vu; Grimes, Weston; Urata, Mark; Chai, Yang


    Bone tissue undergoes constant turnover supported by stem cells. Recent studies showed that perivascular mesenchymal stem cells (MSCs) contribute to the turnover of long bones. Craniofacial bones are flat bones derived from a different embryonic origin than the long bones. The identity and regulating niche for craniofacial bone MSCs remain unknown. Here, we identify Gli1+ cells within the suture mesenchyme as the major MSC population for craniofacial bones. They are not associated with vasculature, give rise to all craniofacial bones in the adult and are activated during injury repair. Gli1+ cells are typical MSCs in vitro. Ablation of Gli1+ cells leads to craniosynostosis and arrest of skull growth, indicating these cells are an indispensible stem cell population. Twist1+/− mice with craniosynostosis show reduced Gli1+ MSCs in sutures, suggesting that craniosynostosis may result from diminished suture stem cells. Our study indicates that craniofacial sutures provide a unique niche for MSCs for craniofacial bone homeostasis and repair. PMID:25799059

  16. Editorial Commentary: All-Suture Anchors, Foam Blocks, and Biomechanical Testing. (United States)

    Brand, Jefferson C


    Barber's biomechanical work is well known to Arthroscopy's readers as thorough, comprehensive, and inclusive of new designs as they become available. In "All-Suture Anchors: Biomechanical Analysis of Pullout Strength, Displacement, and Failure Mode," the latest iteration, Barber and Herbert test all-suture anchors in both porcine femurs and biphasic foam. While we await in vivo clinical trials that compare all-suture anchors to currently used anchors, Barber and Herbert have provided data to inform anchor choice, and using their biomechanical data at time zero from all-suture anchor trials in an animal model, we can determine the anchors' feasibility for human clinical investigations. Copyright © 2017 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  17. Gonioscopy-assisted Transluminal Trabeculotomy (GATT): Thermal Suture Modification With a Dye-stained Rounded Tip. (United States)

    Grover, Davinder S; Fellman, Ronald L


    To describe a novel technique for thermally marking the tip of a suture, in preparation for a gonioscopy-assisted transluminal trabeculotomy. One patient was used as an example for this technique. Technique report. The authors introduce a modification of a novel surgical procedure (GATT) in which a suture is marked and thermally blunted allowing a proper visualization while performing an ab interno, minimally invasive, circumferential 360-degree suture trabeculotomy. The authors have previously reported on the GATT surgery with the use of an illuminated microcatheter, which allowed for visualization of the tip of the catheter as it circumnavigated Schlemm canal. This modification allows for similar visualization of the tip of the suture, however, is much more cost-effective while still maintaining similar safety.

  18. Shape memory alloy fixator system for suturing tissue in minimal access surgery. (United States)

    Xu, W; Frank, T G; Stockham, G; Cuschieri, A


    A new technique for suturing human tissue is described in which tissue closure is achieved by means of small fixators made from shape memory alloy. The aim of the development is to provide an alternative to thread suturing in minimal access surgery, which is quicker and requires less skill to achieve the required suturing quality. The design of the fixators is described in terms of the thermal shape recovery of shape memory alloy and a novel form of finite element analysis, which uses a nonlinear elastic element for the material property. Thermal analysis of the fixators and surrounding tissue is used to predict the temperature distribution during and after the application of electric current heating. This was checked in an in vitro experiment, which confirmed that deployment caused no detectable collateral damage to surrounding tissue. In vivo animal studies on the use of the shape memory alloy fixator for suturing tissue are ongoing to establish safety and healing effects.

  19. Evaluation of endoscopic laser excision of polypropylene mesh/sutures following anti-incontinence procedures.

    LENUS (Irish Health Repository)

    Davis, N F


    We reviewed our experience with and outcome of the largest series to our knowledge of patients who underwent endoscopic laser excision of eroded polypropylene mesh or sutures as a complication of previous anti-incontinence procedures.

  20. Safety and efficacy of unidirectional barbed suture in mini-laparotomy myomectomy

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    Ming-Chao Huang


    Conclusion: The unidirectional knotless barbed suture may facilitate the repair of uterine defects during mini-laparotomy myomectomy by significantly lowering operative time. It may also reduce the intraoperative blood loss.

  1. Comparable biomechanical results for a modified single-row rotator cuff reconstruction using triple-loaded suture anchors versus a suture-bridging double-row repair. (United States)

    Lorbach, Olaf; Kieb, Matthias; Raber, Florian; Busch, Lüder C; Kohn, Dieter; Pape, Dietrich


    To compare the biomechanical properties and footprint coverage of a single-row (SR) repair using a modified suture configuration versus a double-row (DR) suture-bridge repair in small to medium and medium to large rotator cuff tears. We created 25- and 35-mm artificial defects in the rotator cuff of 24 human cadaveric shoulders. The reconstructions were performed as either an SR repair with triple-loaded suture anchors (2 to 3 anchors) and a modified suture configuration or a modified suture-bridge DR repair (4 to 6 anchors). Reconstructions were cyclically loaded from 10 to 60 N. The load was increased stepwise up to 100, 180, and 250 N. Cyclic displacement and load to failure were determined. Furthermore, footprint widths were quantified. In the 25-mm rupture, ultimate load to failure was 533 ± 107 N for the SR repair and 681 ± 250 N for the DR technique (P ≥ .21). In the 35-mm tear, ultimate load to failure was 792 ± 122 N for the SR reconstruction and 891 ± 174 N for the DR reconstruction (P ≥ .28). There were no statistically significant differences for both tested rupture sizes. Cyclic displacement showed no significant differences between the tested configurations at 60 N (P = .563), 100 N (P = .171), 180 N (P = .211), and 250 N (P = .478) for the 25-mm tear. For the 35-mm tear, cyclic displacement showed significantly lower gap formation for the SR reconstruction at 180 N (P = .037) and 250 N (P = .020). No significant differences were found at 60 N (P = .296) and 100 N (P = .077). A significantly greater footprint width (P = .028) was seen for the DR repair (16.2 mm) compared with the SR repair (13.8 mm). However, both reconstructions were able to achieve complete footprint coverage compared with the initial footprint. The tested SR repair using a modified suture configuration was similar in load to failure and cyclic displacement to the DR suture-bridge technique independent of the tested initial sizes of the rupture. The tested DR repair

  2. Contact area and pressure in suture bridge rotator cuff repair using knotless lateral anchors. (United States)

    Tompkins, Marc; Monchik, Keith O; Plante, Matthew J; Fleming, Braden C; Fadale, Paul D


    To evaluate whether the use of knotless lateral anchors in a suture bridge construct produces better contact area and pressure parameters than a suture bridge construct with standard lateral anchors that require knots or a double-row repair. The hypothesis was that knotless lateral anchors would produce better contact area and pressure parameters than the other two constructs. A total of fifteen matched pairs of cadaveric shoulders were divided into three groups. In Group 1, a suture bridge using knotless anchors for the lateral row was performed on five shoulders. A suture bridge using standard lateral row anchors that require knots was performed on the contralateral shoulders. In Group 2, suture bridge with knotless lateral row anchors was compared with double-row repair. In Group 3, suture bridge using standard lateral row anchors was compared with double-row repair. The contact conditions of the rotator cuff footprint were measured using pressure-sensitive film. There were no statistically significant differences between any of the techniques regarding contact area F(2, 15.7) = 3.09, P = 0.07 or mean contact pressure F(2, 15.1) = 2.35, P = 0.12. A post hoc power analysis suggests differences between techniques are likely less than 91-113 mm(2) for area and 0.071-0.089 N for pressure. The use of knotless anchors in the lateral row of a suture bridge repair did not increase the footprint contact area or contact pressure when compared to a suture bridge repair requiring knots laterally or to a double-row repair.

  3. A single centre comparative study of laparoscopic mesh rectopexy versus suture rectopexy

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    Manash Ranjan Sahoo


    Full Text Available Aim: The aim of our study is to compare the results of laparoscopic mesh vs. suture rectopexy. Materials and Methods: In this retrospective study, 70 patients including both male and female of age ranging between 20 years and 65 years (mean 42.5 yrs were subjected to laparoscopic rectopexy during the period between March 2007 and June 2012, of which 38 patients underwent laparoscopic mesh rectopexy and 32 patients laparoscopic suture rectopexy. These patients were followed up for a mean period of 12 months assessing first bowel movement, hospital stay, duration of surgery, faecal incontinence, constipation, recurrence and morbidity. Results: Duration of surgery was 100.8 ± 12.4 minutes in laparoscopic suture rectopexy and 120 ± 10.8 min in laparoscopic mesh rectopexy. Postoperatively, the mean time for the first bowel movement was 38 hrs and 40 hrs, respectively, for suture and mesh rectopexy. Mean hospital stay was five (range: 4-7 days. There was no significant postoperative complication except for one port site infection in mesh rectopexy group. Patients who had varying degree of incontinence preoperatively showed improvement after surgery. Eleven out of 18 (61.1% patients who underwent laparoscopic suture rectopexy as compared to nine of 19 (47.3% patients who underwent laparoscopic mesh rectopexy improved as regards constipation after surgery. Conclusion: There were no significant difference in both groups who underwent surgery except for patients undergoing suture rectopexy had better symptomatic improvement of continence and constipation. Also, cost of mesh used in laparoscopic mesh rectopexy is absent in lap suture rectopexy group. To conclude that laparoscopic suture rectopexy is a safe and feasible procedure and have comparable results as regards operative time, morbidity, bowel function, cost and recurrence or even slightly better results than mesh rectopexy.

  4. Experimental studies on the influence of irradiation (60Co) on wound healing of colonic suture

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    Shoji, Munehiro


    Effects of preoperative 60 Co irradiation on wound healing of colonic suture in adult dogs of mixed breed were discussed. Wound healing 7 days after colonic suture was compared among dogs which received colonic suture immediately, or 3 days, or 7 days after the 60 Co irradiation. As a result, there was not a big difference in their wound healing among these dogs, and disorders of wound healing were not found. Bursting pressure at sutured sites was always lower in irradiated dogs than controls. Recovery of the bursting pressure was 2 days slower in irradiated dogs than non-irradiated dogs for 7 days after the suture. Bursting pressure was the lowest on the 3rd day after the suture in both groups. As to fine changes in irradiated dogs, appearance of recommunicating phenomena in blood vessels, delay of a decrease in avascular regions, delay of granulation, and hypertrophy of vascular walls seemed to be influenced by 60 Co irradiation, but there was not a big difference in these results between irradiated and non-irradiated dogs. An increase in postoperative concentration of hydroproline tended to be little lower in irradiated dogs than controls, which seemed to be influenced by the 60 Co irradiation. This result was also suggested from delay of granulation and remaining inflammations. Effects of 60 Co irradiation on wound healing of colonic suture seemed to be slight generally, because ruptured suture scarecely occurred in the irradiated dogs. When doses used in this experiment were calculated roughly by Ellis's method, irradiation of 60 Co seemed not to influence seriously wound healing if the total of 2,000 to 2,500 rad was irradiated in 8 to 10 doses to human colon. (Tsunoda, M.)

  5. Comparison of Conventional, Trace Element, and Pseudosection Thermobarometry in UHP Eclogite, North Qaidam Terrane, Western China (United States)

    Mattinson, C. G.; Regel, M. E.; Zhang, J.


    In the southeastern North Qaidam terrane, near Dulan, felsic host gneisses enclose minor eclogite lenses. A small (~3°C/km) increase in temperatures to the west based on Zr-in-Rt thermometry is supported by a textural trend of zoned garnet with prograde mineral inclusions in the west to unzoned garnet with only peak-stage inclusions in the east. A western eclogite sample contains minor Ep and trace Phe in addition to Grt-Omp-Qtz-Rt; a strong foliation is defined by banding of Grt and Omp. Garnet Ca falls significantly from core (Alm44Prp23Grs32) to rim (Alm48Prp27Grs23). Phengite contains 3.34-3.36 Si pfu. Conventional Grt-Omp-Phe thermobarometry yields 23-27 kbar, 660-730°C, and Zr-in-Rt thermometry yields 671 ± 9°C (n = 37). An isochemical phase diagram (pseudosection) for the system NCKFMASHO calculated with PerpleX indicates that garnet Xgrs decreases with increasing P and T, suggesting that observed garnet zoning reflects prograde growth. Garnet rim compositional isopleths intersect at 23-27 kbar, 580-620°C, depending on choice of effective bulk composition and assumed Fe3+/Fetotal. Garnet rims help define the foliation, suggesting that these P-T conditions apply to this deformation. An eastern eclogite sample contains minor Ep and abundant, coarse-grained Phe in addition to Grt-Omp-Qtz-Rt; foliation is weak. Garnet zoning is weak; compositions are Alm41-43Prp26-28Grs29-32. Phengite cores contain 3.48-3.56 Si pfu. Conventional Grt-Omp-Phe thermobarometry yields 32-36 kbar, 700-750°C, and Zr-in-Rt thermometry yields 691 ± 12°C (n = 34). Conventional thermobarometry and pseudosections yield similar peak P-T conditions, but from different mineral compositions: thermobarometry yields peak P from high-Ca Grt, but the pseudosection yields peak P from intermediate-Ca Grt; maximum Ca in Grt is predicted at lower P and T. Pseudosection-based peak Ts are significantly lower than those from Zr-in-Rt and conventional thermometry. Wide isopleth spacing in the

  6. Geology of the Severnaya Zemlya Archipelago and the North Kara Terrane in the Russian high Arctic (United States)

    Lorenz, Henning; Männik, Peep; Gee, David; Proskurnin, Vasilij


    The Severnaya Zemlya Archipelago is located at 80°N near the continental shelf break, between the Kara and Laptev seas. Sedimentary successions of Neoproterozoic and Palaeozoic age dominate the bedrock geology. Together with Northern Tajmyr, Severnaya Zemlya constitutes the main land areas of the North Kara Terrane (NKT), which is inferred here to have been a part of the Timanide margin of Baltica, i.e. an integral part of Baltica at least since the Vendian. Vendian turbidites derived from the Timanide Orogen are inferred to have been deposited on Neoproterozoic greenschist facies, granite-intruded basement. Shallow-water siliclastic deposition in the Early to Mid-Cambrian was followed by highly organic-rich shales in the Late Cambrian and influx of more turbidites. An episode of folding, the Kan’on River deformation, separates these formations from the overlying Tremadocian conglomerates and sandstones. In the Early Ordovician, rift-related magmatic rocks accompanied the deposition of variegated marls, sandstones, carbonates and evaporites. Dark shales and gypsiferous limestones characterise the Mid-Ordovician. Late Ordovician quartz-sandstones mark a hiatus, followed by carbonate rocks that extend up into and through most of the Silurian. The latter give way upwards into Old Red Sandstones, which are inferred to have been deposited in a Caledonian foreland basin. Deformation, reaching the area in the latest Devonian or earliest Carboniferous and referred to as the Severnaya Zemlya episode, is thought to be Caledonian-related. The dominating E-vergent structure was controlled by décollement zones in Ordovician evaporite-bearing strata; detachment folds and thrusts developed in the west and were apparently impeded by a barrier of Ordovician igneous rocks in the east. Below the décollement zones, the Neoproterozoic to Early Ordovician succession was deformed into open to close folds. The exposed strata in the lower structural level have been juxtaposed with

  7. Investigation of the best suture pattern to close a stuffed Christmas turkey. (United States)

    Verwilghen, D; Busoni, V; van Galen, G; Wilke, M

    Instructions on how to debone and stuff a turkey are available, but what is the best way to close it up? A randomised trial involving 15 turkeys was performed in order to evaluate skin disruption scores and cosmetic outcomes following the use of different suture patterns. Turkeys were deboned, stuffed and cooked according to guidelines of the US Department of Agriculture Food Safety and Inspection Services. After stuffing, they were randomly assigned to one of five closure groups: simple continuous Lembert; simple continuous Cushing; simple continuous Utrecht; simple continuous; or staples. Turkeys were cooked at 180 °C for two hours ensuring core temperature reached 75 °C. Suture line integrity was evaluated after removal of the sutures and the cosmetic aspect was graded. Before cooking, the Utrecht pattern and skin staples offered the best cosmetic result. After removal of the sutures, the skin remained intact only in the stapled group. All other suture patterns disrupted the skin after removal of the sutures, rendering the turkey less cosmetically appealing for serving. Closure of a stuffed turkey was best performed using skin staples to achieve the best cosmetic results. Using this technique you will be able to impress family and friends at a Christmas dinner, and finally show them your surgical skills.

  8. Identification and dynamics of a cryptic suture zone in tropical rainforest (United States)

    Moritz, C.; Hoskin, C.J.; MacKenzie, J.B.; Phillips, B.L.; Tonione, M.; Silva, N.; VanDerWal, J.; Williams, S.E.; Graham, C.H.


    Suture zones, shared regions of secondary contact between long-isolated lineages, are natural laboratories for studying divergence and speciation. For tropical rainforest, the existence of suture zones and their significance for speciation has been controversial. Using comparative phylogeographic evidence, we locate a morphologically cryptic suture zone in the Australian Wet Tropics rainforest. Fourteen out of 18 contacts involve morphologically cryptic phylogeographic lineages, with mtDNA sequence divergences ranging from 2 to 15 per cent. Contact zones are significantly clustered in a suture zone located between two major Quaternary refugia. Within this area, there is a trend for secondary contacts to occur in regions with low environmental suitability relative to both adjacent refugia and, by inference, the parental lineages. The extent and form of reproductive isolation among interacting lineages varies across species, ranging from random admixture to speciation, in one case via reinforcement. Comparative phylogeographic studies, combined with environmental analysis at a fine-scale and across varying climates, can generate new insights into suture zone formation and to diversification processes in species-rich tropical rainforests. As arenas for evolutionary experimentation, suture zones merit special attention for conservation. PMID:19203915

  9. Endoscopic stent suture fixation for prevention of esophageal stent migration during prolonged dilatation for achalasia treatment. (United States)

    Rieder, E; Asari, R; Paireder, M; Lenglinger, J; Schoppmann, S F


    The aim of this study is to compare endoscopic stent suture fixation with endoscopic clip attachment or the use of partially covered stents (PCS) regarding their capability to prevent stent migration during prolonged dilatation in achalasia. Large-diameter self-expanding metal stents (30 mm × 80 mm) were placed across the gastroesophageal junction in 11 patients with achalasia. Stent removal was scheduled after 4 to 7 days. To prevent stent dislocation, endoscopic clip attachment, endoscopic stent suture fixation, or PCS were used. The Eckardt score was evaluated before and 6 months after prolonged dilatation. After endoscopic stent suture fixation, no (0/4) sutured stent migrated. When endoscopic clips were used, 80% (4/5) clipped stents migrated (p = 0.02). Of two PCS (n = 2), one migrated and one became embedded leading to difficult stent removal. Technical adverse events were not seen in endoscopic stent suture fixation but were significantly correlated with the use of clips or PCS (r = 0.828, p = 0.02). Overall, 72% of patients were in remission regarding their achalasia symptoms 6 months after prolonged dilatation. Endoscopic suture fixation of esophageal stents but not clip attachment appears to be the best method of preventing early migration of esophageal stents placed at difficult locations such as at the naive gastroesophageal junction. © The Authors 2017. Published by Oxford University Press on behalf of International Society for Diseases of the Esophagus. All rights reserved. For permissions, please e-mail:

  10. Augmentation of tendon healing with butyric acid-impregnated sutures: biomechanical evaluation in a rabbit model. (United States)

    Leek, Bryan T; Tasto, James P; Tibor, Lisa M; Healey, Robert M; Freemont, Anthony; Linn, Michael S; Chase, Derek E; Amiel, David


    Butyric acid (BA) has been shown to be angiogenic and to enhance transcriptional activity in tissue. These properties of BA have the potential to augment biological healing of a repaired tendon. To evaluate this possibility both biomechanically and histologically in an animal tendon repair model. Controlled laboratory study. A rabbit Achilles tendon healing model was used to evaluate the biomechanical strength and histological properties at 6 and 12 weeks after repair. Unilateral tendon defects were created in the middle bundle of the Achilles tendon of each rabbit, which were repaired equivalently with either Ultrabraid BA-impregnated sutures or control Ultrabraid sutures. After 6 weeks, BA-impregnated suture repairs had a significantly increased (P Tendons repaired with BA-impregnated sutures demonstrated improved biomechanical properties at 6 weeks relative to control sutures, suggesting a neoangiogenic mechanism of enhanced healing through an increased myofibroblast presence. These findings demonstrate that a relatively simple alteration of suture material may augment early tendon healing to create a stronger repair construct during this time.

  11. Symbol "&" suture to control atonic postpartum hemorrhage with placenta previa accreta. (United States)

    Li, Guang Tai; Li, Xiao Fan; Liu, Ya Jing; Li, Wei; Xu, Hong Mei


    To evaluate the efficacy and safety of a symbol "&" compression suture technique in controlling severe atonic postpartum hemorrhage with placenta previa accreta during cesarean delivery. Nine women with heavy postpartum bleeding from uterine inertia and placenta previa percret, which did not react to conventional initial management protocols, were underwent the suture in the shape of symbol "&" in China Meitan General Hospital. The suture procedure was to staple the anterior and posterior walls (of the lower uterine segment as well as corpus uterus) together using number 1 chromic catgut, with a cross at about 2 cm above the upper boundary of lower uterine segment. Symbol "&" compression suture was capable of stanching the postpartum hemorrhage immediately in all nine women. None of these patients developed complications related to this method. Subsequent pregnancies after the suture were occurred in two women and delivered with repeat cesarean section. Symbol "&" compression suture is a simple, safe and highly effective technique to control the treatment-resistant uterine atonic bleeding, particularly in previous cesarean scar at lower segment and placenta previa accreta.

  12. A technique for the quantification of the 3D connectivity of thin articulations in bony sutures. (United States)

    Maloul, Asmaa; Fialkov, Jeffrey; Hojjat, Seyed-Parsa; Whyne, Cari M


    The anatomy and development of cranial and facial sutures have been studied in detail using histological sections, 2D radiographs and more recently CT imaging. However, little attention has been paid to evaluating and quantifying the connectivity of these thin cortical bone articulations. More recent technological advances such as micro-CT imaging has the potential to be used to provide quantitative measurements of 3D connectivity in bony articulations. This study presents a new technique for quantifying the connectivity of bony projections inside cranial and facial sutures using a combination of skeletonization, thinning algorithms and 3D intensity mapping. The technique is demonstrated in five sutures through semi-automated analysis and image processing of microCT scans. In the sagittal, coronal and frontozygomatic sutures an average bone connectivity of 6.6-11.6% was found with multiple bony projections providing an interlocking structure between adjacent bones. Much higher bone connectivity was present in the zygomaticotemporal and zygomaticomaxillary sutures (22.7-37.4%) with few bony projections. This method combining microCT scanning and image processing techniques was successfully used to quantify the connectivity of thin bone articulations and allowed detailed assessment of sutural fusion in 3D. The wider application of this technique may allow quantification of connectivity in other structures, in particular fracture healing of long bones. Copyright 2009 Elsevier Ltd. All rights reserved.

  13. Cranial Suture Closure in Domestic Dog Breeds and Its Relationships to Skull Morphology. (United States)

    Geiger, Madeleine; Haussman, Sinah


    Bulldog-type brachycephalic domestic dog breeds are characterized by a relatively short and broad skull with a dorsally rotated rostrum (airorhynchy). Not much is known about the association between a bulldog-type skull conformation and peculiar patterns of suture and synchondrosis closure in domestic dogs. In this study, we aim to explore breed-specific patterns of cranial suture and synchondrosis closure in relation to the prebasial angle (proxy for airorhynchy and thus bulldog-type skull conformation) in domestic dogs. For this purpose, we coded closure of 18 sutures and synchondroses in 26 wolves, that is, the wild ancestor of all domestic dogs, and 134 domestic dogs comprising 11 breeds. Comparisons of the relative amount of closing and closed sutures and synchondroses (closure scores) in adult individuals showed that bulldog-type breeds have significantly higher closure scores than non-bulldog-type breeds and that domestic dogs have significantly higher closure scores than the wolf. We further found that the prebasial angle is significantly positively correlated with the amount of closure of the basispheno-presphenoid synchondrosis and sutures of the nose (premaxillo-nasal and maxillo-nasal) and the palate (premaxillo-maxillary and interpalatine). Our results show that there is a correlation between patterns of suture and synchondrosis closure and skull shape in domestic dogs, although the causal relationships remain elusive. © 2016 Wiley Periodicals, Inc.

  14. Bio-inspired ``jigsaw''-like interlocking sutures: Modeling, optimization, 3D printing and testing (United States)

    Malik, I. A.; Mirkhalaf, M.; Barthelat, F.


    Structural biological materials such as bone, teeth or mollusk shells draw their remarkable performance from a sophisticated interplay of architectures and weak interfaces. Pushed to the extreme, this concept leads to sutured materials, which contain thin lines with complex geometries. Sutured materials are prominent in nature, and have recently served as bioinspiration for toughened ceramics and glasses. Sutures can generate large deformations, toughness and damping in otherwise all brittle systems and materials. In this study we examine the design and optimization of sutures with a jigsaw puzzle-like geometry, focusing on the non-linear traction behavior generated by the frictional pullout of the jigsaw tabs. We present analytical models which accurately predict the entire pullout response. Pullout strength and energy absorption increase with higher interlocking angles and for higher coefficients of friction, but the associated high stresses in the solid may fracture the tabs. Systematic optimization reveals a counter-intuitive result: the best pullout performance is achieved with interfaces with low coefficient of friction and high interlocking angle. We finally use 3D printing and mechanical testing to verify the accuracy of the models and of the optimization. The models and guidelines we present here can be extended to other types of geometries and sutured materials subjected to other loading/boundary conditions. The nonlinear responses of sutures are particularly attractive to augment the properties and functionalities of inherently brittle materials such as ceramics and glasses.

  15. Short- and long-term results of chordal reconstruction using artificial suture material (polytetrafluoroethylene and polypropylene in the dog

    Directory of Open Access Journals (Sweden)

    Isamu Kanemoto


    Full Text Available No previous reports have compared the suitability of expanded polytetrafluoroethylene (ePTFE and polypropylene as artificial suture materials for chordal reconstruction in mitral valve plasty (MVP in the dog. Twelve normal dogs were subjected to MVP using surfaceinduced deep hypothermia. In the short-term group (1.5-4 months after surgery, all ePTFE sutures were covered by a tissue sheath including the paired suture arms, which gave the appearance of native chordae from 2 months after surgery. In contrast, all polypropylene sutures were not covered by tissue, and appeared the same as the paired polypropylene suture arms at the operation. In the long-term group (12 months after surgery, all ePTFE sutures were covered by a tissue sheath, which appeared the same as that in the short-term group, and had flexibility without increased thickness with time. In contrast, although the polypropylene suture was covered completely by a tissue sheath in 1 dog, all the other polypropylene sutures were exposed except for both ends of the suture. ePTFE may be superior to polypropylene as an artificial suture material for chordal reconstruction in MVP.

  16. 40Ar/39Ar incremental-release ages of biotite from a progressively remetamorphosed Archean basement terrane in southwestern Labrador

    International Nuclear Information System (INIS)

    Dallmeyer, R.D.


    Gneisses within Archean basement terrane adjacent to the southwestern portion of the Labrador Trough were variably retrograded during a regional metamorphism of Grenville age (ca. 1000 Ma). Bioties from non-retrograded segments of the gneiss terrane record 40 Ar/ 39 Ar plateau and isochron ages which date times of cooling following an episode of the Kenoran orogeny (2376-2391 Ma). A suite of gneiss samples displaying varying degrees of retrograde alteration was collected across the Grenville metamorphic gradient. Bioties in these samples show no petrographic evidence of retrograde alteration, however they do record internally discordant 40 Ar/ 39 Ar age spectra. Although the extent of internal discordance is variable, the overall character of the release patterns is similar with younger apparent ages recorded in intermediate-temperature gas fractions. The total-gas dates range from 2257+-27 Ma (northwest) to 1751+-23 Ma (southeast), suggesting that variable quantities of radiogenic argon were lost from the Archean biotites during Grenville metamorphism. The 'saddle-shaped' nature of the discordant spectra indicates that argon loss was not accomplished through single-stage, volume diffusion processes. (orig./ME)

  17. Geophysical interpretation of the gneiss terrane of northern Washington and southern British Columbia, and its implications for uranium exploration (United States)

    Cady, John W.; Fox, Kenneth F.


    The Omineca crystalline belt of northeastern Washington and southern British Columbia has a regional Bouguer gravity high, and individual gneiss domes within the terrane are marked by local gravity highs. Models of crustal structure that satisfy the limited available seismic-refraction data and explain the gravity high over the gneiss terrane permit the hypothesis that the core metamorphic complexes are the surface expression of a zone of dense infrastructure that makes up the upper 20 km (kilometers) of the crust within the crystalline belt. The Omineca crystalline belt is characterized regionally by low aeromagnetic relief. The gneiss domes and biotite- and biotite-muscovite granites are generally marked by low magnetic relief, whereas hornblende-biotite granites often cause magnetic highs. Exceptional magnetic highs mark zones of magnetic rock within the biotite- and biotite-muscovite granites and the gneiss domes; these areas are worthy of study, both to determine the origin and disposition of the magnetite and to explore the possible existence of uraniferous magnetite deposits.

  18. The Ellsworth terrane, coastal Maine: Geochronology, geochemistry, and Nd-Pb isotopic composition - Implications for the rifting of Ganderia (United States)

    Schulz, K.J.; Stewart, D.B.; Tucker, R.D.; Pollock, J.C.; Ayuso, R.A.


    The Ellsworth terrane is one of a number of fault-bounded blocks that occur along the eastern margin of Ganderia, the western-most of the peri-Gondwanan domains in the northern Appalachians that were accreted to Laurentia in the Paleozoic. Geologic relations, detrital zircon ages, and basalt geochemistry suggest that the Ellsworth terrane is part of Ganderia and not an exotic terrane. In the Penobscot Bay area of coastal Maine, the Ellsworth terrane is dominantly composed of bimodal basalt-rhyolite volcanic sequences of the Ellsworth Schist and unconformably overlying Castine Volcanics. We use new U-Pb zircon geochronology, geochemistry, and Nd and Pb isotopes for these volcanic sequences to constrain the petrogenetic history and paleotectonic setting of the Ellsworth terrane and its relationship with Ganderia. U-Pb zircon geochronology for rhyolites indicates that both the Ellsworth Schist (508.6 ?? 0.8 Ma) and overlying Castine Volcanics (503.5 ?? 2.5 Ma) are Middle Cambrian in age. Two tholefitic basalt types are recognized. Type Tb-1 basalt, present as pillowed and massive lava flows and as sills in both units, has depleted La and Ce ([La/Nd]N = 0.53-0.87) values, flat heavy rare earth element (REE) values, and no positive Th or negative Ta anomalies on primitive mantle-normalized diagrams. In contrast, type Th-2 basalt, present only in the Castine Volcanics, has stightly enriched LREE ([La/Yb]N = 1.42-2.92) values and no Th or Th anomalies. Both basalt types have strongly positive ??Nd (500) values (Th-1 = +7.9-+8.6; Th-2 = +5.6-+7.0) and relatively enriched Pb isotopic compositions (206Ph/204Pb = 18.037-19.784; 207/204Pb = 15.531-15.660; 2088Pb/204Pb = 37.810-38.817). The basalts have compositions transitional between recent normal and enriched mid-ocean-ridge basalt, and they were probably derived by partial melting of compositionatly heterogeneous asthenosphenc mantle. Two types of rhyolite also are present. Type R-1 rhyolite, which mostly occurs as tuffs

  19. Comparison of Suture-Based Anchors and Traditional Bioabsorbable Anchors in Foot and Ankle Surgery. (United States)

    Hembree, W Chad; Tsai, Michael A; Parks, Brent G; Miller, Stuart D

    We compared the pullout strength of a suture-based anchor versus a bioabsorbable anchor in the distal fibula and calcaneus and evaluated the relationship between bone mineral density and peak load to failure. Eight paired cadaveric specimens underwent a modified Broström procedure and Achilles tendon reattachment. The fibula and calcaneus in the paired specimens received either a suture-based anchor or a bioabsorbable suture anchor. The fibular and calcaneal specimens were loaded to failure, defined as a substantial decrease in the applied load or pullout from the bone. In the fibula, the peak load to failure was significantly greater with the suture-based versus the bioabsorbable anchors (133.3 ± 41.8 N versus 76.8 ± 35.3 N; p = .002). No significant difference in load with 5 mm of displacement was found between the 2 groups. In the calcaneus, no difference in the peak load to failure was found between the 2 groups, and the peak load to failure with 5 mm of displacement was significantly lower with the suture-based than with the bioabsorbable anchors (52.2 ± 9.8 N versus 75.9 ± 12.4 N; p = .003). Bone mineral density and peak load to failure were significantly correlated in the fibula with the suture-based anchor. An innovative suture-based anchor had a greater peak load to failure compared with a bioabsorbable anchor in the fibula. In the calcaneus, the load at 5 mm of displacement was significantly lower in the suture-based than in the bioabsorbable group. The correlation findings might indicate the need for a cortical bone shelf with the suture-based anchor. Suture-based anchors could be a viable alternative to bioabsorbable anchors for certain foot and ankle procedures. Copyright © 2016 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  20. Outcomes of the modified Brostrom procedure using suture anchors for chronic lateral ankle instability--a prospective, randomized comparison between single and double suture anchors. (United States)

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


    The present prospective, randomized study was conducted to compare the clinical outcomes of the modified Brostrom procedure using single and double suture anchors for chronic lateral ankle instability. A total of 50 patients were followed up for more than 2 years after undergoing the modified Brostrom procedure. Of the 50 procedures, 25 each were performed using single and double suture anchors by 1 surgeon. The Karlsson scale had improved significantly to 89.8 points and 90.6 points in the single and double anchor groups, respectively. Using the Sefton grading system, 23 cases (92%) in the single anchor group and 22 (88%) in the double anchor group achieved satisfactory results. The talar tilt angle and anterior talar translation on stress radiographs using the Telos device had improved significantly to an average of 5.7° and 4.6 mm in the single anchor group and 4.5° and 4.3 mm in the double anchor group, respectively. The double anchor technique was superior with respect to the postoperative talar tilt. The single and double suture anchor techniques produced similar clinical and functional outcomes, with the exception of talar tilt as a reference of mechanical stability. The modified Brostrom procedure using both single and double suture anchors appears to be an effective treatment method for chronic lateral ankle instability. Copyright © 2013 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  1. Towards a viscoelastic model for the unfused midpalatal suture: development and validation using the midsagittal suture in New Zealand white rabbits. (United States)

    Romanyk, D L; Liu, S S; Lipsett, M G; Toogood, R W; Lagravère, M O; Major, P W; Carey, J P


    Maxillary expansion treatment is a commonly used procedure by orthodontists to widen a patient's upper jaw. As this is typically performed in adolescent patients, the midpalatal suture, connective tissue adjoining the two maxilla halves, remains unfused. Studies that have investigated patient response to expansion treatment, generally through finite element analysis, have considered this suture to behave in a linear elastic manner or it was left vacant. The purpose of the study presented here was to develop a model that could represent the midpalatal suture's viscoelastic behavior. Quasilinear viscoelastic, modified superposition, Schapery's, and Burgers modeling approaches were all considered. Raw data from a previously published study using New Zealand White Rabbits was utilized for model parameter estimation and validation. In this study, Sentalloy(®) coil springs at load levels of 0.49N (50g), 0.98N (100g), and 1.96N (200g) were used to widen the midsagittal suture of live rabbits over a period of 6 weeks. Evaluation was based on a models ability to represent experimental data well over all three load sets. Ideally, a single set of model constants could be used to represent data over all loads tested. Upon completion of the analysis it was found that the modified superposition method was able to replicate experimental data within one standard deviation of the means using a single set of constants for all loads. Future work should focus on model improvement as well as prediction of treatment outcomes. Copyright © 2013 Elsevier Ltd. All rights reserved.

  2. Biomechanical Performance of Medial Row Suture Placement Relative to the Musculotendinous Junction in Transosseous Equivalent Suture Bridge Double-Row Rotator Cuff Repair. (United States)

    Virk, Mandeep S; Bruce, Benjamin; Hussey, Kristen E; Thomas, Jacqueline M; Luthringer, Tyler A; Shewman, Elizabeth F; Wang, Vincent M; Verma, Nikhil N; Romeo, Anthony A; Cole, Brian J


    To compare the biomechanical performance of medial row suture placement relative to the musculotendinous junction (MTJ) in a cadaveric transosseous equivalent suture bridge (TOE-SB) double-row (DR) rotator cuff repair (RCR) model. A TOE-SB DR technique was used to reattach experimentally created supraspinatus tendon tears in 9 pairs of human cadaveric shoulders. The medial row sutures were passed either near the MTJ (MTJ group) or 10 mm lateral to the MTJ (rotator cuff tendon [RCT] group). After the supraspinatus repair, the specimens underwent cyclic loading and load to failure tests. The localized displacement of the markers affixed to the tendon surface was measured with an optical tracking system. The MTJ group showed a significantly higher (P = .03) medial row failure (5/9; 3 during cyclic testing and 2 during load to failure testing) compared with the RCT group (0/9). The mean number of cycles completed during cyclic testing was lower in the MTJ group (77) compared with the RCT group (100; P = .07) because 3 specimens failed in the MTJ group during cyclic loading. There were no significant differences between the 2 study groups with respect to biomechanical properties during the load to failure testing. In a cadaveric TOE-SB DR RCR model, medial row sutures through the MTJ results in a significantly higher rate of medial row failure. In rotator cuff tears with tendon tissue loss, passage of medial row sutures through the MTJ should be avoided in a TOE-SB RCR technique because of the risk of medial row failure. Copyright © 2016. Published by Elsevier Inc.

  3. The B-Lynch uterine brace suture, and a bit of this and a bit of that... (United States)

    Karoshi, Mahantesh


    The widespread application of the B-Lynch brace suture to control postpartum hemorrhage has sparked interest in a variety of adjunctive methods, used alone or in combination, to control uterine bleeding. Although the B-Lynch brace suture has been used with good results throughout the world, failures can and do occur in rare instances, especially when the suture is incorrectly placed for use for an inappropriate indication. Four reports of additional methods to control postpartum hemorrhage are published in this issue of IJGO. Three use the B-Lynch brace suture combined with other techniques. The need for additional techniques reminds the reader of the importance of proper suture application for proper indication. Potential reasons for failure of the B-Lynch suture are provided.

  4. Influence of suturing material on wound healing: Experimental study in dogs

    Directory of Open Access Journals (Sweden)

    Gazivoda Dragan


    Full Text Available Background/Aim. The most common materials implanted in the human organism are suture materials that are classified on the basis of several criteria, usually the origin, structure, and properties. The properties of suture materials are related to its absorbability and non-absorbability. When using resorbable materials it is of great importance to determine whether its absorbability and tensile strength help wound healing in function of time. Sutures themselves can become a source of inflammation, that may reduce or compromise the potential of reparation and regeneration. The aim of this experimental study on dogs was to ascertain whether the absorption rate and the degree of local tissue reactions differ from information provided by the manufacturers, whether there are differences between the applied suture materials and which of the used suture materials have better effect on wound healing. Methods. Experimental testing of the selected suture materials basic characteristics was performed on 6 German Shepherd dogs, which, after induction of general anesthesia, were made 3 identical incisions each in all 4 quadrants (left and right side of the upper and lower jaws, so that 12 horizontal incisions were formed, 10 mm long, 20-25 mm distant from one another, on each animal. Randomly, incisions were stitched up in the following order, starting from back to front: catgut, Dexon®, Vicryl-Rapid®. The experiment was terminated by histopathological examination of tissue samples, taken on postoperative day 3, 7, 14 and 21 in order to identify the effect of healing and the degree of local reaction. Results. The obtained results suggest that catgut has the highest absorption rate, while Dexon® the lowest. Vicryl-Rapid® causes the lowest level of local reactions, while Dexon® the highest. Conclusion. There is no ideal suture material because various patient factors also influence the wound healing process.

  5. Knotless single-row rotator cuff repair: a comparative biomechanical study of 2 knotless suture anchors. (United States)

    Efird, Chad; Traub, Shaun; Baldini, Todd; Rioux-Forker, Dana; Spalazzi, Jeffrey P; Davisson, Twana; Hawkins, Monica; McCarty, Eric


    The purpose of this study was to compare the gap formation during cyclic loading, maximum repair strength, and failure mode of single-row full-thickness supraspinatus repairs performed using 2 knotless suture anchors with differing internal suture-retention mechanisms in a human cadaver model. Nine matched pairs of cadaver shoulders were used. Full-thickness tears were induced by detaching the supraspinatus tendon from the greater tuberosity. Single-row repairs were performed with either type I (Opus Magnum PI; ArthroCare, Austin, Texas) or type II (ReelX STT; Stryker, Mahwah, New Jersey) knotless suture anchors. The repaired tendon was cycled from 10 to 90 N for 500 cycles, followed by load to failure. Gap formation was measured at 5, 100, 200, 300, 400, and 500 cycles with a video digitizing system. Anchor type or location (anterior or posterior) had no effect on gap formation during cyclic loading regardless of position (anterior, P=.385; posterior, P=.389). Maximum load to failure was significantly greater (P=.018) for repairs performed with type II anchors (288±62 N) compared with type I anchors (179±39 N). Primary failure modes were anchor pullout and tendon tearing for type II anchors and suture slippage through the anchor for type I anchors. The internal ratcheting suture-retention mechanism of type II anchors may have helped this anchor outperform the suture-cinching mechanism of type I anchors by supporting significantly higher loads before failure and minimizing suture slippage, potentially leading to stronger repairs clinically. Copyright 2013, SLACK Incorporated.

  6. Biomechanical analysis of suture locations of the distal plantar fascia in partial foot. (United States)

    Guo, Jun-Chao; Wang, Li-Zhen; Mo, Zhong-Jun; Chen, Wei; Fan, Yu-Bo


    The aim of this study was to evaluate the rationality of the suture locations of distal plantar fascia (DPF) after foot amputation to avoid the risk factors of re-amputation or plantar fasciitis. The tensile strain of plantar fascia (PF) in the different regions was measured by uni-axial tensile experiment. A three-dimensional (3D) finite element model was also developed to simulate tensile behaviour of PF in weight bearing conditions. The model includes 12 bones, ligaments, PF, cartilage and soft tissues. Four suture location models for the DPF were considered: the fourth and fifth DPF were sutured on the third metatarsal, the cuboid, and both the third metatarsal and the cuboid, and one un-sutured model. The peak tensile strain of the first, second and third PF was 0.134, 0.128 and 0.138 based on the mechanical test, respectively. The fourth and fifth DPF sutured at the cuboid and the third metatarsal could offer more favourable outcomes. The peak strain of 4.859 × 10(-2), 2.347 × 10(-2) and 1.364 × 10(-2) in the first, second and third PF showed the least outcomes in stance phase. Also, peak strain and stress of the residual PF reduced to 4.859 × 10(-2) and 1.834 MPa, respectively. The stress region was redistributed on the mid-shaft of the first and third PF and the peak stress of medial cuneiform bone evidently decreased. The fourth and fifth DPF suture at the third metatarsal and cuboid was appropriate for the partial foot. The findings are expected to suggest optimal surgical plan of the DPF suture and guide further therapeutic planning of partial foot patients.

  7. Effects of In Utero Thyroxine Exposure on Murine Cranial Suture Growth.

    Directory of Open Access Journals (Sweden)

    R Nicole Howie

    Full Text Available Large scale surveillance studies, case studies, as well as cohort studies have identified the influence of thyroid hormones on calvarial growth and development. Surveillance data suggests maternal thyroid disorders (hyperthyroidism, hypothyroidism with pharmacological replacement, and Maternal Graves Disease are linked to as much as a 2.5 fold increased risk for craniosynostosis. Craniosynostosis is the premature fusion of one or more calvarial growth sites (sutures prior to the completion of brain expansion. Thyroid hormones maintain proper bone mineral densities by interacting with growth hormone and aiding in the regulation of insulin like growth factors (IGFs. Disruption of this hormonal control of bone physiology may lead to altered bone dynamics thereby increasing the risk for craniosynostosis. In order to elucidate the effect of exogenous thyroxine exposure on cranial suture growth and morphology, wild type C57BL6 mouse litters were exposed to thyroxine in utero (control = no treatment; low ~167 ng per day; high ~667 ng per day. Thyroxine exposed mice demonstrated craniofacial dysmorphology (brachycranic. High dose exposed mice showed diminished area of the coronal and widening of the sagittal sutures indicative of premature fusion and compensatory growth. Presence of thyroid receptors was confirmed for the murine cranial suture and markers of proliferation and osteogenesis were increased in sutures from exposed mice. Increased Htra1 and Igf1 gene expression were found in sutures from high dose exposed individuals. Pathways related to the HTRA1/IGF axis, specifically Akt and Wnt, demonstrated evidence of increased activity. Overall our data suggest that maternal exogenous thyroxine exposure can drive calvarial growth alterations and altered suture morphology.

  8. Effects of In Utero Thyroxine Exposure on Murine Cranial Suture Growth. (United States)

    Howie, R Nicole; Durham, Emily L; Black, Laurel; Bennfors, Grace; Parsons, Trish E; Elsalanty, Mohammed E; Yu, Jack C; Weinberg, Seth M; Cray, James J


    Large scale surveillance studies, case studies, as well as cohort studies have identified the influence of thyroid hormones on calvarial growth and development. Surveillance data suggests maternal thyroid disorders (hyperthyroidism, hypothyroidism with pharmacological replacement, and Maternal Graves Disease) are linked to as much as a 2.5 fold increased risk for craniosynostosis. Craniosynostosis is the premature fusion of one or more calvarial growth sites (sutures) prior to the completion of brain expansion. Thyroid hormones maintain proper bone mineral densities by interacting with growth hormone and aiding in the regulation of insulin like growth factors (IGFs). Disruption of this hormonal control of bone physiology may lead to altered bone dynamics thereby increasing the risk for craniosynostosis. In order to elucidate the effect of exogenous thyroxine exposure on cranial suture growth and morphology, wild type C57BL6 mouse litters were exposed to thyroxine in utero (control = no treatment; low ~167 ng per day; high ~667 ng per day). Thyroxine exposed mice demonstrated craniofacial dysmorphology (brachycranic). High dose exposed mice showed diminished area of the coronal and widening of the sagittal sutures indicative of premature fusion and compensatory growth. Presence of thyroid receptors was confirmed for the murine cranial suture and markers of proliferation and osteogenesis were increased in sutures from exposed mice. Increased Htra1 and Igf1 gene expression were found in sutures from high dose exposed individuals. Pathways related to the HTRA1/IGF axis, specifically Akt and Wnt, demonstrated evidence of increased activity. Overall our data suggest that maternal exogenous thyroxine exposure can drive calvarial growth alterations and altered suture morphology.

  9. Comparison of efficacy of polypropylene with chromic catgut suture in stitching paediatric facial lacerations

    International Nuclear Information System (INIS)

    Hussain, A.; Ahmed, R.; Aziz, O.B.A.; Aamir, M.


    Objective: The objective of this study was to compare 5/0 polypropylene suture with 5/0 chromic catgut in small clean pediatric facial laceration repair in terms of cosmetic outcome. Study Design: Randomized controlled trial.Place and Duration of Study: Combined Military Hospital, Rawalpindi from 26th May 2012 to 25th Nov 2012.Patients and Methods: A total of 300 patients of both gender under 12 years of age, with small clean facial lacerations were selected and divided in two equal groups using random number tables. All the patients underwent suturing in minor operating theater of trauma centre CMH Rawalpindi as day care cases, under local anesthesia and aseptic measures. In group 1, polypropylene 5/0 suture was used where as in group 2 chromic catgut 5/0 was used for suturing. Aseptic dressing was applied. All patients were reviewed on 5th day (for stitch removal in polypropylene group) and 3 months post-operatively to establish cosmetic outcome which was determined by scar visual analog score both by parents of the child and consultant surgeon. Results: The mean VAS (visual analog score) as observed by Consultant surgeon was 79.14 and 78.63 for polypropylene and chromic catgut groups respectively. The mean VAS observed by the parents of the child for respective groups was 76.67 and 76.03. The significance value was 0.961 for parental VAS and 0.988 for surgeons VAS depicting insignificant difference in both suture groups.Conclusion: There is no long-term difference in cosmetic outcomes of both the sutures in the repair of facial lacerations in the pediatric population. No difference in complication rate of wound was observed. In addition, the parents of the children in absorbable suture group expressed satisfaction over prevention of psychological trauma of stitch removal. (author)

  10. Randomized clinical trial comparing cold knife conization of the cervix with and without lateral hemostatic sutures. (United States)

    Bueno, Letícia Rossi; Binda, Marcia; Monego, Heleusa; Scherer, Roberta Luísa; Rolim, Karen Machado; Bottini, Alessandra Leal; Fregnani, José H T G; dos Reis, Ricardo


    Compare blood loss during cold knife conization of the cervix with and without lateral hemostatic sutures in the cervical branches of the uterine arteries. Randomized clinical trial. Hospital de Clínicas de Porto Alegre (HCPA). 102 patients that underwent cold knife conization. Women that underwent cold knife conization of the cervix were randomized to undergo the procedure with or without lateral hemostatic sutures. blood loss measured in grams. operative time and postoperative intervention. Only the participants were blinded to group assignment. From March 2009 to August 2012, patients were randomly assigned to one of the study groups. There were no differences in amount of blood loss between patients that underwent the procedure with and without sutures (p = 0.39). Operative time was shorter in the group without suture (p = 0.020). There were no differences in intervention due to bleeding (p = 0.20). Blood loss was greater among menstruating women than for menopausal women (p = 0.011). There were no differences in amount of blood lost between smoking and nonsmoking patients (p = 0.082). Lateral hemostatic sutures do not affect the amount of intraoperative bleeding or the number of postoperative interventions. Their use is not necessary because they result in longer operative time, have a higher cost due to the use of suture material and pose the risk of ureter lesion in case the sutures are not placed at a lower position in the cervix. ClinicalTrials. gov identifier: NCT02184975. Copyright © 2015 IJS Publishing Group Limited. Published by Elsevier Ltd. All rights reserved.

  11. A prospective outcome and cost-effectiveness comparison between two ligament reattachment techniques using suture anchors for chronic ankle instability. (United States)

    Cho, Byung-Ki; Kim, Yong-Min; Park, Kyoung-Jin; Park, Ji-Kang; Kim, Do-Kyoon


    There are various ligament reattachment techniques for the modified Brostrom procedure. There have been few comparative studies on recently developed techniques. This prospective study was performed to compare the functional outcomes of 2 different ligament reattachment techniques using suture anchors. We furthermore evaluated the cost-effectiveness of the suture bridge technique. Forty-five amateur athletes under 30 years of age were followed for more than 2 years. Twenty-four procedures with the suture anchor technique and 21 procedures with the suture bridge technique were performed by one surgeon. The functional evaluation consisted of the American Orthopaedic Foot & Ankle Society (AOFAS) score, Foot and Ankle Outcome Score (FAOS), Karlsson score, Sefton grading system, and the period to return to various forms of exercise (jogging, spurt running, jumping, one leg standing for >1 minute, walking on uneven ground, and going down stairs). Measurement of talar tilt angle and anterior talar translation was obtained from stress radiographs to evaluate mechanical stability. There were no significant differences on AOFAS score, FAOS, Karlsson score, Sefton grade, and stress radiographs. There were no significant differences on the return to exercises, except for jumping. As the most common complication, there were 3 cases of skin irritation by suture materials in the suture anchor group and 2 cases of intraoperative breakage of the suture anchor in suture bridge group. Both ligament reattachment techniques using suture anchors showed similar functional outcomes. Considering the additional medical expenses incurred by more suture anchors, the modified Brostrom procedure using the suture bridge technique had low cost-effectiveness. Proper indication and clinical usefulness of suture bridge technique for chronic ankle instability will be addressed in further studies. Level II, prospective comparative study. © The Author(s) 2014.

  12. The efficacy of laparoscopic intracorporeal linear suture technique as a strategy for reducing recurrences in pediatric inguinal hernia. (United States)

    Lee, S R; Choi, S B


    Pediatric laparoscopic herniorrhaphy has rare complications, but recurrence might occur. The purpose of this manuscript is to evaluate the efficacy of linear suture technique of laparoscopic pediatric herniorrhaphy in reducing recurrences. Laparoscopic surgery was performed on 2223 pediatric patients (under 10 years old) from September 2012 to December 2014 in Damsoyu Hospital, Seoul, Republic of Korea. The causes of recurrence were investigated case by case. The patients were categorized into two groups according to the suture method used in closing the hernia orifice: Group 1 (purse-string suture, 1009 patients) and Group 2 (linear suture, 1214 patients). There were 1413 (63.6%) male and 810 (36.4%) female patients. Mean age was 30.5 ± 29.2 months. A significantly higher proportion of male patients, contralateral patent processus vaginalis, and less proportion of recurrence were observed in Group 2. There were ten cases of recurrence in Group 1 because the internal ring suture could not endure the tension. One recurrence occurred in Group 2. The suture technique and age were found to be a significant risk factor for recurrence. Linear suture technique had a lower recurrence rate (odds ratio = 0.07, with 95% confidence interval 0.01-0.53, and p = 0.004). Purse-string suture technique causes significantly higher occurrence of hernia recurrences than linear suture technique. Linear suture technique can reduce recurrence by increasing the endurance to tension around the internal ring by distributing pressure to a wider area along the linear suture line. Linear suture technique can effectively reduce recurrence in pediatric inguinal herniorrhaphy.

  13. Gastric full-thickness suturing during EMR and for treatment of gastric-wall defects (with video). (United States)

    von Renteln, Daniel; Schmidt, Arthur; Riecken, Bettina; Caca, Karel


    The endoscopic full-thickness Plicator device was initially developed to provide an endoscopic treatment option for patients with GERD. Because the endoscopic full-thickness Plicator enables rapid and easy placement of transmural sutures, comparable with surgical sutures, we used the Plicator device for endoscopic treatment or prevention of GI-wall defects. To describe the outcomes and complications of endoscopic full-thickness suturing during EMR and for the treatment of gastric-wall defects. A report of 4 cases treated with the endoscopic full-thickness suturing between June 2006 and April 2007. A large tertiary-referral center. Four subjects received endoscopic full-thickness suturing. The subjects were women, with a mean age of 67 years. Of the 4 subjects, 3 received endoscopic full-thickness suturing during or after an EMR. One subject received endoscopic full-thickness suturing for treatment of a fistula. Primary outcome measurements were clinical procedural success and procedure-related adverse events. The mean time for endoscopic full-thickness suturing was 15 minutes. In all cases, GI-wall patency was restored or ensured, and no procedure-related complications occurred. All subjects responded well to endoscopic full-thickness suturing. The resection of one GI stromal tumor was incomplete. Because of the Plicator's 60F distal-end diameter, endoscopic full-thickness suturing could only be performed with the patient under midazolam and propofol sedation. The durable Plicator suture might compromise the endoscopic follow-up after EMR. The endoscopic full-thickness Plicator permits rapid and easy placement of transmural sutures and seems to be a safe and effective alternative to surgical intervention to restore GI-wall defects or to ensure GI-wall patency during EMR procedures.

  14. GPR Imaging of Fault Related Folds in a Gold-Bearing Metasedimentary Sequence, Carolina Terrane, Southern Appalachian Mountains (United States)

    Diemer, J. A.; Bobyarchick, A. R.


    The Carolina terrane comprises Ediacaran to earliest Paleozoic mixed magmatic and sedimentary assemblages in the central and eastern Piedmont of the Southern Appalachian Mountains. The terrane was primarily deformed during the Late Ordovician Cherokee orogeny, that reached greenschist facies metamorphism. The Albemarle arc, a younger component of the Carolina terrane, contains volcanogenic metasedimentary rocks with intercalated mainly rhyolitic volcanic rocks. Regional inclined to overturned folds with axial planar cleavage verge southeast. At mesoscopic scales (exposures of a few square meters), folds sympathetic with regional folds are attenuated or truncated by ductile shear zones or contractional faults. Shear and fault zones are most abundant near highly silicified strataform zones in metagraywacke of the Tillery Formation; these zones are also auriferous. GPR profiles were collected across strike of two silicified, gold-bearing zones and enclosing metagraywacke to characterize the scale and extent of folding in the vicinity of ore horizons. Several GSSI SIR-3000 / 100 MHz monostatic GPR profiles were collected in profiles up to 260 meters long. In pre-migration lines processed for time zero and background removal, several clusters of shallow, rolling sigmoidal reflectors appeared separated by sets of parallel, northwest-dipping reflective discontinuities. These features are inferred to be reverse faults carrying contractional folds. After migration with an average velocity of 0.105 m/ns, vertical heights of the inferred folds became attenuated but not removed, and contractional fault reflections remained prominent. After migration, a highly convex-up cluster of reflections initially assumed to be a fold culmination resolved to an elliptical patch of high amplitudes. The patch is likely an undisclosed shaft or covered trench left by earlier gold prospecting. In this survey, useful detail appeared to a depth of 7.5 meters, and only a few gently inclined

  15. Cenozoic mantle composition evolution of southern Tibet indicated by Paleocene ( 64 Ma) pseudoleucite phonolitic rocks in central Lhasa terrane (United States)

    Qi, Yue; Gou, Guo-Ning; Wang, Qiang; Wyman, Derek A.; Jiang, Zi-Qi; Li, Qiu-Li; Zhang, Le


    The question of whether continental subduction processes in collisional orogenic belts can trigger wide-spread mantle metesomatism and crustal material recycling remains unresolved. Miocene (25-8 Ma) ultrapotassic rocks in southern Tibet are the only mantle-derived magmatic rocks emplaced after the collision between India and Asia and they have been linked to the onset of east-west extensional stresses as the surface uplift of the Tibetan Plateau reached near-maximum elevation. However, their petrogenesis remains highly controversial, particularly the issue of whether their extremely enriched Sr-Nd isotopic characteristics were related to metasomatism derived from subducted Indian continental materials during the Cenozoic. Here we report on a Paleocene silicate-unsaturated, pseudoleucite phonolitic dike, in the Rongniduo area of central Lhasa terrane. In-situ SIMS (secondary ion mass spectrometry) apatite U-Pb age indicates the dike was generated at 64.1 ± 4.2 Ma, which slightly predates the age of initial India and Asia collision (about 55-50 Ma). This is the oldest age yet reported for ultrapotassic rocks in southern Tibet. Samples from this dike have distinctly more depleted Sr-Nd (whole rock: (87Sr/86Sr)i = 0.7064 to 0.7062, εNd(t) = - 1.5 to 0.4; in situ apitite: (87Sr/86Sr)i = 0.7059 to 0.7060, εNd(t) = - 2.0 to 0.4) isotopic compositions, than those of Miocene (25-8 Ma) ultrapotassic rocks in the central Lhasa terrane ((87Sr/86Sr)i = 0.7106 to 0.7399, εNd(t) = - 10.6 to - 18.5). Our new data provides important constraints on pre-collisional mantle characteristics beneath the Lhasa terrane. We suggest that these 64 Ma pseudoleucite phonolitic rocks were derived from the enriched lithospheric mantle metasomatized by subducted Tethyan oceanic materials in response to Neo-Tethyan slab roll-back. As a consequence, the younger Miocene ultrapotassic rocks, which display different geochemical compositions from the pre-collisional ultrapotassic rocks, were most

  16. Geochronological and geochemical constraints on the origin of the Yunzhug ophiolite in the Shiquanhe-Yunzhug-Namu Tso ophiolite belt, Lhasa Terrane, Tibetan Plateau (United States)

    Zeng, Yun-Chuan; Xu, Ji-Feng; Chen, Jian-Lin; Wang, Bao-Di; Kang, Zhi-Qiang; Huang, Feng


    The formation of the Shiquanhe-Yunzhug-Namu Tso ophiolite mélange zone (SNMZ) within the Lhasa Terrane, Tibetan Plateau, is key to understanding the Mesozoic tectonic evolution of this terrane, which remains controversial. We show that the Yunzhug ophiolite in the central segment of the SNMZ formed at 150 Ma, based on U-Pb dating of zircons from a gabbroic sample in a well-developed sheeted dike complex. Geochemically, these mafic rocks are dominated by E-MORB-type compositions, along with minor amounts of rocks with P-MORB-type compositions. The samples also exhibit high εNd(t) values and lack negative Nb and Ta anomalies. Data for all the samples plot within the MORB array on a Th/Yb-Nb/Yb diagram. Therefore, these mafic rocks most likely formed in either a slow spreading oceanic setting or an embryonic ocean, and not in a back-arc basin as has been previously assumed. Taking into account the regional geology, we propose that the Yunzhug ophiolite is part of a distinct ophiolitic belt and represents material formed in an embryonic ocean within the Lhasa Terrane, which provides new insights into the Jurassic tectonic evolution of the Lhasa Terrane.

  17. Grenville age of basement rocks in Cape May NJ well: New evidence for Laurentian crust in U.S. Atlantic Coastal Plain basement Chesapeake terrane (United States)

    Sheridan, R.E.; Maguire, T.J.; Feigenson, M.D.; Patino, L.C.; Volkert, R.A.


    The Chesapeake terrane of the U.S. mid-Atlantic Coastal Plain basement is bounded on the northwest by the Salisbury positive gravity and magnetic anomaly and extends to the southeast as far as the Atlantic coast. It underlies the Coastal Plain of Virginia, Maryland, Delaware and southern New Jersey. Rubidium/Strontium dating of the Chesapeake terrane basement yields an age of 1.025 ?? 0.036 Ga. This age is typical of Grenville province rocks of the Middle to Late Proterozoic Laurentian continent. The basement lithologies are similar to some exposed Grenville-age rocks of the Appalachians. The TiO2 and Zr/P2O5 composition of the metagabbro from the Chesapeake terrane basement is overlapped by those of the Proterozoic mafic dikes in the New Jersey Highlands. These new findings support the interpretation that Laurentian basement extends southeast as far as the continental shelf in the U.S. mid-Atlantic region. The subcrop of Laurentian crust under the mid-Atlantic Coastal Plain implies unroofing by erosion of the younger Carolina (Avalon) supracrustal terrane. Dextral-transpression fault duplexes may have caused excessive uplift in the Salisbury Embayment area during the Alleghanian orogeny. This extra uplift in the Salisbury area may have caused the subsequent greater subsidence of the Coastal Plain basement in the embayment.

  18. U-Pb detrital zircon geochronology from the basement of the Central Qilian Terrane: implications for tectonic evolution of northeastern Tibetan Plateau (United States)

    Liu, Changfeng; Wu, Chen; Zhou, Zhiguang; Yan, Zhu; Jiang, Tian; Song, Zhijie; Liu, Wencan; Yang, Xin; Zhang, Hongyuan


    The Tuolai Group dominates the Central Qilian Terrane, and there are different opinions on the age and tectonic attribute of the Tuolai Group. Based on large-scale geologic mapping and zircon dating, the Tuolai Group is divided into four parts: metamorphic supracrustal rocks, Neoproterozoic acid intrusive rocks, early-middle Ordovician acid intrusive rocks and middle Ordovician basic intrusive rocks. The metamorphic supracrustal rocks are the redefined Tuolai complex-group and include gneiss and schist assemblage by faulting contact. Zircon U-Pb LA-MC-ICP-MS dating was conducted on these samples of gneiss and migmatite from the gneiss assemblage, quartzite, two-mica schist and slate from the schist assemblage. The five detrital samples possess similar age spectra; have detrital zircon U-Pb main peak ages of 1.7 Ga with youngest U-Pb ages of 1150 Ma. They are intruded by Neoproterozoic acid intrusive rocks. Therefore, the Tuolai Group belonging to late Mesoproterozoic and early Neoproterozoic. With this caveat in mind, we believe that U-Pb detrital zircon dating, together with the geologic constraints obtained from this study and early work in the neighboring regions. We suggest that the formation age of the entire crystalline basement rocks of metasedimentary sequence from the Central Qilian Terrane should be constrained between the Late Mesoproterozoic and the Late Neoproterozoic, but not the previous Paleoproterozoic. The basement of the Central Qilian Terrane contains the typical Grenville ages, which indicates the Centre Qilian Terrane have been experienced the Grenville orogeny event.

  19. High-Tensile Strength Tape Versus High-Tensile Strength Suture: A Biomechanical Study. (United States)

    Gnandt, Ryan J; Smith, Jennifer L; Nguyen-Ta, Kim; McDonald, Lucas; LeClere, Lance E


    To determine which suture design, high-tensile strength tape or high-tensile strength suture, performed better at securing human tissue across 4 selected suture techniques commonly used in tendinous repair, by comparing the total load at failure measured during a fixed-rate longitudinal single load to failure using a biomechanical testing machine. Matched sets of tendon specimens with bony attachments were dissected from 15 human cadaveric lower extremities in a manner allowing for direct comparison testing. With the use of selected techniques (simple Mason-Allen in the patellar tendon specimens, whip stitch in the quadriceps tendon specimens, and Krackow stitch in the Achilles tendon specimens), 1 sample of each set was sutured with a 2-mm braided, nonabsorbable, high-tensile strength tape and the other with a No. 2 braided, nonabsorbable, high-tensile strength suture. A total of 120 specimens were tested. Each model was loaded to failure at a fixed longitudinal traction rate of 100 mm/min. The maximum load and failure method were recorded. In the whip stitch and the Krackow-stitch models, the high-tensile strength tape had a significantly greater mean load at failure with a difference of 181 N (P = .001) and 94 N (P = .015) respectively. No significant difference was found in the Mason-Allen and simple stitch models. Pull-through remained the most common method of failure at an overall rate of 56.7% (suture = 55%; tape = 58.3%). In biomechanical testing during a single load to failure, high-tensile strength tape performs more favorably than high-tensile strength suture, with a greater mean load to failure, in both the whip- and Krackow-stitch models. Although suture pull-through remains the most common method of failure, high-tensile strength tape requires a significantly greater load to pull-through in a whip-stitch and Krakow-stitch model. The biomechanical data obtained in the current study indicates that high-tensile strength tape may provide better repair

  20. Creep rupture behavior of polypropylene suture material and its applications as a time-release mechanism

    International Nuclear Information System (INIS)

    Kusy, R.P.; Whitley, J.Q.


    The controlled failure of polypropylene (PP) sutures is studied via creep rupture tests. From plots of log time (tB) vs. stress (sigma), linear relationships are generated over the failure times of 1-1000 h. Results show that as a function of stress, the time dependence varies with irradiation dose (15, 20, 25, and 50 Mrad), irradiation atmosphere (air and vacuum), suture diameter (7-0, 6-0, 5-0, and 4-0), and test temperature (26 and 37 degrees C). For a given stress, the time to failure is least for the greatest dose in the presence of air and at the highest temperature. When suture loops are wrapped around a small wire sheave, however, failure occurs in the largest suture as much as two decades sooner than the smallest suture studied. Within the limitations stated herein, they are independent of test method, loop diameter, aging, and humidity. Consequently, after irradiation in vacuum and postirradiation heat treatment, the processed material may be stored at room temperature for at least 1 month. Such materials are advocated when the time release of a dental or medical device is required, for example, in the self-activating cleft palate appliance

  1. Low pacemaker incidence with continuous-sutured valves: a retrospective analysis. (United States)

    Niclauss, Lars; Delay, Dominique; Pfister, Raymond; Colombier, Sebastien; Kirsch, Matthias; Prêtre, René


    Background Permanent pacemaker implantation after surgical aortic valve replacement depends on patient selection and risk factors for conduction disorders. We aimed to identify risk criteria and obtain a selected group comparable to patients assigned to transcatheter aortic valve implantation. Methods Isolated sutured aortic valve replacements in 994 patients treated from 2007 to 2015 were reviewed. Demographics, hospital stay, preexisting conduction disorders, surgical technique, and etiology in patients with and without permanent pacemaker implantation were compared. Reported outcomes after transcatheter aortic valve implantation were compared with those of a subgroup including only degenerative valve disease and first redo. Results The incidence of permanent pacemaker implantation was 2.9%. Longer hospital stay ( p = 0.01), preexisting rhythm disorders ( p pacemaker implantation. Although prostheses were sutured with continuous monofilament in the majority of cases (86%), interrupted pledgetted sutures were used more often in the pacemaker group ( p = 0.002). In the subgroup analysis, the incidence of permanent pacemaker implantation was 2%; preexisting rhythm disorders and the suture technique were still major risk factors. Conclusion Permanent pacemaker implantation depends on etiology, preexisting rhythm disorders, and suture technique, and the 2% incidence compares favorably with the reported 5- to 10-fold higher incidence after transcatheter aortic valve implantation. Cost analysis should take this into account. Often dismissed as minor complication, permanent pacemaker implantation increases the risks of endocarditis, impaired myocardial recovery, and higher mortality if associated with prosthesis regurgitation.

  2. Effect of the use of carprofen in dogs undergoing intense rehabilitation after lateral fabellar suture stabilization. (United States)

    Gordon-Evans, Wanda J; Dunning, Diane; Johnson, Ann L; Knap, Kim E


    To determine whether carprofen, a commercially available NSAID, would decrease perceived exertion and signs of pain in dogs and therefore increase muscle mass and hind limb function without decreasing range of motion after lateral fabellar suture stabilization. Randomized, blinded, controlled clinical trial. 35 dogs with cranial cruciate ligament rupture and lateral fabellar suture stabilization followed by rehabilitation. All dogs underwent surgical stabilization of cranial cruciate ligament rupture by placement of a lateral fabellar suture. Dogs received carprofen (2.2 mg/kg [1 mg/lb], PO, q 12 h) for the first 7 days after surgery and underwent concentrated rehabilitation exercises during weeks 3, 5, and 7 after surgery. Eighteen dogs also received carprofen (2.2 mg/kg, PO, q 12 h) during the weeks of concentrated rehabilitation. Outcomes were measured by a single investigator, who was blinded to group assignments, using pressure platform gait analysis, goniometry, thigh circumference, and mean workout speed at a consistent level of exertion. There were no differences between the 2 groups in ground reaction forces, thigh circumference, or exertion (mean workout speed) over time or at any individual time point. However, both groups improved significantly over time for all outcome measures. Providing carprofen to dogs during concentrated rehabilitation after lateral fabellar suture stabilization did not improve hind limb function, range of motion, or thigh circumference, nor did it decrease perceived exertion, compared with control dogs. Carprofen was not a compulsory component of a physical therapy regimen after lateral fabellar suture stabilization.

  3. The use of quilting suture in abdominoplasty does not require aspiratory drainage for prevention of seroma. (United States)

    Arantes, Henrique Lopes; Rosique, Rodrigo Gouvêa; Rosique, Marina Junqueira Ferreira; Mélega, Jose Marcos


    The formation of seromas after abdominoplasty is a highly prevalent complication that disturbs both the patient and the surgeon. Aspiratory drainage and adhesion sutures (Baroudi suture) are widely used to prevent this complication. This study evaluated the effectiveness of drains in preventing seromas. This retrospective study investigated women submitted to classic abdominoplasty with adhesion sutures. The women were divided into two groups. Group 1 comprised 28 individuals who received no drains, and group 2 consisted of 32 patients that had drains placed. Clinical evaluation of the patients was performed 7 days, 14 days, 1 month, 2 months, 4 months, and 6 months postoperatively. Statistical analysis was accomplished via Fisher's exact test. Group 1 had one case of seroma (3.5%), clinically detected between the first and second postoperative months, whereas group 2 had one case (3.12%) detected 14 days postoperatively. Fisher's test showed a P value of 1.000 (not statistically significant), for a 95% confidence interval of 0.05 to 14.08 and an odds ratio of 0.8387. Clinical evaluation showed no statistical difference in the incidence of seromas after abdominoplasty with adhesion sutures between the patients who received drains and those who did not. The use of adhesion sutures is an effective measure for preventing seromas with no need for additional surgical measures.

  4. Single-layer versus double-layer laparoscopic intracorporeally sutured gastrointestinal anastomoses in the canine model. (United States)

    Tavakoli, Azine; Bakhtiari, Jalal; Khalaj, Ali Reza; Gharagozlou, Mohammad Javad; Veshkini, Abbas


    The objective of this study was to compare the gross and histopathologic changes following 1- versus 2-layer hand-sewn suture techniques in laparoscopic gastrointestinal anastomosis in dogs. This was an experimental prospective study of 16 healthy mixed breed male and female dogs. Animals were randomly divided into 2 groups. Two-layer side-to-side hand-sewn laparoscopic gastrojejunostomies were performed in group A, so that simple interrupted sutures were placed in the outer layer and simple continuous suture was used in the inner layer. The 1-layer simple continuous anastomosis between the stomach and jejunum was done in group B precisely. Specimen were collected from the sites of anastomosis, and H&E statining was performed for light microscopic studies. All animals survived the surgery. There was no gross inflammation, ischemia, apparent granulation tissue, abscess or fistula formation, leakage or stricture formation, and all sites of anastomosis were patent. Several adhesion formations were found in the abdomen with the higher incidence in the control group. Mean scores of leukocyte infiltration and granulation tissue formation at the sites of anastomosis were statistically insignificant between groups (P>0.05). Gross and histopathologic findings revealed that hand-sewn laparoscopic gastrointestinal anastomosis with the 1-layer suture technique is comparable to the 2-layer suture technique.

  5. The efficiacy of anterior and posterior archs suturation at inferior tonsillar pole for posttonsillectomy pain control. (United States)

    Sakallioğlu, Oner; Düzer, Sertaç; Kapusuz, Zeliha


    The aim of our study was to investigate the efficiacy of the suturation technique after completing the tonsillectomy procedure for posttonsillectomy pain control in adult patients. August 2010-February 2011, 44 adult patients, ages ranged from 16 to 41 years old who underwent tonsillectomy at Elaziğ Training and Research Hospital Otorhinolaryngology Clinic were included to the study. After tonsillectomy procedure, anterior and posterior tonsillar archs were sutured each other and so, the area of tonsillectomy lodges which covered with mucosa were increased. Twenty two patients who applied posttonsillectomy suturation were used as study group and remnant 22 patients who did not applied posttonsillectomy suturation were used as control group. The visual analogue score (VAS) was used to evaluate the postoperative pain degree (0 no pain, 10 worst pain). ANOVA test (two ways classification with repeated measures) was used for statistical analysis of VAS values. P < 0.05 was accepted as statistically significant. The effect of time (each post-operative day) on VAS values was significant. The mean VAS values between study and control group on post-operative day 1st, 3rd, 7th, and 10th were statistically significant (P < 0.05). The severity of posttonsillectomy pain was less in study group patients than control group patients. The suturation of anterior and posterior tonsillar archs after tonsillectomy procedure was found effective to alleviate the posttonsillectomy pain in adult patients.

  6. Long-term efficacy of anchored barbed sutures in the face and neck. (United States)

    Kaminer, Michael S; Bogart, Megan; Choi, Christine; Wee, Sue Ann


    The thread lift is a minimally invasive procedure that uses barbed sutures, inserted subcutaneously, to produce lifting of ptotic tissue of the face and neck. There are currently very limited data on longevity and patient satisfaction following barbed suture lifting procedures. The purpose of this study was to assess long-term efficacy following the use of barbed sutures. A satisfaction survey was mailed to 20 patients who were a minimum of 6 months (range, 6 to 16 months) postprocedure. Physician assessment of pre- and postprocedure photographs was also performed. At an average of 11.5 months postprocedure, patients felt that the barbed suture lift met their expectations, rating their satisfaction a 6.9 on a scale of 1 to 10. Independent physicians rated the overall improvement an average of 4.6 of 10. Higher scores were noted in Zone 1 (tear trough/malar fat pad and nasolabial folds) compared to Zone 2 (marionette lines, jowls, and jawline definition) and Zone 3 (platysmal bands and neck contour). The barbed suture lift procedure provides moderate long-term and sustained improvement for facial laxity, with most improvement seen in the tear trough/malar fat pads and nasolabial folds. In this study, clinical efficacy was seen up to 16 months postprocedure.

  7. Efficacy of silver coated surgical sutures on bacterial contamination, cellular response and wound healing

    International Nuclear Information System (INIS)

    Gallo, Anna Lucia; Paladini, Federica; Romano, Alessandro; Verri, Tiziano; Quattrini, Angelo; Sannino, Alessandro; Pollini, Mauro


    The resistance demonstrated by many microorganisms towards conventional antibiotics has stimulated the interest in alternative antimicrobial agents and in novel approaches for prevention of infections. Silver, a natural braod-spectrum antimicrobial agent known since antiquity, has been widely employed in biomedical field due to its recognized antibacterial, antifungal and antiviral properties. In this work, antibacterial silver coatings were deposited on absorbable surgical sutures through the in situ photo-chemical deposition of silver clusters. Scanning electron microscopy (SEM), Energy dispersive X-ray spectroscopy (EDX) and thermo-gravimetric analysis (TGA) were performed in order to investigate the presence and distribution of the silver clusters on the substrate. The amounts of silver deposited and released by the silver treated sutures were calculated through Inductively Coupled Plasma-Mass Spectroscopy (ICP-MS), and the results were related to the biodegradation of the material. The microbiological properties and the potential cytotoxicity of the silver-treated sutures were investigated in relation with hydrolysis experiments, in order to determine the effect of the degradation on antibacterial properties and biocompatibility. - Highlights: • The in situ photo-deposition of silver nano-coatings was used to develop silver treated PGLA sutures. • The silver particles deposited had good distribution and strong adhesion to the substrate. • The silver treated sutures demonstrated good biocompatibility and antibacterial capability. • The presence of silver promoted cell migration and proliferation in the wound area.

  8. The Effect of Suture Anchor Insertion Angle on Calcaneus Pullout Strength: Challenging the Deadman's Angle. (United States)

    Weiss, William M; Saucedo, Ramon P; Robinson, John D; Lo, Chung-Chieh Jason; Morris, Randal P; Panchbhavi, Vinod K


    Refractory cases of Achilles tendinopathy amenable to surgery may include reattachment of the tendon using suture anchors. However, there is paucity of information describing the optimal insertion angle to maximize the tendon footprint and anchor stability in the calcaneus. The purpose of this investigation is to compare the fixation strength of suture anchors inserted at 90° and 45° (the Deadman's angle) relative to the primary compressive trabeculae of the calcaneus. A total of 12 matched pairs of adult cadaveric calcanei were excised and potted to approximate their alignment in vivo. Each pair was implanted with 5.5-mm bioabsorbable suture anchors placed either perpendicular (90°) or oblique (45°) to the primary compressive trabeculae. A tensile load was applied until failure of anchor fixation. Differences in failure load and stiffness between anchor fixation angles were determined by paired t-tests. No significant differences were detected between perpendicular and oblique suture anchor insertion relative to primary compressive trabeculae in terms of load to failure or stiffness. This investigation suggests that the fixation strength of suture anchors inserted perpendicular to the primary compression trabeculae and at the Deadman's angle are possibly comparable. Biomechanical comparison study.

  9. Visibility of sutures of the orbit and periorbital region using multidetector computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Gufler, Hubert; Preis, Markus; Koesling, Sabrina [Dept. of Diagnostic Radiology, Martin-Luther-University Halle-Wittenberg, Halle (Germany)


    Knowledge of cranial suture morphology is crucial in emergency medicine, forensic medicine, and maxillofacial reconstructive surgery. This study assessed the visibility of sutures of the orbit and periorbital region on multidetector computed tomography. Multidetector computed tomography scans of 200 patients (127 males, 73 females; mean age 51.3 years; range, 6-92 years) were evaluated retrospectively. The slice thicknesses varied from 0.5 to 1 mm, and the tube current from 25 to 370 mAs, depending on the CT indication. The visibility of sutures was estimated according to a 4-point scale from 'not visible to well visible' The chi-squared test was used to test the association of the visibility of sutures with the slice thickness, tube current, and age of patients. Statistical significance was assumed at p < 0.05. Overall, best visibility was found for the sutura frontozygomatica (98%), sutura frontonasalis (88.5%), and sutura sphenozygomatica (71.5%), followed by the sutura zygomaticomaxillaris (65.8%), sutura temporozygomatica (41.8%), sutura frontomaxillaris (44.5%), and sutura sphenofrontalis (31%). Poor visibility was found for the sutura frontolacrimalis (16.8%) and sutura frontoethmoidalis (1.3%). The sutura ethmoidomaxillaris, sutura lacrimomaxillaris, and sutura ethmoidolacrimalis were not visible. Although the sutures of the superior, lateral, and inferior orbit are well visible, those of the medial orbit are poorly visible on CT scans.

  10. Comparative Study Between Coaptive Film Versus Suture For Wound Closure After Long Bone Fracture Fixation

    Directory of Open Access Journals (Sweden)

    IM Anuar Ramdhan


    Full Text Available INTRODUCTION: Coaptive film (i.e., Steri-StripsTM is an adhesive tape used to replace sutures in wound closure. The use of coaptive film for wound closure after long bone fracture fixation has not been well documented in the literature. METHODS: The aim of this prospective, randomized controlled trial comparing coaptive film with sutures for wound closure after long bone fracture fixation was skin closure time, incidence of wound complications and scar width at 12 week follow-up. Forty-five patients underwent femur fracture fixation (22 patients’ wound closed with sutures, 23 with coaptive film. RESULTS: The mean time for skin closure using coaptive film was 171.13 seconds compared to 437.27 seconds using suture. The mean wound lengths in the coaptive film group and suture group were 187.65 mm and 196.73 mm, respectively. One patient in each group had wound complications. CONCLUSION: Coaptive film is a time-saving procedure for skin closure following long bone fracture fixation. There is no difference in the incidence of wound complications and scar width between these two methods of skin closure.

  11. Efficacy of silver coated surgical sutures on bacterial contamination, cellular response and wound healing

    Energy Technology Data Exchange (ETDEWEB)

    Gallo, Anna Lucia [Department of Engineering for Innovation, University of Salento, Via Monteroni, 73100 Lecce (Italy); Paladini, Federica, E-mail: [Department of Engineering for Innovation, University of Salento, Via Monteroni, 73100 Lecce (Italy); Romano, Alessandro [Neuropathology Unit, Institute of Experimental Neurology and Division of Neuroscience, IRCCS San Raffaele Scientific Institute, via Olgettina 60, 20132 Milan (Italy); Verri, Tiziano [Di.S.Te.B.A., University of Salento, Via per Monteroni, 73100 Lecce (Italy); Quattrini, Angelo [Neuropathology Unit, Institute of Experimental Neurology and Division of Neuroscience, IRCCS San Raffaele Scientific Institute, via Olgettina 60, 20132 Milan (Italy); Sannino, Alessandro; Pollini, Mauro [Department of Engineering for Innovation, University of Salento, Via Monteroni, 73100 Lecce (Italy)


    The resistance demonstrated by many microorganisms towards conventional antibiotics has stimulated the interest in alternative antimicrobial agents and in novel approaches for prevention of infections. Silver, a natural braod-spectrum antimicrobial agent known since antiquity, has been widely employed in biomedical field due to its recognized antibacterial, antifungal and antiviral properties. In this work, antibacterial silver coatings were deposited on absorbable surgical sutures through the in situ photo-chemical deposition of silver clusters. Scanning electron microscopy (SEM), Energy dispersive X-ray spectroscopy (EDX) and thermo-gravimetric analysis (TGA) were performed in order to investigate the presence and distribution of the silver clusters on the substrate. The amounts of silver deposited and released by the silver treated sutures were calculated through Inductively Coupled Plasma-Mass Spectroscopy (ICP-MS), and the results were related to the biodegradation of the material. The microbiological properties and the potential cytotoxicity of the silver-treated sutures were investigated in relation with hydrolysis experiments, in order to determine the effect of the degradation on antibacterial properties and biocompatibility. - Highlights: • The in situ photo-deposition of silver nano-coatings was used to develop silver treated PGLA sutures. • The silver particles deposited had good distribution and strong adhesion to the substrate. • The silver treated sutures demonstrated good biocompatibility and antibacterial capability. • The presence of silver promoted cell migration and proliferation in the wound area.

  12. LED phototherapy on midpalatal suture after rapid maxilla expansion: a Raman spectroscopic study (United States)

    Rosa, Cristiane B.; Habib, Fernando Antonio L.; de Araújo, Telma M.; dos Santos, Jean N.; Cangussu, Maria Cristina T.; Barbosa, Artur Felipe S.; de Castro, Isabele Cardoso V.; Soares, Luiz Guilherme P.; Pinheiro, Antonio L. B.


    A quick bone formation after maxillary expansion would reduce treatment timeand the biomodulating effects of LED light could contribute for it. The aim of this study was to analyze the effect of LED phototherapy on the acceleration of bone formation at the midpalatal suture after maxilla expansion. Thirty rats divided into 6 groups were used on the study at 2 time points - 7 days: Control; Expansion; and Expansion + LED; and 14 days: Expansion; Expansion + LED in the first week; Expansion and LED in the first and second weeks. LED irradiation occurred at every 48 h during 2 weeks. Expansion was accomplished using a spatula and maintained with a triple helicoid of 0.020" stainless steel orthodontic wire. A LED light (λ850 ± 10nm, 150mW ± 10mW, spot of 0.5cm2, t=120 sec, SAEF of 18J/cm2) was applied in one point in the midpalatal suture immediately behind the upper incisors. Near infrared Raman spectroscopic analysis of the suture region was carried and data submitted to statistical analyzes (p≤0.05). Raman spectrum analysis demonstrated that irradiation increased hydroxyapatite in the midpalatal suture after expansion. The results of this indicate that LED irradiation; have a positive biomodulation contributing to the acceleration of bone formation in the midpalatal suture after expansion procedure.

  13. A bilinear elastic constitutive model applied for midpalatal suture behavior during rapid maxillary expansion

    Directory of Open Access Journals (Sweden)

    Larissa Carvalho Trojan Serpe

    Full Text Available Introduction : This study aims to evaluate the influence of the biomechanical behavior of the midpalatal suture (MPS during the rapid maxillary expansion (RME when modeled by the Finite Element Method. Methods Four simulation alternatives are discussed and, for each analysis, the suture is considered as a functional unit with a different mechanical behavior: (i without MPS elements, (ii MPS with Young's modulus (E equal to 1 MPa, (ii MPS with E equal to 0.01 MPa and (iv MPS with bilinear elastic behavior. Results The stress analysis showed that, when MPS is not considered in the model, stress peaks are reduced in magnitude and their distribution is restricted to a smaller area when compared to the model with the inclusion of MPS (E=1 MPa. The increased suture stiffness also has a direct influence on MPS displacements after 30 expander activations. Conclusion The consideration of the MPS in RME computer models influences greatly the calculated displacements between the suture bone ends, even as the stress levels in maxillary structures. Furthermore, as proposed for the described model, the elastic bilinear behavior assigned to MPS allows coherent prediction of stresses and displacements results, being a good representation for this suture overall behavior.

  14. Geochronology and geochemistry of the Early Jurassic Yeba Formation volcanic rocks in southern Tibet: Initiation of back-arc rifting and crustal accretion in the southern Lhasa Terrane (United States)

    Wei, Youqing; Zhao, Zhidan; Niu, Yaoling; Zhu, Di-Cheng; Liu, Dong; Wang, Qing; Hou, Zengqian; Mo, Xuanxue; Wei, Jiuchuan


    Understanding the geological history of the Lhasa Terrane prior to the India-Asia collision ( 55 ± 10 Ma) is essential for improved models of syn-collisional and post-collisional processes in the southern Lhasa Terrane. The Miocene ( 18-10 Ma) adakitic magmatism with economically significant porphyry-type mineralization has been interpreted as resulting from partial melting of the Jurassic juvenile crust, but how this juvenile crust was accreted remains poorly known. For this reason, we carried out a detailed study on the volcanic rocks of the Yeba Formation (YF) with the results offering insights into the ways in which the juvenile crust may be accreted in the southern Lhasa Terrane in the Jurassic. The YF volcanic rocks are compositionally bimodal, comprising basalt/basaltic andesite and dacite/rhyolite dated at 183-174 Ma. All these rocks have an arc-like signature with enriched large ion lithophile elements (LILEs; e.g., Rb, Ba and U) and light rare earth elements (LREEs) and depleted high field strength elements (HFSEs; e.g., Nb, Ta, Ti). They also have depleted whole-rock Sr-Nd and zircon Hf isotopic compositions, pointing to significant mantle isotopic contributions. Modeling results of trace elements and isotopes are most consistent with the basalts being derived from a mantle source metasomatized by varying enrichment of subduction components. The silicic volcanic rocks show the characteristics of transitional I-S type granites, and are best interpreted as resulting from re-melting of a mixed source of juvenile amphibole-rich lower crust with reworked crustal materials resembling metagraywackes. Importantly, our results indicate northward Neo-Tethyan seafloor subduction beneath the Lhasa Terrane with the YF volcanism being caused by the initiation of back-arc rifting. The back-arc setting is a likely site for juvenile crustal accretion in the southern Lhasa Terrane.

  15. Linking the southern West Junggar terrane to the Yili Block: Insights from the oldest accretionary complexes in West Junggar, NW China (United States)

    Ren, Rong; Han, Bao-Fu; Guan, Shu-Wei; Liu, Bo; Wang, Zeng-Zhen


    West Junggar is known to tectonically correlate with East Kazakhstan; however, the tectonic link of the southern West Junggar terrane to adjacent regions still remains uncertain. Here, we examined the oldest accretionary complexes, thus constraining its tectonic evolution and link during the Early-Middle Paleozoic. They have contrasting lithologic, geochemical, and geochronological features and thus, provenances and tectonic settings. The Laba Unit was derived from the Late Ordovician-Early Devonian continental arc system (peaking at 450-420 Ma) with Precambrian substrate, which formed as early as the Early Devonian and metamorphosed during the Permian; however, the Kekeshayi Unit was accumulated in an intra-oceanic arc setting, and includes the pre-Late Silurian and Late Silurian subunits with or without Precambrian sources. Integrated with the regional data, the southern West Junggar terrane revealed a tectonic link to the northern Yili Block during the Late Silurian to Early Devonian, as suggested by the comparable Precambrian zircon age spectra between the southern West Junggar terrane and the micro-continents in the southern Kazakhstan Orocline, the proximal accumulation of the Laba Unit in the continental arc atop the Yili Block, and the sudden appearance of Precambrian zircons in the Kekeshayi Unit during the Late Silurian. This link rejects the proposals of the southern West Junggar terrane as an extension of the northern Kazakhstan Orocline and the Middle Paleozoic amalgamation of West Junggar. A new linking model is thus proposed, in which the southern West Junggar terrane first evolved individually, and then collided with the Yili Block to constitute the Kazakhstan continent during the Late Silurian. The independent and contrasting intra-oceanic and continental arcs also support the Paleozoic archipelago-type evolution of the Central Asian Orogenic Belt.

  16. Viable adhered Staphylococcus aureus highly reduced on novel antimicrobial sutures using chlorhexidine and octenidine to avoid surgical site infection (SSI) (United States)

    Schneider, Jochen; Harrasser, Norbert; Tübel, Jutta; Mühlhofer, Heinrich; Pförringer, Dominik; von Deimling, Constantin; Foehr, Peter; Kiefel, Barbara; Krämer, Christina; Stemberger, Axel; Schieker, Matthias


    Background Surgical sutures can promote migration of bacteria and thus start infections. Antiseptic coating of sutures may inhibit proliferation of adhered bacteria and avoid such complications. Objectives This study investigated the inhibition of viable adhering bacteria on novel antimicrobially coated surgical sutures using chlorhexidine or octenidine, a critical factor for proliferation at the onset of local infections. The medical need, a rapid eradication of bacteria in wounds, can be fulfilled by a high antimicrobial efficacy during the first days after wound closure. Methods As a pretesting on antibacterial efficacy against relevant bacterial pathogens a zone of inhibition assay was conducted with middle ranged concentrated suture coatings (22 μg/cm). For further investigation of adhering bacteria in detail the most clinically relevant Staphylococcus aureus (ATCC®49230™) was used. Absorbable braided sutures were coated with chlorhexidine-laurate, chlorhexidine-palmitate, octenidine-laurate, and octenidine-palmitate. Each coating type resulted in 11, 22, or 33 μg/cm drug content on sutures. Scanning electron microscopy (SEM) was performed once to inspect the coating quality and twice to investigate if bacteria have colonized on sutures. Adhesion experiments were assessed by exposing coated sutures to S. aureus suspensions for 3 h at 37°C. Subsequently, sutures were sonicated and the number of viable bacteria released from the suture surface was determined. Furthermore, the number of viable planktonic bacteria was measured in suspensions containing antimicrobial sutures. Commercially available sutures without drugs (Vicryl®, PGA Resorba®, and Gunze PGA), as well as triclosan-containing Vicryl® Plus were used as control groups. Results Zone of inhibition assay documented a multispecies efficacy of novel coated sutures against tested bacterial strains, comparable to most relevant S. aureus over 48 hours. SEM pictures demonstrated uniform layers on

  17. Precambrian Field Camp at the University of Minnesota Duluth - Teaching Skills Applicable to Mapping Glaciated Terranes of the Canadian Shield (United States)

    Miller, J. D.; Hudak, G. J.; Peterson, D.


    Since 2007, the central program of the Precambrian Research Center (PRC) at the University of Minnesota Duluth has been a six-week geology field camp focused on the Precambrian geology of the Canadian Shield. This field camp has two main purposes. First and foremost is to teach students specialized field skills and field mapping techniques that can be utilized to map and interpret Precambrian shield terranes characterized by sparse outcrop and abundant glacial cover. In addition to teaching basic outcrop mapping technique , students are introduced to geophysical surveying (gravity, magnetics), glacial drift prospecting, and drill core logging techniques in several of our geological mapping exercises. These mapping methodologies are particularly applicable to minerals exploration in shield terranes. The second and equally important goal of the PRC field camp is to teach students modern map-making and map production skills. During the fifth and sixth weeks of field camp, students conduct "capstone" mapping projects. These projects encompass one week of detailed bedrock mapping in remote regions of northern Minnesota that have not been mapped in detail (e.g. scales greater than 1:24,000) and a second week of map-making and map generation utilizing geographic information systems (currently ArcGIS10), graphics software packages (Adobe Illustrator CS4), and various imaging software for geophysical and topographic data. Over the past five years, PRC students and faculty have collaboratively published 21 geologic maps through the Precambrian Research Center Map Series. These maps are currently being utilized in a variety of ways by industry, academia, and government for mineral exploration programs, development of undergraduate, graduate, and faculty research projects, and for planning, archeological studies, and public education programs in Minnesota's state parks. Acquisition of specialized Precambrian geological mapping skills and geologic map-making proficiencies has

  18. Petrography and geochemistry of five granitic plutons from south central Uruguay: contribution to the knowledge of the Piedra Alta terrane

    International Nuclear Information System (INIS)

    Preciozzi, F.


    Granitoid rocks in south-central Uruguay are largely concentrated in three east-west trending metamorphic belts, known as (from south to north) the Montevideo Belt, the San José Belt and the Arroyo Grande Belt. These belts are separated from one another by intervening bands of gneisses of granitic composition. The whole assemblage, the gneisses as well as the metamorphic belts and their associated granites, collectively constitute the Piedra Alta Terrane. Five of these granite plutons, two from the San José Belt and three from the Arroyo Grande Belt, have been studied in some detail and the chemical composition of 86 samples (major elements as well as a selected suite of trace elements) have been determined. These data, as well as Rb-Sr isotopic data, show that these plutons are typically composite in nature, and that the various units range in age from 1900 Ma to 2500 Ma. The older ages were obtained from the main units of the plutons themselves whereas the younger ages are from late dykes which were emplaced into the plutons and which are clearly not related to them. The plutons are predominantly, but not exclusively, of calc-alkaline affinity and are typically synorogenic whereas the dykes are post-orogenic and are either calc-alkaline or alkaline in composition. These data have been incorporated into a tectonic model for the Piedra Alta Terrane which is considerably different from that heretofore proposed. The essential features of the geological history of the area are: 1) development of an older ''basement'' of granitic gneisses 2) deposition, upon or adjacent to this gneisses basement, of a typical Archean greenstone belt assemblage (no komatiites so far reported) 3) Paleo-proterozoic metamorphism, followed by syn-tectonic to post-tectonic intrusion of the plutonic rocks 4) major tectonic dislocation(s) associated with the Transamazonian orogeny 5) dyke emplacement (post-orogenic to anorogenic) following the Transamazonian orogeny


    Makgoka, M


    Laparoscopic splenectomy is a well described gold standard procedure for various indications. One of the key steps during laparoscopic splenectomy is the hilar pedicle vessels control, which can be challenging in most cases. Most centres around the world recommend the use Ligaclib or endovascular staplers as Methods of choice for hilar pedicle control but the issue is the cost and efficiency of the laparoscopic haemostatic devices. A descriptive retrospective study of patients who had laparoscopic splenectomy from 2013 to present. Hilar splenic vessel control was done with suture ligation. We looked at outcomes of patients offered this technique, complications of this technique, and describing the technique of hilar control in laparoscopic splenectomy. Total of 27 patients had laparoscopic splenectomy with splenic hilar pedicle control with suture ligation. Mean operative time, mean blood volume loss, length of hospital stay, postoperative complications conversion to laparotomy. Laparoscopic hilar pedicle control with suture ligation is safe and effective for the patient in our hospital setting.

  20. Preliminary results with sutured colonic anastomoses reinforced with dye-enhanced fibrinogen and a diode laser (United States)

    Libutti, Steven K.; Williams, Matthew R.; Oz, Mehmet C.; Forde, Kenneth A.; Bass, Lawrence S.; Weinstein, Samuel; Auteri, Joseph S.; Treat, Michael R.; Nowygrod, Roman


    A common cause of morbidity in patients recovering from bowel surgery is leakage from colonic anastomoses. A technique utilizing a laser activated protein solder to strengthen colonic anastomoses in a canine model was evaluated. Following creation of six single-layer interrupted suture anastomoses in four dogs, a protein solder consisting of indocyanine green dye and fibrinogen was topically appied to the serosal surface and exposed to 808 nm continuous wave diode laser energy. Immediately following anastomosis, the mean leakage pressure of sutures alone was 129 +/- 14 mm hg (n equals 6), while the mean leakage pressure of sutures reinforced with the laser welded solder was 312 +/- 32 mm hg (n equals 6) (p anastomoses without causing appreciable thermal injury to surrounding tissues.

  1. Premaxillary-maxillary suture asymmetry in a juvenile Gorilla. Implications for understanding dentofacial growth and development. (United States)

    Schwartz, J H


    A specimen of juvenile gorilla was found that had the premaxillary-maxillary suture coursing between the lateral deciduous incisor and deciduous canine on one side of the jaw, but between the central and lateral deciduous incisors on the other; in the latter, the suture also separates the alveolus of the lateral deciduous incisor from the crypt of the growing successional lateral incisor. Rather than dismiss this exception to the traditional dictum of tooth identification--which is based on the position to teeth relative to this suture--as some inconsequential anomaly, an attempt is made to understand how this can occur within the confines of present understanding of dentofacial growth and development and developmental theory. An hypothesis relating tooth and tooth class identification is presented in the context of ectomesenchymally predifferentiated stem progenitors and subsequent tooth class proliferation.


    Directory of Open Access Journals (Sweden)

    V. M. Popkov


    Full Text Available The investigation deals with the study of the biomechanical properties of renal tissues and the comparison of different hemostatic suture procedures used during resection of the kidney for its tumor. The performed experimental study allows one to recommend that a renal capsule as the organ’s most stable and plastic part must be necessarily inserted into the hemostatic suture on both sides. The elastic modulus (Young’s modulus serves as an integral indicator of the deformation-strength properties of renal tissues, which enables it to be recommended for the wider use in experimental and clinical studies. The proposed modified suture can minimize the number of postoperative bleedings from the renal parenchyma and reduce the time of surgery, thereby improving the results of organ-saving treatment in patients with kidney cancer.

  3. Performance Assessment of Suture Type in Juvenile Chinook Salmon Surgically Implanted with Acoustic Transmitters

    Energy Technology Data Exchange (ETDEWEB)

    Deters, Katherine A.; Brown, Richard S.; Carter, Kathleen M.; Boyd, James W.


    The objective of this study was to determine the best overall suture material to close incisions from the surgical implantation of Juvenile Salmon Acoustic Telemetry System (JSATS) acoustic microtransmitters in subyearling Chinook salmon Oncorhynchus tshawytscha. The effects of seven suture materials, four surgeons, and two water temperatures on suture retention, incision openness, tag retention, tissue inflammation, and tissue ulceration were quantified. The laboratory study, conducted by researchers at the Pacific Northwest National Laboratory, supports a larger effort under way for the U.S. Army Corps of Engineers, Portland District, aimed at determining the suitability of acoustic telemetry for estimating short- and longer-term (30-60 days) juvenile-salmonid survival at Columbia and Snake River dams and through the lower Columbia River.

  4. Two Techniques of Intestinal Wall Suture in Surgical Treatment of Ileus in Dogs and the Importance of Omentalisation

    Directory of Open Access Journals (Sweden)

    M. Crha


    Full Text Available Model experimental studies focused on the intestinal suture techniques in relation to healing, postoperative narrowing of the intestinal lumen or adhesion formation can not comprise a number of clinical factors (foreign body presence in the intestine, haematological abnormalities, septic peritonitis, different age of patients, etc. that under clinical practice conditions may have an effect on the healing of the intestinal suture. The aim of this clinical study was to confirm in a group of dogs surgically treated for small bowel obstruction, whether different techniques of its wall suture may affect the frequency of possible dehiscence occurrence. This study compares two different techniques of intestinal wall suture in relation to postoperative dehiscence of the intestinal wall closure. Based on the clinical observation with regard to the risk of postoperative dehiscence and possible complications in form of adhesions, also the importance of omentalisation in the suture of small bowel was evaluated. No significant difference was demonstrated (p > 0.05 in the frequency of postoperative dehiscence at the site of the intestinal wall closure between the two-layer inverting and singlelayer appositional techniques of suture. Likewise, no significant difference was demonstrated (p > 0.05 in the frequency of dehiscence of intestinal wall suture between patients that underwent intestinal suture omentalisation and those whose intestinal wall suture was not complemented with omentalisation. Based on the results of this clinical study it may be stated that both manual single-layer approximation technique and two-layer inverting technique of the intestinal wall suture are equally safe from the viewpoint of possible dehiscence, and it depends on the surgeon's preference, which one of the said techniques he or she chooses. Concurrently it may be assumed that an exactly performed suture of the intestinal wall does not necessarily require omentalisation.

  5. Self-tapping ability of carbon fibre reinforced polyetheretherketone suture anchors. (United States)

    Feerick, Emer M; Wilson, Joanne; Jarman-Smith, Marcus; Ó'Brádaigh, Conchur M; McGarry, J Patrick


    An experimental and computational investigation of the self-tapping ability of carbon fibre reinforced polyetheretherketone (CFR-PEEK) has been conducted. Six CFR-PEEK suture anchor designs were investigated using PEEK-OPTIMA® Reinforced, a medical grade of CFR-PEEK. Experimental tests were conducted to investigate the maximum axial force and torque required for self-taping insertion of each anchor design. Additional experimental tests were conducted for some anchor designs using pilot holes. Computational simulations were conducted to determine the maximum stress in each anchor design at various stages of insertion. Simulations also were performed to investigate the effect of wall thickness in the anchor head. The maximum axial force required to insert a self-tapping CFR-PEEK suture anchor did not exceed 150 N for any anchor design. The maximum torque required to insert a self-tapping CFR-PEEK suture anchor did not exceed 0.8 Nm. Computational simulations reveal significant stress concentrations in the region of the anchor tip, demonstrating that a re-design of the tip geometry should be performed to avoid fracture during self-tapping, as observed in the experimental component of this study. This study demonstrates the ability of PEEK-OPTIMA Reinforced suture anchors to self-tap polyurethane foam bone analogue. This provides motivation to further investigate the self-tapping ability of CFR-PEEK suture anchors in animal/cadaveric bone. An optimised design for CFR-PEEK suture anchors offers the advantages of radiolucency, and mechanical properties similar to bone with the ability to self-tap. This may have positive implications for reducing surgery times and the associated costs with the procedure. © The Author(s) 2014 Reprints and permissions:

  6. Biomechanical Analysis of Suture Anchor vs Tenodesis Screw for FHL Transfer. (United States)

    Drakos, Mark C; Gott, Michael; Karnovsky, Sydney C; Murphy, Conor I; DeSandis, Bridget A; Chinitz, Noah; Grande, Daniel; Chahine, Nadeen


    Chronic Achilles injury is often treated with flexor hallucis longus (FHL) tendon transfer to the calcaneus using 1 or 2 incisions. A single incision avoids the risks of extended dissections yet yields smaller grafts, which may limit fixation options. We investigated the required length of FHL autograft and biomechanical profiles for suture anchor and biotenodesis screw fixation. Single-incision FHL transfer with suture anchor or biotenodesis screw fixation to the calcaneus was performed on 20 fresh cadaveric specimens. Specimens were cyclically loaded until maximal load to failure. Length of FHL tendon harvest, ultimate load, stiffness, and mode of failure were recorded. Tendon harvest length needed for suture anchor fixation was 16.8 ± 2.1 mm vs 29.6 ± 2.4 mm for biotenodesis screw ( P = .002). Ultimate load to failure was not significantly different between groups. A significant inverse correlation existed between failure load and donor age when all specimens were pooled (ρ = -0.49, P Anchor failure occurred mostly by suture breakage (n = 8). Adequate FHL tendon length could be harvested through a single posterior incision for fixation to the calcaneus with either fixation option, but suture anchor required significantly less graft length. Stiffness, fixation strength, and load to failure were comparable between groups. An inverse correlation existed between failure load and donor age. Younger specimens with screw fixation demonstrated significantly greater failure loads. Adequate harvest length for FHL transfer could be achieved with a single posterior incision. There was no difference in strength of fixation between suture anchor and biotenodesis screw.

  7. Frequency of Dehiscence in Hand-Sutured and Stapled Intestinal Anastomoses in Dogs. (United States)

    Duell, Jason R; Thieman Mankin, Kelley M; Rochat, Mark C; Regier, Penny J; Singh, Ameet; Luther, Jill K; Mison, Michael B; Leeman, Jessica J; Budke, Christine M


    To determine the frequency of dehiscence of hand-sutured and stapled intestinal anastomoses in the dog and compare the surgery duration for the methods of anastomosis. Historical cohort study. Two hundred fourteen client-owned dogs undergoing hand-sutured (n = 142) or stapled (n = 72) intestinal anastomoses. Medical records from 5 referral institutions were searched for dogs undergoing intestinal resection and anastomosis between March 2006 and February 2014. Demographic data, presence of septic peritonitis before surgery, surgical technique (hand-sutured or stapled), surgery duration, surgeon (resident versus faculty member), indication for surgical intervention, anatomic location of resection and anastomosis, and if dehiscence was noted postoperatively were retrieved. Estimated frequencies were summarized and presented as proportions and 95% confidence intervals (CI) and continuous outcomes as mean (95% CI). Comparisons were made across methods of anastomosis. Overall, 29/205 dogs (0.14, 95% CI 0.10-00.19) had dehiscence, including 21/134 dogs (0.16, 0.11-0.23) undergoing hand-sutured anastomosis and 8/71 dogs (0.11, 0.06-0.21) undergoing stapled anastomosis. There was no significant difference in the frequency of dehiscence across anastomosis methods (χ(2), P = .389). The mean (95% CI) surgery duration of 140 minutes (132-147) for hand- sutured anastomoses and 108 minutes (99-119) for stapled anastomoses was significantly different (t-test, P < .001). No significant difference in frequency of dehiscence was noted between hand- sutured and stapled anastomoses in dogs but surgery duration is significantly reduced by the use of staples for intestinal closure. © Copyright 2015 by The American College of Veterinary Surgeons.

  8. Flexor tendon repair: a comparative study between a knotless barbed suture repair and a traditional four-strand monofilament suture repair.

    LENUS (Irish Health Repository)

    Joyce, C W


    We compared the tensile strength of a novel knotless barbed suture method with a traditional four-strand Adelaide technique for flexor tendon repairs. Forty fresh porcine flexor tendons were transected and randomly assigned to one of the repair groups before repair. Biomechanical testing demonstrated that the tensile strengths between both tendon groups were very similar. However, less force was required to create a 2 mm gap in the four-strand repair method compared with the knotless barbed technique. There was a significant reduction in the cross-sectional area in the barbed suture group after repair compared with the Adelaide group. This would create better gliding within the pulley system in vivo and could decrease gapping and tendon rupture.

  9. Thread-Lift Sutures: Still in the Lift? A Systematic Review of the Literature. (United States)

    Gülbitti, Haydar Aslan; Colebunders, Britt; Pirayesh, Ali; Bertossi, Dario; van der Lei, Berend


    In 2006, Villa et al. published a review article concerning the use of thread-lift sutures and concluded that the technique was still in its infancy but had great potential to become a useful and effective procedure for nonsurgical lifting of sagged facial tissues. As 11 years have passed, the authors now performed again a systematic review to determine the real scientific current state of the art on the use of thread-lift sutures. A systematic review was performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines using the PubMed database and using the Medical Subject Headings search term "Rhytidoplasty." "Rhytidoplasty" and the following entry terms were included by this Medical Subject Headings term: "facelift," "facelifts," "face Lift," "Face Lifts," "Lift," "Face," "Lifts," "Platysmotomy," "Platysmotomies," "Rhytidectomy," "Rhytidectomies," "Platysmaplasty," "and "Platysmaplasties." The Medical Subject Headings term "Rhytidoplasty" was combined with the following search terms: "Barbed suture," "Thread lift," "APTOS," "Suture suspension," "Percutaneous," and "Silhouette suture." RefWorks was used to filter duplicates. Three of the authors (H.A.G., B.C., and B.L.) performed the search independently. The initial search with all search terms resulted in 188 articles. After filtering the duplicates and the articles about open procedures, a total of 41 articles remained. Of these, the review articles, case reports, and letters to the editor were subsequently excluded, as were reports dealing with nonbarbed sutures, such as Vicryl and Prolene with Gore-Tex. This resulted in a total of 12 articles, seven additional articles since the five articles reviewed by Villa et al. The authors' review demonstrated that, within the past decade, little or no substantial evidence has been added to the peer-reviewed literature to support or sustain the promising statement about thread-lift sutures as made by Villa et al. in 2006 in terms of

  10. Suture Granuloma Showing False-Positive Findings on FDG-PET

    Directory of Open Access Journals (Sweden)

    Kohei Takahara


    Full Text Available We report a case of a 33-year-old male with a mixed germ-cell testicular tumor. Postoperative follow-up FDG-PET revealed concentration of FDG in the left inguinal area which is not tumor metastasis or local recurrence but suture reactivity granuloma. In this paper, we reviewed suture granulomas associated with false-positive findings on FDG-PET after surgery. If FDG-PET will be used more frequently in the future, it will be necessary to refrain from using silk thread in order to prevent any unnecessary surgery.

  11. Extrinsic mechanism obstructing the opening of a prosthetic mitral valve: an unusual case of suture entrapment. (United States)

    Ozkan, Mehmet; Astarcioglu, Mehmet Ali; Karakoyun, Suleyman; Balkanay, Mehmet


    Obstruction to a prosthetic cardiac valve is a well-recognized complication of cardiac valve replacement. Malfunction of the mobile component of a prosthetic valve to open or close correctly may occur in consequence of intrinsic or extrinsic causes (thrombus, vegetation, entrapment of left ventricular myocardium, suture entanglement, and pannus formation) that may result prosthetic valve stenosis and/or insufficiency. In the case we report a 48-year-old female with valve dysfunction occurred early after surgery, as one valve leaflet was only able to partially open due to suture entrapment. © 2011, Wiley Periodicals, Inc.

  12. Randomized clinical trial of intracutaneously versus transcutaneously sutured ileostomy to prevent stoma-related complications (ISI trial)

    NARCIS (Netherlands)

    Sier, M. F.; Wisselink, D. D.; Ubbink, D. T.; Oostenbroek, R. J.; Veldink, G. J.; Lamme, B.; van Duijvendijk, P.; van Geloven, A. A. W.; Eijsbouts, Q. A. J.; Bemelman, W. A.; van Grevenstein, M. U.; Veltkamp, S. C.; Tolenaar, P. L.; van de Laar, A. W. J. M.; Slooter, G. D.; Sonneveld, D. J. A.


    Ileostomy construction is a common procedure but can be associated with morbidity. The stoma is commonly secured to the skin using transcutaneous sutures. It is hypothesized that intracutaneous sutures result in a tighter adherence of the peristomal skin to the stoma plate to prevent faecal leakage.

  13. Association of abnormal metopic suture causing hypertelorism, interfrontal encephalocele with craniofacial cosmetic deformity associated with myelomeningocele: management literature review

    Directory of Open Access Journals (Sweden)

    Calderon-Miranda Willem Guillermo


    Full Text Available Myelomeningocele may be associated with other neural and extraneural anomalies. Authors present association of metopic suture abnormality, an interfrontal encephalocele with widening of metopic suture and abnormal shape frontal bones in the forehead in those associated with hydrocephalus. Authors describes two neonates with interfrontal encephalocele, representing first series reporting in neonate. Management and pertinent literature is briefly discussed.

  14. Temporary suspension of acute facial paralysis using the S-S Cable Suture (Medical U&A, Tokyo, Japan). (United States)

    Ozaki, Mine; Takushima, Akihiko; Momosawa, Akira; Kurita, Masakazu; Harii, Kiyonori


    For a treatment of facial paralysis, suture suspension of soft tissue is considered effective due to its less invasiveness and relatively simple technique, with minimal bruising and rapid recovery. However, suture suspension effect may not last for a long period of time. We obtained good outcome with temporary static suture suspension in 5 cases of severe facial paralysis in the intervening period between the onset of paralysis and expected spontaneous recovery. We used the S-S Cable Suture (Medical U&A, Tokyo, Japan), which was based on the modification of previously established method using the Gore-Tex cable suture originally reported by Sasaki et al in 2002. Because of the ease of technique and relatively strong lifting capability of the malar pad, we recommend it as a useful procedure for a patient suffering acute facial paralysis with possible spontaneous recovery for an improved quality of life by the quick elimination of facial distortion.

  15. Estudio comparativo de microsutura vascular en ratas: punto simple y punto de colchonero horizontal Comparative study about vascular microsurgery on rats: classic interrupted suture versus horizontal mattress suture

    Directory of Open Access Journals (Sweden)

    C. Casado Sánchez


    Full Text Available La Microcirugía es la técnica empleada para la realización de la microanastomosis vascular. El objetivo del presente estudio es comparar dos tipos de técnicas de microsutura: los puntos simples clásicos, de empleo habitual en la microcirugía vascular, y los puntos de colchonero horizontales, no evaluados habitualmente para este tipo de cirugía. Fueron intervenidas 20 ratas albinas de la cepa Wistar (peso medio de 250 - 300 gr. bajo anestesia general; realizamos sección transversal en la arteria femoral, procediendo a su reparación microquirúrgica inmediata. Se establecieron 2 grupos de animales: en el grupo A (n=10, la microsutura se hizo mediante 6 puntos sueltos simples, y en el grupo B (n=10, empleando 3 puntos de colchonero horizontal. Comprobamos la patencia en el desclampado inmediato y tras una hora del desclampado (para ambas técnicas fue positiva en el 100% de los casos, y la hemorragia en ambos tiempos (se registró un único caso de sangrado en el postoperatorio inmediato en el grupo B, que requirió la revisión de la microsutura. El tiempo medio de ejecución de la sutura en el grupo B, 15 minutos aproximadamente, fue más corto que en el grupo A, 21 minutos aproximadamente, diferencia estadísticamente significativa (p Microsurgery is the procedure of choice for vascular microanastamoses. The objective of this study was to compare two types of suture techniques: classic interrupted suture anastomoses, commonly used for vascular anastamoses in microsurgery, and another technique using horizontal mattress sutures, rarely evaluated in this type of surgery. Twenty albino Wistar rats were operated (average weight: 250 - 300 gr. under general anaesthesia. A transverse section of the femoral artery was performed and immediately followed by an anastamoses. The animals were placed into two groups of ten. The classic 6 interrupted suture anastomoses technique was performed in group A (n = 10 and another technique using 3

  16. Thread-Lift Sutures : Still in the Lift? A Systematic Review of the Literature

    NARCIS (Netherlands)

    Gulbitti, Haydar Aslan; Colebunders, Britt; Pirayesh, Ali; Bertossi, Dario; van der Lei, Berend

    Background: In 2006, Villa et al. published a review article concerning the use of thread-lift sutures and concluded that the technique was still in its infancy but had great potential to become a useful and effective procedure for nonsurgical lifting of sagged facial tissues. As 11 years have

  17. Thread-Lift Sutures : Still in the Lift? A Systematic Review of the Literature

    NARCIS (Netherlands)

    Gülbitti, Haydar Aslan; Colebunders, Britt; Pirayesh, Ali; Bertossi, Dario; van der Lei, Berend


    BACKGROUND: In 2006, Villa et al. published a review article concerning the use of thread-lift sutures and concluded that the technique was still in its infancy but had great potential to become a useful and effective procedure for nonsurgical lifting of sagged facial tissues. As 11 years have

  18. Endoscopic Management of Gastrocutaneous Fistula Using Clipping, Suturing, and Plugging Methods

    Directory of Open Access Journals (Sweden)

    Shou-jiang Tang


    Conclusions: Health care providers need to be aware of this uncommon complication after PEG tube removal and management it with appropriate minimally invasive options where expertise and devices are available. Currently, tissue approximation with clips, intra-gastric and/or trans-abdominal suture placement is the preferred endoscopic options for fistula closure.

  19. 'The Closer'-percutaneous vascular suture device: evaluation of safety and performance in neuroangiography

    International Nuclear Information System (INIS)

    Henk, Christine B.; Grampp, Stephan; Heimberger, Karl; Czerny, Christian; Schindler, Erwin; Mostbeck, Gerhard H.


    Objective: To evaluate the use of the suture mediated vascular closure device concerning practicability and safety in clinical angiography practice. Material and methods: One hundred and seventeen patients (59 female, 58 male, mean age 40.9±13.4) underwent percutaneous closure of common femoral arterial puncture sites following diagnostic neuroangiography using the suture device 'the Closer' (Perclose Inc., Redwood City, CA, USA). Primary success, early problems (within 24 h) and late complications were evaluated. Complications were graded as minor and severe with or without need of surgical intervention and categorized by type. Parameters such as age, gender, sheath size and number of previous arterial punctures were evaluated with respect to complications. Results: Percutaneous closure was primary successful in 85% (100/117). The overall complication rate was 32% (28% mild n=35, 4% severe n=6, which needed surgical intervention). All but one problem occurred within the first 24 h after the suture. Additional manual compression was necessary in 32 cases (25%). There was no significant difference in age and gender between the groups with and without complications. Sheath size was significantly larger (P<0.01) and numbers of preceding angiograms were significantly higher (P<0.01) in the complications group compared with uncomplicated cases. Conclusion: The evaluated percutaneous vascular suture device is useful in clinical practice but limitations concerning patient selection seem to emerge in order to avoid complications

  20. Comparative study of cotton, polyglactin and polyglecaprone sutures in intestinal anastomoses in dogs. (United States)

    Bernis-Filho, Walter Octaviano; Wouters, Flademir; Wouters, Angélica Aparecida Barth; Bernis, Valéria Magro Octaviano; Lopes, Luiz Roberto; Andreollo, Nelson Adami


    Over the years, many sutures were developed and then abandoned. Until now was not found an ideal suture to the intestinal tract or other tissues in general, making the choice a difficult task. To evaluate, macroscopically and microscopically, the healing process of intestinal anastomoses in dogs using polyglecaprone 25, polyglactin 910 and cotton sutures. Twenty adult male dogs were operated on and underwent to three small bowel anastomosis using the technique with submucosal sutures. Were used three threads and the anastomoses were evaluated at different postoperative periods - group I - three days; group II - seven days; group III - 14 days and group IV - 21days. Macroscopic analysis was to assess the presence or absence of peritonitis, aspect of the anastomosis and adhesions. Histological studies of the anastomoses, using hematoxylin and eosin and Masson's trichrome analyzed the exudative inflammation, granulomatous inflammation, the mucosal epithelial coating and collagen fibers. The macroscopic analysis showed good coaptation of the edges with a moderate degree of adhesion between the intestines and omentum three to 21 days after surgery. The microscopic evaluation revealed exudative inflammation with neutrophils and fibrin, which ranged from mild to moderate until the 14th day; granulomatous inflammation with macrophages, multinucleated giant cells and epithelioid cells were more evident at 14th day for the cotton, presence of granulation tissue (fibroblasts) and collagen fibers, a moderate way, from the 7th for the three threads. All three threads showed similar behavior and thus they can be indicated for anastomoses of the small intestine.

  1. Performance of fast-absorbable suture and histo-glue in closing incisions in Brown trout

    DEFF Research Database (Denmark)

    Jepsen, Niels; Larsen, Martin Hage; Aarestrup, Kim


    , growth, tag expulsion rate and incision healing was compared among three groups of dummy transmitter-tagged wild brown trout Salmo trutta where incisions were closed with two types of suture material (absorbable vs. fast absorbable) and Histo-glue. The tagged fish were kept in semi-natural ponds for 20...

  2. A novel suture method to place and adjust peripheral nerve catheters

    DEFF Research Database (Denmark)

    Rothe, C.; Steen-Hansen, C.; Madsen, M. H.


    We have developed a peripheral nerve catheter, attached to a needle, which works like an adjustable suture. We used in-plane ultrasound guidance to place 45 catheters close to the femoral, saphenous, sciatic and distal tibial nerves in cadaver legs. We displaced catheters after their initial...

  3. A novel specialized suture and inserting device for the resuspension of ptotic facial tissues: early results. (United States)

    Bisaccia, Emil; Kadry, Razan; Saap, Liliana; Rogachefsky, Arlene; Scarborough, Dwight


    In the past decade, the popularity of minimally invasive procedures for facial rejuvenation has increased. To describe a new specialized suture, and its associated technique, used to elevate sagging tissues of the face and neck. A detailed description of the technique and the results obtained in 20 patients in whom we have used this novel approach. Attention was given to appropriate patient selection. The primary focus was on the correction of the jowl, jawline, and neck subunits. It involves the percutaneous introduction of a novel 3-0 polypropylene suture that has 10 absorbable hollow cones along its axis that are equally interspersed with knots. Once the absorbable cones are resorbed into the surrounding tissues, the non-absorbable suture component can be removed without compromising the aesthetic outcome. All patients demonstrated improvement in these areas, with minimal complications. One patient required resuspension using the open technique. (Excessive ptotic tissue was later excised for an optimal cosmetic result.) The suture and technique described in this article provide a major contribution to the correction of ptosis of facial tissues. When done in conjunction with other procedures, such as neck and jowl microliposuction, this technique has proven to be a useful addition to facial rejuvenation.

  4. Comparison of functional results of two fixation systems using single-row suturing of rotator cuff. (United States)

    Muniesa-Herrero, M P; Torres-Campos, A; Urgel-Granados, A; Blanco-Llorca, J A; Floría-Arnal, L J; Roncal-Boj, J C; Castro-Sauras, A

    Arthroscopic repair of rotator cuff disorders is a technically demanding but successful procedure. Many anchor and suture alternatives are now available. The choice of the implant by the surgeon is less important than the configuration of the suture used to fix the tendon, however it is necessary to know if there are differences in the results, using each one of them. The aim of the study is to evaluate if there are differences between the knotted and non-knotted implant in terms of functional and satisfaction results. A retrospective study was carried out on 83 patients operated between 2010 and 2014 in our center using 2anchoring systems with and without knotting (39 versus 44 patients respectively), with single row in complete rupture of the rotator cuff. At the end of the follow-up, an average score was obtained on the Constant scale of 74.6 points. 98% of the patients considered the result of the surgery satisfactory. Statistically, there were no significant differences between the 2groups in terms of functionality, satisfaction or reincorporation to activities. The functional results of the single-row cuff suture are satisfactory, although biomechanical studies show advantages in favor of sutures that reproduce a transoseo system. It our series of patients the presence of knotting does not show per se a significant functional difference being both superimposable techniques in absolute values of functionality and patient satisfaction. Copyright © 2018 SECOT. Publicado por Elsevier España, S.L.U. All rights reserved.

  5. Growing skull fracture - rupture of coronal suture caused by vacuum extraction

    International Nuclear Information System (INIS)

    Hansen, K.N.; Pedersen, H.; Petersen, M.B.


    Growing skull fracture is a well known complication to calvarian fracture with underlying dural tear and brain injury in infancy and early childhood. This has been reported in three cases after forceps delivery. To our best knowledge it has never been described after disruption of a calvarian suture caused by vacuum extraction delivery. (orig.)

  6. Tracing the influence of the Trans-European Suture Zone into the mantle transition zone

    Czech Academy of Sciences Publication Activity Database

    Knapmeyer-Endrun, B.; Krüger, F.; Legendre, C. P.; Geissler, W.H.; Plomerová, Jaroslava; Babuška, Vladislav; Gaždová, Renata; Jedlička, Petr; Kolínský, Petr; Málek, Jiří; Novotný, Oldřich; Růžek, Bohuslav


    Roč. 363, FEB 1 (2013), s. 73-87 ISSN 0012-821X Institutional support: RVO:67985530 ; RVO:67985891 Keywords : mantle transition zone * Trans-European Suture Zone * East European Craton Subject RIV: DC - Siesmology, Volcanology, Earth Structure Impact factor: 4.724, year: 2013

  7. Conization of the cervix uteri. Complications in connection with plain catgut or silk suturing

    DEFF Research Database (Denmark)

    Holmskov, A; Qvist, N; Møller, A


    During a retrospective study on postoperative complications in 213 patients who had undergone conization, a (non-significant) reduction in the bleeding rate from 27.9% to 18.6% was found when using silk sutures (102 patients) instead of plain catgut (111 patients) for adaption of the edges of the...

  8. Adjustment of gamma radiation doses for sterilization of Egyptian surgical sutures

    International Nuclear Information System (INIS)

    Tawfik, Z.S.; Helmy, M.M.; Roushdy, H.M.


    The adjustment of gamma radiation doses for sterilization of catguts under local manufacturing conditions has been performed. Average total initial counts for aerobic and anaerobic bacteria per item were relatively low, in the range of 1000 counts for aerobic and 10 counts for anaerobic bacteria. The microfiora (aerobic bacteria) of the studied sutures were isolated and identified to be: Bacillus sp.; Micrococcus varians, Micrococcus roseus, and Staphylococcus. Each purified and identified isolate was exposed to gamma radiation both in liquid media (broth) and in the preservative in which the sutures were supplied by the company. The LD values of the most resistant microorganisms in both case of liquid media and preservative, were obtained to be around 5 KGy. Deliberately contaminated sterile sutures with each isolate and with mixture of isolates were studied. The sterilizing dose was obtained to be 20KGy for most heavily contaminated items (10 10 counts) irradiated both in saline and in preservative. This sterilizing dose was found to be dependent of the initial viable counts. This value was considered to be a safe value for radiosterilization of the studied sutures preserved in isopropyl alcohol, glycerin, and water (90:3.5:16)

  9. Double-Row Suture Anchor Repair of Posterolateral Corner Avulsion Fractures. (United States)

    Gilmer, Brian B


    Posterolateral corner avulsion fractures are a rare variant of ligamentous knee injury primarily described in the skeletally immature population. Injury is often related to a direct varus moment placed on the knee during sporting activities. Various treatment strategies have been discussed ranging from nonoperative management, to excision of the bony fragment, to primary repair with screws or suture. The described technique is a means for achieving fixation of the bony avulsion using principles familiar to double-row transosseous equivalent rotator cuff repair. Proximal anchors are placed in the epiphysis, and sutures are passed in horizontal mattress fashion. Once tied, the limbs of these same sutures are then passed to more distal anchors. Remaining eyelet sutures can be used to manage peripheral tissue. The final repair provides anatomic reduction and compression of the fragment to its bony bed with minimal extracortical hardware prominence and no violation of the physis. Risks include potential for physeal injury or chondral damage to the lateral femoral condyle through aberrant anchor placement. Postoperative care includes toe-touch weight-bearing restrictions and range of motion restrictions of 0°-90° in a hinged brace for 6 weeks followed by gradual return to activity.

  10. A novel technique for distal fingertip replantation: Polypropylene suture guided interpositional vein graft. (United States)

    Dadaci, Mehmet; Ince, Bilsev; Altuntas, Zeynep; Bitik, Ozan; Uzun, Hakan; Bilgen, Fatma


    Despite current advances in microsurgery, fingertip replantation is still controversial, mainly due to its difficulty and cost. The purpose of this study is to describe a new technique of interposition vein graft guided by polypropylene suture in distal fingertip replantation. A total of eight consecutive Tamai zone 1 fingertip replantations performed by the same author were included. All replantations were performed using interposition vein graft guided by polypropylene suture. This technique involved a vein graft of ∼ 2 cm, with appropriate calibration, obtained from the volar part of the forearm and a 2-0 polyprolene suture passed through the interposition vein graft. Then, a polypropylene suture guide carrying the vein graft was inserted into the artery. The anastomosis was easily performed with the aid of 10-0 or 11-0 nylon in a bloodless medium and without encountering the posterior wall problem. Average surgery time was 2.5 hours (range = 2-3 hours). Among eight Tamai zone 1 replantations, six were successful (75%). There were two replantations lost because of arterial failure. This technique may ease fingertip replantations and increase the success rate for Tamai zone 1 injuries.

  11. Development and validation of a new assessment tool for suturing skills in medical students. (United States)

    Sundhagen, Henriette Pisani; Almeland, Stian Kreken; Hansson, Emma


    In recent years, emphasis has been put on that medical student should demonstrate pre-practice/pre-registration core procedural skills to ensure patient safety. Nonetheless, the formal teaching and training of basic suturing skills to medical students have received relatively little attention and there is no standard for what should be tested and how. The aim of this study was to develop and validate, using scientific methods, a tool for assessment of medical students' suturing skills, measuring both micro- and macrosurgical qualities. A tool was constructed and content, construct, concurrent validity, and inter-rater, inter-item, inter-test reliability were tested. Three groups were included: students with no training in suturing skills, students who have had training, plastic surgery. The results show promising reliability and validity when assessing novice medical students' suturing skills. Further studies are needed on implementation of the instrument. Moreover, how the instrument can be used to give formative feedback, evaluate if a required standard is met and for curriculum development needs further investigation.Level of Evidence: Not ratable.

  12. The objective assessment of experts' and novices' suturing skills using an image analysis program. (United States)

    Frischknecht, Adam C; Kasten, Steven J; Hamstra, Stanley J; Perkins, Noel C; Gillespie, R Brent; Armstrong, Thomas J; Minter, Rebecca M


    To objectively assess suturing performance using an image analysis program and to provide validity evidence for this assessment method by comparing experts' and novices' performance. In 2009, the authors used an image analysis program to extract objective variables from digital images of suturing end products obtained during a previous study involving third-year medical students (novices) and surgical faculty and residents (experts). Variables included number of stitches, stitch length, total bite size, travel, stitch orientation, total bite-size-to-travel ratio, and symmetry across the incision ratio. The authors compared all variables between groups to detect significant differences and two variables (total bite-size-to-travel ratio and symmetry across the incision ratio) to ideal values. Five experts and 15 novices participated. Experts' and novices' performances differed significantly (P 0.8) for total bite size (P = .009, d = 1.5), travel (P = .045, d = 1.1), total bite-size-to-travel ratio (P algorithm can extract variables from digital images of a running suture and rapidly provide quantitative summative assessment feedback. The significant differences found between groups confirm that this system can discriminate between skill levels. This image analysis program represents a viable training tool for objectively assessing trainees' suturing, a foundational skill for many medical specialties.

  13. Virtual suturing simulation based on commodity physics engine for medical learning. (United States)

    Choi, Kup-Sze; Chan, Sze-Ho; Pang, Wai-Man


    Development of virtual-reality medical applications is usually a complicated and labour intensive task. This paper explores the feasibility of using commodity physics engine to develop a suturing simulator prototype for manual skills training in the fields of nursing and medicine, so as to enjoy the benefits of rapid development and hardware-accelerated computation. In the prototype, spring-connected boxes of finite dimension are used to simulate soft tissues, whereas needle and thread are modelled with chained segments. Spherical joints are used to simulate suture's flexibility and to facilitate thread cutting. An algorithm is developed to simulate needle insertion and thread advancement through the tissue. Two-handed manipulations and force feedback are enabled with two haptic devices. Experiments on the closure of a wound show that the prototype is able to simulate suturing procedures at interactive rates. The simulator is also used to study a curvature-adaptive suture modelling technique. Issues and limitations of the proposed approach and future development are discussed.

  14. Operative treatment of acromioclavicular joint dislocation: a new technique with suture anchors

    Directory of Open Access Journals (Sweden)

    Zhang Jingwei


    Full Text Available 【Abstract】Objective: To evaluate clinical outcome of suture anchors in strengthening both acromioclavicular and coracoclavicular ligaments in the surgical treatment of acromioclavicular joint dislocation. Methods: Twenty-eight patients with acute traumatic Rockwood III, IV and V dislocations of the acromioclavicular joint surgically treated at our institute between October 2010 and January 2012 were recruited. All patients underwent open reduction combined with suture anchors. Function was evaluated using the ConstantMurley shoulder score. Clinical and radiographic shoulder ratings were evaluated using Taft criteria at 3, 6 and 12 months. Results:Two cases with fixation loosening were not included in final statistical analysis. Other patients obtained full joint reposition on immediate postoperative radiographs. Follow-up was performed with an average of 15.6 months (range, 12-19. After early range of motion exercises, 96.2% of the patients (25/26 could abduct and elevate their shoulders more than 90 degrees within postoperative 3 months. There was no infection. Average Constant-Murley score was 96.3 points (range, 94-100 and mean Taft shoulder rating was 10.7 points (range, 8-12 at 12 months. Conclusion: The suture anchor is a relatively simple technique and can avoid screw removal which is helpful in reconstructing both acromioclavicular and coracoclavicular ligaments in acute traumatic acromioclavicular joint dislocation. Key words: Acromioclavicular joint; Dislocations; Surgery; Suture anchors

  15. Integration of potential and quasipotential geophysical fields and GPR data for delineation of buried karst terranes in complex environments (United States)

    Eppelbaum, L. V.; Alperovich, L. S.; Zheludev, V.; Ezersky, M.; Al-Zoubi, A.; Levi, E.


    Karst is found on particularly soluble rocks, especially limestone, marble, and dolomite (carbonate rocks), but is also developed on gypsum and rock salt. Subsurface carbonate rocks involved in karst groundwater circulation considerably extend the active karst realm, to perhaps 14% of the world's land area (Price, 2009). The phenomenon of the solution weathering of limestone is the most widely known in the world. Active sinkholes growth appears under different industrial constructions, roads, railways, bridges, airports, buildings, etc. Regions with arid and semi-arid climate occupy about 30% of the Earth's land. Subsurface in arid regions is characterized by high variability of physical properties both on lateral and vertical that complicates geophysical survey analysis. Therefore for localization and monitoring of karst terranes effective and reliable geophysical methodologies should be applied. Such advanced methods were developed in microgravity (Eppelbaum et al., 2008; Eppelbaum, 2011b), magnetic (Khesin et al., 1996; Eppelbaum et al., 2000, 2004; Eppelbaum, 2011a), induced polarization (Khesin et al., 1997; Eppelbaum and Khesin, 2002), VLF (Eppelbaum and Khesin, 1992; Eppelbaum and Mishne, 2012), near-surface temperature (Eppelbaum, 2009), self-potential (Khesin et al., 1996; Eppelbaum and Khesin, 2002), and resistivity (Eppelbaum, 1999, 2007a) surveys. Application of some of these methodologies in the western and eastern shores of the Dead Sea area (e.g., Eppelbaum et al., 2008; Ezersky et al., 2010; Al-Zoubi et al., 2011) and in other regions of the world (Eppelbaum, 2007a) has shown their effectiveness. The common procedures for ring structure identification against the noise background and probabilistic-deterministic methods for recognizing the desired targets in complex media are presented in Khesin and Eppelbaum (1997), Eppelbaum et al. (2003), and Eppelbaum (2007b). For integrated analysis of different geophysical fields (including GPR images) intended

  16. The Cannery Formation--Devonian to Early Permian arc-marginal deposits within the Alexander Terrane, Southeastern Alaska (United States)

    Karl, Susan M.; Layer, Paul W.; Harris, Anita G.; Haeussler, Peter J.; Murchey, Benita L.


    cherts on both Admiralty and Kupreanof Islands contain radiolarians as young as Permian, the age of the Cannery Formation is herein extended to Late Devonian through early Permian, to include the early Permian rocks exposed in its type locality. The Cannery Formation is folded and faulted, and its stratigraphic thickness is unknown but inferred to be several hundred meters. The Cannery Formation represents an extended period of marine deposition in moderately deep water, with slow rates of deposition and limited clastic input during Devonian through Pennsylvanian time and increasing argillaceous, volcaniclastic, and bioclastic input during the Permian. The Cannery Formation comprises upper Paleozoic rocks in the Alexander terrane of southeastern Alaska. In the pre-Permian upper Paleozoic, the tectonic setting of the Alexander terrane consisted of two or more evolved oceanic arcs. The lower Permian section is represented by a distinctive suite of rocks in the Alexander terrane, which includes sedimentary and volcanic rocks containing early Permian fossils, metamorphosed rocks with early Permian cooling ages, and intrusive rocks with early Permian cooling ages, that form discrete northwest-trending belts. After restoration of 180 km of dextral displacement of the Chilkat-Chichagof block on the Chatham Strait Fault, these belts consist, from northeast to southwest, of (1) bedded chert, siliceous argillite, volcaniclastic turbidites, pillow basalt, and limestone of the Cannery Formation and the Porcupine Slate of Gilbert and others (1987); (2) greenschist-facies Paleozoic metasedimentary and metavolcanic rocks that have Permian cooling ages; (3) silty limestone and calcareous argillite interbedded with pillow basalt and volcaniclastic rocks of the Halleck Formation and the William Henry Bay area; and (4) intermediate-composition and syenitic plutons. These belts correspond to components of an accretionary complex, contemporary metamorphic rocks, forearc-basin deposits,

  17. [Clinical research of arthroscopic separate double-layer suture bridge technique for delaminated rotator cuff tear]. (United States)

    Ren, Jiangtao; Xu, Cong; Liu, Xianglin; Wang, Jiansong; Li, Zhihuai; Lü, Yongming


    To explore the effectiveness of the arthroscopic separate double-layer suture bridge technique in treatment of the delaminated rotator cuff tear. Between May 2013 and May 2015, 54 patients with the delaminated rotator cuff tears were recruited in the study. They were randomly allocated into 2 groups to receive repair either using arthroscopic separate double-layer suture bridge technique (trial group, n =28) or using arthroscopic whole-layer suture bridge technique (control group, n =26). There was no significant difference in gender, age, injured side, tear type, and preoperative visual analogue scale (VAS) score, Constants score, American Shoulder and Elbow Surgeons (ASES) score, University of California Los Angeles (UCLA) score, and the range of motion of shoulder joint between 2 groups ( P >0.05). Postoperative functional scores, range of motion, and recurrence rate of tear in 2 groups were observed and compared. The operation time was significant longer in trial group than in control group ( t =8.383, P =0.000). All incisions healed at stage Ⅰ without postoperative complication. All the patients were followed up 12 months. At 12 months postoperatively, the UCLA score, ASES score, VAS score, Constant score, and the range of motion were significantly improved when compared with the preoperative values in 2 groups ( P 0.05). Four cases (14.3%) of rotator cuff tear recurred in trial group while 5 cases (19.2%) in control group, showing no significant difference ( χ 2 =0.237, P =0.626). Compared with the arthroscopic whole-layer suture bridge technique, arthroscopic separate double-layer suture bridge technique presents no significant difference in the shoulder function score, the range of motion, and recurrence of rotator cuff tear, while having a longer operation time.

  18. Flexor tendon repair with a knotless, bidirectional barbed suture: an in vivo biomechanical analysis. (United States)

    Maddox, Grady E; Ludwig, Jonathan; Craig, Eric R; Woods, David; Joiner, Aaron; Chaudhari, Nilesh; Killingsworth, Cheryl; Siegal, Gene P; Eberhardt, Alan; Ponce, Brent


    To compare and analyze biomechanical properties and histological characteristics of flexor tendons either repaired by a 4-strand modified Kessler technique or using barbed suture with a knotless repair technique in an in vivo model. A total of 25 chickens underwent surgical transection of the flexor digitorum profundus tendon followed by either a 4-strand Kessler repair or a knotless repair with barbed suture. Chickens were randomly assigned to 1 of 3 groups with various postoperative times to death. Harvested tendons were subjected to biomechanical testing or histologic analysis. Harvested tendons revealed failures in 25% of knotless repairs (8 of 32) and 8% of 4-strand Kessler repairs (2 of 24). Biomechanical testing revealed no significant difference in tensile strength between 4-strand Kessler and barbed repairs; however, this lack of difference may be attributed to lower statistical power. We noted a trend toward a gradual decrease in strength over time for barbed repairs, whereas we noticed the opposite for the 4-strand Kessler repairs. Mode of failure during testing differed between repair types. The barbed repairs tended toward suture breakage as opposed to 4-strand Kessler repairs, which demonstrated suture pullout. Histological analysis identified no difference in the degree of inflammation or fibrosis; however, there was a vigorous foreign body reaction around the 4-strand Kessler repair and no such response around the barbed repairs. In this model, knotless barbed repairs trended toward higher in vivo failure rates and biomechanical inferiority under physiologic conditions, with each repair technique differing in mode of failure and respective histologic reaction. We are unable to recommend the use of knotless barbed repair over the 4-strand modified Kessler technique. For the repair techniques tested, surgeons should prefer standard Kessler repairs over the described knotless technique with barbed suture. Copyright © 2015 American Society for Surgery

  19. The extent of adhesion induction through electrocoagulation and suturing in an experimental rat study. (United States)

    Wallwiener, Christian W; Kraemer, Bernhard; Wallwiener, Markus; Brochhausen, Christoph; Isaacson, Keith B; Rajab, Taufiek K


    To investigate the effect of three types of peritoneal trauma occurring during surgery (high-frequency bipolar current, suturing, and mechanical damage) on postoperative adhesion formation in a rodent animal model. Randomized, controlled experimental trial in an in vitro animal model. Laboratory facilities of a university department of obstetrics and gynecology. Thirty-five female Wistar rats. Bilateral experimental lesions were created on the abdominal wall in every animal. The effect of minimal electrocoagulation was examined by creating lesions (n = 14) through sweeps of a bipolar forceps with a duration of 1 second and standardized pressure. For extensive electrocoagulation standardized lesions (n = 14) were created using sweeps of a duration of 3 seconds and three times more pressure. For mechanical trauma, standardized lesions (n = 14) were created by denuding the peritoneum mechanically. To study the additive effect of suturing, experimental lesions were created by suturing plus minimal electrocoagulation (n = 14) or mechanical denuding (n = 14). Adhesion incidence, quantity, and quality of the resulting adhesions were scored 14 days postoperatively. Adhesions were studied histopathologically. Mechanical denuding of the peritoneum did not result in adhesion formation. After minimal electrocoagulation, mean adhesion quantity of the traumatized area averaged 0%. This contrasted with extensive electrocoagulation, where there was 50% adhesion. Additional suturing increased mean adhesion quantity to 73% and 64% for superficial electrocoagulation and mechanical denuding, respectively. We conclude that superficial trauma limited mostly to the parietal peritoneum may be a negligible factor in adhesion formation in this model. This appears to be irrespective of the mode of trauma. However, additional trauma to the underlying tissues, either by deeper electrocoagulation or suturing, leads to significantly increased adhesion formation. These data also show that there

  20. Suture spanning augmentation of single-row rotator cuff repair: a biomechanical analysis. (United States)

    Early, Nicholas A; Elias, John J; Lippitt, Steven B; Filipkowski, Danielle E; Pedowitz, Robert A; Ciccone, William J


    This in vitro study evaluated the biomechanical benefit of adding spanning sutures to single-row rotator cuff repair. Mechanical testing was performed to evaluate 9 pairs of cadaveric shoulders with complete rotator cuff repairs, with a single-row technique used on one side and the suture spanning technique on the other. The spanning technique included sutures from 2 lateral anchors securing tendon near the musculotendinous junction, spanning the same anchor placement from single-row repair. The supraspinatus muscle was loaded to 100 N at 0.25 Hz for 100 cycles, followed by a ramp to failure. Markers and a video tracking system measured anterior and posterior gap formation across the repair at 25-cycle intervals. The force at which the stiffness decreased by 50% and 75% was determined. Data were compared using paired t-tests. One single-row repair failed at row repairs than for the suture spanning technique. The difference was statistically significant at all cycles for the posterior gap formation (P ≤ .02). The trends were not significant for the anterior gap (P ≥ .13). The loads at which the stiffness decreased by 50% and 75% did not differ significantly between the 2 types of repair (P ≥ .10). The suture spanning technique primarily improved posterior gap formation. Decreased posterior gap formation could reduce failure rates for rotator cuff repair. Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  1. Adjustable suture strabismus surgery in infants and children: a 19-year experience. (United States)

    Kassem, Ahmed; Xue, Gilbert; Gandhi, Niral B; Tian, Jing; Guyton, David L


    To evaluate the success rate of adjustable suture techniques in horizontal eye muscle surgery in children ≤15 years of age over a 19-year period by a single surgeon. The medical records of all consecutive patients in this age group who underwent horizontal eye muscle surgery from 1989 through 2012 were reviewed retrospectively. Patients were divided into two groups: those in whom a nonadjustable suture technique was used and those in whom adjustable sutures were used. The following data were collected: type of strabismus, preoperative measurements, postoperative results, and reoperation rates. A total of 116 cases in the nonadjustable group and 521 cases in the adjustable group were included. In the adjustable group, adjustment was performed in 63% of the cases, because of either an under- (41%) or overcorrection (22%). The adjustment procedure was performed under topical proparacaine in 15% of cases and under intravenous propofol in 85%. For the adjustable group, 3-5 minutes more per muscle intraoperatively and 15-20 minutes for adjustment were required. No complications were encountered during the adjustment procedures. Early success rate, defined as alignment within 8 Δ of straight at 3 to 6 months' postoperative follow-up, was significantly greater in the adjustable group than in the nonadjustable group (77.7% vs 64.6% [P ≤ 0.03]). Of the adjustable patients, 15% required reoperation compared with 21% of the nonadjustable patients. Use of adjustable sutures in horizontal eye muscle surgery in children ≤15 years of age provided an improved success rate and fewer reoperations compared with nonadjustable sutures. Copyright © 2018 American Association for Pediatric Ophthalmology and Strabismus. Published by Elsevier Inc. All rights reserved.

  2. On the metamorphic history of an Archaean granitoid greenstone terrane, East Pilbara, Western Australia, using the 40Ar/39Ar age spectrum technique

    International Nuclear Information System (INIS)

    Wijbrans, J.R.; McDougall, I.


    Age spectrum analyses of blue-green hornblendes from amphibolites from the Western Shaw Belt, East Pilbara, Western Australia, indicate an age of at least 3200 Ma for early regional metamorphism. Ages on hornblende and muscovite from the narrow contact zone with the adjacent Yule Batholith probably data updoming of the granitoid gneiss terranes at 2950 Ma. Hornblendes from within the Shaw Batholith and from a contact zone of a post-tectonic granitoid yield ages of 2840-2900 Ma, indicating either prolonged high temperatures within the granitoid gneiss terranes or a separate thermal pulse associated with the intrusion of post-tectonic granitoids. The preservation of very old hornblendes in a narrow greenstone belt surrounded by massive granitoid gneiss domes indicates that remarkable contrasts in metamorphic geotherms existed over short distances during the Late Archaean, suggesting that updoming occurred during a period of rapid tectonism. (orig.)

  3. On the metamorphic history of an Archaean granitoid greenstone terrane, East Pilbara, Western Australia, using the /sup 40/Ar//sup 39/Ar age spectrum technique

    Energy Technology Data Exchange (ETDEWEB)

    Wijbrans, J.R.; McDougall, I.


    Age spectrum analyses of blue-green hornblendes from amphibolites from the Western Shaw Belt, East Pilbara, Western Australia, indicate an age of at least 3200 Ma for early regional metamorphism. Ages on hornblende and muscovite from the narrow contact zone with the adjacent Yule Batholith probably data updoming of the granitoid gneiss terranes at 2950 Ma. Hornblendes from within the Shaw Batholith and from a contact zone of a post-tectonic granitoid yield ages of 2840-2900 Ma, indicating either prolonged high temperatures within the granitoid gneiss terranes or a separate thermal pulse associated with the intrusion of post-tectonic granitoids. The preservation of very old hornblendes in a narrow greenstone belt surrounded by massive granitoid gneiss domes indicates that remarkable contrasts in metamorphic geotherms existed over short distances during the Late Archaean, suggesting that updoming occurred during a period of rapid tectonism.

  4. Paleomagnetism of Early Paleozoic Rocks from the de Long Archipelago and Tectonics of the New Siberian Islands Terrane (United States)

    Metelkin, D. V.; Chernova, A. I.; Matushkin, N. Y.; Vernikovskiy, V. A.


    The De Long archipelago is located to the north of the Anjou archipelago as a part of a large group between the Laptev Sea and the East Siberian Sea - the New Siberian Islands and consists of Jeannette Island, Bennett Island and Henrietta Island. These islands have been shown to be part of a single continental terrane, whose tectonic history was independent of other continental masses at least since the Ordovician. Paleomagnetic and precise geological data for the De Long archipelago were absent until recently. Only in 2013 special international field trips to the De Long Islands could be organized and geological, isotope-geochronological and paleomagnetic studies were carried out.On Jeannette Island a volcanic-sedimentary sequence intruded by mafic dikes was described. The age of these dikes is more likely Early Ordovician, close to 480 Ma, as evidenced by the results of our 40Ar/39Ar and paleomagnetic investigations of the dolerites as well as the result from detrital zircons in the host rocks published before. On Bennett Island, there are widespread Cambrian-Ordovician mainly terrigenous rocks. Paleomagnetic results from these rocks characterize the paleogeographic position of the De Long archipelago at 465 Ma and perhaps at 530 Ma, although there is no evidence for the primary origin of magnetization for the latter. On Henrietta Island the Early Cambrian volcanic-sedimentary section was investigated. A paleomagnetic pole for 520 Ma was obtained and confirmed by new 40Ar/39Ar results. Adding to our previous paleomagnetic data for the Anjou archipelago the extended variant of the apparent polar wander path for the New Siberian Island terrane was created. The established paleolatitudes define its location in the equatorial and subtropical zone no higher than 40 degrees during the Early Paleozoic. Because there are no good confirmations for true polarity and related geographic hemisphere we present two possibilities for tectonic reconstruction. But both these

  5. Paleomagnetic data from the Caborca terrane, Mexico: Implications for Cordilleran tectonics and the Mojave-Sonora megashear hypothesis (United States)

    Molina Garza, Roberto S.; Geissman, John W.


    Two ancient magnetizations have been isolated in rocks of the Caborca terrane, northwest Mexico. The characteristic magnetizations of Neoproterozoic and Paleozoic miogeoclinal shelf-strata, arc-derived Lower Jurassic marine strata, and Jurassic volcanic and volcaniclastic rocks are of dual polarity and east-northeast declination (or south-southwest) and shallow inclination. Magnetizations in Neoproterozoic and Paleozoic miogeoclinal strata are interpreted as secondary (J*) and to be of similar age to those observed in Lower and Middle Jurassic rocks. Remanence acquisition is bracketed between about 190 and 160 Ma. The overall mean (D=15.0°, I=8.5° n=38 sites; six localities; k=19.1, α95=5.5°) suggests a moderate to large clockwise rotation of 12 to 50° (depending on reference direction assumed) of the Caborca terrane, and rocks of the Sonoran segment of the Cordilleran volcanic arc, with respect to the North America craton. When compared with expected inclinations, observed values are not anomalously steep, arguing against statistically significant southward latitudinal displacement of the Caborca block after remanence acquisition. Late Cretaceous intrusions yield primary, dual-polarity steep inclination ``K'' magnetizations (D=341.4°, I=52.3° n=10 sites; five localities; k=38.3, α95=7.9°) and have locally remagnetized Neoproterozoic and Jurassic strata. When present, secondary (K*) magnetizations in Neoproterozoic strata are of higher coercivity and higher unblocking temperature than the characteristic (J*) magnetization. Importantly, the regional internal consistency of data for Late Cretaceous intrusions suggests that effects of Tertiary tilt or rotation about a vertical axis over the broad region sampled (~5000 km2) are not substantial. Late Cretaceous primary (K) magnetizations and secondary (K*) magnetizations yield a combined mean of D=348.1°, I=50.7° (N=10 localities; 47 sites; k=53.5, α95=6.7°), indicating at most small (displacement is near

  6. Early Cretaceous I-type granites in the Tengchong terrane: New constraints on the late Mesozoic tectonic evolution of southwestern China

    Directory of Open Access Journals (Sweden)

    Yi Fang


    Full Text Available The Early Cretaceous granitoids that are widespread in the Tengchong terrane of Southwest China play a critical role in understanding the tectonic framework associated with the Tethyan oceans. In this study, we present a detailed description of zircon U–Pb ages, whole-rock geochemistry and Hf isotopes for the Laoxiangkeng pluton in the eastern Tengchong terrane and elucidate their petrogenesis and geodynamic implications. Zircon U–Pb dating of the Laoxiangkeng pluton yields ages of 114 ± 1 Ma and 115 ± 1 Ma, which imply an Early Cretaceous magmatic event. The Laoxiangkeng pluton enriched in Si and Na, is calc-alkaline and metaluminous, and has the characteristics of highly fractionated I-type granites. Zircons from the pluton have calculated εHf(t values of −12.7 to −3.7 and two-stage model ages of 1327–1974 Ma, respectively, indicating a mixed source of partial melting of Paleo-Neoproterozoic crust-derived compositions with some inputs of mantle-derived magmas. By integrating all available data for the regional tectonic evolution of the eastern Tethys tectonic domain, we conclude that the Early Cretaceous magmatism in the Tengchong terrane was produced by the northeastward subduction of the Meso-Tethyan Bangong–Nujiang Ocean.

  7. The tectono-magmatic evolution of the occidental terrane and the Paraiba do Sul Klippe within the Neoproterozoic Ribeira orogenic Belt, Southeastern Brazil

    International Nuclear Information System (INIS)

    Valladares, Claudia Sayao; Duarte, Beatriz Paschoal; Heilbron, Monica; Ragatky, Diana


    The occidental Terrane is envisaged as the eastern/southeastern reworked margin of the Sao Francisco/Rio de la Plata plate associated with and E-trending subduction under the Congo plate. The Paraiba do Sul Klippe is part of the Oriental Terrane, envisaged as a portion of the Congo plate. A collisional-stage resulted in intense westward deformation of the Occidental Terrane under intermediate pressure metamorphism (syn-D1+D2 events). A late-collisional stage resulted in subvertical folding and steep shear zones (D3 event). Both stages were associated with voluminous crustal-derived granites. U-Pb and Sm-Nd geochronology as well as geochemical and structural data point to three magmatic episodes: a syn-collisional stage 1; a syn-collisional stage 2; and a late-collisional stage. This paper presents a magmatic evolutionary model for this crustal segment of the Ribeira orogenic belt based on new geological data of Brasiliano granites and data available in the literature. (author)

  8. Petrography and geochronology (U/Pb-Sm/Nd) the Passagem Granite, Pensamiento Granitoid Complex, Paragua Terrane, SW Amazon Craton, Mato Grosso, Brazil

    International Nuclear Information System (INIS)

    Jesus, Gisely Carmo de; Sousa, Maria Zelia Aguiar de; Ruiz, Amarildo Salina; Matos, Joao Batista de


    The Passagem granite includes stocks, plugs and dikes located in the Ricardo Franco hill - Vila Bela da Santissima Trindade region - state of Mato Grosso, central Brazil. The Passagem Granite is included in the Paragua terrane - SW Amazonian Craton. It consists of isotropic monzogranite, sienogranite and more rarely granodiorites with leucocratic dark gray to white color. These rocks range from hypidomorphic inequigranular to xenomorphic texture, fine to medium grained. Biotite is the only primary mafic present as essential phase and characterize an expanded slightly acid sequence formed by a sub-alkaline magmatism of high-potassium calc-alkaline, slightly peraluminous composition from arc magmatic tectonic environment during a post-collisional period. Mechanism of fractional crystallization of plagioclase, biotite, titanite, apatite and zircon associated with simultaneous crustal assimilation are suggested for the evolution of these rocks. The results support the hypothesis of a post-collisional magmatism in the Paragua terrane at 1284 +- 20 Ma corresponding to the crystallization age of the Passagem granite. This paper propose that Passagem Granite represents as an extension in Brazilian terrane of the Pensamiento Granitoid Complex. (author)

  9. Radiological assessment of skull base changes in children with syndromic craniosynostosis: role of ''minor'' sutures

    Energy Technology Data Exchange (ETDEWEB)

    Calandrelli, Rosalinda; D' Apolito, Gabriella; Gaudino, Simona; Stefanetti, Mariangela; Colosimo, Cesare [Universita Cattolica Sacro Cuore, Institute of Radiology, Rome (Italy); Massimi, Luca; Di Rocco, Concezio [Universita Cattolica Sacro Cuore, Institute of Neurosurgery, Rome (Italy)


    This study aims to identify the premature synostosis of ''major'' and ''minor'' sutures of the four ''sutural arches'' of the skull and to perform a morphometric analysis in children with syndromic craniosynostosis in order to evaluate changes in the skull base linked with premature suture synostosis. We reviewed multiplanar high-resolution CT images, implemented with 3D reconstructions, from 18 patients with complex syndromic craniosynostosis and compared them with 18 age-matched healthy subjects. We assessed the calvarial sutures and their extension to the skull base, and then we correlated specific types of synostosis with the size, shape and symmetry of the cranial fossae. We found a marked asymmetry of the skull base growth in all patients. The synostotic involvement around the coronal ring caused a reduction in the growth of the anterior and middle fossae. The size of the posterior cranial fossa was related not only to ''major'' but also to ''minor'' suture synostosis of the lambdoid and parieto-squamosal arches. Changes in the skull base and craniofacial axis symmetry are due to structural and functional relationships between ''major'' and ''minor'' skull sutures, suggesting a structural and functional relationship between the neurocranium and basicranium. The early recognition of prematurely closed skull base sutures may help clinicians and neurosurgeons to establish correct therapeutic approaches. (orig.)

  10. Four-Strand Core Suture Improves Flexor Tendon Repair Compared to Two-Strand Technique in a Rabbit Model

    Directory of Open Access Journals (Sweden)

    Alice Wichelhaus


    Full Text Available Introduction. This study was designed to investigate the influence of the amount of suture material on the formation of peritendinous adhesions of intrasynovial flexor tendon repairs. Materials and Methods. In 14 rabbits, the flexor tendons of the third and the fourth digit of the right hind leg were cut and repaired using a 2- or 4-strand core suture technique. The repaired tendons were harvested after three and eight weeks. The range of motion of the affected toes was measured and the tendons were processed histologically. The distance between the transected tendon ends, the changes in the peritendinous space, and cellular and extracellular inflammatory reaction were quantified by different staining. Results. A 4-strand core suture resulted in significantly less gap formation. The 2-strand core suture showed a tendency to less adhesion formation. Doubling of the intratendinous suture material was accompanied by an initial increase in leukocyte infiltration and showed a greater amount of formation of myofibroblasts. From the third to the eighth week after flexor tendon repair, both the cellular and the extracellular inflammation decreased significantly. Conclusion. A 4-strand core suture repair leads to a significantly better tendon healing process with less diastasis between the sutured tendon ends despite initially pronounced inflammatory response.

  11. The optimum tension for bridging sutures in transosseous-equivalent rotator cuff repair: a cadaveric biomechanical study. (United States)

    Park, Ji Soon; McGarry, Michelle H; Campbell, Sean T; Seo, Hyuk Jun; Lee, Yeon Soo; Kim, Sae Hoon; Lee, Thay Q; Oh, Joo Han


    Transosseous-equivalent (TOE) rotator cuff repair can increase contact area and contact pressure between the repaired cuff tendon and bony footprint and can show higher ultimate loads to failure and smaller gap formation compared with other repair techniques. However, it has been suggested that medial rotator cuff failure after TOE repair may result from increased bridging suture tension. To determine optimum bridging suture tension in TOE repair by evaluating footprint contact and construct failure characteristics at different tensions. Controlled laboratory study. A total of 18 fresh-frozen cadaveric shoulders, randomly divided into 3 groups, were constructed with a TOE configuration using the same medial suture anchor and placing a Tekscan sensing pad between the repaired rotator cuff tendon and footprint. Nine of the 18 shoulders were used to measure footprint contact characteristics. With use of the Tekscan measurement system, the contact pressure and area between the rotator cuff tendon and greater tuberosity were quantified for bridging suture tensions of 60, 90, and 120 N with glenohumeral abduction angles of 0° and 30° and humeral rotation angles of 30° (internal), 0°, and 30° (external). TOE constructs of all 18 shoulders then underwent construct failure testing (cyclic loading and load to failure) to determine the yield load, ultimate load, stiffness, hysteresis, strain, and failure mode at 60 and 120 N of tension. As bridging suture tension increased, contact force, contact pressure, and peak pressure increased significantly at all positions (P .05 for all). Increasing bridging suture tension to over 90 N did not improve contact area but did increase contact force and pressure. Bridging suture tension did not significantly affect ultimate failure loads. Considering the risks of overtensioning bridging sutures, it may be clinically more beneficial to keep bridging suture tension below 90 N. © 2015 The Author(s).

  12. Ancient terrane boundaries as probable seismic hazards: A case study from the northern boundary of the Eastern Ghats Belt, India

    Directory of Open Access Journals (Sweden)

    Saibal Gupta


    Full Text Available In the eastern part of the Indian shield, late Paleozoic–Mesozoic sedimentary rocks of the Talchir Basin lie precisely along a contact of Neoproterozoic age between granulites of the Eastern Ghats Mobile Belt (EGMB and amphibolite facies rocks of the Rengali Province. At present, the northern part of the basin experiences periodic seismicity by reactivation of faults located both within the basin, and in the Rengali Province to the north. Detailed gravity data collected across the basin show that Bouguer anomalies decrease from the EGMB (∼+15 mGal, through the basin (∼−10 mGal, into the Rengali Province (∼−15 mGal. The data are consistent with the reportedly uncompensated nature of the EGMB, and indicate that the crust below the Rengali Province has a cratonic gravity signature. The contact between the two domains with distinct sub-surface structure, inferred from gravity data, coincides with the North Orissa Boundary Fault (NOBF that defines the northern boundary of the Talchir Basin. Post-Gondwana faults are also localized along the northern margin of the basin, and present-day seismic tremors also have epicenters close to the NOBF. This indicates that the NOBF was formed by reactivation of a Neoproterozoic terrane boundary, and continues to be susceptible to seismic activity even at the present-day.

  13. [The speed of nerve-conduction after micro-surgical suture of the tibial nerve of the rabbit (author's transl)]. (United States)

    Weigert, M; Mellerowicz, H; Werhahn, C


    Isolated division of the tibial nerve in the thigh preserving the peroneal and sural nerves does not cause loss of normal position of the animal, in particular of sitting. Nor does it lead to pressure sores. The animals are fitter then after division of the sciatic nerve. Microsurgical suture of the isolated tibial nerve in the thigh of the rabbit with 1 or 2 simple sutures with 10 x 0 thread show that an average recovery can be achieved in over 80 per cent. As few sutures as possible should be used. Otherwise there with be scarring and no return of function.

  14. Impingement syndrome of the shoulder following double row suture anchor technique for arthroscopic rotator cuff repair: a case report

    Directory of Open Access Journals (Sweden)

    Rambani Rohit


    Full Text Available Abstract Introduction Arthroscopic repair of the rotator cuff is a demanding surgery. Accurate placement of anchors is key to success. Case presentation A 38-year-old woman received arthroscopic repair of her rotator cuff using a double row suture anchor technique. Postoperatively, she developed impingement syndrome which resulted from vertical displacement of a suture anchor once the shoulder was mobilised. The anchor was removed eight weeks following initial surgery and the patient had an uneventful recovery. Conclusion Impingement syndrome following arthroscopic repair of the rotator cuffs using double row suture anchor has not been widely reported. This is the first such case where anchoring has resulted in impingement syndrome.

  15. Bridging suture makes consistent and secure fixation in double-row rotator cuff repair. (United States)

    Fukuhara, Tetsutaro; Mihata, Teruhisa; Jun, Bong Jae; Neo, Masashi


    Inconsistent tension distribution may decrease the biomechanical properties of the rotator cuff tendon after double-row repair, resulting in repair failure. The purpose of this study was to compare the tension distribution along the repaired rotator cuff tendon among three double-row repair techniques. In each of 42 fresh-frozen porcine shoulders, a simulated infraspinatus tendon tear was repaired by using 1 of 3 double-row techniques: (1) conventional double-row repair (no bridging suture); (2) transosseous-equivalent repair (bridging suture alone); and (3) compression double-row repair (which combined conventional double-row and bridging sutures). Each specimen underwent cyclic testing at a simulated shoulder abduction angle of 0° or 40° on a material-testing machine. Gap formation and tendon strain were measured during the 1st and 30th cycles. To evaluate tension distribution after cuff repair, difference in gap and tendon strain between the superior and inferior fixations was compared among three double-row techniques. At an abduction angle of 0°, gap formation after either transosseous-equivalent or compression double-row repair was significantly less than that after conventional double-row repair (p row repair (p = 0.01) at 0° abduction had significantly less difference in gap formation between the superior and inferior fixations than did conventional double-row repair. After the 30th cycle, the difference in longitudinal strain between the superior and inferior fixations at 0° abduction was significantly less with compression double-row repair (2.7% ± 2.4%) than with conventional double-row repair (8.6% ± 5.5%, p = 0.03). Bridging sutures facilitate consistent and secure fixation in double-row rotator cuff repairs, suggesting that bridging sutures may be beneficial for distributing tension equally among all sutures during double-row repair of rotator cuff tears. Copyright © 2017 The Japanese Orthopaedic Association. Published by Elsevier B

  16. An evolving tectonic environment of Late Carboniferous to Early Permian granitic plutons in the Chinese Altai and Eastern Junggar terranes, Central Asian Orogenic Belt, NW China (United States)

    Zhang, Chen; Liu, Dongdong; Luo, Qun; Liu, Luofu; Zhang, Yunzhao; Zhu, Deyu; Wang, Pengfei; Dai, Quanqi


    The Central Asian Orogenic Belt (CAOB) represents one of the most important sites of juvenile crustal growth during the Phanerozoic. Located in the central part of the CAOB, the Chinese Altai and Eastern Junggar terranes record the collisional processes between the peri-Siberian and Kazakhstan orogenic systems. However, the precise timing of collision between the two terranes remains controversial. The Wukuli and Kadelat plutons in the Chinese Altai belt are dated at ∼305 and ∼280 Ma respectively, whereas the Aketas pluton in the Eastern Junggar terrane is dated at ∼308 Ma. Granites from the Wukuli and Kadelat plutons are strongly peraluminous (A/CNK > 1.1), and are characterized by low Al2O3, Na2O, MnO, MgO, CaO and heavy rare earth element (HREE) contents, but with high SiO2, K2O and Rb contents as well as high Rb/Sr ratios. Granites from the Wukuli pluton have low εNd(t) and εHf(t) values of -3.7 to -3.4 and -9.7 to +4.9, whereas those from the Kadelat pluton have values of -3.6 to -3.4 and -8.0 to +2.6. These features suggest S-type affinity for the Wukuli and Kadelat plutons with magma derivation through partial melting of Mesoproterozoic metasediments. The Aketas pluton is composed of weakly peraluminous quartz monzonites that have A/CNK values ranging from 0.92 to 1.08, with high Na2O, Sr, and Sr/Y, and low Y, Yb, Nb, and Ta. These rocks display positive εNd(t) (+4.8 to +6.4) and εHf(t) (+9.7 to +14.6) values, and low initial 87Sr/86Sr ratios (0.703357-0.703868), similar to modern adakites, suggesting that the quartz monzonites were derived from the partial melting of lower crustal material. The geochemical characteristics suggest that the Aketas pluton was formed in a subduction-related setting, the Wukuli pluton in a syn-collisional setting, and the Kadelat pluton in the subsequent post-orogenic strike-slip-related setting. In combination with data from other granitoids in these two terranes, the Aketas pluton represents the youngest record of

  17. The role of the sutures in biomechanical dynamic simulation of a macaque cranial finite element model: Implications for the evolution of craniofacial form (United States)

    Wang, Qian; Wood, Sarah A.; Grosse, Ian R.; Ross, Callum F.; Zapata, Uriel; Byron, Craig D.; Wright, Barth W.; Strait, David S.


    The global biomechanical impact of cranial sutures on the face and cranium during dynamic conditions is not well understood. It is hypothesized that sutures act as energy absorbers protecting skulls subjected to dynamic loads. This hypothesis predicts that sutures have a significant impact on global patterns of strain and cranial structural stiffness when analyzed using dynamic simulations; and that this global impact is influenced by suture material properties. In a finite element model developed from a juvenile Rhesus macaque cranium, five different sets of suture material properties for the zygomaticotemporal sutures were tested. The static and dynamic analyses produced similar results in terms of strain patterns and reaction forces, indicating that the zygomaticotemporal sutures have limited impact on global skull mechanics regardless of loading design. Contrary to the functional hypothesis tested here, the zygomaticotemporal sutures did not absorb significant amounts of energy during dynamic simulations regardless of loading speed. It is alternatively hypothesized that sutures are mechanically significant only insofar as they are weak points on the cranium that must be shielded from unduly high stresses so as not to disrupt vitally important growth processes. Thus, sutural and overall cranial form in some vertebrates may be optimized to minimize or otherwise modulate sutural stress and strain. PMID:22190334

  18. Relative efficacy of the argon green, argon blue-green, and krypton red lasers for 10-0 nylon subconjunctival laser suture lysis. (United States)

    Mudgil, A V; To, K W; Balachandran, R M; Janigian, R H; Tsiaras, W G


    To determine the optimal wavelength for subconjunctival laser suture lysis. 130 black monofilament 10-0 nylon sutures were sewn subconjunctivally into the bare sclera of enucleated rabbit globes. The lowest energy levels facilitating laser suture lysis were determined for the argon green (514.5 NM), argon blue-green (488.0 NM, 514.5 NM), and krypton red (647.1 NM) wavelengths. In addition, absorption spectroscopy was performed on the suture material and conjunctiva using the Perkin Elmer W/VIS Lambda 2 spectrometer. Krypton red produced the fewest buttonhole defects, and it was also the most efficient energy source for suture lysis (P = 0.0001) under nontenectomized conjunctiva. Absorbance spectra studies revealed peak absorbance at 628 NM for the 10-0 nylon suture material. Based on animal and absorption spectroscopy studies, krypton red may be a safer and more efficient wavelength for subconjunctival laser suture lysis.

  19. Surgical suture braided with a diclofenac-loaded strand of poly(lactic-co-glycolic acid) for local, sustained pain mitigation. (United States)

    Huh, Beom Kang; Kim, Byung Hwi; Kim, Se-Na; Park, Chun Gwon; Lee, Seung Ho; Kim, Ka Ryeong; Heo, Chan Yeong; Choy, Young Bin


    In this work, we propose a surgical suture that can sustainably release diclofenac (DF) for the local pain relief of surgical wounds. We separately fabricated a DF-loaded strand composed of a biodegradable polymer, poly(lactic-co-glycolic acid) (PLGA), which was then braided with a surgical suture already in clinical use, i.e., VICRYL™. In this way, the drug-delivery suture presented herein could release DF in a sustained manner for 10days while maintaining the mechanical strength needed for wound closure. According to the in vivo results of an induced-pain animal model, the drug-delivery suture mitigated pain throughout the period of persistent pain. The histological analysis of tissue around the sutures showed that the drug-delivery suture exhibited biocompatibility comparable to that of the VICRYL™ suture in clinical use. Copyright © 2017 Elsevier B.V. All rights reserved.

  20. The Rhyacian El Cortijo suture zone: Aeromagnetic signature and insights for the geodynamic evolution of the southwestern Rio de la Plata craton, Argentina

    Directory of Open Access Journals (Sweden)

    Carlos J. Chernicoff


    We envisage the pre-Neoproterozoic evolution of the Tandilia belt to have been initiated by the extension of Neoarchean (∼2650 Ma crust occurred during Siderian times (2500–2300 Ma, causing the separation between the Balcarce, Tandilia and Buenos Aires terranes, and the development of narrow oceans at both north and south sides of the Tandilia terrane, accompanied by ∼2300–2200 Ma sedimentation over transitional –continental to oceanic– crust, and arc magmatism developed in the Tandilia terrane. The island arc represented by the El Cortijo Formation was also developed at this time. At late Rhyacian times, it occurred in both the closure of the narrow oceans developed previously, the entrapment of the El Cortijo island arc, as well as anatectic magmatism in the Balcarce terrane.

  1. A randomized study comparing skin closure in cesarean sections: staples vs subcuticular sutures. (United States)

    Rousseau, Julie-Anne; Girard, Karine; Turcot-Lemay, Lucile; Thomas, Nancy


    We sought to compare postoperative pain according to the skin closure method (subcuticular sutures vs staples) after an elective term cesarean section. A randomized controlled trial of 101 women was performed. Women were randomly assigned to subcuticular sutures or staples. Operative technique and postoperative analgesia were standardized. Stratification was used for primary vs repeat cesareans. Analog pain and satisfaction scales ranging from 0-10 were completed at postoperative days 1 and 3, and at 6 weeks postoperatively. A digital photograph of the incision was taken at 6 weeks postoperatively and evaluated by 3 independent blinded observers. Pain at 6 weeks postoperatively was significantly less in the staple group (0.17 vs 0.51; P = .04). Operative time was shorter in that group (24.6 vs 32.9 minutes; P women's satisfaction. Staples are the method of choice for skin closure for elective term cesareans in our population.

  2. Traction endurance biomechanical study of metallic suture anchors at different insertion angles

    Directory of Open Access Journals (Sweden)

    Azato Flávia Namie


    Full Text Available The suture anchors' insertion angle and its traction resistance are the main subjects of this study. Twenty trials were realized using threaded suture anchors in four diferents angulations (30º /45º /60º /90º in human bone (distal femur and another twenty trials in artificial bone (SawboneTM. The anchors were pulled out being tractioned uprightly from its bone surface by a Kratos Universal test machine. The human bone results found no relation between the main subjects of this study, so whithout statistical value. On the other hand at the artificial bone the insertion angle of 90º beared more traction, being statistically significant compared to the other angles.

  3. Achondroplasia with multiple-suture craniosynostosis: a report of a new case of this rare association. (United States)

    Bessenyei, Beáta; Nagy, Andrea; Balogh, Erzsébet; Novák, László; Bognár, László; Knegt, Alida C; Oláh, Eva


    We report on a female patient with an exceedingly rare combination of achondroplasia and multiple-suture craniosynostosis. Besides the specific features of achondroplasia, synostosis of the metopic, coronal, lambdoid, and squamosal sutures was found. Series of neurosurgical interventions were carried out, principally for acrocephaly and posterior plagiocephaly. The most common achondroplasia mutation, a p.Gly380Arg in the fibroblast growth factor receptor 3 (FGFR3) gene, was detected. Cytogenetic and array CGH analyses, as well as molecular genetic testing of FGFR1, 2, 3 and TWIST1 genes failed to identify any additional genetic alteration. It is suggested that this unusual phenotype is a result of variable expressivity of the common achondroplasia mutation. Copyright © 2013 Wiley Periodicals, Inc.

  4. "Nara" knot for suturing of cleft lip in children to make removal easy

    Directory of Open Access Journals (Sweden)



    Full Text Available Cleft patients usually go through a lifetime of repeated hospital admissions and multiple procedures. Suture removal at a tender age and on a sensitive area like the lip becomes a challenge for the nursing staff. It is also emotionally demanding on the part of the parents. Hence, in most centres these patients are at least sedated if not anaesthetised. We have been using a simple knot and running prolene material so that undoing of the knot becomes easy and suture removal more or less atraumatic. We would like to share our experience with readers through this article. An analysis of 53 cleft lip repairs has shown that this knot is safe and easily removable.

  5. Orthodontic movement of a maxillary incisor through the midpalatal suture: a case report. (United States)

    Garib, Daniela Gamba; Janson, Guilherme; dos Santos, Patrícia Bittencourt Dutra; de Oliveira Baldo, Taiana; de Oliveira, Gabriela Ulian; Ishikiriama, Sérgio Kiyoshi


    Orthodontic space closure is a treatment alternative when a maxillary central incisor is missing. The objective of this report was to present an unusual treatment in which a right maxillary central incisor was moved through the midpalatal suture to replace the absent contralateral tooth. The biologic aspects and clinical appearance of the recontoured lateral and central incisors were analyzed. The position of the examined teeth and the appearance of the surrounding soft tissues were satisfactory; however, the upper midline frenulum deviated to the left. The incisor was successfully moved with no obvious detrimental effects as observed on the final radiographs. In the radiographic and tomographic examinations, the midline suture seemed to have followed the tooth movement. The patient expressed satisfaction with the results. It was concluded that orthodontic movement of the central incisor to replace a missing contralateral tooth is a valid treatment option, and the achievement of an esthetic result requires an interdisciplinary approach, including restorative dentistry and periodontics.

  6. Nickel-titanium wire in circumferential suture of a flexor tendon repair: a comparison to polypropylene. (United States)

    Karjalainen, T; He, M; Chong, A K S; Lim, A Y T; Ryhanen, J


    Nickel-titanium (NiTi) has been proposed as an alternative material for flexor tendon core suture. To our knowledge, its suitability as a circumferential suture of flexor tendon repair has not been investigated before. The purpose of this ex vivo study was to investigate the biomechanical properties of NiTi circumferential repairs and to compare them with commonly used polypropylene. Forty porcine flexor tendons were cut and repaired by simple running or interlocking mattress technique using 100 microm NiTi wire or 6-0 polypropylene. The NiTi circumferential repairs showed superior stiffness, gap resistance, and load to failure when compared to polypropylene repairs with both techniques. Nickel-titanium wire seems to be a potential material for circumferential repair of flexor tendons. Copyright 2010 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  7. Nickel-titanium wire as a flexor tendon suture material: an ex vivo study. (United States)

    Karjalainen, T; Göransson, H; Viinikainen, A; Jämsä, T; Ryhänen, J


    Nickel-titanium shape memory alloy (NiTi) is a new suture material that is easy to handle, is strong, and biocompatible. The purpose of this study was to evaluate the material properties and biomechanical behaviour of 150 microm and 200 microm NiTi wires in flexor tendon repair. Braided polyester (4-0 Ethibond) was used as control. Fifty fresh-frozen porcine flexor tendons were repaired using the Pennington modification of the Kessler repair or a double Kessler technique. NiTi wires were stiffer and reached higher tensile strength compared to braided polyester suture. Repairs with 200 microm NiTi wire had a higher yield force, ultimate force and better resistance to gapping than 4-0 braided polyester repairs. Repairs made with 200 microm NiTi wire achieved higher stiffness and ultimate force than repairs made with 150 microm NiTi wire.

  8. Cosmetic outcome of three sutures levator aponeurosis tuck procedure in congenital ptosis

    International Nuclear Information System (INIS)

    Hussain, I.


    To determine the results of three sutures aponeurosis tuck procedure in patients with congenital ptosis. Twenty-four eyes of 20 patients (13 males and 7 females) with congenital ptosis were included in the study. All these lids had either good or fair levator function. Amount of ptosis in all lids were measured before surgery and their mean calculated. Single surgeon performed the three sutures levator aponeurosis tuck procedure on all these lids. Degree of ptosis, after surgery was measured on multiple occasions and mean of measures of last follow-up was calculated. At this stage, the patients' satisfaction level was also documented. Mean amount of ptosis was 3.25 +- 0.99 mm before surgery and 0.33 +- 0.56 mm after surgery (p < 0.0001). Satisfaction level of 18 (90%) patients was 70-90%, while in 2 (10%) patients it was 50-60%. (author)

  9. Single suture iris-to-capsulorhexis fixation for in-the-bag intraocular lens subluxation. (United States)

    Siegel, Michael J; Condon, Garry P


    We present a simplified modification to a technique for early or mild in-the-bag subluxation that avoids conjunctival and scleral incisions and minimizes intraocular manipulation. While the capsulorhexis edge is grasped with an intraocular forceps to stabilize the IOL-capsular bag complex, a 10-0 polypropylene suture on a long curved needle is used to secure the fibrotic superior capsulorhexis edge to the midperipheral iris at 12 o'clock using a combination of a modified McCannel suture and a Siepser sliding knot. Dr. Condon receives speaker and consultant fees from Alcon Surgical, Inc., Allergan, Inc., and Microsurgical Technology. Although the Microsurgical Technology Condon snare instrument is named after him, Dr. Condon reports no patents, fees, or payments related to it. Dr. Siegel has no financial or proprietary interest in any material or method mentioned. Copyright © 2015. Published by Elsevier Inc.

  10. Management of recurrent epistaxis in an anticoagulated patient by temporarily closing the nares with sutures. (United States)

    Eng, Chee-Yean; Yew, Teck-Aun; Ng, Wai-Siene; El-Hawrani, Amged S


    We describe an unusual case of recurrent, refractory anterior epistaxis in an 86-year-old man with two mechanical heart valves who was on permanent warfarin therapy. His numerous episodes of epistaxis were incited by chronic nose-picking and strong nose-blowing, practices that he continued to engage in despite repeated medical advice to stop. Stopping his anticoagulation therapy was not considered as a management option because of an unacceptably high risk that this would lead to a thromboembolic event. Eventually, we temporarily sutured his nares closed, and his nosebleeds ceased. The suturing was performed in the ward with local anesthesia. This procedure was simple to perform,fairly well tolerated, easily reversible, and highly effective.

  11. Knotless double-row SutureBridge rotator cuff repairs have improved self-reinforcement compared with double-row SutureBridge repairs with tied medial knots: a biomechanical study using an ovine model. (United States)

    Smith, Geoffrey C S; Bouwmeester, Theresia M; Lam, Patrick H


    In double-row SutureBridge (Arthrex, Naples, FL, USA) rotator cuff repairs, increasing tendon load may generate progressively greater compression forces at the repair footprint (self-reinforcement). SutureBridge rotator cuff repairs using tied horizontal mattress sutures medially may limit this effect compared with a knotless construct. Rotator cuff repairs were performed in 9 pairs of ovine shoulders. One group underwent repair with a double-row SutureBridge construct with tied horizontal medial-row mattress sutures. The other group underwent repair in an identical fashion except that medial-row knots were not tied. Footprint contact pressure was measured at 0° and 20° of abduction under loads of 0 to 60 N. Pull-to-failure tests were then performed. In both repair constructs, each 10-N increase in rotator cuff tensile load led to a significant increase in footprint contact pressure (P row SutureBridge configuration, self-reinforcement is seen in repairs with and without medial-row knots. Self-reinforcement is greater with the knotless technique. Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  12. Anastomotic stability and wound healing of colorectal anastomoses sealed and sutured with a collagen fleece in a rat peritonitis model

    Directory of Open Access Journals (Sweden)

    Christoph Holmer


    Conclusion: The use of a thrombin/fibrinogen-coated collagen fleece showed similar efficacy to conventional sutures in colorectal anastomoses in the presence of peritonitis inflammation, and may provide additional benefits due to an increase in mature granulation tissue.

  13. Ab-interno scleral suture loop fixation with cow-hitch knot in posterior chamber intraocular lens decentration

    Directory of Open Access Journals (Sweden)

    Ertugrul Can


    Full Text Available Aim of Study: To describe a simplified ab-interno cow-hitch suture fixation technique for repositioning decentered posterior chamber intraocular lens (PC IOL. Materials and Methods: Two cases are presented with the surgical correction of decentered and subluxated IOL. Ab-interno scleral suture fixation technique with hitch-cow knot in the eye was performed with a ciliary sulcus guide instrument and 1 year follow-up was completed. Results: Both of the patients had well centered lenses postoperatively. Corrected distant and near visual acuities of the patients were improved. There was no significant postoperative complication. In the follow-up period of 1 year, no evidence of suture erosion was found. Conclusions: Ab-interno scleral suture loop fixation with hitch-cow knot in the eye was effective in repositioning decentered or subluxated PC IOLs with excellent postoperative centered lenses and visual outcomes.

  14. Postpartum perineal reapir performed by midwives: A randomised trial comparing two suture techniques for perineal repair leaving the skin unsutured

    DEFF Research Database (Denmark)

    Kindberg, Sara; Misan, Stehouwer; Hvidman, Lone


    Postpartum perineal repair performed by midwives: A randomised trial comparing two suture techniques leaving the skin unsutured. Objective      To compare a continuous suture technique to interrupted stitches using inverted knots for postpartum perineal repair of second-degree lacerations...... and episiotomies.   Design          A double blind randomised controlled trial.   Setting          A Danish university hospital with more than 4800 deliveries annually.   Population   400 healthy primiparous women with a vaginal delivery at term.   Method         Randomisation was computer-controlled. Structured...... healing, patient satisfaction, dyspareunia or need for resuturing. The continuous suture technique was significantly faster (15 min. vs. 17 min, p=0.03) and less suture material was used (1 vs. 2 packets, pskin unsutured...

  15. An easier method for performing a pancreaticojejunostomy for the soft pancreas using a fast-absorbable suture


    Hakamada, Kenichi; Narumi, Shunji; Toyoki, Yoshikazu; Nara, Masaki; Ishido, Kenosuke; Miura, Takuya; Kubo, Norihito; Sasaki, Mutsuo


    AIM: To clarify the usefulness of a new method for performing a pancreaticojejunostomy by using a fast-absorbable suture material irradiated polyglactin 910, and a temporary stent tube for a narrow pancreatic duct with a soft pancreatic texture.

  16. Field report: Research along the Yarlung Suture Zone in Southern Tibet, a persistent geological frontier

    Directory of Open Access Journals (Sweden)

    Andrew K. Laskowski


    Full Text Available The Yarlung Suture Zone in Southern Tibet marks the boundary between India and Asia–formerly separated by an ocean basin–and is a critical record of the tectonic processes that created the Tibetan Plateau. The Yarlung Suture Zone is also a frontier research area, as difficulty of access has limited research activity, providing ample opportunities for new discoveries. This paper documents field research conducted by the authors along the Yarlung suture zone in eastern Xigaze (Shigatse, Rikaze County, ∼250 km west of the city of Lhasa, in July 2017. The goal of this research was to map the Suture Zone structure in detail, and more specifically to understand the branching relationships between two major fault systems—the Great Counter Thrust and Gangdese Thrust. A summary of early geological exploration is included to provide context for this research.

  17. The European Academy laparoscopic “Suturing Training and Testing’’ (SUTT) significantly improves surgeons’ performance (United States)

    Sleiman, Z.; Tanos, V.; Van Belle, Y.; Carvalho, J.L.; Campo, R.


    The efficiency of suturing training and testing (SUTT) model by laparoscopy was evaluated, measuring the suturingskill acquisition of trainee gynecologists at the beginning and at the end of a teaching course. During a workshop organized by the European Academy of Gynecological Surgery (EAGS), 25 participants with three different experience levels in laparoscopy (minor, intermediate and major) performed the 4 exercises of the SUTT model (Ex 1: both hands stitching and continuous suturing, Ex 2: right hand stitching and intracorporeal knotting, Ex 3: left hand stitching and intracorporeal knotting, Ex 4: dominant hand stitching, tissue approximation and intracorporeal knotting). The time needed to perform the exercises is recorded for each trainee and group and statistical analysis used to note the differences. Overall, all trainees achieved significant improvement in suturing time (p psychomotor skills, surgery, teaching, training suturing model. PMID:26977264

  18. Tension-releasing suture appendage on single-incision sling device: A novel approach to postoperative voiding dysfunctions

    Directory of Open Access Journals (Sweden)

    Tsia-Shu Lo


    Conclusion: Tension-releasing suture is effective in the management of immediate postoperative voiding dysfunction in an SIS procedure. SIS operation has good short-term objective and subjective cure rates for female urodynamic stress incontinence.

  19. Repair of acute injuries of the lateral ligament complex of the ankle by suture anchors


    Liu, Xiang-Fei; Fang, Yang; Cao, Zhong-Hua; Li, Guang-Feng; Yang, Guo-Qing


    Objective: The objective of this study was to investigate the clinical curative effect of stage I repair of acute injuries of the lateral ligament complex of the ankle by the application of suture anchors. Methods: We retrospectively analyzed 18 cases of III degree acute injuries of the lateral ligament complex of the ankle. Results: There were statistically significant differences in preoperative and last follow-up VAS pain scores and AOFAS ankle hind-foot function scores. The X-ray talus di...



    Santosh Kumar; Anant Kumar; Sanjay


    BACKGROUND : Shoulder instability and its treatment were described even in ancient times by the Greek and Egyptian physicians. Evidence of shoulder dislocation has been found in archaeological and paleopathological examinations of human shoulders several thousand years old. 1 Many techniques have been described in literature for treatment of recurrent shoulder dislocation. Arthroscopic repair of Bankart’s lesion using suture anchors is a noble technique. A sut...

  1. Comparison of ultrasonic shears and traditional suture ligature for vaginal hysterectomy: randomized controlled trial. (United States)

    Fitz-Gerald, Alison Louise; Tan, Jason; Chan, Kok-Weng; Polyakov, Alex; Edwards, Geoff N; Najjar, Haider; Tsaltas, Jim; Vollenhoven, Beverley


    To compare operating time, intraoperative blood loss, postoperative analgesia, and length of hospital stay using ultrasonic shears vs traditional suture ligature in vaginal hysterectomy. Randomized controlled trial (Canadian Task Force classification I). Gynecology units within a single health network, university hospital. Forty women requiring vaginal hysterectomy because of benign disease. Vaginal hysterectomy performed using either ultrasonically activated shears (USS) or traditional suture ligatures. Twenty-one patients were randomized to the USS arm, and 19 patients to the traditional suture ligature arm. Patient characteristics were comparable. Mean (SD) hysterectomy time and was similar in both the USS and traditional arms, 28.66 (4.0) minutes vs 32.37 (3.18) minutes (p = .47), as was total operating time, 97.38 (8.9) minutes vs 91.63 (7.69) minutes (p = .63). Operative blood loss was significantly decreased in the USS group: 62.63 (12.46) mL vs 136.05 (21.54) mL (p = .006). There was, however, no significant change in hemoglobin concentration between the 2 groups: 19.53 (1.79) g/L vs -16.72 (2.5) g/L. There was no significant difference in mean oxycodone use: 9.29 (2.66) mg vs 8.06 (3.19) mg (p = .77). Length of hospital stay was similar in both groups: 58.98 (3.27) hours vs 60.05 (6.48) hours (p = .88). There was no significant difference in overall complication rates between the groups. Although the Harmonic scalpel system, compared with the traditional suture ligation method, seems to be a safe alternative for securing the pedicles in vaginal hysterectomy, it offers no benefit insofar as operative time, reduction in clinically significant blood loss, and analgesic requirements. Copyright © 2013 AAGL. Published by Elsevier Inc. All rights reserved.

  2. Arthroscopic suture anchor repair of the lateral ligament ankle complex: a cadaveric study. (United States)

    Giza, Eric; Shin, Edward C; Wong, Stephanie E; Acevedo, Jorge I; Mangone, Peter G; Olson, Kirstina; Anderson, Matthew J


    Operative treatment of mechanical ankle instability is indicated for patients with multiple sprains and continued episodes of instability. Open repair of the lateral ankle ligaments involves exposure of the attenuated ligaments and advancement back to their anatomic insertions on the fibula using bone tunnels or suture implants. Open and arthroscopic fixation are equal in strength to failure for anatomic Broström repair. Controlled laboratory study. Seven matched pairs of human cadaveric ankle specimens were randomized into 2 groups of anatomic Broström repair: open or arthroscopic. The calcaneofibular ligament and anterior talofibular ligament were excised from their origin on the fibula. In the open repair group, 2 suture anchors were used to reattach the ligaments to their anatomic origins. In the arthroscopic repair group, identical suture anchors were used for repair via an arthroscopic technique. The ligaments were cyclically loaded 20 times and then tested to failure. Torque to failure, degrees to failure, initial stiffness, and working stiffness were measured. A matched-pair analysis was performed. Power analysis of 0.8 demonstrated that 7 pairs needed to show a difference of 30%, with a 15% standard error at a significance level of α = .05. There was no difference in the degrees to failure, torque to failure, or stiffness for the repaired ligament complex. Nine of 14 specimens failed at the suture anchor. There is no statistical difference in strength or stiffness of a traditional open repair as compared with an arthroscopic anatomic repair of the lateral ligaments of the ankle. An arthroscopic technique can be considered for lateral ligament stabilization in patients with mild to moderate mechanical instability.

  3. Developing an Objective Structured Assessment of Technical Skills for Laparoscopic Suturing and Intracorporeal Knot Tying. (United States)

    Chang, Olivia H; King, Louise P; Modest, Anna M; Hur, Hye-Chun


    To develop a teaching and assessment tool for laparoscopic suturing and intracorporeal knot tying. We designed an Objective Structured Assessment of Technical Skills (OSATS) tool that includes a procedure-specific checklist (PSC) and global rating scale (GRS) to assess laparoscopic suturing and intracorporeal knot-tying performance. Obstetrics and Gynecology residents at our institution were videotaped while performing a laparoscopic suturing and intracorporeal knot-tying task at a surgical simulation workshop. A total of 2 expert reviewers assessed resident performance using the OSATS tool during live performance and 1 month later using the videotaped recordings. OSATS scores were analyzed using the Wilcoxon rank-sum test. Data are presented as median scores (interquartile range [IQR]). Intrarater and interrater reliabilities were assessed using a Spearman correlation and are presented as an r correlation coefficient and p value. An r ≥ 0.8 was considered as a high correlation. After testing, we received feedback from residents and faculty to improve the OSATS tool as part of an iterative design process. In all, 14 of 21 residents (66.7%) completed the study, with 9 junior residents and 5 senior residents. Junior residents had a lower score on the PSC than senior residents did; however, this was not statistically significant (median = 6.0 [IQR: 4.0-10.0] and median = 13.0 [IQR: 10.0-13.0]; p = 0.09). There was excellent intrarater reliability with our OSATS tool (for PSC component, r = 0.88 for Rater 1 and 0.93 for Rater 2, both p assessment and teaching tool for laparoscopic suturing and intracorporeal knot-tying skills. Overall, good intrarater reliability was demonstrated, suggesting that this tool may be useful for longitudinal assessment of surgical skills. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  4. Early treatment using fractional CO2 laser before skin suture during scar revision surgery in Asians. (United States)

    Du, Feiya; Yu, Yusheng; Zhou, Zhiqin; Wang, Liujia; Zheng, Shusen


    Fractional CO 2 laser is one of the most effective treatment options used to resurface scars. However, most previous studies have been performed on mature scars at least 2 months after surgery. Recent studies have emphasized the importance of early treatment to reduce scar formation. In the present study, we described our experience with fractional CO 2 laser intervention before skin suture during scar revision surgery in Asians, and found the treatment was safe and effective.

  5. Four-dimensional Microscope-Integrated Optical Coherence Tomography to Visualize Suture Depth in Strabismus Surgery. (United States)

    Pasricha, Neel D; Bhullar, Paramjit K; Shieh, Christine; Carrasco-Zevallos, Oscar M; Keller, Brenton; Izatt, Joseph A; Toth, Cynthia A; Freedman, Sharon F; Kuo, Anthony N


    The authors report the use of swept-source microscope-integrated optical coherence tomography (SS-MIOCT), capable of live four-dimensional (three-dimensional across time) intraoperative imaging, to directly visualize suture depth during lateral rectus resection. Key surgical steps visualized in this report included needle depth during partial and full-thickness muscle passes along with scleral passes. [J Pediatr Ophthalmol Strabismus. 2017;54:e1-e5.]. Copyright 2017, SLACK Incorporated.

  6. Reinforcement of the pelvic diaphragm using a purse-string suture in dogs: description of technique

    Directory of Open Access Journals (Sweden)

    P.C. Moraes

    Full Text Available ABSTRACT Recurrence of perineal hernias is frequent, and is associated to poor identification of anatomical structures during surgery, inadequate suture placement, and failure of physical support of the pelvic diaphragm after surgical reconstruction. The objective of this work is to describe a novel surgical technique for reinforcement of the pelvic diaphragm after performing the internal obturator transposition technique in dogs with perineal hernia.

  7. PASSEQ 2006-2008: Passive Seismic Experiment in Trans-Europe Suture ZoneI

    Czech Academy of Sciences Publication Activity Database

    Wilde-Piórko, M.; Geissler, W.H.; Plomerová, Jaroslava; Grad, M.; Babuška, Vladislav; Brückl, E.; Cyziene, J.; Czuba, W.; England, R.; Gaczyński, E.; Gaždová, Renata; Gregersen, S.; Guterch, A.; Hanka, W.; Hegedüs, E.; Heuer, B.; Jedlička, Petr; Lazauskiene, J.; Keller, G. R.; Kind, R.; Klinge, K.; Kolínský, Petr; Komminaho, K.; Kozlovskaya, E.; Krüger, F.; Larsen, T.; Majdański, M.; Málek, Jiří; Motuza, G.; Novotný, Oldřich; Pietrasiak, R.; Plenefisch, T.; Růžek, Bohuslav; Sliaupa, S.; Środa, P.; Świeczak, M.; Tiira, T.; Voss, P.; Wiejacz, P.


    Roč. 52, č. 3 (2008), s. 439-448 ISSN 0039-3169 R&D Projects: GA AV ČR IAA300120709 Institutional research plan: CEZ:AV0Z30120515; CEZ:AV0Z30460519 Keywords : lithosphere-asthenosphere system * Trans-European Suture Zone * Teisseyre- Tor nquist Zone Subject RIV: DC - Siesmology, Volcanology, Earth Structure Impact factor: 0.770, year: 2008

  8. Development of advanced antimicrobial and sterilized plasma polypropylene grafted muga (Antheraea assama) silk as suture biomaterial. (United States)

    Gogoi, Dolly; Choudhury, Arup Jyoti; Chutia, Joyanti; Pal, Arup Ratan; Khan, Mojibur; Choudhury, Manash; Pathak, Pallabi; Das, Gouranga; Patil, Dinkar S


    Surface modification of silk fibroin (SF) materials using environmentally friendly and non-hazardous process to tailor them for specific application as biomaterials has drawn a great deal of interest in the field of biomedical research. To further explore this area of research, in this report, polypropylene (PP) grafted muga (Antheraea assama) SF (PP-AASF) suture is developed using plasma treatment and plasma graft polymerization process. For this purpose, AASF is first sterilized in argon (Ar) plasma treatment followed by grafting PP onto its surface. AASF is a non-mulberry variety having superior qualities to mulberry SF and is still unexplored in the context of suture biomaterial. AASF, Ar plasma treated AASF (AASFAr) and PP-AASF are subjected to various characterization techniques for better comparison and the results are attempted to correlate with their observed properties. Excellent mechanical strength, hydrophobicity, antibacterial behavior, and remarkable wound healing activity of PP-AASF over AASF and AASFAr make it a promising candidate for application as sterilized suture biomaterial. Copyright © 2013 Wiley Periodicals, Inc.

  9. Politetrafluorene suture used as artificial mitral chord: mechanical properties and surgical implications. (United States)

    Caimmi, Philippe P; Sabbatini, Maurizio; Fusaro, Luca; Cannas, Mario


    Novel surgical approach to repair degenerative mitral regurgitation such as transapical chordae tendineae replacement and "loop in loop" in loop techniques, need of artificial chordae longer than that used in the older techniques of chordae tendineae replacement. This difference in length has been reported as potential critical point for durability of artificial chordae. In the present paper we have investigated the elastic behavior of different diameter and length politetrafluorene (PTFE) suture threads as substitute of native chordae, to identify their reliability to use as long artificial chordae. PTFE suture threads with different diameters were investigated in their mechanical properties at different length from 2 to 14 cm, by a servo hydraulic testing machine, to test the elastic properties of the sample in their use as mitral chordae substitutes. Our study shows that the chordae length is an important parameter that can change the performance of chordae itself. The analysis of elastic/properties of suture threads specimen, reveals that long PTFE chords have an optimal mechanical behavior in which elongation is accompanied by a safe elastic properties that make them well resistance during multiple tractions. In conclusion the use of PTFE as an artificial chordae may represent a valid choice in case of insertion of artificial chordae with extra anatomic length.

  10. Effect of sensory substitution on suture-manipulation forces for robotic surgical systems. (United States)

    Kitagawa, Masaya; Dokko, Daniell; Okamura, Allison M; Yuh, David D


    Direct haptic (force or tactile) feedback is not yet available in commercial robotic surgical systems. Previous work by our group and others suggests that haptic feedback might significantly enhance the execution of surgical tasks requiring fine suture manipulation, specifically those encountered in cardiothoracic surgery. We studied the effects of substituting direct haptic feedback with visual and auditory cues to provide the operating surgeon with a representation of the forces he or she is applying with robotic telemanipulators. Using the robotic da Vinci surgical system (Intuitive Surgical, Inc, Sunnyvale, Calif), we compared applied forces during a standardized surgical knot-tying task under 4 different sensory-substitution scenarios: no feedback, auditory feedback, visual feedback, and combined auditory-visual feedback. The forces applied with these sensory-substitution modes more closely approximate suture tensions achieved under ideal haptic conditions (ie, hand ties) than forces applied without such sensory feedback. The consistency of applied forces during robot-assisted suture tying aided by visual feedback or combined auditory-visual feedback sensory substitution is superior to that achieved with hand ties. Robot-assisted ties aided with auditory feedback revealed levels of consistency that were generally equivalent or superior to those attained with hand ties. Visual feedback and auditory feedback improve the consistency of robotically applied forces. Sensory substitution, in the form of visual feedback, auditory feedback, or both, confers quantifiable advantages in applied force accuracy and consistency during the performance of a simple surgical task.

  11. In Vitro Comparison of Two Barbed Suture Configurations for Flexor Tendon Repair. (United States)

    Engel, Jamie L; Gabra, Joseph N; Esterle, Andrew R; Lanzinger, William D; Elias, John J


    Purpose  The current study compares the strength of a previously studied technique for flexor tendon repair with barbed sutures to an experimental approach that aligns all the barbs to oppose distraction. Methods  Twelve flexor tendons from cadaveric specimens were mechanically tested following repair of simulated zone II tendon injuries. Two repair techniques utilizing barbed sutures were studied: the Marrero-Amadeo four-core barbed suture approach and the experimental configuration with all barbs on four cores opposing distraction. Maximum applied load at failure, that is, ultimate load, and 2-mm gap force were compared between the two repair techniques, both as raw values and after normalization to cross-sectional area of the intact tendon. Statistical testing was performed using t -tests and Mann-Whitney U -tests, where appropriate, with a significance level of 0.05. Results  The ultimate loads, raw (58.2 N) and normalized (4.8 N/mm 2 ), were significantly larger for the Marrero-Amadeo repair than the proposed experimental approach (35.6 N and 2.7 N/mm 2 ; p  barbs to oppose distraction does not improve strength of the repaired tendon. The Marrero-Amadeo technique was found to have superior strength for use in traumatic zone II flexor tendon injuries.

  12. Microvascular anastomoses in irradiated vessels: A comparison between the Unilink system and sutures

    International Nuclear Information System (INIS)

    Ragnarsson, R.; Berggren, A.; Klintenberg, C.; Ostrup, L.


    A new mechanical device (the Unilink system) was compared to conventional suture anastomoses in irradiated microvessels. Twenty rabbits received a single radiation dose of 20 Gy from a 7-MeV electron source through an anterior neck field. One and 6 months following irradiation, the carotid arteries and facial veins were divided and anastomosed on one side with the Unilink system and on the other side with suture technique. At sacrifice 4 weeks postoperatively, all vessels were evaluated for patency and histologic changes associated with radiation and anastomotic trauma. Histology disclosed severe radiation changes. Also, intimal hyperplasia was consistently found at the anastomotic sites in the arteries, while it was totally absent in the venous anastomoses. Occlusive thrombosis was found in two arteries, one anastomosed with the Unilink system and one sutured. Two other arteries, one from each group, had subtotal occlusions at the anastomotic site. No occlusions occurred in any of the venous anastomoses. The overall patency in this study was 97.5 percent, with no difference between the two techniques

  13. Scanning electron microscopic study of the hydrolytic degradation of poly(glycolic acid) suture

    International Nuclear Information System (INIS)

    Chu, C.C.; Campbell, N.D.


    This article reports the morphological observations on the surface changes of poly-(glycolic acid) sutures which have been exposed to various dosages of gamma irradiation (0, 2.5, 5.0, 10, 20 and 40 Mrad) and duration of immersion (0, 7, 14, 28, 48, 60, and 90 days) in a physiological saline buffer. The most important gross morphological characteristics of PGA suture hydrolytic degradation is the formation of surface cracks on the filaments. The regularity of the surface cracks increased with an increase in the gamma irradiation and the duration of hydrolysis. Surface cracks were not observed in irradiated sutures that had not been subjected to hydrolytic degradation. The arrangement of the surface cracks, their orientation on the filaments, and the direction of crack propagation provide very useful information for depicting the mechanism of hydrolytic degradation in this class of fibrous material. The microfibrillar model of fiber structure has been used as the basis for the proposed degradation mechanism of PGA in vitro. It is believed that hydrolysis occurs initially in the amorphous regions sandwiched between two crystalline zones, as tie-chain segments, free chain ends, and chain folds in these regions degrade into fragments. As degradation proceeds, the size of the fragments reaches the stage at which they can be dissolved into the buffer medium. This dissolution removes the fragments from the amorphous regions, and surface cracks appeared

  14. The improved oval forceps suture-guiding method for minimally invasive Achilles tendon repair. (United States)

    Liu, Yang; Lin, Lixiang; Lin, Chuanlu; Weng, Qihao; Hong, Jianjun


    To discuss the effect and advantage of the improved oval forceps suture-guiding method combined with anchor nail in the treatment of acute Achilles tendon rupture. A retrospective research was performed on 35 cases of acute Achilles tendon rupture treated with the improved oval forceps suture-guiding method from January 2013 to October 2016. Instead of the Achillon device, we perform the Achillon technique with the use of simple oval forceps, combined with absorbable anchor nail, percutaneously to repair the acute Achilles tendon rupture. All patients were followed up for at least 12 months (range, 12-19 months), and all the patients underwent successful repair of their acute Achilles tendon rupture using the improved oval forceps suture-guiding method without any major intra- or postoperative complications. All the patients returned to work with pre-injury levels of activity at a mean of 12.51 ± 0.76 weeks. Mean AOFAS ankle-hindfoot scores improved from 63.95 (range, 51-78) preoperatively to 98.59 (range, 91-100) at last follow-up. This was statistically significant difference (P anchor nail, the improved technique has better repair capacity and expands the operation indication of oval forceps method. Copyright © 2018 Elsevier Ltd. All rights reserved.

  15. Effect of Unshaven Hair with Absorbable Sutures and Early Postoperative Shampoo on Cranial Surgery Site Infection. (United States)

    Oh, Won-Oak; Yeom, Insun; Kim, Dong-Seok; Park, Eun-Kyung; Shim, Kyu-Won


    Cranial surgical site infection is a significant cause of morbidity and mortality in hospitals. Preoperative hair shaving for cranial neurosurgical procedures is performed traditionally in an attempt to protect patients against complications from infections at cranial surgical sites. However, preoperative shaving of surgical incision sites using traditional surgical blades without properly washing the head after surgery can cause infections at surgical sites. Therefore, a rapid protocol in which the scalp remains unshaven and absorbable sutures are used for scalp closure with early postoperative shampooing is examined in this study. A retrospective comparative study was conducted from January 2008 to December 2012. A total of 2,641 patients who underwent unshaven cranial surgery with absorbable sutures for scalp closure were enrolled in this study. Data of 1,882 patients who underwent surgery with the traditional protocol from January 2005 to December 2007 were also analyzed for comparison. Of 2,641 patients who underwent cranial surgery with the rapid protocol, all but 2 (0.07%) patients experienced satisfactory wound healing. Of 1,882 patients who underwent cranial surgery with the traditional protocol, 3 patients (0.15%) had infections. Each infection occurred at the superficial incisional surgical site. Unshaven cranial surgery using absorbable sutures for scalp closure with early postoperative shampooing is safe and effective in the cranial neurosurgery setting. This protocol has a positive psychological effect. It can help patients accept neurosurgical procedures and improve their self-image after the operation. © 2017 S. Karger AG, Basel.

  16. Major Lung Resections Using Manual Suturing Versus Staplers During Fiscal Crisis. (United States)

    Potaris, Konstantinos; Kapetanakis, Emmanuil; Papamichail, Konstantinos; Midvighi, Elena; Verveniotis, Alexis; Parissis, Fotios; Apostolou, Demetrios; Tziortziotis, Vaios; Maimani, Spiridoula; Pouliara, Evangelia; Vogiatzis, Gregorios; Kakaris, Stamatis; Konstantinou, Marios


    AbstractObjective: During fiscal crisis there was a period of shortage of staplers in our hospital, which drove us to manual suturing of bronchi and pulmonary vessels during major lung resections. We present our experience during that period in comparison to a subsequent period when staplers became available again. A total of 256 lobectomies and 78 pneumonectomies were performed using manual suturing (group A), between September 2009 and September 2010, and compared regarding surgical outcome to 248 lobectomies and 60 pneumonectomies using staplers (group B), between September 2011 and September 2012. Although we did not observe statistically significant differences but only a trend towards less operative time, for both lobectomies (p=0.21) and pneumonectomies (p=0.31), we actually noted a 41 and 47 minutes saving of operative time using staplers (group B), in comparison to manual suturing (group A). We also observed a trend towards less morbidity rates in patients of group B, who underwent lobectomy (10.48%), and pneumonectomy (20%), versus patients of group A, who underwent lobectomy (15.62%), and pneumonectomy (30.76%); we did not observe any substantial differences in the other surgical outcome variables, and in patients' demographics comorbidities, and anatomic allocation of surgical procedures performed. The use of staplers offers safety with secure bronchial or vascular sealing, and saving of operative time. Their unavailability at an interval during fiscal crisis although it did not affect surgical outcome, revealed their usefulness and value.

  17. Oesophageal flap valvuloplasty and wrapping suturing prevent gastrooesophageal reflux disease in dogs after oesophageal anastomosis (United States)

    Dai, Ji-Gang; Liu, Quan-Xing; Den, Xu-Feng; Min, Jia-Xin


    AIM: To examine the efficiency of oesophageal flap valvuloplasty and wrapping suturing technique in decreasing the rate of postoperative gastrooesophageal reflux disease in a dog model. METHODS: We operated on 10 dogs in this study. First, we resected a 5-cm portion of the distal oesophagus and then restored the continuity of the oesophageal and gastric walls by end-to-end anastomosis. A group of five dogs was subjected to the oesophageal flap valvuloplasty and wrapping suturing technique, whereas another group (control) of five dogs was subjected to the stapling technique after oesophagectomy. The symptom of gastrooesophageal reflux was recorded by 24-h pH oesophageal monitoring. Endoscopy and barium swallow examination were performed on all dogs. Anastomotic leakage was observed by X-ray imaging, whereas benign anastomotic stricture and mucosal damage were observed by endoscopy. RESULTS: None of the 10 dogs experienced anastomotic leakage after oesophagectomy. Four dogs in the new technology group resumed regular feeding, whereas only two of the dogs in the control group tolerated solid food intake. pH monitoring demonstrated that 25% of the dogs in the experimental group exhibited reflux and that none had mucosal damage consistent with reflux. Conversely, both reflux and mucosal damage were observed in all dogs in the control group. CONCLUSION: The oesophageal flap valvuloplasty and wrapping suturing technique can improve the postoperative quality of life through the long-term elimination of reflux oesophagitis and decreased stricture formation after primary oesophageal anastomosis. PMID:25516655

  18. A previously unreported variant of the synostotic sagittal suture: Case report and review of salient literature

    Directory of Open Access Journals (Sweden)

    Madison Budinich


    Full Text Available Introduction: Sagittal synostosis is a rare congenital disease caused by the premature fusion of the sagittal suture. Craniosynostosis occurs for a variety of reasons, different for every case, and often the etiology is unclear but the anomaly can frequently be seen as part of Crouzon's or Apert's syndromes. Herein, we discuss a rare case of craniosynostosis where the patient presented with a, to our knowledge, a previously undescribed variant of sagittal synostosis. Case report: A 3-month-old female infant presented to a craniofacial clinic for a consultation regarding an abnormal head shape. Images of the skull were performed, demonstrating that the patient had craniosynostosis. The patient displayed no other significant symptoms besides abnormalities in head shape. The sagittal suture was found to extend into the occipital bone where it was synostotic. Conclusion: To our knowledge, a synostotic sagittal suture has not been reported that extended posteriorly it involve the occipital bone. Those who interpret imaging or operate on this part of the skull should consider such a variation. Keywords: Anatomy, Craniosynostosis, Skull, Malformation, Pediatrics

  19. Bioabsorbable Suture Anchor Migration to the Acromioclavicular Joint: How Far Can These Implants Go?

    Directory of Open Access Journals (Sweden)

    Giovanna Medina


    Full Text Available Few complications regarding the use of bioabsorbable suture anchors in the shoulder have been reported. What motivated this case report was the unusual location of the anchor, found in the acromioclavicular joint which, to our knowledge, has never been reported so far. A 53-year old male with previous rotator cuff (RC repair using bioabsorbable suture anchors presented with pain and weakness after 2 years of surgery. A suspicion of retear of the RC led to request of a magnetic resonance image, in which the implant was found located in the acromioclavicular joint. The complications reported with the use of metallic implants around the shoulder led to the development of bioabsorbable anchors. Advantages are their absorption over time, minimizing the risk of migration or interference with revision surgery, less artifacts with magnetic resonance imaging, and tendon-to-bone repair strength similar to metallic anchors. Since the use of bioabsorbable suture anchors is increasing, it is important to know the possible complications associated with these devices.

  20. The biomechanical role of the chondrocranium and sutures in a lizard cranium. (United States)

    Jones, Marc E H; Gröning, Flora; Dutel, Hugo; Sharp, Alana; Fagan, Michael J; Evans, Susan E


    The role of soft tissues in skull biomechanics remains poorly understood. Not least, the chondrocranium, the portion of the braincase which persists as cartilage with varying degrees of mineralization. It also remains commonplace to overlook the biomechanical role of sutures despite evidence that they alter strain distribution. Here, we examine the role of both the sutures and the chondrocranium in the South American tegu lizard Salvator merianae We use multi-body dynamics analysis (MDA) to provide realistic loading conditions for anterior and posterior unilateral biting and a detailed finite element model to examine strain magnitude and distribution. We find that strains within the chondrocranium are greatest during anterior biting and are primarily tensile; also that strain within the cranium is not greatly reduced by the presence of the chondrocranium unless it is given the same material properties as bone. This result contradicts previous suggestions that the anterior portion (the nasal septum) acts as a supporting structure. Inclusion of sutures to the cranium model not only increases overall strain magnitudes but also leads to a more complex distribution of tension and compression rather than that of a beam under sagittal bending. © 2017 The Authors.

  1. Ostomy creation with fewer sutures using tissue adhesives (cyanoacrylates) in inflammatory bowel disease: a pilot study. (United States)

    Uchino, M; Ikeuchi, H; Bando, T; Sasaki, H; Chohno, T; Horio, Y; Takesue, Y


    Introduction Fistula formation around the ostomy site is a stoma-related complication often requiring surgical intervention. This complication may be caused by sutures or may develop as a complication of inflammatory bowel disease. Before conducting a clinical trial, we set out to investigate the safety of ostomy creation with fewer sutures using tissue adhesives in this pilot study. Methods Patients with inflammatory bowel disease who required surgery with ostomy creation at the Hyogo College of Medicine between January 2014 and December 2015 were enrolled. Safety was assessed by evaluating the incidence of stoma-related complications. Ostomy was restricted to loop ileostomy and was created with two sutures and tissue adhesives. Results A total of 14 patients were enrolled. Mean body mass index was 18.9 ± 2.0 kg/m 2 . There were no cases of ostomy retraction and no severe adverse events were observed. Conclusions This pilot study demonstrates that ostomy creation using tissue adhesives is safe. Although retraction and adverse events were not observed, even in patients with inflammatory bowel disease who generally exhibit delayed wound healing, the body mass index was extremely low in this series. This study does not strongly recommend ostomy creation with tissue adhesives; further studies are needed to clarify the efficacy and safety of the procedure.

  2. Absorbable Suture as an Apical Matrix in Single Visit Apexification with Mineral Trioxide Aggregate

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    Ayush Goyal


    Full Text Available Several procedures have been recommended to induce the root end barrier formation in teeth with open apices. Conventional treatment for such cases will require many appointments with an average duration of 12.9 months. During this period, the root canal is susceptible to reinfection from around the provisional restoration, which may promote apical periodontitis and arrest of apical repair. Mineral trioxide aggregate (MTA has been successfully used for one visit apexification wherein the root canal can be obturated within 24 hours after placement of MTA. Using a matrix prior to the placement of MTA avoids its extrusion, reduces leakage in the sealing material, and allows favorable response of the periapical tissues. This report presents a case of apexification where an absorbable suture was used as an apical matrix. Use of an absorbable suture circumvents all the problems associated with other conventional materials. Conclusion. Placement of the matrix made from the suture material is predictable and is easily positioned at the apex and the length can be adjusted as required. 10-month follow-up of the case shows resorbed matrix and bone healing in the periapical region. The patient was asymptomatic during the whole follow-up period and tooth exhibited mobility within physiologic limits and was functioning normally.

  3. Absorbable Suture as an Apical Matrix in Single Visit Apexification with Mineral Trioxide Aggregate. (United States)

    Goyal, Ayush; Nikhil, Vineeta; Jha, Padmanabh


    Several procedures have been recommended to induce the root end barrier formation in teeth with open apices. Conventional treatment for such cases will require many appointments with an average duration of 12.9 months. During this period, the root canal is susceptible to reinfection from around the provisional restoration, which may promote apical periodontitis and arrest of apical repair. Mineral trioxide aggregate (MTA) has been successfully used for one visit apexification wherein the root canal can be obturated within 24 hours after placement of MTA. Using a matrix prior to the placement of MTA avoids its extrusion, reduces leakage in the sealing material, and allows favorable response of the periapical tissues. This report presents a case of apexification where an absorbable suture was used as an apical matrix. Use of an absorbable suture circumvents all the problems associated with other conventional materials. Conclusion . Placement of the matrix made from the suture material is predictable and is easily positioned at the apex and the length can be adjusted as required. 10-month follow-up of the case shows resorbed matrix and bone healing in the periapical region. The patient was asymptomatic during the whole follow-up period and tooth exhibited mobility within physiologic limits and was functioning normally.

  4. [Comparative study of intestinal anastomosis with manual suture and biofragmentable ring in dogs under corticosteroid administration]. (United States)

    Fernandes, L C; Matos, D; Novelli, M D; Kim, S B


    This study analyzed intestinal anastomoses by manual suture and by compression with biofragmentable ring under delay of cicatrization administering parenteral corticoids. Twenty dogs were divided into two groups: control and test, the latter submitted to intramuscular administration of hydrocortisone hemisuccinate, 25 to 33 mg/kg/day, on the 30th preoperative and 7th postoperative days. During surgery, each animal underwent two colon sections with anastomosis by manual suture in a single extramucous plane and compression with biofragmentable ring. The animals were sacrificed 7 days after the procedure to evaluate the anastomoses. In the postoperative period, one death occurred in the test group and two in the control group, caused by nonblocked fistula in the anastomoses by ring compression. Statistically, there was a similar incidence of adherences, fistulas, afferent dilatation and obstruction using comparison methods. On microscopy, deficiency in mucous regeneration of the anastomoses by compression was observed. Computerized histological analysis evidenced in the anastomoses by compression, a greater inflammatory reaction, greater edema of the submucous membrane and enlarged scars. It was concluded that, with the biofragmentable ring, in colonic anastomosis under delay of cicatrization induced by corticoids, similar results to manual suture regarding to postoperative complications incidence were obtained; ring, however, determined worse mucous regeneration and greater cicatricial inflammatory reaction.

  5. Using sutures to attach miniature tracking tags to small bats for multimonth movement and behavioral studies. (United States)

    Castle, Kevin T; Weller, Theodore J; Cryan, Paul M; Hein, Cris D; Schirmacher, Michael R


    Determining the detailed movements of individual animals often requires them to carry tracking devices, but tracking broad-scale movement of small bats (system (GPS) tags and geolocating data loggers to small bats. We used monofilament, synthetic, absorbable sutures to secure GPS tags and data loggers to the skin of anesthetized big brown bats (Eptesicus fuscus) in Colorado and hoary bats (Lasiurus cinereus) in California. GPS tags and data loggers were sutured to 17 bats in this study. Three tagged bats were recaptured 7 months after initial deployment, with tags still attached; none of these bats showed ill effects from the tag. No severe injuries were apparent upon recapture of 6 additional bats that carried tags up to 26 days after attachment; however, one of the bats exhibited skin chafing. Use of absorbable sutures to affix small tracking devices seems to be a safe, effective method for studying movements of bats over multiple months, although additional testing is warranted. This new attachment method has the potential to quickly advance our understanding of small bats, particularly as more sophisticated miniature tracking devices (e.g., satellite tags) become available.

  6. Modality of wound closure after total knee replacement: are staples as safe as sutures? A retrospective study of 181 patients

    Directory of Open Access Journals (Sweden)

    Hammerberg E Mark


    Full Text Available Abstract Background Surgical site wound closure plays a vital role in post-operative success. This effect is magnified in regard to commonly performed elective procedures such as total knee arthroplasty. The use of either sutures or staples for skin re-approximation remains a contested subject, which may have a significant impact on both patient safety and surgical outcome. The literature remains divided on this topic. Methods Two cohorts of patients at a level one trauma and regional referral center were reviewed. Cohorts consisted of consecutive total knee arthroplasties performed by two surgeons who achieved surgical wound re-approximation by either staples or absorbable subcuticular sutures. Outcome variables included time of surgery, wound dehiscence, surgical site infection per Center for Disease Control criteria and repeat procedures for debridement and re-closure. Results 181 patients qualified for study inclusion. Staples were employed in 82 cases (45.3% of total and sutures in 99 cases (54.7%. The staples group had no complications while the sutures group had 9 (9.1%. These consisted of: 4 infections (2 superficial, one deep, one organ/space; three patients required re-suturing for dehiscence; one allergic type reaction to suture material; and one gout flare resulting in dehiscence. The mean surgical time with sutures was 122.3 minutes (sd = 33.4 and with staples was 114 minutes (sd = 24.4. Conclusion This study demonstrated significantly fewer complications with staple use than with suture use. While all complications found in this study cannot be directly attributed to skin re-approximation method, the need for further prospective, randomized trials is established.

  7. Sustained release of neurotrophin-3 via calcium phosphate-coated sutures promotes axonal regeneration after spinal cord injury. (United States)

    Hanna, Amgad; Thompson, Daniel L; Hellenbrand, Daniel J; Lee, Jae-Sung; Madura, Casey J; Wesley, Meredith G; Dillon, Natalie J; Sharma, Tapan; Enright, Connor J; Murphy, William L


    Because of the dynamics of spinal cord injury (SCI), the optimal treatment will almost certainly be a combination approach to control the environment and promote axonal growth. This study uses peripheral nerve grafts (PNGs) as scaffolds for axonal growth while delivering neurotrophin-3 (NT-3) via calcium phosphate (CaP) coatings on surgical sutures. CaP coating was grown on sutures, and NT-3 binding and release were characterized in vitro. Then, the NT-3-loaded sutures were tested in a complete SCI model. Rats were analyzed for functional improvement and axonal growth into the grafts. The CaP-coated sutures exhibited a burst release of NT-3, followed by a sustained release for at least 20 days. Functionally, the rats with PNGs + NT-3-loaded sutures and the rats treated with PNGs scored significantly higher than controls on day 56 postoperatively. However, functional scores in rats treated with PNGs + NT-3-loaded suture were not significantly different from those of rats treated with PNGs alone. Cholera toxin subunit B (CTB) labeling rostral to the graft was not observed in any controls, but CTB labeling rostral to the graft was observed in almost all rats that had had a PNG. Neurofilament labeling on transverse sections of the graft revealed that the rats treated with the NT-3-loaded sutures had significantly more axons per graft than rats treated with an NT-3 injection and rats without NT-3. These data demonstrate that PNGs serve as scaffolds for axonal growth after SCI and that CaP-coated sutures can efficiently release NT-3 to increase axonal regeneration. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  8. The biomechanical effects of polytetrafluoroethylene suture augmentations in lateral-row rotator cuff repairs in an ovine model. (United States)

    Beimers, Lijkele; Lam, Patrick H; Murrell, George A C


    This study investigated the biomechanical effects of expanded polytetrafluoroethylene (ePTFE) suture augmentation patches in rotator cuff repair constructs. The infraspinatus tendon in 24 cadaveric ovine shoulders was repaired using an inverted horizontal mattress suture with 2 knotless bone anchors (ArthroCare, Austin, TX, USA) in a lateral-row configuration. Four different repair groups (6 per group) were created: (1) standard repair using inverted horizontal mattress sutures, (2) repair with ePTFE suture augmentations on the bursal side of the tendon, (3) repair with ePTFE suture augmentations on the articular side, and, (4) repair with ePTFE suture augmentations on both sides of the tendon. Footprint contact pressure, stiffness, and the load to failure of the repair constructs were measured. Repairs with ePTFE suture augmentations on the bursal side exerted significantly more footprint contact pressure (0.40 ± 0.01 MPa) than those on the articular side (0.34 ± 0.02 MPa, P = .04) and those on both sides (0.33 ± 0.02 MPa, P = .01). At 15 degrees of abduction, ePTFE-augmented repairs on the bursal side had higher footprint contact pressure (0.26 ± 0.03 MPa) compared with standard repairs (0.15 ± 0.02 MPa, P = .01) and with ePTFE-augmented repairs on the articular side (0.18 ± 0.02 MPa, P = .03). The ePTFE-augmented repairs on the bursal side demonstrated significantly higher failure loads (178 ± 18 N) than standard repairs (120 ± 17 N, P = .04). Inverted horizontal mattress sutures augmented with ePTFE patches on the bursal side of the tendon enhanced footprint contact pressures and the ultimate load to failure of lateral-row rotator cuff repairs in an ovine model. Copyright © 2014 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  9. Experimental study on tissue phantoms to understand the effect of injury and suturing on human skin mechanical properties. (United States)

    Chanda, Arnab; Unnikrishnan, Vinu; Flynn, Zachary; Lackey, Kim


    Skin injuries are the most common type of injuries occurring in day-to-day life. A skin injury usually manifests itself in the form of a wound or a cut. While a shallow wound may heal by itself within a short time, deep wounds require surgical interventions such as suturing for timely healing. To date, suturing practices are based on a surgeon's experience and may vary widely from one situation to another. Understanding the mechanics of wound closure and suturing of the skin is crucial to improve clinical suturing practices and also to plan automated robotic surgeries. In the literature, phenomenological two-dimensional computational skin models have been developed to study the mechanics of wound closure. Additionally, the effect of skin pre-stress (due to the natural tension of the skin) on wound closure mechanics has been studied. However, in most of these analyses, idealistic two-dimensional skin geometries, materials and loads have been assumed, which are far from reality, and would clearly generate inaccurate quantitative results. In this work, for the first time, a biofidelic human skin tissue phantom was developed using a two-part silicone material. A wound was created on the phantom material and sutures were placed to close the wound. Uniaxial mechanical tests were carried out on the phantom specimens to study the effect of varying wound size, quantity, suture and pre-stress on the mechanical behavior of human skin. Also, the average mechanical behavior of the human skin surrogate was characterized using hyperelastic material models, in the presence of a wound and sutures. To date, such a robust experimental study on the effect of injury and sutures on human skin mechanics has not been attempted. The results of this novel investigation will provide important guidelines for surgical planning and validation of results from computational models in the future.

  10. Endoscopic suture fixation is associated with reduced migration of esophageal fully covered self-expandable metal stents (FCSEMS). (United States)

    Wright, Andrew; Chang, Andrew; Bedi, Aarti Oza; Wamsteker, Erik-Jan; Elta, Grace; Kwon, Richard S; Carrott, Phillip; Elmunzer, B Joseph; Law, Ryan


    Esophageal fully covered self-expandable metal stents (FCSEMS) are indicated for the management of benign and malignant conditions of the esophagus including perforations, leaks, and strictures. FCSEMS are resistant to tissue ingrowth and are removable; however, stent migration occurs in 30-55% of cases. Endoscopic suture fixation of FCSEMS has been utilized to decrease the risk of stent migration though data supporting this practice remain limited. The primary aim of this study was to compare clinical outcomes and migration rate of patients who underwent placement of esophageal FCSEMS with and without endoscopic suture fixation. Our single-center, retrospective, cohort study includes patients who underwent esophageal FCSEMS placement with and without endoscopic suture fixation between January 1, 2012, and November 11, 2015. Baseline patient characteristics, procedural details, and clinical outcomes were abstracted. Logistic regression was performed to identify clinical and technical factors associated with outcomes and stent migration. A total of 51 patients underwent 62 FCSEMS placements, including 21 procedures with endoscopic suture fixation and 41 without. Suture fixation was associated with reduced risk of stent migration (OR 0.13, 95% CI 0.03-0.47). Prior stent migration was associated with significantly higher risk of subsequent migration (OR 6.4, 95% CI 1.6-26.0). Stent migration was associated with lower likelihood of clinical success (OR 0.21, 95% CI 0.06-0.69). There was a trend toward higher clinical success among patients undergoing suture fixation (85.7 vs. 60.9%, p = 0.07). Endoscopic suture fixation of FCSEMS was associated with a reduced stent migration rate. Appropriate patient selection for suture fixation of FCSEMS may lead to reduced migration in high-risk patients.

  11. Two Techniques of Intestinal Wall Suture in Surgical Treatment of Ileus in Dogs and the Importance of Omentalisation


    M. Crha; J. Lorenzová; L. Urbanová; T. Fichtel; A. Nečas


    Model experimental studies focused on the intestinal suture techniques in relation to healing, postoperative narrowing of the intestinal lumen or adhesion formation can not comprise a number of clinical factors (foreign body presence in the intestine, haematological abnormalities, septic peritonitis, different age of patients, etc.) that under clinical practice conditions may have an effect on the healing of the intestinal suture. The aim of this clinical study was to confirm in a group of do...

  12. The metallogeny of Late Triassic rifting of the Alexander terrane in southeastern Alaska and northwestern British Columbia (United States)

    Taylor, C.D.; Premo, W.R.; Meier, A.L.; Taggart, J.E.


    A belt of unusual volcanogenic massive sulfide (VMS) occurrences is located along the eastern margin of the Alexander terrane throughout southeastern Alaska and northwestern British Columbia and exhibits a range of characteristics consistent with a variety of syngenetic to epigenetic deposit types. Deposits within this belt include Greens Creek and Windy Craggy, the economically most significant VMS deposit in Alaska and the largest in North America, respectively. The occurrences are hosted by a discontinuously exposed, 800-km-long belt of rocks that consist of a 200- to 800-m-thick sequence of conglomerate, limestone, marine elastic sedimentary rocks, and tuff intercalated with and overlain by a distinctive unit of mafic pyroclastic rocks and pillowed flows. Faunal data bracket the age of the host rocks between Anisian (Middle Triassic) and late Norian (late Late Triassic). This metallogenic belt is herein referred to as the Alexander Triassic metallogenic belt. The VMS occurrences show systematic differences in degree of structural control, chemistry, and stratigraphic setting along the Alexander Triassic metallogenic belt that suggest important spatial or temporal changes in the tectonic environment of formation. At the southern end of the belt, felsic volcanic rocks overlain by shallow-water limestones characterize the lower part of the sequence. In the southern and middle portion of the belt, a distinctive pebble conglomerate marks the base of the section and is indicative of high-energy deposition in a near slope or basin margin setting. At the northern end of the belt the conglomerates, limestones, and felsic volcanic rocks are absent and the belt is composed of deep-water sedimentary and mafic volcanic rocks. This northward change in depositional environment and lithofacies is accompanied by a northward transition from epithermal-like structurally controlled, discontinuous, vein- and pod-shaped, Pb-Zn-Ag-Ba-(Cu) occurrences with relatively simple mineralogy

  13. Detrital rutile geochemistry and thermometry from the Dabie orogen: Implications for source-sediment links in a UHPM terrane (United States)

    Liu, Lei; Xiao, Yilin; Wörner, G.; Kronz, A.; Simon, K.; Hou, Zhenhui


    This study explores the potential of detrital rutile geochemistry and thermometry as a provenance tracer in rocks from the Central Dabie ultrahigh-pressure metamorphic (UHPM) zone in east-central China that formed during Triassic continental collision. Trace element data of 176 detrital rutile grains selected from local river sediments and 91 rutile grains from distinct bedrocks in the Shuanghe and Bixiling areas, obtained by both electron microprobe (EMP) and in situ LA-ICP-MS analyses, suggest that geochemical compositions and thermometry of detrital rutiles are comparable to those from their potential source rocks. After certification of the Cr-Nb discrimination method for the Central Dabie UHPM zone, we show that 29% of the detrital rutiles in the Shuanghe area were derived from metamafic sources whereas in the Bixiling area that it is up to 76%. Furthermore, the proportion of distinct types of detrital rutiles combined with modal abundances of rutile in metapelites and metamafic bedrocks can be used to estimate the proportion of different source lithologies. Based on this method the proportion of mafic source rocks was estimated to ∼10% at Shuanghe and >60% at Bixiling, respectively, which is consistent with the proportions of eclogite (the major rutile-bearing metamafic rock) distribution in the field. Therefore, the investigation of detrital rutiles is a potential way to evaluate the proportion of metamafic rocks and even to prospect for metamafic bodies in UHPM terranes. Zr-in-rutile temperatures were calculated at different pressures and compared with temperatures derived from rock-in rutiles and garnet-clinopyroxene Fe-Mg thermometers. Temperatures calculated for detrital rutiles range from 606 °C to 707 °C and 566 °C to 752 °C in Shuanghe and Bixiling, respectively, at P = 3 GPa with an average temperatures of ca. 630 °C for both areas. These temperature averages and ranges are similar to those calculated for rutiles from surrounding source rocks

  14. Suture holding capacity of the Achilles tendon during the healing period: an in vivo experimental study in rabbits. (United States)

    Yildirim, Yakup; Kara, Hasan; Cabukoglu, Cengiz; Esemenli, Tanil


    Early motion and weightbearing is known to promote the healing of Achilles tendon repair. It is important to be informed about the repair strength for a secure rehabilitation. There are reports about the initial repair strength of Achilles tendons; however, they are mainly in vitro studies that represent the time zero strength of the repair. Softening of the tendon observed during the biological process of the tendon healing, which may effect the suture holding capacity and in turn the repair strength of the tendon has not been evaluated before. In the current study, the suture holding capacity of rabbit Achilles tendon was observed at various times during the healing period. The suture holding capacity of the tendon at the end of the first and third weeks after surgery was found to be similar within 30% of the control tendon. However, at the end of the fourth week it was doubled reaching 65% of the control tendon. Intrinsic tendon insufficiency which causes a decrease in the suture holding capacity of the tendon may lead to pull-out of the suture material during the postoperative third week. This period is precarious for early motion and weightbearing since the suture holding capacity of the tendon doubled relative to the previous three weeks.

  15. Terrestrial-style feeding in a very early aquatic tetrapod is supported by evidence from experimental analysis of suture morphology. (United States)

    Markey, Molly J; Marshall, Charles R


    There is no consensus on when in the fish-tetrapod transition suction feeding, the primary method of prey capture in the aquatic realm, evolved into the direct biting on prey typical of terrestrial animals. Here, we show that differences in the morphology of selected cranial sutures between species that span the fish-tetrapod transition (the Devonian osteolepiform fish Eusthenopteron, the aquatic Devonian tetrapod Acanthostega, and the Permian terrestrial tetrapod Phonerpeton) can be used to infer when terrestrial feeding first appeared. Our approach consists of defining a sutural morphospace, assigning functional fields to that morphospace based on our previous measurements of suture function made during feeding in the living fish Polypterus, inferring the functions of the fossil sutures based on where they fall in the morphospace, and then using the correlation between feeding mode and the patterns of inferred suture function across the skull roof in taxa where feeding mode is unambiguous to infer the feeding mode practiced by Acanthostega. Using this procedure, we find that the suture morphologies of Acanthostega are inconsistent with the hypothesis that it captured prey primarily by means of suction, which suggests that it may have bitten directly on prey at or near the water's edge. Thus, our data strongly support the hypothesis that the terrestrial mode of feeding first emerged in aquatic taxa.

  16. Roux limb volvulus in laparoscopic Roux-en-Y gastric bypass due to Roux limb stabilization suture: case series. (United States)

    Marr, Brendan; Yenumula, Panduranga


    Complications after laparoscopic Roux-en-Y gastric bypass surgery may be related to the type of surgical technique employed. One technique, the placement of a Roux limb stabilization suture, presumably prevents kink at the gastrojejunal anastomosis. However, it can have an adverse effect and we studied a series of cases presenting with intestinal obstruction secondary to this stitch. A retrospective review of a prospectively collected database of laparoscopic Roux-en-Y gastric bypass cases who had reoperations for Roux limb volvulus was performed at a single bariatric center by a single surgeon. Out of 199 patients who underwent laparoscopic Roux en Y gastric bypass with placement of Roux limb stabilization suture, 4 patients (2.01%) presented with Roux limb volvulus postoperatively. BMI was 45.35 ± 2.95. The postoperative time to presentation was 11 ± 10.6 months. All four patients required surgical exploration to reduce the volvulus. In all cases, the Roux limb volvulus was directly attributable to the presence of the stabilization suture. In subsequent 250 cases where this suture was eliminated, there was no volvulus of Roux limb seen. The use of a stabilization suture can result in volvulus of the Roux limb causing intestinal obstruction and this complication can be prevented by avoiding this suture.

  17. Terrane-Scale Metastability in Subducted Himalayan Continental Crust as Revealed by Integrated Petrological and Geodynamic Modeling (United States)

    Palin, R. M.; Reuber, G. S.; White, R. W.; Kaus, B. J. P.; Weller, O. M.


    The Tso Morari massif, northwest India, is one of only two regions in the Himalayan Range that exposes subduction-related ultrahigh-pressure (UHP) metamorphic rocks. The tectonic evolution of the massif is strongly debated, however, as reported pressure estimates for peak metamorphism range between 2.4 GPa and 4.8 GPa. Such ambiguity hinders effective lithospheric-scale modeling of the early stages of the orogen's evolution. We present the results of integrated petrological and geodynamic modeling (Palin et al., 2017, EPSL) that provide new quantitative constraints on the prograde-to-peak pressure-temperature-time (P-T-t) path, and predict the parageneses that felsic and mafic components of the massif crust should have formed under equilibrium conditions. Our model shows that peak P-T conditions of 2.6-2.8 GPa and 600-620 °C, representative of subduction to 90-100 km depth (assuming lithostatic pressure), were reached just 3 Myr after the onset of collision. These P-T-t constraints correlate well with those reported for similar UHP eclogite in the along-strike Kaghan Valley, Pakistan, suggesting that the northwest Himalaya contains dismembered remnants of a 400-km long UHP terrane comparable in size to the Western Gneiss Region, Norway, and the Dabie-Sulu belt, China. The extremely high pressures (up to 4.8 GPa) for peak metamorphism reported by some workers are likely to be unreliable due to thermobarometry having been performed on minerals that did not represent equilibrium assemblages. Furthermore, key high-P minerals predicted to form in subducted Tso Morari continental crust (e.g. jadeite, Mg-rich garnet) are absent from natural samples in the region, reflecting the widespread metastable preservation of lower-pressure protolith assemblages during subduction and exhumation. This result questions the reliability of geodynamic simulations of orogenesis that are commonly predicated on equilibrium metamorphism operating continuously throughout tectonic cycles.

  18. Silicate-Oxide Equilibria in the Wilson Lake Terrane, Labrador - Evidence for a Pre- Metamorphic Oxidizing Event (United States)

    Korhonen, F. J.; Stout, J. H.


    The presence of Fe3+ and Ti in silicates and their presumed equilibration with Fe2+-Fe3+-Ti oxide minerals has long been recognized as an important factor in metamorphic phase equilibria. The Red Wine Mountains massif is a granulite facies unit in the Wilson Lake terrane of central Labrador, where this equilibration is especially important for estimating both temperature and fO2 during peak metamorphism. Peak assemblages are sapphirine + quartz, and orthopyroxene + sillimanite + quartz. The coexisting oxides, which are largely responsible for the pronounced aeromagnetic high of the massif, consist of nearly pure magnetite and an exsolved titanohematite. Estimates of fO2 based on magnetite + integrated titanohematite compositions are slightly below that defined by the pure magnetite-hematite buffer. This assemblage is also responsible for the magnetic signature of metagabbro and metanorite dikes, a fact which challenges the conventional wisdom that the high Fe3+ content of the host paragneisses was inherited from a highly oxidized ferruginous shale. We suggest here that prior to granulite facies metamorphism, an oxidizing hydrothermal event either coeval or following the emplacement of mafic dikes into the paragneiss host was responsible for the highly oxidized nature of the massif as a whole. Subsequent metamorphism then produced the observed assemblages. This scenario is supported by recent U-Pb zircon and monazite ages of ca. 1626 ± 10 Ma, which indicate that both metagabbro dikes and host paragneiss were metamorphosed at the same time. Dike emplacement and the oxidizing event must have preceded 1626 Ma. The implications of this pre-metamorphic oxidizing event is that Fe3+ becomes an inherent and fixed component in the chemical system during metamorphism. Phase relationships, preliminary thermodynamic modeling, and geothermobarometric constraints indicate that peak temperatures are lower than those previously determined for Fe3+-absent systems. More appropriate

  19. A comparison of single-suture and double-suture incision closures in seaward-migrating juvenile Chinook salmon implanted with acoustic transmitters: implications for research in river basins containing hydropower structures

    Energy Technology Data Exchange (ETDEWEB)

    Brown, Richard S.; Deters, Katherine A.; Cook, Katrina V.; Eppard, M. B.


    Reductions in the size of acoustic transmitters implanted in migrating juvenile salmonids have resulted in the ability to make shorter incisions that may warrant using only a single suture for closure. However, it is not known if one suture will sufficiently hold the incision closed, particularly when outward pressure is placed on the surgical site such as when migrating fish experience pressure changes associated with passage at hydroelectric dams. The objective of this research was to evaluate the effectiveness of single-suture incision closures on juvenile Chinook salmon (Oncorhynchus tshawytscha). Juvenile Chinook salmon were surgically implanted with a 2012 Juvenile Salmon Acoustic Telemetry System (JSATS) transmitter (0.30 g) and a passive integrated transponder tag (0.10 g) and incisions were closed with either one suture or two sutures. Mortality and tag retention were monitored and fish were examined after 7 and 14 days to evaluate tissue responses. In a separate experiment, surgically implanted fish were exposed to simulated turbine passage and then examined for expulsion of transmitters, expulsion of viscera through the incision, and mortal injury. With incisions closed using a single suture, there was no mortality or tag loss and similar or reduced tissue reaction compared to incisions closed with two sutures. Further, surgery time was significantly reduced when one suture was used, which leads to less handling and reduced stress. No tags were expelled during pressure scenarios and expulsion of viscera only occurred in two non-mortally injured fish (5%) with single sutures that were also exposed to very high pressure changes. No viscera expulsion was present in fish exposed to pressure scenarios likely representative of hydroturbine passage at many Columbia River dams (e.g. <2.7 ratio of pressure change; an acclimation pressure of 146.2 absolute kpa and a lowest exposure pressure of ~ 53.3 absolute kpa). Based on these results, we recommend the use of a

  20. Preparation of A Spaceflight: Apoptosis Search in Sutured Wound Healing Models

    Directory of Open Access Journals (Sweden)

    Stefan Riwaldt


    Full Text Available To prepare the ESA (European Space Agency spaceflight project “Wound healing and Sutures in Unloading Conditions”, we studied mechanisms of apoptosis in wound healing models based on ex vivo skin tissue cultures, kept for 10 days alive in serum-free DMEM/F12 medium supplemented with bovine serum albumin, hydrocortisone, insulin, ascorbic acid and antibiotics at 32 °C. The overall goal is to test: (i the viability of tissue specimens; (ii the gene expression of activators and inhibitors of apoptosis and extracellular matrix components in wound and suture models; and (iii to design analytical protocols for future tissue specimens after post-spaceflight download. Hematoxylin-Eosin and Elastica-van-Gieson staining showed a normal skin histology with no signs of necrosis in controls and showed a normal wound suture. TdT-mediated dUTP-biotin nick end labeling for detecting DNA fragmentation revealed no significant apoptosis. No activation of caspase-3 protein was detectable. FASL, FADD, CASP3, CASP8, CASP10, BAX, BCL2, CYC1, APAF1, LAMA3 and SPP1 mRNAs were not altered in epidermis and dermis samples with and without a wound compared to 0 day samples (specimens investigated directly post-surgery. BIRC5, CASP9, and FN1 mRNAs were downregulated in epidermis/dermis samples with and/or without a wound compared to 0 day samples. BIRC2, BIRC3 were upregulated in 10 day wound samples compared to 0 day samples in epidermis/dermis. RELA/FAS mRNAs were elevated in 10 day wound and no wound samples compared to 0 day samples in dermis. In conclusion, we demonstrate that it is possible to maintain live skin tissue cultures for 10 days. The viability analysis showed no significant signs of cell death in wound and suture models. The gene expression analysis demonstrated the interplay of activators and inhibitors of apoptosis and extracellular matrix components, thereby describing important features in ex vivo sutured wound healing models. Collectively, the

  1. Transcatheter pledget-assisted suture tricuspid annuloplasty (PASTA) to create a double-orifice valve. (United States)

    Khan, Jaffar M; Rogers, Toby; Schenke, William H; Greenbaum, Adam B; Babaliaros, Vasilis C; Paone, Gaetano; Ramasawmy, Rajiv; Chen, Marcus Y; Herzka, Daniel A; Lederman, Robert J


    Pledget-assisted suture tricuspid valve annuloplasty (PASTA) is a novel technique using marketed equipment to deliver percutaneous trans-annular sutures to create a double-orifice tricuspid valve. Tricuspid regurgitation is a malignant disease with high surgical mortality and no commercially available transcatheter solution in the US. Two iterations of PASTA were tested using trans-apical or trans-jugular access in swine. Catheters directed paired coronary guidewires to septal and lateral targets on the tricuspid annulus under fluoroscopic and echocardiographic guidance. Guidewires were electrified to traverse the annular targets and exchanged for pledgeted sutures. The sutures were drawn together and knotted, apposing septal and lateral targets, creating a double orifice tricuspid valve. Twenty-two pigs underwent PASTA. Annular and chamber dimensions were reduced (annular area, 10.1 ± 0.8 cm 2 to 3.8 ± 1.5 cm 2 (naïve) and 13.1 ± 1.5 cm 2 to 6.2 ± 1.0 cm 2 (diseased); septal-lateral diameter, 3.9 ± 0.3 mm to 1.4 ± 0.6 mm (naïve) and 4.4 ± 0.4 mm to 1.7 ± 1.0 mm (diseased); and right ventricular end-diastolic volume, 94 ± 13 ml to 85 ± 14 ml (naïve) and 157 ± 25 ml to 143 ± 20 ml (diseased)). MRI derived tricuspid regurgitation fraction fell from 32 ± 12% to 4 ± 5%. Results were sustained at 30 days. Pledget pull-through force was five-fold higher (40.6 ± 11.7N vs 8.0 ± 2.6N, P PASTA reduces annular dimensions and tricuspid regurgitation in pigs. It may be cautiously applied to selected patients with severe tricuspid regurgitation and no options. This is the first transcatheter procedure, to our knowledge, to deliver standard pledgeted sutures to repair cardiac pathology. Published 2018. This article is a U.S. Government work and is in the public domain in the USA.


    Qi, Jie; Duan, Liang; Li, Weiwei; Wei, Wenbo


    To summarize the application and experience of repairing spontaneous Achilles tendon rupture by part-Kessler technique with suture anchor. Between January 2011 and December 2013, 31 patients with spontaneous Achilles tendon rupture were treated by part-Kessler technique with suture anchor. Of 31 cases, 23 were male and 8 were female, aged 16-53 years (mean, 38 years). The left side was involved in 15 cases and the right side in 16 cases. The causes of injury included sudden heel pain and walking weakness during sports in 22 cases; no surefooted down-stairs, slip, and carrying heavy loads in 9 cases. The distance from broken site to the calcaneus adhension of Achilles tendon was 3-6 cm (mean, 4.2 cm). The time from injury to operation was 7 hours to 4 days (mean, 36.8 hours). All incisions healed by first intention without nerve injury or adhering with skin. The patients were followed up 6-24 months (mean, 15 months). All patients could complete 25 times heel raising without difficulty at 6 months after operation. No Achilles tendon rupture occurred again during follow-up. At 6 months after operation, the range of motion of the ankle joint in dorsiflexion and plantar flexion showed no significant difference between normal and affected sides (t=0.648, P=0.525; t=0.524, P=0.605). The circumference of the affected leg was significantly smaller than that of normal leg at 6 months after operation (t=2.074, P=0.041), but no significant difference was found between affected and normal sides at 12 months after operation (t=0.905, P=0.426). The American Orthopedic Foot and Ankle Society (AOFAS) scores at 6, 12, 18, and 24 months after operation were significantly higher than preoperative score (P0.05). Repairing spontaneous Achilles tendon rupture by part-Kessler technique with suture anchor can supply strong strain and decrease the shear forces of suture. So part-Kessler technique with suture anchor is successful in repairing spontaneous Achilles tendon rupture.

  3. Unidirectional barbed suture versus standard monofilament for urethrovesical anastomosis during robotic assisted laparoscopic radical prostatectomy

    Directory of Open Access Journals (Sweden)

    Marc Manganiello


    Full Text Available PURPOSE: V-LocTM180 (Covidien Healthcare, Mansfield, MA is a new unidirectional barbed suture that may reduce loss of tension during a running closure. We evaluated the use of the barbed suture for urethrovesical anastomosis (UVA during robotic assisted laparoscopic prostatectomy (RALP. Time to completion of UVA, post-operative anastomotic leak rate, and urinary incontinence were compared in patients undergoing UVA with 3-0 unidirectional-barbed suture vs. 3-0 MonocrylTM (Ethicon, Somerville, NJ. MATERIALS AND METHODS: Data were prospectively collected for 70 consecutive patients undergoing RALP for prostate cancer between November 2009 and October 2010. In the first 35 patients, the UVA was performed using a modified running van Velthoven anastomosis technique using two separate 3-0 monofilament sutures. In the subsequent 35 patients, the UVA was performed using two running novel unidirectional barbed sutures. At 7-12 days postoperatively, all patients were evaluated with a cystogram to determine anastomotic integrity. Urinary incontinence was assessed at two months and five months by total daily pad usage. Clinical symptoms suggestive of bladder neck contracture were elicited. RESULTS: Age, PSA, Gleason score, prostate size, estimated blood loss, body mass index, and clinical and pathologic stage between the 2 groups were similar. Comparing the monofilament group and V-LocTM180 cohorts, average time to complete the anastomosis was similar (27.4 vs. 26.4 minutes, p = 0.73 as was the rate of urinary extravasation on cystogram (5.7 % vs. 8.6%, p = 0.65. There were no symptomatic bladder neck contractures noted at 5 months of follow-up. At 2 months, the percentage of patients using 2 or more pads per day was lower in the V-LocTM180 cohort (24% vs. 44%, p < 0.02. At 5 months, this difference was no longer evident. CONCLUSIONS: Time to complete the UVA was similar in the intervention and control groups. Rates of urine leak were also comparable

  4. Preparation of A Spaceflight: Apoptosis Search in Sutured Wound Healing Models. (United States)

    Riwaldt, Stefan; Monici, Monica; Graver Petersen, Asbjørn; Birk Jensen, Uffe; Evert, Katja; Pantalone, Desiré; Utpatel, Kirsten; Evert, Matthias; Wehland, Markus; Krüger, Marcus; Kopp, Sascha; Frandsen, Sofie; Corydon, Thomas; Sahana, Jayashree; Bauer, Johann; Lützenberg, Ronald; Infanger, Manfred; Grimm, Daniela


    To prepare the ESA (European Space Agency) spaceflight project "Wound healing and Sutures in Unloading Conditions", we studied mechanisms of apoptosis in wound healing models based on ex vivo skin tissue cultures, kept for 10 days alive in serum-free DMEM/F12 medium supplemented with bovine serum albumin, hydrocortisone, insulin, ascorbic acid and antibiotics at 32 °C. The overall goal is to test: (i) the viability of tissue specimens; (ii) the gene expression of activators and inhibitors of apoptosis and extracellular matrix components in wound and suture models; and (iii) to design analytical protocols for future tissue specimens after post-spaceflight download. Hematoxylin-Eosin and Elastica-van-Gieson staining showed a normal skin histology with no signs of necrosis in controls and showed a normal wound suture. TdT-mediated dUTP-biotin nick end labeling for detecting DNA fragmentation revealed no significant apoptosis. No activation of caspase-3 protein was detectable. FASL , FADD , CASP3 , CASP8 , CASP10 , BAX , BCL2 , CYC1 , APAF1 , LAMA3 and SPP1 mRNAs were not altered in epidermis and dermis samples with and without a wound compared to 0 day samples (specimens investigated directly post-surgery). BIRC5 , CASP9 , and FN1 mRNAs were downregulated in epidermis/dermis samples with and/or without a wound compared to 0 day samples. BIRC2 , BIRC3 were upregulated in 10 day wound samples compared to 0 day samples in epidermis/dermis. RELA/FAS mRNAs were elevated in 10 day wound and no wound samples compared to 0 day samples in dermis. In conclusion, we demonstrate that it is possible to maintain live skin tissue cultures for 10 days. The viability analysis showed no significant signs of cell death in wound and suture models. The gene expression analysis demonstrated the interplay of activators and inhibitors of apoptosis and extracellular matrix components, thereby describing important features in ex vivo sutured wound healing models. Collectively, the performed

  5. Anatomic suture anchor versus the Broström technique for anterior talofibular ligament repair: a biomechanical comparison. (United States)

    Waldrop, Norman E; Wijdicks, Coen A; Jansson, Kyle S; LaPrade, Robert F; Clanton, Thomas O


    Despite the popularity of the Broström procedure for secondary repair of chronic lateral ankle instability, there have been no biomechanical studies reporting on the strength of this secondary repair method, whether using suture fixation or suture anchors. The purpose of our study was to perform a biomechanical comparison of the ultimate load to failure and stiffness of the traditional Broström technique using only a suture repair compared with a suture anchor repair of the anterior talofibular ligament (ATFL) at time zero. We believed that fixation strength of the suture anchor repair would be closer to the strength of the native ligament and allow more aggressive rehabilitation. Controlled laboratory study. Twenty-four fresh-frozen cadaveric ankles were randomly divided into 4 groups of 6 specimens. One group was an intact control group, and the other groups consisted of the traditional Broström and 2 suture anchor modifications (suture anchors in talus or fibula) of the Broström procedure. The specimens were loaded to failure to determine the strength and stiffness of each construct. In load-to-failure testing, ultimate failure loads of the Broström (68.2 ± 27.8 N; P = .013), suture anchor fibula (79.2 ± 34.3 N; P = .037), and suture anchor talus (75.3 ± 45.6 N; P = .027) repairs were significantly lower than that of the intact (160.9 ± 72.2 N) ATFL group. Stiffness of the Broström (6.0 ± 2.5 N/mm; P = .02), suture anchor fibula (6.8 N/mm ± 2.7; P = .05), and suture anchor talus (6.6 N/mm ± 4.0; P = .04) repairs were significantly lower than that of the intact (12.4 N/mm ± 4.1 N/mm) ATFL group. The 3 repair groups were not significantly different from each other, but all 3 were substantially lower in strength and stiffness when compared to the intact ATFL. The use of suture anchors to repair the ATFL produces a repair that can withstand loads to failure similar to the suture-only Broström repair. However, all 3 repair groups were much weaker than

  6. Albert-Lembert versus hybrid-layered suture in hand sewn end-to-end cervical esophagogastric anastomosis after esophageal squamous cell carcinoma resection. (United States)

    Feng, Fan; Sun, Li; Xu, Guanghui; Hong, Liu; Yang, Jianjun; Cai, Lei; Li, Guocai; Guo, Man; Lian, Xiao; Zhang, Hongwei


    Hand sewn cervical esophagogastric anastomosis (CEGA) is regarded as preferred technique by surgeons after esophagectomy. However, considering the anastomotic leakage and stricture, the optimal technique for performing this anastomosis is still under debate. Between November 2010 and September 2012, 230 patients who underwent esophagectomy with hand sewn end-to-end (ETE) CEGA for esophageal squamous cell carcinoma (ESCC) were analyzed retrospectively, including 111 patients underwent Albert-Lembert suture anastomosis and 119 patients underwent hybrid-layered suture anastomosis. Anastomosis construction time was recorded during operation. Anastomotic leakage was recorded through upper gastrointestinal water-soluble contrast examination. Anastomotic stricture was recorded during follow up. The hybrid-layered suture was faster than Albert-Lembert suture (29.40±1.24 min vs. 33.83±1.41 min, P=0.02). The overall anastomotic leak rate was 7.82%, the leak rate in hybrid-layered suture group was significantly lower than that in Albert-Lembert suture group (3.36% vs. 12.61%, P=0.01). The overall anastomotic stricture rate was 9.13%, the stricture rate in hybrid-layered suture group was significantly lower than that in Albert-Lembert suture group (5.04% vs. 13.51%, P=0.04). Hand sewn ETE CEGA with hybrid-layered suture is associated with lower anastomotic leakage and stricture rate compared to hand sewn ETE CEGA with Albert-Lembert suture.

  7. Sedimentology of Hirnantian glaciomarine deposits in the Balkan Terrane, western Bulgaria: Fixing a piece of the north peri-Gondwana jigsaw puzzle (United States)

    Chatalov, Athanas


    Glaciomarine deposits of late Hirnantian age in the western part of the Palaeozoic Balkan Terrane have persistent thickness ( 7 m) and lateral uniformity in rock colour, bedding pattern, lithology, and sedimentary structures. Four lithofacies are distinguished from base to top: lonestone-bearing diamictites, interbedded structureless mudstones, crudely laminated diamictites, and finely laminated mudstones. The diamictites are clast-poor to clast-rich comprising muddy to sandy varieties. Their compositional maturity is evidenced by the very high amount of detrital quartz compared to the paucity of feldspar and unstable lithic grains. Other textural components include extraclasts derived from the local Ordovician basement, mudstone intraclasts, and sediment aggregates. Turbate structures, grain lineations, and soft sediment deformation of the matrix below larger grains are locally observed. Sedimentological analysis reveals that deposition occurred in an ice-intermediate to ice-distal, poorly agitated shelf environment by material supplied from meltwater buoyant plumes and rain-out from ice-rafted debris. Remobilization by mass-flow processes (cohesive debris flows and slumps) was an important mechanism particularly for the formation of massive diamictites. The glaciomarine deposits represent a typical deglaciation sequence reflecting retreat of the ice front (grounded or floating ice sheet), relative sea-level rise and gradually reduced sedimentation rate with increasing contribution from suspension fallout. This sequence was deposited on the non-glaciated shelf of the intracratonic North Gondwana platform along the southern margin of the Rheic Ocean. The Hirnantian strata of the Balkan Terrane can be correlated with similar glaciomarine deposits known from peri-Gondwana terranes elsewhere in Europe showing clear 'Armorican affinity'. Several lines of evidence suggest that the provenance of siliciclastic material was associated mainly with sedimentary recycling of

  8. The Dom Feliciano belt (Brazil-Uruguay)and its fore land (Rio de la Plata Craton): framework, tectonic evolution and correlations with similar terranes of southwestern Africa

    International Nuclear Information System (INIS)

    Basei, M.; Siga, O.; Masquelin, H.; Harara, O.; Reis Neto, J.; Preciozzi, F.


    The Dom Feliciano Belt (DFB) stretches for ca. 1,200 km along southeastern Brazil and eastern Uruguay, with an average width of 150 km. From its northern limit in Santa Catarina to its termination m Uruguay, DFB is internally organized according three crustal segments characterized, from southeast to northwest, by a Granitoid belt (calci-alkaline to alkaline granitoid rocks deformed to different degrees); a Schist belt (volcano-sedimentary rocks metamorphosed from green schist to amphibolite facies), and a Fore land belt (sedimentary and anchimetamorphic volcanic rocks), the latter situated between the Schist belt and the old western terranes. Despite discontinuously covered by younger sediments, the continuity of these three segments is suggested by the similar lithotypes and structural characteristics, as well as by the gravimetric geophysical signature.In this work, DBF is interpreted as the product of successive subduction s and collisions related to the agglutination of different terranes generated or intensely reworked from the Neoproterozoic to the Cambrian, during the Brasiliano and Rio Doce orogenesis, with maximum time starting at 900 Ma (opening of the Adamastor Ocean) and ending at 530 Ma (deformation of the fore land basins) related to the tecto no-magmatic events associated with the formation of the Western Gondwana.Besides the Neoproterozoic DFB and its fore land, the Rio de la Plata Craton and the Luis Alves Microplate, constituted by Paleoproterozoic gneissic-migmatitic rocks, two other tectonic units can be recognized in southeastern Brazil and eastern Uruguay: the Sao Gabriel Block (RS) where Neoproterozoic juvenile material can be characterized in regional scale (in great part associated with an island are), and the Punta del Este Terrane, which presents, in southern Uruguay, an ortho gneiss basement with ages around 1,000 Ma and a meta sedimentary cover (Rocha Group), which can correspond in the South-American portion, to the Namaqua and Gariep

  9. Late Triassic Porphyritic Intrusions And Associated Volcanic Rocks From The Shangri-La Region, Yidun Terrane, Eastern Tibetan Plateau: Implications For Adakitic Magmatism And Porphyry Copper Mineralization (United States)

    Wang, B.; Zhou, M.; Li, J.; Yan, D.


    The Yidun terrane, located on the eastern margin of the Tibetan plateau, has been commonly considered to be a Triassic volcanic arc produced by subduction of the Ganzi-Litang oceanic lithosphere. The Yidun terrane is characterized by numerous arc-affinity granitic intrusions located along a 500-km-long, north-south-trending belt. Among these granitic bodies, several small porphyritic intrusions in the southern segment of the terrane (Shangri-La region) are associated with large porphyry copper deposits. These porphyritc intrusions are composed of diorite and quartz diorite, and spatially associated with andesites and dacites. LA-ICP-MS zircon U-Pb ages of the intrusions range from 230 to 215 Ma. The andesites and dacites are intercalated with slates and sandstones and have ages of around 220 Ma. The intrusive and volcanic rocks have SiO2 contents from 56.6 to 67.1 wt.%, Al2O3 from 14.2 to 17.4 wt.% and MgO from 1.9 to 4.2 wt.%. They show significant negative Nb-Ta anomalies on primitive mantle-normalized spidergrams. They have high La/Yb (13-49) ratios with no prominent Eu anomalies. All the rocks have high Sr (258-1980 ppm), and low Y (13-21 ppm) with high Sr/Y ratios (29-102). The geochemical features indicate that both the volcanic rocks and porphyritic intrusions were derived from adakitic magmas. They have similar initial 87Sr/86Sr ratios (0.7058 to 0.7077) and ɛNd (-1.88 to -4.93) values, but can be further divided into two groups: high silica (HSA) and low silica adakitic rocks (LSA). The HSA, representing an early stage of magmatism (230 to 215 Ma), were derived from oceanic slab melts with limited interaction with the overlying mantle wedge. At 215 Ma, more extensive interaction resulted in the formation of LSA. We propose that HSA were produced by flat subduction leading to melting of oceanic slab, whereas subsequent slab break-off caused the significant interaction between slab melts and the mantle wedge and thus the generation of the LSA. Compared with

  10. Draa Sfar, Morocco: A Visean (331 Ma) pyrrhotite-rich, polymetallic volcanogenic massive sulphide deposit in a Hercynian sediment-dominant terrane


    Marcoux , Eric; Belkabir , Abdelhay; Gibson , Harold L.; Lentz , David; Ruffet , Gilles


    International audience; Draa Sfar is a Visean, stratabound, volcanogenic massive sulphide ore deposit hosted by a Hercynian carbonaceous, black shale-rich succession of the Jebilet terrane, Morocco. The ore deposit contains 10 Mt grading 5.3 wt.% Zn, 2 wt.% Pb, and 0.3 wt.% Cu within two main massive sulphides orebodies, Tazakourt (Zn-rich) and Sidi M'Barek (Zn–Cu rich). Pyrrhotite is by far the dominant sulphide (70 to 95% of total sulphides), sphalerite is fairly abundant, chalcopyrite and ...

  11. Randomized comparison of polyglycolic acid and polyglyconate sutures for abdominal fascial closure after laparotomy in patients with suspected impaired wound healing

    DEFF Research Database (Denmark)

    Osther, P J; Gjøde, P; Mortensen, Sophie Berit Bondegaard


    A randomized study of abdominal fascial closure using interrupted polyglyconate and polyglycolic acid sutures after laparotomy was carried out in 204 consecutive patients with suspected impaired wound healing. There were no statistically significant differences between the two sutures with regard...... to the development of fascial disruption and incisional hernia. Wound infection demanding surgical intervention was found in 7 per cent of patients with polyglyconate sutures and in 16 per cent of those with polyglycolic acid sutures (P = 0.04). Monofilament polyglyconate suture does not reduce the incidence...... of fascial disruption and incisional hernia after laparotomy in patients with suspected impaired wound healing but the incidence of wound infection may be reduced compared with that of multifilament polyglycolic acid suture....

  12. Is the arthroscopic suture bridge technique suitable for full-thickness rotator cuff tears of any size? (United States)

    Lee, Sung Hyun; Kim, Jeong Woo; Kim, Tae Kyun; Kweon, Seok Hyun; Kang, Hong Je; Kim, Se Jin; Park, Jin Sung


    The purpose of this study was to compare functional outcomes and tendon integrity between the suture bridge and modified tension band techniques for arthroscopic rotator cuff repair. A consecutive series of 128 patients who underwent the modified tension band (MTB group; 69 patients) and suture bridge (SB group; 59 patients) techniques were enrolled. The pain visual analogue scale (VAS), Constant, and American Shoulder and Elbow Surgeons (ASES) scores were determined preoperatively and at the final follow-up. Rotator cuff hypotrophy was quantified by calculating the occupation ratio (OR). Rotator cuff integrity and the global fatty degeneration index were determined by using magnetic resonance imaging at 6 months postoperatively. The average VAS, Constant, and ASES scores improved significantly at the final follow-up in both groups (p bridge groups (7.0 vs. 6.8%, respectively; p = n.s.). The retear rate of large-to-massive tears was significantly lower in the suture bridge group than in the modified tension band group (33.3 vs. 70%; p = 0.035). Fatty infiltration (postoperative global fatty degeneration index, p = 0.022) and muscle hypotrophy (postoperative OR, p = 0.038) outcomes were significantly better with the suture bridge technique. The retear rate was lower with the suture bridge technique in the case of large-to-massive rotator cuff tears. Additionally, significant improvements in hypotrophy and fatty infiltration of the rotator cuff were obtained with the suture bridge technique, possibly resulting in better anatomical outcomes. The suture bridge technique was a more effective method for the repair of rotator cuff tears of all sizes as compared to the modified tension band technique. Retrospective Cohort Design, Treatment Study, level III.

  13. Biomechanical comparison of traditional anchors to all-suture anchors in a double-row rotator cuff repair cadaver model. (United States)

    Goschka, Andrew M; Hafer, Jason S; Reynolds, Kirk A; Aberle, Nicholas S; Baldini, Todd H; Hawkins, Monica J; McCarty, Eric C


    To further reduce the invasiveness of arthroscopic rotator cuff repair surgery the all-suture anchor has been developed. The all-suture anchor requires less bone removal and reduces the potential of loose body complications. The all-suture anchor must also have adequate biomechanical strength for the repair to heal. The hypothesis is there is no significant difference in the biomechanical performance of supraspinatus repairs using an all-suture anchor when compared to traditional solid-body suture anchors. Using nine shoulders per group, the supraspinatus tendon was dissected from the greater tuberosity. The four different double row repairs tested were (medial row/lateral row): A: ICONIX2/ICONIX2; B: ICONIX2/Stryker ReelX 3.9mm; C: ICONIX2/Stryker ReelX 4.5mm; D: Arthrex BioComposite CorkScrew FT 4.5mm/Arthrex BioComposite SwiveLock 4.75mm. The ICONIX2 was the only all-suture anchor tested. Tendons underwent cyclic loading from 10 to 100N for 500 cycles, followed by load-to-failure. Data was collected at cycles 5, 100, 200, 300, 400, and 500. One-way ANOVA analysis was used to assess significance (P≤0.05). The anchor combinations tested did not differ significantly in anterior (P>0.4) or posterior (P>0.3) gap formation, construct stiffness (P>0.7), ultimate load (P=0.06), or load to 5mm gap formation (P=0.84). The all-suture anchor demonstrated comparable biomechanical performance in multiple double-row anchor combinations to a combination of traditional solid-body anchors. Thus it may be an attractive option to further reduce the invasiveness of rotator cuff repairs. Copyright © 2015 Elsevier Ltd. All rights reserved.

  14. Triple-Loaded Suture Anchors Versus a Knotless Rip Stop Construct in a Single-Row Rotator Cuff Repair Model. (United States)

    Noyes, Matthew P; Lederman, Evan; Adams, Christopher R; Denard, Patrick J


    To compare the biomechanical properties of single-row repair with triple-loaded (TL) anchor repair versus a knotless rip stop (KRS) repair in a rotator cuff repair model. Rotator cuff tears were created in 8 cadaveric matched-pair specimens and repaired with a TL anchor or KRS construct. In the TL construct, anchors were placed in the greater tuberosity and then all suture limbs were passed through the rotator cuff as simple sutures and tied. In the KRS construct, a 2-mm suture tape was passed through the tendon in an inverted mattress fashion, and a free suture was passed medial to the suture tape to create a rip-stop. Then, the suture tape and free suture were secured with knotless anchors. Displacement was observed with video tracking after cyclic loading, and specimens were loaded to failure. The mean load to failure was 438 ± 59 N in TL anchor repairs compared with 457 ± 110 N in KRS repairs (P = .582). The mean displacement with cyclic loading was 3.8 ± 1.6 mm in TL anchor repairs versus 4.3 ± 1.8 mm in the KRS group (P = .297). Mode of failure was consistent in both groups, with 6 of 8 failures in the TL anchor group and 7 of 8 failures in KRS group occurring from anchor pullout. There is no statistical difference in load to failure and cyclic loading between TL anchor and KRS single-row repair techniques. KRS repair technique may be an alternative method of repairing full-thickness supraspinatus tendon tears with a single-row construct. Copyright © 2018 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  15. Stent migration following endoscopic suture fixation of esophageal self-expandable metal stents: a systematic review and meta-analysis. (United States)

    Law, Ryan; Prabhu, Anoop; Fujii-Lau, Larissa; Shannon, Carol; Singh, Siddharth


    Covered self-expandable metal stents (SEMS) are utilized for the management of benign and malignant esophageal conditions; however, covered SEMS are prone to migration. Endoscopic suture fixation may mitigate the migration risk of covered esophageal SEMS. Hence, we conducted a systematic review and meta-analysis to evaluate the effectiveness and safety of endoscopic suture fixation for covered esophageal SEMS. Following PRISMA guidelines, we performed a systematic review from 2011 to 2016 to identify studies (case control/case series) reporting the technical success and migration rate of covered esophageal SEMS following endoscopic suture fixation. We searched multiple electronic databases and conference proceedings. We calculated pooled rates (and 95% confidence intervals [CI]) of technical success and stent migration using a random effects model. We identified 14 studies (212 patients) describing covered esophageal SEMS placement with endoscopic suture fixation. When reported, SEMS indications included leak/fistula (n = 75), stricture (n = 65), perforation (n = 10), and achalasia (n = 4). The pooled technical success rate was 96.7% (95% CI 92.3-98.6), without heterogeneity (I 2  = 0%). We identified 29 SEMS migrations at rate of 15.9% (95% CI 11.4-21.6), without heterogeneity (I 2  = 0%). Publication bias was observed, and using the trim-and-fill method, a more conservative estimate for stent migration was 17.0%. Suture-related adverse events were estimated to occur in 3.7% (95% CI 1.6-8.2) of cases. Endoscopic suture fixation of covered esophageal SEMS appears to reduce stent migration when compared to published rates of non-anchored SEMS. However, SEMS migration still occurs in approximately 1 out of 6 cases despite excellent immediate technical success and low risk of suture-related adverse events.

  16. A Novel Clinical-Simulated Suture Education for Basic Surgical Skill: Suture on the Biological Tissue Fixed on Standardized Patient Evaluated with Objective Structured Assessment of Technical Skill (OSATS) Tools. (United States)

    Shen, Zhanlong; Yang, Fan; Gao, Pengji; Zeng, Li; Jiang, Guanchao; Wang, Shan; Ye, Yingjiang; Zhu, Fengxue


    Clinical-simulated training has shown benefit in the education of medical students. However, the role of clinical simulation for surgical basic skill training such as suturing techniques remains unclear. Forty-two medical students were asked to perform specific suturing tasks at three stations with the different settings within four minutes (Station 1: Synthetic suture pad fixed on the bench, Station 2: Synthetic suture pad fixed on the standardized patient, Station 3: Pig skin fixed on the standardized patient); the OSATS (Objective Structured Assessment of Technical Skill) tool was used to evaluate the performance of students. A questionnaire was distributed to the students following the examination. Mean performance score of Station 3 was significant lower than that of Station 1 and 2 in the general performance including tissue handling, time, and motion. The suturing techniques of students at Station 2 and 3 were not as accurate as that at Station 1. Inappropriate tension was applied to the knot at Station 2 compared with Station 1 and 3. On the questionnaire, 93% of students considered clinical-simulated training of basic surgical skills was necessary and may increase their confidence in future clinical work as surgeons; 98% of students thought the assessment was more objective when OSATS tool was used for evaluation. Clinical simulation examination assessed with OSATS might throw a novel light on the education of basic surgical skills and may be worthy of wider adoption in the surgical education of medical students.

  17. Genesis of zoned granite plutons in the Iapetus Suture Zone: new constraints from high-precision micro-analysis of accessory minerals


    Miles, Andrew James


    The Trans-Suture Suite (TSS) of granitic plutons located in Northern Britain span the Iapetus Suture and represent a particularly enigmatic stage of post-Caledonian Devonian magmatism. Despite calc-alkaline affinities, proximity to the Iapetus Suture precludes a direct relationship to active subduction. Furthermore, the absence of inherited zircons distinguishes the TSS from plutons of a similar age throughout the Scottish Highlands, and is not easily reconciled with the abunda...

  18. The Uterine Sandwich Method for Placenta Previa Accreta in Mullerian Anomaly: Combining the B-Lynch Compression Suture and an Intrauterine Gauze Tampon

    Directory of Open Access Journals (Sweden)

    Mustafa Kaplanoğlu


    Full Text Available Mullerian duct anomalies may cause obstetric complications, such as postpartum hemorrhage (PPH and placental adhesion anomalies. Uterine compression suture may be useful for controlling PPH (especially atony. In recent studies, uterine compression sutures have been used in placenta accreta. We report a case of PPH, a placenta accreta accompanying a large septae, treated with B-Lynch suture and intrauterine gauze tampon.

  19. Stable Isotope Evidence for a Complex Fluid Evolution of the Northwestern British Columbia Coast Ranges Related to Terrane Accretion (United States)

    Moertle, J.; Holk, G. J.


    Stable isotope geochemistry reveals a complex fluid evolution for the Western Metamorphic Belt (WMB), Coast Ranges Batholith (CRB), Central Gneiss Complex (CGC) and Coast Ranges Megalineament (CRM). These fluids are a product of a complex tectonic history related to terrane accretion that includes oblique convergence, metamorphism, magmatism, and orogenic collapse. From W-to-E, these fluid systems are as follows. High-pressure greenschist-to-amphibolite facies metasedimentary rocks of the WMB record variable mineral δD (-61 to -104‰) and δ18O (e.g., quartz +9.6 to +13.4‰) values with multiple minerals in apparent isotopic equilibrium (T ~ 450-550°C) suggest a low W/R system dominated by metamorphic fluids. Variable and non-equilibrium δD (-53 to -143‰) and δ18O (e.g., biotite +2.3 to +5.3‰) values from diorites of the Quottoon pluton affected by the ductile CRM suggest a complex evolution that involved both metamorphic and meteoric-hydrothermal fluids in this dextral shear zone; these results differ from those 300 km along strike to the north that documented only metamorphic fluids in the CRM (Goldfarb et al., 1988). Our data and those of Magaritz and Taylor (1976) from granulite facies metasediments of the CGC and plutons of the western CRB reveal homogeneous δD values (-62 to -78‰) and a restricted range of δ18O values (e.g., quartz +8.5 to +11.5‰) with all minerals in equilibrium at T > 570°C indicate a system dominated by magmatic fluids. Calculated whole-rock δ18O values (~ +7‰) for the Quottoon pluton and CRB intrusive rocks suggest a mantle origin for these magmas. Reinterpretation of very low δD (< -150‰) and quartz-feldspar δ18O pairs that display extreme disequilibrium (feldspar δ18O values as low as -5‰) from the Ponder pluton, eastern CRB, and Hazelton Group point reveals that the major meteoric-hydrothermal system that affected these rocks was related to Eocene detachment faulting along the Shames Lake fault system, a

  20. Patellar Tendon Repair Augmentation With a Knotless Suture Anchor Internal Brace: A Biomechanical Cadaveric Study. (United States)

    Rothfeld, Alex; Pawlak, Amanda; Liebler, Stephenie A H; Morris, Michael; Paci, James M


    Patellar tendon repair with braided polyethylene suture alone is subject to knot slippage and failure. Several techniques to augment the primary repair have been described. Purpose/Hypothesis: The purpose was to evaluate a novel patellar tendon repair technique augmented with a knotless suture anchor internal brace with suture tape (SAIB). The hypothesis was that this technique would be biomechanically superior to a nonaugmented repair and equivalent to a standard augmentation with an 18-gauge steel wire. Controlled laboratory study. Midsubstance patellar tendon tears were created in 32 human cadaveric knees. Two comparison groups were created. Group 1 compared #2 supersuture repair without augmentation to #2 supersuture repair with SAIB augmentation. Group 2 compared #2 supersuture repair with an 18-gauge stainless steel cerclage wire augmentation to #2 supersuture repair with SAIB augmentation. The specimens were potted and biomechanically loaded on a materials testing machine. Yield load, maximum load, mode of failure, plastic displacement, elastic displacement, and total displacement were calculated for each sample. Standard statistical analysis was performed. There was a statistically significant increase in the mean ± SD yield load and maximum load in the SAIB augmentation group compared with supersuture alone (mean yield load: 646 ± 202 N vs 229 ± 60 N; mean maximum load: 868 ± 162 N vs 365 ± 54 N; P augmented repairs (mean yield load: 495 ± 213 N vs 566 ± 172 N; P = .476; mean maximum load: 737 ± 210 N vs 697 ± 130 N; P = .721). Patellar tendon repair augmented with SAIB is biomechanically superior to repair without augmentation and is equivalent to repair with augmentation with an 18-gauge stainless steel cerclage wire. This novel patellar tendon repair augmentation is equivalent to standard 18-gauge wire augmentation at time zero. It does not require a second surgery for removal, and it is biomechanically superior to primary repair alone.

  1. Outpatient angioplasty and stenting facilitated by percutaneous arterial suture closure devices

    International Nuclear Information System (INIS)

    Wilde, N.T.; Bungay, P.; Johnson, L.; Asquith, J.; Butterfield, J.S.; Ashleigh, R.J.


    Aim: To review our practice of outpatient percutaneous vascular interventions facilitated by an arterial suture device. Materials and methods: A retrospective review of all patients attending this tertiary centre for iliac or femoral intervention was undertaken between February 2001 and December 2004. All patients who underwent angioplasty or stenting had their puncture sites closed using a Perclose suture. Patients w