WorldWideScience

Sample records for transanal endorectal pull-through

  1. Transanal endorectal pull-through for classic segment Hirschsprung's disease: With or without laparoscopic mobilization of the rectosigmoid?

    NARCIS (Netherlands)

    T.J. van de Ven (Teun); C.E.J. Sloots (Pim); M.H.W.A. Wijnen (Marc); R. Rassouli (Roxana); I.A.L.M. Rooij (Iris); R.M.H. Wijnen (René); I. de Blaauw (Ivo)

    2013-01-01

    textabstractBackground It has been suggested that the outcome of transanal endorectal pull-through for classic Hirschprung's disease can be improved by laparoscopically mobilizing the colon before the pullthrough. Methods Charts of 43 patients (2005-2009) with proven recto-sigmoid aganglionosis were

  2. Single-stage transanal endorectal pull-through for Hirschsprung's disease: perspective from a developing country.

    Science.gov (United States)

    Pratap, Akshay; Shakya, Vikal Chandra; Biswas, Binay Kumar; Sinha, Arvind; Tiwari, Awadhesh; Agrawal, Chandra Shekhar; Adhikary, Shailesh

    2007-03-01

    The aim of this study was to evaluate the feasibility, results, and cost-effectiveness of totally transanal endorectal pull-through (TEPT) in the management of rectosigmoid and midsigmoid Hirschsprung's disease (HD) in a low-income country. Between March 2004 and December 2005, 19 children underwent totally TEPT procedure. The patients' ages ranged from 6 days to 13 years. The primary diagnosis in all 19 patients was HD confined to the rectosigmoid region in 15 and midsigmoid in 4. None had a preoperative colostomy. Follow-up period ranged from 4 to 20 months (mean, 8 months). Ages ranged from 0.25 to 65 months, with a mean of 16.24 months. Weights ranged from 3.4 to 13 kg, with a mean of 6.5 kg. Mean time from diagnosis to pull-through procedure was 26 days (range, 6-39 days). The mean length of rectosigmoid resection was 30 cm (range, 20-50 cm). The mean operative time was 95 minutes (range, 75-140 minutes). Mean intraoperative blood loss was 25 mL (range, 15-40 mL). There was one death unrelated to the procedure. One patient had enterocolitis 3 months postoperatively. Average frequency of defecation was 3 (range, 1-6) stools per day. TEPT was associated with a shorter operating time, less blood loss, early return to feeds, and an overall reduced cost. The safety and cost-effective benefits of transanal endorectal pull-through in the treatment of HD are of special interest for a developing country. Our data also suggest that functional outcome following TEPT is highly satisfactory and comparable with other established procedures.

  3. Soave transanal one-stage endorectal pull-through in the treatment of Hirschsprung′s disease of the child above two-year-old: A report of 20 cases

    Directory of Open Access Journals (Sweden)

    Amine Ksia

    2013-01-01

    Full Text Available Background: The definitive treatment of Hirschsprung′s disease is the removal of the aganglionic bowel by a pull-through surgery. In most cases, this surgery is performed in infancy or in the neonatal period as presentation in older children and adulthood is uncommon. Materials and Methods: It is a retrospective study of 20 patients above two-year-old who underwent a transanal Soave one-stage endorectal pull-through procedure for Hirschsprung′s disease between January 2002 and December 2010. Results: Twenty patients were recruited in this study. Fourteen were males and six were females. Patient ages ranged from 2 to 14 years (median age: five years and three months. All patients presented with persistent constipation and abdominal distension. Two of them had an intestinal obstruction that required colostomy. Ten patients (50% had a recto-sigmoid Hirschsprung′s disease. All patients were operated on using a Soave one-stage endorectal pull-through procedure. The laparoscopy was necessary during the pull-through in three cases. The average duration of the intervention was 240 minutes. That represents almost the double of the duration of the same procedure in newborns and infants in our department (130 minutes. Early postoperative complications included one case of anastomosis leakage and one case of intussusception. Late postoperative complications were perineum irritation in five cases (25%, anal stenosis in four cases (20% and enterocolitis in one case (5%. None of our patients developed fecal incontinence. Soiling was reported in four cases (20%. There was no death. Conclusion: Soave transanal one-stage endorectal pull-through is safely feasible in children of more than two years of age. Laparoscopy may be necessary whenever there are difficulties in the pull-through.

  4. Pneumaturia signaling a fistula between the rectum anastomosis and seminal vesicle as a complication after transanal endorectal pull-through operation for Hirschsprung's disease. A method of repair

    Directory of Open Access Journals (Sweden)

    Christina Granéli

    2014-09-01

    Full Text Available A 2-year-old boy underwent an uneventful transanal endorectal pull-through for Hirschsprung's disease. Postoperatively he suffered from pneumaturia which prompted surgical evaluation. He was found to have a rectum to seminal vesicle fistula. He was re-operated closing the fistula through an anterior transperineal approach with a successful operative outcome.

  5. Role of transanal endorectal pull-through in complicated Hirschsprung's disease: experience in 18 patients.

    Science.gov (United States)

    Hadidi, Ahmed; Bartoli, Fabio; Waag, Karl-Ludwig

    2007-03-01

    In Hirschsprung's disease (HD) redo pull-through (PT) is indicated for anastomotic complications and for persistent aganglionosis after previous definitive surgery. This study was undertaken to evaluate the role of transanal approach to redo PT procedure in the management of complicated cases of HD over the last 7 years. Between November 1998 and September 2005, 225 patients with HD were operated using the transanal endorectal PT (TEPT) approach. Eighteen patients had a redo PT owing to persistent aganglionosis. The present study evaluates the role of TEPT approach in patients with persistent aganglionosis (n = 18). Three patients needed a colostomy (n = 2) or ileostomy (n = 1) before the final operation. All the 18 patients underwent transanal mobilization (TEPT) of the colon. Six patients required additional mobilization of the proximal colon (n = 4) and the ileum (n = 2) during the redo PT operation. Median follow-up was 43 months (range, 3-72 months). Sixteen patients have had a good outcome with stool pattern 1 to 4 times daily. One patient had obstructive symptoms for 4 months postoperatively but then settled. One patient has occasional soiling. In this series, TEPT and posterior midline split of the muscle cuff were used with good results. This has the advantage of avoiding injury to the pelvic muscles and nerves. The TEPT approach is combined with transabdominal mobilization of the intestine depending on the length of the aganglionic segment. The outcome has been favorable, but long-term follow-up is necessary for full assessment of those patients.

  6. Complications of Transanal One-stage Endorectal Pull-through Procedure in Infants with Hirschsprung's Disease

    Directory of Open Access Journals (Sweden)

    M Rouzrokh

    2011-08-01

    Full Text Available Introduction: Hirschsprung's disease(HD is a common congenital disease. In 80% of cases, the recto sigmoid junction is involved. Recently, one-stage transanal endorectal pull-through(TAEPT procedure has been popular, but it could have several complications. In this research, we have studied the complications of this procedure. Methods: During a four year period, 86 infants clinically suspected to have HD were admitted at our center. HD was confirmed by rectal biopsy and all were candidates for TAEPT operation. A Swenson-like procedure was performed and in 30 cases, prophylactic Hegar dilatation was done 2 weeks after operation. Results: Anal stricture was seen in 12 cases(14% of which 10 cases were treated by anal dilation and 2 cases were corrected by surgical management. Entrocolitis was seen in 4 cases(5% who were treated by medical management. In 2 cases, retrocolic abscess was present that was treated by spontaneous drainage via tube drain. There was no anastomotic stricture after starting prophylactic anal bouginage. Conclusion: TAEPT has many advantages and few complications. It seems that one of the most common complications is anastomotic stricture that responds well to prophylactic bouginage. We recommend prophylactic anal bouginage with Hegar probe 2 weeks after operation. A long-term follow-up is needed to evaluate the outcomes of these operations.

  7. Fecal incontinence after single-stage Soave's pull-through ...

    African Journals Online (AJOL)

    Journal Home > Vol 8, No 1 (2012) > ... Demographic, clinical data, preoperative investigations, operative records, postoperative ... Keywords: fecal continence, Hirschsprung's disease, Soave's operation, transanal endorectal pull-through ...

  8. The role of transanal endorectal pull-through in the treatment of Hirschsprung's disease - a multicenter experience.

    Science.gov (United States)

    Höllwarth, M E; Rivosecchi, M; Schleef, J; Deluggi, S; Fasching, G; Ceriati, E; Ciprandi, G; DePeppo, F

    2002-09-01

    The transanal approach (TAA) is a new technique for surgery of Hirschsprung's disease (HD) that was introduced by de la Torre in 1998. The purpose of this multicenter study, including experience from three Austrian and one Italian departments of peadiatric surgery, was to evaluate the role of this approach in HD in 18 children aged 1-72 months. In 14 children the TAA only was performed; in 3 an additional laparoscopy was performed and in 1 conversion to a laparotomy was necessary. One complication (abscess) occurred after laparoscopic-assisted pull-through. The postoperative recovery was rapid, no severe long-term problems were observed. The transanal pull-through technique is generally possible in most classic cases of HD with extension of the disease to the sigmoid colon. If necessary, it can be combined with laparoscopy. Our preliminary results show that the technique is safe, less invasive, and gives excellent cosmetic results, and allows rapid recovery. Long-term results are still pending.

  9. Release of obstructing rectal cuff following transanal endorectal ...

    African Journals Online (AJOL)

    symptoms after transanal endorectal pullthrough for ... In both patients, the obstructing symptoms were because of a rectal cuff ... widely adopted for the treatment of Hirschsprung's disease ... The cuff was identified and cut strictly in the midline.

  10. Transanal pull-through procedure for Hirschsprung's disease: a 5-year experience.

    Science.gov (United States)

    Jester, I; Holland-Cunz, S; Loff, S; Hosie, S; Reinshagen, K; Wirth, H; Ali, M; Waag, K-L

    2009-04-01

    Transanal endorectal pull-through (TEPT) has become a widely used approach for the treatment of Hirschsprung's Disease. The technique is safe and, according to previous reports, it has a good clinical outcome. In this study our experience with TEPT in the early postoperative period is evaluated. The clinical course of 34 children (28 boys and 6 girls) who underwent one-stage pull-through operation according to De la Torre for Hirschsprung's disease from January 2003 to December 2007 was reviewed. Their ages ranged from 2 months to 4 years. Complications occurring within the first four weeks after operation were analyzed. Eight of 34 children (24 %) had early complications in the form of dehiscences of the anastomosis. Two children (6 %) had symptomatic anastomotic dehiscences. One child had an almost full retraction of the colon that had to be pulled down and resutured. One child developed a retrorectal abscess three weeks postoperatively due to anastomotic leakage. The dehiscences of 6 children (18 %) were asymptomatic. These dehiscences were detected only with standardized routine examination. The dehiscences healed uneventfully after resuturing. Two other patients (6 %) developed an anastomotic stricture that could be treated with rectal dilatations. Four children (12 %) showed a single episode of postoperative enterocolitis. The rate of early clinical and particularly subclinical complications such as anastomotic dehiscences after TEPT is higher than previously estimated. Patients should be monitored carefully during the early postoperative period. Severe complications can only be avoided with a thorough examination. Early resuturing of dehiscences might be helpful to prevent hazardous sequelae.

  11. 经肛门Soave巨结肠根治术后排便功能的评价%Anorectal function after transanal endorectal pull-through for Hirschsprung's disease

    Institute of Scientific and Technical Information of China (English)

    郭立华; Geha Raj Dahal; 杨合英; 李苏宁; 刘秋亮; 张大; 王家祥

    2009-01-01

    Objective To investigate the long-term anorectal function after transanal endorectal pull-through (TEPT, SOAVE) and colonic plication for Hirschsprung's disease (HD). Methods A retrospective cohort study of 130 patients, who underwent TEPT for HD between October 2003 and October 2008, was carried out to evaluate the anal function. Results Among the 130 patients, 98 patients underwent SOAVE procedure, and 32 patients with long segment, or dilated and straight rectosigmoid underwent laparoscopic assisted transanal pull-through (LATP) procedure. For the disparity between the dilated proximal colon and anus, 15 patients underwent the colonic plication to facilitate colo-anal anastomosis. Ninety patients were followed up. Late postoperative complications were noted in 3 patients including soiling in 2 patients, constipation and enterocolitis in 1 patient. Out of the 56 patients who were followed up over 3 years after operation, continence score was normal in 23 patients, good in 31 patients, and fair in 2 patients. All the patients underwent colonic plication were followed up. Among them, continence score was normal in 6 patients, good in 9 patients, and no postoperative complication was noted.Conclusions The long-term anorectal function after TEPT is good. The outcome of colonic plication is good in patients with dilated but functioned proximal colon. Combined with laparoscopy, colonic plication can become an assistant procedure for TEPT for HD.%目的 观察经肛门Soave巨结肠根治术后排便功能和结肠切端缩口缝合术的效果.方法 回顾性分析2003年10月至2008年10月130例经肛门Soave巨结肠根治术患儿的术后排便功能恢复情况. 结果 130例中98例行经肛门根治术,32例因长段型和直肠乙状结肠呈直筒状行腹腔镜协助经肛门根治术,其中15例因近端结肠切端扩张与肛门口径大小不符行结肠切端缩口缝合后再行肛门结肠吻合.130例术后电话和信件获访90例,远期并发症3

  12. Transanal Endorectal Pull-through for Hirschsprung's Disease ...

    African Journals Online (AJOL)

    HussamHassan

    Pediatric Surgery Unit, Surgery Department, Mansoura University, Mansoura, Egypt. Annals of Pediatric ... induction of anesthesia and continued for 3 days after operation. ..... diagnosis of Hirschsprung disease decreases risk of postoperative ...

  13. Systematic review and meta-analysis of enterocolitis after one-stage transanal pull-through procedure for Hirschsprung's disease.

    LENUS (Irish Health Repository)

    Ruttenstock, Elke

    2012-02-01

    PURPOSE: The transanal one-stage pull-through procedure (TERPT) has gained worldwide popularity over open and laparoscopic-assisted one-stage techniques in children with Hirschsprung\\'s disease (HD). It offers the advantages of avoiding laparotomy, laparoscopy, scars, abdominal contamination, and adhesions. However, enterocolitis associated with Hirschsprung\\'s disease (HAEC) still remains to be a potentially life-threatening complication after pull-through operation. The reported incidence of HAEC ranges from 4.6 to 54%. This meta-analysis was designed to evaluate postoperative incidence of HAEC following TERPT procedure. METHODS: A meta-analysis of cases of TERPT reported between 1998 and 2009 was performed. Detailed information was recorded regarding intraoperative details and postoperative complications with particular emphasis on incidence of HAEC. Diagnosis of HAEC in a HD patient was based on the clinical presentation of diarrhoea, abdominal distension, and fever. RESULTS: Of the 54 published articles worldwide, 27 articles, including 899 patients were identified as reporting entirely TERPT procedure. Postoperative HAEC occurred in 92 patients (10.2%). Recurrent episodes of HAEC were reported in 18 patients (2%). Conservative treatment of HAEC was successful in 75 patients (81.5%), whereas in 17 patients (18.5%) surgical treatment was needed. CONCLUSIONS: This systematic review reveals that TERPT is a safe and less-invasive procedure with a low incidence of postoperative HAEC.

  14. Author Details

    African Journals Online (AJOL)

    Hassan, ME. Vol 8, No 4 (2012) - Articles Quality of life and parents' satisfaction with Duhamel's versus transanal endorectal pull-through for the treatment of Hirschsprung's disease in children. Abstract PDF · Vol 9, No 2 (2013) - Articles Pyloric atresia epidermolysis bullosa aplasia cutis syndrome: a case report and ...

  15. Transanal Pull-Through Procedure with Delayed versus Immediate Coloanal Anastomosis for Anus-Preserving Curative Resection of Lower Rectal Cancer: A Case-Control Study.

    Science.gov (United States)

    Xiong, Yong; Huang, Ping; Ren, Qing-Gui

    2016-06-01

    This case-control study compared the effectiveness and safety of transanal pull-through procedure (TPP) with delayed or immediate coloanal anastomosis (CAA) for anus-preserving curative resection of lower rectal cancer. Lower rectal cancer patients (n = 128) were hospitalized between January 2003 and December 2013 for elective anus-preserving curative resection through a TPP with delayed (n = 72) or immediate (n = 56) CAA. Main outcome measures including surgical safety, resection radicality, and defecation function were assessed. The two groups were comparable in age, sex, gross pathology, histology, and tumor-node-metastasis staging. Both the delayed and immediate CAA TPPs had similar resection radicality and safety profiles. The immediate CAA was associated with a significantly higher risk of anastomotic leakage and defecation impairment. None of patients in the delayed CAA group experienced anastomotic leakage. In conclusion, TPP with delayed CAA may be superior to immediate CAA in minimizing the risk of anastomotic leakage and relevant surgical morbidities, and does not require a temporary ileostomy and second-look restoration of ostomy.

  16. Laparoscopy-assisted versus transabdominal reoperation in Hirschprung's disease for residual aganglionosis and transition zone pathology after transanal pull-through.

    Science.gov (United States)

    Xia, Xue; Li, Ning; Wei, Jia; Zhang, Wen; Yu, Donghai; Zhu, Tianqi; Feng, Jiexiong

    2016-04-01

    This study aims to describe laparoscopic reoperation (LSR) and compare its outcomes with transabdominal reoperation (TAR) for treating Hirschsprung's disease (HD). Eighteen patients with HD underwent reoperation for recurring constipation due to residual aganglionosis and transition zone pathology after an initial transanal procedure (LSR, n=10; TAR, n=8). Preoperative, operative and postoperative data were collected through patient follow-ups ranging from 13 to 75months to compare operative characteristics and postoperative outcomes between the two groups. Ten patients underwent laparoscopic reoperation in our institution without major complications. On average, blood loss was significantly lower in the LSR group (mean±standard deviation, 83±32.7mL) than in the TAR group (185±69mL) (P=0.001). The LSR group had a shorter hospitalization time (12±2days) than the TAR group (15±2.1days) (P=0.02). There was no statistically significant difference in incidence of postoperative complications between the two groups. LSR is safe and technically feasible in HD for recurring constipation due to residual aganglionosis and transition zone pathology, when initial transanal procedure fails. Although RA and TZP can be cured by reoperation, great efforts should be made to diminish the necessity of reoperation. Copyright © 2015 Elsevier Inc. All rights reserved.

  17. Evolución clínica de los pacientes operados de enfermedad de Hirschsprung por técnicas transanales Clinical evolution of patients with Hirschsprung's disease operated on by transanal techniques

    Directory of Open Access Journals (Sweden)

    Hermes Daniel Hernández Alfonso

    2012-09-01

    Full Text Available Introducción: el tratamiento quirúrgico de la enfermedad de Hirschsprung ha evolucionado positivamente desde que, en 1998, De la Torre Mondragón describiera su técnica de descenso endorrectal totalmente transanal. No obstante, estas variantes técnicas son relativamente nuevas y poco se ha escrito en cuanto a su evolución posoperatoria y estado de la continencia de los pacientes operados. Métodos: se realizó un estudio observacional y descriptivo de 43 pacientes operados de enfermedad de Hirschsprung por medio de técnicas transanales, en un solo tiempo quirúrgico, entre 2004 y 2011, en el Hospital Pediátrico Universitario de Centro Habana. Se aplicó un cuestionario a todos los pacientes en relación con el estado de la función intestinal y urinaria en diferentes momentos de la evolución, luego de los 6 meses de operados, y se relacionaron los resultados con aspectos como la edad y la longitud del segmento resecado. Se utilizó el test de Fisher para el análisis estadístico, considerando significativos los valores de pIntroduction: the surgical treatment of Hirschsprung's disease has positively evolved since 1998 when De la Torre Mondragón described his totally transanal endorectal pull through technique. Nevertheless, these technical variants are relatively new and little has been said about the postoperative evolution and the continence status of the surgical patients. Methods: an observational descriptive study of 43 surgical patients, who suffered Hirschsprung's disease and were operated on by transanal one-stage techniques from 2004 to 2011 at university pediatric hospital of Centro Havana, was carried out. All the patients were given a questionnaire to find out the condition of the intestinal and urinary functions at different times, six months after surgery. The results were correlated with age and length of the resected segment. Fisher's test was used for the statistical analysis, being p< 0,05. Results: the average age at

  18. Rectal duplication with sciatic hernia.

    Science.gov (United States)

    Nosek, Marzena; Golonka, Anna; Kalińska-Lipert, Anita; Nachulewicz, Paweł

    2015-07-01

    Rectal duplications represent 5% of all duplications in the alimentary tract, and they are very rarely diagnosed during the neonatal period. The authors present the method of investigation and the results of surgical treatment of a full-term neonate with a sciatic hernia containing a rectal duplication. The procedure started with three-port laparoscopy, but excision of the tubular duplication of the rectum was possible only by a transanal endorectal pull-through approach. The sciatic hernia was closed, and plastic sutures on the buttock finished the procedure. The coincidence of sciatic hernia with rectal duplication is extremely rare, and the method of treatment depends exclusively on the anatomical conditions.

  19. Retrorectal tumors: Excision by transanal endoscopic microsurgery Tumores retrorrectales: excisión por microcirugía endoscópica transanal

    Directory of Open Access Journals (Sweden)

    S. Zoller

    2007-09-01

    Full Text Available Tumours within the retrorectal space are uncommon. Due to their rarity and diverse symptoms they are often misdiagnosed or mistreated. We report three cases of women presenting a variety of symptoms including increased rectal pain, recurrent abscesses/fistulas and constipation. Upon clinical examination and further investigations using MR scan, endorectal ultrasound and endoscopy, a retrorectal mass was suspected in all three cases. In order to achieve a complete excision of the tumor while minimizing trauma, transanal endoscopic microsurgery (TEM was performed. The histology of the multicystic tumor revealed in all three cases a tailgut cyst. As far as we know this is the first report describing the use of TEM for surgical treatment of tumors located in the retrorectal space.Los tumores del espacio retrorrectal representan una patología poco frecuente. Debido a su singularidad incluida la amplia sintomatología con la que debutan, son a veces causa de diagnósticos y tratamientos erróneos. Esta nota clínica informa sobre tres casos surgidos en mujeres con variada sintomatología donde se incluía dolor rectal, enfermedad supurada anal recidivada y estreñimiento. La masa retrorrectal fue diagnosticada tras exploración clínica y pruebas de imagen donde se incluía ecografía endorrectal, resonancia magnética y endoscopia. La exéresis quirúrgica se realizó mediante microcirugía transanal endoscópica, en un intento de combinar una visualización mejorada de la disección y una técnica mínimamente invasiva. La anatomía patológica demostró en los tres casos quistes caudales. Esta nota clínica describe por primera vez en la literatura la resección quirúrgica de tumores localizados en el espacio retrorrectal mediante microcirugía transanal endoscópica.

  20. Laparoscopically assisted anorectal pull-through for rectovestibular ...

    African Journals Online (AJOL)

    Laparoscopically assisted anorectal pull-through for rectovestibular fistula. Taha Alkhatrawi, Radi Elsherbini, Waheed Alturkistani. Abstract. Purpose Laparoscopically assisted anorectal pull-through (LAARP) has been described as an alternative to posterior sagittal anorectoplasty for the surgical treatment of rectourethral ...

  1. Pull-Through Capacity in Plywood and OSB

    DEFF Research Database (Denmark)

    Munch-Andersen, Jørgen; Sørensen, John Dalsgaard

    The characteristic pull-through capacity of heads of nails and screws is needed to determine the rope effect for laterally loaded fasteners used to fix sheathing to timberframes. There is no values given in EN 1995 (Eurocode 5) but data for the pull through capacity of nail and screw heads has be...

  2. Totally Transanal Laparo-Endoscopic Single-Site ProctoColectomy-Ileoanal J-Pouch (TLPC-J: An Experimental Study of a Novel Approach

    Directory of Open Access Journals (Sweden)

    Mohammad Reza Vahdad

    2015-09-01

    Full Text Available Background: The natural orifice transluminal endoscopic surgery (NOTES has become a commonly considered novel approach in the surgical field. The NOTES provide possibility of operation through the natural orifice and decreases the intentional puncture of the systemic organ and subsequent complications. Totally transanal laparo-endoscopic single-site proctoColectomy-Ileoanal J-Pouch (TLPC-J is a novel method in minimally invasive surgery for total colectomy. The main goal of this study is to perform this new method on an animal model, to assess probable complication and to resolve probable issues by using patients that are candidate for total colectomy. Method: Five dogs were prepared in lithotomy position. The TLPC-I procedure consists of endorectal technique with full thickness rectal dissection starting 1 cm orally from the dentate line above the peritoneal reflection and the proximal bowel was replaced into the abdominal cavity. Afterwards, the TriPort system was inserted in the anal canal and mesentrial resection of the total colon, mobilization of a distal ileal segment and intracorporeal suture of an ileal J-loop was accomplished by this system. An incision in the J-loop was conducted transanally. The J-pouch was created with an Endo-GIA® and sutured to the rectal wall. Results: All animals survived and passed stool with clear post operation situation. There was no infection in site of anastomosis. Conclusion: The TLPC-I provides the possibility of surgery without abdominal wall incision and decreases post operation complication such as pain, abdominal wound infection and wound dehiscence. This technique increases the quality of life and surgeons can discharge the patients early.

  3. Perioperative topical nitrate and sphincter function in patients undergoing transanal stapled anastomosis: a randomized, placebo-controlled, double-blinded trial.

    LENUS (Irish Health Repository)

    Winter, D C

    2012-02-03

    PURPOSE: The use of transanal stapling devices may impair continence because of digital dilatation and\\/or instrumentation. This study assessed the effect of pharmacological dilatation of the sphincter prior to stapler insertion. METHODS: A randomized, placebo-controlled, double-blinded study of 60 patients undergoing transanal stapled anastomosis was undertaken. Consenting patients were randomly assigned to receive a single intraoperative dose of topical 0.2 percent nitroglycerin (glyceryl trinitrate) ointment or nitroglycerin-free placebo. All patients were assessed preoperatively and postoperatively by clinical methods (Wexner incontinence scores and examination), anorectal manometry by a station pull-through technique, and endoanal ultrasonography. RESULTS: Intraoperative mean (+\\/-SEM) resting pressures (mmHg) were significantly reduced by nitroglycerin compared with prenitroglycerin levels (9.9 +\\/- 0.9 vs. 50.5 +\\/- 2.7; P = 0.002) or controls (56.0 +\\/- 3.2; P = 0.001). Twenty-one of the 28 controls (75 percent) but only 4 of the 32 patients in the nitroglycerin group (12.5 percent) required digital dilatation to insert the stapling instrument ( P = 0.003). Squeeze pressures were unaltered by the intervention but mean resting pressures were higher in the nitroglycerin group postoperatively (52.9 +\\/- 3.2 - 31.6 +\\/- 1.3 = 21.3 mmHg; 95 percent confidence interval, 14-27). Incontinence scores were lower in the nitroglycerin group at the 3-month (1.1 +\\/- 0.2 vs. 4.6 +\\/- 0.3; P = 0.003) and 12-month (0.9 +\\/- 0.1 vs. 4.4 +\\/- 0.3; P = 0.002) clinic visits. CONCLUSION: Preoperative nitroglycerin dilatation protects sphincter function in patients undergoing transanal stapled anastomoses.

  4. Effectiveness of various surgical methods in treatment of Hirschsprung’s disease in children

    Directory of Open Access Journals (Sweden)

    Lukač Marija

    2016-01-01

    Full Text Available Background/Aim. Hirschsprung’s disease is the most common identifiable developmental disorder of the enteric nervous system, characterized by a failure of its formation in a variable segment of distal bowel. Currently available surgical therapies for Hirschsprung’s disease, although lifesaving, are associated with numerous complications. The aim of our study was to evaluate the effectiveness of different surgical methods and the incidence of serious complications after radical surgery of rectosigmoid Hirschsprung’s disease. Methods. A retrospective analysis, from June 1997 until May 2012 was carried out on 84 patients operated for Hirschsprung’s disease of rectosigmoid colon. Transanal endorectal pull-through was performed in 30 (35.7% patients (group I, while 54 (64.3% patients were operated by other (Soave, Duhamel or Swenson procedures (group II. The age at operation, the incidence and severity of postoperative complications, the need for previous colostomy and the number of reoperations are countered in order to evaluate the efficacy of surgical procedures. Results. In the group I, the mean age at operation was 9.41 ± 6.37 months and in the group II the mean age at operation was 16.8 ± 13.9 months which was significantly higher (p < 0.01. In the group I there were only 3 (10% patients with complications, one (3% of them was prone to only one redo procedure (1.00 ± 0.00 and there was no need for previous colostomy in all patients (100%. In the group II there were 16 (30% patients with significantly frequent complications (p < 0.05, about 2 reoperations on the average (1.94 ± 1.84 in 4 of them (25% and 22 (41% redo procedures, which was, in total, significantly higher than in the group I (p < 0.01. Only Soave’s procedure was performed without previous colostomy in 20 (37% patients. Conclusion. Transanal endorectal pull-through in surgical treatment of patients with Hirschsprung’s disease is more effective than other procedures

  5. Transanal endoscopic operation: a new proposal Operação transanal endoscópica: uma nova proposta

    Directory of Open Access Journals (Sweden)

    José Joaquim Ribeiro da Rocha

    2008-01-01

    Full Text Available PURPOSE: The transanal procedure for rectal cancer surgery is one of the many techniques currently available. Different techniques for local excision of rectal tumors include: conventional transanal technique, posterior access surgery, therapeutic colonoscopy, transanal endoscopic surgery. METHODS: The aim of the present study is to describe a new method of transanal endoscopic resection, transanal endoscopic operation (TEO, and performed with the aid of a surgical proctoscope especially designed for this purpose and report the results obtained in 32 patients submitted to the TEO and to compare these results with those obtained with other techniques currently available. The average proportions of recurrence, post-operation complications and posterior resections were analyzed by means of a metanalysis. Data on the distance and size of rectal lesions, the operative timing and hospitalization time were distributed in graphs according to authors and techniques. RESULTS: The results were favorable and equivalent to those described in the literature. CONCLUSIONS: The surgical proctoscope specially designed for this study is efficient and has a low cost; the TEO is easily performed with the aid of this equipment; the final results were favorable and similar to those obtained with other available techniques for endoscopic transanal intestinal resection, which are of high cost and less availability.INTRODUÇÃO: A operação cirúrgica por acesso transanal no tratamento do câncer retal é uma das várias técnicas utilizadas nessa terapêutica. Há várias técnicas de excisão local para os tumores retais: O método cirúrgico transanal convencional, acessos posteriores, colonoscopia terapêutica e operações transanais endoscópicas. O objetivo é apresentar um novo método de ressecção transanal endoscópica (Operação Transanal Endoscópica - OTE, realizada com um proctoscópio cirúrgico idealizado para o procedimento e divulgar os resultados

  6. Transanal rectopexy - twelve case studies

    Directory of Open Access Journals (Sweden)

    Rubens Henrique Oleques Fernandes

    2012-06-01

    Full Text Available OBJECTIVES: This study analyzed the results of transanal rectopexy and showed the benefits of this surgical technique. METHOD: Twelve patients were submitted to rectopexy between 1997 and 2011. The surgical technique used was transanal rectopexy, where the mesorectum was fixed to the sacrum with nonabsorbable suture. Three patients had been submitted to previous surgery, two by the Delorme technique and one by the Thiersch technique. RESULTS: Postoperative hospital stay ranged from 1 to 4 days. One patient (8.3% had intraoperative hematoma, which was treated with local compression and antibiotics. One patient (8.3% had residual mucosal prolapse, which was resected. Prolapse recurrence was seen in one case (8.3%. Improved incontinence occurred in 75% of patients and one patient reported obstructed evacuation in the first month after surgery. No death occurred. CONCLUSION: Transanal rectopexy is a simple, low cost technique, which has shown good efficacy in rectal prolapse control.OBJETIVO: O presente estudo analisou os resultados da retopexia pela via transanal e expôs os benefícios desta técnica cirúrgica. MÉTODO: Doze pacientes com prolapso foram operados no período de 1997 a 2011. A técnica cirúrgica usada foi a retopexia transanal, onde o mesorreto foi fixado ao sacro com fio inabsorvível. Três pacientes tinham cirurgia prévia, dois pela técnica de Delorme e um pela técnica de Thiersch. RESULTADOS: A permanência hospitalar pós-operatória variou de 1- 4 dias. Uma paciente (8,3% apresentou hematoma transoperatório que foi tratado com compressão local e antibioticoterapia. Um paciente apresentou prolapso mucoso residual (8,3%, que foi ressecado. Houve recidiva da procidência em um caso (8,3%. A melhora da incontinência ocorreu em 75% dos pacientes e uma paciente apresentou bloqueio evacuatório no primeiro mês após a cirurgia. Não houve mortalidade entre os pacientes operados. CONCLUSÃO: A retopexia transanal é uma t

  7. Transanal protrusion of intussusceptions in children

    Directory of Open Access Journals (Sweden)

    Ezomike Uchechukwu Obiora

    2014-01-01

    Full Text Available Background: The aim of the following study is to report our management experience and outcome of transanal protrusion of intussusceptions. Patients and Methods: Retrospective analysis of all cases of intussusceptions protruding through the anal opening from January 2008 to June 2013. Results: Of 62 cases of intussusceptions, transanal protrusion occurred in 10 patients (16% anal protrusion rate with a male:female ratio of 2:3. They were aged 4-96 months (mean 22.6 ± 30.7, median 7.5 months. Six were infants while four were above 1 year. Duration of symptoms ranged from 2 to 14 days (mean 5.9 days ± 3.4 with only two patients presenting within 48 h. Clinical features included vomiting (100%, abdominal pains (100%, bloody mucoid stool (100%, abdominal distension (90%, and palpable left iliac fossa mass (70%. Three patients had preceding diarrhoea (30% and two had preceding upper respiratory tract infection (20%. Duration of hospital stay ranged from 5 to 23 days (mean 12 days ± 5.6. Findings at surgery included seven ileocolic and two colocolic intussusceptions (one patient died before surgery. Operative procedures were right hemicolectomy (5, operative manual reduction (3, left hemicolectomy (1 giving a 67% bowel resection rate. One patient died giving a 10% mortality rate. Conclusion: Transanal protrusion occurred more in females and is associated with late presentation, older age, high bowel resection rate, and high mortality.

  8. Performance Comparison of 1.5 T Endorectal Coil MRI with Non-Endorectal Coil 3.0 T MRI in Patients with Prostate Cancer

    Science.gov (United States)

    Shah, Zarine K.; Elias, Saba N.; Abaza, Ronney; Zynger, Debra L.; DeRenne, Lawrence A.; Knopp, Michael V.; Guo, Beibei; Schurr, Ryan; Heymsfield, Steven B.; Jia, Guang

    2015-01-01

    Rationale and Objectives To compare prostate morphology, image quality, and diagnostic performance of 1.5 T endorectal coil MRI and 3.0 T non-endorectal coil MRI in patients with prostate cancer. Materials and Methods MR images obtained of 83 patients with prostate cancer using 1.5 T MRI systems with an endorectal coil were compared to images collected from 83 patients with a 3.0 T MRI system. Prostate diameters were measured and image quality was evaluated by one ABR-certified radiologist (Reader 1) and one ABR-certified diagnostic medical physicist (Reader 2). The likelihood of the peripheral zone cancer presence in each sextant and local extent were rated and compared with histopathologic findings. Results Prostate anterior-posterior diameter measured by both readers was significantly shorter with 1.5 T endorectal MRI than with 3.0 T MRI. The overall image quality score difference was significant only for Reader 1. Both readers found that the two MRI systems provided similar diagnostic accuracy in cancer localization, extraprostatic extension, and seminal vesicle involvement. Conclusion Non-endorectal coil 3.0 T MRI provides prostate images that are natural in shape and that have comparable image quality to those obtained at 1.5 T with an endorectal coil, but not superior diagnostic performance. These findings suggest an opportunity exists for improving technical aspects of 3.0 T prostate MRI. PMID:25579637

  9. [Transanal laparoscopic radical resection with telescopic anastomosis for low rectal cancer].

    Science.gov (United States)

    Li, Shiyong; Chen, Gang; Du, Junfeng; Chen, Guang; Wei, Xiaojun; Cui, Wei; Yuan, Qiang; Sun, Liang; Bai, Xue; Zuo, Fuyi; Yu, Bo; Dong, Xing; Ji, Xiqing

    2015-06-01

    To assess the safety, feasibility and clinical outcome of laparoscopic radical resection for low rectal cancer with telescopic anastomosis or with colostomy by stapler through transanal resection without abdominal incisions. From January 2010 to September 2014, 37 patients underwent laparoscopic radical resection for low rectal cancer through transanal resection without abdominal incisions. The tumors were 4-7 cm above the anal verge. On preoperative assessment, 26 cases were T1N0M0 and 11 were T2N0M0. For all cases, successful surgery was performed. In telescopic anastomosis group, the mean operative time was (178±21) min, with average blood loss of (76±11) ml and (13±7) lymph nodes harvested. Return of bowel function was (3.0±1.2) d and the hospital stay was (12.0±4.2) d without postoperative complications. Patients were followed up for 3-45 months. Twelve months after surgery, 94.6%(35/37) patients achieved anal function Kirwan grade 1, indicating that their anal function returned to normal. Laparoscopic radical resection for low rectal cancer with telescopic anastomosis or colostomy by stapler through transanal resection without abdominal incisions is safe and feasible. Satisfactory clinical outcome can be achieved mini-invasively.

  10. Benign rectal strictures managed with transanal resection--a novel application for transanal endoscopic microsurgery

    DEFF Research Database (Denmark)

    Baatrup, G; Svensen, R; Ellensen, V S

    2010-01-01

    OBJECTIVE: Six cases of management of rectal strictures by transanal endoscopic microsurgery (TEM) are described. METHOD: Patients are placed in the lithotomy - Trendelenburg position and the stricture is resected from 4-8 o'clock through the entire thickness of the fibrosis. The upper resection...... edge is mobilized including all layers of the rectal wall and the defect is sutured along the circumference. RESULTS: Satisfactory anatomical and functional long-term results were obtained in 5 of 6 patients. CONCLUSION: TEM resection of benign strictures is feasible in some patients and should...

  11. Endorectal magnetic resonance imaging of the prostate and bladder

    International Nuclear Information System (INIS)

    Sugimura, Yoshiki; Hayashi, Norio; Yamashita, Atsushi; Kinbara, Hiroyuki; Arima, Kiminobu; Tochigi, Hiromi; Kawamura, Juichi

    1994-01-01

    Endorectal magnetic resonance imaging (MRI) using an endorectal surface coil has been evaluated basically and clinically. This new modality obtained increased resolution magnetic resonance images of the pathologic conditions of the prostate and bladder. Compared with images obtained with a body coil, the surface coil images clearly demonstrate prostatic intraglandular zonal anatomy. The clear images of prostatic capsule and neurovascular bundle seen on the surface coil may contribute to the local staging of prostate cancer. The staging diagnosis of bladder tumor located in the bladder neck will be the best candidate for endorectal MRI. Enhancement with gadolinium may improve the ability to differentiate superficial from deep bladder-wall tumors. We concluded that endorectal MRI is safely performed and is extremely useful for the local staging of prostate cancer and bladder neck tumor. Further studies will be required to evaluate the clinical significance of this new modality. (author)

  12. Robotic Assisted Transanal Polypectomies: Is There Any Indication?

    Science.gov (United States)

    Gómez Ruiz, Marcos; Cagigas Fernández, Carmen; Alonso Martín, Joaquín; Cristobal Poch, Lidia; Manuel Palazuelos, Carlos; Barredo Cañibano, Francisco Javier; Gómez Fleitas, Manuel; Castillo Diego, Julio

    2017-12-01

    Robotic assisted transanal polipectomy may have advantages compared with the conventional transanal minimally invasive surgery technique. We evaluate the safety, feasibility and advantages of this technique. Between February 2014 and October 2015, 9patients underwent robotic transanal polypectomy. We performed a retrospective study in which we analyse prospectively collected data regarding patient and tumor characteristics, perioperative outcomes, pathological report, morbidity and mortality. A total of 5 male and 4 female patients underwent robotic TAMIS. Lesions were 6,22cm from the anal verge. Mean size was 15,8cm 2 . All procedures were performed in the lithotomy position. Closure of the defect was performed in all cases. Mean blood loss was 39,8ml. Mean operative time was 71,9min. No severe postoperative complications or readmissions occured. Median hospital stay was 2,5 days. Robotic TAMIS is useful to treat complex rectal lesions. Our transanal platform allowed a wider range of movements of the robotic arms and to perform all procedures in the lithotomy position. Copyright © 2017 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

  13. Transanal stent in anterior resection does not prevent anastomotic leakage

    DEFF Research Database (Denmark)

    Bülow, Steffen; Bulut, O; Christensen, Ib Jarle

    2006-01-01

    OBJECTIVE: A defunctioning transanal stent may theoretically reduce the leakage rate after anterior rectal resection. We present a randomized open study with the aim of comparing the leakage rate after anterior resection with a loop ileostomy, a transanal stent, both or neither. PATIENTS AND METH....... On this basis it was decided to discontinue the study prematurely for ethical reasons. CONCLUSION: Decompression of the anastomosis with a transanal stent does not reduce the risk of anastomotic leakage after anterior resection.......OBJECTIVE: A defunctioning transanal stent may theoretically reduce the leakage rate after anterior rectal resection. We present a randomized open study with the aim of comparing the leakage rate after anterior resection with a loop ileostomy, a transanal stent, both or neither. PATIENTS...... AND METHODS: Randomized open trial of 194 patients operated in 11 hospitals during September 2000 to September 2003 with anterior resection for a mobile rectal tumour, 115 men and 79 women, median age 68 years (range 37-90 years). The surgeon decided upon the use of a protective ileostomy, and after...

  14. Magnetic characterization of superparamagnetic nanoparticles pulled through model membranes.

    Science.gov (United States)

    Barnes, Allison L; Wassel, Ronald A; Mondalek, Fadee; Chen, Kejian; Dormer, Kenneth J; Kopke, Richard D

    2007-01-04

    To quantitatively compare in-vitro and in vivo membrane transport studies of targeted delivery, one needs characterization of the magnetically-induced mobility of superparamagnetic iron oxide nanoparticles (SPION). Flux densities, gradients, and nanoparticle properties were measured in order to quantify the magnetic force on the SPION in both an artificial cochlear round window membrane (RWM) model and the guinea pig RWM. Three-dimensional maps were created for flux density and magnetic gradient produced by a 24-well casing of 4.1 kilo-Gauss neodymium-iron-boron (NdFeB) disc magnets. The casing was used to pull SPION through a three-layer cell culture RWM model. Similar maps were created for a 4 inch (10.16 cm) cube 48 MGOe NdFeB magnet used to pull polymeric-nanoparticles through the RWM of anesthetized guinea pigs. Other parameters needed to compute magnetic force were nanoparticle and polymer properties, including average radius, density, magnetic susceptibility, and volume fraction of magnetite. A minimum force of 5.04 x 10(-16) N was determined to adequately pull nanoparticles through the in-vitro model. For the guinea pig RWM, the magnetic force on the polymeric nanoparticles was 9.69 x 10-20 N. Electron microscopy confirmed the movement of the particles through both RWM models. As prospective carriers of therapeutic substances, polymers containing superparamagnetic iron oxide nanoparticles were succesfully pulled through the live RWM. The force required to achieve in vivo transport was significantly lower than that required to pull nanoparticles through the in-vitro RWM model. Indeed very little force was required to accomplish measurable delivery of polymeric-SPION composite nanoparticles across the RWM, suggesting that therapeutic delivery to the inner ear by SPION is feasible.

  15. Hirschsprung's disease: problems with transition-zone pull-through.

    Science.gov (United States)

    Ghose, S I; Squire, B R; Stringer, M D; Batcup, G; Crabbe, D C

    2000-12-01

    It is generally accepted that if surgery for Hirschsprung's disease is to be successful, ganglionic bowel must be anastomosed to the lower rectum or anal canal. Above the aganglionic distal bowel lies a transition zone (TZ) where more subtle abnormalities of innervation are apparent. The significance of this transition zone in respect to the functional outcome of surgery has received little attention. The aim of this study was to identify the incidence of transition zone pull-through (TZPT) in a cohort of children who underwent surgery for Hirschsprung's disease, to identify the reasons why TZPTs occurred, and to identify the functional consequences. The authors report the long-term outcome of these children with emphasis on bowel function and the results of subsequent surgery. A Retrospective study was conducted of children treated at a single institution from 1979 through 1994. TZPT patients were subject to detailed review of surgical records and histopathologic material. Thirteen children were identified with a TZPT. In 12 cases, histopathologic errors contributed to the TZPT: in 5 cases this was caused by single point biopsies missing an asymmetrical TZ, whereas in 7 cases the histopathologic features of the TZ were not recognized. In 1 case the TZPT was caused by surgical error. As a consequence of the TZPT 7 children underwent repeat pull-through. One child is fully continent, one has daytime fecal continence, and 2 others are incontinent. Two children have permanent stomas. One child is clean with antegrade colonic washouts. Repeat pull-throughs were not attempted in 6 children. Two children have achieved full continence, 2 have permanent stomas, 1 is clean with antegrade colonic washouts, and 1 child receives regular suppositories. Transition zone pull-throughs occurred because of a combination of surgical and histopathologic errors. The transition zone may follow an asymmetric course around the circumference of the bowel and may be missed if single

  16. A survey of current practices in management of Hirschsprung′s disease in Nigeria

    Directory of Open Access Journals (Sweden)

    Abdulrasheed A. Nasir

    2014-01-01

    Full Text Available Background: Although there are several modalities of treatment for Hirschsprung′s disease (HD, there are presently no clear guidelines on treatment of the condition by paediatric surgeons in Nigeria. This survey determines the current approach to treatment among Nigerian paediatric surgeons and should help in establishing a consensus and guidelines for care in this and similar setting. Materials and Methods: An online questionnaire was designed using survey Monkey ® to determine current clinical and operative management of patients with HD by consultant paediatric surgeons practicing in the Nigeria. The paediatric surgeons were notified by E-mail, which included a link to the survey on survey Monkey ® . The survey was also administered at the 12 th annual meeting of Association of Paediatric Surgeons of Nigeria in September, 2013, to capture those who did not complete the online survey. Thirty-one paediatric surgeons from 21 different tertiary paediatric surgery centres completed the survey. Results: Sixteen (52% respondents see up to 20% of their patients with HD in the neonatal period. Twenty-six (84% respondents do routine barium enema. Twenty six (84% respondents do full thickness rectal biopsy under general anaesthesia (GA. There was no consistency in operative techniques, with transabominal Swenson′s operation being practiced by 17 (57% respondents and 11 (37% transanal endorectal pull through. 14 (45% do pull through at any age. 12 (39% respondents do more than half of their patient as primary pull through. Conclusion: Full thickness rectal biopsy under GA is still the vogue with variations in the surgical technique for management of Hirshsprung′s disease in Nigeria. Primary pull through procedures is becoming increasingly popular. There′s a need for Paediatric Surgeons in Nigeria to come up with a guideline on management of HD, to guide trainees and other surgeons in the care of these patients.

  17. [Transanal total mesorectal excision for rectal cancer - just a fashion trend?].

    Science.gov (United States)

    Kala, Z; Skrovina, M; Procházka, V; Grolich, T; Klos, K

    2014-12-01

    Transanal total mesorectal excision performed using equipment for transanal minimally invasive surgery is an innovative surgical technique introduced to facilitate this procedure and to reach better oncosurgical outcomes in patients with low rectal cancer. This article presents a brief summary of guidelines for treatment of patients with low rectal carcinoma. Up-to-date information about the principles of this new method, its modifications and contemporary indications is presented. Based on their own experience and literature resources, the authors inform about the advantages, limitations and unresolved issues of minimally invasive transanal mesorectal excision.

  18. New laparoscopic peritoneal pull-through vaginoplasty technique

    Directory of Open Access Journals (Sweden)

    Pravin Mhatre

    2014-01-01

    Full Text Available Background: Many reconstructive surgical procedures have been described for vaginal agenesis. Almost all of them are surgically challenging, multi-staged, time consuming or leave permanent scars on abdomen or skin retrieval sites. Aim: A new simple technique using laparoscopic peritoneal pull-through in creation of neo vagina has been described. Material and Methods: Total of thirty six patients with congenital absence of vagina (MRKH syndrome were treated with laparoscopic peritoneal pull through technique of Dr. Mhatre between 2003 till 2012. The author has described 3 different techniques of peritoneal vaginoplasty. Results: This technique has given excellent results over a period of one to seven years of follow-up. The peritoneal lining changes to stratified squamous epithelium resembling normal vagina and having acidic Ph. Conclusion: Apart from giving excellent normal vaginal function, as the ovary became accessible per vaginum three patients underwent ovum retrieval and pregnancy using surrogate mother, thus making this a fertility enhancing procedure.

  19. Transanal endoscopic microsurgery versus conventional transanal excision for patients with early rectal cancer.

    Science.gov (United States)

    Christoforidis, Dimitrios; Cho, Hyeon-Min; Dixon, Matthew R; Mellgren, Anders F; Madoff, Robert D; Finne, Charles O

    2009-05-01

    To compare transanal endoscopic microsurgery (TEMS) with conventional transanal excision (TAE) in terms of the quality of resection, local recurrence, and survival rates in patients with stage I rectal cancer. Although TEMS is often considered a superior surgical technique to TAE, it is poorly suited for excising tumors in the lower third of the rectum. Such tumors may confer a worse prognosis. We retrospectively reviewed information on all patients with stage pT1 and pT2 rectal adenocarcinoma who underwent local excision from 1997 through mid-2006. We excluded patients with node-positive, metastatic, recurrent, previously irradiated, or snare-excised tumors. Our study included 42 TEMS and 129 TAE patients. We found no significant differences in patient characteristics, adjuvant therapy, tumor stage, or adverse histopathologic features. In the TAE group, 52 (40%) of tumors were TEMS group, only 1 (2%) (P = 0.0001). Surgical margins were less often positive in the TEMS group (2%) than in the TAE group (16%) (P = 0.017). For patients with tumors > or =5 cm from the AV, the estimated 5-year disease-free survival (DFS) rate was similar between the TEMS group (84.1%) and the TAE group (76.1%) (P = 0.651). But within the TAE group, the estimated 5-year DFS rate was better for patients with tumors > or =5 cm from the AV (76.1%) vs. TEMS or TAE) itself--were independent predictors of local recurrence and DFS. The quality of resection is better with TEMS than with TAE. However, the apparently better oncologic outcomes with TEMS can be partly explained by case selection of lower-risk tumors of the upper rectum.

  20. Postoperative Course and Complications after Pull-through Vaginoplasty for Distal Vaginal Atresia.

    Science.gov (United States)

    Mansouri, Roshanak; Dietrich, Jennifer E

    2015-12-01

    To report the usual postoperative course and complications after pull-through vaginoplasty for isolated distal vaginal atresia. Retrospective chart review at Texas Children's Hospital of all patients who were diagnosed with isolated distal vaginal atresia and underwent pull-through vaginoplasty during the study time frame. None. Postoperative complications such as vaginal stenosis or infection and postoperative vaginal diameter. Sixteen patients were identified and charts were reviewed. Patients were initially evaluated by pelvic magnetic resonance imaging and found to have distended hematometrocolpos with distal vaginal atresia. All patients underwent pull-through vaginoplasty with similar operative techniques. The average distance from the perineum to the level of the obstruction was 1.84 ± 1.2 cm. Two patients, both with obstructions at greater than 3 cm, experienced stricture formation postoperatively. Four patients (25%) experienced postoperative vaginitis. One patient (6.25%) experienced a postoperative urinary tract infection. Two groups (3 cm or less versus greater than 3 cm) were compared, and the presence of stricture was statistically different based on mean centimeters from perineum prior to pull-through vaginoplasty (P = .038). Distal vaginal atresia is managed with pull-through vaginoplasty. Atresias that extend greater than 3 cm from the perineum are at increased risk for vaginal stricture formation and should be followed to monitor for their formation. Other complications are infrequent and minor. Copyright © 2015 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

  1. Preclinical cadaveric study of transanal endoscopic da Vinci® surgery.

    Science.gov (United States)

    Hompes, R; Rauh, S M; Hagen, M E; Mortensen, N J

    2012-08-01

    Single-port platforms are increasingly being used for transanal surgery and may be associated with a shorter learning curve than transanal endoscopic microsurgery. However, these procedures remain technically challenging, and robotic technology could overcome some of the limitations and increase intraluminal manoeuvrability. An initial experimental experience with transanal endoscopic da Vinci(®) surgery (TEdS) using a glove port on human cadavers is reported. After initial dry laboratory experiments, the feasibility of TEdS and ideal set-up were further evaluated in human cadavers. For transanal access a glove port was constructed on-table by using a circular anal dilator, a standard wound retractor and a surgical glove. A da Vinci(®) Si HD system was used in combination with the glove port for transanal endoscopic resections. It was possible to perform all necessary tasks to complete a full-thickness excision and closure of the rectal wall, with cadavers in both prone and supine positions. The stable magnified view, combined with the EndoWrist(®) technology of the robotic instruments, made every task straightforward. Intraluminal manoeuvrability could be improved further by intersecting the robotic instruments. The glove port proved to be very reliable and the inherent flexibility of the glove facilitated docking of the robotic arms in a narrow confined space. Using a reliable and universally available glove port, TEdS was feasible and a preferred set-up was determined. Further clinical trials will be necessary to assess the safety and efficacy of this technique. Copyright © 2012 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.

  2. Transanal endoscopic microsurgery: a New Zealand experience.

    Science.gov (United States)

    Bloomfield, Ian; Van Dalen, Roelof; Lolohea, Simione; Wu, Linus

    2017-12-03

    Transanal endoscopic microsurgery (TEMS) is a proven alternative therapy to either radical surgery or endoscopic mucosal resection for rectal neoplasms. It has proven benefits with lower morbidity and mortality compared with total mesorectal excision, and a lower local recurrence rate when compared to endoscopic mucosal techniques. A retrospective data collection of TEMS procedures performed through Waikato District Health Board, New Zealand, from 2010 to 2015 was conducted. Supportive follow-up data were sourced from patient records and from local centres around New Zealand. A total of 137 procedures were performed over the study period, with five being repeat procedures. Procedures were mostly performed for benign lesions (66.4%) with an overall complication rate of 15.3%, only five of which were Clavien-Dindo grade III (3.6%). Our local recurrence rate after resection of benign lesions was 5.1%. Our data set demonstrates the TEMS procedure to be safe compared to radical resection (total mesorectal excision) for sessile rectal lesions. Close endoscopic follow-up is recommended, especially for close or incomplete margins. Good therapeutic results can be obtained for appropriately selected early malignant lesions. TEMS provides better oncological results than endoscopic mucosal resection or transanal excision. © 2017 Royal Australasian College of Surgeons.

  3. Retroperitoneal abscess after transanal minimally invasive surgery: case report and review of literature

    Directory of Open Access Journals (Sweden)

    Aaron Raney

    2017-10-01

    Full Text Available Abscesses are a rare complication of transanal minimally invasive surgery and transanal endoscopic micro surgery. Reported cases have been in the rectal and pre-sacral areas and have been managed with either antibiotics alone or in conjunction with laparotomy and diverting colostomy. We report a case of a large retroperitoneal abscess following a Transanal minimally invasive surgery full thickness rectal polyp excision. The patient was successfully managed conservatively with antibiotics and a percutaneous drain. Retroperitoneal infection should be included in a differential diagnosis following a Transanal minimally invasive surgery procedure as the presentation can be insidious and timely intervention is needed to prevent further morbidity. Resumo: Os abscessos são uma complicação rara da cirurgia de ressecção transanal minimamente invasiva (TAMIS e da micro cirurgia endoscópica transanal (TEMS. Os casos notificados foram nas áreas rectal e pré-sacral e foram administrados com antibióticos isoladamente ou em conjunto com laparotomia e desvio de colostomia. Relatamos um caso de grande abscesso retroperitoneal após uma excisão de pólipo retal de espessura total TAMIS. O paciente foi tratado com sucesso com a administração de antibióticos e drenagem percutânea. Para prevenir mais morbidade é necessária incluir a infecção retroperitoneal no diagnostico diferencial após um procedimento TAMIS onde a apresentação pode ser insidiosa e a intervenção atempada. Keywords: Colorectal surgery, Transanal minimally invasive surgery (TAMIS, Retroperitoneal abscess, Natural orifice transluminal endoscopic surgery (NOTES, Single-site laparoscopic surgery (SILS, Surgical oncology, Palavras-chave: Cirurgia colorretal, Cirurgia de ressecção transanal minimamente invasiva (TAMIS, Abscesso retroperitoneal, Cirurgia endoscópica transluminal de orifício natural (NOTES, Cirurgia laparoscópica de único local (SILS, Oncologia cirúrgica

  4. Robotic transanal total mesorectal excision for rectal cancer: experience with a first case

    NARCIS (Netherlands)

    Verheijen, P.M.; Consten, E.C.J.; Broeders, Ivo Adriaan Maria Johannes

    2014-01-01

    Background: A transanal approach for total mesorectal excision (TME) using a single incision port is feasible. The disadvantages are technical difficulties associated with limited manoeuvrability. Methods: We present our first experience with robotic-assisted transanal total mesorectal excision. A

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

    Science.gov (United States)

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

    2017-04-01

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

  6. Transanal stent in anterior resection does not prevent anastomotic leakage

    DEFF Research Database (Denmark)

    Bülow, Steffen; Bulut, O; Christensen, Ib Jarle

    2006-01-01

    OBJECTIVE: A defunctioning transanal stent may theoretically reduce the leakage rate after anterior rectal resection. We present a randomized open study with the aim of comparing the leakage rate after anterior resection with a loop ileostomy, a transanal stent, both or neither. PATIENTS...... completion of the operation the patients were randomized in two groups with and without a transanal stent. RESULTS: A clinically significant leakage was diagnosed in 25 patients (13%). No significant difference was found 17 of 98 patients with a stent and 8 of 96 without (P = 0.09), or in 9 of 44 ileostomy...... patients with a stent and in 3 of 45 without (P = 0.07). Several leaks over a short time led to an interim analysis after inclusion of 194 of 448 planned patients. The analysis showed no significant protective effect of the stent, and more leakages in the stent group, although not statistically significant...

  7. Pneumoretroperitoneum and Sepsis After Transanal Endoscopic Resection of a Rectal Lateral Spreading Tumor

    Science.gov (United States)

    Coura, Marcelo de Melo Andrade; de Almeida, Romulo Medeiros; Moreira, Natascha Mourão; de Sousa, João Batista; de Oliveira, Paulo Gonçalves

    2017-01-01

    Transanal endoscopic microsurgery is considered a safe, appropriate, and minimally invasive approach, and complications after endoscopic microsurgery are rare. We report a case of sepsis and pneumoretroperitoneum after resection of a rectal lateral spreading tumor. The patient presented with rectal mucous discharge. Colonoscopy revealed a rectal lateral spreading tumor. The patient underwent an endoscopic transanal resection of the lesion. He presented with sepsis of the abdominal focus, and imaging tests revealed pneumoretroperitoneum. A new surgical intervention was performed with a loop colostomy. Despite the existence of other reports on pneumoretroperitoneum after transanal endoscopic microsurgery, what draws attention to this case is the association with sepsis. PMID:28761873

  8. Transcolostomy-site endorectal pullthrough for Hirschsprung's disease

    African Journals Online (AJOL)

    Optimal wound healing occurred in all patients without wound complications. Postoperative perineal excoriation .... Table 1 Results of 13 patients treated with a transcolostomy-site endorectal pullthrough procedure. Patient number. Sex. Age at colostomy. (months). Age at pullthrough. (months). Weight. (kg). Operation time.

  9. Rectum perforation during transanal irrigation: a case story

    DEFF Research Database (Denmark)

    Biering-Sørensen, F; Bing, J; Berggreen, P

    2008-01-01

    STUDY DESIGN: Case report. OBJECTIVES: Report a case of rectum perforation during transanal irrigation (TAI). SETTING: Clinic for Spinal Cord Injuries, and Departments of Gastroenterological Surgery and Radiology. CASE REPORT: A 54-year-old woman with spinal cord lesion for 35 years emptied...... for years her bowel using oral laxative. This became more difficult and took more than 2 h three times a week with reflex stimulation after a chlysma. She wanted to try TAI, and went through the procedure with a nurse one time. The next time she performed the TAI by herself without difficulty. Two hours...

  10. Feasibility study of transanal total mesorectal excision

    NARCIS (Netherlands)

    Velthuis, S.; Boezem, P.B. van den; Peet, D.L. van der; Cuesta, M.A.; Sietses, C.

    2013-01-01

    BACKGROUND: Laparoscopic resection of colorectal cancers is a safe alternative to open surgery. The conversion rate to open surgery remains fairly constant but is associated with increased morbidity. A new approach to the surgical excision of rectal cancer is transanal total mesorectal excision

  11. Transanal Endoscopic Proctectomy: a new approach to the total excision of the mesorectum

    Directory of Open Access Journals (Sweden)

    Carlos Ramon Silveira Mendes

    2015-07-01

    Full Text Available Introduction: Colorectal cancer is a serious public health problem. In 1982, Heald managed to reduce mortality by standardizing the total excision of mesorectum. The use of transanal endoscopic microsurgery has emerged to allow resection of rectal tumors as a minimally invasive method. With the association of Transanal Endoscopic Operation with total excision of mesorectum, it was possible to develop a new approach for total excision of mesorectum. Surgical technique: The procedure is started by the perineal time with Transanal Endoscopic Operation device; introduction of Transanal Endoscopic Operation system follows, with exposure of the lesion with a circumferential incision at a distance between 2 and 4 cm from distal tumor margin after making a purse string suture to close the rectal stump. Then, dissection is carried out by the posterior portion until reaching the presacral avascular fascia, completing the mesorectal circumferential dissection until the peritoneal reflection. After this step, a laparoscopic procedure is performed with the use of three trocars, with mobilization of splenic flexure and ligation of the inferior mesenteric artery, as well as confection of a protective ileostomy. Then, transanal removal of the surgical specimen is performed, and the procedure goes on with a coloanal anastomosis. Resumo: Introdução: O câncer colorretal é um serio problema de saúde publica. Em 1982, Heald conseguiu reduzir a mortalidade com a padronização da excisão total do mesoreto. O uso da Microcirurgia endoscópica transanal surgiu para proporcionar ressecções de tumores de reto como método minimamente invasivo. Com a associação do TEO a ETM foi possível desenvolver uma nova abordagem para ETM. Técnica cirúrgica: O procedimento é iniciado pelo tempo perineal com o aparelho de TEO. Em seguida o sistema TEO é introduzido, com exposição da lesão por meio de uma incisão circunferencial a cerca de 2 a 4 cm da margem distal

  12. Interactive deformation registration of endorectal prostate MRI using ITK thin plate splines.

    Science.gov (United States)

    Cheung, M Rex; Krishnan, Karthik

    2009-03-01

    Magnetic resonance imaging with an endorectal coil allows high-resolution imaging of prostate cancer and the surrounding normal organs. These anatomic details can be used to direct radiotherapy. However, organ deformation introduced by the endorectal coil makes it difficult to register magnetic resonance images for treatment planning. In this study, plug-ins for the volume visualization software VolView were implemented on the basis of algorithms from the National Library of Medicine's Insight Segmentation and Registration Toolkit (ITK). Magnetic resonance images of a phantom simulating human pelvic structures were obtained with and without the endorectal coil balloon inflated. The prostate not deformed by the endorectal balloon was registered to the deformed prostate using an ITK thin plate spline (TPS). This plug-in allows the use of crop planes to limit the deformable registration in the region of interest around the prostate. These crop planes restricted the support of the TPS to the area around the prostate, where most of the deformation occurred. The region outside the crop planes was anchored by grid points. The TPS was more accurate in registering the local deformation of the prostate compared with a TPS variant, the elastic body spline. The TPS was also applied to register an in vivo T(2)-weighted endorectal magnetic resonance image. The intraprostatic tumor was accurately registered. This could potentially guide the boosting of intraprostatic targets. The source and target landmarks were placed graphically. This TPS plug-in allows the registration to be undone. The landmarks could be added, removed, and adjusted in real time and in three dimensions between repeated registrations. This interactive TPS plug-in allows a user to obtain a high level of accuracy satisfactory to a specific application efficiently. Because it is open-source software, the imaging community will be able to validate and improve the algorithm.

  13. Transanal pullthrough for Hirschsprung disease: matched case-control comparison of Soave and Swenson techniques.

    Science.gov (United States)

    Nasr, Ahmed; Haricharan, Ramanath N; Gamarnik, Julie; Langer, Jacob C

    2014-05-01

    Both the Swenson and the Soave procedures have been adapted to a transanal approach. The purpose of this study was to compare outcomes following the transanal Swenson and Soave procedures using a matched case control analysis. A retrospective chart review was performed to identify all transanal Soave and Swenson pullthroughs done at 2 tertiary care children's hospitals between 2000 and 2010. Patients were matched for gestational age, mean weight at time of the operation, level of aganglionosis, and presence of co-morbidities. Student's t-test and chi-squared analysis were performed. Fifty-four patients (Soave 27, Swenson 27) had adequate data for matching and analysis. Mean follow-up was 4±1.6 years and 3.2 ±2.7 years for the Soave and Swenson groups, respectively. No significant differences in mean operating time (Soave:191±55, Swenson:167±61 min, p=0.6), overall hospital stay (6±4 vs 7.8±5 days, p=0.7), and number with intra-operative complications (3 vs 4, p=1.0), post-operative obstructive symptoms (6 vs 9, p=0.5), enterocolitis episodes (4 vs 4, p=1.0), or fecal incontinence (0 vs 2, p=0.4) were noted. After controlling for potential confounders, there were no significant differences in the short and intermediate term outcome between transanal Soave and transanal Swenson pullthrough procedures. Copyright © 2014 Elsevier Inc. All rights reserved.

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

    Science.gov (United States)

    Lista, Frank; Ahmad, Jamil

    2008-03-01

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

  15. Endorectal high dose rate brachytherapy quality assurance

    International Nuclear Information System (INIS)

    Devic, S.; Vuong, T.; Evans, M.; Podgorsak, E.

    2008-01-01

    We describe our quality assurance method for preoperative high dose rate (HDR) brachytherapy of endorectal tumours. Reproduction of the treatment planning dose distribution on a daily basis is crucial for treatment success. Due to the cylindrical symmetry, two types of adjustments are necessary: applicator rotation and dose distribution shift along the applicator axis. (author)

  16. Indications and techniques of transanal endoscopic microsurgery (TEMS).

    Science.gov (United States)

    Qi, Yanjie; Stoddard, David; Monson, John R T

    2011-08-01

    Transanal endoscopic microsurgery (TEMS) has recently reemerged as a valuable technique for the management of rectal neoplasms - both benign and malignant. Since the original description of this technique in the early 1980s, TEMS has emerged as the approach of choice for most benign rectal tumors because of the excellent views provided and superior dissection techniques possible when compared to traditional transanal excision. Many published reports demonstrate that the lowest rates of recurrence are associated with TEMS probably because of full-thickness excision with negative margins. Increasingly, TEMS is being applied to primary rectal cancer when used alone as a full-thickness excision alone or in combination with additional therapies, depending on tumor stage. There is now a significant evidence base to suggest that this approach should be considered as part of a multidisciplinary approach to rectal cancer. This paper describes indications and techniques for this technology.

  17. Comparison of pelvic phased-array versus endorectal coil magnetic resonance imaging at 3 Tesla for local staging of prostate cancer.

    Science.gov (United States)

    Kim, Bum Soo; Kim, Tae-Hwan; Kwon, Tae Gyun; Yoo, Eun Sang

    2012-05-01

    Several studies have demonstrated the superiority of endorectal coil magnetic resonance imaging (MRI) over pelvic phased-array coil MRI at 1.5 Tesla for local staging of prostate cancer. However, few have studied which evaluation is more accurate at 3 Tesla MRI. In this study, we compared the accuracy of local staging of prostate cancer using pelvic phased-array coil or endorectal coil MRI at 3 Tesla. Between January 2005 and May 2010, 151 patients underwent radical prostatectomy. All patients were evaluated with either pelvic phased-array coil or endorectal coil prostate MRI prior to surgery (63 endorectal coils and 88 pelvic phased-array coils). Tumor stage based on MRI was compared with pathologic stage. We calculated the specificity, sensitivity and accuracy of each group in the evaluation of extracapsular extension and seminal vesicle invasion. Both endorectal coil and pelvic phased-array coil MRI achieved high specificity, low sensitivity and moderate accuracy for the detection of extracapsular extension and seminal vesicle invasion. There were statistically no differences in specificity, sensitivity and accuracy between the two groups. Overall staging accuracy, sensitivity and specificity were not significantly different between endorectal coil and pelvic phased-array coil MRI.

  18. Hybrid NOTES: TEO for transanal total mesorectal excision: intracorporeal resection and anastomosis.

    Science.gov (United States)

    Serra-Aracil, Xavier; Mora-López, Laura; Casalots, Alex; Pericay, Carles; Guerrero, Raul; Navarro-Soto, Salvador

    2016-01-01

    Laparoscopic surgery for rectal TME achieves better patient recovery, lower morbidity, and shorter hospital stay than open surgery. However, in laparoscopic rectal surgery, the overall conversion rate is nearly 20%. Transanal TME combined with laparoscopy, known as Hybrid NOTES, is a less invasive procedure that provides adequate solutions to some of the limitations of rectal laparoscopy. Transanal TME via TEO with technical variants (intracorporeal resection and anastomosis, TEO review of the anastomosis) attempts to standardize and simplify the procedure. Prospective observational study was used describe and assess the technique in terms of conversion to open surgery, overall morbidity, surgical site infection and hospital stay. The sample comprised consecutive patients diagnosed with rectal tumor less than 10 cm from the anal verge who were candidates for low anterior resection using TME (except T4). Demographic, surgical, postoperative, and pathological variables were analyzed, as well as morbidity rates. From September 2012 to August 2014, 32 patients were included. The conversion rate was 0%. Overall morbidity was 31.3%, SSI rate was 9.4%, and mean hospital stay was 8 days. Oncological radical criteria were achieved with pathological parameters of 94% of complete TME and a median circumferential margin of 13 mm. The introduction of technical variants of TEO for transanal resection can facilitate a procedure that requires extensive experience in transanal and laparoscopic surgery. Studies of sphincter function, quality of life, and long-term oncological outcome are now necessary.

  19. Diagnostic usefulness of endorectal magnetic resonance imaging with dynamic contrast-enhancement in patients with localized prostate cancer. Mapping studies with biopsy specimens

    International Nuclear Information System (INIS)

    Tanaka, Nobumichi; Samma, Shoji; Joko, Masanori; Akiyama, Tatsuya; Takewa, Megumi; Kitano, Satoru; Okajima, Eigoro

    1999-01-01

    New diagnostic criteria for dynamic magnetic resonance (MR) imaging in prostate cancer are presented. The diagnostic usefulness of endorectal MR imaging with dynamic contrast-enhancement in localized prostate cancer and the validity of these criteria were evaluated. Eighteen untreated patients who were suspected of localized prostate cancer were included in the study. They received endorectal dynamic MR imaging before systematic sextant needle biopsy. First, a mapping study with the findings of MR images and histopathology of biopsy specimens was performed in eight patients out of 18 to compare the difference in T2-weighted images with the endorectal coil and the body coil in the same individuals. Second, another mapping study was performed in all 18 patients by analyzing the findings of endorectal dynamic MR images. For the diagnosis of prostate cancer in MR imaging, we offered diagnostic criteria from our experience in addition to those in plain T2-weighted images from the literature. The overall diagnostic rates of endorectal dynamic MR imaging were 88.9% in accuracy, 100% in sensitivity, and 81.8% in specificity. In the comparison of the endorectal and body coils in T2-weighted images in eight patients, there was no difference in the diagnostic rates except for one more histopathologic false positive portion in endorectal MR imaging. In the second mapping study in 18 patients, the diagnostic rates were 92.6% in accuracy, 88.9% in sensitivity and 93.3% in specificity. Endorectal dynamic imaging raised the diagnostic sensitivity from 77.8 to 88.9%. The data demonstrated the validity of this diagnostic criteria and the diagnostic usefulness of endorectal dynamic MR imaging in localized prostate cancer. (author)

  20. The value of endorectal MR imaging to predict positive biopsies in clinically intermediate-risk prostate cancer patients

    International Nuclear Information System (INIS)

    Vilanova, J.C.; Barcelo, J.; Comet, J.; Capdevila, A.; Dolz, J.L.; Huguet, M.; Aldoma, J.; Delgado, E.; Barcelo, C.

    2001-01-01

    The aim of this study was to assess the effectiveness of endorectal MR imaging in predicting the positive biopsy results in patients with clinically intermediate risk for prostate cancer. We performed a prospective endorectal MR imaging study with 81 patients at intermediate risk to detect prostate cancer between January 1997 and December 1998. Intermediate risk was defined as: prostatic specific antigen (PSA) levels between 4 and 10 ng/ml or PSA levels in the range of 10-20 ng/ml but negative digital rectal examination (DRE) or PSA levels progressively higher (0.75 ng/ml year -1 ). A transrectal sextant biopsy was performed after the endorectal MR exam, and also of the area of suspicion detected by MR imaging. The accuracies were measured, both singly for MR imaging and combined for PSA level and DRE, by calculating the area index of the receiver operating characteristics (ROC) curve. Cancer was detected in 23 patients (28 %). Overall sensitivity and specificity of endorectal MRI was 70 and 76 %, respectively. Accuracy was 71 % estimated from the area under the ROC curve for the total patient group and 84 % for the group of patients with PSA level between 10-20 ng/ml. Positive biopsy rate (PBR) was 63 % for the group with PSA 10-20 ng/ml and a positive MR imaging, and 15 % with a negative MR exam. The PBR was 43 % for the group with PSA 4-10 ng/ml and a positive MR study, and 13 % with a negative MR imaging examination. We would have avoided 63 % of negative biopsies, while missing 30 % of cancers for the total group of patients. Endorectal MR imaging was not a sufficient predictor of positive biopsies for patients clinically at intermediate risk for prostate cancer. Although we should not avoid performing systematic biopsies in patients with endorectal MR imaging negative results, as it will miss a significant number of cancers, selected patients with a PSA levels between 10-20 ng/ml or clinical-biopsy disagreement might benefit from endorectal MR imaging. (orig.)

  1. The value of endorectal MR imaging to predict positive biopsies in clinically intermediate-risk prostate cancer patients

    Energy Technology Data Exchange (ETDEWEB)

    Vilanova, J.C.; Barcelo, J. [Ressonancia Girona, Clinica Girona, Girona (Spain); Comet, J. [Dept. of Urology, Univ. Hospital of Girona (Spain); Capdevila, A.; Dolz, J.L.; Huguet, M.; Aldoma, J.; Delgado, E. [Centre Diagnostic Pedralbes, Cetir Grup Medic, Barcelona (Spain); Barcelo, C. [Dept. of Computer Science and Applied Mathematics, University of Girona (Spain)

    2001-02-01

    The aim of this study was to assess the effectiveness of endorectal MR imaging in predicting the positive biopsy results in patients with clinically intermediate risk for prostate cancer. We performed a prospective endorectal MR imaging study with 81 patients at intermediate risk to detect prostate cancer between January 1997 and December 1998. Intermediate risk was defined as: prostatic specific antigen (PSA) levels between 4 and 10 ng/ml or PSA levels in the range of 10-20 ng/ml but negative digital rectal examination (DRE) or PSA levels progressively higher (0.75 ng/ml year{sup -1}). A transrectal sextant biopsy was performed after the endorectal MR exam, and also of the area of suspicion detected by MR imaging. The accuracies were measured, both singly for MR imaging and combined for PSA level and DRE, by calculating the area index of the receiver operating characteristics (ROC) curve. Cancer was detected in 23 patients (28 %). Overall sensitivity and specificity of endorectal MRI was 70 and 76 %, respectively. Accuracy was 71 % estimated from the area under the ROC curve for the total patient group and 84 % for the group of patients with PSA level between 10-20 ng/ml. Positive biopsy rate (PBR) was 63 % for the group with PSA 10-20 ng/ml and a positive MR imaging, and 15 % with a negative MR exam. The PBR was 43 % for the group with PSA 4-10 ng/ml and a positive MR study, and 13 % with a negative MR imaging examination. We would have avoided 63 % of negative biopsies, while missing 30 % of cancers for the total group of patients. Endorectal MR imaging was not a sufficient predictor of positive biopsies for patients clinically at intermediate risk for prostate cancer. Although we should not avoid performing systematic biopsies in patients with endorectal MR imaging negative results, as it will miss a significant number of cancers, selected patients with a PSA levels between 10-20 ng/ml or clinical-biopsy disagreement might benefit from endorectal MR imaging

  2. Rectal duplication cyst in adults treated with transanal endoscopic microsurgery.

    Science.gov (United States)

    Ben-Ishay, O; Person, B; Eran, B; Hershkovitz, D; Duek, D Simon

    2011-12-01

    Rectal duplication cyst is a rare entity that accounts for approximately 4% of all alimentary tract duplications. To the best of our knowledge, the presented cases are the first reports in the English literature of rectal duplication cyst resection by transanal endoscopic microsurgery. We present two patients; both are 41-year-old women with a palpable rectal mass. Workup revealed a submucosal posterior mass that was then resected by transanal endoscopic microsurgery. The pathology report described cystic lesions with squamous and columnar epithelium and segments of smooth muscle. These findings were compatible with rectal duplication cyst. Our limited experience showed good results with minimal morbidity and mortality for resection of rectal duplication cysts of limited size with no evidence of malignancy.

  3. CT colonography for preoperative examination of the proximal colon using a transanal drainage tube for acute malignant colonic obstruction

    International Nuclear Information System (INIS)

    Sasaki, Kazuaki; Hirano, Yuji; Oono, Keisuke; Sasaki, Kazunori; Someya, Tetsufumi; Harada, Keisuke; Ezoe, Eiri; Furuhata, Tomohisa; Hirata, Koichi

    2011-01-01

    The purpose of this study was to evaluate the feasibility of CT colonography for preoperative examination of the proximal colon using a transanal drainage tube in patients with acute colon obstruction caused by colorectal cancer. Ten patients who received initial treatment for acute malignant colon obstruction at our hospital between June 2004 and December 2008 were studied. In these patients, elective surgery was possible after transanal drainage tube insertion, and the colon on the oral side from the cancer lesion was examined using a drainage tube. Air was injected through the tube into the oral side of the colon, and CT colonography was assessed for the presence or absence of lesions on the oral side. The images of the oral side of the colon were good enough to allow adequate interpretation in 9 of the 10 patients. In the first patient, the visualization of the area near the lesion was somewhat fair, although the right side colon was well visualized. There were no complications associated with this examination. The present preoperative examination using a transanal drainage tube was useful for determining the extent of intestinal resection when patients were not candidates for colonoscopy or barium enema examination. (author)

  4. Impact of the use of an endorectal coil for 3 T prostate MRI on image quality and cancer detection rate.

    Science.gov (United States)

    Gawlitza, Josephin; Reiss-Zimmermann, Martin; Thörmer, Gregor; Schaudinn, Alexander; Linder, Nicolas; Garnov, Nikita; Horn, Lars-Christian; Minh, Do Hoang; Ganzer, Roman; Stolzenburg, Jens-Uwe; Kahn, Thomas; Moche, Michael; Busse, Harald

    2017-02-01

    This work aims to assess the impact of an additional endorectal coil on image quality and cancer detection rate within the same patients. At a single academic medical center, this transversal study included 41 men who underwent T2- and diffusion-weighted imaging at 3 T using surface coils only or in combination with an endorectal coil in the same session. Two blinded readers (A and B) randomly evaluated all image data in separate sessions. Image quality with respect to localization and staging was rated on a five-point scale. Lesions were classified according to their prostate imaging reporting and data system (PIRADS) score version 1. Standard of reference was provided by whole-mount step-section analysis. Mean image quality scores averaged over all localization-related items were significantly higher with additional endorectal coil for both readers (p < 0.001), corresponding staging-related items were only higher for reader B (p < 0.001). With an endorectal coil, the rate of correctly detecting cancer per patient was significantly higher for reader B (p < 0.001) but not for reader A (p = 0.219). The numbers of histologically confirmed tumor lesions were rather similar for both settings. The subjectively rated 3-T image quality was improved with an endorectal coil. In terms of diagnostic performance, the use of an additional endorectal coil was not superior.

  5. Sizing of patent ductus arteriosus in adults for transcatheter closure using the balloon pull-through technique.

    Science.gov (United States)

    Shafi, Nabil A; Singh, Gagan D; Smith, Thomas W; Rogers, Jason H

    2018-05-01

    To describe a novel balloon sizing technique used during adult transcatheter patent ductus arteriosus (PDA) closure. In addition, to determine the clinical and procedural outcomes in six patients who underwent PDA balloon sizing with subsequent deployment of a PDA occluder device. Transcatheter PDA closure in adults has excellent safety and procedural outcomes. However, PDA sizing in adults can be challenging due to variable defect size, high flow state, or anatomical complexity. We describe a series of six cases where the balloon- pull through technique was successfully performed for PDA sizing prior to transcatheter closure. Consecutive adult patients undergoing adult PDA closure at our institution were studied retrospectively. A partially inflated sizing balloon was pulled through the defect from the aorta into the pulmonary artery and the balloon waist diameter was measured. Procedural success and clinical outcomes were obtained. Six adult patients underwent successful balloon pull-through technique for PDA sizing during transcatheter PDA closure, since conventional angiography often gave suboptimal opacification of the defect. All PDAs were treated with closure devices based on balloon PDA sizing with complete closure and no complications. In three patients that underwent preprocedure computed tomography, the balloon size matched the CT derived measurements. The balloon pull-through technique for PDA sizing is a safe and accurate sizing modality in adults undergoing transcatheter PDA closure. © 2017 Wiley Periodicals, Inc.

  6. Laparoscopic-assisted vaginal pull-through: A new approach for congenital adrenal hyperplasia patients with high urogenital sinus

    Directory of Open Access Journals (Sweden)

    Jacques Birraux

    2015-01-01

    Full Text Available Background: To open vaginal cavity to the pelvic floor is part of surgical treatment for urogenital sinus (UGS in girls with congenital adrenal hyperplasia (CAH. For high UGS, this operative procedure can be challenging and may jeopardise urinary continence. Combined perineal and laparoscopic approaches could be useful to minimise perineal dissection and to facilitate the vaginal lowering. Patients and Methods: We report the procedure of a laparoscopic-assisted vaginal pull-through for supra-sphincteric UGS in a 5-year-old girl with CAH. Laparoscopic dissection of the vagina from the posterior wall of the bladder and urethra, division of the confluence and vaginal pull-through to the perineum are described. Discussion: The technique is derived from laparoscopic-assisted treatment for high ano-rectal malformations. Compared with current procedures for treatment for high UGS, laparoscopic-assisted approach allows mobilising vagina with minimal dissection of perineum and complete preservation of urethra. Another major advantage is to provide a direct vision for dissection of the space between rectum and urethra prior to vaginal pull-through. Conclusion: Laparoscopic-assisted vaginal pull-through appears to be an interesting approach for high UGS in CAH patients, reducing dissection and risk of urinary incontinence. This new approach needs to be strengthened by other cases.

  7. Transanal endoscopic microsurgery with 3-D (TEM) or high-definition 2-D transanal endoscopic operation (TEO) for rectal tumors. A prospective, randomized clinical trial.

    Science.gov (United States)

    Serra-Aracil, Xavier; Mora-Lopez, Laura; Alcantara-Moral, Manel; Caro-Tarrago, Aleidis; Navarro-Soto, Salvador

    2014-05-01

    Transanal endoscopic microsurgery (TEM) is a three-dimensional viewing endoscopic system procedure which provides access to rectal tumors through a rectoscope. Two-dimensional transanal endoscopic operation (TEO), with the introduction of high-definition vision, achieves results that are comparable to those of the classical TEM. The main aim of the study was to compare the effectiveness of TEO and TEM systems in a prospective, randomized clinical trial. patients meeting inclusion criteria for diagnosis of rectal tumors with curative intent. Sample size, 36 patients. Patients were randomized to receive one of the two procedures. Study variables recorded were the following: preoperative data (time taken to assemble equipment, surgical time, quality of pneumorectum), postoperative morbidity and mortality, pathology study of the tumors, and economic analysis. Thirty-six patients were analyzed according to intention to treat. Two patients were excluded. The final per-protocol analysis was 34 patients. There were no significant differences in the preoperative or operative variables, quality of pneumorectum, postoperative variables, or pathology results. A trend toward benefit was observed in favor of TEO in time required for assembly, surgical suture time, and total surgical time though the differences were not statistically significant. Statistically significant differences were found in terms of the total cost of the procedure, with mean costs of 2,031  ± 440 for TEO and 2,603  ± 507 for TEM (95% CI 218.15-926.486 , p = 0.003). No technical or clinical differences were observed between the results obtained with the two systems except lower cost with TEO.

  8. Transanal endoscopic microsurgery.

    Science.gov (United States)

    Smart, Christopher J; Cunningham, Chris; Bach, Simon P

    2014-02-01

    Transanal endoscopic microsurgery (TEMS) is a well established method of accurate resection of specimens from the rectum under binocular vision. This review examines its role in the treatment of benign conditions of the rectum and the evidence to support its use and compliment existing endoscopic treatments. The evolution of TEMS in early rectal cancer and the concepts and outcomes of how it has been utilised to treat patients so far are presented. The bespoke nature of early rectal cancer treatment is changing the standard algorithms of rectal cancer care. The future of TEMS in the organ preserving treatment of early rectal cancer is discussed and how as clinicians we are able to select the correct patients for neoadjuvant or radical treatments accurately. The role of radiotherapy and outcomes from combination treatment using TEMS are presented with suggestions for areas of future research. Copyright © 2014. Published by Elsevier Ltd.

  9. Customized Pull Systems for Single-Product Flow Lines

    NARCIS (Netherlands)

    Gaury, E.G.A.; Kleijnen, J.P.C.; Pierreval, H.

    1998-01-01

    Traditionally pull production systems are managed through classic control systems such as Kanban, Conwip, or Base stock, but this paper proposes ‘customized’ pull control. Customization means that a given production line is managed through a pull control system that in principle connects each stage

  10. Transanal total mesorectal excision: a systematic review of the experimental and clinical evidence.

    Science.gov (United States)

    Araujo, S E; Crawshaw, B; Mendes, C R; Delaney, C P

    2015-02-01

    Achieving a clear distal or circumferential resection margins with laparoscopic total mesorectal excision (TME) may be laborious, especially in obese males and when operating on advanced distal rectal tumors with a poor response to neoadjuvant treatment. Transanal (TaTME) is a new natural orifice translumenal endoscopic surgery modality in which the rectum is mobilized transanally using endoscopic techniques with or without laparoscopic assistance. We conducted a comprehensive systematic review of publications on this new technique in PubMed and Embase databases from January, 2008, to July, 2014. Experimental and clinical studies written in English were included. Experimental research with TaTME was done on pigs with and without survival models and on human cadavers. In these studies, laparoscopic or transgastric assistance was frequently used resulting in an easier upper rectal dissection and in a longer rectal specimen. To date, 150 patients in 16 clinical studies have undergone TaTME. In all but 15 cases, transabdominal assistance was used. A rigid transanal endoscopic operations/transanal endoscopic microsurgery (TEO/TEM) platform was used in 37 patients. Rectal adenocarcinoma was the indication in all except for nine cases of benign diseases. Operative times ranged from 90 to 460 min. TME quality was deemed intact, satisfactory, or complete. Involvement in circumferential resection margins was detected in 16 (11.8 %) patients. The mean lymph node harvest was equal or greater than 12 in all studies. Regarding morbidity, pneumoretroperitoneum, damage to the urethra, and air embolism were reported intraoperatively. Mean hospital stay varied from 4 to 14 days. Postoperative complications occurred in 34 (22.7 %) patients. TaTME with TEM is feasible in selected cases. Oncologic safety parameters seem to be adequate although the evidence relies on small retrospective series conducted by highly trained surgeons. Further studies are expected.

  11. Transanal repair of rectocele corrects obstructed defecation if it is not associated with anismus.

    Science.gov (United States)

    Tjandra, J J; Ooi, B S; Tang, C L; Dwyer, P; Carey, M

    1999-12-01

    Rectocele is often associated with anorectal symptoms. Various surgical techniques have been described to repair the rectocele. The surgical results are variable. This study evaluated the results of transanal repair of rectocele, with particular emphasis on the impact of concomitant anismus on postoperative functional outcome. Fifty-nine consecutive females who underwent transanal repair of rectocele for obstructed defecation were prospectively reviewed. All 59 patients were parous with a median parity of 2 (range, 1-6) and a median age of 58 (range, 46-68) years. The median length of follow-up was 19 (range, 6-40) months. Anismus was detected by anorectal physiology and defecography. The functional outcome was assessed by a standard questionnaire, physical examination, anorectal manometry, neurophysiology, and defecography. The quality-of-life index was obtained using a visual analog scale (from 1-10, with 10 being the best). The functional outcome of transanal repair of rectocele was superior in patients without anismus. Forty (93 percent) of the 43 patients without anismus showed improved evacuation after repair compared with 6 (38 percent) of the 16 patients with anismus (Panismus was not present (Panismus, effectively corrects obstructed defecation.

  12. Transanal minimally-invasive surgery (TAMIS: Technique and results from an initial experience

    Directory of Open Access Journals (Sweden)

    Carlos Ramon Silveira Mendes

    2013-10-01

    Full Text Available Transanal endoscopic microsurgery is a minimally-invasive approach for rectal lesions. Superior exposure and access to the entire rectum result in lesser risk of compromised margins and lower recurrence rates, when compared to conventional transanal excision. The aim of this study was to describe a single institution's initial experience with transanal minimally invasive surgery (TAMIS. This was a prospective review of our database. Elev- en procedures from January 2012 to June 2013 were analyzed. Results: eleven operations were completed. Five men were evaluated. Mean age was 62.9 (40-86. Mean follow-up was 9.3 (2-17 months. Average tumor size was 3.8 (1.8-8 cm. Mean distance from anal verge was 6.3 (3-12 cm. Mean operating time was 53.73 (28-118 min. Postoperative complica- tion rate was 9.1%. There were no readmissions. Mortality was null. Operative pathology disclosed the presence of adenoma in four patients, invasive adenocarcinoma in two, neu- roendocrine carcinoma in three, and no residual lesion in one case. TAMIS is a minimally- invasive procedure with low postoperative morbidity at the initial experience. TAMIS is a curative procedure for benign lesions and for selected early cancers. It is useful after neoadjuvant therapy for strictly selected cancers, pending the results of multi-institutional trials. Resumo: Microcirurgia endoscópica transanal é uma abordagem minimamente invasiva para lesões retais. Apresenta menor risco de margem comprometida e menores taxas de recorrência em comparação com excisão transanal convencional. Objetivou-se descrever a experiência inicial, de uma única instituição, com cirurgia minimamente invasiva transanal (TAMIS. Avaliação prospectiva de nosso banco de dados. Onze procedimentos de janeiro de 2012 a junho de 2013, foram analisados. Resultados: onze operações foram concluídas. Havia cinco homens. A média de idade foi de 62,9 (40-86. O acompanhamento médio foi de ww9,3 (2-17 meses. O

  13. Stapled transanal rectal resection in solitary rectal ulcer associated with prolapse of the rectum: a prospective study.

    Science.gov (United States)

    Boccasanta, Paolo; Venturi, Marco; Calabro, Giuseppe; Maciocco, Marco; Roviaro, Gian Carlo

    2008-03-01

    At present, none of the conventional surgical treatments of solitary rectal ulcer associated with internal rectal prolapse seems to be satisfactory because of the high incidence of recurrence. The stapled transanal rectal resection has been demonstrated to successfully cure patients with internal rectal prolapse associated with rectocele, or prolapsed hemorrhoids. This prospective study was designed to evaluate the short-term and long-term results of stapled transanal rectal resection in patients affected by solitary rectal ulcer associated with internal rectal prolapse and nonresponders to biofeedback therapy. Fourteen patients were selected on the basis of validated constipation and continence scorings, clinical examination, anorectal manometry, defecography, and colonoscopy and were submitted to biofeedback therapy. Ten nonresponders were operated on and followed up with incidence of failure, defined as no improvement of symptoms and/or recurrence of rectal ulceration, as the primary outcome measure. Operative time, hospital stay, postoperative pain, time to return to normal activity, overall patient satisfaction index, and presence of residual rectal prolapse also were evaluated. At a mean follow-up of 27.2 (range, 24-34) months, symptoms significantly improved, with 80 percent of excellent/good results and none of the ten operated patients showed a recurrence of rectal ulcer. Operative time, hospital stay, and time to return to normal activity were similar to those reported after stapled transanal rectal resection for obstructed defecation, whereas postoperative pain was slightly higher. One patient complained of perineal abscess, requiring surgery. The stapled transanal rectal resection is safe and effective in the cure of solitary rectal ulcer associated with internal rectal prolapse, with minimal complications and no recurrences after two years. Randomized trials with sufficient number of patients are necessary to compare the efficacy of stapled transanal

  14. Development of a novel endorectal balloon for two-dimensional in-vivo rectal dosimetry

    Energy Technology Data Exchange (ETDEWEB)

    Lim, Young Kyung; Jeang, Eun Hee; Min, Soon Ki; Cho, Kwan Ho [National Cancer Center, Goyang (Korea, Republic of); Hwang, Ui Jung [National Medical Center, Seoul (Korea, Republic of); Choi, Sang Hyoun [Korea Cancer Center Hospital, Seoul (Korea, Republic of); Kwak, Jung Won [Asan Medical Center, Seoul (Korea, Republic of)

    2016-05-15

    In the present study, a new endorectal balloon equipped with radiochromic film was developed, and its dosimetric property was evaluated. A metal-oxide-semiconductor field-effect transistor (MOSFET) was used in a rectal balloon to measure the rectal dose in 3D-CRT and IMRT. Additionally, a thermoluminescent dosimeter (TLD) was attached directly onto the rectal balloon to measure the rectal dose in IMRT and proton therapy. However, in vivo dosimetry that uses such point dosimeters cannot provide 2D dose distribution in a rectal wall (RW). In order to obtain the 2D dose distribution in the rectal wall, a 2D dosimeter that incorporates radiosensitive film is required. A new endorectal balloon capable of 2D in vivo rectal dosimetry was developed. Unlike conventional ERBs, this 2DD-ERB was equipped with a radiosensitive film on the outside of the balloon to directly measure the 2D dose distribution delivered to the ARW by the treatment beam. The dosimetric properties of the 2DD-ERB were measured, and the results showed that the measured dose distributions agreed well with their respective treatment plans within 4%. The film-equipped endorectal balloon is expected to be used as an in vivo dosimeter for measuring the dose distribution in the rectal wall in the modern radiotherapy techniques, such as IMRT, VMAT, HT, and IMPT.

  15. Quality of life and parents' satisfaction with Duhamel's versus ...

    African Journals Online (AJOL)

    Background The aim of this study is to compare the surgical outcome as well as parents' satisfaction and quality of life for children after the transanal and the Duhamel pull-through operations in a single-center experience. Patients and methods A retrospective cohort file review was carried out of all cases of Hirschsprung's ...

  16. Using manual prostate contours to enhance deformable registration of endorectal MRI.

    Science.gov (United States)

    Cheung, M R; Krishnan, K

    2012-10-01

    Endorectal MRI provides detailed images of the prostate anatomy and is useful for radiation treatment planning. Here we describe a Demons field-initialized B-spline deformable registration of prostate MRI. T2-weighted endorectal MRIs of five patients were used. The prostate and the tumor of each patient were manually contoured. The planning MRIs and their segmentations were simulated by warping the corresponding endorectal MRIs using thin plate spline (TPS). Deformable registration was initialized using the deformation field generated using Demons algorithm to map the deformed prostate MRI to the non-deformed one. The solution was refined with B-Spline registration. Volume overlap similarity was used to assess the accuracy of registration and to suggest a minimum margin to account for the registration errors. Initialization using Demons algorithm took about 15 min on a computer with 2.8 GHz Intel, 1.3 GB RAM. Refinement B-spline registration (200 iterations) took less than 5 min. Using the synthetic images as the ground truth, at zero margin, the average (S.D.) 98 (±0.4)% for prostate coverage was 97 (±1)% for tumor. The average (±S.D.) treatment margin required to cover the entire prostate was 1.5 (±0.2)mm. The average (± S.D.) treatment margin required to cover the tumor was 0.7 (±0.1)mm. We also demonstrated the challenges in registering an in vivo deformed MRI to an in vivo non-deformed MRI. We here present a deformable registration scheme that can overcome large deformation. This platform is expected to be useful for prostate cancer radiation treatment planning. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  17. Pure NOTES rectosigmoid resection: transgastric endoscopic IMA dissection and transanal rectal mobilization in animal models.

    Science.gov (United States)

    Park, Sun Jin; Lee, Kil Yeon; Choi, Sung Il; Kang, Byung Mo; Huh, Chang; Choi, Dong Hyun; Lee, Chang Kyun

    2013-07-01

    We report a pure natural orifice translumenal endoscopic surgery (NOTES(®); American Society for Gastrointestinal Endoscopy [Oak Brook, IL] and the Society of American Gastrointestinal and Endoscopic Surgeons [Los Angeles, CA]) rectosigmoidectomy in animal models using transgastric endoscopic inferior mesenteric artery (IMA) dissection and transanal rectal mobilization. Ten live animals (2 pigs weighing 35-40 kg each and 8 dogs weighing 25-30 kg each) were used. A gastrotomy was made using a needle-knife puncture and the balloon dilatation technique or following the creation of a submucosal tunnel. A circular stapler shaft was transanally inserted up to the sigmoid colon for spatial orientation and traction of the mesocolon. The IMA was endoscopically dissected using a Coagrasper™ (Olympus, Tokyo, Japan) and then clipped. Endoscopic division of the sigmoid mesocolon was conducted laterally toward the marginal artery. Transanal full-thickness circumferential rectal and mesorectal dissections were performed, and a colorectal anastomosis was performed using a circular stapler with a single stapling technique. During the transanal approach, the gastrotomy was closed using four endoscopic clips. Endoscopic dissection of the IMA was successful in all cases, but minor bleedings occurred in 3 cases. The mean time from dissection and clipping to division of the IMA was 36.7 minutes (range, 25-45 minutes). The mean operation time was 180.5 minutes (range, 145-210 minutes). There were no intraoperative complications or hemodynamic instability. The mean length of the resected specimen was 11.2 cm (range, 9-17 cm). A pure NOTES approach to rectosigmoid resection using transgastric endoscopic IMA dissection is technically feasible in animal models.

  18. Morphological MRI and 3D proton spectroscopy using endorectal coil in the diagnostics of prostate cancer - preliminary experience

    International Nuclear Information System (INIS)

    Chrzan, R.; Urbanik, A.; Dobrowolski, Z.; Lipczynski, M.

    2006-01-01

    Morphological MR imaging using endorectal coil has high sensitivity but insufficient specificity in the detection of prostatic cancer. Higher specificity may be obtained by combining morphological MR with data on local metabolic disturbances in MR spectroscopy. The aim of our study was to assess the diagnostic accuracy of combined morphological MR and 3D proton spectroscopy using endorectal coil in prostate cancer detection. Morphological MR and 3D proton MR spectroscopy were performed in 20 patients with suspicion of prostate cancer on the basis of DRE, TRUS and/or PSA levels, finally verified in biopsy after MR. The examinations were performed with a 1.5 T GE Signa Excite scanner using an endorectal coil. We used axial, coronal and sagittal T2 FSE, axial T1 SE and 3D PROSE (PROstate Spectroscopy and imaging Examination) sequences. The diagnostic accuracy of combined morphological and spectroscopy assessment was compared to the accuracy of morphological MR alone. The specificity, PPV, and NPV of MR imaging using endorectal coil in the detection of prostatic cancer were higher in combined morphological and spectroscopic assessment compared to morphological assessment alone. 3D MR spectroscopy, in comparison to morphological MR imaging, provides additional data concerning metabolic disturbances in prostate cancer foci. The use of combined morphological MR and MR spectroscopy can improve the specificity of prostate cancer detection. (author)

  19. Sphincter-saving procedure for radiation-injuried rectum. A report of four cases with special reference to pull-through procedure

    Energy Technology Data Exchange (ETDEWEB)

    Moriya, Y.; Koyama, Y.; Hojo, K. (National Cancer Center, Tokyo (Japan))

    1982-09-01

    Up to this time the sigmoid colostomy has been widely accepted and conventional treatment for radiation-injured rectum, but patients without residual malignancy strongly desire to live without colostomy. We have tried to remove the involved rectal segments by sphincter-saving procedures. Four patients underwent these procedures, pull-through procedure in three and low anterior resection in one. Among sphincter-saving procedures, pull-through procedure was most adequate. Provided the following five conditions are fulfilled, pull-through procedure should be considered for severe radiation-injured rectum. (1) No recurrence of initial malignancy in the pelvis. (2) More than 2 cm intact rectal segment above dentate line may be preserved. (3) No radiation-injured segment in upper sigmoid. (4) No severe radiation damage in small intestine. (5) Patients under 70 year-old, with normal tonus of anal sphincter.

  20. Complex rectal polyps: other treatment modalities required when offering a transanal endoscopic microsurgery service.

    LENUS (Irish Health Repository)

    Joyce, Myles R

    2011-09-01

    Complex rectal polyps may present a clinical challenge. The study aim was to assess different treatment modalities required in the management of patients referred for transanal endoscopic microsurgery.

  1. Critical concepts and important anatomic landmarks encountered during transanal total mesorectal excision (taTME): toward the mastery of a new operation for rectal cancer surgery.

    Science.gov (United States)

    Atallah, S; Albert, M; Monson, J R T

    2016-07-01

    Over the past 3 years, colorectal surgeons have begun to adapt the technique of transanal total mesorectal excision. As international experience has been quickly forged, an improved recognition of the pitfalls and the practical details of this disruptive technique have been realized. The purpose of this technical note was to express the various nuances of transanal total mesorectal excision as learned during the course of its clinical application and international teaching, so as to rapidly communicate and share important insights with other surgeons who are in the early adoption phase of this approach. The technical points specific to transanal total mesorectal excision are addressed herein. When correctly applied, these will likely improve the quality of surgery and decrease morbidity attributable to inexperience with the transanal approach to total mesorectal excision.

  2. Initiation of a Transanal Total Mesorectal Excision Program at an Academic Training Program: Evaluating Patient Safety and Quality Outcomes.

    Science.gov (United States)

    Maykel, Justin A; Phatak, Uma R; Suwanabol, Pasithorn A; Schlussel, Andrew T; Davids, Jennifer S; Sturrock, Paul R; Alavi, Karim

    2017-12-01

    Short-term results have shown that transanal total mesorectal excision is safe and effective for patients with mid to low rectal cancers. Transanal total mesorectal excision is considered technically challenging; thus, adoption has been limited to a few academic centers in the United States. The aim of this study is to describe outcomes after the initiation of a transanal total mesorectal excision program in the setting of an academic colorectal training program. This is a single-center retrospective review of consecutive patients who underwent transanal total mesorectal excision from December 2014 to August 2016. This study was conducted at an academic center with a colorectal residency program. Patients with benign and malignant diseases were selected. All transanal total mesorectal excisions were performed with abdominal and perineal teams working simultaneously. The primary outcomes measured were pathologic quality, length of hospital stay, 30-day morbidity, and 30-day mortality. There were 40 patients (24 male). The median age was 55 years (interquartile range, 46.7-63.4) with a median BMI of 29 kg/m (interquartile range, 24.6-32.4). The primary indication was cancer (n = 30), and tumor height from the anal verge ranged from 0.5 to 15 cm. Eighty percent (n = 24) of the patients who had rectal cancer received preoperative chemoradiation. The most common procedures were low anterior resection (67.5%), total proctocolectomy (15%), and abdominoperineal resection (12.5%). Median operative time was 380 minutes (interquartile range, 306-454.4), with no change over time. For patients with malignancy, the mesorectum was complete or nearly complete in 100% of the specimens. A median of 14 lymph nodes (interquartile range, 12-17) were harvested, and 100% of the rectal cancer specimens achieved R0 status. Median length of stay was 4.5 days (interquartile range, 4-7), and there were 6 readmissions (15%). There were no deaths or intraoperative complications. This study

  3. Sphincter-saving reconstruction for radiation-injured rectum. A report of four cases with special reference to the pull-through procedure

    Energy Technology Data Exchange (ETDEWEB)

    Koyama, Yasuo; Moriya, Yoshihiro; Hojo, Keiichi (National Cancer Center, Tokyo (Japan). Hospital)

    1982-12-01

    Up to now sigmoid colostomy has been a widely accepted and conventional treatment for the radiation-injured rectum, but patients without residual malignancy strongly desire to live without a colostomy. We have tried to remove the involved rectal segments by sphincter-saving procedures. Four patients underwent these procedures, pull-through procedure in three and low anterior resection in one. Among sphincter-saving procedures, the pull-through procedure was the most adequate. Provided the following five conditions are fulfilled, the pull-through procedure should be considered for the severely radiation-injured rectum. (1) No recurrence of the initial malignancy in the pelvis. (2) Preferably, a more than 2 cm intact rectal segment above the dentate line preserved. (3) No radiation-injured segment in the upper sigmoid. (4) No severe radiation damage in the small intestine. (5) Normal anal function.

  4. Transanal Drainage of Coloanal Anastomotic Leaks

    Directory of Open Access Journals (Sweden)

    Bradley Sherman

    2018-01-01

    Full Text Available The conventional operative intervention for leaks following coloanal anastomoses has been proximal fecal diversion with or without take-down of anastomosis. A few of these cases are also amenable to percutaneous drainage. Ostomies created in this situation are often permanent, specifically in cases where coloanal anastomoses are taken down at the time of reoperation. We present two patients who developed perianastomotic pelvic abscesses that were treated with transanal large bore catheter drainage resulting in successful salvage of coloanal anastomoses without the need for a laparotomy or ostomy creation. We propose this to be an effective therapeutic approach to leaks involving low coloanal anastomoses in the absence of generalized peritonitis.

  5. Transanal irrigation is effective in functional fecal incontinence

    DEFF Research Database (Denmark)

    Jørgensen, Cecilie Siggaard; Kamperis, Konstantinos; Modin, Line

    2017-01-01

    Functional fecal incontinence (FFI) is divided into cases related to functional constipation (FC) and cases without concomitant constipation termed functional non-retentive fecal incontinence (FNRFI). Transanal irrigation (TAI) is widely used in children with neurogenic fecal incontinence...... and 35% (n = 25) were titrated to daily sessions. Of the 63 children who fulfilled the Rome III criteria of constipation, 46 (73%) showed full response with complete remission of incontinence episodes. Eleven (17%) showed partial response (≥50% reduction). Of nine children with FNRFI, four (44%) showed...

  6. Casing pull tests for directionally drilled environmental wells

    International Nuclear Information System (INIS)

    Staller, G.E.; Wemple, R.P.; Layne, R.R.

    1994-11-01

    A series of tests to evaluate several types of environmental well casings have been conducted by Sandia National Laboratories (SNL) and it's industrial partner, The Charles Machine Works, Inc. (CMW). A test bed was constructed at the CMW test range to model a typical shallow, horizontal, directionally drilled wellbore. Four different types of casings were pulled through this test bed. The loads required to pull the casings through the test bed and the condition of the casing material were documented during the pulling operations. An additional test was conducted to make a comparison of test bed vs actual wellbore casing pull loads. A directionally drilled well was emplaced by CMW to closely match the test bed. An instrumented casing was installed in the well and the pull loads recorded. The completed tests are reviewed and the results reported

  7. Casing pull tests for directionally drilled environmental wells

    Energy Technology Data Exchange (ETDEWEB)

    Staller, G.E.; Wemple, R.P. [Sandia National Labs., Albuquerque, NM (United States); Layne, R.R. [Charles Machine Works, Inc., Perry, OK (United States)

    1994-11-01

    A series of tests to evaluate several types of environmental well casings have been conducted by Sandia National Laboratories (SNL) and it`s industrial partner, The Charles Machine Works, Inc. (CMW). A test bed was constructed at the CMW test range to model a typical shallow, horizontal, directionally drilled wellbore. Four different types of casings were pulled through this test bed. The loads required to pull the casings through the test bed and the condition of the casing material were documented during the pulling operations. An additional test was conducted to make a comparison of test bed vs actual wellbore casing pull loads. A directionally drilled well was emplaced by CMW to closely match the test bed. An instrumented casing was installed in the well and the pull loads recorded. The completed tests are reviewed and the results reported.

  8. Transanal endoscopic microsurgery versus endoscopic mucosal resection for large rectal adenomas (TREND-study)

    NARCIS (Netherlands)

    F.J.C. van den Broek (Frank); E.J.R. de Graaf (Eelco); M.G.W. Dijkgraaf (Marcel); J.B. Reitsma (Johannes); J. Haringsma (Jelle); R. Timmer (Robin); B.L. Weusten (Bas); M.F. Gerhards (Michael); E.C. Consten (Esther); M.P. Schwartz (Matthijs); M.J. Boom (Maarten); E.J. Derksen (Erik); A.B. Bijnen (Bart); P.H.P. Davids (Paul); C. Hoff (Christiaan); H.M. van Dullemen (Hendrik); G.D.N. Heine (Dimitri); K. van der Linde (Klaas); J.M. Jansen (Jeroen); R.C.H. Mallant-Hent (Rosalie); R. Breumelhof (Ronald); H. Geldof (Han); J.C. Hardwick (James); P. Doornebosch (Pascal); A.C.T.M. Depla (Annekatrien); M.F. Ernst (Miranda); I.P. van Munster (Ivo); I.H.J.T. de Hingh (Ignace); E.J. Schoon (Erik); W.A. Bemelman (Willem); P. Fockens (Paul); E. Dekker (Evelien)

    2009-01-01

    textabstractBackground: Recent non-randomized studies suggest that extended endoscopic mucosal resection (EMR) is equally effective in removing large rectal adenomas as transanal endoscopic microsurgery (TEM). If equally effective, EMR might be a more cost-effective approach as this strategy does

  9. Transanal endoscopic microsurgery versus endoscopic mucosal resection for large rectal adenomas (TREND-study)

    NARCIS (Netherlands)

    van den Broek, Frank J. C.; de Graaf, Eelco J. R.; Dijkgraaf, Marcel G. W.; Haringsma, Jelle; Timmer, Robin; Weusten, Bas L. A. M.; Gerhards, Michael F.; Consten, Esther C. J.; Schwartz, Matthijs P.; Boom, Maarten J.; Derksen, Erik J.; Bijnen, A. Bart; Davids, Paul H. P.; Hoff, Christiaan; van Dullemen, Hendrik M.; Heine, G. Dimitri N.; van der Linde, Klaas; Jansen, Jeroen M.; Mallant-Hent, Rosalie C. H.; Breumelhof, Ronald; Geldof, Han; Hardwick, James C. H.; Doornebosch, Pascal G.; Depla, Annekatrien C. T. M.; Ernst, Miranda F.; van Munster, Ivo P.; de Hingh, Ignace H. J. T.; Schoon, Erik J.; Bemelman, Willem A.; Fockens, Paul; Dekker, Evelien; Reitsma, J.

    2009-01-01

    Background: Recent non-randomized studies suggest that extended endoscopic mucosal resection (EMR) is equally effective in removing large rectal adenomas as transanal endoscopic microsurgery (TEM). If equally effective, EMR might be a more cost-effective approach as this strategy does not require

  10. Comparison of Pelvic Phased-Array versus Endorectal Coil Magnetic Resonance Imaging at 3 Tesla for Local Staging of Prostate Cancer

    OpenAIRE

    Kim, Bum Soo; Kim, Tae-Hwan; Kwon, Tae Gyun; Yoo, Eun Sang

    2012-01-01

    Purpose Several studies have demonstrated the superiority of endorectal coil magnetic resonance imaging (MRI) over pelvic phased-array coil MRI at 1.5 Tesla for local staging of prostate cancer. However, few have studied which evaluation is more accurate at 3 Tesla MRI. In this study, we compared the accuracy of local staging of prostate cancer using pelvic phased-array coil or endorectal coil MRI at 3 Tesla. Materials and Methods Between January 2005 and May 2010, 151 patients underwent radi...

  11. Complications of transanal endoscopic microsurgery (TEMS): a prospective audit.

    Science.gov (United States)

    Bignell, M B; Ramwell, A; Evans, J R; Dastur, N; Simson, J N L

    2010-07-01

    The aim of this study was to determine the postoperative complications of Transanal Endoscopic Microsurgery (TEMS) excision of rectal lesions. A prospective audit of 262 consecutive TEMS procedures performed by a single surgeon between 1999 and 2008. The mean age of patients was 72 years. The mean area of the lesions excised was 17.5 cm(2) with a mean diameter of 4.5 cm at a mean distance of 7.4 cm from the dentate line. There were 201 full thickness excisions, 51 partial thickness excisions and nine were mixed or unclassified. Thirty-three (13%) patients developed 41 complications. There were two (0.8%) deaths within 30 days. Pelvic sepsis occurred in seven (3%) patients and was significantly more common after excision of low lesions within 2 cm of the dentate line. Postoperative haemorrhage occurred in seven (3%) patients and was significantly less common when dissection was performed with ultrasonic dissection than with diathermy. Fourteen (5%) patients developed acute urinary retention. Four (1.5%) patients developed rectal stenosis and four (1.5%) suffered uncomplicated surgical emphysema that required no treatment. Transanal endoscopic microsurgery is a safe operation with a low mortality and morbidity. Pelvic sepsis is more common after excision of lesions within 2 cm of the dentate line. Ultrasonic dissection is associated with less postoperative haemorrhage than diathermy.

  12. Occluded Brescia-Cimino Hemodialysis Fistulas: Endovascular Treatment with Both Brachial Arterial and Venous Access Using the Pull-Through Technique

    International Nuclear Information System (INIS)

    Miyayama, Shiro; Matsui, Osamu; Taki, Keiichi; Minami, Tetsuya; Shinmura, Rieko; Ito, Chiharu; Takamatsu, Shigeyuki; Kobayashi, Miki; Ushiogi, Yashuyuki

    2005-01-01

    We retrospectively evaluated the usefulness of both arterial and venous access with the pull-through technique in endovascular treatment of totally occluded Brescia-Cimino fistulas. We treated 26 patients (17 men, 9 women; age range 43-82 years, mean age 66 years) with occluded Brescia-Cimino fistulas. First, the occluded segment was traversed from the antegrade brachial arterial access using a microcatheter-guidewire system. Second, the vein was retrogradely punctured after confirmation of all diseased segments, and a 0.014- or 0.016-inch guidewire was pulled through the venous access when the occluded segment was long. All interventions including thrombolysis, thromboaspiration, angioplasty, and stent placement were performed via the venous access. The occlusion was successfully crossed via the brachial arterial access in 23 patients (88%). In 2 patients it was done from the venous approach. In the remaining patient it was not possible to traverse the occluded segment. The pull-through technique was successful in all 19 attempts. Clinical success was achieved in 96%, the primary patency rates at 6, 12, and 18 months were 83%, 78%, and 69%, the primary assisted patency rates were 92%, 92%, and 72%, and the secondary patency rates were 92%, 92%, and 92%, respectively. Minor complications in 5 patients included venous perforation in 2 (8%), venous rupture in 1 (4%), and regional hematoma in 2 (8%). Our study suggests that endovascular treatments with both arterial and venous access using the pull-through technique are highly effective in restoring function in totally occluded Brescia-Cimino fistulas

  13. The use of local anesthesia and sedation in transanal hemorrhoidal dearterialization with Doppler

    Directory of Open Access Journals (Sweden)

    Fernanda Bellotti Formiga

    2018-04-01

    Full Text Available The treatment of hemorrhoidal disease has never been as innovated as in recent decades. The transanal hemorrhoidal dearterialization with Doppler (THD was described under general anesthesia or spinal blockage and there is no use of local anesthesia reports. This study aims to evaluate the safety of the use of local anesthesia with sedation in THD. For this purpose, two cases are reported describing the technical and safety analysis and results. Both patients were women with grade II and III hemorrhoidal disease. These patients underwent pre-anesthetic sedation with intravenous diazepam, then were positioned in lithotomy and sedated with midazolam and pethidine. The intersphincteric blockage was followed by THD with mucopexy. One patient made a small submucosal hematoma without expansion. The patients were stable and comfortable throughout the procedure. Both were discharged the next day, with regular analgesia. In the seventh postoperative day, both had mild annoyance at constant tenesmus, which was reduced gradually. The cases illustrate that THD is feasible when performed with local anesthesia and sedation, as it is safe and effective. This new technology can be incorporated into services that have a local anesthesia protocol as their standard. Resumo: O tratamento da doença hemorroidária nunca foi tão inovado como nas últimas décadas. A desarterialização hemorroidária transanal é uma dessas inovações. Foi originalmente descrita sob anestesia geral ou bloqueio espinal e não há relatos de utilização de anestesia local. Assim, este estudo visa avaliar a segurança do uso da anestesia local com sedação na desarterialização hemorroidária transanal. Para tal, dois casos são relatados com descrição da técnica e análise da segurança e resultados. Ambas pacientes eram mulheres com doença hemorroidária grau II e III. Foram submetidas à indução anestésica, posicionadas em litotomia e sedadas com midazolan e petidina

  14. Transanal endoscopic micro-surgery (TEMS) for the management of large or sessile rectal adenomas: a review of the technique and indications

    OpenAIRE

    Papagrigoriadis, Savvas

    2006-01-01

    In this review article the surgical technique of Transanal Endoscopic Microsurgery (TEMS) is examined. A number of techniques have been used to treat adenomas of the rectum. The treatment of large adenomas which occupy a large surface of the rectal lumen or adenomas which are flat and grow in a "carpet-like" fashion is particularly challenging. Major rectal surgery carries a risk of morbidity and mortality, particularly in elderly and unfit patients. Although local excision with transanal res...

  15. Delayed pull-in transitions in overdamped MEMS devices

    Science.gov (United States)

    Gomez, Michael; Moulton, Derek E.; Vella, Dominic

    2018-01-01

    We consider the dynamics of overdamped MEMS devices undergoing the pull-in instability. Numerous previous experiments and numerical simulations have shown a significant increase in the pull-in time under DC voltages close to the pull-in voltage. Here the transient dynamics slow down as the device passes through a meta-stable or bottleneck phase, but this slowing down is not well understood quantitatively. Using a lumped parallel-plate model, we perform a detailed analysis of the pull-in dynamics in this regime. We show that the bottleneck phenomenon is a type of critical slowing down arising from the pull-in transition. This allows us to show that the pull-in time obeys an inverse square-root scaling law as the transition is approached; moreover we determine an analytical expression for this pull-in time. We then compare our prediction to a wide range of pull-in time data reported in the literature, showing that the observed slowing down is well captured by our scaling law, which appears to be generic for overdamped pull-in under DC loads. This realization provides a useful design rule with which to tune dynamic response in applications, including state-of-the-art accelerometers and pressure sensors that use pull-in time as a sensing mechanism. We also propose a method to estimate the pull-in voltage based only on data of the pull-in times.

  16. Limited success in patients treated with transanal haemorrhoidal dearterialisation

    DEFF Research Database (Denmark)

    Kjær, Søren; Lund, Henrik Hemmert; Schulze, Svend

    2014-01-01

    INTRODUCTION: Transanal haemorrhoidal dearterialisation (THD) is a novel non-excisional technique based on suture closure of the haemorrhoidal arterial flow feeding the haemorrhoidal plexus. The primary objective of this study was to report the first Danish experience with THD. METHODS: The study......-operatively. Additionally, a structured telephone interview was conducted within two years after the THD operation. RESULTS: During the study period (from January 2011 to January 2013), 93 patients underwent a THD procedure. Twenty patients were exluded from the study which left 73 patients for analysis. Treatment success...

  17. Mapping of the prostate in endorectal coil-based MRI/MRSI and CT: A deformable registration and validation study

    International Nuclear Information System (INIS)

    Lian, J.; Xing, L.; Hunjan, S.; Dumoulin, C.; Levin, J.; Lo, A.; Watkins, R.; Rohling, K.; Giaquinto, R.; Kim, D.; Spielman, D.; Daniel, B.

    2004-01-01

    The endorectal coil is being increasingly used in magnetic resonance imaging (MRI) and MR spectroscopic imaging (MRSI) to obtain anatomic and metabolic images of the prostate with high signal-to-noise ratio (SNR). In practice, however, the use of endorectal probe inevitably distorts the prostate and other soft tissue organs, making the analysis and the use of the acquired image data in treatment planning difficult. The purpose of this work is to develop a deformable image registration algorithm to map the MRI/MRSI information obtained using an endorectal probe onto CT images and to verify the accuracy of the registration by phantom and patient studies. A mapping procedure involved using a thin plate spline (TPS) transformation was implemented to establish voxel-to-voxel correspondence between a reference image and a floating image with deformation. An elastic phantom with a number of implanted fiducial markers was designed for the validation of the quality of the registration. Radiographic images of the phantom were obtained before and after a series of intentionally introduced distortions. After mapping the distorted phantom to the original one, the displacements of the implanted markers were measured with respect to their ideal positions and the mean error was calculated. In patient studies, CT images of three prostate patients were acquired, followed by 3 Tesla (3 T) MR images with a rigid endorectal coil. Registration quality was estimated by the centroid position displacement and image coincidence index (CI). Phantom and patient studies show that TPS-based registration has achieved significantly higher accuracy than the previously reported method based on a rigid-body transformation and scaling. The technique should be useful to map the MR spectroscopic dataset acquired with ER probe onto the treatment planning CT dataset to guide radiotherapy planning

  18. Use of Peristeen® transanal colonic irrigation for bowel management in children: a single-center experience.

    Science.gov (United States)

    Pacilli, Maurizio; Pallot, David; Andrews, Afiya; Downer, Angela; Dale, Louiza; Willetts, Ian

    2014-02-01

    Transanal colonic irrigation has been shown to be effective in bowel management program in adults. However, there exist limited data in children. We appraised the effectiveness of this technique in a series of children with incontinence or constipation and overflow soiling. Following ethical approval, a review of children with incontinence or constipation on a bowel management program with Peristeen® transanal colonic irrigation treated between 2007 and 2012 was performed. Irrigations were performed with a volume of 10-20 ml/kg of water with schedules depending on patient response. Data are reported as median (range). Twenty-three patients were reviewed. Median age at commencement of irrigations was 7 (2-15) years. Median follow-up is 2 (0.7-3.4) years. Diagnoses include the following: spina bifida (n=11), anorectal anomaly (n=6), Hirschsprung's (n=1), and other complex anomalies (n=5). Sixteen (70%) patients had associated anomalies. Twelve (52%) had constipation and overflow soiling, and 11 (48%) had fecal incontinence. Twenty (87%) had associated urinary wetting. Sixteen (70%) children used alternate-day irrigations, 4 (17%) daily irrigations, and 3 (13%) every third-day irrigations. Nine (39%) patients were taking oral laxatives. Sixteen (70%) reported to be clean and 3 (13%) reported a significant improvement, although were having occasional soiling. Four patients (17%) did not tolerate the irrigations and underwent subsequent colostomy formation for intractable soiling. In our experience, Peristeen® transanal colonic irrigation is an effective method of managing patients with focal soiling in childhood. Majority (83%) of children achieve social fecal continence or a significant improvement with occasional soiling. This was accompanied by high parental satisfaction. Peristeen® transanal colonic irrigation is a valid alternative to invasive surgical procedures and should be considered the first line of treatment for bowel management in children with soiling

  19. Human intestinal mucus proteins isolated by transanal irrigation and proctosigmoidoscopy

    Directory of Open Access Journals (Sweden)

    Paola Andrea Gómez Buitrago

    2014-10-01

    Full Text Available Human intestinal mucus essentially consists of a network of Mucin2 glycoproteins embedded in many lower molecular weight proteins. This paper contributes to the proteomic study of human intestinal mucus by comparing two sample collection methods (transanal irrigation and brush cytology during proctosigmoidoscopy and analysis techniques (electrophoresis and digestion in solution. The entire sample collection and treatment process is explained, including protein extraction, digestion and desalination and peptide characterisation using a nanoAcquity UPLC chromatograph coupled to an HDMS spectrometer equipped with a nanoESI source. Collecting mucus via transanal irrigation provided a larger sample volume and protein concentration from a single patient. The proctosigmoidoscopy sample could be analysed via digestion in solution after depleting albumin. The analysis indicates that a simple mucus lysis method can evaluate the electrophoresis and digestion in solution techniques. Studying human intestinal mucus complexes is important because they perform two essential survival functions for humans as the first biochemical and physical defences for the gastrointestinal tract and a habitat for intestinal microbiota, which are primarily hosted in the colon and exceeds the human genetic information and cell number 100- and 10-fold (1.

  20. The Role of Transanal Surgery in the Management of T1 Rectal Cancers.

    Science.gov (United States)

    Hassan, Imran; Wise, Paul E; Margolin, David A; Fleshman, James W

    2015-09-01

    The management of T1 rectal cancers is based on finding the balance between optimal oncologic outcomes and acceptable functional results for the patient. While radical resection involving a proctectomy is considered the most oncologically adequate option, its adverse effects on patient reported outcomes makes this a less than ideal choice in certain circumstances. While local excision can circumvent some of the adverse functional outcomes, its inadequacy in assessing metastatic lymph node disease and the subsequent negative impact of untreated positive lymph nodes on patient prognosis is a cause for concern. As a result, the therapeutic strategy has to be based on patient and disease-related factors in order to identify the best treatment choice that maximizes survival benefit and preserves health-related quality of life. After adequate preoperative staging work up, in selected patients with favorable pathological features, local excision can be considered. These cancers can be removed by transanal local excision or transanal endoscopic microsurgery, depending on the location of the cancer and expertise available. While perioperative morbidity is minimal, close postoperative follow-up is essential.

  1. Novel technique for MR elastography of the prostate using a modified standard endorectal coil as actuator.

    Science.gov (United States)

    Thörmer, Gregor; Reiss-Zimmermann, Martin; Otto, Josephin; Hoffmann, Karl-Titus; Moche, Michael; Garnov, Nikita; Kahn, Thomas; Busse, Harald

    2013-06-01

    To present a novel method for MR elastography (MRE) of the prostate at 3 Tesla using a modified endorectal imaging coil. A commercial endorectal coil was modified to dynamically generate mechanical stress (contraction and dilation) in a prostate phantom with embedded phantom "lesions" (6 mm diameter) and in a porcine model. Resulting tissue displacements were measured with a motion-sensitive EPI sequence at actuation frequencies of 50-200 Hz. Maps of shear modulus G were calculated from the measured phase-difference shear-wave patterns. In the G maps of the phantom, "lesions" were easily discernible against the background. The average G values of regions of interest placed in the "lesion" (8.2 ± 1.9 kPa) were much higher than those in the background (3.6 ± 1.4 kPa) but systematically lower than values reported by the vendor (13.0 ± 1.0 and 6.7 ± 0.7 kPa, respectively). In the porcine model, shear waves could be generated and measured shear moduli were substantially different for muscle (7.1 ± 2.0 kPa), prostate (3.0 ± 1.4 kPa), and bulbourethral gland (5.6 ± 1.9 kPa). An endorectal MRE concept is technically feasible. The presented technique will allow for simultaneous MRE and MRI acquisitions using a commercial base device with minor, MR-conditional modifications. The diagnostic value needs to be determined in further trials. Copyright © 2012 Wiley Periodicals, Inc.

  2. Preliminary results of endorectal surface coil magnetic resonance imaging for local staging of prostate cancer

    NARCIS (Netherlands)

    Jager, G. J.; Barentsz, J. O.; de la Rosette, J. J.; Rosenbusch, G.

    1994-01-01

    To evaluate the effectiveness of endorectal surface coil (ERC) magnetic resonance imaging (MRI) in the local staging of adenocarcinoma of the prostate (ACP). A total of 23 patients who were considered candidates for radical prostatectomy because of clinically localized ACP were examined by ERC-MRI.

  3. Pulled Motzkin paths

    International Nuclear Information System (INIS)

    Janse van Rensburg, E J

    2010-01-01

    In this paper the models of pulled Dyck paths in Janse van Rensburg (2010 J. Phys. A: Math. Theor. 43 215001) are generalized to pulled Motzkin path models. The generating functions of pulled Motzkin paths are determined in terms of series over trinomial coefficients and the elastic response of a Motzkin path pulled at its endpoint (see Orlandini and Whittington (2004 J. Phys. A: Math. Gen. 37 5305-14)) is shown to be R(f) = 0 for forces pushing the endpoint toward the adsorbing line and R(f) = f(1 + 2cosh f))/(2sinh f) → f as f → ∞, for forces pulling the path away from the X-axis. In addition, the elastic response of a Motzkin path pulled at its midpoint is shown to be R(f) = 0 for forces pushing the midpoint toward the adsorbing line and R(f) = f(1 + 2cosh (f/2))/sinh (f/2) → 2f as f → ∞, for forces pulling the path away from the X-axis. Formal combinatorial identities arising from pulled Motzkin path models are also presented. These identities are the generalization of combinatorial identities obtained in directed paths models to their natural trinomial counterparts.

  4. Pulled Motzkin paths

    Energy Technology Data Exchange (ETDEWEB)

    Janse van Rensburg, E J, E-mail: rensburg@yorku.c [Department of Mathematics and Statistics, York University, Toronto, ON, M3J 1P3 (Canada)

    2010-08-20

    In this paper the models of pulled Dyck paths in Janse van Rensburg (2010 J. Phys. A: Math. Theor. 43 215001) are generalized to pulled Motzkin path models. The generating functions of pulled Motzkin paths are determined in terms of series over trinomial coefficients and the elastic response of a Motzkin path pulled at its endpoint (see Orlandini and Whittington (2004 J. Phys. A: Math. Gen. 37 5305-14)) is shown to be R(f) = 0 for forces pushing the endpoint toward the adsorbing line and R(f) = f(1 + 2cosh f))/(2sinh f) {yields} f as f {yields} {infinity}, for forces pulling the path away from the X-axis. In addition, the elastic response of a Motzkin path pulled at its midpoint is shown to be R(f) = 0 for forces pushing the midpoint toward the adsorbing line and R(f) = f(1 + 2cosh (f/2))/sinh (f/2) {yields} 2f as f {yields} {infinity}, for forces pulling the path away from the X-axis. Formal combinatorial identities arising from pulled Motzkin path models are also presented. These identities are the generalization of combinatorial identities obtained in directed paths models to their natural trinomial counterparts.

  5. Pulled Motzkin paths

    Science.gov (United States)

    Janse van Rensburg, E. J.

    2010-08-01

    In this paper the models of pulled Dyck paths in Janse van Rensburg (2010 J. Phys. A: Math. Theor. 43 215001) are generalized to pulled Motzkin path models. The generating functions of pulled Motzkin paths are determined in terms of series over trinomial coefficients and the elastic response of a Motzkin path pulled at its endpoint (see Orlandini and Whittington (2004 J. Phys. A: Math. Gen. 37 5305-14)) is shown to be R(f) = 0 for forces pushing the endpoint toward the adsorbing line and R(f) = f(1 + 2cosh f))/(2sinh f) → f as f → ∞, for forces pulling the path away from the X-axis. In addition, the elastic response of a Motzkin path pulled at its midpoint is shown to be R(f) = 0 for forces pushing the midpoint toward the adsorbing line and R(f) = f(1 + 2cosh (f/2))/sinh (f/2) → 2f as f → ∞, for forces pulling the path away from the X-axis. Formal combinatorial identities arising from pulled Motzkin path models are also presented. These identities are the generalization of combinatorial identities obtained in directed paths models to their natural trinomial counterparts.

  6. Modified transanal repair of congenital H-type rectovestibular fistula ...

    African Journals Online (AJOL)

    Congenital H-type rectovestibular fistulas are rare in the spectrum of anorectal malformations. Repair is associated with recurrence rates of up to 30%, using perineal repair, vestibuloanal pull-through or anterior anorectoplasty. The rarity of the malformation has limited experience with the surgical approach; hence, the rate ...

  7. Magnetic resonance imaging of cervical carcinoma using an endorectal surface coil

    International Nuclear Information System (INIS)

    Brocker, Kerstin A.; Alt, Céline D.; Gebauer, Gerhard; Sohn, Christof; Hallscheidt, Peter

    2014-01-01

    Introduction: The objective of this trial is to investigate the diagnostic value of magnetic resonance imaging (MRI) with an endorectal surface coil for precise local staging of patients with histologically proven cervical cancer by comparing the radiological, clinical, and histological results. Materials and methods: Women with cervical cancer were recruited for this trial between February 2007, and September 2010. All the patients were clinically staged according to the FIGO classification and underwent radiological staging by MRI that employed an endorectal surface coil. The staging results after surgery were compared to histopathology in all the operable patients. Results: A total of 74 consecutive patients were included in the trial. Forty-four (59.5%) patients underwent primary surgery, whereas 30 (40.5%) patients were inoperable according to FIGO and underwent primary radiochemotherapy. The mean age of the patients was 50.6 years. In 11 out of the 44 patients concordant staging results were obtained by all three staging modalities. Thirty-two of the 44 patients were concordantly staged by FIGO and histopathological examination, while only 16 were concordantly staged by eMRI and histopathological examination. eMRI overstaged tumors in 14 cases and understaged them in 7 cases. Conclusions: eMRI is applicable in patients with cervical cancer, yet of no benefit than staging with FIGO or standard pelvic MRI. The most precise preoperative staging procedure still appears to be the clinical examination

  8. Preoperative chemoradiation of locally advanced T3 rectal cancer combined with an endorectal boost

    DEFF Research Database (Denmark)

    Jakobsen, Anders; Mortensen, John P; Bisgaard, Claus

    2006-01-01

    (TRG) system. TRG1 was recorded in 27% of the patients, and a further 27% were classified as TRG2. TRG3 was found in 40%, and 6% had TRG4. The toxicity was low. CONCLUSION: The results indicate that high-dose radiation with concurrent chemotherapy and endorectal brachytherapy is feasible with a high...

  9. Trans-anal barotrauma by compressed air leading to sigmoid perforation due to a dangerous practical joke.

    Science.gov (United States)

    Pahwa, Harvinder Singh; Kumar, Awanish; Srivastava, Rohit; Rai, Anurag

    2012-08-01

    To present a case report of trans-anal barotrauma by high-pressure compressed air jet as a dangerous practical joke, that is, playful insufflation of high-pressure air jet through the anal orifice resulting in sigmoid perforation. The patient presented to emergency a day later with complaints of severe pain in the abdomen and abdominal distension following insufflation of high-pressure air jet through the anus. On examination, he had signs suggestive of perforation peritonitis and x-ray of the abdomen showed gas under the diaphragm. An emergency exploratory laparotomy was performed which revealed a 4-cm perforation in the sigmoid colon. Resection of the segment containing perforation along with the surrounding devitalised part was done with double-barrel colostomy. Reversal of colostomy was done after 8 weeks. Follow-up was uneventful.

  10. T2-weighted endorectal magnetic resonance imaging of prostate cancer after external beam radiation therapy

    International Nuclear Information System (INIS)

    Westphalen, Antonio C.; Kurhanewicz, John; Cunha, Rui M.G.; Hsu, I-Chow; Kornak, John; Zhao, Shoujun; Coakley, Fergus V.

    2009-01-01

    Purpose: To retrospectively determine the accuracy of T2-weighted endorectal MR imaging in the detection of prostate cancer after external beam radiation therapy and to investigate the relationship between imaging accuracy and time since therapy. Materials and Methods: Institutional review board approval was obtained and the study was HIPPA compliant. We identified 59 patients who underwent 1.5 Tesla endorectal MR imaging of the prostate between 1999 and 2006 after definitive external beam radiation therapy for biopsy-proven prostate cancer. Two readers recorded the presence or absence of tumor on T2-weighted images. Logistic regression and Fisher's exact tests for 2x2 tables were used to determine the accuracy of imaging and investigate if accuracy differed between those imaged within 3 years of therapy (n = 25) and those imaged more than 3 years after therapy (n = 34). Transrectal biopsy was used as the standard of reference for the presence or absence of recurrent cancer. Results: Thirty-four of 59 patients (58%) had recurrent prostate cancer detected on biopsy. The overall accuracy of T2-weighted MR imaging in the detection cancer after external beam radiation therapy was 63% (37/59) for reader 1 and 71% for reader 2 (42/59). For both readers, logistic regression showed no difference in accuracy between those imaged within 3 years of therapy and those imaged more than 3 years after therapy (p = 0.86 for reader 1 and 0.44 for reader 2). Conclusion: T2-weighted endorectal MR imaging has low accuracy in the detection of prostate cancer after external beam radiation therapy, irrespective of the time since therapy. (author)

  11. Normal appearance of the prostate and seminal tract: MR imaging using an endorectal surface coil

    International Nuclear Information System (INIS)

    Kim, Myeong Jin; Lee, Jong Tae; Lee, Moo Sang; Choi, Pil Sik; Hong, Sung Joon; Lee, Yeon Hee; Choi, Hak Yong

    1994-01-01

    To assess the ability of MR imaging with an endorectal surface coil for the depiction of normal anatomical structure of prostate and its adjacent organs. MR imaging using an endorectal surface coil was performed in 23 male patients(age ; 20-75) to evaluate various prostatic and vasovesicular disorders, i. e, 14 cases of ejaculatory problems, 3 cases of hypogonadism, and 4 cases of prostatic cancers and 2 cases of benign prostatic hyperplasia. MR images were obtained with axial, sagittal and coronal fast spin echo long TR/TE images and axial spin echo short TR/TE images. Field of views was 10-12 cm and scan thickness was 3-5 mm. Depiction of normal anatomcial structures was excellent in all cases. On T2WI, zonal anatomy of the prostate and prostatic urethra, urethral crest, and ejaculatory duct were cleary visualized. On T1WI, periprostatic fat plane is more cleary visualized. On transverse images, periprostatic structures were well visualized on T1WI,and on T2WI, anterior fibromuscular stroma, transition zone and peripheral zone could be readily differentiated. Coronal images were more helpful in visualization of both central and peripheral zones. Vas deferens, ejaculatory duct and vermontanum were also more easily defined on these images. Sagittal images was helpful in the depiction of anterior fibromuscular stroma, central zone and peripheral zone with prostatic urethra and ejaculatory duct in a single plane. High resolution MR imaging with an endorectal surface coil can readily visualize the normal anatomy of the prostate and its related structures and may be useful in the evaluation of various diseases of prostate and vasvesicular system

  12. Normal appearance of the prostate and seminal tract: MR imaging using an endorectal surface coil

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Myeong Jin; Lee, Jong Tae; Lee, Moo Sang; Choi, Pil Sik; Hong, Sung Joon; Lee, Yeon Hee; Choi, Hak Yong [Yonsei University College of Medicine, Seoul (Korea, Republic of)

    1994-06-15

    To assess the ability of MR imaging with an endorectal surface coil for the depiction of normal anatomical structure of prostate and its adjacent organs. MR imaging using an endorectal surface coil was performed in 23 male patients(age ; 20-75) to evaluate various prostatic and vasovesicular disorders, i. e, 14 cases of ejaculatory problems, 3 cases of hypogonadism, and 4 cases of prostatic cancers and 2 cases of benign prostatic hyperplasia. MR images were obtained with axial, sagittal and coronal fast spin echo long TR/TE images and axial spin echo short TR/TE images. Field of views was 10-12 cm and scan thickness was 3-5 mm. Depiction of normal anatomcial structures was excellent in all cases. On T2WI, zonal anatomy of the prostate and prostatic urethra, urethral crest, and ejaculatory duct were cleary visualized. On T1WI, periprostatic fat plane is more cleary visualized. On transverse images, periprostatic structures were well visualized on T1WI,and on T2WI, anterior fibromuscular stroma, transition zone and peripheral zone could be readily differentiated. Coronal images were more helpful in visualization of both central and peripheral zones. Vas deferens, ejaculatory duct and vermontanum were also more easily defined on these images. Sagittal images was helpful in the depiction of anterior fibromuscular stroma, central zone and peripheral zone with prostatic urethra and ejaculatory duct in a single plane. High resolution MR imaging with an endorectal surface coil can readily visualize the normal anatomy of the prostate and its related structures and may be useful in the evaluation of various diseases of prostate and vasvesicular system.

  13. Anorectal function and outcomes after transanal minimally invasive surgery for rectal tumors

    Directory of Open Access Journals (Sweden)

    Feza Y Karakayali

    2015-01-01

    Full Text Available Background: Transanal endoscopic microsurgery is a minimally invasive technique that allows full-thickness resection and suture closure of the defect for large rectal adenomas, selected low-risk rectal cancers, or small cancers in patients who have a high risk for major surgery. Our aim, in the given prospective study was to report our initial clinical experience with TAMIS, and to evaluate its effects on postoperative anorectal functions. Materials and Methods: In 10 patients treated with TAMIS for benign and malignant rectal tumors, preoperative and postoperative anorectal function was evaluated with anorectal manometry and Cleveland Clinic Incontinence Score. Results: The mean distance of the tumors from the anal verge was 5.6 cm, and mean tumor diameter was 2.6 cm. All resection margins were tumor free. There was no difference in preoperative and 3-week postoperative anorectalmanometry findings; only mean minimum rectal sensory volume was lower at 3 weeks after surgery. The Cleveland Clinic Incontinence Score was normal in all patients except one which resolved by 6 weeks after surgery.The mean postoperative follow-up was 28 weeks without any recurrences. Conclusion: Transanal minimally invasive surgery is a safe and effective procedure for treatment of rectal tumors and can be performed without impairing anorectal functions.

  14. WE-AB-BRA-11: Improved Imaging of Permanent Prostate Brachytherapy Seed Implants by Combining an Endorectal X-Ray Sensor with a CT Scanner

    International Nuclear Information System (INIS)

    Steiner, J; Matthews, K; Jia, G

    2016-01-01

    Purpose: To test feasibility of the use of a digital endorectal x-ray sensor for improved image resolution of permanent brachytherapy seed implants compared to conventional CT. Methods: Two phantoms simulating the male pelvic region were used to test the capabilities of a digital endorectal x-ray sensor for imaging permanent brachytherapy seed implants. Phantom 1 was constructed from acrylic plastic with cavities milled in the locations of the prostate and the rectum. The prostate cavity was filled a Styrofoam plug implanted with 10 training seeds. Phantom 2 was constructed from tissue-equivalent gelatins and contained a prostate phantom implanted with 18 strands of training seeds. For both phantoms, an intraoral digital dental x-ray sensor was placed in the rectum within 2 cm of the seed implants. Scout scans were taken of the phantoms over a limited arc angle using a CT scanner (80 kV, 120–200 mA). The dental sensor was removed from the phantoms and normal helical CT and scout (0 degree) scans using typical parameters for pelvic CT (120 kV, auto-mA) were collected. A shift-and add tomosynthesis algorithm was developed to localize seed plane location normal to detector face. Results: The endorectal sensor produced images with improved resolution compared to CT scans. Seed clusters and individual seed geometry were more discernable using the endorectal sensor. Seed 3D locations, including seeds that were not located in every projection image, were discernable using the shift and add algorithm. Conclusion: This work shows that digital endorectal x-ray sensors are a feasible method for improving imaging of permanent brachytherapy seed implants. Future work will consist of optimizing the tomosynthesis technique to produce higher resolution, lower dose images of 1) permanent brachytherapy seed implants for post-implant dosimetry and 2) fine anatomic details for imaging and managing prostatic disease compared to CT images. Funding: LSU Faculty Start-up Funding

  15. WE-AB-BRA-11: Improved Imaging of Permanent Prostate Brachytherapy Seed Implants by Combining an Endorectal X-Ray Sensor with a CT Scanner

    Energy Technology Data Exchange (ETDEWEB)

    Steiner, J; Matthews, K; Jia, G [Louisiana State University, Baton Rouge, LA (United States)

    2016-06-15

    Purpose: To test feasibility of the use of a digital endorectal x-ray sensor for improved image resolution of permanent brachytherapy seed implants compared to conventional CT. Methods: Two phantoms simulating the male pelvic region were used to test the capabilities of a digital endorectal x-ray sensor for imaging permanent brachytherapy seed implants. Phantom 1 was constructed from acrylic plastic with cavities milled in the locations of the prostate and the rectum. The prostate cavity was filled a Styrofoam plug implanted with 10 training seeds. Phantom 2 was constructed from tissue-equivalent gelatins and contained a prostate phantom implanted with 18 strands of training seeds. For both phantoms, an intraoral digital dental x-ray sensor was placed in the rectum within 2 cm of the seed implants. Scout scans were taken of the phantoms over a limited arc angle using a CT scanner (80 kV, 120–200 mA). The dental sensor was removed from the phantoms and normal helical CT and scout (0 degree) scans using typical parameters for pelvic CT (120 kV, auto-mA) were collected. A shift-and add tomosynthesis algorithm was developed to localize seed plane location normal to detector face. Results: The endorectal sensor produced images with improved resolution compared to CT scans. Seed clusters and individual seed geometry were more discernable using the endorectal sensor. Seed 3D locations, including seeds that were not located in every projection image, were discernable using the shift and add algorithm. Conclusion: This work shows that digital endorectal x-ray sensors are a feasible method for improving imaging of permanent brachytherapy seed implants. Future work will consist of optimizing the tomosynthesis technique to produce higher resolution, lower dose images of 1) permanent brachytherapy seed implants for post-implant dosimetry and 2) fine anatomic details for imaging and managing prostatic disease compared to CT images. Funding: LSU Faculty Start-up Funding

  16. Trichotillomania (Hair-Pulling Disorder)

    Science.gov (United States)

    ... pulling Biting, chewing or eating pulled-out hair Playing with pulled-out hair or rubbing it across ... of trichotillomania: Family history. Genetics may play a role in the development of trichotillomania, and the disorder ...

  17. Anal wall sparing effect of an endorectal balloon in 3D conformal and intensity-modulated prostate radiotherapy.

    NARCIS (Netherlands)

    Smeenk, R.J.; Lin, E.N.J.T. van; Kollenburg, P. van; Kunze-Busch, M.C.; Kaanders, J.H.A.M.

    2009-01-01

    BACKGROUND AND PURPOSE: To investigate the anal wall (Awall) sparing effect of an endorectal balloon (ERB) in 3D conformal radiotherapy (3D-CRT) and intensity-modulated radiotherapy (IMRT) for prostate cancer. MATERIALS AND METHODS: In 24 patients with localized prostate carcinoma, two planning

  18. Transvaginal Mesh and Transanal Resection to Treat Outlet Obstruction Constipation Caused by Rectocele

    OpenAIRE

    Shi, Yang; Yu, Yongjun; Zhang, Xipeng; Li, Yuwei

    2017-01-01

    Background The aim of this study was to evaluate the curative effect of transvaginal mesh repair (TVMR) and stapled transanal rectal resection (STARR) in treating outlet obstruction constipation caused by rectocele. Material/Methods Patients who had outlet obstruction constipation caused by rectocele were retrospectively analyzed and 39 patients were enrolled the study. Patients were assigned to either the TVMR or STARR group. Postoperative factors such as complications, pain, recurrence rate...

  19. Boosting the SNR by adding a receive-only endorectal monopole to an external antenna array for high-resolution, T2 -weighted imaging of early-stage cervical cancer with 7-T MRI

    NARCIS (Netherlands)

    van Kalleveen, I.M.L.; Hoogendam, J.P.; Raaijmakers, A.J.E.; Visser, F.; Arteaga de Castro, C.S.; Verheijen, R.H.M.; Luijten, P.R.; Zweemer, R.P.; Veldhuis, W.B.; Klomp, D.W.J.

    The aim of this study was to investigate the signal-to-noise ratio (SNR) gain in early-stage cervical cancer at ultrahigh-field MRI (e.g. 7 T) using a combination of multiple external antennas and a single endorectal antenna. In particular, we used an endorectal monopole antenna to increase the SNR

  20. Early complications after stapled transanal rectal resection performed using the Contour® Transtar™ device.

    Science.gov (United States)

    Martellucci, J; Talento, P; Carriero, A

    2011-12-01

    This study evaluated the early results (with particular reference to complications) of stapled transanal rectal resection (STARR) carried out using the CCS-30 Contour® Transtar™ device. The procedure was performed in a single centre on patients with obstucted defecation caused by rectocele or rectal intussusception. From July 2007 to February 2009, 133 patients were treated. Preoperatively, all underwent clinical examination, transanal ultrasonography, anorectal manometry and cinedefaecography. Obstructed defaecation syndrome was assessed using the Cleveland Clinic Constipation Score (CCC-S). Early postoperative complications and those occurring within 6 months were recorded. The median follow-up period was 19 (range 12-30) months. The mean ± standard deviation preoperative CCC-S of 19.4 ± 7.1 decreased to 10.1 ± 9.0 postoperatively. The early complication rate was 15.7% and included rectovaginal fistula (n = 1), rectal perforation (n = 1), posterior dehiscence (n = 4), further surgery for retained staples (n = 2), postoperative bleeding (n = 2) and postoperative impaired continence (n = 11). STARR using the Contour Transtar device seems to be effective for treating obstructed defaecation. However, serious complications may occur. © 2011 The Authors. Colorectal Disease © 2011 The Association of Coloproctology of Great Britain and Ireland.

  1. High-resolution T{sub 2}-weighted cervical cancer imaging: a feasibility study on ultra-high-field 7.0-T MRI with an endorectal monopole antenna

    Energy Technology Data Exchange (ETDEWEB)

    Hoogendam, Jacob P.; Verheijen, Rene H.M.; Zweemer, Ronald P. [University Medical Centre Utrecht, Department of Gynaecological Oncology, UMC Utrecht Cancer Centre, PO Box 85500, Utrecht (Netherlands); Kalleveen, Irene M.L.; Castro, Catalina S.A. de; Raaijmakers, Alexander J.E.; Bosch, Maurice A.A.J. van den; Klomp, Dennis W.J.; Veldhuis, Wouter B. [University Medical Centre Utrecht, Department of Radiology, Utrecht (Netherlands)

    2017-03-15

    We studied the feasibility of high-resolution T{sub 2}-weighted cervical cancer imaging on an ultra-high-field 7.0-T magnetic resonance imaging (MRI) system using an endorectal antenna of 4.7-mm thickness. A feasibility study on 20 stage IB1-IIB cervical cancer patients was conducted. All underwent pre-treatment 1.5-T MRI. At 7.0-T MRI, an external transmit/receive array with seven dipole antennae and a single endorectal monopole receive antenna were used. Discomfort levels were assessed. Following individualised phase-based B{sub 1} {sup +} shimming, T{sub 2}-weighted turbo spin echo sequences were completed. Patients had stage IB1 (n = 9), IB2 (n = 4), IIA1 (n = 1) or IIB (n = 6) cervical cancer. Discomfort (ten-point scale) was minimal at placement and removal of the endorectal antenna with a median score of 1 (range, 0-5) and 0 (range, 0-2) respectively. Its use did not result in adverse events or pre-term session discontinuation. To demonstrate feasibility, T{sub 2}-weighted acquisitions from 7.0-T MRI are presented in comparison to 1.5-T MRI. Artefacts on 7.0-T MRI were due to motion, locally destructive B{sub 1} interference, excessive B{sub 1} under the external antennae and SENSE reconstruction. High-resolution T{sub 2}-weighted 7.0-T MRI of stage IB1-IIB cervical cancer is feasible. The addition of an endorectal antenna is well tolerated by patients. (orig.)

  2. Hair Pulling (Trichotillomania)

    Science.gov (United States)

    ... for Families - Vietnamese Spanish Facts for Families Guide Hair Pulling (Trichotillomania) No. 96; Reviewed July 2013 It ... for children and adolescents to play with their hair. However, frequent or obsessive hair pulling can lead ...

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

    Science.gov (United States)

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

    2003-09-01

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

  4. On-line correction of beam portals in the treatment of prostate cancer using an endorectal balloon device

    International Nuclear Information System (INIS)

    Ciernik, Ilja F.; Baumert, Brigitta G.; Egli, Peter; Glanzmann, Christoph; Luetolf, Urs M.

    2002-01-01

    Background: Reproducible target volume assessment is required in order to optimize portal field margins in the treatment of prostate cancer. The benefits of an endorectal balloon on target volume assessment remain unclear. Material and methods: Nine patients were treated with a daily placed air filled rectal balloon. Portal films and computer-associated tomography during the treatment were used to determine the position of the structures of interest. Comparative planning with or without a balloon was performed in order to determine rectal wall exposure to radiation. Results: The range of movements during treatment predicting the position of the prostate in relation to the symphysis was 0.05-0.59 cm in the lateral direction, 0.27-2.2 cm in the antero-posterior direction, and 0.33-1.8 cm in the crano-caudal direction, as compared to the position of the prostate predicted by the balloon ranging from 0.18 to 0.76 cm in the lateral direction, 0.22-1.68 cm in the antero-posterior direction, and 0.58-2.99 cm in the crano-caudal direction. Planning target volumes (PTV) margins as defined by the position of the balloon were 10 mm in the antero-posterior direction, 6 mm in the lateral direction, and 16 mm in the crano-caudal direction. The volume of rectal wall exposed to radiation was reduced from 40 (±12%) to 25% (±19%) with an endorectal balloon (P<0.05). Conclusions: Daily online correction with portal vision for external beam set-up is improved by an endorectal balloon device, leading to improved PTV margins and reduced radiation exposure of the rectal wall

  5. Comparison of endorectal coil and nonendorectal coil T2W and diffusion-weighted MRI at 3 Tesla for localizing prostate cancer: correlation with whole-mount histopathology.

    Science.gov (United States)

    Turkbey, Baris; Merino, Maria J; Gallardo, Elma Carvajal; Shah, Vijay; Aras, Omer; Bernardo, Marcelino; Mena, Esther; Daar, Dagane; Rastinehad, Ardeshir R; Linehan, W Marston; Wood, Bradford J; Pinto, Peter A; Choyke, Peter L

    2014-06-01

    To compare utility of T2-weighted (T2W) MRI and diffusion-weighted MRI (DWI-MRI) obtained with and without an endorectal coil at 3 Tesla (T) for localizing prostate cancer. This Institutional Review Board-approved study included 20 patients (median prostate-specific antigen, 8.4 ng/mL). Patients underwent consecutive prostate MRIs at 3T, first with a surface coil alone, then with combination of surface, endorectal coils (dual coil) followed by robotic assisted radical prostatectomy. Lesions were mapped at time of acquisition on dual-coil T2W, DWI-MRI. To avoid bias, 6 months later nonendorectal coil T2W, DWI-MRI were mapped. Both MRI evaluations were performed by two readers blinded to pathology with differences resolved by consensus. A lesion-based correlation with whole-mount histopathology was performed. At histopathology 51 cancer foci were present ranging in size from 2 to 60 mm. The sensitivity of the endorectal dual-coil, nonendorectal coil MRIs were 0.76, 0.45, respectively. PPVs for endorectal dual-coil, nonendorectal coil MRI were 0.80, 0.64, respectively. Mean size of detected lesions with nonendorectal coil MRI were larger than those detected by dual-coil MRI (22 mm versus 17.4 mm). Dual-coil prostate MRI detected more cancer foci than nonendorectal coil MRI. While nonendorectal coil MRI is an attractive alternative, physicians performing prostate MRI should be aware of its limitations. Copyright © 2013 Wiley Periodicals, Inc.

  6. Multimodality gynecomastia repair by cross-chest power-assisted superficial liposuction combined with endoscopic-assisted pull-through excision.

    Science.gov (United States)

    Ramon, Ytzhack; Fodor, Lucian; Peled, Isaac J; Eldor, Liron; Egozi, Dana; Ullmann, Yehuda

    2005-12-01

    Numerous methods of gynecomastia repair have been described to accomplish removal of breast tissue. Our multimodality surgical approach for the treatment of gynecomastia combines the use of power-assisted superficial cross-chest liposuction with direct pull-through excision of the breast parenchyma under endoscopic supervision. Seventeen patients, aging 17-39, underwent this multimodality approach. According to Simon's grading, 3 patients had grade 1, 5 had grade 2a, 6 had grade 2b, and 3 had grade 3 gynecomastia. Power-assisted liposuction was performed with a 3- or 4-mm triple-hole cannula inserted through the contralateral periareolar medial incision to suction the contralateral prepectoral fatty breast. At the end of the liposuction, the fibrous tissue was easily pulled through the ipsilateral stab wound and excised under endoscopic control. Follow-up time ranged from 6 to 34 months. The amount of fat removed by liposuction varied from 100-800 mL per breast, and the amount of breast parenchyma removed by excision varied from 20-110 g. All patients recovered remarkably well. No complications were recorded. All patients were satisfied with their results. This technique enables an effective treatment of both the fatty and fibrous tissue of the male breast and avoids skin redundancy due to skin contraction. A smooth masculine breast contour is consistently achieved without the stigma of this type of surgery.

  7. PushPull++

    KAUST Repository

    Lipp, Markus

    2014-07-22

    PushPull tools are implemented in most commercial 3D modeling suites. Their purpose is to intuitively transform a face, edge, or vertex, and then to adapt the polygonal mesh locally. However, previous approaches have limitations: Some allow adjustments only when adjacent faces are orthogonal; others support slanted surfaces but never create new details. Moreover, self-intersections and edge-collapses during editing are either ignored or work only partially for solid geometry. To overcome these limitations, we introduce the PushPull++ tool for rapid polygonal modeling. In our solution, we contribute novel methods for adaptive face insertion, adjacent face updates, edge collapse handling, and an intuitive user interface that automatically proposes useful drag directions. We show that PushPull++ reduces the complexity of common modeling tasks by up to an order of magnitude when compared with existing tools. Copyright © ACM.

  8. The progress in diagnostic imaging for staging of bladder and prostate cancer. Endorectal magnetic resonance imaging and magnetization transfer contrast

    International Nuclear Information System (INIS)

    Arima, Kiminobu; Hayashi, Norio; Yanagawa, Makoto; Kawamura, Juichi; Kobayashi, Shigeki; Takeda, Kan; Sugimura, Yoshiki

    1999-01-01

    We retrospectively studied the staging accuracy of endorectal magnetic resonance imaging (MRI) in comparison with transrectal ultrasound examination (TRUS) for 71 localized bladder cancers and 19 localized prostate cancers (PC) radically resected. The accuracy of clinical staging for bladder cancer in endorectal MRI and TRUS was 85.9% and 69.2%, respectively. The presence or absence of the continuity of submucosal enhancement on T2-weighted MRI images could be useful for the staging of bladder cancer. The accuracy of the seminal vesicular invasion for prostate cancer in endorectal MRI and TRUS was 95% and 63%, respectively. To determine whether magnetization transfer contrast (MTC) provides additional information in the diagnosis of prostate cancer, the magnetization transfer ratios (MTRs) were calculated in 22 patients with PC, 5 with benign prostatic hyperplasia (BPH) and 4 controls. The mean MTR in the peripheral zone of the normal prostate (8.0%±3.4 [standard deviation]) showed a statistically significant decrease relative to that in the inner zone of the normal prostate (27.4%±3.4, p<0.01), BPH (25.5%±3.7, p<0.01), pre-treatment PC (30.6%±5.9, p<0.01), and PC after hormonal therapy (20.3%±6.3, p<0.01). The mean MTR in pre-treatment PC was significantly higher than that in BPH, or in PC after hormonal therapy (p<0.01). MTC was considered to be useful for conspicuity of prostate cancer lesion. (author)

  9. Case series with literature review: Surgical approach to megarectum and/or megasigmoid in children with unremitting constipation

    Directory of Open Access Journals (Sweden)

    James G. Glasser

    2018-02-01

    Full Text Available Background: The role of surgery in treating children with functional constipation (FC is controversial, because of the efficacy of bowel management programs. This case series is comprised of failures: 43 children, spanning 25 years' practice, who had megarectosigmoid (MRS and unremitting constipation. Purpose: To determine whether these children were helped by surgery, and to contribute to formulating a standard of care for children with megarectum (MR and/or redundancy of the sigmoid colon (MS who fail medical management. Method: We describe our selection criteria and the procedures we utilized – mucosal proctectomy and endorectal pull-through (MP or sigmoidectomy (SE with colorectal anastomosis at the peritoneal reflection. The internet (social media allowed us to contact most of these patients and obtain extremely long follow-up data. Results: 30/43 patients had MP and 13/43 had SE. Follow-up was obtained in 83% MP and 70% SE patients. 60% of MP and 78% of SE patients reported regular evacuations and no soiling. 20% MP patients had occasional urgency or soiling or episodic constipation. 12% MP and 22% SE patients required antegrade continence enemas (ACE or scheduled cathartics and/or stool softeners. 4% MP had no appreciable benefit, frequent loose stools and soiling, presumably from encopresis. Conclusion: MR is characterized by diminished sensation, poor compliance and defective contractility. Patients with MR do better with MP, which effectively removes the entire rectum versus SE, where normal caliber colon is anastomosed to MR at the peritoneal reflection; furthermore, MP reliably preserves continence; whereas total proctectomy (trans-anal or trans-abdominal may cause incontinence. Keywords: Functional Constipation, Megarectum, Megarectosigmoid, Proctectomy, Sigmoidectomy

  10. Examining professionals' and parents' views of using transanal irrigation with children: Understanding their experiences to develop a shared health resource for education and practise.

    Science.gov (United States)

    Sanders, Caroline; Bray, Lucy

    2014-06-01

    Irrigation as a bowel management approach has been reportedly used with children for more than 20 years. Parents managing their child's chronic bowel problem have previously been shown to have increased emotional stress. The aim of this study was to explore professionals' (n = 24) understanding and parents' (n = 18) experiences of using transanal irrigation with children at home as a mid to longer term bowel management approach. This study was underpinned by action research methodology and used mixed methods determined by an action research group of parents, professionals, researchers, a voluntary sector worker, commercial representative and independent observer. Data informed the study outcome which was the development and evaluation of a shared health resource to support professionals in their holistic approach when prescribing transanal irrigation and guide parents in the areas of education, management, problem solving, support and goal setting. The resource includes constructed case studies from parents of their experiences to inform choice and decision-making between parents and professionals. The shared health resource provides an approach to initiating and evaluating transanal irrigation and is available in a paper format from key Internet sites across hospital, community and voluntary services. © The Author(s) 2013.

  11. Transanal vs laparoscopic total mesorectal excision for rectal cancer

    DEFF Research Database (Denmark)

    Perdawood, Sharaf; Al Khefagie, Ghalib Ali Abod

    2016-01-01

    BACKGROUND: Laparoscopic total mesorectal excision (LaTME) has improved short-term outcomes of rectal cancer surgery with comparable oncological results to open approach. LaTME can be difficult in the lower most part of the rectum, leading potentially to higher rates of complications, conversion...... to open surgery and probably suboptimal oncological quality. Transanal TME (TaTME) can potentially solve these problems. The aim of this study was to compare the short-term results after TaTME with those after LaTME. METHODS: A prospectively collected database of consecutive patients who underwent Ta......TME was maintained. Results were compared with those underwent LaTME in the preceding period. Patients who underwent low anterior resection or intersphincteric abdominoperineal excision (APE) were included. Primary end-points were radical resection and specimen quality. Secondary end-points were complications, rates...

  12. Clinical stage T1c prostate cancer: evaluation with endorectal MR imaging and MR spectroscopic imaging.

    Science.gov (United States)

    Zhang, Jingbo; Hricak, Hedvig; Shukla-Dave, Amita; Akin, Oguz; Ishill, Nicole M; Carlino, Lauren J; Reuter, Victor E; Eastham, James A

    2009-11-01

    To assess the diagnostic accuracy of endorectal magnetic resonance (MR) imaging and MR spectroscopic imaging for prediction of the pathologic stage of prostate cancer and the presence of clinically nonimportant disease in patients with clinical stage T1c prostate cancer. The institutional review board approved-and waived the informed patient consent requirement for-this HIPAA-compliant study involving 158 patients (median age, 58 years; age range, 40-76 years) who had clinical stage T1c prostate cancer, had not been treated preoperatively, and underwent combined 1.5-T endorectal MR imaging-MR spectroscopic imaging between January 2003 and March 2004 before undergoing radical prostatectomy. On the MR images and combined endorectal MR-MR spectroscopic images, two radiologists retrospectively and independently rated the likelihood of cancer in 12 prostate regions and the likelihoods of extracapsular extension (ECE), seminal vesicle invasion (SVI), and adjacent organ invasion by using a five-point scale, and they determined the probability of clinically nonimportant prostate cancer by using a four-point scale. Whole-mount step-section pathology maps were used for imaging-pathologic analysis correlation. Receiver operating characteristic curves were constructed and areas under the curves (AUCs) were estimated nonparametrically for assessment of reader accuracy. At surgical-pathologic analysis, one (0.6%) patient had no cancer; 124 (78%) patients, organ-confined (stage pT2) disease; 29 (18%) patients, ECE (stage pT3a); two (1%) patients, SVI (stage pT3b); and two (1%) patients, bladder neck invasion (stage pT4). Forty-six (29%) patients had a total tumor volume of less than 0.5 cm(3). With combined MR imaging-MR spectroscopic imaging, the two readers achieved 80% accuracy in disease staging and AUCs of 0.62 and 0.71 for the prediction of clinically nonimportant cancer. Clinical stage T1c prostate cancers are heterogeneous in pathologic stage and volume. MR imaging may

  13. Friction Pull Plug and Material Configuration for Anti-Chatter Friction Pull Plug Weld

    Science.gov (United States)

    Littell, Justin Anderson (Inventor)

    2016-01-01

    A friction pull plug is provided for use in forming a plug weld in a hole in a material. The friction pull plug includes a shank and a series of three frustoconical sections. The relative sizes of the sections assure that a central one of the sections defines the initial contact point between the hole's sides. The angle defined by the central one of the sections reduces or eliminates chatter as the plug is pulled into the hole.

  14. Push and pull strategies: applications for health care marketing.

    Science.gov (United States)

    Kingsley, B R

    1987-08-01

    As health care markets mature and expand, strategies available in other industries become useful. This article examines how traditional push-pull strategies apply to health care. Marketers using a push strategy recognize that the sale of their services or goods is dependent upon the endorsement of a middleman and promote their product through the middleman. Those using a pull strategy market directly to the consumer. In this article, the author outlines the advantages and disadvantages of using each strategy.

  15. Prostate cancer: body-array versus endorectal coil MR imaging at 3 T--comparison of image quality, localization, and staging performance.

    NARCIS (Netherlands)

    Heijmink, S.W.T.P.J.; Futterer, J.J.; Hambrock, T.; Takahashi, S.; Scheenen, T.W.J.; Huisman, H.J.; Hulsbergen-van de Kaa, C.A.; Knipscheer, B.C.; Kiemeney, L.A.L.M.; Witjes, J.A.; Barentsz, J.O.

    2007-01-01

    PURPOSE: To prospectively compare image quality and accuracy of prostate cancer localization and staging with body-array coil (BAC) versus endorectal coil (ERC) T2-weighted magnetic resonance (MR) imaging at 3 T, with histopathologic findings as the reference standard. MATERIALS AND METHODS: After

  16. Achieving food security for one million sub-Saharan African poor through push-pull innovation by 2020.

    Science.gov (United States)

    Khan, Zeyaur R; Midega, Charles A O; Pittchar, Jimmy O; Murage, Alice W; Birkett, Michael A; Bruce, Toby J A; Pickett, John A

    2014-04-05

    Food insecurity is a chronic problem in Africa and is likely to worsen with climate change and population growth. It is largely due to poor yields of the cereal crops caused by factors including stemborer pests, striga weeds and degraded soils. A platform technology, 'push-pull', based on locally available companion plants, effectively addresses these constraints resulting in substantial grain yield increases. It involves intercropping cereal crops with a forage legume, desmodium, and planting Napier grass as a border crop. Desmodium repels stemborer moths (push), and attracts their natural enemies, while Napier grass attracts them (pull). Desmodium is very effective in suppressing striga weed while improving soil fertility through nitrogen fixation and improved organic matter content. Both companion plants provide high-value animal fodder, facilitating milk production and diversifying farmers' income sources. To extend these benefits to drier areas and ensure long-term sustainability of the technology in view of climate change, drought-tolerant trap and intercrop plants are being identified. Studies show that the locally commercial brachiaria cv mulato (trap crop) and greenleaf desmodium (intercrop) can tolerate long droughts. New on-farm field trials show that using these two companion crops in adapted push-pull technology provides effective control of stemborers and striga weeds, resulting in significant grain yield increases. Effective multi-level partnerships have been established with national agricultural research and extension systems, non-governmental organizations and other stakeholders to enhance dissemination of the technology with a goal of reaching one million farm households in the region by 2020. These will be supported by an efficient desmodium seed production and distribution system in eastern Africa, relevant policies and stakeholder training and capacity development.

  17. Is the Ellipsoid Formula the New Standard for 3-Tesla MRI Prostate Volume Calculation without Endorectal Coil?

    Science.gov (United States)

    Haas, Matthias; Günzel, Karsten; Miller, Kurt; Hamm, Bernd; Cash, Hannes; Asbach, Patrick

    2017-01-01

    Prostate volume in multiparametric MRI (mpMRI) is of clinical importance. For 3-Tesla mpMRI without endorectal coil, there is no distinctive standard for volume calculation. We tested the accuracy of the ellipsoid formula with planimetric volume measurements as reference and investigated the correlation of gland volume and cancer detection rate on MRI/ultrasound (MRI/US) fusion-guided biopsy. One hundred forty-three patients with findings on 3-Tesla mpMRI suspicious of cancer and subsequent MRI/US fusion-guided targeted biopsy and additional systematic biopsy were analyzed. T2-weighted images were used for measuring the prostate diameters and for planimetric volume measurement by a segmentation software. Planimetric and calculated prostate volumes were compared with clinical data. The median prostate volume was 48.1 ml (interquartile range (IQR) 36.9-62.1 ml). Volume calculated by the ellipsoid formula showed a strong concordance with planimetric volume, with a tendency to underestimate prostate volume (median volume 43.1 ml (IQR 31.2-58.8 ml); r = 0.903, p Tesla mpMRI without endorectal coil. It allows a fast, valid volume calculation in prostate MRI datasets. © 2016 S. Karger AG, Basel.

  18. Pathological outcomes of transanal versus laparoscopic total mesorectal excision for rectal cancer: a systematic review with meta-analysis.

    Science.gov (United States)

    Jiang, Hong-Peng; Li, Yan-Sen; Wang, Bo; Wang, Chang; Liu, Fan; Shen, Zhan-Long; Ye, Ying-Jiang; Wang, Shan

    2018-02-20

    Since 2010, comparative studies on transanal and laparoscopic total mesorectal excision (TME) have been published and it remains unclear about the oncological benefit from transanal total mesorectal excision (taTME). We have searched English databases to identify all taTME studies published between January 2010 and August 2017. Pathological outcomes included circumferential resection margin (CRM), positive CRM (CRM (WMD, 0.833; 95% CI 0.366-1.299; P CRM (OR, 0.505; 95% CI 0.258-0.991; P = 0.047), and a longer DRM (WMD, 6.261; 95% CI 1.049-11.472; P = 0.019). There were no significant differences in other pathological outcomes. Both cumulative meta-analysis and sensitivity analysis were unable to detect potential sources of the heterogeneity in DRM. There was no evidence of publication bias. This meta-analysis revealed that taTME had more advantages on positive CRM, CRM, and DRM compared with laparoscopic TME. Compared with laparoscopic TME, more benefits of taTME on pathological outcomes remained undetected. The current findings are all based on observational studies, RCTs with adequate power are required.

  19. Accurate electrostatic and van der Waals pull-in prediction for fully clamped nano/micro-beams using linear universal graphs of pull-in instability

    Science.gov (United States)

    Tahani, Masoud; Askari, Amir R.

    2014-09-01

    In spite of the fact that pull-in instability of electrically actuated nano/micro-beams has been investigated by many researchers to date, no explicit formula has been presented yet which can predict pull-in voltage based on a geometrically non-linear and distributed parameter model. The objective of present paper is to introduce a simple and accurate formula to predict this value for a fully clamped electrostatically actuated nano/micro-beam. To this end, a non-linear Euler-Bernoulli beam model is employed, which accounts for the axial residual stress, geometric non-linearity of mid-plane stretching, distributed electrostatic force and the van der Waals (vdW) attraction. The non-linear boundary value governing equation of equilibrium is non-dimensionalized and solved iteratively through single-term Galerkin based reduced order model (ROM). The solutions are validated thorough direct comparison with experimental and other existing results reported in previous studies. Pull-in instability under electrical and vdW loads are also investigated using universal graphs. Based on the results of these graphs, non-dimensional pull-in and vdW parameters, which are defined in the text, vary linearly versus the other dimensionless parameters of the problem. Using this fact, some linear equations are presented to predict pull-in voltage, the maximum allowable length, the so-called detachment length, and the minimum allowable gap for a nano/micro-system. These linear equations are also reduced to a couple of universal pull-in formulas for systems with small initial gap. The accuracy of the universal pull-in formulas are also validated by comparing its results with available experimental and some previous geometric linear and closed-form findings published in the literature.

  20. Endorectal coil MRI and MR-spectroscopic imaging in patients with elevated serum prostate specific antigen with negative trus transrectal ultrasound guided biopsy

    Directory of Open Access Journals (Sweden)

    Farooq Ahmad Ganie

    2013-01-01

    Conclusion: Prostatic biopsy directed with endorectal coil MRI and MR-spectroscopic imaging findings in patients with elevated serum PSA and prior negative biopsy, improves the early diagnosis of prostatic carcinoma and accurate localization of prostate cancer within the gland.

  1. Doença de Hirschsprung: experiência com uma série de 55 casos Hirschsprung's disease: experiment with a serie of 55 cases

    Directory of Open Access Journals (Sweden)

    Maria Auxiliadora Monteiro Villar

    2009-09-01

    screened for RET mutations associated with multiple endocrine neoplasias (MEN2A, although none were detected; 63.6% had staged pull-through surgery on the colon or ileum; 12.72% primary transanal endorectal pull-through surgery; the main complications arising from surgery were sepsis, enterocolitis and obstruction of the intestines; abnormal bowel movements were detected years after the surgery; the mortality rate was 9.25%, the causes of death being post-operal enterocolitis and sepsis. CONCLUSION: although patients presented symptoms on birth, most were diagnosed at a later stage. Enterocolitis was the main cause of death. Abnormal bowel movements frequently occurred, requiring prolonged follow-up. Although rare, the association with MEN2A needs to be investigated owing to the highly aggressive nature of the disease. The clinical and genetic heterogeneity of HD necessitates the involvement of a multidisciplinary team.

  2. Endorectal magnetic resonance imaging in persistent hemospermia

    International Nuclear Information System (INIS)

    Prando, Adilson

    2008-01-01

    Objective: To present the spectrum of abnormalities found at endorectal magnetic resonance imaging (E-MRI), in patients with persistent hemospermia. Materials and methods: A review of E-MRI findings observed in 86 patients with persistent hemospermia was performed and results compared with those reported in the literature. Follow-up was possible in 37 of 86 (43%) patients with hemospermia. Results: E-MRI showed abnormal findings in 52 of 86 (60%) patients with hemospermia. These findings were: a) hemorrhagic seminal vesicle and ejaculatory duct, isolated (n = 11 or 21%) or associated with complicated midline prostatic cyst (n = 10 or 19.0%); b) hemorrhagic chronic seminal vesiculitis, isolated (n = 14 or 27%) or associated with calculi within dilated ejaculatory ducts (n = 2 or 4 %); c) hemorrhagic seminal vesicle associated with calculi within dilated ejaculatory duct (n = 4 or 7.7%) or within seminal vesicle (n = 4 or 7.7%); d) non-complicated midline prostatic cyst (n = 6 or 11.5%); and e) prostate cancer (n = 1 or 2%). Successful treatment was more frequent in patients with chronic inflammatory and/or obstructive abnormalities. Conclusion: E-MRI should be considered the modality of choice, for the evaluation of patients with persistent hemospermia. (author)

  3. Endorectal magnetic resonance imaging in persistent hemospermia

    Energy Technology Data Exchange (ETDEWEB)

    Prando, Adilson [Vera Cruz Hospital, Campinas, SP (Brazil). Dept. of Radiology and Diagnostic Imaging

    2008-03-15

    Objective: To present the spectrum of abnormalities found at endorectal magnetic resonance imaging (E-MRI), in patients with persistent hemospermia. Materials and methods: A review of E-MRI findings observed in 86 patients with persistent hemospermia was performed and results compared with those reported in the literature. Follow-up was possible in 37 of 86 (43%) patients with hemospermia. Results: E-MRI showed abnormal findings in 52 of 86 (60%) patients with hemospermia. These findings were: a) hemorrhagic seminal vesicle and ejaculatory duct, isolated (n = 11 or 21%) or associated with complicated midline prostatic cyst (n = 10 or 19.0%); b) hemorrhagic chronic seminal vesiculitis, isolated (n = 14 or 27%) or associated with calculi within dilated ejaculatory ducts (n = 2 or 4 %); c) hemorrhagic seminal vesicle associated with calculi within dilated ejaculatory duct (n = 4 or 7.7%) or within seminal vesicle (n = 4 or 7.7%); d) non-complicated midline prostatic cyst (n = 6 or 11.5%); and e) prostate cancer (n = 1 or 2%). Successful treatment was more frequent in patients with chronic inflammatory and/or obstructive abnormalities. Conclusion: E-MRI should be considered the modality of choice, for the evaluation of patients with persistent hemospermia. (author)

  4. Oil pulling: A traditional method on the edge of evidence

    Directory of Open Access Journals (Sweden)

    H Mythri

    2017-01-01

    Full Text Available Introduction: Oil pulling is an ancient, traditional folk remedy that has been practiced for centuries in India and southern Asia as a holistic Ayurvedic technique. The practice of oil pulling involves placing a tablespoon of an edible oil (e.g. sesame, olive, sunflower, coconut inside the mouth, and swishing or “pulling” the oil through the teeth and oral cavity for anywhere from 1–5 minutes to up to 20 minutes or longer. Materials and Methods: Articles related to oil pulling were collected by using oil pulling as Keyword in Google and Medline. Out of the 21 related articles published till 2016, 6 articles with the proper study designs were used for analysis. Results: The studies were unreliable for many reasons, including the misinterpretation of results due to small sample size and improper study design. Conclusion: Though the promoters claim it as one of the best method to be as adjuvant to mechanical control methods, scientific evidences are lacking.

  5. Pull-production in repetitive remanufacturing

    Energy Technology Data Exchange (ETDEWEB)

    McCaskey, D.W. Jr.

    1992-09-01

    In the past, production activity control practices in most repetitive remanufacturing facilities resembled those used in intermittent production operations. These operations were characterized by large amounts of work-in-process (WIP), frequent work stoppages due to part shortages, excessive overtime, low product velocity, informal scheduling between dependent operations, low employee and management moral, and a lot of wasted time, material, labor, and space. Improvement in production activity control (PAC) methods for repetitive remanufactures has been hampered by uncertainty in: supply of incoming assets, configuration of assets, process times to refurbish assets, and yields in reclamation processes. collectively these uncertainties make shop floor operations seem uncontrollable. However, one United States Army depot has taken on the challenge. Through management supported, cross-functional teams, the Tooele Army Depot has designed and implemented pull-production systems for two of its major products, with several others to follow. This article presents a generalized version of Tooele`s pull-production system and highlights design characteristics which are specific to remanufacturing applications.

  6. Pull-production in repetitive remanufacturing

    Energy Technology Data Exchange (ETDEWEB)

    McCaskey, D.W. Jr.

    1992-09-01

    In the past, production activity control practices in most repetitive remanufacturing facilities resembled those used in intermittent production operations. These operations were characterized by large amounts of work-in-process (WIP), frequent work stoppages due to part shortages, excessive overtime, low product velocity, informal scheduling between dependent operations, low employee and management moral, and a lot of wasted time, material, labor, and space. Improvement in production activity control (PAC) methods for repetitive remanufactures has been hampered by uncertainty in: supply of incoming assets, configuration of assets, process times to refurbish assets, and yields in reclamation processes. collectively these uncertainties make shop floor operations seem uncontrollable. However, one United States Army depot has taken on the challenge. Through management supported, cross-functional teams, the Tooele Army Depot has designed and implemented pull-production systems for two of its major products, with several others to follow. This article presents a generalized version of Tooele's pull-production system and highlights design characteristics which are specific to remanufacturing applications.

  7. Pull-pull position control of dual motor wire rope transmission.

    Science.gov (United States)

    Guo, Quan; Jiao, Zongxia; Yan, Liang; Yu, Qian; Shang, Yaoxing

    2016-08-01

    Wire rope transmission is very efficient because of the small total moving object mass. The wire rope could only transmit pulling force. Therefore it has to be kept in a tightened state during transmission; in high speed applications the dynamic performance depends on the rope's stiffness, which can be adjusted by the wire rope tension. To improve the system dynamic performance output, this paper proposes a novel pull-pull method based on dual motors connected by wire ropes, for precise, high speed position control applications. The method can regulate target position and wire rope tension simultaneously. Wire ropes remain in a pre-tightening state at all times, which prevents the influence of elasticity and reduces the position tracking error in the changing direction process. Simulations and experiments were conducted; the results indicate that both position precision and superior dynamic performance can be synchronously achieved. The research is relevant to space craft precision pointing instruments.

  8. Pulled elbow in children.

    Science.gov (United States)

    Yamanaka, Syunsuke; Goldman, Ran D

    2018-06-01

    Question Our practice is seeing children with relatively minor injuries to their elbows, with a history of "swinging" them when their hands are being held to cross the road. Nothing is usually found on a physical examination. I know that this is likely a "pulled elbow." Can we manage this in the clinic setting rather than sending the family to the emergency department? What would be the best course of action in the clinic setting? Answer Pulled elbow, also called nursemaid's elbow , is a radial head subluxation caused by axial traction or a sudden pull of the extended pronated arm, and it is a very common phenomenon. The practice of swinging children while holding their hands should be abandoned. In the case of pulled elbow, the child usually avoids moving the affected arm, holding it close to his or her body, without considerable pain, and no obvious swelling or deformity can be seen. While a fracture should be excluded, pulled elbow can usually be identified based on this presentation. The reduction procedure can easily be done in the office setting, with an 80% success rate and no complications. The hyperpronation maneuver (holding the elbow at 90° and then firmly pronating the wrist) to reduce pulled elbow has been found to be better than a supination-flexion maneuver (holding the elbow at 90° with one hand, supinating and flexing the elbow rapidly with the other) and should be exercised first. When 2 trials of reduction are unsuccessful, the child's arm should be splinted and the family should be sent for further evaluation. Copyright© the College of Family Physicians of Canada.

  9. Pull-out strength of a headed stud in cracked concrete

    International Nuclear Information System (INIS)

    Takiguchi, K.; Hotta, H.

    1995-01-01

    Pull-out strength of a headed stud due to cone failure of concrete with/without cracks were examined. This paper presents empirical data basis to decide the criteria for designing a headed stud embedded in a shear wall under earthquake. As a result, it is known that cracks running through the stud reduce the pull-out strength, but it almost recovers when the cracks are closed again by an external compressive load. (author). 2 refs., 10 figs., 1 tab

  10. Importance of endorectal US, CT of the pelvic floor, and defecography in the evaluation of defecation disorders

    International Nuclear Information System (INIS)

    Stuckmann, G.; Antonucci, F.; Hirsig, J.; Zollifofer, C.L.

    1989-01-01

    This paper presents a radiologic evaluation of defecation disorders. Twenty-five patients with symptoms of defecation disorders who presented clinically the findings of dysplasia of the external anal sphincter were examined with endorectal US, defecography, and CT. The findings were compared with those of 15 patients who were given a radiologic examination of the pelvis for other reasons. All patients of the first group underwent surgery. The radiological findings are as follows: defecography: a short anal canal (below 1 cm) and a dorsal anocele; CT: a failure of attachment of the external and sphincter to the coccyx; Endorectal US and CT: absence of posterior parts of the external anal sphincter. None of these findings were demonstrated in the comparison group. All patients of the first group underwent surgery and were proved intraoperatively to have dysplasia of the external anal sphincter, which was corrected subsequently. The authors' results show that at least two kinds of external and anal sphincter dysplasia exist. The results of the radiologic examinations correspond with the intraoperative findings. The authors believe that in chronic constipation in children or adults the radiologic examinations mentioned above should be done because surgical correction of anal sphincter dysplasia leads to an immediate improvement of defecation disorders

  11. Self-Induced Backaction Optical Pulling Force

    Science.gov (United States)

    Zhu, Tongtong; Cao, Yongyin; Wang, Lin; Nie, Zhongquan; Cao, Tun; Sun, Fangkui; Jiang, Zehui; Nieto-Vesperinas, Manuel; Liu, Yongmin; Qiu, Cheng-Wei; Ding, Weiqiang

    2018-03-01

    We achieve long-range and continuous optical pulling in a periodic photonic crystal background, which supports a unique Bloch mode with the self-collimation effect. Most interestingly, the pulling force reported here is mainly contributed by the intensity gradient force originating from the self-induced backaction of the object to the self-collimation mode. This force is sharply distinguished from the widely held conception of optical tractor beams based on the scattering force. Also, this pulling force is insensitive to the angle of incidence and can pull multiple objects simultaneously.

  12. MR imaging of the prostate at 3 Tesla: comparison of an external phased-array coil to imaging with an endorectal coil at 1.5 Tesla.

    Science.gov (United States)

    Sosna, Jacob; Pedrosa, Ivan; Dewolf, William C; Mahallati, Houman; Lenkinski, Robert E; Rofsky, Neil M

    2004-08-01

    To qualitatively compare the image quality of torso phased-array 3-Tesla (3T) imaging of the prostate with that of endorectal 1.5-Tesla imaging. Twenty cases of torso phased-array prostate imaging performed at 3-Tesla with FSE T2 weighted images were evaluated by two readers independently for visualization of the posterior border (PB), seminal vesicles (SV), neurovascular bundles (NVB), and image quality rating (IQR). Studies were performed at large fields of view(FOV) (25 cm) (14 cases) (3TL) and smaller FOV (14 cm) (19 cases) (3TS). A comparison was made to 20 consecutive cases of 1.5-T endorectal evaluation performed during the same time period.Results. 3TL produced a significantly better image quality compared with the small FOV for PB (P = .0001), SV (P =.0001), and IQR (P = .0001). There was a marginally significant difference within the NVB category (P = .0535). 3TL produced an image of similar quality to image quality at 1.5 T for PB (P = .3893), SV (P = .8680), NB (P = .2684), and IQR (P = .8599). Prostate image quality at 3T with a torso phased-array coil can be comparable with that of endorectal 1.5-T imaging. These findings suggest that additional options are now available for magnetic resonance imaging of the prostate gland.

  13. Organ-confined prostate cancer: effect of prior transrectal biopsy on endorectal MRI and MR spectroscopic imaging

    International Nuclear Information System (INIS)

    Qayyum, Aliya; Coakley, F.V.; Lu, Y.; Olpin, J.D.; Wu, L.; Yeh, B.M.; Carroll, P.R.; Kurhanewicz, J.

    2004-01-01

    Objective: Our aim was to determine the effect of prior transrectal biopsy on endorectal MRI and MR spectroscopic imaging findings in patients with organ-confined prostate cancer. Materials and Methods: Endorectal MRI and MR spectroscopic imaging were performed in 43 patients with biopsy-proven prostate cancer before radical prostatectomy confirming organ-confined disease. For each sextant, two independent reviewers scored the degree of hemorrhage on a scale from 1 to 5 and recorded the presence or absence of capsular irregularity. A spectroscopist recorded the number of spectrally degraded voxels in the peripheral zone. The outcome variables of capsular irregularity and spectral degradation were correlated with the predictor variables of time from biopsy and degree of hemorrhage after biopsy. Results: Capsular irregularity was unrelated to time from biopsy or to degree of hemorrhage. Spectral degradation was inversely related to time from biopsy (p < 0.01); the mean percentage of degraded peripheral zone voxels was 18.5% within 8 weeks of biopsy compared with 7% after 8 weeks. Spectral degradation was unrelated to the degree of hemorrhage. Conclusion: In organ-confined prostate cancer, capsular irregularity can be seen at any time after biopsy and is independent of the degree of hemorrhage, whereas spectral degradation is seen predominantly in the first 8 weeks after biopsy. MRI staging criteria and guidelines for scheduling studies after biopsy may require appropriate modification. (author)

  14. KRAS Mutant Status, p16 and β-catenin Expression May Predict Local Recurrence in Patients Who Underwent Transanal Endoscopic Microsurgery (TEMS) for Stage I Rectal Cancer.

    Science.gov (United States)

    Sideris, Michail; Moorhead, Jane; Diaz-Cano, Salvador; Bjarnason, Ingvar; Haji, Amyn; Papagrigoriadis, Savvas

    2016-10-01

    Transanal endoscopic microsurgery (TEMS) is emerging as an alternative treatment for rectal cancer Stage I. There remains a risk of local recurrence. The Aim of the study was to study the effect of biomarkers in local recurrence for Stage I rectal cancer following TEMS plus or minus radiotherapy. This is a case control study where we compared 10 early rectal cancers that had recurred, against 19 cases with no recurrence, total 29 patients (age=28.25-86.87, mean age=67.92 years, SD=14.91, Male, N=18, Female, N=11). All patients underwent TEMS for radiological Stage I rectal cancer (yT1N0M0 or yT2N0M0) established with combination of magnetic resonance imaging (MRI) and endorectal ultrasound. We prospectively collected all data on tumour histology, morphological features, as well as follow-up parameters. Molecular analysis was performed to identify their status on BRAF, KRAS, p16 O 6 -methylguanine-DNA methyltransferase (MGMT) and β-catenin. Out of 29 specimens analyzed, 19 were KRAS wild type (65.9%) and 10 mutant (34.5%). Recurrence of the tumour was noted in 10 cases (34.5%) from which 60% were pT1 (N=6) and 40% pT2 (N=4). There was a statistically significant association between KRAS mutant status and local recurrence (N=6, p=0.037). P16 expression greater than 5% (mean=10.8%, min=0, max=95) is linked with earlier recurrence within 11.70 months (N=7, p=0.004). Membranous β-catenin expression (N=12, 48%) was also related with KRAS mutant status (p=0.006) but not with survival (p>0.05). BRAF gene was found to be wild type in all cases tested (N=23). KRAS/p16/β-catenin could be used as a combined biomarker for prediction of local recurrence and stratification of the risk for further surgery. Copyright© 2016 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

  15. TRANSANAL DRAINAGE OF ANASTOMOTIC LEAK FOLLOWING LOW ANTERIOR RESECTION- A NOVEL TECHNIQUE

    Directory of Open Access Journals (Sweden)

    Vinay Boppasamudra Nanjegowda

    2017-03-01

    Full Text Available BACKGROUND Anastomotic leaks after low anterior resection following rectal cancer is the major cause for morbidity and mortality. Various techniques for the conservative management of localised abscesses have been reported, but with variable results. Hence, in search of a new technique to treat anastomotic leak following low anterior resection, which is cost-effective and has good results. MATERIALS AND METHODS This study is a retrospective review of a prospectively maintained data of a novel technique to treat anastomotic leaks after low anterior resection with proximal diverting ileostomy in a single institution. RESULTS A total of 40 patients who underwent low anterior resection with diversion ileostomy for rectal cancer were studied. In them, 6 patients developed Grade B anastomotic leak, which were managed by this novel technique of paediatric endoscopic-guided transanal drainage of anastomotic leak following low anterior resection with diversion ileostomy using a 3-way Foley catheter. All the patients responded well, thus leading to local control of the septic foci without the need for any further radiological intervention or a laparotomy. This lead to salvaging the anastomosis. Out of the 6 patients managed by this technique, one patient developed stricture, which was managed by CRE balloon dilatation. All patients underwent stoma closure after a median postoperative time of 7 months. CONCLUSION Under paediatric endoscopic guidance, transanal drainage of anastomotic leak with an abscess cavity using a 3-way Foley catheter after low anterior resection with double-staple technique prevents further disruption of the anastomosis and local irrigation leads to faster sepsis control thus avoiding the morbidity of relaparotomy. This technique being a bedside procedure is cost-effective and feasible. This leads to good salvage of anastomosis along with early stoma closure and good long-term functional results.

  16. Study on pollution control in residential kitchen based on the push-pull ventilation system

    DEFF Research Database (Denmark)

    Zhou, Bin; Chen, Feng; Dong, Zhibo

    2016-01-01

    Highlights •The push-pull ventilation system is proposed to improve IAQ inside kitchen, where air is supplied through slot air curtain and then exhausted through range hood. •CO2 reduction efficiency with application of air curtain in experiment and simulation in breathing zone was 23.7% and 23.......1%, respectively. •By orthogonal method, the influence of factors on pollution control of the push-pull ventilation system was presented....

  17. Foot placement strategy in pushing and pulling.

    Science.gov (United States)

    Lee, Tzu-Hsien

    2018-01-01

    Pushing and pulling tasks are very common in daily and industrial workplaces. They are one major source of musculoskeletal complaints. This study aimed to examine the foot placement strategy while pushing and pulling. Thirteen young males and ten young females were recruited as participants. A two (pushing and pulling) by four (48 cm, 84 cm, 120 cm, and 156 cm) factorial design was used. Exertion direction and exertion height significantly affected foot placement strategy. Pushing task needed more anteroposterior space than pulling task. The percentages of female/male for trailing foot position ranged from 77% to 90% (pushing) and from 80% to 93% (pulling) across the exertion heights. Practitioners should provide an anteroposterior space approximately to 70% body stature for workers to exert their maximum pulling and pushing strengths.

  18. Non-slipping domains of a pulled spool

    International Nuclear Information System (INIS)

    Wagner, Clemens; Vaterlaus, Andreas

    2014-01-01

    We have investigated the pulled spool by considering pulling angles up to 360 ∘ . Our focus was on downward pulling forces with pulling angles in the range of 180 ∘ to 360 ∘ . In this range we have found a domain of pulling angles where the spool never starts to slip independent of the strength of the pulling force. The size of the domain depends on the static friction coefficient and on the moment of inertia of the spool. The non-slipping domain is mainly formed around the critical angle where the static friction force becomes zero. For low static friction the non-slipping domain decays into two different domains. We have determined the limiting angles of the non-slipping domains and explored the transitions from a single domain to two separated domains in parameter space. (paper)

  19. Esophagogastric Junction pressure morphology: comparison between a station pull-through and real-time 3D-HRM representation.

    Science.gov (United States)

    Nicodème, F; Lin, Z; Pandolfino, J E; Kahrilas, P J

    2013-09-01

    Esophagogastric junction (EGJ) competence is the fundamental defense against reflux making it of great clinical significance. However, characterizing EGJ competence with conventional manometric methodologies has been confounded by its anatomic and physiological complexity. Recent technological advances in miniaturization and electronics have led to the development of a novel device that may overcome these challenges. Nine volunteer subjects were studied with a novel 3D-HRM device providing 7.5 mm axial and 45° radial pressure resolution within the EGJ. Real-time measurements were made at rest and compared to simulations of a conventional pull-through made with the same device. Moreover, 3D-HRM recordings were analyzed to differentiate contributing pressure signals within the EGJ attributable to lower esophageal sphincter (LES), diaphragm, and vasculature. 3D-HRM recordings suggested that sphincter length assessed by a pull-through method greatly exaggerated the estimate of LES length by failing to discriminate among circumferential contractile pressure and asymmetric extrinsic pressure signals attributable to diaphragmatic and vascular structures. Real-time 3D EGJ recordings found that the dominant constituents of EGJ pressure at rest were attributable to the diaphragm. 3D-HRM permits real-time recording of EGJ pressure morphology facilitating analysis of the EGJ constituents responsible for its function as a reflux barrier making it a promising tool in the study of GERD pathophysiology. The enhanced axial and radial recording resolution of the device should facilitate further studies to explore perturbations in the physiological constituents of EGJ pressure in health and disease. © 2013 John Wiley & Sons Ltd.

  20. Localization of a Portion of an Endorectal Balloon for Prostate Image-Guided Radiation Therapy Using Cone-Beam Tomosynthesis: A Feasibility Study

    International Nuclear Information System (INIS)

    Ng, Sook Kien; Zygmanski, Piotr; Lyatskaya, Yulia; D’Amico, Anthony V.; Cormack, Robert A.

    2012-01-01

    Purpose: To assess the feasibility of using cone-beam tomosynthesis (CBTS) to localize the air–tissue interface for the application of prostate image-guided radiation therapy using an endorectal balloon for immobilization and localization. Methods and Materials: A Feldkamp-David-Kress-based CBTS reconstruction was applied to selected sets of cone-beam computed tomography (CBCT) projection data to simulate volumetric imaging achievable from tomosynthesis for a limited range of scan angles. Projection data were calculated from planning CT images of 10 prostate cancer patients treated with an endorectal balloon, as were experimental CBCT projections for a pelvic phantom in two patients. More than 50 points at the air–tissue interface were objectively identified by an intensity-based interface-finding algorithm. Using three-dimensional point sets extracted from CBTS images compared with points extracted from corresponding CBCT images, the relative shift resulting from a reduced scan angle was determined. Because the CBCT and CBTS images were generated from the same projection data set, shift identified was presumed to be due to distortions introduced by the tomosynthesis technique. Results: Scans of ≥60° were shown to be able to localize an air–tissue interface near the isocenter with accuracy on the order of a millimeter. The accuracy was quantified in terms of the mean discrepancy as a function of reconstruction angle. Conclusion: This work provides an understanding of the effect of scan angle used in localization of a portion of an endorectal balloon by means of CBTS. CBTS with relatively small scan angles is capable of accurately localizing an extended interface near the isocenter and may provide clinically relevant measurements to guide IGRT treatments while reducing imaging radiation to the patient.

  1. Localization of a Portion of an Endorectal Balloon for Prostate Image-Guided Radiation Therapy Using Cone-Beam Tomosynthesis: A Feasibility Study

    Energy Technology Data Exchange (ETDEWEB)

    Ng, Sook Kien, E-mail: Sook_Ng@dfci.harvard.edu [Department of Radiation Oncology, Brigham and Women' s Hospital and Harvard Medical School, Boston, MA (United States); Department of Radiation Oncology, Mannheim Medical Centre, University of Heidelberg, Mannheim (Germany); Zygmanski, Piotr; Lyatskaya, Yulia; D' Amico, Anthony V.; Cormack, Robert A. [Department of Radiation Oncology, Brigham and Women' s Hospital and Harvard Medical School, Boston, MA (United States)

    2012-06-01

    Purpose: To assess the feasibility of using cone-beam tomosynthesis (CBTS) to localize the air-tissue interface for the application of prostate image-guided radiation therapy using an endorectal balloon for immobilization and localization. Methods and Materials: A Feldkamp-David-Kress-based CBTS reconstruction was applied to selected sets of cone-beam computed tomography (CBCT) projection data to simulate volumetric imaging achievable from tomosynthesis for a limited range of scan angles. Projection data were calculated from planning CT images of 10 prostate cancer patients treated with an endorectal balloon, as were experimental CBCT projections for a pelvic phantom in two patients. More than 50 points at the air-tissue interface were objectively identified by an intensity-based interface-finding algorithm. Using three-dimensional point sets extracted from CBTS images compared with points extracted from corresponding CBCT images, the relative shift resulting from a reduced scan angle was determined. Because the CBCT and CBTS images were generated from the same projection data set, shift identified was presumed to be due to distortions introduced by the tomosynthesis technique. Results: Scans of {>=}60 Degree-Sign were shown to be able to localize an air-tissue interface near the isocenter with accuracy on the order of a millimeter. The accuracy was quantified in terms of the mean discrepancy as a function of reconstruction angle. Conclusion: This work provides an understanding of the effect of scan angle used in localization of a portion of an endorectal balloon by means of CBTS. CBTS with relatively small scan angles is capable of accurately localizing an extended interface near the isocenter and may provide clinically relevant measurements to guide IGRT treatments while reducing imaging radiation to the patient.

  2. Solar cell contact pull strength as a function of pull-test temperature

    Science.gov (United States)

    Yasui, R. K.; Berman, P. A.

    1972-01-01

    Four types of solar cell contacts were given pull-strength tests at temperatures between -173 and +165 C. Contacts tested were: (1) solder-coated titanium-silver contacts on n-p cells, (2) palladium-containing titanium-silver contacts on n-p cells, (3) titanium-silver contacts on 0.2-mm-thick n-p cells, and (4) solder-coated electroless-nickel-plated contacts on p-n cells. Maximum pull strength was demonstrated at temperatures significantly below the air mass zero cell equilibrium temperature of +60 C. At the lowest temperatures, the chief failure mechanism was silicon fracture along crystallographic planes; at the highest temperatures, it was loss of solder strength. In the intermediate temperatures, many failure mechanisms operated. Pull-strength tests give a good indication of the suitability of solar cell contact systems for space use. Procedures used to maximize the validity of the results are described.

  3. (31) P MR spectroscopic imaging combined with (1) H MR spectroscopic imaging in the human prostate using a double tuned endorectal coil at 7T.

    Science.gov (United States)

    Luttje, Mariska P; Italiaander, Michel G M; Arteaga de Castro, Catalina S; van der Kemp, Wybe J M; Luijten, Peter R; van Vulpen, Marco; van der Heide, Uulke A; Klomp, Dennis W J

    2014-12-01

    Improved diagnostic sensitivity could be obtained in cancer detection and staging when individual compounds of the choline pool can be detected. Therefore, a novel coil design is proposed, providing the ability to acquire both (1) H and (31) P magnetic resonance spectroscopic imaging (MRSI) in patients with prostate cancer. A two-element (1) H/(31) P endorectal coil was designed by adjusting a commercially available 3T endorectal coil. The two-element coil setup was interfaced as a transceiver to a whole body 7T MR scanner. Simulations and phantom measurements were performed to compare the efficiency of the coil. (1) H MRSI and (31) P MRSI were acquired in vivo in prostate cancer patients. The efficiency of the (1) H/(31) P coil is comparable to the dual channel (1) H coil previously published. Individually distinguishable phospholipid metabolites in the in vivo (31) P spectra were: phosphoethanolamine, phosphocholine, phosphate, glycerophosphoethanolamine, glycerophosphocholine, phosphocreatine, and adenosine triposphate. (1) H MRSI was performed within the same scan session, visualizing choline, polyamines, creatine, and citrate. (1) H MRSI and (31) P MRSI can be acquired in the human prostate at 7T within the same scan session using an endorectal coil matched and tuned for (1) H (quadrature) and (31) P (linear) without the need of cable traps and with negligible efficiency losses in the (1) H and (31) P channel. © 2013 Wiley Periodicals, Inc.

  4. The endo-rectal probe prototype for the TOPEM project

    Energy Technology Data Exchange (ETDEWEB)

    Musico, Paolo, E-mail: Paolo.Musico@ge.infn.it

    2016-07-11

    The TOPEM project was funded by INFN with the aim of studying the design of a TOF-PET system dedicated to prostate imaging. During last year a big effort was put into building the prototype of the endo-rectal probe from all point of view: mechanical, thermal, electrical. A dedicated integrated circuit was adopted to have the minimum dimensions: the TOFPET ASIC. The system is composed by a LYSO pixellated crystal which is seen by a 128 SiPM matrix on both surfaces: this permits Depth Of Interaction (DOI) measurement. The 4 needed ASICs are handled by a FPGA board which transmits the acquired data over an UDP connection. The external container was made using 3-D printing technology: internal channels on the external surface permit the flowing of controlled temperature (≈35 °C) water. Electronic components power is dissipated using an internal air flow kept at lower temperature (≈20 °C). The probe is MR compatible: a dedicated small antenna can be accommodated in the container. This will permit simultaneous imaging in MRI and PET systems.

  5. Real-Time Study of Prostate Intrafraction Motion During External Beam Radiotherapy With Daily Endorectal Balloon

    Energy Technology Data Exchange (ETDEWEB)

    Both, Stefan, E-mail: Stefan.Both@uphs.upenn.edu [Department of Radiation Oncology, Hospital of University of Pennsylvania, Philadelphia, PA (United States); Wang, Ken Kang-Hsin; Plastaras, John P.; Deville, Curtiland; Bar Ad, Voika; Tochner, Zelig; Vapiwala, Neha [Department of Radiation Oncology, Hospital of University of Pennsylvania, Philadelphia, PA (United States)

    2011-12-01

    Purpose: To prospectively investigate intrafraction prostate motion during radiofrequency-guided prostate radiotherapy with implanted electromagnetic transponders when daily endorectal balloon (ERB) is used. Methods and Materials: Intrafraction prostate motion from 24 patients in 787 treatment sessions was evaluated based on three-dimensional (3D), lateral, cranial-caudal (CC), and anterior-posterior (AP) displacements. The mean percentage of time with 3D, lateral, CC, and AP prostate displacements >2, 3, 4, 5, 6, 7, 8, 9, and 10 mm in 1 minute intervals was calculated for up to 6 minutes of treatment time. Correlation between the mean percentage time with 3D prostate displacement >3 mm vs. treatment week was investigated. Results: The percentage of time with 3D prostate movement >2, 3, and 4 mm increased with elapsed treatment time (p < 0.05). Prostate movement >5 mm was independent of elapsed treatment time (p = 0.11). The overall mean time with prostate excursions >3 mm was 5%. Directional analysis showed negligible lateral prostate motion; AP and CC motion were comparable. The fraction of time with 3D prostate movement >3 mm did not depend on treatment week of (p > 0.05) over a 4-minute mean treatment time. Conclusions: Daily endorectal balloon consistently stabilizes the prostate, preventing clinically significant displacement (>5 mm). A 3-mm internal margin may sufficiently account for 95% of intrafraction prostate movement for up to 6 minutes of treatment time. Directional analysis suggests that the lateral internal margin could be further reduced to 2 mm.

  6. Lithospheric-scale centrifuge models of pull-apart basins

    Science.gov (United States)

    Corti, Giacomo; Dooley, Tim P.

    2015-11-01

    We present here the results of the first lithospheric-scale centrifuge models of pull-apart basins. The experiments simulate relative displacement of two lithospheric blocks along two offset master faults, with the presence of a weak zone in the offset area localising deformation during strike-slip displacement. Reproducing the entire lithosphere-asthenosphere system provides boundary conditions that are more realistic than the horizontal detachment in traditional 1 g experiments and thus provide a better approximation of the dynamic evolution of natural pull-apart basins. Model results show that local extension in the pull-apart basins is accommodated through development of oblique-slip faulting at the basin margins and cross-basin faults obliquely cutting the rift depression. As observed in previous modelling studies, our centrifuge experiments suggest that the angle of offset between the master fault segments is one of the most important parameters controlling the architecture of pull-apart basins: the basins are lozenge shaped in the case of underlapping master faults, lazy-Z shaped in case of neutral offset and rhomboidal shaped for overlapping master faults. Model cross sections show significant along-strike variations in basin morphology, with transition from narrow V- and U-shaped grabens to a more symmetric, boxlike geometry passing from the basin terminations to the basin centre; a flip in the dominance of the sidewall faults from one end of the basin to the other is observed in all models. These geometries are also typical of 1 g models and characterise several pull-apart basins worldwide. Our models show that the complex faulting in the upper brittle layer corresponds at depth to strong thinning of the ductile layer in the weak zone; a rise of the base of the lithosphere occurs beneath the basin, and maximum lithospheric thinning roughly corresponds to the areas of maximum surface subsidence (i.e., the basin depocentre).

  7. Changes in prostate shape and volume and their implications for radiotherapy after introduction of endorectal balloon as determined by MRI at 3T.

    NARCIS (Netherlands)

    Heijmink, S.W.T.P.J.; Scheenen, T.W.J.; Lin, E.N.J.T. van; Visser, A.G.; Kiemeney, L.A.L.M.; Witjes, J.A.; Barentsz, J.O.

    2009-01-01

    PURPOSE: To determine the changes in prostate shape and volume after the introduction of an endorectal coil (ERC) by means of magnetic resonance imaging (MRI) at 3T. METHODS AND MATERIALS: A total of 44 consecutive patients with biopsy-proven prostate cancer underwent separate MRI examinations at 3T

  8. Prediction of extraprostatic extension by prostate specific antigen velocity, endorectal MRI, and biopsy Gleason score in clinically localized prostate cancer

    International Nuclear Information System (INIS)

    Nishimoto, Koshiro; Nakashima, Jun; Hashiguchi, Akinori; Kikuchi, Eiji; Miyajima, Akira; Nakagawa, Ken; Ohigashi, Takashi; Oya, Mototsugu; Murai, Masaru

    2008-01-01

    The objective of this study was to investigate the clinical value of prostate specific antigen velocity (PSAV) in predicting the extraprostatic extension of clinically localized prostate cancer. One hundred and three patients who underwent radical prostatectomy for clinically localized prostate cancer were included in the analysis. The correlation between preoperative parameters, including PSA-based parameters, clinical stage, and histological biopsy findings, and the pathological findings were analyzed. Logistic regression analysis was performed to identify a significant set of independent predictors for the local extent of the disease. Sixty-four (60.2%) patients had organ confined prostate cancer and 39 (39.8%) patients had extraprostatic cancer. The biopsy Gleason score, PSA, PSA density, PSA density of the transition zone, and PSAV were significantly higher in the patients with extraprostatic cancer than in those with organ confined cancer. Multivariate logistic regression analysis indicated that the biopsy Gleason score, endorectal magnetic resonance imaging findings, and PSAV were significant predictors of extraprostatic cancer (P<0.01). Probability curves for extraprostatic cancer were generated using these three preoperative parameters. The combination of PSAV, endorectal magnetic resonance imaging findings, and biopsy Gleason score can provide additional information for selecting appropriate candidates for radical prostatectomy. (author)

  9. PushPull++

    KAUST Repository

    Lipp, Markus; Wonka, Peter; Mü ller, Pascal

    2014-01-01

    PushPull tools are implemented in most commercial 3D modeling suites. Their purpose is to intuitively transform a face, edge, or vertex, and then to adapt the polygonal mesh locally. However, previous approaches have limitations: Some allow

  10. Modelling the behaviour of the push-pull gel dosimeter

    International Nuclear Information System (INIS)

    Bosi, S.G.; Davies, J.B.; Gorjiara, T.; Baldock, C.

    2010-01-01

    Full text: Recent development of a gel dosimeter based on the radiobleaching pigment, genipin, allows development of a new 3D optically scanned gel dosimeter-the p ush-pull g el. This gel would contain two spectrally complementary pigments, one which darkens with dose and another (e.g. genipin) which bleaches. The two pigments deal separately with the high and low dose ends of the dosimeter's dynamic range. The bleaching pigment would be optimised for high sensitivity and the darkening pigment for low. Employing dual pigments, optimised independently, relaxes the need for compromise between sensitivity at low dose and accuracy at high dose. Such a gel, after exposure, would be read using two successive optical CT scans, at two different wavelengths. The reduction in sensitivity of the darkening pigment (allowed by the use of push-pull) would reduce the occurrence of regions of high optical attenuation which can generate optical CT artefacts. Simulated optical CT reconstructions of the optical density map (Fig. La) scanned at the darkening pigment wavelength of a hypothetical push-pull gel, confirms the reduction in susceptibility to artefacts. Fig. I b shows a profile through the map with no stray light added. The centre of the profile in Fig. I d shows a cupping artefact produced by 10 ppm of stray light. The similarity of Fig. Ic and b show that a 30% sensitivity reduction allowed by push-pull, renders the artefact negligible. This paper presents the results of' these simulations of a push-pull gel scanned using optical CT and also some results of experiments with genipin gel. (author)

  11. August A. Pulle. 1878-1955

    NARCIS (Netherlands)

    Lanjouw, J.

    1955-01-01

    On the 28th of February 1955 Prof. Dr A. A. Pulle died at Utrecht after a long and painful illness. August Adriaan Pulle was born on the 10th of January 1878 at Arnhem, where he also attended the primary and the secundary school. During the later years at the high school his interest in plants was

  12. Using Metaheuristic and Fuzzy System for the Optimization of Material Pull in a Push-Pull Flow Logistics Network

    Directory of Open Access Journals (Sweden)

    Afshin Mehrsai

    2013-01-01

    Full Text Available Alternative material flow strategies in logistics networks have crucial influences on the overall performance of the networks. Material flows can follow push, pull, or hybrid systems. To get the advantages of both push and pull flows in networks, the decoupling-point strategy is used as coordination mean. At this point, material pull has to get optimized concerning customer orders against pushed replenishment-rates. To compensate the ambiguity and uncertainty of both dynamic flows, fuzzy set theory can practically be applied. This paper has conceptual and mathematical parts to explain the performance of the push-pull flow strategy in a supply network and to give a novel solution for optimizing the pull side employing Conwip system. Alternative numbers of pallets and their lot-sizes circulating in the assembly system are getting optimized in accordance with a multi-objective problem; employing a hybrid approach out of meta-heuristics (genetic algorithm and simulated annealing and fuzzy system. Two main fuzzy sets as triangular and trapezoidal are applied in this technique for estimating ill-defined waiting times. The configured technique leads to smoother flows between push and pull sides in complex networks. A discrete-event simulation model is developed to analyze this thesis in an exemplary logistics network with dynamics.

  13. STRENGTH ANALYSIS METHODS OF CIRCULAR PULL BROACH COGS

    Directory of Open Access Journals (Sweden)

    Cosmin MIRIŢOIU

    2010-10-01

    Full Text Available A very big importance in a pull broach designing is represented by its mechanic computation, which trots out the pull broach resistance on various blank tooling, pull broach productivity and also the loadings which is subdued to and the stresses that appear during the chipping process. The pull broach geometric complexity leads to one difficulty concerning the resistance computing methods application (and implicitly, simplifying assumptions application. This present study presents a resistance computing of pull broach cogs, which dresses a circular hole trotting out more methods which can be used in this computing, and the teoretic aspects are then trotted out by an example of a numerical computation for a particular case.

  14. Transanal endoscopic microsurgery as technique surgical for the treatment of the rectal adenocarcinoma: history, evolution and current tendency

    International Nuclear Information System (INIS)

    Vega Padilla, Luis Carlos

    2013-01-01

    The modalities of local and minimally invasive treatment were described for early rectal adenocarcinomas. The most adequate diagnostic studies and interdisciplinary interactions involved were considered in the process and the therapeutic results, in comparison with the current radical treatments. The historical evolution of the different surgical techniques developed over time, and the anatomical and physiological concepts were reviewed. The epidemiological behavior of the disease was documented according to gender, age and most prevalent sites to direct the possible risk groups to suffer the disease. Risk factors that affect patients with colorectal cancer were identified and related to the environment, social habits and hereditary. The different genetic syndromes involved in colorectal cancer, its physiopathology and clinical manifestations and implications were examined with respect to colorectal cancer. Colorectal cancer was defined according to the updated classifications of the American Joint Cancer Committee, according to the depth, affectation of lymph nodes and metastasis to distant organs, in relation to its clinical stage. Current surgical techniques were named to treat early adenocarcinomas of inferior rectus. The different risk factors were analyzed to allow local resections of the early rectal tumors, from the histopalogical, radiological and clinical point of view. The traditional techniques of transanal and radical resection were compared against the transanal endoscopic microsurgery between different aspects such as technical difficulty, recurrence rate, morbidity and mortality, and economic cost [es

  15. Import-push or Export-pull?

    DEFF Research Database (Denmark)

    Jäkel, Ina Charlotte

    2014-01-01

    predictions regarding the export market and the role of product differentiation. Empirical results for a sample of Danish manufacturing industries confirm the import- "push" hypothesis as well as the export- "pull" hypothesis, but also reveal differences across industries. The selection effect of trade...... is mainly driven by the "import-push" if product differentiation is high, whereas it is driven by the "export-pull" if goods are homogeneous....

  16. Import-push or Export-pull?

    DEFF Research Database (Denmark)

    Jäkel, Ina Charlotte

    predictions regarding the export market and the role of product differentiation. Empirical results for a sample of Danish manufacturing industries confirm the import-"push" hypothesis as well as the export-"pull" hypothesis, but also reveal differences across industries. The selection effect of trade...... is mainly driven by the "import-push" if product differentiation is high, whereas it is driven by the "export-pull" if goods are homogeneous....

  17. Parks coloanal pull-through anastomosis for severe, complicated radiation proctitis

    Energy Technology Data Exchange (ETDEWEB)

    Gazet, J.C.

    1985-02-01

    A variety of operations have been proposed for the treatment of radiation injuries of the rectum. In this study, the procedure advocated by the late Sir Alan Parks--resection of the diseased segment down to its points of fixation to the vagina, bladder or prostate; with perianal mucosal stripping of the anorectal segment and primary coloanal (pull-through) anastomosis--was performed in 11 patients. In two others, an attempt at colorectal anastomosis was abandoned because of extreme scarring in the pelvis. The procedures were done following definitive treatment of carcinoma of the rectum (seven patients), carcinoma of the cervix (two patients), carcinoma of the uterus (one patient), carcinoma of the ovary (one patient), seminoma (one patient), and carcinoma of the bladder (one patient). One patient died from a pulmonary embolus on the seventh postoperative day. Of the survivors with a coloanal anastomosis, all had successful closure of their temporary colostomies with follow-up from one to six years. In eight, continence was assessed as being good or excellent. Four patients required anastomotic dilation and another required a surgical procedure for anastomotic stricture. There was one instance each of reoperation for small bowel obstruction and ileocolic fistula. There were no instances of recurrence of hemorrhage, fistulas, perineal pain or tenesmus. The Parks procedure obviates the need for a difficult dissection of the lower rectum and separation of tissues damaged by radiation and avoids the need for eversion techniques. Its selective use is advocated for patients suffering from severe radiation injuries of the rectum.

  18. Parks coloanal pull-through anastomosis for severe, complicated radiation proctitis

    International Nuclear Information System (INIS)

    Gazet, J.C.

    1985-01-01

    A variety of operations have been proposed for the treatment of radiation injuries of the rectum. In this study, the procedure advocated by the late Sir Alan Parks--resection of the diseased segment down to its points of fixation to the vagina, bladder or prostate; with perianal mucosal stripping of the anorectal segment and primary coloanal (pull-through) anastomosis--was performed in 11 patients. In two others, an attempt at colorectal anastomosis was abandoned because of extreme scarring in the pelvis. The procedures were done following definitive treatment of carcinoma of the rectum (seven patients), carcinoma of the cervix (two patients), carcinoma of the uterus (one patient), carcinoma of the ovary (one patient), seminoma (one patient), and carcinoma of the bladder (one patient). One patient died from a pulmonary embolus on the seventh postoperative day. Of the survivors with a coloanal anastomosis, all had successful closure of their temporary colostomies with follow-up from one to six years. In eight, continence was assessed as being good or excellent. Four patients required anastomotic dilation and another required a surgical procedure for anastomotic stricture. There was one instance each of reoperation for small bowel obstruction and ileocolic fistula. There were no instances of recurrence of hemorrhage, fistulas, perineal pain or tenesmus. The Parks procedure obviates the need for a difficult dissection of the lower rectum and separation of tissues damaged by radiation and avoids the need for eversion techniques. Its selective use is advocated for patients suffering from severe radiation injuries of the rectum

  19. Energy requirements of tire pulling.

    Science.gov (United States)

    Fredriksen, Per M; Mamen, Asgeir

    2017-10-01

    We have investigated the effect using walking poles and pulling tires at 4 and 6 km·h-1 (1.11 and 1.67 m·s-1) speeds on oxygen uptake (V̇O2) and heart rate. Eleven subjects, 6 males, with a mean (SD) age of 25.2 (6.9) years participated in field tests involving walking without poles, walking with poles and tire pulling with poles. Increasing the load caused the largest increases in energy demand, more than 4 MET. Speed increase also caused substantial energy increase, approximately 4 MET. Increasing the inclination only modestly increased the oxygen uptake, approximately 2 MET. In both level walking and uphill walking, using poles marginally increased oxygen uptake compared to working without poles. Pulling one tire (12.5 kg) required an oxygen uptake of 27 (4) mL·kg-1·min-1 at 4 km·h-1 and 0% inclination. Adding one more tire (6 kg) drove the oxygen uptake further up to 39 (4) mL·kg-1·min-1. This is close to the requirement of level running at 10.5 km·h-1. Pulling both tires at 6 km·h-1 and 5% inclination required a V̇O2 of 54 (6) mL·kg-1·min-1, equal to running uphill at 5% inclination and 12.5 km·h-1 speed. Heart rate rose comparably with oxygen uptake. At 4 km·h-1 and 0% inclination the increase was 29 bpm, from 134 (21) to 163 (22) bpm when going from pulling one tire to two tires. In the hardest exercise, 6 km·h-1 and 5% inclination, heart rate reached 174 (14) bpm. The study showed that tire pulling even at slow speeds has an energy requirement that is so large that the activity may be feasible as endurance training.

  20. MRI of prostate zonal anatomy with an endorectal surface coil

    International Nuclear Information System (INIS)

    Cornud, F.; Belin, X.; Melki, P.; Helenon, O.; Cretien, Y.; Dufour, B.; Moreau, J.F.

    1995-01-01

    The development of an endorectal surface coil now permits a partial study of the anatomical model developed by McNeal. Axial and coronal views, which were used to establish the model can be obtained in a short period of time with fast spin echo sequences. Axial views are performed along the proximal urethra and coronal views are performed along the axis of the distal urethra and the ejaculatory duts. Anatomical boundaries of the transitional zone are well delineated on axial views, illustrating the concept of 'inner gland'. The prostatic capsule and the neuro-vascular bundles, pathways of extension of the cancer out of the prostate are also well delineated. Coronal sections allow a very good anatomical study of the caudal junction of the vas deferens and the seminal vesicles (the so called weak space), pathway of tumor extension to the seminal vesicles. Differences in signal of the prostatic zones make the outer gland cancers very conspicuous as well as some transitional cancers which can show, in some cases, an homogeneous hyposignal. (authors). 15 refs., 14 figs

  1. Intraoperative hypercarbia and massive surgical emphysema secondary to transanal endoscopic microsurgery (TEMS).

    Science.gov (United States)

    Chandra, Aninda; Clarke, Robert; Shawkat, Hany

    2014-03-12

    We describe a case where full-thickness excision of a rectal lesion caused massive surgical emphysema and subsequent hypercarbia with associated difficulties with ventilation. This unique case highlights the risks of respiratory failure with extraperitoneal insufflation as in this case and as more commonly with intraperitoneal insufflation. Transanal endoscopic microsurgery (TEMS) is a technique that is being increasingly used in the management of large and early malignant rectal polyps. We reviewed the literature in order to understand the case and to highlight factors that should minimise any adverse sequelae. In the presence of ventilatory difficulties secondary to postoperative surgical emphysema, whether via extraperitoneal insufflation as described here or with intraperitoneal insufflation (as in laparoscopy), consider decreasing gas pressures, expediting the procedure, delaying extubation and prolonged close monitoring in recovery with possible admission to a high dependency unit (HDU) or intensive care unit (ICU).

  2. Characterization and Effects of Fiber Pull-Outs in Hole Quality of Carbon Fiber Reinforced Plastics Composite.

    Science.gov (United States)

    Alizadeh Ashrafi, Sina; Miller, Peter W; Wandro, Kevin M; Kim, Dave

    2016-10-13

    Hole quality plays a crucial role in the production of close-tolerance holes utilized in aircraft assembly. Through drilling experiments of carbon fiber-reinforced plastic composites (CFRP), this study investigates the impact of varying drilling feed and speed conditions on fiber pull-out geometries and resulting hole quality parameters. For this study, hole quality parameters include hole size variance, hole roundness, and surface roughness. Fiber pull-out geometries are quantified by using scanning electron microscope (SEM) images of the mechanically-sectioned CFRP-machined holes, to measure pull-out length and depth. Fiber pull-out geometries and the hole quality parameter results are dependent on the drilling feed and spindle speed condition, which determines the forces and undeformed chip thickness during the process. Fiber pull-out geometries influence surface roughness parameters from a surface profilometer, while their effect on other hole quality parameters obtained from a coordinate measuring machine is minimal.

  3. Initial results of 3-dimensional 1H-magnetic resonance spectroscopic imaging in the localization of prostate cancer at 3 Tesla: should we use an endorectal coil?

    NARCIS (Netherlands)

    Yakar, D.; Heijmink, S.W.T.P.J.; Hulsbergen-van de Kaa, C.A.; Huisman, H.J.; Barentsz, J.O.; Futterer, J.J.; Scheenen, T.W.J.

    2011-01-01

    PURPOSE: The purpose of this study was to compare the diagnostic performance of 3 Tesla, 3-dimensional (3D) magnetic resonance spectroscopic imaging (MRSI) in the localization of prostate cancer (PCa) with and without the use of an endorectal coil (ERC). MATERIALS AND METHODS: Our prospective study

  4. Clinical and endorectal ultrasound staging of circumferential rectal cancers

    International Nuclear Information System (INIS)

    Smith, A.; Farmer, K.C.; Chapple, K.

    2008-01-01

    Full text: Circumferential rectal cancers present at a more advanced stage than those located in a single quadrant. Although accurate staging is an important aspect of the preoperative management of the patient with a rectal cancer, the clinical and radiological staging of this subgroup of rectal cancer patients has been poorly studied. All patients with a rectal cancer were assessed clinically (by digital rectal examination and rigid sigmoidoscopy) before the radiological assessment by endorectal ultrasound (ERUS). Data collected included tumour height (distance from anal verge in centimetre) and tumour type (circumferential or non-circumferential). Radiological tumour staging was with the TNM system. Fifty-nine subjects (33 men, 26 women; median age 65 years (range 38-86 years)) were identified with a circumferential rectal cancer. Mean height of the cancer was 8 - 0.4 cm (standard error of the mean; range 2-13 cm). Forty-two cancers were palpable, and 17 cancers were impalpable. All cancers assessed clinically as circumferential were confirmed as circumferential on ERUS scanning. Tumour stage as assessed by ERUS was either T3 (n = 57) or T4 (n = 2). Nodal status was NO (n = 29) and N1 (n = 30). All rectal cancers assessed as circumferential on clinical examination have an ERUS stage of T3 or greater.

  5. Transanal endoscopic micro-surgery (TEMS) for the management of large or sessile rectal adenomas: a review of the technique and indications.

    Science.gov (United States)

    Papagrigoriadis, Savvas

    2006-05-04

    In this review article the surgical technique of Transanal Endoscopic Microsurgery (TEMS) is examined. A number of techniques have been used to treat adenomas of the rectum. The treatment of large adenomas which occupy a large surface of the rectal lumen or adenomas which are flat and grow in a "carpet-like" fashion is particularly challenging. Major rectal surgery carries a risk of morbidity and mortality, particularly in elderly and unfit patients. Although local excision with transanal resection (TAR) and the Kraske sacral operation have been used in the past, during the last twenty years TEMS has become the method of choice for those lesions. TEMS is efficient and minimally invasive. The technique allows the patient to recover rapidly and the incidence of complications is much lower than that of major surgery. In case of recurrence the option of repeat TEMS or major surgery remain available. TEMS has been slow to gain popularity mainly for reasons of cost and steep learning curve but it is now an established procedure and a valuable therapeutic option which is particularly useful for elderly and unfit patients. Gastroenterologists should be aware of the nature and indications of TEMS in order to advise and refer selected patients with rectal adenomas accordingly.

  6. Role of endorectal MR imaging and MR spectroscopic imaging in defining treatable intraprostatic tumor foci in prostate cancer: Quantitative analysis of imaging contour compared to whole-mount histopathology

    International Nuclear Information System (INIS)

    Anwar, Mekhail; Westphalen, Antonio C.; Jung, Adam J.; Noworolski, Susan M.; Simko, Jeffry P.; Kurhanewicz, John; Roach, Mack; Carroll, Peter R.; Coakley, Fergus V.

    2014-01-01

    Purpose: To investigate the role of endorectal MR imaging and MR spectroscopic imaging in defining the contour of treatable intraprostatic tumor foci in prostate cancer, since targeted therapy requires accurate target volume definition. Materials and methods: We retrospectively identified 20 patients with prostate cancer who underwent endorectal MR imaging and MR spectroscopic imaging prior to radical prostatectomy and subsequent creation of detailed histopathological tumor maps from whole-mount step sections. Two experienced radiologists independently reviewed all MR images and electronically contoured all suspected treatable (⩾0.5 cm 3 ) tumor foci. Deformable co-registration in MATLAB was used to calculate the margin of error between imaging and histopathological contours at both capsular and non-capsular surfaces and the treatment margin required to ensure at least 95% tumor coverage. Results: Histopathology showed 17 treatable tumor foci in 16 patients, of which 8 were correctly identified by both readers and an additional 2 were correctly identified by reader 2. For all correctly identified lesions, both readers accurately identified that tumor contacted the prostatic capsule, with no error in contour identification. On the non-capsular border, the median distance between the imaging and histopathological contour was 1.4 mm (range, 0–12). Expanding the contour by 5 mm at the non-capsular margin included 95% of tumor volume not initially covered within the MR contour. Conclusions: Endorectal MR imaging and MR spectroscopic imaging can be used to accurately contour treatable intraprostatic tumor foci; adequate tumor coverage is achieved by expanding the treatment contour at the non-capsular margin by 5 mm

  7. Analytical Model for Hook Anchor Pull-Out

    DEFF Research Database (Denmark)

    Brincker, Rune; Ulfkjær, Jens Peder; Adamsen, Peter

    1995-01-01

    A simple analytical model for the pull-out of a hook anchor is presented. The model is based on a simplified version of the fictitious crack model. It is assumed that the fracture process is the pull-off of a cone shaped concrete part, simplifying the problem by assuming pure rigid body motions...... allowing elastic deformations only in a layer between the pull-out cone and the concrete base. The derived model is in good agreement with experimental results, it predicts size effects and the model parameters found by calibration of the model on experimental data are in good agreement with what should...

  8. Analytical Model for Hook Anchor Pull-out

    DEFF Research Database (Denmark)

    Brincker, Rune; Ulfkjær, J. P.; Adamsen, P.

    A simple analytical model for the pull-out of a hook anchor is presented. The model is based on a simplified version of the fictitious crack model. It is assumed that the fracture process is the pull-off of a cone shaped concrete part, simplifying the problem by assuming pure rigid body motions...... allowing elastic deformations only in a layer between the pull-out cone and the concrete base. The derived model is in good agreement with experimental results, it predicts size effects and the model parameters found by calibration of the model on experimental data are in good agreement with what should...

  9. What Are They Talking About? Analyzing Code Reviews in Pull-Based Development Model

    Institute of Scientific and Technical Information of China (English)

    Zhi-Xing Li; Yue Yu; Gang Yin; Tao Wang; Huai-Min Wang

    2017-01-01

    Code reviews in pull-based model are open to community users on GitHub. Various participants are taking part in the review discussions and the review topics are not only about the improvement of code contributions but also about project evolution and social interaction. A comprehensive understanding of the review topics in pull-based model would be useful to better organize the code review process and optimize review tasks such as reviewer recommendation and pull-request prioritization. In this paper, we first conduct a qualitative study on three popular open-source software projects hosted on GitHub and construct a fine-grained two-level taxonomy covering four level-1 categories (code correctness, pull-request decision-making, project management, and social interaction) and 11 level-2 subcategories (e.g., defect detecting, reviewer assigning, contribution encouraging). Second, we conduct preliminary quantitative analysis on a large set of review comments that were labeled by TSHC (a two-stage hybrid classification algorithm), which is able to automatically classify review comments by combining rule-based and machine-learning techniques. Through the quantitative study, we explore the typical review patterns. We find that the three projects present similar comments distribution on each subcategory. Pull-requests submitted by inexperienced contributors tend to contain potential issues even though they have passed the tests. Furthermore, external contributors are more likely to break project conventions in their early contributions.

  10. Hair loss and hair-pulling in rhesus macaques (Macaca mulatta).

    Science.gov (United States)

    Lutz, Corrine K; Coleman, Kristine; Worlein, Julie; Novak, Melinda A

    2013-07-01

    Alopecia is a common problem in rhesus macaque colonies. A possible cause of this condition is hair-pulling; however the true relationship between hair-pulling and alopecia is unknown. The purpose of this study was to examine the relationship between hair loss and hair-pulling in 1258 rhesus macaques housed in 4 primate colonies across the United States. Alopecia levels ranged from 34.3% to 86.5% (mean, 49.3%) at the primate facilities. At facilities reporting a sex-associated difference, more female macaques were reported to exhibit alopecia than were males. In contrast, more males were reported to hair-pull. Animals reported to hair-pull were significantly more likely to have some amount of alopecia, but rates of hair-pulling were substantially lower than rates of alopecia, ranging from 0.6% to 20.5% (mean, 7.7%) of the populations. These results further demonstrate that hair-pulling plays only a small role in alopecia in rhesus macaques.

  11. Urethral diverticulum after laparoscopically-assisted anorectal pull-through (LAARP) for anorectal malformation: is resection of the diverticulum always necessary?

    Science.gov (United States)

    López, Pedro José; Guelfand, Miguel; Angel, Lorena; Paulos, Angélica; Cadena, Yair; Escala, José M; Letelier, Nelly; Zubieta, Ricardo

    2010-05-01

    With the increased use of minimally invasive surgery, the urethral diverticulum after anorectal surgery has become an issue. The few cases reported have been managed by surgical excision. We hereby report a case of urethral diverticulum after a laparoscopically-assisted anorectal pull-through (LAARP)procedure with a successful outcome after a period of active surveillance. A full-term boy who displayed a high anorectal malformation (ARM) and a rectoprostatic fistula underwent colostomy on the first day. He also showed associated malformations: bilateral low-grade reflux, horseshoe kidney and thoracic hemivertebrae; however, there were no signs of spinal cord tethering. Antimicrobial prophylaxis was started. At the age of 3 months, he underwent a LAARP with a 3 abdominal-port approach. After complete dissection of the distal bowel, the recto-prostatic fistula was identified and tied with metallic clips. A 10 mm trocar was inserted through the centre of the sphincteric complex, which had been previously identified under laparoscopic view during perineal electrical stimulation. The anorectal pull-through was accomplished without tension. The bladder remained stented for 14 days. On the 18th postoperative day, a voiding cystourethrogram (VCUG) showed a 15 X 5 mm image of the diverticulum at the level of the membranous urethra. After 6 months, a new VCUG showed a normal urethra with neither signs of the diverticulum nor strictures; persistence of grade 2 reflux on the right side and resolution of the reflux on the left. When the boy was one year old his colostomy was closed uneventfully. Six months later he had not come into the emergency since the operation and voided with a normal flow. This report suggests that LAARP is a feasible approach for ARM, although urethral diverticulum is a major concern. It may evolve without complications, and eventually resolve spontaneously. Active surveillance might be an option in selected asymptomatic patients; however a longer

  12. Young entrepreneurs pushed by necessity and pulled by opportunity

    DEFF Research Database (Denmark)

    Cheraghi, Maryam

    2017-01-01

    The vocational choice to be an entrepreneur is made in a social context of institutions in society, which channel, regulate, enable and constrain life, with pushes and pulls. The necessity to make a living may push the entrepreneur, or an opportunity for business may pull the entrepreneur to start....... The push by necessity and pull by opportunity are exerted by institutions in society such as its economy and culture. The purpose here is to account for how young entrepreneurs' experiences of opportunity-pull and necessity-push are influenced by society's economic wealth and culture, as traditional versus...... secular-rational culture and as survival versus self-expression culture. - A sample of 41,281 young entrepreneurs in 93 countries was surveyed in Global Entrepreneurship Monitor. - Analyses show that young entrepreneurs' experience of opportunity-pull rather than necessity-push is not distinctly...

  13. Tracer gas evaluations of push-pull ventilation system performance.

    Science.gov (United States)

    Ojima, Jun

    2009-01-01

    A push-pull ventilation system is effective for hazardous material exhaustion. Although a push-pull ventilation system has advantages over a local exhaust hood, some laborious adjustments are required. The pertinence of the adjustments is uncertain because it is difficult to evaluate the performance of a push-pull ventilation system quantitatively. In this study, a measurement of the capture efficiency of a push-pull ventilation system was carried out by means of a tracer gas method. The capture efficiency decreased to 39.3-78.5% when blockage material, a dummy worker and a cross draft, were set in the ventilation zone, but the efficiency was 95.1-97.9% when the cross draft was stopped. The results suggest that the uniform flow of a push-pull ventilation system will detour a blockage and the performance of the system will not be reduced unless a cross draft disturbs the uniform flow.

  14. Pulled elbow in infancy: diagnostic role of imaging

    International Nuclear Information System (INIS)

    Scapinelli, Raffaele; Borgo, Andrea

    2005-01-01

    Purpose. Pulled elbow is a common injury in infancy. Typically the child, after a sudden pull, refuses to use the arm. The history and clinical findings are sufficient to make the diagnosis, and radiography or ultrasonography are not necessary. When imaging procedures are performed, a few small signs are useful to confirm the diagnosis of pulled elbow. Materials and methods. The authors reviewed the radiographic and ultrasonographic signs reported to be suggestive of pulled elbow (increased radio-condylar distance, increased radio-coronoid distance, proximal radio-ulnar diastasis, deviation of the radio-condylar line) and attempted to confirm their presence in children affected by this trauma. Results. Increased radio-condylar and radio-coronoid distance were present in 8 of 8 cases: proximal radio-ulnar diastasis and deviation of the radio-condylar line were inconsistently present. Ultrasonography gave contradictory results. Conclusions. In typical cases of pulled elbow, radiography or ultrasonography are not necessary for diagnosis and treatment. imaging procedures are recommended only in the case of non typical history, in the presence of deformity or traumatic skin lesions and in children over six years of age. Increased radio-coronoid distance on the affected side is the most frequent and visible sign, which can confirm the diagnosis of pulled elbow. Increased radio-condylar distance is also present, but it is not easy to visualize. Proximal radio-ulnar diastasis and deviation of the radio-condylar line are inconstant. Ultrasonography is difficult to standardize [it

  15. Psychophysical basis for maximum pushing and pulling forces: A review and recommendations.

    Science.gov (United States)

    Garg, Arun; Waters, Thomas; Kapellusch, Jay; Karwowski, Waldemar

    2014-03-01

    The objective of this paper was to perform a comprehensive review of psychophysically determined maximum acceptable pushing and pulling forces. Factors affecting pushing and pulling forces are identified and discussed. Recent studies show a significant decrease (compared to previous studies) in maximum acceptable forces for males but not for females when pushing and pulling on a treadmill. A comparison of pushing and pulling forces measured using a high inertia cart with those measured on a treadmill shows that the pushing and pulling forces using high inertia cart are higher for males but are about the same for females. It is concluded that the recommendations of Snook and Ciriello (1991) for pushing and pulling forces are still valid and provide reasonable recommendations for ergonomics practitioners. Regression equations as a function of handle height, frequency of exertion and pushing/pulling distance are provided to estimate maximum initial and sustained forces for pushing and pulling acceptable to 75% male and female workers. At present it is not clear whether pushing or pulling should be favored. Similarly, it is not clear what handle heights would be optimal for pushing and pulling. Epidemiological studies are needed to determine relationships between psychophysically determined maximum acceptable pushing and pulling forces and risk of musculoskeletal injuries, in particular to low back and shoulders.

  16. Push-pull quinoidal porphyrins.

    Science.gov (United States)

    Smith, Martin J; Blake, Iain M; Clegg, William; Anderson, Harry L

    2018-05-01

    A family of push-pull quinoidal porphyrin monomers has been prepared from a meso-formyl porphyrin by bromination, thioacetal formation, palladium-catalyzed coupling with malononitrile and oxidation with DDQ. Attempts at extending this synthesis to a push-pull quinoidal/cumulenic porphyrin dimer were not successful. The crystal structures of the quinoidal porphyrins indicate that there is no significant contribution from singlet biradical or zwitterionic resonance forms. The crystal structure of an ethyne-linked porphyrin dimer shows that the torsion angle between the porphyrin units is only about 3°, in keeping with crystallographic results on related compounds, but contrasting with the torsion angle of about 35° predicted by computational studies. The free-base quinoidal porphyrin monomers form tightly π-stacked layer structures, despite their curved geometries and bulky aryl substituents.

  17. Pushing and pulling in relation to musculoskeletal complaints

    NARCIS (Netherlands)

    Hoozemans, M. J M; Van Der Beek, Allard J.; Frings-Dresen, M. H. W.

    2000-01-01

    The first cross-sectional analyses are presented of a longitudinal study regarding the relationship between pushing and pulling and musculoskeletal disorders. Workers exposed to pushing and pulling and workers who had administrative tasks received a questionnaire. A significant association between

  18. [Design on tester of pull-out force for orthodontic micro implant].

    Science.gov (United States)

    Su, He; Wu, Pei; Wang, Huiyuan; Chen, Yan; Bao, Xuemei

    2013-09-01

    A special device for measuring the pull-out force of orthodontic micro implant was designed, which has the characteristics of simple construction and easy operation, and can be used to detect the pull-out-force of orthodontic micro implant. The tested data was stored and analyzed by a computer, and as the results, the pull-out-force curve, maximum pull-out force as well as average pull-out force were outputted, which was applied in analyzing or investigating the initial stability and immediate loading property of orthodontic micro implant.

  19. Electromyographical Comparison of a Traditional, Suspension Device, and Towel Pull-Up

    Directory of Open Access Journals (Sweden)

    Snarr Ronald L.

    2017-08-01

    Full Text Available Strengthening muscles of the back may have various implications for improving functions of daily living, aiding in the transfer of power in throwing, and assist in injury prevention of the shoulder complex. While several versions of the pull-up exist, there is currently no literature comparing their differences. The purpose of this investigation was to compare the electromyographical activity of the latissimus dorsi, posterior deltoid, middle trapezius, and biceps brachii while performing three variations of the pull-up. Resistance-trained men and women (n =15, age = 24.87 ± 6.52 years participated in this study by performing traditional pull-ups, suspension device pull-ups, and towel pull-ups in a randomized fashion. Each pull-up was performed for three repetitions with a 1.5 bi-acromial grip-width for each participant. Normalized (%MVC electromyographical values were recorded for each muscle group during each pull-up variation. No significant differences existed within the latissimus dorsi, biceps brachii or posterior deltoid between any of the exercises. For the middle trapezius, towel pull-ups provided significantly lower muscle activity than the traditional pull-up, while no differences between suspension pull-ups and the other variations occurred. In conclusion, only one muscular difference existed between the exercise variations and all versions examined provided electromyographical values, determined by current literature, to invoke a sufficient stimulus to promote increases in muscle strength and hypertrophy. Although further research is needed, practitioners can be confident when programming any of the movement variations examined when attempting to elicit adaptations of muscular strength and hypertrophy.

  20. Characteristics and phenomenology of hair-pulling: an exploration of subtypes.

    Science.gov (United States)

    du Toit, P L; van Kradenburg, J; Niehaus, D J; Stein, D J

    2001-01-01

    This study was designed to detail the demographic and phenomenological features of adult chronic hair-pullers. Key possible subtypes were identified a priori. On the basis of the phenomenological data, differences between the following possible subtypes were investigated: hair-pullers with and without DSM-IV trichotillomania (TTM), oral habits, automatic versus focused hair-pulling, positive versus negative affective cues prior to hair-pulling, comorbid self-injurious habits, obsessive-compulsive disorder (OCD), and tics. Forty-seven participants were drawn from an outpatient population of chronic adult hair-pullers. A structured interview that focused on hair-pulling and associated behaviors was administered to participants. Six of the participants (12.8%) were male, and 41 (87.7%) were female. A large number of hair-pullers (63.8%) had comorbid self-injurious habits. A greater proportion of male hair-pullers had comorbid tics when compared with females. Certain subgroups of chronic hair-pullers (e.g., hairpullers with or without automatic/focused hair-pulling, comorbid self-injurious habits, and oral habits) were found to differ on a number of phenomenological and hair-pulling characteristics. However, differences between other possible subgroups (e.g., hair-pullers with or without DSM-IV TTM, comorbid OCD, and negative versus positive affective cues) may reflect greater severity in hair-pulling symptomatology rather than distinct subtypes of chronic hair-pulling. The findings of the present study also indicated that chronic hair-pulling (even in cases where DSM-IV criteria for TTM were not met) has a significant impact on quality of life. The present study provided limited support for the existence of possible subtypes of chronic hair-pulling. Recommendations are made for further investigations into such subtypes. Copyright 2001 by W.B. Saunders Company

  1. KOMPARASI SISTEM MANUFAKTUR PUSH DAN PULL MELALUI PENDEKATAN SIMULASI

    Directory of Open Access Journals (Sweden)

    Eric Wibisono

    2004-01-01

    Full Text Available Manufacturing systems that are often classified as push and pull often invite question: "How far do the differences between those two systems exist?" Many researches have been carried out but succinct answer to the above question is always difficult to reach. The difficulty roots from the variety of definition of the push and pull systems itself and also from the variety of complexity of a manufacturing system. This paper attempts to study the differences in performance between push and pull systems in a relatively simple model that consists of 4 serial processors with buffers located between these processors. Variations being modelled is on the setting of the system's load (high and low and the buffer size with performance being measured include machine utilization, number of outputs and mean flow time of jobs. The approach used is simulation using ProModel software as the tool. From the experiments it can be derived that buffer size turns out to be a very critical factor in system performance. Moreover, it is also proved that when the buffer size is large, push and pull systems do not differ significantly. Abstract in Bahasa Indonesia : Sistem manufaktur yang umumnya dikategorikan menjadi sistem push dan pull sering mengundang pertanyaan: "Seberapa jauh perbedaan dari kedua sistem tersebut ada?" Banyak penelitian telah dilakukan namun jawaban yang lugas atas pertanyaan tersebut sulit diperoleh. Kesulitan ini umumnya berakar dari beragamnya definisi sistem push dan pull itu sendiri serta variasi dari kompleksitas suatu sistem manufaktur. Makalah ini mencoba melihat perbedaan antara kinerja sistem push dan pull dalam suatu model sederhana yang terdiri dari 4 prosesor serial dengan buffer yang diletakkan di antara masing-masing prosesor tersebut. Variasi yang dilakukan adalah pada setting beban kerja sistem (padat dan ringan dan ukuran buffer dengan kinerja yang diukur adalah utilisasi mesin, jumlah output dan rata-rata waktu tinggal job

  2. Three-dimensional conformal external beam radiotherapy compared with permanent prostate implantation in low-risk prostate cancer based on endorectal magnetic resonance spectroscopy imaging and prostate-specific antigen level

    International Nuclear Information System (INIS)

    Pickett, Barby; Kurhanewicz, John; Pouliot, Jean; Weinberg, Vivian; Shinohara, Katsuto; Coakley, Fergus; Roach, Mack

    2006-01-01

    Purpose: To evaluate the metabolic response by comparing the time to resolution of spectroscopic abnormalities (TRSA) and the time to prostate-specific antigen level in low-risk prostate cancer patients after treatment with three-dimensional conformal external beam radiotherapy (3D-CRT) compared with permanent prostate implantation (PPI). Recent studies have suggested that the treatment of low-risk prostate cancer yields similar results for patients treated with 3D-CRT or PPI. Methods and Materials: A total of 50 patients, 25 in each group, who had been treated with 3D-CRT or PPI, had undergone endorectal magnetic resonance spectroscopy imaging before and/or at varying times after therapy. The 3D-CRT patients had received radiation doses of ≥72 Gy compared with 144 Gy for the PPI patients. The spectra from all usable voxels were examined for detectable levels of metabolic signal, and the percentages of atrophic and cancerous voxels were tabulated. Results: The median time to resolution of the spectroscopic abnormalities was 32.2 and 24.8 months and the time to the nadir prostate-specific antigen level was 52.4 and 38.0 months for the 3D-CRT and PPI patients, respectively. Of the 3D-CRT patients, 92% achieved negative endorectal magnetic resonance spectroscopy imaging findings, with 40% having complete metabolic atrophy. All 25 PPI patients had negative endorectal magnetic resonance spectroscopy imaging findings, with 60% achieving complete metabolic atrophy. Conclusion: The results of this study suggest that metabolic and biochemical responses of the prostate are more pronounced after PPI. Our results have not proved PPI is more effective at curing prostate cancer, but they have demonstrated that it may be more effective at destroying prostate metabolism

  3. INTERSESSION RELIABILITY OF UPPER EXTREMITY ISOKINETIC PUSH-PULL TESTING.

    Science.gov (United States)

    Riemann, Bryan L; Davis, Sarah E; Huet, Kevin; Davies, George J

    2016-02-01

    Based on the frequency pushing and pulling patterns are used in functional activities, there is a need to establish an objective method of quantifying the muscle performance characteristics associated with these motions, particularly during the later stages of rehabilitation as criteria for discharge. While isokinetic assessment offers an approach to quantifying muscle performance, little is known about closed kinetic chain (CKC) isokinetic testing of the upper extremity (UE). To determine the intersession reliability of isokinetic upper extremity measurement of pushing and pulling peak force and average power at slow (0.24 m/s), medium (0.43 m/s) and fast (0.61 m/s) velocities in healthy young adults. The secondary purpose was to compare pushing and pulling peak force (PF) and average power (AP) between the upper extremity limbs (dominant, non-dominant) across the three velocities. Twenty-four physically active men and women completed a test-retest (>96 hours) protocol in order to establish isokinetic UE CKC reliability of PF and AP during five maximal push and pull repetitions at three velocities. Both limb and speed orders were randomized between subjects. High test-retest relative reliability using intraclass correlation coefficients (ICC2, 1) were revealed for PF (.91-.97) and AP (.85-.95) across velocities, limbs and directions. PF typical error (% coefficient of variation) ranged from 6.1% to 11.3% while AP ranged from 9.9% to 26.7%. PF decreased significantly (p pushing were significantly greater than pulling at all velocities, however the push-pull differences in PF became less as velocity increased. There were no significant differences identified between the dominant and nondominant limbs. Isokinetically derived UE CKC push-pull PF and AP are reliable measures. The lack of limb differences in healthy normal participants suggests that clinicians can consider bilateral comparisons when interpreting test performance. The increase in pushing PF and

  4. Pull remanufacturing: A case study

    Energy Technology Data Exchange (ETDEWEB)

    Levine, L.O.

    1992-09-01

    This paper describes how pull production methods have been applied to a manual transmission remanufacturing line at Tooele Army Depot in Utah. The paper emphasizes techniques for linking the control of disassembly and cleaning operations to the repair and assembly portions of the production system (PP&C). The primary objective is to show that production planning and control can be simplified when pull mechanisms are combined with shop floor improvements. One approach to applying MRP II to remanufacturing is to use a separate production schedule for the disassembly and assembly portions of the operation. This approach is primarily needed when managing the delivery and inventory of cores is critical to the successful operation of a remanufacturing organization. Because Army depots frequently have an adequate inventory of cores on hand (somewhere on-site), this requirement is usually less significant. Therefore, it is possible to eliminate the use of a master production schedule for disassembly and rely on pull linkages from the repair and assembly operations to control the activity of the disassembly and cleaning operations. In remanufacturing environments having multiple products and adequate buffers of core inventory, effective coordination of disassembly and cleaning functions with assembly production requirements becomes a key production control issue.

  5. Pull remanufacturing: A case study

    Energy Technology Data Exchange (ETDEWEB)

    Levine, L.O.

    1992-09-01

    This paper describes how pull production methods have been applied to a manual transmission remanufacturing line at Tooele Army Depot in Utah. The paper emphasizes techniques for linking the control of disassembly and cleaning operations to the repair and assembly portions of the production system (PP C). The primary objective is to show that production planning and control can be simplified when pull mechanisms are combined with shop floor improvements. One approach to applying MRP II to remanufacturing is to use a separate production schedule for the disassembly and assembly portions of the operation. This approach is primarily needed when managing the delivery and inventory of cores is critical to the successful operation of a remanufacturing organization. Because Army depots frequently have an adequate inventory of cores on hand (somewhere on-site), this requirement is usually less significant. Therefore, it is possible to eliminate the use of a master production schedule for disassembly and rely on pull linkages from the repair and assembly operations to control the activity of the disassembly and cleaning operations. In remanufacturing environments having multiple products and adequate buffers of core inventory, effective coordination of disassembly and cleaning functions with assembly production requirements becomes a key production control issue.

  6. Non-granulomatous prostatitis: MR appearance with an endorectal surface coil; Nichtgranulomatoese Prostatitis: Erscheinungsbild im MRT mit endorektaler Oberflaechenspule (``Endo-MRT``)

    Energy Technology Data Exchange (ETDEWEB)

    Szolar, D.H.M. [Magnetresonanztomographie-Zentrum, Univ. Graz (Austria); Ranner, G. [Magnetresonanztomographie-Zentrum, Univ. Graz (Austria); Preidler, K.W. [Magnetresonanztomographie-Zentrum, Univ. Graz (Austria); Lax, S. [Inst. fuer Pathologische Anatomie, Univ. Graz (Austria)

    1995-01-01

    Inflammatory conditions of the prostate are often idfficult to distinguish from early stages of prostate cancer with imaging techniques. The use of an endorectal surface coil in MRI of the prostate gland has been reported to provide superior resolution and better imaging of details than MRI with a body coil in the diagnosis of early prostate cancer. We report a 34-year-old patient with nonspecific non-granlomatous prostatitis in whom T{sub 2}-weighted endorectal surface coil magnetic resonance imaging (ESCMRI) showed a region of markedly decreased signal intensity in the periphery of the gland. The low signal intensity of the lesion, its sharp demarcation from the normal part of the peripheral zone of the prostate and the marked bulge of the surface contour without capsular breach of the organ were interpreted as evidence of a bioptically proven benign inflammatory condition. (orig.) [Deutsch] Die Unterscheidung entzuendlicher Prozesse von Fruehstadien maligner Neoplasien der Prostata mittels Magnetresonanztomographie bereitet immer wieder Schwierigkeiten. Die Anwendung einer Oberflaechenspule erlaubt durch hoehere Aufloesung eine exaktere Beurteilung der Prostatakapsel, was eine hoehere Treffsicherheit beim Nachweis moeglicher organueberschreitender Infiltrationen bedeutet. Wir praesentieren den Fall eines 34jaehrigen Mannes mit unspezifischer, nichtgranulomatoeser Prostatitis, bei dem das MR-Tomogramm mit endorektal plazierter Oberflaechenspule (Endo-MRT) in der Peripherzone ein Areal deutlich herabgesetzter Signalintensitaet auf T{sub 2}-gewichteten Aufnahmen zeigte. Die scharfe Begrenzung der ausgedehnten signalarmen Laesion gegenueber dem nichtbefallenen Anteil der Peripherzone beim im Endo-MRT identifizierbarer intakter Kapsel liess ein organueberschreitendes Malignom ausschliessen und bestaetigte durch histologische Aufarbeitung der Bioptate den Endo-MRT-Verdachtsbefund einer Prostatitis. (orig.)

  7. Comparison of fluoroscopy-guided pull-type percutaneous radiological gastrostomy (pull-type-PRG) with conventional percutaneous radiological gastrostomy (push-type-PRG): clinical results in 253 patients

    Energy Technology Data Exchange (ETDEWEB)

    Yang, Yang; Schneider, J.; Dueber, C.; Pitton, M.B. [University Medical Center of the Johannes Gutenberg University Mainz, Department of Diagnostic and Interventional Radiology, Mainz (Germany)

    2011-11-15

    To analyze the clinical results and complications of fluoroscopy guided internal-external pull-type percutaneous radiological gastrostomy (pull-type-PRG) and conventional external-internal percutaneous radiological gastrostomy (push-type-PRG). A total of 253 patients underwent radiological gastrostomy between January 2002 and January 2010. Data were collected retrospectively from radiology reports, Chart review of clinical notes, procedure reports, discharge summaries and subsequent hospital visits. Statistical analysis was performed to compare the two methods for gastrostomy with respect to peri-interventional aspects and clinical results. 128 patients received the Pull-type-PRG whereas the other 125 patients were served with the Push-type-PRG. Indications for gastrostomy were similar in these two groups. The most frequent indications for the both methods were stenotic oesophageal tumors or head/neck tumors (54.7% in pull-type-PRG, 68% in push-type-PRG). Gastrostomy procedures were successful in 98.3% in pull-type-PRG compared to 92% in push-type-PRG. There was no procedure-related mortality. Compared to Push-type-PRG, the peri-interventional complication rate was significantly reduced in pull-type-PRG (14.8% versus 34.4%, P = 0.002). Compared to the external-internal push-type-PRG, the internal-external Pull-type-PRG showed a high primary success rate and a decreased incidence of peri-interventional complications. (orig.)

  8. Comparison of fluoroscopy-guided pull-type percutaneous radiological gastrostomy (pull-type-PRG) with conventional percutaneous radiological gastrostomy (push-type-PRG): clinical results in 253 patients

    International Nuclear Information System (INIS)

    Yang, Yang; Schneider, J.; Dueber, C.; Pitton, M.B.

    2011-01-01

    To analyze the clinical results and complications of fluoroscopy guided internal-external pull-type percutaneous radiological gastrostomy (pull-type-PRG) and conventional external-internal percutaneous radiological gastrostomy (push-type-PRG). A total of 253 patients underwent radiological gastrostomy between January 2002 and January 2010. Data were collected retrospectively from radiology reports, Chart review of clinical notes, procedure reports, discharge summaries and subsequent hospital visits. Statistical analysis was performed to compare the two methods for gastrostomy with respect to peri-interventional aspects and clinical results. 128 patients received the Pull-type-PRG whereas the other 125 patients were served with the Push-type-PRG. Indications for gastrostomy were similar in these two groups. The most frequent indications for the both methods were stenotic oesophageal tumors or head/neck tumors (54.7% in pull-type-PRG, 68% in push-type-PRG). Gastrostomy procedures were successful in 98.3% in pull-type-PRG compared to 92% in push-type-PRG. There was no procedure-related mortality. Compared to Push-type-PRG, the peri-interventional complication rate was significantly reduced in pull-type-PRG (14.8% versus 34.4%, P = 0.002). Compared to the external-internal push-type-PRG, the internal-external Pull-type-PRG showed a high primary success rate and a decreased incidence of peri-interventional complications. (orig.)

  9. The role of endorectal coil MRI in patient selection and treatment planning for prostate seed implants

    International Nuclear Information System (INIS)

    Clarke, Daniel H.; Banks, Stephen J.; Wiederhorn, A. Roger; Klousia, John W.; Lissy, Jeanne M.; Miller, Michelle; Able, Arnold M.; Artiles, Carlos; Hindle, William V.; Blair, Deborah N.; Houk, Russell R.; Sheridan, Michael J.

    2002-01-01

    Purpose: To assess the role of endorectal coil magnetic resonance imaging (MRI) staging for patients undergoing seed implantation (SI) with or without external beam radiotherapy (EBRT). Methods and Materials: Between October 1994 and December 1998, 390 patients underwent prostate SI (98% Pd-103, 2% I-125). Seventy-six percent of patients had a prostate serum antigen (PSA) 20. Ten percent of patients had a Gleason score (GS) of 4-5, 54% had GS 6, 29% had GS 7, and 7% had GS ≥ 8. Monotherapy was employed in 46% of patients, and the remaining 54% received combined EBRT and SI. Three hundred twenty-seven were staged by high-resolution phased array pelvic coil, or in most cases, an endorectal coil MRI. The MRI findings were used to guide stage-appropriate treatment recommendations, and to assist in the preplanning and optimization of seed distributions. The criteria utilized to determine MRI-based stage were founded on the reported literature from the University of Pennsylvania. All MRI studies were reviewed by C.A., D.B., or W.H., who were unaware of clinical stage at the time of their review. The biopsy report was available to them as the only clinical correlate. Results: Of the 327 patients staged by MRI, 70% were upstaged from the digital rectal examination-based clinical stage; 26% of T 1 , T 2 patients were upstaged to T 3 . Perineural invasion and the percentage of positive cores predicted for T 3 MRI stage (p 3 intermediate-risk group patients treated by combined therapy with a previous study of T 3 intermediate-risk group treated by radical prostatectomy (RP) at the University of Pennsylvania. Our 36-month PSA FFP was 94% compared with 21% for the previous study's RP patients. Conclusion: MRI is a valuable staging procedure for prostate cancer patients treated by SI. PSA FFP results appear to be improved by MRI staging. MRI T 3 disease can be treated more effectively by SI + EBRT than by RP

  10. Pushing, pulling and manoeuvring an industrial cart: a psychophysiological study.

    Science.gov (United States)

    Giagloglou, Evanthia; Radenkovic, Milan; Brankovic, Sasa; Antoniou, Panagiotis; Zivanovic-Macuzic, Ivana

    2017-09-18

    One of the most frequent manual occupational tasks involves the pushing and pulling of a cart. Although several studies have associated health risks with pushing and pulling, the effects are not clear since occupational tasks have social, cognitive and physical components. The present work investigates a real case of a pushing and pulling occupational task from a manufacturing company. The study initially characterizes the case in accordance with Standard No. ISO 11228-2:2007 as low risk. An experiment with 14 individuals during three modalities of pushing and pulling was performed in order to further investigate the task with the application of electrophysiology. At the end, a simple questionnaire was given. The results show electrophysiological differences among the three modalities of pushing and pulling, with a major difference between action with no load and fully loaded with a full range of motions on the cart to handle.

  11. Biomechanical study of the final push-pull in archery.

    Science.gov (United States)

    Leroyer, P; Van Hoecke, J; Helal, J N

    1993-02-01

    The purpose of this study was to analyse archery performance among eight archers of different abilities by means of displacement pull-hand measurements during the final push-pull phase of the shoot. The archers showed an irregular displacement negatively related to their technical level. Displacement signal analysis showed high power levels in both the 0-5 Hz and 8-12 Hz ranges. The latter peak corresponds to electromyographic tremor observed during a prolonged push-pull effort. The results are discussed in relation to some potentially helpful training procedures such as biofeedback and strength conditioning.

  12. Initial atomic coherences and Ramsey frequency pulling in fountain clocks

    Science.gov (United States)

    Gerginov, Vladislav; Nemitz, Nils; Weyers, Stefan

    2014-09-01

    In the uncertainty budget of primary atomic cesium fountain clocks, evaluations of frequency-pulling shifts of the hyperfine clock transition caused by unintentional excitation of its nearby transitions (Rabi and Ramsey pulling) have been based so far on an approach developed for cesium beam clocks. We re-evaluate this type of frequency pulling in fountain clocks and pay particular attention to the effect of initial coherent atomic states. We find significantly enhanced frequency shifts caused by Ramsey pulling due to sublevel population imbalance and corresponding coherences within the state-selected hyperfine component of the initial atom ground state. Such shifts are experimentally investigated in an atomic fountain clock and quantitative agreement with the predictions of the model is demonstrated.

  13. Shear-controlled evolution of the Red Sea: pull apart model

    Science.gov (United States)

    Makris, J.; Rihm, R.

    1991-11-01

    Results of seismic and other geophysical investigations suggest that strike-slip processes controlled the break-up of the Arabian plate from Africa and initiated the Red Sea Rift. Early oceanisation was facilitated by nucleation of pull apart basins and massive intrusives. The evolution of the Red Sea has gone through different stages. It was a zone of structural weakness already during the Pan-African orogeny approximately 600 Ma. A major reactivation, however, that gradually led to the present-day configuration was initiated during the late Oligocene with intense magmatic activity and the development of a continental rift. Wrench faulting played a key role in the early evolution of the Red Sea, as it shaped most of its western flank as a sharp plate boundary and resulted in the generation and rapid oceanisation of linearly arranged pull apart basins. Spatial distribution of these basins reflects the geometry of the strike-slip zone, which was controlled by pre-existing fault systems like the Najd Shear System, the Central African Fault Zone or the Onib-Hamisana and Baraka suture zones. Strike-slip motion along the latter zones of weakness influenced mainly the Egyptian and Sudanese coastal areas. Arabia was therefore separated from Africa by oceanisation in those regions, where pull apart basins developed. They were still connected in the in-between segments by stretched continental crust. With Arabia as the "moving" and Africa as the "stable" plate the eastern Red Sea flank was formed by pure shear through stretching, thinning and diffuse extension. As a consequence, the eastern and western flanks of the Red Sea are asymmetrical. The acceleration of the movement of Arabia in early/middle Miocene could no longer be accommodated by the opening in the Gulf of Suez and consequently the Dead Sea strike-slip fault developed approximately 14 Ma ago. Since plate motion was still oblique to the major structural trends, the pull apart evolution on the western flank

  14. Workload balancing capability of pull systems in MTO production

    NARCIS (Netherlands)

    Germs, R.; Riezebos, J.

    2010-01-01

    Pull systems focusing on throughput time control and applicable in situations with high variety and customisation are scarce. This paper compares three unit-based pull systems that can cope with such situations: POLCA, CONWIP and m-CONWIP. These systems control the shop floor throughput time of

  15. Cuban experience and the future perspectives of transanal endoscopic microsurgery

    International Nuclear Information System (INIS)

    Barreras Gonzalez, Javier Ernesto; Fernandez Zulueta, Arnulfo; Martinez Alfonso, Miguel Angel; Diaz Canel Fernandez, Osvaldo; Faife Faife, Barbara; Hernandez Gutierrez, Jose Manuel; Olazabal Garcia, Enrique

    2009-01-01

    Introduction: The aim of present study was to assess the indication and the results of transanal endoscopic microsurgery (TEM) for treatment of rectal benign and malign tumors in National Center of Minimal Access Surgery in Havana city. METHODS: A comprehensive review of literature was made on present managing of rectal benign and malign tumors by TEM and results of such technique were assessed during 4 years in National Center of Minimal Access Surgery. RESULTS: During study period 33 patients were operated on by this technique. Main indications of TEM were the presence of adenomas (72,8%). Mean surgical time was of 189,1 minutes; in 4 patients ( 12,1%) transoperative transfusion was used, and hospital stay was of 2,5 days. Main transoperative complications were the rectovaginal fistula, bleeding and dehiscence. Follow-up of patients fluctuates between 1 and 54 months (mean 28,3) with 4 local relapses in adenoma group. CONCLUSIONS: TEM is a safe and effective method for treatment of rectal benign and malign tumors (in early stages). It is the choice technique for the big rectal adenomas and rectum cancer with pT1 stages located in all the ampulla of rectum. It has all advantages of the minimal access surgery; relapse results are similar to that of abdominal surgery without complications of urinary or sexual dysfunction and that of fecal incontinence are minimal.(author)

  16. Experimental Investigations on the Pull-Out Behavior of Tire Strips Reinforced Sands.

    Science.gov (United States)

    Li, Li-Hua; Chen, Yan-Jun; Ferreira, Pedro Miguel Vaz; Liu, Yong; Xiao, Heng-Lin

    2017-06-27

    Waste tires have excellent mechanical performance and have been used as reinforcing material in geotechnical engineering; however, their interface properties are poorly understood. To further our knowledge, this paper examines the pull-out characteristics of waste tire strips in a compacted sand, together with uniaxial and biaxial geogrids also tested under the same conditions. The analysis of the results shows that the interlocking effect and pull-out resistance between the tire strip and the sand is very strong and significantly higher than that of the geogrids. In the early stages of the pull-out test, the resistance is mainly provided by the front portion of the embedded tire strips, as the pull-out test continues, more and more of the areas towards the end of the tire strips are mobilized, showing a progressive failure mechanism. The deformations are proportional to the frictional resistance between the tire-sand interface, and increase as the normal stresses increase. Tire strips of different wear intensities were tested and presented different pull-out resistances; however, the pull-out resistance mobilization patterns were generally similar. The pull-out resistance values obtained show that rubber reinforcement can provide much higher pull-out forces than the geogrid reinforcements tested here, showing that waste tires are an excellent alternative as a reinforcing system, regardless of the environmental advantages.

  17. Pull-in behavior analysis of vibrating functionally graded micro-cantilevers under suddenly DC voltage

    Directory of Open Access Journals (Sweden)

    Jamal Zare

    2015-01-01

    Full Text Available The present research attempts to explain dynamic pull-in instability of functionally graded micro-cantilevers actuated by step DC voltage while the fringing-field effect is taken into account in the vibrational equation of motion. By employing modern asymptotic approach namely Homotopy Perturbation Method with an auxiliary term, high-order frequency-amplitude relation is obtained, then the influences of material properties and actuation voltage on dynamic pull-in behavior are investigated. It is demonstrated that the auxiliary term in the homotopy perturbation method is extremely effective for higher order approximation and two terms in series expansions are sufficient to produce an acceptable solution. The strength of this analytical procedure is verified through comparison with numerical results.

  18. Long-term outcome of stapled transanal rectal resection (STARR) versus stapled hemorrhoidopexys (STH) for grade III-IV hemorrhoids: preliminary results.

    Science.gov (United States)

    Zanella, Simone; Spirch, Saverio; Scarpa, Marco; Ricci, Francesco; Lumachi, Franco

    2014-01-01

    Circular stapled transanal hemorrhoidopexy (STH) was first introduced by A. Longo for the correction of internal mucosal prolapse and obstructed defecation and in 1998, was proposed as alternative to conventional excisional hemorrhoidectomy. More recently, stapled transanal rectal resection (STARR) has gradually gained popularity, as the Longo procedure, in the treatment of hemorrhoids. The aim of our study was to evaluate the usefulness of STARR as alternative to STH in patients with grade III (n=218, 68.1%) and IV (n=102, 31.9%) hemorrhoids. A group of 320 consecutive patients (median age=51 years; range=16-85) underwent STH (n=281) or STARR (n=39) procedure. The rate of postoperative bleeding (53.8% vs. 74.4%, phemorrhoids and a lower incidence of prolapse, both at one year (none vs. 1.4%, p=0.593 and 2.6% vs. 5.3%, p=0.396, respectively) and at two years (none vs. 6.8%, p=0.078 and none vs. 13.2%, p=0.012, respectively). The one-year (9.0 ± 1.8 vs. 9.4 ± 0.7, p=0.171) and two-year (9.6 ± 0.8 vs. 9.1 ± 1.7, p=0.072) general satisfaction was similar but higher in STARR patients than in the STH group. In conclusion, according to our preliminary results, the STARR procedure leads to a lower incidence of complications and recurrences and should be considered for patients with grade III or IV hemorrhoids previously selected for stapled hemorrhoidectomy, as a promising alternative to STH. Copyright © 2014 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

  19. Effect of a powered drive on pushing and pulling forces when transporting bariatric hospital beds.

    Science.gov (United States)

    Wiggermann, Neal

    2017-01-01

    Powered drives designed to assist with moving hospital beds are commercially available but no studies have evaluated whether they reduce the push and pull forces likely contributing to injury in caregivers. This study measured hand forces of 10 caregivers maneuvering a manual and powered bariatric bed through simulated hospital environments (hallway, elevator, and ramp). Peak push and pull forces exceeded previously established psychophysical limits for all activities with the manual bed. For the powered bed, peak forces were significantly (p pushing did not differ between beds. Powered drive may reduce the risk of injury or the number of caregivers needed for transport. Copyright © 2016 Elsevier Ltd. All rights reserved.

  20. Scapula kinematics of pull-up techniques: Avoiding impingement risk with training changes.

    Science.gov (United States)

    Prinold, Joe A I; Bull, Anthony M J

    2016-08-01

    Overhead athletic activities and scapula dyskinesia are linked with shoulder pathology; pull-ups are a common training method for some overhead sports. Different pull-up techniques exist: anecdotally some are easier to perform, and others linked to greater incidences of pathology. This study aims to quantify scapular kinematics and external forces for three pull-up techniques, thus discussing potential injury implications. An observational study was performed with eleven participants (age=26.8±2.4 years) who regularly perform pull-ups. The upward motions of three pull-up techniques were analysed: palms facing anterior, palms facing posterior and wide-grip. A skin-fixed scapula tracking technique with attached retro-reflective markers was used. High intra-participant repeatability was observed: mean coefficients of multiple correlations of 0.87-1.00 in humerothoracic rotations and 0.77-0.90 for scapulothoracic rotations. Standard deviations of hand force was low: kinematics were observed between the pull-up techniques. The reverse technique has extreme glenohumeral internal-external rotation and large deviation from the scapula plane. The wide technique has a reduced range of pro/retraction in the same HT plane of elevation and 90° of arm abduction with 45° external rotation was observed. All these factors suggest increased sub-acromial impingement risk. The scapula tracking technique showed high repeatability. High arm elevation during pull-ups reduces sub-acromial space and increases pressure, increasing the risk of impingement injury. Wide and reverse pull-ups demonstrate kinematics patterns linked with increased impingement risk. Weight-assisted front pull-ups require further investigation and could be recommended for weaker participants. Copyright © 2015 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  1. Polymer translocation under a pulling force: Scaling arguments and threshold forces

    Science.gov (United States)

    Menais, Timothée

    2018-02-01

    DNA translocation through nanopores is one of the most promising strategies for next-generation sequencing technologies. Most experimental and numerical works have focused on polymer translocation biased by electrophoresis, where a pulling force acts on the polymer within the nanopore. An alternative strategy, however, is emerging, which uses optical or magnetic tweezers. In this case, the pulling force is exerted directly at one end of the polymer, which strongly modifies the translocation process. In this paper, we report numerical simulations of both linear and structured (mimicking DNA) polymer models, simple enough to allow for a statistical treatment of the pore structure effects on the translocation time probability distributions. Based on extremely extended computer simulation data, we (i) propose scaling arguments for an extension of the predicted translocation times τ ˜N2F-1 over the moderate forces range and (ii) analyze the effect of pore size and polymer structuration on translocation times τ .

  2. Role of endorectal magnetic resonance spectroscopic imaging in two different Gleason scores in prostate cancer.

    Science.gov (United States)

    Nagarajan, Rajakumar; Margolis, Daniel; McClure, Tim; Raman, Steve; Thomas, M Albert

    2011-01-01

    The major goal of the work was to record three-dimensional magnetic resonance spectroscopic imaging (MRSI) and to compare metabolite ratios between different Gleason scores (GS). MRSI localized by endorectal coil-acquired point-resolved spectroscopy was performed in 14 men with prostate cancer of GS 6 (n = 7) and 7 (n = 7) using a 1.5-tesla MRI scanner. The ratio of (choline + creatine)/citrate was increased with an increase of GS, i.e. 0.590 ± 0.171 in the target lesion and 0.321 ± 0.157 in the contralateral region of patients with a GS of 6 as opposed to 1.082 ± 0.432 in the target lesion and 0.360 ± 0.243 in the contralateral region of patients with a GS of 7. Our pilot results demonstrated that MRSI was an additional biochemical tool which is complementary to the current imaging modalities for early diagnosis and therapeutic management of prostate cancer. Copyright © 2011 S. Karger AG, Basel.

  3. Method to measure the force to pull and to break pin bones of fish.

    Science.gov (United States)

    Balaban, Murat O; Jie, Hubert; Yin Yee, Yin; Alçiçek, Zayde

    2015-02-01

    A texture measurement device was modified to measure the force required to pull pin bones from King salmon (Oncorhynchus tshawytscha), snapper (Pagrus auratus), and kahawai (Arripis trutta). Pulled bones were also subjected to tension to measure the breaking force. For all fish, the pulling force depended on the size of the fish, and on the length of the pin bone (P bones. For example, fresh small salmon (about 1500 g whole) required 600 g on average to pull pin bones, and large fish (about 3700 g whole) required 850 g. Longer bones required greater pulling force. The breaking force followed the same trend. In general, the breaking force was greater than the pulling force. This allows the removal of the bones without breaking them. There was no statistically significant (P > 0.05) difference between the forces (both pulling and breaking) from fresh and frozen/thawed samples, although in general frozen/thawed samples required less force to pull. With the quantification of pulling and breaking forces for pin bones, it is possible to design and build better, "more intelligent" pin bone removal equipment. © 2015 Institute of Food Technologists®

  4. Evaluation of the Prostate Bed for Local Recurrence After Radical Prostatectomy Using Endorectal Magnetic Resonance Imaging

    International Nuclear Information System (INIS)

    Liauw, Stanley L.; Pitroda, Sean P.; Eggener, Scott E.; Stadler, Walter M.; Pelizzari, Charles A.; Vannier, Michael W.; Oto, Aytek

    2013-01-01

    Purpose: To summarize the results of a 4-year period in which endorectal magnetic resonance imaging (MRI) was considered for all men referred for salvage radiation therapy (RT) at a single academic center; to describe the incidence and location of locally recurrent disease in a contemporary cohort of men with biochemical failure after radical prostatectomy (RP), and to identify prognostic variables associated with MRI findings in order to define which patients may have the highest yield of the study. Methods and Materials: Between 2007 and 2011, 88 men without clinically palpable disease underwent eMRI for detectable prostate-specific antigen (PSA) after RP. The median interval between RP and eMRI was 32 months (interquartile range, 14-57 months), and the median PSA level was 0.30 ng/mL (interquartile range, 0.19-0.72 ng/mL). Magnetic resonance imaging scans consisting of T2-weighted, diffusion-weighted, and dynamic contrast-enhanced imaging were evaluated for features consistent with local recurrence. The prostate bed was scored from 0-4, whereby 0 was definitely normal, 1 probably normal, 2 indeterminate, 3 probably abnormal, and 4 definitely abnormal. Local recurrence was defined as having a score of 3-4. Results: Local recurrence was identified in 21 men (24%). Abnormalities were best appreciated on T2-weighted axial images (90%) as focal hypointense lesions. Recurrence locations were perianastomotic (67%) or retrovesical (33%). The only risk factor associated with local recurrence was PSA; recurrence was seen in 37% of men with PSA >0.3 ng/mL vs 13% if PSA ≤0.3 ng/mL (P 3 and was directly associated with PSA (r=0.5, P=.02). The correlation between MRI-based tumor volume and PSA was even stronger in men with positive margins (r=0.8, P<.01). Conclusions: Endorectal MRI can define areas of local recurrence after RP in a minority of men without clinical evidence of disease, with yield related to PSA. Further study is necessary to determine whether eMRI can

  5. Transanal endoscopic microsurgery: a new technique for completion proctectomy.

    Science.gov (United States)

    Liyanage, C; Ramwell, A; Harris, G J; Levy, B F; Simson, J N L

    2013-09-01

    Following subtotal colectomy, the retained rectal stump is a potential source of morbidity. Although restorative ileal pouch-anal anastomosis is the gold standard for ulcerative colitis, up to 14% of patients will opt for a permanent ileostomy and undergo completion proctectomy, traditionally by an abdomino-perineal approach, which itself carries significant morbidity. We describe a new technique of perineal proctectomy using transanal endoscopic microsurgery (TEMS) equipment. To our knowledge, this technique has not previously been described in the literature. Twelve patients, mean (SD) age 66 (±13) years, underwent TEMS proctectomy, performed by a single surgeon between January 2007 and October 2011. Excision began with an intersphincteric dissection following which the TEMS (WOLF) proctoscope was inserted and close rectal dissection was performed, entering the peritoneal cavity (if the top of the stump was intraperitoneal). Following perineal extraction of the specimen, the external sphincter and skin were closed with an absorbable suture. Nine patients had inflammatory bowel disease, two had neoplasia and one had intractable radiation proctitis. The mean (SD) rectal stump length was 17.8 (±6.1) cm and the peritoneal cavity was entered in nine patients, with no small-bowel injury. The median postoperative hospital stay was 5.5 days. In four patients there was delayed healing of the perineal wound. There was no perioperative mortality. TEMS perineal proctectomy is a novel, but safe, technique that may avoid the need for a traditional abdominoperineal approach in selected patients. Colorectal Disease © 2013 The Association of Coloproctology of Great Britain and Ireland.

  6. Frobenius Pull Backs of Vector Bundles in Higher Dimensions

    Indian Academy of Sciences (India)

    We prove that for a smooth projective variety of arbitrary dimension and for a vector bundle over , the Harder–Narasimhan filtration of a Frobenius pull back of is a refinement of the Frobenius pull back of the Harder–Narasimhan filtration of , provided there is a lower bound on the characteristic (in terms of rank of ...

  7. Yarn Pull-Out as a Mechanism for Dissipation of Ballistic Impact Energy in Kevlar KM-2 Fabric, Part 1: Quasi-Static Characterization of Yarn Pull-Out

    National Research Council Canada - National Science Library

    Kirkwood, Keith

    2004-01-01

    .... This study reports the effects of fabric length, number of yarns pulled, arrangement of yarns, and transverse tension on the force-displacement curves for yarn pull-out tests on Kevlar KM-2 fabric...

  8. Optical pulling force and conveyor belt effect in resonator-waveguide system.

    Science.gov (United States)

    Intaraprasonk, Varat; Fan, Shanhui

    2013-09-01

    We present the theoretical condition and actual numerical design that achieves an optical pulling force in resonator-waveguide systems, where the direction of the force on the resonator is in the opposite direction to the input light in the waveguide. We also show that this pulling force can occur in conjunction with the lateral optical equilibrium effect, such that the resonator is maintained at the fixed distance from the waveguide while experiencing the pulling force.

  9. Technology and trend management at the interface of technology push and market pull

    DEFF Research Database (Denmark)

    Maier, Maximilian; Hofmann, Maximilian; Brem, Alexander

    2016-01-01

    Technology push and market pull innovation strategies are playing an important role for the effective management of ideas, technologies, and trends. The coexistence of these two approaches led to many debates and the focus switched several times from putting more effort into technology push aspects...... to fostering market pull approaches in the last decades. Still, there is no in-depth exploration of the interface of technology push and market pull and only few conceptual models are dealing with the connection between technology push and market pull in particular. Therefore, this study puts an exploratory...... focus on the innovation management processes of a global outdoor manufacturer with a special emphasis on the interface between technology push and market pull. From the case findings and our literature we conceptualise a non-linear innovation model that systematically integrates market pull...

  10. A centrifuge simulated push-pull manoeuvre with subsequent reduced +Gz tolerance.

    Science.gov (United States)

    Xu, Yan; Li, Bao-Hui; Zhang, Li-Hui; Jin, Zhao; Wei, Xiao-Yang; Wang, Hong; Wu, San-Yuan; Wang, Hai-Xia; Wang, Quan; Yan, Gui-Ding; Deng, Lue; Geng, Xi-Chen

    2012-07-01

    The push-pull effect (PPE) has been recognized as a deleterious contributor to fatal flight accidents. The purpose of the study was to establish a push-pull manoeuvre (PPM) simulation with a tri-axes centrifuge, studying the effect of this PPM on the +Gz tolerance, and to make this simulation suitable for pilot centrifuge training. The PPM was realized through pre-programmed acceleration profiles consisting of -1 Gz for 5 s followed by a +Gz plateau for 10 s. Relaxed +Gz tolerance recordings were obtained from 20 healthy male fighter aircraft pilots and 6 healthy male volunteers through exposure to pre-programmed profiles with and without previous -1 Gz exposure. A statistically significant decrease in +Gz tolerance was seen in all subjects after -1 Gz for 5 s exposure, 0.87 ± 0.13 G in the volunteer group and 0.95 ± 0.25 G in the pilot group. The ear opacity pulse as a +Gz tolerance endpoint criterion was sometimes found to be unreliable during the PPM experiments. The simulated PPM in this study elicited a PPE, which was obvious from the significant reduction in +Gz tolerance. The PPM profile appears useful to be included in centrifuge training.

  11. Push-pull alkenes: structure and p-electron distribution

    Directory of Open Access Journals (Sweden)

    ERICH KLEINPETER

    2006-01-01

    Full Text Available Push-pull alkenes are substituted alkenes with one or two electron-donating substituents on one end of C=C double bond and with one or two electron-accepting substituents at the other end. Allowance for p-electron delocalization leads to the central C=C double bond becoming ever more polarized and with rising push-pull character, the p-bond order of this double bond is reduced and, conversely, the corresponding p-bond orders of the C–Don and C–Acc bonds are accordingly increased. This push-pull effect is of decisive influence on both the dynamic behavior and the chemical reactivity of this class of compounds and thus it is of considerable interest to both determine and to quantify the inherent push-pull effect. Previously, the barriers to rotation about the C=C, C–Don and/or C–Acc partial double bonds (DG±, as determined by dynamic NMR spectroscopy or the 13C chemical shift difference of the polarized C=C partial double bond (DdC=C were employed for this purpose. However, these parameters can have serious limitations, viz. the barriers can be immeasurable on the NMR timescale (either by being too high or too low; heavily-biased conformers are present, etc. or DdC=C behaves in a non-additive manner with respect to the combination of the four substituents. Hence, a general parameter to quantify the push-pull effect is not yet available. Ab initio MO calculations on a collection of compounds, together with NBO analysis, provided valuable information on the structure, bond energies, electron occupancies and bonding/antibonding interactions. In addition to DG±C=C (either experimentally determined or theoretically calculated and DdC=C, the bond length of the C=C partial double bond was also examined and it proved to be a reliable parameter to quantify the push-pull effect. Equally so, the quotient of the occupation numbers of the antibonding andbonding p orbitals of the central C=C partial double bond ( p*C=C/ pC=C could also be employed for

  12. JİNEKOMASTİDE LİPOSAKŞIN VE PULL-THROUGH TEKNİĞİ KOMBİNASYONU

    OpenAIRE

    Karameşe, Mehtap; Keskin, Mustafa; Sütçü, Mustafa; Akdağ, Osman; Tosun, Zekeriya; Savacı, Nedim

    2011-01-01

    Jinekomasti, erkek meme dokusunun iyi huylu büyümesidir. Uygun bir bekleme süresi içersinde jinekomastide gerileme olmaz ise cerrahi müdahale uygulanabilir. Patolojik glandüler dokunun cerrahi tedavi ile çıkarılması istenmeyen skar oluşumu ile sonuçlanabilmektedir. ‘Pull-through’ tekniği ile kombine liposakşın uygulaması, minimal insizyon yeri gereksinimi ve ameliyat sonrası daha az skar dokusu oluşturması sebebiyle tercih edilebilmektedir. Bu çalışmada glandüler meme büyümesi olan adölesan h...

  13. High-Cycle, Push–Pull Fatigue Fracture Behavior of High-C, Si–Al-Rich Nanostructured Bainite Steel

    Science.gov (United States)

    Zhao, Jing; Ji, Honghong

    2017-01-01

    The high-cycle, push–pull fatigue fracture behavior of high-C, Si–Al-rich nanostructured bainitic steel was studied through the measurement of fatigue limits, a morphology examination and phase composition analysis of the fatigue fracture surface, as well as fractography of the fatigue crack propagation. The results demonstrated that the push–pull fatigue limits at 107 cycles were estimated as 710–889 MPa, for the samples isothermally transformed at the temperature range of 220–260 °C through data extrapolation, measured under the maximum cycle number of 105. Both the interior inclusion and the sample surface constituted the fatigue crack origins. During the fatigue crack propagation, a high amount of secondary cracks were formed in almost parallel arrangements. The apparent plastic deformation occurred in the fracture surface layer, which induced approximately all retained austenite to transform into martensite. PMID:29286325

  14. Pulling an intruder from a granular material: a novel depinning experiment

    Directory of Open Access Journals (Sweden)

    Zhang Yue

    2017-01-01

    Full Text Available Two-dimensional impact experiments by Clark et al. [2] identified the source of inertial drag to be caused by ‘collisions’ with a latent force network, leading to large fluctuations of the force experienced by the impactor. These collisions provided the major drag on an impacting intruder until the intruder was nearly at rest. As a complement, we consider controlled pull-out experiments where a buried intruder is pulled out of a material, starting from rest. This provides a means to better understand the non-inertial part of the drag force, and to explore the mechanisms associated with the force fluctuations. To some extent, the pull out process is a time reversed version of the impact process. In order to visualize this pulling process, we use 2D photoelastic disks from which circular intruders of different radii are pulled out. We present results about the dynamics of the intruder and the structures of the force chains inside the granular system as captured by slow and high speed imaging.

  15. A dimensionless ordered pull-through model of the mammalian lens epithelium evidences scaling across species and explains the age-dependent changes in cell density in the human lens

    Science.gov (United States)

    Wu, Jun Jie; Wu, Weiju; Tholozan, Frederique M.; Saunter, Christopher D.; Girkin, John M.; Quinlan, Roy A.

    2015-01-01

    We present a mathematical (ordered pull-through; OPT) model of the cell-density profile for the mammalian lens epithelium together with new experimental data. The model is based upon dimensionless parameters, an important criterion for inter-species comparisons where lens sizes can vary greatly (e.g. bovine (approx. 18 mm); mouse (approx. 2 mm)) and confirms that mammalian lenses scale with size. The validated model includes two parameters: β/α, which is the ratio of the proliferation rate in the peripheral and in the central region of the lens; and γGZ, a dimensionless pull-through parameter that accounts for the cell transition and exit from the epithelium into the lens body. Best-fit values were determined for mouse, rat, rabbit, bovine and human lens epithelia. The OPT model accounts for the peak in cell density at the periphery of the lens epithelium, a region where cell proliferation is concentrated and reaches a maximum coincident with the germinative zone. The β/α ratio correlates with the measured FGF-2 gradient, a morphogen critical to lens cell survival, proliferation and differentiation. As proliferation declines with age, the OPT model predicted age-dependent changes in cell-density profiles, which we observed in mouse and human lenses. PMID:26236824

  16. Optimization of Contact Force and Pull-in Voltage for Series based MEMS Switch

    Directory of Open Access Journals (Sweden)

    Abhijeet KSHIRSAGAR

    2010-04-01

    Full Text Available Cantilever based metal-to-metal contact type MEMS series switch has many applications namely in RF MEMS, Power MEMS etc. A typical MEMS switch consists of a cantilever as actuating element to make the contact between the two metal terminals of the switch. The cantilever is pulled down by applying a pull-in voltage to the control electrode that is located below the middle portion of the cantilever while only the tip portion of the cantilever makes contact between the two terminals. Detailed analysis of bending of the cantilever for different pull-in voltages reveals some interesting facts. At low pull-in voltage the cantilever tip barely touches the two terminals, thus resulting in very less contact area. To increase contact area a very high pull-in voltage is applied, but it lifts the tip from the free end due to concave curving of the cantilever in the middle region of the cantilever where the electrode is located. Again it results in less contact area. Furthermore, the high pull-in voltage produces large stress at the base of the cantilever close to the anchor. Therefore, an optimum, pull-in voltage must exist at which the concave curving is eliminated and contact area is maximum. In this paper authors report the finding of optimum contact force and pull-in voltage.

  17. Station Program Note Pull Automation

    Science.gov (United States)

    Delgado, Ivan

    2016-01-01

    Upon commencement of my internship, I was in charge of maintaining the CoFR (Certificate of Flight Readiness) Tool. The tool acquires data from existing Excel workbooks on NASA's and Boeing's databases to create a new spreadsheet listing out all the potential safety concerns for upcoming flights and software transitions. Since the application was written in Visual Basic, I had to learn a new programming language and prepare to handle any malfunctions within the program. Shortly afterwards, I was given the assignment to automate the Station Program Note (SPN) Pull process. I developed an application, in Python, that generated a GUI (Graphical User Interface) that will be used by the International Space Station Safety & Mission Assurance team here at Johnson Space Center. The application will allow its users to download online files with the click of a button, import SPN's based on three different pulls, instantly manipulate and filter spreadsheets, and compare the three sources to determine which active SPN's (Station Program Notes) must be reviewed for any upcoming flights, missions, and/or software transitions. Initially, to perform the NASA SPN pull (one of three), I had created the program to allow the user to login to a secure webpage that stores data, input specific parameters, and retrieve the desired SPN's based on their inputs. However, to avoid any conflicts with sustainment, I altered it so that the user may login and download the NASA file independently. After the user has downloaded the file with the click of a button, I defined the program to check for any outdated or pre-existing files, for successful downloads, to acquire the spreadsheet, convert it from a text file to a comma separated file and finally into an Excel spreadsheet to be filtered and later scrutinized for specific SPN numbers. Once this file has been automatically manipulated to provide only the SPN numbers that are desired, they are stored in a global variable, shown on the GUI, and

  18. Affective and Sensory Correlates of Hair Pulling in Pediatric Trichotillomania

    Science.gov (United States)

    Meunier, Suzanne A.; Tolin, David F.; Franklin, Martin

    2009-01-01

    Hair pulling in pediatric populations has not received adequate empirical study. Investigations of the affective and sensory states contributing to the etiology and maintenance of hair pulling may help to elucidate the classification of trichotillomania (TTM) as an impulse control disorder or obsessive-compulsive spectrum disorder. The current…

  19. Force direction in pushing and pulling and Musculo-Skeletal load

    NARCIS (Netherlands)

    Looze, M.P. de; Kuijer, P.P.F.M.

    1999-01-01

    In pushing and pulling wheeled objects, the effect of the exerted force on local musculo-skeletal loads depends on the direction of force exertion. Several questions about the direction of force exertion in pushing and pulling, the effects of handle height and force level on force direction, and the

  20. Impact of margin on tumour and normal tissue dosimetry in patients treated with IMRT using an endorectal balloon for prostate immobilization

    International Nuclear Information System (INIS)

    Ahmad, S.

    2004-01-01

    Full text: In treatment of prostate cancer with IMRT (Intensity Modulated Radiation Therapy), clinical target volume margin is determined by organ motion and set-up error. However, the margin width that achieves the desired dose escalation while minimizing normal tissue exposure is dependent upon the patient immobilization and/or organ localization techniques. In this study, we compare the impact of margin width on the dosimetry of tumour and normal tissues using the endorectal balloon for prostate immobilization. IMRT plans were generated for ten patients using margin widths of 0, 3, 5, 8 and 10 mm. Patients had a planning CT scan in the prone position with an endorectal balloon filled with 100 cc of air for prostate immobilization. The Corvus version 3.0.11 was used for treatment planning. The dose for the prostate and seminal vesicles was 70 Gy in 2 Gy per fractions, prescribed at the 83% isodose line. Dose restrictions to normal tissues were as follows: 33% of bladder was allowed to receive above 65 Gy, 15% of rectum above 68 Gy and 10% of femurs above 45 Gy. Analysis of Variance was used to compare the target and normal tissue doses. Tumour control probability and normal tissue complication probability calculations are currently being performed and will be presented. The mean doses ranged from 73.93 to 75.31 Gy for the prostate and from 73.71 to 75.31 Gy for the seminal vesicles. A 10 mm margin produced significantly lower mean doses compared to 0 or 5 mm for both targets (prostate p 0.062). For bladder and rectum the mean doses ranged from 18.49 to 22.30 Gy (p=0.605) and from 29.34 to 31.33 Gy (p=0.135), respectively, while the percent rectal volumes above 68 Gy were significantly higher for margins of 5, 8 and 10 mm (p<0.006) ranging from 10.72% to 15.81%. Mean doses to the femurs and pelvis were significantly higher for 8 and 10 mm margins, ranging from 20.9 to 29.39 Gy for femurs (p<0.015) and from 15.05 to 19.98 Gy for pelvis (p<0.0005). Also the percent

  1. Transvaginal Mesh and Transanal Resection to Treat Outlet Obstruction Constipation Caused by Rectocele.

    Science.gov (United States)

    Shi, Yang; Yu, Yongjun; Zhang, Xipeng; Li, Yuwei

    2017-02-01

    BACKGROUND The aim of this study was to evaluate the curative effect of transvaginal mesh repair (TVMR) and stapled transanal rectal resection (STARR) in treating outlet obstruction constipation caused by rectocele. MATERIAL AND METHODS Patients who had outlet obstruction constipation caused by rectocele were retrospectively analyzed and 39 patients were enrolled the study. Patients were assigned to either the TVMR or STARR group. Postoperative factors such as complications, pain, recurrence rate, and operative time were compared between the 2 groups. RESULTS Total effective rate was 100% in both groups. No long-term chronic pain occurred and discomfort rate of tenesmus was higher in the STARR group than in the TVMR group. Postoperative defecography showed that the rectocele depth was significantly reduced, and the prolapse of the rectal mucosa and the lower rectal capacity was also decreased. Four cases had mesh exposure in the TVMR group and 2 cases in the STARR group had anastomotic bleeding after the surgery. CONCLUSIONS For outlet obstruction constipation caused by rectocele, TVMR and STARR both obtained satisfactory results. Although TVMR is complex with longer operative time and hospitalization period, its long-term effect is better than that of STARR.

  2. Transvaginal Mesh and Transanal Resection to Treat Outlet Obstruction Constipation Caused by Rectocele

    Science.gov (United States)

    Shi, Yang; Yu, Yongjun; Zhang, Xipeng; Li, Yuwei

    2017-01-01

    Background The aim of this study was to evaluate the curative effect of transvaginal mesh repair (TVMR) and stapled transanal rectal resection (STARR) in treating outlet obstruction constipation caused by rectocele. Material/Methods Patients who had outlet obstruction constipation caused by rectocele were retrospectively analyzed and 39 patients were enrolled the study. Patients were assigned to either the TVMR or STARR group. Postoperative factors such as complications, pain, recurrence rate, and operative time were compared between the 2 groups. Results Total effective rate was 100% in both groups. No long-term chronic pain occurred and discomfort rate of tenesmus was higher in the STARR group than in the TVMR group. Postoperative defecography showed that the rectocele depth was significantly reduced, and the prolapse of the rectal mucosa and the lower rectal capacity was also decreased. Four cases had mesh exposure in the TVMR group and 2 cases in the STARR group had anastomotic bleeding after the surgery. Conclusions For outlet obstruction constipation caused by rectocele, TVMR and STARR both obtained satisfactory results. Although TVMR is complex with longer operative time and hospitalization period, its long-term effect is better than that of STARR. PMID:28146137

  3. High-Cycle, Push–Pull Fatigue Fracture Behavior of High-C, Si–Al-Rich Nanostructured Bainite Steel

    Directory of Open Access Journals (Sweden)

    Jing Zhao

    2017-12-01

    Full Text Available The high-cycle, push–pull fatigue fracture behavior of high-C, Si–Al-rich nanostructured bainitic steel was studied through the measurement of fatigue limits, a morphology examination and phase composition analysis of the fatigue fracture surface, as well as fractography of the fatigue crack propagation. The results demonstrated that the push–pull fatigue limits at 107 cycles were estimated as 710–889 MPa, for the samples isothermally transformed at the temperature range of 220–260 °C through data extrapolation, measured under the maximum cycle number of 105. Both the interior inclusion and the sample surface constituted the fatigue crack origins. During the fatigue crack propagation, a high amount of secondary cracks were formed in almost parallel arrangements. The apparent plastic deformation occurred in the fracture surface layer, which induced approximately all retained austenite to transform into martensite.

  4. Push-pull optical pumping of pure superposition states

    International Nuclear Information System (INIS)

    Jau, Y.-Y.; Miron, E.; Post, A.B.; Kuzma, N.N.; Happer, W.

    2004-01-01

    A new optical pumping method, 'push-pull pumping', can produce very nearly pure, coherent superposition states between the initial and the final sublevels of the important field-independent 0-0 clock resonance of alkali-metal atoms. The key requirement for push-pull pumping is the use of D1 resonant light which alternates between left and right circular polarization at the Bohr frequency of the state. The new pumping method works for a wide range of conditions, including atomic beams with almost no collisions, and atoms in buffer gases with pressures of many atmospheres

  5. 14 mrad Extraction Line Optics for Push-Pull

    International Nuclear Information System (INIS)

    Nosochkov, Y.; Moffeit, K.; Seryi, A.; Morse, W.; Parker, B.

    2007-01-01

    The ILC design is based on a single Interaction Region (IR) with 14 mrad crossing angle and two detectors in the 'push-pull' configuration, where the detectors can alternately occupy the Interaction Point (IP). Consequently, the IR optics must be compatible with different size detectors designed for different distance L* between the IP and the nearest quadrupole. This paper presents the push-pull optics for the ILC extraction line compatible with L*= 3.5 m to 4.5 m, and the simulation results of extraction beam loss at 500 GeV CM with detector solenoid

  6. Pulling cylindrical particles using a soft-nonparaxial tractor beam

    DEFF Research Database (Denmark)

    Novitsky, Andrey; Ding, Weiqiang; Wang, Maoyan

    2017-01-01

    In order to pull objects towards the light source a single tractor beam inevitably needs to be strongly nonparaxial. This stringent requirement makes such a tractor beam somewhat hypothetical. Here we reveal that the cylindrical shape of dielectric particles can effectively mitigate the nonparaxi......In order to pull objects towards the light source a single tractor beam inevitably needs to be strongly nonparaxial. This stringent requirement makes such a tractor beam somewhat hypothetical. Here we reveal that the cylindrical shape of dielectric particles can effectively mitigate...... the nonparaxiality requirements, reducing the incidence angle of the partial plane waves of the light beam down to 45 degrees and even to 30 degrees for respectively dipole and dipole-quadrupole objects. The optical pulling force attributed to the interaction of magnetic dipole and magnetic quadrupole moments...... and sorting of targeted particles....

  7. Abdominoperineal pull-through with simultaneous extravesical detrussoraphy: An alternative surgical technique for congenital pouch colon with high-grade vesicoureteric reflux

    Directory of Open Access Journals (Sweden)

    Monika Bawa

    2018-01-01

    Full Text Available Congenital pouch colon (CPC is frequently associated with vesicoureteric reflux (VUR. These patients require long-term antibiotic prophylaxis and/or an additional surgical intervention for the management of the refluxing system. We propose a single-stage alternative approach in these patients. Two patients diagnosed to have CPC underwent pouch excision and an end colostomy at birth. Further evaluation revealed high-grade reflux in both the patients. At 6 months of age, definitive abdominoperineal pull-through (APPT surgery along with extravesical detrusorrhaphy was performed. In the follow-up at 1 year, they are thriving well with no urinary complaints. Micturating cystourethrogram revealed complete resolution of VUR. This approach takes the advantage of the anesthesia for APPT and offers a relatively simple and quick solution for the refluxing system, thus, enabling the stoppage of antibiotic prophylaxis and obviating the need for a future endoscopy/surgery.

  8. Preliminary results of endorectal surface coil magnetic resonance imaging for local staging of prostate cancer

    International Nuclear Information System (INIS)

    Jager, G.H.; Barentsz, J.O.; Rosette, J.J.M.C.H. de la; Rosenbusch, G.

    1994-01-01

    Objective: To evaluate the effectiveness of endorectal surface coil (ERC) magnetic resonance imaging (MRI) in the local staging of adenocarcinoma of the prostate (ACP). Materials and methods: A total of 23 patients who were considered candidates for radical prostatectomy because of clinically localized ACP were examined by ERC-MRI. All patients underwent laparoscopic or open lymph-node dissection prior to surgery. Four patients had positive lymph nodes at operation. A total of 19 underwant radical prostatectomy, allowing comparison of the MRI data with the surgical pathologic findings. Results: Twelve patients had extraglandular spread of ACP (T3) and 7 had locally confined ACP (T2). ERC-MRI predicted correctly a T3 tumor in 10 of 12 cases and a T2 tumor in 4 of 7 cases. ERC-MRI was 74% accurate in differentiating T2 from T3 tumor. Three cases of overestimation were in studies with poor image quality because of bowel movement motion artifacts. Conclusion: ERC-MRI was found to be a sensitive modality in staging clinically localized ACP. (orig.) [de

  9. Complete eversion and prolapse of bladder following pulling out of a Foley catheter concurrent with uterine prolapse

    Directory of Open Access Journals (Sweden)

    Amulya M Acharya

    2007-01-01

    Full Text Available Complete eversion and transurethral prolapse of the urinary bladder is rare. We report a case of complete eversion and prolapse of bladder that occurred due to self pulling out of an indwelling Foley catheter in a 72-year-old woman. She presented with retention of urine concurrent with complete uterine procidentia. An indwelling Foley catheter was given to relieve the retention. The senile lady pulled out the catheter resulting in complete transurethral prolapse with bladder eversion. Under injection Midazolam sedation and with application of xylocain jelly the prolapsed bladder could be reduced manually back through the urethra. Definite corrective surgery was done later for the uterine prolapse.

  10. Effect of vitrification on number of inner cell mass in mouse blastocysts in conventional straw, closed pulled straw, open pulled straw and cryoloop carriers

    International Nuclear Information System (INIS)

    Ghasem, S.; Negar, K.

    2013-01-01

    Objective: To compare the effect of using open and closed carriers on count of inner cell mass in vitrified mouse blastocyst after warming. Methods: The experimental study was conducted at Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran, from April to September 2010. Forty female NMRI (Naval Medical Research Institute, USA) mice were injected with pregnant mares serum gonadotropin and human chorionic gonadotropin in order to induce super ovulation. Following the latter injection, two or three females were caged with the same-breed male mice. The presence of vaginal plug was examined the following morning. To collect blastocyst embryos, the pregnant females were sacrificed by cervical dislocation at 88-90 hours after the injection and dissected. Blastocysts were collected in phosphate-buffered saline and allocated to four groups: vitrification in conventional straw, closed pulled straw, open pulled straw and cryoloop. The vitrification solution was ethylene glycol, Ficol and sucrose (EFS) 20% and 40%. After storage for 1 month in liquid nitrogen, the blastocysts were thawed in 0.5 M sucrose then cultured in M16 medium. After 6 hours of culture, the number of expanded blastocysts was recorded and stained by double-dye technique. After staining, the number of total cell and inner cell mass was calculated. Results: The re-expansion rate of blastocysts in the cryoloop group (n=90; 78.26%) was significantly higher (p<0.05) than open pulled straw (n=83; 69.16%), closed pulled straw (n=68; 54.83%) and conventional straws (n=63; 51.21%) groups. Significant differences (p<0.05) in the number of inner cell mass in blastocysts vitrified in open pulled straws, closed straws and cryoloop with blastocysts cryopreserved in conventional straws. Conclusion: The re-expansion rate and total cell number of mouse blastocysts vitrified using open system had a better result compared with the closed system. The value of cryoloop and open pulled straws as carriers in

  11. Mechanism of oil-pulling therapy - in vitro study.

    Science.gov (United States)

    Asokan, Sharath; Rathinasamy, T K; Inbamani, N; Menon, Thangam; Kumar, S Senthil; Emmadi, Pamela; Raghuraman, R

    2011-01-01

    Oil pulling has been used extensively as a traditional Indian folk remedy without scientific proof for many years for strengthening teeth, gums and jaws and to prevent decay, oral malodor, bleeding gums and dryness of throat and cracked lips. The aim of this study was to evaluate the antibacterial activity of sesame oil and lignans isolated from sesame oil on oral microorganisms and to check whether saponification or emulsification occurs during oil-pulling therapy. The in vitro study was carried out in three different phases: (1) Antibacterial activity of the lignans and sesame oil were tested by minimum inhibitory concentration assay by agar dilution method and agar well diffusion method, respectively. (2) Increase in free fatty acid level of oil and the quantity of sodium hydroxide (NaOH) used up in the titration are good indicators of saponification process. This was assessed using analytical tests for vegetable oils. (3) Swished oil was observed under light microscope to assess the status of the oil, presence of microorganisms, oral debris and foreign bodies. Sesamin and sesamolin isolated from sesame oil did not have any antibacterial effect against oral microorganisms like Streptococcus mutans, Streptococcus mitis and Streptococcus viridans. Emulsification of sesame oil occurs during oil-pulling therapy. Increased consumption of NaOH in titration is a definite indication of a possible saponification process. The myth that the effect of oil-pulling therapy on oral health was just a placebo effect has been broken and there are clear indications of possible saponification and emulsification process, which enhances its mechanical cleaning action.

  12. Qualidade de vida do paciente submetido à Microcirurgia Endoscópica Transanal (TEM Quality of life after Transanal Endoscopic Microsurgery (TEM

    Directory of Open Access Journals (Sweden)

    Roberto da Silveira Moraes

    2007-03-01

    Full Text Available RACIONAL: A Microcirurgia Endoscópica Transanal (TEM é procedimento minimamente invasivo para o tratamento de tumores retais selecionados. Atualmente, existe crescente interesse médico na medida quantitativa da qualidade de vida. OBJETIVO: Avaliar a qualidade de vida dos pacientes submetidos a TEM no Serviço de Cirurgia do Aparelho Digestivo no Hospital de Clínicas da Universidade Federal do Paraná. MÉTODOS: Trata-se de um estudo observacional prospectivo e de coorte da avaliação da qualidade de vida após TEM. Trinta e quatro pacientes responderam a um questionário composto de 14 questões, abordando aspectos pós-operatórios e laborais. Dirigiam-se elas para levantar dados principalmente sobre: o consentimento informado; a dor experimentada após a operação; a capacidade de o paciente caminhar no período pós-operatório; o período para retorno às atividades habituais; a satisfação com a ausência de cicatriz pós-operatória; a incontinência no pós-operatório; se recomendaria a operação a um familiar ou conhecido. RESULTADOS: Todos os 34 pacientes relataram ter sido adequadamente informados sobre o procedimento. Ausência de dor pós-operatória foi observada em 82,5% e todos se mostraram capazes de deambular no 1º dia do pós-operatório. O retorno às atividades habituais deu-se em média sete dias após o procedimento. Somente cinco pacientes (14,70% apresentaram incontinência fecal transitória, não maior que uma semana. Três pacientes (8,82% necessitaram de re-internação, sendo dois por tumores residuais e outro por recidiva tumoral. Dois pacientes (5,88% referiram modificação temporária na vida sexual após a cirurgia e 97,05% indicariam a TEM a um familiar ou amigo. O período médio de internação foi de três dias. CONCLUSÃO: Os pacientes apresentaram boa evolução, com pouca dor pós-operatória, curto período de internação e baixo índice de complicações, mostrando satisfação e adequada

  13. [Active surveillance for prostate cancer: usefulness of endorectal MR at 1.5 Tesla with pelvic phased array coil in detecting significant tumors].

    Science.gov (United States)

    Luyckx, F; Hallouin, P; Barré, C; Aillet, G; Chauveau, P; Hétet, J-F; Bouchot, O; Rigaud, J

    2011-02-01

    To describe and assess MRI signs of significant tumor in a series of patients who all underwent radical prostatectomy and also fulfilled criteria to choose active surveillance according to French "SurAcaP" protocol. The clinical reports of 681 consecutive patients operated on for prostate cancer between 2002 and 2007 were reviewed retrospectively. All patients had endorectal MR (1.5 Tesla) with pelvic phased array coil. (1.5 T erMR PPA). Sixty-one patients (8.9%) fulfilled "SurAcaP" protocol criteria. Preoperative data (MR+core biopsy) were assessed by comparison to whole-mount step section pathology. 85.3% of the 61 patients entering SurAcaP protocol had significant tumor at pathology. (Non Organ Confined Disease (Non OCD)=8.2%, Gleason sum score>6=39.2%). A new exclusion criterion has been assessed: T3MRI±NPS>1 as a predictor tool of significant tumor. ("T3MRI±NPS>1"=Non OCD at MR±number of positive sextants involved in tumor at MR and/or Core Biopsy > to 1). Sensitivity, specificity, PPV, NPV of the criterion "T3MRI±NPS>1" in predicting significant tumor were, respectively: 77%, 33%, 86%, 20%. Adding this criterion to other criteria of the "SurAcaP" protocol could allow the exclusion of all Non OCD, and a decrease in Gleason sum Score>6 rates (20%). Endorectal MR at 1.5 Tesla with pelvic-phased array coil should be considered when selecting patients for active surveillance in the management of prostate cancer. A criterion based upon MR and core biopsy findings, called "T3MR±NSP>1" may represent an exclusion citeria due to its ability to predict significant tumor. Copyright © 2010 Elsevier Masson SAS. All rights reserved.

  14. Pulling a polymer with anisotropic stiffness near a sticky wall

    International Nuclear Information System (INIS)

    Tabbara, R; Owczarek, A L

    2012-01-01

    We solve exactly a two-dimensional partially directed walk model of a semi-flexible polymer that has one end tethered to a sticky wall, while a pulling force away from the adsorbing surface acts on the free end of the walk. This model generalizes a number of previously considered adsorption models by incorporating individual horizontal and vertical stiffness effects, in competition with a variable pulling angle. A solution to the corresponding generating function is found by means of the kernel method. While the phases and related phase transitions are similar in nature to those found previously the analysis of the model in terms of its physical variables highlights various novel structures in the shapes of the phase diagrams and related behaviour of the polymer. We review the results of previously considered sub-cases, augmenting these findings to include analysis with respect to the model’s physical variables—namely, temperature, pulling force, pulling angle away from the surface, stiffness strength and the ratio of vertical to horizontal stiffness potentials, with our subsequent analysis for the general model focusing on the effect that stiffness has on this pulling angle range. In analysing the model with stiffness we also pay special attention to the case where only vertical stiffness is included. The physical analysis of this case reveals behaviour more closely resembling that of an upward pulling force acting on a polymer than it does of a model where horizontal stiffness acts. The stiffness–temperature phase diagram exhibits re-entrance for low temperatures, previously only seen for three-dimensional or co-polymer models. For the most general model we delineate the shift in the physical behaviour as we change the ratio of vertical to horizontal stiffness between the horizontal-only and the vertical-only stiffness regimes. We find that a number of distinct physical characteristics will only be observed for a model where the vertical stiffness dominates

  15. Push-Pull Ventilation in a Painting Shop for Large Steel Constructions

    DEFF Research Database (Denmark)

    Svidt, Kjeld; Heiselberg, Per

    This paper describes the analysis of a push-pull ventilation system for a painting shop that is used for painting steel chimneys and windmill towers.......This paper describes the analysis of a push-pull ventilation system for a painting shop that is used for painting steel chimneys and windmill towers....

  16. Friction Pull Plug Welding in Aluminum Alloys

    Science.gov (United States)

    Brooke, Shane A.; Bradford, Vann

    2012-01-01

    NASA's Marshall Space Flight Center (MSFC) has recently invested much time and effort into the process development of Friction Pull Plug Welding (FPPW). FPPW, is a welding process similar to Friction Push Plug Welding in that, there is a small rotating part (plug) being spun and simultaneously pulled (forged) into a larger part. These two processes differ, in that push plug welding requires an internal reaction support, while pull plug welding reacts to the load externally. FPPW was originally conceived as a post proof repair technique for the Space Shuttle fs External Tank. FPPW was easily selected as the primary weld process used to close out the termination hole on the Constellation Program's ARES I Upper Stage circumferential Self-Reacting Friction Stir Welds (SR-FSW). The versatility of FPPW allows it to also be used as a repair technique for both SR-FSW and Conventional Friction Stir Welds. To date, all MSFC led development has been concentrated on aluminum alloys (2195, 2219, and 2014). Much work has been done to fully understand and characterize the process's limitations. A heavy emphasis has been spent on plug design, to match the various weldland thicknesses and alloy combinations. This presentation will summarize these development efforts including weld parameter development, process control, parameter sensitivity studies, plug repair techniques, material properties including tensile, fracture and failure analysis.

  17. The string-pulling paradigm in comparative psychology.

    Science.gov (United States)

    Jacobs, Ivo F; Osvath, Mathias

    2015-05-01

    String pulling is one of the most widely used paradigms in comparative psychology. First documented 2 millennia ago, it has been a well-established scientific paradigm for a century. More than 160 bird and mammal species have been tested in over 200 studies with countless methodological variations. The paradigm can be used to address a wide variety of issues on animal cognition; for example, what animals understand about contact and connection as well as whether they rely on perceptual feedback, grasp the functionality of strings, generalize across conditions, apply their knowledge flexibly, and possess insight. Mammals are typically tested on a horizontal configuration, birds on a vertical one, making the studies difficult to compare; in particular, pulling a string vertically requires better coordination and attention. A species' performance on the paradigm is often influenced by its ecology, especially concerning whether limbs are used for foraging. Many other factors can be of importance and should be considered. The string-pulling paradigm is easy to administer, vary, and apply to investigate a wide array of cognitive abilities. Although it can be and has been used to compare species, divergent methods and unclear reporting have limited its comparative utility. With increasing research standards, the paradigm is expected to become an even more fundamental tool in comparative psychology. (c) 2015 APA, all rights reserved).

  18. Image-guided method for TLD-based in vivo rectal dose verification with endorectal balloon in proton therapy for prostate cancer

    International Nuclear Information System (INIS)

    Hsi, Wen C.; Fagundes, Marcio; Zeidan, Omar; Hug, Eugen; Schreuder, Niek

    2013-01-01

    Purpose: To present a practical image-guided method to position an endorectal balloon that improves in vivo thermoluminiscent dosimeter (TLD) measurements of rectal doses in proton therapy for prostate cancer. Methods: TLDs were combined with endorectal balloons to measure dose at the anterior rectal wall during daily proton treatment delivery. Radiopaque metallic markers were employed as surrogates for balloon position reproducibility in rotation and translation. The markers were utilized to guide the balloon orientation during daily treatment employing orthogonal x-ray image-guided patient positioning. TLDs were placed at the 12 o'clock position on the anterior balloon surface at the midprostatic plane. Markers were placed at the 3 and 9 o'clock positions on the balloon to align it with respect to the planned orientation. The balloon rotation along its stem axis, referred to as roll, causes TLD displacement along the anterior-posterior direction. The magnitude of TLD displacement is revealed by the separation distance between markers at opposite sides of the balloon on sagittal x-ray images. Results: A total of 81 in vivo TLD measurements were performed on six patients. Eighty-three percent of all measurements (65 TLD readings) were within +5% and −10% of the planning dose with a mean of −2.1% and a standard deviation of 3.5%. Examination of marker positions with in-room x-ray images of measured doses between −10% and −20% of the planned dose revealed a strong correlation between balloon roll and TLD displacement posteriorly from the planned position. The magnitude of the roll was confirmed by separations of 10–20 mm between the markers which could be corrected by manually adjusting the balloon position and verified by a repeat x-ray image prior to proton delivery. This approach could properly correct the balloon roll, resulting in TLD positioning within 2 mm along the anterior-posterior direction. Conclusions: Our results show that image-guided TLD

  19. An investigation into the cognition behind spontaneous string pulling in New Caledonian crows.

    Directory of Open Access Journals (Sweden)

    Alex H Taylor

    Full Text Available The ability of some bird species to pull up meat hung on a string is a famous example of spontaneous animal problem solving. The "insight" hypothesis claims that this complex behaviour is based on cognitive abilities such as mental scenario building and imagination. An operant conditioning account, in contrast, would claim that this spontaneity is due to each action in string pulling being reinforced by the meat moving closer and remaining closer to the bird on the perch. We presented experienced and naïve New Caledonian crows with a novel, visually restricted string-pulling problem that reduced the quality of visual feedback during string pulling. Experienced crows solved this problem with reduced efficiency and increased errors compared to their performance in standard string pulling. Naïve crows either failed or solved the problem by trial and error learning. However, when visual feedback was available via a mirror mounted next to the apparatus, two naïve crows were able to perform at the same level as the experienced group. Our results raise the possibility that spontaneous string pulling in New Caledonian crows may not be based on insight but on operant conditioning mediated by a perceptual-motor feedback cycle.

  20. The geometry of pull-apart basins in the southern part of Sumatran strike-slip fault zone

    Science.gov (United States)

    Aribowo, Sonny

    2018-02-01

    Models of pull-apart basin geometry have been described by many previous studies in a variety tectonic setting. 2D geometry of Ranau Lake represents a pull-apart basin in the Sumatran Fault Zone. However, there are unclear geomorphic traces of two sub-parallel overlapping strike-slip faults in the boundary of the lake. Nonetheless, clear geomorphic traces that parallel to Kumering Segment of the Sumatran Fault are considered as inactive faults in the southern side of the lake. I demonstrate the angular characteristics of the Ranau Lake and Suoh complex pull-apart basins and compare with pull-apart basin examples from published studies. I use digital elevation model (DEM) image to sketch the shape of the depression of Ranau Lake and Suoh Valley and measure 2D geometry of pull-apart basins. This study shows that Ranau Lake is not a pull-apart basin, and the pull-apart basin is actually located in the eastern side of the lake. Since there is a clear connection between pull-apart basin and volcanic activity in Sumatra, I also predict that the unclear trace of the pull-apart basin near Ranau Lake may be covered by Ranau Caldera and Seminung volcanic products.

  1. A demonstration of NIOSH push-pull ventilation criteria.

    Science.gov (United States)

    Klein, M K

    1987-03-01

    This paper summarizes the results of a study performed on an actual chrome plating tank in order to validate criteria for push-pull ventilation systems developed by Huebener and Hughes at NIOSH. Validation of the criteria was made by taking area industrial hygiene samples for hexavalent and total chrome at ten locations around the plating tank. The sampling was performed during actual production runs or while the tank was operating with a dummy load. The sampling data are summarized. The data show that the push-pull system, operating at Huebener's criteria, could control emissions to below the current standards and guidelines. Conclusions and recommendations are included.

  2. Impact of Androstenone on Leash Pulling and Jumping Up in Dogs

    Directory of Open Access Journals (Sweden)

    Glenna Pirner

    2016-05-01

    Full Text Available Dogs are relinquished to shelters due to behavioral problems, such as leash pulling and jumping up. Interomones are chemical cues produced by one species that elicit a response in a different species. We reported earlier that androstenone, a swine sex pheromone, acts as an interomone to reduce barking in dogs. Here we report two models using 10 dogs/study: a dog jumping and a dog walking model. For the leash-pulling model, each time the dog pulled on the leash the walker either did nothing (NOT, or sprayed the dog with water (H2O, androstenone + water (ANH, androstenone 0.1 µg/mL (AND1, or androstenone 1.0 µg/mL (AND2. The number of pulls during each walk was counted. For the jumping up model, each time the dog jumped the researcher did nothing (NOT, or sprayed the dog with H2O, ANH, AND1, or AND2. The number of jumps and the time between jumps were recorded. In Study 1, ANH, AND1, and AND2 each reduced leash pulling more than NOT and H2O (p< 0.01. In Study 2, all treatments were effective in reducing jumping up behavior. Androstenone reduced jumping up, but not beyond that elicited by a spray of water alone. We conclude that androstenone in multiple delivery vehicles reduced leash pulling. The burst of air intended as a disruptive stimulus in the correction sprays may be too harsh for more sensitive dogs, and as such use of these sprays is cautioned in these animals. For other dogs, this interomone can be used to stop some behavior immediately or as a part of a training program to reduce undesirable behavior.

  3. Beyond Knut Holt's fusion model, balancing market pull and technology push

    NARCIS (Netherlands)

    Nagel, A.P.

    2003-01-01

    Should a firm rely on market pull or on technology push? Some scholars have extreme opinions on this and firms do switch emphasis on push and pull over time. Knut Holt, the first president of ISPIM, presented his so-called Fusion Model in the early 1970s to shed light onto this debate. This paper

  4. Low-back and shoulder complaints among workers with pushing and pulling tasks

    NARCIS (Netherlands)

    Hoozemans, Marco J. M.; van der Beek, Allard J.; Fring-Dresen, Monique H. W.; van der Woude, Luc H. V.; van Dijk, Frank J. H.

    2002-01-01

    Objectives Low-back and shoulder complaints were examined in relation to self-reported and objectively assessed exposure to work-related pushing and pulling. Methods Workers from several companies (eg, nursing homes and flower auctions) with pushing and pulling tasks and, as reference, workers

  5. Do geography and resources influence the need for colostomy in Hirschsprung′s disease and anorectal malformations? A Canadian association of paediatric surgeons: Association of paediatric surgeons of Nigeria survey

    Directory of Open Access Journals (Sweden)

    Lukman O. Abdur-Rahman

    2014-01-01

    Full Text Available Background: This survey compared surgical management of Hirschsprung′s disease (HD and anorectal malformations (ARM in high and low resource settings. Materials and Methods: An online survey was sent to 208 members of the Canadian Association of Paediatric Surgeons (CAPS and the Association of Paediatric Surgeons of Nigeria (APSON. Results: The response rate was 76.8% with 127 complete surveys (APSON 34, CAPS 97. Only 29.5% of APSON surgeons had frozen section available for diagnosis of HD. They were more likely to choose full thickness rectal biopsy (APSON 70.6% vs. CAPS 9.4%, P < 0.05 and do an initial colostomy for HD (APSON 23.5% vs. CAPS 0%, P < 0.05. Experience with trans-anal pull-through for HD was similar in both groups (APSON 76.5%, CAPS 66.7%. CAPS members practising in the United States were more likely to perform a one-stage pull-through for HD during the initial hospitalization (USA 65.4% vs. Canada 28.3%, P < 0.05. The frequency of colostomy in females with vestibular fistula varied widely independent of geography. APSON surgeons were less likely to have enterostomal therapists and patient education resources. Conclusions: Local resources which vary by geographic location affect the management of HD and ARM including colostomy. Collaboration between CAPS and APSON members could address resource and educational needs to improve patient care.

  6. RATE-DEPENDENT PULL-OUT BEARING CAPACITY OF PILES BY SIMILITUDE MODEL TESTS USING SEEPAGE FORCE

    Science.gov (United States)

    Kato, Tatsuya; Kokusho, Takaji

    Pull-out test of model piles was conducted by varying the pull-out velocity and skin friction of piles using a seepage force similitude model test apparatus. Due to the seepage consolidation under the pressure of 150kPa, the effective stress distribution in a prototype saturated soil of 17m could be successfully reproduced in the model ground of 28cm thick, in which the pull-out tests were carried out. The pull-out load rose to a peak value at small displacement, and then decreased to a residual value. At the same time, pore pressure in the vicinity of the pile decreased due to suction near the tip and the positive dilatancy near the pile skin. The maximum pull-out load, pile axial load, side friction and the corresponding displacement increased dramatically with increasing pull-out velocity. It was found that these rate-dependent trends become more prominent with increasing skin friction.

  7. How to manage a late diagnosed Hirschsprung′s disease

    Directory of Open Access Journals (Sweden)

    Mohamed Ouladsaiad

    2016-01-01

    Full Text Available Background: How to manage a late diagnosed Hirschsprung′s disease (HD and how to avoid calibre discrepancy? Subjects and Methods: A retrospective study of all patients diagnosed with HD over 2 years in our hospital from January 2009 to December 2012. Data were analysed for clinical presentations, investigations, surgical procedures and post-operative outcome. Results: Fifteen patients, operated by one single surgeon, were included in this study. The mean age was 6 years (2-16 years. Patients had an ultra-short segment type in 4 cases, rectosigmoid type in 9 cases and descending colonic aganglionosis in 2 cases. Rectal wash out was effective in 12 patients. A blowhole transverse colostomy was performed in 2 patients. Twelve patients underwent one single stage endorectal pull-through. Anastomosis incongruence was avoided by a plication procedure never described before. The assessment of post-operative outcomes by the paediatric incontinence and constipation scoring system revealed a normal continence function in all our patients, but 3 patients suffered from soiling secondary to constipation. Conclusion: One single stage pull-through can be safe and effective in children with late diagnosed HD. Routine rectal washout is a good way to prepare the colon. In some cases, blowhole colostomy can be an option. Anastomosis incongruence is a challenge; we describe a plication procedure to avoid it.

  8. Pretreatment Endorectal Coil Magnetic Resonance Imaging Findings Predict Biochemical Tumor Control in Prostate Cancer Patients Treated With Combination Brachytherapy and External-Beam Radiotherapy

    International Nuclear Information System (INIS)

    Riaz, Nadeem; Afaq, Asim; Akin, Oguz; Pei Xin; Kollmeier, Marisa A.; Cox, Brett; Hricak, Hedvig; Zelefsky, Michael J.

    2012-01-01

    Purpose: To investigate the utility of endorectal coil magenetic resonance imaging (eMRI) in predicting biochemical relapse in prostate cancer patients treated with combination brachytherapy and external-beam radiotherapy. Methods and Materials: Between 2000 and 2008, 279 men with intermediate- or high-risk prostate cancer underwent eMRI of their prostate before receiving brachytherapy and supplemental intensity-modulated radiotherapy. Endorectal coil MRI was performed before treatment and retrospectively reviewed by two radiologists experienced in genitourinary MRI. Image-based variables, including tumor diameter, location, number of sextants involved, and the presence of extracapsular extension (ECE), were incorporated with other established clinical variables to predict biochemical control outcomes. The median follow-up was 49 months (range, 1–13 years). Results: The 5-year biochemical relapse-free survival for the cohort was 92%. Clinical findings predicting recurrence on univariate analysis included Gleason score (hazard ratio [HR] 3.6, p = 0.001), PSA (HR 1.04, p = 0.005), and National Comprehensive Cancer Network risk group (HR 4.1, p = 0.002). Clinical T stage and the use of androgen deprivation therapy were not correlated with biochemical failure. Imaging findings on univariate analysis associated with relapse included ECE on MRI (HR 3.79, p = 0.003), tumor size (HR 2.58, p = 0.04), and T stage (HR 1.71, p = 0.004). On multivariate analysis incorporating both clinical and imaging findings, only ECE on MRI and Gleason score were independent predictors of recurrence. Conclusions: Pretreatment eMRI findings predict for biochemical recurrence in intermediate- and high-risk prostate cancer patients treated with combination brachytherapy and external-beam radiotherapy. Gleason score and the presence of ECE on MRI were the only significant predictors of biochemical relapse in this group of patients.

  9. Pushing and pulling: an assessment tool for occupational health and safety practitioners.

    Science.gov (United States)

    Lind, Carl Mikael

    2018-03-01

    A tool has been developed for supporting practitioners when assessing manual pushing and pulling operations based on an initiative by two global companies in the manufacturing industry. The aim of the tool is to support occupational health and safety practitioners in risk assessment and risk management of pushing and pulling operations in the manufacturing and logistics industries. The tool is based on a nine-multiplier equation that includes a wide range of factors affecting an operator's health risk and capacity in pushing and pulling. These multipliers are based on psychophysical, physiological and biomechanical studies in combination with judgments from an expert group consisting of senior researchers and ergonomists. In order to consider usability, more than 50 occupational health and safety practitioners (e.g., ergonomists, managers, safety representatives and production personnel) participated in the development of the tool. An evaluation by 22 ergonomists supports that the push/pull tool is user friendly in general.

  10. Subtle trade-off existing between (anti)aromaticity, push-pull interaction, keto-enol tautomerism, and steric hindrance when defining the electronic properties of conjugated structures.

    Science.gov (United States)

    Kleinpeter, Erich; Bölke, Ute; Koch, Andreas

    2010-07-22

    The spatial magnetic properties (through space NMR shieldings, TSNMRS) of conjugated structures (benzenoid/quinonoid keto/enol tautomers, 1,3-dihydroxyaryl-2-aldehydes, Don-pi-Acc chromophores with trade-off existing push-pull vs aromatic behavior) have been calculated by the GIAO perturbation method employing the nucleus independent chemical shift (NICS) concept, and visualized as iso-chemical-shielding surfaces (ICSS) of various size and direction. The TSNMRS values, thus obtained, can be successfully employed to quantify and visualize (anti)aromaticity and to identify readily hereby zwitterionic structures due to push-pull behavior of the compounds studied. In addition, the push-pull behavior was quantified by the quotient (pi*/pi) approach of the central partial C=C double bond.

  11. Gastric pull-up reconstruction combined with free jejunal transfer (FJT) following total pharyngolaryngo-oesophagectomy (PLE).

    Science.gov (United States)

    Ni, Song; Zhu, Yiming; Li, Dezhi; Li, Zhengjiang; Wu, Yuehuang; Xu, Zhengang; Liu, Shaoyan

    2015-06-01

    Reconstruction following total pharyngolaryngo-oesophagectomy (PLE) still challenges surgeons because of the extreme length of removed tissue. Gastric pull-up reconstruction, one of the most common reconstructive methods after PLE, has many complications such as anastomotic fistula and gastric necrosis caused by the high anastomotic tension. However, modifications of gastric pull-up reconstruction aiming to reducing the high anastomotic tension have been less reported compared with other aspects with this technique. Here we report a modified gastric pull-up reconstruction combined with free jejunal transfer (FTJ) to reduce the anastomosis tension, and thus to reduce the risk of complications after PLE. Patients underwent a standard surgical procedure including total pharyngolaryngo-oesophagectomy and bilateral internal jugular lymph nodal clearance. A free jejunal graft about 10 cm was harvested and placed in the appropriate position between mobilized stomach and oropharynx. The anastomosis between the free jejunal graft and the gastric tube was created through a stapler. Vascular anastomosis was made between the jejunal artery and the transverse cervical artery, and between the jejunal vein and the internal jugular vein. Hand suturing technique was used in the anastomosis between jejunum and pharynx. None of the patients suffered from any complications such as anastomotic fistula. Both patients resumed early postoperative oral intake. So far, they remain free of tumor recurrence and are in good health for 46 and 18 months, respectively. Considering the tumor status and the patient condition, the gastric pull-up reconstruction combined with FJT after PLE could be a reliable choice. Copyright © 2015 IJS Publishing Group Limited. Published by Elsevier Ltd. All rights reserved.

  12. Future application of Czochralski crystal pulling for silicon

    Science.gov (United States)

    Matlcok, J. H.

    1985-08-01

    Czochralski (Cz) crystal pulling has been the predominant method used for preparing silicon single crystal for the past twenty years. The fundamental technology used has changed little. However, great strides have been made in learning how to make the crystals bigger and of better quality at ever increasing productivity rates. Currently charge sizes of 50 kg of polycrystal silicon are being used for production and crystals up to ten inches in diameter have been grown without major difficulty. The largest material actually being processed in silicon wafer form is 150 mm (6 inches) in diameter. Growing of crystals in a magnetic field has proved to be particularly useful for microscopic impurity control. Major developments in past years on equipment for Cz crystal pulling have included the automatic growth control of the diameter as well as the starting core of the crystal, the use of magnetic fields and around the crystal puller to supress convection, various recharging schemes for dopant control and the use of continuous liquid feed in the crystal puller. The latter, while far from being a reliable production process, is ideal in concept for major improvement in Cz crystal pulling. The Czochralski process will maintain its dominance of silicon crystal production for many years.

  13. Post-Transurethral Resection of the Prostate Inflation of Pressure-Controlled Endorectal Balloon-Impact on Postoperative Bleeding: A Preliminary Experimental Pilot Study.

    Science.gov (United States)

    Mohyelden, Khaled; Ibrahim, Hamdy; Abdel-Kader, Osman; Sherief, Mahmoud H; El-Nashar, Ahmed; Shaker, Hosam; Elkoushy, Mohamed A

    2016-02-01

    To evaluate the impact of rectal balloon (RB) inflation on post-transurethral resection of the prostate (TURP) bleeding in patients with symptomatic benign prostatic hyperplasia. After institutional review board approval, patients who were eligible for TURP were randomized into two equal groups, depending on whether they received postoperative endorectal balloon (RB) (GII) or not (GI). The tip of three-way Foley catheter was fixed to a balloon by a blaster strip to prepare air-tight RB. Postoperatively, the RB was inflated for 15 minutes by a pressure-controlled sphygmomanometer. Perioperative data were compared between both groups, including hemoglobin (Hb) deficit 24-hour postoperatively and at time of discharge. Functional outcomes, anorectal complaints, and adverse events were assessed perioperatively and after 1 and 3 months. Fifty patients were enrolled, including 13 (26%) patients who presented with indwelling urethral catheters. Baseline data and mean resected tissue weight were comparable between both groups, including preoperative Hb (p = 0.17). Immediate postoperative Hb deficit was, comparable between GI and GII patients (0.58 ± 0.18 vs 0.60 ± 0.2, p = 0.56) before RB inflation, respectively. However, compared to GI patients, mean Hb deficit significantly decreased in GII patients 24-hour postoperatively (0.2 ± 0.2 vs 0.7 ± 0.3 g, p = 0.002) and at time of discharge (0.8 ± 0.2 vs 1.3 ± 0.4 g, p = 0.003). GII patients needed significantly less postoperative irrigation (2.1 ± 1.6 vs 8.3 ± 1.8 L, p hematuria or clot retention in either group, while there were no anorectal complaints reported by GII patients. Post-TURP endorectal balloon inflation seems to be simple, safe, and an efficient procedure to reduce postoperative bleeding and irrigation volume. It is significantly associated with shorter catheterization time and hospital stay.

  14. Upper body push and pull strength ratio in recreationally active adults.

    Science.gov (United States)

    Negrete, Rodney J; Hanney, William J; Pabian, Patrick; Kolber, Morey J

    2013-04-01

    Agonist to antagonist strength data is commonly analyzed due to its association with injury and performance. The purpose of this study was to examine the agonist to antagonist ratio of upper body strength using two simple field tests (timed push up/timed modified pull up) in recreationally active adults and to establish the basis for reference standards. One hundred eighty (180) healthy recreationally active adults (111 females and 69 males, aged 18-45 years) performed two tests of upper body strength in random order: 1. Push-ups completed during 3 sets of 15 seconds with a 45 second rest period between each set and 2. Modified pull-ups completed during 3 sets of 15 seconds with a 45 second rest period between each set. The push-up to modified pull-up ratio for the males was 1.57:1, whereas females demonstrated a ratio of 2.72:1. The results suggest that for our group of healthy recreationally active subjects, the upper body "pushing" musculature is approximately 1.5-2.7 times stronger than the musculature involved for pulling. In this study, these recreationally active adults displayed greater strength during the timed push-ups than the modified pull-ups. The relationship of these imbalances to one's performance and or injury risk requires further investigation. The reference values, however, may serve the basis for future comparison and prospective investigations. The field tests in this study can be easily implemented by clinicians and an agonist/antagonist ratio can be determined and compared to our findings. 2b.

  15. Positioning of microtubule organizing centers by cortical pushing and pulling forces

    International Nuclear Information System (INIS)

    Pavin, Nenad; Ma Rui; Jülicher, Frank; Laan, Liedewij; Dogterom, Marileen

    2012-01-01

    Positioning of microtubule (MT) organizing centers with respect to the confining geometry of cells depends on pushing and/or pulling forces generated by MTs that interact with the cell cortex (Dogterom et al 2005 Curr. Opin. Cell Biol. 17 67–74). How, in living cells, these forces lead to proper positioning is still largely an open question. Recently, it was shown by in vitro experiments using artificial microchambers that in a square geometry, MT asters center more reliably by a combination of pulling and pushing forces than by pushing forces alone (Laan et al 2012a Cell 148 502–14). These findings were explained by a physical description of aster mechanics that includes slipping of pushing MT ends along chamber boundaries. In this paper, we extend that theoretical work by studying the influence of the shape of the confining geometry on the positioning process. We find that pushing and pulling forces can have centering or off-centering behavior in different geometries. Pushing forces center in a one-dimensional and a square geometry, but lead to off-centering in a circle if slipping is sufficiently pronounced. Pulling forces, however, do not center in a one-dimensional geometry, but improve centering in a circle and a square. In an elongated stadium geometry, positioning along the short axis depends mainly on pulling forces, while positioning along the long axis depends mainly on pushing forces. Our theoretical results suggest that different positioning strategies could be used by different cell types. (paper)

  16. On-bead chemical synthesis and display of phosphopeptides for affinity pull-down proteomics

    DEFF Research Database (Denmark)

    Malene, Brandt; Madsen, Jens C.; Bunkenborg, Jakob

    2006-01-01

    We describe a new method for phosphopeptide proteomics based on the solid-phase synthesis of phosphopeptides on beads suitable for affinity pull-down experiments. Peptide sequences containing the Bad Ser112 and Ser136 phosphorylation motifs were used as bait in affinity pull-down experiments...... (aldehyde) at the C terminus for potential activity-based proteomics. The synthetic support-bound Bad phosphopeptides were able to pull down 14-3-3zeta. Furthermore, Bad phosphopeptides bound endogenous 14-3-3 proteins, and all seven members of the 14-3-3 family were identified by mass spectrometry....... In control experiments, none of the unphosphorylated Bad peptides bound transfected 14-3-3zeta or endogenous 14-3-3. We conclude that the combined synthesis and display of phosphopeptides on-bead is a fast and efficient method for affinity pull-down proteomics....

  17. Simultaneously 'pushing' and 'pulling' graphene oxide into low-polar solvents through a designed interface.

    Science.gov (United States)

    Liu, Zhen; Liu, Jingquan; Wang, Yichao; Razal, Joselito M; Francis, Paul S; Biggs, Mark J; Barrow, Colin J; Yang, Wenrong

    2018-08-03

    Dispersing graphene oxide (GO) in low-polar solvents can realize a perfect self-assembly with functional molecules and application in removal of organic impurities that only dissolve in low-polar solvents. The surface chemistry of GO plays an important role in its dispersity in these solvents. The direct transfer of hydrophilic GO into low-polar solvents, however, has remained an experimental challenge. In this study, we design an interface to transfer GO by simultaneously 'pushing and pulling' the nanosheets into low-polar solvents. Our approach is outstanding due to the ability to obtain monolayers of chemically reduced GO (CRGO) with designed surface properties in the organic phase. Using the transferred GO or CRGO dispersions, we have fabricated GO/fullerene nanocomposites and assessed the ability of CRGOs for dye adsorption. We hope our work can provide a universal approach for the phase transfer of other nanomaterials.

  18. Development of a program BFQ/VER1 to simulate vapour pull through and liquid entrainment under stratified flow condition

    International Nuclear Information System (INIS)

    Majumdar, P.; Mukhopadyay, D.; Lele, H.G.; Gupta, S.K.

    2000-08-01

    Whether in process industries or nuclear industries, we come across lot of horizontal components, where two-phase or two-component fluids exist in normal or abnormal working conditions. Situations which lead to separation of the phases sees vapour pull through or liquid entrainment phenomena occurring when fluid discharges from horizontal components to the off - take branches. In order to capture the phenomena and applying it to the Indian PHWR during LOCA, a program 'BFQ' has been developed using various models for different fluids and conditions. These models have been validated with various experimental data available in the literature. Smoglie's model has been found to comply with most of the experiments even though it has been developed for air-water system. A modification of the model also been successfully used for feeders located at 45 deg. The result has been well validated with Hassan (1997) experiment for the same configuration. For a typical case of LOCA, RELAP4/MOD6, a widely used Homogenous model for simulating systems, is found to over predict the off-take flow quality from Header under stratified flow condition. (author)

  19. Circular stapled pyloroplasty: a fast and effective technique for pyloric disruption during esophagectomy with gastric pull-up.

    Science.gov (United States)

    Oezcelik, A; DeMeester, S R; Hindoyan, K; Leers, J M; Ayazi, S; Abate, E; Zehetner, J; Hagen, J A; Lipham, J C; DeMeester, T R

    2011-08-01

    The necessity of pyloroplasty after esophagectomy and gastric pull-up is debated. Disadvantages of a standard pyloroplasty include the potential for leak, shortening of the length of the graft, and complexity when done during a minimally invasive procedure. The aim of this study is to report our experience with a novel internal pyloroplasty technique using a circular stapler (CS pyloroplasty), which is applicable for both laparoscopic and open esophagectomy. The records of all patients who underwent an esophagectomy with gastric pull-up and pyloroplasty between 2002 and 2007 were reviewed. The CS pyloroplasty was performed through a lesser curve gastrotomy with a 21-mm CS, while the standard pyloroplasty entailed a longitudinal full thickness incision through the pylorus with mucosal closure in the same direction and a Graham patch. A CS pyloroplasty was performed in 144 and a standard pyloroplasty in 133 patients. The median patient age was 66years, and the median follow-up was 17months, and was similar for both types of pyloroplasty. Routine postoperative videoesophagram was significantly more likely to show a delay in contrast transit through the pylorus after standard pyloroplasty (16% standard vs. 8% CS pyloroplasty, P= 0.03). Significantly more patients had postoperative endoscopy after standard pyloroplasty (40% standard vs. 24% CS pyloroplasty, P= 0.004), but the frequency of pyloric dilatation was similar. There were no leaks with either technique. A circular stapled pyloroplasty is as efficacious as a standard pyloroplasty after esophagectomy with gastric pull-up. Potential advantages include the ease and simplicity of the procedure along with virtually no risk of a leak and no graft shortening. The technique is amenable to both open and minimally invasive procedures. © 2011 Copyright the Authors. Journal compilation © 2011, Wiley Periodicals, Inc. and the International Society for Diseases of the Esophagus.

  20. Ultrasonic Evaluation of the Pull-Off Adhesion between Added Repair Layer and a Concrete Substrate

    Science.gov (United States)

    Czarnecki, Slawomir

    2017-10-01

    This paper concerns the evaluation of the pull-off adhesion between a concrete added repair layer with variable thickness and a concrete substrate, based on parameters assessed using ultrasonic pulse velocity (UPV) method. In construction practice, the experimental determination of pull-off adhesion f b, between added repair layer and a concrete substrate is necessary to assess the quality of repair. This is usually carried out with the use of pull-off method which results in local damage of the added concrete layer in all the testing areas. Bearing this in mind, it is important to describe the method without these disadvantages. The prediction of the pull-off adhesion of the two-layer concrete elements with variable thickness of each layer might be provided by means of UPV method with two-sided access to the investigated element. For this purpose, two-layered cylindrical specimens were obtained by drilling the borehole from a large size specially prepared concrete element. Those two-layer elements were made out of concrete substrate layer and Polymer Cement Concrete (PCC) mortar as an added repair layer. The values of pull-off adhesion f b of the elements were determined before obtaining the samples by using the semi-destructive pull-off method. The ultrasonic wave velocity was determined in samples with variable thickness of each layer and was then compared to theoretical ultrasonic wave velocity predicted for those specimens. The regression curve for the dependence of velocity and pull-off adhesion, determined by the pulloff method, was made. It has been proved that together with an increase of ratio of investigated ultrasonic wave velocity divided by theoretical ultrasonic wave velocity, the pull-off adhesion value f b between added repair layer with variable thickness and a substrate layer also increases.

  1. Positive Harris recurrence and diffusion scale analysis of a push pull queueing network

    NARCIS (Netherlands)

    Nazarathy, J.; Weiss, G.

    2010-01-01

    We consider a push pull queueing network with two servers and two types of job which are processed by the two servers in opposite order, with stochastic generally distributed processing times. This push pull network was introduced by Kopzon and Weiss, who assumed exponential processing times. It is

  2. [Anatomical planes and landmarks of transanal total mesorectal excision for rectal cancer and prophylaxis of intraoperative complications].

    Science.gov (United States)

    Shen, Zhanlong; Ye, Yingjiang; Wang, Shan

    2017-07-25

    Total mesorectal excision (TME) is a mile-stone procedure in the history of rectal cancer surgery, but the exposure of surgical field of distal rectum is usually poor in patients with male, obese and narrow pelvis, which may lead to tumor residue and relative complications. Recently, a new technique called transanal TME (taTME) is considered to solve the above problems, but most medical centers are still in the learning curve of this procedure. Therefore, anatomical planes and landmarks of taTME for rectal cancer and prophylaxis of intraoperative complications are induced in this paper, which includes posterior plane: angle of anus and distal mesorectum and bleeding of mesorectum; rectosacral fascia and presacral bleeding; lateral and posterior-lateral plane: posterior branches of pelvic plexus and damage of anal function; anterior plane: vessel branches of neurovascular bundle and bleeding. Familiarity with the specific anatomical planes and landmarks plays an important role in shortening the learning curve, decreasing the complications, increasing the success rate of operation and standardization of taTME.

  3. Transanal endoscopic microsurgery versus laparoscopic lower anterior resection for the treatment of T1-2 rectal cancers.

    Science.gov (United States)

    Chen, Yue-yu; Liu, Zhao-hui; Zhu, Kun; Shi, Pei-dong; Yin, Lu

    2013-06-01

    It remains unknown whether transanal endoscopic microsurgery (TEMS) is superior to laparoscopic lower anterior resection (LAR) for the treatment of rectal cancer. This study aimed to compare the surgical and oncological effectiveness as well as safety of TEMS and LAR in T1-2 rectal cancer patients. T1-2N0 rectal cancer patients were prospectively and randomly assigned to local excision using TEMS (n=30) or radical resection using LAR (n=30). The primary outcome measures were postoperative recovery course. The operative duration of TEMS was significantly shorter than that of LAR (130.3±16.7 minutes vs. 198.7±16.8 minutes, pTEMS group restarted bowel movement significantly earlier than the LAR group (51.4±5.4h vs. 86.2±8.7h, pTEMS, respectively; no patient (0/30, 0.0%) developed local recurrence following LAR. TEMS was associated with more rapid postoperative recovery and minimal surgical morbidity in T1-2 rectal cancer patients as compared to LAR.

  4. Incidence, treatment and outcome of rectal stenosis following transanal endoscopic microsurgery.

    Science.gov (United States)

    Barker, J A; Hill, J

    2011-09-01

    As an alternative to more radical abdominal surgery, transanal endoscopic microsurgery (TEM) offers a minimally invasive solution for the excision of certain rectal polyps and early-stage rectal tumours. The patient benefits of TEM as compared to radical abdominal surgery are clear; nevertheless, some drawback is possible. The aim of our study was to determine the risk factors, treatment and outcomes of rectal stenosis following TEM. We analysed a series of 354 consecutive patients who underwent TEM for benign or malignant rectal tumours between 1997 and 2009. We recorded the maximum histological diameter of the lesion, and whether the lesion was circumferential. Rectal stenosis was defined as a rectal narrowing not allowing passage of a 12 mm sigmoidoscope. Histological results with a measured specimen diameter were available in 304 of the 354 cases. There were 11 stenoses in total (3.6%), 7 stenoses due to 9 circumferential lesions (78%) and 4 due to lesions with a maximum diameter ≥ 5 cm (3.2%). Two patients presented as emergencies, and the other 9 patients reported symptoms of increased stool frequency at follow-up. Three of the stenoses were associated with recurrent disease. All stenoses were treated by a combination of endoscopic/radiological balloon dilatation or surgically with Hegar's dilators. A median of two procedures were required to treat stenoses until resolution of symptoms. Rectal stenosis following TEM excision is rare. It is predictable in patients with circumferential lesions but is rare in patients with non-circumferential lesions with a maximum diameter ≥ 5 cm. It is effectively treated with surgical or balloon dilatation. Most patients require repeated treatments.

  5. Motion and shape change when using an endorectal balloon during prostate radiation therapy

    International Nuclear Information System (INIS)

    Court, Laurence E.; D'Amico, Anthony V.; Kadam, Dnyanesh; Cormack, Robert

    2006-01-01

    Purpose: To investigate motion and shape change when using an endorectal balloon (ERB) in patients receiving radiotherapy for prostate cancer. Methods: In nine patients treated for prostate cancer using an ERB, the anterior wall of the ERB was contoured on right lateral images taken immediately before irradiation, and on left lateral images taken immediately after irradiation. Changes in the contours were used to calculate inter-fraction shape change and inter-imaging motion and shape change. Inter-imaging motion describes changes that occur after the right lateral image is taken that are seen in the left lateral image. Results: Eighty-six percent of all inter-imaging shifts of the anterior wall of the ERB were in the posterior direction (mean: 1.8 mm, 1 SD: 1.8 mm, maximum posterior shift: 2.8-7.2 mm). The inter-fraction shape change (1 SD) of the anterior wall was equivalent to a change in the angle of the balloon of 2.5-5.7 deg., with a range of 8-20 deg., depending on the patient. Inter-imaging shape changes were similar in size. Conclusions: The inter-imaging motion and shape changes may be explained by the patient relaxing some time after insertion of the ERB, indicating that it could be reduced by a waiting period after insertion before irradiation. Development of image-guided localization strategies should consider intra-fraction motion and also inter- and intra-fraction shape change

  6. MR spectroscopic imaging studies of prostate cancer: comparison of body coil and endorectal coil

    International Nuclear Information System (INIS)

    Li Xinmin; Wang Xiaoying; Guo Xuemei; Wang He; Jiang Xuexiang

    2009-01-01

    Objective: To compare the diagnostic value of MRS acquired by body coil (BODY) and endorectal Coil (ERC) in the detection of prostate cancer. Methods: MRI and 3D MRS were performed in 12 patients with prostate disease, in which 6 of them were proved to have prostate cancer and the other 6 noncancerous disease. Both BODY and ERC MRS were performed in 7 patients, and only BODY MRS was performed in the other 5 patients. All MRS data were quantitatively assessed with a per-sextant method. The metabolic ratio of (Choline + Creatine)/Citrate [(Cho + Crc )/Cit] was measured in each ROI. ROC analysis was carried out to assess and to compare the diagnostic value of BODY and ERC MRS in patients with prostate cancer with Wilcoxon test. Results: (1) The ratios of (Cho + Cre)/Cit in the prostate cancer group (median 1.744, 0.295 to 7.998) was statistically higher than that in the non-prostate cancer group (median 0.412, 0.112 to 2.113)acquired by using BODY MRS(Z=-9.159, P 0.05). (4) ROC analysis for diagnosing prostate cancer showed no significant difference (P=0.851 ) between the areas under the curve of BODY and that of ERC MRS (Az=0.931 and 0.935 respectively). Conclusion: The BODY MRS could provide comparable diagnostic efficacy to ERC MRS in patients with prostate cancer. (authors)

  7. An evaluation of the fluoroscopy-guided percutaneous gastrostomy with the pull technique

    International Nuclear Information System (INIS)

    Uhm, Chang Wook; Won, Jong Yun; Yu, Jeong Sik; Ko, Heung Kyu; Lee, Kwang Hun; Lee, Do Yun; Lee, Jong Tae

    2008-01-01

    To evaluate the safety and usefulness of the fluoroscopy-guided percutaneous gastrostomy (FPG) using a large profile gastrostomy tube accompanied with the pull technique, and without the use of an endoscopy or a gastropexy. From March 2005 to February 2007, 25 patients underwent an FPG using a large profile gastrostomy tube accompanied by the pull technique, in which a 24F pull-type tube was inserted into a patient's mouth and was pulled to the upper abdominal puncture site using a snare, under fluoroscopy. The 18 patients with difficulty swallowing due to muscular atrophic lateral sclerosis or transitional myodystrophy included 5 cases of quadriplegia, 1 case of Parkinson's disease, and 1 metastatic mediastinal tumor. The technical success rate, occurrence of complications, and clinical outcomes were examined. The technical success rate was found to be 100%. In addition, the retention periods for the indwelling tube ranged from 1 to 24 months (mean: 6.5 months), with all tubes retained at a normal position with normal function. No procedure-related mortality occurred. One patient (4%) did however develop a complication in the form of ascites and ascitic fluid leakage around the tube, which was of hepatic origin and was ultimately resolved after the drainage of ascites. As a result of this study the FPG, accompanied with the pull technique using a 24F tube, should be considered as a safe and effective method for examining patients. It was found to have a high success rate and a low complication rate

  8. An evaluation of the fluoroscopy-guided percutaneous gastrostomy with the pull technique

    Energy Technology Data Exchange (ETDEWEB)

    Uhm, Chang Wook; Won, Jong Yun; Yu, Jeong Sik; Ko, Heung Kyu; Lee, Kwang Hun; Lee, Do Yun; Lee, Jong Tae [Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2008-04-15

    To evaluate the safety and usefulness of the fluoroscopy-guided percutaneous gastrostomy (FPG) using a large profile gastrostomy tube accompanied with the pull technique, and without the use of an endoscopy or a gastropexy. From March 2005 to February 2007, 25 patients underwent an FPG using a large profile gastrostomy tube accompanied by the pull technique, in which a 24F pull-type tube was inserted into a patient's mouth and was pulled to the upper abdominal puncture site using a snare, under fluoroscopy. The 18 patients with difficulty swallowing due to muscular atrophic lateral sclerosis or transitional myodystrophy included 5 cases of quadriplegia, 1 case of Parkinson's disease, and 1 metastatic mediastinal tumor. The technical success rate, occurrence of complications, and clinical outcomes were examined. The technical success rate was found to be 100%. In addition, the retention periods for the indwelling tube ranged from 1 to 24 months (mean: 6.5 months), with all tubes retained at a normal position with normal function. No procedure-related mortality occurred. One patient (4%) did however develop a complication in the form of ascites and ascitic fluid leakage around the tube, which was of hepatic origin and was ultimately resolved after the drainage of ascites. As a result of this study the FPG, accompanied with the pull technique using a 24F tube, should be considered as a safe and effective method for examining patients. It was found to have a high success rate and a low complication rate.

  9. Mechanism of oil-pulling therapy -In vitro study

    Directory of Open Access Journals (Sweden)

    Sharath Asokan

    2011-01-01

    Conclusion: The myth that the effect of oil-pulling therapy on oral health was just a placebo effect has been broken and there are clear indications of possible saponification and emulsification process, which enhances its mechanical cleaning action.

  10. Minimizing pulling geometry errors in atomic force microscope single molecule force spectroscopy.

    Science.gov (United States)

    Rivera, Monica; Lee, Whasil; Ke, Changhong; Marszalek, Piotr E; Cole, Daniel G; Clark, Robert L

    2008-10-01

    In atomic force microscopy-based single molecule force spectroscopy (AFM-SMFS), it is assumed that the pulling angle is negligible and that the force applied to the molecule is equivalent to the force measured by the instrument. Recent studies, however, have indicated that the pulling geometry errors can drastically alter the measured force-extension relationship of molecules. Here we describe a software-based alignment method that repositions the cantilever such that it is located directly above the molecule's substrate attachment site. By aligning the applied force with the measurement axis, the molecule is no longer undergoing combined loading, and the full force can be measured by the cantilever. Simulations and experimental results verify the ability of the alignment program to minimize pulling geometry errors in AFM-SMFS studies.

  11. Fluoroscopy-Guided Removal of Pull-Type Gastrostomy Tubes

    International Nuclear Information System (INIS)

    Ahlers, Christopher M.; Schneider, Jens; Lachmann, Ricarda; Herber, Sascha; Dueber, Christoph; Pitton, Michael B.

    2008-01-01

    These case reports demonstrate a radiologic interventional technique for removal of pull-type gastrostomy tubes. This approach proved to be a safe and efficient procedure in two patients. The procedure may be applicable in situations where endoscopic attempts fail.

  12. A novel transanal tube designed to prevent anastomotic leakage after rectal cancer surgery: the WING DRAIN.

    Science.gov (United States)

    Nishigori, Hideaki; Ito, Masaaki; Nishizawa, Yuji

    2017-04-01

    We introduce a novel transanal tube (TAT), named the "WING DRAIN", designed to prevent anastomotic leakage after rectal cancer surgery, and report the fundamental experiments that led to its development. We performed the basic experiments to evaluate the effect of TATs on intestinal decompression, the changes they make in patterns of watery fluid drainage, the changes in their decompression effect when the extension tube connecting the TAT to the collection bag fills with watery drainage fluid, and the variations in intestinal contact and crushing pressure made by some types of TAT. Any type of TAT contributed to decompression in the intestinal tract. Watery drainage commenced from when the water level first rose to the hole in the tip of drain. The intestinal pressure increased with the length of the vertical twist in an extension tube. The crushing pressures of most types of TAT were high enough to cause injury to the intestine. We resolved the problems using an existing TAT for the purpose of intestinal decompression and by creating the first specialized TAT designed to prevent anastomotic leakage after rectal cancer surgery in Japan.

  13. Effect of honeybee stinger and its microstructured barbs on insertion and pull force.

    Science.gov (United States)

    Ling, Jintian; Song, Zhenhua; Wang, Jiarui; Chen, Keyun; Li, Jiyu; Xu, Shujia; Ren, Lei; Chen, Zhipeng; Jin, Dianwen; Jiang, Lelun

    2017-04-01

    Worker honeybee is well-known for its stinger with microscopic backward-facing barbs for self-defense. The natural geometry of the stinger enables painless penetration and adhesion in the human skin to deliver poison. In this study, Apis cerana worker honeybee stinger and acupuncture microneedle (as a barbless stinger) were characterized by Scanning Electron Microscope (SEM). The insertion and pull process of honeybee stinger into rabbit skin was performed by a self-developed mechanical loading equipment in comparison with acupuncture needle. In order to better understand the insertion and pull mechanisms of the stinger and its barbs in human multilayer skin, a nonlinear finite element method (FEM) was conducted. Experimental results showed that the average pull-out force of the stinger was 113.50mN and the average penetration force was only 5.75mN. The average penetration force of the stinger was about one order of magnitude smaller than that of an acupuncture microneedle while the average pull-out force was about 70 times larger than that of an acupuncture microneedle. FEM results showed that the stress concentrations were around the stinger tip and its barbs during the insertion process. The barbs were jammed in and torn the skin during the pull process. The insertion force of the stinger was greatly minimized due to its ultrasharp stinger tip and barbs while the pull force was seriously enhanced due to the mechanical interlocking of the barbs in the skin. These excellent properties are mainly a result of optimal geometry evolved by nature. Such finding may provide an inspiration for the further design of improved tissue adhesives and micro-needles for painless transdermal drug delivery and bio-signal recording. Copyright © 2017 Elsevier Ltd. All rights reserved.

  14. Micro/nano-mechanical test system employing tensile test holder with push-to-pull transformer

    Science.gov (United States)

    Oh, Yunje; Cyrankowski, Edward; Shan, Zhiwei; Asif, Syed Amanula Syed

    2013-05-07

    A micromachined or microelectromechanical system (MEMS) based push-to-pull mechanical transformer for tensile testing of micro-to-nanometer scale material samples including a first structure and a second structure. The second structure is coupled to the first structure by at least one flexible element that enables the second structure to be moveable relative to the first structure, wherein the second structure is disposed relative to the first structure so as to form a pulling gap between the first and second structures such that when an external pushing force is applied to and pushes the second structure in a tensile extension direction a width of the pulling gap increases so as to apply a tensile force to a test sample mounted across the pulling gap between a first sample mounting area on the first structure and a second sample mounting area on the second structure.

  15. MRI of prostate zonal anatomy with an endorectal surface coil; Anatomie zonale de la prostate par IRM endorectale

    Energy Technology Data Exchange (ETDEWEB)

    Cornud, F.; Belin, X.; Melki, P.; Helenon, O.; Cretien, Y.; Dufour, B.; Moreau, J.F. [Hopital Necker-Enfants-Malades, 75 - Paris (France)

    1995-01-01

    The development of an endorectal surface coil now permits a partial study of the anatomical model developed by McNeal. Axial and coronal views, which were used to establish the model can be obtained in a short period of time with fast spin echo sequences. Axial views are performed along the proximal urethra and coronal views are performed along the axis of the distal urethra and the ejaculatory duts. Anatomical boundaries of the transitional zone are well delineated on axial views, illustrating the concept of `inner gland`. The prostatic capsule and the neuro-vascular bundles, pathways of extension of the cancer out of the prostate are also well delineated. Coronal sections allow a very good anatomical study of the caudal junction of the vas deferens and the seminal vesicles (the so called weak space), pathway of tumor extension to the seminal vesicles. Differences in signal of the prostatic zones make the outer gland cancers very conspicuous as well as some transitional cancers which can show, in some cases, an homogeneous hyposignal. (authors). 15 refs., 14 figs.

  16. Transanal endoscopic microsurgery versus endoscopic mucosal resection for large rectal adenomas (TREND-study).

    Science.gov (United States)

    van den Broek, Frank J C; de Graaf, Eelco J R; Dijkgraaf, Marcel G W; Reitsma, Johannes B; Haringsma, Jelle; Timmer, Robin; Weusten, Bas L A M; Gerhards, Michael F; Consten, Esther C J; Schwartz, Matthijs P; Boom, Maarten J; Derksen, Erik J; Bijnen, A Bart; Davids, Paul H P; Hoff, Christiaan; van Dullemen, Hendrik M; Heine, G Dimitri N; van der Linde, Klaas; Jansen, Jeroen M; Mallant-Hent, Rosalie C H; Breumelhof, Ronald; Geldof, Han; Hardwick, James C H; Doornebosch, Pascal G; Depla, Annekatrien C T M; Ernst, Miranda F; van Munster, Ivo P; de Hingh, Ignace H J T; Schoon, Erik J; Bemelman, Willem A; Fockens, Paul; Dekker, Evelien

    2009-03-13

    Recent non-randomized studies suggest that extended endoscopic mucosal resection (EMR) is equally effective in removing large rectal adenomas as transanal endoscopic microsurgery (TEM). If equally effective, EMR might be a more cost-effective approach as this strategy does not require expensive equipment, general anesthesia and hospital admission. Furthermore, EMR appears to be associated with fewer complications.The aim of this study is to compare the cost-effectiveness and cost-utility of TEM and EMR for the resection of large rectal adenomas. Multicenter randomized trial among 15 hospitals in the Netherlands. Patients with a rectal adenoma > or = 3 cm, located between 1-15 cm ab ano, will be randomized to a TEM- or EMR-treatment strategy. For TEM, patients will be treated under general anesthesia, adenomas will be dissected en-bloc by a full-thickness excision, and patients will be admitted to the hospital. For EMR, no or conscious sedation is used, lesions will be resected through the submucosal plane in a piecemeal fashion, and patients will be discharged from the hospital. Residual adenoma that is visible during the first surveillance endoscopy at 3 months will be removed endoscopically in both treatment strategies and is considered as part of the primary treatment. Primary outcome measure is the proportion of patients with recurrence after 3 months. Secondary outcome measures are: 2) number of days not spent in hospital from initial treatment until 2 years afterwards; 3) major and minor morbidity; 4) disease specific and general quality of life; 5) anorectal function; 6) health care utilization and costs. A cost-effectiveness and cost-utility analysis of EMR against TEM for large rectal adenomas will be performed from a societal perspective with respectively the costs per recurrence free patient and the cost per quality adjusted life year as outcome measures. Based on comparable recurrence rates for TEM and EMR of 3.3% and considering an upper-limit of 10

  17. The effects of biting and pulling on the forces generated during feeding in the Komodo dragon (Varanus komodoensis).

    Science.gov (United States)

    D'Amore, Domenic C; Moreno, Karen; McHenry, Colin R; Wroe, Stephen

    2011-01-01

    In addition to biting, it has been speculated that the forces resulting from pulling on food items may also contribute to feeding success in carnivorous vertebrates. We present an in vivo analysis of both bite and pulling forces in Varanus komodoensis, the Komodo dragon, to determine how they contribute to feeding behavior. Observations of cranial modeling and behavior suggest that V. komodoensis feeds using bite force supplemented by pulling in the caudal/ventrocaudal direction. We tested these observations using force gauges/transducers to measure biting and pulling forces. Maximum bite force correlates with both body mass and total body length, likely due to increased muscle mass. Individuals showed consistent behaviors when biting, including the typical medial-caudal head rotation. Pull force correlates best with total body length, longer limbs and larger postcranial motions. None of these forces correlated well with head dimensions. When pulling, V. komodoensis use neck and limb movements that are associated with increased caudal and ventral oriented force. Measured bite force in Varanus komodoensis is similar to several previous estimations based on 3D models, but is low for its body mass relative to other vertebrates. Pull force, especially in the ventrocaudal direction, would allow individuals to hunt and deflesh with high success without the need of strong jaw adductors. In future studies, pull forces need to be considered for a complete understanding of vertebrate carnivore feeding dynamics.

  18. Investigation of the Effect of Internal Mold Release Agent and Filler on the Pulling Force in Pultrusion Process

    Directory of Open Access Journals (Sweden)

    M. Esfandeh

    2007-08-01

    Full Text Available Pulling force is one of the most important variables in pultrusion process which determines the capacity of the pultrusion machine. One of the characteristics of a desired pultrusion process is a low pulling force and a high line speed.Among the important factors affecting the pulling force are the internal mold release agent (IMR and the content and particle size of the filler in resin formulation. In addition to facilitating the part separation from the die, IMR also affects the curing kinetics and in turn the pulling force. In this research, a commercial IMR has been used in a range 1-5 phr. DSC and DMTAAnalyses showed that the presence of IMR in concentrations above 3 phr reduces the heat of curing reaction and also the curing rate. This results in an increase in pulling force. Study of filler effect showed that the increase in filler content from 4 to 8 phr reduces the pulling force but beyond that it is increased. Also, decreasing the filler particle size in line speed lower than 30 cm/min reduces the pulling force but increases it at higher line speed.

  19. Removal of Airborne Contaminants from a Surface Tank by a Push-Pull System

    DEFF Research Database (Denmark)

    Heiselberg, Per; Topp, Claus

    Open surface tanks are used in many industrial processes, and local exhaust systems are often designed to capture and remove toxic fumes diffused from materials in the tanks prior to their escape into the workplace environment. The push-pull system seems to be the most efficient local exhaust...... system, but proper design is required to ensure health and safety of the workers and, furthermore, it is very desirable from an energy conservation point of view to determine an optimum and -an efficient design of push-pull hoods which can exhaust all contaminants with a minimum quantity of volume flow....... The paper describes and discusses different design methods and compares designed values with results from a measurement series of push-pull system efficiency....

  20. Discussion of push-pull equilibrium in well field at Yining in-situ leaching mine, Xinjiang

    International Nuclear Information System (INIS)

    Wang Haifeng; Su Xuebin

    1999-01-01

    Combined with a case of in-situ leaching project, the author discusses the principle and approaches for push-pull equilibrium controlling, and gives the suggestions solving the un-equilibrium problems of push-pull in well field during operation

  1. Evaluation of a peridomestic mosquito trap for integration into an Aedes aegypti (Diptera: Culicidae) push-pull control strategy.

    Science.gov (United States)

    Salazar, Ferdinand V; Achee, Nicole L; Grieco, John P; Prabaripai, Atchariya; Eisen, Lars; Shah, Pankhil; Chareonviriyaphap, Theeraphap

    2012-06-01

    We determined the feasibility of using the BG-Sentinel™ mosquito trap (BGS) as the pull component in a push-pull strategy to reduce indoor biting by Aedes aegypti. This included evaluating varying numbers of traps (1-4) and mosquito release numbers (10, 25, 50, 100, 150, 200, and 250) on recapture rates under screen house conditions. Based on these variations in trap and mosquito numbers, release intervals were rotated through a completely randomized design with environmental factors (temperature, relative humidity, and light intensity) and monitored throughout each experiment. Data from four sampling time points (05:30, 09:30, 13:30, and 17:30) indicate a recapture range among treatments of 66-98%. Furthermore, 2-3 traps were as effective in recapturing mosquitoes as 4 traps for all mosquito release numbers. Time trends indicate Day 1 (the day the mosquitoes were released) as the "impact period" for recapture with peak numbers of marked mosquitoes collected at 09:30 or 4 h post-release. Information from this study will be used to guide the configuration of the BGS trap component of a push-pull vector control strategy currently in the proof-of-concept stage of development in Thailand and Peru. © 2012 The Society for Vector Ecology.

  2. Placement of effective work-in-progress limits in route-specific unit-based pull systems

    NARCIS (Netherlands)

    Ziengs, N.; Riezebos, J.; Germs, R.

    2012-01-01

    Unit-based pull systems control the throughput time of orders in a production system by limiting the number of orders on the shop floor. In production systems where orders can follow different routings on the shop floor, route-specific pull systems that control the progress of orders on the shop

  3. Pull-in and wrinkling instabilities of electroactive dielectric actuators

    International Nuclear Information System (INIS)

    De Tommasi, D; Puglisi, G; Zurlo, G; Saccomandi, G

    2010-01-01

    We propose a model to analyse the insurgence of pull-in and wrinkling failures in electroactive thin films. We take into consideration both cases of voltage and charge control, the role of pre-stretch and the size of activated regions, which are all crucial factors in technological applications of electroactive polymers (EAPs). Based on simple geometrical and material assumptions we deduce an explicit analytical description of these phenomena, allowing a clear physical interpretation of different failure mechanisms such as the occurrence of pull-in and wrinkling. Despite our simple assumptions, the comparison with experiments shows a good qualitative and, interestingly, quantitative agreement. In particular our model shows, in accordance with experiments, the existence of different optimal pre-stretch values, depending on the choice of the actuating parameter of the EAP.

  4. Pull-in and wrinkling instabilities of electroactive dielectric actuators

    Energy Technology Data Exchange (ETDEWEB)

    De Tommasi, D; Puglisi, G; Zurlo, G [Dipartimento di Ingegneria Civile e Ambientale, Politecnico di Bari, 70125 Bari (Italy); Saccomandi, G [Dipartimento di Ingegneria Industriale, Universita degli Studi di Perugia, 06125 Perugia (Italy)

    2010-08-18

    We propose a model to analyse the insurgence of pull-in and wrinkling failures in electroactive thin films. We take into consideration both cases of voltage and charge control, the role of pre-stretch and the size of activated regions, which are all crucial factors in technological applications of electroactive polymers (EAPs). Based on simple geometrical and material assumptions we deduce an explicit analytical description of these phenomena, allowing a clear physical interpretation of different failure mechanisms such as the occurrence of pull-in and wrinkling. Despite our simple assumptions, the comparison with experiments shows a good qualitative and, interestingly, quantitative agreement. In particular our model shows, in accordance with experiments, the existence of different optimal pre-stretch values, depending on the choice of the actuating parameter of the EAP.

  5. UK pulls out of plans for ILC

    CERN Multimedia

    Durrani, Matin

    2007-01-01

    "A funding crisis at one of the UK's leading research councils has forced the country to pull out of plans for the International Linear Collider (ILC). The science and Technology Facilities Council (STFC) says in a report published today that it does not see "a practicable path towards the realization of this facility as currently conceived on a reasonable timescale". (1 page)

  6. The effects of biting and pulling on the forces generated during feeding in the Komodo dragon (Varanus komodoensis.

    Directory of Open Access Journals (Sweden)

    Domenic C D'Amore

    Full Text Available In addition to biting, it has been speculated that the forces resulting from pulling on food items may also contribute to feeding success in carnivorous vertebrates. We present an in vivo analysis of both bite and pulling forces in Varanus komodoensis, the Komodo dragon, to determine how they contribute to feeding behavior. Observations of cranial modeling and behavior suggest that V. komodoensis feeds using bite force supplemented by pulling in the caudal/ventrocaudal direction. We tested these observations using force gauges/transducers to measure biting and pulling forces. Maximum bite force correlates with both body mass and total body length, likely due to increased muscle mass. Individuals showed consistent behaviors when biting, including the typical medial-caudal head rotation. Pull force correlates best with total body length, longer limbs and larger postcranial motions. None of these forces correlated well with head dimensions. When pulling, V. komodoensis use neck and limb movements that are associated with increased caudal and ventral oriented force. Measured bite force in Varanus komodoensis is similar to several previous estimations based on 3D models, but is low for its body mass relative to other vertebrates. Pull force, especially in the ventrocaudal direction, would allow individuals to hunt and deflesh with high success without the need of strong jaw adductors. In future studies, pull forces need to be considered for a complete understanding of vertebrate carnivore feeding dynamics.

  7. Gadolinium-enhanced dynamic magnetic resonance imaging with endorectal coil for local staging of rectal cancer

    International Nuclear Information System (INIS)

    Tamakawa, Mitsuharu; Kawaai, Yuriko; Shirase, Ryuji

    2010-01-01

    The aim of this study was to evaluate the accuracy of dynamic gadolinium (Gd)-enhanced magnetic resonance imaging (MRI) with endorectal coil for assessing tumor invasion based on simple classification criteria. A total of 58 patients with operable primary rectal cancer underwent preoperative MRI. An enhancement pattern in Gd-enhanced dynamic MRI with regard to tumor penetration was clarified. Retrospectively, two observers independently scored T2-weighted MRI and T2-weighted MRI combined with Gd-enhanced dynamic MRI for tumor penetration using the following criteria: With Gd-enhanced dynamic MRI, T1 tumors showed an early enhanced line around the tumor as rim enhancement; T2 tumors appeared as black lines or double layers, as the muscularis propria kept its integrity; T3 tumors showed partial discontinuity of the muscularis propria as a dotted line and a perforated area as an interrupted line. A confidence level scoring system was used, and receiver operating characteristic curves were generated. There were no significant differences at the T1 stage. There were significant differences for observer 1 (P=0.001 for observer 1) at the T2 stage. There were significant differences for both observers (P=0.001 for observer 1 and P=0.005 for observer 2) at the T3 stage. Our criteria for Gd-enhanced dynamic MRI were effective for T3 stage tumors. (author)

  8. Pulse width modulated push-pull driven parallel resonant converter with active free-wheel

    Science.gov (United States)

    Reass, William A.; Schrank, Louis

    2004-06-22

    An apparatus and method for high frequency alternating power generation to control kilowatts of supplied power in microseconds. The present invention includes a means for energy storage, push-pull switching means, control electronics, transformer means, resonant circuitry and means for excess energy recovery, all in electrical communication. A push-pull circuit works synchronously with a force commutated free-wheel transistor to provide current pulses to a transformer. A change in the conduction angle of the push-pull circuit changes the amount of energy coupled into the transformer's secondary oscillating circuit, thereby altering the induced secondary resonating voltage. At the end of each pulse, the force commutated free-wheel transistor causes residual excess energy in the primary circuit to be transmitted back to the storage capacitor for later use.

  9. Nonlinear Finite Element Analysis of Pull-Out Test

    DEFF Research Database (Denmark)

    Saabye Ottesen, N

    1981-01-01

    A specific pull-out test used to determine in-situ concrete compressive strength is analyzed. This test consists of a steel disc that is extracted from the structure. The finite element analysis considers cracking as well as strain hardening and softening in the pre- and post-failure region...

  10. The Effect of Coconut Oil pulling on Streptococcus mutans Count in Saliva in Comparison with Chlorhexidine Mouthwash.

    Science.gov (United States)

    Kaushik, Mamta; Reddy, Pallavi; Sharma, Roshni; Udameshi, Pooja; Mehra, Neha; Marwaha, Aditya

    2016-01-01

    Oil pulling is an age-old practice that has gained modern popularity in promoting oral and systemic health. The scientific verification for this practice is insufficient. Thus, this study evaluated the effect of coconut oil pulling on the count of Streptococcus mutans in saliva and to compare its efficacy with that of Chlorhexidine mouthwash: in vivo. The null hypothesis was that coconut oil pulling has no effect on the bacterial count in saliva. A randomized controlled study was planned and 60 subjects were selected. The subjects were divided into three groups, Group A: Oil pulling, Group B: Chlorhexidine, and Group C: Distilled water. Group A subjects rinsed mouth with 10 ml of coconut oil for 10 minutes. Group B subjects rinsed mouth with 5 ml Chlorhexidine mouthwash for 1 minute and Group C with 5 ml distilled water for 1 minute in the morning before brushing. Saliva samples were collected and cultured on 1st day and after 2 weeks from all subjects. Colonies were counted to compare the efficacy of coconut oil and Chlorhexidine with distilled water. Statistically significant reduction in S. mutans count was seen in both the coconut oil pulling and Chlorhexidine group. Oil pulling can be explored as a safe and effective alternative to Chlorhexidine. Edible oil-pulling therapy is natural, safe and has no side effects. Hence, it can be considered as a preventive therapy at home to maintain oral hygiene.

  11. Causal assessment of occupational pushing or pulling and low back pain: results of a systematic review.

    Science.gov (United States)

    Roffey, Darren M; Wai, Eugene K; Bishop, Paul; Kwon, Brian K; Dagenais, Simon

    2010-06-01

    Low back pain (LBP) is a prevalent and expensive musculoskeletal condition that predominantly occurs in working-age individuals of industrialized nations. Although numerous occupational physical activities have been implicated in its etiology, determining the causation of occupational LBP still remains a challenge. To conduct a systematic review evaluating the causal relationship between occupational pushing or pulling and LBP. Systematic review of the literature. Studies reporting an association between occupational pushing or pulling and LBP. Numerical association between exposure to pushing or pulling and the presence of LBP. A systematic review was performed to identify, evaluate, and summarize the literature related to establishing a causal relationship, according to Bradford-Hill criteria for causation for occupational pushing or pulling and LBP. A search was conducted using Medline, EMBASE, CINAHL, Cochrane Library, and OSH-ROM, gray literature, hand-searching occupational health journals, reference lists of included studies, and expert knowledge. Methodological quality was assessed using a modified Newcastle-Ottawa Scale. This search yielded 2,766 citations. Thirteen studies met the inclusion criteria. Eight were high-quality studies and five were low-quality studies. There was conflicting evidence with one high-quality study demonstrating a positive association between occupational pushing or pulling and LBP and five studies showing no relationship. One study reported a nonstatistically significant dose-response trend, four studies discussed temporality of which one indicated a positive finding, two studies discussed the biological plausibility of a causal link between occupational pushing or pulling and LBP, and no evidence was uncovered to assess the experiment criterion. A qualitative summary of existing studies was not able to find any high-quality studies that fully satisfied any of the Bradford-Hill causation criteria for occupational pushing or

  12. Determinants and magnitudes of manual force strengths and joint moments during two-handed standing maximal horizontal pushing and pulling.

    Science.gov (United States)

    Chow, Amy Y; Dickerson, Clark R

    2016-04-01

    Pushing and pulling are common occupational exertions that are increasingly associated with musculoskeletal complaints. This study focuses on the sensitivity of shoulder capacity to gender, handle height, exertion type (push or pull) and handle orientation for these tasks. All factors except for handle orientation influenced unilateral and total manual force strength (p pushing and pulling tasks for a diverse population. Practitioner Summary: pushing and pulling comprise nearly half of all manual materials handling tasks. Practitioners often assess, design or modify these tasks while incorporating constraints, including manual force direction and handle interface. This study provides guidance to aid design of pushing and pulling tasks in the context of shoulder physical capacity.

  13. Non-paraxial beam to push and pull microparticles

    DEFF Research Database (Denmark)

    Novitsky, Andrey; Qiu, C.-W.

    2011-01-01

    We discuss a feasibility of the pulling (backward) force acting on a spherical microparticle in a non-paraxial Bessel beam. The effect can be explained by the strong interaction of particle's multipoles or by the conservation of momentum in the system “photons-particle.” It is remarkable that the...

  14. Long-Term Cost-Effectiveness of Transanal Irrigation in Patients with Neurogenic Bowel Dysfunction.

    Directory of Open Access Journals (Sweden)

    Anton Emmanuel

    Full Text Available People suffering from neurogenic bowel dysfunction (NBD and an ineffective bowel regimen often suffer from fecal incontinence (FI and related symptoms, which have a huge impact on their quality of life. In these situations, transanal irrigation (TAI has been shown to reduce these symptoms and improve quality of life.To investigate the long-term cost-effectiveness of initiating TAI in patients with NBD who have failed standard bowel care (SBC.A deterministic Markov decision model was developed to project the lifetime health economic outcomes, including quality-adjusted life years (QALYs, episodes of FI, urinary tract infections (UTIs, and stoma surgery when initiating TAI relative to continuing SBC. A data set consisting of 227 patients with NBD due to spinal cord injury (SCI, multiple sclerosis, spina bifida and cauda equina syndrome was used in the analysis. In the model a 30-year old individual with SCI was used as a base-case. A probabilistic sensitivity analysis was applied to evaluate the robustness of the model.The model predicts that a 30-year old SCI patient with a life expectancy of 37 years initiating TAI will experience a 36% reduction in FI episodes, a 29% reduction in UTIs, a 35% reduction in likelihood of stoma surgery and a 0.4 improvement in QALYs, compared with patients continuing SBC. A lifetime cost-saving of £21,768 per patient was estimated for TAI versus continuing SBC alone.TAI is a cost-saving treatment strategy reducing risk of stoma surgery, UTIs, episodes of FI and improving QALYs for NBD patients who have failed SBC.

  15. RF Bead Pull Measurements of the DQW

    CERN Document Server

    Jaume, Guillaume

    2015-01-01

    This report was written within the framework of the CERN Summer Student Program. It is focused on the Radio Frequency study of the Double Quarter Wave Crab Cavity [1] considered for the crab-crossing scheme of the LHC Luminosity upgrade [2]. HFSS simulation [3] and Bead-Pull Measurements technique were used for the characterization of the higher-order terms of the main deflecting mode.

  16. DC dynamic pull-in instability of a dielectric elastomer balloon: an energy-based approach

    Science.gov (United States)

    Sharma, Atul Kumar; Arora, Nitesh; Joglekar, M. M.

    2018-03-01

    This paper reports an energy-based method for the dynamic pull-in instability analysis of a spherical dielectric elastomer (DE) balloon subjected to a quasi-statically applied inflation pressure and a Heaviside step voltage across the balloon wall. The proposed technique relies on establishing the energy balance at the point of maximum stretch in an oscillation cycle, followed by the imposition of an instability condition for extracting the threshold parameters. The material models of the Ogden family are employed for describing the hyperelasticity of the balloon. The accuracy of the critical dynamic pull-in parameters is established by examining the saddle-node bifurcation in the transient response of the balloon obtained by integrating numerically the equation of motion, derived using the Euler-Lagrange equation. The parametric study brings out the effect of inflation pressure on the onset of the pull-in instability in the DE balloon. A quantitative comparison between the static and dynamic pull-in parameters at four different levels of the inflation pressure is presented. The results indicate that the dynamic pull-in instability gets triggered at electric fields that are lower than those corresponding to the static instability. The results of the present investigation can find potential use in the design and development of the balloon actuators subjected to transient loading. The method developed is versatile and can be used in the dynamic instability analysis of other conservative systems of interest.

  17. Effect of the yarn pull-out velocity of shear thickening fluid-impregnated Kevlar fabric on the coefficient of friction

    Energy Technology Data Exchange (ETDEWEB)

    Aikarami, Sh [Dept. of Mechanical and Aerospace Engineering, Science and Research Branch, Islamic Azad University, Tehran (Iran, Islamic Republic of); Kordani, N. [Dept. of Mechanical Engineering, University of Mazandaran, Mazandaran (Iran, Islamic Republic of); Sadough, Vanini A. [Dept. of Mechanical Engineering, Amirkabir University of Technology, Tehran (Iran, Islamic Republic of); Amiri, H. [Technical Campus, Tehran South Branch, Islamic Azad University, Tehran(Iran, Islamic Republic of)

    2016-08-15

    This study explains the yarn pull-out process behavior of woven fabrics in relation to their mechanical properties. Empirical research on the relationship between the yarn pull-out behavior and fabric properties are evaluated, along with a detailed comparison of friction between the fabric fibers in static and dynamic modes. Samples are tested in three modes, namely, neat, dissolved liquid, and silica particle- based Shear thickening fluid (STF)-treated fabric. Accordingly, the presence of STF increases friction between the fabrics and the warp and weft yarns, as well as prevents the displacement of the yarns. Increased friction also leads to an increase in the energy absorption of the yarn pull-out process. In this research, the pull-out test has been performed at three different velocities: 50, 250 and 500 mm/min. Results show that increases in the pull-out velocity increase the pull-out force of the neat and dissolved liquid samples. By contrast, the behavior is completely opposite in the STF-treated sample. Comparing the yarn pull-out values indicates that the STF-treated samples have the highest value, which is approximately three times higher than that of the neat sample.

  18. Effect of the yarn pull-out velocity of shear thickening fluid-impregnated Kevlar fabric on the coefficient of friction

    International Nuclear Information System (INIS)

    Aikarami, Sh; Kordani, N.; Sadough, Vanini A.; Amiri, H.

    2016-01-01

    This study explains the yarn pull-out process behavior of woven fabrics in relation to their mechanical properties. Empirical research on the relationship between the yarn pull-out behavior and fabric properties are evaluated, along with a detailed comparison of friction between the fabric fibers in static and dynamic modes. Samples are tested in three modes, namely, neat, dissolved liquid, and silica particle- based Shear thickening fluid (STF)-treated fabric. Accordingly, the presence of STF increases friction between the fabrics and the warp and weft yarns, as well as prevents the displacement of the yarns. Increased friction also leads to an increase in the energy absorption of the yarn pull-out process. In this research, the pull-out test has been performed at three different velocities: 50, 250 and 500 mm/min. Results show that increases in the pull-out velocity increase the pull-out force of the neat and dissolved liquid samples. By contrast, the behavior is completely opposite in the STF-treated sample. Comparing the yarn pull-out values indicates that the STF-treated samples have the highest value, which is approximately three times higher than that of the neat sample

  19. Optical pulling of airborne absorbing particles and smut spores over a meter-scale distance with negative photophoretic force

    Energy Technology Data Exchange (ETDEWEB)

    Lin, Jinda; Hart, Adam G.; Li, Yong-qing, E-mail: liy@ecu.edu [Department of Physics, East Carolina University, Greenville, North Carolina 27858-4353 (United States)

    2015-04-27

    We demonstrate optical pulling of single light-absorbing particles and smut spores in air over a meter-scale distance using a single collimated laser beam based on negative photophoretic force. The micron-sized particles are pulled towards the light source at a constant speed of 1–10 cm/s in the optical pulling pipeline while undergoing transverse rotation at 0.2–10 kHz. The pulled particles can be manipulated and precisely positioned on the entrance window with an accuracy of ∼20 μm, and their chemical compositions can be characterized with micro-Raman spectroscopy.

  20. Fast Pulling of n-Type Si Ingots for Enhanced Si Solar Cell Production

    Science.gov (United States)

    Kim, Kwanghun; Park, Sanghyun; Park, Jaechang; Pang, Ilsun; Ryu, Sangwoo; Oh, Jihun

    2018-03-01

    Reducing the manufacturing costs of silicon substrates is an important issue in the silicon-based solar cell industry. In this study, we developed a high-throughput ingot growth method by accelerating the pulling speed in the Czochralski process. By controlling the heat flow of the ingot growth chamber and at the solid-liquid interfaces, the pulling speed of an ingot could be increased by 15% compared to the conventional method, while retaining high quality. The wafer obtained at a high pulling speed showed an enhanced minority carrier lifetime compared with conventional wafers, due to the vacancy passivation effect, and also demonstrated comparable bulk resistivity and impurities. The results in this work are expected to open a new way to enhance the productivity of Si wafers used for Si solar cells, and therefore, to reduce the overall manufacturing cost.

  1. Laparoscopic correction of enterocele associated to stapled transanal rectal resection for obstructed defecation syndrome.

    Science.gov (United States)

    Carriero, Alfonso; Picchio, Marcello; Martellucci, Jacopo; Talento, Pasquale; Palimento, Domenico; Spaziani, Erasmo

    2010-03-01

    We report our experience of concomitant laparoscopic treatment for enterocele and stapled transanal rectal resection (STARR) for rectocele and/or rectal prolapse in patients with complex obstructed defecation syndrome (ODS). From June 2005 to June 2007, we submitted 20 patients with ODS due to rectal prolapse and/or rectocele, combined with stable enterocele, to STARR and laparoscopic correction of the enterocele. Preoperative assessment included symptom evaluation with standardized questionnaires, clinical examination, colonoscopy, proctoscopy, anal sphincter ultrasonography, video-defecography with synchronous opacification of the ileal loops in all patients and colpography in female patients, and anorectal manometry. Follow-up was performed in the first, third, sixth, 12th, and 24th month after surgery. Eighteen (90%) patients were submitted to both procedures, simultaneously. One patient, previously submitted to STARR, underwent laparoscopic treatment of the enterocele. Postoperative complications occurred in two (10%) patients: one case of postoperative rectal bleeding and one case of retropneumoperitoneum. Median (range) preoperative and postoperative Altomare's obstructed defecation score was ten (6-14) and two (0-14), respectively (p<0.001). Median (range) preoperative and postoperative quality of life score was 79 (39-109) and 109 (50-126), respectively (p<0.001). No symptom related to ODS was detected at 6-month follow-up (19 patients) and at 24-month follow-up (19 patients). The combination of STARR and laparoscopy provides a safe and effective method to treat ODS caused by rectal internal prolapse and/or rectocele combined with enterocele.

  2. The creation of a peritoneal defect in transanal endoscopic microsurgery does not increase complications.

    Science.gov (United States)

    Ramwell, A; Evans, J; Bignell, M; Mathias, J; Simson, J

    2009-11-01

    During Transanal Endoscopic Microsurgical (TEMS) full-thickness excision of a rectal lesion above the peritoneal reflection, entrance to the peritoneal cavity is inevitable. This has been regarded as a complication that requires conversion to an open procedure. We describe our experience of full thickness intraperitoneal excision of rectal lesions where the peritoneal defect was sutured endoscopically. Data were collected prospectively on 15 patients in whom a peritoneal defect was created intraoperatively during TEMS excision of a rectal lesion. When a defect was recognized, it was closed by endoscopic suture. If there was any doubt regarding security of the closure, a defunctioning loop stoma was fashioned. Between November 1998 and January 2008, a total of 257 patients underwent TEMS during which a peritoneal defect was created in 15 patients. Six patients had a defunctioning stoma formed at the time of TEMS. No patient was defunctioned postoperatively and there were no deaths. The mean hospital stay was 8 days (range 3 to 19 days). A contrast enema showed sub-clinical leaks in two patients for which no treatment was required. No patient developed pelvic or peritoneal sepsis, but one patient had to return to theatre for postoperative bleeding when a single bleeding vessel was coagulated. Full thickness excision of lesions in the intraperitoneal rectum with endoscopic suture of the defect is a safe procedure. Lesions in the upper rectum should not be excluded from TEMS excision because of the chance of peritoneal breach.

  3. Pick-N-Pull Auto Dismantlers, Kansas City, LLC Inc.

    Science.gov (United States)

    The EPA is providing notice of a proposed Administrative Penalty Assessment against Pick-N-Pull Auto Dismantlers, Kansas City, LLC, a subsidiary of Schnitzer Steel Industries, Inc., for alleged violations at its facilities at 8012 East Truman Rd., Kansas C

  4. Correlation of endorectal coil magnetic resonance, transrectal ultrasound and radical prostatectomy findings in assessing extent of prostate cancer in referred urology patients

    International Nuclear Information System (INIS)

    Lavoipierre, A.; Little, A.F.; Greive, K.A.; Royce, P.L.; Snow, R.M.; Frydenberg, M.

    2002-01-01

    Full text: The aim of this study was to compare findings at prostate MR to ultrasound findings and pathology specimens in patients who subsequently underwent radical prostatectomy. Of the 61 patients who underwent composite MR prostate imaging, 39 patients with elevated PSA levels and / or abnormal DRE findings were found to have cancer on transrectal ultrasound (TRUS) and biopsy (random sextant and targeted biopsies). MRI was performed using composite phased array and endorectal coils, using axial T1 and axial, coronal and sagittal T2 weighted images through the prostate, together with axial T1 weighted imaging through the pelvis. Fifteen patients out the 39 patients with documented cancer then underwent radical prostatectomy. The resected specimen pathology was then compared with the MR and TRUS findings. Comparison of findings at MRI with those at prostatectomy indicated approximately 82.4% correlation comparing right side and left side disease (TRUS = 80%). There was a 13.3% false positive for seminal vesicle involvement on MR (TRUS = 0%) and a 10% false negative rate on MR (TRUS 10%) compared with pathology specimens.There was a 26.7% false positive rate of extracapsular extension on MR (TRUS = 0%) and a 6.6% false negative rate on MR (TRUS = 20%) compared with the pathology specimens. Of the 39 patients who had undergone TRUS and biopsy, the disease appeared more extensive on MRI than suspected at ultrasound in 14/39 (35.9%). High resolution MR imaging of the prostate is an acceptable method for assessing the presence of prostate cancer. However, our early experience, in this small series, suggests that there is a high mis-staging of disease on MR as is the case with TRUS, although MR is better than TRUS. The results underscore the need for additional assessment with MR spectroscopy. Copyright (2002) Blackwell Science Pty Ltd

  5. Managing neurogenic bowel dysfunction: what do patients prefer? A discrete choice experiment of patient preferences for transanal irrigation and standard bowel management

    Directory of Open Access Journals (Sweden)

    Nafees B

    2016-02-01

    Full Text Available Beenish Nafees,1 Andrew J Lloyd,2 Rachel S Ballinger,2 Anton Emmanuel3 1Health Outcomes Research, Nafees Consulting Limited, London, 2Patient-Reported Outcomes Research, ICON plc, Oxford, 3Department of Gastroenterology and Nutrition, University College Hospital, London, UK Background: Most patients with bowel dysfunction secondary to neurological illness are managed by a range of nonsurgical methods, including dietary changes, laxatives, and suppository use to transanal irrigation (TAI. The aim of the present study was to explore individuals’ preferences regarding TAI devices and furthermore investigate willingness to pay (WTP for attributes in devices in the UK. Methods: A discrete choice experiment survey was conducted to evaluate the patients’ perceived value of TAI devices. Attributes were selected based upon a literature review and input from clinicians. Interviews were conducted with three clinicians and the survey was developed and finalized with the input from both patients and professionals. The final attributes were “risk of urinary tract infections” (UTIs, “risk of fecal incontinence” (FI, “frequency of use”, “time spent on toilet”, “ease of use”, “level of control/independence”, and “cost”. Participants were recruited by a patient panel of TAI device users in the UK. Data were analyzed using the conditional logit model whereby the coefficients obtained from the model provided an estimate of the (log odds ratios (ORs of preference for attributes. WTP was also estimated for each attribute. Results: A total of 129 participants were included in the final analyses. Sixty two percent of the participants had suffered from three UTIs in the preceding year and 58% of patients reported currently experiencing FI using their current device. All attributes were significant predictors of choice. The most important attributes for participants were the “risk of FI”, “frequency of use”, and “risk of UTIs

  6. Cavity Pull Rod: Device to Promote Single Crystal Growth from the Melt

    Science.gov (United States)

    Goldsby, Jon (Inventor)

    2017-01-01

    A pull rod for use in producing a single crystal from a molten alloy is provided that includes an elongated rod having a first end and a second end, a first cavity defined at the first end and a second cavity defined at the first end and in communication with the first cavity. The first cavity receives the molten alloy and the second cavity vents a gas from the molten alloy to thereby template a single crystal when the pull rod is dipped into and extracted from the molten alloy.

  7. Trunk response and stability in standing under sagittal-symmetric pull-push forces at different orientations, elevations and magnitudes.

    Science.gov (United States)

    El Ouaaid, Z; Shirazi-Adl, A; Plamondon, A

    2018-03-21

    To reduce lifting and associated low back injuries, manual material handling operations often involve pulling-pushing of carts at different weights, orientations, and heights. The loads on spine and risk of injury however need to be investigated. The aim of this study was to evaluate muscle forces, spinal loads and trunk stability in pull-push tasks in sagittal-symmetric, static upright standing posture. Three hand-held load magnitudes (80, 120 and 160 N) at four elevations (0, 20, 40 and 60 cm to the L5-S1) and 24 force directions covering all pull/push orientations were considered. For this purpose, a musculoskeletal finite element model with kinematics measured earlier were used. Results demonstrated that peak spinal forces occur under inclined pull (lift) at upper elevations but inclined push at the lowermost one. Minimal spinal loads, on the other hand, occurred at and around vertical pull directions. Overall, spinal forces closely followed variations in the net external moment of pull-push forces at the L5-S1. Local lumbar muscles were most active in pulls while global extensor muscles in lifts. The trunk stability margin decreased with load elevation except at and around horizontal push; it peaked under pulls and reached minimum at vertical lifts. It also increased with antagonist activity in muscles and intra-abdominal pressure. Results provide insight into the marked effects of variation in the load orientation and elevation on muscle forces, spinal loads and trunk stability and hence offer help in rehabilitation, performance enhancement training and design of safer workplaces. Copyright © 2017 Elsevier Ltd. All rights reserved.

  8. Malfunctioning Plastic Biliary Endoprosthesis: Percutaneous Transhepatic Balloon Pulling Technique

    Directory of Open Access Journals (Sweden)

    Umberto G. Rossi

    2013-01-01

    Full Text Available Percutaneous transhepatic removal techniques for malfunctioning plastic biliary endoprosthesis are considered safe and efficient second-line strategies, when endoscopic procedures are not feasible. We describe the percutaneous transhepatic balloon pulling technique in a patient with an unresectable malignant hilar cholangiocarcinoma.

  9. Clinical utility of an endorectal MRI-guided prostate probe: preliminary examinations

    Directory of Open Access Journals (Sweden)

    Tödter Julia

    2017-09-01

    Full Text Available Prostate cancer (PCa is one of the most common cancer diseases in men in the western countries [1]. Besides the palpation, and the amount of prostate-specific-antigen’s (PSA inside the blood, the current diagnostic imaging technologies are not appropriate. Early diagnosis defining the exact tumor location, spread and margins could make efficient targeted biopsies and image-guided surgery. A multimodal imaging technique containing a transmit-receive surface coil for anatomical MR imaging, a (SPET detector module, consisting of silicon photomultipliers (SiPM, for functional imaging and an ultrasound (US probe are placed as close as possible to the prostate designed as an endorectal tube to increase sensitivity and spatial resolution. All materials that are used are non-magnetic. Advantages of the SiPM are diversified, like non-sensitive to magnetic fields, higher gain (105–106 than standard avalanche photodiodes (APD, good timing properties and compactness. The PET detector should reach approximately 1mm3 spatial resolution together with 60ps FWHM Time-of-Flight resolution and a high efficiency to reduce scanning time and injected dose. A home-made transmit-receive coil surrounding the PET module improves signal-to-noise-ratio (SNR with respect to standard coils will be present. The system will be used as a MRI-insert and be able to visualize anatomic and metabolic information together. The US-probe is guiding examination for correct overlapping of the multimodal images. This procedure will save time, costs and the need of co-registration. By combining all advantages of each system, it will necessarily update the non-invasive treatment of PCa. The system is adapted and tested to a 3 Tesla MR scanner called Trio A Tim system and Allegra system from the company Siemens healthcare with a larmor frequency of 123.2 MHz and an input of 50 Ω free from artifacts. First results on homogeneity of the transmit-receive coil will be presented. Preliminary

  10. Study of alternative strategies to the task clarification activity of the market-pull product development process model

    OpenAIRE

    Motte, Damien

    2009-01-01

    A very large majority of the current product development process models put forward in textbooks present a homogenous structure, what Ulrich & Eppinger [1] call the market-pull model, presented as a generic one, while other possible product development process models are merely seen as variants. This paper focuses on the task clarification and derived activities (mainly the systematic search for customer needs through market study and the supplementary development costs it entails) and in...

  11. Directional preference in dogs: Laterality and "pull of the north".

    Science.gov (United States)

    Adámková, Jana; Svoboda, Jan; Benediktová, Kateřina; Martini, Sabine; Nováková, Petra; Tůma, David; Kučerová, Michaela; Divišová, Michaela; Begall, Sabine; Hart, Vlastimil; Burda, Hynek

    2017-01-01

    Laterality is a well described phenomenon in domestic dogs. It was shown that dogs, under calm Earth's magnetic field conditions, when marking their home ranges, tend to head about north- or southwards and display thus magnetic alignment. The question arises whether magnetic alignment might be affected or even compromised by laterality and vice versa. We tested the preference of dogs to choose between two dishes with snacks that were placed left and right, in different compass directions (north and east, east and south, south and west or west and north) in front of them. Some dogs were right-lateral, some left-lateral but most of them were ambilateral. There was a preference for the dish placed north compared to the one placed east of the dog ("pull of the north"). This effect was highly significant in small and medium-sized breeds but not in larger breeds, highly significant in females, in older dogs, in lateralized dogs but less significant or not significant in males, younger dogs, or ambilateral dogs. Laterality and "pull of the north" are phenomena which should be considered in diverse tasks and behavioral tests with which dogs or other animals might be confronted. The interaction and possible conflict between lateralization and "pull of the north" might be also considered as a reason for shifted magnetic alignment observed in different animal species in different contexts.

  12. Directional preference in dogs: Laterality and "pull of the north"

    Science.gov (United States)

    Adámková, Jana; Svoboda, Jan; Benediktová, Kateřina; Martini, Sabine; Nováková, Petra; Tůma, David; Kučerová, Michaela; Divišová, Michaela; Begall, Sabine; Hart, Vlastimil

    2017-01-01

    Laterality is a well described phenomenon in domestic dogs. It was shown that dogs, under calm Earth's magnetic field conditions, when marking their home ranges, tend to head about north- or southwards and display thus magnetic alignment. The question arises whether magnetic alignment might be affected or even compromised by laterality and vice versa. We tested the preference of dogs to choose between two dishes with snacks that were placed left and right, in different compass directions (north and east, east and south, south and west or west and north) in front of them. Some dogs were right-lateral, some left-lateral but most of them were ambilateral. There was a preference for the dish placed north compared to the one placed east of the dog ("pull of the north"). This effect was highly significant in small and medium-sized breeds but not in larger breeds, highly significant in females, in older dogs, in lateralized dogs but less significant or not significant in males, younger dogs, or ambilateral dogs. Laterality and “pull of the north” are phenomena which should be considered in diverse tasks and behavioral tests with which dogs or other animals might be confronted. The interaction and possible conflict between lateralization and "pull of the north" might be also considered as a reason for shifted magnetic alignment observed in different animal species in different contexts. PMID:28945773

  13. Push-Pull Effects of Three Plant Secondary Metabolites on Oviposition of the Potato Tuber Moth, Phthorimaea operculella

    Science.gov (United States)

    Ma, Y.F.; Xiao, C.

    2013-01-01

    The push-pull effects of three plant secondary metabolites, azadirachtin, eucalyptol, and heptanal, on the oviposition choices of potato tubers by the potato tuber moth, Phthorimaea operculella (Zeller) (Lepidoptera: Gelechiidae) were tested in the laboratory. Azadirachtin at concentrations from 1.5 to 12 mg/L had a significant repellent effect on oviposition. Eucalyptol at concentrations from 3 to 12 mg/L promoted oviposition. Heptanal promoted oviposition at low concentrations from 0.1875 to 3.0 mg/L but repelled it at higher concentrations from 12 to 24 mg/L. The combination of azadirachtin (12 mg/L) with eucalyptol (3.0 mg/L) resulted in a significant pushpull effect of 56.3% on oviposition. The average maximum push-pull effects occurred with the combinations of azadirachtin with heptanal (12 and 0.375 mg/L, respectively; 38.7% push-pull effect), heptanal with eucalyptol (12 and 6 mg/L, respectively; 31.4% push-pull effect), and heptanal (high concentration) with heptanal (low concentration) (12.0 and 0.375 mg/L, respectively; 25% push-pull effect). PMID:24786822

  14. Anal wall sparing effect of an endorectal balloon in 3D conformal and intensity-modulated prostate radiotherapy.

    Science.gov (United States)

    Smeenk, Robert Jan; van Lin, Emile N J Th; van Kollenburg, Peter; Kunze-Busch, Martina; Kaanders, Johannes H A M

    2009-10-01

    To investigate the anal wall (Awall) sparing effect of an endorectal balloon (ERB) in 3D conformal radiotherapy (3D-CRT) and intensity-modulated radiotherapy (IMRT) for prostate cancer. In 24 patients with localized prostate carcinoma, two planning CT-scans were performed: with and without ERB. A prostate planning target volume (PTV) was defined, and the Awall was delineated, using two different methods. Three-field and 4-field 3D-CRT plans, and IMRT plans were generated with a prescription dose of 78Gy. In 144 treatment plans, the minimum dose (D(min)), maximum dose (D(max)), and mean dose (D(mean)) to the Awall were calculated, as well as the Awall volumes exposed to doses ranging from >or=20Gy to >or=70Gy (V(20)-V(70), respectively). In the 3D-CRT plans, an ERB significantly reduced D(mean), D(max), and V(30)-V(70). For IMRT all investigated dose parameters were significantly reduced by the ERB. The absolute reduction of D(mean) was 12Gy in 3D-CRT and was 7.5Gy in IMRT for both methods of Awall delineation. Application of an ERB showed a significant Awall sparing effect in both 3D-CRT and IMRT. This may lead to reduced late anal toxicity in prostate radiotherapy.

  15. Development of Multiorgan Finite Element-Based Prostate Deformation Model Enabling Registration of Endorectal Coil Magnetic Resonance Imaging for Radiotherapy Planning

    International Nuclear Information System (INIS)

    Hensel, Jennifer M.; Menard, Cynthia; Chung, Peter W.M.; Milosevic, Michael F.; Kirilova, Anna; Moseley, Joanne L.; Haider, Masoom A.; Brock, Kristy K.

    2007-01-01

    Purpose: Endorectal coil (ERC) magnetic resonance imaging (MRI) provides superior visualization of the prostate compared with computed tomography at the expense of deformation. This study aimed to develop a multiorgan finite element deformable method, Morfeus, to accurately co-register these images for radiotherapy planning. Methods: Patients with prostate cancer underwent fiducial marker implantation and computed tomography simulation for radiotherapy planning. A series of axial MRI scans were acquired with and without an ERC. The prostate, bladder, rectum, and pubic bones were manually segmented and assigned linear elastic material properties. Morfeus mapped the surface of the bladder and rectum between two imaged states, calculating the deformation of the prostate through biomechanical properties. The accuracy of deformation was measured as fiducial marker error and residual surface deformation between the inferred and actual prostate. The deformation map was inverted to deform from 100 cm 3 to no coil. Results: The data from 19 patients were analyzed. Significant prostate deformation occurred with the ERC (mean intrapatient range, 0.88 ± 0.25 cm). The mean vector error in fiducial marker position (n = 57) was 0.22 ± 0.09 cm, and the mean vector residual surface deformation (n = 19) was 0.15 ± 0.06 cm for deformation from no coil to 100-cm 3 ERC, with an image vector resolution of 0.22 cm. Accurately deformed MRI scans improved soft-tissue resolution of the anatomy for radiotherapy planning. Conclusions: This method of multiorgan deformable registration enabled accurate co-registration of ERC-MRI scans with computed tomography treatment planning images. Superior structural detail was visible on ERC-MRI, which has potential for improving target delineation

  16. Push-Pull and Feedback Mechanisms Can Align Signaling System Outputs with Inputs.

    Science.gov (United States)

    Andrews, Steven S; Peria, William J; Yu, Richard C; Colman-Lerner, Alejandro; Brent, Roger

    2016-11-23

    Many cell signaling systems, including the yeast pheromone response system, exhibit "dose-response alignment" (DoRA), in which output of one or more downstream steps closely matches the fraction of occupied receptors. DoRA can improve the fidelity of transmitted dose information. Here, we searched systematically for biochemical network topologies that produced DoRA. Most networks, including many containing feedback and feedforward loops, could not produce DoRA. However, networks including "push-pull" mechanisms, in which the active form of a signaling species stimulates downstream activity and the nominally inactive form reduces downstream activity, enabled perfect DoRA. Networks containing feedbacks enabled DoRA, but only if they also compared feedback to input and adjusted output to match. Our results establish push-pull as a non-feedback mechanism to align output with variable input and maximize information transfer in signaling systems. They also suggest genetic approaches to determine whether particular signaling systems use feedback or push-pull control. Copyright © 2016 Elsevier Inc. All rights reserved.

  17. Transanal endoscopic microsurgery versus endoscopic mucosal resection for large rectal adenomas (TREND-study

    Directory of Open Access Journals (Sweden)

    Geldof Han

    2009-03-01

    Full Text Available Abstract Background Recent non-randomized studies suggest that extended endoscopic mucosal resection (EMR is equally effective in removing large rectal adenomas as transanal endoscopic microsurgery (TEM. If equally effective, EMR might be a more cost-effective approach as this strategy does not require expensive equipment, general anesthesia and hospital admission. Furthermore, EMR appears to be associated with fewer complications. The aim of this study is to compare the cost-effectiveness and cost-utility of TEM and EMR for the resection of large rectal adenomas. Methods/design Multicenter randomized trial among 15 hospitals in the Netherlands. Patients with a rectal adenoma ≥ 3 cm, located between 1–15 cm ab ano, will be randomized to a TEM- or EMR-treatment strategy. For TEM, patients will be treated under general anesthesia, adenomas will be dissected en-bloc by a full-thickness excision, and patients will be admitted to the hospital. For EMR, no or conscious sedation is used, lesions will be resected through the submucosal plane in a piecemeal fashion, and patients will be discharged from the hospital. Residual adenoma that is visible during the first surveillance endoscopy at 3 months will be removed endoscopically in both treatment strategies and is considered as part of the primary treatment. Primary outcome measure is the proportion of patients with recurrence after 3 months. Secondary outcome measures are: 2 number of days not spent in hospital from initial treatment until 2 years afterwards; 3 major and minor morbidity; 4 disease specific and general quality of life; 5 anorectal function; 6 health care utilization and costs. A cost-effectiveness and cost-utility analysis of EMR against TEM for large rectal adenomas will be performed from a societal perspective with respectively the costs per recurrence free patient and the cost per quality adjusted life year as outcome measures. Based on comparable recurrence rates for TEM and EMR

  18. EFFICACY OF ADDUCTOR PULL BACK EXERCISE ON PAIN AND FUNCTIONAL DISABILITY FOR SACROILIAC JOINT DYSFUNCTION

    Directory of Open Access Journals (Sweden)

    Sai Kumar .N

    2015-08-01

    Full Text Available Background: Sacroiliac joint dysfunction (SIJD is a common problem that causes pain and disability. Adductor pull back exercise is widely used for treating sacroiliac joint dysfunction. No yet research has been directly examined the efficacy of adductor pull back exercise for sacroiliac joint dysfunction. The purpose of the study to find the efficacy of adductor pull back exercise on pain and functional disability for subjects with sacroiliac joint dysfunction. Methods: An experimental study design, 40 subjects with unilateral Sacroiliac joint dysfunction were randomized into two groups: study group (n=20, and control group (n=20. Subjects in study group received adductor pull back exercise along with conventional exercise and Subjects in control group received conventional exercise. The duration of treatment was given for two weeks, three times a day, total six days per week. Outcome measures such as pain was measured using Visual analog scale (VAS, and functional disability was measured using Oswestry Disability Index questionnaire (ODI before and after 2 weeks of the treatment in both the groups. Results: When means were analyzed using Independent ‘t’ test as a parametric and Mann Whitney U test as a non-parametric test, there is a statistically significant improvements in means of VAS, and ODI within the groups. When means were compared using Independent ‘t’ and Mann Whitney U test, there is a significant difference in post-means of VAS and ODI between the groups. Conclusion: The present study concludes that the 2 weeks of adductor pull back exercise along with conventional exercise found statistically and clinically significant effect on improving pain, functional disability for subjects with sacroiliac joint dysfunction. Adductors pull back exercise along with conventional exercise techniques shown to have greater percentage of improvement in improving pain and functional disability for subjects with sacroiliac joint dysfunction.

  19. Fiscal 1974 Sunshine Project result report. R and D on photovoltaic power generation system (R and D on Si ribbon crystal vertical pulling method); 1974 nendo taiyoko hatsuden system no kenkyu kaihatsu seika hokokusho. Silicon tatehiki ribbon kessho no kenkyu kaihatsu

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1975-05-30

    This research includes (1) basic study on Si ribbon crystal vertical pulling method, (2) basic design of continuous Si ribbon crystal vertical pulling mechanism, (3) basic study on vertically pulled Si ribbon crystal, (4) study on capillary materials for capillary crystal pulling method, and (5) basic study on AlAs-GaAs system compound semiconductors. In the 1st research, for Si ribbon crystal vertical pulling growth, the ribbon crystal pulling equipment was prepared and modified, and Si crystals were obtained by capillary and web methods. In the 2nd research, for development of Si ribbon crystal vertical pulling growth technology, study was made on the simple energy-saving resource-saving continuous automatic production process. In the 3rd research, measurement was made on various characteristics of ribbon crystals. In the 4th research, study was made on requirements of capillary materials from the viewpoint of capillary growth mechanism. In the 5th research, basic technology for solar cell production was established through growth experiments of AlAs-GaAs mixed crystals and multiple epitaxial crystal layers. (NEDO)

  20. Biomechanically determined hand force limits protecting the low back during occupational pushing and pulling tasks.

    Science.gov (United States)

    Weston, Eric B; Aurand, Alexander; Dufour, Jonathan S; Knapik, Gregory G; Marras, William S

    2018-06-01

    Though biomechanically determined guidelines exist for lifting, existing recommendations for pushing and pulling were developed using a psychophysical approach. The current study aimed to establish objective hand force limits based on the results of a biomechanical assessment of the forces on the lumbar spine during occupational pushing and pulling activities. Sixty-two subjects performed pushing and pulling tasks in a laboratory setting. An electromyography-assisted biomechanical model estimated spinal loads, while hand force and turning torque were measured via hand transducers. Mixed modelling techniques correlated spinal load with hand force or torque throughout a wide range of exposures in order to develop biomechanically determined hand force and torque limits. Exertion type, exertion direction, handle height and their interactions significantly influenced dependent measures of spinal load, hand force and turning torque. The biomechanically determined guidelines presented herein are up to 30% lower than comparable psychophysically derived limits and particularly more protective for straight pushing. Practitioner Summary: This study utilises a biomechanical model to develop objective biomechanically determined push/pull risk limits assessed via hand forces and turning torque. These limits can be up to 30% lower than existing psychophysically determined pushing and pulling recommendations. Practitioners should consider implementing these guidelines in both risk assessment and workplace design moving forward.

  1. The Pull Model as the E-Commerce Strategy For Business-To-Consumer Sites

    OpenAIRE

    Guillermo Reyes González; Ralf Eder Lange

    2013-01-01

    One of the solutions to stabilize the bullwhip effect is to provide the supply chain with the adequate mechanisms to make the information flow upstream (to the supplier) and downstream (to the consumer). This has led the e-commerce companies to implement a distribution model known as the Pull Model. This paper provides a literature review of the main characteristics of the Pull model and a comparison with the E-Commerce strategies and benefitsJournal: Revista de Administración, Finanzas y Eco...

  2. Selectively Encrypted Pull-Up Based Watermarking of Biometric data

    Science.gov (United States)

    Shinde, S. A.; Patel, Kushal S.

    2012-10-01

    Biometric authentication systems are becoming increasingly popular due to their potential usage in information security. However, digital biometric data (e.g. thumb impression) are themselves vulnerable to security attacks. There are various methods are available to secure biometric data. In biometric watermarking the data are embedded in an image container and are only retrieved if the secrete key is available. This container image is encrypted to have more security against the attack. As wireless devices are equipped with battery as their power supply, they have limited computational capabilities; therefore to reduce energy consumption we use the method of selective encryption of container image. The bit pull-up-based biometric watermarking scheme is based on amplitude modulation and bit priority which reduces the retrieval error rate to great extent. By using selective Encryption mechanism we expect more efficiency in time at the time of encryption as well as decryption. Significant reduction in error rate is expected to be achieved by the bit pull-up method.

  3. Those who pull a rose of sharon off

    International Nuclear Information System (INIS)

    Lee, Byeong Yeong

    2011-06-01

    The contents of this book are going over the U. S. policy on nuclear issue, to bloom a rose of sharon, people who pull a rose of sharon off discharge out of appointment and participation into administration and trial on election law, over the farm hardship period, the story about development of nuclear energy. The report and the contract and the related articles.

  4. DC dynamic pull-in predictions for a generalized clamped–clamped micro-beam based on a continuous model and bifurcation analysis

    International Nuclear Information System (INIS)

    Chao, Paul C-P; Chiu, C W; Liu, Tsu-Hsien

    2008-01-01

    This study is devoted to providing precise predictions of the dc dynamic pull-in voltages of a clamped–clamped micro-beam based on a continuous model. A pull-in phenomenon occurs when the electrostatic force on the micro-beam exceeds the elastic restoring force exerted by beam deformation, leading to contact between the actuated beam and bottom electrode. DC dynamic pull-in means that an instantaneous application of the voltage (a step function such as voltage) is applied. To derive the pull-in voltage, a dynamic model in partial differential equations is established based on the equilibrium among beam flexibility, inertia, residual stress, squeeze film, distributed electrostatic forces and its electrical field fringing effects. The method of Galerkin decomposition is then employed to convert the established system equations into reduced discrete modal equations. Considering lower-order modes and approximating the beam deflection by a different order series, bifurcation based on phase portraits is conducted to derive static and dynamic pull-in voltages. It is found that the static pull-in phenomenon follows dynamic instabilities, and the dc dynamic pull-in voltage is around 91–92% of the static counterpart. However, the derived dynamic pull-in voltage is found to be dependent on the varied beam parameters, different from a fixed predicted value derived in past works, where only lumped models are assumed. Furthermore, accurate closed-form predictions are provided for non-narrow beams. The predictions are finally validated by finite element analysis and available experimental data

  5. Influence of cement compressive strength and porosity on augmentation performance in a model of orthopedic screw pull-out.

    Science.gov (United States)

    Pujari-Palmer, Michael; Robo, Celine; Persson, Cecilia; Procter, Philip; Engqvist, Håkan

    2018-01-01

    Disease and injuries that affect the skeletal system may require surgical intervention and internal fixation, i.e. orthopedic plate and screw insertion, to stabilize the injury and facilitate tissue repair. If the surrounding bone quality is poor the screws may migrate, or the bone may fail, resulting in fixation failure. While numerous studies have shown that cement augmentation of the interface between bone and implant can increase screw pull-out force, the physical properties of cement that influence pull-out force have not been investigated. The present study sought to determine how the physical properties of high strength calcium phosphate cements (hsCPCs, specifically dicalcium phosphate) affected the corresponding orthopedic screw pull-out force in urethane foam models of "healthy" and "osteoporotic" synthetic bone (Sawbones). In the simplest model, where only the bond strength between screw thread and cement (without Sawbone) was tested, the correlation between pull-out force and cement compressive strength (R 2 = 0.79) was weaker than correlation with total cement porosity (R 2 = 0.89). In open pore Sawbone that mimics "healthy" cancellous bone density the stronger cements produced higher pull-out force (50-60% increase). High strength, low porosity cements also produced higher pull-out forces (50-190% increase) in "healthy" Sawbones with cortical fixation if the failure strength of the cortical material was similar to, or greater than (a metal shell), actual cortical bone. This result is of particular clinical relevance where fixation with a metal plate implant is indicated, as the nearby metal can simulate a thicker cortical shell, thereby increasing the pull-out force of screws augmented with stronger cements. The improvement in pull-out force was apparent even at low augmentation volumes of 0.5mL (50% increase), which suggest that in clinical situations where augmentation volume is limited the stronger, lower porosity calcium phosphate cement (CPC) may

  6. Toward automating Hammersmith pulled-to-sit examination of infants using feature point based video object tracking.

    Science.gov (United States)

    Dogra, Debi P; Majumdar, Arun K; Sural, Shamik; Mukherjee, Jayanta; Mukherjee, Suchandra; Singh, Arun

    2012-01-01

    Hammersmith Infant Neurological Examination (HINE) is a set of tests used for grading neurological development of infants on a scale of 0 to 3. These tests help in assessing neurophysiological development of babies, especially preterm infants who are born before (the fetus reaches) the gestational age of 36 weeks. Such tests are often conducted in the follow-up clinics of hospitals for grading infants with suspected disabilities. Assessment based on HINE depends on the expertise of the physicians involved in conducting the examinations. It has been noted that some of these tests, especially pulled-to-sit and lateral tilting, are difficult to assess solely based on visual observation. For example, during the pulled-to-sit examination, the examiner needs to observe the relative movement of the head with respect to torso while pulling the infant by holding wrists. The examiner may find it difficult to follow the head movement from the coronal view. Video object tracking based automatic or semi-automatic analysis can be helpful in this case. In this paper, we present a video based method to automate the analysis of pulled-to-sit examination. In this context, a dynamic programming and node pruning based efficient video object tracking algorithm has been proposed. Pulled-to-sit event detection is handled by the proposed tracking algorithm that uses a 2-D geometric model of the scene. The algorithm has been tested with normal as well as marker based videos of the examination recorded at the neuro-development clinic of the SSKM Hospital, Kolkata, India. It is found that the proposed algorithm is capable of estimating the pulled-to-sit score with sensitivity (80%-92%) and specificity (89%-96%).

  7. Factors influencing selection for a day-case or 23-h stay procedure in transanal endoscopic microsurgery.

    Science.gov (United States)

    Ford, S J; Wheeler, J M D; Borley, N R

    2010-03-01

    Transanal endoscopic microsurgery (TEMS) is an alternative to radical resection of the rectum for benign lesions and early rectal cancer. This study aimed to identify whether day-case TEMS is safe and which factors dictate patient suitability and length of stay (LOS). Details of patients undergoing TEMS resection were retrieved from a tertiary referral prospective database. Of 96 patients, 46 (48 per cent) were day cases, 24 (25 per cent) had a 23-h stay and 26 (27 per cent) were inpatients. The frequency of day-case surgery increased significantly over the study interval (P = 0.050). Distance of the lesion from the anorectal junction, malignant potential and travel distance had no bearing on LOS. Older age (P = 0.004) and duration of surgery (P = 0.002) correlated significantly with increased LOS. Lesions covering one quadrant involved a significantly shorter stay than those covering two or more quadrants (P = 0.002). Maximum diameter (mean 5.7 cm) was strongly related to LOS (P = 0.009). Day-case and 23-h stay patients had a significantly higher proportion of lower-risk lesions (P = 0.001). High-volume day-case TEMS appears safe, even when long travel distances are involved. With advances in practice and procedural safety, traditional risk factors may not be as important as currently thought. (c) 2010 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.

  8. MRI surveillance for the detection of local recurrence in rectal cancer after transanal endoscopic microsurgery

    Energy Technology Data Exchange (ETDEWEB)

    Hupkens, Britt J.P.; Martens, Milou H. [Maastricht University Medical Center, Department of Radiology, Maastricht (Netherlands); Maastricht University Medical Center, Department of Surgery, Maastricht (Netherlands); GROW School for Oncology and Developmental Biology, Maastricht (Netherlands); Maas, Monique [Maastricht University Medical Center, Department of Radiology, Maastricht (Netherlands); The Netherlands Cancer Institute, Department of Radiology, Amsterdam (Netherlands); Deserno, Willem M.L.L.G. [Laurentius Hospital, Department of Radiology, Roermond (Netherlands); Leijtens, Jeroen W.A. [Laurentius Hospital, Department of Surgery, Roermond (Netherlands); Nelemans, Patty J. [Maastricht University, Department of Epidemiology, Maastricht (Netherlands); Bakers, Frans C.H. [Maastricht University Medical Center, Department of Radiology, Maastricht (Netherlands); Maastricht University Medical Centre, Maastricht (Netherlands); Lambregts, Doenja M.J. [The Netherlands Cancer Institute, Department of Radiology, Amsterdam (Netherlands); Beets, Geerard L. [GROW School for Oncology and Developmental Biology, Maastricht (Netherlands); The Netherlands Cancer Institute, Department of Surgery, Amsterdam (Netherlands); Beets-Tan, Regina G.H. [GROW School for Oncology and Developmental Biology, Maastricht (Netherlands); The Netherlands Cancer Institute, Department of Radiology, Amsterdam (Netherlands)

    2017-12-15

    To evaluate diagnostic performance of follow-up MRI for detection of local recurrence of rectal cancer after transanal endoscopic microsurgery (TEM). Between January 2006 and February 2014, 81 patients who underwent TEM were included. Two expert readers (R1 and R2), independently evaluated T2-weighted (T2W) MRI and diffusion-weighted (DWI) MRI for the detection of local recurrence, retrospectively, and recorded confidence on a five-point scale. Diagnostic performance of follow-up MRI was assessed using ROC-curve analysis and kappa statistics for the reproducibility between readers. 293 MRIs were performed, 203 included DWI. 18 (22%) patients developed a local recurrence: luminal 11, nodal two and both five. Areas under the curve (AUCs) for local recurrence detection were 0.72 (R1) and 0.80 (R2) for T2W-MRI. For DWI, AUCs were 0.70 (R1) and 0.89 (R2). For nodal recurrence AUCs were 0.72 (R1) and 0.80 (R2) for T2W-MRI. Reproducibility was good for T2W-MRI (κ0.68 for luminal and κ0.71 for nodal recurrence) and moderate for DWI (κ0.57). AUCs and reproducibility for recurrence detection increased during follow-up. Follow-up with MRI after TEM for rectal cancer is feasible. Postoperative changes can be confusing at the first postoperative MRI, but during follow-up diagnostic performance and reproducibility increase. (orig.)

  9. MRI surveillance for the detection of local recurrence in rectal cancer after transanal endoscopic microsurgery

    International Nuclear Information System (INIS)

    Hupkens, Britt J.P.; Martens, Milou H.; Maas, Monique; Deserno, Willem M.L.L.G.; Leijtens, Jeroen W.A.; Nelemans, Patty J.; Bakers, Frans C.H.; Lambregts, Doenja M.J.; Beets, Geerard L.; Beets-Tan, Regina G.H.

    2017-01-01

    To evaluate diagnostic performance of follow-up MRI for detection of local recurrence of rectal cancer after transanal endoscopic microsurgery (TEM). Between January 2006 and February 2014, 81 patients who underwent TEM were included. Two expert readers (R1 and R2), independently evaluated T2-weighted (T2W) MRI and diffusion-weighted (DWI) MRI for the detection of local recurrence, retrospectively, and recorded confidence on a five-point scale. Diagnostic performance of follow-up MRI was assessed using ROC-curve analysis and kappa statistics for the reproducibility between readers. 293 MRIs were performed, 203 included DWI. 18 (22%) patients developed a local recurrence: luminal 11, nodal two and both five. Areas under the curve (AUCs) for local recurrence detection were 0.72 (R1) and 0.80 (R2) for T2W-MRI. For DWI, AUCs were 0.70 (R1) and 0.89 (R2). For nodal recurrence AUCs were 0.72 (R1) and 0.80 (R2) for T2W-MRI. Reproducibility was good for T2W-MRI (κ0.68 for luminal and κ0.71 for nodal recurrence) and moderate for DWI (κ0.57). AUCs and reproducibility for recurrence detection increased during follow-up. Follow-up with MRI after TEM for rectal cancer is feasible. Postoperative changes can be confusing at the first postoperative MRI, but during follow-up diagnostic performance and reproducibility increase. (orig.)

  10. Stability and servo-control of the crystal pulling process

    International Nuclear Information System (INIS)

    Johansen, T.H.

    1990-11-01

    The paper analyzes why the crystal pulling process needs servo-control, and how it can be implemented. Special emphasis is put on the fundamental question of inherent stability, and how to interpret the signal from a balance when the weighing method is used for cystal diameter detection. 15 refs., 13 figs

  11. [Clinical observation of post-extension pulling massage in treating lumbar disc herniation].

    Science.gov (United States)

    Lü, Li-Jiang; Ke, Xue-Ai; Mao, Xu-Dan; Chen, Xiao-Jie; Wu, Fang-Chao; Tong, Hong-Jie

    2010-10-01

    To observe the clinical effect of post-extension pulling massage in treating lumbar disc herniation. From January 2008 to December 2008, 61 patients with lumbar disc herniation, 34 males and 27 females, ranging in age from 17 to 67 years with an average of 42.6 years, were treated with post-extension pulling massage after continued traction for 30 minutes (on alternate days one time, 3 times as a course of treatment). There was bulging type in 9 cases, hernia type in 22, free type in 30. After a course of treatment, the clinical effects were evaluated according to standard of Macnab, the items included pain, lumbar activity, normal work and life of patients. All patients were followed up from 1 to 9 months with an average of 4.6 months. After treatment, the symptoms and signs of patients had obviously improved in above aspects. According to standard of Macnab, 48 cases got excellent result, 10 good, 2 fair, 1 poor. The post-extension pulling massage in treating lumbar disc herniation can obtain satisfactory results, which have localized site of action, small compression for vertebral body and can reduce accidental injury.

  12. Characteristics Of Virgin And Pulled Wool Fibres Used In Tunisian Handmade Carpets

    Directory of Open Access Journals (Sweden)

    Taoufik Harizi

    2015-08-01

    Full Text Available Abstract Many factors such as production methods fibre quality and structural parameters have distinctive influence on the quality and performance of a hand woven carpet. Because the most common fiber used for producing handmade carpet is wool this experiment was aimed to identify virgin and pulled wool characteristics of Tunisian sheep breeds. A total of 84 sheep and 15 samples of commercial pulled wool were used in this study. Samples of fiber were analyzed using standard objective measurements for staple length SL mean fiber diameter MFD coefficient of variation of fiber diameter FDCV fine fiber contain FC Breaking strength and Elongation. Results showed that Tunisian wool can be considered as medium wool. By conducting well-planned sorting Fine Queue of west sheep breed can supply the wool needed for textile industries. The wool of other sheep breeds can be used in handmade carpets. Also staple strength as one of the important wool characteristic affected significantly by alkali treatment during chemical unhairing process compared with wool collected by shearing process. Great attention must be paid to know the real characteristics of pulled wool before using it in handmade carpet industry.

  13. The effect of oil pulling with pure coconut oil on Streptococcus mutans: A randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Varsha Komath Pavithran

    2017-01-01

    Full Text Available Introduction: Oil pulling as described in ancient Ayurveda involves the use of edible vegetable oils as oral antibacterial agents. It is a practice of swishing oil in the mouth for oral and systemic health benefits. Pure coconut oil has antimicrobial properties and is commonly available in all Indian households. Aim: This study aims to assess the effect of oil pulling therapy with pure coconut oil on Streptococcus mutans count and to compare its efficacy against sesame oil and saline. Materials and Methods: A randomized controlled concurrent parallel- triple blinded clinical trial was conducted. Thirty participants in age range of 20–23 years were randomly allocated into Group A (coconut oil, Group B (sesame oil, and Group C (saline, with 10 in each group. The participants were instructed to swish and pull 10 ml of oil on empty stomach, early morning for 10–15 min. Unstimulated saliva collected before and after oil pulling procedure was analyzed for colony forming units (CFU per ml saliva of S. mutans. The data were analyzed using paired t-test, ANOVA, and post hoc analysis using Tukey's honest significant difference. Statistical significance was set at P < 0.05. Results: A statistically significant reduction in S. mutans CFU count after oil pulling with pure coconut oil (P = 0.001 was found. There was no statistically significant difference between sesame oil and coconut oil (P = 0.97 and between sesame oil and saline (P = 0.061. When efficacy of coconut oil against saline was evaluated, a statistical significant difference (P = 0.039 was found. Conclusion: Oil pulling is an effective method for oral hygiene maintenance as it significantly reduces S. mutans count in the saliva.

  14. Kinematics and kinetics of the bench-press and bench-pull exercises in a strength-trained sporting population.

    Science.gov (United States)

    Pearson, Simon N; Cronin, John B; Hume, Patria A; Slyfield, David

    2009-09-01

    Understanding how loading affects power production in resistance training is a key step in identifying the most optimal way of training muscular power - an essential trait in most sporting movements. Twelve elite male sailors with extensive strength-training experience participated in a comparison of kinematics and kinetics from the upper body musculature, with upper body push (bench press) and pull (bench pull) movements performed across loads of 10-100% of one repetition maximum (1RM). 1RM strength and force were shown to be greater in the bench press, while velocity and power outputs were greater for the bench pull across the range of loads. While power output was at a similar level for the two movements at a low load (10% 1RM), significantly greater power outputs were observed for the bench pull in comparison to the bench press with increased load. Power output (Pmax) was maximized at higher relative loads for both mean and peak power in the bench pull (78.6 +/- 5.7% and 70.4 +/- 5.4% of 1RM) compared to the bench press (53.3 +/- 1.7% and 49.7 +/- 4.4% of 1RM). Findings can most likely be attributed to differences in muscle architecture, which may have training implications for these muscles.

  15. Low pull-in voltage electrostatic MEMS switch using liquid dielectric

    KAUST Repository

    Zidan, Mohammed A.; Kosel, Jü rgen; Salama, Khaled N.

    2014-01-01

    In this paper, we present an electrostatic MEMS switch with liquids as dielectric to reduce the actuation voltage. The concept is verified by simulating a lateral dual gate switch, where the required pull-in voltage is reduced by more than 8 times

  16. Push-you-pull-you: the boundaried self in close relationships.

    Science.gov (United States)

    Rempel, John K; Burris, Christopher T

    2006-02-01

    Based on Amoebic Self Theory, the authors propose that the salience of different threats to the self affects the extent to which an intimate relationship partner is pushed away (excluded) or pulled closer (included). When social threat is salient among persons in relationships, it is hypothesized that partners will attempt to defuse the resulting sense of interpersonal vulnerability: offending partners may be pushed away, whereas offenders themselves may draw closer. When spatial-symbolic threat is salient and the relationship's capacity to function as an identity marker is jeopardized, it is hypothesized that the partner--regardless of his or her role--will be pulled closer to maintain the perception that the relationship is secure. Self-report responses to hypothetical scenarios and perceptions of behaviors during a role-play were generally consistent with these hypotheses, suggesting that both an intimate partner and the relationship with that partner can be incorporated into the self.

  17. Exploring tourists push and pull motivations to visit Mauritius as a tourist destination

    Directory of Open Access Journals (Sweden)

    Hemant Kassean

    2013-01-01

    Full Text Available This study examines the motivational push and pull-factors that affect tourists’ decision in their choice of a holiday destination. 200 questionnaires were completed using a face to face interview among specific groups of travellers to Mauritius (English, French, German, Italian and South African tourists at various points on the island. The findings demonstrate that rest and relaxation are the most compelling push motivation forces followed by nostalgia, escape, novelty and social interaction. The key pull based motives were found to be the special climate and weather of Mauritius, the exquisite landscape and scenery, unique flora and fauna, exotic beaches, the exotic ambience and atmosphere, the welcoming nature of Mauritian hospitality and the authentic Mauritian culture. The Push and pull factors between first time visitors and repeat visitors are discussed in this article and the study essentially contributes to our overall understanding of why holiday makers take travel decisions to opt for long- haul destinations like Mauritius, and can therefore help destination marketers develop better marketing programmes to meet the specific needs of their customers.

  18. Anal wall sparing effect of an endorectal balloon in 3D conformal and intensity-modulated prostate radiotherapy

    International Nuclear Information System (INIS)

    Smeenk, Robert Jan; Lin, Emile N.J.Th. van; Kollenburg, Peter van; Kunze-Busch, Martina; Kaanders, Johannes H.A.M.

    2009-01-01

    Background and purpose: To investigate the anal wall (Awall) sparing effect of an endorectal balloon (ERB) in 3D conformal radiotherapy (3D-CRT) and intensity-modulated radiotherapy (IMRT) for prostate cancer. Materials and methods: In 24 patients with localized prostate carcinoma, two planning CT-scans were performed: with and without ERB. A prostate planning target volume (PTV) was defined, and the Awall was delineated, using two different methods. Three-field and 4-field 3D-CRT plans, and IMRT plans were generated with a prescription dose of 78 Gy. In 144 treatment plans, the minimum dose (D min ), maximum dose (D max ), and mean dose (D mean ) to the Awall were calculated, as well as the Awall volumes exposed to doses ranging from ≥20 Gy to ≥70 Gy (V 20 - V 70 , respectively). Results: In the 3D-CRT plans, an ERB significantly reduced D mean , D max , and V 30 - V 70 . For IMRT all investigated dose parameters were significantly reduced by the ERB. The absolute reduction of D mean was 12 Gy in 3D-CRT and was 7.5 Gy in IMRT for both methods of Awall delineation. Conclusions: Application of an ERB showed a significant Awall sparing effect in both 3D-CRT and IMRT. This may lead to reduced late anal toxicity in prostate radiotherapy.

  19. Lessons learned from tubes pulled from French steam generators

    International Nuclear Information System (INIS)

    Berge, Ph.; Boursier, J.M.; Dallery, D.; De Keroulas, F.; Rouillon, Y.

    1998-01-01

    Since 1981, the Chinon Hot Laboratory has completed more than 380 metallurgical examinations of pulled French steam generator tubes. Electricite de France decided to perform such investigations from the very outset of the French nuclear program, in order to contribute to nuclear power plant safety. The main reasons for withdrawing tubes are to evaluate the degradation, to validate non destructive examination (NDE) techniques, to gain a better understanding of cracking phenomena, and to ensure that the criteria on which plugging operations are based remain conservative. Considerable experience has been accumulated in the field of primary water stress corrosion cracking (PWSCC), OD (secondary) side corrosion, leak and burst tests, and various tube plugging techniques. This paper focuses on the PWSCC phenomenon and on the secondary side corrosion process, and in particular, attempts to correlate French data from pulled tubes with the results of fundamental R and D studies. Finally, within the framework of the Nuclear Power Plant Safety and Maintenance Policy, all these results are discussed in terms of optimization of the field inspection of tube bundles and plugging criteria. (author)

  20. Are pushing and pulling work-related risk factors for upper extremity symptoms? A systematic review of observational studies.

    Science.gov (United States)

    Hoozemans, M J M; Knelange, E B; Frings-Dresen, M H W; Veeger, H E J; Kuijer, P P F M

    2014-11-01

    Systematically review observational studies concerning the question whether workers that perform pushing/pulling activities have an increased risk for upper extremity symptoms as compared to workers that perform no pushing/pulling activities. A search in MEDLINE via PubMed and EMBASE was performed with work-related search terms combined with push/pushing/pull/pulling. Studies had to examine exposure to pushing/pulling in relation to upper extremity symptoms. Two authors performed the literature selection and assessment of the risk of bias in the studies independently. A best evidence synthesis was used to draw conclusions in terms of strong, moderate or conflicting/insufficient evidence. The search resulted in 4764 studies. Seven studies were included, with three of them of low risk of bias, in total including 8279 participants. A positive significant relationship with upper extremity symptoms was observed in all four prospective cohort studies with effect sizes varying between 1.5 and 4.9. Two out of the three remaining studies also reported a positive association with upper extremity symptoms. In addition, significant positive associations with neck/shoulder symptoms were found in two prospective cohort studies with effect sizes of 1.5 and 1.6, and with shoulder symptoms in one of two cross-sectional studies with an effect size of 2.1. There is strong evidence that pushing/pulling is related to upper extremity symptoms, specifically for shoulder symptoms. There is insufficient or conflicting evidence that pushing/pulling is related to (combinations of) upper arm, elbow, forearm, wrist or hand symptoms. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  1. Comparison of Olympic and Hexagonal Barbells With Midthigh Pull, Deadlift, and Countermovement Jump.

    Science.gov (United States)

    Malyszek, Kylie K; Harmon, RoQue A; Dunnick, Dustin D; Costa, Pablo B; Coburn, Jared W; Brown, Lee E

    2017-01-01

    Malyszek, KK, Harmon, RA, Dunnick, DD, Costa, PB, Coburn, JW, and Brown, LE. Comparison of olympic and hexagonal barbells with midthigh pull, deadlift, and countermovement jump. J Strength Cond Res 31(1): 140-145, 2017-Those training for strength and power commonly use different bars and different lifts. The hexagonal barbell (HBar) and Olympic barbell (OBar) are frequently used training implements, and the midthigh pull (MTP) and deadlift (DL) are 2 popular exercises. Therefore, the purpose of this study was to compare force between an HBar and OBar for a MTP, DL, and countermovement jump (CMJ). Twenty resistance-trained men (age = 24.05 ± 2.09 years, ht = 178.07 ± 7.05 cm, mass = 91.42 ± 14.44 kg) volunteered to participate and performed MTP and DL using both bars and a CMJ. Joint angles were recorded for all pulls and the bottom position of the CMJ. Peak ground reaction force (PGRF) was greater in the MTP (3,186.88 ± 543.53 N) than DL (2,501.15 ± 404.04 N) but not different between bars. Midthigh pull joint angles were more extended than DL, and the strongest correlations between isometric and dynamic performance were seen between DL PGRF and CMJ impulse (OBar r = 0.85; HBar r = 0.84). These findings are likely because of the different anatomical characteristics between the MTP and DL and the similarity in joint angles between the DL and CMJ. Therefore, the DL may be an optimal choice for athletes in jump-dependent sports, regardless of bar.

  2. Whole Prostate Volume and Shape Changes with the Use of an Inflatable and Flexible Endorectal Coil

    International Nuclear Information System (INIS)

    Osman, M.; Shebel, H.; Sankineni, S.; Bernardo, M.L.; Daar, D.; Choyke, P.L.; Turkbey, B.; Agarwal, H.K.; Osman, M.; Shebel, H.; Bernardo, M.L.; Wood, P.J.; Pinto, P.A.; Agarwal, H.K.

    2014-01-01

    To determine to what extent an inflatable endorectal coil (ERC) affects whole prostate (WP) volume and shape during prostate MRI. Materials and Methods. 79 consecutive patients underwent T2W MRI at 3T first with a 6-channel surface coil and then with the combination of a 16-channel surface coil and ERC in the same imaging session. WP volume was assessed by manually contouring the prostate in each T2W axial slice. PSA density was also calculated. The maximum anterior-posterior (AP), left-right (LR), and cranio caudal (CC) prostate dimensions were measured. Changes in WP prostate volume, PSA density, and prostate dimensions were then evaluated. Results. In 79 patients, use of an ERC yielded no significant change in whole prostate volume (0.6 ± 5.7 %, Ρ=0.270) and PSA density (-0.2 ±5.6%,Ρ=0.768 ). However, use of an ERC significantly decreased the AP dimension of the prostate by -8.6 ±7.8%(Ρ<0.001), increased LR dimension by 4.5 ± 5.8 %(Ρ<0.001), and increased the CC dimension by 8.8 ±6.9 %( Ρ<0.001). Conclusion. Use of an ERC in prostate MRI results in the shape deformation of the prostate gland with no significant change in the volume of the prostate measured on T2W MRI. Therefore, WP volumes calculated on ERC MRI can be reliably used in clinical work flow.

  3. Ion Concentration- and Voltage-Dependent Push and Pull Mechanisms of Potassium Channel Ion Conduction.

    Directory of Open Access Journals (Sweden)

    Kota Kasahara

    Full Text Available The mechanism of ion conduction by potassium channels is one of the central issues in physiology. In particular, it is still unclear how the ion concentration and the membrane voltage drive ion conduction. We have investigated the dynamics of the ion conduction processes in the Kv1.2 pore domain, by molecular dynamics (MD simulations with several different voltages and ion concentrations. By focusing on the detailed ion movements through the pore including selectivity filter (SF and cavity, we found two major conduction mechanisms, called the III-IV-III and III-II-III mechanisms, and the balance between the ion concentration and the voltage determines the mechanism preference. In the III-IV-III mechanism, the outermost ion in the pore is pushed out by a new ion coming from the intracellular fluid, and four-ion states were transiently observed. In the III-II-III mechanism, the outermost ion is pulled out first, without pushing by incoming ions. Increases in the ion concentration and voltage accelerated ion conductions, but their mechanisms were different. The increase in the ion concentrations facilitated the III-IV-III conductions, while the higher voltages increased the III-II-III conductions, indicating that the pore domain of potassium channels permeates ions by using two different driving forces: a push by intracellular ions and a pull by voltage.

  4. Motivation and Perception of Tourists as Push and Pull Factors to Visit National Park

    Science.gov (United States)

    Said, Jumrin; Maryono

    2018-02-01

    Push-pull theoretical framework is a popular theory to explain the reason why the tourists decide to visit the destination rather than other place, the kind of experience they want to get and the type of activity they want to do. In this paper, it is explained the motivation as push factors and the perception as pull factors of the tourist in deciding the destination based on previous literature and research using descriptive method. The framework asumed that tourists are motivated to fulfill their needs, including to reduce the psychological imbalance and to gain recognition of social status. National Park is one of destination based on nature or commonly knowns as ecotourism. In choosing the destination, the tourists tend to classify their alternative choice based on several criteria, such as the domination perception of tourist from one destination (pull factor), self motivation (push factor) and the available time and money (situational constraints).

  5. Push-pull converter with energy saving circuit for protecting switching transistors from peak power stress

    Science.gov (United States)

    Mclyman, W. T. (Inventor)

    1981-01-01

    In a push-pull converter, switching transistors are protected from peak power stresses by a separate snubber circuit in parallel with each comprising a capacitor and an inductor in series, and a diode in parallel with the inductor. The diode is connected to conduct current of the same polarity as the base-emitter juction of the transistor so that energy stored in the capacitor while the transistor is switched off, to protect it against peak power stress, discharges through the inductor when the transistor is turned on, and after the capacitor is discharges through the diode. To return this energy to the power supply, or to utilize this energy in some external circuit, the inductor may be replaced by a transformer having its secondary winding connected to the power supply or to the external circuit.

  6. Pull-in instability tuning in imperfect nonlinear circular microplates under electrostatic actuation

    Energy Technology Data Exchange (ETDEWEB)

    Jallouli, A.; Kacem, N., E-mail: najib.kacem@univ-fcomte.fr; Bourbon, G.; Le Moal, P.; Walter, V.; Lardies, J.

    2016-12-01

    Highlights: • Dynamic range improvement of electrostatically actuated circular microplates. • Pull-in instability tuning based on geometric nonlinearity and imperfections. • Predictive computational model for the nonlinear behavior of circular microplates. - Abstract: Dynamic range improvement based on geometric nonlinearity and initial deflection is demonstrated with imperfect circular microplates under electrostatic actuation. Depending on design parameters, we prove how the von Kármán nonlinearity and the plate imperfections lead to a significant delay in pull-in occurrence. These promising results open the way towards an accurate identification of static parameters of circular microplates and the development of a predictive model for the nonlinear dynamics of imperfect capacitive micromachined ultrasonic transducers.

  7. OPTICAL PULLING FORCES IN “NANOPARTICLES DIMER IN THE STRUCTURED FIELD” SYSTEM

    Directory of Open Access Journals (Sweden)

    S. V. Sukhov

    2015-01-01

    Full Text Available The subject area of this research is optical pulling forces as one of the manifestations of light mechanical action on material objects. In particular, we investigated optical forces acting on a dimer composed of nanoparticles with a small radius as compared to wavelength. The calculation of Lorentz optical forces was carried out by solving self-consistent system of equations, which made it possible to calculate electromagnetic fields in every point of the structure. We worked out analytic formula, representing the dependence of optical force on the parameters of dimer system and structured radiation made up of two crossing plane waves. For the first time we showed that dimer consisting of two equal dipolar particles can experience an optical pulling force (“negative radiation pressure” in the field of two crossing plane waves. It is shown that the increase of photons momentum (the projection of photons momentum on the direction of structured light propagation after scattering is responsible for this negative radiation pressure. The corresponding scattering diagram showed the increase of forward scattering, that is the conformation of the considered mechanism of pulling forces origination. Our findings would be very useful for increasing capabilities of optical manipulation of nano- and micro-particles.

  8. Measurement of pull-off force on imprinted nanopatterns in an inert liquid

    International Nuclear Information System (INIS)

    Kim, Jae Kwan; Lee, Dong Eon; Lee, Woo Il; Suh, Kahp Y

    2010-01-01

    We report on the measurement of the pull-off force on nanoscale patterns that are formed by thermal nanoimprint lithography (t-NIL). Various patterns with feature sizes in the range of 50-900 nm were fabricated on silicon substrates using a rigiflex polymeric mold of ultraviolet curable polyurethane acrylate (PUA, Young's modulus ∼ 1 GPa) or perfluoropolyether (PFPE, Young's modulus ∼ 10.5 MPa) and a resist layer of polystyrene (PS) of three different molecular weights (M w = 18 100, 211 600 and 2043 000). The pull-off force was measured in non-polar, non-reactive perfluorodecalin (PFD) solvent between a sharp atomic force microscopy (AFM) tip and an imprinted pattern. Our experimental data demonstrated that the measured pull-off forces were in good agreement with a simple adhesion model based on Lifshitz theory. Also, the force on the pressed region (valley) is higher than that on the cavity region (hill), with the ratio (hill/valley) decreasing with the decrease of pattern size and the increase of molecular weight. The confinement effects were more pronounced for smaller patterns ( w = 211 600 and 2043 000) presumably due to sluggish movement of polymer chains into nano-cavities. Finally, the experimental observations were compared with molecular dynamic simulations based on a simplified amorphous polyethylene model.

  9. Is a pulling sensation in the anteroposterior direction associated with otolith dysfunction?

    Science.gov (United States)

    Saka, Naoki; Seo, Toru; Ohta, Shigeto; Sakagami, Masafumi

    2014-03-01

    A pulling sensation in the anteroposterior direction is suggested to originate from a dysfunction of the otolith organs. Previous study with vestibular evoked myogenic potential (VEMP) confirmed that a falling sensation (in an up or down direction) and a lateral tilt sensation (in a right or left direction) were caused by otolith lesions. The purpose of this study was to clarify whether a pulling sensation in the anteroposterior (forward or backward) direction originates from otolith dysfunction. The otolith function was assessed by cervical and ocular VEMPs (cVEMPs and oVEMPs) in 12 patients who complained of a forward or backward pulling sensation. cVEMPs were evaluated by the asymmetry ratio (AR) of the amplitude of the p13-n23 wave and the peak latencies of the p13 and n23 waves. oVEMPs were evaluated by the AR of the amplitude of the n1-p1 wave and the peak latency of the n1 and p1 waves. Abnormal ARs on cVEMP were observed in 7 of 12 patients. Nine of 12 patients had abnormal oVEMP results including 3 bilateral absent responses. Most (10 of 12) patients had abnormal cVEMP and/or oVEMP results. The latency of each detected wave was within the normal ranges.

  10. Push an pull forces in the building and construction industry

    NARCIS (Netherlands)

    Frings-Dresen, M. H. W.; Windhorst, Judith; Hoozemans, M. J M; Van Der Beek, Allard J.; Van der Molen, Henk F.

    2000-01-01

    Push and pull activities are increasing in the building and construction industry. These activities can be assumed as one of the risk factors for the development of low back and upper extremity complaints. For a risk evaluation, besides the frequency and the duration of the activities, information

  11. Establishment of a new pull-out strength testing method to quantify early osseointegration-An experimental pilot study.

    Science.gov (United States)

    Nonhoff, J; Moest, T; Schmitt, Christian Martin; Weisel, T; Bauer, S; Schlegel, K A

    2015-12-01

    The animal study aims to evaluate a new experimental model for measuring sole the influence of the surface characteristics independent from implant macro-design on the level of osseointegration by registering the pull-out strength needed for removal of experimental devices with different surfaces from artificial defects. Seventy-two test bodies (36 with the FRIADENT(®) plus surface, 36 with the P15/HAp biofunctionalized surface) were inserted in six adult domestic pigs with artificial calvarial defects. The experimental devices were designed to fit in the defects leaving a gap between the test body and the local bone. After 21 days of healing, the animals were sacrificed and the test bodies were pulled out with a standardised reproducible pull-out device measuring the pull-out strength. The pull-out strength for both groups was compared. Twenty-one days after insertion a mean force of 412 ± 142 N for the P15/HAp group and 183 ± 105 N for the FRIADENT(®) plus group was measured for the removal of the specimens from the calvarial bone. The difference between the groups was statistically significant (p implant surfaces on the early stage of osseointegration. Copyright © 2015 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  12. HOM identification by bead pulling in the Brookhaven ERL cavity

    CERN Document Server

    Hahn, H; Jain, Puneet; Johnson, Elliott C; Xu, Wencan

    2014-01-01

    Exploratory measurements of the Brookhaven Energy Recovery Linac (ERL) cavity at superconducting temperature produced a long list of high order modes (HOMs). The niobium 5-cell cavity is terminated at each end with HOM ferrite dampers that successfully reduce the Q-factors to levels required to avoid beam break up (BBU) instabilities. However, a number of un-damped resonances with Q≥106 were found at 4 K and their mode identification forms the focus of this paper. The approach taken here consists of bead pulling on a copper (Cu) replica of the ERL cavity with dampers involving various network analyzer measurements. Several different S21 transmission measurements are used, including those taken from the fundamental input coupler to the pick-up probe across the cavity, others between beam-position monitor probes in the beam tubes, and also between probes placed into the cells. The bead pull technique suitable for HOM identification with a metallic needle or dielectric bead is detailed. This paper presents the...

  13. Relationship between interstitial and blood glucose in type 1 diabetes patients: delay and the push-pull phenomenon revisited

    NARCIS (Netherlands)

    Wentholt, Iris M. E.; Hart, Augustus A. M.; Hoekstra, Joost B. L.; DeVries, J. Hans

    2007-01-01

    BACKGROUND: Interpretation of glucose sensor results requires clarification of the relationship between interstitial (IG) and blood (BG) glucose. We examined the delay of IG upon BG change and reinvestigated the push-pull phenomenon in type 1 diabetes patients. The push-pull phenomenon postulates

  14. Class II malocclusion treatment using high-pull headgear with a splint: a systematic review

    Directory of Open Access Journals (Sweden)

    Helder B. Jacob

    2013-04-01

    Full Text Available OBJECTIVE: To systematically review the scientific evidence pertaining to the effectiveness of high-pull headgear in growing Class II subjects. METHODS: A literature survey was performed by electronic database search. The survey covered the period from January 1966 to December 2008 and used Medical Subject Headings (MeSH. Articles were initially selected based on their titles and abstracts; the full articles were then retrieved. The inclusion criteria included growing subjects between 8 to 15 years of age, Class II malocclusion treatment with high-pull headgear, and a control group with Class II malocclusion. References from selected articles were hand-searched for additional publications. Selected studies were evaluated methodologically. RESULTS: Four articles were selected; none were randomized controlled trials. All of the articles clearly formulated their objectives and used appropriate measures. The studies showed that high-pull headgear treatment improves skeletal and dental relationship, distal displacement of the maxilla, vertical eruption control and upper molars distalization. One of the studies showed a slight clockwise rotation of the palatal plane; the others showed no significant treatment effect. The mandible was not affected by the treatment. CONCLUSION: While there is still a lack of strong evidence demonstrating the effects of high-pull headgear with a splint, other studies indicate that the AP relations improve due to distalization of the maxilla and upper molars, with little or no treatment effects in the mandible. Greater attention to the design should be given to improve the quality of such trials.

  15. Optical pulling and pushing forces exerted on silicon nanospheres with strong coherent interaction between electric and magnetic resonances.

    Science.gov (United States)

    Liu, Hongfeng; Panmai, Mingcheng; Peng, Yuanyuan; Lan, Sheng

    2017-05-29

    We investigated theoretically and numerically the optical pulling and pushing forces acting on silicon (Si) nanospheres (NSs) with strong coherent interaction between electric and magnetic resonances. We examined the optical pulling and pushing forces exerted on Si NSs by two interfering waves and revealed the underlying physical mechanism from the viewpoint of electric- and magnetic-dipole manipulation. As compared with a polystyrene (PS) NS, it was found that the optical pulling force for a Si NS with the same size is enlarged by nearly two orders of magnitude. In addition to the optical pulling force appearing at the long-wavelength side of the magnetic dipole resonance, very large optical pushing force is observed at the magnetic quadrupole resonance. The correlation between the optical pulling/pushing force and the directional scattering characterized by the ratio of the forward to backward scattering was revealed. More interestingly, it was found that the high-order electric and magnetic resonances in large Si NSs play an important role in producing optical pulling force which can be generated by not only s-polarized wave but also p-polarized one. Our finding indicates that the strong coherent interaction between the electric and magnetic resonances existing in nanoparticles with large refractive indices can be exploited to manipulate the optical force acting on them and the correlation between the optical force and the directional scattering can be used as guidance. The engineering and manipulation of optical forces will find potential applications in the trapping, transport and sorting of nanoparticles.

  16. Field evaluation of a push-pull system to reduce malaria transmission.

    Directory of Open Access Journals (Sweden)

    David J Menger

    Full Text Available Malaria continues to place a disease burden on millions of people throughout the tropics, especially in sub-Saharan Africa. Although efforts to control mosquito populations and reduce human-vector contact, such as long-lasting insecticidal nets and indoor residual spraying, have led to significant decreases in malaria incidence, further progress is now threatened by the widespread development of physiological and behavioural insecticide-resistance as well as changes in the composition of vector populations. A mosquito-directed push-pull system based on the simultaneous use of attractive and repellent volatiles offers a complementary tool to existing vector-control methods. In this study, the combination of a trap baited with a five-compound attractant and a strip of net-fabric impregnated with micro-encapsulated repellent and placed in the eaves of houses, was tested in a malaria-endemic village in western Kenya. Using the repellent delta-undecalactone, mosquito house entry was reduced by more than 50%, while the traps caught high numbers of outdoor flying mosquitoes. Model simulations predict that, assuming area-wide coverage, the addition of such a push-pull system to existing prevention efforts will result in up to 20-fold reductions in the entomological inoculation rate. Reductions of such magnitude are also predicted when mosquitoes exhibit a high resistance against insecticides. We conclude that a push-pull system based on non-toxic volatiles provides an important addition to existing strategies for malaria prevention.

  17. TU-AB-201-07: Image Guided Endorectal HDR Brachytherapy Using a Compliant Balloon Applicator

    Energy Technology Data Exchange (ETDEWEB)

    Cohen, G; Goodman, K [Memorial Sloan Kettering Cancer Center, New York, NY (United States)

    2015-06-15

    Purpose: High dose rate endorectal brachytherapy is an option to deliver a focal, high-dose radiotherapy to rectal tumors for patients undergoing non-operative management. We investigate a new multichannel, MR compatible applicator with a novel balloon-based design to provide improved treatment geometry. We report on the initial clinical experience using this applicator. Methods: Patients were enrolled on an IRB-approved, dose-escalation protocol evaluating the use of the anorectal (AR-1) applicator (Ancer Medical, Hialeah, FL), a multichannel applicator with two concentric balloons. The inner balloon supports 8 source lumens; the compliant outer balloon expands to separate the normal rectal wall and the source lumens, yet deforms around a firm, exophytic rectal mass, leading to dose escalation to tumor while sparing normal rectum. Under general anesthesia, gold fiducial markers were inserted above and below the tumor, and the AR applicator was placed in the rectum. MRI-based treatment plans were prepared to deliver 15 Gy in 3 weekly fractions to the target volume while sparing healthy rectal tissue, bladder, bowel and anal muscles. Prior to each treatment, CBCT/Fluoroscopy were used to place the applicator in the treatment position and confirm the treatment geometry using rigid registration of the CBCT and planning MRI. After registration of the applicator images, positioning was evaluated based on the match of the gold markers. Results: Highly conformal treatment plans were achieved. MR compatibility of the applicator enabled good tumor visualization. In spite of the non-rigid nature of the applicators and the fact that a new applicator was used at each treatment session, treatment geometry was reproducible to within 2.5 mm. Conclusions: This is the first report on using the AR applicator in patients. Highly conformal plans, confidence in MRI target delineation, in combination with reproducible treatment geometry provide encouraging feedback for continuation with

  18. Effect of oil pulling on Streptococcus mutans count in plaque and saliva using Dentocult SM Strip mutans test: A randomized, controlled, triple-blind study

    Directory of Open Access Journals (Sweden)

    Asokan S

    2008-03-01

    Full Text Available Background: Oil pulling has been used extensively for many years, without scientific evidence or proof, as a traditional Indian folk remedy to prevent teeth decay, oral malodor, bleeding gums, dryness of throat and cracked lips, and for strengthening the teeth, gums, and jaws. Aims: The aim of this study was to evaluate the effect of oil pulling with sesame oil on the count of Streptococcus mutans in plaque and saliva of children, using the Dentocult SM Strip mutans test, and to compare its efficacy with that of chlorhexidine mouthwash. Materials and Methods: Twenty age-matched adolescent boys were selected based on information obtained through a questionnaire. They were divided randomly into two groups: the control or chlorhexidine group (group I and the study or oil pulling group (group II; there were ten subjects in each group. Plaque and saliva samples were collected from all the 20 subjects on the strips from the Dentocult SM kit and, after incubation, the presence of S. mutans was evaluated using the manufacturers′ chart. The study group practiced oil pulling with sesame oil and the control group used chlorhexidine mouthwash for 10 min every day in the morning before brushing. Samples were collected from both groups after 24 h, 48 h, 1 week, and 2 weeks and the efficacy of oil pulling was compared with that of chlorhexidine mouthwash. Results: There was a reduction in the S. mutans count in the plaque and saliva samples of both the study and the control groups. The reduction in the S. mutans count in the plaque of the study group was statistically significant after 1 and 2 weeks (P = 0.01 and P = 0.008, respectively; the control group showed significant reduction at all the four time points (P = 0.01, P = 0.04, P = 0.005, and P = 0.005, respectively, at 24 h, 48 h, 1 week, and 2 weeks. In the saliva samples, significant reduction in S. mutans count was seen in the control group at 48 h, 1 week, and 2 weeks (P = 0.02, P = 0.02, P = 0

  19. Simulation of push-pull inverter using wide bandgap devices

    Science.gov (United States)

    Al-badri, Mustafa; Matin, Mohammed A.

    2016-09-01

    This paper discusses the use of wide bandgap devices (SiC-MOSFET) in the design of a push-pull inverter which provides inexpensive low power dc-ac inverters. The parameters used were 1200V SiC MOSFET(C2M0040120D) made by power company ROHM. This modeling was created using parameters that were provided from a device datasheet. The spice model is provided by this company to study the effect of adding this component on push-pull inverter ordinary circuit and compared results between SiC MOSFET and silicon MOSFET (IRFP260M). The results focused on Vout and Vmos stability as well as on output power and MOSFET power loss because it is a very crucial aspect on DC-AC inverter design. These results are done using the National Instrument simulation program (Multisim 14). It was found that power loss is better in the 12 and 15 vdc inverter. The Vout in the SIC MOSFET circuit shows more stability in the high current low resistance load in comparison to the Silicon MOSFET circuit and this will improve the overall performance of the circuit.

  20. Generic, Extensible, Configurable Push-Pull Framework for Large-Scale Science Missions

    Science.gov (United States)

    Foster, Brian M.; Chang, Albert Y.; Freeborn, Dana J.; Crichton, Daniel J.; Woollard, David M.; Mattmann, Chris A.

    2011-01-01

    different underlying communication middleware (at present, both XMLRPC, and RMI). In addition, the framework is entirely suitable in a multi-mission environment and is supporting both NPP Sounder PEATE and the OCO Mission. Both systems involve tasks such as high-throughput job processing, terabyte-scale data management, and science computing facilities. NPP Sounder PEATE is already using the push-pull framework to accept hundreds of gigabytes of IASI (infrared atmospheric sounding interferometer) data, and is in preparation to accept CRIMS (Cross-track Infrared Microwave Sounding Suite) data. OCO will leverage the framework to download MODIS, CloudSat, and other ancillary data products for use in the high-performance Level 2 Science Algorithm. The National Cancer Institute is also evaluating the framework for use in sharing and disseminating cancer research data through its Early Detection Research Network (EDRN).

  1. A prospective study about functional and anatomic consequences of transanal endoscopic microsurgery Estudio prospectivo de las consecuencias ecográficas y funcionales tras microcirugía transanal endoscópica

    Directory of Open Access Journals (Sweden)

    J. A. Gracia Solanas

    2006-04-01

    Full Text Available Introduction: transanal endoscopic microsurgey (TEM was developed in 1983 by Büess as a minimally invasive technique to manage rectal villous adenomas and early rectal adenocarcinomas. Many studies have been published worldwide about its excellent results in morbidity and recidive rate, but there are few studies addressing functional results. The objective of this study is to analyze the effect of this technique in the anal anatomy and compare with the manometric results. Material and methods: we devised a prospective study of 40 patients. 39% female, 61% male. All of them filled an incontinence questionnaire (Pescatori scale and endoanal ultrasonography and manometry was carried out preoperatively, third month postoperative and at sixth month only if incontinence appeared. Results: 32 patients (80% had villous adenomas and 8 patients (20% had adenocarcinomas (uT1. Three patients complained of flatus incontinence at 3rd postoperative month that disappeared with normal continence at 6th month. Anorectal manometric values: mean anal resting pressure (ARP decreased at 3rd month (from 87.2 mmHg to 70.1 mmHg, as it was for maximal squeeze pressure (MSP from 152.5 mmHg preoperatively to 142.2 mmHg at 3rd month. Ultrasonography demonstrated internal anal sphincter (IAS rupture in 3 patients, with a full integrity of the external anal sphincter in all patients. Conclusions: during TEM, a significant anal dilatation occurs, because of rectoscopy (40 mm wide, what can produce a rupture of IAS, with the consequent decreasing in ARP, and a dilatation without rupture of external sphincter what produces a decreasing of MSP. The fall of anal pressures had minima clinical repercussion when sphincter is intact, but when IAS is broken a temporal incontinence develops.Introducción: la microcirugía transanal endoscópica (TEM fue desarrollada en 1983 por Büess como técnica mínimamente invasiva para el tratamiento de adenomas y adenocarcinomas en estadio

  2. Long-term skeletal effects of high-pull headgear followed by fixed appliances for the treatment of Class II malocclusions.

    Science.gov (United States)

    Bilbo, E Erin; Marshall, Steven D; Southard, Karin A; Allareddy, Verrasathpurush; Holton, Nathan; Thames, Allyn M; Otsby, Marlene S; Southard, Thomas E

    2018-04-18

    The long-term skeletal effects of Class II treatment in growing individuals using high-pull facebow headgear and fixed edgewise appliances have not been reported. The purpose of this study was to evaluate the long-term skeletal effects of treatment using high-pull headgear followed by fixed orthodontic appliances compared to an untreated control group. Changes in anteroposterior and vertical cephalometric measurements of 42 Class II subjects (n = 21, mean age = 10.7 years) before treatment, after headgear correction to Class I molar relationship, after treatment with fixed appliances, and after long-term retention (mean 4.1 years), were compared to similar changes in a matched control group (n = 21, mean age = 10.9 years) by multivariable linear regression models. Compared to control, the study group displayed significant long-term horizontal restriction of A-point (SNA = -1.925°, P appliances resulted in correction to Class I molar through restriction of horizontal maxillary growth with continued horizontal mandibular growth and vertical skeletal changes unaffected. The anteroposterior molar correction and skeletal effects of this treatment were stable long term.

  3. A push-pull system to reduce house entry of malaria mosquitoes

    NARCIS (Netherlands)

    Menger, D.J.; Otieno, B.; Rijk, de M.; Mukabana, W.R.; Loon, van J.J.A.; Takken, W.

    2014-01-01

    Background. Mosquitoes are the dominant vectors of pathogens that cause infectious diseases such as malaria, dengue, yellow fever and filariasis. Current vector control strategies often rely on the use of pyrethroids against which mosquitoes are increasingly developing resistance. Here, a push-pull

  4. Dynamic Pull-In Investigation of a Clamped-Clamped Nanoelectromechanical Beam under Ramp-Input Voltage and the Casimir Force

    Directory of Open Access Journals (Sweden)

    Amir R. Askari

    2014-01-01

    Full Text Available The influence of the Casimir excitation on dynamic pull-in instability of a nanoelectromechanical beam under ramp-input voltage is studied. The ramp-input actuation has applications in frequency sweeping of RF-N/MEMS. The presented model is nonlinear due to the inherent nonlinearity of electrostatics and the Casimir excitations as well as the geometric nonlinearity of midplane stretching. A Galerkin based reduced order modeling is utilized. It is found that the calculated dynamic pull-in ramp input voltage leads to dynamic pull-in step input voltage by increasing the slope of voltage-time diagram. This fact is utilized to verify the results of present study.

  5. Measurement of colour flow with the jet pull angle in $t\\bar{t}$ events using the ATLAS detector

    CERN Document Server

    Neep, Thomas James; The ATLAS collaboration

    2015-01-01

    The distribution and orientation of energy inside jets is predicted to be an experimental handle on colour connections between the hard--scatter quarks and gluons initiating the jets. This poster presents a measurement of the distribution of one such variable, the jet pull angle. The pull angle is measured for jets produced in ttbar events with one W boson decaying leptonically and the other decaying to jets using 20.3 inverse fb of data recorded with the ATLAS detector at a centre--of--mass energy of 8 TeV at the LHC. The jet pull angle distribution is corrected for detector resolution and acceptance effects and is compared to various models.

  6. Three Levels of Push-Pull Dynamics among Chinese International Students' Decision to Study Abroad in the Canadian Context

    Science.gov (United States)

    Chen, Jun Mian

    2017-01-01

    The extant literature on student migration flows generally focus on the traditional push-pull factors of migration at the individual level. Such a tendency excludes the broader levels affecting international student mobility. This paper proposes a hybrid of three levels of push-pull dynamics (micro-individual decision-making, meso-academic…

  7. Modeling the influence of the Casimir force on the pull-in instability of nanowire-fabricated nanotweezers

    Science.gov (United States)

    Farrokhabadi, Amin; Mokhtari, Javad; Rach, Randolph; Abadyan, Mohamadreza

    2015-09-01

    The Casimir force can strongly interfere with the pull-in performance of ultra-small structures. The strength of the Casimir force is significantly affected by the geometries of interacting bodies. Previous investigators have exclusively studied the effect of the Casimir force on the electromechanical instability of nanostructures with planar geometries. However no work has yet considered this effect on the pull-in instability of systems with cylindrical geometries such as nanotweezers fabricated from nanotube/nanowires. In our present work, the influence of the Casimir attraction on the electrostatic response and pull-in instability of nanotweezers fabricated from cylindrical conductive nanowires/nanotubes is theoretically investigated. An asymptotic solution, based on scattering theory, is applied to consider the effect of vacuum fluctuations in the theoretical model. The Euler-Bernoulli beam model is employed, in conjunction with the size-dependent modified couple stress continuum theory, to derive the governing equation of the nanotweezers. The governing nonlinear equations are solved by two different approaches, i.e., the modified Adomian-Padé method (MAD-Padé) and a numerical solution. Various aspects of the problem, i.e., the variation of pull-in parameters, effect of geometry, coupling between the Casimir force and size dependency effects and comparison with the van der Waals force regime are discussed.

  8. Inclusion at Risk? Push- and Pull-Out Phenomena in Inclusive School Systems: The Italian and Norwegian Experiences

    Science.gov (United States)

    Nes, Kari; Demo, Heidrun; Ianes, Dario

    2018-01-01

    The main objective of this article is to explore and compare research data on pull-out and push-out phenomena within inclusive school systems, discussing if and how they represent a risk for inclusion. The terms pull-out and push-out refer to situations in which some groups of students in regular schools learn in settings apart from their peers.…

  9. Oil pulling and importance of traditional medicine in oral health maintenance.

    Science.gov (United States)

    Naseem, Mustafa; Khiyani, Muhammad Faheem; Nauman, Hiba; Zafar, Muhammad Sohail; Shah, Altaf H; Khalil, Hesham S

    2017-01-01

    Dental diseases have detrimental effects on the functionality and quality of life of individuals. In addition, a strong relationship has been established between various oral and systemic diseases. In fact, the prevention and treatment of dental caries and periodontal disease have been shown to reduce the risk of diabetes and heart disease significantly. This goes beyond the role of oral health as a means to identify early manifestations of systemic diseases in the oral cavity. It highlights the necessity of maintaining an optimal oral hygiene to significantly modify the risk factors for serious systemic diseases. The use of oil pulling can be frequently found in ancient medical text and is supported by recent studies for its efficacy and long-term use for maintaining and improving oral health. This article provides an overview on the concept of oil pulling or oil swishing, its mechanism of action and a summary of the evidence available, which highlights the role of oil pulling in specific oral diseases. The goal of this review is to highlight the ancient procedure that has the potential to be used as an adjunct to conventional chemical means of dental plaque control, such as mouth rinses. Incorporating oil swishing as a component of daily oral hygiene can significantly improve oral and general health, specifically in lower socioeconomic groups and rural communities that may have interrupted access to health-care services and dental products such as dentifrices and mouth washes due to various factors; availability and affordability being the most important.

  10. Doppler-Guided Transanal Hemorrhoidal Dearterialization (DG-THD) Versus Stapled Hemorrhoidopexy (SH) in the Treatment of Third-Degree Hemorrhoids: Clinical Results at Short and Long-Term Follow-Up.

    Science.gov (United States)

    Leardi, S; Pessia, B; Mascio, M; Piccione, F; Schietroma, M; Pietroletti, R

    2016-11-01

    The stapled hemorrhoidopexy (SH) and the Doppler-guided transanal hemorrhoidal dearterialization (DG-THD) are minimally invasive procedures for the surgical treatment of hemorrhoids. This study aims to verify the efficacy of the DG-THD versus the SH in the treatment of third-degree hemorrhoids. One hundred consecutive patients were causally allocated to either procedure, obtaining two groups of 50 pts. A clinical examination was performed at 3, 7, 15, and 30 days after the operation. Quality of life, anal symptoms, recurrence of hemorrhoids, and reoperation were assessed by means of a questionnaire and of a clinical examination at long-term follow-up (7.0 year average). At short-term follow-up, the median postoperative pain score was significantly lower in DG-THD group compared to SH group, (V.A.S 2 vs 6; t = 2.65, p hemorrhoids.

  11. Quantitative dual-energy CT for phantomless evaluation of cancellous bone mineral density of the vertebral pedicle: correlation with pedicle screw pull-out strength

    Energy Technology Data Exchange (ETDEWEB)

    Wichmann, Julian L.; Booz, Christian; Bauer, Ralf W.; Kerl, J.M.; Fischer, Sebastian; Lehnert, Thomas; Vogl, Thomas J.; Khan, M.F. [University Hospital Frankfurt, Department of Diagnostic and Interventional Radiology, Frankfurt am Main (Germany); Wesarg, Stefan [Fraunhofer IGD, Cognitive Computing and Medical Imaging, Darmstadt (Germany); Kafchitsas, Konstantinos [Spine Center, Asklepios Klinik Lindenlohe, Schwandorf (Germany)

    2015-06-01

    To evaluate quantitative dual-energy computed tomography (DECT) for phantomless analysis of cancellous bone mineral density (BMD) of vertebral pedicles and to assess the correlation with pedicle screw pull-out strength. Twenty-nine thoracic and lumbar vertebrae from cadaver specimens were examined with DECT. Using dedicated post-processing software, a pedicle screw vector was mapped (R1, intrapedicular segment of the pedicle vector; R2, intermediate segment; R3, intracorporal segment; global, all segments) and BMD was calculated. To invasively evaluate pedicle stability, pedicle screws were drilled through both pedicles and left pedicle screw pull-out strength was measured. Resulting values were correlated using the paired t test and Pearson's linear correlation. Average pedicle screw vector BMD (R1, 0.232 g/cm{sup 3}; R2, 0.166 g/cm{sup 3}; R3, 0.173 g/cm{sup 3}; global, 0.236 g/cm{sup 3}) showed significant differences between R1-R2 (P < 0.002) and R1-R3 (P < 0.034) segments while comparison of R2-R3 did not reach significance (P > 0.668). Average screw pull-out strength (639.2 N) showed a far stronger correlation with R1 (r = 0.80; P < 0.0001) than global BMD (r = 0.42; P = 0.025), R2 (r = 0.37; P = 0.048) and R3 (r = -0.33; P = 0.078) segments. Quantitative DECT allows for phantomless BMD assessment of the vertebral pedicle. BMD of the intrapedicular segment shows a significantly stronger correlation with pedicle screw pull-out strength than other segments. (orig.)

  12. Deadly Throwaways--Plastic Six-Pack Binders and Metal Pull-Tabs Doom Wildlife

    Science.gov (United States)

    Ward, Penny

    1975-01-01

    Thousands of creatures are vulnerable to entrapment, entanglement, strangulation, or starvation as a result of plastic six-pack binders and metal pull-tabs. Possible solutions include: recycling, clean-up campaigns, and strong container legislation. (BT)

  13. Phosphatase PP2A and microtubule-mediated pulling forces disassemble centrosomes during mitotic exit

    Directory of Open Access Journals (Sweden)

    Stephen J. Enos

    2018-01-01

    Full Text Available Centrosomes are microtubule-nucleating organelles that facilitate chromosome segregation and cell division in metazoans. Centrosomes comprise centrioles that organize a micron-scale mass of protein called pericentriolar material (PCM from which microtubules nucleate. During each cell cycle, PCM accumulates around centrioles through phosphorylation-mediated assembly of PCM scaffold proteins. During mitotic exit, PCM swiftly disassembles by an unknown mechanism. Here, we used Caenorhabditis elegans embryos to determine the mechanism and importance of PCM disassembly in dividing cells. We found that the phosphatase PP2A and its regulatory subunit SUR-6 (PP2ASUR-6, together with cortically directed microtubule pulling forces, actively disassemble PCM. In embryos depleted of these activities, ∼25% of PCM persisted from one cell cycle into the next. Purified PP2ASUR-6 could dephosphorylate the major PCM scaffold protein SPD-5 in vitro. Our data suggest that PCM disassembly occurs through a combination of dephosphorylation of PCM components and force-driven fragmentation of the PCM scaffold.

  14. The push-pull tactic for mitigation of mountain pine beetle (Coleoptera: Curculionidae) damage in lodgepole and whitebark pines.

    Science.gov (United States)

    Gillette, Nancy E; Mehmel, Constance J; Mori, Sylvia R; Webster, Jeffrey N; Wood, David L; Erbilgin, Nadir; Owen, Donald R

    2012-12-01

    In an attempt to improve semiochemical-based treatments for protecting forest stands from bark beetle attack, we compared push-pull versus push-only tactics for protecting lodgepole pine (Pinus contorta Douglas ex Loudon) and whitebark pine (Pinus albicaulis Engelm.) stands from attack by mountain pine beetle (Dendroctonus ponderosae Hopkins) in two studies. The first was conducted on replicated 4.04-ha plots in lodgepole pine stands (California, 2008) and the second on 0.81-ha plots in whitebark pine stands (Washington, 2010). In both studies, D. ponderosae population levels were moderate to severe. The treatments were 1) push-only (D. ponderosae antiaggregant semiochemicals alone); 2) push-pull (D. ponderosae antiaggregants plus perimeter traps placed at regular intervals, baited with four-component D. ponderosae aggregation pheromone); and 3) untreated controls. We installed monitoring traps baited with two-component D. ponderosae lures inside each plot to assess effect of treatments on beetle flight. In California, fewer beetles were collected in push-pull treated plots than in control plots, but push-only did not have a significant effect on trap catch. Both treatments significantly reduced the rate of mass and strip attacks by D. ponderosae, but the difference in attack rates between push-pull and push-only was not significant. In Washington, both push-pull and push-only treatments significantly reduced numbers of beetles caught in traps. Differences between attack rates in treated and control plots in Washington were not significant, but the push-only treatment reduced attack rates by 30% compared with both the control and push-pull treatment. We conclude that, at these spatial scales and beetle densities, push-only may be preferable for mitigating D. ponderosae attack because it is much less expensive, simpler, and adding trap-out does not appear to improve efficacy.

  15. Relative quantification of protein-protein interactions using a dual luciferase reporter pull-down assay system.

    Directory of Open Access Journals (Sweden)

    Shuaizheng Jia

    Full Text Available The identification and quantitative analysis of protein-protein interactions are essential to the functional characterization of proteins in the post-proteomics era. The methods currently available are generally time-consuming, technically complicated, insensitive and/or semi-quantitative. The lack of simple, sensitive approaches to precisely quantify protein-protein interactions still prevents our understanding of the functions of many proteins. Here, we develop a novel dual luciferase reporter pull-down assay by combining a biotinylated Firefly luciferase pull-down assay with a dual luciferase reporter assay. The biotinylated Firefly luciferase-tagged protein enables rapid and efficient isolation of a putative Renilla luciferase-tagged binding protein from a relatively small amount of sample. Both of these proteins can be quantitatively detected using the dual luciferase reporter assay system. Protein-protein interactions, including Fos-Jun located in the nucleus; MAVS-TRAF3 in cytoplasm; inducible IRF3 dimerization; viral protein-regulated interactions, such as MAVS-MAVS and MAVS-TRAF3; IRF3 dimerization; and protein interaction domain mapping, are studied using this novel assay system. Herein, we demonstrate that this dual luciferase reporter pull-down assay enables the quantification of the relative amounts of interacting proteins that bind to streptavidin-coupled beads for protein purification. This study provides a simple, rapid, sensitive, and efficient approach to identify and quantify relative protein-protein interactions. Importantly, the dual luciferase reporter pull-down method will facilitate the functional determination of proteins.

  16. Fiscal 1976 Sunshine Project result report. R and D on photovoltaic power generation system (R and D on Si ribbon crystal vertical pulling method); 1976 nendo taiyoko hatsuden system no kenkyu kaihatsu seika hokokusho. Silicon tatehiki ribbon kessho no kenkyu kaihatsu

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1977-03-31

    This report describes the fiscal 1976 research result on Si ribbon crystal vertical pulling method for photovoltaic power generation systems. The equipment for simultaneous growth of 3 ribbon crystals was designed and prepared in consideration of capillary die arrangement, vertical pulling method and control method of temperature profiles on the die surface. The temperature profiles on the die surface were controlled by subheaters for 3 parts of each capillary die which were divided longitudinally. Ribbon crystals grew up to 5mm simultaneously through both end dies. By cooling a part of crystal, fast pulling is probably possible. Study was made on the correlation between various crystal defects of Si ribbon crystals and cell characteristics, and in particular, basic characteristics of SiC deposited particles by SEM observation to reduce their impacts. Possibility of simultaneous vertical pulling of crystals was verified by using a capillary carbon die for multi-pulling. Although crystals grew by eutectic reaction under saturated dissolution of carbon, crystals with no transition were obtained. An SiC-coated die was excellent rather than carbon one. (NEDO)

  17. Contact angle influence on the pull-in voltage of microswitches in the presence of capillary and quantum vacuum effects

    NARCIS (Netherlands)

    Palasantzas, George

    2007-01-01

    Capillary condensation between the electrodes of microswitches influences the effective pull-in voltage in a manner that depends on the contact angle of the capillary meniscus and the presence of plate surface roughness. Indeed, surface roughening is shown to have a stronger influence on the pull-in

  18. Push-Pull Laser-Atomic Oscillator

    International Nuclear Information System (INIS)

    Jau, Y.-Y.; Happer, W.

    2007-01-01

    A vapor of alkali-metal atoms in the external cavity of a semiconductor laser, pumped with a time-independent injection current, can cause the laser to self-modulate at the 'field-independent 0-0 frequency' of the atoms. Push-pull optical pumping by the modulated light drives most of the atoms into a coherent superposition of the two atomic sublevels with an azimuthal quantum number m=0. The atoms modulate the optical loss of the cavity at the sharply defined 0-0 hyperfine frequency. As in a maser, the system is not driven by an external source of microwaves, but a very stable microwave signal can be recovered from the modulated light or from the modulated voltage drop across the laser diode. Potential applications for this new phenomenon include atomic clocks, the production of long-lived coherent atomic states, and the generation of coherent optical combs

  19. N -annulated perylene-based push-pull-type sensitizers

    KAUST Repository

    Qi, Qingbiao; Wang, Xingzhu; Fan, Li; Zheng, Bin; Zeng, Wangdong; Luo, Jie; Huang, Kuo-Wei; Wang, Qing; Wu, Jishan

    2015-01-01

    Alkoxy-wrapped N-annulated perylene (NP) was synthesized and used as a rigid and coplanar π-linker for three push-pull type metal-free sensitizers QB1-QB3. Their optical and electrochemical properties were tuned by varying the structure of acceptor. These new dyes were applied in Co(II)/(III) based dye-sensitized solar cells, and power conversion efficiency up to 6.95% was achieved, indicating that NP could be used as a new building block for the design of high-performance sensitizers in the future.

  20. N -annulated perylene-based push-pull-type sensitizers

    KAUST Repository

    Qi, Qingbiao

    2015-02-06

    Alkoxy-wrapped N-annulated perylene (NP) was synthesized and used as a rigid and coplanar π-linker for three push-pull type metal-free sensitizers QB1-QB3. Their optical and electrochemical properties were tuned by varying the structure of acceptor. These new dyes were applied in Co(II)/(III) based dye-sensitized solar cells, and power conversion efficiency up to 6.95% was achieved, indicating that NP could be used as a new building block for the design of high-performance sensitizers in the future.

  1. The effect of oil pulling with pure coconut oil on Streptococcus mutans: A randomized controlled trial

    OpenAIRE

    Varsha Komath Pavithran; Madhusudhan Krishna; Vinod A Kumar; Ashish Jaiswal; Arul K Selvan; Sudhir Rawlani

    2017-01-01

    Introduction: Oil pulling as described in ancient Ayurveda involves the use of edible vegetable oils as oral antibacterial agents. It is a practice of swishing oil in the mouth for oral and systemic health benefits. Pure coconut oil has antimicrobial properties and is commonly available in all Indian households. Aim: This study aims to assess the effect of oil pulling therapy with pure coconut oil on Streptococcus mutans count and to compare its efficacy against sesame oil and saline. Materia...

  2. Assesing tree-root & soil interaction using pull-out test apparatus

    Science.gov (United States)

    Wibowo, J.; Corcoran, M. K.; Kala, R.; Leavell, D.

    2011-12-01

    Knowing in situ root strength provides a better understanding of the responses of tree root systems against external loads. Root pullout devices are used to record these strengths and can be expressed in two ways: pullout force, which is a direct output from the load cell (measured in pounds) or pullout stress, which is the pullout force divided by root cross section area (measured in pounds per square in.). Pullout tests show not only the possible tensile strength of a tree root, but also the interaction between the tree root and the surrounding geological materials. After discussion with engineers from the University of Nottingham-Trent, the U.S. Army Engineer Research and Development Center (ERDC) constructed a root pullout apparatus with some modifications. These modifications included using a T-System configuration at the base of an aluminum frame instead of a diagonal rod and varying the size of the clamp placed around the tested root. The T-System is placed in front of the root perpendicular to the root path. In the ERDC pullout device, the root was pulled directly without a lever system. A string pot was used to measure displacement when the root was pulled. The device is capable of pulling tree roots with a diameter of up to 2.5 in. and a maximum load of 5000 lbs. Using this device, ERDC conducted field operations in Portland, Oregon; Burlington, Washington; and Albuquerque, New Mexico, on Oregon ash, alder, maple, and cedar trees. In general, pullout tests were conducted approximately 60 deg around the tree selected for the tests. The location of a test depended on the availability of a root near the ground surface. A backhoe was used to remove soil around the tree to locate roots. Before the root was secured in a clamp, root diameter was measured and recorded, and the root was photographed. The tree species, dip angle and dip direction of the root, root location with respect to the tree, tree location, dates, weather, and soil type were also recorded

  3. Initial results of 3-dimensional 1H-magnetic resonance spectroscopic imaging in the localization of prostate cancer at 3 Tesla: should we use an endorectal coil?

    Science.gov (United States)

    Yakar, Derya; Heijmink, Stijn W T P J; Hulsbergen-van de Kaa, Christina A; Huisman, Henkjan; Barentsz, Jelle O; Fütterer, Jurgen J; Scheenen, Tom W J

    2011-05-01

    The purpose of this study was to compare the diagnostic performance of 3 Tesla, 3-dimensional (3D) magnetic resonance spectroscopic imaging (MRSI) in the localization of prostate cancer (PCa) with and without the use of an endorectal coil (ERC). Our prospective study was approved by the institutional review board, and written informed consent was obtained from all patients. Between October 2004 and January 2006, 18 patients with histologically proven PCa on biopsy and scheduled for radical prostatectomy were included and underwent 3D-MRSI with and without an ERC. The prostate was divided into 14 regions of interest (ROIs). Four readers independently rated (on a 5-point scale) their confidence that cancer was present in each of these ROIs. These findings were correlated with whole-mount prostatectomy specimens. Areas under the receiver-operating characteristic curve were determined. A difference with a P Tesla slightly but significantly increased the localization performance compared with not using an ERC.

  4. An Event-driven, Value-based, Pull Systems Engineering Scheduling Approach

    Science.gov (United States)

    2012-03-01

    combining a services approach to systems engineering with a kanban -based scheduling system. It provides the basis for validating the approach with...agent-based simulations. Keywords-systems engineering; systems engineering process; lean; kanban ; process simulation I. INTRODUCTION AND BACKGROUND...approaches [8], [9], we are investigating the use of flow-based pull scheduling techniques ( kanban systems) in a rapid response development

  5. What Explains the Survival Gap of Pushed and Pulled Corporate Spin-offs?

    DEFF Research Database (Denmark)

    Rocha, Vera; Carneiro, Anabela; Varum, Celeste

    2015-01-01

    Unconditionally, pushed spin-offs are found to survive longer than their pulled counterparts. Using matched employer-employee data and novel multivariate decomposition techniques, we show that pushed spin-offs’ relative survival advantage is mostly explained by their larger human capital endowments...

  6. The Effect of Heat Treatment on the Pull-off Strength of Optionally Varnished Surfaces of Five Wood Materials

    Directory of Open Access Journals (Sweden)

    Musa Atar

    2015-09-01

    Full Text Available This study investigated the effects of heat treatment, following optional treatment with synthetic, water-based, and alkyd varnishes, on the pull-off strength of wooden materials sampled from oriental beech (Fagus orientalis L., oak (Quercus petraea Liebl., black poplar (Populus nigra L., pine (Pinus sylvestris L., and fir (Abies bornmulleriana M.. The test samples were subjected to heat treatment at temperatures of 165 °C and 175 °C for periods of 2 and 4 h with a total of 4 variations. With respect to the wood type, the samples of beech wood yielded the highest results for pull-off strength, while fir wood yielded the lowest. With respect to the varnish types, the highest pull-off strength was found in the samples of synthetic varnished beech (5,452 with a 37.2% improvement at 175 °C heat treatment for 4 h, while the lowest results were obtained in the samples of fir (0.991 with a 48.5% decrease at 175 °C heat treatment for 4 h. In conclusion, heat treatment significantly decreased the pull-off strength of the woods.

  7. Identification of 6H-SiC polar faces with pull-off force of atomic force microscopy

    Energy Technology Data Exchange (ETDEWEB)

    Gan, Di; Song, Youting; Yang, Junwei; Chen, Hongxiang [Research & development Center for Functional Crystals, Beijing National Laboratory for Condensed Matter Physics, Institute of Physics, Chinese Academy of Sciences, Beijing 100190 (China); Guo, Liwei, E-mail: lwguo@iphy.ac.cn [Research & development Center for Functional Crystals, Beijing National Laboratory for Condensed Matter Physics, Institute of Physics, Chinese Academy of Sciences, Beijing 100190 (China); Chen, Xiaolong, E-mail: chenx29@iphy.ac.cn [Research & development Center for Functional Crystals, Beijing National Laboratory for Condensed Matter Physics, Institute of Physics, Chinese Academy of Sciences, Beijing 100190 (China); Collaborative Innovation Center of Quantum Matter, Beijing (China)

    2016-12-30

    Highlights: • A new method is proposed and demonstrated to distinguish the polar faces of 6H-SiC by pull-off forces which are clearly different on the Si-face and the C-face of 6H-SiC. • The reliability of this method is confirmed on 6H-SiC samples treated with different surface processing procedures. • The essence of different pull-off forces on different polar faces of 6H-SiC is that the surface energies between them are obviously different. • Theoretical calculations are consistent with our experimental results. - Abstract: Distinguishing SiC (0001) Si-face from SiC (000-1) C-face without any damages is extremely important because the two polar faces have different physical and chemical properties which seriously influence the quality of a homoepitaxy or heteroepitaxy thin film on it. Here, a convenient and nondestructive detection method is developed to distinguish the Si-face and C-face of a (0001) oriented SiC wafer by employing a pull-off force measurement using atomic force microscopy. It is found that the pull-off force from a Si-face of 6H-SiC is about two times of that from a C-face, no matter it is a two-face chemical mechanical polishing or etched 6H-SiC wafer. The method developed here is suitable to identify polar faces of materials only if the two polar faces having different surface energy.

  8. Safety of pull-type and introducer percutaneous endoscopic gastrostomy tubes in oncology patients: a retrospective analysis

    Directory of Open Access Journals (Sweden)

    Pelckmans Paul A

    2011-03-01

    Full Text Available Abstract Background Percutaneous endoscopic gastrostomy (PEG allows long-term tube feeding. Safety of pull-type and introducer PEG placement in oncology patients with head/neck or oesophageal malignancies is unknown. Methods Retrospective analysis of 299 patients undergoing PEG tube placement between January 2006 and December 2008 revealed 57 oncology patients. All patients with head/neck or oesophageal malignancy were treated with chemo- and radiotherapy. In case of high-grade stenosis introducer Freka® Pexact PEG tube was placed (n = 24 and in all other patients (n = 33 conventional pull-type PEG tube. Short-term complications and mortality rates were compared. Results Patients' characteristics and clinical status were comparable in both groups. Short-term complications were encountered in 11/24 (48% introducer PEG patients as compared to only 4/33 (12% pull-type PEG patients (P vs. 0/33 (0%, P vs. 3/33 (9%, NS. Finally, 3/24 gastrointestinal perforations (12% resulted from a difficult placement procedure vs. 1/33 (3%, leading to urgent surgical intervention and admission to ICU. Two introducer PEG patients died at ICU, resulting in an overall mortality rate of 8% vs. 0% (P = 0.091. Conclusion The introducer Freka® Pexact PEG procedure for long-term tube feeding may lead to significantly higher complication and mortality rates in patients with head/neck or oesophageal malignancies treated with chemo- and radiotherapy. It is suggested to use the conventional pull-type PEG tube placement in this group of patients, if possible.

  9. Flat punch adhesion: transition from fracture-based to strength-limited pull-off

    International Nuclear Information System (INIS)

    Jiang, Yijie; Turner, Kevin T; Grierson, David S

    2014-01-01

    The adhesion of a cylindrical flat punch to a surface due to interatomic forces is a well-known problem that is important in many applications, including indentation experiments and the adhesion of fibrillar structures. Traditionally, the pull-off force has been related to the work of adhesion and punch geometry via the Kendall solution that uses a Griffith energy balance to assess crack propagation and pull-off. More recently, it has been shown that under certain conditions, notably at small punch diameters, the contact can behave in a ‘strength-limited’ fashion in which the interface separates uniformly rather than via crack propagation. Here, a Maugis-Dugdale-type analysis of power-law-shaped bodies in contact is used to examine the change in behaviour from the fracture-based Kendall solution to strength-limited pull-off for cylindrical flat punches. The transition from fracture-based to strength-limited behaviour is described in terms of a non-dimensional parameter that is similar to previous quantities used to describe the transition and is a function of the punch size, the elasticity of the contact, and the adhesion properties. The results of this relatively simple analysis compare favourably with results from more complex computational simulations. In addition, the results are used to develop a function that quantifies the transition between the Kendall solution and the strength-limited solution in order to facilitate interpretation of adhesion measurements in the transition regime between the two limits. Finally, the power-law analysis is used to assess the sensitivity of the transition to the exact shape of the punch. (paper)

  10. The Outcomes of Ultralow Anterior Resection or an Abdominoperineal Pull-Through Resection and Coloanal Anastomosis for Radiation-Induced Recto-Vaginal Fistula Patients.

    Science.gov (United States)

    Karakayali, Feza Yarbug; Tezcaner, Tugan; Ozcelik, Umit; Moray, Gokhan

    2016-05-01

    The purpose of this study was to evaluate the outcomes of patients who underwent colorectal resections and coloanal anastomosis for radiation-induced recto-vaginal fistulas (RVFs). The effect of the surgical treatment technique on bowel function, fecal continence, and quality of life of patients was also evaluated. Twenty-one female patients, who received adjuvant chemotherapy and external beam pelvic radiation for cervix carcinoma after radical hysterectomy + pelvic/paraaortic lymph node dissection, having RVF but without tumor recurrence, were included. All patients underwent an ultralow anterior resection (n = 11) or an abdominoperineal pull-through resection and straight coloanal anastomosis (n = 10). A bowel functions questionnaire and a Fecal Incontinence Quality of Life (FIQLI) questionnaire were applied to patients pre-operatively and also 6 months after the ileostomy closure procedures. No recurrent RVF was observed in a mean follow-up period of 20 months after ostomy reversal procedures. The FIQLI depression, lifestyle, and embarrassment scores were significantly improved on the follow-up questionnaire. The mean pre- and post-operative incontinence scores were not significantly different. The spontaneous closure rate after a simple diverting stoma is quite low and local repair procedures usually result in failure. In selected patients, performing a nearly total rectum resection and maintaining the intestinal continuity with a coloanal anastomosis may be accepted as a safe and curative option. Recurrence-free outcome and the improvement of the quality of life of the patients represent the efficiency of this treatment modality.

  11. Static Pull Testing of a New Type of Large Deformation Cable with Constant Resistance

    Directory of Open Access Journals (Sweden)

    Zhigang Tao

    2017-01-01

    Full Text Available A new type of energy-absorbing cable, Constant-Resistance Large Deformation cable (CRLD cable with three different specifications, has been recently developed and tested. An effective cable should occupy the ability of absorbing deformation energy from these geodisaster loads and additionally must be able to yield with the sliding mass movements and plastic deformation over large distances at high displacement rates. The new cable mainly consists of constant-resistance casing tube and frictional cone unit that transfers the load from the slope. When experiencing a static or dynamic load and especially the load exceeding the constant resistance force (CR-F, a static friction force derived from the movement of frictional cone unit in casing tube of CRLD cable, the frictional cone unit will move in the casing tube along the axis and absorb deformation energy, accordingly. In order to assess the performance of three different specified cables in situ, a series of field static pull tests have been performed. The results showed that the first type of CRLD cable can yield 2000 mm displacement while acting 850 kN static pull load, which is superior to that of other two types, analyzing based on the length of the displacement and the level of static pull load.

  12. Is the demand-pull driver equally crucial for product vs process innovation?

    NARCIS (Netherlands)

    Dawid, Herbert; Pellegrino, Gabriele; Vivarelli, Marco

    2017-01-01

    While the extant innovation literature has provided extensive evidence of the so-called "demand-pull" effect, the possible diverse impact of demand evolution on product vs process innovation activities has not been yet investigated. This paper develops a formal model predicting a larger inducing

  13. Simplified method of ''push-pull'' test data analysis for determining in situ reaction rate coefficients

    International Nuclear Information System (INIS)

    Haggerty, R.; Schroth, M.H.; Istok, J.D.

    1998-01-01

    The single-well, ''''push-pull'''' test method is useful for obtaining information on a wide variety of aquifer physical, chemical, and microbiological characteristics. A push-pull test consists of the pulse-type injection of a prepared test solution into a single monitoring well followed by the extraction of the test solution/ground water mixture from the same well. The test solution contains a conservative tracer and one or more reactants selected to investigate a particular process. During the extraction phase, the concentrations of tracer, reactants, and possible reaction products are measured to obtain breakthrough curves for all solutes. This paper presents a simplified method of data analysis that can be used to estimate a first-order reaction rate coefficient from these breakthrough curves. Rate coefficients are obtained by fitting a regression line to a plot of normalized concentrations versus elapsed time, requiring no knowledge of aquifer porosity, dispersivity, or hydraulic conductivity. A semi-analytical solution to the advective-dispersion equation is derived and used in a sensitivity analysis to evaluate the ability of the simplified method to estimate reaction rate coefficients in simulated push-pull tests in a homogeneous, confined aquifer with a fully-penetrating injection/extraction well and varying porosity, dispersivity, test duration, and reaction rate. A numerical flow and transport code (SUTRA) is used to evaluate the ability of the simplified method to estimate reaction rate coefficients in simulated push-pull tests in a heterogeneous, unconfined aquifer with a partially penetrating well. In all cases the simplified method provides accurate estimates of reaction rate coefficients; estimation errors ranged from 0.1 to 8.9% with most errors less than 5%

  14. Determining Pull-Out Deformations by Means of an Online Photogrammetry Monitoring System

    Directory of Open Access Journals (Sweden)

    Emin Özgür Avşar

    2015-03-01

    Full Text Available Chemical anchorages are applied in many engineering implementations, particularly strengthening of reinforced concrete structures. During strengthening procedure; chemical anchorages should be tested, since they supply to transfer the load between existing construction elements and newly added elements. Therefore; the study of the quality of chemical anchorages is an important issue in construction materials science. In this context; the most important experiment is to determine the pull-out loads of embedded anchorage reinforcement by applying axial loads. In this study; it is aimed to determine the displacements of steel reinforcements, embedded into concrete by using chemical anchorages, while applying axial pulling loads. In order to determine the displacements and load - deformation graphs; starting conditions and every 10 bar pressure applied conditions of the steel reinforcements were captured by the cameras. The obtained images were evaluated by using photogrammetric software. Based on the photogrammetric post-processing results, the load - deformation graphs were plotted and the loads at loss of adhesion were determined

  15. Modelo híbrido pull-push en el sector de las telecomunicaciones

    Directory of Open Access Journals (Sweden)

    Cristian Arlex Trejos Taborda

    2016-07-01

    Full Text Available La industria de las telecomunicaciones cambia rápidamente y las barreras de entrada son bajas implicando que la supervivencia en el mercado sea un verdadero desafío para las empresas. En este artículo estudia como los sistemas Pull y Push pueden ser integrados a la cadena de abastecimiento en el sector de telecomunicaciones en Colombia. Se desarrolló un modelo hibrido Pull y Push utilizando dinámica de sistemas en aras de determinar los niveles óptimos y el costo mínimo de inventario, al igual que el nivel óptimo de prestación de servicio a los clientes. Los resultados de la investigación demuestran que el comportamiento del modelo híbrido permite dar respuesta a las necesidades del mercado y de la empresa a la vez, generando niveles de inventario que son mínimos y suficientes para cubrir la demanda.

  16. Single-molecule pull-down (SiMPull) for new-age biochemistry: methodology and biochemical applications of single-molecule pull-down (SiMPull) for probing biomolecular interactions in crude cell extracts.

    Science.gov (United States)

    Aggarwal, Vasudha; Ha, Taekjip

    2014-11-01

    Macromolecular interactions play a central role in many biological processes. Protein-protein interactions have mostly been studied by co-immunoprecipitation, which cannot provide quantitative information on all possible molecular connections present in the complex. We will review a new approach that allows cellular proteins and biomolecular complexes to be studied in real-time at the single-molecule level. This technique is called single-molecule pull-down (SiMPull), because it integrates principles of conventional immunoprecipitation with the powerful single-molecule fluorescence microscopy. SiMPull is used to count how many of each protein is present in the physiological complexes found in cytosol and membranes. Concurrently, it serves as a single-molecule biochemical tool to perform functional studies on the pulled-down proteins. In this review, we will focus on the detailed methodology of SiMPull, its salient features and a wide range of biological applications in comparison with other biosensing tools. © 2014 WILEY Periodicals, Inc.

  17. Initial Assessment of the Acceptability of a Push-Pull Aedes aegypti Control Strategy in Iquitos, Peru and Kanchanaburi, Thailand

    Science.gov (United States)

    Paz-Soldan, Valerie A.; Plasai, Valaikanya; Morrison, Amy C.; Rios-Lopez, Esther J.; Guedez-Gonzales, Shirly; Grieco, John P.; Mundal, Kirk; Chareonviriyaphap, Theeraphap; Achee, Nicole L.

    2011-01-01

    As part of a larger research program evaluating chemical threshold levels for a Push-Pull intervention to reduce man-vector (Aedes aegypti) contact, this qualitative study explored local perceptions and strategies associated with mosquito control within dengue-endemic communities in Peru and Thailand. Focus groups were used to provide preliminary information that would identify possible public acceptance issues to the Push-Pull strategy in each site. Nine focus group discussions (total of 102 individuals) conducted between September 2008 and March 2009 examined several themes: 1) current mosquito control practices; 2) perceptions of spatial repellency and contact irritancy versus killing mosquitoes; and 3) initial perceptions toward mosquito host-seeking traps. Results indicate participants use household-level strategies for insect control that reveal familiarity with the concept of spatial repellent and contact irritant actions of chemicals and that placing traps in the peridomestic environment to remove repelled mosquitoes was acceptable. Preliminary evidence suggests a Push-Pull strategy should be well accepted in these locations. These results will be beneficial for developing future large scale push-pull interventions and are currently being used to guide insecticide application strategies in (entomological) proof-of-concept studies using experimental huts. PMID:21292886

  18. Cost-efficient demand-pull policies for multi-purpose technologies – The case of stationary electricity storage

    International Nuclear Information System (INIS)

    Battke, Benedikt; Schmidt, Tobias S.

    2015-01-01

    Highlights: • A definition of multi-purpose technologies (MPTs) is proposed. • Opportunities for a cost-efficient demand-pull policy strategy for MPTs are derived. • The multi-purpose character of stationary electricity storage (SES) is shown. • An exemplary profitability assessment of one SES technology supports the argument. - Abstract: Stationary electricity storage technologies (SES) allow to increase the shares of intermittent renewable energy technologies in electricity networks. As SES currently exhibit high costs, policy makers have started introducing demand-pull policies in order to foster their diffusion and drive these technologies further down the learning curve. However, as observed in the case of renewable energy technologies, demand-pull policies for technologies can come at high costs in cases where the profitability gap that needs to be covered by the policy support is large. Yet, SES can create value in multiple distinct applications in the power system – making it a “multi-purpose technology”. We argue that policy makers can make use of the multi-purpose character of SES to limit costs of demand-pull policies. We propose a policy strategy which grants support based on the profitability gap in the different applications, thereby moving down the learning curve efficiently. To support our argumentation, we firstly conduct a comprehensive literature review of SES applications exemplifying the multi-purpose character of these technologies. Second, we assess the profitability of one SES technology (vanadium redox flow battery) in five SES applications, highlighting a strong variation of the profitability gap across these applications

  19. Evaluation of methods to assess push/pull forces in a construction task

    NARCIS (Netherlands)

    Hoozemans, M J; Van Der Beek, Allard J.; Frings-Dresena, M H; Van der Molen, Henk F.

    2001-01-01

    The objective of the present study was to determine the validity of methods to assess push/pull forces exerted in a construction task. Forces assessed using a hand-held digital force gauge were compared to those obtained using a highly accurate measuring frame. No significant differences were found

  20. Control and Modeling of Push-Pull Forward Three-Level Converter for Microgrid

    DEFF Research Database (Denmark)

    Yao, Zhilei; Xu, Jing; Guerrero, Josep M.

    2015-01-01

    Renewable energy sources are widely used in microgrid. Output voltage of them is often low and varies widely. Because diodes in three-level legs in traditional three-level (TL) converter are substituted by MOSFETs, the push-pull forward (PPF) TL converter is very suitable for wide and low...

  1. Older age at diagnosis of Hirschsprung disease decreases risk of postoperative enterocolitis, but resection of additional ganglionated bowel does not.

    Science.gov (United States)

    Haricharan, Ramanath N; Seo, Jeong-Meen; Kelly, David R; Mroczek-Musulman, Elizabeth C; Aprahamian, Charles J; Morgan, Traci L; Georgeson, Keith E; Harmon, Carroll M; Saito, Jacqueline M; Barnhart, Douglas C

    2008-06-01

    This study was conducted to determine the effect of age at diagnosis and length of ganglionated bowel resected on postoperative Hirschsprung-associated enterocolitis (HAEC). Children who underwent endorectal pull-through (ERPT) between January 1993 and December 2004 were retrospectively reviewed. t Test, analysis of variance, Kaplan-Meier, and Cox's proportional hazards analyses were performed. Fifty-two children with Hirschsprung disease (median age, 25 days; range, 2 days-16 years) were included. Nineteen (37%) had admissions for HAEC. Proportional hazards regression showed that HAEC admissions decreased by 30% with each doubling of age at diagnosis (P = .03) and increased 9-fold when postoperative stricture was present (P 5 cm]). No significant difference in the number of HAEC admissions during initial 2 years post-ERPT was seen between groups A (n = 18) and B (n = 18). The study had a power of 0.8 to detect a difference of 1 admission over 2 years. Children diagnosed with Hirschsprung disease at younger ages are at a greater risk for postoperative enterocolitis. Excising a longer margin of ganglionated bowel (>5 cm) does not seem to be beneficial in decreasing HAEC admissions.

  2. Investigation on Bond-Slip Behavior of Z-Pin Interfaces in X-Cor® Sandwich Structures Using Z-Pin Pull-Out Test

    Science.gov (United States)

    Shan, Hangying; Xiao, Jun; Chu, Qiyi

    2018-05-01

    The Z-Pin interfacial bond properties play an important role in the structural performance of X-Cor® sandwich structures. This paper presents an experimental investigation on bond-slip behavior of Z-Pin interfaces using Z-Pin pull-out test. Based on the experimental data the whole Z-Pin pull-out process consists of three stages: initial bonding, debonding and frictional sliding. Comparative experimental study on the influence of design parameters on bond-slip behavior of Z-Pin interfaces has also been performed. Numerical analyses were conducted with the ABAQUS finite element (FE) program to simulate the Z-Pins bond-slip response of the pull-out test. The Z-Pins interfacial bond-slip behavior was implemented using nonlinear spring elements characterized with the constitutive relation from experimental results. Numerical results were validated by comparison with experimental data, and reasonably good agreement was achieved between experimental and analytical pull-out force-slip curves.

  3. Pushing and pulling in relation to musculoskeletal disorders : a review of risk factors

    NARCIS (Netherlands)

    Hoozemans, M J; Van Der Beek, Allard J.; Frings-Dresen, M. H. W.; Dijk, F.J.H.; van der Woude, L H

    The objective was to review the literature on risk factors for musculoskeletal disorders related to pushing and pulling. The risk factors have been described and evaluated from four perspectives: epidemiology, psychophysics, physiology, and biomechanics. Epidemiological studies have shown, based on

  4. Pushing and pulling in relation to musculoskeletal disorders: a review of risk factors

    NARCIS (Netherlands)

    Hoozemans, Marco; van der Beek, A.J.; Frings-Dresen, M.H.W.; Dijk, F.J.H.

    1998-01-01

    The objective was to review the literature on risk factors for musculoskeletal disorders related to pushing and pulling. The risk factors have been described and evaluated from four perspectives: epidemiology, psychophysics, physiology, and biomechanics. Epidemiological studies have shown, based on

  5. Rectal cancer: An evidence-based update for primary care providers

    Science.gov (United States)

    Gaertner, Wolfgang B; Kwaan, Mary R; Madoff, Robert D; Melton, Genevieve B

    2015-01-01

    Rectal adenocarcinoma is an important cause of cancer-related deaths worldwide, and key anatomic differences between the rectum and the colon have significant implications for management of rectal cancer. Many advances have been made in the diagnosis and management of rectal cancer. These include clinical staging with imaging studies such as endorectal ultrasound and pelvic magnetic resonance imaging, operative approaches such as transanal endoscopic microsurgery and laparoscopic and robotic assisted proctectomy, as well as refined neoadjuvant and adjuvant therapies. For stage II and III rectal cancers, combined chemoradiotherapy offers the lowest rates of local and distant relapse, and is delivered neoadjuvantly to improve tolerability and optimize surgical outcomes, particularly when sphincter-sparing surgery is an endpoint. The goal in rectal cancer treatment is to optimize disease-free and overall survival while minimizing the risk of local recurrence and toxicity from both radiation and systemic therapy. Optimal patient outcomes depend on multidisciplinary involvement for tailored therapy. The successful management of rectal cancer requires a multidisciplinary approach, with the involvement of enterostomal nurses, gastroenterologists, medical and radiation oncologists, radiologists, pathologists and surgeons. The identification of patients who are candidates for combined modality treatment is particularly useful to optimize outcomes. This article provides an overview of the diagnosis, staging and multimodal therapy of patients with rectal cancer for primary care providers. PMID:26167068

  6. Systematic review and meta-analysis of published trials comparing the effectiveness of transanal endoscopic microsurgery and radical resection in the management of early rectal cancer.

    Science.gov (United States)

    Sajid, M S; Farag, S; Leung, P; Sains, P; Miles, W F A; Baig, M K

    2014-01-01

    A systematic analysis was conducted of trials comparing the effectiveness of transanal endoscopic microsurgery (TEMS) with radical resection (RR) for T1 and T2 rectal cancer. An electronic search was carried out of trials reporting the effectiveness of TEMS and RR in the treatment of T1 and T2 rectal cancers. Ten trials including 942 patients were retrieved. There was a trend toward a higher risk of local recurrence (odds ratio 2.78; 95% confidence interval 1.42, 5.44; z = 2.97; P TEMS compared with RR. The risk of distant recurrence, overall survival (odds ratio 0.90; 95% confidence interval 0.49, 1.66; z = 0.33; P = 0.74) and mortality was similar. TEMS was associated with a shorter operation time and hospital stay and a reduced risk of postoperative complications (P TEMS is superior to RR in the management of early rectal cancer. Larger, better designed and executed prospective studies are needed to answer this question. Colorectal Disease © 2013 The Association of Coloproctology of Great Britain and Ireland.

  7. Use of sequential endorectal US to predict the tumor response of preoperative chemoradiotherapy in rectal cancer.

    Science.gov (United States)

    Li, Ning; Dou, Lizhou; Zhang, Yueming; Jin, Jing; Wang, Guiqi; Xiao, Qin; Li, Yexiong; Wang, Xin; Ren, Hua; Fang, Hui; Wang, Weihu; Wang, Shulian; Liu, Yueping; Song, Yongwen

    2017-03-01

    Accurate prediction of the response to preoperative chemoradiotherapy (CRT) potentially assists in the individualized selection of treatment. Endorectal US (ERUS) is widely used for the pretreatment staging of rectal cancer, but its use for preoperatively predicting the effects of CRT is not well evaluated because of the inflammation, necrosis, and fibrosis induced by CRT. This study assessed the value of sequential ERUS in predicting the efficacy of preoperative CRT for locally advanced rectal cancer. Forty-one patients with clinical stage II/III rectal adenocarcinoma were enrolled prospectively. Radiotherapy was delivered to the pelvis with concurrent chemotherapy of capecitabine and oxaliplatin. Total mesorectal excision was performed 6 to 8 weeks later. EUS measurements of primary tumor maximum diameter were performed before (ERUS1), during (ERUS2), and 6 to 8 weeks after (ERUS3) CRT, and the ratios of these were calculated. Correlations between ERUS values, tumor regression grade (TRG), T down-staging rate, and pathologic complete response (pCR) rate were assessed, and survival was analyzed. There was no significant correlation between ERUS2/ERUS1 and TRG. The value of ERUS3/ERUS1 correlated with pCR rate and TRG but not T down-staging rate. An ERUS3 value of 6.3 mm and ERUS3/ERUS1 of 52% were used as the cut-off for predicting pCR, and patients were divided into good and poor prognosis groups. Although not statistically significant, 3-year recurrence and survival rates of the good prognosis group were better than those of the poor prognosis group. Sequential ERUS may predict therapeutic efficacy of preoperative CRT for locally advanced rectal cancer. (Clinical trial registration number: NCT01582750.). Copyright © 2017 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.

  8. Steady distribution structure of point defects near crystal-melt interface under pulling stop of CZ Si crystal

    Science.gov (United States)

    Abe, T.; Takahashi, T.; Shirai, K.

    2017-02-01

    In order to reveal a steady distribution structure of point defects of no growing Si on the solid-liquid interface, the crystals were grown at a high pulling rate, which Vs becomes predominant, and the pulling was suddenly stopped. After restoring the variations of the crystal by the pulling-stop, the crystals were then left in prolonged contact with the melt. Finally, the crystals were detached and rapidly cooled to freeze point defects and then a distribution of the point defects of the as-grown crystals was observed. As a result, a dislocation loop (DL) region, which is formed by the aggregation of interstitials (Is), was formed over the solid-liquid interface and was surrounded with a Vs-and-Is-free recombination region (Rc-region), although the entire crystals had been Vs rich in the beginning. It was also revealed that the crystal on the solid-liquid interface after the prolonged contact with the melt can partially have a Rc-region to be directly in contact with the melt, unlike a defect distribution of a solid-liquid interface that has been growing. This experimental result contradicts a hypothesis of Voronkov's diffusion model, which always assumes the equilibrium concentrations of Vs and Is as the boundary condition for distribution of point defects on the growth interface. The results were disscussed from a qualitative point of view of temperature distribution and thermal stress by the pulling-stop.

  9. Mechanical load on the low back and shoulders during pushing and pulling of two-wheeled waste containers compared with lifting and carrying of bags and bins.

    Science.gov (United States)

    Schibye, B; Søgaard, K; Martinsen, D; Klausen, K

    2001-08-01

    Compare the mechanical load on the low back and shoulders during pushing and pulling a two-wheeled container with the load during lifting and carrying the same amount of waste. Only little is known about risk factors and mechanical loads during push/pull operations. A complete 2(3) factor push/pull experiment. A two-wheeled container with 25 or 50 kg was pushed in front of and pulled behind the body by seven waste collectors. Further, the same subjects lifted and carried a paper bag and a dustbin both loaded with 7 and 25 kg. All operations were video recorded and the push/pull force was measured by means of a three-dimensional force transducer. Peak Motus and Watbak software were used for digitising and calculation of torque at L4/L5 and the shoulder joints and compression and shear forces at L4/L5. During pushing and pulling the compression at L4/L5 is from 605 to 1445 N. The extension torque at L4/L5 produced by the push/pull force is counteracted by the forward leaning of the upper body. The shear force is below 202 N in all situations. The torque at the shoulders is between 1 and 38 Nm. In the present experiments the torques at the low back and the shoulders are low during pushing and pulling. No relation exists between the size of the external force and the torque at the low back and the shoulder. Pushing and pulling are common in many workplaces and have often replaced lifting and carrying situations. This has emphasised the need for more knowledge of the internal mechanical load on the body during these activities.

  10. Clinical, manometric and profilometric evaluation after surgery for Hirschsprung's disease: comparison between the modified Duhamel and the transanal rectosigmoidectomy techniques Avaliação clínica, manométrica e profilométrica após correção cirúrgica para doença de Hirschsprung: comparação entre as técnicas de Duhamel modificado e a retossigmoidectomia transanal modificada

    Directory of Open Access Journals (Sweden)

    Elaine Cristina Soares Martins

    2009-10-01

    Full Text Available PURPOSE: To evaluate fecal continence, anorectal manometry (AM and profilometry (P, in patients operated for congenital megacolon, using either the modified Duhamel technique (MDT or the modified transanal rectosigmoidectomy (MTR technique. METHODS: 42 patients were evaluated clinically and via AM and P, for postoperative control. The resting, coughing, voluntary contraction, maintained voluntary contraction and perianal stimulation pressures were investigated. The rectosphincteric reflex was tested and the simple and enhanced pressure curves were evaluated. The three-dimensional profilometric outline was produced. Student's t, chi-squared and Fisher's exact tests were used for statistical analysis (pOBJETIVO: Avaliar a continência fecal, a manometria anorretal (MAR e a profilometria (PFM, em pacientes submetidos a tratamento cirúrgico do megacolo congênito pelas técnicas de Duhamel modificado (DM ou de retossigmoidectomia transanal modificada (RTM. MÉTODOS: 42 pacientes foram clinicamente avaliados e submetidos à MAR e PFM para controle pós-operatório. Foram pesquisadas as pressões no repouso (PR, à tosse (T, à contração voluntária (CV, à contração voluntária mantida (CVM e à estimulação perianal (EPA. O reflexo reto-esficteriano (RRE foi testado e as curvas pressóricas simples e potencializada foram avaliadas. Foi elaborado traçado tridimensional de PFM. Utilizamos os testes t de Student, Qui-Quadrado e exato de Fisher para análise estatística (p<0,05. RESULTADOS: A MAR mostrou médias de PR=53,44 mmHg para DM e 60,67 mmHg para RTM; CV média = 94,50 mmHg para o grupo DM e 95,47 mmHg para o grupo RTM. Não houve diferença estatística entre os grupos. A forma das CPS e CPP não apresentou diferença estatística, independentemente da técnica cirúrgica utilizada CONCLUSÃO: As duas técnicas operatórias foram manometricamente equivalentes. DM determinou maior incidência de constipação pós-operatória que RTM. A

  11. Transanal total mesorectal excision (TaTME) for rectal cancer: effects on patient-reported quality of life and functional outcome.

    Science.gov (United States)

    Koedam, T W A; van Ramshorst, G H; Deijen, C L; Elfrink, A K E; Meijerink, W J H J; Bonjer, H J; Sietses, C; Tuynman, J B

    2017-01-01

    Transanal total mesorectal excision (TaTME) has rapidly become an important component of the treatment of rectal cancer surgery. Cohort studies have shown feasibility concerning procedure, specimen quality and morbidity. However, concerns exist about quality of life and ano(neo)rectal function. The aim of this study was to prospectively evaluate quality of life in patients following TaTME for rectal cancer with anastomosis. Consecutive patients who underwent restorative TaTME surgery for rectal adenocarcinoma in an academic teaching center with tertiary referral function were evaluated. Validated questionnaires were prospectively collected. Quality of life was assessed by the EuroQol 5D (EQ-5D), European Organization for Research and Treatment of Cancer's QLQ-C30 and QLQ-CR29 and low anterior resection syndrome (LARS) scale. Outcomes of the questionnaires at 1 and 6 months were compared with preoperative (baseline) values. Thirty patients after restorative TaTME for rectal cancer were included. Deterioration for all domains was mainly observed at 1 month after surgery compared to baseline, but most outcomes had returned to baseline at 6 months. Social function and anal pain remained significantly worse at 6 months. Major LARS (score >30) was 33% at 6 months after ileostomy closure. No end colostomies were required. TaTME is associated with acceptable quality of life and functional outcome at 6 months after surgery comparable to published results after conventional laparoscopic low anterior resection.

  12. Evaluation of Interhandle Distance During Pushing and Pulling of a Four-Caster Cart for Upper Limb Exertion.

    Science.gov (United States)

    Ohnishi, Akihiro; Takanokura, Masato; Sugama, Atsushi

    2016-09-01

    This study examined the relationship between interhandle distances and upper limb exertion during simply pushing and pulling of a cart with four swivel wheels, defined by a roll box pallet (RBP) in a Japanese industrial standard. Six healthy young male participants were asked to push and pull an RBP at a distance of 5.2 m under six conditions corresponding to different interhandle distances (40 cm, 60 cm, and 80 cm) and weights (130 kg and 250 kg). The upper limb exertion was studied by shoulder abduction and flexion, and elbow flexion, as well as surface electromyogram (EMG) in shoulder extensor, and elbow flexor and extensor. Participants were required to provide subjective evaluations on operability after each trial. Subjective operability indicated that a narrower interhandle distance had a better operability for pushing. Interhandle distance was also related to upper limb exertion especially for pushing. A narrow interhandle distance caused smaller shoulder adduction but larger elbow flexion. The normalized EMG data revealed that muscular activity became smaller with a narrow interhandle distance in shoulder extensor. During the pulling task, elbow flexion was smaller at a narrow interhandle distance, although subjective operability and normalized EMG were not significantly varied. A wider interhandle distance, such as 80 cm, was not suitable in the forwardbackward movement of the RBP. Therefore, this study concluded that an interhandle distance of 40 cm would be suitable for pushing and pulling an RBP to protect the workers' hands against the risk of injury by installing inner handles.

  13. Evaluation of pull production control strategies under uncertainty: An integrated fuzzy AHP-TOPSIS approach

    Directory of Open Access Journals (Sweden)

    Aydin Torkabadi

    2018-03-01

    Full Text Available Purpose: Just-In-Time (JIT production has continuously been considered by industrial practitioners and researchers as a leading strategy for the yet popular Lean production. Pull Production Control Policies (PPCPs are the major enablers of JIT that locally control the level of inventory by authorizing the production in each station. Aiming to improve the PPCPs, three authorization mechanisms: Kanban, constant-work-in-process (ConWIP, and a hybrid system, are evaluated by considering uncertainty. Design/methodology/approach: Multi-Criteria Decision Making (MCDM methods are successful in evaluating alternatives with respect to several objectives. The proposed approach of this study applies the fuzzy set theory together with an integrated Analytical Hierarchy Process (AHP and a Technique for Order Performance by Similarity to Ideal Solution (TOPSIS method. Findings: The study finds that hybrid Kanban-ConWIP pull production control policies have a better performance in controlling the studied multi-layer multi-stage manufacturing and assembly system. Practical implications: To examine the approach a real case from automobile electro mechanical part production industry is studied. The production system consists of multiple levels of manufacturing, feeding a multi-stage assembly line with stochastic processing times to satisfy the changing demand. Originality/value: This study proposes the integrated Kanban-ConWIP hybrid pull control policies and implements several alternatives on a multi-stage and multi-layer manufacturing and assembly production system. An integrated Fuzzy AHP TOPSIS method is developed to evaluate the alternatives with respect to several JIT criteria.

  14. A Study to Quantify the Effectiveness of Daily Endorectal Balloon for Prostate Intrafraction Motion Management

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Ken Kang-Hsin, E-mail: wangken@uphs.upenn.edu [Department of Radiation Oncology, Hospital of University of Pennsylvania, Philadelphia, PA (United States); Vapiwala, Neha; Deville, Curtiland; Plastaras, John P.; Scheuermann, Ryan; Lin Haibo; Bar Ad, Voika; Tochner, Zelig; Both, Stefan [Department of Radiation Oncology, Hospital of University of Pennsylvania, Philadelphia, PA (United States)

    2012-07-01

    Purpose: To quantify intrafraction prostate motion between patient groups treated with and without daily endorectal balloon (ERB) employed during prostate radiotherapy and establish the effectiveness of the ERB. Methods: Real-time intrafraction prostate motion from 29 non-ERB (1,061 sessions) and 30 ERB (1,008 sessions) patients was evaluated based on three-dimensional (3D), left, right, cranial, caudal, anterior, and posterior displacements. The average percentage of time with 3D and unidirectional prostate displacements >2, 3, 4, 5, 6, 7, 8, 9, and 10 mm in 1-min intervals was calculated for up to 6 min of treatment time. The Kolmogorov-Smirnov method was used to evaluate the intrafraction prostate motion pattern between both groups. Results: Large 3D motion (up to 1 cm or more) was only observed in the non-ERB group. The motion increased as a function of elapsed time for displacements >2-8 mm for the non-ERB group and >2-4 mm for the ERB group (p < 0.05). The percentage time distributions between the two groups were significantly different for motion >5 mm (p < 0.05). The 3D symmetrical internal margin (IM) can be reduced from 5 to 3 mm (40% reduction), whereas the asymmetrical IM can be reduced from 3 to 2 mm (33% reduction) in cranial, caudal, anterior, and posterior for 6 min of treatment, when ERB is used. Beyond 6 min, the symmetrical 3D and asymmetrical cranial, caudal, anterior, and posterior IMs can be reduced from 9, 4, 7, 7, and 8 to 5, 2, 5, 3, and 4 mm, respectively (up to 57% reduction). Conclusion: The percentage of time that the prostate was displaced in any direction was less in the ERB group for almost all magnitudes of motion considered. The directional analysis shows that the ERB reduced IMs in almost all directions, especially the anterior-posterior direction.

  15. Assessment of the RIVET fixation system for cranioplasty using the pull-out technique.

    Science.gov (United States)

    Sakamoto, Yoshiaki; Minabe, Toshiharu; Kato, Tatsuya; Kishi, Kazuo

    2015-03-01

    Cranioplasty using custom-made hydroxyapatite (HAP) ceramic implants is a common procedure to repair skull defects. However, commercially available titanium screws are only minimally stabilized due to characteristic brittleness. We developed the RIVET technique which involves fixing a bioabsorbable plate atop a HAP block using bioabsorbable screws extending beyond both layers, and evaluated fixation strength using the pull-out test and microtomography. Three experimental conditions were compared: a non-RIVET group, RIVET group, and dry skull control group. Pull-out strength significantly differed across groups (non-RIVET group, 1.33 ± 1.21 kgf; RIVET group, 4.46 ± 0.84 kgf; and control group, 6.99 ± 1.14 kgf, P uses commercially available absorbable plate and screws, and thus can be used widely in clinical applications involving HAP blocks with different porosities and thicknesses. Copyright © 2014 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  16. Electromyographic assessment of trunk and shoulder muscles during a Pilates pull-up exercise

    Directory of Open Access Journals (Sweden)

    Isabel C.N. Sacco

    2014-06-01

    Full Text Available This study compares surface electromyographic activity of the internal oblique, rectus abdominis, multifidus, iliocostalis, anterior deltoids during the pull-up on a lower and on a higher difficulty level. We assessed nine adults with previous experience in Pilates. The root mean square (RMS values were normalized by maximum isometric contraction for each participant. During the ascent phase, the low spring position showed a significantly higher RMS than the high spring position of 8.9% for deltoid, 17.2% for internal oblique, 22.3% for rectus abdominis, 4.1% for iliocostalis, and 5.6% for multifidus, and in the descent phase, the RMS in the lower spring exceeded significantly the high spring position in 1.6% for the deltoid, 10% for internal oblique, 31.4% for rectus abdominis and 11.4% for iliocostalis. There was no predominance of abdominal muscles over the shoulder muscle in any spring position. The pull-up exercise can be a useful choice for the core and anterior deltoid muscles strengthening.

  17. Strike-slip pull-apart process and emplacement of Xiangshan uranium-producing volcanic basin

    International Nuclear Information System (INIS)

    Qiu Aijin; Guo Lingzhi; Shu Liangshu

    2001-01-01

    Xiangshan volcanic basin is one of the famous uranium-producing volcanic basins in China. Emplacement mechanism of Xiangshan uranium-producing volcanic basin is discussed on the basis of the latest research achievements of deep geology in Xiangshan area and the theory of continental dynamics. The study shows that volcanic activity in Xiangshan volcanic basin may be divided into two cycles, and its emplacement is controlled by strike-ship pull-apart process originated from the deep regional faults. Volcanic apparatus in the first cycle was emplaced in EW-trending structure activated by clockwise strike-slipping of NE-trending deep fault, forming the EW-trending fissure-type volcanic effusion belt. Volcanic apparatus in the second cycle was emplaced at junction points of SN-trending pull-apart structure activated by sinistral strike-slipping of NE-trending deep faults and EW-trending basement faults causing the center-type volcanic magma effusion and extrusion. Moreover, the formation mechanism of large-rich uranium deposits is discussed as well

  18. Influence of surface effects on the pull-in instability of NEMS electrostatic switches

    Energy Technology Data Exchange (ETDEWEB)

    Ma, Jianming Bryan; Jiang Liying; Asokanthan, Samuel F, E-mail: lyjiang@eng.uwo.ca, E-mail: sasokanthan@eng.uwo.ca [Department of Mechanical and Materials Engineering, University of Western Ontario, London, ON, N6A 5B9 (Canada)

    2010-12-17

    The influence of surface effects, including residual surface stress and surface elasticity, on the pull-in instability of electrostatic switches in nanoelectromechanical systems (NEMS) is studied using an Euler-Bernoulli beam model. This model is inherently nonlinear due to the driving electrostatic force and Casimir force which become dominant at the nanoscale. Since no exact solutions are available for the resulting nonlinear differential equation, He's homotopy perturbation method (HPM) is used to get the approximate analytical solutions to the static bending of NEMS switches, which are validated by numerical solutions of the finite difference method (FDM). The results demonstrate that surface effects play a significant role in the selection of basic design parameters of NEMS switches, such as static deflection, pull-in voltage and detachment length. Surface effects on low-voltage actuation windows are also characterized for these switches. The present study is envisaged to provide useful insights for the design of NEMS switches.

  19. Benchtop-magnetic resonance imaging (BT-MRI) characterization of push-pull osmotic controlled release systems.

    Science.gov (United States)

    Malaterre, Vincent; Metz, Hendrik; Ogorka, Joerg; Gurny, Robert; Loggia, Nicoletta; Mäder, Karsten

    2009-01-05

    The mechanism of drug release from push-pull osmotic systems (PPOS) has been investigated by Magnetic Resonance Imaging (MRI) using a new benchtop apparatus. The signal intensity profiles of both PPOS layers were monitored non-invasively over time to characterize the hydration and swelling kinetics. The drug release performance was well-correlated to the hydration kinetics. The results show that (i) hydration and swelling critically depend on the tablet core composition, (ii) high osmotic pressure developed by the push layer may lead to bypassing the drug layer and incomplete drug release and (iii) the hydration of both the drug and the push layers needs to be properly balanced to efficiently deliver the drug. MRI is therefore a powerful tool to get insights on the drug delivery mechanism of push-pull osmotic systems, which enable a more efficient optimization of such formulations.

  20. Affecting Factors and Outcome on Intermittent Internet Pulling Behavior in Taiwan's Undergraduate Students

    Science.gov (United States)

    Yang, Hui-Jen; Lay, Yun-Long

    2011-01-01

    Nowadays people's lives heavily rely on Internet facilities. Internet users generally have constant Internet connectivity and intermittently click on sites they want to access even amidst studying or working. In this study, we sought to examine the factors affecting intermittent Internet pulling behavior on undergraduate students. Furthermore, the…

  1. Push versus pull gastrostomy in cancer patients: A single center retrospective analysis of complications and technical success rates.

    Science.gov (United States)

    Currie, B M; Getrajdman, G I; Covey, A M; Alago, W; Erinjeri, J P; Maybody, M; Boas, F E

    2018-04-28

    To compare the technical success and complication rates of push versus pull gastrostomy tubes in cancer patients, and to examine their dependence on operator experience. A retrospective review was performed of 304 cancer patients (170 men, 134 women; mean age 60.3±12.6 [SD], range: 19-102 years) referred for primary gastrostomy tube placement, 88 (29%) of whom had a previously unsuccessful attempt at percutaneous endoscopic gastrostomy (PEG) placement. Analyzed variables included method of insertion (push versus pull), indication for gastrostomy, technical success, operator experience, and procedure-related complications within 30 days of placement. Gastrostomy tubes were placed for feeding in 189 patients and palliative decompression in 115 patients. Technical success was 91%: 78% after endoscopy had previously been unsuccessful and 97% when excluding failures associated with prior endoscopy. In the first 30 days, there were 29 minor complications (17.2%) associated with push gastrostomies, and only 8 minor complications (7.5%) with pull gastrostomies (Ptechnical success rates for more versus less experienced operators. Pull gastrostomy tube placement had a lower rate of complications than push gastrostomy tube placement, especially when the indication was decompression. The technical success rate was high, even after a failed attempt at endoscopic placement. Both the rates of success and complications were independent of operator experience. Copyright © 2018 Société française de radiologie. Published by Elsevier Masson SAS. All rights reserved.

  2. Unshielded asymmetric transmit-only and endorectal receive-only radiofrequency coil for (23) Na MRI of the prostate at 3 tesla.

    Science.gov (United States)

    Farag, Adam; Peterson, Justin Charles; Szekeres, Trevor; Bauman, Glenn; Chin, Joseph; Romagnoli, Cesare; Bartha, Robert; Scholl, Timothy J

    2015-08-01

    To develop and optimize radiofrequency (RF) hardware for the detection of endogenous sodium ((23) Na) by 3.0 Tesla (T) MRI in the human prostate. A transmit-only receive-only (TORO) RF system of resonators consisting of an unshielded, asymmetric, quadrature birdcage (transmit), and an endorectal (ER), linear, surface (receive) coil were developed and tested on a 3T MRI scanner. Two different ER receivers were constructed; a single-tuned ((23) Na) and a dual-tuned ((1) H/(23) Na). Both receivers were evaluated by the measurements of signal-to-noise ratio (SNR) and B1 homogeneity. For tissue sodium concentration (TSC) quantification, vials containing known sodium concentrations were incorporated into the ER. The system was used to measure the prostate TSC of three men (age 55 ± 5 years) with biopsy-proven prostate cancer. B1 field inhomogeneity of the asymmetric transmitter was estimated to be less than 5%. The mean SNR measured in a region of interest within the prostate using the single-tuned ER coil was 54.0 ± 4.6. The mean TSC in the central gland was 60.2 ± 5.7 mmol/L and in the peripheral gland was 70.5 ± 9.0 mmol/L. A TORO system was developed and optimized for (23) Na MRI of the human prostate which showed good sensitivity throughout the prostate for quantitative measurement of TSC. © 2014 Wiley Periodicals, Inc.

  3. Pick-N-Pull Auto Dismantlers, Kansas City, LLC Inc. - Clean Water Act Public Notice

    Science.gov (United States)

    The EPA is providing notice of a proposed Administrative Penalty Assessment against Pick-N-Pull Auto Dismantlers, Kansas City, LLC, a subsidiary of Schnitzer Steel Industries, Inc., for alleged violations at its facilities at 8012 East Truman Rd., Kansas C

  4. Free energy profiles from single-molecule pulling experiments.

    Science.gov (United States)

    Hummer, Gerhard; Szabo, Attila

    2010-12-14

    Nonequilibrium pulling experiments provide detailed information about the thermodynamic and kinetic properties of molecules. We show that unperturbed free energy profiles as a function of molecular extension can be obtained rigorously from such experiments without using work-weighted position histograms. An inverse Weierstrass transform is used to relate the system free energy obtained from the Jarzynski equality directly to the underlying molecular free energy surface. An accurate approximation for the free energy surface is obtained by using the method of steepest descent to evaluate the inverse transform. The formalism is applied to simulated data obtained from a kinetic model of RNA folding, in which the dynamics consists of jumping between linker-dominated folded and unfolded free energy surfaces.

  5. Promoting healthy dietary behaviour through personalised nutrition: technology push or technology pull?

    NARCIS (Netherlands)

    Stewart-Knox, B.; Rankin, A.; Kuznesof, S.; Poínhos, R.; Vaz de Almeida, M.D.; Fischer, A.R.H.; Frewer, L.J.

    2015-01-01

    The notion of educating the public through generic healthy eating messages has pervaded dietary health promotion efforts over the years and continues to do so through various media, despite little evidence for any enduring impact upon eating behaviour. There is growing evidence, however, that

  6. Tumorsize dependent detection rate of endorectal MRI of prostate cancer-A histopathologic correlation with whole-mount sections in 70 patients with prostate cancer

    International Nuclear Information System (INIS)

    Roethke, Matthias C.; Lichy, Matthias P.; Jurgschat, Leo; Hennenlotter, Joerg; Vogel, Ulrich; Schilling, David; Stenzl, Arnulf; Claussen, Claus D.; Schlemmer, Heinz-Peter

    2011-01-01

    Purpose: To evaluate the value of T2w endorectal MRI (eMRI) for correct detection of tumor foci within the prostate regarding tumor size. Materials and Methods: 70 patients with histologically proven prostate cancer were examined with T2w eMRI before radical prostatectomy at a 1.5 T scanner. For evaluation of eMRI, two radiologists evaluated each tumor focus within the gland. After radical prostatectomy, the prostates were prepared as whole-mount sections, according to transversal T2w eMRI. For each slice, tumor surroundings were marked and compared with eMRI. Based on whole-mount section, 315 slices were evaluated and 533 tumor lesions were documented. Results: Based on the T2w eMRI, 213 tumor lesions were described. In 137/213, histology could prove these lesions. EMRI was able to visualize 0/56 lesions with a maximum size of 2 cm 50/56 (89%). False positive eMRI findings were: 2 cm n = 2. Conclusion: T2w eMRI cannot exclude prostate cancer with lesions smaller 10 mm and 0.4 cm 3 respectively. The detection rate for lesions more than 20 mm (1.6 cm 3 ) is to be considered as high.

  7. Optimal Design of a Push-Pull-Forward Half-Bridge (PPFHB) Bidirectional DC–DC Converter With Variable Input Voltage

    DEFF Research Database (Denmark)

    Zhang, Zhe; Thomsen, Ole Cornelius; Andersen, Michael A. E.

    2012-01-01

    This paper presents a low-cost bidirectional isolated dc–dc converte, derived from dual-active-bridge converter for the power sources with variable output voltage like supercapacitors. The proposed converter consists of push-pull-forward circuit half-bridge circuit (PPFHB) and a high-frequency tr......This paper presents a low-cost bidirectional isolated dc–dc converte, derived from dual-active-bridge converter for the power sources with variable output voltage like supercapacitors. The proposed converter consists of push-pull-forward circuit half-bridge circuit (PPFHB) and a high...

  8. Clinical evaluation of an endorectal immobilization system for use in prostate hypofractionated Stereotactic Ablative Body Radiotherapy (SABR)

    International Nuclear Information System (INIS)

    Nicolae, Alexandru; Davidson, Melanie; Easton, Harry; Helou, Joelle; Musunuru, Hima; Loblaw, Andrew; Ravi, Ananth

    2015-01-01

    The objective of this study was to evaluate a novel prostate endorectal immobilization system (EIS) for improving the delivery of hypofractionated Stereotactic Ablative Body Radiotherapy (SABR) for prostate cancer. Twenty patients (n = 20) with low- or intermediate-risk prostate cancer (T1-T2b, Gleason Score < 7, PSA ≤ 20 ng/mL), were treated with an EIS in place using Volumetric Modulated Arc Therapy (VMAT), to a prescription dose of 26 Gy delivered in 2 fractions once per week; the intent of the institutional clinical trial was an attempt to replicate brachytherapy-like dosimetry using SABR. EBT3 radiochromic film embedded within the EIS was used as a quality assurance measure of the delivered dose; additionally, prostate intrafraction motion captured using pre- and post-treatment conebeam computed tomography (CBCT) scans was evaluated. Treatment plans were generated for patients with- and without the EIS to evaluate its effects on target and rectal dosimetry. None of the observed 3-dimensional prostate displacements were ≥ 3 mm over the elapsed treatment time. A Gamma passing rate of 95.64 ± 4.28 % was observed between planned and delivered dose profiles on EBT3 film analysis in the low-dose region. No statistically significant differences between treatment plans with- and without-EIS were observed for rectal, bladder, clinical target volume (CTV), and PTV contours (p = 0.477, 0.484, 0.487, and 0.487, respectively). A mean rectal V80% of 1.07 cc was achieved for plans using the EIS. The EIS enables the safe delivery of brachytherapy-like SABR plans to the prostate while having minimal impact on treatment planning and rectal dosimetry. Consistent and reproducible immobilization of the prostate is possible throughout the duration of these treatments using such a device

  9. From the Push of Fear, to the Pull of Hope: Learning by design ...

    African Journals Online (AJOL)

    From the Push of Fear, to the Pull of Hope: Learning by design. S Sterling. Abstract. No Abstract. Full Text: EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT · Creative Commons License This work is licensed under a Creative Commons Attribution 3.0 License.

  10. Mechanical loading of the low back and shoulders during pushing and pulling activities.

    NARCIS (Netherlands)

    Hoozemans, M.J.M.; Kingma, I.; Dieen, van J.H.; Vries, de W.K.H.; Woude, van der L.H.V.; Veeger, H.E.J.; Frings-Dresen, M.H.W.; Beek, van der A.J.

    2004-01-01

    The objective of this study was to quantify the mechanical load on the low back and shoulders during pushing and pulling in combination with three task constraints: the use of one or two hands, three cart weights, and two handle heights. The second objective was to explore the relation between the

  11. Mechanical loading of the low back and shoulders during pushing and pulling activities

    NARCIS (Netherlands)

    Hoozemans, Marco J. M.; Kuijer, P. Paul F. M.; Kingma, Idsart; van Dieën, Jaap H.; de Vries, Wiebe H. K.; van der Woude, Luc H. V.; Veeger, Dirk Jan H. E. J.; van der Beek, Allard J.; Frings-Dresen, Monique H. W.

    2004-01-01

    The objective of this study was to quantify the mechanical load on the low back and shoulders during pushing and pulling in combination with three task constraints: the use of one or two hands, three cart weights, and two handle heights. The second objective was to explore the relation between the

  12. Dosimetric impacts of endorectal balloon in CyberKnife stereotactic body radiation therapy (SBRT) for early-stage prostate cancer.

    Science.gov (United States)

    Xiang, Hong F; Lu, Hsiao-Ming; Efstathiou, Jason A; Zietman, Anthony L; De Armas, Ricardo; Harris, Kathryn; Bloch, B Nicolas; Qureshi, Muhammad Mustafa; Keohan, Sean; Hirsch, Ariel E

    2017-05-01

    In SBRT for prostate cancer, higher fractional dose to the rectum is a major toxicity concern due to using smaller PTV margin and hypofractionation. We investigate the dosimetric impact on rectum using endorectal balloon (ERB) in prostate SBRT. Twenty prostate cancer patients were included in a retrospective study, ten with ERB and 10 without ERB. Optimized SBRT plans were generated on CyberKnife MultiPlan for 5 × 7.25 Gy to PTV under RTOG-0938 protocol for early-stage prostate cancer. For the rectum and the anterior half rectum, mean dose and percentage of volumes receiving 50%, 80%, 90%, and 100% prescription dose were compared. Using ERB, mean dose to the rectum was 62 cGy (P = 0.001) lower per fraction, and 50 cGy (P = 0.024) lower per fraction for the anterior half rectum. The average V 50% , V 80% , V 90% , and V 100% were lower by 9.9% (P = 0.001), 5.3% (P = 0.0002), 3.4% (P = 0.0002), and 1.2% (P = 0.005) for the rectum, and lower by 10.4% (P = 0.009), 8.3% (P = 0.0004), 5.4% (P = 0.0003), and 2.1% (P = 0.003) for the anterior half rectum. Significant reductions of dose to the rectum using ERB were observed. This may lead to improvement of the rectal toxicity profiles in prostate SBRT. © 2017 The Authors. Journal of Applied Clinical Medical Physics published by Wiley Periodicals, Inc. on behalf of American Association of Physicists in Medicine.

  13. A case of intractable gastrocutaneous fistula after gastric pull-up reconstruction of the pharynx and esophagus

    International Nuclear Information System (INIS)

    Wada, Tadahiko; Tanaka, Shinzo; Hiratsuka, Yasuyuki; Kumabe, Yohei; Yamahara, Kohei; Koyama, Taiji

    2012-01-01

    Pharyngocutaneous or esophagocutaneous fistula formation is not a rare complication after surgical treatment of head/neck cancer. In cases having developed such fistula, conservative treatment with local manipulation or surgical closure of the fistula using a local or pedicled flap is often possible. We recently encountered a case with an intractable gastrocutaneous fistula which occurred a long time after gastric pull-up reconstruction of the pharynx and esophagus. The patient was a 58-year-old female. As treatment for hypopharyngeal and thoracic esophageal cancers, the patient underwent total resections of the laryngopharynx and esophagus and gastric pull-up reconstruction of the esophagus. Postoperatively, 50 Gy radiation was applied to the neck. Although there was no recurrence of cancer, a salivary fistula above the tracheostomy occurred six years after surgery. Closure of the fistula with a local flap was attempted twice, but did not succeed. The fistula was then closed with a deltopectoral (DP) flap, but a fistula recurred five months later. Finally, by resecting the cervical segment of the pulled-up stomach, the esophagus was reconstructed successfully with a free jejunal graft. An intractable fistula should be replaced using tissue with rich blood flow, such as a free jejunal graft. (author)

  14. Range expansions transition from pulled to pushed waves with increasing cooperativity in an experimental microbial population

    Science.gov (United States)

    Gandhi, Saurabh; Yurtsev, Eugene; Korolev, Kirill; Gore, Jeff

    Range expansions are becoming more frequent due to environmental changes and rare long distance dispersal, often facilitated by anthropogenic activities. Simple models in theoretical ecology explain many emergent properties of range expansions, such as a constant expansion velocity, in terms of organism-level properties such as growth and dispersal rates. Testing these quantitative predictions in natural populations is difficult because of large environmental variability. Here, we used a controlled microbial model system to study range expansions of populations with and without intra-specific cooperativity. For non-cooperative growth, the expansion dynamics were dominated by population growth at the low-density front, which pulled the expansion forward. We found these expansions to be in close quantitative agreement with the classical theory of pulled waves by Fisher and Skellam, suitably adapted to our experimental system. However, as cooperativity increased, the expansions transitioned to being pushed, i.e. controlled by growth in the bulk as well as in the front. Although both pulled and pushed waves expand at a constant velocity and appear otherwise similar, their distinct dynamics leads to very different evolutionary consequences. Given the prevalence of cooperative growth in nature, understanding the effects of cooperativity is essential to managing invading species and understanding their evolution.

  15. Comparison of Transverse Intraosseous Loop Technique and Pull Out Suture for Reinsertion of the Flexor Digitorum Profundus tendon. A Retrospective Study.

    Science.gov (United States)

    Rigó, István Zoltán; Røkkum, Magne

    2013-12-01

    We compared the results of two methods for reinsertion of flexor digitorum profundus tendons retrospectively. In 35 fingers of 29 patients pull-out suture and in 13 fingers of 11 patients transverse intraosseous loop technique was performed with a mean follow-up of 8 and 6 months, respectively. Eleven and nine fingers achieved "excellent" or "good" function according to Strickland and Glogovac at 8 weeks; 20 and ten at the last control in the pull-out and transverse intraosseous loop groups, respectively. The difference at 8 weeks was statistically significant in favour of the transverse intraosseous loop group. Ten patients underwent 12 complications in the pull-out group (four superficial infections; one rerupture, one PIP and one DIP joint contracture, one adhesion, two granulomas, one nail deformity and one carpal tunnel syndrome) and four of them were reoperated (one carpal tunnel release, one teno-arthrolysis and two resections of granuloma). There was no complication and no reoperation in the transverse intraosseous loop group, the difference being statistically significant for the former. In our study the transverse intraosseous loop technique seemed to be a safe alternative with possibly better functional results compared to the pull-out suture.

  16. Modeling the effect of intermolecular force on the size-dependent pull-in behavior of beam-type NEMS using modified couple stress theory

    Energy Technology Data Exchange (ETDEWEB)

    Beni, Yaghoub Tadi; Karimipour, Iman [Shahrekord University, Shahrekord (Iran, Islamic Republic of); Abadyan, Mohamadreza [Islamic Azad University, Shahrekord (Iran, Islamic Republic of)

    2014-09-15

    Experimental observations reveal that the physical response of nano structures is size-dependent. Herein, modified couple stress theory has been used to study the effect of intermolecular van der Waals force on the size dependent pull-in of nano bridges and nano cantilevers. Three approaches including using differential transformation method, applying numerical method and developing a simple lumped parameter model have been employed to solve the governing equation of the systems. The pull-in parameters i.e. critical tip deflection and instability voltage of the nano structures have been determined. Effect of the van der Waals attraction and the size dependency and the importance of coupling between them on the pull-in performance have been discussed.

  17. Modeling the effect of intermolecular force on the size-dependent pull-in behavior of beam-type NEMS using modified couple stress theory

    International Nuclear Information System (INIS)

    Beni, Yaghoub Tadi; Karimipour, Iman; Abadyan, Mohamadreza

    2014-01-01

    Experimental observations reveal that the physical response of nano structures is size-dependent. Herein, modified couple stress theory has been used to study the effect of intermolecular van der Waals force on the size dependent pull-in of nano bridges and nano cantilevers. Three approaches including using differential transformation method, applying numerical method and developing a simple lumped parameter model have been employed to solve the governing equation of the systems. The pull-in parameters i.e. critical tip deflection and instability voltage of the nano structures have been determined. Effect of the van der Waals attraction and the size dependency and the importance of coupling between them on the pull-in performance have been discussed.

  18. Anorectal functional outcome after repeated transanal endoscopic microsurgery.

    Science.gov (United States)

    Zhang, Hong-Wei; Han, Xiao-Dong; Wang, Yu; Zhang, Pin; Jin, Zhi-Ming

    2012-10-28

    To evaluate the status of anorectal function after repeated transanal endoscopic microsurgery (TEM). Twenty-one patients undergoing subtotal colectomy with ileorectal anastomosis were included. There were more than 5 large (> 1 cm) polyps in the remaining rectum (range: 6-20 cm from the anal edge). All patients, 19 with villous adenomas and 2 with low-grade adenocarcinomas, underwent TEM with submucosal endoscopic excision at least twice between 2005 and 2011. Anorectal manometry and a questionnaire about incontinence were carried out at week 1 before operation, and at weeks 2 and 3 and 6 mo after the last operation. Anal resting pressure, maximum squeeze pressure, maximum tolerable volume (MTV) and rectoanal inhibitory reflexes (RAIR) were recorded. The integrity and thickness of the internal anal sphincter (IAS) and external anal sphincter (EAS) were also evaluated by endoanal ultrasonography. We determined the physical and mental health status with SF-36 score to assess the effect of multiple TEM on patient quality of life (QoL). All patients answered the questionnaire. Apart from negative RAIR in 4 patients, all of the anorectal manometric values in the 21 patients were normal before operation. Mean anal resting pressure decreased from 38 ± 5 mmHg to 19 ± 3 mmHg (38 ± 5 mmHg vs 19 ± 3 mmHg, P = 0.000) and MTV from 165 ± 19 mL to 60 ± 11 mL (165 ± 19 mL vs 60 ± 11 mL, P = 0.000) at month 3 after surgery. Anal resting pressure and MTV were 37 ± 5 mmHg (38 ± 5 mmHg vs 37 ± 5 mmHg, P = 0.057) and 159 ± 19 mL (165 ± 19 mL vs 159 ± 19 mL, P = 0.071), respectively, at month 6 after TEM. Maximal squeeze pressure decreased from 171 ± 19 mmHg to 62 ± 12 mmHg (171 ± 19 mmHg vs 62 ± 12 mmHg, P = 0.000) at week 2 after operation, and returned to normal values by postoperative month 3 (171 ± 19 vs 166 ± 18, P = 0.051). RAIR were absent in 4 patients preoperatively and in 12 (χ(2) = 4.947, P = 0.026) patients at month 3 after surgery. RAIR was absent only

  19. Trichotillomania (hair pulling disorder), skin picking disorder, and stereotypic movement disorder: toward DSM-V.

    Science.gov (United States)

    Stein, Dan J; Grant, Jon E; Franklin, Martin E; Keuthen, Nancy; Lochner, Christine; Singer, Harvey S; Woods, Douglas W

    2010-06-01

    In DSM-IV-TR, trichotillomania (TTM) is classified as an impulse control disorder (not classified elsewhere), skin picking lacks its own diagnostic category (but might be diagnosed as an impulse control disorder not otherwise specified), and stereotypic movement disorder is classified as a disorder usually first diagnosed in infancy, childhood, or adolescence. ICD-10 classifies TTM as a habit and impulse disorder, and includes stereotyped movement disorders in a section on other behavioral and emotional disorders with onset usually occurring in childhood and adolescence. This article provides a focused review of nosological issues relevant to DSM-V, given recent empirical findings. This review presents a number of options and preliminary recommendations to be considered for DSM-V: (1) Although TTM fits optimally into a category of body-focused repetitive behavioral disorders, in a nosology comprised of relatively few major categories it fits best within a category of motoric obsessive-compulsive spectrum disorders, (2) available evidence does not support continuing to include (current) diagnostic criteria B and C for TTM in DSM-V, (3) the text for TTM should be updated to describe subtypes and forms of hair pulling, (4) there are persuasive reasons for referring to TTM as "hair pulling disorder (trichotillomania)," (5) diagnostic criteria for skin picking disorder should be included in DSM-V or in DSM-Vs Appendix of Criteria Sets Provided for Further Study, and (6) the diagnostic criteria for stereotypic movement disorder should be clarified and simplified, bringing them in line with those for hair pulling and skin picking disorder. (c) 2010 Wiley-Liss, Inc.

  20. Voices from the "Working Lives" Project: The Push-Pull of Work and Care

    Science.gov (United States)

    Fehring, Heather; Herring, Katherine

    2012-01-01

    A recent policy direction in many OECD countries has been to increase workforce participation for women of childbearing age; a policy direction which seemingly runs counter to a need for improved work-life balance for women themselves. This article explores the impact of this somewhat contradictory "push-pull" of policy by examining some…

  1. 拉车作业之肌肉疲劳分析与预测%Analyses and Predictions of Muscular Fatigue For Pulling Tasks

    Institute of Scientific and Technical Information of China (English)

    唐范; 李开伟; 易灿南; 彭露

    2017-01-01

    目的 本研究的第一个目的是以肌力下降、耐受时间及主观评价来比较在不同负荷水平下拉车作业造成的肌肉疲劳水平;第二个目的是建立数学模型来量化拉车作业造成肌肉疲劳的程度;最终目的为提供拉车作业工作设计的提供依据,以降低劳动者肌肉骨骼伤害的风险.方法 通过设计模拟手拉叉车实验,测量两种负荷下被试的实验前后拉力值、持续施力的耐受时间以及身体疲劳主观评价的数据,进行肌肉疲劳分析.结果 实验数据显示拉车作业产生肌肉疲劳,性别和负荷对耐受时间、拉力下降速率产生显着影响;性别也显著影响被试对疲劳的主观评价,身体质量指数是影响耐受时间的显著因子.结论 拉车作业中肌肉疲劳会导致拉力显著下降;性别是影响肌肉疲劳的重要因子,女性被试比男性被试更易疲劳;根据预测函数模型计算的男、女被试的疲劳速率k值分别为0.071、0.099.%Objective The first purpose of this study was to compare the muscular fatigue levels between different workloads for pulling tasks via the analyses of muscular strength decrease, endurance time, and subjective ratings.The second purpose of this study was to establish mathematic models to quantify muscular strength for pulling tasks with the ultimate goal of providing basis for job design for pulling tasks so as to reduce the risk of musculoskeletal disorders.Methods A simulated pallet truck pulling task was designed to investigate the developing of muscular fatigue in performing a truck pulling task.The muscular strength of pulling before and after performing the pulling task, endurance time and the subjective ratings on muscular fatigue were analyzed.Results Pulling tasks resulted in muscular fatigue.Gender and workload significantly affected endurance time, and the decrease rate of the pulling strength.Gender affected the subjective ratings on muscular fatigue significantly

  2. Detection of local recurrent prostate cancer after radical prostatectomy in terms of salvage radiotherapy using dynamic contrast enhanced-MRI without endorectal coil

    Directory of Open Access Journals (Sweden)

    Rischke Hans Christian

    2012-10-01

    Full Text Available Abstract Purpose To evaluate the value of dynamic contrast enhanced Magnetic Resonance Imaging (DCE-MRI without endorectal coil (EC in the detection of local recurrent prostate cancer (PC after radical prostatectomy (RP. Material and methods Thirty-three patients with recurrent PC underwent DCE-MRI without EC before salvage radiotherapy (RT. At median 15 (mean 16±4.9, range 12–27 months after completion of RT all patients showed complete biochemical response. Additional follow up post RT DCE-MRI scans were available. Prostate specific antigen (PSA levels at the time of imaging were correlated to the imaging findings. Results In 22/33 patients (67% early contrast enhancing nodules were detected in the post-prostatectomy fossa on pre-RT DCE-MRI images. The average pre-RT PSA level of the 22 patients with positive pre-RT DCE-MRI findings was significantly higher (mean, 0.74±0.64 ng/mL compared to the pre-RT PSA level of the 11 patients with negative pre-RT DCE-MRI (mean, 0.24±0.13 ng/mL (p Conclusions This is the first study that shows that DCE-MRI without EC can detect local recurrent PC with an estimated accuracy of 83% at low PSA levels. All false negative DCE-MRI scans were detected using a PSA cut-off of ≥0.54 ng/mL.

  3. Choices of Destination for Transnational Higher Education: "Pull" Factors in an Asia Pacific Market

    Science.gov (United States)

    Ahmad, Syed Zamberi; Buchanan, Frederick Robert

    2016-01-01

    Traditional assumptions favouring native English language countries in transnational higher education (TNHE) overlook experiences of international students in new emerging Asian education hubs. Specifically, there has been limited research relating to international students' choice for studying in Malaysia. Drawing from the "push-pull"…

  4. Small-scale field evaluation of push-pull system against early- and outdoor-biting malaria mosquitoes in an area of high pyrethroid resistance in Tanzania [version 1; referees: 2 approved

    Directory of Open Access Journals (Sweden)

    Arnold S. Mmbando

    2017-11-01

    Full Text Available Background: Despite high coverage of indoor interventions like insecticide-treated nets, mosquito-borne infections persist, partly because of outdoor-biting, early-biting and insecticide-resistant vectors. Push-pull systems, where mosquitoes are repelled from humans and attracted to nearby lethal targets, may constitute effective complementary interventions. Methods: A partially randomized cross-over design was used to test efficacy of push-pull in four experimental huts and four local houses, in an area with high pyrethroid resistance in Tanzania. The push-pull system consisted of 1.1% or 2.2% w/v transfluthrin repellent dispensers and an outdoor lure-and-kill device (odour-baited mosquito landing box. Matching controls were set up without push-pull. Adult male volunteers collected mosquitoes attempting to bite them outdoors, but collections were also done indoors using exit traps in experimental huts and by volunteers in the local houses. The collections were done hourly (1830hrs-0730hrs and mosquito catches compared between push-pull and controls. An. gambiae s.l. and An. funestus s.l. were assessed by PCR to identify sibling species, and ELISA to detect Plasmodium falciparum and blood meal sources. Results: Push-pull in experimental huts reduced outdoor-biting for An. arabiensis and Mansonia species by 30% and 41.5% respectively. However, the reductions were marginal and insignificant for An. funestus (12.2%; p>0.05 and Culex (5%; p>0.05. Highest protection against all species occurred before 2200hrs. There was no significant difference in number of mosquitoes inside exit traps in huts with or without push-pull. In local households, push-pull significantly reduced indoor and outdoor-biting of An. arabiensis by 48% and 25% respectively, but had no effect on other species. Conclusion: This push-pull system offered modest protection against outdoor-biting An. arabiensis, without increasing indoor mosquito densities. Additional experimentation

  5. Laser pushing or pulling of absorbing airborne particles

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Chuji, E-mail: cw175@msstate.edu; Gong, Zhiyong [Mississippi State University, Starkville, Mississippi 39759 (United States); Pan, Yong-Le; Videen, Gorden [U.S. Army Research Laboratory, 2800 Powder Mill Road, Adelphi, Maryland 20783 (United States)

    2016-07-04

    A single absorbing particle formed by carbon nanotubes in the size range of 10–50 μm is trapped in air by a laser trapping beam and concurrently illuminated by another laser manipulating beam. When the trapping beam is terminated, the movement of the particle controlled by the manipulating beam is investigated. We report our observations of light-controlled pushing and pulling motions. We show that the movement direction has little relationship with the particle size and manipulating beam's parameters but is dominated by the particle's orientation and morphology. With this observation, the controllable optical manipulation is now able to be generalized to arbitrary particles, including irregularly shaped absorbing particles that are shown in this work.

  6. Building Team Spirit in Organization Management Through a ...

    African Journals Online (AJOL)

    Building Team Spirit in Organization Management Through a System Approach. ... able to function and attain a dynamic equilibrium for desired level of maximum productivity. It thus helps the manager to pull the various components of the organization together with the awareness, desire and commitment for a common goal.

  7. Low pull-in voltage electrostatic MEMS switch using liquid dielectric

    KAUST Repository

    Zidan, Mohammed A.

    2014-08-01

    In this paper, we present an electrostatic MEMS switch with liquids as dielectric to reduce the actuation voltage. The concept is verified by simulating a lateral dual gate switch, where the required pull-in voltage is reduced by more than 8 times after using water as a dielectric, to become as low as 5.36V. The proposed switch is simulated using COMSOL multiphysics using various liquid volumes to study their effect on the switching performance. Finally, we propose the usage of the lateral switch as a single switch XOR logic gate.

  8. Measurement of colour flow with the jet pull angle in $t\\bar{t}$ events using the ATLAS detector

    CERN Document Server

    Neep, Tom; The ATLAS collaboration

    2015-01-01

    The distribution and orientation of energy inside jets is predicted to provide information about colour connections between the quarks and gluons that initiate the jets. If this information can be exploited then it may be a useful additional technique for Standard Model measurements and searches for physics beyond the Standard Model. One variable predicted to contain information about the colour connections between a pair of jets is the jet pull angle. The ATLAS collaboration has measured the jet pull angle using $t\\bar{t}$ events, where a sample of dijets from the decay of a $W$ boson can be cleanly identified.

  9. Transformation from a Single Antenna to a Series Array Using Push/Pull Origami

    Directory of Open Access Journals (Sweden)

    Syed Imran Hussain Shah

    2017-08-01

    Full Text Available We propose a push/pull origami antenna, transformable between a single antenna element and a three-element array. In limited space, the proposed origami antenna can work as a single antenna. When the space is not limited and a higher gain is required, the proposed origami antenna can be transformed to a series antenna array by pulling the frame. In order to push the antenna array back to a single antenna, the frame for each antenna element size must be different. The frame and supporting dielectric materials are built using a three-dimensional (3D printer. The conductive patterns are inkjet-printed on paper. Thus, the proposed origami antenna is built using hybrid printing technology. The 10-dB impedance bandwidth is 2.5–2.65 GHz and 2.48–2.62 GHz for the single-antenna and array mode, respectively, and the peak gains in the single-antenna and array mode are 5.8 dBi and 7.6 dBi, respectively. The proposed antenna can be used for wireless remote-sensing applications.

  10. Transformation from a Single Antenna to a Series Array Using Push/Pull Origami.

    Science.gov (United States)

    Shah, Syed Imran Hussain; Lim, Sungjoon

    2017-08-26

    We propose a push/pull origami antenna, transformable between a single antenna element and a three-element array. In limited space, the proposed origami antenna can work as a single antenna. When the space is not limited and a higher gain is required, the proposed origami antenna can be transformed to a series antenna array by pulling the frame. In order to push the antenna array back to a single antenna, the frame for each antenna element size must be different. The frame and supporting dielectric materials are built using a three-dimensional (3D) printer. The conductive patterns are inkjet-printed on paper. Thus, the proposed origami antenna is built using hybrid printing technology. The 10-dB impedance bandwidth is 2.5-2.65 GHz and 2.48-2.62 GHz for the single-antenna and array mode, respectively, and the peak gains in the single-antenna and array mode are 5.8 dBi and 7.6 dBi, respectively. The proposed antenna can be used for wireless remote-sensing applications.

  11. Evaluation of sulfate reduction at experimentally induced mixing interfaces using small-scale push-pull tests in an aquifer-wetland system

    International Nuclear Information System (INIS)

    Kneeshaw, Tara A.; McGuire, Jennifer T.; Smith, Erik W.; Cozzarelli, Isabelle M.

    2007-01-01

    This paper presents small-scale push-pull tests designed to evaluate the kinetic controls on SO 4 2- reduction in situ at mixing interfaces between a wetland and aquifer impacted by landfill leachate at the Norman Landfill research site, Norman, OK. Quantifying the rates of redox reactions initiated at interfaces is of great interest because interfaces have been shown to be zones of increased biogeochemical transformations and thus may play an important role in natural attenuation. To mimic the aquifer-wetland interface and evaluate reaction rates, SO 4 2- -rich anaerobic aquifer water (∼100mg/LSO 4 2- ) was introduced into SO 4 2- -depleted wetland porewater via push-pull tests. Results showed SO 4 2- reduction was stimulated by the mixing of these waters and first-order rate coefficients were comparable to those measured in other push-pull studies. However, rate data were complex involving either multiple first-order rate coefficients or a more complex rate order. In addition, a lag phase was observed prior to SO 4 2- reduction that persisted until the mixing interface between test solution and native water was recovered, irrespective of temporal and spatial constraints. The lag phase was not eliminated by the addition of electron donor (acetate) to the injected test solution. Subsequent push-pull tests designed to elucidate the nature of the lag phase support the importance of the mixing interface in controlling terminal electron accepting processes. These data suggest redox reactions may occur rapidly at the mixing interface between injected and native waters but not in the injected bulk water mass. Under these circumstances, push-pull test data should be evaluated to ensure the apparent rate is actually a function of time and that complexities in rate data be considered

  12. Anterior cruciate ligament graft tensioning. Is the maximal sustained one-handed pull technique reproducible?

    Directory of Open Access Journals (Sweden)

    Hirpara Kieran M

    2011-07-01

    Full Text Available Abstract Background Tensioning of anterior cruciate ligament (ACL reconstruction grafts affects the clinical outcome of the procedure. As yet, no consensus has been reached regarding the optimum initial tension in an ACL graft. Most surgeons rely on the maximal sustained one-handed pull technique for graft tension. We aim to determine if this technique is reproducible from patient to patient. Findings We created a device to simulate ACL reconstruction surgery using Ilizarov components and porcine flexor tendons. Six experienced ACL reconstruction surgeons volunteered to tension porcine grafts using the device to see if they could produce a consistent tension. None of the surgeons involved were able to accurately reproduce graft tension over a series of repeat trials. Conclusions We conclude that the maximal sustained one-handed pull technique of ACL graft tensioning is not reproducible from trial to trial. We also conclude that the initial tension placed on an ACL graft varies from surgeon to surgeon.

  13. Anterior cruciate ligament graft tensioning. Is the maximal sustained one-handed pull technique reproducible?

    LENUS (Irish Health Repository)

    O'Neill, Barry J

    2011-07-20

    Abstract Background Tensioning of anterior cruciate ligament (ACL) reconstruction grafts affects the clinical outcome of the procedure. As yet, no consensus has been reached regarding the optimum initial tension in an ACL graft. Most surgeons rely on the maximal sustained one-handed pull technique for graft tension. We aim to determine if this technique is reproducible from patient to patient. Findings We created a device to simulate ACL reconstruction surgery using Ilizarov components and porcine flexor tendons. Six experienced ACL reconstruction surgeons volunteered to tension porcine grafts using the device to see if they could produce a consistent tension. None of the surgeons involved were able to accurately reproduce graft tension over a series of repeat trials. Conclusions We conclude that the maximal sustained one-handed pull technique of ACL graft tensioning is not reproducible from trial to trial. We also conclude that the initial tension placed on an ACL graft varies from surgeon to surgeon.

  14. Pull-out test of stud bolts embedded in concrete under an in-plane force

    International Nuclear Information System (INIS)

    Inada, Y.; Saito, H.; Torita, H.; Takiguchi, K.; Ibe, Y.; Taira, T.

    1995-01-01

    There are many steel plates with stud bolts embedded in the R C walls of a nuclear reactor building to support equipment and piping. Under a earthquake, the steel plates are submitted to an out-of-plane force due to the inertia force acting upon equipment and piping. Furthermore, the walls are submitted to an in-plane force, and cracks may occur. A large number of experimental studies have been carried out on the pull-out strength of stud bolts embedded in concrete. Few studies have been performed to understand the strength of stud bolts embedded in concrete under an in-plane force and, further, not any one on the strength for concrete under in-plane force simultaneously to stud bolts under out-of-plane force. This paper describes a test performed to understand the pull-out strength determined by this interaction of in-plane and out-of-plane forces. (author). 5 refs., 9 figs., 5 tabs

  15. Measurement of colour flow with the jet pull angle in tt¯ events using the ATLAS detector at s=8 TeV

    Directory of Open Access Journals (Sweden)

    G. Aad

    2015-11-01

    Full Text Available The distribution and orientation of energy inside jets is predicted to be an experimental handle on colour connections between the hard-scatter quarks and gluons initiating the jets. This Letter presents a measurement of the distribution of one such variable, the jet pull angle. The pull angle is measured for jets produced in tt¯ events with one W boson decaying leptonically and the other decaying to jets using 20.3 fb−1 of data recorded with the ATLAS detector at a centre-of-mass energy of s=8 TeV at the LHC. The jet pull angle distribution is corrected for detector resolution and acceptance effects and is compared to various models.

  16. Integration of market pull and technology push in the corporate front end and innovation management - Insights from the German software industry

    DEFF Research Database (Denmark)

    Brem, Alexander; Voigt, K.-I.

    2009-01-01

    Within the framework of this paper, an extensive literature overview of technology and innovation management aspects on market pull and technology push will be given. The existing classification of market pull and technology push will be particularly shown and called into question by suggesting...... a conceptual framework. Additionally, the most common front end innovation models will be introduced. Finally, the authors will introduce how a technology-based service company is managing the connection of these two alternatives. A special focus will be laid on the accordant methods in order to search...... will be introduced as to how market pull and technology push activities within the corporate technology and innovation management can be integrated. Hence, the purpose of the paper is to introduce a theory-based conceptual framework that can be used in today’s corporate environment. In this context, technology...

  17. Two cases of laparoscopic total colectomy with natural orifice specimen extraction and review of the literature.

    Science.gov (United States)

    Gundogan, Ersin; Aktas, Aydin; Kayaalp, Cuneyt; Gonultas, Fatih; Sumer, Fatih

    2017-09-01

    We present two cases of natural orifice specimen extraction (NOSE) after laparoscopic total colectomy and ileorectal anastomosis (TC-IRA), and we also review all of the previously reported cases. Our aim was to focus on patient selection for NOSE after TC-IRA. The PubMed and Google Scholar databases were scanned. Demographic features, surgical indications, and techniques were analyzed. Basic calculations were used for statistical analysis. A total of 13 cases were detected in addition to our 2 cases. All of the specimens were removed through the natural orifices successfully. No case required a diverting ileostomy. No patients were converted to open surgery or to conventional laparoscopy. Complications were reported in three patients. Transanal extractions were performed in 12 cases (10 colonic inertia, 2 polyposis), and transvaginal extractions were performed in 3 cases (2 malignancy, 1 colonic inertia). Both transanal and transvaginal specimen extractions after laparoscopic TC-IRA can be preferred. However, transanal extraction seems to be feasible in cases of TC for benign disease with a limited mesenteric-omental resection. If the indication is a malignancy requiring a mesenteric-omental resection, a transvaginal route should be preferred for a voluminous specimen.

  18. Modifications of micro-pulling-down method for the growth of selected Li-containing crystals for neutron scintillator and VUV scintillation crystals

    Science.gov (United States)

    Pejchal, J.; Fujimoto, Y.; Chani, V.; Yanagida, T.; Yokota, Y.; Yoshikawa, A.; Nikl, M.; Beitlerova, A.

    2012-12-01

    To develop new and efficient neutron scintillator, Ti-doped LiAlO2 single crystal was grown by micro-pulling-down method. The X-ray excited radioluminescence spectra and neutron light yield were measured. Positive effect of Mg codoping on the overall scintillation efficiency was found. The BaLu2F8 single crystal was grown by micro-pulling-down method using low temperature gradient at growth interface and applying quenching immediately after growth process.

  19. Criterion and Construct Validity of an Isometric Midthigh-Pull Dynamometer for Assessing Whole-Body Strength in Professional Rugby League Players.

    Science.gov (United States)

    Dobbin, Nick; Hunwicks, Richard; Jones, Ben; Till, Kevin; Highton, Jamie; Twist, Craig

    2018-02-01

    To examine the criterion and construct validity of an isometric midthigh-pull dynamometer to assess whole-body strength in professional rugby league players. Fifty-six male rugby league players (33 senior and 23 youth players) performed 4 isometric midthigh-pull efforts (ie, 2 on the dynamometer and 2 on the force platform) in a randomized and counterbalanced order. Isometric peak force was underestimated (P  .05) between the predicted and peak force from the force platform and an adjusted R 2 (79.6%) that represented shrinkage of 0.4% relative to the cross-validation model (80%). Peak force was greater for the senior than the youth professionals using the dynamometer (2261.2 ± 222 cf 1725.1 ± 298.0 N, respectively; P isometric midthigh pull assessed using a dynamometer underestimates criterion peak force but is capable of distinguishing muscle-function characteristics between professional rugby league players of different standards.

  20. Forced reptation revealed by chain pull-out simulations.

    Science.gov (United States)

    Bulacu, Monica; van der Giessen, Erik

    2009-08-14

    We report computation results obtained from extensive molecular dynamics simulations of tensile disentanglement of connector chains placed at the interface between two polymer bulks. Each polymer chain (either belonging to the bulks or being a connector) is treated as a sequence of beads interconnected by springs, using a coarse-grained representation based on the Kremer-Grest model, extended to account for stiffness along the chain backbone. Forced reptation of the connectors was observed during their disentanglement from the bulk chains. The extracted chains are clearly seen following an imaginary "tube" inside the bulks as they are pulled out. The entropic and energetic responses to the external deformation are investigated by monitoring the connector conformation tensor and the modifications of the internal parameters (bonds, bending, and torsion angles along the connectors). The work needed to separate the two bulks is computed from the tensile force induced during debonding in the connector chains. The value of the work reached at total separation is considered as the debonding energy G. The most important parameters controlling G are the length (n) of the chains placed at the interface and their areal density. Our in silico experiments are performed at relatively low areal density and are disregarded if chain scission occurs during disentanglement. As predicted by the reptation theory, for this pure pull-out regime, the power exponent from the scaling G proportional, variant n(a) is a approximately 2, irrespective of chain stiffness. Small variations are found when the connectors form different number of stitches at the interface, or when their length is randomly distributed in between the two bulks. Our results show that the effects of the number of stitches and of the randomness of the block lengths have to be considered together, especially when comparing with experiments where they cannot be controlled rigorously. These results may be significant for

  1. Frequency pulling in a low-voltage medium-power gyrotron

    Science.gov (United States)

    Luo, Li; Du, Chao-Hai; Huang, Ming-Guang; Liu, Pu-Kun

    2018-04-01

    Many recent biomedical applications use medium-power frequency-tunable terahertz (THz) sources, such as sensitivity-enhanced nuclear magnetic resonance, THz imaging, and biomedical treatment. As a promising candidate, a low-voltage gyrotron can generate watt-level, continuous THz-wave radiation. In particular, the frequency-pulling effect in a gyrotron, namely, the effect of the electron beam parameters on the oscillation frequency, can be used to tune the operating frequency. Most previous investigations used complicated and time-consuming gyrotron nonlinear theory to study the influence of many beam parameters on the interaction performance. While gyrotron linear theory investigation demonstrates the advantages of rapidly and clearly revealing the physical influence of individual key beam parameters on the overall system performance, this paper demonstrates systematically the use of gyrotron linear theory to study the frequency-pulling effect in a low-voltage gyrotron with either a Gaussian or a sinusoidal axial-field profile. Furthermore, simulations of a gyrotron operating in the first axial mode are carried out in the framework of nonlinear theory as a contrast. Close agreement is achieved between the two theories. Besides, some interesting results are obtained. In a low-current sinusoidal-profile cavity, the ranges of frequency variation for different axial modes are isolated from each other, and the frequency tuning bandwidth for each axial mode increases by increasing either the beam voltage or pitch factor. Lowering the voltage, the total tuning ranges are squeezed and become concentrated. However, the isolated frequency regions of each axial mode cannot be linked up unless the beam current is increased, meaning that higher current operation is the key to achieving a wider and continuous tuning frequency range. The results presented in this paper can provide a reference for designing a broadband low-voltage gyrotron.

  2. Energy Harvesting from Upper-Limb Pulling Motions for Miniaturized Human-Powered Generators.

    Science.gov (United States)

    Yeo, Jeongjin; Ryu, Mun-ho; Yang, Yoonseok

    2015-07-03

    The human-powered self-generator provides the best solution for individuals who need an instantaneous power supply for travel, outdoor, and emergency use, since it is less dependent on weather conditions and occupies less space than other renewable power supplies. However, many commercial portable self-generators that employ hand-cranking are not used as much as expected in daily lives although they have enough output capacity due to their intensive workload. This study proposes a portable human-powered generator which is designed to obtain mechanical energy from an upper limb pulling motion for improved human motion economy as well as efficient human-mechanical power transfer. A coreless axial-flux permanent magnet machine (APMM) and a flywheel magnet rotor were used in conjunction with a one-way clutched power transmission system in order to obtain effective power from the pulling motion. The developed prototype showed an average energy conversion efficiency of 30.98% and an average output power of 0.32 W with a maximum of 1.89 W. Its small form factor (50 mm × 32 mm × 43.5 mm, 0.05 kg) and the substantial electricity produced verify the effectiveness of the proposed method in the utilization of human power. It is expected that the developed generator could provide a mobile power supply.

  3. Influence of different adhesive systems on the pull-out bond strength of glass fiber posts.

    Science.gov (United States)

    da Silva, Luciana Mendonça; Andrade, Andréa Mello de; Machuca, Melissa Fernanda Garcia; da Silva, Paulo Maurício Batista; da Silva, Ricardo Virgolino C; Veronezi, Maria Cecília

    2008-01-01

    This in vitro study evaluated the tensile bond strength of glass fiber posts (Reforpost - Angelus-Brazil) cemented to root dentin with a resin cement (RelyX ARC - 3M/ESPE) associated with two different adhesive systems (Adper Single Bond - 3M/ESPE and Adper Scotchbond Multi Purpose (MP) Plus - 3M/ESPE), using the pull-out test. Twenty single-rooted human teeth with standardized root canals were randomly assigned to 2 groups (n=10): G1- etching with 37% phosphoric acid gel (3M/ESPE) + Adper Single Bond + #1 post (Reforpost - Angelus) + four #1 accessory posts (Reforpin - Angelus) + resin cement; G2- etching with 37% phosphoric acid gel + Adper Scotchbond MP Plus + #1 post + four #1 accessory posts + resin cement. The specimens were stored in distilled water at 37 degrees C for 7 days and submitted to the pull-out test in a universal testing machine (EMIC) at a crosshead speed of 0.5 mm/min. The mean values of bond strength (kgf) and standard deviation were: G1- 29.163 +/- 7.123; G2- 37.752 +/-13.054. Statistical analysis (Student's t-test; a=0.05 showed no statistically significant difference (pAdhesive bonding failures between resin cement and root canal dentin surface were observed in both groups, with non-polymerized resin cement in the apical portion of the post space when Single Bond was used (G1). The type of adhesive system employed on the fiber post cementation did not influence the pull-out bond strength.

  4. Influence of different adhesive systems on the pull-out bond strength of glass fiber posts

    Directory of Open Access Journals (Sweden)

    Luciana Mendonça da Silva

    2008-06-01

    Full Text Available This in vitro study evaluated the tensile bond strength of glass fiber posts (Reforpost - Angelus-Brazil cemented to root dentin with a resin cement (RelyX ARC - 3M/ESPE associated with two different adhesive systems (Adper Single Bond - 3M/ESPE and Adper Scotchbond Multi Purpose (MP Plus - 3M/ESPE, using the pull-out test. Twenty single-rooted human teeth with standardized root canals were randomly assigned to 2 groups (n=10: G1- etching with 37% phosphoric acid gel (3M/ESPE + Adper Single Bond + #1 post (Reforpost - Angelus + four #1 accessory posts (Reforpin - Angelus + resin cement; G2- etching with 37% phosphoric acid gel + Adper Scotchbond MP Plus + #1 post + four #1 accessory posts + resin cement. The specimens were stored in distilled water at 37°C for 7 days and submitted to the pull-out test in a universal testing machine (EMIC at a crosshead speed of 0.5 mm/min. The mean values of bond strength (kgf and standard deviation were: G1- 29.163 ± 7.123; G2- 37.752 ±13.054. Statistical analysis (Student's t-test; a=0.05 showed no statistically significant difference (p<0.05 between the groups. Adhesive bonding failures between resin cement and root canal dentin surface were observed in both groups, with non-polymerized resin cement in the apical portion of the post space when Single Bond was used (G1. The type of adhesive system employed on the fiber post cementation did not influence the pull-out bond strength.

  5. Analysis of CFRP Joints by Means of T-Pull Mechanical Test and Ultrasonic Defects Detection

    Directory of Open Access Journals (Sweden)

    Caterina Casavola

    2018-04-01

    Full Text Available Defects detection within a composite component, with the aim of understanding and predicting its mechanical behavior, is of great importance in the aeronautical field because the irregularities of the composite material could compromise functionality. The aim of this paper is to detect defects by means of non-destructive testing (NDT on T-pull samples made by carbon fiber reinforced polymers (CFRP and to evaluate their effect on the mechanical response of the material. Samples, obtained from an industrial stringer having an inclined web and realized with a polymeric filler between cap and web, were subjected to ultrasonic monitoring and then to T-pull mechanical tests. All samples were tested with the same load mode and the same test configuration. An experimental set-up consisting of a semiautomatic C-scan ultrasonic mapping system with a phased array probe was designed and developed, optimizing control parameters and implementing image processing software. The present work is carried out on real composites parts that are characterized by having their intrinsic defectiveness, as opposed to the previous similar results in the literature mainly obtained on composite parts with artificially produced defects. In fact, although samples under study were realized free from defects, ultrasonic mapping found defectiveness inside the material. Moreover, the ultrasonic inspection could be useful in detecting both the location and size of defects. Experimental data were critically analyzed and qualitatively correlated with results of T-pull mechanical tests in order to better understand and explain mechanical behavior in terms of fracture mode.

  6. Analysis of CFRP Joints by Means of T-Pull Mechanical Test and Ultrasonic Defects Detection.

    Science.gov (United States)

    Casavola, Caterina; Palano, Fania; De Cillis, Francesco; Tati, Angelo; Terzi, Roberto; Luprano, Vincenza

    2018-04-18

    Defects detection within a composite component, with the aim of understanding and predicting its mechanical behavior, is of great importance in the aeronautical field because the irregularities of the composite material could compromise functionality. The aim of this paper is to detect defects by means of non-destructive testing (NDT) on T-pull samples made by carbon fiber reinforced polymers (CFRP) and to evaluate their effect on the mechanical response of the material. Samples, obtained from an industrial stringer having an inclined web and realized with a polymeric filler between cap and web, were subjected to ultrasonic monitoring and then to T-pull mechanical tests. All samples were tested with the same load mode and the same test configuration. An experimental set-up consisting of a semiautomatic C-scan ultrasonic mapping system with a phased array probe was designed and developed, optimizing control parameters and implementing image processing software. The present work is carried out on real composites parts that are characterized by having their intrinsic defectiveness, as opposed to the previous similar results in the literature mainly obtained on composite parts with artificially produced defects. In fact, although samples under study were realized free from defects, ultrasonic mapping found defectiveness inside the material. Moreover, the ultrasonic inspection could be useful in detecting both the location and size of defects. Experimental data were critically analyzed and qualitatively correlated with results of T-pull mechanical tests in order to better understand and explain mechanical behavior in terms of fracture mode.

  7. Periodic pulling of the drift instability in a thermal plasma

    International Nuclear Information System (INIS)

    Abrams, R.H. Jr.

    1970-01-01

    The primary objective of this thesis is to show that a mode of oscillation in a plasma can be represented by a van der Pol oscillator. The results of an experiment performed on a drift wave in a Q-machine are interpreted in terms of a mechanism developed by Lashinsky. The mechanism, called periodic pulling, predicts a specific kind of spectrum for certain experimental conditions when a van der Pol oscillator is perturbed by a small signal. The observed spectrum, along with other observations, lends credence to the van der Pol oscillator model of a plasma mode

  8. Oscillations of the crystal-melt interface caused by harmonic oscillations of the pulling rate for the cylindrical phase of crystal growth

    Science.gov (United States)

    Vasil'ev, M. G.

    2017-02-01

    A technique for measuring the crystal cross-sectional area with a weight sensor based on the difference between its readings at the extreme rod positions in the stepwise and continuous modes of modulation of the pulling rate is proposed for the low-thermal gradient Czochralski method. A change in the crystallization rate at harmonic oscillations of the pulling rate is estimated with the aim of conserving the quality of the growing crystal for this measurement method.

  9. Abordaje “pull through” para tumores de suelo de boca que requieran RT adyuvante

    Directory of Open Access Journals (Sweden)

    Pablo Crespo Escudero

    2018-05-01

    zona, envío de márgenes, realización de 2 vaciementos funcionales bilaterales y cobertura con colgajo pectoral mayor.-        El paciente ha recibido RT postoperatoria sin efectos adversos salvo mucositis grado I. RESULTADOS: El abordaje pull through permite exponer todo el suelo de la boca, lengua y base de lengua y controlar márgenes quiúrgicos con facilidad.-        El paciente presenta una mejoría total estando asintomático actualmente.CONCLUSIONES:El abordaje pull through permite exponer con claridad lengua, y suelo de boca.Debe fijarse con puntos transfixiantes mandibulares para recomponer el suelo y darle estabilidad.Debe ser tenido en cuenta en pacientes con alto riesgo de osteoradionecrosis.

  10. Local excision of early rectal cancer: is transanal endoscopic microsurgery an alternative to radical surgery? Escisión local del cáncer de recto en estadio precoz: ¿representa la microcirugía transanal endoscópica una alternativa a la cirugía radical?

    Directory of Open Access Journals (Sweden)

    P. Palma

    2009-03-01

    Full Text Available Objective: transanal endoscopic microsurgery (TEM allows locally complete excision of rectal neoplasms and provides an alternative to conventional surgery for benign tumours. However, its role in the curative treatment of invasive carcinoma is controversial. This paper examines the results of TEM compared with radical surgery (RS for T1 rectal cancer. Methods: 51 patients with T1 rectal tumours treated by RS, or local excision by means of TEM were included. The following parameters were evaluated: operating time, blood loss, hospital stay and complications, as well as local recurrence rate and survival. Results: 17 patients were treated by RS and 34 by TEM. Operative time, blood loss, and duration of hospitalization were significantly lower in the TEM group compared with the RS group. In the RS group there were 4 patients with complications which required an operative revision (23.5%, compared to 1 reintervention (2.9% in the TEM group. Local recurrence was 5.88% (n = 2 in the TEM group compared with none after RS (p = 0.547. The overall survival and disease-free survival showed not significant statistical differences between both groups (p = 0.59; p = 1.000, resp.. Conclusions: although local recurrence was only observed after local excision, patients treated with TEM showed no significant differences in terms of overall survival and disease-free survival compared with patients who underwent RS. Inasmuch as local excision represents a minimally invasive technique in terms of morbidity, mortality and functional outcome, TEM should be offered as a valid option for well selected patients with early rectal cancer.Objetivo: la cirugía transanal endoscópica (TEM permite la resección completa de neoplasias de recto siendo una alternativa a la cirugía convencional para tumores benignos. Existe controversia sobre su papel en el tratamiento curativo del cáncer de recto. Esta publicación compara los resultados entre la resección radical (RS y la ex

  11. The Effects of Direction of Exertion, Path, and Load Placement in Nursing Cart Pushing and Pulling Tasks: An Electromyographical Study.

    Science.gov (United States)

    Kao, Huei Chu; Lin, Chiuhsiang Joe; Lee, Yung Hui; Chen, Su Huang

    2015-01-01

    The purpose of this study was to explore the effects of direction of exertion (DOE) (pushing, pulling), path (walking in a straight line, turning left, walking uphill), and load placement (LP) (the 18 blocks were indicated by X, Y and Z axis; there were 3 levels on the X axis, 2 levels on the Y axis, and 3 levels on the Z axis) on muscle activity and ratings of perceived exertion in nursing cart pushing and pulling tasks. Ten participants who were female students and not experienced nurses were recruited to participate in the experiment. Each participant performed 108 experimental trials in the study, consisting of 2 directions of exertion (push and pull), 3 paths, and 18 load placements (indicated by X, Y and Z axes). A 23kg load was placed into one load placement. The dependent variables were electromyographic (EMG) data of four muscles collected bilaterally as follows: Left (L) and right (R) trapezius (TR), flexor digitorum superficialis (FDS), extensor digitorum (ED), and erector spinae (ES) and subjective ratings of perceived exertion (RPE). Split-split-plot ANOVA was conducted to analyze significant differences between DOE, path, and LP in the EMG and RPE data. Pulling cart tasks produced a significantly higher activation of the muscles (RTR:54.4%, LTR:50.3%, LFDS:57.0%, LED:63.4%, RES:40.7%, LES:36.7%) than pushing cart tasks (RTR:42.4%, LTR:35.1%, LFDS:32.3%, LED:55.1%, RES:33.3%, LES:32.1%). A significantly greater perceived exertion was found in pulling cart tasks than pushing cart tasks. Significantly higher activation of all muscles and perceived exertion were observed for walking uphill than walking in a straight line and turning left. Significantly lower muscle activity of all muscles and subject ratings were observed for the central position on the X axis, the bottom position on the Y axis, and the posterior position on the Z axis. These findings suggest that nursing staff should adopt forward pushing when moving a nursing cart, instead of backward

  12. 25 CFR 542.8 - What are the minimum internal control standards for pull tabs?

    Science.gov (United States)

    2010-04-01

    ... 25 Indians 2 2010-04-01 2010-04-01 false What are the minimum internal control standards for pull... SERVICES MINIMUM INTERNAL CONTROL STANDARDS § 542.8 What are the minimum internal control standards for... and/or procedures that provide at least the level of control described by the standards in this...

  13. Modelling of Spring Constant and Pull-down Voltage of Non-uniform RF MEMS Cantilever Incorporating Stress Gradient

    Directory of Open Access Journals (Sweden)

    Shimul Chandra SAHA

    2008-11-01

    Full Text Available We have presented a model for spring constant and pull-down voltage of a non-uniform radio frequency microelectromechanical systems (RF MEMS cantilever that works on electrostatic actuation. The residual stress gradient in the beam material that may arise during the fabrication process is also considered in the model. Using basic force deflection calculation of the suspended beam, a stand-alone model for the spring constant and pull-down voltage of the non-uniform cantilever is developed. To compare the model, simulation is performed using standard Finite Element Method (FEM analysis tolls from CoventorWare. The model matches very well with the FEM simulation results. The model will offer an efficient means of design, analysis, and optimization of RF MEMS cantilever switches.

  14. A novel and simple method using a transanal intestinal long tube for protecting intestinal anastomosis and decompressing the small bowel

    Science.gov (United States)

    2017-01-01

    Purpose I introduce the use of transanal intestinal long tube (TILT) using nasogastric tube. TILT passes from anus to the anastomosis, helping to decompress a dilated bowel loop. Methods TILT procedure was limited to those patients predicting a severe luminal size discrepancy after intestinal anastomosis, and who had postoperative prolonged ileus. We retrospectively reviewed the medical records of 10 infants (7 male an 3 female patients) who were treated using the TILT procedure between 2012 and 2016. Results Median gestational age was 27+5 weeks and birth weight was 940 g. The first operation was done at a median of 4.5 days after birth due to necrotizing enterocolitis perforation (4 cases), isolated intestinal perforation (3 cases), meconium related ileus (1 case), congenital ileal volvulus (1 case), and ileal atresia (1 case). Nine cases of ileostomy closure were planned at a median of 130.5 days with a body weight of 3,060 g. For the ileal atresia case, TILT procedure without additional small bowel resection was performed to treat postoperative prolonged ileus. Nine out of ten were well functioned and defecation via anus was observed in a median of 4.5 days. Milk feeding began at a median of 6 days and the long intestinal tube was removed in a median of 14.5 days. Conclusion I suggested that TILT procedure could be a noninvasive operative option, predicting of size mismatched anastomosis causing prolonged ileus. Passive drainage of proximal intestinal contents might be helpful for decompress endoluminal pressure during the time of anastomosis healing with bowel movement recovery. PMID:28932729

  15. Clinical outcomes of stapled transanal rectal resection (STARR) for obstructed defecation syndrome (ODS): a single institution experience in South Korea.

    Science.gov (United States)

    Song, Kee Ho; Lee, Du Seok; Shin, Jong Keun; Lee, So Jin; Lee, Jae Bum; Yook, Eui Gon; Lee, Doo Han; Kim, Do Sun

    2011-06-01

    The purpose of this study was to assess both the short- and long-term functional outcomes of stapled transanal rectal resection (STARR) in ODS patients. We performed a retrospective review of data that were collected from January 2005 to October 2008. Between January 2005 to June 2006, 58 patients who underwent STARR were enrolled in this study. Follow-up was scheduled for 3 months and 1 year after surgery with the Cleveland Clinic Florida (CCF) constipation score and satisfaction grade. To evaluate the long-term functional outcome, we interviewed the patients by telephone using questionnaires for the CCF score and satisfaction grade on October 2008. The median follow-up period was 34 months (range, 27-46 months). The mean age and sex ratio were 54 years (range, 19-85 years) and 8:50 (M/F). The mean CCF constipation scores were 17.6 before the surgery, 9.5 at 3 months, 9.6 at 12 months, and 10.3 at the time of the latest interview. The satisfaction grade, which was rated as excellent and good by 63.4% of the patients at the time of the latest interview, was worse than that at 3 months (37.8%). Among the cases of the excellent group (19 cases) at postoperative 3 months, 13 cases (68.4%) were classified as excellent or good at the time of the latest interview. The STARR is a safe and effective surgical procedure for restoring the anatomy and function in ODS patients. Strict selection of patients is needed in enhancing and maintaining the patients' satisfaction after the procedure.

  16. Physical and biological determinants of collective behavioural dynamics in complex systems: pulling chain formation in the nest-weaving ant Oecophylla smaragdina.

    Directory of Open Access Journals (Sweden)

    Thomas Bochynek

    Full Text Available The evolution of nest weaving, the inclusion of larval silk in the nest walls, is considered one of the pinnacles of cooperative behaviour in social insects. Within the four ant genera in which this has evolved, Oecophylla are unique in being the only group that precedes the deposition of larval silk by actively manipulating the leaf substrate to form a nest chamber. Here we provide the first descriptions of the manipulation process within a complex-systems framework. Substrate manipulation involves individual ants selecting, grasping and attempting to pull the edge of the substrate. These individuals are then joined by nest mates at the work site, who either select a site beside the first individual or grasp the body of the first or preceding worker to form a chain of pulling ants that together drag and bend the substrate. Site selection by individual workers is not random when confronted with an artificial leaf, with individuals more likely to grasp a substrate at its tip rather than along a more broad edge. The activity of additional individuals is also not random, with their activity being grouped in both space and time. Additional individuals are more likely to join an existing biting individual or pulling group. The positive feedback associated with the early stages of pulling behaviour appears typical for many of the collective actions observed in social insects.

  17. Could local integration of health and social care finally overcome the pull to the centre?

    Science.gov (United States)

    Dixon, Anna

    2018-04-25

    There are several advantages of Bevan's design, such as progressive funding through taxation and equity of access regardless of income, that we must not lose sight of as we celebrate the NHS's (National Health Service) 70th birthday. However, there remain historical fault-lines dividing health and social care. The challenge is how to preserve equity if a more radical reform were implemented to fully integrate both the funding and delivery of health and social care. Funding from national taxation with defined entitlements could preserve both equity in funding and geographical equity. This does not solve the issue of the pull to the centre, which has been a feature of the NHS throughout its history, according to Klein. This will require a fundamental shift in the use of data. Data must be wrenched from the hands of the regulators and put back in the hands of those who generate them for the purposes of improvement.

  18. Measurement of colour flow with the jet pull angle in $t\\bar{t}$ events using the ATLAS detector at $\\sqrt{s}=8$ TeV

    CERN Document Server

    Aad, Georges; Abdallah, Jalal; Abdinov, Ovsat; Aben, Rosemarie; Abolins, Maris; AbouZeid, Ossama; Abramowicz, Halina; Abreu, Henso; Abreu, Ricardo; Abulaiti, Yiming; Acharya, Bobby Samir; Adamczyk, Leszek; Adams, David; Adelman, Jahred; Adomeit, Stefanie; Adye, Tim; Affolder, Tony; Agatonovic-Jovin, Tatjana; Agricola, Johannes; Aguilar-Saavedra, Juan Antonio; Ahlen, Steven; Ahmadov, Faig; Aielli, Giulio; Akerstedt, Henrik; Åkesson, Torsten Paul Ake; Akimov, Andrei; Alberghi, Gian Luigi; Albert, Justin; Albrand, Solveig; Alconada Verzini, Maria Josefina; Aleksa, Martin; Aleksandrov, Igor; Alexa, Calin; Alexander, Gideon; Alexopoulos, Theodoros; Alhroob, Muhammad; Alimonti, Gianluca; Alio, Lion; Alison, John; Alkire, Steven Patrick; Allbrooke, Benedict; Allport, Phillip; Aloisio, Alberto; Alonso, Alejandro; Alonso, Francisco; Alpigiani, Cristiano; Altheimer, Andrew David; Alvarez Gonzalez, Barbara; Άlvarez Piqueras, Damián; Alviggi, Mariagrazia; Amadio, Brian Thomas; Amako, Katsuya; Amaral Coutinho, Yara; Amelung, Christoph; Amidei, Dante; Amor Dos Santos, Susana Patricia; Amorim, Antonio; Amoroso, Simone; Amram, Nir; Amundsen, Glenn; Anastopoulos, Christos; Ancu, Lucian Stefan; Andari, Nansi; Andeen, Timothy; Anders, Christoph Falk; Anders, Gabriel; Anders, John Kenneth; Anderson, Kelby; Andreazza, Attilio; Andrei, George Victor; Angelidakis, Stylianos; Angelozzi, Ivan; Anger, Philipp; Angerami, Aaron; Anghinolfi, Francis; Anisenkov, Alexey; Anjos, Nuno; Annovi, Alberto; Antonelli, Mario; Antonov, Alexey; Antos, Jaroslav; Anulli, Fabio; Aoki, Masato; Aperio Bella, Ludovica; Arabidze, Giorgi; Arai, Yasuo; Araque, Juan Pedro; Arce, Ayana; Arduh, Francisco Anuar; Arguin, Jean-Francois; Argyropoulos, Spyridon; Arik, Metin; Armbruster, Aaron James; Arnaez, Olivier; Arnal, Vanessa; Arnold, Hannah; Arratia, Miguel; Arslan, Ozan; Artamonov, Andrei; Artoni, Giacomo; Asai, Shoji; Asbah, Nedaa; Ashkenazi, Adi; Åsman, Barbro; Asquith, Lily; Assamagan, Ketevi; Astalos, Robert; Atkinson, Markus; Atlay, Naim Bora; Auerbach, Benjamin; Augsten, Kamil; Aurousseau, Mathieu; Avolio, Giuseppe; Axen, Bradley; Ayoub, Mohamad Kassem; Azuelos, Georges; Baak, Max; Baas, Alessandra; Baca, Matthew John; Bacci, Cesare; Bachacou, Henri; Bachas, Konstantinos; Backes, Moritz; Backhaus, Malte; Bagiacchi, Paolo; Bagnaia, Paolo; Bai, Yu; Bain, Travis; Baines, John; Baker, Oliver Keith; Baldin, Evgenii; Balek, Petr; Balestri, Thomas; Balli, Fabrice; Banas, Elzbieta; Banerjee, Swagato; Bannoura, Arwa A E; Bansil, Hardeep Singh; Barak, Liron; Barberio, Elisabetta Luigia; Barberis, Dario; Barbero, Marlon; Barillari, Teresa; Barisonzi, Marcello; Barklow, Timothy; Barlow, Nick; Barnes, Sarah Louise; Barnett, Bruce; Barnett, Michael; Barnovska, Zuzana; Baroncelli, Antonio; Barone, Gaetano; Barr, Alan; Barreiro, Fernando; Barreiro Guimarães da Costa, João; Bartoldus, Rainer; Barton, Adam Edward; Bartos, Pavol; Basalaev, Artem; Bassalat, Ahmed; Basye, Austin; Bates, Richard; Batista, Santiago Juan; Batley, Richard; Battaglia, Marco; Bauce, Matteo; Bauer, Florian; Bawa, Harinder Singh; Beacham, James Baker; Beattie, Michael David; Beau, Tristan; Beauchemin, Pierre-Hugues; Beccherle, Roberto; Bechtle, Philip; Beck, Hans Peter; Becker, Anne Kathrin; Becker, Maurice; Becker, Sebastian; Beckingham, Matthew; Becot, Cyril; Beddall, Andrew; Beddall, Ayda; Bednyakov, Vadim; Bee, Christopher; Beemster, Lars; Beermann, Thomas; Begel, Michael; Behr, Janna Katharina; Belanger-Champagne, Camille; Bell, William; Bella, Gideon; Bellagamba, Lorenzo; Bellerive, Alain; Bellomo, Massimiliano; Belotskiy, Konstantin; Beltramello, Olga; Benary, Odette; Benchekroun, Driss; Bender, Michael; Bendtz, Katarina; Benekos, Nektarios; Benhammou, Yan; Benhar Noccioli, Eleonora; Benitez Garcia, Jorge-Armando; Benjamin, Douglas; Bensinger, James; Bentvelsen, Stan; Beresford, Lydia; Beretta, Matteo; Berge, David; Bergeaas Kuutmann, Elin; Berger, Nicolas; Berghaus, Frank; Beringer, Jürg; Bernard, Clare; Bernard, Nathan Rogers; Bernius, Catrin; Bernlochner, Florian Urs; Berry, Tracey; Berta, Peter; Bertella, Claudia; Bertoli, Gabriele; Bertolucci, Federico; Bertsche, Carolyn; Bertsche, David; Besana, Maria Ilaria; Besjes, Geert-Jan; Bessidskaia Bylund, Olga; Bessner, Martin Florian; Besson, Nathalie; Betancourt, Christopher; Bethke, Siegfried; Bevan, Adrian John; Bhimji, Wahid; Bianchi, Riccardo-Maria; Bianchini, Louis; Bianco, Michele; Biebel, Otmar; Biedermann, Dustin; Bieniek, Stephen Paul; Biglietti, Michela; Bilbao De Mendizabal, Javier; Bilokon, Halina; Bindi, Marcello; Binet, Sebastien; Bingul, Ahmet; Bini, Cesare; Biondi, Silvia; Black, Curtis; Black, James; Black, Kevin; Blackburn, Daniel; Blair, Robert; Blanchard, Jean-Baptiste; Blanco, Jacobo Ezequiel; Blazek, Tomas; Bloch, Ingo; Blocker, Craig; Blum, Walter; Blumenschein, Ulrike; Bobbink, Gerjan; Bobrovnikov, Victor; Bocchetta, Simona Serena; Bocci, Andrea; Bock, Christopher; Boehler, Michael; Bogaerts, Joannes Andreas; Bogavac, Danijela; Bogdanchikov, Alexander; Bohm, Christian; Boisvert, Veronique; Bold, Tomasz; Boldea, Venera; Boldyrev, Alexey; Bomben, Marco; Bona, Marcella; Boonekamp, Maarten; Borisov, Anatoly; Borissov, Guennadi; Borroni, Sara; Bortfeldt, Jonathan; Bortolotto, Valerio; Bos, Kors; Boscherini, Davide; Bosman, Martine; Boudreau, Joseph; Bouffard, Julian; Bouhova-Thacker, Evelina Vassileva; Boumediene, Djamel Eddine; Bourdarios, Claire; Bousson, Nicolas; Boveia, Antonio; Boyd, James; Boyko, Igor; Bozic, Ivan; Bracinik, Juraj; Brandt, Andrew; Brandt, Gerhard; Brandt, Oleg; Bratzler, Uwe; Brau, Benjamin; Brau, James; Braun, Helmut; Brazzale, Simone Federico; Breaden Madden, William Dmitri; Brendlinger, Kurt; Brennan, Amelia Jean; Brenner, Lydia; Brenner, Richard; Bressler, Shikma; Bristow, Kieran; Bristow, Timothy Michael; Britton, Dave; Britzger, Daniel; Brochu, Frederic; Brock, Ian; Brock, Raymond; Bronner, Johanna; Brooijmans, Gustaaf; Brooks, Timothy; Brooks, William; Brosamer, Jacquelyn; Brost, Elizabeth; Brown, Jonathan; Bruckman de Renstrom, Pawel; Bruncko, Dusan; Bruneliere, Renaud; Bruni, Alessia; Bruni, Graziano; Bruschi, Marco; Bruscino, Nello; Bryngemark, Lene; Buanes, Trygve; Buat, Quentin; Buchholz, Peter; Buckley, Andrew; Buda, Stelian Ioan; Budagov, Ioulian; Buehrer, Felix; Bugge, Lars; Bugge, Magnar Kopangen; Bulekov, Oleg; Bullock, Daniel; Burckhart, Helfried; Burdin, Sergey; Burghgrave, Blake; Burke, Stephen; Burmeister, Ingo; Busato, Emmanuel; Büscher, Daniel; Büscher, Volker; Bussey, Peter; Butler, John; Butt, Aatif Imtiaz; Buttar, Craig; Butterworth, Jonathan; Butti, Pierfrancesco; Buttinger, William; Buzatu, Adrian; Buzykaev, Aleksey; Cabrera Urbán, Susana; Caforio, Davide; Cairo, Valentina; Cakir, Orhan; Calace, Noemi; Calafiura, Paolo; Calandri, Alessandro; Calderini, Giovanni; Calfayan, Philippe; Caloba, Luiz; Calvet, David; Calvet, Samuel; Camacho Toro, Reina; Camarda, Stefano; Camarri, Paolo; Cameron, David; Caminal Armadans, Roger; Campana, Simone; Campanelli, Mario; Campoverde, Angel; Canale, Vincenzo; Canepa, Anadi; Cano Bret, Marc; Cantero, Josu; Cantrill, Robert; Cao, Tingting; Capeans Garrido, Maria Del Mar; Caprini, Irinel; Caprini, Mihai; Capua, Marcella; Caputo, Regina; Cardarelli, Roberto; Cardillo, Fabio; Carli, Tancredi; Carlino, Gianpaolo; Carminati, Leonardo; Caron, Sascha; Carquin, Edson; Carrillo-Montoya, German D; Carter, Janet; Carvalho, João; Casadei, Diego; Casado, Maria Pilar; Casolino, Mirkoantonio; Castaneda-Miranda, Elizabeth; Castelli, Angelantonio; Castillo Gimenez, Victoria; Castro, Nuno Filipe; Catastini, Pierluigi; Catinaccio, Andrea; Catmore, James; Cattai, Ariella; Caudron, Julien; Cavaliere, Viviana; Cavalli, Donatella; Cavalli-Sforza, Matteo; Cavasinni, Vincenzo; Ceradini, Filippo; Cerio, Benjamin; Cerny, Karel; Santiago Cerqueira, Augusto; Cerri, Alessandro; Cerrito, Lucio; Cerutti, Fabio; Cerv, Matevz; Cervelli, Alberto; Cetin, Serkant Ali; Chafaq, Aziz; Chakraborty, Dhiman; Chalupkova, Ina; Chang, Philip; Chapman, John Derek; Charlton, Dave; Chau, Chav Chhiv; Chavez Barajas, Carlos Alberto; Cheatham, Susan; Chegwidden, Andrew; Chekanov, Sergei; Chekulaev, Sergey; Chelkov, Gueorgui; Chelstowska, Magda Anna; Chen, Chunhui; Chen, Hucheng; Chen, Karen; Chen, Liming; Chen, Shenjian; Chen, Xin; Chen, Ye; Cheng, Hok Chuen; Cheng, Yangyang; Cheplakov, Alexander; Cheremushkina, Evgenia; Cherkaoui El Moursli, Rajaa; Chernyatin, Valeriy; Cheu, Elliott; Chevalier, Laurent; Chiarella, Vitaliano; Chiarelli, Giorgio; Childers, John Taylor; Chiodini, Gabriele; Chisholm, Andrew; Chislett, Rebecca Thalatta; Chitan, Adrian; Chizhov, Mihail; Choi, Kyungeon; Chouridou, Sofia; Chow, Bonnie Kar Bo; Christodoulou, Valentinos; Chromek-Burckhart, Doris; Chudoba, Jiri; Chuinard, Annabelle Julia; Chwastowski, Janusz; Chytka, Ladislav; Ciapetti, Guido; Ciftci, Abbas Kenan; Cinca, Diane; Cindro, Vladimir; Cioara, Irina Antonela; Ciocio, Alessandra; Citron, Zvi Hirsh; Ciubancan, Mihai; Clark, Allan G; Clark, Brian Lee; Clark, Philip James; Clarke, Robert; Cleland, Bill; Clement, Christophe; Coadou, Yann; Cobal, Marina; Coccaro, Andrea; Cochran, James H; Coffey, Laurel; Cogan, Joshua Godfrey; Colasurdo, Luca; Cole, Brian; Cole, Stephen; Colijn, Auke-Pieter; Collot, Johann; Colombo, Tommaso; Compostella, Gabriele; Conde Muiño, Patricia; Coniavitis, Elias; Connell, Simon Henry; Connelly, Ian; Consonni, Sofia Maria; Consorti, Valerio; Constantinescu, Serban; Conta, Claudio; Conti, Geraldine; Conventi, Francesco; Cooke, Mark; Cooper, Ben; Cooper-Sarkar, Amanda; Cornelissen, Thijs; Corradi, Massimo; Corriveau, Francois; Corso-Radu, Alina; Cortes-Gonzalez, Arely; Cortiana, Giorgio; Costa, Giuseppe; Costa, María José; Costanzo, Davide; Côté, David; Cottin, Giovanna; Cowan, Glen; Cox, Brian; Cranmer, Kyle; Cree, Graham; Crépé-Renaudin, Sabine; Crescioli, Francesco; Cribbs, Wayne Allen; Crispin Ortuzar, Mireia; Cristinziani, Markus; Croft, Vince; Crosetti, Giovanni; Cuhadar Donszelmann, Tulay; Cummings, Jane; Curatolo, Maria; Cuthbert, Cameron; Czirr, Hendrik; Czodrowski, Patrick; D'Auria, Saverio; D'Onofrio, Monica; Da Cunha Sargedas De Sousa, Mario Jose; Da Via, Cinzia; Dabrowski, Wladyslaw; Dafinca, Alexandru; Dai, Tiesheng; Dale, Orjan; Dallaire, Frederick; Dallapiccola, Carlo; Dam, Mogens; Dandoy, Jeffrey Rogers; Dang, Nguyen Phuong; Daniells, Andrew Christopher; Danninger, Matthias; Dano Hoffmann, Maria; Dao, Valerio; Darbo, Giovanni; Darmora, Smita; Dassoulas, James; Dattagupta, Aparajita; Davey, Will; David, Claire; Davidek, Tomas; Davies, Eleanor; Davies, Merlin; Davison, Peter; Davygora, Yuriy; Dawe, Edmund; Dawson, Ian; Daya-Ishmukhametova, Rozmin; De, Kaushik; de Asmundis, Riccardo; De Castro, Stefano; De Cecco, Sandro; De Groot, Nicolo; de Jong, Paul; De la Torre, Hector; De Lorenzi, Francesco; De Nooij, Lucie; De Pedis, Daniele; De Salvo, Alessandro; De Sanctis, Umberto; De Santo, Antonella; De Vivie De Regie, Jean-Baptiste; Dearnaley, William James; Debbe, Ramiro; Debenedetti, Chiara; Dedovich, Dmitri; Deigaard, Ingrid; Del Peso, Jose; Del Prete, Tarcisio; Delgove, David; Deliot, Frederic; Delitzsch, Chris Malena; Deliyergiyev, Maksym; Dell'Acqua, Andrea; Dell'Asta, Lidia; Dell'Orso, Mauro; Della Pietra, Massimo; della Volpe, Domenico; Delmastro, Marco; Delsart, Pierre-Antoine; Deluca, Carolina; DeMarco, David; Demers, Sarah; Demichev, Mikhail; Demilly, Aurelien; Denisov, Sergey; Derendarz, Dominik; Derkaoui, Jamal Eddine; Derue, Frederic; Dervan, Paul; Desch, Klaus Kurt; Deterre, Cecile; Deviveiros, Pier-Olivier; Dewhurst, Alastair; Dhaliwal, Saminder; Di Ciaccio, Anna; Di Ciaccio, Lucia; Di Domenico, Antonio; Di Donato, Camilla; Di Girolamo, Alessandro; Di Girolamo, Beniamino; Di Mattia, Alessandro; Di Micco, Biagio; Di Nardo, Roberto; Di Simone, Andrea; Di Sipio, Riccardo; Di Valentino, David; Diaconu, Cristinel; Diamond, Miriam; Dias, Flavia; Diaz, Marco Aurelio; Diehl, Edward; Dietrich, Janet; Diglio, Sara; Dimitrievska, Aleksandra; Dingfelder, Jochen; Dita, Petre; Dita, Sanda; Dittus, Fridolin; Djama, Fares; Djobava, Tamar; Djuvsland, Julia Isabell; Barros do Vale, Maria Aline; Dobos, Daniel; Dobre, Monica; Doglioni, Caterina; Dohmae, Takeshi; Dolejsi, Jiri; Dolezal, Zdenek; Dolgoshein, Boris; Donadelli, Marisilvia; Donati, Simone; Dondero, Paolo; Donini, Julien; Dopke, Jens; Doria, Alessandra; Dova, Maria-Teresa; Doyle, Tony; Drechsler, Eric; Dris, Manolis; Dubreuil, Emmanuelle; Duchovni, Ehud; Duckeck, Guenter; Ducu, Otilia Anamaria; Duda, Dominik; Dudarev, Alexey; Duflot, Laurent; Duguid, Liam; Dührssen, Michael; Dunford, Monica; Duran Yildiz, Hatice; Düren, Michael; Durglishvili, Archil; Duschinger, Dirk; Dyndal, Mateusz; Eckardt, Christoph; Ecker, Katharina Maria; Edgar, Ryan Christopher; Edson, William; Edwards, Nicholas Charles; Ehrenfeld, Wolfgang; Eifert, Till; Eigen, Gerald; Einsweiler, Kevin; Ekelof, Tord; El Kacimi, Mohamed; Ellert, Mattias; Elles, Sabine; Ellinghaus, Frank; Elliot, Alison; Ellis, Nicolas; Elmsheuser, Johannes; Elsing, Markus; Emeliyanov, Dmitry; Enari, Yuji; Endner, Oliver Chris; Endo, Masaki; Erdmann, Johannes; Ereditato, Antonio; Ernis, Gunar; Ernst, Jesse; Ernst, Michael; Errede, Steven; Ertel, Eugen; Escalier, Marc; Esch, Hendrik; Escobar, Carlos; Esposito, Bellisario; Etienvre, Anne-Isabelle; Etzion, Erez; Evans, Hal; Ezhilov, Alexey; Fabbri, Laura; Facini, Gabriel; Fakhrutdinov, Rinat; Falciano, Speranza; Falla, Rebecca Jane; Faltova, Jana; Fang, Yaquan; Fanti, Marcello; Farbin, Amir; Farilla, Addolorata; Farooque, Trisha; Farrell, Steven; Farrington, Sinead; Farthouat, Philippe; Fassi, Farida; Fassnacht, Patrick; Fassouliotis, Dimitrios; Faucci Giannelli, Michele; Favareto, Andrea; Fayard, Louis; Federic, Pavol; Fedin, Oleg; Fedorko, Wojciech; Feigl, Simon; Feligioni, Lorenzo; Feng, Cunfeng; Feng, Eric; Feng, Haolu; Fenyuk, Alexander; Feremenga, Last; Fernandez Martinez, Patricia; Fernandez Perez, Sonia; Ferrando, James; Ferrari, Arnaud; Ferrari, Pamela; Ferrari, Roberto; Ferreira de Lima, Danilo Enoque; Ferrer, Antonio; Ferrere, Didier; Ferretti, Claudio; Ferretto Parodi, Andrea; Fiascaris, Maria; Fiedler, Frank; Filipčič, Andrej; Filipuzzi, Marco; Filthaut, Frank; Fincke-Keeler, Margret; Finelli, Kevin Daniel; Fiolhais, Miguel; Fiorini, Luca; Firan, Ana; Fischer, Adam; Fischer, Cora; Fischer, Julia; Fisher, Wade Cameron; Fitzgerald, Eric Andrew; Flaschel, Nils; Fleck, Ivor; Fleischmann, Philipp; Fleischmann, Sebastian; Fletcher, Gareth Thomas; Fletcher, Gregory; Fletcher, Rob Roy MacGregor; Flick, Tobias; Floderus, Anders; Flores Castillo, Luis; Flowerdew, Michael; Formica, Andrea; Forti, Alessandra; Fournier, Daniel; Fox, Harald; Fracchia, Silvia; Francavilla, Paolo; Franchini, Matteo; Francis, David; Franconi, Laura; Franklin, Melissa; Frate, Meghan; Fraternali, Marco; Freeborn, David; French, Sky; Friedrich, Felix; Froidevaux, Daniel; Frost, James; Fukunaga, Chikara; Fullana Torregrosa, Esteban; Fulsom, Bryan Gregory; Fusayasu, Takahiro; Fuster, Juan; Gabaldon, Carolina; Gabizon, Ofir; Gabrielli, Alessandro; Gabrielli, Andrea; Gach, Grzegorz; Gadatsch, Stefan; Gadomski, Szymon; Gagliardi, Guido; Gagnon, Pauline; Galea, Cristina; Galhardo, Bruno; Gallas, Elizabeth; Gallop, Bruce; Gallus, Petr; Galster, Gorm Aske Gram Krohn; Gan, KK; Gao, Jun; Gao, Yanyan; Gao, Yongsheng; Garay Walls, Francisca; Garberson, Ford; García, Carmen; García Navarro, José Enrique; Garcia-Sciveres, Maurice; Gardner, Robert; Garelli, Nicoletta; Garonne, Vincent; Gatti, Claudio; Gaudiello, Andrea; Gaudio, Gabriella; Gaur, Bakul; Gauthier, Lea; Gauzzi, Paolo; Gavrilenko, Igor; Gay, Colin; Gaycken, Goetz; Gazis, Evangelos; Ge, Peng; Gecse, Zoltan; Gee, Norman; Geerts, Daniël Alphonsus Adrianus; Geich-Gimbel, Christoph; Geisler, Manuel Patrice; Gemme, Claudia; Genest, Marie-Hélène; Gentile, Simonetta; George, Matthias; George, Simon; Gerbaudo, Davide; Gershon, Avi; Ghasemi, Sara; Ghazlane, Hamid; Giacobbe, Benedetto; Giagu, Stefano; Giangiobbe, Vincent; Giannetti, Paola; Gibbard, Bruce; Gibson, Stephen; Gilchriese, Murdock; Gillam, Thomas; Gillberg, Dag; Gilles, Geoffrey; Gingrich, Douglas; Giokaris, Nikos; Giordani, MarioPaolo; Giorgi, Filippo Maria; Giorgi, Francesco Michelangelo; Giraud, Pierre-Francois; Giromini, Paolo; Giugni, Danilo; Giuliani, Claudia; Giulini, Maddalena; Gjelsten, Børge Kile; Gkaitatzis, Stamatios; Gkialas, Ioannis; Gkougkousis, Evangelos Leonidas; Gladilin, Leonid; Glasman, Claudia; Glatzer, Julian; Glaysher, Paul; Glazov, Alexandre; Goblirsch-Kolb, Maximilian; Goddard, Jack Robert; Godlewski, Jan; Goldfarb, Steven; Golling, Tobias; Golubkov, Dmitry; Gomes, Agostinho; Gonçalo, Ricardo; Goncalves Pinto Firmino Da Costa, Joao; Gonella, Laura; González de la Hoz, Santiago; Gonzalez Parra, Garoe; Gonzalez-Sevilla, Sergio; Goossens, Luc; Gorbounov, Petr Andreevich; Gordon, Howard; Gorelov, Igor; Gorini, Benedetto; Gorini, Edoardo; Gorišek, Andrej; Gornicki, Edward; Goshaw, Alfred; Gössling, Claus; Gostkin, Mikhail Ivanovitch; Goujdami, Driss; Goussiou, Anna; Govender, Nicolin; Gozani, Eitan; Grabas, Herve Marie Xavier; Graber, Lars; Grabowska-Bold, Iwona; Grafström, Per; Grahn, Karl-Johan; Gramling, Johanna; Gramstad, Eirik; Grancagnolo, Sergio; Grassi, Valerio; Gratchev, Vadim; Gray, Heather; Graziani, Enrico; Greenwood, Zeno Dixon; Gregersen, Kristian; Gregor, Ingrid-Maria; Grenier, Philippe; Griffiths, Justin; Grillo, Alexander; Grimm, Kathryn; Grinstein, Sebastian; Gris, Philippe Luc Yves; Grivaz, Jean-Francois; Grohs, Johannes Philipp; Grohsjean, Alexander; Gross, Eilam; Grosse-Knetter, Joern; Grossi, Giulio Cornelio; Grout, Zara Jane; Guan, Liang; Guenther, Jaroslav; Guescini, Francesco; Guest, Daniel; Gueta, Orel; Guido, Elisa; Guillemin, Thibault; Guindon, Stefan; Gul, Umar; Gumpert, Christian; Guo, Jun; Guo, Yicheng; Gupta, Shaun; Gustavino, Giuliano; Gutierrez, Phillip; Gutierrez Ortiz, Nicolas Gilberto; Gutschow, Christian; Guyot, Claude; Gwenlan, Claire; Gwilliam, Carl; Haas, Andy; Haber, Carl; Hadavand, Haleh Khani; Haddad, Nacim; Haefner, Petra; Hageböck, Stephan; Hajduk, Zbigniew; Hakobyan, Hrachya; Haleem, Mahsana; Haley, Joseph; Hall, David; Halladjian, Garabed; Hallewell, Gregory David; Hamacher, Klaus; Hamal, Petr; Hamano, Kenji; Hamer, Matthias; Hamilton, Andrew; Hamity, Guillermo Nicolas; Hamnett, Phillip George; Han, Liang; Hanagaki, Kazunori; Hanawa, Keita; Hance, Michael; Hanke, Paul; Hanna, Remie; Hansen, Jørgen Beck; Hansen, Jorn Dines; Hansen, Maike Christina; Hansen, Peter Henrik; Hara, Kazuhiko; Hard, Andrew; Harenberg, Torsten; Hariri, Faten; Harkusha, Siarhei; Harrington, Robert; Harrison, Paul Fraser; Hartjes, Fred; Hasegawa, Makoto; Hasegawa, Satoshi; Hasegawa, Yoji; Hasib, A; Hassani, Samira; Haug, Sigve; Hauser, Reiner; Hauswald, Lorenz; Havranek, Miroslav; Hawkes, Christopher; Hawkings, Richard John; Hawkins, Anthony David; Hayashi, Takayasu; Hayden, Daniel; Hays, Chris; Hays, Jonathan Michael; Hayward, Helen; Haywood, Stephen; Head, Simon; Heck, Tobias; Hedberg, Vincent; Heelan, Louise; Heim, Sarah; Heim, Timon; Heinemann, Beate; Heinrich, Lukas; Hejbal, Jiri; Helary, Louis; Hellman, Sten; Hellmich, Dennis; Helsens, Clement; Henderson, James; Henderson, Robert; Heng, Yang; Hengler, Christopher; Henrichs, Anna; Henriques Correia, Ana Maria; Henrot-Versille, Sophie; Herbert, Geoffrey Henry; Hernández Jiménez, Yesenia; Herrberg-Schubert, Ruth; Herten, Gregor; Hertenberger, Ralf; Hervas, Luis; Hesketh, Gavin Grant; Hessey, Nigel; Hetherly, Jeffrey Wayne; Hickling, Robert; Higón-Rodriguez, Emilio; Hill, Ewan; Hill, John; Hiller, Karl Heinz; Hillier, Stephen; Hinchliffe, Ian; Hines, Elizabeth; Hinman, Rachel Reisner; Hirose, Minoru; Hirschbuehl, Dominic; Hobbs, John; Hod, Noam; Hodgkinson, Mark; Hodgson, Paul; Hoecker, Andreas; Hoeferkamp, Martin; Hoenig, Friedrich; Hohlfeld, Marc; Hohn, David; Holmes, Tova Ray; Homann, Michael; Hong, Tae Min; Hooft van Huysduynen, Loek; Hopkins, Walter; Horii, Yasuyuki; Horton, Arthur James; Hostachy, Jean-Yves; Hou, Suen; Hoummada, Abdeslam; Howard, Jacob; Howarth, James; Hrabovsky, Miroslav; Hristova, Ivana; Hrivnac, Julius; Hryn'ova, Tetiana; Hrynevich, Aliaksei; Hsu, Catherine; Hsu, Pai-hsien Jennifer; Hsu, Shih-Chieh; Hu, Diedi; Hu, Qipeng; Hu, Xueye; Huang, Yanping; Hubacek, Zdenek; Hubaut, Fabrice; Huegging, Fabian; Huffman, Todd Brian; Hughes, Emlyn; Hughes, Gareth; Huhtinen, Mika; Hülsing, Tobias Alexander; Huseynov, Nazim; Huston, Joey; Huth, John; Iacobucci, Giuseppe; Iakovidis, Georgios; Ibragimov, Iskander; Iconomidou-Fayard, Lydia; Ideal, Emma; Idrissi, Zineb; Iengo, Paolo; Igonkina, Olga; Iizawa, Tomoya; Ikegami, Yoichi; Ikematsu, Katsumasa; Ikeno, Masahiro; Ilchenko, Iurii; Iliadis, Dimitrios; Ilic, Nikolina; Ince, Tayfun; Introzzi, Gianluca; Ioannou, Pavlos; Iodice, Mauro; Iordanidou, Kalliopi; Ippolito, Valerio; Irles Quiles, Adrian; Isaksson, Charlie; Ishino, Masaya; Ishitsuka, Masaki; Ishmukhametov, Renat; Issever, Cigdem; Istin, Serhat; Iturbe Ponce, Julia Mariana; Iuppa, Roberto; Ivarsson, Jenny; Iwanski, Wieslaw; Iwasaki, Hiroyuki; Izen, Joseph; Izzo, Vincenzo; Jabbar, Samina; Jackson, Brett; Jackson, Matthew; Jackson, Paul; Jaekel, Martin; Jain, Vivek; Jakobs, Karl; Jakobsen, Sune; Jakoubek, Tomas; Jakubek, Jan; Jamin, David Olivier; Jana, Dilip; Jansen, Eric; Jansky, Roland; Janssen, Jens; Janus, Michel; Jarlskog, Göran; Javadov, Namig; Javůrek, Tomáš; Jeanty, Laura; Jejelava, Juansher; Jeng, Geng-yuan; Jennens, David; Jenni, Peter; Jentzsch, Jennifer; Jeske, Carl; Jézéquel, Stéphane; Ji, Haoshuang; Jia, Jiangyong; Jiang, Yi; Jiggins, Stephen; Jimenez Pena, Javier; Jin, Shan; Jinaru, Adam; Jinnouchi, Osamu; Joergensen, Morten Dam; Johansson, Per; Johns, Kenneth; Jon-And, Kerstin; Jones, Graham; Jones, Roger; Jones, Tim; Jongmanns, Jan; Jorge, Pedro; Joshi, Kiran Daniel; Jovicevic, Jelena; Ju, Xiangyang; Jung, Christian; Jussel, Patrick; Juste Rozas, Aurelio; Kaci, Mohammed; Kaczmarska, Anna; Kado, Marumi; Kagan, Harris; Kagan, Michael; Kahn, Sebastien Jonathan; Kajomovitz, Enrique; Kalderon, Charles William; Kama, Sami; Kamenshchikov, Andrey; Kanaya, Naoko; Kaneti, Steven; Kantserov, Vadim; Kanzaki, Junichi; Kaplan, Benjamin; Kaplan, Laser Seymour; Kapliy, Anton; Kar, Deepak; Karakostas, Konstantinos; Karamaoun, Andrew; Karastathis, Nikolaos; Kareem, Mohammad Jawad; Karentzos, Efstathios; Karnevskiy, Mikhail; Karpov, Sergey; Karpova, Zoya; Karthik, Krishnaiyengar; Kartvelishvili, Vakhtang; Karyukhin, Andrey; Kashif, Lashkar; Kass, Richard; Kastanas, Alex; Kataoka, Yousuke; Katre, Akshay; Katzy, Judith; Kawagoe, Kiyotomo; Kawamoto, Tatsuo; Kawamura, Gen; Kazama, Shingo; Kazanin, Vassili; Keeler, Richard; Kehoe, Robert; Keller, John; Kempster, Jacob Julian; Keoshkerian, Houry; Kepka, Oldrich; Kerševan, Borut Paul; Kersten, Susanne; Keyes, Robert; Khalil-zada, Farkhad; Khandanyan, Hovhannes; Khanov, Alexander; Kharlamov, Alexey; Khoo, Teng Jian; Khovanskiy, Valery; Khramov, Evgeniy; Khubua, Jemal; Kim, Hee Yeun; Kim, Hyeon Jin; Kim, Shinhong; Kim, Young-Kee; Kimura, Naoki; Kind, Oliver Maria; King, Barry; King, Matthew; King, Samuel Burton; Kirk, Julie; Kiryunin, Andrey; Kishimoto, Tomoe; Kisielewska, Danuta; Kiss, Florian; Kiuchi, Kenji; Kivernyk, Oleh; Kladiva, Eduard; Klein, Matthew Henry; Klein, Max; Klein, Uta; Kleinknecht, Konrad; Klimek, Pawel; Klimentov, Alexei; Klingenberg, Reiner; Klinger, Joel Alexander; Klioutchnikova, Tatiana; Kluge, Eike-Erik; Kluit, Peter; Kluth, Stefan; Knapik, Joanna; Kneringer, Emmerich; Knoops, Edith; Knue, Andrea; Kobayashi, Aine; Kobayashi, Dai; Kobayashi, Tomio; Kobel, Michael; Kocian, Martin; Kodys, Peter; Koffas, Thomas; Koffeman, Els; Kogan, Lucy Anne; Kohlmann, Simon; Kohout, Zdenek; Kohriki, Takashi; Koi, Tatsumi; Kolanoski, Hermann; Koletsou, Iro; Komar, Aston; Komori, Yuto; Kondo, Takahiko; Kondrashova, Nataliia; Köneke, Karsten; König, Adriaan; Kono, Takanori; Konoplich, Rostislav; Konstantinidis, Nikolaos; Kopeliansky, Revital; Koperny, Stefan; Köpke, Lutz; Kopp, Anna Katharina; Korcyl, Krzysztof; Kordas, Kostantinos; Korn, Andreas; Korol, Aleksandr; Korolkov, Ilya; Korolkova, Elena; Kortner, Oliver; Kortner, Sandra; Kosek, Tomas; Kostyukhin, Vadim; Kotov, Vladislav; Kotwal, Ashutosh; Kourkoumeli-Charalampidi, Athina; Kourkoumelis, Christine; Kouskoura, Vasiliki; Koutsman, Alex; Kowalewski, Robert Victor; Kowalski, Tadeusz; Kozanecki, Witold; Kozhin, Anatoly; Kramarenko, Viktor; Kramberger, Gregor; Krasnopevtsev, Dimitriy; Krasny, Mieczyslaw Witold; Krasznahorkay, Attila; Kraus, Jana; Kravchenko, Anton; Kreiss, Sven; Kretz, Moritz; Kretzschmar, Jan; Kreutzfeldt, Kristof; Krieger, Peter; Krizka, Karol; Kroeninger, Kevin; Kroha, Hubert; Kroll, Joe; Kroseberg, Juergen; Krstic, Jelena; Kruchonak, Uladzimir; Krüger, Hans; Krumnack, Nils; Kruse, Amanda; Kruse, Mark; Kruskal, Michael; Kubota, Takashi; Kucuk, Hilal; Kuday, Sinan; Kuehn, Susanne; Kugel, Andreas; Kuger, Fabian; Kuhl, Andrew; Kuhl, Thorsten; Kukhtin, Victor; Kulchitsky, Yuri; Kuleshov, Sergey; Kuna, Marine; Kunigo, Takuto; Kupco, Alexander; Kurashige, Hisaya; Kurochkin, Yurii; Kus, Vlastimil; Kuwertz, Emma Sian; Kuze, Masahiro; Kvita, Jiri; Kwan, Tony; Kyriazopoulos, Dimitrios; La Rosa, Alessandro; La Rosa Navarro, Jose Luis; La Rotonda, Laura; Lacasta, Carlos; Lacava, Francesco; Lacey, James; Lacker, Heiko; Lacour, Didier; Lacuesta, Vicente Ramón; Ladygin, Evgueni; Lafaye, Remi; Laforge, Bertrand; Lagouri, Theodota; Lai, Stanley; Lambourne, Luke; Lammers, Sabine; Lampen, Caleb; Lampl, Walter; Lançon, Eric; Landgraf, Ulrich; Landon, Murrough; Lang, Valerie Susanne; Lange, J örn Christian; Lankford, Andrew; Lanni, Francesco; Lantzsch, Kerstin; Lanza, Agostino; Laplace, Sandrine; Lapoire, Cecile; Laporte, Jean-Francois; Lari, Tommaso; Lasagni Manghi, Federico; Lassnig, Mario; Laurelli, Paolo; Lavrijsen, Wim; Law, Alexander; Laycock, Paul; Lazovich, Tomo; Le Dortz, Olivier; Le Guirriec, Emmanuel; Le Menedeu, Eve; LeBlanc, Matthew Edgar; LeCompte, Thomas; Ledroit-Guillon, Fabienne Agnes Marie; Lee, Claire Alexandra; Lee, Shih-Chang; Lee, Lawrence; Lefebvre, Guillaume; Lefebvre, Michel; Legger, Federica; Leggett, Charles; Lehan, Allan; Lehmann Miotto, Giovanna; Lei, Xiaowen; Leight, William Axel; Leisos, Antonios; Leister, Andrew Gerard; Leite, Marco Aurelio Lisboa; Leitner, Rupert; Lellouch, Daniel; Lemmer, Boris; Leney, Katharine; Lenz, Tatjana; Lenzi, Bruno; Leone, Robert; Leone, Sandra; Leonidopoulos, Christos; Leontsinis, Stefanos; Leroy, Claude; Lester, Christopher; Levchenko, Mikhail; Levêque, Jessica; Levin, Daniel; Levinson, Lorne; Levy, Mark; Lewis, Adrian; Leyko, Agnieszka; Leyton, Michael; Li, Bing; Li, Haifeng; Li, Ho Ling; Li, Lei; Li, Liang; Li, Shu; Li, Yichen; Liang, Zhijun; Liao, Hongbo; Liberti, Barbara; Liblong, Aaron; Lichard, Peter; Lie, Ki; Liebal, Jessica; Liebig, Wolfgang; Limbach, Christian; Limosani, Antonio; Lin, Simon; Lin, Tai-Hua; Linde, Frank; Lindquist, Brian Edward; Linnemann, James; Lipeles, Elliot; Lipniacka, Anna; Lisovyi, Mykhailo; Liss, Tony; Lissauer, David; Lister, Alison; Litke, Alan; Liu, Bo; Liu, Dong; Liu, Hao; Liu, Jian; Liu, Jianbei; Liu, Kun; Liu, Lulu; Liu, Miaoyuan; Liu, Minghui; Liu, Yanwen; Livan, Michele; Lleres, Annick; Llorente Merino, Javier; Lloyd, Stephen; Lo Sterzo, Francesco; Lobodzinska, Ewelina; Loch, Peter; Lockman, William; Loebinger, Fred; Loevschall-Jensen, Ask Emil; Loginov, Andrey; Lohse, Thomas; Lohwasser, Kristin; Lokajicek, Milos; Long, Brian Alexander; Long, Jonathan David; Long, Robin Eamonn; Looper, Kristina Anne; Lopes, Lourenco; Lopez Mateos, David; Lopez Paredes, Brais; Lopez Paz, Ivan; Lorenz, Jeanette; Lorenzo Martinez, Narei; Losada, Marta; Loscutoff, Peter; Lösel, Philipp Jonathan; Lou, XinChou; Lounis, Abdenour; Love, Jeremy; Love, Peter; Lu, Nan; Lubatti, Henry; Luci, Claudio; Lucotte, Arnaud; Luehring, Frederick; Lukas, Wolfgang; Luminari, Lamberto; Lundberg, Olof; Lund-Jensen, Bengt; Lynn, David; Lysak, Roman; Lytken, Else; Ma, Hong; Ma, Lian Liang; Maccarrone, Giovanni; Macchiolo, Anna; Macdonald, Calum Michael; Machado Miguens, Joana; Macina, Daniela; Madaffari, Daniele; Madar, Romain; Maddocks, Harvey Jonathan; Mader, Wolfgang; Madsen, Alexander; Maeland, Steffen; Maeno, Tadashi; Maevskiy, Artem; Magradze, Erekle; Mahboubi, Kambiz; Mahlstedt, Joern; Maiani, Camilla; Maidantchik, Carmen; Maier, Andreas Alexander; Maier, Thomas; Maio, Amélia; Majewski, Stephanie; Makida, Yasuhiro; Makovec, Nikola; Malaescu, Bogdan; Malecki, Pawel; Maleev, Victor; Malek, Fairouz; Mallik, Usha; Malon, David; Malone, Caitlin; Maltezos, Stavros; Malyshev, Vladimir; Malyukov, Sergei; Mamuzic, Judita; Mancini, Giada; Mandelli, Beatrice; Mandelli, Luciano; Mandić, Igor; Mandrysch, Rocco; Maneira, José; Manfredini, Alessandro; Manhaes de Andrade Filho, Luciano; Manjarres Ramos, Joany; Mann, Alexander; Manning, Peter; Manousakis-Katsikakis, Arkadios; Mansoulie, Bruno; Mantifel, Rodger; Mantoani, Matteo; Mapelli, Livio; March, Luis; Marchiori, Giovanni; Marcisovsky, Michal; Marino, Christopher; Marjanovic, Marija; Marley, Daniel; Marroquim, Fernando; Marsden, Stephen Philip; Marshall, Zach; Marti, Lukas Fritz; Marti-Garcia, Salvador; Martin, Brian Thomas; Martin, Tim; Martin, Victoria Jane; Martin dit Latour, Bertrand; Martinez, Mario; Martin-Haugh, Stewart; Martoiu, Victor Sorin; Martyniuk, Alex; Marx, Marilyn; Marzano, Francesco; Marzin, Antoine; Masetti, Lucia; Mashimo, Tetsuro; Mashinistov, Ruslan; Masik, Jiri; Maslennikov, Alexey; Massa, Ignazio; Massa, Lorenzo; Massol, Nicolas; Mastrandrea, Paolo; Mastroberardino, Anna; Masubuchi, Tatsuya; Mättig, Peter; Mattmann, Johannes; Maurer, Julien; Maxfield, Stephen; Maximov, Dmitriy; Mazini, Rachid; Mazza, Simone Michele; Mazzaferro, Luca; Mc Goldrick, Garrin; Mc Kee, Shawn Patrick; McCarn, Allison; McCarthy, Robert; McCarthy, Tom; McCubbin, Norman; McFarlane, Kenneth; Mcfayden, Josh; Mchedlidze, Gvantsa; McMahon, Steve; McPherson, Robert; Medinnis, Michael; Meehan, Samuel; Mehlhase, Sascha; Mehta, Andrew; Meier, Karlheinz; Meineck, Christian; Meirose, Bernhard; Mellado Garcia, Bruce Rafael; Meloni, Federico; Mengarelli, Alberto; Menke, Sven; Meoni, Evelin; Mercurio, Kevin Michael; Mergelmeyer, Sebastian; Mermod, Philippe; Merola, Leonardo; Meroni, Chiara; Merritt, Frank; Messina, Andrea; Metcalfe, Jessica; Mete, Alaettin Serhan; Meyer, Carsten; Meyer, Christopher; Meyer, Jean-Pierre; Meyer, Jochen; Middleton, Robin; Miglioranzi, Silvia; Mijović, Liza; Mikenberg, Giora; Mikestikova, Marcela; Mikuž, Marko; Milesi, Marco; Milic, Adriana; Miller, David; Mills, Corrinne; Milov, Alexander; Milstead, David; Minaenko, Andrey; Minami, Yuto; Minashvili, Irakli; Mincer, Allen; Mindur, Bartosz; Mineev, Mikhail; Ming, Yao; Mir, Lluisa-Maria; Mitani, Takashi; Mitrevski, Jovan; Mitsou, Vasiliki A; Miucci, Antonio; Miyagawa, Paul; Mjörnmark, Jan-Ulf; Moa, Torbjoern; Mochizuki, Kazuya; Mohapatra, Soumya; Mohr, Wolfgang; Molander, Simon; Moles-Valls, Regina; Mönig, Klaus; Monini, Caterina; Monk, James; Monnier, Emmanuel; Montejo Berlingen, Javier; Monticelli, Fernando; Monzani, Simone; Moore, Roger; Morange, Nicolas; Moreno, Deywis; Moreno Llácer, María; Morettini, Paolo; Morgenstern, Marcus; Mori, Daniel; Morii, Masahiro; Morinaga, Masahiro; Morisbak, Vanja; Moritz, Sebastian; Morley, Anthony Keith; Mornacchi, Giuseppe; Morris, John; Mortensen, Simon Stark; Morton, Alexander; Morvaj, Ljiljana; Mosidze, Maia; Moss, Josh; Motohashi, Kazuki; Mount, Richard; Mountricha, Eleni; Mouraviev, Sergei; Moyse, Edward; Muanza, Steve; Mudd, Richard; Mueller, Felix; Mueller, James; Mueller, Ralph Soeren Peter; Mueller, Thibaut; Muenstermann, Daniel; Mullen, Paul; Mullier, Geoffrey; Murillo Quijada, Javier Alberto; Murray, Bill; Musheghyan, Haykuhi; Musto, Elisa; Myagkov, Alexey; Myska, Miroslav; Nachman, Benjamin Philip; Nackenhorst, Olaf; Nadal, Jordi; Nagai, Koichi; Nagai, Ryo; Nagai, Yoshikazu; Nagano, Kunihiro; Nagarkar, Advait; Nagasaka, Yasushi; Nagata, Kazuki; Nagel, Martin; Nagy, Elemer; Nairz, Armin Michael; Nakahama, Yu; Nakamura, Koji; Nakamura, Tomoaki; Nakano, Itsuo; Namasivayam, Harisankar; Naranjo Garcia, Roger Felipe; Narayan, Rohin; Naumann, Thomas; Navarro, Gabriela; Nayyar, Ruchika; Neal, Homer; Nechaeva, Polina; Neep, Thomas James; Nef, Pascal Daniel; Negri, Andrea; Negrini, Matteo; Nektarijevic, Snezana; Nellist, Clara; Nelson, Andrew; Nemecek, Stanislav; Nemethy, Peter; Nepomuceno, Andre Asevedo; Nessi, Marzio; Neubauer, Mark; Neumann, Manuel; Neves, Ricardo; Nevski, Pavel; Newman, Paul; Nguyen, Duong Hai; Nickerson, Richard; Nicolaidou, Rosy; Nicquevert, Bertrand; Nielsen, Jason; Nikiforou, Nikiforos; Nikiforov, Andriy; Nikolaenko, Vladimir; Nikolic-Audit, Irena; Nikolopoulos, Konstantinos; Nilsen, Jon Kerr; Nilsson, Paul; Ninomiya, Yoichi; Nisati, Aleandro; Nisius, Richard; Nobe, Takuya; Nomachi, Masaharu; Nomidis, Ioannis; Nooney, Tamsin; Norberg, Scarlet; Nordberg, Markus; Novgorodova, Olga; Nowak, Sebastian; Nozaki, Mitsuaki; Nozka, Libor; Ntekas, Konstantinos; Nunes Hanninger, Guilherme; Nunnemann, Thomas; Nurse, Emily; Nuti, Francesco; O'Brien, Brendan Joseph; O'grady, Fionnbarr; O'Neil, Dugan; O'Shea, Val; Oakham, Gerald; Oberlack, Horst; Obermann, Theresa; Ocariz, Jose; Ochi, Atsuhiko; Ochoa, Ines; Ochoa-Ricoux, Juan Pedro; Oda, Susumu; Odaka, Shigeru; Ogren, Harold; Oh, Alexander; Oh, Seog; Ohm, Christian; Ohman, Henrik; Oide, Hideyuki; Okamura, Wataru; Okawa, Hideki; Okumura, Yasuyuki; Okuyama, Toyonobu; Olariu, Albert; Olivares Pino, Sebastian Andres; Oliveira Damazio, Denis; Oliver Garcia, Elena; Olszewski, Andrzej; Olszowska, Jolanta; Onofre, António; Onyisi, Peter; Oram, Christopher; Oreglia, Mark; Oren, Yona; Orestano, Domizia; Orlando, Nicola; Oropeza Barrera, Cristina; Orr, Robert; Osculati, Bianca; Ospanov, Rustem; Otero y Garzon, Gustavo; Otono, Hidetoshi; Ouchrif, Mohamed; Ouellette, Eric; Ould-Saada, Farid; Ouraou, Ahmimed; Oussoren, Koen Pieter; Ouyang, Qun; Ovcharova, Ana; Owen, Mark; Owen, Rhys Edward; Ozcan, Veysi Erkcan; Ozturk, Nurcan; Pachal, Katherine; Pacheco Pages, Andres; Padilla Aranda, Cristobal; Pagáčová, Martina; Pagan Griso, Simone; Paganis, Efstathios; Paige, Frank; Pais, Preema; Pajchel, Katarina; Palacino, Gabriel; Palestini, Sandro; Palka, Marek; Pallin, Dominique; Palma, Alberto; Pan, Yibin; Panagiotopoulou, Evgenia; Pandini, Carlo Enrico; Panduro Vazquez, William; Pani, Priscilla; Panitkin, Sergey; Pantea, Dan; Paolozzi, Lorenzo; Papadopoulou, Theodora; Papageorgiou, Konstantinos; Paramonov, Alexander; Paredes Hernandez, Daniela; Parker, Michael Andrew; Parker, Kerry Ann; Parodi, Fabrizio; Parsons, John; Parzefall, Ulrich; Pasqualucci, Enrico; Passaggio, Stefano; Pastore, Fernanda; Pastore, Francesca; Pásztor, Gabriella; Pataraia, Sophio; Patel, Nikhul; Pater, Joleen; Pauly, Thilo; Pearce, James; Pearson, Benjamin; Pedersen, Lars Egholm; Pedersen, Maiken; Pedraza Lopez, Sebastian; Pedro, Rute; Peleganchuk, Sergey; Pelikan, Daniel; Penc, Ondrej; Peng, Cong; Peng, Haiping; Penning, Bjoern; Penwell, John; Perepelitsa, Dennis; Perez Codina, Estel; Pérez García-Estañ, María Teresa; Perini, Laura; Pernegger, Heinz; Perrella, Sabrina; Peschke, Richard; Peshekhonov, Vladimir; Peters, Krisztian; Peters, Yvonne; Petersen, Brian; Petersen, Troels; Petit, Elisabeth; Petridis, Andreas; Petridou, Chariclia; Petroff, Pierre; Petrolo, Emilio; Petrucci, Fabrizio; Pettersson, Nora Emilia; Pezoa, Raquel; Phillips, Peter William; Piacquadio, Giacinto; Pianori, Elisabetta; Picazio, Attilio; Piccaro, Elisa; Piccinini, Maurizio; Pickering, Mark Andrew; Piegaia, Ricardo; Pignotti, David; Pilcher, James; Pilkington, Andrew; Pina, João Antonio; Pinamonti, Michele; Pinfold, James; Pingel, Almut; Pinto, Belmiro; Pires, Sylvestre; Pirumov, Hayk; Pitt, Michael; Pizio, Caterina; Plazak, Lukas; Pleier, Marc-Andre; Pleskot, Vojtech; Plotnikova, Elena; Plucinski, Pawel; Pluth, Daniel; Poettgen, Ruth; Poggioli, Luc; Pohl, David-leon; Polesello, Giacomo; Poley, Anne-luise; Policicchio, Antonio; Polifka, Richard; Polini, Alessandro; Pollard, Christopher Samuel; Polychronakos, Venetios; Pommès, Kathy; Pontecorvo, Ludovico; Pope, Bernard; Popeneciu, Gabriel Alexandru; Popovic, Dragan; Poppleton, Alan; Pospisil, Stanislav; Potamianos, Karolos; Potrap, Igor; Potter, Christina; Potter, Christopher; Poulard, Gilbert; Poveda, Joaquin; Pozdnyakov, Valery; Pralavorio, Pascal; Pranko, Aliaksandr; Prasad, Srivas; Prell, Soeren; Price, Darren; Price, Lawrence; Primavera, Margherita; Prince, Sebastien; Proissl, Manuel; Prokofiev, Kirill; Prokoshin, Fedor; Protopapadaki, Eftychia-sofia; Protopopescu, Serban; Proudfoot, James; Przybycien, Mariusz; Ptacek, Elizabeth; Puddu, Daniele; Pueschel, Elisa; Puldon, David; Purohit, Milind; Puzo, Patrick; Qian, Jianming; Qin, Gang; Qin, Yang; Quadt, Arnulf; Quarrie, David; Quayle, William; Queitsch-Maitland, Michaela; Quilty, Donnchadha; Raddum, Silje; Radeka, Veljko; Radescu, Voica; Radhakrishnan, Sooraj Krishnan; Radloff, Peter; Rados, Pere; Ragusa, Francesco; Rahal, Ghita; Rajagopalan, Srinivasan; Rammensee, Michael; Rangel-Smith, Camila; Rauscher, Felix; Rave, Stefan; Ravenscroft, Thomas; Raymond, Michel; Read, Alexander Lincoln; Readioff, Nathan Peter; Rebuzzi, Daniela; Redelbach, Andreas; Redlinger, George; Reece, Ryan; Reeves, Kendall; Rehnisch, Laura; Reisin, Hernan; Relich, Matthew; Rembser, Christoph; Ren, Huan; Renaud, Adrien; Rescigno, Marco; Resconi, Silvia; Rezanova, Olga; Reznicek, Pavel; Rezvani, Reyhaneh; Richter, Robert; Richter, Stefan; Richter-Was, Elzbieta; Ricken, Oliver; Ridel, Melissa; Rieck, Patrick; Riegel, Christian Johann; Rieger, Julia; Rijssenbeek, Michael; Rimoldi, Adele; Rinaldi, Lorenzo; Ristić, Branislav; Ritsch, Elmar; Riu, Imma; Rizatdinova, Flera; Rizvi, Eram; Robertson, Steven; Robichaud-Veronneau, Andree; Robinson, Dave; Robinson, James; Robson, Aidan; Roda, Chiara; Roe, Shaun; Røhne, Ole; Rolli, Simona; Romaniouk, Anatoli; Romano, Marino; Romano Saez, Silvestre Marino; Romero Adam, Elena; Rompotis, Nikolaos; Ronzani, Manfredi; Roos, Lydia; Ros, Eduardo; Rosati, Stefano; Rosbach, Kilian; Rose, Peyton; Rosendahl, Peter Lundgaard; Rosenthal, Oliver; Rossetti, Valerio; Rossi, Elvira; Rossi, Leonardo Paolo; Rosten, Rachel; Rotaru, Marina; Roth, Itamar; Rothberg, Joseph; Rousseau, David; Royon, Christophe; Rozanov, Alexandre; Rozen, Yoram; Ruan, Xifeng; Rubbo, Francesco; Rubinskiy, Igor; Rud, Viacheslav; Rudolph, Christian; Rudolph, Matthew Scott; Rühr, Frederik; Ruiz-Martinez, Aranzazu; Rurikova, Zuzana; Rusakovich, Nikolai; Ruschke, Alexander; Russell, Heather; Rutherfoord, John; Ruthmann, Nils; Ryabov, Yury; Rybar, Martin; Rybkin, Grigori; Ryder, Nick; Saavedra, Aldo; Sabato, Gabriele; Sacerdoti, Sabrina; Saddique, Asif; Sadrozinski, Hartmut; Sadykov, Renat; Safai Tehrani, Francesco; Saimpert, Matthias; Saito, Tomoyuki; Sakamoto, Hiroshi; Sakurai, Yuki; Salamanna, Giuseppe; Salamon, Andrea; Saleem, Muhammad; Salek, David; Sales De Bruin, Pedro Henrique; Salihagic, Denis; Salnikov, Andrei; Salt, José; Salvatore, Daniela; Salvatore, Pasquale Fabrizio; Salvucci, Antonio; Salzburger, Andreas; Sampsonidis, Dimitrios; Sanchez, Arturo; Sánchez, Javier; Sanchez Martinez, Victoria; Sandaker, Heidi; Sandbach, Ruth Laura; Sander, Heinz Georg; Sanders, Michiel; Sandhoff, Marisa; Sandoval, Carlos; Sandstroem, Rikard; Sankey, Dave; Sannino, Mario; Sansoni, Andrea; Santoni, Claudio; Santonico, Rinaldo; Santos, Helena; Santoyo Castillo, Itzebelt; Sapp, Kevin; Sapronov, Andrey; Saraiva, João; Sarrazin, Bjorn; Sasaki, Osamu; Sasaki, Yuichi; Sato, Koji; Sauvage, Gilles; Sauvan, Emmanuel; Savage, Graham; Savard, Pierre; Sawyer, Craig; Sawyer, Lee; Saxon, James; Sbarra, Carla; Sbrizzi, Antonio; Scanlon, Tim; Scannicchio, Diana; Scarcella, Mark; Scarfone, Valerio; Schaarschmidt, Jana; Schacht, Peter; Schaefer, Douglas; Schaefer, Ralph; Schaeffer, Jan; Schaepe, Steffen; Schaetzel, Sebastian; Schäfer, Uli; Schaffer, Arthur; Schaile, Dorothee; Schamberger, R Dean; Scharf, Veit; Schegelsky, Valery; Scheirich, Daniel; Schernau, Michael; Schiavi, Carlo; Schillo, Christian; Schioppa, Marco; Schlenker, Stefan; Schmidt, Evelyn; Schmieden, Kristof; Schmitt, Christian; Schmitt, Sebastian; Schmitt, Stefan; Schneider, Basil; Schnellbach, Yan Jie; Schnoor, Ulrike; Schoeffel, Laurent; Schoening, Andre; Schoenrock, Bradley Daniel; Schopf, Elisabeth; Schorlemmer, Andre Lukas; Schott, Matthias; Schouten, Doug; Schovancova, Jaroslava; Schramm, Steven; Schreyer, Manuel; Schroeder, Christian; Schuh, Natascha; Schultens, Martin Johannes; Schultz-Coulon, Hans-Christian; Schulz, Holger; Schumacher, Markus; Schumm, Bruce; Schune, Philippe; Schwanenberger, Christian; Schwartz, Matthew; Schwartzman, Ariel; Schwarz, Thomas Andrew; Schwegler, Philipp; Schweiger, Hansdieter; Schwemling, Philippe; Schwienhorst, Reinhard; Schwindling, Jerome; Schwindt, Thomas; Sciacca, Gianfranco; Scifo, Estelle; Sciolla, Gabriella; Scuri, Fabrizio; Scutti, Federico; Searcy, Jacob; Sedov, George; Sedykh, Evgeny; Seema, Pienpen; Seidel, Sally; Seiden, Abraham; Seifert, Frank; Seixas, José; Sekhniaidze, Givi; Sekhon, Karishma; Sekula, Stephen; Seliverstov, Dmitry; Semprini-Cesari, Nicola; Serfon, Cedric; Serin, Laurent; Serkin, Leonid; Serre, Thomas; Sessa, Marco; Seuster, Rolf; Severini, Horst; Sfiligoj, Tina; Sforza, Federico; Sfyrla, Anna; Shabalina, Elizaveta; Shamim, Mansoora; Shan, Lianyou; Shang, Ruo-yu; Shank, James; Shapiro, Marjorie; Shatalov, Pavel; Shaw, Kate; Shaw, Savanna Marie; Shcherbakova, Anna; Shehu, Ciwake Yusufu; Sherwood, Peter; Shi, Liaoshan; Shimizu, Shima; Shimmin, Chase Owen; Shimojima, Makoto; Shiyakova, Mariya; Shmeleva, Alevtina; Shoaleh Saadi, Diane; Shochet, Mel; Shojaii, Seyedruhollah; Shrestha, Suyog; Shulga, Evgeny; Shupe, Michael; Shushkevich, Stanislav; Sicho, Petr; Sidebo, Per Edvin; Sidiropoulou, Ourania; Sidorov, Dmitri; Sidoti, Antonio; Siegert, Frank; Sijacki, Djordje; Silva, José; Silver, Yiftah; Silverstein, Samuel; Simak, Vladislav; Simard, Olivier; Simic, Ljiljana; Simion, Stefan; Simioni, Eduard; Simmons, Brinick; Simon, Dorian; Simoniello, Rosa; Sinervo, Pekka; Sinev, Nikolai; Sioli, Maximiliano; Siragusa, Giovanni; Sisakyan, Alexei; Sivoklokov, Serguei; Sjölin, Jörgen; Sjursen, Therese; Skinner, Malcolm Bruce; Skottowe, Hugh Philip; Skubic, Patrick; Slater, Mark; Slavicek, Tomas; Slawinska, Magdalena; Sliwa, Krzysztof; Smakhtin, Vladimir; Smart, Ben; Smestad, Lillian; Smirnov, Sergei; Smirnov, Yury; Smirnova, Lidia; Smirnova, Oxana; Smith, Matthew; Smith, Russell; Smizanska, Maria; Smolek, Karel; Snesarev, Andrei; Snidero, Giacomo; Snyder, Scott; Sobie, Randall; Socher, Felix; Soffer, Abner; Soh, Dart-yin; Solans, Carlos; Solar, Michael; Solc, Jaroslav; Soldatov, Evgeny; Soldevila, Urmila; Solodkov, Alexander; Soloshenko, Alexei; Solovyanov, Oleg; Solovyev, Victor; Sommer, Philip; Song, Hong Ye; Soni, Nitesh; Sood, Alexander; Sopczak, Andre; Sopko, Bruno; Sopko, Vit; Sorin, Veronica; Sosa, David; Sosebee, Mark; Sotiropoulou, Calliope Louisa; Soualah, Rachik; Soukharev, Andrey; South, David; Sowden, Benjamin; Spagnolo, Stefania; Spalla, Margherita; Spanò, Francesco; Spearman, William Robert; Sperlich, Dennis; Spettel, Fabian; Spighi, Roberto; Spigo, Giancarlo; Spiller, Laurence Anthony; Spousta, Martin; Spreitzer, Teresa; St Denis, Richard Dante; Staerz, Steffen; Stahlman, Jonathan; Stamen, Rainer; Stamm, Soren; Stanecka, Ewa; Stanescu, Cristian; Stanescu-Bellu, Madalina; Stanitzki, Marcel Michael; Stapnes, Steinar; Starchenko, Evgeny; Stark, Jan; Staroba, Pavel; Starovoitov, Pavel; Staszewski, Rafal; Stavina, Pavel; Steinberg, Peter; Stelzer, Bernd; Stelzer, Harald Joerg; Stelzer-Chilton, Oliver; Stenzel, Hasko; Stewart, Graeme; Stillings, Jan Andre; Stockton, Mark; Stoebe, Michael; Stoicea, Gabriel; Stolte, Philipp; Stonjek, Stefan; Stradling, Alden; Straessner, Arno; Stramaglia, Maria Elena; Strandberg, Jonas; Strandberg, Sara; Strandlie, Are; Strauss, Emanuel; Strauss, Michael; Strizenec, Pavol; Ströhmer, Raimund; Strom, David; Stroynowski, Ryszard; Strubig, Antonia; Stucci, Stefania Antonia; Stugu, Bjarne; Styles, Nicholas Adam; Su, Dong; Su, Jun; Subramaniam, Rajivalochan; Succurro, Antonella; Sugaya, Yorihito; Suhr, Chad; Suk, Michal; Sulin, Vladimir; Sultansoy, Saleh; Sumida, Toshi; Sun, Siyuan; Sun, Xiaohu; Sundermann, Jan Erik; Suruliz, Kerim; Susinno, Giancarlo; Sutton, Mark; Suzuki, Shota; Svatos, Michal; Swedish, Stephen; Swiatlowski, Maximilian; Sykora, Ivan; Sykora, Tomas; Ta, Duc; Taccini, Cecilia; Tackmann, Kerstin; Taenzer, Joe; Taffard, Anyes; Tafirout, Reda; Taiblum, Nimrod; Takai, Helio; Takashima, Ryuichi; Takeda, Hiroshi; Takeshita, Tohru; Takubo, Yosuke; Talby, Mossadek; Talyshev, Alexey; Tam, Jason; Tan, Kong Guan; Tanaka, Junichi; Tanaka, Reisaburo; Tanaka, Shuji; Tannenwald, Benjamin Bordy; Tannoury, Nancy; Tapprogge, Stefan; Tarem, Shlomit; Tarrade, Fabien; Tartarelli, Giuseppe Francesco; Tas, Petr; Tasevsky, Marek; Tashiro, Takuya; Tassi, Enrico; Tavares Delgado, Ademar; Tayalati, Yahya; Taylor, Frank; Taylor, Geoffrey; Taylor, Wendy; Teischinger, Florian Alfred; Teixeira Dias Castanheira, Matilde; Teixeira-Dias, Pedro; Temming, Kim Katrin; Ten Kate, Herman; Teng, Ping-Kun; Teoh, Jia Jian; Tepel, Fabian-Phillipp; Terada, Susumu; Terashi, Koji; Terron, Juan; Terzo, Stefano; Testa, Marianna; Teuscher, Richard; Theveneaux-Pelzer, Timothée; Thomas, Juergen; Thomas-Wilsker, Joshuha; Thompson, Emily; Thompson, Paul; Thompson, Ray; Thompson, Stan; Thomsen, Lotte Ansgaard; Thomson, Evelyn; Thomson, Mark; Thun, Rudolf; Tibbetts, Mark James; Ticse Torres, Royer Edson; Tikhomirov, Vladimir; Tikhonov, Yury; Timoshenko, Sergey; Tiouchichine, Elodie; Tipton, Paul; Tisserant, Sylvain; Todome, Kazuki; Todorov, Theodore; Todorova-Nova, Sharka; Tojo, Junji; Tokár, Stanislav; Tokushuku, Katsuo; Tollefson, Kirsten; Tolley, Emma; Tomlinson, Lee; Tomoto, Makoto; Tompkins, Lauren; Toms, Konstantin; Torrence, Eric; Torres, Heberth; Torró Pastor, Emma; Toth, Jozsef; Touchard, Francois; Tovey, Daniel; Trefzger, Thomas; Tremblet, Louis; Tricoli, Alessandro; Trigger, Isabel Marian; Trincaz-Duvoid, Sophie; Tripiana, Martin; Trischuk, William; Trocmé, Benjamin; Troncon, Clara; Trottier-McDonald, Michel; Trovatelli, Monica; True, Patrick; Truong, Loan; Trzebinski, Maciej; Trzupek, Adam; Tsarouchas, Charilaos; Tseng, Jeffrey; Tsiareshka, Pavel; Tsionou, Dimitra; Tsipolitis, Georgios; Tsirintanis, Nikolaos; Tsiskaridze, Shota; Tsiskaridze, Vakhtang; Tskhadadze, Edisher; Tsukerman, Ilya; Tsulaia, Vakhtang; Tsuno, Soshi; Tsybychev, Dmitri; Tudorache, Alexandra; Tudorache, Valentina; Tuna, Alexander Naip; Tupputi, Salvatore; Turchikhin, Semen; Turecek, Daniel; Turra, Ruggero; Turvey, Andrew John; Tuts, Michael; Tykhonov, Andrii; Tylmad, Maja; Tyndel, Mike; Ueda, Ikuo; Ueno, Ryuichi; Ughetto, Michael; Ugland, Maren; Uhlenbrock, Mathias; Ukegawa, Fumihiko; Unal, Guillaume; Undrus, Alexander; Unel, Gokhan; Ungaro, Francesca; Unno, Yoshinobu; Unverdorben, Christopher; Urban, Jozef; Urquijo, Phillip; Urrejola, Pedro; Usai, Giulio; Usanova, Anna; Vacavant, Laurent; Vacek, Vaclav; Vachon, Brigitte; Valderanis, Chrysostomos; Valencic, Nika; Valentinetti, Sara; Valero, Alberto; Valery, Loic; Valkar, Stefan; Valladolid Gallego, Eva; Vallecorsa, Sofia; Valls Ferrer, Juan Antonio; Van Den Wollenberg, Wouter; Van Der Deijl, Pieter; van der Geer, Rogier; van der Graaf, Harry; Van Der Leeuw, Robin; van Eldik, Niels; van Gemmeren, Peter; Van Nieuwkoop, Jacobus; van Vulpen, Ivo; van Woerden, Marius Cornelis; Vanadia, Marco; Vandelli, Wainer; Vanguri, Rami; Vaniachine, Alexandre; Vannucci, Francois; Vardanyan, Gagik; Vari, Riccardo; Varnes, Erich; Varol, Tulin; Varouchas, Dimitris; Vartapetian, Armen; Varvell, Kevin; Vazeille, Francois; Vazquez Schroeder, Tamara; Veatch, Jason; Veloce, Laurelle Maria; Veloso, Filipe; Velz, Thomas; Veneziano, Stefano; Ventura, Andrea; Ventura, Daniel; Venturi, Manuela; Venturi, Nicola; Venturini, Alessio; Vercesi, Valerio; Verducci, Monica; Verkerke, Wouter; Vermeulen, Jos; Vest, Anja; Vetterli, Michel; Viazlo, Oleksandr; Vichou, Irene; Vickey, Trevor; Vickey Boeriu, Oana Elena; Viehhauser, Georg; Viel, Simon; Vigne, Ralph; Villa, Mauro; Villaplana Perez, Miguel; Vilucchi, Elisabetta; Vincter, Manuella; Vinogradov, Vladimir; Vivarelli, Iacopo; Vives Vaque, Francesc; Vlachos, Sotirios; Vladoiu, Dan; Vlasak, Michal; Vogel, Marcelo; Vokac, Petr; Volpi, Guido; Volpi, Matteo; von der Schmitt, Hans; von Radziewski, Holger; von Toerne, Eckhard; Vorobel, Vit; Vorobev, Konstantin; Vos, Marcel; Voss, Rudiger; Vossebeld, Joost; Vranjes, Nenad; Vranjes Milosavljevic, Marija; Vrba, Vaclav; Vreeswijk, Marcel; Vuillermet, Raphael; Vukotic, Ilija; Vykydal, Zdenek; Wagner, Peter; Wagner, Wolfgang; Wahlberg, Hernan; Wahrmund, Sebastian; Wakabayashi, Jun; Walder, James; Walker, Rodney; Walkowiak, Wolfgang; Wang, Chao; Wang, Fuquan; Wang, Haichen; Wang, Hulin; Wang, Jike; Wang, Jin; Wang, Kuhan; Wang, Rui; Wang, Song-Ming; Wang, Tan; Wang, Xiaoxiao; Wanotayaroj, Chaowaroj; Warburton, Andreas; Ward, Patricia; Wardrope, David Robert; Warsinsky, Markus; Washbrook, Andrew; Wasicki, Christoph; Watkins, Peter; Watson, Alan; Watson, Ian; Watson, Miriam; Watts, Gordon; Watts, Stephen; Waugh, Ben; Webb, Samuel; Weber, Michele; Weber, Stefan Wolf; Webster, Jordan S; Weidberg, Anthony; Weinert, Benjamin; Weingarten, Jens; Weiser, Christian; Weits, Hartger; Wells, Phillippa; Wenaus, Torre; Wengler, Thorsten; Wenig, Siegfried; Wermes, Norbert; Werner, Matthias; Werner, Per; Wessels, Martin; Wetter, Jeffrey; Whalen, Kathleen; Wharton, Andrew Mark; White, Andrew; White, Martin; White, Ryan; White, Sebastian; Whiteson, Daniel; Wickens, Fred; Wiedenmann, Werner; Wielers, Monika; Wienemann, Peter; Wiglesworth, Craig; Wiik-Fuchs, Liv Antje Mari; Wildauer, Andreas; Wilkens, Henric George; Williams, Hugh; Williams, Sarah; Willis, Christopher; Willocq, Stephane; Wilson, Alan; Wilson, John; Wingerter-Seez, Isabelle; Winklmeier, Frank; Winter, Benedict Tobias; Wittgen, Matthias; Wittkowski, Josephine; Wollstadt, Simon Jakob; Wolter, Marcin Wladyslaw; Wolters, Helmut; Wosiek, Barbara; Wotschack, Jorg; Woudstra, Martin; Wozniak, Krzysztof; Wu, Mengqing; Wu, Miles; Wu, Sau Lan; Wu, Xin; Wu, Yusheng; Wyatt, Terry Richard; Wynne, Benjamin; Xella, Stefania; Xu, Da; Xu, Lailin; Yabsley, Bruce; Yacoob, Sahal; Yakabe, Ryota; Yamada, Miho; Yamaguchi, Yohei; Yamamoto, Akira; Yamamoto, Shimpei; Yamanaka, Takashi; Yamauchi, Katsuya; Yamazaki, Yuji; Yan, Zhen; Yang, Haijun; Yang, Hongtao; Yang, Yi; Yao, Weiming; Yasu, Yoshiji; Yatsenko, Elena; Yau Wong, Kaven Henry; Ye, Jingbo; Ye, Shuwei; Yeletskikh, Ivan; Yen, Andy L; Yildirim, Eda; Yorita, Kohei; Yoshida, Rikutaro; Yoshihara, Keisuke; Young, Charles; Young, Christopher John; Youssef, Saul; Yu, David Ren-Hwa; Yu, Jaehoon; Yu, Jiaming; Yu, Jie; Yuan, Li; Yuen, Stephanie P; Yurkewicz, Adam; Yusuff, Imran; Zabinski, Bartlomiej; Zaidan, Remi; Zaitsev, Alexander; Zalieckas, Justas; Zaman, Aungshuman; Zambito, Stefano; Zanello, Lucia; Zanzi, Daniele; Zeitnitz, Christian; Zeman, Martin; Zemla, Andrzej; Zengel, Keith; Zenin, Oleg; Ženiš, Tibor; Zerwas, Dirk; Zhang, Dongliang; Zhang, Fangzhou; Zhang, Huijun; Zhang, Jinlong; Zhang, Lei; Zhang, Ruiqi; Zhang, Xueyao; Zhang, Zhiqing; Zhao, Xiandong; Zhao, Yongke; Zhao, Zhengguo; Zhemchugov, Alexey; Zhong, Jiahang; Zhou, Bing; Zhou, Chen; Zhou, Lei; Zhou, Li; Zhou, Ning; Zhu, Cheng Guang; Zhu, Hongbo; Zhu, Junjie; Zhu, Yingchun; Zhuang, Xuai; Zhukov, Konstantin; Zibell, Andre; Zieminska, Daria; Zimine, Nikolai; Zimmermann, Christoph; Zimmermann, Stephanie; Zinonos, Zinonas; Zinser, Markus; Ziolkowski, Michael; Živković, Lidija; Zobernig, Georg; Zoccoli, Antonio; zur Nedden, Martin; Zurzolo, Giovanni; Zwalinski, Lukasz

    2015-09-24

    The distribution and orientation of energy inside jets is predicted to be an experimental handle on colour connections between the hard--scatter quarks and gluons initiating the jets.  This Letter presents a measurement of the distribution of one such variable, the jet pull angle. The pull angle is measured for jets produced in $t\\bar{t}$ events with one $W$ boson decaying leptonically and the other decaying to jets using 20.3 fb$^{-1}$ of data recorded with the ATLAS detector at a centre--of--mass energy of $\\sqrt{s}=8$ TeV at the LHC. The jet pull angle distribution is corrected for detector resolution and acceptance effects and is compared to various models.

  19. Analysis of Unbalanced Magnetic Pull in Wound Rotor Induction Machines using Finite Element Analysis – Transient, Motoring and Generating Modes

    DEFF Research Database (Denmark)

    Dorrell, David G.; Hermann, Alexander Niels August; Jensen, Bogi Bech

    2013-01-01

    eccentricity. The operating conditions are varied so that transient, motoring and doubly-fed induction generator modes are studied. This allows greater understanding of the radial forces involved. Wound rotor induction machines exhibit higher unbalanced magnetic pull than cage induction machines so......There has been much literature on unbalanced magnetic pull in various types of electrical machine. This can lead to bearing wear and additional vibrations in the machine. In this paper a wound rotor induction is studied. Finite element analysis studies are conducted when the rotor has 10 % rotor...

  20. Impact of hand forces and start/stop frequency on physiological responses to three forms of pushing and pulling: a South African perspective.

    Science.gov (United States)

    Ai, Todd

    2012-01-01

    There has been limited attention given to the physiological demands of pushing and pulling, especially in industrially developing countries such as South Africa. Two key factors affecting the physiological demands of these tasks are the hand forces exerted and the start/stop frequency. The purpose of the current study was therefore to investigate the physiological responses to pushing and pulling at various loads and start/stop frequencies. 36 male subjects participated in the study and were required to complete a total of 18 conditions (three techniques: pushing, two- and one-handed pulling; three loads: 200, 350 and 500 kg; and two frequencies: 2 and 4 stops per minute). During each condition the heart rate, oxygen uptake and energy expenditure were measured. Pushing was found to elicit significantly lower responses for all three dependent variables than either form of pulling. The start/stop frequency was also found to have a significant impact on subject responses. The findings of this study indicate that the technique adopted to maneuver loads is critical in determining the physical demands placed on the human operator. Furthermore increasing the frequency of start/stops plays an important role, thus the forces exerted during these two phases are important from a physiological perspective.