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Sample records for underwent closed reduction

  1. Utility of immediate postoperative hip MRI in developmental hip dysplasia: closed vs. open reduction.

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    Jadhav, Siddharth P; More, Snehal R; Shenava, Vinitha; Zhang, Wei; Kan, J Herman

    2018-04-25

    Magnetic resonance imaging (MRI) of the hips is being increasingly used to confirm hip reduction after surgery and spica cast placement for developmental dysplasia of the hip (DDH). To review a single institutional experience with post-spica MRI in children undergoing closed or open hip reduction and describe the utility of MRI in directing the need for re-intervention. Seventy-four patients (52 female, 22 male) who underwent post-spica hip MRI over a 6-year period were retrospectively reviewed. One hundred and seven hips were included. Data reviewed included age at intervention, gender, type of intervention performed, MRI findings, the need for re-intervention and the interval between interventions. Gender was compared between the closed and open reduction groups via the Fisher exact test. Age at the first procedure was compared via the Wilcoxon rank test. Rates of re-intervention after closed and open reduction were calculated and the reasons for re-intervention were reviewed. The mean age at the time of the first intervention was 16.4 months (range: 4 to 63 months). Mean age for the closed reduction group was 10.5 months (range: 4-24 months) and for the open reduction group was 23.7 months (range: 5-63 months), which was significant (P-value open reduction, MRI was useful in deciding re-intervention in only 1 (2%). This patient had prior multiple failed closed and open reductions at an outside institute. Post intervention hip spica MRI is useful in determining the need for re-intervention after closed hip reduction, but its role after open reduction is questionable.

  2. Risk factors for avascular necrosis after closed reduction for developmental dysplasia of the hip.

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    Schur, Mathew D; Lee, Christopher; Arkader, Alexandre; Catalano, Anthony; Choi, Paul D

    2016-06-01

    The purpose of this study was to identify and evaluate risk factors of avascular necrosis (AVN) after closed treatment for developmental dysplasia of the hip (DDH). A retrospective review of children diagnosed with DDH at a tertiary-care children's hospital between 1986 and 2009 was performed. The presence of AVN was assessed according to Salter's classification system. Eighty-two affected hips in 70 children with an average age of 10 months at closed reduction (range 1-31 months) and 5 years (range 2-19 years) of follow-up met the inclusion criteria. Twenty-nine (of 82, 35 %) affected hips developed AVN. The use of pre-reduction traction (p = 0.019) increased the risk of AVN, while preoperative Pavlik harness or brace trial (p = 0.28), presence of ossific nucleus at the time of closed reduction (p = 0.16), and adductor tenotomy (p = 0.37) were not significant factors. Laterality (right vs. left) was also not a significant risk factor (p = 0.75), but patients who underwent closed reduction for bilateral DDH were less likely to develop AVN (p = 0.027). Overall, the degree of abduction did not affect the rate of AVN (p = 0.87). However, in patients treated with closed reduction younger than 6 months of age, the rate of AVN was increased with abduction ≥50° (9/15, 60 %) compared to abduction AVN were more likely to require subsequent surgery (p = 0.034) and more likely to report a fair/poor clinical outcome (p = 0.049). The risk of AVN (35 %) following closed reduction and spica casting for DDH is high. The degree of abduction in spica casts appears to be a risk factor in patients ≤6 months old. The authors recommend that abduction in spica casts should be limited to <50° in children younger than 6 months of age. IV.

  3. Comparison of Early and Delayed Open Reduction and Internal Fixation for Treating Closed Tibial Pilon Fractures.

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    Tang, Xin; Liu, Lei; Tu, Chong-qi; Li, Jian; Li, Qi; Pei, Fu-xing

    2014-07-01

    The timing of surgery for osteosynthesis of type C pilon (AO/OTA) fractures remains controversial. The aim of this study was to determine the outcome of early and delayed open reduction and internal fixation (ORIF) for treating closed type C pilon fractures. Forty-six patients with closed type C pilon fractures matched according to age, gender, soft tissue conditions, and fracture pattern were divided into group A (early group: underwent surgery within 36 hours of the injury) or group B (delayed group: underwent surgery 10 days to 3 weeks postinjury after the soft tissue swelling subsided). In the delayed group, 9 patients were treated first by temporary external fixation. All the closed fractures were managed by ORIF with locking plates. At follow-up, the clinical and radiographic results were retrospectively analyzed. The mean follow-up time was 25.8 months (range, 14 to 48 months) in group A and 26.0 months (range, 15 to 44 months) in group B. There was no significant difference (P > .05) between the 2 groups regarding the rate of soft tissue complication, the rate of fracture union, and the final functional score. The patients in group A had a significantly shorter mean time to fracture union (21.5 ± 4.0 weeks vs 23.3 ± 3.7 weeks, P fractures can be safe and effective, with similar rates of wound complication, fracture union, and final good functional recovery but shorter operative time, union time, and hospital stay. These results favorably compare with delayed ORIF treatment. Level III, retrospective comparative study. © The Author(s) 2014.

  4. Current Concepts in the Mandibular Condyle Fracture Management Part II: Open Reduction Versus Closed Reduction

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    Yang, Jung-Dug; Chung, Ho-Yun; Cho, Byung-Chae

    2012-01-01

    In the treatment of mandibular condyle fracture, conservative treatment using closed reduction or surgical treatment using open reduction can be used. Management of mandibular condylar fractures remains a source of ongoing controversy in oral and maxillofacial trauma. For each type of condylar fracture,the treatment method must be chosen taking into consideration the presence of teeth, fracture height, patient'sadaptation, patient's masticatory system, disturbance of occlusal function, and deviation of the mandible. In the past, closed reduction with concomitant active physical therapy conducted after intermaxillary fixation during the recovery period had been mainly used, but in recent years, open treatment of condylar fractures with rigid internal fixation has become more common. The objective of this review was to evaluate the main variables that determine the choice of an open or closed method for treatment of condylar fractures, identifying their indications, advantages, and disadvantages, and to appraise the current evidence regarding the effectiveness of interventions that are used in the management of fractures of the mandibular condyle. PMID:22872831

  5. Current Concepts in the Mandibular Condyle Fracture Management Part II: Open Reduction Versus Closed Reduction

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    Kang-Young Choi

    2012-07-01

    Full Text Available In the treatment of mandibular condyle fracture, conservative treatment using closed reduction or surgical treatment using open reduction can be used. Management of mandibular condylar fractures remains a source of ongoing controversy in oral and maxillofacial trauma. For each type of condylar fracture,the treatment method must be chosen taking into consideration the presence of teeth, fracture height, patient'sadaptation, patient's masticatory system, disturbance of occlusal function, and deviation of the mandible. In the past, closed reduction with concomitant active physical therapy conducted after intermaxillary fixation during the recovery period had been mainly used, but in recent years, open treatment of condylar fractures with rigid internal fixation has become more common. The objective of this review was to evaluate the main variables that determine the choice of an open or closed method for treatment of condylar fractures, identifying their indications, advantages, and disadvantages, and to appraise the current evidence regarding the effectiveness of interventions that are used in the management of fractures of the mandibular condyle.

  6. Current Concepts in the Mandibular Condyle Fracture Management Part II: Open Reduction Versus Closed Reduction

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    Choi, Kang-Young; Yang, Jung-Dug; Chung, Ho-Yun; Cho, Byung-Chae

    2012-01-01

    In the treatment of mandibular condyle fracture, conservative treatment using closed reduction or surgical treatment using open reduction can be used. Management of mandibular condylar fractures remains a source of ongoing controversy in oral and maxillofacial trauma. For each type of condylar fracture,the treatment method must be chosen taking into consideration the presence of teeth, fracture height, patient'sadaptation, patient's masticatory system, disturbance of occlusal function, and de...

  7. Spica MRI after closed reduction for developmental dysplasia of the hip

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    Desai, Aditi A. [Vanderbilt University School of Medicine, Nashville, TN (United States); Martus, Jeffrey E.; Schoenecker, Jon [Vanderbilt University School of Medicine, Department of Orthopaedics and Rehabilitation, Monroe Carroll Jr. Children' s Hospital at Vanderbilt, Nashville, TN (United States); Kan, J.H. [Vanderbilt University School of Medicine, Department of Radiology and Radiological Sciences, Monroe Carroll Jr. Children' s Hospital at Vanderbilt, Nashville, TN (United States)

    2011-04-15

    Spica MRI is a fast and effective tool to assess morphology after closed reduction for developmental dysplasia of the hip (DDH) without the need for sedation. The multiplanar capabilities allow depiction of coronal and axial reduction of the hips. Due to MRI's inherent ability to delineate soft tissue structures, both intrinsic and extrinsic obstacles to failed reduction may be identified. Technical and interpretative challenges of spica MRI are discussed. (orig.)

  8. Association between open or closed reduction and avascular necrosis in developmental dysplasia of the hip

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    Wang, Ya-Jie; Yang, Fan; Wu, Qi-Jun; Pan, Shi-Nong; Li, Lian-Yong

    2016-01-01

    Abstract Background: The risk of avascular necrosis of the femoral head (AVN) after treatment of developmental dysplasia of the hip is associated with the method of reduction. Some authors have suggested that open reduction is a risk factor for AVN; however, this is controversial. To our knowledge, a quantitative comparison of the incidence of AVN between closed and open reduction has not been conducted. Methods: Published studies were identified by searching PubMed, EMBASE, and the Cochrane Library up to May, 2015, focusing on the incidence of AVN after closed or open reduction for developmental dysplasia of the hip in children aged <3 years. Patients were age-matched who were treated by either closed or open reduction, but without pelvic or femoral osteotomy. Two authors independently assessed eligibility and abstracted data. Discrepancies were discussed and resolved by consensus. We pooled the odds ratios (ORs) and 95% confidence intervals (95%CIs) from individual studies using a random-effects model and evaluated heterogeneity and publication bias. Results: Nine retrospective studies were included in this analysis. The pooled OR for comparing open reduction with closed reduction for all grades of AVN was 2.26 (95%CI = 1.21–4.22), with moderate heterogeneity (I2 = 44.7%, P = 0.107). The pooled OR for grades II to IV AVN was 2.46 (95%CI = 0.93–6.51), with high heterogeneity (I2 = 69.6%, P = 0.003). A significant association was also found for the further surgery between open and closed reduction, with a pooled OR of 0.30 (95%CI = 0.15–0.60) and moderate heterogeneity (I2 = 46.4%, P = 0.133). No evidence of publication bias or significant heterogeneity between subgroups was detected by meta-regression analyses. Conclusion: Findings from this meta-analysis suggest that open reduction is a risk factor for the development of AVN compared with closed treatment. Future studies are warranted to investigate how open reduction

  9. Beyond Waste Reduction: Creating Value with Information Systems in Closed-Loop Supply Chains

    NARCIS (Netherlands)

    O.R. Koppius (Otto); O. Ozdemir (Oznur); E.A. van der Laan (Erwin)

    2011-01-01

    textabstractWe study the role of information systems in enabling closed-loop supply chains. Past research in green IS and closed-loop supply chains has shown that it can result in substantial cost savings and waste reduction. We complement this research by showing that the effects are more than

  10. Applicability and Effectiveness of Closed Reduction of Nasal Fractures under Local Anesthesia

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    Vilela, Fernando

    2014-03-01

    Full Text Available Introduction A significant portion of patients treated in emergency departments have nasal fracture. It is important that the otolaryngologist know how to treat such damage. Objectives To evaluate the effectiveness of nasal fracture reduction under local anesthesia and tolerance to the procedure. Methods Twenty-four patients treated in the emergency department with closed reduction under local anesthesia were prospectively followed. Epidemiologic information and data regarding pain and complications during the management were noted. The degree of satisfaction was researched by visual analog scale. Results The majority of patients were male (75%, and the most common cause of injury was motor vehicle accident. We found a significant association between time to reduction and referred pain during the procedure. In patients in whom the procedure was delayed (over 3 days, there was less pain, and those who bled during the procedure had a shorter average time to reduction than the group of patients who did not bleed. Most patients were very satisfied, with more than 95% of these willing to undergo the same process again, if necessary. Conclusions The closed approach in the clinic under local anesthesia was effective and safe in restoration of the nose.

  11. Close reduction and per cutaneous pinning of supracondylar fractures of humerus in children

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    Iqbal, S.; Maqbool, N.

    2014-01-01

    The purpose of this study was to assess outcome and complications associated with closed reduction and internal fixation of supracondylar fractures type III of humerus in children. Study Design: Quasi - experimental. Place and Duration of Study: Department of Orthopedics, Fauji Foundation Hospital Rawalpindi and Railway General Hospital (RGH), Rawalpindi, from June 2011 to August 2012. Material and Method: The study group included 16 boys and 8 girls aged 4-12 years with supracondyle Type III fractures of humerus, having no neurovascular injury and no appreciable edema. Relevant history and clinical details were taken. All those cases having any neurovascular injury or moderate to severe edema at elbow and presenting late more than two weeks were excluded. These cases were treated with closed reduction and internal fixation. Follow up was done for 6 months to assess the level of cosmetic and function according to the system described by Flynn's et al as excellent, good, fair and poor. Results: Study was completed on 24 patients (16 males and 8 females). All fractures were united in acceptable alignment. At final assessment there were 16 excellent, 5 good, 3 fair. No one was poor. The fair clinical outcome was higher in children above 10 years of age. Conclusion: Closed reduction and internal fixation with cast stabilization can provide precise and good fracture reduction, maintains stabilization for fracture healing, results in good cosmetic outcome, cost effective and facilitates easy removal of implants after treatment. (author)

  12. Closed treatment of overriding distal radial fractures without reduction in children.

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    Crawford, Scott N; Lee, Lorrin S K; Izuka, Byron H

    2012-02-01

    Traditionally, distal radial fractures with marked displacement and angulation have been treated with closed or open reduction techniques. Reduction maneuvers generally require analgesia and sedation, which increase hospital time, cost, patient risk, and the surgeon's time. In our study, a treatment protocol for pediatric distal radial fractures was used in which the fracture was left shortened in an overriding position and a cast was applied without an attempt at anatomic fracture reduction. Consecutive patients three to ten years of age presenting between 2004 and 2009 with a closed overriding fracture of the distal radial metaphysis were followed prospectively. Our protocol consisted of no analgesia, no sedation, and a short arm fiberglass cast gently molded to correct only angulation. Patients were followed for at least one year. All parents or guardians were given a questionnaire assessing their satisfaction with the treatment. Financial analysis was performed with use of Current Procedural Terminology codes and the average total cost of care. Fifty-one children with an average age of 6.9 years were included in the study. Initial radial shortening averaged 5.0 mm. Initial sagittal and coronal angulation averaged 4.0° and 3.2°, respectively. The average duration of casting was forty-two days. Residual sagittal and coronal angulation at the time of final follow-up averaged 2.2° and 0.8°, respectively. All fifty-one patients achieved clinical and radiographic union with a full range of wrist motion. All parents and guardians answered the questionnaire and were satisfied with the treatment. Cost analysis demonstrated that closed reduction with the patient under conscious sedation or general anesthesia is nearly five to six times more expensive than the treatment used in this study. Adding percutaneous pin fixation increases costs nearly ninefold. This treatment protocol presents an alternative approach to overriding distal radial fractures in children and

  13. Oral-motor and electromyographic characterization of patients submitted to open a nd closed reductions of mandibular condyle fracture.

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    Silva, Amanda Pagliotto da; Sassi, Fernanda Chiarion; Andrade, Claudia Regina Furquim de

    To characterize the oral-motor system of adults with mandibular condyle facture comparing the performance of individuals submitted to open reduction with internal fixation (ORIF) and closed reduction with mandibulomaxillary fixation (CRMMF). Study participants were 26 adults divided into three groups: G1 - eight individuals submitted to ORIF for correction of condyle fracture; G2 - nine individuals submitted to CRMMF for correction of condyle fracture; CG - nine healthy volunteers with no alterations of the orofacial myofunctional system. All participants underwent the same clinical protocol: assessment of the orofacial myofunctional system; evaluation of the mandibular range of motion; and surface electromyography (sEMG) of the masticatory muscles. Results indicated that patients with condyle fractures from both groups presented significant differences compared with those from the control group in terms of mobility of the oral-motor organs, mastication, and deglutition. Regarding the measures obtained for mandibular movements, participants with facial fractures from both groups showed significant differences compared with those from the control group, indicating greater restrictions in mandibular motion. As for the analysis of sEMG results, G1 patients presented more symmetrical masseter activation during the task of maximal voluntary teeth clenching. Patients with mandibular condyle fractures present significant deficits in posture, mobility, and function of the oral-motor system. The type of medical treatment does not influence the results of muscle function during the first six months after fracture reduction. Individuals submitted to ORIF of the condyle fracture present more symmetrical activation of the masseter muscle.

  14. Ultrasound-Guided Femoral Nerve Block to Facilitate the Closed Reduction of a Dislocated Hip Prosthesis

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    Edward Carlin

    2017-10-01

    Full Text Available Prosthetic hip dislocation is a common but unfortunate complication in patients who have undergone total hip arthroplasty. Successful closed reduction in the emergency department leads to a reduced length of stay and rate of hospitalization. 1, 2 The use of regional anesthesia by femoral nerve block represents a novel approach for controlling pain in patients with hip pathologies. 3 Ultrasound-guided approaches have been used with great success for controlling pain in patients with hip fractures. 4, 5 Here we report the case of a 90-year-old male who presented with a dislocated hip prosthesis, which was subsequently corrected with closed reduction following delivery of regional anesthesia to the femoral nerve under ultrasound guidance. To our knowledge, this represents the first reported use of an ultrasound-guided femoral nerve block to facilitate closed reduction of a dislocated prosthetic hip, and highlights a novel approach that avoids the use of procedural sedation in an elderly patient.

  15. Comparison of Intravenous Morphine with Sublingual Buprenorphine in Management of Postoperative Pain after Closed Reduction Orthopedic Surgery

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    Ghasem Soltani; Mahmood Khorsand; ALireza Sepehri Shamloo; Lida Jarahi; Nahid Zirak

    2015-01-01

    Background: Postoperative pain is a common side effect following surgery that can significantly reduce surgical quality and patient’s satisfaction. Treatment options are morphine and buprenorphine. We aimed to compare the efficacy of a single dose of intravenous morphine with sublingual buprenorphine in postoperative pain control following closed reduction surgery. Methods: This triple blind clinical trial was conducted on 90 patients referred for closed reduction orthopedic surgery. They wer...

  16. An indigenous method for closed reduction of pediatric mandibular parasymphysis fracture.

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    Kumar, Naresh; Singh, Akhilesh Kumar; Pandey, Arun; Verma, Vishal

    2015-01-01

    Mandibular fractures in children are very rare as compared to adults due to protected anatomic features of child and less exposure to road traffic accidents. Management becomes complicated due to inherent dynamic nature, instability of mixed dentition and fear of surgery. Conservative management can be done with the help of acrylic cap splints along with circum-mandibular wiring, intermaxillary fixation with eyelet wires, arch wires or open reduction and internal fixation with bio-resorbable plates. Different methods have various pros and cons. The choice of anesthesia is also very crucial sometimes. This case report describes a new method of closed reduction with 18 gauge needle simulated as an arch bar performed under local anaesthesia.

  17. Closed reduction and fluoroscopic-assisted percutaneous pinning of 42 physeal fractures in 37 dogs and 4 cats.

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    Boekhout-Ta, Christina L; Kim, Stanley E; Cross, Alan R; Evans, Richard; Pozzi, Antonio

    2017-01-01

    To report complications and clinical outcome of dogs and cats that underwent fluoroscopic-assisted percutaneous pinning (FAPP) of physeal fractures. Retrospective study. Client-owned dogs (n = 37) and cats (n = 4). Records (August 2007-August 2014) of physeal fractures treated with FAPP in 3 hospitals were evaluated. Data collected included signalment, fracture characteristics (etiology, location, duration, Salter-Harris classification, preoperative and postoperative displacement), surgical information (implant size, surgical duration), and outcome assessment information (functional outcome, radiographic outcome, and complications). The majority of animals (92%) were classified as full functional outcome. No significant predictors of functional outcome were identified. The overall complication rate was 15% (n = 6). Elective pin removal rate was 41% (n = 17). Goniometry and limb circumference measurements of the affected and contralateral limbs were not significantly different in dogs for which measurements were obtained. Seventeen of 18 animals (16 dogs, 2 cats) measured had bone length changes on follow-up radiographs. FAPP is associated with an excellent functional outcome in a narrow selection of fracture configurations, specifically those with minimal displacement and for which anatomical alignment can be achieved with closed reduction. © 2016 The American College of Veterinary Surgeons.

  18. A PROSPECTIVE STUDY OF SUPRACONDYLAR FRACTURES OF THE HUMERUS IN CHILDREN TREATED BY CLOSED REDUCTION

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    Ch. Imobi

    2015-08-01

    Full Text Available There is no universal agreement regarding the management of displaced supracondylar fracture of the humerous in children. According to some orthopaedic surgeon almost all supracondylar humeral fractures should be treated operatively by reduction and pinning. While according to others closed reduction and pinning should be used for Gartland type II and some type III fractures. We present 50 cases of displaced supracondylar fracture treated by closed manipulative reduction under G.A. and immobilization with a posterior plaster of paris slab and collar and cuff. OBJECTIVE : T o assess the functional results of the injured elbow and to study the incidence of change in the carrying angle of the elbow. MATERIALS AND METHODS: This prospective study was conducted in 50 patients with extension type of displaced supracondylar fractures of humerus in children (Gartland type II and type III treated by closed manipulative reduction and immobilization in flexion of the elbow with a posterior plaster of paris slab and collar and cuff. Patients were followed up for 6 months. Flexion type of supracondylar fracture and those fractures which are absolutely indicated for operative intervention, Viz an open fracture and severe vascular compromise were excluded from the study. The range of movement and carrying angle was measured with the help of a Goniometer and Flynn criteria were used for functional assessment. RESULTS: At the end of follow up period, the end results were graded as excellent in 40%, good in 42%, fair in 12% and poor in 6%. A satisfactory result was therefore obtained in 94% and unsatisfactory result in 6% of the 50 patients who were followed and evaluated. CONCLUSION: This closed method of treatment for all practical proposes produces least complications, shorter hospital stay, can be expected to yield reproducible consistent satisfactory results not surpassed by any other method of treatment.

  19. Posterior pelvic ring fractures: Closed reduction and percutaneous CT-guided sacroiliac screw fixation

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    Jacob, Augustinus Ludwig; Messmer, Peter; Stock, Klaus-Wilhelm; Suhm, Norbert; Baumann, Bernard; Regazzoni, Pietro; Steinbrich, Wolfgang

    1997-01-01

    Purpose. To assess the midterm results of closed reduction and percutaneous fixation (CRPF) with computed tomography (CT)-guided sacroiliac screw fixation in longitudinal posterior pelvic ring fractures. Methods. Thirteen patients with 15 fractures were treated. Eleven patients received a unilateral, two a bilateral, screw fixation. Twenty-seven screws were implanted. Continuous on-table traction was used in six cases. Mean radiological follow-up was 13 months. Results. Twenty-five (93%) screws were placed correctly. There was no impingement of screws on neurovascular structures. Union occurred in 12 (80%), delayed union in 2 (13%), and nonunion in 1 of 15 (7%) fractures. There was one screw breakage and two axial dislocations. Conclusion. Sacroiliac CRPF of longitudinal fractures of the posterior pelvic ring is technically simple, minimally invasive, well localized, and stable. It should be done by an interventional/surgical team. CT is an excellent guiding modality. Closed reduction may be a problem and succeeds best when performed as early as possible

  20. Closed reduction of slipped capital femoral epiphysis: high-risk factor for avascular necrosis.

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    Kitano, Toshio; Nakagawa, Keisuke; Wada, Mayuko; Moriyama, Michiko

    2015-07-01

    How should we treat acute/unstable slipped capital femoral epiphysis (SCFE) without the development of avascular necrosis (AVN)? To answer this question, we investigated the risk factors of AVN development after SCFE. Seventy-six hips of 64 patients were classified using two kinds of classification systems, Loder's classification based on instability and the conventional classification based on the duration of symptom, because both classifications are related to AVN development. Of 21 unstable SCFEs, seven hips developed AVN. Of 35 hips defined as acute or acute on chronic, nine hips developed AVN. Two stable SCFEs of Loder's classification developed AVN, one was acute and the other was acute on chronic. No hips of chronic SCFE developed AVN. The factor that had influenced AVN development was only closed reduction, whether purposefully or inadvertently, in an acute or unstable SCFE. On the basis of the findings of this study, one should not embark on any modality of closed reduction for an unstable or acute form of SCFE, as there is a high risk for occurrence of AVN. For the same reason, a traction table should not be used for SCFE fixation, so as to avoid an inadvertent reduction or force that can lead to AVN.

  1. Evaluation of late redislocation in patients who underwent open reduction and pelvic osteotomy as treament for developmental dysplasia of the hip.

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    Tuhanioğlu, Ümit; Cicek, Hakan; Ogur, Hasan U; Seyfettinoglu, Firat; Kapukaya, Ahmet

    2017-10-16

    The goal in the treatment of developmental dysplasia of the hip (DDH) is to achieve a stable and concentric reduction and to create a congruent relationship between the femoral head and the acetabulum. This study discusses the causes of loss of reduction in DDH patients who had a concentrically reduced hip at the time of removal of the hip spica cast and cessation of brace use and who later appeared with hip redislocation after mobilisation and ambulation. In addition, the possible interventions in such cases are also discussed. A retrospective evaluation was made of 13 patients diagnosed with DDH who developed redislocation following primary surgery. 6 of them had undergone the 1st surgery in our department between 2008 and 2016 and 7 had udergone surgery in another centre. For comparison reasons a 2nd group was formed of 13 demographically and clinically matched patients who had no loss of reduction. The groups were compared in terms of acetabular index, pelvic length, pelvic width, abduction degree of plaster, ossifying nucleus diameter, acetabular depth, and acetabular volume parameters. The average age of the patients was 23 months at initial surgery and 29 months at the time of revision surgery. No significant difference was found between the groups in terms of acetabular inclination angle, ossifying nucleus diameter, pelvic size, pelvic width, centre edge angle, acetabular volume, and depth. Contracted inferomedial capsule was found in 1 patient who underwent revision surgery and intact transverse acetabular ligament was seen in 1 patient. The loss of reduction in the remaining 11 patients was associated with high total anteversion of the femoral head and acetabulum. Correction of increased combined anteversion by femoral osteotomy can create a safe zone in terms of redislocation and can significantly contribute to the stability provided by capsulorrhaphy and pelvic osteotomy.

  2. Developmental dysplasia of the hip: A computational biomechanical model of the path of least energy for closed reduction.

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    Zwawi, Mohammed A; Moslehy, Faissal A; Rose, Christopher; Huayamave, Victor; Kassab, Alain J; Divo, Eduardo; Jones, Brendan J; Price, Charles T

    2017-08-01

    This study utilized a computational biomechanical model and applied the least energy path principle to investigate two pathways for closed reduction of high grade infantile hip dislocation. The principle of least energy when applied to moving the femoral head from an initial to a final position considers all possible paths that connect them and identifies the path of least resistance. Clinical reports of severe hip dysplasia have concluded that reduction of the femoral head into the acetabulum may occur by a direct pathway over the posterior rim of the acetabulum when using the Pavlik harness, or by an indirect pathway with reduction through the acetabular notch when using the modified Hoffman-Daimler method. This computational study also compared the energy requirements for both pathways. The anatomical and muscular aspects of the model were derived using a combination of MRI and OpenSim data. Results of this study indicate that the path of least energy closely approximates the indirect pathway of the modified Hoffman-Daimler method. The direct pathway over the posterior rim of the acetabulum required more energy for reduction. This biomechanical analysis confirms the clinical observations of the two pathways for closed reduction of severe hip dysplasia. The path of least energy closely approximated the modified Hoffman-Daimler method. Further study of the modified Hoffman-Daimler method for reduction of severe hip dysplasia may be warranted based on this computational biomechanical analysis. © 2016 The Authors. Journal of Orthopaedic Research Published by Wiley Periodicals, Inc. on behalf of Orthopaedic Research Society. J Orthop Res 35:1799-1805, 2017. © 2016 The Authors. Journal of Orthopaedic Research Published by Wiley Periodicals, Inc. on behalf of Orthopaedic Research Society.

  3. Changes in neurotic personality profile associated with reduction of suicidal ideation in patients who underwent psychotherapy in the day hospital for the treatment of neurotic and behavioral disorders.

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    Rodziński, Paweł; Rutkowski, Krzysztof; Sobański, Jerzy A; Mielimąka, Michał; Murzyn, Agnieszka; Cyranka, Katarzyna; Dembińska, Edyta; Grządziel, Karolina; Klasa, Katarzyna; Müldner-Nieckowski, Łukasz; Smiatek-Mazgaj, Bogna

    2015-01-01

    Analysis of associations between changes in neurotic personality profile and reductionof suicidal ideation (SI) - or lack of such reduction - defined as its elimination or reduction of its intensity in patients who underwent a course of intensive psychotherapy conducted in integrative approach with predominance of psychodynamic approach. Symptom Checklist KO"O", Neurotic Personality Questionnaire KON-2006 and Life Inventory completed by 461 women and 219 men treated due to neurotic, behavioral or personality disorders in a day hospital between 2005-2013. During the qualification for the therapy 134 women and 80 men reported SI, of whom 84.3% and 77.5% respectively improved. Patients who improved in terms of SI obtained significantly greater reduction of global neurotic personality disintegration (neuroticism) than others (ppsychotherapy as a treatment method that leads to comprehensive improvement encompassing reduction of neurotic personality disorders (neuroticism) and of majority of neurotic personality traits, as well as SI reduction. The revealed associations weigh in favor of hypothesis on neuroticism as SI predisposing factor in patients with neurotic, behavioral and personality disorders.

  4. Closed reduction, internal fixation with quadratus femoris muscle pedicle bone grafting in displaced femoral neck fracture

    Directory of Open Access Journals (Sweden)

    Chaudhuri Sibaji

    2008-01-01

    Full Text Available Background: Management of femoral neck fracture is still considered as an unsolved problem. It is more evident in displaced fractures where this fracture is considered as some sort of vascular insult to the head of the femur. We have used closed reduction, internal fixation and quadratus femoris muscle pedicle bone grafting in fresh displaced femoral neck fractures. Materials and Methods: From April 1996 to December 2004 we operated 73 consecutive patients of displaced femoral neck fracture in the age group of 24 to 81 years, mean age being 54.6 years. The patients were operated within one week of injury, the mean delay being 3.6 days. Closed reduction internal fixation along with quadratus femoris muscle pedicle bone grafting was done in all cases. They were followed up for an average period of 5.6 years (range 2-11 years. Results: Results were assessed according to modified Harris Hip Scoring system and found to be excellent in 53, good in 12, fair in six and poor in two patients. Bony union occurred in 68 cases, no patient developed avascular necrosis (AVN till date. Conclusion: For fresh displaced femoral neck fracture in physiologically active patients closed reduction, internal fixation and quadratus femoris muscle pedicle bone grafting is a suitable option to secure union and prevent development of AVN.

  5. Acute quadriplegia following closed traction reduction of a cervical facet dislocation in the setting of ossification of the posterior longitudinal ligament: case report.

    Science.gov (United States)

    Wimberley, David W; Vaccaro, Alexander R; Goyal, Nitin; Harrop, James S; Anderson, D Greg; Albert, Todd J; Hilibrand, Alan S

    2005-08-01

    A case report of acute quadriplegia resulting from closed traction reduction of traumatic bilateral cervical facet dislocation in a 54-year-old male with concomitant ossification of the posterior longitudinal ligament (OPLL). To report an unusual presentation of a spinal cord injury, examine the approach to reversal of the injury, and review the treatment and management controversies of acute cervical facet dislocations in specific patient subgroups. The treatment of acute cervical facet dislocations is an area of ongoing controversy, especially regarding the question of the necessity of advanced imaging studies before closed traction reduction of the dislocated cervical spine. The safety of an immediate closed, traction reduction of the cervical spine in awake, alert, cooperative, and appropriately select patients has been reported in several studies. To date, there have been no permanent neurologic deficits resulting from awake, closed reduction reported in the literature. A case of temporary, acute quadriplegia with complete neurologic recovery following successful closed traction reduction of a bilateral cervical facet dislocation in the setting of OPLL is presented. The clinical neurologic examination, radiographic, and advanced imaging studies before and after closed, traction reduction of a cervical facet dislocation are evaluated and discussed. A review of the literature regarding the treatment of acute cervical facet dislocations is presented. Radiographs showed approximately 50% subluxation of the fifth on the sixth cervical vertebrae, along with computerized tomography revealing extensive discontinuous OPLL. The cervical facet dislocation was successfully reduced with an awake, closed traction reduction, before magnetic resonance imaging (MRI) evaluation. The patient subsequently had acute quadriplegia develop, with the ensuing MRI study illustrating severe spinal stenosis at the C5, C6 level as a result of OPLL or a large extruded disc herniation

  6. Comparison of Intravenous Morphine with Sublingual Buprenorphine in Management of Postoperative Pain after Closed Reduction Orthopedic Surgery.

    Science.gov (United States)

    Soltani, Ghasem; Khorsand, Mahmood; Shamloo, Alireza Sepehri; Jarahi, Lida; Zirak, Nahid

    2015-10-01

    Postoperative pain is a common side effect following surgery that can significantly reduce surgical quality and patient's satisfaction. Treatment options are morphine and buprenorphine. We aimed to compare the efficacy of a single dose of intravenous morphine with sublingual buprenorphine in postoperative pain control following closed reduction surgery. This triple blind clinical trial was conducted on 90 patients referred for closed reduction orthopedic surgery. They were older than 18 years and in classes I and II of the American Society of Anesthesiologists (ASA) with an operation time of 30-90 minutes. Patients were divided into two groups of buprenorphine (4.5µg/kg sublingually) and morphine (0.2mg/kg intravenously). Baseline characteristics, vital signs, pain score, level of sedation and pharmacological side effects were recorded in the recovery room (at 0 and 30 minutes), and in the ward (at 3, 6 and 12 hours). SPSS version 19 software was used for data analysis and the significance level was set at P<0.05. Ninety patients were studied, 60 males and 30 females with a mean age of 37.7±16.2 years. There was no significant difference between the two groups in terms of baseline characteristics. Pain score in the morphine group was significantly higher than the buprenorphine group with an average score of 2.5 (P<0.001). Postoperative mean heart rate in the buprenorphine group was four beats lower than the morphine group (P<0.001). Also, in the buprenorphine 48.6% and in the morphine group 86.7% of cases were conscious in recovery (P=0.001) with a higher rate of pruritus in the latter group (P=0.001). Sublingual buprenorphine administration before anesthesia induction in closed reduction surgery can lead to better postoperative pain control in comparison to intravenous morphine. Due to simple usage and longer postoperative sedation, sublingual buprenorphine is recommended as a suitable drug in closed reduction surgery.

  7. Closed reduction of displaced or dislocated mandibular condyle fractures in children using threaded Kirschner wire and external rubber traction.

    Science.gov (United States)

    Kim, J H; Nam, D H

    2015-10-01

    Most surgeons agree that closed treatment provides the best results for condylar fractures in children. Nevertheless, treatment of the paediatric mandibular condyle fracture that is severely displaced or dislocated is controversial. The purpose of this study was to investigate the long-term clinical and radiological outcomes following the treatment of displaced or dislocated condylar fractures in children using threaded Kirschner wire and external rubber traction. This procedure can strengthen the advantage of closed reduction and make up for the shortcomings of open reduction. From March 1, 2005 to December 25, 2011, 11 children aged between 4 and 12 years with displaced or dislocated mandibular condyle fractures were treated using threaded Kirschner wire and external rubber traction under portable C-arm fluoroscopy. All patients had unilateral displaced or dislocated condylar fractures. The follow-up period ranged from 24 to 42 months (mean 29.3 months). Normal occlusion and pain-free function of the temporomandibular joint, without deviation or limitation of jaw opening, was achieved in all patients. This closed reduction technique in displaced or dislocated condylar fractures in children offers a reliable solution in preventing the unfavourable sequelae of closed treatment and the open technique, such as altered morphology, functional disturbances, and facial nerve damage. Copyright © 2015 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  8. Failure mechanisms and closed reduction of a constrained tripolar acetabular liner.

    Science.gov (United States)

    Robertson, William J; Mattern, Christopher J; Hur, John; Su, Edwin P; Pellicci, Paul M

    2009-02-01

    Unlike traditional bipolar constrained liners, the Osteonics Omnifit constrained acetabular insert is a tripolar device, consisting of an inner bipolar bearing articulating within an outer, true liner. Every reported failure of the Omnifit tripolar implant has been by failure at the shell-bone interface (Type I failure), failure at the shell-liner interface (Type II failure), or failure of the locking mechanism resulting in dislocation of the bipolar-liner interface (Type III failure). In this report we present two cases of failure of the Omnifit tripolar at the bipolar-femoral head interface. To our knowledge, these are the first reported cases of failure at the bipolar-femoral head interface (Type IV failure). In addition, we described the first successful closed reduction of a Type IV failure.

  9. Incarceration of the intermeniscal ligament in tibial eminence injury: a block to closed reduction identified using MRI

    International Nuclear Information System (INIS)

    Archibald-Seiffer, Noah; Jacobs, John; Zbojniewicz, Andrew; Shea, Kevin

    2015-01-01

    Tibial eminence fractures are a relatively uncommon injury, but most frequently occur in children and adolescents with open physes. Entrapment of the intermeniscal ligament or the meniscus itself can occur in the setting of a tibial eminence fracture and when present, poses a significant obstacle to successful closed or surgical reduction. Identification of these entrapped structures on preoperative imaging may be helpful to the physicians caring for these patients and assist with preoperative planning. We present a case of a 13-year-old male who sustained a tibial eminence fracture while playing football. Review by the orthopedic surgeon identified entrapment of the intermeniscal ligament. Subsequently, a closed reduction attempt under anesthesia prior to surgery was unsuccessful and arthroscopy was needed to remove the entrapped intermeniscal ligament and reduce the tibial eminence fracture. Pre-operative knowledge of entrapped soft tissue structures under the fracture plane, particularly the meniscus and intermeniscal ligament, provides the surgeon with valuable insight as to how to best counsel patients on the success of treatment options, how to best prepare for operative treatment, and can guide the surgeon during open reduction to maximize treatment success. (orig.)

  10. Incarceration of the intermeniscal ligament in tibial eminence injury: a block to closed reduction identified using MRI

    Energy Technology Data Exchange (ETDEWEB)

    Archibald-Seiffer, Noah; Jacobs, John [University of Utah School of Medicine, Salt Lake City, UT (United States); Zbojniewicz, Andrew [University of Cincinnati Department of Radiology, Cincinnati, OH (United States); Cincinnati Children' s Hospital Medical Center, Division of Pediatric Radiology, Cincinnati, OH (United States); Shea, Kevin [University of Utah School of Medicine, Salt Lake City, UT (United States); St. Luke' s Health System, Boise, ID (United States); St. Luke' s Sports Medicine, Boise, ID (United States)

    2015-05-01

    Tibial eminence fractures are a relatively uncommon injury, but most frequently occur in children and adolescents with open physes. Entrapment of the intermeniscal ligament or the meniscus itself can occur in the setting of a tibial eminence fracture and when present, poses a significant obstacle to successful closed or surgical reduction. Identification of these entrapped structures on preoperative imaging may be helpful to the physicians caring for these patients and assist with preoperative planning. We present a case of a 13-year-old male who sustained a tibial eminence fracture while playing football. Review by the orthopedic surgeon identified entrapment of the intermeniscal ligament. Subsequently, a closed reduction attempt under anesthesia prior to surgery was unsuccessful and arthroscopy was needed to remove the entrapped intermeniscal ligament and reduce the tibial eminence fracture. Pre-operative knowledge of entrapped soft tissue structures under the fracture plane, particularly the meniscus and intermeniscal ligament, provides the surgeon with valuable insight as to how to best counsel patients on the success of treatment options, how to best prepare for operative treatment, and can guide the surgeon during open reduction to maximize treatment success. (orig.)

  11. Study of the X-Ray Diagnosis of Unstable Pelvic Fracture Displacements in Three-Dimensional Space and its Application in Closed Reduction.

    Science.gov (United States)

    Shi, Chengdi; Cai, Leyi; Hu, Wei; Sun, Junying

    2017-09-19

    ABSTRACTS Objective: To study the method of X-ray diagnosis of unstable pelvic fractures displaced in three-dimensional (3D) space and its clinical application in closed reduction. Five models of hemipelvic displacement were made in an adult pelvic specimen. Anteroposterior radiographs of the pelvis were analyzed in PACS. The method of X-ray diagnosis was applied in closed reductions. From February 2012 to June 2016, 23 patients (15 men, 8 women; mean age, 43.4 years) with unstable pelvic fractures were included. All patients were treated by closed reduction and percutaneous cannulate screw fixation of the pelvic ring. According to Tile's classification, the patients were classified into type B1 in 7 cases, B2 in 3, B3 in 3, C1 in 5, C2 in 3, and C3 in 2. The operation time and intraoperative blood loss were recorded. Postoperative images were evaluated by Matta radiographic standards. Five models of displacement were made successfully. The X-ray features of the models were analyzed. For clinical patients, the average operation time was 44.8 min (range, 20-90 min) and the average intraoperative blood loss was 35.7 (range, 20-100) mL. According to the Matta standards, 7 cases were excellent, 12 cases were good, and 4 were fair. The displacements in 3D space of unstable pelvic fractures can be diagnosed rapidly by X-ray analysis to guide closed reduction, with a satisfactory clinical outcome.

  12. Closed External Fixation for Failing or Failed Femoral Shaft Plating in a Developing Country.

    Science.gov (United States)

    Aliakbar, Adil; Witwit, Ibrahim; Al-Algawy, Alaa A Hussein

    2017-08-01

    Femoral shaft fractures are one of the common injuries that is treated by open reduction, with internal fixation by plate and screws or intramedullary nailing, which can achieve a high union rate. To evaluate the outcome of using closed external fixation to augment a failing plate; with signs of screw loosening and increasing bone/plate gap; a failed plate; broken plate; screws completely out of bone with redisplacement of fracture. A retrospective study on 18 patients, aged between 17-42 years, who presented between 6-18 weeks after initial surgical fixation, with pain, difficulty in limb function, deformity and abnormal movement at fracture site, was done. X-Rays showed plating failure with acceptable amount of callus, which unfortunately had refractured. Cases associated with infection and no radiological evidence of callus formation were excluded from this study. Closed reduction was done by manipulation, then fracture fixation by AO external fixator. The patients were encouraged for full weight bearing as early as possible with dynamization later on. Of the 18 patients who underwent external fixation after close reduction, 15 cases showed bone healing in a period between 11-18 weeks (mean of 14.27 weeks) with good alignment (Radiologically). Removal of external fixator was done followed by physical therapy thereafter. Closed external fixation for treatment of failing or failed femoral plating, achieves good success rate and has less complications, is a short time procedure, especially in a hospital with limited resources.

  13. Changes in intensity of neurotic symptoms associated with reduction of suicidal ideation in patients who underwent psychotherapy in the day hospital for the treatment of neurotic and behavioral disorders.

    Science.gov (United States)

    Rodziński, Paweł; Rutkowski, Krzysztof; Murzyn, Agnieszka; Sobański, Jerzy A; Cyranka, Katarzyna; Dembińska, Edyta; Grządziel, Karolina; Klasa, Katarzyna; Mielimąka, Michał; Müldner-Nieckowski, Łukasz; Smiatek-Mazgaj, Bogna

    2017-06-18

    Analysis of associations between changes in the intensity of neurotic symptoms and reduction of suicidal ideation (SI) or lack of SI reduction, in patients who underwent a course of intensive psychotherapy conducted in integrative approach with predominance of psychodynamic approach in a day hospital. Symptom Checklist KO"O" and Life Inventory completed by 461 women and 219 men treated in the psychotherapeutic day hospital due to neurotic, behavioral or personality disorders between 2005-2013. During the qualification for the therapy 134 women and 80 men reported SI, of whom 84.3% and 77.5% respectively improved. The reduction of neurotic symptoms intensity was greater in patients of both genders who improved in terms of SI than in those who did not. This referred to global intensity of neurotic symptoms (OWK coefficient) in both genders (ppsychotherapy as a treatment method that leads to improvement in terms of both SI and neurotic symptoms. This suggests that the applied therapy may be effective in preventing suicidality in this group of patients. The observed associations also point in favor of hypothesis on similarities in etiopathogenesis of and partly identical personality-related factors predisposing to SI and neurotic disorders.

  14. Ununited fracture neck of femur treated with closed reduction and internal fixation with cancellous screw and fibular strut graft

    Directory of Open Access Journals (Sweden)

    Singh Daria

    2006-01-01

    Full Text Available Background: Ununited fracture neck of femur in young adults has been tackled in various ways. Methods: Twenty five patients of ununited fracture neck of femur in age group 21-55 years were treated by closed reduction, cancellous screw fixation and fibular strut graft and followed up for 2-6 years. Time gap between injury and operation was 6 weeks to 58 weeks. Five cases were previously fixed with various fixation devices. Results: Osseous union was achieved in 24 cases with average time of 18.16 weeks. Main complication encountered in follow-up was avascular necrosis of femoral head, others were joint stiffness and shortening. Functional end results were good to excellent in 24 cases. Conclusion: Closed reduction with internal fixation by cancellous screw and fibular strut grafting is easy and useful procedure.

  15. Closed Versus Open Supracondylar Fractures of the Humerus in Children: A Comparison of Clinical and Radiographic Presentation and Results.

    Science.gov (United States)

    Lewine, Eliza; Kim, Jaehon M; Miller, Patricia E; Waters, Peter M; Mahan, Susan T; Snyder, Brian; Hedequist, Daniel; Bae, Donald S

    2018-02-01

    The purpose of this investigation was to compare the presentation and postoperative results of children treated for open and closed, completely displaced type III supracondylar humerus fractures (SCFs). Thirty patients with open and 66 patients with closed, completely displaced type III SCFs were evaluated. Open fractures underwent irrigation and debridement, and all patients were treated by open or closed reduction and pin fixation. Medical records were reviewed to obtain demographic information as well as preoperative and postoperative clinical data regarding mechanism of injury, neurovascular status, associated injuries, postoperative range of motion, infections, and pain. Radiographs were evaluated to quantify displacement, Baumann's angle, humeral capitellar angle, position of the anterior humeral line, and adequacy of reduction. Outcomes were assessed using Flynn criteria. Mean clinical follow-up for the open and closed fracture groups was 8.9 and 5.7 months, respectively. Both groups were similar with respect to age, sex distribution, weight and body mass index, laterality of involvement, and mechanism of injury. At presentation, 35% of closed SCFs and 23% of open SCFs presented with abnormal neurovascular status. There was a higher prevalence of diminished/absent pulses or distal limb ischemia in patients with open injuries (27%) compared with closed fractures (18%). Conversely, severely displaced closed fractures were more commonly associated with nerve injury/palsy at presentation (35%) than those with open fractures (23%). Spontaneous nerve recovery was seen in 87% within 3 to 6 months. Postoperative loss of reduction and malunion were more common in the closed fracture group. However, 84% of patients achieved good-to-excellent results by Flynn criteria, with no appreciable difference based upon open versus closed fractures. With timely wound and fracture treatment, the clinical and radiographic results of children treated for open SCFs is similar to

  16. Traumatic Floating 1st Metacarpal in a 14-Year-Old Boy Managed by Close Reduction and Thumb Spica Immobilization: A Rare Case Report.

    Science.gov (United States)

    Tyagi, Himanshu Ravindra; Kamat, Nandan; Wajekar, Sagar; Mandalia, Saumil H

    2014-01-01

    Double dislocation of thumb metacarpal (MC) is a rare injury which may be secondarily complicated by growth plate injury in children. The management of floating 1st MC is also controversial since the treatment ranges from simple reduction to complex reconstruction surgeries. It is also important to understand the long-term results of different management strategies (close reduction, K-wire fixation, ligament reconstruction) as any residual stiffness or instability of thumb may result in severe disability of the hand. A 14-year-old boy with an alleged history of injury to the thumb due to a fall. The postulated mechanism of injury was forced hyperextension of thumb and axial loading of hand in the prone position. On examination, there was prominent bony swelling over the dorsal aspect of carpometacarpal (CMC) and metacarpophalangeal (MCP) joints which was very tender with diffuse swelling over entire thumb. X-ray showed dorsal dislocation of both MCP and CMC joints, without any fracture (bony avulsion) or volar plate avulsion. Treatment was by way of closed reduction performed by axial traction followed by forced flexion at MCP joint with continuous pressure over the dorsal aspect of the joint. The reduction of CMC joint was done by direct pressure over the dorsal aspect and full abduction of thumb. Following reduction, the thumb was immobilized in a thumb spica. Thus, we conclude it is possible to manage a case of floating 1st MC by closed reduction and immobilization, using proper reduction technique. However, a careful clinical and radiological assessment should be done beforehand for signs of bony injury or ligamentous instability.

  17. Improved image quality in abdominal CT in patients who underwent treatment for hepatocellular carcinoma with small metal implants using a raw data-based metal artifact reduction algorithm

    Energy Technology Data Exchange (ETDEWEB)

    Sofue, Keitaro; Sugimura, Kazuro [Kobe University Graduate School of Medicine, Department of Radiology, Kobe, Hyogo (Japan); Yoshikawa, Takeshi; Ohno, Yoshiharu [Kobe University Graduate School of Medicine, Advanced Biomedical Imaging Research Center, Kobe, Hyogo (Japan); Kobe University Graduate School of Medicine, Division of Functional and Diagnostic Imaging Research, Department of Radiology, Kobe, Hyogo (Japan); Negi, Noriyuki [Kobe University Hospital, Division of Radiology, Kobe, Hyogo (Japan); Inokawa, Hiroyasu; Sugihara, Naoki [Toshiba Medical Systems Corporation, Otawara, Tochigi (Japan)

    2017-07-15

    To determine the value of a raw data-based metal artifact reduction (SEMAR) algorithm for image quality improvement in abdominal CT for patients with small metal implants. Fifty-eight patients with small metal implants (3-15 mm in size) who underwent treatment for hepatocellular carcinoma were imaged with CT. CT data were reconstructed by filtered back projection with and without SEMAR algorithm in axial and coronal planes. To evaluate metal artefact reduction, mean CT number (HU and SD) and artefact index (AI) values within the liver were calculated. Two readers independently evaluated image quality of the liver and pancreas and visualization of vasculature using a 5-point visual score. HU and AI values and image quality on images with and without SEMAR were compared using the paired Student's t-test and Wilcoxon signed rank test. Interobserver agreement was evaluated using linear-weighted κ test. Mean HU and AI on images with SEMAR was significantly lower than those without SEMAR (P < 0.0001). Liver and pancreas image qualities and visualizations of vasculature were significantly improved on CT with SEMAR (P < 0.0001) with substantial or almost perfect agreement (0.62 ≤ κ ≤ 0.83). SEMAR can improve image quality in abdominal CT in patients with small metal implants by reducing metallic artefacts. (orig.)

  18. Improved image quality in abdominal CT in patients who underwent treatment for hepatocellular carcinoma with small metal implants using a raw data-based metal artifact reduction algorithm

    International Nuclear Information System (INIS)

    Sofue, Keitaro; Sugimura, Kazuro; Yoshikawa, Takeshi; Ohno, Yoshiharu; Negi, Noriyuki; Inokawa, Hiroyasu; Sugihara, Naoki

    2017-01-01

    To determine the value of a raw data-based metal artifact reduction (SEMAR) algorithm for image quality improvement in abdominal CT for patients with small metal implants. Fifty-eight patients with small metal implants (3-15 mm in size) who underwent treatment for hepatocellular carcinoma were imaged with CT. CT data were reconstructed by filtered back projection with and without SEMAR algorithm in axial and coronal planes. To evaluate metal artefact reduction, mean CT number (HU and SD) and artefact index (AI) values within the liver were calculated. Two readers independently evaluated image quality of the liver and pancreas and visualization of vasculature using a 5-point visual score. HU and AI values and image quality on images with and without SEMAR were compared using the paired Student's t-test and Wilcoxon signed rank test. Interobserver agreement was evaluated using linear-weighted κ test. Mean HU and AI on images with SEMAR was significantly lower than those without SEMAR (P < 0.0001). Liver and pancreas image qualities and visualizations of vasculature were significantly improved on CT with SEMAR (P < 0.0001) with substantial or almost perfect agreement (0.62 ≤ κ ≤ 0.83). SEMAR can improve image quality in abdominal CT in patients with small metal implants by reducing metallic artefacts. (orig.)

  19. Improved image quality in abdominal CT in patients who underwent treatment for hepatocellular carcinoma with small metal implants using a raw data-based metal artifact reduction algorithm.

    Science.gov (United States)

    Sofue, Keitaro; Yoshikawa, Takeshi; Ohno, Yoshiharu; Negi, Noriyuki; Inokawa, Hiroyasu; Sugihara, Naoki; Sugimura, Kazuro

    2017-07-01

    To determine the value of a raw data-based metal artifact reduction (SEMAR) algorithm for image quality improvement in abdominal CT for patients with small metal implants. Fifty-eight patients with small metal implants (3-15 mm in size) who underwent treatment for hepatocellular carcinoma were imaged with CT. CT data were reconstructed by filtered back projection with and without SEMAR algorithm in axial and coronal planes. To evaluate metal artefact reduction, mean CT number (HU and SD) and artefact index (AI) values within the liver were calculated. Two readers independently evaluated image quality of the liver and pancreas and visualization of vasculature using a 5-point visual score. HU and AI values and image quality on images with and without SEMAR were compared using the paired Student's t-test and Wilcoxon signed rank test. Interobserver agreement was evaluated using linear-weighted κ test. Mean HU and AI on images with SEMAR was significantly lower than those without SEMAR (P small metal implants by reducing metallic artefacts. • SEMAR algorithm significantly reduces metallic artefacts from small implants in abdominal CT. • SEMAR can improve image quality of the liver in dynamic CECT. • Confidence visualization of hepatic vascular anatomies can also be improved by SEMAR.

  20. Minimal packing duration in close reduction for nasal bone fracture treatment.

    Science.gov (United States)

    Choi, Dong Sik; Lee, Jeong Woo; Yang, Jung Dug; Chung, Ho Yun; Cho, Byung Chae; Choi, Kang Young

    2015-04-15

    Nasal bone fracture is the most common type of facial bone fracture. The optimal duration of the packing after closed reduction has been a controversial issue. The packing has several disadvantages such as blocking the nasal airway, causing infection and a headache, which is the most common immediate complication. The present study investigated the minimal and optimal duration of the nasal packing following reduction surgery of nasal bone fracture. A prospective study was performed for the patients undergoing reduction surgery following nasal bone fracture between July 2010 and June 2012. The patients were categorised into three groups according to the duration of nasal packing. For the patients treated between July 2010 and June 2011, nasal packing was maintained for 5 days. For those between July 2011 and December 2011, packing was maintained for 3 days. For those between January 2012 and June 2012, the packing was removed after 1 day. The computed tomography scan and the cephalolateral X-ray were checked at immediate postoperative period after packing removal and 6 months postoperatively. The alteration of heights, deviations, and nasal bone contours with time passage were compared among three groups. The patient satisfaction survey was also performed and compared. A total of 530 patients including 322 of the 5-days packing group, 102 of the 3-days group, and 106 of the 1-day group were enrolled. There was no statistically significant difference between the groups in terms of heights, deviations, and nasal bone contours (p-value ≥ 0.05). In the patient satisfaction survey, the 1-day packing group complained of discomfort related to nasal packing and headache symptoms much less, compared to the other two groups. The present study demonstrated that 1-day packing had comparable postoperative outcome with reducing the patients' discomfort. As such, a longer packing duration was not needed to achieve stable results one day is a reasonable packing time for most

  1. Reduction of impurity contamination in a working gas for closed-cycle MHD power generation

    International Nuclear Information System (INIS)

    Endo, N.; Yoshikawa, K.; Shioda, S.

    1989-01-01

    The reduction of impurity contamination in a working inert gas for closed-cycle MHD power generation is examined. A conceptual operation system of regenerative heat exchangers is proposed for minimizing the amount of combustion gas which mixes in the working inert gas. Experiments have shown that this mixing can be reduced significantly by evacuating and flushing the heat exchangers after being heated by combustion gas. Calculations have shown that, among the main molecular contaminants in the working inert gas, CO 2 , H 2 O and O 2 can be removed as compounds with the seed material, while N 2 and H 2 can be reduced by a partial purification of the circulating working inert gas. (author)

  2. Heterotopic ossification of the elbow after closed reduction and retrograde intramedullary nailing for radial neck fracture treated by anconeus interposition.

    Science.gov (United States)

    Sreenivas, T; Menon, Jagdish; Nataraj, A R

    2013-12-01

    Heterotopic ossification around the elbow can lead to considerable functional disability. We describe a case of a 42-year-old man who developed heterotopic ossification of his elbow after closed reduction of the elbow dislocation and radial neck fracture and retrograde intramedullary nailing for radial neck fracture. During the follow-up after initial surgery, movements of the elbow were gradually deteriorated and diagnosed as heterotopic ossification of the elbow. Implant removal, radial head excision along with heterotopic mass, and also interposition of the anconeus muscle resulted in improvement of his elbow mobility. At 18 months of follow-up, patient had elbow flexion arc of 15°-110°, 70° of supination, and 50° of pronation without recurrence of heterotopic ossification. The uniqueness of this case lies in the treatment of heterotopic ossification of the elbow to prevent its recurrence, which was developed after retrograde intramedullary nailing for radial neck fracture following closed reduction.

  3. Closed reduction with CT-guided screw fixation for unstable sacroiliac joint fracture-dislocation

    Energy Technology Data Exchange (ETDEWEB)

    Baskin, Kevin M.; Cahill, Ann Marie; Kaye, Robin D. [Children' s Hospital of Philadelphia, Department of Radiology, Philadelphia, PA (United States); Born, Christopher T. [Temple University Hospital/Temple Children' s Hospital, Temple Sports Medicine, Marlton, NJ (United States); Grudziak, Jan S. [Children' s Hospital of Pittsburgh, Department of Orthopedic Surgery, Pittsburgh, PA (United States); Towbin, Richard B.

    2004-12-01

    Unstable posterior pelvic ring fractures and dislocations are uncommon but potentially life-threatening injuries in children. Early definitive management reduces risk of immediate complications as well as chronic pain and gait dysfunction. Conventional operative therapy carries substantial risk of extensive blood loss and iatrogenic neurological and vascular injury. Minimally invasive image-guided intervention may further reduce immediate risk and improve long-term outcome. To describe CT-guided closed reduction and internal fixation (CRIF) and review outcomes of unstable fracture-dislocation of the sacroiliac (SI) joint in children. Between 2000 and 2003, three children (two girls, one boy) age 8-14 years were referred to interventional radiology for treatment of unstable SI joint fracture-dislocation not adequately treated with anterior external fixation alone. The three affected SI joints (two left, one right) were treated in a combined approach by pediatric interventional radiologists and orthopedic surgeons, using a percutaneous approach under CT guidance. Over a threaded guiding pin, 7.3 mm cannulated screws were used to achieve stable reduction of the affected SI joints. One screw was removed after slight (2 mm) migration. No neurovascular or other complications occurred. All patients had satisfactory healing with near-anatomic reduction, although recovery of the youngest was delayed by associated spinal injury. Compared to open surgical alternatives, CRIF under CT guidance reduces operating time, decreases blood loss, and allows early definitive fixation and immediate non-weight-bearing mobilization with a low rate of complication for unstable posterior pelvic ring fractures. In addition, CT-guided placement of the guide pin may allow safer screw positioning and may minimize the total number of screws needed to achieve pelvic stability. (orig.)

  4. Closed reduction with CT-guided screw fixation for unstable sacroiliac joint fracture-dislocation

    International Nuclear Information System (INIS)

    Baskin, Kevin M.; Cahill, Ann Marie; Kaye, Robin D.; Born, Christopher T.; Grudziak, Jan S.; Towbin, Richard B.

    2004-01-01

    Unstable posterior pelvic ring fractures and dislocations are uncommon but potentially life-threatening injuries in children. Early definitive management reduces risk of immediate complications as well as chronic pain and gait dysfunction. Conventional operative therapy carries substantial risk of extensive blood loss and iatrogenic neurological and vascular injury. Minimally invasive image-guided intervention may further reduce immediate risk and improve long-term outcome. To describe CT-guided closed reduction and internal fixation (CRIF) and review outcomes of unstable fracture-dislocation of the sacroiliac (SI) joint in children. Between 2000 and 2003, three children (two girls, one boy) age 8-14 years were referred to interventional radiology for treatment of unstable SI joint fracture-dislocation not adequately treated with anterior external fixation alone. The three affected SI joints (two left, one right) were treated in a combined approach by pediatric interventional radiologists and orthopedic surgeons, using a percutaneous approach under CT guidance. Over a threaded guiding pin, 7.3 mm cannulated screws were used to achieve stable reduction of the affected SI joints. One screw was removed after slight (2 mm) migration. No neurovascular or other complications occurred. All patients had satisfactory healing with near-anatomic reduction, although recovery of the youngest was delayed by associated spinal injury. Compared to open surgical alternatives, CRIF under CT guidance reduces operating time, decreases blood loss, and allows early definitive fixation and immediate non-weight-bearing mobilization with a low rate of complication for unstable posterior pelvic ring fractures. In addition, CT-guided placement of the guide pin may allow safer screw positioning and may minimize the total number of screws needed to achieve pelvic stability. (orig.)

  5. Open versus closed reduction: diacapitular fractures of the mandibular condyle.

    Science.gov (United States)

    Chrcanovic, Bruno Ramos

    2012-09-01

    The purpose of the study was to review the literature regarding the evolution of current thoughts on management of diacapitular fractures (DFs) of the mandibular condyle. An electronic search in PubMed was undertaken in March 2012. The titles and abstracts from these results were read to identify studies within the selection criteria. Eligibility criteria included studies reporting clinical series of DFs, including both animal and human studies, without date or language restrictions. The search strategy initially yielded 108 references. Twenty-eight studies were identified without repetition within the selection criteria. Additional hand-searching of the reference lists of selected studies yielded three additional papers. The current indications for open reduction and internal fixation (ORIF) of DFs described in the literature are: (a) fractures affecting the lateral condyle with reduction of mandibular height; (b) fractures in which the proximal fragment dislocates laterally out of the glenoid fossa, which cannot be reduced by closed or open treatment of another part of the mandibular fracture. The indications for conservative treatment are: (a) fractures that do not shorten the condylar height (a fracture with displacement of the medial parts of the condyle); (b) undisplaced fractures; (c) comminution of the condylar head, when the bony fragments are too small for stable fixation; and (d) fractures in children. As the temporomandibular joint disk plays an important role as a barrier preventing ankylosis, it is important to reposition the disk (if displaced/dislocated) during the surgical treatment of DFs. The lateral pterygoid muscle should never be stripped from the medially displaced fragment because its desinsertion disrupts circulation to the medial bony fragment, and also because this muscle helps to restore the muscle function after surgery. ORIF of selected DFs improves prognosis by anatomical bone and soft tissue recovery when combined with physical

  6. Complete Mapping of Complex Disulfide Patterns with Closely-Spaced Cysteines by In-Source Reduction and Data-Dependent Mass Spectrometry

    DEFF Research Database (Denmark)

    Cramer, Christian N; Kelstrup, Christian D; Olsen, Jesper V

    2017-01-01

    bonds are present in complicated patterns. This includes the presence of disulfide bonds in nested patterns and closely spaced cysteines. Unambiguous mapping of such disulfide bonds typically requires advanced MS approaches. In this study, we exploited in-source reduction (ISR) of disulfide bonds during...... the electrospray ionization process to facilitate disulfide bond assignments. We successfully developed a LC-ISR-MS/MS methodology to use as an online and fully automated partial reduction procedure. Postcolumn partial reduction by ISR provided fast and easy identification of peptides involved in disulfide bonding......Mapping of disulfide bonds is an essential part of protein characterization to ensure correct cysteine pairings. For this, mass spectrometry (MS) is the most widely used technique due to fast and accurate characterization. However, MS-based disulfide mapping is challenged when multiple disulfide...

  7. Fluoroscopically guided closed reduction and internal fixation of fractures of the lateral portion of the humeral condyle: prospective clinical study of the technique and results in ten dogs.

    Science.gov (United States)

    Cook, J L; Tomlinson, J L; Reed, A L

    1999-01-01

    To report a technique for fluoroscopically guided closed reduction with internal fixation of fractures of the lateral portion of the humeral condyle (FLHC) and determine the long-term results in 10 clinical cases. Prospective clinical case study. Ten dogs with 11 fractures. Fractures of the lateral portion of the humeral condyle were stabilized with transcondylar screws and Kirschner wires. Closed reduction and implant placement were achieved using intraoperative fluoroscopic guidance. After fracture repair, postoperative radiographs were evaluated for articular alignment and implant placement. Dogs were evaluated after surgery by means of lameness scores, elbow range of motion (ROM), radiographic assessment, and owner evaluation of function. Postoperative reduction was considered anatomic in 6 fractures with all other fractures having ROM values between affected and unaffected elbows. All of the dogs in this study regained 90-100% of full function, based on owner assessment. Fluoroscopic guidance for closed reduction and internal fixation of FLHC in dogs is an effective technique.

  8. Comparison of Intravenous Morphine with Sublingual Buprenorphine in Management of Postoperative Pain after Closed Reduction Orthopedic Surgery

    Directory of Open Access Journals (Sweden)

    Ghasem Soltani

    2015-09-01

    Full Text Available Background: Postoperative pain is a common side effect following surgery that can significantly reduce surgical quality and patient’s satisfaction. Treatment options are morphine and buprenorphine. We aimed to compare the efficacy of a single dose of intravenous morphine with sublingual buprenorphine in postoperative pain control following closed reduction surgery. Methods: This triple blind clinical trial was conducted on 90 patients referred for closed reduction orthopedic surgery. They were older than 18 years and in classes I and II of the American Society of Anesthesiologists (ASA with an operation time of 30-90 minutes. Patients were divided into two groups of buprenorphine (4.5μg/kg sublingually and morphine (0.2mg/kg intravenously. Baseline characteristics, vital signs, pain score, level of sedation and pharmacological side effects were recorded in the recovery room (at 0 and 30 minutes, and in the ward (at 3, 6 and 12 hours. SPSS version 19 software was used for data analysis and the significance level was set at P Results: Ninety patients were studied, 60 males and 30 females with a mean age of 37.7±16.2 years. There was no significant difference between the two groups in terms of baseline characteristics.Pain score in the morphine group was significantly higher than the buprenorphine group with an average score of 2.5 (P

  9. Comparison of Intravenous Morphine with Sublingual Buprenorphine in Management of Postoperative Pain after Closed Reduction Orthopedic Surgery

    Directory of Open Access Journals (Sweden)

    Ghasem Soltani

    2015-10-01

    Full Text Available Background: Postoperative pain is a common side effect following surgery that can significantly reduce surgical quality and patient’s satisfaction. Treatment options are morphine and buprenorphine. We aimed to compare the efficacy of a single dose of intravenous morphine with sublingual buprenorphine in postoperative pain control following closed reduction surgery. Methods: This triple blind clinical trial was conducted on 90 patients referred for closed reduction orthopedic surgery. They were older than 18 years and in classes I and II of the American Society of Anesthesiologists (ASA with an operation time of 30-90 minutes. Patients were divided into two groups of buprenorphine (4.5μg/kg sublingually and morphine (0.2mg/kg intravenously. Baseline characteristics, vital signs, pain score, level of sedation and pharmacological side effects were recorded in the recovery room (at 0 and 30 minutes, and in the ward (at 3, 6 and 12 hours. SPSS version 19 software was used for data analysis and the significance level was set at P Results: Ninety patients were studied, 60 males and 30 females with a mean age of 37.7±16.2 years. There was no significant difference between the two groups in terms of baseline characteristics.Pain score in the morphine group was significantly higher than the buprenorphine group with an average score of 2.5 (P

  10. Phytophthora megakarya and Phytophthora palmivora, Closely Related Causal Agents of Cacao Black Pod Rot, Underwent Increases in Genome Sizes and Gene Numbers by Different Mechanisms

    Science.gov (United States)

    Ali, Shahin S.; Shao, Jonathan; Lary, David J.; Kronmiller, Brent A.; Shen, Danyu; Strem, Mary D.; Amoako-Attah, Ishmael; Akrofi, Andrew Yaw; Begoude, B.A. Didier; ten Hoopen, G. Martijn; Coulibaly, Klotioloma; Kebe, Boubacar Ismaël; Melnick, Rachel L.; Guiltinan, Mark J.; Tyler, Brett M.; Meinhardt, Lyndel W.

    2017-01-01

    Phytophthora megakarya (Pmeg) and Phytophthora palmivora (Ppal) are closely related species causing cacao black pod rot. Although Ppal is a cosmopolitan pathogen, cacao is the only known host of economic importance for Pmeg. Pmeg is more virulent on cacao than Ppal. We sequenced and compared the Pmeg and Ppal genomes and identified virulence-related putative gene models (PGeneM) that may be responsible for their differences in host specificities and virulence. Pmeg and Ppal have estimated genome sizes of 126.88 and 151.23 Mb and PGeneM numbers of 42,036 and 44,327, respectively. The evolutionary histories of Pmeg and Ppal appear quite different. Postspeciation, Ppal underwent whole-genome duplication whereas Pmeg has undergone selective increases in PGeneM numbers, likely through accelerated transposable element-driven duplications. Many PGeneMs in both species failed to match transcripts and may represent pseudogenes or cryptic genetic reservoirs. Pmeg appears to have amplified specific gene families, some of which are virulence-related. Analysis of mycelium, zoospore, and in planta transcriptome expression profiles using neural network self-organizing map analysis generated 24 multivariate and nonlinear self-organizing map classes. Many members of the RxLR, necrosis-inducing phytophthora protein, and pectinase genes families were specifically induced in planta. Pmeg displays a diverse virulence-related gene complement similar in size to and potentially of greater diversity than Ppal but it remains likely that the specific functions of the genes determine each species’ unique characteristics as pathogens. PMID:28186564

  11. ALGORITHM FOR MANAGEMENT OF HYPERTENSIVE PATIENTS UNDERWENT UROLOGY INTERVENTIONS

    Directory of Open Access Journals (Sweden)

    S. S. Davydova

    2013-01-01

    Full Text Available Aim. To study the efficacy of cardiovascular non-invasive complex assessment and pre-operative preparation in hypertensive patients needed in surgical treatment of urology dis- eases.Material and methods. Males (n=883, aged 40 to 80 years were included into the study. The main group consisted of patients that underwent laparotomic nephrectomy (LTN group; n=96 and patients who underwent laparoscopic nephrectomy (LSN group; n=53. Dynamics of ambulatory blood pressure monitoring (ABPM data was analyzed in these groups in the immediate postoperative period. The efficacy of a package of non-invasive methods for cardiovascular system assessment was studied. ABPM was performed after nephrectomy (2-nd and 10-th days after surgery in patients with complaints of vertigo episodes or intense general weakness to correct treatment.Results. In LTN group hypotension episodes or blood pressure (BP elevations were observed in 20 (20.8% and 22 (22.9% patients, respectively, on the 2-nd day after the operation. These complications required antihypertensive treatment correction. Patients with hypotension episodes were significantly older than patients with BP elevation and had significantly lower levels of 24-hour systolic BP, night diastolic BP and minimal night systolic BP. Re-adjustment of antihypertensive treatment on the 10-th postoperative day was required to 2 (10% patients with hypotension episodes and to 1 (4.5% patient with BP elevation. Correction of antihypertensive therapy was required to all patients in LSN group on the day 2, and to 32 (60.4% patients on the 10-th day after the operation. Reduction in the incidence of complications (from 1.2% in 2009 to 0.3% in 2011, p<0.001 was observed during the application of cardiovascular non-invasive complex assessment and preoperative preparation in hypertensive patients.Conclusion. The elaborated management algorithm for patients with concomitant hypertension is recommended to reduce the cardiovascular

  12. ALGORITHM FOR MANAGEMENT OF HYPERTENSIVE PATIENTS UNDERWENT UROLOGY INTERVENTIONS

    Directory of Open Access Journals (Sweden)

    S. S. Davydova

    2015-09-01

    Full Text Available Aim. To study the efficacy of cardiovascular non-invasive complex assessment and pre-operative preparation in hypertensive patients needed in surgical treatment of urology dis- eases.Material and methods. Males (n=883, aged 40 to 80 years were included into the study. The main group consisted of patients that underwent laparotomic nephrectomy (LTN group; n=96 and patients who underwent laparoscopic nephrectomy (LSN group; n=53. Dynamics of ambulatory blood pressure monitoring (ABPM data was analyzed in these groups in the immediate postoperative period. The efficacy of a package of non-invasive methods for cardiovascular system assessment was studied. ABPM was performed after nephrectomy (2-nd and 10-th days after surgery in patients with complaints of vertigo episodes or intense general weakness to correct treatment.Results. In LTN group hypotension episodes or blood pressure (BP elevations were observed in 20 (20.8% and 22 (22.9% patients, respectively, on the 2-nd day after the operation. These complications required antihypertensive treatment correction. Patients with hypotension episodes were significantly older than patients with BP elevation and had significantly lower levels of 24-hour systolic BP, night diastolic BP and minimal night systolic BP. Re-adjustment of antihypertensive treatment on the 10-th postoperative day was required to 2 (10% patients with hypotension episodes and to 1 (4.5% patient with BP elevation. Correction of antihypertensive therapy was required to all patients in LSN group on the day 2, and to 32 (60.4% patients on the 10-th day after the operation. Reduction in the incidence of complications (from 1.2% in 2009 to 0.3% in 2011, p<0.001 was observed during the application of cardiovascular non-invasive complex assessment and preoperative preparation in hypertensive patients.Conclusion. The elaborated management algorithm for patients with concomitant hypertension is recommended to reduce the cardiovascular

  13. Efficacy Evaluation for the Treatment of Subcapital Femoral Neck Fracture in Young Adults by Capsulotomy Reduction and Closed Reduction

    Directory of Open Access Journals (Sweden)

    Cong Liu

    2015-01-01

    Full Text Available Background: Subcapital femoral neck fracture in young adults has many complications, and the incidence is increasing year-by-year. The selection of the proper operation method to avoid them is an ambiguous matter. This study aimed to evaluate the treatment effect of subcapital femoral neck fracture by the capsulotomy and internal fixation with iliac bone grafting or closed reduction and internal fixation in young adults. Methods: From March 2003 to February 2010, 65 young patients with subcapital femoral neck fractures were treated, including 39 males and 26 females with average age of 34.5 years (range, 19-50 years; 29 cases of the left side and 36 cases of the right side. They were randomly divided into Group A with 34 cases treated by closed reduction and internal fixation and Group B with 31 cases treated by the capsulotomy and internal fixation with iliac bone grafting. The two groups had no significant differences in sex, age, body mass index and preoperative Harris Hip Score. The observation criteria involved the length of the incision, blood loss, operation time, nonunion rate, avascular necrosis of the femoral head (ANFH rate and Harris Hip Score. Results: Four of 65 patients were lost follow-up, and the follow-up rate was 93.8%, the average follow-up time was 38.7 months (range, 33-47 months. In Group A, the incision length was 5.1 ± 2.2 cm, blood loss was 84.0 ± 13.2 ml, and operation time was 52.9 ± 10.2 min. In Group B, the incision length was 15.4 ± 4.6 cm, blood loss was 396.0 ± 21.3 ml, and operation time was 116.5 ± 15.3 min. Nonunion occurred in 8 patients (25.2% in Group A and 1 patient (3.3% in Group B. ANFH occurred in 9 patients (29.1% in Group A and 2 patients (6.7% in Group B. Postoperative Harris Hip Score was 89.0 ± 5.6 in Group A and 95.0 ± 4.5 in Group B. The above index of two groups was considered statistically significant (P < 0.05. Conclusions: Capsulotomy and internal fixation with iliac bone grafting can

  14. Clinical study of emergency treatment and selective closed reduction for the treatment of supracondylar humerus fracture in children

    Directory of Open Access Journals (Sweden)

    Wei Zhong

    2016-11-01

    Full Text Available Objective: To study the effect of emergency treatment, selective closed reduction combined with percutaneous Kirschner wire fixation on the treatment of Gartland type-II and type-III supracondylar humerus fracture. Methods: Children who sustained the Gartland type-II and type-III supracondylar fractures of humerus treated with selective closed reduction combined with percutaneous Kirschner wire fixation in our hospital from May 2012 to August 2015 were analyzed retrospectively. They were divided into group A (emergency operation group and group B (selective operation group according to different operation timing. Perioperative situation, blood biochemical parameters, swelling degree and elbow joint function of affected limb were compared between two groups. Results: Operation time for patients of group A was significantly shorter than that of group B [(17.19 ± 2.85 vs. (21.43 ± 3.91 min], and frequency of fluoroscopy during operation of group A was obviously less than that of group B [(6.03 ± 0.95 vs. (7.61 ± 0.92 times]. Swelling index of affected limb in group A at 3 days, 5 days and 7 days after injury was all significantly lower than that in group B [(1.20 ± 0.17 vs. (1.38 ± 0.14, (1.13 ± 0.13 vs. (1.30 ± 0.18, (1.02 ± 0.15 vs. (1.22 ± 0.15]. Hospital for special surgery score at 1 week, 2 weeks, 3 and 4 weeks after removing Kirschner wire had no significant difference between group A and B (88.75 ± 10.18 vs. (89.14 ± 10.52, (94.22 ± 10.85 vs. (93.85 ± 11.08, (95.52 ± 11.27 vs. (95.92 ± 12.19, (95.43 ± 10.96 vs. (96.02 ± 11.38. Contents of serum alanine transaminase, aspertate aminotransferase, total protein, albumin and C-reactive protein in perioperative period had no obvious difference between patients in group A and B. Conclusions: Emergency closed reduction combined with percutaneous Kirschner wire fixation for Gartland type-II and type-III supracondylar humerus fracture in children has less trauma, low swelling degree

  15. [Close reduction combined with minimally invasive percutaneous plate osteosynthesis for proximal and distal tibial fractures: a report of 56 patients].

    Science.gov (United States)

    Liu, Yin-Wen; Kuang, Yong; Gu, Xin-Feng; Zheng, Yu-Xin; Li, Zhi-Qiang; Wei, Xiao-En; Zhang, Ming-Cai; Zhan, Hong-Sheng; Shi, Yin-yu

    2013-03-01

    To evaluate the clinical effects of close reduction combined with minimally invasive percutanous plate osteosynthesis (MIPPO) for proximal and distal tibial fractures. From March 2007 to December 2010, 56 patients with proximal and distal tibial fractures were treated with close reduction combined with MIPPO technique. There were 39 males and 17 females,aged from 22 to 67 years with an average of 41.3 years. Left fracture was in 25 cases and right fracture was in 31 cases; proximal tibial fracture was in 15 cases and distal tibial fractures was in 41 cases; 34 cases caused by fall down and 22 cases caused by road accident. The mean time from injury to operation was 1.7 d. Clinical manifestation included pain, swelling of leg with limitation of activity. According to the standard of Johner-Wruhs, clinical effects were evaluated. The mean operative time was 46 min in 56 patients. All fractures obtained satisfactory reduction and the location of plate was good. Incisions healed with one-stage and no superficial or deep infection was found. All the patients were followed up from 8 to 23 months with an average of 14.2 months. Only one fracture complication with delayed union,and after auto grafting with ilium bone,the fracture got union. Other 55 cases obtained bone healing in 15 to 20 weeks after operation and no internal fixation failure was found. The time of walking was 4-6 months after operation,without limping at 7 months after operation. Both lower extremities were symmetrical and the function of knee and ankle got complete recovery. According to the criteria of Johner-Wruhs score,46 cases obtained excellent results,9 good and 2 fair. Treatment of proximal and distal tibial fractures with close reduction and MIPPO technique can not only preserve soft tissue,simplify operative procedure and decrease wound, but also can obtain rigid internal fixation and guarantee early function exercises of knee and ankle joints. The method has the advantages of less soft tissue

  16. Uranium tetrafluoride reduction closed bomb. Part I: Reduction process general conditions

    International Nuclear Information System (INIS)

    Anca Abati, R.; Lopez Rodriguez, M.

    1961-01-01

    General conditions about the metallo thermic reduction in small bombs (250 and 800 gr. of uranium) has been investigated. Factors such as kind and granulometry of the magnesium used, magnesium excess and preheating temperature, which affect yields and metal quality have been considered. magnesium excess increased yields in a 15% in the small bomb, about the preheating temperature, there is a range between which yields and metal quality does not change. All tests have been made with graphite linings. (Author) 18 refs

  17. Advanced oxidation and reduction processes: Closed-loop applications for mixed waste

    International Nuclear Information System (INIS)

    Coogan, J.J.; Tennant, R.A.; Rosocha, L.A.; Wantuck, P.J.

    1993-01-01

    At Los Alamos we are engaged in applying innovative oxidation and reduction technologies to the destruction of hazardous organics. Non thermal plasmas and relativistic electron-beams both involve the generation of free radicals and are applicable to a wide variety of mixed waste as closed-loop designs can be easily engineered. Silent discharge plasmas (SDP), long used for the generation of ozone, have been demonstrated in the laboratory to be effective in destroying hazardous organic compounds and offer an altemative to existing post-incineration and off-gas treatments. SDP generates very energetic electrons which efficiently create reactive free radicals, without adding the enthalpy associated with very high gas temperatures. A SDP cell has been used as a second stage to a LANL designed, packed-bed reactor (PBR) and has demonstrated DREs as high as 99.9999% for a variety of combustible liquid and gas-based waste streams containing scintillation fluids, nitrates, PCB surrogates, and both chlorinated and fluorinated solvents. Radiolytic treatment of waste using electron-beams and/or bremsstrahlung can be applied to a wide range of waste media (liquids, sludges, and solids). The efficacy and economy of these systems has been demonstrated for aqueous waste through both laboratory and pilot scale studies. We win present recent experimental and theoretical results for systems using stand alone SDP, combined PBR/SDP, and electron-beam treatment methods

  18. The hematoma block: a simple, effective technique for closed reduction of ankle fracture dislocations.

    Science.gov (United States)

    Ross, Adrianne; Catanzariti, Alan R; Mendicino, Robert W

    2011-01-01

    Management of a dislocated ankle fracture can be challenging because of instability of the ankle mortise, a compromised soft tissue envelope, and the potential neurovascular compromise. Every effort should be made to quickly and efficiently relocate the disrupted ankle joint. Within the emergency department setting, narcotics and benzodiazepines can be used to sedate the patient before attempting closed reduction. The combination of narcotics and benzodiazepines provides relief of pain and muscle guarding; however, it conveys a risk of seizure as well as respiratory arrest. An alternative to conscious sedation is the hematoma block, or an intra-articular local anesthetic injection in the ankle joint and the associated fracture hematoma. The hematoma block offers a comparable amount of analgesia to conscious sedation without the additional cardiovascular risk, hospital cost, and procedure time. Copyright © 2011 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  19. Close Intramedullary Interlocking Nailing Versus Locking Compression Plating In the Treatment of Closed Fracture Shaft of the Tibia.

    Science.gov (United States)

    Kundu, I K; Datta, N K; Chowdhury, A Z; Das, K P; Tarik, M M; Faisal, M A

    2016-07-01

    Fracture of tibial shaft is the commonest site of long bone fractures due to its superficial location involving young or middle-age people. Proper management is an important issue regarding the future effective movements. In this study patients were grouped in closed Intra medullary interlocking nailing and locking compression plating. Post-operative follow up at 2 weeks, 6 weeks, 12 weeks and 3 months thereafter up to 6 months were done. Each of the patients was evaluated clinically and radiologically by tucker criteria of Tuker et al. Patients were assessed for pain on full weight bearing and kneeling, shortening and range of motion of knee and ankle joints. Radiological assessment for union of fracture, alignment of fracture and angulations and position of nail and screws and infection were observed during follow up. A total number of 32 patients were selected but only 27 patients were available for follow up for a period of 6 months. They were grouped into Group A, consisting of 15 patients who took the treatment in the form of closed intramedullary interlocking nailing and Group B, consisting of 12 patients those underwent ORIF with locking compression plating. In both of the groups Motor Vehicle Accident was the main mechanism of trauma. Fracture involving the middle 3rd of the tibia is common in both the groups. During post-operative follow up, four patients in Group A complained anterior knee pain, one patient in Group B had superficial infection, most of the patients had no restriction of movement in the ankle and knee joints and a single patient in Group B showed 1.5cm shortening of the lower limb. Period of hospital stay and fracture union time were less in Group A, which was statistically significant. Both groups showed excellent result with minimum complications. So this study permits to conclude that close IM interlocking nailing and open reduction and internal fixation by locking compression plating is equally effective for the management of close

  20. Simulation-Based Educational Module Improves Intern and Medical Student Performance of Closed Reduction and Percutaneous Pinning of Pediatric Supracondylar Humeral Fractures.

    Science.gov (United States)

    Butler, Bennet A; Lawton, Cort D; Burgess, Jamie; Balderama, Earvin S; Barsness, Katherine A; Sarwark, John F

    2017-12-06

    Simulation-based education has been integrated into many orthopaedic residency programs to augment traditional teaching models. Here we describe the development and implementation of a combined didactic and simulation-based course for teaching medical students and interns how to properly perform a closed reduction and percutaneous pinning of a pediatric supracondylar humeral fracture. Subjects included in the study were either orthopaedic surgery interns or subinterns at our institution. Subjects all completed a combined didactic and simulation-based course on pediatric supracondylar humeral fractures. The first part of this course was an electronic (e)-learning module that the subjects could complete at home in approximately 40 minutes. The second part of the course was a 20-minute simulation-based skills learning session completed in the simulation center. Subject knowledge of closed reduction and percutaneous pinning of supracondylar humeral fractures was tested using a 30-question, multiple-choice, written test. Surgical skills were tested in the operating room or in a simulated operating room. Subject pre-intervention and post-intervention scores were compared to determine if and how much they had improved. A total of 21 subjects were tested. These subjects significantly improved their scores on both the written, multiple-choice test and skills test after completing the combined didactic and simulation module. Prior to the module, intern and subintern multiple-choice test scores were significantly worse than postgraduate year (PGY)-2 to PGY-5 resident scores (p < 0.01); after completion of the module, there was no significant difference in the multiple-choice test scores. After completing the module, there was no significant difference in skills test scores between interns and PGY-2 to PGY-5 residents. Both tests were validated using the scores obtained from PGY-2 to PGY-5 residents. Our combined didactic and simulation course significantly improved intern and

  1. Intraocular pressure variations during zygomatic fracture reduction and fixation: a clinical study.

    LENUS (Irish Health Repository)

    Murray, Dylan J

    2012-02-03

    BACKGROUND: The reduction of midface fractures has been associated with the rare but devastating complication of blindness. An increase in intraocular pressure is important in the mechanism of blindness in this setting. In this study, the authors assessed the intraocular pressure in patients who underwent zygomatic fracture reduction (with or without fixation). METHODS: Using applanation tonometry, 29 patients underwent intraocular pressure measurements before, during, and after fracture fixation. The contralateral pressures were measured and used as the control. RESULTS: There were 29 patients with a mean age of 35 years, and the mean time to surgery was 5 days. Preoperatively, all patients had normal intraocular pressures and normal visual acuity. All patients underwent a Gillies lift and 18 patients required open reduction and fixation of the frontozygomatic suture (n = 4) or the infraorbital margin (n = 2), and the remainder (n = 12) required fixation of both points. There was no statistically significant increase in the intraocular pressures following the reduction of uncomplicated zygomatic fractures. Statistically significant pressure reductions were noted immediately after reduction and fixation. CONCLUSIONS: The surgical reduction of uncomplicated zygomatic fractures has no adverse effect on the intraocular pressure. It is the authors\\' opinion that adjunctive measures to reduce the pressures are unnecessary.

  2. Comparative study of the prognosis of an extracorporeal reduction and a closed treatment in mandibular condyle head and/or neck fractures.

    Science.gov (United States)

    Park, Jung-Min; Jang, Yong-Wook; Kim, Seong-Gon; Park, Young-Wook; Rotaru, Horatiu; Baciut, Grigore; Hurubeanu, Lucia

    2010-12-01

    The objective of this study was a comparison of the prognosis between an extracorporeal reduction technique and closed treatment of a mandibular condyle fracture. The relationship between condylar resorption and several clinical variables was also studied. Seventy-one patients who had a mandibular condyle fracture took part in this study. Thirty-five patients (female: 7, male: 28, age: 30.46 ± 14.27 years) were treated by extracorporeal reduction, and 36 patients (male: 24, female: 12, age: 24.28 ± 9.99 years) were treated using a closed treatment. The presence of complications such as condylar resorption, malocclusion, nerve disorder, and disc displacement was evaluated with panoramic radiographs and clinical examinations 12 months after treatment. The relationships between the complications and other clinical variables were evaluated statistically. The anatomic site and fracture type were closely related to condyle resorption in the bivariate analysis. Condylar head fractures showed significantly higher condyle resorption than condylar neck fractures (P = .023). A complex or compound fracture showed significantly higher condyle resorption compared with a simple fracture (P = .006). Patients who had a complex/compound fracture were 34.366 times more likely to have condyle resorption compared with those who had a simple fracture (P = .002). The patient's age and treatment method were also significant predictors for condyle resorption. Fracture type was the strongest predictor of condylar resorption. Because treatment method and patient age were also related to the prognosis, the optimal treatment for mandibular condylar head and/or neck fractures should be individualized according to the patient's condition. Copyright © 2010 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  3. Is Closed Manipulative Reduction and Percutaneous Kirschner Wiring of Supracondylar Humeral Fracture in Children as Day-Care Surgery a Safe Procedure ?

    Directory of Open Access Journals (Sweden)

    Ashok R Nayak

    2013-07-01

    Full Text Available INTRODUCTION: Supracondylar fracture of the humerus is a common injury in children. It accounts for 60% of fractures around the elbow children. If the fracture is not treated properly it may give rise to many complications like malunion, Volkmann’s ischemic contracture, nerve injury, arterial injury, skin slough, heterotopic bone formation , and stiffness of elbow. The management of displaced supracondylar fracture of the elbow is one of the most difficult of the many fractures seen in children. The purpose of the study was to evaluate the anatomical and functional results of treatment of supracondylar fractures of humerus with closed reduction and percutaneous ‘K’ wire fixation as a day care procedure and record associated complications, thus decreasing the cost of treating these fractures and hospitalization. METHODS: Fifty displaced closed extension type supracondylar fractures (Gartland’s type III of the humerus in children were treated by closed reduction and percutaneous fixation with Kirschner wires. All the patients selected for this study had been treated in a day care unit and were discharged in the same evening and followed up at 3 and 6 weeks and 3 months. Open fractures, fractures with neurovascular complications and children older than 15 yrs were excluded. The final results were evaluated by Flynn’s criteria. RESULTS: The majority (72%, of the patients had fracture displaced posteomedially, Fourty one of the fifty patients had satisfactory results. The majority of the patients were male, and the average age was 8-9 years. CONCLUSION: Percutaneous fixation of supracondylar humerus done as a day care procedure is an acceptable modality of treatment and reduces the duration of hospital stay for the patient.

  4. Closed Reduction of Bilateral Posterior Shoulder Dislocation with Medium Impression Defect of the Humeral Head: A Case Report and Review of Its Treatment

    Directory of Open Access Journals (Sweden)

    Soorena Rezazadeh

    2011-01-01

    Full Text Available Bilateral dislocation of the shoulder is a rare injury. The main causes are electrical shock, extreme trauma, and epilepsy. A 25-year-old athletic-body man had sustained bilateral shoulder pain and restricted external rotation following electrical shock for five days. Although articular surface damage was about 50% in the right side and 30% in the left, it could be managed successfully by close reduction without pinning. During one-year follow-up, no recurrent dislocation or limitation of motion was seen. Closed management of medium size defect of the humeral head after posterior dislocation can be performed in cooperative and especially muscular patients.

  5. Conservative management following closed reduction of traumatic anterior dislocation of the shoulder.

    Science.gov (United States)

    Hanchard, Nigel C A; Goodchild, Lorna M; Kottam, Lucksy

    2014-04-30

    Acute anterior dislocation, which is the most common type of shoulder dislocation, usually results from an injury. Subsequently, the shoulder is less stable and is more susceptible to re-dislocation, especially in active young adults. This is an update of a Cochrane review first published in 2006. To assess the effects (benefits and harms) of conservative interventions after closed reduction of traumatic anterior dislocation of the shoulder. These might include immobilisation, rehabilitative interventions or both. We searched the Cochrane Bone, Joint and Muscle Trauma Group Specialised Register (September 2013), the Cochrane Central Register of Controlled Trials (CENTRAL) (2013, Issue 8), MEDLINE (1946 to September 2013), EMBASE (1980 to Week 38, 2013), CINAHL (1982 to September 2013), PEDro (1929 to November 2012), OTseeker (inception to November 2012) and trial registries. We also searched conference proceedings and reference lists of included studies. Randomised or quasi-randomised controlled trials comparing various conservative interventions versus control (no or sham treatment) or other conservative interventions applied after closed reduction of traumatic anterior dislocation of the shoulder. All review authors independently selected trials, assessed risk of bias and extracted data. Study authors were contacted for additional information. Results of comparable groups of trials were pooled. We included three randomised trials and one quasi-randomised trial, which involved 470 participants (371 male) with primary traumatic anterior dislocation of the shoulder reduced by various closed methods. Three studies evaluated mixed populations; in the fourth study, all participants were male and 80% were soldiers. All trials were at some risk of bias but to a differing extent. One was at high risk in all domains of the risk of bias tool, and one was at unclear or high risk in all domains; the other two trials were deemed to have predominantly low risk across all

  6. Efficacy of US-guided Hydrostatic Reduction in Children with Intussusception

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Young Min; Chung, Tae Woong; Yoon, Woong; Chang, Nam Kyu; Heo, Suk Hee; Shin, Sang Soo; Lim, Hyo Sun; Jeong, Yong Yeon; Kang, Heoung Keun [Chonnam National University Hospital, Gwangju (Korea, Republic of)

    2007-09-15

    To assess the success rate and efficacy of US-guided hydrostatic reduction in children with intussusception. We retrospectively evaluated the ultrasonographic findings and clinical features of 121 children (M:F=80:41, mean age= 18 months) who underwent US-guided hydrostatic reduction between November, 2002 and February, 2007 for the diagnosis and treatment of intussusception. The 121 patients underwent 147 procedures, including recurred cases. Successful reduction was achieved in 132 cases (89.8% success rate), as confirmed by post-procedure ultrasonography and clinical findings. Emergency operations were performed in the 10 (6.8%) cases of irreducible intussusceptions, 8 of ileocolic type and 2 of ileoileal type. Perforation occurred in 4 cases (2.7%), and seizure in 1 case during the procedure (0.7%). US-guided hydrostatic reduction is a safe and effective tool for the diagnosis and treatment of pediatric intussusception

  7. Ammonia sensor for closed-loop SCR control

    NARCIS (Netherlands)

    Wang, D.Y.; Yao, S.; Shost, M.; Yoo, J.H.; Cabush, D.; Racine, D.; Cloudt, R.P.M.; Willems, F.P.T.

    2009-01-01

    Selective Catalytic Reduction (SCR) is the dominant solution for meeting future NOx reduction regulations for heavy-duty diesel powertrains. SCR systems benefit from closed-loop control if an appropriate exhaust gas sensor were available. An ammonia sensor has recently been developed for use as a

  8. Ammonia sensor for closed-loop SCR control

    NARCIS (Netherlands)

    Wang, D.Y.; Yao, S.; Shost, M.; Yoo, J.H.; Cabush, D.; Racine, D.; Cloudt, R.P.M.; Willems, F.P.T.

    2008-01-01

    Selective Catalytic Reduction (SCR) is the dominant solution for meeting future NOx reduction regulations for heavy-duty diesel powertrains. SCR systems benefit from closed-loop control if an appropriate exhaust gas sensor were available. An ammonia sensor has recently been developed for use as a

  9. [Design and clinical application of the drilling guide in the treatment of acromioclavicular joint dislocation with closed reduction and Kirschner fixation].

    Science.gov (United States)

    Zhou, Song; Hao, Yong-qiang; Shi, Xiao-lin; Zhao, Huan-li; Gao, Kai-tuo; Sun, Jin-xu

    2011-03-01

    To investigate a drilling guide in the treatment of acromioclavicular joint dislocation with closed reduction and Kirschner fixation and explore the therapeutic effect. From June 2008 to December 2009, 36 patients with acromioclavicular joint dislocation (Tossy III) were treated with closed reduction and Kirschner fixation using a self-designed drilling guide as well as percutaneous repair of acromioclavicular joint. Among the patients, 24 patients were male and 12 patients were female,ranging in age from 20 to 61 years, averaged 38.6 years. The duration from injury to operation ranged from 3.5 to 72 h,with a mean of 15.2 h. No clavicle fracture was found in all cases. The operative time, intra-operative bleeding and therapeutic effects were observed. There were no complications including neurovascular problems. The mean operating time were 20 min,mean blood loss were about 10 ml. According to the observation of postoperative X-ray examination, all Kirschners in acromioclavicular joint were in place. All Kirschners were removed in 6 postoperative weeks. All the patients were followed up ranging from 2 to 26 months (averaged 14.3 months). According to the Karlsson standard,22 patients got an excellent result, 13 good and 1 poor. This method has following advantages: easy operation and fixation; minimum injuries to articular surface; and which would be widely used in clinical practice.

  10. Reduction of Zygomatic Arch Isolated Fracture Using Ultra Sound and Needle Marking.

    Science.gov (United States)

    Kim, Jun Sik; Park, Young Ji; Lee, Yoon Jung; Kim, Nam Gyun; Lee, Kyung Suk

    2016-12-01

    Zygomatic arch is a bony arch constituting the lateral midface, which consists of 25% of all midface fractures. There are a number of ways to evaluate the extent of zygomatic arch fracture. Some authors have reported successful treatment outcomes using ultrasound (U/S). To add to the previous methods, we have considered ways to accurately display the location of the fracture line while using U/S with 23 gauge needle marking. We introduce our method, which provided satisfactory results for reduction using a portable U/S, and it can evaluate the fracture line simultaneously when reduction of an isolated zygomatic arch fracture is necessary, and needle marking, which can easily point out the fracture line on U/S. We studied 21 patients with an isolated zygomatic arch fracture who underwent closed reduction using U/S and needle marking between 2013 and 2015. We achieved satisfactory results in all our cases with respect to reduction by using the Dingman elevator after performing a temporal approach incision, while confirming relative positioning between needle marking and zygomatic fracture at the same time, after insertion of a 23 gauge needle in the skin above the zygomatic arch fracture line parallel to it. We treated 21 patients with an isolated zygomatic arch fracture using U/S and the needle marking method, which provided satisfactory results because the extent of reduction of the fracture could be evaluated in real-time during the operation and exposure to radiation was reduced.

  11. Decreased Oxidative Stress in Male Patients with Active Phase Ankylosing Spondylitis Who Underwent Whole-Body Cryotherapy in Closed Cryochamber

    Directory of Open Access Journals (Sweden)

    Agata Stanek

    2018-01-01

    Full Text Available Objective. The aim of the study was to estimate the impact of whole body cryotherapy (WBC on oxidative stress when performed in a closed cryochamber on patients with ankylosing spondylitis (AS. Material and methods. The effect of ten WBC procedures lasting 3 minutes a day with a subsequent 60-minute session kinesiotherapy on oxidative stress in male AS patients (WBC group n=16 was investigated. To assess the disease activity, the Bath Ankylosing Spondylitis Diseases Activity Index (BASDAI and Bath Ankylosing Spondylitis Functional Index (BASFI were calculated. The WBC group was compared to the kinesiotherapy only (KT; n=16 group. The routine parameters of oxidative stress (antioxidant enzymatic and nonenzymatic antioxidant status, lipid peroxidation products, total oxidative status (TOS, and oxidative stress index (OSI were estimated one day before the beginning and one day after the completion of the research program. Results. After the completion of the treatment in the WBC group, a significant decrease of oxidative stress markers (TOS and OSI and a significant increase of total antioxidant status were observed. The erythrocyte activity of glutathione peroxidase, glutathione reductase decreased significantly in both groups, but the differences of activity of that enzymes prior to post treatment values (Δ in the KT group were significantly higher as compared to the WBC group. The activity of erythrocyte catalase and plasma ZnCu isoenzyme of superoxide dismutase showed a decreased tendency; erythrocyte total superoxide dismutase activity showed an increased tendency in the WBC group after the completion of the treatment. The BASDAI and BASFI decreased significantly in both groups, but the differences of value indexes prior to post treatment (Δ were significantly higher in the WBC than KT group. Conclusion. WBC performed in a closed cryochamber decreases oxidative stress and improves BASDAI and BASFI indexes in male patients during the active

  12. The Fate of DDH Hips Showing Cartilaginous or Fibrous Tissue-filled Joint Spaces Following Primary Reduction.

    Science.gov (United States)

    Kim, Hui Taek; Lee, Tae Hoon; Ahn, Tae Young; Jang, Jae Hoon

    Because the use of magnetic resonance imaging is still not universal for the patients with developmental dysplasia of the hip patients, orthopaedists do not generally distinguish widened joint spaces which are "empty" after primary treatment (and therefore still reducible), from those which are filled and much more difficult to treat. To date no studies have focused on the latter hips. We treated and observed the outcomes for 19 hips which showed filled joint spaces after primary treatment. We retrospectively reviewed 19 cases of developmental dysplasia of the hip: (1) who showed a widened joint space on radiographs after primary treatment; and (2) whose magnetic resonance imaging showed that the widened joint space was accompanied by acetabular cartilage hypertrophy and/or was filled with fibrous tissues. All patients were over 1 year old at the time of primary reduction (reduction was closed in 4 patients, open in 6, and open with pelvic osteotomy in 9). Thirteen patients received at least 1 secondary treatment. Final results were classified using a modified Severin classification. Final outcomes were satisfactory in 10 (52.6%) and unsatisfactory in 9 (47.4%). The widened joint spaces gradually filled with bone, resulting in a shallow acetabulum in the patients with unsatisfactory results. Of 9 patients who underwent combined pelvic osteotomy at the time of primary reduction, results were satisfactory in 6 (66.7%), whereas all patients who had only closed or open primary reduction had unsatisfactory results. Combined pelvic osteotomy at the time of primary reduction is advisable in hips with widened joint spaces. However, hips with filled joint spaces after primary treatment often have unsatisfactory results even after additional pelvic and/or femoral osteotomy. Level IV-prognostic study.

  13. A novel closed reduction with extension block and flexion block using Kirschner wires and microscrew fixation for mallet fractures.

    Science.gov (United States)

    Shimura, Haruhiko; Wakabayashi, Yoshiaki; Nimura, Akimoto

    2014-03-01

    Some patients with mallet fractures who undergo extension block pinning complain of exposed wires, which delay their return to sports and causes inconvenience while performing tasks that require the use of hands during the early postoperative period. The purpose of this retrospective study was to present and evaluate a novel surgical procedure for mallet fractures. We treated 20 patients (14 males and six females; mean age, 38.4 years; range 17-68 years) with displaced mallet fractures involving >30 % of the articular surface using the closed reduction and microscrew fixation between January 2009 and January 2012. The distal interphalangeal joint (DIP) joint was immobilized with a splint for 1-3 weeks on an individual case basis. According to Wehbe and Schneider's classification, there were 12 type IB, six type IIB, and two type IA fractures. The mean follow-up duration was 12.6 months (range 6-31 months). Bone union was achieved in all patients within a mean period of 6.8 weeks, with no incidence of infection, skin necrosis, permanent nail deformity, or secondary osteoarthritis. Only two complications-temporary nail ridging in one patient and a dorsal bump caused by the screw in one patient-were observed. Minimum postoperative displacement was observed in one patient, for whom immobilization with a splint was continued for 4 weeks. Articular incongruity was <1.0 mm in four patients and 1.0-2.0 mm in two patients. Mean DIP joint extension loss was 6.5° and mean flexion was 67.8°. The surgical outcomes were excellent in seven patients, good in nine, and fair in four according to Crawford's evaluation criteria. Our novel surgical procedure combining closed reduction with extension block and flexion block using Kirschner wires and microscrew fixation produces good clinical results with relatively few complications.

  14. Liposuction-assisted four pedicle-based breast reduction (LAFPBR): A new safer technique of breast reduction for elderly patients.

    Science.gov (United States)

    La Padula, Simone; Hersant, Barbara; Noel, Warren; Meningaud, Jean Paul

    2018-05-01

    As older people increasingly care for their body image and remain active longer, the demand for reduction mammaplasty is increasing in this population. Only a few studies of reduction mammaplasty have specifically focussed on the outcomes in elderly women. We developed a new breast reduction technique: the Liposuction-Assisted Four Pedicle-Based Breast Reduction (LAFPBR) that is especially indicated for elderly patients. The aim of this paper was to describe the LAFPBR technique and to determine whether it could be considered a safer option for elderly patients compared to the superomedial pedicle (SMP) technique. A retrospective study included sixty-two women aged 60 years and over who underwent bilateral breast reduction mammaplasty. Thirty-one patients underwent LAFPBR and 31 patients were operated using the SMP technique. Complications and patient satisfaction in both groups were analysed. Patient satisfaction was measured using a validated questionnaire: the client satisfaction questionnaire 8 (CSQ-8). The LAFPBR technique required less operating time, and avoided significant blood loss. Six minor complications were observed in SMP patients. No LAFPBR women developed a procedure-related complication. Patient satisfaction was high with a mean score of 29.65 in LAFPBR patients and 28.68 in SMP patients. The LAFPBR is an easy procedure that appears safer than SMP and results in a high satisfaction rate in elderly women. Copyright © 2018 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  15. Bilateral Breast Reduction Without Opioid Analgesics: A Comparative Study.

    Science.gov (United States)

    Parsa, Fereydoun Don; Cheng, Justin; Stephan, Brad; Castel, Nikki; Kim, Leslie; Murariu, Daniel; Parsa, Alan A

    2017-09-01

    Breast reduction has traditionally been performed under general anesthesia with adjunct opioid use. However, opioids are associated with a wide variety of adverse effects, including nausea, vomiting, constipation, postoperative sedation, dizziness, and addiction. This study compares bilateral breast reduction using a multimodal opioid-free pain management regimen vs traditional general anesthesia with adjunct opioids. A total of 83 female patients were enrolled in this study. Group 1 includes a retrospective series of 39 patients that underwent breast reduction via general anesthesia with adjunct opioid use. This series was compared to 2 prospective groups of patients who did not receive opioids either preoperatively or intraoperatively. In group 2, twenty-six patients underwent surgery under intravenous sedation and local anesthesia. In group 3, eighteen patients underwent surgery with general anesthesia. All patients in groups 2 and 3 received preoperative gabapentin and celecoxib along with infiltration of local anesthetics during the operation and prior to discharge to the Post-Anesthesia Care Unit (PACU). Primary outcome measures included the duration of surgery, time from end of operation to discharge home, postoperative opioid and antiemetic use, and unplanned postoperative hospitalizations. When compared to group 1, groups 2 and 3 experienced a shorter time from end of operation to discharge home (P opioid use (P opioid-free bilateral breast reduction either under local or general anesthesia as an outpatient. This method resulted in significantly less morbidity, use of opioids postoperatively, as well as unplanned hospital admissions compared to "traditional" breast reduction under general anesthesia with the use of opioids. 3. © 2017 The American Society for Aesthetic Plastic Surgery, Inc. Reprints and permission: journals.permissions@oup.com

  16. Overhead Bryant's Traction Does Not Improve the Success of Closed Reduction or Limit AVN in Developmental Dysplasia of the Hip.

    Science.gov (United States)

    Sucato, Daniel J; De La Rocha, Adriana; Lau, Karlee; Ramo, Brandon A

    2017-03-01

    Preoperative Bryant's overhead traction before closed reduction (CR) in developmental dysplasia of the hip (DDH) remains controversial and its success in increasing CR rates and reducing avascular necrosis (AVN) rates has not been specifically reported in a large cohort. IRB-approved retrospective study of patients (below 3 y)who were treated with attempted CR for idiopathic DDH from 1980 to 2009. Successful CR was defined as a hip that remained reduced and did not require repeat CR or open reduction. Patients were grouped by age, hip instability [Ortolani positive (reducible) vs. fixed dislocation], and Tonnis classification and rates of successful CR were compared between groups with PAVN between the traction (18%) and no-traction (8%) groups for all patients (P=0.15). In this retrospective series, preoperative Bryant's traction does not improve the rate of a successful CR for patients with DDH and has no protective effect on the development of AVN of the femoral head. These results suggest that Bryant's overhead traction may not be warranted for patients below 3 years of age with DDH. Level III.

  17. Nipple Reduction With the Chullo-Hat Technique.

    Science.gov (United States)

    Sim, Hyung-Bo; Sun, Sang-Hoon

    2015-08-01

    Although various techniques of nipple reduction have been described in the literature, many are difficult to design or have unreliable outcomes. For men, as well as women who do not plan to breastfeed, it is not necessary to apply a complicated technique that protects the lactiferous ducts. The authors introduce a simple technique for nipple reduction that has achieved consistent, reproducible results. The desired nipple length is marked, and a chullo-hat excision pattern is drawn. After infiltration of a local anesthetic solution around the nipple, excision of the excess nipple tissue is performed, comprising 2 triangular flaps. The remaining 2 pillars are approximated with 5-0 Nylon simple interrupted sutures. However, the wound is not completely closed in the central area of the nipple, which promotes the drainage of discharge. Fifty-three women (106 nipples) underwent this surgery between December 2009 and December 2013. The follow-up period ranged from 6 months to 2 years (mean, 10 months). No major complications occurred, and the scars were very inconspicuous. The postoperative appearance of nipples was consistently similar in size and shape. This simple technique was safe and effective in nipples of different sizes. The results were reliable and consistent with expectations. Although this study included only women, the authors believe that outcomes would be successful in men as well. 4 Therapeutic. © 2015 The American Society for Aesthetic Plastic Surgery, Inc. Reprints and permission: journals.permissions@oup.com.

  18. Acute effects on pulmonary function in young healthy adults exposed to traffic-related air pollution in semi-closed transport hub in Beijing.

    Science.gov (United States)

    Huang, Jing; Deng, Furong; Wu, Shaowei; Zhao, Yan; Shima, Masayuki; Guo, Bin; Liu, Qichen; Guo, Xinbiao

    2016-09-01

    Transport hub is an important part of urban comprehensive transportation system. Traffic-related air pollution can reach high level because of difficulty of diffusion and increase of emission in transport hub. However, whether exposure in this semi-closed traffic micro-environment causes acute changes in pulmonary function of commuters still needs to be explored. Forty young healthy adults participated in this randomized, crossover study. Each participant underwent 2 h exposure in a designated transport hub and, on a separate occasion, in an appointed park. Personal exposures to fine particulate matter (PM 2.5 ), black carbon (BC) and carbon monoxide (CO) were measured. Forced expiratory volume in 1 s (FEV 1 ) and peak expiratory flow (PEF) were assessed pre-, during and post-exposure. Mixed linear models were used to analyze the pulmonary effects of traffic-related air pollutants. Participants had significantly higher exposures to PM 2.5 , BC and CO in the transport hub than in the park. Exposure in transport hub induced significant reductions in FEV 1 and PEF compared with the park during exposure 1 and 2 h. The reductions were significant associated with traffic-related air pollutants. For instance, per 10 μg/m 3 increment in PM 2.5 was associated with -0.15 % (95 % CI -0.28, -0.02 %) reduction in FEV 1 during exposure 2 h. However, effects became attenuate after 2 h exposure. Short-term exposure in transport hub had acute reduction effects on pulmonary function. More attention should be paid to the health effects of exposure in the semi-closed traffic micro-environment.

  19. Evolution of elderly patients who underwent cardiac surgery with cardiopulmonary bypass

    Directory of Open Access Journals (Sweden)

    Alain Moré Duarte

    2016-01-01

    Full Text Available Introduction: There is a steady increase in the number of elderly patients with severe cardiovascular diseases who require a surgical procedure to recover some quality of life that allows them a socially meaningful existence, despite the risks.Objectives: To analyze the behavior of elderly patients who underwent cardiac surgery with cardiopulmonary bypass.Method: A descriptive, retrospective, cross-sectional study was conducted with patients over 65 years of age who underwent surgery at the Cardiocentro Ernesto Che Guevara, in Santa Clara, from January 2013 to March 2014.Results: In the study, 73.1% of patients were men; and there was a predominance of subjects between 65 and 70 years of age, accounting for 67.3%. Coronary artery bypass graft was the most prevalent type of surgery and had the longest cardiopulmonary bypass times. Hypertension was present in 98.1% of patients. The most frequent postoperative complications were renal dysfunction and severe low cardiac output, with 44.2% and 34.6% respectively.Conclusions: There was a predominance of men, the age group of 65 to 70 years, hypertension, and patients who underwent coronary artery bypass graft with prolonged cardiopulmonary bypass. Renal dysfunction was the most frequent complication.

  20. Pseudo tumors of the lung after lung volume reduction surgery.

    Science.gov (United States)

    Oey, Inger F; Jeyapalan, Kanagaratnam; Entwisle, James J; Waller, David A

    2004-03-01

    We describe 2 patients who underwent lung volume reduction surgery, who postoperatively had computed tomographic scans that showed symptomatic mass lesions suggestive of malignancy and an inhaled foreign body. Investigations excluded these conditions with the remaining likely diagnosis of pseudotumor secondary to buttressing material. These potential sequelae of lung volume reduction surgery should be recognized in follow-up investigations.

  1. Close-Spaced High Temperature Knudsen Flow.

    Science.gov (United States)

    1984-06-15

    study of discharge processes in Knudsen mode (collisionless), thermionic energy converters. Areas of research involve mechanism for reducing the...The mechanisms we have chosen to study are: reduction of space-charge through a very close inter- electrode gap (less than 10 microns); transport and...AD-AI4U 471 :NNTIM R~ A Rl M ,i; ,11 , i J)W R8 1070 1 I~ "i E~Hhhh IIt Ll ~ : RASOR ASSOCIATES, INC.- AFOSR.TR. 84-1070 NSR-22-2 CLOSE -SPACED HIGH

  2. The Effect of Carbonaceous Reductant Selection on Chromite Pre-reduction

    Science.gov (United States)

    Kleynhans, E. L. J.; Beukes, J. P.; Van Zyl, P. G.; Bunt, J. R.; Nkosi, N. S. B.; Venter, M.

    2017-04-01

    Ferrochrome (FeCr) production is an energy-intensive process. Currently, the pelletized chromite pre-reduction process, also referred to as solid-state reduction of chromite, is most likely the FeCr production process with the lowest specific electricity consumption, i.e., MWh/t FeCr produced. In this study, the effects of carbonaceous reductant selection on chromite pre-reduction and cured pellet strength were investigated. Multiple linear regression analysis was employed to evaluate the effect of reductant characteristics on the aforementioned two parameters. This yielded mathematical solutions that can be used by FeCr producers to select reductants more optimally in future. Additionally, the results indicated that hydrogen (H)- (24 pct) and volatile content (45.8 pct) were the most significant contributors for predicting variance in pre-reduction and compressive strength, respectively. The role of H within this context is postulated to be linked to the ability of a reductant to release H that can induce reduction. Therefore, contrary to the current operational selection criteria, the authors believe that thermally untreated reductants ( e.g., anthracite, as opposed to coke or char), with volatile contents close to the currently applied specification (to ensure pellet strength), would be optimal, since it would maximize H content that would enhance pre-reduction.

  3. Serum Zn levels in dysphagic patients who underwent endoscopic gastrostomy for long term enteral nutrition

    OpenAIRE

    Adriana Santos, Carla; Fonseca, Jorge; Brito, José; Fernandes, Tânia; Gonçalves, Luísa; Sousa Guerreiro, António

    2014-01-01

    Background and aims: Dysphagic patients who underwent endoscopic gastrostomy (PEG) usually present protein-energy malnutrition, but little is known about micronutrient malnutrition. The aim of the present study was the evaluation of serum zinc in patients who underwent endoscopic gastrostomy and its relationship with serum proteins, whole blood zinc, and the nature of underlying disorder. Methods: From patients that underwent gastrostomy a blood sample was obtained minutes before the procedur...

  4. Pricing, Carbon Emission Reduction, Low-Carbon Promotion and Returning Decision in a Closed-Loop Supply Chain under Vertical and Horizontal Cooperation.

    Science.gov (United States)

    Li, Hui; Wang, Chuanxu; Shang, Meng; Ou, Wei

    2017-11-01

    In this paper, we examine the influences of vertical and horizontal cooperation models on the optimal decisions and performance of a low-carbon closed-loop supply chain (CLSC) with a manufacturer and two retailers, and study optimal operation in the competitive pricing, competitive the low-carbon promotion, the carbon emission reduction, the used-products collection and the profits. We consider the completely decentralized model, M-R vertical cooperation model, R-R horizontal cooperation model, M-R-R vertical and horizontal cooperation model and completely centralized model, and also identify the optimal decision results and profits. It can be observed from a systematic comparison and numerical analysis that the completely centralized model is best in all optimal decision results among all models. In semi-cooperation, the M-R vertical cooperation model is positive, the R-R horizontal cooperation model is passive, and the positivity of the M-R-R vertical and horizontal cooperation model decreases with competitive intensity increasing in the used-products returning, carbon emissions reduction level, low-carbon promotion effort and the profits of the manufacturer and the entire supply chain.

  5. The percutaneous use of a pointed reduction clamp during intramedullary nailing of distal third tibial shaft fractures.

    Science.gov (United States)

    Forman, Jordanna M; Urruela, Adriana M; Egol, Kenneth A

    2011-12-01

    The purpose of this retrospective chart and radiographic review is to describe an effective reduction technique during intramedullary nailing of distal metaphyseal tibia fractures with the use of a pointed percutaneous clamp. Between 2007 and 2010, 100 patients who sustained 102 tibia fractures were definitively treated with an intramedullary nail at one of two medical centers. Diaphyseal fractures and injuries with an associated disruption of the distal tibiofibular joint were excluded from our study. A total of 27 patients with 27 distal metaphyseal tibia fractures (OTA types 42-A, 43-A, and 43-B) were included. All 27 patients underwent IM nailing of their fractures with anatomic reduction achieved using a percutaneously placed pointed reduction clamp prior to insertion of the IM implant. Fracture alignment and angular deformity was assessed using goniometric measurement functions on the PACS system (GE, Waukeshau, WI) obtained from preoperative and postoperative anteroposterior and lateral images for all subjects. Malalignment was defined as more than 5 degrees of angulation in any plane. Fourteen of the fractures were classified as OTA 42-A, 9 were OTA 43-A, and 4 were OTA 43-B. Analysis of post-closed reduction, preoperative anteroposterior radiographs revealed a mean of 7.9 degrees of coronal plane (range: 0.9 degrees-26 degrees) angulation. Post closed reduction preoperative lateral radiographs revealed a mean of 6.8 degrees sagittal plane (range: 0 degrees-24.6 degrees) angulation. Postoperative anteroposterior and lateral radiographs showed the distal segment returned to its anatomical alignment with a mean angulation of 0.5 degrees (range, 0 degrees-3.5 degrees) and 0.7 degrees (range, 0 degrees-4.2 degrees) of varus/ valgus and apex anterior/posterior angulation, respectively. These results showed an acceptable postopertative alignment in all 27 distal third fractures. No intra-operative or postoperative complications were noted in the study group. This

  6. Heavy-duty explosively operated pulsed opening and closing switches

    International Nuclear Information System (INIS)

    Peterson, D.R.; Price, J.H.; Upshaw, J.L.; Weldon, W.F.; Zowarka, R.C.; Gully, J.H.; Spann, M.L.

    1991-01-01

    This paper discusses improvements to heavy duty, explosively operated, opening and closing switches to reduce component cost, installation cost, and turnaround time without sacrificing reliability. Heavy duty opening and closing switches operated by small explosive charges (50 g or less) are essential to operation of the 60 MJ Balcones power supply. The six independent modules - a 10 MJ homopolar generator (HPG) and a 6 μH storage inductor - can be discharged sequentially, a valuable feature for shaping the current pulse delivered to loads such as high-energy railguns. Each delayed inductor must be isolated from the railgun circuit with a heavy duty closing switch capable of carrying megampere currents to millisecond duration. Similar closing switches are used to crowbar the railgun as the projectile approaches the muzzle: noise reduction, reduction of muzzle arc damage, and reduction of post-launch perturbation of projectile flight. The switches - both opening and closing - are characterized by microhm resistance in the closed state. Current is carried in metallic conductors. Metal-to-metal seams which carry current are maintained in uniform high pressure contact. Efficient switching is crucial to efficient conversion: rotor kinetic energy to stored inductive energy with ∼50% efficiency, stored inductive energy to projectile kinetic energy with ∼30% efficiency. The switches must operate with a precision and repeatability of 10 -5 s, readily achievable with explosives. The opening switches must be structurally and thermally capable of carrying megampere currents for more than 100 ms (∼10 5 C) and develop 10 kV upon opening, stay open for 10 - 2 s, and safely and reliably dissipate megajoules of inductive energy in the event of a fault, a failure of the switch to operate or an attempt to commutate into an open circuit

  7. Megarectumsigma underwent surgery for chronic faecal impact action

    International Nuclear Information System (INIS)

    Canessa, C.; Gomez del Valle, M.; Caraballo, M.

    2002-01-01

    Seven patients with megarectumsigma underwent surgery for chronic faecal impaction,reviewing clinical diagnosis, aetiology and medical and surgical management.It is suggested medical management of chronic faecal impaction trying to achieve elective surgery.The curative surgery should include the resection of all pathologic bowel, but in Duhamel procedure and its modifications distal rectal tran section should be at the peritoneal reflection.Habr-Gama modification has shown to be technically easier and it has been communicated good functional results.Local unfavourable conditions may be resolve by staged surgery,which allows outline definitive bowel reconstruction after functional assessment

  8. A randomized trial of pneumatic reduction versus hydrostatic reduction for intussusception in pediatric patients.

    Science.gov (United States)

    Xie, Xiaolong; Wu, Yang; Wang, Qi; Zhao, Yiyang; Chen, Guobin; Xiang, Bo

    2017-08-08

    Data of randomly controlled trials comparing the hydrostatic and pneumatic reduction for intussusception in pediatric patients as initial therapy are lacking. The aim of this study was to conduct a randomly controlled trial to compare the effectiveness and safety of the hydrostatic and pneumatic reduction techniques. All intussusception patients who visited West China Hospital of Sichuan University from January 2014 to December 2015 were enrolled in this study in which they underwent pneumatic reduction or hydrostatic reduction. Patients were randomized into ultrasound-guided hydrostatic or X-ray-guided pneumatic reduction group. The data collected includes demographic data, symptoms, signs, and investigations. The primary outcome of the study was the success rate of reduction. And the secondary outcomes of the study were the rates of intestinal perforations and recurrence. A total of 124 children with intussusception who had met the inclusion criteria were enrolled. The overall success rate of this study was 90.32%. Univariable analysis showed that the success rate of hydrostatic reduction with normal saline (96.77%) was significantly higher than that of pneumatic reduction with air (83.87%) (p=0.015). Perforation after reduction was found in only one of the pneumatic reduction group. The recurrence rate of intussusception in the hydrostatic reduction group was 4.84% compared with 3.23% of pneumatic reduction group. Our study found that ultrasound-guided hydrostatic reduction is a simple, safe and effective nonoperative treatment for pediatric patients suffering from intussusceptions, and should be firstly adopted in the treatment of qualified patients. Therapeutic study TYPE OF STUDY: Prospective study. Copyright © 2017 Elsevier Inc. All rights reserved.

  9. Does fluoroscopy improve outcomes in paediatric forearm fracture reduction?

    International Nuclear Information System (INIS)

    Menachem, S.; Sharfman, Z.T.; Perets, I.; Arami, A.; Eyal, G.; Drexler, M.; Chechik, O.

    2016-01-01

    Aim: To compare the radiographic results of paediatric forearm fracture reduced with and without fluoroscopic enhancement to investigate whether fractures reduced under fluoroscopic guidance would have smaller residual deformities and lower rates of re-reduction and surgery. Materials and methods: A retrospective cohort analysis was conducted comparing paediatric patients with acute forearm fracture in two trauma centres. Demographics and radiographic data from paediatric forearm fractures treated in Trauma Centre A with the aid of a C-arm fluoroscopy were compared to those treated without fluoroscopy in Trauma Centre B. Re-reduction, late displacement, post-reduction deformity, and need for surgical intervention were compared between the two groups. Results: The cohort included 229 children (175 boys and 54 girls, mean age 9.41±3.2 years, range 1–16 years) with unilateral forearm fractures (83 manipulated with fluoroscopy and 146 without). Thirty-four (15%) children underwent re-reduction procedures in the emergency department. Fifty-three (23%) children had secondary displacement in the cast, of which 18 were operated on, 20 were re-manipulated, and the remaining 15 were kept in the cast with an acceptable deformity. Twenty-nine additional children underwent operation for reasons other than secondary displacement. There were no significant differences in re-reduction and surgery rates or in post-reduction deformities between the two groups. Conclusion: The use of fluoroscopy during reduction of forearm fractures in the paediatric population apparently does not have a significant effect on patient outcomes. Reductions performed without fluoroscopy were comparably accurate in correcting deformities in both coronal and sagittal planes. - Highlights: • Compared outcomes of pediatric forearm fracture reduction with and without fluoroscopy. • The use of fluoroscopy during reduction of forearm fractures in the pediatric population apparently does not have a

  10. Pricing, Carbon Emission Reduction, Low-Carbon Promotion and Returning Decision in a Closed-Loop Supply Chain under Vertical and Horizontal Cooperation

    Science.gov (United States)

    Li, Hui; Wang, Chuanxu; Shang, Meng; Ou, Wei

    2017-01-01

    In this paper, we examine the influences of vertical and horizontal cooperation models on the optimal decisions and performance of a low-carbon closed-loop supply chain (CLSC) with a manufacturer and two retailers, and study optimal operation in the competitive pricing, competitive the low-carbon promotion, the carbon emission reduction, the used-products collection and the profits. We consider the completely decentralized model, M-R vertical cooperation model, R-R horizontal cooperation model, M-R-R vertical and horizontal cooperation model and completely centralized model, and also identify the optimal decision results and profits. It can be observed from a systematic comparison and numerical analysis that the completely centralized model is best in all optimal decision results among all models. In semi-cooperation, the M-R vertical cooperation model is positive, the R-R horizontal cooperation model is passive, and the positivity of the M-R-R vertical and horizontal cooperation model decreases with competitive intensity increasing in the used-products returning, carbon emissions reduction level, low-carbon promotion effort and the profits of the manufacturer and the entire supply chain. PMID:29104268

  11. Pricing, Carbon Emission Reduction, Low-Carbon Promotion and Returning Decision in a Closed-Loop Supply Chain under Vertical and Horizontal Cooperation

    Directory of Open Access Journals (Sweden)

    Hui Li

    2017-11-01

    Full Text Available In this paper, we examine the influences of vertical and horizontal cooperation models on the optimal decisions and performance of a low-carbon closed-loop supply chain (CLSC with a manufacturer and two retailers, and study optimal operation in the competitive pricing, competitive the low-carbon promotion, the carbon emission reduction, the used-products collection and the profits. We consider the completely decentralized model, M-R vertical cooperation model, R-R horizontal cooperation model, M-R-R vertical and horizontal cooperation model and completely centralized model, and also identify the optimal decision results and profits. It can be observed from a systematic comparison and numerical analysis that the completely centralized model is best in all optimal decision results among all models. In semi-cooperation, the M-R vertical cooperation model is positive, the R-R horizontal cooperation model is passive, and the positivity of the M-R-R vertical and horizontal cooperation model decreases with competitive intensity increasing in the used-products returning, carbon emissions reduction level, low-carbon promotion effort and the profits of the manufacturer and the entire supply chain.

  12. 7 CFR 1779.80 - Interest rate changes after loan closing.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 12 2010-01-01 2010-01-01 false Interest rate changes after loan closing. 1779.80....80 Interest rate changes after loan closing. (a) General. Subject to the restrictions below, the borrower, lender, and holder (if any) may collectively effect a permanent reduction in the interest rate on...

  13. A closed dorsolateral dislocation of PIP joint of the fourth toe-a case report and review of literature

    Directory of Open Access Journals (Sweden)

    Prof. Giris Kumar Singh

    2009-01-01

    Full Text Available Interphalangeal (IP joint dislocations of the toes are uncommon lesions. We present here a case of closed dorsolateral dislocation of proximal interphalangeal (PIP joint of the fourth toe. Closed reduction and buddy strapping have been done with middle toe for two weeks under digital block. There was painless full range of movement after 2 weeks. We propose that attempt of closed reduction must be given adequately under anesthesia before proceeding for open reduction.

  14. Effect of closed drainage system on edema and ecchymosis following rhinoplasty: a randomized clinical trial

    Directory of Open Access Journals (Sweden)

    Kamran Asadi

    2013-08-01

    Full Text Available Background: The aim of this study was to minimize edema and ecchymosis following rhinoplasty through a closed drainage system to address concealed hemorrhage.Methods: This study was designed as a prospective، double blinded, randomized contr-olled study. Fifty one patients who underwent septorhinoplasty were included in this study and divided in two groups. In group A, a closed drainage system was applied in the most dependent posterior septal area following septal harvesting. Concealed bloody secretions were drained out of mouth in a vacutaner tube during three concecutive post operative days. In control group, group B, exactly the same classic rhinoplasty opera-tion by the same surgeon was done as for study group except omitting the closed drainage system. Degree of supra-tip and eyelid edema was evaluated on post operative days through photographic and software image analysis. Edema and ecchymosis rating of eyelids and ecchymosis of paranasal and cheek area done based on photographic analysis by independent plastic surgeons using a defined grading system.Results: Eyelid ecchymosis was reduced significantly on post operative day 14 in the study group (P=0.03. Ecchymosis of paranasal and check was reduced considerably likewise on days 7 and 14 in group A using Mann-Whitney test (P=0.03. There was no significant deference regarding supra tip edema on post operative days. The same hold true for the eyelids edema.Conclusion: Significant decrement observed in eyelids ecchymosis on day 14 and para-nasal and cheek ecchymosis on postoperative days 7 and 14 in study group. There were no positive effects regarding supra tip and eyelid edema reduction using closed drainage system to evacuate concealed haemorrhage in posterior septum space. There could be different etio-pathologies for two common morbidities following rhinoplasty that should be addressed separately.

  15. Acute myocardial infarctation in patients with critical ischemia underwent lower limb revascularization

    Directory of Open Access Journals (Sweden)

    Esdras Marques Lins

    2013-12-01

    Full Text Available BACKGROUND: Atherosclerosis is the main cause of peripheral artery occlusive disease (PAOD of the lower limbs. Patients with PAOD often also have obstructive atherosclerosis in other arterial sites, mainly the coronary arteries. This means that patients who undergo infrainguinal bypass to treat critical ischemia have a higher risk of AMI. There are, however, few reports in the literature that have assessed this risk properly. OBJECTIVE: The aim of this study was to determine the incidence of acute myocardial infarction in patients who underwent infrainguinal bypass to treat critical ischemia of the lower limbs caused by PAOD. MATERIAL AND METHODS: A total of 64 patients who underwent 82 infrainguinal bypass operations, from February 2011 to July 2012 were studied. All patients had electrocardiograms and troponin I blood assays during the postoperative period (within 72 hours. RESULTS: There were abnormal ECG findings and elevated blood troponin I levels suggestive of AMI in five (6% of the 82 operations performed. All five had conventional surgery. The incidence of AMI as a proportion of the 52 conventional surgery cases was 9.6%. Two patients died. CONCLUSION: There was a 6% AMI incidence among patients who underwent infrainguinal bypass due to PAOD. Considering only cases operated using conventional surgery, the incidence of AMI was 9.6%.

  16. Deep sedation during pneumatic reduction of intussusception.

    Science.gov (United States)

    Ilivitzki, Anat; Shtark, Luda Glozman; Arish, Karin; Engel, Ahuva

    2012-05-01

    Pneumatic reduction of intussusception under fluoroscopic guidance is a routine procedure. The unsedated child may resist the procedure, which may lengthen its duration and increase the radiation dose. We use deep sedation during the procedure to overcome these difficulties. The purpose of this study was to summarize our experience with deep sedation during fluoroscopic reduction of intussusception and assess the added value and complication rate of deep sedation. All children with intussusception who underwent pneumatic reduction in our hospital between January 2004 and June 2011 were included in this retrospective study. Anesthetists sedated the children using propofol. The fluoroscopic studies, ultrasound (US) studies and the childrens' charts were reviewed. One hundred thirty-one attempted reductions were performed in 119 children, of which 121 (92%) were successful and 10 (8%) failed. Two perforations (1.5%) occurred during attempted reduction. Average fluoroscopic time was 1.5 minutes. No complication to sedation was recorded. Deep sedation with propofol did not add any complication to the pneumatic reduction. The fluoroscopic time was short. The success rate of reduction was high,raising the possibility that sedation is beneficial, possibly by smooth muscle relaxation.

  17. A plasma switch synchronous closing operations in high-voltage networks

    International Nuclear Information System (INIS)

    Mourente, P.

    1984-01-01

    Overvoltages and overcurrent arising in energizing or in fast reclosing operations are a concerning problem in high-voltage networks. Reduction of overvoltages and overcurrents is possible using the synchronous closing technique. Some attempts have been done to perform the synchronous closing with conventional circuit-breakers. But since the requirements to synchronous closing and to current interruption are very contradictory this technique is not yet a common practice. Three simple cases may be used as examples to show the benefits of synchronous closing; energizaton of grounded star capacitor bank; back-to-back switching of large capacitor banks; and fast reclosing on transmission lines

  18. Alkaline Fe(III) reduction by a novel alkali-tolerant Serratia sp. isolated from surface sediments close to Sellafield nuclear facility, UK.

    Science.gov (United States)

    Thorpe, Clare L; Morris, Katherine; Boothman, Christopher; Lloyd, Jonathan R

    2012-02-01

    Extensive denitrification resulted in a dramatic increase in pH (from 6.8 to 9.5) in nitrate-impacted, acetate-amended sediment microcosms containing sediment representative of the Sellafield nuclear facility, UK. Denitrification was followed by Fe(III) reduction, indicating the presence of alkali-tolerant, metal-reducing bacteria. A close relative (99% 16S rRNA gene sequence homology) to Serratia liquefaciens dominated progressive enrichment cultures containing Fe(III)-citrate as the sole electron acceptor at pH 9 and was isolated aerobically using solid media. The optimum growth conditions for this facultatively anaerobic Serratia species were investigated, and it was capable of metabolizing a wide range of electron acceptors including oxygen, nitrate, FeGel, Fe-NTA and Fe-citrate and electron donors including acetate, lactate, formate, ethanol, glucose, glycerol and yeast extract at an optimum pH of c. 6.5 at 20 °C. The alkali tolerance of this strain extends the pH range of highly adaptable Fe(III)-reducing Serratia species from mildly acidic pH values associated with acid mine drainage conditions to alkali conditions representative of subsurface sediments stimulated for extensive denitrification and metal reduction. © 2011 Federation of European Microbiological Societies. Published by Blackwell Publishing Ltd. All rights reserved.

  19. Reduction of emission level in approach signals of greater mouse-eared bats (Myotis myotis): No evidence for a closed loop control system for intensity compensation.

    Science.gov (United States)

    Budenz, Tobias; Denzinger, Annette; Schnitzler, Hans-Ulrich

    2018-01-01

    Bats lower the emission SPL when approaching a target. The SPL reduction has been explained by intensity compensation which implies that bats adjust the emission SPL to perceive the retuning echoes at the same level. For a better understanding of this control mechanism we recorded the echolocation signals of four Myotis myotis with an onboard microphone when foraging in the passive mode for rustling mealworms offered in two feeding dishes with different target strength, and determined the reduction rate for the emission SPL and the increase rate for the SPL of the returning echoes. When approaching the dish with higher target strength bats started the reduction of the emission SPL at a larger reaction distance (1.05 ± 0.21 m) and approached it with a lower reduction rate of 7.2 dB/halving of distance (hd), thus producing a change of echo rate at the ears of + 4 dB/hd. At the weaker target reaction distance was shorter (0.71 ± 0.24 m) and the reduction rate (9.1 dB/hd) was higher, producing a change of echo rate of-1.2 dB/hd. Independent of dish type, bats lowered the emission SPL by about 26 dB on average. In one bat where the echo SPL from both targets could be measured, the reduction of emission SPL was triggered when the echo SPL surpassed a similar threshold value around 41-42 dB. Echo SPL was not adjusted at a constant value indicating that Myotis myotis and most likely all other bats do not use a closed loop system for intensity compensation when approaching a target of interest. We propose that bats lower the emission SPL to adjust the SPL of the perceived pulse-echo-pairs to the optimal auditory range for the processing of range information and hypothesize that bats use flow field information not only to control the reduction of the approach speed to the target but also to control the reduction of emission SPL.

  20. Phytophthora megakarya and P. palmivora, closely related causal agents of cacao black pod rot, underwent increases in genome sizes and gene numbers by different mechanisms

    Science.gov (United States)

    Phytophthora megakarya (Pmeg) and P. palmivora (Ppal) are closely related species causing black pod rot of cacao. While Ppal is a cosmopolitan plant pathogen, cacao is the only known host of importance for Pmeg. Pmeg is more virulent on cacao than Ppal. Therefore, we have sequenced both the Pmeg and...

  1. Effect of using pump on postoperative pleural effusion in the patients that underwent CABG

    Directory of Open Access Journals (Sweden)

    Mehmet Özülkü

    2015-08-01

    Full Text Available Abstract Objective: The present study investigated effect of using pump on postoperative pleural effusion in patients who underwent coronary artery bypass grafting. Methods: A total of 256 patients who underwent isolated coronary artery bypass grafting surgery in the Cardiovascular Surgery clinic were enrolled in the study. Jostra-Cobe (Model 043213 105, VLC 865, Sweden heart-lung machine was used in on-pump coronary artery bypass grafting. Off-pump coronary artery bypass grafting was performed using Octopus and Starfish. Proximal anastomoses to the aorta in both on-pump and off-pump techniques were performed by side clamps. The patients were discharged from the hospital between postoperative day 6 and day 11. Results: The incidence of postoperative right pleural effusion and bilateral pleural effusion was found to be higher as a count in Group 1 (on-pump as compared to Group 2 (off-pump. But the difference was not statistically significant [P>0.05 for right pleural effusion (P=0.893, P>0.05 for bilateral pleural effusion (P=0.780]. Left pleural effusion was encountered to be lower in Group 2 (off-pump. The difference was found to be statistically significant (P<0.05, P=0.006. Conclusion: Under the light of these results, it can be said that left pleural effusion is less prevalent in the patients that underwent off-pump coronary artery bypass grafting when compared to the patients that underwent on-pump coronary artery bypass grafting.

  2. Closed-Loop Control of Humidification for Artifact Reduction in Capacitive ECG Measurements.

    Science.gov (United States)

    Leicht, Lennart; Eilebrecht, Benjamin; Weyer, Soren; Leonhardt, Steffen; Teichmann, Daniel

    2017-04-01

    Recording biosignals without the need for direct skin contact offers new opportunities for ubiquitous health monitoring. Electrodes with capacitive coupling have been shown to be suitable for the monitoring of electrical potentials on the body surface, in particular ECG. However, due to triboelectric charge generation and motion artifacts, signal and thus diagnostic quality is inferior to galvanic coupling. Active closed-loop humidification of capacitive electrodes is proposed in this work as a new concept to improve signal quality. A capacitive ECG recording system integrated into a common car seat is presented. It can regulate the micro climate at the interface of electrode and patient by actively dispensing water vapour and monitoring humidity in a closed-loop approach. As a regenerative water reservoir, silica gel is used. The system was evaluated with respect to subjective and objective ECG signal quality. Active humidification was found to have a significant positive effect in case of previously poor quality. Also, it had no diminishing effect in case of already good signal quality.

  3. An indigenous method for closed reduction of pediatric mandibular parasymphysis fracture

    OpenAIRE

    Kumar, Naresh; Singh, Akhilesh Kumar; Pandey, Arun; Verma, Vishal

    2015-01-01

    Mandibular fractures in children are very rare as compared to adults due to protected anatomic features of child and less exposure to road traffic accidents. Management becomes complicated due to inherent dynamic nature, instability of mixed dentition and fear of surgery. Conservative management can be done with the help of acrylic cap splints along with circum-mandibular wiring, intermaxillary fixation with eyelet wires, arch wires or open reduction and internal fixation with bio-resorbable ...

  4. Metallothermic reduction of molybdate

    International Nuclear Information System (INIS)

    Mukherjee, T.K.; Bose, D.K.

    1987-01-01

    This paper gives a brief account of the investigations conducted so far on metallothermic reduction of high grade molybdenite with particular emphasis on the work carried out in Bhabha Atomic Research Centre. Based on thermochemical considerations, the paper first introduces a number of metallic reductants suitable for use in metallothermic reduction of molybdenite. Aluminium, sodium and tin are found to be suitable reducing agents and very rightly they have found most applications in the research and development efforts on metallothermic reduction of molybdenite. The reduction with tin was conducted on fairly large scale both in vacuum and hydrogen atmosphere. The reaction was reported to be invariant depending mainly on the reduction temperature and a temperature of the order of 1250deg to 1300degC was required for good metal recovery. In comparison to tin, aluminothermic reduction of molybdenite was studied more extensively and it was conducted in closed bomb, vacuum and also in open atmosphere. In aluminothermic reduction, the influence of amount of reducing agent, amount of heat booster, preheating temperature and charging procedure on these metal yield was studied in detail. The reduction generally yielded massive molybdenum metal contaminated with aluminium as the major impurity element. Efforts were made to purify the reduced metal by arc melting, electron beam melting and molten salt electrorefining. 9 refs. (author)

  5. Orthopaedic resident preparedness for closed reduction and pinning of pediatric supracondylar fractures is improved by e-learning: a multisite randomized controlled study.

    Science.gov (United States)

    Hearty, Thomas; Maizels, Max; Pring, Maya; Mazur, John; Liu, Raymond; Sarwark, John; Janicki, Joseph

    2013-09-04

    There is a need to provide more efficient surgical training methods for orthopaedic residents. E-learning could possibly increase resident surgical preparedness, confidence, and comfort for surgery. Using closed reduction and pinning of pediatric supracondylar humeral fractures as the index case, we hypothesized that e-learning could increase resident knowledge acquisition for case preparation in the operating room. An e-learning surgical training module was created on the Computer Enhanced Visual Learning platform. The module provides a detailed and focused road map of the procedure utilizing a multimedia format. A multisite prospective randomized controlled study design compared residents who used a textbook for case preparation (control group) with residents who used the same textbook plus completed the e-learning module (test group). All subjects completed a sixty-question test on the theory and methods of the case. After completion of the test, the control group then completed the module as well. All subjects were surveyed on their opinion regarding the effectiveness of the module after performing an actual surgical case. Twenty-eight subjects with no previous experience in this surgery were enrolled at four academic centers. Subjects were randomized into two equal groups. The test group scored significantly better (p < 0.001) and demonstrated competence on the test compared with the control group; the mean correct test score (and standard deviation) was 90.9% ± 6.8% for the test group and 73.5% ± 6.4% for the control group. All residents surveyed (n = 27) agreed that the module is a useful supplement to traditional methods for case preparation and twenty-two of twenty-seven residents agreed that it reduced their anxiety during the case and improved their attention to surgical detail. E-learning using the Computer Enhanced Visual Learning platform significantly improved preparedness, confidence, and comfort with percutaneous closed reduction and pinning of a

  6. The concept and method of closed reduction and internal fixation: a new approach for the treatment of simple zygoma fractures.

    Science.gov (United States)

    Uda, Hirokazu; Kamochi, Hideaki; Sugawara, Yasushi; Sarukawa, Syunji; Sunaga, Ataru

    2013-11-01

    The authors have developed a new minimally invasive surgical procedure for simple zygoma fractures, a closed reduction and internal fixation method, that uses a cannulated cortical screw system. From 2007 to 2012, 42 selected patients with simple zygoma fractures without ocular problems or shear at the zygomatic frontal portion were treated with this method. The mean age of the patients was 33 years (range, 13 to 77 years). The authors achieved good repositioning, equivalent to results achieved with conventional procedures in all cases. No notable complication occurred except for minor infection in two cases. Mean operative time was 32 minutes (range, 19 to 58 minutes). Postoperative relapse was found only in the posterior direction (poperative time, less effect on soft tissue, maintenance of bone healing potential, and decreased postoperative pain and swelling. The authors concluded that this method has the potential to become a future surgical procedure for simple zygoma fractures. Therapeutic, IV.

  7. Outcome of Patients Underwent Emergency Department Thoracotomy and Its Predictive Factors

    Directory of Open Access Journals (Sweden)

    Shahram Paydar

    2014-08-01

    Full Text Available Introduction: Emergency department thoracotomy (EDT may serve as the last survival chance for patients who arrive at hospital in extremis. It is considered as an effective tool for improvement of traumatic patients’ outcome. The present study was done with the goal of assessing the outcome of patients who underwent EDT and its predictive factors. Methods: In the present study, medical charts of 50 retrospective and 8 prospective cases underwent emergency department thoracotomy (EDT were reviewed during November 2011 to June 2013. Comparisons between survived and died patients were performed by Mann-Whitney U test and the predictive factors of EDT outcome were measured using multivariate logistic regression analysis. P < 0.05 considered statistically significant. Results: Fifty eight cases of EDT were enrolled (86.2% male. The mean age of patients was 43.27±19.85 years with the range of 18-85. The mean time duration of CPR was recorded as 37.12±12.49 minutes. Eleven cases (19% were alive to be transported to OR (defined as ED survived. The mean time of survival in ED survived patients was 223.5±450.8 hours. More than 24 hours survival rate (late survived was 6.9% (4 cases. Only one case (1.7% survived to discharge from hospital (mortality rate=98.3%. There were only a significant relation between ED survival and SBP, GCS, CPR duration, and chest trauma (p=0.04. The results demonstrated that initial SBP lower than 80 mmHg (OR=1.03, 95% CI: 1.001-1.05, p=0.04 and presence of chest trauma (OR=2.6, 95% CI: 1.75-3.16, p=0.02 were independent predictive factors of EDT mortality. Conclusion: The findings of the present study showed that the survival rate of trauma patients underwent EDT was 1.7%. In addition, it was defined that falling systolic blood pressure below 80 mmHg and blunt trauma of chest are independent factors that along with poor outcome.

  8. Impact of Open Reduction on Surgical Strategies for Missed Monteggia Fracture in Children.

    Science.gov (United States)

    Park, Hoon; Park, Kwang Won; Park, Kun Bo; Kim, Hyun Woo; Eom, Nam Kyu; Lee, Dong Hoon

    2017-07-01

    The aims of this study were to review our cases of missed Monteggia fracture treated by open reduction of the radial head with or without ulnar osteotomy and to investigate the indications for open reduction alone in surgical treatment of missed Monteggia fracture. We retrospectively reviewed 22 patients who presented with missed Monteggia fracture. The patients' mean age at the time of surgery was 7.6 years. The mean interval from injury to surgery was 16.1 months. The surgical procedure consisted of open reduction of the radiocapitellar joint followed by ulnar osteotomy without reconstruction of the annular ligament. The mean period of follow-up was 3.8 years. Radiographic assessment was performed for the maximum ulnar bow (MUB) and the location of the MUB. Clinical results were evaluated with the Mayo Elbow Performance Index and Kim's scores. Five patients underwent open reduction alone, and 17 patients underwent open reduction and ulnar osteotomy. When the MUB was less than 4 mm and the location of the MUB was in the distal 40% of the ulna, we could achieve reduction of the radial head without ulnar osteotomy. The radial head was maintained in a completely reduced position in 21 patients and was dislocated in one patient at final follow-up. Open reduction alone can be an attractive surgical option in select patients with missed Monteggia fracture with minimal bowing of the distal ulna. However, ulnar osteotomy should be considered in patients with a definite ulnar deformity. © Copyright: Yonsei University College of Medicine 2017

  9. [Clinical practice guideline on closed tibial plateau fractures in adulthood].

    Science.gov (United States)

    Ocegueda-Sosa, Miguel Ángel; Valenzuela-Flores, Adriana Abigail; Aldaco-García, Víctor Daniel; Flores-Aguilar, Sergio; Manilla-Lezama, Nicolás; Pérez-Hernández, Jorge

    2013-01-01

    Closed tibiae plateau fractures are common injuries in the emergency room. The optimal treatment is not well defined or established. For this reason, there are several surgical management options: open reduction and internal fixation, closed reduction and percutaneous synthesis, external fixation, and even conservative treatment for this kind of fracture. The mechanism of production of this fracture is through large varus or valgus deformation to which is added a factor of axial load. The trauma may be direct or indirect. The degree of displacement, fragmentation and involvement of soft tissues like ligaments, menisci, vascular and nerve structures are determined by the magnitude of the force exerted. Any intra-articular fracture treatment can lead to an erroneous instability, deformity and limitation of motion with subsequent arthritic changes, leading to joint incongruity, limiting activity and significantly altering the quality of life. Open reduction and internal fixation with anatomic restitution is the method used in this type of fracture. However, the results of numerous publications can be questioned due to the inclusion in the same study of fractures treated with very different methods.

  10. Incidence of Bradycardia and Outcomes of Patients Who Underwent Orbital Atherectomy Without a Temporary Pacemaker.

    Science.gov (United States)

    Lee, Michael S; Nguyen, Heajung; Shlofmitz, Richard

    2017-02-01

    We analyzed the incidence of bradycardia and the safety of patients with severely calcified coronary lesions who underwent orbital atherectomy without the insertion of a temporary pacemaker. The presence of severely calcified coronary lesions can increase the complexity of percutaneous coronary intervention due to the difficulty in advancing and optimally expanding the stent. High-pressure inflations to predilate calcified lesions may cause angiographic complications like perforation and dissection. Suboptimal stent expansion is associated with stent thrombosis and restenosis. Orbital atherectomy safely and effectively modifies calcified plaque to facilitate optimal stent expansion. The incidence of bradycardia in orbital atherectomy is unknown. Fifty consecutive patients underwent orbital atherectomy from February 2014 to September 2016 at our institution, none of whom underwent insertion of a temporary pacemaker. The final analysis included 47 patients in this retrospective study as 3 patients were excluded because of permanent pacemaker implantation. The primary endpoint was significant bradycardia, defined as bradycardia requiring emergent pacemaker placement or a heart rate pacemaker appears to be safe.

  11. Comparison of Voice Quality Between Patients Who Underwent Inferior Turbinoplasty or Radiofrequency Cauterization.

    Science.gov (United States)

    Göker, Ayşe Enise; Aydoğdu, İmran; Saltürk, Ziya; Berkiten, Güler; Atar, Yavuz; Kumral, Tolgar Lütfi; Uyar, Yavuz

    2017-01-01

    The aim of this study was to analyze and compare the vocal quality in patients who underwent either submucosal turbinectomy or radiofrequency cauterization. In this study, we enrolled 60 patients diagnosed with inferior concha hypertrophy. These patients were divided into two groups by using computer program "Research Randomizer." Of the 60 patients, 30 underwent submucosal inferior turbinoplasty and 30 underwent radiofrequency cauterization. The control group was composed of 30 healthy adults with no nasal or upper aerodigestive system pathology. The patients were checked at weeks 1, 2, and 4. Voice records were taken before the procedure and at week 4 postprocedure. The mean age of patients in the inferior turbinoplasty group was 29.4 years (range: 19-42 years); in the radiofrequency group, it was 30.30 years (range: 18-50 years). There was no statistical difference in age between groups. In the inferior turbinoplasty group, there were 16 male and 14 female patients, and in the radiofrequency group, there were 13 male and 17 female patients. There was no significant difference in the number of males and females between groups. Voice professionals, especially singers, actors, and actresses, should be informed about possible voice changes before undergoing endonasal surgery because these individuals are more sensitive to changes in resonance organs. We believe that voice quality should be regarded as a highly important parameter when measuring the success of endonasal surgery. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  12. Vertical Patellar Dislocation: Reduction by the Push Up and Rotate Method, A Case Report and Literature Review.

    Science.gov (United States)

    Ahmad Khan, Hayat; Bashir Shah, Adil; Kamal, Younis

    2016-11-01

    Patellar dislocation is an emergency. Vertical patellar dislocation is rare, often seen in adolescents and mostly due to sports injuries or high-velocity trauma. Few cases have been reported in the literature. Closed or open reduction under general anesthesia is often needed. We report a case of vertical locked patellar dislocation in a 26-year-old male, which was reduced by a simple closed method under spinal anaesthesia. A literature review regarding the various methods of treatment is also discussed. A 26-year-old male experienced a trivial accident while descending stairs, sustaining patellar dislocation. The closed method of reduction was attempted, using a simple technique. Reduction was confirmed and postoperative rehabilitation was started. Follow-up was uneventful. Vertical patellar dislocations are encountered rarely in the emergency department. Adolescents are not the only victims, and high-velocity trauma is not the essential cause. Unnecessary manipulation should be avoided. The closed reduction method is simple, but the surgeon should be prepared for open reduction.

  13. Current Concepts in the Mandibular Condyle Fracture Management Part II: Open Reduction Versus Closed Reduction

    Directory of Open Access Journals (Sweden)

    Kang-Young Choi

    2012-07-01

    Full Text Available In the treatment of mandibular condyle fracture, conservative treatment using closedreduction or surgical treatment using open reduction can be used. Management of mandibularcondylar fractures remains a source of ongoing controversy in oral and maxillofacial trauma.For each type of condylar fracture,the treatment method must be chosen taking intoconsideration the presence of teeth, fracture height, patient’sadaptation, patient’s masticatorysystem, disturbance of occlusal function, and deviation of the mandible. In the past, closedreduction with concomitant active physical therapy conducted after intermaxillary fixationduring the recovery period had been mainly used, but in recent years, open treatment ofcondylar fractures with rigid internal fixation has become more common. The objectiveof this review was to evaluate the main variables that determine the choice of an open orclosed method for treatment of condylar fractures, identifying their indications, advantages,and disadvantages, and to appraise the current evidence regarding the effectiveness ofinterventions that are used in the management of fractures of the mandibular condyle.

  14. Comparing minimally supervised home-based and closely supervised gym-based exercise programs in weight reduction and insulin resistance after bariatric surgery: A randomized clinical trial.

    Science.gov (United States)

    Kaviani, Sara; Dadgostar, Haleh; Mazaherinezhad, Ali; Adib, Hanie; Solaymani-Dodaran, Masoud; Soheilipour, Fahimeh; Hakiminezhad, Mahdi

    2017-01-01

    Background: Effectiveness of various exercise protocols in weight reduction after bariatric surgery has not been sufficiently explored in the literature. Thus, in the present study, we aimed at comparing the effect of minimally supervised home-based and closely supervised gym-based exercise programs on weight reduction and insulin resistance after bariatric surgery. Methods: Females undergoing gastric bypass surgery were invited to participate in an exercise program and were randomly allocated into 2 groups using a random number generator in Excel. They were either offered a minimally supervised home-based (MSHB) or closely supervised gym-based (CSGB) exercise program. The CSGB protocol constitutes 2 weekly training sessions under ACSM guidelines. In the MSHB protocol, the participants received a notebook containing a list of recommended aerobic and resistance exercises, a log to record their activity, and a schedule of follow-up phone calls and clinic visits. Both groups received a pedometer. We measured their weight, BMI, lipid profile, FBS, and insulin level at baseline and at 20 weeks after the exercises, the results of which were compared using t test or Mann-Whitney U test at the end of the study. All the processes were observed by 1 senior resident in sport medicine. Results: A total of 80 patients were recruited who were all able to complete our study (MSHB= 38 and CSGB= 42). The baseline comparison revealed that the 2 groups were similar. The mean change (reduction) in BMI was slightly better in CSGB (8.61 95% CI 7.76-9.45) compared with the MSHB (5.18 95% CI 3.91-6.46); p< 0.01. However, the 2 groups did not have a statistically significant difference in the amount of change in the other factors including FBS and Homa.ir. Conclusion: As we expected a non-inferiority result, our results showed that both MSHB and CSGB exercise methods are somewhat equally effective in improving lipid profile and insulin resistance in the 2 groups, but a slightly better

  15. Long-term follow-up and patient satisfaction after reduction mammoplasty: Superomedial versus inferior pedicle

    Directory of Open Access Journals (Sweden)

    Mohamed Makboul

    2016-01-01

    Full Text Available Background: Surgery for hypertrophied breasts represents a challenge for plastic surgeons. The search for a good post-surgical cosmetic breast has led to the development of many techniques. Objectives for reduction mammoplasty are to achieve elevated, symmetrical breasts, a round shape, good projection, small cicatrices that are not very perceptible, and a lasting result. Patients and Methods: This study was carried out on sixty cases who had done reduction mammoplasty from January 2009 to December 2014. All patients were examined and were asked for late post-operative results and overall patients' satisfaction. Results: Long-term projection and contour of the breast were more satisfactory among patients who had superomedial pedicle with a statistically significant difference. No statistically significant difference was observed between patients underwent either superomedial or inferior pedicle reduction mammoplasty with regard to breast shape symmetry, nipple symmetry and sensation. The mean score for satisfaction was higher among patients who underwent superomedial pedicle rather than the inferior pedicle method. Conclusion: The superomedial pedicle shows better long-term cosmetic results.

  16. [A Distal Bile Duct Carcinoma Patient Who Underwent Surgical Resection for Liver Metastasis].

    Science.gov (United States)

    Komiyama, Sosuke; Izumiya, Yasuhito; Kimura, Yu; Nakashima, Shingo; Kin, Syuichi; Kawakami, Sadao

    2018-03-01

    A 70-year-old man with distal bile duct carcinoma underwent a subtotal stomach-preserving pancreaticoduodenectomy without adjuvant chemotherapy. One and a half years after the surgery, elevated levels of serum SPan-1(38.1 U/mL)were observed and CT scans demonstrated a solitary metastasis, 25mm in size, in segment 8 of the liver. The patient received 2 courses of gemcitabine-cisplatin combination chemotherapy. No new lesions were detected after chemotherapy and the patient underwent a partial liver resection of segment 8. The pathological examination revealed a metachronous distant metastasis originating from the bile duct carcinoma. Subsequently, the patient received S-1 adjuvant chemotherapy for 6 months. Following completion of all therapies, the patient survived without tumor recurrence for 3 years and 10 months after the initial operation. Thus, surgical interventions might be effective in improving prognosis among selected patients with postoperative liver metastasis of bile duct carcinoma.

  17. Open Reduction in Pediatric Condylar Fracture.

    Science.gov (United States)

    Barbosa, Alexandre Agostini; Mariano, Ronaldo Célio

    2017-05-01

    Facial fractures in children are rare. Lack of pneumatization, fat pockets, mixed dentition, contribute to the elasticity and bone stability. When mandibular fractures occur in children, most often involve the condyle by indirect trauma. Such fractures are the center of discussion on the form of treatment if this should be performed conservatively, or held the reduction and fixation of the fracture with surgical exposure of the fragments. In condylar fractures in children, in most patients, the proposed treatment is closed reduction. Treatment with open reduction and fixation has its specific indications. In this case, the authors report a patient cycling accident victim, with cut-contusion injury in ment with limited mouth opening and left condylar fracture with medial rotation. The treatment was the reduction and fixation of fragments by open process.

  18. Angular reduction in multiparticle matrix elements

    International Nuclear Information System (INIS)

    Lehman, D.R.; Parke, W.C.

    1989-01-01

    A general method for reduction of coupled spherical harmonic products is presented. When the total angular coupling is zero, the reduction leads to an explicitly real expression in the scalar products of the unit vector arguments of the spherical harmonics. For nonscalar couplings, the reduction gives Cartesian tensor forms for the spherical harmonic products; tensors built from the physical vectors in the original expression. The reduction for arbitrary couplings is given in closed form, making it amenable to symbolic manipulation on a computer. The final expressions do not depend on a special choice of coordinate axes, nor do they contain azimuthal quantum number summations, or do they have complex tensor terms for couplings to a scalar; consequently, they are easily interpretable from the properties of the physical vectors they contain

  19. Comparative analysis of pain in patients who underwent total knee replacement regarding the tourniquet pressure

    Directory of Open Access Journals (Sweden)

    Marcos George de Souza Leão

    Full Text Available ABSTRACT OBJECTIVES: To evaluate through the visual analog scale (VAS the pain in patients undergoing total knee replacement (TKR with different pressures of the pneumatic tourniquet. METHODS: An observational, randomized, descriptive study on an analytical basis, with 60 patients who underwent TKR, divided into two groups, which were matched: a group where TKR was performed with tourniquet pressures of 350 mmHg (standard and the other with systolic blood pressure plus 100 mmHg (P + 100. These patients had their pain assessed by VAS at 48 h, and at the 5th and 15th days after procedure. Secondarily, the following were also measured: range of motion (ROM, complications, and blood drainage volume in each group; the data were subjected to statistical analysis. RESULTS: After data analysis, there was no statistical difference regarding the incidence of complications (p = 0.612, ROM (p = 0.202, bleeding after 24 and 48 h (p = 0.432 and p = 0.254 or in relation to VAS. No correlation was observed between time of ischemia compared to VAS and bleeding. CONCLUSIONS: The use of the pneumatic tourniquet pressure at 350 mmHg or systolic blood pressure plus 100 mmHg did not influence the pain, blood loss, ROM, and complications. Therefore the pressures at these levels are safe and do not change the surgery outcomes; the time of ischemia must be closely observed to avoid major complications.

  20. Describing the macroscopic world: Closing the circle within the dynamical reduction program

    International Nuclear Information System (INIS)

    Ghirardi, G.C.; Grassi, R.; Benatti, F.

    1994-06-01

    With reference to recently proposed theoretical models accounting for reduction in terms of a unified dynamics governing all physical processes we analyze the problem of working out a world view accommodating our knowledge about natural phenomena. We stress the relevant conceptual differences between the considered models and standard quantum mechanics. In spite of the fact that both theories describe systems within a genuine Hilbert space framework, the peculiar features of the spontaneous reduction models limit drastically the states which are dynamically stable. This fact by itself allows one to work out an interpretation of the formalism which makes possible to give a satisfactory description of the world in terms of the values taken by an appropriately defined mass density function in ordinary configuration space. A topology based on this function and which is radically different from the one characterizing the Hilbert space is introduced and in terms of it the ideal of similarity of macroscopic situations is precisely defined. Finally, the formalism and the interpretation are shown to yield a natural criterion for establishing the psycho-physical parallelism. The conclusion is that, within the considered theories and at the nonrelativistic level, one can satisfy all sensible requirements for a completely satisfactory macro-objective description of reality. (author). 21 refs, 1 fig

  1. Dysphagia among Adult Patients who Underwent Surgery for Esophageal Atresia at Birth

    Directory of Open Access Journals (Sweden)

    Valérie Huynh-Trudeau

    2015-01-01

    Full Text Available BACKGROUND: Clinical experiences of adults who underwent surgery for esophageal atresia at birth is limited. There is some evidence that suggests considerable long-term morbidity, partly because of dysphagia, which has been reported in up to 85% of adult patients who undergo surgery for esophageal atresia. The authors hypothesized that dysphagia in this population is caused by dysmotility and/or anatomical anomalies.

  2. Evaluation of recovery in lip closing pressure and occlusal force and contact area after orthognathic surgery.

    Science.gov (United States)

    Ueki, Koichiro; Moroi, Akinori; Sotobori, Megumi; Ishihara, Yuri; Marukawa, Kohei; Iguchi, Ran; Kosaka, Akihiko; Ikawa, Hiroumi; Nakazawa, Ryuichi; Higuchi, Masatoshi

    2014-10-01

    The purpose of this study was to evaluate the relationship between lip closing force, occlusal contact area and occlusal force after orthognathic surgery in skeletal Class III patients. The subjects consisted of 54 patients (28 female and 26 male) diagnosed with mandibular prognathism who underwent sagittal split ramus osteotomy with and without Le Fort I osteotomy. Maximum and minimum lip closing forces, occlusal contact area and occlusal force were measured pre-operatively, 6 months and 1 year post-operative. Maximum and minimum lip closing forces, occlusal contact area and occlusal force increased with time after surgery, however a significant increase was not found in the occlusal contact area in women. In increased ratio (6 months/pre-operative and 1 year/pre-operative), the maximum lip closing force was significantly correlated with the occlusal contact area (P contact area and lip closing force, and an increase ratio in maximum lip closing force was associated with an increased ratio in occlusal contact area. Copyright © 2014 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  3. Closed reduction and fluoroscopic assisted percutaneous pinning of 42 physeal fractures in 37 dogs and 4 cats

    OpenAIRE

    Boekhout-Ta, Christina L; Kim, Stanley E; Corss, Alan R; Pozzi, Antonio; Evans, Richard

    2017-01-01

    OBJECTIVE: To report complications and clinical outcome of dogs and cats that underwent fluoroscopic-assisted percutaneous pinning (FAPP) of physeal fractures. STUDY DESIGN: Retrospective study. ANIMALS: Client-owned dogs (n = 37) and cats (n = 4). MATERIALS AND METHODS: Records (August 2007-August 2014) of physeal fractures treated with FAPP in 3 hospitals were evaluated. Data collected included signalment, fracture characteristics (etiology, location, duration, Salter-Harris classi...

  4. Impact of Polypharmacy on Adherence to Evidence-Based Medication in Patients who Underwent Percutaneous Coronary Intervention.

    Science.gov (United States)

    Mohammed, Shaban; Arabi, Abdulrahaman; El-Menyar, Ayman; Abdulkarim, Sabir; AlJundi, Amer; Alqahtani, Awad; Arafa, Salah; Al Suwaidi, Jassim

    2016-01-01

    The primary objective of this study was to evaluate the impact of polypharmacy on primary and secondary adherence to evidence-based medication (EBM) and to measure factors associated with non-adherence among patients who underwent percutaneous coronary intervention (PCI). We conducted a retrospective analysis for patients who underwent PCI at a tertiary cardiac care hospital in Qatar. Patients who had polypharmacy (defined as ≥6 medications) were compared with those who had no polypharmacy at hospital discharge in terms of primary and secondary adherence to dual antiplatelet therapy (DAPT), beta-blockers (BB), angiotensin converting enzyme inhibitors (ACEIs) and statins. A total of 557 patients (mean age: 53±10 years; 85%; males) who underwent PCI were included. The majority of patients (84.6%) received ≥6 medications (polypharmacy group) while only 15.4% patients received ≥5 medications (nonpolypharmacy group). The two groups were comparable in term of gender, nationality, socioeconomic status and medical insurance. The non-polypharmacy patients had significantly higher adherence to first refill of DAPT compared with patients in the polypharmacy group (100 vs. 76.9%; p=0.001). Similarly, the non-polypharmacy patients were significantly more adherent to secondary preventive medications (BB, ACEI and statins) than the polypharmacy group. In patients who underwent PCI, polypharmacy at discharge could play a negative role in the adherence to the first refill of EBM. Further studies should investigate other parameters that contribute to long term non-adherence.

  5. Thermogravimetric study of the kinetics of lithium titanate reduction by hydrogen

    International Nuclear Information System (INIS)

    Sonak, Sagar; Rakesh, R.; Jain, Uttam; Mukherjee, Abhishek; Kumar, Sanjay; Krishnamurthy, Nagaiyar

    2014-01-01

    Highlights: • Li 2 TiO 3 powder is synthesized by the gel combustion route. • Activation energy of reduction of Li 2 TiO 3 by H 2 found out to be 27.45 kJ/mol H 2 . • Non-stoichiometric phase of Li 2 TiO 3 is formed in hydrogen atmosphere. • One-dimensional diffusion appears to be the most probable mechanism of reduction. - Abstract: The lithium titanate powder was synthesized by gel-combustion route. The mechanism and the kinetics of hydrogen interaction with lithium titanate powder were studied using non-isothermal thermogravimetric technique. Lithium titanate underwent reduction in hydrogen atmosphere which led to the formation of oxygen deficient non-stoichiometric compound in lithium titanate. One-dimensional diffusion appeared to be the most probable reaction mechanism. The activation energy for reduction of lithium titanate under hydrogen atmosphere was found to be 27.4 kJ/mol/K. Structural changes after hydrogen reduction in lithium titanate were observed in X-ray diffraction analysis

  6. BARIUM REDUCTION OF INTUSSUSCEPTION IN INFANCY

    Science.gov (United States)

    Denenholz, Edward J.; Feher, George. S.

    1955-01-01

    Barium enema reduction was used as the initial routine treatment in 29 infants with intussusception. In 22 of them the intussusception was reduced by this means. In three of eight patients operated upon the intussusception was found to be reduced. Four of the remaining five patients had clinical or x-ray evidence of complications before reduction by barium enema was attempted. Twenty-one of the patients, all of whom were observed in private practice, were treated without admission to the hospital. After reduction, these patients were observed closely by the clinician. None of these patients showed clinical or x-ray signs of complications before reduction. Certain clinical and roentgen criteria must be satisfied before it can be concluded that reduction by barium enema is complete. If there are clinical signs of complications with x-ray evidence of small bowel obstruction, only a very cautious attempt at hydrostatic reduction should be made. As the time factor is generally a reliable clinical guide to reducibility, the late cases should be viewed with greater caution. Long duration of symptoms, however, is not per se a contraindication to an attempt at hydrostatic reduction. PMID:13230908

  7. Factors related to postoperative pain among patients who underwent radiofrequency ablation of hepatocellular carcinoma

    International Nuclear Information System (INIS)

    Hsieh, Y.-C.; Yap, Y.-S.; Hung, C.-H.; Chen, C.-H.; Lu, S.-N.; Wang, J.-H.

    2013-01-01

    Aim: To evaluate the incidence and associated factors of postoperative intense pain and haemodynamic changes during radiofrequency ablation of hepatocellular carcinoma. Materials and methods: A total of 123 consecutive hepatocellular carcinoma patients who underwent radiofrequency ablation were prospectively recruited. Patient factors, tumour characteristics, procedural factors, intraoperative haemodynamic changes, complications, postoperative events, laboratory values before and after ablation, and postoperative pain were evaluated. Postoperative pain was scored using a visual analogue scale after the procedure. Results: The mean age of the patients was 65.6 ± 9.6 years. In multiple logistic regression analysis, patients who underwent general anaesthesia [odds ratio (95% CI): 2.68 (1.23–5.81); p = 0.013] and had more postoperative nausea and vomiting episodes [3.10 (1.11–8.63); p = 0.036] were associated with intense pain. These findings remain robust after propensity score matching. For mean difference values between before and after RFA, higher in change in aspartate transaminase (p = 0.026), alanine transaminase (p = 0.016) and white blood cell count (p = 0.015), and lower in change in haemoglobin (p = 0.009) were also correlated with intense pain. There was no significant difference in haemodynamic changes between the general anaesthesia and local anaesthesia group during ablation. Conclusion: General anaesthesia, postoperative nausea and vomiting, and laboratory factors were associated with postoperative intense pain in patients who underwent radiofrequency ablation. Counselling and modification of analgesics should be considered in patients with related factors for intense pain

  8. Lung volume reduction surgery in bronchopulmonary dysplasia.

    Science.gov (United States)

    Siaplaouras, J; Heckmann, M; Reiss, I; Schaible, T; Waag, K L; Gortner, L

    2003-06-01

    We report on a female preterm infant of 29 wk gestational age, who developed acquired lobar emphysema after prolonged artificial ventilation secondary to respiratory disease syndrome and bronchopulmonary dysplasia. The infant underwent atypical segmentectomy at the age of 12 mo because of life-threatening hypoxaemia with pulmonary hypertension and failure of conservative treatment. Lung volume reduction surgery (LVRS) dramatically improved the respiratory function and resulted in adequate weight gain and psychomotor development. In selected cases LVRS can be an option for lobar emphysema in premature infants with severe bronchopulmonary dysplasia.

  9. Three-dimensional MRI Analysis of Femoral Head Remodeling After Reduction in Patients With Developmental Dysplasia of the Hip.

    Science.gov (United States)

    Tsukagoshi, Yuta; Kamada, Hiroshi; Kamegaya, Makoto; Takeuchi, Ryoko; Nakagawa, Shogo; Tomaru, Yohei; Tanaka, Kenta; Onishi, Mio; Nishino, Tomofumi; Yamazaki, Masashi

    2018-05-02

    Previous reports on patients with developmental dysplasia of the hip (DDH) showed that the prereduced femoral head was notably smaller and more nonspherical than the intact head, with growth failure observed at the proximal posteromedial area. We evaluated the shape of the femoral head cartilage in patients with DDH before and after reduction, with size and sphericity assessed using 3-dimensional (3D) magnetic resonance imaging (MRI). We studied 10 patients with unilateral DDH (all female) who underwent closed reduction. Patients with avascular necrosis of the femoral head on the plain radiograph 1 year after reduction were excluded. 3D MRI was performed before reduction and after reduction, at 2 years of age. 3D-image analysis software was used to reconstruct the multiplanes. After setting the axial, coronal, and sagittal planes in the software (based on the femoral shaft and neck axes), the smallest sphere that included the femoral head cartilage was drawn, the diameter was measured, and the center of the sphere was defined as the femoral head center. We measured the distance between the center and cartilage surface every 30 degrees on the 3 reconstructed planes. Sphericity of the femoral head was calculated using a ratio (the distance divided by each radius) and compared between prereduction and postreduction. The mean patient age was 7±3 and 26±3 months at the first and second MRI, respectively. The mean duration between the reduction and second MRI was 18±3 months. The femoral head diameter was 26.7±1.5 and 26.0±1.6 mm on the diseased and intact sides, respectively (P=0.069). The ratios of the posteromedial area on the axial plane and the proximoposterior area on the sagittal plane after reduction were significantly larger than before reduction (P<0.01). We demonstrated that the size of the reduced femoral head was nearly equal to that of the intact femoral head and that the growth failure area of the head before reduction, in the proximal posteromedial

  10. Topotactic reduction as a route to new close-packed anion deficient perovskites: structure and magnetism of 4H-BaMnO(2+x).

    Science.gov (United States)

    Hadermann, Joke; Abakumov, Artem M; Adkin, Josephine J; Hayward, Michael A

    2009-08-05

    The anion-deficient perovskite 4H-BaMnO(2+x) has been obtained by a topotactic reduction, with LiH, of the hexagonal perovskite 4H-BaMnO(3-x). The crystal structure of 4H-BaMnO(2+x) was solved using electron diffraction and X-ray powder diffraction and further refined using neutron powder diffraction (S.G. Pnma, a = 10.375(2) A, b = 9.466(2) A, c = 11.276(3) A, at 373 K). The orthorhombic superstructure arises from the ordering of oxygen vacancies within a 4H (chch) stacking of close packed c-type BaO(2.5) and h-type BaO(1.5) layers. The ordering of the oxygen vacancies transforms the Mn(2)O(9) units of face-sharing MnO(6) octahedra into Mn(2)O(7) (two corner-sharing tetrahedra) and Mn(2)O(6) (two edge-sharing tetrahedra) groups. The Mn(2)O(7) and Mn(2)O(6) groups are linked by corner-sharing into a three-dimensional framework. The structures of the BaO(2.5) and BaO(1.5) layers are different from those observed previously in anion-deficient perovskites providing a new type of order pattern of oxygen atoms and vacancies in close packed structures. Magnetization measurements and neutron diffraction data reveal 4H-BaMnO(2+x) adopts an antiferromagnetically ordered state below T(N) approximately 350 K.

  11. 7 CFR 3575.80 - Interest rate changes after loan closing.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 15 2010-01-01 2010-01-01 false Interest rate changes after loan closing. 3575.80..., DEPARTMENT OF AGRICULTURE GENERAL Community Programs Guaranteed Loans § 3575.80 Interest rate changes after...) may collectively effect a permanent reduction in the interest rate on the guaranteed loan at any time...

  12. [Socio-environmental vulnerability, disaster risk-reduction and resilience-building: lessons from the earthquake in Haiti and torrential rains in the mountain range close to Rio de Janeiro in Brazil].

    Science.gov (United States)

    de Freitas, Carlos Machado; de Carvalho, Mauren Lopes; Ximenes, Elisa Francioli; Arraes, Eduardo Fonseca; Gomes, José Orlando

    2012-06-01

    Data on disasters around the world reveal greater seriousness in countries with lower social and economic development levels. In this context, disaster risk-reduction and resilience-building policies are priorities in the sustainable development agenda, featuring among the topics selected for the Rio+20 Summit. By means of a contribution of a conceptual nature and from examples of disasters in countries with different development levels, namely the Haiti earthquake and the torrential rains in the mountain range close to Rio de Janeiro in Brazil, the scope of this article is to demonstrate how socio-environmental vulnerability creates conditions for disasters, while at the same time limiting strategies for their prevention and mitigation. Lastly, some of the measures that disaster risk reduction and resilience-building demand in a socio-environmental vulnerability context are highlighted. These involve changes in the current patterns of social, economic and environmental development geared toward ecological sustainability and social justice as pillars of sustainable development.

  13. Close to Transplant Renal Artery Stenosis and Percutaneous Transluminal Treatment

    Directory of Open Access Journals (Sweden)

    Leonardou Polytimi

    2011-01-01

    Full Text Available Purpose. To evaluate the efficacy of percutaneous transluminal angioplasty (PTA in the management of arterial stenosis located close to the allograft anastomosis (close-TRAS. Materials and Methods. 31 patients with renal transplants were admitted to our institution because of persistent hypertension and impairment of transplant renal function and underwent angiography for vascular investigation. 27 were diagnosed suffering from transplant renal artery stenosis (TRAS, whereas 4 had severe iliac artery stenosis proximal to the transplant anastomosis (Prox-TRAS. 3 cases of TRAS coexisted with segmental renal arterial stenosis, whereas 3 other cases of TRAS were caused by kinking and focal stenosis in the middle of the transplanted renal artery. Results. Angioplasty and stenting were successfully applied to all patients with iliac artery stenosis as well as to those with TRAS and segmental artery stenosis. Two of three patients with kinking were well treated with angioplasty and stenting, whereas one treated only with angioplasty necessitated surgery. No major procedure-related complications appeared, and the result was decrease of the serum creatinine level and of the blood pressure. Conclusions. PTA is the appropriate initial treatment of TRAS and close-TRAS, with low morbidity and mortality rates, achieving improvement of graft function and amelioration of hypertension.

  14. A controlled clinical study of serosa-invasive gastric carcinoma patients who underwent surgery plus intraperitoneal hyperthermo-chemo-perfusion (IHCP).

    Science.gov (United States)

    Kim, J Y; Bae, H S

    2001-01-01

    Despite recent advances in the treatment of advanced gastric carcinomas, no satisfactory outcomes are available because of micrometastases and free-floating carcinoma cells already existing in the peritoneal cavity. From 1990, we started using intraperitoneal hyperthermo-chemo-perfusion (IHCP) to prevent and to treat peritoneal metastasis after surgical resection of stomach cancer. We analyzed 103 serosa-invasive gastric carcinoma patients who underwent surgical resection between 1990 and 1995. Fifty-two patients who received surgery plus IHCP were compared with 51 patients who underwent surgery only, as controls. IHCP was administered for 2 h with an automatic IHCP device (closed-circuit system) just after surgical resection, with the patient under hypothermic general anesthesia (32.4 degrees C-34.0 degrees C). As perfusate, we used 1.5% peritoneal dialysis solution mixed with 10 micrograms/ml of mitomycin-C (MMC), warmed at an inflow temperature of over 44 degrees C. The overall 5-year survival rate (5-YSR) of the 103 patients was 29.97%. The 5-YSR was higher in the IHCP group than in the control group, at 32.7% and 27.1%, respectively, but this difference was not significant. However, in the 65 serosa-invasive gastric carcinoma patients (excluding those in stage IV) the 5-YSR was significantly higher (P = 0.0379) in the IHCP group than in the control group, at 58.6% and 44.4%, respectively. On multivariate analysis of all 103 patients, depth of tumor invasion and lymph node metastasis were significant factors for survival, whereas significant factors on univariate analysis, such as combined operation, distant metastasis, and peritoneal metastasis, were not significant. The most common recurrence patterns were loco-regional in the IHCP group and peritoneal in the control group. Complete cytoreductive surgery plus IHCP is effective to prevent and to treat peritoneal metastasis, and it should lead to long-term survival for serosa-invasive gastric carcinoma patients

  15. Poor adherence to clinical guidelines for women undergoing breast reduction

    DEFF Research Database (Denmark)

    Aydin, Dogu; Hansen, Lone Bak; Ikander, Peder

    2016-01-01

    INTRODUCTION: Indication for breast reduction in a publically funded or an insurance-funded setting depends on the severity of the subjective symptoms and on the clinical evaluation. The purpose of this study was to evaluate whether Danish surgeons follow a clinical practice recommending a minimum...... tissue resection weight of 400-500 g per breast. METHODS: Included in the study were a total of 366 female patients with breast hypertrophy who underwent bilateral breast reduction surgery at three large university hospitals in Denmark in the period from August 2008 to November 2013. The patients' height...... hospitals in Denmark in the 2008-2013 period. Our findings are surprising and beg the question if the guidelines...

  16. Pressure tube rupture in a closed tank

    International Nuclear Information System (INIS)

    Khater, H.A.; Hadaller, G.I.; Stern, F.

    1985-06-01

    A study has been prepared on the feasibility of conducting pressure tube/calandria tube rupture tests in a closed tank, simulating a scaled-down calandria vessel. The study includes: i) a review of previous work, ii) an analytical investigation of the scaling problem of the calandria vessel and relevant in-core structures, iii) selection of a method for initiating pressure tube/calandria tube rupture, iv) a set of specifications for the test assembly, v) general arrangement drawings, vi) a proposal for a test matrix, vii) a survey and evaluation of existing facilities which could provide the required high pressure, temperature and fluid inventory, and viii) a cost estimate for the detailed design and construction, instrumentation, data acquisition and reduction, testing and reporting. The study concludes that it is both technically and practically feasible to conduct pressure tube rupture tests in a closed tank

  17. Effect of closed-loop order processing on the time to initial antimicrobial therapy.

    Science.gov (United States)

    Panosh, Nicole; Rew, Richardd; Sharpe, Michelle

    2012-08-15

    The results of a study comparing the average time to initiation of i.v. antimicrobial therapy with closed-versus open-loop order entry and processing are reported. A retrospective cohort study was performed to compare order-to-administration times for initial doses of i.v. antimicrobials before and after a closed-loop order-processing system including computerized prescriber order entry (CPOE) was implemented at a large medical center. A total of 741 i.v. antimicrobial administrations to adult patients during designated five-month preimplementation and postimplementation study periods were assessed. Drug-use reports generated by the pharmacy database were used to identify order-entry times, and medication administration records were reviewed to determine times of i.v. antimicrobial administration. The mean ± S.D. order-to-administration times before and after the implementation of the CPOE system and closed-loop order processing were 3.18 ± 2.60 and 2.00 ± 1.89 hours, respectively, a reduction of 1.18 hours (p Closed-loop order processing was associated with significant reductions in the average time to initiation of i.v. therapy in all patient care areas evaluated (cardiology, general medicine, and oncology). The study results suggest that CPOE-based closed-loop order processing can play an important role in achieving compliance with current practice guidelines calling for increased efforts to ensure the prompt initiation of i.v. antimicrobials for severe infections (e.g., sepsis, meningitis). Implementation of a closed-loop order-processing system resulted in a significant decrease in order-to-administration times for i.v. antimicrobial therapy.

  18. Endoscopic submucosal dissection for anorectal tumor with hemorrhoids close to the dentate line: a multicenter study of Hiroshima GI Endoscopy Study Group.

    Science.gov (United States)

    Tamaru, Yuzuru; Oka, Shiro; Tanaka, Shinji; Hiraga, Yuko; Kunihiro, Masaki; Nagata, Shinji; Furudoi, Akira; Ninomiya, Yuki; Asayama, Naoki; Shigita, Kenjiro; Nishiyama, Soki; Hayashi, Nana; Chayama, Kazuaki

    2016-10-01

    The lower rectum close to the dentate line has distinct characteristics, making endoscopic submucosal dissection (ESD) of tumors challenging. We assessed clinical outcomes of ESD for such patients with hemorrhoids. Sixty-four patients (mean age, 68 years) underwent ESD for anorectal tumors close to the dentate line. We divided patients into those with (Group A, 45 patients) and without hemorrhoids (Group B, 19 patients). We examined en bloc and histological en bloc resection rates, procedure time, complication rates, and postoperative prognosis after ESD. The mean tumor size was 43 mm. Histologic diagnoses were adenoma (42 %, 27/64), carcinoma in situ (44 %, 28/64), and T1 carcinoma (14 %, 9/64). There was no significant difference in en bloc resection (93 %, 42/45 vs. 95 %, 18/19) or postoperative bleeding rates (16 %, 7/45 vs. 11 %, 2/19) between Groups A and B, respectively. The mean procedural durations were 120 and 124 min, respectively, in Groups A and B. No perforations occurred. There was no significant difference in postoperative anal pain rate between Groups A (18 %, 8/45) and B (16 %, 3/19), and it resolved within a few days in all cases. There was one case of stricture in Group B. Two patients with T1 carcinoma underwent additional surgery, one underwent chemotherapy, and five had no additional treatment. No recurrence occurred during the follow-up period of 38 months. ESD is safe and effective for anorectal tumors close to the dentate line in patients with hemorrhoids.

  19. The evaluation of breast tissues removed during reductive mammaplasty with dual energy X-ray absorptiometry

    International Nuclear Information System (INIS)

    De Lorenzo, Antonino; Gravante, Gianpiero; Sorge, Roberto; Nicoli, Fabio; Caruso, Riccardo; Araco, Antonino; Servidio, Michele; Orlandi, Augusto; Cervelli, Valerio

    2009-01-01

    Purpose: We conducted a case-control study in which patients were evaluated with dual energy X-ray absorptiometry (DEXA) before and after breast reduction surgery, and results were correlated with the histological examination. Our goal was to confirm the DEXA as a precise technique for the measurement of breast composition, in order to propose it for the preoperative evaluation of plastic surgery patients. Materials and methods: We prospectively recruited all women that underwent reduction mammaplasty and excluded patients with contraindications to the operation or those that previously underwent bariatric surgery to reduce their weight. Patients were evaluated with DEXA 1 week before and after surgery. Results: From February to October 2006 we recruited 25 patients. The statistical analysis found a significant reduction of weight, BMI, regional fat free mass and fat mass after the operation. The comparison between DEXA and the histological analysis produced a correlation r = 0.989 (r 2 = 0.978), with a predictivity of 98% and a percentage of error 8.3% (95% confidence intervals -252.6, 273.7; 95% limits of agreements of Bland and Altman -436.0, 457.1). Similar results were obtained with the analysis of fat. Conclusions: Our study demonstrated that conventional segmental DEXA is a very precise technique to measure the amount of tissue removed in breast reductions and could open future application in the preoperative assessment of patients undergoing such operations.

  20. The evaluation of breast tissues removed during reductive mammaplasty with dual energy X-ray absorptiometry

    Energy Technology Data Exchange (ETDEWEB)

    De Lorenzo, Antonino [Division of Human Nutrition, University of Tor Vergata in Rome (Italy); Gravante, Gianpiero [Division of Human Nutrition, University of Tor Vergata in Rome (Italy); Department of Surgery, Whipps Cross University Hospital, London (United Kingdom)], E-mail: ggravante@hotmail.com; Sorge, Roberto [Laboratory of Biometry, University of Tor Vergata in Rome (Italy); Nicoli, Fabio; Caruso, Riccardo; Araco, Antonino [Department of Plastic Surgery, University of Tor Vergata in Rome (Italy); Servidio, Michele [Division of Human Nutrition, University of Tor Vergata in Rome (Italy); Orlandi, Augusto [Department of Biopathology, Anatomic Pathology Institute, University of Tor Vergata in Rome (Italy); Cervelli, Valerio [Department of Plastic Surgery, University of Tor Vergata in Rome (Italy)

    2009-06-15

    Purpose: We conducted a case-control study in which patients were evaluated with dual energy X-ray absorptiometry (DEXA) before and after breast reduction surgery, and results were correlated with the histological examination. Our goal was to confirm the DEXA as a precise technique for the measurement of breast composition, in order to propose it for the preoperative evaluation of plastic surgery patients. Materials and methods: We prospectively recruited all women that underwent reduction mammaplasty and excluded patients with contraindications to the operation or those that previously underwent bariatric surgery to reduce their weight. Patients were evaluated with DEXA 1 week before and after surgery. Results: From February to October 2006 we recruited 25 patients. The statistical analysis found a significant reduction of weight, BMI, regional fat free mass and fat mass after the operation. The comparison between DEXA and the histological analysis produced a correlation r = 0.989 (r{sup 2} = 0.978), with a predictivity of 98% and a percentage of error 8.3% (95% confidence intervals -252.6, 273.7; 95% limits of agreements of Bland and Altman -436.0, 457.1). Similar results were obtained with the analysis of fat. Conclusions: Our study demonstrated that conventional segmental DEXA is a very precise technique to measure the amount of tissue removed in breast reductions and could open future application in the preoperative assessment of patients undergoing such operations.

  1. Clinical outcome of trans-sacral interbody fusion after partial reduction for high-grade l5-s1 spondylolisthesis.

    Science.gov (United States)

    Smith, J A; Deviren, V; Berven, S; Kleinstueck, F; Bradford, D S

    2001-10-15

    A clinical retrospective study was conducted. To evaluate the clinical and radiographic outcome of reduction followed by trans-sacral interbody fusion for high-grade spondylolisthesis. In situ posterior interbody fusion with fibula allograft has improved the fusion rates for patients with high-grade spondylolisthesis. The use of this technique in conjunction with partial reduction has not been reported. Nine consecutive patients underwent treatment of high-grade (Grade 3 or 4) spondylolisthesis with partial reduction followed by posterior interbody fusion using cortical allograft. The average age at the time of surgery was 27 years (range, 8-51 years), and the average follow-up period was 43 months (range, 24-72 months). Before surgery, eight patients had low back pain, seven patients had radiating leg pain, and five patients had hamstring tightness. The average grade of spondylolisthesis by Meyerding grading was 3.9 (range, 3-5). Charts and radiographs were evaluated, and outcomes were collected by use of the modified SRS outcomes instrument. Radiographic indexes demonstrated significant improvement with partial reduction and fusion. The slip angle, as measured from the inferior endplate of L5, improved from 41.2 degrees (range, 24-82 degrees ) before surgery to 21 degrees (range, 5-40 degrees ) after surgery. All the patients were extremely or somewhat satisfied with surgery. The two patients who underwent this operation without initial instrumentation experienced fractures of their interbody grafts. Both of these patients underwent repair of the pseudarthrosis with placement of trans-sacral pedicle screw instrumentation and subsequent fusion. Partial reduction followed by posterior interbody fusion is an effective technique for the management of high-grade spondylolisthesis in pediatric and adult patient populations, as assessed by radiographic and clinical criteria. Pedicle screw instrumentation with the sacral screws capturing L5 is recommended when this

  2. Transoral open reduction and fixation of mandibular condylar base and neck fractures in children and young teenagers--a beneficial treatment option?

    Science.gov (United States)

    Schiel, Sebastian; Mayer, Peter; Probst, Florian; Otto, Sven; Cornelius, Carl-Peter

    2013-07-01

    To evaluate the possible benefits of open surgery, endoscopically assisted reduction and fixation using a transoral route was used in a selected series of pediatric patients with displaced condylar base and neck fractures. A cohort of 6 patients (1 male and 5 female; age range, 7 to 15 yr; mean, 13.4 yr) with displaced condylar base and neck fractures (n = 9) were included. Inclusion criteria were age younger than 16 years, fracture of the condylar base or neck, and displacement of the fracture by at least 45°. Fractures were classified using conventional radiography, cone-beam computed tomography, or computed tomography. Patients underwent transoral endoscopically assisted open reduction and fixation using miniplate osteosynthesis. Postoperatively, patients were followed clinically and radiographically for 18 months. Complete follow-up varied from 18 to 35 months (median, 24.5 months). All patients showed normal occlusion and pain-free unrestricted function of the temporomandibular joint at 3, 6, 12, and 18 months postoperatively. There were no signs of incomplete remodeling or deformation of the condyles. Transoral endoscopically assisted surgical treatment of severely displaced condylar base and neck fractures in children and young teenagers offers a reliable solution to preclude the sequelae of closed treatment, such as altered morphology and functional disturbances, eliminates visible scars, and lowers the risk of facial nerve damage compared with open reduction using an extraoral approach. Crown Copyright © 2013. Published by Elsevier Inc. All rights reserved.

  3. Closed-loop waveform control of boost inverter

    DEFF Research Database (Denmark)

    Zhu, Guo Rong; Xiao, Cheng Yuan; Wang, Haoran

    2016-01-01

    The input current of single-phase inverter typically has an AC ripple component at twice the output frequency, which causes a reduction in both the operating lifetime of its DC source and the efficiency of the system. In this paper, the closed-loop performance of a proposed waveform control method...... to eliminate such a ripple current in boost inverter is investigated. The small-signal stability and the dynamic characteristic of the inverter system for input voltage or wide range load variations under the closed-loop waveform control method are studied. It is validated that with the closedloop waveform...... control, not only was stability achieved, the reference voltage of the boost inverter capacitors can be instantaneously adjusted to match the new load, thereby achieving improved ripple mitigation for a wide load range. Furthermore, with the control and feedback mechanism, there is minimal level of ripple...

  4. Fracture Union in Closed Interlocking Nail in Femoral Fracture

    Directory of Open Access Journals (Sweden)

    R L Sahu

    2010-09-01

    Full Text Available INTRODUCTION: Fractures shaft femur is a major cause of morbidity and mortality in patients with lower extremity injuries. The objective of this study was to find out the outcome of Interlocking nail in fracture femur. METHODS: This study was conducted in the Department of Orthopaedic surgery in M. M. Medical College from July 2006 to November 2008. Seventy eight patients were recruited from Emergency and out patient department having closed fracture of femoral shaft. All patients were operated under general or spinal anesthesia. All patients were followed for nine months. RESULTS: Out of seventy eight patients, sixty nine patients underwent union in 90 to 150 days with a mean of 110.68 days. Touch down weight bearing was started on 2nd post-operative day. Complications found in four patients who had non-union, and five patients had delayed union which was treated with dynamization and bone graft. The results were excellent in 88.46% and good in 6.41% patients. CONCLUSIONS: We concluded that this technique is advantageous because of early mobilization (early weight bearing, less complication with good results and is economical. Keywords: close reamed interlocking nail, dynamization, femoral shaft fractures, union

  5. Effect of different pneumoperitoneum pressure on stress state in patients underwent gynecological laparoscopy

    Directory of Open Access Journals (Sweden)

    Ai-Yun Shen

    2016-10-01

    Full Text Available Objective: To observe the effect of different CO2 pneumoperitoneum pressure on the stress state in patients underwent gynecological laparoscopy. Methods: A total of 90 patients who were admitted in our hospital from February, 2015 to October, 2015 for gynecological laparoscopy were included in the study and divided into groups A, B, and C according to different CO2 pneumoperitoneum pressure. The changes of HR, BP, and PetCO2 during the operation process in the three groups were recorded. The changes of stress indicators before operation (T0, 30 min during operation (T1, and 12 h after operation (T2 were compared. Results: The difference of HR, BP, and PetCO2 levels before operation among the three groups was not statistically significant (P>0.05. HR, BP, and PetCO2 levels 30 min after pneumoperitoneum were significantly elevated when compared with before operation (P0.05. PetCO2 level 30 min after pneumoperitoneum in group B was significantly higher than that in group A (P0.05. Conclusions: Low pneumoperitoneum pressure has a small effect on the stress state in patients underwent gynecological laparoscopy, will not affect the surgical operation, and can obtain a preferable muscular relaxation and vision field; therefore, it can be selected in preference.

  6. The Characteristics of Cervical Cancer Patients Who Underwent a Radical Hysterectomy at Sanglah Hospital Denpasar in 2015

    Directory of Open Access Journals (Sweden)

    I Nyoman Bayu Mahendra

    2016-05-01

    Full Text Available Background: Cervical cancer is the most common gynecologic cancer in women. It is the main cause of cancer-related death in women in developing countries. Cervical cancer in Indonesia is the second most cancer affecting Indonesian women and the prevalence is relatively stable in the last 30 years. Cervical cancer was closely related to the histologic type of itself. A squamous cell carcinoma has a specific route of local spreading and a lymphatic route. The sample of this study are cervical cancer patients who underwent a radical hysterectomy from January 1 to December 31, 2015 in Sanglah Hospital Denpasar, Bali. The aim of this study is to discover the characteristics of the patients by age, parity, education level, marital status, sexual activity, the first symptoms and the early screening done, and the clinical staging. Methods: This descriptive study involved 20 patients in Sanglah Hospital Denpasar who had a radical hysterectomy from January 1 until December 31, 2015. The characteristics are gathered from the patients’ medical record. Results: The most cases done radical hysterectomy between 41-45 years old which proportion was 40%, the most parity was parity 2 (60%, elementary school was the most education level (35%, all of the samples only married once and sexually active, the most first symptom was vaginal bleeding (55%, only 10% had pap smear as early detection, and the most clinical stage was stage IIB (50%.

  7. Medial versus anterior open reduction for developmental hip dislocation in age-matched patients.

    Science.gov (United States)

    Hoellwarth, Jason S; Kim, Young-Jo; Millis, Michael B; Kasser, James R; Zurakowski, David; Matheney, Travis H

    2015-01-01

    The difference between medial (MAOR) and anterior (AAOR) approaches for open reduction of developmental hip dysplasia in terms of risk for avascular necrosis (AVN) and need for further corrective surgery (FCS, femoral and/or acetabular osteotomy) is unclear. This study compared age-matched cohorts undergoing either MAOR or AAOR in terms of these 2 primary outcomes. Prognostic impact of presence of ossific nucleus at time of open reduction was also investigated. Institutional review board approval was obtained. Nineteen hips (14 patients) managed by MAOR were matched with 19 hips (18 patients) managed by AAOR based on age at operation (mean 6.0; range, 1.4 to 14.9 mo). Patients with neuromuscular conditions and known connective tissue disorders were excluded. Primary outcomes assessed at minimum 2 years' follow-up included radiographic evidence of AVN (Kalamchi and MacEwen) or requiring FCS. MAOR and AAOR cohorts were similar regarding age at open reduction, sex, laterality, and follow-up duration. One hip in each group had AVN before open reduction thus were excluded from AVN analysis. At minimum 2 years postoperatively (mean 6.2; range, 1.8 to 11.7 y), 4/18 (22%) MAOR and 5/18 (28%) AAOR met the same criteria for AVN (P=1.0). No predictors of AVN could be identified by regression analysis. Presence of an ossific nucleus preoperatively was not a protective factor from AVN (P=0.27). FCS was required in 4/19 (21%) MAOR and 7/19 (37%) AAOR hips (P=0.48). However, 7/12 (54%) hips failing closed reduction required FCS compared with 4/26 (16%) hips without prior failed closed reduction (P=0.024). Cox regression analysis showed that patients who failed closed reduction had an annual risk of requiring FCS approximately 6 times that of patients without a history of failed closed reduction (hazard ratio=6.1; 95% CI, 1.5-24.4; P=0.009), independent of surgical approach (P=0.55) or length of follow-up (P=0.78). In this study of age-matched patients undergoing either MAOR or

  8. Proper time axis of a closed relativistic system

    International Nuclear Information System (INIS)

    Chernikov, N.A.; Fadeev, N.G.; Shavokhina, N.S.

    1997-01-01

    The definition of a proper time axis of a closed relativistic system of colliding particles is given. The solution of the proper time axis problem is presented. If the light velocity c equals the imaginary unit i, then in the case of a plane motion of the system the problem about the proper time axis turns out to be equivalent to the known in engineering mechanics problem about the reduction of any system of forces, applied to a rigid body, to the dynamic screw. In the general case, when c=i, the problem about the proper time axis turns out to be equivalent to the problem about the reduction to the dynamic screw of a system of forces, applied to a rigid body in a four-dimensional Euclidean space

  9. Does the pancreatic volume reduction rate using serial computed tomographic volumetry predict new onset diabetes after pancreaticoduodenectomy?

    Science.gov (United States)

    Yun, Sung Pil; Seo, Hyung-Il; Kim, Suk; Kim, Dong Uk; Baek, Dong Hoon

    2017-01-01

    Abstract Volume reduction of the pancreatic tissues following a pancreatectomy can lead to the deterioration of glucose homeostasis. This is defined as pancreatogenic diabetes mellitus (DM). The objective of this study was to investigate the occurrence of new-onset DM (NODM) and evaluate the risk factors, including the pancreas volume reduction rate in patients undergoing pancreaticoduodenectomy (PD). Sixty-six patients without preoperative DM underwent PD for periampullary tumors between August 2007 and December 2012 and were included in this analysis. These patients underwent follow-up tests and abdominal computed tomography (CT) scan 7 days, 6 months, 12 months, 24 months, and 36 months after the operation. The pancreas volume reduction rate was calculated by CT volumetry. The patients were divided into 2 groups according to the postoperative development of DM. After PD, newly diagnosed DM occurred in 16 patients (24.2%). The incidence of DM was highest among patients with carcinomas with an advanced T stage. The pancreatic volume reduction rate after 6 and 12 months in the NODM group was significantly higher than the normal glucose group in the univariate analysis. In the multivariate analysis, the pancreatic volume reduction rate 6 months after PD was the only significant predictive factor for the development of NODM (P = 0.002). This study suggests that the pancreatic volume reduction rate 6 months after PD was the only significant predictive factor for the development of NODM. CT volumetry of the pancreas may be useful as a predictor of NODM after PD. PMID:28353594

  10. The art of trochanteric fracture reduction.

    Science.gov (United States)

    Biber, Roland; Berger, Johanna; Bail, Hermann Josef

    2016-12-01

    The name of Ender is primarily associated with the Ender nails, which were popular for trochanteric fracture fixation more than thirty years ago. However, Ender's concepts were not limited to the implant. Ender developed a unique classification system for trochanteric and subtrochanteric fractures, which provided the theory for closed reduction maneuvers that made the method so successful in his hands. While Ender's nails have become history in the meantime, his principles of fracture reduction can be readily applied on surgery with modern implants such as proximal femoral nails. This article reflects the classification and the principles published by Hans Georg Ender in some print work hardly available nowadays. Copyright © 2016 Elsevier Ltd. All rights reserved.

  11. Open versus closed reduction: mandibular condylar fractures in children.

    Science.gov (United States)

    Chrcanovic, Bruno Ramos

    2012-09-01

    lead to persistent malocclusion. Thus, the indication of open reduction and internal fixation increases with age.

  12. Microbiological evidence for Fe(III) reduction on early Earth

    Science.gov (United States)

    Vargas, Madeline; Kashefi, Kazem; Blunt-Harris, Elizabeth L.; Lovley, Derek R.

    1998-09-01

    It is generally considered that sulphur reduction was one of the earliest forms of microbial respiration, because the known microorganisms that are most closely related to the last common ancestor of modern life are primarily anaerobic, sulphur-reducing hyperthermophiles. However, geochemical evidence indicates that Fe(III) is more likely than sulphur to have been the first external electron acceptor of global significance in microbial metabolism. Here we show that Archaea and Bacteria that are most closely related to the last common ancestor can reduce Fe(III) to Fe(II) and conserve energy to support growth from this respiration. Surprisingly, even Thermotoga maritima, previously considered to have only a fermentative metabolism, could grow as a respiratory organism when Fe(III) was provided as an electron acceptor. These results provide microbiological evidence that Fe(III) reduction could have been an important process on early Earth and suggest that microorganisms might contribute to Fe(III) reduction in modern hot biospheres. Furthermore, our discovery that hyperthermophiles that had previously been thought to require sulphur for cultivation can instead be grown without the production of toxic and corrosive sulphide, should aid biochemical investigations of these poorly understood organisms.

  13. Photochemical reduction of CO{sub 2} to fuels and chemicals

    Energy Technology Data Exchange (ETDEWEB)

    DuBois, D. [National Renewable Energy Lab., Golden, CO (United States); Eisenberg, R. [Univ. of Rochester, NY (United States); Fujita, E. [Brookhaven National Lab., Upton, NY (United States)

    1996-09-01

    Photochemical reduction of CO{sub 2} represents a potentially useful approach to developing a sustainable source of carbon-based chemicals, fuels, and materials. In this report the present status of photochemical CO{sub 2} reduction is assessed, areas that need to be better understood for advancement are identified, and approaches to overcoming barriers are suggested. Because of the interdisciplinary nature of this field, assessments of three closely interrelated areas are given including integrated photochemical systems for catalytic CO{sub 2} reduction, thermal catalytic CO{sub 2} reactions, and electrochemical CO{sub 2} reduction. The report concludes with a summary and assessment of potential impacts of this area on chemical and energy technologies.

  14. [Findings from Total Colonoscopy in Obstructive Colorectal Cancer Patients Who Underwent Stent Placement as a Bridge to Surgery(BTS)].

    Science.gov (United States)

    Maruo, Hirotoshi; Tsuyuki, Hajime; Kojima, Tadahiro; Koreyasu, Ryohei; Nakamura, Koichi; Higashi, Yukihiro; Shoji, Tsuyoshi; Yamazaki, Masanori; Nishiyama, Raisuke; Ito, Tatsuhiro; Koike, Kota; Ikeda, Takashi; Takayanagi, Yasuhiro; Kubota, Hiroyuki

    2017-11-01

    We clinically investigated 34 patients with obstructive colorectal cancer who underwent placement of a colonic stent as a bridge to surgery(BTS), focusing on endoscopic findings after stent placement.Twenty -nine patients(85.3%)underwent colonoscopy after stent placement, and the entire large intestine could be observed in 28(96.6%).Coexisting lesions were observed in 22(78.6%)of these 28 patients.The lesions comprised adenomatous polyps in 17 patients(60.7%), synchronous colon cancers in 5 patients(17.9%), and obstructive colitis in 3 patients(10.7%), with some overlapping cases.All patients with multiple cancers underwent one-stage surgery, and all lesions were excised at the same time.Colonoscopy after colonic stent placement is important for preoperative diagnosis of coexisting lesions and planning the extent of resection. These considerations support the utility of colonic stenting for BTS.

  15. Feasibility of a reduction protocol in the emergency department for diaphyseal forearm fractures in children.

    Science.gov (United States)

    Pesenti, S; Litzelmann, E; Kahil, M; Mallet, C; Jehanno, P; Mercier, J-C; Ilharreborde, B; Mazda, K

    2015-09-01

    Diaphyseal forearm fractures are very common pediatric traumas. At present, distal radius metaphyseal fractures are often successfully treated with closed reduction by emergency physicians. However, the management of diaphyseal fractures remains controversial. The purpose of this study was to analyze the results of diaphyseal forearm fractures in the emergency department (ED) in children. In a prospective 2-year-study, all closed diaphyseal forearm fractures in patients under 15, with an angle of >15° and treated by closed reduction in the ED were included. Fractures with overlapping fragments were excluded. Reduction was performed by an emergency physician, with a standardized analgesic protocol (painkillers and nitrous oxide). Clinical tolerance was checked within the first 24hours, and the radiographic stability of reduction was assessed at days 8 and 15. Initial and final follow-up radiographs were analyzed. Elbow and wrist range of motion was assessed at the final follow-up. Sixty patients (41 boys and 19 girls) were included. Mean age was 5.2 years old (±3). At initial evaluation, the maximum angle was 30° (±11.3). After reduction, the maximum angle was significantly reduced (30° vs. 5°, P<0.001). Mean immobilization in a cast was 11.7 weeks (±2). There were no cast related complications in any of these children. There was no surgery for secondary displacement. Full range of motion was obtained in all patients at the final follow-up. The outcome of conservative treatment of closed diaphyseal forearm fractures, without overlapping fragments was excellent. However, reduction is usually performed in the operating room by orthopedic surgeons under general anesthesia and requires hospitalization, which is very expensive. The results of this study show that high quality care may be obtained in the ED by a trained and experienced team. These results are similar to those for distal metaphyseal fractures, which could extend the indications for reduction in the

  16. Detailed Study of Closed Stator Slots for a Direct-Driven Synchronous Permanent Magnet Linear Wave Energy Converter

    Directory of Open Access Journals (Sweden)

    Erik Lejerskog

    2014-01-01

    Full Text Available The aim of this paper is to analyze how a permanent magnet linear generator for wave power behaves when the stator slots are closed. The usual design of stator geometry is to use open slots to maintain a low magnetic leakage flux between the stator teeth. By doing this, harmonics are induced in the magnetic flux density in the air-gap due to slotting. The closed slots are designed to cause saturation, to keep the permeability low. This reduces the slot harmonics in the magnetic flux density, but will also increase the flux leakage between the stator teeth. An analytical model has been created to study the flux through the closed slots and the result compared with finite element simulations. The outcome shows a reduction of the cogging force and a reduction of the harmonics of the magnetic flux density in the air-gap. It also shows a small increase of the total magnetic flux entering the stator and an increased magnetic flux leakage through the closed slots.

  17. The Comparison of Intrathecal Morphine and IV Morphine PCA on Pain Control, Patient Satisfaction, Morphine Consumption, and Adverse Effects in Patients Undergoing Reduction Mammoplasty

    OpenAIRE

    Karamese, Mehtap; Akda?, Osman; Kara, ?nci; Y?ld?ran, Gokce Unal; Tosun, Zekeriya

    2015-01-01

    Background: Following breast reduction procedures, the level of postoperative pain can be severe, and sufficient pain control influences a patient's physiological, immunological, and psychological status. Objective: The aim of this study was to examine the use of intrathecal morphine (ITM) in breast reduction surgery with patient-controlled analgesia (PCA). Methods: Sixty-two female patients who underwent breast reductions with the same technique participated in this study. The study group (I...

  18. Noise-based tube current reduction method with iterative reconstruction for reduction of radiation exposure in coronary CT angiography

    International Nuclear Information System (INIS)

    Shen, Junlin; Du, Xiangying; Guo, Daode; Cao, Lizhen; Gao, Yan; Bai, Mei; Li, Pengyu; Liu, Jiabin; Li, Kuncheng

    2013-01-01

    Purpose: To investigate the potential of noise-based tube current reduction method with iterative reconstruction to reduce radiation exposure while achieving consistent image quality in coronary CT angiography (CCTA). Materials and methods: 294 patients underwent CCTA on a 64-detector row CT equipped with iterative reconstruction. 102 patients with fixed tube current were assigned to Group 1, which was used to establish noise-based tube current modulation formulas, where tube current was modulated by the noise of test bolus image. 192 patients with noise-based tube current were randomly assigned to Group 2 and Group 3. Filtered back projection was applied for Group 2 and iterative reconstruction for Group 3. Qualitative image quality was assessed with a 5 point score. Image noise, signal intensity, volume CT dose index, and dose-length product were measured. Results: The noise-based tube current modulation formulas were established through regression analysis using image noise measurements in Group 1. Image noise was precisely maintained at the target value of 35.00 HU with small interquartile ranges for Group 2 (34.17–35.08 HU) and Group 3 (34.34–35.03 HU), while it was from 28.41 to 36.49 HU for Group 1. All images in the three groups were acceptable for diagnosis. A relative 14% and 41% reduction in effective dose for Group 2 and Group 3 were observed compared with Group 1. Conclusion: Adequate image quality could be maintained at a desired and consistent noise level with overall 14% dose reduction using noise-based tube current reduction method. The use of iterative reconstruction further achieved approximately 40% reduction in effective dose

  19. On H-closed and U-closed functions | Cammaroto | Quaestiones ...

    African Journals Online (AJOL)

    In this article, we extend the work on H-closed functions started by Cammaroto, Fedorchuk and Porter in 1998. Also, U-closed functions are introduced and characterized in terms of filters and adherence. The hereditary and productivity properties are examined and developed for both H-closed and U-closed functions.

  20. Sonography-guided hydrostatic reduction of ileocolic intussusception in children: analysis of failure and success in consecutive patients presenting timely to the hospital.

    Science.gov (United States)

    Menke, Jan; Kahl, Fritz

    2015-03-01

    In children with ileocolic intussusception sonography is increasingly being used for diagnosis, whereas fluoroscopy is frequently used for guiding non-invasive reduction. This study assessed the success rate of radiation-free sonography-guided hydrostatic reduction in children with ileocolic intussusception, using novel well-defined success rate indices. All children were evaluated who presented from 2005 to 2013 to the local university hospital with ileocolic intussusception. The patients were treated with sonography-guided hydrostatic reduction unless primary surgery was clinically indicated. The according success rate was determined by indices of Bekdash et al. They represent the ratio of persistently successful non-surgical reductions versus four different denominators, depending on including/excluding cases with primary surgery and including/excluding cases requiring bowel resection/intervention. Fifty-six consecutive patients were included (age, 3 months to 7.8 years). About 80% of the patients presented until 24 h and 20% until 48 h after the onset of symptoms. Seven patients underwent primary surgery, with bowel resection required in three cases. Hydrostatic reduction was attempted in 49 patients, being permanently successful in 41 cases (selective reduction rate 41/49 = 83.7%; crude reduction rate 41/56 = 73.2%). The remaining eight patients underwent secondary surgery, with just two patients not requiring surgical bowel resection/intervention (corrected selective reduction rate 41/43 = 95.3%). The composite reduction rate was 87.2% (successful/feasible reductions, 41/47). Radiation-free sonography-guided hydrostatic reduction has a good success rate in children with ileocolic intussusception. It may be particularly valuable in centers that are already experienced with using sonography for the diagnosis.

  1. Microdose flare-up vs. flexible-multidose GnRH antagonist protocols for poor responder patients who underwent ICSI.

    Science.gov (United States)

    Esinler, I

    2014-01-01

    To compare the performance of microdose flare-up (MF) and flexible-multidose gonadotropin-releasing hormone (GnRH) antagonist protocols in poor responder patients who underwent intracytoplasmic sperm injection (ICSI). One hundred and 12 consecutive patients (217 cycles) suspected to have poor ovarian response were enrolled. Group 1 (MF GnRH agonist group) constituted 64 patients (135 cycles) who underwent MF GnRH agonist protocol. Group 2 (flexible-multidose GnRH antagonist group) constituted 48 patients (82 cycles) who underwent flexible-multidose GnRH antagonist protocol. The duration of stimulation (d) (11.5 +/- 2.1 vs. 10.4 +/- 2.7, p or = seven blastomeres and < 10% fragmentation at day 3 (35.9% vs. 65.1%, p < 0.05) were significantly lower in Group 1 when compared to Group 2. The number of embryos transferred (2.2 +/- 1.3 vs. 2.4 +/- 0.9), the clinical pregnancy per embryo transfer (16.3% vs. 25.8%), and the implantation rate (8.6% vs. 12.2%) were comparable between groups. Although the flexible-multidose GnRH antagonist protocol produced better oocyte and embryo parameters, the clinical pregnancy rate and the implantation rates were comparable between the flexible-multidose GnRH antagonist and MF protocols in poor responder patients.

  2. HAEMATOMA BLOCK- AN EFFECTIVE ALTERNATIVE TO GENERAL ANAESTHESIA FOR REDUCTION OF DISTAL RADIUS FRACTURES

    Directory of Open Access Journals (Sweden)

    Prabhati Rani Mishra

    2016-12-01

    Full Text Available BACKGROUND Most common fracture in elderly patients is distal radius fracture. The most common method of management is closed reduction and immobilisation. The aim of the study is to compare the analgesic effects of haematoma block and general anaesthesia for closed reduction of distal fracture of radius. MATERIALS AND METHODS A prospective randomised controlled study was carried out among 100 patients of age group between 15-70 years of either sex who had fracture distal radius between 2015-2016. The patients having multiple fractures, pathological fractures or suffering from any organic diseases were excluded from the study. After taking informed written consent, the patients were randomised into two equal groups. In group A, reduction of fracture was done following administration of IV propofol and in group B after infiltration with 2% lignocaine into fracture haematoma site. Pain score was compared by VAS before, during and after manipulation in both the groups. Time taken from presentation at emergency department to reduction and discharge from hospital was also compared. Statistical analysis was done by applying SPSS software. RESULTS 100 patients of mean age 42.5 years, male: female 43:57 with fracture distal radius were studied. Mean time from admission to fracture reduction in group A was 2.64±0.93 hours and in group B 0.90±0.45 hours (P=0.0001. Discharge time from hospital after reduction of fracture in group A was 4.24±0.94 hours and in group B 0.75±0.2 hours (P=0.0001. VAS during reduction in group A was 0 and in group B 0.98±0.8 (P=0.0001. 10 minutes after reduction VAS in group A was 2.28±0.24 and group B 0.72±0.45 (P=0.0001. CONCLUSION For closed reduction of distal radius fracture, haematoma block with lignocaine is safe and effective alternative to intravenous general anaesthesia with propofol.

  3. Limiting Factors for Microbial Fe(III)-Reduction In a Landfill Leachate Polluted Aquifer (Vejen, Denmark)

    DEFF Research Database (Denmark)

    Albrechtsen, Hans-Jørgen; Heron, Gorm; Christensen, Thomas Højlund

    1995-01-01

    Aquifer sediment samples from two locations within the anaerobic leachate plume of a municipal landfill were compared with respect to microbiology (especially Fe(III)-reduction) and geochemistry. The samples close to the landfill were characterized by low contents of Fe(III), whereas samples from...... the more distant cluster were rich in Fe(III)-oxides. The active microbial population seemed to be less dense in samples more distant from the landfill (measured by ATP and phospholipid fatty acids (PLFA)), but the microbial communities were very similar in the two sample clusters according...... to the composition of PLFA. Very little, if any, Fe(III)-reduction was observed close to the landfill, but all the more distant samples showed evident microbially mediated Fe(III)-reduction. After amendment with both acetate and Fe(III), all the samples showed a potential for Fe(III)-reduction, and the in situ Fe...

  4. [Treatment of temporo-mandibular joint closed-lock using intra-articular injection of mepivacaine with immediate resolution durable in time (six months follow-up)].

    Science.gov (United States)

    Guarda Nardini, L; Tito, R; Beltrame, A

    2002-01-01

    The purpose of this study was to assess the value of intra-articular fluid injection under pressure, as a technique suggested for temporo-mandibular joint (TMJ) closed-lock treatment, and to determine if there is a persisting lock resolution in time. Twelve patients were studied at our centre, with a diagnosis of TMJ closed-lock, not amenable with conventional therapies. All patients underwent a MRI scan, confirming the presence of anteriorly displaced disk. This technique is based on intra-articular injection of anaesthetic (mepivacaine cloridrate) under pressure, using the so called pumping technique, that allows an inferior distraction of the condyle. The study has a six months follow-up. After closed-lock resolution all patients underwent physiotherapy with guided mouth opening, for one month. Mandibular function (maximal mouth opening) increased on average of 20.2 mm after treatment, and of 21.1 mm six months later (p=0.00000; with p<0.005). Pain decreased on average from VAS=6.75 to VAS=0.3 (p=0.00001; with p<0.005). The masticatory efficiency improved from VAS=5.25 to VAS=8.75 (p=0.002; p<0.005). Functional TMJ limitation level is significantly increased (p=0.002; p<0.005). Also, patient's efficacy judgement (mean value 3.58= good) and tolerability judgement (mean value 2.92=good) indicate that this therapy is well accepted. This technique is easy to perform, well tolerated and does not need specific instruments: it permits the resolution of TMJ closed-lock, decreases the pain and improves masticatory efficiency. All these effects persist in time. Subjects with recent closed-lock have an immediate and complete functional recovery while patients with chronic closed-lock do not.

  5. Prediction of Pathological Complete Response Using Endoscopic Findings and Outcomes of Patients Who Underwent Watchful Waiting After Chemoradiotherapy for Rectal Cancer.

    Science.gov (United States)

    Kawai, Kazushige; Ishihara, Soichiro; Nozawa, Hiroaki; Hata, Keisuke; Kiyomatsu, Tomomichi; Morikawa, Teppei; Fukayama, Masashi; Watanabe, Toshiaki

    2017-04-01

    Nonoperative management for patients with rectal cancer who have achieved a clinical complete response after chemoradiotherapy is becoming increasingly important in recent years. However, the definition of and modality used for patients with clinical complete response differ greatly between institutions, and the role of endoscopic assessment as a nonoperative approach has not been fully investigated. This study aimed to investigate the ability of endoscopic assessments to predict pathological regression of rectal cancer after chemoradiotherapy and the applicability of these assessments for the watchful waiting approach. This was a retrospective comparative study. This study was conducted at a single referral hospital. A total of 198 patients with rectal cancer underwent preoperative endoscopic assessments after chemoradiotherapy. Of them, 186 patients underwent radical surgery with lymph node dissection. The histopathological findings of resected tissues were compared with the preoperative endoscopic findings. Twelve patients refused radical surgery and chose watchful waiting; their outcomes were compared with the outcomes of patients who underwent radical surgery. The endoscopic criteria correlated well with tumor regression grading. The sensitivity and specificity for a pathological complete response were 65.0% to 87.1% and 39.1% to 78.3%. However, endoscopic assessment could not fully discriminate pathological complete responses, and the outcomes of patients who underwent watchful waiting were considerably poorer than the patients who underwent radical surgery. Eventually, 41.7% of the patients who underwent watchful waiting experienced uncontrollable local failure, and many of these occurrences were observed more than 3 years after chemoradiotherapy. The number of the patients treated with the watchful waiting strategy was limited, and the selection was not randomized. Although endoscopic assessment after chemoradiotherapy correlated with pathological response

  6. Safety and Tolerability of Transitioning from Cangrelor to Ticagrelor in Patients Who Underwent Percutaneous Coronary Intervention.

    Science.gov (United States)

    Badreldin, Hisham A; Carter, Danielle; Cook, Bryan M; Qamar, Arman; Vaduganathan, Muthiah; Bhatt, Deepak L

    2017-08-01

    The 3 phase 3 CHAMPION (Cangrelor vs Standard Therapy to Achieve Optimal Management of Platelet Inhibition) trials collectively demonstrated the safety of transitioning from cangrelor, a potent, parenteral rapidly-acting P2Y 12 inhibitor, to clopidogrel in patients who underwent percutaneous coronary intervention (PCI). However, variation in timing of therapy, site-specific binding, and drug half-lives may theoretically complicate switching to other oral P2Y 12 inhibitors. Since regulatory approval, limited data are available regarding the "real-world" safety and tolerability of transitioning to these more potent oral P2Y 12 antagonists. From November 2015 to January 2017, we evaluated the clinical profiles and efficacy and safety outcomes in cangrelor-treated patients who underwent PCI transitioned to clopidogrel (n = 42) or ticagrelor (n = 82) at a large, tertiary care center. Most patients receiving cangrelor underwent PCI with a drug-eluting stent for acute coronary syndrome via a radial approach in the background of unfractionated heparin. Stent thrombosis within 48 hours was rare and occurred in 1 patient treated with ticagrelor. Global Use of Strategies to Open Occluded Coronary Arteries-defined bleeding occurred in 20% of patients switched to ticagrelor and 29% of patients switched to clopidogrel, but none were severe or life-threatening. In conclusion, rates of stent thrombosis and severe/life-threatening bleeding were low and comparable with those identified in the CHAMPION program, despite use of more potent oral P2Y 12 inhibition. Copyright © 2017 Elsevier Inc. All rights reserved.

  7. Cavity closure during compression between semi-closed die using superplastic tin-lead alloy

    International Nuclear Information System (INIS)

    Zaid, A. I. O.; Al-Tamimi, M. M.

    2013-01-01

    Superplasticity is a feature of a material or alloy, which allows the material to deform plastically to an extremely large strain at low values of stress under certain loading conditions of strain rate and temperature. Eutectic tin-lead alloy is a practical material for research investigations as it possesses a superplastic behavior at room temperature and low strain rate which makes it a useful tool in simulating the ordinary engineering materials at high strain rate and temperature, and has been extensively used as a model material. In this paper, superplastic tin-lead alloy was used at room temperature to simulate the closure of cavities in steels at high temperatures in the hot region under dynamic loading (high strain rate) under the effect of compressive loads using semi-closed dies (modified dies) with 45 degree inclination and compare the results from these dies with those of flat platens (open dies) published previously. Hollow specimens having different values of bore diameter (Db) to outer diameter (Dout), of the same height and volume were investigated under 40% height reduction. The cavity closure for each specimen was determined. Comparison is made between flat platens and semi-closed dies regarding cavity closure based on bore diameter, bore volume, reduction percentage in bore diameter and reduction percentage in bore volume, at the 40% reduction in height. It was found that modifying the platens (45 degree inclination) resulted in lower values of bore diameters and volume i.e. higher values of reduction in bore diameters and volumes percentages irrespective of the value of bore diameter and the ratio of Db/Dout. (author)

  8. Fluoroscopy-guided hydrostatic reduction of intussusception in infancy: role of pharmacological premedication.

    Science.gov (United States)

    Esposito, Francesco; Ambrosio, Concetta; De Fronzo, Simona; Panico, Maria Rita; D'Aprano, Marilena; Giugliano, Anna Marcella; Noviello, Domenico; Oresta, Patrizia

    2015-06-01

    Intussusception is one of the most common causes of paediatric emergency. Fluoroscopy-guided hydrostatic reduction is a common nonoperative management strategy for the treatment of intussusception. The role of pharmacological premedication in increasing the success rate of hydrostatic reduction is still controversial. The purpose of this study was to verify the presence of a possible correlation between pharmacological premedication and the percentage of hydrostatic reduction of intussusception in paediatric patients. This study considered children with a diagnosis of idiopathic intussusception treated at our hospital between January 2007 and June 2013. One group of patients underwent hydrostatic reduction by barium enema without any preliminary therapy. A second group of patients received pharmacological premedication with both a sedative and an anti-oedematous agent before the procedure. A total of 398 patients were treated with barium enema for therapeutic purposes. In the group of patients who received no premedication (n = 254), 165 (65 %) children achieved hydrostatic reduction of the intussusception. Among the patients who received pharmacological premedication prior to barium enema (n = 144), 122 (85 %) children achieved resolution of the intussusception. Our study shows that the use of pharmacological premedication is effective for the reduction of the intussusception, as its limit patient stress, fluoroscopic time and radiation dose.

  9. Poor adherence to clinical guidelines for women undergoing breast reduction

    DEFF Research Database (Denmark)

    Aydin, Dogu; Hansen, Lone Bak; Ikander, Peder

    2016-01-01

    INTRODUCTION: Indication for breast reduction in a publically funded or an insurance-funded setting depends on the severity of the subjective symptoms and on the clinical evaluation. The purpose of this study was to evaluate whether Danish surgeons follow a clinical practice recommending a minimum...... tissue resection weight of 400-500 g per breast. METHODS: Included in the study were a total of 366 female patients with breast hypertrophy who underwent bilateral breast reduction surgery at three large university hospitals in Denmark in the period from August 2008 to November 2013. The patients' height......, weight and standard breast measurement were registered as was the weight of breast tissue resection. The preoperative breast volume was measured using transparent plastic cups designed for this purpose. RESULTS: Among the 366 female participants, the median age was 40 years, the median BMI was 24 kg/m2...

  10. Intussusception in children: Hydrostatic reduction under US guidance - own experience

    International Nuclear Information System (INIS)

    Roik, D.; Brzewski, M.; Biejat, A.; Marcinski, M.

    2008-01-01

    Intussusception in children is a common abdominal emergency. Recent years have brought a New promising method of nonsurgical invagination treatment, hydrostatic reduction under sonographic (US) guidance. The major advantage of this method is lack of the ionized radiation. The aim of our study is to asses the safety and effectiveness of hydrostatic reduction under US guidance used as a first choice method of invagination treatment in our department. >From July 2006 to December 2007, 33 procedures of hydrostatic reduction under US guidance were performed in 27 children, aged from 7 months to 6 years and 10 months. The procedure was performed in US room by radiologist and surgeon with the use of self-constructed set for saline enema. The sedation of patient was routinely performed. The initial procedure was effective in 23 patients (pts) (85%). In 5 pts the recurrence of intussusception occurred and in 3 of them next attempt of the reduction was successful. In 4 cases the initial procedures failed, and those children were operated. Total amount of 6 pts underwent an operation. We do not observe any complications connected with the procedure. Hydrostatic reduction of children intusussception under US-guidance is safe and effective method. Our initial results meet the recommended limits of successful reduction rates. It encouraged us to evaluation and further implementation of this method. Water enema is a first choice method of invagination treatment in our hospital. (authors)

  11. Operational characteristics of hybrid-type SFCL with closed and open cores

    International Nuclear Information System (INIS)

    Cho, Y.S.; Lee, N.Y.; Choi, H.S.; Chung, D.C.; Lim, S.H.

    2007-01-01

    We investigated the operational characteristics of the hybrid-type superconducting fault current limiter (SFCL) with the closed and the open cores, which induced the variation of the magnetic flux between the primary and the secondary windings. The experimental set-up of the hybrid-type SFCL with the closed and the open cores were prepared and the experimental analyses for the current limiting characteristics were performed. The peak value of the fault current in the hybrid-type SFCL with the open core was higher than that of the closed core at the first cycle after fault occurrence. However, in the case of the hybrid-type SFCL with the open core, the limiting current level after fault occurrence was decreased less than that of the hybrid-type SFCL with the closed core, because the magnetic leakage reluctance of the open core was higher than that of the closed core. The quench time (T q ) and the arrival time (T a ) for the peak voltage (V SC ) in the hybrid-type SFCL with the closed core were faster than that of the hybrid-type SFCL with the open core due to the increase of the mutual flux. We verified that the consumption power in the hybrid-type SFCL with the open core was larger owing to the increase of leakage flux by the reduction of mutual inductance between primary and secondary windings

  12. Emphysema lung lobe volume reduction: effects on the ipsilateral and contralateral lobes

    Energy Technology Data Exchange (ETDEWEB)

    Brown, Matthew S.; Kim, Hyun J.; Abtin, Fereidoun G.; Galperin-Aizenberg, Maya; Pais, Richard; Da Costa, Irene G.; Ordookhani, Arash; Chong, Daniel; Ni, Chiayi; McNitt-Gray, Michael F.; Goldin, Jonathan G. [David Geffen School of Medicine at UCLA, Center for Computer Vision and Imaging Biomarkers, Department of Radiological Sciences, Los Angeles, CA (United States); Strange, Charlie [Medical University of South Carolina, Department of Pulmonary and Critical Care Medicine, Columbia, SC (United States); Tashkin, Donald P. [David Geffen School of Medicine at UCLA, Division of Pulmonary and Critical Care Medicine, Los Angeles, CA (United States)

    2012-07-15

    To investigate volumetric and density changes in the ipsilateral and contralateral lobes following volume reduction of an emphysematous target lobe. The study included 289 subjects with heterogeneous emphysema, who underwent bronchoscopic volume reduction of the most diseased lobe with endobronchial valves and 132 untreated controls. Lobar volume and low-attenuation relative area (RA) changes post-procedure were measured from computed tomography images. Regression analysis (Spearman's rho) was performed to test the association between change in the target lobe volume and changes in volume and density variables in the other lobes. The target lobe volume at full inspiration in the treatment group had a mean reduction of -0.45 L (SE = 0.034, P < 0.0001), and was associated with volume increases in the ipsilateral lobe (rho = -0.68, P < 0.0001) and contralateral lung (rho = -0.16, P = 0.006), and overall reductions in expiratory RA (rho = 0.31, P < 0.0001) and residual volume (RV)/total lung capacity (TLC) (rho = 0.13, P = 0.03). When the volume of an emphysematous target lobe is reduced, the volume is redistributed primarily to the ipsilateral lobe, with an overall reduction. Image-based changes in lobar volumes and densities indicate that target lobe volume reduction is associated with statistically significant overall reductions in air trapping, consistent with expansion of the healthier lung. (orig.)

  13. Emphysema lung lobe volume reduction: effects on the ipsilateral and contralateral lobes

    International Nuclear Information System (INIS)

    Brown, Matthew S.; Kim, Hyun J.; Abtin, Fereidoun G.; Galperin-Aizenberg, Maya; Pais, Richard; Da Costa, Irene G.; Ordookhani, Arash; Chong, Daniel; Ni, Chiayi; McNitt-Gray, Michael F.; Goldin, Jonathan G.; Strange, Charlie; Tashkin, Donald P.

    2012-01-01

    To investigate volumetric and density changes in the ipsilateral and contralateral lobes following volume reduction of an emphysematous target lobe. The study included 289 subjects with heterogeneous emphysema, who underwent bronchoscopic volume reduction of the most diseased lobe with endobronchial valves and 132 untreated controls. Lobar volume and low-attenuation relative area (RA) changes post-procedure were measured from computed tomography images. Regression analysis (Spearman's rho) was performed to test the association between change in the target lobe volume and changes in volume and density variables in the other lobes. The target lobe volume at full inspiration in the treatment group had a mean reduction of -0.45 L (SE = 0.034, P < 0.0001), and was associated with volume increases in the ipsilateral lobe (rho = -0.68, P < 0.0001) and contralateral lung (rho = -0.16, P = 0.006), and overall reductions in expiratory RA (rho = 0.31, P < 0.0001) and residual volume (RV)/total lung capacity (TLC) (rho = 0.13, P = 0.03). When the volume of an emphysematous target lobe is reduced, the volume is redistributed primarily to the ipsilateral lobe, with an overall reduction. Image-based changes in lobar volumes and densities indicate that target lobe volume reduction is associated with statistically significant overall reductions in air trapping, consistent with expansion of the healthier lung. (orig.)

  14. Atrial fibrillation ablation using a closed irrigation radiofrequency ablation catheter.

    Science.gov (United States)

    Golden, Keith; Mounsey, John Paul; Chung, Eugene; Roomiani, Pahresah; Morse, Michael Andew; Patel, Ankit; Gehi, Anil

    2012-05-01

    Catheter ablation is an effective therapy for symptomatic, medically refractory atrial fibrillation (AF). Open-irrigated radiofrequency (RF) ablation catheters produce transmural lesions at the cost of increased fluid delivery. In vivo models suggest closed-irrigated RF catheters create equivalent lesions, but clinical outcomes are limited. A cohort of 195 sequential patients with symptomatic AF underwent stepwise AF ablation (AFA) using a closed-irrigation ablation catheter. Recurrence of AF was monitored and outcomes were evaluated using Kaplan-Meier survival analysis and Cox proportional hazards models. Mean age was 59.0 years, 74.9% were male, 56.4% of patients were paroxysmal and mean duration of AF was 5.4 years. Patients had multiple comorbidities including hypertension (76.4%), tobacco abuse (42.1%), diabetes (17.4%), and obesity (mean body mass index 30.8). The median follow-up was 55.8 weeks. Overall event-free survival was 73.6% with one ablation and 77.4% after reablation (reablation rate was 8.7%). Median time to recurrence was 26.9 weeks. AF was more likely to recur in patients being treated with antiarrhythmic therapy at the time of last follow-up (recurrence rate 30.3% with antiarrhythmic drugs, 13.2% without antiarrhythmic drugs; hazard ratio [HR] 2.2, 95% confidence interval [CI] 1.1-4.4, P = 0.024) and in those with a history of AF greater than 2 years duration (HR 2.7, 95% CI 1.1-6.9, P = 0.038). Our study represents the largest cohort of patients receiving AFA with closed-irrigation ablation catheters. We demonstrate comparable outcomes to those previously reported in studies of open-irrigation ablation catheters. Given the theoretical benefits of a closed-irrigation system, a large head-to-head comparison using this catheter is warranted. ©2012, The Authors. Journal compilation ©2012 Wiley Periodicals, Inc.

  15. Comparisons of receive array interference reduction techniques under erroneous generalized transmit beamforming

    KAUST Repository

    Radaydeh, Redha Mahmoud; Alouini, Mohamed-Slim

    2014-01-01

    information for the desired user spatially uncorrelated transmit channels on the effectiveness of transmit beamforming for different interference reduction techniques is investigated. The case of over-loaded receive array with closely-spaced elements

  16. Evaluation of Nitrate and Nitrite Reduction Kinetics Related to Liquid-Air-Interface Corrosion

    International Nuclear Information System (INIS)

    Li, Xiaoji; Gui, F.; Cong, Hongbo; Brossia, C.S.; Frankel, G.S.

    2014-01-01

    Liquid-air interface (LAI) corrosion has been a concern for causing leaks in the carbon steel tanks used for holding high-level radioactive liquid waste. To assist in understanding the mechanism of LAI corrosion, the kinetics of nitrate and nitrite reduction reactions were investigated electrochemically. Cyclic voltammetry and cathodic polarization measurements indicated that the nitrite reduction reaction exhibited faster kinetics than the nitrate reduction reaction at higher cathodic overpotential. However, the primary reduction reaction at the open circuit potential under aerated conditions was the oxygen reduction reaction. The reduction of residual oxygen was also the dominant cathodic reaction at open circuit potential in deaerated conditions. Moreover, the kinetics of oxygen reduction on steel electrodes were significantly influenced by the sample immersion conditions (partial vs. full) for aerated liquid nuclear waste simulants, but not for deaerated conditions. Lastly, the gaseous products formed during LAI corrosion were analyzed using the gas detector tube method and gas chromatography-mass spectrometry and found to contain NH 3 , NO 2 and NO. However, the results suggested that these products were caused by the local acidification generated by the hydrolysis of cations after LAI corrosion underwent extensive propagation, instead of being directly reduced in alkaline conditions. Thus, the results in this work showed that the kinetics of nitrate and nitrite reduction could not generate a salt concentration cell in the meniscus region to cause LAI corrosion

  17. HLA-G regulatory haplotypes and implantation outcome in couples who underwent assisted reproduction treatment.

    Science.gov (United States)

    Costa, Cynthia Hernandes; Gelmini, Georgia Fernanda; Wowk, Pryscilla Fanini; Mattar, Sibelle Botogosque; Vargas, Rafael Gustavo; Roxo, Valéria Maria Munhoz Sperandio; Schuffner, Alessandro; Bicalho, Maria da Graça

    2012-09-01

    The role of HLA-G in several clinical conditions related to reproduction has been investigated. Important polymorphisms have been found within the 5'URR and 3'UTR regions of the HLA-G promoter. The aim of the present study was to investigate 16 SNPs in the 5'URR and 14-bp insertion/deletion (ins/del) polymorphism located in the 3'UTR region of the HLA-G gene and its possible association with the implantation outcome in couples who underwent assisted reproduction treatments (ART). The case group was composed of 25 ART couples. Ninety-four couples with two or more term pregnancies composed the control group. Polymorphism haplotype frequencies of the HLA-G were determined for both groups. The Haplotype 5, Haplotype 8 and Haplotype 11 were absolute absence in ART couples. The HLA-G*01:01:02a, HLA-G*01:01:02b alleles and the 14-bp ins polymorphism, Haplotype 2, showed an increased frequency in case women and similar distribution between case and control men. However, this susceptibility haplotype is significantly presented in case women and in couple with failure implantation after treatment, which led us to suggest a maternal effect, associated with this haplotype, once their presence in women is related to a higher number of couples who underwent ART. Copyright © 2012. Published by Elsevier Inc.

  18. On the problem of model reduction in the gap metric

    NARCIS (Netherlands)

    Mutsaers, M.E.C.; Weiland, S.

    2010-01-01

    This paper deals with the model reduction problem where, for a given linear time-invariant dynamical system of complexity n, a simpler system of complexity r closed, shift invariant

  19. Projects to Improve Air Quality at Ports – 2014 Diesel Emissions Reduction Act (DERA) Funding Opportunity - Closed Announcement FY 2014

    Science.gov (United States)

    OTAQ is soliciting proposals that achieve reductions in diesel emissions produced by diesel engines and diesel emissions exposure, from fleets operating at marine and inland water ports under the Diesel Emissions Reduction Act (DERA).

  20. Projects to Improve Air Quality at Ports – 2013 Diesel Emissions Reduction Act (DERA) Funding Opportunity - Closed Announcement FY 2014

    Science.gov (United States)

    OTAQ is soliciting proposals that achieve reductions in diesel emissions produced by diesel engines and diesel emissions exposure, from fleets operating at marine and inland water ports under the Diesel Emissions Reduction Act (DERA).

  1. Intraoperative seizures and seizures outcome in patients underwent awake craniotomy.

    Science.gov (United States)

    Yuan, Yang; Peizhi, Zhou; Xiang, Wang; Yanhui, Liu; Ruofei, Liang; Shu, Jiang; Qing, Mao

    2016-11-25

    Awake craniotomies (AC) could reduce neurological deficits compared with patients under general anesthesia, however, intraoperative seizure is a major reason causing awake surgery failure. The purpose of the study was to give a comprehensive overview the published articles focused on seizure incidence in awake craniotomy. Bibliographic searches of the EMBASE, MEDLINE,were performed to identify articles and conference abstracts that investigated the intraoperative seizure frequency of patients underwent AC. Twenty-five studies were included in this meta-analysis. Among the 25 included studies, one was randomized controlled trials and 5 of them were comparable studies. The pooled data suggested the general intraoperative seizure(IOS) rate for patients with AC was 8%(fixed effect model), sub-group analysis identified IOS rate for glioma patients was 8% and low grade patients was 10%. The pooled data showed early seizure rates of AC patients was 11% and late seizure rates was 35%. This systematic review and meta-analysis shows that awake craniotomy is a safe technique with relatively low intraoperative seizure occurrence. However, few RCTs were available, and the acquisition of further evidence through high-quality RCTs is highly recommended.

  2. Closed-form expressions for integrals of MKdV and sine-Gordon maps

    International Nuclear Information System (INIS)

    Kamp, Peter H van der; Rojas, O; Quispel, G R W

    2007-01-01

    We present closed-form expressions for approximately N integrals of 2N-dimensional maps. The maps are obtained by travelling wave reductions of the modified Korteweg-de Vries equation and of the sine-Gordon equation, respectively. We provide the integrating factors corresponding to the integrals. Moreover we show how the integrals and the integrating factors relate to the staircase method

  3. Central subspace dimensionality reduction using covariance operators.

    Science.gov (United States)

    Kim, Minyoung; Pavlovic, Vladimir

    2011-04-01

    We consider the task of dimensionality reduction informed by real-valued multivariate labels. The problem is often treated as Dimensionality Reduction for Regression (DRR), whose goal is to find a low-dimensional representation, the central subspace, of the input data that preserves the statistical correlation with the targets. A class of DRR methods exploits the notion of inverse regression (IR) to discover central subspaces. Whereas most existing IR techniques rely on explicit output space slicing, we propose a novel method called the Covariance Operator Inverse Regression (COIR) that generalizes IR to nonlinear input/output spaces without explicit target slicing. COIR's unique properties make DRR applicable to problem domains with high-dimensional output data corrupted by potentially significant amounts of noise. Unlike recent kernel dimensionality reduction methods that employ iterative nonconvex optimization, COIR yields a closed-form solution. We also establish the link between COIR, other DRR techniques, and popular supervised dimensionality reduction methods, including canonical correlation analysis and linear discriminant analysis. We then extend COIR to semi-supervised settings where many of the input points lack their labels. We demonstrate the benefits of COIR on several important regression problems in both fully supervised and semi-supervised settings.

  4. Geometric subspace updates with applications to online adaptive nonlinear model reduction

    DEFF Research Database (Denmark)

    Zimmermann, Ralf; Peherstorfer, Benjamin; Willcox, Karen

    2018-01-01

    In many scientific applications, including model reduction and image processing, subspaces are used as ansatz spaces for the low-dimensional approximation and reconstruction of the state vectors of interest. We introduce a procedure for adapting an existing subspace based on information from...... Estimation (GROUSE). We establish for GROUSE a closed-form expression for the residual function along the geodesic descent direction. Specific applications of subspace adaptation are discussed in the context of image processing and model reduction of nonlinear partial differential equation systems....

  5. Sarcopenia: a new predictor of postoperative complications for elderly gastric cancer patients who underwent radical gastrectomy.

    Science.gov (United States)

    Zhou, Chong-Jun; Zhang, Feng-Min; Zhang, Fei-Yu; Yu, Zhen; Chen, Xiao-Lei; Shen, Xian; Zhuang, Cheng-Le; Chen, Xiao-Xi

    2017-05-01

    A geriatric assessment is needed to identify high-risk elderly patients with gastric cancer. However, the current geriatric assessment has been considered to be either time-consuming or subjective. The present study aimed to investigate the predictive effect of sarcopenia on the postoperative complications for elderly patients who underwent radical gastrectomy. We conducted a prospective study of patients who underwent radical gastrectomy from August 2014 to December 2015. Computed tomography-assessed lumbar skeletal muscle, handgrip strength, and gait speed were measured to define sarcopenia. Sarcopenia was present in 69 of 240 patients (28.8%) and was associated with lower body mass index, lower serum albumin, lower hemoglobin, and higher nutritional risk screening 2002 scores. Postoperative complications significantly increased in the sarcopenic patients (49.3% versus 24.6%, P sarcopenia (odds ratio: 2.959, 95% CI: 1.629-5.373, P Sarcopenia, presented as a new geriatric assessment factor, was a strong and independent risk factor for postoperative complications of elderly patients with gastric cancer. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. In situ spectroscopic monitoring of CO2 reduction at copper oxide electrode.

    Science.gov (United States)

    Wang, Liying; Gupta, Kalyani; Goodall, Josephine B M; Darr, Jawwad A; Holt, Katherine B

    2017-04-28

    Copper oxide modified electrodes were investigated as a function of applied electrode potential using in situ infrared spectroscopy and ex situ Raman and X-ray photoelectron spectroscopy. In deoxygenated KHCO 3 electrolyte bicarbonate and carbonate species were found to adsorb to the electrode during reduction and the CuO was reduced to Cu(i) or Cu(0) species. Carbonate was incorporated into the structure and the CuO starting material was not regenerated on cycling to positive potentials. In contrast, in CO 2 saturated KHCO 3 solution, surface adsorption of bicarbonate and carbonate was not observed and adsorption of a carbonato-species was observed with in situ infrared spectroscopy. This species is believed to be activated, bent CO 2 . On cycling to negative potentials, larger reduction currents were observed in the presence of CO 2 ; however, less of the charge could be attributed to the reduction of CuO. In the presence of CO 2 CuO underwent reduction to Cu 2 O and potentially Cu, with no incorporation of carbonate. Under these conditions the CuO starting material could be regenerated by cycling to positive potentials.

  7. [A Case of Ascending Colon Cancer with Lynch Syndrome Who Underwent XELOX Adjuvant Chemotherapy].

    Science.gov (United States)

    Takase, Koki; Murata, Kohei; Kagawa, Yoshinori; Nose, Yohei; Kawai, Kenji; Sakamoto, Takuya; Naito, Atsushi; Murakami, Kohei; Katsura, Yoshiteru; Omura, Yoshiaki; Takeno, Atsushi; Nakatsuka, Shinichi; Takeda, Yutaka; Kato, Takeshi; Tamura, Shigeyuki

    2018-01-01

    Lynch syndrome is an inherited syndrome with the development of the colorectal and various other cancers. Lynch syndrome is caused by mutations in the mismatch repair genes. A 33 year-old male underwent XELOX adjuvant chemotherapy for ascending colon cancer with Lynch syndrome. Although efficacy of 5-FU is not demonstrated in Lynch syndrome, MOSAIC trial had suggested a benefit from FOLFOX compared with 5-FU in patients who have colorectal cancer with Lynch syndrome. Oxaliplatin-based adjuvant chemotherapy can be a therapeutic option for colorectal cancer in lynch syndrome patients.

  8. Surgical management of low grade isthmic spondylolisthesis; a randomized controlled study of the surgical fixation with and without reduction

    Directory of Open Access Journals (Sweden)

    Bashaireh Khaldoon M

    2011-07-01

    Full Text Available Abstract Background spondylolisthesis is a condition in which a vertebra slips out of the proper position onto the bone below it as a result of pars interarticularis defect. The slipped segment produces abnormal positioning of the vertebrae in relation to each other along the spinal column and causes mechanical back pain and neural breach. Materials and methods A randomized and double blinded study consisted of 41 patients aged 36-69 years (18 females and 28 males treated for symptomatic spondylolisthesis between December,2006 and December, 2009. All patients were randomly distributed into two groups I and II. Twenty patients were in Group I; they underwent reduction of the slipped vertebrae by using Reduction-Screw Technique and posterior lumbar interbody fixation (PLIF. Group II consisted of twenty one patients who underwent only surgical fixation (PLIF without reduction. All patients in this study had same pre and post operative management. Results only one case had broken rod in group I that required revision. Superficial wound infection was experienced in two patients and one patient, from group II, developed wound hematoma. The outcome in both groups was variable on the short term but was almost the same on the long term follow up. Conclusion surgical management of symptomatic low grade spondylolisthesis should include neural decompression and surgical fixation. Reduction of slipped vertebral bodies is unnecessary as the ultimate outcome will be likely similar.

  9. Cortical Blindness In Fat Embolism Syndrome Following Fracture Manipulative Procedure

    Directory of Open Access Journals (Sweden)

    A Shahrulazua

    2010-03-01

    Full Text Available Fat embolism syndrome is a well-recognised sequela of long bone trauma as well as intramedullary orthopaedic procedures. However, it has rarely been described following manipulation, reduction of fracture, and application of external fixator. Furthermore, bilateral ocular blindness is seldom the first manifestation; instead respiratory and other cerebral symptoms being most common. We describe a case with this rare presentation in a patient who underwent a trial of closed reduction, then open reduction of a femur fracture, followed by external fixation performed at day 47 post-initial trauma.

  10. Dose reduction in chest CT: Comparison of the adaptive iterative dose reduction 3D, adaptive iterative dose reduction, and filtered back projection reconstruction techniques

    Energy Technology Data Exchange (ETDEWEB)

    Yamada, Yoshitake, E-mail: yamada@rad.med.keio.ac.jp [Department of Diagnostic Radiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582 (Japan); Jinzaki, Masahiro, E-mail: jinzaki@rad.med.keio.ac.jp [Department of Diagnostic Radiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582 (Japan); Hosokawa, Takahiro, E-mail: hosokawa@rad.med.keio.ac.jp [Department of Diagnostic Radiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582 (Japan); Tanami, Yutaka, E-mail: tanami@rad.med.keio.ac.jp [Department of Diagnostic Radiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582 (Japan); Sugiura, Hiroaki, E-mail: hsugiura@rad.med.keio.ac.jp [Department of Diagnostic Radiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582 (Japan); Abe, Takayuki, E-mail: tabe@z5.keio.jp [Center for Clinical Research, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582 (Japan); Kuribayashi, Sachio, E-mail: skuribay@a5.keio.jp [Department of Diagnostic Radiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582 (Japan)

    2012-12-15

    Objectives: To assess the effectiveness of adaptive iterative dose reduction (AIDR) and AIDR 3D in improving the image quality in low-dose chest CT (LDCT). Materials and methods: Fifty patients underwent standard-dose chest CT (SDCT) and LDCT simultaneously, performed under automatic exposure control with noise index of 19 and 38 (for a 2-mm slice thickness), respectively. The SDCT images were reconstructed with filtered back projection (SDCT-FBP images), and the LDCT images with FBP, AIDR and AIDR 3D (LDCT-FBP, LDCT-AIDR and LDCT-AIDR 3D images, respectively). On all the 200 lung and 200 mediastinal image series, objective image noise and signal-to-noise ratio (SNR) were measured in several regions, and two blinded radiologists independently assessed the subjective image quality. Wilcoxon's signed rank sum test with Bonferroni's correction was used for the statistical analyses. Results: The mean dose reduction in LDCT was 64.2% as compared with the dose in SDCT. LDCT-AIDR 3D images showed significantly reduced objective noise and significantly increased SNR in all regions as compared to the SDCT-FBP, LDCT-FBP and LDCT-AIDR images (all, P ≤ 0.003). In all assessments of the image quality, LDCT-AIDR 3D images were superior to LDCT-AIDR and LDCT-FBP images. The overall diagnostic acceptability of both the lung and mediastinal LDCT-AIDR 3D images was comparable to that of the lung and mediastinal SDCT-FBP images. Conclusions: AIDR 3D is superior to AIDR. Intra-individual comparisons between SDCT and LDCT suggest that AIDR 3D allows a 64.2% reduction of the radiation dose as compared to SDCT, by substantially reducing the objective image noise and increasing the SNR, while maintaining the overall diagnostic acceptability.

  11. Revisiting the effects of organic solvents on the thermal reduction of graphite oxide

    International Nuclear Information System (INIS)

    Barroso-Bujans, Fabienne; Fierro, José Luis G.; Alegría, Angel; Colmenero, Juan

    2011-01-01

    Highlights: ► Retention of organic solvent on graphite oxide interlayer space. ► Decreasing exfoliation temperature. ► Close link between structure and thermal behavior of solvent treated graphite oxide. ► Restacking inhibition of thermally reduced graphite oxide sheets. ► Changes in kinetic mechanisms of thermal reduction. - Abstract: Treatment of graphite oxide (GO) with organic solvents via sorption from either liquid or gas phase, and subsequent desorption, induces profound changes in the layered GO structure: loss of stacking order, retention of trace amounts of solvents and decreasing decomposition temperature. This study presents new evidences of the effect of organic solvents on the thermal reduction of GO by means of thermogravimetric analysis, X-ray diffraction and X-ray photoelectron spectroscopy. The results reveal a relative higher decrease of the oxygen amounts in solvent-treated GO as compared to untreated GO and the restacking inhibition of the thermally reduced GO sheets upon slow heating. The kinetic experiments evidence changes occurring in the reduction mechanisms of the solvent-treated GO, which support the close link between GO structure and thermal properties.

  12. Minimally invasive treatment of tibial pilon fractures through arthroscopy and external fixator-assisted reduction.

    Science.gov (United States)

    Luo, Huasong; Chen, Liaobin; Liu, Kebin; Peng, Songming; Zhang, Jien; Yi, Yang

    2016-01-01

    The aim of this study was to evaluate the clinical outcome of tibial pilon fractures treated with arthroscopy and assisted reduction with an external fixator. Thirteen patients with tibial pilon fractures underwent assisted reduction for limited lower internal fixation with an external fixator under arthroscopic guidance. The weight-bearing time was decided on the basis of repeat radiography of the tibia 3 months after surgery. Postoperative ankle function was evaluated according to the Mazur scoring system. Healing of fractures was achieved in all cases, with no complications such as severe infection, skin necrosis, or an exposed plate. There were 9 excellent, 2 good, and 2 poor outcomes, scored according to the Mazur system. The acceptance rate was 85%. Arthroscopy and external fixator-assisted reduction for the minimally invasive treatment of tibial pilon fractures not only produced less trauma but also protected the soft tissues and blood supply surrounding the fractures. External fixation could indirectly provide reduction and effective operative space for arthroscopic implantation, especially for AO type B fractures and partial AO type C1 fractures.

  13. Synthesis of anti-tumour phosphatidylinositol analogues from glucose by the use of ring-closing olefin metathesis

    DEFF Research Database (Denmark)

    Andresen, Thomas Lars; Skytte, Dorthe M.; Madsen, Robert

    2004-01-01

    A divergent strategy is described for synthesis of the novel phosphatidylinositols 1-3. The synthetic approach commences from benzyl-protected methyl 6-iodo-6-deoxy-a-D-glucopyranoside, which undergoes zinc-mediated reductive fragmentation followed by vinyl Grignard addition and ring-closing meta...

  14. The Demographics of Patients with Skin Cancer who Underwent Surgery in Diyarbakır and Performed Surgical Techniques

    Directory of Open Access Journals (Sweden)

    Burhan Özalp

    2018-06-01

    Full Text Available Objective: The major factor for developing malignant skin cancers is sunlight exposure. This study aimed to evaluate the demographics of patients with skin cancers who underwent surgery in Diyarbakır where the population is exposed to more sunlight than most other Turkish cities. Methods: The medical records of patients who underwent surgery for malignant skin cancer excision between 2011 and 2016 were searched using University Hospital’s patient database program. Data about patients’ demographics, cancer features, and the surgical techniques performed were collected. Results: Over a 5-year period, 190 patients underwent surgical excision. The male to female ratio was 1.56, and the mean age was 65.8 ± 15.7 (range, 20-94 years. The most common skin cancer was basal cell carcinoma (n=138, 72.7%, followed by squamous cell carcinoma (n=45, 23.7% and malignant melanoma (n=5, 2.6%. The most common surgery was primary excision, which was performed in 90 of 190 patients (47.36%; tissue reconstruction with a skin graft or flap surgery was required for the remaining 100 (52.63%, showing a significant difference (p<0.001. Conclusion: Basal cell carcinoma is the most common skin cancer, and less than half of the patients sought treatment immediately after they recognized the lesion. The public should be educated about skin cancers to increase early diagnosis and encourage timely treatment, thereby decreasing morbidity and mortality from skin cancer.

  15. MRI-Guided Intervention for Breast Lesions Using the Freehand Technique in a 3.0-T Closed-Bore MRI Scanner: Feasibility and Initial Results

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Hye Young [Department of Radiology, Gyeongsang National University Hospital, Jinju 660-702 (Korea, Republic of); Kim, Sun Mi; Jang, Mijung; Yun, Bo La [Department of Radiology, Seoul National University Bundang Hospital, Seongnam 463-707 (Korea, Republic of); Kim, Sung-Won; Kang, Eunyoung [Department of Surgery, Seoul National University Bundang Hospital, Seongnam 463-707 (Korea, Republic of); Park, So Yeon [Department of Pathology, Seoul National University Bundang Hospital, Seongnam 463-707 (Korea, Republic of); Moon, Woo Kyung [Department of Radiology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul 110-744 (Korea, Republic of); Ko, Eun Sook [Department of Radiology, Samsung Medical Center, Seoul 135-710 (Korea, Republic of)

    2013-07-01

    To report the feasibility of magnetic resonance imaging (MRI)-guided intervention for diagnosing suspicious breast lesions detectable by MRI only, using the freehand technique with a 3.0-T closed-bore MRI scanner. Five women with 5 consecutive MRI-only breast lesions underwent MRI-guided intervention: 3 underwent MRI-guided needle localization and 2, MRI-guided vacuum-assisted biopsy. The interventions were performed in a 3.0-T closed-bore MRI system using a dedicated phased-array breast coil with the patients in the prone position; the freehand technique was used. Technical success and histopathologic outcome were analyzed. MRI showed that four lesions were masses (mean size, 11.5 mm; range, 7-18 mm); and 1, a nonmass-like enhancement (maximum diameter, 21 mm). The locations of the lesions with respect to the breast with index cancer were as follows: different quadrant, same breast - 3 cases; same quadrant, same breast - 1 case; and contralateral breast - 1 case. Histopathologic evaluation of the lesions treated with needle localization disclosed perilobular hemangioma, fibrocystic change, and fibroadenomatous change. The lesions treated with vacuum-assisted biopsy demonstrated a radial scar and atypical apocrine hyperplasia. Follow-up MRI after 2-7 months (mean, 4.6 months) confirmed complete lesion removal in all cases. MRI-guided intervention for breast lesions using the freehand technique with a 3.0-T closed-bore MRI scanner is feasible and accurate for diagnosing MRI-only lesions.

  16. MRI-Guided Intervention for Breast Lesions Using the Freehand Technique in a 3.0-T Closed-Bore MRI Scanner: Feasibility and Initial Results

    International Nuclear Information System (INIS)

    Choi, Hye Young; Kim, Sun Mi; Jang, Mijung; Yun, Bo La; Kim, Sung-Won; Kang, Eunyoung; Park, So Yeon; Moon, Woo Kyung; Ko, Eun Sook

    2013-01-01

    To report the feasibility of magnetic resonance imaging (MRI)-guided intervention for diagnosing suspicious breast lesions detectable by MRI only, using the freehand technique with a 3.0-T closed-bore MRI scanner. Five women with 5 consecutive MRI-only breast lesions underwent MRI-guided intervention: 3 underwent MRI-guided needle localization and 2, MRI-guided vacuum-assisted biopsy. The interventions were performed in a 3.0-T closed-bore MRI system using a dedicated phased-array breast coil with the patients in the prone position; the freehand technique was used. Technical success and histopathologic outcome were analyzed. MRI showed that four lesions were masses (mean size, 11.5 mm; range, 7-18 mm); and 1, a nonmass-like enhancement (maximum diameter, 21 mm). The locations of the lesions with respect to the breast with index cancer were as follows: different quadrant, same breast - 3 cases; same quadrant, same breast - 1 case; and contralateral breast - 1 case. Histopathologic evaluation of the lesions treated with needle localization disclosed perilobular hemangioma, fibrocystic change, and fibroadenomatous change. The lesions treated with vacuum-assisted biopsy demonstrated a radial scar and atypical apocrine hyperplasia. Follow-up MRI after 2-7 months (mean, 4.6 months) confirmed complete lesion removal in all cases. MRI-guided intervention for breast lesions using the freehand technique with a 3.0-T closed-bore MRI scanner is feasible and accurate for diagnosing MRI-only lesions

  17. the contributions of agricultural growth to poverty reduction in ethiopia

    African Journals Online (AJOL)

    RahelYilma

    in poverty is estimated indirectly. In the second ... Currently it is estimated that close to half of the ... of land nor private investors can purchase land from rural dwellers. ..... (1995-2000) and extrapolating to 2020 provides a poverty incidence of 39.4. The ..... return in terms of poverty reduction from a growth in farm productivity.

  18. Surgical treatment for pilon fracture of the ankle-open reduction and internal fixation.

    Science.gov (United States)

    Chen, Y W; Huang, P J; Hsu, C Y; Kuo, C H; Cheng, Y M; Lin, S Y; Chen, L H; Chiang, H C

    1998-01-01

    From 1991 to 1994, 39 ankles of 38 patients underwent surgical open reduction and internal fixation for pilon fractures. These patients included 29 males and 9 females with an average age of 38.6 y/o (range 28 y/o-58 y/o). The follow up and evaluation period averaged 31.7 months (range 22Ms-44Ms), during which time a standing x-ray for arthrosis grading and functional scale was used for clinical evaluation. Complications included 1 case of infection, 1 case of loss reduction, 2 cases of partial skin necrosis and 2 cases of delayed union. Post-traumatic arthritis occurred in 23 ankles (59%) but only 4 ankles of grade 4 arthrosis resulted in poor functional scale and the overall satisfactory rate was 82%. It was found that anatomic reduction, rigid fixation and early motion exercise are important to successful treatment of ankle fractures. Regarding pilon fracture, specifically the severity of fracture pattern and delay of reduction are important problems to overcome to ensure successful results. Therefore, adequate surgical approach for entire view of ankle joint, reduction and fixation of fibula, sufficient bone graft for articular support, intraoperative x-ray check and postoperative immobilization are essential for the achievement of better clinical results.

  19. Surrogate pregnancy in a patient who underwent radical hysterectomy and bilateral transposition of ovaries.

    Science.gov (United States)

    Azem, Foad; Yovel, Israel; Wagman, Israel; Kapostiansky, Rita; Lessing, Joseph B; Amit, Ami

    2003-05-01

    To evaluate IVF-surrogate pregnancy in a patient with ovarian transposition after radical hysterectomy for carcinoma of the cervix. Case report. A maternity hospital in Tel Aviv that is a major tertiary care and referral center. A 29-year-old woman who underwent Wertheim's hysterectomy for carcinoma of the uterine cervix and ovarian transposition before total pelvic irradiation. Standard IVF treatment, transabdominal oocyte retrieval, and transfer to surrogate mother. Outcome of IVF cycle. A twin pregnancy in the first cycle. This is the second reported case of controlled ovarian stimulation and oocyte retrieval performed on a transposed ovary.

  20. Dysphagia among adult patients who underwent surgery for esophageal atresia at birth.

    Science.gov (United States)

    Huynh Trudeau, Valérie; Maynard, Stéphanie; Terzic, Tatjana; Soucy, Geneviève; Bouin, Mickeal

    2015-03-01

    Clinical experiences of adults who underwent surgery for esophageal atresia at birth is limited. There is some evidence that suggests considerable long-term morbidity, partly because of dysphagia, which has been reported in up to 85% of adult patients who undergo surgery for esophageal atresia. The authors hypothesized that dysphagia in this population is caused by dysmotility and⁄or anatomical anomalies. To determine the motor and anatomical causes of dysphagia. A total of 41 adults, followed at the Esophageal Atresia Clinic at Hôpital Saint-Luc (Montreal, Quebec), were approached to particpate in the present prospective study. Evaluation was completed using upper endoscopy, manometry and barium swallow for the participants who consented. The medical charts of respondents were systematically reviewed from the neonatal period to 18 years of age to assess medical and surgical history. All 41 patients followed at the clinic consented and were included in the study. Dysphagia was present in 73% of patients. Esophagogastroduodenoscopy was performed in 32 patients: hiatal hernia was present in 62% (n=20); esophageal diverticulum in 13% (n=4); macroscopic Barrett esophagus in 31% (n=10); and esophagitis in 19% (n=6). Histological esophagitis was present in 20% and intestinal metaplasia in 10%. There were no cases of dysplagia or adenocarcinoma. Esophageal manometry was performed on 56% of the patients (n=23). Manometry revealed hypomotility in 100% of patients and included an insufficient number of peristaltic waves in 96%, nonpropagating peristalsis in 78% and low-wave amplitude in 95%. Complete aperistalsis was present in 78%. The lower esophageal sphincter was abnormal in 12 (52%) patients, with incomplete relaxation the most common anomaly. Of the 41 patients, 29 (71%) consented to a barium swallow, which was abnormal in 13 (45%). The anomalies found were short esophageal dilation in 28%, delay in esophageal emptying in 14%, diverticula in 14% and stenosis in 7

  1. Efficiency comparison of 3 kinds of arterial puncture closing devices

    International Nuclear Information System (INIS)

    Feng Xiaodi; Jin Xian; Chen Yueguang; Xiao Hongbing; Yu Qiang; Chen Chengjun; Zhang Dadong

    2007-01-01

    Objective: To evaluate the efficiencies of arterial puncture closing devices (APCDs) including Angioseal, Perclose and Boomerang in patients undergone coronary angiography or percutaneous vascular interventions. Methods: 1497 patients underwent cardiac catheterization procedures were divided into manual compression group(639 cases) and APCDs closure group (576 cases with Angioseal, 151 cases Perclose and 11.3 cases of Boomerang). The times of maneuver, hemorrhage complication and other rare complications were assessed, recorded and compared. Results: The times for maneuver of standard manual compression group, Angioseal group, Perclose group and Boomerang group were (21.4±2.7) h, (3.5±2.3) h, (3.7± 2.6) h and (3.9±2.8) h respectively. The APCDs could obviously reduce bed rest time in comparing to that of manual compression. The rates of failure of the operations were 2.7%, 1.4%, 8.6% and 3.5% (P =0.006, P<0.001); and the rates of hemorrhage were 9.2%, 5.8%, 12.6% and 8.0% respectively for each of the four mentioned groups (P=0.005). Except the failure operations, the incidence of hemorrhage complications among the groups showed no significant differences. Conclusion: Application of APCDs to close the puncture site can significantly reduce the bed rest time, but not the incidence of hemorrhage complications. (authors)

  2. Long-term outcomes of septal reduction for obstructive hypertrophic cardiomyopathy.

    Science.gov (United States)

    Sedehi, Daniel; Finocchiaro, Gherardo; Tibayan, Yen; Chi, Jeffrey; Pavlovic, Aleksandra; Kim, Young M; Tibayan, Frederick A; Reitz, Bruce A; Robbins, Robert C; Woo, Joseph; Ha, Richard; Lee, David P; Ashley, Euan A

    2015-07-01

    Surgical myectomy and alcohol septal ablation (ASA) aim to decrease left ventricular outflow tract (LVOT) gradient in hypertrophic cardiomyopathy (HCM). Outcome of myectomy beyond 10 years has rarely been described. We describe 20 years of follow-up of surgical myectomy and 5 years of follow-up for ASA performed for obstructive HCM. We studied 171 patients who underwent myectomy for symptomatic LVOT obstruction between 1972 and 2006. In addition, we studied 52 patients who underwent ASA for the same indication and who declined surgery. Follow-up of New York Heart Association (NYHA) functional class, echocardiographic data, and vital status were obtained from patient records. Mortality rates were compared with expected mortality rates of age- and sex-matched populations. Surgical myectomy improved NYHA class (2.74±0.65 to 1.54±0.74, phistorical data from non-operated HCM patients. Survival after ASA at 2 and 5 years was 97.8% and 94.7%, respectively. Short-term (5 year) survival after ASA (SMR=0.61, p=0.48) was comparable to that of the general population. Long-term follow-up of septal reduction strategies in obstructive HCM reveals that surgical myectomy and ASA are effective for symptom relief and LVOT gradient reduction and are associated with favorable survival. While overall prognosis for the community HCM population is similar to the general population, the need for surgical myectomy may identify a sub-group with poorer long-term prognosis. We await long-term outcomes of more extensive myectomy approaches adopted in the past 10 years at major institutions. Copyright © 2015. Published by Elsevier Ltd.

  3. Autologous inferior dermal sling (autoderm) with concomitant skin-envelope reduction mastectomy: an excellent surgical choice for women with macromastia and clinically significant ptosis.

    Science.gov (United States)

    Dietz, Jill; Lundgren, P; Veeramani, A; O'Rourke, C; Bernard, S; Djohan, R; Larson, J; Isakov, R; Yetman, R

    2012-10-01

    Skin-sparing mastectomy and prosthetic reconstruction can be complicated by poor surgical outcomes in large-breasted, obese women. This article describes a single surgeon's experience comparing conventional skin-sparing mastectomy (SSM) and skin-reduction mastectomy using an autologous vascularized inferior dermal/cutaneous sling (autoderm). From July 2007 to May 2012, patients undergoing skin-sparing mastectomy were evaluated for surgical outcomes. After July 2009, the surgeon performed skin-reduction mastectomies with autoderm (SRM-AD) on all patients with macromastia or grade 3-4 ptosis. Remaining patients in this time period (SSM-cont) underwent conventional skin-sparing mastectomies while all previous patients (historical) also underwent skin-sparing mastectomies (SSM-hist). A predictive model was used to compare the large historical patients (who would have had reduction mastectomy if available) with the smaller historical patients to evaluate the effect of the procedure. Body mass index (BMI) and specimen weight were higher in both the SRM group and large historical group. The hazard ratio for having skin-reduction mastectomy was 0.53 (P = 0.51) compared with the historical group. There was a total of 16 complications for the whole study. Smoking was the only significant risk factor. This study shows that mastectomy with prosthetic reconstruction using a skin-reduction technique with autoderm can be done safely with a low complication rate and improved cosmetic outcomes in the traditionally "at-risk" group of women with high BMI and large ptotic breasts.

  4. Numerical investigation of closed-loop control for Hall accelerators

    International Nuclear Information System (INIS)

    Barral, S.; Miedzik, J.

    2011-01-01

    Low frequency discharge current oscillations in Hall accelerators are conventionally damped with external inductor-capacitor (LC) or resistor-inductor-capacitor (RLC) networks. The role of such network in the stabilization of the plasma discharge is investigated with a numerical model and the potential advantages of proportional-integral-derivative (PID) closed-loop control over RLC networks are subsequently assessed using either discharge voltage or magnetic field modulation. Simulations confirm the reduction of current oscillations in the presence of a RLC network, but suggest that PID control could ensure nearly oscillation-free operation with little sensitivity toward the PID settings.

  5. CLOSING MACULAR HOLES WITH "MACULAR PLUG" WITHOUT GAS TAMPONADE AND POSTOPERATIVE POSTURING.

    Science.gov (United States)

    Chakrabarti, Meena; Benjamin, Preethi; Chakrabarti, Keya; Chakrabarti, Arup

    2017-03-01

    To investigate the surgical results of macular hole surgery without gas tamponade or postoperative posturing in patients with Stage 3 and Stage 4 macular holes with ≥500 μm mean base diameter. Retrospective interventional case series. Twenty-six patients with Stage 3 and Stage 4 macular holes. Twenty-six eyes of 26 patients with Stage 3 and Stage 4 macular holes and a mean base diameter of 892.8 ± 349 μm underwent pars plana 23-gauge vitrectomy with broad internal limiting membrane peel (ILM peel), inverted ILM flap repositioning (ILMR), and use of autologous gluconated blood clumps as a macular plug to close the macular hole. No fluid-air exchange, endotamponade, or postoperative posturing was used. The subjects were followed up for 12 months. The anatomical outcome of the procedure was evaluated by fundus examination and optical coherence tomography. Spectral domain optical coherence tomography was used to study the restoration of the outer retinal layer integrity in the postoperative period. The preoperative and postoperative best-corrected visual acuities in logMAR units were compared to evaluate functional outcome. Macular hole closure and best-corrected visual acuity before and after surgery. Twenty-six patients with mean age 62.8 ± 7.3 years, preoperative median best-corrected visual acuity 6/60 (1.0 logMAR units), and a mean base diameter of 892.8 ± 349 μm underwent surgery to close macular holes without gas tamponade or postoperative posturing. Twenty patients (76.9%) were phakic. Twenty eyes (76.92%) had Stage 3 macular holes and 6 eyes (23.10%) had Stage 4 macular holes. After a single surgery, hole closure was achieved in 100% of eyes. The median best-corrected visual acuity improved from 6/60 (1.0 logMAR units) to 6/18 (0.50 logMAR units) (P hole closure with statically significant functional improvement for large Stage 3 and Stage 4 macular holes.

  6. Reduction mammoplasty as a treatment for symptomatic central venous stenosis

    Directory of Open Access Journals (Sweden)

    Denise Seok Fun Fok

    2018-03-01

    Full Text Available Central venous stenosis is a rare cause of unilateral breast edema occurring in hemodialysis patients that needs to be differentiated from other differential diagnoses, including, but not limited to, inflammatory breast carcinoma, mastitis, lymphedema, and congestive heart failure. All reports of similar cases in the available literature have described improvement or resolution of the edema after treatment. Herein, we report and discuss the pathophysiology of breast edema formation in a patient who presented with massive left-sided breast edema 7 years after being diagnosed with central venous stenosis. Medical and minimally invasive therapy had not been successful, so she underwent reduction mammoplasty to relieve the symptoms.

  7. Reduction of thyroid volume following radioiodine therapy for functional autonomy

    International Nuclear Information System (INIS)

    Luster, M.; Jacob, M.; Thelen, M.H.; Michalowski, U.; Deutsch, U.; Reiners, C.

    1995-01-01

    In a retrospective study we evaluated the data of 112 patients who underwent radioiodine treatment for functional autonomy of the thyroid at Essen University Hospital from 1988 to 1993. Therapeutic activities of radioiodine were administered after individual determination of activity for intended radiation doses (150-300 Gy) taking into consideration autonomously functioning volume, maximum uptake, and effective half-life. The achieved dose was calculated by means of measurement of the radioiodine kinetics during therapy. Depending on the type of autonomous function of the thyroid (solitary autonomously functioning nodule, multiple autonomously functioning nodules, autonomously functioning thyroid tissue) volume reductions between 39 and 46% were found approximately 6 months after treatment. (orig.) [de

  8. Laparoscopy-assisted hydrostatic in situ reduction of intussusception: A reasonable alternative?

    Directory of Open Access Journals (Sweden)

    V. V. S. S. Chandrasekharam

    2011-01-01

    Full Text Available Aim: To evaluate an alternative way of reducing intussusceptions under laparoscopic guidance. Materials and Methods: This is a retrospective observational study of children who underwent laparoscopy-assisted hydrostatic in situ reduction of intussusceptions (LAHIRI. Under general anesthesia with laparoscopic vision, warm saline was infused into the rectum with a 16-18 F Foley catheter and a drip set till the intussusception was reduced. Results: Eleven patients [age 7.8 (±2.8 months] were operated over a period of 1 year. Ten (90.9% patients had ileocolic intussusception, which got completely reduced, but one (9% had ileo-ileocolic intusussception, in whom manual reduction by extending the subumbilical incision was required to reduce the ileoileal part. The mean duration of surgery was 38.5 (±6.6 min. No patient had bowel ischemia and there were no intra- or postoperative complications. Conclusions: LAHIRI appears to be an effective and safe technique in children. Specific advantages are that it is performed in a controlled environment in the operating room, avoids patient apprehension and discomfort, avoids bowel handling, provides a safe opportunity to create higher intraluminal pressure, ensures visual assessment of bowel vascularity and completeness of reduction.

  9. Poisson-Jacobi reduction of homogeneous tensors

    International Nuclear Information System (INIS)

    Grabowski, J; Iglesias, D; Marrero, J C; Padron, E; Urbanski, P

    2004-01-01

    The notion of homogeneous tensors is discussed. We show that there is a one-to-one correspondence between multivector fields on a manifold M, homogeneous with respect to a vector field Δ on M, and first-order polydifferential operators on a closed submanifold N of codimension 1 such that Δ is transversal to N. This correspondence relates the Schouten-Nijenhuis bracket of multivector fields on M to the Schouten-Jacobi bracket of first-order polydifferential operators on N and generalizes the Poissonization of Jacobi manifolds. Actually, it can be viewed as a super-Poissonization. This procedure of passing from a homogeneous multivector field to a first-order polydifferential operator can also be understood as a sort of reduction; in the standard case-a half of a Poisson reduction. A dual version of the above correspondence yields in particular the correspondence between Δ-homogeneous symplectic structures on M and contact structures on N

  10. Corpus callosum lesions after closed head injury in children: MRI, clinical features and outcome

    International Nuclear Information System (INIS)

    Mendelsohn, D.B.; Bruce, D.

    1992-01-01

    Thirty-four children who sustained moderate to severe closed head injury underwent magnetic resonance imaging (MRI). Eight (24%) had MRI evidence of corpus callosum injury, most commonly within the posterior body and splenium. In contradistinction to reports in adults, there was no definite relationship between callosal injury and lower initial Glasgow Coma Scale scores, nor was there a significantly higher incidence of primary brain-stem lesions, diffuse axonal shear injury or intraventricular hemorrhage. In none of these 8 children did the initial admission computed tomography show evidence of callosal injury. Callosal injuries on MRI are not necessarily a poor prognostic finding, the majority of the 8 children showing good functional recovery. (orig.)

  11. Void consolidation during open-die forging for ultralarge rotor shafts. (1. Formulation of void-closing behavior)

    International Nuclear Information System (INIS)

    Ono, Shin-ichi; Minami, Katsuyuki; Ochiai, Tomoyuki; Iwadate, Tadao; Nakata, Shin-ichi.

    1995-01-01

    Open-die forging experiments using different die geometries under hot isothermal conditions and three-dimensional simulations using rigid-plastic finite-element method were performed to formulate a void-closing behavior using only two factors; the integral of hydrostatic stress and the equivalent strain. First, upsetting, side-upsetting and V-shape die cogging of several cylinders with a spherical void at the center are carried out and the information on the void volume reduction is obtained. Seconds, the same forgings, but without voids is treated numerically and the development of stress and strain at the location of voids is investigated. Then, by combining these results, and using regression analysis, it is found that the void volume reduction is expressed as a polynomial function of the two factors. When the polynomial function is used, various forging methods can be evaluated quantitatively in terms of void-closing behavior. Therefore it is beneficial to optimize the forging process for a large rotor shaft. (author)

  12. Closed hollow bulb obturator--one-step fabrication: a clinical report.

    Science.gov (United States)

    Buzayan, Muaiyed M; Ariffin, Yusnidar T; Yunus, Norsiah

    2013-10-01

    A method is described for the fabrication of a closed hollow bulb obturator prosthesis using a hard thermoforming splint material and heat-cured acrylic resin. The technique allowed the thickness of the thermoformed bulb to be optimized for weight reduction, while the autopolymerized seal area was covered in heat-cured acrylic resin, thus eliminating potential leakage and discoloration. This technique permits the obturator prosthesis to be processed to completion from the wax trial denture without additional laboratory investing, flasking, and processing. © 2013 by the American College of Prosthodontists.

  13. The investigation of the FM heavy forging process by the Moiré method. Part II: Consecutive reduction results

    NARCIS (Netherlands)

    Wang, S.L.; Cao, Q.X.

    1994-01-01

    In part I of this work (preceding paper), single-reduction results on the FM forging process were reported. In the work reported in this paper, the cavity closing laws of the consecutive reduction process were investigated, the appropriate turn-over and feed procedure being obtained, along with the

  14. Infertility and Weight Reduction: Influence and Outcome

    International Nuclear Information System (INIS)

    Khaskheli, M. N.; Baloch, S.; Baloch, A. S.

    2013-01-01

    Objective: To assess the effect of weight reduction in obese infertile women on conception rate spontaneously as well as with ovulation induction and pregnancy outcome. Study Design: Observational experimental study. Place and Duration of Study: Different private clinics at Mirpurkhas, Thana Bola Khan and Hyderabad, Sindh, Pakistan, from March 2008 to February 2011. Methodology: Infertile women who were obese with the body mass index (BMI) > 30 kg/ m2 and failed to conceive within 2-5 years after taking treatment of infertility for many cycles were inducted. These women underwent life style change program related to exercise and diet for 6 months and in the next 6 months they were observed for spontaneous conception. Those women who failed to conceive were prescribed ovulation induction (clomifene citrate) for the next 6 months and were observed for conception. After conception, they visited regularly during antenatal period till delivery. The data was collected and analyzed on SPSS version 17. Results: The mean decrease in the body index observed was 9.6 +- 1.23 kg/m2, spontaneous conception rate was (n = 35, 41.17%) and miscarriage rate was (n = 9, 16.66%). Conclusion: Weight reduction leads to high spontaneous conception rate as well as with ovulation induction therapy and improves the pregnancy outcome. (author)

  15. Transauricular embolization of the rabbit coronary artery for experimental myocardial infarction: comparison of a minimally invasive closed-chest model with open-chest surgery

    Directory of Open Access Journals (Sweden)

    Katsanos Konstantinos

    2012-02-01

    Full Text Available Abstract Introduction To date, most animal studies of myocardial ischemia have used open-chest models with direct surgical coronary artery ligation. We aimed to develop a novel, percutaneous, minimally-invasive, closed-chest model of experimental myocardial infarction (EMI in the New Zealand White rabbit and compare it with the standard open-chest surgical model in order to minimize local and systemic side-effects of major surgery. Methods New Zealand White rabbits were handled in conformity with the "Guide for the Care and Use of Laboratory Animals" and underwent EMI under intravenous anesthesia. Group A underwent EMI with an open-chest method involving surgical tracheostomy, a mini median sternotomy incision and left anterior descending (LAD coronary artery ligation with a plain suture, whereas Group B underwent EMI with a closed-chest method involving fluoroscopy-guided percutaneous transauricular intra-arterial access, superselective LAD catheterization and distal coronary embolization with a micro-coil. Electrocardiography (ECG, cardiac enzymes and transcatheter left ventricular end-diastolic pressure (LVEDP measurements were recorded. Surviving animals were euthanized after 4 weeks and the hearts were harvested for Hematoxylin-eosin and Masson-trichrome staining. Results In total, 38 subjects underwent EMI with a surgical (n = 17 or endovascular (n = 21 approach. ST-segment elevation (1.90 ± 0.71 mm occurred sharply after surgical LAD ligation compared to progressive ST elevation (2.01 ± 0.84 mm;p = 0.68 within 15-20 min after LAD micro-coil embolization. Increase of troponin and other cardiac enzymes, abnormal ischemic Q waves and LVEDP changes were recorded in both groups without any significant differences (p > 0.05. Infarct area was similar in both models (0.86 ± 0.35 cm in the surgical group vs. 0.92 ± 0.54 cm in the percutaneous group;p = 0.68. Conclusion The proposed model of transauricular coronary coil embolization avoids

  16. Pure meat – public perceptions of risk reduction strategies in meat production

    DEFF Research Database (Denmark)

    Korzen, Sara Marie; Sandøe, Peter; Lassen, Jesper

    2011-01-01

    generally have an aversion to risk reduction strategies. Some variation was found, however, in the rejection of the strategies. Thus, more acceptable strategies are characterised by a low degree of technological interference, and by being close to the consumer’s experience in everyday life and/or familiar...

  17. Circulating S100B and Adiponectin in Children Who Underwent Open Heart Surgery and Cardiopulmonary Bypass

    Directory of Open Access Journals (Sweden)

    Alessandro Varrica

    2015-01-01

    Full Text Available Background. S100B protein, previously proposed as a consolidated marker of brain damage in congenital heart disease (CHD newborns who underwent cardiac surgery and cardiopulmonary bypass (CPB, has been progressively abandoned due to S100B CNS extra-source such as adipose tissue. The present study investigated CHD newborns, if adipose tissue contributes significantly to S100B serum levels. Methods. We conducted a prospective study in 26 CHD infants, without preexisting neurological disorders, who underwent cardiac surgery and CPB in whom blood samples for S100B and adiponectin (ADN measurement were drawn at five perioperative time-points. Results. S100B showed a significant increase from hospital admission up to 24 h after procedure reaching its maximum peak (P0.05 have been found all along perioperative monitoring. ADN/S100B ratio pattern was identical to S100B alone with the higher peak at the end of CPB and remained higher up to 24 h from surgery. Conclusions. The present study provides evidence that, in CHD infants, S100B protein is not affected by an extra-source adipose tissue release as suggested by no changes in circulating ADN concentrations.

  18. Influence of the reduction-crucible material on the uranium properties

    International Nuclear Information System (INIS)

    Braga, F.J.C.; Bose, A.; Freitas, C.T. de

    1979-01-01

    The uranium obtained by UF 4 reduction using Mg in bombs coated with different materials such as alumina, blast furnace slag, Zirconia and graphite was studied. The reduction process involves a reaction that altains temperatures of the order of 1600 0 C at tightly closed enclosure environment. Assuming in this process that the only possible influencial agent on the reaction main product, i.e., metallic uranium is the own bomb coaling, different properties, mechanical-metallurgical and phase-transformation characteristics were examined and the influences of the coating materials were compared. The comparison of these properties was also studied in uranium refined by arc fusion. (Author) [pt

  19. Influence of Reduction Promoters on Stability of Cobalt/g-Alumina Fischer-Tropsch Synthesis Catalysts

    OpenAIRE

    Gary Jacobs; Wenping Ma; Burtron H. Davis

    2014-01-01

    This focused review article underscores how metal reduction promoters can impact deactivation phenomena associated with cobalt Fischer-Tropsch synthesis catalysts. Promoters can exacerbate sintering if the additional cobalt metal clusters, formed as a result of the promoting effect, are in close proximity at the nanoscale to other cobalt particles on the surface. Recent efforts have shown that when promoters are used to facilitate the reduction of small crystallites with the aim of increasing...

  20. Reduction of Graphene Oxide to Graphene by Using Gamma Irradiation

    International Nuclear Information System (INIS)

    Shamellia Sharin; Irman Abdul Rahman; Ainee Fatimah Ahmad

    2015-01-01

    This research aims to gauge the ability of gamma radiation to induce the reduction of graphene oxide to graphene. Graphene oxide powders were dispersed into a mixture of alcohol and deionized water, and the mixture was then irradiated with a "6"0Co source using a GammaCell 220 Excel irradiator at absorbed doses of 0, 5, 15, 20 and 35 kGy. According to characterization using Fourier Transformed Infrared Spectroscopy (FTIR), it can be seen that almost every oxygen-containing functional group has been removed after irradiation of the graphene oxide mixture. Reduction of graphene oxide was also proven from the characterization using UV-Vis Spectroscopy, in which the wavelength of graphene oxide at 237 nm was red-shifted to 277 nm after being irradiated and the peak at 292 nm, (indicating the carboxyl group) disappears in the UV-Vis spectrum of reduced graphene oxide. Morphology of graphene oxide also changed from a smooth and flat surface to crumpled. The ratio of carbon/ oxygen in the graphene oxide was lower than the carbon/ oxygen of reduced graphene oxide. At the end of the experiment, it can be deduced that graphene oxide underwent reduction, characterized before and after irradiation using Emission Scanned Electron Microscopy and Energy Dispersive X-ray, Fourier Transformed Infrared Spectroscopy and UV-Vis Spectroscopy. Therefore, we postulate that the irradiation technique that induces reduction, can be used to obtain reduced graphene oxide from graphene oxide. (author)

  1. Average chewing pattern improvements following Disclusion Time reduction.

    Science.gov (United States)

    Kerstein, Robert B; Radke, John

    2017-05-01

    Studies involving electrognathographic (EGN) recordings of chewing improvements obtained following occlusal adjustment therapy are rare, as most studies lack 'chewing' within the research. The objectives of this study were to determine if reducing long Disclusion Time to short Disclusion Time with the immediate complete anterior guidance development (ICAGD) coronoplasty in symptomatic subjects altered their average chewing pattern (ACP) and their muscle function. Twenty-nine muscularly symptomatic subjects underwent simultaneous EMG and EGN recordings of right and left gum chewing, before and after the ICAGD coronoplasty. Statistical differences in the mean Disclusion Time, the mean muscle contraction cycle, and the mean ACP resultant from ICAGD underwent the Student's paired t-test (α = 0.05). Disclusion Time reductions from ICAGD were significant (2.11-0.45 s. p = 0.0000). Post-ICAGD muscle changes were significant in the mean area (p = 0.000001), the peak amplitude (p = 0.00005), the time to peak contraction (p chewing position became closer to centric occlusion (p chewing velocities increased (p chewing pattern (ACP) shape, speed, consistency, muscular coordination, and vertical opening improvements can be significantly improved in muscularly dysfunctional TMD patients within one week's time of undergoing the ICAGD enameloplasty. Computer-measured and guided occlusal adjustments quickly and physiologically improved chewing, without requiring the patients to wear pre- or post-treatment appliances.

  2. Ontogenetic Tooth Reduction in Stenopterygius quadriscissus (Reptilia: Ichthyosauria: Negative Allometry, Changes in Growth Rate, and Early Senescence of the Dental Lamina.

    Directory of Open Access Journals (Sweden)

    Daniel G Dick

    Full Text Available We explore the functional, developmental, and evolutionary processes which are argued to produce tooth reduction in the extinct marine reptile Stenopterygius quadriscissus (Reptilia: Ichthyosauria. We analyze the relationship between mandible growth and tooth size, shape, and count, to establish an ontogenetic trend. The pattern in S. quadriscissus is consistent with hypotheses of tooth size reduction by neutral selection, and this unusual morphology (a functionally edentulous rostrum was produced by a series of different evolutionary developmental changes that are known for other taxa showing tooth reduction and loss. Specifically, this species evolved functional edentulism by evolutionary changes in the growth allometry of the dentition and by altering growth rates through ontogeny. This observation supports previous hypotheses that S. quadriscissus underwent ontogenetic tooth reduction. Tooth reduction in S. quadriscissus may be caused by unique selective pressures resulting from prey choice and feeding behavior, expanding our current understanding of the mechanisms producing tooth reduction.

  3. One step synthesis of chlorine-free Pt/Nitrogen-doped graphene composite for oxygen reduction reaction

    KAUST Repository

    Varga, Tamá s; Varga, Á gnes Tí mea; Ballai, Gergő; Haspel, Henrik; Kukovecz, Á kos; Kó nya, Z.

    2018-01-01

    Chlorine-free Platinum/nitrogen-doped graphene oxygen reduction reaction catalysts were synthesized by a one step method of annealing a mixture of platinum acetylacetonate and graphene oxide under ammonia atmosphere. Nanoparticles with close

  4. Glass Polarization Induced Drift of a Closed-Loop Micro-Accelerometer

    Directory of Open Access Journals (Sweden)

    Wu Zhou

    2018-01-01

    Full Text Available The glass polarization effects were introduced in this paper to study the main cause of turn-on drift phenomenon of closed-loop micro-accelerometers. The glass substrate underneath the sensitive silicon structure underwent a polarizing process when the DC bias voltage was applied. The slow polarizing process induced an additional electrostatic field to continually drag the movable mass block from one position to another so that the sensing capacitance was changed, which led to an output drift of micro-accelerometers. This drift was indirectly tested by experiments and could be sharply reduced by a shielding layer deposited on the glass substrate because the extra electrical filed was prohibited from generating extra electrostatic forces on the movable fingers of the mass block. The experimental results indicate the average magnitude of drift decreased about 73%, from 3.69 to 0.99 mV. The conclusions proposed in this paper showed a meaningful guideline to improve the stability of micro-devices based on silicon-on-glass structures.

  5. Glass Polarization Induced Drift of a Closed-Loop Micro-Accelerometer.

    Science.gov (United States)

    Zhou, Wu; He, Jiangbo; Yu, Huijun; Peng, Bei; He, Xiaoping

    2018-01-20

    The glass polarization effects were introduced in this paper to study the main cause of turn-on drift phenomenon of closed-loop micro-accelerometers. The glass substrate underneath the sensitive silicon structure underwent a polarizing process when the DC bias voltage was applied. The slow polarizing process induced an additional electrostatic field to continually drag the movable mass block from one position to another so that the sensing capacitance was changed, which led to an output drift of micro-accelerometers. This drift was indirectly tested by experiments and could be sharply reduced by a shielding layer deposited on the glass substrate because the extra electrical filed was prohibited from generating extra electrostatic forces on the movable fingers of the mass block. The experimental results indicate the average magnitude of drift decreased about 73%, from 3.69 to 0.99 mV. The conclusions proposed in this paper showed a meaningful guideline to improve the stability of micro-devices based on silicon-on-glass structures.

  6. Reduction of chromium (VI by the indirect action of Thiobacillus thioparus

    Directory of Open Access Journals (Sweden)

    E. Donati

    2003-03-01

    Full Text Available The microbial reduction of chromium(VI to chromium(III has been one of the most widely studied forms of metal bioremediation. Recently, we have found that Thiobacillus ferrooxidans and Thiobacillus thiooxidans, growing on elemental sulphur, can indirectly promote chromium(VI reduction by producing reducing agents such as sulphite and thiosulphate, which abiotically reduce chromium(VI. Those species of Thiobacillus are acidophilic bacteria which grow optimally at pH values lower than 4. However, most of those reducing agents are stabilised at higher pH values. Thus, the present paper reports on the ability to reduce chromium(VI using another specie of Thiobacilli, Thiobacillus thioparus, which is able to grow at pH close to 7.0. T. thioparus cultures were carried out in a fermentation vessel containing medium and sulphur as the sole energy source and maintained at 30ºC and 400 rpm. The pH was adjusted to 6.0, 7.0 or 8.0 and maintained with the automatic addition of KOH. Our results show high chromium (VI reduction values (close to 100% at the end of bacterial growth at the three pH values. The results of these experiments are very promising for development of a microbiological process to be used in the detoxification of chromium(VI-polluted effluents.

  7. Wind Noise Reduction in a Non-Porous Subsurface Windscreen

    Science.gov (United States)

    Zuckerwar, Allan J.; Shams, Qamar A.; Knight, H. Keith

    2012-01-01

    Measurements of wind noise reduction were conducted on a box-shaped, subsurface windscreen made of closed cell polyurethane foam. The windscreen was installed in the ground with the lid flush with the ground surface. The wind was generated by means of a fan, situated on the ground, and the wind speed was measured at the center of the windscreen lid with an ultrasonic anemometer. The wind speed was controlled by moving the fan to selected distances from the windscreen. The wind noise was measured on a PCB Piezotronics 3†electret microphone. Wind noise spectra were measured with the microphone exposed directly to the wind (atop the windscreen lid) and with the microphone installed inside the windscreen. The difference between the two spectra comprises the wind noise reduction. At wind speeds of 3, 5, and 7 m/s, the wind noise reduction is typically 15 dB over the frequency range of 0.1-20 Hz.

  8. Reduction of artifacts caused by orthopedic hardware in the spine in spectral detector CT examinations using virtual monoenergetic image reconstructions and metal-artifact-reduction algorithms

    Energy Technology Data Exchange (ETDEWEB)

    Grosse Hokamp, Nils; Neuhaus, V.; Abdullayev, N.; Laukamp, K.; Lennartz, S.; Mpotsaris, A.; Borggrefe, J. [University Hospital Cologne, Department of Diagnostic and Interventional Radiology, Cologne (Germany)

    2018-02-15

    Aim of this study was to assess the artifact reduction in patients with orthopedic hardware in the spine as provided by (1) metal-artifact-reduction algorithms (O-MAR) and (2) virtual monoenergetic images (MonoE) as provided by spectral detector CT (SDCT) compared to conventional iterative reconstruction (CI). In all, 28 consecutive patients with orthopedic hardware in the spine who underwent SDCT-examinations were included. CI, O-MAR and MonoE (40-200 keV) images were reconstructed. Attenuation (HU) and noise (SD) were measured in order to calculate signal-to-noise ratio (SNR) of paravertebral muscle and spinal canal. Subjective image quality was assessed by two radiologists in terms of image quality and extent of artifact reduction. O-MAR and high-keV MonoE showed significant decrease of hypodense artifacts in terms of higher attenuation as compared to CI (CI vs O-MAR, 200 keV MonoE: -396.5HU vs. -115.2HU, -48.1HU; both p ≤ 0.001). Further, artifacts as depicted by noise were reduced in O-MAR and high-keV MonoE as compared to CI in (1) paravertebral muscle and (2) spinal canal - CI vs. O-MAR/200 keV: (1) 34.7 ± 19.0 HU vs. 26.4 ± 14.4 HU, p ≤ 0.05/27.4 ± 16.1, n.s.; (2) 103.4 ± 61.3 HU vs. 72.6 ± 62.6 HU/60.9 ± 40.1 HU, both p ≤ 0.001. Subjectively both O-MAR and high-keV images yielded an artifact reduction in up to 24/28 patients. Both, O-MAR and high-keV MonoE reconstructions as provided by SDCT lead to objective and subjective artifact reduction, thus the combination of O-MAR and MonoE seems promising for further reduction. (orig.)

  9. Effects of emission reductions from the smelters in Sudbury on recovery of lakes within the metal deposition zone

    Energy Technology Data Exchange (ETDEWEB)

    Keller, W.; Heneberry, J.; Clark, M.; Malette, M.; Gunn, J. [Laurentian Univ., Sudbury, ON (Canada) Dept. of Biology

    1999-07-01

    Recent trends are examined in the chemistry of Sudbury lakes for evidence of further chemical recovery, as well as some of the biological characteristics of recovering Sudbury lakes. Preliminary results are provided from studies investigating physical, chemical and biological factors that may influence the lake recovery process with a focus on the lakes close to Sudbury that were historically the most severely affected. Smelter emission reductions in the Sudbury area have led to substantial changes in the water quality of area lakes, and decreases in acidity, sulfate, and copper and nickel concentrations followed the substantial decreases in emissions during the 1970s and similar trends are continuing after the implementation of large additional smelter emission reductions in the 1990s. Some of the most highly affected lakes close to the Sudbury smelters have showed very dramatic reductions in acidity and metal concentrations during the 1990s. Evaluation of the direct effects of the recent emissions reductions is confounded by the potential continuing effects of previous emission reductions and the effects of weather variations on chemistry time trends in Sudbury lakes. Continued monitoring of Sudbury lakes is essential to evaluate the ultimate effect of emission reduction programs, to develop an understanding of the recovery process, and to determine the need for any additional emission reduction requirements. 38 refs., 7 figs.

  10. Artifact reduction of different metallic implants in flat detector C-arm CT.

    Science.gov (United States)

    Hung, S-C; Wu, C-C; Lin, C-J; Guo, W-Y; Luo, C-B; Chang, F-C; Chang, C-Y

    2014-07-01

    Flat detector CT has been increasingly used as a follow-up examination after endovascular intervention. Metal artifact reduction has been successfully demonstrated in coil mass cases, but only in a small series. We attempted to objectively and subjectively evaluate the feasibility of metal artifact reduction with various metallic objects and coil lengths. We retrospectively reprocessed the flat detector CT data of 28 patients (15 men, 13 women; mean age, 55.6 years) after they underwent endovascular treatment (20 coiling ± stent placement, 6 liquid embolizers) or shunt drainage (n = 2) between January 2009 and November 2011 by using a metal artifact reduction correction algorithm. We measured CT value ranges and noise by using region-of-interest methods, and 2 experienced neuroradiologists rated the degrees of improved imaging quality and artifact reduction by comparing uncorrected and corrected images. After we applied the metal artifact reduction algorithm, the CT value ranges and the noise were substantially reduced (1815.3 ± 793.7 versus 231.7 ± 95.9 and 319.9 ± 136.6 versus 45.9 ± 14.0; both P metallic objects and various sizes of coil masses. The rater study achieved an overall improvement of imaging quality and artifact reduction (85.7% and 78.6% of cases by 2 raters, respectively), with the greatest improvement in the coiling group, moderate improvement in the liquid embolizers, and the smallest improvement in ventricular shunting (overall agreement, 0.857). The metal artifact reduction algorithm substantially reduced artifacts and improved the objective image quality in every studied case. It also allowed improved diagnostic confidence in most cases. © 2014 by American Journal of Neuroradiology.

  11. Beneficial Effect of the Nutritional Support in Children Who Underwent Hematopoietic Stem Cell Transplant.

    Science.gov (United States)

    Koç, Nevra; Gündüz, Mehmet; Tavil, Betül; Azik, M Fatih; Coşkun, Zeynep; Yardımcı, Hülya; Uçkan, Duygu; Tunç, Bahattin

    2017-08-01

    The aim of this study was to evaluate nutritional status in children who underwent hematopoietic stem cell transplant compared with a healthy control group. A secondary aim was to utilize mid-upper arm circumference as a measure of nutritional status in these groups of children. Our study group included 40 children (18 girls, 22 boys) with mean age of 9.2 ± 4.6 years (range, 2-17 y) who underwent hematopoietic stem cell transplant. Our control group consisted of 20 healthy children (9 girls, 11 boys). The children were evaluated at admission to the hospital and followed regularly 3, 6, 9, and 12 months after discharge from the hospital. In the study group, 27 of 40 patients (67.5%) received nutritional support during hematopoietic stem cell transplant, with 15 patients (56%) receiving enteral nutrition, 6 (22%) receiving total parenteral nutrition, and 6 (22%) receiving enteral and total parenteral nutrition. Chronic malnutrition rate in the study group was 47.5% on admission to the hospital, with the control group having a rate of 20%. One year after transplant, the rate decreased to 20% in the study group and 5% in the control group. The mid-upper arm circumference was lower in children in the study group versus the control group at the beginning of the study (P groups at follow-up examinations (P > .05). During follow-up, all anthropometric measurements increased significantly in both groups. Monitoring nutritional status and initiating appropriate nutritional support improved the success of hematopoietic stem cell transplant and provided a more comfortable process during the transplant period. Furthermore, mid-upper arm circumference is a more sensitive, useful, and safer parameter that can be used to measure nutritional status of children who undergo hematopoietic stem cell transplant.

  12. Do we understand the linkages between economic growth, poverty targets and poverty reduction?

    DEFF Research Database (Denmark)

    Casse, Thorkil; Jensen, Stig Eduard Breitenstein

    2009-01-01

    This article contributes to the debate on poverty trends in Africa, looking at the argument for a correspondence between economic growth and poverty reduction. It questions whether a link between economic growth and poverty reduction can be established. We first look at the general picture...... appears more obvious, social and political unrest in 2009 casts doubt on the reliability of the data. Indeed, it is probable that an increase in poverty contributed to the crisis in Madagascar. Furthermore, there a signs that in both countries poverty strategies are increasingly giving way to Poverty...... Reduction Growth Facility programmes, closely related to former structural adjustment loans. We conclude, first, that analysing poverty strategies through Poverty Reduction Strategy Papers does not help in resolving the uncertainty, since these strategies assume a priori the existence of a link between...

  13. Auto-Baecklund transformation and similarity reductions to the variable coefficients variant Boussinesq system

    Energy Technology Data Exchange (ETDEWEB)

    Moussa, M.H.M. [Department of Mathematic, Faculty of Education, Ain Shams University, Roxy, Hiliopolis, Cairo (Egypt)], E-mail: m_h_m_moussa@yahoo.com; El Shikh, Rehab M. [Department of Mathematic, Faculty of Education, Ain Shams University, Roxy, Hiliopolis, Cairo (Egypt)

    2008-02-25

    Based on the closed connections among the homogeneous balance (HB) method, Weiss-Tabor-Carneval (WTC) method and Clarkson-Kruskal (CK) method, we study Baecklund transformation and similarity reductions of the variable coefficients variant Boussinesq system. In the meantime, new exact solutions also are found.

  14. Failure of a repeat course of cyclooxygenase inhibitor to close a PDA is a risk factor for developing chronic lung disease in ELBW infants

    Directory of Open Access Journals (Sweden)

    Adrouche-Amrani Lynda

    2012-01-01

    Full Text Available Abstract Background The optimal treatment regimen or protocol for managing a persistent patent ductus arteriosus (PDA in extremely low birth weight (ELBW infants has not been well established. This study was aimed at evaluating the failure rate of a cyclooxygenase (COX inhibitor (COI for PDA closure and to determine the incidence of a PDA requiring ligation in ELBW infants. We examined the clinical characteristics and risk factors that may predict the clinical consequences of failure of PDA closure by COI. Methods Medical information on 138 infants with birth weight (BW 48 hours was retrieved. Clinical characteristics and outcomes of patients whose PDAs closed with COI were compared with those who did not close. Results Of the 138 patients, 112 survived to discharge. Eighty (71.4% of those who survived received 1-3 courses of COI treatment for a symptomatic PDA. A total of 32 (40% failed COI treatment and underwent PDA ligation. Multivariable logistic regression analysis suggests that the observed differences in the outcomes in infants with or without symptomatic PDA can be explained by the babies with symptomatic PDA being more immature and sicker. No significant difference was seen in the incidence of chronic lung disease (CLD in infants whose PDA was treated medically versus those who failed medical treatment and then underwent ligation. However, after adjusting for disease severity and other known risk factors, the odds ratio of developing CLD for surviving babies with a persistent PDA compared to those whose PDA was successfully closed with 1-2 courses of COI is 3.24 (1.07-9.81; p = 0.038. Conclusions When successfully treated, PDA in ELBW infants did not contribute significantly to the adverse outcomes such as CLD, retinopathy of prematurity (ROP and age at discharge. This suggests that it is beneficial for a hemodynamically significant PDA to be closed. The failure of a repeat course of COI to close a PDA is a major risk factor for

  15. Bit-rate reduction strategies for noise suppression with a remote wireless microphone

    NARCIS (Netherlands)

    Cvijanovic, N.; Sadiq, O.; Srinivasan, S.

    2012-01-01

    In single channel non-stationary noise reduction it is paramount that a good noise reference is available in a timely manner to maintaina high quality speech signal. Using a remote wireless microphone placed close to a noise source, a good estimate of the noise power spectral density (PSD) can be

  16. Bit rate reduction strategies for noise suppression using a remote wireless microphone

    NARCIS (Netherlands)

    Cvijanovic, N.; Sadiq, O.; Srinivasan, S.

    2012-01-01

    In single-channel non-stationary noise reduction it is paramount that a good noise reference is available in a timely manner to maintain a high quality speech signal. Using a remote wireless microphone placed close to a noise source, a good estimate of the noise power spectral density (PSD) can be

  17. Multiple gas reduction strategy

    Energy Technology Data Exchange (ETDEWEB)

    A. Kurosawa [Institute of Applied Energy, Tokyo (Japan)

    2003-07-01

    Future global warming has a close relationship with the abatement potential of six greenhouse gases (GHGs), including carbon dioxide (CO{sub 2}), methane (CH{sub 4}), nitrous oxide (N{sub 2}O), hydrofluorocarbons (HFCs), perfluorocarbons (PFCs), and sulfur hexafluoride (SF6). Therefore, multiple gas reduction flexibility should be assessed. The emission of each non-CO{sub 2} GHG is calculated endogenously by the sum of the product of the emission factor and the endogenous activity index using an integrated assessment model, GRAPE (Global Relationship Assessment to Protect the Environment). The model consists of five modules dealing with issues on energy, climate, land use, macroeconomics and environmental impacts. The uncertainty in the non-CO{sub 2} GHG emission inventory and emission factors is discussed. 5 refs., 3 figs., 1 tab.

  18. Functional capacity and postural pain outcomes after reduction mammaplasty.

    Science.gov (United States)

    Freire, Marcia; Neto, Miguel Sabino; Garcia, Elvio Bueno; Quaresma, Marina Rodrigues; Ferreira, Lydia Masako

    2007-04-01

    Neck, shoulder, and lower back pain and reduction of functional capacity can be caused by breast hypertrophy. Reduction mammaplasty appears to improve these aspects. After a systematic review of the literature, no scientific evidence was found to confirm this hypothesis. The authors' objective was to evaluate the impact of reduction mammaplasty on pain and functional capacity of patients with mammary hypertrophy. One hundred patients with mammary hypertrophy, between 18 and 55 years old, with no previous mammary surgery, were consecutively selected from the Plastic Surgery Outpatient Clinic of the Universidade Federal de São Paulo-Escola Paulista de Medicina and randomly allocated into two groups. Group A (n = 50) underwent mammaplasty reduction immediately, whereas group B patients (n = 50) were placed on a waiting list (control group). All patients were interviewed for clinical and demographic data and evaluated to measure pain and functional capacity. To measure shoulder, neck, and lower back pain, a visual analogue scale (0 = no pain, 10 = unbearable pain) was used. The Stanford Health Assessment Questionnaire (HAQ-20), Brazilian validated version (0 = best, 3 = worst), was applied to assess functional capacity. Pain and functional capacity were measured at baseline and 6 months after surgery. Forty-six of 50 patients, from both groups, completed the study. The mean (+/-SD) patient age in groups A and B was 31.6 +/- 11 and 32.3 +/- 10 years, respectively. The mean breast tissue weight was 1052 +/- 188 g. Functional capacity in group A was improved 6 months after reduction mammaplasty, compared with group B (control), in the following aspects: getting dressed, getting up, walking, maintaining personal hygiene, reaching, and grasping objects. The mean pain intensity dropped in the lower back, from 5.7 to 1.3; in the shoulders, from 6.1 to 1.1; and in the neck, from 5.2 to 0.9. Reduction mammaplasty improved functional capacity and relieved pain in the lower back

  19. Use of negative-pressure dressings and split-thickness skin grafts following penile shaft reduction and reduction scrotoplasty in the management of penoscrotal elephantiasis.

    Science.gov (United States)

    Stokes, Tracey H; Follmar, Keith E; Silverstein, Ari D; Weizer, Alon Z; Donatucci, Craig F; Anderson, Everett E; Erdmann, Detlev

    2006-06-01

    From 1988 to 2005, 8 men who presented with penoscrotal elephantiasis underwent penile shaft degloving and reduction scrotoplasty, followed by transplantation of a split-thickness skin graft (STSG) to the penile shaft. The etiology of elephantiasis in these patients included self-injection of viscous fluid and postsurgical obstructive lymphedema. In the 6 most recent cases, negative-pressure dressings were applied over the STSG to promote graft take, and STSG take rate was 100%. The results of our series corroborate those of a previous report, which showed circumferential negative-pressure dressings to be safe and efficacious in bolstering STSGs to the penile shaft. Furthermore, these results suggest that the use of negative-pressure dressings may improve graft take in this patient population.

  20. An Evaluation of Telecommuting As a Trip Reduction Measure

    OpenAIRE

    Kitamura, Ryuichi; Mokhtarian, Patricia L.; Pendyala, Ram M.

    1991-01-01

    Telecommuting, which is the performance of work at home or at a center close to home using telecommunications, has attracted growing interest among planners and researchers as a strategy for reducing traveldemand. This paper investigates the potential of telecommuting as a trip reduction measure, using data obtained from a telecommuting pilot project involving State of California government employees. In this pilot project, a three-day trip diary was administered, before and after te...

  1. A Comprehensive HIV Stigma-reduction and Wellness-enhancement Community Intervention: A Case Study.

    NARCIS (Netherlands)

    French, H.; Greeff, M.; Watson, M.J.; Doak, C.M.

    2014-01-01

    We describe the implementation of a comprehensive HIV stigma-reduction and wellness-enhancement community intervention that focused on people living with HIV (PLWH), as well as people living close to them (PLC) from six designated groups. A holistic multiple case study design was used in urban and

  2. Quantum noise and stochastic reduction

    International Nuclear Information System (INIS)

    Brody, Dorje C; Hughston, Lane P

    2006-01-01

    In standard nonrelativistic quantum mechanics the expectation of the energy is a conserved quantity. It is possible to extend the dynamical law associated with the evolution of a quantum state consistently to include a nonlinear stochastic component, while respecting the conservation law. According to the dynamics thus obtained, referred to as the energy-based stochastic Schroedinger equation, an arbitrary initial state collapses spontaneously to one of the energy eigenstates, thus describing the phenomenon of quantum state reduction. In this paper, two such models are investigated: one that achieves state reduction in infinite time and the other in finite time. The properties of the associated energy expectation process and the energy variance process are worked out in detail. By use of a novel application of a nonlinear filtering method, closed-form solutions-algebraic in character and involving no integration-are obtained of both these models. In each case, the solution is expressed in terms of a random variable representing the terminal energy of the system and an independent noise process. With these solutions at hand it is possible to simulate explicitly the dynamics of the quantum states of complicated physical systems

  3. Furfural reduction mechanism of a zinc-dependent alcohol dehydrogenase from Cupriavidus necator JMP134

    Science.gov (United States)

    Kang, ChulHee; Hayes, Robert; Sanchez, Emiliano J.; Webb, Brian N.; Li, Qunrui; Hooper, Travis; Nissen, Mark S.; Xun, Luying

    2012-01-01

    Summary FurX is a tetrameric Zn-dependent alcohol dehydrogenase (ADH) from Cupriavidus necator JMP134. The enzyme rapidly reduces furfural with NADH as the reducing power. For the first time among characterized ADHs, the high-resolution structures of all reaction steps were obtained in a time-resolved manner, thereby illustrating the complete catalytic events of NADH-dependent reduction of furfural and the dynamic Zn2+ coordination among Glu66, water, substrate and product. In the fully closed conformation of the NADH complex, the catalytic turnover proved faster than observed for the partially closed conformation due to an effective proton transfer network. The domain motion triggered by NAD(H) association/dissociation appeared to facilitate dynamic interchanges in Zn2+ coordination with substrate and product molecules, ultimately increasing the enzymatic turnover rate. NAD+ dissociation appeared to be a slow process, involving multiple steps in concert with a domain opening and reconfiguration of Glu66. This agrees with the report that the cofactor is not dissociated from FurX during ethanol-dependent reduction of furfural, in which ethanol reduces NAD+ to NADH that is subsequently used for furfural reduction. PMID:22081946

  4. Lead-cooled fast-neutron reactor (BREST) (Approaches to the closed NFC) - 5435

    International Nuclear Information System (INIS)

    Dragunov, Y.G.; Lemekhov, V.V.; Moiseyev, A.V.; Smirnov, V.S.; Tocheny, L.V.; Umanskiy, A.A.

    2015-01-01

    The BREST-OD-300 reactor is under development in Russia. It is an intrinsically safe pilot demonstration lead-cooled fast reactor with uranium-plutonium nitride fuel. This reactor is based on a new concept of inherent safety whose basic principles are: -) the exclusion of severe accidents at the plant (reactivity type, loss of cooling, fires, explosions) that require the resettlement of the population; -) the closing of the nuclear fuel cycle through the burning of minor actinides; -) the environmental acceptability through the maximal reduction of the amount of high-level long-lived radioactive waste nuclides - nuclear fuel cycle products, sent for the final disposal; -) the technological strengthening of non-proliferation. Closed fuel cycle with reactors of BREST type burning minor actinides gives the opportunity to achieve the radiation equivalence between radioactive wastes and natural uranium during a time period about 300 years

  5. A systematic review comparing open-book and closed-book examinations: Evaluating effects on development of critical thinking skills.

    Science.gov (United States)

    Johanns, Beth; Dinkens, Amber; Moore, Jill

    2017-11-01

    The advantages of using traditional closed-book examinations are closely compared to the advantages of using open-book examinations for the development of critical thinking skills in nursing students. The use of critical thinking skills is vital among nurses to assess patient needs and modify standard approaches to individualize care for better patient outcomes. The following areas are compared and contrasted for both closed-book and open-book examinations: examination preparation, rote memorization versus active learning, intellectual engagement, simulation of working environment, higher order thinking skills, anxiety reduction and student satisfaction. During investigation of closed-book examinations and open-book examinations, the use of collaborative testing was unveiled. Collaborative testing combines areas from both closed-book and open-book examinations. Based on the systematic review of literature, the recommendation is to use a mixed method of examination types throughout the course of the nursing program. Each type of examination helps develop different skill sets in the nursing student. Copyright © 2017 Elsevier Ltd. All rights reserved.

  6. Brachial artery injury due to closed posterior elbow dislocation: case report☆

    Directory of Open Access Journals (Sweden)

    Alberto Naoki Miyazaki

    2016-04-01

    Full Text Available An association between closed posterior elbow dislocation and traumatic brachial artery injury is rare. Absence of radial pulse on palpation is an important warning sign and arteriography is the gold-standard diagnostic test. Early diagnosis is essential for appropriate treatment to be provided. This consists of joint reduction and immobilization, along with urgent surgical restoration of arterial flow. Here, a case (novel to the Brazilian literature of an association between these injuries (and the treatment implemented in a 27-year-old male patient is reported. These injuries were sustained through physical assault.

  7. Comparative analysis of perinatal outcome of spontaneous pregnancy reduction and multifetal pregnancy reduction in triplet pregnancies conceived after assisted reproductive technique

    Directory of Open Access Journals (Sweden)

    Shilpa Bhandari

    2016-01-01

    Full Text Available INTRODUCTION: With the advent of assisted reproductive treatment options, the incidence of multiple pregnancies has increased. Although the need for elective single embryo transfer is emphasized time and again, its uniform applicability in practice is yet a distant goal. In view of the fact that triplet and higher order pregnancies are associated with significant fetomaternal complications, the fetal reduction is a commonly used option in such cases. This retrospective study aims to compare the perinatal outcome in patients with triplet gestation who have undergone spontaneous fetal reduction (SFR as against those in whom multifetal pregnancy reduction (MFPR was done. MATERIALS AND METHODS: In the present study, eighty patients with triplet gestation at 6 weeks were considered. The patients underwent SFR or MFPR at or before 12-13 weeks and were divided into two groups (34 and 46, respectively. RESULTS: Our study found no statistical difference in perinatal outcome between the SFR and MFPR groups in terms of average gestational age at delivery, abortion rate, preterm delivery rate, and birth weight. The study shows that the risk of aborting all fetuses after SFR is three times (odds ratio [OR] = 3.600, 95% confidence interval [CI] = 0.2794-46.388 that of MFPR in subsequent 2 weeks. There were more chances of loss of extra fetus in SFR (23.5% group than MFPR group (8.7% (OR = 3.889, 95% CI = 1.030-14.680. As neither group offers any significant benefit from preterm delivery, multiple pregnancies continue to be responsible for preterm delivery despite fetal reduction. CONCLUSION: There appears to be some advantages of MFPR in perinatal outcome when compared to SFR, especially if the latter happens at advanced gestation. Therefore, although it is advisable to wait for SFR to occur, in patients with triplet gestation at 11-12 weeks, MFPR is a viable option to be considered.

  8. Strategies for Small Volume Resuscitation: Hyperosmotic-Hyperoncotic Solutions, Hemoglobin Based Oxygen Carriers and Closed-Loop Resuscitation

    Science.gov (United States)

    Kramer, George C.; Wade, Charles E.; Dubick, Michael A.; Atkins, James L.

    2004-01-01

    Introduction: Logistic constraints on combat casualty care preclude traditional resuscitation strategies which can require volumes and weights 3 fold or greater than hemorrhaged volume. We present a review of quantitative analyses of clinical and animal data on small volume strategies using 1) hypertonic-hyperosmotic solutions (HHS); 2) hemoglobin based oxygen carriers (HBOCs) and 3) closed-loop infusion regimens.Methods and Results: Literature searches and recent queries to industry and academic researchers have allowed us to evaluate the record of 81 human HHS studies (12 trauma trials), 19 human HBOCs studies (3trauma trials) and two clinical studies of closed-loop resuscitation.There are several hundreds animal studies and at least 82 clinical trials and reports evaluating small volume7.2%-7.5% hypertonic saline (HS) most often combined with colloids, e.g., dextran (HSD) or hetastarch(HSS). HSD and HSS data has been published for 1,108 and 392 patients, respectively. Human studies have documented volume sparing and hemodynamic improvements. Meta-analyses suggest improved survival for hypotensive trauma patients treated with HSD with significant reductions in mortality found for patients with blood pressure blood use and lower mortality compared to historic controls of patients refusing blood. Transfusion reductions with HBOC use have been modest. Two HBOCs (Hemopure and Polyheme) are now in new or planned large-scale multicenter prehospital trials of trauma treatment. A new implementation of small volume resuscitation is closed-loop resuscitation (CLR), which employs microprocessors to titrate just enough fluid to reach a physiologic target . Animal studies suggest less risk of rebleeding in uncontrolled hemorrhage and a reduction in fluid needs with CLR. The first clinical application of CLR was treatment of burn shock and the US Army. Conclusions: Independently sponsored civilian trauma trials and clinical evaluations in operational combat conditions of

  9. Autoantibodies Affect Brain Density Reduction in Nonneuropsychiatric Systemic Lupus Erythematosus Patients

    Directory of Open Access Journals (Sweden)

    Jian Xu

    2015-01-01

    Full Text Available This study explores the relationship between autoantibodies and brain density reduction in SLE patients without major neuropsychiatric manifestation (NPSLE. Ninety-five NPSLE patients without obvious cerebral deficits, as determined by conventional MRI, as well as 89 control subjects, underwent high-resolution structural MRI. Whole-brain density of grey matter (GMD and white matter (WMD were calculated for each individual, and correlations between the brain density, symptom severity, immunosuppressive agent (ISA, and autoantibody levels were assessed. The GMD and WMD of the SLE group decreased compared to controls. GMD was negatively associated with SLE activity. The WMD of patients who received ISA treatment were higher than that in the patients who did not. The WMD of patients with anticardiolipin (ACL or anti-SSB/La antibodies was lower than in patients without these antibodies, while the GMD was lower in patients with anti-SM or anti-U1RNP antibodies. Thus, obvious brain atrophy can occur very early even before the development of significant symptoms and specific autoantibodies might contribute to the reduction of GMD or WMD in NPSLE patients. However, ISAs showed protective effects in minimizing GMD and WMD reduction. The presence of these specific autoantibodies might help identify early brain damage in NPSLE patients.

  10. Simulation of cortico-basal ganglia oscillations and their suppression by closed loop deep brain stimulation.

    Science.gov (United States)

    Grant, Peadar F; Lowery, Madeleine M

    2013-07-01

    A new model of deep brain stimulation (DBS) is presented that integrates volume conduction effects with a neural model of pathological beta-band oscillations in the cortico-basal ganglia network. The model is used to test the clinical hypothesis that closed-loop control of the amplitude of DBS may be possible, based on the average rectified value of beta-band oscillations in the local field potential. Simulation of closed-loop high-frequency DBS was shown to yield energy savings, with the magnitude of the energy saved dependent on the strength of coupling between the subthalamic nucleus and the remainder of the cortico-basal ganglia network. When closed-loop DBS was applied to a strongly coupled cortico-basal ganglia network, the stimulation energy delivered over a 480 s period was reduced by up to 42%. Greater energy reductions were observed for weakly coupled networks, as the stimulation amplitude reduced to zero once the initial desynchronization had occurred. The results provide support for the application of closed-loop high-frequency DBS based on electrophysiological biomarkers.

  11. Continuous flow reduction of artemisinic acid utilizing multi-injection strategies-closing the gap towards a fully continuous synthesis of antimalarial drugs.

    Science.gov (United States)

    Pieber, Bartholomäus; Glasnov, Toma; Kappe, C Oliver

    2015-03-09

    One of the rare alternative reagents for the reduction of carbon-carbon double bonds is diimide (HN=NH), which can be generated in situ from hydrazine hydrate (N2H4⋅H2O) and O2. Although this selective method is extremely clean and powerful, it is rarely used, as the rate-determining oxidation of hydrazine in the absence of a catalyst is relatively slow using conventional batch protocols. A continuous high-temperature/high-pressure methodology dramatically enhances the initial oxidation step, at the same time allowing for a safe and scalable processing of the hazardous reaction mixture. Simple alkenes can be selectively reduced within 10-20 min at 100-120 °C and 20 bar O2 pressure. The development of a multi-injection reactor platform for the periodic addition of N2H4⋅H2O enables the reduction of less reactive olefins even at lower reaction temperatures. This concept was utilized for the highly selective reduction of artemisinic acid to dihydroartemisinic acid, the precursor molecule for the semisynthesis of the antimalarial drug artemisinin. The industrially relevant reduction was achieved by using four consecutive liquid feeds (of N2H4⋅H2O) and residence time units resulting in a highly selective reduction within approximately 40 min at 60 °C and 20 bar O2 pressure, providing dihydroartemisinic acid in ≥93% yield and ≥95% selectivity. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  12. [An easy, safe and affective method for the treatment of intussusception: ultrasound-guided hydrostatic reduction].

    Science.gov (United States)

    Ülger, Fatma Esra Bahadır; Ülger, Aykut; Karakaya, Ali Erdal; Tüten, Fatih; Katı, Ömer; Çolak, Mustafa

    2014-03-01

    Intussusception is one of the important causes of intestinal obstruction in children. Hydrostatic reduction under ultrasound guidance is a popular treatment method for intussusception. In the present study, we aimed to explain the demographic characteristics of and treatment approaches in patients diagnosed with intussusception by ultrasound. Forty-one patients diagnosed with intussusception by ultrasound between August 2011 and May 2013 were retrospectively analyzed. Twenty-four of these patients who had no contraindications had been treated with ultrasound-guided hydrostatic reduction. Twenty-four of the patients were male and 17 were female, a 1.4/1 male-to-female ratio. The majority of the patients were between the ages of 6-24 months and 2-5 years. The mean age was 31.12±26.32 months (range 3-125). Patients were more frequently diagnosed in April and May. Seventeen patients who had clinical contraindications enrolled directly for surgery. In 20 of the 24 patients who underwent ultrasound-guided hydrostatic reduction, reduction was achieved. Three experienced recurrence. In two of these patients, successful reduction was achieved with the second attempt. The remaining patient was enrolled for surgery. Hydrostatic reduction was performed 26 times on these 24 patients, and in 22, success was achieved (84.6%). No procedure-related complications occurred in the patients. Ultrasound-guided hydrostatic reduction, with its high success rates and lack of radiation risk, should be the first choice therapeutic approach for children diagnosed with intussusception.

  13. Behaviour and design considerations for continuous flow closed-open-closed liquid microchannels.

    Science.gov (United States)

    Melin, Jessica; van der Wijngaart, Wouter; Stemme, Göran

    2005-06-01

    This paper introduces a method of combining open and closed microchannels in a single component in a novel way which couples the benefits of both open and closed microfluidic systems and introduces interesting on-chip microfluidic behaviour. Fluid behaviour in such a component, based on continuous pressure driven flow and surface tension, is discussed in terms of cross sectional flow behaviour, robustness, flow-pressure performance, and its application to microfluidic interfacing. The closed-open-closed microchannel possesses the versatility of upstream and downstream closed microfluidics along with open fluidic direct access. The device has the advantage of eliminating gas bubbles present upstream when these enter the open channel section. The unique behaviour of this device opens the door to applications including direct liquid sample interfacing without the need for additional and bulky sample tubing.

  14. Analysis of Beamformer Directed Single-Channel Noise Reduction System for Hearing Aid Applications

    DEFF Research Database (Denmark)

    Jensen, Jesper; Pedersen, Michael Syskind

    2015-01-01

    We study multi-microphone noise reduction systems consisting of a beamformer and a single-channel (SC) noise reduction stage. In particular, we present and analyse a maximum likelihood (ML) method for jointly estimating the target and noise power spectral densities (psd's) entering the SC filter....... We show that the estimators are minimum variance and unbiased, and provide closed-form expressions for their mean-square error (MSE). Furthermore, we show that the MSE of the noise psd estimator is particularly simple: it is independent of target signal characteristics, frequency, and microphone...

  15. MADR: metal artifact detection and reduction

    Science.gov (United States)

    Jaiswal, Sunil Prasad; Ha, Sungsoo; Mueller, Klaus

    2016-04-01

    Metal in CT-imaged objects drastically reduces the quality of these images due to the severe artifacts it can cause. Most metal artifacts reduction (MAR) algorithms consider the metal-affected sinogram portions as the corrupted data and replace them via sophisticated interpolation methods. While these schemes are successful in removing the metal artifacts, they fail to recover some of the edge information. To address these problems, the frequency shift metal artifact reduction algorithm (FSMAR) was recently proposed. It exploits the information hidden in the uncorrected image and combines the high frequency (edge) components of the uncorrected image with the low frequency components of the corrected image. Although this can effectively transfer the edge information of the uncorrected image, it also introduces some unwanted artifacts. The essential problem of these algorithms is that they lack the capability of detecting the artifacts and as a result cannot discriminate between desired and undesired edges. We propose a scheme that does better in these respects. Our Metal Artifact Detection and Reduction (MADR) scheme constructs a weight map which stores whether a pixel in the uncorrected image belongs to an artifact region or a non-artifact region. This weight matrix is optimal in the Linear Minimum Mean Square Sense (LMMSE). Our results demonstrate that MADR outperforms the existing algorithms and ensures that the anatomical structures close to metal implants are better preserved.

  16. Treatment of Developmental Dysplasia of the Hip: Short and Mid-term Outcome

    Directory of Open Access Journals (Sweden)

    Asim AM

    2011-03-01

    Full Text Available OBJECTIVE: To review the presentation and outcome of developmental dysplasia of the hip (DDH cases in the last 6 years. METHODOLOGY: We retrospectively reviewed the presentation as well as short and mid-term outcome of 17 children (18 hips with DDH seen and treated from 2004 to 2010. Treatment was either splinting with Pavlik harness, closed or open reduction depending on age at presentation and the individual needs of each patient. RESULTS: The average age at presentation was 31.1 months, and the male to female ratio was 1:4.6. Six patients (35% presented early (less than 6 months old while 7 patients (41% presented between 6 -24 months. In these 2 groups splinting or closed reduction under anaesthesia was initially utilized for treatment depending on age, and open reduction was used after failure of closed reduction and for those presented late. Average age at the time of closed reduction was 11 months, and 6 years for those underwent open reduction. The average period of follow up for all patients was 29.4 months. The final outcome was successful in 12 hips (66% in 11 patients. Ten of these presented at less than 2 years old, in the other 6 hips in which there was failure, 50% presented after 3 years of age. CONCLUSION: Late presentation of DDH is still common in Malaysia, which necessitates more complex management and more frequent occurrences of unfavourable results.

  17. Open reduction-internal fixation of a navicular body fracture with dorsal displacement of the first and second cuneiforms: a case report.

    Science.gov (United States)

    Andersen, Robert C; Neiderer, Katherine; Martin, Billy; Dancho, James

    2013-01-01

    Body fractures of the tarsal navicular are relatively uncommon. To date, there is little literature discussing a navicular body fracture with dorsal subluxation of the first and second cuneiforms over the navicular. This case study presents a 30-year-old patient with this injury. He underwent open reduction internal fixation of the navicular body fracture successfully but failed adequate reduction of the navicular cuneiform joint after ligamentous reconstruction. After revisional surgery, he also failed 6 weeks of percutanous pinning with Kirschner-wire fixation. When comparing the literature of a similar injury, the Lisfranc fracture disclocation, the same principles may apply. One should consider rigid open reduction internal fixation or even primary fusion to treat disclocation of the naviculocuneiform joint following a navicular body fracture.

  18. Feasibility of closed Fe(II)/Fe(III) system for product-reflux in Nitrox process

    International Nuclear Information System (INIS)

    Adachi, M.; Ishida, T.

    1981-01-01

    A concept of closed reflux system for stable isotope fractionation by chemical exchange method has been introduced. In a closed system a chemical agent used to convert one chemical species of an isotopic exchange reaction into the other at the product end is regenerated on site by means of an electrochemical or thermal process. It offers a convenience of eliminating the needs for transporting chemicals to and from the site and an advantage of allowing leniency in the degree of completeness of the reflux reaction. Feasibility of use of Fe(II) salt solutions in a closed reflux system for the Nitrox process for 15 N fractionation has been studied. Two of such systems, FeSO 4 in H 2 SO 4 and Fe(ClO 4 ) 2 in HClO 4 , are adopted for packed column operation. For both systems, the rate of reduction of nitric acid increases with increasing acid concentration, the solubility of the salts decreases with the increasing acid concentration, and the reflux reaction can be made to go to completion. Evaluation of such a closed reflux system will have to include that of performance of regenerative process

  19. Catalyzed reduction of nitrate in aqueous solutions

    International Nuclear Information System (INIS)

    Haas, P.A.

    1994-08-01

    Sodium nitrate and other nitrate salts in wastes is a major source of difficulty for permanent disposal. Reduction of nitrate using aluminum metal has been demonstrated, but NH 3 , hydrazine, or organic compounds containing oxygen would be advantageous for reduction of nitrate in sodium nitrate solutions. Objective of this seed money study was to determine minimum conditions for reduction. Proposed procedure was batchwise heating of aqueous solutions in closed vessels with monitoring of temperatures and pressures. A simple, convenient apparatus and procedure were demonstrated for observing formation of gaseous products and collecting samples for analyses. The test conditions were 250 degree C and 1000 psi max. Any useful reduction of sodium nitrate to sodium hydroxide as the primary product was not found. The nitrate present at pHs 3 or NH 4 NO 3 is easily decomposed, and the effect of nitromethane at these low pHs was confirmed. When acetic acid or formic acid was added, 21 to 56% of the nitrate in sodium nitrate solutions was reduced by methanol or formaldehyde. With hydrazine and acetic acid, 73 % of the nitrate was decomposed to convert NaNO 3 to sodium acetate. With hydrazine and formic acid, 36% of the nitrate was decomposed. If these products are more acceptable for final disposal than sodium nitrate, the reagents are cheap and the conversion conditions would be practical for easy use. Ammonium acetate or formate salts did not significantly reduce nitrate in sodium nitrate solutions

  20. Propagators for a quantized scalar field in a static closed universe

    International Nuclear Information System (INIS)

    Nariai, Hidekazu; Azuma, Takahiro.

    1978-07-01

    In a previous paper, a massive scalar field in an expanding closed universe was canonically quantized by taking full account of its coupling-type with the background universe and of the latter's topological (spherical or elliptic) nature. General formulae (including the parts of vacuum fluctuation which should after all be removed by a suitable regularization) for the energy density and pressure of the quantized medium were derived. Various propagators for the quantized scalar field were also dealt with, because the Feynman propagator in particular became important as soon as the pair-creation of those particles was called for. However, there will be an intimate relation between the former hydrodynamic quantities and the pair-creation of their constituents. Accordingly, this problem is studied in detail by adopting a static closed universe (for simplicity in the reduction of various expressions derived in the previous paper) and examining the behavior of various bi-scalar propagators in the universe. (author)

  1. Clinical outcomes for 14 consecutive patients with solid pseudopapillary neoplasms who underwent laparoscopic distal pancreatectomy.

    Science.gov (United States)

    Nakamura, Yoshiharu; Matsushita, Akira; Katsuno, Akira; Yamahatsu, Kazuya; Sumiyoshi, Hiroki; Mizuguchi, Yoshiaki; Uchida, Eiji

    2016-02-01

    The postoperative results of laparoscopic distal pancreatectomy for solid pseudopapillary neoplasm of the pancreas (SPN), including the effects of spleen-preserving resection, are still to be elucidated. Of the 139 patients who underwent laparoscopic pancreatectomy for non-cancerous tumors, 14 consecutive patients (average age, 29.6 years; 1 man, 13 women) with solitary SPN who underwent laparoscopic distal pancreatectomy between March 2004 and June 2015 were enrolled. The tumors had a mean diameter of 4.8 cm. Laparoscopic spleen-preserving distal pancreatectomy was performed in eight patients (spleen-preserving group), including two cases involving pancreatic tail preservation, and laparoscopic spleno-distal pancreatectomy was performed in six patients (standard resection group). The median operating time was 317 min, and the median blood loss was 50 mL. Postoperatively, grade B pancreatic fistulas appeared in two patients (14.3%) but resolved with conservative treatment. No patients had postoperative complications, other than pancreatic fistulas, or required reoperation. The median postoperative hospital stay was 11 days, and the postoperative mortality was zero.None of the patients had positive surgical margins or lymph nodes with metastasis. The median follow-up period did not significantly differ between the two groups (20 vs 39 months, P = 0.1368). All of the patients are alive and free from recurrent tumors without major late-phase complications. Laparoscopic distal pancreatectomy might be a suitable treatment for patients with SPN. A spleen-preserving operation is preferable for younger patients with SPN, and this study demonstrated the non-inferiority of the procedure compared to spleno-distal pancreatectomy. © 2015 Japan Society for Endoscopic Surgery, Asia Endosurgery Task Force and John Wiley & Sons Australia, Ltd.

  2. A system architecture for online data interpretation and reduction in fluorescence microscopy

    Science.gov (United States)

    Röder, Thorsten; Geisbauer, Matthias; Chen, Yang; Knoll, Alois; Uhl, Rainer

    2010-01-01

    In this paper we present a high-throughput sample screening system that enables real-time data analysis and reduction for live cell analysis using fluorescence microscopy. We propose a novel system architecture capable of analyzing a large amount of samples during the experiment and thus greatly minimizing the post-analysis phase that is the common practice today. By utilizing data reduction algorithms, relevant information of the target cells is extracted from the online collected data stream, and then used to adjust the experiment parameters in real-time, allowing the system to dynamically react on changing sample properties and to control the microscope setup accordingly. The proposed system consists of an integrated DSP-FPGA hybrid solution to ensure the required real-time constraints, to execute efficiently the underlying computer vision algorithms and to close the perception-action loop. We demonstrate our approach by addressing the selective imaging of cells with a particular combination of markers. With this novel closed-loop system the amount of superfluous collected data is minimized, while at the same time the information entropy increases.

  3. Comparisons of receive array interference reduction techniques under erroneous generalized transmit beamforming

    KAUST Repository

    Radaydeh, Redha Mahmoud

    2014-02-01

    This paper studies generalized single-stream transmit beamforming employing receive array co-channel interference reduction algorithms under slow and flat fading multiuser wireless systems. The impact of imperfect prediction of channel state information for the desired user spatially uncorrelated transmit channels on the effectiveness of transmit beamforming for different interference reduction techniques is investigated. The case of over-loaded receive array with closely-spaced elements is considered, wherein it can be configured to specified interfering sources. Both dominant interference reduction and adaptive interference reduction techniques for statistically ordered and unordered interferers powers, respectively, are thoroughly studied. The effect of outdated statistical ordering of the interferers powers on the efficiency of dominant interference reduction is studied and then compared against the adaptive interference reduction. For the system models described above, new analytical formulations for the statistics of combined signal-to-interference-plus-noise ratio are presented, from which results for conventional maximum ratio transmission and single-antenna best transmit selection can be directly deduced as limiting cases. These results are then utilized to obtain quantitative measures for various performance metrics. They are also used to compare the achieved performance of various configuration models under consideration. © 1972-2012 IEEE.

  4. Solar radon reduction at six homes in northeast Iowa

    International Nuclear Information System (INIS)

    Rhoads, H.E.; Hoekje, P.L.

    1995-01-01

    Growing concern about radon lung cancer risks, carbon monoxide poisoning, and the sick building syndrome have increased demand for improved indoor air quality. Through solar pre-heating of ventilation air, the Solar Radon Reduction System (SRRS) provides energy benefits with lower installation costs than conventional air-to-air heat exchangers and sub-slab suction approaches. Indoor air quality is improved through dilution, combustion appliance make-up air, pressurization, and reduced radon infiltration through induced-draft solar air collectors drawing supply air from outdoors. Installed at six homes in Waterloo and Cedar Falls, Iowa, the SRRS was found to significantly reduce radon concentrations in all houses with energy benefits and improved overall indoor comfort. Up to 73% reductions from closed house levels as high as 20.9 pCi/L were achieved

  5. Radiation safety and protection of close contacts from radiators after implantation of radioactive 125I seeds

    International Nuclear Information System (INIS)

    Sui Aixia; Li Jianmin; Tang Fulong; Zhang Hongtao; Ren Ju'na; Pang Linbin; Xia Haishui; Gao Zhen; Wu Lili; Wang Juan

    2012-01-01

    Objective: To study the effective dose and precaution time of the irradiation of the close contact from the radiators who underwent implantation of radioactive 125 I seeds so as to guide scientifically people how to avoid radiation damage. Methods: Twenty patients with different types of cancer underwent implantation of radioactive 125 I seeds with the median value of implantation depth of 2.16 cm. Within 24 h after the operations the dose rates 30 cm and 100 cm from the skin were measured with pocket-size radiometer so as to imitate the situations of the close contacts. The effective doses and precaution times of different persons were calculated according to relevant formula. Results: The dose rate a person received at the same time points (1, 54, 78, and 109 d, respectively) decreased along with the increase of the distance from the skin (t=5.962, 5.961, 5.961, 5.962, P<0.05), and the dose rate a person received at the same distance from the skin decreased along with the extension of time (30 cm: t=6.236, 6.236, 6.235, P<0.05; 100 cm: t=7.310, 7.315, 7.314, P<0.05). At different time points, the dose rates at 30 cm distance point were all significant higher than those at the 100 cm point (P <0.05). The adult living together, minors and pregnant women sharing the room, colleagues,adults who slept together with the patients began to reach the 50% dose constraint values 0, 54, 78 and 109 days after the operation. Conclusions: After their precaution time, it's safe to contact with the patients for the groups; otherwise, it's necessary to take some protect works within the precaution time. (authors)

  6. Electrochemical reduction of imazamethabenz methyl on mercury and carbon electrodes

    International Nuclear Information System (INIS)

    Ruiz Montoya, Mercedes; Pintado, Sara; Rodriguez Mellado, Jose Miguel

    2010-01-01

    This paper presents polarographic and voltammetric studies of the reduction of the herbicide imazamethabenz methyl (2/3-methyl-(4-isopropyl-4-methyl-5-oxo-2-imidazolin-2-yl)-p-toluate), on mercury and carbon electrodes. The electrochemical studies were performed in strongly acidic media (0.1-2.7 M H 2 SO 4 ) as well as in the pH range of 1-12. The overall reduction process involves the uptake of two electrons. The results obtained in polarography show that there is the reduction of two species, related via an acid-base equilibrium, and having very close reduction potentials. The voltammetric results obtained with a glassy carbon electrode were very similar to those observed on mercury electrodes. The reducible group in the molecule is the imidazolinone ring. In strongly acidic media (pH a ), the reaction mechanism proposed is the reduction of the protonated herbicide by an electrochemical-chemical-electrochemical (ECE) process, being the r.d.s. the second electron transfer. At pH > pK a the neutral form of the herbicide is reduced and the second electron transfer becomes reversible or quasi-reversible. In basic media, the species reduced is the deprotonated imazamethabenz methyl and the r.d.s. is the second electron transfer.

  7. Electrochemical reduction of imazamethabenz methyl on mercury and carbon electrodes

    Energy Technology Data Exchange (ETDEWEB)

    Ruiz Montoya, Mercedes, E-mail: mmontoya@uhu.e [Departamento de Ingenieria Quimica, Quimica Fisica y Quimica Organica, Universidad de Huelva, Campus El Carmen, Facultad de Ciencias Experimentales, E-21071 Huelva (Spain); Pintado, Sara; Rodriguez Mellado, Jose Miguel [Departamento de Quimica Fisica y Termodinamica Aplicada, Universidad de Cordoba, Campus Universitario de Rabanales, edificio ' Marie Curie' , E-14014 Cordoba (Spain)

    2010-03-30

    This paper presents polarographic and voltammetric studies of the reduction of the herbicide imazamethabenz methyl (2/3-methyl-(4-isopropyl-4-methyl-5-oxo-2-imidazolin-2-yl)-p-toluate), on mercury and carbon electrodes. The electrochemical studies were performed in strongly acidic media (0.1-2.7 M H{sub 2}SO{sub 4}) as well as in the pH range of 1-12. The overall reduction process involves the uptake of two electrons. The results obtained in polarography show that there is the reduction of two species, related via an acid-base equilibrium, and having very close reduction potentials. The voltammetric results obtained with a glassy carbon electrode were very similar to those observed on mercury electrodes. The reducible group in the molecule is the imidazolinone ring. In strongly acidic media (pH < pK{sub a}), the reaction mechanism proposed is the reduction of the protonated herbicide by an electrochemical-chemical-electrochemical (ECE) process, being the r.d.s. the second electron transfer. At pH > pK{sub a} the neutral form of the herbicide is reduced and the second electron transfer becomes reversible or quasi-reversible. In basic media, the species reduced is the deprotonated imazamethabenz methyl and the r.d.s. is the second electron transfer.

  8. A proliferation-resistant closed nuclear fuel cycle with radiation-equivalent disposal of radioactive waste

    International Nuclear Information System (INIS)

    Adamov, E.O.; Gabaraev, B.A.; Ganev, I.K.; Lopatkin, A.V.; Orlov, V.V.

    1998-01-01

    The growing energy demand in the next century can be met by large-scale nuclear power that can be deployed around fast reactors operating in a closed U-Pu cycle. The main requirements to the future fuel cycle are 1) reduction of the radiation risk from radioactive waste owing to transmutation of the most hazardous long-lived actinides and fission products in reactors and due to thorough treatment of radwaste to remove these elements, with provision of a balance between the activity of waste put to final disposal and that of uranium extracted from earth; 2) no possibility to use closed cycle facilities for Pu extraction from spent fuel for the purpose of weapons production; physical protection of fuel against thefts (nonproliferation). (author)

  9. Follow-up CT and CT angiography after intracranial aneurysm clipping and coiling - improved image quality by iterative metal artifact reduction

    Energy Technology Data Exchange (ETDEWEB)

    Bier, Georg; Hempel, Johann-Martin; Oergel, Anja; Hauser, Till-Karsten; Ernemann, Ulrike; Hennersdorf, Florian [Eberhard Karls University Tuebingen, Department of Diagnostic and Interventional Neuroradiology, Tuebingen (Germany); Bongers, Malte Niklas [Eberhard Karls University Tuebingen, Department of Diagnostic and Interventional Radiology, Tuebingen (Germany)

    2017-07-15

    This paper aims to evaluate a new iterative metal artifact reduction algorithm for post-interventional evaluation of brain tissue and intracranial arteries. The data of 20 patients that underwent follow-up cranial CT and cranial CT angiography after clipping or coiling of an intracranial aneurysm was retrospectively analyzed. After the images were processed using a novel iterative metal artifact reduction algorithm, images with and without metal artifact reduction were qualitatively evaluated by two readers, using a five-point Likert scale. Moreover, artifact strength was quantitatively assessed in terms of CT attenuation and standard deviation alterations. The qualitative analysis yielded a significant increase in image quality (p = 0.0057) in iteratively processed images with substantial inter-observer agreement (k = 0.72), while the CTA image quality did not differ (p = 0.864) and even showed vessel contrast reduction in six cases (30%). The mean relative attenuation difference was 27% without metal artifact reduction vs. 11% for iterative metal artifact reduction images (p = 0.0003). The new iterative metal artifact reduction algorithm enhances non-enhanced CT image quality after clipping or coiling, but in CT-angiography images, the contrast of adjacent vessels can be compromised. (orig.)

  10. Follow-up CT and CT angiography after intracranial aneurysm clipping and coiling - improved image quality by iterative metal artifact reduction

    International Nuclear Information System (INIS)

    Bier, Georg; Hempel, Johann-Martin; Oergel, Anja; Hauser, Till-Karsten; Ernemann, Ulrike; Hennersdorf, Florian; Bongers, Malte Niklas

    2017-01-01

    This paper aims to evaluate a new iterative metal artifact reduction algorithm for post-interventional evaluation of brain tissue and intracranial arteries. The data of 20 patients that underwent follow-up cranial CT and cranial CT angiography after clipping or coiling of an intracranial aneurysm was retrospectively analyzed. After the images were processed using a novel iterative metal artifact reduction algorithm, images with and without metal artifact reduction were qualitatively evaluated by two readers, using a five-point Likert scale. Moreover, artifact strength was quantitatively assessed in terms of CT attenuation and standard deviation alterations. The qualitative analysis yielded a significant increase in image quality (p = 0.0057) in iteratively processed images with substantial inter-observer agreement (k = 0.72), while the CTA image quality did not differ (p = 0.864) and even showed vessel contrast reduction in six cases (30%). The mean relative attenuation difference was 27% without metal artifact reduction vs. 11% for iterative metal artifact reduction images (p = 0.0003). The new iterative metal artifact reduction algorithm enhances non-enhanced CT image quality after clipping or coiling, but in CT-angiography images, the contrast of adjacent vessels can be compromised. (orig.)

  11. Cobamide-mediated enzymatic reductive dehalogenation via long-range electron transfer.

    Science.gov (United States)

    Kunze, Cindy; Bommer, Martin; Hagen, Wilfred R; Uksa, Marie; Dobbek, Holger; Schubert, Torsten; Diekert, Gabriele

    2017-07-03

    The capacity of metal-containing porphyrinoids to mediate reductive dehalogenation is implemented in cobamide-containing reductive dehalogenases (RDases), which serve as terminal reductases in organohalide-respiring microbes. RDases allow for the exploitation of halogenated compounds as electron acceptors. Their reaction mechanism is under debate. Here we report on substrate-enzyme interactions in a tetrachloroethene RDase (PceA) that also converts aryl halides. The shape of PceA's highly apolar active site directs binding of bromophenols at some distance from the cobalt and with the hydroxyl substituent towards the metal. A close cobalt-substrate interaction is not observed by electron paramagnetic resonance spectroscopy. Nonetheless, a halogen substituent para to the hydroxyl group is reductively eliminated and the path of the leaving halide is traced in the structure. Based on these findings, an enzymatic mechanism relying on a long-range electron transfer is concluded, which is without parallel in vitamin B 12 -dependent biochemistry and represents an effective mode of RDase catalysis.

  12. Pipe closing device

    International Nuclear Information System (INIS)

    Klahn, F.C.; Nolan, J.H.; Wills, C.

    1979-01-01

    The closing device closes the upper end of a support tube for monitoring samples. It meshes with the upper connecting piece of the monitorung sample capsule, and loads the capsule within the bore of the support tube, so that it is fixed but can be released. The closing device consists of an interlocking component with a chamber and several ratchets which hang down. The interlocking component surrounds the actuating component for positioning the ratchets. The interlocking and actuating components are movable axially relative to each other. (DG) [de

  13. Localization and traces in open-closed topological Landau-Ginzburg models

    International Nuclear Information System (INIS)

    Herbst, Manfred; Lazaroiu, Calin-Iuliu

    2005-01-01

    We reconsider the issue of localization in open-closed B-twisted Landau-Ginzburg models with arbitrary Calabi-Yau target. Through careful analysis of zero-mode reduction, we show that the closed model allows for a one-parameter family of localization pictures, which generalize the standard residue representation. The parameter λ which indexes these pictures measures the area of worldsheets with S 2 topology, with the residue representation obtained in the limit of small area. In the boundary sector, we find a double family of such pictures, depending on parameters λ and μ which measure the area and boundary length of worldsheets with disk topology. We show that setting μ = 0 and varying λ interpolates between the localization picture of the B-model with a noncompact target space and a certain residue representation proposed recently. This gives a complete derivation of the boundary residue formula, starting from the explicit construction of the boundary coupling. We also show that the various localization pictures are related by a semigroup of homotopy equivalences

  14. COBALT: A GN&C Payload for Testing ALHAT Capabilities in Closed-Loop Terrestrial Rocket Flights

    Science.gov (United States)

    Carson, John M., III; Amzajerdian, Farzin; Hines, Glenn D.; O'Neal, Travis V.; Robertson, Edward A.; Seubert, Carl; Trawny, Nikolas

    2016-01-01

    The COBALT (CoOperative Blending of Autonomous Landing Technology) payload is being developed within NASA as a risk reduction activity to mature, integrate and test ALHAT (Autonomous precision Landing and Hazard Avoidance Technology) systems targeted for infusion into near-term robotic and future human space flight missions. The initial COBALT payload instantiation is integrating the third-generation ALHAT Navigation Doppler Lidar (NDL) sensor, for ultra high-precision velocity plus range measurements, with the passive-optical Lander Vision System (LVS) that provides Terrain Relative Navigation (TRN) global-position estimates. The COBALT payload will be integrated onboard a rocket-propulsive terrestrial testbed and will provide precise navigation estimates and guidance planning during two flight test campaigns in 2017 (one open-loop and closed- loop). The NDL is targeting performance capabilities desired for future Mars and Moon Entry, Descent and Landing (EDL). The LVS is already baselined for TRN on the Mars 2020 robotic lander mission. The COBALT platform will provide NASA with a new risk-reduction capability to test integrated EDL Guidance, Navigation and Control (GN&C) components in closed-loop flight demonstrations prior to the actual mission EDL.

  15. Effect of Polymer Type and Mixing of Polymers on Drag Reduction in Turbulent Pipe Flow

    Directory of Open Access Journals (Sweden)

    Salam Hadi Hussein

    2017-05-01

    Full Text Available The paper reports on studies on effect of the type of polymer on drag reduction. The study conducted through circular pipe using Carboxy Methyl Cellulose (CMC, Xanthan gum (XG and their mixing in equal ratios as additives in pipe of diameter 0.0381m. The study covered range of parameters like concentration, mean velocity and angle of inclination of pipe. The maximum drag reduction observed was about 58%, 46% and 46% for the three polymers respectively. It is found that the drag reduction for the mixture is close to the drag reduction for XG polymer. The SPSS program has been used for correlate the data that have been obtained. The drag reduction percentage is correlated in terms of Reynolds number Re, additive concentration C (ppm and angle of inclination of pipe (deg, and the relations obtained is mentioned.

  16. Efficacy of intradermal mesotherapy in cellulite reduction - Conventional and high-frequency ultrasound monitoring results.

    Science.gov (United States)

    Sylwia, Malinowska; Krzysztof, Mlosek Robert

    2017-10-01

    Cellulite affects the majority of women and is an unacceptable cosmetic defect. Therefore, effective methods for cellulite reduction are being sought. Intradermal mesotherapy is one of such methods. The aim of the study was to assess the efficacy of intradermal mesotherapy in cellulite reduction, using conventional and high-frequency ultrasound. Twenty-one women with cellulite underwent a series of intradermal mesotherapy procedures. The following parameters were assessed: thickness of epidermis, dermis and hypodermis, echogenicity of dermis and the surface area of serrated hypodermis-dermis junction. Furthermore, the thigh circumference was measured; body mass index and cellulite severity were assessed based on photographs using Nürnberger-Müller's scale. Intradermal mesotherapy reduced severity of cellulite. The surface area of serrated hypodermis-dermis junction and hypodermis thickness decreased significantly as compared to baseline. Cellulite reduction was also confirmed by palpation, decreased thigh circumference and the Nürnberger-Müller's grade. There were no statistically significant changes in epidermis or dermis thickness, body weight and the BMI. Intradermal mesotherapy offers effective cellulite reduction. It is a simple and safe treatment, which makes it popular. Further research in mesotherapy is essential due to a limited number of published studies. Ultrasound is a useful method to monitor intradermal mesotherapy and assess its efficacy.

  17. Gains following perceptual learning are closely linked to the initial visual acuity.

    Science.gov (United States)

    Yehezkel, Oren; Sterkin, Anna; Lev, Maria; Levi, Dennis M; Polat, Uri

    2016-04-28

    The goal of the present study was to evaluate the dependence of perceptual learning gains on initial visual acuity (VA), in a large sample of subjects with a wide range of VAs. A large sample of normally sighted and presbyopic subjects (N = 119; aged 40 to 63) with a wide range of uncorrected near visual acuities (VA, -0.12 to 0.8 LogMAR), underwent perceptual learning. Training consisted of detecting briefly presented Gabor stimuli under spatial and temporal masking conditions. Consistent with previous findings, perceptual learning induced a significant improvement in near VA and reading speed under conditions of limited exposure duration. Our results show that the improvements in VA and reading speed observed following perceptual learning are closely linked to the initial VA, with only a minor fraction of the observed improvement that may be attributed to the additional sessions performed by those with the worse VA.

  18. Outcomes in closed reamed interlocking nail in fractures of shaft of femur

    International Nuclear Information System (INIS)

    Mohammad, T.; Sawati, A.; Ahmed, A.

    2015-01-01

    Femoral shaft fracture is one of the common fractures seen in accident and emergency department of our hospital. Violent forces are required to break this and strongest of human bones. There are various treatment modalities for femoral shaft fractures in adults like traction, brace, platting, intramedullary nail (IMN), external fixators and inter locking nails. The study was done with an objective to evaluate the results of closed reamed interlocking nail in fractures of shaft of femur. Methods: A prospective study of 114 cases of femoral shaft fractures was carried out at orthopaedic unit of Ayub Teaching Hospital Abbottabad during 1 year. All these cases were treated with statically locked nails under spinal or general anaesthesia. These cases were followed up for up to one year and Results of the interlocking nail were observed in terms of union and complications. Results: Out of 114 patients, 95 underwent union in 90-150 days with a mean of 110.68 days. Ten patients had dynamization within six weeks because of obvious fracture gap in radiograph. There were 3 patients who had non-union, and 6 patients had delayed union which was treated with dynamization. Conclusion: Close reamed interlocking intramedullary nail in femoral shaft fractures is the treatment of choice. Patient rehabilitation is early, hospitalization is short, and fracture healing response is good. (author)

  19. MRI diagnosis of trapped periosteum following incomplete closed reduction of distal tibial Salter-Harris II fracture

    International Nuclear Information System (INIS)

    Raman, Subha; Wallace, E.C.

    2011-01-01

    Irreducible fracture of the distal tibial physis due to interposed soft tissue including periosteum is well documented in the orthopedic literature but is uncommon. This condition has been associated with subsequent growth disturbance and requires open reduction. There are very few prior reports of MRI depiction of soft tissue interposition and none of periosteal interposition in the distal tibial physis. This is a relatively common location of physeal injury and related growth disturbance. We present a case of periosteum trapped in the distal tibial physis, diagnosed on MRI, in a Salter-Harris II fracture and its management implications. (orig.)

  20. PREVALENCE OF FOVEOLAR LUCENCY WITH DIFFERENT GAS TAMPONADES IN SURGICALLY CLOSED MACULAR HOLES ASSESSED BY SPECTRAL DOMAIN OPTICAL COHERENCE TOMOGRAPHY.

    Science.gov (United States)

    Zarranz-Ventura, Javier; Ellabban, Abdallah A; Sim, Dawn A; Keane, Pearse A; Kirkpatrick, James N; Sallam, Ahmed A B

    2017-07-07

    To evaluate the prevalence of foveolar lucency (FL) in surgically closed macular holes by spectral domain optical coherence tomography. One hundred forty-two eyes of 132 patients underwent pars plana vitrectomy, internal limiting membrane peeling, and gas tamponade in a 60-month time frame. Anatomical success and FL rates assessed by spectral domain optical coherence tomography, mean preoperative, and postoperative best-measured visual acuity and surgical details were retrospectively analyzed. Spectral domain optical coherence tomography confirmed closed holes with FL in 33.7% (34/101) of eyes at 1 month, 7.3% (9/123) at 3 months, 4.6% (6/129) at 6 months, and 3% (4/133) at 12 months. Prevalence of FL in closed holes at Month 1 was lower in C3F8-treated eyes (9.5%, 2/21) compared with C2F6 (40.9%, 18/44, P = 0.03) and SF6-treated eyes (38.9%, 14/36, P = 0.05). No differences were observed at Month 3. No differences in best-measured visual acuity change were observed between closed holes with or without FL at Month 1 (-0.14 ± 0.19 vs. -0.11 ± 0.23, P = 0.48) or any of the other time points. Temporary FL is a highly prevalent feature in successfully closed macular holes. Eyes treated with C3F8 gas had lower rates of FL at Month 1 than C2F6 and SF6-treated eyes. The presence of FL in closed holes does not seem to have any effect on the visual outcomes.

  1. Predictors of Time to Union After Operative Fixation of Closed Ankle Fractures.

    Science.gov (United States)

    Matson, Andrew P; Hamid, Kamran S; Adams, Samuel B

    2017-08-01

    Ankle fractures are common and represent a significant burden to society. We aim to report the rate of union as determined by clinical and radiographic data, and to identify factors that predict time to union. A cohort of 112 consecutive patients with isolated, closed, operative malleolar ankle fractures treated with open reduction and internal fixation was retrospectively reviewed for time to clinical union. Clinical union was defined based on radiographic and clinical parameters, and delayed union was defined by time to union >12 weeks. Injury characteristics, patient factors and treatment variables were recorded, and statistical techniques employed included the Chi-square test, the Student's T-test, and multivariate linear regression modeling. Forty-two (37.5%) of patients who achieved union did so in less than 12 weeks, and 69 (61.6%) of these patients demonstrated delayed union at a mean of 16.7 weeks (range, 12.1-26.7 weeks), and the remaining patient required revision surgery. Factors associated with higher rates of delayed union or increased time to union included tobacco use, bimalleolar fixation, and high energy mechanism (all punion were BMI, dislocation of the tibiotalar joint, external fixation for initial stabilization and delay of definitive management (all punion following open reduction and internal fixation of closed ankle fractures. These findings should assist with patient counseling, and help guide the provider when considering adjunctive therapies that promote bone healing. Prognostic, Level IV: Case series.

  2. Outcomes of The Isolated Closed Tibial Shaft Fractures Treated Nonsurgically

    Directory of Open Access Journals (Sweden)

    Dawood Jafari

    2011-05-01

    Full Text Available Background: Fractures of the tibia are important for their commonness and controversy in their management. Both conservative and surgical techniques have been introduced in an effort to speed time to union while minimizing the occurrence of complications. Standard treatment for low-energy tibial shaft fractures includes closed reduction and cast immobilization.The purpose of our study was to analyze retention of reduction after cast immobilization of simple isolated closed tibial fractures.Methods:All cases of the diagnosed isolated closed tibial shaft fracture treated non-surgically at Shafa Yahyaeian Hospital, between 2006 and 2009 were retrieved from medical records. We reviewed all medical records and radiographs of these patients to inquire about the patients’ demographic data used to analyze the outcomes of the non-surgical treatment.Results:Of the 26 patients examined, males were more commonly affected. The mean age was 27.46   (SD=7.58.The most common causes of injury were direct blow and motorcycle to pedestrian accident. Followup duration for each patient had an average of 9.12 months (SD=2.36. Using AO/OTA classification, distributed as 38.5% A1.1, 26.9% A2.1 and 34.6% A3.1 fractures. Most fractures were sustained in the lower third of the tibia (53.85%. All fractures eventually healed in an average of 13.7 weeks (SD=3.24. There was one case of delayed union in the 22nd week. In 92.3% of patients, shortening of bone was less than 1 cm, while in 7.7% patients, was more than 1.5 cm. We observed an anterior or posterior angulation > 10 ° in 2 (7.69% patients. Moreover, in 4 (15.38% patients we found varus angulation > 5°. Therefore, final deformity was observed in 8 (30.77% patients. No patient had non-union, rotational malalignment of more than 10 degrees, an infection, or a compartment syndrome.Conclusion : Our non-surgical treatment’s outcomes were not satisfactory, despite applying all principles for conservative treatment and

  3. APACHE II SCORING SYSTEM AND ITS MODIFICATION FOR THE ASSESSMENT OF DISEASE SEVERITY IN CHILDREN WHO UNDERWENT POLYCHEMOTHERAPY

    Directory of Open Access Journals (Sweden)

    А. V. Sotnikov

    2014-01-01

    Full Text Available Short-term disease prognosis should be considered for the appropriate treatment policy based on the assessment of disease severity in patients with acute disease. The adequate assessment of disease severity and prognosis allows the indications for transferring patients to the resuscitation and intensive care department to be defined more precisely. Disease severity of patients who underwent polychemotherapy was assessed using APACHE II scoring system.

  4. School Closings in Philadelphia

    Science.gov (United States)

    Jack, James; Sludden, John

    2013-01-01

    In 2012, the School District of Philadelphia closed six schools. In 2013, it closed 24. The closure of 30 schools has occurred amid a financial crisis, headlined by the district's $1.35 billion deficit. School closures are one piece of the district's plan to cut expenditures and close its budget gap. The closures are also intended to make…

  5. Diverse Reductive Dehalogenases Are Associated with Clostridiales-Enriched Microcosms Dechlorinating 1,2-Dichloroethane

    KAUST Repository

    Merlino, Giuseppe; Balloi, Annalisa; Marzorati, Massimo; Mapelli, Francesca; Rizzi, Aurora; Lavazza, Davide; de Ferra, Francesca; Carpani, Giovanna; Daffonchio, Daniele

    2015-01-01

    The achievement of successful biostimulation of active microbiomes for the cleanup of a polluted site is strictly dependent on the knowledge of the key microorganisms equipped with the relevant catabolic genes responsible for the degradation process. In this work, we present the characterization of the bacterial community developed in anaerobic microcosms after biostimulation with the electron donor lactate of groundwater polluted with 1,2-dichloroethane (1,2-DCA). Through a multilevel analysis, we have assessed (i) the structural analysis of the bacterial community; (ii) the identification of putative dehalorespiring bacteria; (iii) the characterization of functional genes encoding for putative 1,2-DCA reductive dehalogenases (RDs). Following the biostimulation treatment, the structure of the bacterial community underwent a notable change of the main phylotypes, with the enrichment of representatives of the order Clostridiales . Through PCR targeting conserved regions within known RD genes, four novel variants of RDs previously associated with the reductive dechlorination of 1,2-DCA were identified in the metagenome of the Clostridiales-dominated bacterial community.

  6. Diverse Reductive Dehalogenases Are Associated with Clostridiales-Enriched Microcosms Dechlorinating 1,2-Dichloroethane

    KAUST Repository

    Merlino, Giuseppe

    2015-03-06

    The achievement of successful biostimulation of active microbiomes for the cleanup of a polluted site is strictly dependent on the knowledge of the key microorganisms equipped with the relevant catabolic genes responsible for the degradation process. In this work, we present the characterization of the bacterial community developed in anaerobic microcosms after biostimulation with the electron donor lactate of groundwater polluted with 1,2-dichloroethane (1,2-DCA). Through a multilevel analysis, we have assessed (i) the structural analysis of the bacterial community; (ii) the identification of putative dehalorespiring bacteria; (iii) the characterization of functional genes encoding for putative 1,2-DCA reductive dehalogenases (RDs). Following the biostimulation treatment, the structure of the bacterial community underwent a notable change of the main phylotypes, with the enrichment of representatives of the order Clostridiales . Through PCR targeting conserved regions within known RD genes, four novel variants of RDs previously associated with the reductive dechlorination of 1,2-DCA were identified in the metagenome of the Clostridiales-dominated bacterial community.

  7. [Manipulative reduction and small splint fixation combined with micromovement exercise for treatment of humeral shaft fractures].

    Science.gov (United States)

    Tang, Hao-chen; Xiang, Ming; Chen, Hang; Hu, Xiao-chuan; Yang, Guo-yong

    2016-01-01

    To investigate the therapeutic efficacy of bone-setting manipulative reduction and small splint fixation combined with micro-movement theory exercise for treatment of humeral shaft fractures. From March 2011 to February 2014, 64 cases of humeral shaft fractures were treated by bone-setting manipulative reduction and small splint fixation including 28 males and 36 females with an average age of 38.1 years old ranging from 22 to 67 years old. According to the classification of AO/OTA, there were 10 cases of type A1, 12 cases of type A2,11 cases of type A3,10 cases of type B1,12 cases of type B2, 7 cases of type B3, 2 cases of type C1, 1 case of type C2, 1 case of type C3. After close reduction early functional exercise performed according to micro-movement theory. All patients had no other parts of the fractures, neurovascular injury, and serious medical problems. Patients were followed up for fracture healing, shoulder and elbow joint function recovery, and curative effect. All patients were followed up from 10 to 12 months with an average of 10.3 months. Of them, 2 cases had a small amount of callus growth at 3 months after close reduction, so instead of operation; 2 cases appeared radial nerve symptoms after close reduction ,so instead of operation. Other patients were osseous healing, the time was 8 to 12 weeks with an average of 10.2 weeks. After osseous healing, according to Constant-Murley score system ,the average score was (93.5 ± 3.2) points, the result was excellent in 29 cases, good in 29 cases, fair in 6 cases, excellent and good rate was 90.3%; according to the Mayo score system, the average score was (93.7 ± 4.2) points, the result was excellent in 35 cases, good in 23 cases, fair in 6 cases, excellent and good rate was 91.9%. Bone-setting manipulative reduction and small splint fixation combined with micromovement theory exercise for treatment of humeral shaft fractures has advantage of positive effect, easy and inexpensive method, the treatment has

  8. Activation of the central melanocortin system in rats persistently reduces body and fat mass independently of caloric reduction.

    Science.gov (United States)

    Côté, Isabelle; Green, Sara M; Morgan, Drake; Carter, Christy S; Tümer, Nihal; Scarpace, Philip J

    2018-03-01

    Recent evidence indicate that melanotan II (MTII) reduces body mass independently of caloric reduction. Because MTII induces a transient hypophagia, caloric reduction is still considered a primary mechanism for MTII-mediated body mass loss. To examine the contribution of caloric reduction to long-term body mass loss in response to MTII, we centrally infused MTII or vehicle in ad libitum fed (MTII and Control) animals in comparison with a group of animals that were pair-fed (PF) to the MTII group. Food intake and body mass were recorded daily, and body composition was assessed biweekly. The present study demonstrates that central MTII-mediated body mass loss is only partially mediated by caloric restriction, and the long-term body mass loss is independent of the initial hypophagia. More importantly, central MTII administration induced a rapid but sustained fat mass loss, independently of caloric reduction. MTII-treated animals preserved their lean/fat mass ratio throughout the study, whereas PF animals underwent a transient reduction of lean/fat mass ratio that was only normalized when food intake returned to Control level. In summary, it can be concluded that activation of the central melanocortin system in rats persistently reduces body and fat mass independently of caloric reduction.

  9. Salivary cortisol levels are associated with outcomes of weight reduction therapy in obese Japanese patients.

    Science.gov (United States)

    Himeno, Akihiro; Satoh-Asahara, Noriko; Usui, Takeshi; Wada, Hiromichi; Tochiya, Mayu; Kono, Shigeo; Yamada-Goto, Nobuko; Katsuura, Goro; Hasegawa, Koji; Nakao, Kazuwa; Shimatsu, Akira

    2012-02-01

    Dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis can increase the risk of cardiovascular disease (CVD). However, the detailed relationships of HPA axis activity with weight reduction and CVD risk factors in obese patients have not been examined. This study was designed to elucidate the associations of salivary cortisol levels with weight reduction and CVD risk factors in obese patients. As a marker of HPA axis activity, we measured the morning salivary cortisol levels of 83 obese Japanese outpatients. We also examined metabolic parameters, inflammatory markers, and indicators of arterial stiffness, that is, the pulse wave velocity and cardio-ankle vascular index. All 83 obese patients underwent 3-month weight reduction therapy with lifestyle modification. At the baseline, multivariate regression analysis revealed that only logarithmic transformation of C-reactive protein (β = 0.258, P cortisol levels. However, other metabolic parameters were not significantly associated with the salivary cortisol levels. In addition, lower salivary cortisol levels and higher body weight at the baseline were the only independent determinants of successful weight loss through the weight reduction therapy (P cortisol levels are significantly associated with the levels of an inflammatory marker, arterial stiffness, and successful weight reduction in obese patients. Therefore, salivary cortisol could be a useful marker for assessing and managing body weight and CVD risk factors in obese patients. Copyright © 2012 Elsevier Inc. All rights reserved.

  10. Reduction of the Areolar Diameter After Ultrasound-Assisted Liposuction for Gynecomastia.

    Science.gov (United States)

    Keskin, Mustafa; Sutcu, Mustafa; Hanci, Mustafa; Cigsar, Bulent

    2017-08-01

    One of the clinical aspects characterizing gynecomastia is the enlargement of the nipple-areolar complex (NAC) due to hypertrophic breast glands, and the excessive fatty tissue underneath. The purpose of this study was to quantify the reduction of the areolar diameter after ultrasound-assisted liposuction (UAL) of the male breast. The horizontal diameters of the NACs of 30 men who underwent UAL were measured before surgery, 1 month after surgery and 6 months after surgery in a standard fashion. Those patients with surgical gland removals of any kind were not included in this study. The mean age of the patients was 27.9 years, and all of the patients had bilateral grade I, II, or III gynecomastia. The mean diameter of the NACs before surgery was 35.36 mm (range, 26-55 mm), and after surgery, the mean diameter of the NACs was initially reduced to 28.8 mm (range, 23-44 mm) and later to 28.57 mm (range, 23-42 mm). The mean volume of breast tissue aspirated was 382 mL per breast, and the percentage of reduction was 17.3%. The reduction of areola diameter was statistically significant after first month. A significant positive correlation was identified between the liposuction volume and areolar diameter reduction. In cases of gynecomastia, the removal of the glandular and fatty tissue underneath the areola releases the expanding forces and pressure that enlarge it. In many cases of gynecomastia, UAL alone is effective in reducing the size of the NAC and allows the surgeon to avoid placing scars on the breast.

  11. Waste reduction and recycling initiatives in Japanese cities: lessons from Yokohama and Kamakura.

    Science.gov (United States)

    Hotta, Yasuhiko; Aoki-Suzuki, Chika

    2014-09-01

    Waste reduction and recycling at the city level will acquire greater significance in the near future due to rising global volumes of waste. This paper seeks to identify policy-relevant drivers for successful promotion of waste reduction and recycling. Factors influencing the success of waste reduction and recycling campaigns are identified. Two case study cities in Japan which depict the successful use of the 3Rs (reduce, reuse and recycle) at the municipal level are presented. In these cases, the existence of incinerators, which are generally considered as disincentives for recycling, was not functioning as a disincentive but rather as an incentive for waste reduction. Owing to the high cost of incineration facilities, the movement to close incinerators has become a strong incentive for waste reduction and recycling in these two cities. The study suggests that careful consideration is necessary when making decisions concerning high-cost waste treatment facilities with high installation, maintenance and renewal outlays. In addition, intensive source separation and other municipal recycling initiatives have a high potential for producing positive results. © The Author(s) 2014.

  12. Testing of indoor radon reduction techniques in eastern Pennsylvania: An update

    International Nuclear Information System (INIS)

    Henschel, D.B.; Scott, A.G.

    1987-01-01

    EPA has installed radon reduction measures in 38 houses in the Reading Prong region of eastern Pennsylvania. All were basement houses with hollow block or poured concrete foundation walls. The reduction approaches tested in most houses involved active soil ventilation, including: suction on the footing drain tile system; suction underneath the concrete slabs, using pipes inserted through the slabs from inside the house; and ventilation of the void network inside hollow block foundation walls. Heat recovery ventilators (HRVs) were tested in three houses. The current results confirm that, for the houses tested here, drain tile suction appears consistently able to provide high radon reductions when a complete loop of drain tile exists, often reducing high-radon houses to 4 pCi/l (148 B1/m 3 ) and less. Sub-slab suction (with pipes through the slab) can also provide high reductions if a sufficient number of suction pipes are located properly. Placement of one or more sub-slab suction pipes near each perimeter wall appears in this testing to aid in treating the major soil gas entry routes, although fewer pipes can sometimes give high reductions if conditions are favorable. For effective radon reduction using any active soil ventilation technique, it is important that major wall and slab openings be closed, and that a fan be employed that is capable of developing adequate static pressure

  13. One-electron standard reduction potentials of nitroaromatic and cyclic nitramine explosives

    International Nuclear Information System (INIS)

    Uchimiya, Minori; Gorb, Leonid; Isayev, Olexandr; Qasim, Mohammad M.; Leszczynski, Jerzy

    2010-01-01

    Extensive studies have been conducted in the past decades to predict the environmental abiotic and biotic redox fate of nitroaromatic and nitramine explosives. However, surprisingly little information is available on one-electron standard reduction potentials (E o (R-NO 2 /R-NO 2 - )). The E o (R-NO 2 /R-NO 2 - ) is an essential thermodynamic parameter for predicting the rate and extent of reductive transformation for energetic residues. In this study, experimental (linear free energy relationships) and theoretical (ab initio calculation) approaches were employed to determine E o (R-NO 2 /R-NO 2 - ) for nitroaromatic, (caged) cyclic nitramine, and nitroimino explosives that are found in military installations or are emerging contaminants. The results indicate a close agreement between experimental and theoretical E o (R-NO 2 /R-NO 2 - ) and suggest a key trend: E o (R-NO 2 /R-NO 2 - ) value decreases from di- and tri-nitroaromatic (e.g., 2,4-dinitroanisole) to nitramine (e.g., RDX) to nitroimino compound (e.g., nitroguanidine). The observed trend in E o (R-NO 2 /R-NO 2 - ) agrees with reported rate trends for reductive degradation, suggesting a thermodynamic control on the reduction rate under anoxic/suboxic conditions. - Reduction of explosives becomes less thermodynamically favorable as the one-electron standard reduction potential decreases from di- and tri-nitroaromatic, nitramine, to nitroimino compounds.

  14. Malignant-looking thyroid nodules with size reduction: Core needle biopsy results

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Ha Young; Baek, Jung Hwan; Ha, Eun Jun; Park, Jee Won; Lee, Jeong Hyun; Song, Dong Eun; Shong, Young Kee [Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of)

    2016-08-15

    The aim of this study was to evaluate whether malignant-looking thyroid nodules with size reduction were malignant or not. From November 2010 to July 2011, we retrospectively enrolled 16 patients with 16 nodules (11 females and five males; mean age, 55 years) who underwent core needle biopsy (CNB), and whose thyroid nodules had malignant ultrasonographic (US) features, although they showed size reduction (>20% decrease in maximum diameter) during the follow-up period (mean, 37±27 months). The histologic findings of the CNB specimen were reviewed and correlated with the US findings. US studies were analyzed for their internal content, shape, margin, echogenicity, the presence of microcalcification and macrocalcification, inner isoechoic rim, and low-echoic halo. All nodules were confirmed as benign by CNB. Pathologic analysis was available for 12 CNB specimens. US imaging showed central hypoechogenicity or marked hypoechogenicity in all cases and a peripheral isoechoic rim in 15 nodules. US-pathologic correlation showed that the central hypoechoic area was primarily composed of fibrosis (12/12) and hemorrhage (8/12) and that the isoechoic rim was composed of follicular cells. In our study, the CNB results of all of the malignant-looking thyroid nodules with size reduction were benign and were primarily composed of internal fibrosis and hemorrhage. Understanding these US and pathologic features could prevent repeated fine-needle aspiration or unnecessary diagnostic surgery.

  15. Effects of imperfections on the dynamic aperture and closed orbit of the IPNS Upgrade synchrotron

    International Nuclear Information System (INIS)

    Lessner, E.; Chae, Y.C.; Kim, S.

    1995-01-01

    Magnet imperfections and misalignments are analyzed in terms of their effects on the dynamic aperture and closed orbit of the IPNS Upgrade synchrotron. The dynamic aperture is limited primarily by the presence of chromaticity-correcting sextupoles. With the sextupoles energized to the values required to adjust the chromaticities to zero, further reductions of the dynamic aperture caused by dipole strength and roll errors, quadrupole strength and alignment errors, and higher-order multipole errors are studied by tracking. Design specifications for the dipole corrector magnets are obtained and the dynamic aperture is studied before and after correction of the closed orbit. The use of harmonic-correcting sextupoles to reduce the amplitude-dependent tune shifts driven by the chromaticity-correcting sextupoles is investigated

  16. Perturbative method for the derivation of quantum kinetic theory based on closed-time-path formalism

    International Nuclear Information System (INIS)

    Koide, Jun

    2002-01-01

    Within the closed-time-path formalism, a perturbative method is presented, which reduces the microscopic field theory to the quantum kinetic theory. In order to make this reduction, the expectation value of a physical quantity must be calculated under the condition that the Wigner distribution function is fixed, because it is the independent dynamical variable in the quantum kinetic theory. It is shown that when a nonequilibrium Green function in the form of the generalized Kadanoff-Baym ansatz is utilized, this condition appears as a cancellation of a certain part of contributions in the diagrammatic expression of the expectation value. Together with the quantum kinetic equation, which can be derived in the closed-time-path formalism, this method provides a basis for the kinetic-theoretical description

  17. Oxygen reduction at platinum nanoparticles supported on carbon cryogel in alkaline solution

    Directory of Open Access Journals (Sweden)

    N. R. ELEZOVIC

    2007-07-01

    Full Text Available The oxygen reduction reaction was investigated in 0.1 M NaOH solution, on a porous coated electrode formed of Pt particles supported on carbon cryogel. The Pt/C catalyst was characterized by the X-ray diffraction (XRD, transmission electron microscopy (TEM and cyclic voltammetry techniques. The results demonstrated a successful reduction of Pt to metallic form and homogenous Pt particle size distribution with a mean particle size of about 2.7 nm. The ORR kinetics was investigated by linear sweep polarization at a rotating disc electrode. The results showed the existence of two E – log j regions, usually referred to polycrystalline Pt in acid and alkaline solution. At low current densities (lcd, the Tafel slope was found to be close to –2.3RT/F, while at high current densities (hcd it was found to be close to –2×2.3RT/F. It is proposed that the main path in the ORR mechanism on Pt particles was the direct four-electron process, with the transfer of the first electron as the rate determining step. If the activities are expressed through the specific current densities, a small enhancement of the catalytic activity for Pt/C was observed compared to that of polycrystalline Pt. The effect of the Pt particle size on the electrocatalysis of oxygen reduction was ascribed to the predominant (111 facets of the platinum crystallites.

  18. Effect of phosphorus addition on the reductive transformation of pentachlorophenol (PCP) and iron reduction with microorganism involvement.

    Science.gov (United States)

    Wang, Yongkui; Liu, Xianli; Huang, Jiexun; Xiao, Wensheng; Zhang, Jiaquan; Yin, Chunqin

    2017-10-01

    The transformation of phosphorus added to the soil environment has been proven to be influenced by the Fe biochemical process, which thereby may affect the transformation of organic chlorinated contaminants. However, the amount of related literatures regarding this topic is limited. This study aimed to determine the effects of phosphorus addition on pentachlorophenol (PCP) anaerobic transformation, iron reduction, and paddy soil microbial community structure. Results showed that the transformation of phosphorus, iron, and PCP were closely related to the microorganisms. Moreover, phosphorus addition significantly influenced PCP transformation and iron reduction, which promoted and inhibited these processes at low and high concentrations, respectively. Both the maximum reaction rate of PCP transformation and the maximum Fe(II) amount produced were obtained at 1 mmol/L phosphorus concentration. Among the various phosphorus species, dissolved P and NaOH-P considerably changed, whereas only slight changes were observed for the remaining phosphorus species. Microbial community structure analysis demonstrated that adding low concentration of phosphorus promoted the growth of Clostridium bowmanii, Clostridium hungatei, and Clostridium intestinale and Pseudomonas veronii. By contrast, high-concentration phosphorus inhibited growth of these microorganisms, similar to the curves of PCP transformation and iron reduction. These observations indicated that Clostridium and P. veronii, especially Clostridium, played a vital role in the transformation of related substances in the system. All these findings may serve as a reference for the complicated reactions among the multiple components of soils.

  19. Spontaneous rapid reduction of a large acute subdural hematoma.

    Science.gov (United States)

    Lee, Chul-Hee; Kang, Dong Ho; Hwang, Soo Hyun; Park, In Sung; Jung, Jin-Myung; Han, Jong Woo

    2009-12-01

    The majority of acute post-traumatic subdural hematomas (ASDH) require urgent surgical evacuation. Spontaneous resolution of ASDH has been reported in some cases. We report here on a case of a patient with a large amount of ASDH that was rapidly reduced. A 61-yr-old man was found unconscious following a high speed motor vehicle accident. On initial examination, his Glasgow Coma Score scale was 4/15. His pupils were fully dilated and non-reactive to bright light. Brain computed tomography (CT) showed a massive right-sided ASDH. The decision was made to treat him conservatively because of his poor clinical condition. Another brain CT approximately 14 hr after the initial scan demonstrated a remarkable reduction of the previous ASDH and there was the new appearance of high density in the subdural space adjacent to the falx and the tentorium. Thirty days after his admission, brain CT revealed chronic SDH and the patient underwent surgery. The patient is currently able to obey simple commands. In conclusion, spontaneous rapid resolution/reduction of ASDH may occur in some patients. The mechanisms are most likely the result of dilution by cerebrospinal fluid and the redistribution of hematoma especially in patients with brain atrophy.

  20. Do Motivational Interviewing Behaviors Predict Reductions in Partner Aggression for Men and Women?

    Science.gov (United States)

    Woodin, Erica M.; Sotskova, Alina; O’Leary, K. Daniel

    2011-01-01

    Motivational interviewing is a directive, non-confrontational intervention to promote behavior change. The current study examined therapist behaviors during a successful brief motivational interviewing intervention for physically aggressive college dating couples (Woodin & O’Leary, 2010). Forty-five minute motivational interviews with each partner were videotaped and coded using the Motivational Interviewing Treatment Integrity scale (MITI; Moyers, Martin, Manuel, & Miller, 2003). Hierarchical modeling analyses demonstrated that therapist behaviors consistent with motivational interviewing competency predicted significantly greater reductions in physical aggression perpetration following the intervention. Specifically, greater reflection to question ratios by the therapists predicted reductions in aggression for both men and women, greater percentages of open versus closed questions predicted aggression reductions for women, and there was a trend for greater levels of global therapist empathy to predict aggression reductions for women. These findings provide evidence that motivational interviewing seems to have an effect on behavior change through therapist behaviors consistent with the theoretical underpinnings of motivational interviewing. PMID:22119133

  1. Close binary stars

    International Nuclear Information System (INIS)

    Larsson-Leander, G.

    1979-01-01

    Studies of close binary stars are being persued more vigorously than ever, with about 3000 research papers and notes pertaining to the field being published during the triennium 1976-1978. Many major advances and spectacular discoveries were made, mostly due to increased observational efficiency and precision, especially in the X-ray, radio, and ultraviolet domains. Progress reports are presented in the following areas: observational techniques, methods of analyzing light curves, observational data, physical data, structure and models of close binaries, statistical investigations, and origin and evolution of close binaries. Reports from the Coordinates Programs Committee, the Committee for Extra-Terrestrial Observations and the Working Group on RS CVn binaries are included. (Auth./C.F.)

  2. 75 FR 7370 - Closed Captioning of Video Programming; Closed Captioning Requirements for Digital Television...

    Science.gov (United States)

    2010-02-19

    ... FEDERAL COMMUNICATIONS COMMISSION 47 CFR Part 79 [CG Docket No. 05-231; ET Docket No. 99-254; FCC 08-255] Closed Captioning of Video Programming; Closed Captioning Requirements for Digital Television... Captioning of Video Programming; Closed Captioning Requirements for Digital Television Receivers, Declaratory...

  3. The Hitchin model, Poisson-quasi-Nijenhuis, geometry and symmetry reduction

    International Nuclear Information System (INIS)

    Zucchini, Roberto

    2007-01-01

    We revisit our earlier work on the AKSZ-like formulation of topological sigma model on generalized complex manifolds, or Hitchin model, [20]. We show that the target space geometry geometry implied by the BV master equations is Poisson-quasi-Nijenhuis geometry recently introduced and studied by Stienon and Xu (in the untwisted case) in [44]. Poisson-quasi-Nijenhuis geometry is more general than generalized complex geometry and comprises it as a particular case. Next, we show how gauging and reduction can be implemented in the Hitchin model. We find that the geometry resulting form the BV master equation is closely related to but more general than that recently described by Lin and Tolman in [40, 41], suggesting a natural framework for the study of reduction of Poisson-quasi-Nijenhuis manifolds

  4. Technical study on reduction of patient exposure in x-ray examination

    International Nuclear Information System (INIS)

    Ohtsuka, Akiyoshi

    1983-01-01

    This paper deals with the necessity, problems and technical factors on the reduction of the patient exposure, as well as the source of disagreement between doctors and radiologic technologists with respect to their psychological evaluation of the radiological image quality. (1) The patient exposure has a close relationship to the radiological image quality and is affected by many physical and psychological factors. (2) From the patient's point of view, reduction of the patient exposure without the decrease of the image quality has the same meaning as improving the image quality without the increase of the patient exposure. (3) It is known that, in the observation of the radiological image, the radiologic technologists basically attach more importance to the physical evaluation while doctors attach more importance to the psychological evaluation. (4) If doctors and radiologic technologists have more knowledge concerning the radiological imaging technology, optimization of radiographic technique, reduction of the patient exposure and improvement of the diagnostic accuracy can be expected. (author)

  5. Nonsurgical reduction of the interventricular septum in patients with hypertrophic cardiomyopathy.

    Science.gov (United States)

    Shamim, Waqar; Yousufuddin, Mohammed; Wang, Duolao; Henein, Michael; Seggewiss, Hubert; Flather, Marcus; Coats, Andrew J S; Sigwart, Ulrich

    2002-10-24

    In patients with hypertrophic cardiomyopathy and obstruction of the left ventricular outflow tract, nonsurgical reduction of the septum is a treatment option when medical therapy has failed. We investigated the long-term effects of nonsurgical reduction of the septum on functional capacity and electrocardiographic and echocardiographic characteristics. Sixty-four consecutive patients with hypertrophic cardiomyopathy and a mean (+/-SD) age of 48.5+/-17.2 years underwent nonsurgical reduction of the septum by injection of ethanol into the septal perforator branch of the left anterior descending coronary artery. These patients were assessed by exercise testing, electrocardiography, and resting and dobutamine (stress-induced) echocardiography after a mean period of 3.0+/-1.3 years. At follow-up, patients had significant improvements in New York Heart Association class, peak oxygen consumption (from 18.4+/-5.8 to 30.0+/-4.4 ml per kilogram of body weight per minute, P<0.001), and left ventricular outflow tract gradients (resting gradient, from 64+/-36 to 16+/-15 mm Hg; P<0.001; stress-induced gradient, from 132+/-34 to 45+/-19 mm Hg; P<0.001). Procedure-related complications included right bundle-branch block in all patients, complete heart block in 31 patients (48 percent), and significant increases in QRS and corrected QT intervals. Seventeen patients (27 percent) required permanent pacing. R-wave amplitude was significantly decreased (from 32+/-8 to 17+/-7 mV, P<0.001). The dimensions of the left ventricular cavity increased, and the interventricular septal thickness was reduced. Nonsurgical septal reduction leads to sustained improvements in both subjective and objective measures of exercise capacity in association with a persistent reduction in resting and stress-induced left ventricular outflow tract gradients. It is also associated with a high incidence of procedure-related complete heart block, however, often requiring permanent pacing. Copyright 2002

  6. Effect of different chemical modification of carbon nanotubes for the oxygen reduction reaction in alkaline media

    International Nuclear Information System (INIS)

    Dumitru, Anca; Mamlouk, M.; Scott, K.

    2014-01-01

    The electrochemical reduction of oxygen on chemically modified multi-walled carbon nanotubes (CNTs) electrodes in 1 M KOH solution has been studied using the rotating ring disc electrode (RDE). The surface modification of CNTs has been estimated by XPS and Raman spectroscopy. The effect of different oxygen functionalities on the surface of carbon nanotube for the oxygen reduction reaction (ORR) is considered in terms of the number of electrons (n) involved. Electrochemical studies indicate that in the case of the modification of CNTs with citric acid and diazonium salts the n values were close to two in the measured potential range, and the electrochemical reduction is limited to the production of peroxide as the final product. In the case of the modification of carbon nanotubes with peroxymonosulphuric acid, in the measured potential range, the n value is close to 4 indicating the four-electron pathway for the ORR. By correlating ORR measurements with the XPS analysis, we propose that the increase in electrocatalytic activity towards the ORR, for CNT can be attributed to the increase in C-O groups on the surface of CNTs after modification with peroxymonosulphuric acid

  7. Epidural Hematoma and Abscess Related to Thoracic Epidural Analgesia: A Single-Center Study of 2,907 Patients Who Underwent Lung Surgery.

    Science.gov (United States)

    Kupersztych-Hagege, Elisa; Dubuisson, Etienne; Szekely, Barbara; Michel-Cherqui, Mireille; François Dreyfus, Jean; Fischler, Marc; Le Guen, Morgan

    2017-04-01

    To report the major complications (epidural hematoma and abscess) of postoperative thoracic epidural analgesia in patients who underwent lung surgery. Prospective, monocentric study. A university hospital. All lung surgical patients who received postoperative thoracic epidural analgesia between November 2007 and November 2015. Thoracic epidural analgesia for patients who underwent lung surgery. During the study period, data for 2,907 patients were recorded. The following 3 major complications were encountered: 1 case of epidural hematoma (0.34 case/1,000; 95% confidence interval 0.061-1.946), for which surgery was performed, and 2 cases of epidural abscesses (0.68 case/1,000; 95% confidence interval 0.189-2.505), which were treated medically. The risk range of serious complications was moderate; only the patient who experienced an epidural hematoma also experienced permanent sequelae. Copyright © 2017 Elsevier Inc. All rights reserved.

  8. Storage of Renewable Energy by Reduction of CO2 with Hydrogen.

    Science.gov (United States)

    Züttel, Andreas; Mauron, Philippe; Kato, Shunsuke; Callini, Elsa; Holzer, Marco; Huang, Jianmei

    2015-01-01

    The main difference between the past energy economy during the industrialization period which was mainly based on mining of fossil fuels, e.g. coal, oil and methane and the future energy economy based on renewable energy is the requirement for storage of the energy fluxes. Renewable energy, except biomass, appears in time- and location-dependent energy fluxes as heat or electricity upon conversion. Storage and transport of energy requires a high energy density and has to be realized in a closed materials cycle. The hydrogen cycle, i.e. production of hydrogen from water by renewable energy, storage and use of hydrogen in fuel cells, combustion engines or turbines, is a closed cycle. However, the hydrogen density in a storage system is limited to 20 mass% and 150 kg/m(3) which limits the energy density to about half of the energy density in fossil fuels. Introducing CO(2) into the cycle and storing hydrogen by the reduction of CO(2) to hydrocarbons allows renewable energy to be converted into synthetic fuels with the same energy density as fossil fuels. The resulting cycle is a closed cycle (CO(2) neutral) if CO(2) is extracted from the atmosphere. Today's technology allows CO(2) to be reduced either by the Sabatier reaction to methane, by the reversed water gas shift reaction to CO and further reduction of CO by the Fischer-Tropsch synthesis (FTS) to hydrocarbons or over methanol to gasoline. The overall process can only be realized on a very large scale, because the large number of by-products of FTS requires the use of a refinery. Therefore, a well-controlled reaction to a specific product is required for the efficient conversion of renewable energy (electricity) into an easy to store liquid hydrocarbon (fuel). In order to realize a closed hydrocarbon cycle the two major challenges are to extract CO(2) from the atmosphere close to the thermodynamic limit and to reduce CO(2) with hydrogen in a controlled reaction to a specific hydrocarbon. Nanomaterials with

  9. Correlation between location of transposed ovary and function in cervical cancer patients who underwent radical hysterectomy.

    Science.gov (United States)

    Yoon, Aera; Lee, Yoo-Young; Park, Won; Huh, Seung Jae; Choi, Chel Hun; Kim, Tae-Joong; Lee, Jeong-Won; Kim, Byoung-Gie; Bae, Duk-Soo

    2015-05-01

    The study investigated the association between the location of transposed ovaries and posttreatment ovarian function in patients with early cervical cancer (IB1-IIA) who underwent radical hysterectomy and ovarian transposition with or without adjuvant therapies. Retrospective medical records were reviewed to enroll the patients with early cervical cancer who underwent ovarian transposition during radical hysterectomy at Samsung Medical Center between July 1995 and July 2012. Serum follicle-stimulating hormone (FSH) level was used as a surrogate marker for ovarian function. Twenty-one patients were enrolled. The median age and body mass index (BMI) were 31 years (range, 24-39 years) and 21.3 kg/m² (range, 17.7-31.2 kg/m²), respectively. The median serum FSH level after treatment was 7.9 mIU/mL (range, 2.4-143.4 mIU/mL). The median distance from the iliac crest to transposed ovaries on erect plain abdominal x-ray was 0.5 cm (range, -2.7 to 5.2 cm). In multivariate analysis, posttreatment serum FSH levels were significantly associated with the location of transposed ovaries (β = -8.1, P = 0.032), concurrent chemoradiation (CCRT) as an adjuvant therapy (β = 71.08, P = 0.006), and BMI before treatment (underweight: β = -59.93, P = 0.05; overweight: β = -40.62, P = 0.041). Location of transposed ovaries, adjuvant CCRT, and BMI before treatment may be associated with ovarian function after treatment. We suggest that ovaries should be transposed as highly as possible during radical hysterectomy to preserve ovarian function in young patients with early cervical cancer who might be a candidate for adjuvant CCRT and who have low BMI before treatment.

  10. [Should surgeons keep performing drainage after breast reduction?

    Science.gov (United States)

    Vidali, N; Chevet-Noel, A; Ringenbach, P; Andreoletti, J B

    2018-04-09

    Despite the absence of "evidence-based medicine", the use of closed suction drainage in breast surgery is currently the standard practice. Its goal is to minimize the amount of fluid at the operation site, the dead space that can involve postoperative complications. The purpose of this study is to demonstrate that with or without drainage the complication rate is unchanged. We conducted a retrospective and comparative study of two groups of breast reduction with and without drainage. Every complication has been recorded and statistically analyzed: seroma and hematoma, infections, wound breakdown, skin flap or nipple-areola complex necrosis, fat necrosis and reoperation. A total of 138 breast reductions were performed (37 drained patients and 32 non-drained). Data collection of complications was done on average 10months after the operation (1-15). There was no statistical difference between the two groups regarding the complication rate. Our results confirm the ones found in the literature. Except for specific cases (e.g. gigantomasty), this study demonstrates that after breast reduction, drainage is not appropriate. Drains do not reduce postoperative complications and can increase hospitalization length of stay (inducing higher costs). Furthermore, it is often source of pain, anxiety and discomfort for patients. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

  11. Ion extraction capabilities of closely spaced grids

    Science.gov (United States)

    Rovang, D. C.; Wilbur, P. J.

    1982-01-01

    The ion extraction capabilities of accelerator systems with small screen hole diameters (less than 2.0 mm) are investigated at net-accelerating voltages of 100, 300, and 500 V. Results show that the impingement-limited perveance is not dramatically affected by reductions in screen hole diameter to 1.0 mm, but impingement-limited performance was found to be dependent on the grid separation distance, the discharge-to-total accelerating voltage ratio, and the net-to-total accelerating voltage ratio. Results obtained using small hole diameters and closely spaced grids indicate a new mode of grid operation where high current density operation can be achieved with a specified net acceleration voltage by operating the grids at a high rather than low net-to-total acceleration voltage. Beam current densities as high as 25 mA/sq cm were obtained using grids with 1.0 mm diameter holes operating at a net accelerating voltage of 500 V.

  12. Major reduction in 30-day mortality after elective colorectal cancer surgery

    DEFF Research Database (Denmark)

    Iversen, Lene Hjerrild; Ingeholm, Peter; Gögenur, Ismail

    2014-01-01

    BACKGROUND: For years, the outcome of colorectal cancer (CRC) surgery has been inferior in Denmark compared to its neighbouring countries. Several strategies have been initiated in Denmark to improve CRC prognosis. We studied whether there has been any effect on postoperative mortality based...... on the information from a national database. METHODS: Patients who underwent elective major surgery for CRC in the period 2001-2011 were identified in the national Danish Colorectal Cancer Group database. Thirty-day mortality rates were calculated and factors with impact on mortality were identified using logistic...... the study period. CONCLUSION: The 30-day mortality rate after elective major surgery for CRC has decreased significantly in Denmark in the past decade. Laparoscopic surgical approach was associated with a reduction in mortality in colon cancer....

  13. Percutaneous clamping of spiral and oblique fractures of the tibial shaft: a safe and effective reduction aid during intramedullary nailing.

    Science.gov (United States)

    Collinge, Cory A; Beltran, Michael J; Dollahite, Henry A; Huber, Florian G

    2015-06-01

    The reduction of tibial shaft fractures during intramedullary nailing is important if limb alignment is to be restored and successful clinical outcomes are expected. We have used a percutaneously applied (or open) clamp or clamps to achieve and maintain reduction during nailing of all amendable tibial shaft fractures. In this article, we describe the technique and preliminary results comparing closed, simple spiral and oblique tibial shaft fractures (OTA 42-A1 and A2) managed with percutaneous clamp-assisted nailing (CAN) versus nailing using manual reduction (MRN) held by the surgical team. In the MRN group, there were an increased fracture gap (P = 0.04) and trends toward malalignment (P = 0.07) and healing time (P = 0.06) compared with the CAN group. There were also trends in clinical; no wound complications occurred in either group. We have found that percutaneous CAN of closed, simple spiral and oblique tibial shaft fractures seems safe and allows for early predictable union with reproducible alignment compared with nailing using MRN.

  14. Closed to reason: time for accountability for the International Narcotic Control Board

    Directory of Open Access Journals (Sweden)

    Small Dan

    2007-05-01

    International Harm Reduction Development Program (IHRD joined by former United Nations Special Envoy for HIV/AIDS in Africa, the respected Canadian statesman Stephen Lewis. The full report, "Closed to Reason: The International Narcotics Control Board and HIV/AIDS" is attached along [see Additional file 1] with a Russian translation of the key findings of the authors [see Additional files 2] as well as Russian and Chinese translations of this abstract [see Additional 3 and 4]. As the report makes very clear, the time to inject some accountability and reason into the INCB is now. Additional file 1 Closed to Reason: The International Narcotics Control Board and HIV/AIDS. Report by J. Csete and D. Wolfe of the Canadian HIV/AIDS Legal Network; International Harm Reduction Development Program (IHRD; Open Society Institute (OSI; 2007:1–32. Click here for file Additional file 2 Closed to Reason: The International Narcotics Control Board and HIV/AIDS Key Findings. Russian translation of key findings of the above report. Click here for file Additional file 3 "Closed to Reason": Time for Accountability for the International Narcotic Control Board. Russian translation of abstract of the above editorial. Click here for file Additional file 4 "Closed to Reason": Time for accountability for the International Narcotic Control Board. Chinese translation of abstract of the above editorial. Click here for file Howmany times must a man look up Before he can see the sky Yes and how many ears Must one man have Before he can hear people cry? Yes, and how many deaths Will it take till he knows That too many people have died? Bob Dylan

  15. [The Postero-Lateral Approach--An Alternative to Closed Anterior-Posterior Screw Fixation of a Dislocated Postero-Lateral Fragment of the Distal Tibia in Complex Ankle Fractures].

    Science.gov (United States)

    von Rüden, C; Hackl, S; Woltmann, A; Friederichs, J; Bühren, V; Hierholzer, C

    2015-06-01

    The dislocated posterolateral fragment of the distal tibia is considered as a key fragment for the successful reduction of comminuted ankle fractures. The reduction of this fragment can either be achieved indirectly by joint reduction using the technique of closed anterior-posterior screw fixation, or directly using the open posterolateral approach followed by plate fixation. The aim of this study was to compare the outcome after stabilization of the dislocated posterolateral tibia fragment using either closed reduction and screw fixation, or open reduction and plate fixation via the posterolateral approach in complex ankle fractures. In a prospective study between 01/2010 and 12/2012, all mono-injured patients with closed ankle fractures and dislocated posterolateral tibia fragments were assessed 12 months after osteosynthesis. Parameters included: size of the posterolateral tibia fragment relative to the tibial joint surface (CT scan, in %) as an indicator of injury severity, unreduced area of tibial joint surface postoperatively, treatment outcome assessed by using the "Ankle Fracture Scoring System" (AFSS), as well as epidemiological data and duration of the initial hospital treatment. In 11 patients (10 female, 1 male; age 51.6 ± 2.6 years [mean ± SEM], size of tibia fragment 42.1 ± 2.5 %) the fragment fixation was performed using a posterolateral approach. Impaired postoperative wound healing occurred in 2 patients of this group. In the comparison group, 12 patients were treated using the technique of closed anterior-posterior screw fixation (10 female, 2 male; age 59.5 ± 6.7 years, size of tibia fragment 45.9 ± 1.5 %). One patient of this group suffered an incomplete lesion of the superficial peroneal nerve. Radiological evaluation of the joint surface using CT scan imaging demonstrated significantly less dislocation of the tibial joint surface following the open posterolateral approach (0.60 ± 0.20 mm) compared to the closed

  16. Tumor deposit is a poor prognostic indicator in patients who underwent simultaneous resection for synchronous colorectal liver metastases

    Directory of Open Access Journals (Sweden)

    Lin Q

    2015-01-01

    Full Text Available Qi Lin,# Ye Wei,# Li Ren,# Yunshi Zhong,# Chunzhi Qin, Peng Zheng, Pingping Xu, Dexiang Zhu, Meiling Ji, Jianmin XuDepartment of General Surgery, Zhongshan Hospital, Fudan University, Shanghai, People's Republic of China#These authors contributed equally to this workBackground: Tumor deposits are one of the important influencing factors among the different editions of Tumor, Node, Metastasis classification. Incidence and prognosis of tumor deposits in stage I, II, and III colorectal cancer patients has been explored. The aim of this study was to determine the prognostic value of tumor deposits in stage IV colorectal cancer patients who underwent simultaneous resection for synchronous colorectal liver metastases (SCRLM.Methods: Clinicopathological and outcome data of 146 consecutive SCRLM patients who underwent simultaneous R0 resection between July 2003 and July 2013 were collected from our prospectively established SCRLM database. The prognostic value of tumor deposits was evaluated by Kaplan–Meier and Cox regression analysis.Results: Tumor deposits were detected in 41.8% (61/146 of these SCRLM patients. Tumor deposits were significantly correlated with lymph node metastasis and nerve invasion of the primary tumors (P=0.002, P=0.041; respectively. The Kaplan–Meier survival analysis revealed that the overall survival (OS and disease-free survival (DFS of SCRLM patients with tumor deposits were significantly poorer than those with no tumor deposits (P=0.039, P=0.001; respectively. And with multivariate analysis, we found that positive tumor deposits were significantly associated with shorter DFS independent of lymph node status (P=0.002. Subgroup analysis found that of the 57 SCRLM patients with negative lymph node status, the OS and DFS of patients with positive tumor deposits were significantly shorter than those with negative tumor deposits (P=0.002 and P=0.031, respectively. Of the 89 patients with positive lymph node status, the OS of

  17. The application of closed reduction internal fixation and iliac bone block grafting in the treatment of acute displaced femoral neck fractures.

    Directory of Open Access Journals (Sweden)

    Zhiyong Li

    Full Text Available OBJECTIVE: This study aimed to evaluate the preliminary clinical and radiographic outcomes of acute displaced femoral neck fracture treated by closed reduction and internal fixation (CRIF with free iliac bone block grafting with comparison to a routine protocol of CRIF without bone grafting. METHODS: From December 2008 to February 2010, 220 adult patients with acute displaced femoral neck fractures were enrolled in this study. In study group, there were 124 patients (57 males, 67 females with a mean age of 44.8 years (range, 20-64 years. There were 70 transcervical fractures and 54 subcapital fractures. The patients were treated by CRIF and free iliac bone block grafting. The control group consisted of 96 adult patients (46 males, 50 females with a mean age of 46.3 years (range, 23-64 years. There were 61 transcervical fractures and 35 subcapital fractures. The patients in control group were treated by CRIF without bone grafting. RESULTS: In study group, 112 patients were followed up for an average of 27.4 months (range, 24-34 months. All fractures healed within 5 months. However, 10 patients presented AVN of the femoral heads. The mean Harris score was 88.6 (range, 41-100. In control group, 68 patients were followed up for an average of 31.2 months (range, 24-42 months. The rates of AVN of the femoral head and fracture nonunion in control group were 26.5% (18/68 and 16.2% (11/68, respectively, significantly higher than those in study group (both P<0.05. The mean Harris score in control group was 83.8 (41-100, significantly lower than that in study group (P<0.05. CONCLUSION: Acute displaced femoral neck fractures can be treated by CRIF and free iliac bone block grafting in a minimally invasive manner. This technique can guarantee uneventful fracture healing and significantly reduce the rate of femoral head osteonecrosis.

  18. Study of the seroma volume changes in the patients who underwent Accelerated Partial Breast Irradiation

    International Nuclear Information System (INIS)

    Kim, Dae Ho; Son, Sang Jun; Mun, Jun Ki; Seo, Seok Jin; Lee, Je Hee

    2016-01-01

    By analyzing seroma volume changes in the patients who underwent Partial breast radiation therapy after breast conserving surgery, we try to contribute to the improvement of radiotherapy effect. Enrolled 20 patients who underwent partial breast radiation therapy by ViewRay MRIdian System were subject. After seeking for the size of the removed sample in the patients during surgery and obtained seroma volume changes on a weekly basis. On the Basis of acquired volume, it was compared with age, term from start of the first treatment after surgery, BMI (body mass index) and the extracted sample size during surgery. And using the ViewRay MRIdian RTP System, the figure was analyzed by PTV(=seroma volume + margin) to obtain a specific volume of the Partial breast radiation therapy. The changes of seroma volume from MR simulation to the first treatment (a week) is 0~5% in 8, 5~10% in 3, 10 to 15% in 2, and 20% or more in 5 people. Two patients(A, B patient) among subjects showed the biggest change. The A patient's 100% of the prescribed dose volume is 213.08 cc, PTV is 181.93 cc, seroma volume is 15.3 cc in initial plan. However, while seroma volume decreased 65.36% to 5.3 cc, 100% of the prescribed dose volume was reduced to 3.4% to 102.43 cc and PTV also did 43.6% to 102.54 cc. In the case of the B patient, seroma volume decreased 42.57% from 20.2 cc to 11.6 cc. Because of that, 100% of the prescribed dose volume decreased 8.1% and PTV also did to 40%. As the period between the first therapy and surgery is shorter, the patient is elder and the size of sample is smaller than 100 cc, the change grow bigger. It is desirable to establish an adaptive plan according to each patient's changes of seroma volume through continuous observation. Because partial breast patients is more sensitive than WBRT patients about dose conformity in accordance with the volume change

  19. Convergent Reduction of Ovariole Number Associated with Subterranean Life in Beetles

    Science.gov (United States)

    Faille, Arnaud; Pluot-Sigwalt, Dominique

    2015-01-01

    Background Some species of obligate cavernicolous beetles are known to possess a unique feature—a contraction of the larval cycle. In contrast to many other subterranean beetles, life-cycle contraction in Trechini ground beetles (Carabidae) is correlated with a reduction in the number of eggs and a drastic reduction in the number of ovarioles. This remarkable peculiarity has only been reported for a small number of closely related species. Results We give a description of the female internal reproductive system for six species of Trechini, including five subterranean species, with a particular focus on the western Pyrenean radiation of Aphaenops, a group for which nothing is known regarding the early life stages. We redescribe the internal female genitalia of A. crypticola Linder. Study of the ovarioles allowed us to infer the postembryonic development of the larvae for each species examined. We then used a phylogenetic framework to recognize two independent reductions in the number of ovarioles in the Pyrenean lineage. We discuss the multiple convergent evolutions in ovariole number and the potential link between a reduction of ovariole number and troglobiomorphism in a phylogenetic context. Conclusions There is an extreme reduction in ovariole number and size within the species studied; the eggs produced by small ovarioles have a remarkably large size. A reduction to one ovariole has occurred independently at least twice in this subterranean group. A reduction in the number of ovarioles in ground beetles is one of the striking consequences of subterranean specialization and it is correlated with another remarkable adaptation of subterranean beetles, a reduction in the number of larval instars. PMID:26151557

  20. Convergent Reduction of Ovariole Number Associated with Subterranean Life in Beetles.

    Directory of Open Access Journals (Sweden)

    Arnaud Faille

    Full Text Available Some species of obligate cavernicolous beetles are known to possess a unique feature-a contraction of the larval cycle. In contrast to many other subterranean beetles, life-cycle contraction in Trechini ground beetles (Carabidae is correlated with a reduction in the number of eggs and a drastic reduction in the number of ovarioles. This remarkable peculiarity has only been reported for a small number of closely related species.We give a description of the female internal reproductive system for six species of Trechini, including five subterranean species, with a particular focus on the western Pyrenean radiation of Aphaenops, a group for which nothing is known regarding the early life stages. We redescribe the internal female genitalia of A. crypticola Linder. Study of the ovarioles allowed us to infer the postembryonic development of the larvae for each species examined. We then used a phylogenetic framework to recognize two independent reductions in the number of ovarioles in the Pyrenean lineage. We discuss the multiple convergent evolutions in ovariole number and the potential link between a reduction of ovariole number and troglobiomorphism in a phylogenetic context.There is an extreme reduction in ovariole number and size within the species studied; the eggs produced by small ovarioles have a remarkably large size. A reduction to one ovariole has occurred independently at least twice in this subterranean group. A reduction in the number of ovarioles in ground beetles is one of the striking consequences of subterranean specialization and it is correlated with another remarkable adaptation of subterranean beetles, a reduction in the number of larval instars.

  1. Emergency Closed Reduction of a C4/5 Fracture Dislocation with Complete Paraplegia Resulting in Profound Neurologic Recovery

    Directory of Open Access Journals (Sweden)

    Christian W. Müller

    2013-01-01

    Full Text Available Introduction. Cervical spinal cord injuries due to traumatic fractures are associated with persistent neurological deficits. Although clinical evidence is weak, early decompression, defined as <24–72 h, has been frequently proposed. Animal studies show better outcomes after early decompression within one hour or less, which can hardly ever be achieved in clinical practice. Case Presentation. A 37-year-old patient was hospitalized after being hit by a shying horse. After diagnosis of C4/5 fracture dislocation and complete paraplegia, she was intubated and sedated with deep relaxation. Emergency reduction was performed at approximately 120 minutes after trauma. Subsequently, a standard anterior decompression, discectomy, and fusion were carried out. She was then transferred to a specialized rehabilitation hospital. Her neurologic function improved from AIS grade A on admission to grade B postoperatively and grade D after four months of rehabilitation. One year after the accident, she was ambulatory without walking aids and restarted horse riding. Discussion and Conclusion. Rarely in clinical practice, decompression of the spine canal can be performed as early as in this case. This case highlights the potential benefit of utmost early reduction in cervical fracture dislocations with compression of the spinal cord.

  2. Fuzzy multi-objective sustainable and green closed-loop supply chain network design

    DEFF Research Database (Denmark)

    Soleimani, Hamed; Govindan, Kannan; Saghafi, Hamid

    2017-01-01

    recycling raw material recycling. Modeling this chain is carried out by accounting for environmental considerations, total profit optimization, and reduction of lost working days due to occupational accidents, we well as maximizing responsiveness to customer demand. In order to solve the model, genetic...... algorithm has been used and multiple scenarios with different aspects have been studied. Solving this model provides decisions regarding opening or closing of each of the components of the network and the optimal product flow among them. The results prove the feasibility of the presented model...... and the applicability of the developed solution methodology....

  3. Classroom Demonstration: Combustion of Diamond to Carbon Dioxide Followed by Reduction to Graphite

    Science.gov (United States)

    Miyauchi, Takuya; Kamata, Masahiro

    2012-01-01

    An educational demonstration shows the combustion of carbon to carbon dioxide and then the reduction of carbon dioxide to carbon. A melee diamond is the source of the carbon and the reaction is carried out in a closed flask. The demonstration helps students to realize that diamonds are made of carbon and that atoms do not change or vanish in…

  4. One-electron standard reduction potentials of nitroaromatic and cyclic nitramine explosives

    Energy Technology Data Exchange (ETDEWEB)

    Uchimiya, Minori, E-mail: sophie.uchimiya@ars.usda.go [Environmental Laboratory, U.S. Army Engineer Research and Development Center, Vicksburg, MS 39180 (United States); Gorb, Leonid [SpecPro Inc, 3909 Halls Ferry Road, Vicksburg, MS 39180 (United States); Isayev, Olexandr [Department of Chemistry, Case Western Reserve University, Cleveland, OH 44106 (United States); Qasim, Mohammad M. [Environmental Laboratory, U.S. Army Engineer Research and Development Center, Vicksburg, MS 39180 (United States); Leszczynski, Jerzy [Environmental Laboratory, U.S. Army Engineer Research and Development Center, Vicksburg, MS 39180 (United States); Interdisciplinary Center for Nanotoxicity, Jackson State University, Jackson, MS 39217 (United States)

    2010-10-15

    Extensive studies have been conducted in the past decades to predict the environmental abiotic and biotic redox fate of nitroaromatic and nitramine explosives. However, surprisingly little information is available on one-electron standard reduction potentials (E{sup o}(R-NO{sub 2}/R-NO{sub 2}{sup -})). The E{sup o}(R-NO{sub 2}/R-NO{sub 2}{sup -}) is an essential thermodynamic parameter for predicting the rate and extent of reductive transformation for energetic residues. In this study, experimental (linear free energy relationships) and theoretical (ab initio calculation) approaches were employed to determine E{sup o}(R-NO{sub 2}/R-NO{sub 2}{sup -}) for nitroaromatic, (caged) cyclic nitramine, and nitroimino explosives that are found in military installations or are emerging contaminants. The results indicate a close agreement between experimental and theoretical E{sup o}(R-NO{sub 2}/R-NO{sub 2}{sup -}) and suggest a key trend: E{sup o}(R-NO{sub 2}/R-NO{sub 2}{sup -}) value decreases from di- and tri-nitroaromatic (e.g., 2,4-dinitroanisole) to nitramine (e.g., RDX) to nitroimino compound (e.g., nitroguanidine). The observed trend in E{sup o}(R-NO{sub 2}/R-NO{sub 2}{sup -}) agrees with reported rate trends for reductive degradation, suggesting a thermodynamic control on the reduction rate under anoxic/suboxic conditions. - Reduction of explosives becomes less thermodynamically favorable as the one-electron standard reduction potential decreases from di- and tri-nitroaromatic, nitramine, to nitroimino compounds.

  5. Aortoseptal angle and pressure gradient reduction following balloon valvuloplasty in dogs with severe subaortic stenosis.

    Science.gov (United States)

    Shen, L; Estrada, A H; Côté, E; Powell, M A; Winter, B; Lamb, K

    2017-04-01

    To determine the relationship between aortoseptal angle (AoSA) and the short- and long-term systolic pressure gradient (PG) reduction following combined cutting and high-pressure balloon valvuloplasty (CB/HPBV) in dogs with severe subaortic stenosis. Retrospective study of 22 client-owned dogs of various breeds with severe subaortic stenosis (mean left ventricular to aortic PG = 143 mmHg; range = 80-322 mmHg) that underwent CB/HPBV. Initial angiographic and left apical and right-sided parasternal long-axis view echocardiographic video loops were used for measuring the angle between the plane of the interventricular septum and the longitudinal axis of the ascending aorta. The PG reduction ratio immediately after CB/HPBV and 6 and 12 months later were compared with AoSA. Weak correlations were observed for all instances of PG reduction ratio and AoSA type. Significantly greater mean differences of PG reduction ratio were observed for angles >160° than for angles 160° mean: 54.45, standard error [SE]: ±3.8; 160° mean: 57.73, SE: ±10.9; 160° mean: 76.11, SE: ±17.5; Dogs with AoSA >160° on right-sided parasternal long-axis view echocardiograms responded with a greater PG reduction following CB/HPBV than did dogs with AoSA dogs that are candidates for CB/HPBV. Crown Copyright © 2016. Published by Elsevier B.V. All rights reserved.

  6. Evaluation of incidence and histolopathological findings of breast lesions in reduction mammoplasty specimens: Uludag University experience

    International Nuclear Information System (INIS)

    Aytac, B.; Tolunay, S.; Erturk, F.Y.; Kahveci, R.

    2013-01-01

    To report the incidence of benign, pre-cancerous and malignant lesions in reduction mammoplasty specimens. Methods: The retrospective study was conducted at the Uludag University, Bursa, Turkey and comprised data of 264 patients who underwent bilateral breast reduction between 2004 and 2009. Operative reports and pathological findings of all patients were reviewed. Patients were divided into three age groups with reference to the hormonal characteristics: girls and women between 13 and 35 years constituted group 1; women older than 35 and younger than 50 years old were clustered in group 2; and women over 50 years formed group 3. Descriptive statistics were applied. Results: Fibrocystic disease was the most common (n=402; 76.13%) lesion in all groups. Proliferative lesions such as intraductal epithelial hyperplasia and atypical ductal hyperplasia were each found in 0.4% (n=2) cases. There were 2(0.4%) cases with invasive ductal carcinoma, and 1 (0.2%) case with ductal carcinoma in situ. All malignant tumours were found in patients over 50 years of age. Conclusion: Microscopic examination of macroscopically normal breast tissue from breast reduction specimens may provide noteworthy pathological findings. Histological sampling of reduction mammoplasty specimens gave rise to the early detection of occult neoplastic breast lesions. (author)

  7. Electrochemical processing of spent nuclear fuels: An overview of oxide reduction in pyroprocessing technology

    Directory of Open Access Journals (Sweden)

    Eun-Young Choi

    2015-12-01

    Full Text Available The electrochemical reduction process has been used to reduce spent oxide fuel to a metallic form using pyroprocessing technology for a closed fuel cycle in combination with a metal-fuel fast reactor. In the electrochemical reduction process, oxides fuels are loaded at the cathode basket in molten Li2O–LiCl salt and electrochemically reduced to the metal form. Various approaches based on thermodynamic calculations and experimental studies have been used to understand the electrode reaction and efficiently treat spent fuels. The factors that affect the speed of the electrochemical reduction have been determined to optimize the process and scale-up the electrolysis cell. In addition, demonstrations of the integrated series of processes (electrorefining and salt distillation with the electrochemical reduction have been conducted to realize the oxide fuel cycle. This overview provides insight into the current status of and issues related to the electrochemical processing of spent nuclear fuels.

  8. Impact of high-density lipoprotein 3 cholesterol subfraction on periprocedural myocardial injury in patients who underwent elective percutaneous coronary intervention.

    Science.gov (United States)

    Harada, Kazuhiro; Kikuchi, Ryosuke; Suzuki, Susumu; Tanaka, Akihito; Aoki, Toshijiro; Iwakawa, Naoki; Kojima, Hiroki; Hirayama, Kenshi; Mitsuda, Takayuki; Sumi, Takuya; Negishi, Yosuke; Ishii, Hideki; Murohara, Toyoaki

    2018-02-02

    Periprocedural myocardial injury (PMI) is a major complication of percutaneous coronary intervention (PCI) and is associated with atherosclerotic coronary plaque and worse clinical outcomes. High-density lipoprotein cholesterol (HDL-C) is a protective factor for cardiovascular disease. However, the role of HDL-C subfractions, such as HDL2 cholesterol (HDL2-C) or HDL3 cholesterol (HDL3-C), in cardiovascular disease remains unclear. The purpose of the study was to investigate the relationship between HDL2-C and HDL3-C subfractions and the incidence of PMI in patients who underwent elective PCI. We enrolled 129 patients who underwent elective PCI for stable angina pectoris. PMI was defined as an increase in high-sensitivity troponin T levels > 5 times the upper normal limit (> 0.070 ng/mL) at 24 h after PCI. Serum HDL-C subfractions (HDL2-C and HDL3-C) were assessed using ultracentrifugation in patients with and those without PMI. HDL3-C levels were significantly lower in patients with PMI than in those without (15.1 ± 3.0 mg/dL vs. 16.4 ± 2.9 mg/dL, p = 0.016) and had an independent and inverse association with PMI (odds ratio, 0.86; 95% confidence interval, 0.74-0.99; p = 0.038). When divided by the cut-off value of HDL3-C for PMI (14.3 mg/dL), the incidence of PMI was significantly higher in low HDL3-C patients than in high HDL3-C patients (51.2% vs. 30.2%, p = 0.020). HDL3-C was an independent inverse predictor of PMI in patients who underwent elective PCI.

  9. 27 CFR 44.146 - Closing.

    Science.gov (United States)

    2010-04-01

    ... PAYMENT OF TAX, OR WITH DRAWBACK OF TAX Operations by Export Warehouse Proprietors Inventories § 44.146 Closing. A closing inventory shall be made by the export warehouse proprietor when he transfers ownership or concludes business. Where the proprietor transfers ownership the closing inventory shall be made...

  10. Stress and Quality of Life for Taiwanese Women Who Underwent Infertility Treatment.

    Science.gov (United States)

    Cheng, Ching-Yu; Stevenson, Eleanor Lowndes; Yang, Cheng-Ta; Liou, Shwu-Ru

    2018-04-28

    To describe the psychological stress and quality of life experienced by women who underwent fertility treatment in Taiwan. Cross-sectional, correlational study. Recruitment was conducted and questionnaires administered at a reproductive medicine center in Chiayi City, Taiwan. Informed consent to participate was obtained from 126 women who sought fertility treatment at the center. The Chinese Fertility Problem Inventory and Fertility Quality of Life scale were used to measure participants' levels of fertility-related stress and fertility-related quality of life. Descriptive statistics, correlation, and regression analysis were used. Overall, participants reported low levels of fertility-related stress and fertility-related quality of life; however, they had relatively high levels of stress related to need for parenthood. Women who were older, had greater body mass indexes, and consumed coffee regularly had lower fertility-related quality of life. Social and relationship concerns and stress related to need for parenthood were significant predictors of low fertility-related quality of life. In a culture in which childbearing is generally an expectation and an important part of family life, women who experience infertility are at risk to experience fertility-related stress. Social support and family consultation might be offered to improve women's fertility-related quality of life. Copyright © 2018 AWHONN, the Association of Women’s Health, Obstetric and Neonatal Nurses. Published by Elsevier Inc. All rights reserved.

  11. 27 CFR 40.426 - Closing.

    Science.gov (United States)

    2010-04-01

    ... TOBACCO Manufacture of Cigarette Papers and Tubes Operations by Manufacturers § 40.426 Closing. A closing report, covering the period from the first of the month to the date of the closing inventory, shall be made with such inventory. (72 Stat. 1422; 26 U.S.C. 5722) Inventories ...

  12. Autotransplantation of spleen tissue in children with mansonic schistosomiasis who underwent splenectomy: Evaluation of splenic residual functions

    Directory of Open Access Journals (Sweden)

    Brandt Carlos Teixeira

    1998-01-01

    Full Text Available Autotransplantation of spleen tissue is an attempt for maintenance of splenic functions when splenectomy is indicated in children. It minimizes the risks of overwhelming postsplenectomy infection and it has been done in children with severe portal hypertension due to hepatosplenic mansonic schistosomiasis that underwent splenectomy. The purposes of this investigation were to study the morphology of the residual splenic tissue; to evaluate the residual filtration function of this splenosis; and to assess the immune response to polyvalent pneumococcal vaccine of these patients. Twenty-three children with portal hypertension from mansonic schistosomiasis who underwent splenectomy, ligature of the left gastric vein, autotransplantation of spleen tissue into an omental pouch were evaluated for residual splenic parenchyma and functions. Tc-99m sulfur colloid liver-spleen scans were used for detection of splenic nodules. The search for Howell Jolly bodies were used for assessing the filtration function and Enzyme-linked immunosorbent assay was used for measuring the relative rise in titter of specific pneumococcal antibodies. Splenosis was evident in all children; however, in two there were less than five splenic nodules in the greater omentum, which was considered insufficient. Howell-Jolly bodies were found in the peripheral blood only in these two patients with less evident splenosis. The immune response was adequate in 15 patients; it was intermediate in 4 patients and inadequate in 4 patients. Autotransplantation of spleen tissue into an omental pouch is efficient in maintaining the filtration splenic function in more than 90% of the cases and the immune response to pneumococcal vaccination in approximately 65% of the children.

  13. 7 CFR 1927.56 - Scheduling loan closing.

    Science.gov (United States)

    2010-01-01

    ... REGULATIONS TITLE CLEARANCE AND LOAN CLOSING Real Estate Title Clearance and Loan Closing § 1927.56 Scheduling loan closing. The agency, in coordination with the closing agent, will arrange a loan closing and send loan closing instructions, on an agency form to the closing agent when the agency determines that the...

  14. Letter to the Editor: First direct observations of the reduced striations at pump frequencies close to the electron gyroharmonics

    Directory of Open Access Journals (Sweden)

    M. T. Rietveld

    Full Text Available It is well known that the ionospheric plasma response to high-power HF radio waves changes drastically as the heater frequency approaches harmonics of the electron gyrofrequency. These include changes in the spectrum of the stimulated electromagnetic emission, reduction in the anomalous absorption of low-power diagnostic waves propagating through the heated volume, and reduction in the large scale F-region heating. Theoretical models as well as previous experimental evidence point towards the absence of small-scale field-aligned plasma density irregularities at pump frequencies close to electron gyroharmonics as the main cause of these changes. Results presented in this paper are the first direct observations of the reduced striations at the 3rd gyroharmonic made by the CUTLASS radar. In addition, simultaneous EISCAT observations have revealed that the "enhanced ion-line" usually present in the EISCAT ion-line spectrum during the first few seconds after heater switch on, persisted at varying strengths while the heater was transmitting at frequencies close to the 3rd electron gyroharmonics.Key words. Ionosphere (active experiments; ionospheric irregularities · Radio science (ionospheric physics

  15. Letter to the Editor: First direct observations of the reduced striations at pump frequencies close to the electron gyroharmonics

    Directory of Open Access Journals (Sweden)

    F. Honary

    1999-09-01

    Full Text Available It is well known that the ionospheric plasma response to high-power HF radio waves changes drastically as the heater frequency approaches harmonics of the electron gyrofrequency. These include changes in the spectrum of the stimulated electromagnetic emission, reduction in the anomalous absorption of low-power diagnostic waves propagating through the heated volume, and reduction in the large scale F-region heating. Theoretical models as well as previous experimental evidence point towards the absence of small-scale field-aligned plasma density irregularities at pump frequencies close to electron gyroharmonics as the main cause of these changes. Results presented in this paper are the first direct observations of the reduced striations at the 3rd gyroharmonic made by the CUTLASS radar. In addition, simultaneous EISCAT observations have revealed that the "enhanced ion-line" usually present in the EISCAT ion-line spectrum during the first few seconds after heater switch on, persisted at varying strengths while the heater was transmitting at frequencies close to the 3rd electron gyroharmonics.Key words. Ionosphere (active experiments; ionospheric irregularities · Radio science (ionospheric physics

  16. Towards Energy Demand Reduction in Social Housing Buildings: Envelope System Optimization Strategies

    Directory of Open Access Journals (Sweden)

    Paula M. Esquivias

    2012-07-01

    Full Text Available This work evaluates the potential for the reduction of energy demand in residential buildings by acting on the exterior envelope, both in newly constructed buildings and in the retrofitting of existing stock. It focuses on analysing social housing buildings in Mediterranean areas and on quantifying the scope of that reduction in the application of different envelope design strategies, with the purpose of prioritizing their application based on their energy efficiency. The analyses and quantifications were made by means of the generation of energy models with the TRNSYS tool for simple or combined solutions, identifying possible potentials for reduction of the energy demand from 20% to 25%, basically by acting on the windows. The case study was a newly built social housing building of a closed block type located in Seville (Spain. Its constructive techniques and the insulation level of its envelope are standardized for current buildings widespread across Mediterranean Europe.

  17. Limited open reduction is better for simple- distal tibial shaft fractures than minimally invasive plate osteosynthesis.

    Science.gov (United States)

    Li, Q; Zeng, B F; Luo, C F; Song, S; Zhang, C Q; Kong, W Q

    2014-07-24

    The aim of this study was to compare the effects and indications of minimally invasive plate osteosynthesis (MIPO) and limited open reduction (LOR) for managing distal tibial shaft fractures. A total of 79 cases of distal tibial shaft fractures were treated surgically in our trauma center. The 79 fracture cases were classified into type A, B, and C (C1) according to the Arbeitsgemeinschaft für Osteosynthesefragen (AO) classification, with 28, 32, and 19 cases, respectively. Among the 79 fracture cases, 52 were closed fractures and 27 were open fractures (GUSTILO, I-II). After adequate preparation, 48 cases were treated with LOR and 31 cases were treated with MIPO. All cases were followed up for 12 to 18 months, with an average of 16.4 months. During the follow-up period, 76 fracture cases were healed in the first stage, whereas the 3 cases that developed non-union were treated by changing the fixation device and autografting. For types A, B, and some of C simple fractures (C1), LOR accelerated the fracture healing and lowered the non-union rate. One case suffered from regional soft tissue infection, which was controlled by wound dressing and intravenous antibiotics. Another case that developed local skin necrosis underwent local flap transplant. LOR promoted bone healing and lowered the non-union rate of several simple-distal tibial shaft fractures. Thereafter, the incidence of soft tissue complication was not significantly increased. However, for complex and comminuted fractures, MIPO was the preferred method for correcting bone alignment and protecting soft tissue, leading to functional recovery.

  18. Comparison of PSA value at last follow-up of patients who underwent low-dose rate brachytherapy and intensity-modulated radiation therapy for prostate cancer.

    Science.gov (United States)

    Tanaka, Nobumichi; Asakawa, Isao; Nakai, Yasushi; Miyake, Makito; Anai, Satoshi; Fujii, Tomomi; Hasegawa, Masatoshi; Konishi, Noboru; Fujimoto, Kiyohide

    2017-08-25

    To compare the PSA value at the last follow-up of patients who underwent prostate low-dose rate brachytherapy (LDR-BT) with that of patients who underwent intensity-modulated radiation therapy (IMRT). A total of 610 prostate cancer patients (cT1c-3bN0M0) were enrolled, and 445 of them underwent LDR-BT, while 165 received IMRT (74-76 Gy). The median follow-up period of these two groups was 75 months (LDR-BT) and 78 months (IMRT), respectively. We also evaluated the biochemical recurrence (BCR)-free rate using two definitions (Phoenix definition and PSA ≥ 0.2 ng/mL). The percentage of patients who achieved PSA LDR-BT group and 49.7% in the IMRT group (p LDR-BT group and 32.1% in the IMRT group (p LDR-BT groups was 89.5 and 95.0% (p LDR-BT groups, respectively (p LDR-BT was significantly lower than that of IMRT, and this result was particularly marked in patients with a normal testosterone level at the last follow-up.

  19. Restaurants closed over Christmas

    CERN Multimedia

    2011-01-01

    The restaurants will be closed during the Christmas holiday period : please note that all three CERN Restaurants will be closed from 5 p.m. on Wednesday, 21 December until Wednesday, 4 January inclusive. The Restaurants will reopen on Thursday, 5 January 2012.

  20. A study on the electrolytic reduction of uranium oxide in a LiCl-Li2O molten salt

    International Nuclear Information System (INIS)

    Su, J. S.; Hu, J. M.; Hong, S. S.; Jang, D. S.; Park, S. W.

    2003-01-01

    New electrolytic reduction technology was proposed that is based on the integration of metallization of uranium oxide and Li 2 O electrowinning. In this electrolytic reduction reaction, electrolytically reduced Li deposits on cathode and simultaneously reacts with uranium oxides to produce uranium metal showing more than 99% conversion. For the verification of process feasibility, the experiments to obtain basic data on the metallization of uranium oxide, investigation of reaction mechanism, the characteristics of closed recycle of Li 2 O and mass transfer were carried out. This evolutionary electrolytic reduction technology would give benefits over the conventional Li-reduction process improving economic viability such as: avoidance of handling of chemically active Li-LiCl molten salt, increase of metallization yield, and simplification of process

  1. [Lung volume reduction surgery for severe pulmonary emphysema in Iceland].

    Science.gov (United States)

    Gunnarsson, Sverrir I; Johannsson, Kristinn B; Guðjónsdóttir, Marta; Jónsson, Steinn; Beck, Hans J; Magnusson, Bjorn; Gudbjartsson, Tomas

    2011-12-01

    Lung volume reduction surgery (LVRS) can benefit patients with severe emphysema. The aim of this study was to evaluate the outcome of LVRS performed in Iceland. A prospective study of 16 consecutive patients who underwent bilateral LVRS through median sternotomy between January 1996 and December 2008. All patients had disabling dyspnea, lung hyperinflation, and emphysema with upper lobe predominance. Preoperatively all patients underwent pulmonary rehabilitation. Spirometry, lung volumes, arterial blood gases and exercise capacity were measured before and after surgery. Mean follow-up time was 8.7 years. Mean age was 59.2 ± 5.9 years. All patients had a history of heavy smoking. There was no perioperative mortality and survival was 100%, 93%, and 63% at 1, 5, and 10 years, respectively. The forced expiratory volume in 1 second (FEV1) and the forced vital capacity (FVC) improved significantly after surgery by 35% (plung capacity, residual volume and partial pressure of CO2 also showed statistically significant improvements but exercise capacity, O2 consumption and diffusing capacity of the lung for CO did not change. Prolonged air leak (≥ 7 days) was the most common complication (n=7). Five patients required reoperation, most commonly for sternal dehiscence (n=4). In this small prospective study, FEV1 and FVC increased and lung volumes and PaCO2 improved after LVRS. Long term survival was satisfactory although complications such as reoperations for sternal dehiscence were common and hospital stay therefore often prolonged.

  2. Ahp2 (Hop2) function in Arabidopsis thaliana (Ler) is required for stabilization of close alignment and synaptonemal complex formation except for the two short arms that contain nucleolus organizer regions.

    Science.gov (United States)

    Stronghill, P; Pathan, N; Ha, H; Supijono, E; Hasenkampf, C

    2010-08-01

    A cytological comparative analysis of male meiocytes was performed for Arabidopsis wild type and the ahp2 (hop2) mutant with emphasis on ahp2's largely uncharacterized prophase I. Leptotene progression appeared normal in ahp2 meiocytes; chromosomes exhibited regular axis formation and assumed a typical polarized nuclear organization. In contrast, 4',6'-diamidino-2-phenylindole-stained ahp2 pachytene chromosome spreads demonstrated a severe reduction in stabilized pairing. However, transmission electron microscopy (TEM) analysis of sections from meiocytes revealed that ahp2 chromosome axes underwent significant amounts of close alignment (44% of total axis). This apparent paradox strongly suggests that the Ahp2 protein is involved in the stabilization of homologous chromosome close alignment. Fluorescent in situ hybridization in combination with Zyp1 immunostaining revealed that ahp2 mutants undergo homologous synapsis of the nucleolus-organizer-region-bearing short arms of chromosomes 2 and 4, despite the otherwise "nucleus-wide" lack of stabilized pairing. The duration of ahp2 zygotene was significantly prolonged and is most likely due to difficulties in chromosome alignment stabilization and subsequent synaptonemal complex formation. Ahp2 and Mnd1 proteins have previously been shown, "in vitro," to form a heterodimer. Here we show, "in situ," that the Ahp2 and Mnd1 proteins are synchronous in their appearance and disappearance from meiotic chromosomes. Both the Ahp2 and Mnd1 proteins localize along the chromosomal axis. However, localization of the Ahp2 protein was entirely foci-based whereas Mnd1 protein exhibited an immunostaining pattern with some foci along the axis and a diffuse staining for the rest of the chromosome.

  3. Re-establishing filtering capabilities of machined porous beryllium via chemical reduction and cleaning

    International Nuclear Information System (INIS)

    Randall, W.L.

    1975-01-01

    Porous beryllium is furnished in sheets of varying sizes and thickness; it is therefore necessary that it be machined into specified sizes. A chemical reduction and cleaning procedure was devised to remove the disrupted surface, open the sealed pores of the material, and clean entrapped contaminates from the internal structure. Dimensional stability can be closely controlled and material size is of no consequence. (U.S.)

  4. Minding the close relationship.

    Science.gov (United States)

    Harvey, J H; Omarzu, J

    1997-01-01

    In this theoretical analysis, we argue that a process referred to as minding is essential for a couple to feel mutually close and satisfied in a close relationship over a long period Minding represents a package of mutual self-disclosure, other forms of goal-oriented behavior aimed at facilitating the relationship, and attributions about self's and other's motivations, intentions, and Mort in the relationship. Self-disclosure and attribution activities in minding are aimed at getting to know the other, trying to understand the other's motivations and deeper disposition as they pertain to the relationship, and showing respect and acceptance for knowledge gained about other. We link the concept of minding to other major ideas and literatures about how couples achieve closeness: self-disclosure and social penetration, intimacy, empathy and empathic accuracy, and love and self-expansion. We argue that the minding process articulated here has not previously been delineated and that it is a useful composite notion about essential steps in bonding among humans. We also argue that the minding concept stretches our understanding of the interface of attribution and close relationships. We present research possibilities and implications and consider possible alternative positions and counter arguments about the merits of the minding idea for close relationship satisfaction.

  5. Citrus aurantium Naringenin Prevents Osteosarcoma Progression and Recurrence in the Patients Who Underwent Osteosarcoma Surgery by Improving Antioxidant Capability

    Directory of Open Access Journals (Sweden)

    Lirong Zhang

    2018-01-01

    Full Text Available Citrus aurantium is rich in flavonoids, which may prevent osteosarcoma progression, but its related molecular mechanism remains unclear. Flavonoids were extracted from C. aurantium and purified by reparative HPLC. Each fraction was identified by using electrospray ionisation mass spectrometry (ESI-MS. Three main components (naringin, naringenin, and hesperetin were isolated from C. aurantium. Naringenin inhibited the growth of MG-63 cells, whereas naringin and hesperetin had no inhibitory function on cell growth. ROS production was increased in naringin- and hesperetin-treated groups after one day of culture while the level was always lowest in the naringenin-treated group after three days of culture. 95 osteosarcoma patients who underwent surgery were assigned into two groups: naringenin group (NG, received 20 mg naringenin daily, n=47 and control group (CG, received 20 mg placebo daily, n=48. After an average of two-year follow-up, osteosarcoma volumes were smaller in the NG group than in the CG group (P>0.01. The rate of osteosarcoma recurrence was also lower in the NG group than in CG group. ROS levels were lower in the NG group than in the CG group. Thus, naringenin from Citrus aurantium inhibits osteosarcoma progression and local recurrence in the patients who underwent osteosarcoma surgery by improving antioxidant capability.

  6. Citrus aurantium Naringenin Prevents Osteosarcoma Progression and Recurrence in the Patients Who Underwent Osteosarcoma Surgery by Improving Antioxidant Capability.

    Science.gov (United States)

    Zhang, Lirong; Xu, Xiaohua; Jiang, Tiechao; Wu, Kunzhe; Ding, Chuanbo; Liu, Zhen; Zhang, Xuanhe; Yu, Tianhua; Song, Changlong

    2018-01-01

    Citrus aurantium is rich in flavonoids, which may prevent osteosarcoma progression, but its related molecular mechanism remains unclear. Flavonoids were extracted from C. aurantium and purified by reparative HPLC. Each fraction was identified by using electrospray ionisation mass spectrometry (ESI-MS). Three main components (naringin, naringenin, and hesperetin) were isolated from C. aurantium . Naringenin inhibited the growth of MG-63 cells, whereas naringin and hesperetin had no inhibitory function on cell growth. ROS production was increased in naringin- and hesperetin-treated groups after one day of culture while the level was always lowest in the naringenin-treated group after three days of culture. 95 osteosarcoma patients who underwent surgery were assigned into two groups: naringenin group (NG, received 20 mg naringenin daily, n = 47) and control group (CG, received 20 mg placebo daily, n = 48). After an average of two-year follow-up, osteosarcoma volumes were smaller in the NG group than in the CG group ( P > 0.01). The rate of osteosarcoma recurrence was also lower in the NG group than in CG group. ROS levels were lower in the NG group than in the CG group. Thus, naringenin from Citrus aurantium inhibits osteosarcoma progression and local recurrence in the patients who underwent osteosarcoma surgery by improving antioxidant capability.

  7. Dimensionality reduction of collective motion by principal manifolds

    Science.gov (United States)

    Gajamannage, Kelum; Butail, Sachit; Porfiri, Maurizio; Bollt, Erik M.

    2015-01-01

    While the existence of low-dimensional embedding manifolds has been shown in patterns of collective motion, the current battery of nonlinear dimensionality reduction methods is not amenable to the analysis of such manifolds. This is mainly due to the necessary spectral decomposition step, which limits control over the mapping from the original high-dimensional space to the embedding space. Here, we propose an alternative approach that demands a two-dimensional embedding which topologically summarizes the high-dimensional data. In this sense, our approach is closely related to the construction of one-dimensional principal curves that minimize orthogonal error to data points subject to smoothness constraints. Specifically, we construct a two-dimensional principal manifold directly in the high-dimensional space using cubic smoothing splines, and define the embedding coordinates in terms of geodesic distances. Thus, the mapping from the high-dimensional data to the manifold is defined in terms of local coordinates. Through representative examples, we show that compared to existing nonlinear dimensionality reduction methods, the principal manifold retains the original structure even in noisy and sparse datasets. The principal manifold finding algorithm is applied to configurations obtained from a dynamical system of multiple agents simulating a complex maneuver called predator mobbing, and the resulting two-dimensional embedding is compared with that of a well-established nonlinear dimensionality reduction method.

  8. Drag reduction of a car model by linear genetic programming control

    Science.gov (United States)

    Li, Ruiying; Noack, Bernd R.; Cordier, Laurent; Borée, Jacques; Harambat, Fabien

    2017-08-01

    We investigate open- and closed-loop active control for aerodynamic drag reduction of a car model. Turbulent flow around a blunt-edged Ahmed body is examined at ReH≈ 3× 105 based on body height. The actuation is performed with pulsed jets at all trailing edges (multiple inputs) combined with a Coanda deflection surface. The flow is monitored with 16 pressure sensors distributed at the rear side (multiple outputs). We apply a recently developed model-free control strategy building on genetic programming in Dracopoulos and Kent (Neural Comput Appl 6:214-228, 1997) and Gautier et al. (J Fluid Mech 770:424-441, 2015). The optimized control laws comprise periodic forcing, multi-frequency forcing and sensor-based feedback including also time-history information feedback and combinations thereof. Key enabler is linear genetic programming (LGP) as powerful regression technique for optimizing the multiple-input multiple-output control laws. The proposed LGP control can select the best open- or closed-loop control in an unsupervised manner. Approximately 33% base pressure recovery associated with 22% drag reduction is achieved in all considered classes of control laws. Intriguingly, the feedback actuation emulates periodic high-frequency forcing. In addition, the control identified automatically the only sensor which listens to high-frequency flow components with good signal to noise ratio. Our control strategy is, in principle, applicable to all multiple actuators and sensors experiments.

  9. 7 CFR 764.402 - Loan closing.

    Science.gov (United States)

    2010-01-01

    ... SPECIAL PROGRAMS DIRECT LOAN MAKING Loan Decision and Closing § 764.402 Loan closing. (a) Signature... information for the Agency to reconfirm approval and proceed with loan closing. (3) The Agency or closing... account will be used according to subpart B of part 761 of this chapter when these processes are not...

  10. Plant growth and mineral recycle trade-offs in different scenarios for a CELSS. [Closed Ecological Life Support System

    Science.gov (United States)

    Ballou, E. V.; Wydeven, T.; Spitze, L. A.

    1982-01-01

    Data for hydroponic plant growth in a manned system test is combined with nutritional recommendations to suport trade-off calculations for closed and partially closed life support system scenarios. Published data are used as guidelines for the masses of mineral nutrients needed for higher plant production. The results of calculations based on various scenarios are presented for various combinations of plant growth chamber utilization and fraction of mineral recycle. Estimates are made of the masses of material needed to meet human nutritional requirements in the various scenarios. It appears that food production from a plant growth chamber with mineral recycle is favorable to reduction of the total launch weight in missions exceeding 3 years.

  11. Evaluation of a visual acuity test using closed Landolt-Cs to determine malingering.

    Science.gov (United States)

    Kröger, Nils; Jürgens, Clemens; Kohlmann, Thomas; Tost, Frank

    2017-12-01

    To evaluate a visual acuity test (VAT) with unexpected optotypes to detect malingering. We tested two groups. Group 1 consisted of 20 individuals with normal best corrected visual acuity (BCVA). Group 2 included participants with ocular diseases and reduced BCVA. All subjects underwent a VAT proposed by Gräf and Roesen to assess suspected malingering. This test used 36 charts with one Landolt-C per page. The first 20 optotypes were Landolt-Cs, while at positions 21, 26, 30, and 34 closed rings were presented. The testing distance was adapted to 50% of the test person's visual acuity. The test person was requested to name the gap direction of the Landolt-C within 3 s. The complete testing conversation was recorded digitally to determine response latency for each optotype from the audio tracks. The average response time was 0.46 s in group 1 and 0.45 s in group 2 for the first 20 Landolt-Cs. In both groups the response time was significantly extended (p ring compared to the mean of the first 20 Landolt-Cs, (group 1: 2.9 s; group 2: 2.3 s). The following three closed rings had also longer response times. However, these differences were not significant. Our results suggest that the proposed test may be helpful to evaluate ocular malingering. The testing procedure appeared to be feasible and showed good repeatability. The fast training effect may be a limitation for malingering detection.

  12. Explosion Amplitude Reduction due to Fractures in Water-Saturated and Dry Granite

    Science.gov (United States)

    Stroujkova, A. F.; Leidig, M.; Bonner, J. L.

    2013-12-01

    Empirical observations made at the Semipalatinsk Test Site suggest that nuclear tests in the fracture zones left by previous explosions ('repeat shots') show reduced seismic amplitudes compared to the nuclear tests in virgin rocks. Likely mechanisms for the amplitude reduction in the repeat shots include increased porosity and reduced strength and elastic moduli, leading to pore closing and frictional sliding. Presence of pore water significantly decreases rock compressibility and strength, thus affecting seismic amplitudes. A series of explosion experiments were conducted in order to define the physical mechanism responsible for the amplitude reduction and to quantify the degree of the amplitude reduction in fracture zones of previously detonated explosions. Explosions in water-saturated granite were conducted in central New Hampshire in 2011 and 2012. Additional explosions in dry granite were detonated in Barre, VT in 2013. The amplitude reduction is different between dry and water-saturated crystalline rocks. Significant reduction in seismic amplitudes (by a factor of 2-3) in water-saturated rocks was achieved only when the repeat shot was detonated in the extensive damage zone created by a significantly larger (by a factor of 5) explosion. In case where the first and the second explosions were similar in yield, the amplitude reduction was relatively modest (5-20%). In dry rocks the amplitude reduction reached a factor of 2 even in less extensive damage zones. In addition there are differences in frequency dependence of the spectral amplitude ratios between explosions in dry and water-saturated rocks. Thus the amplitude reduction is sensitive to the extent of the damage zone as well as the pore water content.

  13. Closed string field theory

    International Nuclear Information System (INIS)

    Strominger, A.

    1987-01-01

    A gauge invariant cubic action describing bosonic closed string field theory is constructed. The gauge symmetries include local spacetime diffeomorphisms. The conventional closed string spectrum and trilinear couplings are reproduced after spontaneous symmetry breaking. The action S is constructed from the usual ''open string'' field of ghost number minus one half. It is given by the associator of the string field product which is non-vanishing because of associativity anomalies. S does not describe open string propagation because open string states associate and can thereby be shifted away. A field theory of closed and open strings can be obtained by adding to S the cubic open string action. (orig.)

  14. Comparative study of short-term cardiovascular autonomic control in cardiac surgery patients who underwent coronary artery bypass grafting or correction of valvular heart disease.

    Science.gov (United States)

    Shvartz, Vladimir A; Kiselev, Anton R; Karavaev, Anatoly S; Vulf, Kristina A; Borovkova, Ekaterina I; Prokhorov, Mikhail D; Petrosyan, Andrey D; Bockeria, Olga L

    2018-01-01

    Introduction: Our aim was to perform a comparative study of short-term cardiovascular autonomic control in cardiac surgery patients who underwent coronary artery bypass grafting (CABG) or surgical correction of valvular heart disease (SCVHD ). Methods: The synchronous 15 minutes records of heart rate variability (HRV) and finger's photoplethysmographic waveform variability (PPGV) were performed in 42 cardiac surgery patients (12 women) aged 61.8 ± 8.6 years (mean ± standard deviation), who underwent CABG, and 36 patients (16 women) aged 54.2 ± 14.9 years, who underwent SCVHD , before surgery and in 5-7 days after surgery. Conventional time and frequency domain measures of HRV and index S of synchronization between the slow oscillations in PPGV and HRV were analyzed. We also calculated personal dynamics of these indices after surgery. Results: We found no differences ( Р > 0.05) in all studied autonomic indices (preoperative and post-surgery) between studied patients' groups, except for the preoperative heart rate, which was higher in patients who underwent SCVHD ( P = 0.013). We have shown a pronounced preoperative and post-surgery variability (magnitude of inter-quartile ranges) of all autonomic indices in studied patients. In the cluster analysis based on cardiovascular autonomic indices (preoperative and post-surgery), we divided all patients into two clusters (38 and 40 subjects) which did not differ in all clinical characteristics (except for the preoperative hematocrit, P = 0.038), index S, and all post-surgery HRV indices. First cluster (38 patients) had higher preoperative values of the HR, TP, HF, and HF%, and lower preoperative values of the LF% and LF/HF. Conclusion: The variability of cardiovascular autonomic indices in on-pump cardiac surgery patients (two characteristic clusters were identified based on preoperative indices) was not associated with their clinical characteristics and features of surgical procedure (including cardioplegia).

  15. National environmental targets and international emission reduction instruments

    International Nuclear Information System (INIS)

    Morthorst, P.E.

    2003-01-01

    power market can be recommended, if these initiatives efficiently are expected to contribute in achieving the national CO 2 -reduction targets. Countries most ambitious in implementing renewable energy technologies will only partly be gaining the CO 2 -reduction benefits themselves. The ambitious countries will support the less ambitious ones in achieving their GHG-reduction targets. Finally, in a TGC-market context the most ambitious countries to fulfil their TGC-quotas will have to buy certificates from the less ambitious ones, although this only contributes to fulfilling a national target for renewable development, not in reaching their national CO 2 -reduction targets. However, a combination of an international tradable permits market and a green certificate market is seen to be efficient in contributing in achieving the national CO 2 -reduction targets if a close co-ordination of the two instruments is undertaken at least at the national level: When the green power production is increased, the tradable permits quota should be decreased correspondingly. Otherwise the expected CO 2 -reductions will not contribute by the full value in achieving the national targets for greenhouse gas reductions. Thus, if it is a prerequisite that renewable power contributes to achieving national GHG-reduction targets, then the combination of these two markets might be the right solution

  16. Study of the seroma volume changes in the patients who underwent Accelerated Partial Breast Irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Dae Ho; Son, Sang Jun; Mun, Jun Ki; Seo, Seok Jin; Lee, Je Hee [Dept. of Radiation Oncology, Seoul National University Hospital, Seoul (Korea, Republic of)

    2016-06-15

    By analyzing seroma volume changes in the patients who underwent Partial breast radiation therapy after breast conserving surgery, we try to contribute to the improvement of radiotherapy effect. Enrolled 20 patients who underwent partial breast radiation therapy by ViewRay MRIdian System were subject. After seeking for the size of the removed sample in the patients during surgery and obtained seroma volume changes on a weekly basis. On the Basis of acquired volume, it was compared with age, term from start of the first treatment after surgery, BMI (body mass index) and the extracted sample size during surgery. And using the ViewRay MRIdian RTP System, the figure was analyzed by PTV(=seroma volume + margin) to obtain a specific volume of the Partial breast radiation therapy. The changes of seroma volume from MR simulation to the first treatment (a week) is 0~5% in 8, 5~10% in 3, 10 to 15% in 2, and 20% or more in 5 people. Two patients(A, B patient) among subjects showed the biggest change. The A patient's 100% of the prescribed dose volume is 213.08 cc, PTV is 181.93 cc, seroma volume is 15.3 cc in initial plan. However, while seroma volume decreased 65.36% to 5.3 cc, 100% of the prescribed dose volume was reduced to 3.4% to 102.43 cc and PTV also did 43.6% to 102.54 cc. In the case of the B patient, seroma volume decreased 42.57% from 20.2 cc to 11.6 cc. Because of that, 100% of the prescribed dose volume decreased 8.1% and PTV also did to 40%. As the period between the first therapy and surgery is shorter, the patient is elder and the size of sample is smaller than 100 cc, the change grow bigger. It is desirable to establish an adaptive plan according to each patient's changes of seroma volume through continuous observation. Because partial breast patients is more sensitive than WBRT patients about dose conformity in accordance with the volume change.

  17. A New Risk Factor Profile for Contrast-Induced Acute Kidney Injury in Patients Who Underwent an Emergency Percutaneous Coronary Intervention.

    Science.gov (United States)

    Yuan, Ying; Qiu, Hong; Song, Lei; Hu, Xiaoying; Luo, Tong; Zhao, Xueyan; Zhang, Jun; Wu, Yuan; Qiao, Shubin; Yang, Yuejin; Gao, Runlin

    2018-07-01

    We developed a new risk factor profile for contrast-induced acute kidney injury (CI-AKI) under a new definition in patients who underwent an emergency percutaneous coronary intervention (PCI). Consecutive patients (n = 1061) who underwent an emergency PCI were divided into a derivation group (n = 761) and a validation group (n = 300). The rates of CI-AKI were 23.5% (definition 1: serum creatinine [SCr] increase ≥25% in 72 hours), 4.3% (definition 2: SCr increase ≥44.2 μmol/L in 72 hours), and 7.0% (definition 3: SCr increase ≥44.2 μmol/L in 7 days). Due to the high sensitivity of definition 1 and the high rate of missed cases for late diagnosis of CI-AKI under definition 2, definition 3 was used in the study. The risk factor profile included body surface area 15.00 × 10 9 /L ( P = .047), estimated glomerular filtration rate 133 μmol/L ( P = .007), intra-aortic balloon pump application ( P = .006), and diuretics administration ( P risk factor profile of CI-AKI under a new CI-AKI definition in emergency PCI patients is easily applicable with a useful predictive value.

  18. Large-volume reduction mammaplasty: the effect of body mass index on postoperative complications.

    Science.gov (United States)

    Gamboa-Bobadilla, G Mabel; Killingsworth, Christopher

    2007-03-01

    Eighty-six women underwent modified inferior pedicled reduction mammaplasty. All were grouped according to body mass index (BMI): 14 in the overweight group, 51 in the obese group, and 21 in the morbidly obese group. The mean ages were 34, 35, and 36, respectively, for the 3 groups and were not statistically different. The mean resection weight in the overweight group was 929 g, 1316 g for the obese group, and 1760 g for the morbidly obese group. Wound healing complications increased with BMI; the overweight, obese, and morbidly obese groups had 21%, 43%, and 71% of complications, respectively. The results were not statistically different. The rate of repeat operations increased proportionally with the BMI to 7%, 8%, and 19%, respectively. Postoperative BMI was measured in 30 patients. Fifty percent of this group had limited preoperative activity secondary to breast enlargement. The mean postoperative follow-up period was 43 months. Forty-seven percent of this group continued to have limited activity after breast reduction with a mean BMI of 37.8 kg/m2. The mean BMI of all women was 37.41 kg/m2 with a total BMI change of -0.4 kg/m2, suggesting that most women do not lose a significant amount of weight after breast reduction. There was no statistical difference in long-term BMI.

  19. Influence of Reduction Promoters on Stability of Cobalt/g-Alumina Fischer-Tropsch Synthesis Catalysts

    Directory of Open Access Journals (Sweden)

    Gary Jacobs

    2014-03-01

    Full Text Available This focused review article underscores how metal reduction promoters can impact deactivation phenomena associated with cobalt Fischer-Tropsch synthesis catalysts. Promoters can exacerbate sintering if the additional cobalt metal clusters, formed as a result of the promoting effect, are in close proximity at the nanoscale to other cobalt particles on the surface. Recent efforts have shown that when promoters are used to facilitate the reduction of small crystallites with the aim of increasing surface Co0 site densities (e.g., in research catalysts, ultra-small crystallites (e.g., <2–4.4 nm formed are more susceptible to oxidation at high conversion relative to larger ones. The choice of promoter is important, as certain metals (e.g., Au that promote cobalt oxide reduction can separate from cobalt during oxidation-reduction (regeneration cycles. Finally, some elements have been identified to promote reduction but either poison the surface of Co0 (e.g., Cu, or produce excessive light gas selectivity (e.g., Cu and Pd, or Au at high loading. Computational studies indicate that certain promoters may inhibit polymeric C formation by hindering C-C coupling.

  20. Potencial fitotóxico de Dicranopteris flexuosa (Schrad. Underw. (Gleicheniaceae Phytotoxic potential of Dicranopteris flexuosa (Schrad. Underw. (Gleicheniaceae

    Directory of Open Access Journals (Sweden)

    Valerí Schmidt da Silva

    2011-03-01

    laboratory, four concentrations (0, 250, 500, 1000 mg.L-1 were applied to four replicates of 50 seeds each. Analysis of the results indicates a reduction in speed and/or inhibition of germination, stimulation of root growth in eudicots and root inhibition in the monocots studied. For the bioassays carried out in the greenhouse, the plant materials were applied at the same concentrations as those in the laboratory bioassays, with eight replicates of five seeds each. Analysis of the results indicates that root length was affected by the crude ethanol extract resulting in stimulation in tomato and inhibition in onion and wheat. Aerial dry mass was higher at the lower concentration in lettuce and wheat. The ethyl acetate fraction presented higher content of total phenols and flavonoids. Although the results are preliminary, they indicate that ethanol extract and semipurified fractions of D. flexuosa contain substances that modify seedling growth of lettuce, tomato, onion and wheat.

  1. [A survey of perioperative asthmatic attack among patients with bronchial asthma underwent general anesthesia].

    Science.gov (United States)

    Ie, Kenya; Yoshizawa, Atsuto; Hirano, Satoru; Izumi, Sinyuu; Hojo, Masaaki; Sugiyama, Haruhito; Kobayasi, Nobuyuki; Kudou, Kouichirou; Maehara, Yasuhiro; Kawachi, Masaharu; Miyakoshi, Kouichi

    2010-07-01

    We investigated the risk factor of perioperative asthmatic attack and effectiveness of preventing treatment for asthmatic attack before operation. We performed retrospective chart review of one hundred eleven patients with asthma underwent general anesthesia and surgical intervention from January 2006 to October 2007 in our hospital. The rate of perioperative asthmatic attack were as follows; 10.2% (5 in 49 cases) in no pretreatment group, 7.5% (3 in 40 cases) in any pretreatments except for systemic steroid, and 4.5% (1 in 22 cases) in systemic steroid pretreatment group. Neither preoperative asthma severity nor duration from the last attack had significant relevancy to perioperative attack rate. The otolaryngological surgery, especially those have nasal polyp and oral surgery had high perioperative asthma attack rate, although there was no significant difference. We recommend the systemic steroid pretreatment for asthmatic patients, especially when they have known risk factor such as administration of the systemic steroid within 6 months, or possibly new risk factor such as nasal polyp, otolaryngological and oral surgery.

  2. Integrating Entropy and Closed Frequent Pattern Mining for Social Network Modelling and Analysis

    Science.gov (United States)

    Adnan, Muhaimenul; Alhajj, Reda; Rokne, Jon

    The recent increase in the explicitly available social networks has attracted the attention of the research community to investigate how it would be possible to benefit from such a powerful model in producing effective solutions for problems in other domains where the social network is implicit; we argue that social networks do exist around us but the key issue is how to realize and analyze them. This chapter presents a novel approach for constructing a social network model by an integrated framework that first preparing the data to be analyzed and then applies entropy and frequent closed patterns mining for network construction. For a given problem, we first prepare the data by identifying items and transactions, which arc the basic ingredients for frequent closed patterns mining. Items arc main objects in the problem and a transaction is a set of items that could exist together at one time (e.g., items purchased in one visit to the supermarket). Transactions could be analyzed to discover frequent closed patterns using any of the well-known techniques. Frequent closed patterns have the advantage that they successfully grab the inherent information content of the dataset and is applicable to a broader set of domains. Entropies of the frequent closed patterns arc used to keep the dimensionality of the feature vectors to a reasonable size; it is a kind of feature reduction process. Finally, we analyze the dynamic behavior of the constructed social network. Experiments were conducted on a synthetic dataset and on the Enron corpus email dataset. The results presented in the chapter show that social networks extracted from a feature set as frequent closed patterns successfully carry the community structure information. Moreover, for the Enron email dataset, we present an analysis to dynamically indicate the deviations from each user's individual and community profile. These indications of deviations can be very useful to identify unusual events.

  3. Close Approach Prediction Analysis of the Earth Science Constellation with the Fengyun-1C Debris

    Science.gov (United States)

    Duncan, Matthew; Rand, David K.

    2008-01-01

    Routine satellite operations for the Earth Science Constellation (ESC) include collision risk assessment between members of the constellation and other orbiting space objects. Each day, close approach predictions are generated by a U.S. Department of Defense Joint Space Operations Center Orbital Safety Analyst using the high accuracy Space Object Catalog maintained by the Air Force's 1" Space Control Squadron. Prediction results and other ancillary data such as state vector information are sent to NASAJGoddard Space Flight Center's (GSFC's) Collision Risk Assessment analysis team for review. Collision analysis is performed and the GSFC team works with the ESC member missions to develop risk reduction strategies as necessary. This paper presents various close approach statistics for the ESC. The ESC missions have been affected by debris from the recent anti-satellite test which destroyed the Chinese Fengyun- 1 C satellite. The paper also presents the percentage of close approach events induced by the Fengyun-1C debris, and presents analysis results which predict the future effects on the ESC caused by this event. Specifically, the Fengyun-1C debris is propagated for twenty years using high-performance computing technology and close approach predictions are generated for the ESC. The percent increase in the total number of conjunction events is considered to be an estimate of the collision risk due to the Fengyun-1C break- UP.

  4. Photochemical modelling of photo-oxidant levels over the Swiss plateau and emission reduction scenarios

    International Nuclear Information System (INIS)

    Rosselet, C.M.; Kerr, J.A.

    1993-05-01

    During summertime high pressure conditions, high photo-oxidant (O 3 , H 2 O 2 , PAN and others) levels are frequently observed in the planetary boundary layer in central Europe. It is well known that close to the earth's surface ozone is formed by complex reactions involving VOC, NO x , and sunlight. Substantial reductions of both precursors are needed to reduce photo-oxidant levels. In this context the reductions of the abundance of the precursors and the variation of their ratios is of great importance. Here we report model calculations from the Harwell Photochemical Trajectory Model of the levels of O 3 , H 2 O 2 and PAN along a trajectory over the Swiss Plateau from Lake Constance to Lake Geneva. These calculations are in satisfactory agreement with measurements made during the intensive observation period of the research program POLLUMET (Pollution and Meteorology in Switzerland). Sensitivity calculations of emission reduction scenarios indicate that on the Swiss Plateau the ozone production may be mainly NO x -limited; under conditions where the CO levels are closer to the upper limit within the range (120-600 ppbv). The calculated peak ozone level reduction caused by an exclusive NO x -emission reduction is about three times larger than that caused by an exclusive VOC reduction. The combined reduction of all precursor compounds is the most efficient strategy, although it is only marginally more efficient than the NO x -reduction scenario alone. (author) figs., tabs., 75 refs

  5. A Study on the Electrolytic Reduction Mechanism of Uranium Oxide in a LiCl-Li2O Molten Salt

    International Nuclear Information System (INIS)

    Oh, Seung Chul; Hur, Jin Mok; Seo, Chung Seok; Park, Seong Won

    2003-01-01

    This study proposed a new electrolytic reduction technology that is based on the integration of simultaneous uranium oxide metallization and Li 2 O electrowinning. In this electrolytic reduction reaction, electrolytically reduced Li deposits on cathode and simultaneously reacts with uranium oxides to produce uranium metal showing more than 99% conversion. For the verification of process feasibility, the experiments to obtain basic data on the metallization of uranium oxide, investigation of reaction mechanism, the characteristics of closed recycle of Li 2 O and mass transfer were carried out. This evolutionary electrolytic reduction technology would give benefits over the conventional Li-reduction process improving economic viability such as: avoidance of handling of chemically active Li-LiCl molten salt increase of metallization yield, and simplification of process.

  6. The role of social closeness during tape stripping to facilitate skin barrier recovery: Preliminary findings.

    Science.gov (United States)

    Robinson, Hayley; Ravikulan, Abhimati; Nater, Urs M; Skoluda, Nadine; Jarrett, Paul; Broadbent, Elizabeth

    2017-07-01

    Social support is known to reduce the negative effects of stress on health, but there is mixed evidence for the effects of social support on wound healing. This study aimed to investigate whether undergoing a task designed to promote social closeness with a fellow participant and being paired with that person during a tape-stripping procedure could reduce stress and improve skin barrier recovery compared to going through tape stripping alone. Seventy-two healthy adults were randomized to either a social closeness condition where participants completed a relationship-building task and tape stripping in pairs or a control condition where they completed tape stripping alone. Skin barrier recovery was measured using transepidermal water loss. Salivary cortisol and alpha-amylase were collected at four time points as markers of the endocrine and autonomic stress response. Social closeness had a beneficial effect on skin barrier recovery compared to the control condition, t(54) = 2.86, p = .006, r = .36. Social closeness significantly reduced self-reported stress. The effects of the intervention on skin barrier recovery were moderated by self-reported stress reduction (p = .035). There were no significant differences in cortisol between groups, but alpha-amylase increased significantly more from baseline to after tape stripping in the control group compared to the intervention group. This is the first study to show that social closeness with a person going through a similar unfamiliar procedure can positively influence wound healing. Future research needs to replicate these findings in other wound types and in clinical settings. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  7. Do instability markers predict satisfactory reduction and requirement for later surgery in emergency department patients with wrist fracture?

    Science.gov (United States)

    Winayak, Amar; Gossat, Alyza; Cooper, Jenny; Ritchie, Peter; Lim, Wei; Klim, Sharon; Kelly, Anne-Maree

    2018-02-01

    Research suggests that the presence of instability markers in patients with displaced distal radial fractures is associated with poorer outcome. Our aims were to determine whether the presence of previously defined instability markers could predict the likelihood of successful ED reduction and requirement for a secondary procedure after ED reduction. Retrospective cohort study performed by medical record review. Adult ED patients coded as having an isolated wrist fracture and having fracture reduction in ED were eligible for inclusion. Data collected included demographics, history of osteoporosis, mechanism of injury, radiological features on X-rays and performance of a secondary procedure. Outcomes of interest were the rate of successful fracture reduction in ED (against defined radiological criteria), the rate of secondary procedures and the association between the number of defined instability risk factors and successful reduction and performance of a secondary surgical procedure. Analysis was by χ 2 test, receiver operating characteristic curve, logistic regression analyses. Three hundred and nineteen patients were studied; median age 62 years, 77% female. Sixty-five per cent of patients had satisfactory fracture reduction in ED (95% CI 59%-70%). Eighty-six patients underwent a secondary procedure to reduce/stabilise their fracture (28%, 95% CI 23%-33%). Younger age, lack of satisfactory ED reduction and increased number of instability factors were independently predictive of the performance of a secondary procedure. Instability risk factors are common in patients with wrist fractures requiring reduction in ED. The number of instability factors is not a strong predictor of the performance of secondary procedures. © 2017 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

  8. Anterior screw fixation of a dislocated type II odontoid fracture facilitated by transoral and posterior cervical manual reduction.

    Science.gov (United States)

    Piedra, Mark P; Hunt, Matthew A; Nemecek, Andrew N

    2009-10-01

    Early fixation of type II odontoid fractures has been shown to provide high rates of long-term stabilization and osteosynthesis. In this report, the authors present the case of a patient with a locked type II odontoid fracture treated by anterior screw fixation facilitated by closed transoral and posterior cervical manual reduction. While transoral intraoperative reduction of a partially displaced odontoid fracture has previously been described, the authors present the first case utilizing this technique in the treatment of a completely dislocated type II odontoid fracture.

  9. One-electron reduction of 2- and 6-methyl-1,4-naphthoquinone bioreductive alkylating agents

    International Nuclear Information System (INIS)

    Wilson, I.; Wardman, P.; Lin, T.S.; Sartorelli, A.C.

    1986-01-01

    The semiquinones, Q.-, of derivatives of 2- and 6-methyl-1,4-naphthoquinones, some incorporating leaving groups with substituents such as CH 2 Br or CH 2 OCONHCH 3 , have been produced by radiolytic reduction of Q by (CH 3 )2COH radicals. The absorption spectra and decay kinetics of Q.- were all closely similar to that produced from 2-methyl-1,4-naphthoquinone, with no evidence for unimolecular elimination of a leaving group in the semiquinone form, but immediate loss of leaving group upon two-electron reduction of Q to the hydroquinone. The redox equilibria between Q/Q.- and O2/O2.- were characterized, and reduction potentials of the couples Q/Q.- in water at pH 7.6 were calculated. The implications of these observations for the use of these compounds as bioreductive alkylating agents or as radiosensitizers with potential selective activity toward hypoxic cells are discussed

  10. Reduction in albuminuria translates to reduction in cardiovascular events in hypertensive patients with left ventricular hypertrophy and diabetes

    DEFF Research Database (Denmark)

    Ibsen, H.; Olsen, M.H.; Wachtell, K.

    2008-01-01

    In type 2 diabetes the degree of albuminuria is strongly related to progression of diabetic renal disease, as well as to the risk for cardiovascular complications. If normoalbuminuria is maintained, the risk of diabetic nephropathy is very low. In individuals with microalbuminuria, the rate......, strongly predicted risk for cardiovascular complications. This indicates that when albuminuria is used as a risk predictor for cardiovascular events, so called normal values should be redefined. Traditional values for normo-micro-macroalbuminuria are primarily defined as predictors for the risk...... baseline values of albuminuria had the greatest benefit in terms of reduction in cardiovascular morbidity and mortality on losartan as compared with atenolol. The level of albuminuria during treatment was closely related to the risk for cardiovascular events. We conclude that tiny amounts of albuminuria...

  11. Clinical Outcomes of patients with coronary artery disease who underwent FFR evaluation of intermediate coronary lesionS– COFFRS study

    Directory of Open Access Journals (Sweden)

    Srinivasa Prasad

    2017-07-01

    Conclusion: In our experience, MACE events were not higher in patients with FFR > 0.8 and kept under medical therapy and were similarly lower in patients with FFR ≤0.8 and underwent revascularisation (p = 0.73. Also MACE events were higher in patients with FFR ≤ 0.8 and did not undergo revascularisation compared to other two appropriately treated groups (p = 0.03. FFR based revascularization decision appears to be a safe strategy in Indian patients.

  12. A kinetic study of biological Cr(VI) reduction in trickling filters with different filter media types

    International Nuclear Information System (INIS)

    Dermou, E.; Vayenas, D.V.

    2007-01-01

    Two pilot-scale trickling filters were used in order to estimate Cr(VI) reduction through biological mechanisms in biofilm reactors operated in SBR mode with recirculation using different filter media types, i.e. plastic media and calcitic gravel. The feed concentrations of Cr(VI) examined were about 5, 10, 20, 30, 50 and 100 mg/l, while the concentration of the organic carbon was constant at 400 mg/l, in order to avoid carbon limitations in the bulk liquid. Maximum reduction rates of 4.8 and 4.7 g Cr(VI)/d were observed for feed Cr(VI) concentration of about 5 mg Cr(VI)/l, for the filters with the plastic support material and the gravel media, respectively. The reduction rates were significantly affected by the feed Cr(VI) concentration in both bioreactors. A dual-enzyme kinetic model was used in order to describe Cr(VI) reduction by aerobically grown mixed cultures. Model predictions were found to correspond very closely to experimental quantitative observations of Cr(VI) reduction at both pilot-scale trickling filters used

  13. ON NANO Λg-CLOSED SETS

    OpenAIRE

    Rajasekaran, Ilangovan; Nethaji, Ochanan

    2017-01-01

    Abstaract−In this paper, we introduce nano ∧g-closed sets in nano topological spaces. Some properties of nano ∧g-closed sets and nano ∧g-open sets are weaker forms of nano closed sets and nano open sets

  14. Ipsilateral Closed Clavicle and Scapular spine Fracture with Acromioclavicular Joint Disruption.

    Science.gov (United States)

    Kembhavi, Raghavendra S; James, Boblee

    2015-01-01

    Injuries around shoulder and clavicle are quite common. Injuries involving lateral end of clavicle involving acromioclavicular joints are commoner injuries. In this rare injury, we report about a case involving clavicle and scapular spine fracture with acromioclavicular disruption which has never been described in English literature as per our knowledge. A patient with closed clavicle and scapular spine fracture with acromioclavicular joint disruption was treated with open reduction and internal fixation of clavicle and scapular spine as a staged procedures. Six months post operatively, patient had excellent functional recovery with near full range of movements. Though rare complex injury, clavicle fracture with scapular spine fracture with acromioclavicular disruption, when managed properly with good physiotherapy protocol post operatively will result in good clinical and functional outcome.

  15. Long-term psychological distress, and styles of coping, in parents of children and adolescents who underwent invasive treatment for congenital cardiac disease

    NARCIS (Netherlands)

    Spijkerboer, Alinda W.; Helbing, Willem A.; Bogers, Ad J. J. C.; van Domburg, Ron T.; Verhulst, Frank C.; Utens, Elisabeth M. W. J.

    2007-01-01

    To assess the level of psychological distress and styles of coping in both mothers and fathers of children who underwent invasive treatment for congenital cardiac disease at least 7 years and 6 months ago. The General Health Questionnaire and the Utrecht Coping List were completed by parents of

  16. Harm Reduction as “Continuum Care” in Alcohol Abuse Disorder

    Directory of Open Access Journals (Sweden)

    Icro Maremmani

    2015-11-01

    Full Text Available Alcohol abuse is one of the most important risk factors for health and is a major cause of death and morbidity. Despite this, only about one-tenth of individuals with alcohol abuse disorders receive therapeutic intervention and specific rehabilitation. Among the various dichotomies that limit an effective approach to the problem of alcohol use disorder treatment, one of the most prominent is integrated treatment versus harm reduction. For years, these two divergent strategies have been considered to be opposite poles of different philosophies of intervention. One is bound to the search for methods that aim to lead the subject to complete abstinence; the other prioritizes a progressive decline in substance use, with maximum reduction in the damage that is correlated with curtailing that use. Reduction of alcohol intake does not require any particular setting, but does require close collaboration between the general practitioner, specialized services for addiction, alcohology services and psychiatry. In patients who reach that target, significant savings in terms of health and social costs can be achieved. Harm reduction is a desirable target, even from an economic point of view. At the present state of neuroscientific knowledge, it is possible to go one step further in the logic that led to the integration of psychosocial and pharmacological approaches, by attempting to remove the shadows of social judgment that, at present, are aiming for a course of treatment that is directed towards absolute abstention.

  17. Thermodynamic analysis of the reduction process of Colombian lateritic nickel ore

    International Nuclear Information System (INIS)

    Diaz, S. C.; Garces, A.; Restrepo, O. J.; Lara, M. A.; Camporredondo, J. E.

    2015-01-01

    The Colombian nickeliferous laterites are minerals used for the nickel extraction by hydrometallurgical and pyrometallurgical processes. In this work the thermodynamic behaviour of three Colombian lateritic mineral samples are described, with contents of 1.42%, 1.78% y 2.04% of nickel, when they are subjected to the calcination and reduction processes. The mineral was characterized using X Rays Diffraction and X Rays Fluorescence, giving evidence of the presence of mineralogical species such as nepouite (Ni 3 Si 2 O 5 (OH) 4 ), goethite (Fe 2 O 3 .H 2 O), silica (SiO 2 ), antigorite (Mg 3 Si 2 O 5 (OH) 4 ) and fosferite (Mg 2 SiO 4 ). The thermodynamic analysis was conducted using the software HSC Chemistry for Windows 5.1 and was focused in the quantitative determination of the chemical evolution of the mixture of these minerals with variable quantities of coal, in function of temperature. The results produced by the program showed, in the equilibrium, the feasibility of complete reduction of the nickel, and additionally, a considerable high percentage of reduction of iron oxides (up to 99%) using ratio C/O .1 at temperatures close to 1100 degree centigrade. (Author)

  18. Infinitary Combinatory Reduction Systems: Normalising Reduction Strategies

    NARCIS (Netherlands)

    Ketema, J.; Simonsen, Jakob Grue

    2010-01-01

    We study normalising reduction strategies for infinitary Combinatory Reduction Systems (iCRSs). We prove that all fair, outermost-fair, and needed-fair strategies are normalising for orthogonal, fully-extended iCRSs. These facts properly generalise a number of results on normalising strategies in

  19. Comparative Effectiveness of Emergency Resuscitative Thoracotomy versus Closed Chest Compressions among Patients with Critical Blunt Trauma: A Nationwide Cohort Study in Japan.

    Science.gov (United States)

    Suzuki, Kodai; Inoue, Shigeaki; Morita, Seiji; Watanabe, Nobuo; Shintani, Ayumi; Inokuchi, Sadaki; Ogura, Shinji

    2016-01-01

    Although emergency resuscitative thoracotomy is performed as a salvage maneuver for critical blunt trauma patients, evidence supporting superior effectiveness of emergency resuscitative thoracotomy compared to conventional closed-chest compressions remains insufficient. The objective of this study was to investigate whether emergency resuscitative thoracotomy at the emergency department or in the operating room was associated with favourable outcomes after blunt trauma and to compare its effectiveness with that of closed-chest compressions. This was a retrospective nationwide cohort study. Data were obtained from the Japan Trauma Data Bank for the period between 2004 and 2012. The primary and secondary outcomes were patient survival rates 24 h and 28 d after emergency department arrival. Statistical analyses were performed using multivariable generalized mixed-effects regression analysis. We adjusted for the effects of different hospitals by introducing random intercepts in regression analysis to account for the differential quality of emergency resuscitative thoracotomy at hospitals where patients in cardiac arrest were treated. Sensitivity analyses were performed using propensity score matching. In total, 1,377 consecutive, critical blunt trauma patients who received cardiopulmonary resuscitation in the emergency department or operating room were included in the study. Of these patients, 484 (35.1%) underwent emergency resuscitative thoracotomy and 893 (64.9%) received closed-chest compressions. Compared to closed-chest compressions, emergency resuscitative thoracotomy was associated with lower survival rate 24 h after emergency department arrival (4.5% vs. 17.5%, respectively, P chest compressions (P chest compressions.

  20. Treatment of chronic anterior shoulder dislocation by open reduction and simultaneous Bankart lesion repair

    Directory of Open Access Journals (Sweden)

    Rouhani Alireza

    2010-06-01

    Full Text Available Abstract Background Untreated chronic shoulder dislocation eventually leads to functional disability and pain. Open reduction with different fixation methods have been introduced for most chronic shoulder dislocation. We hypothesized that open reduction and simultaneous Bankart lesion repair in chronic anterior shoulder dislocation obviates the need for joint fixation and leads to better results than previously reported methods. Methods Eight patients with chronic anterior dislocation of shoulder underwent open reduction and capsulolabral complex repair after an average delay of 10 weeks from injury. Early motion was allowed the day after surgery in the safe position and the clinical and radiographic results were analyzed at an average follow-up of one year. Results The average Rowe and Zarin's score was 86 points. Four out of eight shoulders were graded as excellent, three as good and one as fair (Rowe and Zarins system. All patients were able to perform their daily activities and they had either mild or no pain. Anterior active forward flexion loss averaged 18 degrees, external active rotation loss averaged 17.5 degrees and internal active rotation loss averaged 3 vertebral body levels. Mild degenerative joint changes were noted in one patient. Conclusion The results show that the overall prognosis for this method of operation is more favorable than the previously reported methods and we recommend concomitant open reduction and capsulolabral complex repair for the treatment of old anterior shoulder dislocation. Level of Evidence Therapeutic study, Level IV (case series [no, or historical, control group

  1. Oriented open-closed string theory revisited

    International Nuclear Information System (INIS)

    Zwiebach, B.

    1998-01-01

    String theory on D-brane backgrounds is open-closed string theory. Given the relevance of this fact, we give details and elaborate upon our earlier construction of oriented open-closed string field theory. In order to incorporate explicitly closed strings, the classical sector of this theory is open strings with a homotopy associative A ∞ algebraic structure. We build a suitable Batalin-Vilkovisky algebra on moduli spaces of bordered Ricmann surfaces, the construction of which involves a few subtleties arising from the open string punctures and cyclicity conditions. All vertices coupling open and closed strings through disks are described explicitly. Subalgebras of the algebra of surfaces with boundaries are used to discuss symmetries of classical open string theory induced by the closed string sector, and to write classical open string field theory on general closed string backgrounds. We give a preliminary analysis of the ghost-dilaton theorem. copyright 1998 Academic Press, Inc

  2. High pressure does not counterbalance the advantages of open techniques over closed techniques during heated intraperitoneal chemotherapy with oxaliplatin.

    Science.gov (United States)

    Facy, Olivier; Combier, Christophe; Poussier, Matthieu; Magnin, Guy; Ladoire, Sylvain; Ghiringhelli, François; Chauffert, B; Rat, Patrick; Ortega-Deballon, Pablo

    2015-01-01

    Heated intraperitoneal chemotherapy (HIPEC) treats residual microscopic disease after cytoreductive surgery. In experimental models, the open HIPEC technique has shown a higher and more homogenous concentration of platinum in the peritoneum than achieved using the closed technique. A 25-cm H2O pressure enhances the penetration of oxaliplatin. Because pressure is easier to set up with the closed technique, high pressure may counterbalance the drawbacks of this technique versus open HIPEC, and a higher pressure may induce a higher penetration. Because higher concentration does not mean deeper penetration, a study of tissues beneath the peritoneum is required. Finally, achieving a deeper penetration (and a higher concentration) raises the question of the passage of drugs through the surgical glove and the surgeon's safety. Four groups of pigs underwent HIPEC with oxaliplatin (150 mg/L) for 30 minutes in open isobaric pressure and pressure at 25 cm H2O, and closed pressure at 25 and 40 cm H2O. Systemic absorption and peritoneal mapping of the concentration of platinum were analyzed, as well as in the retroperitoneal tissue and the surgical gloves. Blood concentrations were higher in open groups. In the parietal surfaces, the concentrations were not different between the isobaric and the closed groups (47.08, 56.39, and 48.57 mg/kg, respectively), but were higher in the open high-pressure group (85.93 mg/kg). In the visceral surfaces, they were lower in the closed groups (3.2 and 3.05 mg/kg) than in the open groups (7.03 and 9.56 mg/kg). Platinum concentrations were similar in the deep retroperitoneal tissue when compared between isobaric and high-pressure procedures. No platin was detected in the internal aspect of the gloves. The use of high pressure during HIPEC does not counterbalance the drawbacks of closed techniques. The tissue concentration of oxaliplatin achieved with the open techniques is higher, even if high pressure is applied during a closed technique

  3. Long-Duration Testing of a Temperature-Swing Adsorption Compressor for Carbon Dioxide for Closed-Loop Air Revitalization Systems

    Science.gov (United States)

    Rosen, Micha; Mulloth, Lila; Varghese, Mini

    2005-01-01

    This paper describes the results of long-duration testing of a temperature-swing adsorption compressor that has application in the International Space Station (ISS) and future spacecraft for closing the air revitalization loop. The air revitalization system of the ISS operates in an open loop mode and relies on the resupply of oxygen and other consumables from Earth for the life support of astronauts. A compressor is required for delivering the carbon dioxide from a removal assembly to a reduction unit to recover oxygen and thereby closing the air-loop. The TSAC is a solid-state compressor that has the capability to remove CO2 from a low-pressure source, and subsequently store, compress, and deliver at a higher pressure as required by a processor. The TSAC is an ideal interface device for CO2 removal and reduction units in the air revitalization loop of a spacecraft for oxygen recovery. The TSAC was developed and its operation was successfully verified in integration tests with the flight-like Carbon Dioxide Removal Assembly (CDRA) at Marshall Space Flight Center prior to the long-duration tests. Long-duration tests reveal the impacts of repeated thermal cycling on the compressor components and the adsorbent material.

  4. Closed recirculation-Water treatment

    International Nuclear Information System (INIS)

    Hamza, Hamza B.; Ben Ali, Salah; Saad, Mohamed A.; Traish, Massud R.

    2005-01-01

    This water treatment is a practical work applied in the center, for a closed recirculation-water system. The system had experienced a serious corrosion problem, due to the use of inadequate water. This work includes chemical preparation for the system. Water treatment, special additives, and follow-up, which resulted in the stability of the case. This work can be applied specially for closed recirculation warm, normal, and chilled water. (author)

  5. [effectiveness of open reduction and internal fixation without opening joint capsule on tibial plateau fracture].

    Science.gov (United States)

    Chen, Qi; Xu, Xiaofeng; Huang, Yonghui; Cao, Xingbing; Meng, Chen; Cao, Xueshu; Wei, Changbao

    2014-12-01

    To introduce the surgery method to reset and fix tibial plateau fracture without opening joint capsule, and evaluate the safety and effectiveness of this method. Between July 2011 and July 2013, 51 patients with tibial plateau fracture accorded with the inclusion criteria were included. All of 51 patients, 17 cases underwent open reduction and internal fixation without opening joint capsule in trial group, and 34 cases underwent traditional surgery method in control group. There was no significant difference in gender, age, cause of injury, time from injury to admission, side of injury, and types of fracture between 2 groups (P > 0.05). The operation time, intraoperative blood loss, incision length, incision healing, and fracture healing were compared between 2 groups. The tibial-femoral angle and collapse of joint surface were measured on X-ray film. At last follow-up, joint function was evaluated with Hospital for Special Surgery (HSS) knee function scale. The intraoperative blood loss in trial group was significantly less than that in control group (P time and the rate of incision healing between 2 groups (P > 0.05). The patients were followed up 12-30 months (mean, 20.4 months) in trial group and 12-31 months (mean, 18.2 months) in control group. X-ray films indicated that all cases in 2 groups obtained fracture healing; there was no significant difference in the fracture healing time between 2 groups (t=1.382, P=0.173). On X-ray films, difference was not significant in tibial-femoral angle and collapse of joint surface between 2 groups (P > 0.05). HSS score of the knee in trial group was significantly higher than that of control group (t=3.161, P=0.003). It can reduce the intraoperative blood loss and shorten the incision length to use open reduction and internal fixation without opening joint capsule for tibial plateau fracture. Traction of joint capsule is helpful in the reduction and good recovery of joint surface collapse. In addition, the surgery without

  6. High current vacuum closing switch

    International Nuclear Information System (INIS)

    Dolgachev, G.I.; Maslennikov, D.D.; Romanov, A.S.; Ushakov, A.G.

    2005-01-01

    The paper proposes a powerful pulsed closing vacuum switch for high current commutation consisting of series of the vacuum diodes with near 1 mm gaps having closing time determined by the gaps shortening with the near-electrode plasmas [ru

  7. Use of the BREAST-Q™ Survey in the Prospective Evaluation of Reduction Mammaplasty Outcomes.

    Science.gov (United States)

    Cabral, Isaias Vieira; da Silva Garcia, Edgard; Sobrinho, Rebecca Neponucena; Pinto, Natália Lana Larcher; Juliano, Yara; Veiga-Filho, Joel; Ferreira, Lydia Masako; Veiga, Daniela Francescato

    2018-04-01

    BREAST-Q™ is a patient-reported outcomes survey instrument with a specific module that evaluates breast reduction surgery. It allows assessment of patient's satisfaction with received treatment and evaluates the impact of surgery on different aspects of the patient's quality of life. This article aims to assess the satisfaction and quality of life of patients who underwent reduction mammaplasty. Women aged between 18 and 60 years, with a body mass index ranging from 19 to 30 kg/m 2 , who were already scheduled for reduction mammaplasty, were included in the study. The Brazilian version of the BREAST-Q™ Reduction/Mastopexy Module (preoperative 1.0 and postoperative 1.0 versions) was self-applied preoperatively and 1 and 6 months after the operation. One hundred and seven patients were included in the study and completed the 6-month follow-up. The median age was 33 years, and the median preoperative body mass index was 25 kg/m 2 . The superomedial pedicle was used in 96.3% of the cases, and the total median weight of the resected breast was 1115 g. There was a significant improvement in the scores of the scales: Psychosocial well-being, Sexual well-being, Physical well-being, and Satisfaction with the breasts compared to the preoperative assessment (p < 0.0001). The scales Satisfaction with the NAC and Satisfaction with the outcome, available only in the postoperative version, demonstrated high satisfaction rates at the two postoperative periods evaluated. Reduction mammaplasty improved the quality of life and provided high levels of patient satisfaction with outcomes 1 and 6 months postoperatively. 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 www.springer.com/00266 .

  8. A virtual closed loop method for closed loop identification

    NARCIS (Netherlands)

    Agüero, J.C.; Goodwin, G.C.; Hof, Van den P.M.J.

    2011-01-01

    Indirect methods for the identification of linear plant models on the basis of closed loop data are based on the use of (reconstructed) input signals that are uncorrelated with the noise. This generally requires exact (linear) controller knowledge. On the other hand, direct identification requires

  9. [Evaluation of the antithrombotic strategy in low thrombotic risk patients who underwent aortic valve replacement with a bioprosthesis].

    Science.gov (United States)

    Aceves-Velázquez, Eduardo; Vieyra-Herrera, Gerardo; Rodríguez-Chávez, Laura; Herrera-Alarcón, Valentín

    2017-07-16

    According to current guidelines, in patients without additional risk factors who have undergone aortic valve replacement with a bioprosthesis, anticoagulation in the first 3 months after surgery is still a matter of debate. According to current evidence, aspirin in low doses is a reasonable alternative to vitamin K antagonists (VKA). A comparison is made between the incidence of thrombotic and haemorrhagic complications in patients with low thrombotic risk who underwent aortic valve replacement with a bioprosthesis in the National Institute of Cardiology of Ignacio Chávez of Mexico. The hypothesis: aspirin as monotherapy has a beneficial effect compared to VKA. The studied patients were the low thrombotic risk patients who underwent aortic valve replacement with a bioprosthesis in the National Institute of Cardiology of Ignacio Chávez of Mexico from 2011 to 2015. The groups studied were: aspirin only, VKA only, and the combination of VKA plus aspirin. The patients were retrospectively followed-up for 12 months, and the thrombotic and haemorrhagic complications were documented. Of the 231 patients included in the study, only one patient in the VKA only group presented with a haemorrhagic complication. No thrombotic complications were observed. In the present study no thrombotic complications were observed in patients who did not receive anticoagulation in the first 3 months after an aortic valve replacement with a bioprosthesis after a follow up period of 12 months. This suggests that the use of aspirin only is safe during this period. Copyright © 2017 Instituto Nacional de Cardiología Ignacio Chávez. Publicado por Masson Doyma México S.A. All rights reserved.

  10. 7 CFR 1927.58 - Closing the transaction.

    Science.gov (United States)

    2010-01-01

    ... REGULATIONS TITLE CLEARANCE AND LOAN CLOSING Real Estate Title Clearance and Loan Closing § 1927.58 Closing the transaction. The closing agent will cooperate with the approval official, borrower, seller, and... when a loan is being made to a borrower who already owns the real estate to be mortgaged. This...

  11. On some properties of conjugacy closed loops

    International Nuclear Information System (INIS)

    Adeniran, John Olusola

    2002-07-01

    It is shown that central loops are not conjugacy closed loops but instead are loops of units in their loop algebras that are conjugacy closed. It is also shown that certain inner mappings of a conjugacy closed loop are nuclear. Some invariants of left conjugacy closed loops are obtained. (author)

  12. Reduction redux.

    Science.gov (United States)

    Shapiro, Lawrence

    2018-04-01

    Putnam's criticisms of the identity theory attack a straw man. Fodor's criticisms of reduction attack a straw man. Properly interpreted, Nagel offered a conception of reduction that captures everything a physicalist could want. I update Nagel, introducing the idea of overlap, and show why multiple realization poses no challenge to reduction so construed. Copyright © 2017 Elsevier Ltd. All rights reserved.

  13. Comparison of open and closed techniques of haemorrhoidectomy in terms of post-operative complications

    International Nuclear Information System (INIS)

    Majeed, S.; Qamar, S.R.; Tariq, M.; Ali, M.A.

    2015-01-01

    Haemorrhoids have been diagnosed and treated since the dawn of civilization, yet their cause, nature, symptomatology and especially their treatment options, remain hotly debated. The general principle however is that treatment should be directed by symptoms and the degree of haemorrhoids. The objective of the study is to compare early and late complications and wound healing time in open versus closed methods of haemorrhoidectomy. Methods: This was a Randomized control trial conducted at Department of Surgery CMH Kharian for a period of 3 years. During the period of study, patients presenting in Surgical OPD (Age Range 20-72 Years) with 3rd or 4th degree haemorrhoids requiring haemorrhoidectomy (n=364) were divided in two groups:- Group-1 was subjected to haemorrhoidectomy by open (Milligan-Morgan) technique and Group-2 underwent closed (Ferguson) haemorrhoidectomy. All patients were followed up for 2 months post-operatively and assessed for duration of wound healing and post-operative complications. Results: In group-1 (Open haemorrhoidectomy) patients ages ranged from 21-70 years with a mean age of 43 years (SD1±2.51). Duration of wound healing in this group was on the average 22 days (SD±5.76). Incidence of early post-operative complications including haemorrhage, infection and urinary retention was 4.94%, 8.24% and 7.14% respectively. The only late complication observed was anal stenosis in one patient (0.55%). No fissure or faecal incontinence was observed in this group. In group-2 (subjected to closed haemorrhoidectomy), patients ages ranged from 20-72 years with a mean age of 42 years (SD±10.31). Duration of wound healing was on the average 14 days (SD±3.25). Incidence of early post- operative complications, i.e., haemorrhage, infection and urinary retention was 2.19%, 7.69% and 2.75% respectively. No late complications (stenosis, fissure or incontinence) were observed in this group. Conclusion: There is no statistical significant difference between open

  14. Prognostic significance of nuclear factor of activated T-cells 5 expression in non-small cell lung cancer patients who underwent surgical resection.

    Science.gov (United States)

    Cho, Hyun Jin; Yun, Hwan-Jung; Yang, Hee Chul; Kim, Soo Jin; Kang, Shin Kwang; Che, Chengri; Lee, Sang Do; Kang, Min-Woong

    2018-06-01

    Nuclear factor of activated T-cells 5 (NFAT5) is known to be correlated with migration or invasion of tumor cells based on previous in vitro studies. The aim of this study was to analyze the relationship between NFAT5 expression and clinical prognosis in non-small cell lung cancer (NSCLC) patients who underwent surgical resection. A total of 92 NSCLC patients who underwent surgical resection were enrolled. The tissue microarray core was obtained from surgically resected tumor specimens. NFAT5 expression was evaluated by immunohistochemistry. Relationships of NFAT5 expression with disease recurrence, overall survival, and disease-free survival (DFS) were analyzed. The mean age of 92 patients was 63.7 y. The median follow-up duration was 63.3 mo. Fifty-one (55%) patients exhibited positive expression of NFAT5. Disease recurrence in the NFAT5-positive group was significantly (P = 0.022) higher than that in the NFAT5-negative group. NFAT5-positive expression (odds ratio: 2.632, 95% confidence interval: 1.071-6.465, P = 0.035) and pathologic N stage (N1-2 versus N0; odds ratio: 3.174, 95% confidence interval: 1.241-8.123, P = 0.016) were independent and significant risk factors for disease recurrence. DFS of the NFAT5-positive group was significantly worse than that of the NFAT5-negative group (89.7 versus 48.7 mo, P = 0.011). A multivariate analysis identified NFAT5 expression (P < 0.029) as a significant independent risk factor for DFS of patients with postoperative pathologic T and N stages (P < 0.001 and P = 0.017, respectively). NFAT5 expression is a useful prognostic biomarker for NSCLC patients who underwent surgical resection. Copyright © 2018 Elsevier Inc. All rights reserved.

  15. Long-Haul Truck Sleeper Heating Load Reduction Package for Rest Period Idling

    Energy Technology Data Exchange (ETDEWEB)

    Lustbader, Jason Aaron; Kekelia, Bidzina; Tomerlin, Jeff; Kreutzer, Cory J.; Yeakel, Skip; Adelman, Steven; Luo, Zhiming; Zehme, John

    2016-04-05

    Annual fuel use for sleeper cab truck rest period idling is estimated at 667 million gallons in the United States, or 6.8% of long-haul truck fuel use. Truck idling during a rest period represents zero freight efficiency and is largely done to supply accessory power for climate conditioning of the cab. The National Renewable Energy Laboratory's CoolCab project aims to reduce heating, ventilating, and air conditioning (HVAC) loads and resulting fuel use from rest period idling by working closely with industry to design efficient long-haul truck thermal management systems while maintaining occupant comfort. Enhancing the thermal performance of cab/sleepers will enable smaller, lighter, and more cost-effective idle reduction solutions. In addition, if the fuel savings provide a one- to three-year payback period, fleet owners will be economically motivated to incorporate them. For candidate idle reduction technologies to be implemented by original equipment manufacturers and fleets, their effectiveness must be quantified. To address this need, several promising candidate technologies were evaluated through experimentation and modeling to determine their effectiveness in reducing rest period HVAC loads. Load reduction strategies were grouped into the focus areas of solar envelope, occupant environment, conductive pathways, and efficient equipment. Technologies in each of these focus areas were investigated in collaboration with industry partners. The most promising of these technologies were then combined with the goal of exceeding a 30% reduction in HVAC loads. These technologies included 'ultra-white' paint, advanced insulation, and advanced curtain design. Previous testing showed more than a 35.7% reduction in air conditioning loads. This paper describes the overall heat transfer coefficient testing of this advanced load reduction technology package that showed more than a 43% reduction in heating load. Adding an additional layer of advanced insulation

  16. WFH: closing the global gap--achieving optimal care.

    Science.gov (United States)

    Skinner, Mark W

    2012-07-01

    For 50 years, the World Federation of Hemophilia (WFH) has been working globally to close the gap in care and to achieve Treatment for All patients, men and women, with haemophilia and other inherited bleeding disorders, regardless of where they might live. The WFH estimates that more than one in 1000 men and women has a bleeding disorder equating to 6,900,000 worldwide. To close the gap in care between developed and developing nations a continued focus on the successful strategies deployed heretofore will be required. However, in response to the rapid advances in treatment and emerging therapeutic advances on the horizon it will also require fresh approaches and renewed strategic thinking. It is difficult to predict what each therapeutic advance on the horizon will mean for the future, but there is no doubt that we are in a golden age of research and development, which has the prospect of revolutionizing treatment once again. An improved understanding of "optimal" treatment is fundamental to the continued evolution of global care. The challenges of answering government and payer demands for evidence-based medicine, and cost justification for the introduction and enhancement of treatment, are ever-present and growing. To sustain and improve care it is critical to build the body of outcome data for individual patients, within haemophilia treatment centers (HTCs), nationally, regionally and globally. Emerging therapeutic advances (longer half-life therapies and gene transfer) should not be justified or brought to market based only on the notion that they will be economically more affordable, although that may be the case, but rather more importantly that they will be therapeutically more advantageous. Improvements in treatment adherence, reductions in bleeding frequency (including microhemorrhages), better management of trough levels, and improved health outcomes (including quality of life) should be the foremost considerations. As part of a new WFH strategic plan

  17. Redução fechada e fixação esquelética externa tipo II para o tratamento de fraturas de tibiotarso em pombos domésticos (Columba livia Closed reduction and type-II external skeletal fixation for treatment of tibiotarsus fractures in domestic pigeons (Columba livia

    Directory of Open Access Journals (Sweden)

    Marcelo Meller Alievi

    2001-12-01

    Full Text Available A redução fechada e o fixador esquelético externo tipo II foram avaliados para o tratamento de fraturas de tibiotarso em pombos domésticos (Columba livia. Foram utilizadas doze aves adultas. Os pombos foram anestesiados com a associação de xilazina e cetamina e, em seguida, foi realizada fratura do tibiotarso direito através de pressão digital sobre a diáfise do membro. Quatro pinos de Kirschner, dois proximais e dois distais ao foco da fratura, foram inseridos através de ambas as corticais ósseas e, após redução fechada da fratura, conectados externamente por duas barras de acrílico autopolimerizável, uma na face lateral e outra na face medial do membro. Em cinco aves, foi observado radiograficamente desvio ósseo angular, porém, a função do membro não foi afetada. O tempo médio e o desvio padrão para a cicatrização óssea foram 24,8 ± 4,89 dias. Os resultados demonstram que a redução fechada e o fixador esquelético externo tipo II são efetivos para o tratamento de fraturas de tibiotarso em pombos domésticos (Columba livia.The aim of this study was to evaluate the use of closed reduction and type-II external skeletal fixation for treatment of tibiotarsus fractures in domestic pigeons (Columba livia. Twelve adult domestic pigeons were used. Anesthesia was induced with xylazine and ketamine hydrochloride; the right tibiotarsus was manually fractured by digital pressure applied at the mid-diaphysis. Four Kirschner wires were placed through both cortices of the bone, two proximal and two distal to the fracture site, and, after closed reduction of the fracture, they were stabilized by two acrilic bars, one in the lateral and another in the medial surface of the tibiotarsus. Abnormalities in bone angulation were observed radiographically in five birds; however, the function of the limb was not noticeably impaired. The mean time ± standard deviation for fracture healing was 24.8 ± 4.89 days. The results of this

  18. FSD-HSO Optimization Algorithm for Closed Fringes Interferogram Demodulation

    Directory of Open Access Journals (Sweden)

    Ulises H. Rodriguez-Marmolejo

    2016-01-01

    Full Text Available Due to the physical nature of the interference phenomenon, extracting the phase of an interferogram is a known sinusoidal modulation problem. In order to solve this problem, a new hybrid mathematical optimization model for phase extraction is established. The combination of frequency guide sequential demodulation and harmony search optimization algorithms is used for demodulating closed fringes patterns in order to find the phase of interferogram applications. The proposed algorithm is tested in four sets of different synthetic interferograms, finding a range of average relative error in phase reconstructions of 0.14–0.39 rad. For reference, experimental results are compared with the genetic algorithm optimization technique, obtaining a reduction in the error up to 0.1448 rad. Finally, the proposed algorithm is compared with a very known demodulation algorithm, using a real interferogram, obtaining a relative error of 1.561 rad. Results are shown in patterns with complex fringes distribution.

  19. Closed Form Aliasing Probability For Q-ary Symmetric Errors

    Directory of Open Access Journals (Sweden)

    Geetani Edirisooriya

    1996-01-01

    Full Text Available In Built-In Self-Test (BIST techniques, test data reduction can be achieved using Linear Feedback Shift Registers (LFSRs. A faulty circuit may escape detection due to loss of information inherent to data compaction schemes. This is referred to as aliasing. The probability of aliasing in Multiple-Input Shift-Registers (MISRs has been studied under various bit error models. By modeling the signature analyzer as a Markov process we show that the closed form expression derived for aliasing probability previously, for MISRs with primitive polynomials under q-ary symmetric error model holds for all MISRs irrespective of their feedback polynomials and for group cellular automata signature analyzers as well. If the erroneous behaviour of a circuit can be modelled with q-ary symmetric errors, then the test circuit complexity and propagation delay associated with the signature analyzer can be minimized by using a set of m single bit LFSRs without increasing the probability of aliasing.

  20. Selective catalytic reduction of nitric oxide by ammonia over Cu-exchanged Cuban natural zeolites

    International Nuclear Information System (INIS)

    Moreno-Tost, Ramon; Santamaria-Gonzalez, Jose; Rodriguez-Castellon, Enrique; Jimenez-Lopez, Antonio; Autie, Miguel A.; Glacial, Marisol Carreras; Gonzalez, Edel; Pozas, Carlos De las

    2004-01-01

    The catalytic selective reduction of NO over Cu-exchanged natural zeolites (mordenite (MP) and clinoptilolite (HC)) from Cuba using NH 3 as reducing agent and in the presence of excess oxygen was studied. Cu(II)-exchanged zeolites are very active catalysts, with conversions of NO of 95%, a high selectivity to N 2 at low temperatures, and exhibiting good water tolerance. The chemical state of the Cu(II) in exchanged zeolites was characterized by H 2 -TPR and XPS. Cu(II)-exchanged clinoptilolite underwent a severe deactivation in the presence of SO 2 . However, Cu(II)-exchanged mordenite not only maintained its catalytic activity, but even showed a slight improvement after 20h of reaction in the presence of 100ppm of SO 2

  1. Pump integrated closed loop control. The intelligent actuator pump - state of the art and perspectives; Pumpenintegrierte Prozessregelung. Der intelligente Aktor Pumpe - Stand und Moeglichkeiten

    Energy Technology Data Exchange (ETDEWEB)

    Paulus, Thomas; Schullerer, Joachim; Oesterle, Manfred [KSB AG, Frankenthal (Germany)

    2009-07-01

    In many areas of industrial automation, centrifugal pumps and systems of centrifugal pumps are important actuators of a process und therefore a fundamental part of the entire plant. In contrary to the controlled valves, located behind the pump in the pipework system, the functions of the intelligent actuator pump or system of pumps are rarely used and noticed. With regard to the reduction of life cycle costs of the asset pump, pump integrated closed loop control of the fluid transport task has advantages over central closed loop control e.g. in a process control system. This article contains a survey of the intelligent actuator pump, its structure and functions with regard to the solution of the fluid transport task and according pump integrated closed loop control. (orig.)

  2. Catalytic selective reduction of NO with ethylene over a series of copper catalysts on amorphous silicas

    International Nuclear Information System (INIS)

    Carniti, P.; Gervasini, A.; Modica, V.H.; Ravasio, N.

    2000-01-01

    Catalytic selective reduction of NO to N 2 was studied comparing a series of Cu-based catalysts (ca. 8wt.%) supported over amorphous pure and modified silicas: SiO 2 , SiO 2 -Al 2 O 3 , SiO 2 -TiO 2 , SiO 2 -ZrO 2 . The catalysts were prepared by the chemisorption-hydrolysis method which ensured the formation of a unique copper phase well dispersed over all supports, as confirmed by scanning electron micrographs (SEMs). Temperature-programmed reduction (TPR) analyses confirmed the presence of dispersed copper species which underwent complete reduction at a temperature of about 220C, independently of the support. It was found that the support affects the extent of NO reduction as well as the selectivity to N 2 formation. Maximum N 2 yield was found in the range 275-300C. The catalyst prepared over SiO 2 -Al 2 O 3 was the most active and selective with respect to the other silicas. Competitiveness factors (c.f.'s) as high as 13-20% in the temperature range 200-250C could be calculated. For all catalysts, the temperature of the N 2 peak maximum did not correspond to that of the maximum C 2 H 4 oxidation to CO 2 , suggesting the presence of two different sites for the oxidation and the reduction activity. On the catalyst prepared on SiO 2 -Al 2 O 3 , a kinetic interpretation of catalytic data collected at different contact times and temperatures permitted evaluating the ratio between kinetic coefficients as well as the difference between activation energies of NO reduction by C 2 H 4 and C 2 H 4 oxidation by O 2

  3. Strategies for Small Volume Resuscitation: Hyperosmotic-Hyperoncotic Solutions, Hemoglobin Based Oxygen Carriers and Closed-Loop Resuscitation

    Science.gov (United States)

    Kramer, George C.; Wade, Charles E.; Dubick, Michael A.; Atkins, James L.

    2004-01-01

    Introduction: Logistic constraints on combat casualty care preclude traditional resuscitation strategies which can require volumes and weights 3 fold or greater than hemorrhaged volume. We present a review of quantitative analyses of clinical and animal data on small volume strategies using 1) hypertonic-hyperosmotic solutions (HHS); 2) hemoglobin based oxygen carriers (HBOCs) and 3) closed-loop infusion regimens.Methods and Results: Literature searches and recent queries to industry and academic researchers have allowed us to evaluate the record of 81 human HHS studies (12 trauma trials), 19 human HBOCs studies (3trauma trials) and two clinical studies of closed-loop resuscitation.There are several hundreds animal studies and at least 82 clinical trials and reports evaluating small volume7.2%-7.5% hypertonic saline (HS) most often combined with colloids, e.g., dextran (HSD) or hetastarch(HSS). HSD and HSS data has been published for 1,108 and 392 patients, respectively. Human studies have documented volume sparing and hemodynamic improvements. Meta-analyses suggest improved survival for hypotensive trauma patients treated with HSD with significant reductions in mortality found for patients with blood pressure surgery. HSD and HSS have received regulatory approval in 14 and 3 countries, respectively, with 81,000+ units sold. The primary reported use was head injury and trauma resuscitation. Complications and reported adverse events are surprisingly rare and not significantly different from other solutions.HBOCs are potent volume expanders in addition to oxygen carriers with volume expansion greater than standard colloids. Several investigators have evaluated small volume hyperoncotic HBOCs or HS-HBOC formulations for hypotensive and normotensive resuscitation in animals. A consistent finding in resuscitation with HBOCs is depressed cardiac output. There is some evidence that HBOCs more efficiently unload oxygen from plasma hemoglobin as well as facilitate RBC

  4. Intraoperative Sensorcaine significantly improves postoperative pain management in outpatient reduction mammaplasty.

    Science.gov (United States)

    Culliford, Alfred T; Spector, Jason A; Flores, Roberto L; Louie, Otway; Choi, Mihye; Karp, Nolan S

    2007-09-15

    Breast reduction is one of the most frequently performed plastic surgical procedures in the United States; more than 160,500 patients underwent the procedure in 2005. Many outpatient reduction mammaplasty patients report the greatest postoperative discomfort in the first 48 hours. The authors' investigated the effect of intraoperative topical application of the long-acting local anesthetic agent bupivacaine (Sensorcaine or Marcaine) on postoperative pain, time to postanesthesia care unit discharge, and postoperative use of narcotic medication. In a prospective, randomized, single-blind trial, intraoperative use of Sensorcaine versus placebo (normal saline) was compared. Postoperative pain was quantified using the visual analogue scale, and time to discharge from the postanesthesia care unit was recorded. Patients documented their outpatient pain medication usage. Of the 37 patients enrolled in the study, 20 were treated with intraoperative topical Sensorcaine and 17 received placebo. Patients treated with Sensorcaine were discharged home significantly faster (2.9 hours versus 3.8 hours, p = 0.002). The control arm consistently had higher pain scores in the postanesthesia care unit (although not statistically significant) than the Sensorcaine group using the visual analogue scale system. Furthermore, patients receiving Sensorcaine required significantly less narcotic medication while recovering at home (mean, 3.5 tablets of Vicodin) than the control group (mean, 6.4 tablets; p = 0.001). There were no complications resulting from Sensorcaine usage. This prospective, randomized, single-blind study demonstrates that a single dose of intraoperative Sensorcaine provides a safe, inexpensive, and efficacious way to significantly shorten the length of postanesthesia care unit stay and significantly decrease postoperative opioid analgesic use in patients undergoing ambulatory reduction mammaplasty.

  5. Search for open-quote open-quote polarized close-quote close-quote instantons in the vacuum

    International Nuclear Information System (INIS)

    Kuchiev, M.Y.

    1996-01-01

    The new phase of a gauge theory in which the instantons are open-quote open-quote polarized,close-quote close-quote i.e., have the preferred orientation, is discussed. A class of gauge theories with the specific condensates of the scalar fields is considered. In these models there exists an interaction between instantons resulting from one-fermion loop corrections. The interaction makes the identical orientation of instantons the most probable, permitting one to expect the system to undergo a phase transition into the state with polarized instantons. The existence of this phase is confirmed in the mean-field approximation in which there is a first-order phase transition separating the open-quote open-quote polarized phase close-quote close-quote from the usual nonpolarized one. The considered phase can be important for the description of gravity in the framework of the gauge field theory. copyright 1996 The American Physical Society

  6. Association of PTP1B with Outcomes of Breast Cancer Patients Who Underwent Neoadjuvant Chemotherapy.

    Science.gov (United States)

    Rivera Franco, Monica M; Leon Rodriguez, Eucario; Martinez Benitez, Braulio; Villanueva Rodriguez, Luisa G; de la Luz Sevilla Gonzalez, Maria; Armengol Alonso, Alejandra

    2016-01-01

    PTP1B is involved in the oncogenesis of breast cancer. In addition, neoadjuvant therapy has been widely used in breast cancer; thus, a measurement to assess survival improvement could be pathological complete response (pCR). Our objective was to associate PTP1B overexpression with outcomes of breast cancer patients who underwent neoadjuvant chemotherapy. Forty-six specimens were included. Diagnostic biopsies were immunostained using anti-PTP1B antibody. Expression was categorized as negative (<5%) and overexpression (≥5%). Patients' responses were graded according to the Miller-Payne system. Sixty-three percent of patients overexpressed PTP1B. There was no significant association between PTP1B overexpression and pCR ( P = 0.2). However, when associated with intrinsic subtypes, overexpression was higher in human epidermal growth factor receptor 2-positive-enriched specimens ( P = 0.02). Ten-year progression-free survival showed no differences. Our preliminary results do not show an association between PTP1B over-expression and pCR; however, given the limited sample and heterogeneous treatment in our cohort, this hypothesis cannot be excluded.

  7. Association of PTP1B with Outcomes of Breast Cancer Patients who Underwent Neoadjuvant Chemotherapy

    Directory of Open Access Journals (Sweden)

    Monica M. Rivera Franco

    2016-01-01

    Full Text Available PTP1B is involved in the oncogenesis of breast cancer. In addition, neoadjuvant therapy has been widely used in breast cancer; thus, a measurement to assess survival improvement could be pathological complete response (pCR. Our objective was to associate PTP1B overexpression with outcomes of breast cancer patients who underwent neoadjuvant chemotherapy. Forty-six specimens were included. Diagnostic biopsies were immunostained using anti-PTP1B antibody. Expression was categorized as negative (<5% and overexpression (≥5%. Patients' responses were graded according to the Miller-Payne system. Sixty-three percent of patients overexpressed PTP1B. There was no significant association between PTP1B overexpression and pCR (P = 0.2. However, when associated with intrinsic subtypes, overexpression was higher in human epidermal growth factor receptor 2-positive-enriched specimens (P = 0.02. Ten-year progression-free survival showed no differences. Our preliminary results do not show an association between PTP1B overexpression and pCR; however, given the limited sample and heterogeneous treatment in our cohort, this hypothesis cannot be excluded.

  8. Treatment of type 2 and 4 olecranon fractures with locking compression plate (LCP) osteosynthesis in horses: a prospective study (2002-2008)

    OpenAIRE

    Jackson, M; Kummer, M; Auer, J; Hagen, R; Fürst, A

    2011-01-01

    This prospective study describes a series of 18 olecranon fractures in 16 horses that were treated with locking compression plates (LCP). Twelve of the 18 fractures were simple (type 2), whereas six were comminuted (type 4). Six fractures were open and 12 were closed. Each horse underwent LCP osteosynthesis consisting of open reduction and application of one or two LCP. Complete fracture healing was achieved in 13 horses. Three horses had to be euthanatized: two because of severe infection an...

  9. A non-contact complete knee dislocation with popliteal artery disruption, a rare martial arts injury

    OpenAIRE

    Viswanath, Y; Rogers, I

    1999-01-01

    Complete knee dislocation is a rare injury and an associated incidence of popliteal artery damage ranges from 16-60% of cases. It occurs commonly in road traffic accidents and in high velocity trauma where significant contact remains as the usual mode of injury. We describe a rare case of non-contact knee dislocation with popliteal artery injury sustained while practising Aikido, a type of martial art. This patient successfully underwent closed reduction of the knee with an emergency vein byp...

  10. Prognostic analysis of uterine cervical cancer treated with postoperative radiotherapy: importance of positive or close parametrial resection margin

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Yi Jun; Lee, Kyung Ja; Park, Kyung Ran [Dept. of Radiation Oncology, (Korea, Republic of); and others

    2015-06-15

    To analyze prognostic factors for locoregional recurrence (LRR), distant metastasis (DM), and overall survival (OS) in cervical cancer patients who underwent radical hysterectomy followed by postoperative radiotherapy (PORT) in a single institute. Clinicopathologic data of 135 patients with clinical stage IA2 to IIA2 cervical cancer treated with PORT from 2001 to 2012 were reviewed, retrospectively. Postoperative parametrial resection margin (PRM) and vaginal resection margin (VRM) were investigated separately. The median treatment dosage of external beam radiotherapy (EBRT) to the whole pelvis was 50.4 Gy in 1.8 Gy/fraction. High-dose-rate vaginal brachytherapy after EBRT was given to patients with positive or close VRMs. Concurrent platinum-based chemoradiotherapy (CCRT) was administered to 73 patients with positive resection margin, lymph node (LN) metastasis, or direct extension of parametrium. Kaplan-Meier method and log-rank test were used for analyzing LRR, DM, and OS; Cox regression was applied to analyze prognostic factors. The 5-year disease-free survival was 79% and 5-year OS was 91%. In univariate analysis, positive or close PRM, LN metastasis, direct extension of parametrium, lymphovascular invasion, histology of adenocarcinoma, and chemotherapy were related with more DM and poor OS. In multivariate analysis, PRM and LN metastasis remained independent prognostic factors for OS. PORT after radical hysterectomy in uterine cervical cancer showed excellent OS in this study. Positive or close PRM after radical hysterectomy in uterine cervical cancer correlates with poor prognosis even with CCRT. Therefore, additional treatments to improve local control such as radiation boosting need to be considered.

  11. Gain reduction due to space charge at high counting rates in multiwire proportional chambers

    International Nuclear Information System (INIS)

    Smith, G.C.; Mathieson, E.

    1986-10-01

    Measurements with a small MWPC of gas gain reduction, due to ion space charge at high counting rates, have been compared with theoretical predictions. The quantity ln(q/q 0 )/(q/q 0 ), where (q/q 0 ) is the relative reduced avalanche charge, has been found to be closely proportional to count rate, as predicted. The constant of proportionality is in good agreement with calculations made with a modified version of the original, simplified theory

  12. Intra-articular Entrapment of Medial Epicondyle Fracture Fragment in Elbow Joint Dislocation Causing Ulnar Neuropraxia: A Case Report

    Directory of Open Access Journals (Sweden)

    Syed J

    2017-03-01

    Full Text Available Traumatic elbow dislocations in children are rare but most of them are complex dislocations, and in such dislocations, medial humerus epicondyle fractureis the most common associated injury. Fracture incarceration in the elbow joint occurs in 5-18% of medial humerus epicondyle fractures but ulnar neuropraxia is very rare. Open reduction internal fixation is indicated in medial humerus epicondyle fracture with fracture incarceration, ulnar neuropraxia, marked instability or open fracture. Operative treatment options include fragment excision and sutures, closed or open reduction and Kirschner wire fixation, open reduction and suture fixation, open reduction and smooth pin fixation, and open reduction and screw fixation. However, ulnar nerve transposition is debatable as good outcome had been reported with and without nerve transposition. We report a case of a 13-year old boy, who presented with right elbow dislocation and intra-articular entrapment of medial humerus epicondyle fracture fragment, complicated with sensory ulnar neuropraxia, following a fall onto his right outstretched hand in a motor vehicle accident. The elbow joint was reduced using close manipulative reduction but the fracture fragment remained entrapped post-reduction. The patient then underwent open reduction and screw fixation of the medial humerus epicondyle fracture without ulnar nerve transposition. He had good functional outcome six weeks after surgical intervention, with complete recovery of ulnar neuropraxia six months later. Currently, he is doing well at school and is active with his sporting activity.

  13. Closed-Form Formula of the Transverse Dynamic Stiffness of a Shallowly Inclined Taut Cable

    Directory of Open Access Journals (Sweden)

    Dan-hui Dan

    2014-01-01

    Full Text Available The segmented vibration-governed equations and their general solutions for cables acted upon by intermediate transverse forces are derived by applying Hamilton’s principle. Including the effects of sagging, flexible stiffness, clamped boundary conditions, and inclination angle of the cable, the element-wise dynamic stiffness for each cable segment, split into segments having unique transverse forces, is derived. By using methods from the global stiffness assembly process of FEM, the global level of the cables’ dynamic equilibrium equation is obtained, and, as a result, the final closed-form formula of transverse dynamic stiffness is derived. Additionally, the corresponding analytic form, without considering sagging effects, is also obtained. Case studies are conducted on the aspects of accuracy, rationality of the distribution on the spatial field, and frequency domains of dynamic stiffness calculations. By comparison with the Guyan-based static FEM reduction method, it is shown that the result obtained from the proposed closed-form solution, which includes sagging effects, is exact and rational, thus creating a powerful tool in transverse vibration analysis.

  14. Subluxation of iris-sutured intraocular lenses and results of a closed chamber technique for repositioning after penetrating keratoplasty.

    Science.gov (United States)

    Jabbur, Nada S; Akpek, Esen Karamursel; Stark, Walter J

    2005-05-01

    To describe subluxation of iris-fixated intraocular lenses (IOLs) after penetrating keratoplasty (PK) as a postoperative complication and report the long-term outcomes of a closed-chamber refixation technique used in the management. This was a retrospective, noncomparative interventional case series in which 19 consecutive patient charts with a subluxated iris-fixated IOL after PK were retrospectively reviewed. Fourteen of the patients underwent surgery using a closed-chamber refixation technique. These patients were evaluated for visual outcome and surgical complications associated with the procedure. In 13 patients, postoperative follow-up was available. In all 13 cases, the fixated IOL appeared stable and remained well positioned during a follow-up period of 56 months (range, 6-122). All patients (100%) achieved improved uncorrected visual acuity. The postoperative visual acuity ranged from 20/20 to 20/100 with a mean of 20/40. Vitreous hemorrhage occurred in 1 patient, and an additional patient required a second surgery using the same technique. Both of these patients did well with a final visual acuity of 20/40 and 20/50, respectively. Subluxation of iris-fixated IOL after PK can occur as a postoperative complication. The technique that we herein describe enables secure refixation of subluxated IOLs and yields favorable long-term results.

  15. Novel utilization of 3D technology and the hybrid operating theatre: Peri-operative assessment of posterior sterno-clavicular dislocation using cone beam CT

    International Nuclear Information System (INIS)

    Crowhurst, James A; Campbell, Douglas; Whitby, Mark; Pathmanathan, Pavthrun

    2013-01-01

    A patient with a medial and posterior dislocation of the right sterno-clavicular (SC) joint and displacement of the trachea and brachiocephalic artery by the medial head of the clavicle underwent general anaesthetic in the operating theatre for an open reduction procedure. The surgeon initially attempted a closed reduction, but this required imaging to check SC alignment. The patient was transferred to an adjacent hybrid operating theatre for imaging. Cone beam computed tomography (CBCT) was performed, which successfully demonstrated a significant reduction in the dislocation of the SC joint. The trachea and brachiocephalic artery were no longer compressed or displaced. This case study demonstrates an alternative to the patient being transferred to the medical imaging department for multi-slice CT. It also describes a novel use of the hybrid operating theatre and its CBCT capabilities

  16. Novel utilization of 3D technology and the hybrid operating theatre: Peri-operative assessment of posterior sterno-clavicular dislocation using cone beam CT

    Energy Technology Data Exchange (ETDEWEB)

    Crowhurst, James A; Campbell, Douglas; Whitby, Mark; Pathmanathan, Pavthrun [The Prince Charles Hospital, Rode Road, Chermside, Queensland (Australia)

    2013-06-15

    A patient with a medial and posterior dislocation of the right sterno-clavicular (SC) joint and displacement of the trachea and brachiocephalic artery by the medial head of the clavicle underwent general anaesthetic in the operating theatre for an open reduction procedure. The surgeon initially attempted a closed reduction, but this required imaging to check SC alignment. The patient was transferred to an adjacent hybrid operating theatre for imaging. Cone beam computed tomography (CBCT) was performed, which successfully demonstrated a significant reduction in the dislocation of the SC joint. The trachea and brachiocephalic artery were no longer compressed or displaced. This case study demonstrates an alternative to the patient being transferred to the medical imaging department for multi-slice CT. It also describes a novel use of the hybrid operating theatre and its CBCT capabilities.

  17. 65. Impact of focused echocardiography in clinical decision of patients presented with STMI, underwent primary percutenouse angioplasty

    Directory of Open Access Journals (Sweden)

    M. Qasem

    2016-07-01

    Full Text Available Echocardiography in coronary artery diseases is an essential, routine echocardiography prior to primary percutaneous angioplasty is not clear. In our clinical practice in primary angioplasty we faced lots of complications either before or during or after the procedure. Moreover, lots of incidental findings that discovered after the procedure which if known will affect the plan of management. One-hundred-nineteen consecutive underwent primary angioplasty. All patients underwent FE prior to the procedure in catheterization lab while the patient was preparing for the procedure. FE with 2DE of LV at base, mid and apex, and apical stander views. Diastology grading, E/E′ and color doppler of mitral and aortic valve were performed. (N = 119 case of STMI were enrolled, mean age 51 ± 12 year. Eleven cases (9.2% had normal coronary and normal LV function. Twenty cases (17% of MI complication detected before the procedures: RV infarction 8.4% (5.1% asymptomatic and 3.3% symptomatic, ischemic MR (8.4%, LV apical aneurysm (0.8%, significant pericardial effusion (0.80%. Acute pulmonary edema in 17 cases (14.3%: six cases (5.1% developed acute pulmonary edema on the cath lab with grade 3 diastolic dysfunction and E/E ′  >20, 9 cases (7.6% develop acute pulmonary edema in CCU with grade 2–3 diastolic dysfunction and E/E′ 15–20. 2 cases (2.7% develop acute pulmonary in CCU with grade 1–2 diastolic dysfunction and E/E′ 9–14. One case (0.8% presented cardiac tamponade 2 h post PCI. Incidental finding not related to STMI were as follow: 2 cases (1.7% with severe fibro degenerative MR, 2 cases (1.7% with mild to moderate AR and 2 cases (1.7% with mild to moderate AS. Isoled CABG 5/4.2% and CABG and MVR 2/1.7%. FE play an important role in guiding the management, early detection the incidental findings and complication post PCI.

  18. The application of dose-reduction simulation in neonatal head CT scan

    International Nuclear Information System (INIS)

    Liu Yue; Peng Yun; Zeng Jinjin; Zhang Qifeng; Li Jianying

    2009-01-01

    Objective: To determine the effects of dose reduction on multi-slice spiral CT (MSCT) of neonatal head and assess the lowest possible radiation for acceptable clinical images. Methods: Fifty-seven newborns suspected intracranial hemorrhage were entered into the study and underwent MSCT scans. Original images at three anatomic levels (posterior fossa, basal ganglia, centrum semiovale) were collected and synthetic noise was added so as to simulate dose reductions of 25%, 40%, 50% and 70%, respectively by using the noise addition tool. A total of 855 image data sets were obtained for the 57 patients. Original and simulated dose-reduction scan images were analyzed. Image noise and image quality were assessed by two independent experienced pediatric radiologists using diagnostic acceptability score, subjective image noise score on a 5-point scale and objective noise index. Image noise was measured by respectively placing region of interest (ROI) at cerebellum, thalamus and corona radiata of 3 different slices. And the noise index and mean value was calculated. The degree of inter-observer concordance was determined by Kappa statistical analysis. The Spearman statistical correlations between the noise index and diagnostic acceptability score were performed. Results: On the images of original dose and simulated dose reductions of 25%, 40%, 50% and 70%, the diagnostic acceptability was 4.47±0.51, 3.96±0.33, 3.21±0.45, 2.92±0.32, and 1.85±0.57, respectively, the subjective image scores were 1.62±0.48, 1.99±0.48, 2.76±0.81, 3.19±0.67, and 4.27±0.54, respectively, the noise index were 1.90±0.19, 2.17±0.20. 2.44± 0.25, 2.68±0.28, and 3.37±0.39, respectively. The two radiologists had good interobserver agreement for diagnostic acceptability (K=0.860, P=0.017) and for image noise scoring(K=0.630, P=0.022). There was significant statistical correlation between image noise index and diagnostic acceptability (r= 0.826,P=0.001). At 40% dose reduction to the standard

  19. Unusual Co moment reduction in the NiCoO/Co exchange bias system

    Energy Technology Data Exchange (ETDEWEB)

    Brueck, S. [Max-Planck-Institut fuer Metallforschung, Heisenbergstrasse 3, D-70569 Stuttgart (Germany)]. E-mail: brueck@mf.mpg.de; Goering, E. [Max-Planck-Institut fuer Metallforschung, Heisenbergstrasse 3, D-70569 Stuttgart (Germany); Tang, Y.J. [Center for Magnetic Recording Research, University of California at San Diego, 9500 Gilman Dr., La Jolla, CA 92093-0401 (United States); Schuetz, G. [Max-Planck-Institut fuer Metallforschung, Heisenbergstrasse 3, D-70569 Stuttgart (Germany); Berkowitz, A.E. [Center for Magnetic Recording Research, University of California at San Diego, 9500 Gilman Dr., La Jolla, CA 92093-0401 (United States); Department of Physics, University of California at San Diego, 9500 Gilman Dr., La Jolla, CA 92093-0401 (United States)

    2007-03-15

    To answer the question on how the explicit mechanism of coupling in the antiferromagnetic alloy NiCoO is established when in close contact to a ferromagnetic Co layer, X-ray magnetic circular dichroism (XMCD) measurements have been performed. Precise XMCD spectra at the L{sub 2,3}-edge of Ni as well as Co have been obtained at room temperature and at 80K by measuring total electron yield X-ray absorption spectra. The Ni XMCD clearly shows the existence of free, rotatable magnetic Ni moments in the antiferromagnet. As for the Co, XMCD at room temperature shows an average magnetic moment comparable to bulk values. Cooling the sample to 80K decreases the average Co moment by 10%. This decrease is explained by a reduction of ferromagnetic cobalt moments related to antiferromagnetic coupling or pinning close to the interface.

  20. Close-In Substellar Companions and the Formation of sdB-Type Close Binary Stars

    Directory of Open Access Journals (Sweden)

    L. Y. Zhu

    2015-02-01

    Full Text Available The sdB-type close binaries are believed to have experienced a common-envelope phase and may evolve into cataclysmic binaries (CVs. About 10% of all known sdB binaries are eclipsing binaries consisting of very hot subdwarf primaries and low-mass companions with short orbital periods. The eclipse profiles of these systems are very narrow and deep, which benefits the determination of high precise eclipsing times and makes the detection of small and close-in tertiary bodies possible. Since 2006 we have monitored some sdB-type eclipsing binaries to search for the close-in substellar companions by analyzing the light travel time effect. Here some progresses of the program are reviewed and the formation of sdB-type binary is discussed.

  1. [Study on reductive surgery for pelvic organ prolapse concomitant with anti-incontinence sling for treatment of occult stress urinary incontinence].

    Science.gov (United States)

    Zhang, Xiaolong; Lu, Yongxian; Shen, Wenjie; Liu, Jingxia; Ge, Jing; Liu, Xin; Zhao, Ying; Niu, Ke; Zhang, Yinghui; Wang, Wenying; Qiu, Chengli

    2014-06-01

    To evaluate the clinical outcome of anti-incontinence sling in the treatment of occult stress urinary incontinence (OSUI) during reductive surgery for advanced pelvic organ prolapse (POP). From Jun. 2003 to Dec. 2012, 78 patients with OSUI underwent reductive surgery for advanced POP such as high uterosacral ligament suspension, sacrospinous ligament suspension and sacral colpopexy in the First Affiliated Hospital, General Hospital of People's Liberation Army. Among them, 41 patients received reductive surgery alone was enrolled in non-concomitant anti-incontinence group and the other 37 patients who underwent same surgery with tension-free vaginal tape (TVT) or tension-free vaginal tape-obturator technique (TVT-O) was in anti-incontinence group. The patient's demography, objective and subjective outcomes, as well as complications and injures were compared between the two groups. The pelvic organ prolapse quantitation (POP-Q) was used to evaluate the objective outcomes of POP. Urinary distress inventory (UDI-6) and incontinence impact questionnaire short form (IIQ-7) were used to evaluate the subjective outcomes of stress urinary incontinence (SUI). Compared with the non-concomitant anti-incontinence group, the objective outcomes of reductive surgery exhibited no significant differences (100%, 78/78), and only the operation time of anti-incontinence group slightly increased 16 minutes. The occurrence rate of postoperative SUI was 12% (5/41), 15% (6/41), 17% (7/41) respectively after the operation at 2-month, 6-month and 12-month follow up in the non-concomitant anti-incontinence group; and the occurrence rate of the anti-incontinence group was 3% (1/37), 3% (1/37), 3% (1/37); but none of patients in the two groups require further surgery for stress urinary incontinence. Mean score of UDI-6 and IIQ-7 in all the patients decreased significantly after operation at 2-month, 6-month and 12-month follow up (all P statistic difference between the two groups (P > 0.05). It

  2. Closed-loop thrust and pressure profile throttling of a nitrous oxide/hydroxyl-terminated polybutadiene hybrid rocket motor

    Science.gov (United States)

    Peterson, Zachary W.

    Hybrid motors that employ non-toxic, non-explosive components with a liquid oxidizer and a solid hydrocarbon fuel grain have inherently safe operating characteristics. The inherent safety of hybrid rocket motors offers the potential to greatly reduce overall operating costs. Another key advantage of hybrid rocket motors is the potential for in-flight shutdown, restart, and throttle by controlling the pressure drop between the oxidizer tank and the injector. This research designed, developed, and ground tested a closed-loop throttle controller for a hybrid rocket motor using nitrous oxide and hydroxyl-terminated polybutadiene as propellants. The research simultaneously developed closed-loop throttle algorithms and lab scale motor hardware to evaluate the fidelity of the throttle simulations and algorithms. Initial open-loop motor tests were performed to better classify system parameters and to validate motor performance values. Deep-throttle open-loop tests evaluated limits of stable thrust that can be achieved on the test hardware. Open-loop tests demonstrated the ability to throttle the motor to less than 10% of maximum thrust with little reduction in effective specific impulse and acoustical stability. Following the open-loop development, closed-loop, hardware-in-the-loop tests were performed. The closed-loop controller successfully tracked prescribed step and ramp command profiles with a high degree of fidelity. Steady-state accuracy was greatly improved over uncontrolled thrust.

  3. Metal porphyrin intercalated reduced graphene oxide nanocomposite utilized for electrocatalytic oxygen reduction

    Directory of Open Access Journals (Sweden)

    Mingyan Wang

    2017-07-01

    Full Text Available In this paper, we report a simple and facile self-assembly method to successfully fabricate cationic metal porphyrin –MtTMPyP (Mt= Cobalt (II, Manganese (III, or Iron (III; TMPyP = 5, 10, 15, 20-tetrakis (N-methylpyridinium-4-yl porphyrin intercalated into the layer of graphene oxide (GO by the cooperative effects of electrostatic and π–π stacking interaction between positively charged metal porphyrin and negatively charged GO sheets. Followed by reduction with hydrazine vapor, a series of novel 2D MtTMPyP/rGOn were fabricated. The as-prepared 2D hybrids were fully characterized and tested as non-noble metal catalysts for oxygen reduction reaction (ORR in an alkaline medium. The MtTMPyP/rGOn hybrids, especially CoTMPyP/rGO5, demonstrated an improved electrocatalytic activity for ORR and a number of exchanged electrons close to 4-electron reaction, increased stability and excellent tolerance to methanol, showing a potential alternative catalyst for ORR in fuel cells and air batteries. Keywords: Metal porphyrin, Reduced graphene oxide, Intercalation, Oxygen reduction reaction, Catalyst

  4. Observing the Progressive Decoherence of the open-quote open-quote Meter close-quote close-quote in a Quantum Measurement

    International Nuclear Information System (INIS)

    Brune, M.; Hagley, E.; Dreyer, J.; Maitre, X.; Maali, A.; Wunderlich, C.; Raimond, J.M.; Haroche, S.

    1996-01-01

    A mesoscopic superposition of quantum states involving radiation fields with classically distinct phases was created and its progressive decoherence observed. The experiment involved Rydberg atoms interacting one at a time with a few photon coherent fields trapped in a high Q microwave cavity. The mesoscopic superposition was the equivalent of an open-quote open-quote atom+measuringapparatus close-quote close-quote system in which the open-quote open-quote meter close-quote close-quote was pointing simultaneously towards two different directions emdash a open-quote open-quote Schroedinger cat.close-quote close-quote The decoherence phenomenon transforming this superposition into a statistical mixture was observed while it unfolded, providing a direct insight into a process at the heart of quantum measurement. copyright 1996 The American Physical Society

  5. Open-closed homotopy algebra in mathematical physics

    International Nuclear Information System (INIS)

    Kajiura, Hiroshige; Stasheff, Jim

    2006-01-01

    In this paper we discuss various aspects of open-closed homotopy algebras (OCHAs) presented in our previous paper, inspired by Zwiebach's open-closed string field theory, but that first paper concentrated on the mathematical aspects. Here we show how an OCHA is obtained by extracting the tree part of Zwiebach's quantum open-closed string field theory. We clarify the explicit relation of an OCHA with Kontsevich's deformation quantization and with the B-models of homological mirror symmetry. An explicit form of the minimal model for an OCHA is given as well as its relation to the perturbative expansion of open-closed string field theory. We show that our open-closed homotopy algebra gives us a general scheme for deformation of open string structures (A ∞ algebras) by closed strings (L ∞ algebras)

  6. Treatment of mandibular symphyseal fracture combined with dislocated intracapsular condylar fractures.

    Science.gov (United States)

    Xu, Xiaofeng; Shi, Jun; Xu, Bing; Dai, Jiewen; Zhang, Shilei

    2015-03-01

    To evaluate the treatment methods of mandibular symphyseal fracture combined with dislocated intracapsular condylar fractures (MSF&DICF) and to compare the effect of different treatment methods of condylar fractures. Twenty-eight patients with MSF&DICF were included in this study. Twenty-two sites were treated by open reduction, and all the medial condylar fragments were fixed with titanium screws; whereas the other 22 sites underwent close treatment. The surgical effect between these 2 groups was compared based on clinical examination and radiographic examination results. Seventeen of 22 condyle fractures were repositioned in the surgery group, whereas 4 of 22 condyle fractures were repositioned in the close treatment group. Statistical difference was observed between these 2 groups (P condyle fractures should be treated by surgical reduction with the maintenance of the attachment of lateral pterygoid muscle, which is beneficial to repositioning the dislocated condyle to its original physiological position, to closure of the mandibular lingual gap, to restore the mandibular width.

  7. Association between ambient air pollution and pregnancy rate in women who underwent IVF.

    Science.gov (United States)

    Choe, S A; Jun, Y B; Lee, W S; Yoon, T K; Kim, S Y

    2018-04-05

    Are the concentrations of five criteria air pollutants associated with probabilities of biochemical pregnancy loss and intrauterine pregnancy in women? Increased concentrations of ambient particulate matter (PM10), nitrogen dioxide (NO2), carbon monoxide (CO) during controlled ovarian stimulation (COS) and after embryo transfer were associated with a decreased probability of intrauterine pregnancy. Exposure to high ambient air pollution was suggested to be associated with low fertility and high early pregnancy loss in women. Using a retrospective cohort study design, we analysed 6621 cycles of 4581 patients who underwent one or more fresh IVF cycles at a fertility centre from January 2006 to December 2014, and lived in Seoul at the time of IVF treatment. To estimate patients' individual exposure to air pollution, we computed averages of hourly concentrations of five air pollutants including PM10, NO2, CO, sulphur dioxide (SO2) and ozone (O3) measured at 40 regulatory monitoring sites in Seoul for each of the four exposure periods: period 1 (start of COS to oocyte retrieval), period 2 (oocyte retrieval to embryo transfer), period 3 (embryo transfer to hCG test), and period 4 (start of COS to hCG test). Hazard ratios (HRs) from the time-varying Cox-proportional hazards model were used to estimate probabilities of biochemical pregnancy loss and intrauterine pregnancy for an interquartile range (IQR) increase in each air pollutant concentration during each period, after adjusting for individual characteristics. We tested the robustness of the result using generalised linear mixed model, accounting for within-woman correlation. Mean age of the women was 35 years. Average BMI was 20.9 kg/m2 and the study population underwent 1.4 IVF cycles on average. Cumulative pregnancy rate in multiple IVF cycles was 51.3% per person. Survival analysis showed that air pollution during periods 1 and 3 was generally associated with IVF outcomes. Increased NO2 (adjusted HR = 0.93, 95% CI

  8. Amphiregulin Antibody and Reduction of Axial Elongation in Experimental Myopia

    Directory of Open Access Journals (Sweden)

    Wen Jun Jiang

    2017-03-01

    Full Text Available To examine the mechanism of ocular axial elongation in myopia, guinea pigs (age: 2–3 weeks which either underwent unilateral or bilateral lens-induced myopization (group 1 or which were primarily myopic at baseline (group 2 received unilateral intraocular injections of amphiregulin antibody (doses: 5, 10, or 15 μg three times in intervals of 9 days. A third group of emmetropic guinea pigs got intraocular unilateral injections of amphiregulin (doses: 0.25, 0.50 or 1.00 ng, respectively. In each group, the contralateral eyes received intraocular injections of Ringer's solution. In intra-animal inter-eye comparison and intra-eye follow-up comparison in groups 1 and 2, the study eyes as compared to the contralateral eyes showed a dose-dependent reduction in axial elongation. In group 3, study eyes and control eyes did not differ significantly in axial elongation. Immunohistochemistry revealed amphiregulin labelling at the retinal pigment epithelium in eyes with lens-induced myopization and Ringer's solution injection, but not in eyes with amphiregulin antibody injection. Intraocular injections of amphiregulin-antibody led to a reduction of lens-induced axial myopic elongation and of the physiological eye enlargement in young guinea pigs. In contrast, intraocularly injected amphiregulin in a dose of ≤1 ng did not show a significant effect. Amphiregulin may be one of several essential molecular factors for axial elongation.

  9. Y-configuration double-stent-assisted coiling using two closed-cell stents for wide-neck basilar tip aneurysms.

    Science.gov (United States)

    Jeon, Pyoung; Kim, Byung Moon; Kim, Dong Joon; Kim, Dong I K; Park, Keun Young

    2014-09-01

    This study aimed to evaluate clinical and angiographic outcomes of Y-configuration double-stent-assisted (Y-stent) coiling using two closed-cell stents for wide-necked basilar tip aneurysm (BTA). A total of 25 patients underwent Y-stent coiling using two closed-cell stents as a first-time treatment in 18 (3 ruptured) BTAs, retreatment in 2 BTAs and as a third treatment in 5 wide-necked BTAs. Clinical and angiographic outcomes were evaluated retrospectively. Treatment-related complications were three (12.0 %) thromboembolic infarctions due to two acute in-stent thromboses and one embolism. Twenty-two (88 %) patients had favorable outcomes (modified Rankin scale score [mRS], 0-2) during the follow-up period (mean, 30 months; range, 6-54 months). Two patients died: one from initial subarachnoid hemorrhage and the other from intracerebral hemorrhage due to underlying Moyamoya disease. Post-treatment angiograms showed complete occlusion in nine aneurysms, residual neck in 11 aneurysms and residual sac in five aneurysms. Follow-up angiograms were available at least once between 5 to 34 months (mean, 16 months) in 21 patients. Nineteen patients showed improved or stable states (complete occlusion, n = 17; residual neck, n = 2). Major recurrences occurred in two BTAs (9.5 %). Those two major recurrent aneurysms had been large-sized aneurysms at the initial coiling procedure. Both showed not only coil compaction but also progressive growth to giant-sized aneurysms and intra-aneurysmal thrombus formation at the Y-stent coiling as a third-time treatment. Y-stent coiling using two closed-cell stents is a safe and durable treatment option for wide-necked BTA, but may have limited efficacy for large/giant sized and thrombosed aneurysms.

  10. The Disability Impact and Associated Cost per Disability in Women Who Underwent Surgical Revision of Transvaginal Mesh Kits for Prolapse Repair.

    Science.gov (United States)

    Javadian, Pouya; Shobeiri, S Abbas

    2017-09-13

    The aim of this study was to investigate disability impact in patients and cost to the families of patients who have had complications of transvaginal prolapse mesh kits and underwent surgical revision. Patients who developed complications of transvaginal mesh kits for prolapse and who had undergone vaginal prolapse mesh surgical revision/removal in 2009 to 2014 at a single institution were identified by Current Procedural Terminology codes. The group was invited to complete a phone survey pertaining to the initial vaginal mesh used for prolapse surgery utilizing Sheehan Disability Scale (scale 0-10) and Years of life Lived with Disability (YLDs) questionnaires. The data collected were used to estimate the disability and cost analysis. We used our data to estimate the economic and quality-of-life impact of vaginal mesh complications on patients in the United States RESULTS: Sixty-two patients (62/198 [31.2%]) were consented to participate and completed the questionnaires by phone. Extremely disabled patients were 18 (29%) of 62 of whole cases, and 5 (8%) of 62 reported that they had no disability after vaginal mesh surgery. The median for overall disability score after vaginal mesh procedure was 8 (which reflects marked disability on a scale of 0-10). The majority of patients missed a median of 12 months of their school or work because of their mesh complications. Thirty-seven (59.6%) of 62 did not improve after mesh removal. Twenty-one (33.9%) of 62 stated that their family income dropped because of productivity loss related to mesh complications. The mean time between vaginal mesh surgery and mesh removal procedure was 4.7 years. Sheehan Disability Scale scores are significantly correlated with YLDs outcomes. Patients' overall disability score showed a significant correlation with YLDs scores (P mesh for prolapse reduction complications had a sustained disability impact that continued despite mesh removal. Likewise, the complications were associated with

  11. A study on the reduction of uranium oxide to uranium metal in LiCl molten salt

    International Nuclear Information System (INIS)

    Seo, J. S.; Hur, J. M.; Lee, W. K.; Hong, S. S.; Kang, D. S.; Park, S. W.

    2002-01-01

    Research for the analysis on a metallization process of uranium oxide in LiCl-Li molten salt was carried out. Effect of a concentration of Li 2 O on the metallization process was also studied. The new concept, electrochemical reduction of uranium oxide in LiCl-Li 2 O molten salt was proposed. The concept is based on the integrated process of metallization of UO 2 with simultaneous electrochemical reduction of Li 2 O which is recycled in a closed system. In a LiCl-Li molten salt system, U 3 O 8 whose conversion ratio to U turns out to be 97.1%, showed a better metallization characteristic than UO 2 . It is verified that electrochemically reduced Li is well deposited on the UO 2 powder cathode through a porous magnesia filter in LiCl-Li 2 O molten salt. In that process Li 2 O was from by the reduction process of UO 2 to U. This electrochemical reduction process showed good results to covert UO 2 to U

  12. Comparison of two-staged ORIF and limited internal fixation with external fixator for closed tibial plafond fractures.

    Science.gov (United States)

    Wang, Cheng; Li, Ying; Huang, Lei; Wang, Manyi

    2010-10-01

    To compare the results of two-staged open reduction and internal fixation (ORIF) and limited internal fixation with external fixator (LIFEF) for closed tibial plafond fractures. From January 2005 to June 2007, 56 patients with closed type B3 or C Pilon fractures were randomly allocated into groups I and II. Two-staged ORIF was performed in group I and LIFEF in group II. The outcome measures included bone union, nonunion, malunion, pin-tract infection, wound infection, osteomyelitis, ankle joint function, etc. These postoperative data were analyzed with Statistical Package for Social Sciences (SPSS) 13.0. Incidence of superficial soft tissue infection (involved in wound infection or pin-tract infection) in group I was lower than that in group II (P delayed union, and arthritis symptoms, with no statistical significance. Both groups resulted similar ankle joint function. Logistic regression analysis indicated that smoking and fracture pattern were the two factors significantly influencing the final outcomes. In the treatment of closed tibial plafond fractures, both two-staged ORIF and LIFEF offer similar results. Patients undergo LIFEF carry significantly greater radiation exposure and higher superficial soft tissue infection rate (usually occurs on pin tract and does not affect the final outcomes).

  13. Damage Detection on Sudden Stiffness Reduction Based on Discrete Wavelet Transform

    Directory of Open Access Journals (Sweden)

    Bo Chen

    2014-01-01

    Full Text Available The sudden stiffness reduction in a structure may cause the signal discontinuity in the acceleration responses close to the damage location at the damage time instant. To this end, the damage detection on sudden stiffness reduction of building structures has been actively investigated in this study. The signal discontinuity of the structural acceleration responses of an example building is extracted based on the discrete wavelet transform. It is proved that the variation of the first level detail coefficients of the wavelet transform at damage instant is linearly proportional to the magnitude of the stiffness reduction. A new damage index is proposed and implemented to detect the damage time instant, location, and severity of a structure due to a sudden change of structural stiffness. Numerical simulation using a five-story shear building under different types of excitation is carried out to assess the effectiveness and reliability of the proposed damage index for the building at different damage levels. The sensitivity of the damage index to the intensity and frequency range of measurement noise is also investigated. The made observations demonstrate that the proposed damage index can accurately identify the sudden damage events if the noise intensity is limited.

  14. Social Participation and Disaster Risk Reduction Behaviors in Tsunami Prone Areas

    Science.gov (United States)

    Witvorapong, Nopphol; Muttarak, Raya; Pothisiri, Wiraporn

    2015-01-01

    This paper examines the relationships between social participation and disaster risk reduction actions. A survey of 557 households in tsunami prone areas in Phang Nga, Thailand was conducted following the 2012 Indian Ocean earthquakes. We use a multivariate probit model to jointly estimate the likelihood of undertaking three responses to earthquake and tsunami hazards (namely, (1) following disaster-related news closely, (2) preparing emergency kits and/or having a family emergency plan, and (3) having an intention to migrate) and community participation. We find that those who experienced losses from the 2004 tsunami are more likely to participate in community activities and respond to earthquake hazards. Compared to men, women are more likely to prepare emergency kits and/or have an emergency plan and have a greater intention to migrate. Living in a community with a higher proportion of women with tertiary education increases the probability of engaging in community activities and carrying out disaster risk reduction measures. Individuals who participate in village-based activities are 5.2% more likely to undertake all three risk reduction actions compared to those not engaging in community activities. This implies that encouraging participation in community activities can have positive externalities in disaster mitigation. PMID:26153891

  15. Exactly solvable quantum state reduction models with time-dependent coupling

    International Nuclear Information System (INIS)

    Brody, Dorje C; Constantinou, Irene C; Dear, James D C; Hughston, Lane P

    2006-01-01

    A closed-form solution to the energy-based stochastic Schroedinger equation with a time-dependent coupling is obtained. The solution is algebraic in character, and is expressed directly in terms of independent random data. The data consist of (i) a random variable H which has the distribution P(H=E i ) = π i , where π i is the transition probability vertical bar (ψ 0 vertical bar Φ i ) vertical bar 2 from the initial state vertical bar ψ 0 ) to the Lueders state vertical bar Φ i ) with energy E i , and (ii) an independent P-Brownian motion, where P is the physical probability measure associated with the dynamics of the reduction process. When the coupling is time independent, it is known that state reduction occurs asymptotically-that is to say, over an infinite time horizon. In the case of a time-dependent coupling, we show that if the magnitude of the coupling decreases sufficiently rapidly, then the energy variance will be reduced under the dynamics, but the state need not reach an energy eigenstate. This situation corresponds to the case of a 'partial' or 'incomplete' measurement of the energy. We also construct an example of a model where the opposite situation prevails, in which complete state reduction is achieved after the passage of a finite period of time

  16. A study on the electrolytic reduction of U3O8 to uranium metal in LiCl-Li2O molten salt

    International Nuclear Information System (INIS)

    Seo, J. S.; Heo, J. M.; Hong, S. S.; Kang, D. S.; Park, S. W.

    2002-01-01

    New electrolytic reduction technology was proposed that is based on the intregration of metallization of U 3 O 8 and Li 2 O electrowinning. In this electrolytic reduction reaction, electrolytically reduced Li deposits on cathode and simultaneously reacts with uranium oxide to produce uranium metal showing more than 99% conversion. For the verification of process feasibility, the experiments to obtain basic data on the metallization of uranium oxide, materials for cathode and anode electrode, the characteristics of closed recycle of Li 2 O and mass transfer were carried out. This evolutionary electrolytic reduction technology would give benefits over the conventional Li-reduction process improving economic viability such as: avoidance of handling of chemically active Li-LiCl molten salt, increase of metallization yield, and simplification of process

  17. Integrable reductions of many component magnetic systems in (1,1) dimensions

    International Nuclear Information System (INIS)

    Makhankov, V.G.; Pashaev, O.K.

    1983-01-01

    A generalized many component Heisenberg spin chain with phonon interaction is proposed. Some reductions of the proposed model leading to different real magnetic systems such as many chained magnetic crystals with nontrivial interchain couplings, a mixture of many chained ferro and antiferromagnets, a ''colour'' generalized Pierels-Hubbard model, etc., are studied. It has been shown that the dynamics of all the above real models are close to some integrable systems and coincide with them in certain limits. Such integrable systems are the coupled generalised system of Yajima and Oikawa and U(p,q) nonlinear Schrodinger equation, already well studied. (Auth.)

  18. Hosotani model in closed string theory

    International Nuclear Information System (INIS)

    Shiraishi, Kiyoshi.

    1988-11-01

    Hosotani mechanism in the closed string theory with current algebra symmetry is described by the (old covariant) operator method. We compare the gauge symmetry breaking mechanism in a string theory which has SU(2) symmetry with the one in an equivalent compactified closed string theory. We also investigate the difference between Hosotani mechanism and Higgs mechanism in closed string theories by calculation of a fourpoint amplitude of 'Higgs' bosons at tree level. (author)

  19. Use of an elliptical aperture to control saturation in closely-coupled, cold iron, superconducting dipole magnets

    International Nuclear Information System (INIS)

    Morgan, G.

    1985-01-01

    The high fields permitted by superconducting windings result in saturation of closely-coupled iron in dipole and quadrupole beam transport magnets. Coupland suggested using a triangular cutout at the poles to reduce the change in the sextupole (b 2 ) term due to saturation. The use of an elliptical aperture in a close-coupled dipole for the Relativistic Heavy Ion Collider (RHIC) has been studied using the BNL computer program MDP (a version of GFUN). The ellipse aspect ratio was varied while holding the horizontal (minor) radius constant. The proper aspect ratio gives no shift in b 2 sue to saturation, and a reduction in the b 4 shift. A modification of the ellipse also reduces b 4 . The elliptical aperture introduces a large b 2 term at low field which must be compensated for by the coil design. A practical coil design which does this for the RHIC magnet is presented. 5 refs., 2 figs., 3 tabs

  20. MR image findings on advanced internal derangement of the temporomandibular joints. Cases of disc position changed from anterior disc displacement with reduction to without reduction

    International Nuclear Information System (INIS)

    Igarashi, Chinami; Kobayashi, Kaoru; Yuasa, Masao; Imanaka, Masahiro; Yamamoto, Akira

    2005-01-01

    This study was designed to evaluate the suggestion that the clinical findings and MR image findings of anterior disc displacement with reduction cases could not reduce the disc displacement within the follow-up period. We selected 26 joints without remarkable bone changes in the condylar head or glenoid fossa in which reduction disappeared during follow-up. Clinical evaluation focused on temporomandibular pain, trismus, and joint sound. MR imaging was targeted for configuration of articular disc, degree of disc displacement, and condylar head position. Clinical signs observed with progression of the condition were disappearance of joint sound in 12/26 joints (46.1%), temporomandibular pain in 15/26 joints (57.6%), and decreased distance of opening mouth in 19/26 joints (73%). MR image findings were disc configuration changes in 12/26 joints (46.1%), increased degree of anterior displacement of disc in 20/26 joints (76.9%), and condylar head position changes in 9/26 joints (34.6%). It is suggested that the advanced stage of internal derangement is closely associated with the degree of disc displacement. (author)

  1. Comportamiento de los pacientesancianosoperados de cirugíacardíaca con circulaciónextracorpórea/ Evolution of elderly patients who underwent cardiac surgery with cardiopulmonary bypass

    Directory of Open Access Journals (Sweden)

    Alain Moré Duarte

    2015-10-01

    Full Text Available Introduction: There is a steady increase in the number of elderly patients with severe cardiovascular diseases who require a surgical procedure to recover some quality of life that allows them a socially meaningful existence, despite the risks. Objectives: To analyze the behavior of elderly patients who underwent cardiac surgery with cardiopulmonary bypass. Method: A descriptive, retrospective, cross-sectional study was conducted with patients over 65 years of age who underwent surgery at the Cardiocentro Ernesto Che Guevara, in Santa Clara, from January 2013 to March 2014. Results: In the study, 73.1% of patients were men; and there was a predominance of subjects between 65 and 70 years of age, accounting for 67.3%. Coronary artery bypass graft was the most prevalent type of surgery and had the longest cardiopulmonary bypass times. Hypertension was present in 98.1% of patients. The most frequent postoperative complications were renal dysfunction and severe low cardiac output, with 44.2% and 34.6% respectively. Conclusions: There was a predominance of men, the age group of 65 to 70 years, hypertension, and patients who underwent coronary artery bypass graft with prolonged cardiopulmonary bypass. Renal dysfunction was the most frequent complication.

  2. Biogeochemical Processes Controlling Microbial Reductive Precipitation of Radionuclides

    International Nuclear Information System (INIS)

    Fredrickson, James K.; Brooks, Scott C.

    2004-01-01

    This project is focused on elucidating the principal biogeochemical reactions that govern the concentrations, chemical speciation, and distribution of the redox sensitive contaminants uranium (U) and technetium (Tc) between the aqueous and solid phases. The research is designed to provide new insights into the under-explored areas of competing geochemical and microbiological oxidation-reduction reactions that govern the fate and transport of redox sensitive contaminants and to generate fundamental scientific understanding of the identity and stoichiometry of competing microbial reduction and geochemical oxidation reactions. These goals and objectives are met through a series of hypothesis-driven tasks that focus on (1) the use of well-characterized microorganisms and synthetic and natural mineral oxidants, (2) advanced spectroscopic and microscopic techniques to monitor redox transformations of U and Tc, and (3) the use of flow-through experiments to more closely approximate groundwater environments. The results are providing an improved understanding and predictive capability of the mechanisms that govern the redox dynamics of radionuclides in subsurface environments. For purposes of this poster, the results are divided into three sections: (1) influence of Ca on U(VI) bioreduction; (2) localization of biogenic UO 2 and TcO 2 ; and (3) reactivity of Mn(III/IV) oxides.

  3. Teaching the Basics: Development and Validation of a Distal Radius Reduction and Casting Model.

    Science.gov (United States)

    Seeley, Mark A; Fabricant, Peter D; Lawrence, J Todd R

    2017-09-01

    Approximately one-third of reduced pediatric distal radius fractures redisplace, resulting in further treatment. Two major modifiable risk factors for loss of reduction are reduction adequacy and cast quality. Closed reduction and immobilization of distal radius fractures is an Accreditation Council for Graduate Medical Education residency milestone. Teaching and assessing competency could be improved with a life-like simulation training tool. Our goal was to develop and validate a realistic distal radius fracture reduction and casting simulator as determined by (1) a questionnaire regarding the "realism" of the model and (2) the quantitative assessments of reduction time, residual angulation, and displacement. A distal radius fracture model was created with radiopaque bony segments and articulating elbows and shoulders. Simulated periosteum and internal deforming forces required proper reduction and casting techniques to achieve and maintain reduction. The forces required were estimated through an iterative process through feedback from experienced clinicians. Embedded monofilaments allowed for quantitative assessment of residual displacement and angulation through the use of fluoroscopy. Subjects were asked to perform closed reduction and apply a long arm fiberglass cast. Primary performance variables assessed included reduction time, residual angulation, and displacement. Secondary performance variables consisted of number of fluoroscopic images, casting time, and cast index (defined as the ratio of the internal width of the forearm cast in the sagittal plane to the internal width in the coronal plane at the fracture site). Subject grading was performed by two blinded reviewers. Interrater reliability was nearly perfect across all measurements (intraclass correlation coefficient range, 0.94-0.99), thus disagreements in measurements were handled by averaging the assessed values. After completion the participants answered a Likert-based questionnaire regarding the

  4. An Engineered Disulfide Bond Reversibly Traps the IgE-Fc3-4 in a Closed, Nonreceptor Binding Conformation

    Energy Technology Data Exchange (ETDEWEB)

    Wurzburg, Beth A.; Kim, Beomkyu; Tarchevskaya, Svetlana S.; Eggel, Alexander; Vogel, Monique; Jardetzky, Theodore S. [Bern; (Stanford-MED)

    2013-08-02

    IgE antibodies interact with the high affinity IgE Fc receptor, FcϵRI, and activate inflammatory pathways associated with the allergic response. The IgE-Fc region, comprising the C-terminal domains of the IgE heavy chain, binds FcϵRI and can adopt different conformations ranging from a closed form incompatible with receptor binding to an open, receptor-bound state. A number of intermediate states are also observed in different IgE-Fc crystal forms. To further explore this apparent IgE-Fc conformational flexibility and to potentially trap a closed, inactive state, we generated a series of disulfide bond mutants. Here we describe the structure and biochemical properties of an IgE-Fc mutant that is trapped in the closed, non-receptor binding state via an engineered disulfide at residue 335 (Cys-335). Reduction of the disulfide at Cys-335 restores the ability of IgE-Fc to bind to its high affinity receptor, FcϵRIα. The structure of the Cys-335 mutant shows that its conformation is within the range of previously observed, closed form IgE-Fc structures and that it retains the hydrophobic pocket found in the hinge region of the closed conformation. Locking the IgE-Fc into the closed state with the Cys-335 mutation does not affect binding of two other IgE-Fc ligands, omalizumab and DARPin E2_79, demonstrating selective blocking of the high affinity receptor binding.

  5. Closing the loop.

    Science.gov (United States)

    Dassau, E; Atlas, E; Phillip, M

    2010-02-01

    The dream of closing the loop is actually the dream of creating an artificial pancreas and freeing the patients from being involved with the care of their own diabetes. Insulin-dependent diabetes (type 1) is a chronic incurable disease which requires constant therapy without the possibility of any 'holidays' or insulin-free days. It means that patients have to inject insulin every day of their life, several times per day, and in order to do it safely they also have to measure their blood glucose levels several times per day. Patients need to plan their meals, their physical activities and their insulin regime - there is only very small room for spontaneous activities. This is why the desire for an artificial pancreas is so strong despite the fact that it will not cure the diabetic patients. Attempts to develop a closed-loop system started in the 1960s but never got to a clinical practical stage of development. In recent years the availability of continuous glucose sensors revived those efforts and stimulated the clinician and researchers to believe that closing the loop might be possible nowadays. Many papers have been published over the years describing several different ideas on how to close the loop. Most of the suggested systems have a sensing arm that measures the blood glucose repeatedly or continuously, an insulin delivery arm that injects insulin upon command and a computer that makes the decisions of when and how much insulin to deliver. The differences between the various published systems in the literature are mainly in their control algorithms. However, there are also differences related to the method and site of glucose measurement and insulin delivery. SC glucose measurements and insulin delivery are the most studied option but other combinations of insulin measurements and glucose delivery including intravascular and intraperitoneal (IP) are explored. We tried to select recent publications that we believe had influenced and inspired people interested

  6. Frontal and subcortical grey matter reductions in PTSD.

    Science.gov (United States)

    O'Doherty, Daniel C M; Tickell, Ashleigh; Ryder, Will; Chan, Charles; Hermens, Daniel F; Bennett, Maxwell R; Lagopoulos, Jim

    2017-08-30

    Post-traumatic stress disorder (PTSD) is characterised by a range of debilitating psychological, physical and cognitive symptoms. PTSD has been associated with grey matter atrophy in limbic and frontal cortical brain regions. However, previous studies have reported heterogeneous findings, with grey matter changes observed beyond limbic/frontal areas. Seventy-five adults were recruited from the community, 25 diagnosed with PTSD along with 25 healthy and 25 trauma exposed age and gender matched controls. Participants underwent clinical assessment and magnetic resonance imaging. The data-analyses method Voxel Based Morphometry (VBM) was used to estimate cortical grey matter volumes. When compared to both healthy and trauma exposed controls, PTSD subjects demonstrated decreased grey matter volumes within subcortical brain regions-including the hippocampus and amygdala-along with reductions in the anterior cingulate cortex, frontal medial cortex, middle frontal gyrus, superior frontal gyrus, paracingulate gyrus, and precuneus cortex. Significant negative correlations were found between total CAPS lifetime clinical scores/sub-scores and GM volume of both the PTSD and TC groups. GM volumes of the left rACC and right amygdala showed a significant negative correlation within PTSD diagnosed subjects. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

  7. Vaginal delivery among women who underwent labor induction with vaginal dinoprostone (PGE2) insert: a retrospective study of 1656 women in China.

    Science.gov (United States)

    Zhao, Lei; Lin, Ying; Jiang, Ting-Ting; Wang, Ling; Li, Min; Wang, Ying; Sun, Guo-Qiang; Xiao, Mei

    2017-12-21

    This study aimed to qualify relevant factors for vaginal delivery among women who underwent labor induction with vaginal dinoprostone (PGE2) insert in a Chinese tertiary maternity hospital. A retrospective study was conducted in Hubei Maternal and Child Health Hospital. A total of 1656 pregnancies that underwent labor induction with vaginal dinoprostone insert between January and August 2016 were finally included in this study. Data were analyzed using univariate and multivariable regression modeling. Of 1656 women with PGE2-induced labor at term, 396 (23.91%) gave birth by cesarean section, 1260 (76.09%) had a vaginal delivery among which 921 (55.61%) delivered vaginally within 24 h. Multivariable regression analysis showed that maternal age (p labor induction, which was markedly higher than the overall annual vaginal delivery rate of 65.1% in China during 2014. Maternal age, parity, baseline fetal heart rate, and birth weight were significant factors for vaginal delivery. This study enables us to better understand the efficiency of dinoprostone and the potential predictors of vaginal delivery in dinoprostone-induced labor, which may be helpful to guide the clinical use of dinoprostone and therefore provide better service clinically.

  8. 27 CFR 70.485 - Closing agreements.

    Science.gov (United States)

    2010-04-01

    ... Relating to Alcohol, Tobacco, Firearms, and Explosives Administrative Remedies § 70.485 Closing agreements... disadvantage through consummation of such an agreement. (b) Scope of closing agreement—(1) In general. A...

  9. Image noise reduction technology reduces radiation in a radial-first cardiac catheterization laboratory

    Energy Technology Data Exchange (ETDEWEB)

    Gunja, Ateka; Pandey, Yagya [Department of Veterans Affairs, Jesse Brown VA Medical Center, Chicago, IL (United States); Division of Cardiology, Department of Medicine, University of Illinois at Chicago, Chicago, IL (United States); Xie, Hui [Division of Epidemiology and Biostatistics, University of Illinois at Chicago, Chicago, IL (United States); Faculty of Health Sciences, Simon Fraser University, Burnaby, BC (Canada); Wolska, Beata M. [Department of Physiology and Biophysics, Center for Cardiovascular Research, University of Illinois at Chicago, Chicago, IL (United States); Shroff, Adhir R.; Ardati, Amer K. [Department of Veterans Affairs, Jesse Brown VA Medical Center, Chicago, IL (United States); Division of Cardiology, Department of Medicine, University of Illinois at Chicago, Chicago, IL (United States); Vidovich, Mladen I., E-mail: miv@uic.edu [Department of Veterans Affairs, Jesse Brown VA Medical Center, Chicago, IL (United States); Division of Cardiology, Department of Medicine, University of Illinois at Chicago, Chicago, IL (United States)

    2017-04-15

    Background: Transradial coronary angiography (TRA) has been associated with increased radiation doses. We hypothesized that contemporary image noise reduction technology would reduce radiation doses in the cardiac catheterization laboratory in a typical clinical setting. Methods and results: We performed a single-center, retrospective analysis of 400 consecutive patients who underwent diagnostic and interventional cardiac catheterizations in a predominantly TRA laboratory with traditional fluoroscopy (N = 200) and a new image noise reduction fluoroscopy system (N = 200). The primary endpoint was radiation dose (mGy cm{sup 2}). Secondary endpoints were contrast dose, fluoroscopy times, number of cineangiograms, and radiation dose by operator between the two study periods. Radiation was reduced by 44.7% between the old and new cardiac catheterization laboratory (75.8 mGy cm{sup 2} ± 74.0 vs. 41.9 mGy cm{sup 2} ± 40.7, p < 0.0001). Radiation was reduced for both diagnostic procedures (45.9%, p < 0.0001) and interventional procedures (37.7%, p < 0.0001). There was no statistically significant difference in radiation dose between individual operators (p = 0.84). In multivariate analysis, radiation dose remained significantly decreased with the use of the new system (p < 0.0001) and was associated with weight (p < 0.0001), previous coronary artery bypass grafting (p < 0.0007) and greater than 3 stents used (p < 0.0004). TRA was used in 90% of all cases in both periods. Compared with a transfemoral approach (TFA), TRA was not associated with higher radiation doses (p = 0.20). Conclusions: Image noise reduction technology significantly reduces radiation dose in a contemporary radial-first cardiac catheterization clinical practice. - Highlights: • Radial arterial access has been associated with higher doses compared to femoral access. • In a radial-first cardiac catheterization laboratory (90% radial) we examined radiation doses reduction with a contemporary image

  10. Image noise reduction technology reduces radiation in a radial-first cardiac catheterization laboratory

    International Nuclear Information System (INIS)

    Gunja, Ateka; Pandey, Yagya; Xie, Hui; Wolska, Beata M.; Shroff, Adhir R.; Ardati, Amer K.; Vidovich, Mladen I.

    2017-01-01

    Background: Transradial coronary angiography (TRA) has been associated with increased radiation doses. We hypothesized that contemporary image noise reduction technology would reduce radiation doses in the cardiac catheterization laboratory in a typical clinical setting. Methods and results: We performed a single-center, retrospective analysis of 400 consecutive patients who underwent diagnostic and interventional cardiac catheterizations in a predominantly TRA laboratory with traditional fluoroscopy (N = 200) and a new image noise reduction fluoroscopy system (N = 200). The primary endpoint was radiation dose (mGy cm"2). Secondary endpoints were contrast dose, fluoroscopy times, number of cineangiograms, and radiation dose by operator between the two study periods. Radiation was reduced by 44.7% between the old and new cardiac catheterization laboratory (75.8 mGy cm"2 ± 74.0 vs. 41.9 mGy cm"2 ± 40.7, p < 0.0001). Radiation was reduced for both diagnostic procedures (45.9%, p < 0.0001) and interventional procedures (37.7%, p < 0.0001). There was no statistically significant difference in radiation dose between individual operators (p = 0.84). In multivariate analysis, radiation dose remained significantly decreased with the use of the new system (p < 0.0001) and was associated with weight (p < 0.0001), previous coronary artery bypass grafting (p < 0.0007) and greater than 3 stents used (p < 0.0004). TRA was used in 90% of all cases in both periods. Compared with a transfemoral approach (TFA), TRA was not associated with higher radiation doses (p = 0.20). Conclusions: Image noise reduction technology significantly reduces radiation dose in a contemporary radial-first cardiac catheterization clinical practice. - Highlights: • Radial arterial access has been associated with higher doses compared to femoral access. • In a radial-first cardiac catheterization laboratory (90% radial) we examined radiation doses reduction with a contemporary image-noise compared to

  11. Inflation in a closed universe

    Science.gov (United States)

    Ratra, Bharat

    2017-11-01

    To derive a power spectrum for energy density inhomogeneities in a closed universe, we study a spatially-closed inflation-modified hot big bang model whose evolutionary history is divided into three epochs: an early slowly-rolling scalar field inflation epoch and the usual radiation and nonrelativistic matter epochs. (For our purposes it is not necessary to consider a final dark energy dominated epoch.) We derive general solutions of the relativistic linear perturbation equations in each epoch. The constants of integration in the inflation epoch solutions are determined from de Sitter invariant quantum-mechanical initial conditions in the Lorentzian section of the inflating closed de Sitter space derived from Hawking's prescription that the quantum state of the universe only include field configurations that are regular on the Euclidean (de Sitter) sphere section. The constants of integration in the radiation and matter epoch solutions are determined from joining conditions derived by requiring that the linear perturbation equations remain nonsingular at the transitions between epochs. The matter epoch power spectrum of gauge-invariant energy density inhomogeneities is not a power law, and depends on spatial wave number in the way expected for a generalization to the closed model of the standard flat-space scale-invariant power spectrum. The power spectrum we derive appears to differ from a number of other closed inflation model power spectra derived assuming different (presumably non de Sitter invariant) initial conditions.

  12. Long-Haul Truck Sleeper Heating Load Reduction Package for Rest Period Idling: Preprint

    Energy Technology Data Exchange (ETDEWEB)

    Lustbader, Jason; Kekelia, Bidzina; Tomerlin, Jeff; Kreutzer, Cory; Adelman, Steve; Yeakel, Skip; Luo, Zhiming; Zehme, John

    2016-03-24

    Annual fuel use for sleeper cab truck rest period idling is estimated at 667 million gallons in the United States, or 6.8% of long-haul truck fuel use. Truck idling during a rest period represents zero freight efficiency and is largely done to supply accessory power for climate conditioning of the cab. The National Renewable Energy Laboratory's CoolCab project aims to reduce heating, ventilating, and air conditioning (HVAC) loads and resulting fuel use from rest period idling by working closely with industry to design efficient long-haul truck thermal management systems while maintaining occupant comfort. Enhancing the thermal performance of cab/sleepers will enable smaller, lighter, and more cost-effective idle reduction solutions. In addition, if the fuel savings provide a one- to three-year payback period, fleet owners will be economically motivated to incorporate them. For candidate idle reduction technologies to be implemented by original equipment manufacturers and fleets, their effectiveness must be quantified. To address this need, several promising candidate technologies were evaluated through experimentation and modeling to determine their effectiveness in reducing rest period HVAC loads. Load reduction strategies were grouped into the focus areas of solar envelope, occupant environment, conductive pathways, and efficient equipment. Technologies in each of these focus areas were investigated in collaboration with industry partners. The most promising of these technologies were then combined with the goal of exceeding a 30% reduction in HVAC loads. These technologies included 'ultra-white' paint, advanced insulation, and advanced curtain design. Previous testing showed more than a 35.7% reduction in air conditioning loads. This paper describes the overall heat transfer coefficient testing of this advanced load reduction technology package that showed more than a 43% reduction in heating load. Adding an additional layer of advanced insulation

  13. Gradient-driven flux-tube simulations of ion temperature gradient turbulence close to the non-linear threshold

    Energy Technology Data Exchange (ETDEWEB)

    Peeters, A. G.; Rath, F.; Buchholz, R.; Grosshauser, S. R.; Strintzi, D.; Weikl, A. [Physics Department, University of Bayreuth, Universitätsstrasse 30, Bayreuth (Germany); Camenen, Y. [Aix Marseille Univ, CNRS, PIIM, UMR 7345, Marseille (France); Candy, J. [General Atomics, PO Box 85608, San Diego, California 92186-5608 (United States); Casson, F. J. [CCFE, Culham Science Centre, Abingdon OX14 3DB, Oxon (United Kingdom); Hornsby, W. A. [Max Planck Institut für Plasmaphysik, Boltzmannstrasse 2 85748 Garching (Germany)

    2016-08-15

    It is shown that Ion Temperature Gradient turbulence close to the threshold exhibits a long time behaviour, with smaller heat fluxes at later times. This reduction is connected with the slow growth of long wave length zonal flows, and consequently, the numerical dissipation on these flows must be sufficiently small. Close to the nonlinear threshold for turbulence generation, a relatively small dissipation can maintain a turbulent state with a sizeable heat flux, through the damping of the zonal flow. Lowering the dissipation causes the turbulence, for temperature gradients close to the threshold, to be subdued. The heat flux then does not go smoothly to zero when the threshold is approached from above. Rather, a finite minimum heat flux is obtained below which no fully developed turbulent state exists. The threshold value of the temperature gradient length at which this finite heat flux is obtained is up to 30% larger compared with the threshold value obtained by extrapolating the heat flux to zero, and the cyclone base case is found to be nonlinearly stable. Transport is subdued when a fully developed staircase structure in the E × B shearing rate forms. Just above the threshold, an incomplete staircase develops, and transport is mediated by avalanche structures which propagate through the marginally stable regions.

  14. Will Big Data Close the Missing Heritability Gap?

    Science.gov (United States)

    Kim, Hwasoon; Grueneberg, Alexander; Vazquez, Ana I; Hsu, Stephen; de Los Campos, Gustavo

    2017-11-01

    Despite the important discoveries reported by genome-wide association (GWA) studies, for most traits and diseases the prediction R-squared (R-sq.) achieved with genetic scores remains considerably lower than the trait heritability. Modern biobanks will soon deliver unprecedentedly large biomedical data sets: Will the advent of big data close the gap between the trait heritability and the proportion of variance that can be explained by a genomic predictor? We addressed this question using Bayesian methods and a data analysis approach that produces a surface response relating prediction R-sq. with sample size and model complexity ( e.g. , number of SNPs). We applied the methodology to data from the interim release of the UK Biobank. Focusing on human height as a model trait and using 80,000 records for model training, we achieved a prediction R-sq. in testing ( n = 22,221) of 0.24 (95% C.I.: 0.23-0.25). Our estimates show that prediction R-sq. increases with sample size, reaching an estimated plateau at values that ranged from 0.1 to 0.37 for models using 500 and 50,000 (GWA-selected) SNPs, respectively. Soon much larger data sets will become available. Using the estimated surface response, we forecast that larger sample sizes will lead to further improvements in prediction R-sq. We conclude that big data will lead to a substantial reduction of the gap between trait heritability and the proportion of interindividual differences that can be explained with a genomic predictor. However, even with the power of big data, for complex traits we anticipate that the gap between prediction R-sq. and trait heritability will not be fully closed. Copyright © 2017 by the Genetics Society of America.

  15. A and B Theories of Closed Time

    Directory of Open Access Journals (Sweden)

    Phill Dowe

    Full Text Available ABSTRACT Closed time is possible in several senses of ‘possible’. One might like to know, therefore, whether closed time is possible in the sense that it is compatible with standard metaphysical theories of time. In this paper I am concerned with whether closed time is compatible with A and/or B theories of time. A common enough view amongst philosophers is that B theories do but A theories do not allow closed time. However, I show that prima-facie neither approach allows closed time, but that with a little work standard versions of both approaches do. This shows that there’s no special problem with the notion of eternal return.

  16. [POKING REDUCTION TREATMENT OF DISPLACED SCAPULAR NECK FRACTURE WITH SHOULDER ARTHROSCOPY-ASSISTED SURGERY].

    Science.gov (United States)

    Qu, Feng; Yuan, Bangtuo; Qi, Wei; Wang, Junliang; Shen, Xuezhen; Wang, Jiangtao; Zhao, Gang; Liu, Yujie

    2014-07-01

    To discuss the effectiveness of Poking reduction with shoulder arthroscopy-assisted surgery for displaced scapular neck fracture. Between January 2009 and January 2012, 9 cases of displaced scapular neck fracture underwent shoulder arthroscopy-assisted surgery for Poking reduction treatment. Of 9 cases, 6 were men, and 3 were women, aged 21-54 years (mean, 39 years). The causes were traffic accident injury in 7 cases, falling injury from height in 1 case, and hurt injury in 1 case. The shoulder abduction, flexion, and external rotation were obviously limited. X-ray films showed all cases had obvious displaced scapular neck fracture. Three-dimensional reconstruction of CT showed a grossly displaced of fracture. The time of injury to surgery was 4-27 days (mean, 11 days). Patients obtained healing of incision by first intension, without infection, neurovascular injury, or other surgery-related complications. All patients were followed up 19- 31 months (mean, 23 months). X-ray films showed scapular neck fractures healed from 7 to 11 weeks (mean, 8 weeks). At last follow-up, the shoulder abduction, flexion, and external rotation activity were improved significantly when compared with ones at preoperation (P shoulder Constant score, American Shoulder and Elbow Surgenos (ASES) score, and Rowe score were significantly better than preoperative scores (P shoulder stability and reduce complications.

  17. Effect of preinfarction angina pectoris on long-term survival in patients with ST-segment elevation myocardial infarction who underwent primary percutaneous coronary intervention.

    Science.gov (United States)

    Taniguchi, Tomohiko; Shiomi, Hiroki; Toyota, Toshiaki; Morimoto, Takeshi; Akao, Masaharu; Nakatsuma, Kenji; Ono, Koh; Makiyama, Takeru; Shizuta, Satoshi; Furukawa, Yutaka; Nakagawa, Yoshihisa; Ando, Kenji; Kadota, Kazushige; Horie, Minoru; Kimura, Takeshi

    2014-10-15

    The influence of preinfarction angina pectoris (AP) on long-term clinical outcomes in patients with ST-segment elevation myocardial infarction (STEMI) who underwent primary percutaneous coronary intervention (PCI) remains controversial. In 5,429 patients with acute myocardial infarction (AMI) enrolled in the Coronary Revascularization Demonstrating Outcome Study in Kyoto AMI Registry, the present study population consisted of 3,476 patients with STEMI who underwent primary PCI within 24 hours of symptom onset and in whom the data on preinfarction AP were available. Preinfarction AP defined as AP occurring within 48 hours of hospital arrival was present in 675 patients (19.4%). Patients with preinfarction AP was younger and more often had anterior AMI and longer total ischemic time, whereas they less often had history of heart failure, atrial fibrillation, and shock presentation. The infarct size estimated by peak creatinine phosphokinase was significantly smaller in patients with than in patients without preinfarction AP (median [interquartile range] 2,141 [965 to 3,867] IU/L vs 2,462 [1,257 to 4,495] IU/L, p <0.001). The cumulative 5-year incidence of death was significantly lower in patients with preinfarction AP (12.4% vs 20.7%, p <0.001) with median follow-up interval of 1,845 days. After adjusting for confounders, preinfarction AP was independently associated with a lower risk for death (hazard ratio 0.69, 95% confidence interval 0.54 to 0.86, p = 0.001). The lower risk for 5-year mortality in patients with preinfarction AP was consistently observed across subgroups stratified by total ischemic time, initial Thrombolysis In Myocardial Infarction flow grade, hemodynamic status, infarct location, and diabetes mellitus. In conclusion, preinfarction AP was independently associated with lower 5-year mortality in patients with STEMI who underwent primary PCI. Copyright © 2014 Elsevier Inc. All rights reserved.

  18. 76 FR 76449 - Post Office Closing

    Science.gov (United States)

    2011-12-07

    ... the closing of the Spring Dale, West Virginia post office has been filed. It identifies preliminary... Postal Service's determination to close the Spring Dale post office in Spring Dale, West Virginia. The...

  19. Favorable Outcome with Close Margins in Patients Undergoing Nipple/Skin Sparing Mastectomy with Immediate Breast Reconstruction: 5-year Follow-up

    Directory of Open Access Journals (Sweden)

    Enver Özkurt1

    2018-02-01

    Full Text Available Background: Implant-based breast reconstruction after mastectomy has recently been reported to be the preferred type of surgery among breast-specific surgeons and plastic surgeons. Aims: To explore the significant clinicopathological factors associated with long-term outcome related to local recurrences of the nipple among patients who underwent immediate breast reconstruction with tissue expander or implant after mastectomy. Study Design: Retrospective cohort. Methods: From January 2007 to January 2013, 51 breast cancer patients who underwent immediate breast reconstruction with tissue expander or implant were retrospectively analysed. Patients’ demographic data, clinicopathological characteristics, and clinical outcome by disease-free survival and disease-specific survival analyses were determined. Results: The median follow-up was 64 (31-114 months. Of the 57 mastectomies, 41 were skin sparing mastectomy (72% and 16 were nipple-areola sparing mastectomy (28%. Immediate breast reconstruction surgery included tissue expander (n=46, 81% or implant (n=11, 19% placement. The molecular subgroups of 47 invasive cancers were as follows: luminal A (n=23, 49%, luminal B (n=16, 34%, non-luminal HER2 (n=5, 10.6, triple negative breast cancer (n=3, 6.4%. The 5-years disease-specific survival, disease-free survival, and locoregional recurrence-free survival rates were 96.8%, 90%, and 97.6% respectively. Patients with luminal A cancer were found to have an improved 5-year disease-free survival time than other (luminal A; 100% vs. non-luminal A; 78%; p=0.028. Of the 14 nipple-areola sparing mastectomy, 13 had a close median tumour distance to nipple-areola complex (<20 mm with a 5-year locoregional recurrence free survival of 100%. Conclusion: Immediate breast reconstruction with implant or tissue expander can be safely applied in patients undergoing skin sparing mastectomy or nipple-areola sparing mastectomy. Patients with luminal-A type show the most

  20. Design Principles for Closed Loop Supply Chains

    NARCIS (Netherlands)

    H.R. Krikke (Harold); C.P. Pappis (Costas); G.T. Tsoulfas; J.M. Bloemhof-Ruwaard (Jacqueline)

    2001-01-01

    textabstractIn this paper we study design principles for closed loop supply chains. Closed loop supply chains aim at closing material flows thereby limiting emission and residual waste, but also providing customer service at low cost. We study 'traditional' and 'new' design principles known in the

  1. Low total cortisol correlates closely with low free cortisol in traumatic brain injury and predicts mortality and long-term hypopituitarism

    LENUS (Irish Health Repository)

    Hannon, M J

    2011-06-01

    Published data has demonstrated that low 0900h plasma total cortisol (PTC) in the acute phase following traumatic brain injury (TBI) predicts mortality. However, there is concern regarding the use of PTC to evaluate the pituitary-adrenal axis in acutely unwell patients due to potential discrepancies between PTC and plasma free cortisol (PFC) due to variations in corticosteroid binding globulin (CBG). We hypothesised that low PTC would correlate closely with PFC and would predict mortality and long-term hypopituitarism.100 patients (84 men, median age 33, range 18-75) were recruited on admission with TBI (mean GCS+\\/-SD = 8.59+\\/-4.2). Each patient had PTC and CBG measured on days 1, 3, 5, 7, and 10 following TBI. Results were compared with 15 patients admitted to ITU following vascular surgery. A PTC <300nmol\\/L in a patient in ITU was regarded clinically as inappropriately low. PFC was calculated for 25% of TBI samples and all control samples using Coolen\\'s equation (1). TBI patients reattended for dynamic pituitary testing >6 months after TBI.All controls had PTC >500 nmol\\/L on day 1, and >300 nmol on days 3–10. By contrast, 78\\/100 TBI patients had at least one PTC <300 nmol\\/L.TBI patients in the lowest quartile of final PTC measurement had the highest mortality (p=0.0187). PTC correlated closely with PFC in both TBI patients (r=0.99, p<0.0001) and controls (r=0.99, p<0.0001). 32\\/79 (40.5%) of TBI survivors attended for dynamic pituitary testing. The median time to dynamic pituitary testing was 14 months (range 6–24 months). 15\\/32 (46.9%) underwent insulin tolerance testing, 9\\/32 (28.1%) underwent glucagon testing and 8\\/32 (25%) underwent short synacthen testing. 6\\/32 (18.8%) were ACTH deficient, of whom 5\\/6 (83.3%) previously had low PTC. 6\\/32 were GH deficient, all of whom previously had low PTC. One patient was gonadotropin deficient; he previously had low PTC. No patients were TSH or prolactin deficient. Overall, 12\\/32 (37

  2. Uranium tetrafluoride reduction closed bomb. Part I: Reduction process general conditions; Reduccion del tetrafluoruro de uranio en bomba cerrada. Part I. estudio de las variables generales del proceso de reduccion

    Energy Technology Data Exchange (ETDEWEB)

    Anca Abati, R; Lopez Rodriguez, M

    1961-07-01

    General conditions about the metallo thermic reduction in small bombs (250 and 800 gr. of uranium) has been investigated. Factors such as kind and granulometry of the magnesium used, magnesium excess and preheating temperature, which affect yields and metal quality have been considered. magnesium excess increased yields in a 15% in the small bomb, about the preheating temperature, there is a range between which yields and metal quality does not change. All tests have been made with graphite linings. (Author) 18 refs.

  3. Microbial reductive dehalogenation.

    Science.gov (United States)

    Mohn, W W; Tiedje, J M

    1992-01-01

    A wide variety of compounds can be biodegraded via reductive removal of halogen substituents. This process can degrade toxic pollutants, some of which are not known to be biodegraded by any other means. Reductive dehalogenation of aromatic compounds has been found primarily in undefined, syntrophic anaerobic communities. We discuss ecological and physiological principles which appear to be important in these communities and evaluate how widely applicable these principles are. Anaerobic communities that catalyze reductive dehalogenation appear to differ in many respects. A large number of pure cultures which catalyze reductive dehalogenation of aliphatic compounds are known, in contrast to only a few organisms which catalyze reductive dehalogenation of aromatic compounds. Desulfomonile tiedjei DCB-1 is an anaerobe which dehalogenates aromatic compounds and is physiologically and morphologically unusual in a number of respects, including the ability to exploit reductive dehalogenation for energy metabolism. When possible, we use D. tiedjei as a model to understand dehalogenating organisms in the above-mentioned undefined systems. Aerobes use reductive dehalogenation for substrates which are resistant to known mechanisms of oxidative attack. Reductive dehalogenation, especially of aliphatic compounds, has recently been found in cell-free systems. These systems give us an insight into how and why microorganisms catalyze this activity. In some cases transition metal complexes serve as catalysts, whereas in other cases, particularly with aromatic substrates, the catalysts appear to be enzymes. Images PMID:1406492

  4. Enema reduction of intussusception: the success rate of hydrostatic and pneumatic reduction.

    Science.gov (United States)

    Khorana, Jiraporn; Singhavejsakul, Jesda; Ukarapol, Nuthapong; Laohapensang, Mongkol; Wakhanrittee, Junsujee; Patumanond, Jayanton

    2015-01-01

    Intussusception is a common surgical emergency in infants and children. The incidence of intussusception is from one to four per 2,000 infants and children. If there is no peritonitis, perforation sign on abdominal radiographic studies, and nonresponsive shock, nonoperative reduction by pneumatic or hydrostatic enema can be performed. The purpose of this study was to compare the success rates of both the methods. Two institutional retrospective cohort studies were performed. All intussusception patients (ICD-10 code K56.1) who had visited Chiang Mai University Hospital and Siriraj Hospital from January 2006 to December 2012 were included in the study. The data were obtained by chart reviews and electronic databases, which included demographic data, symptoms, signs, and investigations. The patients were grouped according to the method of reduction followed into pneumatic reduction and hydrostatic reduction groups with the outcome being the success of the reduction technique. One hundred and seventy episodes of intussusception occurring in the patients of Chiang Mai University Hospital and Siriraj Hospital were included in this study. The success rate of pneumatic reduction was 61% and that of hydrostatic reduction was 44% (P=0.036). Multivariable analysis and adjusting of the factors by propensity scores were performed; the success rate of pneumatic reduction was 1.48 times more than that of hydrostatic reduction (P=0.036, 95% confidence interval [CI] =1.03-2.13). Both pneumatic and hydrostatic reduction can be performed safely according to the experience of the radiologist or pediatric surgeon and hospital setting. This study showed that pneumatic reduction had a higher success rate than hydrostatic reduction.

  5. Synthesis of trans-disubstituted alkenes by cobalt-catalyzed reductive coupling of terminal alkynes with activated alkenes.

    Science.gov (United States)

    Mannathan, Subramaniyan; Cheng, Chien-Hong

    2012-09-10

    A cobalt-catalyzed reductive coupling of terminal alkynes, RC≡CH, with activated alkenes, R'CH=CH(2), in the presence of zinc and water to give functionalized trans-disubstituted alkenes, RCH=CHCH(2)CH(2)R', is described. A variety of aromatic terminal alkynes underwent reductive coupling with activated alkenes including enones, acrylates, acrylonitrile, and vinyl sulfones in the presence of a CoCl(2)/P(OMe)(3)/Zn catalyst system to afford 1,2-trans-disubstituted alkenes with high regio- and stereoselectivity. Similarly, aliphatic terminal alkynes also efficiently participated in the coupling reaction with acrylates, enones, and vinyl sulfone, in the presence of the CoCl(2)/P(OPh)(3)/Zn system providing a mixture of 1,2-trans- and 1,1-disubstituted functionalized terminal alkene products in high yields. The scope of the reaction was also extended by the coupling of 1,3-enynes and acetylene gas with alkenes. Furthermore, a phosphine-free cobalt-catalyzed reductive coupling of terminal alkynes with enones, affording 1,2-trans-disubstituted alkenes as the major products in a high regioisomeric ratio, is demonstrated. In the reactions, less expensive and air-stable cobalt complexes, a mild reducing agent (Zn) and a simple hydrogen source (water) were used. A possible reaction mechanism involving a cobaltacyclopentene as the key intermediate is proposed. Copyright © 2012 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  6. Enhanced electrocatalytic CO2 reduction via field-induced reagent concentration

    Science.gov (United States)

    Liu, Min; Pang, Yuanjie; Zhang, Bo; de Luna, Phil; Voznyy, Oleksandr; Xu, Jixian; Zheng, Xueli; Dinh, Cao Thang; Fan, Fengjia; Cao, Changhong; de Arquer, F. Pelayo García; Safaei, Tina Saberi; Mepham, Adam; Klinkova, Anna; Kumacheva, Eugenia; Filleter, Tobin; Sinton, David; Kelley, Shana O.; Sargent, Edward H.

    2016-09-01

    Electrochemical reduction of carbon dioxide (CO2) to carbon monoxide (CO) is the first step in the synthesis of more complex carbon-based fuels and feedstocks using renewable electricity. Unfortunately, the reaction suffers from slow kinetics owing to the low local concentration of CO2 surrounding typical CO2 reduction reaction catalysts. Alkali metal cations are known to overcome this limitation through non-covalent interactions with adsorbed reagent species, but the effect is restricted by the solubility of relevant salts. Large applied electrode potentials can also enhance CO2 adsorption, but this comes at the cost of increased hydrogen (H2) evolution. Here we report that nanostructured electrodes produce, at low applied overpotentials, local high electric fields that concentrate electrolyte cations, which in turn leads to a high local concentration of CO2 close to the active CO2 reduction reaction surface. Simulations reveal tenfold higher electric fields associated with metallic nanometre-sized tips compared to quasi-planar electrode regions, and measurements using gold nanoneedles confirm a field-induced reagent concentration that enables the CO2 reduction reaction to proceed with a geometric current density for CO of 22 milliamperes per square centimetre at -0.35 volts (overpotential of 0.24 volts). This performance surpasses by an order of magnitude the performance of the best gold nanorods, nanoparticles and oxide-derived noble metal catalysts. Similarly designed palladium nanoneedle electrocatalysts produce formate with a Faradaic efficiency of more than 90 per cent and an unprecedented geometric current density for formate of 10 milliamperes per square centimetre at -0.2 volts, demonstrating the wider applicability of the field-induced reagent concentration concept.

  7. Feasibility of Performing Total Skin-Sparing Mastectomy in Patients With Prior Circumareolar Mastopexy or Reduction Mammoplasty Incisions.

    Science.gov (United States)

    Vaughn, Carolyn J; Peled, Anne Warren; Esserman, Laura J; Foster, Robert D

    2013-06-19

    Total skin-sparing mastectomy (TSSM) techniques with preservation of the nipple-areolar complex (NAC) skin are becoming increasingly popular due to improved cosmesis without compromise in oncologic safety. However, these techniques are not routinely offered to patients who have undergone previous breast surgery involving circumareolar incisions due to concern for NAC viability. We reviewed the outcomes of TSSM in 11 patients who underwent 21 TSSM procedures at our institution between 2008 and 2011. All patients had undergone previous breast surgery including reduction mammaplasty (7 breasts), mastopexy (4 breasts), augmentation (3 breasts), and combined mastopexy-augmentation (7 breasts). Incisions from previous breast surgery included circumareolar (11 cases) and Wise pattern (10 cases) incisions. All patients underwent TSSM through an inframammary incision followed by immediate tissue expander reconstruction and subsequent implant exchange. Patient demographics, previous breast surgery details, tumor and treatment characteristics, and postoperative complications were reviewed. Mean patient age was 43 years (range, 35-53 years) and mean body mass index was 24 kg/m (range, 19-32 kg/m). Mean follow-up was 10.2 months (range, 3-20 months).Indications for TSSM included prophylactic risk reduction in 10 cases, in situ cancer in 2 cases, and invasive cancer in 9 cases. Mean time from previous breast surgery to mastectomy was 6.9 years (range, 6 months-26 years). Major complications requiring operative reintervention included 1 (4.8%) case of cellulitis requiring expander removal and 2 (9.5%) cases of wound breakdown requiring operative closure. There were no complications involving the NAC. Total skin-sparing mastectomy with immediate reconstruction can safely be performed in patients who have undergone previous breast surgery involving circumareolar incisions. Our preferred technique in this group of patients is to perform TSSM through an inframammary incision with 2

  8. Effect of intracapsular steroid injection in combination with arthrocentesis followed by mouth opening exercises and nonsteroidal anti-inflammatory drug treatment for closed lock

    International Nuclear Information System (INIS)

    Wakita, Takeshi; Kurita, Kenichi; Nakatsuka, Kensuke

    2010-01-01

    Recent biochemical studies of synovial fluids indicate that temporomandibular joint (TMJ) symptoms are caused by intra-articular inflammation. There are various ways to manage such disorders. Arthrocentesis is one effective treatment for closed lock. The aim of this study was to evaluate the efficacy of arthrocentesis (steroid injection) followed by mouth opening exercises during non-steroidal anti-inflammatory drug (NSAID) therapy as a primary treatment for closed lock. The ultimate goal was to increase the improvement rate and the number of patients with no TMJ dysfunction. Subjects were selected from a series of patients with newly diagnosed closed lock who presented at Aichi-Gakuin University Hospital between January 2003 and December 2004. Sixty-two patients were confirmed to have closed lock with MRI. The patients underwent two consecutive sessions of arthrocentesis at a 2 week interval and were followed up every 2 weeks for 12 weeks. NSAID administration and mouth opening exercises were performed daily until the patient's symptoms improved. The improvement rate was calculated as the percentage of improved cases among the total number of cases in each group. The improvement rates were 27%, 43%, 56%, 62%, 65%, and 71% after 2, 4, 6, 8, 10, and 12 weeks, respectively. Improvement to a TMJ classification of no dysfunction was achieved in 11% of the patients. This combination therapy (steroid injection) is an effective primary treatment because the improvement rate was as higher as 71%, and 11% of all patients had improved to a TMJ classification of no dysfunction. (author)

  9. Comparative Effectiveness of Emergency Resuscitative Thoracotomy versus Closed Chest Compressions among Patients with Critical Blunt Trauma: A Nationwide Cohort Study in Japan.

    Directory of Open Access Journals (Sweden)

    Kodai Suzuki

    Full Text Available Although emergency resuscitative thoracotomy is performed as a salvage maneuver for critical blunt trauma patients, evidence supporting superior effectiveness of emergency resuscitative thoracotomy compared to conventional closed-chest compressions remains insufficient. The objective of this study was to investigate whether emergency resuscitative thoracotomy at the emergency department or in the operating room was associated with favourable outcomes after blunt trauma and to compare its effectiveness with that of closed-chest compressions.This was a retrospective nationwide cohort study. Data were obtained from the Japan Trauma Data Bank for the period between 2004 and 2012. The primary and secondary outcomes were patient survival rates 24 h and 28 d after emergency department arrival. Statistical analyses were performed using multivariable generalized mixed-effects regression analysis. We adjusted for the effects of different hospitals by introducing random intercepts in regression analysis to account for the differential quality of emergency resuscitative thoracotomy at hospitals where patients in cardiac arrest were treated. Sensitivity analyses were performed using propensity score matching.In total, 1,377 consecutive, critical blunt trauma patients who received cardiopulmonary resuscitation in the emergency department or operating room were included in the study. Of these patients, 484 (35.1% underwent emergency resuscitative thoracotomy and 893 (64.9% received closed-chest compressions. Compared to closed-chest compressions, emergency resuscitative thoracotomy was associated with lower survival rate 24 h after emergency department arrival (4.5% vs. 17.5%, respectively, P < 0.001 and 28 d after arrival (1.2% vs. 6.0%, respectively, P < 0.001. Multivariable generalized mixed-effects regression analysis with and without a propensity score-matched dataset revealed that the odds ratio for an unfavorable survival rate after 24 h was lower for

  10. Antioxidant-capacity-based models for the prediction of acrylamide reduction by flavonoids.

    Science.gov (United States)

    Cheng, Jun; Chen, Xinyu; Zhao, Sheng; Zhang, Yu

    2015-02-01

    The aim of this study was to investigate the applicability of artificial neural network (ANN) and multiple linear regression (MLR) models for the estimation of acrylamide reduction by flavonoids, using multiple antioxidant capacities of Maillard reaction products as variables via a microwave food processing workstation. The addition of selected flavonoids could effectively reduce acrylamide formation, which may be closely related to the number of phenolic hydroxyl groups of flavonoids (R: 0.735-0.951, Pcapacity (ΔTEAC) measured by DPPH (R(2)=0.833), ABTS (R(2)=0.860) or FRAP (R(2)=0.824) assay. Both ANN and MLR models could effectively serve as predictive tools for estimating the reduction of acrylamide affected by flavonoids. The current predictive model study provides a low-cost and easy-to-use approach to the estimation of rates at which acrylamide is degraded, while avoiding tedious sample pretreatment procedures and advanced instrumental analysis. Copyright © 2014 Elsevier Ltd. All rights reserved.

  11. Principal Components as a Data Reduction and Noise Reduction Technique

    Science.gov (United States)

    Imhoff, M. L.; Campbell, W. J.

    1982-01-01

    The potential of principal components as a pipeline data reduction technique for thematic mapper data was assessed and principal components analysis and its transformation as a noise reduction technique was examined. Two primary factors were considered: (1) how might data reduction and noise reduction using the principal components transformation affect the extraction of accurate spectral classifications; and (2) what are the real savings in terms of computer processing and storage costs of using reduced data over the full 7-band TM complement. An area in central Pennsylvania was chosen for a study area. The image data for the project were collected using the Earth Resources Laboratory's thematic mapper simulator (TMS) instrument.

  12. Melatonin Does Not Affect Oxidative/Inflammatory Biomarkers in a Closed-Chest Porcine Model of Acute Myocardial Infarction

    DEFF Research Database (Denmark)

    Halladin, Natalie L.; Ekelof, Sarah; Jensen, Svend Eggert

    2014-01-01

    Aim: To test whether melatonin reduces oxidative and inflammatory biomarkers in a closed-chest porcine model of acute myocardial infarction. Materials and Methods: Twenty pigs were randomized to receive a total dosage of 200 mg (0.4 mg/ml) of melatonin, or placebo immediately prior to reperfusion....... There was an increase in hs-TnT, but no significant difference between the melatonin-treated and placebo-treated groups. There were no significant differences in development of any of the circulating plasma markers between the two groups. Conclusion: Melatonin treatment did not result in reduction of inflammatory...

  13. Compressive sensing for feedback reduction in MIMO broadcast channels

    KAUST Repository

    Eltayeb, Mohammed E.

    2014-09-01

    In multi-antenna broadcast networks, the base stations (BSs) rely on the channel state information (CSI) of the users to perform user scheduling and downlink transmission. However, in networks with large number of users, obtaining CSI from all users is arduous, if not impossible, in practice. This paper proposes channel feedback reduction techniques based on the theory of compressive sensing (CS), which permits the BS to obtain CSI with acceptable recovery guarantees under substantially reduced feedback overhead. Additionally, assuming noisy CS measurements at the BS, inexpensive ways for improving post-CS detection are explored. The proposed techniques are shown to reduce the feedback overhead, improve CS detection at the BS, and achieve a sum-rate close to that obtained by noiseless dedicated feedback channels.

  14. On integrable c < 1 open-closed string theory

    International Nuclear Information System (INIS)

    Johnson, C.V.

    1994-01-01

    The integrable structure of open-closed string theories in the (p, q) conformal minimal model backgrounds is presented. The relation between the τ-function of the closed string theory and that of the open-closed string theory is uncovered. The resulting description of the open-closed string theory is shown to fit very naturally into the framework of the sl(q, C) KdV hierarchies. In particular, the twisted bosons which underlie and organise the structure of the closed string theory play a similar role here and may be employed to derive loop equations and correlation function recursion relations for the open-closed strings in a simple way. (orig.)

  15. 7 CFR 1927.54 - Requirements for closing agents.

    Science.gov (United States)

    2010-01-01

    ... closing agent and close agency real estate loans, provide necessary title clearance, and perform such... PROGRAM REGULATIONS TITLE CLEARANCE AND LOAN CLOSING Real Estate Title Clearance and Loan Closing § 1927... practice law in the state where the real estate security is located and who complies with the bonding and...

  16. 40 CFR 73.38 - Closing of accounts.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 16 2010-07-01 2010-07-01 false Closing of accounts. 73.38 Section 73...) SULFUR DIOXIDE ALLOWANCE SYSTEM Allowance Tracking System § 73.38 Closing of accounts. (a) General... close the general account by submitting an allowance transfer, pursuant to § 73.50 and § 73.52...

  17. Modified APHA closed-tube reflux colorimetric method for TOC determination in water and wastewater.

    Science.gov (United States)

    Salihu, Simon Olonkwoh; Bakar, Nor Kartini Abu

    2018-05-30

    The analysis of total organic carbon (TOC) by the American Public Health Association (APHA) closed-tube reflux colorimetric method requires potassium dichromate (K 2 Cr 2 O 7 ), silver sulfate (AgSO 4 ), and mercury (HgSO 4 ) sulfate in addition to large volumes of both reagents and samples. The method relies on the release of oxygen from dichromate on heating which is consumed by carbon associated with organic compounds. The method risks environmental pollution by discharging large amounts of chromium (VI) and silver and mercury sulfates. The present method used potassium monochromate (K 2 CrO 4 ) to generate the K 2 Cr 2 O 7 on demand in the first phase. In addition, miniaturizing the procedure to semi microanalysis decreased the consumption of reagents and samples. In the second phase, mercury sulfate was eliminated as part of the digestion mixture through the introduction of sodium bismuthate (NaBiO 3 ) for the removal of chlorides from the sample. The modified method, the potassium monochromate closed-tube colorimetry with sodium bismuthate chloride removal (KMCC-Bi), generates the potassium dichromate on demand and eliminates mercury sulfate. The semi microanalysis procedure leads to a 60% reduction in sample volume and ≈ 33.33 and 60% reduction in monochromate and silver sulfate consumption respectively. The LOD and LOQ were 10.17 and 33.90 mg L -1 for APHA, and 4.95 and 16.95 mg L -1 for KMCC-Bi. Recovery was between 83 to 98% APHA and 92 to 104% KMCC-Bi, while the RSD (%) ranged between 0.8 to 5.0% APHA and 0.00 to 0.62% KMCC-Bi. The method was applied for the UV-Vis spectrometry determination of COD in water and wastewater. Statistics was done by MINITAB 17 or MS Excel 2016. ᅟ Graphical abstract.

  18. Reduction in language testing

    DEFF Research Database (Denmark)

    Dimova, Slobodanka; Jensen, Christian

    2013-01-01

    /video recorded speech samples and written reports produced by two experienced raters after testing. Our findings suggest that reduction or reduction-like pronunciation features are found in tested L2 speech, but whenever raters identify and comment on such reductions, they tend to assess reductions negatively......This study represents an initial exploration of raters' comments and actual realisations of form reductions in L2 test speech performances. Performances of three L2 speakers were selected as case studies and illustrations of how reductions are evaluated by the raters. The analysis is based on audio...

  19. Gender-linked impact of epicardial adipose tissue volume in patients who underwent coronary artery bypass graft surgery or non-coronary valve surgery

    OpenAIRE

    Maimaituxun, Gulinu; Shimabukuro, Michio; Salim, Hotimah Masdan; Tabata, Minoru; Yuji, Daisuke; Morimoto, Yoshihisa; Akasaka, Takeshi; Matsuura, Tomomi; Yagi, Shusuke; Fukuda, Daiju; Yamada, Hirotsugu; Soeki, Takeshi; Sugimoto, Takaki; Tanaka, Masashi; Takanashi, Shuichiro

    2017-01-01

    Background Traditional and non-traditional risk factors for atherosclerotic cardiovascular disease (ASCVD) are different between men and women. Gender-linked impact of epicardial adipose tissue volume (EATV) in patients undergoing coronary artery bypass grafting (CABG) remains unknown. Methods Gender-linked impact of EATV, abdominal fat distribution and other traditional ASCVD risk factors were compared in 172 patients (men: 115; women: 57) who underwent CABG or non-coronary valvular surgery ...

  20. Process energy reduction

    International Nuclear Information System (INIS)

    Lowthian, W.E.

    1993-01-01

    Process Energy Reduction (PER) is a demand-side energy reduction approach which complements and often supplants other traditional energy reduction methods such as conservation and heat recovery. Because the application of PER is less obvious than the traditional methods, it takes some time to learn the steps as well as practice to become proficient in its use. However, the benefit is significant, often far outweighing the traditional energy reduction approaches. Furthermore, the method usually results in a better process having less waste and pollution along with improved yields, increased capacity, and lower operating costs

  1. The Comparison of Intrathecal Morphine and IV Morphine PCA on Pain Control, Patient Satisfaction, Morphine Consumption, and Adverse Effects in Patients Undergoing Reduction Mammoplasty.

    Science.gov (United States)

    Karamese, Mehtap; Akdağ, Osman; Kara, İnci; Yıldıran, Gokce Unal; Tosun, Zekeriya

    2015-01-01

    Following breast reduction procedures, the level of postoperative pain can be severe, and sufficient pain control influences a patient's physiological, immunological, and psychological status. The aim of this study was to examine the use of intrathecal morphine (ITM) in breast reduction surgery with patient-controlled analgesia (PCA). Sixty-two female patients who underwent breast reductions with the same technique participated in this study. The study group (ITM + PCA) included 32 patients; a single shot (0.2 mg) of ITM and intravenous morphine with PCA were administered. In the control group, morphine PCA alone was intravenously administered to 30 patients. Comparisons between the groups of cumulative morphine consumption, visual analog scale scores, and patient satisfaction scores, which were the primary outcome measures, and adverse effects, which were the secondary outcome measures, were conducted. The patients in the 2 groups had similar degrees of pain and satisfaction scores. The study group had lower cumulative morphine consumption (P = .001) than the PCA-only control group; there was no statistically significant difference in adverse effects between the 2 groups. Intrathecal morphine may effectively control pain with lower total morphine consumption following breast reduction surgery.

  2. Use of intra-medullary stacked nailing in the reduction of proximal plastic deformity in a pediatric Monteggia fracture: a case report

    Directory of Open Access Journals (Sweden)

    Huntley James S

    2011-04-01

    Full Text Available Abstract Introduction In a Monteggia fracture dislocation, it is important to reduce the ulnar fracture completely. Extensive plastic deformation of the proximal ulna may make reduction by closed manipulation impossible. Case presentation We report the case of a four-year-old Caucasian boy in whom the plastic deformation of the proximal ulna was reduced, and this reduction was maintained, using intra-medullary stacked nailing. Conclusion The technique of stacked nailing is a useful addition to the armamentarium in the management of the potentially awkward Monteggia fracture.

  3. Molecular-state close-coupling theory including continuum states. I. Derivation of close-coupled equations

    International Nuclear Information System (INIS)

    Thorson, W.R.; Bandarage, G.

    1988-01-01

    We formulate a close-coupling theory of slow ion-atom collisions based on molecular (adiabatic) electronic states, and including the electronic continuum. The continuum is represented by packet states spanning it locally and constructed explicitly from exact continuum states. Particular attention is given to two fundamental questions: (1) Unbound electrons can escape from the local region spanned by the packet states. We derive close-coupled integral equations correctly including the escape effects; the ''propagator'' generated by these integral equations does not conserve probability within the close-coupled basis. Previous molecular-state formulations including the continuum give no account of escape effects. (2) Nonadiabatic couplings of adiabatic continuum states with the same energy are singular, reflecting the fact that an adiabatic description of continuum behavior is not valid outside a local region. We treat these singularities explicitly and show that an accurate representation of nonadiabatic couplings within the local region spanned by a set of packet states is well behaved. Hence an adiabatic basis-set description can be used to describe close coupling to the continuum in a local ''interaction region,'' provided the effects of escape are included. In principle, the formulation developed here can be extended to a large class of model problems involving many-electron systems and including models for Penning ionization and collisional detachment processes

  4. Simultaneous requirement of carbon dioxide and abscisic acid for stomatal closing in Xanthium strumarium L.

    Science.gov (United States)

    Raschke, K

    1975-01-01

    Open stomata of detached leaves of Xanthium strumarium L. closed only when carbon dioxide and abscisic acid (ABA) were presented simultaneously. Three parameters of stomatal closing were determined after additions of ABA to the irrigation water of detached leaves, while the leaves were exposed to various CO2 concentrations ([CO2]s) in the air; a) the delay between addition of ABA and a reduction of stomatal conductance by 5%, b) the velocity of stomatal closing, and c) the new conductance. Changes in all three parameters showed that stomatal responses to ABA were enhanced by CO2; this effect followed saturation kinetics. Half saturation occurred at an estimated [CO2] in the stomatal pore of 200 μl l(-1). With respect to ABA, stomata responded in normal air with half their maximal amplitude at [ABA]s between 10(-6) and 10(-5) M(+-)-ABA. The amounts of ABA taken up by the leaves during the delay increased with a power strumarium.Based on earlier findings and on the results of this investigation it is suggested that stomata close if the cytoplasm of the guard cells contains much malate and H(+). The acid content in turn is determined by the relative rates of production of malic acid (from endogenous as well as exogenous CO2) and its removal (by transport of the anion into the vacuole and exchange of the H(+) for K(+) with the environment of the guard cells). The simultaneous requirement of CO2 and ABA for stomatal closure leads to the inference that ABA inhibits the expulsion of H(+) from guard cells.

  5. Open reduction and internal fixation versus casting for highly comminuted and intra-articular fractures of the distal radius (ORCHID): protocol for a randomized clinical multi-center trial.

    Science.gov (United States)

    Bartl, Christoph; Stengel, Dirk; Bruckner, Thomas; Rossion, Inga; Luntz, Steffen; Seiler, Christoph; Gebhard, Florian

    2011-03-22

    Fractures of the distal radius represent the most common fracture in elderly patients, and often indicate the onset of symptomatic osteoporosis. A variety of treatment options is available, including closed reduction and plaster casting, K-wire-stabilization, external fixation and open reduction and internal fixation (ORIF) with volar locked plating. The latter is widely promoted by clinicians and hardware manufacturers. Closed reduction and cast stabilization for six weeks is a simple, convenient, and ubiquitously available intervention. In contrast, ORIF requires hospitalization, but allows for functional rehabilitation.Given the lack of randomized controlled trials, it remains unclear whether ORIF leads to better functional outcomes one year after injury than closed reduction and casting. ORCHID (Open reduction and internal fixation versus casting for highly comminuted intra-articular fractures of the distal radius) is a pragmatic, randomized, multi-center, clinical trial with two parallel treatment arms. It is planned to include 504 patients in 15 participating centers throughout Germany over a three-year period. Patients are allocated by a central web-based randomization tool.The primary objective is to determine differences in the Short Form 36 (SF-36) Physical Component Score (PCS) between volar locked plating and closed reduction and casting of intraarticular, comminuted distal radius fractures in patients > 65 years of age one year after the fracture. Secondary outcomes include differences in other SF-36 dimensions, the EuroQol-5D questionnaire, the Disability of the Arm, Shoulder, and Hand (DASH) instrument. Also, the range of motion in the affected wrist, activities of daily living, complications (including secondary ORIF and revision surgery), as well as serious adverse events will be assessed. Data obtained during the trial will be used for later health-economic evaluations. The trial architecture involves a central statistical unit, an independent

  6. Catalytic reduction of NOx in gasoline engine exhaust over copper- and nickel-exchanged X-zeolite catalysts

    International Nuclear Information System (INIS)

    Bhattacharyya, S.; Das, R.K.

    2001-01-01

    Catalytic removal of NO x in engine exhaust gases can be accomplished by non-selective reduction, selective reduction and decomposition. Noble metals are extensively used for non-selective reduction of NO x and up to 90% of engine NO x emissions can be reduced in a stoichiometric exhaust. This requirement of having the stoichiometric fuel-air ratio acts against efficiency improvement of engines. Selective NO x reduction in the presence of different reductants such as, NH 3 , urea or hydrocarbons, requires close control of the amount of reductant being injected which otherwise may be emitted as a pollutant. Catalytic decomposition is the best option for NO x removal. Nevertheless, catalysts which are durable, economic and active for NO x reduction at normal engine exhaust temperature ranges are still being investigated. Three catalysts based on X-zeolite have been developed by exchanging the Na+ ion with copper, nickel and copper-nickel metal ions and applied to the exhaust of a stationary gasoline engine to explore their potential for catalytic reduction of NO x under a wide range of engine and exhaust conditions. Some encouraging results have been obtained. The catalyst Cu-X exhibits much better NO x reduction performance at any temperature in comparison to Cu-Ni-X and Ni-X; while Cu-Ni-X catalyst exhibits slightly better performance than Ni-X catalyst. Maximum NO x efficiency achieved with Cu-X catalyst is 59.2% at a space velocity (sv) of 31 000 h -1 ; while for Cu-Ni-X and Ni-X catalysts the equivalent numbers are 60.4% and 56% respectively at a sv of 22 000 h -1 . Unlike noble metals, the doped X-zeolite catalysts exhibit significant NO x reduction capability for a wide range of air/fuel ratio and with a slower rate of decline as well with increase in air/fuel ratio. (author)

  7. Air-Cooled Design of a Temperature-Swing Adsorption Compressor for Closed-Loop Air Revitalization Systems

    Science.gov (United States)

    Mulloth, Lila M.; Affleck, Dave L.; Rosen, Micha; LeVan, M. Douglas; Wang, Yuan; Cavalcante, Celio L.

    2004-01-01

    The air revitalization system of the International Space Station (ISS) operates in an open loop mode and relies on the resupply of oxygen and other consumables from earth for the life support of astronauts. A compressor is required for delivering the carbon dioxide from a removal assembly to a reduction unit to recover oxygen and thereby closing the air-loop. We have a developed a temperature-swing adsorption compressor (TSAC) for performing these tasks that is energy efficient, quiet, and has no rapidly moving parts. This paper discusses the mechanical design and the results of thermal model validation tests of a TSAC that uses air as the cooling medium.

  8. Bacillus Strains Most Closely Related to Bacillus nealsonii Are Not Effectively Circumscribed within the Taxonomic Species Definition

    Directory of Open Access Journals (Sweden)

    K. Kealy Peak

    2011-01-01

    Full Text Available Bacillus strains with >99.7% 16S rRNA gene sequence similarity were characterized with DNA:DNA hybridization, cellular fatty acid (CFA analysis, and testing of 100 phenotypic traits. When paired with the most closely related type strain, percent DNA:DNA similarities (% S for six Bacillus strains were all far below the recommended 70% threshold value for species circumscription with Bacillus nealsonii. An apparent genomic group of four Bacillus strain pairings with 94%–70% S was contradicted by the failure of the strains to cluster in CFA- and phenotype-based dendrograms as well as by their differentiation with 9–13 species level discriminators such as nitrate reduction, temperature range, and acid production from carbohydrates. The novel Bacillus strains were monophyletic and very closely related based on 16S rRNA gene sequence. Coherent genomic groups were not however supported by similarly organized phenotypic clusters. Therefore, the strains were not effectively circumscribed within the taxonomic species definition.

  9. Radiation dose reduction in paediatric coronary computed tomography: assessment of effective dose and image quality

    International Nuclear Information System (INIS)

    Habib Geryes, Bouchra; Calmon, Raphael; Boddaert, Nathalie; Khraiche, Diala; Bonnet, Damien; Raimondi, Francesca

    2016-01-01

    To assess the impact of different protocols on radiation dose and image quality for paediatric coronary computed tomography (cCT). From January-2012 to June-2014, 140 children who underwent cCT on a 64-slice scanner were included. Two consecutive changes in imaging protocols were performed: 1) the use of adaptive statistical iterative reconstruction (ASIR); 2) the optimization of acquisition parameters. Effective dose (ED) was calculated by conversion of the dose-length product. Image quality was assessed as excellent, good or with significant artefacts. Patients were divided in three age groups: 0-4, 5-7 and 8-18 years. The use of ASIR combined to the adjustment of scan settings allowed a reduction in the median ED of 58 %, 82 % and 85 % in 0-4, 5-7 and 8-18 years group, respectively (7.3 ± 1.4 vs 3.1 ± 0.7 mSv, 5.5 ± 1.6 vs 1 ± 1.9 mSv and 5.3 ± 5.0 vs 0.8 ± 2.0 mSv, all p < 0,05). Prospective protocol was used in 51 % of children. The reduction in radiation dose was not associated with reduction in diagnostic image quality as assessed by the frequency of coronary segments with excellent or good image quality (88 %). cCT can be obtained at very low radiation doses in children using ASIR, and prospective acquisition with optimized imaging parameters. (orig.)

  10. Evaluation of postoperative patient satisfaction after covering the nasal dorsum with upper lateral cartilage: "upper lateral closing".

    Science.gov (United States)

    Çağıcı, Can Alper

    2017-11-16

    Following nasal hump removal during septorhinoplasty, the middle vault should be reconstructed to avoid functional and esthetic problems. Middle vault reconstruction, however, may result in widening of the middle vault and may need a camouflage graft to cover dorsal irregularities. To present the results of reconstructing the middle vault with a technique that covers the nasal dorsum with upper lateral cartilage, from the viewpoint of patient satisfaction. Retrospective study of patients who underwent septorhinoplasty that included nasal dorsum closure with upper lateral cartilage from December 1, 2014 to January 31, 2016. Those with postoperative follow-up of less than 3 months were excluded. The final study group included 39 patients. The same surgeon performed all septorhinoplasties. The dorsum was closed using an "upper lateral closing" technique that approximated upper lateral cartilages to each other over the septum. Postoperative patient satisfaction was determined using a visual analog scale and the rhinoplasty outcomes evaluation questionnaire. The questionnaire evaluates patient esthetic and functional satisfaction with the operated nose. High scores indicate improved esthetic results. No dorsal irregularities were seen at postoperative follow-up evaluation of the patients. For esthetic nasal appearance, the median visual analogue scale scores was 86%, and the mean for the questionnaire was 77.03%. The natural dome-shaped anatomy of the nasal dorsum was achieved by approximating the upper lateral cartilages to each other. Closing the dorsum with this technique also covers any dorsal irregularities and results in a smooth dorsum. Patients expressed satisfaction with the esthetic and functional aspects of the smooth, attractive nasal dorsum. Copyright © 2017 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

  11. The Role of Nerve Exploration in Supracondylar Humerus Fracture in Children with Nerve Injury

    Directory of Open Access Journals (Sweden)

    Anuar RIM

    2015-11-01

    Full Text Available The supracondylar humerus fracture (SCHF in children is common and can be complicated with nerve injury either primarily immediate post-trauma or secondarily posttreatment. The concept of neurapraxic nerve injury makes most surgeons choose to ‘watch and see’ the nerve recovery before deciding second surgery if the nerve does not recover. We report three cases of nerve injury in SCHF, all of which underwent nerve exploration for different reasons. Early reduction in the Casualty is important to release the nerve tension before transferring the patient to the operation room. If close reduction fails, we proceed to explore the nerve together with open reduction of the fracture. In iatrogenic nerve injury, we recommend nerve exploration to determine the surgical procedure that is causing the injury. Primary nerve exploration will allow early assessment of the injured nerve and minimize subsequent surgery.

  12. The association between orthostatic hypotension and cognitive state among adults 65 years and older who underwent a comprehensive geriatric assessment

    Science.gov (United States)

    Punchick, Boris; Freud, Tamar; Press, Yan

    2016-01-01

    Abstract The prevalence of cognitive impairment and orthostatic hypotension (OH) increases with age, but the results of studies that assessed possible associations between them are inconsistent. The aim of this study is to assess possible associations between cognitive impairment and OH in patients ≥65 years of age who underwent a comprehensive geriatric assessment. A retrospective analysis was conducted of the computerized medical records of the study population from 2005 to 2013. Data collected included blood pressure measurements that enabled the calculation of OH, results of the mini-mental state examination (MMSE), results of the Montreal cognitive assessment (MoCA) test, and cognitive diagnoses that were determined over the course of the assessment. The rate of OH in the study population of 571 adults was 32.1%. The mean MMSE score was 22.5 ± 5.2 among participants with OH and 21.6 ± 5.8 among those without OH (P = 0.09). The absence of a significant association between OH and MMSE remained after adjusting the MMSE score for age and education level. The mean MoCA score was 16.4 ± 5.0 among participants with OH and 16.4 ± 4.8 among those without (P = 0.33). The prevalence of OH was 39% among participants without cognitive impairment, 28.9% among those with mild cognitive impairment (MCI), and 30.6% among those with dementia (P = 0.13). There was no association between OH and cognitive impairment in adults who underwent a comprehensive geriatric assessment. PMID:27442658

  13. Low luminance/eyes closed and monochromatic stimulations reduce variability of flash visual evoked potential latency

    Directory of Open Access Journals (Sweden)

    Senthil Kumar Subramanian

    2013-01-01

    Full Text Available Context: Visual evoked potentials are useful in investigating the physiology and pathophysiology of the human visual system. Flash visual evoked potential (FVEP, though technically easier, has less clinical utility because it shows great variations in both latency and amplitude for normal subjects. Aim: To study the effect of eye closure, low luminance, and monochromatic stimulation on the variability of FVEPs. Subjects and Methods: Subjects in self-reported good health in the age group of 18-30 years were divided into three groups. All participants underwent FVEP recording with eyes open and with white light at 0.6 J luminance (standard technique. Next recording was done in group 1 with closed eyes, group 2 with 1.2 and 20 J luminance, and group 3 with red and blue lights, while keeping all the other parameters constant. Two trials were given for each eye, for each technique. The same procedure was repeated at the same clock time on the following day. Statistical Analysis: Variation in FVEP latencies between the individuals (interindividual variability and the variations within the same individual for four trials (intraindividual variability were assessed using coefficient of variance (COV. The technique with lower COV was considered the better method. Results: Recording done with closed eyes, 0.6 J luminance, and monochromatic light (blue > red showed lower interindividual and intraindividual variability in P2 and N2 as compared to standard techniques. Conclusions: Low luminance flash stimulations and monochromatic light will reduce FVEP latency variability and may be clinically useful modifications of FVEP recording technique.

  14. Automatically closing swing gate closure assembly

    Science.gov (United States)

    Chang, Shih-Chih; Schuck, William J.; Gilmore, Richard F.

    1988-01-01

    A swing gate closure assembly for nuclear reactor tipoff assembly wherein the swing gate is cammed open by a fuel element or spacer but is reliably closed at a desired closing rate primarily by hydraulic forces in the absence of a fuel charge.

  15. Vaginal carcinoma in a young woman who underwent fertility-sparing treatment involving chemotherapy and conservative surgery.

    Science.gov (United States)

    Mabuchi, Yasushi; Yahata, Tamaki; Kobayashi, Aya; Tanizaki, Yuko; Minami, Sawako; Ino, Kazuhiko

    2015-06-01

    Vaginal carcinoma is a rare gynecological malignancy that is usually treated by radiation therapy and/or surgery combined with chemotherapy. Here, we report a case of invasive vaginal carcinoma in a young woman who underwent fertility-sparing treatment involving neoadjuvant chemotherapy and conservative surgery. A 36-year-old non-parous woman had a solid tumor in the vagina. Positron emission tomography/computed tomography showed a tumor in the vagina with high FDG uptake (SUV = 17.33) but no metastatic lesions. The patient was diagnosed with vaginal squamous cell carcinoma, FIGO stage I, T1N0M0. Because she wished to retain her fertility, neoadjuvant chemotherapy consisting of irinotecan hydrochloride and nedaplatin was initiated. After four courses of chemotherapy, partial vaginectomy was carried out and the pathological diagnosis of the residual lesion was VAIN 3. Following two further courses of the same chemotherapy, she obtained complete response, and has shown no evidence of disease for 14 months. © 2014 The Authors. Journal of Obstetrics and Gynaecology Research © 2014 Japan Society of Obstetrics and Gynecology.

  16. Closed retrograde retrieval of the distal broken segment of femoral cannulated intramedullary nail using a ball-tipped guide wire.

    Science.gov (United States)

    Metikala, Sreenivasulu; Mohammed, Riazuddin

    2011-07-01

    Extracting broken segments of intramedullay nails from long bones can be an operative challenge, particularly from the distal end. We report a case series where a simple and reproducible technique of extracting broken femoral cannulated nails using a ball-tipped guide wire is described. This closed technique involves no additional equipment or instruments. Eight patients who underwent the described method were included in the study. The technique involves using a standard plain guide wire passed through the cannulated distal broken nail segment after extraction of the proximal nail fragment. The plain guide wire is then advanced distally into the knee joint carefully under fluoroscopy imaging. Over this wire, a 5-millimeter (mm) cannulated large drill bit is used to create a track up to the distal broken nail segment. Through the small knee wound, a ball-tipped guide wire is passed, smooth end first, till the ball engages the end of the nail. The guide wire is then extracted along with the broken nail through the proximal wound. The method was successfully used in all eight patients for removal of broken cannulated intramedullary nail from the femoral canal without any complications. All patients underwent exchange nailing with successful bone union in six months. None of the patients had any problems at the knee joint at the final follow-up. We report a technique for successful extraction of the distal fragment of broken femoral intramedullary nails without additional surgical approaches.

  17. Potential for Landing Gear Noise Reduction on Advanced Aircraft Configurations

    Science.gov (United States)

    Thomas, Russell H.; Nickol, Craig L.; Burley, Casey L.; Guo, Yueping

    2016-01-01

    The potential of significantly reducing aircraft landing gear noise is explored for aircraft configurations with engines installed above the wings or the fuselage. An innovative concept is studied that does not alter the main gear assembly itself but does shorten the main strut and integrates the gear in pods whose interior surfaces are treated with acoustic liner. The concept is meant to achieve maximum noise reduction so that main landing gears can be eliminated as a major source of airframe noise. By applying this concept to an aircraft configuration with 2025 entry-into-service technology levels, it is shown that compared to noise levels of current technology, the main gear noise can be reduced by 10 EPNL dB, bringing the main gear noise close to a floor established by other components such as the nose gear. The assessment of the noise reduction potential accounts for design features for the advanced aircraft configuration and includes the effects of local flow velocity in and around the pods, gear noise reflection from the airframe, and reflection and attenuation from acoustic liner treatment on pod surfaces and doors. A technical roadmap for maturing this concept is discussed, and the possible drag increase at cruise due to the addition of the pods is identified as a challenge, which needs to be quantified and minimized possibly with the combination of detailed design and application of drag reduction technologies.

  18. Lifetime of rho meson in correlation with magnetic-dimensional reduction

    Energy Technology Data Exchange (ETDEWEB)

    Kawaguchi, Mamiya [Nagoya University, Department of Physics, Nagoya (Japan); Matsuzaki, Shinya [Nagoya University, Department of Physics, Nagoya (Japan); Nagoya University, Institute for Advanced Research, Nagoya (Japan)

    2017-04-15

    It is naively expected that in a strong magnetic configuration, the Landau quantization ceases the neutral rho meson to decay to the charged pion pair, so the neutral rho meson will be long-lived. To closely access this naive observation, we explicitly compute the charged pion loop in the magnetic field at the one-loop level, to evaluate the magnetic dependence of the lifetime for the neutral rho meson as well as its mass. Due to the dimensional reduction induced by the magnetic field (violation of the Lorentz invariance), the polarization (spin s{sub z} = 0, ±1) modes of the rho meson, as well as the corresponding pole mass and width, are decomposed in a nontrivial manner compared to the vacuum case. To see the significance of the reduction effect, we simply take the lowest Landau level approximation to analyze the spin-dependent rho masses and widths. We find that the ''fate'' of the rho meson may be more complicated because of the magnetic-dimensional reduction: as the magnetic field increases, the rho width for the spin s{sub z} = 0 starts to develop, reaches a peak, then vanishes at the critical magnetic field to which the folklore refers. On the other side, the decay rates of the other rhos for s{sub z} = ±1 monotonically increase as the magnetic field develops. The correlation between the polarization dependence and the Landau level truncation is also addressed. (orig.)

  19. Stanford type A aortic dissection with closed false lumen: Analysis of prognostic factors at initial CT or MRI

    Energy Technology Data Exchange (ETDEWEB)

    Matsuoka, Yohjiro; Sakamoto, Ichiro; Ogawa, Yohji; Sueyoshi, Eijun; Hayashi, Kuniaki; Takagi, Masatake [Nagasaki Univ. (Japan). School of Medicine; Narimatsu, Motoharu

    1997-08-01

    Nineteen patients with Stanford type A acute aortic dissection with closed false lumen were reviewed. In the follow-up examinations, ulcerlike projection (ULP) in the ascending aorta (AA) or aortic arch (AR) was identified in 8 of 19 patients. In 5 of these 8 patients, acute cardiac tamponade occurred and 3 of them died. In the other 11 patients, there was no mortality, and only one patient underwent elective surgery. The appearance of ULP in the AA/AR is considered an indication for urgent surgery because it is regarded as a precursor of lethal complications such as cardiac tamponade. The purpose of this study was to investigate predictors of the appearance of ULP in the AA/AR with early imagings (CT or MRI) before the appearance of ULP. The patients were divided into two groups: patients with ULP in the AA/AR (8 patients) and others (11 patients). Initial CT or MRI findings of the thoracic aorta were retrospectively statistically analyzed in each group. Three predictive factors were statistically significant for the appearance of ULP in the AA/AR (diameter of the AA{>=}5 cm, thickness of the false lumen of the AA{>=}1 cm, thickness of the false lumen of the AA{>=} that of the descending aorta). Close attention should be paid, if any of these 3 factors is observed at initial CT or MRI. (author)

  20. Stanford type A aortic dissection with closed false lumen: Analysis of prognostic factors at initial CT or MRI

    International Nuclear Information System (INIS)

    Matsuoka, Yohjiro; Sakamoto, Ichiro; Ogawa, Yohji; Sueyoshi, Eijun; Hayashi, Kuniaki; Takagi, Masatake; Narimatsu, Motoharu.

    1997-01-01

    Nineteen patients with Stanford type A acute aortic dissection with closed false lumen were reviewed. In the follow-up examinations, ulcerlike projection (ULP) in the ascending aorta (AA) or aortic arch (AR) was identified in 8 of 19 patients. In 5 of these 8 patients, acute cardiac tamponade occurred and 3 of them died. In the other 11 patients, there was no mortality, and only one patient underwent elective surgery. The appearance of ULP in the AA/AR is considered an indication for urgent surgery because it is regarded as a precursor of lethal complications such as cardiac tamponade. The purpose of this study was to investigate predictors of the appearance of ULP in the AA/AR with early imagings (CT or MRI) before the appearance of ULP. The patients were divided into two groups: patients with ULP in the AA/AR (8 patients) and others (11 patients). Initial CT or MRI findings of the thoracic aorta were retrospectively statistically analyzed in each group. Three predictive factors were statistically significant for the appearance of ULP in the AA/AR (diameter of the AA≥5 cm, thickness of the false lumen of the AA≥1 cm, thickness of the false lumen of the AA≥ that of the descending aorta). Close attention should be paid, if any of these 3 factors is observed at initial CT or MRI. (author)