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Sample records for benign inguinal lump

  1. Single benign metastasising leiomyoma of an inguinal lymph node.

    PubMed

    Laban, Kamil G; Tobon-Morales, Roberto E; Hodge, Janice A L; Schreuder, Henk W R

    2016-01-01

    Benign metastasising leiomyoma (BML) is a rare benign disease associated with uterine leiomyoma and history of uterine surgery. It most frequently occurs in premenopausal woman, with a pulmonary localisation, and consisting of multiple nodules. We present an uncommon case of a 69-year-old woman with a single BML of an inguinal lymph node. CT scans of thorax and abdomen excluded other metastasis localisation. The patient was cured with surgical excision of the mass. Lymph node involvement has been reported incidentally in BML literature. Lymphangitic spread can be considered a possible mechanism of BML metastasis. PMID:27511755

  2. Benign scalp lump as an unusual presentation of extranodal Rosai-Dorfman disease

    PubMed Central

    Chen, Min Wei; King, Nicolas K. K.; Selvarajan, Sathiyamoorthy; Low, David C. Y.

    2014-01-01

    Background: Rosai–Dorfman disease (RDD) is a rare benign histioproliferative disease. It is typically characterized by benign histiocyte proliferation with lymphadenopathy, fever, and leukocytosis and was first described in 1969 by Rosai and Dorfman. Extranodal involvement has been reported in approximately up to 43% of the cases with isolated central nervous system (CNS) manifestations being even rarer. Case Description: We report our management of a 41-year-old female with extranodalpurely CNS RDD presenting as a benign scalp lump. Her lump progressed from an asymptomatic benign lesion to one causing localized cerebral edema. Treatment was surgical excision of both the cervical and CNS lesions achieving complete removal of the lesions and resolution of her symptoms. Conclusion: RDD is a rare condition and isolated CNS RDD is even less common. Benign scalp lumps have a myriad of differential diagnoses, but RDD should be a consideration in the presence of preexisting RDD lesions at other sites given its potential to progress and result in morbidity. It is imperative to be aware that symptoms may be especially deceiving as the absence of lymphadenopathy may point away from RDD as the diagnosis. PMID:25024899

  3. Affects of Anxiety and Depression on Health-Related Quality of Life among Patients with Benign Breast Lumps Diagnosed via Ultrasonography in China

    PubMed Central

    Lou, Zhe; Li, Yinyan; Yang, Yilong; Wang, Lie; Yang, Jun

    2015-01-01

    There is a high incidence of benign breast lumps among women, and these lumps may lead to physical and psychological problems. This study aims to evaluate anxiety and depressive symptoms among patients with benign breast lumps diagnosed via ultrasonography and investigate their impacts on health-related quality of life (HRQOL). A cross-sectional survey was conducted in Shenyang, China, from January to November 2013. Data were collected with self-administered questionnaires, including the Zung Self-Rating Anxiety Scale (SAS), the Center for Epidemiologic Studies Depression Scale (CES-D), and the 36-item Short-Form Health Survey (SF-36), together with demographic characteristics, from patients of the Department of Breast Surgery of the First Affiliated Hospital of China Medical University. Hierarchical multiple regression analysis (HMR) was performed to explore the effects of anxiety and depression on HRQOL. The overall prevalences of anxiety (SAS score ≥ 40) and depression (CES-D scores ≥ 16) were 40.2% and 62.0%, respectively, and 37.5% of the participants had both of these psychological symptoms. The means and standard deviations of PCS and MCS were 75.42 (15.22) and 68.70 (17.71), respectively. Anxiety and depressive symptoms were significantly negatively associated with the HRQOL of patients with benign breast lumps diagnosed via ultrasonography. Women with benign breast lumps diagnosed via ultrasonography in China experienced relatively high levels of anxiety and depressive symptoms. Anxiety and depressive symptoms had significant negative impacts on both the mental and physical quality of life (QOL) of women with benign breast lumps. Beyond the necessary clinical treatment procedures, psychological guidance and detailed explanations of the disease should be offered to alleviate the anxiety and depressive symptoms and enhance the HRQOL of patients with benign breast lumps. PMID:26343700

  4. A Randomized Pilot Study of Inositol in Association with Betaine and Boswellia in the Management of Mastalgia and Benign Breast Lump in Premenopausal Women.

    PubMed

    Pasta, Vittorio; Dinicola, Simona; Giuliani, Alessandro; Harrath, Abdel Halim; Alwasel, Saleh H; Tartaglia, Francesco; Cucina, Alessandra; Bizzarri, Mariano

    2016-01-01

    Benign mammary lumps and mastalgia are the most common breast disorders; yet, there is no clear-cut consensus about the best strategy for their treatment. We hypothesized that a combination, including boswellic acid, betaine, and myoinositol, would be beneficial in breast disorders by exerting a pleiotropic effect on multiple pathways. Indeed, myoinositol has already been proven to modulate some factors involved in the genesis of breast diseases, such as fibrosis and metabolic and endocrine cues. In our study, 76 women were randomly assigned to either the experimental or the placebo arm. After six months of treatment, statistically significant differences between the two groups were recorded for pain relief (56% vs 17%) and breast density reduction (60% vs 9%). Furthermore, benign breast mass dimension showed a reduction in the experimental group (40% vs 16%). The combination of boswellic acid, betaine, and myoinositol has been demonstrated to be effective in the treatment of breast pain and radiologically and histologically confirmed benign breast mass and in the reduction of breast density, one of the pivotal risk factors for the development of breast cancer, without any side effects. PMID:27127407

  5. A Randomized Pilot Study of Inositol in Association with Betaine and Boswellia in the Management of Mastalgia and Benign Breast Lump in Premenopausal Women

    PubMed Central

    Pasta, Vittorio; Dinicola, Simona; Giuliani, Alessandro; Harrath, Abdel Halim; Alwasel, Saleh H.; Tartaglia, Francesco; Cucina, Alessandra; Bizzarri, Mariano

    2016-01-01

    Benign mammary lumps and mastalgia are the most common breast disorders; yet, there is no clear-cut consensus about the best strategy for their treatment. We hypothesized that a combination, including boswellic acid, betaine, and myoinositol, would be beneficial in breast disorders by exerting a pleiotropic effect on multiple pathways. Indeed, myoinositol has already been proven to modulate some factors involved in the genesis of breast diseases, such as fibrosis and metabolic and endocrine cues. In our study, 76 women were randomly assigned to either the experimental or the placebo arm. After six months of treatment, statistically significant differences between the two groups were recorded for pain relief (56% vs 17%) and breast density reduction (60% vs 9%). Furthermore, benign breast mass dimension showed a reduction in the experimental group (40% vs 16%). The combination of boswellic acid, betaine, and myoinositol has been demonstrated to be effective in the treatment of breast pain and radiologically and histologically confirmed benign breast mass and in the reduction of breast density, one of the pivotal risk factors for the development of breast cancer, without any side effects. PMID:27127407

  6. Armpit lump

    MedlinePlus

    ... You will be asked questions about your medical history and symptoms, such as: When did you first notice the lump? Has the lump changed? Are you breastfeeding? Is there anything that makes the lump worse? ...

  7. Breast lump

    MedlinePlus

    Breast mass ... males and females of all ages have normal breast tissue. This tissue responds to hormone changes. Because of this, lumps can come and go. Breast lumps may appear at any age: Both male ...

  8. Testicle lump

    MedlinePlus

    Lump in the testicle; Scrotal mass ... Possible causes of a painful scrotal mass include: A cyst-like lump in the scrotum that contains fluid and dead sperm cells (spermatocele) Epididymitis Infection of the scrotal sac ...

  9. Neck lump

    MedlinePlus

    The health care provider will take your medical history and do a physical exam. You may be asked questions such as: Where is the lump located? Is it a hard lump or a soft, pliable (moves slightly), bag-like (cystic) mass? Is it painless? Is the ...

  10. Breast lump

    MedlinePlus

    ... new lumps or breast changes. Ask about your risk factors for breast cancer, and screening and prevention for breast cancer. When ... from you. You will be asked about your factors that may increase the risk of breast cancer . The provider will perform a thorough breast exam. ...

  11. A benign or malignant eyelid lump – can you tell? An unusual collision tumour highlighting the difficulty differentiating a hidrocystoma from a basal cell carcinoma

    PubMed Central

    Jayaprakasam, Anuradha; Rene, Cornelius

    2012-01-01

    Hidrocystoma and basal cell carcinoma (BCC) are common eyelid lesions. The former is benign while the latter is malignant and can cause significant destruction of the adnexal structures, orbital invasion and visual loss. The authors describe a case of a 76-year-old female with a slow growing right upper lid lesion which was diagnosed as a hidrocystoma but excision biopsy revealed a collision tumour comprised of a BCC abutting a hidrocystoma in the same lesion. Cystic BCC can masquerade as hidrocystoma but there are no previous case reports of BCC coexisting with hidrocystoma in the same lesion. This case highlights the fact that apparently benign lesions, such as hidrocystomas, may actually be malignant or coexist with malignant pathology. Clinicians should have a low threshold for appropriate excision biopsy and histological examination of such lesions, especially if there are sinister features, such as lash loss, induration, pigmentation or a pearly appearance. PMID:22744259

  12. Spontaneous thrombosis of congenital extrahepatic portosystemic shunt (Abernethy malformation) simulating inguinal hernia incarceration.

    PubMed

    Afzal, Samara; Nair, Amit; Grainger, Jennie; Latif, Sherif; Rehman, Atiq-ur

    2010-08-01

    Tender lumps in the inguinal region are often explored emergently to treat suspected hernial strangulation. We discuss the case of an adult male who presented acutely with a tender inguinal swelling and raised inflammatory markers and was therefore deemed as requiring surgical exploration. However preoperative abdominal computerized tomography (CT) revealed an extensive thrombosing congenital venous malformation of portosystemic origin with extension into the symptomatic inguinal canal. A potentially lethal exsanguination from surgery was thus avoided. PMID:20551093

  13. Skin lumps

    MedlinePlus

    ... and contains fluid or semisolid material Benign skin growths such as seborrheic keratoses or neurofibromas Boils , painful, red bumps usually involving an infected hair follicle Corn or callus, caused by skin thickening in response ...

  14. Robotic inguinal hernia repair.

    PubMed

    Escobar Dominguez, Jose E; Gonzalez, Anthony; Donkor, Charan

    2015-09-01

    Inguinal hernias have been described throughout the history of medicine with many efforts to achieve the cure. Currently, with the advantages of minimally invasive surgery, new questions arise: what is going to be the best approach for inguinal hernia repair? Is there a real benefit with the robotic approach? Should minimally invasive hernia surgery be the standard of care? In this report we address these questions by describing our experience with robotic inguinal hernia repair. PMID:26153353

  15. Inguinal herniorrhaphy in women.

    PubMed

    Bay-Nielsen, Morten; Kehlet, Henrik

    2006-03-01

    Inguinal hernias in women are relatively rare, and an outcome in this specific subgroup of hernias has not been documented in the literature. An analysis was performed using data from the prospective recording of 3,696 female inguinal hernia repairs in the national Danish hernia database, in the 5.5 year period from January 1, 1998 to June 30, 2003, where observation time specific reoperation rates were used as a proxy for recurrence. In the 3,696 female inguinal herniorrhaphies recorded, the overall reoperation rate was 4.3%, which is slightly higher compared to male inguinal herniorrhaphies (3.1%) (P=0.001). The reoperation rate was independent of the type of surgical repair. In 41.5% of the reoperations a femoral hernia was found, compared to 5.4% in males. Female inguinal herniorrhaphy is followed by a higher reoperation rate than in males, and is unrelated to the type of repair. The frequent finding of a femoral hernia at reoperation suggests the need for the exploration of the femoral canal at the primary operation. PMID:16132186

  16. Paraperitoneal Inguinal Hernia of Ureter

    PubMed Central

    Lu, Albert; Burstein, Jerome

    2012-01-01

    Inguinal herniation of ureter is an uncommon finding that can potentially lead to obstructive uropathy. We report a case of inguinal herniation of ureter discovered incidentally during workup for acute renal failure and ultrasound finding of hydronephrosis. PMID:23365714

  17. Epidermoid cyst at a rare location, as a content of inguinal hernia: A case report with a review of the literature

    PubMed Central

    Meher, Sadananda; Baijal, Manish; Soni, Vandana; Sharma, Anil; Khullar, Rajesh; Chowbey, Pradeep

    2016-01-01

    Epidermoid cysts can occur in a variety of locations including the face, trunk, neck, extremities, and scalp. No case of epidermoid cyst as content of inguinal hernia has been reported so far; however, cases with dermoid, teratoma, lipoma, lymphangioma and leiomyoma as content of inguinal canal have been reported. A 29-year-old female presented with a lump in the left inguinal region that was clinically diagnosed as left inguinal hernia. The patient was planned for laparoscopic inguinal hernia repair after routine investigation. Intraoperatively, a cystic mass was found to be attached to the left round ligament that was excised completely. Histopathological report was consistent with epidermal inclusion cyst. Inguinal epidermoid cyst mimicking inguinal hernia is a rare entity. If such a cyst is encountered during operation, it should be completely excised. PMID:27279405

  18. Inguinal hernia - discharge

    MedlinePlus

    You or your child had surgery to repair an inguinal hernia caused by a weakness in the abdominal wall in your groin area. You or your child probably had general (asleep and pain-free) or spinal or epidural (numb from the waist down) anesthesia. If ...

  19. Lump in the abdomen

    MedlinePlus

    A lump in the abdomen is a small area of swelling or bulge of tissue in the belly . ... Most often, a lump in the abdomen is caused by a hernia. An abdominal hernia occurs when there is a weak spot in the abdominal wall. This allows the ...

  20. Elective laparoscopic surgery for sigmoid colon carcinoma incarcerated within an inguinal hernia: report of a case.

    PubMed

    Kanemura, Takashi; Takeno, Atsushi; Tamura, Shigeyuki; Okishiro, Masatsugu; Nakahira, Shin; Suzuki, Rei; Nakata, Ken; Egawa, Chiyomi; Miki, Hirohumi; Takeda, Yutaka; Kato, Takeshi

    2014-07-01

    Primary colon carcinoma within an inguinal hernia sac is very rare and most reported cases were found at emergency open surgery for an incarcerated hernia. We report a case of incarcerated sigmoid colon carcinoma diagnosed preoperatively and treated with elective laparoscopic surgery. A 67-year-old man with a 2-year history of swelling of the scrotum and a breast lump was referred to us for surgical treatment of an irreducible left inguinal hernia and a right breast tumor. Blood examination results showed severe anemia. Computed tomography scan and endoscopic biopsy confirmed sigmoid colon carcinoma incarcerated in the left inguinal hernia. Thus, we performed definitive laparoscopic sigmoidectomy and conventional hernia repair for preoperatively diagnosed sigmoid colon carcinoma within an inguinal hernia. PMID:23846798

  1. Round Ligament Leiomyoma Presenting as an Incarcerated Inguinal Hernia: Case Report and Review of the Literature

    PubMed Central

    Mandel, Marc

    2016-01-01

    Leiomyomas are common benign gynecologic tumors occurring in up to 30% of women. Round ligament leiomyomas however are very rare and, if symptomatic, can present as an inguinal hernia. We report the case of a 47-year-old woman who presented with an irreducible inguinal mass consistent with an incarcerated hernia. Intraoperatively, the mass was found to be a round ligament leiomyoma, a diagnosis that was confirmed by histopathology following excision of the mass. Although rare, round ligament leiomyomas should be part of the differential diagnosis of an inguinal hernia in females. PMID:27144048

  2. An Uncommon Case of Adolescent Ovarian Teratoma Incarcerated in Inguinal Hernia

    PubMed Central

    Girgenti, Vincenza; Cimador, Marcello; Li Voti, Giuseppe

    2016-01-01

    Mature cystic teratoma is the most frequent benign ovarian neoplastic lesion in adolescents and is generally composed of fully differentiated tissue arising from multipotential three germinal layers. It accounts for approximately 50% of benign ovarian tumors in childhood. Rarely, a bilateral, synchronous, or metachronous presentation can be observed, supporting a conservative approach as the first surgical approach. We report a case of an ovarian mature cystic incarcerated in indirect inguinal hernia in a 15-year-old girl undergoing ovary-sparing surgery. To our knowledge this is the first case of such lesion incarcerated in an inguinal hernia reported in literature. PMID:27525145

  3. Hernias: inguinal and incisional.

    PubMed

    Kingsnorth, Andrew; LeBlanc, Karl

    2003-11-01

    In the past decade hernia surgery has been challenged by two new technologies: by laparoscopy, which has attempted to change the traditional open operative techniques, and by prosthetic mesh, which has achieved much lower recurrence rates. The demand by health care providers for increasingly efficient and cost-effective surgery has resulted in modifications to pathways of care to encourage more widespread adoption of day case, outpatient surgery, and local anaesthesia. In addition, the UK National Institute for Clinical Excellence has recommended strategies for bilateral and recurrent hernias. Here, we discuss these strategies and review some neglected aspects of hernia management such as trusses, antibiotic cover, return to work and activity, and emergency surgery. Many of the principles of management apply equally to inguinal and incisional hernias. We recommend that the more difficult and complex of the procedures be referred to specialists. PMID:14615114

  4. Breast lump removal

    MedlinePlus

    ... 21441069 . Heisey RE, McCready DR. Office management of a palpable breast lump with aspiration. CMAJ . 2010;182:693-6. PMID: 20194561 www.ncbi.nlm.nih.gov/pubmed/20194561 . Hunt KK, Green MC, Buchholz TA. Diseases of the breast. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL. Sabiston ...

  5. Lump wood combustion process

    NASA Astrophysics Data System (ADS)

    Kubesa, Petr; Horák, Jiří; Branc, Michal; Krpec, Kamil; Hopan, František; Koloničný, Jan; Ochodek, Tadeáš; Drastichová, Vendula; Martiník, Lubomír; Malcho, Milan

    2014-08-01

    The article deals with the combustion process for lump wood in low-power fireplaces (units to dozens of kW). Such a combustion process is cyclical in its nature, and what combustion facility users are most interested in is the frequency, at which fuel needs to be stoked to the fireplace. The paper defines the basic terms such as burnout curve and burning rate curve, which are closely related to the stocking frequency. The fuel burning rate is directly dependent on the immediate thermal power of the fireplace. This is also related to the temperature achieved in the fireplace, magnitude of flue gas losses and the ability to generate conditions favouring the full burnout of the fuel's combustible component, which, at once ensures the minimum production of combustible pollutants. Another part of the paper describes experiments conducted in traditional fireplaces with a grate, at which well-dried lump wood was combusted.

  6. Gravity-Capillary Lumps

    NASA Astrophysics Data System (ADS)

    Akylas, Triantaphyllos R.; Kim, Boguk

    2004-11-01

    In dispersive wave systems, it is known that 1-D plane solitary waves can bifurcate from linear sinusoidal wavetrains at particular wave numbers k = k0 where the phase speed c(k) happens to be an extremum (dc/dk| _0=0) and equals the group speed c_g(k_0). Two distinct possibilities thus arise: either the extremum occurs in the long-wave limit (k_0=0) and, as in shallow water, the bifurcating solitary waves are of the KdV type; or k0 ne 0 and the solitary waves are in the form of packets, described by the NLS equation to leading order, as for gravity-capillary waves in deep water. Here it is pointed out that an entirely analogous scenario is valid for the genesis of 2-D solitary waves or `lumps'. Lumps also may bifurcate at extrema of the phase speed and do so when 1-D solitary waves happen to be unstable to transverse perturbations; moreover, they have algebraically decaying tails and are either of the KPI type (e.g. in shallow water in the presence of strong surface tension) or of the wave packet type (e.g. in deep water) and are described by an elliptic-elliptic Davey-Stewartson equation system to leading order. Examples of steady lump profiles are presented and their dynamics is discussed.

  7. [Inguinal swelling and ankle edema after inguinal hernia operation].

    PubMed

    Oettl, T; Tzankov, A; Ramseier, E

    2007-06-13

    We diagnosed an aggressive Non-Hodgkin-Lymphoma (diffuse large B-cell lymphoma, DLBCL) in a patient with a fast growing inguinal mass. Only one third of all suspicious inguinal lymph nodes that are investigated histologically are found to be malignant lymphoma. If so, an accurate histopathological evaluation of sufficient neoplastic tissue is critical. Prognosis in DLBCL is highly associated with the IPI score. Overall survival has been improved by the CHOP-R regimen established in 2002, with a disease-free survival exceeding 50%. PMID:17616038

  8. Breast lumps: a rare site for rheumatoid nodules.

    PubMed

    Iqbal, Fahad Mujtaba; Ali, Hiam; Vidya, Raghavan

    2015-01-01

    Granulomatous mastitis (GM) of the breast is a rare benign inflammatory disease and its presentation closely mimics breast cancer. Its diagnosis is mainly based on histology and there is no consensus agreement regarding its management. We report a case of a 60-year-old woman presenting with a right breast lump associated with a history of rheumatoid arthritis and raised rheumatoid factor. Following triple assessment (history and examination, imaging and biopsy), GM was diagnosed and she was treated conservatively. PMID:25903203

  9. Periappendicular Abscess Presenting within an Inguinal Hernia

    PubMed Central

    Loberant, Norman; Bickel, Amitai

    2015-01-01

    The presence of the appendix within an inguinal hernia is a rare finding. We present the case of an elderly woman who developed appendicitis within an inguinal hernia, complicated by a supervening periappendicular abscess. She was successfully treated with a combination of antibiotics and percutaneous drainage. PMID:26605128

  10. Lumped transmission line avalanche pulser

    DOEpatents

    Booth, R.

    1995-07-18

    A lumped linear avalanche transistor pulse generator utilizes stacked transistors in parallel within a stage and couples a plurality of said stages, in series with increasing zener diode limited voltages per stage and decreasing balanced capacitance load per stage to yield a high voltage, high and constant current, very short pulse. 8 figs.

  11. Lumped transmission line avalanche pulser

    DOEpatents

    Booth, Rex

    1995-01-01

    A lumped linear avalanche transistor pulse generator utilizes stacked transistors in parallel within a stage and couples a plurality of said stages, in series with increasing zener diode limited voltages per stage and decreasing balanced capacitance load per stage to yield a high voltage, high and constant current, very short pulse.

  12. Lump solutions of the BKP equation

    NASA Astrophysics Data System (ADS)

    Gilson, C. R.; Nimmo, J. J. C.

    1990-07-01

    Rational solutions of the BKP equation which decay to zero in all directions in the plane are obtained. These solutions are analogous to the lump solutions of the KPI equation. Properties of the single lump solution are described and the form of the N-lump solution is given. It is shown that single lump solutions are only non-singular for spectral parameters lying in certain regions of the complex plane.

  13. Giant Condyloma Acuminata of the Inguinal Region.

    PubMed

    Nain, Prabhdeep Singh; Sidhu, Sudeep; Garg, Bhavna

    2015-12-01

    A 70-year-old male presented with a progressively increasing polypoidal lesion in the right inguinal region since last 10 years. He had no anal or penile lesion. Excision biopsy was done under spinal anaesthesia. Histopathology showed it to be a giant condyloma acuminata. We report this case due to its large size and its location in inguinal region without pre-existing anal or rectal lesion. PMID:26730100

  14. Uncommon content in congenial inguinal hernia.

    PubMed

    Harjai, Man Mohan

    2014-10-01

    Although sliding indirect inguinal hernias containing the ipsilateral ovary and fallopian tube are not uncommon in infant girls, sliding hernias containing uterus with both ovaries and fallopian tubes are extremely rare. At surgery, a 5-month-old infant girl was found to have an indirect hernia in which the uterus and fallopian tubes were sliding components with a wide deep inguinal ring. PMID:25336812

  15. Phase 1 prospective evaluation of the oncological adequacy of robotic assisted video-endoscopic inguinal lymphadenectomy in patients with penile carcinoma

    PubMed Central

    Matin, Surena F.; Cormier, Janice N.; Ward, John F.; Pisters, Louis L.; Wood, Christopher G.; Dinney, Colin P. N.; Royal, Richard E.; Huang, Xuelin; Pettaway, Curtis A.

    2012-01-01

    OBJECTIVE To prospectively determine the oncological adequacy of robotic assisted video-endoscopic inguinal lymphadenectomy (RAVEIL). PATIENTS AND METHODS Patients with T1-3N0 penile cancer were enrolled into a prospective phase I trial at a tertiary care institution from March 2010 to January 2012. All patients underwent an initial RAVEIL approach. Verification of adequacy of dissection was performed by an independent surgeon via a separate open incision at the conclusion of the RAVEIL procedure. Out of 10 patients, if more than two superficial inguinal fields with ≥ 2 nodes or more than four with ≥ 1 node remained within the superficial dissection field, the study would not proceed to phase II. RESULTS Of 10 enrolled patients two had inguinal metastases and all positive nodes were detected by RAVEIL. The remaining eight patients had no metastases, with a mean of nine (range 5–21) left and nine (range 6–17) right nodes removed. One inguinal field RAVEIL was converted to an open dissection. The verifying surgeon confirmed that 18 of 19 inguinal fields (94.7% in nine patients) had an adequate dissection. Two benign nodes were found just beneath Scarpa’s fascia above the inguinal dissection field. Limitations of the study include an inability to determine decisively what specific wound complications were related to RAVEIL because of the protocol-specified creation of a small inguinal incision for verification of adequate dissection. CONCLUSIONS RAVEIL allowed adequate staging of disease in the inguinal region among patients with penile cancer at risk for inguinal metastases. PMID:23551693

  16. [Botulinum toxin A for the treatment of familial benign pemphigus].

    PubMed

    López-Ferrer, A; Alomar, A

    2012-01-01

    Familial benign pemphigus or Hailey-Hailey disease is a rare bullous disease that presents clinically with recurrent flares of erosions and vesicles that mainly affect the skinfolds. Many topical and systemic therapies have been proposed. Hyperhidrosis is one of the factors that can trigger or aggravate a flare-up, and its treatment is therefore important for controlling the disease and preventing further episodes. We report 3 patients with axillary and/or inguinal benign familial pemphigus that responded favorably to treatment with subcutaneous botulinum toxin. PMID:21872830

  17. [Surgical treatment of recurrent inguinal hernia using prosthetic materials].

    PubMed

    Paino, O; Rosato, L; Cossavella, D; Catania, S; Coluccio, G

    1998-03-01

    The authors affirm that plastic surgery using graft materials is a feasible technique also in case of recurrent inguinal hernia. They follow with interest the evolution of laparoscopic techniques which are still the cause of some perplexity. The paper reports a series of nine recurrent inguinal hernias out of 447 inguinal hernias operated during the period May 1994-May 1996. PMID:9617112

  18. Retroperitoneal vascular malformation mimicking incarcerated inguinal hernia.

    PubMed

    Dubey, Indu Bhushan; Sharma, Anuj; Singh, Ajay Kumar; Mohanty, Debajyoti

    2011-01-01

    A 30-year-old man presented to the Department of Surgery with a painful groin swelling on right side. Exploration revealed a reddish-blue hemangiomatous mass in the scrotum extending through inguinal canal into the retroperitoneum. On further dissection swelling was found to be originating from right external iliac vein. The swelling was excised after ligating all vascular connections. The histopathological examination of excised mass confirmed the diagnosis of venous variety of vascular malformation. This is the first reported case of vascular malformation arising from retroperitoneum and extending into inguinoscrotal region, presenting as incarcerated inguinal hernia. PMID:21633582

  19. [Anatomy and mechanism of inguinal hernias].

    PubMed

    Flament, J B; Avisse, C; Delattre, J F

    1997-02-01

    Anterior abdominal wall presents a weak point between the pelvic bone and the muscular arch of transverse and internal oblique muscles. This myo-pectineal orifice, crossed by the inguinal ligament is closed by the transversalis fascia. All groin hernias, inguinal directs, indirects or femoral, result from a defect of the transversalis fascia. They have two causes. Congenital hernias result from a persisting peritoneo-vaginal canal. Acquired hernias result from a progressive weakening of the transversalis fascia depending on connective tissue insufficiency and increase of intra-abdominal pressure. PMID:9122597

  20. Laparoscopy for Hemoperitoneum After Traditional Inguinal Hernia Repair

    PubMed Central

    Kasamatsu, Hajime; Fujita, Sadanori; Mori, Hiroshi

    2002-01-01

    Hemoperitoneum after inguinal hernia repair, with the exception of laparoscopic herniorrhaphy, is extremely rare. No other case of hemoperitoneum after traditional open inguinal hernia repair has been reported in the English-language literature. A 39-year-old woman had undergone inguinal hernia repair with the Bassini repair technique. Lower abdominal pain and anemia occurred on postoperative day 1. Laparoscopy was performed and revealed hemoperitoneum caused as a complication of inguinal hernia repair. The abdominal cavity was thoroughly washed with saline solution, and the aspirated blood was processed and reinfused. Laparoscopy for hemoperitoneum as a complication after inguinal hernia repair was very useful for both diagnosis and treatment. PMID:12166761

  1. Pain related sexual dysfunction after inguinal herniorrhaphy.

    PubMed

    Aasvang, Eske Kvanner; Møhl, Bo; Bay-Nielsen, Morten; Kehlet, Henrik

    2006-06-01

    To determine the incidence of pain related sexual dysfunction 1 year after inguinal herniorrhaphy and to assess the impact pain has on sexual function. In contrast to the well-described about 10% risk of chronic wound related pain after inguinal herniorrhaphy, chronic genital pain, dysejaculation, and sexual dysfunction have only been described sporadically. The aim was therefore to describe these symptoms in a questionnaire study. A nationwide detailed questionnaire study in September 2004 of pain related sexual dysfunction in all men aged 18-40 years undergoing inguinal herniorrhaphy between October 2002 and June 2003 (n=1015) based upon the nationwide Danish Hernia Database collaboration. The response rate was 68.4%. Combined frequent and moderate or severe pain from the previous hernia site during activity was reported by 187 patients (18.4%). Pain during sexual activity was reported by 224 patients (22.1%), of which 68 (6.7%) had moderate or severe pain occurring every third time or more. Genital or ejaculatory pain was found in 125 patients (12.3%), and 28 (2.8%) patients reported that the pain impaired their sexual activity to a moderate or severe degree. Pain during sexual activity and subsequent sexual dysfunction represent a clinically significant problem in about 3% of younger male patients with a previous inguinal herniorrhaphy. Intraoperative nerve damage and disposition to other chronic pain conditions are among the most likely pathogenic factors. PMID:16545910

  2. Pig surgery: cryptorchidectomy using an inguinal approach.

    PubMed

    Scollo, A; Martelli, P; Borri, E; Mazzoni, C

    2016-06-11

    The objective of the study was to determine whether a less-invasive surgical technique used in cryptorchid horses, dogs and cats can be used successfully to remove retained testicles in pigs on farm. In total, 284 monolateral cryptorchid pigs underwent surgery on-farm condition, during which an incision was made over the inguinal ring and the undescended testicle was located for removal via identification of the vaginal process and the embryonic gubernaculum. A traction of these structures allowed the testis to pass through the deep and the superficial rings up to its exteriorisation outside the abdominal wall through the inguinal canal. The undescended testicle was located in the abdomen in 258 cases (90.8 per cent) and in the inguinal region in the remaining 26 cases (9.1 per cent). In none of the pigs was the abdominal cavity breached or the inguinal rings enlarged. However, in 23 pigs (8.1 per cent) the gubernaculum testis was thin and it frayed and ruptured when traction was applied, requiring a recovering by inserting a finger and Kelly curved forceps into the abdomen through the inguinal ring. In two pigs (0.7 per cent), the undescended testicle was not found. All surgical procedures were completed within 6-12 minutes. Four pigs died within two days after surgery (1.4 per cent). Major intraoperative or long-term complications did not occur. Results suggested that this surgical method is highly effective and could be used as a primary surgical approach in cryptorchid pigs as it is in cryptorchid dogs, cats and horses. PMID:27053253

  3. A rapidly growing lid lump

    PubMed Central

    Koay, Su-Yin; Lee, Richard M H; Hugkulstone, Charles; Rodrigues, Ian Aureliano Stephen

    2014-01-01

    A 97-year-old woman presented with a 5-month history of a rapidly growing, painless, left upper eyelid lesion. Examination revealed a large vascularised, ulcerated nodule on the left upper lid, causing significant ptosis. Wide local excision of the lesion was performed and the wound was left to heal by secondary intention. Histology and immunohistochemistry of the lesion confirmed a diagnosis of Merkel cell carcinoma, a rare primary malignancy of the eyelid which has significant morbidity and mortality. Although uncommon, this diagnosis should always be considered in any patient with a rapidly growing lid lump. In view of the patient's age, known dementia and family wishes, the patient was managed conservatively, with no further investigations performed. She was due to be followed up in clinic on a regular basis, but has since died from other causes. PMID:25123568

  4. Jack in the box: inguinal endometriosis.

    PubMed

    Pandey, Deeksha; Coondoo, Ambika; Shetty, Jyothi; Mathew, Stanley

    2015-01-01

    A 39-year-old woman with a left-sided inguinal swelling was referred to us with a diagnosis of inguinal hernia. On asking leading questions, the patient gave a typical history of cyclical pain and increased swelling during menstruation. Fine-needle aspiration biopsy revealed endometrial glands. Preoperatively, the extent of the endometriotic lesion was delineated using MRI. The lesion was approached through the patient's caesarean scar for cosmetic reasons and excised in toto. Final diagnosis was round ligament endometriosis. The patient was asymptomatic at 3, 6 and 12 months' follow-up. This case re-emphasises the fact that endometriosis is an enigmatic disease and can be found anywhere in the body. Thus, a woman of reproductive age presenting with any cyclical symptom should be asked about its relation to her menstrual cycle. PMID:25827916

  5. Pain control following inguinal herniorrhaphy: current perspectives

    PubMed Central

    Bjurstrom, Martin F; Nicol, Andrea L; Amid, Parviz K; Chen, David C

    2014-01-01

    Inguinal hernia repair is one of the most common surgeries performed worldwide. With the success of modern hernia repair techniques, recurrence rates have significantly declined, with a lower incidence than the development of chronic postherniorrhaphy inguinal pain (CPIP). The avoidance of CPIP is arguably the most important clinical outcome and has the greatest impact on patient satisfaction, health care utilization, societal cost, and quality of life. The etiology of CPIP is multifactorial, with overlapping neuropathic and nociceptive components contributing to this complex syndrome. Treatment is often challenging, and no definitive treatment algorithm exists. Multidisciplinary management of this complex problem improves outcomes, as treatment must be individualized. Current medical, pharmacologic, interventional, and surgical management strategies are reviewed. PMID:24920934

  6. Sigma model BPS lumps on a torus

    NASA Astrophysics Data System (ADS)

    Nakamula, Atsushi; Sasaki, Shin

    2012-09-01

    We study doubly periodic Bogomol’nyi-Prasad-Sommerfield lumps in supersymmetric CPN-1 nonlinear sigma models on a torus T2. Following the philosophy of the Harrington-Shepard construction of calorons in Yang-Mills theory, we obtain the n-lump solutions on compact spaces by suitably arranging the n lumps on R2 at equal intervals. We examine the modular invariance of the solutions and find that there are no modular invariant solutions for n=1, 2 in this construction.

  7. Chronic Pain after Inguinal Hernia Repair

    PubMed Central

    Manangi, Mallikarjuna; Shivashankar, Santhosh

    2014-01-01

    Background. Chronic postherniorrhaphy groin pain is defined as pain lasting >6 months after surgery, which is one of the most important complications occurring after inguinal hernia repair, which occurs with greater frequency than previously thought. Material and Methods. Patients undergoing elective inguinal hernioplasty in Victoria Hospital from November 2011 to May 2013 were included in the study. A total of 227 patients met the inclusion criteria and were available for followup at end of six months. Detailed preoperative, intraoperative, and postoperative details of cases were recorded according to proforma. The postoperative pain and pain at days two and seven and at end of six months were recorded on a VAS scale. Results. Chronic pain at six-month followup was present in 89 patients constituting 39.4% of all patients undergoing hernia repair. It was seen that 26.9% without preoperative pain developed chronic pain whereas 76.7% of patients with preoperative pain developed chronic pain. Preemptive analgesia failed to show statistical significance in development of chronic pain (P = 0.079). Nerve injury was present in 22 of cases; it was found that nerve injury significantly affected development of chronic pain (P = 0.001). On multivariate analysis, it was found that development of chronic pain following hernia surgery was dependent upon factors like preoperative pain, type of anesthesia, nerve injury, postoperative local infiltration, postoperative complication, and most importantly the early postoperative pain. Conclusions. In the present study, we found that chronic pain following inguinal hernia repair causes significant morbidity to patients and should not be ignored. Preemptive analgesia and operation under local anesthesia significantly affect pain. Intraoperative identification and preservation of all inguinal nerves are very important. Early diagnosis and management of chronic pain can remove suffering of the patient.

  8. Chronic pain after open inguinal hernia repair.

    PubMed

    Nikkolo, Ceith; Lepner, Urmas

    2016-01-01

    Following the widespread use of mesh repairs, recurrence rates after inguinal hernia surgery have become acceptable and focus has shifted from recurrence to chronic pain. Although pain can be controlled with analgesics, chronic postsurgical pain is a major clinical problem, which can significantly influence the patient's quality of life. The rate of chronic pain after inguinal hernia mesh repair can reach 51.6%. The reasons for posthernioplasty chronic pain are often unclear. It has been linked to nerve injury and nerve entrapment, but there is also association between the rate of chronic pain and the type of mesh used for hernia repair. As there are >160 meshes available in the market, it is difficult to choose a mesh whose usage would result in the best outcome. Different mesh characteristics have been studied, among them weight of mesh has probably gained the most attention. The choice of adequate therapy for chronic groin pain after inguinal hernia repair is controversial. The European Hernia Society recommends that a multidisciplinary approach at a pain clinic should be considered for the treatment of chronic postoperative pain. Although surgical treatment of chronic posthernioplasty pain is limited because of the lack of relevant research data, resection of entrapped nerves, mesh removal in the case of mesh related pain or removal of fixation sutures can be beneficial for the patient with severe pain after inguinal hernia surgery. One drawback of published studies is the lack of consensus over definition of chronic pain, which makes it complicated to compare the results of different studies and to conduct meta-analyses and systematic reviews. Therefore, a uniform definition of chronic pain and its best assessment methods should be developed in order to conduct top quality multicenter randomized trials. Further research to develop meshes with optimal parameters is of vital importance and should be encouraged. PMID:26567717

  9. Inguinal herniation with hydrometra/mucometra in a poodle bitch

    PubMed Central

    Sontas, B. Hasan; Toydemir, F.T. Seval; Erdogan, Özge; Şennazli, Gülbin; Ekici, Hayri

    2013-01-01

    A 5-year-old, sexually intact poodle bitch was presented with a 2-year history of inguinal mass. A tentative diagnosis of hydrometra/mucometra with inguinal herniation was made and ovariohysterectomy with hernia repair was performed. Both fluid-filled uterine horns, both broad ligaments, and the uterine body were observed to be herniated through the inguinal ring. On histopathology, marked edema and diffuse hemorrhage were diagnosed in the uterus. PMID:24155486

  10. Inguinal herniation with hydrometra/mucometra in a poodle bitch.

    PubMed

    Sontas, B Hasan; Toydemir, F T Seval; Erdogan, Ozge; Sennazli, Gülbin; Ekici, Hayri

    2013-09-01

    A 5-year-old, sexually intact poodle bitch was presented with a 2-year history of inguinal mass. A tentative diagnosis of hydrometra/mucometra with inguinal herniation was made and ovariohysterectomy with hernia repair was performed. Both fluid-filled uterine horns, both broad ligaments, and the uterine body were observed to be herniated through the inguinal ring. On histopathology, marked edema and diffuse hemorrhage were diagnosed in the uterus. PMID:24155486

  11. Anal Canal Cancer: Management of Inguinal Nodes and Benefit of Prophylactic Inguinal Irradiation (CORS-03 Study)

    SciTech Connect

    Ortholan, Cecile; Resbeut, Michel; Hannoun-Levi, Jean-Michel; Teissier, Eric; Gerard, Jean-Pierre; Ronchin, Philippe; Zaccariotto, Audrey; Minsat, Mathieu; Benezery, Karen; Francois, Eric; Salem, Naji; Ellis, Steve; Azria, David; Champetier, Cedric; Gross, Emmanuel; Cowen, Didier

    2012-04-01

    Purpose: To evaluate the benefit of prophylactic inguinal irradiation (PII) in anal canal squamous cell carcinoma (ASCC). Methods and Materials: This retrospective study analyzed the outcome of 208 patients presenting with ASCC treated between 2000 and 2004 in four cancer centers of the south of France. Results: The population study included 35 T1, 86 T2, 59 T3, 20 T4, and 8 T stage unknown patients. Twenty-seven patients presented with macroscopic inguinal node involvement. Of the 181 patients with uninvolved nodes at presentation, 75 received a PII to a total dose of 45-50 Gy (PII group) and 106 did not receive PII (no PII group). Compared with the no PII group, patients in the PII group were younger (60% vs. 41% of patients age <68 years, p = 0.01) and had larger tumor (T3-4 = 46% vs. 27% p = 0.01). The other characteristics were well balanced between the two groups. Median follow-up was 61 months. Fourteen patients in the no PII group vs. 1 patient in the PII group developed inguinal recurrence. The 5-year cumulative rate of inguinal recurrence (CRIR) was 2% and 16% in PII and no PII group respectively (p = 0.006). In the no PII group, the 5-year CRIR was 12% and 30% for T1-T2 and T3-T4 respectively (p = 0.02). Overall survival, disease-specific survival, and disease-free survival were similar between the two groups. In the PII group, no Grade >2 toxicity of the lower extremity was observed. Conclusion: PII with a dose of 45 Gy is safe and highly efficient to prevent inguinal recurrence and should be recommended for all T3-4 tumors. For early-stage tumors, PII should also be discussed, because the 5-year inguinal recurrence risk remains substantial when omitting PII (about 10%).

  12. Inguinal mass in a college football player: a case study.

    PubMed

    Rich, B S; Hough, D O; Monroe, J S; Nogle, S

    1993-03-01

    A 22-yr-old male college football player presented with a 3-wk history of a mass in his right inguinal area. Originally thought by the athlete to be a groin strain, evaluation revealed a large indirect inguinal hernia. Surgical evaluation was obtained to confirm the diagnosis of a 4-cm opening at the external inguinal ring. The hernia completely and spontaneously reduced in the supine position. The athlete was successfully allowed to participate with the use of a truss and underwent an uneventful surgical repair at the end of the season. The diagnosis and treatment of inguinal hernias are reviewed. PMID:8455445

  13. Angiomyomatous hamartoma in an inguinal lymph node with proliferating pericytes/smooth muscle cells, plexiform vessel tangles, and ectopic calcification.

    PubMed

    Lee, Chii-Hong; Chang, Tung-Cheng; Ku, Jan-Wen

    2015-01-01

    Angiomyomatous hamartoma (AMH) is a rare benign lesion, which occurs almost exclusively in the inguinal lymph nodes. We herein report a case of a female elder who presented with a long-standing inguinal mass. Microscopically, the mass showed a zonal distribution, characterized by thick-walled muscular vessels, fibrosis, and calcification in the hilum and proliferating spindle cells around thin-walled vessels and plexiform vessel tangles at the periphery. The spindle cells show positive immunoreactivity of smooth muscle actin and CD34 with a heterogeneous expression of desmin and CD44. Although the pathogenesis of AMH remains uncertain, the histological features and immunohistochemical findings of this case imply a disordered or exuberant angiogenic process. PMID:25885141

  14. 20 CFR 225.26 - Residual Lump-Sum PIA.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... Lump-Sum Payable § 225.26 Residual Lump-Sum PIA. The Residual Lump-Sum PIA (RLS PIA) is used to compute... determining the amount of the residual lump-sum payable, as explained in part 234 of this chapter. The RLS PIA.... The RLS PIA is computed just like the retirement Tier I PIA described in subpart B of this...

  15. 20 CFR 225.26 - Residual Lump-Sum PIA.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... Lump-Sum Payable § 225.26 Residual Lump-Sum PIA. The Residual Lump-Sum PIA (RLS PIA) is used to compute... determining the amount of the residual lump-sum payable, as explained in part 234 of this chapter. The RLS PIA.... The RLS PIA is computed just like the retirement Tier I PIA described in subpart B of this...

  16. 20 CFR 225.26 - Residual Lump-Sum PIA.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... Lump-Sum Payable § 225.26 Residual Lump-Sum PIA. The Residual Lump-Sum PIA (RLS PIA) is used to compute... determining the amount of the residual lump-sum payable, as explained in part 234 of this chapter. The RLS PIA.... The RLS PIA is computed just like the retirement Tier I PIA described in subpart B of this...

  17. 20 CFR 225.26 - Residual Lump-Sum PIA.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... Lump-Sum Payable § 225.26 Residual Lump-Sum PIA. The Residual Lump-Sum PIA (RLS PIA) is used to compute... determining the amount of the residual lump-sum payable, as explained in part 234 of this chapter. The RLS PIA.... The RLS PIA is computed just like the retirement Tier I PIA described in subpart B of this...

  18. 20 CFR 225.26 - Residual Lump-Sum PIA.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... Lump-Sum Payable § 225.26 Residual Lump-Sum PIA. The Residual Lump-Sum PIA (RLS PIA) is used to compute... determining the amount of the residual lump-sum payable, as explained in part 234 of this chapter. The RLS PIA.... The RLS PIA is computed just like the retirement Tier I PIA described in subpart B of this...

  19. Significance of nuclear morphometry in benign and malignant breast aspirates

    PubMed Central

    Narasimha, Aparna; Vasavi, B; Kumar, Harendra ML

    2013-01-01

    Background: Breast carcinoma is one of the most common cancers occurring in the female population world-wide. Normal cells gradually transform to form the cancer cells through several stages. Nuclear changes occurring during these transformational steps need to be assessed objectively. Hence nuclear morphometry can be used as a diagnostic tool. Aim: To compare the nuclear morphometric parameters of benign and malignant breast aspirates. Study Design: Cytology was used to categorize aspirates from the breast lumps in to malignant (30 cases), and benign (30 cases). Nuclear parameters were calculated using the Image J 1.44C morphometric software. Several nuclear size parameters were analyzed. Results: The nuclear area, perimeter, diameter, compactness, and concave points were found to be statistically significant (P < 0.05) parameters in differentiating benign, and malignant aspirates. Conclusion: Nuclear morphometry was thus, a useful objective tool in the differentiating benign, and malignant breast lesions. PMID:23776836

  20. Mesothelioma - benign-fibrous

    MedlinePlus

    Mesothelioma - benign; Mesothelioma - fibrous; Pleural fibroma; Solitary fibrous tumor of the pleura ... other reasons. Other tests that may show benign mesothelioma include: CT scan of the chest Open lung ...

  1. Benign Breast Problems and Conditions

    MedlinePlus

    ... find a lump in my breast? • What is mammography? • What happens if a suspicious lump or area ... exam, more tests may be recommended. What is mammography? Mammography can be used as a screening test ...

  2. A Rare Case of Round Ligament Leiomyoma: An Inguinal Mass

    PubMed Central

    E, Harish; P B, Indudhara

    2014-01-01

    Tumours of round ligament of uterus are rare. Leiomyoma of the round ligament can present as inguinal swelling mimicking an incarcerated/irreducible hernia / inguinal secondaries / lymph node. It arises from smooth muscle of round ligament. It can be diagnosed preoperatively by CT scan or following exploration. Surgery is the treatment of choice for this condition. PMID:25478407

  3. [Surgery of inguinal hernias in the geriatric patient].

    PubMed

    Palumbo, P; Pulcini, M; Vietri, F; Turano, R; Gallinaro, L; Montesano, G; Martinelli, V

    1997-10-01

    The Authors report a series of 73 elderly patients undergone to Lichtenstein hernioplasty with local anaesthesia. Treatment of inguinal hernia in emergency involves a high mortality; on the contrary, the lack of complications and a very good patient compliance shows that elective repair of inguinal hernia should be preferred and performed in the elderly. PMID:9479989

  4. Breast cancer with inguinal node recurrence.

    PubMed

    Goyal, Shikha; Puri, Tarun; Julka, Pramod K

    2015-03-01

    Surgery and irradiation for breast cancer may interfere with conventional pathways of spread, leading to bizarre patterns of dissemination through lymphatics or through hematogenous route. Lymphoscintigraphic studies may help identify nodal involvement. Other possible reasons could be occurrence of primary breast cancer in accessory breast tissue retained in the vulva following involution of milk line. We describe a case of triple negative breast cancer, who developed contralateral breast cancer during treatment. Three years later, she developed isolated inguinal nodal metastases, which responded to local radiotherapy and chemotherapy. However, the patient relapsed after 2 years and could not be salvaged thereafter. PMID:25455282

  5. Inguinal Lymph Node Anthracosis: A Case Report

    PubMed Central

    Soto, Carlos Alberto

    2016-01-01

    Summary: Anthracosis is defined as black, dense pigments in tissues, usually carbon deposits. We, as surgeons, have to make decisions during surgery to the best of our knowledge and based on what the literature provides us. We present the case of a 30-year-old female patient who underwent abdominoplasty. During surgery, bilateral inguinal pigmented and enlarged lymph nodes were seen. Biopsy of the nodes was done to rule out any malignancy. The results showed tattoo pigments on all lymph nodes. We present this case as tattoo pigment migration, which has been rarely described. PMID:27536493

  6. ROBOTIC ASSISTED SINGLE SITE FOR BILATERAL INGUINAL HERNIA REPAIR

    PubMed Central

    BOSI, Henrique Rasia; GUIMARÃES, José Ricardo; CAVAZZOLA, Leandro Totti

    2016-01-01

    ABSTRACT Background: The inguinal hernia is one of the most frequent surgical diseases, being frequent procedure and surgeon´s everyday practice. Aim: To present technical details in making hernioplasty using robotic equipment on bilateral inguinal hernia repair with single port and preliminary results with the method. Method: The bilateral inguinal hernia repair was performed by using the Single-Site(c) Da Vinci Surgical Access Platform to the abdominal cavity and the placement of clamps. Results: This technique proved to be effective for inguinal hernia and have more aesthetic result when compared to other techniques. Conclusions: Inguinal hernia repair robot-assisted with single-trocar is feasible and effective. However, still has higher costs needing surgical team special training. PMID:27438038

  7. Neural coding of passive lump detection in compliant artificial tissue

    PubMed Central

    Gwilliam, James C.; Yoshioka, Takashi; Hsiao, Steven S.

    2014-01-01

    Here, we investigate the neural mechanisms of detecting lumps embedded in artificial compliant tissues. We performed a combined psychophysical study of humans performing a passive lump detection task with a neurophysiological study in nonhuman primates (Macaca mulatta) where we recorded the responses of peripheral mechanoreceptive afferents to lumps embedded at various depths in intermediates (rubbers) of varying compliance. The psychophysical results reveal that human lump detection is greatly degraded by both lump depth and decreased compliance of the intermediate. The neurophysiology results reveal that only the slowly adapting type 1 (SA1) afferents provide a clear spatial representation of lumps at all depths and that the representation is affected by lump size, depth, and compliance of the intermediate. The rapidly adapting afferents are considerably less sensitive to the lump. We defined eight neural response measures that we hypothesized could explain the psychophysical behavior, including peak firing rate, spatial spread of neural activity, and additional parameters derived from these measures. We find that peak firing rate encodes the depth of the lump, and the neural spatial spread of the SA1 response encodes for lump size but not lump shape. We also find that the perception of lump size may be affected by the compliance of the intermediate. The results show that lump detection is based on a spatial population code of the SA1 afferents, which is distorted by the depth of the lump and compliance of the tissue. PMID:24805077

  8. Lump Solitons in Surface Tension Dominated Flows

    NASA Astrophysics Data System (ADS)

    Milewski, Paul; Berger, Kurt

    1999-11-01

    The Kadomtsev-Petviashvilli I equation (KPI) which models small-amplitude, weakly three-dimensional surface-tension dominated long waves is integrable and allows for algebraically decaying lump solitary waves. It is not known (theoretically or numerically) whether the full free-surface Euler equations support such solutions. We consider an intermediate model, the generalised Benney-Luke equation (gBL) which is isotropic (not weakly three-dimensional) and contains KPI as a limit. We show numerically that: 1. gBL supports lump solitary waves; 2. These waves collide elastically and are stable; 3. They are generated by resonant flow over an obstacle.

  9. Comments on lump solutions in SFT

    NASA Astrophysics Data System (ADS)

    Bonora, Loriano; Tolla, Driba D.

    2016-04-01

    We analyze a recently proposed scheme to construct analytic lump solutions in open SFT. We argue that in order for the scheme to be operative and to guarantee background independence it must be implemented in the same 2D conformal field theory in which SFT is formulated. We outline and discuss two different possible approaches. Next we reconsider an older proposal for analytic lump solutions and implement a few improvements. In the course of the analysis we formulate a distinction between regular and singular gauge transformations and advocate the necessity of defining a topology in the space of string fields.

  10. [Is the presence of an asymptomatic inguinal hernia enough to justify repair?].

    PubMed

    Metzger, Jürg

    2015-11-11

    The risk of strangulation in case of a inguinal hernia is low. Patients with a symptomatic inguinal hernia should undergo an operation. Morbidity and mortality in inguinal hernia surgery are very rare. There is also non-conservative treatment of inguinal hernias. Trusses should no longer be recommended. Watchful waiting is an option for men with minimally symptomatic or asymptomatic inguinal hernias. But patients must be informed that there is a high risk of becoming symptomatic. PMID:26558931

  11. Transverse testicular ectopia: a rare association with inguinal hernia

    PubMed Central

    Dahal, Prakash; Koirala, Rabin; Subedi, Neeraj

    2014-01-01

    Transverse testicular ectopia (TTE) is a rare anomaly that is commonly associated with inguinal hernia. Most of the reported cases are in children with very few reported cases in adults. We report a case of 42 years, fertile male, who presented with left reducible inguinal hernia. During surgery, he was found to have a left indirect inguinal hernia with TTE with both testes on the left side. Hernioplasty and bilateral orchidopexy were performed. He had an uneventful recovery. Most of these cases are diagnosed intraoperatively, but imaging (ultrasonography and magnetic resonance imaging) has emerged as a promising tool for preoperative diagnosis although ultrasound missed it in this case. PMID:25287117

  12. Inguinal hernia repair: toward Asian guidelines.

    PubMed

    Lomanto, Davide; Cheah, Wei-Keat; Faylona, Jose Macario; Huang, Ching Shui; Lohsiriwat, Darin; Maleachi, Andy; Yang, George Pei Cheung; Li, Michael Ka-Wai; Tumtavitikul, Sathien; Sharma, Anil; Hartung, Rolf Ulrich; Choi, Young Bai; Sutedja, Barlian

    2015-02-01

    Groin hernias are very common, and surgical treatment is usually recommended. In fact, hernia repair is the most common surgical procedure performed worldwide. In countries such as the USA, China, and India, there may easily be over 1 million repairs every year. The need for this surgery has become an important socioeconomic problem and may affect health-care providers, especially in aging societies. Surgical repair using mesh is recommended and widely employed in Western countries, but in many developing countries, tissue-to-tissue repair is still the preferred surgical procedure due to economic constraints. For these reason, the development and implementation of guidelines, consensus, or recommendations may aim to clarify issues related to best practices in inguinal hernia repair in Asia. A group of Asian experts in hernia repair gathered together to debate inguinal hernia treatments in Asia in an attempt to reach some consensus or develop recommendations on best practices in the region. The need for recommendations or guidelines was unanimously confirmed to help overcome the discrepancy in clinical practice between countries; the experts decided to focus mainly on the technical aspects of open repair, which is the most common surgery for hernia in our region. After the identification of 12 main topics for discussion (indication, age, and sex; symptomatic and asymptomatic hernia: type of hernia; type of treatment; hospital admission; preoperative care; anesthesia; surgical technique; perioperative care; postoperative care; early complications; and long-term complications), a search of the literature was carried out according to the five levels of the Oxford Classification of Evidence and the four grades of recommendation. PMID:25598054

  13. 22 CFR 19.13-1 - Lump-sum credit.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 22 Foreign Relations 1 2014-04-01 2014-04-01 false Lump-sum credit. 19.13-1 Section 19.13-1... THE FOREIGN SERVICE RETIREMENT AND DISABILITY SYSTEM § 19.13-1 Lump-sum credit. “Lump-sum credit” is the compulsory and special contributions to a participant's or former participant's credit in the...

  14. 22 CFR 19.13-1 - Lump-sum credit.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Lump-sum credit. 19.13-1 Section 19.13-1... THE FOREIGN SERVICE RETIREMENT AND DISABILITY SYSTEM § 19.13-1 Lump-sum credit. “Lump-sum credit” is the compulsory and special contributions to a participant's or former participant's credit in the...

  15. 22 CFR 19.13-1 - Lump-sum credit.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 22 Foreign Relations 1 2011-04-01 2011-04-01 false Lump-sum credit. 19.13-1 Section 19.13-1... THE FOREIGN SERVICE RETIREMENT AND DISABILITY SYSTEM § 19.13-1 Lump-sum credit. “Lump-sum credit” is the compulsory and special contributions to a participant's or former participant's credit in the...

  16. 22 CFR 19.13-1 - Lump-sum credit.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 22 Foreign Relations 1 2013-04-01 2013-04-01 false Lump-sum credit. 19.13-1 Section 19.13-1... THE FOREIGN SERVICE RETIREMENT AND DISABILITY SYSTEM § 19.13-1 Lump-sum credit. “Lump-sum credit” is the compulsory and special contributions to a participant's or former participant's credit in the...

  17. Left Inguinal Bladder Hernia that Causes Dilatation in the Ureter.

    PubMed

    Ugur, Mustafa; Atcı, Nesrin; Oruc, Cem; Akkucuk, Seckin; Aydogan, Akin

    2016-05-01

    The scrotal bladder hernia is a rare condition that may present as scrotal swelling and urinary system obstruction or infection symptoms. Diagnosis of this condition before the operation decreases the severe complications like bladder injury during operation. In this article, a 75-year-old man presented to our clinic with right inguinal swelling and lower urinary system infection. Inguinal bladder hernia was diagnosed after performing a computed tomography. The hernia was repaired without any complications. PMID:27179171

  18. [Complications associated with inguinal orchiectomy and scrotal orchiectomy].

    PubMed

    Anheuser, P; Kranz, J; Will, J; Dieckmann, K P

    2014-05-01

    Inguinal excision of testis is technically an elementary surgical procedure. According to the indication (e.g., malignant tumors, infarction, inflammation), an inguinal or alternatively a transcrotal approach is possible. Despite its straightforwardness, surgery of the scrotum includes remarkable risks and complications such as postoperative hemorrhage, hematoma formation, infections, and disturbances of wound healing followed by insufficient unfavorable cosmetic results. Nerve injury may be accompanied by temporary or persistent paresthesias which have been documented in our patients undergoing orchiectomy. PMID:24744108

  19. Acute Osteomyelitis of the Symphysis Pubis after Inguinal Hernia Surgery

    PubMed Central

    Tekin, Recep; Ceylan Tekin, Rojbin; Ceylan Cevik, Figen; Cevik, Remzi

    2015-01-01

    Osteomyelitis of pubic symphysis is infectious inflammatory condition of the symphysis pubis and rare complication of surgery around inguinal and groin region. It should be kept in mind in the differential diagnosis of lower pelvic pain and should be sought in cases of pelvic insufficiency fractures. Herein, we present a case of a 55-year-old man with osteomyelitis of the symphysis pubis following inguinal hernia surgery for diagnosis and management of this rare condition. PMID:25973280

  20. Retroperitoneal mass presenting as recurrent inguinal hernia: A case report

    PubMed Central

    Tardu, Ali; Yagci, Mehmet Ali; Karagul, Servet; Ertugrul, Ismail; Kayaalp, Cuneyt

    2016-01-01

    Introduction Retroperitoneal masses presenting as an inguinal hernia are rare conditions. Presentation of case A 53 year old male admitted with the symptoms of weight loss, abdominal discomfort and left sided recurrent inguinal hernia. Physical examination demonstrated an abdominal mass in the left flank and an irreducible, painless scrotal mass. He had a history of left sided inguinal hernia surgery six years ago. Computed tomography revealed a large enhancing left sided retroperitoneal mass invading the colon, pancreas and kidney and it was going down towards the left scrotum. Unblock tumor resection including the neighboring organs (left kidney, left colon, distal pancreas with spleen) was performed. Scrotal extension of the tumor was also excised and the inguinal canal was repaired primarily. Histopathology of the mass was myxoid-liposarcoma. The patient has disease free, without hernia recurrence but poor in renal function after twenty months follow-up. Discussion Large retroperitoneal tumors may grow towards the inguinal region and they can mimic an inguinal hernia. An irreducible, painless and hard scrotal mass should be considered from this perspective. PMID:26812669

  1. Dark lump excitations in superfluid Fermi gases

    NASA Astrophysics Data System (ADS)

    Xu, Yan-Xia; Duan, Wen-Shan

    2012-11-01

    We study the linear and nonlinear properties of two-dimensional matter-wave pulses in disk-shaped superfluid Fermi gases. A Kadomtsev—Petviashvili I (KPI) solitary wave has been realized for superfluid Fermi gases in the limited cases of Bardeen—Cooper—Schrieffer (BCS) regime, Bose—Einstein condensate (BEC) regime, and unitarity regime. One-lump solution as well as one-line soliton solutions for the KPI equation are obtained, and two-line soliton solutions with the same amplitude are also studied in the limited cases. The dependence of the lump propagating velocity and the sound speed of two-dimensional superfluid Fermi gases on the interaction parameter are investigated for the limited cases of BEC and unitarity.

  2. Lumped elements characterize Q in dielectric resonators

    NASA Technical Reports Server (NTRS)

    Hearn, Chase P.

    1993-01-01

    It has been earlier observed (Podcameni et al., 1981) that, as the coupling factor between a microstrip-coupled dielectric resonator and the line becomes much larger than unity, the unloaded quality factor (Q) of the resonator decreases. In this paper it is shown that this effect can be explained using lumped-element models of the coupling line, when the dielectric resonator is either overcoupled or undercoupled to the line.

  3. Exophytic benign prostatic hyperplasia.

    PubMed

    Blaschko, Sarah D; Eisenberg, Michael L

    2011-08-01

    A 60-year-old man had incidental finding of a multilobular 8 × 7 × 7-cm mass identified posterior to the urinary bladder in continuity with the prostate. The man's prostate-specific antigen was 1.87, and he denied any lower urinary tract symptoms. A transrectal ultrasound-guided biopsy demonstrated benign prostatic tissue. A computed tomography-guided needle aspiration demonstrated a benign epithelium-lined cyst, likely prostatic in origin. Benign prostatic hyperplasia is a proliferation of prostatic epithelial and stromal cells. Although prostatic hyperplasia is usually restricted to the prostate gland, hyperplastic nodules occasionally protrude outside the prostate and rarely form exophytic pelvic masses. PMID:20869104

  4. Women, breast lump discovery, and associated stress.

    PubMed

    MacFarlane, M E; Sony, S D

    1992-01-01

    To learn about anxiety experienced by women before they undergo breast biopsy, we surveyed by telephone 42 females aged 18 or over who were scheduled for this procedure. Unlike other studies, the present investigation explores retrospectively the impact of the discovery of a breast lump, hospitalization, and factors that aggravate and alleviate anxiety. An interview guide and an adaptation of the Spielberger, Gorsuch, and Lushene (1970) State Trait Anxiety Inventory Scale were used for data collection. The stress and coping models developed by Lazarus and Launier (1978) and Lazarus and Folkman (1984) contributed to the conceptual framework used in this study. Findings indicate that the anxiety levels of women after the discovery of a breast lump and prior to knowledge of biopsy results were extremely high. Age and time delay in contacting the physician had a statistically significant relationship on the participants' stress levels. The findings provide information that contributes to understanding the problem of anxiety originating from the discovery of a breast lump. PMID:1556029

  5. Open inguinal herniotomy: Analysis of variations

    PubMed Central

    Ibrahim, Musa; Ladan, Mu’azu Adamu; Abdussalam, Umar Sharif; Getso, Kabiru Ibrahim; Mohammad, Mohammad Aminu; Chukwuemeka, Anyanwu Lofty-John; Owolabi, Femi Luqman; Akhparov, Nurlan Nurkenovich; Aipov, Rassulbek Rakhmanberdievich

    2015-01-01

    Background: Repair of congenital groin hernia/hydrocele is the most common surgical procedure performed by paediatric surgeons. There is dearth of literature comparing the outcomes of open herniotomy in children using various surgical approaches. This study was aimed at evaluating the efficacy of open herniotomy by comparing external ring incision, hernial sac twisting and whether or not double ligation has benefit over a single suture application. Materials and Methods: A multi-centre prospective randomised clinical trial was conducted with a total of 428 patients having congenital inguinal hernia and/or hydrocele. Patients were randomly assigned into four groups: RO (had external ring opened, hernial sac twisted and doubly ligated), ST (had hernial sac twisted and doubly ligated without opening the ring), DL (had double ligation of hernial sac without ring opening nor twisted) while SL (had single ligation of hernial sac with neither ring opening nor sac twisting). Results: A total of 458 repairs were done. Patients’ age ranged from 0.25 years (3 months) to 21 years in group RO with mean of 4.87 ± 4.07 (median, 4), 0.069 years (24 days) to 17 years in group ST with mean of 4.23 ± 4.03 (median, 3), 0.5 years (6 months) to 16 years in group DL with mean of 4.59 ± 3.87 (median, 4) and 1 year to 19 years in group SL with mean of 5.00 ± 4.19 (median, 4). Operation time per repair was 26.50 ± 5.46 min, range 16-40 min (median, 27 min) in group RO, 22.18 ± 5.34 min, range 12-39 min (median, 21 min) in group ST while 17.98 ± 3.40 min with range of 12-39 min (median, 17 min) in group DL and 15.27 ± 4.18 min, range 7-40 min (median, 15 min) in group SL P < 0.0001. The mean paracetamol dose/patient was 3.96 ± 1.43, 2.94 ± 0.81, 2.18 ± 0.69, 1.87 ± 0.78 in group RO, ST, DL and SL, respectively, P < 0.0001. Conclusion: Congenital inguinal hernia repair with opening of the external ring, hernia sac twisting and double ligation of the processus vaginalis confers

  6. Prosthetic Mesh Repair for Incarcerated Inguinal Hernia

    PubMed Central

    Tatar, Cihad; Tüzün, İshak Sefa; Karşıdağ, Tamer; Kızılkaya, Mehmet Celal; Yılmaz, Erdem

    2016-01-01

    Background: Incarcerated inguinal hernia is a commonly encountered urgent surgical condition, and tension-free repair is a well-established method for the treatment of non-complicated cases. However, due to the risk of prosthetic material-related infections, the use of mesh in the repair of strangulated or incarcerated hernia has often been subject to debate. Recent studies have demonstrated that biomaterials represent suitable materials for performing urgent hernia repair. Certain studies recommend mesh repair only for cases where no bowel resection is required; other studies, however, recommend mesh repair for patients requiring bowel resection as well. Aim: The aim of this study was to compare the outcomes of different surgical techniques performed for strangulated hernia, and to evaluate the effect of mesh use on postoperative complications. Study Design: Retrospective cross-sectional study. Methods: This retrospective study was performed with 151 patients who had been admitted to our hospital’s emergency department to undergo surgery for a diagnosis of incarcerated inguinal hernia. The patients were divided into two groups based on the applied surgical technique. Group 1 consisted of 112 patients treated with mesh-based repair techniques, while Group 2 consisted of 39 patients treated with tissue repair techniques. Patients in Group 1 were further divided into two sub-groups: one consisting of patients undergoing bowel resection (Group 3), and the other consisting of patients not undergoing bowel resection (Group 4). Results: In Group 1, it was observed that eight (7.14%) of the patients had wound infections, while two (1.78%) had hematomas, four (3.57%) had seromas, and one (0.89%) had relapse. In Group 2, one (2.56%) of the patients had a wound infection, while three (7.69%) had hematomas, one (2.56%) had seroma, and none had relapses. There were no statistically significant differences between the two groups with respect to wound infection, seroma

  7. Benign prostate hyperplasia (BPH) - resources

    MedlinePlus

    Resources - benign prostatic hyperplasia (BPH); Prostate enlargement resources; BPH resources ... organizations provide information on benign prostatic hyperplasia ( prostate enlargement ): National Kidney and Urologic Diseases Information Clearinghouse -- www. ...

  8. The Benign Hamburger.

    ERIC Educational Resources Information Center

    Peaslee, Graham; Lantz, Juliette M.; Walczak, Mary M.

    1998-01-01

    Uses a case study of food poisoning from hamburgers at the fictitious Jill-at-the-Grill to teach the nuclear science behind food irradiation. Includes case teaching notes on the benign hamburger. (ASK)

  9. Benign positional vertigo

    MedlinePlus

    ... Clinical practice guideline: Benign paroxysmal positional vertigo. Otolaryngol Head Neck Surg . 2008;139(5 Suppl 4):S47-S81. ... BH, Lund V, et al, eds. Cummings Otolaryngology: Head & Neck Surgery . 6th ed. Philadelphia, PA: Elsevier Mosby; 2015: ...

  10. A case of suboccipital lump with a rare and unexpected diagnosis of apocrine cystadenoma

    PubMed Central

    Maguire, Richard; Maguire, Errol

    2015-01-01

    Introduction Cystadenoma of apocrine origin is a tumour of the sweat gland that is benign in nature. Classification of this pathology is based upon histological characteristics plus histochemical analysis. Prevalence of cystadenoma has been suggested to be quite rare, in the region of 1 in 1000 of subcutaneous biopsies observed. Presentation of case We present a case of a 40 year old man referred by his GP with a suboccipital lump, present for some years. On examination the lump was approximately 4–5 cm in diameter and an unusual punctum was present. The patient proceeded to an excision of the lesion and the gross specimen showed characteristics of a multiloculated cyst, measuring some 5 cm × 3.5 cm. Histopathology of the tumour revealed an apocrine cystadenoma; there were no features suggestive of malignancy. Discussion Previous classification of cystadenoma via histological and immunohistochemical method; has revealed only two distinct entities and the term hydrocystoma was often used in place of cystadenoma. More recent studies have suggested that a third type can be identified via immunohistochemical analysis. This third type; apocrine hydrocystoma, reveals that those previously defined as eccrine in origin may also be related to the apocrine ducts. Conclusion Apocrine cystadenoma remains a benign pathology and treatment should be focussed on excision, without need for further intervention. Apocrine cystadenoma remains a relatively rare pathology, though one which should not recur if adequate treatment is given. PMID:26670411

  11. A Clinicopathological Study of Benign Phyllodes Tumour of Breast with Emphasis on Unusual Features

    PubMed Central

    Naik, Reena

    2016-01-01

    Introduction Benign Phyllodes Tumours (PTs) are rare fibroepithelial neoplasms that resemble fibroadenoma. But unlike fibroadenoma, benign PT can recur and both stromal & epithelial components can progress to malignancy. Contrary to earlier belief that benign PT is a stromal neoplasm and possibly arises from fibroadenoma, more recent molecular studies have suggested that both stroma and epithelium can become neoplastic. Sometimes, benign PT can occur synchronously with fibroadenoma. Here histomorphologic analysis of eleven cases of benign PT are presented including some unusual features. Materials and Methods Eleven cases of benign PT diagnosed between Dec 2014 and Jan 2016 in the Department of Pathology were studied. The demographic and clinicopathological features were analysed. Results The most common age group affected was 20-30 years (range: 13-45). Clinical features included pain, lump and bleeding from nipple. The tumour size varied from 2.5-18 cm in diameter. H&E stained sections showed secondary changes (haemorrhage, myxoid, change, cystic degeneration), epithelial hyperplasia (8), squamous & columnar metaplasia (1), benign tubular adenoma like areas (1), Ductal Carcinoma In Situ (DCIS) (1), Invasive Ductal Carcinoma (IDC) (1), Pseudoangiomatous Stromal Hyperplasia (PASH) (1), histologic infarction (2), tumour necrosis (1) and synchronous fibroadenoma (1). Unusual histologic features included atypical ductal hyperplasia, DCIS, IDC, synchronous fibroadenoma and tubular adenoma like areas arising within benign PT. Conclusion This study shows a spectrum of hyperplastic, metaplastic, dysplastic, benign, in-situ-malignancy and even invasive ductal malignancy occurring in benign PT. Therefore adequate and extensive sampling is recommended for accurate diagnosis.

  12. Proficiency of Surgeons in Inguinal Hernia Repair

    PubMed Central

    Neumayer, Leigh A.; Gawande, Atul A.; Wang, Jia; Giobbie-Hurder, Anita; Itani, Kamal M. F.; Fitzgibbons, Robert J.; Reda, Domenic; Jonasson, Olga

    2005-01-01

    Objectives: We examined the influence of surgeon age and other factors on proficiency in laparoscopic or open hernia repair. Summary Background Data: In a multicenter, randomized trial comparing open and laparoscopic herniorrhaphies, conducted in Veterans Administration hospitals (CSP 456), we reported significant differences in recurrence rates (RR) for the laparoscopic procedure as a result of surgeons’ experience. We have also reported significant differences in RR for the open procedure related to resident postgraduate year (PGY) level. Methods: We analyzed data from unilateral laparoscopic and open herniorrhaphies from CSP 456 (n = 1629). Surgeon's experience (experienced ≥250 procedures; inexperienced <250), surgeon's age, median PGY level of the participating resident, operation time, and hospital observed-to-expected (O/E) ratios for mortality were potential independent predictors of RR. Results: Age was dichotomized into older (≥45 years) and younger (<45 years). Surgeon's inexperience and older age were significant predictors of recurrence in laparoscopic herniorrhaphy. The odds of recurrence for an inexperienced surgeon aged 45 years or older was 1.72 times that of a younger inexperienced surgeon. For open repairs, although surgeon's age and operation time appeared to be related to recurrence, only median PGY level of <3 was a significant independent predictor. Conclusion: This analysis demonstrates that surgeon's age of 45 years and older, when combined with inexperience in laparoscopic inguinal herniorrhaphies, increases risk of recurrence. For open repairs, only a median PGY level of <3 was a significant risk factor. PMID:16135920

  13. Video endoscopic inguinal lymphadenectomy for radical management of inguinal nodes in patients with penile squamous cell carcinoma

    PubMed Central

    Chaudhari, Rajeev; Khant, Shahil Rameshbhai; Patel, Dipen

    2016-01-01

    Background: Inguinal lymph node involvement is an important prognostic factor in penile cancer. Inguinal lymph node dissection allows staging and treatment of inguinal nodal disease. However, it causes morbidity and is associated with complications such as lymphocele, skin loss, and infection. Aims: To report our institutional experience with video endoscopic inguinal lymphadenectomy (VEIL) for radical management of inguinal nodes in patients with penile squamous cell carcinoma. Materials and Methods: It is a prospective analysis of data of patients that underwent VEIL, by a single surgeon, from 2008 to 2015. 14 patients of penile carcinoma were suitable for VEIL technique were included in this study and followed. Data analyzed included mean operative time, mean lymph node yield, intraoperative complications, cutaneous complication, lymph-related complications, and surgical emphysema. Results: The mean age of patients was 57.8 years (range: 45–70 years). Mean operative time for VEIL was 194.86 min (178–210 min). Mean lymph node yield was 7.68 (range: 5–11 nodes). No intraoperative complication was experienced during series. We noted no cutaneous complications, localized lymphocele were seen in total 6 units out of 22 units (27.2%). Surgical emphysema is seen in 3 limbs (13.63%). There was significantly decreased overall morbidity in our study. Follow-up of 10 out of 14 patients with median of 48 months shows no recurrence. Conclusions: In our early experience, VEIL is a safe and feasible technique in patients with penile carcinoma who require radical inguinal lymphadenectomy. It allows the removal of inguinal lymph nodes within the same limits as in conventional surgical dissection and reduces surgical morbidity substantially. PMID:27453648

  14. [A brief history of the inguinal hernia operation in adults].

    PubMed

    Bekker, J; Keeman, J N; Simons, M P; Aufenacker, Th J

    2007-04-21

    Late into the 19th century, treatment for inguinal hernias consisted of repositioning the hernia with trusses or using 'softening agents' such as warm herbal baths and moist bandages. Surgical resection or cauterisation, often combined with hemicastration, was only considered for cases ofstrangulated hernia that could not be repositioned. Bassini (1844-1924) is credited with developing the precursor to the modern inguinal hernia operation at the end of the 19th century. Bassini's essential discovery was that the transverse fascia plays a key role in the pathophysiology of inguinal hernias. Bassini's operation, consisting of complete incision of the transverse fascia and reconstruction of the inguinal floor, was considered the gold standard for nearly a century. One problem with the conventional Bassini operation was the tension applied to tissues, which led to a high rate of recurrence. Although Bassini's operation has now become obsolete, current surgical approaches still centre on fortification of the inguinal floor. This tension-free repair now uses synthetic mesh that is positioned using an open anterior approach, laparoscopic surgery, or a preperitoneal technique. PMID:17500346

  15. Simultaneous repair of bilateral inguinal hernias under local anesthesia.

    PubMed Central

    Amid, P K; Shulman, A G; Lichtenstein, I L

    1996-01-01

    OBJECTIVE: The authors confirm the advantages of simultaneous repair of bilateral inguinal hernias, indicate that it is feasible to perform the procedure under local anesthesia, and suggest that when an open tension-free technique is used, the results are superior to those of laparoscopic repair of bilateral inguinal hernias. SUMMARY BACKGROUND DATA: Between 1971 and 1995, simultaneous repair of bilateral inguinal hernias were performed in 2953 men. Initially, between 1971 and 1984, patients with indirect hernias underwent the traditional tissue approximation repair. Those with direct hernias had the same procedure, with the repair additionally buttressed by a sheet of Marlex mesh (Davol, Inc., Cronston, RI). Between 1984 and 1995, both direct and indirect hernias were repaired using the open tension-free hernioplasty procedure. METHOD: The 2953 patients underwent simultaneous repair of bilateral inguinal hernias under local anesthesia in a private practice setting in general hospitals. RESULTS: In those cases in which the "tension free" technique was used, patients experienced minimal to mild postoperative pain and had a short recovery period, with a recurrence rate of 0.1%. CONCLUSIONS: Uncomplicated bilateral inguinal hernias in adults are best treated simultaneously. It is feasible to perform the operation under local anesthesia, and when an open tension-free repair is used, postoperative pain and recovery periods are equally comparable with those of laparoscopic repair, although the complication and the recurrence rates are significantly less. Images Figure 1. Figure 2. Figure 3. PMID:8604904

  16. Quantization of lumped elements electrical circuits revisited

    NASA Astrophysics Data System (ADS)

    Lalumiere, Kevin; Najafi­-Yazdi, Alireza

    In 1995, the ``Les Houches'' seminar of Michel Devoret introduced a method to quantize lumped elements electrical circuits. This method has since been formalized using the matricial formalism, in particular by G. Burkard. Starting from these seminal contributions, we present a new algorithm to quantify electrical circuits. This algorithm unites the features of Devoret's and Burkad's approaches. We minimize the set of assumptions made so that the method can treat directly most electrical circuits. This includes circuits with resistances, mutual inductances, voltage and current sources. We conclude with a discussion about the choice of the basis in which the Hamiltonian operator should be written, an issue which is often overlooked.

  17. Bilateral Inguinal Hernia Containing Urinary Bladder as Sole Content With "Pelvic Mickey Mouse Sign".

    PubMed

    Indiran, Venkatraman

    2016-04-01

    Inguinal hernias may contain urinary bladder as one of its contents, but very rarely have it as sole content. Inguinal vesical hernias may be unilateral or bilateral. When bilateral, inguinal vesical hernia may produce "pelvic Mickey mouse sign." This case reinforces the "pelvic Mickey mouse sign" in bilateral inguinal hernia containing only urinary bladder as content, which has been described only once before. PMID:26775075

  18. Colonic carcinoma presenting as strangulated inguinal hernia: report of two cases and review of the literature.

    PubMed

    Slater, R; Amatya, U; Shorthouse, A J

    2008-09-01

    Inguinal hernia and colonic carcinoma are common surgical conditions, yet carcinoma of the colon occurring within an inguinal hernia sac is rare. Of 25 reported cases, only one was a perforated sigmoid colon carcinoma in an inguinal hernia. We report two cases of sigmoid colon carcinoma, one of which had locally perforated. Each presented within a strangulated inguinal hernia. Oncologically correct surgery in these patients presents a technical challenge. PMID:18798013

  19. A rare cause of inguinal hernia: scrotal cystocele

    PubMed Central

    Zihni, İsmail; Duran, Ali; Soysal, Volkan

    2016-01-01

    Herniation of the urinary bladder into the inguinal canal is rare. It constitutes 1–3% of all inguinal hernias. Bladder herniation is usually asymptomatic, and it is usually diagnosed during surgery or as a result of intra-operative bladder injury. Male patients with lower urinary tract symptoms or with a history of previous hernia surgery are at increased risk of bladder herniation. Typically, patients complain of inguinal or scrotal swelling, dysuria and shrinkage of scrotal swelling after voiding. Early diagnosis with radiological imaging is important to prevent complications during surgery. Intravenous pyelography, retrograde cystography, pelvic ultrasound, computed tomography and magnetic resonance imaging can be used for preoperative diagnosis. In this report, a patient is presented who presented to our clinic with scrotal swelling and was diagnosed with scrotal bladder herniation by retrograde cystography, taken due to clinical suspicion based on his history.

  20. [Femoroacetabular impingement as a cause of inguinal pain].

    PubMed

    Mardones R, Rodrigo; Barrientos C, Víctor; Nemtala U, Fernando; Tomic, Alexander; Salineros U, Matías

    2010-01-01

    Femoro-acetabular impingement is an anatomical disturbance of the hip, caused by a deformity of the acetabulum, femur or both that causes an abnormal contact between both structures during certain movements. Its prevalence is 10 to 15% and causes chronic inguinal pain. It can be confused with several other causes of inguinal pain such as hernias, facet syndromes, a renal colic, etc. Patients with this condition are usually young individuals with inguinal pain that may appear after a minor trauma. During examination, pain may be elicited by infernal rotation and abduction movements of hip, flexed in 90 degrees . Plain hip X ray is the most commonly used diagnostic method. Non-steroidal anti-inflammatory drugs and physical therapy can be used to alleviate pain, but the definitive treatment is surgical. PMID:20361159

  1. Benign Essential Blepharospasm

    MedlinePlus

    ... Clinical Trials Organizations Column1 Column2 Benign Essential Blepharospasm Research Foundation 637 North 7th Street Suite 102 P.O. ... 832-0788 Fax: 409-832-0890 Dystonia Medical Research Foundation 1 East Wacker Drive Suite 2810 Chicago, IL ...

  2. Benign bone tumors.

    PubMed

    Gilday, D L; Ash, J M

    1976-01-01

    There is little information in the literature concerning the role of bone scanning in benign bone neoplasms except for sporadic reports. Since the advent of 99mTc-polyphosphate, bone imaging has proven feasible and useful in locating the cause of bone pain, such as in osteoid osteomas, which are not always radiologically apparent, and in evaluating whether or not a radiologic lesion is indeed benign and solitary. Blood-pool images are particularly important in neoplastic disease, since the absence of hyperemia in the immediate postinjection period favors the diagnosis of a benign neoplasm, as does low-grade uptake on the delayed study. The scan, including pinhole magnification images, is especially valuable in diagnosing lesions in the spine and pelvis, which are poorly seen radiologically. We have studied various types of benign bone tumors, including simple and aneurysmal bone cysts, fibrous cortical defects, and nonossifying fibromas, all of which had minimal or no increased uptake of the radiopharmaceutical, unless traumatized. Although osteochondromas and enchondromas showed varied accumulation of activity, the scan was useful in differentiating these from sarcomatous lesions. All osteoid osteomas demonstrated marked activity, and could be accurately located preoperatively, as could the extent of fibrous dysplasia. The bone scan in the reticuloses also showed abnormal accumulation of activity, and aided in arriving at the prognosis and treatment of histiocytic bone lesions. PMID:1082170

  3. The Liquid Lift: Looking Natural Without Lumps

    PubMed Central

    de Felipe, Iñigo; Redondo, Pedro

    2015-01-01

    Context: Hyaluronic acid (HA) is the most common filler used to rejuvenate. Today, a three-dimensional approach prevails over previous techniques in which this material was used in specific areas of the face such as the nasolabial fold, the marionette line, and the eye trough giving a strange appearance that does not look natural. Even with a volumizing purpose, the injection of HA can sometimes produce clinically detectable nodules or lumps where the filler is deposited. Aims: To develop a new technique of injecting HA that can provide more natural results and avoid the lumpiness and nodular appearance that sometimes occurs with the injection of HA. To detect whether mixing HA with diluted anesthetic agent modifies its behavior. Settings and Design: Prospective, case control, single-center study on a private clinic setting. Materials and Methods: Eighty six patients were enrolled in this study. All of them had a previous treatment with nondiluted HA using a needle at least a year before. Patients were injected with 8 mL of reticulated HA (RHA) mixed with 6 mL of saline and 2 mL of anesthetic agent. The mixture was administered through a cannula inserted in the face, one at mid-cheek and another at frontal-temporal point of entry. Owing to the lifting effect of this mixture we called this procedure liquid lift (LL). Patients were evaluated 1 month, 6 months, and a year later and asked to compare the LL with previous experiences in terms of natural look, pain, and appearance of nodules. Statistical Analysis Used: Student's t-test. Results: One month after the treatment, 83 out of 86 patients (96.5%) thought LL produced a more natural look than the previous treatment with the needle. Sixty two (72%) considered LL less painful than the previous treatment and only eight (9.3%) could detect lumps or nodules 1 month after LL was performed compared with 46 (53.5%) that described this problem with previous needle injections. The incidence of bruising was also clearly lower

  4. Inguinal Lymph Nodes in Carcinoma Penis-Observation or Surgery?

    PubMed Central

    Althaf, Syed; Gangaiah, Dinesh M.; Dev, Kapil; Kurpad, Vishnu P.; Gurawalia, Jaiprakash

    2016-01-01

    Introduction In Indian sub-continent the presentation of carcinoma penis is variable. Mostly presents with palpable inguinal lymph nodes but not confirm of metastases. Aim To evaluate whether all clinically positive nodes are metastatic and decide when to address inguinal lymph node. Materials and Methods A retrospective observational study on carcinoma penis from a regional cancer centre of south India over a period from 2001 to 2012. All the clinical, investigational, operative, pathology details and follow-up data were collected from patient records. Results Two hundred and thirty cases of carcinoma penis have been identified and 112 cases had clinically positive nodes. In 74 cases fine needle cytology was positive for malignancy and they have been addressed with block dissection with surgery of primary lesion. At two years follow up, 70 patients were identified with inguinal lymph node metastasis and block dissection was performed and all was were positive for malignancy on histology. The rate of recurrence is related to the T stage of the primary tumour. Conclusion It can be concluded that elective surgery is appropriate for palpable inguinal lymph nodes and prophylactic nodal dissection in high risk cases of carcinoma penis. PMID:26894163

  5. Ectopic decidual reaction mimicking inguinal lymphoma on ultrasound

    PubMed Central

    Prangsgaard, T; Lorentzen, T

    2014-01-01

    Ectopic decidual reaction has been described in various intraperitoneal locations. We present a case of unusual ectopic decidual reaction in the groin mimicking inguinal lymphoma on ultrasound in a pregnant woman. This case contributes evidence illustrating the variability of the clinical presentation of ectopic decidual reaction.

  6. Inguinal Hernia and Airport Scanners: An Emerging Indication for Repair?

    PubMed Central

    Cawich, Shamir O.; Maharaj, Ravi; Dan, Dilip

    2013-01-01

    The use of advanced imaging technology at international airports is increasing in popularity as a corollary to heightened security concerns across the globe. Operators of airport scanners should be educated about common medical disorders such as inguinal herniae in order to avoid unnecessary harassment of travelers since they will encounter these with increasing frequency. PMID:24368923

  7. Two Ports Laparoscopic Inguinal Hernia Repair in Children

    PubMed Central

    Ibrahim, Medhat M.

    2015-01-01

    Introduction. Several laparoscopic treatment techniques were designed for improving the outcome over the last decade. The various techniques differ in their approach to the inguinal internal ring, suturing and knotting techniques, number of ports used in the procedures, and mode of dissection of the hernia sac. Patients and Surgical Technique. 90 children were subjected to surgery and they undergone two-port laparoscopic repair of inguinal hernia in children. Technique feasibility in relation to other modalities of repair was the aim of this work. 90 children including 75 males and 15 females underwent surgery. Hernia in 55 cases was right-sided and in 15 left-sided. Two patients had recurrent hernia following open hernia repair. 70 (77.7%) cases were suffering unilateral hernia and 20 (22.2%) patients had bilateral hernia. Out of the 20 cases 5 cases were diagnosed by laparoscope (25%). The patients' median age was 18 months. The mean operative time for unilateral repairs was 15 to 20 minutes and bilateral was 21 to 30 minutes. There was no conversion. The complications were as follows: one case was recurrent right inguinal hernia and the second was stitch sinus. Discussion. The results confirm the safety and efficacy of two ports laparoscopic hernia repair in congenital inguinal hernia in relation to other modalities of treatment. PMID:25785196

  8. Sampson's Artery Hemorrhage after Inguinal Hernia Repair: Second Case Reported

    PubMed Central

    Adjei Boachie, Joseph

    2016-01-01

    Sampson artery is normally obliterated in postembryonic development. In rare cases it can remain patent and complicate a routine outpatient herniorrhaphy when severed. This is the second reported case in the available English literature of hemoperitoneum due to bleeding from a patent Sampson's artery following an open inguinal hernia repair. PMID:27247822

  9. Sampson's Artery Hemorrhage after Inguinal Hernia Repair: Second Case Reported.

    PubMed

    Adjei Boachie, Joseph; Smith-Singares, Eduardo

    2016-01-01

    Sampson artery is normally obliterated in postembryonic development. In rare cases it can remain patent and complicate a routine outpatient herniorrhaphy when severed. This is the second reported case in the available English literature of hemoperitoneum due to bleeding from a patent Sampson's artery following an open inguinal hernia repair. PMID:27247822

  10. Single-site video endoscopic inguinal lymphadenectomy: initial report.

    PubMed

    Tobias-Machado, Marcos; Correa, Walter F; Reis, Leonardo Oliveira; Starling, Eduardo S; de Castro Neves, Oseas; Juliano, Roberto V; Pompeo, Antonio C L

    2011-04-01

    Techniques that attempt to further reduce the morbidity and improve cosmesis of laparoscopic surgery have particularly generated interest. Since its initial urologic description in 2007, there has been a surge of interest in laparoendoscopic single-site surgery, which is now an emerging technique within the field of minimally invasive urologic surgery. This report describes a preliminary experience with single-site video endoscopic inguinal lymphadenectomy (SSVEIL) compared with conventional video endoscopic inguinal lymphadenectomy (VEIL) on inguinal nodes management in a 45-year-old man with pT(2) grade 2 squamous cell penile carcinoma and impalpable inguinal nodes. VEIL with saphenous vein preservation in the left leg and SSVEIL on the other side presented no difference concerning operative time (100 vs 120 min), blood loss (50 mL), drainage volume, number of nodes retrieved (8), pain, and oncologic outcome. The patient had an uneventful postoperative course, was discharged 12 hours after the procedure, and preferred the aesthetic result of SSVEIL. Further refinements in technology will likely alleviate many of the persistent technical problems. Additional rigorous comparison studies are needed to evaluate the true benefits of the technique and the extent of its clinical application, mainly oncologic results, before the widespread adoption of SSVEIL. Ultimately, advance breakthroughs in fields of in-vivo instrumentation, robotics, and purpose-built robotic platforms will bring its potential to full clinical realization. PMID:21226622

  11. Unexpected fatal outcome of laparoscopic inguinal hernia repair.

    PubMed

    Ginelliová, Alžbeta; Farkaš, Daniel; Farkašová Iannaccone, Silvia; Vyhnálková, Vlasta

    2016-06-01

    In this paper we report the autopsy findings of a long-term warfarinized 60-year-old man who died unexpectedly 2 days after undergoing laparoscopic transabdominal pre-peritoneal (TAPP) inguinal hernia repair. In his medical records it was stated that the perioperative and postoperative period was uneventful with no sign of bleeding and he was discharged the day after surgery. Autopsy revealed massive bleeding in the pre-peritoneal space at the surgery site and a massive left inguinal canal hematoma spreading through the spermatic cord to the left scrotum. There was no evidence of retroperitoneal bleeding. No sign of traumatic injury to the abdominal wall, major abdominal and pelvic vessels was revealed. The cause of death was hemorrhagic shock. We believe that this is the first documented case of fatal outcome after TAPP inguinal hernia repair in Slovakia. Inguinal hernias account for approximately two-thirds of all abdominal wall hernias. The reported case demonstrates that routine procedures such as TAPP hernia repair can have a fatal outcome, not due to any surgical mishap but because of the altered health status of the patient. PMID:27076122

  12. Thymic teratoma masquerading as a thyroid lump.

    PubMed

    Cho, W S; Sahota, R; Tanweer, F; Conboy, P

    2014-05-01

    Teratomas are germ cell tumours commonly found in the sacrococcygeal region, ovary, testicle or, infrequently, the mediastinum. In very rare circumstances, these tumours are found in the neck. This case represents a thymic teratoma presenting as what appeared to be an intrathyroid lesion. This has not been described previously and demonstrates an unusual presentation of a neck lump necessitating two operations and a multidisciplinary approach for management. We would also like to highlight that while patients undergo imaging to guide surgery, the surgeon must always be prepared for the unexpected and recognise situations where the operation should be converted to an exploratory procedure instead of full resection. Often, combined surgical care is the best option for difficult congenital cases. PMID:24780013

  13. On burning a lump of coal

    NASA Astrophysics Data System (ADS)

    Alonso-Serrano, Ana; Visser, Matt

    2016-06-01

    Burning something, (e.g. the proverbial lump of coal, or an encyclopaedia for that matter), in a blackbody furnace leads to an approximately Planck emission spectrum with an average entropy/information transfer of approximately 3.9 ± 2.5 bits per emitted photon. This quantitative and qualitative result depends only on the underlying unitarity of the quantum physics of burning, combined with the statistical mechanics of blackbody radiation. The fact that the utterly standard and unitarity preserving process of burning something (in fact, burning anything) nevertheless has an associated entropy/information budget, and the quantitative size of that entropy/information budget, is a severely under-appreciated feature of standard quantum statistical physics.

  14. Benign breast disease and consumption of beverages containing methylxanthines.

    PubMed

    La Vecchia, C; Franceschi, S; Parazzini, F; Regallo, M; Decarli, A; Gallus, G; Di Pietro, S; Tognoni, G

    1985-05-01

    The relationship between methylxanthine (Mx) consumption and benign breast disease was evaluated in a case-control study of 288 women with histologically confirmed benign breast lumps (203 dysplastic lesions and 85 benign tumors) and 2 groups of control women--285 patients in the hospital for acute conditions apparently unrelated to the consumption of Mx-containing beverages and 291 outpatients. The relative risk estimates of dysplastic breast lesions (fibrocystic disease), with allowance for all identified potential distorting factors, for women who drank 1-2 or 3 or more cups of coffee per day were 4.1 and 6.4, respectively, when the hospital controls were the comparison group and 2.0 and 3.7, respectively, when the outpatient controls were the comparison group. The relationship was even stronger when the total consumption of Mx-containing beverages (coffee plus tea) was considered and increased with increasing duration of use. The association was not explained by any of the major risk factors for fibrocystic breast diseases or by differences in general characteristics or other lifestyle habits between cases and controls. Mx consumption was not related to the risk of benign breast tumors (fibroadenomas). These findings support the hypothesis that Mx consumption is related to the risk of dysplastic lesions of the breast. PMID:3858587

  15. Benign familial hyperphosphatasemia

    SciTech Connect

    Siraganian, P.A.; Mulvihill, J.J.; Mulivor, R.A.; Miller, R.W. )

    1989-03-03

    Elevated alkaline phosphatase activity in serum suggests bone or liver disease or a neoplasm but can also indicate pregnancy or another benign condition. A family with benign hyperphosphatasemia was studied to elucidate the genetics and enzyme defect. Serum total alkaline phosphatase activity was greater than the population mean in all six family members, and more than 7 SDs above the mean in two of four offspring. Monoclonal antibodies to three alkaline phosphatase isoenzymes, intestinal, placental, and tissue nonspecific demonstrated markedly increased intestinal alkaline phosphatase levels in all family members and significantly elevated liver/bone/kidney activity in the two offspring. Guanidine hydrochloride denaturation of the liver/bone/kidney component showed high alkaline phosphatase activity from liver in both siblings and from bone in one. The mode of inheritance in this family is obscure, but a complex regulation of the products of two different alkaline phosphatase genes seems likely. Steps toward diagnosis are suggested. Early recognition of this benign biochemical abnormality should help to avoid unnecessary diagnostic tests.

  16. Lump Solution of (2+1)-Dimensional Boussinesq Equation

    NASA Astrophysics Data System (ADS)

    Ma, Hong-Cai; Deng, Ai-Ping

    2016-05-01

    A class of lump solutions of (2+1)-dimensional Boussinesq equation are obtained with the help of Maple by using Hirota bilinear method. Some contour plots with different determinant values are sequentially made to show that the corresponding lump solution tends to zero when the determinant approaches zero. The particular lump solutions with specific values of the involved parameters are plotted, as illustrative examples. Supported by the National Natural Science Foundation of China under Grant No. 10647112 and the Fund of Science and Technology Commission of Shanghai Municipality under Grant No. ZX201307000014

  17. Nonlinearly Coupled Superconducting Lumped Element Resonators

    NASA Astrophysics Data System (ADS)

    Collodo, Michele C.; Potočnik, Anton; Rubio Abadal, Antonio; Mondal, Mintu; Oppliger, Markus; Wallraff, Andreas

    We study SQUID-mediated tunable coupling between two superconducting on-chip resonators in the microwave frequency range. In this circuit QED implementation, we employ lumped-element type resonators, which consist of Nb thin film structured into interdigitated finger shunt capacitors and meander inductors. A SQUID, functioning as flux dependent and intrinsically nonlinear inductor, is placed as a coupling element together with an interdigitated capacitor between the two resonators (cf. A. Baust et al., Phys Rev. B 91 014515 (2015)). We perform a spectroscopic measurement in a dilution refrigerator and find the linear photon hopping rate between the resonators to be widely tunable as well as suppressible for an appropriate choice of parameters, which is made possible due to the interplay of inductively and capacitively mediated coupling. Vanishing linear coupling promotes nonlinear effects ranging from onsite- to cross-Kerr interaction. A dominating cross-Kerr interaction related to this configuration is notable, as it induces a unique quantum state. In the course of analog quantum simulations, such elementary building blocks can serve as a precursor for more complex geometries and thus pave the way to a number of novel quantum phases of light

  18. Optical lumped element microwave kinetic inductance detectors

    NASA Astrophysics Data System (ADS)

    Marsden, Danica; Mazin, Benjamin A.; Bumble, Bruce; Meeker, Seth; O'Brien, Kieran; McHugh, Sean; Strader, Matthew; Langman, Eric

    2012-07-01

    Microwave Kinetic Inductance Detectors, or MKIDs, have proven to be a powerful cryogenic detector technology due to their sensitivity and the ease with which they can be multiplexed into large arrays. An MKID is an energy sensor based on a photon-variable superconducting inductance in a lithographed microresonator. It is capable of functioning as both a photon detector across the electromagnetic spectrum and a particle detector. We have recently demonstrated the world's first photon-counting, energy-resolving, ultraviolet, optical, and near infrared MKID focal plane array in the ARCONS camera at the Palomar 200" telescope. Optical Lumped Element (OLE) MKID arrays have significant advantages over semiconductor detectors such as charge coupled devices (CCDs). They can count individual photons with essentially no false counts and determine the energy (to a few percent) and arrival time (to ≍1μs) of every photon, with good quantum efficiency. Initial devices were degraded by substrate events from photons passing through the Titanium Nitride (TiN) material of the resonator and being absorbed in the substrate. Recent work has eliminated this issue, with a solution found to be increasing the thickness of the TiN resonator from 20 to 60 nm.

  19. Benign Metastasizing Leiomyoma.

    PubMed

    Pacheco-Rodriguez, Gustavo; Taveira-DaSilva, Angelo M; Moss, Joel

    2016-09-01

    Benign metastasizing leiomyoma (BML) is a rare and poorly characterized disease affecting primarily premenopausal women. Asymptomatic patients are often diagnosed incidentally by radiographs or other lung-imaging procedures performed for other indications, and the diagnosis is eventually confirmed by biopsy. Patients with BML are usually treated pharmacologically with antiestrogen therapies or surgically with oophorectomy or hysterectomy. Antiestrogen therapy is typically efficacious and, in general, most patients have a favorable prognosis. Asymptomatic patients with a confirmed diagnosis of BML, may be followed conservatively without treatment. PMID:27514603

  20. Fournier's Gangrene as a Postoperative Complication of Inguinal Hernia Repair

    PubMed Central

    Dinc, Tolga; Kayilioglu, Selami Ilgaz; Sozen, Isa; Yildiz, Baris Dogu; Coskun, Faruk

    2014-01-01

    Fournier's gangrene is the necrotizing fasciitis of perianal, genitourinary, and perineal regions. Herein, we present a case of scrotal Fournier's gangrene as a postoperative complication of inguinal hernia repair. A 51-year-old male with giant indirect hernia is presented. Patient underwent inguinal hernia repair, and after an unproblematic recovery period, he was discharged. He applied to our outpatient clinic on the fifth day with swollen and painful scrotum and it turned out to be Fournier's gangrene. Polypropylene mesh was not infected. Patient recovered and was discharged after repeated debridements. Basic principles in treatment of Fournier's gangrene are comprised of initial resuscitation, broad-spectrum antibiotics therapy, and early aggressive debridement. In the management of presented case, aggressive debridement was made right after diagnosis and broad-spectrum antibiotics were given to the hemodynamically stable patient. In these circumstances, the important question is whether we could prevent occurrence of Fournier's gangrene. PMID:25506030

  1. [A Case of Anal Canal Carcinoma with Inguinal Lymph Node Metastasis Treated with Laparoscopic Abdominoperineal Resection].

    PubMed

    Tonooka, Toru; Takiguchi, Nobuhiro; Yamamoto, Hiroshi; Nabeya, Yoshihiro; Ikeda, Atsushi; Kainuma, Osamu; Soda, Hiroaki; Cho, Akihiro; Saito, Hiroshige; Arimitsu, Hidehito; Yanagibashi, Hiroo; Kobayashi, Ryosuke; Chibana, Tomofumi; Tokoro, Yukinari; Nagata, Matsuo

    2015-11-01

    We report a case of anal canal cancer with inguinal lymph node metastasis treated with laparoscopic abdominoperineal resection combined with inguinal lymph node dissection. A 52-year-old woman was diagnosed with anal squamous carcinoma after excision of an anal canal tumor. Further examination revealed right inguinal lymph node metastasis. Chemoradiotherapy was administered but was discontinued because of serious adverse events. We therefore performed laparoscopic abdominoperineal resection combined with inguinal lymph node dissection. The pathological findings revealed residual squamous cell carcinoma at the lymphatic vessels in the rectal wall and lymph nodes, including the right inguinal region. Therapeutic effect of Grade 1a was achieved in spite of interruption of the chemoradiotherapy. She was discharged 17 days after the operation, and no recurrence was observed for 11 months. Radical resection was performed for the anal canal squamous cell carcinoma with the metastasis to the right inguinal lymph node, even after interruption of the chemoradiotherapy. PMID:26805350

  2. Quality of life in patients undergoing inguinal hernia repair.

    PubMed Central

    Lawrence, K.; McWhinnie, D.; Jenkinson, C.; Coulter, A.

    1997-01-01

    Inguinal hernia repair is one of the most common surgical procedures undertaken in the NHS. Despite this, no previous work has examined quality of life in this patient group. This study examines quality of life preoperatively and at 3 and 6 months postoperatively in 140 patients undergoing inguinal hernia repair in the context of a randomised controlled trial of laparoscopic versus open hernia repair. Surgery was undertaken on a day case basis, and quality of life was assessed using the Short Form 36 (SF36). In the initial phase of the study, 57% of those screened for suitability met the study inclusion criteria and were randomised. No significant differences were found between laparoscopic and open hernia repair in terms of quality of life at 3 and 6 months postoperatively. No difference was found between 3 and 6 month scores, suggesting that patients had already made a good recovery by 3 months. A significant improvement was found between preoperative and postoperative scores, with the greatest change arising on dimensions assessing pain, physical function, and role limitation owing to physical restriction. After standardising for age, sex, and social class, a comparison of the hernia patients to population norms for the SF36 was consistent with improvement from preoperative to postoperative assessment. This study has demonstrated the improvement in quality of life in patients undergoing elective inguinal hernia repair by experienced surgeons on a day case basis. It has also demonstrated the feasibility of assessing quality of life using generic measures in this patient group. Further work in this area is required. Ultimately, the priority given to elective inguinal hernia repair will depend on how the demonstrated benefits compare with those derived from other elective surgical procedures. PMID:9038494

  3. Beware of spontaneous reduction "en masse" of inguinal hernia.

    PubMed

    Berney, C R

    2015-12-01

    Reduction 'en masse' of inguinal hernia is a rare entity defined as manual reduction of an external hernia sac back through the abdominal wall but where its content still remains incarcerated or strangulated into a displaced position, most often in the pre-peritoneal space. Small bowel obstruction habitually follows requiring urgent repair, preferentially via a trans-abdominal approach. Pre-operative clinical diagnosis is difficult and abdominal CT-scan imaging is the investigation of choice. PMID:24430579

  4. Association Between Thoracic Aortic Disease and Inguinal Hernia

    PubMed Central

    Olsson, Christian; Eriksson, Per; Franco‐Cereceda, Anders

    2014-01-01

    Background The study hypothesis was that thoracic aortic disease (TAD) is associated with a higher‐than‐expected prevalence of inguinal hernia. Such an association has been reported for abdominal aortic aneurysm (AAA) and hernia. Unlike AAA, TAD is not necessarily detectable with clinical examination or ultrasound, and there are no population‐based screening programs for TAD. Therefore, conditions associated with TAD, such as inguinal hernia, are of particular clinical relevance. Methods and Results The prevalence of inguinal hernia in subjects with TAD was determined from nation‐wide register data and compared to a non‐TAD group (patients with isolated aortic stenosis). Groups were balanced using propensity score matching. Multivariable statistical analysis (logistic regression) was performed to identify variables independently associated with hernia. Hernia prevalence was 110 of 750 (15%) in subjects with TAD versus 29 of 301 (9.6%) in non‐TAD, P=0.03. This statistically significant difference remained after propensity score matching: 21 of 159 (13%) in TAD versus 14 of 159 (8.9%) in non‐TAD, P<0.001. Variables independently associated with hernia in multivariable analysis were male sex (odds ratio [OR] with 95% confidence interval [95% CI]) 3.4 (2.1 to 5.4), P<0.001; increased age, OR 1.02/year (1.004 to 1.04), P=0.014; and TAD, OR 1.8 (1.1 to 2.8), P=0.015. Conclusions The prevalence of inguinal hernia (15%) in TAD is higher than expected in a general population and higher in TAD, compared to non‐TAD. TAD is independently associated with hernia in multivariable analysis. Presence or history of hernia may be of importance in detecting TAD, and the association warrants further study. PMID:25146705

  5. 7 CFR 1726.205 - Multiparty lump sum quotations.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ..., DEPARTMENT OF AGRICULTURE ELECTRIC SYSTEM CONSTRUCTION POLICIES AND PROCEDURES Procurement Procedures § 1726.205 Multiparty lump sum quotations. The borrower or its engineer must contact a sufficient number...

  6. 7 CFR 1726.205 - Multiparty lump sum quotations.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ..., DEPARTMENT OF AGRICULTURE ELECTRIC SYSTEM CONSTRUCTION POLICIES AND PROCEDURES Procurement Procedures § 1726.205 Multiparty lump sum quotations. The borrower or its engineer must contact a sufficient number...

  7. 7 CFR 1726.205 - Multiparty lump sum quotations.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ..., DEPARTMENT OF AGRICULTURE ELECTRIC SYSTEM CONSTRUCTION POLICIES AND PROCEDURES Procurement Procedures § 1726.205 Multiparty lump sum quotations. The borrower or its engineer must contact a sufficient number...

  8. 7 CFR 1726.205 - Multiparty lump sum quotations.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ..., DEPARTMENT OF AGRICULTURE ELECTRIC SYSTEM CONSTRUCTION POLICIES AND PROCEDURES Procurement Procedures § 1726.205 Multiparty lump sum quotations. The borrower or its engineer must contact a sufficient number...

  9. 7 CFR 1726.205 - Multiparty lump sum quotations.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ..., DEPARTMENT OF AGRICULTURE ELECTRIC SYSTEM CONSTRUCTION POLICIES AND PROCEDURES Procurement Procedures § 1726.205 Multiparty lump sum quotations. The borrower or its engineer must contact a sufficient number...

  10. Lump solutions to the Kadomtsev-Petviashvili equation

    NASA Astrophysics Data System (ADS)

    Ma, Wen-Xiu

    2015-09-01

    Through symbolic computation with Maple, a class of lump solutions, rationally localized in all directions in the space, to the (2 + 1)-dimensional Kadomtsev-Petviashvili (KP) equation is presented, making use of its Hirota bilinear form. The resulting lump solutions contain six free parameters, two of which are due to the translation invariance of the KP equation and the other four of which satisfy a non-zero determinant condition guaranteeing analyticity and rational localization of the solutions. Three contour plots with different determinant values are sequentially made to show that the corresponding lump solution tends to zero when the determinant approaches zero. Two particular lump solutions with specific values of the involved parameters are plotted, as illustrative examples.

  11. Benign follicular tumors*

    PubMed Central

    Tellechea, Oscar; Cardoso, José Carlos; Reis, José Pedro; Ramos, Leonor; Gameiro, Ana Rita; Coutinho, Inês; Baptista, António Poiares

    2015-01-01

    Benign follicular tumors comprise a large and heterogeneous group of neoplasms that share a common histogenesis and display morphological features resembling one or several portions of the normal hair follicle, or recapitulate part of its embryological development. Most cases present it as clinically nondescript single lesions and essentially of dermatological relevance. Occasionally, however, these lesions be multiple and represent a cutaneous marker of complex syndromes associated with an increased risk of visceral neoplasms. In this article, the authors present the microscopic structure of the normal hair follicle as a basis to understand the type and level of differentiation of the various follicular tumors. The main clinicopathological features and differential diagnosis of benign follicular tumors are then discussed, including dilated pore of Winer, pilar sheath acanthoma, trichoadenoma, trichilemmoma, infundibuloma, proliferating trichilemmal cyst/tumor, trichoblastoma and its variants, pilomatricoma, trichodiscoma/fibrofolliculoma, neurofollicular hamartoma and trichofolliculoma. In addition, the main syndromes presenting with multiple follicular tumors are also discussed, namely Cowden, Birt-Hogg-Dubé, Rombo and Bazex-Dupré-Christol syndromes, as well as multiple tumors of follicular infundibulum (infundibulomatosis) and multiple trichoepitheliomas. Although the diagnosis of follicular tumors relies on histological examination, we highlight the importance of their knowledge for the clinician, especially when in presence of patients with multiple lesions that may be the cutaneous marker of a cancer-prone syndrome. The dermatologist is therefore in a privileged position to recognize these lesions, which is extremely important to provide further propedeutic, appropriate referral and genetic counseling for these patients. PMID:26734858

  12. Does inguinal hernia repair have an effect on sexual functions?

    PubMed Central

    Sonbahar, Bilgehan Çağdaş; Bora, Gül; Özalp, Necdet; Kara, Cengiz

    2016-01-01

    Introduction The aim of this study is to evaluate sexual functions which are affected by inguinal hernias and may change after hernia repair surgery. Material and methods A total of 47 patients who underwent Lichtenstein tension-free anterior repair and inguinal hernia surgery were evaluated in terms of erectile function, intercourse function, sexual desire, overall satisfaction and orgasm satisfaction using the International Index of Erectile function questionnaire (IIEF) scoring system before surgery and in the first and sixth months after surgery. Parameters evaluated with the IIEF score before the surgery and in the first and sixth months after surgery were compared statistically using the Wilcoxon test. Results The average age of patients was 46.2 ±11.2 years (range: 22–67). It was determined that all scores, apart from sexual desire (p = 0.08), significantly increased in the postoperative first and sixth months compared to the preoperative period. It was measured that the preoperative sexual desire score increased significantly in the postoperative sixth month (p <0.001). A significant score was also detected when all scores in the postoperative sixth month were compared to the postoperative first month. Conclusions Inguinal hernia surgery positively affects sexual functions compared to the preoperative period. The improvement in sexual parameters in addition to the benefits of hernia removal and presence of no significant postoperative complications indicates that this surgery is useful and safe. PMID:27551560

  13. Peritoneography (Herniography) for Detecting Occult Inguinal Hernia in Patients with Inguinodynia

    PubMed Central

    Heise, Charles P.; Sproat, Ian A.; Starling, James R.

    2002-01-01

    Objective To evaluate the usefulness of peritoneography in patients referred with inguinal pain (inguinodynia) and clinically absent inguinal hernia on physical examination. Summary Background Data In patients with chronic groin pain, peritoneography is a seldom-used yet available technique that can detect an occult inguinal hernia. The value of peritoneography in the diagnosis of occult inguinal hernia has been previously shown. Methods During a 60-month period, 80 consecutive patients with complaints of persistent inguinal pain (inguinodynia) without evidence of hernia on clinical examination were referred for outpatient evaluation by peritoneography. Twenty-nine patients had prior inguinal surgery in the region of their current pain. Peritoneography was performed using a midline or paraumbilical approach. Radiographs were obtained with patients in prone and prone oblique positions with the head elevated 20° to 25°, both with and without provocative maneuvers. All available records were retrospectively reviewed for radiographic findings and outcome. Results Of the 80 patients undergoing peritoneography, 36 (45%) were diagnosed radiographically to have inguinal hernias that were not detectable clinically. Twenty-seven of these patients subsequently underwent inguinal exploration, and a hernia was confirmed in 24 (89%). Of the patients having prior inguinal surgery in the region of their pain, 12/29 (41%) were diagnosed by peritoneography with a hernia. Two complications (2.5%), both colon perforations that did not require significant intervention, occurred as a result of peritoneography. Conclusions Peritoneography is highly reliable for detecting clinically occult inguinal hernia and has a low complication rate. Its usefulness is shown in a prospective consecutive series for detection of occult hernias in patients with chronic inguinal pain. The authors conclude that peritoneography is a safe and useful diagnostic test in the setting of persistent inguinal pain

  14. Sertoliform cystadenoma: a rare benign tumour of the rete testis

    PubMed Central

    2013-01-01

    Abstract Sertoliform cystadenoma of the rete testis represents an uncommon benign tumour. They appear in patients from 26 to 62 years of age. We describe a case of a 66-year-old man with a tumour in the area of the epididymal head. The tumour markers were not increased. Under the assumption of a malignant testicular tumour an inguinal orchiectomy was performed. The cut surface of this tumour was of grey/white color and showed small cysts. The tumour consisted of two compartments. The epithelial like tumour cells showed a sertoliform growth pattern and cystic dilatations. In between the tumour cells repeatedly actin expressing sclerotic areas could be recognized as the second tumour component. Proliferative activity was not increased. Immunohistochemically the tumour cells were positiv for inhibin, S-100, and CD 99. Alpha feto protein (AFP), human chorionic gonadotropin (ß-HCG) and placental alkaline phosphatase (PLAP) as well as synaptophysin, epithelial membrane antigene (EMA), and BCL-2 were not expressed. As far as we know this is the sixth reported case of this tumour. Because of the benign nature of this tumour the correct diagnosis is important for the intra- and postoperative management. Here we present a case of this rare tumour and discuss potential differential diagnosis. Virtual Slides The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1956026143857335 PMID:23406299

  15. 20 CFR 234.12 - 1937 Act lump-sum death payment.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false 1937 Act lump-sum death payment. 234.12 Section 234.12 Employees' Benefits RAILROAD RETIREMENT BOARD REGULATIONS UNDER THE RAILROAD RETIREMENT ACT LUMP-SUM PAYMENTS Lump-Sum Death Payment § 234.12 1937 Act lump-sum death payment. (a) The 1937...

  16. 20 CFR 234.12 - 1937 Act lump-sum death payment.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 20 Employees' Benefits 1 2014-04-01 2012-04-01 true 1937 Act lump-sum death payment. 234.12 Section 234.12 Employees' Benefits RAILROAD RETIREMENT BOARD REGULATIONS UNDER THE RAILROAD RETIREMENT ACT LUMP-SUM PAYMENTS Lump-Sum Death Payment § 234.12 1937 Act lump-sum death payment. (a) The 1937...

  17. 20 CFR 234.12 - 1937 Act lump-sum death payment.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 20 Employees' Benefits 1 2013-04-01 2012-04-01 true 1937 Act lump-sum death payment. 234.12 Section 234.12 Employees' Benefits RAILROAD RETIREMENT BOARD REGULATIONS UNDER THE RAILROAD RETIREMENT ACT LUMP-SUM PAYMENTS Lump-Sum Death Payment § 234.12 1937 Act lump-sum death payment. (a) The 1937...

  18. 20 CFR 234.12 - 1937 Act lump-sum death payment.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 20 Employees' Benefits 1 2012-04-01 2012-04-01 false 1937 Act lump-sum death payment. 234.12 Section 234.12 Employees' Benefits RAILROAD RETIREMENT BOARD REGULATIONS UNDER THE RAILROAD RETIREMENT ACT LUMP-SUM PAYMENTS Lump-Sum Death Payment § 234.12 1937 Act lump-sum death payment. (a) The 1937...

  19. 20 CFR 234.12 - 1937 Act lump-sum death payment.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 20 Employees' Benefits 1 2011-04-01 2011-04-01 false 1937 Act lump-sum death payment. 234.12 Section 234.12 Employees' Benefits RAILROAD RETIREMENT BOARD REGULATIONS UNDER THE RAILROAD RETIREMENT ACT LUMP-SUM PAYMENTS Lump-Sum Death Payment § 234.12 1937 Act lump-sum death payment. (a) The 1937...

  20. Laparoscopic inguinal herniorrhaphy. Results of a multicenter trial.

    PubMed Central

    Fitzgibbons, R J; Camps, J; Cornet, D A; Nguyen, N X; Litke, B S; Annibali, R; Salerno, G M

    1995-01-01

    OBJECTIVE: The purpose of this study was to determine if laparoscopic inguinal herniorrhaphy represents a viable alternative to the conventional repair and to assess whether a prospective randomized controlled trial comparing both procedures is warranted. METHODS: Three types of laparoscopic inguinal herniorrhaphies (transabdominal preperitoneal [TAPP], intraperitoneal onlay mesh [IPOM], and totally extraperitoneal [EXTRA]) were studied in a phase II design. Twenty-one investigators from 19 institutions participated. Approval from the local human research committee was required at each institution before patients could be enrolled. RESULTS: There were 686 patients with 869 hernias; 366 (42.1%) were direct, 414 (47.6%) were indirect, 22 (2.5%) were femoral, and 67 (7.7%) were combination hernias. The TAPP procedure was used for 562 hernias, the IPOM was used for 217 hernias, and the EXTRA was used for 87 hernias. Sixty-one patients had additional abdominal procedures performed at the time of laparoscopy without any adverse affects on their herniorrhaphies. The overall recurrence rate was 4.5%, with a minimum follow-up of 15 months. Complications were divided into the following three groups: 1) those related to laparoscopy, 2) those related to the patient, and 3) those related to the herniorrhaphy. Complications related to the laparoscopy occurred in 5.4% of patients; bleeding or abdominal wall hematomas occurred 31 times, (two patients required transfusion); one patient had bowel perforation, which was sutured laparoscopically; a bladder injury required laparotomy for management. Patient complications occurred in 6.7%. The majority involved the urinary tract (5.8%). Two patients required secondary abdominal procedures for adhesions, one for pain in the right lower quadrant and the other for adhesive small bowel obstruction. Postoperative myocardial infarction on day 5 resulted in the only operative mortality, for a rate of 0.1%. Complications related to the

  1. [Benign endobronchial tumors].

    PubMed

    Nikhtianov, Kh

    1980-01-01

    Endobronchial localizations of benign neoplasms are met with in 24.5 per cent of the cases. Right lung localizations are more frequent. More than half of them are broadly based (57.5 per cent). In most of the cases it is a matter of nonepithelial tumours of which a greater intensity is displayed by hamartomas /7/, vascular /4/ and neurogenic /3/ neoformations. The size of endobronchial tumours varies from 1 to 10 cm. Cases measuring 1-3 cm are the most numerous. Those of the "iceberg" type appear to be larger. The size per se has a relative importance for the clinical picture. Endobronchial tumours exhibit a clear cut clinical picture, and run a clinical course in three stages, determined by the degree of bronchial obturation and longstanding of the condition. The most common symptoms are coughing /80.7 per cent/, expectoration /50.0 per cent/, rales /57.6 per cent/, dullness /38.4 per cent/ and lacking respiration /38.4 per cent/. The nosological entity by itself is less conclusive for the clinical course. The X-ray data have orientation and by no means decisive significance for the diagnosis. The "crab pincers" sign in the bronchial lumen during bronchography has a definite importance. Bronchoscopy in conjunction with biopsy is a dependable method of preoperative diagnosing. It contributes greatly to the nosological diagnosis. Even nowadays, the diagnosis of endobronchial tumours is difficult. A rather exact diagnosis can be made intraoperatively, whereas the most accurate diagnosis is established only after histological study. The treatment of endobronchial benign neoplasms is operative. The number of medium /lobectomies/ and extensive /pulmonectomies/ pulmonary resections is considerable. In case of early diagnosis and intervention, sparing resection is the naturally indicated size of operation - mainly resection and plasty of the bronchi without lobectomy. The advantages of circular resection are substantial. Reconstructive operations of "clarinet" and

  2. Benign prostatic hyperplasia.

    PubMed

    Chughtai, Bilal; Forde, James C; Thomas, Dominique Dana Marie; Laor, Leanna; Hossack, Tania; Woo, Henry H; Te, Alexis E; Kaplan, Steven A

    2016-01-01

    Benign prostatic hyperplasia (BPH), which causes lower urinary tract symptoms (LUTS), is a common diagnosis among the ageing male population with increasing prevalence. Many risks factors, both modifiable and non-modifiable, can increase the risk of development and progression of BPH and LUTS. The symptoms can be obstructive (resulting in urinary hesitancy, weak stream, straining or prolonged voiding) or irritative (resulting in increased urinary frequency and urgency, nocturia, urge incontinence and reduced voiding volumes), or can affect the patient after micturition (for example, postvoid dribble or incomplete emptying). BPH occurs when both stromal and epithelial cells of the prostate in the transitional zone proliferate by processes that are thought to be influenced by inflammation and sex hormones, causing prostate enlargement. Patients with LUTS undergo several key diagnostic investigations before being diagnosed with BPH. Treatment options for men with BPH start at watchful waiting and progress through medical to surgical interventions. For the majority of patients, the starting point on the treatment pathway will be dictated by their symptoms and degree of bother. PMID:27147135

  3. Benign small bowel tumor.

    PubMed Central

    Wilson, J M; Melvin, D B; Gray, G; Thorbjarnarson, B

    1975-01-01

    The clinical record and histologic sections of 84 cases of benign small bowel tumor are reviewed. Manifestations of systemic diseases, congenital anomalies, and lesions of either the ileocecal valve or periampullary region were excluded. In the same time span there were 96 small bowel malignancies. Clinical presentation, pathologic findings, management and result are compared to the collected published experience of about 2000 cases. There were 36 leiomyomas, 22 lipomas, 9 angiomas, 6 neurofibromas and 4 fibromas. Thirty-six men and 48 women were affected; the majority in their fifth and sixth decade. Seventy-eight were operative and 6 autopsy diagnoses. The most common symptom was obstruction (42%) followed by hemorrhage (34%) and pain (22%), relative frequency differing for the various specific tumors. There were rarely significant physical findings. A diagnosis of small bowel tumor was made radiologically in 30 patients. Because of the nonspecificity of other signs and symptoms, an acute awareness of the possibility of small bowel tumor is mandatory for preoperative anticipation of the diagnosis. Local resection was performed in all with no deaths or significant postoperative complications. PMID:1078626

  4. Baritosis: a benign pneumoconiosis.

    PubMed Central

    Doig, A T

    1976-01-01

    Baritosis is one of the benign pneumoconioses in which inhaled particulate matter lies in the lungs for years without producing symptoms, abnormal physical signs, incapacity for work, interference with lung function, or liability to develop pulmonary or bronchial infections or other thoracic disease. Owing to the high radio-opacity of barium, the discrete shadows in the chest radiograph are extremely dense. Even in the most well-marked cases with extreme profusion of the opacities, massive shadows do not occur. When exposure to barium dust ceases the opacities begin slowly to disappear. Nine cases of baritosis occurring in a small factory in which barytes was crushed, graded, and milled are described. Two of the cases occurred after only 18 and 21 month's exposure, and 9 of the 10 men employed for more than one and a half years had baritosis. Five of the affected men examined at intervals since their exposure to barytes ceased in 1964 showed marked clearing of their radiological abnormalities. Images PMID:1257935

  5. A rare case of appendicitis incarcerated in an inguinal hernia.

    PubMed

    Smith-Singares, Eduardo; Boachie, Joseph Adjei; Iglesias, Izaskun Melania

    2016-01-01

    Amyand's hernia was coined after Claudius Amyand (1660-1740), who was the first to describe the presence of a perforated appendix in a hernial sac and also was the first to perform a successful appendectomy in 1735. It is an exceptionally rare condition in which the hernia itself contains the appendix, which may not necessarily be inflamed. The presence of an inflamed appendix further contributes to the rarity of this case. We report a case of acute appendicitis brought on by its incarceration in the inguinal hernia. PMID:27273683

  6. A rare case of appendicitis incarcerated in an inguinal hernia

    PubMed Central

    Smith-Singares, Eduardo; Boachie, Joseph Adjei; Iglesias, Izaskun Melania

    2016-01-01

    Amyand's hernia was coined after Claudius Amyand (1660–1740), who was the first to describe the presence of a perforated appendix in a hernial sac and also was the first to perform a successful appendectomy in 1735. It is an exceptionally rare condition in which the hernia itself contains the appendix, which may not necessarily be inflamed. The presence of an inflamed appendix further contributes to the rarity of this case. We report a case of acute appendicitis brought on by its incarceration in the inguinal hernia. PMID:27273683

  7. Application of Mass Lumped Higher Order Finite Elements

    SciTech Connect

    Chen, J.; Strauss, H. R.; Jardin, S. C.; Park, W.; Sugiyama, L. E.; G. Fu; Breslau, J.

    2005-11-01

    There are many interesting phenomena in extended-MHD such as anisotropic transport, mhd, 2-fluid effects stellarator and hot particles. Any one of them challenges numerical analysts, and researchers are seeking for higher order methods, such as higher order finite difference, higher order finite elements and hp/spectral elements. It is true that these methods give more accurate solution than their linear counterparts. However, numerically they are prohibitively expensive. Here we give a successful solution of this conflict by applying mass lumped higher order finite elements. This type of elements not only keep second/third order accuracy but also scale closely to linear elements by doing mass lumping. This is especially true for second order lump elements. Full M3D and anisotropic transport models are studied.

  8. Optical Kerr Spatiotemporal Dark-Lump Dynamics of Hydrodynamic Origin.

    PubMed

    Baronio, Fabio; Wabnitz, Stefan; Kodama, Yuji

    2016-04-29

    There is considerable fundamental and applicative interest in obtaining nondiffractive and nondispersive spatiotemporal localized wave packets propagating in optical cubic nonlinear or Kerr media. Here, we analytically predict the existence of a novel family of spatiotemporal dark lump solitary wave solutions of the (2+1)D nonlinear Schrödinger equation. Dark lumps represent multidimensional holes of light on a continuous wave background. We analytically derive the dark lumps from the hydrodynamic exact soliton solutions of the (2+1)D shallow water Kadomtsev-Petviashvili model, inheriting their complex interaction properties. This finding opens a novel path for the excitation and control of optical spatiotemporal waveforms of hydrodynamic footprint and multidimensional optical extreme wave phenomena. PMID:27176522

  9. Optical Kerr Spatiotemporal Dark-Lump Dynamics of Hydrodynamic Origin

    NASA Astrophysics Data System (ADS)

    Baronio, Fabio; Wabnitz, Stefan; Kodama, Yuji

    2016-04-01

    There is considerable fundamental and applicative interest in obtaining nondiffractive and nondispersive spatiotemporal localized wave packets propagating in optical cubic nonlinear or Kerr media. Here, we analytically predict the existence of a novel family of spatiotemporal dark lump solitary wave solutions of the (2 +1 )D nonlinear Schrödinger equation. Dark lumps represent multidimensional holes of light on a continuous wave background. We analytically derive the dark lumps from the hydrodynamic exact soliton solutions of the (2 +1 )D shallow water Kadomtsev-Petviashvili model, inheriting their complex interaction properties. This finding opens a novel path for the excitation and control of optical spatiotemporal waveforms of hydrodynamic footprint and multidimensional optical extreme wave phenomena.

  10. Multiple lumps in the breast due to Mycobacterium fortuitum.

    PubMed

    Chandanwale, Shirish S; Gulati, Ishita; Baravkar, Dadaso S; Shinde, Sumedha P; Mishra, Neha

    2016-04-01

    Although breast tissue is the most resistant to tuberculosis, its incidence is increasing worldwide. High incidence of breast tuberculosis is presumed in India. The rapidly growing nontubercular mycobacteria, such as Mycobacterium fortuitum and Mycobacterium chelonae, are of increasing clinical importance because infections due to these organisms are often hospital acquired. The true incidence of M. fortuitum is unknown but it has been estimated to be between 4 and 6 cases per one million people. It causes skin or soft tissue infections following trauma or surgery. Breast infection with M. fortuitum is very uncommon. The most common clinical presentation of breast tuberculosis is a painless lump. Multiple lumps are rarely reported. The culture and molecular studies are the keystone for differentiation of various mycobacterium species. We report one such case of a 25-year-old female presenting with multiple painless lumps due to M. fortuitum infection in the left breast. PMID:27451824

  11. Laparoscopic inguinal hernia repair in children using the percutaneous internal ring suturing technique – own experience

    PubMed Central

    Patkowski, Dariusz

    2014-01-01

    Introduction Percutaneous internal ring suturing (PIRS) is a method of laparoscopic herniorrhaphy, i.e. percutaneous closure of the internal inguinal ring under the control of a telescope placed in the umbilicus. Aim To evaluate the usefulness of the PIRS technique. Material and methods Fifty-five children (39 girls and 16 boys) underwent surgery using this method in our institution between 2008 and 2010. Results In 10 cases the presence of an open inguinal canal on the opposite side was also noted during surgery, and umbilical hernia was recognized in 2 patients. In 5 cases it was necessary to convert to the open surgery because of the inability to continue the laparoscopic procedure. In 1 case, male pseudohermaphroditism was diagnosed during surgery. Recurrent inguinal hernia required a conventional method of surgery in 1 child. Other children did not exhibit the characteristics of hernia recurrence. The inguinal canals were followed up with postoperative ultrasound examination in 29 children. In 23 children, the ultrasound examination showed no dilatation of the inguinal canal. In the other 6 children dilatation of the inguinal canal or the presence of fluid within the inguinal canal was observed during ultrasound. In 6 children symptoms such as swelling and soreness around the inguinal canal developed within 3 to 6 months after surgery. Conclusions Inguinal hernia surgery using the PIRS procedure is an alternative, effective, minimally invasive method of surgery. Visualization of the peritoneal cavity allows for detection of other abnormalities, as well as for performing other procedures during the same session (such as closing the contralateral inguinal canal or umbilical hernia surgery). PMID:24729810

  12. Electrical Lumped Model Examination for Load Variation of Circulation System

    NASA Astrophysics Data System (ADS)

    Koya, Yoshiharu; Ito, Mitsuyo; Mizoshiri, Isao

    Modeling and analysis of the circulation system enables the characteristic decision of circulation system in the body to be made. So, many models of circulation system have been proposed. But, they are complicated because the models include a lot of elements. Therefore, we proposed a complete circulation model as a lumped electrical circuit, which is comparatively simple. In this paper, we examine the effectiveness of the complete circulation model as a lumped electrical circuit. We use normal, angina pectoris, dilated cardiomyopathy and myocardial infarction for evaluation of the ventricular contraction function.

  13. Staphylococcus lugdunensis Infections: High Frequency of Inguinal Area Carriage

    PubMed Central

    van der Mee-Marquet, N.; Achard, A.; Mereghetti, L.; Danton, A.; Minier, M.; Quentin, R.

    2003-01-01

    Following a change in surgical practice, we noted that the rate at which Staphylococcus lugdunensis was isolated from samples from the plastic surgery unit of our hospital increased considerably. We investigated the sources of these S. lugdunensis strains, and we found that in the case of drain colonization or surgical site infection, the strain was more likely to have come from the patient's skin bacteria when the pubic site had been shaved preoperatively. To test the hypothesis of pubic site colonization, we evaluated the prevalence of S. lugdunensis carriage among the cutaneous flora of the inguinal area. We found that 22% of 140 incoming patients carried S. lugdunensis in this area and that carriage at both inguinal folds was frequent (68% of carriers). A study of the genetic structure of the total population, including the clinical (n = 18) and the commensal (n = 53) strains, revealed that the diversity of the species was low and that the population was composed of two major groups that diverged at a distance of 35%. No particular characteristics made it possible to distinguish between clinical and commensal strains. Only isolates producing β-lactamase were homogeneous; six of the eight β-lactamase-positive strains displayed the same pulsed-field gel electrophoresis pattern. PMID:12682121

  14. Lumped-element models characterize DR coupling effects

    NASA Technical Reports Server (NTRS)

    Hearn, Chase P.

    1992-01-01

    An approach to the analysis of closely spaced resonances produced by a microstrip coupled dielectric resonator is presented. In particular, it is shown that the use of a lumped-element model significantly simplifies the analysis. An experimental verification demonstrates that the model predicts the adjacent complementary resonances to within 1.6 percent of the measured value.

  15. Leaks, Lumps, and Lines: Stigma and Women's Bodies

    ERIC Educational Resources Information Center

    Chrisler, Joan C.

    2011-01-01

    Women's bodies have often been positioned in art and popular culture as monstrous or defiled and women's bodily products (e.g., menstrual fluid, breast milk) as disgusting. This framing has led to the stigmatization of aspects of women's bodies (e.g., leaking fluids, lumps of fat, and lines in the skin that indicate aging), especially those…

  16. 29 CFR 4044.75 - Other lump sum benefits.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Regulations Relating to Labor (Continued) PENSION BENEFIT GUARANTY CORPORATION PLAN TERMINATIONS ALLOCATION OF... sum benefits. The value of a lump sum benefit which is not covered under § 4044.73 or § 4044.74 is equal to— (a) The value under the qualifying bid, if an insurer provides the benefit; or (b) The...

  17. Can we omit prophylactic inguinal nodal irradiation in anal cancer patients?

    PubMed Central

    Kim, Hakyoung; Park, Hee Chul; Choi, Doo Ho; Ahn, Yong Chan; Kim, Seung Tae; Park, Joon Oh; Park, Young Suk; Kim, Hee Cheol

    2015-01-01

    Purpose To evaluate the appropriateness of prophylactic inguinal nodal irradiation (PINI), we analyzed patterns of failure in anal cancer patients who were inguinal node-negative at presentation and did not receive PINI. Materials and Methods We retrospectively reviewed the records of 33 anal cancer patients treated by definitive concurrent chemoradiation therapy (CCRT) between 1994 and 2013. Radiotherapy consisted of a total dose of 44-45 Gy (22-25 fractions in 5 weeks) on the whole pelvis, anus, and perineum. Except inguinal lymphadenopathy was present at initial diagnosis, the entire inguinal chain was not included in the radiation field. In other words, there was no PINI. Results The median follow-up duration was 50 months (range, 4 to 218 months). Median survival and progression-free survival (PFS) were 57 months (range, 10 to 218 months) and 50 months (range, 4 to 218 months), respectively. Among the survival, the median follow-up duration was 51 months (range, 12 to 218 months). The 5-year overall survival and PFS rates were 93.4% and 88.8%, respectively. Although none of the patients received inguinal node irradiation for prophylactic purposes, there was no inguinal recurrence. Conclusion Treatment of anal cancer by omitting PINI might be considered in selected patients with clinically uninvolved inguinal nodes. PMID:26157677

  18. Pictorial essay: USG of lumps and bumps of the foot and ankle

    PubMed Central

    Botchu, Rajesh; Khan, Aman; Bhatt, Raj

    2010-01-01

    USG is a cost-effective and dynamic way to interrogate superficial lumps and bumps. We present a pictorial review of the USG findings in various “lumps and bumps” of the foot and ankle. PMID:20607019

  19. Selective inguinal lymphadenectomy in the treatment of invasive squamous cell carcinoma of the vulva.

    PubMed

    Desimone, Christopher P; Elder, Jeffrey; van Nagell, John R

    2011-01-01

    En bloc radical vulvectomy with bilateral inguinofemoral lymphadenectomy has now been replaced by radical wide excision and selective inguinal lymphadenectomy based on the stage and location of invasive vulvar cancer. Early stage lateral cancers can be effectively treated by radical wide excision and ipsilateral superficial inguinal lymphadenectomy. Lymph node mapping using perilesional injection of radiocolloid and blue dye may identify sentinel lymph nodes which can be removed, thereby avoiding the morbidity of full inguinal lymphadenectomy in selected patients with early stage disease. PMID:22312500

  20. [A case report of eosinophilic funiculitis difficult to distinguish from incarceration of inguinal hernia].

    PubMed

    Araki, Azumi; Yanagisawa, Masahiro; Nagasima, Masazumi; Komiya, Atushi; Takano, Tetuzo; Ikeda, Ichiro

    2013-02-01

    A 45-year-old man visited our emergency room with left inguinal pain, mass and high-grade fever. Emergency surgery was performed with a primary diagnosis of left inguinal hernia. Although there was no hernia, there was a mass involving the spermatic cord in the left inguinal canal. We performed high orchiectomy because of the possibility of malignancy. Pathological findings showed eosinophilic infiltration in the mass lesion. An allergic inflammation was suspected to have occurred in the spermatic cord. His postoperative course was good. PMID:23552761

  1. 20 CFR 234.11 - 1974 Act lump-sum death payment.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false 1974 Act lump-sum death payment. 234.11... LUMP-SUM PAYMENTS Lump-Sum Death Payment § 234.11 1974 Act lump-sum death payment. (a) The total amount... household” as the employee at the time of the employee's death. (Refer to § 234.21 for an explanation...

  2. 20 CFR 234.11 - 1974 Act lump-sum death payment.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 20 Employees' Benefits 1 2012-04-01 2012-04-01 false 1974 Act lump-sum death payment. 234.11... LUMP-SUM PAYMENTS Lump-Sum Death Payment § 234.11 1974 Act lump-sum death payment. (a) The total amount... household” as the employee at the time of the employee's death. (Refer to § 234.21 for an explanation...

  3. 20 CFR 234.11 - 1974 Act lump-sum death payment.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 20 Employees' Benefits 1 2014-04-01 2012-04-01 true 1974 Act lump-sum death payment. 234.11... LUMP-SUM PAYMENTS Lump-Sum Death Payment § 234.11 1974 Act lump-sum death payment. (a) The total amount... household” as the employee at the time of the employee's death. (Refer to § 234.21 for an explanation...

  4. 20 CFR 234.11 - 1974 Act lump-sum death payment.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 20 Employees' Benefits 1 2011-04-01 2011-04-01 false 1974 Act lump-sum death payment. 234.11... LUMP-SUM PAYMENTS Lump-Sum Death Payment § 234.11 1974 Act lump-sum death payment. (a) The total amount... household” as the employee at the time of the employee's death. (Refer to § 234.21 for an explanation...

  5. 20 CFR 234.11 - 1974 Act lump-sum death payment.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 20 Employees' Benefits 1 2013-04-01 2012-04-01 true 1974 Act lump-sum death payment. 234.11... LUMP-SUM PAYMENTS Lump-Sum Death Payment § 234.11 1974 Act lump-sum death payment. (a) The total amount... household” as the employee at the time of the employee's death. (Refer to § 234.21 for an explanation...

  6. 5 CFR 550.1205 - Calculating a lump-sum payment.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 5 Administrative Personnel 1 2011-01-01 2011-01-01 false Calculating a lump-sum payment. 550.1205 Section 550.1205 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS PAY ADMINISTRATION (GENERAL) Lump-Sum Payment for Accumulated and Accrued Annual Leave § 550.1205 Calculating a lump-sum payment. (a) An agency...

  7. 5 CFR 837.305 - Lump-sum credit not reduced.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... regulation, the amount of an annuitant's lump-sum credit to the Fund shall not be reduced by the amount of... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Lump-sum credit not reduced. 837.305... REGULATIONS (CONTINUED) REEMPLOYMENT OF ANNUITANTS Coverage and Contributions § 837.305 Lump-sum credit...

  8. 5 CFR 837.305 - Lump-sum credit not reduced.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... regulation, the amount of an annuitant's lump-sum credit to the Fund shall not be reduced by the amount of... 5 Administrative Personnel 2 2014-01-01 2014-01-01 false Lump-sum credit not reduced. 837.305... REGULATIONS (CONTINUED) REEMPLOYMENT OF ANNUITANTS Coverage and Contributions § 837.305 Lump-sum credit...

  9. 5 CFR 837.305 - Lump-sum credit not reduced.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... regulation, the amount of an annuitant's lump-sum credit to the Fund shall not be reduced by the amount of... 5 Administrative Personnel 2 2012-01-01 2012-01-01 false Lump-sum credit not reduced. 837.305... REGULATIONS (CONTINUED) REEMPLOYMENT OF ANNUITANTS Coverage and Contributions § 837.305 Lump-sum credit...

  10. 5 CFR 837.305 - Lump-sum credit not reduced.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... regulation, the amount of an annuitant's lump-sum credit to the Fund shall not be reduced by the amount of... 5 Administrative Personnel 2 2013-01-01 2013-01-01 false Lump-sum credit not reduced. 837.305... REGULATIONS (CONTINUED) REEMPLOYMENT OF ANNUITANTS Coverage and Contributions § 837.305 Lump-sum credit...

  11. 5 CFR 837.305 - Lump-sum credit not reduced.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... regulation, the amount of an annuitant's lump-sum credit to the Fund shall not be reduced by the amount of... 5 Administrative Personnel 2 2011-01-01 2011-01-01 false Lump-sum credit not reduced. 837.305... REGULATIONS (CONTINUED) REEMPLOYMENT OF ANNUITANTS Coverage and Contributions § 837.305 Lump-sum credit...

  12. Cholesterol and benign prostate disease.

    PubMed

    Freeman, Michael R; Solomon, Keith R

    2011-01-01

    The origins of benign prostatic diseases, such as benign prostatic hyperplasia (BPH) and chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS), are poorly understood. Patients suffering from benign prostatic symptoms report a substantially reduced quality of life, and the relationship between benign prostate conditions and prostate cancer is uncertain. Epidemiologic data for BPH and CP/CPPS are limited, however an apparent association between BPH symptoms and cardiovascular disease (CVD) has been consistently reported. The prostate synthesizes and stores large amounts of cholesterol and prostate tissues may be particularly sensitive to perturbations in cholesterol metabolism. Hypercholesterolemia, a major risk factor for CVD, is also a risk factor for BPH. Animal model and clinical trial findings suggest that agents that inhibit cholesterol absorption from the intestine, such as the class of compounds known as polyene macrolides, can reduce prostate gland size and improve lower urinary tract symptoms (LUTS). Observational studies indicate that cholesterol-lowering drugs reduce the risk of aggressive prostate cancer, while prostate cancer cell growth and survival pathways depend in part on cholesterol-sensitive biochemical mechanisms. Here we review the evidence that cholesterol metabolism plays a role in the incidence of benign prostate disease and we highlight possible therapeutic approaches based on this concept. PMID:21862201

  13. Sudden unexpected death due to strangulated inguinal hernia.

    PubMed

    Menezes, Ritesh G; Padubidri, Jagadish Rao; Raghavendra Babu, Y P; Naik, Ramadas; Kanchan, Tanuj; Senthilkumaran, Subramanian; Chawla, Khushboo

    2016-06-01

    Sudden unwitnessed, unexpected deaths when the bodies are found in public places require a complete and meticulous medicolegal autopsy to ascertain the cause and manner of death to avoid further unnecessary investigations by the legal authorities. Such deaths attributed to gastrointestinal causes at autopsy are relatively uncommon. We report a case of sudden unexpected death due to strangulated inguinal hernia in a 60-year-old man. The body was discovered in a public area near a place of worship. The present case illustrates a potentially preventable sudden unexpected death due to a surgically correctable gastrointestinal condition. In the present case, the individual feared being hospitalised for treatment of his scrotal swelling with potential surgery and the eventual loss of daily income. In our opinion, such apprehensions may have delayed the potentially life-saving hospital surgical intervention in the individual. PMID:26837567

  14. Tourniquet Master Training for Junctional and Inguinal Hemorrhage Control (TMT).

    PubMed

    Weyhrauch, Peter W; Niehaus, James; Metzger, Max; Laufer, Shlomi; Kwan, Calvin; Pugh, Carla

    2014-01-01

    Junctional and inguinal bleeding is a significant and challenging problem on the battlefield. Inventors have developed new types of tourniquets, including the Abdominal Aortic Tourniquet™ (AAT) and the Combat Ready Clamp™ (CRoC) to address these abdominal and pelvic injuries. While these hemorrhage control technologies have been developed, validated, and approved for use, training systems that teach and refresh skills related to these technologies have not been developed. These training systems are vital because these skills can be difficult to train and are infrequently used. To address these needs, a sensor-enabled manikin was designed. Using the sensor data, the different phases of applying the tourniquet were captured and key performance was measured. PMID:24732556

  15. [A giant myxoid leiomyoma mimicking an inguinal hernia].

    PubMed

    Huszár, Orsolya; Zaránd, Attila; Szántó, Gyöngyi; Juhász, Viktória; Székely, Eszter; Novák, András; Molnár, Béla Ákos; Harsányi, László

    2016-03-01

    Leiomyoma is a rare, smooth muscle tumour that can occur everywhere in the human body. The authors present the history of a 60-year-old female, who had a giant, Mullerian type myxoid leiomyoma in the inguinal region mimicking acute abdominal symptoms. After examination the authors removed the soft tissue mass in the right femoral region reaching down in supine position to the middle third of the leg measuring 335 × 495 × 437 mm in greatest diameters in weight 33 kg. Reconstruction of the tissue defect was performed using oncoplastic guidelines. During the follow-up time no tumour recurrence was detected and the quality of life of the patient improved significantly. PMID:26920330

  16. Environmentally Benign Stab Detonators

    SciTech Connect

    Gash, A E

    2006-07-07

    The coupling of energetic metallic multilayers (a.k.a. flash metal) with energetic sol-gel synthesis and processing is an entirely new approach to forming energetic devices for several DoD and DOE needs. They are also practical and commercially viable manufacturing techniques. Improved occupational safety and health, performance, reliability, reproducibility, and environmentally acceptable processing can be achieved using these methodologies and materials. The development and fielding of this technology will enhance mission readiness and reduce the costs, environmental risks and the necessity of resolving environmental concerns related to maintaining military readiness while simultaneously enhancing safety and health. Without sacrificing current performance, we will formulate new impact initiated device (IID) compositions to replace materials from the current composition that pose significant environmental, health, and safety problems associated with functions such as synthesis, material receipt, storage, handling, processing into the composition, reaction products from testing, and safe disposal. To do this, we will advance the use of nanocomposite preparation via the use of multilayer flash metal and sol-gel technologies and apply it to new small IIDs. This work will also serve to demonstrate that these technologies and resultant materials are relevant and practical to a variety of energetic needs of DoD and DOE. The goal will be to produce an IID whose composition is acceptable by OSHA, EPA, the Clean Air Act, Clean Water Act, Resource Recovery Act, etc. standards, without sacrificing current performance. The development of environmentally benign stab detonators and igniters will result in the removal of hazardous and toxic components associated with their manufacturing, handling, and use. This will lead to improved worker safety during manufacturing as well as reduced exposure of Service personnel during their storage and or use in operations. The

  17. The rare benign liver tumors.

    PubMed

    Skalicky, T; Treska, V; Liska, V; Sutnar, A; Molacek, J; Mirka, H; Ferda, J; Ohlidalova, K

    2007-01-01

    As opposed to malignant secondary tumors, metastases of the colorectal carcinoma are benign tumors of the liver that are quite rare in the Czech Republic. From the 55 patients operated on since 2000 at our department for benign liver tumors, the most frequent are haemangiomas, focal nodular hyperplasia (FNH) and hepatocelular adenoma. Only 7.3% of them form a different histological type of a tumor than this most frequently occurring trio of tumors. The authors describe three cases of rather rare liver tumors with benign behavior that have the potential of becoming malignant. It concerns mucin producing biliary tumors, which correspond to the pancreatic intraductal papillary mucin tumor, hepatic cystadenoma with ovarian stroma and a liver hamartoma in an adult patient (Ref 13). Full Text (Free, PDF) www.bmj.sk. PMID:17694811

  18. Use of Fine-Needle Aspiration in the Evaluation of Breast Lumps

    PubMed Central

    Bukhari, Mulazim Hussain; Arshad, Madiha; Jamal, Shahid; Niazi, Shahida; Bashir, Shahid; Bakhshi, Irfan M.; Shaharyar

    2011-01-01

    Background. A study was designed to see the role of fine needle aspiration cytology (FNAC) in palpable breast lumps. Materials and Methods. Four hundred and twenty five (425) patients came to the Department of Pathology King Edward Medical University, Lahore in four years for FNAC of their palpable breast masses from June 2006 to June 2010. FNAC diagnosis was compared with histological diagnosis to see the accuracy of fine needle aspiration cytology for neoplastic lesions. Results. There were 271/425 benign, 120/425 malignant, and 32/425 suspicious smears. Inadequate samples were repeated twice or thrice, and the degree of success was improved with consecutive repeating approaches. The frequency of inadequacy declined from 86 to 18, and 2 for first, second and third attempts, respectively. The number of repeats increased the diagnostic accuracy of aspirates which is statistically significant (P = .000). Invasive ductal carcinoma was the most commonly reported lesion with maximum incidence in the 4th, 5th, and 6th decades followed by invasive lobular carcinoma and other malignant lesions. The sensitivity, specificity, accuracy, negative predictive value, and the positive predictive value of FNAC was 98%, 100%, 98%, 100%, and 97%, respectively. Conclusion. FNAC serves as a rapid, economical, and reliable tool for the diagnosis of palpable breast lesions because the cytopathological examination of these lesions before operation or treatment serves as an important diagnostic modality. PMID:21789264

  19. Fournier's gangrene secondary to an acutely inflamed appendix herniating into the deep inguinal ring

    PubMed Central

    Sarmah, Piyush B.; Khan, Mashuk; Zilvetti, Miguel

    2015-01-01

    Fournier's gangrene (FG) requires prompt recognition and management. We report the case of a 68-year-old man who presented with extensive pain and purple discolouration from the right iliac fossa to perineum. Computed tomography demonstrated gas within the right hemiscrotum extending into the inguinal canal and right buttock, with a right pelvic fluid and air collection. At debridement necrotic fluid was arising from the superficial inguinal ring so laparotomy was performed, revealing a grossly inflamed appendix herniating into the inguinal canal; a right hemicolectomy was performed. Unfortunately, the patient went into cardiac arrest and passed away on the operating table. Histological analysis demonstrated acute-on-chronic inflammation involving the appendix. The condition where appendicitis is implicated in FG is usually due to retroperitoneal rupture and tracking into the perineal spaces. This is the first case reported of an inflamed appendix herniating into the inguinal canal and thus causing FG. PMID:25829533

  20. A Rare Case Report of Inguinal Hernia with Persistent Mullerian Duct and Klinefelter Syndrome

    PubMed Central

    Om, Prabha; Shridatt, Sharma Ankit; Patni, Ankur; Verma, Naveen

    2016-01-01

    Inguinal hernia in male is a common problem but having female reproductive organs in hernial sac is rare. It occur because of failure of mullerian duct to regress in a male fetus during embryonic development, result in a syndrome known as Persistent Mullerian Duct Syndrome (PMDS), which is a rare entity of male pseudohermaphroditism. We hereby present a case of 21-year-old male patient reported with complains of cryptorchidism and inguinal hernia. Generally diagnosis of PMDS was established during investigation like ultrasonography, MRI for localization of undescended testis and during surgical exploration for inguinal hernia or cryptorchidism. Our patient was operated by bilateral inguinal incision; hernial sac contained adult size uterus fallopian tube and upper 2/3rd of vagina. On karyotyping it was found that he was a case of klinefelter syndrome also. Association of PMDS with klinefelter syndrome is very rare. PMID:27504355

  1. A Rare Case Report of Inguinal Hernia with Persistent Mullerian Duct and Klinefelter Syndrome.

    PubMed

    Dadheech, Darpan; Om, Prabha; Shridatt, Sharma Ankit; Patni, Ankur; Verma, Naveen

    2016-06-01

    Inguinal hernia in male is a common problem but having female reproductive organs in hernial sac is rare. It occur because of failure of mullerian duct to regress in a male fetus during embryonic development, result in a syndrome known as Persistent Mullerian Duct Syndrome (PMDS), which is a rare entity of male pseudohermaphroditism. We hereby present a case of 21-year-old male patient reported with complains of cryptorchidism and inguinal hernia. Generally diagnosis of PMDS was established during investigation like ultrasonography, MRI for localization of undescended testis and during surgical exploration for inguinal hernia or cryptorchidism. Our patient was operated by bilateral inguinal incision; hernial sac contained adult size uterus fallopian tube and upper 2/3(rd) of vagina. On karyotyping it was found that he was a case of klinefelter syndrome also. Association of PMDS with klinefelter syndrome is very rare. PMID:27504355

  2. Occult distal urethral carcinoma presenting as metastatic carcinoma in the inguinal lymph nodes.

    PubMed

    Hammer-Hansen, Niels; Høyer, Søren; Jensen, Jørgen Bjerggaard

    2015-02-01

    A 65-year-old man presented with metastatic squamous cell carcinoma in the inguinal lymph nodes from an unknown primary tumour. The initial work-up lacked clinical examination of the glans penis, in part due to the patient having phimosis. More than a year after presentation, a primary tumour, located distally on the penis, was diagnosed. A discussion of urethral carcinoma as well as inguinal lymph-node metastasis of unknown primary tumour is presented. PMID:25313619

  3. Current concepts of inguinal-related and adductor-related groin pain.

    PubMed

    Dimitrakopoulou, Alexandra; Schilders, Ernest

    2016-05-14

    Groin pain encompasses a number of conditions from the lower abdomen, inguinal region, proximal adductors, hip joint, upper anterior thigh and perineum. The complexity of the anatomy, the heterogeneous terminology and the overlapping symptoms of different conditions that may co-exist epitomise the challenges in diagnosis and treatment. Inguinal-related and adductor-related pain is the most common cause of groin pain and will be discussed in this article. PMID:27174069

  4. A Lumped Parameter Model for Feedback Studies in Tokamaks

    NASA Astrophysics Data System (ADS)

    Chance, M. S.; Chu, M. S.; Okabayashi, M.; Glasser, A. H.

    2004-11-01

    A lumped circuit model of the feedback stabilization studies in tokamaks is calculated. This work parallels the formulation by Boozer^a, is analogous to the studies done on axisymmetric modes^b, and generalizes the cylindrical model^c. The lumped circuit parameters are derived from the DCON derived eigenfunctions of the plasma, the resistive shell and the feedback coils. The inductances are calculated using the VACUUM code which is designed to calculate the responses between the various elements in the feedback system. The results are compared with the normal mode^d and the system identification^e approaches. ^aA.H. Boozer, Phys. Plasmas 5, 3350 (1998). ^b E.A. Lazarus et al., Nucl. Fusion 30, 111 (1990). ^c M. Okabayashi et al., Nucl. Fusion 38, 1607 (1998). ^dM.S. Chu et al., Nucl. Fusion 43, 441 (2003). ^eY.Q. Liu et al., Phys. Plasmas 7, 3681 (2000).

  5. RCS reduction of a microstrip patch using lumped loads

    NASA Technical Reports Server (NTRS)

    Volakis, John L.; Alexanian, Angelos

    1992-01-01

    In this report we consider the radar cross section (RCS) of a single rectangular patch antenna in a recessed cavity. Using a previously developed finite element-boundary integral method code, a study is performed on the patch's RCS as a function of frequency. To reduce the RCS of the patch at the resonant frequency, lumped (resistive) loads are placed at the edges of the patch. The effects of the lumped loads on the patch's RCS and gain are examined and it is observed that the RCS and gain are reduced as the as the load value decreases, whereas the antenna's bandwidth is increased. At resonance, the usual relations between the RCS and gain is observed, but it is shown that this relation no longer holds at frequencies away from resonance.

  6. Sensitivity of Lumped Constraints Using the Adjoint Method

    NASA Technical Reports Server (NTRS)

    Akgun, Mehmet A.; Haftka, Raphael T.; Wu, K. Chauncey; Walsh, Joanne L.

    1999-01-01

    Adjoint sensitivity calculation of stress, buckling and displacement constraints may be much less expensive than direct sensitivity calculation when the number of load cases is large. Adjoint stress and displacement sensitivities are available in the literature. Expressions for local buckling sensitivity of isotropic plate elements are derived in this study. Computational efficiency of the adjoint method is sensitive to the number of constraints and, therefore, the method benefits from constraint lumping. A continuum version of the Kreisselmeier-Steinhauser (KS) function is chosen to lump constraints. The adjoint and direct methods are compared for three examples: a truss structure, a simple HSCT wing model, and a large HSCT model. These sensitivity derivatives are then used in optimization.

  7. Exuberant cortical thymocyte proliferation mimicking T-lymphoblastic lymphoma within recurrent large inguinal lymph node masses of localized Castleman disease.

    PubMed

    Kansal, Rina; Nathwani, Bharat N; Yiakoumis, Xanthi; Moschogiannis, Maria; Sachanas, Sotirios; Stefanaki, Kalliopi; Pangalis, Gerassimos A

    2015-07-01

    We report a 13-year-old adolescent girl, the youngest thus far, with "an indolent T-lymphoblastic" proliferation (~10%) that uniquely presented within recurrent, large inguinal lymph node masses in a predominating (90%) background of Castleman disease. These nodal masses were resected thrice; the patient is well 5 years after diagnosis without further treatment. Histologically, the features of Castleman disease, hyaline vascular type, were present. Importantly, the interfollicular T-lymphoblastic component occurred as multiple clusters and islands of variable shapes and sizes composed of small "lymphoblasts" indistinguishable from normal cortical thymocytes but without thymic epithelial cells. Immunohistochemically, these lymphoblasts were consistent with the intermediate stage of T-cell differentiation (TdT(+)CD34(-)CD99(+)CD1a(+)CD2(+)CD3(+)CD4(+)CD8(+)CD5(+)CD7(+)CD10(+) [subset]), with 80% Ki-67. Molecularly, the T cells were nonclonal. Our case provides evidence for the benign nature of this highly unusual and poorly understood entity; because the current terminology can be readily misinterpreted as an indolent lymphoblastic lymphoma, we suggest a new term accurately reflecting this entity. PMID:25953658

  8. The development of the gubernaculum and inguinal closure in the marsupial Macropus eugenii

    PubMed Central

    Coveney, Douglas; Shaw, Geoffrey; Hutson, John M; Renfree, Marilyn B

    2002-01-01

    This study reports the developmental anatomy of testicular descent and inguinal closure of the tammar wallaby (Macropus eugenii) from birth to maturity. In females the ovary migrated caudally between days 10 and 20 after birth. The gubernaculum differentiates into the round ligament in the abdomen and extra-abdominally as the ilio-marsupialis muscle of the mammary glands. In males the testes migrated to the internal inguinal ring by day 20 post partum (pp), coinciding with the enlargement of the gubernaculum, and from the internal inguinal ring to the scrotum between days 20 and 65 pp. During descent there was an increase in the hyaluronic acid concentration in cells of the gubernaculum and scrotum. Development of the cremaster muscle began by day 10 pp on the periphery of the gubernaculum and its basic structure was completed by day 60 pp. After descent the inguinal canal closed between days 50 and 60 pp, but a small irregular lumen persisted, somewhat similar to that seen in the congenital scrotal hydrocoele of humans. Tammars have a hopping mode of locomotion and, like humans, are essentially bipedal. We suggest that inguinal closure evolved in these two species because their upright posture may otherwise lead to a high incidence of inguinal hernias. PMID:12363275

  9. Laparoscopic Repair of Inguinal Hernia Using Surgisis Mesh and Fibrin Sealant

    PubMed Central

    2006-01-01

    Objective: We tested the hypothesis that laparoscopic inguinal herniorrhaphy using Surgisis mesh secured with fibrin sealant is an effective long-term treatment for repair of inguinal hernia. This case series involved 38 adult patients with 51 inguinal hernias treated in a primary care center. Methods: Between December 2002 and May 2005, 38 patients with 45 primary and 6 recurrent inguinal hernias were treated with laparoscopic repair by the total extra-peritoneal mesh placement (TEP) technique using Surgisis mesh secured into place with fibrin sealant. Postoperative complications, incidence of pain, and recurrence were recorded, as evaluated at 2 weeks, 6 weeks, 1 year, and with a follow-up questionnaire and telephone interview conducted in May and June 2005. Results: The operations were successfully performed on all patients with no complications or revisions to an open procedure. Average follow-up was 13 months (range, 1 to 30). One hernia recurred (second recurrence of unilateral direct hernia), indicating a 2% recurrence rate. Conclusions: Laparoscopic repair of inguinal hernia using Surgisis mesh secured with fibrin sealant can be effectively used to treat primary, recurrent, direct, indirect, and bilateral inguinal hernias in adults without complications and minimal recurrence within 1-year of follow-up. PMID:17575758

  10. Ricci magnetic geodesic motion of vortices and lumps

    NASA Astrophysics Data System (ADS)

    Alqahtani, L. S.; Speight, J. M.

    2015-12-01

    Ricci magnetic geodesic (RMG) motion in a Kähler manifold is the analogue of geodesic motion in the presence of a magnetic field proportional to the Ricci form. It has been conjectured to model low-energy dynamics of vortex solitons in the presence of a Chern-Simons term, the Kähler manifold in question being the n-vortex moduli space. This paper presents a detailed study of RMG motion in soliton moduli spaces, focusing on the cases of hyperbolic vortices and spherical CP1 lumps. It is shown that RMG flow localizes on fixed point sets of groups of holomorphic isometries, but that the flow on such submanifolds does not, in general, coincide with their intrinsic RMG flow. For planar vortices, it is shown that RMG flow differs from an earlier reduced dynamics proposed by Kim and Lee, and that the latter flow is ill-defined on the vortex coincidence set. An explicit formula for the metric on the whole moduli space of hyperbolic two-vortices is computed (extending an old result of Strachan's), and RMG motion of centred two-vortices is studied in detail. Turning to lumps, the moduli space of static n-lumps is Ratn, the space of degree n rational maps, which is known to be Kähler and geodesically incomplete. It is proved that Rat1 is, somewhat surprisingly, RMG complete (meaning that the initial value problem for RMG motion has a global solution for all initial data). It is also proved that the submanifold of rotationally equivariant n-lumps, Ratneq, a topologically cylindrical surface of revolution, is intrinsically RMG incomplete for n = 2 and all n ≥ 5, but that the extrinsic RMG flow on Rat2eq (defined by the inclusion Rat2eq ↪Rat2) is complete.

  11. The energy of the analytic lump solution in SFT

    NASA Astrophysics Data System (ADS)

    Bonora, L.; Giaccari, S.; Tolla, D. D.

    2011-08-01

    In a previous paper a method was proposed to find exact analytic solutions of open string field theory describing lower dimensional lumps, by incorporating in string field theory an exact renormalization group flow generated by a relevant operator in a worldsheet CFT. In this paper we compute the energy of one such solution, which is expected to represent a D24 brane. We show, both numerically and analytically, that its value corresponds to the theoretically expected one.

  12. Lumped mass modeling of overburden motion during explosive blasting

    SciTech Connect

    Schamaun, J. T.

    1981-02-01

    The in situ extraction of oil from most oil shale beds is highly dependent upon explosive fracturing and rubbling of rock in a controlled and predictable manner. Besides the rubbling requirement, it is also important that the surrounding rock remain competent to minimize fluid leakage during processing. For rubbling concepts in which the overburden is explosively lifted to provide the required void in an oil shale zone, an engineering lumped mass model has been devised to describe the motion of the overburden. The model simulates the overburden as an array of interacting lumped masses which are loaded from below with a time-dependent force to approximate the explosive load. Correlation with experimental data obtained from field blasting operations shows that this model will provide an adequate approximation of overburden behavior. The basic features of the model are described in the report along with the correlations with field data. Results from several parametric studies are also presented which were used to aid in blast design. This lumped mass model can be extended to include other parameters and has potential for the study of other related blasting situations.

  13. Lumped parametric model of the human ear for sound transmission.

    PubMed

    Feng, Bin; Gan, Rong Z

    2004-09-01

    A lumped parametric model of the human auditoria peripherals consisting of six masses suspended with six springs and ten dashpots was proposed. This model will provide the quantitative basis for the construction of a physical model of the human middle ear. The lumped model parameters were first identified using published anatomical data, and then determined through a parameter optimization process. The transfer function of the middle ear obtained from human temporal bone experiments with laser Doppler interferometers was used for creating the target function during the optimization process. It was found that, among 14 spring and dashpot parameters, there were five parameters which had pronounced effects on the dynamic behaviors of the model. The detailed discussion on the sensitivity of those parameters was provided with appropriate applications for sound transmission in the ear. We expect that the methods for characterizing the lumped model of the human ear and the model parameters will be useful for theoretical modeling of the ear function and construction of the ear physical model. PMID:15300453

  14. Diagnosing Common Benign Skin Tumors.

    PubMed

    Higgins, James C; Maher, Michael H; Douglas, Mark S

    2015-10-01

    Patients will experience a wide range of skin growths and changes over their lifetime. Family physicians should be able to distinguish potentially malignant from benign skin tumors. Most lesions can be diagnosed on the basis of history and clinical examination. Lesions that are suspicious for malignancy, those with changing characteristics, symptomatic lesions, and those that cause cosmetic problems may warrant medical therapy, a simple office procedure (e.g., excision, cryosurgery, laser ablation), or referral. Acrochordons are extremely common, small, and typically pedunculated benign neoplasms. Simple scissor or shave excision, electrodesiccation, or cryosurgery can be used for treatment. Sebaceous hyperplasia presents as asymptomatic, discrete, soft, pale yellow, shiny bumps on the forehead or cheeks, or near hair follicles. Except for cosmesis, they have no clinical significance. Lipomas are soft, flesh-colored nodules that are easily moveable under the overlying skin. Keratoacanthomas are rapidly growing, squamoproliferative benign tumors that resemble squamous cell carcinomas. Early simple excision is recommended. Pyogenic granuloma is a rapidly growing nodule that bleeds easily. Treatment includes laser ablation or shave excision with electrodesiccation of the base. Dermatofibromas are an idiopathic benign proliferation of fibroblasts. No treatment is required unless there is a change in size or color, bleeding, or irritation from trauma. Epidermal inclusion cysts can be treated by simple excision with removal of the cyst and cyst wall. Seborrheic keratoses and cherry angiomas generally do not require treatment. PMID:26447443

  15. Pathogenesis of benign adrenocortical tumors.

    PubMed

    Vezzosi, Delphine; Bertherat, Jérôme; Groussin, Lionel

    2010-12-01

    Most adrenocortical tumors (ACT) are benign unilateral adrenocortical adenomas, often discovered incidentally. Exceptionally, ACT are bilateral. However bilateral ACT have been very helpful to progress in the pathophysiology of ACT. Although most ACT are of sporadic origin, they may also be part of syndromic and/or hereditary disorders. The identification of the genetics of familial diseases associated with benign ACT has been helpful to define somatic alterations in sporadic ACT: for example, identification of PRKAR1A mutations in Carney complex or alterations of the Wnt/β-catenin pathway in Familial Adenomatous Polyposis Coli. Components of the cAMP signaling pathway-for example, adrenocorticotropic-hormone receptors and other membrane receptors, Gs protein, phosphodiesterases and protein kinase A-can be altered to various degrees in benign cortisol-secreting ACT. These progress have been important for the understanding of the pathogenesis of benign ACT, but already have profound implications for clinical management, for example in unraveling the genetic origin of disease in some patients with ACT. They also have therapeutic consequences, and should help to develop new therapeutic options. PMID:21115158

  16. Inguinal Abnormalities in Male Patients with Acetabular Fractures Treated Using an Ilioinguinal Exposure

    PubMed Central

    Firoozabadi, Reza; Stafford, Paul; Routt, Milton

    2015-01-01

    Background: Surgeons performing an ilioinguinal exposure for acetabular fracture surgery need to be aware of aberrant findings such as inguinal hernias and spermatic cord lesions. The purpose of this study is to report these occurrences in a clinical series of adult males undergoing acetabular fracture fixation and a series of adult male cadavers. The secondary aim is to characterize these abnormalities to aid surgeons in detecting these abnormalities preoperatively and coordinating a surgical plan with a general surgeon. Methods: Clinical study- Retrospective review of treated acetabular fractures through an ilioinguinal approach. Incidence of inguinal canal and spermatic cord abnormalities requiring general surgery consultation were identified. Corresponding CT scans were reviewed and radiographic characteristics of the spermatic cord abnormalities and/or hernias were noted. Cadaveric study- 18 male cadavers dissected bilaterally using an ilioinguinal exposure. The inguinal canal and the contents of the spermatic cord were identified and characterized. Results: Clinical Study- 5.7% (5/87) of patients had spermatic cord lesion and/or inguinal hernia requiring general surgical intervention. Preoperative pelvic CT scan review identified abnormalities noted intraoperatively in four of the five patients. Cord lipomas visualized as enlargements of the spermatic cord with homogeneous density. Hernias visualized as enlarged spermatic cords with heterogeneous density. Cadaver Study- 31% (11/36) of cadavers studied had spermatic cord and/or inguinal canal abnormalities. Average cord diameter in those with abnormalities was 24.9 mm (15-28) compared to 16 mm (11-22) in normal cords, which was statistically significant. Discussion: The clinical and cadaveric findings emphasize the importance of understanding inguinal abnormalities and the value of detecting them preoperatively. The preoperative pelvic CT scans were highly sensitive in detecting inguinal abnormalities. PMID

  17. A prospective study of bilateral inguinal hernia repair.

    PubMed Central

    Serpell, J. W.; Johnson, C. D.; Jarrett, P. E.

    1990-01-01

    A prospective study of outcome after inguinal hernia repair in patients undergoing simultaneous repair of bilateral hernias (n = 31), sequential repair of bilateral hernias (n = 5), and unilateral hernia repair (n = 75) is reported. There were no differences in wound complications, post-operative respiratory complications, or other adverse effects in the three groups. Operating time was similar in the unilateral and bilateral simultaneous repairs (median 55 min), but was longer (100 min) for the combination of two sequential repairs. Hospital stay was shortest for patients undergoing unilateral repair (2 days) but was less with bilateral simultaneous repair (4 days) than after two sequential repairs (total of 6 days). There were 12 (11%) wound complications of which five (5%) were infections. There was no difference in complication rate between unilateral and bilateral hernia repair. Postoperative recovery was assessed prospectively and was recorded at 1 month. There was no difference between unilateral and bilateral simultaneous repairs in the number of days before the patient was able to climb stairs easily, drive a car or return to work. The duration of the requirement for analgesia was similar in each group. We conclude that bilateral simultaneous hernia repair can be carried out with no greater morbidity than a unilateral repair, and the return to normal activity is as rapid. Bilateral hernias should be repaired simultaneously rather than sequentially. PMID:2221764

  18. Early clinical outcomes following laparoscopic inguinal hernia repair.

    PubMed

    Tolver, Mette Astrup

    2013-07-01

    Laparoscopic inguinal hernia repair (TAPP) has gained increasing popularity because of less post-operative pain and a shorter duration of convalescence compared with open hernia repair technique (Lichtenstein). However, investigation of duration of convalescence with non-restrictive recommendations, and a procedure-specific characterization of the early clinical outcomes after TAPP was lacking. Furthermore, optimization of the post-operative period with fibrin sealant versus tacks for fixation of mesh, and the glucocorticoid dexamethasone versus placebo needed to be investigated in randomized clinical trials. The objective of this PhD thesis was to characterize the early clinical outcomes after TAPP and optimize the post-operative period. The four studies included in this thesis have investigated duration of convalescence and procedure-specific post-operative pain and other early clinical outcomes after TAPP. Furthermore, it has been shown that fibrin sealant can improve the early post-operative period compared with tacks, while dexamethasone showed no advantages apart from reduced use of antiemetics compared with placebo. Based on these findings, and the existing knowledge, 3-5 days of convalescence should be expected when 1 day of convalescence is recommended and future studies should focus on reducing intraabdominal pain after TAPP. Fibrin sealant can optimize the early clinical outcomes but the risk of hernia recurrence and chronic pain needs to be evaluated. Dexamethasone should be investigated in higher doses. PMID:23809977

  19. A rare benign ovarian tumour.

    PubMed

    Palmeiro, Marta Morna; Cunha, Teresa Margarida; Loureiro, Ana Luisa; Esteves, Gonçalo

    2016-01-01

    Sclerosing stromal tumour (SST) of the ovary is an extremely rare and benign ovarian neoplasm, accounting for 6% of the sex cord stromal ovarian tumours subtype. Usually, it is found during the second and third decades of life. Patients commonly present with pelvic pain, a palpable pelvic mass or menstrual irregularity. We report a case of a 20-year-old woman reporting of mild pelvic pain, with normal laboratory data. On imaging examinations, a large right adnexal tumour was found, with features suggesting an ovarian sex cord tumour. The patient underwent right salpingo-oophorectomy, diagnosing a SST of the ovary. This paper also reviews the literature, and emphasises the typical pathological and imaging characteristics of these rare benign ovarian lesions, and their impact, in a conservative surgery. PMID:26933186

  20. Benign Pediatric Salivary Gland Lesions.

    PubMed

    Carlson, Eric R; Ord, Robert A

    2016-02-01

    Salivary gland lesions are rare in pediatric patients. In addition, the types of salivary gland tumors are different in their distribution in specific sites in the major and minor salivary glands in children compared with adults. This article reviews benign neoplastic and nonneoplastic salivary gland disorders in pediatric patients to help clinicians to develop an orderly differential diagnosis that will lead to expedient treatment of pediatric patients with salivary gland lesions. PMID:26614702

  1. A candidate for a classical lump in four euclidean dimensions

    NASA Astrophysics Data System (ADS)

    Tchrakian, D. H.

    1985-05-01

    A generalisation of the Yang-Mills-Maxwell-Higgs (YMMH) system is proposed. This system is the residual theory obtained from the dimensional reduction characterized by M8 = E4 × S2 × S2, of a gauge theory which has finite action field configurations in eight euclidean dimensions. The resulting system reduces to YMMH for a small radius of compactification (η-1 and η2- and is put forward as a possible classical lump in four euclidean dimensions. Mailing address during 1984-1985: School of Theoretical Physics, Dublin Institute for Advanced Studies, 10 Burlington Road, Dublin 4, Ireland.

  2. Lumped circuit model of RF amplifier for SPICE simulator

    NASA Astrophysics Data System (ADS)

    Opalska, Katarzyna

    2014-11-01

    The paper presents the lumped model of RF amplifier for the generic SPICE circuit simulator. Model is constructed on the basis of measured s-parameter data set of the amplifier. Data - transformed to admittance (y) domain - is approximated by rational functions, which later are synthesized as RLC (sub)circuits. Final amplifier model - obtained by representing Y matrix of two-port circuit by the set of passive components and controlled voltage/current sources - is shown to be equivalent to the original s-based model and may be used in any generic circuit simulator.

  3. Lumped-circuit model of four vane RFQ resonator

    NASA Astrophysics Data System (ADS)

    Wangler, T. P.

    The RF cavity code SUPERFISH is a necessary tool in designing RF cavities and it is often used it for approximate analytic formulas of electromagnetic properties of a cavity. One approach for the RFQ four vane cavity is the use of analytic solutions associated with an inclined plane waveguide. The large capacity vane loading in the four vane RFQ resonator give a convenient representation by a simple lumped circuit model. Formulas are derived which depend on a single unknown parameter: the vane capacitance per unit length, which can be calculated for different vane geometries using SUPERFISH. The formulas from the model are useful for estimating the RFQ's electromagnetic properties.

  4. Random effects of fissile lumps in molten salt reactors

    SciTech Connect

    Dulla, S.; Ravetto, P.; Prinja, A. K.

    2013-07-01

    The problem of the effect of fissile lumps spatially appearing in a random fashion inside a fluid fuel reactor is addressed. The effect on reactivity is evaluated by means of first-order perturbation theory. The analysis is carried out in diffusion theory with the presence of delayed neutron emissions in one dimensional plane geometry. The estimation of the mean value and standard deviation of the reactivity inserted is performed by Monte Carlo simulations and a deterministic quadrature approach, to compare the methods in terms of computational effort and the accuracy of the results. The results presented show that the effects constitute an important issue in the assessment of these innovative systems. (authors)

  5. Laparoscopic Transabdominal Preperitoneal Inguinal Hernia Repair Using Memory-Ring Mesh: A Pilot Study

    PubMed Central

    Nomura, Tsutomu; Matsuda, Akihisa; Takao, Yoshimune

    2016-01-01

    Purpose. To evaluate the feasibility, safety, and effectiveness of laparoscopic transabdominal preperitoneal (TAPP) inguinal hernia repair using a memory-ring patch (Polysoft™ mesh). Patients and Methods. Between April 2010 and March 2013, a total of 76 inguinal hernias underwent TAPP repair using Polysoft mesh in 67 adults under general anesthesia. Three different senior resident surgeons performed TAPP repair under the instruction of a specialist surgeon. Nine patients had bilateral hernias. The 76 hernias included 37 indirect inguinal hernias, 29 direct hernias, 1 femoral hernia, 1 pantaloon hernia (combined direct/indirect inguinal hernia), and 8 recurrent hernias after open anterior hernia repair. The immediate postoperative outcomes as well as the short-term outcomes (mainly recurrence and incidence of chronic pain) were studied. Results. There was no conversion from TAPP repair to anterior open repair. The mean operation time was 109 minutes (range, 40–132) for unilateral hernia repair. Scrotal seroma was diagnosed at the operation site in 5 patients. No patient had operation-related orchitis, testicle edema, trocar site infection, or chronic pain during follow-up. Conclusions. The use of Polysoft mesh for TAPP inguinal hernia repair does not seem to adversely affect the quality of repair. The use of this mesh is therefore feasible and safe and may reduce postoperative pain.

  6. Devolatilization Characteristics and Kinetic Analysis of Lump Coal from China COREX3000 Under High Temperature

    NASA Astrophysics Data System (ADS)

    Xu, Runsheng; Zhang, Jianliang; Wang, Guangwei; Zuo, Haibin; Liu, Zhengjian; Jiao, Kexin; Liu, Yanxiang; Li, Kejiang

    2016-08-01

    A devolatilization study of two lump coals used in China COREX3000 was carried out in a self-developed thermo-gravimetry at four temperature conditions [1173 K, 1273 K, 1373 K, and 1473 K (900 °C, 1000 °C, 1100 °C, and 1200 °C)] under N2. This study reveals that the working temperature has a strong impact on the devolatilization rate of the lump coal: the reaction rate increases with the increasing temperature. However, the temperature has little influence on the maximum mass loss. The conversion rate curve shows that the reaction rate of HY lump coal is higher than KG lump coal. The lump coals were analyzed by XRD, FTIR, and optical microscopy to explore the correlation between devolatilization rate and properties of lump coal. The results show that the higher reaction rate of HY lump coal attributes to its more active maceral components, less aromaticity and orientation degree of the crystallite, and more oxygenated functional groups. The random nucleation and nuclei growth model (RNGM), volume model (VM), and unreacted shrinking core model (URCM) were employed to describe the reaction behavior of lump coal. It was concluded from kinetics analysis that RNGM model was the best model for describing the devolatilization of lump coals. The apparent activation energies of isothermal devolatilization of HY lump coal and KG lump coal are 42.35 and 45.83 kJ/mol, respectively. This study has implications for the characteristics and mechanism modeling of devolatilization of lump coal in COREX gasifier.

  7. Devolatilization Characteristics and Kinetic Analysis of Lump Coal from China COREX3000 Under High Temperature

    NASA Astrophysics Data System (ADS)

    Xu, Runsheng; Zhang, Jianliang; Wang, Guangwei; Zuo, Haibin; Liu, Zhengjian; Jiao, Kexin; Liu, Yanxiang; Li, Kejiang

    2016-05-01

    A devolatilization study of two lump coals used in China COREX3000 was carried out in a self-developed thermo-gravimetry at four temperature conditions [1173 K, 1273 K, 1373 K, and 1473 K (900 °C, 1000 °C, 1100 °C, and 1200 °C)] under N2. This study reveals that the working temperature has a strong impact on the devolatilization rate of the lump coal: the reaction rate increases with the increasing temperature. However, the temperature has little influence on the maximum mass loss. The conversion rate curve shows that the reaction rate of HY lump coal is higher than KG lump coal. The lump coals were analyzed by XRD, FTIR, and optical microscopy to explore the correlation between devolatilization rate and properties of lump coal. The results show that the higher reaction rate of HY lump coal attributes to its more active maceral components, less aromaticity and orientation degree of the crystallite, and more oxygenated functional groups. The random nucleation and nuclei growth model (RNGM), volume model (VM), and unreacted shrinking core model (URCM) were employed to describe the reaction behavior of lump coal. It was concluded from kinetics analysis that RNGM model was the best model for describing the devolatilization of lump coals. The apparent activation energies of isothermal devolatilization of HY lump coal and KG lump coal are 42.35 and 45.83 kJ/mol, respectively. This study has implications for the characteristics and mechanism modeling of devolatilization of lump coal in COREX gasifier.

  8. Apoptosis in extracorporeal preserved inguinal fat flaps of the rat.

    PubMed

    Herold, Christian; Rennekampff, Hans O; Ohm, Lea; Strauss, Sarah; Linkner, Jörn; Reimers, Kerstin; Allmeling, Christina; Vaske, Bernhard; Vogt, Peter M

    2012-04-01

    Fat cells are fragile cells with a short life span outside the body. Ways to reduce cell death in a biochemical way are almost unknown due to scarce information on the type of cellular death that is induced in fat tissue. This study was designed to investigate the apoptotic pathways of fat tissue in a permanent perfusion bioreactor system with the Hannover preservation solution and the Eurocollins solution in fat flaps of rats. In Lewis rats, the inguinal adipofascial flaps were elevated bilaterally and placed in a bioreactor at 37°C. To detect caspases 3, 8, 9 and 12, immunofluorescence stains of fat tissue specimen were analysed at several time points after preservation of flaps were placed in Hannover solution and Eurocollins solution for 10 days. An additional visual assessment of viability by a calcein based life/dead test was performed. It revealed a superior viability of the adipose tissue preserved in Hannover solution. Immunofluorescence staining demonstrated that apoptotic pathways via mitochondria, endoplasmatic reticulum and death receptors were activated, as Caspases 8, 9 and 12 were detected. Caspase 3 as an effector in the common apoptotic pathway was detected as well. Adipose tissue preserved at 37°C ex vivo in a bioreactor system undergoes apoptosis. Immunofluorescence examination of the fat tissue preserved ex vivo revealed that apoptotic pathways via mitochondria, endoplasmatic reticulum and death receptors are being activated. Significantly less activation of Caspase 3, 8, 9 and 12 in flaps preserved in Hannover solution in comparison to Eurocollins was found, supporting the anti apoptotic characteristics of Hannover solution. Based on these findings, further research to modify the apoptotic pathways to ameliorate viability of fat tissue can be performed. PMID:22223358

  9. Effects of lump characteristics on plutonium self absorption correction methods

    SciTech Connect

    Curtis, D. C.; Wormald, M. R.; Croft, S.

    2007-07-01

    An evaluation study has been undertaken to assess the robustness of several published Pu self-absorption correction methods against variation in size, shape, density etc. for use in the gamma assay of nuclear waste. The correction methods studied are a numerical plutonium self absorption correction (PuSAC) technique, the Fleissner 2-line, Fleissner 3-line and Infinite Energy Extrapolation methods with both linear and polynomial extrapolation to 1/E=0. The performance of these methods has been compared for a limited set of measured encapsulated PuO{sub 2} sources plus a range of modelled unencapsulated Pu lumps. An indication of the magnitude of the uncertainties of the numerical PuSAC method has been determined for cases of blind assays where the Pu material, shape and distribution are unknown with the aim of ultimately applying it to real waste. The importance of the range of Pu lumps used in the baseline modelled dataset has been examined. Data are presented to illustrate how the uncertainties in the method are affected by the shape, composition, density, number and mass distribution of Pu particles in a sample for a given modelled base dataset. (authors)

  10. A Low-Cost Teaching Model of Inguinal Canal: A Useful Method to Teach Surgical Concepts in Hernia Repair

    ERIC Educational Resources Information Center

    Ansaloni, Luca; Catena, Fausto; Coccolini, Frederico; Ceresoli, Marco; Pinna, Antonio Daniele

    2014-01-01

    Objectives: Inguinal canal anatomy and hernia repair is difficult for medical students and surgical residents to comprehend. Methods: Using low-cost material, a 3-dimensional inexpensive model of the inguinal canal was created to allow students to learn anatomical details and landmarks and to perform their own simulated hernia repair. In order to…

  11. Diagnosis and successful surgical treatment of an unusual inguinal liposarcoma in a pet ferret (Mustela putorius furo)

    PubMed Central

    Gardhouse, Sara; Eshar, David; Fromstein, Jordan; Smith, Dale A.

    2013-01-01

    A 4 1/2-year-old female spayed ferret (Mustela putorius furo) was presented for a rapidly growing mass in the inguinal region. Following a complete clinical evaluation, the unusual mass was surgically removed and the histopathological diagnosis was an inguinal liposarcoma. No post-operative complications were observed over a 14-month follow-up period. PMID:24155472

  12. Inguinal hernia containing bladder and ureteroneocystostomy: a rare cause for acute renal graft dysfunction.

    PubMed

    Coelho, Hugo; Nunes, Pedro; Canhoto, Carolina; Temido, Paulo

    2016-01-01

    A 77-year-old man presented with acute graft dysfunction 25 years after a renal transplant in the left iliac fossa. He also had an asymptomatic left inguinal hernia. Renal ultrasound showed a significant pyelocalicial dilation of the kidney graft and the patient was submitted to a percutaneous nephrostomy. An antegrade nephrostogram was performed, which showed a dilated ureter and the bladder included in the left inguinal hernia that caused the obstructive uropathy. Concomitant retrograde cystography also showed a significant portion of the bladder in the hernia sac. The patient was submitted to inguinal hernia repair, which resolved the obstruction. We present a rare and potentially curable cause of obstructive uropathy in a transplant recipient; it is possible to revert graft dysfunction and prevent graft loss if the condition is recognised early. PMID:26912768

  13. Triorchidism: Presenting as Undescended Testis in a Case of Indirect Inguinal Hernia

    PubMed Central

    Gandhi, Saurabh S.; Patel, Chintan B.; Wagh, Amol N.; Gawli, Virendra; Jain, Nimesh A.

    2016-01-01

    Triorchidism is the commonest variety of polyorchidism, an entity with more than two testis is an extremely rare congenital anomaly of the testis. Although excision of the abnormal testis is a safer alternative proposed, recent literature suggests more conservative approach in normal testes with watchful regular follow up to screen for malignancy. This case presented as a left inguinal swelling diagnosed as indirect left inguinal hernia. The left side testis was of smaller size (about half) with normal sperm count, morphology and motility. Intraoperatively indirect inguinal hernia was noted with supernumerary testis at deep ring in addition to normal left testis in left scrotal sac. The ectopic testis were small (2.5×2.5×1 cm) lacking epididymis and with short vas deferens. An evident normal semen analysis and varied anatomy, the decision for orchidectomy of ectopic testis was taken. The histopathological finding was consistent with arrest in germ cell development. PMID:27478577

  14. Inguinal Hernia Containing Uterus, Fallopian Tube, and Ovary in a Premature Newborn

    PubMed Central

    Karadeniz Cerit, Kıvılcım; Ergelen, Rabia; Colak, Emel; Dagli, Tolga E.

    2015-01-01

    A female infant weighing 2,200 g was delivered at 34 weeks of gestation by vaginal delivery. She presented with an irreducible mass in the left inguinal region at 32 days of age. An ultrasonography (US) was performed and an incarcerated hernia containing uterus, fallopian tube, and ovary was diagnosed preoperatively. Surgery was performed through an inguinal approach; the uterus, fallopian tube, and ovary were found in the hernia sac. High ligation and an additional repair of the internal inguinal ring were performed. Patent processus vaginalis was found during contralateral exploration and also closed. The postoperative course was uneventful. After one year of follow-up, there have been no signs of recurrence. PMID:26351609

  15. FNAC Versus Core Needle Biopsy: A Comparative Study in Evaluation of Palpable Breast Lump

    PubMed Central

    Saha, Abhijit; Mukhopadhyay, Madhumita; Sarkar, Koushik; Saha, Ashis Kumar; Sarkar, Diptendra KR

    2016-01-01

    Introduction Breast carcinoma is the most common malignant tumour and the leading cause of carcinoma death in women in world. The main purpose of FNAC or CNB of breast lumps is to confirm cancer preoperatively and to avoid unnecessary surgery in specific benign conditions. Aims and Objective The objective of the study was to compare between Fine Needle Aspiration Cytology (FNAC) and Core Needle Biopsy (CNB) in the diagnosis of breast carcinoma with final histological diagnosis from excision specimen as it is gold standard. Materials and Methods A prospective study was done on 50 cases. Patients undergoing all three procedures (Fine Needle Aspiration Cytology and Core Needle Biopsy done at Department of Pathology; subsequent excision surgeries done at Department of General Surgery) were selected. May Grunwald Giemsa (MGG) and Papaniculou (PAP) staining were performed on cytology smears. Haematoxylin and Eosin (H&E) staining was done on both the CNB and tissue specimens obtained from subsequent excision surgeries to see the histological features. Results FNAC showed sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy were 69%, 100%, 100%, 38.1%, and 74% respectively in diagnosing carcinoma. CNB had sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of 88.3%, 100%, 100%, 53.3% and 86%. Both FNAC and CNB showed statistically significant correlation with confirmatory HPE of excision specimen (p-value <0.05) in the diagnosis of breast carcinoma. Conclusion Fine needle aspiration cytology (FNAC) is a rapid, less complicated, economical, reliable and relevant method for the preoperative pathological diagnosis of breast carcinoma in a developing nation like ours. If the initial FNAC is inadequate, core needle biopsy (CNB) can be a useful second line method of pathological diagnosis in order to minimize the chance of missed diagnosis of breast cancer. PMID:27042469

  16. Lumps, Bumps, and Things that Go Itch in Your Office!

    ERIC Educational Resources Information Center

    McLeod, Renee P.

    2003-01-01

    This article presents a short dermatological case presentation involving a 12-year-old white male who has Pityriasis rosea. Pityriasis rosea is an acute, benign, self-limiting disorder that affects males and females equally. It rarely occurs in children younger than 5 years of age but can occur in children as young as 1 year. It is most commonly…

  17. A successful laparoscopic neovaginoplasty using peritoneum in Müllerian agenesis with inguinal ovaries accompanied by primary ovarian insufficiency

    PubMed Central

    Gweon, Seonghye; Lee, Jisun; Hwang, Suna; Hwang, Kyoung Joo

    2016-01-01

    The combination of Müllerian agenesis with inguinal ovaries accompanied by primary ovarian insufficiency is extremely rare. A 21-year-old Korean woman was referred to our center with primary amenorrhea. The patient was diagnosed with Müllerian agenesis with inguinal ovaries. Her hormonal profile showed hypergonadotrophic hypogonadism suggesting primary ovarian insufficiency. We performed laparoscopic neovaginoplasty using modified Davydov's procedure and reposition inguinal ovaries in the pelvic cavity. Oral estrogen replacement was applied for the treatment of primary ovarian insufficiency. This is a rare case report on Mayer-Rokitansky-Kuster-Hauser syndrome accompanied not only by inguinal ovaries but also with primary ovarian insufficiency. We present our first experience on the laparoscopic neovaginoplasty performed on the patient with müllerian agenesis accompanied by inguinal ovaries and primary ovarian insufficiency. PMID:27462606

  18. Anteromedial thigh perforator flap to cover the inguinal region in a crossover femorofemoral bypass

    PubMed Central

    Maldonado, Andrés A.; García-Domínguez, Jose; González-Hidalgo, Carmen; Fernández-Casado, Jose Luis; Fonseca, Raúl

    2015-01-01

    Abstract We report the case of a 48-year-old male with an exposition of a femorofemoral crossover bypass in the inguinal region and superficial femoral occlusion. This was successfully treated using an anteromedial thigh (AMT) pedicled flap based on the perforator vessel of the descending branch of the lateral circumflex femoral artery. Our report focuses on: i) considering the AMT flap as a safe and easy option to cover the inguinal region in cases of bypass exposure; ii) describing the attachment of this flap to the deep femoral artery in a patient with superficial femoral occlusion, in spite of some literature controversy. PMID:27252966

  19. Early experience of robotic-assisted inguinal lymphadenectomy: review of surgical outcomes relative to alternative approaches.

    PubMed

    Kharadjian, Talar B; Matin, Surena F; Pettaway, Curtis A

    2014-06-01

    Inguinal lymph node dissection is a diagnostic and potentially curative treatment for penile carcinoma, which has historically been associated with high morbidity rates. This review summarizes the initial outcomes of robotic-assisted inguinal lymphadenectomy (RAIL) compared with the outcomes of the standard open and endoscopic approaches. The early experience suggests that RAIL may yield comparable oncologic outcomes, although future prospective studies of RAIL with greater numbers of participants and long-term follow-up are needed to evaluate the incidence and severity of perioperative and postoperative complications. PMID:24756453

  20. Unusual cause of pneumomediastinum in a laparoscopic extraperitoneal inguinal hernia repair

    PubMed Central

    Teng, Tze Yeong; Lau, Cheryl Chien-Li

    2014-01-01

    Pneumomediastinum is an extremely rare complication after laparoscopic inguinal hernia repair. Very few cases have been reported in the surgical literature to date and most reports indicate pneumoperitoneum from the transabdominal preperitoneal approach as a causative factor. This case report describes a patient in whom an elective total extraperitoneal inguinal hernia repair was complicated by a pneumomediastinum without concomitant pneumoperitoneum, and identifies the tracking of air along the anterior extraperitoneal space and endothoracic fascia as a cause. Previous case reports were reviewed and possible etiologies are discussed. PMID:25348336

  1. Palpable inguinal mass in a girl after omphalocele repair: US findings.

    PubMed

    Esposito, F; De Fronzo, S; Migliaccio, B; Oresta, P

    2013-01-01

    Hydrocele of the canal of Nuck is a rare cause of inguinal swelling in females. We present the case of a 9-year-old girl, who underwent omphalocele repair shortly after birth. She presented with a painless swelling in the right inguinal region; it was of a hard elastic consistency and ultrasound image showed an oval lesion containing fluid, located in the subcutaneous soft tissue. Removal of the lesion and histological examination of the surgical specimen confirmed cyst of the canal of Nuck. PMID:24046798

  2. 24 CFR 84.82 - Provisions applicable only to lump sum grants.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... acceptable sureties, as prescribed in 31 CFR part 223, “Surety Companies Doing Business with the United... 24 Housing and Urban Development 1 2010-04-01 2010-04-01 false Provisions applicable only to lump... Provisions applicable only to lump sum grants. In addition to the provisions of this subpart E, subparts...

  3. DEVELOPMENT OF A LUMPED-PARAMETER MODEL OF INDOOR RADON CONCENTRATIONS

    EPA Science Inventory

    The report describes a simplified, lumped-parameter model to characterize indoor radon concentrations from data that are more readily available than those required for existing mathematical models. he lumped-parameter model was developed from numerous sensitivity analyses with th...

  4. 46 CFR 148.245 - Direct reduced iron (DRI); lumps, pellets, and cold-molded briquettes.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 5 2011-10-01 2011-10-01 false Direct reduced iron (DRI); lumps, pellets, and cold-molded briquettes. 148.245 Section 148.245 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY... Requirements for Certain Materials § 148.245 Direct reduced iron (DRI); lumps, pellets, and...

  5. 46 CFR 148.245 - Direct reduced iron (DRI); lumps, pellets, and cold-molded briquettes.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 46 Shipping 5 2014-10-01 2014-10-01 false Direct reduced iron (DRI); lumps, pellets, and cold-molded briquettes. 148.245 Section 148.245 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY... Requirements for Certain Materials § 148.245 Direct reduced iron (DRI); lumps, pellets, and...

  6. 46 CFR 148.245 - Direct reduced iron (DRI); lumps, pellets, and cold-molded briquettes.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 46 Shipping 5 2013-10-01 2013-10-01 false Direct reduced iron (DRI); lumps, pellets, and cold-molded briquettes. 148.245 Section 148.245 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY... Requirements for Certain Materials § 148.245 Direct reduced iron (DRI); lumps, pellets, and...

  7. Waveguide metatronics: Lumped circuitry based on structural dispersion.

    PubMed

    Li, Yue; Liberal, Iñigo; Della Giovampaola, Cristian; Engheta, Nader

    2016-06-01

    Engineering optical nanocircuits by exploiting modularization concepts and methods inherited from electronics may lead to multiple innovations in optical information processing at the nanoscale. We introduce the concept of "waveguide metatronics," an advanced form of optical metatronics that uses structural dispersion in waveguides to obtain the materials and structures required to construct this class of circuitry. Using numerical simulations, we demonstrate that the design of a metatronic circuit can be carried out by using a waveguide filled with materials with positive permittivity. This includes the implementation of all "lumped" circuit elements and their assembly in a single circuit board. In doing so, we extend the concepts of optical metatronics to frequency ranges where there are no natural plasmonic materials available. The proposed methodology could be exploited as a platform to experimentally validate optical metatronic circuits in other frequency regimes, such as microwave frequency setups, and/or to provide a new route to design optical nanocircuitry. PMID:27386566

  8. Frequent complaints of testicular lumps by young prisoners.

    PubMed

    Mohanty, Kailash C

    2008-05-01

    The definition of the age of young offenders was changed by an Act of Parliament (The Crime and Disorder Act 1998), which was implemented by the Home Office on 1 April 2000. This Act brought down the upper-age limit of young offenders from 20 to 17. Our objective was to investigate the sexually transmitted infections (STIs) among this redefined group of young offenders. Among various types of STIs, we observed that a significant number of young prisoners had complaints of testicular lumps (35%), which were not reported in the past. We tried to find out the reason for this common complaint and believe that this was due to extra vigilance, and testicular self-examination in conjunction with sex and relationship programmes which ran alongside other programmes developed as a joint venture by Prisoner Learning and Skills Unit, Prison Health Policy Unit and Sex Education Forum. PMID:18482964

  9. New equivalent lumped electrical circuit for piezoelectric transformers.

    PubMed

    Gonnard, Paul; Schmitt, P M; Brissaud, Michel

    2006-04-01

    A new equivalent circuit is proposed for a contour-vibration-mode piezoelectric transformer (PT). It is shown that the usual lumped equivalent circuit derived from the conventional Mason approach is not accurate. The proposed circuit, built on experimental measurements, makes an explicit difference between the elastic energies stored respectively on the primary and secondary parts. The experimental and theoretical resonance frequencies with the secondary in open or short circuit are in good agreement as well as the output "voltage-current" characteristic and the optimum efficiency working point. This circuit can be extended to various PT configurations and appears to be a useful tool for modeling electronic devices that integrate piezoelectric transformers. PMID:16615585

  10. Lumped-circuit model of four-vane RFQ resonator

    SciTech Connect

    Wangler, T.P.

    1984-01-01

    Although the rf cavity code SUPERFISH is a necessary tool for designing rf cavities, it is often useful to have approximate analytic formulas for the electromagnetic properties of a cavity. One approach for the RFQ four-vane cavity is to use the analtytic solutions associated with an inclined plane waveguide. The large capacitive vane loading in the four-vane RFQ resonator allows a convenient representation by a simple lumped-circuit model. Formulas are derived that depend on a single unknown parameter: the vane capacitance per unit length, which can be calculated for different vane geometries using SUPERFISH. The formulas from the model are useful for estimating the RFQ's electromagnetic properties as a function of parameters such as frequency and intervane voltage.

  11. Management of Benign Prostatic Hyperplasia.

    PubMed

    Kim, Eric H; Larson, Jeffrey A; Andriole, Gerald L

    2016-01-01

    Benign prostatic hyperplasia (BPH) and associated lower urinary tract symptoms (LUTS) commonly affect older men. Age-related changes associated with metabolic disturbances, changes in hormone balance, and chronic inflammation may cause BPH development. The diagnosis of BPH hinges on a thorough medical history and focused physical examination, with attention to other conditions that may be causing LUTS. Digital rectal examination and urinalysis should be performed. Other testing may be considered depending on presentation of symptoms, including prostate-specific antigen, serum creatinine, urine cytology, imaging, cystourethroscopy, post-void residual, and pressure-flow studies. Many medical and surgical treatment options exist. Surgery should be reserved for patients who either have failed medical management or have complications from BPH, such as recurrent urinary tract infections, refractory urinary retention, bladder stones, or renal insufficiency as a result of obstructive uropathy. PMID:26331999

  12. [Radiotherapy of benign intracranial tumors].

    PubMed

    Delannes, M; Latorzeff, I; Chand, M E; Huchet, A; Dupin, C; Colin, P

    2016-09-01

    Most of the benign intracranial tumors are meningiomas, vestibular schwannomas, pituitary adenomas, craniopharyngiomas, and glomus tumors. Some of them grow very slowly, and can be observed without specific treatment, especially if they are asymptomatic. Symptomatic or growing tumors are treated by surgery, which is the reference treatment. When surgery is not possible, due to the location of the lesion, or general conditions, radiotherapy can be applied, as it is if there is a postoperative growing residual tumor, or a local relapse. Indications have to be discussed in polydisciplinary meetings, with precise evaluation of the benefit and risks of the treatments. The techniques to be used are the most modern ones, as multimodal imaging and image-guided radiation therapy. Stereotactic treatments, using fractionated or single doses depending on the size or the location of the tumors, are commonly realized, to avoid as much a possible the occurrence of late side effects. PMID:27523417

  13. On the stability of lumps and wave collapse in water waves.

    PubMed

    Akylas, T R; Cho, Yeunwoo

    2008-08-13

    In the classical water-wave problem, fully localized nonlinear waves of permanent form, commonly referred to as lumps, are possible only if both gravity and surface tension are present. While much attention has been paid to shallow-water lumps, which are generalizations of Korteweg-de Vries solitary waves, the present study is concerned with a distinct class of gravity-capillary lumps recently found on water of finite or infinite depth. In the near linear limit, these lumps resemble locally confined wave packets with envelope and wave crests moving at the same speed, and they can be approximated in terms of a particular steady solution (ground state) of an elliptic equation system of the Benney-Roskes-Davey-Stewartson (BRDS) type, which governs the coupled evolution of the envelope along with the induced mean flow. According to the BRDS equations, however, initial conditions above a certain threshold develop a singularity in finite time, known as wave collapse, due to nonlinear focusing; the ground state, in fact, being exactly at the threshold for collapse suggests that the newly discovered lumps are unstable. In an effort to understand the role of this singularity in the dynamics of lumps, here we consider the fifth-order Kadomtsev-Petviashvili equation, a model for weakly nonlinear gravity-capillary waves on water of finite depth when the Bond number is close to one-third, which also admits lumps of the wave packet type. It is found that an exchange of stability occurs at a certain finite wave steepness, lumps being unstable below but stable above this critical value. As a result, a small-amplitude lump, which is linearly unstable and according to the BRDS equations would be prone to wave collapse, depending on the perturbation, either decays into dispersive waves or evolves into an oscillatory state near a finite-amplitude stable lump. PMID:18487123

  14. Use of a truss to maintain inguinal hernia reduction in a very low birth weight infant.

    PubMed

    Ruderman, J W; Schick, J B; Sherman, M; Reagan, Y; Hanks, G; Weitzman, J J

    1995-01-01

    Trusses are not usually used in management of inguinal hernia of the very low birth weight infant. A potential benefit of this therapy is maintenance of hernia reduction, thus delaying operative repair until the infant is larger and healthier. We designed a safe and effective truss with supplies found in most neonatal intensive care units. PMID:7595774

  15. Tailored approach in inguinal hernia repair - decision tree based on the guidelines.

    PubMed

    Köckerling, Ferdinand; Schug-Pass, Christine

    2014-01-01

    The endoscopic procedures TEP and TAPP and the open techniques Lichtenstein, Plug and Patch, and PHS currently represent the gold standard in inguinal hernia repair recommended in the guidelines of the European Hernia Society, the International Endohernia Society, and the European Association of Endoscopic Surgery. Eighty-two percent of experienced hernia surgeons use the "tailored approach," the differentiated use of the several inguinal hernia repair techniques depending on the findings of the patient, trying to minimize the risks. The following differential therapeutic situations must be distinguished in inguinal hernia repair: unilateral in men, unilateral in women, bilateral, scrotal, after previous pelvic and lower abdominal surgery, no general anesthesia possible, recurrence, and emergency surgery. Evidence-based guidelines and consensus conferences of experts give recommendations for the best approach in the individual situation of a patient. This review tries to summarize the recommendations of the various guidelines and to transfer them into a practical decision tree for the daily work of surgeons performing inguinal hernia repair. PMID:25593944

  16. A genome-wide association study identifies four novel susceptibility loci underlying inguinal hernia

    PubMed Central

    Jorgenson, Eric; Makki, Nadja; Shen, Ling; Chen, David C.; Tian, Chao; Eckalbar, Walter L.; Hinds, David; Ahituv, Nadav; Avins, Andrew

    2015-01-01

    Inguinal hernia repair is one of the most commonly performed operations in the world, yet little is known about the genetic mechanisms that predispose individuals to develop inguinal hernias. We perform a genome-wide association analysis of surgically confirmed inguinal hernias in 72,805 subjects (5,295 cases and 67,510 controls) and confirm top associations in an independent cohort of 92,444 subjects with self-reported hernia repair surgeries (9,701 cases and 82,743 controls). We identify four novel inguinal hernia susceptibility loci in the regions of EFEMP1, WT1, EBF2 and ADAMTS6. Moreover, we observe expression of all four genes in mouse connective tissue and network analyses show an important role for two of these genes (EFEMP1 and WT1) in connective tissue maintenance/homoeostasis. Our findings provide insight into the aetiology of hernia development and highlight genetic pathways for studies of hernia development and its treatment. PMID:26686553

  17. Vesical calculus formation on non-absorbable sutures used for open inguinal hernia repair

    PubMed Central

    Almarzouq, Ahmad; Mahmoud, Akram H.; Ashebu, Samuel D.; Kehinde, Elijah O.

    2014-01-01

    INTRODUCTION Iatrogenic injuries to the urogenital tract are rare, with the bladder being the organ most affected. We describe a case of a vesical calculus that formed on non-absorbable sutures that were used to repair an inguinal hernia. PRESENTATION OF CASE A 45-year-old male presented with frank haematuria and dysuria 2 years following an open left inguinal hernia repair. A CT urography showed a vesical calculus adherent to the left anterio-lateral wall of the bladder. Cystoscopy revealed that the calculus formed on non-absorbable sutures. Cystolapaxy was performed followed by cystoscopic excision of the sutures. The patient's post-operative course was uneventful. DISCUSSION Foreign bodies in the urinary bladder always act as a nidus for formation of a calculus. Iatrogenic bladder injuries are common during hernia repair. It is however rare for sutures used to repair an inguinal hernia to involve the urinary bladder wall. The patient most likely had a full bladder at the time of hernia repair or the bladder was part of the contents of the hernia sac. CONCLUSION This case illustrates the need to ensure that the bladder is empty prior to pelvic surgery and for surgeons to have a good understanding of inguinal anatomy to avoid injuring the contents of the hernia sac. PMID:25308188

  18. Omental torsion with left-sided inguinal hernia: a rare preoperative diagnosis.

    PubMed

    Kayan, Mustafa; Sabuncuoglu, Mehmet Zafer; Çetin, Meltem; Çetin, Recep; Benzin, Mehmet Fatih; Benzin, Şeyma; Yaşar, Selçuk; İbişoğlu, Seda

    2013-01-01

    Omental torsion is a rare disease. It can be difficult to identify if it is not clinically considered in the preoperative period, and this pathology may lead to an acute abdomen. We present the characteristic computed tomography findings and clinical particulars in a 34-year-old male patient with longstanding left inguinal hernia associated with an extraordinary diagnosis. PMID:23206629

  19. Medial Versus Traditional Approach to US-guided TAP Blocks for Open Inguinal Hernia Repair

    ClinicalTrials.gov

    2012-04-30

    Abdominal Muscles/Ultrasonography; Adult; Ambulatory Surgical Procedures; Anesthetics, Local/Administration & Dosage; Ropivacaine/Administration & Dosage; Ropivacaine/Analogs & Derivatives; Hernia, Inguinal/Surgery; Humans; Nerve Block/Methods; Pain Measurement/Methods; Pain, Postoperative/Prevention & Control; Ultrasonography, Interventional

  20. The Onstep Method for Inguinal Hernia Repair: Operative Technique and Technical Tips

    PubMed Central

    Andresen, Kristoffer

    2016-01-01

    Inguinal hernia repair is one of the most common surgical procedures and several different surgical techniques are available. The Onstep method is a new promising technique. The technique is simple with a number of straightforward steps. This paper provides a full description of the technique together with tips and tricks to make it easy and without complications. PMID:27379255

  1. Vasal Injury During Inguinal Herniorrhaphy: A Case Report and Review of the Literature

    PubMed Central

    Flechner, Lawrence; Smith, James; Treseler, Patrick; Maa, John

    2014-01-01

    An injury to the vas deferens during inguinal herniorrhaphy from possible tethering of the vas has not, to our knowledge, previously been described in the surgical literature. We report a case of iatrogenic injury of the vas deferens that occurred during elective hernia repair in a 28-year-old man who had previously sustained blunt trauma to the abdomen and pelvis. PMID:25662530

  2. Facts for Life: Benign Breast Changes

    MedlinePlus

    ... this series: • Biopsy • Screening and Early Detection • Imaging Methods Used to Find Breast Cancer • Mammography • When You Discover a Lump or Change Susan G. Komen ® is not a health care provider and does not give medical advice. The information provided in this material is not meant to be used for self- ...

  3. LUMPED: a Visual Basic code of lumped-parameter models for mean residence time analyses of groundwater systems

    NASA Astrophysics Data System (ADS)

    Ozyurt, N. N.; Bayari, C. S.

    2003-02-01

    A Microsoft ® Visual Basic 6.0 (Microsoft Corporation, 1987-1998) code of 15 lumped-parameter models is presented for the analysis of mean residence time in aquifers. Groundwater flow systems obeying plug and exponential flow models and their combinations of parallel or serial connection can be simulated by these steady-state models which may include complications such as bypass flow and dead volume. Each model accepts tritium, krypton-85, chlorofluorocarbons (CFC-11, CFC-12 and CFC-113) and sulfur hexafluoride (SF 6) as environmental tracer. Retardation of gas tracers in the unsaturated zone and their degradation in the flow system may also be accounted for. The executable code has been tested to run under Windows 95 or higher operating systems. The results of comparisons between other comparable codes are discussed and the limitations are indicated.

  4. Familial benign chronic pemphigus (Hailey-Hailey Disease): use of topical immunomodulators as a modern treatment option.

    PubMed

    Tchernev, Georgi; Cardoso, José Carlos

    2011-05-01

    Benign chronic familial pemphigus (Hailey-Hailey disease) is a rare autosomal dominant blistering skin disorder characterized by suprabasal cell separation (acantholysis) of the epidermis. The Hailey brothers first described it in 1939. Hailey-Hailey disease usually appears in the third or fourth decade, although it can occur at any age. Heat, sweating and friction often exacerbates the disease, and most patients have worse symptoms during summer. It is characterized clinically by a recurrent eruption of vesicles and bullae at the sites of friction and intertriginous areas. We report a 51-year-old male presenting with grey-brown hyperkeratosis with partial papillomatosis and lichenification in the axillary and inguinal areas and infiltrated erythematous lesions in the infraorbitary region, on the side of the face. Biopsies obtained from inguinal and axillar areas revealed parakeratotic crusts overlying an acantholytic epidermis. A biopsy from one of the lesions from the infraorbital area showed a Jessner-Kanof lymphocytic infiltration. The patient was treated with antimicrobials and four days later, topical Pimecrolimus was started, leading to an improvement of the clinical picture. The efficacy of Pimecrolimus in our case suggests that cellular immunity could play a role in the pathogenesis of Hailey-Hailey disease. PMID:22051715

  5. First Case Report of Acute Renal Failure After Mesh-Plug Inguinal Hernia Repair in a Kidney Transplant Recipient

    PubMed Central

    Veroux, Massimiliano; Ardita, Vincenzo; Zerbo, Domenico; Caglià, Pietro; Palmucci, Stefano; Sinagra, Nunziata; Giaquinta, Alessia; Veroux, Pierfrancesco

    2016-01-01

    Abstract Acute renal failure due to ureter compression after a mesh-plug inguinal repair in a kidney transplant recipient has not been previously reported to our knowledge. A 62-year-old man, who successfully underwent kidney transplantation from a deceased donor 6 years earlier, was admitted for elective repair of a direct inguinal hernia. The patient underwent an open mesh-plug repair of the inguinal hernia with placement of a plug in the preperitoneal space. We did not observe the transplanted ureter and bladder during dissection of the inguinal canal. Immediately after surgery, the patient became anuric, and a graft sonography demonstrated massive hydronephrosis. The serum creatinine level increased rapidly, and the patient underwent an emergency reoperation 8 hours later. During surgery, we did not identify the ureter but, immediately after plug removal, urine output increased progressively. We completed the hernia repair using the standard technique, without plug interposition, and the postoperative course was uneventful with complete resolution of graft dysfunction 3 days later. Furthermore, we reviewed the clinical features of complications related to inguinal hernia surgery. An increased risk of urological complications was reported recently in patients with a previous prosthetic hernia repair undergoing kidney transplantation, mainly due to the mesh adhesion to surrounding structures, making the extraperitoneal dissection during the transplant surgery very challenging. Moreover, older male kidney transplant recipients undergoing an inguinal hernia repair may be at higher risk of graft dysfunction due to inguinal herniation of a transplanted ureter. Mesh-plug inguinal hernia repair is a safe surgical technique, but this unique case suggests that kidney transplant recipients with inguinal hernia may be at higher risk of serious urological complications. Surgeons must be aware of the graft and ureter position before proceeding with hernia repair. A prompt

  6. Extramedullary hematopoiesis in a case of benign mixed mammary tumor in a female dog: cytological and histopathological assessment

    PubMed Central

    2010-01-01

    Backgroud Extramedullary hematopoiesis (EMH) is defined as the presence of hematopoietic stem cells such as erythroid and myeloid lineage plus megakaryocytes in extramedullary sites like liver, spleen and lymph nodes and is usually associated with either bone marrow or hematological disorders. Mammary EMH is a rare condition either in human and veterinary medicine and can be associated with benign mixed mammary tumors, similarly to that described in this case. Case presentation Hematopoietic stem cells were found in a benign mixed mammary tumor of a 7-year-old female mongrel dog that presents a nodule in the left inguinal mammary gland. The patient did not have any hematological abnormalities. Cytological evaluation demonstrated two distinct cell populations, composed of either epithelial or mesenchymal cells, sometimes associated with a fibrillar acidophilic matrix, apart from megakaryocytes, osteoclasts, metarubricytes, prorubricytes, rubricytes, rubriblasts, promyelocytes, myeloblasts. Histological examination confirmed the presence of an active hematopoietic bone marrow within the bone tissue of a benign mammary mixed tumor. Conclusions EMH is a rare condition described in veterinary medicine that can be associated with mammary mixed tumors. It's detection can be associated with several neoplastic and non-neoplastic mammary lesions, i.e. osteosarcomas, mixed tumors and bone metaplasia. PMID:20846427

  7. Benign Hydronephrosis and Elevated of Serum Levels of Carbohydrate Antigen CA 19-9: A Case Report.

    PubMed

    Filipovic, Branka; Milinić, Nikola; Gacic, Jasna; Markovic, Olivera; Djokovic, Aleksandra; Filipovic, Branislav

    2016-01-01

    BACKGROUND Carbohydrate tumor-associated antigen (CA 19-9) has been shown to be upregulated in other malignant tumors including gastric, ovarian, hepatocellular, and colorectal carcinoma as well as benign diseases of the biliary track such as pancreatitis, cholangitis, and choledocholithiasis. According to the available literature, in several cases of benign hydronephrosis and in a few cases of benign renal diseases, elevated CA 19-9 has been noted. CASE REPORT A 58-year-old Caucasian male patient was admitted in our clinic with complaints about blunt abdominal pain in the past two-month period localized in the right lumbar region and irradiating into the right inguinal area, constipation, abdominal bloating, and intermittent hematuria. The concentration of serum CA 19-9 was 3500 U/mL. Urine cytology provided no signs of abnormality. Intravenous urography visualized right-sided pyelon and ureter duplex with the defect in contrast shade of the pyelon, caused by a stag horn calculus. Contrast added computerized axial tomography of the abdomen and pelvis visualized the pyelon casted concretion spreading throughout the right pyelon, with ureterohydronephrosis with the distal block for passage of the contrast to the distal part of the ureter. CONCLUSIONS There is no doubt that CA 19-9 level is occasionally elevated in patients with obstructive urolithiasis as it was in our case. In the routine medical praxis, urolithiasis should not be neglected in the differential diagnosis of elevated concentrations of CA 19-9 marker. PMID:27287959

  8. Cure of inguinal hernias with large preperitoneal prosthesis: Experience of 2,312 cases.

    PubMed

    Alexandre, J H; Bouillot, J L; Dupin, P; Aouad, K; Bethoux, J P

    2006-09-01

    It is clear that the recurrence rates after nonprosthetic methods for the repair of inguinal hernias, like McVay, Bassini or Shouldice techniques, are high (6-10%). Since 20 years, we are convinced, in the GREPA-EHS group, about the advantages of the use of a prosthetic mesh in majority of patients for repairs of primary or recurrent inguinal hernias and incisional hernias. We describe our typical technique for the cure of all inguinal hernias. We place a large supple mesh, by open inguinal route, posterior to the transversalis fascia and anterior to the peritoneum. We have made a double modification in the initial technique of Rives - the use of a very large unsplit prosthesis (15 × 17 cm) and the parietalization of the spermatic cord helped by a wide opening of the Fruchaud's orifice by diversion of the epigastric vessels. The positioning of the mesh is about the same as in the TEP technique but with the advantages of reduction in the vital laparoscopic risks and reinforcement of the wall by a short tension-free McVay technique.For this prospective study, we repaired 2,312 consecutive hernias in 1,828 patients, 284 of which were recurrent. We present our results in terms of quality of repairs, recurrence rates (0.4%), morbidity rate (8%), and mortality rate (0.8%).This technique involves the placement by an open incisional route of a large preperitoneal sheet of mesh for initial treatment of all inguinal hernias - including scrotal, giant or femoral - to ensure a definitive solid muscular wall, even for recurrent hernias. PMID:21187983

  9. Comparison of robotic versus laparoscopic transabdominal preperitoneal (TAPP) inguinal hernia repair.

    PubMed

    Waite, Kimberly E; Herman, Mark A; Doyle, Patrick J

    2016-09-01

    Despite growing popularity and potential advantages of robotics in general surgery, there is very little published data regarding robotic inguinal hernia repair. This study examines a single surgeon's early experience with robotic TAPP inguinal hernia repair compared with laparoscopic TAPP repair in terms of feasibility and cost. We performed a retrospective review of 63 consecutive patients (24 laparoscopic and 39 robotic) who underwent inguinal hernia repair between December 2012-December 2014 at a single institution by a single surgeon. Data examined included gender, age, BMI, operative times, recovery room times, pain scale ratings, and cost. Patient groups were the same in terms of age and BMI. The mean operative time (77.5 vs 60.7 min, p = 0.001) and room time (109.3 vs 93.0 min, p = 0.001) were significantly longer for the robotic vs the laparoscopic patients. Recovery room time (109.1 vs 133.5 min, p = 0.026) and average pain scores in recovery (2.5 vs 3.8, p = 0.02) were significantly less for the robotic group. The average direct cost of the laparoscopic group was $3216 compared with $3479 for the robotic group. The average contribution margin for the laparoscopic group was $2396 compared with $2489 for the robotic group. Robotic TAPP inguinal hernia repair had longer operative times, but patients spent less time in recovery and noted less pain than patients who underwent laparoscopic TAPP inguinal hernia repair. The direct cost and contribution margin are nearly equivalent. These results should allow the continued investigation of this technique without concern over excess cost. PMID:27112781

  10. A 5-year Review of Darning Technique of Inguinal Hernia Repair

    PubMed Central

    Olasehinde, Olalekan O; Adisa, Adewale O; Agbakwuru, Elugwaraonu A; Etonyeaku, Amarachukwu C; Kolawole, Oladapo A; Mosanya, Arinze O

    2015-01-01

    Context: The Darning technique of inguinal hernia repair is a tissue-based technique with documented low recurrence rate in some parts of the world. Though practiced in our setting, little is documented on its outcome. Aims: The aim was to review the outcome of Darning technique of inguinal hernia repair in our setting. Study Design: A descriptive retrospective study. Patients and Methods: Clinical records of all patients who had inguinal hernia repair using the Darning technique between January 2007 and December 2011 in our institution were obtained. Details of sociodemographic data, intraoperative findings and postoperative complications were reviewed. Statistical Analysis Used: simple frequencies, proportions and cross-tabulations. Results: A total of 132 patients whose ages ranged from 15 to 84 years (mean = 49.4 years) with a male: female ratio of 12:1 were studied. Majority of the hernias were right sided (68.9%), mostly indirect (81.8%). The procedures were for emergencies in 17 (12.9%) cases whereas the rest (87.1%) were done electively. Most procedures, 110 (83.3%) were performed under local anesthesia. Surgical site infection was the most common complication occurring in six patients (4.5%), while four patients (3%) had chronic groin pain. At a mean follow-up period of 15 months there were two recurrences (1.5%) both occurring in patients with bilateral hernias (P = 0.001). Conclusions: The Darning technique of inguinal hernia repair is a safe and effective method for inguinal hernia repair in our setting. PMID:25838768