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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. 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

  14. 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

  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. [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

  19. 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

  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

    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

  10. 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

  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. [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

  3. 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

  4. 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

  5. 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

  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. 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.

  9. 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.

  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, 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...

  14. 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...

  15. 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...

  16. 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...

  17. [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

  18. 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

  19. 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

  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. 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

  6. 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

  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. 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

  15. [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

  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 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

  5. 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

  6. 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

  7. 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.

  8. 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

  9. 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

  10. 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

  11. 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

  12. 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.

  13. 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

  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. 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

  3. 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

  4. 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

  5. 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.

  6. 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...

  7. 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...

  8. 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...

  9. 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...

  10. 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...

  11. 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

  12. 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

  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 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

  3. 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

  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. 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.

  8. 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.

  9. 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

  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. 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…

  15. 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...

  16. 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.

  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 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...

  7. 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...

  8. 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...

  9. 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...

  10. 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...

  11. 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...

  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. 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

  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. 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

  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. 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

  9. 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

  10. 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.

  11. 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.

  12. 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

  13. 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.

  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. 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.

  2. 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.

  3. 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.

  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

    2016-05-01

    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.

  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

    2016-08-01

    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.

  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. 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

  19. 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

  20. 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

  1. 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

  2. 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...

  3. 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...

  4. 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...

  5. 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...

  6. 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...

  7. 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

  8. 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

  9. 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

  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. [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

  12. 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

  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. 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

  15. 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

  16. 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

  17. 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

  18. 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

  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. 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

  1. 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

  2. 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.

  3. 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- ...

  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. 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

  7. 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

  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

  11. 20 CFR 404.401 - Deduction, reduction, and nonpayment of monthly benefits or lump-sum death payments.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... monthly benefits or lump-sum death payments. 404.401 Section 404.401 Employees' Benefits SOCIAL SECURITY... Nonpayments of Benefits § 404.401 Deduction, reduction, and nonpayment of monthly benefits or lump-sum death....384 of this part for provisions concerning special payments at age 72) or the lump-sum death...

  12. Benign hereditary chorea: an update.

    PubMed

    Inzelberg, Rivka; Weinberger, Moran; Gak, Eva

    2011-06-01

    Benign hereditary chorea (BHC, MIM 118700) is a rare autosomal dominant disorder manifesting with chorea in conjunction with hypothyroidism and respiratory problems, a triad also named "brain-lung-thyroid syndrome". BHC is characterized by childhood onset with minimal or no progression into adult life and normal cognitive function. The genetic basis of BHC has been partially resolved, when mutations in the TTF1 gene on chromosome 14q13 encoding the thyroid transcription factor-1 have been identified in a number of BHC patients, suggesting that aberration of TTF1 transcriptional function or haploinsufficiency is associated with this disorder. TTF1 (also known as TITF1, TEBP or NKX2-1), belonging to the NKX2 homeodomain transcription factor family, has been implicated in several important molecular pathways essential for brain, thyroid and lung morphogenesis. Clinical evaluation of TTF1 gene mutations carrier patients exposed the involvement of each of the triad's components characterized by heterogeneity between index cases and even within families. This review highlights the current updates on expanded clinical aspects of BHC, imaging and treatment experience, its genetic markers, proposed molecular mechanisms, animal models and link to cancer. PMID:21292530

  13. Management of Benign Biliary Strictures

    SciTech Connect

    Laasch, Hans-Ulrich; Martin, Derrick F.

    2002-12-15

    Benign biliary strictures are most commonly a consequence of injury at laparoscopic cholecystectomy or fibrosis after biliary-enteric anastomosis. These strictures are notoriously difficult to treat and traditionally are managed by resection and fashioning of acholedocho- or hepato-jejunostomy. Promising results are being achieved with newer minimally invasive techniques using endoscopic or percutaneous dilatation and/or stenting and these are likely to play an increasing role in the management. Even low-grade biliary obstruction carries the risks of stone formation, ascending cholangitis and hepatic cirrhosis and it is important to identify and treat this group of patients. There is currently no consensus on which patient should have what type of procedure, and the full range of techniques may not be available in all hospitals. Careful assessment of the risks and likely benefits have to be made on an individual basis. This article reviews the current literature and discusses the options available. The techniques of endoscopic and percutaneous dilatation and stenting are described with evaluation of the likely success and complication rates and compared to the gold standard of biliary-enteric anastomosis.

  14. Analysis and synthesis of distributed-lumped-active networks by digital computer

    NASA Technical Reports Server (NTRS)

    1973-01-01

    The use of digital computational techniques in the analysis and synthesis of DLA (distributed lumped active) networks is considered. This class of networks consists of three distinct types of elements, namely, distributed elements (modeled by partial differential equations), lumped elements (modeled by algebraic relations and ordinary differential equations), and active elements (modeled by algebraic relations). Such a characterization is applicable to a broad class of circuits, especially including those usually referred to as linear integrated circuits, since the fabrication techniques for such circuits readily produce elements which may be modeled as distributed, as well as the more conventional lumped and active ones.

  15. Endoscopic management of benign tracheobronchial tumors

    PubMed Central

    Gao, Hui; Ding, Xin; Wei, Dong; Cheng, Peng; Su, Xiaomei; Liu, Huanyi; Zhang, Tao

    2011-01-01

    Even though benign tracheobronchial tumors are quite rare, they still can induce airway obstruction, result in suffocation, and need emergent management to remove the obstructing lesions and make the respiratory tracts unobstructed. Although the preferred therapy is surgery, it is still difficult to deal with the tumors in some cases, and the complications of surgery are common. Therefore, bronchoscopic managements, such as Nd: YAG laser, electrocautery, APC and Cryotherapy, are very important to treat benign tracheobronchial tumors and can cure most of them. The efficacy of therapeutic endoscopy for the treatment of patients with benign airways obstruction has been established. However, in order to maximally eradicate the benign tumors with minimal damage to patients, the success of bronchoscopic managements for the treatment strongly depends on the diligent identification of the various factors, including the location, size, shape of tumor, and the age, status, cardio respiratory function of patients, and full comprehension of the limits and potential of each particular technique. Because the advantages and disadvantages of above mentioned interventional methods, single method can not solve all clinical issues. Therefore, in order to remove benign tracheobronchial tumors completely, and reduce the incidence of recurrence as far as possible, many doctors combine several methods of them to treat complicated benign tracheobronchial tumors. This article reviews the core principles and techniques available to the bronchoscope managing benign tracheobronchial tumors. PMID:22263100

  16. Lumped model of bending electrostrictive transducers for energy harvesting

    NASA Astrophysics Data System (ADS)

    Lallart, Mickaël; Wang, Liuqing; Richard, Claude; Petit, Lionel; Guyomar, Daniel

    2014-09-01

    Electroactive polymers, and more particular dielectric electrostrictive polymers, have been of great interest over the last decade thanks to their flexibility, easy processing, conformability, and relatively low cost. Their application as actuators, sensors, or energy harvesters suits very well to systems that require high strain. In particular, bending devices are an important application field of such materials, especially when dealing with devices subjected to air or liquid flows. Nevertheless, the design of such devices and their associated electrical interface still requires starting from the local aspects of the electrostrictive effect. In order to provide a simple yet efficient design tool, this paper exposes a simple lumped model for electrostrictive dielectric devices working under flexural solicitation. Based on the analysis of the converted energy with respect to the provided energy, it is shown that electrostrictive systems can easily be reduced to a simple spring-mass-damper system with a quadratic dependence to the applied voltage on the mechanical side and to a current source controlled by the applied voltage with a capacitive internal impedance on the electrical side. Experimental measurements carried out to evaluate the mechanical to electrical conversion effect as well as the energy harvesting abilities in such systems also validate the proposed approach.

  17. Finding and Testing Network Communities by Lumped Markov Chains

    PubMed Central

    Piccardi, Carlo

    2011-01-01

    Identifying communities (or clusters), namely groups of nodes with comparatively strong internal connectivity, is a fundamental task for deeply understanding the structure and function of a network. Yet, there is a lack of formal criteria for defining communities and for testing their significance. We propose a sharp definition that is based on a quality threshold. By means of a lumped Markov chain model of a random walker, a quality measure called “persistence probability” is associated to a cluster, which is then defined as an “-community” if such a probability is not smaller than . Consistently, a partition composed of -communities is an “-partition.” These definitions turn out to be very effective for finding and testing communities. If a set of candidate partitions is available, setting the desired -level allows one to immediately select the -partition with the finest decomposition. Simultaneously, the persistence probabilities quantify the quality of each single community. Given its ability in individually assessing each single cluster, this approach can also disclose single well-defined communities even in networks that overall do not possess a definite clusterized structure. PMID:22073245

  18. Depletion optimization of lumped burnable poisons in pressurized water reactors

    SciTech Connect

    Kodah, Z.H.

    1982-01-01

    Techniques were developed to construct a set of basic poison depletion curves which deplete in a monotonical manner. These curves were combined to match a required optimized depletion profile by utilizing either linear or non-linear programming methods. Three computer codes, LEOPARD, XSDRN, and EXTERMINATOR-2 were used in the analyses. A depletion routine was developed and incorporated into the XSDRN code to allow the depletion of fuel, fission products, and burnable poisons. The Three Mile Island Unit-1 reactor core was used in this work as a typical PWR core. Two fundamental burnable poison rod designs were studied. They are a solid cylindrical poison rod and an annular cylindrical poison rod with water filling the central region.These two designs have either a uniform mixture of burnable poisons or lumped spheroids of burnable poisons in the poison region. Boron and gadolinium are the two burnable poisons which were investigated in this project. Thermal self-shielding factor calculations for solid and annular poison rods were conducted. Also expressions for overall thermal self-shielding factors for one or more than one size group of poison spheroids inside solid and annular poison rods were derived and studied. Poison spheroids deplete at a slower rate than the poison mixture because each spheroid exhibits some self-shielding effects of its own. The larger the spheroid, the higher the self-shielding effects due to the increase in poison concentration.

  19. Optimizing bandwidth and dynamic range of lumped Josephson parametric amplifiers

    NASA Astrophysics Data System (ADS)

    Eddins, A.; Vijay, R.; Macklin, C.; Minev, Z.; Siddiqi, I.

    2013-03-01

    Superconducting parametric amplifiers have revolutionized the field of quantum measurement by providing high gain, ultra-low noise amplification. They have been used successfully for high-fidelity qubit state measurements, probing nano-mechanical resonators, quantum feedback, and for microwave quantum optics experiments. Though several designs exist, a simple and robust architecture is the Lumped Josephson Parametric Amplifier (LJPA). This device consists of a capacitively shunted SQUID directly coupled to a transmission line to form a low quality factor (Q) nonlinear resonator. We discuss amplifiers which can be tuned over the full 4-8 GHz band with 20-25 dB of gain and 10 - 50 MHz of signal bandwidth. However, similar to other parametric amplifiers employing a resonant circuit, the LJPA suffers from low dynamic range and has a -1 dB gain compression point of order -130 dBm. We explore new designs comprised of an array of SQUIDs to improve the dynamic range. We will present the results of numerical simulations and preliminary experiments. We will also briefly discuss improvements obtained from different biasing methods and packaging. This research was supported by the Army Research Office under a QCT grant.

  20. Nonlinear inverse synthesis technique for optical links with lumped amplification.

    PubMed

    Le, Son Thai; Prilepsky, Jaroslaw E; Turitsyn, Sergei K

    2015-04-01

    The nonlinear inverse synthesis (NIS) method, in which information is encoded directly onto the continuous part of the nonlinear signal spectrum, has been proposed recently as a promising digital signal processing technique for combating fiber nonlinearity impairments. However, because the NIS method is based on the integrability property of the lossless nonlinear Schrödinger equation, the original approach can only be applied directly to optical links with ideal distributed Raman amplification. In this paper, we propose and assess a modified scheme of the NIS method, which can be used effectively in standard optical links with lumped amplifiers, such as, erbium-doped fiber amplifiers (EDFAs). The proposed scheme takes into account the average effect of the fiber loss to obtain an integrable model (lossless path-averaged model) to which the NIS technique is applicable. We found that the error between lossless path-averaged and lossy models increases linearly with transmission distance and input power (measured in dB). We numerically demonstrate the feasibility of the proposed NIS scheme in a burst mode with orthogonal frequency division multiplexing (OFDM) transmission scheme with advanced modulation formats (e.g., QPSK, 16QAM, and 64QAM), showing a performance improvement up to 3.5 dB; these results are comparable to those achievable with multi-step per span digital back-propagation. PMID:25968670

  1. Laparoscopic vs conventional tension free inguinal herniorrhaphy: 2005 society of American Gastrointestinal Endoscopic Surgeons (SAGES) annual meeting debate.

    PubMed

    Puri, V; Felix, E; Fitzgibbons, R J

    2006-12-01

    This report summarizes the 2005 Society of American Gastrointestinal and Endoscopic Surgeons' inguinal herniorrhaphy debate. Most inguinal herniorrhaphies in the United States are performed using one of several prosthesis-based, tension-free (TFR) procedures. Approximately 15% of the procedures used are laparoscopic inguinal herniorrhaphies (LIH). Technical ease, lower cost, and local anesthesia are the major advantages attributed to TFR, whereas superior cosmesis, less perioperative pain, and a faster return to normal activity is attributed to LIH. The overall cost-benefit ratio, incidence of chronic pain syndromes, and relevance of a recent major trial could not be entirely settled in this debate. The importance of adequate training for surgeons undertaking LIH cannot be overemphasized. Experienced surgeons displaying equivalent results for LIH and TFR are justified in offering LIH to patients with primary unilateral inguinal hernias. PMID:17024526

  2. Differential Blood and Mucosal Immune Responses against an HIV-1 Vaccine Administered via Inguinal or Deltoid Injection

    PubMed Central

    Price, Charles; Hultin, Lance E.; Elliott, Julie; Hultin, Patricia M.; Shih, Roger; Hausner, Mary Ann; Ng, Hwee L.; Hoffman, Jennifer; Jamieson, Beth D.

    2014-01-01

    Mucosal immunity is central to sexual transmission and overall pathogenesis of HIV-1 infection, but the ability of vaccines to induce immune responses in mucosal tissue compartments is poorly defined. Because macaque vaccine studies suggest that inguinal (versus limb) vaccination may better target sexually-exposed mucosa, we performed a randomized, double-blinded, placebo-controlled Phase I trial in HIV-1-uninfected volunteers, using the recombinant Canarypox (CP) vaccine vCP205 delivered by different routes. 12 persons received vaccine and 6 received placebo, divided evenly between deltoid-intramuscular (deltoid-IM) or inguinal-subcutaneous (inguinal-SC) injection routes. The most significant safety events were injection site reactions (Grade 3) in one inguinal vaccinee. CP-specific antibodies were detected in the blood of all 12 vaccinees by Day 24, while HIV-1-specific antibodies were observed in the blood and gut mucosa of 1/9 and 4/9 evaluated vaccinees respectively, with gut antibodies appearing earlier in inguinal vaccinees (24–180 versus 180–365 days). HIV-1-specific CD8+ T lymphocytes (CTLs) were observed in 7/12 vaccinees, and blood and gut targeting were distinct. Within blood, both deltoid and inguinal responders had detectable CTL responses by 17–24 days; inguinal responders had early responses (within 10 days) while deltoid responders had later responses (24–180 days) in gut mucosa. Our results demonstrate relative safety of inguinal vaccination and qualitative or quantitative compartmentalization of immune responses between blood and gut mucosa, and highlight the importance of not only evaluating early blood responses to HIV-1 vaccines but also mucosal responses over time. Trial Registration ClinicalTrials.gov NCT00076817 PMID:24558403

  3. A new, simple operative approach for bilateral inguinal hernia repair in girls: A single transverse supra-pubic incision

    PubMed Central

    Zarroug, Abdalla E.; Alkhebel, Antar M.; Gibreel, Waleed O.; Almassry, Mohammed

    2015-01-01

    Background: Inguinal hernia repair remains one of the most common operations performed by pediatric surgeons. We described a new surgical approach for treating bilateral inguinal hernias in girls through a small single transverse supra-pubic incision. Materials and Methods: A new approach was performed on female children 12-years-old and younger with bilateral inguinal hernias between January 2005 and April 2012. Technique: A single transverse suprapubic incision (1-1.5 cm) was made. Using sharp and blunt dissection bilateral hernias were exposed and repaired using a standard high ligation. Results: Ninety-nine girls with a preoperative clinical diagnosis of bilateral inguinal hernia were included. Median age was 2 years (range: 1 month to 12 years). All patients underwent general anesthesia. Median operative time was 12 minutes (range 5-22). There were no intra-operative complications or misdiagnosis. Two patients had bilateral sliding hernias and the remainder had indirect hernias. Post-operatively two patients developed non-expanding small hematomas, both treated non-operatively without sequelae. There were zero hernia recurrence and median follow-up was 5 years (range: 1-8 years) on 99% of patients. Conclusion: We described a new, safe, simple, and rapid approach for bilateral inguinal hernia repair in female pediatric population. A single transverse suprapubic skin incision was adequate for exposing both inguinal regions with excellent postoperative results. PMID:26628807

  4. Robotic bilateral inguinal lymphadenectomy in penile cancer, development of a technique without robot repositioning: a case report

    PubMed Central

    Sotelo, Rene; Cabrera, Marino; Carmona, Oswaldo; de Andrade, Robert; Martin, Oscar; Fernandez, Golena

    2013-01-01

    Introduction Inguinal lymphadenectomy is the treatment of choice for patients with penile cancer and inguinal lymph node metastases. We describe the performance of the robotic bilateral inguinal lymphadenectomy technique without repositioning the robot in a patient with penile carcinoma and high risk for nodal metastases and no palpable lymph nodes. Materials and methods A 64-year-old male patient was diagnosed with penile cancer (TNM: T3 N 0 M 0) and underwent a total penectomy with perineal urethrostomy. We performed a robotic bilateral inguinal lymphadenectomy four weeks after the penectomy. Results The entire procedure was performed with the robot-assisted technique. The operative time, median estimated blood loss, and hospital stay was 360 min, 100 ml (50 ml in the right side and 150 ml in the left side), and three days, respectively. Metastatic nodes were present in both inguinal regions, with a yield of 19 lymph nodes on the right and 14 on the left. The patient presented with a left-side lymphocele that was drained at follow-up. No other complications were reported. Conclusion Robotic bilateral inguinal lymphadenectomy secondary to penile cancer is feasible, safe, and provides a good performance. Prospective studies are required to include a larger number of patients and long-term monitoring to assess the results of this procedure in comparison with open and laparoscopic techniques. PMID:24101945

  5. 20 CFR 10.422 - May compensation payments be issued in a lump sum?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... compensation payments be issued in a lump sum? (a) In exercise of the discretion afforded under 5 U.S.C. 8135(a...-sum payments for wage-loss benefits, OWCP will not exercise further discretion in the matter....

  6. Ultrabroadband Microwave Metamaterial Absorber Based on Electric SRR Loaded with Lumped Resistors

    NASA Astrophysics Data System (ADS)

    Zhao, Jingcheng; Cheng, Yongzhi

    2016-06-01

    An ultrabroadband microwave metamaterial absorber (MMA) based on an electric split-ring resonator (ESRR) loaded with lumped resistors is presented. Compared with an ESRR MMA, the composite MMA (CMMA) loaded with lumped resistors offers stronger absorption over an extremely extended bandwidth. The reflectance simulated under different substrate loss conditions indicates that incident electromagnetic (EM) wave energy is mainly consumed by the lumped resistors. The simulated surface current and power loss density distributions further illustrate the mechanism underlying the observed absorption. Further simulation results indicate that the performance of the CMMA can be tuned by adjusting structural parameters of the ESRR and lumped resistor parameters. We fabricated and measured MMA and CMMA samples. The CMMA yielded below -10 dB reflectance from 4.4 GHz to 18 GHz experimentally, with absorption bandwidth and relative bandwidth of 13.6 GHz and 121.4%, respectively. This ultrabroadband microwave absorber has potential applications in the electromagnetic energy harvesting and stealth fields.

  7. Frequency domain analysis and synthesis of lumped parameter systems using nonlinear least squares techniques

    NASA Technical Reports Server (NTRS)

    Hays, J. R.

    1969-01-01

    Lumped parametric system models are simplified and computationally advantageous in the frequency domain of linear systems. Nonlinear least squares computer program finds the least square best estimate for any number of parameters in an arbitrarily complicated model.

  8. 46 CFR 148.245 - Direct reduced iron (DRI); lumps, pellets, and cold-molded briquettes.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... resistant to fire and passage of water. (c) DRI lumps, pellets, or cold-molded briquettes that are wet, or... cold-molded briquettes in bulk must ensure that an inert atmosphere of less than 5 percent oxygen and...

  9. Performance of an advanced lump correction algorithm for gamma-ray assays of plutonium

    SciTech Connect

    Prettyman, T.H.; Sprinkle, J.K. Jr.; Sheppard, G.A.

    1994-08-01

    The results of an experimental study to evaluate the performance of an advanced lump correction algorithm for gamma-ray assays of plutonium is presented. The algorithm is applied to correct segmented gamma scanner (SGS) and tomographic gamma scanner (TGS) assays of plutonium samples in 55-gal. drums containing heterogeneous matrices. The relative ability of the SGS and TGS to separate matrix and lump effects is examined, and a technique to detect gross heterogeneity in SGS assays is presented.

  10. Construction of rogue wave and lump solutions for nonlinear evolution equations

    NASA Astrophysics Data System (ADS)

    Lü, Zhuosheng; Chen, Yinnan

    2015-07-01

    Based on symbolic computation and an ansatz, we present a constructive algorithm to seek rogue wave and lump solutions for nonlinear evolution equations. As illustrative examples, we consider the potential-YTSF equation and a variable coefficient KP equation, and obtain nonsingular rational solutions of the two equations. The solutions can be rogue wave or lump solutions under different parameter conditions. We also present graphic illustration of some special solutions which would help better understand the evolution of solution waves.

  11. Synthesis and Characterization of Environmentally Benign Nanoparticles

    EPA Science Inventory

    There has been a growing interest in replacing current non-biodegradable and toxic nanosystems with environmentally benign biopolymer based ones to minimize post-utilization hazards due to uncontrolled accumulation of nanoparticles in the environment. Lignin based nanoparticles (...

  12. Benign idiopathic partial epilepsy and brain lesion.

    PubMed

    Stephani, U; Doose, H

    1999-03-01

    A 14-year-old girl had severe head trauma from a dog bite at the age of 9 days. This resulted in extensive brain damage, tetraplegia, mental retardation, and epilepsy. The seizures were of rolandic type, and the EEG showed multifocal sharp waves. The course was benign. The initial diagnosis of a pure symptomatic epilepsy was revised after demonstrating typical benign focal sharp waves in the EEG of the healthy sister. Thus a phenocopy of a benign partial epilepsy by the brain lesion could be excluded with sufficient certainty. This observation allows the conclusion that the genetic disposition underlying the sharp-wave trait characteristic of benign partial epilepsies can be involved also in the pathogenesis of seemingly pure symptomatic epilepsies. EEG studies on siblings of such patients are needed to exclude possible phenocopies. PMID:10080522

  13. ENVIRONMENTALLY-BENIGN MULTIPHASE CATALYSIS. (R826034)

    EPA Science Inventory

    Environmental concerns stemming from the use of conventional solvents and from hazardous waste generation have propelled research efforts aimed at developing benign chemical processing techniques that either eliminate or significantly mitigate pollution at the source. This pap...

  14. An extraneural primary anaplastic ependymoma at the subcutaneous inguinal region: Report of a rare case.

    PubMed

    Sayar, Hamide; Ersen, Ayca; Kurtul, Neslihan; Yazar, Mehmet Fatih; Balakan, Ozan

    2015-01-01

    Ependymomas commonly arise in the central nervous system. Extraneural presentation is quite rare. Herein, we describe a primary extraneural ependymoma in a young female. The mass was located in the right inguinal area. The cut surface of the 7.5 mm × 6.5 mm × 4.5 mm sized tumor was brownish-yellow in color. Histologically, it was hypercellular exhibiting pseudorosette or rosette formations and some papillary structures. Mitosis was counted as high as 10 per 10 high power fields. Neither necrosis nor vascular endothelial proliferation within the tumor was observed. Tumor cells showed strong glial fibrillary acidic protein immunoreactivity. On epithelial membrane antigen, intracytoplasmic dot-like immunostaining was observed. This is the first report presenting a primary extraneural anaplastic ependymoma arising in the inguinal subcutaneous region. PMID:26549094

  15. Minimally invasive surgical technique integrating multiple procedures with large specimen extraction via inguinal hernia orifice

    PubMed Central

    Mani, Vishnu R.; Ahmed, Leaque

    2015-01-01

    While laparoscopic surgery can be performed using small skin incisions, any resected specimen must still be able to fit through these opening. For procedures, such as cholecystectomies and appendectomies, this is not usually a problem; however, for large specimens such as bowel or large tumors, this becomes problematic. Currently, the standard technique is to attempt piecemeal removal of the specimen or enlarge one of the laparoscopic incisions, effectively creating a mini laparotomy. Creating a larger incision adds many of the drawbacks of open laparotomy and should be avoided whenever possible. In this article, we present a new technique of combining the repair of an inguinal hernia, umbilical hernia with a duodenal tumor resection in order to extract the specimen through the inguinal hernia orifice. PMID:26703927

  16. [Inguinal tumor: a rare occurrence of hydatid disease. A case report].

    PubMed

    Calvo, A M; Cires, J M; Montón, S; Sarasibar, H; Lasanta, P; Artázcoz, F J

    2007-01-01

    Osseous hydatid disease is an infrequent entity that represents 0.5-2.5% of all hydatidoses. The vertebrae are the most commonly affected bones (50%), followed by the pelvis (25%) and the long bones (15-25%). The clinical manifestations appear when there is large scale osseous destruction or complications, which is why the diagnosis is generally made in late stages through imaging techniques and on occasion in an intra-operational form. Treatment in operable cases is by surgical extirpation, which can be associated with medical treatment with albendazol. We present the case of a patient with osseous hydatidosis, localised in the pelvis, with an absence of other affected organs. The only clinical manifestation presented by the patient was an inguinal tumour on the right side. The patient received a clinical intervention facing the suspicion of an inguinal hernia, complicated by the intra-operational discovery of pelvic hydatidosis. PMID:18227901

  17. Pulmonary Langerhans Cell Histiocytosis in an Adult Diagnosed with Solitary Inguinal Lymphadenopathy.

    PubMed

    Luo, Wei; Li, Ya-lun; Jia, Lian; Liu, Chun-tao

    2015-01-01

    We herein report an extremely rare case of pulmonary Langerhans cell histiocytosis with a solitary enlarged inguinal lymph node. A 19-year-old man presented with a non-productive cough lasting for over a five-month period and an enlarged left inguinal lymph node that had persisted for four months. A histopathological study of the lymph node specimens found Langerhans cells coupled with eosinophils. Positive immunohistochemical staining for langerin, Cluster of Differentiation 1a, S100 in the Langerhans cells confirmed the diagnosis, and a mildly impaired ventilation function in addition to multiple peripheral pulmonary cystic lesions were detected. The patient was managed with prednisone (0.5 mg/kg daily), with slow tapering over several months. PMID:26134198

  18. Case 230: Congenital Inguinal Herniation of the Left Ureter (Extraperitoneal Form).

    PubMed

    Di Nicolò, Pierpaolo; Aleo, Daniele; Riccioli, Emilio; Granata, Antonio

    2016-06-01

    History A 52-year-old man with a history of urinary tract infections and a previous clinical diagnosis of left inguinal hernia presented to the nephrologist with recent onset of dysuria and increasing swelling in the left inguinoscrotal region in the absence of fever or scrotal trauma. There was no relevant surgical or family history. The general physical examination findings were unremarkable, with a normal abdomen at both visual inspection and palpation; urogenital examination revealed a small left-sided palpable mass of the testis, compatible with an inguinal hernia or hydrocele. At first, gray-scale and color Doppler ultrasonographic (US) images of the testes and the inguinoscrotal region were obtained. Contrast material-enhanced computed tomographic (CT) images of the lower abdomen and pelvis were then obtained to further evaluate the urinary tract. PMID:27183410

  19. Characterization of high order spatial discretizations and lumping techniques for discontinuous finite element SN transport

    SciTech Connect

    Maginot, P. G.; Ragusa, J. C.; Morel, J. E.

    2013-07-01

    We examine several possible methods of mass matrix lumping for discontinuous finite element discrete ordinates transport using a Lagrange interpolatory polynomial trial space. Though positive outflow angular flux is guaranteed with traditional mass matrix lumping in a purely absorbing 1-D slab cell for the linear discontinuous approximation, we show that when used with higher degree interpolatory polynomial trial spaces, traditional lumping does yield strictly positive outflows and does not increase in accuracy with an increase in trial space polynomial degree. As an alternative, we examine methods which are 'self-lumping'. Self-lumping methods yield diagonal mass matrices by using numerical quadrature restricted to the Lagrange interpolatory points. Using equally-spaced interpolatory points, self-lumping is achieved through the use of closed Newton-Cotes formulas, resulting in strictly positive outflows in pure absorbers for odd power polynomials in 1-D slab geometry. By changing interpolatory points from the traditional equally-spaced points to the quadrature points of the Gauss-Legendre or Lobatto-Gauss-Legendre quadratures, it is possible to generate solution representations with a diagonal mass matrix and a strictly positive outflow for any degree polynomial solution representation in a pure absorber medium in 1-D slab geometry. Further, there is no inherent limit to local truncation error order of accuracy when using interpolatory points that correspond to the quadrature points of high order accuracy numerical quadrature schemes. (authors)

  20. Vitello-intestinal duct injury after transabdominal preperitoneal inguinal hernia repair.

    PubMed

    Albeyatti, Amina; Hussain, Abdulzahra; El-Hasani, Shamsi

    2013-02-01

    A 71-year-old patient underwent a transabdominal preperitoneal right inguinal hernia repair and presented to the emergency department 48 hours postoperatively with nonspecific abdominal and chest pain and was diagnosed an abdominal abscess at the umbilicus by computed tomography. Laparotomy showed a vitello-intestinal duct injury caused by the umbilical trocar at his previous laparoscopic surgery. We will discuss this rare complication and how to avoid it in future practice. PMID:23386168

  1. Surgery Duration Predicts Urinary Retention after Inguinal Herniorraphy: A Single Institution Review

    PubMed Central

    Hudak, Kevin E.; Frelich, Matthew J.; Rettenmaier, Chris R.; Xiang, Qun; Wallace, James R.; Kastenmeier, Andrew S.; Gould, Jon C.; Goldblatt, Matthew I.

    2016-01-01

    Background Inguinal hernia repair, laparoscopic or open, is one of the most frequently performed operations in general surgery. Postoperative urinary retention (POUR) can occur in 0.2–35% of patients after inguinal hernia repair. The primary objective of this study was to determine the incidence of POUR after inguinal hernia repair. As a secondary goal, we sought to determine if perioperative and patient factors predicted urinary retention. Methods This study is a retrospective review of patients who underwent inguinal hernia repair with synthetic mesh at the Medical College of Wisconsin from January 2007 to June 2012. Procedures were performed by four surgeons. Clinical information and perioperative outcomes were collected up to hospital discharge. Urinary retention was defined as need for urinary catheterization post-operatively. Results A total of 192 patients were included in the study (88 bilateral, 46%) and (104 unilateral, 54%). The majority of subjects (76%) underwent laparoscopic repair. The overall POUR rate was 13%, with 25 of 192 patients requiring a Foley catheter prior to discharge POUR was significantly associated with bilateral hernia repairs (p=0.04), BMI≥35kg/m2 (p=0.05) and longer operative times (p=0.03). Based on odds ratio estimates, for every 10-minute increase in operative time, an 11% increase in the odds of urinary retention is expected (OR 1.11, CI 1.004 – 1.223; p=0.04). For every 10-minute increase in operative time, an 11% increase in POUR is expected. Conclusions Bilateral hernia repairs, BMI ≥ 35kg/m2, and operative time are significant predictors of POUR. These factors are important to determine potential risk to patients and interventions such as strict fluid administration, use of catheters, and potential premedication. PMID:25612548

  2. Small Bowel Neuroendocrine Tumors with Inguinal Metastases: A Diagnostic and Therapeutic Dilemma

    PubMed Central

    Daly, Kevin P; Askarian, Farhad; Saif, Muhammad W

    2016-01-01

    Small bowel neuroendocrine tumors (NETs) are frequently characterized by a strong propensity to metastasize to the liver, mesentery, and peritoneum. However, only a few extra-abdominal metastatic sites have been reported in the published literature. The present paper implicates that primary small bowel NETs may unusually metastasize to the inguinal lymph nodes. Furthermore, we discuss the formidable diagnostic and therapeutic challenges associated with the metastatic NETs. PMID:27555990

  3. A nonlinear lumped model for ultrasound systems using CMUT arrays.

    PubMed

    Satir, Sarp; Degertekin, F Levent

    2015-10-01

    We present a nonlinear lumped model that predicts the electrical input-output behavior of an ultrasonic system using CMUTs with arbitrary array/membrane/electrode geometry in different transmit-receive configurations and drive signals. The receive-only operation, where the electrical output signal of the CMUT array in response to incident pressure field is calculated, is included by modifying the boundary elementbased vibroacoustic formulation for a CMUT array in rigid baffle. Along with the accurate large signal transmit model, this formulation covers pitch-catch and pulse-echo operation when transmit and receive signals can be separated in time. In cases when this separation is not valid, such as CMUTs used in continuous wave transmit-receive mode, pulse-echo mode with a nearby hard or soft wall or in a bounded space such as in a microfluidic channel, an efficient formulation based on the method of images is used. Some of these particular applications and the overall modeling approach have been validated through comparison with finite element analysis on specific examples including CMUTs with multiple electrodes. To further demonstrate the capability of the model for imaging applications, the two-way response of a partial dual-ring intravascular ultrasound array is simulated using a parallel computing cluster, where the output currents of individual array elements are calculated for given input pulse and compared with experimental results. With its versatility, the presented model can be a useful tool for rapid iterative CMUT-based system design and simulation for a broad range of ultrasonic applications. PMID:26470049

  4. Abdominal musculature abnormalities as a cause of groin pain in athletes. Inguinal hernias and pubalgia.

    PubMed

    Taylor, D C; Meyers, W C; Moylan, J A; Lohnes, J; Bassett, F H; Garrett, W E

    1991-01-01

    There has been increasing interest within the European sports medicine community regarding the etiology and treatment of groin pain in the athlete. Groin pain is most commonly caused by musculotendinous strains of the adductors and other muscles crossing the hip joint, but may also be related to abdominal wall abnormalities. Cases may be termed "pubalgia" if physical examination does not reveal inguinal hernia and there is an absence of other etiology for groin pain. We present nine cases of patients who underwent herniorrhaphies for groin pain. Two patients had groin pain without evidence of a hernia preoperatively (pubalgia). In the remaining seven patients we determined the presence of a hernia by physical examination. At operation, eight patients were found to have inguinal hernias. One patient had no hernia but had partial avulsion of the internal oblique fibers from their insertion at the public tubercle. The average interval from operation to return to full activity was 11 weeks. All patients returned to full activity within 3 months of surgery. One patient had persistent symptoms of mild incisional tenderness, but otherwise there were no recurrences, complications, or persistence of symptoms. Abnormalities of the abdominal wall, including inguinal hernias and microscopic tears or avulsions of the internal oblique muscle, can be an overlooked source of groin pain in the athlete. Operative treatment of this condition with herniorrhaphy can return the athlete to his sport within 3 months. PMID:1831010

  5. Clinical Curative Effect of Mesalt Combined with Mepilex Dressing in Postoperative Infection of Inguinal Hernia

    PubMed Central

    Liu, Zhenjun; Xiong, Zhonghua; Wu, Jiayu; Wang, Fang

    2015-01-01

    Background Inguinal hernia is a common surgical disease. Tension-free hernioplasty is currently commonly used for its treatment, with multiple advantages such as simple surgical method, low recurrence rate, and ability to be performed in primary care hospitals, but the risk of incision infection still exists. Mild infection can be cured by local washing, dressing, and systemic antibiotics. If the infection is severe, the wound may not heal after removing the patch, and secondary suturing is needed. Material/Methods A total of 60 patients with postoperative infection after tension-free repair of inguinal hernia were randomly divided into control (n=30) and treatment (n=30) groups. Patients in the treatment group received Mesalt combined with Mepilex for dressing while the patients in the control group received conventional gauze for dressing. Pain degree, wound healing time, and dressing times were observed. Results The clinical therapeutic effect in the treatment group was significantly better than in the control group. The treatment group exhibited significantly less pain when patients receive dressing, shorter wounds healing time (15±3.5 vs. 30±5.0), and less dressing frequency (10±2.1 vs. 20±2.4). Conclusions Mesalt combined with Mepilex can effectively improve postoperative infection after inguinal hernia treatment, obviously reducing pain, shorting wound healing time, and decreasing dressing frequency. It can be widely used in clinical practice. PMID:25854191

  6. Management of severe lower abdominal or inguinal pain in high-performance athletes. PAIN (Performing Athletes with Abdominal or Inguinal Neuromuscular Pain Study Group).

    PubMed

    Meyers, W C; Foley, D P; Garrett, W E; Lohnes, J H; Mandlebaum, B R

    2000-01-01

    The purpose of this study was to gain insight into the pathophysiologic processes of severe lower-abdominal or inguinal pain in high-performance athletes. We evaluated 276 patients; 175 underwent pelvic floor repairs. Of the 157 athletes who had not undergone previous surgery, 124 (79%) participated at a professional or other highly competitive level, and 138 patients (88%) had adductor pain that accompanied the lower-abdominal or inguinal pain. More patients underwent related adductor releases during the later operative period in the series. Evaluation revealed 38 other abnormalities, including severe hip problems and malignancies. There were 152 athletes (97%) who returned to previous levels of performance. The syndrome was uncommon in women and the results were less predictable in nonathletes. A distinct syndrome of lower-abdominal/adductor pain in male athletes appears correctable by a procedure designed to strengthen the anterior pelvic floor. The location and pattern of pain and the operative success suggest the cause to be a combination of abdominal hyperextension and thigh hyperabduction, with the pivot point being the pubic symphysis. Diagnosis of "athletic pubalgia" and surgery should be limited to a select group of high-performance athletes. The consideration of other causes of groin pain in the patient is critical. PMID:10653536

  7. Lumped-element tunable absorptive bandstop filter and its applications

    NASA Astrophysics Data System (ADS)

    Kim, Byung Guk

    To avoid the cost, large size, and complexity of going off-chip between individually packaged components, it is desirable to integrate as many components as possible. For on-chip passive filter design, size constraints and the quality factor limit the amount of attenuation that can be achieved. This work demonstrates the use of absorptive bandstop filters which gives anomalously deep notches for a given Q-factor. A lumped-element-only topology enables a realization on a chip for the first time. For reconfigurable RF front-ends, a frequency-agile design is newly developed with Q-tunable resonators because an absorptive bandstop filter must balance both intrinsic Q of the resonators and the resonant frequency of the filter. Despite using small-size, low-Q resonators in the bandstop filter design, a large stopband attenuation with a capability of frequency tuning is achieved with potential to suppress potential interference or an image frequency signal. Higher-order absorptive bandstop filters which give higher selectivity are also demonstrated. The sensing of the unused bands is a pre-requisite and important function so that the cognitive radio system can track and use available frequencies. When the ultra-wideband ADC is utilized for sensing to find the unused bands or read the spectrum availability, both the high power interferences and small power signals are the signals we are interested, but the wideband ADC has a limited dynamic range. Since we have the signals with various frequencies and power levels, it is required to have something that can give different gains at different frequencies. This work proposes a frequency equalizer which gives selective attenuation at desired different frequencies, and absorptive bandstop filter with variable attenuation is proposed in this work. For a wide-band receiver or application, it is not typical for AGC to control different gain or attenuation levels at different frequencies. Using frequency selective attenuation, it is

  8. Parameterization of distributed hydrological models: learning from the experiences of lumped modeling

    NASA Astrophysics Data System (ADS)

    Moreda, Fekadu; Koren, Victor; Zhang, Ziya; Reed, Seann; Smith, Michael

    2006-03-01

    The Hydrology Lab (HL) of the National Oceanic and Atmospheric Administration's National Weather Service (NOAA/NWS), Office of Hydrologic Development (OHD) is currently developing and testing the HL Research Modeling System (HL-RMS). Currently, the system has one snow model (SNOW-17) and two runoff models: the Sacramento Soil Moisture Accounting (SAC-SMA) and the Continuous Antecedent Precipitation Index (CONT-API). The NWS lumped CONT-API model is operational in one of the NWS River Forecasting Centers (RFCs), the Middle Atlantic RFC (MARFC) in the United States. This study deals with the derivation of a priori distributed parameters for the CONT-API model. In our strategy, initial distributed parameters based on the calibrated lumped CONT-API parameters of 67 basins in the Susquehanna River Basin are derived. This study shows that the CONT-API model six-hourly calibrated parameters can be used in an one-hourly lumped model with only minor changes in total runoff volume (less than 5%). However, to obtain the timing of simulated hydrographs, appropriate one-hourly unit hydrographs need to be derived. A priori-distributed model parameters were based on relationships between soil properties and calibrated lumped CONT-API parameters. Multiple linear regressions with coefficients of determination ranging from 0.39 to 0.63 were obtained for 10 lumped model parameters. Using these predicted parameters, the lumped model produced simulations having Nash-Sutcliffe efficiency, Neff, statistics ranging from 0.69 to 0.78 for five of the 67 basins. These are commensurate with goodness-of-fit statistics from lumped model calibrations. Furthermore, application of the method in deriving a priori parameters gave a promising result in distributed model simulations.

  9. Benign Mesenchymal Stromal Cells in Human Sarcomas

    PubMed Central

    Morozov, Alexei; Downey, Robert J.; Healey, John; Moreira, Andre L.; Lou, Emil; Leung, Roland; Edgar, Mark; Singer, Samuel; LaQuaglia, Michael; Maki, Robert G.; Moore, Malcolm A.S.

    2010-01-01

    Purpose Recent evidence suggests that at least some sarcomas arise through aberrant differentiation of mesenchymal stromal cells (MSCs), but MSCs have never been isolated directly from human sarcoma specimens. Experimental Design We examined human sarcoma cell lines and primary adherent cultures derived from human sarcoma surgical samples for features of MSCs. We further characterized primary cultures as either benign or malignant by the presence of tumor-defining genetic lesions and tumor formation in immunocompromised mice. Results We show that a dedifferentiated liposarcoma cell line DDLS8817 demonstrates fat, bone and cartilage trilineage differentiation potential characteristic of MSCs. Primary sarcoma cultures have the morphology, surface immunophenotype and differentiation potential characteristic of MSCs. Surprisingly, many of these cultures are benign as they do not form tumors in mice and lack sarcoma-defining genetic lesions. Consistent with the recently proposed pericyte origin of MSCs in normal human tissues, sarcoma-derived benign MSCs express markers of pericytes and cooperate with endothelial cells in tube formation assays. In human sarcoma specimens, a subset of CD146-positive microvascular pericytes express CD105, an MSC marker, while malignant cells largely do not. In an in vitro co-culture model, sarcoma-derived benign MSCs as well as normal human pericytes markedly stimulate the growth of sarcoma cell lines. Conclusions Sarcoma-derived benign MSCs/pericytes represent a previously undescribed stromal cell type in sarcoma which may contribute to tumor formation. PMID:21138865

  10. Benign metastasizing leiomyoma of the lung

    PubMed Central

    2013-01-01

    Benign leiomyomas of the uterus are uncommonly found in association with benign smooth muscle tumors beyond the confines of the uterus. Benign metastasizing leiomyoma (BML) is a rare disease in which the lung is described to be the most afflicted extrauterine organ. We present a brief review of the literature, along with case reports for four patients who were followed up after resection of a pulmonary lesion or after pathological confirmation by biopsy. The clinical course of BML varies from chronic asymptomatic appearance to rapid progression, leading to respiratory failure and death. Our BML patients did not complain of pulmonary symptoms, such as cough, dyspnea, or chest tightness. Pathology revealed benign leiomyomas with no atypia and mitotic activity <5 per 10 high-power field. Immunohistochemical staining was positive for actin and desmin. A standard treatment for BML has not yet been established. Because of the hormone-sensitive characteristics of BML, treatments are based on hormonal manipulation along with either surgical or medical oophorectomy. Benign metastasizing leiomyoma can be observed in postmenopausal women. We observed four patients who did not receive adjuvant hormonal therapy because they were postmenopausal or perimenopausal. All patients are still healthy and show no evidence of recurrence or progression of the disease. PMID:24134076

  11. Malignancy and the benign lymphoepithelial lesion.

    PubMed

    Batsakis, J G; Bernacki, E G; Rice, D H; Stebler, M E

    1975-02-01

    The benign lymphoepithelial lesion of salivary glands is now considered the histological hallmark of a variety of clinical and pathological disorders affecting salivary tissues. Malignancy arising in the lesion is uncommon, but may take origin in either the epithelial or lymphoreticular components. Lymphomas and pseudolymphomas associated with salivary gland lymphoepithelial lesions have been predominately extra-salivary and strongly correlated with Sjögren's syndrome. Epithelial malignancy has not been associated with autoimmunity and with few exceptions has been of the anaplastic type. This report presents two patients with intra-salivary lymphomas arising in a benign lymphoepithelial lesion of salivary glands and a patient with anaplastic carcinoma arising in the epithelial islands of the lesion. The fourth patient manifested pseudolymphomatous lymphoreticular hyperplasia in lung and submandibular gland and illustrates the possible multiple organ involvement that may occur in patients with benign lymphoepithelial lesion, even without clinical evidence of concommitant autoimmune disorders. PMID:1172885

  12. [Testicular cancer with inguinal lymph node metastasis in a patient with prior orchiopexy for undescended testis: a case report].

    PubMed

    Minato, Noriko; Yamaguchi, Yuichiro; Koga, Minoru; Sugao, Hideki; Hoshi, Minako; Mori, Hiroshi

    2011-11-01

    A 36-year-old man referred to our hospital with the chief complaint of painful left inguinal mass and fever. He had undergone left orchiopexy for undescended testis at 10 years of age. With the suspicion of an incarceration of inguinal hernia, an operation was performed. However, there was no hernia sac, and only swelling inguinal lymph nodes were found. Pathological diagnosis of the nodes was metastatic embryonal carcinoma, with suspicion of testicular origin. As scrotal ultrasonography revealed a hypoehcoic mass within the left atrophic testis, left high orchiectomy was performed. Pathological diagnosis of the left testicular mass was seminoma. A definite diagnosis was left testicular cancer, mixed type of seminoma and embryonal carcinoma, with inguinal nodes metastasis, pT1N2M0. He received 3 courses of bleomycin, etoposide, and cisplatin (BEP) chemotherapy, and there has been no sign of metastasis nor recurrence 18 months after the operation. To our knowledge, this is the 11th case in Japan of testicular cancer with inguinal node metastasis in a patient with prior orchiopexy for undescended testis. PMID:22166830

  13. Laparoscopic treatment for inguinal hernia combined with cryptorchidism: Totally extraperitoneal repair with orchiectomy under the same operative view

    PubMed Central

    Fujishima, Hajime; Sasaki, Atsushi; Takeuchi, Yu; Morimoto, Akio; Inomata, Masafumi

    2015-01-01

    Introduction Approximately 7% of child patients with inguinal hernias also present with cryptorchidism. On the other hand, combined adult cases are uncommon. Here we report two adult cases of inguinal hernia combined with intra-canalicular cryptorchidism who underwent totally extraperitoneal (TEP) repair with orchiectomy under the same operative view. Presentation of cases We treated two patients (49- and 38-year-old men) with right indirect inguinal hernias and cryptorchidism. Both patients underwent TEP repair with orchiectomy. In operative findings, an atrophic testis was drawn out with a hernia sac from the internal inguinal ring. After the testis was separated from the sac and cord structure was sheared, it was removed. The procedure did not require special techniques and devices. In both patients, the postoperative courses were satisfactory. Discussion To our knowledge, there has been only one such reported case till date which demonstrated the feasibility of TEP repair accompanied by orchiectomy. Conclusions TEP repair with orchiectomy under the same operative view could be safely performed in adults with an inguinal hernia combined with extra-abdominal cryptorchidism. This procedure could be an option for the treatment of such adult patients. PMID:26581081

  14. Application of Biologically Based Lumping To Investigate the Toxicokinetic Interactions of a Complex Gasoline Mixture.

    PubMed

    Jasper, Micah N; Martin, Sheppard A; Oshiro, Wendy M; Ford, Jermaine; Bushnell, Philip J; El-Masri, Hisham

    2016-03-15

    People are often exposed to complex mixtures of environmental chemicals such as gasoline, tobacco smoke, water contaminants, or food additives. We developed an approach that applies chemical lumping methods to complex mixtures, in this case gasoline, based on biologically relevant parameters used in physiologically based pharmacokinetic (PBPK) modeling. Inhalation exposures were performed with rats to evaluate the performance of our PBPK model and chemical lumping method. There were 109 chemicals identified and quantified in the vapor in the chamber. The time-course toxicokinetic profiles of 10 target chemicals were also determined from blood samples collected during and following the in vivo experiments. A general PBPK model was used to compare the experimental data to the simulated values of blood concentration for 10 target chemicals with various numbers of lumps, iteratively increasing from 0 to 99. Large reductions in simulation error were gained by incorporating enzymatic chemical interactions, in comparison to simulating the individual chemicals separately. The error was further reduced by lumping the 99 nontarget chemicals. The same biologically based lumping approach can be used to simplify any complex mixture with tens, hundreds, or thousands of constituents. PMID:26889718

  15. Modeling of plasma-based CO2 conversion: lumping of the vibrational levels

    NASA Astrophysics Data System (ADS)

    Berthelot, Antonin; Bogaerts, Annemie

    2016-08-01

    Although CO2 conversion by plasma technology is gaining increasing interest, the underlying mechanisms for an energy-efficient process are still far from understood. In this work, a reduced non-equilibrium CO2 plasma chemistry set, based on level lumping of the vibrational levels, is proposed and the reliability of this level-lumping method is tested by a self-consistent zero-dimensional code. A severe reduction of the number of equations to be solved is achieved, which is crucial to be able to model non-equilibrium CO2 plasmas by 2-dimensional models. Typical conditions of pressure and power used in a microwave plasma for CO2 conversion are investigated. Several different sets, using different numbers of lumped groups, are considered. The lumped models with 1, 2 or 3 groups are able to reproduce the gas temperature, electron density and electron temperature profiles, as calculated by the full model treating all individual excited levels, in the entire pressure range investigated. Furthermore, a 3-groups model is also able to reproduce the shape of the vibrational distribution function (VDF) and gives the most reliable prediction of the CO2 conversion. A strong influence of the vibrational excitation on the plasma characteristics is observed. Finally, the limitations of the lumped-levels method are discussed.

  16. The Unusual but Benign in Pediatric Surgery

    PubMed Central

    Shandling, Barry

    1985-01-01

    The problem of what is normal and what is not is closely related to whether or not, if something is indeed abnormal, it matters. Anticipating the outcome will affect the management in infants and children of such relatively benign conditions as hydroceles, umbilical hernias, diseases of the male and female breasts, lymphadenopathy and the intact prepuce. Unnecessary investigations such as barium studies which do not affect management are inadvisable. Congenital torticollis and undescended testis, seemingly benign, must be appropriately treated, however, in order to avoid lifelong sequelae. PMID:21274156

  17. Osteoid osteoma and benign osteoblastoma in childhood.

    PubMed Central

    Black, J A; Levick, R K; Sharrard, W J

    1979-01-01

    Three cases of osteoid osteoma and one of benign osteoblastoma in children are described. The main complaint was severe pain which was worse at night; it was relieved by aspirin or other analgesics. The diagnosis was made on clinical and radiological grounds and was confirmed on histological examination of the central nidus removed at operation. The pain was relieved in the patients with osteoid osteoma, and it was very much less after operative removal of the benign osteoblastoma. Both conditions are probably variations of the same disease process, depending on the anatomical site and the type of bone affected. Images Fig. 1 Fig. 2 Fig. 3 Fig. 4 PMID:475430

  18. Radiofrequency ablation for benign thyroid nodules.

    PubMed

    Bernardi, S; Stacul, F; Zecchin, M; Dobrinja, C; Zanconati, F; Fabris, B

    2016-09-01

    Benign thyroid nodules are an extremely common occurrence. Radiofrequency ablation (RFA) is gaining ground as an effective technique for their treatment, in case they become symptomatic. Here we review what are the current indications to RFA, its outcomes in terms of efficacy, tolerability, and cost, and also how it compares to the other conventional and experimental treatment modalities for benign thyroid nodules. Moreover, we will also address the issue of treating with this technique patients with cardiac pacemakers (PM) or implantable cardioverter-defibrillators (ICD), as it is a rather frequent occurrence that has never been addressed in detail in the literature. PMID:27098804

  19. Benign Cystic Mesothelioma Misdiagnosed as Peritoneal Carcinomatosis

    PubMed Central

    Shin, Hyun Deok; Kim, Suk Bae

    2016-01-01

    Benign cystic mesothelioma (BCM) is a rare benign disease that forms multicystic masses in the abdomen, pelvis, and retroperitoneum. It occurs predominantly in young to middle-aged women. The majority of cases were associated with a history of abdominal or pelvic operation, a history of endometriosis, and pelvic inflammatory disease. We present a unique case of BCM which is different to the previous cases. The patient was a 52-year-old man showing features of peritoneal carcinomatosis accompanied by ascites on abdominal computed tomography scans. We herein report a case of BCM misdiagnosed with peritoneal carcinomatosis.

  20. Anacostia River Basin: Large, Medium, and Small Lumps

    NASA Astrophysics Data System (ADS)

    Feldman, A. D.; Dufour, A.; Dotson, H. W.

    2001-05-01

    constructed using the U.S. Army Corps of Engineers' Hydrologic Modeling System, HEC-HMS. HMS can simulate any-sized river basin with unlimited subbasins and routing reaches. It can also simulate subbasin runoff on a gridded, semi-distributed basis. The Anacostia Basin was analyzed in three levels of detail at each gauge: one subbasin, five-to-ten subbasins, and 20-to-30 subbasins. Those levels of detail serve three analysis purposes, respectively: flow-frequency at the gauge, flow frequencies at flood-damage centers in other locations, and flow frequencies throughout the basin for local floodplain management. In addition to comparing simulation results for these different-sized lumps, a 4-km gridded representation of the basin is compared to the large, single-subbasin approach.

  1. Polarization-Independent, Thin, Broadband Metamaterial Absorber Using Double-Circle Rings Loaded with Lumped Resistances

    NASA Astrophysics Data System (ADS)

    Chen, Junfeng; Huang, Xiutao; Zerihun, Gebru; Hu, Zhaoyang; Wang, Shengming; Wang, Guodong; Hu, Xiwei; Liu, Minghai

    2015-11-01

    We present a broadband and polarization-insensitive metamaterial absorber (MA) composed of a dielectric substrate sandwiched with double-circle rings (DCRs) and welded with lumped resistances and continuous metal film. The structure is designed with thickness of 3 mm and investigated by simulation, fabrication, and experiment. The results show that the composite MA loaded with lumped resistances has wider absorptivity compared with a structure with only DCRs. The simulation results indicate that the proposed absorber achieves 7.60-GHz-wide absorption from 8.87 GHz to 16.47 GHz with absorptivity greater than 90%, in excellent agreement with experimental results. Further simulations indicate that there exist optimal values for the lumped resistances for which the absorptivity is the highest and the bandwidth widest. Additionally, the proposed MA is polarization insensitive at normal incidence. Simulation results for wide angles of incidence of both transverse electric and transverse magnetic waves are also investigated.

  2. Helium-volume dynamics of Upper Freeport coal powder and lumps

    SciTech Connect

    Romanov, V.N.; Soong, Yee

    2009-01-01

    Exposure to 7 MPa of helium at room temperature alters the texture of Upper Freeport coal in a lump form. The differences in texture and porosity between coal powder and lumps may affect the transport and interaction of fluids and coal. In this work, the information about the coal texture and micro- and meso-porosity was obtained via the BET, BJH, and Dubinin–Astakhov analyses. We further investigated the free-fluid-phase volume (free-volume) effects due to helium interaction with the powder and the lumps. During the manometric experiment, helium penetration into the dry coal matrix resulted in slow relaxation of pressure. After exposure of coal to helium, there have been no significant changes of the macroscopic dimensions observed and the relaxation process can be attributed to microscopic ‘free-volume’ effects. Evolution of the sorption–desorption rates indicates that exposure to helium may change the texture and apparent (helium) density of dry coal.

  3. Note: A calibration method to determine the lumped-circuit parameters of a magnetic probe

    NASA Astrophysics Data System (ADS)

    Li, Fuming; Chen, Zhipeng; Zhu, Lizhi; Liu, Hai; Wang, Zhijiang; Zhuang, Ge

    2016-06-01

    This paper describes a novel method to determine the lumped-circuit parameters of a magnetic inductive probe for calibration by using Helmholtz coils with high frequency power supply (frequency range: 10 kHz-400 kHz). The whole calibration circuit system can be separated into two parts: "generator" circuit and "receiver" circuit. By implementing the Fourier transform, two analytical lumped-circuit models, with respect to these separated circuits, are constructed to obtain the transfer function between each other. Herein, the precise lumped-circuit parameters (including the resistance, inductance, and capacitance) of the magnetic probe can be determined by fitting the experimental data to the transfer function. Regarding the fitting results, the finite impedance of magnetic probe can be used to analyze the transmission of a high-frequency signal between magnetic probes, cables, and acquisition system.

  4. Helium-volume dynamics of Upper Freeport coal powder and lumps

    SciTech Connect

    Romanov, Vyacheslav; Soong, Yee

    2009-01-01

    Exposure to 7 MPa of helium at room temperature alters the texture of Upper Freeport coal in a lump form. The differences in texture and porosity between coal powder and lumps may affect the transport and interaction of fluids and coal. In this work, the information about the coal texture and micro- and meso-porosity was obtained via the BET, BJH, and Dubinin-Astakhov analyses. We further investigated the free-fluid-phase volume (free-volume) effects due to helium interaction with the powder and the lumps. During the manometric experiment, helium penetration into the dry coal matrix resulted in slow relaxation of pressure. After exposure of coal to helium, there have been no significant changes of the macroscopic dimensions observed and the relaxation process can be attributed to microscopic 'freevolume' effects. Evolution of the sorption-desorption rates indicates that exposure to helium may change the texture and apparent (helium) density of dry coal.

  5. Inclusion of lumped elements in finite difference time domain electromagnetic calculations

    SciTech Connect

    Thomas, V.A.; Jones, M.E.; Mason, R.J.

    1994-12-31

    A general approach for including lumped circuit elements in a finite difference, time domain (FD-TD) solution of Maxwell`s equations is presented. The methodology allows the direct access to SPICE to model the lumped circuits, while the full 3-Dimensional solution to Maxwell`s equations provides the electromagnetic field evolution. This type of approach could be used to mode a pulsed power machine by using a SPICE model for the driver and using an electromagnetic PIC code for the plasma/electromagnetics calculation. The evolution of the driver can be made self consistent with the behavior of the plasma load. Other applications are also possible, including modeling of nonlinear microwave circuits (as long as the non-linearities may be expressed in terms of a lumped element) and self-consistent calculation of very high speed computer interconnections and digital circuits.

  6. Tension free open inguinal hernia repair using an innovative self gripping semi-resorbable mesh

    PubMed Central

    Chastan, Philippe

    2006-01-01

    Aims: Inguinal hernia repair according to Lichtenstein technique has become the most common procedure performed by general surgeons. Heavy weight polypropylene meshes have been reported to stimulate inflammatory reaction responsible for mesh shrinkage when scar tissue evolved. Additionally, some concerns remain regarding the relationship between chronic pain and mesh fixation technique. In order to reduce those drawbacks, we have developed a new mesh for anterior tension free inguinal hernia repair which exhibits self-gripping absorbable properties. Materials and Methods: 52 patients (69 hernias) were prospectivly operated with this mesh (SOFRADIM-France) made of low-weight isoelastic large pores knitted fabric which incorporated resorbable micro hooks that provides self gripping properties to the mesh during the first months post-implantation. The fixation of the mesh onto the tissues is significantly facilitated. The mesh is secured around the cord with a self gripping flap. After complete tissular ingrowth and resorption of the PLA hooks, the low-weight (40 g/m2) polypropylene mesh insures the long term wall reinforcement. Results: Peroperativly, no complication was reported, the mesh was easy to handle and to fix. Discharge was obtained at Day 1. No perioperative complication occurred, return to daily activities was obtained at Day 5.5. At one month, no neurological pain or other complications were described. Conclusions: Based on the first results of this clinical study, this unique concept of low density self gripping mesh should allows an efficient treatment of inguinal hernia. It should reduce postoperative complications and the extent of required suture fixation, making the procedure more reproducible PMID:21187984

  7. Anterior preperitoneal repair of extremely large inguinal hernias: An alternative technique☆☆☆

    PubMed Central

    Koning, Giel G.; Vriens, Patrick W.H.E.

    2011-01-01

    INTRODUCTION Standard open anterior inguinal hernia repair is nowadays performed using a soft mesh to prevent recurrence and to minimalize postoperative chronic pain. To further reduce postoperative chronic pain, the use of a preperitoneal placed mesh has been suggested. In extremely large hernias, the lateral side of the mesh can be insufficient to fully embrace the hernial sac. We describe the use of two preperitoneal placed meshes to repair extremely large hernias. This ‘Butterfly Technique’ has proven to be useful. Hernias were classified according to hernia classification of the European Hernia Society (EHS) during operation. Extremely large indirect hernias were repaired by using two inverted meshes to cover the deep inguinal ring both medial and lateral. Follow up was at least 6 months. VAS pain score was assessed in all patients during follow up. Outcomes of these Butterfly repairs were evaluated. Medical drawings were made to illustrate this technique. A Total of 689 patients underwent anterior hernia repair 2006–2008. PRESENTATION OF CASE Seven male patients (1%) presented with extremely large hernial sacs. All these patients were men. Mean age 69.9 years (range: 63–76), EHS classifications of hernias were all unilateral. Follow up was at least 6 months. Recurrence did not occur after repair. Chronic pain was not reported. Discussion Open preperitoneal hernia repair of extremely large hernias has not been described. The seven patients were trated with this technique uneventfully. No chronic pain occurred. CONCLUSION The Butterfly Technique is an easy and safe alternative in anterior preperitoneal repair of extremely large inguinal hernias. PMID:22288042

  8. Preperitoneal Surgery Using a Self-Adhesive Mesh for Inguinal Hernia Repair

    PubMed Central

    Oguntodu, Olakunle F.; Rodriguez, Francisco; Rassadi, Roozbeh; Haley, Michael; Shively, Cynthia J.; Dzandu, James K.

    2014-01-01

    Background and Objectives: Laparoscopic preperitoneal hernia repair with mesh has been reported to result in improved patient outcomes. However, there are few published data on the use of a totally extraperitoneal (TEP) approach. The purpose of this study was to present our experience and evaluate early outcomes of TEP inguinal hernia repair with self-adhesive mesh. Methods: This cohort study was a retrospective review of patients who underwent laparoscopic TEP inguinal hernial repair from April 4, 2010, through July 22, 2014. Data assessed were age, sex, body mass index (BMI), hernia repair indications, hernia type, pain, paresthesia, occurrence (bilateral or unilateral), recurrence, and patient satisfaction. Descriptive and regression analyses were performed. Results: Six hundred forty patients underwent laparoscopic preperitoneal hernia surgery with self-adhesive mesh. The average age was 56 years, nearly all were men (95.8%), and the mean BMI was 26.2 kg/m2. Cases involved primary hernia more frequently than recurrent hernia (94% vs 6%; P < .05). After surgery, 92% of the patients reported no more than minimal pain, <1% reported paresthesia, and 0.2% had early recurrence. There were 7 conversions to an open procedure. The patients had no adverse reactions to anesthesia and no bladder injury. Postoperative acute pain or recurrence was not explained by demographics, BMI, or preoperative pain. There were significant associations of hernia side, recurrence, occurrence, and sex with composite end points. Nearly all patients (98%) were satisfied with the outcome. Conclusion: The use of self-adhesive, Velcro-type mesh in laparoscopic TEP inguinal hernia repair is associated with reduced pain; low rates of early recurrence, infection, and hematoma; and improved patient satisfaction. PMID:25587212

  9. Local anesthetic infusion pumps improve postoperative pain after inguinal hernia repair: a randomized trial.

    PubMed

    Sanchez, Barry; Waxman, Kenneth; Tatevossian, Raymond; Gamberdella, Marla; Read, Bruce

    2004-11-01

    Pain after an open inguinal hernia repair may be significant. In fact, some surgeons feel that the pain after open repair justifies a laparoscopic approach. The purpose of this study was to determine if the use of local anesthetic infusion pumps would reduce postoperative pain after open inguinal hernia repair. We performed a prospective, double-blind randomized study of 45 open plug and patch inguinal hernia repairs. Patients were randomized to receive either 0.25 per cent bupivicaine or saline solution via an elastomeric infusion pump (ON-Q) for 48 hours, at 2 cc/h. The catheters were placed in the subcutaneous tissue and removed on postoperative day 3. Both groups were prescribed hydrocodone to use in the postoperative period at the prescribed dosage as needed for pain. Interviews were conducted on postoperative days 3 and 7, and patient's questionnaires, including pain scores, amount of pain medicine used, and any complications, were collected accordingly. During the first 5 postoperative days, postoperative pain was assessed using a visual analog scale. Twenty-three repairs were randomized to the bupivicaine group and 22 repairs randomized to the placebo group. In the bupivicaine group, there was a significant decrease in postoperative pain on postoperative days 2 through 5 with P values <0.05. This significant difference continued through postoperative day 5, 2 days after the infusion pumps were removed. Patients who had bupivicaine instilled in their infusion pump had statistically significant lower subjective pain scores on postoperative days 2 through 5. This significant difference continued even after the infusion pumps were removed. Local anesthetic infusion pumps significantly decreased the amount of early postoperative pain. Pain relief persisted for 2 days after catheter and pump removal. PMID:15586515

  10. Single-Port Onlay Mesh Repair of Recurrent Inguinal Hernias after Failed Anterior and Laparoscopic Repairs

    PubMed Central

    Tran, Kim; Zajkowska, Marta; Lam, Vincent; Hawthorne, Wayne J.

    2015-01-01

    Background and Objectives: Despite the exponential increase in the use of laparoscopic inguinal herniorrhaphy, overall recurrence rates have remained unchanged. Therefore, a growing number of patients are presenting with recurrent hernias after conventional anterior and laparoscopic repairs have failed. This study reports our experience with single-incision laparoscopic (SIL) intraperitoneal onlay mesh (IPOM) repair of these hernias. Methods: Patients referred with two or more recurrences of inguinal hernia underwent SIL-IPOM from November 1, 2009, to June 24, 2014. A 2.5-cm infraumbilical incision was made, and an SIL port was placed intraperitoneally. Modified dissection techniques were used: chopstick and inline dissection, 5.5-mm/52-cm/30° angled laparoscope, and conventional straight dissecting instruments. The peritoneum was incised above the pubic symphysis, and dissection was continued laterally and proximally, raising the inferior flap below the previous extraperitoneal mesh while reducing any direct, indirect, femoral, or cord lipoma before placement of antiadhesive mesh, which was fixed to the pubic ramus, as well as superiorly, with nonabsorbable tacks before the inferior border was fixed with fibrin sealant. The inferior peritoneal flap was then tacked back onto the mesh. Results: Nine male patients underwent SIL-IPOM. Their mean age was 53 years and mean body mass index was 26.8 kg/m2. Mean mesh size was 275 cm2. Mean operation time was 125 minutes, with a hospital stay of 1 day. The umbilical scar length was 23 mm at the 6-week follow-up. There were no intra-/postoperative complications, port-site hernias, chronic groin pain, or recurrence of the hernia during a mean follow-up of 24 months. Conclusion: Inguinal hernias recurring after two or more failed conventional anterior and laparoscopic repairs can be safely and efficiently treated with SIL-IPOM. PMID:25848186

  11. Single-Incision Laparoscopic Intraperitoneal Onlay Mesh Repair for the Treatment of Multiple Recurrent Inguinal Hernias

    PubMed Central

    Tran, Kim; Zajkowska, Marta; Lam, Vincent; Hawthorne, Wayne

    2014-01-01

    Introduction: Despite an exponential rise in laparoscopic surgery for inguinal herniorrhaphy, overall recurrence rates have remained unchanged. Therefore, an increasing number of patients present with recurrent hernias after having failed anterior and laparoscopic repairs. This study reports our experience with single-incision laparoscopic (SIL) intraperitoneal onlay mesh (IPOM) repair for these hernias. Materials and methods: All patients referred with multiply recurrent inguinal hernias underwent SIL-IPOM from November 1 2009 to October 30 2013. A 2.5-cm infraumbilical incision was made and a SIL surgical port was placed intraperitoneally. Modified dissection techniques, namely, “chopsticks” and “inline” dissection, 5.5 mm/52 cm/30° angled laparoscope and conventional straight dissecting instruments were used. The peritoneum was incised above the symphysis pubis and dissection continued laterally and proximally raising an inferior flap, below a previous extraperitoneal mesh, while reducing any direct/indirect/femoral/cord lipoma before placement of antiadhesive mesh that was fixed into the pubic ramus as well as superiorly with nonabsorbable tacks before fixing its inferior border with fibrin sealant. The inferior peritoneal flap was then tacked back onto the mesh. Results: There were 9 male patients who underwent SIL-IPOM. Mean age was 55 years old and mean body mass index was 26.8 kg/m2. Mean mesh size was 275 cm2. Mean operation time was 125 minutes with hospital stay of 1 day and umbilical scar length of 21 mm at 4 weeks' follow-up. There were no intraoperative/postoperative complications, port-site hernias, chronic groin pain, or recurrence with mean follow-up of 20 months. Conclusions: Multiply recurrent inguinal hernias after failed conventional anterior and laparoscopic repairs can be treated safely and efficiently with SIL-IPOM. PMID:25392643

  12. Laparoscopic transabdominal preperitoneal approach for recurrent inguinal hernia: A randomized trial

    PubMed Central

    Saber, Aly; Hokkam, Emad N.; Ellabban, Goda M.

    2015-01-01

    INTRODUCTION: The repair of the recurrent hernia is a daunting task because of already weakened tissues and distorted anatomy. Open posterior preperitoneal approach gives results far superior to those of the anterior approach. Laparoscopic transabdominal preperitoneal (TAPP) inguinal hernia repair is an evolving technique associated with advantages of a minimally invasive approach. The present work aimed at comparing these three approaches for repair of recurrent inguinal hernia regarding complications and early recurrence. MATERIALS AND METHODS: A total of 180 patients were divided randomly into three equal groups: A, B, and C. Group A patients were subjected to open posterior preperitoneal approach , those of group B were subjected to transinguinal anterior tension-free repair and group C patients were subjected to TAPP. The primary end point was recurrence and the secondary end points were time off from work, postoperative pain, scrotal swelling, and wound infections. RESULTS: The mean hospital stay, the mean time to return to work and the mean time off from work were less in group C then A and B. Chronic postoperative pain was observed in eight patients in group A (13.33%), in 18 patients in group B (30%) and six patients in group C (10%). The overall complication rate was 19.7% in both groups A and C and 34.36% in group B. CONCLUSION: In recurrent inguinal hernia, the laparoscopic and open posterior approaches are equally effective in term of operative outcome. The open preperitoneal hernia repair is inexpensive, has a low recurrence rate. Postoperative recovery is short and postoperative pain is minimal. This approach gives results far superior to those of the commonly used anterior approach. However, while laparoscopic hernia repair requires a lengthy learning curve and is difficult to learn and perform, it has advantages of less post-operative pain, early recovery with minimal hospital stay, low post-operative complications and recurrence. Trial

  13. Safety of Minimally Invasive Radical Prostatectomy in Patients with Prior Abdominopelvic or Inguinal Surgery

    PubMed Central

    Reese, Adam C.; Mettee, Lynda Z.; Pavlovich, Christian P.

    2015-01-01

    Abstract Introduction: Despite the widespread use of minimally invasive radical prostatectomy (MIRP), there remain concerns regarding its safety in patients with a history of prior abdominopelvic or inguinal surgery. Methods: A prospective database of 1165 MIRP procedures performed by a single surgeon at a high-volume tertiary care center from 2001 to 2013 was analyzed. After an initial period of transperitoneal MIRP (TP), an extraperitoneal (EP) approach was used preferentially beginning in 2005 (for both laparoscopic and robotic cases), and robotics were used preferentially beginning in 2010. Overall perioperative complications, major complications (Clavien-Dindo III or IV), and abdominal complications (e.g., ileus, bowel/organ injury, or vascular injury) were compared for patients with and without a prior surgical history. Uni- and multivariate logistic regression were used to control the impact of robotics, approach, operative time, estimated blood loss, case number, prostate weight, and primary Gleason on complications. Results: Three hundred patients undergoing MIRP had prior abdominopelvic or inguinal surgery (25.8%). Of these, 102 (34%) underwent TP and 198 (66%) EP MIRP. Robotics was used in 286 cases (24.6%) and pure laparoscopy in 879 (75.4%). Complications occurred in 111 patients (9.5%) from the total cohort, with major complications in 32 (2.75%) and abdominal complications in 19 (1.63%). Prior surgery was not associated with overall, major, or abdominal complications. Of the controlling factors, only increasing operative time was associated with postoperative abdominal complications (most of which were ileus) on multivariate analysis. Conclusions: In this large single-surgeon series where both EP and TP approaches to MIRP are utilized, prior abdominopelvic or inguinal surgery was not associated with an increased risk of perioperative complications. PMID:25137522

  14. Different Management Options for Transplant Ureteral Obstructions within an Inguinal Hernia

    PubMed Central

    Cheung, Felix; Debartolo, Merrit Marion; Copertino, Leonard Michael; Szafran, April Adams; Estrada, Chelsea Caron; Lynch, Patrick Gerard; Darras, Frank Sam

    2016-01-01

    Ureteral obstruction secondary to an inguinal hernia with transplant ureteral component is an extremely rare entity with only several case reports found in literature. In all previously reported cases, management of the obstruction involved temporary drainage with ureteral stenting or nephrostomy tube placements followed by delayed definitive repair. We present two case reports, here one being the first one managed by immediate definitive repair via ureteral reimplant and herniorrhaphy and a second case by delayed definitive repair after percutaneous nephrostomy tube placement. Both patients continued to do well postoperatively with normalization of renal function on follow-up. PMID:27144049

  15. Intestinal perforation as a long-term complication of plug and mesh inguinal hernioplasty: case report.

    PubMed

    Benedetti, M; Albertario, S; Niebel, T; Bianchi, C; Tinozzi, F P; Moglia, P; Arcidiaco, M; Tinozzi, S

    2005-03-01

    Tension-free and sutureless hernioplasty by plug and mesh of nonreabsorbable material is one of the most common techniques for inguinal hernia repair. It's a simple and quick procedure with a low cost and allows for a short hospital stay. It shows a low reoccurrence rate, but it can result, in very few cases, in complications strictly related to prosthetic material. The literature describes some cases of plug migration from its proper position, for example, to the scrotum, preperitoneal adipose tissue, and abdominal cavity. We report on a case of sigmoid colon perforation due to a plug of Trabucco hernioplasty performed 2 years previously. PMID:15290610

  16. Benign Prostatic Hyperplasia: from Bench to Clinic

    PubMed Central

    Cho, Hee Ju

    2012-01-01

    Benign prostatic hyperplasia (BPH) is a prevalent disease, especially in old men, and often results in lower urinary tract symptoms (LUTS). This chronic disease has important care implications and financial risks to the health care system. LUTS are caused not only by mechanical prostatic obstruction but also by the dynamic component of obstruction. The exact etiology of BPH and its consequences, benign prostatic enlargement and benign prostatic obstruction, are not identified. Various theories concerning the causes of benign prostate enlargement and LUTS, such as metabolic syndrome, inflammation, growth factors, androgen receptor, epithelial-stromal interaction, and lifestyle, are discussed. Incomplete overlap of prostatic enlargement with symptoms and obstruction encourages focus on symptoms rather than prostate enlargement and the shifting from surgery to medicine as the treatment of BPH. Several alpha antagonists, including alfuzosin, doxazosin, tamsulosin, and terazosin, have shown excellent efficacy without severe adverse effects. In addition, new alpha antagonists, silodosin and naftopidil, and phosphodiesterase 5 inhibitors are emerging as BPH treatments. In surgical treatment, laser surgery such as photoselective vaporization of the prostate and holmium laser prostatectomy have been introduced to reduce complications and are used as alternatives to transurethral resection of the prostate (TURP) and open prostatectomy. The status of TURP as the gold standard treatment of BPH is still evolving. We review several preclinical and clinical studies about the etiology of BPH and treatment options. PMID:22468207

  17. Unusual Benign Tumors of the Breast

    PubMed Central

    Adrada, Beatriz E; Krishnamurthy, Savitri; Carkaci, Selin; Posleman-Monetto, Flavia E; Ewere, Adesuwa; Whitman, Gary J

    2015-01-01

    The purpose of this article is to describe the imaging characteristics of a variety of benign breast tumors that may be encountered in daily practice, in order to formulate an appropriate differential diagnosis and to establish concordance between the imaging and the pathologic findings, and to assist the clinician with appropriate management. PMID:26085959

  18. CSF imaging in benign intracranial hypertension

    PubMed Central

    James, A. Everette; Harbert, J. C.; Hoffer, P. B.; DeLand, F. H.

    1974-01-01

    The cisternographic images in 10 patients with benign intracranial hypertension were reviewed. Nine were normal. Transfer of labelled tracer from the subarachnoid space was measured in five patients and was found to be abnormal in only two. The relation of these findings to the proposed pathophysiological alterations is discussed. Images

  19. Design of experiments for measuring heat-transfer coefficients with a lumped-parameter calorimeter

    NASA Technical Reports Server (NTRS)

    Vanfossen, G. J., Jr.

    1975-01-01

    A theoretical investigation was conducted to determine optimum experimental conditions for using a lumped-parameter calorimeter to measure heat-transfer coefficients and heating rates. A mathematical model of the transient temperature response of the calorimeter was used with the measured temperature response to predict the heat-transfer coefficient and the rate of heating. A sensitivity analysis was used to determine the optimum transient experiment for simultaneously measuring the heat addition during heating and the convective heat-transfer coefficient during heating and cooling of a lumped-parameter calorimeter. Optimum experiments were also designed for measuring the convective heat-transfer coefficient during both heating and cooling and cooling only.

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

    PubMed Central

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

    2016-01-01

    Patient: Male, 58 Final Diagnosis: Hydronephrosis Symptoms: Blunt abdominal pain • constipation • constipation Medication: — Clinical Procedure: Extracorporeal shock wave lithotripsy and percutaneous nephrostolithotomy Specialty: Gastroenterology and Hepatology Objective: Rare co-existance of disease or pathology 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

  1. Endoscopic totally extraperitoneal (TEP) hernia repair for inguinal disruption (Sportsman's hernia): rationale and design of a prospective observational cohort study (TEP-ID-study)

    PubMed Central

    Voorbrood, C E H; Goedhart, E; Verleisdonk, E J M M; Sanders, F; Naafs, D; Burgmans, J P J

    2016-01-01

    Introduction Chronic inguinal pain is a frequently occurring problem in athletes. A diagnosis of inguinal disruption is performed by exclusion of other conditions causing groin pain. Up to now, conservative medical management is considered to be the primary treatment for this condition. Relevant large and prospective clinical studies regarding the treatment of inguinal disruption are limited; however, recent studies have shown the benefits of the totally extraperitoneal patch (TEP) technique. This study provides a complete assessment of the inguinal area in athletes with chronic inguinal pain before and after treatment with the TEP hernia repair technique. Methods and analysis We describe the rationale and design of an observational cohort study for surgical treatment with the endoscopic TEP hernia repair technique in athletes with a painful groin (inguinal disruption). The study is being conducted in a high-volume, single centre hospital with specialty in TEP hernia repair. Patients over 18 years, suffering from inguinal pain for at least 3 months during or after playing sports, and whom have not undergone previous inguinal surgery and have received no benefit from physiotherapy are eligible for inclusion. Patients with any another cause of inguinal pain, proven by physical examination, inguinal ultrasound, X-pelvis/hip or MRI are excluded. Primary outcome is reduction in pain after 3 months. Secondary outcomes are pain reduction, physical functioning, and resumption of sport (in frequency and intensity). Ethics and dissemination An unrestricted research grant for general study purposes was assigned to the Hernia Centre. This study itself is not directly subject to the above mentioned research grant or any other financial sponsorship. We intend to publish the outcome of the study, regardless of the findings. All authors will give final approval of the manuscript version to be published. PMID:26739740

  2. 24 CFR 84.80 - Conditions for use of Lump Sum (fixed price or fixed amount) grants.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... (fixed price or fixed amount) grants. 84.80 Section 84.80 Housing and Urban Development Office of the... AGREEMENTS WITH INSTITUTIONS OF HIGHER EDUCATION, HOSPITALS, AND OTHER NON-PROFIT ORGANIZATIONS Use of Lump Sum Grants § 84.80 Conditions for use of Lump Sum (fixed price or fixed amount) grants. (a) Heads...

  3. 5 CFR 831.2011 - Effect of part 772 of this chapter on CSRS lump-sum payments.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ..., when the Board issues a final order cancelling the employee's separation, or when the agency and the... MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) RETIREMENT Payment of Lump Sums § 831.2011... amount of the lump-sum payment from any back pay to which the employee is entitled as required by 5...

  4. The Comparison of Lichtenstein Procedure with and without Mesh-Fixation for Inguinal Hernia Repair

    PubMed Central

    Ersoz, Feyzullah; Culcu, Serdar; Duzkoylu, Yigit; Bektas, Hasan; Sari, Serkan; Arikan, Soykan; Deniz, Mehmet Mehdi

    2016-01-01

    Aim. Although inguinal hernia repair is the most frequently performed surgical procedure in the world, the best repair method has not gained acceptance yet. The ideal repair must be safe, simple, and easy to perform and require minimal dissection which provides enough exploration, maintain patient's comfort in the early stage, and also be cost-effective, reducing operation costs, labor loss, hospital stay, and recurrence. Materials and Methods. There were eighty-five patients between the ages of 18 and 75, diagnosed with inguinal hernia in our clinic. Lichtenstein procedure for hernia repair was performed under spinal anesthesia in all patients. Forty-two patients had the standard procedure and, in 43 patients, the polypropylene mesh was used without fixation. All patients were examined and questioned on the 7th day of the operation in terms of pain, scrotal edema, and the presence of seroma and later on in the 6th postoperative month in terms of paresthesia, neuropraxia, and recurrence by a single physician. Results. Operative time and pain scores in the nonfixation group were significantly lower, without any increase in rates of recurrence. Conclusion. Based on these findings, in Lichtenstein hernia repair method, nonfixation technique can be used safely with better results. PMID:27200411

  5. Previous appendicitis may affect peritoneal overlap of the mesh in laparoscopic inguinal hernia repair.

    PubMed

    Vecchio, R; Di Martino, M; Lipari, G; Sambataro, L

    2002-02-01

    Laparoscopic inguinal hernia repair is now increasingly performed in bilateral and recurrent groin hernias. The avoidance of direct exposure of the commonly used meshes to the abdominal viscera is considered essential to reduce the risk of bowel adhesions. We report a case of bilateral inguinal hernia repair in a patients who had had an appendectomy performed 8 years earlier for a perforated appendicitis. Probably as a result of previous inflammation, any attempt to dissect the preperitoneal layer in the right side resulted in peritoneal lacerations. Since the peritoneum could not be used to cover the mesh, we decided to position an expanded polytetrafluoroethylene (e-PTFE) mesh to avoid postoperative adhesions. The mesh was fixed with tacks to the symphysis pubis, Cooper's ligament, the ilio-pubic tract, and the transversalis fascia 2 cm above the hernia defect. This case suggests that in patient with previous appendicitis, a difficult preperitoneal dissection can be expected. In such cases, especially in young patients for whom future surgical operations cannot be excluded, any attempt to reduce adhesions is justified. At the present time, the use of e-PTFE meshes, which induce no tissue reaction, is a good option in this situation. PMID:11967702

  6. Simultaneous Extraperitoneal Laparoscopic Radical Prostatectomy and Intraperitoneal Inguinal Hernia Repair With Mesh

    PubMed Central

    Knoll, Abraham; Teixeira, Julio A.

    2005-01-01

    Objective: This report depicts the feasibility of the concomitant repair of a large direct inguinal hernia with mesh by using the intraperitoneal onlay approach after extra-peritoneal laparoscopic radical prostatectomy. Methods: A 66-year-old man with localized adenocarcinoma of the prostate was referred for laparoscopic radical prostatectomy. The patient also had a 4-cm right, direct inguinal hernia, found on physical examination. To minimize the risk of infection of the mesh, an extraperitoneal laparoscopic prostatectomy was performed in the standard fashion after which transperitoneal access was obtained for the hernia repair. The hernia repair was completed by reduction of the hernia sac, followed by prosthetic mesh onlay. In this fashion, the peritoneum separated the prostatectomy space from the mesh. A single preoperative and postoperative dose of cefazolin was administered. Results: The procedure was completed with no difficulty. Total operative time was 4.5 hours with an estimated blood loss of 450 mL. The final pathology revealed pT2cN0M0 prostate cancer with negative margins. No infectious or bowel complications occurred. At 10-month follow-up, no evidence existed of recurrence of prostate cancer or the hernia. Conclusion: Concomitant intraperitoneal laparoscopic mesh hernia repair and extraperitoneal laparoscopic prostatectomy are feasible. This can decrease the risk of potential infectious complications by separating the mesh from the space of Retzius where the prostatectomy is performed and the lower urinary tract is opened. PMID:15984719

  7. Genetic and functional analysis of the TBX3 gene promoter in indirect inguinal hernia.

    PubMed

    Zhao, Zhongqing; Tian, Wenjun; Wang, Lin; Wang, Haihua; Qin, Xianyun; Xing, Qining; Pang, Shuchao; Yan, Bo

    2015-01-01

    Inguinal hernia is a common developmental disease in children and most cases are indirect inguinal hernia (IIH). Genetic factors have been suggested to play important roles in IIH. Although IIH has been observed in several human syndromes, genetic causes and molecular mechanisms for IIH remain unknown. TBX3 is a member of the T-box family of transcription factors that are essential to the embryonic development. Human studies and animal experiments have demonstrated that TBX3 is required for the development of the heart, limbs, mammary glands and other tissues and organs. TBX3 gene expression has been detected in human fibroblast and tissues of abdominal wall. We speculated that TBX3 may be involved in the IIH formation. Since TBX3 activity is highly dosage-sensitive, a TBX3 gene promoter was genetically and functionally analyzed in IIH patients and ethnic-matched controls in this study. One heterozygous deletion variant (g.4820_4821del) was identified in one IIH patient, but in none of controls. The variant significantly decreased TBX3 gene promoter activities, likely by creating a binding site for sex-determining region Y (SRY), mobility group transcription factor. One heterozygous insertion variant (g.3913_3914ins) was only found in one control, which did not affect TBX3 gene promoter activities. Taken together, TBX3 gene variants may contribute to IIH as a rare risk factor by reducing TBX3 levels. PMID:25455105

  8. Negative pressure wound therapy for inguinal lymphatic complications in critically ill patients

    PubMed Central

    Cheong, Yong-Kyu; Jun, Heungman; Song, Gi-Won; Moon, Ki-Myung; Kwon, Tae-Won; Lee, Sung-Gyu

    2013-01-01

    Purpose In this study, we investigated the therapeutic potential of regulated negative pressure vacuum-assisted wound therapy for inguinal lymphatic complications in critically ill, liver transplant recipients. Methods The great saphenous vein was harvested for hepatic vein reconstruction during liver transplantation in 599 living-donor liver transplant recipients. Fourteen of the recipients (2.3%) developed postoperative inguinal lymphatic complications and were treated with negative pressure wound therapy, and they were included in this study. Results The average total duration of negative pressure wound therapy was 23 days (range, 11 to 42 days). Complete resolution of the lymphatic complications and wound healing were achieved in all 14 patients, 5 of whom were treated in hospital and 9 as outpatients. There was no clinically detectable infection, bleeding or recurrence after an average follow-up of 27 months (range, 7 to 36 months). Conclusion Negative pressure wound therapy is an effective, readily-available treatment option that is less invasive than exploration and ligation of leaking lymphatics and provides good control of drainage and rapid wound closure in critically ill patients. PMID:24020023

  9. Metastatic malignant melanoma of the inguinal lymph node with unknown primary lesion.

    PubMed

    Eltawansy, Sherif Ali; Panasiti, Ryane; Hasanien, Samaa; Lourdusamy, Dennis; Sharon, David

    2015-01-01

    Background. Malignant melanoma could present with metastasis with unknown primary (MUP) and this happens in 2-3% according to the studies. Around 90% of melanomas have cutaneous origin, but still there are melanomas that could be found in visceral organs or lymph nodes with unknown primary site. Spontaneous regression of the primary site could be an explanation. Case Report. We report a 58-year-old Caucasian male who presented with a right sided swelling in the inguinal region. Surgery was performed and biopsy showed metastatic malignant melanoma. No cutaneous lesions were identified by history or physical examination. Work up could not detect the primary lesion and patient was started on radiotherapy and immunotherapy. Conclusion. We present a case of malignant melanoma of unknown primary presenting in an unusual place which is the inguinal lymph node. Theories try to explain the pathway of development of such tumors and one of the theories mentions that it could be a spontaneous regression of the primary cutaneous lesion. Another theory is that it could be from transformation of aberrant melanocyte within the lymph node. Prognosis is postulated to be better in this case than in melanoma with a known primary. PMID:25705230

  10. [BENIGN TUMORS OF MEDIASTINUM: CLINIC, DIAGNOSIS, SURGICAL TREATMENT].

    PubMed

    Kalabukha, I A; Mayetniy, E M

    2015-12-01

    Results of surgical treatment of 18 patients in a thoracic surgery clinic for benign tumors of mediastinum are presented. The symptoms of benign tumors, efficacy of application of welding technologies in operative intervention were analyzed. PMID:27025028

  11. Isolated benign primary cutaneous plasmacytosis in a child.

    PubMed

    On, Hye Rang; Lee, Sang Eun; Kim, You Chan; Kim, Soo-Chan

    2014-01-01

    Isolated benign primary cutaneous plasmacytosis in a child is a very rare and benign disease. Herein we present a case of this condition occurring in a child who showed good response to topical corticosteroid. PMID:25424220

  12. A novel benign solution for collagen processing

    NASA Astrophysics Data System (ADS)

    Arnoult, Olivier

    Collagen is the main protein constituting the extracellular matrix (ECM) of tissues in the body (skin, cartilage, blood vessels...). It exists many types of collagen, this work studies only fibrillar collagen (e.g. collagen type I contained in the skin) that exhibits a triple helical structure composed of 3 alpha-helical collagen chains. This particular and defined hierarchical structure is essential to the biological and mechanical properties of the collagen. Processing collagen into scaffolds to mimic the ECM is crucial for successful tissue engineering. Recently collagen was processed into fibrous and porous scaffold using electrospinning process. However the solvent (HFIP) used for electrospinning is extremely toxic for the user and expensive. This work shows that HFIP can be replaced by a benign mixture composed of water, salt and alcohol. Yet only three alcohols (methanol, ethanol and iso-propanol) enable the dissolution of large quantity of collagen in the benign mixture, with a wide range of alcohol to buffer ratio, and conserve the collagen hierarchical structure at least as well as the HFIP. Collagen can be electrospun from the benign mixture into sub-micron fibers with concentrations as low as 6 wt-% for a wide range of alcohol to buffer ratio, with at least 10wt-% of salt, and any of the three alcohols. Specific conditions yield nano size fibers. After processing from HFIP or a benign mixture, collagen is water soluble and needs to be chemically crosslink for tissue engineering application. Post-crosslinking with 1-ethyl-3-(3-dimethylaminopropyl) carbodiimide hydrochloride (EDC) results in the loss of the scaffold fibrous aspect and porosity, hence it is useless for tissue engineering. Such issue could be prevented by incorporating the crosslinker into the mixture prior to electrospinning. When EDC is used alone, collagen forms a gel in the mixture within minutes, preventing electrospinning. The addition of N-hydroxysuccinimide (NHS) in excess to EDC

  13. Extension of the Babinet principle to scatterers with lumped impedance loads

    NASA Astrophysics Data System (ADS)

    Moore, J.

    1993-02-01

    It is shown that the Babinet principle for scattering by complementary screens can be extended to complementary screens with lumped impedance loads. The complementary loads need to be in a relationship of the same form as the well known relationship between input impedances of Booker.

  14. 29 CFR Appendix B to Part 4022 - Lump Sum Interest Rates for PBGC Payments

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... affecting part 4022, appendix B, see the List of CFR Sections Affected, which appears in the Finding Aids... 29 Labor 9 2010-07-01 2010-07-01 false Lump Sum Interest Rates for PBGC Payments B Appendix B to... AND BENEFITS BENEFITS PAYABLE IN TERMINATED SINGLE-EMPLOYER PLANS Pt. 4022, App. B Appendix B to...

  15. 24 CFR 570.513 - Lump sum drawdown for financing of property rehabilitation activities.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... the parties, the terms and conditions on which CDBG funds are to be deposited and used or returned... and other benefits to be provided by the financial institution in return for the lump sum deposit, and... recipient may be required by HUD to return all or part of the deposited funds to the recipient's letter...

  16. On deriving lumped models for blood flow and pressure in the systemic arteries.

    PubMed

    Olufsen, Mette S; Nadim, Ali

    2004-06-01

    Windkessel and similar lumped models are often used to represent blood flow and pressure in systemic arteries. The windkessel model was originally developed by Stephen Hales (1733) and Otto Frank (1899) who used it to describe blood flow in the heart. In this paper we start with the onedimensional axisymmetric Navier-Stokes equations for time-dependent blood flow in a rigid vessel to derive lumped models relating flow and pressure. This is done through Laplace transform and its inversion via residue theory. Upon keeping contributions from one, two, or more residues, we derive lumped models of successively higher order. We focus on zeroth, first and second order models and relate them to electrical circuit analogs, in which current is equivalent to flow and voltage to pressure. By incorporating effects of compliance through addition of capacitors, windkessel and related lumped models are obtained. Our results show that given the radius of a blood vessel, it is possible to determine the order of the model that would be appropriate for analyzing the flow and pressure in that vessel. For instance, in small rigid vessels ( R < 0.2 cm) it is adequate to use Poiseuille's law to express the relation between flow and pressure, whereas for large vessels it might be necessary to incorporate spatial dependence by using a one-dimensional model accounting for axial variations. PMID:20369960

  17. 5 CFR 837.306 - Refund of lump-sum credit.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 5 Administrative Personnel 2 2011-01-01 2011-01-01 false Refund of lump-sum credit. 837.306 Section 837.306 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) REEMPLOYMENT OF ANNUITANTS Coverage and Contributions § 837.306 Refund of...

  18. 5 CFR 837.602 - Lump-sum payment of retirement deductions.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 5 Administrative Personnel 2 2011-01-01 2011-01-01 false Lump-sum payment of retirement deductions. 837.602 Section 837.602 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL... entitled under the provisions of 5 U.S.C. 8342(c) or 8424(d), as appropriate....

  19. 24 CFR 84.82 - Provisions applicable only to lump sum grants.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... and B of this part apply to lump sum grants. (a) Financial and program management. Paragraphs (b) through (e) of this section prescribe standards for financial management systems, methods for making payments, budget revision approvals, and making audits. (b) Standards for financial management systems....

  20. 24 CFR 84.82 - Provisions applicable only to lump sum grants.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... and B of this part apply to lump sum grants. (a) Financial and program management. Paragraphs (b) through (e) of this section prescribe standards for financial management systems, methods for making payments, budget revision approvals, and making audits. (b) Standards for financial management systems....

  1. 24 CFR 84.82 - Provisions applicable only to lump sum grants.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... and B of this part apply to lump sum grants. (a) Financial and program management. Paragraphs (b) through (e) of this section prescribe standards for financial management systems, methods for making payments, budget revision approvals, and making audits. (b) Standards for financial management systems....

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

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... and B of this part apply to lump sum grants. (a) Financial and program management. Paragraphs (b) through (e) of this section prescribe standards for financial management systems, methods for making payments, budget revision approvals, and making audits. (b) Standards for financial management systems....

  3. 5 CFR 831.2005 - Designation of beneficiary for lump-sum payment.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Designation of beneficiary for lump-sum payment. 831.2005 Section 831.2005 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED.... (e) A change of beneficiary may be made at any time and without the knowledge or consent of...

  4. 24 CFR 570.513 - Lump sum drawdown for financing of property rehabilitation activities.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... the letter of credit in a lump sum to establish a rehabilitation fund in one or more private financial...) Rehabilitation staffing and management capacity during the period specified in the agreement to undertake... recipient's rehabilitation program administrative costs and the administrative costs of the...

  5. 24 CFR 570.513 - Lump sum drawdown for financing of property rehabilitation activities.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... property rehabilitation activities. 570.513 Section 570.513 Housing and Urban Development Regulations... rehabilitation activities. Subject to the conditions prescribed in this section, recipients may draw funds from the letter of credit in a lump sum to establish a rehabilitation fund in one or more private...

  6. 20 CFR 222.31 - Relationship as child for annuity and lump-sum payment purposes.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... by the employee's widow or widower after the employee's death); or (3) The equitably adopted child of... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false Relationship as child for annuity and lump... UNDER THE RAILROAD RETIREMENT ACT FAMILY RELATIONSHIPS Relationship as Child § 222.31 Relationship...

  7. School-Based Management: The Advantages of Lump-Sum Transfers.

    ERIC Educational Resources Information Center

    Neal, Richard G.

    1994-01-01

    Indicates the advantages under school-based management of transferring funds to the individual schools in a lump sum with minimal encumbrances, along with the freedom to transfer funds within the school budget. Transferring money to the schools, along with corresponding decision-making powers, enhances responsibility and accountability. (MLF)

  8. 5 CFR 838.1010 - Court orders or decrees preventing payment of lump sums.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Court orders or decrees preventing payment of lump sums. 838.1010 Section 838.1010 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT... Affecting Civil Service Retirement Benefits § 838.1010 Court orders or decrees preventing payment of...

  9. Long-Term CO2 Sorption on Upper Freeport Coal Powder and Lumps

    SciTech Connect

    Romanov, V; Soong, Y

    2008-03-01

    Powder and lumps of the Argonne Premium Upper Freeport coal were compared in a 9-month-long CO2 sorption-desorption study. On the basis of the slope analysis, CO2 induced the lumps swelling by 7%. The powder swelled by 8% and then rapidly shrank by 3% on desorption. This was verified by a "single point" injection of helium and the pressure-and-density technique, which was sufficiently sensitive. Low-pressure Langmuir-fit parameters suggest that the microporous textures of the powder and lumps are similar. The samples demonstrated greatly increased sticking coefficients and a slightly larger number of the "sorption ready" sites, after the CO2-induced swelling and structural rearrangement resulted in variable degrees of the matrix shrinkage. No permanent changes in the void volume and dry mass were detected after complete desorption. The observed hysteresis in sorption-desorption behavior of both samples upon the approach to the CO2 density fluctuation ridge is interpreted as a contribution of condensation and coalescence of CO2 clusters in mesopores. The differences between the two samples in the magnitude of the enhanced capillary condensation, with or without dissolution, demonstrate the importance of changes in mesoporous texture caused by grinding of coal lumps into powder.

  10. Long-Term CO2 Sorption on Upper Freeport Coal Powder and Lumps

    SciTech Connect

    Romanov, Vyacheslav; Soong, Yee

    2008-03-01

    Powder and lumps of the Argonne Premium Upper Freeport coal were compared in a 9-month-long CO2 sorption-desorption study. On the basis of the slope analysis, CO2 induced the lumps swelling by 7%. The powder swelled by 8% and then rapidly shrank by 3% on desorption. This was verified by a “single point” injection of helium and the pressure-and-density technique, which was sufficiently sensitive. Low-pressure Langmuir-fit parameters suggest that the microporous textures of the powder and lumps are similar. The samples demonstrated greatly increased sticking coefficients and a slightly larger number of the “sorption ready” sites, after the CO2-induced swelling and structural rearrangement resulted in variable degrees of the matrix shrinkage. No permanent changes in the void volume and dry mass were detected after complete desorption. The observed hysteresis in sorption-desorption behavior of both samples upon the approach to the CO2 density fluctuation ridge is interpreted as a contribution of condensation and coalescence of CO2 clusters in mesopores. The differences between the two samples in the magnitude of the enhanced capillary condensation, with or without dissolution, demonstrate the importance of changes in mesoporous texture caused by grinding of coal lumps into powder.

  11. Long-term CO{sub 2} sorption on Upper Freeport coal powder and lumps

    SciTech Connect

    Vyacheslav Romanov; Yee Soong

    2008-03-15

    Powder and lumps of the Argonne Premium Upper Freeport coal were compared in a 9-month-long CO{sub 2} sorption-desorption study. On the basis of the slope analysis, CO{sub 2} induced the lumps swelling by 7%. The powder swelled by 8% and then rapidly shrank by 3% on desorption. This was verified by a 'single point' injection of helium and the pressure-and-density technique, which was sufficiently sensitive. Low-pressure Langmuir-fit parameters suggest that the microporous textures of the powder and lumps are similar. The samples demonstrated greatly increased sticking coefficients and a slightly larger number of the 'sorption ready' sites, after the CO{sub 2}-induced swelling and structural rearrangement resulted in variable degrees of the matrix shrinkage. No permanent changes in the void volume and dry mass were detected after complete desorption. The observed hysteresis in sorption-desorption behavior of both samples upon the approach to the CO{sub 2} density fluctuation ridge is interpreted as a contribution of condensation and coalescence of CO{sub 2} clusters in mesopores. The differences between the two samples in the magnitude of the enhanced capillary condensation, with or without dissolution, demonstrate the importance of changes in mesoporous texture caused by grinding of coal lumps into powder. 15 refs., 2 figs., 2 tabs.

  12. 20 CFR 725.521 - Commutation of payments; lump sum awards.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 20 Employees' Benefits 4 2012-04-01 2012-04-01 false Commutation of payments; lump sum awards. 725.521 Section 725.521 Employees' Benefits OFFICE OF WORKERS' COMPENSATION PROGRAMS, DEPARTMENT OF LABOR FEDERAL COAL MINE HEALTH AND SAFETY ACT OF 1969, AS AMENDED CLAIMS FOR BENEFITS UNDER PART C OF TITLE IV OF THE FEDERAL MINE SAFETY AND HEALTH...

  13. Lumped Parameter Modeling for Rapid Vibration Response Prototyping and Test Correlation for Electronic Units

    NASA Technical Reports Server (NTRS)

    Van Dyke, Michael B.

    2013-01-01

    Present preliminary work using lumped parameter models to approximate dynamic response of electronic units to random vibration; Derive a general N-DOF model for application to electronic units; Illustrate parametric influence of model parameters; Implication of coupled dynamics for unit/board design; Demonstrate use of model to infer printed wiring board (PWB) dynamics from external chassis test measurement.

  14. 29 CFR Appendix C to Part 4022 - Lump Sum Interest Rates for Private-Sector Payments

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... List of CFR Sections Affected, which appears in the Finding Aids section of the printed volume and on... 29 Labor 9 2010-07-01 2010-07-01 false Lump Sum Interest Rates for Private-Sector Payments C Appendix C to Part 4022 Labor Regulations Relating to Labor (Continued) PENSION BENEFIT...

  15. Awareness that early cancer lump is painless could decrease breast cancer mortality in developing countries.

    PubMed

    Garg, Pankaj

    2016-06-10

    There are several factors which contribute to patients' reporting late to healthcare facility even after detecting the breast lump (patient delay). Amongst these, one of the important factors in low- and middle-income countries is lack of awareness that early cancer lump is painless (ECLIPs). Pain is often taken as a danger sign and absence of pain is often not taken seriously. The studies have shown that up to 98% of women in low-income countries are unaware that a painless lump could be a warning sign of early breast cancer. This fact is significant because this could be one of the prime reasons for the women having discovered a painless lump in the breast, accidentally or by breast self-examination, presume it to be harmless and don't report early to health care facility. Therefore, creating awareness about ECLIPs could be an effective strategy to reduce mortality due to breast cancer in low- and middle-income countries. Moreover, unlike modifying risk factors which requires long term behavior modification, creating awareness about ECLIPs is easy and cost effective. PMID:27298772

  16. Awareness that early cancer lump is painless could decrease breast cancer mortality in developing countries

    PubMed Central

    Garg, Pankaj

    2016-01-01

    There are several factors which contribute to patients’ reporting late to healthcare facility even after detecting the breast lump (patient delay). Amongst these, one of the important factors in low- and middle-income countries is lack of awareness that early cancer lump is painless (ECLIPs). Pain is often taken as a danger sign and absence of pain is often not taken seriously. The studies have shown that up to 98% of women in low-income countries are unaware that a painless lump could be a warning sign of early breast cancer. This fact is significant because this could be one of the prime reasons for the women having discovered a painless lump in the breast, accidentally or by breast self-examination, presume it to be harmless and don’t report early to health care facility. Therefore, creating awareness about ECLIPs could be an effective strategy to reduce mortality due to breast cancer in low- and middle-income countries. Moreover, unlike modifying risk factors which requires long term behavior modification, creating awareness about ECLIPs is easy and cost effective. PMID:27298772

  17. Asymptotic and numerical analysis of free surface flows: Lump solitons and wave turbulence

    NASA Astrophysics Data System (ADS)

    Berger, Kurt Michael

    Three-dimensional solitary waves or lump solitons are known to be solutions to the Kadomtsev-Petviashvili I (KP-I) equation, which models small-amplitude shallow-water waves when the Bond number is greater than ⅓. Recently, Pego and Quintero presented a proof of the existence of such waves for the Benney-Luke equation with surface tension. Here we establish an explicit connection between the lump solitons of these two equations and numerically compute the Benney-Luke lump solitons and their speed-amplitude relation. Furthermore, we numerically collide two Benney-Luke lump solitons to illustrate their soliton wave character. Finally, we study the flow over an obstacle near the linear shallow-water speed and show that three-dimensional lump solitons are periodically generated. In the second part of this dissertation, our goal is to study, numerically, the statistics of a large number of interacting finite-depth gravity surface waves. The weak- or wave-turbulence problem consists of finding statistical states with constant flux of energy in wavenumber space. These states are obtained by forcing and dissipating the conservative water wave problem at disparate scales and predicting the spectrum, often as a Kolmogorov-like power law, at intermediate scales. Majda, McLaughlin, and Tabak started the numerical investigation of the predictions of weak turbulence theory using a nonlinear dispersive NLS model equation. Here we investigate wave turbulence in a manner similar to Majda et al, but for an equation modeling gravity water waves, which is the original context in which the problem was posed. We perform long time computations on the one-dimensional, finite-depth Benney-Luke equation and compute various statistical quantities of interest. To validate this model, we first show, analytically and numerically, that Benney-Luke equations correctly predict the main deterministic aspects of resonant gravity wave interactions: resonant quartets, Benjamin-Feir type wave

  18. Assessment of health risks due to arsenic from iron ore lumps in a beach setting.

    PubMed

    Swartjes, Frank A; Janssen, Paul J C M

    2016-09-01

    In 2011, an artificial hook-shaped peninsula of 128ha beach area was created along the Dutch coast, containing thousands of iron ore lumps, which include arsenic from natural origin. Elemental arsenic and inorganic arsenic induce a range of toxicological effects and has been classified as proven human carcinogens. The combination of easy access to the beach and the presence of arsenic raised concern about possible human health effects by the local authorities. The objective of this study is therefore to investigate human health risks from the presence of arsenic-containing iron ore lumps in a beach setting. The exposure scenarios underlying the human health-based risk limits for contaminated land in The Netherlands, based on soil material ingestion and a residential setting, are not appropriate. Two specific exposure scenarios related to the playing with iron ore lumps on the beach ('sandcastle building') are developed on the basis of expert judgement, relating to children in the age of 2 to 12years, i.e., a worst case exposure scenario and a precautionary scenario. Subsequently, exposure is calculated by the quantification of the following factors: hand loading, soil-mouth transfer effectivity, hand-mouth contact frequency, contact surface, body weight and the relative oral bioavailability factor. By lack of consensus on a universal reference dose for arsenic for use in the stage of risk characterization, three different types of assessments have been evaluated: on the basis of the current Provisional Tolerable Daily Intake (PTWI), on the basis of the Benchmark Dose Lower limit (BMDL), and by a comparison of exposure from the iron ore lumps with background exposure. It is concluded, certainly from the perspective of the conservative exposure assessment, that unacceptable human health risks due to exposure to arsenic from the iron ore lumps are unlikely and there is no need for risk management actions. PMID:27145491

  19. [Surgery of benign vocal fold lesions].

    PubMed

    Olthoff, A

    2016-09-01

    Surgical treatment of benign vocal fold lesions can be indicated for clinical or functional reasons. The principles of phonosurgery have to be maintained in either case. The appropriate phonosurgical technique depends on the type of vocal fold lesion. Depending on the findings, phonosurgery aims to maintain or improve voice quality. The evaluation of clinical and functional results includes indirect laryngoscopy, videostroboscopy, and voice analysis. PMID:27552826

  20. A benign maxillary tumour with malignant features.

    PubMed

    Ricalde, Rosario R; Lim, Aimee Caroline E; Lopa, Ramon Antonio B; Carnate, Jose M

    2010-06-01

    Non-specific biopsy results such as chronic inflammation, hemorrhage, necrosis can be frustrating to the clinician. This is especially true if the patient presents with clinical features suggestive of an aggressive tumour. This is a review of the clinical features, diagnostic dilemmas and surgical management of a benign maxillary mass with malignant features - a disease called hematoma-like mass of the maxillary sinus (HLMMS). Our experience with five cases will also be cited. PMID:20502750

  1. Large Penile Mass With Unusual Benign Histopathology.

    PubMed

    Johnson, Nate; Voznesensky, Maria; VerLee, Graham

    2015-09-01

    Pseudoepitheliomatous hyperplasia is an extremely rare condition presenting as a lesion on the glans penis in older men. Physical exam without biopsy cannot differentiate malignant from nonmalignant growth. We report a case of large penile mass in an elderly male with a history of lichen sclerosis, highly suspicious for malignancy. Subsequent surgical removal and biopsy demonstrated pseudoepitheliomatous hyperplasia, an unusual benign histopathologic diagnosis with unclear prognosis. We review the literature and discuss options for treatment and surveillance. PMID:26793536

  2. Benign Diseases and Neoplasms of the Penis.

    PubMed

    Wasco, Matthew J; Shah, Rajal B

    2009-03-01

    This article provides comprehensive review of benign diseases and neoplastic conditions of the penis. It describes and provides representative images of clinical, key pathologic features and ancillary techniques to aid in differential diagnoses. It examines these diseases from the epidemiologic standpoint, looks at environmental and genetic factors, and outlines the new histologic entities for penile neoplasms with distinct outcomes and clinical behavior that have been proposed in recent years. PMID:26838101

  3. Benign prostatic hyperplasia: A clinical review.

    PubMed

    Skinder, Danielle; Zacharia, Ilana; Studin, Jillian; Covino, Jean

    2016-08-01

    Benign prostatic hyperplasia (BPH) is an increasingly common diagnosis seen in men over age 50 years. Primary care providers must be aware of patient presentation, diagnostic tests, appropriate lifestyle modifications, treatment options, and potential complications in order to properly manage and educate patients with BPH. If left untreated, BPH can significantly decrease a man's quality of life; however, many pharmacologic and surgical treatments are available to control the symptoms. PMID:27367595

  4. Incidence of pain after inguinal hernia repair in the elderly. A retrospective historical cohort evaluation of 18-years’ experience with a mesh & plug inguinal hernia repair method on about 3000 patients

    PubMed Central

    2013-01-01

    Background Chronic pain after prosthetic inguinal hernioplasty is one of the most important current issues in the current literature debate. Mechanisms related to pain development are only partially known. Influence of age as well as other factors is still unclear. The aim of this work was to evaluate whether development of chronic pain after open prosthetic plug and mesh inguinal hernioplasty is influenced by age. Methods Analysis was retrospectively conducted, dividing our cohort of patients (2,902) who had undergone prosthetic open plug&mesh inguinal hernioplasty from Jannuary 1994 to May 2012, following only the age criterion (cut-off 65 yrs.), into two groups (Gr.A<65 yrs, Gr.B>65 yrs.). All patients were routinely submitted to a postoperative questionnaire. Complications such as analgesic assumption were registered in both groups. Pain intensity was classified following the Visual Analogic Scale (VAS). Incidence of chronic pain, discomfort, and numbness, was assessed in both groups. Statistical significance was assessed by X2-test. Results Only 0.2% of patients suffered from a recurrence in our cohort. Postoperative chronic pain was observed in Gr. A in 0.12% of patients vs Gr.B 0.09% (p>0.05). Incidence of other postoperative symptoms such as discomfort or numbness were slightly prevalent on young patients (respectively p = 0.0286 and p = 0.01), while for hyperesthesia and sensation of foreign body no statistically significant difference of incidence between groups was observed. Conclusions Real chronic pain after inguinal hernioplasty is a rare clinical entity. Other causes of chronic pain should be accurately researched and excluded. In young patients psychological factors seem to show a slight influence. There was no influence of age on chronic postoperative pain incidence after inguinal hernioplasty. PMID:24268023

  5. Novel retrograde puncture method to establish preperitoneal space for laparoscopic direct inguinal hernia repair with internal ring suturing

    PubMed Central

    Jiang, H.; Ma, R.; Zhang, X.

    2016-01-01

    The aim of this study was to explore the clinical efficacy of a novel retrograde puncture approach to establish a preperitoneal space for laparoscopic direct inguinal hernia repair with inguinal ring suturing. Forty-two patients who underwent laparoscopic inguinal hernia repair with retrograde puncture for preperitoneal space establishment as well as inguinal ring suturing between August 2013 and March 2014 at our hospital were enrolled. Preperitoneal space was successfully established in all patients, with a mean establishment time of 6 min. Laparoscopic repairs were successful in all patients, with a mean surgical time of 26±15.1 min. Mean postoperative hospitalization duration was 3.0±0.7 days. Two patients suffered from postoperative local hematomas, which were relieved after puncturing and drainage. Four patients had short-term local pain. There were no cases of chronic pain. Patients were followed up for 6 months to 1 year, and no recurrence was observed. Our results demonstrate that preperitoneal space established by the retrograde puncture technique can be successfully used in adult laparoscopic hernioplasty to avoid intraoperative mesh fixation, and thus reduce medical costs. PMID:27191609

  6. Complete transection of the urethra and corpora cavernosa: a complication after laparoscopic repair (TEP) of an inguinal hernia.

    PubMed

    Rehme, C; Rübben, H; Heß, J

    2016-06-01

    Complete transection of both corpora cavernosa and the urethra is a very rare condition in urology. We report the case of a 59-year-old man with complete transection of the corpora cavernosa and the urethra during a laparoscopic repair of a recurrent inguinal hernia. PMID:25943096

  7. Efficacy of ultrasound-guided transversus abdominis plane block for postoperative analgesia in patients undergoing inguinal hernia repair

    PubMed Central

    Venkatraman, Rajagopalan; Abhinaya, Ranganathan Jothi; Sakthivel, Ayyanar; Sivarajan, Govindarajan

    2016-01-01

    Background and aim Transversus abdominis plane block (TAP block) is a novel procedure to provide postoperative analgesia following inguinal hernia surgery. The utilization of ultrasound has greatly augmented the success rate of this block and additionally avoiding complications. The aim of our study was to gauge the analgesic efficacy of ultrasound-guided TAP block in patients undergoing unilateral inguinal hernia repair. Materials and methods Sixty patients scheduled for elective inguinal hernia repair were selected for the study. At the end of the surgical procedure, they were randomly divided into two groups. Ultrasound-guided TAP block was performed with 20 mL of ropivacaine 0.2% (group A) or normal saline (group B). Visual analog scale (VAS) scores were used to assess pain. Paracetamol was given if VAS > 3 and tramadol was used when VAS > 6. Patients were monitored for VAS scores and total analgesic consumption for the 24-hour period. Results The TAP block with ropivacaine (group A) reduced VAS scores at 4, 6, and 12 hours. There was no distinction in VAS scores at 0, 2, and 24 hours between the two groups. The duration of analgesia for TAP block with ropivacaine lasted for 390 minutes. Total analgesics consumption was also significantly reduced in group A than group B. No complication was reported to TAP block in both the groups. Conclusion The ultrasound-guided TAP block provides good postoperative analgesia, reduces analgesic requirements, and provides good VAS scores with fewer complications following inguinal hernia surgery. PMID:26848274

  8. Environmentally benign silicon solar cell manufacturing

    SciTech Connect

    Tsuo, Y.S.; Gee, J.M.; Menna, P.; Strebkov, D.S.; Pinov, A.; Zadde, V.

    1998-09-01

    The manufacturing of silicon devices--from polysilicon production, crystal growth, ingot slicing, wafer cleaning, device processing, to encapsulation--requires many steps that are energy intensive and use large amounts of water and toxic chemicals. In the past two years, the silicon integrated-circuit (IC) industry has initiated several programs to promote environmentally benign manufacturing, i.e., manufacturing practices that recover, recycle, and reuse materials resources with a minimal consumption of energy. Crystalline-silicon solar photovoltaic (PV) modules, which accounted for 87% of the worldwide module shipments in 1997, are large-area devices with many manufacturing steps similar to those used in the IC industry. Obviously, there are significant opportunities for the PV industry to implement more environmentally benign manufacturing approaches. Such approaches often have the potential for significant cost reduction by reducing energy use and/or the purchase volume of new chemicals and by cutting the amount of used chemicals that must be discarded. This paper will review recent accomplishments of the IC industry initiatives and discuss new processes for environmentally benign silicon solar-cell manufacturing.

  9. Comparison of Positron Emission Tomography Scanning and Sentinel Node Biopsy in the Detection of Inguinal Node Metastases in Patients With Anal Cancer

    SciTech Connect

    Mistrangelo, Massimiliano; Pelosi, Ettore; Bello, Marilena; Castellano, Isabella; Cassoni, Paola; Ricardi, Umberto; Munoz, Fernando; Racca, Patrizia; Contu, Viviana; Beltramo, Giancarlo; Morino, Mario; Mussa, Antonio

    2010-05-01

    Background: Inguinal lymph node metastases in patients with anal cancer are an independent prognostic factor for local failure and overall mortality. Inguinal lymph node status can be adequately assessed with sentinel node biopsy, and the radiotherapy strategy can subsequently be changed. We compared this technique vs. dedicated 18F-fluorodeoxyglucose positron emission tomography (PET) to determine which was the better tool for staging inguinal lymph nodes. Methods and Materials: In our department, 27 patients (9 men and 18 women) underwent both inguinal sentinel node biopsy and PET-CT. PET-CT was performed before treatment and then at 1 and 3 months after treatment. Results: PET-CT scans detected no inguinal metastases in 20 of 27 patients and metastases in the remaining 7. Histologic analysis of the sentinel lymph node detected metastases in only three patients (four PET-CT false positives). HIV status was not found to influence the results. None of the patients negative at sentinel node biopsy developed metastases during the follow-up period. PET-CT had a sensitivity of 100%, with a negative predictive value of 100%. Owing to the high number of false positives, PET-CT specificity was 83%, and positive predictive value was 43%. Conclusions: In this series of patients with anal cancer, inguinal sentinel node biopsy was superior to PET-CT for staging inguinal lymph nodes.

  10. [Dramatic response of penile cancer with inguinal lymph node metastases to neoadjuvant chemotherapy with paclitaxel, ifosfamide and cisplatin : a case report].

    PubMed

    Kubota, Yasuaki; Nakano, Masahiro; Nagai, Shingo; Matsuoka, Kae; Arakawa, Hirotaka; Horie, Kengo; Deguchi, Takashi; Kato, Hisakazu

    2015-01-01

    Carcinoma of the penis is rare, and the prognosis of penile cancer with inguinal metastases is extremely poor. Standard chemotherapy for advanced penile cancer has not been established because of its rarity. A case of penile cancer with inguinal metastases that responded well to neoadjuvant chemotherapy with paclitaxel, ifosfamide and cisplatin (TIP) is described. A 55-year-old Japanese male visited our hospital for a penile tumor and fixed, 4 cm, right inguinal lymph nodes. Computed tomography and 18F-FDG-PET imaging showed not only right but also left inguinal lymphadenopathy. Penile cancer (clinical stage T3N3M0, 7th edition TNM classification) was diagnosed, and partial penectomy and right inguinal biopsy were performed. The pathological examination revealed squamous cell carcinoma of the penis with right inguinal lymph node metastasis. The inguinal metastases were judged to be unsuitable for radical resection ; and, paclitaxel 60 mg/m2 (day 1), ifosfamide 1,200 mg/m2 (days 1-3), and cisplatin 60 mg/m2 (days 1-3) were given at 3-week intervals as neoadjuvant chemotherapy. After 4 courses of chemotherapy, the inguinal metastases were markedly reduced. He had neutropenia (grade 3) during each course and peripheral neuropathy after 2 courses, but there were no severe complications. The patient underwent bilateral inguinal and pelvic lymphadenectomy after neoadjuvant chemotherapy. Pathological examination revealed no viable cells in the resected specimens. The patient remains alive and well with no evidence of recurrence 8 months after this radical treatment. TIP chemotherapy appears to be effective for advanced penile cancer. PMID:25656018

  11. Inguinal Orchiectomy

    MedlinePlus

    ... Thank you very much!" and take the pathology report to a medical oncologist for a second opinion. In fact, depending on the results, you might even want to get a second opinion on the pathology report. This is particularly important for people who have ...

  12. Inguinal Hernia

    MedlinePlus

    ... Griffin Rodgers, Director of the NIDDK Clinical Trials Current research studies and how you can volunteer Community Outreach and Health Fairs Science-based information and tips for planning an outreach effort or community event For Health Care Professionals Patient and provider resources ...

  13. Inguinal Hernia

    MedlinePlus

    ... Health Issues Conditions Abdominal ADHD Allergies & Asthma Autism Cancer Chest & Lungs Chronic Conditions Cleft & Craniofacial Developmental Disabilities Ear Nose & Throat Emotional Problems Eyes Fever From Insects or Animals Genitals and Urinary Tract Glands & Growth ...

  14. Inguinal Hernia

    MedlinePlus

    ... Tips for applicants; human subjects research information; grant review and management resources; and commonly used funding mechanisms, including diversity and small business programs Research Programs & Contacts Research program and staff ...

  15. 20 CFR 404.392 - Who is entitled to the lump-sum death payment when there is no widow(er) who was living in the...

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Who is entitled to the lump-sum death payment...-Age, Disability, Dependents' and Survivors' Insurance Benefits; Period of Disability Lump-Sum Death Payment § 404.392 Who is entitled to the lump-sum death payment when there is no widow(er) who was...

  16. Microsurgical inguinal varicocelectomy with delivery of the testis: an artery and lymphatic sparing technique.

    PubMed

    Goldstein, M; Gilbert, B R; Dicker, A P; Dwosh, J; Gnecco, C

    1992-12-01

    Conventional techniques of varicocele repair are associated with substantial risks of hydrocele formation, ligation of the testicular artery, and varicocele recurrence. We describe a microsurgical technique of varicocelectomy that significantly lowers the incidence of these complications. The testicle is delivered through a 2 to 3 cm. inguinal incision, and all external spermatic and gubernacular veins are ligated. The testis is returned to the scrotum and the spermatic cord is dissected under the operating microscope. The testicular artery and lymphatics are identified and preserved. All internal spermatic veins are doubly ligated with small hemoclips or 4-zero silk and divided. The vas deferens and its vessels are preserved. Initially, we performed 33 conventional inguinal varicocelectomies in 24 men without delivery of the testis or use of a microscope. Postoperatively, 3 unilateral hydroceles (9%) and 3 unilateral recurrences (9%) were detected. For the next 12 cases 2.5x loupes were used resulting in no hydroceles but another recurrence (8%). We then performed 640 varicocelectomies in 429 men using the microsurgical technique with delivery of the testis. Among 382 men available for followup examination from 6 months to 7 years postoperatively no hydroceles and no cases of testicular atrophy were found. A total of 4 unilateral recurrent varicoceles (0.6%) was identified. The differences between the techniques in the incidence of hydrocele formation and varicocele recurrence are highly significant (p < 0.001). No wound infections occurred in any men. Four scrotal hematomas (0.6%), 1 of which required surgical drainage, occurred in the group with microsurgical ligation and delivery of the testis compared to none with the conventional technique. Preoperative and postoperative semen analyses (mean 3.57 analyses per patient) were obtained on 271 men. The changes in sperm count x 10(6) cc (36.9 to 46.8, p < 0.001), per cent motility (39.6 to 45.7%, p < 0.001) and per

  17. TIPP and Lichtenstein modalities for inguinal hernia repair: a cost minimisation analysis alongside a randomised trial.

    PubMed

    Koning, G G; Adang, E M M; Stalmeier, P F M; Keus, F; Vriens, P W H E; van Laarhoven, C J H M

    2013-12-01

    The transinguinal preperitoneal (TIPP) technique using a soft mesh with a memory ring was developed recently for inguinal hernia repair. To compare TIPP with the Lichtenstein method, a randomised trial was conducted (ISRCTN93798494). The aim of this study was to perform an economic evaluation of the TIPP modality compared to the Lichtenstein modality from both a hospital and societal perspective alongside the clinical trial. The TULIP study was a double-blind randomised clinical trial comparing two techniques for inguinal hernia repair (TIPP and Lichtenstein). Correct generation of the allocation sequence, allocation concealment, blinding, and follow-up were used/applied according to the recommendations of the Cochrane Handbook. Next to the cost drivers, the short-form-36 health survey (SF-36) data from the TULIP trial was used to determine utility. The SF-36 data from the TULIP trial were revised using the SF-6D algorithm according to Brazier. Two scenarios-a hospital and a societal perspective-were presented. If the analyses showed no difference in effects (on the SF-6D) the cost effectiveness decision rule to cost minimisation was altered. No significant difference in SF-6D utility between both modalities was found (mean difference: 0.888, 95% CI -1.02 to 1.23); consequently, the economic decision rule became cost minimisation. For the hospital perspective no significant differences in costs were found (mean difference: euro -13, 95% CI euro -130 to euro 104). However, when including productivity gains in the analysis, significant differences (P = 0.037) in costs favouring the TIPP modality (mean saving: euro 1,472, 95% CI euro 463- euro 2,714) were found. The results show that TIPP is a cost-saving inguinal hernia repair technique compared to the Lichtenstein modality against equal effectiveness expressed as quality adjusted life week at 1 year given a societal perspective. In the trial, TIPP patients showed on average a quicker recovery of 6.5 days compared to

  18. LUMPED Unsteady: a Visual Basic ® code of unsteady-state lumped-parameter models for mean residence time analyses of groundwater systems

    NASA Astrophysics Data System (ADS)

    Ozyurt, N. Nur; Bayari, C. Serdar

    2005-04-01

    A Microsoft ® Visual Basic 6.0 (Microsoft Corporation, 1987-1998) code of 9 lumped-parameter models of unsteady flow is presented for the analysis of mean residence time in aquifers. Groundwater flow systems obeying plug and well-mixed flow models and their combinations in parallel or serial connection can be simulated by the code. Models can use tritium, tritiugenic He-3, oxygen-18, deuterium, krypton-85, chlorofluorocarbons (CFC-11, CFC-12 and CFC-113) and sulfur hexafluoride (SF 6) as the environmental tracers. The executable code runs under all 32-bit Windows operating systems. Details of the code are explained and its limitations are indicated.

  19. Rarity in conspicuity—Ultrasound diagnosis of sliding left inguinal hernia through canal of Nuck with uterus, fallopian tubes and ovaries

    PubMed Central

    Muthiyal, Sreekumar; Kini, Vishwanatha; Kounsal, Avin; Ibrahim, Ashraf Abdelhamid

    2016-01-01

    We present a case of a one month old female infant who presented with left inguinal swelling. She was prematurely born at 32 weeks of gestational age. Preoperative ultrasound showed features of sliding indirect inguinal hernia with both ovaries, fallopian tubes and uterus; which were also evident per operatively. Patient underwent successful hernia repair and uneventful post-operative period. Patient is on follow up currently. In conclusion, we attempt to highlight the exiguous prevalence of inguinal hernia with uterus, fallopian tubes and ovaries; which has been sparsely reported in the literature and also the importance of preoperative of sonography. PMID:27069977

  20. Utilization of Coke Oven Gas and Converter Gas in the Direct Reduction of Lump Iron Ore

    NASA Astrophysics Data System (ADS)

    Mousa, Elsayed Abdelhady; Babich, Alexander; Senk, Dieter

    2014-04-01

    The application of off-gases from the integrated steel plant for the direct reduction of lump iron ore could decrease not only the total production cost but also the energy consumption and CO2 emissions. The current study investigates the efficiency of reformed coke oven gas (RCOG), original coke oven gas (OCOG), and coke oven gas/basic oxygen furnace gas mixtures (RCOG/BOFG and OCOG/BOFG) in the direct reduction of lump iron ore. The results were compared to that of reformed natural gas (RNG), which is already applied in the commercial direct reduction processes. The reduction of lump ore was carried out at temperatures in the range of 1073 K to 1323 K (800 °C to 1050 °C) to simulate the reduction zone in direct reduction processes. Reflected light microscopy, scanning electron microscopy, and X-ray diffraction analysis were used to characterize the microstructure and the developed phases in the original and reduced lump iron ore. The rate-controlling mechanism of the reduced lump ore was predicted from the calculation of apparent activation energy and the examination of microstructure. At 1073 K to 1323 K (800 °C to 1050 °C), the reduction rate of lump ore was the highest in RCOG followed by OCOG. The reduction rate was found to decrease in the order RCOG > OCOG > RNG > OCOG-BOF > RCOG-BOFG at temperatures 1173 K to 1323 K (900 °C to 1050 °C). The developed fayalite (Fe2SiO4), which resulted from the reaction between wüstite and silica, had a significant effect on the reduction process. The reduction rate was increased as H2 content in the applied gas mixtures increased. The rate-determining step was mainly interfacial chemical reaction with limitation by gaseous diffusion at both initial (20 pct reduction) and moderate (60 pct reduction) stages of reduction. The solid-state diffusion mechanism affected the reduction rate only at moderate stages of reduction.

  1. Experience with 300 laparoscopic inguinal hernia repairs with up to 3 years follow-up.

    PubMed Central

    Davies, N. M.; Dunn, D. C.; Appleton, B.; Bevington, E.

    1995-01-01

    The long-term results of 300 laparoscopic inguinal hernia repairs are reported with 11 cases followed up more than 3 years, 104 cases more than 2 years, and 225 cases more than 1 year. There were five early failures owing to the use of too small a piece of mesh. There have been no long-term recurrences. The results indicate that transabdominal preperitoneal laparoscopic mesh repair of hernias is a satisfactory technique with a low recurrence rate and a low major complication rate (4%). Patients have found the procedure to be remarkably pain free and 51% have taken no analgesics after discharge from hospital. Of the patients, 78% returned to work within 2 weeks of the operation. These results suggest that laparoscopic hernia repair can be performed safely with excellent long-term results. PMID:8540657

  2. Epidural anaesthesia through caudal catheters for inguinal herniotomies in awake ex-premature babies.

    PubMed

    Peutrell, J M; Hughes, D G

    1993-02-01

    Ex-premature babies are at risk of apnoea after surgery. Regional anaesthesia has been used as an alternative to general anaesthesia for some surgical procedures in the belief that it may be safer. However, single dose caudal epidural and subarachnoid anaesthetics have a duration of action which may be insufficient for some operations. The level and duration of anaesthesia can be extended if local anaesthetic is given through an epidural catheter. In addition, the dose needed to provide adequate anaesthesia may be lower because the local anaesthetic is given at an appropriate segmental level. We report our experience of caudal epidural anaesthesia in nine, awake ex-premature babies who were having inguinal herniotomies. The anaesthesia was excellent in six babies. Two babies cried briefly with peritoneal or spermatic cord traction. One other baby needed supplementation with nitrous oxide in oxygen in order to complete the surgery. The majority of babies slept throughout surgery. There were no reported postoperative complications. PMID:8460759

  3. Primary subcutaneous inguinal hydatid cyst: diagnosis by fine needle aspiration cytology.

    PubMed

    Bagga, Permeet Kaur; Bhargava, Satish Kumar; Aggarwal, Neema; Chander, Yogesh

    2014-08-01

    Hydatid disease or human cystic echinococcosis, recognized by ancient scholars such as Hippocrates, Galen and Rhazes, is one of the oldest diseases known to man. Though hydatid cyst may develop in almost any part of the body, a solitary primary subcutaneous localization is an extremely rare entity. We herein report a case of primary subcutaneous inguinal hydatid cyst which was diagnosed by fine needle aspiration cytology. Radiological examination done subsequently corroborated with the cytodiagnosis of Hydatid cyst and did not show involvement of any other organ or site. Histopathological examination of surgically removed cyst confirmed the diagnosis of Hydatid cyst. Hydatid disease should be considered in the differential diagnosis of all unusual swellings in soft tissues, especially in regions where the disease is endemic. PMID:25302206

  4. [Bursitis iliopectinea--a rare differential diagnosis of painful inguinal swelling].

    PubMed

    Gresser, J; Bitz, K; Binswanger, R; Hegglin, J

    1992-08-01

    The syndrome of iliopectineal bursitis is an important differential diagnosis of a painful swelling in the inguinal region. Symptoms are local swelling and pain, radiation of pain along the femoral nerve, troubles of arterial or venous circulation and even dysuria or dysmenorrhoea in case the bursa penetrates into the pelvis. The diagnosis is established by conventional radiology (signs of osteoarthritis as one of the pathogenetic reasons), ultrasound (liquid mass lateral to the femoral vessels), punction (clear fluid, eventually synovial cells), contrast injection (dimension of the bursa and communication to the hip joint) and computed tomography (dimension, relation to hip and vessels). The treatment is the excision of the bursa, if conservative therapy is not successful. The excision requires tedious, cautious dissection because of the important structures adjacent and a possible communication to the hip joint must be eradicated. PMID:1428931

  5. Magnesium Versus Bupivacaine Infiltration in Controlling Postoperative Pain in Inguinal Hernia Repair

    PubMed Central

    Razavi, Seyed Sajad; Peyvandi, Hasan; Badrkhani Jam, Ali Reza; Safari, Farhad; Teymourian, Houman; Mohajerani, Seyed Amir

    2015-01-01

    Background: Postoperative pain is one of the most common problems after hernia repair. Decrease in postoperative pain accelerates functional recovery, decreases duration of hospital stay and postoperative morbidity. Objectives: To compare postoperative analgesic effect of infiltration of magnesium versus bupivacaine into incision of inguinal hernia repair. Patients and Methods: In a double blind clinical trial, 80 patients’ candidates for elective inguinal hernia repair were enrolled. Right before closure of incision, in Bupivacaine group 5 mL Bupivacaine 0.5% added to 5 mL normal saline and in Magnesium group, 10 mL Magnesium sulfate 20% was infused subcutaneously. Pain score was measured using numeric rating score (NRS) at 1, 3, 6, 12 and 24 hours postoperatively. If NRS was above 3, 1 mg morphine was administered as rescue analgesic until patient felt comfortable or NRS < 3. Results: Postoperative pain scores at 1 and 3 hours were not significantly different between bupivacaine and magnesium groups (P = 0.21, 0.224; respectively). However, at 6 (P = 0.003), 12 (P = 0.028) and 24 (P = 0.022) hours postoperative, pain score (NRS) was significantly lower in bupivacaine group. Number of patients needed at least 1 dose of rescue morphine (P = 0.001), mean number of episodes asked for morphine during next 24 hours (P = 0.001) and total dose of morphine requirement (P = 0.01) were significantly lower in bupivacaine group. Conclusions: Magnesium infiltration did not decrease total dose and number of episodes needed for morphine rescue analgesic. Bupivacaine infiltration into surgical site was more effective than magnesium sulfate infiltration in postoperative pain control. PMID:26705525

  6. Immunological reaction and oxidative stress after light or heavy polypropylene mesh implantation in inguinal hernioplasty

    PubMed Central

    Donati, Marcello; Brancato, Giovanna; Grosso, Giuseppe; Li Volti, Giovanni; La Camera, Giuseppina; Cardì, Francesco; Basile, Francesco; Donati, Angelo

    2016-01-01

    Abstract The relationship between mesh weight and host tissue reaction has, so far, not been fully investigated. Lightweight meshes (LWM) are thought to give less inflammatory response compared with heavyweight meshes (HWM). The present study is a randomized, controlled, double-blind clinical trial performed in 61 patients who underwent an elective inguinal hernioplasty. The primary outcome of the study was to investigate the relationship between total amount of prosthetic material (polypropylene), immunological reaction, and oxidative stress. The study was double-blinded. Sixty-one patients were recruited for the study and randomly assigned to 2 groups (groups A and B). Levels of inflammation markers (interleukin-6 [IL-6] and tumor necrosis factor-α [TNF-α]) and oxidative stress markers (reduced glutathione [GSH] and lipid hydroperoxides [LOOH]) were determined preoperatively and after undergoing inguinal hernioplasty (after 6, 72, and 288 hours), respectively, with LWM and HWM. There was no significant difference in IL-6 levels between HWM and LWM (P = 0.3, 0.7, 0.8 after 6, 72, and 288 hours, respectively). A statistically significant difference was found after 72 hours for TNF-α (P = 0.01), for GSH after 6 hours (P < 0.01), and after 6 and 72 hours for LOOH (P = 0.05, 0.01, respectively). Oxidative stress occurred at earlier time points and was pore accentuated HWM versus LWM and prodromal to TNF-α increase. Also, in randomized clinical trial, the use of LWM gives advantages in terms of less inflammatory response when compared with HWM. Moreover, there is a significant higher oxidative stress after implantation of HWM. The intensity of oxidative stress seems to be strongly related to the amount of implanted polypropylene. (Trial registration number: NCT01090284). PMID:27310955

  7. Incarcerated Inguinal Hernia Mesh Repair: Effect on Testicular Blood Flow and Sperm Autoimmunity.

    PubMed

    Krnić, Dragan; Družijanić, Nikica; Štula, Ivana; Čapkun, Vesna; Krnić, Duška

    2016-01-01

    BACKGROUND The aim of our study was to determine an influence of incarcerated inguinal hernia mesh repair on testicular circulation and to investigate consequent sperm autoimmunity as a possible reason for infertility. MATERIAL AND METHODS This prospective study was performed over a 3-year period, and 50 male patients were included; 25 of these patients underwent elective open mesh hernia repair (Group I). Group II consisted of 25 patients who had surgery for incarcerated inguinal hernia. Doppler ultrasound evaluation of the testicular blood flow and blood samplings for antisperm antibodies (ASA) was performed in all patients before the surgery, on the second day, and 5 months after. Main outcome ultrasound measures were resistive index (RI) and pulsative index (PI), as their values are inversely proportional to testicular blood flow. RESULTS In Group I, RI, and PI temporarily increased after surgery and then returned to basal values in the late postoperative period. Friedman analysis showed a significant difference in RI and PI for all measurements in Group II (p<0.05), with a significant decrease between the preoperative, early, and late postoperative periods. All final values were within reference range, including ASA, despite significant increase of ASA in the late postoperative period. CONCLUSIONS Although statistically significant differences in values of testicular flow parameters and immunologic sensitization in observed time, final values remained within the reference ranges in all patients. Our results suggest that the polypropylene mesh probably does not cause any clinically significant effect on testicular flow and immunologic response in both groups of patients. PMID:27149257

  8. Open preperitoneal versus anterior approach for recurrent inguinal hernia: a randomized study

    PubMed Central

    2012-01-01

    Background Inguinal herniorrhaphy remains one of the most common general surgical operations, with approximately 15% performed for recurrence. The repair of the resulting recurrent hernia is a daunting task because of already weakened tissues and obscured and distorted anatomy. The aim of this study is to compare the posterior preperitoneal versus anterior tension-free approach for repair of unilateral recurrent inguinal hernia regarding complications and early recurrence. Methods 120 Patients in this study were divided randomly into 2 main groups; Group A patients were subjected to posterior preperitoneal approach and those of group B were subjected to conventional anterior tension-free repair. The primary end point was recurrence and the secondary end points were time off from work, postoperative pain, scrotal swelling and wound infections. Results The mean hospital stay was 1.2 days and 4.7, the mean time to return work was 8.2 and 11.2 days and the mean time off from work was 9.4 and 15.9 days in group A and B respectively. The maximum follow-up period was 48 months and the minimum was 14 months with a mean value as 37.11 ± 5.14 months. Only 2 recurrences (3.3%) in group A and 4 cases (6.25%) in group B were seen. The final pain score per patient and the overall complication rate were higher in group B. Conclusions The open preperitoneal repair offers the advantages of low recurrence rate and allows covering all potential defects with one piece of mesh and is far superior to the anterior approach. Trial Registration ACTRN12611000337976 PMID:23110701

  9. Feasibility and Safety of Video Endoscopic Inguinal Lymphadenectomy in Vulvar Cancer: A Systematic Review

    PubMed Central

    Yao, De-Sheng

    2015-01-01

    Objective To systematically review previous studies and to evaluate the feasibility and safety of video endoscopic inguinal lymphadenectomy (VEIL) in vulvar cancer. Methods We conducted a comprehensive review of studies published through September 2014 to retrieve all relevant articles. The PubMed, EMBASE, Web of Science, Cochrane Library, Wan Fang Data and Chinese National Knowledge Infrastructure databases were systematically searched for all relevant studies published in English or Chinese through September 2014. Data were abstracted independently by two reviewers, and any differences were resolved by consensus. Results A total of 9 studies containing 249 VEIL procedures involving 138 patients were reviewed. Of the 249 VEIL procedures, only 1 (0.4%) was converted to an open procedure for suturing because of injury to the femoral vein. The range of operative time was 62 to 110 minutes, and the range of estimated blood loss was 5.5 to 22 ml. The range of the number of harvested lymph nodes was 7.3 to 16. The length of hospital stay varied from 7 to 13.6 days across reports. The incidence of lymph node metastasis was 19.7% (27/138), and the recurrence rate was 4.3% (3/70) within 3 to 41 months of follow-up. One or more short-term complications were documented in 18 of 138 (13.0%) patients. Complications after VEIL were observed in 14 (10.13%) patients and in 15 (6.0%) of the VEIL cases, including major lymphocyst formation in 9 (3.6%), lymphorrhea in 2 (0.8%), inguinal wound infection without wound breakdown in 3 (1.2%) and lymphedema in 1 (0.4%). Conclusions VEIL appears to be a feasible procedure in the management of vulvar cancer. There may be potential benefits that result in lower morbidity compared to traditional methods, but this has yet to be objectively proven. PMID:26496391

  10. Clarithromycin Culprit of Benign Intracranial Hypertension

    PubMed Central

    Khan, Habib Rehman; Mason, Colin; Mulcahy, Riona

    2015-01-01

    Benign intracranial hypertension is characterized with increase in CSF opening pressure with no specific etiology. It is predominantly found in women of child bearing age and particularly in individuals with obesity. Visual disturbances or loss and associated headaches are common and can lead to blindness if left untreated. Diagnosis can be achieved once other causes of visual loss, headaches and high opening pressures are excluded. Management consists of serial optic disc assessments although no specific treatment is available despite recent trials using carbonic anhydrase inhibitors. Diet modification and weight management can help in therapy. PMID:26713029

  11. OTC tamsulosin for benign prostatic hyperplasia.

    PubMed

    2010-10-01

    Earlier this year, tamsulosin, an alpha blocker previously only available on prescription, became available for sale by pharmacists as a treatment for functional symptoms of benign prostatic hyperplasia (BPH) in men aged 45-75 years (Flomax Relief MR - Boehringer Ingelheim). A television advert for the over-the-counter (OTC) product claims that it is a "simple and effective" treatment that can relieve symptoms within 1 week, allowing the user to "take control of your annoying pee problems".¹ Here we review the evidence on tamsulosin and assess whether its availability as an OTC product confers worthwhile advantages. PMID:20926447

  12. Thallium-201 uptake in a benign thymoma

    SciTech Connect

    Campeau, R.J.; Ey, E.H.; Varma, D.G.

    1986-07-01

    A 68-year-old woman was admitted with atypical angina. A chest radiograph showed an anterior mediastinal mass that was confirmed on CT. The mass was relatively avascular and separate from the heart and great vessels. She underwent stress thallium testing that demonstrated no exercise-induced ischemia; however, an abnormal focus of thallium activity was present in the anterior mediastinum on stress and redistribution images. Cardiac catheterization demonstrated a normal left ventriculogram, coronary arteries and thoracic aorta. Subsequent surgery and pathologic examination revealed the mass to be a benign thymoma arising in the right lobe of the thymus gland.

  13. Models for studying benign prostatic hyperplasia.

    PubMed

    Mahapokai, W; Van Sluijs, F J; Schalken, J A

    2000-07-01

    Benign prostatic hyperplasia (BPH) is one of the most common diseases affecting aging man. Attempts have been made to clarify the etiology and pathogenesis and, to that end, experimental models have been developed. To date, in vitro and in vivo models have been used, depending on the concept of the study. Spontaneous animal models are limited to the chimpanzee and the dog. Ethical and financial factors restrict the applicability of these models. The hormonal-induced canine BPH model is a good alternative that closely resembles human BPH in many aspects. The experimental models currently used for studying BPH are reviewed. Prostate Cancer and Prostatic Diseases (2000) 3, 28-33 PMID:12497158

  14. Benign schwannoma of the maxillary antrum

    PubMed Central

    Hegde, Oshin; Desai, Dinkar; Bhandarkar, Gowri P.; Paul, Tony

    2016-01-01

    Schwannoma also known commonly as neurilemmoma and schwann cell tumor is a benign nerve sheath tumor. About 1/3rd cases of schwannoma arise from the head and neck region but rarely from the nasal and paranasal sinuses. The recurrence rate in these cases has reported to be very rare. We report a rare case of schwannoma in a 60-year-old woman arising from the maxillary sinus further eroding the orbital floor and nasal bone. We have also described the clinical presentation, radiological, histological findings, and management of the case. PMID:27095911

  15. Endoscopic management of benign biliary strictures

    PubMed Central

    Visrodia, Kavel H; Tabibian, James H; Baron, Todd H

    2015-01-01

    Endoscopic management of biliary obstruction has evolved tremendously since the introduction of flexible fiberoptic endoscopes over 50 years ago. For the last several decades, endoscopic retrograde cholangiopancreatography (ERCP) has become established as the mainstay for definitively diagnosing and relieving biliary obstruction. In addition, and more recently, endoscopic ultrasonography (EUS) has gained increasing favor as an auxiliary diagnostic and therapeutic modality in facilitating decompression of the biliary tree. Here, we provide a review of the current and continually evolving role of gastrointestinal endoscopy, including both ERCP and EUS, in the management of biliary obstruction with a focus on benign biliary strictures. PMID:26322153

  16. Multiconductor Transmission-Line Theory That Includes an Antenna Process with a Lumped-Parameter Circuit

    NASA Astrophysics Data System (ADS)

    Toki, Hiroshi; Abe, Masayuki

    2016-03-01

    Electromagnetic noise was studied theoretically by developing a multiconductor transmission-line (MTL) theory derived from Maxwell’s equations without any approximations. The MTL theory naturally contains the antenna process, and for the case of three lines it is written in terms of normal, common, and antenna modes. Here we develop a theoretical method to solve the MTL equations by introducing boundary conditions consisting of a lumped-parameter circuit in order to describe the performance of any electric circuit for good performance without noise. The finite-difference time-domain (FDTD) method is a powerful algorithm to solve time-dependent coupled differential equations for a combined distributed- and lumped-parameter circuit.

  17. Boundary and midpoint behaviors of lump solutions in vacuum string field theory

    SciTech Connect

    Hata, Hiroyuki; Moriyama, Sanefumi

    2005-08-15

    We discuss various issues concerning the behaviors near the boundary ({sigma}=0,{pi}) and the midpoint ({sigma}={pi}/2) of the open string coordinate X({sigma}) and its conjugate momentum P({sigma})=-i{delta}/{delta}X({sigma}) acting on the matter projectors of vacuum string field theory. Our original interest is in the dynamical change of the boundary conditions of the open string coordinate from the Neumann one in the translationally invariant backgrounds to the Dirichlet one in the D-brane backgrounds. We find that the Dirichlet boundary condition is realized on a lump solution only partially and only when its parameter takes a special value. On the other hand, the string midpoint has a mysterious property: it obeys the Neumann (Dirichlet) condition in the translationally invariant (lump) background.

  18. Examination of Ventricular Contraction Function Using Electrical Lumped Circuit Model of Circulation System

    NASA Astrophysics Data System (ADS)

    Ito, Mitsuyo; Koya, Yoshiharu; Mizoshiri, Isao

    Presently, many of the already proposed blood circulation models are mainly partial models although they are precise models. A complete model that is a combination of these partial models are difficult to analyze because it is complicated to consider both the viscosity of blood and circulatory details at the same time. So, it is difficult to control the model parameters in order to adapt to various cases of circulatory diseases. This paper proposes a complete circulation model as a lumped electrical circuit, which is comparatively simple. In the circuit model, total blood is modeled as seven lumped capacitors, representing the functions of atriums, ventricles, arteries, veins and lungs. We regard the variation of the ventricle capacitance as the driving force of the complete circulation model. In our model, we considered only the variation of pressure between each part and the blood capacity of each part. In particular, the contraction function of the left ventricle is examined under the consideration of whole blood circulation.

  19. Travelling waves in boundary-controlled, non-uniform, cascaded lumped systems

    NASA Astrophysics Data System (ADS)

    O'Connor, William J.; Zhu, Ming

    2013-08-01

    A companion paper considers travelling and standing waves in cascaded, lumped, mass-spring systems, controlled by two boundary actuators, one at each end, when the system is uniform. It first proposes definitions of waves in finite lumped systems. It then shows how to control the actuators to establish desired waves from rest, and to maintain them despite disturbances. The present paper extends this work to the more general, non-uniform case, when mass and spring values can be arbitrary. A special "bi-uniform" case is first studied, consisting of two different uniform cascaded systems in series, with an obvious, uncontrolled, impedance mismatch where they meet. The paper shows how boundary actuator control systems can be designed to establish, and robustly maintain, apparently pure travelling waves of constant amplitude in either the first or the second uniform section, in each case with an appropriate, partial, standing wave pattern in the other section. Then a more general non-uniform case is studied. A definition of a "pure travelling wave" in non-uniform systems is proposed. Curiously, it does not imply constant amplitude motion. It does however yield maximum power transfer between boundary actuators. The definition, and its implementation in a control system, involves extending the notions of "pure" travelling waves, of standing waves, and of input and output impedances of sources and loads, when applied to non-uniform lumped systems. Practical, robust control strategies are presented for all cases.

  20. Hydrothermal liquefaction of cornstalk: 7-lump distribution and characterization of products.

    PubMed

    Liu, Hua-Min; Li, Ming-Fei; Sun, Run-Cang

    2013-01-01

    Hydrothermal liquefaction of cornstalk at 180-300 °C at ratios of water to cornstalk of 6-14 was conducted, and the reaction products were lumped into gas, water-soluble organics (ethanol-insoluble and ethanol-soluble organics), heavy oil, volatile organic compounds, and acid-soluble and acid-insoluble solid residues. Low temperature, high ratio of water to cornstalk, and short reaction time favored the formation of bio-oil (ethanol-insoluble organics, ethanol-soluble organics, and heavy oil) but inhibited the formation of acid-insoluble solid residue. Increasing temperature and reaction time increased the yields of gas and volatile organic compounds, whereas decreased the yield of acid-soluble solid residue. Bio-oil yields increased first and then decreased at a ratio of water to cornstalk higher than 10. Overall, the studied reaction parameters influenced the conversion among the lumps and product properties. This study suggests that lump analysis provides a promising approach to describe the product distributions in biomass liquefaction. PMID:23196222

  1. MEMS 3-DoF gyroscope design, modeling and simulation through equivalent circuit lumped parameter model

    SciTech Connect

    Mian, Muhammad Umer Khir, M. H. Md.; Tang, T. B.; Dennis, John Ojur; Riaz, Kashif; Iqbal, Abid; Bazaz, Shafaat A.

    2015-07-22

    Pre-fabrication, behavioural and performance analysis with computer aided design (CAD) tools is a common and fabrication cost effective practice. In light of this we present a simulation methodology for a dual-mass oscillator based 3 Degree of Freedom (3-DoF) MEMS gyroscope. 3-DoF Gyroscope is modeled through lumped parameter models using equivalent circuit elements. These equivalent circuits consist of elementary components which are counterpart of their respective mechanical components, used to design and fabricate 3-DoF MEMS gyroscope. Complete designing of equivalent circuit model, mathematical modeling and simulation are being presented in this paper. Behaviors of the equivalent lumped models derived for the proposed device design are simulated in MEMSPRO T-SPICE software. Simulations are carried out with the design specifications following design rules of the MetalMUMPS fabrication process. Drive mass resonant frequencies simulated by this technique are 1.59 kHz and 2.05 kHz respectively, which are close to the resonant frequencies found by the analytical formulation of the gyroscope. The lumped equivalent circuit modeling technique proved to be a time efficient modeling technique for the analysis of complex MEMS devices like 3-DoF gyroscopes. The technique proves to be an alternative approach to the complex and time consuming couple field analysis Finite Element Analysis (FEA) previously used.

  2. Comparison of the AWA lumped-circuit model of electrical discharges with empirical data

    SciTech Connect

    Maier, W.B. II; Kadish, A. ); Robiscoe, R.T. . Dept. of Physics)

    1990-12-01

    The authors compare experimental data for three 1.7-m-long transient discharges with an AWA lumped- circuit discharge model in which the arc resistance is taken from the Arc Welder's Ansatz, R{sub a} = V*/{vert bar}I {vert bar}, where V* is a positive constant and I is the discharge current. In addition to the arc resistance, there is a small series resistance R present in the external circuit. A single value for each of R and V* is deduced from the data, and these values are used to characterize all three discharges. Adequate agreement with the experimental data is obtained; for example, the authors predict the proper number of current reversals for each discharge and abrupt termination of current flow after a finite time. The authors suggest that the AWA lumped circuit provides a better representation of the data than a standard lumped-circuit RLC model and hence is more useful as a tool for prediction and interpretation of discharges.

  3. MEMS 3-DoF gyroscope design, modeling and simulation through equivalent circuit lumped parameter model

    NASA Astrophysics Data System (ADS)

    Mian, Muhammad Umer; Dennis, John Ojur; Khir, M. H. Md.; Riaz, Kashif; Iqbal, Abid; Bazaz, Shafaat A.; Tang, T. B.

    2015-07-01

    Pre-fabrication, behavioural and performance analysis with computer aided design (CAD) tools is a common and fabrication cost effective practice. In light of this we present a simulation methodology for a dual-mass oscillator based 3 Degree of Freedom (3-DoF) MEMS gyroscope. 3-DoF Gyroscope is modeled through lumped parameter models using equivalent circuit elements. These equivalent circuits consist of elementary components which are counterpart of their respective mechanical components, used to design and fabricate 3-DoF MEMS gyroscope. Complete designing of equivalent circuit model, mathematical modeling and simulation are being presented in this paper. Behaviors of the equivalent lumped models derived for the proposed device design are simulated in MEMSPRO T-SPICE software. Simulations are carried out with the design specifications following design rules of the MetalMUMPS fabrication process. Drive mass resonant frequencies simulated by this technique are 1.59 kHz and 2.05 kHz respectively, which are close to the resonant frequencies found by the analytical formulation of the gyroscope. The lumped equivalent circuit modeling technique proved to be a time efficient modeling technique for the analysis of complex MEMS devices like 3-DoF gyroscopes. The technique proves to be an alternative approach to the complex and time consuming couple field analysis Finite Element Analysis (FEA) previously used.

  4. Wet oxidation of an azo dye: Lumped kinetics in batch and mixed flow reactors

    SciTech Connect

    Donlagic, J.; Levec, J.

    1999-12-01

    Oxidation of a dilute aqueous solution of a model azo dye pollutant (Orange II) was studied in batch and continuous well-mixed (CSTR) reactors. Both reactors operate at 200--250 C, and total pressures up to 50 bar and at oxygen partial pressure from 10 to 30 bar. The model pollutant concentrations were in a range between 100 and 1,000 mg/L, which may be found in industrial wastewaters. The dye oxidation undergoes parallel-consecutive reaction pathways, in which it first decomposes thermally and oxidatively to aromatic intermediates and via organic acids to the final product carbon dioxide. To develop a kinetic equation capable of predicting organic carbon reduction, all organic species present in solution were lumped by total organic carbon (TOC). The lumped oxidation rate in batch reactor exhibited second-order behavior, whereas in the CSTR is was found linearly proportional to its TOC concentration. The lump behavior in batch reactor was dominated by the refractory low molecular mass aliphatic acids formed during the oxidation.

  5. Are deep eutectic solvents benign or toxic?

    PubMed

    Hayyan, Maan; Hashim, Mohd Ali; Hayyan, Adeeb; Al-Saadi, Mohammed A; AlNashef, Inas M; Mirghani, Mohamed E S; Saheed, Olorunnisola Kola

    2013-02-01

    In continuation of investigation for environmentally benign protocol for new solvents termed deep eutectic solvents (DESs), it is herein reported results concerning the toxicity and cytotoxicity of choline chloride (ChCl) based DESs with four hydrogen bond donors including glycerine, ethylene glycol, triethylene glycol and urea. The toxicity was investigated using two Gram positive bacteria Bacillus subtilis and Staphylococcus aureus, and two Gram negative bacteria Escherichia coli and Pseudomonas aeruginosa. The cytotoxicity effect was tested using the Artemia salina leach. It was found that there was no toxic effect for the tested DESs on all of the studied bacteria confirming their benign effects on these bacteria. Nevertheless, it was found that the cytotoxicity of DESs was much higher than their individual components (e.g. glycerine, ChCl) indicating that their toxicological behavior is different. For our best knowledge this is the first time that toxicity and cytotoxicity of DESs were studied. The toxicity and cytotoxicity of DESs varied depending on the structure of components. Careful usage of the terms non-toxicity and biodegradability must be considered. More investigation on this matter is required. PMID:23200570

  6. Breast-feeding and benign breast disease.

    PubMed

    Bernardi, S; Londero, A P; Bertozzi, S; Driul, L; Marchesoni, D; Petri, R

    2012-01-01

    Benign breast disease (BBD) is very common among women in their fertile age, but its correlation with breast reproductive function remains unclear. Our study aimed to investigate the relation between BBD and breast-feeding. We collected data on 105 women with BBD and 98 controls, focusing on their reproductive history and breast-feeding. We analysed data by R (version 2.12.1) considering p < 0.05 as significant. The results showed that fibroadenoma represented the most frequent BBD (55%), followed by fibrocystic changes (19%), intraductal papilloma (6%) and inflammatory breast disorders (5%). The mean age was 31.5 years (± 6.1), BMI 21.2 kg/m² (± 3.4) and age at menarche 13.0 years (± 1.5). Duration of breast-feeding was not significantly different between controls and BBD types (p = NS). Selecting women with fibroadenoma breast-feeding duration directly correlated with the number of benign lesions (p < 0.05), which remains significant also by multivariate analysis. It was concluded that there seemed to be no difference in breast-feeding among BBDs types, but lactation may influence the number of fibroadenomas. Moreover, prospective studies would better define the correlation between lactation and BBDs. PMID:22185539

  7. Histiocytic sarcoma that mimics benign histiocytosis.

    PubMed

    Boisseau-Garsaud, A M; Vergier, B; Beylot-Barry, M; Nastasel-Menini, F; Dubus, P; de Mascarel, A; Eghbali, H; Beylot, C

    1996-06-01

    A 28-year-old man presented with a histiocytic sarcoma of a very uncommon origin, as it had developed for several years like a benign cutaneous histiocytosis resembling generalized eruptive histiocytoma before becoming acute, with nodal and massive pulmonary involvement. Despite various chemotherapies, the patient died within 8 months. Skin biopsies showed histiocytic proliferation in the dermis and node biopsies showed histiocytic proliferation with a sinusoidal pattern. Immunohistochemical analysis, performed on paraffin-embedded sections, demonstrated strong labeling of tumoral cells for CD68 and moderate labeling for CD3 and CD4. CD30 labeling was negative. S-100 protein was positive on a Langerhans' cell reactive subpopulation. Electron microscopy confirmed the histiocytic nature of malignant cells and showed cytoplasmic inclusions such as regularly laminated bodies, dense bodies and pleomorphic inclusions. No Birbeck granules were seen. A gene rearrangement study of T-cell receptor gamma and immunoglobulin heavy chain genes showed a germline configuration. Histiocytic sarcoma is an extremely rare true histiocytic malignancy, the existence of which has been recently debated since it has often been mistaken in the past for large cell lymphomas. Such a deceptive onset as benign cutaneous histiocytosis has not been described in the literature to our knowledge. PMID:8793665

  8. 26 CFR 11.402(e)(4)(B)-1 - Election to treat an amount as a lump sum distribution.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 26 Internal Revenue 14 2010-04-01 2010-04-01 false Election to treat an amount as a lump sum... EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974 § 11.402(e)(4)(B)-1 Election to treat an amount as a lump... is described in section 402(e)(4)(A) and which is not an annuity contract may be treated as a...

  9. 36 CFR 223.64 - Appraisal on a lump-sum value or rate per unit of measure basis.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... or rate per unit of measure basis. 223.64 Section 223.64 Parks, Forests, and Public Property FOREST... Contracts Appraisal and Pricing § 223.64 Appraisal on a lump-sum value or rate per unit of measure basis. Timber may be appraised and sold at a lump-sum value or at a rate per unit of measure which rate may...

  10. Flexible hydrological modeling - Disaggregation from lumped catchment scale to higher spatial resolutions

    NASA Astrophysics Data System (ADS)

    Tran, Quoc Quan; Willems, Patrick; Pannemans, Bart; Blanckaert, Joris; Pereira, Fernando; Nossent, Jiri; Cauwenberghs, Kris; Vansteenkiste, Thomas

    2015-04-01

    Based on an international literature review on model structures of existing rainfall-runoff and hydrological models, a generalized model structure is proposed. It consists of different types of meteorological components, storage components, splitting components and routing components. They can be spatially organized in a lumped way, or on a grid, spatially interlinked by source-to-sink or grid-to-grid (cell-to-cell) routing. The grid size of the model can be chosen depending on the application. The user can select/change the spatial resolution depending on the needs and/or the evaluation of the accuracy of the model results, or use different spatial resolutions in parallel for different applications. Major research questions addressed during the study are: How can we assure consistent results of the model at any spatial detail? How can we avoid strong or sudden changes in model parameters and corresponding simulation results, when one moves from one level of spatial detail to another? How can we limit the problem of overparameterization/equifinality when we move from the lumped model to the spatially distributed model? The proposed approach is a step-wise one, where first the lumped conceptual model is calibrated using a systematic, data-based approach, followed by a disaggregation step where the lumped parameters are disaggregated based on spatial catchment characteristics (topography, land use, soil characteristics). In this way, disaggregation can be done down to any spatial scale, and consistently among scales. Only few additional calibration parameters are introduced to scale the absolute spatial differences in model parameters, but keeping the relative differences as obtained from the spatial catchment characteristics. After calibration of the spatial model, the accuracies of the lumped and spatial models were compared for peak, low and cumulative runoff total and sub-flows (at downstream and internal gauging stations). For the distributed models, additional

  11. Giant anterior urethral diverticulum with a calculus masquerading as left inguinal hernia: A missed diagnosis, a lesson to learn

    PubMed Central

    Kushwaha, Renu; Goel, Prabudh; Kureel, Shiv Narain

    2013-01-01

    Congenital anterior urethral diverticulum is an infrequent but important cause of infravesical obstructive uropathy in children. Clinical spectrum usually includes obstructive or irritative urinary symptoms or penile ballooning during the act of micturition. We share our experience in a case of giant anterior urethral diverticulum with a contained calculus presenting as a huge inguino-scrotal swelling and masquerading as left inguinal hernia. The fluctuation in the size of the swelling related to the act of micturition was mistaken for cough impulse. He was subjected to a left inguinal herniotomy, following which he developed urine leak from the surgery wound and was subsequently referred to our centre for further management. The importance of a detailed history, meticulous physical examination, and diagnostic imaging has been stressed. The surgical approach in such cases has also been highlighted. PMID:24019642

  12. Small bowel obstruction caused by self-anchoring suture used for peritoneal closure following robotic inguinal hernia repair

    PubMed Central

    Khan, Faraz A.; Hashmi, Asra; Edelman, David A.

    2016-01-01

    Laparoscopic inguinal herniorraphy is a commonly performed procedure given the reported decrease in pain and earlier return to activity when compared with the open approach. Moreover, robotic assistance offers the operating surgeon considerable ergonomic advantages, making it an attractive alternative to conventional laparoscopic herniorraphy. Robotic herniorraphy utilizes the transabdominal preperitoneal approach where following repair peritoneal closure is necessary to avoid mesh exposure to the viscera. Self-anchoring sutures are frequently used to this end given the ease of use and knotless application. We present an unusual case of post-operative small bowel obstruction following robotic inguinal hernia repair caused by the self-anchoring suture used for peritoneal closure. This patient presented 3 days post-procedure with symptoms and cross-sectional imaging indicative of small bowel obstruction with a clear transition point. Underwent laparoscopic lysis of a single adhesive band originating from the loose intraperitoneal end of the suture leading to resolution of symptoms. PMID:27340230

  13. [Testicular tumor with opposite inguinal lymph node metastasis in a patient with prior orchiopexy for undescended testis].

    PubMed

    Hayashi, Keiichiro; Fukagai, Takashi; Morita, Masashi; Igarashi, Atsushi; Kushima, Miki

    2015-01-01

    The patient was a 54-year-old man. At age 6 years, he had undergone orchiopexy for left undescended testis. Six months prior to the current presentation, he visited our hospital with a chief complaint of painless enlargement of the left testis. Left high orchiectomy was performed under a diagnosis of left testicular tumor. Histopathological examination determined the tumor to be a seminoma (pT2). Postoperatively, the patient was placed on surveillance without preventive radiation treatment. He visited our hospital six months after surgery due to a painless mass in the right inguinal region. All tumor markers (AFP, HCG-β, and LDH) were within normal ranges. However, based on ultrasound and CT scan findings, lymph node metastasis was suspected and a right inguinal lymph node excision was thus performed. Histopathological examination led to the diagnosis of seminoma. PMID:25656016

  14. Sclerosing extramedullary hematopoietic tumor presenting as an inguinal mass in a patient with primary myelofibrosis: a diagnostic pitfall

    PubMed Central

    Gu, Mi-Jin

    2015-01-01

    Sclerosing extramedullary hematopoietic tumor (SEMHT) is a rare lesion and presented as retroperitoneal or serosal-based mass. A 53-year-old man with a long history of primary myelofibrosis, presented with abdominal distension and inguinal mass. Pathologic examination of inguinal mass revealed a prominent sclerotic background with thick collagen deposits and mono, bi, or tri-lineage hematopoietic tissue containing atypical megakaryocytes and variable proportions of myeloid and erythroid series. The atypical megakaryocytes were positive for Factor VIII and CD61. SEMHT may be misdiagnosed as lymphocyte depleted Hodgkin’s disease, as a mesenchymal neoplasm, or as carcinoma, because of the presence of large atypical cells and marked fibrosis when clinical information regarding PMF is unknown. Awareness of the bizarre atypical megakaryocyte morphology with immature hematopoietic cells and of clinical history is essential to prevent misdiagnosis. PMID:26045874

  15. The role of cross sectional imaging in the management of acute pyogenic inguinal abscess - extrapelvic versus intrapelvic origin

    PubMed Central

    2013-01-01

    Background Abscesses involving the inguinal region as manifestations of complex soft-tissue infections are rare, and the infectious route is usually unclear. The purpose of this study was to ascertain the importance of imaging study and whether the clinical presentations differ between the extrapelvic and intrapelvic origin. Methods Patients who presented with inguinal abscess between January 2003 and December 2010 were evaluated retrospectively. All patients received broad-spectrum antibiotic therapy and debridement. Imaging studies, including computed tomography or magnetic resonance imaging, were performed in all patients to elucidate the origin and extent of infectious disease, and the results were reviewed. Clinical data, laboratory examination findings, and culture results were analyzed. Results Twenty-eight patients were enrolled in the study: 13 patients whose infections were of extrapelvic origin (Group 1) and 15 patients of intrapelvic origin (Group 2). Imaging studies yielded information that helped guiding the treatment. Gram-positive coccus infection was more frequent in Group 1 (p < 0.001), while mixed pathogen and anaerobic bacterial infection were more frequent in Group 2 (p = 0.002 and p = 0.006, respectively). Group 2 had a higher incidence of history of malignancy and chronic renal failure (p = 0.044 and p = 0.038, respectively). Conclusions Computed tomography and magnetic resonance imaging are helpful in diagnosing cases of inguinal abscess and determining the extent of infection. In patients presenting with acute pyogenic inguinal abscess, a higher prevalence of chronic renal failure and history of malignancy were found in those with an intrapelvic, as compared with an extrapelvic, origin of infection. PMID:23537455

  16. Elective Inguinal Node Irradiation in Early-Stage T2N0 Anal Cancer: Prognostic Impact on Locoregional Control

    SciTech Connect

    Zilli, Thomas; Betz, Michael; Bieri, Sabine; Ris, Frederic; Roche, Bruno; Roth, Arnaud D.; Allal, Abdelkarim S.

    2013-09-01

    Purpose: To evaluate the influence of elective inguinal node radiation therapy (INRT) on locoregional control (LRC) in patients with early-stage T2N0 anal cancer treated conservatively with primary RT. Methods and Materials: Between 1976 and 2008, 116 patients with T2 node-negative anal cancer were treated curatively with RT alone (n=48) or by combined chemoradiation therapy (CRT) (n=68) incorporating mitomycin C and 5-fluorouracil. Sixty-four percent of the patients (n=74) received elective INRT. Results: Over a median follow-up of 69 months (range, 4-243 months), 97 (84%) and 95 patients (82%) were locally and locoregionally controlled, respectively. Rates for 5-year actuarial local control, LRC, cancer-specific, and overall survival for the entire population were 81.7% ± 3.8%, 79.2% ± 4.1%, 91.1% ± 3.0%, and 72.1% ± 4.5%, respectively. The overall 5-year inguinal relapse-free survival was 92.3% ± 2.9%. Isolated inguinal recurrence occurred in 2 patients (4.7%) treated without INRT, whereas no groin relapse was observed in those treated with INRT. The 5-year LRC rates for patients treated with and without INRT and with RT alone versus combined CRT were 80.1% ± 5.0% versus 77.8% ± 7.0% (P=.967) and 71.0% ± 7.2% versus 85.4% ± 4.5% (P=.147), respectively. A trend toward a higher rate of grade ≥3 acute toxicity was observed in patients treated with INRT (53% vs 31%, P=.076). Conclusions: In cases of node-negative T2 anal cancer, the inguinal relapse rate remains relatively low with or without INRT. The role of INRT in the treatment of early-stage anal carcinoma needs to be investigated in future prospective trials.

  17. A Complete Sutureless, Hernia Repair for Primary Inguinal Hernia The Trabucco Repair: A Tribute to Ermanno Trabucco.

    PubMed

    Campanelli, Giampiero; Bruni, Piero Giovanni; Cavalli, Marta; Morlacchi, Andrea

    2016-04-01

    Since 1989, the authors have been using the Trabucco tension-free and sutureless technique for the repair of primary groin hernia with a pre-shaped mesh in more than 8,000 surgical procedures for complex and "simple" abdominal and inguinal hernias; over 4,000 cases have been considered in this study. The great majority of these procedures were performed under local anaesthesia and with a complete and careful nerve sparing. Compared to the Lichtenstein's technique, which is currently the golden standard treatment worldwide, there are no significant differences in the observed recurrence rate (below 2%). For the Law of Pascal, the pre-shaped prosthesis developed by Trabucco remains stretched uniformly in the inguinal canal, without the need to be secured with sutures and without forming dead space, which is a cause of infections, pain, and recurrence. The main advantage of a tension-free and sutureless repair is given by the relevant reduction in postoperative chronic neuralgia, which is not an uncommon complication and, depending on its intensity, can also potentially jeopardize a patient's work and social activities. The identification and the sparing of the three nerves of the inguinal region is of crucial importance to reduce the rate of neuralgia in the short and long term. Furthermore, the use of a local anaesthesia imposes the surgeon to properly recognize those nerves and to respect them during the repair. It goes without saying that the complete exposition of the right anatomy of inguinal canal is mandatory. The intentional section of one or more nerves, when it is not technically possible to achieve a satisfactory nerve sparing, or special tricks to create proper fenestrations (small window) on the edge of the prosthesis to prevent the scar tissue to involve the spared nerves, ensures a further reduction of the rate of neuralgia and excellent patient outcomes. PMID:27175818

  18. Evaluation of Anesthesia Profile in Pediatric Patients after Inguinal Hernia Repair with Caudal Block or Local Wound Infiltration

    PubMed Central

    Gavrilovska-Brzanov, Aleksandra; Kuzmanovska, Biljana; Kartalov, Andrijan; Donev, Ljupco; Lleshi, Albert; Jovanovski-Srceva, Marija; Spirovska, Tatjana; Brzanov, Nikola; Simeonov, Risto

    2016-01-01

    AIM: The aim of this study is to evaluate anesthesia and recovery profile in pediatric patients after inguinal hernia repair with caudal block or local wound infiltration. MATERIAL AND METHODS: In this prospective interventional clinical study, the anesthesia and recovery profile was assessed in sixty pediatric patients undergoing inguinal hernia repair. Enrolled children were randomly assigned to either Group Caudal or Group Local infiltration. For caudal blocks, Caudal Group received 1 ml/kg of 0.25% bupivacaine; Local Infiltration Group received 0.2 ml/kg 0.25% bupivacaine. Investigator who was blinded to group allocation provided postoperative care and assessments. Postoperative pain was assessed. Motor functions and sedation were assessed as well. RESULTS: The two groups did not differ in terms of patient characteristic data and surgical profiles and there weren’t any hemodynamic changes between groups. Regarding the difference between groups for analgesic requirement there were two major points - on one hand it was statistically significant p < 0.05 whereas on the other hand time to first analgesic administration was not statistically significant p = 0.40. There were significant differences in the incidence of adverse effects in caudal and local group including: vomiting, delirium and urinary retention. CONCLUSIONS: Between children undergoing inguinal hernia repair, local wound infiltration insures safety and satisfactory analgesia for surgery. Compared to caudal block it is not overwhelming. Caudal block provides longer analgesia, however complications are rather common. PMID:27275337

  19. Use of fibrin glue in preventing pseudorecurrence after laparoscopic total extraperitoneal repair of large indirect inguinal hernia

    PubMed Central

    Sürgit, Önder; Çavuşoğlu, Nadir Turgut; Ünal, Yılmaz; Koşar, Pınar Nergis; İçen, Duygu

    2016-01-01

    Purpose Seroma is among the most common complications of laparoscopic total extraperitoneal (TEP) for especially large indirect inguinal hernia, and may be regarded as a recurrence by some patients. A potential area localized behind the mesh and extending from the inguinal cord into the scrotum may be one of the major etiological factors of this complication. Our aim is to describe a novel technique in preventing pseudorecurrence by using fibrin sealant to close that potential dead space. Methods Forty male patients who underwent laparoscopic TEP for indirect inguinal hernia with at least 100-mL volume were included in this prospective clinical study. While fibrin sealant was used to close the potential dead space in the study group, nothing was used in the control group. The volume of postoperative fluid collection on ultrasound was compared between the groups. Results Patient characteristics and the volumes of hernia sac were similar between the 2 groups. The mean volume of postoperative fluid collection was found as 120.2 mL in the control group and 53.7 mL in the study group, indicating a statistical significance (P < 0.001). Conclusion Minimizing the potential dead space with a fibrin sealant can reduce the amount of postoperative fluid collection, namely the incidence of pseudorecurrence. PMID:27617253

  20. [Technique of repair of acquired inguinal hernia by anterior reinforcement of the Fruchaud floor with polypropylene mesh].

    PubMed

    Ferrari, C A

    1998-01-01

    The main cause of acquired inguinal hernia is weakness of Fruchaud's deep muscolofascial floor, following metabolically-determined collagen disorders. A technique for the anterior reinforcement of this structure with polypropylene mesh is described here. Following intermuscular decollement, the mesh is placed in direct contact with the surface formed by the transversalis fascia and the transversus abdominis muscle and stretched as extensively as possible. Because the posterior aspect of the inguinal canal is the true barrier to abdominal pressure, the author believe that its direct reinforcement, without interposition of the internal oblique muscle, constitutes the most correct anatomo-surgical approach to hernia repair. This is the case for both indirect hernias, in which the internal ring is reconstructed at a deeper level, and for direct hernias, in which the "tent effect" of the prosthesis is prevented. Ninety-two primary inguinal hernias (56 indirect, 29 direct and 7 direct and indirect) in 87 patients were repaired with this technique. Seventy-nine patients were followed up from 2 to 24 months. Early complications included: 7 ecchymosis, 3 seromas, 2 subcutaneous infections, 3 testicular swellings. Incision and testicular pain for longer than 6 months occurred in 2 cases. No prosthetic infections or recurrences have been detected up to the present. PMID:9577132

  1. Endoscopic management of benign biliary strictures.

    PubMed

    Rustagi, Tarun; Jamidar, Priya A

    2015-01-01

    Benign biliary strictures are a common indication for endoscopic retrograde cholangiopancreatography (ERCP). Endoscopic management has evolved over the last 2 decades as the current standard of care. The most common etiologies of strictures encountered are following surgery and those related to chronic pancreatitis. High-quality cross-sectional imaging provides a road map for endoscopic management. Currently, sequential placement of multiple plastic biliary stents represents the preferred approach. There is an increasing role for the treatment of these strictures using covered metal stents, but due to conflicting reports of efficacies as well as cost and complications, this approach should only be entertained following careful consideration. Optimal management of strictures is best achieved using a team approach with the surgeon and interventional radiologist playing an important role. PMID:25613176

  2. Benign Intracranial Hypertension: A Diagnostic Dilemma

    PubMed Central

    Shaw, Gary Y.; Million, Stephanie K.

    2012-01-01

    Benign intracranial hypertension (BIH) (also known as pseudotumor cerebri and empty sella syndrome) remains a diagnostic challenge to most physicians. The modified Dandy criteria consist of, the classic findings of headache, pulsatile tinnitus, papilledema, and elevated cerebrospinal fluid (CSF) pressure, however, these are rarely collectively present in any one patient. Furthermore, these findings can wax and wane over time. Due to the nature of this disease, both signs and symptoms may be intermittent, making definitive diagnosis difficult. Newer imaging studies, particularly the magnetic resonance venogram (MRV) along with a constellation of correlative findings and associated diseases have given new impetus in the diagnosis, treatment, and pathophysiology of this disease. This has led the authors to offer modifications to the classic Dandy criteria. This report presents three representative cases of BIH highlighting many of the newer advances in both diagnosis and treatment of this perplexing disorder. PMID:22928139

  3. Clinical Evaluation of Benign Prostatic Hyperplasia

    PubMed Central

    McVary, Kevin T

    2003-01-01

    Benign prostatic hyperplasia (BPH) is the most common neoplastic condition afflicting men and constitutes a major factor impacting male health. Clinical evaluation to assess the presence and degree of voiding dysfunction and/or the role of BPH in its presence has an increasingly broad spectrum of treatment goals. The goals of the evaluation of such men are to identify the patient’s voiding or, more appropriately, urinary tract problems, both symptomatic and physiologic; to establish the etiologic role of BPH in these problems; to evaluate the necessity for and probability of success and risks of various therapeutic approaches; and to present the results of these assessments to the patient so he can make an informed decision about management recommendations and available alternatives. PMID:16985961

  4. Clinical Evaluation of Benign Prostatic Hyperplasia

    PubMed Central

    McVary, Kevin T

    2003-01-01

    Benign prostatic hyperplasia (BPH) is the most common neoplastic condition afflicting men and constitutes a major factor impacting male health. Clinical evaluation to assess the presence and degree of voiding dysfunction and/or the role of BPH in its presence has an increasingly broad spectrum of treatment goals. The goals of the evaluation of such men are to identify the patient’s voiding or, more appropriately, urinary tract problems, both symptomatic and physiologic; to establish the etiologic role of BPH in these problems; to evaluate the necessity for and probability of success and risks of various therapeutic approaches; and to present the results of these assessments to the patient so he can make an informed decision about management recommendations and available alternatives. PMID:16985968

  5. Benign Vascular Malformation at the Ischial Tuberosity.

    PubMed

    Said, Rami; Bevelaqua, Anna-Christina

    2016-07-01

    A 31-year-old female student was referred to physical therapy with a chief complaint of proximal, posterior left thigh pain that began insidiously 12 months prior, and progressively worsened while training for a half-marathon. A mobile, soft mass was identified just inferior to the ischial tuberosity that was tender and painful to palpation, recreating the patient's chief complaint. Radiographic findings were negative for a suspected avulsion fracture at the ischial tuberosity. Therefore, the physician performed musculoskeletal ultrasonography, which revealed a superficial hypoechoic mass with vascular flow. Magnetic resonance imaging and a subsequent biopsy led to the diagnosis of a benign vascular malformation. J Orthop Sports Phys Ther 2016;46(7):607. doi:10.2519/jospt.2016.0410. PMID:27363574

  6. [Benign thyroid nodules: diagnostic and therapeutic approach].

    PubMed

    Durante, Cosimo; Cava, Francesco; Paciaroni, Alessandra; Filetti, Sebastiano

    2008-05-01

    In the last years an increase in thyroid nodules detection has been reported from several epidemiological studies. This trend is largely due to the routine use of diagnostic sonography procedures in clinical practice. Thyroid nodules, both palpable or not palpable, rarely turn out to be malignant. Fine-needle aspiration cytology (FNAc) plays a central role in establishing the nature of the nodule. Excluded the presence of malignant lesions, which are generally treated with surgery, physicians are faced with a variety of therapeutic options, and choosing the optimal approach can be a difficult task. These include a periodic follow-up alone without treatment, the iodine supplementation, the thyroid-hormone suppressive therapy, the radioiodine administration, the percutaneous ethanol injections, and the new technique of laser photocoagulation. In all cases, decisions on the management of benign thyroid nodules should always be based on clinical target and a careful analysis of benefits and risks to the patient. PMID:18581970

  7. Palladium-Catalyzed Environmentally Benign Acylation.

    PubMed

    Suchand, Basuli; Satyanarayana, Gedu

    2016-08-01

    Recent trends in research have gained an orientation toward developing efficient strategies using innocuous reagents. The earlier reported transition-metal-catalyzed carbonylations involved either toxic carbon monoxide (CO) gas as carbonylating agent or functional-group-assisted ortho sp(2) C-H activation (i.e., ortho acylation) or carbonylation by activation of the carbonyl group (i.e., via the formation of enamines). Contradicting these methods, here we describe an environmentally benign process, [Pd]-catalyzed direct carbonylation starting from simple and commercially available iodo arenes and aldehydes, for the synthesis of a wide variety of ketones. Moreover, this method comprises direct coupling of iodoarenes with aldehydes without activation of the carbonyl and also without directing group assistance. Significantly, the strategy was successfully applied to the synthesis n-butylphthalide and pitofenone. PMID:27377566

  8. [Neuroophthalmological aspects of benign intracranial hypertension].

    PubMed

    Eliseeva, N M; Serova, N K; Gasparian, S S; Shifrin, M A

    2008-01-01

    Benign intracranial hypertension (BICH) is characterized by elevated spinal fluid pressure in the absence of space-occupying lesion in the skull, dilated cerebral ventricles, significant neurological disorders, and altered spinal fluid composition. Forty-nine patients with a female predominance were examined. Their age ranged from 4 to 52 years (median 39 years). The most common predictors of BICH were overweight, endocrine disorders, and cerebral sinus thrombosis. Ophthalmoscopically, the patients were found to have early, moderate, and significant papilledema, and secondary optic atrophy. Examination of visual functions revealed these or those disturbances of visual acuity and/or field of vision in 43 of the 49 patients. The incidence and degree of visual disturbances depended on the stage of papilledema. Timely diagnosis and treatment in patients with BICH allows the development of visual disturbances to be prevented in them. PMID:18589651

  9. Benign Duodenocolic Fistula: a Case Report.

    PubMed

    Soheili, Marzieh; Honarmand, Shirin; Soleimani, Heshmatollah; Elyasi, Anvar

    2015-08-01

    Benign duodenocolic fistula (DCF), known as a fistula between the duodenum and colon with or without cecum of nonmalignant origin, is an unusual complication of different gastrointestinal diseases. The present paper records a case in which the patient presented with chronic diarrhea, abdominal pain, weight loss as well as having a history of gastric ulcer. Most frequently the condition presents with signs of malabsorption such as weight loss and diarrhea, but other symptoms include nausea, vomiting (sometimes with fecal), and abdominal pain. Gastrointestinal inflammatory conditions are the usual causes. The most common ones are perforated duodenal ulcer and Crohn's disease. Barium enemas are usually diagnostic. Treatment consists of excising the fistula and repairing the duodenal and colonic defects. Closure of the fistula provides quick relief. PMID:26545997

  10. [Surgical therapy of benign thyroid gland diseases].

    PubMed

    Mann, B; Buhr, H J

    1998-01-01

    Operations due to benign thyroid diseases are one of the most common elective surgical procedures performed in Germany. In the majority of cases, the preoperative determination of the serum thyrotropin concentration and an ultrasound of the thyroid region are sufficient preoperative investigations. In cases of thyroid functional disorders a scintigram should be additionally performed. Indications for operation in nodular goiter are local, mechanical compression, suspicion of malignancy and focal or disseminated autonomy. In Graves' disease the indication for operation is usually recurrent hyperthyroidism after medical treatment. In endemic nodular goiter the morphology of the nodular thyroid tissue is the guideline for resection; i.e. all nodules have to be removed. In Graves' disease the function of the remaining thyroid tissue is essential. The standardized subtotal resection with remaining tissue around the hilus, which frequently barries nodules, should be avoided. Instead a selective resection which takes the individual morphology and function of the diseased thyroid tissue into account should be favorized. With this operative technique the surgeon will have frequently direct contact with the recurrent nerve and the parathyroids. It is documented, that intraoperative visualisation of the recurrent nerve decreases not only the rate of permanent nerve damages but increases as well the completeness of resection. Additionally, ligation of the inferior thyroid artery decreases the incidence of residual or recurrent disease without enlarging the risk of postoperative parathyroiprive hypocalcemia. An individual follow-up with iodine and/or thyroxine replacement therapy is an indispensable component of the surgical therapeutic approach. The target of thyroxine substitution in patients after resection due to benign thyroid diseases is a physiologic serum thyrotropin concentration (0.3 to 4.0 mU/l). PMID:9542021

  11. [Presumed benign ovarian tumors during pregnancy].

    PubMed

    Tariel, O; Huissoud, C; Rudigoz, R C; Dubernard, G

    2013-12-01

    The incidence of ovarian tumors diagnosed during pregnancy is between 0.3 and 5.4% (LE2). The most common ovarian tumors diagnosed during pregnancy are functional cysts diagnosed incidentally during the first trimester ultrasound (LE2) and spontaneous regression is often observed. Dermoid cysts and cystadenoma are the most frequent organic benign ovarian tumors diagnosed during pregnancy (LE2). The main complication of presumed benign ovarian tumor (PBOT) during pregnancy is adnexal torsion and is estimated at around 8% (LE2), especially at the end of the first trimester and during the second trimester (LE4). Tumor markers are not reliable during pregnancy to assess the risk of malignancy of ovarian tumor (LE2). Ultrasound remains the gold standard for characterizing an ovarian tumor during pregnancy (LE3), but with a lower specificity for the diagnosis of malignancy. Pelvic MRI is accurate in the diagnosis of ovarian tumors during pregnancy and brings additional information to ultrasound (LE4). Ultrasound-guided aspiration of ovarian tumors is not recommended during pregnancy (grade C). Expectation is recommended in cases of PBOT during pregnancy, which does not enlarge (grade C). Whatever the gestational age, surgery is recommended in patients with symptoms suggesting an adnexal torsion (grade C). Laparoscopy is possible during the first and second trimester of pregnancy for the management of symptomatic PBOT (LE3). The risk of miscarriage following surgery (laparoscopy and laparotomy) for ovarian tumor during pregnancy is estimated at 2.8% (LE3). The route of delivery should not be modified by the ovarian tumour, except in case of praevia cyst requiring a cesarean section, a complication or suspicion of malignancy (grade C). Surgical treatment of PBOT may be performed during a cesarean section indicated for another reason. The risk of torsion is increased during the postpartum period (LE4). PMID:24210242

  12. Breast Lump

    MedlinePlus

    ... decisions about when and where they should receive healthcare. Unfortunately, most people lack the medical knowledge needed to make these decisions safely. FreeMD.com is powered by a computer program that performs symptom triage. The goal of ...

  13. [Treatment of benign laryngeal diseases using a CO2 laser].

    PubMed

    Betka, J; Klozar, J; Kasík, P; Taudy, M; Tichý, S

    1989-05-01

    CO2 laser surgery is becoming a part of larynx surgery. The authors inform about their experience in benign larynx tumours treatment. They present analysis of concrete therapeutic procedures in individual larynx affections. They conclude that laser surgery is an advantegous method for benign larynx tumours treatment. PMID:2772545

  14. Study protocol for a randomized controlled trial for anterior inguinal hernia repair: transrectus sheath preperitoneal mesh repair compared to transinguinal preperitoneal procedure

    PubMed Central

    2013-01-01

    Background Anterior open treatment of the inguinal hernia with a tension-free mesh has reduced the incidence of hernia recurrence. The Lichtenstein procedure is the current reference technique for inguinal hernia treatment. Chronic pain has become the main postoperative complication after surgical inguinal hernia repair, especially following Lichtenstein. Preliminary experiences with a soft mesh positioned in the preperitoneal space (PPS) by transinguinal preperitoneal (TIPP) or total extraperitoneal (TEP) technique, showed promising results considering the reduction of postoperative chronic pain. Evolution of surgical innovations for inguinal hernia repair led to an open, direct approach with preperitoneal mesh position, such as TIPP. Based on the TIPP procedure, another preperitoneal repair has been recently developed, the transrectus sheath preperitoneal (TREPP) mesh repair. Methods The ENTREPPMENT trial is a multicentre randomized clinical trial. Patients will be randomly allocated to anterior inguinal hernia repair according to the TREPP mesh repair or TIPP procedure. All patients with a primary unilateral inguinal hernia, eligible for operation, will be invited to participate in the trial. The primary outcome measure will be the number of patients with postoperative chronic pain. Secondary outcome measures will be serious adverse events (SAEs), including recurrence, hemorrhage, return to daily activities (for example work), operative time and hospital stay. Alongside the trial health status, an economic evaluation will be performed. To demonstrate that inguinal hernia repair according to the TREPP technique reduces the percentage of patients with postoperative chronic pain from 12% to <6%, a sample size of 800 patients is required (two-sided test, α = 0.05, 80% power).The ENTREPPMENT trial aims to evaluate the TREPP and TIPP procedures from patients’ perspective. It is hypothesized that the TREPP technique may reduce the number of patients with any

  15. Study of Pellets and Lumps as Raw Materials in Silicon Production from Quartz and Silicon Carbide

    NASA Astrophysics Data System (ADS)

    Dal Martello, E.; Tranell, G.; Gaal, S.; Raaness, O. S.; Tang, K.; Arnberg, L.

    2011-10-01

    The use of high-purity carbon and quartz raw materials reduces the need for comprehensive refining steps after the silicon has been produced carbothermically in the electric reduction furnace. The current work aims at comparing the reaction mechanisms and kinetics occurring in the inner part of the reduction furnace when pellets or lumpy charge is used, as well as the effect of the raw material mix. Laboratory-scale carbothermic reduction experiments have been carried out in an induction furnace. High-purity silicon carbide and two different high-purity hydrothermal quartzes were charged as raw materials at different molar ratios. The charge was in the form of lumps (size, 2-5 mm) or as powder (size, 10-20 μm), mixed and agglomerated as pellets (size, 1-3 mm) and reacted at 2273 K (2000 °C). The thermal properties of the quartzes were measured also by heating a small piece of quartz in CO atmosphere. The investigated quartzes have different reactivity in reducing atmosphere. The carbothermal reduction experiments show differences in the reacted charge between pellets and lumps as charge material. Solid-gas reactions take place from the inside of the pellets porosity, whereas reactions in lumps occur topochemically. Silicon in pellets is produced mainly in the rim zone. Larger volumes of silicon have been found when using lumpy charge. More SiO is produced when using pellets than for lumpy SiO2 for the same molar ratio and heating conditions. The two SiC polytypes used in the carbothermal reduction experiments as carbon reductants presented different reactivity.

  16. Chemical, biological and microbiological evaluation of cyclodextrin finished polyamide inguinal meshes.

    PubMed

    El Ghoul, Y; Blanchemain, N; Laurent, T; Campagne, C; El Achari, A; Roudesli, S; Morcellet, M; Martel, B; Hildebrand, H F

    2008-09-01

    This study describes the use of cyclodextrins (CDs) as a finishing agent of polyamide (PA) fibers used in order to obtain inguinal meshes with improved antibiotic delivery properties. The finishing process involved polymerization between citric acid and CDs, which yielded a cross-linked polymer that physically adhered to the surface of PA fibers. This permanent functionalization was characterized by evaluating the damping property with a polar liquid (glycerol) via the drop contact angle method for various rates of modification of the fabrics. The biological and microbiological effects of the PA, which were functionalized with hydroxypropylated derivate of gamma-CD (HP-gamma-CDs) and charged with ciprofloxacin (CFX), were evaluated by cell culture assays. We observed a good adhesion and proliferation of fibroblastic cells (NIH3T3) after 3 and 6 days and no detectable toxicity of the modified substrate. The in vitro antibacterial activity of the HP-gamma-CD grafted PA fabrics charged with CFX against the bacteria Staphylococcus aureus, Staphylococcus epidermidis and Escherichia coli was greatly superior to that of the virgin sample within a 24h batch experiment in human blood plasma medium. In conclusion, these results from our study offer an insight into the efficient performance of CDs as drug delivery systems for multiple applications in the fields of biomaterials and medical textiles. PMID:18378201

  17. Cellular and molecular remodeling of inguinal adipose tissue mitochondria by dietary methionine restriction.

    PubMed

    Patil, Yuvraj N; Dille, Kelly N; Burk, David H; Cortez, Cory C; Gettys, Thomas W

    2015-11-01

    Dietary methionine restriction (MR) produces a coordinated series of biochemical and physiological responses that improve biomarkers of metabolic health, increase energy expenditure, limit fat accretion and improve overall insulin sensitivity. Inguinal white adipose tissue (IWAT) is a primary target and site of action where the diet initiates transcriptional programs linked to enhancing both synthesis and oxidation of lipid. Using a combination of ex vivo approaches to assess dietary effects on cell morphology and function, we report that dietary MR produced a fourfold increase in multilocular, UCP1-expressing cells within this depot in conjunction with significant increases in mitochondrial content, size and cristae density. Dietary MR increased expression of multiple enzymes within the citric acid cycle, as well as respiratory complexes I, II and III. The physiological significance of these responses, evaluated in isolated mitochondria by high-resolution respirometry, was a significant increase in respiratory capacity measured using multiple substrates. The morphological, transcriptional and biochemical remodeling of IWAT mitochondria enhances the synthetic and oxidative capacity of this tissue and collectively underlies its expanded role as a significant contributor to the overall increase in metabolic flexibility and uncoupled respiration produced by the diet. PMID:26278039

  18. Saphenous neuralgia: a complication of vascular reconstructions below the inguinal ligament.

    PubMed Central

    Adar, R; Meyer, E; Zweig, A

    1979-01-01

    Although relatively frequent in our experience saphenous neuralgia (SN) is not usually reported as a complication of vascular operations below the inguinal ligament. In 55 patients undergoing extended deep femoral angioplasty (EDFA, n = 28) and femoropopliteal bypass graft (FPBG, n = 27) special attention was paid to incidence and severity of postoperative SN. Severe early postoperative SN was seen in 8/28 patients with EDFA and in 6/27 with FPBG. Milder SN was seen in 10 more patients with EDFA, and 3 other developed SN many months after surgery. The milder forms of SN and late SN were not encountered after FPBG. SN usually improved with the passage of time, and at last follow-up averaging 18 months for EDFA and 33 months for FPBG there remained only 23 patients with mild SN (15 after EDFA and 8 after FPBG). The etiology of SN appears to be trauma to the nerve sustained during operation. Age, sex, diabetes, or the addition of lumbar sympathectomy to the vascular operation did not affect the risk of sustaining early postoperative SN. Increased awareness of this complication may help to understand its pathophysiology better, and possibly to decrease its incidence. PMID:507971

  19. Deep venous thromboembolism in patients undergoing inguinal lymph node dissection for melanoma

    SciTech Connect

    Arbeit, J.M.; Lowry, S.F.; Line, B.R.

    1981-11-01

    Deep venous thromboembolism (DVT) was studied in 44 patients with clinical Stage I, II, and III melanoma undergoing staging and therapeutic inguinal lymph node dissection. The ability of two noninvasive methods of surveillance, the phleborheograph (PRG) and the /sup 125/I fibrinogen scan to detect deep venous thrombosis was determined by comparison with prospective bilateral lower extremity venograms. In addition, the therapeutic impact, both beneficial and detrimental, of low dose heparin, 5000 units administered subcutaneously two hours prior to and every eight hours after operation was determined in a double blind study. The sensitivity of the PRG and /sup 125/I fibrinogen scan were both 20%. There were five deep venous thrombi, and two pulmonary emboli for a combined incidence of DVT of 13.6% for the entire patient population. However, there was no significant difference in the incidence of DVT between the two groups. The heparin-treated patients had an increased total volume (796 +/- 516 versus 388 +/- 208 ml; p < 0.05), and duration of wound drainage (9 +/- 4 versus 13 +/- 6 days; p < 0.05).

  20. Deep venous thromboembolism in patients undergoing inguinal lymph node dissection for melanoma

    SciTech Connect

    Arbeit, J.M.; Lowry, S.F.; Line, B.R.; Jones, D.C.; Brennan, M.F.

    1981-01-01

    Deep venous thromboembolism (DVT) was studied in 44 patients with clinical Stage I, II, and III melanoma undergoing staging and therapeutic inguinal lymph node dissection. The ability of two noninvasive methods of surveillance, the phleborheograph (PRG) and the /sup 125/I fibrinogen scan to detect deep venous thrombosis was determined by comparison with prospective bilateral lower extremity venograms. In addition, the therapeutic impact, both beneficial and detrimental, of low dose heparin, 5000 units administered subcutaneously two hours prior to and every eight hours after operation was determined in a double blind study. The sensitivity of the PRG and /sup 125/I fibrinogen scan were both 20%. There were five deep venous thrombi, and two pulmonary emboli for a combined incidence of DVT of 13.6% for the entire patient population. However, there was no significant difference in the incidence of DVT between the two groups. The heparin-treated patients had an increased total volume (796 +/- 516 versus 388 +/- 208 ml; p less than 0.05), and duration of wound drainage (9 +/- 4 versus 13 +/- 6 days; p less than 0.05).

  1. General anesthesia plus ilioinguinal nerve block versus spinal anesthesia for ambulatory inguinal herniorrhapy

    PubMed Central

    Vizcaíno-Martínez, Lucía; Gómez-Ríos, Manuel Ángel; López-Calviño, Beatriz

    2014-01-01

    Objective: The aim was to evaluate general anesthesia (GA) plus ilioinguinal nerve block (IIB) versus spinal anesthesia (SA) in patients scheduled for ambulatory inguinal hernia repair regarding pain management, anesthesia recovery and reducing potential complications. Materials and Methods: A double-blind, prospective, randomized, controlled study in patients American Society of Anesthesiologists I-III randomized into two groups: GA plus IIB group, induction of anesthesia with propofol, maintenance with sevoflurane, airway management with laryngeal mask allowing spontaneous ventilation and ultrasound-guided IIB; SA group, patients who underwent spinal block with 2% mepivacaine. The study variables were pain intensity, assessed by visual analog scale, analgesic requirements until hospital discharge, time to ambulation and discharge, postoperative complications-related to both techniques and satisfaction experienced. Results: Thirty-two patients were enrolled; 16 patients in each group. The differences regarding pain were statistically significant at 2 h of admission (P < 0.001) and at discharge (P < 0.001) in favor of the GA plus ilioinguinal block group. In addition in this group, analgesic requirements were lower than SA group (P < 0.001), with times of ambulation and discharge significantly shorter. The SA group had a higher tendency to develop complications and less satisfaction. Conclusion: General anesthesia plus IIB is better than SA regarding postoperative analgesia, time to mobilization and discharge, side-effect profile and satisfaction experienced by the patients. PMID:25422612

  2. Changes in uncuffed endotracheal tube leak during laparoscopic inguinal herniorrhaphy in children.

    PubMed

    Noguchi, Akiko; Kuga, Kumiko; Tashiro, Naoki; Shimakawa, Yusuke; Shono, Takeshi; Hirakawa, Naomi; Sakaguchi, Yoshiro

    2016-08-01

    The present study was conducted to investigate changes in uncuffed endotracheal tube (ETT) leak during laparoscopic surgery. The study included 31 patients aged between 1 and 6 years scheduled for elective laparoscopic inguinal herniorrhaphy. Inspiratory and expiratory tidal volumes (TVi and TVe) were measured during mechanical ventilation, and ETT leak was calculated using the formula-ETT leak = (TVi - TVe)/TVi × 100 (%), assessed at the following time-points-5 min after the start of mechanical ventilation (T1, baseline), just before the start of surgery (T2), 5 min after the induction of pneumoperitoneum with 15° Trendelenburg tilt (T3), and at the end of surgery (T4). Additionally, leak pressure was assessed after successful tracheal intubation (T0, baseline) at T2, T3 and T4. Uncuffed ETT leak significantly decreased at T3 compared with T1 (baseline). Leak pressure significantly increased at T3 and T4 compared with T0 (baseline). Further studies are needed in order to determine whether the results are universal and associated with clinically significant outcomes. PMID:27193326

  3. Total costs of laparoscopic and lichtenstein inguinal hernia repairs: a randomized prospective study.

    PubMed

    Heikkinen, T; Haukipuro, K; Leppälä, J; Hulkko, A

    1997-02-01

    In a prospective, randomized study, laparoscopic (n = 20) and Lichtenstein (n = 18) inguinal hernia repairs were compared in relation to operative time, operative costs, hospital stay, postoperative pain, return to work, patient satisfaction, complications, and total costs. All the operations were performed with the patient under general anesthesia. The median operative times in the laparoscopic and Lichtenstein groups were 71.5 (range, 43-140) and 45 (16-83) min, respectively (p < 0.001). Postoperative pain and use of analgesics was less in the laparoscopic group. The median time to return to work was 14 (8-26) days in the laparoscopic group and 19 (5-40) days in the Lichtenstein group. More complications occurred in the Lichtenstein group. The median of the operative costs, in U.S. dollars, was $1,395 and $878, respectively, and the median total costs (including community expenses resulting from lost workdays) were $4,796 in the laparoscopic and $5,320 in the Lichtenstein groups. PMID:9116938

  4. Dysuria, Urinary Retention, and Inguinal Pain as Manifestation of Sacral Bannwarth Syndrome

    PubMed Central

    Finsterer, Josef; Dauth, Johannes; Angel, Kurt; Markowicz, Mateusz

    2015-01-01

    Only few cases with sacral radiculitis due to infection with Borrelia burgdorferi leading to neurogenic urinary dysfunction have been reported. A 57-year-old male developed urethral pain and urinary retention, requiring permanent catheterization. Extensive urological investigations did not reveal a specific cause, which was why neurogenic bladder dysfunction was suspected. Neurologic exam revealed only mildly reduced tendon reflexes. Cerebral and spinal MRI were noninformative. CSF investigations, however, revealed pleocytosis, elevated protein, and antibodies against Borrelia burgdorferi. Intravenous ceftriaxone for three weeks resulted in immediate improvement of bladder dysfunction, with continuous decline of residual urine volume and continuous increase of spontaneous urine volume even after removal of the catheter and initiation of self-catheterization. Sacral radiculitis due to infection with Borrelia burgdorferi is a potential cause of detrusor areflexia and urethral, perineal, inguinal, and scrotal pain and may be misinterpreted as cystitis or urethritis. Ceftriaxone may result in progressive recovery of bladder dysfunction and pain. Neuroborreliosis may manifest exclusively as neurourological problem. PMID:26664404

  5. Benign Biliary Strictures: Diagnostic Evaluation and Approaches to Percutaneous Treatment.

    PubMed

    Fidelman, Nicholas

    2015-12-01

    Interventional radiologists are often consulted to help identify and treat biliary strictures that can result from a variety of benign etiologies. Mainstays of noninvasive imaging for benign biliary strictures include ultrasound, contrast-enhanced computed tomography and magnetic resonance imaging, magnetic resonance cholangiopancreatography, and computed tomography cholangiography. Endoscopic retrograde cholangiography is the invasive diagnostic procedure of choice, allowing both localization of a stricture and treatment. Percutaneous biliary interventions are reserved for patients who are not candidates for endoscopic retrograde cholangiography (eg, history of distal gastrectomy and biliary-enteric anastomosis to a jejunal roux limb). This review discusses the roles of percutaneous transhepatic cholangiography and biliary drainage in the diagnosis of benign biliary strictures. The methodology for crossing benign biliary strictures, approaches to balloon dilation, management of recalcitrant strictures (ie, large-bore biliary catheters and retrievable covered stents), and the expected outcomes and complications of percutaneous treatment of benign biliary strictures are also addressed. PMID:26615161

  6. Design of an Invisible Radome by Frequency Selective Surfaces Loaded with Lumped Resistors

    NASA Astrophysics Data System (ADS)

    Liu, Li-Guo; Li, You-Quan; Meng, Qing-Zhi; Wu, Wei-Wei; Mo, Jin-Jun; Fu, Yun-Qi; Yuan, Nai-Chang

    2013-06-01

    A novel radome is presented, which is transparent at operating frequency and is invisible out of band. In order to prevent reflection of the incoming power, frequency selective surfaces loaded with the lumped resistors are employed. To obtain the pass-band properties in lower frequencies, the convoluted slots are utilized. By comparison with the results obtained both by full wave analysis and by the measurements, the performance of the radome is verified. It performs with high transmission characteristics in band, and broadband absorbing properties out of band simultaneously. The oblique incidences are also investigated for both transmission coefficients and reflection ones.

  7. A compact design for the Josephson mixer: The lumped element circuit

    SciTech Connect

    Pillet, J.-D.; Flurin, E.; Mallet, F. Huard, B.

    2015-06-01

    We present a compact and efficient design in terms of gain, bandwidth, and dynamical range for the Josephson mixer, the superconducting circuit performing three-wave mixing at microwave frequencies. In an all lumped-element based circuit with galvanically coupled ports, we demonstrate nondegenerate amplification for microwave signals over a bandwidth up to 50 MHz for a power gain of 20 dB. The quantum efficiency of the mixer is shown to be about 70%, and its saturation power reaches −112 dBm.

  8. Fluid dynamics of heart valves during atrial fibrillation: a lumped parameter-based approach.

    PubMed

    Scarsoglio, S; Camporeale, C; Guala, A; Ridolfi, L

    2016-08-01

    Atrial fibrillation (AF) consequences on the heart valve dynamics are usually studied along with a valvular disfunction or disease, since in medical monitoring, the two pathologies are often concomitant. Aim of the present work is to study, through a stochastic lumped-parameter approach, the basic fluid dynamics variations of heart valves, when only paroxysmal AF is present with respect to the normal sinus rhythm in absence of any valvular pathology. Among the most common parameters interpreting the valvular function, the most useful turns out to be the regurgitant volume. During AF, both atrial valves do not seem to worsen their performance, while the ventricular efficiency is remarkably reduced. PMID:26460925

  9. Lump solitons in a higher-order nonlinear equation in 2 +1 dimensions

    NASA Astrophysics Data System (ADS)

    Estévez, P. G.; Díaz, E.; Domínguez-Adame, F.; Cerveró, Jose M.; Diez, E.

    2016-06-01

    We propose and examine an integrable system of nonlinear equations that generalizes the nonlinear Schrödinger equation to 2 +1 dimensions. This integrable system of equations is a promising starting point to elaborate more accurate models in nonlinear optics and molecular systems within the continuum limit. The Lax pair for the system is derived after applying the singular manifold method. We also present an iterative procedure to construct the solutions from a seed solution. Solutions with one-, two-, and three-lump solitons are thoroughly discussed.

  10. Diagnosing a parotid lump: fine needle aspiration cytology or core biopsy?

    PubMed

    Howlett, D C

    2006-04-01

    Fine needle aspiration cytology (FNAC) has been widely adopted for the cytological diagnosis of parotid lumps. FNAC does have drawbacks, even under optimum conditions and may be associated with poor levels of diagnostic accuracy, particularly outside the specialized clinic environment. Ultrasound-guided core biopsy (USCB) is a relatively recently described technique in the parotid gland which has been well tolerated and has demonstrated a high degree of diagnostic accuracy in several studies. This article discusses the merits and pitfalls of FNAC, together with the technique of USCB and also highlights the potential advantages benefit provided by USCB in parotid diagnosis. PMID:16585720

  11. Lump solitons in a higher-order nonlinear equation in 2+1 dimensions.

    PubMed

    Estévez, P G; Díaz, E; Domínguez-Adame, F; Cerveró, Jose M; Diez, E

    2016-06-01

    We propose and examine an integrable system of nonlinear equations that generalizes the nonlinear Schrödinger equation to 2+1 dimensions. This integrable system of equations is a promising starting point to elaborate more accurate models in nonlinear optics and molecular systems within the continuum limit. The Lax pair for the system is derived after applying the singular manifold method. We also present an iterative procedure to construct the solutions from a seed solution. Solutions with one-, two-, and three-lump solitons are thoroughly discussed. PMID:27415266

  12. Parametric nonlinear lumped element model for circular CMUTs in collapsed mode.

    PubMed

    Aydoğdu, Elif; Ozgurluk, Alper; Atalar, Abdullah; Köymen, Hayrettin

    2014-01-01

    We present a parametric equivalent circuit model for a circular CMUT in collapsed mode. First, we calculate the collapsed membrane deflection, utilizing the exact electrical force distribution in the analytical formulation of membrane deflection. Then we develop a lumped element model of collapsed membrane operation. The radiation impedance for collapsed mode is also included in the model. The model is merged with the uncollapsed mode model to obtain a simulation tool that handles all CMUT behavior, in transmit or receive. Large- and small-signal operation of a single CMUT can be fully simulated for any excitation regime. The results are in good agreement with FEM simulations. PMID:24402904

  13. Design, fabrication, and testing of lumped element kinetic inductance detectors for 3 mm CMB Observations

    NASA Astrophysics Data System (ADS)

    Lowitz, Amy E.; Brown, Ari-David; Stevenson, Thomas R.; Timbie, Peter T.; Wollack, Edward J.

    2014-07-01

    Kinetic inductance detectors (KIDs) are a promising technology for low-noise, highly-multiplexible mm- and submm-wave detection. KIDs have a number of advantages over other detector technologies, which make them an appealing option in the cosmic microwave background B-mode anisotropy search, including passive frequency domain multiplexing and relatively simple fabrication, but have suffered from challenges associated with noise control. Here we describe design and fabrication of a 20-pixel prototype array of lumped element molybdenum KIDs. We show Q, frequency and temperature measurements from the array under dark conditions. We also present evidence for a double superconducting gap in molybdenum.

  14. Parametric study of turbine blade platform friction damping using the lumped parameter analysis

    NASA Technical Reports Server (NTRS)

    Dominic, R. J.

    1984-01-01

    The hardware configuration used in the present study of turbine blade planform friction damping, by means of the lumped parameter analysis, is the first turbine stage of the Space Shuttle Main Engine's High Pressure Fuel Turbopump. The analysis procedure solves the nonlinear equations of motion for a turbine blade that is acted on by a platform friction damper, using an iterative matrix method. Attention is given to the effects on blade deflection response of variations in friction coefficient, the normal force on the friction surface interface, blade hysteretic damping, the blade-to-blade phase angle of the harmonic forcing function, and the amplitude of the forcing function.

  15. An exceptional case of bilateral gestational gigantomastia with multiple breast lumps.

    PubMed

    Traoré, Bangaly; Kamate, Bakarou; Conde, Mamoudou; Keita, Ahmed Monzomba; Kourouma, Tidiane; Dem, Ahmadou

    2015-01-01

    Bilateral gigantomastia is a rare condition, often associated with pregnancy that is characterized by a diffuse enlargement of both breasts. Here we present a case of a late 20s woman in her seven months pregnancy with a bilateral gestational gigantomastia associated with multiple breast lumps. Histological analysis revealed a fibroadenoma. Her prolactin level after caesarean delivery was found particularly high. A significant decrease in breast size was achieved with bromocriptine treatment in conjunction with a bilateral lumpectomy. This case report highlights the diversity of gigantomastia and emphasizes the importance of a tailored, multidisciplinary approach to the diagnosis and treatment of this condition. PMID:26161232

  16. Charge on luminous bodies resembling natural ball lightning produced via electrical arcs through lump silicon.

    PubMed

    Porter, Christina L; Miley, Galen P; Griffiths, David J; Sánchez, Erik

    2014-12-01

    A phenomenon resembling natural ball lightning can be produced via electrical arcing through silicon. We use lump silicon instead of silicon wafers to achieve higher production rates and larger, longer-lived luminous balls than previously reported. The luminous balls consist of a silicon core surrounded by a porous network of loosely bound silicon dioxide nanoparticles. We find that the balls carry a small net charge on the order of 10(-12) C and propose that the nanoparticles are electrostatically bound to the core due to this charge. PMID:25615201

  17. Charge on luminous bodies resembling natural ball lightning produced via electrical arcs through lump silicon

    NASA Astrophysics Data System (ADS)

    Porter, Christina L.; Miley, Galen P.; Griffiths, David J.; Sánchez, Erik

    2014-12-01

    A phenomenon resembling natural ball lightning can be produced via electrical arcing through silicon. We use lump silicon instead of silicon wafers to achieve higher production rates and larger, longer-lived luminous balls than previously reported. The luminous balls consist of a silicon core surrounded by a porous network of loosely bound silicon dioxide nanoparticles. We find that the balls carry a small net charge on the order of 10-12 C and propose that the nanoparticles are electrostatically bound to the core due to this charge.

  18. Compact Bandpass Filter Based on Parallel-coupled Lines and Quasi-lumped Structure

    NASA Astrophysics Data System (ADS)

    Ding, Chen; Li, Jiao; Wei, Feng; Shi, Xiao-Wei

    2016-01-01

    A compact microstrip bandpass filter (BPF) using quarter-wavelength resonators is proposed based on the parallel-coupled lines (PCLs) and quasi-lumped structure. A method based on the matrix and network transformation of cascaded-quadruplet (CQ) filters is investigated and successfully applied to the BPF design. The design formulas for the proposed BPF are analytically developed. Specifically, in order to verify the feasibility of the proposed method, three BPFs centering at 1.575 GHz with different FBWs are designed. Good agreement between the simulated and measured results is observed. Moreover, the designed filters can achieve a wide stopband.

  19. An exceptional case of bilateral gestational gigantomastia with multiple breast lumps

    PubMed Central

    Traoré, Bangaly; Kamate, Bakarou; Conde, Mamoudou; Keita, Ahmed Monzomba; Kourouma, Tidiane; Dem, Ahmadou

    2015-01-01

    Bilateral gigantomastia is a rare condition, often associated with pregnancy that is characterized by a diffuse enlargement of both breasts. Here we present a case of a late 20s woman in her seven months pregnancy with a bilateral gestational gigantomastia associated with multiple breast lumps. Histological analysis revealed a fibroadenoma. Her prolactin level after caesarean delivery was found particularly high. A significant decrease in breast size was achieved with bromocriptine treatment in conjunction with a bilateral lumpectomy. This case report highlights the diversity of gigantomastia and emphasizes the importance of a tailored, multidisciplinary approach to the diagnosis and treatment of this condition. PMID:26161232

  20. Design, Fabrication, and Testing of Lumped Element Kinetic inductance Detectors for 3 mm CMB Observations

    NASA Technical Reports Server (NTRS)

    Lowitz, Amy E.; Brown, Ari David; Stevenson, Thomas R.; Timbie, Peter T.; Wollack, Edward J.

    2014-01-01

    Kinetic inductance detectors (KIDs) are a promising technology for low-noise, highly-multiplexible mm- and submm-wave detection. KIDs have a number of advantages over other detector technologies, which make them an appealing option in the cosmic microwave background B-mode anisotropy search, including passive frequency domain multiplexing and relatively simple fabrication, but have suffered from challenges associated with noise control. Here we describe design and fabrication of a 20-pixel prototype array of lumped element molybdenum KIDs. We show Q, frequency and temperature measurements from the array under dark conditions. We also present evidence for a double superconducting gap in molybdenum.

  1. Ultrasound of pediatric breast masses: what to do with lumps and bumps.

    PubMed

    Valeur, Natalie S; Rahbar, Habib; Chapman, Teresa

    2015-10-01

    The approach to breast masses in children differs from that in adults in many ways, including the differential diagnostic considerations, imaging algorithm and appropriateness of biopsy as a means of further characterization. Most pediatric breast masses are benign, either related to breast development or benign neoplastic processes. Biopsy is rarely needed and can damage the developing breast; thus radiologists must be familiar with the imaging appearance of common entities so that biopsies are judiciously recommended. The purpose of this article is to describe the imaging appearances of the normally developing pediatric breast as well as illustrate the imaging findings of a spectrum of diseases, including those that are benign (fibroadenoma, juvenile papillomatosis, pseudoangiomatous stromal hyperplasia, gynecomastia, abscess and fat necrosis), malignant (breast carcinoma and metastases), and have variable malignant potential (phyllodes tumor). PMID:26164440

  2. A generalized lumped-element equivalent circuit for tunable magnetoelectric microwave devices with multi-magnetoelectric laminates

    NASA Astrophysics Data System (ADS)

    Zhou, Hao-Miao; Lian, Jing

    2014-05-01

    According to the microwave transmission principle and the mechanism of ferromagnetic resonance, a generalized lumped element model for electrically and magnetically magnetoelectric tunable microwave devices with multi-magnetoelectric laminates is established. This model is introduced the RLC series resonant circuit and an ideal transformer model to characterize the ferromagnetic resonance effect and the coupling between microstrip line and the magnetoelectric laminates. Then, the model is degenerated to an existing microwave resonator, which contains only a single block magnetoelectric laminate, and transmission characteristics results predicted by the lumped element model are compared with the experimental results and the electromagnetic simulated results. It is found that the lumped circuit model can effectively predict the center frequency and bandwidth of the resonator. After that, the lumped element model is used to predict the band characteristics and the magnetic and electric tunability of the filter with multi-magnetoelectric laminates. The results show that the application of multi-magnetoelectric laminates in filters can not only broaden bandwidth, but also control the work frequency band by tuning the external electrostatic and magnetostatic field on the magnetoelectric laminates. Therefore, considering the practicality and versatility of microwave devices with multi-magnetoelectric laminates, the effective lumped element model can provide the theoretical basis for the design of novel magnetoelectric devices.

  3. Benign disease of the common bile duct.

    PubMed

    Saxena, R; Pradeep, R; Chander, J; Kumar, P; Wig, J D; Yadav, R V; Kaushik, S P

    1988-08-01

    The incidence of common bile duct (CBD) pathology in a group of patients with benign biliary disease (n = 505) was found to be 23.2 per cent. The spectrum included 111 patients (90.2 per cent) with CBD stones, 37 of whom (33.3 per cent) had no symptoms or findings pre-operatively indicating CBD involvement. Five patients had papillary stenosis, three had postoperative CBD strictures, one had a choledochal cyst and one had an external biliary fistula. Of the 100 CBDs measuring more than 10 mm in diameter, 90 harboured calculi. In the remaining 23 CBDs measuring less than 10 mm, calculi were present in 21. The presence of CBD calculi was demonstrated by intra-operative cholangiography in 49 patients. In the remaining patients (n = 74), the diagnosis of CBD pathology was made either by percutaneous transhepatic cholangiography, endoscopic retrograde cholangio-pancreatography, T-tube cholangiography or peroperative palpation. The surgical procedures performed included choledochotomy and T-tube drainage (n = 74), transduodenal sphincteroplasty (n = 27) and choledochoduodenostomy (n = 18). The overall mortality and morbidity of CBD exploration was 3.3 per cent and 24.4 per cent respectively, which was significantly greater than that for cholecystectomy alone (0.3 per cent and 8.6 per cent respectively). Transduodenal sphincteroplasty carried a much higher mortality (11 per cent) and morbidity (52 per cent) when compared with other procedures. PMID:3167536

  4. [Pharmacological treatment of benign prostatic hyperplasia].

    PubMed

    Oelke, M; Martinelli, E

    2016-01-01

    The pharmacological treatment of benign prostatic hyperplasia (BPH) is indicated when men suffer from lower urinary tract symptoms (LUTS) but there are no absolute indications for prostate surgery or severe bladder outlet obstruction. Phytotherapy can be used in men with mild to moderate LUTS and alpha-blockers can quickly and effectively decrease the LUTS and symptomatic disease progression. Phosphodiesterase type 5 inhibitors (PDE5-I) are an alternative to alpha-blockers when men experience bothersome side effects from alpha-blockers or erectile dysfunction. If patients predominantly have bladder storage symptoms and a small prostate, muscarinic receptor antagonists are a viable treatment option. The combination of alpha-blocker plus muscarinic receptor antagonist is more efficacious in reducing LUTS than the single drugs alone. The 5 alpha-reductase inhibitors (5ARI) can significantly decrease LUTS and disease progression (e.g. acute urinary retention and need for prostate surgery) in men with larger prostates (> 30-40 ml). The combination of 5ARI plus alpha-blocker can reduce LUTS and disease progression more effectively than drug monotherapy. Combination therapy with PDE5-I (tadalafil) plus 5ARI (finasteride) reduces LUTS more substantially than 5ARI alone and, additionally, PDE5-Is reduce the sexual side effects during 5ARI treatment. PMID:26676726

  5. Benign and pathological electrocardiographic changes in athletes.

    PubMed

    Machado, Marino; Vaz Silva, Manuel

    2015-12-01

    Sudden cardiac death is the leading cause of death in athletes during sport. It is a tragic event that generates significant media attention and discussion throughout society as to whether everything possible had been done to prevent it. Regular physical exercise causes cardiac remodeling at both the mechanical and electrical level, known as athlete's heart, resulting in an electrocardiogram (ECG) considered abnormal compared with the ECGs of the general population. Some of these electrocardiographic changes are considered normal or physiological in athletes, while others suggest underlying cardiac disease with the potential to cause sudden cardiac death. There is thus an urgent need to define the electrocardiographic patterns that allow or prohibit participation in sports, and to differentiate them in terms of gender, ethnicity and age. The purpose of this review is to present the latest data on the electrocardiographic changes considered benign or pathological that are typically found in athletes and to critically analyze the most recent criteria for classifying ECGs in this population (the Seattle criteria), comparing them with previous guidelines and with the latest studies on the subject. This article also examines the question of including ECGs in pre-participation screening programs, the US and European approaches to the subject, and the most up-to-date data on the sensitivity, specificity and cost-effectiveness of the ECG in athletes. PMID:26643438

  6. Benign paroxysmal tonic upgaze of childhood.

    PubMed

    Ouvrier, R A; Billson, F

    1988-07-01

    Four cases of an apparently benign ocular motor syndrome of childhood are reported. The features of the disorder are: (1) onset in early life; (2) periods of constant or variably sustained tonic conjugate upward deviation of the eyes; (3) down-beating saccades in attempted downgaze, which are difficult to sustain below the neutral positions; (4) apparently normal horizontal eye movements; (5) frequent relief by sleep; (6) otherwise normal neurological findings apart from mild ataxia, chronic in one boy and at times of illness in one of the other patients; (7) absence of deterioration during observation spanning up to 15 years; (8) eventual improvement but with some residual ocular movement problems in two cases; (9) normal metabolic, electroencephalographic, and neuroradiologic investigations; (10) normal brain examination findings in one patient who died accidentally; and (11) an apparently good response to levodopa therapy in one patient. To the authors' knowledge, this condition has not been described previously. It may be a new levodopa-responsive condition, secondary to a localized neurotransmitter deficiency. PMID:3209843

  7. Diode Laser Excision of Oral Benign Lesions

    PubMed Central

    Mathur, Ena; Sareen, Mohit; Dhaka, Payal; Baghla, Pallavi

    2015-01-01

    Introduction: Lasers have made tremendous progress in the field of dentistry and have turned out to be crucial in oral surgery as collateral approach for soft tissue surgery. This rapid progress can be attributed to the fact that lasers allow efficient execution of soft tissue procedures with excellent hemostasis and field visibility. When matched to scalpel, electrocautery or high frequency devices, lasers offer maximum postoperative patient comfort. Methods: Four patients agreed to undergo surgical removal of benign lesions of the oral cavity. 810 nm diode lasers were used in continuous wave mode for excisional biopsy. The specimens were sent for histopathological examination and patients were assessed on intraoperative and postoperative complications. Results: Diode laser surgery was rapid, bloodless and well accepted by patients and led to complete resolution of the lesions. The excised specimen proved adequate for histopathological examination. Hemostasis was achieved immediately after the procedure with minimal postoperative problems, discomfort and scarring. Conclusion: We conclude that diode lasers are rapidly becoming the standard of care in contemporary dental practice and can be employed in procedures requiring excisional biopsy of oral soft tissue lesions with minimal problems in histopathological diagnosis. PMID:26464781

  8. Clinical Investigation of Benign Asbestos Pleural Effusion

    PubMed Central

    Fujimoto, Nobukazu; Gemba, Kenichi; Aoe, Keisuke; Kato, Katsuya; Yokoyama, Takako; Usami, Ikuji; Onishi, Kazuo; Mizuhashi, Keiichi; Yusa, Toshikazu; Kishimoto, Takumi

    2015-01-01

    There is no detailed information about benign asbestos pleural effusion (BAPE). The aim of the study was to clarify the clinical features of BAPE. The criteria of enrolled patients were as follows: (1) history of asbestos exposure; (2) presence of pleural effusion determined by chest X-ray, CT, and thoracentesis; and (3) the absence of other causes of effusion. Clinical information was retrospectively analysed and the radiological images were reviewed. There were 110 BAPE patients between 1991 and 2012. All were males and the median age at diagnosis was 74 years. The median duration of asbestos exposure and period of latency for disease onset of BAPE were 31 and 48 years, respectively. Mean values of hyaluronic acid, adenosine deaminase, and carcinoembryonic antigen in the pleural fluid were 39,840 ng/mL, 23.9 IU/L, and 1.8 ng/mL, respectively. Pleural plaques were detected in 98 cases (89.1%). Asbestosis was present in 6 (5.5%) cases, rounded atelectasis was detected in 41 (37.3%) cases, and diffuse pleural thickening (DPT) was detected in 30 (27.3%) cases. One case developed lung cancer (LC) before and after BAPE. None of the cases developed malignant pleural mesothelioma (MPM) during the follow-up. PMID:26689234

  9. [Minimally Invasive Treatment of Esophageal Benign Diseases].

    PubMed

    Inoue, Haruhiro

    2016-07-01

    As a minimally invasive treatment of esophageal achalasia per-oral endoscopic myotomy( POEM) was developed in 2008. More than 1,100 cases of achalasia-related diseases received POEM. Success rate of the procedure was more than 95%(Eckerdt score improvement 3 points and more). No serious( Clavian-Dindo classification III b and more) complication was experienced. These results suggest that POEM becomes a standard minimally invasive treatment for achalasia-related diseases. As an off-shoot of POEM submucosal tumor removal through submucosal tunnel (per-oral endoscopic tumor resection:POET) was developed and safely performed. Best indication of POET is less than 5 cm esophageal leiomyoma. A novel endoscopic treatment of gastroesophageal reflux disease (GERD) was developed. Anti-reflux mucosectomy( ARMS) is nearly circumferential mucosal reduction of gastric cardia mucosa. ARMS is performed in 56 consecutive cases of refractory GERD. No major complications were encountered and excellent clinical results. Best indication of ARMS is a refractory GERD without long sliding hernia. Longest follow-up case is more than 10 years. Minimally invasive treatments for esophageal benign diseases are currently performed by therapeutic endoscopy. PMID:27440038

  10. Skin conditions: benign nodular skin lesions.

    PubMed

    Nguyen, Tam; Zuniga, Ramiro

    2013-04-01

    Benign subcutaneous lesions are a common reason that patients visit family physicians. Lipomas are the most common of these lesions; they most often occur on the trunk and proximal extremities. Recent data show that as many as half of the fat cells in lipomas are atypical. Ultrasound is used increasingly to confirm lipoma diagnosis, but deep lesions should be evaluated with magnetic resonance imaging study or computed tomography scan to exclude involvement of underlying structures and/or liposarcoma. Small lesions can sometimes be managed with serial injections of midpotency steroids. Larger lesions (larger than 5 cm), those compressing other structures, or those suspicious for malignancy should be excised using standard surgical excision or, when possible, the newer minimal-scar segmental extraction technique. Ganglion cysts are another common lesion, the presence of which often is confirmed with ultrasound if the diagnosis is not clinically apparent. Management includes splinting, aspiration, and/or injection of steroids, with or without hyaluronidase. Epidermal inclusion cysts, also called sebaceous cysts, typically are asymptomatic unless they become infected. Ultrasound can aid in diagnosis. The only definitive management is surgical excision with complete removal of the cyst wall or capsule, using minimal-scar segmental extraction or conventional surgical removal. PMID:23600336

  11. Magnetic resonance imaging of benign prostatic hyperplasia

    PubMed Central

    Guneyli, Serkan; Ward, Emily; Thomas, Stephen; Yousuf, Ambereen Nehal; Trilisky, Igor; Peng, Yahui; Antic, Tatjana; Oto, Aytekin

    2016-01-01

    Benign prostatic hyperplasia (BPH) is a common condition in middle-aged and older men and negatively affects the quality of life. An ultrasound classification for BPH based on a previous pathologic classification was reported, and the types of BPH were classified according to different enlargement locations in the prostate. Afterwards, this classification was demonstrated using magnetic resonance imaging (MRI). The classification of BPH is important, as patients with different types of BPH can have different symptoms and treatment options. BPH types on MRI are as follows: type 0, an equal to or less than 25 cm3 prostate showing little or no zonal enlargements; type 1, bilateral transition zone (TZ) enlargement; type 2, retrourethral enlargement; type 3, bilateral TZ and retrourethral enlargement; type 4, pedunculated enlargement; type 5, pedunculated with bilateral TZ and/or retrourethral enlargement; type 6, subtrigonal or ectopic enlargement; type 7, other combinations of enlargements. We retrospectively evaluated MRI images of BPH patients who were histologically diagnosed and presented the different types of BPH on MRI. MRI, with its advantage of multiplanar imaging and superior soft tissue contrast resolution, can be used in BPH patients for differentiation of BPH from prostate cancer, estimation of zonal and entire prostatic volumes, determination of the stromal/glandular ratio, detection of the enlargement locations, and classification of BPH types which may be potentially helpful in choosing the optimal treatment. PMID:27015442

  12. Lumped parameter estimation for the embryonic chick vascular system: a time-domain approach using MLAB.

    PubMed

    Yoshigi, M; Knott, G D; Keller, B B

    2000-08-01

    We have evaluated several lumped parameter analog models for the early chick embryonic vascular system that may be used to infer loading characteristics of the developing heart. We measured dorsal aortic pressure and flow simultaneously with a servo-null pressure system and a pulsed Doppler velocimeter. Four different analog circuit models were chosen for comparisons. We formulated the time-domain differential equations specifying the relations between pressure and flow in the models, and then estimated the lumped parameters that produced the best fit. The MLAB mathematical modeling software was used for solving differential equations, and for minimizing the difference between model-predicted values and experimental data. The traditional three-element Windkessel model with an added inductance term was most often the best-fitting model. This is compatible with the previous study using a frequency-domain approach. The procedures developed for the current study are adaptable for the study of a variety of nonlinear models, and distributed parameter models for mammalian cardiovascular development with mechanically, pharmacologically, or genetically altered conditions. PMID:10927152

  13. An electromagnetic and thermodynamic lumped parameter model of an explosively driven regenerative magnetohydrodynamic generator

    SciTech Connect

    Morrison, J.L.

    1992-12-01

    The objective of this research is to develop a simple, yet accurate, lumped parameter mathematical model for an explosively driven magnetohydrodynamic generator that can predict the pulse power variables of voltage and current from startup through regenerative operation. The inputs to the model will be the plasma properties entering the generator as predicted by the explosive shock model of Reference [1]. The strategy used was to simplify electromagnetic and thermodynamic three dimensional effects into a zero dimensional model. The model will provide a convenient tool for researchers to optimize designs to be used in pulse power applications. The model is validated using experimental data of Reference [1]. An overview of the operation of the explosively driven generator is first presented. Then a simplified electrical circuit model that describes basic performance of the device is developed. Then a lumped parameter model that incorporates the coupled electromagnetic and thermodynamic effects that govern generator performance is described and developed. The model is based on fundamental physical principles and parameters that were either obtained directly from design data or estimated from experimental data. The model was used to obtain parameter sensitivities and predict beyond the limits observed in the experiments to the levels desired by the potential Department of Defense sponsors. The model identifies process limitations that provide direction for future research.

  14. Lumped parameter analysis of a stringer reinforced plate excited by band limited noise

    NASA Technical Reports Server (NTRS)

    Bilyeu, D. J.; Whitehouse, G. D.; Whitehurst, C. A.

    1972-01-01

    The maximum root-mean-square response of a square clamped plate, subjected to a stationary random excitation, was determined both theoretically and empirically. For the tests, a 40 x 40 x 1/4 aluminum sheet was milled out to provide a thin waffle plate with 9 panels. The plate was acoustically excited, with the frequency range limited between 25 Hz and 500 Hz. The root-mean-square power of the random excitations, 149 decibels, was nearly constant for all natural frequencies of the plate system. Strain gage readings at 14 points were plotted as power spectral densities and root-mean-square displacements. A modal damping ratio matrix was determined from the response curves. Damping ratios were found to be a function of frequency, but not of location on the plate. For comparisons with the theoretical response, the plate was subdivided into 14 modes and anlayzed as a damped, lumped parameter system by use of an approximate normal-mode method. This method gave the best predictions of the power spectral densities for the lower frequencies. That prediction errors increased for the higher frequencies is attributed to improper assumptions for mass distribution and the insufficient number of lumped mass points.

  15. Modelling rogue waves through exact dynamical lump soliton controlled by ocean currents

    PubMed Central

    Kundu, Anjan; Mukherjee, Abhik; Naskar, Tapan

    2014-01-01

    Rogue waves are extraordinarily high and steep isolated waves, which appear suddenly in a calm sea and disappear equally fast. However, though the rogue waves are localized surface waves, their theoretical models and experimental observations are available mostly in one dimension, with the majority of them admitting only limited and fixed amplitude and modular inclination of the wave. We propose two dimensions, exactly solvable nonlinear Schrödinger (NLS) equation derivable from the basic hydrodynamic equations and endowed with integrable structures. The proposed two-dimensional equation exhibits modulation instability and frequency correction induced by the nonlinear effect, with a directional preference, all of which can be determined through precise analytic result. The two-dimensional NLS equation allows also an exact lump soliton which can model a full-grown surface rogue wave with adjustable height and modular inclination. The lump soliton under the influence of an ocean current appears and disappears preceded by a hole state, with its dynamics controlled by the current term. These desirable properties make our exact model promising for describing ocean rogue waves. PMID:24711719

  16. A test of GEM T2 from GEOSAT crossovers using latitude lumped coefficients

    NASA Astrophysics Data System (ADS)

    Klokočník, Jaroslav; Wagner, Carl A.

    1994-06-01

    New Latitude Lumped Coefficients (LLC) of a geopotential model are defined as representing the principal differences of the radial distance to a satellite due to the model at single-orbit crossovers in an Exact Repeat Mission. In contrast with previously defined orbital lumped coefficients, the LLC here are dependent only on the geopotential order (without degree distinction) and the latitude. We examine discrepancies in altimetrically determined sea surface heights at over 30000 crossover positions of GEOSAT during its ERM, 1986 1989, after removal of many variable media and surface effects (Cheney et al., 1991) as well as initial condition orbit error. The mean of these discrepancies along well represented latitude bands in the southern hemisphere are used to determine the LLC errors for Goddard Earth Model T2, which was the reference for the GEOSAT sea surface heights. GEM T2 was derived from satelliteonly tracking data with good representation of the GEOSAT orbit. Relating the ”measured” LLC discrepancies to projections of commission error from the GEM T2 variance-covariance matrix, we find that — except for order 3 — GEM T2's performance is as expected. This test represents the first spectral calibration of a gravity model with independent, purely radial orbit data.

  17. Design Optimization Tool for Synthetic Jet Actuators Using Lumped Element Modeling

    NASA Technical Reports Server (NTRS)

    Gallas, Quentin; Sheplak, Mark; Cattafesta, Louis N., III; Gorton, Susan A. (Technical Monitor)

    2005-01-01

    The performance specifications of any actuator are quantified in terms of an exhaustive list of parameters such as bandwidth, output control authority, etc. Flow-control applications benefit from a known actuator frequency response function that relates the input voltage to the output property of interest (e.g., maximum velocity, volumetric flow rate, momentum flux, etc.). Clearly, the required performance metrics are application specific, and methods are needed to achieve the optimal design of these devices. Design and optimization studies have been conducted for piezoelectric cantilever-type flow control actuators, but the modeling issues are simpler compared to synthetic jets. Here, lumped element modeling (LEM) is combined with equivalent circuit representations to estimate the nonlinear dynamic response of a synthetic jet as a function of device dimensions, material properties, and external flow conditions. These models provide reasonable agreement between predicted and measured frequency response functions and thus are suitable for use as design tools. In this work, we have developed a Matlab-based design optimization tool for piezoelectric synthetic jet actuators based on the lumped element models mentioned above. Significant improvements were achieved by optimizing the piezoceramic diaphragm dimensions. Synthetic-jet actuators were fabricated and benchtop tested to fully document their behavior and validate a companion optimization effort. It is hoped that the tool developed from this investigation will assist in the design and deployment of these actuators.

  18. Reaction Mechanism of Siderite Lump in Coal-Based Direct Reduction

    NASA Astrophysics Data System (ADS)

    Zhu, Deqing; Luo, Yanhong; Pan, Jian; Zhou, Xianlin

    2016-02-01

    Siderite is one of the significant iron ore resources in China and yet is difficult to upgrade by traditional beneficiation processes. A process of coal-based direct reduction-magnetic separation was successfully developed for the beneficiation of siderite. However, few studies have thoroughly investigated the mechanism of the direct reduction of siderite. In order to reveal the reaction mechanism of coal-based direct reduction of siderite lump, thermodynamics of direct reduction was investigated with coal as the reductant. The thermodynamics results indicate that coal-based direct reduction process of siderite lump at 1,050°C follows the steps as FeCO3→ Fe3O4→ FeO → Fe, which is verified by chemical titration analysis, X-ray diffraction and scanning electron microscope. The microstructure of siderite sample varies with different reduction stages and some 45% porosity induced by thermal decomposition of siderite is conductive to subsequent reduction. The conversion of FeO to Fe is the main reduction rate-controlling step. The reduced product with the metallic iron size over 30 μm can be effectively beneficiated by wet magnetic separation after grinding. The obvious layered structure of reduced product is due to different heat transfer resistance, CO and CO2 concentration.

  19. Comparison of climate datasets for lumped hydrological modeling over the continental United States

    NASA Astrophysics Data System (ADS)

    Essou, Gilles R. C.; Arsenault, Richard; Brissette, François P.

    2016-06-01

    Climate data measured by weather stations are crucially important and regularly used in hydrologic modeling. However, they are not always available due to the low spatial density and short record history of many station networks. To overcome these limitations, gridded datasets have become increasingly available. They have excellent continuous spatial coverage and no missing data. However, these datasets are usually interpolated using station data, with little new information besides elevation. Furthermore, minimal validation has been done on most of these datasets. This study compares three such datasets covering the continental United States to evaluate their differences and their impact on lumped hydrological modeling. Three daily time step gridded datasets with resolutions varying between 0.25° and 1 km were used in this study - Santa-Clara, Daymet and CPC. The hydrological modeling evaluation of these datasets was performed over 424 basins from the MOPEX database. Results show that there are significant differences between the datasets, even though they were essentially all interpolated from almost the same climate databases. Despite those differences, the hydrological model used in this study was able to perform equally well after a specific calibration to each dataset. While there were a few exceptions, by and large, Nash-Sutcliffe efficiency metrics obtained in validation were not statistically different from one database to the other for most basins. It appears that there are no reasons to favor one dataset versus another for lumped hydrological modeling, and that these datasets perform just as well as using the original station data.

  20. Accuracy of lumped-parameter representations for heat conduction modeling in multilayer slabs

    NASA Astrophysics Data System (ADS)

    Gori, Paola; Guattari, Claudia; de Lieto Vollaro, Roberto; Evangelisti, Luca

    2015-11-01

    Heat conduction in homogeneous solids can be studied by resorting to one-dimensional schemes, as is often done, e.g., for building construction elements. In such situations, a simple model often employed makes use of an electrical analogy between temperature and heat flux, on one side, and voltage and electrical current on the other side. Within this framework, a few lumped-parameter representations have been described in literature to describe the thermal behavior of a single homogeneous slab or of multilayer slabs. Such models have the advantage of providing some physical insight into the phenomenon of one-dimensional heat conduction, by conveying the concepts of thermal resistance and thermal capacitance, the latter related to heat storage ability. There is, however, a certain degree of approximation in such models. The simplifying assumptions and approximations underlying these approaches will be reviewed and discussed in this contribution. The accuracy of some lumped-parameter model will be analyzed in order to show under which circumstances the approximate solutions can be satisfactorily employed. In particular, the focus will be on the comparison of the predictions that approximate and accurate methods provide when studying the influence of layer order and distribution on the thermal performance of multilayer structures.

  1. A 7 years old girl with abdominal lump and per-vaginal bleeding of hypothyroidism.

    PubMed

    Roy, N; Nahar, K; Begum, B; Sarker, U K; Akter, F; Roy, J; Chakrabarty, R

    2015-01-01

    Hypothyroidism is a common endocrine disorder resulting from decreased secretion of thyroid hormone. The diagnosis of hypothyroidism is suggested from the clinical and laboratory findings. Here we present a case report on this disease with rare presentation of abdominal lump and pervaginal bleeding in childhood. A 7 years old girl admitted in a tertiary level hospital with abdominal lump and irregular per vaginal bleeding. Abdominal swelling was gradually increasing in size & associated with lower abdominal pain for last 5 months. On examination the girl was moderately anaemic, mildly oedematous, distended lower abdomen and a mass in left iliac region. Her thyroid function test, serum FSH, serum LH, serum Prolactin was done and high FSH, LH, Prolactin levels were found. Ultrasonography of lower abdomen revealed bulky uterus and bilateral ovarian cysts. MRI of Brain showed feature of pituitary microadenoma. Finally the patient was diagnosed as primary hypothyroidism and bilateral follicular ovarian cyst with pituitary adenoma developed as its consequence. The case is reported for clinical awareness & to share our experience. PMID:25725684

  2. Impedimetric detection and lumped element modelling of a hemagglutination assay in microdroplets.

    PubMed

    Marcali, Merve; Elbuken, Caglar

    2016-07-01

    Droplet-based microfluidic systems offer tremendous benefits for high throughput biochemical assays. Despite the wide use of electrical detection for microfluidic systems, application of impedimetric sensing for droplet systems is very limited. This is mainly due to the insulating oil-based continuous phase used for most aqueous samples of interest. We present modelling and experimental verification of impedimetric detection of hemagglutination in microdroplets. We have detected agglutinated red blood cells in microdroplets and screened whole blood samples for multiple antibody sera using conventional microelectrodes. We were able to form antibody and whole blood microdroplets in PDMS microchannels without any tedious chemical surface treatment. Following the injection of a blood sample into antibody droplets, we have detected the agglutination-positive and negative droplets in an automated manner. In order to understand the characteristics of impedimetric detection inside microdroplets, we have developed the lumped electrical circuit equivalent of an impedimetric droplet content detection system. The empirical lumped element values are in accordance with similar models developed for single phase electrical impedance spectroscopy systems. The presented approach is of interest for label-free, quantitative analysis of droplets. In addition, the standard electronic equipment used for detection allows miniaturized detection circuitries that can be integrated with a fluidic system for a quantitative microdroplet-based hemagglutination assay that is conventionally performed in well plates. PMID:27270895

  3. (Quantum) spacetime as a statistical geometry of lumps in random networks

    NASA Astrophysics Data System (ADS)

    Requardt, Manfred

    2000-05-01

    In the following we undertake to describe how macroscopic spacetime (or rather, a microscopic protoform of it) is supposed to emerge as a superstructure of a web of lumps in a stochastic discrete network structure. As in preceding work (mentioned below), our analysis is based on the working philosophy that both physics and the corresponding mathematics have to be genuinely discrete on the primordial (Planck scale) level. This strategy is concretely implemented in the form of cellular networks and random graphs. One of our main themes is the development of the concept of physical (proto)points or lumps as densely entangled subcomplexes of the network and their respective web, establishing something like (proto)causality. It may perhaps be said that certain parts of our programme are realizations of some early ideas of Menger and more recent ones sketched by Smolin a couple of years ago. We briefly indicate how this two-storey concept of quantum spacetime can be used to encode the (at least in our view) existing non-local aspects of quantum theory without violating macroscopic spacetime causality!

  4. PRRT2 mutation in Japanese children with benign infantile epilepsy.

    PubMed

    Okumura, Akihisa; Shimojima, Keiko; Kubota, Tetsuo; Abe, Shinpei; Yamashita, Shintaro; Imai, Katsumi; Okanishi, Tohru; Enoki, Hideo; Fukasawa, Tatsuya; Tanabe, Takuya; Dibbens, Leanne M; Shimizu, Toshiaki; Yamamoto, Toshiyuki

    2013-08-01

    Mutations in PRRT2 genes have been identified as a major cause of benign infantile epilepsy and/or paroxysmal kinesigenic dyskinesia. We explored mutations in PRRT2 in Japanese patients with BIE as well as its related conditions including convulsion with mild gastroenteritis and benign early infantile epilepsy. We explored PRRT2 mutations in Japanese children who had had unprovoked infantile seizures or convulsion with mild gastroenteritis. The probands included 16 children with benign infantile epilepsy, 6 children with convulsions with mild gastroenteritis, and 2 siblings with benign early infantile epilepsy. In addition, we recruited samples from family members when PRRT2 mutation was identified in the proband. Statistical analyses were performed to identify differences in probands with benign infantile epilepsy according to the presence or absence of PRRT2 mutation. Among a total of 24 probands, PRRT2 mutations was identified only in 6 probands with benign infantile epilepsy. A common insertion mutation, c.649_650insC, was found in 5 families and a novel missense mutation, c.981C>G (I327M), in one. The family history of paroxysmal kinesigenic dyskinesia was more common in probands with PRRT2 mutations than in those without mutations. Our study revealed that PRRT2 mutations are common in Japanese patients with benign infantile epilepsy, especially in patients with a family history of paroxysmal kinesigenic dyskinesia. PMID:23131349

  5. Thyroid carcinoma masquerading as a solitary benign hyperfunctioning nodule

    SciTech Connect

    Sandler, M.P.; Fellmeth, B.; Salhany, K.E.; Patton, J.A.

    1988-06-01

    Focal hot nodules on iodine thyroid images are associated with an exceedingly low incidence of malignancy. Most previously reported hot carcinomas represent the coexistence of small malignancies in or adjacent to a benign hot lesion. Described here is a 3-cm papillary carcinoma that fulfilled the criteria for benignancy on Tc-99m and I-123 imaging. Coincidental carcinoma within a benign lesion was excluded by detailed scintigraphic-pathologic correlation of the tumor. The implications of this case on the management of the solitary hot nodule are discussed and the literature reviewed.

  6. Characteristics of "malignant" vs. "benign" electrocardiographic patterns of early repolarization.

    PubMed

    Tikkanen, J T; Huikuri, H V

    2015-01-01

    The electrocardiographic (ECG) pattern of early repolarization (ER) has historically been regarded as a benign ECG variant, but during the past few years, this concept has been challenged based on multiple reports linking the ER pattern with an increased risk of sudden cardiac death. Although the mechanistic basis of ventricular arrhythmogenesis in patients with ER pattern is still incompletely understood, there is increasing information about the ECG and phenotype characteristics of "malignant" vs. "benign" patterns of ER. This review presents the current evidence of markers of "benign" and a more severe nature of ER. PMID:25634766

  7. Multinucleate Giant Cells in FNAC of Benign Breast Lesions: Its Significance

    PubMed Central

    R, Kalyani; Murthy V, Srinivasa

    2014-01-01

    Background: Multinucleate giant cells are described in breast aspirates. However, due to its rarity very few cases have been described cytologically. Hence recognition and correct interpretation of their presence is difficult, yet crucial for accurate diagnosis. Materials and Methods: The prospective study of FNAC (fine needle aspirate cytology) of breast lumps was conducted for a period of six months. Direct smears were prepared from the material aspirated. In case of fluid aspirates, centrifuge done and cell sediment was used for making smears. Smears were alcohol fixed and stained with PAP/H&E or air dried smears were stained with Leishman stain. Further smears were subjected to immunocytochemistry using vimentin and CD34 markers to know the origin of multinucleate giant cells. Results: We have reported 11 cases of breast lesions, which showed multinucleate giant cells on FNAC. Out of the 11 cases, Cytologically six cases showed granuloma debris with relative proportion of epithelioid histiocytes, lymphocytes, neutrophils and multinucleate giant cells. Two cases were diagnosed as acute suppurative granulomatous mastitis. Two cases of fibroadenoma and one case of fat necrosis showed multinucleate giant cells. Immunocytochemistry showed vimentin positivity in both stromal and histiocytic type of multinucleate giant cells and in isolated histiocytes. CD34 was focally positive in histiocytic type of giant cells. Conclusion: An effort is made to distinguish between the stromal and histiocytic type giant cells in non-neoplastic breast lesions. Further molecular studies have to be done to know the exact histogenesis and role of these multinucleate giant cells in benign lesions. PMID:25653953

  8. Features of respiratory support during laparoscopic correction of inguinal hernias in children

    PubMed Central

    Mishchuk, Volodymyr; Dvorakevych, Andriy; Khomyak, Volodymyr

    2016-01-01

    Introduction The objectives were to study the changes in the mechanics of respiration in children undergoing surgery depending on the value of intra-abdominal pressure (IAP) during laparoscopic procedures, and to compare the effects of different mechanical ventilation modes – pressure controlled (PCV) and volume controlled (VCV) ventilation – on the mechanics of respiration considering carboxyperitoneum conditions (CP). Aim To study the changes in the mechanics of respiration in operated children depending on the value of intra-abdominal pressure during laparoscopic procedures. Material and methods Fifty-two children aged 1–12 years undergoing laparoscopic surgery on inguinal hernias were randomly allocated to receive mechanical ventilation using either VCV (n = 24) or PCV (n = 28) mode. Respiratory mechanics were measured before application of carboxyperitoneum (initial data) and after the gas had been pumped into the abdominal cavity, at the following intra-abdominal pressure values: 6 mm Hg, 8 mm Hg, 10 mm Hg, 12 mm Hg, 14 mm Hg. Results Elevation of intra-abdominal pressure due to carboxyperitoneum conditions had a negative effect on the mechanics of respiration. Changes in the respiratory mechanics were restrictive in nature in both groups. The patients who were receiving pressure controlled ventilation showed a decrease in tidal volume, exhaled minute volume, and dynamic lung compliance, which affected the gas exchange at intra-abdominal pressure values ≥ 12 mm Hg. Patients who were receiving volume controlled ventilation showed an increase in peak inspiratory pressure and mean airway pressure and a decrease in dynamic lung compliance in response to higher intra-abdominal pressure. A significant increase of concentration of exhaled carbon dioxide (etCO2) was registered at IAP ≥ 12 mm Hg. Conclusions Application of carboxyperitoneum causes increased intra-abdominal pressure and restrictive disorders in respiratory mechanics. Intra-abdominal pressure

  9. Comparative Study of Inguinal Hernia Repair Rates After Radical Prostatectomy or External Beam Radiotherapy

    SciTech Connect

    Lughezzani, Giovanni; Sun, Maxine; Perrotte, Paul; Alasker, Ahmed; Jeldres, Claudio; Isbarn, Hendrik; Budaeus, Lars; Lattouf, Jean-Baptiste; Valiquette, Luc; Benard, Francois; Saad, Fred; Graefen, Markus; Montorsi, Francesco; Karakiewicz, Pierre I.

    2010-12-01

    Purpose: We tested the hypothesis that patients treated for localized prostate cancer with radical prostatectomy (RP) have a higher risk of requiring an inguinal hernia (IH) repair than their counterparts treated with external beam radiotherapy (EBRT). Methods and Materials: Within the Quebec Health Plan database, we identified 6,422 men treated with RP and 4,685 men treated with EBRT for localized prostate cancer between 1990 and 2000, in addition to 6,933 control patients who underwent a prostate biopsy. From among that population, we identified patients who underwent a unilateral or bilateral hernia repair after either RP or EBRT. Kaplan-Meier plots showed IH repair-free survival rates. Univariable and multivariable Cox regression models tested the predictors of IH repair after RP or EBRT. Covariates consisted of age, year of surgery, and Charlson Comorbidity Index. Results: IH repair-free survival rates at 1, 2, 5, and 10 years were 96.8, 94.3, 90.5, and 86.2% vs. 98.9, 98.0, 95.4, and 92.2%, respectively, in RP vs. EBRT patients (log-rank test, p < 0.001). IH repair-free survival rates in the biopsy population were 98.3, 97.1, 94.9, and 90.2% at the same four time points. In multivariable Cox regression models, RP predisposed to a 2.3-fold higher risk of IH repair than EBRT (p < 0.001). Besides therapy type, patient age (p < 0.001) represented the only other independent predictor of IH repair. Conclusions: RP predisposes to a higher rate of IH repair relative to EBRT. This observation should be considered at informed consent.

  10. The Effects of Different Anaesthetic Techniques on Surgical Stress Response During Inguinal Hernia Operations

    PubMed Central

    Acar, Derya; Erkılıç, Ezgi Karakaş; Gümüş, Tülin; Şahin, Duygu; Dinçel, Aylin Sepici; Kanbak, Orhan

    2015-01-01

    Objective The aim of this study is to compare the effects of 3 different kinds of anaesthesia on stress response induced by surgery. Methods Sixty patients aged between 25–70 American Society of Anesthesiologists (ASA) I–II group to undergo inguinal herniography were included in this study. Patients were randomly divided into 3 groups of 20. Group 1 received general anaesthesia with sevoflurane/air/remifentanil, patients in Group 2 received total intravenous anaesthesia (TIVA) with propofol/air/remifentanil and Group 3 received spinal anaesthesia induced by hyperbaric bupivacaine, adjoined by remifentanil sedation. Mean arterial pressure (MAP), heart rate and SpO2 values were recorded preoperatively, intraoperatively and postoperatively at certain periods. Cortisol, leptin and glucose levels were preoperatively detected. Intervals were as; 15 minutes prior to the induction of anaesthesia, at intraoperative first hour and at the postoperative third and twenty-forth hours. Results MAP and heart rate values were similar in the inhalational anaesthesia and TIVA groups but relatively higher in the spinal anaesthesia group. Blood glucose levels were elevated, insulin levels were decreased in all groups, at the intraoperative first hour. Biphasic variation in blood leptin levels was observed in all groups, as the levels were lower than the preoperative control values at the intraoperative first and postoperative third hours and significantly higher at the postoperative twenty-forth hour. There was a significant decrease in cortisol level percentage change in the TIVA group at the intraoperative 1st hour, increasing in the other groups. Conclusion We concluded that TIVA supresses the stress response induced by surgery better by lowering cortisol levels, leading to a lower increase in blood glucose levels and a lower decrease in blood insulin levels when compared to others. Furthermore, leptin levels were increased at the postoperative twenty-forth hour. The lower

  11. [Diagnosis of presumed benign ovarian tumors].

    PubMed

    Laculle-Massin, C; Collinet, P; Faye, N

    2013-12-01

    Symptoms of presumed benign ovarian tumors (PBOT) are not specific (LE4). Personal or family history of gynecological cancers can guide the diagnostic strategy. Clinical examination is ineffective for positive, topographic and etiologic diagnosis of PBOT (LE4). Signs of hormonal impregnation may refer to certain types of tumors (LE4). For any patient presenting with a pelvic mass, pelvic ultrasound is in the first-line exam (grade A); it can classify most ovarian tumors. In case of pure liquid unilocular mass smaller than 7 cm, ultrasound is sufficient to characterize the mass (grade A). In case of indeterminate or complex ovarian mass on ultrasound, MRI is useful to characterize the mass (LE2). Beyond 7 cm, the diagnostic performance of ultrasound decreases (LE2). When a non-unilocular liquid ovarian formation is characterized using ultrasound as determinate mass, ultrasound scan is the only exam recommended (grade B). MRI is indicated as a second-line scan for indeterminate masses or greater than 7 cm (grade B). Cyst puncture for diagnostic purposes has no place in the diagnostic strategy of ovarian cysts (grade C). In case of PBOT in pre-pubertal period, dosing biomarkers is useful but should not delay care. In adult women with PBOT, the measurement of CA125 is not recommended for first-line diagnosis (grade C). Current literature data are not sufficient to specify the diagnostic strategy for an ovarian tumor discovered incidentally during laparoscopy. In case of discovery of a high CA125 value, pelvic ultrasound is the first-line examination. The literature data are still limited to define a CA125 threshold value requiring further exploration or special monitoring, in case of normal pelvic ultrasound. PMID:24210239

  12. Hereditary benign telangiectasia: first case in Iran.

    PubMed

    Javidi, Zari; Maleki, M; Mashayekhi, V; Nahidi, Y; Omidvar Borna, A

    2006-07-01

    A 14-year-old boy was referred to the Dermatology Clinic of the Medical University of Mashhad, Iran, with numerous cutaneous telangiectasias on the face, ears, lips, and back of the hands, with lesions in the temporal region being the first to appear (Figs 1-3). His mother stated that the lesions had been present for 10 years with an increase in the past 6 months. He had no history of bleeding from the nose, mouth, gastrointestinal tract, and other mucosal surfaces, and there was no sign of organ involvement. On inspection, no lesions were detected on the nasal mucosa, external ear, over the tympanic membrane, or mouth. The patient is one member of a family of six. His mother is healthy, but similar lesions were seen in his father, sister and one of his brothers with similar distributions. Lesions were also seen in his aunt and paternal grandmother, showing disease distribution in six members of this family from three generations. The oldest brother is 20 years of age and mentioned the onset of disease from the age of 10 years. The sister is 18 years of age and lesions started to appear 7 years ago; she claims that the lesions regress during her menstrual period. The youngest brother is 4 years of age and shows no sign of cutaneous lesions as yet. The parents are not consanguineous. Generalized telangiectasia with a predominant distribution on light-exposed skin, an autosomal dominant inheritance, and no sign of systemic or mucosal involvement and bleeding disorders indicates a diagnosis of hereditary benign telangiectasia. Our patient did not consent to biopsy. PMID:16863520

  13. Current Laser Treatments for Benign Prostatic Hyperplasia

    PubMed Central

    Son, Hwancheol; Song, Sang Hoon

    2010-01-01

    The latest technical improvements in the surgical armamentarium are remarkable. In particular, advancements in the urologic field are so exceptional that we could observe the flare-up of robot-assisted laparoscopic radical prostatectomy for prostate cancer and laser prostatectomy for benign prostatic hyperplasia (BPH). Photoselective vaporization of the prostate (PVP) and holmium laser prostatectomy are the most generalized options for laser surgery of BPH, and both modalities have shown good postoperative results. In comparison to transurethral prostatectomy (TURP), they showed similar efficacy and a much lower complication rate in randomized prospective clinical trials. Even in cases of large prostates, laser prostatectomy showed comparable efficacy and safety profiles compared to open prostatectomy. From a technical point of view, PVP is considered to be an easier technique for the urologist to master. Furthermore, patients can be safely followed up in an outpatient clinic. Holmium laser enucleation of the prostate (HoLEP) mimics open prostatectomy because the adenomatous tissue is peeled off the surgical capsule in both procedures. Therefore, HoLEP shows notable volume reduction of the prostate similar to open prostatectomy with fewer blood transfusions, shorter hospital stay, and cost reduction regardless of prostate size. Outcomes of laser prostatectomy for BPH are encouraging but sometimes are unbalanced because safety and feasibility studies were reported mainly for PVP, whereas long-term data are mostly available for HoLEP. We need longer-term randomized clinical data to identify the reoperation rate of PVP and to determine which procedure is the ideal alternative to TURP and open prostatectomy for each patient. PMID:21165192

  14. [Interstitial laser coagulation of benign prostatic hyperplasia].

    PubMed

    Muschter, R; Hessel, S; Hofstetter, A; Keiditsch, E; Rothenberger, K H; Schneede, P; Frank, F

    1993-07-01

    We report on the new method of interstitial laser coagulation for the treatment of benign prostatic hyperplasia (BPH). The procedure is based on the interstitial application of Nd:YAG laser irradiation, delivered through a new light guide system. Such light applicators coagulate constant tissue volumes in a homogeneous manner, as proven by in vitro studies in different tissues, including surgically removed prostate adenoma. The extent of the coagulation is determined by laser power and irradiation time. At 5 W, for example, and during a 10-min period, this zone reached a diameter of up to 20 mm. Temperatures generated in the process were over 100 degrees C, as measured by time/space resolution. These results were confirmed by in vivo studies in canine prostates. In the course of 7 weeks, the coagulated areas formed scars with degeneration and fibrosis, accompanied by marked shrinking. Neighbouring organs were not affected. The method was successfully transferred to clinical practice. The application of the light guides to the lateral lobes was performed percutaneously from the perineum under transrectal ultrasound guidance. The median lobe was punctured transurethrally under direct vision. Twenty-seven patients with an average age of 67.7 years were treated between July 1991 and March 1992. At the time of evaluation 15 patients had a follow-up of more than 2 months. They experienced a mean increase of peak flow rate from 6.6 to 15.2 ml/s and a mean decrease of residual volume from 206 to 38 ml. This was accompanied by a marked lessening of symptoms. The average prostate weight decreased from 63 to 44 g. Sexually active patients did not experience retrograde ejaculation.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7690498

  15. ULTRAPRO Hernia System versus lichtenstein repair in treatment of primary inguinal hernias: a prospective randomized controlled study.

    PubMed

    Karateke, Faruk; Ozyazici, Sefa; Menekse, Ebru; Özdogan, Hatice; Kunt, Mevlüt; Bozkurt, Hilmi; Bali, İlhan; Özdogan, Mehmet

    2014-01-01

    The Lichtenstein repair has been recommended as the gold standard for inguinal hernia repair. However, postoperative discomfort still constitutes a concern and an area for improvement. New mesh materials have been continuously introduced to achieve this goal. The goal of the present study was to investigate the outcomes of ULTRAPRO Hernia System (UHS) compared with Lichtenstein mesh repair. A total of 99 male patients with primary unilateral inguinal hernia were included in the study during the period of September 2010-January 2012. Patients with body mass index>30, comorbid diseases, and anesthetic risk of ASA-III and ASA-IV were excluded. The patients were randomly allocated to operation with the Lichtenstein technique (group L) or UHS. Demographics, operative and postoperative/recovery data, and short- and medium-term outcomes of the patients were recorded. A total of 50 patients in group L and 49 patients in group UHS were analyzed. The median follow-up time for the study was 33 months. There were no significant differences regarding demographics, complications, and rehabilitation between the groups. Overall, there was a prolonged operation time in the UHS group compared with the L group (UHS: 53.7±5.7 minutes; L: 44.5±5.5 minutes; P<0.001). UHS may provide results similar to those for the Lichtenstein technique in open repair of inguinal hernias regarding perioperative course, complications, recovery, and recurrence rates. However, because of reduced costs and the lack of need for the exploration of the preperitoneal space, we conclude that the Lichtenstein technique should be recommended as the first choice. PMID:25058771

  16. Cost-effectiveness of extraperitoneal laparoscopic inguinal hernia repair: a randomized comparison with conventional herniorrhaphy. Coala trial group.

    PubMed Central

    Liem, M S; Halsema, J A; van der Graaf, Y; Schrijvers, A J; van Vroonhoven, T J

    1997-01-01

    OBJECTIVE: To determine the cost-effectiveness of laparoscopic inguinal hernia repair. SUMMARY BACKGROUND DATA: Laparoscopic inguinal hernia repair seems superior to open techniques with respect to short-term results. An issue yet to be studied in depth remains the cost-effectiveness of the procedure. As part of a multicenter randomized study in which >1000 patients were included, a cost-effectiveness analysis from a societal point of view was performed. METHODS: After informed consent, all resource costs, both in and outside the hospital, for patients between August 1994 and July 1995 were recorded prospectively. Actual costs were calculated in a standardized fashion according to international guidelines. The main measures used for the evaluation of inguinal hernia repair were the number of averted recurrences and quality of life measured with the Short Form 36 questionnaire. RESULTS: Resource costs were recorded for 273 patients, 139 in the open and 134 in the laparoscopic group. Both groups were comparable at baseline. Average total hospital costs were Dfl 1384.91 (standard deviation: Dfl 440.15) for the open repair group and Dfl 2417.24 (standard deviation: Dfl 577.10) for laparoscopic repair, including a disposable kit of Dfl 676. Societal costs, including costs for days of sick leave, were lower for the laparoscopic repair and offset the hospital costs by Dfl 780.83 (75.6%), leaving the laparoscopic repair Dfl 251.50 more expensive (Dfl 4665 versus Dfl 4916.50). At present, the recurrence rate is 2.6% lower after laparoscopic repair. Thus, 38 laparoscopic repairs, costing an additional Dfl 9,557, prevent the occurrence of one recurrent hernia. Quality of life was better after laparoscopic repair. CONCLUSION: A better quality of life in the recovery period and the possibility of replacing parts of the disposable kit with reusable instruments may result in the laparoscopic repair becoming dominantly better--that is, less expensive and more effective from a

  17. 99mTc-MDP uptake in SPECT/CT by a bladder hernia simulating inguinal metastasis: A case report

    PubMed Central

    JI, TIEFENG; GAO, DAPENG; CHEN, BIN; WANG, RENJIE; GAO, SHI

    2016-01-01

    A 72-year-old male with a history of prostate cancer and high prostate specific antigen levels underwent 99mtechnetium-methylene diphosphonate (99mTc-MDP) single-photon emission computed tomography/computed tomography (SPECT/CT), to identify bone metastasis. The patient possessed no previous history of serious illnesses or surgical procedures and no family history of malignancies. A whole-body CT scan revealed an intense MDP uptake in the right inguinal region on the anterior view, but not in the posterior view, which was suspected to be a metastatic lesion. However, there was no evidence of bone metastasis on the CT scan. In addition, an increased 99mTc-MDP uptake was indicated on the SPECT images in the right inguinal region, which appeared to be separate from the main bladder activity. CT images of the pelvis revealed an inferior tongue-like extension of the bladder into the right inguinal region. Fused SPECT/CT axial images indicated the circular accumulation of the 99mTc-MDP in the medial right groin, with well-defined walls that connected the accumulation to the bladder. The final diagnosis was a bladder hernia (T2N0M0), which may have been responsible for the misdiagnosis of bone metastasis due to the use of radiopharmaceuticals (99mTc-MDP) that were mainly excreted through urination. Considering the comprehensive situation of the patient, radical prostatectomy was performed. The bladder hernia was subsequently monitored by follow-up examination every 3 months, and remains alive and under follow-up to date. PMID:26893749

  18. Recurrence of inguinal hernias repaired in a large hernia surgical specialty hospital and general hospitals in Ontario, Canada

    PubMed Central

    Malik, Atiqa; Bell, Chaim M.; Stukel, Thérèse A.; Urbach, David R.

    2016-01-01

    Background The effect of hospital specialization on the risk of hernia recurrence after inguinal hernia repair is not well described. Methods We studied Ontario residents who had primary elective inguinal hernia repair at an Ontario hospital between 1993 and 2007 using population-based, administrative health data. We compared patients from a large hernia specialty hospital (Shouldice Hospital) with those from general hospitals to determine the risk of recurrence. Results We studied 235 192 patients, 27.7% of whom had surgery at Shouldice hospital. The age-standardized proportion of patients who had a recurrence ranged from 5.21% (95% confidence interval [CI] 4.94%–5.49%) among patients who had surgery at the lowest volume general hospitals to 4.79% (95% CI 4.54%–5.04%) who had surgery at the highest volume general hospitals. In contrast, patients who had surgery at the Shouldice Hospital had an age-standardized recurrence risk of 1.15% (95% CI 1.05%–1.25%). Compared with patients who had surgery at the lowest volume hospitals, hernia recurrence among those treated at the Shouldice Hospital was significantly lower after adjustment for the effects of age, sex, comorbidity and income level (adjusted hazard ratio 0.21, 95% CI 0.19–0.23, p < 0.001). Conclusion Inguinal hernia repair at Shouldice Hospital was associated with a significantly lower risk of subsequent surgery for recurrence than repair at a general hospital. While specialty hospitals may have better outcomes for treatment of common surgical conditions than general hospitals, these benefits must be weighed against potential negative impacts on clinical care and the financial sustainability of general hospitals. PMID:26574701

  19. Early assessment of bilateral inguinal hernia repair: A comparison between the laparoscopic total extraperitoneal and Stoppa approaches

    PubMed Central

    Utiyama, Edivaldo Massazo; Damous, Sérgio Henrique Bastos; Tanaka, Eduardo Yassushi; Yoo, Jin Hwan; de Miranda, Jocielle Santos; Ushinohama, Adriano Zuardi; Faro, Mario Paulo; Birolini, Claudio Augusto Vianna

    2016-01-01

    BACKGROUND: The present clinical trial was designed to compare the results of bilateral inguinal hernia repair between patients who underwent the conventional Stoppa technique and laparoscopic total extraperitoneal repair (LTE) with a single mesh and without staple fixation. PATIENTS AND METHODS: This controlled, randomised clinical trial was conducted at General Surgery and Trauma of the Clinics Hospital, Medical School, the University of São Paulo between September 2010 and February 2011. Totally, 50 male patients, with a bilateral inguinal hernia, older than 25 years were considered eligible for the study. The following parameters were analysed during the early post-operative period: (1) The intensity of surgical trauma, operation time, C-reactive protein (CRP) levels, white blood cell count, bleeding and pain intensity; (2) quality of life assessment; and (3) post-operative complications. RESULTS: LTE procedure was longer than the Stoppa procedure (134.6 min ± 38.3 vs. 90.6 min ± 41.3; P < 0.05). The levels of CRP were higher in the Stoppa group (P < 0.05) but the number of leucocytes, haematocrit, and haemoglobin were similar between the groups (P > 0.05). There was no difference in pain during the 1st and 7th post-operative, physical functioning, physical limitation, the impact of pain on daily activities, and the Carolinas Comfort Scale during the 7th and 15th post-operative (P > 0.05). Complications occurred in 88% of Stoppa group (22 patients) and 64% in LTE group (16 patients) (P < 0.05). CONCLUSION: The comparative study between the Stoppa and LTE approaches for the bilateral inguinal hernia repair demonstrated that: (1) The LTE approach showed less surgical trauma despite the longer operation time; (2) Quality of life during the early post-operative period were similar; and (3) Complication rates were higher in the Stoppa group. PMID:27279401

  20. Energy-state formulation of lumped volume dynamic equations with application to a simplified free piston Stirling engine

    NASA Technical Reports Server (NTRS)

    Daniele, C. J.; Lorenzo, C. F.

    1979-01-01

    Lumped volume dynamic equations are derived using an energy state formulation. This technique requires that kinetic and potential energy state functions be written for the physical system being investigated. To account for losses in the system, a Rayleigh dissipation function is formed. Using these functions, a Lagrangian is formed and using Lagrange's equation, the equations of motion for the system are derived. The results of the application of this technique to a lumped volume are used to derive a model for the free piston Stirling engine. The model was simplified and programmed on an analog computer. Results are given comparing the model response with experimental data.