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Sample records for early surgical results

  1. Early results after surgical treatment of left Ventricular Aneurysm

    PubMed Central

    2012-01-01

    Background Left ventricular aneurysm (LVA) is a serious complication of myocardial infarction and reduces the chances of survival. Controversy still exists regarding the optimal surgical technique for LVA repair. We analyze the efficacy of two techniques, linear vs. endoventricular circular patch plasty, for repair of LVA and the efficacy of surgical ventricular restoration (SVR) on beating heart. Methods This study included 62 patients who underwent SVR from 1086 consecutive patients were subjected to coronary artery bypass grafting (CABG) between 2000 and 2009. All selected patients were divided either into group liner or patch according to the choice of the repair technique depended on factors such as localization, size and dimension of the scar. The patients also were divided either into group beating heart or cardioplegia. The pre-, intra- and postoperative relevant data of all selected patients were analyzed. Results The mortality was not significantly different between linear and patch repair groups, also the actuarial survival rates within 24 months (p= 0.529). Postoperative echocardiographic findings showed significant improvements in left ventricular function in both groups. The beating heart technique reduced postoperative peak release by 27% for Cardiac troponin I (cTnI) compared with the cardioplegia group (0.46 ± 0.06 ng/mL versus 0.63 ± 0.09 ng/mL, p= 0.004), and increased the perioperative survival by 9% (97.2% versus 88.5%), but the actuarial survival rates were not significantly different between the groups from 2 to 24 months (p= 0.151). Conclusions Both techniques (linear and patch) achieved good results with respect to mortality, functional status and survival. The choice of surgical technique should be adapted in each patient. The beating heart technique may to some extent relieve myocardial injury in patients undergoing SVR. PMID:23171698

  2. Surgical hip dislocation in symptomatic cam femoroacetabular impingement: what matters in early good results?

    PubMed Central

    2011-01-01

    In order to assess outcome and possible predictors of early good results, a prospective study on 22 patients who were treated with save surgical hip dislocation for symptomatic isolated cam-type femoroacetabular impingement (FAI) was performed. After a follow-up of 6 and 12 months, standard clinical and radiographic parameters were recorded. A statistically significant improvement of the clinical status according to the Harris hip score could be assessed at six months (p-value = 0.003) and 12 months (p-value = 0.001) post-surgery. By comparing standard clinical and radiographic preoperative parameters with various follow-up outcomes, we revealed no specific parameter with predictive value. These findings are important for centers that have just started to use this surgical technique and are still identifying their learning curve. PMID:21719395

  3. Surgical hip dislocation in symptomatic cam femoroacetabular impingement: what matters in early good results?

    PubMed

    Jäger, M; Bittersohl, B; Zilkens, Christoph; Hosalkar, H S; Stefanovska, K; Kurth, S; Krauspe, R

    2011-05-12

    In order to assess outcome and possible predictors of early good results, a prospective study on 22 patients who were treated with save surgical hip dislocation for symptomatic isolated cam-type femoroacetabular impingement (FAI) was performed. After a follow-up of 6 and 12 months, standard clinical and radiographic parameters were recorded. A statistically significant improvement of the clinical status according to the Harris hip score could be assessed at six months (p-value = 0.003) and 12 months (p-value = 0.001) post-surgery. By comparing standard clinical and radiographic preoperative parameters with various follow-up outcomes, we revealed no specific parameter with predictive value. These findings are important for centers that have just started to use this surgical technique and are still identifying their learning curve. PMID:21719395

  4. Results of late surgical intervention in children with early-onset bilateral cataracts

    PubMed Central

    Ganesh, Suma; Arora, Priyanka; Sethi, Sumita; Gandhi, Tapan K; Kalia, Amy; Chatterjee, Garga; Sinha, Pawan

    2016-01-01

    Background Cataracts are a major cause of childhood blindness globally. Although surgically treatable, it is unclear whether children would benefit from such interventions beyond the first few years of life, which are believed to constitute `critical' periods for visual development. Aims To study visual acuity outcomes after late treatment of early-onset cataracts and also to determine whether there are longitudinal changes in postoperative acuity. Methods We identified 53 children with dense cataracts with an onset within the first half-year after birth through a survey of over 20 000 rural children in India. All had accompanying nystagmus and were older than 8 years of age at the time of treatment. They underwent bilateral cataract surgery and intraocular lens implantation. We then assessed their best-corrected visual acuity 6 weeks and 6 months after surgery. Results 48 children from the pool of 53 showed improvement in their visual acuity after surgery. Our longitudinal assessments demonstrated further improvements in visual acuity for the majority of these children proceeding from the 6-week to 6-month assessment. Interestingly, older children in our subject pool did not differ significantly from the younger ones in the extent of improvement they exhibit. Conclusions and relevance Our results demonstrate that not only can significant vision be acquired until late in childhood, but that neural processes underlying even basic aspects of vision like resolution acuity remain malleable until at least adolescence. These data argue for the provision of cataract treatment to all children, irrespective of their age. PMID:24879807

  5. Aggressive Surgical Management of Post-Infarction Angina: Results of Myocardial Revascularization Early After Transmural Infarction

    PubMed Central

    Disesa, Verdi J.; O'Neil, Anne C.; Bitran, Dani; Cohn, Lawrence H.; Shemin, Richard J.; Collins, John J.

    1985-01-01

    In our Division of Cardiothoracic Surgery between 1970 and 1982, 110 patients (88 males and 22 females) had coronary artery bypass grafts (CABG) performed for unstable angina pectoris after acute transmural myocardial infarction. Fifty-one patients (mean age 59 years) had CABG within 2 weeks of myocardial infarction (Group 1); and 59 patients (mean age 56 years) (p = NS) within 6 weeks of myocardial infarction (Group 2). The incidence of preoperative arrhythmias, left ventricular ejection fraction, end-diastolic pressure, and the number of vessels diseased were similar in Groups 1 and 2. The incidence of cardiogenic shock was higher in Group 1 (16/51, 31% vs 2/59, 3% [p < 0.001]). This was also the case with the use of the intraaortic balloon (32/51, 63% vs 12/59, 20% [p < 0.001]), and the need for emergency operation (29/51, 57% vs 4/59, 7% [p < 0.001]). The mean number of grafts was 2.8 in Group 1 and 3.0 in Group 2 (p = NS). Operative mortality was 20% (10/51) in Group 1 and 7% (4/59) in Group 2 (p < 0.01). Excluding patients in cardiogenic shock, operative mortality was 0% (0/35) in Group 1 and 5% (3/57) in Group 2 (p = NS). Incidences of late death, recurrent angina, and permanent disability were similar during mean follow-up times of 3.2 years in Group 1 and 4.1 years in Group 2. Actuarial probability of survival was 96% at 1 year and 83% at 5 years. Myocardial revascularization early after transmural myocardial infarction has a low risk, especially in the absence of cardiogenic shock. These results justify an aggressive approach to unstable angina, including patients within 2 weeks of transmural infarction. PMID:15226989

  6. Early-onset glaucoma in Axenfeld-Rieger anomaly: long-term surgical results and visual outcome.

    PubMed

    Mandal, A K; Pehere, N

    2016-07-01

    PurposeTo determine the long-term surgical and visual outcomes in Indian children with early-onset glaucoma associated with Axenfeld-Rieger anomaly (ARA).MethodsThis is a retrospective analysis of 44 eyes of 24 consecutive children with early-onset glaucoma (within 3 years of age) and ARA who underwent glaucoma surgery over a 20-year period (1991-2010) by a single surgeon. Main outcome measures were pre- and postoperative intraocular pressures (IOPs), corneal clarity, visual acuities (VAs), refractive errors, success rate, time of surgical failure, and complications.ResultsThe series consisted of 38 primary combined trabeculotomy-trabeculectomy (CTT) and 6 primary trabeculectomy procedures (Schlemm's canal could not be identified in these eyes). There was a statistically significant reduction in IOP postoperatively (27.07±4.88 vs 14.88±3.62 mm Hg; P<0.0001) with a mean reduction of 45.14%. Success probability by Kaplan-Meier survival analysis was 93% till 5 years, and then 88.1%, 82.3%, 70.5%, 56.4%, and 42.3% at year 6, 7, 8, 9, and 10, respectively. Preoperative corneal edema was present in 43/44 eyes (97.72%) and cleared in 42 eyes (97.67%). There was one case each with intraoperative hyphema and with shallow chamber postoperatively and both were successfully managed successfully. There was no incidence of endophthalmitis or any other sight-threatening complication. Data on VA were available in 34 eyes (77.3%). At final follow-up visit, 15 (44.1%) eyes had best corrected VA ⩾6/18.ConclusionsPrimary CTT is safe and effective for early-onset glaucoma associated with ARA. It leads to excellent IOP control and satisfactory visual outcome. PMID:27055677

  7. Early results from an angiosome-directed open surgical technique for venous arterialization in patients with critical lower limb ischemia

    PubMed Central

    Houlind, Kim; Christensen, Johnny; Hallenberg, Christian; Jepsen, Jørn M.

    2013-01-01

    Background Patients with critical lower limb ischemia without patent pedal arteries cannot be treated by the conventional arterial reconstruction. Venous arterialization has been suggested to improve limb salvage in this subgroup of patients but has not gained wide acceptance. We report our early experience after implementing deep and superficial venous arterialization of the lower limb. Materials and methods Ten patients with critical ischemia and without crural or pedal arteries available for conventional bypass surgery or angioplasty were treated with distal venous arterialization. Inflow was from the most distal unobstructed segment. Run-off was the dorsal pedal venous arch (n=5), the dorsal pedal venous arch and a concomitant vein of the posterior tibial artery (n=3), or the dorsal pedal venous arch and a concomitant vein of the common plantar artery (n=2) depending on the location of the ischemic lesion. Venous valves were destroyed using antegrade valvulotomes, guide wires, knob needles, or retrograde valvulotomes via an extra incision. Results Seven of the operated limbs were amputated after 23 (1–256) days (median [range]). The main reasons for amputation were lack of healing of either the original wound, of incisional wounds on the foot, or persisting pain at rest. In three cases, the bypass was open at the time of amputation. Two patients experienced complete wound healing after 231 and 342 days, respectively. By the end of follow-up, the last patient was ambulating with slow wound healing but without pain 309 days after surgery. Conclusion Venous arterialization may be used as a treatment of otherwise unsalveable limbs. The success rate is, however, limited. Technical optimization of the technique is warranted. PMID:24358432

  8. Contemporary Surgical Management of Early Glottic Cancer.

    PubMed

    Hartl, Dana M; Brasnu, Daniel F

    2015-08-01

    For early-stage T1-T2 glottic squamous cell carcinoma, transoral laser microsurgery (TLM) is the main surgical modality, with rates of local control and laryngeal preservation ranging from 85% to 100% and low morbidity. For extensive lesions, open conservation laryngeal surgery may enable wider resections than TLM but at costs of longer hospital stay and higher postoperative morbidity. Surgery provides results that are comparable to nonsurgical treatment options while reserving radiation therapy for recurrences or second primary cancers, particularly in younger patients. In the future, transoral robot-assisted surgery may enable more extensive transoral resections than laser alone, decreasing further the indications for open surgery. PMID:26233790

  9. Results of surgical therapy for lung carcinoma.

    PubMed

    Paris, F; Padilla, J; Tarazona, V; Blasco, E; Canto, A; Pastor, J; Zarza, A G

    1979-01-01

    A series of 300 pulmonary resections in patients with lung carcinoma is presented. Total survival rate of the series since the operation, including surgical mortality, was 33% at 3 years and 24% at 5 years. The survival rate and surgical criteria were correlated, having better results when standard surgery was performed. The authors emphasize that the surgical figures of the series are of great value as the surgical indications were large and nonselective, with 85% of resectability in the thoracotomies. PMID:229985

  10. [Salter innominate osteotomy : Indications, surgical technique, results].

    PubMed

    Schulze, A; Tingart, M

    2016-08-01

    The prevalence of congenital hip dysplasia in Germany is 2-4 % and that of hip dislocation is 0.5-1 %. If early therapy is not successful or the hip dysplasia or dislocation is diagnosed too late (children of over 1 year of age) surgical treatment is indicated to increase the femoral coverage. The innominate osteotomy, published by Robert B. Salter 1961, is a worldwide established technique to improve the lateral and ventral coverage of the femoral head in primary or secondary hip dysplasia or dislocation. In this paper we discuss Salter's technique and present indications, the perioperative procedure, operative modifications and operative extensions and demonstrate the anatomical requirements, postoperative biomechanical changes and long-term results. PMID:27351429

  11. Early predictive factors for lower-extremity motor or sensory deficits and surgical results of patients with spinal tuberculosis: A retrospective study of 329 patients.

    PubMed

    Wang, Hongwei; Yang, Xiao; Shi, Ying; Zhou, Yue; Li, Changqing; Chen, Yu; Yu, Hailong; Wang, Qi; Liu, Jun; Cheng, Jiwei; Zhao, Yiwen; Han, Jianda; Xiang, Liangbi

    2016-08-01

    Many studies about the characteristics of spinal tuberculosis (STB) have been published, but none has investigated the predictive factors for lower-extremity motor or sensory deficits (LMSD) in patients with STB.The objective of this study was to find early predictive factors for LMSD and evaluate surgical results of patients with STB.From 2001 through 2010, 329 patients with STB were treated in our department and surgical treatment was performed in 274 patients. The factors assessed included age, sex, duration of symptoms, worsening of illness, clinical symptoms, clinical signs, imaging characteristics, kyphotic angle, Oswestry disability index (ODI), and visual analogue scale (VAS) scores.Of the 329 patients studied, 164 presented with LMSD (the LMSD group), of which 93 patients (28.3%) had motor deficits and 177 patients (53.8%) had sensory disturbance. The other 165 patients were included in the control group (the No LMSD group). Using univariate logistic regression analysis, we found that the sex (P = 0.042), age (P = 0.001), worsening of sickness (P = 0.013), location (P = 0.009), and spinal compression (P = 0.035) were the risk factors of LMSD. Furthermore, the multivariate logistic regression analysis indicated that age (OR = 1.761, 95% CI: 1.227-2.526, P = 0.002), worsening of sickness (yes vs no: OR = 1.910, 95% CI: 1.161-3.141, P = 0.011), location (T vs C: OR = 0.204, 95% CI: 0.063-0.662, P = 0.008), and spinal compression (yes vs no: OR = 1.672, 95% CI: 1.020-2.741, P = 0.042) were independent risk factors of LMSD. Surgical treatment was performed in 274 patients. The kyphotic angle improved from 25.8 ± 9.1° preoperatively to 14.0 ± 7.6°, with a mean correction of 11.8 ± 4.0°, and a mean correction loss of 1.5 ± 1.8° at final visit. There were significant differences between the preoperative and the final ODI and VAS scores in both groups (P < 0.001 and P < 0

  12. Early versus Late Surgical Treatment for Neurogenic Thoracic Outlet Syndrome

    PubMed Central

    Al-Hashel, Jasem Yousef; El Shorbgy, Ashraf Ali M. A.; Elshereef, Rawhia R.

    2013-01-01

    Objectives. To compare the outcome of early surgical intervention versus late surgical treatment in cases of neurogenic thoracic outlet syndrome (NTOS). Design. Prospective study. Settings. Secondary care (Al-Minia University Hospital, Egypt) from 2007 to 2010. Participants. Thirty-five patients of NTOS (25 women and 10 men, aged 20–52 years), were classified into 2 groups. First group (20 patients) was operated within 3 months of the onset and the second group (15 patients) was operated 6 months after physiotherapy. Interventions. All patients were operated via supraclavicular surgical approach. Outcomes Measures. Both groups were evaluated clinically and, neurophysiologically and answered the disabilities of the arm, shoulder, and hand (DASH) questionnaire preoperatively and 6 months after the surgery. Results. Paraesthesia, pain, and sensory nerve action potential (SNAP) of ulnar nerve were significantly improved in group one. Muscle weakness and denervation in electromyography EMG were less frequent in group one. The postoperative DASH score improved in both groups but it was less significant in group two (P < .001 in group 1 and P < .05 in group 2). Conclusions. Surgical treatment of NTOS improves functional disability and stop degeneration of the nerves. Early surgical treatment decreases the occurrence of muscle wasting and denervation of nerves compared to late surgery. PMID:24109518

  13. Non-surgical treatments for the management of early osteoarthritis.

    PubMed

    Filardo, Giuseppe; Kon, Elizaveta; Longo, Umile Giuseppe; Madry, Henning; Marchettini, Paolo; Marmotti, Antonio; Van Assche, Dieter; Zanon, Giacomo; Peretti, Giuseppe M

    2016-06-01

    Non-surgical treatments are usually the first choice for the management of knee degeneration, especially in the early osteoarthritis (OA) phase when no clear lesions or combined abnormalities need to be addressed surgically. Early OA may be addressed by a wide range of non-surgical approaches, from non-pharmacological modalities to dietary supplements and pharmacological therapies, as well as physical therapies and novel biological minimally invasive procedures involving injections of various substances to obtain a clinical improvement and possibly a disease-modifying effect. Numerous pharmaceutical agents are able to provide clinical benefit, but no one has shown all the characteristic of an ideal treatment, and side effects have been reported at both systemic and local level. Patients and physicians should have realistic outcome goals in pharmacological treatment, which should be considered together with other conservative measures. Among these, exercise is an effective conservative approach, while physical therapies lack literature support. Even though a combination of these therapeutic options might be the most suitable strategy, there is a paucity of studies focusing on combining treatments, which is the most common clinical scenario. Further studies are needed to increase the limited evidence on non-surgical treatments and their combination, to optimize indications, application modalities, and results with particular focus on early OA. In fact, most of the available evidence regards established OA. Increased knowledge about degeneration mechanisms will help to better target the available treatments and develop new biological options, where preliminary results are promising, especially concerning early disease phases. Specific treatments aimed at improving joint homoeostasis, or even counteracting tissue damage by inducing regenerative processes, might be successful in early OA, where tissue loss and anatomical changes are still at very initial stages. PMID

  14. Surgical treatment for apparent early stage endometrial cancer

    PubMed Central

    2014-01-01

    Most experts would agree that the standard surgical treatment for endometrial cancer includes a hysterectomy and bilateral salpingo-oophorectomy; however, the benefit of full surgical staging with lymph node dissection in patients with apparent early stage disease remains a topic of debate. Recent prospective data and advances in laparoscopic techniques have transformed this disease into one that can be successfully managed with minimally invasive surgery. This review will discuss the current surgical management of apparent early stage endometrial cancer and some of the new techniques that are being incorporated. PMID:24596812

  15. Intramedullary hemangioblastomas: surgical results in 16 patients.

    PubMed

    Joaquim, Andrei F; Ghizoni, Enrico; dos Santos, Marcos Juliano; Valadares, Marcelo Gomes C; da Silva, Felipe Soares; Tedeschi, Helder

    2015-08-01

    OBJECT Hemangioblastomas are rare, benign, highly vascularized tumors that can be found throughout the neuraxis but are mainly located in the cerebellum and in the spinal cord. Spinal hemangioblastomas can present with motor and sensory deficits, whose severity varies according to the size and location of the tumor. Resection is the best treatment option to avoid neurological deterioration. The authors report surgical results in the treatment of intramedullary hemangioblastomas and discuss the technical nuances important to achieving total resection without adding new deficits. METHODS A consecutive series of patients with intramedullary hemangioblastomas operated on between 2000 and 2014 by the senior author (H.T.) is presented. The functional scale proposed by McCormick was used to evaluate the patients' neurological status before and after surgery. RESULTS Sixteen patients were included in the study and underwent 17 surgeries. Follow-up was at least 6 months. Age at presentation varied from 13 to 58 years (mean 33.8 years). Ten patients (62.5%) were males and 6 patients (37.5%) were females. Seven (43.75%) of the 16 patients had associated von Hippel-Lindau syndrome, with hemangioblastomas also presenting in other locations. Three patients had multiple tumors in the same segment in the spinal cord, and 10 patients (62.5%) presented with cysts. According to the site of presentation, 11 tumors (68.75%) were localized at the cervical region (including the cervicomedullary junction) and 5 tumors (31.25%) at the thoracic level. Total resection was achieved in all cases, evidenced by postoperative MRI. Four patients had some functional worsening immediately after surgery. After 6 months, 1 patient had functional worsening compared with preoperative status, and 2 patients had clinical improvement. The majority of the patients remained clinically stable postoperatively. CONCLUSIONS Adequate knowledge of anatomy and the correct use of microsurgical techniques allowed

  16. Mesh Achilles tendon lengthening--a new method to treat equinus deformity in patients with spastic cerebral palsy: surgical technique and early results.

    PubMed

    Lin, Cheng-Li; Lin, Chii-Jeng; Huang, Ming-Tung; Su, Wei-Ren; Wu, Tung-Tai

    2013-01-01

    Equinus of the ankle is a common deformity in spastic cerebral palsy. Many methods have been developed to lengthen the Achilles tendon to correct the deformity. A new mesh Achilles tendon lengthening (ATL) procedure that might decrease immobilization and promote recovery was performed in 36 tendons with equinus deformity (22 patients, average age=6.2). The results were compared with those of two other methods: the Vulpius group and the Z-lengthening group. The corrected dorsiflexion angle of the ankle at a subsequent 2-year follow-up of the mesh ATL and Vulpius groups matched (25.5±3.0 and 27.1±3.5°, respectively), whereas that of the Z-lengthening group was higher (33.9±3.8°). Nevertheless, statistics of the timing of each patient's readiness to begin rehabilitation and walking as well as gaining better stability for running and one-legged hopping indicated that the mesh ATL group recovered significantly quicker than the Vulpius and Z-lengthening groups. The mesh ATL procedure achieves a successful correction of the equinus deformity in spastic cerebral palsy comparable with that of the Vulpius procedure, with the advantage of preserving the gastrocnemius without a complete section. This confers greater antigravity stability and quicker recovery in patients. PMID:23192252

  17. Surgical results of sacral perineural (Tarlov) cysts.

    PubMed

    Tanaka, Masato; Nakahara, Shinnosuke; Ito, Yasuo; Nakanishi, Kazuo; Sugimoto, Yoshihisa; Ikuma, Hisanori; Ozaki, Toshifumi

    2006-02-01

    The purpose of this study was to investigate the surgical outcomes and to determine indicators of the necessity of surgical intervention. Twelve consecutive patients harboring symptomatic sacral perineural cysts were treated between 1995 and 2003. All patients were assessed for neurological deficits and pain by neurological examination. Magnetic resonance of imaging, computerized tomography, and myelography were performed to detect signs of delayed filling of the cysts. We performed a release of the valve and imbrication of the sacral cysts with laminectomies in 8 cases or recapping laminectomies in 4 cases. After surgery, symptoms improved in 10 (83%) of 12 patients, with an average follow-up of 27 months. Ten patients had sacral perineural cysts with signs of positive filling defect. Two (17%) of 12 patients experienced no significant improvement. In one of these patients, the filling defect was negative. In conclusion, a positive filling defect may become an indicator of good treatment outcomes. PMID:16508691

  18. Ventricular septal defect: early against late surgical repair

    PubMed Central

    Siddiqui, Waqas J.; Iyer, Praneet; Amba, Samridhi; Muddassir, Salman; Cheboterav, Oleg

    2016-01-01

    Ventricular septal defect (VSD) is a rare complication of right ventricular infarction (RVI) which is associated with significant mortality, if not treated appropriately. It typically occurs within the first 10–14 days after myocardial infarction. Surgical repair has been shown to reduce in-hospital mortality from 90% to 33–45%. Early surgical VSD repair has also been associated with high 30-day operative mortality of 34–37%. Furthermore, after an acute MI the friable myocardium enhances the risk of recurrent VSD with early surgical repair. We present a case of a middle-aged woman who developed VSD after an RVI. Her surgical repair was delayed by 2 weeks due to development of Staphylococcus aureus bacteremia. During this period, she was managed medically and later on underwent percutaneous repair with an amplatzer VSD occluder device. Keeping this patient encounter in mind, we would like to emphasize on the limited recommendations available for early against late surgical repair of VSD. PMID:26908387

  19. Klatskin tumor--results of surgical therapy.

    PubMed

    Zovak, Mario; Doko, Marko; Glavan, Elizabet; Hochstädter, Hrvoje; Roić, Goran; Ljubicić, Neven

    2004-06-01

    Between January 1st 1990 and December 31st 1999, 24 patients affected by Klatskin tumor underwent operation in our department of surgery. According to Bismuth's classification, there were 0 (0%) type I, 5 (21%) type II, 6 (25%) type IIIa, 4 (17%) type IIIb and 9 (37%) type IV tumors. Five patients (21%) were treated by curative resection (group I) while in 14 patients (58%) palliative surgical procedure was performed (group II). In 5 cases (21%) the extension of malignancy did not allowed any procedure (group III). Curative resection for malignant tumors of the hepatic duct bifurcation included wide tumor excision and bile duct resection at the liver hilum (with wedge hepatic resection in one patient) and creation of biliary-enteric anastomosis. Palliative surgical procedure included stent insertion. Jaundice was completely relieved in all patients undergoing resection, since 3 patients (21%) after stenting hadn't satisfactory biliary drainage. There was 1 (20%) perioperative death in the group 1, while in group 2, 5 patients (36%) died postoperatively. In this series, the mean postoperative survival of all patients was 16 months. The mean postoperative survival of patients undergoing localized tumor resection with curative intent was 38 months, in contrast to 10 months for those undergoing operative stent insertion. in addition, only 1 patient from group III, in whom only exploratory surgery were performed survived 7 months, while other 4 patients died in the hospital. This retrospective review suggests that aggressive surgical treatment could improve survival and quality of life in patients suffering from Klatskin tumor. PMID:15636089

  20. Survival analysis following early surgical success in intermittent exotropia surgery

    PubMed Central

    Lee, Joo Yeon; Ko, Sung Ju; Baek, Sung Uk

    2014-01-01

    AIM To assess the consecutive recurrence following early success of intermittent exotropia surgery and to determine the clinical factors that affect the survival. METHODS One hundred and thirty-five patients who underwent intermittent exotropia surgery and experienced early surgical success [≤5 prism diopters (PD) esophoria (E) to ≤10 PD exophoria (X) on the postoperative sixth month] were enrolled in this study. Their consecutive survival on the postoperative first year, second year and third year and at the last visit of fourth year or more, and the factors that might affect their survival, were analyzed. The final surgical outcomes after the postoperative fourth year were also investigated by dividing the patients into the success group (≤5 PD E to ≤10 PD X) and the failure group (>5 PD esodeviation or >10 PD exodeviation) RESULTS The survival rates from the Kaplan-Meier analysis were 97.78%, 92.89%, 83.70% and 50.49% on the postoperative first, second and third years and fourth year or more, respectively. None of the clinical factors was determined to have affected the survival. The amount of the exodrift was largest (2.29 PD) between the first year and the second year, and smallest (1.47 PD) between the fourth year and the last visit. Sixty-three patients had their final visit after the postoperative fourth year, and 29 of them were in the failure group. Twenty-five patients in the failure group had an intermittent exotropia (IXT) of <20 PD with good to fair distant fusion; two had an IXT of <20 PD with poor distant fusion; one had an IXT of ≥20 PD with fair distant fusion; and another had delayed-onset consecutive esotropia. The exodeviation on the postoperative sixth month was smaller in the success group than in the failure group (2.81 PD vs 5.86 PD, P=0.012). The reoperation rate for recurrent IXT was 3.7%. CONCLUSION The survival rate steadily decreases with the exodrift, but the amount of the exodrift decreases with long-term follow-up. The

  1. Surgical Treatment of Early-Stage Cervical Cancer.

    PubMed

    Brucker, Sara Y; Ulrich, Uwe A

    2016-01-01

    Surgical treatment of cervical cancer has been a cornerstone in the management of this malignancy for more than 100 years. Today, for early-stage and low-risk cervical cancer, surgery is still considered the gold standard. If the preoperative assessment of the tumor reveals a situation prompting postoperative adjuvant radiochemotherapy, the latter should be planned as the primary treatment option, being preceded by staging laparoscopy including pelvic and paraaortic lymph node dissection. As an alternative to the open approach, the definitive surgical treatment should be either performed laparoscopically, or be laparoscopic-assisted, or laparoscopically robotic-assisted. PMID:27614875

  2. [OPTIMIZATION OF THE SURGICAL TREATMENT RESULTS IN CONOTRUNCAL CARDIAC FAILURES IN LARGE AORTO-PULMONARY COLLATERAL ARTERIES].

    PubMed

    Bablyak, O D

    2015-09-01

    The results of surgical treatment of 83 patients, suffering conotruncal cardiac failures and large aorto-pulmonary collateral arteries, were analyzed. In 2007 - 2014 yrs a radical correction of the failure (RCF) was performed in 53 (64%) of them. RCF was achieved, using three surgical approaches. The algorithm of a surgical approach choice was introduced, guaranteeing the operation time shortening and artificial blood circulation application, have improved the course of early postoperative period. It was proved, that improvement of surgical results is possible, if a correct surgical tactic choosed and surgical approaches rationally applied. PMID:26817084

  3. Early Surgical Therapy for Drug-Resistant Temporal Lobe Epilepsy

    PubMed Central

    Engel, Jerome; McDermott, Michael P.; Wiebe, Samuel; Langfitt, John T.; Stern, John M.; Dewar, Sandra; Sperling, Michael R.; Gardiner, Irenita; Erba, Giuseppe; Fried, Itzhak; Jacobs, Margaret; Vinters, Harry V.; Mintzer, Scott; Kieburtz, Karl

    2016-01-01

    Context Despite reported success, surgery for pharmacoresistant seizures is often seen as a last resort. Patients are typically referred for surgery after 20 years of seizures, often too late to avoid significant disability and premature death. Objective We sought to determine whether surgery soon after failure of 2 antiepileptic drug (AED) trials is superior to continued medical management in controlling seizures and improving quality of life (QOL). Design, Setting, and Participants The Early Randomized Surgical Epilepsy Trial (ERSET) is a multicenter, controlled, parallel-group clinical trial performed at 16 US epilepsy surgery centers. The 38 participants (18 men and 20 women; aged ≥ 12 years) had mesial temporal lobe epilepsy (MTLE) and disabling seizues for no more than 2 consecutive years following adequate trials of 2 brand-name AEDs. Eligibility for anteromesial temporal resection (AMTR) was based on a standardized presurgical evaluation protocol. Participants were randomized to continued AED treatment or AMTR 2003–2007, and observed for 2 years. Planned enrollment was 200, but the trial was halted prematurely due to slow accrual. Intervention Receipt of continued AED treatment (n=23) or a standardized AMTR plus AED treatment (n = 15). In the medical group, 7 participants underwent AMTR prior to the end of follow-up and 1 participant in the surgical group never received surgery. Main Outcome Measures The primary outcome variable was freedom from disabling seizures during year 2 of follow-up. Secondary outcome variables were health-related QOL (measured primarily by the 2-year change in the Quality of Life in Epilepsy 89 [QOLIE-89] overall T-score), cognitive function, and social adaptation. Results Zero of 23 participants in the medical group and 11 of 15 in the surgical group were seizure free during year 2 of follow-up (odds ratio=∞; 95% CI, 11.8 to ∞;P <.001). In an intention-to-treat analysis, the mean improvement in QOLIE-89 overall T-score was

  4. [The surgical results in traumatic cataract].

    PubMed

    Chiseliţă, D; Vancea, P P; Filimon, O; Brănişteanu, D; Bredetean, M; Poiata, I

    1995-01-01

    The retrospective analysis of the postoperative course in 204 traumatic cataracts (140 isolated, simple cataracts and 64 aggravated ones) showed an apparent functional improvement in the simple cases (preoperative and postoperative visual acuity 0.0139 and 0.8520, respectively); the incidence of postoperative detachment of retina was of 4.9%, that of postoperative endophthalmitis that of cystoid macular edema of 3.2%; complications more commonly occurred in aggravated traumatic cataracts and partially accounted for the poorer functional results. During the investigated interval (1988-1992) a rapid shift to extracapsular cataract extraction and posterior chamber lens implants was made. The crystalline grafts preserved binocular vision in 92% of the cases and contact lens in 50% of the cases. Lens implant remains a matchless solution for the visual rehabilitation of the patients with aphakia. PMID:7654673

  5. Surgical treatment of early breast cancer in day surgery.

    PubMed

    Marrazzo, Antonio; Taormina, Pietra; David, Massimo; Riili, Ignazio; Lo Gerfo, Domenico; Casà, Luigi; Noto, Antonio; Mercadante, Sebastiano

    2007-01-01

    Quadrantectomy and associated sentinel lymph node biopsy (SLNB) is currently employed in most breast surgery centres as the gold standard in the treatment of early breast cancer. This approach has a modest morbidity and can usually be performed in a day-surgery regimen, leading to best acceptance by the patients. This reports outlines the experience of our Breast Unit with quadrantectomy and SLNB in day surgery for early breast cancer. One hundred patients presenting to our institution with primary invasive breast cancer measuring less than 3 cm and clinically negative axillary nodes underwent quadrantectomy and SLNB in day surgery. For 60 women with breast cancer the sentinel node was negative, so the only definitive surgical treatment was performed in the day-surgery regimen; 40 patients with positive sentinel nodes were hospitalised a second time for axillary dissection. In these patients that needed clearance of the axilla, SLNB was performed on the only positive node in 22 cases (55%). None of the patients admitted for quadrantectomy and SLNB in day surgery required re-hospitalisation after discharge. All patients proved to be fully satisfied with early discharge from hospital when questioned on the occasion of subsequent monitoring. Short-stay surgical programs in early invasive breast cancer treatment are feasible today owing to the availability of less invasive approaches such as quadrantectomy and SLNB. There are two main pointers to a distinct advantage for this kind of approach, i.e. recovery and psychological adjustment. Recovery from surgery is faster and the patient tends to play down the seriousness of the operation and to have a better mental attitude to neoplastic disease. Moreover, when performing quadrantectomy with SLNB in day surgery fewer than 50% of breast cancer patients (40% in our experience) require another surgical treatment, concluding the surgery in a single session. PMID:18019641

  6. Learning from mistakes: early twentieth-century surgical practice.

    PubMed

    Wilde, Sally; Hirst, Geoffrey

    2009-01-01

    Archibald Watson was an Australian anatomist and surgeon who kept operating theater diaries. He made detailed notes on the work of surgeons that he observed in Britain and North America, as well as in Australia. Watson's diaries provide significant evidence that early twentieth-century surgeons did not just apply scientific knowledge produced somewhere else. They generated new surgical knowledge themselves and worked within a culture that valued innovation. Some of the surgeons observed by Watson practiced in academic centers and regularly engaged in laboratory research, but most did not. Nevertheless, it is clear that whether in Australia, Britain, or North America, the active search for improved techniques was a routine feature of the practice of full-time surgeons. In the process, they often made mistakes--or rather, they often did things with which at least some of their colleagues did not agree. Much of surgical practice was contestable. Doing things the "right" way and finding better ways to do things were overlapping categories; but it is often difficult or impossible to draw any distinction at all between doing things the "wrong" way and failed attempts at finding a better way to perform an operation. This article examines some aspects of the relationship between scientific ideas, clinical experience, contestable errors, and the generation of new knowledge through surgical practice. PMID:18669573

  7. Surgical treatment of early onset scoliosis in neurofibromatosis.

    PubMed

    Greggi, Tiziana; Martikos, Konstantinos

    2012-01-01

    Case series report of twenty-three patients, aged between 4 and 11 years, were surgically treated at the Authors' Spine Surgery Division in the past 15 years. Mean follow-up is 5 years (range, 18 months to 15 years). Mean age at the time of surgical procedure was 9.1 years (range, 4 years to 11 years). Average scoliosis was 48° (range, 38° to 82°) and skeletal maturity according to Risser sign was 0 in all of the patients. Patients were divided into 2 Groups according to the surgical procedure adopted. Posterior only instrumentation was performed in 16 patients that presented with a thoracic kyphosis lower than 50° (Group A), in the remaining 7 patients showing thoracic kyphosis exceeding 50°, combined anterior and posterior instrumented arthrodesis was performed (Group B). One patient, belonging to Group A, was instrumented with growing rod without fusion. Average correction of scoliosis was 60%, overall complication rate 24% and major 7%. Crankshaft phenomenon was observed in 21% (Group A): in these cases, anterior arthrodesis was performed after a mean 15-month from first surgical procedure. Fusion failure was observed in 1 (Group B) patient who underwent revision of posterior instrumentation. Clinical and radiographic evaluation at F-up showed good outcome in terms of deformity progression and quality of life. Early and aggressive surgery is the most effective management for dystrophic curves in neurofibromatosis has been proven to be. Our experience confirms the need for spinal stabilization even in pediatric age in rapidly progressive spinal deformities. PMID:22744522

  8. Evaluation of results of surgical procedures in the elderly.

    PubMed

    Linn, B S; Linn, M W; Wallen, N

    1982-01-01

    Authorities are not in full agreement in regard to risk of surgery in the elderly. One hundred eight studies of surgery in the elderly over the past 40 years were reviewed. The purpose was not merely to tabulate results, but to identify differences existing between reports with regard to data reported that could affect results independent of the surgical management itself. Sources of variance that need to be taken into account in comparing mortality rates between studies, such as whether mortality was computed by number of patients or operations, differing lengths of follow-up for recording mortality, proportions of emergency versus elective operations, and types of surgical procedures, were documented. A nine-item confidence in results scale was used to classify studies into high and low confidence groups. Surgical specialties scored substantially higher than general surgical studies. More recent studies received higher scores than earlier studies. Although mortality rates varied widely depending on methods of their calculation, there appeared to be a trend toward increases in elective, but not emergency, mortality rates in general surgery since 1941 that should be examined more closely. One thing that cannot be answered clearly from these studies is the relative risk of surgery with age. Some control of variations between studies and standardization of reporting surgical deaths are required before risk of surgery in the elderly can be assessed more accurately. PMID:7055387

  9. Expectant Versus Surgical Management of Early Pregnancy Miscarriages- A Prospective Study

    PubMed Central

    Pulikkathodi, Mumtaz; Vahab, Abdul; Kunjitty, Valsan Mankara; Imrana, Hassan Sheikh

    2015-01-01

    Background Surgical, medical and expectant management are the various options available to manage early pregnancy miscarriages; each with its own merits and demerits. In the last two decades, the efficacy and safety of expectant management which allows for the spontaneous passage of retained products of conception has been studied and confirmed. Aim To compare the safety and efficacy of expectant management of early pregnancy miscarriages with surgical uterine evacuation. Materials and Methods The prospective study conducted in tertiary care centre for 5 years, included 212 patients with USG confirmed pregnancy miscarriages of less than 13 weeks, who were allocated to expectant management (Cases, n=112) and surgical evacuation (Control, n=100). Patients were allocated for expectant management as outpatients for 2 weeks, without any intervention till they had spontaneous complete miscarriage which was confirmed by sonography. Those who failed to do so, underwent a planned surgical uterine evacuation. Emergency admission and evacuation was done, if the patients became symptomatic in the waiting period. Patients allocated to surgical group underwent planned surgical evacuation once diagnosed. Success rate and complications like emergency evacuation, vaginal bleeding, abdominal pain, limitation of physical activity and patient satisfaction were assessed. Both groups were followed up for 6 more weeks. Statistical analysis was done with Z-test. Results Success rate of the expectant management was 71% as against 97% in surgical group. Severe vaginal bleeding was comparable (5% in both groups), 8% of expectant had severe abdominal pain versus 4% in surgical group. Unplanned admissions and emergency evacuation rate was high in expectant 9% against 1% in surgical group. Twenty one percent patients in expectant and 17% patients in surgical group experienced limitation of physical activity. Overall patient satisfaction rate was comparable (74% in expectant 80% in surgical

  10. Early results and review of the literature of a novel hybrid surgical technique combining cervical arthrodesis and disc arthroplasty for treating multilevel degenerative disc disease: opposite or complementary techniques?

    PubMed Central

    Assietti, Roberto; Corbino, Leonardo; Olindo, Giuseppe; Foti, Pietro V.; Russo, Vittorio; Albanese, Vincenzo

    2009-01-01

    We report the clinical and radiological results on the safety and efficacy of an unusual surgical strategy coupling anterior cervical discectomy and fusion and total disc replacement in a single-stage procedure, in patients with symptomatic, multilevel cervical degenerative disc disease (DDD). The proposed hybrid, single-stage, fusion–nonfusion technique aims either at restoring or maintaining motion where appropriate or favouring bony fusion when indicated by degenerative changes. Twenty-four patients (mean age 46.7 years) with symptomatic, multilevel DDD, either soft disc hernia or different stage spondylosis per single level, with predominant anterior myeloradicular compression and absence of severe alterations of cervical spine sagittal alignment, have been operated using such hybrid technique. Fifteen patients underwent a two-level surgery, seven patients received a three-level surgery and two a four-level procedure, for a total of 59 implanted devices (27 disc prostheses and 32 cages). Follow-up ranged between 12 and 40 months (mean 23.8 months). In all but one patient clinical follow-up (neurological examination, Nurick scale, NDI, SF-36) demonstrated significant improvement; radiological evaluation showed functioning disc prostheses (total range of motion 3–15°) and fusion through cages. None of the patients needed revision surgery for persisting or recurring symptoms, procedure-related complications or devices dislocations. To the authors’ best knowledge, this is the first study with the longest available follow-up describing a different concept in the management of cervical multilevel DDD. Although larger series with longer follow-up are needed, in selected cases of symptomatic multilevel DDD, the proposed surgical strategy appears to be a safe and reliable application of combined arthroplasty and arthrodesis during a single surgical procedure. PMID:19415346

  11. Patellar tendinopathy: late-stage results from surgical treatment☆

    PubMed Central

    Cenni, Marcos Henrique Frauendorf; Silva, Thiago Daniel Macedo; do Nascimento, Bruno Fajardo; de Andrade, Rodrigo Cristiano; Júnior, Lúcio Flávio Biondi Pinheiro; Nicolai, Oscar Pinheiro

    2015-01-01

    Objective To evaluate the late-stage results from surgical treatment of patellar tendinopathy (PT), using the Visa score (Victorian Institute of Sport Tendon Study Group) and the Verheyden method. Methods This was a retrospective study in which the postoperative results from 12 patients (14 knees) who were operated between July 2002 and February 2011 were evaluated. The patients included in the study presented patellar tendinopathy that was refractory to conservative treatment, without any other concomitant lesions. Patients who were not properly followed up during the postoperative period were excluded. Results Using the Verheyden method, nine patients were considered to have very good results, two had good results and one had poor results. In relation to Visa, the mean was 92.4 points and only two patients had scores less than 70 points (66 and 55 points). Conclusion When surgical treatment for patellar tendinopathy is correctly indicated, it has good long-term results. PMID:26535202

  12. The Planck Mission: Early Results

    SciTech Connect

    Marco Bersanelli

    2012-03-07

    The ESA Planck space mission, launched on May 14, 2009, is dedicated to high precision measurements of the cosmic microwave background (CMB), the first light of the universe, both in temperature and polarization. The satellite observes the full sky from a far-Earth orbit with two cryogenic instruments in the 30-850 GHz range at the focal plane of a 1.5-meter telescope. The primary objective of Planck is to measure with unprecedented precision the key cosmological parameters and to provide accurate tests of physics in the early universe. Planck has recently completed the fifth full-sky survey. The data analysis is underway. The first cosmology results are expected in early 2013 while a number of astrophysical results have been recently delivered to the community, including galactic and extragalactic astrophysics and a rich catalogue of radio and infrared sources. These results demonstrate the excellent in-orbit performance of the instruments and give excellent prospects for the forthcoming cosmological results.

  13. Pediatric Glaucoma: A Literature's Review and Analysis of Surgical Results

    PubMed Central

    Scuderi, Gianluca; Iacovello, Daniela; Pranno, Federica; Plateroti, Pasquale; Scuderi, Luca

    2015-01-01

    The purpose of this paper is to review the surgical options available for the management of pediatric glaucoma, to evaluate their advantages and disadvantages together with their long-term efficacy, all with the intent to give guidelines to physicians on which elements are to be considered when taking a surgical decision. Currently there is a range of surgical procedures that are being used for the management of pediatric glaucoma. Within these, some are completely new approaches, while others are improvements of the more traditional procedures. Throughout this vast range of surgical options, angle surgery remains the first choice in mild cases and both goniotomy and trabeculotomy have good success rates. Trabeculectomy with or without mitomycin C (MMC) is preferred in refractory cases, in aphakic eyes, and in older children. GDIs have a good success rate in aphakic eyes. Nonpenetrating deep sclerectomy is still rarely used; nevertheless the results of ongoing studies are encouraging. The different clinical situations should always be weighed against the risks associated with the procedures for the individual patients. Glaucomatous progression can occur many years after its stabilization and at any time during the follow-up period; for this reason life-long assessment is necessary. PMID:26451368

  14. Internal carotid pseudo-occlusion: early and late results.

    PubMed

    Pulli, R; Frosini, P; Gatti, M; Narcetti, S; Bernacchi, R; Pratesi, C

    1997-02-01

    Internal carotid pseudo-occlusion (ICP) is a pathology of difficult diagnostic evaluation and treatment in the group of extracranial carotid diseases. The authors report the results of 24 ICP(S) surgically treated in the last five years. No perioperative death was reported. The neurological morbility rate was as low as 4% (1/24), which is quite a good results for this high-risk pathology. Clinical and instrumental follow-up was performed (at 1-3-6-12-24 months from surgery). Six early asymptomatic thromboses (25%) were observed, and the remaining patients showed patent vessels and no symptoms at all. In conclusion surgical treatment of ICP is often able to prevent cerebral ischaemia, and the high rate of early occlusion should not limit surgical indication. PMID:9128116

  15. POSTEROSUPERIOR SURGICAL ACCESS ROUTE FOR TREATMENT OF ACROMIOCLAVICULAR DISLOCATIONS: RESULTS FROM 84 SURGICAL CASES

    PubMed Central

    Dal Molin, Danilo Canesin; Ribeiro, Fabiano Rebouças; Filho, Rômulo Brasil; Filardi, Cantídio Salvador; Tenor, Antonio Carlos; Stipp, Willian Nandi; Petros, Rodrigo Souto Borges

    2015-01-01

    Objective: To evaluate the results from surgical treatment of 84 cases of acute acromioclavicular dislocation, using a posterosuperior access route. Methods: Eighty-four cases of acute acromioclavicular dislocation (grade III in the Allman-Tossy classification) operated between November 2002 and May 2010 were evaluated. The patients’ mean age was 34 years. The diagnoses were made using clinical and radiographic evaluations. The patients were operated by the same surgical team, within three weeks of the date of the trauma, using a posterosuperior approach to the shoulder to access the top of the base of the coracoid process for placement of two anchors, which were used in reducing the dislocation. The minimum follow-up was 12 months. The postoperative clinical-radiographic evaluation was done using the modified Karlsson criteria and the University of California at Los Angeles (UCLA) score. Results: 92.8% of the 84 patients treated presented good or excellent results, and 7.2% presented fair or poor results, using the UCLA assessment score. According to the modified Karlsson criteria, 76.2% were assessed as grade A, 17.9% as grade B and 5.9% as grade C. Conclusion: The posterosuperior access route to the shoulder is a new option for accessing the coracoid process and treating acromioclavicular dislocation, with clinical and radiographic results equivalent to those in the literature. PMID:27047866

  16. [Results of surgical treatment of generalized emphysema of the lungs].

    PubMed

    Iaitskiĭ, N A; Varlamov, V V; Gorbunkov, S D; Akopov, A L; Chernyĭ, S M; Lukina, O V; Chermenskiĭ, A G; Gembitskaia, T E

    2014-01-01

    An analysis of examination and treatment results was made in 123 patients with generalized emphysema of the lungs and respiratory failure of II-III degree. The patients were divided into two groups according to the age: younger than 40 years old (group A - 9 patients),40 years old and older (group B - 114). A surgical reduction of lung volume was performed to correct the respiratory failure in 69 patients. The rate of postoperative complications consisted of 14.7% in group A and it was 42.2% in group B. PMID:25055526

  17. Results of Surgical Therapy in Patients with Medullary Thyroid Carcinoma.

    PubMed

    Vlad, Mihaela; Zosin, Ioana; Timar, Bogdan; Lazar, Fulger; Vlad, Adrian; Timar, Romulus; Cornianu, Marioara

    2016-08-01

    Medullary thyroid carcinoma (MTC) is a rare form of malignancy, having an intermediate prognosis. Controversies exist regarding the best surgical approach. The aim of the study was to analyze the outcome in a group of patients with MTC, diagnosed and followed up in a single care center. We performed a retrospective analysis of all the patients diagnosed with MTC in the Department of Endocrinology from the County Emergency Hospital Timisoara between 1992 and 2012. The study group included 19 patients, 6 men (31.6 %), mean age 41.2 ± 12.5 years (20-72 years). The preoperative diagnosis was based on the protocol for nodular thyroid disease. Total or near-total thyroidectomy was performed in 10 out of 16 patients who could be operated. Postoperative follow-up included repeated measurements of serum calcitonin and imaging investigations. Nine out of the total of 19 (47.3 %) patients had hereditary forms of MTC. Most of the cases (84.2 %) were submitted to surgery. The median duration of follow-up was 84 months. The pTNM staging indicated that the majority of the patients with hereditary MTC were diagnosed in an earlier stage. Disease remission was achieved in 7 cases (43.8 %). Four patients, all with sporadic forms, died. Survival rates at 1, 5 and 10 years were significantly higher (p = 0.048) in patients with hereditary MTC. An early diagnosis of MTC allows a better surgical approach and an improved survival rate. We support the general recommendation that modified radical neck dissection is not necessary for all the patients with MTC. PMID:27574350

  18. SURGICAL TREATMENT OF SEVERE OBESITY IN TEENS: LATE RESULTS

    PubMed Central

    FERRAZ, Álvaro Antônio Bandeira; de SIQUEIRA, Luciana Teixeira; NORONHA, Clarissa Guedes; de HOLANDA, Danilo Belem Rodrigues; de ARAÚJO-JÚNIOR, José Guido Corrêa; MUNIZ, Mariana Gomes

    2015-01-01

    Background : In children is estimated that the prevalence of overweight and obesity has increased up to five times in developed countries and up to four in developing countries. In Brazil, the proportion of children and adolescents who are overweight also increased from approximately 4.1% to 13.9%. Aim : To evaluate the surgical results of severe obesity in adolescents. Methods : Retrospective descriptive study of 2737 patients with severe obesity that underwent Roux-en-Y gastric bypass selecting from the total 44 patients with mean age of 18.1 years, 14 males and 30 females, most (37) operated by laparotomy. There was follow-up of 20 patients (45.45%). All were followed preoperatively by a multidisciplinary team and had indication confirmed for surgical unanimous approval of all team members. Results : Among the 20 adolescent, 14 were female. From five teenagers using anti-hypertension or hypoglycemic drugs before surgery, four (80%) had drug discontinuation and one (20%) reduced the dose in 50% postoperatively. The average weight loss was 45.4 kg after a mean follow up of 60 months. There were no deaths or severe postoperative complications. Among those who underwent postoperative follow-up with a multidisciplinary team, 18 were with BMI<30. Conclusions : Adolescents undergoing Roux-en-Y gastric bypass has good response in relation to weight loss and improvement of comorbidities. There was a low rate of complications and no deaths. All patients were satisfied with their personal results. PMID:26537264

  19. Surgical robotics: the early chronicles: a personal historical perspective.

    PubMed

    Satava, Richard M

    2002-02-01

    The use of robotics has been emerging for approximately 75 years, but only during the past 5 years has the potential of robotics been recognized by the surgical community as a whole. This personal perspective chronicles the development of robotics for the general surgical community, the role of the military medical research effort, and many of the major programs that contributed to the current success of robotics. PMID:12008765

  20. Distance Learning Improves Attainment of Professional Milestones in the Early Years of Surgical Training

    PubMed Central

    Smith, Paula J. W.; Wigmore, Stephen J.; Paisley, Anna; Lamb, Peter; Richards, Jennifer M. J.; Robson, Andrew J.; Revie, Erica; McKeown, Dermot; Dewhurst, David; Garden, O. James

    2013-01-01

    Objectives: To assess the impact of a surgical sciences e-learning programme in supporting the academic development of surgical trainees during their preparation for professional examination. Background: In 2007, a 3-year online part-time Master of Surgical Sciences (MSc) degree programme was launched, utilizing an innovative platform with virtual case scenarios based on common surgical conditions addressed by the curriculum relating to the Membership Examination of the Royal Colleges of Surgeons (MRCS). Multiple-choice questions with feedback and discussion boards facilitated by expert clinical tutors provided formative assessment. Summative assessment comprised written examination at the end of each of the first 2 years (equivalent to MRCS level), culminating in submission of a research dissertation in year 3 toward an MSc. Methods: Students' age, gender, and level at entry to the programme were documented. Anonymized student feedback from 2008 to 2012 was examined using online questionnaires, and performance in the MSc programme was compared to MRCS examination outcomes for students who had consented to release of their results. Results: A total of 517 surgical trainees from 40 countries were recruited over the 6-year period, and 116 MSc students have graduated to date. Of 368 students, 279 (76%) were foundation doctors (interns) and had not commenced formal surgical training on enrolling in the MSc programme. However, level at entry did not influence performance (P > 0.05 across all 3 years). Average pass rates since the programme launched, for those students completing all of the required assessments, were 84% ± 11% in year 1, 85% ± 10% in year 2, and 88% ± 7% in year 3 of the MSc programme. MSc students had significantly higher MRCS pass rates than nonenrolled trainees (67% vs 51%, P < 0.01, n = 352). There was a significant correlation between MRCS examination performance and overall performance in the MSc (R2 = 58%; P < 0.01, n = 37). Of 248 respondents

  1. Surgical management of fungal endophthalmitis resulting from fungal keratitis

    PubMed Central

    Gao, Yan; Chen, Nan; Dong, Xiao-Guang; Yuan, Gong-Qiang; Yu, Bin; Xie, Li-Xin

    2016-01-01

    AIM To report the fungal organisms, clinical features, surgical treatment strategies, and outcomes of patients with culture-proven exogenous fungal endophthalmitis (EFE) secondary to keratitis, and evaluate the role of surgery in the treatment. METHODS The clinical records of 27 patients (27 eyes) with culture-proven EFE resulting from fungal keratitis treated at Shandong Eye Institute from January 2007 to January 2015 were retrospectively reviewed. Information about fungal culture results, clinical features, surgical procedures, and final visual acuity was obtained. RESULTS There were 39 positive culture results from samples of cornea, hypopyon, vitreous and lens capsule, accounting for 56%, 26%, 15% and 2.5%, respectively. Fusarium was identified in 44% (12/27) of the eyes, followed by Aspergillus in 22% (6/27). Posterior segment infection was involved in 78% (21/27) of the patients. The corneal infection was larger than 3 mm ×3 mm in 89% (24/27) of the patients, and 22% (6/27) of them had the entire cornea, and even the sclera involved. Three eyes had silicone oil tamponade, and two eyes had retinal detachment. Twenty-two eyes (81.5%) underwent penetrating keratoplasty (PKP), and over half of them (54.5%) were operated within 3d from the onset of antifungal therapy. Fourteen eyes (52%) underwent intracameral antifungal drug injection, and three of them required repeated injections. Fifteen eyes (55.6%) underwent pars plana vitrectomy (PPV). The rate of the eyes undergoing PPV as the initial surgical procedure was 60% (9/15), lower than 77% in PKP. Intravitreal injection was given in 59% of the eyes (16/27), and 75% of them required repeated injections. The final visual acuity was 20/100 or better in 37% of the eyes, and better than counting fingers in 55.6% of the eyes. Five eyes (18.5%) were eviscerated. In the two eyes with concurrent retinal detachment, one achieved retinal reattachment, and the other was eviscerated. In the three eyes with silicone oil

  2. [Osteosynthesis of the clavicle. Indications, surgical technique, results].

    PubMed

    Lindenmaier, H L; Kuner, E H; Becker, B

    1991-05-01

    The osteosynthesis of the clavicle should be the exception and should only be indicated in the case of complicated fractures. The high rate of pseudoarthrosis given in medical literature, is due to errors in indication, selection of implants and in surgical techniques. Procedures like intramedullar wiring, axial screwing and single cerclage-wire suture are unsuited for osteosynthesis of the clavicle. After osteosynthesis of the clavicle we have found exceptional positive results, with respect to functional, radiological and after subjective evaluation, at a low rate of complication without any consequences occurring in the years to come. These results show, that mainly good or even excellent success can be achieved, at a limited indication, combined with careful surgery and a standardized surgery procedure of osteosynthesis of the clavicle. PMID:1874044

  3. Predicting anatomical results of surgical treatment of idiopathic macular hole

    PubMed Central

    Shpak, Alexander A.; Shkvorchenko, Dmitry O.; Sharafetdinov, Ilias Kh.; Yukhanova, Olga A.

    2016-01-01

    AIM To determine the parameters most informative in predicting the anatomical results of surgical treatment of idiopathic full-thickness macular hole (IMH). METHODS One hundred and sixty-two consecutive patients (170 eyes) after primary operation for IMH were enrolled. Outcomes were classified as anatomical success when both IMH closure and restoration of the outer retinal structure were achieved. “Prospective” group included 108 patients (115 eyes) followed with optical coherence tomography (OCT) and microperimetry for 1y after surgery. Potential prognostic criteria, except microperimetry data, were tested in “retrospective” group (54 patients, 55 eyes). Prognostic value of each parameter was determined using receiver operating characteristic (ROC) analysis. Combined predictive power of the best prognostic parameters was tested with the use of linear discriminant analysis. RESULTS IMH closure was achieved in 106 eyes (92%) in the prospective group and 49 eyes (89%) in the retrospective group. Despite anatomical closure, the outer retinal structure was not restored in two eyes in the first group and in one eye in the second group. Preoperative central subfield retinal thickness demonstrated the best discriminatory capability between eyes with anatomical success and failure: area under the ROC-curve (AUC) 0.938 (95% CI: 0.881-0.995), sensitivity 64% at fixed specificity 95% (cut-off value 300 µm) in the prospective group; sensitivity 57% and specificity 90% in the retrospective group. Other continuous parameters except tractional hole index (AUC: 0.796, 95% CI: 0.591-1.000) had significantly lower AUCs (P<0.05). The best combination of the parameters, established by discriminant analysis in the prospective group, could not confirm its predictive value in the retrospective group. CONCLUSION Preoperative central subfield retinal thickness is a strong and probably the best predictor of anatomical results of IMH surgical treatment. PMID:26949645

  4. Endoscopic versus surgical resection for early colorectal cancer—a systematic review and meta-analysis

    PubMed Central

    de Moura, Eduardo Guimaraes Hourneaux; Bernardo, Wanderley Marques; Leite de Castro, Vinicius; Morais, Cintia; Baba, Elisa Ryoka; Safatle-Ribeiro, Adriana Vaz

    2016-01-01

    Background To investigate the available data on the treatment of early colorectal cancer (CRC), either endoscopically or surgically. Methods Two independent reviewers searched MEDLINE, EMBASE, CENTRAL COCHRANE, LILACS and EBSCO for articles published up to August 2015. No language or dates filters were applied. Inclusion criteria were studies with published data about patients with early colonic or rectal cancer undergoing either endoscopic resection (i.e., mucosectomy or submucosal dissection) or surgical resection (i.e., open or laparoscopic). Extracted data items undergoing meta-analysis were en bloc resection rate, curative resection rate, and complications. A complementary analysis was performed on procedure time. The risk of bias among studies was evaluated with funnel-plot expressions, and sensitivity analyses were carried out whenever a high heterogeneity was found. The risk of bias within studies was assessed with the Newcastle score. Results A total of 12,819 articles were identified in the preliminary search. After applying inclusion and exclusion criteria, three cohort studies with a total of 768 patients undergoing endoscopic resection and 552 patients undergoing surgical resection were included. The en bloc resection rate risk difference was −11% [−13%, −8% confidence interval (CI)], demonstrating worse outcome results for the endoscopic resection group as compared to the surgical resection group [number need to harm (NNH) =10]. The curative resection rate risk difference was −9% [(−12%, 6% CI)] after a sensitivity analysis was performed, which also demonstrated worse outcomes in the intervention group (NNH =12). The complications rate exhibited a −7% risk difference [(−11%, −4% CI)], denoting a lesser number of complications in the endoscopic group [Number Need to Treat (NNT =15). A complementary analysis of procedure time with two of the selected studies demonstrated a mean difference of −118.32 min [(−127.77, −108.87 CI)], in

  5. Flexor Tendon Sheath Ganglions: Results of Surgical Excision

    PubMed Central

    Spencer, Edwin E.

    2007-01-01

    The purpose of our study was to review the clinical features and determine the results following surgical excision of a flexor tendon sheath ganglion. A retrospective analysis of 24 consecutive patients (25 ganglions) who underwent excision of a painful flexor tendon sheath ganglion by the same surgeon was performed. The patient’s medical and operative records were reviewed. Each patient was invited to return for an evaluation, which consisted of a clinical interview, completion of a questionnaire, and physical examination. Those patients that were unable to return underwent a detailed telephone interview. Sixteen patients returned for a clinical evaluation, while eight patients underwent a telephone interview. There were 15 women and nine men, with an average age of 43 years (range, 21–68 years). The dominant hand was involved in 15 patients. The long finger was most commonly involved (11 cases). The ganglion arose from the A1 pulley in 13 cases, between the A1 and A2 pulleys in three cases, and from the A2 pulley in nine cases. At an average follow-up of 18.5 months (range, 5–38 months), all of the patients were satisfied with their final result. No patient developed a recurrence and all returned to their previous functional level. There were two minor complications that resolved uneventfully; one patient experienced mild incisional tenderness, while an additional patient experienced transient digital nerve paresthesias. We conclude that surgical excision is a simple, safe, and effective method for treating a painful ganglion of the digital flexor tendon sheath. PMID:18780066

  6. Saddle pulmonary embolism: right ventricular strain an indicator for early surgical approach

    PubMed Central

    Namana, Vinod; Siddiqui, Sabah; Balasubramanian, Ram; Sarasam, Rajeswer; Shetty, Vijay

    2016-01-01

    Current mainstay treatment for pulmonary embolism (PE) includes oral anticoagulation, thrombolytic therapy, catheter embolectomy and acute surgical embolectomy. Surgical embolectomy is reserved for hemodynamically unstable patients (cardiogenic shock, cardiac arrest) and contraindication to thrombolytic therapy. We report a case of saddle PE in a young female with echocardiographic signs of right ventricular (RV) dysfunction who underwent early acute surgical embolectomy with a positive outcome. It would be beneficial to use bedside echocardiography even in hemodynamically stable patients to determine RV strain as this could act as an early indicator suggesting the escalation of therapy. PMID:27274856

  7. [Results of Surgical Treatment of Infective Valvular Endocarditis].

    PubMed

    Ivanov, V A; Domnin, V V; Yarigin, I V

    2015-01-01

    Immediate and long-term results of surgical treatment of infective valvular endocarditis (IVE) in 438 patients during the period from 1978 to 2013 are presented. Overall hospital mortality was 9.1% (11.2 and 6.7% among patients operated in the active stage of IVE and in remission, respectively) Depending on the site of infection mortality was: aortic valve (AV) - 7.9, mitral valve (MV) 10.1, MV and AV 10.7, tricuspid valve (TV) 6 7%. Overall 5 and 10 year survival after surgery was 78.6 4.7 and 66.2 3.9%, respectively. The lowest 5 and 10 year survival was observed in patients with MV and AV defects (66.3 and 52.7%, respectively). Long-term follow-up, the most consistent results are indicated in patients undergoing surgery with primary IE: to 1 year after surgery 94.5% survived to 5 year - 87%, to 10 - 85.5% of patients. In the group of patients with secondary IE to the first, fifth and tenth year observation survived 86.3%, 77.4%, 70.6%, respectively. The main reason for poor results was increasing heart failure, and recurrent infection. PMID:26502502

  8. Flail extremity resulting from constriction band syndrome: Neurovascular implications and surgical management

    PubMed Central

    Rapp, Scott J.; Pan, Brian S.; Yakuboff, Kevin P.

    2014-01-01

    Abstract Purpose: Constriction band syndrome afflicting in utero development can lead to devastating and possibly fatal outcomes. A lack of consensus regarding noninvasive testing and surgical modalities is likely secondary to the continued poorly understood pathology. Methods: We provide a case report of a 6-month-old boy who presented with a functional, nonsensate upper limb after surgical release of midhumeral banding at 3 months of age. Results: Exploration revealed intact, albeit atrophic, peripheral nerves with brachial artery disruption above the elbow. Sural nerve grafting was performed and 2-year follow-up demonstrated return of protective sensation in the median nerve distribution with minimal motor return. Conclusion: This case demonstrates that nerves present distal to the original soft tissue insult oppose the idea of failure of nerve formation. Early nerve grafting at the time of initial Z-plasty release may serve to improve long-term functional outcomes.

  9. LESS living donor nephrectomy: Surgical technique and results

    PubMed Central

    Alessimi, Abdullah; Adam, Emilie; Haber, Georges-Pascal; Badet, Lionel; Codas, Ricardo; Fehri, Hakim Fassi; Martin, Xavier; Crouzet, Sébastien

    2015-01-01

    Purpose: We present the findings of 50 patients undergoing pure trans-umbilical laparo-endoscopic single-site surgery (LESS) living donor nephrectomy (LDN), between February 2010 and May 2014. Materials and Methods: Laparo-endoscopic single-site surgery LDN was performed through an umbilical incision. Different trocars were used, namely Gelpoint (Applied Mιdical, Rancho Santa Margarita, CA) SILS port (Covidien, Hamilton, Bermuda), R-port (Olympus Surgical, Orangeburg, NY) and standard trocars, inserted through the same skin incision but using separate fascial punctures. The standard laparoscopic technique was employed. The kidney was pre-entrapped in a retrieval bag and extracted trans-umbilically. Data were collected prospectively including questionnaires containing patient reported oral pain medication duration and time to recovery. Results: LESS LDN was successful in all patients. Mean warm ischemia time was 6.2 min (3–15), mean procedure time was 233.2 min (172–300), and hospitalization stay was 3.94 days (3–7) with a visual analogue pain score at discharge of 1.32 (0–3). No intraoperative complications occurred. The mean time of oral pain medication was 8.72 days (1–20) and final scar length was 4.06 cm (3–5). Each allograft was functional. Conclusion: Although challenging, trans-umbilical LESS LDN seems to be feasible and safe. Hence, LESS has the potential to improve cosmetic results and decrease morbidity. PMID:26229326

  10. ALOHA Cabled Observatory: Early Results

    NASA Astrophysics Data System (ADS)

    Howe, B. M.; Lukas, R.; Duennebier, F. K.

    2011-12-01

    The ALOHA Cabled Observatory (ACO) was installed 6 June 2011, extending power, network communications and timing to a seafloor node and instruments at 4726 m water depth 100 km north of Oahu. The system was installed using ROV Jason operated from the R/V Kilo Moana. Station ALOHA is the field site of the Hawaii Ocean Time-series (HOT) program that has investigated temporal dynamics in biology, physics, and chemistry since 1988. HOT conducts near monthly ship-based sampling and makes continuous observations from moored instruments to document and study climate and ecosystem variability over semi-diurnal to decadal time scales. The cabled observatory system will provide the infrastructure for continuous, interactive ocean sampling enabling new measurements as well as a new mode of ocean observing that integrates ship and cabled observations. The ACO is a prototypical example of a deep observatory system that uses a retired first-generation fiber-optic telecommunications cable. Sensors provide live video, sound from local and distant sources, and measure currents, pressure, temperature, and salinity. Preliminary results will be presented and discussed.

  11. Oncological and Functional Outcome after Surgical Treatment of Early Glottic Carcinoma without Anterior Commissure Involvement

    PubMed Central

    Milovanovic, Jovica; Jotic, Ana; Djukic, Vojko; Pavlovic, Bojan; Trivic, Aleksandar; Krejovic-Trivic, Sanja; Milovanovic, Andjela; Milovanovic, Aleksandar; Artiko, Vera; Banko, Bojan

    2014-01-01

    Introduction. Glottic carcinoma can be successfully diagnosed in its early stages and treated with high percentage of success. Organ preservation and optimal functional outcomes could be achieved with wide array of surgical techniques for early glottic cancer, including endoscopic approaches or open laryngeal preserving procedures, making surgery the preferred method of treatment of early glottic carcinoma in the last few years. Material and Methods. Prospective study was done on 59 patients treated for Tis and T1a glottic carcinoma over a one-year time period in a tertiary medical center. Patients were treated with endoscopic laser cordectomy (types II–IV cordectomies according to European Laryngological Society classification of endoscopic cordectomies) and open cordectomy through laryngofissure. Follow-up period was 60 months. Clinical and oncological results were followed postoperatively. Voice quality after the treatment was assessed using multidimensional voice analysis 12 months after the treatment. Results. There were no significant differences between oncological and functional results among two groups of patients, though complications were more frequent in patients treated with open cordectomy. Conclusion. Endoscopic laser surgery should be the first treatment of choice in treatment of early glottic carcinomas, though open approach through laryngofissure should be available for selected cases where anatomical factors present limiting adequate tumor removal. PMID:24991554

  12. Surgical Management for Early-Stage Bilateral Breast Cancer Patients in China

    PubMed Central

    Xue, Jing-yan; Quan, Chen-lian; Tan, Yu-long; Liu, Guang-yu; Shao, Zhi-min; Wu, Jiong

    2015-01-01

    Background The aim of this study was to investigate the current surgical management strategy for bilateral breast cancer (BBC) patients and to assess the changes in this strategy in China. Methods This is a retrospective review of all patients with early-stage BBC who underwent surgical treatment at the Fudan University Shanghai Cancer Center between June 2007 and June 2014. Results A total of 15,337 patients with primary breast cancer were identified. Of these patients, 218 (1.5%) suffered from synchronous bilateral breast cancer (sBBC), and 296 (2.0%) suffered from metachronous bilateral breast cancer (mBBC). Patients with a lobular carcinoma component, those with estrogen receptor-positive cancer, and those with an accompanying sclerosing adenosis in the affected breast tended to develop BBC. The rates of bilateral mastectomy, breast conserving therapy, reconstruction, and combined surgeries were 86.2%, 6.4%, 3.7%, and 3.7%, respectively, for patients with sBBC and 81.1%, 4.4%, 3.0%, and 11.5%, respectively, for patients with mBBC. The interval between bilateral cancers, age at first diagnosis of breast cancer, histopathological type, and stage have significant impacts on the choice of surgery for patients with BBC. Conclusions Bilateral mastectomy was the dominant surgical management for patients with BBC in China, despite the increased application of breast reconstruction surgery observed in recent years. Bilateral prosthetic breast reconstruction was the ideal choice for patients with sBBC. Chinese surgeons should take responsibility for patient education and inform their patients about their surgical options. PMID:25874699

  13. Surgical approaches towards fertility preservation in young patients with early invasive cervical carcinoma.

    PubMed

    Mandic, A; Novakovic, P; Nincic, D

    2009-01-01

    Cervical cancer still remains one of the major problems in developing countries. The last decade of 20th century has seen a trend towards more conservative surgical approaches in the treatment of early-stage disease in young patients. The trend of delaying childbearing, nowadays, increases preservation of fertility, and reproductive function is a major concern when counseling these young women with regard to the effects of treatment for cervical cancer. Radical trachelectomy, either with abdominal or vaginal surgical approach, showed promise as treatment option in young patients with early cervical cancer. The basic principle of such a surgical approach is an operation aiming at preserving the uterine body and removing the cervix, parametrium, with bilateral pelvic lymphadenectomy, and creating a utero-vaginal anastomosis, either laparoscopically or by laparotomy. Both surgical approaches are evaluated after a search of the relevant literature in Pub Med or Medline. PMID:20148446

  14. Percutaneous radiofrequency ablation versus surgical radiofrequency ablation for malignant liver tumours: the long-term results

    PubMed Central

    Wong, John; Lee, Kit-Fai; Yu, Simon Chun-Ho; Lee, Paul Sing-Fun; Cheung, Yue-Sun; Chong, Ching-Ning; Ip, Philip Ching-Tak; Lai, Paul Bo-San

    2013-01-01

    Background Radiofrequency ablation (RFA) has been used to treat hepatocellular carcinoma (HCC) and liver metastases for more than 10 years with promising early outcomes. Preliminary results comparing percutaneous and surgical approaches have shown no difference in short-term outcomes. In this study, the longer-term outcomes were presented. Methods Patients with liver malignancies treated by RFA were prospectively studied from 2003 to 2011. Post-ablation assessment by computed tomography (CT) scan and serum biochemistry was performed at regular intervals. Recurrence rates and long-term survival were analysed. Results A total of 233 patients with liver malignancies (75.5% HCC and 24.5% liver metastases) were analysed. Three RFA approaches were used (percutaneous 58.4%, laparoscopic 9.4% and open 32.2%). The median follow-up time was 29 months. Complete ablation was achieved in 83.7%, with no difference between the two approaches. More wound and chest complications were observed in the surgical group. Intra-hepatic recurrences were observed in 69.5%; extra-hepatic recurrences were detected in 22.3%, with no difference between the two groups. There was no statistical difference between the two approaches in overall 1-, 3- and 5-year survival. Conclusion An extended period of follow-up in patients with liver malignancies showed that RFA is an effective treatment. No difference was demonstrated between the percutaneous and surgical approach, in terms of recurrence and survival. PMID:23458320

  15. Surgical management of bilateral bronchiectases: results in 29 patients.

    PubMed

    Aghajanzadeh, Manucher; Sarshad, Ali; Amani, Hosin; Alavy, Ali

    2006-06-01

    Bronchiectasis is a major cause of morbidity and mortality in developing countries. Staged bilateral segmental resection of the lungs is performed in selected patients. Our experience of surgical removal of 87 bilateral bronchiectases in 29 patients during an 11-year period was reviewed retrospectively. High-resolution computed tomography was performed preoperatively in all patients to locate the anatomic sites of bronchiectasis. The mortality and morbidity of the surgical procedure, clinical symptoms, age distribution, etiology, bacteriology, and operative procedures were analyzed. There were 22 males (76%) and 7 females (24%), aged 5 to 60 years, with a mean age of 30 years. Complications developed in 11 patients (38%); atelectasia was the most common (14%). There was one hospital death. Clinical symptoms disappeared in 19 (66%) patients, improved in 5 (17%), and were unchanged in 4 (14%). Staged bilateral resection for bronchiectases can be performed at any age with acceptable morbidity and mortality. PMID:16714699

  16. Surgical Management of Early Endometrial Cancer: An Update and Proposal of a Therapeutic Algorithm

    PubMed Central

    Falcone, Francesca; Balbi, Giancarlo; Di Martino, Luca; Grauso, Flavio; Salzillo, Maria Elena; Messalli, Enrico Michelino

    2014-01-01

    In the last few years technical improvements have produced a dramatic shift from traditional open surgery towards a minimally invasive approach for the management of early endometrial cancer. Advancement in minimally invasive surgical approaches has allowed extensive staging procedures to be performed with significantly reduced patient morbidity. Debate is ongoing regarding the choice of a minimally invasive approach that has the most effective benefit for the patients, the surgeon, and the healthcare system as a whole. Surgical treatment of women with presumed early endometrial cancer should take into account the features of endometrial disease and the general surgical risk of the patient. Women with endometrial cancer are often aged, obese, and with cardiovascular and metabolic comorbidities that increase the risk of peri-operative complications, so it is important to tailor the extent and the radicalness of surgery in order to decrease morbidity and mortality potentially derivable from unnecessary procedures. In this regard women with negative nodes derive no benefit from unnecessary lymphadenectomy, but may develop short- and long-term morbidity related to this procedure. Preoperative and intraoperative techniques could be critical tools for tailoring the extent and the radicalness of surgery in the management of women with presumed early endometrial cancer. In this review we will discuss updates in surgical management of early endometrial cancer and also the role of preoperative and intraoperative evaluation of lymph node status in influencing surgical options, with the aim of proposing a management algorithm based on the literature and our experience. PMID:25063051

  17. [Results of surgical treatment of pelvic fractures in polytraumatized patients].

    PubMed

    Roder, J D; Stübinger, B; Gmeinwieser, J; Müller, E; Claudi, B F

    1988-06-01

    High-speed accidents involving automobiles and two-wheeled vehicles with resultant entrapment and crush injuries have led to an ever-increasing incidence of pelvic fracture within the realm of multiple trauma. Between the years 1982 and 1986 ninety-eight cases of pelvic fracture were operatively stabilised by the Department of Surgery and the Outpatient Department of the Technical University, Klinikum Rechts der Isar, Munich, West Germany. This paper is a report on fifty-five of these patients who were discovered to have suffered additional multitrauma. Independent from those patients found to have sustained multitraumatisation, twenty-four cases of isolated acetabulum fracture as well as four instances of pelvic ring fracture and one fracture of the pelvic brim were also documented. Combinations of the above mentioned fractures were uncovered in twenty-six patients. With fifty-four of the fracture injuries, osteosynthesis was carried out while in one case primary alloarthroplasty was deemed necessary. Following a mean post-treatment period of twenty-six months forty-five of the patients were objectively evaluated for results of treatment according to the methodology of Merle d'Aubigne. 70% of those patients assessed were rated with a "good" result. At the time of follow-up thirty-five (78%) of the forty-five reexamined individuals reported to be once again employed. Early operative treatment along with internal stabilisation and prompt initiation of physiotherapy have proved decisive in obtaining a favourable postoperative result. PMID:2900595

  18. Surgical and conservative treatment of patients with congenital scoliosis: α search for long-term results

    PubMed Central

    2011-01-01

    Background In view of the limited data available on the conservative treatment of patients with congenital scoliosis (CS), early surgery is suggested in mild cases with formation failures. Patients with segmentation failures will not benefit from conservative treatment. The purpose of this review is to identify the mid- or long-term results of spinal fusion surgery in patients with congenital scoliosis. Methods Retrospective and prospective studies were included, reporting on the outcome of surgery in patients with congenital scoliosis. Studies concerning a small numbers of cases treated conservatively were included too. We analyzed mid-term (5 to 7 years) and long-term results (7 years or more), both as regards the maintenance of the correction of scoliosis and the safety of instrumentation, the early and late complications of surgery and their effect on quality of life. Results A small number of studies of surgically treated patients were found, contained follow-up periods of 4-6 years that in the most cases, skeletal maturity was not yet reached, and few with follow-up of 36-44 years. The results of bracing in children with congenital scoliosis, mainly in cases with failure of formation, were also studied. Discussion Spinal surgery in patients with congenital scoliosis is regarded in short as a safe procedure and should be performed. On the other hand, early and late complications are also described, concerning not only intraoperative and immediate postoperative problems, but also the safety and efficacy of the spinal instrumentation and the possibility of developing neurological disorders and the long-term effect these may have on both lung function and the quality of life of children. Conclusions Few cases indicate the long-term results of surgical techniques, in the natural progression of scoliosis. Similarly, few cases have been reported on the influence of conservative treatment. In conclusion, patients with segmentation failures should be treated

  19. Comparison of minimally invasive surgery with standard open surgery for vertebral thoracic metastases causing acute myelopathy in patients with short- or mid-term life expectancy: surgical technique and early clinical results.

    PubMed

    Miscusi, Massimo; Polli, Filippo Maria; Forcato, Stefano; Ricciardi, Luca; Frati, Alessandro; Cimatti, Marco; De Martino, Luca; Ramieri, Alessandro; Raco, Antonino

    2015-05-01

    OBJECT Spinal metastasis is common in patients with cancer. About 70% of symptomatic lesions are found in the thoracic region of the spine, and cord compression presents as the initial symptom in 5%-10% of patients. Minimally invasive spine surgery (MISS) has recently been advocated as a useful approach for spinal metastases, with the aim of decreasing the morbidity associated with more traditional open spine surgery; furthermore, the recovery time is reduced after MISS, such that postoperative chemotherapy and radiotherapy can begin sooner. METHODS Two series of oncological patients, who presented with acute myelopathy due to vertebral thoracic metastases, were compared in this study. Patients with complete paraplegia for more than 24 hours and with a modified Bauer score greater than 2 were excluded from the study. The first group (n = 23) comprised patients who were prospectively enrolled from May 2010 to September 2013, and who were treated with minimally invasive laminotomy/laminectomy and percutaneous stabilization. The second group (n = 19) comprised patients from whom data were retrospectively collected before May 2010, and who had been treated with laminectomy and stabilization with traditional open surgery. Patient groups were similar regarding general characteristics and neurological impairment. Results were analyzed in terms of neurological recovery (American Spinal Injury Association grade), complications, pain relief (visual analog scale), and quality of life (European Organisation for Research and Treatment of Cancer [EORTC] QLQ-C30 and EORTC QLQ-BM22 scales) at the 30-day follow-up. Operation time, postoperative duration of bed rest, duration of hospitalization, intraoperative blood loss, and the need and length of postoperative opioid administration were also evaluated. RESULTS There were no significant differences between the 2 groups in terms of neurological recovery and complications. Nevertheless, the MISS group showed a clear and significant

  20. Effect of early surgery in high surgical risk geriatric patients with femoral neck fracture and taking antiplatelet agents

    PubMed Central

    Sa-ngasoongsong, Paphon; Kulachote, Noratep; Sirisreetreerux, Norachart; Chanplakorn, Pongsthorn; Laohajaroensombat, Sukij; Pinsiranon, Nithiwut; Woratanarat, Patarawan; Kawinwonggowit, Viroj; Suphachatwong, Chanyut; Wajanavisit, Wiwat

    2015-01-01

    AIM: To investigate the effect of early surgical intervention on the high surgical risk elderly patients who sustained femoral neck fracture (FNF) and taking concomitant antiplatelet agents. METHODS: Between 2010 and 2012, a prospective study was conducted on 49 geriatric patients, who took antiplatelet agents, sustained FNF and underwent surgery within 72 h [early surgery (ES) group], and these were compared with a retrospective consecutive case series of patients with similar characteristics (45 cases) who had delayed surgery (DS group) after 72 h during an earlier 3-year period. Postoperative outcomes were followed for one year and compared. RESULTS: There were non-significant differences in perioperative blood loss, blood transfusion, intensive care unit requirement and postoperative mortality (P > 0.05 all). There were 2 patients (4%) in the DS group who died after surgery (P = 0.23). However, the ES group showed a significantly better postoperative outcome in terms of postoperative complications, length of hospital stay, and functional outcome (P < 0.05 all). CONCLUSION: Early hip surgery in geriatric hip fracture patients with ongoing antiplatelet treatment was not associated with a significant increase of perioperative blood loss and postoperative mortality. Moreover, ES resulted in a better postoperative surgical outcome. In early hip surgery protocol, the antiplatelet agents are discontinued and the patient is operated on within 72 h after admission, which is safe and effective for the medically fit patients. PMID:26716093

  1. Preliminary results of a computerized Placido disk surgical corneal topographer

    NASA Astrophysics Data System (ADS)

    Carvalho, Luis A.; Tonissi, S. A.; Castro, Jarbas C.

    1999-06-01

    We have developed a novel instrument for computerized corneal topography during surgery. The instrument measures a region of approximately 7 mm in diameter, providing the surgeon with precise values of power and astigmatism. The system is based on a Placido Disc projecting system, which is attached to the objective lens of the surgical microscope. The Placido Disc pattern is reflected by a 50% beam splitter attached to the body of the microscope. At the beam splitter we installed our home-made adaptor and a CCD monochromatic high resolution camera. A high quality frame grabber is installed on a PC and images are digitized at a 480x640 resolution. Algorithms based on image processing techniques were implemented for edge detection of pattern. Calibrating curves based on 4 spherical surfaces were generated and approximately 3600 points were calculated for each exam. Preliminary measurements on 10 healthy corneas were compared with the measurements made on an EyeSys Corneal Topographer. Mean deviation was 0.05 for radius of curvature, 0.24 D for power and 5 degrees for cylinder. This system, with some improvements, may be successfully used to diminish high post surgical astigmatisms in surgeries such as cataract and corneal transplant. This system could also be used to gather preoperative data in corneal topography assisted LASIK.

  2. ESOPHAGEAL MUCOSAL RESECTION VERSUS ESOPHAGECTOMY: A COMPARATIVE STUDY OF SURGICAL RESULTS IN PATIENTS WITH ADVANCED MEGAESOPHAGUS

    PubMed Central

    de OLIVEIRA, Gustavo Carvalho; da ROCHA, Rodrigo Lima Bastos; COELHO-NETO, João de Souza; TERCIOTTI-JUNIOR, Valdir; LOPES, Luiz Roberto; ANDREOLLO, Nelson Adami

    2015-01-01

    Background The surgical treatment of advanced megaesophagus has no consensus, being esophagectomy the more commonly used method. Since it has high morbimortality - inconvenient for benign disease -, in recent years an alternative has been introduced: the esophageal mucosal resection. Aim To compare early and late results of the two techniques evaluating the operative time, length of ICU stay; postoperative hospitalization; total hospitalization; intra- and postoperative complication rates; mortality; and long-term results. Methods Were evaluated retrospectively 40 charts, 23 esophagectomies and 17 mucosectomies. In assessing postoperative results, interviews were conducted by using a specific questionnaire. Results Comparing the means of esophagectomy and mucosal resection, respectively, the data were: 1) surgical time - 310.2 min and 279.7 min (p> 0.05); 2) length of stay in ICU - 5 days and 2.53 days (p <0.05); 3) total time of hospitalization - 24.25 days and 20.76 days (p> 0.05); 4) length of hospital stay after surgery - 19.05 days and 14.94 days (p> 0.05); 5) presence of intraoperative complications - 65% and 18% (p <0.05); 6) the presence of postoperative complications - 65% and 35% (p> 0.05). In the assessment of late postoperative score (range 0-10) esophagectomy (n = 5) obtained 8.8 points and 8.8 points also got mucosal resection (n = 5). Conclusions Esophageal mucosal resection proved to be good alternative for surgical treatment of megaesophagus. It was advantageous in the immediate postoperative period by presenting a lower average time in operation, the total hospitalization, ICU staying and complications rate. In the late postoperative period, the result was excellent and good in both operations. PMID:25861065

  3. [Advances in Surgical Treatment of Early Stage Non-small Cell Lung Cancer].

    PubMed

    Hu, Jian; Bao, Feichao

    2016-06-20

    Lung cancer is the leading cause of cancer-related deaths worldwide, computed tomography screening has made the disease spectrum of lung cancer shift from the previously predominating central local advanced squamous cell carcinoma to early stage lung adenocarcinoma represented by solitary pulmonary nodule, ground-glass opacity (GGO) and sub-centimeter nodule. This paper reviewed the recent proceeding in the surgical management of early stage lung cancer. PMID:27335305

  4. Triaging early-stage lung cancer patients into non-surgical pathways: who, when, and what?

    PubMed Central

    Kong, Feng-Ming (Spring)

    2015-01-01

    More lung cancer patients are being diagnosed at an earlier stage due to improved diagnostic imaging techniques, a trend that is expected to accelerate with the dissemination of lung cancer screening. Surgical resection has always been considered the standard treatment for patients with early-stage non-small cell lung cancer (NSCLC). However, non-surgical treatment options for patients with early-stage NSCLC have evolved significantly over the past decade with many new and exciting alternative treatments now available. These alternative treatments include radiofrequency ablation (RFA), microwave ablation (MWA), percutaneous cryoablation therapy (PCT), photodynamic therapy (PDT) and external beam radiation therapy (EBRT), including stereotactic body radiation therapy (SBRT) and accelerated hypofractionated radiation therapy. We describe the established alternatives to surgical resection, their advantages and disadvantages, potential complications and efficacy. We then describe the optimal treatment approach for patients with early-stage NSCLC based on tumor operability, size and location. Finally, we discuss future directions and whether any alternative therapies will challenge surgical resection as the treatment of choice for patients with operable early-stage lung cancer. PMID:26380185

  5. Triaging early-stage lung cancer patients into non-surgical pathways: who, when, and what?

    PubMed

    Sroufe, Rameses; Kong, Feng-Ming Spring

    2015-08-01

    More lung cancer patients are being diagnosed at an earlier stage due to improved diagnostic imaging techniques, a trend that is expected to accelerate with the dissemination of lung cancer screening. Surgical resection has always been considered the standard treatment for patients with early-stage non-small cell lung cancer (NSCLC). However, non-surgical treatment options for patients with early-stage NSCLC have evolved significantly over the past decade with many new and exciting alternative treatments now available. These alternative treatments include radiofrequency ablation (RFA), microwave ablation (MWA), percutaneous cryoablation therapy (PCT), photodynamic therapy (PDT) and external beam radiation therapy (EBRT), including stereotactic body radiation therapy (SBRT) and accelerated hypofractionated radiation therapy. We describe the established alternatives to surgical resection, their advantages and disadvantages, potential complications and efficacy. We then describe the optimal treatment approach for patients with early-stage NSCLC based on tumor operability, size and location. Finally, we discuss future directions and whether any alternative therapies will challenge surgical resection as the treatment of choice for patients with operable early-stage lung cancer. PMID:26380185

  6. Surgical treatment of early acute thrombosis of mechanical mitral prosthesis.

    PubMed

    Jiang, Shengli; Zhang, Tao; Ren, Chonglei; Wang, Yao

    2010-10-01

    Prosthetic valve thrombosis is a rare but life threatening complication of mechanical heart valve prosthesis. A 44-year-old woman diagnosed with rheumatic heart disease with severe mitral valve stenosis, moderate tricuspid valve insufficiency, and atrial fibrillation underwent transseptal mitral valve replacement and tricuspid valvuloplasty in our department. Heparin and warfarin were routinely used postoperatively. Although the international normalized ratio (INR), activated partial thromboplastin time ratio, and platelet count were satisfactory, the patient presented with severe dyspnea suddenly 10 days after discharge; echocardiogram showed that the prosthetic posterior leaflet was immobile. The patient suffered cardiac arrest suddenly during the examination and cardiopulmonary resuscitation was carried out successfully. Emergent surgery was performed, confirming the prosthetic valve thrombosis. The prosthetic valve was replaced with another mechanical prosthesis. The patient recovered smoothly and was discharged 14 days later with atrial fibrillation. During the 12-months follow-up period, her prosthetic valve and heart function were normal with INR around 3.0. This case highlights the need for awareness among clinicians for the possibility of valve thrombosis in the early postoperative period. PMID:20961833

  7. Nodular fasciitis on temple area resulting in surgical trauma.

    PubMed

    Choi, Hwan Jun; Jung, Kyu Hwa; Lee, Hyun Ju

    2014-11-01

    Nodular fasciitis (NF) is a pseudosarcomatous reactive proliferative lesion that commonly occurs as a solitary, well-circumscribed, painful, rapidly growing soft tissue mass. It appears at any age, but incidence peaks in the third decade, with a slight predilection for women. It is most commonly located on the extremities, followed by the chest and trunk. Although a common site in the pediatric population, NF is found on the head and neck only in 7% to 20% in the adult population and includes the cheek, parotid region, zygoma, periorbital area, eyelid, forehead, and intraoral sites. The cause of NF is unknown, but an association with trauma may be present. A case of NF over the temple area in a 28-year-old man who has no trauma history but has surgical incisional biopsy history and tenderness on palpation is reported. PMID:25364967

  8. Abortion - surgical

    MedlinePlus

    Suction curettage; Surgical abortion; Elective abortion - surgical; Therapeutic abortion - surgical ... problem. Your pregnancy is harmful to your health (therapeutic abortion). The pregnancy resulted after a traumatic event ...

  9. [Immediate and long-term results of surgical treatment of patients for traumatic mandibular fracture].

    PubMed

    Kopchak, A V

    2014-01-01

    The analysis of immediate and long-term results of the surgical treatment of 286 patients, operated for traumatic mandibular fractures in the Department of Oral and Maxillofacial Surgery, National O. O. Bogomolets Medical University. In 67% of patients the anatomical shape of the bone was adequately restored. The presence of residual displacements in other cases was determined by the fracture type and localization, the technical complexity of the surgical intervention, lack of fixation rigidity under certain functional load conditions. In long terms of observation the infection and inflammatory complications were observed in 13.4% of patients, delayed unition and non-unition of bone fragments occurred--in 4.7%, arthosis with persistent dysfunction of the temporomandibular joint--in 6.7%, fibrous ankylosis--in 1.3%. Secondary displacement of fragments was observed in 23.5% of patients due to insufficient stiffness and reliaability of the bone-fixatorsystem. The non-precise reposition of fragments and secondary displacements in the early and late postoperative period were the main cause of occlusal disturbances of various severities, noted in 28% of operated patients, limitation of mouth opening (10%), TMJ disorders and changes in masticatory stereotype (33%), the sensation of pain and discomfort in tough food chewing (35%). A statistical analysis of the effectiveness of different osteosynthesis methods depending on the type and localization of the fracture was carried out and recommendations for usage of fixation devices in clinical practice were given. PMID:24923155

  10. Predictors of Imaging Surveillance for Surgically Treated, Early-Stage Lung Cancer

    PubMed Central

    Backhus, Leah M; Farjah, Farhood; Zeliadt, Steven B; Varghese, Thomas K; Cheng, Aaron; Kessler, Larry; Au, David H; Flum, David R

    2014-01-01

    Background Current guidelines recommend routine imaging surveillance for non-small cell lung cancer (NSCLC) patients following treatment. Little is known about surveillance patterns for surgically resected, early-stage lung cancer patients in the community-at-large. We sought to characterize surveillance patterns in a national cohort. Methods We conducted a retrospective study using Surveillance, Epidemiology, and End-Results (SEER)-Medicare database (1995-2010). Patients with stage I/II NSCLC treated with surgical resection were included. Our primary outcome was receipt of imaging between 4 and 8 months following surgery. Covariates included demographics and comorbidities. Results Chest radiography (CXR) was the most frequent initial modality (60%) followed by chest computerized tomography (CT) (25%). Positron emission tomography (PET) was least frequent as initial imaging modality (3%). A total of 13% of patients received no imaging within the initial surveillance period. Adherence to National Comprehensive Cancer Network (NCCN) guidelines for imaging by overall prevalence was 47% for receipt of CT, however rates of CT imaging increased over time from 28% to 61% (p<0.01). Reduced rates of CT imaging were associated with stage I disease and surgery as the sole treatment modality. Conclusions Imaging following definitive surgery for NSCLC predominantly utilizes CXR rather than CT. Most of this imaging is likely for surveillance and in that context, CXR has inferior detection rates for recurrence and detection of new cancers. Adherence to guideline recommended CT surveillance following surgery is poor, but the reason multifactorial. Efforts to improve adherence to imaging surveillance must be coupled with greater evidence demonstrating improved long-term outcomes. PMID:25282167

  11. Iatrogenic Femoral Pseudoaneurysm and Secondary Ipsilateral Deep Vein Thrombosis: An Indication for Early Surgical Exploration.

    PubMed

    Papadakis, Marios; Zirngibl, Hubert; Floros, Nikolaos

    2016-07-01

    Pseudoaneurysm formation often complicates transfemoral interventional procedures. Nonsurgical treatment consists of femoral compression and thrombin injection under ultrasound guidance. We report a 74-year-old man who was diagnosed with a pseudoaneurysm, following coronary angiography. Duplex ultrasound revealed deep vein thrombosis of the ipsilateral common femoral vein. Ultrasound-guided thrombin injection was unsuccessfully performed, and the patient subsequently underwent surgical exploration for repair of the pseudoaneurysm and release of the venous compression. The increased local inflammation, because of the thrombosis, added in surgical difficulties. We conclude that early surgical intervention should be considered as a primary strategy in patients with femoral pseudoaneurysms and deep vein thrombosis secondary to femoral compression. PMID:27174354

  12. Methods for Surgical Targeting of the STN in Early-Stage Parkinson's Disease.

    PubMed

    Camalier, Corrie R; Konrad, Peter E; Gill, Chandler E; Kao, Chris; Remple, Michael R; Nasr, Hana M; Davis, Thomas L; Hedera, Peter; Phibbs, Fenna T; Molinari, Anna L; Neimat, Joseph S; Charles, David

    2014-01-01

    Patients with Parkinson's disease (PD) experience progressive neurological decline, and future interventional therapies are thought to show most promise in early stages of the disease. There is much interest in therapies that target the subthalamic nucleus (STN) with surgical access. While locating STN in advanced disease patients (Hoehn-Yahr Stage III or IV) is well understood and routinely performed at many centers in the context of deep brain stimulation surgery, the ability to identify this nucleus in early-stage patients has not previously been explored in a sizeable cohort. We report surgical methods used to target the STN in 15 patients with early PD (Hoehn-Yahr Stage II), using a combination of image guided surgery, microelectrode recordings, and clinical responses to macrostimulation of the region surrounding the STN. Measures of electrophysiology (firing rates and root mean squared activity) have previously been found to be lower than in later-stage patients, however, the patterns of electrophysiology seen and dopamimetic macrostimulation effects are qualitatively similar to those seen in advanced stages. Our experience with surgical implantation of Parkinson's patients with minimal motor symptoms suggest that it remains possible to accurately target the STN in early-stage PD using traditional methods. PMID:24678307

  13. ‘Minimum-incision’ endoscopically assisted transvesical prostatectomy: Surgical technique and early outcomes

    PubMed Central

    El-Karamany, Tarek M.; Al-Adl, Ahmed M.; Abdel-Baky, Shabieb A.; Abdel-Azeem, Abdallah F.; Zaazaa, Mohamed A.

    2014-01-01

    Objective To describe the surgical technique and report the early outcomes of a ‘minimum-incision’ endoscopically assisted transvesical prostatectomy (MEATP) for managing benign prostatic obstruction secondary to a large (>80 g) prostate. Patients and methods In a prospective feasibility trial, 60 men with large benign prostates underwent MEATP. The baseline and postoperative evaluation included the International Prostate Symptom Score (IPSS), a measurement of maximum urinary flow rate (Qmax), and the postvoid residual (PVR) urine volume. The adenoma was enucleated digitally through a 3-cm suprapubic skin incision, and haemostasis was completed with endoscopic coagulation of the prostatic fossa. Perioperative complications were recorded and stratified according to the modified Clavien–Dindo score. Results The mean (SD, range) prostate weight estimated by ultrasonography was 102.9 (15.4, 80–160) g, the operative duration was 52 (8, 40–65) min, the haemoglobin loss was 2.1 (1, 0.4–5) g/dL, the catheterisation time was 5.2 (1.3, 4–9) days, and the hospital stay was 6.2 (1.4, 5–10) days. There were 21 complications recorded in 16 (27%) patients, and most (86%) were of grades 1 and 2. The most frequent complications were bleeding requiring a blood transfusion (8%), and prolonged drainage (5%). There was a significant improvement at 3 months after surgery in the IPSS (8.6 vs. 21.6, P < 0.001), Qmax (19.5 vs. 7.7, P < 0.001), and PVR (15.8 vs. 83.9 mL, P < 0.001). Conclusion MEATP is feasible, safe and effective. Comparative studies and long-term data are required to determine its role in the surgical treatment of large-volume BPH. PMID:26019954

  14. Reduction pneumonoplasty for emphysema. Early results.

    PubMed Central

    Little, A G; Swain, J A; Nino, J J; Prabhu, R D; Schlachter, M D; Barcia, T C

    1995-01-01

    OBJECTIVE: The authors determined the role of Nd:YAG laser reduction pneumonoplasty for selected patients with diffuse emphysema. SUMMARY BACKGROUND DATA: The study is based on the concepts introduced 30 years ago by Brantigan regarding the value of lung reduction surgery in patients with emphysema. The authors used minimally invasive techniques with the hopes of providing appropriate clinical results with the least surgical morbidity. METHODS: Fifty-five patients with advanced symptomatic emphysema were treated with unilateral Nd:YAG laser reduction pneumonoplasty to achieve lung volume reduction. RESULTS: Patients experienced significant improvement in exercise capacity and relief of breathlessness. This correlated with improvement in objective measures of pulmonary function and with reduction in lung volume by radiographic and spirometric measures. Significant associated hospital morbidity and a 5.5% mortality were associated. CONCLUSIONS: These encouraging results with treatment of only one lung will be built on with both sequential lung and simultaneous, bilateral lung treatment protocols. Images Figure 1. Figure 2. PMID:7677465

  15. Early diagnosis of post-varicella necrotising fasciitis: A medical and surgical emergency

    PubMed Central

    Xavier, Rose; Abraham, Bobby; Cherian, Vinod Jacob; Joseph, Jobin I.

    2016-01-01

    Necrotising fasciitis (NF) is an extremely rare complication of a rather common paediatric viral exanthem varicella. Delayed diagnosis and treatment can lead to significant morbidity and mortality. Laboratory risk indicator of NF score aids in early clinical diagnosis in suspected cases of post-varicella NF thus enabling timely intervention. Surgery delayed for more than 24 hours, is an independent risk factor for death. Surgical debridement with good antibiotic coverage is the definitive treatment for NF. PMID:27251524

  16. [Surgical Therapy of Acquired Unilateral Diaphragmatic Paralysis: Indication and Results].

    PubMed

    Wiesemann, S; Haager, B; Passlick, B

    2016-09-01

    Unilateral elevation of the diaphragm may be due to various causes and requires further elucidation when the aetiology is unknown. Elevation of the diaphragm is often caused by diaphragmatic paralysis, either due to damage to the phrenic nerve or to the phrenic muscle. Patients typically complain of increased respiratory distress when lying down, bending or swimming. Basic diagnostic testing consists of a chest X-ray, as well as spirometry and computer tomography of the neck and chest. In many cases, no cause can be identified for the diaphragmatic paralysis. In symptomatic patients, diaphragm plication leads to fixation and thus to a reduction in the paradoxal respiratory movement of the paralysed diaphragm. In a large majority of studies, this results in significant and lasting improvement in vital capacity and respiratory distress. Spontaneous recovery of diaphragm paralysis is possible, even after several months, so a waiting period of at least 6 months should elapse before diaphragmatic plication is performed, if the clinical situation allows. The procedure can be performed minimally invasively, with low morbidity and mortality. When cutting the phrenic nerve, a nerve suture is recommended, if possible, or otherwise diaphragm plication during the procedure, especially in the case of pneumonectomy. This review provides an overview of the causes, pathophysiology, symptoms, diagnosis, therapy and results of diaphragmatic plication in acquired, unilateral diaphragmatic paralysis in adults, and suggests an algorithm for diagnostic testing and therapy. PMID:27607888

  17. Planck early results. VII. The Early Release Compact Source Catalogue

    NASA Astrophysics Data System (ADS)

    Planck Collaboration; Ade, P. A. R.; Aghanim, N.; Arnaud, M.; Ashdown, M.; Aumont, J.; Baccigalupi, C.; Balbi, A.; Banday, A. J.; Barreiro, R. B.; Bartlett, J. G.; Battaner, E.; Benabed, K.; Benoît, A.; Bernard, J.-P.; Bersanelli, M.; Bhatia, R.; Bonaldi, A.; Bonavera, L.; Bond, J. R.; Borrill, J.; Bouchet, F. R.; Bucher, M.; Burigana, C.; Butler, R. C.; Cabella, P.; Cantalupo, C. M.; Cappellini, B.; Cardoso, J.-F.; Carvalho, P.; Catalano, A.; Cayón, L.; Challinor, A.; Chamballu, A.; Chary, R.-R.; Chen, X.; Chiang, L.-Y.; Chiang, C.; Christensen, P. R.; Clements, D. L.; Colombi, S.; Couchot, F.; Coulais, A.; Crill, B. P.; Cuttaia, F.; Danese, L.; Davis, R. J.; de Bernardis, P.; de Rosa, A.; de Zotti, G.; Delabrouille, J.; Delouis, J.-M.; Désert, F.-X.; Dickinson, C.; Diego, J. M.; Dolag, K.; Dole, H.; Donzelli, S.; Doré, O.; Dörl, U.; Douspis, M.; Dupac, X.; Efstathiou, G.; Enßlin, T. A.; Eriksen, H. K.; Finelli, F.; Forni, O.; Fosalba, P.; Frailis, M.; Franceschi, E.; Galeotta, S.; Ganga, K.; Giard, M.; Giraud-Héraud, Y.; González-Nuevo, J.; Górski, K. M.; Gratton, S.; Gregorio, A.; Gruppuso, A.; Haissinski, J.; Hansen, F. K.; Harrison, D.; Helou, G.; Henrot-Versillé, S.; Hernández-Monteagudo, C.; Herranz, D.; Hildebrandt, S. R.; Hivon, E.; Hobson, M.; Holmes, W. A.; Hornstrup, A.; Hovest, W.; Hoyland, R. J.; Huffenberger, K. M.; Huynh, M.; Jaffe, A. H.; Jones, W. C.; Juvela, M.; Keihänen, E.; Keskitalo, R.; Kisner, T. S.; Kneissl, R.; Knox, L.; Kurki-Suonio, H.; Lagache, G.; Lähteenmäki, A.; Lamarre, J.-M.; Lasenby, A.; Laureijs, R. J.; Lawrence, C. R.; Leach, S.; Leahy, J. P.; Leonardi, R.; León-Tavares, J.; Leroy, C.; Lilje, P. B.; Linden-Vørnle, M.; López-Caniego, M.; Lubin, P. M.; Macías-Pérez, J. F.; MacTavish, C. J.; Maffei, B.; Maggio, G.; Maino, D.; Mandolesi, N.; Mann, R.; Maris, M.; Marleau, F.; Marshall, D. J.; Martínez-González, E.; Masi, S.; Massardi, M.; Matarrese, S.; Matthai, F.; Mazzotta, P.; McGehee, P.; Meinhold, P. R.; Melchiorri, A.; Melin, J.-B.; Mendes, L.; Mennella, A.; Mitra, S.; Miville-Deschênes, M.-A.; Moneti, A.; Montier, L.; Morgante, G.; Mortlock, D.; Munshi, D.; Murphy, A.; Naselsky, P.; Natoli, P.; Netterfield, C. B.; Nørgaard-Nielsen, H. U.; Noviello, F.; Novikov, D.; Novikov, I.; O'Dwyer, I. J.; Osborne, S.; Pajot, F.; Paladini, R.; Partridge, B.; Pasian, F.; Patanchon, G.; Pearson, T. J.; Perdereau, O.; Perotto, L.; Perrotta, F.; Piacentini, F.; Piat, M.; Piffaretti, R.; Plaszczynski, S.; Platania, P.; Pointecouteau, E.; Polenta, G.; Ponthieu, N.; Poutanen, T.; Pratt, G. W.; Prézeau, G.; Prunet, S.; Puget, J.-L.; Rachen, J. P.; Reach, W. T.; Rebolo, R.; Reinecke, M.; Renault, C.; Ricciardi, S.; Riller, T.; Ristorcelli, I.; Rocha, G.; Rosset, C.; Rowan-Robinson, M.; Rubiño-Martín, J. A.; Rusholme, B.; Sajina, A.; Sandri, M.; Santos, D.; Savini, G.; Schaefer, B. M.; Scott, D.; Seiffert, M. D.; Shellard, P.; Smoot, G. F.; Starck, J.-L.; Stivoli, F.; Stolyarov, V.; Sudiwala, R.; Sunyaev, R.; Sygnet, J.-F.; Tauber, J. A.; Tavagnacco, D.; Terenzi, L.; Toffolatti, L.; Tomasi, M.; Torre, J.-P.; Tristram, M.; Tuovinen, J.; Türler, M.; Umana, G.; Valenziano, L.; Valiviita, J.; Varis, J.; Vielva, P.; Villa, F.; Vittorio, N.; Wade, L. A.; Wandelt, B. D.; White, S. D. M.; Wilkinson, A.; Yvon, D.; Zacchei, A.; Zonca, A.

    2011-12-01

    A brief description of the methodology of construction, contents and usage of the Planck Early Release Compact Source Catalogue (ERCSC), including the Early Cold Cores (ECC) and the Early Sunyaev-Zeldovich (ESZ) cluster catalogue is provided. The catalogue is based on data that consist of mapping the entire sky once and 60% of the sky a second time by Planck, thereby comprising the first high sensitivity radio/submillimetre observations of the entire sky. Four source detection algorithms were run as part of the ERCSC pipeline. A Monte-Carlo algorithm based on the injection and extraction of artificial sources into the Planck maps was implemented to select reliable sources among all extracted candidates such that the cumulative reliability of the catalogue is ≥90%. There is no requirement on completeness for the ERCSC. As a result of the Monte-Carlo assessment of reliability of sources from the different techniques, an implementation of the PowellSnakes source extraction technique was used at the five frequencies between 30 and 143GHz while the SExtractor technique was used between 217 and 857GHz. The 10σ photometric flux density limit of the catalogue at |b| > 30° is 0.49, 1.0, 0.67, 0.5, 0.33, 0.28, 0.25, 0.47 and 0.82 Jy at each of the nine frequencies between 30 and 857GHz. Sources which are up to a factor of ~2 fainter than this limit, and which are present in "clean" regions of the Galaxy where the sky background due to emission from the interstellar medium is low, are included in the ERCSC if they meet the high reliability criterion. The Planck ERCSC sources have known associations to stars with dust shells, stellar cores, radio galaxies, blazars, infrared luminous galaxies and Galactic interstellar medium features. A significant fraction of unclassified sources are also present in the catalogs. In addition, two early release catalogs that contain 915 cold molecular cloud core candidates and 189 SZ cluster candidates that have been generated using

  18. Dissecting aneurysm of the descending aorta. Improved surgical results in 91 patients.

    PubMed

    Reul, G J; Cooley, D A; Hallman, G L; Reddy, S B; Kyger, E R; Wukasch, D C

    1975-05-01

    Dissecting aneurysm of the descending thoraic aorta (type iii) is a specific disease process whose pathogenesis, pathologic description, surgical treatment, and prognosis is different from dissections of the ascending arota (types l and ll). From 1964 through 1974, 91 patients underwent surgical correction of type iii dissection. The operative mortality was 21% and late mortality, up to ten years follow-up, was 13%. During the past four years, operative mortality has dropped to 6.5%. Mortality was determined by extent of the aneurysm and underlying cardiac disease. Antihypertensive and negative ionotropic drugs have not been used as definitive treatment but as adjuncts in perioperative support. Based on our present mortality of 6.5%, with no late mortality, we urge early surgical treatment of acute and chronic dissecting aneurysms of the descending thoracic aorta before extension, rupture, or massive enlargement of the aneurysm occurs. PMID:1093515

  19. Results of Surgical Treatment of Schwannomas Arising from Extremities

    PubMed Central

    Urban, Maciej; Wnukiewicz, Witold; Reichert, Paweł; Ziółkowski, Piotr

    2015-01-01

    Schwannomas are benign neoplasms derived from Schwann cells. In this work, we present our experience in operative management of schwannomas and analyse results of treatment. Clinical material consisted of 34 patients, in whom 44 schwannomas located in extremities were excised between 1985 and 2013. Thirty-five tumours originated from major peripheral nerves and 9 from small nerve branches. Postoperatively, in the first group of tumours, pain resolved in 100%, paresthesias in 83.3%, and Hoffmann-Tinel sign in 91.6% of the patients. Improvement in motor function was noted in 28.5% of the cases, in sensory function: complete in 70%, and partial in 15%. The most frequently affected major peripheral nerves were the ulnar (11 tumours) and median (5 tumours) nerves. Schwannomas originating from small nerve branches were removed without identification of the site of origin. After their resection, definitive healing was achieved. Conclusions. (1) Schwannomas located in extremities arise predominantly from major peripheral nerves, most commonly the ulnar and median nerves. (2) Gradual tumour growth causes exacerbation of compression neuropathy, creating an indication for surgery. (3) In most cases, improvement in peripheral nerve function after excision of schwannoma is achieved. (4) The risk of new permanent postoperative neurological deficits is low. PMID:25793198

  20. Kepler Mission Development Challenges and Early Results

    NASA Technical Reports Server (NTRS)

    Fanson, J.; Duren, R.; Frerking, M.

    2011-01-01

    Kepler is NASA s first mission capable of detecting Earth-size planets orbiting in the habitable zone of stars other than the Sun. Kepler comprises a space telescope designed to continuously monitor the brightnesses of more than 100,000 target stars, and a ground segment to analyze the measured stellar light curves and detect the signatures of orbiting planets. In order to detect Earth-size planets orbiting Sun-like stars Kepler was designed to provide unprecedented photometric sensitivity and stability. This paper addresses some of the technical challenges encountered during the development of the Kepler mission and the measures taken to overcome them. Early scientific results are summarized.

  1. Kepler Mission Development Challenges and Early Results

    NASA Technical Reports Server (NTRS)

    Fanson, J.

    2011-01-01

    Kepler is NASA`s first mission capable of detecting Earth-size planets orbiting in the habitable zone of stars other than the sun. Kepler comprises a space telescope designed to continuously monitor the brightnesses of more than 100,000 target stars, and a ground segment to analyze the measured stellar light curves and detect the signatures of orbiting planets. In order to detect Earth-size planets orbiting Sun-like stars Kepler was designed to provide unprecedented photometric sensitivity and stability. This paper addresses some of the technical challenges encountered during the development of the Kepler mission and the measures taken to overcome them. Early scientific results are summarized.

  2. IRAD experience on surgical type A acute dissection patients: results and predictors of mortality

    PubMed Central

    Berretta, Paolo; Patel, Himanshu J.; Gleason, Thomas G.; Sundt, Thoralf M.; Myrmel, Truls; Desai, Nimesh; Korach, Amit; Panza, Antonello; Bavaria, Joe; Khoynezhad, Ali; Woznicki, Elise; Montgomery, Dan; Isselbacher, Eric M.; Di Bartolomeo, Roberto; Fattori, Rossella; Nienaber, Christoph A.; Eagle, Kim A.; Trimarchi, Santi

    2016-01-01

    Type A acute aortic dissection (TAAD) is a disease that has a catastrophic impact on a patient’s life and emergent surgery represents a key goal of early treatment. Despite continuous improvements in imaging techniques, medical therapy and surgical management, early mortality in patients undergoing TAAD repair still remains high, ranging from 17% to 26%. In this setting, the International Registry of Acute Aortic Dissection (IRAD), the largest worldwide registry for acute aortic dissection, was established to assess clinical characteristics, management and outcomes of TAAD patients. The present review aimed to evaluate and comment on outcomes of TAAD surgery as reported from IRAD series. PMID:27563547

  3. Planck early results. I. The Planck mission

    NASA Astrophysics Data System (ADS)

    Planck Collaboration; Ade, P. A. R.; Aghanim, N.; Arnaud, M.; Ashdown, M.; Aumont, J.; Baccigalupi, C.; Baker, M.; Balbi, A.; Banday, A. J.; Barreiro, R. B.; Bartlett, J. G.; Battaner, E.; Benabed, K.; Bennett, K.; Benoît, A.; Bernard, J.-P.; Bersanelli, M.; Bhatia, R.; Bock, J. J.; Bonaldi, A.; Bond, J. R.; Borrill, J.; Bouchet, F. R.; Bradshaw, T.; Bremer, M.; Bucher, M.; Burigana, C.; Butler, R. C.; Cabella, P.; Cantalupo, C. M.; Cappellini, B.; Cardoso, J.-F.; Carr, R.; Casale, M.; Catalano, A.; Cayón, L.; Challinor, A.; Chamballu, A.; Charra, J.; Chary, R.-R.; Chiang, L.-Y.; Chiang, C.; Christensen, P. R.; Clements, D. L.; Colombi, S.; Couchot, F.; Coulais, A.; Crill, B. P.; Crone, G.; Crook, M.; Cuttaia, F.; Danese, L.; D'Arcangelo, O.; Davies, R. D.; Davis, R. J.; de Bernardis, P.; de Bruin, J.; de Gasperis, G.; de Rosa, A.; de Zotti, G.; Delabrouille, J.; Delouis, J.-M.; Désert, F.-X.; Dick, J.; Dickinson, C.; Dolag, K.; Dole, H.; Donzelli, S.; Doré, O.; Dörl, U.; Douspis, M.; Dupac, X.; Efstathiou, G.; Enßlin, T. A.; Eriksen, H. K.; Finelli, F.; Foley, S.; Forni, O.; Fosalba, P.; Frailis, M.; Franceschi, E.; Freschi, M.; Gaier, T. C.; Galeotta, S.; Gallegos, J.; Gandolfo, B.; Ganga, K.; Giard, M.; Giardino, G.; Gienger, G.; Giraud-Héraud, Y.; González, J.; González-Nuevo, J.; Górski, K. M.; Gratton, S.; Gregorio, A.; Gruppuso, A.; Guyot, G.; Haissinski, J.; Hansen, F. K.; Harrison, D.; Helou, G.; Henrot-Versillé, S.; Hernández-Monteagudo, C.; Herranz, D.; Hildebrandt, S. R.; Hivon, E.; Hobson, M.; Holmes, W. A.; Hornstrup, A.; Hovest, W.; Hoyland, R. J.; Huffenberger, K. M.; Jaffe, A. H.; Jagemann, T.; Jones, W. C.; Juillet, J. J.; Juvela, M.; Kangaslahti, P.; Keihänen, E.; Keskitalo, R.; Kisner, T. S.; Kneissl, R.; Knox, L.; Krassenburg, M.; Kurki-Suonio, H.; Lagache, G.; Lähteenmäki, A.; Lamarre, J.-M.; Lange, A. E.; Lasenby, A.; Laureijs, R. J.; Lawrence, C. R.; Leach, S.; Leahy, J. P.; Leonardi, R.; Leroy, C.; Lilje, P. B.; Linden-Vørnle, M.; López-Caniego, M.; Lowe, S.; Lubin, P. M.; Macías-Pérez, J. F.; Maciaszek, T.; MacTavish, C. J.; Maffei, B.; Maino, D.; Mandolesi, N.; Mann, R.; Maris, M.; Martínez-González, E.; Masi, S.; Massardi, M.; Matarrese, S.; Matthai, F.; Mazzotta, P.; McDonald, A.; McGehee, P.; Meinhold, P. R.; Melchiorri, A.; Melin, J.-B.; Mendes, L.; Mennella, A.; Mevi, C.; Miniscalco, R.; Mitra, S.; Miville-Deschênes, M.-A.; Moneti, A.; Montier, L.; Morgante, G.; Morisset, N.; Mortlock, D.; Munshi, D.; Murphy, A.; Naselsky, P.; Natoli, P.; Netterfield, C. B.; Nørgaard-Nielsen, H. U.; Noviello, F.; Novikov, D.; Novikov, I.; O'Dwyer, I. J.; Ortiz, I.; Osborne, S.; Osuna, P.; Oxborrow, C. A.; Pajot, F.; Paladini, R.; Partridge, B.; Pasian, F.; Passvogel, T.; Patanchon, G.; Pearson, D.; Pearson, T. J.; Perdereau, O.; Perotto, L.; Perrotta, F.; Piacentini, F.; Piat, M.; Pierpaoli, E.; Plaszczynski, S.; Platania, P.; Pointecouteau, E.; Polenta, G.; Ponthieu, N.; Popa, L.; Poutanen, T.; Prézeau, G.; Prunet, S.; Puget, J.-L.; Rachen, J. P.; Reach, W. T.; Rebolo, R.; Reinecke, M.; Reix, J.-M.; Renault, C.; Ricciardi, S.; Riller, T.; Ristorcelli, I.; Rocha, G.; Rosset, C.; Rowan-Robinson, M.; Rubiño-Martín, J. A.; Rusholme, B.; Salerno, E.; Sandri, M.; Santos, D.; Savini, G.; Schaefer, B. M.; Scott, D.; Seiffert, M. D.; Shellard, P.; Simonetto, A.; Smoot, G. F.; Sozzi, C.; Starck, J.-L.; Sternberg, J.; Stivoli, F.; Stolyarov, V.; Stompor, R.; Stringhetti, L.; Sudiwala, R.; Sunyaev, R.; Sygnet, J.-F.; Tapiador, D.; Tauber, J. A.; Tavagnacco, D.; Taylor, D.; Terenzi, L.; Texier, D.; Toffolatti, L.; Tomasi, M.; Torre, J.-P.; Tristram, M.; Tuovinen, J.; Türler, M.; Tuttlebee, M.; Umana, G.; Valenziano, L.; Valiviita, J.; Varis, J.; Vibert, L.; Vielva, P.; Villa, F.; Vittorio, N.; Wade, L. A.; Wandelt, B. D.; Watson, C.; White, S. D. M.; White, M.; Wilkinson, A.; Yvon, D.; Zacchei, A.; Zonca, A.

    2011-12-01

    The European Space Agency's Planck satellite was launched on 14 May 2009, and has been surveying the sky stably and continuously since 13 August 2009. Its performance is well in line with expectations, and it will continue to gather scientific data until the end of its cryogenic lifetime. We give an overview of the history of Planck in its first year of operations, and describe some of the key performance aspects of the satellite. This paper is part of a package submitted in conjunction with Planck's Early Release Compact Source Catalogue, the first data product based on Planck to be released publicly. The package describes the scientific performance of the Planck payload, and presents results on a variety of astrophysical topics related to the sources included in the Catalogue, as well as selected topics on diffuse emission. Corresponding author: J. A. Tauber, e-mail: jtauber@rssd.esa.int

  4. Implications of a two-step procedure in surgical management of patients with early-stage endometrioid endometrial cancer

    PubMed Central

    Bleu, Géraldine; Merlot, Benjamin; Boulanger, Loïc; Vinatier, Denis; Kerdraon, Olivier; Collinet, Pierre

    2015-01-01

    Objective Since European Society for Medical Oncology (ESMO) recommendations and French guidelines, pelvic lymphadenectomy should not be systematically performed for women with early-stage endometrioid endometrial cancer (EEC) preoperatively assessed at presumed low- or intermediate-risk. The aim of our study was to evaluate the change of our surgical practices after ESMO recommendations, and to evaluate the rate and morbidity of second surgical procedure in case of understaging after the first surgery. Methods This retrospective single-center study included women with EEC preoperatively assessed at presumed low- or intermediate-risk who had surgery between 2006 and 2013. Two periods were defined the times before and after ESMO recommendations. Demographics characteristics, surgical management, operative morbidity, and rate of understaging were compared. The rate of second surgical procedure required for lymph node resection during the second period and its morbidity were also studied. Results Sixty-one and sixty-two patients were operated for EEC preoperatively assessed at presumed low-or intermediate-risk before and after ESMO recommendations, respectively. Although immediate pelvic lymphadenectomy was performed more frequently during the first period than the second period (88.5% vs. 19.4%; p<0.001), the rate of postoperative risk-elevating or upstaging were comparable between the two periods (31.1% vs. 27.4%; p=0.71). Among the patients requiring second surgical procedure during the second period (21.0%), 30.8% did not undergo the second surgery due to their comorbidity or old age. For the patients who underwent second surgical procedure, mean operative time of the second procedure was 246.1±117.8 minutes. Third operation was required in 33.3% of them because of postoperative complications. Conclusion Since ESMO recommendations, second surgical procedure for lymph node resection is often required for women with EEC presumed at low- or intermediate-risk. This

  5. Correction of facial asymmetry resulting from hemimandibular hyperplasia: surgical steps to the esthetic result.

    PubMed

    Avelar, Rafael Linard; Becker, Otávio Emmel; Dolzan, André do Nascimento; Göelzer, Juliana Gonçalves; Haas, Orion Luiz; de Oliveira, Rogério Belle

    2012-11-01

    Hemimandibular hyperplasia is a facial deformity in which there is an increase in the condyle, neck of the condyle or ramus, and an occlusal cant. Different surgical treatments are proposed in the literature, from simple low or high condylectomy to more complex procedures combining osteotomies in different sites of the mandible. Surgical procedure is defined by the scintigraphic diagnosis of activity or inactivity in the center of condylar growth. The case report describes a 35-year-old female patient with hemimandibular hyperplasia on the left side with inactivity of condylar growth, successfully treated with bilateral sagittal split ramus osteotomy associated with a basilar osteotomy in form of "L" on the affected side. The surgical technique was easily executed, with an improvement in function, aesthetics, and patient satisfaction. Correction of facial asymmetry caused by excessive growth of the mandible using this basilar osteotomy in the form of "L" combined with bilateral sagittal split ramus osteotomy proved to be a relatively simple technique of easy execution with a low risk of nerve damage. PMID:23172437

  6. Early diagnosis and surgical intervention of acute aortic dissection by transesophageal color flow mapping.

    PubMed

    Adachi, H; Kyo, S; Takamoto, S; Kimura, S; Yokote, Y; Omoto, R

    1990-11-01

    To determine whether transesophageal color Doppler echocardiography (TEE) is useful for the early diagnosis and surgical intervention in acute aortic dissection, 57 serial patients with acute aortic dissection were examined. These patients were evaluated by TEE with either the single-plane probe (39 patients) or the biplanar probe (18 patients) just after admission. The intimal flap was detected in all patients, and there were 18 patients with type A dissection and 39 patients with type B dissection. The entry was visualized in 83% of type A dissection cases and in 90% of type B dissection cases. In two of 18 patients examined with the biplanar probe technique, the entry was detected in the longitudinal view only. Emergency operations were performed in 18 patients with type A dissection and in 10 patients with ruptured type B dissection. Twenty-nine of 39 patients with type B dissection were treated conservatively. The operative mortality rate of patients with type A dissection was 22%, and that of patients with ruptured type B dissection was 60%. The major advantage of TEE is its ease of application at the bedside or in the operating room, which allows immediate and accurate diagnosis of acute aortic dissection for emergency surgical intervention. Biplanar TEE provides additional acoustic windows, ease of spatial orientation, and more accurate visualization of entry. TEE is a useful and powerful diagnostic tool for acute aortic dissection, and by using this method, one may achieve a more rapid and aggressive surgical approach for patients with acute aortic dissection. PMID:2225402

  7. Early Results from the Long Wavelength Array

    NASA Astrophysics Data System (ADS)

    Taylor, Gregory B.; LWA Collaboration

    2012-01-01

    The Long Wavelength Array (LWA) will be a new multi-purpose radio telescope operating in the frequency range 10-88 MHz. Scientific programs include pulsars, supernova remnants, general transient searches, radio recombination lines, solar and Jupiter bursts, investigations into the "dark ages" using redshifted hydrogen, and ionospheric phenomena. Upon completion, LWA will consist of 53 phased array "stations” distributed accross a region over 400 km in diameter. Each station consists of 256 pairs of dipole-type antennas whose signals are formed into beams, with outputs transported to a central location for high-resolution aperture synthesis imaging. The resulting image sensitivity is estimated to be a few mJy (5sigma, 8 MHz, 2 polarizations, 1 h, zenith) from 20-80 MHz; with angular resolution of a few arcseconds. Additional information is online at http://lwa.unm.edu. Partners in the LWA project include LANL, JPL, NRAO, NRL, UNM, NMT, and Virginia Tech. The first station of the LWA, called "LWA1", is located near the center of the EVLA and has recently begun scientific operations. The LWA1 images the sky in realtime using the "transient buffer - narrowband” (TBN) system which is operational with 257 dipoles, and a bandwidth of 70 kHz. The LWA1 can also form up to 4 beams on the sky simultaneously with 16 MHz bandwidth in each of two tuning and full polarization. Early results include observations of pulsars, the Sun, and Jupiter.

  8. Early Results from Dharmar Planet Survey

    NASA Astrophysics Data System (ADS)

    Ma, Bo; Ge, Jian; Sithajan, Sirinrat; Powell, Scott; Varosi, Frank; Williamson, Michael; Muterspaugh, Matt; Barnes, Rory; Singer, Mickey

    2015-12-01

    The Dharma Planet Survey (DPS) with the TOU optical spectrograph at the 2m AST (soon at the dedicated robotic 50inch on Mt. Lemmon) is designed to detect and characterize sub-Jovian planets with high cadence (100 RVs per target) and high Doppler precision (~1-2 m/s) at the orbital region (~100-450 days) uncovered by previous RV surveys. The ultimate goal is to detect potentially habitable super-Earths to independently measure η⊕ and provide high priority targets for future space direct-imaging missions (such as WFIRST-AFTA and LUVOIR surveyor) to identify possible biomarkers supporting life (Ge et al. 2014). It will initially search for and characterize low mass planets around 100 nearby bright FGK dwarfs (25 late F, 50 G dwarfs and 25 K dwarfs with V<7 and within 25 pc) in 2016-2018, observe more targets and continue to monitor targets with linear trends after 2018. This poster presents our survey plan and early results.

  9. Focal neuronal migration disorders and intractable partial epilepsy: results of surgical treatment.

    PubMed

    Palmini, A; Andermann, F; Olivier, A; Tampieri, D; Robitaille, Y

    1991-12-01

    Twenty-six patients with focal or lateralized neuronal migration disorders and intractable partial epilepsy were treated surgically. Twenty-four had reliable follow-up ranging from 1 to 15 years (mean, 5.0). Pathologically, they fell into two categories: focal cortical dysplasia (12 patients) and forme fruste of tuberous sclerosis (8 patients). In the remaining 4 patients, the material was inadequate for histological analysis. Outcome regarding seizure control was assessed according to a classification most sensitive to variations in frequency of major attacks. Ten (42%) of the 24 patients achieved good or excellent outcome, 6 (25%) had a worthwhile decrease in seizure frequency, and 8 (33%) had only discrete improvement. The variable most strongly correlated with surgical outcome was the amount of lesion removed. Seventy-seven percent of patients in whom a complete excision or excision of 50% or more of the lesion was accomplished achieved excellent or good surgical outcome. Conversely, no patient with less than 50% of the lesion removed attained the same result. There was no correlation between other clinical, radiological, or electrographic variables and outcome regarding seizure control. Specifically there was no significant correlation between the amount of excision of the epileptogenic area as judged by scalp electroencephalography and electrocorticography studies, and surgical outcome. In patients with neuronal migration disorders and intractable partial epilepsy, removal of the structural abnormality takes precedence over removal of epileptogenic tissue as the main surgical strategy to achieve seizure control. PMID:1789692

  10. LANDSAT 7: Early on-Orbit Results

    NASA Technical Reports Server (NTRS)

    Williams, D. L.; Irons, J. R.; Barker, J. L.; Markham, B. L.; Pedelty, J, A.

    1999-01-01

    As this article was being submitted in mid-March, 1999, Landsat 7 had been cleared for an official launch date of April, 15, 1999, approximately 4 - 5 weeks prior to the Portland ASPRS conference. Although it is hoped that the presentation in Portland will be the first public status report on the in-orbit performance of the Landsat 7 spacecraft and the ETM+ instrument, it is impossible to discuss "early on-orbit performance" prior to launch. Therefore, we have chosen to summarize the overarching salient features of the Landsat 7 program, and we will point to some web sites where additional information about the program can be found (e.g., http://geo.arc.nasa.gov/sge/landsat/landsat. html). At this time, the Landsat Project Science Office is pleased to report that the performance of the ETM+ instrument appears to be very good. In addition to excellent instrument performance, a robust data acquisition plan has been developed with the goal of acquiring a seasonally-refreshed archive of global land observations at the EROS Data Center annually. A ground processing system is being implemented at EROS that will be capable of capturing, processing and archiving 250 Landsat scenes per day, and delivering 100 scene products to users each day. The cost of a systematically-processed Level 1 product will be less than $600, and there will be no copyright protection on the data. The net result is that the use of remote sensing data in our daily lives is expected to grow dramatically. This growth is expected to benefit all facets of the land remote sensing community.

  11. Brain abscess and subdural empyema. Factors influencing mortality and results of various surgical techniques.

    PubMed Central

    Van Alphen, H A; Dreissen, J J

    1976-01-01

    The authors review the results of various surgical techniques in relation to mortality and morbidity in 100 consecutive cases of brain abscess and subdural empyema. The mortality rate is the same with total excision and fractional drainage of brain abscesses, although in acute and subacute cases slight differences between both techniques are seen. In terms of morbidity, fractional drainage appears to be more favourable than total excision. The authors believe that factors other than surgical procedure influence mortality in cases of brain abscess and subdural empyema. These factors are defined in detail. Images PMID:932767

  12. Current surgical results of acute type A aortic dissection in Japan.

    PubMed

    Okita, Yutaka

    2016-07-01

    Current surgical results of acute type A aortic dissection in Japan are presented. According to the annual survey by the Japanese Association of Thoracic Surgery, 4,444 patients with acute type A aortic dissection underwent surgical procedures and the overall hospital mortality was 9.1% in 2013. The prevalence of aortic root replacement with a valve sparing technique, total arch replacement (TAR), and frozen stent graft are presented and strategies for thrombosed dissection or organ malperfusion syndrome secondary to acute aortic dissection are discussed. PMID:27563550

  13. Current surgical results of acute type A aortic dissection in Japan

    PubMed Central

    2016-01-01

    Current surgical results of acute type A aortic dissection in Japan are presented. According to the annual survey by the Japanese Association of Thoracic Surgery, 4,444 patients with acute type A aortic dissection underwent surgical procedures and the overall hospital mortality was 9.1% in 2013. The prevalence of aortic root replacement with a valve sparing technique, total arch replacement (TAR), and frozen stent graft are presented and strategies for thrombosed dissection or organ malperfusion syndrome secondary to acute aortic dissection are discussed. PMID:27563550

  14. ASSESSMENT OF THE RESULTS FROM ARTHROSCOPIC SURGICAL TREATMENT FOR TRAUMATIC ANTERIOR SHOULDER DISLOCATION: FIRST EPISODE

    PubMed Central

    Miyazaki, Alberto Naoki; Fregoneze, Marcelo; Santos, Pedro Doneux; da Silva, Luciana Andrade; do Val Sella, Guilherme; Botelho, Vinicius; Duarte, Clodoaldo; Checchia, Sergio Luiz

    2015-01-01

    Objective: To assess the clinical results obtained of patients who underwent arthroscopic surgical treatment following a first episode of traumatic anterior shoulder dislocation. Methods: Between August 2000 and October 2008, 14 shoulders of 14 patients were treated by the Shoulder and Elbow Group of Santa Casa Hospital, São Paulo. Thirteen patients (93%) were male and one (7%) was female; their ages ranged from 17 to 41 years, with a mean of 28 years. All of the patients evaluated were regularly practicing a sports activity (which required physical vigor of the upper limbs). The time that had elapsed between the trauma and the surgical treatment ranged from seven to 60 days, with a mean of 20 days. The surgical procedure was performed with arthroscopic viewing, with the patient positioned in lateral decubitus. Fixation of the labral-ligamentous complex was achieved using bioabsorbable anchors. The postoperative clinical assessment was made using Rowe and UCLA criteria. Joint mobility was measured according to the guidance from ASES (American Shoulder and Elbow Surgeons). The length of postoperative follow-up ranged from 24 to 120 months, with a mean of 45 months. Results: All the patients achieved satisfactory results, (85% excellent and 15% good), as shown by UCLA, while 100% of the results were excellent according Rowe. The “grip test” was negative for all the patients. Conclusion: Surgical treatment after a first episode of traumatic anterior shoulder dislocation seems to be a good therapeutic option for young active patients who practice sports activities. PMID:27042625

  15. Comparison of Laparoscopy and Laparotomy in Surgical Staging of Apparent Early Ovarian Cancer

    PubMed Central

    Lu, Qi; Qu, Hong; Liu, Chongdong; Wang, Shuzhen; Zhang, Zhiqiang; Zhang, Zhenyu

    2016-01-01

    Abstract The aim of this study was to compare the safety and morbidity of laparoscopic versus laparotomic comprehensive staging of apparent early stage ovarian cancer. In this retrospective study, the outcomes of patients with apparent stage I ovarian cancer who underwent laparoscopic or laparotomic comprehensive surgical staging from January 2002 to January 2014 were evaluated. The long-term survival of patients with early ovarian cancer was compared. Forty-two patients were treated by laparoscopy, and 50 were treated by laparotomy. The median operative time was 200 minutes in the laparoscopy group and 240 minutes in the laparotomy group (P >0.05). The median length of hospital stay was 3 days in the laparoscopy group and 7 days in the laparotomy group (P <0.05). Following laparoscopic and laparotomic staging, the cancer was upstaged for 9 (21.4%) and 10 (20.0%) women, respectively. The median follow-up time was 82 months in the laparoscopic and laparotomic groups, respectively. Excluding the upstaged patients, no recurrence was observed in the present study, and the overall survival and 5-year survival rates were 100% in both the laparoscopy and laparotomy groups. Laparoscopic and laparotomic comprehensive staging of early ovarian cancer were similar in terms of staging adequacy, accuracy and survival rate. Laparoscopic staging was associated with a significantly reduced hospital stay. Prospective randomized trials are required to evaluate the overall oncologic outcomes. PMID:27196468

  16. Oncological and functional results of open, robot-assisted and laparoscopic radical prostatectomy: does surgical approach and surgical experience matter?

    PubMed

    Herrmann, T R; Rabenalt, R; Stolzenburg, J U; Liatsikos, E N; Imkamp, F; Tezval, H; Gross, A J; Jonas, U; Burchardt, M

    2007-04-01

    The treatment of prostate cancer has undergone a fundamental change in the last decade. New surgical and nonsurgical minimal invasive methods have evolved. As the methodology of the different treatments is commonly known to urologists, this article focuses on oncological and functional outcome of open retropubic (ORP), trans- or extraperitoneal endoscopical (LRP), and robot-assisted radical prostatectomy (RALP), based on personal experience and review of the literature. A MEDLINE search was performed to review the literature on LRP and RALP between 1982 and 2007 with special emphasis on oncological and functional results, technical considerations, comparison of LRP and RALP to ORP, laparoscopic training, historical aspects, and cost-efficiency of the techniques. Based on diligent training and proctoring programs, a continuous dissemination of laparoscopic techniques takes place. There is a trend towards the extraperitoneal access in most of the minimal invasive programs at least in the European community. Mid-term outcomes of LRP and short-term outcomes of RALP achieved equivalence to open surgery with regards to complications, oncologic and functional results. Distinct advantages of LRP include less postoperative pain, lower transfusion rates, shorter convalescence, and better cosmetics. In contrast to RALP, LRP reaches cost-equivalence with open surgery in selected centers. LRP and RALP reproduce the short-term results of open surgery while providing the advantages of a minimal access. Video-assisted teaching improves the transfer of anatomical knowledge and technical knowhow, but the discussion about the longer learning curve for laparoscopy handling remains. The future will show if European centers adopt the use of robots comparable to the United States. PMID:17354014

  17. RESULTS FROM CLINICAL AND RADIOLOGICAL FOLLOW-UP, AFTER SURGICAL TREATMENT OF CHONDROBLASTOMA

    PubMed Central

    Penna, Valter; Toller, Eduardo Areas; Ferreira, Adriano Jander; Dias, Dante Palloni Costa

    2015-01-01

    Objectives: To evaluate the long-term clinical and radiological results from patients who underwent surgical treatment of chondroblastoma, between 2003 and 2009, by the same surgical team, using the same operative technique. Methods: A retrospective study was conducted on 12 patients with histological diagnoses of chondroblastoma, who were attended between 2003 and 2009 at the Pius XII Foundation (Barretos Cancer Hospital, Barretos, State of São Paulo). These patients underwent surgical treatment with intralesional resection of the tumor, adjuvant electrocauterization and replacement with methyl methacrylate (11 cases) or an autologous graft from the iliac crest (one case). The preoperative evaluation included physical examination, plain radiographs of the site, magnetic resonance imaging, computed axial tomography and bone scintigraphy. The patients were assessed clinically and radiologically according to a predefined protocol, with a series of plain radiographs, and a functional assessment in accordance with the Enneking functional score. Results: The average age at the time of diagnosis was 14 years and 4 months. The most frequent location affected was the distal femoral epiphysis (75%), followed by the proximal tibial epiphysis (16.6%) and the calcaneus (8.4%). There was higher prevalence among the female patients than among the male patients (3:1). In three cases, preoperative biopsy was necessary. During the follow-up, there was no evidence of local tumor recurrence, and all the patients presented an excellent functional result from the surgical technique used, with Enneking scores ranging from 20 to 30. Conclusion: Surgical treatment of chondroblastoma, using intralesional resection, adjuvant electrocauterization and replacement with methyl methacrylate or bone graft produced good results. PMID:27027054

  18. Early Surgical Management of Large Scalp Infantile Hemangioma Using the TopClosure® Tension-Relief System.

    PubMed

    Zhu, Zhanyong; Yang, Xilin; Zhao, Yueqiang; Fan, Huajun; Yu, Mosheng; Topaz, Moris

    2015-11-01

    Infantile hemangiomas (IHs) are the most common benign vascular neoplasms of infancy and childhood. The majority do not need medical intervention. However, large ulcerated scalp IHs may lead to fatal bleeding as well as severe cosmetic disfigurement that indicate early surgical excision, inflicting substantial surgical risks, with short- and long-term morbidity.The TopClosure Tension-Relief System (TRS) is an innovative skin stretching and wound closure-secure system that facilitates primary closure of relatively large skin defects. This system has been shown as a substitute for skin grafts, flaps, or tissue expanders.We describe a case of a giant IH of the scalp usually requiring a complex surgical approach, which was immediately primarily closed applying the TRS.A 3-day-old female infant presented with a giant scalp hemangioma at birth that rapidly grew in the neonatal period with early signs of ulceration. The patient underwent surgical resection of the giant scalp hemangioma with immediate primary closure of the defect using the TRS. Surgical procedure and postoperative period were uneventful.Early surgical resections of IHs at infancy carry substantial surgical risks and morbidity. This is the first reported case of early resection of a scalp hemangioma in the neonatal period, with successful immediate primary closure by application of stress-relaxation technique through the TRS. The application of the TopClosure TRS in this age group has significant advantages. It reduces the complexity and length of surgery, reducing blood loss, eliminating donor site morbidity, improving wound aesthetics, and minimizing the need for future reconstructive procedures. PMID:26632734

  19. Role of concanavalin A lectin in recognition of pterygium remnant after surgical excision: Preliminary results of a prospective study

    PubMed Central

    Díaz-González, Juan A; Mayoral-Chávez, Miguel A; Bohórquez, Paulina Leyva; de la Torre, Ma. del Pilar Gabriel; Hernández-Cruz, Pedro; Martínez-Cruz, Ruth

    2007-01-01

    Background: Pterygium is one of the most common conjunctival diseases among ophthalmic pathologies. The frequency of recurrences is high, either after surgical treatment or after treatment combined with mitomycin C or beta-radiation therapy. Aims: The purpose of this study was to determine whether concanavalin A (ConA) lectin bound to the pterygial surface can be used to detect recurrence or remnants of pterygium after surgical excision. Materials and Methods: This was a prospective study on 20 patients with pterygium, divided in five stages, pre-surgery, early post-surgery (24h), late post-surgery (seven days), very late post-surgery (four weeks) and two months after the procedure. A drop of fluorescein-marked Con A (35 µg/mL) was instilled in the lower conjunctival eyelid sac and the eye was exposed to the light of a Wood′s lamp for an average of five seconds. Results: Out of the 20 patients, eight patients were found to have fluorescent stretch marks over the scar corresponding to residual pterygial tissue at four weeks; two months after the procedure of re-surgery we observed no fluorescent remnants. All residual pterygia were confirmed through histochemistry studies. Conclusion: It was possible to detect remnants of pterygium in postoperative patients and recurrences in early pre-clinical stages through the visualization of fluorescent ConA bound to the pterygial surface. PMID:17699943

  20. [Caustic stenosis of the esophagus in Libreville. Results of the surgical treatment].

    PubMed

    Ondo N'Dong, F; Eyamame, D; Makaya, J; Mabamba, C; Aldunate, R S; Mbumbe King, A; Bellamy, J; Diane, C

    1992-04-01

    41 cases of caustic stenosis of the oesophagus were treated surgically by the thoracic and visceral surgical teams of La Fodation Jeanne Ebori and L'Hopital Pédiatrique d'Owendo in Libreville. The lesions were due to bleach ingestion in 38 cases, caustic soda in 2 cases and sulfuric acid in 1 case. Ingestion was an accident in 29 cases and voluntary in 12. There were 32 men and 9 women. Among them, there were 32 infants and 9 adults. The mean age was 4.5 years for the infants and 25 years for the adults. The surgical procedures were gastrostomy, followed by dilatations of the stenosis in 19 cases, esophagoplasty using the stomach, with pyloroplasty and jejunostomy in 4 cases, and gastrostomy associated with esophagoplasty using the colon in 18 cases. Mortality rate was 2.4%. It was about 1 patient, from general causes. Cervical or thoracic fistulae occurred in 4 patients, all of them successfully treated by medical means, and 3 patients had regressive pulmonary infections. The mean follow-up was 4 years, with good results. The authors suggest a surgical attitude in the management of caustic stenosis, every time the medical management is unsuccessfull. PMID:1527196

  1. Serous Macular Detachment Secondary to Optic Pit: Surgical Treatment and Long Time Results

    PubMed Central

    Cevher, Selim; Sahinoglu-Keskek, Nedime; Unal, Fikret; Demirduzen, Selahaddin; Oksuz, Huseyin

    2016-01-01

    32-year-old Turkish male patient presented with an optic disk pit and serous macular detachment in the left eye. Spectral domain optical coherence tomography revealed serous macular detachment and retinoschisis. After vitrectomy the retina gradually flattened and vision was gradually improved. We aimed to report a case of serous macula detachment secondary to optic pit and long term result of surgical treatment. PMID:26881159

  2. Distal tears of the hamstring muscles: review of the literature and our results of surgical treatment

    PubMed Central

    Lempainen, Lasse; Sarimo, Janne; Mattila, Kimmo; Heikkilä, Jouni; Orava, Sakari

    2007-01-01

    Background Hamstring strains are among the most frequent injuries in sports, especially in events requiring sprinting and running. Distal tears of the hamstring muscles requiring surgical treatment are scarcely reported in the literature. Objective To evaluate the results of surgical treatment for distal hamstring tears. Design A case series of 18 operatively treated distal hamstring muscle tears combined with a review of previously published cases in the English literature. Retrospective study; level of evidence 4. Setting Mehiläinen Sports Trauma Research Center, Mehiläinen Hospital and Sports Clinic, Turku, Finland. Patients Between 1992 and 2005, a total of 18 athletes with a distal hamstring tear were operated at our centre. Main outcome measurements At follow‐up, the patients were asked about possible symptoms (pain, weakness, stiffness) and their return to the pre‐injury level of sport. Results The final results were rated excellent in 13 cases, good in 1 case, fair in 3 cases and poor in 1 case. 14 of the 18 patients were able to return to their former level of sport after an average of 4 months (range 2–6 months). Conclusions Surgical treatment seems to be beneficial in distal hamstring tears in selected cases. PMID:17138628

  3. Can the results of treatment of deep venous thrombosis be improved by combining surgical thrombectomy with regional fibrinolysis?

    PubMed

    Nachbur, B B; Beck, E A; Senn, A

    1980-01-01

    A new mode of treatment of extensive acute and subacute deep venous thrombosis of the lower extremities is introduced. For this purpose the beneficial effects of surgical thrombectomy and of thrombolysis with streptokinase are combined during the course of a single surgical intervention. Rapid-flow regional perfusion is the vehicle used for administration of streptokinase and probably represents the third arm of this therapeutic approach by adding a hemodynamic wash-out effect. Because the thrombolytic agent is rinsed out of the circuit at the end of regional perfusion the usual side effects and contra-indications of this drug are avoided. Early and late results of this treatment are assessed clinically and with repeat venograms in a group of 9 patients. Highly satisfactory results were obtained in 6 patients with complete anatomical and functional restoration of deep veins along their entire length in three cases. It is felt that continued use of this method is warranted and that the results of treatment of deep venous thrombosis can thus be improved. PMID:6993494

  4. Management of spontaneous extramedullary spinal haematomas: results in eight patients after MRI diagnosis and surgical decompression.

    PubMed Central

    Langmayr, J J; Ortler, M; Dessl, A; Twerdy, K; Aichner, F; Felber, S

    1995-01-01

    Spinal cord compression due to extradural and subdural haemorrhage is a neurosurgical emergency. Differences in clinical presentation in relation to localisation of the haematoma, value of MRI as a diagnostic tool, surgical treatment, and prognosis were investigated in a retrospective case series of eight patients with extradural (n = four) and subdural (n = four) haematomas. Results of MRI were compared with operative findings and proved to be of high sensitivity in defining the type of bleeding and delineating craniocaudal extension and ventrodorsal location. Surgical treatment by decompressive laminectomy, haematoma evacuation, and postoperative high dose corticosteroids resulted in resolution of symptoms in five patients and improvement in the clinical situation in two patients. One patient with a chronic subdural haematoma had a second operation because of arachnoidal adhesions. One patient presented with a complete cord transection syndrome due to an acute subdural haematoma and remained paraplegic. It is concluded that prompt, reliable, and non-invasive diagnosis by MRI leads to efficient surgical treatment and a favourable outcome in this rare condition. Images PMID:7561928

  5. Early Results from the DES SN Survey

    NASA Astrophysics Data System (ADS)

    Scolnic, Daniel; Dark Energy Survey

    2016-01-01

    The Dark Energy Survey Supernova program (DES SN) has already discovered over 1000 Type Ia supernovae with well-sampled multi-color light curves in the redshift range 0.1 < z < 1.2. I will present an overview of the survey and show recent advances in our detection, photometry, calibration and spectroscopic follow-up pipelines. I will go over initial results from photometric classification of our sample and discuss methods used to reach measurements of cosmological parameters.

  6. Surgical hip dislocation does not result in atrophy or fatty infiltration of periarticular hip muscles

    PubMed Central

    Glynn, Aaron A.; Barattiero, Fabio Y.; Albers, Christoph E.; Hanke, Markus S.; Steppacher, Simon D.; Tannast, Moritz

    2014-01-01

    Surgical hip dislocation is the gold standard for treatment of femoroacetabular impingement (FAI). It utilizes an intermuscular and internervous approach to the hip. Concerns have been expressed that this approach causes soft tissue trauma resulting in post-operative muscle weakness of patients undergoing this procedure. We therefore asked whether surgical hip dislocation leads to (i) atrophy (decreased muscle diameter or cross-sectional area [CSA]) and (ii) degeneration (fatty infiltration) of 18 evaluated periarticular hip muscles. We retrospectively evaluated 32 patients (34 hips) following surgical hip dislocation for the treatment of FAI using pre and post-operative magnetic resonance (MR) arthrography of the hip. We evaluated muscle diameter, CSA and degree of fatty infiltration according to Goutallier for 18 periarticular hip muscles on axial and sagittal views. The mean interval between pre and post-operative MR was 1.9 ± 1.5 years (range, 0.4–6.1 years). Pre and post-operative muscle diameter and CSA of all 18 evaluated hip muscles did not differ. There was no post-operative change in the Goutallier classification for any of the evaluated 18 muscles. No muscle had post-operative degeneration higher than Grade 1 according to Goutallier. No atrophy or degeneration of periarticular hip muscles could be found following surgical hip dislocation for treatment of FAI. Any raised concerns about the invasiveness and potential muscle trauma for this type of surgery are unfounded. Level III, retrospective comparative study. See guidelines for authors for a complete description of levels of evidence. PMID:27011807

  7. Early results of the Acclaim elbow replacement.

    PubMed

    Bassi, R S; Simmons, D; Ali, F; Nuttall, D; Birch, A; Trail, I A; Stanley, J K

    2007-04-01

    The Acclaim total elbow replacement is a modular system which allows implantation in both unlinked and linked modes. The results of the use of this implant in primary total elbow replacement in 36 patients, operated on between July 2000 and August 2002, are presented at a mean follow-up of 36 months (24 to 49). Only one patient did not have good relief of pain, but all had improved movement and function. No implant showed clinical or radiological loosening, although one had a lucent area in three of seven humeral zones. The short-term results of the Acclaim total elbow replacement are encouraging. However, 11 patients (30.5%) suffered an intra-operative fracture of the humeral condyle. This did not affect the outcome, or the requirement for further surgery, except in one case where the fracture failed to unite. This problem has hopefully been addressed by redesigning the humeral resection guide. Other complications included three cases of ulnar neuropathy (8.3%) and one of deep infection (2.8%). PMID:17463117

  8. Early and late surgical treatment of orbital dystopia in craniofacial malformation.

    PubMed

    De Ponte, F S; Fadda, T; Rinna, C; Brunelli, A; Iannetti, G

    1997-01-01

    Orbital dystopia is one of the most frequent clinical signs of craniofacial malformation. The term dystopia indicates the mono- and bilateral asymmetry of the orbits at least in one of the three-dimensional planes. The diagnosis is based on the clinical test of the patient with the support of diagnostic instruments such as teleradiography in both standard projections, axial computed tomographic (CT) scans at a rate of 1:1 through the neuro-orbital plan, and the three-dimensional CT. Good results of the surgical treatment depend on the patient's age and on adequate programming, which should consider the anomalies in the three spatial planes. The VTO is obtained through a protocol of analysis on cephalometric graphics of the teleradiographics on the CT at a rate of 1:1. The surgical treatment of orbital dystopia is different depending on the age of the patient and the cause of the orbital anomaly. In the case of growing patients, it is preferable to use the fronto-orbital bandeau technique so as not to damage the dental buds, whereas in grown patients Tessier's orbital quadrant technique is used. Even the fixation is quite different between patients who are growing and those who are already grown. In still-growing patients, rigid internal fixation is used only in some cases to avoid the interference with the growth mechanisms. PMID:10332293

  9. Early Results from AIRS/AMSU/HSB

    NASA Technical Reports Server (NTRS)

    Susskind, Joel; Barnet, Christopher; Blaisdell, John; Iredell, Lena; Keita, Fricky; Kouvaris, Lou

    2003-01-01

    AIRS was launched on EOS Aqua on May 5, 2002, together with AMSU A and HSB, to form a next generation polar orbiting infiared and microwave atmospheric sounding system. The primary products of AIRS/AMSU/HSB are twice daily global fields of atmospheric temperature-humidity profiles, ozone profiles, sea/land surface skin temperature, and cloud related parameters including OLR. The sounding goals of AIRS are to produce 1 km tropospheric layer mean temperatures with an rms error of lK, and layer precipitable water with an rms error of 20%, in cases with up to 80% effective cloud cover. Pre-launch simulation studies indicated that these results should be achievable. Minor modifications have been made to the pre-launch retrieval algorithm as described in this paper. Sample fields of parameters retrieved from AIRS/AMSU/HSB data are presented and validated as a function of retrieved fractional cloud cover. As in simulation, the degradation of retrieval accuracy with increasing cloud cover is small. Select fields are also compared to those contained in the ECMWF analysis, done without the benefit of AIRS data, to demonstrate information that AIRS can add to that already contained in the ECMWF analysis.

  10. Landsat-7 Mission and Early Results

    NASA Technical Reports Server (NTRS)

    Dolan, S. Kenneth; Sabelhaus, Phillip A.; Williams, Darrel L.; Irons, James R.; Barker, John L.; Markham, Brian L.; Bolek, Joseph T.; Scott, Steven S.; Thompson, R. J.; Rapp, Jeffrey J.

    1999-01-01

    The Landsat-7 mission has the goal of acquiring annual data sets of reflective band digital imagery of the landmass of the Earth at a spatial resolution of 30 meters for a period of five years using the Enhanced Thematic Mapper Plus (ETM+) imager on the Landsat-7 satellite. The satellite was launched on April 15, 1999. The mission builds on the 27-year continuous archive of thematic images of the Earth from previous Landsat satellites. This paper will describe the ETM+ instrument, the spacecraft, and the ground processing system in place to accomplish the mission. Results from the first few months in orbit will be given, with emphasis on performance parameters that affect image quality, quantity, and availability. There will also be a discussion of the Landsat Data Policy and the user interface designed to make contents of the archive readily available, expedite ordering, and distribute the data quickly. Landsat-7, established by a Presidential Directive and a Public Law, is a joint program of the National Aeronautics and Space Administration (NASA) Earth Science Enterprise and the United States Geological Survey (USGS) Earth Resources Observing System (EROS) Data Center.

  11. Early Results from the Qweak Experiment

    NASA Astrophysics Data System (ADS)

    Androic, D.; Armstrong, D. S.; Asaturyan, A.; Averett, T.; Balewski, J.; Beaufait, J.; Beminiwattha, R. S.; Benesch, J.; Benmokhtar, F.; Birchall, J.; Carlini, R. D.; Cates, G. D.; Cornejo, J. C.; Covrig, S.; Dalton, M. M.; Davis, C. A.; Deconinck, W.; Diefenbach, J.; Dowd, J. F.; Dunne, J. A.; Dutta, D.; Duvall, W. S.; Elaasar, M.; Falk, W. R.; Finn, J. M.; Forest, T.; Gaskell, D.; Gericke, M. T. W.; Grames, J.; Gray, V. M.; Grimm, K.; Guo, F.; Hoskins, J. R.; Johnston, K.; Jones, D.; Jones, M.; Jones, R.; Kargiantoulakis, M.; King, P. M.; Korkmaz, E.; Kowalski, S.; Leacock, J.; Leckey, J.; Lee, A. R.; Lee, J. H.; Lee, L.; MacEwan, S.; Mack, D.; Magee, J. A.; Mahurin, R.; Mammei, J.; Martin, J.; McHugh, M. J.; Meekins, D.; Mei, J.; Michaels, R.; Micherdzinska, A.; Mkrtchyan, A.; Mkrtchyan, H.; Morgan, N.; Myers, K. E.; Narayan, A.; Ndukum, L. Z.; Nelyubin, V.; Nuruzzaman; van Oers, W. T. H.; Opper, A. K.; Page, S. A.; Pan, J.; Paschke, K.; Phillips, S. K.; Pitt, M. L.; Poelker, M.; Rajotte, J. F.; Ramsay, W. D.; Roche, J.; Sawatzky, B.; Seva, T.; Shabestari, M. H.; Silwal, R.; Simicevic, N.; Smith, G. R.; Solvignon, P.; Spayde, D. T.; Subedi, A.; Subedi, R.; Suleiman, R.; Tadevosyan, V.; Tobias, W. A.; Tvaskis, V.; Waidyawansa, B.; Wang, P.; Wells, S. P.; Wood, S. A.; Yang, S.; Young, R. D.; Zhamkochyan, S.

    2014-03-01

    A subset of results from the recently completed Jefferson Lab Qweak experiment are reported. This experiment, sensitive to physics beyond the Standard Model, exploits the small parity-violating asymmetry in elastic e{{p}} scattering to provide the first determination of the proton's weak charge Q_w^p. The experiment employed a 180 μA longitudinally polarized 1.16 GeV electron beam on a 35 cm long liquid hydrogen target. Scattered electrons in the angular range 6° < θ < 12° corresponding to Q2 = 0.025 GeV2 were detected in eight Cerenkov detectors arrayed symmetrically around the beam axis. The goals of the experiment were to provide a measure of e{{p}} to 4.2% (combined statisstatistical and systematic error), which implies a measure of sin2(θw) at the level of 0.3%, and to help constrain the vector weak quark charges C1u and C1d. The experimental method is described, with particular focus on the challenges associated with the world's highest power LH2 target. The new constraints on C1u and C1d provided by the subset of the experiment's data analyzed to date will also be shown, together with the extracted weak charge of the neutron.

  12. Upside-down stomach – results of mini-invasive surgical therapy

    PubMed Central

    Vrba, Radek; Aujesky, Rene; Vomackova, Katherine; Zbrozkova, Lenka

    2011-01-01

    Aim The authors evaluate the results of mini-invasive therapy in patients diagnosed with upside-down stomach. Material and methods From 1998 to 2008, a total of 27 patients diagnosed with upside-down stomach were surgically treated at the 1st Department of Surgery, University Hospital Olomouc. Before the operation, patients were examined endoscopically and a barium swallow was performed. In all 27 patients (100%), the operation was performed electively laparoscopically. The principle of the operation in all cases was reposition of the stomach into the abdominal cavity, resection of the hernial sac and hiatoplasty. In addition, in 15 patients (56%) with reflux symptoms or endoscopic findings of reflux oesophagitis, fundoplication in Nissen's modification was also performed. Fundopexy was indicated in 12 patients (44%). Results In all patients (100%), the operation was performed mini-invasively; conversion to an open procedure was never necessary. In 3 cases (11%), the left pleural cavity was opened during the operation; this was treated by introducing a chest drain. The operation mortality in the patient set was zero; morbidity was 11%. A year after the operation, patients were re-examined, and follow-up endoscopy and barium swallow were performed. Conclusions In all patients diagnosed with upside-down stomach, surgical treatment is indicated due to the risk of developing severe complications. Mini-invasive surgical therapy in the hands of an experienced surgeon is a safe procedure which offers patients all the benefits of mini-invasive therapy with promising short- and long-term results. PMID:23255985

  13. Aneurysm of the tibial-saphenous fistula in hemodialysis patient: the results of surgical treatment

    PubMed Central

    Günday, Murat

    2011-01-01

    Arteriovenous fistulas are widely used for hemodialysis patients with end-stage renal failure. Due to the lack of suitable veins because of the arteriovenous fistulas previously opened in the upper extremity, alternative access routes are being tested. Few complications of long-term alternative arteriovenous fistulas have been reported in the literature. We report the results of surgical repairs of aneurysms that occurred on anterior tibial-saphenous arteriovenous fistulas (along the vein) in patients with end-stage renal disease after 5 years on hemodialysis. PMID:22140315

  14. Surgical treatment of chronic idiopathic thrombocytopenic purpura: results in 107 cases

    SciTech Connect

    Cola, B.; Tonielli, E.; Sacco, S.; Brulatti, M.; Franchini, A.

    1986-07-01

    Between 1972 and 1985, 107 patients with chronic Idiopathic Thrombocytopenic Purpura underwent splenectomy. Platelet life span and sites of sequestration were studied with labelled platelets and external scanning. Medical treatment was always of scarce and transient effectiveness and had considerable side effects. Splenectomy had minimal complications and mortality and caused no hazard of overwhelming sepsis in adults. The results of splenectomy were very satisfying, especially when platelet sequestration was mainly splenic (remission in about 90% of patients). Surgical treatment is at present the most effective in patients with chronic ITP.

  15. Early results with the Mutaf technique: a novel off-midline approach in pilonidal sinus surgery

    PubMed Central

    Zorlu, Musa; Zobacı, Ethem; Kocak, Cem; Yastı, Ahmet Çınar; Dolapçı, Mete

    2016-01-01

    Purpose The objective of the present study was to compare different off-midline techniques in terms of their advantages and disadvantages. Methods A total of 81 patients were included in this prospective, controlled, randomized study. Patients in group 1 were treated with the Limberg flap, and patients in group 2 were treated with Mutaf technique. Patients were followed up for 9 months postsurgically and assessed at regular intervals. Results A total of 41 and 40 patients received surgical treatment with Limberg or Mutaf techniques, respectively. The 2 groups were similar in terms of age, gender, body mass index, and Tezel pilonidal sinus classification. Also, the 2 groups were comparable with regard to the frequency of preoperative discharge from the wound site, history of abscess formation, and the resultant antibiotic use. Early results showed similar recurrence rates and surgical-site complications between the 2 groups. Although a lower visual analogue scale score was found in group 2 at postoperative day 1, seroma persistence, time to withdrawal of surgical drains, and wound healing were more prolonged. Conclusion In this study, Mutaf technique was comparable to Limberg flap in the treatment of pilonidal sinus. Therefore, Mutaf technique may be offered as a viable surgical therapeutic option among off-midline closure approaches. PMID:27186571

  16. Results of endoscopic and surgical fistula treatment in oesophagointestinal anastomosis after gastrectomy

    PubMed Central

    Ciostek, Piotr; Petryka, Robert; Słowik, Jakub; Jarosz, Mirosław

    2015-01-01

    Introduction Intestinal fistulas occur in 4–8% of cases of upper gastrointestinal tract surgery. Until now, surgery has been the standard of treating fistulas in oesophagointestinal anastomosis. The use of stents and haemoclips still causes much controversy, but more and more publications present good results with this type of treatment. Aim To present results of endoscopic and surgical treatment of fistulas in oesophagointestinal anastomosis after gastrectomy. Material and methods A fistula in the oesophagointestinal anastomosis was observed in 23 (4.8%) patients within an 18-year period. The indications for endoscopic treatment were small fistulas (< 50 ml/day), and large (> 50 ml/day) fistulas in subjects with no symptoms of peritonitis or abscess were treated with implantation a of covered stent. Surgical treatment was performed with a large fistula leading to peritonitis and complicated gangrene of margins and/or the presence of abscess. Results Four subjects were treated endoscopically with the use of haemoclips, resulting in 50% technical and clinical success. We implanted stents in 12 patients. Technical success was achieved in all the patients, yet permanent closure of the fistula was reported for 8 (66%) subjects. The percentage of patients operated on for fistula was 33%. We recorded 4 deaths in this group. Conclusions The use of haemoclips in treatment of small fistulas, and self-expandable, covered stents in treatment of medium and large fistulas, is an effective method that shortens the hospitalisation period and accelerates introduction of oral nutrition while reducing the number of fatal complications. PMID:26865886

  17. Myelopathy Caused by Soft Cervical Disc Herniation : Surgical Results and Prognostic Factors

    PubMed Central

    Kim, Young-Jin; Yi, Hyeong-Joong; Kim, Young-Soo; Ko, Yong; Oh, Suck Jun

    2007-01-01

    Objective The purpose of this study was to investigate the surgical results and prognostic factors for patients with soft cervical disc herniation with myelopathy. Methods During the last 7 years, 26 patients with cervical discogenic myelopathy were undertaken anterior discectomy and fusion. Clinical and radiographic features were reviewed to evaluate the surgical results and prognostic factors. The clinical outcome was judged using two grading systems (Herkowitz's scale and Nurick's grade). Results Male were predominant (4:1), and C5-6 was the most frequently involved level. Gait disturbance, variable degree of spasticity, discomfort in chest and abdomen, hand numbness were the most obvious signs. Magnetic resonance(MR) images showed that central disc herniation was revealed in 16 cases, and accompanying cord signal changes in 4. Postoperatively, 23 patients showed favorable results (excellent, good and fair) according to Herkowitz's scale. Conclusion Anterior cervical discectomy and fusion effectively reduced myelopathic symptoms due to soft cervical disc herniation. The authors assured that the shorter duration of clinical attention, the lesser the degree of myelopathy and better outcome in discogenic myelopathy. PMID:19096586

  18. From Apprentice to Master: Social Disciplining and Surgical Education in Early Modern London, 1570-1640

    ERIC Educational Resources Information Center

    Chamberland, Celeste

    2013-01-01

    Due to its ascendancy as the administrative and commercial center of early modern England, London experienced sustained growth in the latter half of the sixteenth century, as waves of rural immigrants sought to enhance their material conditions by tapping into the city's bustling occupational and civic networks. The resultant crowded urban…

  19. Clinical Findings and Results of Surgical Resection in 19 Cases of Spinal Osteoid Osteoma

    PubMed Central

    Etemadifar, Mohammad Reza

    2015-01-01

    Study Design Descriptive cases series. Purpose To evaluate clinical findings and results of conventional surgery in patients with spinal osteoid osteoma (OO). Overview of Literature OO is a rare benign tumor with spinal involvement rate of about 10%-20%. Methods This descriptive study was conducted on 19 patients (11 males and 8 females with an average age of 19.8 years) with documented histopathological and imaging findings of OO referred to a university hospital. Neurologic symptoms and pain were scored before and after the open surgical excision. Data were analyzed by SPSS ver. 16 software using chi-square and significance level of 0.05. Results The most common complaint was back or neck pain (84.2%) and in 68.4% spinal deformity (mostly scoliosis) shown with an average cobb angle of 21° at presentation. The sites of involvement were 35% in the lumbar, 35% in the thoracic, 25% in the cervical, and 5% in the sacrum. Lamina was the most common site (50%) of involvement with predilection for the right side (p=0.001). All patients were treated by conventional surgical excision with a complete recovery of pain and deformity. No recurrence occurred after a mean follow up of 44.5 months, but 4 of 19 cases instrumented because of induced instability. In one case there were two levels of involvement (C7-T1) simultaneously. Interestingly, 10 out of 19 of our cases belonged to a specific race (Bakhtiari). Conclusions Surgical intra-lesional curettage is potentially an effective method without any recurrence, which can lead to spontaneous scoliosis recovery and pain relief. Race may be a potential risk factor for spinal (OO). PMID:26097653

  20. Surgical manipulation of the gut elicits an intestinal muscularis inflammatory response resulting in postsurgical ileus.

    PubMed Central

    Kalff, J C; Schraut, W H; Simmons, R L; Bauer, A J

    1998-01-01

    OBJECTIVE: To investigate the pathophysiologic mechanisms that lead to ileus after abdominal surgery. SUMMARY BACKGROUND DATA: The common supposition is that more invasive operations are associated with a more extensive ileus. The cellular mechanisms of postsurgical ileus remain elusive, and few studies have addressed the mechanisms. METHODS: Rats were subjected to incremental degrees of surgical manipulation: laparotomy, eventration, "running," and compression of the bowel. On postsurgical days 1 and 7, muscularis infiltrates were characterized immunohistochemically. Circular muscle activity was assessed using mechanical and intracellular recording techniques in vitro. RESULTS: Surgical manipulation caused an increase in resident phagocytes that stained for the activation marker lymphocyte function-associated antigen (LFA-1). Incremental degrees of manipulation also caused a progressive increase in neutrophil infiltration and a decrease in bethanechol-stimulated contractions. Compression also caused an increase in other leukocytes: macrophages, monocytes, dendritic cells, T cells, natural killer cells, and mast cells. CONCLUSION: The data support the hypothesis that the degree of gut paralysis to cholinergic stimulation is directly proportional to the degree of trauma, the activation of resident gut muscularis phagocytes, and the extent of cellular infiltration. Therefore, postsurgical ileus may be a result of an inflammatory response to minimal trauma in which the resident macrophages, activated by physical forces, set an inflammatory response into motion, leading to muscle dysfunction. Images Figure 4. Figure 5. Figure 7. PMID:9833803

  1. Long-term results of endosurgical and open surgical approach for Zenker diverticulum

    PubMed Central

    Bonavina, Luigi; Bona, Davide; Abraham, Medhanie; Saino, Greta; Abate, Emmanuele

    2007-01-01

    AIM: To assess the effectiveness of minimally invasive versus traditional open surgical approach in the treatment of Zenker diverticulum. METHODS: Between 1976 and 2006, 297 patients underwent transoral stapling (n = 181) or stapled diverticulectomy and cricopharyngeal myotomy (n = 116). Subjective and objective evaluations of the outcome of the two procedures were made at 1 and 6 mo after operation, and then every year. Long-term follow-up data were available for a subgroup of patients at a minimum of 5 and 10 years. RESULTS: The operative time and hospital stay were markedly reduced in patients undergoing the endosurgical approach. Overall, 92% of patients undergoing the endosurgical approach and 94% of those undergoing the open approach were symptom-free or were significantly improved after a median follow-up of 27 and 48 mo, respectively. At a minimum follow-up of 5 and 10 years, most patients were asymptomatic after both procedures, except for those individuals undergoing an endosurgical procedure for a small diverticulum (< 3 cm). CONCLUSION: Both operations relieve the outflow obstruction at the pharyngoesophageal junction, indicating that cricopharyngeal myotomy has an important therapeutic role in this disease independent of the resection of the pouch and of the surgical approach. Diverticula smaller than 3 cm represent a formal contraindication to the endosurgical approach because the common wall is too short to accommodate one cartridge of staples and to allow complete division of the sphincter. PMID:17552006

  2. Open versus Laparoscopic Surgery: Does the Surgical Technique Influence Pain Outcome? Results from an International Registry

    PubMed Central

    Allvin, Renée; Rawal, Narinder; Johanzon, Eva; Bäckström, Ragnar

    2016-01-01

    Postoperative pain management relevant for specific surgical procedures is debated. The importance of evaluating pain with consideration given to type of surgery and the patient's perspective has been emphasized. In this prospective cohort study, we analysed outcome data from 607 patients in the international PAIN OUT registry for assessment and comparison of postoperative pain outcome within the 24 first hours after laparoscopic and open colonic surgery. Patients from the laparoscopic group scored minimum pain at a higher level than the open group (P = 0.012). Apart from minimum pain, no other significant differences in patient reported outcomes were observed. Maximum pain scores >3 were reported from 77% (laparoscopic) and 68% (open) patients (mean ≥ 5 in both groups). Pain interference with mobilization was reported by 87–93% of patients. Both groups scored high levels of patient satisfaction. In the open group, a higher frequency of patients received a combination of general and regional anaesthesia, which had an impact of the minimum pain score. Our results from registry data indicate that surgical technique does not influence the quality of postoperative pain management during the first postoperative day if adequate analgesia is given. PMID:27127649

  3. Laparoscopic vasectomy in African savannah elephant (Loxodonta africana); surgical technique and results.

    PubMed

    Marais, Hendrik J; Hendrickson, Dean A; Stetter, Mark; Zuba, Jeffery R; Penning, Mark; Siegal-Willott, Jess; Hardy, Christine

    2013-12-01

    Several small, enclosed reserves in southern Africa are experiencing significant elephant population growth, which has resulted in associated environmental damage and changes in biodiversity. Although several techniques exist to control elephant populations, e.g., culling, relocation, and immunocontraception, the technique of laparoscopic vasectomy of free-ranging bull elephants was investigated. Bilateral vasectomies were performed in 45 elephants. Of these elephants, one died within 24 hr of recovery and two had complications during surgery but recovered uneventfully. Histologic examination confirmed the resected tissue as ductus deferens in all the bulls. Most animals recovered uneventfully and showed no abnormal behavior after surgery. Complications recorded included incisional dehiscence, 1 full-thickness and 2 partial-thickness lacerations of the large intestine, and initial sling-associated complications, for example, deep radial nerve paresis. One bull was found dead 6 weeks after surgery without showing any prior abnormal signs. Vasectomy in free-ranging African bull elephants may be effectively performed in their normal environment. The surgical procedure can be used as a realistic population management tool in free-ranging elephants without major anesthetic, surgical, or postoperative complications. PMID:24437080

  4. Surgical management of acute cholecystitis. Results of a nation-wide survey among Spanish surgeons.

    PubMed

    Badia, Josep M; Nve, Esther; Jimeno, Jaime; Guirao, Xavier; Figueras, Joan; Arias-Díaz, Javier

    2014-10-01

    There is a wide variability in the management of acute cholecystitis. A survey among the members of the Spanish Association of Surgeons (AEC) analyzed the preferences of Spanish surgeons for its surgical management. The majority of the 771 responders didn't declare any subspecialty (41.6%), 21% were HPB surgeons, followed by colorectal and upper-GI specialities. Early cholecystectomy during the first admission is the preferred method of management of 92.3% of surgeons, but only 42.7% succeed in adopting this practice. The most frequent reasons for changing their preferred practice were: Patients not fit for surgery (43.6%) and lack of availability of emergency operating room (35.2%). A total of 88.9% perform surgery laparoscopically. The majority of AEC surgeons advise index admission cholecystectomy for acute cholecystitis, although only half of them succeed in its actual implementation. There is room for improvement in the management of acute cholecystitis in Spanish hospitals. PMID:24857607

  5. Clinical Usefulness of Watch-PAT for Assessing the Surgical Results of Obstructive Sleep Apnea Syndrome

    PubMed Central

    Park, Chong Yoon; Hong, Joon Hyeong; Lee, Jae Heon; Lee, Kyu Eun; Cho, Hyun Sang; Lim, Su Jin; Kwak, Jin Wook; Kim, Kyung Soo; Kim, Hyun Jik

    2014-01-01

    Objective: This study aimed to assess the accuracy and clinical efficacy of a wrist-worn device that is based on peripheral arterial tonometry (watch-PAT) to evaluate the surgical results of obstructive sleep apnea (OSA) syndrome subjects. Study Design and Method: Thirty-five subjects who were diagnosed with OSA and underwent sleep surgeries such as septoplasty, tonsillectomy, or uvuloplasty to correct their airway collapse, participated in this study; the watch-PAT-derived respiratory disturbance index (RDI), apnea and hypopnea index (AHI), lowest oxygen saturation, and valid sleep time were measured after the sleep surgery. Results: The present study showed that RDI (32.8 ± 10.7 vs 14.8 ± 7.5), AHI (30.3 ± 8.6 vs 13.4 ± 8.2 events/h), lowest oxygen saturation (78.2% ± 8.4% vs 90.5% ± 7.1%), and valid sleep time (329.1 ± 47.2 min and a postoperative value of 389.1 ± 50.1 min) recovered to within a normal range after surgery in 28 subjects. In addition, good agreement was found between watch-PAT-derived factors and visual analogue scales for changes in subjective symptoms, such as snoring, apnea, and daytime somnolence. Seven of the 35 subjects showed no improvement for their subjective symptoms and complained of snoring and apnea after surgery. We found that the RDI and AHI of those 7 subjects were not reduced, and the changes between pre- and postoperative values which were measured with watch-PAT were minimal. Their postoperative lowest oxygen saturation and valid sleep time were not elevated per the watch-PAT. The results support a strong correlation between the findings from watch-PAT and improved symptoms after surgical correction of an airway collapse. Conclusions: Our study provides evidence that the factors measured by the watch-PAT might be reliable indicators of symptomatic changes in OSA subjects after sleep surgery and also shows that the watch-PAT is a highly sensitive portable device for estimating treatment results in OSA. Citation: Park CY

  6. Early Childhood Teacher Research: From Questions to Results

    ERIC Educational Resources Information Center

    Castle, Kathryn

    2011-01-01

    What is early childhood teacher research and why is it important? How does a teacher researcher formulate a research question and a plan for doing research? How do teachers apply research results to effect change? "Early Childhood Teacher Research" is an exciting new resource that will address the sorts of questions and concerns that pre- and…

  7. [Long-term results of surgical treatment of lumbar disk herniation in adults].

    PubMed

    Dudek, H; Michno, T; Łebkowski, W J; Kozłowski, A

    2001-01-01

    The authors present long-term results (10.2 years post-op) of surgical treatment of lumbar disc herniation in 1003 patients operated at the Department of Neurosurgery by the University of Medical Sciences in Białystok. The operated group comprised 33.1% women (mean age--55.6 years) and 68.7% men (mean age 57.3 years). Ten years post-op 15.9% women and 5.8% men kept the recommended diet, 14% women and 7.0% men continued muscle strengthening exercise. Ten years post-op excellent and good results were noted in respectively 42.4% and 46.5% women and 45.4% and 46.6% men. PMID:11761755

  8. EARLY SURGICAL COMPLICATIONS AFTER GASTRIC BY-PASS: A LITERATURE REVIEW

    PubMed Central

    ACQUAFRESCA, Pablo A.; PALERMO, Mariano; ROGULA, Tomasz; DUZA, Guillermo E.; SERRA, Edgardo

    2015-01-01

    Introduction Gastric bypass is today the most frequently performed bariatric procedure,but, despite of it, several complications can occur with varied morbimortality. Probably all bariatric surgeons know these complications, but, as bariatric surgery continues to spread, general surgeon must be familiarized to it and its management. Gastric bypass complications can be divided into two groups: early and late complications, taking into account the two weeks period after the surgery. This paper will focus the early ones. Method Literature review was carried out using Medline/PubMed, Cochrane Library, SciELO, and additional information on institutional sites of interest crossing the headings: gastric bypass AND complications; follow-up studies AND complications; postoperative complications AND anastomosis, Roux-en-Y; obesity AND postoperative complications. Search language was English. Results There were selected 26 studies that matched the headings. Early complications included: anastomotic or staple line leaks, gastrointestinal bleeding, intestinal obstruction and incorrect Roux limb reconstruction. Conclusions Knowledge on strategies on how to reduce the risk and incidence of complications must be acquired, and every surgeon must be familiar with these complications in order to achieve an earlier recognition and perform the best intervention. PMID:25861076

  9. Early radiographic diagnosis of peri-implantitis enhances the outcome of peri-implantitis treatment: a 5-year retrospective study after non-surgical treatment

    PubMed Central

    Chang, Hee-Yung; Park, Shin-Young; Kim, Jin-Ah; Kim, Young-Kyun

    2015-01-01

    Purpose This retrospective study evaluated the relationship between the timing of peri-implantitis diagnosis and marginal bone level after a 5-year follow-up of non-surgical peri-implantitis treatment. Methods Thirty-three patients (69 implants) were given peri-implantitis diagnosis in 2008-2009 in Seoul National University Bundang Hospital. Among them, 31 implants from 16 patients were included in this study. They were treated non-surgically in this hospital, and came for regular maintenance visits for at least 5 years after peri-implantitis treatment. Radiographic marginal bone levels at each interval were measured and statistical analysis was performed. Results Timing of peri-implantitis was one of the significant factors affecting initial bone loss and total bone loss not additional bone after peri-implantitis diagnosis. Patients with cardiovascular disease and diabetic mellitus were positively influenced on both initial bone loss and total bone loss. Patients who needed periodontal treatment after implant placement showed a negative effect on bone loss compared to those who needed periodontal treatment before implant placement during entire periods. Implant location also significantly influenced on amounts of bone loss. Mandibular implants showed less bone loss than maxillary implants. Among surgical factors, combined use of autogenous and xenogenic bone graft materials showed a negative effect on bone loss compared to autogenous bone graft materials. Use of membrane negatively affected on initial bone loss but positively on additional bone loss and total bone loss. Thread exposure showed positive effects on initial bone loss and total bone loss. Conclusions Early peri-implantitis diagnosis led to early non-surgical intervention for peri-implantitis treatment, which resulted in the maintenance of the bone level as well as preservation of the implant. Graphical Abstract PMID:26131368

  10. Surgical management of severe deformity resulting from posterior tibial tendon dysfunction.

    PubMed

    Coetzee, J C; Hansen, S T

    2001-12-01

    A retrospective case study format was used to evaluate the results of surgical treatment of severe deformities due to long-standing tibialis posterior tendon dysfunction. To be included in the study, the peri-talar (talonavicular) subluxation on a weight-bearing AP X-ray should have been at least 75%. This criterion limited the field to patients with long-standing, rigid, severe deformities. Surgical correction was obtained through a two-incision approach, dorsomedial and dorsolateral. Significant shortening of the medial column and extensive removal of adaptive bone formation was necessary to allow reduction of the hind- and midfoot deformity. Stable internal fixation using multiple screws was used to secure the reduction. Eleven patients, 12 feet were evaluated. The patients were evaluated using the American Orthopedic Foot and Ankle Society Ankle and Hindfoot Score as well as a questionnaire on footwear and satisfaction rating. The average score improved from 30 points pre-op to 74 points post-op (out of 100). P-value 0.0001. Pain score improved from 11/40 to 33/40. Function improved from 19/50 to 33/50. Alignment improved from 0/10 to 8/10. The radiological parameters showed an average improvement of 31 degrees in the lateral talo-1st metatarsal angle, 11 degrees in the calcaneal pitch, and 35 degrees in the AP talo-1st metatarsal angle. All three parameters were highly significant with P-values of 0.0001. Multiple complications occurred. This included two delayed unions with breakage of screws and partial loss of correction, four wound problems, two sural nerve impairments and three patients requiring hardware removal. Even though it is an extensive procedure with multiple potential complications it still offers a substantial improvement in quality of life. PMID:11783917

  11. Surgical Results of Retrograde Mastoidectomy with Primary Reconstruction of the Ear Canal and Mastoid Cavity

    PubMed Central

    Kuo, Chao-Yin; Huang, Bor-Rong; Chang, Wei-Kang; Tsai, Yang-Lien; Lin, Yuan-Yung; Tsai, Wan-Chun

    2015-01-01

    The aim of this study was to retrospectively review the long-term hearing results and the impact of mastoid exclusion/obliteration in patients with cholesteatoma (102 ears) who underwent retrograde tympanomastoidectomy and in whom bone chips/paté were applied as the sole materials during the procedure. In 79 ears, this was combined with ossiculoplasty in a single-stage procedure. In >71% of ears, the results of audiometric testing were monitored for more than 2 years. The results suggested there was a significant gain in hearing following surgery, with respect to the postoperative change in both air-conduction thresholds and air-bone gaps (P < 0.001). Linear regression analyses of pure-tone averages at different frequencies, before and after surgery, demonstrated that patients benefitted from a postoperative hearing gain at low and middle frequencies, but their hearing often deteriorated at frequencies of 8000 Hz. As for the impact of the type of tympanoplasty on hearing outcomes, type III-interposition markedly increased hearing gain. The overall rate of postoperative adverse events was 8.8%. We conclude that reconstruction of the ear canal and mastoid via mastoid exclusion/obliteration using bone chips/paté can be considered as an alternative procedure following retrograde mastoidectomy. It gives excellent surgical results and has fewer postoperative adverse events. PMID:25861632

  12. Anomalous Origin of the Left Coronary Artery from the Pulmonary Artery: Diagnoses and Surgical Results in 12 Pediatric Patients

    PubMed Central

    Tirado, Antonio Moruno; Hosseinpour, Reza; de Soto, Jose Santos

    2015-01-01

    Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital condition. It responds well to early diagnosis and treatment, but otherwise the prognosis is poor. We present our case series of 12 patients (mean age, 2 ± 2.58 yr; age range, 2 mo–8 yr), emphasizing the diagnostic process and discussing our surgical results. The diagnosis of ALCAPA should be suspected in infants who have dilated cardiomyopathy with electrocardiographic changes that suggest ischemia, and in older children who have isolated mitral regurgitation. When clinical suspicion is high, the results of 2-dimensional echocardiography combined with color-flow Doppler studies in expert hands can establish the diagnosis, thus avoiding angiography in critically ill infants. The treatment of choice in our patients was transfer and reimplantation of the left coronary artery onto the ascending aorta. There were 2 deaths: both were infants in extremis who underwent emergency surgery. An older child with severe ventricular dysfunction was given mechanical ventricular assistance and then heart transplantation. As of this report, all 10 survivors remained well and asymptomatic. PMID:26413018

  13. RESULTS OF SURGICAL TREATMENT OF DENERATIVE ARTHROPATHY OF THE ROTATOR CUFF USING HEMIARTHROPLASTY- CTA®

    PubMed Central

    Filho, Rômulo Brasil; Ribeiro, Fabiano Rebouças; Tenor, Antonio Carlos; Filho, Cantidio Salvador Filardi; da Costa, Guilherme Barbieri Leme; Storti, Thiago Medeiros; da Costa Garcia, André; Lutfi, Hilton Vargas

    2015-01-01

    Objective: To assess results of CTA® partial shoulder arthroplasty for treatment of degenerative arthropathy of the rotator cuff. Methods: Between December 2006 and June 2009, 23 shoulders of 23 patients were submitted to CTA® type partial shoulder arthroplasty for treatment of arthropathy secondary to rotator cuff injury. Post-operative follow up time ranged from 6 to 35 months. Mean age was 74.1 years. Patients were predominantly female, representing 78.3% of cases. The right limb was affected in 18 patients. All patients had undergone at least 6 months of physiotherapy without improvement of the algetic picture, and being submitted to surgery by the same surgical team. None of the patients had history of surgery on the affected shoulder. The method elected for assessing patients during post-operative follow up was based on UCLA scoring criteria. Results: Improvement in pain was observed in all patients after arthroplasty. Mean UCLA pain score was 9.22 (ranging from 10 to 8). Mean function was 6 (10 to 2). Active frontal flexion was 2.39 (highest score 4 and lowest 0). Mean frontal flexion force was 4.09, maximum was 5 and minimum 3. Mean score on the UCLA was 26.52. 95% were satisfied with the surgery. Conclusion: CTA® type partial shoulder arthroplasty produced satisfactory results in the treatment of degenerative arthropathy of the rotator cuff and had a low rate of complications. PMID:27028431

  14. INPRES (intraoperative presentation of surgical planning and simulation results): augmented reality for craniofacial surgery

    NASA Astrophysics Data System (ADS)

    Salb, Tobias; Brief, Jakob; Welzel, Thomas; Giesler, Bjoern; Hassfeld, Steffan; Muehling, Joachim; Dillmann, Ruediger

    2003-05-01

    In this paper we present recent developments and pre-clinical validation results of our approach for augmented reality (AR, for short) in craniofacial surgery. A commercial Sony Glasstron display is used for optical see-through overlay of surgical planning and simulation results with a patient inside the operation room (OR). For the tracking of the glasses, of the patient and of various medical instruments an NDI Polaris system is used as standard solution. A complementary inside-out navigation approach has been realized with a panoramic camera. This device is mounted on the head of the surgeon for tracking of fiducials placed on the walls of the OR. Further tasks described include the calibration of the head-mounted display (HMD), the registration of virtual objects with the real world and the detection of occlusions in the object overlay with help of two miniature CCD cameras. The evaluation of our work took place in the laboratory environment and showed promising results. Future work will concentrate on the optimization of the technical features of the prototype and on the development of a system for everyday clinical use.

  15. Severity of lung fibrosis affects early surgical outcomes of lung cancer among patients with combined pulmonary fibrosis and emphysema.

    PubMed

    Mimae, Takahiro; Suzuki, Kenji; Tsuboi, Masahiro; Ikeda, Norihiko; Takamochi, Kazuya; Aokage, Keiju; Shimada, Yoshihisa; Miyata, Yoshihiro; Okada, Morihito

    2016-07-01

    Combined pulmonary fibrosis and emphysema (CPFE) is defined as upper lobe emphysema and lower lobe fibrosis, which are representative lung disorders that increase the prevalence of lung cancer. This unique disorder may affect the morbidity and mortality during the early period after surgery. The present study aimed to identify which clinicopathological features significantly affect early surgical outcomes after lung resection in nonsmall cell lung cancer (NSCLC) patients and in those with CPFE.We retrospectively assessed 2295 patients with NSCLC and found that 151 (6.6%) had CPFE. All were surgically treated between January 2008 and December 2010 at 4 institutions.The postoperative complication rates for patients with and without CPFE were 39% and 17%, respectively. The 90-day mortality rates were higher among patients with than without CPFE (7.9% vs 1%). Acute exacerbation of interstitial pneumonia was the main cause of death among 12 patients with CPFE who died within 90 days after surgery. Multivariate logistic regression analysis selected CPFE, gender, age, and clinical stage as independent predictive factors for postoperative complications, and CPFE, clinical stage, and sex for 90-day mortality. The severity of lung fibrosis on preoperative CT images was an independent predictive factor for 90-day mortality among patients with CPFE.The key predictive factor for postoperative mortality and complications of lung resection for NSCLC was CPFE. The severity of lung fibrosis was the principal predictor of early outcomes after lung surgery among patients with CPFE and NSCLC. PMID:27442681

  16. Current issues result in a paradigm shift in reprocessing medical and surgical instruments.

    PubMed

    Alfa, Michelle J

    2016-05-01

    The objective of this report is to review the available scientific data on reprocessing of medical and surgical instruments and discuss the current issues related to cleaning and disinfection of flexible endoscopes and intracavitary ultrasound probes. PMID:27131134

  17. Gastrointestinal stromal tumors of the duodenum: Surgical management and survival results

    PubMed Central

    Liang, Xiao; Yu, Hong; Zhu, Lin-Hua; Wang, Xian-Fa; Cai, Xiu-Jun

    2013-01-01

    AIM: To provide long-term survival results of operable duodenal gastrointestinal stromal tumors (DGISTs) in a tertiary center in China. METHODS: In this retrospective study, the pathological data of 28 patients with DGISTs who had been treated surgically at the Second Department of General Surgery, Sir Run Run Shaw Hospital (SRRSH) from June 1998 to December 2006 were reviewed. All pathological slides were examined by a single pathologist to confirm the diagnosis. In patients whose diagnosis was not confirmed by immunohistochemistry at the time of resection, representative paraffin blocks were reassembled, and sections were studied using antibodies against CD117 (c-kit), CD34, smooth muscle actin (SMA), vimentin, S-100, actin (HHF35), and desmin. Operative procedures were classified as wedge resection (WR, local resection with pure closure, without duodenal transection or anastomosis), segmental resection [SR, duodenal transection with Roux-Y or Billroth II gastrojejunostomy (G-J), end-to-end duodenoduodenostomy (D-D), end-to-end or end-to-side duodenojejunostomy (D-J)], and pancreaticoduodenectomy (PD, Whipple operation with pancreatojejunostomy). R0 resection was pursued in all cases, and at least R1 resection was achieved. Regional lymphadenectomy was not performed. Clinical manifestations, surgery, medical treatment and follow-up data were retrospectively analyzed. Related studies in the literature were reviewed. RESULTS: There were 12 males and 16 females patients, with a median age of 53 years (20-76 years). Their major complaints were “gastrointestinal bleeding” (57.2%) and “nonspecific discomfort” (32.1%). About 14.3%, 60.7%, 17.9%, and 7.1% of the tumors originated in the first to fourth portion, respectively, with a median size of 5.8 cm (1.6-20 cm). Treatment was by WR in 5 cases (17.9%), SR in 13 cases (46.4%), and by PD in 10 cases (35.7%). The morbidity and mortality rates were 35.7% and 3.6%, respectively. The median post-operative stay was

  18. Surgical treatment of ruptures of the Achilles tendon: a review of long-term results.

    PubMed

    Krueger-Franke, M; Siebert, C H; Scherzer, S

    1995-06-01

    The rupture of the Achilles tendon is frequently sports-related. In the time from 1 January, 1978 until 31 December, 1988, we treated 358 men and 54 women with such an injury at the Staatliche Orthopaedische Klinik in Munich. The average age of these patients was 43 years. The site of the rupture was generally located between 3-5 cm proximal of the distal insertion of the tendon. In the follow-up examination of 122 patients with surgical treatment of tendo calcaneus ruptures 85% showed 'good' to 'very good' subjective results. Of the operated patients 97% would choose the same treatment under similar circumstances. The isokinetic studies demonstrated a loss of static and dynamic strength in plantar flexion of the ankle joint of 9.1%, and 16.7% respectively, when compared to the healthy contralateral side. The ultrasound examination revealed a thickening of the tendon and of the dorsal paratenon with changes in the internal structure of the injured Achilles tendon. In spite of these favourable results, the high complication rate of 15.1% shows the need for new and extensive studies regarding the various alternative treatment forms, such as functional, non-operative options, to finally resolve the debate about the optimal treatment of Achilles tendon ruptures. PMID:7551757

  19. [Autologous fat grafting in the surgical management of painful scar: preliminary results].

    PubMed

    Baptista, C; Iniesta, A; Nguyen, P; Legré, R; Gay, A-M

    2013-10-01

    The purpose of this study was to report our experience about the effectiveness of autologous fat injections in the management of painful scars. Between 2010 and 2012, all patients with persistent incisional pain despite a well-conduced 6 months medical treatment received an autologous fat graft according to the technique originally described by Coleman. Results interpretation was based on pain improvement thanks to a Visual Analogic Scale (VAS), postoperative patient satisfaction, reduction on analgesics intake and quality of life improvement. Eleven patients were included, the mean quantity of fat injected was 11cm(3). Nine patients (1.5%) benefited from a complete or significant pain decrease, 74.5% reported being very satisfied or satisfied with the result. The mean reduction of VAS was 3.5 points. We did not observe any complication. Autologous fat grafting is an innovative therapeutic approach and appears to be an attractive concept in the management of scar neuromas resistant to drug treatment, by providing an easy effective and safe surgical treatment. PMID:24035685

  20. [Percutaneous closure of patent ductus arteriosus: results and costs compared to surgical closure].

    PubMed

    Vieu, T; Beaurain, S; Angel, C; Leriche, H; Petit, J; Conso, J F; Planché, C; Losay, J

    1995-10-01

    The comparison of the clinical results and costs of the two methods of closure of patient ductus arteriosus was undertaken in two comparable groups of 40 patients treated in the same period in the same hospital. After transcatheter closure there was a 9% residual shunt rate at 3 years, the 2 patients with a residual continuous murmur being operated secondarily. The only complication was severe haemolysis which regressed after transcatheter ablation of the prosthesis. After surgical closure, there were no residual shunt. Some postoperative complications were observed in 20% of cases, usually benign (ventilatory problems, dysphonia or urinary infection), but occasionally more serious (peroperative lesion of the pulmonary artery). Morbidity, inherent to the technique of closure, was very different and much less in catheter closure. The average cost (daily cost x average length of hospital stay) was much less with transcatheter closure 38,558 francs versus 11,240 francs. On the other hand, the direct cost of transcatheter closure was greater than that of surgery: 32,798 francs versus 20,903 francs, the difference being related to the actual price of the prosthesis. The authors conclude that the 3 year results of transcatheter closure of patent ductus arterious make this technique a reasonable therapeutic alternative to surgery. From the safety point of view, the two techniques are comparable bu patient confort is greater with transcatheter closure for an increase in cost of the initial procedure which should decrease in relation to the types and prices of the prosthesis used. PMID:8745615

  1. [Early reoperation for infection in orthopedic surgery of the leg (arthroplasties and hip surgical procedures excluded)].

    PubMed

    Lortat-Jacob, A; Hardy, P; Benoit, J

    1990-01-01

    The authors report 32 cases of post-operative infections reoperated before the first month of which 12 articular fractures of the tibia. 6 tibial osteotomies of valgisation, 6 tibial diaphyseal fractures, 2 fractures of the lower extremity of the femur, 2 bimalleolar fractures, 1 serious knee sprain, 1 patellar fracture, 1 calcaneum fracture and an arthroscopic arthrolysis of the knee. Twelve of them had an articular infection. Globally, they have obtained 22 satisfactory results (very good or good) and 10 non satisfactory results out of which 2 deaths and 1 amputation. The bad results were due either to a particularly aggressive germ (streptococcus and gas gangrene), or to an articular infection insufficiently controlled: 5 out of the 10 arthrites on infected articular fractures have had a non satisfactory result. As for metaphyseal infections, a simple cleaning has given 4 very good results out of 6, the 2 excluded being very serious and special cases. For the 6 diaphyseal leg infections after osteosynthesis, the early reoperation has not avoided a secundary graft in a picture of infected pseudoarthrosis. In view of this series, the authors propose to adapt the cleaning operation to the localisation and to the presence or not of an articular infection. PMID:2148414

  2. Simultaneous hybrid peripheral re-vascularization: early results.

    PubMed

    Yurekli, Ismail; Gokalp, Orhan; Gunes, Tevfik; Yilik, Levent; Gurbuz, Ali

    2013-10-01

    Endovascular and open surgical interventions may be combined in treatment of peripheral arterial disease. In this study, we presented our simultaneous hybrid peripheral interventions under the light of current literature data. Eleven patients who were operated for occlusive peripheral arterial disease without aneurysms between June 2008 and November 2010 at our hybrid operating room were investigated retrospectively. Generally, endovascular intervention was performed initially, and then followed by surgery. After hybrid interventions, control angiograms were held during the same session. None of the patients experienced either stent or graft occlusion during early postoperative period. Primary patency rate was found to be 100% for the postoperative first six months. Ankle-brachial indices (ABI) increased significantly during postoperative period and clinical symptoms were relieved in all patients (mean preoperative ABI: 0.43 ± 0.08, mean postoperative sixth month ABI: 0.87 ± 0.08). Peripheral hybrid interventions may be performed both in separate sessions and also simultaneously by experienced teams if an angiography device is available within the operating room. PMID:23518846

  3. [Anterior dislocation of the fibula resulting from surgical malreduction: a case report].

    PubMed

    Wang, Z Y; Wu, X B

    2016-04-18

    Ankle joint fracture is one of the most common types of fracture. There are many researches on the injury mechanism, treatment principles and surgical techniques. A type of injury which combines posterior dislocation of fibula, known as the Bosworth injury, is relatively rare. In 1947, Bosworth first described this type of injury as an unusual ankle fracture dislocation with fixed posterior fracture dislocation of the distal part of the fibula. In this type of fracture, the proximal fibular shaft fragment locks behind the tibialis posterior tubercle. This rare ankle fracture variant is often not recognized in initial radiographs and requires a computed tomographic (CT) scan for verification. But there are already many reports, discussing the injury mechanism, treatment principles and surgical techniques. However, there are few reports of anterior dislocation of the fibula, caused by either injury or surgery. The mechanism of the injury is still not clear. This article reports a case of anterior dislocation of the fibula. We report a patient with left ankle open fracture (Lauge-Hansen pronation-external rotation stage III, Gustilo IIIA). Open reduction and internal fixation was done in the initial surgery, but ended up with poor reduction, resulting in fibula anterior dislocation, anterior dislocation of talus and tibia fibular dislocation. The fibula was dislocated anteriorly of the tibia, which rarely happened. The patient suffered severe ankle joint dysfunction. The second operation took out the original internal fixation, reduced the fracture, and reset the internal fixation. The function of ankle joint was improved obviously after operation. But because of the initial injury and the two operations, the soft tissue around the fracture was greatly damaged. 6 months after the second operation, and the fracture still not healed, so the bone graft was carried out in the third surgery. Two months after the third surgery, the function of the ankle was significantly

  4. [Gallstone ileus as a cause of acute abdomen. Importance of early diagnosis for surgical treatment].

    PubMed

    Martín-Pérez, Jesica; Delgado-Plasencia, Luciano; Bravo-Gutiérrez, Alberto; Burillo-Putze, Guillermo; Martínez-Riera, Antonio; Alarcó-Hernández, Antonio; Medina-Arana y, Vicente

    2013-10-01

    Gallstone ileus is an uncommon type of mechanical intestinal obstruction caused by an intraluminal gallstone, and preoperative diagnosis is difficult in the Emergency department. This study is a retrospective analysis of the clinical presentation of 5 patients with gallstone ileus treated between 2000-2010. Clinical features, diagnostic testing, and surgical treatment were analyzed. Five patients were included: 2 cases showed bowel obstruction; 2 patients presented a recurrent gallstone ileus with prior surgical intervention; and one patient presented acute peritonitis due to perforation of an ileal diverticula. In all cases CT confirmed the preoperative diagnosis. In our experience, gallstone ileus may present with clinical features other than intestinal obstruction. In suspicious cases CT may be useful to decrease diagnostic delay, which is associated with more complications. PMID:24050832

  5. Impact of Cosmetic Result on Selection of Surgical Treatment in Patients With Localized Prostate Cancer

    PubMed Central

    Martinez-Salamanca, Juan Ignacio; Maestro, Mario Alvarez; Galarza, Ignacio Sola; Rodriguez, Joaquin Carballido

    2014-01-01

    Objectives: To analyze the effect of cosmetic outcome as an isolated variable in patients undergoing surgical treatment based on the incision used in the 3 variants of radical prostatectomy: open (infraumbilical incision and Pfannestiel incision) and laparoscopic, or robotic (6 ports) surgery. Patients and methods: 612 male patients 40 to 70 years of age with a negative history of prostate disease were invited to participate. Each patient was evaluated by questionnaire accompanied by a set of 6 photographs showing the cosmetic appearance of the 3 approaches, with and without undergarments. Participants ranked the approaches according to preference, on the basis of cosmesis. We also recorded demographic variables: age, body mass index, marital status, education level, and physical activity. Results: Of the 577 patients who completed the questionnaries, the 6-port minimally invasive approach represents the option preferred by 52% of the participants, followed by the Pfannestiel incision (46%), and the infraumbilical incision (11%), respectively. The univariate and multivariate analyses did not show statistically significant differences when comparing the approach preferred by the patients and the sub-analyses for demographic variables, except for patients who exercised who preferred the Pfannestiel incision (58%) instead of minimally invasive approach (42%) with statistically significant differences. Conclusion: The minimally invasive approach was the approach of choice for the majority of patients in the treatment of prostate cancer. The Pfannestiel incision represents an acceptable alternative. More research and investment may be necesary to improve cosmetic outcomes. PMID:25516703

  6. [Paraganglioma of the middle ear. The retrospective analysis of the results of the surgical treatment].

    PubMed

    Rzaev, R M; Rzaev, Rt R

    2016-01-01

    The objective of the present study was to analyze the results of and to summarize the experience with diagnostics and surgical treatment of the patients presenting with paraganglioma of the middle ear (PME). A total of 5 patients were available for the examination (all of the women) including two in whom the extension of the tumour corresponded to class A paraganglioma (according to the classification of U. Fisch) and three with class B paraganglioma (two having the tumour that occupied mezo- and hypotympanum and one with the tumour extending into the infralabyrinthine space). All the patients of the former group and 2 of the three in the latter group were operated with the use of the retroauricular-endomeatal approach. The remaining patient with class B paraganglioma extending into the infralabyrinthine space and the suspected destruction of the outer wall of the internal carotid artery by the tumour or its penetration into the channel was treated with the use of the retroauricular-endomeata-transmastoidal approach. The long-term postoperative catamnesticobservation of the thus treated patients has demonstrated the absence of a recurrent tumour within at least 3 tears after surgery. All the patientseported he preserved hearing function. PMID:27213651

  7. Intraocular surgery in a large diabetes patient population: risk factors and surgical results.

    PubMed

    Ostri, Christoffer

    2014-05-01

    The prevalence of diabetes is on the increase in developed countries. Accordingly, the prevention and treatment of vision-threatening diabetic eye complications is assuming greater importance. The overall aim of this thesis is to analyse risk factors for intraocular surgery in a large diabetes population and to report surgical results. The specific objectives are to (1) estimate the incidence of diabetic vitrectomy and analyse risk factors (Study I), (2) report long-term results, prognostic factors and incidence of cataract surgery after diabetic vitrectomy (Study II), (3) report results and prognostic factors after cataract surgery in diabetes patients (Study III) and (4) analyse risk factors for diabetic papillopathy with emphasis on metabolic control variability (Study IV). All studies are based on a close-to-complete national surgery register and a large, closely followed diabetic retinopathy screening population. Study I (cohort study, 3980 type 1 diabetes patients) illustrates that diabetic vitrectomy is rarely required in a diabetes patient population with varying degrees of diabetic retinopathy. The risk of reaching diabetic vitrectomy increases fourfold with poor metabolic control, defined as glycosylated haemoglobin A1c > 75 mmol/mol (~9%), which points to good metabolic control as an important preventive measure. Study II (cohort study, 167 diabetes patients) shows that most diabetic vitrectomy patients stand to gain visual acuity ≥0.3 after surgery. Visual acuity is stable after 1 year, and the stability is maintained through 10 years of follow-up. The use of silicone oil for endotamponade is a consistent long-term predictor of low vision after surgery. The risk of requiring cataract surgery after diabetic vitrectomy is substantial, and the risk increases if silicone oil is used. Study III (cohort study, 285 diabetes patients) shows, on the other hand, that diabetes patients can expect a significant improvement in visual acuity after cataract

  8. Prognostic factors of early outcome and discharge status in patients undergoing surgical intervention following traumatic intracranial hemorrhage.

    PubMed

    Fujii, Tatsuhiro; Moriel, Gabriela; Kramer, Daniel R; Attenello, Frank; Zada, Gabriel

    2016-09-01

    Over the past several decades, the rate of traumatic brain injury (TBI)-related emergency room visits in the United States has steadily increased, yet mortality in these patients has decreased. This improvement in outcome is largely due to advances in prehospital care, intensive care unit management, and the effectiveness of neurosurgical procedures, such as decompressive craniectomies. It is imperative to identify clinical factors predictive of patients who benefit from early mobilization of resources and operative treatment. Equally important is the identification of patients with good prognostic signs among patients receiving surgical intervention for TBI. We conducted a retrospective chart review of 181 patients requiring craniectomies and craniotomies for decompression or evacuation of an intracranial hemorrhage following TBI at a single level I trauma center between 2008-2010. Demographic features and perioperative clinical characteristics of these patients were examined in relation to favorable outcomes, defined as discharge to home or a rehabilitation facility, and unfavorable outcomes, defined as in-hospital mortality or discharge to step-down medical facilities. Younger age, greater Glasgow Coma Scale (GCS) score on admission, absence of preoperative coagulopathies, absence of hypernatremia, and absence of fever were all independent predictors of favorable outcome. Additionally, increased operative duration and increased length of hospital stay were identified as independent predictors of negative outcomes after surgery. This work supports some of the current prognostic models in the literature and identifies additional clinical variables with predictive value of early outcome and discharge status in patients undergoing surgical evacuation of traumatic intracranial hemorrhages. PMID:27424129

  9. Improvement in the Results of Surgical Treatment of Advanced Squamous Esophageal Carcinoma During 15 Consecutive Years

    PubMed Central

    Ando, Nobutoshi; Ozawa, Soji; Kitagawa, Yuko; Shinozawa, Yotaro; Kitajima, Masaki

    2000-01-01

    Objective To document the clinicopathologic characteristics and survival of patients undergoing esophagectomy for squamous carcinoma of the thoracic esophagus, and to examine the factors contributing to improvements in outcome noted in patients with advanced carcinoma. Summary Background Data Japanese and some Western surgeons recently have reported that radical esophagectomy with extensive lymphadenectomy conferred a survival advantage to patients with esophageal carcinoma. The factors contributing to this improvement in results have not been well defined. Methods From 1981 to 1995, 419 patients with carcinoma of the thoracic esophagus underwent esophagectomy at the Keio University Hospital. The clinicopathologic characteristics and survival of patients treated between 1981 and 1987 were compared with those of patients treated between 1988 and 1995. Multivariate analysis using the Cox regression model was carried out to evaluate the impact of 15 variables on survival of patients with p stage IIa to IV disease. Several variables related to prognosis were examined to identify differences between the two time periods. Results The 5-year survival rate for all patients was 40.0%. The 5-year survival rate was 17.7% for p stage IIa to IV patients treated during the earlier period and 37.6% for those treated during the latter period. The Cox regression model revealed seven variables to be important prognostic factors. Of these seven, three (severity of postoperative complications, degree of residual tumor, and number of dissected mediastinal nodes) were found to be significantly different between the earlier and latter periods. Conclusions The survival of patients undergoing surgery for advanced carcinoma (p stage IIa to IV) of the thoracic esophagus has improved during the past 15 years. The authors’ data suggest that this improvement is due mainly to advances in surgical technique and perioperative management. PMID:10903602

  10. Surgical results of the slipped medial rectus muscle after hang back recession surgery

    PubMed Central

    Duranoglu, Yasar; Ilhan, Hatice Deniz; Guler Alis, Meryem

    2014-01-01

    AIM To analyze the surgical results of a slipped medial rectus muscle (MRM) after hang back recession surgery for esotropia. METHODS Twenty-one patients who underwent re-exploration for diagnosed slipped muscle after hang back recession surgery were included in this retrospective study. Dynamic magnetic resonance imaging was performed to identify the location of the slipped muscle. Ocular motility was evaluated with assessment with prism and cover test in gaze at cardinal positions. The operations were performed by the same consultant. Intraoperative forced duction test was performed under general anesthesia. The empty sheath of the slipped MRM was resected and the muscle was advanced to the original insertion site in all patients. RESULTS The average age of 21 patients who had consecutive exotropia with a slipped MRM at the time of presentation was 17.4±5.4y (5-50y). The average duration between the first operation and the diagnosis of the slipped muscle was 25mo (12 to 36mo). The mean follow up after the corrective surgery was 28mo. The mean preoperative adduction limitation in the field of action of the slipped muscle was -2.26 (ranging from -1 to -4). All patients had full adduction postoperatively. CONCLUSION The diagnosis of the slipped muscle should be confirmed during the strabismus surgery. The slipped muscle may be caused due to insufficient suture and excessive rubbing of the eye. When divergent strabismus is observed after the recession of the MRM, a slipped muscle should be considered in the differential diagnosis. PMID:25540761

  11. Early Scientific Results from the Rejuvenated Hubble Space Telescope

    NASA Technical Reports Server (NTRS)

    Niedner, Malcolm

    2010-01-01

    With the complete success of Servicing Mission 4 (SM4) to the Hubble Space Telescope in May, 2009, the Observatory's capabilities are extremely broad and beyond anything it has previously been equipped with. I will present results on the important early science corning out of the telescope and discuss prospects for the future."

  12. Early results from the ultra heavy cosmic ray experiment

    NASA Technical Reports Server (NTRS)

    Osullivan, D.; Thompson, A.; Bosch, J.; Keegan, R.; Wenzel, K.-P.; Jansen, F.; Domingo, C.

    1995-01-01

    Data extraction and analysis of the LDEF Ultra Heavy Cosmic Ray Experiment is continuing. Almost twice the pre LDEF world sample has been investigated and some details of the charge spectrum in the region from Z approximately 70 up to and including the actinides are presented. The early results indicate r process enhancement over solar system source abundances.

  13. Neutropenic enterocolitis in a child with acute myeloid leukemia successfully treated with early surgical intervention.

    PubMed

    Lingutla, Arun Kumar; Anand, Asha S; Shah, Sandip A; Patel, Apurva A; Kumar, Sumit; Shah, Pankaj M; Shukla, Shilin N; Parikh, Bharat J; Talati, Shailesh S; Panchal, Harsha; Parikh, Sonia; Parekh, Bhavesh B; Bhatt, Shivani J

    2013-09-01

    Neutropenic entrocolitis (NE) is a life threatening complication of acute leukemia. The case presented here is of a 12 year old boy with acute myeloid leukemia, who developed neutropenic enterocolitis after induction with BFM-93 protocol. Patient underwent exploratory laparotomy during grade 4 neutropenia after failure on conservative line of management of NE. Patient withstood the procedure with supportive care and recovered. This case is reported because NE is a rare but potentially fatal complication and there are no clear guidelines for surgical intervention. PMID:24426370

  14. Surgical results in patients with hepatitis virus-related hepatocellular carcinoma in Taiwan.

    PubMed

    Chen, Miin-Fu; Jeng, Long-Bin; Lee, Wei-Chen

    2002-06-01

    To investigate the surgical results of hepatectomy for hepatocellular carcinoma in relation to hepatitis virus status in Taiwan, 252 patients (196 men and 56 women; March 1992 to August 1998) were reviewed. The patients were divided into four groups: 30 patients (11.9%) seronegative for both hepatitis B surface antigen (HBsAg) and antihepatitis C antibody (HCVAb) (N-HCC group); 133 patients (52.8%) seropositive for HBsAg and seronegative for HCVAb (B-HCC group); 66 patients (26.2%) seronegative for HBsAg and seropositive for HCVAb (C-HCC group); and 23 patients (9.1%) seropositive for both HBsAg and HCVAb (BC-HCC group). Patients in group C-HCC were older (p = 0.001) and had a higher incidence of diabetes mellitus (p = 0.004). Also, they had a higher indocyanine green retention rate at 15 minutes (p = 0.021), longer international normalization ratio for the prothrombin time (p = 0.049), and smaller tumor (p = 0.006). Postoperative complications and hospital mortality were significantly higher in patients in the C-HCC and BC-HCC groups (p = 0.046, 0.021). All patients were followed 12 to 76 months after hepatectomy (mean 23.5 +/- 16.3 months). The 1-, 3-, and 5-year overall cumulative survival rates of the 252 patients in this series were 80%, 54.3%, and 34.2%, respectively. The cumulative intrahepatic recurrence rates were 46.5%, 64.9%, and 72.9% at 1, 3, and 5 years, respectively. The mean disease-free survival time was longest in group C-HCC and shortest in group BC-HCC (p = 0.020). The overall survival time and cumulative survival rates in the four groups were not significantly different (p = 0.146). PMID:12053231

  15. Surgical Treatment for Ischemic Heart Failure (STICH) Trial: Mode of Death Results

    PubMed Central

    Carson, Peter; Wertheimer, John; Miller, Alan; O'Connor, Christopher M.; Pina, Ileana L.; Selzman, Craig; Sueta, Carla; She, Lilin; Greene, Deborah; Lee, Kerry L.; Jones, Robert H.; Velazquez, Eric J.

    2013-01-01

    Objective To assess the effect of the addition of coronary artery bypass grafting (CABG) to medical therapy on mode of death in heart failure. Background While CABG therapy is widely used in ischemic cardiomyopathy patients, there is no prospective clinical trial data on mode of death. Methods The Surgical Treatment for Ischemic Heart Failure Trial (STICH) compared the strategy of CABG plus medical therapy to medical therapy alone in 1212 ischemic cardiomyopathy patients with reduced ejection fraction. A clinical events committee adjudicated deaths using pre-specified definitions for mode of death. Results In STICH, there were 462 deaths over a median follow-up of 56 months. The addition of CABG therapy tended to reduce cardiovascular deaths (HR 0.83; CI (0.68, 1.03),p=0.09) and significantly reduced the most common modes of death: sudden death (HR 0.73; CI (.54–.99) p=0.041) and fatal pump failure events (HR 0.64; CI (.41–1.00) p=0.05). Time-dependent estimates indicate that the protective effect of CABG principally occurred after 24 months in both categories. Deaths post- cardiovascular procedures were increased in CABG patients (HR 3.11 CI (1.47–6.60), but fatal myocardial infarction deaths were lower (HR 0.07 CI (0.01–0.57). Non- cardiovascular deaths were infrequent and did not differ between groups. Conclusion In STICH, the addition of CABG to medical therapy reduced the most common modes of death: sudden death and fatal pump failure events. The beneficial effects were principally seen after 2 years. Post-procedure deaths were increased in patients randomized to CABG while myocardial infarction deaths were decreased. PMID:24621972

  16. Clinical characteristics of patients with asymptomatic intracranial meningiomas and results of their surgical management.

    PubMed

    Zeng, Lingcheng; Wang, Long; Ye, Fei; Chen, Jingcao; Lei, Ting; Chen, Jian

    2015-07-01

    Surgery performed during the asymptomatic phase of meningioma remains controversial. The effects of surgery and the factors associated with postsurgical complications and patient prognosis were studied to optimize surgical decisions for clinicians who treat asymptomatic patients. The medical records of 513 patients with meningiomas (112 patients were asymptomatic) treated at our hospital from May 2007 to April 2012 were retrospectively reviewed. The results were analyzed with univariate and multivariate analyses. Asymptomatic meningiomas were characterized by a more common cerebral hemispheric location, a smaller size, and a lack of peritumoral edema. A significantly higher Simpson I resection rate of 95.2 % was achieved in tumors located in the cerebral hemisphere; in contrast, a rate of 66.7 % was obtained in tumors located at the skull base (P = 0.003). The overall postsurgical complication rate was 13.6 %, which was lower than the rate of 21.7 % in the symptomatic patients. Hemiplegia was the most common complication, which occurred most often in the patients with tumors in parietal locations (P = 0.015). Ninety-two percent of the asymptomatic patients achieved a Glasgow Outcome Scale (GOS) score of 5 1 year after the operation, and significantly more patients younger than 60 years of age obtained a GOS score of 5 compared with patients older than 60 years of age (P = 0.006). To achieve maximal tumor resection and good patient recovery, tumor location and patient age should be carefully considered prior to choosing to perform surgery in asymptomatic patients. PMID:25697143

  17. Influences on Early and Medium-Term Survival Following Surgical Repair of the Aortic Arch

    PubMed Central

    Bashir, Mohamad; Field, Mark; Shaw, Matthew; Fok, Matthew; Harrington, Deborah; Kuduvalli, Manoj; Oo, Aung

    2014-01-01

    Objectives: It is now well established by many groups that surgery on the aortic arch may be achieved with consistently low morbidity and mortality along with relatively good survival compared to estimated natural history for a number of aortic arch pathologies. The objectives of this study were to: 1) report, compare, and analyze our morbidity and mortality outcomes for hemiarch and total aortic arch surgery; 2) examine the survival benefit of hemiarch and total aortic arch surgery compared to age- and sex-matched controls; and 3) define factors which influence survival in these two groups and, in particular, identify those that are modifiable and potentially actionable. Methods: Outcomes from patients undergoing surgical resection of both hemiarch and total aortic arch at the Liverpool Heart and Chest Hospital between June 1999 and December 2012 were examined in a retrospective analysis of data collected for The Society for Cardiothoracic Surgeons (UK). Results: Over the period studied, a total of 1240 patients underwent aortic surgery, from which 287 were identified as having undergone hemi to total aortic arch surgery under deep or moderate hypothermic circulatory arrest. Twenty three percent of patients' surgeries were nonelective. The median age at the time of patients undergoing elective hemiarch was 64.3 years and total arch was 65.3 years (P = 0.25), with 40.1% being female in the entire group. A total of 140 patients underwent elective hemiarch replacement, while 81 underwent elective total arch replacement. Etiology of the aortic pathology was degenerative in 51.2% of the two groups, with 87.1% requiring aortic valve repair in the elective hemiarch group and 64.2% in the elective total arch group (P < 0.001). Elective in-hospital mortality was 2.1% in the hemiarch group and 6.2% (P = 0.15) in the total arch group with corresponding rates of stroke (2.9% versus 4.9%, P = 0.47), renal failure (4.3% versus 6.2%, P = 0.54), reexploration for bleeding (4

  18. Esophageal disorders in 61 horses. Results of nonsurgical and surgical management.

    PubMed

    Craig, D R; Shivy, D R; Pankowski, R L; Erb, H N

    1989-01-01

    Obstructive esophageal disorders in 61 horses included feed or foreign body impaction (27 horses), strictures (18 horses), perforations (11 horses), and diverticula (5 horses). Horses with feed impaction were treated nonsurgically (25 horses) or by esophagotomy (2 horses). Survival to discharge was 78%, and 37% of these had persistent chronic obstruction at home. Long-term survival was 52%. Long-term survival of nine horses treated nonsurgically for esophageal strictures was 22%; for nine horses treated surgically it was 44%. Long-term survival of horses treated nonsurgically was significantly better in acute than chronic strictures. Surgical repair of esophageal mural strictures was more successful than repair of annular or mucosal strictures. One third of the horses with strictures were foals. Long-term survival for horses with strictures was 33%. Long-term survival was higher for the horses with perforations managed surgically (2 of 4) than nonsurgically (0 of 7). Long-term survival for this group was 18%. One esophageal diverticulum was managed nonsurgically, and four were treated surgically; all horses survived long term. Complications of obstructive esophageal disorders included aspiration pneumonia, chronic obstruction, esophageal mucosal ulceration, postoperative infection, pleuritis, laminitis, laryngeal paralysis, and Horner's syndrome. PMID:2513678

  19. [Implementation and evaluation of error prevention measures in surgical clinics: Results of a current online survey].

    PubMed

    Rothmund, Matthias; Kohlmann, Thomas; Heidecke, Claus-Dieter; Siebert, Hartmut; Ansorg, Jörg

    2015-01-01

    In the autumn of 2014, more than 3,000 surgeons completed an online questionnaire asking for the prevalence and efficiency of instruments to prevent adverse events within surgical departments in Germany. About 90 % of the respondents stated that perioperative checklists, preoperative marking of the surgical site and the documentation of hospital infections had been implemented in their institution; and 75 % of the institutions had introduced critical incident reporting systems (CIRS), morbidity and mortality conferences and identification bracelets for patients. The surgeons were asked to rank the different instruments for the prevention of adverse events. According to the respondents, preoperative marking of the surgical site and the use of checklists were at the top of the efficacy ranking, followed by an introductory course for surgeons starting work in a hospital or when new devices became available. Only 50 % of the responding surgeons perceived CIRS as being efficient. Overall, the answers showed that instruments to increase patient safety were commonly available in surgical departments. On the other hand, there is still room for improvement in daily practice. PMID:26354140

  20. Construction and early commissioning results of the AGS Booster

    SciTech Connect

    Weng, W.T.; Ahrens, L.; Damm, R.; McNerney, A.J.

    1991-01-01

    The AGS Booster synchrotron has been designed to accelerate protons from 200 MeV to 1.5 GeV and heavy ions from several MeV per nucleon to several hundred MeV per nucleon for all the nuclei up to gold. The design requirements and measurements results of major accelerator components and systems are presented. The early commissioning results of the injection is also presented. 12 refs., 9 figs., 2 tabs.

  1. Fiber heart valve prosthesis: Early in vitro fatigue results.

    PubMed

    Vaesken, Antoine; Khoffi, Foued; Heim, Frederic; Dieval, Florence; Chakfe, Nabil

    2016-07-01

    Transcatheter aortic valve replacement has become today a largely considered alternative technique to surgical valve replacement in patients with high risk for open chest surgery. Biological valve tissue used in the transcatheter devices has shown success over 5 years now, but the procedure remains expensive. Moreover, different studies point out potential degradations that the tissue can undergo when folded to lower diameter and released in calcified environment with irregular geometry, which may jeopardize the durability of the device. The use of synthetic materials, like textile in particular, to replace biological valve leaflets would help reducing the procedure costs, and limit the degradations when the valve is crimped. Textile polyester material has been extensively used in the vascular surgery and is characterized by outstanding folding and strength properties combined with proven biocompatibility. However, the friction effects that occur between filaments and between yarns within a fabric under flexure loading could be critical for the resistance of the material on the long term. The purpose of this study was to assess the early fatigue performances of textile valve prototypes under accelerated cyclic loading up to 200 Mio cycles. Durability tests show that the fibrous material undergoes rearrangements between fibrous elements within the textile construction and the mechanical properties are modified on the long term. But testing is not complete with 200 Mio cycles. The material should be tested up to a higher number of cycles in future work to test the effective long-term durability. © 2015 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 104B: 986-992, 2016. PMID:25980361

  2. A Panel of Genetic Polymorphism for the Prediction of Prognosis in Patients with Early Stage Non-Small Cell Lung Cancer after Surgical Resection

    PubMed Central

    Jeon, Hyo-Sung; Choi, Yi-Young; Lee, Won Kee; Lee, Eung Bae; Lee, Hyun Cheol; Kang, Hyo-Gyoung; Yoo, Seung Soo; Lee, Jaehee; Cha, Seung Ick; Kim, Chang Ho; Lee, Myung Hoon; Kim, Young Tae; Jheon, Sanghoon; Park, Jae Yong

    2015-01-01

    Background This study was conducted to investigate whether a panel of eight genetic polymorphisms can predict the prognosis of patients with early stage non-small cell lung cancer (NSCLC) after surgical resection. Materials and Methods We selected eight single nucleotide polymorphisms (SNPs) which have been associated with the prognosis of lung cancer patients after surgery in our previous studies. A total of 814 patients with early stage NSCLC who underwent curative surgical resection were enrolled. The association of the eight SNPs with overall survival (OS) and disease-free survival (DFS) was analyzed. Results The eight SNPs (CD3EAP rs967591, TNFRSF10B rs1047266, AKT1 rs3803300, C3 rs2287845, HOMER2 rs1256428, GNB2L1 rs3756585, ADAMTSL3 rs11259927, and CD3D rs3181259) were significantly associated with OS and/or DFS. Combining those eight SNPs, we designed a prognostic index to predict the prognosis of patients. According to relative risk of death, a score value was assigned to each genotype of the SNPs. A worse prognosis corresponded to a higher score value, and the sum of score values of eight SNPs defined the prognostic index of a patient. When we categorized the patients into two groups based on the prognostic index, high risk group was significantly associated with worse OS and DFS compared to low risk group (aHR for OS = 2.21, 95% CI = 1.69–2.88, P = 8.0 x 10−9, and aHR for DFS = 1.58, 95% CI = 1.29–1.94, P = 1.0 x 10−5). Conclusions Prognostic index using eight genetic polymorphisms may be useful for the prognostication of patients with surgically resected NSCLC. PMID:26462029

  3. Critical diagnoses in surgical pathology: a retrospective single-institution study to monitor guidelines for communication of urgent results.

    PubMed

    Huang, Eric C; Kuo, Frank C; Fletcher, Christopher D M; Nosé, Vânia

    2009-07-01

    Recent attention has shifted toward defining critical values in surgical pathology, as used in clinical pathology for urgent laboratory results, which require immediate physician notification. The Association of Directors of Anatomic and Surgical Pathology recently proposed a schema for critical values in surgical pathology, better defined as critical diagnoses (CDs). To this end, our department established guidelines defining the timely communication and documentation of urgent findings. To monitor policy effectiveness and to refine a customized list of CDs, we analyzed reports over two identical 6-month periods in 2006 and 2007 for the proper documentation and communication of urgent results. Of all the general surgical pathology cases examined, slightly more than 3% were communicated urgently to the requesting physicians. Approximately 20% of those cases fell into one of the recently proposed CD categories, whereas the remaining cases had conditions that were not specified by the Association of Directors of Anatomic and Surgical Pathology, but nonetheless justified immediate notification based on local practice, such as graft-versus-host disease, acute tubulo-interstitial nephritis, and unsuspected amyloidosis. Consecutive cases from a 4-day period reviewed in 2006 showed that 23.5% notified cases were not properly documented in the final report. However, the compliance rate improved to 100% for a similar period in 2007. Our study demonstrates the need for any CD list to be customized at a given institution to address all the potential diagnoses necessary for patient care and management. It further shows that continuous monitoring and education with regard to CDs and timely communication and documentation of unexpected surgical pathology findings are important measures for optimizing patient safety. PMID:19390422

  4. Peripheral nerve injuries resulting from common surgical procedures in the lower portion of the abdomen.

    PubMed

    Stulz, P; Pfeiffer, K M

    1982-03-01

    Twenty-three patients had a painful ilioinguinal and/or iliohypogastric nerve entrapment syndrome following common surgical procedures in the lower portion of the abdomen (appendectomy, repair of inguinal hernia, and gynecologic procedures through transverse incision). The diagnostic triad of nerve entrapment after operation comprises (1) typical burning or lancinating pain near the incision that radiates to the area supplied by the nerve, (2) clear evidence of impaired sensory perception of the nerve, and (3) pain relieved by infiltration with anesthetic for local effects at the site where the two nerves leave the internal oblique muscle. Surgical repair of the scar with resection of the compromised nerve is the most effective treatment. Sixteen patients became symptom free after neurectomy, seven still suffer chronic pain in the scar. PMID:7065874

  5. Does cognitive functioning predict chronic pain? Results from a prospective surgical cohort.

    PubMed

    Attal, Nadine; Masselin-Dubois, Anne; Martinez, Valéria; Jayr, Christian; Albi, Aline; Fermanian, Jacques; Bouhassira, Didier; Baudic, Sophie

    2014-03-01

    It is well established that chronic pain impairs cognition, particularly memory, attention and mental flexibility. Overlaps have been found between the brain regions involved in pain modulation and cognition, including in particular the prefrontal cortex and the anterior cingulate cortex, which are involved in executive function, attention and memory. However, whether cognitive function may predict chronic pain has not been investigated. We addressed this question in surgical patients, because such patients can be followed prospectively and may have no pain before surgery. In this prospective longitudinal study, we investigated the links between executive function, visual memory and attention, as assessed by clinical measurements and the development of chronic pain, its severity and neuropathic symptoms (based on the 'Douleur Neuropathique 4' questionnaire), 6 and 12 months after surgery (total knee arthroplasty for osteoarthritis or breast surgery for cancer). Neuropsychological tests included the Trail-Making Test A and B, and the Rey-Osterrieth Complex Figure copy and immediate recall, which assess cognitive flexibility, visuospatial processing and visual memory. Anxiety, depression and coping strategies were also evaluated. In total, we investigated 189 patients before surgery: 96% were re-evaluated at 6 months, and 88% at 12 months. Multivariate logistic regression (stepwise selection) for the total group of patients indicated that the presence of clinical meaningful pain at 6 and 12 months (pain intensity ≥ 3/10) was predicted by poorer cognitive performance in the Trail Making Test B (P = 0.0009 and 0.02 for pain at 6 and 12 months, respectively), Rey-Osterrieth Complex Figure copy (P = 0.015 and 0.006 for pain at 6 and 12 months, respectively) and recall (P = 0.016 for pain at 12 months), independently of affective variables. Linear regression analyses indicated that impaired scores on these tests predicted pain intensity (P < 0.01) and neuropathic

  6. Ultrasound bone cutting for surgically assisted rapid maxillary expansion under local anesthesia. Preliminary results.

    PubMed

    Robiony, M; Polini, F; Costa, F; Zerman, N; Politi, M

    2007-06-01

    Surgically assisted rapid maxillary expansion (SARME) is a well-established therapy for correction of maxillary transverse deficiency in adults, when consolidation of sutures has just been completed. It can be performed either under general or under local anesthesia and it can be accomplished with many surgical techniques. One of the most critical steps of SARME is the detachment of the pterygo-maxillary junction, due to the risks connected to such procedure. When required to obtain specific expansion patterns, the pterygo-maxillary separation has been suggested until now only for interventions under general anesthesia, due to the dangerousness and the rawness of this surgical step in awake patients. The authors introduce the use of an ultrasonic bone-cutting device to perform all osteotomic steps of SARME under local anesthesia on an outpatient basis, including pterygo-maxillary detachment. This ultrasonic device is unique in that the osteotomic action occurs only when the tool is employed on mineralized tissues, while it stops on soft tissues. It works in a linear pattern of vibration and it allows precise osteotomies without producing any heat damage to osteotomic surfaces and without any dangerous hammer-related stroke. Due to its precision and safety, this device named Piezosurgery, allows patients to undergo all the steps of SARME under local anesthesia, also without hospitalization. PMID:17625493

  7. [Prevention and treatment of early complications of surgical treatment of peptic ulcer].

    PubMed

    Gorbashko, A I; Savich, L V; Egorov, N V; Medvedev, E D

    1989-02-01

    An experience with the operative treatment of 1620 patients has shown that incidence of postoperative complications can be reduced by using active aspiration of the gastric stump content, early intestinal feeding, autohemotransfusions for the substitution of the intraoperative blood loss. PMID:2728254

  8. Medical versus surgical methods of early abortion: protocol for a systematic review and environmental scan of patient decision aids

    PubMed Central

    Donnelly, Kyla Z; Thompson, Rachel

    2015-01-01

    Introduction Currently, we lack understanding of the content, quality and impact of patient decision aids to support decision-making between medical and surgical methods of early abortion. We plan to undertake a systematic review of peer-reviewed literature to identify, appraise and describe the impact of early abortion method decision aids evaluated quantitatively (Part I), and an environmental scan to identify and appraise other early abortion method decision aids developed in the US (Part II). Methods and analysis For the systematic review, we will search PubMed, Cochrane Library, CINAHL, EMBASE and PsycINFO databases for articles describing experimental and observational studies evaluating the impact of an early abortion method decision aid on women's decision-making processes and outcomes. For the environmental scan, we will identify decision aids by supplementing the systematic review search with Internet-based searches and key informant consultation. The primary reviewer will assess all studies and decision aids for eligibility, and a second reviewer will also assess a subset of these. Both reviewers will independently assess risk of bias in the studies and abstract data using a piloted form. Finally, both reviewers will assess decision aid quality using the International Patient Decision Aid Standards criteria, ease of readability using Flesch/Flesch-Kincaid tests, and informational content using directed content analysis. Ethics and dissemination As this study does not involve human subjects, ethical approval will not be sought. We aim to disseminate the findings in a scientific journal, via academic and/or professional conferences and among the broader community to contribute knowledge about current early abortion method decision-making support. Trial registration number This protocol is registered in the International Prospective Register of Systematic Reviews (CRD42015016717). PMID:26173718

  9. Review of early clinical results and complications associated with oblique lumbar interbody fusion (OLIF).

    PubMed

    Phan, Kevin; Maharaj, Monish; Assem, Yusuf; Mobbs, Ralph J

    2016-09-01

    Lumbar interbody fusion represents an effective surgical intervention for patients with lumbar degenerative diseases, spondylolisthesis, disc herniation, pseudoarthrosis and spinal deformities. Traditionally, conventional open anterior lumbar interbody fusion and posterior/transforaminal lumbar interbody fusion techniques have been employed with excellent results, but each with their own advantages and caveats. Most recently, the antero-oblique trajectory has been introduced, providing yet another corridor to access the lumbar spine. Termed the oblique lumbar interbody fusion, this approach accesses the spine between the anterior vessels and psoas muscles, avoiding both sets of structures to allow efficient clearance of the disc space and application of a large interbody device to afford distraction for foraminal decompression and endplate preparation for rapid and thorough fusion. This review aims to summarize the early clinical results and complications of this new technique and discusses potential future directions of research. PMID:27349468

  10. Early Weak Lensing Results From The Dark Energy Survey

    NASA Astrophysics Data System (ADS)

    Maccrann, Niall; Dark Energy Survey Collaboration

    2016-01-01

    I present the early weak lensing results, including cosmological constraints, from the Dark Energy Survey (DES). Although only 3% of the final survey, DES Science Verification data already constituted a competitive weak lensing dataset, and the thoroughly tested shear catalogs allowed a number of interesting science analyses including cosmology from cosmic shear, mass mapping, combining lensing with galaxy clustering and combining with CMB lensing. I will summarize the main results of these analyses, discuss common systematic effects which need to be addressed to take advantage of the greater statistical power of main survey data, and outline some of improvements at various stages of the analysis pipeline that aim to do this.

  11. Fibrotic contracture of the canine infraspinatus muscle: pathophysiology and prevention by early surgical intervention.

    PubMed

    Devor, Morten; Sørby, R

    2006-01-01

    Fibrotic contracture of the canine infraspinatus muscle (FCIM) is considered a rare musculotendineous disorder mainly affecting hunting dogs. After an acute onset of a painful non-weight bearing lameness, the initial pain and lameness improve over a period of one to four weeks, after which a characteristic circumducted gait abnormality develops in the forelimb. The initial injury to the infraspinatus muscle is not fully recognized or correctly interpreted in most cases, at least not with regard to its potential as a precursor of myopathy and FCIM. A mixed breed hunting dog developed an acute and extremely painful swelling of the infraspinatus muscle. The injury was easily recognized during clinical examination. The clinical signs were interpreted as an osteo-fascial compartment syndrome (OFCS) of the infraspinatus muscle. Immediate surgical decompression of the osteo-fascial compartment to prevent development of FCIM was undertaken. The histopathological and immunohistochemical examinations of the injured infrapinatus muscle revealed tissue changes that indicated acute muscle rupture, without any signs of an initiating degenerative process. On the day following surgery the dog was fully weight bearing. Restriction of activity for four weeks was recommended. Eight months after the initial injury, the dog had completely recovered and had full days of vigorous exercise and hunting activity without any apparent lameness. The findings in this case suggested that the infraspinatus muscle may be considered to be an osteo-fascial compartment in dogs and must be added to the list of compartments that may pose a potential risk for OFCS in the canine extremity. PMID:16810356

  12. Comparison of early postoperative pain among surgical techniques for obstructive sleep apnea.

    PubMed

    Akcam, Timur; Arslan, Hasan Huseyin; Deniz, Suleyman; Genc, Hakan; Karakoc, Omer; Senkal, Serkan; Gerek, Mustafa

    2012-11-01

    One of the criticized aspects of surgeries for obstructive sleep apnea (OSA) is postoperative pain. We performed a study to compare the severity of pain occurring after different surgical techniques and to determine analgesic requirements in the first postoperative 24 h. Forty-eight patients with primary snoring or OSA who underwent anterior palatoplasty (AP), lateral pharyngoplasty (LP) or tongue base suspension suture (TBS) were included in this study. A visual analog scale (VAS) was used for measuring pain intensity. Tramadol with patient-controlled analgesia (PCA) device and when necessary rescue pethidine was used for pain relief. VAS pain scores, total PCA-tramadol consumptions and requirement of rescue analgesic in AP, LP and TBS groups were compared. Pain scores in TBS group were higher than AP group in all of the study time points except at 12th hour and LP group until the 10th hour. When compared with AP group, VAS was significantly higher in LP group at the 1st hour. Mean total tramadol consumptions were significantly different between the groups (AP-LP, p = 0.039; AP-TBS, p < 0.001; LP-TBS, p < 0.001). It was highest in the TBS group and lowest in the AP group. In the LP group, three patients (16.7 %) needed rescue analgesia in comparison with 11 (73.3 %) in the TBS group. None of the patients in the AP group needed rescue analgesic. AP is the least painful and TBS is the most painful procedure. PCA-bolus tramadol effectively treats pain caused by AP and LP; however, alleviation of pain caused by TBS usually needs rescue opioid analgesic. PMID:22699627

  13. 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

  14. The beauty of anatomy: visual displays and surgical education in early-nineteenth-century London.

    PubMed

    Berkowitz, Carin

    2011-01-01

    The early-nineteenth-century artist, anatomist, and teacher Sir Charles Bell saw anatomy and art as closely related subjects. He taught anatomy to artists and surgeons, illustrated his own anatomical texts, and wrote a treatise on the use of anatomy in art. The author explores the connections among visual displays representing human anatomy, aesthetics, and pedagogical practices for Bell and a particular group of British surgeon-anatomists. Creating anatomical models and drawings was thought to discipline the surgeon's hand, while the study of anatomy and comparative anatomy would discipline the artist's eye. And for Bell, beauty made drawings into better pedagogical tools. PMID:21804185

  15. [Results of conservative therapy in early breast carcinoma].

    PubMed

    Gatĕk, J; Duben, J; Dudesek, B; Schön, J

    2000-05-01

    The authors present a review on the development of views on breast cancer from the beginning of the century and contemporary views on the problem, its solution world-wide and in the Czech Republic. They base on their own group of 475 patients of 1991-1998, they analyze the development of possible solutions of early breast cancer and their view on the discussed problem. With regard to favourable results they advocate progressive breast preserving operations associated with postoperative radiotherapy and the use of the method of sentinel nodes. PMID:10916438

  16. The Advanced Photon Source: Performance and results from early operation

    SciTech Connect

    Moncton, D.E.

    1997-10-01

    The Advanced Photon Source at Argonne National Laboratory is now providing researchers with extreme-brilliance undulator radiation in the hard x-ray region of the spectrum. All technical facilities and components are operational and have met design specifications. Fourteen research teams, occupying 20 sectors on the APS experiment hall floor, are currently installing beamline instrumentation or actively taking data. An overview is presented for the first operational years of the Advanced Photon Source. Emphasis is on the performance of accelerators and insertion devices, as well as early scientific results and future plans.

  17. Surgical Simulation

    PubMed Central

    Sutherland, Leanne M.; Middleton, Philippa F.; Anthony, Adrian; Hamdorf, Jeffrey; Cregan, Patrick; Scott, David; Maddern, Guy J.

    2006-01-01

    Objective: To evaluate the effectiveness of surgical simulation compared with other methods of surgical training. Summary Background Data: Surgical simulation (with or without computers) is attractive because it avoids the use of patients for skills practice and provides relevant technical training for trainees before they operate on humans. Methods: Studies were identified through searches of MEDLINE, EMBASE, the Cochrane Library, and other databases until April 2005. Included studies must have been randomized controlled trials (RCTs) assessing any training technique using at least some elements of surgical simulation, which reported measures of surgical task performance. Results: Thirty RCTs with 760 participants were able to be included, although the quality of the RCTs was often poor. Computer simulation generally showed better results than no training at all (and than physical trainer/model training in one RCT), but was not convincingly superior to standard training (such as surgical drills) or video simulation (particularly when assessed by operative performance). Video simulation did not show consistently better results than groups with no training at all, and there were not enough data to determine if video simulation was better than standard training or the use of models. Model simulation may have been better than standard training, and cadaver training may have been better than model training. Conclusions: While there may be compelling reasons to reduce reliance on patients, cadavers, and animals for surgical training, none of the methods of simulated training has yet been shown to be better than other forms of surgical training. PMID:16495690

  18. Effects of surgical stress on early nonspecific immune response in children.

    PubMed

    Prabhu, P Santosh; Sridharan, S; Ramesh, S

    2014-02-01

    Surgery alters the body's homeostatic balance and defense mechanisms. In adults transient postoperative cellular and humoral immunosuppression after different degrees of operative stress has been reported. In children the immunologic consequences of operations are not elaborated. This study investigates the effect of minor and major surgery on early nonspecific immune response in terms of neutrophil counts and function. Forty-three children undergoing minor and major elective procedures were studied. Blood samples were collected before, immediately after, and 72 h after surgery. Total white cell count, differential neutrophil count, and neutrophil phagocytic function were studied using nitroblue tetrazolium test. Children were divided into two groups-group 1 underwent minor surgery and group 2 major surgery. In group 1 there was a significant drop in total counts after surgery, but in group 2 total counts were not affected. In both groups, the percentage of neutrophils increased immediately after surgery but fell to near or less than preoperative levels 72 h after surgery. However, the assessment of neutrophil functions by nitroblue tetrazolium test in both unstimulated and stimulated forms revealed it to be unchanged in group 1. In group 2 the unstimulated neutrophil function was elevated 72 h after surgery, whereas stimulated function was elevated immediately after surgery. Minor surgery does not alter the early nonspecific immune response. However, major surgery seems to induce a transient increase in neutrophil phagocytic activity. PMID:24799783

  19. Video-thoracoscopic surgical pleurodesis in the management of malignant pleural effusion: the importance of an early intervention.

    PubMed

    Marrazzo, Antonio; Noto, Antonio; Casà, Luigi; Taormina, Pietra; Lo Gerfo, Domenico; David, Massimo; Mercadante, Sebastiano

    2005-07-01

    Thoracentesis plays an important role in cancer patients with symptomatic effusions, although its effect is short-lived and symptoms recur in almost all patients. Early video-thoracoscopic surgical pleurodesis may provide added benefit to a group of patients with advanced cancer presenting with symptomatic malignant pleural effusion. Seventy-six patients with advanced cancer and pleural effusion due to pulmonary-pleural metastases were recruited. In 51 cases (67.1%), at least one thoracentesis was performed before admission for surgery. Preoperative staging consisted of chest radiograph, CT scan, and blood gas analysis. The mean Karnofsky performance status was about 50. Pleurodesis with talc poudrage was completely successful in all patients, with a morbidity rate of 2.6%. There was no post-operative mortality. Three patients (3.9%) underwent further thoracenteses for recurrence of pleural effusion within two months after the procedure. Early use of talc insufflated by video-thoracoscopic surgery is an effective and relatively safe method for treating pleural effusion, and preventing recurrence, in advanced cancer patients. PMID:16043010

  20. Preface: The LAMOST Galactic surveys and early results

    NASA Astrophysics Data System (ADS)

    Liu, Xiao-Wei; Zhao, Gang; Hou, Jin-Liang

    2015-08-01

    By the time of this writing, the ongoing LAMOST Galactic surveys have collected approximately 4.5 million stellar spectra with signal-to-noise ratios better than 10 per pixel. This special issue is devoted to early results from the surveys, mostly based on the LAMOST Data Release 1 (DR1; Luo et al., this volume) that contains data secured by May 2013, the end of the first year of regular surveys, although a few studies have made use of data collected in the second year of regular surveys. LAMOST DR1 was released to the Chinese astronomical community and international partners in August 2013 and made public to the whole world in March 2015. Here we briefly review the scope and motivation, data reduction and release, as well as early results of the surveys. As the project advances, one can expect that these surveys will yield an exquisite description of the distribution, kinematics and chemistry of Galactic stellar populations, especially those within a few kpc of the Sun, a robust measurement of the local dark matter density, and, consequently, shed light on how our Galaxy, and other galaxies in general, form and evolve.

  1. EVALUATION OF THE RESULTS OF SURGICAL TREATMENT OF POSTTRAUMATIC STIFFNESS OF THE ELBOW IN SKELETALLY MATURE PATIENTS

    PubMed Central

    Miyazaki, Alberto Naoki; Fregoneze, Marcelo; Santos, Pedro Doneux; da Silva, Luciana Andrade; Di Giunta, Giovanni; Watanabe, Lucio Norio; Checchia, Sérgio Luiz

    2015-01-01

    Objective: To evaluate the results from surgical treatment of posttraumatic stiffness of the elbow in skeletally mature patients. Methods: Between October 2000 and October 2007, 45 elbows of 45 patients underwent surgical treatment performed by the Shoulder and Elbow Surgery Group, Department of Orthopedics and Traumatology, School of Medical Sciences, Santa Casa de São Paulo. Ten patients were treated arthroscopically and the remainder by open surgery. The minimum follow-up was six months, with a mean of 22 months. Their ages ranged from 17 to 72 years, with a mean of 36 years and three months. Males predominated, accounting for 60% of the cases. The dominant limb was involved in 56.5% of the cases. The clinical evaluation of the results was done by using the criteria of the American Medical Association (AMA), as modified by Bruce; the Mayo Elbow Performance Score (MEPS); and measurements on the gain of flexion-extension arc and the final range of motion. Results: According to the AMA criteria, as modified by Bruce, 42.2% of our results were satisfactory, whereas 77.8% were satisfactory according to MEPS. The mean postoperative flexion-extension arc was 106°, and the main gain in range was 46°. The evaluation of the variables showed that patients with an initial flexion arc greater than 90° achieved a greater final flexion-extension arc, and those with an initial extension less than or equal to 60° gained greater range of motion. Conclusion: Surgical treatment of posttraumatic stiffness of the elbow in skeletally mature individuals was shown to be satisfactory according to MEPS, but unsatisfactory according to AMA. We observed that the patients with preoperative flexion greater than 90° evolved with a greater flexion-extension arc after surgical treatment, while those who had contracture with extension less than or equal to 60° gained a greater range of motion. PMID:27026959

  2. Utility of PET/CT Imaging Performed Early After Surgical Resection in the Adjuvant Treatment Planning for Head and Neck Cancer

    SciTech Connect

    Shintani, Stephanie A.; Foote, Robert L. Lowe, Val J.; Brown, Paul D.; Garces, Yolanda I.; Kasperbauer, Jan L.

    2008-02-01

    Purpose: To evaluate the utility of positron emission tomography (PET)/computed tomography (CT) early after surgical resection and before postoperative adjuvant radiation therapy. Methods and Materials: We studied a prospective cohort of 91 consecutive patients referred for postoperative adjuvant radiation therapy after complete surgical resection. Tumor histologies included 62 squamous cell and 29 non-squamous cell cancers. Median time between surgery and postoperative PET/CT was 28 days (range, 13-75 days). Findings suspicious for persistent/recurrent cancer or distant metastasis were biopsied. Correlation was made with changes in patient care. Results: Based on PET/CT findings, 24 patients (26.4%) underwent biopsy of suspicious sites. Three patients with suspicious findings did not undergo biopsy because the abnormalities were not easily accessible. Eleven (45.8%) biopsies were positive for cancer. Treatment was changed for 14 (15.4%) patients (11 positive biopsy and 3 nonbiopsied patients) as a result. Treatment changes included abandonment of radiation therapy and switching to palliative chemotherapy or hospice care (4), increasing the radiation therapy dose (6), extending the radiation therapy treatment volume and increasing the dose (1), additional surgery (2), and adding palliative chemotherapy to palliative radiation therapy (1). Treatment for recurrent cancer and primary skin cancer were significant predictors of having a biopsy-proven, treatment-changing positive PET/CT (p < 0.03). Conclusions: Even with an expectedly high rate of false positive PET/CT scans in this early postoperative period, PET/CT changed patient management in a relatively large proportion of patients. PET/CT can be recommended in the postoperative, preradiation therapy setting with the understanding that treatment-altering PET/CT findings should be biopsied for confirmation.

  3. DEEP-South: Network Construction, Test Runs and Early Results

    NASA Astrophysics Data System (ADS)

    Moon, Hong-Kyu; Kim, Myung-Jin; Yim, Hong-Suh; Choi, Young-Jun; Bae, Young-Ho; Roh, Dong-Goo; Park, Jintae; Moon, Bora

    2016-01-01

    Korea Microlensing Telescope Network (KMTNet) which consists of three identical 1.6 m wide-field telescopes with 18k × 18k CCDs, is the first optical survey system of its kind. The combination of fast optics and the mosaic CCD delivers seeing limited images over a 4 square degrees field of view. The main science goal of KMTNet is the discovery and characterization of exoplanets, yet it also offers various other science applications including DEep Ecliptic Patrol of SOUTHern sky (DEEP-South). The aim of DEEP-South is to discover and characterize asteroids and comets, including Near Earth Objects (NEOs). We started test runs last February after commissioning, and will return to normal operations in October 2015. A summary of early results from the test runs will be presented.

  4. Evaluation of the results from arthroscopic surgical treatment of rotator cuff injuries in patients aged 65 years and over☆

    PubMed Central

    Miyazaki, Alberto Naoki; da Silva, Luciana Andrade; Santos, Pedro Doenux; Checchia, Sergio Luiz; Cohen, Carina; Giora, Taís Stedile Busin

    2015-01-01

    Objectives To evaluate the results from arthroscopic surgical treatment of rotator cuff injuries in patients aged 65 years and over. Methods Between 1998 and 2009, 168 patients underwent operations. Five cases were excluded. The remaining 163 patients were stratified according to their age group: 65–69 years (49.1%), 70–74 (26.4%) and 75 years and over (24.5%). Their mean age was 71 years (range: 65–83). There were 63 male patients (38.7%). The mean length of time with pain, from the onset of symptoms to the surgery, was 23 months (range: 2 days to 240 months). Sixty-two patients (38%) reported histories of trauma and 26 (16%) reported that their pain worsened through exertion. Results From the UCLA criteria, 80.4% of the results were excellent, 16% good, 1.8% fair and 1.8% poor. Complications occurred in 11%. The final clinical result did not show any correlation with age progression, injury size or tendons affected. However, there was a significant association (p < 0.001) between the presence of trauma and larger injuries. The length of time between the onset of symptoms and the surgical procedure had a significant relationship (p < 0.027) with the postoperative results: the longer this time was, the worse the results were. Conclusion Arthroscopic treatment of rotator cuff injuries in patients aged 65 years and over presented excellent and good results in 96.4% of the cases, according to the UCLA assessment, with a low complication rate. Advanced age did not show any influence on the postoperative clinical evolution, but the earlier the surgical treatment was instituted, the better the results were. PMID:26229935

  5. Early on-orbit calibration results from Aqua MODIS

    NASA Astrophysics Data System (ADS)

    Xiong, Xiaoxiong; Barnes, William L.

    2003-04-01

    Aqua MODIS, also known as the MODIS Flight Model 1 (FM1), was launched on May 4, 2002. It opened its nadir aperture door (NAD) on June 24, 2002, beginning its Earth observing mission. In this paper, we present early results from Aqua MODIS on-orbit calibration and characterization and assess the instrument's overall performance. MODIS has 36 spectral bands located on four focal plane assemblies (FPAs). Bands 1-19, and 26 with wavelengths from 0.412 to 2.1 microns are the reflective solar bands (RSB) that are calibrated on-orbit by a solar diffuser (SD). The degradation of the SD is tracked using a solar diffuser stability monitor (SDSM). The bands 20-25, and 27-36 with wavelengths from 3.75 to 14.5 microns are the thermal emissive bands (TEB) that are calibrated on-orbit by a blackbody (BB). Early results indicate that the on-orbit performance has been in good agreement with the predications determined from pre-launch measurements. Except for band 21, the low gain fire band, band 6, known to have some inoperable detectors from pre-launch characterization, and one noisy detector in band 36, all of the detectors' noise characterizations are within their specifications. Examples of the sensor's short-term and limited long-term responses in both TEB and RSB will be provided to illustrate the sensor's on-orbit stability. In addition, we will show some of the improvements that Aqua MODIS made over its predecessor, Terra MODIS (Protoflight Model - PFM), such as removal of the optical leak into the long-wave infrared (LWIR) photoconductive (PC) bands and reduction of electronic crosstalk and out-of-band (OOB) thermal leak into the short-wave infrared (SWIR) bands.

  6. Surgical Trial In Traumatic intraCerebral Haemorrhage (STITCH): a randomised controlled trial of Early Surgery compared with Initial Conservative Treatment.

    PubMed Central

    Gregson, Barbara A; Rowan, Elise N; Francis, Richard; McNamee, Paul; Boyers, Dwayne; Mitchell, Patrick; McColl, Elaine; Chambers, Iain R; Unterberg, Andreas; Mendelow, A David

    2015-01-01

    BACKGROUND While it is accepted practice to remove extradural (EDH) and subdural haematomas (SDH) following traumatic brain injury, the role of surgery in parenchymal traumatic intracerebral haemorrhage (TICH) is controversial. There is no evidence to support Early Surgery in this condition. OBJECTIVES There have been a number of trials investigating surgery for spontaneous intracerebral haemorrhage but none for TICH. This study aimed to establish whether or not a policy of Early Surgery for TICH improves outcome compared with a policy of Initial Conservative Treatment. DESIGN This was an international multicentre pragmatic parallel group trial. Patients were randomised via an independent telephone/web-based randomisation service. SETTING Neurosurgical units in 59 hospitals in 20 countries registered to take part in the study. PARTICIPANTS The study planned to recruit 840 adult patients. Patients had to be within 48 hours of head injury with no more than two intracerebral haematomas greater than 10 ml. They did not have a SDH or EDH that required evacuation or any severe comorbidity that would mean they could not achieve a favourable outcome if they made a complete recovery from their head injury. INTERVENTIONS Patients were randomised to Early Surgery within 12 hours or to Initial Conservative Treatment with delayed evacuation if it became clinically appropriate. MAIN OUTCOME MEASURES The Extended Glasgow Outcome Scale (GOSE) was measured at 6 months via a postal questionnaire. The primary outcome was the traditional dichotomised split into favourable outcome (good recovery or moderate disability) and unfavourable outcome (severe disability, vegetative, dead). Secondary outcomes included mortality and an ordinal assessment of Glasgow Outcome Scale and Rankin Scale. RESULTS Patient recruitment began in December 2009 but was halted by the funding body because of low UK recruitment in September 2012. In total, 170 patients were randomised from 31 centres in 13

  7. Early Results of a New Rotating Hinge Knee Implant

    PubMed Central

    Neuhaus, Hans-Joachim; Miehlke, Rolf; Schuh, Reinhard; Kubista, Bernd

    2014-01-01

    Background. Indication for rotating hinge (RH) total knee arthroplasty (TKA) includes primary and revision cases, with contradictory results. The aim of this study was to report prospective early results of a new modular rotating hinge TKA (EnduRo). For this implant several new design features and a new bearing material (carbon-fiber reinforced poly-ether-ether-ketone) have been developed. Furthermore, we tried to establish a new classification of failure modes for revision TKA. Methods. 152 EnduRo rotating-hinge prostheses were implanted in two centers. In 90 patients a primary implantation has been performed and 62 patients were revision cases. Knee Society Score (KSS), Western Ontario and McMaster Osteoarthritis Index (WOMAC), Oxford Knee Score (OKS), and Range of motion (ROM) were assessed before surgery, 3 months postoperatively, 12 months postoperatively, and annually thereafter. We defined 3 types of complications: Type 1, infection; type 2, periprosthetic complications; type 3, implant failures. Results. KSS, WOMAC, OKS, and ROM revealed significant improvements between the preoperative and the follow-up investigations. There were 14 complications (9.2%) leading to revision surgery, predominantly type 2. Conclusion. Our study shows excellent clinical results of the EnduRo TKA. Furthermore, no premature material failure or unusual biological response to the new bearing material could be detected. PMID:25089279

  8. Pediatric endocanalicular diode laser dacryocystorhinostomy: results of a minimally invasive surgical technique.

    PubMed

    Uysal, Ismail Onder; Ozçimen, Muammer; Yener, Halil Ibrahim; Kal, Ali

    2011-09-01

    The purpose of this study was to evaluate the effectiveness of endocanalicular diode laser dacryocystorhinostomy (DCR), which is a minimally invasive surgical technique, in pediatric patients with congenital nasolacrimal duct obstruction (NLDO). A retrospective study was carried out on patients treated between October 2008 and August 2009 for nasolacrimal duct obstruction with an endocanalicular diode laser procedure. Patients diagnosed as having nasolacrimal duct obstruction were included in this study and an endocanalicular diode laser procedure was performed. The main outcome measures were patients' previous treatments, clinical presentation, operative and postoperative complications, postoperative follow-up and resolution of epiphora. Eighteen children (10 girls, 8 boys) with a mean age of 6.11 ± 2.08 years (range, 4-10) underwent 20 endocanalicular laser DCR operations for congenital NLDO. In all eyes (100%), there was a history of epiphora and chronic dacryocystitis; two (10%) presented with acute dacryocystitis. Previous procedures included probing and irrigation of all eyes (100%) and silicone tube intubation in nine eyes (45%). None of the patients underwent any previous DCR operations. During a mean postoperative follow-up period of 20.50 ± 3.24 months (range, 14-24 months), the anatomical success rate (patency of ostium on nasal endoscopy) was 100%, and the clinical success rate (resolution of epiphora) was 85%. Endocanalicular diode laser DCR is an effective treatment modality for pediatric patients with congenital NLDO that compares favorably with the reported success rates of external and endoscopic endonasal DCR. Moreover, it has an added advantage of shorter operative time, less morbidity and avoidance of overnight admission. PMID:21442420

  9. Surgical injury-induced early neocortical microvascular changes and characteristics of the cells populating the peri-lesion zone.

    PubMed

    Sulejczak, Dorota; Chrapusta, Stanisław J; Kozłowski, Wojciech; Frontczak-Baniewicz, Małgorzata

    2016-01-01

    Adult mammalian brain contains a number of specialized neurovascular structures termed "niches" that act as sources of neuronal cells throughout the individual's life. Some of the niches generate neurons to satisfy the need for 'replacement' neurons within the same or closely located brain structures, whereas the other can provide such cells for more distant destinations in the brain. A common characteristic of known neurovascular niches is the presence of a complex 3-dimensional network of basal lamina processes, called fractones. It apparently plays a major role in communication between the various niche-populating cell types as well as in niche activity and output. We hypothesized that similar niches may form ad hoc after a mechanical brain trauma, and tested this possibility in a rat model of surgical brain injury. Four days after removing a small fragment of sensorimotor cortex, the peri-wound region showed numerous symptoms of active repair and remodeling of brain parenchyma, including the presence of multiple cell types of immature phenotypes. The latter, as shown by a variety of light and electron microscopy techniques, included endothelial cell precursors as well as nestin-positive immature neural cells of astrocytic or non-glial characteristics. However, there was no evidence of in situ neurogenesis or a considerable migration of cells from SVZ. The centers of the said repair processes were capillary blood vessels connected with basal lamina-formed fractones. These results indicate that surgical brain trauma causes the formation of a vascular niche with no apparent neurogenic potential. PMID:27373950

  10. Early results with the cementless Variall hip system.

    PubMed

    Suda, Arnold J; Knahr, Karl

    2009-01-01

    This study presents the early results of the Variall cementless hip system, a further development of the reliable Alloclassic Zweymüller system. In a prospective randomized study, 319 patients (333 hips) underwent the Variall cementless hip system with four different bearings and were scored using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) Score and the Short Form-36 health survey form, with a follow-up period of 3 years. The patients were grouped according to age, with those in the age range 23-75 years as group one (n = 285) and those over 75 years of age as group two (n = 48). For both the Short Form-36 and WOMAC scoring, worse function was found in group two (i.e., patients >75 years). In this group, the function scores were worse in patients who received a conventional polyethylene bearing. The clinical and radiological results after 5 or more years will lead to a clearer prediction. PMID:19105776

  11. Quality of Life and Economic Outcomes with Surgical Ventricular Reconstruction in Ischemic Heart Failure: Results From the Surgical Treatment for Ischemic Heart Failure Trial

    PubMed Central

    Mark, Daniel B.; M.P.H; Knight, J. David; Velazquez, Eric J.; Howlett, Jonathan G.; Spertus, John A.; Djokovic, Ljubomir T.; Harding, Tina M.; Rankin, Gena R.; R.D.; Drew, Laura A.; Szygula-Jurkiewicz, Bozena; Adlbrecht, Christopher; Anstrom, Kevin J.

    2009-01-01

    Background Surgical ventricular reconstruction (SVR) is used in conjunction with coronary artery bypass graft surgery (CABG) to improve left ventricular function and clinical outcomes in selected patients with ischemic heart failure. The impact of SVR on quality of life and medical costs is unknown. Methods We compared CABG plus SVR with CABG alone in 1000 patients with ischemic heart failure, a large anterior wall scar, and a left ventricular ejection fraction ≤ 0.35. In 991 (99% of eligible), we collected a battery of quality of life (QOL) instruments. The principal, pre-specified QOL measure was the Kansas City Cardiomyopathy Questionnaire (KCCQ), which evaluates the effects of heart failure symptoms on QOL using a scale from 0 to 100 with higher scores indicating better QOL. Structured QOL interviews were conducted at baseline, 4, 12, 24, and 36 months post randomization and were ≥ 92% complete. Cost data were collected on 196 of 200 (98%) patients enrolled in the United States. Results Heart-failure-related QOL outcomes did not differ between the two treatment strategies out to 3 years (median KCCQ scores for CABG alone and CABG plus SVR, respectively: baseline 53 versus 54, p=0.53; 3 years 85 versus 84, p=0.89). There were no treatment-related differences in other QOL measures. In the US patients, total index hospitalization costs averaged over $14,500 higher for CABG plus SVR (P=0.004) due primarily to 4.2 extra post-operative high-intensity care days in the hospital. Conclusions Addition of SVR to CABG in patients with ischemic heart failure did not improve quality of life but significantly increased health care costs. PMID:19376309

  12. Liver transplantation in children from living related donors. Surgical techniques and results.

    PubMed Central

    Broelsch, C E; Whitington, P F; Emond, J C; Heffron, T G; Thistlethwaite, J R; Stevens, L; Piper, J; Whitington, S H; Lichtor, J L

    1991-01-01

    three procedures, in which a full left hepatectomy was performed. After alteration of the procedure into a left lateral segmentectomy, no complications were encountered. The left lateral segmentectomy presents minimal surgical trauma to the liver and should remain the primary approach for obtaining a liver graft from a living donor. For children, transplantation of a left lateral segment from a live donor provides a new way of providing a transplant of appropriate size and with good function. The success of this program has led to the acceptance of LRT for general clinical application in the authors' institution. PMID:1953097

  13. A Portable Fluorescence Camera for Testing Surgical Specimens in the Operating Room: Description and Early Evaluation

    PubMed Central

    Kakareka, John W.; McCann, Thomas E.; Kosaka, Nobuyuki; Mitsunaga, Makoto; Morgan, Nicole Y.; Pohida, Thomas J.; Choyke, Peter L.; Kobayashi, Hisataka

    2011-01-01

    Purpose Clinical translation of novel optical probes requires testing of human specimens ex vivo to ensure efficacy. However, it may be difficult to remove human tissue from the operating room due to regulatory/privacy issues. Therefore, we designed a portable fluorescence camera to test targeted optical imaging probes on human specimens in the operating room. Procedures A compact benchtop fluorescence camera was designed and built in-house. A mouse xenograft model of ovarian cancer with an activatable imaging probe based on rhodamine green was used to test the device. Comparison was made to commercially available imaging systems. Results The prototype camera produced images comparable to images acquired with commercially available, non-portable imaging systems. Conclusion We demonstrate the feasibility of a specimen-based portable fluorescence camera for use in the operating room. Its small size ensures that tissue excised from patients can be tested promptly for fluorescence within the operating room environment, thus expediting the testing of novel imaging probes. PMID:20960235

  14. Surgical pathology of early stage non-small cell lung carcinoma

    PubMed Central

    Beasley, Mary Beth; Dembitzer, Francine R.

    2016-01-01

    The histologic classification of non-small cell lung carcinoma (NSCLC), particularly adenocarcinoma (ADC), has undergone extensive study in recent decades, ultimately resulting in an extensively updated classification system. The 2015 World Health Organization (WHO) classification of ADC provides greatly improved prognostic information in comparison to the 2004 WHO classification. Several issues still require further investigation: lepidic predominant ADC, prognostic significance of poor prognostic subtypes such as micropapillary carcinoma, the more recently described concept of spread of tumor through airspaces (STAS), and the utility of sublobar resections. While limited resection appears to be suitable for tumors with a ground glass radiographic appearance, which typically correspond to adenocarcinoma in situ (MIS) or minimally invasive adenocarcinoma (MIA) histologically, the role of sublobar resection in radiographic solid tumors is not as clear, and the impact of histologic subtypes with a poor prognosis needs further evaluation. Squamous cell carcinoma (SCC) has not been as extensively studied and the current classification lacks subclassification with significant prognostic information. PMID:27429964

  15. Planck early results. XIV. ERCSC validation and extreme radio sources

    NASA Astrophysics Data System (ADS)

    Planck Collaboration; Ade, P. A. R.; Aghanim, N.; Angelakis, E.; Arnaud, M.; Ashdown, M.; Aumont, J.; Baccigalupi, C.; Balbi, A.; Banday, A. J.; Barreiro, R. B.; Bartlett, J. G.; Battaner, E.; Benabed, K.; Benoît, A.; Bernard, J.-P.; Bersanelli, M.; Bhatia, R.; Bonaldi, A.; Bonavera, L.; Bond, J. R.; Borrill, J.; Bouchet, F. R.; Bucher, M.; Burigana, C.; Cabella, P.; Cappellini, B.; Cardoso, J.-F.; Catalano, A.; Cayón, L.; Challinor, A.; Chamballu, A.; Chary, R.-R.; Chen, X.; Chiang, L.-Y.; Christensen, P. R.; Clements, D. L.; Colombi, S.; Couchot, F.; Coulais, A.; Crill, B. P.; Cuttaia, F.; Danese, L.; Davies, R. D.; Davis, R. J.; de Bernardis, P.; de Gasperis, G.; de Rosa, A.; de Zotti, G.; Delabrouille, J.; Delouis, J.-M.; Désert, F.-X.; Dickinson, C.; Donzelli, S.; Doré, O.; Dörl, U.; Douspis, M.; Dupac, X.; Efstathiou, G.; Enßlin, T. A.; Finelli, F.; Forni, O.; Frailis, M.; Franceschi, E.; Fuhrmann, L.; Galeotta, S.; Ganga, K.; Giard, M.; Giardino, G.; Giraud-Héraud, Y.; González-Nuevo, J.; Górski, K. M.; Gratton, S.; Gregorio, A.; Gruppuso, A.; Harrison, D.; Henrot-Versillé, S.; Herranz, D.; Hildebrandt, S. R.; Hivon, E.; Hobson, M.; Holmes, W. A.; Hovest, W.; Hoyland, R. J.; Huffenberger, K. M.; Huynh, M.; Jaffe, A. H.; Juvela, M.; Keihänen, E.; Keskitalo, R.; Kisner, T. S.; Kneissl, R.; Knox, L.; Krichbaum, T. P.; Kurki-Suonio, H.; Lagache, G.; Lähteenmäki, A.; Lamarre, J.-M.; Lasenby, A.; Laureijs, R. J.; Lavonen, N.; Lawrence, C. R.; Leach, S.; Leahy, J. P.; Leonardi, R.; León-Tavares, J.; Linden-Vørnle, M.; López-Caniego, M.; Lubin, P. M.; Macías-Pérez, J. F.; Maffei, B.; Maino, D.; Mandolesi, N.; Mann, R.; Maris, M.; Marleau, F.; Martínez-González, E.; Masi, S.; Massardi, M.; Matarrese, S.; Matthai, F.; Mazzotta, P.; Meinhold, P. R.; Melchiorri, A.; Mendes, L.; Mennella, A.; Mingaliev, M.; Miville-Deschênes, M.-A.; Moneti, A.; Montier, L.; Morgante, G.; Mortlock, D.; Munshi, D.; Murphy, A.; Naselsky, P.; Natoli, P.; Nestoras, I.; Netterfield, C. B.; Nieppola, E.; Nørgaard-Nielsen, H. U.; Noviello, F.; Novikov, D.; Novikov, I.; Osborne, S.; Pajot, F.; Paladini, R.; Partridge, B.; Pasian, F.; Patanchon, G.; Pearson, T. J.; Perdereau, O.; Perotto, L.; Perrotta, F.; Piacentini, F.; Piat, M.; Pierpaoli, E.; Plaszczynski, S.; Platania, P.; Pointecouteau, E.; Polenta, G.; Ponthieu, N.; Poutanen, T.; Prézeau, G.; Procopio, P.; Prunet, S.; Puget, J.-L.; Rachen, J. P.; Reach, W. T.; Rebolo, R.; Reinecke, M.; Renault, C.; Ricciardi, S.; Riller, T.; Riquelme, D.; Ristorcelli, I.; Rocha, G.; Rosset, C.; Rowan-Robinson, M.; Rubiño-Martín, J. A.; Rusholme, B.; Sajina, A.; Sandri, M.; Savolainen, P.; Scott, D.; Seiffert, M. D.; Sievers, A.; Smoot, G. F.; Sotnikova, Y.; Starck, J.-L.; Stivoli, F.; Stolyarov, V.; Sudiwala, R.; Sygnet, J.-F.; Tammi, J.; Tauber, J. A.; Terenzi, L.; Toffolatti, L.; Tomasi, M.; Tornikoski, M.; Torre, J.-P.; Tristram, M.; Tuovinen, J.; Türler, M.; Turunen, M.; Umana, G.; Ungerechts, H.; Valenziano, L.; Varis, J.; Vielva, P.; Villa, F.; Vittorio, N.; Wade, L. A.; Wandelt, B. D.; Wilkinson, A.; Yvon, D.; Zacchei, A.; Zensus, J. A.; Zonca, A.

    2011-12-01

    Planck's all-sky surveys at 30-857 GHz provide an unprecedented opportunity to follow the radio spectra of a large sample of extragalactic sources to frequencies 2-20 times higher than allowed by past, large-area, ground-based surveys. We combine the results of the Planck Early Release Compact Source Catalog (ERCSC) with quasi-simultaneous ground-based observations as well as archival data at frequencies below or overlapping Planck frequency bands, to validate the astrometry and photometry of the ERCSC radio sources and study the spectral features shown in this new frequency window opened by Planck. The ERCSC source positions and flux density scales are found to be consistent with the ground-based observations. We present and discuss the spectral energy distributions of a sample of "extreme" radio sources, to illustrate the richness of the ERCSC for the study of extragalactic radio sources. Variability is found to play a role in the unusual spectral features of some of these sources. Corresponding author: B. Partridge, e-mail: bpartrid@haverford.edu

  16. The EOLE experiment: Early results and current objectives

    NASA Technical Reports Server (NTRS)

    Morel, P.; Bandeen, W. R.

    1972-01-01

    The EOLE experiment with 480 constant level balloons released in the Southern Hemisphere is described. Each balloon floating freely at approximately the 200 mb level, is a precise tracer of the horizontal motion of air masses, the accuracy of which is limited only by the laminated structure of the stratospheric flow, within an RMS uncertainty of 1.5 m/sec. The balloons were found after 2 months to distribute at random over the whole hemisphere outside the tropics, irrespective of their original launching site. Early results of Eulerian and Lagrangian averages of the EOLE wind data are given for describing the mean 200 mb zonal and meridional circulations. The effect of the small scale eddies of two-dimensional turbulence has been studied with respect to the relative eddy diffusion of pairs of balloons and the relative dispersion of triangular clusters. New estimates of the RMS divergence of the 200 mb flow are given, together with their scale dependence which was found to be a logarithmic law.

  17. Open Surgical Treatment for Femoroacetabular Impingement in Patients over Thirty Years: Two Years Follow-up Results

    PubMed Central

    2015-01-01

    Purpose We report short term results of open surgical treatment for symptomatic femoroacetabular impingement (FAI) in patients over the age of 30 years. Materials and Methods Between May 2011 and June 2012, thirteen FAI hips (11 patients) with hip pain persisting longer than 6 months were treated by either surgical hip dislocation (SHD) or anterior mini-open. They were followed up for longer than 2 years. The 11 patients included 7 females and 4 males with a mean age of 45 (range, 33-60) years. They were clinically evaluated for modified Harris hip score (MHHS) and University of California at Los Angeles (UCLA) activity level. Their lateral center-edge angle, acetabular index, and alpha angle were measured and compared. Results Acetabuloplasties were performed for seven cases. Femoral osteochondroplasty was performed for all thirteen cases. At minimum follow-up of two year (range, 24-29 months), all patients had substantial relief in preoperative pain with improvement in range of motion. The median MHHS was significantly (P<0.05) improved from 61 points preoperatively to 87 points at the last follow-up. The median UCLA activity level was 7 (range, 5-8) at last follow-up. Radiological indices improved. Two cases showed mild residual pain attributable to adhesion between capsule and reshaped femoral head-neck area. Conclusion Open surgical treatment of FAI was a reliable and effective treatment method in symptomatic FAIs for patients over the age of 30 years without advanced arthritic change of hip joint at short term follow-up.

  18. Randomized Controlled Trial of Forward-Planned Intensity Modulated Radiotherapy for Early Breast Cancer: Interim Results at 2 Years

    SciTech Connect

    Barnett, Gillian C.; Wilkinson, Jennifer S.; Moody, Anne M.; Wilson, Charles B.; Twyman, Nicola; Wishart, Gordon C.; Burnet, Neil G.; Coles, Charlotte E.

    2012-02-01

    Purpose: This single-center randomized trial was designed to investigate whether intensity-modulated radiotherapy (IMRT) reduces late toxicity in patients with early-stage breast cancer. Methods and Materials: The standard tangential plans of 1,145 nonselected patients were analyzed. The patients with inhomogeneous plans were randomized to a simple method of forward-planned IMRT or standard radiotherapy (RT). The primary endpoint was serial photographic assessment of breast shrinkage. Results: At 2 years, no significant difference was found in the development of any photographically assessed breast shrinkage between the patients randomized to the interventional or control group (odds ratio, 1.51; 95% confidence interval, 0.83-1.58; p = .41). The patients in the control group were more likely to develop telangiectasia than those in the IMRT group (odds ratio, 1.68; 95% confidence interval 1.13-2.40; p = .009). Poor baseline surgical cosmesis resulted in poor overall cosmesis at 2 years after RT. In patients who had good surgical cosmesis, those randomized to IMRT were less likely to deteriorate to a moderate or poor overall cosmesis than those in the control group (odds ratio, 0.63; 95% confidence interval, 0.39-1.03, p = .061). Conclusions: IMRT can lead to a significant reduction in telangiectasia at comparatively early follow-up of only 2 years after RT completion. An important component of breast induration and shrinkage will actually result from the surgery and not from the RT. Surgical cosmesis is an important determinant of overall cosmesis and could partially mask the longer term benefits of IMRT at this early stage.

  19. Robotic Esophagectomy for Cancer: Early Results and Lessons Learned.

    PubMed

    Cerfolio, Robert J; Wei, Benjamin; Hawn, Mary T; Minnich, Douglas J

    2016-01-01

    Minimally invasive esophagectomy with intrathoracic dissection and anastomosis is increasingly performed. Our objectives are to report our operative technique, early results and lessons learned. This is a retrospective review of 85 consecutive patients who were scheduled for minimally invasive Ivor Lewis esophagectomy (laparoscopic or robotic abdominal and robotic chest) for esophageal cancer. Between 4/2011 and 3/2015, 85 (74 men, median age: 63) patients underwent robotic Ivor Lewis esophageal resection. In all, 64 patients (75%) had preoperative chemoradiotherapy, 99% had esophageal cancer, and 99% had an R0 resection. There were no abdominal or thoracic conversions for bleeding. There was 1 abdominal conversion for the inability to completely staple the gastric conduit. The mean operative time was 6 hours, median blood loss was 35ml (no intraoperative transfusions), median number of resected lymph nodes was 22, and median length of stay was 8 days. Conduit complications (anastomotic leak or conduit ischemia) occurred in 6 patients. The 30 and 90-day mortality were 3/85 (3.5%) and 9/85 (10.6%), respectively. Initial poor results led to protocol changes via root cause analysis: longer rehabilitation before surgery, liver biopsy in patients with history of suspected cirrhosis, and refinements to conduit preparation and anastomotic technique. Robotic Ivor Lewis esophagectomy for cancer provides an R0 resection with excellent lymph node resection. Our preferred port placement and operative techniques are described. Disappointingly high thoracic conduit problems and 30 and 90-day mortality led to lessons learned and implementation of change which are shared. PMID:27568155

  20. Extrahepatic biliary atresia: preoperative assessment and surgical results in 47 consecutive cases.

    PubMed Central

    Psacharopoulos, H T; Howard, E R; Portmann, B; Mowat, A P

    1980-01-01

    Of 47 consecutive infants with extrahepatic biliary atresia, effective bile drainage with the return of the serum bilirubin concentration to normal, was achieved in 17 (38%). Direct bile duct-to-bowl anastomosis, attempted in 15 infants, produced bile drainage in only those 4 (9%) in whom bile could be seen within the bile duct remnants at laparotomy. 13 (45%) of 29 infants subjected to portoenterostomy (direct liver-to-bowel anastomosis) had satisfactory prolonged bile drainage with normal serum bilirubin values. Although a correct preoperative diagnosis was made in each case, in 3 (6%) the 72-hour faecal rose bengal 131I excretion was greater than 10% of the injected dose, and in 5 (11%) the hepatic histology did not indicate bile duct obstruction, showing that both investigations are necessary for preoperative diagnosis. Preoperative clinical, laboratory, and hepatic histological features in the 16 jaundice-free survivors showed no significant difference when compared with the 31 infants in whom surgery was successful. Cholangitis occurred in only 7 (43%) of 16 infants with satisfactory bile drainage and was easily controlled with antibiotic treatment. No cutaneous enterostomies were performed. In most survivors liver function tests remain abnormal, but the patients are symptom-free. While it is too early to predict a long-term prognosis for these children, our eldest survivors are healthy and show normal development. PMID:7436455

  1. AVASCULAR NECROSIS OF THE FEMORAL HEAD IN HIV-INFECTED PATIENTS: PRELIMINARY RESULTS FROM SURGICAL TREATMENT FOR CERAMIC-CERAMIC JOINT REPLACEMENT

    PubMed Central

    Cabrita, Henrique Amorim; Santos, Alexandre Leme de Godoy; Gobbi, Riccardo Gomes; Lima, Ana Lúcia Munhoz; Oliveira, Priscila Rosalba; Ejnisman, Leandro; Gurgel, Henrique Melo Campos; Uip, David; Camanho, Gilberto Luis

    2015-01-01

    Objectives: To evaluate the initial functional results and early complication rate of ceramic-ceramic total hip replacements among patients living with HIV who presented osteonecrosis of the femoral head. Method: Twelve HIV–positive patients with a diagnosis of osteonecrosis of the incongruent femoral head were evaluated using clinical and laboratory criteria and the WOMAC functional scale before and after treatment with joint replacement. Results: We observed that 83.3% of the subjects were taking protease inhibitors, 75% had dyslipidemia and 66.6% had lipodystrophy syndrome. The improvement over the evolution of the WOMAC score was statistically significant at six and twelve months after the operation, in comparison with the preoperative score. We did not observe complications secondary to this procedure. Conclusion: Total hip arthroplasty with a ceramic-ceramic implant for treating avascular necrosis of the hip is an appropriate surgical option for this portion of the population. It provides a significant initial functional improvement and a low early complication rate. PMID:27047876

  2. The Seismic Effect of Impacts on Asteroids: Early Modeling Results

    NASA Astrophysics Data System (ADS)

    Richardson, J. E.; Melosh, H. J.; Greenberg, R. J.

    2003-12-01

    Crater counts made from the NEAR spacecraft images of the asteroid 433 Eros have revealed a paucity of small craters on this small body. Seismic shaking from impacts has been cited as a potential means of small crater erasure, and we present early results from mathematical, hydrocode, and seismic waveform modeling used to investigate this hypothesis. The seismic effects of an impact on a small body can be divided into two categories: (1) surface shaking due to the passage of discrete seismic pulses shortly after impact, and (2) surface shaking due to reverberations following the dispersion of seismic energy throughout the body. Seismic pulse effects are magnified due to the very low surface gravity of these bodies, with relatively small impacts having global seismic effects. An impact producing a 1 km diameter crater on a 20 km diameter asteroid will generate surface accelerations of over 10 g (where g is the asteroid's surface gravitational acceleration) out to an angular radius of 50 deg from the impact site, more than 2 g accelerations over the remaining surface of the asteroid, with a secondary peak of 2-10 g accelerations near the antipode of the impact. In addition, due to their small size and potentially high seismic quality factors (Q > 3000, based upon the lunar seismic data), asteroids can experience seismic reverberations lasting for several minutes following an impact. These reverberations will cause additional surface shaking, primarily at the peak frequencies injected by the impact (1-200 Hz). Impacts which produce craters in the 0.1-1 km diameter range on a 20 km diameter asteroid are able to generate reverberations of better than 1 g vertical acceleration over the entire surface. This secondary shaking may thus contribute strongly to modification of the surface topography.

  3. Quality of life and self-esteem in patients submitted to surgical treatment of skin carcinomas: long-term results*

    PubMed Central

    Maciel, Paula Curitiba; Veiga-Filho, Joel; de Carvalho, Marcelo Prado; Fonseca, Fernando Elias Martins; Ferreira, Lydia Masako; Veiga, Daniela Francescato

    2014-01-01

    BACKGROUND Cancer is a multifactorial disease and skin carcinomas are the most common type of cancer. Assessing quality of life and self-esteem outcomes in skin cancer patients is important because these are indicators of the results of the treatment, translating how patients face their lives and their personal relationships. OBJECTIVE To assess the late impact of the surgical treatment of head and/or neck skin carcinomas on quality of life and self-esteem of the patients. METHODS Fifty patients with head or neck skin carcinomas were enrolled. Their age ranged between 30 and 75 years, 27 were men and 23 were women. Patients were assessed with regard to quality of life and self-esteem, preoperatively and five years postoperatively. Validated instruments were used: the MOS 36-item Short-form Health Survey (SF-36) and the Rosenberg Self-esteem/EPM-UNIFESP Scale. The Wilcoxon signed-rank test was used for the statistical analysis. RESULTS Twenty-two patients completed the five-year follow-up, 54.5% women and 45.5% men. Compared to the preoperative assessment, patients had an improvement in mental health (p=0.011) and in self-esteem (p=0.002). There was no statistical difference with regard to the other domains of the SF-36. CONCLUSION Patients submitted to surgical treatment of skin carcinoma improved mental health and self-esteem in the late postsurgical testing. PMID:25054746

  4. Surgical Correction of Posttraumatic Scapulothoracic Bursitis, Rhomboid Major Muscle Injury, Ipsilateral Glenohumeral Instability, and Headaches Resulting from Circus Acrobatic Maneuvers

    PubMed Central

    Skedros, John G.; Langston, Tanner D.; Phippen, Colton M.

    2015-01-01

    We report the case of a 28-year-old transgender (male-to-female) patient that had a partial tear of the rhomboid major tendon, scapulothoracic bursitis, and glenohumeral instability on the same side. These conditions resulted from traumatic events during circus acrobatic maneuvers. Additional aspects of this case that make it unique include (1) the main traumatic event occurred during a flagpole exercise, where the patient's trunk was suspended horizontally while a vertical pole was grasped with both hands, (2) headaches were associated with the periscapular injury and they improved after scapulothoracic bursectomy and rhomboid tendon repair, (3) surgical correction was done during the same operation with an open anterior capsular-labral reconstruction, open scapulothoracic bursectomy without bone resection, and rhomboid tendon repair, (4) a postoperative complication of tearing of the serratus anterior and rhomboid muscle attachments with recurrent scapulothoracic pain occurred from patient noncompliance, and (5) the postoperative complication was surgically corrected and ultimately resulted in an excellent outcome at the one-year final follow-up. PMID:26273484

  5. SURGICAL TREATMENT OF DISTAL RADIUS FRACTURES WITH A VOLAR LOCKED PLATE: CORRELATION OF CLINICAL AND RADIOGRAPHIC RESULTS

    PubMed Central

    Xavier, Claudio Roberto Martins; Dal Molin, Danilo Canesin; dos Santos, Rafael Mota Marins; dos Santos, Roberto Della Torre; Neto, Julio Cezar Ferreira

    2015-01-01

    Objectives: To analyze and correlate the clinical and radiographic results from patients with distal radius fractures who underwent surgical treatment with a fixed-angle volar locked plate. Methods: Sixty-four patients with distal radius fractures were evaluated. They all underwent surgical treatment with a volar locked plate for the distal radius, with a minimum of six months of postoperative follow-up. They underwent a physical examination that measured range of motion and grip strength, answered the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire and underwent radiographic examination. Results: In the physical examination on the patients, all the range-of-motion measurements were reduced. Grip strength measured in kgf was on average 85.8% of the strength on the unaffected side. The mean DASH score was 15.99. A significant relationship was found between lower DASH scores and losses of extension and grip strength. On the radiographs, the mean values in relation to the unfractured side were 84.0% for radial inclination, 85.4% for radial length and 86.8% for volar deviation of the radius. Loss of radial length was correlated with losses of extension and grip strength. PMID:27027046

  6. A PROSPECTIVE STUDY OF ALTERNATING OCCLUSION PRIOR TO SURGICAL ALIGNMENT FOR INFANTILE ESOTROPIA: ONE-YEAR POSTOPERATIVE MOTOR RESULTS

    PubMed Central

    Ing, Malcolm R; Norcia, Anthony; Stager, David; Black, Bradley; Hoffman, Robert; Mazow, Malcolm; Troia, Sebastian; Scott, William; Lambert, Scott

    2005-01-01

    Purpose Alternating occlusion prior to surgical alignment has been suggested by some strabismologists to possibly enhance the treatment of infantile esotropia. This report presents the data for 44 patients prospectively enrolled by random assignment to an alternating occlusion or no occlusion subgroup followed for 1 year postoperatively. Methods All patients were measured at entry into the study, at the time of surgery, and at 6 weeks and 1 year postoperatively. Alternating occlusion was full-time and symmetric for those with no amblyopia but asymmetric for those with amblyopia. The subgroup that did not receive alternating occlusion had occlusion for amblyopia only. Initial surgeries were performed between the ages of 6 and 13 months. Results The patients, as a whole, showed a significant increase of 9.14 prism diopters when followed for a mean of 4.2 months prior to initial surgery (P < .00027). Seventy-five percent of all patients were aligned by the initial surgery. Ninety-one percent of those patients aligned at 6 weeks were also aligned at the 1-year postoperative date. The results were similar for both the control group and the patients treated with alternating occlusion. Conclusion In our sample of patients, alternating occlusion does not detectably alter the increase in angle of deviation between the dates of entry and the date of the initial surgical alignment procedure, nor does it influence the postoperative alignment at 6 weeks or at 1 year. PMID:17057785

  7. Surgical options for the early-stage breast cancer: factors associated with patient choice and postoperative quality of life.

    PubMed

    Pusic, A; Thompson, T A; Kerrigan, C L; Sargeant, R; Slezak, S; Chang, B W; Kelzlsouer, K J; Manson, P N

    1999-10-01

    Patients with early-stage breast cancer have three surgical options: lumpectomy with radiotherapy, mastectomy alone, and mastectomy with breast reconstruction. Our objective was to compare women in these three groups with respect to demographics, preoperative counseling, postoperative body image, and quality of life. Women having undergone surgery for stage 1 or 2 breast cancer between 1990 and 1995 were selected by random sampling of hospital tumor registries and were mailed a self-administered questionnaire, which included the Medical Outcomes Survey Short Form 36. Patients were stratified into three mutually exclusive groups: lumpectomy with axillary node dissection and radiotherapy, modified radical mastectomy, and modified radical mastectomy with breast reconstruction. In total, 267 of 525 surveys were returned (50.9 percent). Compared with mastectomy patients, breast reconstruction patients were younger (p < 0.001), better educated (p = 0.001), and more likely Caucasian (p = 0.02). Among mastectomy patients, 54.9 percent recalled that lumpectomy had been discussed preoperatively and 39.7 percent recalled discussion of breast reconstruction. Post-operative comfort with appearance was significantly lower for mastectomy patients. The relationship between type of surgery and postoperative quality of life varied with age. Under 55, quality of life was lowest for mastectomy patients on all but two Medical Outcomes Survey Short Form 36 subscales. Over 55, quality of life was lowest for lumpectomy patients on all subscales (p < 0.05 for all subscales except social functioning and role-emotional). Treatment choice may be related to age, race, education, and preoperative counseling. Whereas the effect of breast cancer on a woman's life is complex and individual, the type of surgery performed is a significant variable, whose impact may be related to patient age. PMID:10513913

  8. Two-flap palatoplasty: description of the surgical technique and reporting of results at a single center.

    PubMed

    Koudoumnakis, Emmanouel; Vlastos, Ioannis M; Parpounas, Kostas; Houlakis, Michael

    2012-03-01

    Two-flap palatoplasty is commonly used to treat cleft palate defects, but only a few reports on outcomes have been published in the literature. We conducted a retrospective analysis of 257 cases of cleft palate treated with two-flap palatoplasty at a single center in Greece over a 13-year period. Our outcomes data included surgical complication rates, the results of speech assessments, midface development, and other parameters. We found a low rate of short- and long-term complications that required revision surgery, such as symptomatic fistula (5.4%) and velopharyngeal insufficiency (5.3%). Speech outcomes in relation to intelligibility, hypernasality, and nasal emissions were satisfactory in 70 to 86% of patients. Dental arch relationships, as estimated by the 5-Year-Olds Index, were judged to be either good or excellent in 62% of those evaluated. A considerable proportion of patients (45%) who had otitis media with effusion experienced a spontaneous resolution without the use of tympanostomy tubes 2 to 8 months after their operation. We conclude that two-flap palatoplasty is an effective procedure that warrants further attention. We describe the surgical technique in detail. Our technique includes a modified intravelar veloplasty that incorporates near-total muscle retropositioning. PMID:22430346

  9. Extensive necrotising fasciitis in a 4-day-old neonate: a successful outcome from modern dressings, intensive care and early surgical intervention.

    PubMed

    Sakata, Shinichiro; Das Gupta, Romi; Leditschke, J Fred; Kimble, Roy M

    2009-01-01

    Necrotising fasciitis (NF) is a fulminant and life-threatening soft tissue infection, which leads to vascular thrombosis and cutaneous ischemia. We present our experience with extensive necrotising fasciitis in a 4-day-old neonate and stress the importance of early diagnosis, modern dressings including negative pressure therapy, prompt surgical debridement and intensive care to improve the survival and cosmetic outcome of children with NF. PMID:18982332

  10. Evaluation of INPRES--Intraoperative Presentation of surgical planning and simulation results.

    PubMed

    Salb, Tobias; Brief, Jakob; Burgert, Oliver; Gockel, Tilo; Hassfeld, Stefan; Muehling, Joachim; Dillmann, Ruediger

    2003-01-01

    In this paper we present fundamental results of the first evaluation of INPRES in a laboratory environment. While the system itself--an HMD-based approach for intraoperative augmented reality in head and neck surgery--has been described elsewhere several times, this paper will focus on methods and outcome of recently accomplished test procedures. PMID:15455913

  11. Recurrent surgical site infection of the spine diagnosed by dual (18)F-NaF-bone PET/CT with early-phase scan.

    PubMed

    Shim, Jai-Joon; Lee, Jeong Won; Jeon, Min Hyok; Lee, Sang Mi

    2016-09-01

    We report a case of a 31-year-old man who showed recurrently elevated level of the serum inflammatory marker C-reactive protein (CRP) after spinal operation. He underwent (18)F-flurodeoxyglucose ((18)F-FDG) positron emission tomography/computed tomography (PET/CT) and dual (18)F-sodium-fluoride ((18)F-NaF) PET/CT with an additional early-phase scan to find a hidden inflammation focus. Only mildly increased (18)F-FDG was found at the surgical site of T11 spine on (18)F-FDG PET/CT. In contrast, dual (18)F-NaF bone PET/CT with early-phase scan demonstrated focal active inflammation at the surgical site of T11 spine. After a revision operation of the T11 spine, serum CRP level decreased to the normal range without any symptom or sign of inflammation. Inflammatory focus in the surgical site of the spine can be detected with using dual (18)F-NaF bone PET/CT scan with early-phase scan. PMID:27388912

  12. [Surgical treatment of concomitant strabism in children younger than 15 years. Results 6 weeks after surgery].

    PubMed

    Haugen, O H; Støle, M P

    1995-02-20

    In order to evaluate the short-term results we carried out a retrospective study on 104 children who had been operated on in 1993 for concomitant convergent (n = 74) and divergent (n = 30) strabismus. Six weeks after the operation an alignment within 0-10 delta was achieved in 64% of the convergent children and 44% of the divergent children. When we evaluated the subgroups of children with convergent strabismus we found a postoperative alignment within 0-10 delta in 54% of the patients with strabismus from before six months of age (infantile esotropia), and in 93% of the children in whom the strabismus was present from after two years of age. In the total material we could demonstrate an improvement in binocular function in 17%. Based on a total evaluation we consider that 80% obtained a good postoperative result. We believe that continual, computer-based evaluation of the strabismus patients would be a valuable tool to further improve our results. PMID:7900114

  13. The surgical treatment of chronic intestinal ischemia: results of a recent series.

    PubMed

    Illuminati, G; Caliò, F G; D'Urso, A; Papaspiropoulos, V; Mancini, P; Ceccanei, G

    2004-04-01

    Due to the rarity of the condition, large and prospective series defining the optimal method of digestive arteries revascularization, for the treatment of chronic intestinal ischemia, are lacking. The aim of this consecutive sample clinical study was to test the hypothesis that flexible application of different revascularization methods, according to individual cases, will yield the best results in the management of chronic intestinal ischemia. Eleven patients, of a mean age of 56 years, underwent revascularization of 11 digestive arteries for symptomatic chronic mesenteric occlusive disease. Eleven superior mesenteric arteries and one celiac axis were revascularized. The revascularization techniques included retrograde bypass grafting in 7 cases, antegrade bypass grafting in 2, percutaneous arterial angioplasty in 1, and arterial reimplantation in one case. The donor axis for either reimplantation or bypass grafting was the infrarenal aorta in 4 cases, an infrarenal Dacron graft in 4, and the celiac aorta in one case. Grafting materials included 5 polytetrafluoroethylene (PTFE) and 3 Dacron grafts. Concomitant procedures included 3 aorto-ilio-femoral grafts and one renal artery revascularization. Mean follow-up duration was 31 months. There was no operative mortality. Cumulative survival rate was 88.9% at 36 months (SE 12.1%). Primary patency rate was 90% at 36 months (SE 11.6%). The symptom free rate was 90% at 36 months (SE 11.6%). Direct reimplantation, antegrade and retrograde bypass grafting, all allow good mid-term results: the choice of the optimal method depends on the anatomic and general patient's status. Associated infrarenal and renal arterial lesions can be safely treated in the same time of digestive revascularization. Angioplasty alone yields poor results and should be limited to patients at poor risk for surgery. PMID:15154575

  14. Early surgical and functional outcomes comparison of the supercapsular percutaneously-assisted total hip and traditional posterior surgical techniques for total hip arthroplasty: protocol for a randomized, controlled study

    PubMed Central

    Cronin, Michael D.; Gofton, Wade; Erwin, Lindsey; Chow, James

    2015-01-01

    Background Total hip arthroplasty (THA) is one of the most commonly performed and successful orthopaedic surgeries. While the long-term success of THA is well documented, there is still significant room for improving patient speed of recovery and return to activities. The surgical technique used during THA has the potential to affect these early outcomes. Methods The described design is a single center, prospective, randomized, controlled study. Subjects will be randomized to receive THA using either the supercapsular percutaneously-assisted total hip (SuperPath) or traditional posterior surgical techniques. Subjects will be evaluated using Timed Up and Go (TUG), Timed Stair Climb (TSC), Hip Dysfunction and Osteoarthritis Outcome Score (HOOS), and Visual Analog Scale (VAS) for pain level estimation preoperatively, during the hospital stay, and at 2, 6 weeks, and 100 days post-discharge. Other endpoints to be evaluated include: length of stay (LOS); discharge status; transfusion rates; readmission rates; complication rates; operative time; date returned to work; and acetabular component anteversion and inclination angles. Discussion The described study will determine the effect of a tissue-sparing surgical technique on short term subject recovery following THA in comparison to the most commonly used technique in clinical practice. PMID:26734645

  15. [Results of the surgical treatment of bridge callus through silastic membrane interposition].

    PubMed

    Zilch, H

    1979-01-01

    A report on 5 cases with successful treatment of a posttraumatic synostosis of radius and ulna by resection and interposition of a silastic-membrane is presented. This membrane has to ensheath one of the forearm bones for at least half of its circumference and it is fixed partially with Dexon sutures. During operation it is necessary to confirm this fixation of the membrane, which must be unchanged after rotation of the forearm. The range of movement reached 4 years after operation was about 120 degrees (100-130 degrees) on an average. A better result can only be expected by an osteotomy of the radius and correction of its position. PMID:554848

  16. Preoperative evaluation, surgical procedure, follow up and results of 150 cochlear implantations

    PubMed Central

    Kyriafinis, G; Vital, V; Psifidis, A; Constantinidis, J; Nikolaou, A; Hitoglou-Antoniadou, M; Kouloulas, A

    2007-01-01

    Background: The cochlear implantation is among the most important achievements of medicine and biotechnology in the last 20 years, because it allows individuals who had never heard or had lost their hearing to perceive sound and improve their quality of life. Selection criteria for candidates are strict and are evaluated in each individual by a scientific committee specially trained for implantations which includes Ear Nose and Throat (ENT) surgeon, audiologist, psychiatrist and speech therapist. Patients and methods: In our department, the first cochlear implantation was performed in 1995. During the last ten years more than 250 individuals have been evaluated due to profound hearing loss and 170 of them were found to be suitable candidates for cochlear implantation. One hundred and fifty (150) have already been operated and most of them are children with congenital hearing loss. No major or permanent complications were recorded in any of our 150 patients. Activation and fitting/mapping of the cochlear implant is initiated three weeks post-operatively. Regular follow- up and mapping of the implant are held, more frequently in children, along with specialized speech therapy. Each new mapping is evaluated according to the record of the patient with regard to the acoustic perception of sounds and speech and the discrimination of individual elements of phonation based on a protocol that we have created for the needs of Greek language. Results: Speech discrimination (AHEPA Hospital protocol), before the Implantation, at the activation of the cochlear implant and till 4 years of the follow-up showed that in our patients, we obtained better and faster results in post-speech acquisition adults with recent or chronic deafness and in children with congenital deafness operated before the 5th year of age, who underwent special preoperative speech therapy programme, fact which is in agreement with current literature. Patient satisfaction evaluated by "Sanders" psychometrics

  17. Abortion - surgical

    MedlinePlus

    Suction curettage; Surgical abortion; Elective abortion - surgical; Therapeutic abortion - surgical ... Surgical abortion involves dilating the opening to the uterus (cervix) and placing a small suction tube into the uterus. ...

  18. Early Results of Recently Introduced Laparoscopic Adjustable Gastric Banding Procedure for Morbid Obesity in Croatia

    PubMed Central

    Franjic, B. D.; Glavan, E.; Bekavac-Beslin, M.

    2006-01-01

    Introduction: Morbid obesity is a growing medical problem that has become of epidemic proportions. Various dietary and pharmaceutical approaches do not obtain acceptable long-term results. Surgery, however, especially gastric restriction, represents a viable therapeutic solution. Individuals with a body mass index (BMI) >40 kg/m2 or >35 kg/m2 with at least one severe comorbidity are considered morbidly obese and generally qualify for weight-loss surgery. Laparoscopic adjustable gastric banding (LAGB) is currently the most commonly performed procedure, because it is minimally invasive, does not cause metabolic complications, is completely reversible, and is adjustable. In Croatia, the first LAGB was performed in May 2004 at Clinical Hospital “Sestre Milosrdnice.” The aim of this report is to illustrate a newly performed surgical treatment and its results for morbid obesity in Croatia. Methods: Within a 12-month period, the adjustable gastric band was implanted in 15 morbidly obese patients (female, 8; male, 7; mean age, 46.67 years; range, 26 –59 years). The so-called “pars flaccida” technique was used. Results: One operation required conversion to laparotomy due to a gastric lesion, and 1 laparoscopy operation was terminated due to massive postoperative adhesions. The average duration of surgery was 90±30 minutes. Mean length of stay was 4.9 days (range, 3–9). An average BMI at the time of surgery was 52.21 kg/m2 (range, 45.29 to 61.59; mean body weight was 155.58 kg (range, 127 to 204). Throughout 1-, 3-, 6-, 9-, and 12-month follow-ups, an average of 18.71%, 25.06%, 34.37%, 41.23%, and 47.32% of excessive weight loss (EWL) was observed. Good tolerance and a low complication rate were noted. Conclusion: LAGB resulted in good early results and a low complication rate. LAGB appears to be a quality surgical procedure for the management of morbid obesity. PMID:17575750

  19. Giant retinal tears. Surgical techniques and results using perfluorodecalin and silicone oil tamponade.

    PubMed

    Mathis, A; Pagot, V; Gazagne, C; Malecaze, F

    1992-01-01

    Intraoperative use of perfluorocarbon liquids in the management of giant retinal tears was introduced about 4 years ago. Twenty-four patients were operated on for giant retinal tears using perfluorodecalin and silicone oil tamponade. All patients underwent pars plana vitrectomy, unfolding of the giant retinal tears by perfluorodecalin, perfluorodecalin-silicone oil exchange, and endophotocoagulation. The lens was removed in 10 of 14 phakic patients, and encircling scleral buckle was placed in 18 cases. Twenty-three of 24 retinas remained successfully attached with a minimum of 6 months of follow-up. Short-term results of intraoperative use of perfluorodecalin and silicone oil tamponade in the management of giant retinal tears are encouraging. Perfluorodecalin offers the advantage of low cost compared with other perfluoro-carbon liquids like perfluoro-n-octane. The exchange with silicone oil offers the advantages of easy removal of perfluorodecalin and absence of posterior slippage of the retinal tear. PMID:1455087

  20. Anconeus muscle transposition for failed surgical treatment of tennis elbow: preliminary results.

    PubMed

    Degreef, Ilse; Van Raebroeckx, Antoon; De Smet, Luc

    2005-04-01

    The authors conducted a retrospective study on their first 10 patients treated with an anconeus muscle transposition after failed surgery for chronic lateral epicondylitis. All patients had initially been treated conservatively, and subsequently with a classical or percutaneous release of the common extensor origin. The secundary procedure involved wide excision of the common extensor origin, débridement of the lateral epicondyle and rotation of the anconeus muscle into the defect. At follow-up the results were excellent in 3 patients, good in 4 and poor in 3. This appears as a valid salvage procedure for lateral epicondylitis, since the operation was performed as a second or even a third approach. PMID:16152847

  1. Surgical treatment of chronic achilles tendinopathy: long-term results of the endoscopic technique.

    PubMed

    Maquirriain, Javier

    2013-01-01

    Surgery has long been established as a valid alternative for chronic Achilles tendinopathies that have failed conservative treatment. Endoscopic procedures have shown satisfactory preliminary results for managing such injuries. The aim of the present study was to evaluate the long-term clinical outcomes of endoscopic surgery in patients with chronic midportion Achilles tendinopathy. We evaluated 27 endoscopic procedures in 24 patients (mean age 45.5 ± 8.9 years; 12 males and 12 females) with chronic Achilles tendinopathy and at least 5 (mean 7.7, range 5 to 14) years of follow-up. All ambulatory procedures consisted of paratenon debridement and longitudinal tenotomies. The clinical evaluation included 2 specific functional rating systems (the Achilles Tendon Scoring System and the Victorian Institute Sport Assessment-Achilles questionnaire) and a pain visual analog scale. Patient satisfaction with the procedure was assessed using a patient global assessment response to therapy Likert scale score. All patients had an improved clinical outcome at the final follow-up visit. Both scoring systems showed significant improvement in all clinical outcomes at the last follow-up visit. The Victorian Institute Sport Assessment-Achilles questionnaire score had improved from 37.0 ± 4.9 points preoperatively to 97.5 ± 12.1 points postoperatively (p = .0006). The Achilles Tendon Scoring System score had improved from 32.6 ± 13.1 points preoperatively to 97.2 ± 12.3 points postoperatively (p = .000006). The pain visual analog scale score averaged 0.2 ± 1.1, and the patient global assessment response to therapy score was 0.25 ± 0.71. The percentage of patients with an excellent patient global assessment response to therapy score was 85.1%. Two postoperative problems were reported (7.4%): a delayed keloid lesion and a seroma with chronic fistula. The infection rate and systemic complication rate were 0%. In conclusion, endoscopic surgery provided a high rate of excellent

  2. Stage II endometrial carcinoma. Results and complications of a combined radiotherapeutic-surgical approach

    SciTech Connect

    Larson, D.M.; Copeland, L.J.; Gallager, H.S.; Kong, J.P.; Wharton, J.T.; Stringer, C.A.

    1988-04-15

    Since one third of the patients with Stage II endometrial carcinoma have occult extrauterine pelvic metastases at diagnosis, adequate treatment must include the pelvic lymph nodes and parametria. Eighty-three patients with Stage II endometrial carcinoma were treated between January 1964 and December 1983. Sixty-nine patients (83%) received combined whole-pelvic irradiation and surgery, five (6%) had surgery alone and nine (11%) had radiotherapy alone. Five-year actuarial survival rates were 67%, 60%, and 38%, respectively. No pelvic recurrence occurred in the 69 patients who received the combined therapy, and there was no vaginal recurrence in the 80 patients treated with intracavity radium. There was a significantly lower incidence of pelvic lymph node metastases (P = 0.03) in patients treated with preoperative irradiation. The median time to recurrence was 17 months, with 67% of the recurrences diagnosed before 2 years, and 88% within 5 years. Ten patients (12%) incurred severe complications and three died as a result. Whole-pelvic irradiation, intracavity radium, and hysterectomy are effective treatment for occult pelvic and vaginal disease.

  3. Surgical results and protocols in the spectrum of tetralogy of Fallot.

    PubMed Central

    Kirklin, J W; Blackstone, E H; Kirklin, J K; Pacifico, A D; Aramendi, J; Bargeron, L M

    1983-01-01

    Between 1967 and July 1982, 1103 operations were performed for the tetralogy of Fallot of all types with 116 (10.5%) hospital deaths. Eighty-eight hospital deaths (10.5%) occurred in the 836 patients undergoing repair. The incremental risk factors for hospital death after repair include pulmonary arterial problems (p = 0.0002), major associated cardiac anomalies (p less than 0.0001), small size (young age) (p less than 0.0001), and more than one previous operation (p = 0.0004). Absent pulmonary valve is a risk factor (p = 0.04). In patients with pulmonary stenosis, the hospital mortality has decreased with time (p = 0.08), but the incremental risk of a high hematocrit (p = 0.0003) and of transannular patching (p = 0.05) has persisted. In the current era, the risk of repair in patients with pulmonary stenosis is estimated to be 1.6% (70% confidence limits [CL] 0.7% to 3.5%) at age 5 years, and at age 12 months to be 4.1% (CL 2.7% to 6.3%) without a transannular patch and 7.7% (CL a5.3% to 11%) with one. When pulmonary atresia is present, the probability of hospital death after repair when a valved extracardiac conduit is used is estimated to be lowest (5%; CL 2% to 8%) between 5 1/2 and 16 years of age. No deaths occurred among 53 patients with pulmonary stenosis receiving a primary palliative Blalock-Taussig or Gore-Tex shunt, and six deaths (12%) occurred in 51 patients with pulmonary atresia. Serious interim complications (sudden death, brain abscess) after these shunts occurred in two (1.9%; CL 0.6% to 4.5%) of the patients operated on. No iatrogenic pulmonary arterial problems have been recognized. Protocols based on these results are presented. Many of these selective recommendations may become unnecessary if the damaging effects of cardiopulmonary bypass are overcome by future research. Images Fig. 2. Fig. 3. PMID:6615049

  4. Indications, surgical technique, and long-term functional results of colon interposition or bypass.

    PubMed Central

    DeMeester, T R; Johansson, K E; Franze, I; Eypasch, E; Lu, C T; McGill, J E; Zaninotto, G

    1988-01-01

    Over a 17-year period, 92 patients with esophageal disease underwent colon interposition or bypass, with each operation performed by the same surgeon. The indication was cure of cancer in 20 patients, relief of dysphagia in 55 (cancer in 17 patients and benign in 38), loss of gastrointestinal (G.I.) continuity in ten, and tracheoesophageal fistula in seven patients (malignant in five, benign in 2). The thirty-day operative mortality rate was 5%, and the hospital mortality rate was 9%. Graft necrosis occurred in seven of 92 patients, four of whom later underwent a successful second reconstruction. Thirteen patients required subsequent revisional surgery. In 85 patients, the left colon based on the inferior mesenteric artery was used, and in seven, the right colon was used. Technical insights were gained to help preserve the blood supply to the graft and improve its function in transporting food. Thirty-four patients were available for interview 2-17 years after operation (median of 5 years) 28 of whom had benign disease, and six of whom had malignant disease); 82% of the patients felt they were cured of their preoperative symptoms, 18% improved, and none worsened. Eighty-eight per cent of the patients were able to receive an unrestricted diet. All patients except one were satisfied with the results of surgery, and, asked what they would do if they had to make the choice again, all responded that they would have the operation. Twenty-six of the interviewed patients had their eating ability evaluated with a test meal and the transit time of a liquid and solid barium bolus measured. Compared to controls, patients with colon interpositions consumed a smaller capacity meal over a longer period of time and were not dependent on liquids to flush the food through the colon graft. A colon interposition provides good quality of deglutition, is very durable, and is the organ of choice for patients who require an esophageal substitute and are potential candidates for long

  5. Is Lesional Stability in Vitiligo More Important Than Disease Stability for Performing Surgical Interventions? Results from a Multicentric Study

    PubMed Central

    Majid, Imran; Mysore, Venkataram; Salim, Thurakkal; Lahiri, Koushik; Chatterji, Manas; Khunger, Niti; Talwar, Suresh; Sachhidanand, S; Barua, Shyamanta

    2016-01-01

    Background: Ensuring stability of the disease process is essential for undertaking surgical intervention in vitiligo. However, there is no consensus regarding the minimum duration of stability or the relative importance of disease and lesional stability in selecting patients for vitiligo grafting. Aim: This multicentric study aims to assess the relative importance of lesional and disease stability on selecting patients for vitiligo grafting. Materials and Methods: One hundred seventy patients were recruited into the study and divided into two groups: Group A with lesional stability of >1 year but overall disease stability of only 6-11 months and Group B with overall disease stability of >1 year. Patients underwent either tissue or cellular vitiligo grafting on the selected lesions and the repigmentation achieved was scored from 0 (no repigmentation) to 6 (100% repigmentation). Repigmentation achieved on different sites of the body was compared between the two groups. Adverse effects at both the donor and the recipient sites were also compared. Results: Of the 170 patients who were enrolled, 82 patients were placed in Group A and 88 patients in Group B. Average repigmentation achieved (on scale of 0 to 6) was 3.8 and 4.04 in Group A and Group B, respectively. In Group A, ≥90% repigmentation was achieved in 36.6% (30/82) patients, while 37.5% (33/88) achieved similar results in Group B. Additionally, 47.6% (39/82) and 53.4% (47/88) of cases achieved partial repigmentation in Group A and Group B, respectively. Perigraft halo was the commonest adverse effect observed in both groups. Statistical analysis revealed no significant differences between the two groups with respect to the repigmentation achieved or adverse effects observed. Repigmentation achieved was the best on the face and neck area, while acral areas responded the least. Conclusions: Lesional stability seems to be as relevant as the overall disease stability in selecting patients for surgical

  6. Surgical treatment of GERD. Comperative study of WTP vs. Toupet fundoplication – results of 151 consecutive cases

    PubMed Central

    Wróblewski, Tadeusz; Nowosad, Małgorzata; Krawczyk, Marek

    2016-01-01

    Introduction Gastroesophageal reflux disease (GERD) is recognized as one of the most common disorders of the upper gastrointestinal tract (GIT). The best choice of management for advanced GERD is laparoscopic surgery. Aim To compare and evaluate the results of surgical treatment of GERD patients operated on using two different techniques. Material and methods Between 2001 and 2012, 353 patients (211 female and 142 male), aged 17–76 years (mean 44), underwent laparoscopic antireflux surgery. The study included patients who underwent a Toupet fundoplication or Wroblewski Tadeusz procedure (WTP). Results The mean age of the group was 47.77 years (17–80 years). Forty-nine (32.45%) patients had severe symptoms, 93 (61.58%) had mild symptoms and 9 (5.96%) had a single mild but intolerable sign of GERD. Eighty-six (56.95%) patients had a Toupet fundoplication and 65 (43.04%) had a WTP. The follow-up period was 18–144 months. The average operating time for Toupet fundoplication and the WTP procedure was 164 min (90–300 min) and 147 min (90–210 min), respectively. The perioperative mortality rate was 0.66%. The average post-operative hospitalization period was 5.4 days (2–16 post-operative days (POD) = Toupet) vs. 4.7 days (2–9 POD = WTP). No reoperations were performed. No major surgical complications were identified. Conclusions Wroblewski Tadeusz procedure due to a low percentage of post-operative complications, good quality of life of patients and a zero recurrence rate of hiatal hernia should be a method of choice. PMID:27458484

  7. Carotid Stenting with Distal Protection in High-Surgical-Risk Patients: One-Year Results of the ASTI Trial

    SciTech Connect

    Bosiers, Marc; Scheinert, Dierk; Mathias, Klaus; Langhoff, Ralf; Mudra, Harald; Diaz-Cartelle, Juan

    2015-04-15

    PurposeThis prospective, multicenter, nonrandomized study evaluated the periprocedural and 1-year outcomes in high-surgical-risk patients with carotid artery stenosis treated with the Adapt Carotid Stent plus FilterWire EZ distal protection catheter (Boston Scientific Corporation, Natick, MA).Materials and MethodsThe study enrolled 100 patients (32 symptomatic, 63 asymptomatic, 5 unknown) at high risk for carotid endarterectomy due to prespecified anatomical criteria and/or medical comorbidities. Thirty-day and 1-year follow-up included clinical evaluation, carotid duplex ultrasound, and independent neurologic and NIH stroke scale assessments. One-year endpoints included the composite rate of major adverse events (MAE), defined as death, stroke, and myocardial infarction (MI) and the rates of late ipsilateral stroke (31–365 days), target lesion revascularization, and in-stent restenosis.ResultsOf the 100 enrolled patients, technical success was achieved in 90.9 % (90/99). The 30-day MAE rate (5.1 %) consisted of major stroke (2.0 %) and minor stroke (3.1 %); no deaths or MIs occurred. The 1-year MAE rate (12.2 %) consisted of death, MI, and stroke rates of 4.4, 3.3, and 8.9 %, respectively. Late ipsilateral stroke (31–365 days) rate was 1.1 %. Symptomatic patients had higher rates of death (11.1 vs. 1.7 %) and MI (7.4 vs. 1.7 %), but lower rates of major (7.4 vs. 10.0 %) and minor stroke (0.0 vs. 6.7 %), compared with asymptomatic patients.ConclusionResults through 1 year postprocedure demonstrated that carotid artery stenting with Adapt Carotid Stent and FilterWire EZ is safe and effective in high-risk-surgical patients.

  8. Aquarius Radiometer Performance: Early On-Orbit Calibration and Results

    NASA Technical Reports Server (NTRS)

    Piepmeier, Jeffrey R.; LeVine, David M.; Yueh, Simon H.; Wentz, Frank; Ruf, Christopher

    2012-01-01

    The Aquarius/SAC-D observatory was launched into a 657-km altitude, 6-PM ascending node, sun-synchronous polar orbit from Vandenberg, California, USA on June 10, 2011. The Aquarius instrument was commissioned two months after launch and began operating in mission mode August 25. The Aquarius radiometer meets all engineering requirements, exhibited initial calibration biases within expected error bars, and continues to operate well. A review of the instrument design, discussion of early on-orbit performance and calibration assessment, and investigation of an on-going calibration drift are summarized in this abstract.

  9. Myocardial Viability and Impact of Surgical Ventricular Reconstruction on Outcomes of Patients with Severe Left Ventricular Dysfunction Undergoing Coronary Artery Bypass Surgery: Results of the Surgical Treatment for Ischemic Heart Failure (STICH) Trial

    PubMed Central

    Holly, Thomas A.; Bonow, Robert O.; Arnold, J. Malcolm O.; Oh, Jae K.; Varadarajan, Padmini; Pohost, Gerald M.; Haddad, Haissam; Jones, Robert H.; Velazquez, Eric J.; Birkenfeld, Bozena; Asch, Federico M.; Malinowski, Marcin; Barretto, Rodrigo; Kalil, Renato A.K.; Berman, Daniel S.; Sun, Jie-Lena; Lee, Kerry L.; Panza, Julio A.

    2014-01-01

    Objective In the Surgical Treatment for Ischemic Heart Failure (STICH) trial, surgical ventricular reconstruction plus coronary artery bypass surgery was not associated with a reduction in the rate of death or cardiac hospitalization compared to bypass alone. We hypothesized that the absence of viable myocardium identifies patients with coronary artery disease and left ventricular dysfunction who have a greater benefit with coronary artery bypass graft surgery and surgical ventricular reconstruction compared to bypass alone. Methods Myocardial viability was assessed by single photon computed tomography in 267 of the 1,000 patients randomized to bypass or bypass plus surgical ventricular reconstruction in STICH. Myocardial viability was assessed on a per patient basis as well as regionally based on pre-specified criteria. Results At 3 years, there was no difference in mortality or the combined outcome of death or cardiac hospitalization between those with and those without viability, and there was no significant interaction between the type of surgery and global viability status with respect to mortality or death plus cardiac hospitalization. Furthermore, there was no difference in mortality or death plus cardiac hospitalization between those with and without anterior wall or apical scar, and no significant interaction between the presence of scar in these regions and the type of surgery with respect to mortality. Conclusion In patients with coronary artery disease and severe regional left ventricular dysfunction, assessment of myocardial viability does not identify patients who will derive a mortality benefit from adding surgical ventricular reconstruction to coronary artery bypass graft surgery. PMID:25152476

  10. Similar Clinical and Surgical Outcomes Achieved with Early Compared to Late Anti-TNF Induction in Mild-to-Moderate Ulcerative Colitis: A Retrospective Cohort Study

    PubMed Central

    Fedorak, Darryl K.; Dieleman, Levinus A.; Halloran, Brendan P.

    2016-01-01

    Background. Biologic agents targeting tumor necrosis factor alpha are effective in the management of ulcerative colitis (UC), but their use is often postponed until after failure of other treatment modalities. Objectives. We aim to determine if earlier treatment with infliximab or adalimumab alters clinical and surgical outcomes in UC patients. Methods. A retrospective cohort study was conducted evaluating UC outpatients treated with infliximab or adalimumab from 2003 to 2014. Patients were stratified by time to first anti-TNF exposure; early initiation was defined as starting treatment within three years of diagnosis. Primary outcomes were colectomy, UC-related hospitalization, and clinical secondary loss of response. Kaplan-Meier analysis was used to assess time to the primary outcomes. Results. 115 patients were included (78 infliximab, 37 adalimumab). Median follow-up was 175.6 weeks (IQR 72.4–228.4 weeks). Fifty-seven (49.6%) patients received early anti-TNF therapy; median time to treatment in this group was 38.1 (23.3–91.0) weeks compared to 414.0 (254.0–561.3) weeks in the late initiator cohort (p < 0.0001). Patients treated with early anti-TNF therapy had more severe endoscopic disease at induction (mean Mayo endoscopy subscore 2.46 (SD ± 0.66) versus 1.86 (±0.67), p < 0.001) and trended towards increased risk of colectomy (17.5% versus 8.6%, p = 0.16) and UC-related hospitalization (43.9% versus 27.6%, p = 0.07). In multivariate regression analysis, early anti-TNF induction was not associated with colectomy (HR 2.02 [95% CI: 0.57–7.20]), hospitalization (HR 1.66 [0.84–3.30]), or secondary loss of response (HR 0.86 [0.52–1.42]). Conclusions. Anti-TNF therapy is initiated earlier in patients with severe UC but earlier treatment does not prevent hospitalization, colectomy, or secondary loss of response. PMID:27478817

  11. Lymphopenia and Elevated Blood C-Reactive Protein Levels at Four Days Postoperatively Are Useful Markers for Early Detection of Surgical Site Infection Following Posterior Lumbar Instrumentation Surgery

    PubMed Central

    Shigematsu, Hideki; Koizumi, Munehisa; Nakajima, Hiroshi; Okuda, Akinori; Morimoto, Yasuhiko; Masuda, Keisuke; Tanaka, Yasuhito

    2016-01-01

    Study Design Case-control study. Purpose To identify the characteristics of candidate indexes for early detection of surgical site infection (SSI). Overview of Literature SSI is a serious complication of spinal instrumentation surgery. Early diagnosis and treatment are crucial for the welfare of the patient postoperation. Methods We retrospectively reviewed laboratory data of patients who underwent posterior lumbar instrumentation surgery for degenerative spine disease. The sensitivity and specificity of six laboratory markers for early detection of SSI were calculated: greater elevation of the white blood cell count at day 7 than at day 4 postoperatively, greater elevation of the C-reactive protein (CRP) level at day 7 than at day 4 postoperatively, a CRP level of >10 mg/dL at 4 days postoperatively, neutrophil percentage of >75% at 4 days postoperatively, a lymphocyte percentage of <10% at 4 days postoperatively, and a lymphocyte count of <1,000/µL at 4 days postoperatively. Statistical analysis was via Fisher's exact test and a p-value of <0.05 was considered significant. Results In total, 85 patients were enrolled. Of these, five patients developed deep SSI. The sensitivity and specificity of each index were as follows: index 1, 20.0% and 77.5%; index 2, 20.0% and 83.8%; index 3, 40.0% and 97.5%; index 4, 40.0% and 86.3%; index 5, 0% and 96.3%; and index 6, 80.0% and 80.0%. A significant difference was noted for indexes 3 and 6. Conclusions A CRP level of >10 mg/dL at 4 days postoperatively would be useful for definitive diagnosis of SSI, and a lymphocyte count of <1,000/µL at 4 days postoperatively would be a useful screening test for SSI. Although laboratory markers for early detection of SSI have been frequently reported, we believe that it is important to understand the characteristics of each index for a precise diagnosis. PMID:27114760

  12. The bonebridge as a transcutaneous bone conduction hearing system: preliminary surgical and audiological results in children and adolescents.

    PubMed

    Hassepass, Frederike; Bulla, Stefan; Aschendorff, Antje; Maier, Wolfgang; Traser, Louisa; Steinmetz, Christian; Wesarg, Thomas; Arndt, Susan

    2015-09-01

    The Bonebridge (®) (BB, Med-El) is a newly designed transcutaneous active bone conductive implant with functional outcome similar to percutaneous bone-anchored hearing systems (BAHS). It is currently approved only for patients ≥18 years. Since the BB allows the skin to remain intact and therefore should be able to overcome some of the issues related to percutaneous BAHS including skin reactions, wound infection and implant extrusion, it would be especially attractive for use in children. We present a preliminary series of the first three cases of BB implantation in children/adolescents (10-16 years). Two subjects were affected by conductive hearing loss (CHL) and one subject by single-sided deafness (SSD). The surgical procedure with transmastoid approach was completed in all cases without complications. Both subjects with CHL showed an increase in speech perception thresholds in quiet from preoperative unaided to 6 months postoperatively with BB of 37 dB, respectively, of 12 dB. The adolescent with SSD attained -3.1 dB unaided vs. -5.6 dB with the BB in the "speech and noise from the front" presentation and +0.5 unaided vs. -5.0 dB with the BB in the "speech from the unilateral deaf side/noise from the normal hearing side" presentation using the adaptive Oldenburg Sentence Test. The results show a straightforward surgical procedure and satisfactory functional gain after BB implantation also in children/adolescents. BB implantation in patients ≤18 years is currently an "off-label use" so that detailed information about alternative treatment options, operation risks and the lack of approval for use in children is essential. PMID:24970289

  13. A Better 9th Grade: Early Results from an Experimental Study of the Early College High School Model

    ERIC Educational Resources Information Center

    SERVE Center at University of North Carolina at Greensboro, 2010

    2010-01-01

    To increase the number of students graduating from high school prepared for college, North Carolina has established the largest number of Early College High Schools (ECHS) in the United States. Early results from a rigorous, independent study of North Carolina's initiative have shown that these schools have substantial positive impacts on student…

  14. Photodynamic therapy (PDT) in early central lung cancer: a treatment option for patients ineligible for surgical resection

    PubMed Central

    Moghissi, Keyvan; Dixon, Kate; Thorpe, James Andrew Charles; Stringer, Mark; Oxtoby, Christopher

    2007-01-01

    Objectives To review the Yorkshire Laser Centre experience with bronchoscopic photodynamic therapy (PDT) in early central lung cancer in subjects not eligible for surgery and to discuss diagnostic problems and the indications for PDT in such cases. Methods Of 200 patients undergoing bronchoscopic PDT, 21 had early central lung cancer and were entered into a prospective study. Patients underwent standard investigations including white light bronchoscopy in all and autofluorescence bronchoscopy in 12 of the most recent cases. Indications for bronchoscopic PDT were recurrence/metachronous endobronchial lesions following previous treatment with curative intent in 10 patients (11 lesions), ineligibility for surgery because of poor cardiorespiratory function in 8 patients (9 lesions) and declined consent to operation in 3 patients. PDT consisted of intravenous administration of Photofrin 2 mg/kg followed by bronchoscopic illumination 24–48 h later. Results 29 treatments were performed in 21 patients (23 lesions). There was no procedure‐related or 30 day mortality. One patient developed mild skin photosensitivity. All patients expressed satisfaction with the treatment and had a complete response of variable duration. Six patients died at 3–103 months (mean 39.3), three of which were not as a result of cancer. Fifteen patients were alive at 12–82 months. Conclusion Bronchoscopic PDT in early central lung cancer can achieve long disease‐free survival and should be considered as a treatment option in those ineligible for resection. Autofluorescence bronchoscopy is a valuable complementary investigation for identification of synchronous lesions and accurate illumination in bronchoscopic PDT. PMID:17090572

  15. Planck early results. V. The Low Frequency Instrument data processing

    NASA Astrophysics Data System (ADS)

    Zacchei, A.; Maino, D.; Baccigalupi, C.; Bersanelli, M.; Bonaldi, A.; Bonavera, L.; Burigana, C.; Butler, R. C.; Cuttaia, F.; de Zotti, G.; Dick, J.; Frailis, M.; Galeotta, S.; González-Nuevo, J.; Górski, K. M.; Gregorio, A.; Keihänen, E.; Keskitalo, R.; Knoche, J.; Kurki-Suonio, H.; Lawrence, C. R.; Leach, S.; Leahy, J. P.; López-Caniego, M.; Mandolesi, N.; Maris, M.; Matthai, F.; Meinhold, P. R.; Mennella, A.; Morgante, G.; Morisset, N.; Natoli, P.; Pasian, F.; Perrotta, F.; Polenta, G.; Poutanen, T.; Reinecke, M.; Ricciardi, S.; Rohlfs, R.; Sandri, M.; Suur-Uski, A.-S.; Tauber, J. A.; Tavagnacco, D.; Terenzi, L.; Tomasi, M.; Valiviita, J.; Villa, F.; Zonca, A.; Banday, A. J.; Barreiro, R. B.; Bartlett, J. G.; Bartolo, N.; Bedini, L.; Bennett, K.; Binko, P.; Borrill, J.; Bouchet, F. R.; Bremer, M.; Cabella, P.; Cappellini, B.; Chen, X.; Colombo, L.; Cruz, M.; Curto, A.; Danese, L.; Davies, R. D.; Davis, R. J.; de Gasperis, G.; de Rosa, A.; de Troia, G.; Dickinson, C.; Diego, J. M.; Donzelli, S.; Dörl, U.; Efstathiou, G.; Enßlin, T. A.; Eriksen, H. K.; Falvella, M. C.; Finelli, F.; Franceschi, E.; Gaier, T. C.; Gasparo, F.; Génova-Santos, R. T.; Giardino, G.; Gómez, F.; Gruppuso, A.; Hansen, F. K.; Hell, R.; Herranz, D.; Hovest, W.; Huynh, M.; Jewell, J.; Juvela, M.; Kisner, T. S.; Knox, L.; Lähteenmäki, A.; Lamarre, J.-M.; Leonardi, R.; León-Tavares, J.; Lilje, P. B.; Lubin, P. M.; Maggio, G.; Marinucci, D.; Martínez-González, E.; Massardi, M.; Matarrese, S.; Meharga, M. T.; Melchiorri, A.; Migliaccio, M.; Mitra, S.; Moss, A.; Nørgaard-Nielsen, H. U.; Pagano, L.; Paladini, R.; Paoletti, D.; Partridge, B.; Pearson, D.; Pettorino, V.; Pietrobon, D.; Prézeau, G.; Procopio, P.; Puget, J.-L.; Quercellini, C.; Rachen, J. P.; Rebolo, R.; Robbers, G.; Rocha, G.; Rubiño-Martín, J. A.; Salerno, E.; Savelainen, M.; Scott, D.; Seiffert, M. D.; Silk, J. I.; Smoot, G. F.; Sternberg, J.; Stivoli, F.; Stompor, R.; Tofani, G.; Toffolatti, L.; Tuovinen, J.; Türler, M.; Umana, G.; Vielva, P.; Vittorio, N.; Vuerli, C.; Wade, L. A.; Watson, R.; White, S. D. M.; Wilkinson, A.

    2011-12-01

    We describe the processing of data from the Low Frequency Instrument (LFI) used in production of the Planck Early Release Compact Source Catalogue (ERCSC). In particular, we discuss the steps involved in reducing the data from telemetry packets to cleaned, calibrated, time-ordered data (TOD) and frequency maps. Data are continuously calibrated using the modulation of the temperature of the cosmic microwave background radiation induced by the motion of the spacecraft. Noise properties are estimated from TOD from which the sky signal has been removed using a generalized least square map-making algorithm. Measured 1/f noise knee-frequencies range from ~100 mHz at 30 GHz to a few tens of mHz at 70GHz. A destriping code (Madam) is employed to combine radiometric data and pointing information into sky maps, minimizing the variance of correlated noise. Noise covariance matrices required to compute statistical uncertainties on LFI and Planck products are also produced. Main beams are estimated down to the ≈-10dB level using Jupiter transits, which are also used for geometrical calibration of the focal plane. Corresponding author: A. Zacchei, e-mail: zacchei@oats.inaf.it

  16. Early result of heart transplantation in Japan: Osaka University experience.

    PubMed

    Fukushima, Norihide; Miyamoto, Yuji; Ohtake, Shigeaki; Sawa, Yoshiki; Takahashi, Toshiki; Nishimura, Motonobu

    2004-06-01

    Since the new organ transplantation law was established in 1997, 17 heart transplantations have been performed in Japan, 7 of which were carried out at Osaka University Hospital. Recipient diagnosis was dilated cardiomyopathy in 2, dilated phase of hypertrophic cardiomyopathy in 4, and post-myocarditis cardiomyopathy in 1. Ages ranged from 8 to 49 years with a mean of 35.3 years. Five patients were bridged with a left ventricular assist device. The waiting period was 182-977 days (mean, 643 days). There was no early or late death during follow-up of 1-4.8 years. Under a standard triple-drug regimen using mycophenolate, there were 3 rejection episodes greater than grade 3 in 2 patients, and humoral rejection requiring plasmapheresis in one. A young boy whose donor was a hemodynamically compromised adult developed neurological sequelae after resuscitation following ventricular tachycardia. All patients were discharged and went back to work or their regular daily life. Although the donor shortage is still severe in Japan, the resumption of heart transplantation has been satisfactory, and left ventricular assist devices have played a crucial role. PMID:15213084

  17. FRONTIER FIELDS: HIGH-REDSHIFT PREDICTIONS AND EARLY RESULTS

    SciTech Connect

    Coe, Dan; Bradley, Larry; Zitrin, Adi

    2015-02-20

    The Frontier Fields program is obtaining deep Hubble and Spitzer Space Telescope images of new ''blank'' fields and nearby fields gravitationally lensed by massive galaxy clusters. The Hubble images of the lensed fields are revealing nJy sources (AB mag > 31), the faintest galaxies yet observed. The full program will transform our understanding of galaxy evolution in the first 600 million years (z > 9). Previous programs have yielded a dozen or so z > 9 candidates, including perhaps fewer than expected in the Ultra Deep Field and more than expected in shallower Hubble images. In this paper, we present high-redshift (z > 6) number count predictions for the Frontier Fields and candidates in three of the first Hubble images. We show the full Frontier Fields program may yield up to ∼70 z > 9 candidates (∼6 per field). We base this estimate on an extrapolation of luminosity functions observed between 4 < z < 8 and gravitational lensing models submitted by the community. However, in the first two deep infrared Hubble images obtained to date, we find z ∼ 8 candidates but no strong candidates at z > 9. We defer quantitative analysis of the z > 9 deficit (including detection completeness estimates) to future work including additional data. At these redshifts, cosmic variance (field-to-field variation) is expected to be significant (greater than ±50%) and include clustering of early galaxies formed in overdensities. The full Frontier Fields program will significantly mitigate this uncertainty by observing six independent sightlines each with a lensing cluster and nearby blank field.

  18. Early Science Results from the Dark Energy Survey

    NASA Astrophysics Data System (ADS)

    Ross, Ashley

    2015-04-01

    The Dark Energy Survey (DES) is a next-generation large galaxy survey designed to unravel the mystery of the nature of the dark energy that powers the current accelerated expansion of the Universe. The DES collaboration built and participated in the installation and commissioning of DECam, a 570 mega-pixel optical and near-infrared camera with a large 3 deg2 field of view, set at the prime focus of the Víctor M. Blanco 4-meter telescope in at the Cerro Tololo Inter-American Observatory in Chile. Using DECam, DES will map 5000 deg2 to a depth IAB ~ 24 and observe designated supernova survey fields at high cadence. These data will allow DES to measure positions, approximate redshifts, and shapes for 300 million galaxies, the light-curves of several thousand supernovae, and the masses of tens of thousands of galaxy clusters. Using these data, DES will use four main probes to study the properties of dark energy: galaxy clustering on large scales, weak gravitational lensing, galaxy-cluster abundance, and supernova distances. I describe the early progress of the survey and provide highlights of the science analyses that have been completed so far. These include: large-scale galaxy clustering measurements; significant detection of a cross-correlation with SPT CMB lensing maps; galaxy-shear and shear-shear correlation function measurements; discoveries of super-luminous supernovae, dozens of strong lenses, and redshift > 6 quasars; and characterization of DES galaxy clusters and SNe1a light-curves.

  19. The Global Precipitation Measurement Mission: NASA Status and Early Results

    NASA Astrophysics Data System (ADS)

    Skofronick-Jackson, Gail; Huffman, G.; Petersen, W.; Kidd, Chris

    capabilities will be presented along with early imagery of GPM’s retrievals of precipitation.

  20. The effect of surgical factors on early patient-reported outcome measures (PROMS) following total knee replacement.

    PubMed

    Baker, P N; Deehan, D J; Lees, D; Jameson, S; Avery, P J; Gregg, P J; Reed, M R

    2012-08-01

    Patient-reported outcome measures (PROMs) are increasingly being used to assess functional outcome and patient satisfaction. They provide a framework for comparisons between surgical units, and individual surgeons for benchmarking and financial remuneration. Better performance may bring the reward of more customers as patients and commissioners seek out high performers for their elective procedures. Using National Joint Registry (NJR) data linked to PROMs we identified 22,691 primary total knee replacements (TKRs) undertaken for osteoarthritis in England and Wales between August 2008 and February 2011, and identified the surgical factors that influenced the improvements in the Oxford knee score (OKS) and EuroQol-5D (EQ-5D) assessment using multiple regression analysis. After correction for patient factors the only surgical factors that influenced PROMs were implant brand and hospital type (both p < 0.001). However, the effects of surgical factors upon the PROMs were modest compared with patient factors. For both the OKS and the EQ-5D the most important factors influencing the improvement in PROMs were the corresponding pre-operative score and the patient's general health status. Despite having only a small effect on PROMs, this study has shown that both implant brand and hospital type do influence reported subjective functional scores following TKR. In the current climate of financial austerity, proposed performance-based remuneration and wider patient choice, it would seem unwise to ignore these effects and the influence of a range of additional patient factors. PMID:22844046

  1. Postthrombotic Syndrome: Surgical Possibilities

    PubMed Central

    Khanna, Ajay K.; Singh, Shivanshu

    2012-01-01

    Postthrombotic syndrome (PTS) is a late outcome of deep vein thrombosis characterized by cramping pain, swelling, hyperpigmentation, eczema, lipodermatosclerosis, and ulceration in the leg due to increased venous outflow resistance and reflux venous flow. Newer surgical and endovascular interventions have a promising result in the management of postthrombotic syndrome. Early surgical or endovascular interventions in appropriately selected patients may decrease the incidence of recurrent ulceration and skin changes and provide a better quality of life. Duplex and IVUS (intravenous ultrasound) along with venography serve as cornerstone investigative tools for assessment of reflux and obstruction. Venous obstruction, if present, should be addressed earlier than reflux. It requires endovenous stenting, endophlebectomy, or open bypass procedures. Venous stripping, foam sclerotherapy, radiofrequency, or laser ablation are used to abolish superficial venous reflux. Valvuloplasty procedures are useful for incompetent but intact deep venous valves, while transposition or axillary vein autotransplantation is done for completely destroyed valves. PMID:22084674

  2. The cost effectiveness of early management of acute appendicitis underlies the importance of curative surgical services to a primary healthcare programme

    PubMed Central

    Aldous, C; Handley, J; Clarke, D

    2013-01-01

    Introduction Appendicitis in the developing world is a cause of significant preventable morbidity. This prospective study from a regional hospital in South Africa constructs a robust cost model that demonstrates the cost effectiveness of an efficient curative surgical service in a primary healthcare-orientated system. Methods A prospective audit of all patients with acute appendicitis admitted to Edendale Hospital was undertaken from September 2010 to September 2011. A microcosting approach was used to construct a cost model based on the estimated cost of operative and perioperative interventions together with the associated hospital stay. For cost analysis, patients were divided into the following cohorts: uncomplicated appendicitis, complicated appendicitis with localised intra-abdominal sepsis, complicated appendicitis with generalised intra-abdominal sepsis, with and without intensive care unit admission. Results Two hundred patients were operated on for acute appendicitis. Of these, 36% (71/200) had uncomplicated appendicitis and 57% (114/200) had perforation. Pathologies other than appendicitis were present in 8% (15/200) and these patients were excluded. Of the perforated appendices, 45% (51/114) had intra-abdominal contamination that was localised while 55% (63/114) generalised sepsis. The mean cost for each patient was: 6,578 ZAR (£566) for uncomplicated appendicitis; 14,791 ZAR (£1,272) for perforation with localised intra-abdominal sepsis and 34,773 ZAR (£2,990) for perforation with generalised intra-abdominal sepsis without intensive care admission. With intensive care admission it was 77,816 ZAR (£6,692). The total cost of managing acute appendicitis was 4,272,871 ZAR (£367,467). Almost 90% of this total cost was owing to advanced disease with abdominal sepsis and therefore potentially preventable. Conclusions Early uncomplicated appendicitis treated appropriately carries little morbidity and is relatively inexpensive to treat. As the pathology

  3. Long-term results of the surgical treatment of Peyronie's disease with Egydio's technique: a European multicentre study

    PubMed Central

    Sansalone, Salvatore; Garaffa, Giulio; Djinovic, Rados; Pecoraro, Stefano; Silvani, Mauro; Barbagli, Guido; Zucchi, Alessandro; Vespasiani, Giuseppe; Loreto, Carla

    2011-01-01

    The long-term outcomes of 157 patients affected by Peyronie's disease (PD) who underwent penile straightening with Egydio's technique between January 2004 and December 2008 are reported. Only patients with PD who were stable for at least 6–12 months prior to surgery were enrolled in this study. Preoperative assessment included a dynamic echo colour Doppler ultrasound scan to evaluate the degree of penile deformity and the peak systolic velocity in the cavernosal arteries and an assessment of erectile function with the administration of the International Index of Erectile Function 5 (IIEF-5) questionnaire. Stretched penile length was recorded pre- and postoperatively. Surgical complications, cosmesis and sexual function, patient satisfaction and postoperative erectile function were assessed postoperatively at 3 months, 1 year and 2 years, respectively. After a median follow-up period of 20 months (range: 12–24 months), we found that mild residual curvature (12%) and glans hypoesthesia (3%) were the only causes of partial dissatisfaction. No rejection of the graft was observed. All patients recovered their ability to penetrate with no difficulty. In addition, an intraoperative average increase of 2.5 cm (range: 1.7–4.1 cm) in stretched penile length was recorded, with all patients engaging in penetrative sexual intercourse. In conclusion, this procedure represents a safe and reproducible technique for the correction of penile curvature resulting from PD and yields excellent cosmetic and functional results. PMID:21743482

  4. Early Results of Endovascular Treatment of the Thoracic Aorta Using the Valiant Endograft

    SciTech Connect

    Thompson, Matt Ivaz, Stella; Cheshire, Nicholas; Fattori, Rosella; Rousseau, Herve; Heijmen, Robin; Beregi, Jean-Paul; Thony, Frederic; Horne, Gillian; Morgan, Robert; Loftus, Ian

    2007-11-15

    Endovascular repair of the thoracic aorta has been adopted as the first-line therapy for much pathology. Initial results from the early-generation endografts have highlighted the potential of this technique. Newer-generation endografts have now been introduced into clinical practice and careful assessment of their performance should be mandatory. This study describes the initial experience with the Valiant endograft and makes comparisons with similar series documenting previous-generation endografts. Data were retrospectively collected on 180 patients treated with the Valiant endograft at seven European centers between March 2005 and October 2006. The patient cohort consisted of 66 patients with thoracic aneurysms, 22 with thoracoabdominal aneurysms, 19 with an acute aortic syndrome, 52 with aneurysmal degeneration of a chronic dissection, and 21 patients with traumatic aortic transection. The overall 30-day mortality for the series was 7.2%, with a stroke rate of 3.8% and a paraplegia rate of 3.3%. Subgroup analysis demonstrated that mortality differed significantly between different indications; thoracic aneurysms (6.1%), thoracoabdominal aneurysms (27.3%), acute aortic syndrome (10.5%), chronic dissections (1.9%), and acute transections (0%). Adjunctive surgical procedures were required in 63 patients, and 51% of patients had grafts deployed proximal to the left subclavian artery. Comparison with a series of earlier-generation grafts demonstrated a significant increase in complexity of procedure as assessed by graft implantation site, number of grafts and patient comorbidity. The data demonstrate acceptable results for a new-generation endograft in series of patients with diverse thoracic aortic pathology. Comparison of clinical outcomes between different endografts poses considerable challenges due to differing case complexity.

  5. Subcutaneous Direct-to-Implant Breast Reconstruction: Surgical, Functional, and Aesthetic Results after Long-Term Follow-Up

    PubMed Central

    Calabrese, Claudio; Cecconi, Lorenzo; Santi, Caterina; Gjondedaj, Ulpjana; Roselli, Jenny; Nori, Jacopo; Fausto, Alfonso; Orzalesi, Lorenzo; Casella, Donato

    2015-01-01

    Abstract Background: Direct-to-implant breast reconstruction can be achieved more easily by means of soft-tissue replacement devices such as dermal matrices and synthetic meshes. The feasibility of a subcutaneous approach has been recently investigated by some studies with different devices functioning as implant support. Aim of this study is to analyze the long-term results, both objective and subjective, of a previous nonrandomized trial comparing prepectoral (subcutaneous) and retropectoral breast reconstructions. Methods: Patients enrolled in a nonrandomized prospective trial, comparing the standard retropectoral reconstruction and the prepectoral subcutaneous approach, using a titanium-coated mesh in both techniques, were followed up and evaluated for long-term results. Cases were compared in terms of the causes and rate of reinterventions, of the postoperative BREAST-Q questionnaire results, and of an objective surgical evaluation. Results: The subcutaneous group had a rate of implant failure and removal of 5.1% when compared with 0% in the retropectoral group. Aesthetic outcome was significantly better for the subcutaneous group both at a subjective and at an objective evaluation. Capsular contracture rate was 0% in the subcutaneous group. Conclusions: A higher rate of implant failure and removal, although not significant, always because of skin flaps and wound problems, should be taken into account for a careful patients selection. The subcutaneous breast reconstruction shows good long-term results. A coherent subjective and objective cosmetic advantage of this approach emerges. Moreover, no capsular contracture is evident, albeit in a relatively limited number of cases. PMID:26893999

  6. Mathematical Rigor vs. Conceptual Change: Some Early Results

    NASA Astrophysics Data System (ADS)

    Alexander, W. R.

    2003-05-01

    Results from two different pedagogical approaches to teaching introductory astronomy at the college level will be presented. The first of these approaches is a descriptive, conceptually based approach that emphasizes conceptual change. This descriptive class is typically an elective for non-science majors. The other approach is a mathematically rigorous treatment that emphasizes problem solving and is designed to prepare students for further study in astronomy. The mathematically rigorous class is typically taken by science majors. It also fulfills an elective science requirement for these science majors. The Astronomy Diagnostic Test version 2 (ADT 2.0) was used as an assessment instrument since the validity and reliability have been investigated by previous researchers. The ADT 2.0 was administered as both a pre-test and post-test to both groups. Initial results show no significant difference between the two groups in the post-test. However, there is a slightly greater improvement for the descriptive class between the pre and post testing compared to the mathematically rigorous course. There was great care to account for variables. These variables included: selection of text, class format as well as instructor differences. Results indicate that the mathematically rigorous model, doesn't improve conceptual understanding any better than the conceptual change model. Additional results indicate that there is a similar gender bias in favor of males that has been measured by previous investigators. This research has been funded by the College of Science and Mathematics at James Madison University.

  7. Debridement Arthroplasty for Post-traumatic Stiff Elbow: Intraoperative Factors Affecting the Clinical Results of Surgical Treatment

    PubMed Central

    Cho, Nam Su; Lim, Chan Teak; Yi, Jin Woong

    2009-01-01

    Background This study evaluated the outcomes of debridement arthroplasty for stiff elbows, as well as the factors affecting clinical outcomes after surgical treatment. Methods Eighteen patients with post-traumatic stiff elbows were treated with debridement arthroplasty using a posterior approach. The mean patient age was 33 years (range, 16 to 59 years), and the average follow-up period was 59 months (range, 24 to 141 months). The patient's ability to perform activities of daily living, including combing their hair, feeding themselves, performing hygiene, and putting on shirt and shoes, were evaluated using the Mayo Elbow Performance Score. Results At the last follow-up, 16 elbows had painless motion. Two patients continued to complain of mild intermittent pain. The flexion and extension improved to 121° and 10° after surgery, respectively, indicating an average 34° increase in elbow flexion range and an average 25° increase in elbow extension range (p < 0.001, p < 0.001). The Mayo Elbow Performance Score at the last follow-up was excellent in nine elbows (50%) and good in nine elbows (50%). Conclusions Debridement arthroplasty is a predictable procedure for the treatment of intractable stiff elbow, provided that the elbow is stable and congruous. PMID:19884994

  8. Surgical Results of Anderson-Hynes Dismembered Pyeloplasty Without Internal Drainage in Adults With Ureteroplevic Junction Obstruction

    PubMed Central

    Yarmohamadi, Aliasghar; Saeedi, Parisa; Hoghabrosadat, Amir

    2015-01-01

    Background: Anderson-Hynes dismembered pyeloplasty is the gold standard therapeutic approach to ureteropelvic junction obstruction (UPJO). Use of a drainage method to protect the suture line from leakage is a matter of controversy. Objectives: We have compared the surgical outcome of Anderson-Hynes dismembered pyeloplasty for UPJO repair, with or without internal stenting. Patients and Methods: Eighty-two patients with UPJO were evaluated from 1996 to 2002. Complicated or emergent cases were excluded. Classic standard dismembered pyeloplasty was performed. Internal drainage, with a double j catheter, was performed in several patients, randomly. Another drain was also placed in the retroperitoneal space. The follow-up of patients was planned weekly, with patient visits and urine analysis and intravenous pyelography (IVP) and diethylene-triamine-pentaacetate (DTPA) scan after one month. Results: The study group consisted of 51 male and 31 female patients, who were mostly in the age range of 20 - 40 years. Comparing the two techniques of pyeloplasty with or without internal drainage, there was no significant difference between groups regarding extravasation and anastomosis complications, such as leakage, stenosis, urinoma formation or evidence of obstruction on postoperative IVP or DTPA scan. However, a higher incidence of catheter related urinary symptoms and flank pain was reported among those with internal stent. Conclusions: Pyeloplasty, with adequate spatulation, hemostasis and a watertight anastomosis, represents the mainstay of successful pyeloplasty and there may be no significant benefit for urethral stenting, especially in non-complicated cases. PMID:26034744

  9. Evaluation of the results from surgical treatment of the terrible triad of the elbow☆☆☆

    PubMed Central

    Naoki Miyazaki, Alberto; Santos Checchia, Caio; Fagotti, Lorenzo; Fregonez, Marcelo; Doneux Santos, Pedro; da Silva, Luciana Andrade; do Val Sella, Guilherme; Luiz Checchi, Sergio

    2014-01-01

    Objective to evaluate the results from surgical treatment of the terrible triad of the elbow (fracture of the radial head, fracture of the coronoid process and elbow dislocation) and its complications. Methods between August 2002 and August 2010, 15 patients (15 elbows) with the terrible triad were treated by the Shoulder and Elbow Group of the Department of Orthopedics and Traumatology, School of Medical Sciences, Santa Casa de São Paulo. Nine (60%) were male and six (40%) were female; their ages ranged from 21 to 66 years, with a mean of 41 years. With the exception of one case that underwent arthroscopic surgery, all the patients underwent open surgery. The fracture of the coronoid process was fixed in 10 patients (66.7%). The fracture of the radial head was treated by means of internal osteosynthesis in 11 cases (73.3%); in three cases (20%), the radial head was resected; and in one case, only the fragment of the fracture was resected. The collateral ligaments, except for one case, were repaired whenever they were found to be injured; ten cases (66.7%) of medial collateral injury and 15 (100%) of lateral collateral injury were found. The mean length of the postoperative follow‐up was 62 months, with a minimum of 12 months. The postoperative evaluation was done by means of the Bruce score. Results more than 80% of the patients recovered their functional ranges of motion but, according to the Bruce score, only 26% of the patients achieved results that were considered satisfactory. Conclusion despite the unsatisfactory results, the functional ranges of motion and elbow function could be restored. PMID:26229812

  10. Materials Adherence Experiment on Mars Pathfinder: Early results

    SciTech Connect

    Landis, G.A.; Jenkins, P.P.; Hunter, G.

    1997-12-31

    The Materials Adherence Experiment (MAE) on the Pathfinder Sojourner rover will measure the dust deposition rate. By August, the Sojourner Rover on Mars Pathfinder will have completed its primary mission, and the experiment will have data on dust deposition during the first three weeks of operation on Mars. This paper will present the initial data from the experiment. This will be the first presentation of the results from the Pathfinder MAE experiment.

  11. Early Results and Spaceflight Implications of the SWAB Flight Experiment

    NASA Technical Reports Server (NTRS)

    Ott, C. Mark; Pierson, Duane L.

    2007-01-01

    Microbial monitoring of spacecraft environments provides key information in the assessment of infectious disease risk to the crew. Monitoring aboard the Mir space station and International Space Station (ISS) has provided a tremendous informational baseline to aid in determining the types and concentrations of microorganisms during a mission. Still, current microbial monitoring hardware utilizes culture-based methodology which may not detect many medically significant organisms, such as Legionella pneumophila. We hypothesize that evaluation of the ISS environment using non-culture-based technologies would reveal microorganisms not previously reported in spacecraft, allowing for a more complete health assessment. To achieve this goal, a spaceflight experiment, operationally designated as SWAB, was designed to evaluate the DNA from environmental samples collected from ISS and vehicles destined for ISS. Results from initial samples indicate that the sample collection and return procedures were successful. Analysis of these samples using denaturing gradient gel electrophoresis and targeted PCR primers for fungal contaminants is underway. The current results of SWAB and their implication for in-flight molecular analysis of environmental samples will be discussed.

  12. Lidar In-space Technology Experiment: Overview and early results

    NASA Technical Reports Server (NTRS)

    McCormick, M. Patrick

    1995-01-01

    The September 1994 Shuttle flight of the Lidar In-space Technology Experiment (LITE) brought to fruition 10 years of effort at NASA's Langley Research Center where it was built. Being the first flight of a spaceborne lidar to measure atmospheric constituents and parameters and surface properties, it culminates the efforts of many worldwide over the last 20 years to usher in this new remote sensing technique from space. This paper will describe the LITE instrument, the in-orbit performance, and initial results. In addition, the global correlative measurements program will be outlined which involved 60 groups in 20 countries who made various simultaneous ground-based or aircraft measurements as LITE flew overhead.

  13. Early Run 2 Hard QCD Results from the ATLAS Collaboration

    NASA Astrophysics Data System (ADS)

    Orlando, Nicola

    2016-07-01

    We provide an overview of hard QCD results based on data collected with the ATLAS detector in proton-proton collision at √s = 13 TeV at the Large Hadron Collider. The production of high transverse momentum jets, photons and photon-pairs were studied; the inclusive jet cross section is found to agree well with the prediction of perturbative QCD calculations performed at next-to-leading accuracy. The production cross sections for W and Z bosons in their e and μ decays was measured; in general, agreement is found with the expectation of next-to-next-to leading order QCD calculations and interesting sensitivities to the proton structure functions are already observed. The top production cross sections were measured in different top decay channels and found to agree with the state of the art QCD predictions.

  14. CMS tracking performance results from early LHC operation

    SciTech Connect

    Khachatryan, Vardan; et al.

    2010-11-24

    The first LHC pp collisions at centre-of-mass energies of 0.9 and 2.36 TeV were recorded by the CMS detector in December 2009. The trajectories of charged particles produced in the collisions were reconstructed using the all-silicon Tracker and their momenta were measured in the 3.8 T axial magnetic field. Results from the Tracker commissioning are presented including studies of timing, efficiency, signal-to-noise, resolution, and ionization energy. Reconstructed tracks are used to benchmark the performance in terms of track and vertex resolutions, reconstruction of decays, estimation of ionization energy loss, as well as identification of photon conversions, nuclear interactions, and heavy-flavour decays.

  15. Early and Late Results Following Choledochoduodenostomy and Choledochojejunostomy

    PubMed Central

    Terpstra, O. T.

    1990-01-01

    Objective —To evaluate the results and complications of choledochoduodenostomy and choledochojejunostomy for benign and malignant disease and to review them in the light of the survival of the underlying disorders. Design —Retrospective analysis of medical records completed by a thorough inquiry for all patients who were lost to follow-up. Setting —Referrals for primary and secondary surgery for obstructive biliary disease to a university hospital from 1974–1987. Patients —After exclusion of patients who underwent a pancreaticoduodenectomy for cancer (Whipple procedure) 113 patients were included in the study (choledochoduodenostomy = CD, N = 64 and choledochojejunostomy = CJ, N = 49). A complete follow-up was achieved in 105 of 113 patients (93%). Interventions —An inquiry was made at the civil registration office if the patients were alive or not. The general practitioners of the patients who had died were contacted about the cause of death and the possible biliary symptoms preceding death and the patients who were still alive received a questionaire which scrutinized all possible complications and side effects of the operation. Endpoints —Cholangitis, recurrence of the underlying disease or death of the patient. Measurements and main results —Operative mortality was 4.7% following CD and 12.2% following CJ. Procedure-related complications were found in 10.9% and 28.6% respectively. Recurrent cholangitis was not seen after CD and in three patients with a CJ (6.1%). Survival following biliodigestive anastomosis for benign obstruction was comparable for age and sex matched survival. Conclusions —Although CD for choledocholithiasis has largely been replaced by endoscopic papillotomy and although the choice between the two procedures in malignant disease is most frequently dictated by the operative findings, we conclude that the choledochoduodenostomy is a relative simple operation with a low risk of cholangitis. PMID:2278911

  16. LSNR Airborne LIDAR Mapping System Design and Early Results (Invited)

    NASA Astrophysics Data System (ADS)

    Shrestha, K.; Carter, W. E.; Slatton, K. C.

    2009-12-01

    Low signal-to-noise ratio (LSNR) detection techniques allow for implementation of airborne light detection and range (LIDAR) instrumentation aboard platforms with prohibitive power, size, and weight restrictions. The University of Florida has developed the Coastal Area Tactical-mapping System (CATS), a prototype LSNR LIDAR system capable of single photon laser ranging. CATS is designed to operate in a fixed-wing aircraft flying 600 m above ground level, producing 532 nm, 480 ps, 3 μJ output pulses at 8 kHz. To achieve continuous coverage of the terrain with 20 cm spatial resolution in a single pass, a 10x10 array of laser beamlets is scanned. A Risley prism scanner (two rotating V-coated optical wedges) allows the array of laser beamlets to be deflected in a variety of patterns, including conical, spiral, and lines at selected angles to the direction of flight. Backscattered laser photons are imaged onto a 100 channel (10x10 segmented-anode) photomultiplier tube (PMT) with a micro-channel plate (MCP) amplifier. Each channel of the PMT is connected to a multi-stop 2 GHz event timer. Here we report on tests in which ranges for known targets were accumulated for repeated laser shots and statistical analyses were applied to evaluate range accuracy, minimum separation distance, bathymetric mapping depth, and atmospheric scattering. Ground-based field test results have yielded 10 cm range accuracy and sub-meter feature identification at variable scan settings. These experiments also show that a secondary surface can be detected at a distance of 15 cm from the first. Range errors in secondary surface identification for six separate trials were within 7.5 cm, or within the timing resolution limit of the system. Operating at multi-photon sensitivity may have value for situations in which high ambient noise precludes single-photon sensitivity. Low reflectivity targets submerged in highly turbid waters can cause detection issues. CATS offers the capability to adjust the

  17. NASA'S Coastal and Ocean Airborne Science Testbed (COAST): Early Results

    NASA Astrophysics Data System (ADS)

    Guild, L. S.; Dungan, J. L.; Edwards, M.; Russell, P. B.; Morrow, J. H.; Kudela, R. M.; Myers, J. S.; Livingston, J.; Lobitz, B.; Torres-Perez, J.

    2012-12-01

    The NASA Coastal and Ocean Airborne Science Testbed (COAST) project advances coastal ecosystems research and ocean color calibration and validation capability by providing a unique airborne payload optimized for remote sensing in the optically complex coastal zone. The COAST instrument suite combines a customized imaging spectrometer, sunphotometer system, and a new bio-optical radiometer package to obtain ocean/coastal/atmosphere data simultaneously in flight for the first time. The imaging spectrometer (Headwall) is optimized in the blue region of the spectrum to emphasize remote sensing of marine and freshwater ecosystems. Simultaneous measurements supporting empirical atmospheric correction of image data is accomplished using the Ames Airborne Tracking Sunphotometer (AATS-14). Coastal Airborne In situ Radiometers (C-AIR, Biospherical Instruments, Inc.), developed for COAST for airborne campaigns from field-deployed microradiometer instrumentation, will provide measurements of apparent optical properties at the land/ocean boundary including optically shallow aquatic ecosystems. Ship-based measurements allowed validation of airborne measurements. Radiative transfer modeling on in-water measurements from the HyperPro and Compact-Optical Profiling System (C-OPS, the in-water companion to C-AIR) profiling systems allows for comparison of airborne and in-situ water leaving radiance measurements. Results of the October 2011 Monterey Bay COAST mission include preliminary data on coastal ocean color products, coincident spatial and temporal data on aerosol optical depth and water vapor column content, as well as derived exact water-leaving radiances.

  18. Early results from ISEE-A electric field measurements

    NASA Technical Reports Server (NTRS)

    Heppner, J. P.; Maynard, N. C.; Aggson, T. L.

    1978-01-01

    In the solar wind and in middle latitude regions of the magnetosphere, spacecraft sheath fields obscure the ambient field under low plasma flux conditions such that valid measurements are confined to periods of moderately intense flux. Initial results show: (1) that the DC electric field is enhanced by roughly a factor of two in a narrow region at the front, increasing B, edge of the bow shock, (2) that scale lengths for large changes in E at the subsolar magnetopause are considerably shorter than scale lengths associated with the magnetic structure of the magnetopause, and (3) that the transverse distribution of B-aligned E-fields between the outer magnetosphere and ionospheric levels must be highly complex to account for the random turbulent appearance of the magnetospheric fields and the lack of corresponding time-space variations at ionospheric levels. Spike-like, non-oscillatory, fields lasting less than 0.2 seconds are occasionally seen at the bow shock and at the magnetopause and also intermittently appear in magnetosheath and plasma sheet regions under highly variable field conditions.

  19. Early Results from the Q{sub weak} Experiment

    SciTech Connect

    Androic, D; Armstrong, D S; Asaturyan, A; Averett, T; Balewski, J; Beaufait, J; Beminiwattha, R S; Benesch, J; Benmokhtar, F; Birchall, J; Carlini, R D; Cates, G D; Cornejo, J C; Covrig, S; Dalton, M M; Davis, C A; Deconinck, W; Diefenbach, J; Dowd, J F; Dunne, J A; Dutta, D; Duvall, W S; Elaasar, M; Falk, W R; Finn, J M; Forest, T; Gaskel, D; Gericke, M T.W.; Grames, J; Gray, V M; Grimm, K; Guo, F; Hoskins, J R; Johnston, K; Jones, D; Jones, M; Jones, R; Kargiantoulakis, M; King, P M; Korkmaz, E; Kowalski, S; Leacock, J; Leckey, J; Lee, A R; Lee, J H; Lee, L; MacEwan, S; Mack, D; Magee, J A; Mahurin, R; Mammei, J; Martin, J; McHugh, M J; Meekins, D; Mei, J; Michaels, R; Micherdzinska, A; Mkrtchyan, A; Mkrtchyan, H; Morgan, N; Myers, K E; Narayan, A; Ndukum, L Z; Nelyubin, V; W T H, Nuruzzaman; Oers, van; Opper, A K; Page, S A; Pan, J; Paschke, K; Phillips, S K; Pitt, M L; Poelker, M; Rajotte, J F; Ramsay, W D; Roche, J; Sawatzky, B; Seva, T; Shabestari, M H; Silwal, R; Simicevic, N; Smith, G R; Solvignon, P; Spayde, D T; Subedi, A; Subedi, R; Suleiman, R; Tadevosyan, V; Tobias, W A; Tvaskis, V; Waidyawansa, B; Wang, P; Wells, S P; Wood, S A; Yang, S; Young, R D; Zhamkochyan, S

    2014-03-01

    A subset of results from the recently completed Jefferson Lab Q{sub weak} experiment are reported. This experiment, sensitive to physics beyond the Standard Model, exploits the small parity-violating asymmetry in elastic {vector e}p scattering to provide the first determination of the protons weak charge Q{sub w}{sup p}. The experiment employed a 180 {micro}A longitudinally polarized 1.16 GeV electron beam on a 35 cm long liquid hydrogen target. Scattered electrons corresponding to Q{sup 2} of 0.025 GeV{sup 2} were detected in eight Cerenkov detectors arrayed symmetrically around the beam axis. The goals of the experiment were to provide a measure of Q{sub w}{sup p} to 4.2 percent (combined statistical and systematic error), which implies a measure of sin2(thetaw) at the level of 0.3 percent, and to help constrain the vector weak quark charges C{sub 1u} and C{sub 1d}. The experimental method is described, with particular focus on the challenges associated with the worlds highest power LH{sub 2} target. The new constraints on C{sub 1u} and C{sub 1d} provided by the subset of the experiments data analyzed to date will also be shown, together with the extracted weak charge of the neutron.

  20. Early Results of Retrograde Transpopliteal Angioplasty of Iliofemoral Lesions

    SciTech Connect

    Saha, Saumitra; Gibson, Matthew; Magee, Timothy R.; Galland, Robert B.; Torrie, E. Peter H.

    2001-12-15

    Purpose: To assess whether the retrograde transpopliteal approach is a safe, practical and effective alternative to femoral puncture for percutaneous transluminal angioplasty (PTA).Methods: Forty PTAs in 38 patients were evaluated. Intentional subintimal recanalization was performed in 13 limbs. Ultrasound evaluation of the popliteal fossa was carried out 30 min and 24 hr post procedurally in the first 10 patients to exclude local complications. All patients had a follow-up of at least 6 weeks.Results: The indication for PTA was critical ischemia in seven limbs and disabling claudication in the remainder.Stenoses (single or multiple) were present in 24 and occlusion in 15.The superficial femoral artery (SFA) was the commonest segment affected(36) followed by common femoral artery (CFA) in four and iliac artery in four. Technical success was achieved in 38 of 39 limbs where angioplasty was carried out. In one limb no lesion was found.Immediate complications were distal embolization in two and thrombosis in one. None of these required immediate surgery. There were no puncture site hematomas or popliteal arteriovenous fistulae.Symptomatic patency at 6 weeks was 85%. Further reconstructive surgery was required in three limbs and amputation in two.Conclusion: The transpopliteal approach has a high technical success rate and a low complication rate with a potential to develop into an outpatient procedure. It should be considered for flush SFA occulsions or iliac disease with tandem CFA/SFA disease where the contralateral femoral approach is often technically difficult.

  1. The Earth Radiation Budget Experiment - Early validation results

    NASA Technical Reports Server (NTRS)

    Smith, G. L.; Barkstrom, B. R.; Harrison, E. F.; Huck, F. O.; Cess, R.; Coakley, J.; Duncan, C.; King, M.; Mecherikunnel, A.; Gruber, A.

    1986-01-01

    The primary techniques used to obtain and validate the data of the Earth Radiation Budget Experiment (ERBE) are described, together with preliminary results of the validation. The ERBE consists of radiometers aboard the ERB Satellite, dedicated to a 57-deg orbit, and each of the two NOAA meteorological spacecraft (NOAA 9 and NOAA G) in near polar orbits. The radiometers include scanning narrow field-of-view (FOV) and nadir-looking wide and medium FOV radiometers, and a solar monitoring channel. Measurements of the solar constant by the solar monitors, and the wide and medium FOV radiometers of the ERB and the NOAA 9 spacecraft agree within a fraction of a percent. Comparison of the wide and medium FOV radiometers with the scanning radiometers showed an agreement of 1 to 4 percent. The multiple ERBE satellites are acquiring the first global measurements of regional scale-diurnal variations in the earth's radiation budget. These were verified by comparison with the high-temporal-resolution geostationary satellite data.

  2. Photodynamic therapy for locally advanced pancreatic cancer: early clinical results

    NASA Astrophysics Data System (ADS)

    Sandanayake, N. S.; Huggett, M. T.; Bown, S. G.; Pogue, B. W.; Hasan, T.; Pereira, S. P.

    2010-02-01

    Pancreatic adenocarcinoma ranks as the fourth most common cause of cancer death in the USA. Patients usually present late with advanced disease, limiting attempted curative surgery to 10% of cases. Overall prognosis is poor with one-year survival rates of less than 10% with palliative chemotherapy and/or radiotherapy. Given these dismal results, a minimally invasive treatment capable of local destruction of tumor tissue with low morbidity may have a place in the treatment of this disease. In this paper we review the preclinical photodynamic therapy (PDT) studies which have shown that it is possible to achieve a zone of necrosis in normal pancreas and implanted tumour tissue. Side effects of treatment and evidence of a potential survival advantage are discussed. We describe the only published clinical study of pancreatic interstitial PDT, which was carried out by our group (Bown et al Gut 2002), in 16 patients with unresectable locally advanced pancreatic adenocarcinoma. All patients had evidence of tumor necrosis on follow-up imaging, with a median survival from diagnosis of 12.5 months. Finally, we outline a phase I dose-escalation study of verteporfin single fibre PDT followed by standard gemcitabine chemotherapy which our group is currently undertaking in patients with locally advanced pancreatic cancer. Randomized controlled studies are also planned.

  3. HUNTING THE COOLEST DWARFS: METHODS AND EARLY RESULTS

    SciTech Connect

    Schneider, A.; Song, Inseok; Melis, Carl; Zuckerman, B. E-mail: song@physast.uga.edu E-mail: ben@astro.ucla.edu

    2011-12-20

    We present the methods and first results of a survey of nearby high proper motion main-sequence stars to probe for cool companions with the Gemini camera at Lick Observatory. This survey uses a sample of old (age > 2 Gyr) stars as targets to probe for companions down to temperatures of 500 K. Multi-epoch observations allow us to discriminate comoving companions from background objects. So far, our survey has successfully rediscovered the wide T8.5 companion to GJ 1263 and has discovered a companion to the nearby M0V star GJ 660.1. The companion to GJ 660.1 (GJ 660.1B) is {approx}4 mag fainter than its host star in the J-band and is located at a projected separation of {approx}120 AU. Known trigonometric parallax and Two Micron All Sky Survey magnitudes for the GJ 660.1 system indicate a spectral type for the companion of M9 {+-} 2.

  4. Early laparoscopic management of appendicular mass in children: Still a taboo, or time for a change in surgical philosophy?

    PubMed Central

    Agrawal, Vikesh; Acharya, Himanshu; Chanchlani, Roshan; Sharma, Dhananjaya

    2016-01-01

    INTRODUCTION: Early appendicectomy has been found to be a safe and better alternative for management of appendicular mass in various studies in adults, while very few studies report such advantages in the paediatric population. We conducted this study to assess the safety, efficacy and need of early laparoscopic appendicectomy (ELA) in child patients with appendicular mass. MATERIALS AND METHODS: All patients with appendicular mass who underwent ELA at our institute between September 2011 and August 2014 were retrospectively reviewed. Appendicular mass was defined as a right iliac fossa mass in a case of acute appendicitis, diagnosed by clinical, laboratory and radiological evaluation, and palpation under anaesthesia, the patient being subjected to laparoscopic treatment. RESULTS: Forty-eight (48) patients were confirmed to have appendicular mass intraoperatively and were included in the analysis. There were 30 males and 18 females, with ages ranging 7-13 years (mean 9 years). In the present study, appendicular complications included appendicular abscess (62.5%), gangrenous appendicitis (25%), sloughed-out appendix (8.33%) and appendicular perforation (4.16%). The average operative time was 72 min (range 45-93 min). One case (1.92%) required conversion to open procedure due to failure of identification of the appendicular base of a sloughed-out appendix. Post-operative complications were found in 4 (7.69%) patients, of whom 3 (5.76%) had minor wound infection at the umbilical port site and 1 (1.92%) had post-operative pelvic abscess, which was managed with percutaneous aspiration. DISCUSSION: ELA avoids misdiagnosis, treats complicated appendicitis at its outset, and avoids complications and/or failure of non-operative treatment of a potentially lethal, diseased appendix. This approach is associated with minimal complications in experienced hands and is a safe and feasible option in children with appendicular mass. PMID:27073299

  5. [INFLUENCE TIMING OF THE START OF ENTERAL NUTRITION ON THE IMMEDIATE RESULTS OF SURGICAL TREATMENT OF COLON CANCER].

    PubMed

    Mahmudov, D E

    2015-12-01

    Results of treatment of 215 patients with colon cancer (CC), whom performed at the clinic radical or palliative intervention were analyzed. In 100 patients (control group) enteral nutrition (EN) began after the restoration of the alimentary canal functions; in 115 (main group)--no later than 12 hours after surgery. For the EN in all patients used a balanced liquid mixture "Frezubin" manufactured by Fresenius Kabi GmbH (Germany). It is proved that early EN is a safe and effective method in the program of the accelerated rehabilitation of patients after surgery for CC. PMID:27025022

  6. The earth radiation budget experiment: Early validation results

    NASA Astrophysics Data System (ADS)

    Smith, G. Louis; Barkstrom, Bruce R.; Harrison, Edwin F.

    The Earth Radiation Budget Experiment (ERBE) consists of radiometers on a dedicated spacecraft in a 57° inclination orbit, which has a precessional period of 2 months, and on two NOAA operational meteorological spacecraft in near polar orbits. The radiometers include scanning narrow field-of-view (FOV) and nadir-looking wide and medium FOV radiometers covering the ranges 0.2 to 5 μm and 5 to 50 μm and a solar monitoring channel. This paper describes the validation procedures and preliminary results. Each of the radiometer channels underwent extensive ground calibration, and the instrument packages include in-flight calibration facilities which, to date, show negligible changes of the instruments in orbit, except for gradual degradation of the suprasil dome of the shortwave wide FOV (about 4% per year). Measurements of the solar constant by the solar monitors, wide FOV, and medium FOV radiometers of two spacecraft agree to a fraction of a percent. Intercomparisons of the wide and medium FOV radiometers with the scanning radiometers show agreement of 1 to 4%. The multiple ERBE satellites are acquiring the first global measurements of regional scale diurnal variations in the Earth's radiation budget. These diurnal variations are verified by comparison with high temporal resolution geostationary satellite data. Other principal investigators of the ERBE Science Team are: R. Cess, SUNY, Stoneybrook; J. Coakley, NCAR; C. Duncan, M. King and A Mecherikunnel, Goddard Space Flight Center, NASA; A. Gruber and A.J. Miller, NOAA; D. Hartmann, U. Washington; F.B. House, Drexel U.; F.O. Huck, Langley Research Center, NASA; G. Hunt, Imperial College, London U.; R. Kandel and A. Berroir, Laboratory of Dynamic Meteorology, Ecole Polytechique; V. Ramanathan, U. Chicago; E. Raschke, U. of Cologne; W.L. Smith, U. of Wisconsin and T.H. Vonder Haar, Colorado State U.

  7. Comparison of Surgical Blade and Cryosurgery with Liquid Nitrogen Techniques in Treatment of Physiologic Gingival Pigmentation: Short Term Results

    PubMed Central

    Rahmati, Saeed; Darijani, Mansoore; Nourelahi, Maryam

    2014-01-01

    Statement of the Problem: Melanin pigmentation of the gingiva is a crucial esthetic problem. A variety of methods have been used for gingival depigmentation. Purpose: The purpose of this study was to compare the results of two treatment modalities: scalpel technique and cryotherapy with liquid nitrogen in treatment of gingival pigmentation. Materials and Method: Twenty patients with chief complaint of gingival pigmentation participated in our study. 10 patients were treated with cryotherapy and remaining 10 participants were undergone the scalpel technique surgery. We evaluated acquiescence and comfort of the patients, degree of depigmentation, based on the area of pigmentation shown by gridlines option in Microsoft Paint software, and the presence or absence of gingival recession before and one month after treatment. Data was analyzed using Mann-Whitney and Chi-Square tests. A significance level of p≤ 0.05 was adopted. Results: Mean value and standard deviation of depigmentation for group A and group B was 96.17±2.51 and 95±2.48, respectively. The difference was not statistically significant (p= 0.225). There was no association between the treatment modality and the gingival recession (p= 0.303) or the treatment modality and the patient satisfaction (p= 0.346). No significant difference was found between gingival recession measures before and after the operation in the two treatment modalities. Conclusion: Surgical blade and cryosurgery with liquid nitrogen had no significant difference in treatment of physiologic gingival pigmentation. Both Techniques are acceptable in the treatment of gingival pigmentation. PMID:25469354

  8. Early Results from Swift AGN and Cluster Survey

    NASA Astrophysics Data System (ADS)

    Dai, Xinyu; Griffin, Rhiannon; Nugent, Jenna; Kochanek, Christopher S.; Bregman, Joel N.

    2016-04-01

    The Swift AGN and Cluster Survey (SACS) uses 125 deg^2 of Swift X-ray Telescope serendipitous fields with variable depths surrounding gamma-ray bursts to provide a medium depth (4 × 10^-15 erg cm^-2 s^-1) and area survey filling the gap between deep, narrow Chandra/XMM-Newton surveys and wide, shallow ROSAT surveys. Here, we present the first two papers in a series of publications for SACS. In the first paper, we introduce our method and catalog of 22,563 point sources and 442 extended sources. SACS provides excellent constraints on the AGN and cluster number counts at the bright end with negligible uncertainties due to cosmic variance, and these constraints are consistent with previous measurements. The depth and areal coverage of SACS is well suited for galaxy cluster surveys outside the local universe, reaching z > 1 for massive clusters. In the second paper, we use SDSS DR8 data to study the 203 extended SACS sources that are located within the SDSS footprint. We search for galaxy over-densities in 3-D space using SDSS galaxies and their photometric redshifts near the Swift galaxy cluster candidates. We find 103 Swift clusters with a > 3σ over-density. The remaining targets are potentially located at higher redshifts and require deeper optical follow-up observations for confirmations as galaxy clusters. We present a series of cluster properties including the redshift, BCG magnitude, BCG-to-X-ray center offset, optical richness, X-ray luminosity and red sequences. We compare the observed redshift distribution of the sample with a theoretical model, and find that our sample is complete for z ≤ 0.3 and 80% complete for z ≤ 0.4, consistent with the survey depth of SDSS. These analysis results suggest that our Swift cluster selection algorithm presented in our first paper has yielded a statistically well-defined cluster sample for further studying cluster evolution and cosmology. In the end, we will discuss our ongoing optical identification of z>0.5 cluster

  9. Fertility-preserving surgical procedures, techniques.

    PubMed

    Martinez, Alejandra; Poilblanc, Mathieu; Ferron, Gwenael; De Cuypere, Mariolene; Jouve, Eva; Querleu, Denis

    2012-06-01

    As a result of the trend toward late childbearing, fertility preservation has become a major issue in young women with gynaecological cancer. Fertility-sparing treatments have been successfully attempted in selected cases of cervical, endometrial and ovarian cancer, and gynaecologists should be familiar with fertility-preserving options in women with gynaecological malignancies. Options to preserve fertility include shielding to reduce radiation damage, fertility preservation when undergoing cytotoxic treatments, cryopreservation, assisted reproduction techniques, and fertility-sparing surgical procedures. Radical vaginal trachelectomy with laparoscopic lymphadenectomy is an oncologically safe, fertility-preserving procedure. It has been accepted worldwide as a surgical treatment of small early stage cervical cancers. Selected cases of early stage ovarian cancer can be treated by unilateral salpingo-ophorectomy and surgical staging. Hysteroscopic resection and progesterone treatment are used in young women who have endometrial cancer to maintain fertility and avoid surgical menopause. Appropriate patient selection, and careful oncologic, psychologic, reproductive and obstetric counselling, is mandatory. PMID:22503435

  10. Protocol for a pre-implementation and post-implementation study on shared decision-making in the surgical treatment of women with early-stage breast cancer

    PubMed Central

    Savelberg, Wilma; Moser, Albine; Smidt, Marjolein; Boersma, Liesbeth; Haekens, Christel; van der Weijden, Trudy

    2015-01-01

    Background The majority of patients diagnosed with early-stage breast cancer are in a position to choose between having a mastectomy or lumpectomy with radiation therapy (breast-conserving therapy). Since the long-term survival rates for mastectomy and for lumpectomy with radiation therapy are comparable, patients’ informed preferences are important for decision-making. Although most clinicians believe that they do include patients in the decision-making process, the information that women with breast cancer receive regarding the surgical options is often rather subjective, and does not invite patients to express their preferences. Shared decision-making (SDM) is meant to help patients clarify their preferences, resulting in greater satisfaction with their final choice. Patient decision aids can be very supportive in SDM. We present the protocol of a study to β test a patient decision aid and optimise strategies for the implementation of SDM regarding the treatment of early-stage breast cancer in the actual clinical setting. Methods/design This paper concerns a pre-implementation and post-implementation study, lasting from October 2014 to June 2015. The intervention consists of implementing SDM using a patient decision aid. The intervention will be evaluated using qualitative and quantitative measures, acquired prior to, during and after the implementation of SDM. Outcome measures are knowledge about treatment, perceived SDM and decisional conflict. We will also conduct face-to-face interviews with a sample of these patients and their care providers, to assess their experiences with the implementation of SDM and the patient decision aid. Ethics and dissemination This protocol was approved by the Maastricht University Medical Centre (MUMC) ethics committee. The findings will be disseminated through peer-reviewed journal articles and presentations at national conferences. Findings will be used to finalise a multi-faceted implementation strategy to test the

  11. Clinical results of a surgical technique using endobuttons for complete tendon tear of pectoralis major muscle: report of five cases

    PubMed Central

    2011-01-01

    Background We herein describe a surgical technique for the repair of complete tear of the pectoralis major (PM) tendon using endobuttons to strengthen initial fixation. Methods Five male patients (3 judo players, 1 martial arts player, and 1 body builder) were treated within 2 weeks of sustaining complete tear of the PM tendon. Average age at surgery and follow-up period were 28.4 years (range, 23-33) and 28.8 months (range, 24-36). A rectangular bone trough (about 1 × 4 cm) was created on the humerus at the insertion of the distal PM tendon. The tendon stump was introduced into this trough, and fixed to the reverse side of the humeral cortex using endobuttons and non-absorbable suture. Clinical assessment of re-tear was examined by MRI. Shoulder range of motion (ROM), outcome of treatment, and isometric power were measured at final follow-up. Results There were no clinical re-tears, and MRI findings also showed continuity of the PM tendon in all cases at final follow-up. Average ROM did not differ significantly between the affected and unaffected shoulders. The clinical outcomes at final follow-up were excellent (4/5 cases) or good (1/5). In addition, postoperative isometric power in horizontal flexion of the affected shoulder showed complete recovery when compared with the unaffected side. Conclusions Satisfactory outcomes could be obtained when surgery using the endobutton technique was performed within 2 weeks after complete tear of the PM tendon. Therefore, our new technique appears promising as a useful method to treat complete tear of the PM tendon. PMID:21955511

  12. Choice of surgical access for retroperitoneoscopic ureterolithotomy according to the results of 3D reconstruction of operational zone agreed with the patient: initial experience

    PubMed Central

    Bashirov, Valerii I.; Furman, Yakov A.; Rozhentsov, Alexey A.; Yeruslanov, Ruslan V.; Kudryavtsev, Alexandr A.

    2013-01-01

    Introduction For the procedure retroperitoneoscopic ureterolithotomy, the problems of access choice and thus visualization with utilizing minimally invasive surgical access (either with gasless single port method or gas insufflation) are solved. The decisions are based on the method of presurgery planning, grounded on matching the patient with a 3D model of the zone of surgical interest reconstructed according to the results of tomographic examination. Material and methods We used a hardware–software complex (HSC) for virtual modeling of the surgery zone and choosing the optimum points for minimally invasive surgical access. The HSC was recruited to choose optimum surgical access, realize presurgery planning, and estimation of the safety of the way of access chosen. The original method of matching the system of coordinates of a virtual model with the patient was offered. Results 12 patients with the calculus in the upper part of ureter averaging 11.5 (9–14) mm in size underwent gasless retroperitoneoscopic ureterolithotomy with use of the HSC. Mean age of the patients was 36.4 (25–49) years old. The surgeries lasted an average of 35.5 (25–40) minutes. Blood loss was averaged at 55.0 (30–90) ml. Healing by first intention was registered with all the patients. The mean hospitalization time was 6.0 (4–7) days. There were neither any complications nor difficulties, nor conversions from incorrectly chosen surgical access. Conclusions The choice of the optimum surgical access according to the results of a virtual 3D model of the operation zone, matching the system of coordinates of the model with patient concurrence, and presurgery planning, was effective in cases of gasless single port and with gas insufflation retroperitoneoscopic ureterolithotomy. PMID:24757541

  13. The results of anterior radical debridement and anterior instrumentation in Pott's disease and comparison with other surgical techniques.

    PubMed

    Benli, I T; Kiş, M; Akalin, S; Citak, M; Kanevetçi, S; Duman, E

    2000-04-01

    Classic procedure in the treatment of vertebral tuberculosis is drainage of the abscess, curettage of the devitalized vertebra and application of antituberculous chemotherapy regimen. Posterior instrumentation results are encouraging in the prevention or treatment of late kyphosis; however, a second stage operation is needed. Recently, posterolateral or transpedicular drainage without anterior drainage or posterior instrumentation following anterior drainage in the same session is preferred to avoid kyphotic deformity. Seventy-six patients with spinal tuberculosis were operated in the 1st Department of Orthopaedics and Traumatology, Ankara Social Security Hospital, between January 1987 and January 1997. There were four children in our series. Average follow-up period was 36.1 +/- 14.5 months and the average age at the time of operation was 40.8 +/- 15.2 years. This study reports the surgical results of 45 patients with Pott's disease who had anterior radical debridement with anterior fusion and anterior instrumentation [14 patients with Z-plate and 31 patients with Cotrel-Dubousset-Hopf (CDH system)]. The results are compared with those of 8 patients who had posterolateral drainage and posterior fusion, 12 patients who had only anterior drainage and anterior strut grafting and, 11 patients who had posterior instrumentation following anterior radical debridement in the same session in terms of fusion rates, correction of kyphotic deformity, recurrence rate and clinical results. All patients had one year consecutive triple drug therapy. Preoperative 23.2 degrees +/- 12.5 degrees local kyphosis angle was lowered to 6.1 degrees +/- 6.9 degrees with a correction rate of 77.4 +/- 22.3%. When the other three groups which had been instrumented were compared, the correction rates in the local kyphosis angle values were not statistically different and the variation in loss of correction at the last follow-up was also statistically insignificant. The sagittal contour of the

  14. Early clinical and radiographical results of keel-less and shallow keel cervical disc replacement

    PubMed Central

    Ling, Ji Min; Tiruchelvarayan, Rajendra

    2015-01-01

    Background: Cervical disc replacements has been shown to be as effective as fusions in the treatment of radiculopathy or myelopathy due to disc prolapse. Newer implants were designed to reduce the difficulty of end-plate preparation. Since 2010, the authors have started using Discocerv (Alphatec Spine, Carlsbad, USA) a keel-less implant and Activ-C (B. Braun, Sheffield, UK), a shallow keel implant. Aim: The aim of this study was to compare the duration of surgery between cervical disc replacement and anterior cervical discectomy and fusion, and also to evaluate the functional outcome, complications, and radiographic outcome of cervical disc replacement. Results: Fifty patients were included (20 disc replacement and 30 fusion). This was a single surgeon retrospective study, with all surgery performed by the senior author (RT). The mean operation duration for single-level disc replacement was 2.6 h, and for single-level fusion was 2.4 h (P = 0.4684). For 2-levels surgery, the result was 3.5 h for 2-level hybrid surgery (one level disc replacement and one level fusion) and 3.4 h for fusion (P = 0.4489). Disc replacement resulted in preservation of an average of 67% of the angle of motion at the sagittal plane (FFflexion-extension). The average range of motion after disc replacement was 6.1°. The median clinical follow-up duration was 2 years (average 1.8 years). There was no incidence of major complications or significant neurovascular injury in this series of patients. A significant improvement in short form-36 scores was seen as early as 3 months postoperative (from 58 preoperative to 92 at 3 months). The improvement was sustained up to the fourth year of follow-up. Conclusion: Cervical arthroplasty with keel-less and shallow keel implants are safe and relatively easy to perform. The surgical time for disc replacement is not significantly longer than standard fusion surgery. There is reasonably good preservation of motion. The short-term functional improvement is

  15. Surgical management of recurrent disc herniations with microdiscectomy and long-term results on life quality: Detailed analysis of 70 cases

    PubMed Central

    Albayrak, Serdal; Ozturk, Sait; Durdag, Emre; Ayden, Ömer

    2016-01-01

    Background: Aim of this paper is to recall the surgical technique used in the recurrent lumbar disc herniations (LDHs) and to share our experiences. Materials and Methods: Out of series of 1115 patients who underwent operations for LDH between 2006 and 2013, 70 patients underwent re-operations, which were included in this study. During surgery, lateral decompression performed over the medial facet joint to the superior facet joint border was seen after widening the laminectomy defect, and microdiscectomy was performed. The demographic findings of the patients, their complaints in admission to hospital, the level of operation, the condition of dural injury, the first admission in the prospective analysis, and their quality of life were evaluated through the Oswestry scoring during their postoperative 1st, 3rd, 6th-month and 1st, 3rd, 5th and 7th-year follow-up. In the statical analysis, Friedman test was performed for the comparison of the Oswestry scores and Siegel Castellan test was used for the paired nonparametrical data. A P < 0.05 was considered statistically significant. Results: Considering the Oswestry Index during the follow-ups, the values in the postoperative early period and follow-ups were seen to be significantly lower than those at the time of admission to hospital (P < 0.05). None of the patients, who re-operated by microdiscectomy, presented with iatrogenic instability in 7 years follow-up period. Conclusion: Microdiscectomy performed through a proper technique in the re-operation of recurrent disc herniations eases complaints and improves the quality of life. Long-term follow-ups are required for more accurate results. PMID:26933352

  16. Early results using an ePTFE membrane for pericardial closure following coronary bypass grafting.

    PubMed

    Bhatnagar, G; Fremes, S E; Christakis, G T; Goldman, B S

    1998-05-01

    A prospective randomized trial was conducted to evaluate the early efficacy and safety of the Gortex surgical membrane. Three hundred two patients (265 males, 37 females) undergoing isolated coronary bypass surgery were randomized to receive a Gortex membrane (GM = 138) or have the pericardium left open (complication [C] = 164). The groups did not differ in age, gender, urgency of procedure, length of procedure, or use of arterial grafts. Two deaths occurred in each group giving an overall mortality of 1.3%. Fifty-three (17%) patients experienced some complication (C = 34, 21%), GM = 19 (14%). Although the combined complication rate was higher in the control group, this was not statistically significant (chi2 = 2.51, p = 0.11). Postoperative ischemic events (C = 8, GM = 4) observed between the groups were not significant (chi2 = 0.05, p = 0.8), and no statistically significant difference was observed between the incidences of infections (C = 7, GM = 5) or mediastinal complications (C = 3, GM = 3). The Gortex surgical membrane can be used safely without increasing the risk of infection or mediastinal complications. The incidence of recurrent myocardial ischemia, a possible indicator of graft compression, was not higher following membrane implantation. Efficacy at injury prevention will need to be determined by a longitudinal follow-up study presently underway. PMID:10193989

  17. Single-port laparoscopic colectomy versus conventional laparoscopic colectomy for colon cancer: a comparison of surgical results

    PubMed Central

    2012-01-01

    Background Single-port laparoscopic surgery is a new technique that leaves no visible scar. This new technique has generated strong interest among surgeons worldwide. However, single-port laparoscopic colon surgery has not yet been standardized. Our aim in this study was to evaluate the feasibility of single-port laparoscopic colectomy compared with conventional laparoscopic colectomy for colon cancer. Methods We conducted a case-matched, controlled study comparing single-port laparoscopic colectomy to conventional laparoscopic colectomy for right-sided colon cancer. Results A total of ten patients were included for the single-port laparoscopic colectomy (S-LAC) group and ten patients for the conventional laparoscopic colectomy (C-LAC) group. The length of the skin incision in the S-LAC group was significantly shorter than that of the C-LAC group. Conclusion Our early experiences indicated that S-LAC for right-sided colon cancer is a feasible and safe procedure and that S-LAC results in a better cosmetic outcome. PMID:22531017

  18. Total Hip Arthroplasty Performed Through Direct Anterior Approach Provides Superior Early Outcome: Results of a Randomized, Prospective Study.

    PubMed

    Parvizi, Javad; Restrepo, Camilo; Maltenfort, Mitchell G

    2016-07-01

    Studies suggest that total hip arthroplasty (THA) performed through direct anterior (DA) approach has better functional outcomes than other surgical approaches. The immediate to very early outcomes of DA THA are not known. A prospective, randomized study examined the very early outcome of THA performed through DA versus direct lateral approach. The functional outcomes on day 1, day 2, week 6, week 12, 6 months, and 1 year were measured. Patients receiving DA THA had significantly higher functional scores during the early period following surgery. The difference in functional scores leveled out at 6 months. PMID:27241374

  19. 3D planning in orthognathic surgery: CAD/CAM surgical splints and prediction of the soft and hard tissues results - our experience in 16 cases.

    PubMed

    Aboul-Hosn Centenero, Samir; Hernández-Alfaro, Federico

    2012-02-01

    The aim of this article is to determine the advantages of 3D planning in predicting postoperative results and manufacturing surgical splints using CAD/CAM (Computer Aided Design/Computer Aided Manufacturing) technology in orthognathic surgery when the software program Simplant OMS 10.1 (Materialise(®), Leuven, Belgium) was used for the purpose of this study which was carried out on 16 patients. A conventional preoperative treatment plan was devised for each patient following our Centre's standard protocol, and surgical splints were manufactured. These splints were used as study controls. The preoperative treatment plans devised were then transferred to a 3D-virtual environment on a personal computer (PC). Surgery was simulated, the prediction of results on soft and hard tissue produced, and surgical splints manufactured using CAD/CAM technology. In the operating room, both types of surgical splints were compared and the degree of similitude in results obtained in three planes was calculated. The maxillary osteotomy line was taken as the point of reference. The level of concordance was used to compare the surgical splints. Three months after surgery a second set of 3D images were obtained and used to obtain linear and angular measurements on screen. Using the Intraclass Correlation Coefficient these postoperative measurements were compared with the measurements obtained when predicting postoperative results. Results showed that a high degree of correlation in 15 of the 16 cases. A high coefficient of correlation was obtained in the majority of predictions of results in hard tissue, although less precise results were obtained in measurements in soft tissue in the labial area. The study shows that the software program used in the study is reliable for 3D planning and for the manufacture of surgical splints using CAD/CAM technology. Nevertheless, further progress in the development of technologies for the acquisition of 3D images, new versions of software programs

  20. Evaluation of coblation lingual tonsil removal technique for obstructive sleep apnea in Asians: preliminary results of surgical morbidity and prognosticators.

    PubMed

    Wee, Jee Hye; Tan, Kenglu; Lee, Woo-Hyun; Rhee, Chae-Seo; Kim, Jeong-Whun

    2015-09-01

    Retroglossal obstruction is one of the etiologies causing obstructive sleep apnea (OSA) and can be addressed by removing some tissues of the tongue base. However, because of its deep-seated location, its surgical removal is still challenging. Although coblation technique has been introduced, its efficacy and morbidity need further evaluation, particularly in Asians. This study aimed to assess its safety and effectiveness and to identify outcome prognosticators. Forty-seven OSA patients who underwent coblation lingual tonsil removal were included. Retroglossal obstruction was confirmed by drug-induced sleep videofluoroscopy. Attended full-night polysomnography was performed twice; before and 6 months after surgery in 27 patients. The tongue base was fully exposed with three deep-seated traction sutures, visualized with a 30° or 70° endoscope, and ablated using a coblator. Surgical success was defined with postoperative apnea hypopnea index (AHI) <20 and reduction >50 %. Postoperative morbidities were evaluated. Demographic and polysomnographic parameters between success and failure groups were compared. None of the patients had immediate postoperative hemorrhage. Postoperatively, one patient had delayed hemorrhage and one patient severe respiratory difficulty. Taste loss, tongue dysmotility, dental injury or severe oropharyngeal stricture were absent. A mean AHI decreased from 37.7 ± 18.6 to 18.7 ± 14.8/h (P < 0.001). The success rate was 55.6 %. Their mean minimal oxygen saturation was significantly lower (P = 0.004) in the failure group. Coblation lingual tonsil removal technique showed minimal morbidity and favorable outcome in Koreans. The surgical outcome might be associated with the severity of single respiratory events. PMID:25323152

  1. [Comprehensive evaluation of long-term results of surgical treatment and principles of postoperative rehabilitation of children with anorectal atresia].

    PubMed

    Kaplan, V M; Sitkovskiĭ, N B; Babiĭ, Ia M; Chernienko, Iu L; Gbenu, A S; Kondratskiĭ, N N; Takoeva, T I; Bodnar', V V

    1992-01-01

    The examination and treatment of 22 children at the age of from 2 to 14 years after surgical correction of fistulous forms of atresia of the anus and rectum was carried out. In all the patients, besides of general clinical investigations, the special studies of the large intestine with the use of roentgenologic and functional methods were performed. A scale-table for assessment of a degree of anal incompetence have been developed, criteria for choice of rational tactics for rehabilitation of the patients established. PMID:1453622

  2. Early palaeozoic palaeomagnetism in Australia I. Cambrian results from the Flinders Ranges, South Australia II. Late Early Cambrian results from Kangaroo Island, South Australia III. Middle to early-Late Cambrian results from the Amadeus Basin, Northern Territory

    NASA Astrophysics Data System (ADS)

    Klootwijk, C. T.

    1980-04-01

    I. Cambrian results from the Flinders Ranges, South Australia A total of 460 samples from six sequences spanning the Cambrian succession of the Flinders Ranges (Adelaide "Geosyncline", South Australia) has been analyzed through thermal demagnetization studies. All samples showed a recent field component, generally constituting more than 50% of the initial intensity, which in most cases was removed by 200-400°C. Two characteristic magnetic components have been identified: (A) A secondary magnetic component of Cambro-Ordovician age (S-pole at 75.3°E 26.0°N, α95 = 7.4°, N = 5 localities) interpreted as having been induced by thermochemical activity during a period of enhanced heat flux prior to the Late Cambrian-Early Ordovician diastrophistic phases of the Delamarian Orogeny. (B) A primary magnetic component, which indicates rapid polar motion during the Early Cambrian and a much reduced polar motion during the Middle Cambrian. Representative palaeomagnetic pole positions for the primary component are: (1) Basal Hawker Group (earliest Cambrian): S-pole at 2.3°E 26.7°S, d p = 8.1°, d m = 14.3°, N = 10 (sites). (2) Billy Creek Formation— Wirrealpa Limestone— Aroona Creek Limestone (late Early Cambrian to early Middle Cambrian): S-pole at 20.1°E 37.4°S, d p = 7.2°, dm = 14.4°, N = 11(sites). (3) Basal Lake Frame Group (Middle Cambrian): S-pole at 26.1°E 29.3°S, d p = 6.6°, d m = 13.1°, N =10 (sites). (4) Pantapinna Formation (late Middle Cambrian?): S-pole at 29.2°E 36.4°S, d p = 8.4°, dm = 16.7°, N = 4 (sites). Available data suggest that deposition of the Lake Frome Group beds probably did not continue into the Late Cambrian. II. Late Early Cambrian results from Kangaroo Island, South Australia A total of 108 block samples from a late Early Cambrian red-bed sequence on Kangaroo Island (Adelaide "Geosyncline", South Australia) has been analysed through thermal demagnetization studies. All samples contained a recent field component of

  3. Surgical Patterns of Care in Patients with Invasive Breast Cancer Treated with Neoadjuvant Systemic Therapy and Breast Magnetic Resonance Imaging: Results of a Secondary Analysis of TBCRC 017

    PubMed Central

    McGuire, Kandace P.; Hwang, E. Shelley; Cantor, Alan; Golshan, Mehra; Meric-Bernstam, Funda; Horton, Janet K.; Nanda, Rita; Amos, Keith D.; Forero, Andres; Hudis, Cliff A.; Meszoely, Ingrid; De Los Santos, Jennifer F.

    2015-01-01

    Background Neoadjuvant chemotherapy (NCT) down-stages advanced primary tumors, with magnetic resonance imaging (MRI) being the most sensitive imaging predictor of response. However, the impact of MRI evaluation on surgical treatment decisions in the neoadjuvant setting has not been well described. We report surgical patterns of care across 8 National Cancer Institute comprehensive cancer centers in women receiving both NCT and MRI to evaluate the impact of MRI findings on surgical planning. Methods Seven hundred seventy women from 8 institutions received NCT with MRI obtained both before and after systemic treatment. Univariate and multivariate analyses of imaging, patient-, and tumor-related covariates associated with choice of breast surgery were conducted. Results MRI and surgical data were available on 759 of 770 patients. A total of 345 of 759 (45 %) patients received breast-conserving surgery and 414 of 759 (55 %) received mastectomy. Mastectomy occurred more commonly in patients with incomplete MRI response versus complete (58 vs. 43 %) (p = 0.0003). On multivariate analysis, positive estrogen receptor status (p = 0.02), incomplete MRI response (p = 0.0003), higher baseline T classification (p < 0.0001), younger age (p < 0.0006), and institution (p = 0.003) were independent predictors of mastectomy. A statistically significant trend toward increasing use of mastectomy with increasing T stage at presentation (p < 0.0001) was observed in patients with incomplete response by MRI only. Among women with complete response on MRI, 43 % underwent mastectomy. Conclusions Within a multi-institutional cohort of women undergoing neoadjuvant treatment for breast cancer, MRI findings were not clearly associated with extent of surgery. This study shows that receptor status, T stage at diagnosis, young age, and treating institution are more significant determinants of surgical treatment choice than MRI response data. PMID:25059792

  4. Predominant Leg Pain Is Associated With Better Surgical Outcomes in Degenerative Spondylolisthesis and Spinal Stenosis: Results from the Spine Patient Outcomes Research Trial (SPORT)

    PubMed Central

    Pearson, Adam; Blood, Emily; Lurie, Jon; Abdu, William; Sengupta, Dilip; Frymoyer, John W.; Weinstein, James

    2010-01-01

    Study Design As-treated analysis of the Spine Patient Outcomes Research Trial (SPORT). Objective To compare baseline characteristics and surgical and nonoperative outcomes in degenerative spondylolisthesis (DS) and spinal stenosis (SpS) patients stratified by predominant pain location (i.e. leg vs. back). Summary of Background Data Evidence suggests that degenerative spondylolisthesis (DS) and spinal stenosis (SpS) patients with predominant leg pain may have better surgical outcomes than patients with predominant low back pain (LBP). Methods The DS cohort included 591 patients (62% underwent surgery), and the SpS cohort included 615 patients (62% underwent surgery). Patients were classified as leg pain predominant, LBP predominant or having equal pain according to baseline pain scores. Baseline characteristics were compared between the three predominant pain location groups within each diagnostic category, and changes in surgical and nonoperative outcome scores were compared through two years. Longitudinal regression models including baseline covariates were used to control for confounders. Results Among DS patients at baseline, 34% had predominant leg pain, 26% had predominant LBP, and 40% had equal pain. Similarly, 32% of SpS patients had predominant leg pain, 26% had predominant LBP, and 42% had equal pain. DS and SpS patients with predominant leg pain had baseline scores indicative of less severe symptoms. Leg pain predominant DS and SpS patients treated surgically improved significantly more than LBP predominant patients on all primary outcome measures at one and two years. Surgical outcomes for the equal pain groups were intermediate to those of the predominant leg pain and LBP groups. The differences in nonoperative outcomes were less consistent. Conclusions Predominant leg pain patients improved significantly more with surgery than predominant LBP patients. However, predominant LBP patients still improved significantly more with surgery than with

  5. Aesthetic surgical training in the UK independent sector--the clients' view: Results of a survey on 155 private patients.

    PubMed

    Schenker, M; Lees, V C; McGeorge, D D; Orton, C I; Hancock, K

    2006-01-01

    As training opportunities in cosmetic surgery become less frequent in teaching hospitals, this survey set out to examine the attitudes of patients towards extending this training into the independent health sector. We questioned 155 private patients, 95% of who were happy for trainees to sit in during their consultations. Of these, 85% were comfortable with the presence of the trainee throughout their appointments and 92% said they saw advantages in having such trainees present. However, patients were less enthusiastic about trainees carrying out procedures, under consultant supervision and for a reduced fee. The survey found that while 49% felt it was a good idea, only 32% would consider it for themselves. Seventeen percent of patients thought this offer alone was inappropriate. This survey has shown that while the vast majority of private patients supported and were happy to participate in higher surgical training during private consultations, fewer would consider the possibility of cosmetic surgery performed by supervised trainees for reduced fees. The implications of these findings for higher surgical training in Plastic Surgery in the UK are discussed. PMID:17046628

  6. Surgical Instrument Restraint in Weightlessness

    NASA Technical Reports Server (NTRS)

    Campbell, Mark R.; Dawson, David L.; Melton, Shannon; Hooker, Dona; Cantu, Hilda

    2000-01-01

    Performing a surgical procedure during spaceflight will become more likely with longer duration missions in the near future. Minimal surgical capability has been present on previous missions as the definitive medical care time was short and the likelihood of surgical events too low to justify surgical hardware availability. Early demonstrations of surgical procedures in the weightlessness of parabolic flight indicated the need for careful logistical planning and restraint of surgical hardware. The consideration of human ergonomics also has more impact in weightlessness than in the conventionall-g environment. Three methods of surgical instrument restraint - a Minor Surgical Kit (MSK), a Surgical Restraint Scrub Suit (SRSS), and a Surgical Tray (ST) were evaluated in parabolic flight surgical procedures. The Minor Surgical Kit was easily stored, easily deployed, and demonstrated the best ability to facilitate a surgical procedure in weightlessness. Important factors in this surgical restraint system include excellent organization of supplies, ability to maintain sterility, accessibility while providing secure restraint, ability to dispose of sharp items and biological trash, and ergonomical efficiency.

  7. Early palaeozoic palaeomagnetism in Australia I. Cambrian results from the Flinders Ranges, South Australia II. Late Early Cambrian results from Kangaroo Island, South Australia III. Middle to early-Late Cambrian results from the Amadeus Basin, Northern Territory

    NASA Astrophysics Data System (ADS)

    Klootwijk, C. T.

    1980-04-01

    I. Cambrian results from the Flinders Ranges, South Australia A total of 460 samples from six sequences spanning the Cambrian succession of the Flinders Ranges (Adelaide "Geosyncline", South Australia) has been analyzed through thermal demagnetization studies. All samples showed a recent field component, generally constituting more than 50% of the initial intensity, which in most cases was removed by 200-400°C. Two characteristic magnetic components have been identified: (A) A secondary magnetic component of Cambro-Ordovician age (S-pole at 75.3°E 26.0°N, α95 = 7.4°, N = 5 localities) interpreted as having been induced by thermochemical activity during a period of enhanced heat flux prior to the Late Cambrian-Early Ordovician diastrophistic phases of the Delamarian Orogeny. (B) A primary magnetic component, which indicates rapid polar motion during the Early Cambrian and a much reduced polar motion during the Middle Cambrian. Representative palaeomagnetic pole positions for the primary component are: (1) Basal Hawker Group (earliest Cambrian): S-pole at 2.3°E 26.7°S, d p = 8.1°, d m = 14.3°, N = 10 (sites). (2) Billy Creek Formation— Wirrealpa Limestone— Aroona Creek Limestone (late Early Cambrian to early Middle Cambrian): S-pole at 20.1°E 37.4°S, d p = 7.2°, dm = 14.4°, N = 11(sites). (3) Basal Lake Frame Group (Middle Cambrian): S-pole at 26.1°E 29.3°S, d p = 6.6°, d m = 13.1°, N =10 (sites). (4) Pantapinna Formation (late Middle Cambrian?): S-pole at 29.2°E 36.4°S, d p = 8.4°, dm = 16.7°, N = 4 (sites). Available data suggest that deposition of the Lake Frome Group beds probably did not continue into the Late Cambrian. II. Late Early Cambrian results from Kangaroo Island, South Australia A total of 108 block samples from a late Early Cambrian red-bed sequence on Kangaroo Island (Adelaide "Geosyncline", South Australia) has been analysed through thermal demagnetization studies. All samples contained a recent field component of

  8. Iatrogenic right coronary artery stenosis resulting from surgical tricuspid valve replacement: case report and review of the literature.

    PubMed

    Morrissy, Stephen J; Atkins, Broadus Zane; Rogers, Jason H

    2014-12-01

    Iatrogenic injury to the right coronary artery (RCA) is a rare complication of tricuspid valve surgery. We herein describe the first-ever report of RCA injury related to tricuspid valve replacement surgery. A 38-year-old man with recurrent tricuspid endocarditis underwent redo tricuspid valve replacement by means of a minimally invasive right thoracotomy with a 32-mm St. Jude bioprosthetic valve. His post-operative course was complicated by pulseless ventricular tachycardia requiring CPR and defibrillation. Cardiac catheterization revealed a "kinked" stenotic distal RCA. The lesion was noted to be flow limiting by fractional flow reserve and was treated with two everolimus-eluting stents. The RCA runs in the atrioventricular groove and is susceptible to injury especially in the region of the posterior leaflet of the tricuspid valve, where the relationship of the tricuspid annulus to the RCA is most intimate. Repair of surgically induced coronary stenosis can be accomplished with percutaneous intervention. PMID:25131346

  9. Surgical Strategies for Spontaneous Intracerebral Hemorrhage.

    PubMed

    Ziai, Wendy; Nyquist, Paul; Hanley, Daniel F

    2016-06-01

    In recent decades, the surgical treatment of intracerebral hemorrhage (ICH) has become a focus of scientific inquest. This effort has been led by an international group of neurologists and neurosurgeons with the goal of studying functional recovery and developing new surgical techniques to facilitate improved clinical outcomes. Currently, the two most pressing ICH investigational goals are (1) early blood pressure control, and (2) safe hematoma volume reduction. Achieving these goals would support decision-making, level-of-care choices, and the global research strategy of developing biologically informed treatments. Herein the authors review conventional and minimally invasive surgical approaches to spontaneous ICH, articulating the scope of the problem, recent clinical trials, management issues, and relevant questions for future research. The authors propose that strategies using minimally invasive techniques including clot aspiration with stereotactic guidance may give better results with improved clinical outcomes compared with standard open surgical approaches. PMID:27214701

  10. Carpal tunnel syndrome in hemodialysis patients as a dialysis-related amyloidosis manifestation – incidence, risk factors and results of surgical treatment

    PubMed Central

    Kopeć, Jerzy; Gądek, Artur; Drożdż, Maciej; Miśkowiec, Krzysztof; Dutka, Julian; Sydor, Antoni; Chowaniec, Eve; Sułowicz, Władysław

    2011-01-01

    Summary Background Carpal tunnel syndrome (CTS) is the most common complication of dialysis-related amyloidosis (DRA) developing in patients on long-term dialysis therapy. The aim of this study was to evaluate the incidence of CTS and identify factors influencing the development of CTS in patients on maintenance hemodialysis, as well as results of its surgical treatment. Material/Methods The study included 386 patients, among whom CTS was diagnosed in 40 patients (10.4%) on the basis of signs and physical symptoms, as well as by nerve conduction. The group of patients with CTS and the group of patients without CTS were compared according to age (mean 54.50 vs. 56.48 years) and duration of dialysis treatment. Initial analysis of CTS incidence by sex, presence of anti-HCV antibodies, and location of arterio-venous fistula (AV fistula) was undertaken. Results Duration of dialysis treatment was the statistically significant risk factor for the development of CTS (16.05 vs. 4.51 years; p<0.0001). Among patients treated for a long period on hemodialysis (20–30 years), 100% required surgical release procedures, while 66.66% of those treated for 15–19 years, 42.1% of those treated for 10–14 years, and 1.6% of those treated for less than 10 years. CTS was diagnosed more often in anti-HCV-positive patients as compared with anti-HCV-negative patients (47.5 vs. 6.9%; p<0.0001). No significant differences were found when comparing CTS incidence by sex or between the development of CTS requiring surgical release intervention and location of the AV fistula. Conclusions Surgical release procedure of the carpal tunnel gave good treatment results in patients with CTS. PMID:21873947

  11. Accelerated Hypofractionated Radiotherapy for Early-Stage Non-Small-Cell Lung Cancer: Long-Term Results

    SciTech Connect

    Soliman, Hany; Cheung, Patrick; Yeung, Latifa; Poon, Ian; Balogh, Judith; Barbera, Lisa; Spayne, Jacqueline; Danjoux, Cyril; Dahele, Max; Ung, Yee

    2011-02-01

    Purpose: To retrospectively review the results of a single-institution series of accelerated hypofractionated radiotherapy for early-stage non-small-cell lung cancer (NSCLC) in patients who are medically inoperable or who refuse surgery. Methods and Materials: Peripherally located T1 to T3 N0 M0 tumors were treated with 48 to 60 Gy in 12 to 15 fractions between 1996 and 2007. No elective nodal irradiation was delivered. Patient, tumor, and treatment information was abstracted from the medical records. Results: A total of 124 tumors were treated in 118 patients (56 male and 62 female). Median age at diagnosis was 76.3 years (range, 49-90 years). In all, 113 patients (95.8%) were not surgical candidates because of medical comorbidities. The 2- and 5-year overall survival (OS) rates were 51.0% and 23.3%, respectively, and the 2- and 5-year cause-specific survival (CSS) rates were 67.6% and 59.8%, respectively. The 2- and 5-year actuarial local control (LC) rates were 76.2% and 70.1%, respectively. Univariate analysis revealed that tumor size less than 3cm compared with greater than 3 cm resulted in significantly improved OS (40.0% vs. 5.0% at 5 years; p = 0.0002), CSS (69.7% vs. 45.1% at 5 years; p = 0.0461), and a trend toward better LC (82.5% vs. 66.9% at 2 years, 76.6% vs. 60.8% at 5 years; p = 0.0685). Treatment was well tolerated and there were no treatment delays because of acute toxicity. Conclusions: Accelerated hypofractionated radiotherapy with 48 to 60 Gy using fractions of 4 Gy per day provides very good results for small tumors in medically inoperable patients with early-stage NSCLC.

  12. Evaluation of the results from surgical treatment of fractures of the lateral extremity of the clavicle, using the double ligature technique☆

    PubMed Central

    Miyazaki, Alberto Naoki; da Silva, Luciana Andrade; do Val Sella, Guilhermel; Checchia, Sergio Luiz; Cândido dos Santos, Sílvia Helena Cavadinha; Chadud, Vitor Schneider

    2015-01-01

    Objective To evaluate the incidence of consolidation in surgical treatment of fractures of the lateral extremity of the clavicle using the double subcoracoid ligature technique, with nonabsorbable No. 5 thread. Methods Between May 1993 and June 2013, the Shoulder and Elbow Group of our service surgically treated 116 patients (116 shoulders) with fractures of the lateral extremity of the clavicle. Among these, we were able to reassess 65 cases. The surgical technique used consisted of double subcoracoid ligature with two nonabsorbable threads. In two patients classified as type III, we had to combine this technique with use of an interfragmentary screw for fixation of the intra-articular portion of the acromioclavicular joint. Results We achieved fracture consolidation in 90%. Fourteen cases (21%) evolved with major complications: four cases of pseudarthrosis, five of adhesive capsulitis, two of delayed consolidation and three of loss of reduction. Two cases (3%) evolved with minor complications of skin granuloma. Conclusion The double ligature technique for fractures of the lateral extremity of the clavicle promotes the stabilization needed for consolidation to take place, without the need for synthesis using metal components. It avoids reoperation for the synthesis material to be removed. Moreover, it is a low-cost procedure with good reproducibility and preservation of the acromioclavicular joint. PMID:26229907

  13. Laparoscopic nephrectomy: safe and comfortable surgical alternative for living donors and for good results of graft function.

    PubMed

    Rocca, X; Espinoza, O; Hidalgo, F; Gonzalez, F

    2005-10-01

    Laparoscopic nephrectomy for kidney donation from living related donors has the advantages of a less invasive surgical access, better cosmesis, and a shorter hospital stay for the donor. However, some workers have reported up to 10% life-threatening complications for the donor using this technique. The purpose of our study was to evaluate hand-assisted laparoscopic nephrectomy for living donors of kidney transplants in terms of graft function. Thirty donors who underwent open nephrectomy (ON) were compared with 27 who had hand-assisted nephrectomy (HALN). Surgery and ischemia times, hospital stay, bleeding, graft function, remaining kidney function, and complications were compared in both groups. Mean surgery time was 126.9 minutes for ON and 98 minutes for HALN (P = .0005), warm ischemia time was 3 minutes versus 6 for ON vs HALN, respectively (P = .02). Hospitalization stay was 6.3 days for ON versus 4.8 days for HALN (P = .0015). Differences in change in hematocrit and in serum creatinine levels were not significant; graft outcomes were also similar. Complications were minimal. We conclude that HALN is a valid, safe technique to obtain kidneys from living related donors, significantly reducing the hospital stay and allowing return to normal activities sooner, with risks falling within those reported in the literature. PMID:16298592

  14. Management of Facial Nerve in Surgical Treatment of Previously Untreated Fisch Class C Tympanojugular Paragangliomas: Long-Term Results

    PubMed Central

    Bacciu, Andrea; Ait Mimoune, Hassan; D'Orazio, Flavia; Vitullo, Francesca; Russo, Alessandra; Sanna, Mario

    2013-01-01

    The aim of this study was to evaluate the long-term facial nerve outcome according to management of the facial nerve in patients undergoing surgery for Fisch class C tympanojugular paragangliomas. The study population consisted of 122 patients. The infratemporal type A approach was the most common surgical procedure. The facial nerve was left in place in 2 (1.6%) of the 122 patients, anteriorly rerouted in 97 (79.5%), anteriorly rerouted with segmental resection of the epineurium in 7 (5.7%), and sacrificed and reconstructed in 15 (12.3%). One patient underwent cross-face nerve grafting. At last follow-up, House-Brackmann grade I to II was achieved in 51.5% of patients who underwent anterior rerouting and in 28.5% of those who underwent anterior rerouting with resection of the epineurium. A House-Brackmann grade III was achieved in 73.3% of patients who underwent cable nerve graft interposition. The two patients in whom the facial nerve was left in place experienced grade I and grade III, respectively. The patient who underwent cross-face nerve grafting had grade III. Gross total resection was achieved in 105 cases (86%). Management of the facial nerve in tympanojugular paraganglioma surgery can be expected to ensure satisfactory facial function long-term outcome. PMID:24498582

  15. Reducing surgical site infection incidence through a network: results from the French ISO-RAISIN surveillance system.

    PubMed

    Astagneau, P; L'Hériteau, F; Daniel, F; Parneix, P; Venier, A-G; Malavaud, S; Jarno, P; Lejeune, B; Savey, A; Metzger, M-H; Bernet, C; Fabry, J; Rabaud, C; Tronel, H; Thiolet, J-M; Coignard, B

    2009-06-01

    Surgical-site infections (SSIs) are a key target for nosocomial infection control programmes. We evaluated the impact of an eight-year national SSI surveillance system named ISO-RAISIN (infection du site opératoire - Réseau Alerte Investigation Surveillance des Infections). Consecutive patients undergoing surgery were enrolled during a three-month period each year and surveyed for 30 days following surgery. A standardised form was completed for each patient including SSI diagnosis according to standard criteria, and several risk factors such as wound class, American Society of Anesthesiologists (ASA) score, operation duration, elective/emergency surgery, and type of surgery. From 1999 to 2006, 14,845 SSIs were identified in 964,128 patients (overall crude incidence: 1.54%) operated on in 838 participating hospitals. The crude overall SSI incidence decreased from 2.04% to 1.26% (P<0.001; relative reduction: -38%) and the National Nosocomial Infections Surveillance system (NNIS)-0 adjusted SSI incidence from 1.10% to 0.74% (P<0.001; relative reduction: -33%). The most significant SSI incidence reduction was observed for hernia repair and caesarean section, and to a lesser extent, cholecystectomy, hip prosthesis arthroplasty, and mastectomy. Active surveillance striving for a benchmark throughout a network is an effective strategy to reduce SSI incidence. PMID:19380181

  16. Final Visual Acuity Results in the Early Treatment for Retinopathy of Prematurity Study

    PubMed Central

    2014-01-01

    Objective To compare visual acuity at 6 years of age in eyes that received early treatment for high-risk prethreshold retinopathy of prematurity (ROP) with conventionally-managed eyes. Methods Infants with symmetrical, high-risk prethreshold ROP (N=317) had one eye randomized to earlier treatment at high-risk prethreshold disease and the other eye managed conventionally, treated if ROP progressed to threshold severity. For asymmetric cases (N=84), the high-risk prethreshold eye was randomized to either early treatment or conventional management. Main Outcome Measures ETDRS visual acuity measured at 6 years of age by masked testers. Retinal structure was assessed as a secondary outcome. Results Analysis of all subjects with high-risk prethreshold ROP showed no statistically significant benefit for early treatment (24.6% v. 29.0% unfavorable outcome, P=0.15). Analysis of 6-year visual acuity results according to the Type 1 and 2 clinical algorithm showed a benefit for Type 1 eyes (25.1% v. 32.8%, P=0.02) treated early, but not Type 2 eyes (23.6% v. 19.4%, P=0.37). Early treated eyes showed a significantly better structural outcome compared with conventionally managed eyes (8.9% v. 15.2% unfavorable outcome, P<0.001), with no greater risk of ocular complications. Conclusion Early treatment for Type 1 high-risk prethreshold eyes improved visual acuity outcomes at 6 years of age. Early treatment for Type 2 high-risk prethreshold eyes did not. Application to Clinical Practice Type 1 eyes, not Type 2 eyes should be treated early. These results are particularly important considering that 52 % of Type 2 high-risk prethreshold eyes underwent regression of ROP without requiring treatment. PMID:20385926

  17. Surgical Airway

    PubMed Central

    Patel, Sapna A; Meyer, Tanya K

    2014-01-01

    Close to 3% of all intubation attempts are considered difficult airways, for which a plan for a surgical airway should be considered. Our article provides an overview of the different types of surgical airways. This article provides a comprehensive review of the main types of surgical airways, relevant anatomy, necessary equipment, indications and contraindications, preparation and positioning, technique, complications, and tips for management. It is important to remember that the placement of a surgical airway is a lifesaving procedure and should be considered in any setting when one “cannot intubate, cannot ventilate”. PMID:24741501

  18. Grating Visual Acuity Results in the Early Treatment for Retinopathy of Prematurity Study

    PubMed Central

    2015-01-01

    Objective To compare grating (resolution) visual acuity at 6 years of age in eyes that received early treatment (ET) for high-risk prethreshold retinopathy of prematurity (ROP) versus eyes that were managed conventionally (CM). Methods In a randomized clinical trial, infants with bilateral, high-risk prethreshold ROP (N=317) had one eye treated early at high-risk prethreshold disease and the other eye managed conventionally, and treated if ROP progressed to threshold severity. For asymmetric cases (N=84), the high-risk prethreshold eye was randomized to either ET or CM. Main Outcome Measures Grating visual acuity measured at 6 years of age by masked testers using Teller acuity cards. Results Monocular grating acuity results were obtained from 317 (86%) of 370 surviving children. Analysis of grating acuity results for all subjects with high-risk prethreshold ROP showed no statistically significant overall benefit for early treatment (18.1% vs 22.8% unfavorable outcome, P=0.08). When the 6-year grating acuity results were analyzed according to a clinical algorithm (high-risk Type 1 and high-risk Type 2 prethreshold ROP), a benefit was seen in Type 1 eyes (16.4% vs 25.2%, P=0.004) that were treated early, but not in Type 2 eyes (21.3% vs 15.9%, P=0.29). Conclusion Early treatment for eyes with Type 1 ROP improved grating acuity outcomes but early treatment for eyes with Type 2 ROP did not. Application to Clinical Medicine Type I eyes should be treated early; however, based on acuity results at age 6 years, Type 2 eyes should be cautiously monitored for progression to Type 1 ROP. Trial Registration NCT00027222 PMID:21746974

  19. Surgical treatments for osteoarthritis.

    PubMed

    de l'Escalopier, Nicolas; Anract, Philippe; Biau, David

    2016-06-01

    There are two main surgical treatments for osteoarthritis: conservative treatments, where the damaged cartilage is left in place, and radical treatments, where the cartilage is replaced by an artificial endoprosthesis; this latter procedure is termed joint arthroplasty. These treatments are only offered to symptomatic patients. Arthrodesis is yet another surgical intervention in cases of osteoarthritis. It will sacrifice the joint's articular function and is performed on small osteoarthritic joints, such as wrists and ankles, for instance. Osteoarthritis symptoms are usually the consequence of an imbalance between the load applied to a joint and the surface available to support that load. Therefore, conservative treatments will either tend to decrease the load exerted on the joint, such as in a tibial valgus osteotomy for instance, or to improve the articular surface supporting that load. Sometimes, both can be provided at the same time; the peri-acetabular osteotomy for hip dysplasia is an example of such a procedure. Conservative treatments are usually offered to young patients in order to delay, if not avoid, the need for a joint prosthesis. They are usually performed before osteoarthritis appears or at an early stage. Joint arthroplasties have overwhelmingly excellent functional results and today's research is directed towards providing rapid recovery, very long-term stability, and the assurance of a good functionality in extreme conditions. However, complications with joint arthroplasties can be serious with little, if any, reasonable salvage solution. Therefore, these procedures are offered to patients who have failed adequate medical treatment measures. PMID:27185463

  20. Laparoscopic cholecystectomy: evolution, early results, and impact on nonsurgical gallstone therapies.

    PubMed

    Brandon, J C; Velez, M A; Teplick, S K; Mueller, P R; Rattner, D W; Broadwater, J R; Lang, N P; Eidt, J F

    1991-08-01

    Laparoscopic cholecystectomy, a surgical technique first performed in France, has gained widespread acceptance among surgeons in the United States. The abdominal cavity is inflated by carbon dioxide, a video monitor is inserted via a laparoscope placed periumbilically, and the gallbladder is freed and removed from the liver bed by using small subcostal ports for access and dissection. Intraoperative cholangiography is routinely performed, but uncertainty exists about how best to manage choledocholithiasis. Compared with traditional cholecystectomy, initial reports describing laparoscopic cholecystectomy cite shorter recovery times because no large incisions are made, thus potentially reducing the cost and morbidity of cholecystectomy. A survey of 614 early cases supports these claims, with a reported complication rate of 1.5% and quick resumption of normal activities by patients. Because of its promise for reduced morbidity, laparoscopic cholecystectomy is challenging open cholecystectomy as the therapeutic gold standard for symptomatic cholelithiasis. Thus, the standard to which the nonsurgical gallstone therapies, such as lithotripsy and contact dissolution, will be compared may shift to laparoscopic cholecystectomy. As the laparoscopic complications are similar to those of traditional cholecystectomy, such as abscesses and bile leaks, their percutaneous treatment should not change. PMID:1830188

  1. Does age affect surgical outcomes in patients with degenerative cervical myelopathy? Results from the prospective multicenter AOSpine International study on 479 patients

    PubMed Central

    Nakashima, Hiroaki; Tetreault, Lindsay A; Nagoshi, Narihito; Nouri, Aria; Kopjar, Branko; Arnold, Paul M; Bartels, Ronald; Defino, Helton; Kale, Shashank; Zhou, Qiang; Fehlings, Michael G

    2016-01-01

    Background In general, older patients with degenerative cervical myelopathy (DCM) are felt to have lower recovery potential following surgery due to increased degenerative pathology, comorbidities, reduced physiological reserves and age-related changes to the spinal cord. This study aims to determine whether age truly is an independent predictor of surgical outcome and to provide evidence to guide practice and decision-making. Methods A total of 479 patients with DCM were prospectively enrolled in the CSM-International study at 16 centres. Our sample was divided into a younger group (<65 years) and an elderly (≥65 years) group. A mixed model analytic approach was used to evaluate differences in the modified Japanese Orthopaedic Association (mJOA), Nurick, Short Form-36 (SF-36) and Neck Disability Index (NDI) scores between groups. We first created an unadjusted model between age and surgical outcome and then developed two adjusted models that accounted for variations in (1) baseline characteristics and (2) both baseline and surgical factors. Results Of the 479 patients, 360 (75.16%) were <65 years and 119 (24.84%) were ≥65 years. Elderly patients had a worse preoperative health status (p<0.0001) and were functionally more severe (p<0.0001). The majority of younger patients (64.96%) underwent anterior surgery, whereas the preferred approach in the elderly group was posterior (58.62%, p<0.0001). Elderly patients had a greater number of decompressed levels than younger patients (p<0.0001). At 24 months after surgery, younger patients achieved a higher postoperative mJOA (p<0.0001) and a lower Nurick score (p<0.0001) than elderly patients. After adjustments for patient and surgical characteristics, these differences in postoperative outcome scores decreased but remained significant. Conclusions Older age is an independent predictor of functional status in patients with DCM. However, patients over 65 with DCM still achieve functionally significant

  2. Factors associated with early sexual debut in Slovenia: results of a general population survey

    PubMed Central

    Klavs, I; Rodrigues, L C; Weiss, H A; Hayes, R

    2006-01-01

    Objectives To investigate time trends in age at first heterosexual intercourse (FHI) and associated factors. Methods Data were collected from a national probability sample of the general population aged 18–49 years. Results Median age at FHI was 17 years for men and 18 years for women, but declined from 18 years to 17 years in men born after the early 1960s and in women born after the early 1970s. Early FHI (before age 16) was reported by 15.2% of men and 7.4% of women, but in recent cohorts (born 1975–82), proportions were similar in both sexes (16.9% and 14.4%, respectively). In women, higher educational level and acquiring most knowledge about sex from parents or in school were associated with later age at FHI. Half the women with early FHI judged the event to have occurred too soon. 4.2% of women with early FHI reported coercion at FHI, compared to 0.9% overall. The main factor associated with early FHI in men was not living with both parents up to the age of 15. Individuals with early FHI were more likely to report higher risk sexual behaviour as well as teenage motherhood and, for men, not having used a condom at FHI and bacterial sexually transmitted infections. Three in four individuals with early FHI thought they had inadequate sexual knowledge at FHI. Many would have liked to have learned more from parents and in school. Conclusions Improved sexual education among young Slovenians should aim to delay FHI until a more mature age and to be better prepared for safer sex. PMID:17151034

  3. Early Blindness Results in Developmental Plasticity for Auditory Motion Processing within Auditory and Occipital Cortex

    PubMed Central

    Jiang, Fang; Stecker, G. Christopher; Boynton, Geoffrey M.; Fine, Ione

    2016-01-01

    Early blind subjects exhibit superior abilities for processing auditory motion, which are accompanied by enhanced BOLD responses to auditory motion within hMT+ and reduced responses within right planum temporale (rPT). Here, by comparing BOLD responses to auditory motion in hMT+ and rPT within sighted controls, early blind, late blind, and sight-recovery individuals, we were able to separately examine the effects of developmental and adult visual deprivation on cortical plasticity within these two areas. We find that both the enhanced auditory motion responses in hMT+ and the reduced functionality in rPT are driven by the absence of visual experience early in life; neither loss nor recovery of vision later in life had a discernable influence on plasticity within these areas. Cortical plasticity as a result of blindness has generally be presumed to be mediated by competition across modalities within a given cortical region. The reduced functionality within rPT as a result of early visual loss implicates an additional mechanism for cross modal plasticity as a result of early blindness—competition across different cortical areas for functional role. PMID:27458357

  4. Early Blindness Results in Developmental Plasticity for Auditory Motion Processing within Auditory and Occipital Cortex.

    PubMed

    Jiang, Fang; Stecker, G Christopher; Boynton, Geoffrey M; Fine, Ione

    2016-01-01

    Early blind subjects exhibit superior abilities for processing auditory motion, which are accompanied by enhanced BOLD responses to auditory motion within hMT+ and reduced responses within right planum temporale (rPT). Here, by comparing BOLD responses to auditory motion in hMT+ and rPT within sighted controls, early blind, late blind, and sight-recovery individuals, we were able to separately examine the effects of developmental and adult visual deprivation on cortical plasticity within these two areas. We find that both the enhanced auditory motion responses in hMT+ and the reduced functionality in rPT are driven by the absence of visual experience early in life; neither loss nor recovery of vision later in life had a discernable influence on plasticity within these areas. Cortical plasticity as a result of blindness has generally be presumed to be mediated by competition across modalities within a given cortical region. The reduced functionality within rPT as a result of early visual loss implicates an additional mechanism for cross modal plasticity as a result of early blindness-competition across different cortical areas for functional role. PMID:27458357

  5. Surgical revolutions.

    PubMed

    Toledo-Pereyra, Luis H

    2008-01-01

    Many surgical revolutions distinguish the history and evolution of surgery. They come in different sizes and exert a variable effect on the development and practice of the discipline. As science and technology rapidly evolve, so too does the creation of new paradigms, ideas and innovations or discoveries for the improvement of the surgical sciences. Surgical revolutions are not new, and have existed for centuries even though they have been more frequently recognized since the middle of the 19th century, 20th century and down to the present. Surgical revolutionaries are indispensable in the conception and completion of any surgical revolution. However, scientific and technological advances have supported the culmination of each revolution. PMID:18615311

  6. Long-term results of forward intensity-modulated radiation therapy for patients with early-stage breast cancer

    PubMed Central

    Ha, Boram; Lee, Jihae; Lee, Kyung-Ja; Lee, Rena; Moon, Byung In

    2013-01-01

    Purpose To observe long-term clinical outcomes for patients with early-stage breast cancer treated with forward intensity-modulated radiation therapy (IMRT), including local control and clinical toxicities. Materials and Methods We retrospectively analyzed a total of 214 patients with stage I-II breast cancer who were treated with breast conserving surgery followed by adjuvant breast radiation therapy between 2001 and 2008. All patients were treated using forward IMRT. The whole breast was irradiated to a dose of 50 to 50.4 Gy followed by an 8 to 12 Gy electron boost to the surgical bed. Results The median age was 46 years (range, 21 to 82 years) and the medial follow-up time was 7.3 years (range, 2.4 to 11.7 years). Stage T1 was 139 (65%) and T2 was 75 (35%), respectively. Ipsilateral breast recurrence was observed in 3 patients. The 5- and 10-year local control rates were 99.1% and 97.8%, respectively. The cosmetic outcome was evaluated according to the Harvard scale and 89.4% of patients were scored as excellent or good. Conclusion The whole breast radiation therapy as an adjuvant treatment using a forward IMRT technique showed excellent long-term local control as well as favorable outcomes of toxicity and cosmesis. PMID:24501706

  7. Melanocortin 1 Receptor-Signaling Deficiency Results in an Articular Cartilage Phenotype and Accelerates Pathogenesis of Surgically Induced Murine Osteoarthritis

    PubMed Central

    Hackmayer, Gerit; Greth, Carina; Bauer, Richard J.; Kleinschmidt, Kerstin; Bettenworth, Dominik; Böhm, Markus; Grifka, Joachim; Grässel, Susanne

    2014-01-01

    Proopiomelanocortin-derived peptides exert pleiotropic effects via binding to melanocortin receptors (MCR). MCR-subtypes have been detected in cartilage and bone and mediate an increasing number of effects in diathrodial joints. This study aims to determine the role of MC1-receptors (MC1) in joint physiology and pathogenesis of osteoarthritis (OA) using MC1-signaling deficient mice (Mc1re/e). OA was surgically induced in Mc1re/e and wild-type (WT) mice by transection of the medial meniscotibial ligament. Histomorphometry of Safranin O stained articular cartilage was performed with non-operated controls (11 weeks and 6 months) and 4/8 weeks past surgery. µCT–analysis for assessing epiphyseal bone architecture was performed as a longitudinal study at 4/8 weeks after OA-induction. Collagen II, ICAM-1 and MC1 expression was analysed by immunohistochemistry. Mc1re/e mice display less Safranin O and collagen II stained articular cartilage area compared to WT prior to OA-induction without signs of spontaneous cartilage surface erosion. This MC1-signaling deficiency related cartilage phenotype persisted in 6 month animals. At 4/8 weeks after OA-induction cartilage erosions were increased in Mc1re/e knees paralleled by weaker collagen II staining. Prior to OA-induction, Mc1re/e mice do not differ from WT with respect to bone parameters. During OA, Mc1re/e mice developed more osteophytes and had higher epiphyseal bone density and mass. Trabecular thickness was increased while concomitantly trabecular separation was decreased in Mc1re/e mice. Numbers of ICAM-positive chondrocytes were equal in non-operated 11 weeks Mc1re/e and WT whereas number of positive chondrocytes decreased during OA-progression. Unchallenged Mc1re/e mice display smaller articular cartilage covered area without OA-related surface erosions indicating that MC1-signaling is critical for proper cartilage matrix integrity and formation. When challenged with OA, Mc1re/e mice develop a more severe OA

  8. The results of early physiotherapy on a child with incontinentia pigmenti with encephalocele

    PubMed Central

    Kara, Ozgun Kaya; Mutlu, Akmer; Gunel, Mintaze Kerem

    2010-01-01

    This study aimed to exhibit the effects of early physiotherapy and discusses post-treatment results on a patient with incontinentia pigmenti (IP) with encephalocele. Physiotherapy evaluations of the child included cognitive, fine and gross motor development assessed with the Bayley Scales of Infant and Toddler Development – Third Edition (Bayley-III), disability level with the gross motor function classification system, gross motor function with the gross motor function measurement (GMFM), and tonus evaluation with the Modified Ashworth Scale. The child was included in a physiotherapy and rehabilitation programme based on neurodevelopmental treatment three times a week. Although cognitive and motor development according to Bayley-III improved in the present case, motor and cognitive retardation became more apparent with growth. GMFM results indicated a large improvement from 5.88% to 47.73%. Presentation of this case shows the significance of early physiotherapy in this first study on physiotherapy for IP during the early rehabilitation process. PMID:22767665

  9. Early prenatal androgenization results in diminished ovarian reserve in adult female rhesus monkeys

    PubMed Central

    Dumesic, D.A.; Patankar, M.S.; Barnett, D.K.; Lesnick, T.G.; Hutcherson, B.A.; Abbott, D.H.

    2009-01-01

    BACKGROUND Early prenatal androgenization (PA) accelerates follicle differentiation and impairs embryogenesis in adult female rhesus monkeys (Macaca mulatta) undergoing FSH therapy for IVF. To determine whether androgen excess in utero affects follicle development over time, this study examines whether PA exposure, beginning at gestational days 40–44 (early treated) or 100–115 (late treated), alters the decline in serum anti-Mullerian hormone (AMH) levels with age in adult female rhesus monkeys and perturbs their ovarian response to recombinant human FSH (rhFSH) therapy for IVF. METHODS Thirteen normal (control), 11 early-treated and 6 late-treated PA adult female monkeys had serum AMH levels measured at random times of the menstrual cycle or anovulatory period. Using some of the same animals, basal serum AMH, gonadotrophins and steroids were also measured in six normal, five early-treated and three late-treated PA female monkeys undergoing FSH therapy for IVF during late-reproductive life (>17 years); serum AMH also was measured on day of HCG administration and at oocyte retrieval. RESULTS Serum AMH levels in early-treated PA females declined with age to levels that were significantly lower than those of normal (P ≤ 0.05) and late-treated PA females (P ≤ 0.025) by late-reproductive life. Serum AMH levels positively predicted numbers of total/mature oocytes retrieved, with early-treated PA females having the lowest serum AMH levels, fewest oocytes retrieved and lowest percentage of females with fertilized oocytes that cleaved. CONCLUSIONS Based on these animals, early PA appears to program an exaggerated decline in ovarian reserve with age, suggesting that epigenetically induced hormonal factors during fetal development may influence the cohort size of ovarian follicles after birth. PMID:19740899

  10. Prenatal rapamycin results in early and late behavioral abnormalities in wildtype C57Bl/6 mice

    PubMed Central

    Tsai, Peter T.; Green-Colozzi, Emily; Goto, June; Anderl, Stefanie; Kwiatkowski, David; Sahin, Mustafa

    2012-01-01

    Mammalian target of rapamycin (mTOR) signaling has been shown to be deregulated in a number of genetic, neurodevelopmental disorders including Tuberous Sclerosis Complex, Neurofibromatosis, Fragile X, and Rett syndromes. As a result, mTOR inhibitors, such as rapamycin and its analogs, offer potential therapeutic avenues for these disorders. Some of these disorders – such as Tuberous Sclerosis Complex – can be diagnosed prenatally. Thus, prenatal administration of these inhibitors could potentially prevent the development of the devastating symptoms associated with these disorders. To assess the possible detrimental effects of prenatal rapamycin treatment, we evaluated both early and late behavioral effects of a single rapamycin treatment at embryonic day 16.5 in wildtype C57Bl/6 mice. This treatment adversely impacted early developmental milestones as well as motor function in adult animals. Rapamycin also resulted in anxiety-like behaviors during both early development and adulthood but did not affect adult social behaviors. Together, these results indicate that a single, prenatal rapamycin treatment not only adversely affects early postnatal development but also results in long lasting negative effects, persisting into adulthood. These findings are of importance in considering prenatal administration of rapamycin and related drugs in the treatment of patients with neurogenetic, neurodevelopmental disorders. PMID:23229624

  11. Enhancing Student Services at Owens Community College: Early Results from the Opening Doors Demonstration in Ohio

    ERIC Educational Resources Information Center

    Scrivener, Susan; Pih, Michael

    2007-01-01

    MDRC launched Opening Doors in 2003 to study the effects of community college programs designed to help students persist in school and earn a credential. This report presents early results from the Opening Doors program at Owens Community College in Toledo, Ohio, which operated from 2004 through 2006. The two-semester program served students whose…

  12. Cardiovascular and selected comorbidities in early arthritis and early spondyloarthritis, a comparative study: results from the ESPOIR and DESIR cohorts

    PubMed Central

    Gherghe, Ana Maria; Dougados, Maxime; Combe, Bernard; Landewé, Robert; Mihai, Carina; Berenbaum, Francis; Mariette, Xavier; Wolterbeek, Ron; van der Heijde, Désirée

    2015-01-01

    Objectives To investigate the prevalence of comorbidities in early rheumatoid arthritis (ERA) and early axial spondyloarthritis (ESpA) versus the general population. Methods Baseline data of 689 patients with ERA from the Etude et Suivi des Polyarthrites Indifférenciées Récentes (ESPOIR) cohort (age 48.2±12.1 years, symptoms duration 14.2±14.5 weeks) and 645 patients with ESpA from Devenir des Spondylarthropathies Indifférenciées Récentes (DESIR; age 32.8±8.4 years, axial symptoms duration 79.0±45.7 weeks) were analysed. Metabolic and cardiovascular diseases (CVD), infections and neoplasia were determined in each cohort. The prevalence (95% CI) of several comorbidities was compared with that in the French general population. For patients without CVD, the 10-year risk of developing CVD was calculated using the Framingham and SCORE equations. The heart age was calculated using the 2008 Framingham points system. Results 42% of patients with ERA and 20.3% of patients with ESpA had at least 1 comorbidity; the most common were arterial hypertension (AHT) and dyslipidaemia. AHT prevalence (95% CI) in ERA (18.2% (15.5% to 21.3%)), but not in ESpA (5.08% (3.57% to 7.14%)), was significantly increased (p<0.05) compared with the general population (7.58%). Prevalence of tuberculosis history was higher in ERA (4.7% (3.3% to 6.6%)), and ESpA (0.99% (0.4% to 2.3%)) than in the general population (0.02%; both p<0.05). No differences were observed in malignancies, coronary heart disease or diabetes. In ERA, among patients without a history of CVD, an intermediate to high CVD risk was found. The heart age exceeded the real age by 4.1±9.6 years in ERA and by 2.1±7.0 years in ESpA (p<0.001). Conclusions We found an increased prevalence of AHT and tuberculosis history in ERA and ESpA, and an increased CVD risk. These results should prompt rheumatologists to check these comorbidities early in the disease. PMID:26535145

  13. Extracranial Carotid Artery Stenting in Surgically High-Risk Patients Using the Carotid Wallstent Endoprosthesis:Midterm Clinical and Ultrasound Follow-Up Results

    SciTech Connect

    Maleux, Geert Bernaerts, Pauwel; Thijs, Vincent; Daenens, Kim; Vaninbroukx, Johan; Fourneau, Inge; Nevelsteen, Andre

    2003-08-15

    The purpose of this study was to evaluate the feasibility, safety and midterm outcome of elective implantation of the Carotid Wallstent (registered) in patients considered to be at high surgical risk. In a prospective study, 54 carotid artery stenoses in 51 patients were stented over a 24-month period. Three patients underwent bilateral carotid artery stenting. Institutional inclusion criteria for invasive treatment of carotid occlusive disease (carotid endarterectomy or carotid artery stenting) are patients presenting with a 70% or more symptomatic stenosis and those with an 80% or more asymptomatic stenosis having a life-expectancy of more than 1 year. All patients treated by carotid artery stenting were considered at high risk for carotid endarterectomy because of a hostile neck (17 patients-31.5%) or because of severe comorbidities (37 patients-68.5%). No cerebral protection device was used. Of the 54 lesions, 33 (61.1%) were symptomatic and 21 (38.8%) were asymptomatic. Follow-up was performed by physical examination and by duplex ultrasonography at 1 month, 6 months, 1 year and 2 years after the procedure. All 54 lesions could be stented successfully without periprocedural stroke. Advert events during follow-up (mean 13.9 {+-} 5.7 months) were non-stroke-related death in 6 patients (11.1%), minor stroke in 4 stented hemispheres(7.4%), transient ipsilateral facial pain in 1 patient (1.8%),infection of the stented surgical patch in 1 patient (1.8%) and asymptomatic in stent restenosis in 4 patients (7.4%). The percutaneous implantation of the Carotid Wallstent (registered) , even without cerebral protection device, appears to be a safe procedure with acceptable clinical and ultrasonographic follow-up results in patients at high surgical risk. But some late adverse events such as ipsilateral recurrence of non-disabling (minor) stroke or in stent restenosis still remain real challenging problems.

  14. Surgical and Functional Results of Hybrid 25-27-Gauge Vitrectomy Combined with Coaxial 2.2 mm Small Incision Cataract Surgery

    PubMed Central

    Höhn, Fabian; Kretz, Florian; Pavlidis, Mitrofanis

    2016-01-01

    Purpose. To investigate outcomes after coaxial 2.2 mm small incision cataract surgery combined with hybrid 25-27-gauge vitrectomy in eyes with vitreoretinal disease and age-related cataract. Methods. A single-center, retrospective case series study of 55 subjects (55 eyes) with a mean age of 70 years who underwent combined small incision phacoemulsification, intraocular lens (IOL) implantation, and hybrid 25-27-gauge vitrectomy during the 12-month period to December 2014. Intraoperative and postoperative complications and visual results were the main outcome measures. Results. The mean follow-up period was 6 months (range: 2–18 months). Intraoperative findings were 3 retinal breaks (5.5%). No cases required corneal or scleral suture or conversion to larger-gauge vitrectomy. Postoperative complications consisted of posterior capsule opacification (12.7%), elevated intraocular pressure >30 mmHg (1.8%), and fibrin reaction (5.5%). There were no cases of hypotony (<7 mmHg), IOL decentration, or postoperative endophthalmitis. Visual acuity (mean ± SD) improved from 0.52 ± 0.6 logMAR preoperatively to 0.22 ± 0.46 logMAR at final postoperative visit (P < 0.0001). Conclusion. Surgical and visual outcomes suggest hybrid 25-27-gauge vitrectomy combined with small incision phacoemulsification and IOL implantation is feasible, safe, and effective as a one-step surgical procedure for the management of vitreoretinal pathologies and concurrent cataract. PMID:26966558

  15. Surgical and Functional Results of Hybrid 25-27-Gauge Vitrectomy Combined with Coaxial 2.2 mm Small Incision Cataract Surgery.

    PubMed

    Höhn, Fabian; Kretz, Florian; Pavlidis, Mitrofanis

    2016-01-01

    Purpose. To investigate outcomes after coaxial 2.2 mm small incision cataract surgery combined with hybrid 25-27-gauge vitrectomy in eyes with vitreoretinal disease and age-related cataract. Methods. A single-center, retrospective case series study of 55 subjects (55 eyes) with a mean age of 70 years who underwent combined small incision phacoemulsification, intraocular lens (IOL) implantation, and hybrid 25-27-gauge vitrectomy during the 12-month period to December 2014. Intraoperative and postoperative complications and visual results were the main outcome measures. Results. The mean follow-up period was 6 months (range: 2-18 months). Intraoperative findings were 3 retinal breaks (5.5%). No cases required corneal or scleral suture or conversion to larger-gauge vitrectomy. Postoperative complications consisted of posterior capsule opacification (12.7%), elevated intraocular pressure >30 mmHg (1.8%), and fibrin reaction (5.5%). There were no cases of hypotony (<7 mmHg), IOL decentration, or postoperative endophthalmitis. Visual acuity (mean ± SD) improved from 0.52 ± 0.6 logMAR preoperatively to 0.22 ± 0.46 logMAR at final postoperative visit (P < 0.0001). Conclusion. Surgical and visual outcomes suggest hybrid 25-27-gauge vitrectomy combined with small incision phacoemulsification and IOL implantation is feasible, safe, and effective as a one-step surgical procedure for the management of vitreoretinal pathologies and concurrent cataract. PMID:26966558

  16. Surgical Technologists

    MedlinePlus

    ... in place during the procedure, or set up robotic surgical equipment. Technologists also may handle specimens taken ... sterilization techniques, how to set up technical or robotic equipment, and preventing and controlling infections. In addition ...

  17. Surgical Mesh

    MedlinePlus

    ... Device Safety Safety Communications Surgical Mesh: FDA Safety Communication Share Tweet Linkedin Pin it More sharing options ... Prolapse and Stress Urinary Incontinence More in Safety Communications Information About Heparin Preventing Tubing and Luer Misconnections ...

  18. Risk factors and therapeutic results of early local recurrence after transcatheter arterial chemoembolization

    PubMed Central

    Rou, Woo Sun; Lee, Byung Seok; Moon, Hee Seok; Lee, Eaum Seok; Kim, Seok Hyun; Lee, Heon Young

    2014-01-01

    AIM: To identify factors affecting early local recurrence after transcatheter arterial chemoembolization (TACE) and investigate treatments and outcomes for local recurrence. METHODS: Early local recurrence and no early local recurrence groups drawn from 134 patients who were initially diagnosed with hepatocellular carcinoma (HCC) and showed a complete response (CR) to TACE treatment between January 1, 2006, and January 31, 2012, were analyzed by univariate and multivariate analyses. Additionally, the subsequent treatment for patients with recurrence was analyzed, and in cases in which TACE had been performed, the cumulative recurrence rates were calculated using the Kaplan-Meier method and compared with those of the primary lesion. RESULTS: The 1-, 2-, and 3-year survival rates were 92.3%, 60.2%, and 39.8%, respectively, in the early local recurrence group, which were significantly lower than those in both the late local and no local recurrence groups (P < 0.001). On multivariate analyses, non-compact lipiodol uptake, large tumor size, and an alpha-fetoprotein > 20 ng/mL after achieving a CR were significant predictors. When TACE was performed for early and late locally recurrent lesions, a CR was observed in 15 patients (41.7%) and 11 patients (78.6%), and the cumulative recurrence rates at 6, 12, and 24 mo were 17.9%, 43.3%, and 71.2%, respectively, which did not differ significantly from those after the first CR of 20.5%, 44.0%, and 58.6%, respectively (P = 0.639). CONCLUSION: Closer monitoring and active treatments must be provided to patients with risk factors for early local recurrence of HCC. PMID:24944494

  19. Early results from Magsat. [studies of near-earth magnetic fields

    NASA Technical Reports Server (NTRS)

    Langel, R. A.; Estes, R. H.; Mayhew, M. A.

    1981-01-01

    Papers presented at the May 27, 1981 meeting of the American Geophysical Union concerning early results from the Magsat satellite program, which was designed to study the near-earth magnetic fields originating in the core and lithosphere, are discussed. The satellite was launched on October 30, 1979 into a sun-synchronous (twilight) orbit, and re-entered the atmosphere on June 11, 1980. Instruments carried included a cesium vapor magnetometer to measure field magnitudes, a fluxgate magnetometer to measure field components and an optical system to measure fluxgate magnetometer orientation. Early results concerned spherical harmonic models, fields due to ionospheric and magnetospheric currents, the identification and interpretation of fields from lithospheric sources. The preliminary results confirm the possibility of separating the measured field into core, crustal and external components, and represent significant developments in analytical techniques in main-field modelling and the physics of the field sources.

  20. [Surgical treatment of bronchiectases in elderly patients].

    PubMed

    Danilov, G P; Makeeva, R P; Shornikov, V A; Zil'ber, E K; Akopov, A L

    2010-01-01

    The authors present experiences with surgical treatment of 29 patients (aged 50-64 years) with bronchiectases. Early and late results were analyzed. It was shown that complex approach to the estimation of the findings of radiography, spiral computed tomography, investigation of the external respiration function, fibrobronchoscopy and bronchoscopy, if necessary, allowed operating the patients older than 50 years with local forms of bronchiectases which gave good results. PMID:21137257

  1. [The surgical treatment of high myopia with dura mater. The results obtained long term (a clinical study)].

    PubMed

    Costin, D; Vancea, P P; Caraman, C; Burlea, M; Antohi, D; Popa, C; Stoian, R

    1990-01-01

    The paper presents the postoperative results obtained by performing scleroplasty with dura-mater in 127 progressive myopic eyes. The authors consider that the homologue dura-mater represents a high quality material to make scleral plasties. The evolution of myopia has ceased in over 60% of the cases. PMID:2100861

  2. Surgical results of cranioplasty with a polymethylmethacrylate customized cranial implant in pediatric patients: a single-center experience.

    PubMed

    Fiaschi, Pietro; Pavanello, Marco; Imperato, Alessia; Dallolio, Villiam; Accogli, Andrea; Capra, Valeria; Consales, Alessandro; Cama, Armando; Piatelli, Gianluca

    2016-06-01

    OBJECTIVE Cranioplasty is a reconstructive procedure used to restore skull anatomy and repair skull defects. Optimal skull reconstruction is a challenge for neurosurgeons, and the strategy used to achieve the best result remains a topic of debate, especially in pediatric patients for whom the continuing skull growth makes the choice of material more difficult. When the native bone flap, which is universally accepted as the preferred option in pediatric patients, is unavailable, the authors' choice of prosthetic material is a polymethylmethacrylate (PMMA) implant designed using a custom-made technique. In this paper the authors present the results of their clinical series of 12 custom-made PMMA implants in pediatric patients. METHODS A retrospective study of the patients who had undergone cranioplasty at Gaslini Children's Hospital between 2006 and 2013 was conducted. A total of 12 consecutive cranioplasties in 12 patients was reviewed, in which a patient-specific PMMA implant was manufactured using a virtual 3D model and then transformed into a physical model using selective laser sintering or 3D printing. All patients or parents were administered a questionnaire to assess how the patient/parent judged the aesthetic result. RESULTS Patient age at craniectomy ranged from 5 months to 12.5 years, with a mean age of 84.33 months at cranioplasty. The mean extension of the custom-made plastic was 56.83 cm(2). The mean time between craniectomy and cranioplasty was 9.25 months. The mean follow-up duration was 55.7 months. No major complications were recorded; 3 patients experienced minor/moderate complications (prosthesis dislocation, granuloma formation, and fluid collection). CONCLUSIONS In this patient series, PMMA resulted in an extremely low complication rate and the custom-made technique was associated with an excellent grade of patient or parent satisfaction on long-term follow up. PMID:26824593

  3. Results from conceptual design study of potential early commercial MHD/steam power plants

    NASA Technical Reports Server (NTRS)

    Hals, F.; Kessler, R.; Swallom, D.; Westra, L.; Zar, J.; Morgan, W.; Bozzuto, C.

    1981-01-01

    This paper presents conceptual design information for a potential early MHD power plant developed in the second phase of a joint study of such plants. Conceptual designs of plant components and equipment with performance, operational characteristics and costs are reported on. Plant economics and overall performance including full and part load operation are reviewed. Environmental aspects and the methods incorporated in plant design for emission control of sulfur and nitrogen oxides are reviewed. Results from reliability/availability analysis conducted are also included.

  4. A full featured handheld LIBS analyzer with early results for defense and security

    NASA Astrophysics Data System (ADS)

    Day, D.; Connors, B.; Jennings, M.; Egan, J.; Derman, K.; Soucy, P.; Moller, S.; Sackett, D.

    2015-06-01

    A handheld LIBS instrument has been designed that includes most features found in large bench-top systems including variable gating, argon purge, high resolution, wide spectral range, sample rastering, and video targeting. In this presentation we will discuss the feature selection, trade-off decisions and new developments that made this kind of size reduction possible. Early results will be presented for elemental presence detection and quantification with specific emphasis on defense and security.

  5. Early MAVEN results on the Mars Upper Atmosphere and Atmospheric Loss to Space

    NASA Astrophysics Data System (ADS)

    Jakosky, B. M.; Grebowsky, J. M.; Luhmann, J. G.

    2015-10-01

    The Mars Atmosphere and Volatile Evolution (MAVEN) spacecraft went into orbit around Mars on 21 September 2014. After a commissioning phase that included science observations of Mars and of Comet Siding Spring during its close approach, its primary science phase began on 16 November 2014 and will run for a full Earth year, until November 2015. Early results on structure, composition and dynamics of the upper atmosphere and on escape to space will be presented.

  6. Results from conceptual design study of potential early commercial MHD/steam power plants

    NASA Astrophysics Data System (ADS)

    Hals, F.; Kessler, R.; Swallom, D.; Westra, L.; Zar, J.; Morgan, W.; Bozzuto, C.

    1981-06-01

    This paper presents conceptual design information for a potential early MHD power plant developed in the second phase of a joint study of such plants. Conceptual designs of plant components and equipment with performance, operational characteristics and costs are reported on. Plant economics and overall performance including full and part load operation are reviewed. Environmental aspects and the methods incorporated in plant design for emission control of sulfur and nitrogen oxides are reviewed. Results from reliability/availability analysis conducted are also included.

  7. [Surgical results of dissection of the superficial temporal artery in patients with preglaucoma and initial open-angle glaucoma].

    PubMed

    Shilkin, G A; Iartseva, N S; Mironova, E M; Oreshkina, R M; Mikhaĭlova, G D

    1989-01-01

    Results of superficial temporal artery dissection performed in 42 patients (44 eyes) with preglaucoma and initial open-angle glaucoma have shown no impairement of visual field, visual acuity, optic disc in the period from 0.5 to 1.5 years after it. The increased linear rate of bloodflow after the operation remained stable in 17 eyes of patients with preglaucoma and in 14 eyes of patients with glaucoma. Intraocular pressure became normalized in 20 and 19 eyes as well as intraocular fluid outflow in 14 and 13 eyes, respectively. In both groups there was a tendency to normalization of retinal functions and hydrodynamics of the eye. Thus, the operation produces improvement of regional bloodflow, tonographic and electrophysiologic indices. Its usage is considered to be reasonable, but, when determining indications to it, an individual approach is necessary. PMID:2755669

  8. Web-Based Training in Early Autism Screening: Results from a Pilot Study

    PubMed Central

    Stone, Wendy L.; Ousley, Opal Y.; Swanson, Amy

    2011-01-01

    Abstract Background Lack of familiarity with early signs of autism by community service providers has resulted in significant delays in children receiving early intervention services necessary to improve long-term outcomes. The Screening Tool for Autism in Toddlers and Young Children (STAT) was specifically developed to identify early behavioral features of autism. Although STAT training has been available for years, access is limited because of few STAT trainers and geographic concerns. This study evaluated the efficacy and acceptability of Web-based training of the STAT as a means of increasing accessibility to this training. Materials and Methods Thirty professionals from three geographic areas participated. Roughly 1 of 3 had little or no training on autism assessment. The tutorial contains a general overview, administration and scoring conventions, and item-specific content and concepts. Participants completed a pretest and then completed the STAT tutorial at their own pace, followed by a post-test and a user satisfaction questionnaire. Results Mean scores on STAT concepts significantly improved after taking the tutorial (p < 0.001). At pretest, only 1 person (3%) obtained correct scores on at least 80% of the items (a priori cutoff for a “pass”), compared with 22 (73%) at post-test (p < 0.001). The majority of trainees enjoyed taking the tutorial, thought it was well organized, relevant, interesting, and useful, and felt it was easy to understand and operate. Discussion Results support Web-based training as a promising method for promoting early identification of autism and may help overcome problems associated with the critical shortage of autism-screening professionals. PMID:21939382

  9. FINAL RESULTS OF THE EARLY TREATMENT FOR RETINOPATHY OF PREMATURITY (ETROP) RANDOMIZED TRIAL

    PubMed Central

    Good, William V

    2004-01-01

    ABSTRACT Purpose To present the final results of the Early Treatment for Retinopathy of Prematurity Study. Methods Infants with bilateral high-risk prethreshold retinopathy of prematurity (ROP) (n = 317) had one eye randomized to early retinal ablative treatment and the fellow eye managed conventionally (control eye). In asymmetric cases (n = 84), the eye with high-risk prethreshold ROP was randomized to early or to conventional management. High risk was determined using a model based on the Cryotherapy for Retinopathy of Prematurity natural history cohort. The primary outcome was visual acuity assessed by masked testers using the Teller acuity card procedure. Structural examinations were performed at 6 and 9 months. Results Grating acuity results showed a reduction in unfavorable visual acuity outcomes with earlier treatment, from 19.8% to 14.3% (P < .005). Unfavorable structural outcomes were reduced from 15.6% to 9.0% (P < .001) at 9 months. Further analysis supported retinal ablative therapy for eyes with type I ROP, defined as zone I, any stage ROP with plus disease; zone I, stage 3 ROP without plus disease; or zone II, stage 2 or 3 with plus disease. The analysis supported a “wait and watch” approach to type II ROP, defined as zone I, stage 1 and 2 without plus disease, or zone II, stage 3 without plus disease. These eyes should be considered for treatment only if they progress to type I ROP or threshold. Conclusion Early treatment of high-risk prethreshold ROP significantly reduced unfavorable outcomes in both primary and secondary (structural) measures. PMID:15747762

  10. Twenty-Year Experience of Heart Transplantation: Early and Long-Term Results

    PubMed Central

    Lee, Jae-Hong; Yeom, Sang Yoon; Hwang, Ho Young; Choi, Jae-Woong; Cho, Hyun-Jai; Lee, Hae-Young; Huh, Jae-Hak; Kim, Ki-Bong

    2016-01-01

    Background We evaluated early and long-term results after heart transplantation (HTPL). Methods One hundred five consecutive patients (male:female=80:25) who underwent HTPL between 1994 and 2013 were enrolled. Based on the changes in immunosuppressive regimen, the study patients were divided into two groups. Early and long-term clinical outcomes were evaluated and compared between the patients who underwent HTPL before (group E, n=41) and after July 2009 (group L, n=64). The group L patients were older (p<0.001), had higher incidence of hypertension (p=0.001) and chronic kidney disease (p<0.001), and more frequently needed preoperative mechanical ventilation (p=0.027) and mechanical circulatory support (p=0.014) than the group E patients. Results Overall operative mortality was 3.8%, and postoperative morbidities included acute kidney injury (n=31), respiratory complications (n=16), reoperation for bleeding (n=15) and wound complications (n=10). There were no significant differences in early results except acute kidney injury between group E and group L patients. Overall survival rates at 1, 5, and 10 years were 83.8%, 67.7%, and 54.9%, respectively, with no significant difference between the two patient groups. Rejection-free rates at 1 and 5 years were 63.0% and 59.7%, respectively; rates were significantly higher in group L than in group E (p<0.001). Conclusion Despite increased preoperative comorbidities, group L patients showed similar early and long-term outcomes and significantly higher rejection-free rates when compared with group E patients. PMID:27525232

  11. Early results of an in vivo trial of ESS in thyroid cancer

    NASA Astrophysics Data System (ADS)

    Rosen, Jennifer E.; Goukassian, Ilona D.; A'Amar, Ousama M.; Bigio, Irving J.; Lee, Stephanie L.

    2012-02-01

    Introduction: Thyroid cancer is the most common endocrine malignancy. The current gold standard for diagnosis, fine-needle aspiration (FNA) biopsy, yields 10-25% of indeterminate cytology results, leading to patients undergoing thyroidectomy for diagnosis. We assessed the technical potential of a miniaturized in vivo ESS (elastic light scattering spectroscopy) probe, built into an FNA needle assembly, to differentiate benign from malignant thyroid nodules. Methods: Under IRB approval, 15 patients in the endocrine clinic undergoing FNAB of a thyroid nodule had collection of ESS data using our novel miniaturized FNA probe. Using final surgical pathology as our gold standard, data post processing and visual inspection was completed. Results: 225 spectra were grouped and analyzed (120 benign, 30 malignant and 75 from indeterminate cytology). ESS probes demonstrated excellent reproducibility in use. Initial analysis of these preliminary data is promising, indicating distinction of spectral ESS features between malignant and benign conditions. Conclusion(s): An in vivo trial of an invasive miniaturized integrated ESS biopsy probe is acceptable to patients, and collection of ESS data is feasible and reliable. With development of a disease-specific algorithm, ESS could potentially be used as an in-situ real time intra-operative diagnostic tool or as a minimally invasive adjunct to conventional FNA cytology.

  12. [New possibilities in the postoperative measures to prevent bleeding in cardiac surgery. Will the recombinant activated factor VII improve surgical results?].

    PubMed

    Skalski, Janusz H; Czapla, Jerzy; Nadziakiewicz, Paweł; Kaczmarski, Jacek; Zembala, Marian

    2002-01-01

    The authors present the diagnostic and therapeutic management in bleeding episodes associated with cardiosurgical operations, which constitutes the policy that is employed at Department of Cardiac Surgery and Transplantology, Silesian Academy of Medicine, Zabrze, Poland. The paper also presents a compendium of information on the pathophysiology of coagulation processes, most significant from the standpoint of cardiosurgical practice. Separate issues associated with providing optimal hemostasis in patients operated on using cardiopulmonary bypass are discussed, along with the effect of cardiac procedures on coagulation processes. Further, the authors present their clinical observations and experience in the utilization of the recombinant activated factor VII (NovoSeven, NovoNordisk) in two patients with severe perioperative bleeding. In the first case bleeding was associated heart transplantation procedure in a 37-year old woman, who had previously been twice subjected to operations for valvular heart disease. A dysfunction of two artificial valves implanted 15 years previously resulted in considerable heart muscle damage and an extremenally severe form of cardiac insufficiency. Two months after the heart transplant the patient unfortunately died due to infectious complications. In the second patient the recombinant activated factor VII was employed in an attempt at controlling severe bleeding encountered in a 15-year old boy in the course of reoperation in surgical treatment of a complex congenital heart defect. In this case the treatment was successful. In both described patients who were characterized by a high risk of surgical bleeding, the employment of the recombinant activated factor VII led to significant improvement in coagulation system indices and the hemostatic outcome was regarded positive. The authors state that the introduction of the recombinant activated factor VII to clinical practice in a selected group of patients presenting with most serious

  13. The use of fibre-based demineralised bone matrix in major acetabular reconstruction: surgical technique and preliminary results

    PubMed Central

    Karoubi, Mathieu; Dumaine, Valérie; Courpied, Jean Pierre

    2010-01-01

    Acetabular osteolysis associated with socket loosening is one of the main long-term complications of total hip arthroplasty. In case of major bone loss, where <50% host bone coverage can be obtained with a porous-coated cementless cup, it is generally agreed that a metal ring or cage in association with a cemented component and allograft bone should be used. In order to promote allograft bone consolidation and incorporation, we have associated demineralised bone matrix (DBM, Grafton® A Flex) to the construct ion. Here we describe the technical details of major acetabular reconstruction using the Kerboull acetabular reinforcement device with allograft bone and DBM. This device has a hook that must be placed under the teardrop of the acetabulum and a plate for iliac fixation. The main advantages of this device are help in restoring the normal centre of hip rotation, guiding the reconstruction and partially unloading the graft. The Kerboull acetabular reinforcement device has provided a 92% survival rate free of loosening at 13-year follow-up in a consecutive series of 60 type III and IV deficiencies. Our preliminary results using DBM indicate faster allograft consolidation and remodelling. PMID:21057788

  14. Approach-Related Complications of Anterior Lumbar Interbody Fusion: Results of a Combined Spine and Vascular Surgical Team

    PubMed Central

    Mobbs, Ralph J.; Phan, Kevin; Daly, Daniel; Rao, Prashanth J.; Lennox, Andrew

    2015-01-01

    Study Design Retrospective analysis of prospectively collected cohort data. Objective Anterior lumbar interbody fusion (ALIF) is a commonly performed procedure for the treatment of degenerative diseases of the lumbar spine. Detailed and comprehensive descriptions of intra- and postoperative complications of ALIF are surprisingly limited in the literature. In this report, we describe our experience with a team model for ALIF and report all complications occurring in our patient series. Methods Patients were prospectively enrolled between January 2009 and January 2013 by a combined spine surgeon and vascular surgeon team. All patients underwent an open ALIF using an anterior approach to the lumbosacral spine. Results From the 227 ALIF cases, mean operative blood loss was 103 mL, ranging from 30 to 900 mL. Mean operative time was 78 minutes. The average length of stay was 5.2 days. Intraoperative vascular injury requiring primary repair with suturing occurred in 15 patients (6.6%). There were 2 cases of postoperative retroperitoneal hematoma. Three patients (1.3%) had incisional hernia requiring revision surgery; 7 (3.1%) patients had prolonged ileus (>7 days) managed conservatively. Four patients described retrograde ejaculation. Sympathetic dysfunction occurred in 15 (6.6%) patients. There were 5 (2.2%) cases of superficial wound infection treated with oral antibiotics, with no deep wound infections requiring reoperation or intravenous therapy. There were no mortalities in this series. Conclusions ALIF is a safe procedure when performed by a combined vascular surgeon and spine surgeon team with acceptably low complication rates. Our series confirms that the team approach results in short operative times and length of stay, with rapid control of intraoperative vessel injury and low overall blood loss. PMID:26933616

  15. Approach-Related Complications of Anterior Lumbar Interbody Fusion: Results of a Combined Spine and Vascular Surgical Team.

    PubMed

    Mobbs, Ralph J; Phan, Kevin; Daly, Daniel; Rao, Prashanth J; Lennox, Andrew

    2016-03-01

    Study Design Retrospective analysis of prospectively collected cohort data. Objective Anterior lumbar interbody fusion (ALIF) is a commonly performed procedure for the treatment of degenerative diseases of the lumbar spine. Detailed and comprehensive descriptions of intra- and postoperative complications of ALIF are surprisingly limited in the literature. In this report, we describe our experience with a team model for ALIF and report all complications occurring in our patient series. Methods Patients were prospectively enrolled between January 2009 and January 2013 by a combined spine surgeon and vascular surgeon team. All patients underwent an open ALIF using an anterior approach to the lumbosacral spine. Results From the 227 ALIF cases, mean operative blood loss was 103 mL, ranging from 30 to 900 mL. Mean operative time was 78 minutes. The average length of stay was 5.2 days. Intraoperative vascular injury requiring primary repair with suturing occurred in 15 patients (6.6%). There were 2 cases of postoperative retroperitoneal hematoma. Three patients (1.3%) had incisional hernia requiring revision surgery; 7 (3.1%) patients had prolonged ileus (>7 days) managed conservatively. Four patients described retrograde ejaculation. Sympathetic dysfunction occurred in 15 (6.6%) patients. There were 5 (2.2%) cases of superficial wound infection treated with oral antibiotics, with no deep wound infections requiring reoperation or intravenous therapy. There were no mortalities in this series. Conclusions ALIF is a safe procedure when performed by a combined vascular surgeon and spine surgeon team with acceptably low complication rates. Our series confirms that the team approach results in short operative times and length of stay, with rapid control of intraoperative vessel injury and low overall blood loss. PMID:26933616

  16. Early Hearing-Impairment Results in Crossmodal Reorganization of Ferret Core Auditory Cortex

    PubMed Central

    Meredith, M. Alex; Allman, Brian L.

    2012-01-01

    Numerous investigations of cortical crossmodal plasticity, most often in congenital or early-deaf subjects, have indicated that secondary auditory cortical areas reorganize to exhibit visual responsiveness while the core auditory regions are largely spared. However, a recent study of adult-deafened ferrets demonstrated that core auditory cortex was reorganized by the somatosensory modality. Because adult animals have matured beyond their critical period of sensory development and plasticity, it was not known if adult-deafening and early-deafening would generate the same crossmodal results. The present study used young, ototoxically-lesioned ferrets (n = 3) that, after maturation (avg. = 173 days old), showed significant hearing deficits (avg. threshold = 72 dB SPL). Recordings from single-units (n = 132) in core auditory cortex showed that 72% were activated by somatosensory stimulation (compared to 1% in hearing controls). In addition, tracer injection into early hearing-impaired core auditory cortex labeled essentially the same auditory cortical and thalamic projection sources as seen for injections in the hearing controls, indicating that the functional reorganization was not the result of new or latent projections to the cortex. These data, along with similar observations from adult-deafened and adult hearing-impaired animals, support the recently proposed brainstem theory for crossmodal plasticity induced by hearing loss. PMID:22888454

  17. Early Results from the NASA Orbiting Carbon Observatory-2 (OCO-2)

    NASA Astrophysics Data System (ADS)

    Crisp, David; Eldering, Annmarie

    2015-04-01

    The Orbiting Carbon Observatory-2 (OCO-2) is NASA's first satellite designed to collect the measurements needed to estimate the column-averaged carbon dioxide (CO2) dry air mole fraction, XCO2, with the sensitivity, accuracy, and resolution needed to characterize the CO2 sources and sinks on regional scales over the globe. OCO-2 was successfully launched from Vandenberg Air Force Base in California on July 2, 2014 and joined the 705-km Afternoon Constellation (A-Train) on August 3, 2014. The three-channel imaging grating spectrometer was then cooled to its operating temperatures and a comprehensive series of characterization and calibration activities were initiated. Since early October 2014, the observatory has been routinely collecting almost 1 million soundings over the sunlit hemisphere each day. Early cloud screening results indicate that 15-30% of these measurements may be sufficiently cloud free to yield precise estimates of XCO2. Initial deliveries of calibrated, geo-located OCO-2 spectra to the NASA Goddard Earth Science Data and Information Services Center (GES DISC) began on December 30, 2014. Preliminary estimates of XCO2 retrieved from these data are currently being validated against observations from the Total Carbon Column Observing Network (TCCON) and other standards. Routine deliveries XCO2 and other products, including surface pressure and chlorophyll fluorescence, to the GES DISC are expected to begin before the end of March, 2015. This presentation will summarize the status of the OCO-2 mission and the coverage, resolution, and accuracy of its early results.

  18. Parametric flutter studies of an arrow-wing configuration: Some early results

    NASA Technical Reports Server (NTRS)

    Durham, Michael H.; Cole, Stanley R.; Cazier, F. W., Jr.; Keller, Donald F.; Parker, Ellen C.; Wilkie, W. Keats

    1988-01-01

    Some early experimental results from a combined experimental and analytical study being conducted at NASA-Langley of the transonic flutter characterisitics of a generic arrow wing configuration are presented. The planned study includes the parametric variation of a variety of structural and geometric characteristics. Presented here are flutter results of the basic arrow wing, for the basic wing with the addition of two simulated lower-surface-mounted engine nacelles, and for the basic wing with the addition of both the fin and the engine nacelles.

  19. Early Hyperbaric Oxygen Therapy for Reducing Radiotherapy Side Effects: Early Results of a Randomized Trial in Oropharyngeal and Nasopharyngeal Cancer

    SciTech Connect

    Teguh, David N.; Levendag, Peter C.; Noever, Inge; Voet, Peter; Est, Henrie van der; Rooij, Peter van; Dumans, Antoine G.; Boer, Maarten F. de; Huls, Michiel van der; Sterk, Wouter; Schmitz, Paul

    2009-11-01

    Purpose: Comparison of quality of life (QoL) and side effects in a randomized trial for early hyperbaric oxygen therapy (HBOT) after radiotherapy (RT). Methods and Materials: From 2006, 19 patients with tumor originating from the tonsillar fossa and/or soft palate (15), base of tongue (1), and nasopharynx (3) were randomized to receive HBOT or not. HBOT consisted of 30 sessions at 2.5 ATA (15 msw) with oxygen breathing for 90 min daily, 5 days per week, applied shortly after the RT treatment was completed. As of 2005, all patients received validated questionnaires (i.e., the European Organization for Research and Treatment of Cancer [EORTC] QLQ-C30, EORTC QLQ Head and Neck Cancer Module (H and N35), Performance Status Scale): before treatment; at the start of RT treatment; after 46 Gy; at the end of RT treatment; and 2, 4, and 6 weeks and 3, 6, 12, and 18 months after follow-up. Results: On all QoL items, better scores were obtained in patients treated with hyperbaric oxygen. The difference between HBOT vs. non-HBOT was significant for all parameters: EORTC H and N35 Swallowing (p = 0.011), EORTC H and N35 Dry Mouth (p = 0.009), EORTC H and N35, Sticky Saliva (p = 0.01), PSS Eating in Public (p = 0.027), and Pain in Mouth (visual analogue scale; p < 0.0001). Conclusions: Patients randomized for receiving hyperbaric oxygen after the RT had better QoL scores for swallowing, sticky saliva, xerostomia, and pain in mouth.

  20. Early enteral feeding, compared with parenteral, reduces postoperative septic complications. The results of a meta-analysis.

    PubMed Central

    Moore, F A; Feliciano, D V; Andrassy, R J; McArdle, A H; Booth, F V; Morgenstein-Wagner, T B; Kellum, J M; Welling, R E; Moore, E E

    1992-01-01

    This two-part meta-analysis combined data from eight prospective randomized trials designed to compare the nutritional efficacy of early enteral (TEN) and parenteral (TPN) nutrition in high-risk surgical patients. The combined data gave sufficient patient numbers (TEN, n = 118; TPN, n = 112) to adequately address whether route of substrate delivery affected septic complication incidence. Phase I (dropouts excluded) meta-analysis confirmed data homogeneity across study sites, that TEN and TPN groups were comparable, and that significantly fewer TEN patients experienced septic complications (TEN, 18%; TPN, 35%; p = 0.01). Phase II meta-analysis, an intent-to-treat analysis (dropouts included), confirmed that fewer TEN patients developed septic complications. Further breakdown by patient type showed that all trauma and blunt trauma subgroups had the most significant reduction in septic complications when fed enterally. In conclusion, this meta-analysis attests to the feasibility of early postoperative TEN in high-risk surgical patients and that these patients have reduced septic morbidity rates compared with those administered TPN. PMID:1386982

  1. Pure oxygen ventilation during general anaesthesia does not result in increased postoperative respiratory morbidity but decreases surgical site infection. An observational clinical study

    PubMed Central

    Suksompong, Sirilak; Weiler, Jürgen; Zander, Rolf

    2014-01-01

    Background. Pure oxygen ventilation during anaesthesia is debatable, as it may lead to development of atelectasis. Rationale of the study was to demonstrate the harmlessness of ventilation with pure oxygen. Methods. This is a single-centre, one-department observational trial. Prospectively collected routine-data of 76,784 patients undergoing general, gynaecological, orthopaedic, and vascular surgery during 1995–2009 were retrospectively analysed. Postoperative hypoxia, unplanned ICU-admission, surgical site infection (SSI), postoperative nausea and vomiting (PONV), and hospital mortality were continuously recorded. During 1996 the anaesthetic ventilation for all patients was changed from 30% oxygen plus 70% nitrous oxide to 100% oxygen in low-flow mode. Therefore, in order to minimize the potential of confounding due to a variety of treatments being used, we directly compared years 1995 (30% oxygen) and 1997 (100%), whereas the period 1998 to 2009 is simply described. Results. Comparing 1995 to 1997 pure oxygen ventilation led to a decreased incidence of postoperative hypoxic events (4.3 to 3.0%; p < 0.0001) and hospital mortality (2.1 to 1.6%; p = 0.088) as well as SSI (8.0 to 5.0%; p < 0.0001) and PONV (21.6 to 17.5%; p < 0.0001). There was no effect on unplanned ICU-admission (1.1 to 0.9; p = 0.18). Conclusions. The observed effects may be partly due to pure oxygen ventilation, abandonment of nitrous oxide, and application of low-flow anesthesia. Pure oxygen ventilation during general anaesthesia is harmless, as long as certain standards are adhered to. It makes anaesthesia simpler and safer and may reduce clinical morbidity, such as postoperative hypoxia and surgical site infection. PMID:25320681

  2. The Early Result of Cementless Arthroplasty for Femur Neck Fracture in Elderly Patients with Severe Osteoporosis

    PubMed Central

    Seo, Jae-Seong; Shin, Seong-Kee; Jun, Sung-Han; Cho, Chang-Ho

    2014-01-01

    Purpose The purposes of the current study were to assess the early results of cementless hip arthroplasty (HA) for femoral neck fractures in elderly patients with severe osteoporosis and to compare the clinical outcomes between those who underwent total HA (THA) or bipolar hemiarthroplasty (BHA). Materials and Methods From April 2011 to May 2012, we performed 87 cementless HAs for displaced femoral neck fractures in elderly patients (≥65 years) with severe osteoporosis. Among them, we studied 70 hips that were able to be followed-up for >24 months. Of these, 34 underwent THA and 36 underwent BHA. Clinical results were evaluated using the Harris hip score (HHS), Koval classification, and radiographs. Results Only one instance of femoral stem loosening was observed. Additionally, no dislocations were observed and no revision surgeries were required. The mean changes in the functional items of the HHS scores were 2.8 and 5.2 for those who underwent THA and BHA, respectively (P<0.05). According to the Koval classification used for the ambulatory status analysis, the mean perioperative change in the grade was 0.8 (0-4), with no significant differences noted between the THA and BHA groups. Conclusion The early results of cementless HA for femur neck fractures in elderly patients with osteoporosis were satisfactory, and THA was found to have a functional advantage over BHA.

  3. Surgical wound infection surveillance.

    PubMed

    Lee, J T

    2003-12-01

    Measuring the frequency of a defined outcome flaw for a series of patients undergoing operative procedures generates information for performance evaluation. Such data influence decisions to improve care if used responsibly. Wound infection (WI), bacterial invasion of the incision, is the most common infectious complication of surgical care and WI prevention has value because the complication affects economic, patient satisfaction, and patient functional status outcomes. WI frequency, one kind of surgical outcome flaw rate, is traditionally used to judge one aspect of surgical care quality. At the author's institution, global WI surveillance was conducted without interruption for 20 years. Results for 85,260 consecutive inpatient operations performed during the period showed that secular changes in infection rates occurred but were not necessarily caused by surgical care quality decrements. PMID:14750065

  4. GLOBULAR CLUSTER POPULATIONS: FIRST RESULTS FROM S{sup 4}G EARLY-TYPE GALAXIES

    SciTech Connect

    Zaritsky, Dennis; Aravena, Manuel; Athanassoula, E.; Bosma, Albert; Comerón, Sébastien; Laine, Jarkko; Laurikainen, Eija; Salo, Heikki; Elmegreen, Bruce G.; Erroz-Ferrer, Santiago; Knapen, Johan H.; Gadotti, Dimitri A.; Muñoz-Mateos, Juan Carlos; Hinz, Joannah L.; Ho, Luis C.; Holwerda, Benne; Sheth, Kartik

    2015-02-01

    Using 3.6 μm images of 97 early-type galaxies, we develop and verify methodology to measure globular cluster populations from the S{sup 4}G survey images. We find that (1) the ratio, T {sub N}, of the number of clusters, N {sub CL}, to parent galaxy stellar mass, M {sub *}, rises weakly with M {sub *} for early-type galaxies with M {sub *} > 10{sup 10} M {sub ☉} when we calculate galaxy masses using a universal stellar initial mass function (IMF) but that the dependence of T {sub N} on M {sub *} is removed entirely once we correct for the recently uncovered systematic variation of IMF with M {sub *}; and (2) for M {sub *} < 10{sup 10} M {sub ☉}, there is no trend between N {sub CL} and M {sub *}, the scatter in T {sub N} is significantly larger (approaching two orders of magnitude), and there is evidence to support a previous, independent suggestion of two families of galaxies. The behavior of N {sub CL} in the lower-mass systems is more difficult to measure because these systems are inherently cluster-poor, but our results may add to previous evidence that large variations in cluster formation and destruction efficiencies are to be found among low-mass galaxies. The average fraction of stellar mass in clusters is ∼0.0014 for M {sub *} > 10{sup 10} M {sub ☉} and can be as large as ∼0.02 for less massive galaxies. These are the first results from the S{sup 4}G sample of galaxies and will be enhanced by the sample of early-type galaxies now being added to S{sup 4}G and complemented by the study of later-type galaxies within S{sup 4}G.

  5. Surgical results of dynamic nonfusion stabilization with the Segmental Spinal Correction System for degenerative lumbar spinal diseases with instability: Minimum 2-year follow-up

    PubMed Central

    Ohta, Hideki; Matsumoto, Yoshiyuki; Morishita, Yuichirou; Sakai, Tsubasa; Huang, George; Kida, Hirotaka; Takemitsu, Yoshiharu

    2011-01-01

    Background When spinal fusion is applied to degenerative lumbar spinal disease with instability, adjacent segment disorder will be an issue in the future. However, decompression alone could cause recurrence of spinal canal stenosis because of increased instability on operated segments and lead to revision surgery. Covering the disadvantages of both procedures, we applied nonfusion stabilization with the Segmental Spinal Correction System (Ulrich Medical, Ulm, Germany) and decompression. Methods The surgical results of 52 patients (35 men and 17 women) with a minimum 2-year follow-up were analyzed: 10 patients with lumbar spinal canal stenosis, 15 with lumbar canal stenosis with disc herniation, 20 with degenerative spondylolisthesis, 6 with disc herniation, and 1 with lumbar discopathy. Results The Japanese Orthopaedic Association score was improved, from 14.4 ± 5.3 to 25.5 ± 2.8. The improvement rate was 76%. Range of motion of the operated segments was significantly decreased, from 9.6° ± 4.2° to 2.0° ± 1.8°. Only 1 patient had adjacent segment disease that required revision surgery. There was only 1 screw breakage, but the patient was asymptomatic. Conclusions Over a minimum 2-year follow-up, the results of nonfusion stabilization with the Segmental Spinal Correction System for unstable degenerative lumbar disease were good. It is necessary to follow up the cases with a focus on adjacent segment disorders in the future. PMID:25802671

  6. The NASA Soil Moisture Active Passive (SMAP) Mission Status and Early Results

    NASA Astrophysics Data System (ADS)

    Entekhabi, D.; Yueh, S. H.; O'Neill, P. E.; Entin, J. K.; Njoku, E. G.; Kellogg, K.

    2015-12-01

    NASA's Soil Moisture Active Passive (SMAP) mission was launched on January 31, 2015. SMAP provides high-resolution, frequent revisit global mapping of soil moisture and freeze/thaw state based on coincident L-band radiometer and L-band radar measurements. The primary science goal of SMAP is to provide new perspectives on how the three fundamental cycles of the Earth system, the water, energy and carbon cycles, are linked together over land. Soil moisture is the key variable that links the three cycles and makes their co-variations synchronous in time. Soil moisture products with varying resolution and coverage are produced from the radiometer alone, radar alone, radiometer-radar combination and data assimilation. In this session the status of the SMAP observatory and early results based on the science data products will be included. The science data acquisition began in May 2015 following several weeks of observatory and instrument commissioning. An intense calibration and validation period followed. Preliminary science products on instrument measurements, soil moisture, landscape frozen or thawed status, and net ecosystem exchange are available at publicly-accessible data archives. The presentation will include early and summary results on the validation of these products. The instrument measurements can also be used to map sea-ice coverage, ocean surface winds and sea surface salinity. Examples of these global retrievals are also presented.

  7. Detection of early bronchial cancer by autofluorescence: results in patients with H&N cancer

    NASA Astrophysics Data System (ADS)

    Gabrecht, Tanja; Radu, Alexandre; Zellweger, Matthieu; Lovisa, Blaise; Goujon, Didier; Grosjean, Pierre; van den Bergh, Hubert; Monnier, Philippe; Wagnières, Georges

    2007-07-01

    Head and neck (H&N) cancer patients have a high incidence of second primary tumours in the tracheobronchial tree. Diagnostic autofluorescence bronchoscopy (DAFE) has shown promising results in the detection of early neoplastic and pre-neoplastic changes in the bronchi. We have investigated the medical impact of DAFE in a population of H&N cancer patients. The bronchoscopies were performed using a modified commercially available DAFE system. Endoscopic imaging of the tissue autofluorescence (AF) was combined with an online image analysis procedure allowing to discriminate between true and false positive results. White light (WL) bronchoscopy was performed as a control. Twenty-one patients with high lung cancer risk factors underwent WL and AF bronchoscopy with this improved system. Forty-one biopsies were taken on macroscopicall suspicious (WL or AF positive) sites. Seven patients were found to have second primary tumours in the bronchi. The sensitivity for the detection of these early lesions with the DAFE was 1.6 times larger than the sensitivity of WL bronchoscopy only. The positive predictive value (PPV) for AF is 79% (33% for WL alone). The PPV of both methods together is 100%. DAFE proved to be efficient for the detection of second primary lesions in H&N cancer patients and can be used as a simple addition to pre-operative work-up or follow-up in this patient population.

  8. Early allograft dysfunction in liver transplantation with donation after cardiac death donors results in inferior survival.

    PubMed

    Lee, David D; Singh, Amandeep; Burns, Justin M; Perry, Dana K; Nguyen, Justin H; Taner, C Burcin

    2014-12-01

    Donation after cardiac death (DCD) liver allografts have been associated with increased morbidity from primary nonfunction, biliary complications, early allograft failure, cost, and mortality. Early allograft dysfunction (EAD) after liver transplantation has been found to be associated with inferior patient and graft survival. In a cohort of 205 consecutive liver-only transplant patients with allografts from DCD donors at a single center, the incidence of EAD was found to be 39.5%. The patient survival rates for those with no EAD and those with EAD at 1, 3, and 5 years were 97% and 89%, 79% and 79%, and 61% and 54%, respectively (P = 0.009). Allograft survival rates for recipients with no EAD and those with EAD at 1, 3, and 5 years were 90% and 75%, 72% and 64%, and 53% and 43%, respectively (P = 0.003). A multivariate analysis demonstrated a significant association between the development of EAD and the cold ischemia time [odds ratio (OR) = 1.26, 95% confidence interval (CI) = 1.01-1.56, P = 0.037] and hepatocellular cancer as a secondary diagnosis in recipients (OR = 2.26, 95% CI = 1.11-4.58, P = 0.025). There was no correlation between EAD and the development of ischemic cholangiopathy. In conclusion, EAD results in inferior patient and graft survival in recipients of DCD liver allografts. Understanding the events that cause EAD and developing preventive or early therapeutic approaches should be the focus of future investigations. PMID:25179581

  9. EVALUATION OF THE RESULTS FROM ARTHROSCOPIC SURGICAL TREATMENT FOR TRAUMATIC ANTERIOR SHOULDER INSTABILITY USING SUTURING OF THE LESION AT THE OPENED MARGIN OF THE GLENOID CAVITY

    PubMed Central

    Miyazaki, Alberto Naoki; Fregoneze, Marcelo; Santos, Pedro Doneux; da Silva, Luciana Andrade; do Val Sella, Guilherme; Duarte, Clodoaldo; Botelho, Vinícius; Checchia, Sergio Luiz

    2015-01-01

    Objective: To evaluate the clinical results from patients with traumatic anterior shoulder instability that was treated surgically through arthroscopic viewing, using bioabsorbable anchors and a technique for remove the cartilage of the anterior glenoid rim for repairing a Bankart lesion. Method: Between March 2006 and October 2008, 27 shoulders in 27 patients with a diagnosis of traumatic anterior shoulder instability were operated. The patients’ mean age was 28 years and they had had between two and 25 previous episodes of dislocation. The patients were predominantly male (24; 89%). The minimum length of follow-up was 24 months and the mean was 36 months. None of the patients had previously undergone surgery on the affected shoulder or had any significant bone lesion at the glenoid margin. The postoperative clinical assessment was done using the Rowe scale. To measure the preoperative and postoperative joint range of motion, we used the method described by the American Academy of Orthopaedic Surgeons (AAOS). Results: According to the Rowe criteria, 25 patients (93%) achieved excellent results and two (7%) had poor results. None of the patients presented good or fair results. Twenty-three patients were satisfied with the results obtained (85%), and returned to their activities without limitations, while four patients (15%) had some degree of limitation. There was recurrence of instability in two patients (7%). Conclusion: Treatment of traumatic anterior shoulder instability through arthroscopic viewing using a technique for remove the cartilage of the anterior glenoid rim for repairing a Bankart lesion provided excellent results for 93% of the patients operated. PMID:27042640

  10. Regression model estimation of early season crop proportions: North Dakota, some preliminary results

    NASA Technical Reports Server (NTRS)

    Lin, K. K. (Principal Investigator)

    1982-01-01

    To estimate crop proportions early in the season, an approach is proposed based on: use of a regression-based prediction equation to obtain an a priori estimate for specific major crop groups; modification of this estimate using current-year LANDSAT and weather data; and a breakdown of the major crop groups into specific crops by regression models. Results from the development and evaluation of appropriate regression models for the first portion of the proposed approach are presented. The results show that the model predicts 1980 crop proportions very well at both county and crop reporting district levels. In terms of planted acreage, the model underpredicted 9.1 percent of the 1980 published data on planted acreage at the county level. It predicted almost exactly the 1980 published data on planted acreage at the crop reporting district level and overpredicted the planted acreage by just 0.92 percent.

  11. The Effect of Preoperative Subcutaneous Fat Thickness on Surgical Site Infection Risk in Patients Undergoing Colorectal Surgery: Results of a Multisite, Prospective Cohort Study.

    PubMed

    Nakagawa, Hiromi; Ohno, Kaori; Ikeda, Shunya; Muto, Masaki

    2016-08-01

    Surgical site infection (SSI) is one of the most frequent postoperative complications among patients undergoing elective colorectal surgery. A multisite, prospective cohort study was conducted to investigate whether the thickness of subcutaneous fat (TSF) influences the occurrence of SSI in patients undergoing colorectal surgery. Participants included patients scheduled to receive colorectal laparotomy for colorectal cancer and who were under the care of a wound ostomy continence nurse at 17 participating general hospitals in Japan. Patients were not eligible to participate if they had undergone emergency surgery, reoperation, or laparoscopic surgery. Demographic, wound, and surgical data and American Society of Anesthesiologists (ASA) scale scores were collected and assessed, along with nutritional status, TSF, body mass index, and risk factors for SSI (ie, length of surgery and wound classification). The incidence of SSI and nutritional conditions was assessed weekly for 30 days after surgery. Of the 155 participants (mean age 68.9 ± 10.8 years, 53 [34.2%] of whom were women), 90 (58.1%) underwent rectal surgery, and the remaining 65 underwent colon surgery. Seventy-two (72, 46.5%) of the 155 patients underwent colostomy surgery; 24 (15.5%) developed a SSI. The mean onset of SSI was 7.3 ± 2.9 days after surgery and commonly observed in the stoma group when the ASA score was 3 or higher (P = 0.02). Patients who developed SSI resumed oral dietary intake later than those without SSI (7.4 days versus 4.6 days, P = 0.02). Multivariate analysis indicated TSF >15 mm (P = 0.01), Alb level <3.5 g/dL at postoperative days 14 (P = 0.03) and 21 (P = 0.02), and total protein level <6.8 g/dL at postoperative day 7 (P = 0.02) were statistically significantly correlated with SSI occurrence. These results suggest preoperative TSF and preoperative and postoperative serum albumin levels are independent risk factors for SSI in patients undergoing colorectal surgery, confirming

  12. Early administration of enzyme replacement therapy for Pompe disease: short-term follow-up results.

    PubMed

    Hamdan, M A; Almalik, M H; Mirghani, H M

    2008-12-01

    Pompe disease (glycogen storage disease II, OMIM # 232300), is a hereditary lysosomal disorder. It is characterized by deficiency of acid alpha-glucosidase enzyme (acid maltase, GAA, OMIM *606800, EC 3.1.26.2), secondary to mutations in the GAA gene (HGNC:4065) on chromosome 17q25.2-q25.3. Absent enzyme activity in the infantile form of Pompe disease results in abnormal glycogen deposition in the skeletal, cardiac, and smooth muscles, leading to hypertrophic cardiomyopathy, feeding abnormalities, hypotonia, weakness, respiratory insufficiency, and ultimately death. Prenatal diagnosis is accomplished by enzyme assay, mutation analysis or electron microscopy of amniotic fluid cells or chorionic villus sample. However, these techniques may not always be available, and can result in perinatal morbidity and fetal loss. Early diagnosis of Pompe disease results in early institution of enzyme replacement therapy (ERT), which minimizes morbidity and prolongs survival. We report the case of a 35-week part-of-twin neonate, whose older sibling died earlier because of infantile Pompe disease. At 32 weeks of gestation, fetal echocardiography showed hypertrophic cardiomyopathy in twin 1, which persisted until birth at 35 weeks of gestation. Diagnosis was confirmed after birth by enzyme assay, and mutation analysis showing homozygosity for the sequence change 1327-2A>G (GAA intr 8). Administration of ERT at 18 h of age, resulted in normalization of cardiac abnormalities within 21 weeks of therapy, and normal neurodevelopmental assessment at 46 weeks, using Griffiths Mental Development Scales. To our knowledge, this is the youngest patient reported to receive ERT for Pompe disease, and the first report of prenatal diagnosis of Pompe disease by fetal echocardiography. PMID:19067231

  13. Deriving DICOM surgical extensions from surgical workflows

    NASA Astrophysics Data System (ADS)

    Burgert, O.; Neumuth, T.; Gessat, M.; Jacobs, S.; Lemke, H. U.

    2007-03-01

    The generation, storage, transfer, and representation of image data in radiology are standardized by DICOM. To cover the needs of image guided surgery or computer assisted surgery in general one needs to handle patient information besides image data. A large number of objects must be defined in DICOM to address the needs of surgery. We propose an analysis process based on Surgical Workflows that helps to identify these objects together with use cases and requirements motivating for their specification. As the first result we confirmed the need for the specification of representation and transfer of geometric models. The analysis of Surgical Workflows has shown that geometric models are widely used to represent planned procedure steps, surgical tools, anatomical structures, or prosthesis in the context of surgical planning, image guided surgery, augmented reality, and simulation. By now, the models are stored and transferred in several file formats bare of contextual information. The standardization of data types including contextual information and specifications for handling of geometric models allows a broader usage of such models. This paper explains the specification process leading to Geometry Mesh Service Object Pair classes. This process can be a template for the definition of further DICOM classes.

  14. Early Clinical and Radiographic Results of Minimally Invasive Anterior Approach Hip Arthroplasty

    PubMed Central

    Alexandrov, Tamara; Ahlmann, Elke R.; Menendez, Lawrence R.

    2014-01-01

    We present a retrospective review of the early results and complications in a series of 35 consecutive patients with 43 total hip arthroplasties performed through an anterior muscle sparing minimally invasive approach. We found the early complication rates and radiographic outcomes comparable to those reported from arthroplasties performed via traditional approaches. Complications included dislocation (2%), femur fracture (2%), greater trochanteric fracture (12%), postoperative periprosthetic intertrochanteric fracture (2%), femoral nerve palsy (5%), hematoma (2%), and postoperative iliopsoas avulsion (2%). Radiographic analysis revealed average cup anteversion of 19.6° ± 6.6, average cup abduction angle of 48.4° ± 7, stem varus of 0.9° ± 2, and a mean leg length discrepancy of 0.7 mm. The anterior approach to the hip is an attractive alternative to the more traditional approaches. Acceptable component placement with comparable complication rates is possible using a muscle sparing technique which may lead to faster overall recovery. PMID:24715984

  15. Surgical induction, histological evaluation, and MRI identification of cartilage necrosis in the distal femur in goats to model early lesions of osteochondrosis

    PubMed Central

    Tóth, Ferenc; Nissi, Mikko J.; Wang, Luning; Ellermann, Jutta M.; Carlson, Cathy S

    2014-01-01

    Objective Identify and interrupt the vascular supply to portions of the distal femoral articularepiphyseal cartilage complex (AECC) in goat kids to induce cartilage necrosis, characteristic of early lesions of osteochondrosis; then utilize MRI to identify necrotic areas of cartilage. Design Distal femora were perfused and cleared in goat kids of various ages to visualize the vascular supply to the distal femoral AECC. Vessels located on the axial aspect of the medial femoral condyle and on the abaxial side of the lateral trochlear ridge were transected in eight 4-day-old goats to induce cartilage necrosis. Goats were euthanized 1, 2, 3, 4, 5, 6, 9, and 10 weeks post operatively and operated stifles were harvested. Adiabatic T1ρ relaxation time maps of the harvested distal femora were generated using a 9.4T MR scanner, after which samples were evaluated histologically. Results Interruption of the vascular supply to the medial femoral condyle caused lesions of cartilage necrosis in 6/8 goat kids that were demonstrated histologically. Adiabatic T1ρ relaxation time mapping identified these areas of cartilage necrosis in 5/6 cases. No significant findings were detected after transection of perichondrial vessels supplying the lateral trochlear ridge. Conclusions Cartilage necrosis, characteristic of early osteochondrosis, can be induced by interrupting the vascular supply to the distal femoral AECC in goat kids. The ability of high field MRI to identify these areas of cartilage necrosis in the AECC using the adiabatic T1ρ sequence suggests that this technique may be useful in the future for the early diagnosis of osteochondrosis. PMID:25463443

  16. Early-life seizures result in deficits in social behavior and learning.

    PubMed

    Lugo, Joaquin N; Swann, John W; Anderson, Anne E

    2014-06-01

    Children with epilepsy show a high co-morbidity with psychiatric disorders and autism. One of the critical determinants of a child's behavioral outcome with autism and cognitive dysfunction is the age of onset of seizures. In order to examine whether seizures during postnatal days 7-11 result in learning and memory deficits and behavioral features of autism we administered the inhalant flurothyl to induce seizures in C57BL/6J mice. Mice received three seizures per day for five days starting on postnatal day 7. Parallel control groups consisted of similarly handled animals that were not exposed to flurothyl and naïve mice. Subjects were then processed through a battery of behavioral tests in adulthood: elevated-plus maze, nose-poke assay, marble burying, social partition, social chamber, fear conditioning, and Morris water maze. Mice with early-life seizures had learning and memory deficits in the training portion of the Morris water maze (p<0.05) and probe trial (p<0.01). Mice with seizures showed no differences in marble burying, the nose-poke assay, or elevated plus-maze testing compared to controls. However, they showed a significant difference in the social chamber and social partition tests. Mice with seizures during postnatal days 7-11 showed a significant decrease in social interaction in the social chamber test and had a significant impairment in social behavior in the social partition test. Together, these results indicate that early life seizures result in deficits in hippocampal-dependent memory tasks and produce long-term disruptions in social behavior. PMID:24685665

  17. Early Discharge Planning and Improved Care Transitions: Pre-Admission Assessment for Readmission Risk in an Elective Orthopedic and Cardiovascular Surgical Population

    PubMed Central

    Mola, Ana; Rosenfeld, Peri; Ford, Shauna

    2016-01-01

    Background/Methods: Readmission prevention is a marker of patient care quality and requires comprehensive, early discharge planning for safe hospital transitions. Effectively performed, this process supports patient satisfaction, efficient resource utilization, and care integration. This study developed/tested the utility of a predictive early discharge risk assessment with 366 elective orthopedic/cardiovascular surgery patients. Quality improvement cycles were undertaken for the design and to inform analytic plan. An 8-item questionnaire, which includes patient self-reported health, was integrated into care managers’ telephonic pre-admission assessments during a 12-month period. Results: Regression models found the questionnaire to be predictive of readmission (p ≤ .005; R2 = .334) and length-of-stay (p ≤ .001; R2 = .314). Independent variables of “lives-alone” and “self-rated health” were statistically significant for increased readmission odds, as was “self-rated health” for increased length-of-stay. Quality measures, patient experience and increased rates of discharges-to-home further supported the benefit of embedding these questions into the pro-active planning process. Conclusion: The pilot discharge risk assessment was predictive of readmission risk and length-of-stay for elective orthopedic/cardiovascular patients. Given the usability of the questionnaire in advance of elective admissions, it can facilitate pro-active discharge planning essential for producing quality outcomes and addressing new reimbursement methodologies for continuum-based episodes of care.

  18. Characteristics and Early Science Results of the Virgin Islands Robotic Telescope at the Etelman Observatory

    NASA Astrophysics Data System (ADS)

    Morris, David C.; Neff, J. E.; Hakkila, J. E.

    2014-01-01

    The Virgin Islands Robotic Telescope is an 0.5m robotic telescope located at the easternmost and southernmost optical observatory in the United States at a latitude of 18.5N and longitude of 65W. The observatory is located on the island of St Thomas in the USVI. Astronomers from the College of Charleston and the University of the Virgin Islands collaborate to maintain and operate the facility. Science goals of the facility include optical follow-up of high-energy transients, extra-solar planet observations, and near-Earth asteroid searches. The facility also supports a wide-reaching education and outreach program dedicated to raising the level of STEM engagement and enrichment in the USVI. We detail the characteristics, capabilities, and early results from the observatory. The observatory is growing its staff and science activities and potential topics for collaboration will be discussed.

  19. Early Scientific Results and Future Prospects for the Rejuvenated Hubble Space Telescope

    NASA Technical Reports Server (NTRS)

    Niedner, Malcolm B.

    2010-01-01

    Following the extraordinarily successful Servicing Mission 4 (SM4) of Hubble Space Telescope (HST) in May of 2009, the Observatory is now fully equipped with a broad array of powerful science instruments that put it at the pinnacle of its scientific power. Relevant to the subject matter of the Beyond 2010 Conference, HST will be well-placed over the next five-plus years to advance our knowledge of the formation of high-redshift galaxies and their growth with cosmic time; the emergence of structure in the early universe via Dark Matter-driven gravitational instability; and the universe's expansion history and any resulting implications for the temporal character of Dark Energy. These are fitting projects for the iconic facility now celebrating its 20th anniversary in orbit.

  20. Two Eyes, 3D Early Results: Stereoscopic vs 2D Representations of Highly Spatial Scientific Imagery

    NASA Astrophysics Data System (ADS)

    Price, Aaron

    2013-06-01

    "Two Eyes, 3D" is a 3-year NSF funded research project to study the educational impacts of using stereoscopic representations in informal settings. The first study conducted as part of the project tested children 5-12 on their ability to perceive spatial elements of slides of scientific objects shown to them in either stereoscopic or 2D format. Children were also tested for prior spatial ability. Early results suggest that stereoscopy does not have a major impact on perceiving spatial elements of an image, but it does have a more significant impact on how the children apply that knowledge when presented with a common sense situation. The project is run by the AAVSO and this study was conducted at the Boston Museum of Science.

  1. Early- to mid-Holocene vegetation development in northern Iceland: project outline and preliminary results

    NASA Astrophysics Data System (ADS)

    Eddudóttir, S.; Erlendsson, E.; Gísladóttir, G.

    2013-12-01

    Iceland is a key site for the study of Holocene vegetation and climate variations due to its location in the North Atlantic. The aim of the project is to reconstruct the history of Holocene vegetation development in Austur-Húnavatnssýsla, northern Iceland. Using pollen and macrofossils, patterns of vegetation change in three locations will be reconstructed, forming a transect from coastal extremes to the highland margin. The palynological and macrofossil data will be combined with a robust regional chronology, constructed by combining tephra layers with radiocarbon-dated macrofossils. Available data covering the vegetation history of Iceland are scarce. This study will improve the understanding of how environmental factors have driven vegetation development during the Holocene. Pollen analysis has been carried out on a section of a lacustrine core from the first study site of this project, a lowland site in Svínadalur valley. The analysed section of the core covers the period from Younger Dryas to the mid-Holocene. The results show a transition from pioneering vegetation during the cold period of Younger Dryas to the birch forests of the Holocene Thermal Maximum. An initial expansion of birch and gradual closing of vegetation cover was halted during early-Holocene, probably due to a period of cooling climate. An age model for the core has yet to be constructed, however this change in vegetation may be the result of cooling during the 8.2 ka event that has previously been recorded in proxies from Icelandic lakes. This cooling event has however not been seen in Icelandic terrestrial biotic palaeorecords before. The impact of this event seen in the Svínadalur core may underscore a vulnerability of the early-Holocene terrestrial ecosystem to climatic fluctuations. The study is funded by the Eimskip University fund, University of Iceland Research Fund and Landsvirkjun's Energy Research Fund, the study is also supported by the INTIMATE EU COST action in the form of a

  2. Laser welding in penetrating keratoplasty and cataract surgery of pediatric patients: early results

    NASA Astrophysics Data System (ADS)

    Rossi, Francesca; Pini, Roberto; Menabuoni, Luca; Malandrini, Alex; Canovetti, Annalisa; Lenzetti, Ivo; Capozzi, Paolo; Valente, Paola; Buzzonetti, Luca

    2013-03-01

    Diode laser welding of ocular tissues is a procedure that enables minimally invasive closure of a corneal wound. This procedure is based on a photothermal effect: a water solution of Indocyanine Green (ICG) is inserted in the surgical wound, in order to stain the corneal tissue walls. The stained tissue is then irradiated with a low power infrared diode laser, delivering laser light through a 300-μm core diameter optical fiber. This procedure enables an immediate closure of the wounds: it is thus possible to reduce or to substitute the use of surgical threads. This is of particular interest in children, because the immediate closure improves refractive outcome and anti-amblyopic effect; moreover this procedure avoids several general anaesthesia for suture management. In this work, we present the first use of diode laser welding procedure in paediatric patients. 5 selected patients underwent cataract surgery (Group 1), while 4 underwent fs-laserassisted penetrating keratoplasty (Group 2). In Group 1 the conventional surgery procedure was performed, while no stitches were used for the closure of the surgical wounds: these were laser welded and immediately closed. In Group 2 the donor button was sutured upon the recipient by 8 single stitches, instead of 16 single stitches or a running suture. The laser welding procedure was performed in order to join the donor tissue to the recipient bed. Objective observations in the follow up study evidenced a perfect adhesion of the laser welded tissues, no collateral effects and an optimal restoration of the treated tissues.

  3. Factors associated with early menarche: results from the French Health Behaviour in School-aged Children (HBSC) study

    PubMed Central

    2010-01-01

    Background Puberty is a transition period making physiological development a challenge adolescents have to face. Early pubertal development could be associated with higher risks of poor health. Our objective was to examine risk behaviours, physical and psychological determinants associated with early menarche (<11 years). Methods Early menarche was assessed in the Health Behaviour in School-aged Children French cross-sectional survey. Data were collected in 2006 by anonymous self-reported standardized questionnaire from a nationally representative sample of 1072 15 years old girls in school classrooms. Family environment, school experience, physical and psychological factors, risk behaviours (substance use and sexual initiation) were recorded. Logistic regression models were applied (analysing for crude and adjusted relationships between early menarche and risk behaviours controlled for family context). Results Median age at menarche was 13.0 years; 57 girls (5.3%) were early-matured. Controlled for familial environment, early menarche was associated with having had more than two life-drunkenness episodes (adjusted OR = 2.5 [1.3-4.6]), early sexual initiation (adjusted OR = 2.8 [1.3-6.0]) and overweight (adjusted OR = 7.3 [3.6-14.9]). Conclusion Early-maturing girls may affiliate with older adolescents, hence engage in risk behaviours linked to their appearance rather than their maturity level. Factors associated with early menarche highlight the need to focus attention on early-matured girls to prevent further health problems linked to risk behaviours. PMID:20353570

  4. Modified surgical techniques of free vascularized fibular grafting for treatment of the osteonecrosis of femoral head: results from a series of 407 cases.

    PubMed

    Gao, You-Shui; Chen, Sheng-Bao; Jin, Dong-Xu; Sheng, Jia-Gen; Cheng, Xiang-Guo; Zhang, Chang-Qing

    2013-11-01

    The goal for treatment of osteonecrosis of the femoral head (ONFH) is to relieve pain, preserve the contour of the femoral head, and delay the need for total hip arthroplasty. The free vascularized fibular grafting (FVFG) has been shown to support the subchondral architecture as well as restore local circulation for the necrotic femoral head in treatment of ONFH. This report aimed to present the clinical results of the use of a modified surgical technique of FVFG for treatment of ONFH. Four hundred and seven patients with 578 hips of ONFH were included. The patients' average age was 36.7 years old (ranging 19-55 years old). The disease was staged from II to V based on the Steinberg classification system. By the modified procedure, the vascularized fibular graft was harvested via a lateral incision with fibular osteotomy prior to the exposure of the vascular pedicle, and the removal of necrotic tissue and inset of graft were performed through an anterior approach. The operative time averaged 90 min for unilateral ONFH (ranging 75-110 min) and 190 min for simultaneous treatment of bilateral ONFH (ranging 160-230 min). The average length of follow-up was 5.0 years (ranging 3-10 years). The complications included one infection in one case, temporary loss of sensation of the thigh in eleven cases, and restricted motion of the great toe in nine cases. The Harris hip score of patients improved from 65.0 to 86.9 on average. Radiographic evaluation showed no changes in 331 hips (57.3%), improvement in 195 hips (33.7%) and necrosis progression in 52 hips (9.0%). Twenty-three hips (4.0%) in 20 patients had total hip arthroplasty during the period. These results show that the modified technique of the use of FVFG for treatment of ONFH yields similar postoperative results in comparison to the traditional method. PMID:23907776

  5. Fractures of the neck of the fifth metacarpal bone, treated by percutaneous intramedullary nailing: surgical technique, radiological and clinical results study (28 cases).

    PubMed

    Boussakri, Hassan; Elidrissi, Mohamad; Azarkane, Mohamad; Bensaad, Soufiane; Bachiri, Mohammed; Shimi, Mohamed; Elibrahimi, Abdelhalim; Elmrini, Abdelmajid

    2014-01-01

    This study report the results in 28 patients affected by closed fractures of the neck of the fifth metacarpal bone (boxer's fracture), treated with percutaneous elastic intramedullary nailing using a single wire, to verify the effectiveness of this surgical treatment. We reviewed the results of 28 patients treated with A single Kirschner wire (K-wire) pre-bent in a lazy-S fashion with a mild bend at approximately 5 millimeters, The K-wire is inserted blunt end first in an antegrade manner and the fracture reduced as the wire is passed across the fracture site The wire is usually removed with pliers post-operatively at four weeks in the fracture clinic. The follow-up period averaged of 20,75 months. The parameters evaluated included angulation, rotational alignment, postoperative metacarpophalangeal (MCP) range of motion, and time to union. We opted for this treatment in all cases, regardless volar angulation of the metacarpal head, malrotation of the fifth finger and associated or/no with a severe swelling of the hand. All the patients were reviewed clinically and radiologically at an average of 20,75 months after surgery. At the final follow-up, no patient reported residual pain and All fractures proceeded to bony union but we have one fracture had to be revised for failed fixation and three superficial wound infections needed antibiotic treatment. We recommend that this minimally invasive: percutaneous intramedullary nailing using a single k-wire in all metacarpal neck fracture (boxers' fractures), especially when severe swelling of the hand is present, with good functional results and low morbidity. PMID:25419314

  6. Glucose and urea kinetics in patients with early and advanced gastrointestinal cancer: the response to glucose infusion, parenteral feeding, and surgical resection

    SciTech Connect

    Shaw, J.H.; Wolfe, R.R.

    1987-02-01

    We isotopically determined rates of glucose turnover, urea turnover, and glucose oxidation in normal volunteers (n = 16), patients with early gastrointestinal (EGI) cancer (n = 6), and patients with advanced gastrointestinal (AGI) cancer (n = 10). Studies were performed in the basal state, during glucose infusion (4 mg/kg/min), and during total parenteral feeding (patients with AGI cancer only). Patients with early stages of the disease were also studied 2 to 3 months after resection of the cancer. Basal rates of glucose turnover were similar in volunteers and in patients with EGI cancer (13.9 +/- 0.3 mumol/kg/min and 13.3 +/- 0.2 mumol/kg/min, respectively) but were significantly higher in patients with AGI cancer (17.6 +/- 1.4 mumol/kg/min). Glucose infusion resulted in significantly less suppression of endogenous production in both patient groups than that seen in the volunteers (76% +/- 6% for EGI group, 69% +/- 7% for AGI group, and 94% +/- 4% for volunteers). The rate of glucose oxidation increased progressively in proportion to the tumor bulk. In the volunteers the percent of VCO2 from glucose oxidation was 23.9% +/- 0.7%, and in EGI and AGI groups the values were 32.8% +/- 2.0% and 43.0% +/- 3.0%, respectively. After curative resection of the cancer, glucose utilization decreased significantly (p less than 0.05). The rate of urea turnover was significantly higher in the AGI group (8.4 +/- 1.0 mumol/kg/min) in comparison with the volunteer group value of 5.9 +/- 0.6 mumol/kg/min (p less than 0.03). Glucose infusion resulted in a significant suppression of urea turnover in the volunteers (p less than 0.02), but in the AGI group glucose infusion did not induce a statistically significant decrease.

  7. Early Learning Standards: Results from a National Survey to Document Trends in State-Level Policies and Practices

    ERIC Educational Resources Information Center

    Scott-Little, Catherine; Lesko, Jim; Martella, Jana; Milburn, Penny

    2007-01-01

    Early learning standards--documents that outline what children should know and be able to do before kindergarten entry--are increasingly common in the United States. Data from a national survey are presented to illustrate trends in how states have developed and implemented early learning standards within the past four years. Results indicate that…

  8. Missed Opportunities for Early Infant HIV Diagnosis: Results of A National Study in South Africa

    PubMed Central

    Jackson, Debra; Goga, Ameena E.; Crowley, Siobhan; Doherty, Tanya; Mogashoa, Mary M.; Dinh, Thu-Ha; Sherman, Gayle G.

    2015-01-01

    Background: Services to diagnose early infant HIV infection should be offered at the 6-week immunization visit. Despite high 6-week immunization attendance, the coverage of early infant diagnosis (EID) is low in many sub-Saharan countries. We explored reasons for such missed opportunities at 6-week immunization visits. Methods: We used data from 2 cross-sectional surveys conducted in 2010 in South Africa. A national assessment was undertaken among randomly selected public facilities (n = 625) to ascertain procedures for EID. A subsample of these facilities (n = 565) was revisited to assess the HIV status of 4- to 8-week-old infants receiving 6-week immunization. We examined potential missed opportunities for EID. We used logistic regression to assess factors influencing maternal intention to report for EID at 6-week immunization visits. Results: EID services were available in >95% of facilities and 72% of immunization service points (ISPs). The majority (68%) of ISPs provide EID for infants with reported or documented (on infant's Road-to-Health Chart/booklet—iRtHC) HIV exposure. Only 9% of ISPs offered provider-initiated counseling and testing for infants of undocumented/unknown HIV exposure. Interviews with self-reported HIV-positive mothers at ISPs revealed that only 55% had their HIV status documented on their iRtHC and 35% intended to request EID during 6-week immunization. Maternal nonreporting for EID was associated with fear of discrimination, poor adherence to antiretrovirals, and inadequate knowledge about mother-to-child HIV transmission. Conclusions: Missed opportunities for EID were attributed to poor documentation of HIV status on iRtHC, inadequate maternal knowledge about mother-to-child HIV transmission, fear of discrimination, and the lack of provider-initiated counseling and testing service for undocumented, unknown, or undeclared HIV-exposed infants. PMID:25469521

  9. Early Prefrontal Functional Blockade in Rats Results in Schizophrenia-Related Anomalies in Behavior and Dopamine

    PubMed Central

    Meyer, Francisca; Louilot, Alain

    2012-01-01

    Growing evidence suggests schizophrenia may arise from abnormalities in early brain development. The prefrontal cortex (PFC) stands out as one of the main regions affected in schizophrenia. Latent inhibition, an interesting cognitive marker for schizophrenia, has been found in some studies to be reduced in acute patients. It is generally widely accepted that there is a dopaminergic dysfunctioning in schizophrenia. Moreover, several authors have reported that the psychostimulant, D-amphetamine (D-AMP), exacerbates symptoms in patients with schizophrenia. We explored in rats the effects in adulthood of neonatal transient inactivation of the PFC on behavioral and neurochemical anomalies associated with schizophrenia. Following tetrodotoxin (TTX) inactivation of the left PFC at postnatal day 8, latent inhibition-related dopaminergic responses and dopaminergic reactivity to D-AMP were monitored using in vivo voltammetry in the left core part of the nucleus accumbens in adult freely moving rats. Dopaminergic responses and behavioral responses were followed in parallel. Prefrontal neonatal inactivation resulted in disrupted behavioral responses of latent inhibition and latent inhibition-related dopaminergic responses in the core subregion. After D-AMP challenge, the highest dose (1.5 mg/kg i.p.) induced a greater dopamine increase in the core in rats microinjected with TTX, and a parallel increase in locomotor activity, suggesting that following prefrontal neonatal TTX inactivation animals display a greater behavioral and dopaminergic reactivity to D-AMP. Transitory inactivation of the PFC early in the postnatal developmental period leads to behavioral and neurochemical changes in adulthood that are meaningful for schizophrenia modeling. The data obtained may help our understanding of the pathophysiology of this disabling disorder. PMID:22588351

  10. Early postnatal nociceptive stimulation results in deficits of spatial memory in male rats.

    PubMed

    Amaral, Cristiane; Antonio, Bruno; Oliveira, Maria Gabriela Menezes; Hamani, Clement; Guinsburg, Ruth; Covolan, Luciene

    2015-11-01

    Prematurely-born infants are exposed to multiple invasive procedures while in the intensive care unit. Newborn rats and humans have similar behavioral responses to noxious stimulation. Previous studies have shown that early noxious stimuli may alter dentate gyrus neurogenesis and the behavioral repertoire of adult rats. We evaluated the late effects of noxious stimulation administered during different phases of development on two spatial memory tests; object recognition (OR) and Morris water maze (WM) tests. Noxious stimulation was induced by an intra-plantar injection of complete Freund's adjuvant (CFA) on postnatal (P) day 1 (group P1) or 8 (P8). Control animals were not stimulated. Behavioral tests were conducted on P60 in both male and female animals. In the WM, three domains were evaluated: acquisition, probe trial performance and reversal re-acquisition. The number of Nissl stained cells in the dentate granule cell layer was assessed by stereological counting. The OR test revealed that P1 male rats had poor long-term memory compared to the control and P8 groups. In the WM, no short- or long-term memory differences were detected between early postnatal-stimulated male and female rats and their respective controls. However, the ability to find the hidden platform in a new position was reduced in P1 male rats. The number of dentate granule cells in P8 males was higher than in all other groups. This study demonstrates that noxious stimulation on P1 results in spatial learning deficits in male animals, but does not disrupt the development of the hippocampus-dependent strategies of learning and memory. PMID:26348792

  11. Tangential Radiotherapy Without Axillary Surgery in Early-Stage Breast Cancer: Results of a Prospective Trial

    SciTech Connect

    Wong, Julia S.; Winer, Eric P.

    2008-11-01

    Purpose: To determine the risk of regional-nodal recurrence in patients with early-stage, invasive breast cancer, with clinically negative axillary nodes, who were treated with breast-conserving surgery, 'high tangential' breast radiotherapy, and hormonal therapy, without axillary surgery or the use of a separate nodal radiation field. Methods and Materials: Between September 1998 and November 2003, 74 patients who were {>=}55 years of age with Stage I-II clinically node-negative, hormone-receptor-positive breast cancer underwent tumor excision to negative margins without axillary surgery as a part of a multi-institutional prospective study. Postoperatively, all underwent high-tangential, whole-breast radiotherapy with a boost to the tumor bed, followed by 5 years of hormonal therapy. Results: For the 74 patients enrolled, the median age was 74.5 years, and the median pathologic tumor size was 1.2 cm. Lymphatic vessel invasion was present in 5 patients (7%). At a median follow-up of 52 months, no regional-nodal failures or ipsilateral breast recurrences had been identified (95% confidence interval, 0-4%). Eight patients died, one of metastatic disease and seven of other causes. Conclusion: In this select group of mainly older patients with early-stage hormone-responsive breast cancer and clinically negative axillary nodes, treatment with high-tangential breast radiotherapy and hormonal therapy, without axillary surgery, yielded a low regional recurrence rate. Such patients might be spared more extensive axillary treatment (axillary surgery, including sentinel node biopsy, or a separate nodal radiation field), with its associated time, expense, and morbidity.

  12. Early interruption of exclusive breastfeeding: results from the eight-country MAL-ED study.

    PubMed

    Patil, Crystal L; Turab, Ali; Ambikapathi, Ramya; Nesamvuni, Cebisa; Chandyo, Ram Krishna; Bose, Anuradha; Islam, M Munirul; Ahmed, A M Shamsir; Olortegui, Maribel Paredes; de Moraes, Milena Lima; Caulfield, Laura E

    2015-01-01

    We report the infant feeding experiences in the first month of life for 2,053 infants participating in "Malnutrition and Enteric Infections: Consequences for Child Health and Development" (MAL-ED). Eight sites (in Bangladesh, India, Nepal, Pakistan, Brazil, Peru, South Africa, Tanzania), each followed a cohort of children from birth (by day 17), collecting detailed information on infant feeding practices, diet and illness episodes. Mothers were queried twice weekly regarding health status, breastfeeding and the introduction (or no) of non-breast milk liquids and foods. Here, our goal is to describe the early infant feeding practices in the cohort and evaluate factors associated with termination of exclusive breastfeeding in the first month of life. With data from enrollment to a visit at 28-33 days of life, we characterized exclusive, predominant or partial breastfeeding (using a median of 6-9 visits per child across the sites). Only 6 of 2,053 infants were never breastfed. By one month, the prevalences of exclusive breastfeeding were < 60% in 6 of 8 sites, and of partial breastfeeding (or no) were > 20% in 6 of 8 sites. Logistic regression revealed that prelacteal feeding (given to 4-63% of infants) increased the likelihood of partial breastfeeding (Odds Ratio (OR): 1.48 (95% confidence interval (CI): 1.04, 2.10), as did the withholding of colostrum (2-16% of infants) (OR: 1.63:1.01, 2.62), and being a first-time mother (OR: 1.38:1.10, 1.75). Our results reveal diversity across these sites, but an overall trend of early transition away from exclusive breastfeeding in the first month of life. Interventions which introduce or reinforce the WHO/UNICEF Ten Steps for Successful Breastfeeding are needed in these sites to improve breastfeeding initiation, to reinforce exclusive breastfeeding and delay introduction of non-breast milk foods and/or liquids. PMID:26825923

  13. [Surgical treatment of acute mediastinitis].

    PubMed

    Krüger, M; Decker, S; Schneider, J P; Haverich, A; Schega, O

    2016-06-01

    Despite modern intensive care management, acute mediastinitis is still associated with a high morbidity and mortality (up to approximately 40 %). Effective antibiotic therapy, intensive care management, elimination of the causative sources of infection and drainage of the affected mediastinal compartments are the cornerstones of therapy in a multidisciplinary treatment concept. Early diagnosis, prompt and uncompromising initial therapy and planned computed tomography (CT) control after the first stages of therapy in order to decide on the necessity for surgical re-interventions are essential for achieving optimal results. Knowledge of the specific anatomical characteristics is crucial for the understanding of this disease and its treatment; therefore, the current knowledge on fascial layers and interstitial spaces from the neck to the mediastinum is described and discussed. A possible foudroyant spread of the infection, especially within the posterior mediastinum, has to be anticipated. The approach to the mediastinum depends on the mediastinal compartments affected, on the causative disease and on the patient's clinical situation. The surgical approach should be adapted to the particular clinical situation of the individual patient and to the surgical experience of the surgeon. When in doubt, the more invasive approach to the mediastinum, such as bilateral thoracotomy, is recommended. An ascending mediastinitis due to pancreatitis is a very rare condition; however, as chest pains are often the main clinical sign surgeons should be aware of this differential diagnosis. An intraoperative brown-black serous fluid in the mediastinal tissue is virtually pathognomonic. The treatment results of esophageal perforation as the most frequent cause of mediastinitis have been improved by integration of various interventional procedures. Hyperbaric oxygen therapy or immunoglobulin treatment can play an auxiliary role in selected patients with acute mediastinitis. PMID

  14. Planck early results. XIII. Statistical properties of extragalactic radio sources in the Planck Early Release Compact Source Catalogue

    NASA Astrophysics Data System (ADS)

    Planck Collaboration; Ade, P. A. R.; Aghanim, N.; Argüeso, F.; Arnaud, M.; Ashdown, M.; Aumont, J.; Baccigalupi, C.; Balbi, A.; Banday, A. J.; Barreiro, R. B.; Bartlett, J. G.; Battaner, E.; Benabed, K.; Bernard, J.-P.; Bersanelli, M.; Bhatia, R.; Bonaldi, A.; Bonavera, L.; Bond, J. R.; Borrill, J.; Bouchet, F. R.; Bucher, M.; Burigana, C.; Cabella, P.; Cappellini, B.; Cardoso, J.-F.; Catalano, A.; Cayón, L.; Challinor, A.; Chamballu, A.; Chary, R.-R.; Chen, X.; Chiang, L.-Y.; Christensen, P. R.; Clements, D. L.; Colafrancesco, S.; Colombi, S.; Couchot, F.; Crill, B. P.; Cuttaia, F.; Danese, L.; Davies, R. D.; Davis, R. J.; de Bernardis, P.; de Gasperis, G.; de Rosa, A.; de Zotti, G.; Delabrouille, J.; Delouis, J.-M.; Désert, F.-X.; Dickinson, C.; Dole, H.; Donzelli, S.; Doré, O.; Dörl, U.; Douspis, M.; Dupac, X.; Efstathiou, G.; Enßlin, T. A.; Eriksen, H. K.; Finelli, F.; Forni, O.; Frailis, M.; Franceschi, E.; Galeotta, S.; Ganga, K.; Giard, M.; Giardino, G.; Giraud-Héraud, Y.; González-Nuevo, J.; Górski, K. M.; Gratton, S.; Gregorio, A.; Gruppuso, A.; Hansen, F. K.; Harrison, D.; Henrot-Versillé, S.; Herranz, D.; Hildebrandt, S. R.; Hivon, E.; Hobson, M.; Holmes, W. A.; Hovest, W.; Hoyland, R. J.; Huffenberger, K. M.; Jaffe, A. H.; Juvela, M.; Keihänen, E.; Keskitalo, R.; Kisner, T. S.; Kneissl, R.; Knox, L.; Kurki-Suonio, H.; Lagache, G.; Lähteenmäki, A.; Lasenby, A.; Laureijs, R. J.; Lawrence, C. R.; Leach, S.; Leahy, J. P.; Leonardi, R.; Lilje, P. B.; Linden-Vørnle, M.; López-Caniego, M.; Lubin, P. M.; Macías-Pérez, J. F.; Maffei, B.; Magliocchetti, M.; Maino, D.; Mandolesi, N.; Mann, R.; Maris, M.; Martínez-González, E.; Masi, S.; Massardi, M.; Matarrese, S.; Matthai, F.; Mazzotta, P.; Meinhold, P. R.; Melchiorri, A.; Mendes, L.; Mennella, A.; Miville-Deschênes, M.-A.; Moneti, A.; Montier, L.; Morgante, G.; Mortlock, D.; Munshi, D.; Murphy, A.; Naselsky, P.; Natoli, P.; Netterfield, C. B.; Nørgaard-Nielsen, H. U.; Noviello, F.; Novikov, D.; Novikov, I.; O'Dwyer, I. J.; Osborne, S.; Pajot, F.; Paladini, R.; Partridge, B.; Pasian, F.; Patanchon, G.; Pearson, T. J.; Perdereau, O.; Perotto, L.; Perrotta, F.; Piacentini, F.; Piat, M.; Pierpaoli, E.; Plaszczynski, S.; Platania, P.; Pointecouteau, E.; Polenta, G.; Ponthieu, N.; Poutanen, T.; Prézeau, G.; Prunet, S.; Puget, J.-L.; Rachen, J. P.; Rebolo, R.; Reinecke, M.; Ricciardi, S.; Riller, T.; Ristorcelli, I.; Rocha, G.; Rosset, C.; Rowan-Robinson, M.; Rubiño-Martín, J. A.; Rusholme, B.; Sajina, A.; Sandri, M.; Scott, D.; Seiffert, M. D.; Serjeant, S.; Shellard, P.; Smoot, G. F.; Starck, J.-L.; Stivoli, F.; Stolyarov, V.; Stompor, R.; Sudiwala, R.; Sygnet, J.-F.; Tauber, J. A.; Terenzi, L.; Toffolatti, L.; Tomasi, M.; Torre, J.-P.; Tristram, M.; Tuovinen, J.; Türler, M.; Umana, G.; Valenziano, L.; Varis, J.; Vielva, P.; Villa, F.; Vittorio, N.; Wade, L. A.; Wandelt, B. D.; Wilkinson, A.; Yvon, D.; Zacchei, A.; Zonca, A.

    2011-12-01

    The data reported in Planck's Early Release Compact Source Catalogue (ERCSC) are exploited to measure the number counts (dN/dS) of extragalactic radio sources at 30, 44, 70, 100, 143 and 217 GHz. Due to the full-sky nature of the catalogue, this measurement extends to the rarest and brightest sources in the sky. At lower frequencies (30, 44, and 70 GHz) our counts are in very good agreement with estimates based on WMAP data, being somewhat deeper at 30 and 70 GHz, and somewhat shallower at 44 GHz. Planck's source counts at 143 and 217 GHz join smoothly with the fainter ones provided by the SPT and ACT surveys over small fractions of the sky. An analysis of source spectra, exploiting Planck's uniquely broad spectral coverage, finds clear evidence of a steepening of the mean spectral index above about 70 GHz. This implies that, at these frequencies, the contamination of the CMB power spectrum by radio sources below the detection limit is significantly lower than previously estimated. Corresponding author: J. González-Nuevo, e-mail: gnuevo@sissa.it

  15. New comprehensive surgical curriculum of pre-graduate surgical education

    PubMed Central

    Łaski, Dariusz; Makarewicz, Wojciech; Proczko, Monika; Gruca, Zbigniew; Śledziński, Zbigniew

    2013-01-01

    Introduction Surgical education has become one of the most important directions in modern surgery evolution. To meet growing need for appropriate training in laparoscopic and, even more importantly, classic surgical skills, a curriculum involving contemporary tuition methods is needed. Advanced, structuralised training, which includes advanced technologies like virtual reality training, video coaching and motivative aspects of competition, seems to be important for an adequate education programme. Material and methods In academic years 2009/2010 and 2010/2011 the Department of General, Endocrine and Transplant Surgery of the Medical University of Gdansk together with the Pomeranian Foundation for Progress in Surgery organized 4480 h of training in that area of classic (2744) and laparoscopic (1736) skills. Both groups were involved in the programme of training in which the two most important aspects were reliable evaluation of the results and effective motivation to work. Skill evaluation at different stages of the programme were based on completion time and quality measurements. Apart from that, at the end of the course, the participants completed a questionnaire on their subjective perspective on this innovative curriculum, the quality and stability of the skills they obtained. Results In both arms of the programme (laparoscopic and classic) a statistically significant improvement was obtained as early as after the second and third sessions in half of the exercises. The acquired skills were stable over time, as proved by the plateau of completion time achieved in 11 out of 12 exercises. The results of the post-training questionnaire revealed that the participants were very satisfied with the structuralised form of training and appreciated the motivational role of competition. Conclusions Contemporary surgical training should be organized as a systematic, well-evaluated and goal-oriented programme similar to the one proposed by our team. The use of contemporary

  16. Early prenatal exposure to LPS results in anxiety- and depression-related behaviors in adulthood.

    PubMed

    Depino, A M

    2015-07-23

    Maternal immune activation can result in different behavioral abnormalities and brain dysfunction, depending on the nature of the inflammogen and the timing of the challenge. Few studies report the possible link between prenatal exposure to inflammation and mood disorders. Here we aimed to evaluate the effects of a single low lipopolysaccharide (LPS) injection to the dam at gestational day 9 on the offspring behavior and hippocampal function. We found that mice exposed to LPS show anxiety- and depression-related behaviors. Specifically, we found that animals prenatally exposed to LPS avoided the open arms of an elevated plus maze, the center of an open field and the lit side of a light/dark box, and they spent more time immobile in both the forced swimming and tail suspension tests, when compared with offspring of saline-injected dams. In addition, LPS mice had reduced serotonin and noradrenaline levels in the hippocampus and diminished Reelin immunoreactivity in the dentate gyrus, while their adult hippocampal neurogenesis was not affected. Results presented here support specific long-term effects of the response to a bacterial immunogen early in pregnancy, as opposed to different effects previously reported of viral immunogens and/or responses in late pregnancy. Our work adds to recent reports and stresses the relevance of considering prenatal exposure to a maternal immune response as a risk factor for mood disorders. PMID:25943476

  17. The ASTER Global Digital Elevation Model version 2.0 - Early Validation Results

    NASA Astrophysics Data System (ADS)

    Meyer, D. J.; Tachikawa, T.; Abrams, M.; Tsu, H.; Hato, M.; Gesch, D. B.; Crippen, R. E.

    2011-12-01

    The Advanced Spaceborne Thermal Emission and Reflection Radiometer (ASTER) on NASA's Terra spacecraft is capable of collecting in-track stereo using nadir- and aft looking near infrared cameras. Since 2001, these stereo pairs have been used to produce single-scene (60 x 60 km) digital elevation models having vertical (root-mean-squared-error) accuracies generally between 10 m and 25 m. On June 29, 2009, NASA and the Ministry of Economy, Trade and Industry (METI) of Japan released a Global Digital Elevation Model (GDEM) to users worldwide at no charge as a contribution to the Global Earth Observing System of Systems (GEOSS). This "version 1.0" ASTER GDEM (GDEM v1.0) was compiled from over 1.2 million scene-based DEMs covering land surface between 83°N and 83°S latitudes. This GDEM is a 1 arc-second elevation grid divided and distributed as 1°-by-1° tiles. ** A joint US-Japan validation team assessed the accuracy of the GDEM v1.0, augmented by a team of 20 cooperators selected through an Announcement of Opportunity (AO). In summary, the GDEM v1.0 was found to have an overall accuracy of around 20 meters at the 95% confidence interval. The team also noted several artifacts associated with poor coverage, cloud contamination, water masking issues and the stacking process used to produce the GDEM from individual scene-based DEMs. An independent horizontal resolution study estimated the effective spatial resolution of the GDEM v1.0 to be on the order of 120 meters. ** NASA & METI will release a second version of the ASTER GDEM (v2.0) in mid-October, 2011. The GDEM v2.0 has the same gridding and tile structure as v1.0, but benefits from the inclusion of 300,000 additional scenes to improve coverage, a smaller correlation kernel (5x5 versus 9x9 for v1.0) yielding higher spatial resolution, and improved water masking. This abstract presents early validation results available at the time of submission. Early results indicate: (1) the overall accuracy (both horizontal and

  18. [Immediate and remote results of surgical treatment of patients presenting with pathological tortuosity of internal carotid arteries and accompanying ocular ischaemic syndrome].

    PubMed

    Gavrilenko, A V; Kuklin, A V; Kisileva, T N; Abramian, A V; Omarzhanova, I I

    2013-01-01

    The article deals with the data concerning the efficacy of reconstructive operations and conservative treatment in patients presenting with pathological tortuosity of internal carotid arteries. The study included a total of 63 patients. The diagnostic algorithm was as follows: studying the haemodynamics of the internal carotid arteries, assessing the neurological status, and the methods of examining the eye. The patients were subdivided into two groups: Group One consisted of operated on patients (n=37) and Group Two comprising patients treated conservatively (n=26). The patients according to the neurological status were subdivided as follows: an asymptomatic course in 25 (39.7%) patients, transitory ischaemic attacks in 18 (28.6%) patients, dyscirculatory encephalopathy in 12 (19 %) patients, and stroke in 8 (12.7%) patients. Ophthalmological symptomatology was predominantly manifested by fits of amaurosis fugax in 19 (30.2%) patients and processes of maculodystrophy in 49 (77.8 %) patients. We assessed the immediate (day 30) and remote (1 year) results of conservative and surgical treatment. Group One patients demonstrated cessation of the amaurosis fugax attacks, improvement of the acuity of vision by 0.1 and more, enlargement of the borders of the field of vision, disappearance of scotomas, as well as arrest of the processes of maculodystrophy. Patients with transitory ischaemic attacks and dyscirculatory encephalopathy changed to the category of asymptomatic patients. In Group Two patients the dynamics of the neurological status was negative and the patients continued to experience fits of amaurosis fugas. The dynamics of the opthalmological symptomatology was weakly pronounced. PMID:24429568

  19. Surgical prosthetic treatment

    PubMed Central

    Carulli, Christian; Matassi, Fabrizio; Civinini, Roberto; Villano, Marco; Innocenti, Massimo

    2010-01-01

    Fragility fractures typically occur in elderly patients related principally to osteoporosis. A significative percentage of these fractures have to be treated surgically but comorbilities are often present, and need to be grossly stabilized before surgery. However, there is for these fractures a high rate of morbidity and mortality at short-term. Moreover, patients affected by a fragility fracture are at risk for another fragility fracture later in life. The Authors present an overview of the main patterns of proximal femoral fractures, underlining the peculiar features and choices of surgical treatment, and relating to specific indications and results of each treatment. PMID:22461289

  20. [Pulmonary Echinococcosis: Surgical Aspects].

    PubMed

    Eichhorn, M E; Hoffmann, H; Dienemann, H

    2015-10-01

    Pulmonary cystic echinococcosis is a very rare disease in Germany. It is caused by the larvae of the dog tapeworm (echinococcus granulosus). The liver is the most affected organ, followed by the lungs. Surgery remains the main therapeutic approach for pulmonary CE. Whenever possible, parenchyma-preserving lung surgery should be preferred over anatomic lung resections. To ensure best therapeutic results, surgery needs to be performed under precise consideration of important infectiological aspects and patients should be treated in specialised centres based on interdisciplinary consensus. In addition to surgical aspects, this review summarises special infectiological features of this disease, which are crucial to the surgical approach. PMID:26351761

  1. Costs and Cost-Effectiveness of Carotid Stenting versus Endarterectomy for Patients at Standard Surgical Risk: Results from the Carotid Revascularization Endarterectomy versus Stenting Trial (CREST)

    PubMed Central

    Vilain, Katherine R.; Magnuson, Elizabeth A.; Li, Haiyan; Clark, Wayne M.; Begg, Richard J.; Sam, Albert D.; Sternbergh, W. Charles; Weaver, Fred A.; Gray, William A.; Voeks, Jenifer H.; Brott, Thomas G.; Cohen, David J.

    2012-01-01

    CEA compared with CAS, projected 10-year outcomes from this controlled clinical trial demonstrate only trivial differences in overall healthcare costs and quality-adjusted life expectancy between the 2 strategies. If the CREST results can be replicated in clinical practice, these findings suggest that factors other than cost-effectiveness should be considered when deciding between treatment options for carotid artery stenosis in patients at standard risk for surgical complications. PMID:22821614

  2. Intraoperative Radiotherapy in Early-Stage Breast Cancer: Results of the Montpellier Phase II Trial

    SciTech Connect

    Lemanski, Claire; Azria, David; Gourgon-Bourgade, Sophie; Gutowski, Marian; Rouanet, Phillippe; Saint-Aubert, Bernard; Ailleres, Norbert; Fenoglietto, Pascal; Dubois, Jean-Bernard

    2010-03-01

    Purpose: We recently presented the intraoperative radiotherapy (IORT) technique given as a reliable alternative to conventional boost radiation after breast-conserving surgery. The low crude numbers of recurrence in elderly patients led us to investigate the feasibility and the efficacy of this procedure as a sole treatment. Methods and Materials: We included 94 patients older than 65 years in this phase II trial. Among them, 42 patients presented with all the inclusion criteria, i.e., stages pT0 to pT1 and pN0, ductal invasive unifocal carcinoma, and tumor-free margin of >2 mm. IORT was delivered using a dedicated linear accelerator. One 21-Gy fraction was prescribed and specified at the 90% isodose, using electrons. In vivo dosimetry was performed for all patients. The primary endpoint was the quality index. Secondary endpoints were quality of life, local recurrences, cosmetic results, and specific and overall rates of survival. Results: The median follow-up was 30 months (range, 12-49 months), and median age was 72 years (range, 66-80 years). The median tumor diameter was 10 mm. All patients received the total prescribed dose. No acute grade 3 toxicities were observed. Endpoints for all but one patient corresponded to acceptable quality index criteria. Pretreatment quality-of-life scores were maximal, and no significant decrease was observed during follow-up. Cosmesis was good to excellent at 6 months. Two patients experienced recurrence but underwent salvage mastectomy. Conclusion: Our results confirm that exclusive partial-breast IORT is feasible for treating early-stage breast cancer in the elderly. IORT may be considered an alternative treatment for a selected population and offers a safe one-step treatment.

  3. Early life exposure to allergen and ozone results in altered development in adolescent rhesus macaque lungs

    SciTech Connect

    Herring, M.J.; Putney, L.F.; St George, J.A.; Avdalovic, M.V.; Schelegle, E.S.; Miller, L.A.; Hyde, D.M.

    2015-02-15

    In rhesus macaques, previous studies have shown that episodic exposure to allergen alone or combined with ozone inhalation during the first 6 months of life results in a condition with many of the hallmarks of asthma. This exposure regimen results in altered development of the distal airways and parenchyma (Avdalovic et al., 2012). We hypothesized that the observed alterations in the lung parenchyma would be permanent following a long-term recovery in filtered air (FA) housing. Forty-eight infant rhesus macaques (30 days old) sensitized to house dust mite (HDM) were treated with two week cycles of FA, house dust mite allergen (HDMA), ozone (O{sub 3}) or HDMA/ozone (HDMA + O{sub 3}) for five months. At the end of the five months, six animals from each group were necropsied. The other six animals in each group were allowed to recover in FA for 30 more months at which time they were necropsied. Design-based stereology was used to estimate volumes of lung components, number of alveoli, size of alveoli, distribution of alveolar volumes, interalveolar capillary density. After 30 months of recovery, monkeys exposed to HDMA, in either group, had significantly more alveoli than filtered air. These alveoli also had higher capillary densities as compared with FA controls. These results indicate that early life exposure to HDMA alone or HDMA + O{sub 3} alters the development process in the lung alveoli. - Highlights: • Abnormal lung development after postnatal exposure to ozone and allergen • This remodeling is shown as smaller, more numerous alveoli and narrower airways. • Allergen appears to have more of an effect than ozone during recovery. • These animals also have continued airway hyperresponsiveness (Moore et al. 2014)

  4. Planck early results. IV. First assessment of the High Frequency Instrument in-flight performance

    NASA Astrophysics Data System (ADS)

    Planck HFI Core Team; Ade, P. A. R.; Aghanim, N.; Ansari, R.; Arnaud, M.; Ashdown, M.; Aumont, J.; Banday, A. J.; Bartelmann, M.; Bartlett, J. G.; Battaner, E.; Benabed, K.; Benoît, A.; Bernard, J.-P.; Bersanelli, M.; Bhatia, R.; Bock, J. J.; Bond, J. R.; Borrill, J.; Bouchet, F. R.; Boulanger, F.; Bradshaw, T.; Bréelle, E.; Bucher, M.; Camus, P.; Cardoso, J.-F.; Catalano, A.; Challinor, A.; Chamballu, A.; Charra, J.; Charra, M.; Chary, R.-R.; Chiang, C.; Church, S.; Clements, D. L.; Colombi, S.; Couchot, F.; Coulais, A.; Cressiot, C.; Crill, B. P.; Crook, M.; de Bernardis, P.; Delabrouille, J.; Delouis, J.-M.; Désert, F.-X.; Dolag, K.; Dole, H.; Doré, O.; Douspis, M.; Efstathiou, G.; Eng, P.; Filliard, C.; Forni, O.; Fosalba, P.; Fourmond, J.-J.; Ganga, K.; Giard, M.; Girard, D.; Giraud-Héraud, Y.; Gispert, R.; Górski, K. M.; Gratton, S.; Griffin, M.; Guyot, G.; Haissinski, J.; Harrison, D.; Helou, G.; Henrot-Versillé, S.; Hernández-Monteagudo, C.; Hildebrandt, S. R.; Hills, R.; Hivon, E.; Hobson, M.; Holmes, W. A.; Huffenberger, K. M.; Jaffe, A. H.; Jones, W. C.; Kaplan, J.; Kneissl, R.; Knox, L.; Lagache, G.; Lamarre, J.-M.; Lami, P.; Lange, A. E.; Lasenby, A.; Lavabre, A.; Lawrence, C. R.; Leriche, B.; Leroy, C.; Longval, Y.; Macías-Pérez, J. F.; Maciaszek, T.; MacTavish, C. J.; Maffei, B.; Mandolesi, N.; Mann, R.; Mansoux, B.; Masi, S.; Matsumura, T.; McGehee, P.; Melin, J.-B.; Mercier, C.; Miville-Deschênes, M.-A.; Moneti, A.; Montier, L.; Mortlock, D.; Murphy, A.; Nati, F.; Netterfield, C. B.; Nørgaard-Nielsen, H. U.; North, C.; Noviello, F.; Novikov, D.; Osborne, S.; Paine, C.; Pajot, F.; Patanchon, G.; Peacocke, T.; Pearson, T. J.; Perdereau, O.; Perotto, L.; Piacentini, F.; Piat, M.; Plaszczynski, S.; Pointecouteau, E.; Pons, R.; Ponthieu, N.; Prézeau, G.; Prunet, S.; Puget, J.-L.; Reach, W. T.; Renault, C.; Ristorcelli, I.; Rocha, G.; Rosset, C.; Roudier, G.; Rowan-Robinson, M.; Rusholme, B.; Santos, D.; Savini, G.; Schaefer, B. M.; Shellard, P.; Spencer, L.; Starck, J.-L.; Stassi, P.; Stolyarov, V.; Stompor, R.; Sudiwala, R.; Sunyaev, R.; Sygnet, J.-F.; Tauber, J. A.; Thum, C.; Torre, J.-P.; Touze, F.; Tristram, M.; van Leeuwen, F.; Vibert, L.; Vibert, D.; Wade, L. A.; Wandelt, B. D.; White, S. D. M.; Wiesemeyer, H.; Woodcraft, A.; Yurchenko, V.; Yvon, D.; Zacchei, A.

    2011-12-01

    The Planck High Frequency Instrument (HFI) is designed to measure the temperature and polarization anisotropies of the cosmic microwave background and Galactic foregrounds in six ~30% bands centered at 100, 143, 217, 353, 545, and 857 GHz at an angular resolution of 10' (100 GHz), 7' (143 GHz), and 5' (217 GHz and higher). HFI has been operating flawlessly since launch on 14 May 2009, with the bolometers reaching 100 mK the first week of July. The settings of the readout electronics, including bolometer bias currents, that optimize HFI's noise performance on orbit are nearly the same as the ones chosen during ground testing. Observations of Mars, Jupiter, and Saturn have confirmed that the optical beams and the time responses of the detection chains are in good agreement with the predictions of physical optics modeling and pre-launch measurements. The Detectors suffer from a high flux of cosmic rays due to historically low levels of solar activity. As a result of the redundancy of Planck's observation strategy, theremoval of a few percent of data contaminated by glitches does not significantly affect the instrumental sensitivity. The cosmic ray flux represents a significant and variable heat load on the sub-Kelvin stage. Temporal variation and the inhomogeneous distribution of the flux results in thermal fluctuations that are a probable source of low frequency noise. The removal of systematic effects in the time ordered data provides a signal with an average noise equivalent power that is 70% of the goal in the 0.6-2.5 Hz range. This is slightly higher than was achieved during the pre-launch characterization but better than predicted in the early phases of the project. The improvement over the goal is a result of the low level of instrumental background loading achieved by the optical and thermal design of the HFI. Corresponding author: J.-M. Lamarre, jean-michel.lamarre@obspm.fr

  5. Differential population synthesis of early-type galaxies. III. Synthesis results

    SciTech Connect

    Pickles, A.J.

    1985-09-15

    Synthesis results are presented for 12 elliptical and five lenticular galaxies which cover nearly a 6 mag range of absolute magnitude in the Fornax cluster (V = 1430 km s ). The results of age, metallicity, and mass-to-light ratio (M/L) determinations are presented differentially as functions of galactic luminosity and morphology. Bright elliptical galaxies are well represented by main-sequence turnoff colors of (V-R)/sub c/roughly-equal0.37 and B-Vroughly-equal0.70, in good agreement with O'Connell's results for bright Virgo ellipticals. The relatively young main-sequence turnoff ages, of 6-10 Gyr for ellipticals of all luminosities, indicate that substantial star formation activity occurred in these galaxies for a period of 6dagger10 Gyr after the epoch of globular cluster formation. There is strong evidence for small amounts of current star formation in at least the brightest ellipticals of all luminosities, indicate that substantial star formation in at least the brightest ellipticals, variation in the amount of which may account for significant dispersion in the cluster U-V versus V color-magnitude relation. A metallicity gradient in (Fe/H) of at least 0.16 dex per absolute magnitude is derived, with the brightest ellipticals being 2 to 3 times more metal-rich than solar. The mean metallicities and turnoff ages of the faintest ellipticals are probably dependent on environment. Distance-independent upper limits to galaxy M/L ratios derived from the syntheses conform well with M/L ratios derived from velocity dispersion measurements and give no evidence for unseen mass in the nuclei of early type galaxies of any luminosity.

  6. A Pilot Clinical Trial of Creatine and Minocycline in Early Parkinson Disease: 18-Month Results

    PubMed Central

    2015-01-01

    Objective To report an 18-month follow-up on creatine and minocycline futility study, the Neuroprotective Exploratory Trials in Parkinson Disease, Futility Study 1 (NET-PD FS-1). Background The NET-PD FS-1 futility study on creatine and minocycline found neither agent futile in slowing down the progression of disability in Parkinson disease (PD) at 12 months using the prespecified futility threshold. An additional 6 months of follow-up aimed to assess safety and potential interactions of the study interventions with anti-parkinsonian therapy. Methods Additional 6 months of follow-up in randomized, blinded phase II trial of creatine (dosage, 10 g/d) and minocycline (dosage, 200 mg/d) in subjects with early PD. Results By 18 months, symptomatic treatment of PD symptoms was required in 61% of creatine, 62% of minocycline, and 60% of placebo-treated subjects. Study treatment was prematurely discontinued in 9%, 23%, and 6% of subjects in the creatine, minocycline, and placebo arms, respectively. Creatine and minocycline did not seem to adversely influence the response to symptomatic therapy nor increase adverse events. Conclusions Data from this small, 18-month phase II trial of creatine and minocycline do not demonstrate safety concerns that would preclude a large, phase III efficacy trial, although the decreased tolerability of minocycline is a concern. PMID:18520981

  7. Adaptive multi-sensor biomimetics for unsupervised submarine hunt (AMBUSH): Early results

    NASA Astrophysics Data System (ADS)

    Blouin, Stéphane

    2014-10-01

    Underwater surveillance is inherently difficult because acoustic wave propagation and transmission are limited and unpredictable when targets and sensors move around in the communication-opaque undersea environment. Today's Navy underwater sensors enable the collection of a massive amount of data, often analyzed offtine. The Navy of tomorrow will dominate by making sense of that data in real-time. DRDC's AMBUSH project proposes a new undersea-surveillance network paradigm that will enable such a real-time operation. Nature abounds with examples of collaborative tasks taking place despite limited communication and computational capabilities. This publication describes a year's worth of research efforts finding inspiration in Nature's collaborative tasks such as wolves hunting in packs. This project proposes the utilization of a heterogeneous network combining both static and mobile network nodes. The military objective is to enable an unsupervised surveillance capability while maximizing target localization performance and endurance. The scientific objective is to develop the necessary technology to acoustically and passively localize a noise-source of interest in shallow waters. The project fulfills these objectives via distributed computing and adaptation to changing undersea conditions. Specific research interests discussed here relate to approaches for performing: (a) network self-discovery, (b) network connectivity self-assessment, (c) opportunistic network routing, (d) distributed data-aggregation, and (e) simulation of underwater acoustic propagation. We present early results then followed by a discussion about future work.

  8. AKARI—Infrared Satellite Mission—Present Status and Early Results

    NASA Astrophysics Data System (ADS)

    Onaka, Takashi

    2009-04-01

    AKARI, formerly known as ASTRO-F, is a satellite mission dedicated to infrared astronomy for the first time in Japan. It has a 685-mm aperture telescope with two focal-plane instruments cooled by liquid helium (LHe) and mechanical coolers on board for observations in the 2-180 μm infrared spectral range. AKARI was launched on 2006 February 21 (UT) into a sun-synchronous polar orbit and started observations in May, 2006. It carried 179 liter LHe that lasted for 550 days and observations with LHe were carried out for more than 15 months. During the LHe holding period, AKARI made all-sky survey observations with six bands from 9 to 160 μm, which surpass the IRAS all-sky survey data in the sensitivity, spatial resolution, and spectral coverage. Together with the all-sky observation, AKARI also made pointing observations for about 10 min at a given position of the sky to execute deep imaging and spectroscopy from near- to far-infrared. Both focal-plane instruments work successfully on orbit and more than 90% of the sky was observed in the all-sky survey. After LHe exhaustion, near-infrared observations are planned to continue. This paper reports the in-orbit performance of AKARI and its early observational results so far obtained.

  9. Early Instrument Performance Results from the Terra/Moderate Resolution Imaging Spectroradiometer (MODIS)

    NASA Technical Reports Server (NTRS)

    Salomonson, V. V.; Guenther, B. W.; Barnes, W. L.; Murphy, R. E.

    2000-01-01

    The Moderate Resolution Imaging Spectroradiometer (MODIS) is a major observational capability flying on the Earth Observing System (EOS) AM-1 "Terra" mission. This mission is to go into orbit in late 1999 or very early 2000. The MODIS was developed to provide improved observations of land, ocean, and atmosphere features relative to "heritage instruments" such as the NOAA Advanced Very High Resolution Radiometer (AVHRR), the Nimbus Coastal Zone Color Scanner (CZCS)and the SeaStar/SeaWiFS instruments, in particular. In addition the MODIS should provide complementary observations to the Landsat-7 Thematic Mapper and the NOAA HIRS instrument. There has been considerable effort to include capabilities or plans to characterize and assure calibration of the instrument data. These efforts include on on-board blackbody (BB), a solar diffuser (SID), a solar diffuser stability monitor (SDSM), and a spectral radiometric calibration assembly (SDSM). These devices, along with careful analyses of scenes acquired during orbit, are expected to allow comparisons with pre-launch expectations regarding spatial performance, spectral performance, and radiometric performance. In addition deep space observations and observations of the moon are to be used to characterize instrument performance. The purpose of this paper is to provide quantitative comparisons, as results become available from the Terra MODIS, to heritage instruments, pre-launch expectations and specifications.

  10. Early results from the Northern Gulf of Mexico Ecosystem Change and Hazard Susceptibility Project

    USGS Publications Warehouse

    Brock, John C.; Lavoie, Dawn L.; Poore, Richard Z.

    2011-01-01

    The northern Gulf of Mexico coastal region and its diverse ecosystems are threatened by population and development pressure and by the impacts of rising sea level and severe storms such as the series of hurricanes that has impacted the northern Gulf in recent years. In response to the complex management issues facing the region, the U.S. Geological Survey (USGS) organized a multidisciplinary research program to coordinate the activities of USGS and other scientists working in the northern Gulf of Mexico region (fig. 1). The Northern Gulf of Mexico (NGOM) Ecosystem Change and Hazard Susceptibility Project aims to develop a thorough understanding of the dynamic coastal ecosystems on the northern Gulf coast, the impact of human activities on these ecosystems, and the vulnerability of ecosystems and human communities to more frequent and more intense hurricanes in the future. A special issue of Geo-Marine Letters published in December 2009 is devoted to early results of studies completed as part of this project. These studies, which have been conducted at sites throughout the northern Gulf region, from the Chandeleur Islands to Apalachicola Bay, have focused on three themes: (1) The underlying geologic framework that exerts controls over coastal processes (2) The impact of human activities on nearshore water quality (3) Hurricanes and associated effects

  11. Overview and Early Results of the Superconducting Submillimeter-Wave Limb-Emission Sounder (SMILES)

    NASA Astrophysics Data System (ADS)

    Shiotani, Masato

    2010-05-01

    The Superconducting Submillimeter-Wave Limb-Emission Sounder (SMILES) was developed to be aboard the Japanese Experiment Module (JEM) on the International Space Station (ISS) under the cooperation of the Japan Aerospace Exploration Agency (JAXA) and the National Institute of Information and Communication Technology (NICT). SMILES was successfully launched by the H-IIB rocket with the H-II Transfer Vehicle (HTV) on September 11, 2009 and was attached to JEM on September 25. Mission objectives are: i) Space demonstration of 4-K mechanical cooler and super-conductive mixer for the submillimeter limb-emission sounding in the frequency bands of 624.32- 627.32 GHz and 649.12- 650.32 GHz, and ii) global observations of atmospheric minor constituents in the middle atmosphere (O3, HCl, ClO, HO2, HOCl, BrO, O3 isotopes, HNO3, CH3CN, etc), contributing to the atmospheric sciences. SMILES started atmospheric observations on October 12, 2009, and has been making very precise measurements on several radical species crucial to the ozone chemistry with its high-sensitivity. In this presentation, the overview of SMILES and the early results will be shown to demonstrate its high potential to observe the atmospheric minor constituents in the middle atmosphere.

  12. Early intervention and prevention of anxiety disorders in children: results at 2-year follow-up.

    PubMed

    Dadds, M R; Holland, D E; Laurens, K R; Mullins, M; Barrett, P M; Spence, S H

    1999-02-01

    The Queensland Early Intervention and Prevention of Anxiety Project evaluated a child- and family-focused group intervention for preventing anxiety problems in children. This article reports on 12- and 24-month follow-up data to previously reported outcomes at posttreatment and at 6-month follow-up. A total of 1,786 7- to 14-year-olds were screened for anxiety problems using teacher nominations and children's self-report. After diagnostic interviews, 128 children were selected and assigned to either a 10-week school-based child- and parent-focused psychosocial intervention or a monitoring group. Both groups showed improvements immediately at postintervention and at 6-month follow-up; the improvement was maintained in the intervention group only reducing the rate of existing anxiety disorder and preventing the onset of new anxiety disorders. At 12 months, the groups converged, but the superiority of the intervention group was evident again at 2-year follow-up. Severity of pretreatment diagnoses, gender, and parental anxiety predicted poor initial response to intervention, whereas pretreatment severity was the only predictor of chronicity at 24 months. Overall, follow-up results show that a brief school-based intervention for children can produce durable reductions in anxiety problems. PMID:10028219

  13. Spectroscopic Analysis of Metal-poor Stars from LAMOST: Early Results

    NASA Astrophysics Data System (ADS)

    Li, Hai-Ning; Zhao, Gang; Christlieb, Norbert; Wang, Liang; Wang, Wei; Zhang, Yong; Hou, Yonghui; Yuan, Hailong

    2015-01-01

    We report on early results from a pilot program searching for metal-poor stars with LAMOST and follow-up high-resolution observation acquired with the MIKE spectrograph attached to the Magellan II telescope. We performed detailed abundance analysis for eight objects with iron abundances [Fe/H] < -2.0, including five extremely metal-poor (EMP; [Fe/H] < -3.0) stars with two having [Fe/H] < -3.5. Among these objects, three are newly discovered EMP stars, one of which is confirmed for the first time with high-resolution spectral observations. Three program stars are regarded as carbon-enhanced metal-poor (CEMP) stars, including two stars with no enhancement in their neutron-capture elements, which thus possibly belong to the class of CEMP-no stars; one of these objects also exhibits significant enhancement in nitrogen, and is thus a potential carbon and nitrogen-enhanced metal-poor star. The [X/Fe] ratios of the sample stars generally agree with those reported in the literature for other metal-poor stars in the same [Fe/H] range. We also compared the abundance patterns of individual program stars with the average abundance pattern of metal-poor stars and find only one chemically peculiar object with abundances of at least two elements (other than C and N) showing deviations larger than 0.5 dex. The distribution of [Sr/Ba] versus [Ba/H] agrees that an additional nucleosynthesis mechanism is needed aside from a single r-process. Two program stars with extremely low abundances of Sr and Ba support the prospect that both main and weak r-processes may have operated during the early phase of Galactic chemical evolution. The distribution of [C/N] shows that there are two groups of carbon-normal giants with different degrees of mixing. However, it is difficult to explain the observed behavior of the [C/N] of the nitrogen-enhanced unevolved stars based on current data.

  14. Early Results from the Curiosity Rover's SAM Investigation at Gale Crater

    NASA Astrophysics Data System (ADS)

    Mahaffy, Paul; Webster, Chris; Cabane, Michael; Coll, Patrice

    2013-04-01

    The goals of the Mars Science Laboratory Mission (1, 2) are to explore the potential of the Gale Crater landing site to support life either in the distant past or the present. The contribution of the Sample Analysis at Mars (SAM) instrument suite (3) in this exploration of habitability is (A) to search for organic compounds in rocks and soils, (B) to determine the composition of inorganic volatiles compounds in the atmosphere or extracted from solid materials, and (C) to measure the isotopic composition of several of these volatiles. While prime exploration targets of MSL's Curiosity Rover are the layers in the central mound (Mt. Sharp) of Gale crater the initial exploration of region near the landing point has revealed a diverse geology and the early part of the mission has been spent both commissioning the 10 Curiosity instruments and the Rover subsystems and making first time measurements of both atmospheric and solid samples. SAM is located in the interior of MSL's Curiosity rover next to the XRD/XRF CheMin instrument. A variety of imaging, laser induced breakdown spectroscopy, and elemental analysis instrumentation serves to locate sampling sites and interogate candidate materials before solid sample is collected either with a drill or a scoop for delivery to SAM and CheMin. SAM's instruments are a quadrupole mass spectrometer (QMS), a tunable laser spectrometer (TLS), and a 6-column gas chromatograph (GC). These are coupled through a solid sample transport system and a gas processing and enrichment system. The SAM suite is able to measure a suite of light isotopes and to analyze volatiles directly from the atmosphere or thermally released from solid samples. Early results from SAM atmospheric runs include a determination of: new volume mixing ratios for the 5 major isotopic constituents showing Ar approximately equal to N2; an upper limit of 3.5 ppb for the volume mixing ratio of methane; C and O isotope ratios showing both heavier than terrestrial averages

  15. SPECTROSCOPIC ANALYSIS OF METAL-POOR STARS FROM LAMOST: EARLY RESULTS

    SciTech Connect

    Li, Hai-Ning; Zhao, Gang; Wang, Liang; Wang, Wei; Yuan, Hailong; Christlieb, Norbert; Zhang, Yong; Hou, Yonghui E-mail: gzhao@nao.cas.cn

    2015-01-10

    We report on early results from a pilot program searching for metal-poor stars with LAMOST and follow-up high-resolution observation acquired with the MIKE spectrograph attached to the Magellan II telescope. We performed detailed abundance analysis for eight objects with iron abundances [Fe/H] < -2.0, including five extremely metal-poor (EMP; [Fe/H] < -3.0) stars with two having [Fe/H] < -3.5. Among these objects, three are newly discovered EMP stars, one of which is confirmed for the first time with high-resolution spectral observations. Three program stars are regarded as carbon-enhanced metal-poor (CEMP) stars, including two stars with no enhancement in their neutron-capture elements, which thus possibly belong to the class of CEMP-no stars; one of these objects also exhibits significant enhancement in nitrogen, and is thus a potential carbon and nitrogen-enhanced metal-poor star. The [X/Fe] ratios of the sample stars generally agree with those reported in the literature for other metal-poor stars in the same [Fe/H] range. We also compared the abundance patterns of individual program stars with the average abundance pattern of metal-poor stars and find only one chemically peculiar object with abundances of at least two elements (other than C and N) showing deviations larger than 0.5 dex. The distribution of [Sr/Ba] versus [Ba/H] agrees that an additional nucleosynthesis mechanism is needed aside from a single r-process. Two program stars with extremely low abundances of Sr and Ba support the prospect that both main and weak r-processes may have operated during the early phase of Galactic chemical evolution. The distribution of [C/N] shows that there are two groups of carbon-normal giants with different degrees of mixing. However, it is difficult to explain the observed behavior of the [C/N] of the nitrogen-enhanced unevolved stars based on current data.

  16. Surgical progress: surgical management of infective endocarditis.

    PubMed Central

    Mills, S A

    1982-01-01

    Infective endocarditis of bacterial or fungal origin may arise in either the left or the right heart and can involve both natural and prosthetic valves. The diagnosis is based primarily upon clinical criteria and positive blood cultures, but serial electrocardiograms, fluoroscopy, and two-dimensional echocardiograms may also be helpful. The initial treatment should consist of antibiotic therapy and is itself often adequate in effecting cure. However, careful observation during antibiotic treatment is mandatory, since the development of congestive heart failure due to valvular obstruction or destruction can be an indication for surgical intervention. Other surgical indications include a failure to respond to antibiotic therapy, pulmonary or systemic emboli, evidence of abscess involving the valvular ring (particularly prevalent with prosthetic valve endocarditis), Brucella infection, and the onset of conduction disturbances. The goals of surgical treatment are removal of infective tissue, restoration of valve function, and correction of associated mechanical disorders. The results are surprisingly good, especially for a condition of this severity. Images Fig. 2. Fig. 3. Fig. 4. Fig. 5. Fig. 6. PMID:7065743

  17. The JCMT Plane Survey: early results from the ℓ = 30° field

    NASA Astrophysics Data System (ADS)

    Moore, T. J. T.; Plume, R.; Thompson, M. A.; Parsons, H.; Urquhart, J. S.; Eden, D. J.; Dempsey, J. T.; Morgan, L. K.; Thomas, H. S.; Buckle, J.; Brunt, C. M.; Butner, H.; Carretero, D.; Chrysostomou, A.; deVilliers, H. M.; Fich, M.; Hoare, M. G.; Manser, G.; Mottram, J. C.; Natario, C.; Olguin, F.; Peretto, N.; Polychroni, D.; Redman, R. O.; Rigby, A. J.; Salji, C.; Summers, L. J.; Berry, D.; Currie, M. J.; Jenness, T.; Pestalozzi, M.; Traficante, A.; Bastien, P.; diFrancesco, J.; Davis, C. J.; Evans, A.; Friberg, P.; Fuller, G. A.; Gibb, A. G.; Gibson, S.; Hill, T.; Johnstone, D.; Joncas, G.; Longmore, S. N.; Lumsden, S. L.; Martin, P. G.; Lu'o'ng, Q. Nguyê˜n.; Pineda, J. E.; Purcell, C.; Richer, J. S.; Schieven, G. H.; Shipman, R.; Spaans, M.; Taylor, A. R.; Viti, S.; Weferling, B.; White, G. J.; Zhu, M.

    2015-11-01

    We present early results from the JCMT (James Clerk Maxwell Telescope) Plane Survey (JPS), which has surveyed the northern inner Galactic plane between longitudes ℓ = 7° and ℓ = 63° in the 850-μm continuum with SCUBA-2 (Submm Common-User Bolometer Array 2), as part of the JCMT Legacy Survey programme. Data from the ℓ = 30° survey region, which contains the massive-star-forming regions W43 and G29.96, are analysed after approximately 40 per cent of the observations had been completed. The pixel-to-pixel noise is found to be 19 mJy beam-1 after a smooth over the beam area, and the projected equivalent noise levels in the final survey are expected to be around 10 mJy beam-1. An initial extraction of compact sources was performed using the FELLWALKER method, resulting in the detection of 1029 sources above a 5σ surface-brightness threshold. The completeness limits in these data are estimated to be around 0.2 Jy beam-1 (peak flux density) and 0.8 Jy (integrated flux density) and are therefore probably already dominated by source confusion in this relatively crowded section of the survey. The flux densities of extracted compact sources are consistent with those of matching detections in the shallower APEX (Atacama Pathfinder Experiment) Telescope Large Area Survey of the Galaxy (ATLASGAL) survey. We analyse the virial and evolutionary state of the detected clumps in the W43 star-forming complex and find that they appear younger than the Galactic-plane average.

  18. Single-Fraction Intraoperative Radiotherapy for Breast Cancer: Early Cosmetic Results

    SciTech Connect

    Beal, Kathryn McCormick, Beryl; Zelefsky, Michael J.; Borgen, Patrick; Fey, Jane; Goldberg, Jessica; Sacchini, Virgilio

    2007-09-01

    Purpose: To evaluate the cosmetic outcome of patients treated with wide local excision and intraoperative radiotherapy for early-stage breast cancer. Methods and Materials: A total of 50 women were treated on a pilot study to evaluate the feasibility of intraoperative radiotherapy at wide local excision. The eligibility criteria included age >60, tumor size {<=}2.0 cm, clinically negative lymph nodes, and biopsy-established diagnosis. After wide local excision, a custom breast applicator was placed in the excision cavity, and a dose of 20 Gy was prescribed to a depth of 1 cm. After 18 patients were treated, the dose was constrained laterally to 18 Gy. The cosmetic outcome was evaluated by photographs at baseline and at 6 and 12 months postoperatively. Four examiners graded the photographs for symmetry, edema, discoloration, contour, and scarring. The grades were evaluated in relationship to the volume of irradiated tissue, tumor location, and dose at the lateral aspects of the cavity. Results: The median volume of tissue receiving 100% of the prescription dose was 47 cm{sup 3} (range, 20-97 cm{sup 3}). Patients with {<=}47 cm{sup 3} of treated tissue had better cosmetic outcomes than did the women who had >47 cm{sup 3} of treated tissue. Women who had received 18 Gy at the lateral aspects of their cavities had better cosmetic outcomes than did women who had received 20 Gy at the lateral aspects. When comparing the 6- and 12-month results, the scores remained stable for 63%, improved for 17%, and worsened for 20%. Conclusion: Intraoperative radiotherapy appears feasible for selected patients. A favorable cosmetic outcome appears to be related to a smaller treatment volume. The cosmetic outcome is acceptable, although additional follow-up is necessary.

  19. Titan: Preliminary results on surface properties and photometry from VIMS observations of the early flybys

    USGS Publications Warehouse

    Buratti, B.J.; Sotin, C.; Brown, R.H.; Hicks, M.D.; Clark, R.N.; Mosher, J.A.; McCord, T.B.; Jaumann, R.; Baines, K.H.; Nicholson, P.D.; Momary, T.; Simonelli, D.P.; Sicardy, B.

    2006-01-01

    Cassini observations of the surface of Titan offer unprecedented views of its surface through atmospheric windows in the 1-5 ??m region. Images obtained in windows for which the haze opacity is low can be used to derive quantitative photometric parameters such as albedo and albedo distribution, and physical properties such as roughness and particle characteristics. Images from the early Titan flybys, particularly T0, Ta, and T5 have been analyzed to create albedo maps in the 2.01 and 2.73 ??m windows. We find the average normal reflectance at these two wavelengths to be 0.15??0.02 and 0.035??0.003, respectively. Titan's surface is bifurcated into two albedo regimes, particularly at 2.01 ??m. Analysis of these two regimes to understand the physical character of the surface was accomplished with a macroscopic roughness model. We find that the two types of surface have substantially different roughness, with the low-albedo surface exhibiting mean slope angles of ???18??, and the high-albedo terrain having a much more substantial roughness with a mean slope angle of ???34??. A single-scattering phase function approximated by a one-term Henyey-Greenstein equation was also fit to each unit. Titan's surface is back-scattering (g???0.3-0.4), and does not exhibit substantially different backscattering behavior between the two terrains. Our results suggest that two distinct geophysical domains exist on Titan: a bright region cut by deep drainage channels and a relatively smooth surface. The two terrains are covered by a film or a coating of particles perhaps precipitated from the satellite's haze layer and transported by eolian processes. Our results are preliminary: more accurate values for the surface albedo and physical parameters will be derived as more data is gathered by the Cassini spacecraft and as a more complete radiative transfer model is developed from both Cassini orbiter and Huygens Lander measurements. ?? 2006 Elsevier Ltd. All rights reserved.

  20. Annulo-nucleoplasty using Disc-FX in the management of lumbar disc pathology: Early results

    PubMed Central

    Kumar, Aravind; Siddharth M, Shah; Sambhav P, Shah; Tan, Justin

    2014-01-01

    Background Back pain due to Lumbar Disc Disease is a major clinical problem. The treatment options range from physiotherapy to fusion surgery. A number of minimally invasive procedures have also been developed in the recent past for its management. Disc-FX is a new minimally invasive technique that combines percutaneous discectomy, nuclear ablation and annular modification. Literature on its role in the management of lumbar disc pathology is scarce. Methods We included 24 consecutive patients who underwent the Disc-FX for back pain due to lumbar disc pathology non-responsive to non-operative treatment for a period of at least 6 months. Based on Magnetic Resonance Imaging (MRI) these patients fell into 2 groups – those with degenerative disc disease (DDD) (n = 12) and those with a contained lumbar disc herniation (CLDH)(n = 12). They were evaluated using the Visual analogue scale (VAS), Oswestry Disability Index (ODI) and Short Form-36 (SF-36) scores preoperatively and postoperatively. Results The mean age was 37.9 years (21-53 years). There were 17 males and 7 females. One patient in each subgroup was excluded from the final evaluation. Significant improvement was seen in all outcome measures. The overall rate of reintervention for persistent symptoms was 18.18% (4/22); in the CLDH subgroup, it was 36.36% (4/11). Conclusions and level of evidence Early results after the Disc-FX procedure suggest that it s a reasonable treatment option for patients with back pain due to lumbar disc disease, especially for those with DDD who fail conservative treatment. It could be an alternative to procedures like fusion or disc replacement. This study presents Level IV evidence. Clinical relevance We feel that our study establishes Disc-FX as a modality of treating symptomatic lumbar disc disease due to DDD. However, longer term prospective studies are needed to prove this and to evaluate its role in the treatment of patients with CLDH. PMID:25694914

  1. PROBA-V Energetic Particle Telescope instrument and its early science results

    NASA Astrophysics Data System (ADS)

    Cyamukungu, Mathias; O'Brien, Paul; Benck, Sylvie; Evans, Hugh; Nieminen, Petteri; Mazur, Joseph; Daly, Eamonn; Borisov, Stanislav

    The Energetic Particle Telescope (EPT) is a science-class instrument designed to measure contamination-free spectra of electrons (0.5 - 10 MeV), protons (9 - 300 MeV) and He-ions (38 - 1200 MeV) within a 52 deg. Field Of View (FOV) angle and a 149 cm(2) sr aperture geometrical factor. The instrument is modular and it can be in-flight configured so as to provide up to 19 energy channels per particle type. The EPT dimensions are 210 mm x 162 mm x 128 mm, the total mass is 4.6 kgs and its power consumption amounts to 5.6 Watts. The satellite PROBA-V was launched on the 7th May 2013 onto a sun-synchronous circular Low Earth Orbit at 820 km altitude and 98.7 deg. inclination. Its local time at descending node is 10:30. The EPT has been accommodated onto the S/C so as to get its boresight oriented Eastwards during local night time and Westwards during local day time. However, the East/West orientation has been modified during the commissioning phase to allow measurements of Pitch Angle Distribution (PAD). The latters were part of a plan aimed at validating the EPT hardware and the data analysis software. The EPT is currently acquiring data that are used for (i) cross-validation of radiation monitors or spectrometers, (ii) cross-validation of space radiation models, (iii) development of steady-state electron and proton flux models and (iv) space weather studies. The EPT validation results along with early results of the ongoing science studies are presented in this paper.

  2. Survival of Implants in Immediate Extraction Sockets of Anterior Teeth: Early Clinical Results

    PubMed Central

    Sabir, Mohammad

    2015-01-01

    Background The aims and objectives of this study were placement of implants in freshly extracted sockets of anterior teeth and to evaluate the implant stability, peri-implant radiolucency and gingival inflammation around implant over a short period of 30 months. Materials and Methods A total of 12 patients (8 male and 4 female), ranging in the age from 20 to 50 years, from March 2007 to June 2007, were evaluated for immediate implant placement into 22 fresh extraction sockets. Only maxillary and mandibular anterior teeth/roots (central incisors, lateral incisors and canines) were considered for replacement with implants. One piece implant with integrated abutment and integrated surface, non-submerged, threaded and tapered at apical 5 mm, sand-blasted and acid etched surfaced implants (HI-TEC TRX-OP Implants of Life Care Company) were used. Results The mobility was not present in any of the implants at all the follow up visits. There were 2 implants at 6 month, 1 implant at 12 month, 1 implant at 18 month visits, showing peri-implant radiolucency at some sites at bone to implant contact site. Severe gingival inflammation was not observed in any of the implant site. At every follow-up visit, every implant met the criteria of success and none was found to be failed over a 30 months duration i.e. 100% success rate was achieved by implants in immediate extraction socket. Conclusion The success rate of implant survival in this study was found 100%. These implants have fulfilled all the criteria of implant success and based on the defined criteria, the success rate of implants placed in immediate extraction sockets of anterior teeth compared favorably with the conventional implants. The early results of the present study showed that high survival rates with the implants in immediate extraction sockets can be achieved. PMID:26266220

  3. Confocal microendoscopy: Characterization of imaging bundles, fluorescent contrast agents, and early clinical results

    NASA Astrophysics Data System (ADS)

    Udovich, Joshua Anthony

    Ovarian cancer is the fifth leading cause of cancer related deaths among women. Early detection improves the chances of survival following diagnosis, and new imaging modalities have the potential to reduce deaths due to this disease. The confocal microendoscope (CME) is a non-destructive in-vivo imaging device for visualization of the ovaries that operates in real-time. Two components of the CME system are evaluated in this paper, and initial results from an ongoing clinical trial are presented. Fiber-optic imaging bundles are used in the CME imaging catheter to relay images over distances of up to 20 feet. When detecting fluorescent signals from investigated tissue, any fluorescence in the system can potentially reduce contrast in images. The emission and transmission properties of three commercially available fiber optic imaging bundles were evaluated. Emission maps of fluorescence from bundles were generated at multiple excitation wavelengths to determine the profile and amount of fluorescence present in bundles manufactured by Sumitomo, Fujikura, and Schott. Results are also presented that show the variation of transmittance as a function of illumination angle in these bundles. Users of high-resolution fiber-optic imaging bundles should be aware of these properties and take them into account during system design. Contrast is improved in images obtained with the CME through the application of topical dyes. Acridine orange (AO) and SYTO 16 are two fluorescent stains that are used to show the size, shape, and distribution of cell nuclei. Unfortunately, little is known about the effects of these dyes on living tissues. This study was undertaken to evaluate the effects of dye treatment on peritoneal tissues in mice. Seventy-five Balb/c mice were split into five groups of fifteen and given peritoneal injections of dye or saline. The proportions of negative outcomes for the control and test groups were compared using confidence intervals and the Fisher's exact test

  4. [Surgical treatment of syringomyelia].

    PubMed

    Abe, T; Okuda, Y; Nagashima, H; Isojima, A; Tani, S

    1995-12-01

    Eighty cases of surgically treated syringomyelia were retrospectively reviewed. The cases were classified into following 4 types, type 1: syringomyelia with Chiari malformation (54 cases), type 2: syringomyelia with basal arachnoiditis (15 cases), type 3: syringomyelia with an obstruction of the foramen Magendie (1 case), and type 4: syringomyelia with spinal arachnoiditis (14 cases). Foramen magnum decompression (FMD) was performed in patients with type 1, in type 2 fourth ventricle-subarachnoid shunt was additionally performed. Gardner's operation was performed in patients with type 3. Syrinx-peritoneal shunt was performed in patients with type 4. Surgical procedures for syringomyelia which we selected were thought to be appropriate, based on postoperative syrinx collapse rate in MRI. However, postoperative clinical course was much different in each type of syringomyelia after the collapse of syrinx had been equally achieved. Neurological disorders were stopped in deterioration after surgery in all cases of type 1. However, motor weakness was still deteriorated in half cases of type 2, and in 60% of type 4. When clinical severity of the patients with type 1 and 2, based on the distribution of dissociated sensory loss and motor weakness, were classified into 5 grades. The rate of improvement of patient's symptoms and signs was higher in the lower grades. We concluded that a surgical treatment for syringomyelia was essentially a preventive one, therefore it should be done in early stage of disorders. PMID:8752412

  5. Acute Vs Delayed ACL Reconstruction. Early Differences and Preliminary Two Year Results

    PubMed Central

    Eriksson, Karl; Barenius, Björn

    2016-01-01

    Objectives: Historically acute ACL reconstruction has been avoided due to reports of early rehabilitation problems with stiffness. Are these reports still valid today with modern arthroscopic techniques? Methods: 70 patients with a high recreational activity level (Tegner ≥6) who presented with a acute ACL injury were randomized to an acute reconstruction within 8 days from the injury or delayed reconstruction after 6-10 weeks. Four surgeons performed the ACL reconstructions with quadrupled semitendinosus tendon grafts and endobutton and metallic interference screw fixation. The rehabilitation training was performed at the same physiotherapy center for all patients. The follow up at 6 and 24 months included ROM, Lachman, Rolimeter, pivot shift, one leg hop, IKDC, KOOS, Lysholm and Tegner activity level. Results: There were no differences between the groups in ROM, IKDC, activity level or laxity at 6 months. Four patients had a combined extension and flexion deficit of more than 15 degrees, two from each group. In the acute group 79% had an objective IKDC grade A or B compared with 73% in the delayed group. The one leg hop index above 90% was found in 50% in the acute group and 24% in the delayed group (p=0.04). Functional data for the 2-year follow up are not available at the time of abstract writing. The median activity level according to Tegner was restored to pre-injury levels in both groups after one year, and was stationary at 2 years. The visual analogue scale (VAS) response to the question “How is your knee working on a scale from 0-100? (100 = best)” revealed 81 in the acute and 71 in the delayed group (p=0.1). To the question “How does your knee affect your activity level on a scale from 0-100? (100 = no affection)” the mean score was 75 in the acute group and 67 in the delayed group (p=0.3). At one and two years the KOOS was statistically similar between the groups but with slightly higher subscale “Sport and recreation” scores, 85 in the

  6. Neurobiological consequences of early stress and childhood maltreatment: are results from human and animal studies comparable?

    PubMed

    Teicher, Martin H; Tomoda, Akemi; Andersen, Susan L

    2006-07-01

    Recent studies have reported an association between exposure to childhood abuse or neglect and alterations in brain structure or function. One limitation of these studies is that they are correlational and do not provide evidence of a cause-effect relationship. Preclinical studies on the effects of exposure to early life stress can demonstrate causality, and can enrich our understanding of the clinical research if we hypothesize that the consequences of early abuse are predominantly mediated through the induction of stress responses. Exposure to early abuse and early stress has each been associated with the emergence of epileptiform electroencephalogram (EEG) abnormalities, alterations in corpus callosum area, and reduced volume or synaptic density of the hippocampus. Further, there is evidence that different brain regions have unique periods when they are maximally sensitive to the effects of early stress. To date, preclinical studies have guided clinical investigations and will continue to provide important insight into studies on molecular mechanisms and gene-environment interactions. PMID:16891580

  7. Uncertainty and sensitivity analysis of early exposure results with the MACCS Reactor Accident Consequence Model

    SciTech Connect

    Helton, J.C.; Johnson, J.D.; McKay, M.D.; Shiver, A.W.; Sprung, J.L.

    1995-01-01

    Uncertainty and sensitivity analysis techniques based on Latin hypercube sampling, partial correlation analysis and stepwise regression analysis are used in an investigation with the MACCS model of the early health effects associated with a severe accident at a nuclear power station. The primary purpose of this study is to provide guidance on the variables to be considered in future review work to reduce the uncertainty in the important variables used in the calculation of reactor accident consequences. The effects of 34 imprecisely known input variables on the following reactor accident consequences are studied: number of early fatalities, number of cases of prodromal vomiting, population dose within 10 mi of the reactor, population dose within 1000 mi of the reactor, individual early fatality probability within 1 mi of the reactor, and maximum early fatality distance. When the predicted variables are considered collectively, the following input variables were found to be the dominant contributors to uncertainty: scaling factor for horizontal dispersion, dry deposition velocity, inhalation protection factor for nonevacuees, groundshine shielding factor for nonevacuees, early fatality hazard function alpha value for bone marrow exposure, and scaling factor for vertical dispersion.

  8. Early results of pulsed dye laser angioplasty with integral ball-tips in long femoral occlusions

    NASA Astrophysics Data System (ADS)

    Murray, Alan; Mitchell, David C.; Wood, Richard F. M.

    1990-07-01

    A Pulsed Dye laser together with specifically designed integral ball-tipped optical fibres have been used for the primary recanalisation of femoropopliteal vascular disease in 25 limbs of 23 patients. All patients had complete occlusions of the vessels ranging from 8-49cms in length (mean 22cms), having presented with critical ischaemia (18) or severe claudication warranting operative intervention (5). Pedal ulceration was present in 8 limbs and digital gangrene in 4. The laser produced visible light at 480nm in lOOmJ/lus pulses, at a frequency of 10-20Hz. The energy delivery device comprised a smooth atraumatic ball-tip constructed from the glass of the optical fibre, which was loaded retrogradely into a standard balloon angioplasty catheter. The device was introduced through a common femoral artery cutdown. Angiographic recanalisation was achieved in 22 of the 25 limbs with a mean energy of 280J(range 68-727J) and in each case the channel created by the laser fibre was augmented by balloon angioplasty. Technical failure occurred in three cases, caused by a wall dissection, persistent side-branch entry and incomplete lesion penetration respectively. Eighteen of procedures (72%) were clinically successful with marked symptomatic improvement. Of the four angiographic successful but clinical failures, acute occlusion within 48 hours occurred in 2 diabetic patients with very poor run-off and distal gangrene. The third case failed acutely due to a technically inadequate balloon dilatation and the fourth patient failed to improve symptomatically due to widespread with segmental tibial vessel disease below a successful recanalisation. Over a mean follow-up period of 7 months, three patients died of myocardial infarction. Twelve of the 23 patients (52%) remain well with patent vessels. These early results demonstrate the efficacy of pulsed dye laser angioplasty using ball-tipped optical fibres.

  9. The Hobby-Eberly Telescope Dark Energy Experiment (HETDEX): Description and Early Pilot Survey Results

    NASA Astrophysics Data System (ADS)

    Hill, G. J.; Gebhardt, K.; Komatsu, E.; Drory, N.; MacQueen, P. J.; Adams, J.; Blanc, G. A.; Koehler, R.; Rafal, M.; Roth, M. M.; Kelz, A.; Gronwall, C.; Ciardullo, R.; Schneider, D. P.

    2008-10-01

    The Hobby-Eberly Telescope Dark Energy Experiment (HETDEX) will outfit the 10 m HET with a new wide field and an array of 150 integral-field spectrographs to survey a 420 deg^2 area in the north Galactic cap. Each fiber-coupled unit spectrograph will cover 350-550 nm, simultaneously. This instrument, called VIRUS, will produce ˜34,000 spectra per exposure, and will open up the emission-line universe to large surveys for the first time. The survey will detect 0.8 million Lyman-alpha emitting (LAE) galaxies with 1.9early epoch using baryonic acoustic oscillations and the shape of the power spectrum. The aim of HETDEX is to provide a direct detection of dark energy at z˜3. The measurement will constrain the evolution of dark energy and will also provide 0.1%-level accuracy on the curvature of the Universe, ten times better than current. The prototype of the VIRUS unit spectrograph (VIRUS-P) is a powerful instrument in its own right. Used on the McDonald 2.7~m, it covers the largest area of any integral field spectrograph, and reaches wavelengths down to 340 nm. VIRUS-P is being used for a pilot survey to better measure the properties of LAE galaxies in support of HETDEX. We report initial results from this survey.

  10. Implementing intensity modulated radiotherapy to the prostate bed: Dosimetric study and early clinical results

    SciTech Connect

    Riou, Olivier; Laliberté, Benoit; Azria, David; Menkarios, Cathy; Llacer Moscardo, Carmen; Dubois, Jean-Bernard; Aillères, Norbert; Fenoglietto, Pascal

    2013-07-01

    Salvage intensity modulated radiotherapy (IMRT) to the prostate bed has hardly been studied so far. We present here a feasibility study and early clinical results for 10 patients. These patients were selected on the basis of having either a biochemical relapse or high risk histology after prostatectomy. They were treated using “sliding-window” IMRT to 68 Gy in 34 fractions. Three-dimensional conformal radiotherapy (3D-CRT) plans were generated using the same planning computed tomography data set. Dose coverage of planning target volumes (PTVs) and of organs-at-risk (OAR, namely: rectum, bladder, and femoral heads) were compared. Acute toxicity and chronic toxicity were measured using the Common Toxicity Criteria for Adverse Events version 3.0 scale. IMRT significantly reduces the dose above the prescription dose given to the PTV1 (mean dose: IMRT 67.2 Gy vs 3D-CRT 67.7 Gy (p = 0.0137)), without altering dose coverage for PTV2 (mean dose: IMRT 68.1 Gy vs 3D-CRT 68.0 Gy (p = 0.3750)). Doses to OAR were lower with IMRT and differences were statistically significant (mean dose: IMRT 51.4 Gy vs 3D-CRT 56.6 Gy for rectum (p = 0.002), IMRT 45.1 Gy vs 3D-CRT 53.1 Gy for bladder (p = 0.002), and IMRT 26.1 Gy vs 3D-CRT 28.4 Gy for femoral heads (p = 0.0059)). There was no acute or chronic genitourinary or gastrointestinal toxicity >1 with a median follow-up of 38 months. IMRT to the prostatic fossa is feasible and reduces dose to OAR, with consequential limited toxicity.

  11. Results from early programmatic implementation of Xpert MTB/RIF testing in nine countries

    PubMed Central

    2014-01-01

    Background The Xpert MTB/RIF assay has garnered significant interest as a sensitive and rapid diagnostic tool to improve detection of sensitive and drug resistant tuberculosis. However, most existing literature has described the performance of MTB/RIF testing only in study conditions; little information is available on its use in routine case finding. TB REACH is a multi-country initiative focusing on innovative ways to improve case notification. Methods We selected a convenience sample of nine TB REACH projects for inclusion to cover a range of implementers, regions and approaches. Standard quarterly reports and machine data from the first 12 months of MTB/RIF implementation in each project were utilized to analyze patient yields, rifampicin resistance, and failed tests. Data was collected from September 2011 to March 2013. A questionnaire was implemented and semi-structured interviews with project staff were conducted to gather information on user experiences and challenges. Results All projects used MTB/RIF testing for people with suspected TB, as opposed to testing for drug resistance among already diagnosed patients. The projects placed 65 machines (196 modules) in a variety of facilities and employed numerous case-finding strategies and testing algorithms. The projects consumed 47,973 MTB/RIF tests. Of valid tests, 7,195 (16.8%) were positive for MTB. A total of 982 rifampicin resistant results were found (13.6% of positive tests). Of all tests conducted, 10.6% failed. The need for continuous power supply was noted by all projects and most used locally procured solutions. There was considerable heterogeneity in how results were reported and recorded, reflecting the lack of standardized guidance in some countries. Conclusions The findings of this study begin to fill the gaps among guidelines, research findings, and real-world implementation of MTB/RIF testing. Testing with Xpert MTB/RIF detected a large number of people with TB that routine services failed to

  12. Intraoperative radiotherapy during lung cancer surgery: Technical description and early clinical results

    SciTech Connect

    Calvo, F.A.; Ortiz de Urbina, D.; Abuchaibe, O.; Azinovic, I.; Aristu, J.; Santos, M.; Escude, L.; Herreros, J.; Llorens, R. )

    1990-07-01

    A phase I-II study of intraoperative radiotherapy (IORT) for Stage III lung cancer was performed in 34 patients during a period of 58 months. Loco-regional treatment included tumor resection if technically feasible, IORT boost of electron beams using moderate single doses (10-15 Gy) to tumor bearing areas and external photon beam irradiation (46-50 Gy in 5 weeks) using conventional fields. Indications for this study were unresectable hiliar tumors (14, 41%), and mediastinal, hiliar and/or chest wall residual disease following resection (20, 59%). Thirty-four procedures, with 40 IORT fields, have been analyzed to describe the relevant technical aspects and the toxicity. IORT was delivered using acrylic transparent cones of different diameters. Surgical approach consisted in a lateral thoracotomy in all patients (21 right side and 13 left side). Tissues included within the IORT field were: tumor or residual tumor tissues (34, 100%), collapsed lung parenchyma and main bronchus not surgically manipulated (14, 41%), bronchial stump and vascular suture following resection (19, 55%), mediastinal structures (20, 58%), and brachial plexus (1, 3%). The bronchial suture was covered with pleural or pericardial flap after IORT in 10 cases (29%). Life threatening toxicity related to IORT consisted in broncho-pleural fistula (1, 3%) and massive hemoptysis (1, 3%). Other reversible toxic events were acute pneumonitis (12, 85%) and esophagitis (10, 50%). Long term asymptomatic lung fibrosis was detected in 11 cases (32%). Median survival time for the entire group has been 12 months. With a median follow-up time of 12 months the freedom from thoracic recurrence rate is 30% (65% in cases with tumor resection). Projected actuarial survival rates at 4 years were 28% for resected group and 7% for unresected cases.

  13. Boundary conditions of patient-specific fluid dynamics modelling of cavopulmonary connections: possible adaptation of pulmonary resistances results in a critical issue for a virtual surgical planning

    PubMed Central

    Pennati, Giancarlo; Corsini, Chiara; Cosentino, Daria; Hsia, Tain-Yen; Luisi, Vincenzo S.; Dubini, Gabriele; Migliavacca, Francesco

    2011-01-01

    Cavopulmonary connections are surgical procedures used to treat a variety of complex congenital cardiac defects. Virtual pre-operative planning based on in silico patient-specific modelling might become a powerful tool in the surgical decision-making process. For this purpose, three-dimensional models can be easily developed from medical imaging data to investigate individual haemodynamics. However, the definition of patient-specific boundary conditions is still a crucial issue. The present study describes an approach to evaluate the vascular impedance of the right and left lungs on the basis of pre-operative clinical data and numerical simulations. Computational fluid dynamics techniques are applied to a patient with a bidirectional cavopulmonary anastomosis, who later underwent a total cavopulmonary connection (TCPC). Multi-scale models describing the surgical region and the lungs are adopted, while the flow rates measured in the venae cavae are used at the model inlets. Pre-operative and post-operative conditions are investigated; namely, TCPC haemodynamics, which are predicted using patient-specific pre-operative boundary conditions, indicates that the pre-operative balanced lung resistances are not compatible with the TCPC measured flows, suggesting that the pulmonary vascular impedances changed individually after the surgery. These modifications might be the consequence of adaptation to the altered pulmonary blood flows. PMID:22670201

  14. Integrating earth observations and model results provides earlier Famine Early Warning

    NASA Astrophysics Data System (ADS)

    Brown, M. E.; Funk, C. C.; Galu, G.; Choularton, R.

    2007-12-01

    Remote sensing allows us to detect slowly evolving natural hazards such as agricultural drought. Famine early warning systems transform this data into actionable policy information, enabling humanitarian organizations to respond in a timely and appropriate manner. These life saving responses are increasingly important. In 2006, 1 out of 8 people did not have enough to eat, 22 million more people became undernourished, and 22 countries provided 6.5 billion dollars in food aid. The motivation is strong, therefore, to increase the effectiveness of every dollar of food aid provided, ensuring that the assistance arrives sufficiently early to ward off human and economic catastrophe. Properly interpreted remote sensing information reduces the influence of politics in determining the amount and location of aid delivered. In this talk we will review three recent contributions that earth observations have provided to famine early warning: trend identification, increasingly accurate forecasts of food security conditions, and enhanced integration of biophysical and socio-economic data.

  15. Early milk intake, later bone health: results from using the milk history questionnaire.

    PubMed

    Vatanparast, Hassanali; Whiting, Susan J

    2004-06-01

    Milk intake is considered an important determinant of peak bone mass; consequently, its intake early in life may decrease risk of osteoporotic fractures later. Using the milk history questionnaire, many investigators have conducted retrospective cross-sectional studies and have determined a positive effect of milk intake in childhood and adolescence on bone mineral density in adult white women. By contrast, a recent study indicates that early milk intake has no beneficial effect on bone mineral density in black women. The milk history questionnaire can assist in determining diet-bone relationships in various groups. PMID:15291400

  16. Early results on 67P/Churyumov-Gerasimenko observed by Rosetta/OSIRIS

    NASA Astrophysics Data System (ADS)

    Sierks, H.; Tubiana, C.; Snodgrass, C.; Agarwal, J.; Güttler, C.; Oklay, N.; Vincent, J.; Küppers, M.; Barbieri, C.; Lamy, P.; Rickman, H.; Rodrigo, R.; Koschny, D.; Hviid, S.; Mottola, S.; Osiris Team

    2014-07-01

    March/April 2014. At this time, Rosetta will be at about 4 million kilometers from the comet and 67P will still be unresolved. We present results about the early cometary activity based on OSIRIS images. Orange-filter images (central wavelength 649.2 nm) will be used to determine the dust environment of 67P, since this wavelength range is quite free from gas emission lines. Moreover, a series of lightcurves will be taken to compare with the existing ones and look for possible changes in the rotational period due to its last perihelion passage.

  17. Cosmetic Outcomes for Accelerated Partial Breast Irradiation Before Surgical Excision of Early-Stage Breast Cancer Using Single-Dose Intraoperative Radiotherapy

    SciTech Connect

    Kimple, Randall J.; Klauber-DeMore, Nancy; Kuzmiak, Cherie M.; Pavic, Dag; Lian, Jun; Livasy, Chad A.; Esler, Laura; Moore, Dominic T.; Sartor, Carolyn I.; Ollila, David W.

    2011-02-01

    Purpose: Determine cosmetic outcome and toxicity profile of intraoperative radiation delivered before tumor excision for patients with early-stage breast cancer. Methods and Materials: Patients age 48 or older with ultrasound-visible invasive ductal cancers <3 cm and clinically negative lymph nodes were eligible for treatment on this institutional review board-approved Phase II clinical trial. Treatment planning ultrasound was used to select an electron energy and cone size sufficient to cover the tumor plus a 1.5- to 2.0-cm circumferential margin laterally and a 1-cm-deep margin with the 90% isodose line. The dose was prescribed to a nominal 15 Gy and delivered using a Mobetron electron irradiator before tumor excision by segmental mastectomy. Physician- and patient-assessed cosmetic outcome and patient satisfaction were determined by questionnaire. Results: From March 2003 to July 2007, 71 patients were treated with intraoperative radiation therapy. Of those, 56 patients were evaluable, with a median follow-up of 3.1 years (minimum 1 year). Physician and patient assessment of cosmesis was 'good or excellent' (Radiation Therapy Oncology Group cosmesis scale) in 45/56 (80%) and 32/42 (76%) of all patients, respectively. Eleven patients who received additional whole breast radiation had similar rates of good or excellent cosmesis: 40/48 (83%) and 29/36 (81%), respectively). Grade 1 or 2 acute toxicities were seen in 4/71 (6%) patients. No Grade 3 or 4 toxicities or serious adverse events have been seen. Conclusion: Intraoperative radiotherapy delivered to an in situ tumor is feasible with acceptable acute tolerance. Patient and physician assessment of the cosmetic outcome is good to excellent.

  18. Early and Long-Term Results of Subclavian Angioplasty in Aortoarteritis (Takayasu Disease): Comparison with Atherosclerosis

    SciTech Connect

    Tyagi, Sanjay; Verma, Puneet K.; Gambhir, Daljeet S.; Kaul, Upkar A.; Saha, Renuka; Arora, Ramesh

    1998-05-15

    Purpose: To compare the early andlong-term outcomes of subclavian artery angioplasty in patients with aortoarteritis and atherosclerosis. Methods: Sixty-one subclavian artery angioplasties were performed in 55 consecutive patients with aortoarteritis (n= 32) and atherosclerosis (n= 23) between 1986 and 1995. An arch aortogram followed by a selective subclavian artery angiogram was done to profile the site and extent of the lesion, its relation to the vertebral artery, and the distal circulation. Percutaneous transluminal angioplasty (PTA) was performed via the femoral route for 56 stenotic lesions and 5 total occlusions. Results: PTA was successful in 52 (92.8%) stenotic lesions and 3 (60%) total occlusions. Three patients (5.4%) had complications, that could be effectively managed nonsurgically. Compared with atherosclerosis, patients with aortoarteritis were younger (27.4 {+-} 9.3 years vs 54.5 {+-} 10.5 years; p < 0.001), more often female (75% vs 17.4%; p < 0.001), gangrene was uncommon (0% vs 17.4%; p < 0.05), and diffuse involvement was seen more often (43.8% vs 4.4%; p < 0.001). The luminal diameter stenoses were similar before PTA (88.6 {+-} 9.7% vs 89.0 {+-} 9.1%; p= NS). Higher balloon inflation pressure was required to dilate the lesions of aortoarteritis (9.9 {+-} 4.6 ATM vs 5.5 {+-} 1.0 ATM; p < 0.001). This group had more residual stenosis (15.5 {+-} 12.4% vs 8.3 {+-} 9.4%; p < 0.05) after PTA. There were no neurological sequelae, even in PTA of prevertebral lesions. On 3-120 months (mean 43.3 {+-} 28.9 months) follow-up of 40 patients, restenosis was more often observed in patients with aortoarteritis, particularly in those with diffuse arterial narrowing. These lesions could be effectively redilated. Clinical symptoms showed marked improvement after successful angioplasty. Conclusion: Subclavian PTA is safe and can be performed as effectively in aortoarteritis as in atherosclerosis, with good long-term results. Long-term follow-up shows that it

  19. Intervention with African American Premature Infants: Four-Month Results of an Early Intervention Program

    ERIC Educational Resources Information Center

    Teti, Douglas M.; Black, Maureen M.; Viscardi, Rose; Glass, Penny; O'Connell, Melissa A.; Baker, Linda; Cusson, Regina; Reiner Hess, Christine

    2009-01-01

    This study evaluates the efficacy of an early intervention program targeting African American mothers and their premature, low birth weight infants at 3 to 4 months' corrected age from four neonatal intensive care units, 173 families are recruited (84 intervention, 89 control). The 8-session, 20-week intervention consists of a psychoeducational…

  20. Ongoing Proof: Results from the Canton Early College High School Class of 2010

    ERIC Educational Resources Information Center

    Rochford, Joseph A.

    2010-01-01

    In 2005, the Canton City Schools (CCS), Stark College of Technology (SSCT), Canton Professional Educators Association (CPEA) and the Stark Education Partnership (SEP) came together to found Canton's Early College High School (CECHS). The goal of CECHS is to allow students an opportunity to earn both a diploma and an Associate Degree during their…

  1. Early generation selection results from a two year, six location study

    Technology Transfer Automated Retrieval System (TEKTRAN)

    In potato breeding programs, early generation selections are rarely evaluated in multiple environments because of limited seed quantities. By the time seed quantities are available, few clones remain from the original population. The purpose of this study was to allow multiple locations to select ...

  2. Effect of Formative and Ability Test Results on Early Learning of Students

    ERIC Educational Resources Information Center

    Kadir, Abdul; Ardi, Muhammad; Nurhayati, B.; Dirawan, Gufran Darma

    2016-01-01

    The objective of this study was to examine the relationship of formative tests to early learning ability of students in the science learning style. This research used an experimental method with a 2 x 2 factorial design. The participants comprised all the students in class VII of the Islamic Junior High School State of Kolaka, a total of 343…

  3. Exercise Effects on Fitness and Bone Mineral Density in Early Postmenopausal Women: 1-Year EFOPS Results.

    ERIC Educational Resources Information Center

    Kemmler, Wolfgang; Engelke, Klaus; Lauber, Dirk; Weineck, Juergen; Hensen, Johannes; Kalender, Willi A.

    2002-01-01

    Investigated the effect of intense exercise training on physical fitness, coronary heart disease, bone mineral density (BMD), and parameters related to quality of life in early postmenopausal women with osteopenia. Data on woman in control and exercise training groups indicated that the intense exercise training program was effective in improving…

  4. The Employment Retention and Advancement Project Early Results from Four Sites

    ERIC Educational Resources Information Center

    Bloom, Dan; Hendra, Richard; Martinson, Karin; Scrivener, Susan

    2005-01-01

    Millions of welfare recipients have entered the labor force in the past decade, but surveys show that many remain in unstable, low-paying jobs that offer few opportunities for advancement. This report presents early evidence on the effectiveness of four diverse programs designed to help current or former welfare recipients work more steadily and…

  5. Model Registry of Early Childhood Visual Impairment: First-Year Results.

    ERIC Educational Resources Information Center

    Hatton, Deborah D.

    2001-01-01

    A study obtained data on 406 children from birth to age 3 with visual impairments at the point of entry into specialized early intervention programs in nine states. The majority were legally blind and had additional disabilities. About a six-month mean lag was found between diagnosis and referral for services. (Contains references.) (Author/CR)

  6. Early MAVEN Results on the Mars Upper Atmosphere and Atmospheric Loss to Space

    NASA Astrophysics Data System (ADS)

    Jakosky, Bruce; Grebowsky, Joseph; Luhmann, Janet

    2015-04-01

    , operations, and calibrations. We also expect to have sufficient data collected to allow us to reach preliminary conclusions about the state of the upper atmosphere, interactions with the solar wind, escape of atmospheric gas to space at the present epoch, and integrated escape to space over time. These early results will be presented.

  7. Enceladus-Mimas paradox: a result of different early evolutions of satellites?

    NASA Astrophysics Data System (ADS)

    Czechowski, Leszek; Witek, Piotr

    2015-04-01

    the coefficient of the heat conduction in the considered layer, i.e.: kconv =Nu k. This approach is used successfully in parameterized theory of convection for SSC in the Earth and other planets (e.g. [3], [4]). Parameterization of liquid state convection (LSC) is even simpler. Ra in molten region is very high (usually higher than 1016). The LSC could be very intensive resulting in almost adiabatic temperature gradient given by: dT-= gαmT-, dr cpm where αm and cpm are thermal expansion coefficient and specific heat in molten region, g is the local gravity. In Enceladus and Mimas the adiabatic gradient is low and therefore LSC region is almost isothermal. 2. Results: Comparison of thermal models of Mimas and Enceladus indicates that conditions favorable for starting tidal heating (interior hot enough) lasted for short time (~107yr) in Mimas and for ~108 yr in Enceladus. This could explain Mimas-Enceladus paradox. 3. Conclusions: The Mimas-Enceladus paradox is probably the result of short time when Mimas was hot enough to allow for substantial tidal heating. The Mimas-Tethys resonance formed later when Mimas was already cool. (see also [1, 4]) The full text of the paper will be published in Acta Geophysica [5]. Acknowledgements: The research is partly supported by National Science Centre (grant 2011/ 01/ B/ ST10/06653). References : [1] Czechowski, L. (2014) Some remarks on the early evolution of Enceladus. Planet. Sp. Sc. 104, 185-199. [2] Merk, R., Breuer, D., Spohn, T. (2002). Numerical modeling of 26Al induced radioactive melting of asteroids concerning accretion. Icarus 199, 183-191. [3] Sharpe, H.N., Peltier, W.R., (1978) Parameterized mantle convection and the Earth's thermal history. Geophys. Res. Lett. 5, 737-740. [4] Czechowski, L. (2006) Parameterized model of convection driven by tidal and radiogenic heating. Adv. Space Res. 38, 788-793. [5] Czechowski, L., Witek, P. (2015) Comparisons of early evolutions of Mimas and Enceladus. Submitted to Acta

  8. Salmonella enterica Typhimurium DT104 challenge of pigs using an ileal loop surgical model indicate early host responses involve IL-27 controlled INF pathway

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Understanding the early responses of the immune system following infection with Salmonella is necessary in the search for management practices that might improve the health of animals and reduce the economic impact of this pathogen. Using a ligated ileal loop pig model, we challenged with Salmonella...

  9. Radical radiotherapy for early glottic cancer: Results in a series of 1087 patients from two Italian radiation oncology centers. I. The case of T1N0 disease

    SciTech Connect

    Cellai, Enrico; Frata, Paolo; Magrini, Stefano M. . E-mail: magrini@med.unibs.it; Paiar, Fabiola; Barca, Raffaella; Fondelli, Simona; Polli, Caterina; Livi, Lorenzo; Bonetti, Bartolomea; Vitali, Elisabetta; De Stefani, Agostina; Buglione, Michela; Biti, Gianpaolo

    2005-12-01

    Purpose: To retrospectively evaluate local control rates, late damage incidence, functional results, and second tumor occurrence according to the different patient, tumor, and treatment features in a large bi-institutional series of T1 glottic cancer. Methods and Materials: A total of 831 T1 glottic cancer cases treated consecutively with radical intent at the Florence University Radiation Oncology Department (FLO) and at the Radiation Oncology Department of University of Brescia-Istituto del Radio 'O. Alberti' (BS) were studied. Actuarial cumulative local control probability (LC), disease-specific (DSS), and overall survival (OS) rates have been calculated and compared in the different clinical and therapeutic subgroups with both univariate and multivariate analysis. Types of relapse and their surgical salvage have been evaluated, along with the functional results of treatment. Late damage incidence and second tumor cumulative probability (STP) have been also calculated. Results: In the entire series, 3-, 5-, and 10-year OS was equal to 86%, 77%, and 57%, respectively. Corresponding values for LC were 86%, 84%, and 83% and for DSS 96%, 95%, and 93%, taking into account surgical salvage of relapsed cases. Eighty-seven percent of the patients were cured with function preserved. Main determinants of a worse LC at univariate analysis were: male gender, earlier treatment period, larger tumor extent, anterior commissure involvement, and the use of Cobalt 60. At multivariate analysis, only gender, tumor extent, anterior commissure involvement, and beam type retained statistical significance. Higher total doses and larger field sizes are significantly related (logistic regression) with a higher late damage incidence. Scatterplot analysis of various combinations of field dimensions and total dose showed that field dimensions >35 and <49 cm{sup 2}, together with doses of >65 Gy, offer the best local control results together with an acceptably low late damage incidence

  10. Thymoma: current medical and surgical management.

    PubMed

    Kesler, Kenneth A; Wright, Cameron D; Loehrer, Patrick J

    2004-03-01

    Thymoma is a rare neoplasm usually with an indolent growth pattern; however, local invasion and/or dissemination may occur. Surgery has been the standard of care for early stage disease with good to excellent cure rates anticipated. This neoplasm has been found to be relatively sensitive to cisplatinum-based chemotherapy as compared with most other epithelial tumors. Aggressive multimodality therapy therefore can result in long-term disease-free survival for patients presenting with locally advanced or even disseminated disease. This chapter outlines the current medical and surgical treatment options for thymoma. PMID:15229793

  11. Prognostic Value of Lymph Node Ratio in Patients Receiving Combined Surgical Resection for Gastric Cancer Liver Metastasis: Results from Two National Centers in China.

    PubMed

    Li, Mu-Xing; Jin, Zheng-Xiong; Zhou, Jian-Guo; Ying, Jian-Ming; Liang, Zhi-Yong; Mao, Xin-Xin; Bi, Xin-Yu; Zhao, Jian-Jun; Li, Zhi-Yu; Huang, Zhen; Zhang, Ye-Fan; Li, Yuan; Chen, Xiao; Hu, Xu-Hui; Hu, Han-Jie; Zhao, Dong-Bing; Wang, Ying-Yi; Cai, Jian-Qiang; Zhao, Hong

    2016-04-01

    The purpose of this study was to evaluate the prognostic value of lymph node ratio (LNR) in patients with gastric cancer liver metastasis (GCLM) who received combined surgical resection.A retrospective analysis of 46 patients from two hospitals was conducted. Patients were dichotomized into two groups (high LNR and low LNR) by the median value of LNR. The overall survival (OS) and recurrence-free survival (RFS) were analyzed by the Kaplan-Meier method with the log-rank test. The Cox proportional hazard model was used to carry out the subsequent multivariate analyses. And the relationship between LNR and clinicopathological characteristics was assessed.The cut-off value defining elevated LNR was 0.347. With a median follow-up of 67.5 months, the median OS and RFS of the patients were 17 and 9.5 months, respectively. Six patients survived for >5 years after surgery. Patients with higher LNR had significantly shorter OS and RFS than those with lower LNR. In the multivariate analyses, higher LNR and multiple liver metastatic tumors were identified as the independent prognostic factors for both OS and RFS. Elevated LNR was significantly associated with advanced pN stage (P <0.001), larger primary tumor size (P = 0.046), the presence of microvascular invasion (P = 0.008), and neoadjuvant chemotherapy (P = 0.004).LNR may be prognostic indicator for patients with GCLM treated by synchronous surgical resection. Patients with lower LNR and single liver metastasis may gain more survival benefits from the surgical resection. Further prospective studies with reasonable study design are warranted. PMID:27100426

  12. Prognostic Value of Lymph Node Ratio in Patients Receiving Combined Surgical Resection for Gastric Cancer Liver Metastasis: Results from Two National Centers in China

    PubMed Central

    Li, Mu-Xing; Jin, Zheng-Xiong; Zhou, Jian-Guo; Ying, Jian-Ming; Liang, Zhi-Yong; Mao, Xin-Xin; Bi, Xin-Yu; Zhao, Jian-Jun; Li, Zhi-Yu; Huang, Zhen; Zhang, Ye-Fan; Li, Yuan; Chen, Xiao; Hu, Xu-Hui; Hu, Han-Jie; Zhao, Dong-Bing; Wang, Ying-Yi; Cai, Jian-Qiang; Zhao, Hong

    2016-01-01

    Abstract The purpose of this study was to evaluate the prognostic value of lymph node ratio (LNR) in patients with gastric cancer liver metastasis (GCLM) who received combined surgical resection. A retrospective analysis of 46 patients from two hospitals was conducted. Patients were dichotomized into two groups (high LNR and low LNR) by the median value of LNR. The overall survival (OS) and recurrence-free survival (RFS) were analyzed by the Kaplan–Meier method with the log-rank test. The Cox proportional hazard model was used to carry out the subsequent multivariate analyses. And the relationship between LNR and clinicopathological characteristics was assessed. The cut-off value defining elevated LNR was 0.347. With a median follow-up of 67.5 months, the median OS and RFS of the patients were 17 and 9.5 months, respectively. Six patients survived for >5 years after surgery. Patients with higher LNR had significantly shorter OS and RFS than those with lower LNR. In the multivariate analyses, higher LNR and multiple liver metastatic tumors were identified as the independent prognostic factors for both OS and RFS. Elevated LNR was significantly associated with advanced pN stage (P <0.001), larger primary tumor size (P = 0.046), the presence of microvascular invasion (P = 0.008), and neoadjuvant chemotherapy (P = 0.004). LNR may be prognostic indicator for patients with GCLM treated by synchronous surgical resection. Patients with lower LNR and single liver metastasis may gain more survival benefits from the surgical resection. Further prospective studies with reasonable study design are warranted. PMID:27100426

  13. Conceptual design study of potential early commercial MHD powerplant. Report of task 2 results

    NASA Astrophysics Data System (ADS)

    Hals, F. A.

    1981-03-01

    The conceptual design of one of the potential early commercial MHD power plants was studied. The plant employs oxygen enrichment of the combustion air and preheating of this oxygen enriched air to an intermediate temperature of 1200 F attainable with a tubular type recuperative heat exchanger. Conceptual designs of plant componets and equipment with performance, operational characteristics, and costs are reported. Plant economics and overall performance including full and part load operation are reviewed. The projected performance and estimated cost of this early MHD plant are compared to conventional power plants, although it does not offer the same high efficiency and low costs as the mature MHD power plant. Environmental aspects and the methods incorporated in plant design for emission control of sulfur and nitrogen are reviewed.

  14. Conceptual design study of potential early commercial MHD powerplant. Report of task 2 results

    NASA Technical Reports Server (NTRS)

    Hals, F. A.

    1981-01-01

    The conceptual design of one of the potential early commercial MHD power plants was studied. The plant employs oxygen enrichment of the combustion air and preheating of this oxygen enriched air to an intermediate temperature of 1200 F attainable with a tubular type recuperative heat exchanger. Conceptual designs of plant componets and equipment with performance, operational characteristics, and costs are reported. Plant economics and overall performance including full and part load operation are reviewed. The projected performance and estimated cost of this early MHD plant are compared to conventional power plants, although it does not offer the same high efficiency and low costs as the mature MHD power plant. Environmental aspects and the methods incorporated in plant design for emission control of sulfur and nitrogen are reviewed.

  15. The Coastal Area Tactical-mapping System (CATS): Early Test Results

    NASA Astrophysics Data System (ADS)

    Carter, W. E.; Shrestha, R. L.; Slatton, K. C.; Shrestha, K.; Cossio, T.

    2006-12-01

    Researchers at the University of Florida (UF) are developing a next generation airborne laser mapping instrument under a contract with the Office of Naval Research. The Coastal Area Tactical-mapping System (CATS) is based on a different paradigm than the commercially developed units currently in wide use. The commercial units achieve a high signal-to-noise ratio (SNR) per pulse by using a relatively long pulse (typically about 10 nanoseconds) infrared laser, illuminating a single small footprint (typically a few decimeters in diameter) with a strong signal (typically on the order of 100 microjoules per pulse). Laser pulse rates of 25 kHz to 100 kHz are common. The detector is a single avalanche photodiode, and the signal is large enough that multiple discrete returns (from vegetation) can be detected sequentially, or the unit can be equipped with a wave form digitizer. The CATS unit uses a short pulse (480 picosecond FWHM) frequency-doubled NdYAG (0.530 micrometer wavelength) micro laser, and illuminates a patch (nominally 2 meters by 2 meters) with a 10 by 10 array of laser beams, each having about 30 nanojoules of energy. The returning signals may be as low as a single photon per channel, and the sensor is a 100 channel photomultiplier tube (PMT). The range electronics have multi-stop capabilities in each channel. Each channel of the CATS instrument has a much lower SNR than the current generation of commercial units, but even operating at pulse rates as low as 8,000 pulses per second, it provides essentially contiguous coverage of the terrain in a single pass, sampling 800,000 points per second—as compared to 100,000 points per second for the leading commercial unit. And the short laser pulse length results in sub-nanosecond inter-pulse dead times. Another anticipated advantage of the CATS design is being able to penetrate water to depths of about 5 meters. The CATS unit is fully assembled and ground testing began in early 2006. Initial testing has focused on

  16. Early infantile Krabbe disease: results of the World-Wide Krabbe Registry.

    PubMed

    Duffner, Patricia K; Barczykowski, Amy; Jalal, Kabir; Yan, Li; Kay, Denise M; Carter, Randy L

    2011-09-01

    New York State began screening for Krabbe disease in 2006 to identify infants with Krabbe disease before symptom onset. Because neither galactocerebrosidase activity nor most genotypes reliably predict phenotype, the World Wide Registry was developed to determine whether other clinical/neurodiagnostic data could predict early infantile Krabbe disease in the newborn screening population. Data on disease course, galactocerebrosidase activity, DNA mutations, and initial neurodiagnostic studies in 67 symptomatic children with early infantile Krabbe disease were obtained from parent questionnaires and medical records. Initial signs included crying/irritability, cortical fisting, and poor head control. Galactocerebrosidase activity was uniformly low. Eight of 17 manifested novel mutations. Ninety-two percent (n = 25) exhibited elevated cerebrospinal fluid protein; 76% (n = 42) demonstrated abnormal magnetic resonance images; 67% (n = 15) exhibited abnormal computed tomography findings; 43% (n = 28) produced abnormal electroencephalogram findings; 100% (n = 5) demonstrated abnormal nerve conduction velocities; 83% (n = 6) produced abnormal brainstem evoked responses; and 50% (n = 6) exhibited abnormal visual evoked responses. One, 2, and 3 year survivals were 60%, 26%, and 14%, respectively. Although most symptomatic patients with the early infantile phenotype manifested abnormal cerebrospinal fluid protein, magnetic resonance imaging, brainstem evoked responses, and nerve conduction velocities, studies of affected children may be normal. Other biomarkers are needed to predict phenotype in the newborn screening population. PMID:21824559

  17. Epilepsy Surgery for Pediatric Epilepsy: Optimal Timing of Surgical Intervention

    PubMed Central

    SUGANO, Hidenori; ARAI, Hajime

    2015-01-01

    Pediatric epilepsy has a wide variety of etiology and severity. A recent epidemiological study suggested that surgery might be indicated in as many as 5% of the pediatric epilepsy population. Now, we know that effective epilepsy surgery can result in seizure freedom and improvement of psychomotor development. Seizure control is the most effective way to improve patients neurologically and psychologically. In this review, we look over the recent evidence related to pediatric epilepsy surgery, and try to establish the optimal surgical timing for patients with intractable epilepsy. Appropriate surgical timing depends on the etiology and natural history of the epilepsy to be treated. The most common etiology of pediatric intractable epilepsy patients is malformation of cortical development (MCD) and early surgery is recommended for them. Patients operated on earlier than 12 months of age tended to improve their psychomotor development compared to those operated on later. Recent progress in neuroimaging and electrophysiological studies provide the possibility of very early diagnosis and comprehensive surgical management even at an age before 12 months. Epilepsy surgery is the only solution for patients with MCD or other congenital diseases associated with intractable epilepsy, therefore physicians should aim at an early and precise diagnosis and predicting the future damage, consider a surgical solution within an optimal timing. PMID:25925754

  18. The Mars Science Laboratory Mission: Early Results from Gale Crater Landing Site

    NASA Astrophysics Data System (ADS)

    Flatow, I.; Grotzinger, J. P.; Blake, D.; Crisp, J. A.; Edgett, K. S.; Gellert, R.; Gomez-Elvira, J.; Hassler, D. M.; Mahaffy, P. R.; Malin, M. C.; Meyer, M. A.; Mitrofanov, I.; Vasavada, A. R.; Wiens, R. C.

    2012-12-01

    The Mars Science Laboratory rover, Curiosity, landed at Gale Crater on August 5th (PDT) and initiated an investigation of modern and ancient environments. The 155-km diameter Gale Crater was chosen as Curiosity's field site based on several attributes: the interior Mount Sharp preserves a succession of flat-lying strata extending almost 5 km above the elevation of the landing site; the lower few hundred meters of the mound show a progression with relative age from clay-bearing to sulfate-bearing strata, separated by an unconformity from overlying likely anhydrous strata; the landing ellipse is characterized by a mixture of alluvial fan and high thermal inertia/high albedo stratified deposits; and a number of stratigraphically/geomorphically distinct fluvial features. Gale's regional context and strong evidence for a progression through multiple potentially habitable environments, represented by a stratigraphic record of extraordinary extent, ensure preservation of a rich record of the environmental history of early Mars. Curiosity has an expected lifetime of at least one Mars year (~23 months), and drive capability of at least 20 km. The MSL science payload was specifically assembled to assess habitability and includes a gas chromatograph-mass spectrometer and gas analyzer that will search for organic carbon in rocks, regolith fines, and the atmosphere (SAM); an x-ray diffractometer that will determine mineralogical diversity (CheMin); focusable cameras that can image landscapes and rock/regolith textures in natural color (MAHLI, Mastcam); an alpha-particle x-ray spectrometer for in situ determination of rock and soil chemistry (APXS); a laser-induced breakdown spectrometer to remotely sense the chemical composition of rocks and minerals (ChemCam); an active/passive neutron spectrometer designed to search for water in rocks/regolith (DAN); a weather station to measure modern-day environmental variables (REMS); and a sensor designed for continuous monitoring of

  19. Radical radiotherapy for early glottic cancer: Results in a series of 1087 patients from two Italian radiation oncology centers. II. The case of T2N0 disease

    SciTech Connect

    Frata, Paolo; Cellai, Enrico; Magrini, Stefano M. . E-mail: magrini@med.unibs.it; Bonetti, Bartolomea; Vitali, Elisabetta; Tonoli, Sandro; Buglione, Michela; Paiar, Fabiola; Barca, Raffaella; Fondelli, Simona; Polli, Caterina; Livi, Lorenzo; Biti, Gianpaolo

    2005-12-01

    Purpose: To retrospectively evaluate local control rates, late damage incidence, functional results, and second-tumor occurrence according to the different patient, tumor, and treatment features in a large bi-institutional series of T2 glottic cancer. Methods and Materials: A total of 256 T2 glottic cancer cases treated consecutively with radical intent at the Florence University Radiation Oncology Department (FLO) and at the Radiation Oncology Department of University of Brescia, Istituto del Radio 'O. Alberti' (BS) were studied. Cumulative probability of local control (LC), disease-specific survival (DSS), and overall survival (OS) rates were calculated and compared in the different clinical and therapeutic subgroups by both univariate and multivariate analysis. Types of relapse and their surgical salvage were evaluated, along with the functional results of treatment. Late-damage incidence and second-tumor cumulative probability (STP) were also calculated. Results: In the entire series, 3-year, 5-year, and 10-year OS rates were, respectively, 73%, 59%, and 37%. Corresponding values for cumulative LC probability were 73%, 73%, and 70% and for DSS, 89%, 86%, and 85%, taking into account surgical salvage of relapsed cases. Seventy-three percent of the patients were cured with function preserved. Main determinants of a worse LC at univariate analysis were larger tumor extent and impaired cord mobility. At multivariate analysis, the same factors retained statistical significance. Twenty-year STP was 23%, with second-tumor deaths less frequent than larynx cancer deaths (20 of 256 vs. 30 of 256). Incidence of late damage was higher in the first decade of accrual (22%) than in the last decade (10%, p = 0.03); the same was true for severe late damage (9% vs. 1.8%). Conclusion: Present-day radical radiotherapy can be considered a standard treatment for T2 glottic cancer. Better results are obtained in patients with less extended disease. Late damage is relatively

  20. Widespread Magmatism as a Result of Impact Related Decompression Melting on Early Mars

    NASA Astrophysics Data System (ADS)

    Edwards, C. S.; Bandfield, J. L.; Christensen, P. R.; Rogers, D.

    2012-12-01

    Flat-floored craters on Mars have been observed since early spacecraft viewed the surface. Early work characterized these craters as infilled by sedimentary materials [e.g. Christensen, 1983] but later work using THEMIS thermal inertia determined these craters contain some of the rockiest materials on the planet and not sedimentary materials [Edwards et al., 2009]. Here we investigate the distribution, physical properties (morphology and thermal inertia), and composition of these craters over the entire planet. We find the majority of rocky crater floors identified (~3300) are concentrated in the low albedo (0.1-0.17), cratered southern highlands. These craters are associated with the highest thermal inertia values (e.g. > 500 to 2000 J m-2 K-1 s-1/2), some of the most mafic materials on the planet (enriched in olivine/pyroxene vs. high-Si phases/plagioclase, often with >10-15% olivine areal abundance), and formed ~3.5 billion years ago. Based on the properties of the crater fill materials described, three mechanisms are considered for the formation of flat-floored, high thermal inertia crater floors on Mars including: 1) the lithification/induration of sediments, 2) the ponding of crustal melt material related to the heat generated during the impact process, and 3) infilling by volcanic materials. We find the only likely scenario is volcanic infilling through fractures created in the impact event. Furthermore, we find the generation of the primitive magma would be directly sourced from the decompression melting of the martian mantle due to the removal of several kilometers of overlying crustal material by the impactor. As the ancient martian crust was likely thin and the geothermal gradients were significantly higher than present day [e.g. Zuber, 2001], the decompression melting of the mantle [Bertka and Holloway, 1994] would be more likely to occur on early Mars then under present day conditions. This is borne out by the ancient ages (~3-4Ga) of the crater floors

  1. The Charcot foot: medical and surgical therapy.

    PubMed

    Ulbrecht, Jan S; Wukich, Dane K

    2008-12-01

    Charcot neuro-osteoarthropathy (CN) is among the most devastating complications of neuropathy and now most commonly occurs in the feet of diabetic patients. Because it is relatively rare and because most patients and practitioners do not expect major bone pathology in the absence of significant pain, CN is often misdiagnosed as cellulitis, deep venous thrombosis, or gout. Also, radiographs early in the process are often relatively unremarkable. Although MRI findings are characteristic, treatment should not wait for the MRI result. The hot swollen erythematous neuropathic foot suspected to be CN should be emergently mechanically protected, usually in an irremovable total contact cast. Mechanical protection is the mainstay of conservative therapy, but surgical reconstruction of a deformed foot can usually also be successful. Unless diagnosed very early, significant decrements in quality of life result. Controlled studies are urgently needed to identify best practices. PMID:18990300

  2. Clinical results of early stage prostatic cancer treated by pelvic lymphadenectomy and /sup 125/I implants

    SciTech Connect

    Kandzari, S.J.; Belis, J.A.; Kim, J.C.; Gnepp, D.R.; Riley, R.S.

    1982-05-01

    Eighty patients with clinically early stage adenocarcinoma of the prostate were treated with pelvic lymphadenectomy and interstitial implantation of /sup 125/I seeds. A new applicator that permits greater accuracy in spacing the seeds has been developed. Postoperative complications were minimal, with urinary irritability being the most common. Multiple transrectal needle biopsies were performed 12 and 18 months after treatment in 46 patients. The prostatic biopsies were negative for carcinoma in 61 per cent and positive in 39 per cent of the patients. Long-term followup is needed to correlate post-treatment biopsies with survival and to determine if patients with positive biopsies should receive further treatment.

  3. Solar Maximum Mission experiment - Early results from the soft X-ray polychromator experiment

    NASA Technical Reports Server (NTRS)

    Gabriel, A. H.; Phillips, K. J. H.; Culhane, J. L.; Bentley, R. D.; Parmar, A. N.; Rapley, C. G.; Acton, L. W.; Leibacher, J. W.; Jordan, C.; Antonucci, E.

    1981-01-01

    It is pointed out that the X-ray polychromator experiment has been in operation on the Solar Maximum Mission satellite for more than three months. Using a number of different modes, the polychromator is observing flares and active regions in the wavelength range 1-23 A. These modes include polychromatic imaging, high resolution line profiles, high dispersion spectra, and light curves with high time-resolution. Data are described and some of the early analysis and interpretation is presented. All the interpretations are based on simple approximate methods; it is noted, however, that in most cases more elaborate and reliable methods are close to being applied.

  4. Stroke: indications for emergent surgical intervention.

    PubMed

    Pikus, H J; Heros, R C

    1999-01-01

    As the brain attack message is disseminated throughout our medical community and the awareness of the public increases, neurosurgeons will have the opportunity to treat patients with stroke at a much earlier time in the evolution of the process than we have been accustomed. Are the relatively unimpressive results of acute surgical intervention in patients operated on later in the course of the disease applicable to those who seek medical attention early, within the first few hours of ictus? There is little firm data. However, there is an overwhelming amount of anecdotal and experimental evidence supporting the potential for ultra-early intervention, which frequently should be surgical. New surgical techniques may improve safety and feasibility of emergent operations. In the coming years, diagnostic techniques such as perfusion/diffusion magnetic resonance imaging will allow the clinician to determine who may benefit from intervention. These determinations will be made on physiological data, addressing the issues of tissue viability and degree of compromise of the blood-brain barrier. In the future, the window of opportunity for intervention will not be solely a function of time from ictus or a qualitative impression based on collateral circulation as extrapolated from angiography, transcranial Doppler, or magnetic resonance angiography. These new magnetic resonance imaging techniques, which are beginning to be tested clinically or are still in the developmental stages, will provide the functional data now provided by positron emission tomography and xenon computed tomography, but with improved sensitivity, specificity, and logistical ease. Neurosurgeons have been leaders in stroke care and have provided some of the most important experimental rationale for the brain attack concept. These contributions include demonstration of the ischemic penumbra, the importance of time and potential collateral circulation as factors determining viability of ischemic tissue, and

  5. Surgical services for children in developing countries.

    PubMed Central

    Bickler, S. W.; Rode, H.

    2002-01-01

    There is growing evidence that childhood surgical conditions, especially injuries, are common in developing countries and that poor care results in significant numbers of deaths and cases of disability. Unfortunately, however, surgical care is not considered an essential component of most child health programmes. Strategies for improving paediatric surgical care should be evidence-based and cost-effective and should aim to benefit the largest possible number of children. The most likely way of achieving policy change is to demonstrate that childhood surgical conditions are a significant public health problem. For paediatric purposes, special attention should also be given to defining a cost-effective package of surgical services, improving surgical care at the community level, and strengthening surgical education. Surgical care should be an essential component of child health programmes in developing countries. PMID:12471405

  6. Surgical management of macular holes: results using gas tamponade alone, or in combination with autologous platelet concentrate, or transforming growth factor β2

    PubMed Central

    Minihan, M; Goggin, M; Cleary, P

    1997-01-01

    BACKGROUND—Vitrectomy and gas tamponade has become a recognised technique for the treatment of macular holes. In an attempt to improve the anatomic and visual success of the procedure, various adjunctive therapies—cytokines, serum, and platelets—have been employed. A consecutive series of 85 eyes which underwent macular hole surgery using gas tamponade alone, or gas tamponade with either the cytokine transforming growth factor β2 (TGF-β2) or autologous platelet concentrate is reported.
METHODS—Twenty eyes had vitrectomy and 20% SF6 gas tamponade; 15 had vitrectomy, 20% SF6 gas, and TGF-β2; 50 had vitrectomy, 16% C3F8 gas tamponade, and 0.1 ml of autologous platelet concentrate prepared during the procedure.
RESULTS—Anatomic success occurred in 86% of eyes, with 96% of the platelet treated group achieving closure of the macular hole. Visual acuity improved by two lines or more in 65% of the SF6 only group, 33% of those treated with TGF-β2, and in 74% of the platelet treated group. In the platelet treated group 40% achieved 6/12 or better and 62% achieved 6/18 or better. The best visual results were obtained in stage 2 holes.
CONCLUSION—Vitrectomy for macular holes is often of benefit and patients may recover good visual acuity, especially early in the disease process. The procedure has a number of serious complications, and the postoperative posturing requirement is difficult. Patients need to be informed of such concerns before surgery.

 PMID:9497468

  7. Retrocerebellar arachnoid cyst resulting in syringomyelia in a patient without tonsillar herniation: successful surgical treatment with reconstruction of CSF flow in the foramen magnum region.

    PubMed

    Sun, Liyong; Emich, Stephan; Fu, Wenzhuo; Chen, Zan; Hao, Wu; Ling, Feng; Jian, Fengzeng

    2016-04-01

    A retrocerebellar arachnoid cyst causing syringomyelia is extremely rare without tonsillar herniation. The authors present a 44-year-old woman with symptoms of foramen magnum compression and syringomyelia. Magnetic resonance imaging demonstrated a large retrocerebellar arachnoid cyst with a large cervicothoracic syrinx but no signs of tonsillar herniation or hydrocephalus. The patient underwent a foramen magnum decompression with C1 laminectomy, microsurgical fenestration of the cyst, and duraplasty. After successful reconstruction of CSF flow, the patient experienced a relief of symptoms and a significant reduction of the syrinx. The intraoperative findings support the theory of a piston mechanism in the development of syringomyelia. Additional arachnoidal adhesions may also obstruct the CSF flow around the craniocervical junction. We recommend the surgical treatment should consist of an adequate decompression of the foramen magnum, wide microsurgical arachnoidal debridement, and duraplasty with autologous grafts sutured in a watertight way. PMID:26728365

  8. Surgical Management in Primary Congenital Glaucoma: Four Debates

    PubMed Central

    Chang, Ta C.; Cavuoto, Kara M.

    2013-01-01

    Primary congenital glaucoma is a worldwide diagnostic and therapeutic challenge. Although medical management is often a temporizing measure, early surgical intervention is the definitive treatment. As the abundance of surgical treatment options continues to expand, the authors will compare and contrast the available options and attempt to provide a consensus on surgical management. PMID:23762530

  9. Feasibility of subcutaneous gentamicin and pressurized irrigation as adjuvant strategies to reduce surgical site infection in colorectal surgery: results of a pilot study.

    PubMed

    Dineen, Sean P; Pham, Thai H; Murray, Bryce W; Parker, Betty J; Hartless, Kathleen; Anthony, Thomas; Huerta, Sergio

    2015-06-01

    Surgical site infections (SSIs) remain a common and costly morbidity after colorectal surgery. This rate remains high even in the setting of strict adherence to Surgical Care Improvement Project Protocols. The aim of our pilot study was to determine the feasibility and safety of subcutaneous gentamicin injection or pressurized irrigation as adjuncts to reduce SSI. A total of 132 patients who underwent colorectal surgery at the VA North Texas Health Care System were prospectively assigned to a pressurized irrigation group (n = 44), a preincision gentamicin injection group (n = 48), or control (n = 40). The primary objective was to assess safety and feasibility of these strategies. Patient demographics were matched among groups. Univariate and multivariate analyses were performed to identify possible predictions of SSI in this cohort. The rate of SSI in the control group was 25 per cent, 13.5 per cent in the pressurized irrigation group, and 12.5 per cent in the gentamicin group (P = 0.26). Combined, the intervention groups had a 13 per cent SSI versus 25 per cent control (P = 0.09). Operative time was not increased by the interventions and no intraoperative complications specifically related to the interventions were noted. Postoperative complications were not different between groups. Both albumin and body mass index were associated with SSI. Body mass index was and independent predictor of SSI (P = 0.006). In conclusion, this pilot study demonstrates the feasibility of the interventions described. There was no detrimental effect of either intervention. There was trend toward a reduction in SSI in the intervention group, which warrants further investigation. PMID:26031269

  10. Rewarding Progress, Reducing Debt: Early Results from Ohio's Performance-Based Scholarship Demonstration for Low-Income Parents

    ERIC Educational Resources Information Center

    Cha, Paulette; Patel, Reshma

    2010-01-01

    This report presents early results from a rigorous evaluation of a performance-based scholarship program that was implemented at three community colleges in Ohio during the 2008-2009 academic year. The program in Ohio that is the subject of this report is part of MDRC's national Performance-Based Scholarship (PBS) Demonstration, which was…

  11. Enhancing Student Services at Lorain County Community College: Early Results from the Opening Doors Demonstration in Ohio

    ERIC Educational Resources Information Center

    Scrivener, Susan; Au, Jenny

    2007-01-01

    In 2003, MDRC and a consortium of funders launched the Opening Doors demonstration to test reforms in six community colleges aimed at helping students stay in school and earn credentials. This report presents early results from the Opening Doors program at Lorain County Community College in Elyria, Ohio. The program provided intensive advising and…

  12. Simulation in Surgical Education

    PubMed Central

    de Montbrun, Sandra L.; MacRae, Helen

    2012-01-01

    The pedagogical approach to surgical training has changed significantly over the past few decades. No longer are surgical skills solely acquired through a traditional apprenticeship model of training. The acquisition of many technical and nontechnical skills is moving from the operating room to the surgical skills laboratory through the use of simulation. Many platforms exist for the learning and assessment of surgical skills. In this article, the authors provide a broad overview of some of the currently available surgical simulation modalities including bench-top models, laparoscopic simulators, simulation for new surgical technologies, and simulation for nontechnical surgical skills. PMID:23997671

  13. Electronic surgical record management.

    PubMed

    Rockman, Justin

    2010-01-01

    This paper explores the challenges surgical practices face in coordinating surgeries and how the electronic surgical record management (ESRM) approach to surgical coordination can solve these problems and improve efficiency. Surgical practices continue to experience costly inefficiencies when managing surgical coordination. Application software like practice management and electronic health record systems have enabled practices to "go digital" for their administrative, financial, and clinical data. However, surgical coordination is still a manual and labor-intensive process. Surgical practices need to create a central and secure record of their surgeries. When surgical data are inputted once only and stored in a central repository, the data are transformed into active information that can be outputted to any form, letter, calendar, or report. ESRM is a new approach to surgical coordination. It enables surgical practices to automate and streamline their processes, reduce costs, and ensure that patients receive the best possible care. PMID:20480775

  14. Correcting the Results of the Wrong Model: Treatment Effects under Early Detection of Cancer

    PubMed Central

    Lee, Shih-Yuan; Tsodikov, Alex

    2013-01-01

    Early detection of cancer leads to variability of the point of diagnosis advanced by the amount of the so-called lead time, a random variable. Estimated treatment effects by the proportional hazards (PH) model may be biased if this variability is ignored. We study how true and PH-estimated treatment effects differ in screened vs. unscreened populations and offer an approximate correction for the reported PH-based estimate that does not require raw data, targeting a meta-analysis-type application. We rely on a joint cancer incidence and survival model of prostate cancer to furnish key information for the correction. The procedure is applied to a series of prostate cancer data analyses using the PH models reported in the literature. Simulations are used for assessing the quality of the method and sensitivity analyses. PMID:24032001

  15. Percutaneous coronary angioscopy with a new steerable microangioscope: experimental and early clinical results

    NASA Astrophysics Data System (ADS)

    Ramee, Stephen R.; White, Christopher J.; Mesa, Juan E.; Murgo, Joseph P.; Doyle, Andrew T.; McQueen, Colleen L.

    1990-07-01

    We have developed a new, steerable microangioscope for performing percutaneous coronary angioscopy. The angioscopic catheter is made of polyethylene, contains a distal balloon for occlusion of blood flow during imaging, fits through an 8 Fr percutaneous coronary angioplasty (PTCA) guiding catheter and is steerable by means of a guidewire. Initial feasibility was demonstrated in animal studies involving both peripheral and coronary arteries. Angioscopic findings in normal vessels included normal endothelial surface, collateral blood flow, and side branches. Angioscopy was also performed after balloon denudation of the arteries, laser- assisted balloon angioplasty, and stent implantation. In early human clinical trials we have performed percutaneous angioscopy in six patients undergoing percutaneous coronary angioplasty without complications. Findings in these patients include atherosclerotic plaque, thrombus, and dissection. This new device has great potential for use in the research, diagnosis, and treatment of coronary atherosclerosis.

  16. Current status and early result of the ILAS-II onboard the ADEOS-II satellite

    NASA Astrophysics Data System (ADS)

    Nakajima, H.; Sugita, T.; Yokota, T.; Kanzawa, H.; Kobayashi, H.; Sasano, Y.

    2003-04-01

    The Improved Limb Atmospheric Spectrometer-II (ILAS-II) onboard the Advanced Earth Observing Satellite-II (ADEOS-II) was successfully launched on 14 December, 2002 from NASDA's Tanegashima Space Center. ILAS-II is a solar-occultation atmospheric sensor which will measure vertical profiles of O_3, HNO_3, NO_2, N_2O, CH_4, H_2O, ClONO_2, aerosol extinction coefficients etc. with four grating spectrometers. After the initial checkout of the ILAS-II which is scheduled in January-February, 2003, ILAS-II will make routine measurements from early April. A validation campaign is scheduled to be taken place in Kiruna, Sweden in which several balloon-borne measurements are planned. Preliminary data from ILAS-II on both northern and southern polar regions using the latest data retrieval algorithm will be presented.

  17. Exome Sequencing in a Family Identifies RECQL5 Mutation Resulting in Early Myocardial Infarction

    PubMed Central

    Xie, Xiang; Zheng, Ying-Ying; Adi, Dilare; Yang, Yi-Ning; Ma, Yi-Tong; Li, Xiao-Mei; Fu, Zhen-Yan; Ma, Xiang; Liu, Fen; Yu, Zi-Xiang; Chen, You; Huang, Ying

    2016-01-01

    Abstract Coronary artery disease (CAD) including myocardial infarction (MI) is the leading cause of death worldwide and is commonly caused by the interaction between genetic factors and environmental risks. Despite intensive efforts using linkage and candidate gene approaches, the genetic etiology for the majority of families with a multigenerational early CAD /MI predisposition is unknown. In this study, we used whole-exome sequencing of 10 individuals from 1 early MI family, in which 4 siblings were diagnosed with MI before the age of 55, to identify potential predisposing genes. We identified a mutation in the RECQL5 gene, 1 of the 5 members of the RECQ family which are involved in the maintenance of genomic stability. This novel mutation, which is a TG insert at position 73,626,918 on the 13 chromosome and occurs before the last nucleotide of the introns 11 acceptor splice site affecting splicing of RECQL5. RT-PCR suggested the control subject had a full-length mRNA including exon 12, but the patients with RECQL5 mutation had a shorter mRNA form involving splicing of exons 11 to 13 directly, with skipping of exon 12. Quantitative RT-PCR analysis of RECQL5 exon 12 demonstrated that individuals whose genotype is mutant homozygote had only trace amounts of mRNA containing this exon and the family members who carry the heterozygous genotype had a level at 48% to 55% of the control's level. These findings provide insight into both the pathogenesis of MI and the role of RECQL5 gene in human disease. PMID:26844521

  18. THE STELLAR INITIAL MASS FUNCTION IN EARLY-TYPE GALAXIES FROM ABSORPTION LINE SPECTROSCOPY. II. RESULTS

    SciTech Connect

    Conroy, Charlie; Van Dokkum, Pieter G.

    2012-11-20

    The spectral absorption lines in early-type galaxies contain a wealth of information regarding the detailed abundance pattern, star formation history, and stellar initial mass function (IMF) of the underlying stellar population. Using our new population synthesis model that accounts for the effect of variable abundance ratios of 11 elements, we analyze very high quality absorption line spectra of 38 early-type galaxies and the nuclear bulge of M31. These data extend to 1 {mu}m and they therefore include the IMF-sensitive spectral features Na I, Ca II, and FeH at 0.82 {mu}m, 0.86 {mu}m, and 0.99 {mu}m, respectively. The models fit the data well, with typical rms residuals {approx}< 1%. Strong constraints on the IMF and therefore the stellar mass-to-light ratio, (M/L){sub stars}, are derived for individual galaxies. We find that the IMF becomes increasingly bottom-heavy with increasing velocity dispersion and [Mg/Fe]. At the lowest dispersions and [Mg/Fe] values the derived IMF is consistent with the Milky Way (MW) IMF, while at the highest dispersions and [Mg/Fe] values the derived IMF contains more low-mass stars (is more bottom-heavy) than even a Salpeter IMF. Our best-fit (M/L){sub stars} values do not exceed dynamically based M/L values. We also apply our models to stacked spectra of four metal-rich globular clusters in M31 and find an (M/L){sub stars} that implies fewer low-mass stars than a MW IMF, again agreeing with dynamical constraints. We discuss other possible explanations for the observed trends and conclude that variation in the IMF is the simplest and most plausible.

  19. Combined radiation and burn injury results in exaggerated early pulmonary inflammation

    PubMed Central

    Palmer, Jessica L.; Deburghgraeve, Cory R.; Bird, Melanie D.; Hauer-Jensen, Martin; Chen, Michael M.; Yong, Sherri; Kovacs, Elizabeth J.

    2014-01-01

    Events such as a nuclear meltdown accident or nuclear attack have potential for severe radiation injuries. Radiation injury frequently occurs in combination with other forms of trauma, most often burns. Thus far, combined injury studies have focused mainly on skin wound healing and damage to the gut. Since both radiation exposure and remote burn have pulmonary consequences, we examined the early effects of combined injury on the lung. C57BL/6 male mice were subjected to 5 Gy of total body irradiation followed by a 15% total body surface area scald burn. Lungs from surviving animals were examined for evidence of inflammation and pneumonitis. At 48 hours post-injury, pathology of the lungs from combined injury mice showed greater inflammation compared to all other treatment groups, with marked red blood cell and leukocyte congestion of the pulmonary vasculature. There was excessive leukocyte accumulation, primarily neutrophils, in the vasculature and interstitium, with occasional cells in the alveolar space. At 24 and 48 hours post-injury, myeloperoxidase levels in lungs of mice given combined injury were elevated compared to all other treatment groups (p<0.01), confirming histological evidence of neutrophil accumulation. Pulmonary levels of the neutrophil chemoattractant KC (CXCL1) were 3 times above that of either injury alone (p<0.05). Further, monocyte chemotactic protein-1 (MCP-1, CCL2) was increased 2-fold and 3-fold compared to burn injury or radiation injury, respectively (p<0.05). Together, these data suggest that combined radiation and burn injury augments early pulmonary congestion and inflammation.. Currently, countermeasures for this unique type of injury are extremely limited. Further research is needed to elucidate the mechanisms behind the synergistic effects of combined injury in order to develop appropriate treatments. PMID:23899376

  20. Early Results from the Wisconsin H-Alpha Mapper Southern Sky Survey

    NASA Astrophysics Data System (ADS)

    Haffner, L. Matthew; Reynolds, R. J.; Madsen, G. J.; Hill, A. S.; Barger, K. A.; Jaehnig, K. P.; Mierkiewicz, E. J.; Percival, J. W.

    2010-01-01

    After a successful eleven-year campaign at Kitt Peak, we moved the Wisconsin H-Alpha Mapper (WHAM) to Cerro Tololo in early 2009. Here we present some of the early data after the first nine months under southern skies. These maps begin to complete the first all-sky, kinematic survey of the diffuse Hα emission from the Milky Way. Much of this emission arises from the Warm Ionized Medium (WIM), a significant component of the ISM that extends a few kiloparsecs above the Galactic disk. The WHAM instrument consists of a 0.6 m primary lens housed in a steerable siderostat coupled to a 15 cm dual-etalon Fabry-Perot spectrometer. The optical configuration delivers a spatially integrated spectrum from a one-degree beam on the sky covering 200 km/s with 12 km/s spectral resolution. Short, 30-second exposures allow us to cover the observable sky in about two years at sensitivity levels of about 0.1 R (EM 0.2 pc cm-6). While this first look at the data focuses on the Hα survey, WHAM is also capable of observing many other optical emission lines, revealing fascinating trends in the temperature and ionization state of the WIM. Our ongoing studies of the physical conditions of diffuse ionized gas will continue in the south following the Hα survey. In addition, future observations using our survey mode will cover the full velocity range of the Magellanic Stream, Bridge, and Clouds to trace the ionized gas associated with these neighboring systems. WHAM is supported by NSF award AST-0607512 and has made this smooth relocation south due to the excellent staff at KPNO and CTIO.

  1. Effects of Cognitive Enhancement Therapy on Employment Outcomes in Early Schizophrenia: Results From a Two-Year Randomized Trial

    PubMed Central

    Eack, Shaun M.; Hogarty, Gerard E.; Greenwald, Deborah P.; Hogarty, Susan S.; Keshavan, Matcheri S.

    2013-01-01

    Objective To examine the effects of psychosocial cognitive rehabilitation on employment outcomes in a randomized controlled trial for individuals with early course schizophrenia. Method Early course schizophrenia outpatients (N = 58) were randomly assigned to Cognitive Enhancement Therapy (CET) or an Enriched Supportive Therapy (EST) control and treated for two years. Comprehensive data on cognition and employment were collected annually. Results Individuals treated with CET were significantly more likely to be competitively employed, had greater earnings from employment, and were more satisfied with their employment status by the end of treatment compared to EST recipients. Mediator analyses revealed that improvements in both social and non-social cognition mediated the CET effects on employment. Conclusion CET can help facilitate employment in early schizophrenia, by addressing the cognitive impairments that limit functioning in the disorder. Inclusion of cognitive rehabilitation in social work practice can support more optimal functional recovery from schizophrenia. PMID:23885163

  2. Surgical treatment analysis of idiopathic esophageal achalasia

    PubMed Central

    de AQUINO, José Luis Braga; SAID, Marcelo Manzano; PEREIRA, Douglas Rizzanti; do AMARAL, Paula Casals; LIMA, Juliana Carolina Alves; LEANDRO-MERHI, Vânia Aparecida

    2015-01-01

    Background Idiopathic esophageal achalasia is an inflammatory disease of unknown origin, characterized by aperistalsis of the esophageal body and failure of the lower esophageal sphincter in response to swallowing, with consequent dysphagia. Aim To demonstrate the results of surgical therapy in these patients, evaluating the occurred local and systemic complications. Methods Were studied retrospectively 32 patients, 22 of whom presented non-advanced stage of the disease (Stage I/II) and 10 with advanced disease (Stage III/IV). All of them had the clinical conditions to be submitted to surgery. The diagnoses were done by clinical, endoscopic, cardiological, radiological and esophageal manometry analysis. Pre-surgical evaluation was done with a questionnaire based on the most predisposing factors in the development of the disease and the surgical indication was based on the stage of the disease. Results The patients with non-advanced stages were submitted to cardiomyotomy with fundoplication, wherein in the post-surgical early assessment, only one (4,4%) presented pulmonary infection, but had a good outcome. In patients with advanced disease, seven were submitted to esophageal mucosectomy preserving the muscular layer, wherein one patient (14,2%) presented dehiscence of gastric cervical esophagus anastomosis as well as pulmonary infection; all of these complications were resolved with proper specific treatment; the other three patients with advanced stage were submitted to transmediastinal esophagectomy; two of them presented hydropneumothorax with good evolution, and one of them also presented fistula of the cervical esophagogastric anastomosis, but with spontaneous healing after conservative treatment and nutritional support. The two patients with fistula of the cervical anastomosis progressed to stenosis, with good results after endoscopic dilations. In the medium and long term assessment done in 23 patients, all of them reported improvement in life quality, with

  3. [Surgical reduction of fat surplus leading to pulmonary embolism].

    PubMed

    Richling, Nina; Friedrich, Elisabeth; Deutinger, Maria; Riedmüller, Eva-Maria; Janata, Karin; Laggner, Anton N

    2004-12-30

    Surgical reduction of fat surplus is usually performed on healthy individuals and is reported as a safe procedure as it is not associated with a lethal outcome. Due to the anticipation of peri- and postoperative bleeding as a result of the large wound area, which may have a negative influence on the cosmetic result, patients often receive no or only inadequate anticoagulation. We report three cases in which surgical reduction of fat surplus led to sudden collapse and cardiac arrest. In all of our patients, fatal pulmonary embolism was the cause of cardiac arrest. These patients received only inadequate or no anticoagulation. Early postoperative mobilization, elastic stockings and compressive wound-dressing did not prevent pulmonary embolism. In addition to early postoperative mobilization of the patient and even though there is a risk of perioperative bleeding complications, the use of anticoagulation is highly recommended in surgical procedures like abdominoplasty or dermolipectomy. If sudden dyspnea, chest pain, collapse or cardiac arrest occurs after surgical interventions like these, pulmonary embolism should be considered and further diagnostic steps should be initiated. PMID:15690971

  4. Defining the Pathway to Definitive Care and Surgical Decompression after Traumatic Spinal Cord Injury: Results of a Canadian Population-Based Cohort Study.

    PubMed

    Wilson, Jefferson R; Voth, Jennifer; Singh, Anoushka; Middleton, James; Jaglal, Susan B; Singh, Jeffrey M; Mainprize, Todd G; Yee, Albert; Fehlings, Michael G

    2016-05-15

    Early access to specialized care after acute traumatic spinal cord injury (SCI) is associated with improved outcomes. However, many SCI patients do not receive timely access to such care. To characterize and quantify patients' pathway to definitive care and surgery post SCI, and to identify factors that may delay expeditious care, a population based cohort study was performed in Ontario. Using provincial administrative health data, adult patients with acute traumatic SCI who underwent surgery between 2002 and 2011 were identified using SCI specific ICD-10 codes. The relationship between predictor variables and a) time to arrival at the site of definitive care and b) time to surgery was statistically evaluated. Of 1,111 patients meeting eligibility criteria, mean times to arrival at the site of definitive care and to surgery were 8.1 ± 25.5 and 49.4 ± 65.0 hours respectively, with 53.3% of patients having surgery prior to 24 hours. While most patients (88.4%) reached the site of definitive care within 6 hours, only 34.2% reached surgery within 12 hours of arrival. Older age (IRR = 1.01; 95% CI: 1.01, 1.02), increased number of stops at intermediate health care centers (IRR = 7.70; 95% CI: 7.54, 7.86), higher comorbidity index (IRR = 1.43; 95% CI: 1.14, 1.72) and fall related SCI etiology (IRR = 1.16; 95% CI: 1.02, 1.29) were associated with increased time to arrival at definitive care. For surgery, increased age (OR = 1.02; 95% CI: 1.01, 1.03) and stops at intermediate health centers (OR = 2.48; 95% CI: 1.35, 4.56) were associated with a greater odds of undergoing late surgery (>24hrs). These results can inform policy decisions and facilitate creation of a streamlined path to specialized care for patients with acute SCI. PMID:26652196

  5. Early and Middle Miocene Antarctic Climate and Ice Sheet variability: ANDRILL SMS Project results

    NASA Astrophysics Data System (ADS)

    Harwood, David; Florindo, Fabio; Levy, Richard; Talarico, Franco; Sms Project Science Team Members

    2010-05-01

    The sedimentary archive recovered during the ANDRILL Southern McMurdo Sound Project (SMS) comprises an expanded early and middle Miocene section deposited in a high-accommodation continental margin location, proximal to glacial ice influence from the West Antarctic Ice Sheet, East Antarctic Ice Sheet, and local ice in the Transantarctic Mountains. The AND-2A drillhole reached a total depth of 1138.54 mbsf, and obtained an excellent quality core with 98% recovery through the cored interval. Stratigraphic sequences and facies interpretations reveal a cyclical history of environmental variation influenced by climate, glacial advance/retreat cycles, and water depth variation. These lower and middle Miocene shallow marine sediments were deposited in the subsiding Victoria Land Basin, during a period of relatively steady thermal subsidence, on the coastal plain and continental shelf seaward of the rising Transantarctic Mountains. A well-developed chronostratigraphic framework developed through integrated diatom biostratigraphy, magnetostratigraphy, Sr isotope geochemistry, and radiometric dating of volcanic materials, allows for the comparison of events recognized in this drillcore with events identified in distal proxy records from deep-sea stable isotope studies, and in sea-level reconstructions based on continental shelf sequence stratigraphy. More than 60 sequences recognized in the AND-2A drillcore represent repeating lithological changes in glacimarine, terrigenous, volcanic and biogenic sediments, deposited during a dynamic climate regime, that appear to reflect a variable pace of Milankovitch forcing.

  6. gPhoton: A Time-Tagged Database of Every GALEX Photon and Early Science Results

    NASA Astrophysics Data System (ADS)

    Fleming, Scott W.; Million, Chase; Shiao, Bernie; Thompson, Randy; Tseng, Shui-Ay; Rogers, Anthony; Smith, Myron; White, Richard L.; Levay, Karen

    2014-06-01

    The Galaxy Evolution Explorer (GALEX) mission observed a large fraction of the sky in FUV and NUV at time resolutions of five thousandths of a second, spanning a decade of operation. Due to technical limitations when the data were first archived, the ability to use GALEX data at such high time resolutions was limited: the primary data products were images that w