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Sample records for entre anastomoses intestinais

  1. Computational modeling of vascular anastomoses.

    PubMed

    Migliavacca, Francesco; Dubini, Gabriele

    2005-06-01

    Recent development of computational technology allows a level of knowledge of biomechanical factors in the healthy or pathological cardiovascular system that was unthinkable a few years ago. In particular, computational fluid dynamics (CFD) and computational structural (CS) analyses have been used to evaluate specific quantities, such as fluid and wall stresses and strains, which are very difficult to measure in vivo. Indeed, CFD and CS offer much more variability and resolution than in vitro and in vivo methods, yet computations must be validated by careful comparison with experimental and clinical data. The enormous parallel development of clinical imaging such as magnetic resonance or computed tomography opens a new way toward a detailed patient-specific description of the actual hemodynamics and structural behavior of living tissues. Coupling of CFD/CS and clinical images is becoming a standard evaluation that is expected to become part of the clinical practice in the diagnosis and in the surgical planning in advanced medical centers. This review focuses on computational studies of fluid and structural dynamics of a number of vascular anastomoses: the coronary bypass graft anastomoses, the arterial peripheral anastomoses, the arterio-venous graft anastomoses and the vascular anastomoses performed in the correction of congenital heart diseases. PMID:15772842

  2. Anastomosing Rivers are Disequilibrium Patterns

    NASA Astrophysics Data System (ADS)

    Lavooi, E.; de Haas, T.; Kleinhans, M. G.; Makaske, B.; Smith, D. G.

    2010-12-01

    Anastomosing rivers have multiple interconnected channels that enclose floodbasins. Various theories have been proposed to explain this pattern, including an increased discharge conveyance and sediment transport capacity of multiple channels, or, alternatively, a tendency to avulse due to upstream sediment overloading. The former implies an equilibrium pattern whereas the latter implies a temporary increase of the number of channels. Our objective was to test these hypotheses on a well-documented case: the upper Columbia River. We combined a geological approach with physics-based morphological modelling. Three geological sections across the entire valley were constructed based on hand auger data, covering a depth up to 8.6 m corresponding to the last 4000 years, corroborated by 14C dating. The sections were integrated with surface mapping to derive proportions of channel and floodplain sediment volumes and sedimentation rates along the river. Existing sediment transport measurements at a location upstream and downstream of the study area were re-analysed and time-integrated for comparison. A network model was built based on gradually varied flow equations, sediment transport prediction, mass conservation and detailed transverse slope and spiral meander flow effects at the bifurcations. The geological sections show a clear downstream trend of decreasing number of channels and decreasing bed sediment deposition in channels and crevasses, indicating bed sediment overloading from upstream and subsequent avulsions. The measured suspended sediment is much larger than the amount captured in the floodplains, indicating that this is not limiting the aggradation in the valley. Extensive crevasse splays in the upstream section and an increased bed elevation and gradient demonstrate a tendency to avulse due to overloading of bed sediment. The measured bedload transport indeed indicates bed material overloading. The 14C dating confirms that long-term average floodplain

  3. Argon laser-welded arteriovenous anastomoses.

    PubMed

    White, R A; Kopchok, G; Donayre, C; White, G; Lyons, R; Fujitani, R; Klein, S R; Uitto, J

    1987-11-01

    This study compared the healing of laser-welded and sutured canine femoral arteriovenous anastomoses. Arteriovenous fistulas 2 cm in length were created bilaterally in the femoral vessels of 10 dogs and were studied at 1 (n = 2), 2 (n = 2), 4 (n = 3), and 8 (n = 3) weeks. In each animal, one anastomosis (control) was closed with running 6-0 polypropylene sutures, and the contralateral anastomosis (experimental) was sealed with an argon laser (0.5 watt, 4 minutes of exposure, 1830 J/cm2/1 cm length of anastomosis). At removal all experimental anastomoses were patent without hematomas, aneurysms, or luminal narrowing. Histologic examination at 4 weeks revealed that laser-welded anastomoses had less inflammatory response and almost normal collagen and elastin reorientation. At 8 weeks sutured anastomoses had significant intimal hyperplasia whereas laser repairs had normal luminal architecture. Tensile strength and collagen production, measured by the synthesis of hydroxyproline and the steady-state levels of type I and type III procollagen messenger ribonucleic acids, at the anastomoses and in adjacent vein and artery specimens were similar in sutured and laser-welded repairs at 2, 4, and 8 weeks. We conclude that argon laser welding of anastomoses is an acceptable alternative to suture techniques, with the advantage of improved healing without foreign body response and possible diminished intimal hyperplasia at the anastomotic line. PMID:3312648

  4. Compression anastomoses in colorectal surgery: a review.

    PubMed

    Zbar, A P; Nir, Y; Weizman, A; Rabau, M; Senagore, A

    2012-06-01

    The main serious risks of anastomotic construction in the colon and rectum include dehiscence and stricture formation. There is a resurgence of interest in sutureless anastomoses formed by compression elements since the introduction of shape memory alloy (SMA) systems, which evoke minimal early inflammatory response whilst maintaining anastomotic integrity. Currently, the most commonly used SMA is the nickel-titanium (NiTi) alloy that is highly biocompatible, returning to its pre-deformed stable (austenite) shape under different mechanical and thermal loads for use in humans. Pre-clinical data for shape memory alloy systems in colorectal anastomoses are limited, but it appears to be safe in porcine and canine models with limited leakage and reduced stricture formation. There does not appear to be any difference in tissue biochemistry of inflammatory markers when compared with conventional stapled techniques, although the few studies available show a markedly reduced early inflammatory response at the anastomotic site with the NiTi device. The majority of the clinical data concerning compression anastomoses are derived from the biofragmentable anastomotic ring device. This device has fallen out of use because of reported leaks, instrumental failure and problems with device expulsion. A novel SMA device, the NiTi anastomotic ring, permits construction of a low rectal anastomosis construction during open or laparoscopic procedures. The preliminary data demonstrate a safety comparable to conventional staple technology. This device also provides the potential of benefit of reduced anastomotic inflammation, because the compression ring results in direct serosa-to-serosa (or alternatively serosa-to-muscularis propria) apposition without the persistence of residual foreign material. This type of construction could lead to a reduced incidence of early anastomotic leakage and/or the development of anastomotic stenosis. Randomized clinical trials employing a NiTi arm for

  5. Early Experience with Stapled Gastrointestinal Anastomoses in a Nigerian Hospital

    PubMed Central

    Adisa, AO; Olasehinde, O; Arowolo, OA; Alatise, OI; Agbakwuru, EA

    2015-01-01

    Background: Hand-sewn gastrointestinal anastomoses has been the traditional approach to gastrointestinal anastomosis in Nigeria while stapled anastomoses are infrequently performed in few centers. Objectives: To describe the outcome of our initial experience with stapled gastrointestinal anastomoses in a semi-urban patient population. Patients and Methods: Consecutive patients who had stapled gastrointestinal anastomoses between January 2011 and June 2014 in a Nigerian tertiary hospital were prospectively evaluated. Indications for operation, procedures performed and anastomoses constructed and postoperative outcome of each patient were documented. Results: Nineteen patients including seven males and 12 females had stapled anastomoses within the period. Their ages ranged between 41 and 68 (mean 52.5) years. Six (31.6%) Roux-en-Y gastrojejunostomies, 6 (31.6%) ileo-colic, 3 (15.8%) ileo-ileal, 2 (10.5%) colo-colic, and 2 (10.5%) colo-anal anastomoses were performed. Indications include antral gastric cancer in 4 (21.1%), right colon cancer 4 (21.1%), ileal perforations in 3 (15.8%) while 2 (10.5%) each had left colon cancer, common bile duct obstruction, rectal cancer and ruptured appendix. Mean duration of operation was 108 ± 46 min and mean duration of postoperative stay was 5 ± 2.6 days. No intraoperative complications were recorded and no anastomotic leakage occurred. At a median follow-up of 5 months no staple related stricture had occurred. Conclusions: Stapled gastrointestinal anastomoses are associated with a good outcome in our center. We propose a prospective, large-population randomized comparison of the technique with hand-sewn anastomoses. PMID:26425069

  6. Effect of preoperative irradiation on healing of low colorectal anastomoses

    SciTech Connect

    Morgenstern, L.; Sanders, G.; Wahlstrom, E.; Yadegar, J.; Amodeo, P.

    1984-02-01

    The effect of preoperative irradiation on the healing of low colorectal anastomoses was studied experimentally. In 12 dogs in whom preoperative irradiation of 4,000 rads was given before low colorectal stapled anastomosis was performed, anastomotic leakage occurred in 66 percent. More than half of the anastomotic leaks were associated with either severe sepsis or death. In a matched group of control animals that underwent stapled anastomoses without irradiation, no anastomotic complications occurred. The clinical implications of this study are that stapled anastomoses in irradiated colon are at serious risk of anastomotic dehiscence and, therefore, should be protected with a proximal colostomy.

  7. Effects of radiation therapy in microvascular anastomoses

    SciTech Connect

    Fried, M.P.

    1985-07-01

    The otolaryngologist, as a head and neck surgeon, commonly cares for patients with upper aerodigestive tract malignancies. Therapy of these neoplasms often requires wide excision. One standard reconstructive procedure utilizes pedicled regional flaps, both dermal and myodermal which have some disadvantages. The shortcomings of these pedicled regional flaps have led to the use of the vascularized free flap in certain cases. The occasional case may lead to catastrophe if microanastomoses fail when combined with radiation. Notwithstanding, many surgical series have reported success when radiation has been given. The present investigation was undertaken to assess the effects of radiation therapy on microvascular anastomoses when radiation is administered pre- or postoperatively or when nonradiated tissue is transferred to an irradiated recipient site. These effects were observed serially in an experimental rat model using a tubed superficial epigastric flap that adequately reflected tissue viability and vascular patency. The histologic changes were then noted over a three month period after completion of both radiation and surgery. This study adds credence to the observation of the lack of deleterious effects of radiation on experimental microvascular anastomotic patency whether the radiation is given before or after surgery or if radiated tissue is approximated to nonradiated vessels.

  8. Bowel anastomoses: The theory, the practice and the evidence base

    PubMed Central

    Goulder, Frances

    2012-01-01

    Since the introduction of stapling instruments in the 1970s various studies have compared the results of sutured and stapled bowel anastomoses. A literature search was performed from 1960 to 2010 and articles relating to small bowel, colonic and colorectal anastomotic techniques were reviewed. References from these articles were also reviewed, and relevant articles obtained. Either a stapled or sutured gastrointestinal tract anastomosis is acceptable in most situations. The available evidence suggests that in the following situations, however, particular anastomotic techniques may result in fewer complications: A stapled side-to-side ileocolic anastomosis is preferable following a right hemicolectomy for cancer. A stapled side-to-side anastomosis is likely also preferable after an ileocolic resection for Crohn’s disease. Colorectal anastomoses can be sutured or stapled with similar results, although the incidence of strictures is higher following stapled anastomoses. Following reversal of loop ileostomy there is some evidence to suggest that a stapled side-to-side anastomosis or sutured enterotomy closure (rather than spout resection and sutured anastomosis) results in fewer complications. Non-randomised data has indicated that small bowel anastomoses are best sutured in the trauma patient. This article reviews the theory, practice and evidence base behind the various gastrointestinal anastomoses to help the practising general surgeon make evidence based operative decisions. PMID:23293735

  9. Exoscope Update: Automated Laser Welding Of Circumferential Tissue Anastomoses

    NASA Astrophysics Data System (ADS)

    Sauer, Jude S.; McGuire, Kevin P.; Hinshaw, J. Raymond

    1989-09-01

    The speed, accuracy and efficiency of using laser energy to fuse together or weld living tissue makes laser tissue welding one of the most exciting areas of medical research today. Numerous investigators using animal models and several surgeons conducting clinical studies have demonstrated many promising potential applications of laser tissue welding. Accurate tissue positioning and well controlled delivery of laser energy during laser welding are essential for consistently successful laser tissue repairs. Many surgical procedures involve the creation of functional anastomoses, which are patent connections between hollow, tubular tissue structures, like bowel, blood vessels or fallopian tubes. We are developing the Exoscope SystemTM to automate and simplify the production of laser welded end-to-end and end-to-side anastomoses. Any laser light that can be passed through an optical fiber can be used in this system. The Exoscope SystemTM employs a fiber optic Exoscope Device,TM which provides for the precise placement of laser energy onto the abutted tissue seam, and a biocompatible, dissolvable intraluminal PolySurgeTM stent, which holds the tissue in circumferential apposition during lasing. The feasibility of employing the Exoscope SystemTM technique for the construction of rabbit small bowel anastomoses was successfully demonstrated in a Phase I study comparing 30 Exoscope SystemTM laser welded anastomoses to 30 conventional sutured anastomoses.

  10. Vascular anastomoses in dichorionic diamniotic-fused placentas.

    PubMed

    Foschini, Maria P; Gabrielli, Liliana; Dorji, Tshering; Kos, Marina; Lazzarotto, Tiziana; Lanari, Marcello; Landini, Maria P

    2003-10-01

    A case of fetal twin-to-twin cytomegalovirus infection through a dichorionic diamniotic (DiDi)-fused placenta prompted our search for possible vascular anastomoses in this type of placenta. This case and three additional DiDi-fused placentas were studied with gross (macro) sections and a three-dimensional (3D) stereomicroscopic technique. Two twins were dizygotic (they differed in gender and blood groups) and the other two were probably monozygotic. Macrosections and 3D-image analysis demonstrated side-to-side connections between small subchorionic vessels. These findings demonstrate that vascular anastomoses are present in DiDi-fused placentas. PMID:14501816

  11. Scintiscanning in the evaluation of biliary enteric anastomoses.

    PubMed

    Tidmore, H; Ram, M D

    1985-03-01

    The evaluation of symptomatic patients who have undergone biliary enteric anastomoses, particularly when the diversion was into the jejunum, is difficult. Conventional techniques for evaluation, such as oral cholecystography (OCG), intravenous cholangiography (IVC), ultrasonography (US), computer-assisted tomography scanning (CT scanning), or endoscopy are not adequate to provide definitive information on the patency of the anastomoses. Hepatobiliary scintiscanning using 99mTc-HIDA and BIDA (iminodiacetic acid derivatives) was performed on 12 patients. The patients were from 11 to 72 years of age and included ten men and two women. The scan results were correlated with US, CT scan, percutaneous transhepatic cholangiography (PTC), operative findings, and final diagnosis. Scanning was highly accurate in this group and could be performed successfully even in jaundiced patients (total serum bilirubin level up to 20.0 mg/dl). In patients in whom dilated bile ducts were demonstrated (by US, CT scan, or scintiscan), only the scintiscan revealed the true patency of the anastomoses. The advantages of the technique are that it is simple and noninvasive. Delayed transit of bile (scanning agent) to bowel is a very reliable indication of partial or complete obstruction. Scintiscanning is the only technique that demonstrated the functional state of biliary secretion and excretion into bowel in patients with previous biliary enteric anastomoses. PMID:3883866

  12. Anastomosing hemangioma: The first case report in the bladder

    PubMed Central

    JIN, LU; LIU, JIAJU; LI, YIFAN; SUN, SHUOLEI; MAO, XIANGMING; YANG, SHANGQI; LAI, YONGQING

    2016-01-01

    A rare neoplasm, termed ‘anastomosing hemangioma’ (AH), has been previously described in the genitourinary tract. To date, 29 cases of AH have been reported in the literature, and the case reported in the present study is, to the best of our knowledge, the first AH described in the urinary bladder. It is essential to distinguish AH from malignant vascular tumors due to the different treatments required and the prognosis. The patient in this case study was asymptomatic, with a neoplasm of ~1 cm within the right wall of the bladder. Pathologically, the lesion was predominantly composed of a structure comprising a small vascular cavity and irregularly fenestrated anastomosing vascular channels, with no clear atypia of the endothelial cells. PMID:26893881

  13. Myopericytoma proliferating in an unusual anastomosing multinodular fashion.

    PubMed

    Inoue, Takuya; Misago, Noriyuki; Asami, Akihiko; Tokunaga, Osamu; Narisawa, Yutaka

    2016-05-01

    We herein describe a case of myopericytoma that proliferated in an unusual fashion. Myopericytoma is described as a group of rare, benign, dermal or subcutaneous tumors that are characterized histologically by a striking, concentric, perivascular proliferation of spindle cells and showing apparent differentiation towards perivascular myoid cells. Myopericytoma forms a morphological continuum with myofibroma/myofibromatosis, glomus tumor and angioleiomyoma. The patient was a 64-year-old woman who demonstrated a recurrent ulcer on an atrophic plaque on her left shin. A histopathological examination of the plaque demonstrated that tumor cells proliferated in an anastomosing multinodular fashion along the vessels in the dermis and subcutaneous tissue. In those nodules, there were numerous, small, concentric proliferations of myoid-appearing spindle cells around small vascular lumina. The present case is an unusual example of myopericytoma, manifesting in a characteristic anastomosing, multinodular, infiltrating fashion. PMID:26499100

  14. Long-term follow up of renal anastomosing hemangioma mimicking renal angiosarcoma.

    PubMed

    Heidegger, Isabel; Pichler, Renate; Schäfer, Georg; Zelger, Bernhard; Zelger, Bettina; Aigner, Friedrich; Bektic, Jasmin; Horninger, Wolfgang

    2014-08-01

    Anastomosing hemangioma of the kidney is a very rare neoplasm, currently 19 cases have been reported in the literature. First described in 2009, histopathologically anastomosing hemangioma is similar to aggressive angiosarcoma. No long-term follow-up data of anastomosing hemangioma have been described yet. Here, we present the case of a healthy 56-year-old man diagnosed in 2002 with a 7 × 5-cm anastomosing hemangioma mimicking an aggressive renal angiosarcoma. The patient underwent nephrectomy and has been followed up disease free for 13 years. PMID:24650180

  15. Technical Feasibility of TachoSil Application on Esophageal Anastomoses

    PubMed Central

    Haverkamp, Leonie; Ruurda, Jelle P.; van Hillegersberg, Richard

    2015-01-01

    Purpose. Sealing esophageal anastomoses with a sealant patch (TachoSil) containing human fibrinogen and thrombin may improve mechanical strength. The aim was to evaluate the technical feasibility of the application of a sealant patch in upper gastrointestinal surgery. Methods. In total 15 patients, 18–80 years old, undergoing thoracolaparoscopic esophagectomy with esophagogastrostomy or laparoscopic total gastrectomy with esophagojejunostomy was included. Different techniques of anastomotic TachoSil patch application were tested and recorded on video. Results. TachoSil was successfully applied to the esophagogastrostomy (n = 11) and to the esophagojejunostomy (n = 4). A median of 2 (1–6) attempts was necessary to reach successful application. The median duration was 7 (3–26) minutes before successful application was accomplished. The best technique in esophagectomy was the application of TachoSil with the use of 2 cellophane sheets. For total gastrectomy, the patch was folded into a harmonica shape and wrapped around the esophagojejunostomy. Although not significant, the number of attempts and time to success showed a decreasing trend along with the increased experience. Conclusion. Application of TachoSil as a sealant of esophageal anastomoses was technically feasible. Future studies may investigate the value of TachoSil application on the prevention of anastomotic leakage. PMID:26101523

  16. Technical Feasibility of TachoSil Application on Esophageal Anastomoses.

    PubMed

    Haverkamp, Leonie; Ruurda, Jelle P; van Hillegersberg, Richard

    2015-01-01

    Purpose. Sealing esophageal anastomoses with a sealant patch (TachoSil) containing human fibrinogen and thrombin may improve mechanical strength. The aim was to evaluate the technical feasibility of the application of a sealant patch in upper gastrointestinal surgery. Methods. In total 15 patients, 18-80 years old, undergoing thoracolaparoscopic esophagectomy with esophagogastrostomy or laparoscopic total gastrectomy with esophagojejunostomy was included. Different techniques of anastomotic TachoSil patch application were tested and recorded on video. Results. TachoSil was successfully applied to the esophagogastrostomy (n = 11) and to the esophagojejunostomy (n = 4). A median of 2 (1-6) attempts was necessary to reach successful application. The median duration was 7 (3-26) minutes before successful application was accomplished. The best technique in esophagectomy was the application of TachoSil with the use of 2 cellophane sheets. For total gastrectomy, the patch was folded into a harmonica shape and wrapped around the esophagojejunostomy. Although not significant, the number of attempts and time to success showed a decreasing trend along with the increased experience. Conclusion. Application of TachoSil as a sealant of esophageal anastomoses was technically feasible. Future studies may investigate the value of TachoSil application on the prevention of anastomotic leakage. PMID:26101523

  17. Sutureless microvascular anastomoses by a biodegradable laser-activated solid protein solder.

    PubMed

    Maitz, P K; Trickett, R I; Dekker, P; Tos, P; Dawes, J M; Piper, J A; Lanzetta, M; Owen, E R

    1999-11-01

    A new sutureless technique to successfully anastomose the abdominal aorta of rats (1.3 mm in diameter) by using a fully biodegradable, laser-activated protein solder is presented. A total of 90 rats were divided into two groups randomly. In group one, the anastomoses were performed by using conventional microsuturing technique, whereas in group two, the anastomoses were performed by using a new laser welding technique. In addition, each of the two groups were divided into five subgroups and evaluated at different follow-up periods (10 minutes, 1 hour, 1 day, 1 week, and 6 weeks). At these intervals, the anastomoses were evaluated for patency and tensile strength. Three anastomoses in each subgroup were processed for light and electron microscopy. All anastomoses were found to be patent. The mean clamp time of the anastomoses performed with conventional suturing was 20.6 minutes compared with 7.2 minutes for the laser-activated welded anastomoses (p < 0.001). The strain measurements showed a stronger mechanical bond of the sutured anastomoses in the initial phase. However, at 6 weeks the tensile strength of the laser-welded anastomoses was higher compared with the conventional suture technique. Histologic evaluations revealed a near complete resorption of the solder after 6 weeks. The junction site of the vessel ends cannot be determined on the luminal side of the artery. In conclusion, a resorbable protein used as a solder, activated by a diode laser, can provide a reliable, safe, and rapid arterial anastomosis, which could be performed by any microsurgeon faster than conventional suturing after a short learning curve. PMID:10541175

  18. Preliminary experience with laser reinforcement of vascular anastomoses

    NASA Astrophysics Data System (ADS)

    Oz, Mehmet C.; Bass, Lawrence S.; Williams, Matthew R.; Benvenisty, Alan I.; Hardy, Mark A.; Libutti, Steven K.; Eaton, Alexander M.; Treat, Michael R.; Nowygrod, Roman

    1991-06-01

    Laser tissue soldering techniques allow reinforcement of sutured repairs and may be a useful adjunct in reducing anastomotic bleeding. Initial results of our clinical trial with laser solder reinforcement are reported. Twenty-one patients underwent standard polytetraflouroethylene (PTFE) graft arteriovenous fistula (AVF) creation. In 11 patients thrombin soaked gelatin sponges were placed around the anastomoses and in 10 laser reinforcement was accomplished. Three lasers were used: KTP (532 nm, power density 4.1 W/cm2, spot size .5 cm), CO2 (10,600 nm, power density 14.1 W/cm2, spot size .3 cm), and diode (805 nm, power density 9.6 W/cm2, spot size .2 cm). The solder consisting of 0.4 cc hyaluronate, 0.2 cc albumin, and 3 drops of the appropriate laser enhancing dye (fluorescein for KTP, indocyanine green for the diode, water for CO2) was applied to the target tissues prior to laser exposure. The laser was directed over the tissue in a sweeping motion until the solder had desiccated. Several lessons are evident from our experience. First, over exposure to the laser results in solder charring and ineffective reinforcement. Greater laser exposure with less undesired solder damage is achieved if dye is added to the solder. Second, the solder should be spread over the target in a thin layer to facilitate controlled desiccation and tissue bonding. Additional layers can be applied as required. Although improvements in the solder and laser technique are required, these early results demonstrate a potential clinical use for laser soldered reinforcement during vascular anastomoses.

  19. Intrapulmonary arteriovenous anastomoses in humans with chronic obstructive pulmonary disease: implications for cryptogenic stroke?

    PubMed

    Norris, H Cameron; Mangum, Tyler S; Kern, Julia P; Elliott, Jonathan E; Beasley, Kara M; Goodman, Randy D; Mladinov, Suzana; Barak, Otto F; Bakovic, Darija; Dujic, Zeljko; Lovering, Andrew T

    2016-08-01

    What is the central question of this study? Do individuals with chronic obstructive pulmonary disease have blood flow through intrapulmonary arteriovenous anastomoses at rest or during exercise? What is the main finding and its importance? Individuals with chronic obstructive pulmonary disease have a greater prevalence of blood flow through intrapulmonary arteriovenous anastomoses at rest than age-matched control subjects. Given that the intrapulmonary arteriovenous anastomoses are large enough to permit venous emboli to pass into the arterial circulation, patients with chronic obstructive pulmonary disease and an elevated risk of thrombus formation may be at risk of intrapulmonary arteriovenous anastomosis-facilitated embolic injury (e.g. stroke or transient ischaemic attack). The pulmonary capillaries prevent stroke by filtering venous emboli from the circulation. Intrapulmonary arteriovenous anastomoses are large-diameter (≥50 μm) vascular connections in the lung that may compromise the integrity of the pulmonary capillary filter and have recently been linked to cryptogenic stroke and transient ischaemic attack. Prothrombotic populations, such as individuals with chronic obstructive pulmonary disease (COPD), may be at increased risk of stroke and transient ischaemic attack facilitated by intrapulmonary arteriovenous anastomoses, but the prevalence and degree of blood flow through intrapulmonary arteriovenous anastomoses in this population has not been fully examined and compared with age-matched healthy control subjects. We used saline contrast echocardiography to assess blood flow through intrapulmonary arteriovenous anastomoses at rest (n = 29 COPD and 19 control subjects) and during exercise (n = 10 COPD and 10 control subjects) in subjects with COPD and age-matched healthy control subjects. Blood flow through intrapulmonary arteriovenous anastomoses was detected in 23% of subjects with COPD at rest and was significantly higher compared with age

  20. Endoscopic magnetic cholecystodigestive anastomoses: personal technique for palliative treatment of distal bile duct obstruction.

    PubMed

    Saveliev, V S; Avaliani, M V; Bashirov, A D

    1993-04-01

    A new type of endoscopic surgery (magnetic cholecystodigestive anastomoses) is presented as an alternative to conventional palliative treatment of mechanical obstruction with icterus located below the bile duct inlet. By means of endoscopic technique, two clinically usable methods of creating delayed magnetic cholecystogastric anastomoses and one modality of implanting cholecystoenteric and enteroenteric anastomosis have been worked out in the experiment conducted on 50 mongrels with mechanical icterus. Ring-shaped or rectangular magnets were implanted in the gallbladder through laparoscopic cholecystostomy. Implantation into the stomach was accompanied by simultaneous gastroscopy. In clinical conditions, four endoscopic cholecystogastric anastomoses and one cholecystoduodenal anastomosis have been performed on patients suffering from malignant obstruction of distal bile duct due to cancer of the head of the pancreas, making any radical surgery pointless. The preliminary results indicate that endoscopic magnetic cholecystodigestive anastomoses can serve as a form of palliative treatment of distal bile duct malignant obstructions. PMID:7686058

  1. Morphology of Red Creek, Wyoming, an arid-region anastomosing channel system

    USGS Publications Warehouse

    Schumann, R.R.

    1989-01-01

    The narrow, deep, and sinuous main channel is flanked by anastomosing flood channels, or anabranches. Most anabranches are initiated at meander bends. The primary mechanism of anabranch initiation is avulsion during overbank floods. -from Author

  2. Anastomosing Haemangioma of the Kidney Involving a Segmental Branch of the Renal Vein

    PubMed Central

    Omiyale, Ayodeji Oluwarotimi; Golash, Anurag; Mann, Amandeep; Kyriakidis, Dimitris; Kalyanasundaram, Karthik

    2015-01-01

    Anastomosing variant of capillary haemangioma is a rare and recently described vascular tumour with a proclivity for the genitourinary tract. Here we present the case of a 64-year-old man with incidental finding of 3.4 cm renal mass on CT who had laparoscopic nephrectomy with a good postoperative recovery. Histopathological diagnosis of anastomosing haemangioma of the kidney was made and the patient was followed up for 10 months without evidence of tumour recurrence. PMID:26435872

  3. Anastomosing Haemangioma of the Kidney Involving a Segmental Branch of the Renal Vein.

    PubMed

    Omiyale, Ayodeji Oluwarotimi; Golash, Anurag; Mann, Amandeep; Kyriakidis, Dimitris; Kalyanasundaram, Karthik

    2015-01-01

    Anastomosing variant of capillary haemangioma is a rare and recently described vascular tumour with a proclivity for the genitourinary tract. Here we present the case of a 64-year-old man with incidental finding of 3.4 cm renal mass on CT who had laparoscopic nephrectomy with a good postoperative recovery. Histopathological diagnosis of anastomosing haemangioma of the kidney was made and the patient was followed up for 10 months without evidence of tumour recurrence. PMID:26435872

  4. [Immediate and long term post-operative controls of rat uterus anastomoses].

    PubMed

    Gianaroli, L; Livani, M F

    1980-11-15

    The Authors examine the immediate control (passage of methylene blue) and the long term control (hysterography, and biopsies at later stages after the interventions) in the microsurgical anastomoses of a rat uterus. The technique of each single investigation is shown and the results are discussed. Particular attention is given to the histological data which ratifies not only anatomical but also physiological outcomes. The differences among the anastomoses carried out in a single and a double layer are verified. PMID:7011342

  5. Microvascular anastomoses for bone grafts in the treatment of massive defects in bone.

    PubMed

    Weiland, A J; Daniel, R K

    1979-01-01

    Six patients with large defects in bone are described in whom we performed microvascular anastomoses of grafted fibular vessels (arteries and veins) to vessels in the recipient site. Two other patients, with massive loss of bone and skin, were treated by grafting of osteocutaneous composites also using microvascular anastomoses. All but one defect healed successfully. There is a wide potential for applications of these two techniques in the treatment of large segmental bone defects secondary to trauma or following tumor resection. PMID:365868

  6. Comparison Between Monochorionic and Dichorionic Placentas With Special Attention to Vascular Anastomoses and Placental Share.

    PubMed

    Zhao, Depeng; Lipa, Michal; Wielgos, Miroslaw; Cohen, Danielle; Middeldorp, Johanna M; Oepkes, Dick; Lopriore, Enrico

    2016-06-01

    Placental vascular anastomoses in twins lead to a shared circulation and may subsequently enable the development of severe complications such as twin-twin transfusion syndrome (TTTS) and twin anemia-polycythemia sequence (TAPS). The presence of vascular anastomoses has frequently and systematically been studied in monochorionic (MC) placentas, but only rarely in dichorionic (DC) placentas. The aim of this study was to compare the prevalence of vascular anastomoses and evaluate the sharing discordance in MC and DC placentas. All consecutive placentas of MC and DC twins delivered at the Leiden University Medical Center (the Netherlands) and Medical University of Warsaw (Poland) from 2012 to 2015 were routinely injected with colored dye and included in the study. We excluded twin pregnancies treated with fetoscopic laser surgery. A total of 258 placentas were analyzed in this study, including 134 MC placentas and 124 DC placentas. Vascular anastomoses were present in 99% (133/134) of MC placentas and 0% of DC placentas (p < .01). Placental share discordance between MC twins was significantly larger compared to DC twins, 19.8 (interquartile range [IQR] 8.1-33.3) and 10.8 (IQR 6.2-19.0), respectively (p < .01). Vascular anastomoses associated complications occurred in 16% (22/134) MC twins. Our findings show that vascular anastomoses are almost ubiquitous in MC placentas, but non-existent in DC placentas. In addition, unequal placental sharing appears to be more common in MC than in DC placentas. PMID:27068823

  7. Colored microspheres reveal interarterial microvascular anastomoses in canine myocardium.

    PubMed

    Cicutti, N; Rakusan, K; Downey, H F

    1992-01-01

    While the presence of microvascular intercommunication within an individual myocardial arterial bed is well documented, there is a paucity of data to support the existence of anastomoses emanating from independent arterial beds. Simultaneous in-vivo infusion of two different colored microsphere suspensions into the left anterior descending (LAD) and left circumflex (LCx) coronary arteries identified a specific interface region of canine myocardium that was perfused by both arterial branches. Subsequent microscopic/morphometric analysis of 40 microns serial sections in eight hearts revealed clustering of microspheres in their respective perfusion territories (red microspheres in the LAD region away from the interface, blue microspheres in the LCx field away from the interface), along with a mutually perfused borderzone. In each tissue section, two regions within this zone were identified and their maximum widths measured. One region was defined as the Interface Transition Zone (ITZ) (mean width = 5251 +/- 770 microns; mean +/- SD). This region was formed by an intermingling of microvessels supplied by the parent arteries of the adjacent perfusion territories; it separated tissue containing only one or the other colored microspheres. The second region was defined as the Boundary Watershed Zone (BWZ) (mean zone width = 3151 +/- 611 microns; mean +/- SD). This region was formed by capillaries containing sphere aggregates of both colors; it was located exclusively within the ITZ. In addition, the ITZ and BWZ were significantly wider in subepicardial than in subendocardial regions (p less than 0.001). PMID:1417709

  8. Colonic anastomoses and non-steroidal anti-inflammatory drugs.

    PubMed

    Slim, K; Joris, J; Beloeil, H

    2016-08-01

    Nonsteroidal anti-inflammatory drugs (NSAID) play an important role in the treatment of post-operative pain, particularly in the context of enhanced recovery after colorectal surgery. Several recent articles have suggested that NSAID may have a deleterious effect on colo-colic or colo-rectal anastomoses. The aim of this review is to analyze the evidence based on meta-analyses and cohort studies in the literature. A systematic review of clinical studies identified twelve studies including two meta-analyses and ten comparative cohort studies that included a large number of patients. The data in these studies are heterogeneous, often biased, and do not permit a formal recommendation based on a high level of evidence. The main conclusion of this review is that the balance of benefit vs. risk (analgesic effect/risk of anastomotic disruption) is acceptable; it appears (with a low level of evidence) that a prescription of NSAID for 48h after surgery may be recommended for elective colon surgery. Nevertheless, it is important to respect the specific contra-indications of NSAID and avoid post-operative NSAID use if there are risk factors for anastomotic leakage: advanced age, malnutrition, severe co-morbidities, intra-operative difficulties. PMID:27480526

  9. Effects of Fatigue and Sleep Deprivation on Microvascular Anastomoses.

    PubMed

    Basaran, Karaca; Mercan, Ebru Sen; Aygit, Ahmet Cemal

    2015-06-01

    Previous studies have investigated the effects of various human-based factors, such as tremor, exercise, and posture, on microsurgical performance. In this study, the authors investigated the effects of sleep deprivation and fatigue on microsurgery. A total of 48 Wistar Hannover rats were divided into 3 groups (16 anastomoses in each group) to be operated on at 3 different times: in the morning at 08:00 hours (group I), at night on the same day (01:00 h, group II), and the next morning at 09:00 hours (group III) following a night with no sleep. The blindly evaluated parameters were anastomotic times, error score (ES), global rating scale (GRS), autopsy scores (ASs), and patency. There was progressive decrease in the anastomosis times between the groups (P > 0.05). The patency rates were 93% in group I, 81% in group II, and 81% in group III (P > 0.05). The ES (P < 0.01), AS (P < 0.001), and GRS (P < 0.001) revealed significant results. Comparison between the groups showed that other than the anastomosis time, the night group (group II) showed a significant drop when compared with the preceding morning group (group I) (ES P < 0.01, AS P < .001, and GRS P < 0.001). In most of the parameters, the errors occurred with fatigue after the day and reached a maximum at the end of the day (group II). This study provides valuable data that might have significant medicolegal implications for controversial issues. More studies, however, including multiple surgeons with different experience levels, might be required to fully elucidate the overall effects of fatigue and sleep deprivation on microsurgery. PMID:26080191

  10. Microvascular anastomoses in irradiated vessels: A comparison between the Unilink system and sutures

    SciTech Connect

    Ragnarsson, R.; Berggren, A.; Klintenberg, C.; Ostrup, L. )

    1990-03-01

    A new mechanical device (the Unilink system) was compared to conventional suture anastomoses in irradiated microvessels. Twenty rabbits received a single radiation dose of 20 Gy from a 7-MeV electron source through an anterior neck field. One and 6 months following irradiation, the carotid arteries and facial veins were divided and anastomosed on one side with the Unilink system and on the other side with suture technique. At sacrifice 4 weeks postoperatively, all vessels were evaluated for patency and histologic changes associated with radiation and anastomotic trauma. Histology disclosed severe radiation changes. Also, intimal hyperplasia was consistently found at the anastomotic sites in the arteries, while it was totally absent in the venous anastomoses. Occlusive thrombosis was found in two arteries, one anastomosed with the Unilink system and one sutured. Two other arteries, one from each group, had subtotal occlusions at the anastomotic site. No occlusions occurred in any of the venous anastomoses. The overall patency in this study was 97.5 percent, with no difference between the two techniques.

  11. The Hydromorphic Character of Developing Anastomosed Systems Determined from Metre Scale Resolution Aerial LIDAR

    NASA Astrophysics Data System (ADS)

    Entwistle, N. S.; Heritage, G. L.; Bentley, S.

    2012-12-01

    Anastomosing channels are rare in the UK primarily due to inappropriate channel and floodplain engineering and management. This study examines the character of developing anastomosed channels on the River Wear and the River Irthing in northern England using metre scale resolution aerial LIDAR data. The LIDAR data are used to create a detailed digital surface and terrain models (DSM & DTM) of the study reaches. The data accurately records vegetation character and sub-channel planform and morphology. Topographic metrics reveal a well-developed vegetation community and a diverse terrain, dominated by an interlinked channel network split by variable length, generally low elevation interfluves. Utilisation of the LIDAR DEM in the JFLOW+ 2D hydrodynamic model has generated local hydraulic variable estimates through the anastomosed reaches across a range of flows. These data demonstrate clearly how elevated flows are transferred out of the primary channel and distributed along the interconnected secondary channel network, creating a diverse set of hydraulic environments. Interfluve areas become quickly inundated further dissipating flow energy. Shear stress estimates across the study sites reveal a generally reduced ability to mobilise sediments and erode channel margins. It would appear that the topographic character of these developing anastomosing sites efficiently manages flood flow energy, activating secondary channels and low elevation interfluves to distribute flood flows, creating a dynamically stable river environment. These findings are contrasted against data from wandering channel systems, characterised by a poorly developed riparian vegetation community, where bar deposition and bank erosion dominate. A model of channel evolution linking wandering and anastomosed channel types is proposed, demonstrating from the topographic data how wandering systems may develop into anastomosed systems with appropriate riparian vegetation management.

  12. Biotic drivers of anastomosing channel pattern in headwater streams of the Colorado Rocky Mountains

    NASA Astrophysics Data System (ADS)

    Wohl, E. E.

    2010-12-01

    Most of the headwater rivers in the Colorado Rocky Mountains, USA occur as single channels in steep, narrow valleys. Where variations in bedrock erodibility create segments of wider, lower gradient valleys, however, anastomosing channels can occur if one of two biotic drivers is present. Where a disturbance such as a forest fire or windstorm allows pioneer woody species to colonize valley bottoms, beavers can establish colonies. Beavers build dams that enhance overbank flooding and raise the local water table, limiting the return of conifers and promoting aspen-willow (Populus-Salix) forests that provide food for the beavers. Beavers facilitate the formation of multiple channels by digging small canal-like features across the floodplain and by damming the main channel and promoting channel avulsion. In old-growth conifer forests, channel-spanning logjams can enhance overbank flows that facilitate the development of multiple (sub)parallel channels that extend for 50-300 m downstream. Enhanced overbank flows and multiple channels increase the retention of instream wood, creating a self-enhancing feedback of more jams. At least two thresholds must be crossed for anastomosing driven by logjams to develop; a valley morphology threshold and a wood load threshold. Anastomosing channels are present where stream gradient < 4% and the ratio of (channel width/valley-bottom width) < 0.2; only single channels flow through old-growth forests in valley segments that are steeper and narrower. The average wood piece diameter in old-growth anastomosing channel segments > 20 cm, whereas average piece diameter in forests that have not been disturbed in a century is 10-20 cm; channels in these younger forests do not exhibit anastomosing planforms. Wood load in old-growth anastomosing channels averages 200 m3/ha; old-growth and younger forest single channels average < 100 m3/ha.

  13. Success of free flap anastomoses performed within the zone of trauma in acute lower limb reconstruction.

    PubMed

    Bendon, Charlotte L; Giele, Henk P

    2016-07-01

    Traditionally, in free flap cover of lower limb injuries, every attempt is made to perform anastomoses proximal to the zone of injury. We report on the success of anastomoses within the zone of trauma, at the level of the fracture, avoiding further dissection and exposure. The records of free flap reconstructions for fractures of the lower extremity at a tertiary trauma centre between 2004 and 2010 were retrospectively reviewed. A total of 48 lower limb fractures required free flap reconstruction, performed at 28 days post injury (0-275 days). Anastomoses were proximal (21), distal (5) or within the zone of trauma (22). There was no significant difference (p > 0.05) in return to theatre, revision of anastomosis or flap survival between groups. Of the 22 performed within the zone of injury, five returned to theatre but only two for revision of anastomosis and 20 (91%) of these flaps survived. Of the 48 free flaps, arterial anastomoses were end to end in 34 (71%) and end to side in 14 (30%). There was no significant difference (p > 0.05) in return to theatre, revision of anastomosis or flap survival between the end-to-end and end-to-side groups. There was a tendency for arterial anastomoses to be performed end to end outside the zone of trauma (23/26) compared to within the zone of trauma (11/22). Our data suggest that free flap anastomoses can be performed safely in the zone of trauma in lower limb injuries. PMID:27108076

  14. The importance of radiological controls of anastomoses after upper gastrointestinal tract surgery - a retrospective cohort study

    PubMed Central

    2010-01-01

    Introduction This study was designed to analyze whether routine radiological controls of anastomoses in the upper gastrointestinal tract an early detection of anastomotic leaks. Patients and Methods 135 patients who underwent upper gastrointestinal tract surgery were retrospectively analyzed. Patients in the first group (n = 55) underwent routine radiological control of the anastomoses. In the second group (n = 80) the radiological control was only performed in case of clinical symptoms or signs of anastomotic leaks. Results The incidence of anastomotic leaks in the patients seen by us was 5.2%, equivalent to 7 of 135 patients In Group 1 leaks were seen in 4 of 55 patients (7,2%) in group 2 leaks were seen in 3 of 80 (3,8%). The radiological control of the anastomoses with contrast swallow showed the leakage in two cases. Twice the results were false negative. The sensitivity of computed tomography was 100%. Discussion Routine radiological control of anastomoses with contrast swallow only has low sensitivity. This procedure should not be performed routinely any more. The radiological control should be used in cases with signs of anastomotic leakage or with postoperatively impaired gastrointestinal passage. PMID:21070633

  15. NOTE: Polyhydramnios and arterio-arterial placental anastomoses may beneficially affect monochorionic twin pregnancies

    NASA Astrophysics Data System (ADS)

    van Gemert, Martin J. C.; Kranenburg-Lakeman, Phillis; Milovanovic, Zeljko; Vergroesen, Isabelle; Boer, Kees

    2001-03-01

    Our objective was to appraise whether an increased amniotic fluid pressure by polyhydramnios can beneficially affect monochorionic twins that are haemodynamically connected by arterio-venous plus arterio-arterial placental anastomoses. We assessed the effects of polyhydramnios in monochorionic twin placentas, combining (a) data from previous in vitro placental perfusion experiments in singleton term placentas under simulated normal and increased amniotic fluid pressures with (b) logical deduction from observations made in monochorionic twins. Our hypothesis is that in monochorionic placentas, an increased amniotic fluid pressure increases the placental microvascular resistance but not the resistance of placental chorionic plate arteries. Hence, an increased amniotic fluid pressure increases the microvascular resistance of the joint cotyledon, the arterio-venous resistance, but not the arterio-arterial resistance. This proposed mechanism reduces arterio-venous but not oppositely directed arterio-arterial transfusion. Therefore, reversal of the normal direction of net foeto-foetal transfusion may develop, which will reduce the circulatory imbalance that evolved between the monochorionic foetal twins. In contrast, in monochorionic twins connected by unidirectional or bidirectional arterio-venous anastomoses reversal of the normal direction of net foeto-foetal transfusion will not occur. In conclusion, reversal of the normal direction of net foeto-foetal transfusion, induced by polyhydramnios, is protective against the onset and severity of twin-twin transfusion syndrome in monochorionic twins connected by arterio-venous plus arterio-arterial anastomoses, but not by unidirectional or bidirectional arterio-venous anastomoses.

  16. Venous Thrombosis in Handsewn vs. Coupled Venous Anastomoses in 857 Consecutive Breast Free Flaps

    PubMed Central

    Kulkarni, Anita R; Mehrara, Babak J; Pusic, Andrea L; Cordeiro, Peter G; Matros, Evan; McCarthy, Colleen M; Disa, Joseph J

    2016-01-01

    Background The Anastomotic Coupling Device has demonstrated safety and efficacy; however, the coupler has never been compared directly to handsewn venous anastomoses exclusively in breast reconstruction. We hypothesized that rates of venous thrombosis would be lower using the coupler versus handsewn anastomoses in free flap breast reconstruction. Methods We performed a retrospective review utilizing clinic records, hospital records, and operative reports for 857 consecutive breast free flaps at a single institution from 1997-2012. Data was collected on reconstruction type, recipient vessels, timing, laterality, preoperative radiation, chemotherapy, venous thrombosis, and flap outcome. We compared rates of venous thrombosis between handsewn and coupled anastomoses for breast free flaps. Chi square test was used to calculate statistical significance. Results A total of 857 consecutive free flaps were performed for breast reconstruction in 647 patients over 16 years. The venous anastomosis was handsewn in 303 flaps, and the anastomotic coupler was used in 554 flaps. The rate of venous thrombosis requiring anastomotic revision in the handsewn group was 0.04% (12/303), compared to 0.01% in the coupled group (8/554; p=0.02). Conclusion The anastomotic coupler was more effective in preventing venous thrombosis than handsewn anastomoses in our series. While our study demonstrates improved patency rates using the venous coupler in breast reconstruction, we were unable to definitively separate this finding from potential confounding variables due to the low rates of thrombosis in both groups. Our data is consistent with current literature, which suggests that the coupler is a safe and effective alternative to hand sutured anastomoses. PMID:26372685

  17. Retinal vein-to-vein anastomoses in Sturge-Weber syndrome documented by ultra-widefield fluorescein angiography.

    PubMed

    Quan, Ann V; Moore, Grant H; Tsui, Irena

    2015-06-01

    We report the case of a 6-year-old boy with Sturge-Weber syndrome and unilateral glaucoma in his left eye. He was born with a port wine mark involving his upper left eyelid. On ultra-widefield fluorescein angiography, he was found to have several vein-to-vein anastomoses in his left retina. To our knowledge, this is the first documentation of retinal vein-to-vein anastomoses in Sturge-Weber syndrome. PMID:25944745

  18. Collagen deposition and mechanical strength of colon anastomoses and skin incisional wounds of rats.

    PubMed

    Oxlund, H; Christensen, H; Seyer-Hansen, M; Andreassen, T T

    1996-11-01

    The mechanical strength development of healing wounds depends on the formation of collagen fibrils bridging the wound cleft. A considerable deposition, degradation, and remodeling of these fibrils takes place influencing the mechanical strength of the healing wounds. A method for studies of wound collagen metabolism in vivo is delineated, enabling determination of collagen deposition per hour in rat colon anastomoses and skin incisional wounds. Labeled proline was incorporated into wound collagen with a flooding dose of unlabeled proline, reducing errors introduced by proline recycling and proline de novo synthesis. The mechanical strength was determined by a materials testing machine. In both colon anastomoses and skin wounds a substantial increase in collagen deposition was observed at Day 2, reached a maximum at Day 6, and was still relatively high at Day 12 during the remodeling of collagen fibers in the wound cleft. The collagen deposition in colon anastomoses at Day 6, however, was 10-fold higher compared with that of the skin incisional wounds. The time course of the collagen deposition was much alike in colon anastomoses and skin incisional wounds reaching a maximum at Day 6. The mechanical strength of these two rather different types of wounds was increased correspondingly and to the same level during the 1st week of healing. The measurements of collagen deposition, collagen content, and biomechanical strength indicated a substantial turnover of newly synthesized and deposited collagen during the early phases of wound healing. On the basis of this, it seems obvious that even small disturbances to the balance between collagen synthesis, deposition, collagen cross-linking, and collagen degradation/remodeling may result in defective wound healing. PMID:8954827

  19. Decreased leakage rate of colonic anastomoses by tachosil coating: an experimental study.

    PubMed

    Pommergaard, Hans-Christian; Achiam, Michael Patrick; Burcharth, Jakob; Rosenberg, Jacob

    2014-01-01

    Colorectal anastomotic coating has been proposed as a means to lower the leakage rate. Prior to clinical testing, coating materials need thorough experimental evaluation to ensure safety and efficacy. The aim of this study was to evaluate Tachosil as an anastomotic coating agent. Technically insufficient colon anastomoses were created in 80 C57BL/6 mice, and in half of the animals the anastomoses were covered with Tachosil. The animals were examined for clinical signs of anastomotic leakage, and the breaking strength of the anastomoses was evaluated. The number of leakages was reduced by Tachosil coating (10/40 versus 20/40 in controls; P=0.037). However, more cases of large bowel obstruction were found in the Tachosil group (12/40 versus 0/40 in controls; P<0.0005). Breaking strength was comparable between the Tachosil and control groups (0.49 N versus 0.52 N, respectively; P=0.423). Clinical studies are needed to clarify the efficacy of Tachosil anastomotic coating. PMID:25058765

  20. Fibrinogen and thrombin concentrations are critical for fibrin glue adherence in rat high-risk colon anastomoses

    PubMed Central

    Buen, Eliseo Portilla-de; Orozco-Mosqueda, Abel; Leal-Cortés, Caridad; Vázquez-Camacho, Gonzalo; Fuentes-Orozco, Clotilde; Alvarez-Villaseñor, Andrea Socorro; Macías-Amezcua, Michel Dassaejv; González-Ojeda, Alejandro

    2014-01-01

    OBJECTIVE: Fibrin glues have not been consistently successful in preventing the dehiscence of high-risk colonic anastomoses. Fibrinogen and thrombin concentrations in glues determine their ability to function as sealants, healers, and/or adhesives. The objective of the current study was to compare the effects of different concentrations of fibrinogen and thrombin on bursting pressure, leaks, dehiscence, and morphology of high-risk ischemic colonic anastomoses using fibrin glue in rats. METHODS: Colonic anastomoses in adult female Sprague-Dawley rats (weight, 250-350 g) treated with fibrin glue containing different concentrations of fibrinogen and thrombin were evaluated at post-operative day 5. The interventions were low-risk (normal) or high-risk (ischemic) end-to-end colonic anastomoses using polypropylene sutures and topical application of fibrinogen at high (120 mg/mL) or low (40 mg/mL) concentrations and thrombin at high (1000 IU/mL) or low (500 IU/mL) concentrations. RESULTS: Ischemia alone, anastomosis alone, or both together reduced the bursting pressure. Glues containing a low fibrinogen concentration improved this parameter in all cases. High thrombin in combination with low fibrinogen also improved adherence exclusively in low-risk anastomoses. No differences were detected with respect to macroscopic parameters, histopathology, or hydroxyproline content at 5 days post-anastomosis. CONCLUSIONS: Fibrin glue with a low fibrinogen content normalizes the bursting pressure of high-risk ischemic left-colon anastomoses in rats at day 5 after surgery. PMID:24714834

  1. Preliminary results of laser-assisted sealing of hand-sewn canine esophageal anastomoses

    NASA Astrophysics Data System (ADS)

    Auteri, Joseph S.; Oz, Mehmet C.; Sanchez, Juan A.; Bass, Lawrence S.; Jeevanandam, Valluvan; Williams, Matthew R.; Smith, Craig R.; Treat, Michael R.

    1991-07-01

    Dehiscence rates of esophageal anastomoses range between 5 and 20%. Causative factors include ischemia, tension, foreign body reaction, microabscesses, and the negative pressure within the thoracic cavity. Laser assisted tissue sealing (LATS) has been shown to decrease anastomotic leakage rates in other tissues. Using a canine model the efficacy of LATS in enhancing single layer hand swen intrathoracic esophageal anastomoses was assessed. Via a left thoracotomy, paired two centimeter transverse incisions (one laser sealed, one control) were made in the proximal and distal esophagus in nine dogs. Both were sewn using a single layer of 4-0 polyglycolic acid. A combination of albumin (0.2 cc), sodium hyaluronate (0.4 cc), and indocyanine green (1 gtt) was applied to one of the randomly chosen hand sewn repairs. The albumin/hyaluronate combination is used to provide a protein matrix across the anastomosis for ingrowth of fibroblasts. Indocyanine green dye selectively absorbs at OM805 nm which matches the output of the diode laser (808 +/- 1 nm), thus improving uptake of laser energy by the targeted tissues. The anastomosis was then exposed to continuous wave diode laser energy for OM2 minutes at a power density of 9.6 W/cm2. The esophagus was recovered either at the time of sealing or two days postoperatively and infused with saline under pressure. Bursting pressures were considered the point of initial saline leakage. At time 0 there was no significant difference in bursting pressures between the LATS group and controls. However, at two days postoperatively controls burst at 121 +/- 14 mmHg while the laser assisted anastomoses burst at 295 +/- 35 mmHg (p < .005). HPS staining of uninjured portions of the laser sealed anastomoses revealed minimal thermal injury to the mucosal surface initially, with some regeneration of mucosal lining at two days postoperatively. No foreign body reaction to the solder was noted. Laser reinforcement of single layer hand sewn esophageal

  2. Blood flow through arteriovenous anastomoses and its thermal function in the laying hen.

    PubMed Central

    Wolfenson, D

    1983-01-01

    1. Total (arteriovenous anastomoses + capillary) blood flow (t.b.f.) and capillary blood flow (c.b.f.) distribution were determined by 52 and 15 micron microspheres respectively, in body organs of six unanaesthetized laying hens, exposed to thermoneutral air temperatures. 2. Statistically significant differences between t.b.f. and c.b.f. were only found in the unfeathered metatarsal skin, comb and wattles. The c.b.f. constituted 22, 42 and 45% of t.b.f. respectively, indicating significant arteriovenous anastomoses (a.v.a.) blood flow. Differences between t.b.f. and c.b.f. were small in the two larger ovarian follicles and digestive tract and were negligible in reproductive tract, liver and kidney. 3. Microspheres of different size have been injected into the external ischiadic artery in order to examine the vasomotor responses of leg tissues in twenty-one hens kept in thermoneutral, cold or hot conditions. 4. In cold, thermoneutral and hot conditions 1, 16 and 35% of whole leg blood flow respectively passed through a.v.a. Only c.b.f. was present in bone and muscle in either treatment; cold and heat reduced it in bones and cold increased it in muscles. Arteriovenous anastomoses blood flow appeared mostly in unfeathered skin; it constituted 17, 53 and 83% of t.b.f. to this tissue in cold, thermoneutral and hot conditions, while t.b.f. increased from 1.4 to 14% and 30% of whole leg blood flow respectively. Blood flow to feathered skin decreased during heat and cold. PMID:6864561

  3. Uterus transplantation model in sheep with heterotopic whole graft and aorta and cava anastomoses.

    PubMed

    Gonzalez-Pinto, I M; Tryphonopoulos, P; Avison, D L; Nishida, S; Tekin, A; Santiago, S; Tzakis, A G

    2013-06-01

    Uterine transplantation in the sheep model has been described as a partial or whole orthotopic graft from a living donor with vascular anastomoses. As an alternative to surrogate pregnancy or adoption uterus transplantation might be indicated for cases of infertility of uterine origin. The main complications might be rejection and thrombosis. The objective of this work was to develop a model of whole uterus transplantation that was applicable to the human setting, using grafts obtained from brain-dead donors, and suitable for immunologic and viability follow-up with a reduced risk of thrombosis. Two donors and 1 recipient were operated. The first graft was used for an anatomic study; the second was used for transplantation. The donor operation consisted of an en bloc harvest of the uterus, adnexa, and proximal vagina with the distal aorta and cava. After harvest the donor sheep was humanely killed. In the recipient ewe, heterotopic implantation was performed in the lower abdomen. An End-to-side anastomoses of aorta and cava were performed below the recipient's renal vessels. A cutaneous vaginal stoma was performed in the right lower quadrant. The recipient ewe was humanely killed for an autopsy study. The anatomy of uterine veins of the ewe differs from the human. The uterine and ovarian veins join, forming the utero-ovarian vein, which drains at the confluence of the common iliac to the cava. En bloc harvesting allows for rapid graft preparation, with vascular cuffs easily anastomosed with a low risk of thrombosis. The vaginal stoma seems appropriate to facilitate follow-up and graft biopsy. This approach can be a suitable experimental model applicable to humans using grafts from brain-dead donors. PMID:23769047

  4. Anastomosing hemangioma arising from the kidney: a case of slow progression in four years and review of literature

    PubMed Central

    Zhang, Wei; Wang, Qiang; Liu, Yu-Lin; Yu, Wen-Juan; Liu, Yan; Zhao, Hui; Zhuang, Jie; Jiang, Yan-Xia; Li, Yu-Jun

    2015-01-01

    Reported herein is a renal anastomosing hemangioma which developed slowly in the past four years. A 25-year-old woman was found a mass localized in the upper portion four years ago, and only slow progression in the past four years. She underwent a laparoscopic partial nephrectomy of right kidney and diagnosed as anastomosing hemangioma. On histology the vascular components of the tumor had an anastomosing pattern without well-definite margins. Immunohistochemically, only endothelial markers (CD31, CD34) were expressed on the vascular components of tumor cells. Smooth muscle actin (SMA), cytokeratin (CK), EMA and S-100 and so on were all negative in the epithelioid tumor cells. The patient was alive at 16 months after operation, without any evidence recurrence or metastasis. Anastomosing hemangioma is an extremely rare vascular neoplasm; only 23 cases were previously described until now. Our report of anastomosing hemangioma arising from the kidney with slow progression will improve the knowledge of primary vascular tumors arising in the kidney. PMID:25973131

  5. Lymphoscintigraphy as an adjunctive procedure in the perioperative assessment of patients undergoing microlymphaticovenous anastomoses

    SciTech Connect

    Sacks, G.A.; Sandler, M.P.; Born, M.L.; Clanton, J.A.; Franklin, J.D.; Partain, C.L.

    1983-07-01

    Microlymphaticovenous anastomoses provide a potential for reducing lymphedema of the upper extremity complicating radical mastectomy or irradiation. Lymphoscintigraphy with technetium isotopes is a valuable investigative modality in the perioperative evaluation of patients undergoing this surgical procedure. The radionuclide studies provide information regarding structural change and physiologic derangement with a low radiation dose to the patient. It is a simple, painless procedure requiring minimal skill and no surgical intervention. In addition, a reproducible method for preparing a radiocolloid suitable for lymphatic imaging using an approved drug as a precursor has been developed.

  6. [Evaluation of a 20 years' experience of colo-anal anastomoses. Indications, results and pitfalls].

    PubMed

    Hautefeuille, P; Saab, M; Valleur, P

    1991-01-01

    Seventy nine anastomoses were performed over a 20 year period. Indications included 68 rectal adenocarcinomas and 11 benign lesions. There was no operative mortality. Anastomotic leak was the main cause of morbidity: 12 clinical (15%) and 4 radiological leaks. The 5-year actuarial disease-free survival was 70%, 7 local recurrences (10%) were observed; 6 were Dukes C and 1 Dukes B. Functional results were assessed in 61 patients. They were considered to be excellent in 35 (57%), good in 24 (39%) and bad in 2 (4%). Six failures were noted: 3 technical, 1 oncologic and 2 functional. Pitfalls of coloanal anastomosis are discussed. PMID:2064292

  7. NOTE: Thrombosis of anastomoses may affect the staging sequence of twin twin transfusion syndrome

    NASA Astrophysics Data System (ADS)

    van den Wijngaard, Jeroen P. H. M.; Ross, Michael G.; van Gemert, Martin J. C.

    2008-03-01

    Twin-twin transfusion syndrome (TTTS) is a severe complication of monozygotic (identical) twins, which share one single monochorionic placenta. It is caused by placental anastomoses which link the two fetoplacental circulations of the twins and allow a chronic net inter-twin transfusion to develop between the fetuses. Clinical presentation of TTTS manifestations has been classified into five different stages. In this paper, we used our computational model of TTTS and examined the possible differences between chronic and rapidly increasing inter-twin transfusion in the simulated TTTS staging sequence. Our results suggest that rapid alterations in the net inter-twin transfusion, e.g. due to thrombosis of placental anastomoses, may produce a different staging sequence than in TTTS caused by chronic inter-twin transfusion. These results may aid an improved knowledge of TTTS pathophysiology under conditions of a rapidly changing cardiovascular function, and contribute to the planning of optimal intervention under such circumstances. Supported in part by the European Community Euro-twin-2-twin project (JPHMvdW) and by the National Institutes of Health, grant HL40899 (MGR).

  8. Microarterial anastomoses: A parameterised computational study examining the effect of suture position on intravascular blood flow.

    PubMed

    Wain, R A J; Hammond, D; McPhillips, M; Whitty, J P M; Ahmed, W

    2016-05-01

    This study investigates the extent to which individual aspects of suture placement influence local haemodynamics within microarterial anastomoses. An attempt to physically quantify flow characteristics of blood past microvascular sutures is made using computational fluid dynamics (CFD) software. Particular focus has been placed on increased shear strain rate (SSR), a known precipitant of intravascular platelet activation and thrombosis. Measurements were taken from micrographs of sutured anastomoses in chicken femoral vessels, with each assessed for bite width, suture angle and suture spacing. Computational geometries were then created to represent the anastomosis. Each suture characteristic was parameterised to allow independent or simultaneous adjustment. Flow rates were obtained from anonymised Doppler ultrasound scans of analogous vessels during preoperative assessment for autologous breast reconstruction. Vessel simulations were performed in 2.5mm ducts with blood as the working fluid. Vessel walls were non-compliant and a continuous Newtonian flow was applied, in accordance with current literature. Suture bite angle and spacing had significant effects on local haemodynamics, causing notably higher local SSRs, when simulated at extremes of surgical practice. A combined simulation, encompassing subtle changes of each suture parameter simultaneously i.e. representing optimum technique, created a more favourable SSR profile. As such, haemodynamic changes associated with optimum suture placement are unlikely to influence thrombus formation significantly. These findings support adherence to the basic principles of good microsurgical practice. PMID:26876115

  9. Blood flow through sutured and coupled microvascular anastomoses: a comparative computational study.

    PubMed

    Wain, Richard A J; Whitty, Justin P M; Dalal, Milind D; Holmes, Michael C; Ahmed, Waqar

    2014-07-01

    This study uses computational fluid dynamics (CFD) to model blood flow through idealised sutured and coupled arterial anastomoses to investigate the affect of each technique on intravascular blood flow. Local flow phenomena are examined in detail to study characteristics that potentially initiate thrombus formation; for example, changes in velocity profile, wall shear stress (WSS), and shear strain rate (SSR). Idealised geometries of sutured and coupled anastomoses were created with dimensions identical to microvascular suture material and a commercially available coupling device using CFD software. Vessels were modelled as non-compliant 1 mm diameter ducts, and blood was simulated as a Newtonian fluid, in keeping with previous studies. All analyses were steady-state and performed on arteries. The sutured simulation revealed a reduced boundary velocity profile; high WSS; and high SSR at the suture sites. The coupled anastomosis simulation showed a small increase in maximum WSS at the anastomotic region compared to a pristine vessel, however, this was less than half that of the sutured model. The coupled vessel displayed an average WSS equivalent to a pristine vessel simulation. Taken together these observations demonstrate a theoretically more thrombogenic profile in a sutured anastomosis when compared to a coupled vessel. Data from simulations on a coupled anastomosis reveal a profile that is nearly equivalent to that of a pristine vessel. Based purely on the combination of less favourable flow properties shown using these idealised arterial models, the sutured method is potentially more thrombogenic than a coupled anastomosis. PMID:24731801

  10. [A Case of ECA-MCA Double Anastomoses for Hemorrhagic Type of Twig-Like MCA].

    PubMed

    Inoue, Akihiro; Kohno, Kanehisa; Fukumoto, Shinya; Ichikawa, Haruhisa; Onoue, Shinji; Miyazaki, Hajime; Ozaki, Saya; Iwata, Shinji

    2016-06-01

    Herein, we describe the case of a superficial temporal artery(STA)- and occipital artery (OA)-middle cerebral artery (MCA) double anastomoses that we performed to treat a hemorrhagic twig-like MCA. A 55-year-old man presented to our hospital for investigation of an incidentally identified left MCA occlusion. Left cerebral angiography revealed a twig-like MCA. The (123)I-IMP-single photon emission computed tomography( SPECT) demonstrated no reduction in the cerebral blood flow (CBF), so the patient was initially observed with no treatment. Three months later, he was readmitted with a disturbance of consciousness. The cranial computed tomography revealed a subcortical hemorrhage in the left frontotemporal region and a subdural hematoma. The hematoma was removed via emergency craniotomy. The abnormal vessels were identified and resected, but the parietal branch of the STA was damaged during the skin incision. The histological examination did not reveal the marked fibrous thickening of the intima or wavy internal elastic lamina typically seen with Moyamoya disease. Six months after the initial surgery, a STA-MCA bypass surgery was planned to prevent a future hemorrhage by reducing the hemodynamic overload of the twig-like MCA and improving the cerebral ischemia in the MCA territory that was detected on the preoperative SPECT. However, the parietal branch of the left STA had been injured during the first operation, so we performed a double anastomoses to the MCA using the frontal branch of the STA and the OA. The patient's postoperative course was uneventful and he was discharged 2 weeks after surgery. The follow-up study performed 1 year postoperatively demonstrated no evidence of cerebral infarction and revealed an improvement in the resting CBF and vascular reactivity in the left cerebral hemisphere. No subsequent cerebrovascular events have occurred in this patient during the 7 years since the double anastomoses surgery. Direct bypass for flow conversion from the

  11. Histological characteristics of collagen denaturation and injuries in bipolar radiofrequency-induced colonic anastomoses.

    PubMed

    Zhao, Lingxi; Zhuo, Changhua; Song, Chengli; Li, Xinxiang; Zhou, Yu; Shi, Debing

    2015-03-01

    Bipolar radiofrequency-induced thermo-fusion has been explored as an advanced surgical method for intestinal anastomoses; however, the histological characteristics of collagen denaturation and injuries arising from this process remain unclear. The aim of this study was to investigate the microcosmic changes and tissue damage of fusion regions with various parameters of injury. Ex vivo colons of pigs were fused serosa-serosa on two carrier rings, which were installed on a homemade anastomotic device. Five levels of compressive pressure from 171 to 313 kPa were applied for 5s to fuse the colons under radiofrequency power of 160 W, and then the collagen denaturation of the fused region was examined by transmission electron microscopy. Light microscopy was utilized to observe histological slices that were stained with picrosirius red in order to visualize the tissue injuries under two levels of radiofrequency power (120 vs. 140 W) and operation time (5 vs. 10s). Transmission electron micrographs showed that increased compressive pressure led to thicker denatured collagen fibrils and wider gaps between each collagen fibril. Serosa adhesion regions appeared abundant in collagen. No histological differences were observed when 120 W of power was applied for 5 and 10s. Significant muscle cracking occurred when colons were fused using 140 W for 5s. When the operation time was extended to 10s, 140 W led to tight fusion and less splitting on muscles. These results suggest that higher compressive pressure results in more severe collagen unfolding and also reduces collagen crosslinking in fused colons. Improved radiofrequency power along with operation time could avoid tissue injury upon radiofrequency-induced colonic anastomoses. PMID:25434604

  12. Characteristics of bedrock-alluvial anastomosed rivers: the Mekong River in Cambodia

    NASA Astrophysics Data System (ADS)

    Meshkova, Liubov. V.; Carling, Paul. A.

    2010-05-01

    The Mekong River is the 12th largest river in the world in terms of its length and mean annual discharge and yet it is poorly investigated. In the north eastern regions of Cambodia the Mekong River develops a multichannel pattern. It is characterised by a complex of intersecting bedrock channels, well vegetated alluvial and seasonally inundated islands, various types of sand bars, numerous bedrock exposures, rapids, waterfalls and deep bedrock pools which can be classified as a large mixed bedrock-alluvial anastomosed river of a tropical monsoonal climate zone. In order to complete a portrait of the river at the high level of details new data on morphology, geology and sediments were obtained during field surveys of a 120 km river section in Cambodia and combined with information from published literature and interpretation of available remote sensing images. This process has enabled to update and clarify knowledge on morphology of observed islands and floodplain, comprehensive geology and tectonic structures, hydrological regime and land cover. Complex analyses of the collected data have distinguished several geomorphological zones accordingly to frequency of morphological elements, the planview configuration of channels and vertical profile characteristics. The occurrence of each zone is a subject of variable controlling factors such as local topography, channel gradient, structural and tectonic elements and intercalating geological units. Evolution of the channel pattern has been considered at both short- and long term time scales. Historical cartographic and remote sensing materials were applied to determine planform channel changes over the last 50 years revealing the channels stability and cases of occasional, local erosion and deposition. The channel network was extracted from vector layers to examine channels and islands width and length parameters, bifurcation angles at the upstream end of islands and to obtain main channel network indices such as braiding

  13. The microvascular anastomotic coupler for venous anastomoses in free flap breast reconstruction improves outcomes

    PubMed Central

    Rozen, Warren Matthew; Chowdhry, Muhammad; Patel, Nakul Gamanlal; Chow, Whitney T.H.; Griffiths, Matthew; Ramakrishnan, Venkat V.

    2016-01-01

    Background Venous couplers are ubiquitous around the world and are a useful tool for the reconstructive microsurgeon. A systematic review of coupler performance studies demonstrated a thrombosis rate range of 0% to 3%, whilst the average time of using the device is 5 minutes. There is sparse published data on cost analysis and the impact of operator experience on the anastomotic coupler device success. Improvements in outcomes other than time benefits have also not been shown. This study aims to address these deficiencies in the literature. Methods A retrospective clinical study was undertaken, aiming to compare equivalent groups of patients that had free flap surgery with venous micro-anastomoses with those that had sutured anastomoses. The cohort comprised all patients undergoing microsurgical breast reconstruction at the St Andrew’s Centre for Plastic Surgery & Burns from January 2009 to December 2014. Results Between January 2010 to December 2014, 1,064 patients underwent 1,206 free flap breast reconstructions. The average age of patients was 50 years. Seventy percent of patients underwent mastectomy and immediate reconstruction during this period with the remaining 30% having a delayed reconstruction. The 1,206 free flaps comprised of 83 transverse myocutaneous gracilis (TMG) flaps, and 1,123 deep inferior epigastric artery perforator (DIEP) flaps. In total the coupler was used in 319 flaps, 26% of the cohort. There was a statistically significant clinical benefit in using the anastomotic coupler for venous anastomosis. Overall, the return to theatre rate was 12.69% whilst the overall flap loss rate was 0.75%. The overall coupler failure rate was significantly less at 1.4% whilst sutured vein failure rate was 3.57% (P=0.001). Conclusions The anastomotic coupler for venous anastomosis in free flap surgery is associated with reduced operating times, reduced take-backs to theatre and cost benefits. This is the first study to demonstrate clear clinical benefits

  14. On the bulky appliances and artero-venous anastomoses in the vascular district of the base of the brain.

    PubMed

    Acone, F; Sanna, M; Cappai, M G; Bo Minelli, L; Gazza, F; Botti, M

    2000-01-01

    It has been studied the vascular territory of the base of the brain and it has been pointed out the presence of characteristical structural arrangements of the vasal wall and artero-venous anastomoses. The just mentioned characteristical structures are placed in points where a vessel divides itself or creates a collateral branch and their functional engagement is target-oriented to control the blood flux. PMID:11043440

  15. Laser therapy for twin-twin transfusion syndrome in the absence of fetoscopically visible placental vascular anastomoses.

    PubMed

    Ishii, Keisuke; Taguchi, Takako; Yamamoto, Ryo; Murata, Masaharu; Sasahara, Jun; Mitsuda, Nobuaki

    2013-01-01

    Fetoscopic laser photocoagulation (FLP) was performed at 22 weeks of gestation for a pregnancy complicated with twin-twin transfusion syndrome (TTTS) and an anterior placenta. However, vascular anastomoses could not be identified by the fetoscope. To dichotomize the circulation between the twins, the terminal ends of the paired artery and vein of the recipient twin were coagulated. In addition, a line was drawn with the laser connecting the dots, which had been coagulated. The Doppler waveform as well as the amniotic fluid volume of each twin normalized after the procedure. The twins were delivered by cesarean section subsequent to onset of labor at gestational week 30; the recipient twin weighed 1,350 g and the donor twin weighed 550 g. Both twins had a normal neurologic exam at 6 months of age. Patent placental vascular anastomoses could not be detected. This case demonstrates that vascular anastomoses in TTTS may not be identified by a fetoscope and that FLP to coagulate the entire vascular equator closer to the area of the recipient twin was effective in this rare situation. PMID:24008354

  16. Seasonal evolution of subglacial drainage pathways within a soft bedded anastomosing system

    NASA Astrophysics Data System (ADS)

    Hart, Jane; Young, David; Martinez, Kirk

    2016-04-01

    We have studied the dynamic annual subglacial behavior associated with Skálafellsjökull, Iceland, a temperate glacier resting on a deformable sediment layer, using subglacial wireless probes to measure till water pressure and tilt, surface installations to measure glacier motion, and a camera to measure river discharge. We argue that the subglacial hydrology system changes throughout the year from a fast connected system in the spring and autumn (with balanced inputs and outputs), to a duel system in summer with fast channels and slow moving storage (with greater inputs than outputs). In winter there is an episodic fast system associated with high meltwater input accompanied by changes in till water pressure and ice velocity and releases of water from a heterogeneous storage sources to produce some of the largest annual discharges. We develop models to relate the observed summer and winter discharges to daily ice surface melt. We demonstrate that there is a subglacial anastomosing system, consisting of water sheets at the ice-bed interface, bedrock cavities, braided channels with associated back-water reservoir areas, which has the ability to rapidly change channel form depending on melt-water inputs, and easily access water stored within a series of linked subglacial reservoirs.

  17. Self-anastomosing ability and vegetative incompatibility of Tuber borchii isolates.

    PubMed

    Sbrana, Cristiana; Nuti, Marco P; Giovannetti, Manuela

    2007-11-01

    In this work, different mycelial isolates of the ectomycorrhizal fungus Tuber borchii were analysed for their ability to form self-anastomoses, which were monitored by time-lapse live-cell imaging, providing a description of the anastomosis process. Self-fusions were evidenced in three out of five isolates, with frequencies ranging between 50 and 88% of hyphal contacts. Time-lapse video microscopy evidenced that during pre-contact events, hyphae were capable of growth re-orientation functional to hyphal contact: the time elapsed between hyphal growth re-direction and complete fusion ranged from 115 to 200 min. After anastomosis, protoplasmic flow occurred between fused hyphae and nuclei could be detected in fusion bridges. Vegetative incompatibility was also assessed by analysing macroscopic and microscopic hyphal interactions between paired T. borchii mycelia. Both plate-pairing tests and microscopic analyses showed vegetative compatibility only within the same isolate, whereas different degrees of incompatible responses were observed in inter-isolate pairings. The diversity of T. borchii strains revealed by cytomorphological approaches is consistent with their genetic diversity obtained by molecular methods. PMID:17721790

  18. Review of renal anastomosing hemangioma with focus on clinical and pathological aspects.

    PubMed

    Kuroda, N; Ohe, C; Deepika, S; Yorita, K; Mikami, S; Furuya, M; Nagashima, Y; Hes, O; Agaimy, A; Michal, M; Amin, M B

    2016-06-01

    Renal anastomosing hemangiomas (RAH) has been recently proposed as a new entity. In this article, we summarize the clinicopathologic features of this tumor. RAH usually develops on a background of end-stage renal disease. Macroscopically, tumors are well-defined and their cut surface shows mahogany brown spongy tissue with epicenter in the renal medulla. Tumors are usually small, but larger lesions are reported. On microscopic examination, the tumor consists of sinusoid-like vascular channels lined by cuboidal endothelial cells with occasional hobnail-like appearance of endothelial cells closely mimicking splenic sinusoids. Eosinophilic hyaline globules may be present in the cytoplasm of neoplastic endothelial cells. Extramedullary hematopoiesis containing erythroid precursor and megakaryocytes may be present in the vascular lumens. Immunohistochemically, endothelial cells are positive for CD31 and CD34, but negative for D2-40, GLUT-1 and HHV8. The surrounding stroma around endothelial cells demonstrates positivity for  smooth muscle action. To date, there are no studies on molecular genetic aspects of RAH. This tumor is indolent based on site and size of the lesion, partial or nephrectomy is sufficient as a therapeutic modality. PMID:27543862

  19. The effects of nitroglycerin, norepinephrine and aminophylline on intrapulmonary arteriovenous anastomoses in healthy humans at rest.

    PubMed

    Lozo, Mislav; Lojpur, Mihajlo; Madden, Dennis; Lozo, Petar; Banic, Ivana; Dujic, Zeljko

    2014-08-01

    We have investigated the effects of the intravenous infusion of nitroglycerin (NTG), norepinephrine (NE) and aminophylline (AMP) on the opening and recruitment of intrapulmonary arteriovenous anastomoses (IPAVA) in healthy humans at rest. In ten volunteers saline contrast echocardiography was performed during administration of two doses of the NTG (3μgkg(-1)min(-1) and 6μgkg(-1)min(-1)) and NE (0.1μgkg(-1)min(-1) and 0.25μgkg(-1)min(-1)) as well as 30min following the administration of AMP at rate of 6mgkg(-1). Echocardiography was used to assign bubble scores (0-5) based on the number and spatial distribution of bubbles in the left ventricle. Doppler ultrasound was used to estimate pulmonary artery systolic pressure. Using a Finometer the following hemodynamic parameters were assessed: heart rate, stroke volume, cardiac output, total peripheral resistance as well as systolic, diastolic and mean arterial pressure. The most important finding from the current study was that nitroglycerin, norepinephrine and aminophylline in the applied doses were not found to promote IPAVA opening in healthy humans at rest. PMID:24802049

  20. The double transverse microvascular clamp: a new instrument for microsurgical anastomoses.

    PubMed

    El-Shazly, Mohamed

    2012-11-01

    Since the introduction of microvascular surgeries, the sophisticated ideas and techniques of tissue transplantations are continually advancing and searching for the best work conditions to present the best outcomes in these critical interferences. Every tissue transplant has its donor vessels, artery and vein, which should be anastomosed to recipient vessels. A new instrument, the double transverse microvascular clamp (DTMC), has been developed to be applied simultaneously, as one clamp, to both the artery and its accompanying vein. The transverse design of this clamp keeps the artery separate from its vein, allowing each anastomosis to be performed more easily. The limited clamp surface area minimizes the glazing and blurring effects. Applying only one clamp to the two vessels presents more work space and overcomes the crowdedness caused by the use of two single clamps. Using a DTMC on both the recipient and donor vessels provides optimal suture maneuverability and ideal work situation compared with the use of two double approximating clamps. We believe this DTMC would be a valuable addition to the microsurgical instruments market. PMID:22711201

  1. Anastomosing channels and arroyo development on the Nogoa River, Central Queensland, Australia

    NASA Astrophysics Data System (ADS)

    Finlayson, B. L.; Brizga, S. O.

    1993-05-01

    It is widely accepted that European settlement in Australia has had a major impact on river channels. For many parts of Australia records are available which permit the history of channel changes to be reconstructed over most of the post-settlement period. In this paper the history of changes on part of the Nogoa River in Central Queensland is described from the first European contact until the present. The river channel at this site has changed from an anastomosing pattern to a single large channel (arroyo). There is evidence to suggest that such changes have occurred also in the past but an unusual feature of the present incision phase is that incision is synchronous throughout the region. This may have been triggered by the introduction of cattle which naturally congregate in the moister valley bottoms in this otherwise dry environment. The changes observed here reflect those reported for the semiarid regions of the USA. A linking factor appears to be hydrological behaviour characterised by high levels of variability in the annual flood series, which appears to render such streams more sensitive to disturbance than those with less variable flood behaviour.

  2. Effects of bromopride on expression of metalloproteinases and interleukins in left colonic anastomoses: an experimental study.

    PubMed

    Silva, S M; Jerônimo, M S; Silva-Pereira, I; Bocca, A L; Sousa, J B

    2014-10-01

    Anastomotic dehiscence is the most severe complication of colorectal surgery. Metalloproteinases (MMPs) and interleukins (ILs) can be used to analyze the healing process of anastomosis. To evaluate the effects of bromopride on MMP and cytokine gene expression in left colonic anastomoses in rats with or without induced abdominal sepsis, 80 rats were divided into two groups for euthanasia on the third or seventh postoperative day (POD). They were then divided into subgroups of 20 rats for sepsis induction or not, and then into subgroups of 10 rats for administration of bromopride or saline. Left colonic anastomosis was performed and abdominal sepsis was induced by cecal ligation and puncture. A colonic segment containing the anastomosis was removed for analysis of gene expression of MMP-1α, MMP-8, MMP-13, IL-β, IL-6, IL-10, tumor necrosis factor-α (TNF-α), and interferon-γ (IFN-γ). On the third POD, bromopride was associated with increased MMP-1α, MMP-13, IL-6, IFN-γ, and IL-10 gene expression. On the seventh POD, all MMP transcripts became negatively modulated and all IL transcripts became positively modulated. In the presence of sepsis, bromopride administration increased MMP-8 and IFN-γ gene expression and decreased MMP-1, TNF-α, IL-6, and IL-10 gene expression on the third POD. On the seventh POD, we observed increased expression of MMP-13 and all cytokines, except for TNF-α. In conclusion, bromopride interferes with MMP and IL gene expression during anastomotic healing. Further studies are needed to correlate these changes with the healing process. PMID:25140813

  3. Intrapulmonary arteriovenous anastomoses in humans--response to exercise and the environment.

    PubMed

    Lovering, Andrew T; Duke, Joseph W; Elliott, Jonathan E

    2015-02-01

    Intrapulmonary arteriovenous anastomoses (IPAVA) have been known to exist in human lungs for over 60 years. The majority of the work in this area has largely focused on characterizing the conditions in which IPAVA blood flow (Q̇IPAVA ) is either increased, e.g. during exercise, acute normobaric hypoxia, and the intravenous infusion of catecholamines, or absent/decreased, e.g. at rest and in all conditions with alveolar hyperoxia (FIO2 = 1.0). Additionally, Q̇IPAVA is present in utero and shortly after birth, but is reduced in older (>50 years) adults during exercise and with alveolar hypoxia, suggesting potential developmental origins and an effect of age. The physiological and pathophysiological roles of Q̇IPAVA are only beginning to be understood and therefore these data remain controversial. Although evidence is accumulating in support of important roles in both health and disease, including associations with pulmonary arterial pressure, and adverse neurological sequelae, there is much work that remains to be done to fully understand the physiological and pathophysiological roles of IPAVA. The development of novel approaches to studying these pathways that can overcome the limitations of the currently employed techniques will greatly help to better quantify Q̇IPAVA and identify the consequences of Q̇IPAVA on physiological and pathophysiological processes. Nevertheless, based on currently published data, our proposed working model is that Q̇IPAVA occurs due to passive recruitment under conditions of exercise and supine body posture, but can be further modified by active redistribution of pulmonary blood flow under hypoxic and hyperoxic conditions. PMID:25565568

  4. Intrapulmonary arteriovenous anastomoses in humans – response to exercise and the environment

    PubMed Central

    Lovering, Andrew T; Duke, Joseph W; Elliott, Jonathan E

    2015-01-01

    Intrapulmonary arteriovenous anastomoses (IPAVA) have been known to exist in human lungs for over 60 years. The majority of the work in this area has largely focused on characterizing the conditions in which IPAVA blood flow (IPAVA) is either increased, e.g. during exercise, acute normobaric hypoxia, and the intravenous infusion of catecholamines, or absent/decreased, e.g. at rest and in all conditions with alveolar hyperoxia ( = 1.0). Additionally, IPAVA is present in utero and shortly after birth, but is reduced in older (>50 years) adults during exercise and with alveolar hypoxia, suggesting potential developmental origins and an effect of age. The physiological and pathophysiological roles of IPAVA are only beginning to be understood and therefore these data remain controversial. Although evidence is accumulating in support of important roles in both health and disease, including associations with pulmonary arterial pressure, and adverse neurological sequelae, there is much work that remains to be done to fully understand the physiological and pathophysiological roles of IPAVA. The development of novel approaches to studying these pathways that can overcome the limitations of the currently employed techniques will greatly help to better quantify IPAVA and identify the consequences of IPAVA on physiological and pathophysiological processes. Nevertheless, based on currently published data, our proposed working model is that IPAVA occurs due to passive recruitment under conditions of exercise and supine body posture, but can be further modified by active redistribution of pulmonary blood flow under hypoxic and hyperoxic conditions. PMID:25565568

  5. Adhesions and Healing of Intestinal Anastomoses: The Effect of Anti-Adhesion Barriers.

    PubMed

    Ntourakis, Dimitrios; Katsimpoulas, Michail; Tanoglidi, Anna; Barbatis, Calypso; Karayannacos, Panayotis E; Sergentanis, Theodoros N; Kostomitsopoulos, Nikolaos; Machairas, Anastasios

    2016-06-01

    Background Postoperative adhesions are the result of aberrant peritoneal healing. As they are the leading cause of postoperative bowel obstruction, anti-adherence barriers are advocated for their prevention. This study looks into the effect of these biomaterials on the healing of intestinal anastomoses. Materials and Methods Thirty-three New Zealand White rabbits underwent laparotomy, transection of the terminal ileum, and creation of an end-to-end anastomosis. Animals were randomized into 3 groups: the Control group (n = 11); the Icodextrin group, receiving icodextrin 4% intraperitonealy (n = 11); and the HA/CMC group, having the anastomosis wrapped with a hyaluronic acid/carboxymethylcellulose film (n = 11). All animals were sacrificed on the seventh postoperative day. Macroscopic adhesions were graded and anastomotic strength was tested by the burst pressure. Histological healing was assessed in a semiquantitative way for the presence of ulceration, reepithelization, granulation tissue, inflammation, eosinophilic infiltration, serosal inflammation, and microscopic adhesions. Univariate and multivariate analysis was used. Results are given as medians with interquartile range. Results The median adhesion scores were the following: Control 1 (0-3), Icodextrin 0 (0-1), HA/CMC 0 (0-0), P = .017. The burst pressure did not differ between the groups; however, all except one bowel segments tested burst away from the anastomosis. The macroscopic and histological anastomotic healing was comparable in all 3 groups. A poor histological anastomotic healing score was associated with a higher adhesion grade (odds ratio = 1.92; 95% confidence interval = 1.06-3.47; P = .032). Conclusion Adhesion formation was inhibited by the materials tested without direct detrimental effects on anastomotic healing. Poor anastomotic healing provokes adhesions even in the presence of anti-adhesion barriers. PMID:26474604

  6. Anastomosing hemangioma of the kidney: a literature review of a rare morphological variant of hemangioma

    PubMed Central

    2015-01-01

    Background Anastomosing hemangioma (AH) of the kidney is a recently described morphological variant of hemangioma. It poses a diagnostic dilemma for clinicians because of its rarity and the overlapping features it shares with other renal vascular tumors. The aim of this paper is to review all the cases of AH of the kidney in the literature. Methods The literature was extensively searched for case reports of AH of the kidney and the clinical and pathological characteristics of the tumor were extracted. Results A total of 45 cases were reviewed. The mean age of presentation was 50 years (range, 15-83 years) and male sex accounted for 68.8% of the cases reviewed. AH of the kidney was mostly unilateral with only 4 cases of bilateral involvement of the kidney. The average size of the tumor is 1.5 cm (range, 0.1-7 cm). Incidental finding of AH of the kidney accounted for 62% of the cases reviewed. The ultrasound findings demonstrated varying echogenicity and the tumor appeared as solid and well demarcated heterogeneous masses on CT. The average follow up of the patients in this review was 26 months (range, 1-156 months). Conclusions AH of the kidney is a rare vascular tumor and a morphological variant of hemangioma. It has a characteristic sinusoidal architecture with a semblance of splenic sinusoids. It has overlapping clinical and imaging features with other vascular tumors of the kidney. Histological review and immunohistochemical studies are essential for accurate diagnosis. AH runs a benign course without evidence of disease recurrence during follow up. PMID:26244138

  7. Arterio-venous anastomoses in the human skin and their role in temperature control.

    PubMed

    Walløe, Lars

    2016-01-01

    Arterio-venous anastomoses (AVAs) are direct connections between small arteries and small veins. In humans they are numerous in the glabrous skin of the hands and feet. The AVAs are short vessel segments with a large inner diameter and a very thick muscular wall. They are densely innervated by adrenergic axons. When they are open, they provide a low-resistance connection between arteries and veins, shunting blood directly into the venous plexuses of the limbs. The AVAs play an important role in temperature regulation in humans in their thermoneutral zone, which for a naked resting human is about 26°C to 36°C, but lower when active and clothed. From the temperature control center in the hypothalamus, bursts of nerve impulses are sent simultaneously to all AVAs. The AVAs are all closed near the lower end and all open near the upper end of the thermoneutral zone. The small veins in the skin of the arms and legs are also contracted near the lower end of the thermoneutral zone and relax to a wider cross section as the ambient temperature rises. At the cold end of the thermoneutral range, the blood returns to the heart through the deep veins and cools the arterial blood through a countercurrent mechanism. As the ambient temperature rises, more blood is returned through the superficial venous plexuses and veins and heats the skin surface of the full length of the 4 limbs. This skin surface is responsible for a large part of the loss of heat from the body toward the upper end of the thermoneutral zone. PMID:27227081

  8. The effects of 5-fluorouracil and interferon-alpha on early healing of experimental intestinal anastomoses.

    PubMed Central

    de Waard, J. W.; Wobbes, T.; de Man, B. M.; van der Linden, C. J.; Hendriks, T.

    1996-01-01

    The continuing search for effective adjuvant therapy after resection of intestinal malignancies has prompted a growing interest in both immediate post-operative regional chemotherapy and the combination of 5-fluorouracil (5-FU) and interferon-alpha as drugs of choice. We have compared the effects of both compounds, alone and together, on early healing of intestinal anastomoses. Four groups (n = 26 each) of rats underwent resection and anastomosis of both ileum and colon: a control group and three groups receiving intraperitoneal 5-FU, interferon-alpha or both on the day of surgery and the next 2 days. Animals were killed 3 or 7 days (n = 10 each) after operation in order to measure anastomotic strength and hydroxyproline content. The remaining six animals in each group were used to study anastomotic collagen synthetic capacity at day 3. Three days after operation, ileal anastomotic bursting pressure was lowered by 37% in the 5-FU/interferon-alpha group (P = 0.0104). At day 7, anastomotic breaking strength was reduced significantly in ileum (P = 0.0221) and colon (P = 0.0054) of the 5-FU/interferon-alpha group and in colon of the interferon-alpha group (P = 0.0221). Collagen synthetic capacity was strongly suppressed by 5-FU but not by interferon-alpha. However, no differences in anastomotic hydroxyproline content were observed between groups at both days 3 and 7. Thus, post-operative use of interferon-alpha, in particular in combination with 5-FU, may be detrimental to anastomotic repair in the intestine. PMID:8795572

  9. Modelling streamflow in a large anastomosing river of the arid zone, Diamantina River, Australia

    NASA Astrophysics Data System (ADS)

    Costelloe, J. F.; Grayson, R. B.; McMahon, T. A.

    2006-05-01

    Anastomosing rivers form a subset of the anabranching family of river types and provide considerable challenges to modelling of their streamflow because of complex flow patterns across greatly varying floodplain widths. Estimates of distributed flow data are required for catchment management purposes and ecological studies of these rivers but are hindered by a paucity of measured discharge data. A grid-based, semi-distributed, conceptual model structure is applied to a 330 km reach of the arid zone Diamantina River of central Australia. Model complexity is constrained by data availability with only a single gauging station located at the downstream end of the reach to provide discharge data for model calibration. The model uses a simple conceptual bucket structure and accounts for exceptionally high transmission losses as well as flow patterns and wave speeds that vary with discharge within the reach. The intricate flow patterns across the floodplains widths of up to 50 km are simulated using a grid-based structure that required the following features: (i) cell connections that are explicitly defined using a code that allows for multi-directional flow from a cell; and (ii) each cell having a binary flow pattern, with the second connection pattern being triggered when the surface storage of the cell exceeds a calibrated level for a given land-type. Satellite images were used to define the flow paths, and hence cell connection patterns, utilised by various sized floods. The model was able to provide acceptable simulation of large floods but with decreasing model performance in the simulation of small to medium sized floods. Simulation suggested that incorrectly defined flow paths for the smaller floods were a major factor in this decreased performance. The capability of the model would be improved by further detailed mapping, using satellite imagery, of spatial patterns of inundation as discharge varies.

  10. Arterio-venous anastomoses in the human skin and their role in temperature control

    PubMed Central

    Walløe, Lars

    2016-01-01

    ABSTRACT Arterio-venous anastomoses (AVAs) are direct connections between small arteries and small veins. In humans they are numerous in the glabrous skin of the hands and feet. The AVAs are short vessel segments with a large inner diameter and a very thick muscular wall. They are densely innervated by adrenergic axons. When they are open, they provide a low-resistance connection between arteries and veins, shunting blood directly into the venous plexuses of the limbs. The AVAs play an important role in temperature regulation in humans in their thermoneutral zone, which for a naked resting human is about 26°C to 36°C, but lower when active and clothed. From the temperature control center in the hypothalamus, bursts of nerve impulses are sent simultaneously to all AVAs. The AVAs are all closed near the lower end and all open near the upper end of the thermoneutral zone. The small veins in the skin of the arms and legs are also contracted near the lower end of the thermoneutral zone and relax to a wider cross section as the ambient temperature rises. At the cold end of the thermoneutral range, the blood returns to the heart through the deep veins and cools the arterial blood through a countercurrent mechanism. As the ambient temperature rises, more blood is returned through the superficial venous plexuses and veins and heats the skin surface of the full length of the 4 limbs. This skin surface is responsible for a large part of the loss of heat from the body toward the upper end of the thermoneutral zone. PMID:27227081

  11. Anastomoses of the Ovarian and Uterine Arteries: A Potential Pitfall and Cause of Failure of Uterine Embolization

    SciTech Connect

    Matson, Matthew; Nicholson, Anthony; Belli, Anna-Maria

    2000-09-15

    Four women with symptomatic uterine fibroids were treated by uterine artery embolization (UAE). In all cases both uterine arteries were embolized via a single femoral puncture with polyvinyl alcohol using a selective catheter technique. In three cases, the ovarian artery was not visible on the initial angiogram before embolization, but appeared after the second uterine artery had been treated. In one case of clinical failure following UAE, a repeat angiogram demonstrated filling of the fibroids from the ovarian artery. Anastomoses between uterine and ovarian arteries may cause problems for radiologists performing UAE and are a potential cause of treatment failure.

  12. Hypoxia, not pulmonary vascular pressure, induces blood flow through intrapulmonary arteriovenous anastomoses

    PubMed Central

    Tremblay, Joshua C; Lovering, Andrew T; Ainslie, Philip N; Stembridge, Mike; Burgess, Keith R; Bakker, Akke; Donnelly, Joseph; Lucas, Samuel JE; Lewis, Nia CS; Dominelli, Paolo B; Henderson, William R; Dominelli, Giulio S; Sheel, A William; Foster, Glen E

    2015-01-01

    Blood flow through intrapulmonary arteriovenous anastomoses (IPAVA) is increased with exposure to acute hypoxia and has been associated with pulmonary artery systolic pressure (PASP). We aimed to determine the direct relationship between blood flow through IPAVA and PASP in 10 participants with no detectable intracardiac shunt by comparing: (1) isocapnic hypoxia (control); (2) isocapnic hypoxia with oral administration of acetazolamide (AZ; 250 mg, three times a day for 48 h) to prevent increases in PASP; and (3) isocapnic hypoxia with AZ and 8.4% NaHCO3 infusion (AZ + HCO3–) to control for AZ-induced acidosis. Isocapnic hypoxia (20 min) was maintained by end-tidal forcing, blood flow through IPAVA was determined by agitated saline contrast echocardiography and PASP was estimated by Doppler ultrasound. Arterial blood samples were collected at rest before each isocapnic–hypoxia condition to determine pH, [HCO3–] and . AZ decreased pH (–0.08 ± 0.01), [HCO3–] (−7.1 ± 0.7 mmol l−1) and (−4.5 ± 1.4 mmHg; P < 0.01), while intravenous NaHCO3 restored arterial blood gas parameters to control levels. Although PASP increased from baseline in all three hypoxic conditions (P < 0.05), a main effect of condition expressed an 11 ± 2% reduction in PASP from control (P < 0.001) following AZ administration while intravenous NaHCO3 partially restored the PASP response to isocapnic hypoxia. Blood flow through IPAVA increased during exposure to isocapnic hypoxia (P < 0.01) and was unrelated to PASP, cardiac output and pulmonary vascular resistance for all conditions. In conclusion, isocapnic hypoxia induces blood flow through IPAVA independent of changes in PASP and the influence of AZ on the PASP response to isocapnic hypoxia is dependent upon the H+ concentration or . PMID:25416621

  13. Effect of swirling flow on platelet concentration distribution in small-caliber artificial grafts and end-to-end anastomoses

    NASA Astrophysics Data System (ADS)

    Zhan, Fan; Fan, Yu-Bo; Deng, Xiao-Yan

    2011-10-01

    Platelet concentration near the blood vessel wall is one of the major factors in the adhesion of platelets to the wall. In our previous studies, it was found that swirling flows could suppress platelet adhesion in small-caliber artificial grafts and end-to-end anastomoses. In order to better understand the beneficial effect of the swirling flow, we numerically analyzed the near-wall concentration distribution of platelets in a straight tube and a sudden tubular expansion tube under both swirling flow and normal flow conditions. The numerical models were created based on our previous experimental studies. The simulation results revealed that when compared with the normal flow, the swirling flow could significantly reduce the near-wall concentration of platelets in both the straight tube and the expansion tube. The present numerical study therefore indicates that the reduction in platelet adhesion under swirling flow conditions in small-caliber arterial grafts, or in end-to-end anastomoses as observed in our previous experimental study, was possibly through a mechanism of platelet transport, in which the swirling flow reduced the near-wall concentration of platelets.

  14. Anastomosing Hemangiomas Arising in Unusual Locations: A Clinicopathologic Study of 17 Soft Tissue Cases Showing a Predilection for the Paraspinal Region.

    PubMed

    John, Ivy; Folpe, Andrew L

    2016-08-01

    Anastomosing hemangioma, a recently recognized benign vascular neoplasm originally described in the kidney, may be confused with well-differentiated angiosarcoma. Rare cases of anastomosing hemangiomas have been described in the liver and in nonrenal genitourinary sites. We report a series of 17 anastomosing hemangiomas occurring in unusual locations, in particular in the paravertebral soft tissues. The 17 tumors occurred in 10 male and 6 female patients, ranging in age from 2 to 85 years. One patient had bilateral, synchronous tumors involving the right paracaval and left para-aortic soft tissues. Thirteen (76%) cases involved the soft tissues near the vertebral column, including the paravertebral region (n=4), the psoas muscle (n=2), the costovertebral angle (n=2), para-aortic soft tissue (n=2), and the paracaval, parasacral, and retroperitoneal soft tissues (n=1 each). Other locations included the anterior mediastinum, uterine cornu, infundibular pelvic ligament, and upper arm (n=1 each). Imaging studies, available in 13 cases, were not felt to be diagnostic of a hemangioma. The tumors ranged from 1.5 to 7.5 cm (median, 3.6 cm) in size and were grossly well demarcated. All cases showed typical morphologic features of anastomosing hemangiomas, including a nonlobular architecture, an anastomosing proliferation of capillary-sized vessels with mild endothelial cell nuclear variability, scattered hobnailed endothelial cells, and small fibrin thrombi. Mitotic activity was rare or absent. Adipocytic metaplasia and extramedullary hematopoiesis were present in subsets of cases. When performed, immunohistochemical studies showed expression of endothelial markers (eg, CD31, CD34). In only 1 case did the submitting pathologist favor a diagnosis of anastomosing hemangioma; 4 cases were submitted specifically to exclude a well-differentiated angiosarcoma. Clinical follow-up available in 13 cases has not revealed any local recurrences or metastases. This series, the first

  15. The Association of Anastomosed fluvial deposits and dinosaur tracks, eggs, and nests: Implications for the interpretation of floodplain environments and a possible survival strategy for ornithopods

    SciTech Connect

    Nadon, G.C. )

    1993-02-01

    The St. Mary River Formation (Maastrichtian) consists of anastomosed fluvial deposits containing several hundred track-bearing beds. Paleontologic and sedimentologic analyses of these beds indicate that large herbivores, ornithopods, inhabited a seasonal wetland dominated by marshes and lakes. Shallow tracks in fine-grained sediments, formed as the sediments dewatered to the point of stiffness, display the highest resolution of detail. The preservation potential of tracks in anastomosed fluvial deposits is large because of the abundance of soft substrates to record the tracks and the occurrence of annual flooding to rapidly bury the footprints. Comparison of the St. Mary River Formation to other anastomosed fluvial deposits as old as the Early Jurassic confirms that tracks are common in this type of deposit. The variation in preservation of track types and depth of penetration raises the possibility that ornithopods employed a survival strategy involving seasonal wetlands. The wetlands provided an abundant food source and at the same time the combination of a soft substrate and flooded conditions would have effectively countered the superior speed and agility of large carnivores. The relatively common occurrence of ornithopod eggshells from anastomosed fluvial deposits suggests that the abundant food supply accompanying the wet season also made the wetlands an ideal location to rear young. These data can be used to refine the interpretations of depositional environment derived from the sediments by allowing estimates to be made regarding the early post-depositional conditions of the sediments. 95 refs., 7 figs., 1 tab.

  16. Reconstruction of severe anophthalmic orbits and atresic eye sockets after enucleation and irradiation of retinoblastoma by vascular anastomosed free dorsalis pedis flaps' transplantation.

    PubMed

    Bi, Xiaoping; Fan, Xianqun; Zhou, Huifang; Shi, Wodong; Xiao, Caiwen; Lin, Min; Li, Zhenkang

    2011-05-01

    Retinoblastoma is a common malignant intraocular tumor in childhood, and most patients require enucleation or exenteration even with irradiation. Severe anophthalmic orbits and atresic eye sockets are not rare. We conducted a retrospective study to evaluate the results of surgical management of reconstruction of severe anophthalmic orbits and atresic eye sockets with vascular anastomosed free dorsalis pedis flap transplantation. There were 5 patients (5 eyes) who underwent reconstructive surgery of severe anophthalmic orbits and atresic eye sockets after enucleation and irradiation of retinoblastoma in our hospital during the 3 years. All patients had enucleation and irradiation immediately after the retinoblastoma was diagnosed and had never worn artificial eyes because of the atresic eye sockets. Vascular anastomosed free dorsalis pedis flaps, whose dimensions were typically 6.5 × 5.5 cm(2), were transplanted to reconstruct the severe anophthalmic orbits and atresic eye sockets. The donor sites were covered by free abdominal skin flaps. All the vascular anastomosed free dorsalis pedis flaps were valid after more than 6 months of follow-up. And then all the 5 patients underwent secondary autogenous dermal fat implantation to augment the supraorbital area depression. After the 2-stage reconstruction surgery, the dimensions of the eye sockets were adequate, and all patients were able to wear their prosthesis and had a satisfactory cosmetic result. Implantation of alloplastic materials is not recommended because of insufficient blood supply of the irradiated orbital area. PMID:21558948

  17. Bone scintigraphy in evaluating the viability of composite bone grafts revascularized by microvascular anastomoses, conventional autogenous bone grafts, and free non-revascularized periosteal grafts

    SciTech Connect

    Berggren, A.; Weiland, A.J.; Ostrup, L.T.

    1982-07-01

    Researchers studied the value of bone scintigraphy in the assessment of anastomotic patency and bone-cell viability in free bone grafts revascularized by microvascular anastomoses in twenty-seven dogs. The dogs were divided into three different groups, and scintigraphy was carried out using technetium-labeled methylene diphosphonate in composite bone grafts revascularized by microvascular anastomoses, conventional autogenous bone grafts, and periosteal grafts placed in different recipient beds. The viability of the grafts were evaluated by histological examination and fluorescence microscopy after triple labeling with oxytetracycline on the first postoperative day, alizarin complexone on the fourth postoperative day, and DCAF on the eleventh postoperative day. A positive scintiscan within the first week following surgery indicated patent microvascular anastomoses, and histological study and fluorescence microscopy confirmed that bone throughout the graft was viable. A positive scintiscan one week after surgery or later does not necessarily indicate microvascular patency or bone-cell survival, because new bone formed by creeping substitution on the surface of a dead bone graft can result in this finding.

  18. Anastomosing hemangioma of the kidney: a case report of a rare subtype of hemangioma mimicking angiosarcoma and review of the literature

    PubMed Central

    Zhao, Ming; Li, Changshui; Zheng, Jiangjiang; Sun, Ke

    2013-01-01

    Anastomosing hemangioma is a recently described, unusual variant of capillary hemangioma which seems to be unique for the genitourinary system, with a particular proclivity for the kidney. Histologically, it is characterized by a unique sinusoidal architecture reminiscent of splenic parenchyma that can lead to concern for angiosarcoma. We herein report a further case of anastomosing hemangioma originating in the right kidney of a 48-year-old Chinese man. The patient had a past medical history significant for hepatocellular carcinoma; this tumor was incidentally identified as an asymptomatic right renal mass during the periodical surveillance of the hepatic cancer. The resected tumor measured 2.5cm in maximum diameter and microscopically demonstrated an overall lobulated growth pattern with alternating cellular areas composed of anastomosing sinusoidal capillary-sized vessels lined by hobnail endothelial cells, and edematous, hyaline paucicellular areas. Cytologically the tumor cells were generally bland and exhibited positivity for CD31, CD34 immunohistochemically. The patient had been in a good status without evidence of tumor recurrence 12 months after the surgery. This rare variant renal hemangioma is in need of more recognition and should not be over-diagnosed as a malignance, particularly angiosarcoma. PMID:23573324

  19. Unsteady simulation of distal blood flow in an end-to-side anastomosed coronary bypass graft with stenosis.

    PubMed

    Najarian, Siamak; Dargahi, Javad; Firouzi, Faramarz; Afsari, Jamshid

    2006-01-01

    In this paper, we report on the unsteady state modeling of blood flow in an end-to-side anastomosed bypass graft, which has a stenosis upstream from the junction. In coronary artery bypass grafting/surgery (CABG), new arteries are created in order to provide blood to the heart using other blood vessels as conduits to bypass the blocked section in the patient's coronary arteries. The failure of coronary artery bypass procedures has been attributed to both intimal hyperplasia (IH) and atherosclerosis. It is believed that these two phenomena are, in turn, related to the local hemodynamic factors. In this work, a three-dimensional computational fluid dynamics analysis is used to simulate the physiological blood flow through a model of a stenosed coronary bypass graft with the realistic assumption of non-Newtonian flow for human blood. For different flow repartitions and at different times of the cycle, both the recirculating areas and wall shear stress (WSS) are studied. Based on the different distribution of flow rates in the bypass graft and the host artery, the flow features are investigated and the influence of non-Newtonian behavior is discussed in terms of separation points, reattachment points, and the wall shear stresses. Various differences are observed based on the assumption of non-Newtonian behavior of blood, which have not been reported before when a simplified Newtonian approach is utilized. PMID:17075169

  20. [FORMATION OF BILIODIGESTIVE AND INTERINTESTINAL ANASTOMOSES IN ENVIRONMENT OF BILIARY PERITONITIS, USING A HIGH FREQUENCY ELECTRIC WELDING IN EXPERIMENT].

    PubMed

    Nychytaylo, M Yu; Furmanov, Yu O; Gutsulyak, A I; Savytska, I M; Lopatkina, K G; Zagriychuk, M S; Goman, A V

    2016-01-01

    In experiment on 20 rabbits a diffuse biliary peritonitis was simulated, using intraabdominal injection of a laboratory culture of E. coli suspension and a medicinal bile. In 24 h on background of peritonitis on excluded loop of a small bowel in accordance to method of Roux, using a high frequency electric welding with the help of apparatus Patonmed EKB3-300 a one-layered everting cholecystoenteroanastomosis and enteroenteroanastomosis was formated. In a 6 mo postoperatively a connection line was not revealed from outside or from inside, the signs of stenosis were absent. In environment of a diffuse biliary peritonitis a welding technologies have permitted to form a hermetic and competent biliodigestive and interintestinal anastomoses, the processes of a welding suture regeneration postoperatively have a typical course. Using a high frequency-electric welding it is possible to perform a one-staged reconstructive interventions in environment of a pronounced inflammation of tissues due to subsequent precise conjunction of mucosal sheets of connected organs, preventing the anastomotic stricture formation. PMID:27249933

  1. 1.9-um diode-laser-assisted anastomoses in reconstructive microsurgery: preliminary results in 12 patients

    NASA Astrophysics Data System (ADS)

    Mordon, Serge R.; Schoffs, Michel; Martinot, Veronique L.; Buys, Bruno; Patenotre, Philippe; Lesage, Jean C.; Dhelin, Guy

    1998-01-01

    The authors reported an original 1.9 micrometer diode laser assisted microvascular anastomosis (LAMA) in human. This technique has been applied in 12 patients during reconstructive surgery for digital replantations (n equals 2), for digital revascularizations (n equals 3) and for free flap transfers (n equals 7). Fourteen end-to-end anastomoses (10 arteries, 4 veins) were performed. LAMA were always performed on vessel which did not impede the chance of success of the surgical procedure in case of thrombosis. LAMA was performed with a 1.9 micrometer diode laser after placement of 2 equidistant stitches. The didoes spot was obtained by means of an optic fiber transmitted to the vessel wall via a pencil size hand piece. The used parameters were as followed: spot size equals 400 micrometer, power equals 70 to 220 mW, time equals 0.7 to 2 seconds, mean fluence equals 115 J/cm2. The mechanism involved is a thermal effect on the collagen of the adventitia and media leading to a phenomena which the authors have termed 'heliofusion.' This preliminary trial has permitted to define the modalities of its use in human. The technique is simple, rapid and easily learned. The equipment is not cumbersome, sterilizable and very ergonomic. LAMA does not replace sutures but is complementary, thanks to a reduction in the number of stitches used and to an access to surgical areas which are not easily accessible. This study must be completed by a larger scale study to confirm this technique and its reliability. Others uses could performed on different tissues such as biliary and urinary track, specially under laparoscopic conditions.

  2. "Entre libre" dans la classe ("Entre Libre" in the Classroom).

    ERIC Educational Resources Information Center

    Compte, Carmen

    1987-01-01

    In an interview, two teachers describe and discuss their different classroom use of the same set of instructional materials for "Entre Libre" and compare the results. Activities include role playing, music, and reporting. (MSE)

  3. Proof-of-Concept Studies for Marker-Based Ultrasound Doppler Analysis of Microvascular Anastomoses in a Modified Large Animal Model.

    PubMed

    Coon, Devin; Chen, Lei; Boctor, Emad M; Prince, Jerry L; Bojovic, Branko

    2016-05-01

    Background Despite attempts to solve the problem of flap monitoring, assessing the patency of vascular anastomoses postoperatively remains challenging. In addition, experimental data suggest that near-total vessel occlusion is necessary to produce significant changes in clinical appearance or monitoring devices. We sought to develop an ultrasound-based system that would provide definitive data on anastomotic function. Methods A system was developed consisting of a resorbable marker made from poly-lactic-co-glycolic acid (PLGA) implanted during the time of surgery coupled with ultrasound software to detect the anastomotic site and perform Doppler flow analysis. Surgical procedures consisting of microvascular free tissue transfer or femoral vessel cutdown were performed followed by marker placement, closure, and ultrasound monitoring. Transient vascular occlusion was produced via vessel-loop constriction. Permanent thrombosis was induced via an Arduino-controlled system applying current to the vessel intima. Results Four surgeries (one femoral vessel cutdown and three microvascular tissue transfer) were successfully performed in Yorkshire swine. The markers were readily visualized under ultrasound and provided a bounding area for Doppler analysis as well as orientation guidance. Transient spasm and partial occlusion were detected based on changes in Doppler data, while complete occlusion was evident as the total loss of color Doppler. Conclusion In this preliminary report, we have conceptualized and developed a novel system that enables the real-time visualization of vascular pedicle flow at the bedside using Doppler ultrasound and a surgically implanted marker. In a large animal model, use of the system allowed identification of the anastomosis, flow analysis, and real-time detection of flow loss. PMID:26645155

  4. Comparison of standard 4-row versus 6-row 3-D linear cutter stapler in creation of gastrointestinal system anastomoses: a prospective randomized trial

    PubMed Central

    Sozutek, Alper; Colak, Tahsin; Dag, Ahmet; Olmez, Tolga

    2012-01-01

    OBJECTIVE: This prospective study was conducted to compare the clinical outcomes of a 6-row 3-D linear cutter with the standard 4-row linear cutter in patients who underwent elective gastrointestinal surgery anastomosis. METHOD: Patients who underwent elective open gastrointestinal surgery that included stapled anastomosis using a linear cutter (Proximate®, Ethicon Endo-Surgery, Cincinnati, OH) between January 2011 and May 2011 were included in the study. The patients were randomly assigned to two groups according to the linear cutter that was used in the surgery: the standard 4-row cutter (the S group) or the new 6-row cutter (the N group). The groups were compared based on the patient demographic data, the laboratory parameters, the preoperative diagnosis, the surgery performed, the operation time, intra- or postoperative complications, the time to oral tolerance and the length of the hospital stay. RESULTS: The S group included 11 male and nine female patients with a mean age of 65±12 (35-84) years, while the N group included 13 male and eight female patients with a mean age of 62±11 (46-79) years (p = 0.448, p = 0.443, respectively). Anastomotic line bleeding was observed in eight (40%) patients in the S group and in one (4.7%) patient in the N group (p = 0.006). Dehiscence of the anastomosis line was observed in two (10%) patients in the S group and none in the N group (p = 0.131). Anastomotic leakage developed in three (15%) patients in the S group and in one (4.7%) patient in the N group (p = 0.269). The mean hospital stay was 12.65±6.1 days in the S group and 9.52±2.9 days in the N group (p = 0.043). CONCLUSION: The 6-row 3-D linear cutter is a safe and easily applied instrument that can be used to create anastomoses in gastrointestinal surgery. The new stapler provides some usage benefits and is also superior to the standard linear cutter with regard to anastomotic line bleeding. PMID:23018300

  5. [Nerve anastomoses. Sutures or fibrinogenic glue? Preliminary results].

    PubMed

    Boedts, D; Bouckaert, J I

    1984-01-01

    A comparative animal experiment was set up between two nerve anastomosis techniques, one by sealing nerve ends with a fibrinogen-thrombine glue and the other by classical perineural suturing. It was concluded that glueing nerve ends, from the surgical-technical point of view is a better method than suturing. It is an easy, time-sparing method which allows excellent coaptation of the severed nerves with minimal iatrogenic trauma. On the long run however some questions remain. There is the problem of induced fibrosis by using high doses of aprotinine and factor XIII at the site of the nerve junctions and on the other hand the influence of fibrinolysis in traumatized tissues, with early decrease of tensile strength at the junctions before nerve healing. So glued nerve ends should be completely free of tension, protected against secondary shearing forces, and also immobilization of the region is required. PMID:6385609

  6. Microarterial anastomoses using the diode laser: long term morphological results

    NASA Astrophysics Data System (ADS)

    Tang, Jing; Prudhomme, Michel; Rouy, Simone; Godlewski, Guilhem; Ovtchinikoff, Serge; Delacretaz, Guy P.; Salathe, Rene-Paul

    1996-01-01

    In a series of 70 Wistar rats submitted to a noncontact diode laser-assisted carotid end-to-end anastomosis (LAMA) versus controlateral manual suture microanastomosis (CMA), contrast angiography and scanning electron microscopy were performed in a group of 18 animals at a long-term follow up to 7 months after operation. The investigation of angiography realized by means of a CGR General Electric DG 200 with a 512 digital matrix gave precise images of vessel wall repair and vessel patency. It permitted a simultaneous comparison between laser and manual anastomosis. Patency rate was 83% in LAMA and 78% in CMA. Nonlethal complications such as 1 stenosis, 2 thromboses in LAMA and 1 stenosis, 2 thromboses, and 1 pseudoaneurysm in CMA were observed. The results could be correlated to scanning electron microscopy findings and confirmed the morphological superiority of the laser technique.

  7. [Rat uterus anastomoses in a single and a double layer].

    PubMed

    Gianaroli, L; Bufferli, M; Livani, M F

    1980-11-15

    The Authors display their results on microsurgical operations in rat's uteri. After having described the instruments and methods used, the surgical techniques and the differences between a single and a double layer suture are discussed. However the formation of intraoperative adherences, which can damage the functional results of the intervention, is studied. And what's more the mean number of live born foetuses is seen as an attainable parameter for future validations. PMID:7011341

  8. [The prevention and treatment of the incompetence of esophageal anastomoses].

    PubMed

    Kasatkin, V F; Glumov, E E; Gevorkian, Iu A; Doshanova, R Kh; Krat, V A; Kruglov, S V; Kaĭmakchi, O Iu; Korobka, V L; Oreshkina, A D; Snezhko, A V

    1999-01-01

    The main cause of lethal outcomes after operations on the oesophagus and cardia remains failure of esophageal anastomosis. The lack of substantial positive changes in prophylaxis and especially in treatment of this complication is explained by etiological approach to this problem. Pathogenesis of the failure is determined by the only trigger--penetration of infection into the tissues of anastomotic area. The authors have developed and introduced into practice the method and the device to influence the basic link of the pathogenesis. The application of the method of permanent irrigation and sealing of the esophageal anastomosis line in treatment of 917 patients made it possible to cut down lethal outcomes from insufficiency of esophageal anastomosis to 0.1%. PMID:10410514

  9. La problematica de la demarcacion entre ciencia y pseudociencia y sus implicaciones en la educacion cientifica

    NASA Astrophysics Data System (ADS)

    Jimenez Tolentino, Dinorah

    2011-12-01

    En la sociedad prevalece una tendencia generalizada hacia la inclusion de creencias y practicas pseudocientificas. Esta investigacion responde a la necesidad de analizar como la proliferacion de las pseudociencias afecta la vision que tienen los estudiantes universitarios sobre las ciencias naturales. A tales efectos, la investigadora describe las concepciones epistemologicas que tienen los estudiantes sobre las ciencias y las pseudociencias e identifica los criterios de demarcacion, entre un area y otra, que se derivan de estas concepciones. De igual modo, esta identifica las creencias y practicas pseudocientificas de mayor arraigo entre los estudiantes, destacando, a su vez, la razon de ser de las mismas. Por ultimo, la investigadora analiza las implicaciones educativas de la problematica de la demarcacion entre ciencia y pseudociencia. La investigacion es de naturaleza mixta, enmarcada en los paradigmas empirico- analitico y cualitativo. El proceso investigativo se llevo a cabo mediante la administracion del cuestionario Criterios para la demarcacion entre ciencia y pseudociencia. La parte cualitativa estuvo enmarcada en el diseno de estudio de caso, recopilando informacion mediante entrevistas semiestructuradas en dos grupos focales. La poblacion de estudio estuvo constituida por estudiantes universitarios del nivel subgraduado de la Universidad Central de Bayamon. Los resultados del estudio reflejaron las concepciones erroneas de los estudiantes sobre la naturaleza de las ciencias y las pseudociencias. Con respecto a la demarcacion entre ciencia y pseudociencia, el criterio imperante entre los universitarios es el de la verificabilidad, considerando la aplicacion del metodo cientifico como el metodo para demostrar la veracidad de las teorias cientificas. Las creencias y practicas pseudocientificas no son muy frecuentes entre los universitarios. Estos atribuyen las mismas a la prevalencia de elementos supersticiosos y al engano a que es sometida la poblacion

  10. Entre Dos Mundos/Between Two Worlds: Youth Violence Prevention for Acculturating Latino Families

    ERIC Educational Resources Information Center

    Smokowski, Paul R.; Bacallao, Martica

    2009-01-01

    Objective: This study evaluated the efficacy of Entre Dos Mundos/Between Two Worlds (EDM) prevention for Latino adolescents. Method: In an experimental trial to compare implementation formats, 41 Latino families were randomly assigned to EDM action-oriented skills training groups, and 47 families were randomly assigned to unstructured EDM support…

  11. ESTIGMA Y VIH/SIDA ENTRE PADRES/MADRES Y ADOLESCENTES PUERTORRIQUEÑOS/AS

    PubMed Central

    Pérez, Grace Rosado; Reyes, Glendalys Rivera; Villanueva, Victoria Larrieux; Torres, Gilliam J. Torres; Díaz, Elba Betancourt; Varas-Díaz, Nelson; Villaruel, Antonia

    2016-01-01

    La comunicación entre padres/madres y adolescentes sobre el tema de la sexualidad es importante para el desarrollo de la salud de personas jóvenes. Dicha comunicación puede verse negativamente impactada por actitudes estigmatizantes hacia el tema del VIH/SIDA. El objetivo de este estudio fue identificar actitudes estigmatizantes hacia el VIH/SIDA entre padres/madres y adolescentes puertorriqueños/as. Este esfuerzo es parte del Proyecto Cuídalos, dirigido a probar una intervención en formato electrónico que busca aumentar la comunicación sobre sexualidad y salud entre padres/madres y adolescentes mediante un diseño experimental con 458 diadas de padres/madres y adolescentes de 13 a 17 años. Para propósitos de este artículo reportamos estadísticas descriptivas sobre estigma hacia el VIH/SIDA con la información recopilada en la medición basal. Tanto adultos/as como adolescentes mostraron actitudes estigmatizantes hacia el VIH/SIDA. A la luz de los resultados es necesario continuar desarrollando intervenciones para la reducción de estigma en esta población. Los/as padres/madres pueden ser un recurso invaluable para reducir el estigma en los/as jóvenes, y prevenir conductas sexuales de riesgo e infecciones. PMID:27099649

  12. Estudo comparativo entre estrelas centrais de nebulosas planetárias deficientes em hidrogênio

    NASA Astrophysics Data System (ADS)

    Marcolino, W. L. F.; de Araújo, F. X.

    2003-08-01

    Apresentamos neste trabalho o resultado de um estudo das principais características espectrais das estrelas centrais de nebulosas planetárias (ECNP) deficientes em hidrogênio. A origem e a evolução dessas estrelas ainda constitui um problema em aberto na evolução estelar. Geralmente esses objetos são divididos em [WCE], [WCL] e [WELS]. Os tipos [WCE] e [WCL] apresentam um espectro típico de uma estrela Wolf-Rayet carbonada de população I e as [WELS] apresentam linhas fracas de carbono e oxigênio em emissão. Existem evidências que apontam a seguinte sequência evolutiva : [WCL] = > [WCE] = > [WELS] = > PG 1159 (pré anã-branca). No entanto, tal cenário apresenta falhas como por exemplo a falta de ECNP entre os tipos [WCL] e [WCE]. Baseados em uma amostra de 24 objetos obtida no telescópio de 1.52m em La Silla, Chile (acordo ESO/ON), ao longo do ano 2000, apresentamos os resultados da comparação das larguras equivalentes de diversas linhas relevantes entre os tipos [WCL], [WCE] e [WELS]. Verificamos que nossos dados estão de acordo com a sequência evolutiva. Baseado nas linhas de C IV, conseguimos dividir pela primeira vez as [WELS] em dois grupos principais. Além disso, os dados reforçam a afirmação de que as [WCE] são as estrelas que possuem a maior temperatura entre as ECNP deficientes em hidrogênio. Discutimos ainda, a escassez de dados disponíveis na literatura e a necessidade da obtenção de parametros físicos para estes objetos.

  13. Etude des relations entre photosynthese respiration, transpiration et nutrition minerale chez le ble

    NASA Astrophysics Data System (ADS)

    André, M.; Ducloux, H.; Richaud, C.; Massimino, D.; Daguenet, A.; Massimino, J.; Gerbaud, A.

    La croissance du Blé Triticum aestivum a été étudiée en environnement contrôlé et fermé pendant une période de 70 jours. Les échanges gazeux (Photosynthèse, Respiration) hydriques (Transpiration) et la consommation en éléments minéraux (Azote, Phosphore, Potassium) ont été mesurés en continu. On présentera les relations dynamiques observées entre les différentes fonctions physiologiques, d'une part sous l'influence de la croissance et d'autre part en réponse à des modifications de l'environnement. L'influence de la teneur en CO2 pendant la croissance (teneur normale ou doublée) sera mise en évidence.

  14. No Financial Disincentive for Choosing More Healthful Entrées on Children’s Menus in Full-Service Restaurants

    PubMed Central

    West, Delia

    2013-01-01

    Children are eating restaurant foods more than ever before, and price is among the top considerations for food choices. We categorized and enumerated entrées on children’s menus from 75 full-service restaurant chains to compare prices of more healthful and less healthful entrées to test the assumption that more healthful food is more expensive. The mean (standard deviation) price of more healthful entrées ($5.38 [$2.01]) was not significantly different from the price of less healthful entrées ($5.27 [$2.04]). In contrast to research demonstrating that more healthful foods tend to be more expensive in grocery stores, more healthful entrées on children’s menus in restaurants were not more expensive than less healthful entrées. PMID:23742942

  15. An Environmental Management Model of Thermal Waters in Entre Ríos Province, Argentina

    NASA Astrophysics Data System (ADS)

    Pablo, Mársico Daniel; Luís, Díaz Eduardo; Ivana, Zecca; Oscar, Dallacosta; Antonio, Paz-González

    2015-04-01

    Deep exploratory drillings, i.e. those with more than 500 meters depth, have been performed in the Entre Ríos province, Argentina, in order to ascertain the presence of thermal water. Drilling began in 1994, and until now there have been 18 polls with very variable results in terms of mineralization, resource flow, and temperature. The aim of this study was to present a management model, which should allow operators of thermal complexes to further develop procedures for safeguarding the biodiversity of the ecosystems involved, both during exploration and exploitation activities. The environmental management Plan proposed is constituted by a set of technical procedures that are formulated and should be performed during the stages of exploration and exploitation of the resource, and consists of: environmental monitoring, environmental audit, public information and contingency programs. This Plan describes the measures and proposals aimed at protecting environmental quality in the area of influence of a thermal complex project, ensuring that its execution remains environmentally responsibly, and allowing implementation of specific actions to prevent or correct environmental impacts, as predicted in the evaluation of the Environmental Program. The audit of environmental impact includes and takes into account natural factors, such as water, soil, atmosphere, flora and fauna, and also cultural factors. The technical audit Plan was prepared in order to get a systematic structure and organization of the verification process, and also with regard to document the degree of implementation of the proposed mitigation measures. Finally, an environmental contingency program was implemented, and its objective was to consider the safeguarding of life and its natural environment. Thus, a guide has been developed with the main actions to be taken on a contingency, since forecast increases the efficiency of the response. The methodology developed here was adopted as the procedure

  16. Reai-time imaging of Myeioid Ceiis Dynamics in ApcMin/+ intestinai Tumors by Spinning Disk Confocai Microscopy

    PubMed Central

    Werb, Zena

    2015-01-01

    Myeloid cells are the most abundant immune cells within tumors and have been shown to promote tumor progression. Modern intravital imaging techniques enable the observation of live cellular behavior inside the organ but can be challenging in some types of cancer due to organ and tumor accessibility such as intestine. Direct observation of intestinal tumors has not been previously reported. A surgical procedure described here allows direct observation of myeloid cell dynamics within the intestinal tumors in live mice by using transgenic fluorescent reporter mice and injectable tracers or antibodies. For this purpose, a four-color, multi-region, micro-lensed spinning disk confocai microscope that allows long-term continuous imaging with rapid image acquisition has been used. ApcMin/+ Spc mice that develop multiple adenomas in the small intestine are crossed with c-fms-EGFP mice to visualize myeloid cells and with ACTB-ECFP mice to visualize intestinal epithelial cells of the crypts. Procedures for labeling different tumor components, such as blood vessels and neutrophils, and the procedure for positioning the tumor for imaging through the serosal surface are also described. Time-lapse movies compiled from several hours of imaging allow the analysis of myeloid cell behavior in situ in the intestinal microenvironment. PMID:25350573

  17. Religiosidade, juventude e sexualidade: entre a autonomia e a rigidez1

    PubMed Central

    Silva, Cristiane Gonçalves da; Santos, Alessandro Oliveira; Licciardi, Daniele Carli; Paiva, Vera; Parker, Richard

    2009-01-01

    Esse artigo descreve como jovens religiosos e autoridades religiosas de sua comunidade compreendem a sexualidade, considerando suas experiências pessoais e como membros de comunidades religiosas. A análise pretende contribuir para que políticas públicas dedicadas à promoção da saúde sexual da juventude considerem a religiosidade, no contexto de um estado laico e da promoção do direito à prevenção. Foram realizadas 26 entrevistas abertas e semidirigidas em diferentes comunidades da região metropolitana da cidade de São Paulo (comunidades católicas, da umbanda, do candomblé e de diferentes denominações evangélicas) sobre iniciação sexual, casamento, gravidez, contracepção e prevenção das DST/Aids, homossexualidade, aborto e direitos humanos. Observou-se como jovens e autoridades religiosas convivem com a tensão entre tradição e modernidade e os distintos discursos sobre a sexualidade. Como sujeitos religiosos (do discurso religioso) e sujeitos sexuais (de discursos sobre sexualidade), devem ser incorporados pelos programas como sujeitos de direito nos termos de sua religiosidade. PMID:21886456

  18. Occurrence of alternariol and alternariol monomethyl ether in beverages from the Entre Rios Province market, Argentina.

    PubMed

    Broggi, Leticia; Reynoso, Cora; Resnik, Silvia; Martinez, Fernanda; Drunday, Vanesa; Bernal, Angela Romero

    2013-02-01

    One hundred and eighty five samples of red, white and rosé wines and different juices purchased in Entre Rios, Argentina, were analyzed for the Alternaria mycotoxins alternariol (AOH) and alternariol methyl ether (AME). White wines were analyzed after removal of alcohol by a nitrogen stream and concentrated. AOH in red wines was cleaned up by solid-phase extraction columns in series (octadecyl and amino propyl modified silica) and AME quantified directly on the sample. The juices were filtered and concentrated, and then all sample extracts were quantified by high performance liquid chromatography with photodiode array detector that allows confirmation through UV spectra. Method validation revealed a good sensitivity with adequate LOD and LOQ for AME and less sensitivity for AOH (i.e. white wine: AME 0.8 and 1.4 ng/mL, AOH 2 and 3.3 ng/mL; red wine: AME 0.1 and 0.2 ng/mL, AOH 4.5 and 7.5 ng/mL; apple juice: AME 1.7 and 2.8 ng/mL, AOH 5 and 9 ng/mL; other juices: AME 2.0 and 3.1 ng/mL, AOH 6 and 10 ng/mL). Recoveries in all cases were greater than 80 %. Four of 53 white wine samples were contaminated with AOH with a maximum level of 18 ng/mL, 6 of 56 samples of red wine had a maximum of 13 ng/mL, and 3 of 68 samples of juices had traces of AOH. AME was less frequently detected than AOH, and the LOD and LOQ for AME are smaller than for AOH. Only three samples of white wine and one of red wine were contaminated, but in only one white wine sample (AME 225 ng/mL) did the toxin level exceed the LOQ. PMID:23334721

  19. Analyse des interactions energetiques entre un arena et son systeme de refrigeration

    NASA Astrophysics Data System (ADS)

    Seghouani, Lotfi

    La presente these s'inscrit dans le cadre d'un projet strategique sur les arenas finance par le CRSNG (Conseil de Recherche en Sciences Naturelles et en Genie du Canada) qui a pour but principal le developpement d'un outil numerique capable d'estimer et d'optimiser la consommation d'energie dans les arenas et curlings. Notre travail s'inscrit comme une suite a un travail deja realise par DAOUD et coll. (2006, 2007) qui a developpe un modele 3D (AIM) en regime transitoire de l'arena Camilien Houde a Montreal et qui calcule les flux de chaleur a travers l'enveloppe du batiment ainsi que les distributions de temperatures et d'humidite durant une annee meteorologique typique. En particulier, il calcule les flux de chaleur a travers la couche de glace dus a la convection, la radiation et la condensation. Dans un premier temps nous avons developpe un modele de la structure sous la glace (BIM) qui tient compte de sa geometrie 3D, des differentes couches, de l'effet transitoire, des gains de chaleur du sol en dessous et autour de l'arena etudie ainsi que de la temperature d'entree de la saumure dans la dalle de beton. Par la suite le BIM a ete couple le AIM. Dans la deuxieme etape, nous avons developpe un modele du systeme de refrigeration (REFSYS) en regime quasi-permanent pour l'arena etudie sur la base d'une combinaison de relations thermodynamiques, de correlations de transfert de chaleur et de relations elaborees a partir de donnees disponibles dans le catalogue du manufacturier. Enfin le couplage final entre l'AIM +BIM et le REFSYS a ete effectue sous l'interface du logiciel TRNSYS. Plusieurs etudes parametriques on ete entreprises pour evaluer les effets du climat, de la temperature de la saumure, de l'epaisseur de la glace, etc. sur la consommation energetique de l'arena. Aussi, quelques strategies pour diminuer cette consommation ont ete etudiees. Le considerable potentiel de recuperation de chaleur au niveau des condenseurs qui peut reduire l'energie requise par

  20. Spectral imaging reveals microvessel physiology and function from anastomoses to thromboses

    NASA Astrophysics Data System (ADS)

    Wankhede, Mamta; Agarwal, Nikita; Fraga-Silva, Rodrigo A.; Dedeugd, Casey; Raizada, Mohan K.; Oh, S. Paul; Sorg, Brian S.

    2010-01-01

    Abnormal microvascular physiology and function is common in many diseases. Numerous pathologies include hypervascularity, aberrant angiogenesis, or abnormal vascular remodeling among the characteristic features of the disease, and quantitative imaging and measurement of microvessel function can be important to increase understanding of these diseases. Several optical techniques are useful for direct imaging of microvascular function. Spectral imaging is one such technique that can be used to assess microvascular oxygen transport function with high spatial and temporal resolution in microvessel networks through measurements of hemoglobin saturation. We highlight novel observation made with our intravital microscopy spectral imaging system employed with mouse dorsal skin-fold window chambers for imaging hemoglobin saturation in microvessel networks. Specifically, we image acute oxygenation fluctuations in a tumor microvessel network, the development of arteriovenous malformations in a mouse model of hereditary hemorrhagic telangiectasia, and the formation of spontaneous and induced microvascular thromboses and occlusions.

  1. Anastomosing grabens, low-angle faults, and Tertiary thrust( ) faults, western Markagunt Plateau, southwestern Utah

    SciTech Connect

    Maldonado, F.; Sable, E.G. )

    1993-04-01

    A structurally complex terrane composed of grabens and horsts, low-angle faults, Tertiary thrust( ) faults, gravity-slide blocks, and debris deposits has been mapped along the western Markagunt Plateau, east of Parowan and Summit, southwestern Utah. This terrane, structurally situated within the transition between the Basin and Range and Colorado Plateau provinces, contains Tertiary volcanic and sedimentary and Cretaceous sedimentary rocks. The structures are mostly Miocene to Oligocene but some are Pleistocene. The oldest structure is the Red Hills low-angle shear zone, interpreted as a shallow structure that decoupled an upper plate composed of a Miocene-Oligocene volcanic ash-flow tuff and volcaniclastic succession from a lower plate of Tertiary sedimentary rocks. The period of deformation on the shear zone is bracketed from field relationships between 22.5 and 20 Ma. The graben-horst system trends northeast and formed after about 20 Ma (and probably much later) based on displacement of dated dikes and a laccolith. The central part of the system contains many grabens that merge toward its southerly end to become a single graben. Within these grabens, (1) older structures are preserved, (2) debris eroded from horst walls forms lobe-shaped deposits, (3) Pleistocene basaltic cinder cones have localized along graben-bounding faults, and (4) rock units are locally folded suggesting some component of lateral translation along graben-bounding faults. Megabreccia deposits and landslide debris are common. Megabreccia deposits are interpreted as gravity-slide blocks of Miocene-Oligocene( ) age resulting from formation of the Red Hills shear zone, although some may be related to volcanism, and still others to later deformation. The debris deposits are landslides of Pleistocene-Pliocene( ) age possibly caused by continued uplift of the Markagunt Plateau.

  2. Intraepithelial lymphocytosis is a frequent finding in biopsies from ileal pouch-anal anastomoses.

    PubMed

    Schaeffer, David F; Walsh, Joanna C; Tyler, Andrea D; Ben-Bassat, Ofer; Silverberg, Mark S; Riddell, Robert H; Kirsch, Richard

    2016-08-01

    Following restorative proctocolectomy with an ileal pouch-anal anastomosis, the small bowel mucosa undergoes several specific histologic adaptions, which may be unrelated to the underlying disease or symptoms of pouchitis. An increase in intraepithelial lymphocytes (IELs) has not been described as part of this spectrum. Mucosal biopsies of the ileal pouch and afferent limb of 230 patients (mean age: 45.7y [18.3-74.7], gender [female/male]: 117/113) with a functioning ileal pouch-anal anastomosis (mean time since ileostomy closure: 10.8months) and associated clinically annotated outcome data were assessed for IELs/100 enterocytes. Forty-two patients (18.3%) showed an increase in IELs (≥20 IELs/100 enterocytes [range 20-39]), in pouch and/or afferent limb biopsies. Intraepithelial lymphocytosis was more commonly observed in afferent limb compared to pouch biopsies (18.8% vs 8.3%; P = .42) and in familial adenomatous polyposis compared to ulcerative colitis patients (16% vs 8%; P = 0.36), but neither difference reached statistical significance. No cases with increased IELs displayed severe villous blunting. Increased IELs were not significantly associated with age, sex, ethnicity, smoking history, time since ileostomy, use of antibiotics, biologic agents, anti-diarrheal agents or probiotics, C-reactive protein levels or differential white cell count. None of the 42 patients with increased IELs had positive celiac serology (anti-human tissue transglutaminase IgA [ELISA] with corresponding total serum IgA). Intraepithelial lymphocytosis in pouch biopsies may represent a subclinical response to an altered bacterial microenvironment. Pathologists should be aware that intraepithelial lymphocytosis is part of the spectrum of changes in pouch biopsies, and only rarely is due to celiac disease. PMID:27063473

  3. Multiple tracheal resections and anastomoses in a blue and gold macaw (Ara ararauna).

    PubMed

    Jankowski, Gwen; Nevarez, Javier G; Beaufrere, Hugues; Baumgartner, Wes; Reed, Scott; Tully, Thomas N; Hedlund, Cheryl; Hennig, Geoff; Huck, Jennifer

    2010-12-01

    A 1.5-year-old, male blue and gold macaw (Ara ararauna) was anesthetized for a health examination and blood collection. The following day it was returned for episodes of coughing. The bird was presented again 13 days after the initial presentation with severe dyspnea. A tracheal stenosis was diagnosed by endoscopy and treated by surgical resection of 5 tracheal rings and tracheal anastomosis. The bird was discharged but returned 2 days later with a recurrent stenosis. Bougienage and balloon dilation of the stenotic area were performed separately; each resulted in less than 48 hours' improvement in clinical signs after treatment. A second tracheal resection and anastomosis was performed, during which an additional 10 tracheal rings were removed. This second anastomosis was significantly more difficult to complete given the marked variation in diameter of the proximal and distal tracheal segments. The macaw recovered without complication and has had no recurrence of respiratory abnormalities 2 years after the second surgery. This report describes the longest total tracheal segment to be resected, followed by tracheal anastomosis, in a psittacine bird. The positive outcome in this case suggests that, when surgical therapy is elected, an aggressive approach is necessary to prevent recurrence of tracheal stenosis. In addition, macaws can recover well even after significant lengths of the trachea are resected. PMID:21302763

  4. Unique Technique for Open Surgical Repair after Failed Endovascular Aneurysm Repair with Proximal Anastomoses

    PubMed Central

    Hirota, Jun; Mori, Kazuki; Shuto, Takashi; Okamoto, Keitaro; Sato, Aiko; Wada, Tomoyuki; Anai, Hirofumi; Miyamoto, Shinji

    2016-01-01

    Endovascular aortic aneurysm repair (EVAR) has revolutionized the management of abdominal aortic aneurysms (AAAs), with lower perioperative morbidity and mortality compared to conventional surgical repair. However, late secondary re-interventions after EVAR are still needed before aneurysm rupture in many cases. A patient with impending rupture of an AAA associated with a type I endoleak 7 years after EVAR who was successfully treated with a unique technique of fixation of the proximal aortic neck taking into account the structure of the stent graft is reported. This technique offers a safe solution to late open conversion after failed EVAR. PMID:27375808

  5. [Interintestinal anastomoses formation using permanent magnet in surgical treatment of children with intestinal stomas].

    PubMed

    Gatkin, E Ya; Razumovsky, A Yu; Korsunsky, A A; Konovalov, A K; Sergeev, A V; Vinogradov, A Ya; Sein, V A

    2015-01-01

    It was analyzed the results of treatment of 48 children aged from 1 month to 14 years. In these observations by the 6th - 7th days after doubleintestinalstoma formation magnetic dies with inductance from 300 to 360 mTl and energy force at least 255 kJ/m3 were introduced into lumen of afferent and efferent intestinal loops. Attractive or compression force between dies was 600 g, i.e. force per 1 cm2 was 200 g according to dies' surface 1.12.83.0 cm. Magnets are not only surgical instruments but also physiotherapeutic devices improving microcirculation and stimulating regeneration in the area of anastomosis. Interintestinal anastomosis has been completely formed for 5-7 days. Thereafter magnetic dies have been removed. Stool was normalized in 45 of 48 observations after surgery (1-3 times daily). Intestinal discharge from ileostomy reduced to minimal amount. In 2 patients irregular bowel movements was observed due to adhesive stenosis of interintestinal anastomosis. Magnetic dies can't be established in 1 case due to adhesive process. Hospital stay was from 10 to 25 days in 41 children. 7 patients were discharged for outpatient treatment later. All children were under observation for the period 2-4 months after discharge. Signs of hypotrophy including body weight deficit within 10% of age norm were diagnosed only in 3 children with prematurity degree I-II. Hereafter children were repeatedly hospitalized; intestinal stomas were surgically removed using conventional technique. Thus complete convalescence was obtained. PMID:26271323

  6. Seroprevalence of Salmonella and Mycoplasma infection in backyard chickens in the state of Entre Rios in Argentina.

    PubMed

    Xavier, J; Pascal, D; Crespo, E; Schell, H L; Trinidad, J A; Bueno, D J

    2011-04-01

    The present work was conducted to study the seroprevalence of Salmonella, Mycoplasma gallisepticum (MG), and Mycoplasma synoviae (MS) infection in backyard chickens located in Entre Ríos, Argentina, over 3 periods of time. A total of 2,441 sera samples were collected from backyard chickens belonging to 256 family farms in 16 counties in the state of Entre Ríos from January to May 2003 (first period), December 2004 to April 2005 (second period), and October 2006 to May 2007 (third period). The prevalence of family farms testing seropositive for Salmonella averaged 23.9, 15.9, and 28.6% during the first, second, and third period, respectively. The highest prevalence of Salmonella-seropositive farms recorded (66.7%) was on farms from Concordia county, and the lowest prevalence (0%) was on farms from La Paz county. In contrast, the prevalence of family farms seropositive for MG averaged 32.8, 55.1, and 76.2% during the first, second, and third periods, respectively. The highest prevalence of MG-seropositive farms (100%) was found in the counties of Victoria and Tala, and the lowest prevalence (8.7%) was found on farms on Colón county. The prevalence of family farms seropositive for MS averaged 68.6 and 100% during the first and second periods, respectively. The highest prevalence of MS-seropositive farms (100%) was on farms in 85% of the counties tested, and the lowest prevalence (21.7%) was on farms from Colón county. Salmonella, MG, and MS infection are present at high levels in backyard chicken farms, and this presents a high risk to commercial poultry production in Entre Ríos, the state with the highest chicken population and density in Argentina. PMID:21406358

  7. Clostridium perfringens growth from spore inocula in sous-vide processed pork-based Mexican entrée.

    PubMed

    Miguel-Garcia, Denise Y; Juneja, Vijay K; Valenzuela-Melendrez, Martin; Díaz-Cinco, Martha E; Thippareddi, H; Aida Peña-Ramos, E

    2009-01-01

    The combined effect of Citricidal wih irradiation on Clostridium perfringens growth from spores in a sous-vide processed marinated pork meat Mexican entrée was investigated. Citricidal was added at 200 or 800 ppm after mixing pork meat with tomatillo sauce and inoculated with 3 log(10) CFU/g of C. perfringens spores. Samples were irradiated at either 0 or 2 kGy, heated to an internal temperature of 71 degrees C, and stored at 4 degrees C for 28 d, 15 degrees C for 45 d, and 25 degrees C for 26 h. To simulate the conditions that may occur during transportation, distribution, storage, or handling in supermarkets or by consumers, the effect of static temperature abuse on C. perfringens growth was assessed by transferring samples stored at 4 to 25 degrees C for 13 and 15 h. Total C. perfringens populations were determined by plating diluted samples on tryptose-sulfite-cycloserine agar. Growth was not observed up to 45 d of storage at 15 degrees C in samples supplemented with 800 ppm of Citricidal. At 25 degrees C, no significant differences (P > 0.05) on the lag phase duration due to antimicrobial treatments was observed. The temperature abuse of refrigerated products for up to 15 h did not lead to C. perfringens growth to high infective dose levels of 1 million cells required to cause food poisoning. The results suggest that 800 ppm Citricidal can have significant bacteriostatic activity against C. perfringens and may provide a degree of protection against this pathogen in sous-vide processed marinated pork meat Mexican entrée, under mild temperature abuse (

  8. Effect of grapefruit seed extract on thermal inactivation of Listeria monocytogenes during sous-vide processing of two marinated Mexican meat entrées

    Technology Transfer Automated Retrieval System (TEKTRAN)

    D and z values of Listeria monocytogenes were obtained for two Mexican meat entrées: pork meat marinated in tomatillo (green tomato) sauce (PTS) and beef marinated in a red chili sauce (BRCS), with addition of 0, 200 and 800 ppm of grapefruit seed extract (GSE). Meat samples, inoculated with L.monoc...

  9. A Process Evaluation of an Efficacious Family-Based Intervention to Promote Healthy Eating: The "Entre Familia: Reflejos de Salud" Study

    ERIC Educational Resources Information Center

    Schmied, Emily; Parada, Humberto; Horton, Lucy; Ibarra, Leticia; Ayala, Guadalupe

    2015-01-01

    "Entre Familia: Reflejos de Salud" was a successful family-based randomized controlled trial designed to improve dietary behaviors and intake among U.S. Latino families, specifically fruit and vegetable intake. The novel intervention design merged a community health worker ("promotora") model with an entertainment-education…

  10. Soil Quality Indicators to Define Land Use in the Area of Native Forest of Entre Ríos, Argentina

    NASA Astrophysics Data System (ADS)

    Wilson, M. G.; Tasi, H. A.; Paz González, A.; Díaz, E. L.; Sasal, M. C.

    2012-04-01

    The main economic activity in the area of native forest of the province of Entre Ríos (Argentina) has long been the agricultural and/or livestock production, especially cattle breeding. In recent years, the proportion of agricultural crops in the rotations, especially that of soybean, has increased, thus leading to an increase in the need for land clearing to incorporate new lands for agricultural use. Most of these lands are considered marginal for agricultural use. In addition rice farming with irrigation is a critical part of the Entre Ríos economy. Defining and assessing soil quality indicators (SQI) that show the evolution of the soil with different uses and management systems is a way to contribute to the knowledge of soil quality. The aims of this study were to characterize the current land use and land tenure in the area of native forest of Entre Ríos, as well as to identify and select variables sensitive to agricultural and/or livestock use of the most representative soils of this area (indicators of the dynamic quality of the soil) and define the most appropriate land use according to land suitability and behavior of these indicators. We identified the most representative soil subgroups (corresponding to the orders Vertisols, Mollisols and Alfisols) and defined the production systems livestock-agricultural, agricultural-livestock, agricultural without irrigation, and rice crop irrigated with water from groundwater and surface reservoirs. We also determined the physical, physico-chemical, chemical and microbiological variables of the soil, and characterized the quality of the water for irrigation. We selected the SQI using Principal Components Analysis, to form a minimum data set (MDS). The change in the use of the land responded to a favorable economic situation for agriculture that started in the 1990's. The leasing and sharecropping schemes and the incidental contracts have become increasingly important, predominating over the undivided property. We

  11. State of Conservation of the Native Forests in Entre Ríos (Argentina) and Changes in Land Use

    NASA Astrophysics Data System (ADS)

    Sabattini, R. A.; Sione, S. M.; Ledesma, S. G.; Sabattini, J. A.; Wilson, M. G.

    2012-04-01

    The native forest area of Entre Ríos province (Argentina) is associated with a constant change in land use, with an increase in recent years in agricultural use, especially for soybean crop. In addition, since its inadequate management has triggered degradation processes of the natural forest structure, the implementation of strategies for the restoration and conservation of native forests has become a priority. The aim of this study was to diagnose the conservation state of the native forest in the basin of the Estacas Stream (Entre Ríos, Argentina) after the change in land use, to help design guidelines for the restoration and sustainable management of these ecosystems. The field study was conducted in October 2010, in a representative area of the native forest of 73,000 ha. Using Landsat 5-TM images (INPE), environments were separated by manual vectorization, identifying and classifying native forests and other lands (agricultural, urban). Using a field exploratory survey (58 geo-referenced sampling points), we developed patterns corresponding to the different types of forests, contrasting this information with the digital data of the images. The native forests were classified according to type (high/low forest, open/closed forest, savanna), successional stage (climax, successional or regeneration forest) and degree of disturbance (weed growth, erosion, fire), and their frequency determined. Each classification was assessed by a contingency matrix, and global reliability index and the Kappa index. The information obtained generated a classification map of native forests in the basin scale. We found that the native forest covered an area of 42,726.91 ha, accounting for 58.52% of the total basin area, and that the rest corresponded to other land uses. The most frequent native forests (59.09%) were climax forest, but accounted for only 8.2% of the basin area. Within this group, the most important were the low and open forest, with Prosopis affinis and Prosopis

  12. On acoplamento mecânico entre a antena e o transdutor no detector de ondas gravitacionais Mario Schenberg

    NASA Astrophysics Data System (ADS)

    Melo, J. L.; Aguiar, O. D.; Velloso, W. F., Jr.; Lucena, A. U.

    2003-08-01

    O detector de ondas gravitacionais MARIO SCHENBERG consistirá de uma massa esférica de cobre-alumínio de 1150kg resfriada a 4K, sobre a qual serão instalados 6 transdutores de nióbio. Com estes trandutores pretende-se converter um possível sinal de onda gravitacional detectado em sinal elétrico, para tanto é necessário que o acoplamento mecânico entre os transdutores e a massa ressonante seja o maior possível. Isto significa que o transdutor deve ser ressonante na mesma freqüência que a antena (aproximadamente 3200Hz). Neste trabalho foi desenvolvida uma geometria para a estrutura mecânica do trandutor. Isto foi feito criando-se modelos em elementos finitos usando-se o "software" MSC/Nastran. Estes modelos criados foram analisados estaticamente (cálculo de tensões) e dinamicamente (cálculo das freqüências de ressonâncias e seus respectivos modos normais) de maneira a se obter o primeiro modo normal do transdutor em 3200Hz. A partir destes cálculos escolheu-se a melhor geometria para o transdutor. Os próximos passos do trabalho serão: usinar este transdutor em uma barra de nióbio e testá-lo à temperatura ambiente e à baixa temperatura. Após isto, pretende-se testá-lo na própria antena resfriada.

  13. Half-size me? How calorie and price information influence ordering on restaurant menus with both half and full entrée portion sizes.

    PubMed

    Haws, Kelly L; Liu, Peggy J

    2016-02-01

    Many restaurants are increasingly required to display calorie information on their menus. We present a study examining how consumers' food choices are affected by the presence of calorie information on restaurant menus. However, unlike prior research on this topic, we focus on the effect of calorie information on food choices made from a menu that contains both full size portions and half size portions of entrées. This different focus is important because many restaurants increasingly provide more than one portion size option per entrée. Additionally, we examine whether the impact of calorie information differs depending on whether full portions are cheaper per unit than half portions (non-linear pricing) or whether they have a similar per unit price (linear pricing). We find that when linear pricing is used, calorie information leads people to order fewer calories. This decrease occurs as people switch from unhealthy full sized portions to healthy full sized portions, not to unhealthy half sized portions. In contrast, when non-linear pricing is used, calorie information has no impact on calories selected. Considering the impact of calorie information on consumers' choices from menus with more than one entrée portion size option is increasingly important given restaurant and legislative trends, and the present research demonstrates that calorie information and pricing scheme may interact to affect choices from such menus. PMID:26654889

  14. Cristallisation, syncristallisation, et alliages moléculaires entre le lorazépam et l'oxazépam

    NASA Astrophysics Data System (ADS)

    Mascherpa-Corral, D.; Mascherpa, G.; Chauvet, A.

    1993-04-01

    Le polymorphisme et pseudopolymorphisme du lorazépam et oxazépam ont été étudiés par analyse thermique, calorimétrie différentielle à balayage et diffraction de rayons X. Deux formes polymorphes du lorazépam et plusieurs mono et hemisolvates ont été isolés à partir de recristallisation dans divers soivants. Aucun polymorphisme ni solvate n'a été mis en évidence avec l'oxazépam. Les paramètres cristallographiques des phases isolées ont été déterminées. A 160 et 203°C, le lorazépam et l'oxazépam perdent respectivement une molécule d'eau pour donner après réarrangement la quinazolinecarboxaldéhyde correspondante. La syncristallisation des deux benzodiazépines dans le benzène conduit à des alliages moléculaires à miscibilité totale à l'état solide dans tout le domaine de concentration entre l'exazépam el la forme α du lorazépam, elle n'est que partielle avec la forme β. Thermal analysis, differential scanning calorimetry, and X-ray diffraction were carried out to study the polymorphism and pseudopolymorphism of lorazepam and oxazepam. Two polymorphic forms of lorazepam and several mono- or hemisolvates were obtained after recrystallization from various solvents. No polymorphic form or solvate has been found for oxazepam. The crystallographic parameters of these new phases were determined. Lorazepam and oxazepam can lose a molecule of water at 160 and 203°C, respectively, and rearrange to quinazolinecarboxaldehyde. Mixed crystals of the two benzodiazepines, after recrystallization from benzene, lead to molecular alloys with complete solid solubility between oxazepam and the α-form of lorazepam over the whole range of composition but only to partial solubility with the β-form of lorazepam.

  15. Relation entre les caractéristiques des table-bancs et les mesures anthropométriques des écoliers au Benin

    PubMed Central

    Falola, Stève Marjelin; Gouthon, Polycarpe; Falola, Jean-Marie; Fiogbe, Michel Armand; Nigan, Issiako Bio

    2014-01-01

    Introduction Le mobilier scolaire et la posture assise en classe sont souvent impliqués dans l'apparition des douleurs rachidiennes, influant de fait sur la qualité des tâches réalisées par les apprenants. Aucune étude n'a encore vérifié le degré d'adéquation entre les caractéristiques du mobilier et celles des écoliers au Bénin. L'objectif de cette étude transversale est donc de déterminer la relation entre les dimensions des table-bancs utilisées en classe et les mesures anthropométriques des écoliers au Bénin. Methods Elle a été réalisée avec un échantillon probabiliste de 678 écoliers, âgés de 4 à 17 ans. Les mesures anthropométriques des écoliers et les mensurations relatives aux longueurs, largeurs et hauteurs des table-bancs ont été mesurées, puis intégrées aux équations proposées dans la littérature. Les pourcentages des valeurs situées hors des limitesacceptables, dérivées de l'application des équations ont été calculés. Results La largeur et la hauteur des table-bancs utilisées par les écoliers étaient plus élevées (p < 0,05) que les valeurs de référence recommandées par les structures officielles de contrôle et de production des mobiliers scolaires au Bénin. Quel que soit le sexe, il y avait une inadéquation entre la largeur du banc et la longueur fesse-poplité, puis entre la hauteur de la table et la distance coude-bancdes écoliers. Conclusion Les résultats suggèrent de prendre en compte l’évolution des mesures anthropométriques des écoliers dans la confection des table-bancs, afin de promouvoir de bonnes postures assises en classe et de réduire le risque de troubles du rachis. PMID:25317232

  16. Effect of Grapefruit Seed Extract on Thermal Inactivation of Listeria monocytogenes during Sous-Vide Processing of Two Marinated Mexican Meat Entrées.

    PubMed

    Valenzuela-Melendres, Martin; Peña-Ramos, E Aida; Juneja, Vijay K; Camou, Juan Pedro; Cumplido-Barbeitia, German

    2016-07-01

    D- and z-values for Listeria monocytogenes were obtained for two Mexican meat entrées: pork meat marinated in tomatillo (green tomato) sauce (PTS) and beef marinated in a red chili sauce (BRCS), with addition of 0, 200, and 800 ppm of grapefruit seed extract (GSE). Meat samples inoculated with L. monocytogenes were packaged in sterile bags, immersed in a water bath, and held at 55, 57.5, 60, and 62.5°C for different periods of time. Depending upon the temperature, D-values at 0 ppm of GSE ranged from 26.19 to 2.03 min in BRCS and 26.41 to 0.8 min in PTS. Adding 800 ppm of GSE to BRCS thermally treated at 55 and 62.5°C significantly decreased inactivation time by 35%. A reduction in time of 25.9, 10.6, and 40.1% at 55, 57.5, and 60°C, respectively, was observed in PTS with 800 ppm of GSE. The z-values of L. monocytogenes were not significantly affected by GSE addition; average z-values were 7.25 and 5.09°C for BRCS and PTS, respectively. Estimated thermal lethality for a 7-D log reduction of L. monocytogenes under commercial-size sous-vide conditions at a reference temperature of 55°C was reached at 78 and 71 min for BRCS without and with 800 ppm of GSE, respectively. For PTS, 7-D reduction was attained at 69 and 61 min without and with addition of 800 ppm of GSE, respectively. Supplementing both Mexican meat entrées (BRCS and PTS) with 800 ppm of GSE rendered L. monocytogenes cells more sensitive to the lethal effect of heat. The results of this study will assist the retail food industry in designing acceptance limits on critical control points pertaining to cooking regimes to effectively eliminate L. monocytogenes in BRCS and PTS sous-vide processed Mexican meat entrées. PMID:27357037

  17. A Process Evaluation of an Efficacious Family-Based Intervention to Promote Healthy Eating: The Entre Familia: Reflejos de Salud Study.

    PubMed

    Schmied, Emily; Parada, Humberto; Horton, Lucy; Ibarra, Leticia; Ayala, Guadalupe

    2015-10-01

    Entre Familia: Reflejos de Salud was a successful family-based randomized controlled trial designed to improve dietary behaviors and intake among U.S. Latino families, specifically fruit and vegetable intake. The novel intervention design merged a community health worker (promotora) model with an entertainment-education component. This process evaluation examined intervention implementation and assessed relationships between implementation factors and dietary change. Participants included 180 mothers randomized to an intervention condition. Process evaluation measures were obtained from participant interviews and promotora notes and included fidelity, dose delivered (i.e., minutes of promotora in-person contact with families, number of promotora home visits), and dose received (i.e., participant use of and satisfaction with intervention materials). Outcome variables included changes in vegetable intake and the use of behavioral strategies to increase dietary fiber and decrease dietary fat intake. Participant satisfaction was high, and fidelity was achieved; 87.5% of families received the planned number of promotora home visits. In the multivariable model, satisfaction with intervention materials predicted more frequent use of strategies to increase dietary fiber (p ≤ .01). Trends suggested that keeping families in the prescribed intervention timeline and obtaining support from other social network members through sharing of program materials may improve changes. Study findings elucidate the relationship between specific intervention processes and dietary changes. PMID:25810469

  18. Uma Comparação entre Técnicas de Propagação de Erros em Astrofísica: Monte Carlo x Bootstrap

    NASA Astrophysics Data System (ADS)

    Zabot, Alexandre; Baptista, Raymundo

    2005-07-01

    Neste trabalho é feito um estudo comparativo entre dois algoritmos numéricos usados para propagação de erros em dados experimentais. Um deles é conhecido por Método de Monte carlo e o outro por Método de Bootstrap. Recentemente, Dhullon & Watson argüiram que a aplicação do método de Monte Carlo introduz ruído nos dados, e propuseram então a utilização do Bootstrap como alternativa capaz de produzir resultados superiores. O objetivo deste trabalho é testar a validade dessa afirmação. As duas técnicas foram aplicadas a três problemas diferentes: o ajsute de modelos de emissão LTE simples e atmosfera estelar a espectros estelares observados e o ajuste de curvas de luz de eclipses de Variáveis Cataclísmicas para a detemrinação da distribuição radial de brilho dos seus discos de acréscimo. Os métodos foram testados quanto à sua robusteza, ou seja, a capacidade de prover resultados coerentes enre si. Além disso, as soluções dos métodos foram comparadas. Os resultados indicam que não existe evidência de superioridade de um métodos em relação ao outro.

  19. Métastases cutanées vues au laboratoire d'anatomie pathologique à Lomé, Togo entre 2005 et 2014

    PubMed Central

    Darre, Tchin; Saka, Bayaki; Landoh, Dadja Essoya; Mouhari-Toure, Abas; Amegbor, Koffi; Pitché, Palokinam; Napo-Koura, Gado

    2015-01-01

    Introduction L'objectif de cette étude était de documenter le profil épidémiologique et histologique des métastases cutanées vues au laboratoire d'anatomie pathologique (LAP) de Lomé. Méthodes Il s'agissait d'une étude descriptive et transversale portant sur des cas de métastases cutanées observées au LAP du CHU Sylvanus Olympio entre 2005 et 2014. Résultats Au cours de cette période d’étude, nous avons recensé 32 cas de métastases cutanées représentant 3,2% (1005 cas) de l'ensemble des cas de métastases enregistrées au LAP. L’âge moyen des patients atteints de ces métastases cutanées était de 42,6 ans et le sex-ratio (F/H) de 2,2. Sur le plan macroscopique, ces métastases étaient nodulaires dans 15 cas, bourgeonnantes dans 12 cas, ulcéré dans 3 cas et ulcéro-bourgeonnant dans 2 cas. Les types histologiques étaient représentés par les adénocarcinomes (19 cas, 59,4%), les carcinomes épidermoïdes (8 cas, 25%), la maladie de Paget (3 cas, 9,4%), le carcinome à petites cellules du type neuroendocrine (un cas, 3,1%) et le mélanome (un cas, 3,1%). Selon le degré de différenciation, les métastases cutanées étaient bien différenciées dans 14 cas (56%). Les principales localisations de ces métastases cutanées étaient le thorax (11 cas, 34,4%) suivi de l'abdomen (10 cas, 31,3%). Les cancers primitifs étaient surtout d'origine mammaire (14 cas, 43,7%). Conclusion Cette étude montre que les métastases cutanées sont relativement rares et les tumeurs malignes d'origine mammaire sont les tumeurs primitives prédominantes. Avec un pourcentage élevé des formes peu différenciées et celles indifférenciées, l'amélioration du plateau technique du LAP (immunohistochimie) permettra d'accroitre ses capacités diagnostiques. PMID:27047627

  20. A Reappraising of Cosmography: the Interface Between Astronomical and Geographic Studies. (Breton Title: Releitura do Conceito de Cosmografia: a Interface Entre os Estudos Astronômicos e Geográficos.) Una Relectura del Concepto de Cosmografía: la Interfase Entre los Estudios Astronómicos y Geográficos

    NASA Astrophysics Data System (ADS)

    Azevedo Sobreira, Paulo Henrique

    2012-12-01

    The concept of "Cosmography" is in disuse since the 80s of the last century, but the astronomical themes previously discussed in the school subjects of Geography and Cosmography remain in current textbooks. The use of term "Cosmography" was rescued in this research, and the study of its re-signification prompted the appearance of the term Geographic Cosmography. The Geographic Cosmography is a field of studies of the Geography, whose set of knowledge and skills is predominantly scholar. It studies the interface between terrestrial and celestial knowledge, and assigns a geographic significance to them. It examines human and natural relationships with Sidereal Space and its consequences for society and nature. O conceito de "Cosmografia" está em desuso desde os anos 80 do século XX, mas os temas astronômicos anteriormente abordados nas disciplinas escolares de Cosmografia e de Geografia permanecem nos atuais livros didáticos. O uso do termo "Cosmografia" foi resgatado nesta pesquisa e o estudo de sua ressignificação proporcionou o surgimento do termo Cosmografia Geográfica. A Cosmografia Geográfica é um campo de estudos da Geografia, cujo conjunto de conhecimentos e habilidades é predominantemente escolar. Estuda a interface entre os conhecimentos terrestres e os celestes e lhes atribui significância geográfica. Analisa as relações humanas e naturais com o Espaço Sideral e suas consequências para a sociedade e a natureza.

    Aunque el concepto de "Cosmografía" no se usa desde la década de los '80 del siglo pasado, los temas astronómicos que se enseñaban anteriormente en las asignaturas escolares de Cosmografía y de Geografía permanecen en los actuales libros didácticos. El uso del término "Cosmografía" fue rescatado en esta investigación y el estudio de su resignificación proporcionó el surgimiento del término Cosmografía Geográfica. La Cosmografía Geográfica es un campo de estudio de la Geografía, donde

  1. Etude des phenomenes chimiques au contact entre le bloc cathodique et la barre collectrice d'une cellule d'electrolyse d'aluminium

    NASA Astrophysics Data System (ADS)

    Lebeuf, Martin

    La production d'aluminium est une industrie importante au Québec. Les propriétés de ce métal le vouent à de multiples usages présents et futurs dans le cadre d'une économie moderne durable. Toutefois, le procédé Hall-Héroult est très énergivore et des progrès demeurent donc nécessaires pour en diminuer les coûts financiers et environnementaux. Parmi les améliorations envisageables de la cellule d'électrolyse se trouve le contact entre la cathode et la barre collectrice, qui doit offrir une faible résistivité au passage du courant électrique. En cours d'opération de la cellule, ce contact a tendance à se dégrader, générant des pertes énergétiques significatives. Les causes de cette dégradation, pouvant provenir de phénomènes chimiques, thermiques, mécaniques et/ou électriques, demeurent mal comprises. Le but du présent projet était donc d'étudier les phénomènes chimiques se produisant au contact bloc-barre de la cellule d'électrolyse Hall-Héroult. En premier lieu, un aspect crucial à considérer est la pénétration du bain électrolytique dans la cathode, car des composés de bain atteignent éventuellement la barre collectrice et peuvent y réagir. A cet effet, une méthode novatrice a été développée afin d'étudier les cathodes et la pénétration du bain dans celles-ci à l'aide de la microtomographie à rayons X. Cette méthode rapide et efficace s'est avérée fort utile dans le projet et a un potentiel important pour l'étude future des cathodes et des phénomènes qui s'y produisent. Ensuite, une cellule d'électrolyse rectangulaire à petite échelle a été développée. Plusieurs phénomènes observés 'en industrie sur des autopsies de cellules post-opération et rapportés dans la littérature ont été reproduis avec succès à l'aide de cette cellule expérimentale. Puis, des tests sans électrolyse, ciblant l'effet du bain électrolytique sur l'acier, ont aussi été conçus et complétés afin de s

  2. Le renforcement de l'interface entre les services de santé publique et de première ligne : enjeux et pistes de solution

    PubMed Central

    Paquette, Daniel; Reinharz, Daniel

    2009-01-01

    Le développement de liens étroits entre la santé publique et les services cliniques, notamment ceux offerts par les médecins de famille œuvrant en première ligne, est prôné dans tous systèmes de santé occidentaux. On suppose que les collaborations formant une telle interface ont des impacts positifs à la fois sur la qualité des soins, sur le fardeau des maladies et sur l'équité dans le système de santé. Si les acteurs des deux domaines admettent le bien-fondé de l'interface et favorisent en principe son développement, plusieurs barrières nuisent aux collaborations dans la réalité. Or, peu est connu sur ces barrières dans le système de santé québécois. Cette étude vise à répondre à ce manque d'information en étudiant l'interface à partir d'une perspective organisationnelle. Deux cadres conceptuels ont été utilisés, soit la typologie de Lasker (1997) et les archétypes de Hinings et Greenwood (1988). L'analyse met en évidence deux des six formes de collaboration proposées par la typologie utilisée, soit la coordination des services aux individus et la mise à profit des rencontres cliniques pour les fins de la santé publique. Les activités associées à ces formes de collaboration, qui sont importantes eu égard au mandat de la santé publique, comportent un intérêt essentiellement pour la santé publique et sont déterminées en pratique unilatéralement par cette dernière. En outre, le manque de coordination des activités qui impliquent une collaboration avec les médecins constitue un obstacle au développement de telles activités en créant des irritants pour les médecins. Il y a donc, dans le système de santé québécois, des possibilités de développement de l'interface là où la collaboration se fait également au profit du travail clinique et là où elle tient compte des contraintes du milieu clinique. PMID:20436801

  3. Pincharse sin infectarse: estrategias para prevenir la infección por el VIH y el VHC entre usuarios de drogas inyectables

    PubMed Central

    MATEU-GELABERT, P.; FRIEDMAN, S.; SANDOVAL, M.

    2011-01-01

    infectarse por el VIH (sólo un doble negativo tuvo un amplio conocimiento sobre la hepatitis C). Estas intencionalidades no son mutuamente excluyentes. La presencia de varias refuerza la puesta en práctica a diario de comportamientos que pueden ayudar al que se inyecta a mantenerse libre de infecciones durante años. Algunas prácticas que hemos identificado se implementan en grupo y se comunican de UDI a UDI, de esta manera se extienden entre algunas redes sociales de UDI. Conclusiones Los UDI que permanecen sin infectarse planean e implementan estrategias de prevención en circunstancias donde otros UDI aplican prácticas de riesgo. El mantenimiento de la no infección no es, por lo tanto, un resultado del azar, sino más bien el resultado del esfuerzo (agencia) de los UDI. Investigar y extender estas estrategias y tácticas a través de programas de prevención podría contribuir a la prevención del VIH y el VHC. PMID:21915175

  4. Le transfert de connaissances entre les mathematiques et les sciences. Une etude exploratoire aupres d'eleves de 4e secondaire

    NASA Astrophysics Data System (ADS)

    Samson, Ghislain

    2003-06-01

    Au moment ou dans plusieurs pays on travaille a refondre les programmes d'etudes, tant au primaire qu'au secondaire, l'interet pour le transfert renait. Un des concepts fondamentaux en apprentissage consiste en l'habilete a reutiliser de facon consciente et efficace un acquis d'une situation a une autre situation. Cette recherche emane de preoccupations professionnelles au moment ou le chercheur etait enseignant au secondaire. Au cours de ces annees, il lui a ete possible de constater que plusieurs eleves percevaient difficilement les liens presents entre les disciplines mathematiques et scientifiques. Des travaux en psychologie cognitive et plus particulierement selon une perspective du traitement de l'information ont servi de cadre de reference pour evaluer et analyser les capacites de transfert aupres d'eleves de 4e secondaire. Ce cadre de reference permet de formuler le principal objectif qui est de mieux comprendre le processus de transfert chez des eleves en situation de resolution de problemes scientifiques. Cette these s'interesse donc au transfert en tant que phenomene important du processus d'apprentissage au sens de l'integration. La methode de recherche choisie, de nature qualitative, est principalement axee sur l'evaluation de la capacite a transferer des connaissances lors d'une epreuve et d'un entretien. Pour evaluer ce potentiel de transfert, nous avons elabore deux outils: une epreuve en mathematiques et en sciences et un guide d'entretien. Pour la passation de l'epreuve, le chercheur a pu compter sur la collaboration de 130 sujets provenant de deux ecoles. L'entretien complete la prise de donnees avec 13 sujets ayant accepte de poursuivre l'etude. Les donnees recueillies par ces instruments font ensuite l'objet d'une analyse de contenu. En premier lieu, les verbatims de l'epreuve et de l'entretien ont ete transcrits, puis codifies. La correction des reponses fournies pour les problemes resolus s'est faite a partir d'une grille d

  5. Use of bioabsorbable staple reinforcement material in side-to-side anastomoses: Suture line reinforcement of the weak point of the anastomosis

    PubMed Central

    Kimura, Masahiro; Terashita, Yukio

    2016-01-01

    Background Few studies have been designed regarding optimal reinforcement of the crotch of a side-to-side anastomosis. The purpose of this study was to clarify the weak point of the side-to-side anastomosis and to evaluate the effect of bioabsorbable reinforcement material. Methods Fresh pig small bowel was used for all experiments. A side-to-side anastomosis was performed using a linear stapler, and the burst pressure of the anastomosis was measured. Three separate experiments were done. In experiment 1, the weak point and the burst pressure of that point were defined. In experiment 2, the burst pressure of the side of the anastomosis was measured. In experiment 3, we evaluated the effect of Neoveil® to strengthen the weak point of the anastomosis. Results The weak point of the side-to side anastomosis was the crotch and the burst pressure was 39.8 ± 5.7 mmHg. The burst pressure of the side of the anastomosis was 109.9 ± 7.9 mmHg. This was significantly higher than the burst pressure of the crotch (P = 0.008). The burst pressure of the crotch in the group with Neoveil® was 83.3 ± 14.9 mmHg. This pressure was significantly higher than the group with no Neoveil® reinforcement (P = 0.001). Conclusion These findings suggest that the use of Neoveil® as a buttressing material is associated with reinforced staple lines and increased crotch burst pressures compared to non-buttressed staple lines. Neoveil® was found to perform comparably to clinically available buttress materials in this ex vivo model. Reinforcement of the weak point of the side-to-side anastomosis with Neoveil®may lead to fewer anastomotic leaks. PMID:27158487

  6. [Esophagojejunal anastomoses with the EEA stapler after total gastrectomy. Technic and immediate results apropos of a recent series of 32 cases].

    PubMed

    Le Treut, Y P; Delpero, J R; Sabiani, P; Berthet, B; Bozon-Verduraz, E; Pol, B; Bricot, R

    1987-12-01

    32 consecutive total gastrectomies for cancer (20 extended total gastrectomies) were carried out through an abdominal approach. Reconstruction using a Rouxen-Y loop (28 cases) or an interposed jejunal loop (four cases) was done with an EEA stapled oesophago jejunostomy: 25 end to side and 5 end to end anastomosis were performed and two technical failures led to complete manual anastomosis. All patients have had post-operative X-ray examination: there was no anastomotic leakage in this series, even in the 3 patients (10%) who have died during the post-operative course. A critical study of this series and eight others one from elsewhere is presented: it is concluded that the stapling device allows an easier and safer oesophagojejunostomy than manual procedure, when great care is taken of technical details. PMID:3436987

  7. Association entre les hormones sexuelles, les marqueurs de remodelage osseux et la densité minérale osseuse chez des femmes ménopausées d'origine marocaine (étude transversale)

    PubMed Central

    El Maataoui, Aissam; Biaz, Asmae; El Boukhrissi, Fatima; El Machtani, Si; Dami, Abdellah; Bouhsain, Sanae; Bamou, Youssef; El Maghraoui, Abdellah; Ouzzif, Zhor

    2015-01-01

    Introduction Le présent travail se propose d’étudier la relation entre les hormones sexuelles, notamment l’œstradiol et l'indice de l’œstradiol libre, le sulfate de déhydroépiandrosterone et la sex hormone binding globulin, les marqueurs de remodelage osseux et la densité minérale osseuse chez une population de femmes marocaine ménopausées. Méthodes Il s'agit d'une étude transversale, menée sur une période de 6 mois d'octobre 2012 à fin avril 2013 et ayant fait participer deux cent deux (202). Résultats L’œstradiol et l'indice d’œstradiol libre (IEL) ont montré une corrélation négative respectivement à l'ostéocalcine (OC), à la crosslaps (β-CTX) et l'OC (p<0.001). La sulfate de déhydroepiandrosterone S-DHEA a été corrélée positivement à l'OC (p<0.001), alors que e taux sérique de la sex hormone binding globulin (SHBG) l'a été corrélé à la β-CTX et l'OC (p<0.001). Par ailleurs, une corrélation positive a été établie entre la densité minérale osseuse (DMO) au col de fémur et le poids, l'indice de masse corporelle (IMC), l'IEL et la S-DHEA. Une corrélation négative a été retrouvée entre la DMO au col de fémur d'une part et l’âge, la DDR, la SHBG, la β-CTX et l'OC d'une autre part. Conclusion Le présent travail montre que l'augmentation de l’âge et la diminution de l’œstradiol libre expliquent la diminution de la DMO au niveau du col du fémur, alors que l'augmentation du taux sérique de la SHBG et la diminution du poids expliquent la diminution de la DMO au rachis lombaire. PMID:26848353

  8. Competition entre supraconductivite et magnetisme au voisinage de la transition de Mott dans le conducteur organique quasi-bidimensionnel k-(BEDT-TTF)2copper[N(CN)2]bromine

    NASA Astrophysics Data System (ADS)

    Fournier, David

    Les conducteurs organiques quasi-bidimensionnels kappa-ET2X presentent d'importantes similitudes avec les SCHT telles qu'une phase isolant de Mott, un regime de pseudogap et un etat supraconducteur. L'etude de leurs proprietes apparait donc complementaire. Parmi les interrogations persistantes concernant la physique de ces systemes, l'origine du (ou des) processus exotique d'appariement, responsable de la supraconductivite est le sujet suscitant l'interet le plus marque dans la communaute. L'hypothese d'un mecanisme lie a la proximite d'un etat antiferromagnetique est privilegiee. Une etape importante dans la resolution de cette problematique est l'identification de la symetrie du parametre d'ordre. D'apres de nombreux travaux sur les systemes fortement correles, la sonde ultrasonore, de par sa sensibilite aux excitations de quasiparticule a basse temperature, est consideree comme particulierement adaptee a l'etude de cette propriete. Cependant, son emploi necessite l'utilisation d'un compose metallique a basse temperature et completement supraconducteur. Le compose metallique organique kappa-ET 2Cu[N(CN)2]Br presente toutes les caracteristiques necessaires a l'etude de cette propriete. En effet, il est situe loin de la transition du premier ordre de Mott et est completement supraconducteur. De facon surprenante, ce systeme semble se coupler fortement avec le reseau ce qui augmente significativement la sensibilite de cette sonde aux proprietes du gaz electronique. Cependant, des difficultes techniques importantes, liees a la nature intrinseque de ce materiau, doivent etre surmontees pour proceder a des mesures suivant differentes polarisations. La presente etude a profondement modifie notre comprehension de ce systeme. En effet, ces mesures ont permis de constater que le kappa-ET2Cu[N(CN)2]Br est un compose qui est situe en bordure de la zone de coexistence entre la supraconductivite et le magnetisme, ce qui constitue un resultat totalement inattendu. De plus, la

  9. Factores socio-económicos asociados a la percepción de situación socioeconómica entre adultos mayores de dos países latinoamericanos

    PubMed Central

    Brenes-Camacho, Gilbert

    2014-01-01

    El objetivo principal del artículo es estudiar la asociación entre la percepción subjetiva sobre la situación económica propia y una serie de medidas objetivas de bienestar socioeconómico –fuentes de ingresos, tenencia de vivienda, nivel educativo y transferencias familiares informales de dinero- entre adultos mayores de dos países Latinoamericanos: México y Costa Rica. Los datos se obtienen de las primeras rondas de dos encuestas sobre envejecimiento: CRELES para Costa Rica y ENASEM para México. La variable dependiente más importante se obtiene de las respuestas a las pregunta “¿Cómo califica su situación económica actual?” en Costa Rica y “¿Diría usted que su situación económica es…?” en México. Para ambas encuestas, las respuestas se codificaron en forma binaria; el código 0 representa las categorías Excelente, Muy buena y Buena, y el código 1 representa a las categorías Regular y Mala. Se encontró que el ingreso por jubilación es un importante determinante de la percepción de bienestar en ambos países. En Costa Rica, el ingreso del cónyuge y la tenencia de vivienda son importantes predictores de la percepción de bienestar, mientras que en México, los ingresos por transferencias están fuertemente asociados con dicha percepción. PMID:25360057

  10. Aceptabilidad del diagnóstico rápido casero para HIV entre hombres gay y otros hombres que tienen sexo con hombres (G&HSH) de la Ciudad de Buenos Aires.

    PubMed

    Balán, Iván C; Carballo-Diéguez, Alex; Marone, Rubén O; Pando, María A; Barreda, Victoria; Avila, María M

    2011-03-01

    El uso del diagnóstico rápido para HIV en Argentina, así como otros países de Latinoamérica, ha sido limitado hasta el momento. Este trabajo reporta los resultados provenientes de un estudio cualitativo realizado entre hombres gays y otros hombres que tienen sexo con hombres (G&HSH) de la Ciudad de Buenos Aires, Argentina. El objetivo principal del mismo fue conocer las ventajas y desventajas que los hombres G&HSH perciben en relación al diagnóstico rápido casero para HIV. Se realizaron ocho grupos focales con 73 participantes en los cuales se discutió acerca de las ventajas y desventajas del uso de los diagnósticos rápidos. Las respuestas fueron codificadas utilizando un programa para análisis de datos cualitativos (NVivo) y analizadas temáticamente. Los participantes describieron numerosas ventajas sobre el uso del diagnóstico rápido casero, aunque algunos reportaron importantes preocupaciones dentro de las cuales se destaca la posibilidad de impulsos suicidas si alguien recibe un resultado positivo estando solo. En términos generales se observó una gran aceptabilidad para el uso del diagnóstico rápido si el mismo es realizado por personal de salud en lugares acondicionados para este fin. PMID:25284951

  11. Determinação de elementos próprios dos asteróides troianos: comparação entre as teorias semi-analítica e sintética

    NASA Astrophysics Data System (ADS)

    Roig, F.; Beaugé, C.

    2003-08-01

    Além do cálculo semi-analítico de elementos próprios dos asteróides Troianos (Beaugé & Roig 2001, Icarus 153, 391), recentemente foi apresentado um novo conjunto destes elementos próprios determinado através de uma teoria sintética (Knenezevic & Milani 2003, comunicação pessoal). As bases de dados contendo estas determinações estão disponiveis na pagina web do Asteroid Dynamical Site (http://hamilton.dm.unipi.it/cgi-bin/astdys/astibo). Nesta comunicação apresentamos os primeiros resultados de um estudo comparativo entre ambos conjuntos de elementos próprios, analisando suas vantagens e desvantagens, assim como os limites de precisão de cada conjunto. Mostramos que os elementos próprios sintéticos são mais precisos que os smi-analíticos para grandes amplitudes de libração do ângulo s = l-lJup, embora acontece o contrario para os corpos cuja amplitude de libração é muito pequena. Finalmente discutimos a influencia destes erros na determinação de familias de asteroides e da estrutura resonante em torno dos pontos Lagrangeanos L4 e L5.

  12. Aceptabilidad del diagnóstico rápido casero para HIV entre hombres gay y otros hombres que tienen sexo con hombres (G&HSH) de la Ciudad de Buenos Aires

    PubMed Central

    Balán, Iván C.; Carballo-Diéguez, Alex; Marone, Rubén O.; Pando, María A.; Barreda, Victoria; Ávila, María M.

    2011-01-01

    Resumen El uso del diagnóstico rápido para HIV en Argentina, así como otros países de Latinoamérica, ha sido limitado hasta el momento. Este trabajo reporta los resultados provenientes de un estudio cualitativo realizado entre hombres gays y otros hombres que tienen sexo con hombres (G&HSH) de la Ciudad de Buenos Aires, Argentina. El objetivo principal del mismo fue conocer las ventajas y desventajas que los hombres G&HSH perciben en relación al diagnóstico rápido casero para HIV. Se realizaron ocho grupos focales con 73 participantes en los cuales se discutió acerca de las ventajas y desventajas del uso de los diagnósticos rápidos. Las respuestas fueron codificadas utilizando un programa para análisis de datos cualitativos (NVivo) y analizadas temáticamente. Los participantes describieron numerosas ventajas sobre el uso del diagnóstico rápido casero, aunque algunos reportaron importantes preocupaciones dentro de las cuales se destaca la posibilidad de impulsos suicidas si alguien recibe un resultado positivo estando solo. En términos generales se observó una gran aceptabilidad para el uso del diagnóstico rápido si el mismo es realizado por personal de salud en lugares acondicionados para este fin. PMID:25284951

  13. Traces de l'interaction entre galaxies

    NASA Astrophysics Data System (ADS)

    Duc, Pierre-Alain

    2016-08-01

    Within a galaxy, collisions between stars are exceptional; collisions between galaxies are themselves much more frequent. They are even supposed to play a major role in the formation of structures according to the standard hierarchical cosmological model. Gravitational interactions, tidal forces and following mergers shape the morphology of galaxies, and leave vestiges which can survive for a few Gyr. They consist of stellar shells, streams, tails and plumes which emit a diffuse and extended optical light. Several deep imaging projects use telescopes of all sizes to try to detect this light. We detail here what the census of collisional debris can tel us about the past history of galaxies and about the models and simulations supposedly accounting for it.

  14. A Concepção de Universo entre Alunos do Ensino Médio de São Paulo e suas Fontes de Aquisição

    NASA Astrophysics Data System (ADS)

    Araújo, M. A. A.; Elias, D. C. N.; Amaral, L. H.; Araújo, M. S. T.; Voelzke, M. R.

    2006-08-01

    Nesse trabalho procurou-se identificar por meio de um questionário as concepções de Universo, de espaço e tempo que sustentam a visão de mundo de um grupo de 270 estudantes de Ensino Médio, pertencentes a três escolas de São Paulo. As questões relacionadas aos conhecimentos prévios dos estudantes permitiram constatar que há pouco conhecimento acerca dos temas investigados, destacando-se que apenas 20% dos alunos foram capazes de relacionar as semanas com as fases da lua, enquanto 28% associaram as estações do ano à inclinação do eixo de rotação da Terra e 23% tinham noções das distâncias entre objetos celestes próximos da Terra. Enquanto 56% conseguiram relacionar o Big Bang com a origem do Universo, verificou-se que 37% reconheciam ano-luz como unidade de distância e 60% concebiam o Sol como uma estrela. No que se refere às fontes de aquisição que proporcionaram esses conhecimentos, apesar de 60% dos alunos indicarem a escola como principal fonte dos conhecimentos de Ast! ronomia, verificou-se claramente que para a maioria dos alunos seus conceitos ainda são inadequados, havendo necessidade de aprimoramento da abordagem desses conteúdos, pois apesar de popular, a Astronomia ainda é veiculada de maneira pouco esclarecedora e com imprecisões. Nesse contexto, são discutidas algumas possíveis contribuições que podem ser dadas para o ensino de Astronomia pelo uso das ferramentas computacionais nas escolas.

  15. Distinción Empírica Entre Engagement y Trabajolismo en Enfermeras Hospitalarias de Japón: Efecto Sobre la Calidad del Sueño y el Desempeño Laboral

    PubMed Central

    Kubota, Kazumi; Shimazu, Akihito; Kawakami, Norito; Takahashi, Masaya; Nakata, Akinori; Schaufeli, Wilmar B.

    2016-01-01

    Objetivo El objetivo de este estudio es demostrar la distinción entre engagement y trabajolismo, estudiando su relación con la calidad del sueño y el desempeño laboral. Método Un total de 447 enfermeras de 3 hospitales de Japón fueron entrevistadas mediante un cuestionario autoadministrado que incluía la escala Utrecht (UWES, Utrecht Work Engagement Scale), la Escala de Adicción al Trabajo Holandesa (DUWAS, Dutch Workaholism Scale), preguntas sobre la calidad del sueño (7 ítems) con respecto a (1) dificultad para conciliar el sueño, (2) dificultad para mantener el sueño, (3) despertar temprano por la mañana, (4) dormirse o tomar siestas durante el día, (5) somnolencia diurna excesiva en el trabajo, (6) dificultad para despertarse por la mañana, y (7) despertar cansado en la mañana, y el Cuestionario sobre Salud y Desempeño (CSD) de la Organización Mundial de la Salud. Resultados Los modelos de ecuaciones estructurales demostraron que el engagement se relaciona positivamente con la calidad del sueño y el rendimiento laboral, mientras que el trabajolismo tiene una relación negativa con la calidad del sueño y el desempeño laboral. Conclusión Los resultados indican que el engagement y el trabajolismo son conceptualmente diferentes. El primero tiene una connotación positiva, mientras que el segundo se asocia de manera negativa al bienestar (buena calidad del sueño y buen rendimiento en el trabajo). PMID:26752805

  16. L’annonce d’une déficience motrice cérébrale : Une relation de confiance à construire entre les parents, le personnel paramédical et les médecins

    PubMed Central

    Pelchat, Diane; Lefebvre, Hélène; Bouchard, Jean-Marie

    2001-01-01

    RÉSUMÉ : L’annonce d’une déficience motrice cérébrale et des incapacités qui en découlent est une situation difficile à vivre pour les parents et les dispensateurs de soins (personnel paramédical et médecins). Un examen de la documentation médicale démontre que depuis vingt ans, le nombre de parents insatisfaits n’a pas changé. L’étude de type qualitatif et exploratoire, effectuée à la demande de milieux de réadaptation, vise à décrire le processus d’annonce d’un diagnostic de déficience motrice cérébrale (DMC) à partir de l’expérience des différents acteurs en cause et à déterminer les facteurs qui facilitent ou compliquent la relation de confiance. Les résultats indiquent que les parents et les dispensateurs de soins vivent dans deux mondes de perception différents au moment de l’annonce, lesquels se rejoignent difficilement. Les parents sont envahis par le drame qu’ils vivent, tandis que les médecins sont concentrés sur le contenu à transmettre aux parents. Cette annonce provoque une importante incertitude qui bloque la communication entre les partenaires, mais elle pourrait devenir un stimulant à de nouvelles stratégies d’adaptation. PMID:20084263

  17. Establishing the Empirical Relationship Between Non-Science Majoring Undergraduate Learners' Spatial Thinking Skills and Their Conceptual Astronomy Knowledge. (Spanish Title: Estableciendo Una Relación Empírica Entre el Razonamiento Espacial de los Estudiantes de Graduación de Carreras no Científicas y su Conocimento Conceptual de la Astronomía.) Estabelecendo Uma Relação Empírica Entre o RacioCínio Espacial dos Estudantes de Graduação EM Carreiras Não Científicas e Seu Conhecimento Conceitual da Astronomia

    NASA Astrophysics Data System (ADS)

    Heyer, Inge; Slater, Stephanie J.; Slater, Timothy F.

    2013-12-01

    The astronomy education community has tacitly assumed that learning astronomy is a conceptual domain resting upon spatial thinking skills. As a first step to formally identify an empirical relationship, undergraduate students in a non-major introductory astronomy survey class at a mediumsized, Ph.D. granting, mid-western US university were given pre- and post-astronomy conceptual diagnostics and spatial reasoning diagnostics, Instruments used were the "Test Of Astronomy Standards" and "What Do You Know?" Using only fully matched data for analysis, our sample consisted of 86 undergraduate non-science majors. Students' normalized gains for astronomy surveys were low at .26 and .13 respectively. Students' spatial thinking was measured using an instrument designed specifically for this study. Correlations between the astronomy instruments' pre- to post-course gain scores and the spatial assessment instrument show moderate to strong relationships suggesting the relationship between spatial reasoning and astronomy ability can explain about 25% of the variation in student achievement. La comunidad de educación en astronomía ha supuesto de forma tácita que el aprendizaje de la astronomía consiste en un dominio conceptual fundamentado en el razonamiento espacial. Como un primer paso para identificar formalmente una relación empírica entre estas dos cosas, utilizamos como muestra los estudantes de graduación de carreras no científicas de un curso experimental en una universidad norteamericana del medioeste de porte mediano con programa de Doctorado em curso, en el cual estos estudiantes se sometieron a un diagnóstico de razonamiento espacial y conceptos astronómicos antes e después del mismo. Las herramientas utilizadas fueron el Test Of Astronomy Standards (TOAST) y el cuestionario What do you know? Utilizando solo los datos completamente consistentes para este análisis, nuestra muestra consistió en 86 estudantes de graduación. Las mejoras, depués de

  18. Evaluacion entre colegas profesores (Peer Review of Teachers). ERIC Digest.

    ERIC Educational Resources Information Center

    Hertling, Elizabeth

    This digest in Spanish examines peer review, focusing on how these types of reviews can improve teacher competence. Peer review is often linked to peer assistance, which helps new and veteran teachers improve their knowledge and skills. In peer-review programs, consulting teachers conduct formal evaluations and recommend whether the participating…

  19. "Lo Ultimo": "Consejos"--"Un Dialogo Respetoso Entre Colegas"

    ERIC Educational Resources Information Center

    Vasquez, Olga A.; Flores, Belinda Bustos; Clark, Ellen Riojas

    2001-01-01

    "Los testimonios," or life stories, shared in this volume reveal that academia represents a labyrinth of challenges for aspiring and emerging Latina scholars--a story these authors know all too well. As Latina "veterana" scholars, who have traveled this arduous journey, the authors recognize that their collective efforts have…

  20. Etude de la flore bactérienne contaminant les téléphones mobiles avant et après la désinfection: comparaison entre les professionnels soignants de l'hôpital militaire d'instruction Mohammed V de Rabat et les témoins

    PubMed Central

    Uwingabiye, Jean; Moustanfii, Wafaa; Chadli, Meryem; Sekhsokh, Yassine

    2015-01-01

    Introduction L'objectif de notre travail était évaluer la contamination microbienne des téléphones mobiles utilisés par les personnels soignants des différents services de l'hôpital militaire d'instructions Mohammed V de Rabat et la comparer à celui d'une population témoin et aussi démontrer l'efficacité des solutions hydroalcoolique dans la désinfection de ces téléphones mobiles. Méthodes Il s'agit d'une étude descriptive transversale réalisée sur une période de 9 mois entre septembre 2010 et juin 2011, dans le service de bactériologie de l'hôpital militaire d'Instruction Mohammed V. Résultats L’étude bactériologique a été faite sur 240 téléphones mobiles dont 50% provenaient de personnels de sante. Le taux de contamination bactérienne de tous les téléphones mobiles était de 100%. Les cultures des bactéries isolées au niveau des téléphones mobiles du personnel médical étaient plus polymorphes que celles de la population témoin (p=0,028). Parmi 437 bactéries isolées: 223(51%) provenaient de téléphones de personnels de santé et 214(49%) de téléphones de la population témoin avec une différence qui n’était pas statistiquement significative(p>0,05) sauf pour les isolats de Staphylocoque à coagulase négative et Staphylococcus aureus. Les bactéries isolées étaient représentées par: Staphylocoque à coagulase (57,7%), Staphylococcus aureus (18,1%), Corynebacterium sp (18,8%), Bacillus sp (2,3%) et autres (2,2%). La différence entre la prévalence des bactéries isolées selon les services et les fonctions des personnels de santé n’était pas statistiquement significative (p>0,05). La désinfection des téléphones portables par la solution hydroalcoolique a réduit à 99,5% le nombre des colonies. Conclusion Ce travail montre que les téléphones portables pourraient jouer un rôle dans la transmission des infections nosocomiales et communautaires. Dans le cadre de prévention de ces risques, il faut

  1. Toxicité sérotoninergique résultant d’une interaction médicamenteuse entre le bleu de méthylène et les inhibiteurs de la recapture de la sérotonine

    PubMed Central

    Charbonneau, Annie

    2013-01-01

    RÉSUMÉ Contexte : Le bleu de méthylène est employé en pratique pour diverses raisons médicales. Des données récentes ont évoqué une interaction potentielle avec les inhibiteurs de la recapture de la sérotonine, pouvant conduire à une toxicité sérotoninergique. Objectif : Décrire le risque de toxicité sérotoninergique associé à l’interaction entre le bleu de méthylène et les inhibiteurs de la recapture de la sérotonine. Sources de l’information : Les publications pertinentes ont été ciblées systématiquement au moyen des moteurs de recherche MEDLINE (1946 au 21 mars 2013) et Embase (1974 à 2013, semaine 11) en utilisant les mots clés suivants : methylene blue, methylthioninium, monoamine oxidase inhibitors, serotonin reuptake inhibitors et serotonin syndrome. Aucune restriction touchant l’indication du bleu de méthylène ou la langue n’a été appliquée. Les références des publications ont également été analysées. Sélection des études et extraction des données : Dix-huit études de cas et deux séries de cas systématiques ont été sélectionnées. Aucune étude clinique aléatoire n’a encore été publiée. Synthèse des résultats : La première étude de cas à avoir soupçonné une interaction entre le bleu de méthylène et les inhibiteurs de la recapture de la sérotonine est parue en 2003. Dix-sept autres études de cas décrivant le même type d’interaction ont par la suite été rapportées. Les deux séries de cas ont regroupé les données de quelques 325 parathyroïdectomies où le bleu de méthylène avait été employé comme agent colorant. Les 17 patients qui ont présenté une toxicité du système nerveux central prenaient tous en période préopératoire des inhibiteurs de recapture de la sérotonine. Conclusion : Lorsqu’il est administré en concomitance avec des inhibiteurs de recapture de la sérotonine, le bleu de méthylène peut conduire à une toxicité sérotoninergique à une dose aussi

  2. The transclival artery: a variant persistent carotid-basilar arterial anastomosis not previously reported.

    PubMed

    Kirkland, Jared D; Dahlin, Brian C; O'Brien, William T

    2016-01-01

    During embryological development, primitive anastomoses exist between the carotid and vertebrobasilar arteries. These anastomoses typically regress or are incorporated into the developing vasculature. Persistence beyond fetal development, however, results in vascular anomalies that alter haemodynamic flow with a predisposition for aneurysm formation. The carotid-vertebrobasilar anastomoses mirror the primitive communications and include (from most to least common) the trigeminal, hypoglossal, proatlantal and otic arteries. The hypoglossal and proatlantal variants extend through the hypoglossal canal or foramen magnum, respectively. We present a previously undescribed variant of these persistent fetal anastomoses, the 'transclival artery', which courses through its own transclival skull base canal/foramen. PMID:27413022

  3. Anastomosis

    MedlinePlus

    Examples of surgical anastomoses are: Arteriovenous fistula (an opening created between an artery and vein) for dialysis Colostomy (an opening created between the bowel and the abdomen) Intestinal, ...

  4. "Entre Familia": Immigrant Parents' Strategies for Involvement in Children's Schooling

    ERIC Educational Resources Information Center

    Poza, Luis; Brooks, Maneka Deanna; Valdés, Guadalupe

    2014-01-01

    Teachers and administrators in schools with large, working-class Latino populations often complain of parents' indifference or lack of involvement in children's schooling because of their low visibility at school events and relatively little face-to-face communication with teachers and school administration. In a series of…

  5. Dominicanas entre La Gran Manzana y Quisqueya: Family, Schooling, and Language Learning in a Transnational Context

    ERIC Educational Resources Information Center

    Rodriguez, Tracy

    2009-01-01

    Drawing from a one-year qualitative research study, this article explores the transnational lives and experiences of three young women and their little sisters in New York with close ties to the Dominican Republic. Using ethnographic research methods--life history interviews, focus groups, participant observation, and document analysis, I examine…

  6. La formation a Bukavu au Zaire: une course entre l'education et la catastrophe

    NASA Astrophysics Data System (ADS)

    Balegamire, Bazilashe Juvénal

    1996-11-01

    A description of the socio-educational situation in Bukavu since the colonial era clearly shows why the population has sought means of overcoming the gradual abandonment by the Zairean State of its responsibilities, which has been aggravated by the large-scale influx into Kivu, in Eastern Zaire, of refugees from Rwanda and Burundi and of Zaireans who has been living in those countries for some years. These means are principally trade occupations, small-time selling, short-term vocational training and higher and university education at private institutions which are financed locally and/or by funds from the North. A new approach has been deveoped, that of training the trainers working for non-governmental development organisations. Trainers of trainers have been recruited locally among the many graduates of the Higher Institutes of Education and Rural Development, which have been affected by unemployment and the miserable salaries which the State offers to its employees. The trainers of trainers could be trained by the Higher Institute of Rural Development, making the largest possible use of local skills. However, such training should be one of a set of reforms of the Zairean education system. All of this only makes sense if Zaire and its neighbours urgently defuse present socio-political tensions so that all of our populations can peacefully and resolutely engage in the healthy transformation of our societies.

  7. Entre Dos Mundos/Between Two Worlds: Bicultural Development in Context

    ERIC Educational Resources Information Center

    Bacallao, Martica L.; Smokowski, Paul R.

    2009-01-01

    How do Mexican immigrant adolescents balance different, and often oppositional, cultural influences in the acculturation process? In this article, we explore how acculturating adolescents absorb cultural messages and go about creating their (multiple) identities. Guided by Alternation Theory, in-depth qualitative interviews were conducted with 12…

  8. Let's Talk About Water: Film Screenings as an Entrée to Water Science

    NASA Astrophysics Data System (ADS)

    Hooper, R. P.; Lilienfeld, L.; Arrigo, J.

    2011-12-01

    "Let's Talk about Water" is a film symposium designed to bring together experts and the public to talk about the complex water issues facing society. The format of the event is quite simple: a panel of experts and the audience view a water documentary (such as "FLOW", "Liquid Assets", or "Gasland") together and there is an extended moderated discussion period following the film between the panel and the audience. Properly handled, this simple format can be very effective. A film creates a context of subject and language for the discussion--it gets the audience and the panel on the same page. The moderators must actively manage the discussion, both challenging the panelists with follow up questions, asking questions to simplify the language the expert is using, and passing a question among panelists to bring out different points of view. The panelists are provided with the film in advance to view and, most importantly, meet the day before the event to discuss the film. This makes for a much more convivial discussion at the event. We have found that these discussions can easily be sustained for 90 to 120 minutes with active audience participation. This format has been applied at college campuses with a target audience of lower-level undergraduates. Student clubs are engaged to help with publicity before the event and to assist with registration and ushering during the event. Appropriate classes offer extra credit for student attendance to ensure a strong turnout. A Hollywood film ("Chinatown" in southern California, "A Civil Action" in Boston) is shown on campus during the week preceding the event to help advertise the event. The event itself is typically held on a Saturday with a morning screening of the film. The audience is provided with index cards and pencils to write down questions they have about the film. A lunch is provided during which the questions are organized and used to initiate different discussion themes. The discussion begins with points raised by the movie (are these issues real? Do they apply here? What are the scientific, engineering, and policy solutions to these problems?) and then segues into a discussion about career opportunities in the water sector. Our past events at UC Irvine and at UMass Boston have been successful in attracting large audiences and have been viewed positively by attendees.

  9. La Communicacion entre los Centros de Investigacion en Educacion (Communication among Educational Research Centers).

    ERIC Educational Resources Information Center

    Schiefelbein, Ernesto

    1972-01-01

    In Latin America there is a lack of communication concerning educational research. This lack has been underlined in many regional meetings, but no action has been taken. Possible steps that would lead to improvement include circulation of research summaries, both for completed and current works, efforts by research centers to organize meetings,…

  10. Actividades interrelacionadas entre el nino y la familia (Interrelated Activities between the Child and the Family).

    ERIC Educational Resources Information Center

    Veglio, Ana M.

    1993-01-01

    Offers a rationale for parent involvement in early childhood education. Describes the benefits of mother-child gymnastics in terms of the development of motor skills and positive attitudes toward school. Highlights particular exercises and games. (AC)

  11. Vinculación entre varios cúmulos estelares y estructuras del medio interestelar

    NASA Astrophysics Data System (ADS)

    Corti, M. A.; Baume, G. L.; Panei, J. A.; Suad, L. A.; Testori, J. C.; Borissova, J.; Kurtev, R.; Chené, A. N.; Ramirez Alegría, S.

    2015-08-01

    We study the embedded clusters DBS77, 78, 102, 160, and 161 located in the Galactic plane in the fourth quadrant of the Milky Way and the surrounding interstellar medium (ISM). We analyzed UBVIc photometry (SOAR) and infrared spectroscopy (NTT, ESO). We complemented these data with JHK (VVV2MASS), HI 21 cm bands (SGPS), 1.4 GHz (ATCA), and 4.85 GHz (PMN). We did multiband analysis and spectral classification of the brightest stars in each area. We also identified the ISM structures possibly related to the clusters. Finally, we obtained the main parameters of the studied clusters, the structures of the ISM and the link between them.

  12. New York: Les ecoles entre SURR et STAR (New York: Schools between SURR and STAR).

    ERIC Educational Resources Information Center

    Ueberschlag, Roger

    1994-01-01

    Three problems of New York City (New York) schools--overpopulation, low academic standards, violence--are examined, and an effort led by parent and teacher organizations to improve conditions is described. Threatened closings (schools under registration review, SURR) and a program of violence reduction (Straight Talk about Risks, STAR) are noted.…

  13. GPS, punto de contacto entre la Astronomía y otras disciplinas

    NASA Astrophysics Data System (ADS)

    Perdomo, R.

    En los primeros años de la pasada década, un grupo de Astrónomos de La Plata iniciaron trabajos de investigación en Geodesia Satelital. En esta presentación se propone repasar sus principales logros y situarlos en el contexto del desarrollo de la disciplina a nivel mundial. Por entonces las aplicaciones prácticas de la disciplina eran indirectas y solo evidentes para los especialistas. Los errores del Posicionamiento Satelital eran de varios metros y en posicionamiento relativo, del orden de medio metro. Estos resultados se lograban al cabo de varios días de medición continuada. En los años siguientes, el sistema GPS alcanzó su nivel operacional y produjo una revolución tanto en lo relacionado con los tiempos de medición como con las precisiones. El grupo de La Plata se desarrolló simultáneamente con GPS, lo que posibilitó su participación actual en diversos temas vigentes: aplicaciones de alta precisión para la materialización de sistemas terrestres de referencia, monitoreo de movimientos de la corteza, contribución con servicios internacionales para la determinación de movimientos tectónicos globales y regionales, monitoreo de la ionósfera a partir de la propagación de las señales, determinación de la ondulación del geoide a escala local, etc. También se generaron muchas aplicaciones prácticas algunas en tiempo real: navegación, apoyo a imágenes aéreas o satelitales, aplicaciones a la agricultura, catastro y ordenamiento territorial, apoyo a relevamientos geofísicos, etc.

  14. L'Harmonisation des langues maliennes: entre l'Integration nationale et régionale

    NASA Astrophysics Data System (ADS)

    Ouane, Adama

    1991-03-01

    The standardization of Malian languages, which began in the period after independence, has been an educational reform guided more by linguists than by any institutional framework laid down by the political authorities of the country. This situation has permitted the technical application of a scientific strategy, but it has not led to widespread and general acceptance of the formulas which have been worked out. The consequent opposition between technical and political considerations, which have admittedly not always been in conflict, has been complicated by a set of additional factors which have made it difficult to reconcile internal (national) harmonization, dictated by local tendencies and balances between languages, and the need to respect the (regional) ecolinguistics of the country, whose linguistic and sociocultural divisions frequently extend well into other countries of the sub-region. This conflict is illustrated by the example of Malian languages with a wide regional distribution — Bamanan (Bambara) and Fulfulde (Fulani) — and by that of languages with a narrower distribution such as Bomu and Syenara-Mamara. The standardization of orthography and the creation of terminology in the MAPE (Mandingo-Peul) Project are the manifestation of a general acceptance of regionalism, while the choice of central, standard languages has often been made without regard for regional factors.

  15. L' upwelling de la côte atlantique du Maroc entre 1994 et 1998

    NASA Astrophysics Data System (ADS)

    Makaoui, Ahmed; Orbi, Abdelattif; Hilmi, Karim; Zizah, Soukaina; Larissi, Jamila; Talbi, Mohammed

    2005-12-01

    The pelagic ecosystem of the Moroccan Atlantic coast is influenced by the spatiotemporal variability of upwelling. The changes in the physicochemical and biological parameters as well as their interrelationship and regrouping by the principal components analysis allowed us to subdivide the Atlantic coast in four active areas: two areas located at the north of Cape Juby (28°N), characterised by a summery activity and two areas located at the south, active permanently, with a variable intensity. To cite this article: A. Makaoui et al., C. R. Geoscience 337 (2005).

  16. Proximal anastomosis using the OrVil circular stapler in major upper gastrointestinal surgery.

    PubMed

    Knight, Benjamin C; Rice, Samuel J; Devitt, Peter G; Lord, Andrew; Game, Philip A; Thompson, Sarah K

    2014-07-01

    Anastomoses in major upper gastrointestinal surgery can be technically demanding, especially handsewn anastomoses traversing the diaphragmatic hiatus. The OrVil stapler is a unique circular stapler that allows rapid creation of various upper gastrointestinal anastomoses in technically challenging circumstances, particularly if additional proximal clearance is desirable. Little is reported in the literature regarding its outcomes and complication rates. In this 'How I do It' article, we describe our technique and experience with the OrVil in major upper gastrointestinal surgery. PMID:24553876

  17. Latissimus dorsi free flap for coverage of sacral radiodermatitis in the ambulatory patient

    SciTech Connect

    Stark, D.; Tofield, J.J.; Terranova, W.; Hurley, D.; Kenney, J.

    1987-07-01

    Ambulatory patients with large sacral ulcers can represent extremely challenging coverage problems. Technical options become fewer when sacral ulcers are coupled with radiation dermatitis. Latissimus dorsi free flap transfer, with direct anastomoses to sacral vessels, is described in 2 patients.

  18. ULTRASTRUCTURE OF NORMAL AND NEOPLASTIC EXOCRINE PANCREAS IN THE MUMMICHOG, FUNDULUS HETEROLCLITUS

    EPA Science Inventory

    The ultrastructure of normal exocrine pancreas and exocrine pancreatic neoplasms in Fundulus heteroclitus from a creosote-contaminated environment in the Elizabeth River, Virginia, is described. he normal exocrine pancreas in this species was an anastomosing tubular rather than a...

  19. Les mucocèles appendiculaires, problèmes diagnostiques et thérapeutiques: à propos de 26 cas

    PubMed Central

    Hedfi, Mohamed; Jomni, Med Taieb; Ghachem, Dorra Ben; Abdelhedi, Cherif; Chouchene, Adnene

    2015-01-01

    La mucocèle appendiculaire est une affection rare caractérisée par une dilatation de la lumière appendiculaire avec des altérations muqueuses linéaires, une hypersécrétion de mucus. Nous avons réalisé une étude rétrospective entre le mois de janvier 2000 et le mois Décembre 2014. Vingt six patients dont 16 hommes et 10 femmes ayant un âge moyen de 43 ans ont été colligés. Les douleurs abdominales étaient un symptôme constant. Quatre malades (15%) avaient une masse palpable au niveau de la fosse iliaque droite et un autre avait une ascite lors du diagnostic. Une complication à type d'occlusion intestinale aigue était révélatrice dans deux cas. Le diagnostic était évoqué en préopératoire par l'imagerie chez neuf (34%) patients. Une appendicectomie simple était réalisée chez 8 patients. Trois malades ont eu une résection iléo-caecale devant un aspect per opératoire de masse appendiculaire. Le geste était une hémi colectomie droite avec anastomose iléo transverse pour 5 patients, une résection iléo-caecale pour deux patients et une réduction tumorale associée à une évacuation de l'ascite dans un autre cas. L'examen anatomo-pathologique avait conclu à une mucocèle rétentionnelle bénigne, un cystadénome mucineux et à un cystadénocarcinome chez respectivement 15, 7 et 4 malades. PMID:26985280

  20. Transition quantique entre états électroniques de systèmes bi-couche

    NASA Astrophysics Data System (ADS)

    Pasquier, Vincent

    The possible phase transitions when two layers at filling factor νt=1 are gradually separated are studied in this article. In the bosonic case the system should undergo a pairing transition from a Fermi liquid to an incompressible state. In the Fermionic case, the state evolves from an incompressible (1,1,1) state to a Fermi liquid. It is speculated that there is an intermediate phase involving charge two quasiparticles. To cite this article: V. Pasquier, C. R. Physique 3 (2002) 709-715.

  1. Henri Chretien, un savant entre science et technique: reflections a propos de l'invention de l'hypergonar

    NASA Astrophysics Data System (ADS)

    Le Guet Tully, Francoise

    At the beggining of the 20-th century, French engineers and scientists were not well acquainted with some of the importnat principles of applied optics developed elsewhere, especially in Germany, over the preceding fifty years. In preparation for a career as a designer of astronomical instruments, Henri Chretien visited observatories in several countries and read widely. His research in optics produced many tangible advances. The Richy-Chretien telescope, which gained popularity in the 1960s and still in use today, was designed in 1910, based on an application of the principles developed by Abbe in Germany first to make color movies and then, though another application of the same principle, to project motion pictures onto a wide screen (The "Hypergonar" objective).

  2. Entre el Renacimiento y el Nuevo Mundo: Vida y obras de Hernan Perez de Oliva (1494?-1531)

    ERIC Educational Resources Information Center

    Pellus Perez, Elena

    2012-01-01

    Hernan Perez de Oliva (1494?-1531) was a learned Spanish humanist who wrote his major works in the decades following the discovery of America. By articulating events of his career and literary life, my goal is to comprehend his contributions to the early literary production regarding the newly-found Americas. The thesis consists of three parts.…

  3. Detection of PhIP in grilled chicken entrées at popular chain restaurants throughout California.

    PubMed

    Sullivan, Kristie M; Erickson, Michael A; Sandusky, Chad B; Barnard, Neal D

    2008-01-01

    Heterocyclic amines (HCAs), compounds formed when meat is cooked at high temperatures particularly through pan frying, grilling, or barbequing, pose a potential carcinogenic risk to the public. It is unclear whether there is any level at which consumption of HCAs can be considered safe. Efforts to measure these compounds mainly include cooking studies under laboratory conditions and some measurement of home-cooked foods, but analysis of commercially cooked foods has been minimal. Attempts to estimate exposure of the public to these compounds must take into consideration dining outside the home, which could result in significant exposure for some individuals. We surveyed at least 9 locations each of 7 popular chain restaurants (McDonald's, Burger King, Chick-fil-A, Chili's, TGI Friday's, Outback Steakhouse, and Applebee's) in California, collecting one or two entrees from each location. Entrees were analyzed for 2-amino-1-methyl-6-phenylimidazo[4,5-b]pyridine (PhIP) using high-performance liquid chromatography tandem mass spectrometry. All 100 samples contained PhIP. Concentrations were variable within and between entrees and ranged from 0.08 to 43.2 ng/g. When factoring in the weight of the entrees, absolute levels of PhIP reached over 1,000 ng for some entrees. Potential strategies for reducing exposure include the avoidance of meats cooked using methods that are known to form PhIP. PMID:18791922

  4. Neuropatía persistente aumenta el riesgo de caídas entre supervivientes de cáncer

    Cancer.gov

    Muchas mujeres supervivientes de cáncer tienen problemas de movilidad y de otras funciones físicas como resultado de la neuropatía periférica persistente causada por el tratamiento de quimioterapia, según un estudio nuevo.

  5. Interactivite, relations entre interlocuteurs et constitution d'unites conversationnelles (Interaction Processes, Participants' Relationships and Definition of Conversation Units).

    ERIC Educational Resources Information Center

    Zenone, Anna

    1981-01-01

    Analyzes a type of conversational exchange where the participants focus on a given subject or theme contributing personal views to the discussion. Characterizes the relationship among the participants as a "cooperative conflict," examining the internal structure of speech acts and their illocutory functions, particularly the initiatory and…

  6. Alternancia entre el estado de emisión de Rayos-X y Pulsar en Sistemas Binarios Interactuantes

    NASA Astrophysics Data System (ADS)

    De Vito, M. A.; Benvenuto, O. G.; Horvath, J. E.

    2015-08-01

    Redbacks belong to the family of binary systems in which one of the components is a pulsar. Recent observations show redbacks that have switched their state from pulsar - low mass companion (where the accretion of material over the pulsar has ceased) to low mass X-ray binary system (where emission is produced by the mass accretion on the pulsar), or inversely. The irradiation effect included in our models leads to cyclic mass transfer episodes, which allow close binary systems to switch between one state to other. We apply our results to the case of PSR J1723-2837, and discuss the need to include new ingredients in our code of binary evolution to describe the observed state transitions.

  7. Estimation du risque collisionnel entre une sonde spatiale cométaire et un fragment du noyau

    NASA Astrophysics Data System (ADS)

    Desvoivres, Emmanuel; Klinger, Jürgen; Levasseur-Regourd, Anny-Chantal

    2000-03-01

    Several comets will be approached by space probes during the two next decades. The presence of a fragment of the nucleus in the coma is a real danger. We have estimated the probability of presence of a boulder in the inner coma, using a model for the dynamics of fragments. Specific recommandations are deduced in order to reduce the risk of a collision.

  8. Metonymie dans la presse ecrite: entre discours et langue (Metonymies in the Press: Between Discourse and Language).

    ERIC Educational Resources Information Center

    Lecolle, Michelle

    2001-01-01

    This paper describes certain metonymies that are often employed in the daily French press. In such metonymies, a human being or a set of individuals are referred to by means of the name of an institutional location (i.e., a capital city, a ministry in a western country, the name of a country). These metonymic patterns do not seem to be used by…

  9. Diriger un Memoire Professionnel--Entre Dispositif Institutionnel et Problematique Relationnelle: Le Cas de la Formation des Enseignants en France.

    ERIC Educational Resources Information Center

    Bailleul, Marc; Bodergat, Jean-Yves

    2001-01-01

    Describes research conducted in a French teacher training college about the supervision of preservice teachers writing professional dissertations (which became compulsory in 1991). After describing elementary and secondary level preservice teachers' perspectives, researchers examined the perspectives of their supervisors to show discrepancies.…

  10. Modelisation de l'interaction entre une impulsion laser ultrabreve et une nanostructure plasmonique en milieu aqueux

    NASA Astrophysics Data System (ADS)

    Boulais, Etienne

    There is still a limited understanding of the basic mechanisms and processes triggered by laser irradiation that lead to the damaging of the surrounding structures. In particular, there exists for the moment no complete modelling of the process that includes all potential sources of cellular damage, including temperature rise, plasma generation, pressure wave emission and vapor bubble formation. This thesis presents such a modelling, with the cell environment emulated by a much simpler aqueous medium. Water is used as its optical, mechanical and thermal characteristic are similar enough to the cell environment to enable the transposition of the results and tendencies observed in water to this medium. Modelling consists in a continuous medium based approach that uses coupled partial differential equations to simulate the nanostructure-water system's response to an ultrafast laser pulse. The time-dependant field distribution in the system is simulated using classical electromagnetic theory, while the temperature in the nanostructure is calculated using a two-temperature model. Generation and heating of a plasma in the nanostructure's vicinity from photoionization and impact ionization in the near-field, as well as from photothermal emission from the nanostructure at the metal interface are also included. This plasma locally modifies the refractive index, which alters the simulated optical response of the system. Energy relaxation from this plasma as well as heat conduction from the nanostructure's lattice transfer energy to the water, which dynamics and thermodynamics evolutions are simulated from hydrodynamic and energy conservation equations. Modelling is used for analyzing the interaction of a near-infrared ultrafast laser pulse (45 fs, 800 nm, 200 mJ/cm2) with two distinct systems : a 100nm gold nanoparticle and a 10x41 nm2 gold nanorod. The gold nanoparticle shows a plasmon resonance at a ˜550 nm wavelength, and is thus slightly off-resonance at the 800 nm irradiation wavelength. In opposition, the gold nanorod shows a plasmon resonance directly at 800 nm and is thus in-resonance at the irradiation wavelength. The system of tightly coupled time-dependant non-linear partial differential equations is solved in 3D using a finite-element method. The modelling shows the generation of vapor bubble around both systems, which maximal diameter and growth time are validated from spectroscopic measurements. Results show an important production of plasma in the nanostructure's near field, which fast relaxation heats rapidly the surrounding water, leading to the emission of strong pressure wave and to the formation of a vapor bubble. Simulations further demonstrate the crucial importance of the plasma in the cavitation mechanism. For both the nanoparticle and the nanorod, results show that most of the laser energy is indeed absorbed in the plasma surrounding the nanostructure rather than in the nanostructure itself. In particular, the energy absorbed in the nanoparticle is shown to be insufficient to induce the formation of a vapor bubble at 200 mJ/cm2, whereas such a bubble is experimentally observed. This is a major result of the thesis, as such a plasma-mediated plasmonic enhanced cavitation mechanism has never been reported in the literature. The existence of this plasma-mediated mechanism that does not rely on the particle extreme heating to initiate cavitation has important consequences on cell nanosurgery applications. Finally, based on the same modelling, we develop a simple and efficient method to evaluate the potential of specific nanostructures and irradiation parameters for cell nanosurgery. We introduce a performance factor based on minimizing the energy density deposited in the nanostructure to avoid fragmentation, while maximizing the overall energy deposited in the system, to enhance the production of vapor bubbles. Results predict off-resonance 175 nm gold nanoparticles to be best suited for near-infrared ultrafast laser cell nanosurgery using 45 fs pulses at a wavelength of 800 nm. They also confirm the low inte

  11. Experimental study of sutureless vascular anastomosis with use of glued prosthesis in rabbits

    PubMed Central

    Vokrri, Lulzim; Qavdarbasha, Arsim; Rudari, Hajriz; Ahmetaj, Halil; Manxhuka-Kërliu, Suzana; Hyseni, Nexhmi; Porcu, Paolo; Cinquin, Philippe; Sessa, Carmine

    2015-01-01

    Objective The objective of this study is to explore the feasibility and efficacy of a new technique for sutureless vascular anastomosis, using glued prosthesis, as a sole anastomosis fixation method in rabbits. Methods Ten rabbits were randomly selected to conduct the experiment. Five rabbits underwent direct anastomosis of infrarenal abdominal aorta, with glued prosthesis. In five other rabbits, reconstruction was done by sutured anastomosis. All animals were immediately examined by echo-Doppler for patency of anastomosis. The burst pressure of the glued anastomosis was measured and compared with that of a sutured artery. The animals were euthanized, and tissue samples were taken for histological examination immediately after the experiment. Results Compared to conventional anastomoses, sutureless vascular anastomoses required shorter time of creation and significantly reduced blood loss (P<5%). There was no significant difference on the average blood flow through the anastomosis between two groups at the end of surgery. All anastomoses with glued prosthesis, examined by echo-Doppler, were patent at the anastomotic site, except one, which was stenosed immediately after surgery. In the control group, except one with stenosis, all conventional anastomoses were patent. Mean burst pressure at the anastomotic site for sutureless anastomoses was lower than in control group. Macroscopically, the BioGlue did not demonstrate any adhesion to the surrounding tissue as it was covered by the vascular prosthesis. Histological examination showed low-grade inflammatory reaction in glued anastomoses versus no inflammatory reaction at the sutured anastomoses. Conclusion This technique may provide a feasible and successful alternative in vascular surgery. However, further long-term studies are necessary to elucidate the break pressure and degree of inflammation at the anastomotic site. PMID:25848302

  12. A novel colonic anastomosis technique involving fixed polyglycolic acid mesh

    PubMed Central

    Aysan, Erhan; Bektas, Hasan; Ersoz, Feyzullah; Sari, Serkan; Kaygusuz, Arslan

    2010-01-01

    Background: Polyglycolic acid mesh (PAM) reinforcement of colonic anastomoses were evaluated. Methods: Twenty female albino rabbits were divided into two groups. Each rabbit underwent segmental colonic resection with single-layer anastomosis. In one group of rabbits, PAM of length equal to the circumference of the anastomosis was applied. Rabbits were sacrificed on postoperative day 10 and peritoneal adhesions, anastomosis burst pressure, and anastomosis histopathological characteristics were evaluated. Results: The average burst pressure for the control and PAM groups was 149±15.95 mmHgand 224±124.5 mmHg, respectively (p=0.578). All control anastomoses burst, whereas only five (50%) PAM anastomoses burst (p<0.03). There was no anastomotic leakage in the control group, whereas three PAM group anastomoses leaked (p=0.210). The collagen fiber density and amount of neovascularization were lower in the PAM than the control group (p=0.001 and p=0.002, respectively). The average peritoneal adhesion value was 1.6±0.51 in the control group and 2.9±0.31 in the PAM group (p<0.0001). Conclusion: The new fixed PAM-reinforced anastomosis technique resulted in an increased risk of anastomosis leakage and peritoneal adhesion, but also higher in non-burst anastomoses. PMID:21072268

  13. Long-term prospective evaluation of intestinal anastomosis using stainless steel staples in 14 dogs.

    PubMed

    Benlloch-Gonzalez, Manuel; Gomes, Eymeric; Bouvy, Bernard; Poncet, Cyrill

    2015-07-01

    This prospective clinical study evaluated the use, complications, and clinical and ultrasonographic follow-ups of end-to-end intestinal anastomoses with skin staples in naturally occurring diseases in canine small and large intestines. Intestinal anastomoses were performed in 14 dogs and pre-, peri-, and postoperative data were recorded. Postoperative clinical and ultrasound evaluations were performed at regular intervals for 1 year. The mean time taken to construct the anastomosis was 5 min. There were no intraoperative complications. Hemorrhage and colonic stricture were the main postoperative complications. Staple loss occurred in 2 cases. Absence of wall layering and focal wall thickening were observed in all cases at each ultrasonographic follow-up. Hyperechoic fat was observed in all but 1 of the cases at month 1. Nine dogs were alive with normal digestive function at the end of the study. The skin stapler technique enabled rapid construction of consistent anastomoses with inexpensive stapling material. PMID:26130833

  14. Long-term prospective evaluation of intestinal anastomosis using stainless steel staples in 14 dogs

    PubMed Central

    Benlloch-Gonzalez, Manuel; Gomes, Eymeric; Bouvy, Bernard; Poncet, Cyrill

    2015-01-01

    This prospective clinical study evaluated the use, complications, and clinical and ultrasonographic follow-ups of end-to-end intestinal anastomoses with skin staples in naturally occurring diseases in canine small and large intestines. Intestinal anastomoses were performed in 14 dogs and pre-, peri-, and postoperative data were recorded. Postoperative clinical and ultrasound evaluations were performed at regular intervals for 1 year. The mean time taken to construct the anastomosis was 5 min. There were no intraoperative complications. Hemorrhage and colonic stricture were the main postoperative complications. Staple loss occurred in 2 cases. Absence of wall layering and focal wall thickening were observed in all cases at each ultrasonographic follow-up. Hyperechoic fat was observed in all but 1 of the cases at month 1. Nine dogs were alive with normal digestive function at the end of the study. The skin stapler technique enabled rapid construction of consistent anastomoses with inexpensive stapling material. PMID:26130833

  15. Does hyperbaric oxygen therapy prevent airway anastomosis from breakdown?

    PubMed

    Dickhoff, Chris; Daniels, Johannes M A; van den Brink, Ad; Paul, Marinus A; Verhagen, Ad F T M

    2015-02-01

    Ischemia with subsequent necrosis of anastomoses, after central airway resection and reconstruction, remains a feared complication for thoracic surgeons and their patients. To date, there is no evidence to support the use of hyperbaric oxygen in the prevention of necrosis of airway reconstructions in humans. We present a patient who underwent central airway surgery with postoperative ischemia of an end-to-side anastomosis. Repeat visit to a hyperbaric oxygen chamber seemed to prevent the anastomosis from subsequent necrosis and dehiscence with complete healing as a result. In conclusion, hyperbaric oxygen treatment can be considered when ischemia or necrosis is observed in central airway anastomoses during postoperative bronchoscopic surveillance. PMID:25639406

  16. Persistent primitive trigeminal artery associated with monocular blindness and external carotid-vertebral artery anastomosis

    PubMed Central

    Yin, Suo; Zhang, Hong T.; Zhang, Dao P.; Zhang, Shu L.

    2015-01-01

    In this paper, we present 2 rare cases of persistent embryonic anastomoses. In one case, the patient presented with persistent trigeminal artery along with multiple foci of cerebral infarction as well as central retinal artery thrombosis. In the other case, the patient had direct anastomosis of the vertebral artery with ipsilateral external carotid artery as well as pontine infarction, aneurysm, and unilateral hypoplasia of the vertebral artery. The findings in these cases may shed light on the clinical presentation of such persistent anastomoses and aid their detection in clinical settings. PMID:25935186

  17. Persistent primitive trigeminal artery associated with monocular blindness and external carotid-vertebral artery anastomosis.

    PubMed

    Yin, Suo; Zhang, Hong T; Zhang, Dao P; Zhang, Shu L

    2015-05-01

    In this paper, we present 2 rare cases of persistent embryonic anastomoses. In one case, the patient presented with persistent trigeminal artery along with multiple foci of cerebral infarction as well as central retinal artery thrombosis. In the other case, the patient had direct anastomosis of the vertebral artery with ipsilateral external carotid artery as well as pontine infarction, aneurysm, and unilateral hypoplasia of the vertebral artery. The findings in these cases may shed light on the clinical presentation of such persistent anastomoses and aid their detection in clinical settings. PMID:25935186

  18. Collateral Pathways in Portal Hypertension

    PubMed Central

    Sharma, Malay; Rameshbabu, Chittapuram S.

    2012-01-01

    Presence of portosystemic collateral veins (PSCV) is common in portal hypertension due to cirrhosis. Physiologically, normal portosystemic anastomoses exist which exhibit hepatofugal flow. With the development of portal hypertension, transmission of backpressure leads to increased flow in these patent normal portosystemic anastomoses. In extrahepatic portal vein obstruction collateral circulation develops in a hepatopetal direction and portoportal pathways are frequently found. The objective of this review is to illustrate the various PSCV and portoportal collateral vein pathways pertinent to portal hypertension in liver cirrhosis and EHPVO. PMID:25755456

  19. The History of Treatment of Twin-to-Twin Transfusion Syndrome.

    PubMed

    Glennon, Chelsea L; Shemer, Scott A; Palma-Dias, Ricardo; Umstad, Mark P

    2016-06-01

    Historical suggestions of twin-to-twin transfusion syndrome (TTTS) date back to the early 17th century. Placental anastomoses were first reported in 1687; however, it was Schatz who first identified their importance in 1875. He recognized 'the area of transfusion' within the 'villous district' of the placenta, which he named the 'third circulation'. This article describes how the management of TTTS has evolved as we have gained a more sophisticated understanding and appreciation of the complex vascular anastomoses that exist in monochorionic twin placentae. Currently, fetosopic laser occlusion is the preferred treatment option for TTTS. PMID:27203604

  20. Microsurgical replantation of partial avulsion of the scalp. Case report.

    PubMed

    Svensson, H; Njalsson, T

    1995-06-01

    An 8-year-old girl was bitten by a dog and, as well as minor wounds, had a complete avulsion of the central part of the scalp covering an area of 8 x 10 cm. By rotating the replant 180 degrees and by using 5 cm long vein grafts, two sleeve anastomoses, and two end-to-end anastomoses the blood supply was restored. The operation lasted nine hours, and she stayed in hospital for 12 days. Her clinical course was uneventful. At follow-up 23 months later the cosmetic and functional results were good. PMID:7569816

  1. [Role of twin reversed arterial perfusion syndrome in the development of fetus acardius].

    PubMed

    Nizyaeva, N V; Kostyukov, K V; Gladkova, K A; Kulikova, G V; Shchegolev, A I

    2016-01-01

    Monochorionic multiple pregnancy has a higher risk for obstetric complications, including those due to the development of twin-to-twin transfusion syndrome and reversed arterial perfusion syndrome (TRAP sequence). The latter occurs in 0.1% of all monochorionic pregnancies. The basis for TRAP sequence is a relationship between arterial and venous anastomoses from the appropriate placental areas, causing a recipient fetus to develop at the expense of a donor fetus. The presence of abnormal anastomoses is considered to be a main cause of acardia. The prognosis for a donor fetus is also unfavorable: the mortality rates in the absence of intrauterine correction are as high as 55%. PMID:27600783

  2. Cystic lymphoid hyperplasia of the parotid gland as the initial manifestation of HIV infection

    PubMed Central

    Wu, Bingcheng; Ngo, Raymond; Petersson, Fredrik

    2014-01-01

    We report the case of a patient who presented with cystic lymphoid hyperplasia of the right parotid gland as the index diagnosis of HIV infection. Histological examination of the excised parotid gland revealed a solid-cystic lymphoepithelial lesion with a non-keratinous squamous epithelium, which grew into the lymphoid component via anastomosing cords and islands. These anastomosing cords and islands contained variably abundant B cells, several subepithelial multinucleated histiocytes, salivary ducts infiltrated by small lymphocytes, and a dense lymphoid infiltrate containing lymphoid follicles with enlarged, irregular germinal centres. PMID:24452982

  3. Le syndrome de la pince aorto-mésentérique chez l'enfant: à propos d'un cas primitive

    PubMed Central

    Fall, Mbaye; Bâ, Papa Abdoulaye; Touré, Fodé Baba; Mbaye, Pape Alassane; Ngom, Gabriel

    2014-01-01

    Le syndrome de la pince aorto-mésentérique résulte de la compression du troisième duodénum entre l'artère mésentérique supérieure et l'aorte. Elle détermine un tableau d'occlusion intestinale haute aiguë ou chronique. Nous faisons une revue de la littérature à partir d'un cas de syndrome de la pince aorto-mésentérique. Il s'agit d'un nourrisson de 16 mois suivi pour des vomissements alimentaires évoluant depuis l’âge de 03 mois et rebelles au traitement médical. Il s'agit de vomissements postprandiaux tardifs d'apparition intermittente, améliorés par la position de décubitus ventral. Le bilan radiologique composé d'une radiographie de l'abdomen sans préparation, d'un transit oeso-gastroduodénal (TOGD) et d'un angioscanner a permis d'aboutir au diagnostic d'obstruction extrinsèque et incomplète du 3ème duodénum par la pince aorto-mésentérique. Une dérivation interne par duodéno-jéjunostomie sur anse en oméga a permis de contourner l'obstacle vasculaire avec des suites simples. Le TOGD de contrôle du 9ème jour postopératoire a montré une bonne perméabilité de l'anastomose duodéno-jéjunale. Les vomissements ont disparu et on note un gain pondéral de 2 kg en 3 mois. Les vomissements chroniques chez le nourrisson sont d’étiologies variées. L'obstacle siégeant au 3ème duodénum est le plus souvent dû à une pince aorto-mésentérique. Malheureusement ce diagnostic est rarement porté surtout en Afrique probablement du fait de l'insuffisance des moyens diagnostiques en particulier dans les zones reculées. Le traitement peut être fait par les moyens chirurgicaux ou nutritionnels. PMID:25767670

  4. Biofragmentable bowel anastomosis ring: comparative efficacy studies in dogs.

    PubMed

    Maney, J W; Katz, A R; Li, L K; Pace, W G; Hardy, T G

    1988-01-01

    Three studies were conducted in a total of 178 dogs to determine the efficacy of a biofragmentable bowel anastomosis ring (BAR) composed of polyglycolic acid and 12.5% barium sulfate. Wound strength and healing of BAR, suture, and staple colonic anastomoses were compared for intervals of up to 1 year. The effect of systemic steroid treatment and BAR size on anastomotic wound strength and healing was also studied. The BARs fragmented at a mean time of 15.06 days postoperatively and were passed in the feces without injury. Wound strength was determined by measurements of the pressure required to burst the anastomosed colonic segment and measurements of the tension required to break 10 mm wide longitudinal strips of the anastomosed segment. The studies demonstrated that wound strength had progressed to a point where continued mechanical support (with sutures or staples) was no longer required by 14 days in both nontreated and steroid-treated dogs. Gross healing evaluations at 21 days and beyond showed no differences due to anastomotic method. Microscopic evaluations suggested that residual granulation tissue was less at the sites of BAR asastomoses than at sites of suture or staple anastomoses at the 1-year interval, suggesting that healing may be better with BAR than with standard methods of colon anastomosis. PMID:3336869

  5. Aortic arch vessel anomalies associated with persistent trigeminal artery.

    PubMed

    Lotfi, Mehrzad; Nabavizadeh, Seyed Ali; Foroughi, Amin Abolhasani

    2012-01-01

    Developmental anomalies of the aortic arch vessels and persistent trigeminal artery that is the most common of the four anomalous carotid-basilar anastomoses are repeatedly reported in the literature as separate entities. Herein we report a previously undescribed variant including the coexistence of persistent trigeminal artery, truncus bicaroticus and direct origin of left vertebral artery from aortic arch. PMID:22542381

  6. Jejunal perforation due to porcupine quill ingestion in a horse

    PubMed Central

    Anderson, Stacy L.; Panizzi, Luca; Bracamonte, Jose

    2014-01-01

    An 8-month-old Andalusian filly was treated for jejunal perforations due to ingestion of a porcupine quill. During exploratory laparotomy, 2 separate stapled side-to-side jejunojejunal resection and anastomoses were performed. Post-operative complications after 2 years follow-up included mild incisional herniation following incisional infection and chronic intermittent colic. PMID:24489394

  7. Jejunal perforation due to porcupine quill ingestion in a horse.

    PubMed

    Anderson, Stacy L; Panizzi, Luca; Bracamonte, Jose

    2014-02-01

    An 8-month-old Andalusian filly was treated for jejunal perforations due to ingestion of a porcupine quill. During exploratory laparotomy, 2 separate stapled side-to-side jejunojejunal resection and anastomoses were performed. Post-operative complications after 2 years follow-up included mild incisional herniation following incisional infection and chronic intermittent colic. PMID:24489394

  8. Improved numerical modelling of morphodynamics of rivers with steep banks

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The flow and sediment transport processes near steep streambanks, which are commonly found in meandering, braided, and anastomosing stream systems, exhibit complex patterns. The interactions between bed and bank morphologic adjustment, and their governing processes are still not well understood. Inc...

  9. Streamlined erosional residuals and drumlins in central British Columbia, Canada

    NASA Astrophysics Data System (ADS)

    McClenagan, J. Donald

    2013-05-01

    The upland-lowland pattern in the plateau region of central British Columbia, Canada forms an extremely large anastomosing channel network, with the uplands representing interfluves between channels. The study area landscape is remarkably similar in form to water-produced channel systems and qualitatively resembles flood landscapes from the Channelled Scablands and the margins of the Laurentide Ice Sheet. Numerical shape analysis of the area erosional residuals gives similar results as those derived from known flood landscapes; the length-to-width ratios of the uplands (L/W = 2.38, R2 = 0.89) are similar to those reported for braid bars and erosional residuals formed by glacial outburst floods. Thus, the study area landscape records a megaflood or floods that almost completely immersed the landscape. Drumlins with, in places, ubiquitous hairpin furrows, locations downstream from steep slopes facing into the flow, and eroded into till and bedrock similarly reflect regional-scale meltwater flow that immersed the landscape. The regional flow submerged the anastomosing channels at the time of drumlin formation. Drumlins likely formed as the anastomosing network developed; divergent drumlin orientations probably reflect either late flow or separate drumlin-forming events that did not appreciably alter the anastomosing system.

  10. Use of Absorbable Sutures in Canine Carotid Arteries

    PubMed Central

    Rey, Alejandro R.; Carrillo-Farga, Joaquin; Velasco, Carlos O.; Valencia, Martin O.V.

    1990-01-01

    To study the functional and microstructural characteristics of polydioxanone sutures in vascular surgery, we created 48 vascular anastomoses in the right and left common carotid arteries of 24 mongrel dogs. In each animal, polydioxanone sutures were used in 1 carotid artery, and polypropylene sutures were used in the contralateral carotid artery. Twelve groups of 2 animals each were then formed. The 1st group was observed for 1 month, the 2nd for 2 months, the 3rd for 3 months, and so on until the 12th group, which was observed for 12 months. At the end of each observation period, reoperation was undertaken to evaluate the vascular anastomoses by means of angiography and microscopy. The polypropylene anastomoses showed a marked deformity, with tissue retraction and a foreign body reaction. In contrast, the polydioxanone anastomoses exhibited satisfactory healing, without deformity, and were well tolerated histologically. We believe that polydioxanone may be a useful, alternative vascular suture material. (Texas Heart Institute Journal 1990;17:99-102) Images PMID:15227391

  11. New treatment for ileal pouch-anal or coloanal anastomotic stenosis.

    PubMed

    Benoist, S; Panis, Y; Berdah, S; Hautefeuille, P; Valleur, P

    1998-07-01

    Persistent anastomotic stricture following ileal pouch-anal or coloanal anastomoses can be treated by transanal resection using a stapler or a more complex procedure, such as transanal pouch advancement with neoanastomosis. We propose an easier and faster technique, which does not require any particular device. Its long-term functional results are satisfactory in most patients. PMID:9678384

  12. Real-time mosaicing of fetoscopic videos using SIFT

    NASA Astrophysics Data System (ADS)

    Daga, Pankaj; Chadebecq, François; Shakir, Dzhoshkun I.; Herrera, Luis Carlos G.; Tella, Marcel; Dwyer, George; David, Anna L.; Deprest, Jan; Stoyanov, Danail; Vercauteren, Tom; Ourselin, Sebastien

    2016-03-01

    Fetoscopic laser photo-coagulation of the placental vascular anastomoses remains the most effective therapy for twin-to-twin transfusion syndrome (TTTS) in monochorionic twin pregnancies. However, to ensure the success of the intervention, complete photo-coagulation of all anastomoses is needed. This is made difficult by the limited field of view of the fetoscopic video guidance, which hinders the surgeon's ability to locate all the anastomoses. A potential solution to this problem is to expand the field of view of the placental surface by creating a mosaic from overlapping fetoscopic images. This mosaic can then be used for anastomoses localization and spatial orientation during surgery. However, this requires accurate and fast algorithms that can operate within the real-time constraints of fetal surgery. In this work, we present an image mosaicing framework that leverages the parallelism of modern GPUs and can process clinical fetoscopic images in real-time. Initial qualitative results on ex-vivo placental images indicate that the proposed framework can generate clinically useful mosaics from fetoscopic videos in real-time.

  13. Temporary Placement of Stent Grafts in Postsurgical Benign Biliary Strictures: a Single Center Experience

    PubMed Central

    Willatt, Jonathon M; Arabi, Mohammad; Cwikiel, Wojciech B

    2011-01-01

    Objective To evaluate the effect of temporary stent graft placement in the treatment of benign anastomotic biliary strictures. Materials and Methods Nine patients, five women and four men, 22-64 years old (mean, 47.5 years), with chronic benign biliary anastomotic strictures, refractory to repeated balloon dilations, were treated by prolonged, temporary placement of stent-grafts. Four patients had strictures following a liver transplantation; three of them in bilio-enteric anastomoses and one in a choledocho-choledochostomy. Four of the other five patients had strictures at bilio-enteric anastomoses, which developed after complications following laparoscopic cholecystectomies and in one after a Whipple procedure for duodenal carcinoma. In eight patients, balloon-expandable stent-grafts were placed and one patient was treated by insertion of a self-expanding stent-graft. Results In the transplant group, treatment of patients with bilio-enteric anastomoses was unsuccessful (mean stent duration, 30 days). The patient treated for stenosis in the choledocho-choledochostomy responded well to consecutive self-expanding stent-graft placement (total placement duration, 112 days). All patients with bilio-enteric anastomoses in the non-transplant group were treated successfully with stent-grafts (mean placement duration, 37 days). Conclusion Treatment of benign biliary strictures with temporary placement of stent-grafts has a positive effect, but is less successful in patients with strictures developed following a liver transplant. PMID:22043153

  14. Persistent median artery in the carpal tunnel and anastomosis with superficial palmar arch.

    PubMed

    Bijannejad, Dariush; Azandeh, Saeed; Javadnia, Fatemeh; Gholami, Mohammad Reza; Gharravi, Anneh Mohammad; Zhaleh, Mohsen

    2016-01-01

    Persistent median artery (PMA) in present cadaver originated from the brachial artery and anastomosed with the superficial palmar arch (SPA). As the PMA may be the cause of carpal tunnel syndrome and SPA is the main source of arterial supply, knowledge of which are important for the hand surgical interventions. PMID:27583265

  15. Persistent median artery in the carpal tunnel and anastomosis with superficial palmar arch

    PubMed Central

    Bijannejad, Dariush; Azandeh, Saeed; Javadnia, Fatemeh; Gholami, Mohammad Reza; Gharravi, Anneh Mohammad; zhaleh, Mohsen

    2016-01-01

    Abstract Persistent median artery (PMA) in present cadaver originated from the brachial artery and anastomosed with the superficial palmar arch (SPA). As the PMA may be the cause of carpal tunnel syndrome and SPA is the main source of arterial supply, knowledge of which are important for the hand surgical interventions. PMID:27583265

  16. Intraoperative assessment of microperfusion with visible light spectroscopy in colorectal anastomosis

    NASA Astrophysics Data System (ADS)

    Karliczek, Anne; Benaron, David A.; Baas, Peter; van der Stoel, Anne; Wiggers, Theo; van Dam, Gooitzen M.

    2007-07-01

    In gastrointestinal surgery, leakage of anastomoses in general is a challenging problem because of the related mortality and morbidity1,2. The highest incidence of anastomotic leakage is found at the most proximal and most distal parts of the digestive tract, i.e. esophageal and colorectal anastomoses. Increased strain and limited vascular supply at the anastomoses are the two main reasons of leakage, especially in the absence of a serosal layer at these sites2,3,4. Apart from these local risk factors, several general risk factors attributed to the occurrence of anastomotic failure, of which smoking, cardiovascular disease, gender, age and malnutrition are the most important2,5-8. Most of these factors suggest local ischemia as an important cause of anastomotic dehiscence. In colorectal anastomosis the vascular supply is compromised due to resection of the diseased bowel segment. The vascular supply of the rectal stump is compromised by resection of the proximal feeding sigmoidal vessels. Apart from co-existing morbidities such as sepsis, cardiovascular and several systemic diseases, the altered vascular supply frequently compromises the microcirculation at both ends of the anastomosis, and is as such responsible for the higher rate of leakage compared to small and other large bowel anastomoses9,10.

  17. Intraoperative assessment of microperfusion with visible light spectroscopy in oesophageal and colorectal anastomosis

    NASA Astrophysics Data System (ADS)

    Karliczek, Anne; Benaron, David A.; Baas, Peter; van der Stoel, Anne; Wiggers, Theo; Plukker, John; van Dam, Gooitzen M.

    2007-07-01

    In gastrointestinal surgery, leakage of anastomoses in general is a challenging problem because of the related mortality and morbidity1,2. The highest incidence of anastomotic leakage is found at the most proximal and most distal parts of the digestive tract, i.e. esophageal and colorectal anastomoses. Increased strain and limited vascular supply at the anastomoses are the two main reasons of leakage, especially in the absence of a serosal layer at these sites2,3,4. Apart from these local risk factors, several general risk factors attributed to the occurrence of anastomotic failure, of which smoking, cardiovascular disease, gender, age and malnutrition are the most important2,5-8. Most of these factors suggest local ischemia as an important cause of anastomotic dehiscence. In esophageal resection the blood supply to the remaining esophageal end is compromised due to ligation of arteries and resection of surrounding mediastinal tissue. Furthermore, the gastric conduit, usually only based on the right gastroepiploic artery, is transposed from its anatomical abdominal position into the thoracic cavity and cervical region. Apart from co-existing morbidities such as sepsis, cardiovascular and several systemic diseases, the altered vascular supply frequently compromises the microcirculation at both ends of the anastomosis, and is as such responsible for the higher rate of leakage compared to small and other large bowel anastomoses9,10.

  18. Tracheal anastomosis using indocyanine green dye enhanced fibrinogen with a near-infrared diode laser

    NASA Astrophysics Data System (ADS)

    Auteri, Joseph S.; Jeevanandam, Valluvan; Oz, Mehmet C.; Libutti, Steven K.; Kirby, Thomas J.; Smith, Craig R.; Treat, Michael R.

    1990-06-01

    A major obstacle to lung transplantation and combined heart- lung transplantation is dehiscence of the tracheobronchial anastomosis. We explored the possibility of laser welded anastomoses in canine tracheas in vivo. Laser anastomoses were performed on three-quarter circumferential anterior tracheotomies. A continous wave diode laser (808 +1 nm) at a power density of 9.6 watts/cm was used. Human fibrinogen was mixed with indocyanine green dye (ICG, max absorbance 805 nm) and applied to the anastomosis site prior to laser exposure. Animals were sacrificed at 0, 21 and 28 days post-operatively. At sacrifice weld bursting pressures were measured by raising intratracheal pressure using forced ventilation via an endotracheal tube. Sutured and laser welded anastomoses had similar bursting pressures, and exhibited satisfactory histologic evidence of healing. However, compared to polypropylene sutured controls, the laser welded anastomoses exhibited less peritracheal inflammatory reaction and showed visibly smoother luminal surfaces at 21 and 28 days post- operatively. Tracheal anastomosis using ICG dye enhanced fibrinogen combined with the near-infrared diode laser is a promising extension of the technology of laser tissue fusion and deserves further study.

  19. Using monitoring, LiDAR and MODFLOW to Estimate Hyporheic Fluxes for a Dynamic Large River Riparian Area

    EPA Science Inventory

    In unrevetted reaches, the Willamette River in northwest Oregon is a dynamic anastomosing system. Riparian zones are frequently divided into multiple islands during most of the wet winter season. The dividing stream channels are mostly absent during the dry summer season. This po...

  20. A comparison of absorbable suture and argon laser welding for lateral repair of arteries.

    PubMed

    Lawrence, P F; Li, K; Merrell, S W; Goodman, G R

    1991-08-01

    Conventional vascular anastomoses between autogenous vessels are performed with nonabsorbable sutures. Recently, use of absorbable sutures and laser-assisted vascular anastomoses has been advocated because of their improved healing characteristics. This study compared arterial repairs with the argon laser, absorbable suture, and nonabsorbable suture for technical characteristics including additional suture and overall success rates, burst strength, and cost. Absorbable and nonabsorbable suture closures were comparable with respect to technique, but laser-assisted vascular anastomosis was technically more demanding and required almost twice as much time for completion. The argon laser successfully closed only 58.6% of the arteriotomies, and 90% of the closures required additional sutures for complete hemostasis. All sutured arteriotomies were successfully completed by use of either absorbable or nonabsorbable suture. Burst strength was similar for all groups, but was uniformly greater than 300 mm Hg for sutured repairs, whereas two of five laser-assisted closures burst below 300 mm Hg. Finally, costs for purchasing ($35,000) and operating ($300/hr.) an argon laser make laser-assisted vascular anastomosis much more expensive than sutured repair. These data suggest argon laser-assisted vascular anastomoses are more technically demanding, less successful, and more expensive than conventional sutured anastomoses when evaluated in large caliber arteries in a canine model. Absorbable suture, however, is comparable to conventional nonabsorbable sutured arterial repairs in expense, handling characteristics, and success rates with the added advantage of eliminating permanent foreign body in the arterial wall when it is absorbed. PMID:1861329

  1. Solomon Technique Versus Selective Coagulation for Twin-Twin Transfusion Syndrome.

    PubMed

    Slaghekke, Femke; Oepkes, Dick

    2016-06-01

    Monochorionic twin pregnancies can be complicated by twin-to-twin transfusion syndrome (TTTS). The best treatment option for TTTS is fetoscopic laser coagulation of the vascular anastomoses between donor and recipient. After laser therapy, up to 33% residual anastomoses were seen. These residual anastomoses can cause twin anemia polycythemia sequence (TAPS) and recurrent TTTS. In order to reduce the number of residual anastomoses and their complications, a new technique, the Solomon technique, where the whole vascular equator will be coagulated, was introduced. The Solomon technique showed a reduction of recurrent TTS compared to the selective technique. The incidence of recurrent TTTS after the Solomon technique ranged from 0% to 3.9% compared to 5.3-8.5% after the selective technique. The incidence of TAPS after the Solomon technique ranged from 0% to 2.9% compared to 4.2-15.6% after the selective technique. The Solomon technique may improve dual survival rates ranging from 64% to 85% compared to 46-76% for the selective technique. There was no difference reported in procedure-related complications such as intrauterine infection and preterm premature rupture of membranes. The Solomon technique significantly reduced the incidence of TAPS and recurrent TTTS and may improve survival and neonatal outcome, without identifiable adverse outcome or complications; therefore, the Solomon technique is recommended for the treatment of TTTS. PMID:27203607

  2. “Can't Walk Nor Raise Arms to Head”

    PubMed Central

    Pendleton, Courtney; Dorsi, Michael J.; Belzberg, Allan J.; Cohen-Gadol, Aaron A.; Quiñones-Hinojosa, Alfredo

    2015-01-01

    Study Design This study was a retrospective chart review for patients undergoing operative treatment by Dr. Harvey Cushing at the Johns Hopkins Hospital between 1896 and 1912. Objective To illustrate the early use of peripheral nerve anastomoses for the treatment of postpoliomyelitis paralysis. Summary of Background Data At the turn of the 20th century, poliomyelitis was recognized as a disease of neurons; neurological surgeons sought to find a surgical cure for the paralysis occurring after the disease onset. Peripheral nerve anastomoses were an attractive option employed during this time. Methods Following IRB approval, and through the courtesy of the Alan Mason Chesney Archives, the surgical records of the Johns Hopkins Hospital from 1896 to 1912 were reviewed. A single case of peripheral nerve anastomosis for the treatment of postpoliomyelitis paralysis was selected for further analysis. Results Cushing performed a multiple peripheral nerve anastomoses in a 3-year-old girl. Although the patient experienced no postoperative complications, there was no improvement in her function at the time of discharge from the hospital, and no long-term follow-up was available. Conclusion While unsuccessful, Cushing's use of peripheral nerve anastomoses to restore motor function in the pediatric patient described here demonstrates his commitment to pushing the boundaries of neurological surgery at the turn of the 20th century. PMID:21301395

  3. Retinal pigment epithelial hamartoma--unusual manifestations.

    PubMed Central

    Rosenberg, P. R.; Walsh, J. B.

    1984-01-01

    Hamartoma of the retinal pigment epithelium is an uncommon tumour of young adults. We have seen 2 patients with this clinical diagnosis, both with unusual manifestations. In one patient growth of the tumour was observed over a 5-year period. In the second patient arterial-arterial anastomoses were detected at a site distal to the tumour. Images PMID:6722077

  4. Entre dois mundos: vida quotidiana de criancas portuguesas na america [Between Two Worlds: The Daily Life of Portuguese Children in America].

    ERIC Educational Resources Information Center

    de Meneses, Fernando

    This Portuguese reader with accompanying teacher's guide describes the culture shock that Portuguese children and their families face when they immigrate to North America. The reader is divided into 75 short stories about the families that come from the rural areas of Portugal where there has been little industrialization. The purpose of the…

  5. Modelo Crosscultural de Pasantias para Lideres de la Educacion: Cooperacion entre Estados Unidos y Venezuela (Designing an Effective School Administrator Internship Program: United States and Venezuela Cooperation).

    ERIC Educational Resources Information Center

    Serafin, Ana Gil; Thompson, Eugene W.

    A model was developed of an internship program designed to give valuable cross-cultural experience to school administrators in training at universities in the United States and Venezuela. A naturalistic approach was used to develop the model. Leading school administrators and educational leadership theorists in both countries were interviewed by…

  6. Etude, par principes premiers, des effets de la correlation entre electrons sur les proprietes electroniques et magnetiques de polymeres pontes et de supraconducteurs a haute temperature critique

    NASA Astrophysics Data System (ADS)

    Pesant, Simon

    Description of complex systems by Density functional theory is treated in this thesis. First, the Density functional theory and a few functionals used to simulate cristals are presented. Specifically, the LDA and GGA functionnals are described and their limits are exposed. Furthermore, the Hubbard model as well as the LDA+U functionnal are addressed in this chapter. These methods enable the study of highly correlated materials. Then, results obtained on polymers are summarized in two articles. The first one treats the band gap variation of ladder-type polymers compared to non ladder type ones. The second article considers small band gap polymers. In this case, it will be shown that an hybrid functional, which contains exact exchange, is required to describe the electronic properties of the polymers under study. Finally, the last chapter address the study of cuprates superconductors. The LDA+U can account for the localization of electrons in copper orbitals. Consequently, a study of the impact of this functionnal on electronic properties of cuprates is conducted. The chapter is ended by an article treating magnetic orders in doped La 2CuO4. Supplementary materials of the second article and a description of the theory of superconductivity of Bardeen, Cooper and Schrieffer are put in annex. Keywords : Electronic correlation, DFT, LDA+U, cuprates, polymers, magnetic orders

  7. Mise en évidence de fortes circulations verticales temporaires entre zones humides et aquifères alluviaux et régionaux

    NASA Astrophysics Data System (ADS)

    Weng, Philippe; Coudrain-Ribstein, Anne; Kao, Cyril; Bendjoudi, Hocine; Marsily, Ghislain de

    1999-08-01

    Tensiometric and piezometric values were recorded in an alluvial valley of the Seine wetland from February to November 1998. As a consequence of two flood events, the groundwater head once rose above the soil surface. When the water level in the Seine decreased, the vertical hydraulic gradient between the underlying Senonian chalk and the alluvia increased to 16 %o. During the few days of recession the alluvial wetlands were fed by an upward flow from the regional chalk aquifer and drained towards the river through a more permeable alluvial layer (1.5 m to 7 m below soil surface).

  8. Associação entre lipid accumulation product (LAP) e hirsutismo na síndrome do ovário policístico.

    PubMed

    Oliveira, Flávia Ribeiro de; Rezende, Mariana Bicalho; Faria, Nícolas Figueiredo; Dias, Tomás Ribeiro Gonçalves; Oliveira, Walter Carlos Santos de; Rocha, Ana Luiza Lunardi; Cândido, Ana Lúcia

    2016-02-01

    Objective Polycystic ovary syndrome (PCOS) is the most common endocrine metabolic disorder in women between menarche and menopause. Clinical hyperandrogenism is the most important diagnostic criterion of the syndrome, which manifests as hirsutism in 70% of cases. Hirsute carriers of PCOS have high cardiovascular risk. Lipid accumulation product (LAP) is an index for the evaluation of lipid accumulation in adults and the prediction of cardiovascular risk. The aim of this study was to evaluate the association between LAP and hirsutism in women with PCOS. Methods This was a cross-sectional observational study of a secondary database, which included 263 patients who had visited the Hyperandrogenism Outpatient Clinic from November 2009 to July 2014. The exclusion criteria were patients without Ferriman-Gallwey index (FGI) and/or LAP data. We used the Rotterdam criteria for the diagnosis of PCOS. All patients underwent medical assessment followed by measurement and recording of anthropometric data and the laboratory tests for measurement of the following: thyroid-stimulating hormone, follicle-stimulating hormone, prolactin, total testosterone, sex hormone binding globulin, 17-α-hydroxyprogesterone (follicular phase), glycohemoglobin A1c, and basal insulin. In addition, the subjects underwent lipid profiling and oral glucose tolerance tests. Other laboratory measurements were determined according to clinical criteria. LAP and the homeostatic model assessment index (HOMA-IR) were calculated using the data obtained. We divided patients into two groups: the PCOS group with normal LAP (< 34.5) and the PCOS group with altered LAP (> 34.5) to compare the occurrence of hirsutism. For statistical analysis, we used SPSS Statistics for Windows® and Microsoft Excel programs, with descriptive (frequencies, percentages, means, and standard deviations) and comparative analyses (Student's t-test and Chi-square test). We considered relations significant when the p-value was ≤ 0.05. Results LAP was high in most patients (n = 177; 67.3%) and the FGI indicated that 58.5% of the patients (n = 154) had hirsutism. The analysis by LAP quartiles showed a positive correlation (p = 0.04) among patients with a high FGI and an upper quartile LAP (> 79.5) when compared with those with LAP < 29.0 (lower quartile). Conclusion This study demonstrated an association between high LAP and hirsutism. The FGI could represent a simple and low-cost tool to infer an increased cardiovascular risk in women with PCOS. PMID:26909772

  9. L'Alternance entre les auxiliaires "avoir" et "etre" en francais parle a Montreal (Alternation between the Auxiliaries "Avoir" and "Etre" in Spoken French in Montreal)

    ERIC Educational Resources Information Center

    Sankoff, Gillian; Thibault, Pierrette

    1977-01-01

    A study of the spoken French of 120 residents of Montreal. The researchers were interested in the linguistic and social factors influencing the use of "avoir" and "etre." Results show that this usage corresponds to a tendancy to regularize conjugations. (Text is in French.) (AMH)

  10. Entre dicho y hecho ...: An Assessment of the Application of Research from Second Language Acquisition and Related Fields to the Creation of Spanish CALL Materials for Lexical Acquisition

    ERIC Educational Resources Information Center

    Lafford, Barbara A.; Lafford, Peter A.; Sykes, Julie

    2007-01-01

    Despite the problems presented by lexical errors in second language (L2) communication, most computer assisted language learning (CALL) programs tend to focus on the acquisition of grammar points rather than on the development of the L2 lexicon. In addition, CALL vocabulary tasks are typically limited in scope and mechanical in nature, covering…

  11. Católicos, fidelidade conjugal e AIDS: entre a cruz da doutrina moral e as espadas do cotidiano sexual dos adeptos1

    PubMed Central

    Rios, Luis Felipe; de Aquino, Francisca Luciana; Muñoz-Laboy, Miguel; Oliveira, Cinthia; Parker, Richard

    2009-01-01

    Neste artigo discutimos a visão da Igreja Católica sobre sexualidade na interface com a epidemia do HIV/AIDS. Nossa reflexão está embasada em pesquisa etnográfica que envolveu dois meses de observação participante do cotidiano de católicos de um bairro popular da Região Metropolitana do Recife, além de contar com entrevistas a onze dos leigos engajados nos serviços religiosos da igreja do bairro e a oito sacerdotes que realizam seus trabalhos religiosos em outras localidades. Nelas abordamos diferentes temáticas relacionadas ao enfrentamento da epidemia da AIDS. Nesse contexto, conjugalidade e fidelidade se afiguram como importantes analisadores de como aqueles lidam com a epidemia, em uma variedade de re-descrições práticas e de re-interpretações conceptuais das assertivas do discurso moral religioso – ainda que, muitos impasses permaneçam em aberto em termos das prerrogativas da Igreja e seus possíveis rebatimentos na saúde sexual dos adeptos. PMID:21765650

  12. En la búsqueda de características en eyecciones coronales de masa que discriminen entre dos paradigmas físicos en modelos de ECMs

    NASA Astrophysics Data System (ADS)

    Paissan, G.; Stenborg, G.; Rovira, M.

    Se conocen tres diferentes fenómenos de gran escala que ocurren en la atmósfera solar, denominados eyecciones coronales de masa (ECMs), protuberancias eruptivas y grandes fulguraciones de dos bandas. Estos fenómenos están estrechamente relacionados y podrían ser distintas manifestaciones de un único proceso físico. Las ECMs son definidas como eyecciones de gran escala de masa y flujo magnético desde la baja corona al espacio interplanetario. Desde su descubrimiento en los '70, muchos modelos han sido propuestos para explicar su origen y evolución. La explicación física de las ECMs es un tema de debate intenso. No obstante, los modelos pueden sintetizarse en dos grandes grupos: 1) los modelos de inyección de flujo y 2) los modelos de almacenamiento y liberación. En este trabajo, se presentan los estudios realizados con una serie de eventos observados con el coronógrafo MICA (Mirror Coronograph for Argentina), el telescopio en H-alfa HASTA (H-alpha Solar Telescope for Argentina) y los coronógrafos C2 y C3 de la sonda SOHO (Solar and Heliospheric Observatory). Los eventos que pudieron ser identificados como ECMs son contrastados dentro del esquema de los dos paradigmas teóricos propuestos.

  13. La preparacion del maestro y la interaccion entre maestro y nino en programas preescolares (Teacher Preparation and Teacher-Child Interaction in Preschools). ERIC Digest.

    ERIC Educational Resources Information Center

    Kontos, Susan; Wilcox-Herzog, Amanda

    It is generally agreed that because so much basic early learning occurs through interactive experiences when children are very young, the quality of teacher-child interactions contributes substantially to effects of group care and preschool education on children. Thus it is important to know if specialized teacher education in early childhood…

  14. Transitioning to new child-care nutrition policies: nutrient content of preschool menus differs by presence of vegetarian main entrée.

    PubMed

    Turner-McGrievy, Gabrielle M; Hales, Sarah B; Baum, Angela C

    2014-01-01

    Children who attend child care outside the home may be at increased risk for developing obesity. In 2012, the South Carolina ABC Child Care program issued new standards for food and nutrition. The goal of our study (conducted June to December 2012) was to examine changes that occurred at a large, Columbia, SC, preschool during the implementation of the South Carolina ABC Child Care program standards using an observational design, including a survey of parents and nutrient analysis of menus. The nutrition content of menu items before (n=15 days; six of which were vegetarian) and after (n=15 days; six of which were vegetarian) implementation of the new standards was compared. In addition, parents (N=75) were surveyed to examine opinions and support for the changes. Independent samples t tests were used to compare nutrient values before and after menu changes and analysis of variance was used to compare pre- and post-change vegetarian menus and pre- and post-change nonvegetarian menus. There were no significant differences between before and after menus with the exception of a 0.3 cup/day increase in vegetables (P<0.05). Vegetarian menus after the revisions were significantly higher in fiber (13 ± 3 g) than postrevision nonvegetarian menus (11 ± 3 g; P<0.05) and lower in sodium (1,068 ± 207 mg) than postrevision nonvegetarian menus (1,656 ± 488 mg; P<0.05). Standards that received the most parental support were serving at least two vegetables (score of 8.7 on a scale of one to nine) and two fruits per day (score of 8.6) and implementing policies against staff using food as a reward or punishment (score of 8.6). The center-specific policy of only bringing healthy foods for celebrations received the lowest support (score of 5.8). Adding more vegetarian menu items has the potential to improve the nutrient content of menus while keeping energy intake, saturated fat, sodium, and cholesterol levels at a more optimum level. PMID:24144990

  15. Etude comparative entre l'astrolabe dit "carolingien" et l'astrolabe d'Abù-Bakr ibn Yusuf de Toulouse.

    NASA Astrophysics Data System (ADS)

    D'Hollander, R.

    This article is a comparative study that is essentially technical. It is based on very careful measurements of an accuracy of up to one tenth of a millimetre carried out on the plates and retes of the two astrolabes examined by the writer. Abù-Bakr ibn Yusuf's astrolabe is in the Musée Paul Dupuy in Toulouse. It was made in 1216-17 in Marrakech.

  16. Relationship between Emotional Intelligence and Mental Health in School Counselors (Relación entre Inteligencia Emocional y salud mental en Orientadores Educativos)

    ERIC Educational Resources Information Center

    Cejudo, Javier

    2016-01-01

    Introduction: The purpose of the present research is aimed at studying the relationship between emotional intelligence as an ability and emotional intelligence as a trait and mental health of a sample of school counsellors. Method: The sample has been made up of 203 school counsellors. The instruments used have been: Mayer-Salovey-Caruso Emotional…

  17. Psychological Correlates of the Transmission and Acceptance of Rumors about AIDS = Correlates Psychologiques Entre la Transmission et l'Acceptation des Rumeurs sur le SIDA.

    ERIC Educational Resources Information Center

    Kimmel, Allan J.

    Public reactions to the Acquired Immune Deficiency Syndrome (AIDS) crisis are accompanied by the sorts of emotional and cognitive factors that have been identified by researchers as predictors of rumor generation and transmission. The present investigation attempted to ascertain the extent that various subjective factors (including anxiety,…

  18. Uma comparação entre técnicas de propagação de erros em astrofísica: Monte Carlo x Bootstrap

    NASA Astrophysics Data System (ADS)

    Waelkens, A. H.; Janot Pacheco, E.

    2003-08-01

    Recentemente Dhillon & Watson (2001) criticaram o procedimento de determinação de erros via simulações de Monte Carlo no caso do imageamento indireto de estrelas, por introduzir ruído nos dados e resultar em erros superestimados. Estes autores propuseram a utilização alternativa do método de Bootstrap como uma técnica superior para a estimativa de erros. Neste trabalho apresentamos os resultados de um estudo comparativo da performance das técnicas de simulação por Monte Carlo e por Bootstrap para a determinação de erros em duas situações de interesse: (i) ajuste de modelos a espectros observados e (ii) imageamento indireto de discos de acréscimo com técnicas de mapeamento por eclipse. No caso (i), os dados de entrada são espectros de emissão simples de hidrogênio aos quais é adicionado ruído gaussiano de amplitude selecionada. No caso (ii), são produzidas curvas de luz do eclipse de uma distribuição de brilho seguindo a lei TµR-3/4 para discos estacionários cuja taxa de acréscimo varia ao longo do eclipse segundo uma distribuição gaussiana de amplitude selecionada, simulando o ruído. A avaliação da performance é feita com o auxílio de um diagrama do erro relativo na grandeza ajustada, conforme obtido por cada método, versus o erro relativo (ruído/sinal) dos dados de entrada. O estudo mostra que as duas técnicas produzem resultados semelhantes nos dois casos, e que a suposta superioridade do método de Bootstrap não se confirma.

  19. Origine physique du contraste entre activité électrique au dessus des terres et des océans

    NASA Astrophysics Data System (ADS)

    Williams, Earle; Stanfill, Sharon

    2002-12-01

    New tests and older ideas are explored to understand the origin of the pronounced contrast in lightning between land and sea. The behavior of islands as miniature continents with variable area supports the traditional thermal hypothesis over the aerosol hypothesis for lightning control. The substantial land-ocean contrast in updraft strength is supported globally by TRMM (Tropical Rainfall Measuring Mission) radar comparisons of mixed phase radar reflectivity. The land-ocean updraft contrast is grossly inconsistent with the land-ocean contrast in CAPE (Convective Available Potential Energy), from the standpoint of parcel theory. This inconsistency is resolved by the scaling of buoyant parcel size with cloud base height, as suggested by earlier investigators. Strongly electrified continental convection is then favored by a larger surface Bowen ratio, and by larger, more strongly buoyant boundary layer parcels which more efficiently transform CAPE to kinetic energy of the updraft in the moist stage of conditional instability. To cite this article: E. Williams, S. Stanfill, C. R. Physique 3 (2002) 1277-1292.

  20. Relación física entre el cúmulo abierto Hogg 15 y la estrella Wolf-Rayet WR 47

    NASA Astrophysics Data System (ADS)

    Piatti, A. E.; Bica, E.; Santos, J. F. C., Jr.; Clariá, J. J.

    We revise the fundamental parameters of the faint open cluster Hogg 15, for which two recent colour-magnitude diagram (CMD) studies have obtained significantly different ages (Sagar et al. 2001, MNRAS, 327, 23; Piatti & Clariá 2001, A&A, 370, 931). In the present study, we combine a series of methods trying to constrain age, together with other fundamental parameters. We employ spatial extractions to construct the CMDs, and the cluster integrated spectrum to compare the latter with those of templates of known age. For Hogg 15 we derive an age of (20 ± 10) Myr, a reddening of (1.10 ± 0.05) mag, and a distance of (3.1 ± 0.5) kpc. We conclude that the estimation of an older age in the study of Piatti & Clariá can be accounted for in terms of main sequence/turnoff curvature being blurred in the CMDs, an effect mainly caused by field contamination. To clarify the issue of whether the Wolf-Rayet star HDE 311884 (WR 47), known to be a WN6 + O5V binary system, is associated or not with Hogg 15, we discuss its fundamental parameters, particularly its distance. Based on the WR 47 spectrum and available photometry, we assume that the underestimated distance implied by the Hipparcos parallax (216 pc) is affected by its binary character. By comparing the WR 47 spectrum with those of WR stars of a similar type, we conclude that WR 47 is not affected by a E(B-V) colour excess much higher than that associated with Hogg 15, namely E(B-V) = 1.10. On the basis of the WR 47's resulting distance of (5.2 ± 0.9) kpc, which largely surpasses that of the cluster, we conclude that WR 47 is not related to Hogg 15 from the point of view of origin, since the cluster and the star do not belong to the same formation event.

  1. Vinculación Física entre Super Cáscaras de Hidrógeno Neutro y Formación Estelar Reciente

    NASA Astrophysics Data System (ADS)

    Corti, M. A.; Arnal, E. M.

    Many of the known galactic HI supershells (SCHI) may have been formed by the combined effects of stellar winds and supernovae explotions. Having most of them dynamic lifetimes of a few times 10^7 yr, these huge structures are likely to outlive the stars that gave rise to them. Hence, these SCHI may be used as fossil records of the Milky Way star formation history. Furthermore, along their evolution SCHI may trigger star formation. In this paper we analyze the genetic link put forward by McClure-Griffiths et al. (2002) between the OB association Cen OB1 and the SCHI GSH305+01-24. From our study we conclude that GSH305+01-24 may not represent a real physical structure. Instead, we believe that this structure is best represented by two unrelated huge HI shells. The role played by Cen OB1 in powering one of these HI shells is unclear for the time being. FULL TEXT IN SPANISH.

  2. Denomination et categorisation des modeles d'enseignement des langues: entre institution et pratique (Denomination and Categorization of Language Teaching Models: Between Institution and Practice).

    ERIC Educational Resources Information Center

    Gajo, Laurent; Matthey, Marinette

    1998-01-01

    The process and issues of labeling language program models is discussed insofar as it may affect the objectives, content, and method of instruction. The first section describes the origins, stated objectives, and implementation of a Neuchatel (Switzerland) school program integrating heritage language and culture into the school curriculum, noting…

  3. L'espace du mouvement: Une analyse des conflits dans les interactions entre institutrice et eleves d'une ecole maternelle

    NASA Astrophysics Data System (ADS)

    Galvão, Izabel

    1995-01-01

    The research described in this article, winner of the Gottfried Hausmann Prize for 1994, was carried out in a kindergarten in São Paolo, Brazil, using the theory developed by Henri Wallon. The aim was to examine how primary school children are affected in their development by: (a) unnecessary restrictions placed on their physical movements during lessons; and (b) failure to organize the classroom space in a way that assists the learning process. The author concludes that these factors lead to tensions in the classroom which could be avoided through a different approach to movement and space.

  4. Make the Reading-Writing Connection: Tips for Parents of Young Learners = Haga el enlace entre lectura y escrita: Consejos para padres de jovenes que estan aprendiendo.

    ERIC Educational Resources Information Center

    International Reading Association, Newark, DE.

    This brochure offers parents tips on helping their children connect writing with reading. It begins by noting that preschool children often want to scribble on paper, scribbles which sometimes represent a story. It suggests making space in the home for literacy, and encouraging early efforts. The brochure then offers four brief activities for…

  5. Previniendo el Uso de Drogas entre Ninos y Adolescentes: Una Guia Basada en Investigaciones (Preventing Drug Use among Children and Adolescents: A Research-Based Guide).

    ERIC Educational Resources Information Center

    Sloboda, Zili; David, Susan L.

    This question and answer guide provides an overview of the research on the origins and pathways of drug abuse, the basic principles derived from effective drug abuse prevention research, and the application of research results to the prevention of drug use among young people. The basic principles derived from drug abuse prevention research are…

  6. Thriving Together: Connecting Rural School Improvement and Community Development = Prosperando juntos: La conexion entre el mejoramiento de la escuela rural y el desarrollo comunitario.

    ERIC Educational Resources Information Center

    Boethel, Martha

    Available in English or Spanish, this resource guide aims to help rural schools and communities learn ways of supporting each other so that both can thrive. Background information and basic tools are provided for starting a joint school-community development effort. Chapters contain: (1) outline of the guide and statement of beliefs about…

  7. The Effect of Low Dose Irradiation and Grapefruit Extract on C. perfringens Growth from Spores in sous vide Processed Pork-Based Mexican Entrée

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Sous vide, a common cooking method for meat and poultry products is widely used for providing ready-to-eat meals. Traditionally, these products have limited shelf life, ranging from 2 to 3 weeks. However, similar products may be stored for longer periods in the U.S. and other countries, requiring ad...

  8. Relación entre la orientación de Nebulosas Planetarias y el campo magnético galáctico

    NASA Astrophysics Data System (ADS)

    Weidmann, W.; Díaz, R. J.; Carranza, G.

    Un estudio detallado de las orientaciones diferenciales de nebulosas planetarias en todo el cielo sugiere fuertemente una relación con la dirección de los campos magnéticos de origen galáctico, determinados en la polarización de estrellas de campo. Esto da consistencia a la hipótesis de que la orientación de las nebulosas planetarias ovaladas es inducida, al menos parcialmente, por el campo magnético general de la Vía Láctea.

  9. Contribution à l'analyse des inter-relations entre activités humaines et variabilité climatique : cas du Sud forestier ivoirien

    NASA Astrophysics Data System (ADS)

    Yao, Télésphore Brou; Servat, Eric; Paturel, Jean-Emmanuel

    1998-12-01

    The South Ivorian Forest has suffered a large rainfall deficit for 25 years. At the same time, it has been noticed that the movement of the coffee and cocoa production seems concomitant with that of the isohyets during recent decades. The variations in albedo and rainfall gradient seem to be linked to the significant changes to the forest cover. These could affect precipitation locally.

  10. Incidence and time of intraoperative vascular complications in head and neck microsurgery.

    PubMed

    Wolff, Klaus-Dietrich; Hölzle, Frank; Wysluch, Andreas; Mücke, Thomas; Kesting, Marco

    2008-01-01

    Vascular occlusion is still the main reason for flap loss and occurs mostly within the first hours after performing anastomoses. Many surgeons still prefer to perform reconstruction and close the defect before starting to anastomose. The aim of this investigation was to find out if detection of early vascular occlusion is facilitated with a prolonged observation period. Between January 2000 and August of 2006, 350 consecutive free flap transfers for reconstruction in maxillofacial surgery were analyzed. In all flaps vascular anastomoses were performed prior to definite flap insertion. The flaps were controlled continuously during soft tissue or bony reconstruction until final wound closure at the neck. Complete operation time, ischemia time of the flap, and time from reperfusion to wound closure (direct pedicle observation time) were registered for each flap. In 350 flaps (138 radial forearm, 94 fibular, 53 ALT, 23 DCIA, 26 soleus perforator, 9 lateral arm, 5 lat. dorsi, and 2 scapular), operation time in average was 8.5 h, ischemia time varied between 78 and 139 min (average 104 min), and direct pedicle observation time of the flaps was 144 min in average (93-192 min). Four arteries and 2 veins showed immediate failure within 5 min after clamp removal, 10 arteries and 6 veins developed thromboses during the direct pedicle observation time. Out of these 16 vascular complications, 15 developed later than 15 min, 7 of them later than 30 min, and 2 of them later than 45 min. The overall complication rate including secondary revision of the pedicle was 16.8%, and an overall flap survival rate resulted in 95.4%. We conclude that microvascular anastomoses should be controlled for at least 45 min before definite wound closure. By performing anastomoses first and flap insertion second, this can be easily warranted. PMID:18286659

  11. Use of Barbed Sutures in Laparoscopic Gastrointestinal Single-Layer Sutures

    PubMed Central

    Kaji, Masahide; Kinoshita, Jun; Shimizu, Koichi

    2016-01-01

    Background and Objectives: Laparoscopic anastomotic methods are not commonly used because of the cumbersome laparoscopic intracorporeal sutures and tying involved. The barbed suture is one of the various devices developed to simplify the placement of intracorporeal sutures. However, barbed sutures are not commonly used during reconstruction after radical gastrectomy in cancer patients or for single-layer entire-thickness running suturing for intestinal anastomoses. We describe the procedure for using barbed sutures and report on the short-term surgical outcomes. Methods: Between August 2012 and March 2014, 15-cm-long barbed sutures (V-Loc 180; Covidien, Mansfield, MA, USA) were used for laparoscopic intestinal anastomoses, including intestinal hole closure for esophagojejunal and gastrojejunal anastomoses after mechanical anastomoses and gastric wall closure after partial resection. Results: In total, 38 patients underwent 40 laparoscopic anastomoses (esophagojejunostomies, 26; gastrojejunostomies, 7; and simple closure of gastric defect, 7); no cases required conversion to open surgery. Two cases exhibited positive air leak test results during surgery (1 case of esophagojejunostomy and 1 case of simple closure of gastric defect). Two cases of intestinal obstruction were noted; of those, one patient with postoperative intestinal paresis (grade II) was managed conservatively, and the other underwent repeat laparoscopic surgery (grade IIIb) for internal herniation unrelated to V-Loc use. No postoperative complications at the anastomosis site and no surgery-related deaths were noted. Conclusion: Single-layer entire-thickness running suturing with the V-Loc 180 barbed suture after stapled side-to-side intestinal anastomosis was found to be safe and feasible in the reported cases. PMID:27493467

  12. Temperature control during laser vessel welding.

    PubMed

    Springer, T A; Welch, A J

    1993-02-01

    A technique is described for the computer control of temperature during laser vessel welding. The technique is based on the use of thermal feedback from a calibrated IR sensor. The utilization of thermalfeedback makes it possible for welding to be performed at a quasiconstant temperature. An experimentalsystem based on this concept has been developed and evaluated in mock anastomoses with vasculartissue. A computer simulation of laser vessel welding with a one-dimensional heat conduction model hasbeen performed. Model parameters have been adjusted so that the relative effect of laser penetrationdepth and tissue dehydration as well as the role of thermal feedback in limiting the peak surfacetemperature can be studied. The results of the mock anastomoses are discussed in light of the computer model. PMID:20802719

  13. Impaired blood supply in the colonic anastomosis in mice compromises healing.

    PubMed

    Pommergaard, Hans-Christian; Achiam, Michael Patrick; Burcharth, Jakob; Rosenberg, Jacob

    2015-01-01

    Colon anastomotic leakage has a multifactorial etiology and ischemia is considered one of the most important single factors. However, no existing animal models have established a direct link between ischemia and anastomotic leakage. The aim of this study was to establish a model of colon anastomotic leakage as a result of tissue ischemia. In colon anastomoses of 53 C57BL/6 mice, varying degrees of ischemia were induced. Supplying vessels were divided with bipolar coagulation in order to reduce anastomotic breaking strength and create clinical anastomotic leakage. Breaking strength of all the ischemic anastomoses were significantly lower compared with controls. Increasing ischemia resulted in higher rates of large bowel obstruction without creating anastomotic leakage. Healing was compromised as a result of impaired blood supply. However, clinical leakage was absent. Pure ischemia in otherwise healthy experimental animals may be too simple of an approach to create clinical leakage. PMID:25594642

  14. A multiphase transitioning peptide hydrogel for suturing ultrasmall vessels.

    PubMed

    Smith, Daniel J; Brat, Gabriel A; Medina, Scott H; Tong, Dedi; Huang, Yong; Grahammer, Johanna; Furtmüller, Georg J; Oh, Byoung Chol; Nagy-Smith, Katelyn J; Walczak, Piotr; Brandacher, Gerald; Schneider, Joel P

    2016-01-01

    Many surgeries are complicated by the need to anastomose, or reconnect, micrometre-scale vessels. Although suturing remains the gold standard for anastomosing vessels, it is difficult to place sutures correctly through collapsed lumen, making the procedure prone to failure. Here, we report a multiphase transitioning peptide hydrogel that can be injected into the lumen of vessels to facilitate suturing. The peptide, which contains a photocaged glutamic acid, forms a solid-like gel in a syringe and can be shear-thin delivered to the lumen of collapsed vessels (where it distends the vessel) and the space between two vessels (where it is used to approximate the vessel ends). Suturing is performed directly through the gel. Light is used to initiate the final gel-sol phase transition that disrupts the hydrogel network, allowing the gel to be removed and blood flow to resume. This gel adds a new tool to the armamentarium for micro- and supermicrosurgical procedures. PMID:26524396

  15. Transient Ischemic Attack in the Setting of Carotid Atheromatous Disease with a Persistent Primitive Hypoglossal Artery Successfully Treated with Stenting: A Case Report.

    PubMed

    Huang, Meng; Moisi, Marc; Zwillman, Michael E; Volpi, John J; Diaz, Orlando; Klucznik, Richard

    2016-01-01

    Fetal brain perfusion is supplied by the primitive dorsal aorta anteriorly, longitudinal neural arteries posteriorly, and anastomotic transverse segmentals. Most notable of these connections are the primitive trigeminal, otic, hypoglossal, and proatlantal arteries. With cranial-cervical circulatory maturation and development of the posterior communicating segments and vertebro-basilar system, these primitive segmental anastomoses normally regress. Anomalous neurovascular development can result in persistence of these anastomoses. Due to its territory of perfusion, the persistent primitive hypoglossal artery (PPHA) is associated with vertebral artery and posterior communicating artery hypoplasia or aplasia. As a consequence, primary blood supply to the hindbrain comes chiefly from this single artery. Although usually clinically silent, PPHA is susceptible to common cerebrovascular disorders including athero-ischemic disease and saccular aneurysmal dilation to name a few. We present a case of transient ischemic attack in a patient with a PPHA and proximal atherosclerotic disease treated by endovascular stenting. PMID:26929891

  16. Transient Ischemic Attack in the Setting of Carotid Atheromatous Disease with a Persistent Primitive Hypoglossal Artery Successfully Treated with Stenting: A Case Report

    PubMed Central

    Moisi, Marc; Zwillman, Michael E; Volpi, John J; Diaz, Orlando; Klucznik, Richard

    2016-01-01

    Fetal brain perfusion is supplied by the primitive dorsal aorta anteriorly, longitudinal neural arteries posteriorly, and anastomotic transverse segmentals. Most notable of these connections are the primitive trigeminal, otic, hypoglossal, and proatlantal arteries. With cranial-cervical circulatory maturation and development of the posterior communicating segments and vertebro-basilar system, these primitive segmental anastomoses normally regress. Anomalous neurovascular development can result in persistence of these anastomoses. Due to its territory of perfusion, the persistent primitive hypoglossal artery (PPHA) is associated with vertebral artery and posterior communicating artery hypoplasia or aplasia. As a consequence, primary blood supply to the hindbrain comes chiefly from this single artery. Although usually clinically silent, PPHA is susceptible to common cerebrovascular disorders including athero-ischemic disease and saccular aneurysmal dilation to name a few. We present a case of transient ischemic attack in a patient with a PPHA and proximal atherosclerotic disease treated by endovascular stenting.  PMID:26929891

  17. Hepatic venography in noncirrhotic idiopathic portal hypertension: comparison with cirrhosis of the liver

    SciTech Connect

    Futagawa, S.; Fukazawa, M.; Musha, H.

    1981-11-01

    Free and wedged hepatic venography were carried out in 37 patients with idiopathic portal hypertension (IPH) and the findings compared with those in 88 patients with cirrhosis of the liver. Characteristic changes in IPH included frequent vein-to-vein anastomoses, narrower angles between large veins and their tributaries, smooth and wavy middle-sized to large branches (giving a general ''weeping willow'' appearance), homogeneous sinusoidal filling, and minimal to absent filling of the portal venous system on wedged retrograde portography. In cirrhosis, by contrast, changes included rare vein-to-vein anastomoses, wide angles between veins and tributaries, irregular stenoses of large veins and branches at various levels, spotty sinusoidal filling, and frequent retrograde flow in the portal venous system. Hepatic venography is helpful in differentiating IPH from cirrhosis.

  18. Hepatopancreatic arterial ring: bilateral symmetric typology in human celiaco-mesenteric arterial system.

    PubMed

    Kosaka, Motohiro; Horiuchi, Kanji; Nishida, Keiichiro; Taguchi, Takehito; Murakami, Takuro; Ohtsuka, Aiji

    2002-10-01

    The celiac and mesenteric arterial system including the left gastric, splenic, common hepatic, and superior mesenteric arteries shows various types of origins, courses, ramifications and anastomoses. In order to explain the various expressions of this system, we have proposed a typological model, in which celiacomesenteric arteries develop as paired or bilaterally symmetrical primordial vessels originated from the anterior aspect of the aorta, and these vessels anastomose each other with longitudinal and horizontal pathways. Here, we report 3 unusual cases characterized by arterial rings, formed by the left gastric, left accessory hepatic, proper hepatic, anterior pancreaticoduodenal, and dorsal pancreatic arteries. The dorsal pancreatic and anterior pancreaticoduodenal arteries are located to the right and left of the embryonic pancreas developing in the dorsal mesentery, respectively. Such hepatopancreatic arterial rings simultaneously containing right and left elements can only be explained using our typological model, in which the concept of paired arteries or bilateral symmetry is introduced. PMID:12530508

  19. Fetal Intra-Peritoneal Transfusion for the Management of Very Early Spontaneous Twin Anemia-Polycythemia Sequence in an Obese Patient With a Whole Anterior Placenta.

    PubMed

    Guenot, Cécile; Robyr, Romaine; Jastrow, Nicole; Vial, Yvan; Raio, Luigi; Baud, David

    2016-04-01

    Twin anemia-polycythemia sequence (TAPS) is a rare condition in monochorionic twin pregnancies. Small intertwin placental vascular communications allow transfusion, which results in a hemoglobin difference in the twins in the absence of oligohydramnios or polyhydramnios. We report here a case of TAPS diagnosed at 17 weeks' gestation in an obese patient (BMI 42) with a whole anterior placenta. The only possible treatment at this stage of pregnancy was intra-uterine transfusion (IUT), which was repeated weekly until photocoagulation of placental anastomoses was feasible. Fetoscopic laser surgery is the only curative treatment, but is challenging in TAPS because of the absence of polyhydramnios and the presence of minuscule anastomoses. An anterior placenta and high BMI can make the procedure even more challenging. This case report demonstrates that very early and rapidly progressing TAPS with technically complicated conditions (elevated BMI and anterior placenta) can be successfully managed with IUT until laser procedure is achievable. PMID:26996223

  20. Applications of microvascular surgery.

    PubMed

    Miller, C W; Fowler, J D

    1990-09-01

    The advent of microvascular surgery has radically changed the discipline of human reconstructive surgery over the last decade. The ability to anastomose vessels less than 1 mm in diameter allows the distant transfer of tissues with a known blood supply from one area of the body to another. These tissues can be detached from their local blood supply and reperfused by anastomosing vessels supplying the tissue transfer to vessels near the recipient site. This technique has been used to transfer a variety of tissues and combinations of tissues including skin, muscle, bone, and bowel to solve a variety of difficult reconstructive problems. Applications, potential applications, and problems associated with microvascular free tissue transfer will be discussed in this chapter. PMID:2134600

  1. Simultaneous Extended ALT Flaps for Foot Salvage After Severe Frostbite.

    PubMed

    Fodor, Marius; Bota, Olimpiu; Fodor, Lucian

    2016-01-01

    Plantar area reconstruction represents the most challenging part of the lower limb. The anterolateral thigh (ALT) flap proved to be a versatile flap for this special area. Herein, we present the application of bilateral ALT free flaps for foot salvage after frostbite injury and long-term follow-up. Single perforator bilateral ALT flaps (304 and 320 cm) were harvested and anastomosed to posterior tibial vessels. The lateral femoral cutaneous nerve was anastomosed to the calcaneal branches of the posterior tibial nerve. The two-point discrimination test showed values from 16 to 28 mm in different flap areas 5 years later. The patient is able to walk with crutches. This is the first case report of bilateral ALT for foot salvage. PMID:26284647

  2. Repair of a canine forelimb skin deficit by microvascular transfer of a caudal superficial epigastric flap.

    PubMed

    Lewin, G A; Smith, J H

    2010-02-01

    Extensive skin loss from the forelimb of a Border collie was repaired by a microvascular caudal superficial epigastric flap, with secondary meshing of the flap to increase coverage. The caudal superficial epigastric artery and vein were anastomosed to the brachial artery and vein. End-to-end anastomosis to the brachial artery and vein did not compromise peripheral blood flow, and no flap necrosis was observed after subsequent limited meshing of the flap. PMID:20070493

  3. [Modern morpho-functional concepts in cephalic arterial distribution].

    PubMed

    Scutariu, M D; Ciupilan, Corina

    2005-01-01

    The present paper provides a general morphofunctional study of the oro-maxillary-facial cephalic arterial area that shows some particular hemodynamic characteristics. The internal maxillary artery supplies a very large territory, with numerous and wide anastomoses. In order to understand the hemodynamic characteristics of this artery, we analyzed some older theories, such as: Ludwig von Bertalanffy's General Systems Theory, Walter Zimmermann's Telome Theory, and some general rheological principles also. PMID:16607795

  4. Littoral cell angiosarcoma in a dog.

    PubMed

    Gal, A; Yamate, J; Golbar, H M; Spoerer, K; Fredrickson, R

    2013-01-01

    This report describes the microscopical and immunohistochemical characteristics of littoral cell angiosarcoma in a 12-year-old, neutered female, beagle dog. The dog succumbed to metastatic disease 3 months after diagnosis of a mid-splenic mass. The tumour was characterized by two histological patterns: anastomosing microvascular channels and microvascular papillary fronds. The neoplastic cells expressed both endothelial and histiocytic markers and were erythrophagocytic. Immunohistochemical findings consistent with malignancy were CD34 expression and high Ki67 nuclear immunoreactivity. PMID:23453493

  5. Giant infantile hemangioendothelioma of the liver. Scintigraphic diagnosis.

    PubMed

    Park, C H; Hwang, H S; Hong, J; Pak, M S

    1996-04-01

    Infantile hemangioendothelioma of the liver is benign mesenchymal tumor composed of anastomosing vascular channels lined with plump endothelial cells. It is a congenital lesion noted at birth or during the first 6 months of life. The authors report a large infantile hemangioendothelioma that was imaged with anatomical modalities and Tc-99m RBC scintigraphy. An early "blush" on Tc-99m RBC hepatic scintigraphy is a diagnostic feature of infantile hemangioendothelioma. PMID:8925610

  6. Twin Anemia Polycythemia Sequence: Current Views on Pathogenesis, Diagnostic Criteria, Perinatal Management, and Outcome.

    PubMed

    Tollenaar, Lisanne S A; Slaghekke, Femke; Middeldorp, Johanna M; Klumper, Frans J; Haak, Monique C; Oepkes, Dick; Lopriore, Enrico

    2016-06-01

    Monochorionic twins share a single placenta and are connected with each other through vascular anastomoses. Unbalanced inter-twin blood transfusion may lead to various complications, including twin-to-twin transfusion syndrome (TTTS) and twin anemia polycythemia sequence (TAPS). TAPS was first described less than a decade ago, and the pathogenesis of TAPS results from slow blood transfusion from donor to recipient through a few minuscule vascular anastomoses. This gradually leads to anemia in the donor and polycythemia in the recipient, in the absence of twin oligo-polyhydramnios sequence (TOPS). TAPS may occur spontaneously in 3-5% of monochorionic twins or after laser surgery for TTTS. The prevalence of post-laser TAPS varies from 2% to 16% of TTTS cases, depending on the rate of residual anastomoses. Pre-natal diagnosis of TAPS is currently based on discordant measurements of the middle cerebral artery peak systolic velocity (MCA-PSV; >1.5 multiples of the median [MoM] in donors and 8 g/dL), and at least one of the following: reticulocyte count ratio >1.7 or minuscule placental anastomoses. Management includes expectant management, and intra-uterine blood transfusion (IUT) with or without partial exchange transfusion (PET) or fetoscopic laser surgery. Post-laser TAPS can be prevented by using the Solomon laser surgery technique. Short-term neonatal outcome ranges from isolated inter-twin Hb differences to severe neonatal morbidity and neonatal death. Long-term neonatal outcome in post-laser TAPS is comparable with long-term outcome after treated TTTS. This review summarizes the current knowledge after 10 years of research on the pathogenesis, diagnosis, management, and outcome in TAPS. PMID:27068715

  7. Large-scale erosional and depositional features of the Channeled Scabland

    NASA Technical Reports Server (NTRS)

    Baker, V. R.

    1978-01-01

    The channeled scabland is a great anastomosing complex of highly overfit stand channels eroded into the basalt bedrock and overlying sediments of the Columbia Plateau. Both the erosional and depositional bed forms in these channels are described according to a simple hierarchical classification. The catastrophic flood flows produced macroforms (scale controlled by channel width) through the erosion of rock and sediment and by deposition (bars). Mesoforms (scale controlled by channel depth) are also erosional and depositional.

  8. Arterial laser welding with a 1.9 micrometer Raman-shifted laser.

    PubMed

    Zelt, D T; LaMuraglia, G M; L'Italien, G J; Megerman, J; Kung, R T; Stewart, R B; Abbott, W M

    1992-06-01

    A new 1.9 micron Raman-shifted neodymium:yttrium aluminum garnet (Nd:YAG) laser was used for small vessel welding. Bursting pressures and stresses of sutured and laser-welded arteriotomies created in the rat femoral artery and aorta were measured. Sutured arteriotomies had a significantly higher burst stress than laser-welded arteriotomies. Although there were no significant differences in burst stress at the various laser powers tested, an optimal power was identified. The laser was also used to weld transected rat aortas. The average power delivered was 200 mW for 30 seconds per anastomosis. The average time for completing an anastomosis was 6 minutes compared with 18 minutes when sutures were used. In relation to proximal aortic diameter, there was a 7.9% decrease at the anastomosis immediately (n = 4), and a 6.6% and 4.9% increase occurred at 24 hours (n = 4) and 10 weeks (n = 5), respectively. Acute anastomotic compliance, and compliance at 24 hours and 10 weeks were decreased by 47.2%, 39.5%, and 47.8%, respectively, and were similar to sutured anastomoses. Histology showed little thermal denaturation of the aorta within 0.6 mm of the anastomosis, approximately 1 mm of medial cell death, and nearly normal elastic fiber alignment. One focal false aneurysm was noted at 10 weeks. Although the sutured and laser-welded anastomoses share similar compliance changes, the laser-welded anastomoses are more isodiametric. This preliminary experience with the 1.9 micron laser shows the distinct advantages of a handheld fiber, no requirement for cooling irrigation, speed, and no difference in compliance from sutured anastomoses. PMID:1597884

  9. Laser assisted internal mammary artery-coronary artery anastomosis - an experimental study

    NASA Astrophysics Data System (ADS)

    Zhu, Hong-Sheng; Zhang, Liang-ping; Feng, Lian

    2005-07-01

    Objective: To observe the time required for anastomosis and the reliability for pressure tolerance after internal mammay artery (IMA) -coronary artery anastomosis. Method: Eight sheep underwent thoracotomy and left IMA harvest. In group I (T) the IMA were anastomosed to left anterior descending artery (LAD) with 7-0 prolene suture (n=4) and in group II (LA) IMA were anastomosed to LAD with laser. Result: The time required for laser technique was shorter than that required in suturing technique [117.5+/-39.48min (total) and 38.25+/-6.23 min vs 62.5+/-37.83 min (total) and 20+/-6.53 min respectively ] (p<0.01). Prior to closing thoracotomy both two groups endured the impact of pharmacologic vasopressor. No leakage at the anastomosed site was observed in both groups. After the closure of thoracotomy, well tolerance for both adrenalin and thoracic negative pressure was observed in the two groups. The peak systolic pressure induced by pharmacologic agent was similar in both groups. Neither stenosis nor thrombus or embolism was observed and immediate patency rate in both groups was 100%. Conclusion: Laser assisted technique seems to be favorable for patency rate and could lead to better result after coronary artery bypass grafting(CABG).

  10. The Retrograde Ulnar Dorsal Flap: Surgical Technique and Experience as Island Flap in Coverage of Hand Defects.

    PubMed

    Vergara-Amador, Enrique

    2015-09-01

    Flaps from the forearm are often used to reconstruct soft-tissue defects in the hand. The retrograde ulnar dorsal flap has the advantage that it does not sacrifice a major vascular axis. The anatomic bases of this flap are the proximal and distal branch of the ulnar dorsal artery. The distal branch is partially accompanied with the dorsal branch of the ulnar nerve, and arrives under the abductor digiti quinti muscle making anastomoses with the deep branch of the ulnar artery. The proximal branch reaching the proximal third of the forearm, and anastomose with perforating branches of the ulnar artery. I used this island flap in 12 patients with coverage defects on the hand. The biggest flap was 13×6 cm. Only 1 flap had partial necrosis which did not lead to problems. The retrograde ulnar dorsal flap is a flap designed with reverse flow from the distal branch of the ulnar dorsal artery, and which does not sacrifice the ulnar artery. The donor defect on the forearm ulnar side had a greater esthetic acceptance. Knowing other distal anastomoses, described by other authors later, dorsal at the base of the fourth interdigital space grant greater security to the retrograde ulnar dorsal flap. It is worth highlighting the importance of preserving the adipofascial tissue around the pedicle. Experience with this flap permits us to state that it is a safe and reproducible flap to cover any defect on the dorsal of the hand as well as the first web space. PMID:26079665

  11. Genetic Diversity of Isolates of Glomus mosseae from Different Geographic Areas Detected by Vegetative Compatibility Testing and Biochemical and Molecular Analysis

    PubMed Central

    Giovannetti, Manuela; Sbrana, Cristiana; Strani, Patrizia; Agnolucci, Monica; Rinaudo, Valeria; Avio, Luciano

    2003-01-01

    We detected, for the first time, the occurrence of vegetative incompatibility between different isolates of the arbuscular mycorrhizal fungal species Glomus mosseae. Vegetative compatibility tests performed on germlings belonging to the same isolate showed that six geographically different isolates were capable of self-anastomosing, and that the percentage of hyphal contacts leading to fusions ranged from 60 to 85%. Successful anastomoses were characterized by complete fusion of hyphal walls, protoplasm continuity and occurrence of nuclei in the middle of hyphal bridges. No anastomoses could be detected between hyphae belonging to different isolates, which intersected without any reaction in 49 to 68% of contacts. Microscopic examinations detected hyphal incompatibility responses in diverse pairings, consisting of protoplasm retraction from the tips and septum formation in the approaching hyphae, even before physical contact with neighboring hyphae. Interestingly, many hyphal tips showed precontact tropism, suggesting that specific recognition signals may be involved during this stage. The intraspecific genetic diversity of G. mosseae revealed by vegetative compatibility tests was confirmed by total protein profiles and internal transcribed spacer-restriction fragment length polymorphism profiles, which evidenced a higher level of molecular diversity between the two European isolates IMA1 and BEG25 than between IMA1 and the two American isolates. Since arbuscular mycorrhizal fungi lack a tractable genetic system, vegetative compatibility tests may represent an easy assay for the detection of genetically different mycelia and an additional powerful tool for investigating the population structure and genetics of these obligate symbionts. PMID:12514049

  12. CO2 vascular anastomosis of atherosclerotic and calcified arteries

    NASA Astrophysics Data System (ADS)

    White, John V.; Leefmans, Eric; Stewart, Gwendolyn J.; Katz, Mira L.; Comerota, Anthony J.

    1990-06-01

    The technique for CO2 laser fusion vascular anastomosis in normal vessels has been well established. Normal arterial wall has a predictable thermal response to the incident laser energy, with rapid heating and cooling of collagen within the arterial wall. Since atherosclerosis involves subendothelial cellular proliferation, lipid and calcium deposition, it may modify the thermal responsiveness of the arterial wall. To this study, CO2 laser fusion anastomoses were attempted in rabbits with non-calcific atherosclerosis and humans with calcific atherosclerosis. All anastomoses were successfully completed without alteration in technique despite the presence of plaque at the site of laser fusion. Histology of rabbit vessels revealed the classic laser fusion cap within the adventitia and persistent atherosclerotic plaque at the flow surface. Duplex imaging of patients post-operatively demonstrated long term anastomotic patency in 2 of 3 fistulae. These results suggest that neither non-calcified or calcified atherosclerosis significantly alters the arterial wall thermal responsiveness to CO2 laser energy or inhibits creation of laser fusion anastomoses. Therefore, this technique may be applicable to the treatment of patients with atherosclerotic occlusive disease.

  13. Elevated Shear Stress in Arteriovenous Fistulae: Is There Mechanical Homeostasis?

    NASA Astrophysics Data System (ADS)

    McGah, Patrick; Leotta, Daniel; Beach, Kirk; Aliseda, Alberto

    2011-11-01

    Arteriovenous fistulae are created surgically to provide access for dialysis in patients with renal failure. The current hypothesis is that the rapid remodeling occurring after the fistula creation is in part a process to restore the mechanical stresses to some preferred level (i.e. mechanical homeostasis). Given that nearly 50% of fistulae require an intervention after one year, understanding the altered hemodynamic stress is important in improving clinical outcomes. We perform numerical simulations of four patient-specific models of functioning fistulae reconstructed from 3D Doppler ultrasound scans. Our results show that the vessels are subjected to `normal' shear stresses away from the anastomosis; about 1 Pa in the veins and about 2.5 Pa in the arteries. However, simulations show that part of the anastomoses are consistently subjected to very high shear stress (>10Pa) over the cardiac cycle. These elevated values shear stresses are caused by the transitional flows at the anastomoses including flow separation and quasiperiodic vortex shedding. This suggests that the remodeling process lowers shear stress in the fistula but that it is limited as evidenced by the elevated shear at the anastomoses. This constant insult on the arterialized venous wall may explain the process of late fistula failure in which the dialysis access become occluded after years of use. Supported by an R21 Grant from NIDDK (DK081823).

  14. Redescription of Chabaudacuaria multispinosa (Pérez Vigueras, 1938) n. g., n. comb. (Nematoda: Spirurida: Acuariidae) based on specimens from Ardea herodias L. and Nyctanassa violacea (L.) (Ardeidae) in Florida.

    PubMed

    Mutafchiev, Yasen; Kinsella, John M

    2012-10-01

    Chabaudacuaria n. g. is erected, as monotypic, for C. multispinosa (Pérez Vigueras, 1938) n. comb. (Spirurida: Acuariidae) [syns Cheilospirura multispinosa Pérez Vigueras, 1938; Acuaria multispinosa (Pérez Vigueras, 1938) Yamaguti, 1961]. This species, a parasite of various ardeid birds, is redescribed by means of light and scanning electron microscopy based on material from great blue herons Ardea herodias L. and yellow-crowned night herons Nyctanassa violacea (L.) in Florida, USA. Chabaudacuaria n. g. resembles Acuaria Bremser, 1811, Cheilospirura Diesing, 1861, Skrjabinocerca Schikhobalova, 1930 and Xenocordon Mawson, 1982 in its straight cordons which do not anastomose. However, it can be distinguished from them by the didelphic-prodelphic uterus and the absence of caudal alae in the males. In the pattern of its cordons (consisting of a row of plates and a longitudinal ridge) and the absence of an area rugosa, the new genus is similar to Chevreuxia Seurat, 1918, Syncuaria Gil'bert, 1927, Aviculariella Wehr, 1931, Skrjabinocara Kurashvili, 1940, Decorataria Sobolev, 1949 and Desportesius Chabaud & Campana, 1949, which are characterised by anastomosing cordons. The didelphic-prodelphic female reproductive system of Chabaudacuaria is intermediate between the didelphic-amphidelphic uterus of Chevreuxia and the monodelphic-prodelphic uterus of Syncuaria, Aviculariella, Skrjabinocara, Desportesius and Decorataria. Therefore, the straight and non-anastomosing cordons are considered to be autapomorphic for Chabaudacuaria. PMID:22983796

  15. Otic artery: a review of normal and pathological features.

    PubMed

    Vasović, Ljiljana; Arsić, Stojanka; Vlajković, Slobodan; Jovanović, Ivan; Jovanović, Predrag; Ugrenović, Sladjana; Andjelković, Zlatibor

    2010-05-01

    Three primitive arteries - the trigeminal, otic and hypoglossal take the names according to their close relation with the V, VIII and XII cranial nerves, while at the cervical level, the first segmental artery is named the primitive proatlantal intersegmental artery. When the human embryo is 4 mm long, these arteries serve as transitory anastomoses between primitive internal carotid arteries and bilateral longitudinal neural arterial plexus, which is the precursor of future basilar artery. Normal and/or abnormal morphofunctional aspects of the prenatal and postnatal forms of the otic artery are described according to the personal and literature data. Many (ab) normal arteries are also noted in differential diagnosis of the otic artery. Postnatally, individual incidence rates of the carotid-vertebrobasilar anastomoses have been found to be inversely related to their order of disappearance. The persistent trigeminal artery has a reported incidence from 0.06-0.6%, whereas the persistent primitive otic artery has been convincingly documented only in minor rates. Persistent carotid-vertebrobasilar anastomoses between the anterior and posterior cranial circulation are important to recognize during angiography for endovascular and surgical planning. Most frequently, the otic artery was an incidental finding. PMID:20424561

  16. Modern Pearl River Delta and Permian Huainan coalfield, China: A comparative sedimentary facies study

    USGS Publications Warehouse

    Suping, P.; Flores, R.M.

    1996-01-01

    Sedimentary facies types of the Pleistocene deposits of the Modern Pearl River Delta in Guangdong Province, China and Permian Member D deposits in Huainan coalfield in Anhui Province are exemplified by depositional facies of anastomosing fluvial systems. In both study areas, sand/sandstone and mud/mudstone-dominated facies types formed in diverging and converging, coeval fluvial channels laterally juxtaposed with floodplains containing ponds, lakes, and topogenous mires. The mires accumulated thin to thick peat/coal deposits that vary in vertical and lateral distribution between the two study areas. This difference is probably due to attendant sedimentary processes that affected the floodplain environments. The ancestral floodplains of the Modern Pearl River Delta were reworked by combined fluvial and tidal and estuarine processes. In contrast, the floodplains of the Permian Member D were mainly influenced by freshwater fluvial processes. In addition, the thick, laterally extensive coal zones of the Permian Member D may have formed in topogenous mires that developed on abandoned courses of anastomosing fluvial systems. This is typified by Seam 13-1, which is a blanket-like body that thickens to as much as 8 in but also splits into thinner beds. This seam overlies deposits of diverging and converging, coeval fluvial channels of the Sandstone D, and associated overbank-floodplain deposits. The limited areal extent of lenticular Pleistocene peat deposits of the Modern Pearl River Delta is due to their primary accumulation in topogenous mires in the central floodplains that were restricted by contemporaneous anastomosing channels.

  17. [DISORDERS OF LUNG FUNCTION IN THE EARLY POSTOPERATIVE PERIOD IN PATIENTS OPERATED ON THE ASCENDING AORTA WITH THE EXPANSION OF INTERVENTION ON THE AORTIC ARCH].

    PubMed

    Bokeria, L A; Nikitin, E S; Mironenko, V A; Rychin, S V; Vyganovskaya, N B; Makrushin, I M; Gordeev, S L

    2015-01-01

    Precapillary artery--arterial (bronchial artery--pulmonay artery) anastomoses, come into play in cases where the locking artery open and alveoli washed arterialized blood. Normally, these anastomoses are closed. Intrapulmonary shunts carry blood supply acinar hinder extraordinary circumstances (chronic pulmonary embolism, surgery, occurring in cardiopulmonary bypass, when the flaw of blood through the Iungs is suspended for the duration of cardiopulmonary bypass). Patients operated on the ascending aorta with the expansion of intervention on the nortic arch during the correction of pathology carry blood supply only the central nervous system. All other organs and systems at this time were protected by mild hypothermia. However, during circulatory arrest, required for correction of pathology acinar damage as a result of hypoxia, probably because there is no blood flow in the pulmonary artery and there is no blood flow in the bronchial arteries. Last, in the ordinary course of artificial circulation, capable due to arterio-arterial pulmonary anastomoses prevent hypoxic damage to acinar, not lead to persistent hypoxemia in the immediate postoperative period in these patients, as a result of violations of lung diffusion capacity. PMID:27019884

  18. Anastomotic leakage in rectal cancer surgery: The role of blood perfusion

    PubMed Central

    Rutegård, Martin; Rutegård, Jörgen

    2015-01-01

    Anastomotic leakage after anterior resection for rectal cancer remains a common and often devastating complication. Preoperative risk factors for anastomotic leakage have been studied extensively and are used for patient selection, especially whether to perform a diverting stoma or not. From the current literature, data suggest that perfusion in the rectal stump rather than in the colonic limb may be more important for the integrity of the colorectal anastomosis. Moreover, available research suggests that the mid and upper rectum is considerably more vascularized than the lower part, in which the posterior compartment seems most vulnerable. These data fit neatly with the observation that anastomotic leaks are far more frequent in patients undergoing total compared to partial mesorectal excision, and also that most leaks occur dorsally. Clinical judgment has been shown to ineffectively assess anastomotic viability, while promising methods to measure blood perfusion are evolving. Much interest has recently been turned to near-infrared light technology, enhanced with fluorescent agents, which enables intraoperative perfusion assessment. Preliminary data are promising, but large-scale controlled trials are lacking. With maturation of such technology, perfusion measurements may in the future inform the surgeon whether anastomoses are at risk. In high colorectal anastomoses, anastomotic revision might be feasible, while a diverting stoma could be fashioned selectively instead of routinely for low anastomoses. PMID:26649151

  19. Renal Transplantation by Automatic Anastomotic Device in a Porcine Model.

    PubMed

    Lo Monte, Attilio Ignazio; Damiano, Giuseppe; Palumbo, Vincenzo Davide; Spinelli, Gabriele; Buscemi, Giuseppe

    2015-10-01

    Automatic vascular staplers for vascular anastomoses in kidney transplantation may dramatically reduce the operative time and, in particular, warm ischemia time, thus increasing the outcome of transplantation. Ten pigs underwent kidney auto-transplantation by automatic anastomotic device. Kidneys were collected by laparotomy with selective ligations at the renal hilum and perfused with cold storage solution. To overcome the shortage in length of renal hilum, a tract of the internal jugular vein was harvested to increase the length of the vessels. The anastomoses were totally performed by the use of the anastomotic device. On 10 kidney transplants, nine were successful and no complications occurred. Renal resistive indexes showed a slight increase in the immediate postoperative period returning normal at 10 days of follow-up. We demonstrated the possibility to perform renal vascular anastomoses by means of an automatic anastomotic device. This instrument developed for coronary bypass surgery by virtue of the small caliber of the vessels could be adopted on a larger scale for renal transplantation. The reduced warm ischemia time needed for anastomosis may help to achieve a better outcome for the graft and expand the pool of marginal donors in renal transplantation. PMID:25900063

  20. "Mini-Flow-Through" Deep Inferior Epigastric Perforator Flap for Breast Reconstruction with Preservation of Both Internal Mammary and Deep Inferior Epigastric Vessels

    PubMed Central

    Sugawara, Jun; Yasumura, Kazunori; Mikami, Taro; Kobayashi, Shinji; Maegawa, Jiro

    2015-01-01

    This procedure was developed for preservation of the rectus muscle components and deep inferior epigastric vessel after deep inferior epigastric perforator (DIEP) flap harvesting. A 53-year-old woman with granuloma caused by silicone injection underwent bilateral nipple-sparing mastectomies and immediate reconstruction with "mini-flow-through" DIEP flaps. The flaps were dissected based on the single largest perforator with a short segment of the lateral branch of the deep inferior epigastric vessel that was transected as a free flap for breast reconstruction. The short segments of the donor deep inferior epigastric vessel branch are primarily end-to-end anastomosed to each other. A short T-shaped pedicle mini-flow-through DIEP flap is interposed in the incised recipient's internal mammary vessels with two arterial and four concomitant venous anastomoses. Although it requires multiple vascular anastomoses and a short pedicle for the flap setting, the mini-flow-through DIEP flap provides a large pedicle caliber, enabling safer microsurgical anastomosis and well-vascularized tissue for creating a natural breast without consuming time or compromising the rectus muscle components and vascular flow of both the deep inferior epigastric and internal mammary vessels. PMID:26618128

  1. Surgical techniques of orthotopic rat liver transplantation.

    PubMed

    Spiegel, H U; Palmes, D

    1998-01-01

    Liver transplantation in rats is frequently used as a transplantation model. Although liver transplantation in larger laboratory animals such as dogs and pigs is technically easier, the rat has become the most important subject for experimental liver transplantation because of the availability of genetically defined animals. Numerous surgical techniques have been developed that permit the investigator to carry out studies with high clinical relevance. In this article the principal models of orthotopic rat liver transplantation and their technical modifications of vessel anastomoses, rearterialization, and bile duct reconstruction techniques are reviewed. More than 20 transplantation models are described in detail and demonstrated with clear illustrations. Finally, the advantages and uses of all the surgical procedures (e.g., suture and cuff anastomoses, bile duct anastomoses, and rearterialization techniques), specific problems, and survival criteria are discussed and the experiences of investigators who applied these techniques are analyzed. In conclusion, an overview and critical evaluation of all surgical techniques of orthotopic rat liver transplantation are given, together with instructions for learning these techniques. PMID:9700616

  2. In vivo perfusion assessment of an anastomosis surgery on porcine intestinal model (Conference Presentation)

    NASA Astrophysics Data System (ADS)

    Le, Hanh N. D.; Opferman, Justin; Decker, Ryan; Cheon, Gyeong W.; Kim, Peter C. W.; Kang, Jin U.; Krieger, Axel

    2016-04-01

    Anastomosis, the connection of two structures, is a critical procedure for reconstructive surgery with over 1 million cases/year for visceral indication alone. However, complication rates such as strictures and leakage affect up to 19% of cases for colorectal anastomoses and up to 30% for visceral transplantation anastomoses. Local ischemia plays a critical role in anastomotic complications, making blood perfusion an important indicator for tissue health and predictor for healing following anastomosis. In this work, we apply a real time multispectral imaging technique to monitor impact on tissue perfusion due to varying interrupted suture spacing and suture tensions. Multispectral tissue images at 470, 540, 560, 580, 670 and 760 nm are analyzed in conjunction with an empirical model based on diffuse reflectance process to quantify the hemoglobin oxygen saturation within the suture site. The investigated tissues for anastomoses include porcine small (jejunum and ileum) and large (transverse colon) intestines. Two experiments using interrupted suturing with suture spacing of 1, 2, and 3 mm and tension levels from 0 N to 2.5 N are conducted. Tissue perfusion at 5, 10, 20 and 30 min after suturing are recorded and compared with the initial normal state. The result indicates the contrast between healthy and ischemic tissue areas and assists the determination of suturing spacing and tension. Therefore, the assessment of tissue perfusion will permit the development and intra-surgical monitoring of an optimal suture protocol during anastomosis with less complications and improved functional outcome.

  3. A Practical and Less Invasive Total Cavopulmonary Connection Sheep Model

    PubMed Central

    Wang, Dongfang; Plunkett, Mark; Gao, Guodong; Zhou, Xiaoqin; Ballard-Croft, Cherry; Reda, Hassan; Zwischenberger, Joseph B.

    2016-01-01

    Our goal is to develop a less invasive total cavopulmonary connection (TCPC) sheep model for testing total cavopulmonary assist (CPA) devices. Thirteen sheep underwent a right 4th intercostal lateral thoracotomy. In series I (n=6), a polytetrafluoroethylene (PTFE) extracardiac conduit (ECC) was connected to inferior vena cava (IVC) and superior vena cava (SVC) by end to side anastomosis. The SVC/IVC remained connected to right atrium (RA). A PTFE graft bridged ECC to right pulmonary artery (RPA). Clamps between SVC/IVC anastomoses and RA diverted total venous blood to pulmonary circulation. In series II (n=7), temporary bypasses between SVC/IVC to RA allowed SVC/IVC to be cut off from RA for better RPA exposure. The ECC-SVC/IVC were end-end anastomosed and ECC-RPA side-side anastomosed for total SVC/IVC to PA conversion. In each series, one sheep died of bleeding. In 5 sheep in series I and 6 sheep in series II, the TCPC model was successfully created with significantly increased central venous pressure and significantly decreased pulmonary artery pressure/arterial blood pressure. Our acute TCPC sheep model has a less traumatic right thoracotomy with no cardiopulmonary bypass and less blood loss with no blood transfusion, facilitating future long-term CPA device evaluation. PMID:24399067

  4. Sutureless colon anastomosis with fibrin glue in the rat.

    PubMed

    Haukipuro, K A; Hulkko, O A; Alavaikko, M J; Laitinen, S T

    1988-08-01

    The only technique available for creating an intestinal anastomosis without tissue strangulation is gluing. Theoretically, this could lead to a higher hydroxyproline content and greater mechanical strength than in a sutured anastomosis. To test the hypothesis, 83 rats underwent left colon resection and inverted primary anastomosis with either one layer of sutures (NG group) or fibrin glue (FG group). Seven-day FG anastomoses showed less adhesions (P = .02) but one subclinical leakage and a further radiologic one, compared with a greater amount of adhesions but no leakages in the NG group. The mean bursting pressures (mmHg) in the FG and NG groups, respectively, were 25 +/- 20 (SD) and 63 +/- 23 (N.S.) 30 minutes after surgery, 107 +/- 33 and 115 +/- 30 after one day, 81 +/- 31 and 133 +/- 26 (P less than .001) after four days, and 161 +/- 36 and 175 +/- 24 after seven days. The somewhat earlier rise in hydroxyproline content in the glued anastomoses did not lead to significant intergroup differences. The glued anastomoses were thus weak during the critical lag period of healing. Also, by preventing adhesion formation, the glue may reduce the extra blood supply from perianastomotic vessels. The outcomes might have differed more under demanding experimental or clinical situations. PMID:2456902

  5. Fibrin glue protection of primary anastomosis in the obstructed left colon. An experimental study on the rat.

    PubMed

    Hulkko, O A; Haukipuro, K A; Laitinen, S T

    1988-01-01

    A left-sided colon obstruction was produced with a polypropylene sling in 65 rats. Colon resection and primary anastomosis were performed three days later. The animals were then randomly allocated to the FG (fibrin glue) group receiving sealing of the anastomosis with 0.4 ml of fibrin glue (Beriplast R), or to the NG (non-glue) group. The anastomoses were assessed 30 min, two days and four days later. Adhesion formation was similar in both groups. The number of macroscopic or radiological leakages did not differ either. At 30 min the mean bursting pressure was 74.6 +/- 8.6 (SD) mmHg in the FG group and 58.3 +/- 21.6 mmHg in NG (non-glue) group (p less than 0.05, Mann-Whitney test). Later on the strength of the anastomoses was equal in both groups. We conclude that the initial sealing of weak points in the anastomoses was beneficial but the inherent strength per se could not be enhanced. PMID:2451367

  6. [Arteriovenous anastomosis in nasal cavities using microcorrosion technique].

    PubMed

    Passàli, D; Buccella, M G; Vetuschi, A; Bellussi, L

    1990-01-01

    In the present study the morphology of arteriovenous anastomoses in the nasal area are analyzed using the microcorrosion technique. This technique calls for perfusion of the vascular system, passing through the left ventricle, with Batson's of the vessels. For the first time in the microcorrosion study of the nasal vascular network human fetuses (from the 12th to 24th week of intrauterine life) obtained from spontaneous abortions were used as well as rats weighing from 250 to 300 gr. The animals were anesthetized with sodium thiopental prior to administration of the resin. A specimen containing the facial muscles, the nasal pyramid, the maxillary bone and the palatine bones was excised. Then, from this specimen the nasal septum and the two lateral portions of the nose were obtained. The bony and soft perivascular tissues were removed by placing the casts in an aqueous 20% KOH solution. Finally the corrosion cases were observed under a scanning electron microscope (EM). Within the nasal cavities the microcorrosion technique makes it possible to identify three different vascular layers: superficial, intermediate and deep. In the latter it proved possible to visualize the two types of arteriovenous anastomoses: i.e. simple and complex. On the basis of both vascular course and the impressions left by the endothelial cell nuclei it proved possible to differentiate between the arterial and venous portions of the anastomoses. PMID:2095105

  7. Le traumatisme du colon: l'expérience du CHU Hassan II de Fès

    PubMed Central

    Benjelloun, El Bachir; Hafid, Hasnai; Karim, Ibnmajdoub; Ousadden, Abdelmalek; Mazaz, Khalid; Taleb, Kahlid Ait

    2012-01-01

    Introduction Les traumatismes du colon sont associés à un risque majeur de complications septiques et de mortalité. Le but de notre étude est d’évaluer les circonstances, la prise en charge, le suivi et les facteurs pronostic de morbidité postopératoire des malades victimes d'un traumatisme colique. Méthodes Il s'agit d'une étude rétrospective sur une série de 49 patients opérés pour des plaies coliques aux services de chirurgie viscérale du CHU HASSAN II de Fès sur une période de 8 ans de juillet 2003 à juillet 2011. Résultats L’âge moyen de nos patients était de 25ans (16-70) avec une nette prédominance masculine (93.8%). Les plaies coliques secondaires à un traumatisme par arme blanche représentent 85% des cas (42 patients), suivi par les plaies iatrogènes au cours d'une coloscopie chez 6 patients (13%), puis les contusions abdominales chez 1 patient (2%). Les parties du cadre colique les plus touchées étaient le colon transverse chez 19 patients (38%) et le colon descendant chez 12 patients (24, 5%). Le colon sigmoïde était le segment le plus touché au cours d'une coloscopie4/6. Quarante-deux patients (85%) ont eu une suture primaire des plaies coliques, six patients (13%) une diversion fécale et un patient (2%) une résection-anastomose. Deux patients (4%) sont décédés suite à un choc septique. La morbidité globale était de 38,7% dominé essentiellement par l'infection de la paroi chez 14 patients et une péritonite post opératoire chez 3 patients. L'analyse univarié a montré une différence significatif en terme d'infection de la paroi entre le groupe colostomie versus suture simple (50% vs 20,9% p<0,05). L'atteinte du colon gauche et la réalisation d'une colostomie sont associés à un risque plus élevés de complications postopératoires. Conclusion La suture primaire peut être effectuée avec un faible taux de complications postopératoire chez la majorité des patients suite à un traumatisme du colon. PMID

  8. Reach-Scale Hydraulic Influence on Sediment Dynamics and Morphological Development in a Bedrock Influenced River

    NASA Astrophysics Data System (ADS)

    Entwistle, N. S.; Heritage, G. L.; Milan, D. J.; Tooth, S.

    2014-12-01

    Many large rivers in southern Africa are characterised by a macro-channel cut 10 - 20 m into the ancient planation surface. This has resulted in a variable channel morphology strongly influenced by bedrock outcrops. The influence of bedrock upon flow hydraulics and sediment transport often results in a repeat sequence of alluvial channel types behind bedrock obstructions. This study investigates the hydraulic controls on channel type sequencing on the Sabie River, which drains a 6500 km2 semi-arid catchment of the Lowveld of South Africa and Mozambique. Aerial LIDAR data within the Kruger National Park was interrogated to isolate a bedrock influenced anastomosing reach, together with its associated alluvial sequences up- and downstream. These data were used to create a 2m DEM and a 2D flow model (JFLOW) was used to simulate a sequence of flows from 20 m3s-1 to 5000 m3s-1, with spatial data on water surface, flow depth and channel velocity extracted from the model. Water surface data revealed the strong gradient control exerted by the bedrock influenced anastomosed channel, creating hydraulic conditions suitable for deposition upstream and restricting sedimentation downstream. Steepening of the gradient through the anastomosing reach resulted in altered hydraulics and a changed pattern of sedimentation. At moderate discharges, flow is distributed efficiently across numerous interconnected channels, over low berms and islands, promoting sedimentation. Similarly the backwater effect encourages deposition of fine sediments upstream to create and maintain the alluvial sequence. Under higher flows, water levels rise significantly in the confined upstream reach and shear stress exceeds the threshold necessary to strip stored sediment. In contrast, conditions within the anastomosed reach remain less energetic due to the continued effect of flow distribution. Under extreme flow conditions the bedrock influence is drowned out resulting in dramatically increased energy levels

  9. Cinématique des failles entre les unités subbétiques pendant le Miocène (secteur central de la cordillère Bétique).

    NASA Astrophysics Data System (ADS)

    Galindo-Zaldívar, Jesús; Ruano, Patricia; Jabaloy, Antonio; López-Chicano, Manuel

    2000-12-01

    The kinematic analysis of the low-angle faults that separate the major units of the Subbetic Zone indicates two main stages of translations. In the first stage, of Burdigalian to basal Tortonian age, the hanging walls moved toward the WSW, and thrusts developed in some sectors of the External Zones. Simultaneously, in the Internal Zones, the activity of extensional detachments shows the same kinematics. In the second stage, affecting up to basal Tortonian rocks, northwest-verging thrusts were active. The Subbetic tectonic units probably underwent relative rotation during the development of these structures.

  10. A Comparison of Chinese and Colombian University EFL Students Regarding Learner Autonomy (Comparación entre estudiantes universitarios de inglés chinos y colombianos con respecto a su autonomía como aprendices)

    ERIC Educational Resources Information Center

    Buendía Arias, Ximena Paola

    2015-01-01

    This research seeks to gain deeper understanding of learner autonomy in English as a Foreign Language students from different cultures through the identification and analysis of similarities and differences between Chinese and Colombian students from two public universities: Tianjin Foreign Studies University in China and Universidad Surcolombiana…

  11. Corrélations entre propriétésélectriques et structurales de solutions solides de type fluorinea`exce`s d'anions: Essai de mode`lisation

    NASA Astrophysics Data System (ADS)

    Reau, J. M.; Senegas, J.; El Omari, M.

    1990-02-01

    In a fluoride ion excess CaF 2-type solid solution of formulation M 2+1-xM' 2+αxF 2+αx (α = 1, 2, 3) , the sum of the interstitial fluoride ions n F int and the sum of the vacancies in normal sites n □ can be represented according to general equations y = (mx 3 + λqx)(x 2 + q) : the m and λ parameters depend on structural features, and q is bound to electrical properties. This model allows one to correlate in a continuous way the composition dependence of electrical properties and the progressive extension of clusterization when the substitution rate increases.

  12. [The EMECAM project: a discussion of the results in the participating cities. Estudio Multicéntrico Español sobre la Relación entre la Contaminación Atmosférica y la Mortalidad].

    PubMed

    Ballester Díez, F; Sáez Zafra, M; Pérez-Hoyos, S; Daponte Codina, A; Bellido Blasco, J B; Cañada Martínez, A; Abad Díez, J M; Pérez Boíllos, M J; Alonso Fustel, M E; Taracido Trunk, M; Aguinaga Ontoso, I; Guillén Pérez, J J; Ordóñez Iriarte, J M; Saurina Canals, C; Tenías Burillo, J M

    1999-01-01

    This article draws a comparison and provides a discussion of the findings resulting from the local analyses of the 14 cities participating in the EMECAM Project. An analysis is made of the time series related to mortality, pollutants (particles in suspension, SO2, NO2, O3 and CO), temperature and other factors taken from records of public institutions. By using Poisson autoregressive regression, an estimate has been made of the short-term relationship between the number of deaths and the air pollution indicators in each one of the following cities: Barcelona, metropolitan area of Bilbao, Cartagena, Castellón, Gijón, Huelva, Madrid, Pamplona, Seville, Oviedo, Valencia, Vigo, Vitoria and Saragossa. The findings reveal the air pollution figures in our country to be similar to those of other European cities. The levels of the different pollutants point toward road traffic as being the main source of most of this pollution. A relationship has been found between the mortality and different pollutants in most cities, although the results are not homogeneous among the cities and show variability in the different causes under study. In some cities, especially in those having smaller populations, there have been no findings providing any evidence of a relationship, or the findings themselves are not highly consistent. The meta-analysis will provide estimates for all of the cities as a whole and will allow the possibility of making a more clear-cut assessment of the time lag impact of air pollution on the mortality. Worthy of special mention is the participation in this project of public health officers as actively involved researchers. PMID:10410614

  13. Repertoire de didacticiels de francais langue seconde ou etrangere publies entre 1980 et 1988 (List of Courseware for French as a Second or Foreign Language Published between 1980 and 1988). Publication K-11.

    ERIC Educational Resources Information Center

    H.-Lemonnier, France; And Others

    A listing of 97 items of courseware includes programs in seven categories, pertaining to: (1) vocabulary; (2) grammar; (3) verb conjugation; (4) syntax and/or morphosyntax; (5) reading and/or writing; (6) oral language; and (7) other areas of French second language instruction. Each citation includes the title, program type (e.g. drill, game),…

  14. Exploring Elementary Students' Power and Solidarity Relations in an EFL Classroom (Exploración de las relaciones de poder y solidaridad entre estudiantes de primaria en la clase de inglés como lengua extranjera)

    ERIC Educational Resources Information Center

    Méndez, Tatiana; García, Andrea

    2012-01-01

    This article derives from a critical discourse analysis study that reports the characteristics of elementary school students' power and solidarity relations in English as a foreign language classroom in Bogotá, Colombia, while we were doing our teaching English as a foreign language practicum. The study was based on theories of power and…

  15. Como ayudar a su hijo durante los primeros anos de la adolescencia: Para los padres con ninos entre las edades de 10 a 14 anos (Helping Your Child through Early Adolescence: For Parents of Children from 10 through 14).

    ERIC Educational Resources Information Center

    Paulu, Nancy

    Recognizing that parents and families can greatly influence the development of their 10- through 14-year-olds, this Spanish-language booklet is part of a national effort to provide parents with the latest research and practical information to help them support their children both at home and in school. The booklet is organized in 13 sections…

  16. La Desercion Escolar en los Niveles de Sexto y Noveno Grado: Una Comparacion Entre Zonas Rurales y Urbanas. Boletin 219 (The Educational Desertion in the 6th and 9th Grades: A Comparison Between Rural and Urban Zones. Bulletin 219).

    ERIC Educational Resources Information Center

    Lopez, Maria I. Hernandez; And Others

    In 1962 and again in 1965, a group of sixth and ninth grade students in selected schools in four Puerto Rican communities were interviewed to investigate the factors influencing students' decision to withdraw from school before completing twelfth grade and to identify some characteristics of dropouts. Of 616 students interviewed in 1962, 20.9% of…

  17. Teacher Collaboration Praxis: Conflicts, Borders, and Ideologies from a Micropolitical Perspective (La práctica colaborativa entre docentes: conflictos, fronteras e ideologías desde una perspectiva micropolítica)

    ERIC Educational Resources Information Center

    Keranen, Nancy; Encinas Prudencio, Fátima

    2014-01-01

    This paper looks at a feature of teacher collaboration within Achinstein's (2002) micropolitics of collaboration but from an intrapersonal perspective. Results discussed feature issues of conflict, borders, and ideologies within each participating teacher rather than between teachers. Unresolved or unacknowledged intrapersonal conflict might lead…

  18. Suivis temporels comparés de la structure thermique d'eaux côtières libanaises (Batroun) et françaises (Marseille) entre juin 1999 et octobre 2002

    NASA Astrophysics Data System (ADS)

    Abboud-Abi Saab, Marie; Romano, Jean-Claude; Bensoussan, Nathaniel; Fakhri, Milad

    2004-11-01

    Vertical temperature profiles were recorded from June 1999 to October 2002 (at least once a month) at two Mediterranean sites, in the eastern basin (Batroun, Lebanon; 0-100 m) and in the northwestern basin (Marseilles, France; 0-55 m). At the two sites, the thermal seasonal evolution and the thermocline time dynamics are quite identical. But in the Lebanese waters, at comparable water depths, temperatures are currently 4 to 5 °C higher than in the French waters, the thermocline is longer (more than 6 months), permanent and deeper (40-50 m) than in Marseilles (20-30 m). The latter frequently disappears in summer due to northwest winds inducing cold waters. This is principally due to differences in prevailing wind regimes at each site. Such evaluation, coupled with long-term observations of temporal evolution of coastal water at the regional level of the Mediterranean basins, will shed light on temperature regime fluctuations and their consequences in the context of global warming of the Mediterranean. To cite this article: M. Abboud-Abi Saab et al., C. R. Geoscience 336 (2004).

  19. Vinculos Entre la Capacitacion de Docentes y el Desarrollo de Materiales Educativos Impresos--Anotaciones para Una Discusion (Links between In-service Teacher Training and the Development of Printed Educational Aids).

    ERIC Educational Resources Information Center

    Valle, Victor M.

    Textbooks and other printed materials will be ever present, in the foreseeable future, as major aids for teaching and learning processes. New textbooks imply new guidelines for teachers, and the ways to handle such guidelines demand teacher training. This paper explains some links between inservice teacher training programs and the development of…

  20. Adequation between environmental shifts and human speciations during the Plio-PleistoceneAdéquation entre changements environnementaux et spéciations humaines au Plio-Pléistocène

    NASA Astrophysics Data System (ADS)

    Zeitoun, Valery

    2000-01-01

    Several synthetic studies provide evidence of faunistic and floristic shifts as consequences of global climatic events around 2.5 and 1.8 Ma. Some authors are more confident in the role played by local tectonic events to explain such a change in terms of vicariance. It is possible that astronomic, tectonic and climatic variations are linked, as the lithosphere is a catalyst for biosphere more or less strong according to the period. The purpose of this paper is to confront independent environmental and anatomical data to try to understand the evolutionary process in hominids, with particular emphasis on species of the genus Homo in East Africa during the Plio-Pleistocene period. Thus the result of a cladistic analysis based on 35 Otus and 468 features of the calvaria is showing the onset of at least four species to describe the grade of Homo habilis, living in East Africa. The radiation is congruent with the contemporaneous environmental shifts around 2.5 Ma, as is also the case for bovids or cercopithecids. Some Homo erectus left Africa when another climatic pulse happened around 1.8 Ma.

  1. Relaciones hidrogeologicas y medioambientales entre el mar mediterraneo, El saladar y el acuifero de agua amarga (provincia de alicante). Incidencia de las explotaciones de las desaladoras de alicante I Y II Y medidas correctoras

    NASA Astrophysics Data System (ADS)

    Manteca, Ivan Alhama

    The Agua Amarga coastal aquifer, located in the south of Alicante province, has been subjected to successive anthropogenic actions: salt works activity (1925-1975) and water withdrawal to supply the Alicante I and II desalination plants (since 2003). These interventions have influenced the salinity and the flow regime. Due to the existence of a salt marsh of ecological interest linked to the aquifer, the 'Mancomunidad de los Canales del Taibilla' (agency responsible for the desalination plants) designed a piezometric network for monitoring piezometry and electrical conductivity (in operation since May 2008). Soil humidity and piezometrics levels have been recovered by means of a seawater pouring programme over the salt marsh (since December 2009),which represents the third anthropic intervention. In this memoria, we investigate the Agua Amarga coastal aquifer to develop a physical conceptual model. Firstly, the study area is characterized in relation to climatology, geology, geomorphology and hydrogeology, using published information, describing, in addition, the desalination plants catchment system. Next, based on hydrogeological studies prior to the start up of the desalination plants, the aquifer is characterized: type, lithology, hydraulic parameters, thickness, surface extension, etc. Water quantity relating to rainfall, water withdrawal and pourings over the salt marsh, have been integrated in conjunction with data from monthly piezometric campaigns. In adittion, in order to gain insight into the groundwater mixing processes, chemical and isotope analyses were carried out on meteoric water and groundwater samples taken at different locations. The results were used to elaborate a conceptual physical model and a water budget. As an extension tool to understand processes and assess aquifer management, a 3-D fluid-flow and solute-transport model is designed with SEAWAT. Also, the 2-D physical characterization of scenarios with seawater intrusion and salt flats is presented. Finally, after describing ecological values of the salt marsh, the effect of the seawater pouring programme on aquifer piezometry and salinity is studied, assessing the possibility of applying this pilot scheme to other scenarios.

  2. Les "petits mots" de coordination: etude diachronique de leur apparition chez quatre enfants entre 3 et 4 ans (The "Little" Coordinating Words: A Diachronic Study of Their Appearance in Four Children, ages 3-4)

    ERIC Educational Resources Information Center

    Chambaz, Marcelle; And Others

    1975-01-01

    Reports on a diachronic study concerning the syntactic phenomena of coordination and subordination and their place in language acquisition. The organization and evolution of the coordination system of 4 children, ages 3-6 was studied. The need for investigation of adult speech for further understanding acquisition is stressed. (Text is in French.)…

  3. Etude de l'interface entre le profil psycho-spirituel des futurs maitres et le developpement psychosocial (Study of the Relationship between the Psycho-Spiritual Profile of Future Teachers and Their Psycho-Social Development).

    ERIC Educational Resources Information Center

    Michaud, Claude

    1996-01-01

    Describes a study examining the spiritual experiences among young adults in Ontario to help inform efforts to revise teacher education programs in Canada. Highlights the diversity of subjects' spiritual experiences and describes three typologies of individual spiritual development. Reviews the roles of the church, university, and school in teacher…

  4. Predictive Relationship between Humane Values of Adolescents Cyberbullying and Cyberbullying Sensibility (Relaciones predictivas entre los valores humanos de los adolescentes, el acoso cibernético y la sensibilidad al acoso cibernético)

    ERIC Educational Resources Information Center

    Dilmac, Bülent; Yurt, Eyüp; Aydin, Mustafa; Kasarci, Ismail

    2016-01-01

    Introduction: Cyberbullying has been more common than the traditional bullying in recent years. As with the traditional bullying, humane values likely to explain the reason why adolescents tend to bully via cyber-means. Cyber-bullying behaviors also reasoned by adolescents' sensibility towards it. This study investigates the predictive…

  5. Potencial de Seqüestro de Carbono Atmosférico entre Diferentes Cultivares de Milho (Zea mays L.) sob Condiç o de Déficit Hídrico

    Technology Transfer Automated Retrieval System (TEKTRAN)

    There is a question concerning the role of agricultural practices on carbon sequestration enhancement. By producing biomass with agricultural crops and adding this residue to soil, it should act on the mitigation process of the greenhouse effect, especially CO2. The objectives of this study were to ...

  6. Histoire d’un itinéraire épidémiologique entre le Burkina Faso et la Côte d’Ivoire : le cas des foyers de maladie du sommeil de Koudougou

    PubMed Central

    Kiendrébéogo, D.; Kambiré, R.; Jamonneau, V.; Lingué, K.; Solano, P.; Courtin, F.

    2012-01-01

    Dans la première moitié du XXème siècle, alors que la Haute-Volta (actuel Burkina Faso) subissait une terrible épidémie de maladie du sommeil, l’administration coloniale française a orchestré des déplacements massifs de populations de la Haute-Volta vers la Côte d’Ivoire, pour exploiter le territoire. Cela a conduit à la mise en place de villages de colonisation Mossi en zone forestière ivoirienne, comme ceux de Koudougou, issus de l’une des régions les plus peuplées de Haute-Volta, mais aussi l’une des plus touchées par la maladie du sommeil. Depuis 2000, au Burkina Faso, c’est dans le district sanitaire de Koudougou que sont dépistés passivement le plus grand nombre de trypanosomés en provenance de Côte d’Ivoire. Qui sont-ils ? Où habitent-ils au Burkina Faso ? D’où viennent-ils de Côte d’Ivoire ? Après avoir retracé l’histoire épidémiologique des villages de Koudougou au Burkina Faso et en Côte d’Ivoire, nous avons recherché les trypanosomés dépistés passivement depuis 2000 dans le district sanitaire de Koudougou au Burkina Faso. Au total, dix trypanosomés ont été enquêtés. Le processus de propagation de la maladie du sommeil dans l’espace ivoiro-burkinabé a été mis en évidence et des zones à risque de la maladie identifiées dans ce même espace. PMID:23193525

  7. O Imperio como Argumento: Um Contraponto entre Joaquim Nabuco e o Bispo D. Jose Mauricio da Rocha (The Empire as Argument: A Counterpoint between Joaquim Nabuco and the Bishop Dom Jose Mauricio da Rocha).

    ERIC Educational Resources Information Center

    Marson, Izabel Andrade

    1998-01-01

    Dialogs with the previous article establishing a comparative analysis between the political acceptance present in the reactionary speech of Dom Jose Mauricio da Rocha and in the monarchist words of Joaquim Nabuco. (PA)

  8. Conséquences de l'interaction entre préférences pour l'habitat et quantité de ressources trophiques sur les communautés d'insectes coprophages (Coleoptera: Scarabaeoidea)

    NASA Astrophysics Data System (ADS)

    Kadiri, Nassera; Lobo, Jorge M.; Lumaret, Jean-Pierre

    Between the years 1988 and 1995, five dung beetle communities were studied in combined conditions of habitat and trophic resources. Investigations were conducted on La Viale experimental farm, in the Causse Méjean, southern France. At each site, dung beetle traps of standard design were set up simultaneously. In most situations, the vegetation cover acted like a filter that allowed the penetration of several ubiquitous but fundamentally open-habitat dung beetle species into forest, at the same time drastically limiting their numbers. Open and close sites differed significantly, open and grazed sites showing the highest richness, abundance and biomass in beetles. Both in open and close sites, a significant increase in trophic resources led to an increase of the diversity and evenness. However in open-habitat, when resources were too abundant, few species were favoured and the diversity and evenness decreased. In forest-habitat, a continuous grazing during several years (increase in resources) modified the dung beetle community, with a high increase in the numbers and biomass of beetles but a smaller increase in richness. Numbers in forest habitat readjusted to the level observed in open habitat with equivalent trophic resources. Similarly to what was observed in open pastures, the forest communities were able to adjust their numbers to the level of available trophic resources. Resources were a more active variable than the structure of habitat on the dung beetle communities. Important resources go against the filter effect which allows the penetration under cover of open-habitat species. Changes were slow (several years), and forest communities remained weak. The poverty of forest habitats is discussed: This scarcity in species is probably due to long time human activities in Europe which drastically reduced forest habitats and developped grazing, favouring generalist and heliophilous open-habitat dung beetle species. Actual grassland communities in Europe are richer than their homologous communities in North America. Conversely, in North America where human activities are recent, the true forest dung beetle communities are still diverse and richer than grassland communities.

  9. Online Peer Feedback between Colombian and New Zealand FL Beginners: A Comparison and Lessons Learned (Retroalimentación virtual de pares entre aprendices principiantes de lengua de Colombia y Nueva Zelanda: una comparación y lecciones aprendidas)

    ERIC Educational Resources Information Center

    Tolosa, Constanza; Ordóñez, Claudia Lucía; Alfonso, Tania

    2015-01-01

    We report on an exploratory study comparing the performance as online tutors of two groups of beginner eleven-year-old students of English in Colombia and Spanish in New Zealand. The native speaker students of the foreign language the others were learning corrected paragraphs written by their peers. The feedback provided by each group of tutors…

  10. Como ayudar a su hijo a tener exito en la escuela, con actividades para ninos entre las edades de 5 a 11 anos (Helping Your Child Succeed in School, with Activities for Children Ages 5 through 11).

    ERIC Educational Resources Information Center

    Paulu, Nancy

    At the heart of the No Child Left Behind Act of 2001 is a promise to raise standards for all children and to help all children meet those standards. This Spanish-language booklet provides information that parents can use to help their child succeed in school. Following an introduction, the second section of the booklet, "The Basics," offers…

  11. Vinculacion Entre La Educacion Y El Mundo Del Trabajo: Informe Final. (Coloquio Regional Caracas, Venezuela, Septiembre 2-6, 1985) = The Linkage Between Education and Employment: Final Report of the Regional Colloquium (Caracas, Venezuela, September 2-6, 1985).

    ERIC Educational Resources Information Center

    United Nations Educational, Scientific, and Cultural Organization, Santiago (Chile). Regional Office for Education in Latin America and the Caribbean.

    At this regional colloquium 13 papers were presented concerning the relationship between education and employment. Themes addressed were: (1) the transformation of the workplace by technology and science; (2) the future of the disadvantaged population as a consequence of the technological revolution; and (3) the resulting changes in the education…

  12. Le « Harcèlement Entre Pairs » À L'école élémentaire Tchèque: Une Question D'interprétation

    NASA Astrophysics Data System (ADS)

    Kohout-Diaz, Magdalena

    2008-07-01

    "PEER BULLYING" IN CZECH PRIMARY SCHOOLS: A QUESTION OF INTERPRETATION—This article questions adults' reports of an alleged increase in peer bullying at Czech primary schools. A survey on the school climate revealed that the pupils see it as a generally positive one and consider their relationships to be good. However, compared to France, their behaviour towards the adults is aggressive and rude. This apparent contradiction is linked to a conflict between the educational norms carried over from the old regime (behavioural control and conformism) and the new socio-economic paradigms (critical thinking and free enterprise). Public opinion, the media and a number of scientifically-questionable studies have drawn attention to the phenomenon of peer bullying ( šikana), and applied an imported concept to describe it ( school bullying). This makes it possible to avoid questioning the part played by the adults, the school and the researchers; justify segregating pupils from socially, culturally or economically disadvantaged backgrounds (Roma); and facilitate the country's socio-economic inclusion in the European Union by highlighting educational problems about whose nature there is general agreement.

  13. The Differences between Spoken and Written Grammar in English, in Comparison with Vietnamese (Las Diferencias entre la Gramática Oral y Escrita del Idioma Inglés en Comparación con el Idioma Vietnamita)

    ERIC Educational Resources Information Center

    Thanh, Nguyen Cao

    2015-01-01

    The fundamental point of this paper is to describe and evaluate some differences between spoken and written grammar in English, and compare some of the points with Vietnamese. This paper illustrates that spoken grammar is less rigid than written grammar. Moreover, it highlights the distinction between speaking and writing in terms of subordination…

  14. Highlighting the Impacts of North-South Research Collaboration among Canadian and Southern Higher Education Partners (Principaux impacts des collaborations de recherche Nord-Sud entre les partenaires des etablissements d'enseignement superieur du Canada et du Sud)

    ERIC Educational Resources Information Center

    Association of Universities and Colleges of Canada, 2006

    2006-01-01

    The Association of Universities and Colleges of Canada (AUCC) felt it was timely to create an academic forum in which university researchers have the opportunity to engage with their peers and relevant stakeholders and document the impacts of their North-South research collaboration in a peer-reviewed publication. The Association achieved this by…

  15. Parámetros astrofísicos fundamentales de 6 cúmulos de la Nube Mayor de Magallanes en el rango de transición entre 200 y 700 millones de años

    NASA Astrophysics Data System (ADS)

    Piatti, A. E.; Bica, E.; Geisler, D.; Clariá, J. J.

    Complementing our recent Washington photometric studies on intermediate age and young Large Magellanic Cloud (LMC) clusters, we present in this work new results for 6 previously unstudied star clusters in the transition range 200-700 Myr. We study NGC 1836, NGC 1860 and NGC 1865, which are projected on the LMC bar; SL 444, also located in the central disc but outside the bar, and LW 224 and SL 548, both located in the outer disc. We derive ages and metallicities from extracted T1 versus C-T1 colour-magnitude diagrams (CMDs), using theoretical isochrones recently computed for the Washington system. For the metallicity determinations, these CMDs are particularly sensitive. We also estimate ages and metallicities of the surrounding fields of NGC 1860 and NGC 1865 by employing the δT1 index and theoretical isochrones.

  16. Pushing Too Little, Praising Too Much? Intercultural Misunderstandings between a Chinese Doctoral Student and a Dutch Supervisor (¿Empujando muy poco, felicitando demasiado? Malentendidos interculturales entre un estudiante de doctorado Chino y un supervisor Holandés)

    ERIC Educational Resources Information Center

    Hu, Yanjuan; van Veen, Klaas; Corda, Alessandra

    2016-01-01

    To understand the challenges and their causes in interactions between Western supervisors and international doctoral students, we conducted a self-study of our experiences as a Chinese international student and her Dutch supervisor during her doctoral research project. We found the supervisor and the student to differ in their expectations of the…

  17. Peer Interaction: A Social Perspective towards the Development of Foreign Language Learning (Interacción entre pares: una perspectiva social hacia el desarrollo del aprendizaje en una lengua extranjera)

    ERIC Educational Resources Information Center

    Gómez Lobatón, July Carolina

    2011-01-01

    This pedagogical innovation aims at discovering new ways of interaction that go beyond the unidirectional relationship that is presented in the classrooms most of the times. The innovation considers peers to be active agents in the construction of knowledge and proposes new ways to arrange groups in the classroom so that the arrangement can…

  18. Positive Prevention: Successful Approaches To Preventing Youthful Drug and Alcohol Use [and] La Prevencion Positiva: Metodos que han tenido exito en la prevencion del uso de drogas y alcohol entre la juventud.

    ERIC Educational Resources Information Center

    American Association of School Administrators, Arlington, VA.

    The United States has the highest rate of youthful drug abuse of any industrialized country in the world. There is a growing awareness that drug and alcohol use are closely connected to other problems such as teenage suicide, adolescent pregnancy, traffic fatalities, juvenile delinquency, poor school performance, runaways, and dropouts. Youthful…

  19. Improved donor liver position selection and revascularization for heterotopic auxiliary liver transplantation with portal vein arterialization

    PubMed Central

    Li, Jun; Zhang, Yujun; Ren, Jianjun; Zhang, Junjing; Qiao, Jianliang; Meng, Xingkai

    2015-01-01

    Purpose: To establish an animal model of improved donor liver position selection and revascularization for heterotopic auxiliary liver transplantation with portal vein arterialization (HALT-PVA). Methods: Sprague-Dawley rats were utilized to establish models. Improved HALT-PVA was conducted for the experimental rat: hepatic common artery of donor liver was end-to-side anastomosed to portal vein which was end-to-side anastomosed to the left common iliac artery of host rat, while the segments of inferior vena cava superior and inferior to the donor liver were end-to-side anastomosed to the inferior vena cava of host rat, respectively. For the control rats, liver transplantations were conducted through end-to-end anastomosis between portal vein of donor liver and stand tube placed in right renal artery of host rat, and end-to-side anastomosis between the inferior vena cava inferior to the donor liver with the inferior vena cava of host rat, while the inferior vena cava superior to the donor liver was stitched up. Besides, hepaticoenterostomy were performed to all rats and survival status were monitored. ALT, AST, TBil and CHE were tested continuously after operation, and pathological examination of liver tissues were performed. Results: The survival rate was 93.3% (14/15). ALT, AST, TBil and CHE for experimental group showed a rapider recovery of liver functions than controls. Pathological examinations of liver tissues from the experimental-group rats showed better presentation than the control-group rats. Conclusions: The improved HALT-PVA better accords with the normal anatomy, with little detriment to implanted liver, and therefore is a good model for HALT-PVA related research. PMID:26770477

  20. Optical Magnification Should Be Mandatory for Microsurgery: Scientific Basis and Clinical Data Contributing to Quality Assurance

    PubMed Central

    Schoeffl, Harald; Lazzeri, Davide; Schnelzer, Richard; Froschauer, Stefan M.

    2013-01-01

    Background Microsurgical techniques are considered standard procedures in reconstructive surgery. Although microsurgery by itself is defined as surgery aided by optical magnification, there are no guidelines for determining in which clinical situations a microscope or loupe should be used. Therefore, we conducted standardized experiments to objectively assess the impact of optical magnification in microsurgery. Methods Sixteen participants of microsurgical training courses had to complete 2 sets of experiments. Each set had to be performed with an unaided eye, surgical loupes, and a regular operating microscope. The first set of experiments included coaptation of a chicken femoral nerve, and the second set consisted of anastomosing porcine coronary arteries. Evaluation of the sutured nerves and vessels were performed by 2 experienced microsurgeons using an operating microscope. Results The 16 participants of the study completed all of the experiments. The nerve coaptation and vascular anastomoses exercises showed a direct relationship of error frequency and lower optical magnification, meaning that the highest number of microsurgical errors occurred with the unaided eye. For nerve coaptation, there was a strong relationship (P<0.05) between the number of mistakes and magnification, and this relationship was very strong (P<0.01) for vascular anastomoses. Conclusions We were able to prove that microsurgical success is directly related to optical magnification. The human eye's ability to discriminate potentially important anatomical structures is limited, which might be detrimental for clinical results. Although not legally mandatory, surgeries such as reparative surgery after hand trauma should be conducted with magnifying devices for achieving optimal patient outcomes. PMID:23532716

  1. Does really previous stenting affect graft patency following CABG? A 5-year follow-up: The effect of PCI on graft survival.

    PubMed

    Songur, Murat Çetin; Özyalçin, Sertan; Özen, Anıl; Şimşek, Erdal; Kervan, Ümit; Taşoğlu, İrfan; Kaplan, Sadi; Köse, Kenan; Ulus, Ahmet Tulga

    2016-04-01

    The aim of this study was to compare the graft patency rates among patients who had a previous history of percutaneous coronary intervention (PCI) followed by coronary artery bypass grafting surgery (CABG) with the patients who had experienced CABG surgery alone. The 69 patients who were included in the study had a history of bare metal stent implantation prior to CABG (group 1). The coronary angiography results were compared with 69 patients who had a previous history of CABG (group 2). Graft patency rates of the left anterior descending artery and circumflex anastomoses are statistically significant for both groups, whereas the right coronary artery anastomoses are not statistically significant (p = 0.008; 0.009; 0.2). Graft patency rate of LIMA-LAD anastomoses was 43.9 ± 10.8 % in group 1 and 86.2 ± 6 % in group 2 for means of 60 months (p = 0.0001) and circumflex coronary artery anastomosis is 28.9 ± 0.9 % in group 1, 65.7 ± 10.8 % in group 2 (p = 0.0001) and the right coronary artery anastomosis is 37.2 ± 13.6 % in group 1, 56.4 ± 8.9 % in group 2 (p = 0.0001). The graft patency rates of coronary arteries without previous stent implantation were higher than the patients with previous stent implantation and experienced CABG. The results suggest that prior PCI may induce atherosclerotic events in the vessel that can adversely affect graft patency after surgery. PMID:25637043

  2. Subclavian artery aneurysm in a patient with vascular Ehlers-Danlos syndrome.

    PubMed

    Yasuda, Shota; Imoto, Kiyotaka; Uchida, Keiji; Uranaka, Yasuko; Kurosawa, Kenji; Masuda, Munetaka

    2016-02-01

    We describe our experience of surgical treatment in a 28-year-old woman with vascular Ehlers-Danlos syndrome. A right subclavian artery aneurysm was detected. The right vertebral artery arose from the aneurysm. Digital subtraction angiography showed interruption of the left vertebral artery. The aneurysm was excised and the right vertebral artery was anastomosed end-to-side to the right common carotid artery under deep hypothermia and circulatory arrest. The patient remained very well 4 years after surgery, with no late vascular complication. PMID:25293415

  3. Thumb Replantation Using the Superficial Palmar Branch of the Radial Artery.

    PubMed

    Cho, Sang Hyun; Bahar-Moni, Ahmed Suparno; Park, Hyun Chul

    2016-08-01

    The thumb is the most important part of the hand. If thumb is amputated, all efforts should be made to replant it to preserve hand functions. Good functional outcome can be obtained with successful thumb replantation than with other reconstructive surgery. We present a case of thumb amputation of a 44 -year-old male with severe damage to the soft tissues and bony structures of the radial part of the hand. We performed the replantation anastomosing the superficial palmar branch of the radial artery as donor artery as the proximal part of thumb digital arteries were severely damaged due to crush injury and got favorable result. PMID:27625540

  4. Transcatheter Embolization of Bronchial Artery Arising from Left Circumflex Coronary Artery in a Patient with Massive Hemoptysis

    SciTech Connect

    Cho, Jaemin; Shin, Taebeom Jun, Kyeongneo; Ryoo, Jaeuk; Choi, Hocheol; Choi, Bongryeong; Hwang, Jinyong

    2010-02-15

    It has been reported that anastomoses between the bronchial and the coronary arteries can become dilated and functional in certain diseases, provoking angina pectoris through coronary steal syndrome. The condition can be treated with endovascular or surgical management. It is possible that this abnormality may be associated with hemoptysis in patients with parenchymal or vascular disease of the lung but this condition is very rare. We present the coronary CT angiographic findings of bronchial arteries arising from the left coronary artery and their treatment with transcatheter embolization for the control of massive hemoptysis.

  5. Iatrogenic ascending aortic dissection following cannulation for arterial return and for infusion of cardioplegic solution: Prevention and repair

    PubMed Central

    Ugorji, Clement C.; Cooley, Denton A.; Norman, John C.

    1980-01-01

    Two patients are presented in whom dissection of the ascending aorta resulted from cannulation for arterial return and from the infusion of cardioplegic solution. The dissections were recognized promptly. Following dissection in the first patient, the femoral artery was used to reestablish systemic perfusion. The aortic valve and dissected ascending aorta were replaced, and three vessels were grafted. In the second patient, the dissected anterior wall of the ascending aorta was excised and replaced with a low-porosity Dacron patch into which the proximal aortocoronary anastomoses were inserted. Predisposing factors are discussed, along with preventive measures and methods of repair. PMID:15216287

  6. Dependent Lung Tension Pneumothorax During 1-Lung Ventilation: Treatment by Transmediastinal Thoracentesis.

    PubMed

    Kenta, Okitsu; Shoko, Arimoto; Takeshi, Iritakenishi; Satoshi, Hagihira; Yuji, Fujino; Yasushi, Shintani; Masato, Minami; Meinoshin, Okumura

    2015-08-15

    Contralateral tension pneumothorax during 1-lung ventilation is rare but life threatening. We report the case of a patient who developed tension pneumothorax of the dependent lung during 1-lung ventilation while the surgeon was anastomosing the bronchi after sleeve lobectomy. Ventilation was not possible in either the dependent or nondependent lung, leading to severe desaturation and cardiac arrest. While the surgeons were administering direct cardiac compression, we suspected tension pneumothorax. As soon as the surgeons pierced the mediastinal pleura, adequate circulation was restored. Immediate diagnosis and treatment is important for this complication. PMID:26275308

  7. Variant PTA Terminating in Cerebellar Artery, Associated with Multiple Aneurysms

    PubMed Central

    Hwang, Yeong Uk

    2016-01-01

    Persistent trigeminal artery (PTA) is one of the remnant fetal anastomoses between the carotid artery and basilar artery. PTAs are classified according to angiographic appearance and various connection. Among them, those directly terminating in the cerebellar arteries are rare subtype. In addition, aneurysms of the PTA are unusual in the literature and have not previously accompanied this subtype of PTA connecting cerebellar artery. We present the first case of an aneurysm of the PTA which is directly terminating in the cerebellar arteries and combined with multiple aneurysms. PMID:27446623

  8. Rare anatomical variations of persistent trigeminal artery in two patients with non-aneurysmal subarachnoid hemorrhage.

    PubMed

    Samaniego, Edgar A; Dabus, Guilherme; Andreone, Vincenzo; Linfante, Italo

    2011-09-01

    Carotid-basilar anastomoses are remnants of the fetal circulation and although rare, they may become symptomatic and should be recognized during cerebral angiography. Two patients are described with non-aneurysmal subarachnoid hemorrhage and persistent trigeminal arteries (PTA) found on cerebral angiography. In the first patient, the PTA ended in the anterior inferior cerebellar artery (AICA) and posterior inferior cerebellar artery. The second patient had a PTA terminating in the AICA and superior cerebellar artery. These rare anatomical PTA variants should be recognized on cerebral angiography. PMID:21990842

  9. Variant PTA Terminating in Cerebellar Artery, Associated with Multiple Aneurysms.

    PubMed

    Hwang, Yeong Uk; Kim, Jin Woo

    2016-01-01

    Persistent trigeminal artery (PTA) is one of the remnant fetal anastomoses between the carotid artery and basilar artery. PTAs are classified according to angiographic appearance and various connection. Among them, those directly terminating in the cerebellar arteries are rare subtype. In addition, aneurysms of the PTA are unusual in the literature and have not previously accompanied this subtype of PTA connecting cerebellar artery. We present the first case of an aneurysm of the PTA which is directly terminating in the cerebellar arteries and combined with multiple aneurysms. PMID:27446623

  10. Effect of six-month hypokinesia in dogs on mineral component, reconstruction and mechanical properties of bone tissue

    NASA Technical Reports Server (NTRS)

    Volozhin, A. I.; Pavlova, M. P.; Muradov, I. S.; Stupakov, G. P.; Korzhenyants, V. A.

    1980-01-01

    Ca45 incorporation into the bones of the limbs, particularly in the area of the muscle attachment increased in dogs as a result of 6 month hypokinesia. There were no phenomena of osteoporosis in the cortical layer of the diaphyses; however, changes in the form of osteons, an increase in the number of anastomoses between the channels and the thinning of the subperiosteal layer pointed to disturbances of the bone tissue reconstruction. Mineral saturation of the bone microstructures of the experimental dogs had a tendency to rise. No changes in the mechanical properties of the long bones occurred as a result of hypokinesia in dogs.

  11. Depositional models for two Tertiary coal-bearing sequences in the Powder River Basin, Wyoming, USA

    USGS Publications Warehouse

    Warwick, P.D.; Stanton, R.W.

    1988-01-01

    Depositional controls on peat-forming environments which produce thick (>10 m) coal beds can be inferred from relationships between coal bed geometry, maceral composition and associated lithologies. The Wyodak-Anderson peat is interpreted to have formed in restricted parts of the floodplain that were separated by deposits of contemporaneous, anastomosed channels. The Felix coal bed is interpreted to have formed as a raised but widespread peat on an abandoned platform of meander-belt sands. These models may be useful as predictive tools for coal exploration and production. -from Authors

  12. Endovascular Treatment of a Ruptured Para-Anastomotic Aneurysm of the Abdominal Aorta

    SciTech Connect

    Sfyroeras, Giorgos S.; Lioupis, Christos Bessias, Nikolaos; Maras, Dimitris; Pomoni, Maria; Andrikopoulos, Vassilios

    2008-07-15

    We report a case of a ruptured para-anastomotic aortic aneurysm treated with implantation of a bifurcated stent-graft. A 72-year-old patient, who had undergone aortobifemoral bypass for aortoiliac occlusive disease 16 years ago, presented with a ruptured para-anastomotic aortic aneurysm. A bifurcated stent-graft was successfully deployed into the old bifurcated graft. This is the first report of a bifurcated stent-graft being placed through an 'end-to-side' anastomosed old aortobifemoral graft. Endovascular treatment of ruptured para-anastomotic aortic aneurysms can be accomplished successfully, avoiding open surgery which is associated with increased mortality and morbidity.

  13. Basic Vascular Neuroanatomy of the Brain and Spine: What the General Interventional Radiologist Needs to Know

    PubMed Central

    Prince, Ethan A.; Ahn, Sun Ho

    2013-01-01

    This article is intended to provide a review of clinically relevant neurovascular anatomy. A solid understanding of the vascular anatomy of the brain and spine are essential for the safe and effective performance of neurointerventional radiology. Key concepts to master include collateral pathways and anastomoses between the external and internal carotid circulation, the Circle of Willis as a route to otherwise inaccessible intracranial vascular distributions, and the origin of spinal arterial blood supply. These concepts will be highlighted using clinical angiographic examples with discussion of relevant embryology and pathology as needed. PMID:24436544

  14. Recurrent oral pyogenic granuloma in port-wine stain.

    PubMed

    da Silva, Alessandra Dutra; Silva, Carolina Amália Barcellos; de Camargo Moraes, Paulo; Thomaz, Luiz Alexandre; Furuse, Cristiane; de Araújo, Vera Cavalcanti

    2011-11-01

    Pyogenic granuloma (PG) is a benign inflammatory lesion, nonneoplastic in nature, which occurs in the oral cavity and skin. This lesion arises in response to various stimuli such as low-grade local irritations, traumatic injury, or hormonal factors. Recently, in some cases, the occurrence of recurrent PGs in skin associated with vascular lesions, such as port-wine stains, has been described. It has been postulated that this association is promoted by arteriovenous anastomoses in the vascular lesions, leading to the development of PG. The authors discuss 2 cases of recurrent PG in patients with a port-wine stain, and the treatment options adopted. PMID:22134277

  15. Reverse U aortotomy (Kırali incision) for aortic valve replacement.

    PubMed

    Kırali, Kaan

    2016-06-01

    The presence of patent vein grafts on the proximal aorta may cause technical difficulties during reoperations for aortic valve replacement after previous coronary artery bypass surgery. A 65-year-old man underwent reoperation for aortic valve replacement two years after his first open heart surgery (valve-sparing aortic root replacement and aorta-right coronary artery saphenous vein graft). The aortotomy incision was started approximately 2 cm above the proximal anastomosis and continued down at both sides until the prosthetic graft. The reverse U aortotomy prevents unnecessary and risky manipulations of proximal anastomoses, provides perfect exposure, and can be used securely during reoperative aortic valve surgery. PMID:25759482

  16. Revisiting the enzymes stored in the laticifers of Carica papaya in the context of their possible participation in the plant defence mechanism.

    PubMed

    El Moussaoui, A; Nijs, M; Paul, C; Wintjens, R; Vincentelli, J; Azarkan, M; Looze, Y

    2001-04-01

    In the tropical species Carica papaya, the articulated and anastomosing laticifers form a dense network of vessels displayed in all aerial parts of the plant. Damaging the papaya tree inevitably severs its laticifers, eliciting an abrupt release of latex. Besides the well-known cysteine proteinases, papain, chymopapain, caricain and glycyl endopeptidase, papaya latex is also a rich source of other enzymes. Together, these enzymes could provide an important contribution to plant defence mechanisms by sanitising and sealing the wounded areas on the tree. PMID:11361091

  17. Successful treatment of anastomotic jejunal varices with N-butyl-2-cyanoacrylate (Histoacryl): single-center experience.

    PubMed

    Gubler, C; Glenck, M; Pfammatter, T; Bauerfeind, P

    2012-08-01

    Obscure gastrointestinal bleeding can lead to extensive diagnostic work-up, as well as repeated episodes of hospitalizations with significant morbidity. Patients with a previous small-bowel anastomosis seem to be prone to varices at this site, even in the absence of portal hypertension. We report here five cases with varices of this type. All the anastomoses in these patients were reached using overtube-assisted single- or double-balloon enteroscopy. The bleeding varices were treated by injecting N-butyl-2-cyanoacrylate (Histoacryl). Bleeding was stopped in all five patients without any adverse events, requiring one session in four patients and a second session in one patient. PMID:22833023

  18. Does amniotic fluid volume affect fetofetal transfusion in monochorionic twin pregnancies? Modelling two possible mechanisms

    NASA Astrophysics Data System (ADS)

    Umur, Asli; van Gemert, Martin J. C.; Ross, Michael G.

    2002-06-01

    Clinical evidence suggests that increased amniotic fluid volume due to polyhydramnios increases placental vascular resistance. We have sought to model the possible effects of an increased amniotic fluid volume on the net fetofetal transfusion in monochorionic twin pregnancies. We wanted to compare these effects with the results of previous simulations, which aimed to explain why the twin-twin transfusion syndrome (TTTS) placentas more often include bidirectional arteriovenous (AV) rather than AV plus arterioarterial (AA) anastomoses. We extended our mathematical model of TTTS by simulating two different mechanisms that increase the placental vascular resistance as a consequence of polyhydramnios. First, there is an increase in the placental capillary resistance and hence in deep AV and opposite AV (denoted as VA) resistances due to polyhydramnios. Second, there is an increase in the resistance of chorionic veins due to polyhydramnios, assuming that these veins act as Starling resistors. We then simulated the effects of polyhydramnios on different placental anastomotic patterns. The results were as follows. In the first mechanism (polyhydramnios affects AV-VA resistances), an increased amniotic fluid volume hardly affected bidirectional AV, but slightly decreased fetofetal transfusion in AV plus AA anastomoses. However, for these effects to change the natural development of the pregnancy, polyhydramnios needed to persist for approximately 4 weeks, and by comparing the effects of polyhydramnios with the effects of amnioreduction, amnioreduction was more beneficial for normalizing the donor amniotic fluid volume. Therefore, these beneficial effects due to polyhydramnios have no practical clinical significance. In the second mechanism (Starling resistor for chorionic veins), polyhydramnios slightly increased fetofetal transfusion and hence slightly increased TTTS severity in bidirectional AV and AV plus VV, but did not affect AV plus AA anastomoses. In conclusion, we

  19. Appendicocalicostomy: A case of mistaken identity

    PubMed Central

    Sharma, S.; Shah, K.; Santhosh, B. S.; Rizvi, S. J.

    2014-01-01

    Anatomical structures with similar appearance may at times be confused for each other. This situation can be compounded by lack of normal anatomical planes. We did ureterocalicostomy on a 32-year-female with secondary pelvi-ureteral junction obstruction. Post-operatively, it was discovered that she had a long appendix running parallel to ureter in retroperitoneum, which was misidentified as ureter and anastomosed to the lower pole of the kidney. She was re-explored, appendix was removed, ureter was identified and ureterocalicostomy was done. Patient is asymptomatic at 1 year follow-up. PMID:24744527

  20. Urokinase infusion of chronically occluded femoropopliteal Gortex bypass grafts via the popliteal approach.

    PubMed

    Dorros, G; Hall, P; Iyer, S S

    1991-11-01

    Thrombolysis of two occluded above-knee femoropopliteal Gortex bypass grafts utilizing the popliteal approach for catheter placement was successfully performed without complication. In both cases, the proximal anastomoses of the graft could not be identified. A percutaneous popliteal approach was used for catheter placement and delivery of urokinase. Angioplasty was performed on the unveiled stenoses that, presumptively, led to graft closure. Selective thrombolysis via catheter placed from popliteal approach is a new technique for recanalization of occluded femoropopliteal bypass grafts and warrants further investigation. PMID:1764742

  1. Response to ‘Discussion: “Streamlined erosional residuals and drumlins in central British Columbia, Canada”’

    NASA Astrophysics Data System (ADS)

    McClenagan, J. Donald

    2014-03-01

    A response is given to 'Discussion: “Streamlined erosional residuals and drumlins in central British Columbia, Canada”'. Emphasis is made that the main purpose of the paper under discussion is to present the recognition of a distinctive landscape pattern in central British Columbia that appears to be an immense anastomosing channel network. A channel network of the magnitude described requires a large magnitude of flowing water to form it. Thus, that recognizable landscape pattern and associated upland landform shapes can be explained as products of water erosion. Such landscape patterns are observed being formed by water today.

  2. Systemic Artery to Pulmonary Artery Fistula Associated with Mitral Regurgitation: Successful Treatment with Endovascular Embolization

    SciTech Connect

    Iwazawa, Jin; Nakamura, Kenji; Hamuro, Masao; Nango, Mineyoshi; Sakai, Yukimasa; Nishida, Norifumi

    2008-07-15

    We present the case of a 60-year-old woman with symptomatic mitral regurgitation caused by a left-to-right shunt via anastomoses consisting of microfistulae, most likely of inflammatory origin, between the right subclavian artery and the right pulmonary artery. The three arteries responsible for fistulous formation, including the internal mammary, thyrocervical, and lateral thoracic arteries, were successfully occluded by transcatheter embolization using superabsorbent polymer microsphere (SAP-MS) particles combined with metallic coils. No complications have been identified following treatment with SAP-MS particles. This approach significantly reduced the patient's mitral regurgitation and she has remained asymptomatic for more than 4 years.

  3. Abnormal Origin and Course of the Accessory Phrenic Nerve: Case Report.

    PubMed

    Paraskevas, George; Koutsouflianiotis, Konstantinos; Kitsoulis, Panagiotis; Spyridakis, Ioannis

    2016-01-01

    In the current cadaveric study an unusual sizeable accessory phrenic nerve (APN) was encountered emerging from the trunk of the supraclavicular nerves and forming a triangular loop that was anastomosing with the phrenic nerve. That neural loop surrounded the superficial cervical artery which displayed a spiral course. The form of a triangular loop of APN involving the aforementioned artery and originating from the supraclavicular nerve to the best of our knowledge has not been documented previously in the literature. The variable morphological features of the APN along with its clinical applications are briefly discussed. PMID:27526310

  4. Extrahepatic biliary tract in chinchilla (Chinchilla laniger, Molina).

    PubMed

    Nowak, E; Kuchinka, J; Szczurkowski, A; Kuder, T

    2015-06-01

    The aim of the study was the macromorphological analysis of extrahepatic biliary tract in chinchilla (Chinchilla laniger Molina). Bile ducts, the gall bladder and portal vein were injected with coloured latex. Using the technique of dissection, bile ducts were isolated from the liver lobes. It was found that the cystic duct in this species is rarely single. Hepatic ducts form a system of multiple anastomosing structures running in the hepatoduodenal ligament. Many bile duct openings were observed in the duodenal papilla. The results confirm wide variations of the biliary tract in mammals and may be important for comparative analysis of the morphological differentiation of these structures in small mammals. PMID:25091180

  5. [Cerebellar stroke].

    PubMed

    Paradowski, Michał; Zimny, Anna; Paradowski, Bogusław

    2015-01-01

    Cerebellar stroke belongs to a group of rare diseases of vascular origin. Cerebellum, supplied by three pairs of arteries (AICA, PICA, SCA) with many anastomoses between them is less susceptible for a stroke, especially ischemic one. Diagnosis of the stroke in this region is harder due to lower sensibility of commonly used CT of the head in case of stroke suspicion. The authors highlight clinical symptoms distinguishing between vascular territories or topographical locations of the stroke, diagnostic procedures, classical and surgical treatment, the most common misdiagnoses are also mentioned. The authors suggest a diagnostic and therapeutic algorithm development, including rtPA treatment criteria for ischemic cerebellar stroke. PMID:26181157

  6. A preliminary assessment of the fluid erosional processes that shaped the Martian outflow channels

    NASA Technical Reports Server (NTRS)

    Baker, V. R.

    1978-01-01

    Catastrophic floods may be the mechanism which created Martian outflow channels and the distinctive assemblage of channel landforms, including regional and local anastomosing patterns, expanding and contracting reaches correlated with flow constrictions, streamlined uplands, inner channels with recessional headcuts, pendant forms on the downcurrent sides of flow obstacles, and scour marks around the obstacles. A terrestrial landscape which contains analogs to all the Martian outflow features is the Channeled Scabland of eastern Washington, formed by catastrophic flooding across differentially resistant basalt, loess and sedimentary rock. Both hydrodynamic theory and the properties of the boundary undergoing deformation need to be considered in studying the forms that result from catastrophic flooding.

  7. Maxillary ameloblastic fibroma in a dog.

    PubMed

    Miles, C R; Bell, C M; Pinkerton, M E; Soukup, J W

    2011-07-01

    A 4-year-old spayed female Golden Retriever was presented for evaluation of a rostral maxillary gingival mass. An en bloc resection was performed after histologic diagnosis of ameloblastic fibroma from an incisional biopsy specimen. Histologically, the tumor was composed of (1) poorly differentiated vimentin-positive mesenchymal cells that surrounded islands and (2) thin anastomosing trabeculae of odontogenic epithelium that variably coexpressed pancytokeratin and vimentin. To the authors' knowledge, this is the first report of ameloblastic fibroma in a dog. The clinical, radiographic, and histologic findings in this case are compared to those in other domestic animals and humans. PMID:20861502

  8. Comment by J.P. Figueiredo, & Hoorn, C. on 'Late Miocene sedimentary environments in south-western Amazonia (Solimões Formation; Brazil)' by Martin Gross, Werner E. Piller, Maria Ines Ramos, Jackson Douglas da Silva Paz

    NASA Astrophysics Data System (ADS)

    Figueiredo, Jorge Jesus Picanço

    2012-04-01

    In their paper Gross et al., 2011 present an excellent description of a series of outcrops from the Eirunepe region in western Amazonia (Brazil). The authors interpret these sediments as relics of a Late Miocene anastomosing fluvial system and conclude that the paleogeography of the entire western Amazon region must have been characterized by this environmental setting. They also imply that therefore a long-lived lake system - or megawetland - never existed. We contend this assumption for some reasons, amongst them, the most important are: (1) this is an inconsistent overgeneralized conclusion; (2) The authors make references to previous scientific works we published which we consider incorrect, and therefore can mislead their readers.

  9. Pseudoangio-matous stromal hyperplasia: A rare tumor of the breast.

    PubMed

    Shahi, Kedar Singh; Bhandari, Geeta; Gupta, Rakesh Kumar; Sawai, Malvika

    2015-01-01

    Pseudoangiomatous stromal hyperplasia (PASH) is a benign breast entity described first by Vuitch et al., in 1986. PASH is a benign stromal lesion containing complex anastomosing channels lined by slender spindle cells. It can be mistaken with fibroadenoma on ultrasound examination and histologically with low-grade angiosarcoma and phyllodes tumor. Here, presented is a case report of a 30-year-old female who presented with huge palpable lump in left breast. Ultrasonography revealed the lesion as giant fibroadenoma and fine needle aspiration cytology report was suggestive of cystosarcoma phyllodes. Excision and reduction mammoplasty was done and histopathology report was suggestive of PASH. PMID:26881624

  10. Laser welding--suitable for vascular anastomosis?

    PubMed

    Schmiedt, W; Gruber, G; Iversen, S; Oelert, H

    1994-12-01

    Carotid arteries of 21 piglets were transsected and reanastomosed either by laser welding (Neodym:YAG laser) or by conventional suture anastomosis. Histological specimens of the anastomoses obtained 2 to 32 days after the operation showed less foreign body reaction and intimal hyperplasia after laser welding than after suturing. There was, however, no significant difference when comparing occurrence of thrombosis, patency rate, or growth of the anastomosis in growing animals. Neither our study nor a review of the literature of laser-assisted vascular anastomosis in microvessels and large arteries up to 5 mm diameter could establish a definite clinical application for laser welding in vascular anastomosis. PMID:7534952

  11. The question of the fusion of neuron processes.

    PubMed

    Sotnikov, O S; Rybakova, G I; Solov'eva, I A

    2008-10-01

    The authors, whilst accepting the neuron theory, present data indicating the possibility that neuronal syncytia exist when myelin-coated ring-like structures form in the dendritic field, in nerve arcades close to neuron bodies, and on formation of thick, straight anastomoses between neuron bodies. Studies using computerized time-lapse videomicroscopy in cultures of isolated neurons demonstrated the mechanism by which these structures form. This report provides the first evidence of the time parameters of the fusion of the processes of a single live neuron; the fusion of fragments of an isolated glial-free fiber was demonstrated. PMID:18802755

  12. Restoration of the pelvic circulation in patients with abdominal aortic aneurysms receiving aortobifemoral grafts.

    PubMed

    Cardia, G; Tumolo, R; Cafagna, L

    1998-04-01

    When operating on abdominal aortic aneurysms associated with stenoses or occlusions of iliac vessels, surgeons may face the problem of reestablishing circulation to pelvic or gluteal territories. A new technique consists of anastomosing a posterior opening in the body or one of the branches of a bifurcated graft, distally sutured to the femoral artery, to the distal aortic stump, which contains all the patent vessels arising from the end of the aorta, such as inferior mesenteric and lumbar arteries. This technique, successfully performed in two cases, has the advantages of avoiding closure of the distal aortic stump and a possible backflow leak and of ensuring adequate pelvic circulation. PMID:9576094

  13. Precambrian rocks in Tenmile Canyon

    SciTech Connect

    Reed, J.C. Jr.

    1993-12-31

    This paper describes the geology encountered as part of a geology field trip. The low glaciated knobs a few meters northwest along I-70 in Colorado expose thinly layered medium- and fine-grained hornblende and biotite gneisses and amphibolite cut by numerous light-colored anastomosing dikes. Many layers in the gneisses are conspicuously boudinaged and some display small and medium scale intrafolial isoclines. A string of 1--3 m long pods of coarse amphibolite probably represents a dismembered mafic sill or transposed dike. All of these features indicate intense layer parallel ductile deformation.

  14. Contributions of wound configurations to anastomotic strengths: comparisons of argon and Ho:YAG laser-assisted rat intestine tissue welds

    NASA Astrophysics Data System (ADS)

    Thomsen, Sharon L.; Cilesiz, Inci F.; Welch, Ashley J.

    1996-05-01

    Temperature feedback control (TFC) of cw argon ion and cw Ho:YAG laser-assisted anastomoses of severed rat intestines increased wound stability during the first 72 hours after surgery when compared to laser anastomosies formed without temperature control. Comparisons of in vitro bursting pressures measurements and qualitative and quantitative histopathology observations of wound healing were performed to discover the factors associated with this increased stability. Close apposition of the wound edges and decreased abscess formation were found to be associated with good wound healing. No differences in bursting pressure measurements and wound healing patterns were associated with the laser (wavelength) used or between the TFC and non-TFC groups.

  15. Surgical revasculization for pediatric renovascular hypertension caused by fibromuscular dysplasia.

    PubMed

    Murashita, Takashi; Kanemitsu, Hideo; Fukunaga, Naoto; Konishi, Yasunobu; Nakamura, Ken; Sakon, Yoshito; Koyama, Tadaaki

    2014-01-01

    A 4-year male was referred to our hospital for high fever. Incidentally, abnormally high blood pressure was detected. A thorough examination revealed severe stenosis at the origin of two left renal arteries and elevation of plasma renin activity as well as aldosterone level. Some lesions of previous asymptomatic brain bleeding were also revealed. Instead of using prosthetic materials, we transected renal arteries and directly anastomosed them to abdominal aorta, expecting subsequent growth of native vessels. The postoperative course was uneventful. The plasma renin activity and aldosterone level as well as the dose of antihypertensive drug decreased significantly after the operation. PMID:24719664

  16. Outcome of Kidney Allografts in Recipients With a Femoral Arteriovenous Fistula: Report of Two Cases.

    PubMed

    Özdemir-van Brunschot, Denise M D; de Sévaux, Ruud G L; van Hamersvelt, Henk W; Warlé, Michiel C

    2016-09-01

    Two patients, who were on hemodialysis over a femoral arteriovenous fistula, were transplanted in our center. Despite adequate blood pressure, perfusion of the renal allograft remained poor after completion of the vascular anastomoses. Ligation of the femoral arteriovenous fistula (1.6 L/min) led to adequate perfusion. Initial graft function was good. Although it remains unclear whether ischemia of a renal allograft is caused by venous hypertension or vascular steal due to a femoral arteriovenous fistula, it might be necessary to ligate a femoral arteriovenous fistula to obtain adequate graft perfusion. PMID:27313989

  17. Contribution of the vertebral artery to cerebral circulation in the rat snake Elaphe obsoleta

    NASA Technical Reports Server (NTRS)

    Zippel, K. C.; Lillywhite, H. B.; Mladinich, C. R.; Hargens, A. (Principal Investigator)

    1998-01-01

    Blood supplying the brain in vertebrates is carried primarily by the carotid vasculature. In most mammals, cerebral blood flow is supplemented by the vertebral arteries, which anastomose with the carotids at the base of the brain. In other tetrapods, cerebral blood is generally believed to be supplied exclusively by the carotid vasculature, and the vertebral arteries are usually described as disappearing into the dorsal musculature between the heart and head. There have been several reports of a vertebral artery connection with the cephalic vasculature in snakes. We measured regional blood flows using fluorescently labeled microspheres and demonstrated that the vertebral artery contributes a small but significant fraction of cerebral blood flow (approximately 13% of total) in the rat snake Elaphe obsoleta. Vascular casts of the anterior vessels revealed that the vertebral artery connection is indirect, through multiple anastomoses with the inferior spinal artery, which connects with the carotid vasculature near the base of the skull. Using digital subtraction angiography, fluoroscopy, and direct observations of flow in isolated vessels, we confirmed that blood in the inferior spinal artery flows craniad from a point anterior to the vertebral artery connections. Such collateral blood supply could potentially contribute to the maintenance of cerebral circulation during circumstances when craniad blood flow is compromised, e.g., during the gravitational stress of climbing.

  18. N-butyl Cyanoacrylate Glue Embolization of Arterial Networks to Facilitate Hepatic Arterial Skeletonization before Radioembolization

    SciTech Connect

    Samuelson, Shaun D.; Louie, John D.; Sze, Daniel Y.

    2013-06-15

    Purpose. Avoidance of nontarget microsphere deposition via hepatoenteric anastomoses is essential to the safety of yttrium-90 radioembolization (RE). The hepatic hilar arterial network may remain partially patent after coil embolization of major arteries, resulting in persistent risk. We retrospectively reviewed cases where n-butyl cyanoacrylate (n-BCA) glue embolization was used to facilitate endovascular hepatic arterial skeletonization before RE. Methods. A total of 543 RE procedures performed between June 2004 and March 2012 were reviewed, and 10 were identified where n-BCA was used to embolize hepatoenteric anastomoses. Arterial anatomy, prior coil embolization, and technical details were recorded. Outcomes were reviewed to identify subsequent complications of n-BCA embolization or nontarget RE. Results. The rate of complete technical success was 80 % and partial success 20 %, with one nontarget embolization complication resulting in a minor change in treatment plan. No evidence of gastrointestinal or biliary ischemia or infarction was identified, and no microsphere-related gastroduodenal ulcerations or other evidence of nontarget RE were seen. Median volume of n-BCA used was <0.1 ml. Conclusion. n-BCA glue embolization is useful to eliminate hepatoenteric networks that may result in nontarget RE, especially in those that persist after coil embolization of major vessels such as the gastroduodenal and right gastric arteries.

  19. [Post-therapeutic lymphedema of the arm--possibilities and limits of diagnosis and therapy].

    PubMed

    Döller, W

    1999-01-01

    The post-therapeutical secondary arm lymphedema is the most frequent complication after a curatively treated cancer of mamma. For the diagnosis and therapy the knowledge of physiology and pathophysiology of lymphedema and of specific anatomy are necessary. The diagnosis facilities are essentially limited to a basic diagnosis (anamnesis, inspection, palpation, sonography, functional-diagnosis). Specific apparative diagnostics like lab, sonography, CT, MRI and PTE have to be applied especially at an early stage of the secondary arm lymphedema for the differential diagnosis between the secondary malign and secondary benign arm lymphedema. Specific apparative examinations like lymphscintigraphy and lymphography are limited and solely indicated for special questions. As a therapy possibility of the secondary arm-lymph edema, a conservative therapy, that is, the complex two-stage-decongestive physiotherapy (CDP) is recommended as first choice. Surgical therapies such as autologous lympho-lymphostatic anastomoses and lymphovenous anastomoses are only recommended in selected individual cases. The secondary malignant arm lymphedema must be primarily treated oncologically; lymphological therapy measures have to be postponed. Diagnosis and therapy are limited through lymphological incompetence and insufficient patient compliance. In this respect the provision of financial resources through National Health policy ist regarded as utterly important. PMID:10378339

  20. [Robot-assisted Coronary Artery Bypass Grafting].

    PubMed

    Ishikawa, Norihiko; Watanabe, Go

    2016-07-01

    The application for robot-assisted coronary surgery ranges from internal thoracic artery (ITA) harvesting with hand-sewn anastomoses to totally endoscopic coronary artery bypass grafting (TECAB), either on- or off-pump. The bilateral IMA can be harvested with the aid of a surgical robot and then multivessel bypass grafting can follow. Such robot-assisted minimally invasive direct coronary artery bypass grafting is called "ThoraCAB". Surgical robots cannot only endoscopically harvest the ITA but they can also anastomose the coronary artery in TECAB. But TECAB still has the difficulties, such as narrow surgical field in Japanese patients. Both procedures have the significant advantages of minimizing surgical trauma, such as reduced comlications, faster return back to normal activities and being improved cosmesis, and which have resulted in the development of minimally invasive surgery. Robot-assisted cardiac surgery for structural heart disease has been approved by the Ministry of Health, Labour and Welfare (MHLW) since December 2015, however, robot-assisted cardiac surgery for TECAB has not been approved yet in Japan. PMID:27440015

  1. Laparoscopic gastro-jejunal anastomosis using novel r2 deflectable instruments in an ex vivo model.

    PubMed

    Zdichavsky, Marty; Krautwald, Martina; Feilitzsch, Maximilian V; Wichmann, Dörte; Königsrainer, Alfred; Schurr, Marc Oliver

    2016-04-01

    Objective A novel 5 mm steerable instrument system (r2-DRIVE) was developed with active tip deflection and tip and shaft rotation. The feasibility and training effect of the r2 instruments were determined in a phantom model. Material and methods Experienced laparoscopic surgeons and untrained novices performed laparoscopic gastro-jejunal anastomoses using porcine tissue and r2 DRIVE-instruments. Mean anastomosis time, anastomosis width and burst pressure were measured. Number of stitches, skipped stitches and dropped needles were counted. Results of trained and untrained subjects were compared. Results Mean time for suturing decreased rapidly for all participants, but was more evident for untrained persons. After five anastomoses no relevant improvement in anastomotic time was seen for the skilled group. The ease of use, efficacy of manipulation and swift training effect with the novel r2 instruments for both experienced laparoscopic surgeons and untrained non-surgeons could be demonstrated and after few cases stable anastomosis times and a fast learning curve were obtained. Conclusions This study demonstrates the ease of use, efficacy of manipulation and swift training effect with the novel r2 instruments for both experienced laparoscopic surgeons and untrained non-surgeons. After few cases stable anastomosis times and a fast learning curve were obtained. PMID:26635060

  2. The structure of the Temsamane fold-and-thrust stack (eastern Rif, Morocco): Evolution of a transpressional orogenic wedge

    NASA Astrophysics Data System (ADS)

    Jabaloy-Sánchez, Antonio; Azdimousa, Ali; Booth-Rea, Guillermo; Asebriy, Lahcen; Vázquez-Vílchez, Mercedes; Martínez-Martínez, José Miguel; Gabites, Janet

    2015-11-01

    The structure of the Temsamane fold-and-thrust stack corresponds to four units limited by anastomosing ductile shear zones cutting a trend of south verging recumbent folds. This ductile stack was formed in an inclined left-handed transpressional zone at the North African paleomargin during Chattian to Langhian times producing two main deformational events. The first event (Dp) produced a Sp/Lp planar linear fabric generated in a non-coaxial deformation with a top-to-the-WSW sense of movement and was associated to metamorphic P-T conditions varying from late diagenesis in the southernmost Temsamane outcrops to epizone in the north. According to the 40Ar/39Ar ages, this deformation occurred at Chattian-Aquitanian times. The second deformational event (Dc event) generated ENE-WSW trending folds with SSE vergence and a set of anastomosing shear zones with Sm/Lm planar linear fabric. The latter units were generated at around 15 Ma (Langhian), and indicate a strong localization of the simple shear component of the transpression. Moreover, this orientation is compatible with the kinematics of the Temsamane detachment, which can explain most of the uplift of the Temsamane rocks from the middle to the uppermost crust. The described evolution indicates that collision between the western Mediterranean terranes and the North African paleomargin and the formation of the Rifean orogenic wedge occurred at Chattian to Langhian times.

  3. A Functional Perspective on the Embryology and Anatomy of the Cerebral Blood Supply.

    PubMed

    Menshawi, Khaled; Mohr, Jay P; Gutierrez, Jose

    2015-05-01

    The anatomy of the arterial system supplying blood to the brain can influence the development of arterial disease such as aneurysms, dolichoectasia and atherosclerosis. As the arteries supplying blood to the brain develop during embryogenesis, variation in their anatomy may occur and this variation may influence the development of arterial disease. Angiogenesis, which occurs mainly by sprouting of parent arteries, is the first stage at which variations can occur. At day 24 of embryological life, the internal carotid artery is the first artery to form and it provides all the blood required by the primitive brain. As the occipital region, brain stem and cerebellum enlarge; the internal carotid supply becomes insufficient, triggering the development of the posterior circulation. At this stage, the posterior circulation consists of a primitive mesh of arterial networks that originate from projection of penetrators from the distal carotid artery and more proximally from carotid-vertebrobasilar anastomoses. These anastomoses regress when the basilar artery and the vertebral arteries become independent from the internal carotid artery, but their persistence is not uncommon in adults (e.g., persistent trigeminal artery). Other common remnants of embryological development include fenestration or duplication (most commonly of the basilar artery), hypoplasia (typically of the posterior communicating artery) or agenesis (typically of the anterior communicating artery). Learning more about the hemodynamic consequence that these variants may have on the brain territories they supply may help understand better the underlying physiopathology of cerebral arterial remodeling and stroke in patients with these variants. PMID:26060802

  4. Fusiform aneurysm of a persistent primitive trigeminal artery associated with cerebrovascular anatomic variations: a report of two cases.

    PubMed

    Pleş, Horia; Loukas, Marios; Andall, Rebecca G; Andall, Naomi R; Iacob, Nicoleta; Miclăuş, GraŢian Dragoslav; Matusz, Petru; Tubbs, R Shane

    2015-01-01

    There are four embryonic anastomoses that exist between the internal carotid artery (ICA) and the vertebrobasilar (VB) system, which may fail to regress postfetal life; one of which is the trigeminal artery. Other persistent anastomoses include those formed by the hypoglossal, otic and proatlantic intersegmental arteries. In addition, other cerebrovascular variations may accompany a persistent primitive trigeminal artery (PPTA); such as arteriovenous malformations, aneurysms, carotid-cavernous fistulas and stenotic cerebral vessels. We present two very rare cases of a left PPTA. In the first case, there was a past medical history significant for cervico-thoraco-lumbar spondylitis and in the second case of an operated occipital astrocytoma. In both cases, the PPTA was associated with a fusiform aneurysm located in the carotidian (lateral) aspect of the PPTA as well as other cerebrovascular anatomic variations. In the first case, the length of the PPTA was 26.0 mm and its endoluminal diameter, at its origin at the ICA, was 1.8 mm; the aneurysm has a length of 8.4 mm. In the second case, the length of the PPTA was 31.0 mm and its endoluminal diameter at its origin at the ICA was 3.0 mm; the aneurysm have a length of 7.6 mm. Identification of these variant vessels should not be ignored before planning and execution of neurosurgeries to prevent possible perioperative risks. PMID:26662153

  5. Near-Infrared Imaging for the Assessment of Anastomotic Patency, Thrombosis, and Reperfusion in Microsurgery: A Pilot Study in a Porcine Model

    PubMed Central

    Vargas, Christina R.; Nguyen, John T.; Ashitate, Yoshitomo; Silvestre, Jason; Venugopal, Vivek; Neacsu, Florin; Kettenring, Frank; Frangioni, John V.; Gioux, Sylvain; Lee, Bernard T.

    2015-01-01

    Background Advances in microsurgical techniques have increased the use of free tissue transfer. Methods of intraoperative flap perfusion assessment, however, still rely primarily on subjective evaluation of traditional clinical parameters. Anastomotic thrombosis, if not expeditiously identified and revised, can result in flap loss with significant associated morbidity. This study aims to evaluate the use of near-infrared (NIR) fluorescence imaging in the assessment of microsurgical anastomotic patency, thrombosis, and vascular revision. Materials and Methods A model of pedicle thrombosis was created using bilateral abdominal flaps isolated on deep superior epigastric vascular pedicles in four Yorkshire pigs. Following flap elevation, microvascular arterial and venous anastomoses were performed unilaterally, preserving an intact contralateral control flap. Thrombosis was induced at the arterial anastomosis site using ferric chloride, and both flaps imaged using NIR fluorescence angiography. The thrombosed vascular segments were subsequently excised and new anastomoses performed to restore flow. Follow-up imaging of both flaps was then obtained to confirm patency using fluorescence imaging technology. Results Pedicled abdominal flaps were created and successful anastomotic thrombosis was induced unilaterally in each pig. Fluorescence imaging technology identified large decreases in tissue perfusion of the thrombosed flap within 2 minutes. After successful revision anastomosis, NIR imaging demonstrated dramatic increase in flow to the reconstructed flap, but intensity did not return to pre-thrombosis levels. Conclusions Early identification of anastomotic thrombosis is important in successful free tissue transfer. Real-time, intraoperative evaluation of flap perfusion, anastomotic thrombosis, and successful revision can be performed using NIR fluorescence imaging. PMID:25571855

  6. Tooth serration morphologies in the genus Machimosaurus (Crocodylomorpha, Thalattosuchia) from the Late Jurassic of Europe.

    PubMed

    Young, Mark T; Steel, Lorna; Brusatte, Stephen L; Foffa, Davide; Lepage, Yves

    2014-11-01

    Machimosaurus was a large-bodied durophagous/chelonivorous genus of teleosaurid crocodylomorph that lived in shallow marine and brackish ecosystems during the Late Jurassic. Among teleosaurids, Machimosaurus and its sister taxon 'Steneosaurus' obtusidens are characterized by having foreshortened rostra, proportionally enlarged supratemporal fenestrae and blunt teeth with numerous apicobasal ridges and a shorter anastomosed ridged pattern in the apical region. A recent study on 'S.' obtusidens dentition found both true denticles and false serrations (enamel ridges which contact the carinae). Here, we comprehensively describe and figure the dentition of Machimosaurus, and find that Machimosaurus buffetauti and Machimosaurus hugii have four types of serration or serration-like structures, including both denticles and false denticles on the carinae. The denticles are irregularly shaped and are not always discrete units, whereas the false denticles caused by the interaction between the superficial enamel ridges and the carinae are restricted to the apical region. Peculiarly, the most 'denticle-like' structures are discrete, bulbous units on the apicobasal and apical anastomosed ridges of M. hugii. These 'pseudo-denticles' have never, to our knowledge, previously been reported among crocodylomorphs, and their precise function is unclear. They may have increased the surface area of the apical region and/or strengthened the enamel, both of which would have been advantageous for a durophagous taxon feeding on hard objects such as turtles. PMID:26064563

  7. Distinct expression profiles of stromelysin-2 (MMP-10), collagenase-3 (MMP-13), macrophage metalloelastase (MMP-12), and tissue inhibitor of metalloproteinases-3 (TIMP-3) in intestinal ulcerations.

    PubMed Central

    Vaalamo, M.; Karjalainen-Lindsberg, M. L.; Puolakkainen, P.; Kere, J.; Saarialho-Kere, U.

    1998-01-01

    Programmed expression of matrix metalloproteinases is involved in wound healing in various organs. We have previously demonstrated enhanced expression of collagenase-1, stromelysin-1, matrilysin, and tissue inhibitor of metalloproteinases (TIMP-1) in gastrointestinal ulcerations. To further define the role of matrix-degrading enzymes and their inhibitors in intestinal inflammation and ulcerations, the expression of stromelysin-2 (MMP-10), collagenase-3 (MMP-13), macrophage metalloelastase (HME, MMP-12), and TIMP-3 mRNAs was studied using in situ hybridization and immunohistochemistry in 38 samples representing ulcerative colitis, Crohn's disease, ischemic colitis, and normal intestine. As controls for normally healing intestinal wounds, 12 postoperative samples of rat experimental jejunal anastomoses were also examined. The colitis types studied did not essentially differ in their MMP expression. We found stromelysin-2 mRNA in laminin-5-positive and Ki-67-negative enterocytes bordering the ulcerations. HME was abundantly expressed by macrophages in the vicinity of shedding mucosal epithelium and beneath the necrotic surface of the ulcers. Collagenase-3 and TIMP-3 were expressed by fibroblast-like cells deeper in the remodeling intestinal wall. Expression for stromelysin-2 and collagenase-3 was observed in granulation tissue, but not the epithelium, of the rat anastomoses. Our results suggest a role for stromelysin-2 in epithelial migration and for metalloelastase in macrophage movement and epithelial cell shedding. Images Figure 1 Figure 2 Figure 3 Figure 4 PMID:9546361

  8. Systematization and description of the internal carotid arteries and their main ramifications at the brain base in turtles (Trachemys scripta elegans).

    PubMed

    Voll, Juliana; Campos, Rui

    2016-08-01

    Thirty turtle brains (Trachemys scripta elegans) were injected with latex to systematize and describe the internal carotid arteries and their main ramifications at the brain base. The internal carotid arteries had one intercarotid anastomosis. At the level of the tuber cinereum, the internal carotid artery bifurcated into its terminal branches, the rostral and the caudal branches. The rostral branch emitted the rostral choroid artery, the orbital artery, and a series of middle cerebral arteries. After giving off the last middle cerebral artery, the rostral branch continued as the rostral cerebral artery in the cerebral longitudinal fissure, and had one anastomosis with its contralateral homologous artery, the rostral communicating artery, making the first rostral closure of the cerebral arterial circle. Next, the rostral cerebral arteries anastomosed forming a rostral interhemispheric artery, making the second rostral closure of the cerebral arterial circle. The internal carotid artery, after emitting its rostral branch, continued caudally as the caudal branch. The caudal branch ran caudally along the ventral surface of the mesencephalic tegmentum, emitted the caudal cerebral artery and the mesencephalic artery, and continued caudomedially while progressively narrowing, and anastomosed with its contralateral homologous artery, forming the basilar artery. The narrower portion also emitted the trigeminal artery. The anastomosis of the caudal branches closed the cerebral arterial circle caudally. The internal carotid arteries exclusively supplied the cerebral arterial circle of the turtle. Anat Rec, 299:1090-1098, 2016. © 2016 Wiley Periodicals, Inc. PMID:27145530

  9. Tooth serration morphologies in the genus Machimosaurus (Crocodylomorpha, Thalattosuchia) from the Late Jurassic of Europe

    PubMed Central

    Young, Mark T.; Steel, Lorna; Brusatte, Stephen L.; Foffa, Davide; Lepage, Yves

    2014-01-01

    Machimosaurus was a large-bodied durophagous/chelonivorous genus of teleosaurid crocodylomorph that lived in shallow marine and brackish ecosystems during the Late Jurassic. Among teleosaurids, Machimosaurus and its sister taxon ‘Steneosaurus’ obtusidens are characterized by having foreshortened rostra, proportionally enlarged supratemporal fenestrae and blunt teeth with numerous apicobasal ridges and a shorter anastomosed ridged pattern in the apical region. A recent study on ‘S.’ obtusidens dentition found both true denticles and false serrations (enamel ridges which contact the carinae). Here, we comprehensively describe and figure the dentition of Machimosaurus, and find that Machimosaurus buffetauti and Machimosaurus hugii have four types of serration or serration-like structures, including both denticles and false denticles on the carinae. The denticles are irregularly shaped and are not always discrete units, whereas the false denticles caused by the interaction between the superficial enamel ridges and the carinae are restricted to the apical region. Peculiarly, the most ‘denticle-like’ structures are discrete, bulbous units on the apicobasal and apical anastomosed ridges of M. hugii. These ‘pseudo-denticles’ have never, to our knowledge, previously been reported among crocodylomorphs, and their precise function is unclear. They may have increased the surface area of the apical region and/or strengthened the enamel, both of which would have been advantageous for a durophagous taxon feeding on hard objects such as turtles. PMID:26064563

  10. Reflectance spectrometry of placental vessels in cases of twin-twin transfusion syndrome: experiments and modeling

    NASA Astrophysics Data System (ADS)

    Lines, Collin; Kim, Oleg; McMurdy, John; Luks, Francois; Alber, Mark; Crawford, Greg

    2013-03-01

    A stochastic photon transport model in multilayer skin tissue combined with reflectance spectroscopy measurements is used to study placental vessels in cases of twin-twin transfusion syndrome (TTTS). TTTS occurs in about 12% of monozygotic (identical) twin pregnancies wherein flow within placental vessels linking the twins together becomes unbalanced, leading to dual mortality. Endoscopic laser ablation can halt the syndrome by occluding the anastomoses connecting the two fetuses. The objective of this study is to develop a technique to determine hemoglobin (Hb) content through spectral analysis of diffuse reflectance spectra of placental vessels to aid in identification of the anastomoses. Previous work by researchers at Brown University has shown that the reflectance spectra of the donor twin and recipient twin are considerably different in the wavelengths for Hb absorbance. This presentation will give preliminary results for a Monte Carlo model adapted to fit the physiology of the placenta that can be used to quantitative determine the Hb levels. The reflectance spectra of the vessels are simulated for different values of Hb as well oxygenation and water concentration with the vessel and placental mass. The preliminary results will be shown to be in good approximation with the prior experimental data. The combination of modeling with spectroscopic measurement will provide a new tool for detailed prenatal study.

  11. Anatomical variation of arterial supply to the rabbit stomach.

    PubMed

    Ikegami, Reona; Tanimoto, Yoshimasa; Kishimoto, Miori; Shibata, Hideshi

    2016-05-01

    Gastric stasis is common in rabbits, and gastrotomy may be performed to cure this pathological condition. Detailed descriptions of the arterial supply to the stomach are essential for this surgical operation, but published descriptions are limited. Here, we investigated anatomical variations of the arterial supply to the stomach in 43 New Zealand White rabbits by injecting colored latex into arteries. We observed that the left gastric artery that arose as the second branch from the celiac artery provided 1-3 parietal and 1-3 visceral branches to the stomach, with various branching patterns depending on the case. In 34 of 43 cases, the left gastric artery ended upon entering the gastric wall at the lesser curvature, whereas in the remaining cases, the artery continued as the hepatic artery without entering the gastric wall. The right gastric artery that branched off from the gastroduodenal artery also supplied the lesser curvature sinistrally but did not anastomose with the left gastric artery. In 40 cases, the hepatic artery provided 1-4 pyloric branches. In the fundic region, the short gastric arteries arose from the splenic artery and varied in number from 2 to 6. The right and left gastroepiploic arteries anastomosed to give 2-7 branches to the greater curvature. The results showed that many variations occurred in the arteries supplying the rabbit stomach, suggesting that such variations should be considered when performing veterinary surgical treatments in rabbits. PMID:26615866

  12. [Hepatobiliary anastomosis techniques].

    PubMed

    Heidenhain, C; Rosch, R; Neumann, U P

    2011-01-01

    The success of hepatobiliary anastomoses is influenced by the diameter of the bile duct, the location within the biliary tract, the situation of primary or revision surgery and accompanying infections. The exact preoperative diagnostics of the anatomy of the biliary tract are indispensable for low complication rates. Within reconstructive surgery, hepaticojejunostomy has been established as the standard technique and a biliodigestive anastomosis is performed proximal to the cystic duct and 2-3 cm below the fork in the hepatic duct. In general, end-to-end anastomoses of the common bile duct are not recommended due to the high risk for stenosis. Within the liver hilus an exact preparation of all tubular structures is mandatory. With regard to possible perioperative complications operations on the hepatic duct or segmental bile ducts should be performed in specialized centers. Methods of drainage in hepatobiliary surgery are percutaneous transhepatic cholangiodrainage (PTCD), internal-external drainage, internal drainage with endoscopic or surgically placed stents, external-internal-external drainage and the T-drain. PMID:21153387

  13. Arterial Vascularization of the Gastrointestinal Tract of the Pampas Deer (Ozotoceros bezoarticus, Linnaeus, 1758).

    PubMed

    Pérez, W; Vazquez, N; Ungerfeld, R

    2016-06-01

    Based on gross dissection of fifteen adult animals (11 females, 4 males), we described the arterial supply of the stomach and intestines of the pampas deer (Ozotoceros bezoarticus), a South American endangered species. The coeliac artery emitted the splenic, left gastric and hepatic arteries. The splenic artery directed towards the spleen, and the right ruminal artery, which is its only collateral directed towards the stomach, being the main artery of the rumen. The left gastric artery gave origin to the left ruminal, the reticular and the left gastroepiploic arteries. The left gastroepiploic artery originated the reticular accessory artery. Both arteries, gastric and left gastroepiploic, anastomosed their right counterparts derived from the hepatic artery on the curvatures of the abomasum. The cranial mesenteric artery irrigated the second half of the duodenum until the beginning of the descending colon. The thickest branch emitted by the cranial mesenteric artery was the ileocolic artery, which was destined to the ascending colon, caecum and ileum. The colic branches and the right colic arteries were irradiated on the right surface of the spiral loop of the ascending colon and distributed to both centripetal and centrifugal coils of the ascending colon; the colic branches were also anastomosed with the last jejunals and ileals and with the right colic arteries. There were no variations in the origin of any of the main branches derived from the coeliac and cranial mesenteric arteries. This species had a basic pattern of arterial distribution similar to small domestic ruminants. PMID:26224544

  14. Anatomical variation of arterial supply to the rabbit stomach

    PubMed Central

    IKEGAMI, Reona; TANIMOTO, Yoshimasa; KISHIMOTO, Miori; SHIBATA, Hideshi

    2015-01-01

    Gastric stasis is common in rabbits, and gastrotomy may be performed to cure this pathological condition. Detailed descriptions of the arterial supply to the stomach are essential for this surgical operation, but published descriptions are limited. Here, we investigated anatomical variations of the arterial supply to the stomach in 43 New Zealand White rabbits by injecting colored latex into arteries. We observed that the left gastric artery that arose as the second branch from the celiac artery provided 1–3 parietal and 1–3 visceral branches to the stomach, with various branching patterns depending on the case. In 34 of 43 cases, the left gastric artery ended upon entering the gastric wall at the lesser curvature, whereas in the remaining cases, the artery continued as the hepatic artery without entering the gastric wall. The right gastric artery that branched off from the gastroduodenal artery also supplied the lesser curvature sinistrally but did not anastomose with the left gastric artery. In 40 cases, the hepatic artery provided 1–4 pyloric branches. In the fundic region, the short gastric arteries arose from the splenic artery and varied in number from 2 to 6. The right and left gastroepiploic arteries anastomosed to give 2–7 branches to the greater curvature. The results showed that many variations occurred in the arteries supplying the rabbit stomach, suggesting that such variations should be considered when performing veterinary surgical treatments in rabbits. PMID:26615866

  15. Primary anastomosis in the treatment of acute disease of the unprepared left colon.

    PubMed

    Trillo, C; Paris, M F; Brennan, J T

    1998-09-01

    Between June 1, 1990 and December 31, 1996, 58 consecutive patients with unprepared colons were urgently explored for nontraumatic disease with intent to proceed with primary left-sided colonic anastomosis. Unprotected anastomoses were not attempted in 15 patients. The causes of exclusion included preoperative and intraoperative shock in three patients, and three patients were on long-term high-dose steroids, four had gross fecal contamination of the peritoneal cavity, four had large pelvic abscesses, and one had ischemic colitis. All 43 patients undergoing anastomosis without protective colostomy had stapled anastomoses. Indications included complicated diverticular disease in 32 cases. There were nine cases of obstruction from colorectal carcinoma and one obstruction due to sigmoid volvulus. There was one case of perforation from pseudomembranous enterocolitis. The most common complications were: atelectasis in nine cases, wound infection in two cases, and prolonged ileus in two cases. Pelvic abscess occurred in one case. There was one wound dehiscence. There was one anastomotic dehiscence, and there was no mortality. Operative time averaged 85 minutes and hospital length of stay 9.7 days. Primary anastomosis of the unprepared left colon is safe in most urgent and emergent situations, thus avoiding the significant morbidity and cost of colostomy closure. PMID:9731807

  16. Free transfer of a large sensory flap from the first web space and dorsum of the foot including the second toe for reconstruction of a mutilated hand.

    PubMed

    Rose, E H; Buncke, H J

    1981-03-01

    A 19-year-old man sustained a mutilating crush injury in August, 1978, in an 80-ton punch press. The injury resulted in transmetacarpal amputations of the index through little fingers. The thumb was revascularized by microvascular anastomoses. The replanted index to the little finger position failed. A free transfer of the patient's second toe to the fifth metacarpal was done to provide a post to oppose the thumb. The first web space of the toe was used in expanding the contracted single cleft of the hand. The innervated dorsal foot flap provided coverage for the dorsal surface of the hand. Anatomically, the entire composite transfer was supported by the dorsalis pedis artery anastomosed to the radial artery. The nerve sutures were between the plantar digital nerves and sensory fascicles of the median nerve and the deep peroneal to the dorsal branch of the radial. The extensor and flexor tendons were also repaired. This procedure differs from the neurovascular island transfer of the first web described by Strauch and Tsur by inclusion of the second toe in the free transfer. PMID:7229297

  17. Enclosed passive infraversion lavage-drainage system (EPILDS): a novel safe technique for local management of early stage bile leakage and pancreatic fistula Post Pancreatoduodenectomy.

    PubMed

    Jiang, Kai; Zhang, Wenzhi; Feng, Yuquan; Su, Ming; Dong, Jiahong; Huang, Zhiqiang

    2014-04-01

    This study's objective was to test the new drainage apparatus called enclosed passive infraversion lavage-drainage system (EPILDS) in the treatment of bile leakage and pancreatic fistula Post Pancreatoduodenectomys. The EPILDS device has a design of a siphon. The inlet bag that contains the rinse liquid is put lower than the abdominal lacuna to be washed but higher than the outlet bag. The hydrostatic pressure difference between the inlet and outlet bags constitutes the driving force of the flow. The three-way cock valves are installed in the inlet and outlet tubes to facilitate the washing of occluded tubes. Two side by side Penrose drainage tubes were placed during the operation. One tube passed through the posterior side of pancreatico-jejunal and biliary-jejunal anastomoses, right paracolic gutter, and exited through an opening made in the right lower abdomen. Second tube came from the smaller sac, went through the anterior side of pancreatico-jejunal and biliary-jejunal anastomoses, and exited through an opening made in the left upper abdomen. Using this system, we successfully treated two patients. Both inlet and outlet volumes were observed to verify that the outlet exceeds the inlet volume. In conclusion, EPILDS has a simple and practical design. It changes the active washing process into a passive one, in which the input is controlled by the exiting fluid. This is the effective and safe system for treatment of severe bile leakage and pancreatic fistula at the early postoperative stage. PMID:24006154

  18. Halstedian technique revisited. Innovations in teaching surgical skills.

    PubMed Central

    Barnes, R W; Lang, N P; Whiteside, M F

    1989-01-01

    This paper reviews the laboratory models used to teach fundamental surgical skills in our general surgery residency. The laboratory modules allow supervision and self-instruction, practice, and videotape monitoring of the following techniques: skin incision, suturing, knot tying, hemostasis, vascular anastomosis, and intestinal anastomosis. Pigs' feet simulate human skin for exercises in skin incision, lesion excision, suturing, and basic plastic surgical techniques. Latex tubing and penrose drains allow experience in suturing, knot tying, and hemostasis. Polytetrafluoroethylene vascular prostheses permit quantification of the precision of needle passage and suturing by measurement of leakage of water through a vascular anastomosis. Reconstituted, lyophilized, irradiated bovine arteries and ileum provide models of biologic tissue for creating handsewn vascular anastomoses and sutured or stapled gastrointestinal anastomoses. A headlamp videocamera allows unobstructive recording of the resident's technical performance and provides subsequent visual feedback for self-improvement when compared to reference instructional videotapes. We feel that these innovations may enhance surgical dexterity of residents without the need for animal sacrifice. Our goal is to foreshorten the learning curve for basic surgical skills and improve performance in the clinical operating room. Images Fig. 1. Fig. 2. Fig. 3. Fig. 4. Fig. 5. Fig. 6. PMID:2742408

  19. High resolution sequence stratigraphy of Scythian-early Anisian continental deposits of east of Paris basin: Applications to gas storage

    SciTech Connect

    Roselyne, F.; Guillocheau, F.; Wicquart, E.

    1995-08-01

    Continental facies of Scythian-early Anisian age (Buntsandstein) of East of the Paris Basin form the underground gas storage reservoir exploited by Gaz de France in the area of Nancy (east of France). An accurate sedimentological study and the application of Genetic Stratigraphy principles lead to the understanding of the deposition of fluvial, which form the reservoirs, and to the reconstruction of their geometries. The subsurface data are calibrated on outcrops. Three types of fluvial systems (braided, sinuous to straight and anastomosed) are defined. A special focus on anastomosed channels permits to differentiate a proximal and a distal facies. Study of laterally continuous outcrops induces recurrent cycles of thickness, velocity and time variations (few tens to hundred ka). These correspond to the highest frequence stratigraphic units, i.e. parasequences or genetic units. Maximum of channel and levee presentation occurs during base-level rise: base-level fall is characterised by amalgamation of sets, by-pass and erosion. This method is applied to subsurface data by an accurate calibration of well logs on cores. Thus the electric expression of genetic units corresponding to different environments is determined as well as the expression of base-level variations. The correlation of these units using stacking pattern method leads to a very fine subdivision of reservoir between timelines. Different orders of depositional sequences are pointed out, resulting in reservoir geometry characterization and permeability barrier distribution.

  20. [A case of bile peritonitis caused by jejunal perforation after radiofrequency ablation for the multiple liver metastases from cholangiocarcinoma successfully treated with various interventional radiological procedures after pancreatoduodenectomy].

    PubMed

    Yasumoto, Taku; Shimizu, Junzo; Watanabe, Noriyuki; Inada, Masami; Nakata, Saki; Sato, Masayuki; Hayashi, Shoho; Dono, Keizo; Kitada, Masashi; Shimano, Takashi

    2009-11-01

    The case is a man in his 50s who had a curative surgical resection for cholangiocarcinoma in August 2006. The lesion was judged to be T3, N1, H0, P0, M0 and Stage III, and then he received various treatments including thermotherapy, CD3-activated T lymphocyte therapy. Then from June 2007, he was treated for multiple liver metastases by GEM, radiofrequency ablation (RFA), stereotactic radiotherapy, S-1, dendritic cell therapy. But there were multiple liver metastases whose maximum size was 17 mm in diameter and he was introduced to our hospital. In September 2008, ultrasonography and CT fluoroscopy guided RFA was operated on him for the liver tumors with a safety margin. But 2 hours after the ablation, he complained of epigastralgia. CT examination revealed a bile peritonitis caused by perforation of the jejunum which has been anastomosed to the pancreas, and was adjacent to the avascular area caused by RFA in segment 4 of the liver. We treated him by various interventional procedures including percutaneous drainage for bile leakage, pancreatic fistula, abscess in peritoneal cavity, and biloma in segment 3. Fifty days after the ablation, T-tube, with which pancreatic fluid and bile was induced from the cecal portion of the anastomosed jejunum to the anal side slipping through the perforated point, was successfully inserted through right flank, and resulted in complete recovery from a major technical complication of the bile peritonitis. PMID:20037334

  1. Microvasculature of the human cerebral white matter: arteries of the deep white matter.

    PubMed

    Nonaka, Hiroko; Akima, Michio; Hatori, Tsutomu; Nagayama, Tadashi; Zhang, Zean; Ihara, Fumie

    2003-06-01

    The vascular architecture of the human cerebral deep white matter was studied using soft X-ray and diaphanized specimens, achieved by intra-arterial injection of barium and vascular stain respectively, and also by electron microscopic examination of the corrosion cast of arteries in normal adult brains. The deep white matter arteries passed through the cerebral cortex with a few branches to the cortex and ran straight through the white matter. The arteries concentrated ventriculopetally to the white matter around the lateral ventricle. Anastomoses were noted around the ventricular wall at the terminals of the deep white matter arteries. No centrifugal branches irrigating the periventricular white matter from the lenticulo-striate arteries were observed in the present study. The presence of anastomoses among the terminal branches of deep white matter arteries protects against ischemic change or infarction in this area from an occlusion of a single deep white matter artery. This may lead to development of terminal zone infarction from ischemia or vascular diseases, affecting multiple deep white matter arteries. The subcortical and deep white matter arteries had thick adventitial sheaths and large adventitial spaces in the white matter but not in the cortex. The presence or absence of the adventitial space is regarded as another characteristic difference between the arteries in the white matter and cortex. This difference may influence pathological changes in vascular lesions in these respective areas. PMID:12777099

  2. Quantification of sympathetic vascular responses in skin by laser Doppler flowmetry.

    PubMed

    Khan, F; Spence, V A; Wilson, S B; Abbot, N C

    1991-05-01

    An improved physiological test of focal sympathetic nervous function using a laser Doppler flowmeter is presented. The test evaluates rapid reflex changes in skin blood flow at the finger tip where there are abundant arteriovenous anastomoses with dense sympathetic innervation. Indirect body heating was employed in all subjects to induce central vasodilation and to obtain stable comparable finger tip blood flows prior to stimulus. The reflex vasoconstriction which occurs following inspiratory gasp and contralateral hand cold challenge was quantified and its reproducibility investigated on three separate occasions in 20 young subjects. The variability in responses both within and between young subjects was small. The test was applied to 10 diabetic patients with autonomic neuropathy and to 10 age-matched control subjects. Vasoconstrictor reflexes were significantly lower in the diabetic group (p less than 0.005) with responses lower than 2 SD from the mean for age-matched controls. In conclusion, the test provides an assessment of focal autonomic damage which can be applied to other regions of the body rich in arteriovenous anastomoses and may have application in clinical studies investigating autonomic activity. PMID:2060997

  3. NOTE: Haemodynamic resistance model of monochorionic twin pregnancies complicated by acardiac twinning

    NASA Astrophysics Data System (ADS)

    Umur, Asli; van Gemert, Martin J. C.; van den Wijngaard, Jeroen P. H. M.; Ross, Michael G.; Nikkels, Peter G. J.

    2004-07-01

    An acardiac twin is a severely malformed monochorionic twin fetus that lacks most organs, particularly a heart. It grows during pregnancy, because it is perfused by its developmentally normal co-twin (called the pump twin) via a set of placental arterioarterial and venovenous anastomoses. The pump twin dies intrauterine or neonatally in about 50% of the cases due to congestive heart failure, polyhydramnios and prematurity. Because the pathophysiology of this pregnancy is currently incompletely understood, we modified our previous haemodynamic model of monochorionic twins connected by placental vascular anastomoses to include the analysis of acardiac twin pregnancies. We incorporated the fetoplacental circulation as a resistance circuit and used the fetal umbilical flow that perfuses the body to define fetal growth, rather than the placental flow as done previously. Using this modified model, we predicted that the pump twin has excess blood volume and increased mean arterial blood pressure compared to those in the acardiac twin. Placental perfusion of the acardiac twin is significantly reduced compared to normal, as a consequence of an increased venous pressure, possibly implying reduced acardiac placental growth. In conclusion, the haemodynamic analysis may contribute to an increased knowledge of the pathophysiologic consequences of an acardiac body mass for the pump twin.

  4. Surgical techniques in short bowel syndrome.

    PubMed

    Waag, K L; Heller, K

    1990-01-01

    An operation according to Bianchi in a 2-year-old girl is described and indications as well as technical procedure are discussed. The girl was born with a gastroschisis. There was a jejunal perforation 10 cm below the ligament of Treitz caused by a volvulus. Only 20 cm of the jejunum remained. Moreover, only the left part of the colon was present. Total parenteral nutrition for 2 years was necessary. The principle of the operation is based on a longitudinal division of the remaining bowel and a creation of two separate bowel tubes out of the divided bowel halves, thus effecting an isoperistaltic serial connection by means of two anastomoses. This is technically possible since each half of the bowel wall has its own blood supply. The vessels originating from the mesenterium branch off before they reach the bowel wall so that the mesenteric dissection line can be anastomosed longitudinally with the antimesenteric border. This results in doubling of the bowel length, narrowing of the preoperatively dilated bowel diameter, closer contact of bowel contents with the mucosa, prolonged transit time and a Bacteroides colonization which is reduced by more effective peristalsis. Indications, time of operation and our own experiences are discussed and three cases are described. All children are alive and show marked improvement in nutrition. PMID:2105523

  5. Bilateral pseudoangiomatous stromal hyperplasia in a human immunodeficiency viral-infected patient.

    PubMed

    Larbcharoensub, Noppadol; Wattanatranon, Duangkamon; Sanpaphant, Suda; Sri-Utenchai, Nithid; Wiratkapun, Cholatip; Kongdan, Youwanush

    2015-01-01

    Pseudoangiomatous stromal hyperplasia (PASH) is an uncommon mesenchymal neoplasm of the breast demonstrating stromal myofibroblastic proliferation and having the appearance of anastomosing slit-like pseudovascular spaces lined by spindle-shaped cells. A case of nodular PASH of the bilateral breasts in a 40-year-old woman with clinically presenting with a progressive enlarged breast lump is reported. Mammographic and ultrasonographic features of the right and left breasts showed a large solid lump with well-circumscribed border measuring 4 cm × 1.7 cm × 3.4 cm and 13.8 cm × 10.9 cm × 12.1 cm, respectively. Wide excision of the right breast and quadrantectomy of the left breast were performed. The histopathological examination of the lesion showed anastomosing slit-like pseudovascular spaces. The stromal cells were immunoreactive for muscle actin (HHF35), smooth muscle actin, and progesterone receptor. Clinical and pathological findings with briefly reviewed relevant literatures are discussed. This is the first clinicopathological and radiological report of bilateral mammary nodular PASH in a human immunodeficiency viral-infected patient. PMID:26275264

  6. MICROSURGICAL TRANSFER OF THE GRACILIS MUSCLE FOR ELBOW FLEXION IN BRACHIAL PLEXUS INJURY IN ADULTS: RETROSPECTIVE STUDY OF EIGHT CASES

    PubMed Central

    Kimura, Luiz Koiti; do Nascimento, Alexandre Tadeu; Capócio, Roberto; Mattar, Rames; Rezende, Marcelo Rosa; Wei, Teng Hsiang; Torres, Luciano Ruiz; Moya, Fernando Munhoz

    2015-01-01

    Objective: Treating brachial plexus injuries is a major challenge, especially lesions that are presented late, with more than 12 months of evolution. We retrospectively analyzed patients who underwent one of the possibilities for attempting to restore the function of upper limbs affected under such conditions: microsurgical transfer of the gracilis muscle for elbow flexion. Methods: Eight patients were included, divided into two groups: one in which the procedure consisted of neurorrhaphy of the muscle flap with sural nerve grafting and anastomosis more distally; and the other, in which the neurorrhaphy was performed directly on the spinal accessory nerve, with anastomosis in thoracoacromial vessels. Results: We found a significant difference between the groups. A greater number of satisfactory results (75% M4) were found among patients who underwent direct neurorrhaphy, whereas the procedure using grafts for neurorrhaphy was less successful (25% M4). Conclusion: Patients who underwent microsurgical functional transfer of the gracilis muscle in which vascular anastomoses were performed in thoracoacromial vessels presented better functional outcomes than shown by those whose anastomoses were in the brachial artery with subsequent use of a nerve graft. PMID:27027050

  7. Effect of non-steroidal anti-inflammatory drugs on the increasing the incidence of colonic anastomosis in rats

    PubMed Central

    Ji, Chengdong; Xiong, Yuanchang; Pan, Xin; Guo, Xuan; Li, Zhen; Qian, Shuwen; Xu, Chang; Yu, De-Hua; Liao, Wan-Qing

    2015-01-01

    Background: Anastomotic leakage is one of serious complications of colorectal surgery. Research is inconsistent about whether non-steroidal anti-inflammatory drugs influence the healing of colorectal anastomoses and increase the incidence of anastomotic leakage. Objective: To study the influence of NSAIDs on the healing of rat colonic anastomoses. Design: This was an animal randomized-control trial. This study was approved by the ethical committee of Yangpu Hospital, Tongji University. Intervention: 90 healthy Sprague-Dawley rats were randomly divided into 6 groups of 15 rats/group. Trail was performed in C (cotrol group) with no drugs, group M with morphine for analgesia, group F with flurbiprofen axeil, group L with lornoxicam, and group P with parecoxib sodium. Main outcome measures: The main outcomes measures were serological indexes including vascular endothelial growth factor, prostaglandin E2, hydroxyproline, and C reactive protein; histological specimens from the anastomotic stoma tissue including the collagen proportion, and hydroxyproline, cycloxygenase-2, and vascular endothelial growth factor content; physical indicators, including stoma fracture pressure, fracture strength and anastomotic leakage. Results: No significant difference was observed among the indices of each group (P > 0.05). A significant difference occurred after operation (P < 0.05), with the data for groups K and M being dramatically higher than those for group F. Limitation: The study was nonblinded. Conclusion: The postoperative usages of non-steroidal anti-inflammatory drugs can decrease the strength of anastomotic tissue, and increase the incidence of anastomotic leakage. PMID:26261490

  8. A Functional Perspective on the Embryology and Anatomy of the Cerebral Blood Supply

    PubMed Central

    Menshawi, Khaled; Mohr, Jay P

    2015-01-01

    The anatomy of the arterial system supplying blood to the brain can influence the development of arterial disease such as aneurysms, dolichoectasia and atherosclerosis. As the arteries supplying blood to the brain develop during embryogenesis, variation in their anatomy may occur and this variation may influence the development of arterial disease. Angiogenesis, which occurs mainly by sprouting of parent arteries, is the first stage at which variations can occur. At day 24 of embryological life, the internal carotid artery is the first artery to form and it provides all the blood required by the primitive brain. As the occipital region, brain stem and cerebellum enlarge; the internal carotid supply becomes insufficient, triggering the development of the posterior circulation. At this stage, the posterior circulation consists of a primitive mesh of arterial networks that originate from projection of penetrators from the distal carotid artery and more proximally from carotid-vertebrobasilar anastomoses. These anastomoses regress when the basilar artery and the vertebral arteries become independent from the internal carotid artery, but their persistence is not uncommon in adults (e.g., persistent trigeminal artery). Other common remnants of embryological development include fenestration or duplication (most commonly of the basilar artery), hypoplasia (typically of the posterior communicating artery) or agenesis (typically of the anterior communicating artery). Learning more about the hemodynamic consequence that these variants may have on the brain territories they supply may help understand better the underlying physiopathology of cerebral arterial remodeling and stroke in patients with these variants. PMID:26060802

  9. Surgical management of radiation enteritis

    SciTech Connect

    Galland, R.B.; Spencer, J.

    1986-02-01

    Seventy patients (17 men and 53 women) were seen with radiation-injured gut between 1958 and 1984. The median age at treatment with radiotherapy was 54 years. External radiotherapy was used in all cases, combined with internal treatment for cervical cancer. Ninety-seven gastrointestinal lesions were produced. There were 63 strictures, 14 fistulas, 12 perforations, and eight bleeds. The period between radiotherapy and clinical manifestation of the lesion was approximately 2 years, being longest for strictures. The majority of the lesions were in the rectosigmoid or mid and distal small bowel. Sixty-one patients required one or more operations, and review of the operative results up to 1977 showed a high incidence of anastomotic leak and death after resection and primary anastomosis. However, we noticed that the ascending, transverse, and descending colon were relatively free of radiation-induced disease. Since then we have used a nonirradiated part of the colon for one end of the anastomosis. Thus terminal ileal resection has been followed by an ileotransverse anastomosis and rectosigmoid resection by mobilization of the splenic flexure to bring it down for anastomosis. With these techniques there has been one leak in 14 anastomoses and none of the 12 patients have died. These results are significantly better (p less than 0.02) than our previous figures when 14 of 27 anastomoses leaked, with 10 deaths. We conclude that use of nonirradiated bowel for at least one end of an anastomosis significantly improves the results of resection of irradiated bowel.

  10. Fibrin glue as a protective tool for microanastomoses in limb reconstructive surgery

    PubMed Central

    Langer, Stefan; Schildhauer, Thomas A.; Dudda, Marcel; Sauber, Jeannine; Spindler, Nick

    2015-01-01

    Aim: Fibrin glue becomes a more and more routinely used tool for stabilization of microanastomoses and nerve repair. This paper summarizes the technical properties and advantages of its use in a wide variety of microsurgical contexts, and includes an exemplary limb reconstructive case. Patients and methods: A total of 131 patients who had undergone elective and emergency microsurgery mainly of the limbs were retrospectively analyzed, as was the use of free flaps. Results: The use of fibrin glue allows for proper positioning of anastomoses and repaired nerves. No torsion of the pedicle could be seen. The flap survival rated >94%. The fibrin glue could stay in place in >99%. In the rare case of revision, the fibrin glue could easily be removed without damaging the region of the microanastomosis. Conclusion: Fibrin glue should not be used to repair insufficient, i.e., leaking anastomoses, but it does protect the site of anastomosis from tissue and fluid pressure. It prevents the pedickle from torsion and its use facilitates relocation of the microanastomoses in cases of revision surgery. PMID:26759762

  11. Niti CAR 27 Versus a Conventional End-to-End Anastomosis Stapler in a Laparoscopic Anterior Resection for Sigmoid Colon Cancer

    PubMed Central

    Kwag, Seung-Jin; Kim, Jun-Gi; Kang, Won-Kyung; Lee, Jin-Kwon

    2014-01-01

    Purpose The Niti CAR 27 (ColonRing) uses compression to create an anastomosis. This study aimed to investigate the safety and the effectiveness of the anastomosis created with the Niti CAR 27 in a laparoscopic anterior resection for sigmoid colon cancer. Methods In a single-center study, 157 consecutive patients who received an operation between March 2010 and December 2011 were retrospectively assessed. The Niti CAR 27 (CAR group, 63 patients) colorectal anastomoses were compared with the conventional double-stapled (CDS group, 94 patients) colorectal anastomoses. Intraoperative, immediate postoperative and 6-month follow-up data were recorded. Results There were no statistically significant differences between the two groups in terms of age, gender, tumor location and other clinical characteristics. One patient (1.6%) in the CAR group and 2 patients (2.1%) in the CDS group experienced complications of anastomotic leakage (P = 0.647). These three patients underwent a diverting loop ileostomy. There were 2 cases (2.1%) of bleeding at the anastomosis site in the CDS group. All patients underwent a follow-up colonoscopy (median, 6 months). One patient in the CAR group experienced anastomotic stricture (1.6% vs. 0%; P = 0.401). This complication was solved by using balloon dilatation. Conclusion Anastomosis using the Niti CAR 27 device in a laparoscopic anterior resection for sigmoid colon cancer is safe and feasible. Its use is equivalent to that of the conventional double-stapler. PMID:24851217

  12. Optimization of the Outflow Graft Position and Angle in a Left Ventricular Assist Device

    NASA Astrophysics Data System (ADS)

    McGah, Patrick; Prisco, Anthony; Beckman, Jennifer; Mokadam, Nahush; Mahr, Claudius; Aliseda, Alberto

    2015-11-01

    The placement of the outflow graft in the aorta plays a key role in the hemodynamics of Left Ventricle Assist Devices (LVAD), a medical device with a growing importance in the treatment of end-stage heart failure. We use a patient-specific computational model of the VAD and the ascending aorta to investigate the impact of VAD outflow graft configuration on the residence time and wall shear stresses along the ascending aorta and the ostia of the upper branches. The flow induced by the combination of VAD output through the graft anastomosed to the aorta and the limited cardiac output through intermittent opening of the aortic valve is studied to determine the nature of thrombogenic flow patterns. Outflow grafts are virtually anastomosed along the ascending aorta or subclavian artery of the patient-specific model at different positions and angles that are surgically-informed. Detailed markers of thrombosis, such as cell residence time, wall shear stress, and shear stress gradients are analyzed and compared for the different configurations. The angle of incidence of the outflow graft critically influences the volume of recirculating flow between aortic valve and anastomosis, and the aortic pressure acting against aortic valve opening.

  13. Prospective evaluation of outcome measures in free-flap surgery.

    PubMed

    Kelly, John L; Eadie, Patricia A; Orr, David; Al-Rawi, Mogdad; O'Donnell, Margaret; Lawlor, Denis

    2004-08-01

    Free-flap failure is usually caused by venous or arterial thrombosis. In many cases, lack of experience and surgical delay also contribute to flap loss. The authors prospectively analyzed the outcome of 57 free flaps over a 28-month period (January, 1999 to April, 2001). The setting was a university hospital tertiary referral center. Anastomotic technique, ischemia time, choice of anticoagulant, and the grade of surgeon were recorded. The type of flap, medications, and co-morbidities, including preoperative radiotherapy, were also documented. Ten flaps were re-explored (17 percent). There were four cases of complete flap failure (6.7 percent) and five cases of partial failure (8.5 percent). In patients who received perioperative systemic heparin or dextran, there was no evidence of flap failure (p = .08). The mean ischemia time was similar in flaps that failed (95 +/- 29 min) and in those that survived (92 +/- 34 min). Also, the number of anastomoses performed by trainees in flaps that failed (22 percent), was similar to the number in flaps that survived (28 percent). Nine patients received preoperative radiotherapy, and there was complete flap survival in each case. This study reveals that closely supervised anastomoses performed by trainees may have a similar outcome to those performed by more senior surgeons. There was no adverse effect from radiotherapy or increased ischemia time on flap survival. PMID:15356760

  14. Radionuclide studies in postoperative evaluation of the Fontan procedure

    SciTech Connect

    Brendel, A.J.; Wynchank, S.; Choussat, A.; Barat, J.L.; Deville, C.; Ducassou, D.; Fontan, F.

    1984-10-01

    Radionuclide studies were performed on 12 patients who had had a Fontan operation for cyanotic congenital heart disease, six of whom had undergone a prior palliative Glenn procedure. The patients without prior Glenn anastomoses were studied by radionuclide first-pass angiocardiography, using a right antecubital vein injection of /sup 99m/Tc pertechnetate. The patients with Glenn anastomoses required two injections, one by femoral vein to study the Fontan procedure, using bolus injection of /sup 99m/Tc pertechnetate or microspheres, and the second by right anetcubital vein to study the Glenn anastomosis and right lung, using a bolus of microspheres. Noninvasive radionuclide methods seem to be dependable in the postoperative evaluation of patients after the Fontan procedure. First-pass angiocardiography is most helpful in evaluating the dynamics and distribution of blood flow, especially the right atrial output, and gated blood-pool scintigraphy offers a better evaluation of right atrial and left ventricular contraction, so both supply complementary information.

  15. Modern surgical management of breast cancer therapy related upper limb and breast lymphoedema.

    PubMed

    Leung, Nelson; Furniss, Dominic; Giele, Henk

    2015-04-01

    Breast cancer is the commonest cancer in the UK. Advances in breast cancer treatment means that the sequelae of treatment are affecting more women and for a longer duration. Lymphoedema is one such sequela, with wide-ranging implications, from serious functional and psychological effects at the individual level to wider economic burdens to society. Breast cancer-related lymphoedema is principally managed by conservative therapy comprising compression garments and manual decongestive massage. This approach is effective for early stages of lymphoedema, but it is not curative and the effectiveness depends on patient compliance. Early surgical approaches were ablative, gave significant morbidity and hence, reserved for the most severe cases of refractory lymphoedema. However, recent non-ablative reconstructive surgical approaches have seen a revival of interest in the prevention or surgical management of breast cancer-related lymphoedema. This review examines the modern surgical techniques for the treatment of breast cancer-related lymphoedema. Liposuction reduces the volume and symptoms of lymphedema, but requires continual compressive therapy to avoid recurrence. Lymphatic reconstruction or bypass techniques including lymph node transfer (inguinal nodes are transferred to the affected limb), lymphatico-lymphatic bypass (lymphatics bypass the axilla using a lymph vessel graft reconstructing lymphatic flow from arm to neck) and lymphaticovenous anastomoses (lymphatics in the arm are joined to the venous system aiding lymph drainage) show promise in reducing lymphedema significantly. Further research is required, including into the role of primary lymphaticovenous anastomoses in the prevention of lymphedema at the time of axillary dissection. PMID:25747119

  16. Skeletonization of the internal thoracic artery: a randomized comparison of harvesting methods.

    PubMed

    Urso, Stefano; Alvarez, Luis; Sádaba, Rafael; Greco, Ernesto

    2008-02-01

    We performed a randomized study to compare internal thoracic artery (ITA) flow response to two harvesting methods used in the skeletonization procedure: ultrasonic scalpel and bipolar electrocautery. Sixty patients scheduled for CABG were randomized to receive either ultrasonically (n=30 patients) or electrocautery (n=30 patients) skeletonized ITAs. Intraoperative ITA graft mean flows were obtained with a transit-time flowmeter. ITA flows were evaluated at the beginning (Time 1) and at the end (Time 2) of the harvesting procedure. Post-cardiopulmonary bypass (CPB) flow measurement (Time 3) was obtained in the ITA grafts anastomosed to the left anterior descending artery. Intraoperative mean flow decreased significantly within ultrasonic group (Group U) and electrocautery group (Group E) at the end of the harvesting procedure (P<0.0001 in both cases). Within both groups the final mean flow measured on anastomosed ITAs (Time 3) was significantly higher than the beginning ITA flow value (Time 1). No statistical difference was noted comparing ITA flows between the two groups at any time of evaluation. Skeletonization harvesting of the ITA produces a modification of the mean flow. The quantity and the reversibility of this phenomenon, probably related to vasospasm, are independent from the energy source used in the skeletonization procedure. PMID:17998305

  17. Intraoral anastomosis of a prelaminated radial forearm flap in reconstruction of a large persistent cleft palate.

    PubMed

    Landes, Constantin; Cornea, Petruta; Teiler, Anna; Ballon, Alexander; Sader, Robert

    2014-03-01

    In this report, we present a case of a prelaminated radial forearm flap in reconstruction of a large persistent cleft palate with transoral single arterial and three venous anastomoses. A 17-years-old female patient presented a large cleft palate defect and complete dentition, dysmelia of both arms and bilateral thumb aplasia. A radial flap was prelaminated using oral mucosa 5 days prior to transplantation. Five days after flap prelamination, the facial artery and vein, submandibular vein, and a venous branch to the masseter muscle behind the buccinator muscle fibers were exposed through an intraoral incision lateral to the inferior right mucogingival junction. The radial artery, its bilateral accompanying veins, and the cephalic vein of transplanted flap were anastomosed transorally to the facial vessels, submandibular vein, and masseter branch. The vessel pedicle ran through the palatoglossal arch dorsal to the second upper molar. Good flow and flap perfusion were evinced, and further-on successful healing was achieved. The case encourages similar treatment in comparable situations avoiding facial nerve hazard and extraoral scars. PMID:24174205

  18. Intussusception causing postoperative intestinal obstruction following free jejunum transfer in adults: two case reports and review of the literature.

    PubMed

    Matsumoto, Akira; Watanabe, Masayuki; Shigaki, Hironobu; Okumura, Yasuhiro; Nishida, Koujiro; Mine, Shinji; Yamada, Kazuhiko; Yanaga, Katsuhiko; Sano, Takeshi

    2015-12-01

    Intussusception is a rare cause of postoperative intestinal obstruction in adults. We experienced two cases of bowel obstruction due to the jejuno-jejunal intussusception after harvest of a free jejunum graft for reconstruction after cervical esophagectomy. Bowel obstruction occurred early in the postoperative course, and reoperations were needed in both cases. In both case, the anastomotic site was resected and re-anastomosed in a side-to-side fashion. Recurrence of intussusception has not been observed. In the literature, such a complication has been documented in two case series and a case report. The reported incidence of postoperative intussusception of the case series was 2.8% and 7.4%, respectively. The jejuno-jejunal anastomoses were performed with end-to-end fashion by two layered hand-sewn suture (Albert-Lembert method) in all cases reported. In order to prevent the occurrence of postoperative intussusception, we recommend to harvest a free jejunal graft as far from the Treitz ligament as possible and to avoid reconstruction by an Albert-Lembert end-to-end anastomosis. PMID:26943396

  19. Microvascular anastomosis guidance and evaluation using real-time three-dimensional Fourier-domain Doppler optical coherence tomography

    PubMed Central

    Ibrahim, Zuhaib; Tong, Dedi; Zhu, Shan; Mao, Qi; Pang, John; Andrew Lee, Wei Ping; Brandacher, Gerald; Kang, Jin U.

    2013-01-01

    Abstract. Vascular and microvascular anastomoses are critical components of reconstructive microsurgery, vascular surgery, and transplant surgery. Intraoperative surgical guidance using a surgical imaging modality that provides an in-depth view and three-dimensional (3-D) imaging can potentially improve outcome following both conventional and innovative anastomosis techniques. Objective postoperative imaging of the anastomosed vessel can potentially improve the salvage rate when combined with other clinical assessment tools, such as capillary refill, temperature, blanching, and skin turgor. Compared to other contemporary postoperative monitoring modalities—computed tomography angiograms, magnetic resonance (MR) angiograms, and ultrasound Doppler—optical coherence tomography (OCT) is a noninvasive high-resolution (micron-level), high-speed, 3-D imaging modality that has been adopted widely in biomedical and clinical applications. For the first time, to the best of our knowledge, the feasibility of real-time 3-D phase-resolved Doppler OCT (PRDOCT) as an assisted intra- and postoperative imaging modality for microvascular anastomosis of rodent femoral vessels is demonstrated, which will provide new insights and a potential breakthrough to microvascular and supermicrovascular surgery. PMID:23856833

  20. La langue parlee le plus souvent entre les parents et les enfants: un facteur crucial dans l'acquisition linguistique de l'enfant dans un milieu bilingue (The Language Most Often Spoken between Parents and Children: A Crucial Factor in Child Language Acquisition in a Bilingual Environment). Working Papers on Bilingualism, No. 7.

    ERIC Educational Resources Information Center

    Hebrard, Pierre; Mougeon, Raymond

    The data for the study were gathered in the course of a larger sociolinguistic survey carried out among francophones from Welland and Sudbury, Ontario. Among other things, the acquisition of spoken English by bilingual francophone students from these cities was studied in depth, using error analysis. The present study attempts to show that in a…

  1. Efectos Especiales de Anclaje (Estudio sobre Regresiones de Juicios Condicionales). Parte 1: Distincion entre Efectos Aditivos y Efectos Multiplicativos en el Fenomeno de Anclaje (Special Effects of Anchoring (Study on Regression of Conditional Judgements) Part 1: Distinction Between Additive Effects and Multiplicative Effects in the Phenomenon of Anchoring). Publication No. 17.

    ERIC Educational Resources Information Center

    Lopez Alonso, A. O.

    A linear relationship was found between judgements given by 160 subjects to 7 objects presented as single stimuli (alpha judgements) and judgements given to the same objects presented with a condition (gamma judgements). This relationship holds for alpha judgements and the gamma judgements that belong to a family of constant stimulus and varying…

  2. Global Professional Identity in Deterretorialized Spaces: A Case Study of a Critical Dialogue between Expert and Novice Nonnative English Speaker Teachers (Identidad profesional global en espacios desterritorializados: un estudio de caso de los diálogos críticos entre profesores de inglés no nativos)

    ERIC Educational Resources Information Center

    Guerrero Nieto, Carmen Helena; Meadows, Bryan

    2015-01-01

    This study analyzes the online, peer-peer dialogue between two groups of nonnative English-speaking teachers who are attending graduate programs in Colombia and the United States. Framed by the theoretical concepts of critical pedagogy and global professional identity, a qualitative analysis of the data shows that their expert vs. novice roles…

  3. Construyendo un Puente entre la Educacion del Dotado y el Mejoramiento Escolar Integral. Resumen. La Serie de Decision Basada en la Investigacion (Building a Bridge between Gifted Education and Total School Improvement. Summary. Talent Development Research-Based Decision Making Series).

    ERIC Educational Resources Information Center

    Renzulli, Joseph S.

    This monograph addresses the role of gifted education in total school improvement by describing three service delivery components (the Total Talent Portfolio, Curriculum Modification Techniques, and Enrichment Learning and Teaching) and several organizational components of the Schoolwide Enrichment Model (SEM). The report describes how the SEM can…

  4. Tensions entre rationalité technique et intérêts politiques : l’exemple de la mise en œuvre de la Loi sur les agences de développement de réseaux locaux de services de santé et de services sociaux au Québec

    PubMed Central

    Contandriopoulos, D.; Hudon, Raymond; Martin, Elisabeth; Thompson, Daniel

    2013-01-01

    Sommaire L’objet de cet article est constitué par les processus décisionnels entourant la mise en œuvre de la Loi sur les agences de développement de réseaux locaux de services de santé et de services sociaux (Loi 25). Nous entendons mettre en lumière les stratégies des groupes ou institutions de diverses natures qui ont fait valoir leurs préférences et ont tenté, avec un succès inégal, d’influencer les décisions relatives à cette réforme majeure de la structure du système de santé québécois. Au plan théorique, nous nous appuyons principalement sur les modèles d’analyse du lobbying qui, depuis les travaux fondateurs de Milbrath (1960, 1963), présentent cette pratique comme un processus fondamental d’échange d’information. Selon les données colligées dans les retranscriptions d’entrevues, les stratégies observées correspondent effectivement aux caractéristiques constitutives du lobbying et, dans quelques situations, à celles du patronage. La combinaison de ces divers éléments révèle que la mise en œuvre de la Loi 25 s’avère être avant tout un processus proprement politique. Ainsi, furent relégués au second plan les arguments techniques qui composaient initialement les objectifs de la Loi. PMID:23509412

  5. El juego entre el nacimiento y los 7 anos: Un manual para ludotecarias. Investigacion-accion sobre la Familia y la Primera Infancia. UNESCO Sector de Educacion Monografia (Play between Birth and 7 Years: A Manual for Preschool Teachers. Action Research in Family and Early Childhood. UNESCO Education Sector Monograph).

    ERIC Educational Resources Information Center

    Grellet, Carolina

    The purpose of this Spanish-language manual is to help preschool teachers better understand theoretical concepts related to children's play. Following a preface that discusses UNESCO's activities related to early childhood education, the two main sections of the manual discuss children's play between 0-2 years and 2-7 years. Each section includes…

  6. Mitigation of Disagreement in Peer Review among L2 Learners and Native Speakers in a College Writing Class (Mitigación del Impacto de las Opiniones de Desacuerdo en el Proceso de Revisión por Pares entre Estudiantes de una Segunda Lengua y Hablantes Nativos en una Clase de Escritura a Nivel Universitario)

    ERIC Educational Resources Information Center

    Christoffersen, Katherine O'Donnell

    2015-01-01

    Peer review is now a commonplace practice in process-oriented writing instruction. A crucial aspect of peer review is assessing another classmate's work, which encompasses the act of disagreement. Given its prevalence in the classroom, it is necessary to analyze how L2 learners mitigate disagreement in the context of peer review with other L2…

  7. [The EMECAM protocol: an analysis of the short-term effect of air pollution on mortality. Estudio Multicéntrico Español sobre la Relación entre la Contaminación Atmosférica u la Mortalidad].

    PubMed

    Pérez-Hoyos, S; Sáez Zafra, M; Barceló, M A; Cambra, C; Figueiras Guzmán, A; Ordóñez, J M; Guillén Grima, F; Ocaña, R; Bellido, J; Cirera Suárez, L; López, A A; Rodríguez, V; Alcalá Nalvaiz, T; Ballester Díez, F

    1999-01-01

    The aim of this study is to Mortality show the protocol of analysis which was set out as part of the EMECAM Project, illustrating the application thereof to the effect of pollution has on the mortality in the city of Valencia. The response variables considered will be the daily deaths rate resulting from all causes, except external ones. The explicative variables are the daily series of different pollutants (black smoke, SO2, NO2, CO, O3). As possible confusion variables, weather factors, structural factors and weekly cases of flu are taken into account. A Poisson regression model is built up for each one of the four deaths series in two stages. In the first stage, a baseline model is fitted using the possible confusion variables. In the second stage, the pollution variables or the time legs thereof are included, controlling the residual autocorrelation by including mortality time lags. The process of fitting the baseline model is as follows: 1) Include the significant sinusoidal terms up to the sixth order. 2) Include the significant temperature or temperature squared terms with the time lags thereof up to the 7th order. 3) Repeat this process with the relative humidity. 4) Add in the significant terms of calendar years, daily tendency and tendency squared. 5) The days of the week as dummy variables are always included in the model. 6) Include the holidays and the significant time lags of up to two weeks of flu. Following the reassessment of the model, each one of the pollutants and the time lags thereof up to the fifth order are proven out. The impact is analyzed by six-month periods, including interaction terms. PMID:10410600

  8. En sus marcas--Listos--A leer! Para los cuidadores de ninos pequenos: Actividades de lenguaje para la primera infancia y ninez entre el nacimiento y los 5 anos. El reto: A leer, America! (Ready--Set--Read! For Caregivers: Early Childhood Language Activities for Children from Birth through Age Five. America Reads Challenge).

    ERIC Educational Resources Information Center

    Department of Education, Washington, DC.

    This Ready--Set--Read Kit includes an activity guide for caregivers, a 1997-98 early childhood activity calendar, and an early childhood growth chart. The activity guide presents activities and ideas that caregivers (family child care providers and the teachers, staff, and volunteers in child development programs) can use to help young children…

  9. En sus marcas--Listos--A leer! Para las familias: Actividades de lenguaje para la primera infancia y ninez entre el nacimiento y los 5 anos. El reto: A leer, America! (Ready--Set--Read! For Families: Early Childhood Language Activities for Children from Birth through Age Five. America Reads Challenge).

    ERIC Educational Resources Information Center

    Department of Education, Washington, DC.

    This Ready--Set--Read Kit includes an activity guide for families, a 1997-98 early childhood activity calendar, and an early childhood growth wallchart. The activity guide presents activities and ideas that families (adults who have nurturing relationships with a child--a mother, father, grandparent, other relative, or close friend) can use to…

  10. Human Relations Activities for the Single Parent To Develop More Effective Parent/Child Relations. Bilingual Guide = Actividades sobre relaciones humanas para ayudar al padre-soltero o madre-soltera a desarrollar una relacion efectiva entre padre e hijo Guia bilingue.

    ERIC Educational Resources Information Center

    Peterson, Susan

    Written in English and Spanish, this bilingual guide offers 10 activities which single parents can use to improve their relationships with their children. Objectives of activities include: (1) developing children's responsibility for work tasks in the home; (2) improving sibling relationships; (3) discussing emergencies with children; (4)…

  11. Linking: Today's Libraries, Tomorrow's Technologies. Report of the Bibliographic and Communications Network Pilot Project. Canadian Network Papers Number 7 = Le Lien entre les Bibliotheques d'Aujourd'hui et les Technologies de Demain. Rapport du Projet Pilote du Reseau de Services Bibliographiques et de Communications. Documents sur les Reseaux Canadiens Numero 7.

    ERIC Educational Resources Information Center

    National Library of Canada, Ottawa (Ontario).

    A pilot project was conducted from May 1980 to November 1983 to test the application of iNet--a decentralized, packet-switched telecommunications network--to bibliographic data interchange in Canada. The principal components of the project were participation of the Bibliographic Common Interest Group (BCIP), a group of libraries with stand-alone,…

  12. Sur les inocérames de Tercis (Landes, France) : le meilleur outil corrélatif entre Europe et Amérique du Nord autour de la limite Campanien MaastrichtienInoceramids of the site of Tercis (Landes, France): the best correlative tool between Europe and North America across the Campanian Maastrichtian boundary

    NASA Astrophysics Data System (ADS)

    Odin, Gilles Serge; Walaszczyk, Ireneusz

    2003-01-01

    Four hundred inoceramids have been collected in the geological site at Tercis, where the Campanian-Maastrichtian boundary has been recently defined. At Tercis, a distinct drop of the adult size of inoceramids is observed between levels 111 and 117 and two turnovers of faunal composition were documented between levels 94 and 96 and between levels 111 and 117; the latter interval encompasses the stage boundary. The recognised inoceramid assemblages are very close to those known from North America, allowing better correlation than before between the two domains in the interval 77-70 Ma. The presence of these faunas perfectly located in the section leads to consider the Tercis section as the best known reference for this fossil group, the surprisingly good correlative potential of which has still to be considered in many areas.

  13. How To Talk to Your Doctor (and Get Your Doctor To Talk to You!). An Educational Workshop on Doctor Patient Communication = Como Hablarle a su Doctor (iY que su doctor le hable a usted!). Un seminario educativo sobre la comunicacion entre el doctor y el paciente.

    ERIC Educational Resources Information Center

    Baylor Coll. of Medicine, Houston, TX.

    This workshop, written in both English and Spanish, focuses on improving communication between physician and patient. In the workshop, the trainers will talk about "building bridges" between patient and doctor by understanding the doctor's role and his/her duty to the patient. According to the workshop, a person's doctor should communicate…

  14. Le complexe annulaire d'âge Oligocène de l'Achkal (hoggar Central, Sud Algérie) : témoin de la transition au Cénozoïque entre les magmatismes tholéitique et alcalin. Évidences par les isotopes du Sr, Nd et Pb

    NASA Astrophysics Data System (ADS)

    Maza, Mustapha; Briqueu, Louis; Dautria, Jean-Marie; Bosch, Delphine

    1998-08-01

    The Achkal Oligocene ring complex cross-cuts the Upper Eocene tholeiitic traps located on the top of the Hoggar swell. The plutonic rocks range from tholeiitic gabbros to alkali essexites, monzonites and syenites, whereas the volcanites are restricted to late peralkaline rhyolites. The affinity change linked to the large isotopic heterogeneities (from EM1 to HIMU) suggests that the parental magmas are issued from two distinct mantle sources, first lithospheric then deeper. The Achkal has recorded the magmatic evolution of the Hoggar hot spot, between Eocene and Miocene.

  15. Les Differences dans l'emploi de la construction possessive "N1"+"DE"+"N2" entre le XIX et le XX s. dans la prose litteraire francaise (Differences in the Use of the Possessive Construction "N1"+"de"+"N2" between 19th and 20th Century French Literature).

    ERIC Educational Resources Information Center

    Roglic, Vera

    1991-01-01

    Study looks at frequency of noun1 + de + noun2 possessive in French prose. Researchers used chi-square and Pearson test to analyze results of syntagmatic possessive construction in works by Hugo, Stendahl, Balzac, Zola, Gide, Malraux, St. Exupery, and Sartre. Findings indicate that syntagmatic genitive possessive is more commonly found in…

  16. Contamination par le nickel et d'autres métaux lors de la manipulation des pièces de monnaie comparaison entre francs français et eurosContamination by nickel and other metals resulting from the manipulation of coins comparison between French francs and euros

    NASA Astrophysics Data System (ADS)

    Fournier, P.-G.; Govers, T. R.; Fournier, J.; Abani, M.

    The introduction of the euro has revived the interest for potential nickel allergies. We show that the handling of a single used nickel coin releases an average of 0.45 μg of nickel, 0.26 μg of copper and 0.08 μg of zinc, whereas a euro coin composed of nickel alloys releases 0.25 μg of nickel, 1.3 μg of copper and 0.17 μg of zinc. These levels of contamination, favored by friction during handling, differ from those obtained on the basis of the EN 1811 test applicable to solubilisation in artificial sweat. The evaluation of allergy risks following the introduction of the euro may require the consideration of potential synergies between the metals mentioned above. To cite this article: P.-G. Fournier et al., C. R. Physique 3 (2002) 749-758.

  17. L'impact de l'enseignement de la biologie sur la construction de la distinction entre normal et pathologique chez les eleves du secondaire Marocain (The Impact of Teaching Biology on the Way Moroccan High School Students Construe the Difference between Normal and Pathological).

    ERIC Educational Resources Information Center

    Khzami, Salah-Eddine; Favre, Daniel

    2002-01-01

    Study of the distinction between the notions of the normal and the pathological among Moroccan high school students and their teachers of biology found that students confused the registers of the normal/abnormal with the healthy/pathological, a fact that is at odds with current teaching in biology. It also found a possible link to the values held…

  18. Apports des phyllosilicates dans la différenciation entre altération hypogène et altération supergène dans le basalte triasique du Moyen Atlas (Maroc)Contribution of phyllosilicates to distinguish between hypogene alteration and weathering in Triassic basalt from Middle Atlas (Morocco)

    NASA Astrophysics Data System (ADS)

    Dekayir, Abdelilah; Danot, Michel; Allali, Nabil

    2002-09-01

    Triassic basalt of the Middle Atlas has been subject to metamorphic transformation then weathering. Occurrence in both metabasalt and saprolite of ubiquitous clay minerals, such as smectite and mixed layers chlorite-smectite, makes it difficult to distinguish between the two alteration facies and explains the interest of complementary sources of information. In the Bhallil weathering profile, petrographical and mineralogical analyses of primary igneous minerals and their alteration products coupled with Fe oxidation state determination in clay fractions allow to identify three alteration facies: ( i) metamorphic basalt, where iron occurs mainly as the ferrous form; ( ii) the lower part of saprolite, where iron is partially oxidized to its ferric form; ( iii) the upper part of saprolite, where iron is completely oxidized. To cite this article: A. Dekayir et al., C. R. Geoscience 334 (2002) 877-884.

  19. Synergie entre la télédétection multispectrale et les données de terrain pour la conception d'un nouveau modèle géodynamique d'ouverture du bassin paléozoîque des Jebilet centrales (Maroc)

    NASA Astrophysics Data System (ADS)

    El Harti, Abderrazak; Bannari, Abderrazak; Bachaoui, El Mostafa; Aarab, El Mostafa; Girouard, Guillaume; El Ghmari, Abderrahmen

    2004-11-01

    The geodynamic model of the Palaeozoic basin opening of central Jebilet has been unknown before this study in spite of the abundance in the geological studies carried out in the studied sector using conventional methods. This is due to the scarcity of the key beds and synsedimentary structures. Using the synergy between the image data of the Landsat satellite TM sensor and the ground data, we have highlighted, herein, new structural data allowing the design of a new model of the Palaeozoic basin opening of central Jebilet. This opening could have been made according to dextral submeridian transverse faults with the individualization of subequatorial normal faults. To cite this article: A. El Harti et al., C. R. Geoscience 336 (2004).

  20. Single-Layer Continuous Versus Two-Layer Interrupted Intestinal Anastomosis

    PubMed Central

    Burch, Jon M.; Franciose, Reginald J.; Moore, Ernest E.; Biffl, Walter L.; Offner, Patrick J.

    2000-01-01

    Objective To determine the suitability of a single-layer continuous technique for intestinal anastomosis in a surgical training program. Summary Background Data Several recent reports have advocated the use of a continuous single-layer technique for intestinal anastomosis. Purported advantages include shorter time for construction, lower cost, and perhaps a lower rate of anastomotic leakage. The authors hypothesized that the single-layer continuous anastomosis could be safely introduced into a surgical training program and that it could be performed in less time and at a lower cost than the two-layer interrupted anastomosis. Methods The study was conducted during a 3-year period ending September 1999. All adult patients requiring intestinal anastomosis were considered eligible. Patients who required anastomosis to the stomach, duodenum, and rectum were excluded. Patients were also excluded if the surgeon did not believe either technique could be used. Patients were randomly assigned to one- or two-layer techniques. Single-layer anastomoses were performed with a continuous 3–0 polypropylene suture. Two-layer anastomoses were constructed using interrupted 3–0 silk Lembert sutures for the outer layer and a continuous 3–0 polyglycolic acid suture for the inner layer. The time for anastomosis began with the placement of the first stitch and ended when the last stitch was cut. Anastomotic leak was defined as radiographic demonstration of a fistula or nonabsorbable material draining from a wound after oral administration, or visible disruption of the suture line during reexploration. Results Sixty-five single-layer and 67 two-layer anastomoses were performed. The groups were evenly matched according to age, sex, diagnosis, and location of the anastomosis. Two leaks (3.1%) occurred in the single-layer group and one (1.5%) in the two-layer group. Two abscesses (3.0%) occurred in each group. A mean of 20.8 minutes was required to construct a single-layer anastomosis

  1. Study on shallow-water delta characteristics by utilizing seismic sedimentologic methods in Zilaitun Oilfield, Huanghua Depression, East China

    NASA Astrophysics Data System (ADS)

    Liu, Shan; Wang, Jiahao

    2015-04-01

    Shallow-water delta is characterized by widely distributed distributary channels from plentiful previous studies. But how to tenuously depict its planar geomorphology remains a difficult problem at present. This paper discussed the feasibility of seismic sedimentologic methods to interpret distributary channels distribution and summarized shallow-water delta characteristics. Huanghua Depression of Bohai Bay Basin is the Cenozoic rift basin in east China. Zilaitun Oilfield lies in the Kongdian buried-hill belt of Huanghua Depression. The oil layer is mainly distributed in the Paleocene Kongdian Formation. From core samples, 1st member of Kongdian Formation mainly consists of finer grain-size sandstone and amaranth mudstone, revealing a shallow-water environment. In the sandstone of distributary channels, sedimentary structures such as erosional surface, lag deposit, parallel bedding and trough cross-bedding are developed, illustrating an intensive hydrodynamic condition. Combining logging data, shallow-water delta mainly developed delta front subfacies. Microfacies of the delta front include subaqueous distributary channel, mouth bar and interdistributary bay in study area. A vertical discontinuous sequence was formed on account of the lack of distal bar. Subaqueous distributary channels are characterized by cylinder and conical well log curves. By extraction of RMS amplitudes from 3-D seismic data, seismic strata slices reveal banding distribution of sand bodies. Cylinder and conical logging curves demonstrated that these sand bodies are developed in distributary channels. The NE-trending anastomosing and dendritic distributary channels are widely developed in 1st member of Kongdian Formation. When the lake expanded, the river frequently bifurcated and diverted due to the rise of the relative lake-level, forming deep and wide anastomosing distributary channels. These channels extended as far as 13.2 km. The width is from 600 m to 1000 m. The average thickness of

  2. Full robot-assisted gastrectomy with intracorporeal robot-sewn anastomosis produces satisfying outcomes

    PubMed Central

    Liu, Xin-Xin; Jiang, Zhi-Wei; Chen, Ping; Zhao, Yan; Pan, Hua-Feng; Li, Jie-Shou

    2013-01-01

    AIM: To evaluate the feasibility and safety of full robot-assisted gastrectomy with intracorporeal robot hand-sewn anastomosis in the treatment of gastric cancer. METHODS: From September 2011 to March 2013, 110 consecutive patients with gastric cancer at the authors’ institution were enrolled for robotic gastrectomies. According to tumor location, total gastrectomy, distal or proximal subtotal gastrectomy with D2 lymphadenectomy was fully performed by the da Vinci Robotic Surgical System. All construction, including Roux-en-Y jejunal limb, esophagojejunal, gastroduodenal and gastrojejunal anastomoses were fully carried out by the intracorporeal robot-sewn method. At the end of surgery, the specimen was removed through a 3-4 cm incision at the umbilicus trocar point. The details of the surgical technique are well illustrated. The benefits in terms of surgical and oncologic outcomes are well documented, as well as the failure rate and postoperative complications. RESULTS: From a total of 110 enrolled patients, radical gastrectomy could not be performed in 2 patients due to late stage disease; 1 patient was converted to laparotomy because of uncontrollable hemorrhage, and 1 obese patient was converted due to difficult exposure; 2 patients underwent extra-corporeal anastomosis by minilaparotomy to ensure adequate tumor margin. Robot-sewn anastomoses were successfully performed for 12 proximal, 38 distal and 54 total gastrectomies. The average surgical time was 272.52 ± 53.91 min and the average amount of bleeding was 80.78 ± 32.37 mL. The average number of harvested lymph nodes was 23.1 ± 5.3. All specimens showed adequate surgical margin. With regard to tumor staging, 26, 32 and 46 patients were staged as I, II and III, respectively. The average hospitalization time after surgery was 6.2 d. One patient experienced a duodenal stump anastomotic leak, which was mild and treated conservatively. One patient was readmitted for intra-abdominal infection and was

  3. An Early Pennsylvanian threshold for the influence of vegetation on fluvial landscapes, based on the geological record of Atlantic Canada

    NASA Astrophysics Data System (ADS)

    Gibling, Martin; Ielpi, Alessandro; Bashforth, Arden; Davies, Neil

    2015-04-01

    Vegetation profoundly influences modern fluvial systems, depending on plant life-history strategies, tolerance to disturbance, and habitat drainage. However, direct evidence for these dynamic relationships is cryptic and has commonly been overlooked in ancient deposits. We report evidence for profound interactions between channels, in situ and transported vegetation in Lower Pennsylvanian formations of Atlantic Canada (~310 Ma), attributed to braided, meandering and fixed-channel (anastomosing) systems. Plant groups include lycopsids that preferred stable wetland settings, disturbance-tolerant calamitaleans, and deeply rooted cordaitaleans (early gymnosperms) that originated in the late Mississippian and colonised both wetland and dryland settings. For the meandering and anastomosing channel deposits, upright vegetation was observed within channel-based bedforms and bars and on channel margins. Lycopsids and calamitalean groves colonized the channel bed and bank-attached bars during periods of reduced flow, nucleating bar growth after flow resumed. Upright lycopsids and cordaitaleans are common along channel cutbanks and are locally tilted towards the channel, implying involvement in bank stabilization. Rhizoconcretions that formed around deep cordaitalean roots may have aided bank reinforcement. Tetrapod and arthropod trackways in the channel deposits indicate a close linkage between riparian and aquatic ecosystems. In the braided systems, sediments that contain abundant cordaitalean logs constitute nearly 20% of channel deposits, and the logs form channel-base lags, fill channels up to 6 m deep, and form nuclei for shallow sandbars. Log accumulations overlain by shale lenses imply a contribution to channel avulsion. Rooted channel-sandstones containing upright trees are interpreted as vegetated islands in an island-braided system. Anastomosing systems are abundant in these Lower Pennsylvanian formations but rare in older strata, and the multi-channel island

  4. The retrograde limb of internal mammary vessels as reliable recipient vessels in DIEP flap breast reconstruction: a clinical and radiological study.

    PubMed

    Salgarello, Marzia; Visconti, Giuseppe; Barone-Adesi, Liliana; Cina, Alessandro

    2015-04-01

    For many microsurgeons, antegrade internal mammary vessels (AIMVs) represent the recipients of choice in autogenous breast reconstruction. For the past few years, the retrograde internal mammary vessels (RIMVs) have been demonstrated to be a further reliable option when needed, according to many papers focusing more on the vein than on the artery. Besides the clinical evidence, the hemodynamic features of the retrograde system have been very seldom analyzed.In this article, we report our clinical experience with deep inferior epigastric perforator (DIEP) flaps anastomosed to RIMVs, along with a perioperative radiological follow-up to study RIMVs' hemodynamics and to further support the reliability of the retrograde system with particular focus on the retrograde internal mammary artery.Prospective, preoperative, and postoperative (3 days, 21 days, and 3 months, respectively) color Doppler sonographies of the internal mammary artery (IMA) and DIEPs have been performed to collect the velocity of flow (v) and resistive index (RI) data. Twenty-two patients agreed to undergo this protocol, of which 10 unipedicle flaps were anastomosed to AIMVs ("control" group), 10 bipedicle DIEPs to both AIMVs and RIMVs ("study" group), and 2 DIEPs anastomosed to retrograde internal mammary artery and antegrade internal mammary vein (not statistically analyzed for their paucity). Student t test was performed to compare the "control" and "study" groups.All the flaps survived, and no re-exploration was needed. Internal mammary artery and perforators v showed similar but speculate trend, whereas IMA and perforators RI looked stable during that time. Significant differences have been found in the "study" group for IMA v at 3-day period, for perforator v at 21- and 90-day periods, and for perforator RI at 90-day period, without any clinical implication for flap viability.Retrograde internal mammary vessels can be considered reliable vessels for both arterial flap input and venous flap

  5. Experimental study of pancreaticojejunostomy completed using anastomotic chains.

    PubMed

    Pan, Wei-Dong; Xu, Rui-Yun; Li, Nan; Fang, He-Ping; Pan, Cu-Zhi; Tang, Zhao-Feng

    2010-07-01

    The most difficult, time-consuming, and complication-prone step in pancreaticoduodenectomy is the pancreaticojejunostomy step. The largest disadvantage of this kind of anastomosis is the high incidence of postoperative anastomotic leakage. Once pancreatic leakage occurs, the patient death rate can be very high. The aim of this study was to design a pancreaticojejunostomy procedure using anastomotic chains, which results in the cut end of the jejunum being attached to the pancreatic stump without suturing, and to evaluate the safety and efficacy of this procedure in domestic pigs. The pancreaticojejunal anastomotic chains had the following structures: the chains consisted of two braceletlike chains made of titanium, named chain A and chain B. The function of chain A was to attach the free jejunal end onto the pancreatic stump, whereas the function of chain B was to tighten the contact between the jejunal wall and the surface of the pancreatic stump to eliminate gaps between the two structures and ensure tightness that is sufficient to guarantee that there is no leakage of jejunal fluid or pancreatic juice. The following procedure was used to assess the safety and efficacy of the procedure: pancreaticojejunostomies were performed on ten domestic pigs using anastomotic chains. The time required to complete the pancreaticojejunal anastomoses, the pressure tolerance of the pancreaticojejunal anastomoses, the pig death rate, and the histopathological examinations of the pancreaticojejunostomy tissues were recorded. The average time required to complete the pancreaticojejunal anastomosis procedure was 13+/-2 min. The observed tolerance pressure of the pancreaticojejunal anastomoses was more than 90 mm H(2)O. All ten domestic pigs that underwent operations were still alive four weeks after the operations. Pathological examinations showed that the anastomotic surfaces were completely healed, and the pancreatic cutting surfaces were primarily epithelialized. In conclusion

  6. Experimental study of pancreaticojejunostomy completed using anastomotic chains

    NASA Astrophysics Data System (ADS)

    Pan, Wei-Dong; Xu, Rui-Yun; Li, Nan; Fang, He-Ping; Pan, Cu-Zhi; Tang, Zhao-Feng

    2010-07-01

    The most difficult, time-consuming, and complication-prone step in pancreaticoduodenectomy is the pancreaticojejunostomy step. The largest disadvantage of this kind of anastomosis is the high incidence of postoperative anastomotic leakage. Once pancreatic leakage occurs, the patient death rate can be very high. The aim of this study was to design a pancreaticojejunostomy procedure using anastomotic chains, which results in the cut end of the jejunum being attached to the pancreatic stump without suturing, and to evaluate the safety and efficacy of this procedure in domestic pigs. The pancreaticojejunal anastomotic chains had the following structures: the chains consisted of two braceletlike chains made of titanium, named chain A and chain B. The function of chain A was to attach the free jejunal end onto the pancreatic stump, whereas the function of chain B was to tighten the contact between the jejunal wall and the surface of the pancreatic stump to eliminate gaps between the two structures and ensure tightness that is sufficient to guarantee that there is no leakage of jejunal fluid or pancreatic juice. The following procedure was used to assess the safety and efficacy of the procedure: pancreaticojejunostomies were performed on ten domestic pigs using anastomotic chains. The time required to complete the pancreaticojejunal anastomoses, the pressure tolerance of the pancreaticojejunal anastomoses, the pig death rate, and the histopathological examinations of the pancreaticojejunostomy tissues were recorded. The average time required to complete the pancreaticojejunal anastomosis procedure was 13±2 min. The observed tolerance pressure of the pancreaticojejunal anastomoses was more than 90 mm H2O. All ten domestic pigs that underwent operations were still alive four weeks after the operations. Pathological examinations showed that the anastomotic surfaces were completely healed, and the pancreatic cutting surfaces were primarily epithelialized. In conclusion, the

  7. Reconstruction of a rare variant of the left hepatic vein in a left lateral segment liver graft from a living donor: Technical notes

    PubMed Central

    Veerankutty, Fadl H.; Ali, T.U. Shabeer; Manoj, Krishnan Sarojam; Venugopal, B.

    2016-01-01

    Reconstruction of hepatic veins in living donor liver transplantation (LDLT) is often technically challenging and a good venous outflow is essential for survival of the graft and patient. We describe a quadrangular patch venoplasty technique used for the reconstruction of a rare variant of the left hepatic vein (LHV) in a pediatric LDLT with left lateral segment (LLS) graft. Segment II vein in the graft was draining directly into the inferior vena cava (IVC) and segment III vein was draining into the middle hepatic vein (MHV) after receiving a tributary from segment IV so that there were two widely separated ostia at the cut surface. This is one of the rarest variations of the LHV and is so called type 3 variant; it is usually reconstructed using interposition tubular conduits necessitating two separate anastomoses at the IVC. PMID:26862296

  8. Reconstruction of a rare variant of the left hepatic vein in a left lateral segment liver graft from a living donor: Technical notes.

    PubMed

    Veerankutty, Fadl H; Ali, T U Shabeer; Manoj, Krishnan Sarojam; Venugopal, B

    2016-01-01

    Reconstruction of hepatic veins in living donor liver transplantation (LDLT) is often technically challenging and a good venous outflow is essential for survival of the graft and patient. We describe a quadrangular patch venoplasty technique used for the reconstruction of a rare variant of the left hepatic vein (LHV) in a pediatric LDLT with left lateral segment (LLS) graft. Segment II vein in the graft was draining directly into the inferior vena cava (IVC) and segment III vein was draining into the middle hepatic vein (MHV) after receiving a tributary from segment IV so that there were two widely separated ostia at the cut surface. This is one of the rarest variations of the LHV and is so called type 3 variant; it is usually reconstructed using interposition tubular conduits necessitating two separate anastomoses at the IVC. PMID:26862296

  9. Taxonomic and Molecular Identification of Mesocriconema and Criconemoides Species (Nematoda: Criconematidae)

    PubMed Central

    Cordero, Marco A.; Robbins, Robert T.; Szalanski, Allen L.

    2012-01-01

    Populations of Mesocriconema curvatum, M. kirjanovae, M. onoense, M. ornatum, M. sphaerocephala, M. surinamense, M. vadense, M. xenoplax, and Criconemoides informis from different geographical areas in the continental United States were characterized morphologically and molecularly. A new ring nematode from Washington County, Arkansas, is also described and named Mesocriconema ozarkiense n. sp., This new species is characterized by females with small flattened submedian lobes, lower than or at the same level as the labial disc, vagina straight, very well developed spermatheca without sperm, no more than one anastomoses, L=379-512 μm, V=89-93, stylet length = 49-61 μm, R=107-119, annuli with slightly crenate margins on tail portion and a simple anterior vulval lip. The molecular characterization of M. ozarkiense n. sp. using the ITS rRNA gene sequence and the phylogenesis relationship of this new species with the ring nematodes included in this study are provided. PMID:23482878

  10. [Clinical applications of magnetic resonance cholangiopancreatography].

    PubMed

    Soto, J A; Castrillón, G A

    2007-01-01

    Magnetic resonance cholangiopancreatography (MRCP) is the most important diagnostic alternative that has been developed in recent years for the evaluation of the biliary and pancreatic ducts. The advantages of this technique are: it does not use contrast media or ionizing radiation; it is noninvasive and complication free; and, the examination is relatively short (approximately 20 to 30 minutes). MRCP has high sensitivity and specificity for diagnosing biliary dilatation and for determining the site and cause of stenosis. Its diagnostic precision for biliary and pancreatic stones is similar to that of endoscopic retrograde cholangiopancreatography (ERCP). MRCP has replaced ERCP in biliary and pancreatic anatomic variants. In unsuccessful ERCP, MRCP is nearly the only diagnostic modality for the evaluation of the biliary tract. Other applications include primary sclerosing cholangitis, stenosis after liver transplantation, and the evaluation of bilioenteric anastomoses. This article reviews the clinical applications of MRCP in the evaluation of biliopancreatic diseases. PMID:18021667

  11. [The technology of apical infection control].

    PubMed

    Qing, Yu; Yang, Yang; Bei, Chang

    2014-10-01

    Root canal therapy is the most efficient way to treat pulptitis and periapical inflammation, which can clear infections of root canal systems, fill the root canal firmly, and avoid reinfection. However, the variations in root canal morphology and complexity of infection confer difficulty in thoroughly eliminating microorganisms and their by-products in the root canal system, especially in the root apex area (including the top one-third of the root canal and periapical tissue), which is described as the hardest area to clean during endodontic treatment. Infection is difficult to remove entirely because the apex area is hard to approach using dental instruments and because of the existence of special morphological structures, such as apical ramification, intercanal anastomoses, and lateral branch of root canal. This review gives a brief introduction of the characteristics and difficulties of apical infection and knowledge on how to control such infections, including root apex preparation, irrigation and disinfection, and root canal filling. PMID:25490815

  12. [Microcirculation of the Achilles tendon and significance of the paratenon. A study with the plastination method].

    PubMed

    Graf, J; Schneider, U; Niethard, F U

    1990-05-01

    Rupture of a healthy Achilles tendon is disputed. A previous degenerative process with ischemia after recurrent microtraumas is usually held to be responsible. The vascular anatomy of eight human specimens was defined with a new method after perfusion through the femoral artery. This method allows exact analysis of the vessels even at a microscopic level. In contrast with the literature, the authors found a large number of anastomoses between the extra- and the intratendinous vessel system. The well-vascularized paratenon is therefore very important for the nutrition of the Achilles tendon. This fact must be taken into account during the surgical treatment of a rupture. The authors agree with the studies of the anatomist Lang who found a decrease of the intratendinous vascularization in an area 3 to 5 cm above the insertion in the os calcis. However a relationship between the frequency of rupture in this area and the vascular anatomy has not yet been shown. PMID:2198202

  13. Laser-induced tissue fluorescence in radiofrequency tissue-fusion characterization

    NASA Astrophysics Data System (ADS)

    Su, Lei; Fonseca, Martina B.; Arya, Shobhit; Kudo, Hiromi; Goldin, Robert; Hanna, George B.; Elson, Daniel S.

    2014-01-01

    Heat-induced tissue fusion is an important procedure in modern surgery and can greatly reduce trauma, complications, and mortality during minimally invasive surgical blood vessel anastomosis, but it may also have further benefits if applied to other tissue types such as small and large intestine anastomoses. We present a tissue-fusion characterization technology using laser-induced fluorescence spectroscopy, which provides further insight into tissue constituent variations at the molecular level. In particular, an increase of fluorescence intensity in 450- to 550-nm range for 375- and 405-nm excitation suggests that the collagen cross-linking in fused tissues increased. Our experimental and statistical analyses showed that, by using fluorescence spectral data, good fusion could be differentiated from other cases with an accuracy of more than 95%. This suggests that the fluorescence spectroscopy could be potentially used as a feedback control method in online tissue-fusion monitoring.

  14. [The super extended sub-mental flap or combo sub-mental flap].

    PubMed

    Martin, D

    2014-08-01

    The author presents a technical variation of the sub-mental flap including in a conventional pedicled flap both sub-mental axes and their anastomoses on the midline. The assessment of the first flaps raised according to this method confirms the improvement of the distal blood supply. It allows the possibility to harvest "super extended" flaps reaching the contralateral auricular lobula. This variation can be considered as an axial flap which only the tip, located beyond the mandibular angle, is at random. The evolution of the sub-mental flap from its original description to this variation called "combo sub-mental flap" is then presented. Its reliability and the technical simplification it provides will have to be assessed in the future. PMID:24840945

  15. [US-guided transhepatic drainage of a mediastinal abscess].

    PubMed

    Simón-Yarza, I; Viteri-Ramírez, G; García-Lallana, A; Benito, A

    2014-01-01

    Anastomoses often leak after esophageal surgery; if they are not detected in time, leaks can give rise to complications like fluid collections, superinfections, and mediastinitis. Although these complications usually require surgical treatment, different series of patients successfully treated with conservative or minimally invasive approaches have been reported. We present the case of a patient who developed a mediastinal abscess after epiphrenic diverticulectomy. We treated the abscess with US-guided percutaneous transhepatic drainage to avoid surgical reintervention. Although other cases of a transhepatic approach to thoracic lesions have been reported, to our knowledge this is the first report of this technique in mediastinal abscesses. We recommend that transhepatic drainage be considered a therapeutic option in the management of these complications. PMID:22464798

  16. Cortex-sparing infarction in triple cervical artery dissection following chiropractic neck manipulation

    PubMed Central

    Melikyan, Gayane; Kamran, Saadat; Akhtar, Naveed; Deleu, Dirk; Miyares, Francisco Ruiz

    2015-01-01

    Background: Multivessel cervical dissection with cortical sparing is exceptional in clinical practice. Case presentation: A 55-year-old man presented with acute-onset neck pain with associated sudden onset right-sided hemiparesis and dysphasia after chiropractic manipulation for chronic neck pain. Results and Discussion: Magnetic resonance imaging revealed bilateral internal carotid artery dissection and left extracranial vertebral artery dissection with bilateral anterior cerebral artery territory infarctions and large cortical-sparing left middle cerebral artery infarction. This suggests the presence of functionally patent and interconnecting leptomeningeal anastomoses between cerebral arteries, which may provide sufficient blood flow to salvage penumbral regions when a supplying artery is occluded. Conclusion: Chiropractic cervical manipulation can result in catastrophic vascular lesions preventable if these practices are limited to highly specialized personnel under very specific situations. PMID:26835412

  17. Prognostic factors on survival rate of fingers replantation

    PubMed Central

    Lima, José Queiroz; Carli, Alberto De; Nakamoto, Hugo Alberto; Bersani, Gustavo; Crepaldi, Bruno Eiras; de Rezende, Marcelo Rosa

    2015-01-01

    Objective: To evaluate the factors that influence the survival rate of replantation and revascularization of the thumb and/or fingers. Methods: We included fifty cases treated in our department from May 2012 to October 2013 with total or partial finger amputations, which had blood perfusion deficit and underwent vascular anastomosis. The parameters evaluated were: age, gender, comorbidities, trauma, time and type of ischemia, mechanism, the injured area, number of anastomosed vessels and use of vein grafts. The results were statistically analyzed and type I error value was set at p <0.05 . Results: Fifty four percent of the 50 performed replantation survived. Of 15 revascularizations performed, the survival rate was 93.3%. The only factor that affected the survival of the amputated limb was the necessity of venous anastomosis. Conclusion: We could not establish contraindications or absolute indications for the replantation and revascularization of finger amputations in this study. Level of Evidence III, Retropective Study. PMID:26327788

  18. On how whales avoid decompression sickness and why they sometimes strand.

    PubMed

    Blix, Arnoldus Schytte; Walløe, Lars; Messelt, Edward B

    2013-09-15

    Whales are unique in that the supply of blood to the brain is not by the internal carotid arteries, but by way of thoracic and intra-vertebral arterial retia. We found in the harbor porpoise (Phocoena phocoena) that these retia split up into smaller anastomosing vessels and thin-walled sinusoid structures that are embedded in fat. The solubility of nitrogen is at least six times larger in fat than in water, and we suggest that nitrogen in supersaturated blood will be absorbed in the fat, by diffusion, during the very slow passage of the blood through the arterial retia. Formation of nitrogen bubbles that may reach the brain is thereby avoided. We also suggest that mass stranding of whales may be due to disturbances to their normal dive profiles, resulting in extra release of nitrogen that may overburden the nitrogen 'trap' and allow bubbles to reach the brain and cause abnormal behavior. PMID:23788698

  19. Ruptured cerebral aneurysm associated with a persistent primitive trigeminal artery variant

    PubMed Central

    Yamamoto, Takahiro; Hasegawa, Yu; Ohmori, Yuki; Kawano, Takayuki; Kai, Yutaka; Morioka, Motohiro; Kuratsu, Jun-ichi

    2011-01-01

    Background: Primitive trigeminal artery variants (PTAVs) are one of the rare persistent fetal anastomoses between the carotid and vertebrobasilar circulations. They originate from the internal carotid artery and join one of the cerebellar arteries instead of the basilar artery. Case Description: We present an 82-year-old woman with subarachnoid hemorrhage due to a ruptured aneurysm originating at a PTAV. Three-dimensional computed tomography angiogram and cerebral angiography revealed bilateral PTAV and two aneurysms originating at the left PTAV. The proximal and distal aneurysms were saccular and fusiform, respectively. She underwent surgical treatment and her postoperative course was uneventful. Conclusion: Our case demonstrates that extremely rare cerebral aneurysms associated with PTAV can be addressed successfully by surgical intervention. PMID:22059121

  20. Fusiform aneurysm of a persistent trigeminal artery associated with rare intracranial arterial variations and subarachnoid hemorrhage.

    PubMed

    Kimball, David; Ples, Horia; Kimball, Heather; Miclaus, Gratian D; Matusz, Petru; Loukas, Marios

    2015-01-01

    The trigeminal artery is one of four primitive anastomoses between the internal carotid artery and vertebrobasilar system that regresses in the sixth week of fetal development. A persistent trigeminal artery (PTA) is generally an incidental finding but may also be associated with intracranial vascular pathologies such as aneurysms, arteriovenous malformations, and cranial nerve compression syndromes. We present an extremely rare case of a right PTA with an associated bleeding fusiform aneurysm located in the carotidian (lateral) part of the PTA. In addition, this rare anatomic variation was associated with bilateral absence of the posterior communicating arteries, a left posterior cerebral artery originating from the left internal carotid artery, and agenesis of the A1 segment of the left anterior cerebral artery. PMID:25053265

  1. Isostatic uplift, crustal attenuation, and the evolution of an extensional detachment system in southwestern Nevada

    SciTech Connect

    Scott, R.B.

    1987-12-31

    Geological and geophysical evidence supports the existence of extensional detachments, between the Sheep Range and Death Valley. It is proposed that geographically separated pieces of detachments between Death Valley and the Sheep Range are parts of a regional detachment system that has evolved since the Miocene, and that the system consists of lenses of strata separated by an anastomosing network of low- and high-angle normal faults. This manuscript emphasizes the probability that isostatic uplift within the region of greatest crustal attenuation in this system, the Bullfrog Hills core complex, controlled the evolution of the detachment system between the breakaway zone a the Sheep Range and the core complex. Features in this system are described from east to west, which is the apparent direction of tectonic transport.

  2. The Vascularized Medial Femoral Corticoperiosteal Flap for Thumb Reconstruction

    PubMed Central

    Amin, Kavit; Darhouse, Nagham; Sivakumar, Bran; Floyd, David

    2015-01-01

    Summary: We present an interesting method of shaping a vascularized medial femoral condyle (MFC) flap into a “neophalanx” for phalangeal reconstruction. Our patient presented with limited strength and function secondary to fracture nonunion of the proximal phalanx of the dominant thumb. Following excision of the pseudarthrosis, an MFC corticoperiosteal flap was harvested, sculpted into a prism shape and inset. The superomedial genicular pedicle was anastomosed to the princeps pollicis artery and a cephalic tributary. On follow-up, new bone growth was seen on radiographs and the patient had substantially improved function, with full metacarpophalangeal extension, a Kapandji score of 9, and a markedly reduced Disabilities of the Arm, Shoulder and Hand score of 2.68. The MFC flap is useful for reconstruction of bony defects, with minimal donor morbidity. This versatile vascularized flap can be crafted to requisite shapes and is useful for small defects in the hand, including phalangeal reconstruction. PMID:26495205

  3. The Combination of Gastroschisis, Jejunal Atresia, and Colonic Atresia in a Newborn

    PubMed Central

    Bauman, Zachary; Nanagas, Victor

    2015-01-01

    We encountered a rare case of gastroschisis associated with jejunal atresia and colonic atresia. In our case, the jejunal atresia was not discovered for 27 days after the initial abdominal wall closure. The colonic atresia was not discovered for 48 days after initial repair of the gastroschisis secondary to the rarity of the disorder. Both types of atresia were repaired with primary hand-sewn anastomoses. Other than the prolonged parenteral nutrition and hyperbilirubinemia, our patient did very well throughout his hospital course. Based on our case presentation, small bowel atresia and colonic atresia must be considered in patients who undergo abdominal wall closure for gastroschisis with prolonged symptoms suggestive of bowel obstruction. Our case report also demonstrates primary enteric anastomosis as a safe, well-tolerated surgical option for patients with types of intestinal atresia. PMID:26180651

  4. A case of basaloid follicular hamartoma.

    PubMed

    Go, Jae Wan; Oh, Hwa Eun; Cho, Han Kyoung; Kang, Won Hyoung; Ro, Byung In

    2010-05-01

    Basaloid follicular hamartoma (BFH), uncommon rare benign neoplasm connected to the adnexal structures, presents with multiple clinical manifestations that can develop into basal cell carcinoma. BFH may be congenital or acquired, and the congenital form can be further divided into the generalized and unilateral type, and the acquired form may present as localized and solitary lesions. Congenital, generalized BFH is associated with systemic diseases such as alopecia, cystic fibrosis, hypohidrosis, and myasthenia gravis. In contrast, sporadic cases are observed as unilateral or localized lesions. BFH shows thick cords and thin strands of anastomosing basaloid proliferations that arise from hair follicles and are enclosed by loose fibrous stroma. Here, we report a 70-year-old man with an acquired, solitary form of BFH. PMID:20548923

  5. Musculature of an illoricate predatory rotifer Asplanchnopus multiceps as revealed by phalloidin fluorescence and confocal microscopy.

    PubMed

    Kotikova, E A; Raikova, O I; Reuter, M; Gustafsson, M K S

    2004-06-01

    The pattern of muscles in the actively swimming predatory rotifer Asplanchnopus multiceps is revealed by staining with tetramethyl-rhodamine isothiocyanate (TRITC)-labelled phalloidin and confocal scanning laser microscopy (CSLM). The major components of the musculature are: prominent semicircular muscles of the corona; paired lateral, dorsal and ventral retractors in the trunk; a network of six seemingly complete circular muscles and anastomosing longitudinal muscles in the trunk; two short foot retractors, originating from a transverse muscle in the lower third of the trunk. The sphincter of the corona marks the boundary between the head and the trunk. The muscular patterns in rotifers with different lifestyles differ clearly, therefore, the muscular patterns seem to be determined by the mode of locomotion and feeding behaviour. PMID:15140596

  6. Severe hypoxemia during carinal resection in the lateral position under one-lung ventilation of a non-dependent lung: a case report

    PubMed Central

    Koo, Chang-Hoon; Jung, Yoo Sun; Lee, Yong-Hun; Kim, Hyun-Chang; Bahk, Jae-Hyon

    2016-01-01

    During one-lung ventilation (OLV) in the lateral position, the dependent, ventilated lung receives more blood flow than the non-dependent, non-ventilated lung owing to gravity, improving the match of ventilation and perfusion. Conversely, in the rare clinical situations when OLV is applied to the non-dependent lung, arterial oxygenation can get worse due to considerable shunt flow to the dependent non-ventilated lung. We report a case of severe hypoxemia during carinal resection under OLV of a non-dependent lung. In this case, OLV had to be applied to the non-dependent lung in the lateral position because the bronchus of the non-dependent lung was anastomosed with the trachea, whereas the bronchus of the dependent lung had already been resected for carinal resection. The subsequent hypoxemia resulting from the shunt flow to the dependent non-ventilated lung was treated successfully by ligating the pulmonary artery of the dependent lung. PMID:27274375

  7. Impact of surgical shape on blood flow pattern for patient specific coronary artery bypass graft (CABG) surgery

    NASA Astrophysics Data System (ADS)

    Sankaran, Sethuraman; Marsden, Alison

    2010-11-01

    We present a numerical framework for studying blood flow patterns in patients who have undergone coronary artery bypass surgeries. We use a stabilized finite element framework for performing blood flow simulations. Specialized lumped parameter boundary conditions for the coronary arteries, aorta and its branches are utilized. Computational models of CABG patients are constructed from CT scan images. A comprehensive study of how surgical shape affects hemodynamics in patient-specific CABG surgery has not been performed till date. The objective of this work is to study the effect of surgical geometry on blood flow pattern, especially downstream and in the proximity of the suture locations of the bypass graft. Quantities such as energy efficiency, wall shear stresses and its gradients and oscillatory shear index are extracted and compared for different surgical shapes in a systematic fashion. A framework and results for robust optimization of bypass graft anastomoses in unsteady flow will be presented. Implications of surgical geometry on graft patency will be discussed.

  8. Clinical evaluation of a closed, one-stage, stapled, functional, end-to-end jejuno-ileal anastomosis in 5 horses

    PubMed Central

    Anderson, Stacy L.; Blackford, James T.; Kelmer, S. Gal

    2012-01-01

    This study describes the outcome and complications in horses that had a closed, one-stage, stapled, functional, end-to-end (COSFE) jejuno-ileal anastomosis (JIA) following resection of compromised small intestine. Medical records were reviewed to identify all horses that had a COSFE JIA performed during exploratory laparotomy and to determine post-operative complications and final outcome. All 5 horses that were identified had successful COSFE JIA with resection of various amounts of distal jejunum and proximal ileum. Post-operative ileus occurred in 1 of the 5 horses. All horses survived at least 1 year after surgery. The survival times and incidence of post-operative ileus compared favorably with published results for other types of small intestinal resection and anastomoses. A COSFE JIA is a viable surgical procedure to correct lesions of the distal jejunum and proximal ileum. PMID:23450864

  9. The Tapestry of Life: Lateral Transfers of Heritable Elements - Scientific Meeting

    SciTech Connect

    Claire M. Fraser, Ph.D.

    2005-12-31

    The Sackler Colloquium The Tapestry of Life: Lateral Transfers of Heritable Elements was held on December 12-13, 2005. What Darwin saw as a tree of life descending in a linear fashion, is now more accurately seen as a tapestry of life, an anastomosing network, with important lateral transfers of heritable elements among parallel lines of descent These transfers range in complexity from small insertion sequences, to whole genes, gene islands, and portions of whole genomes which may be combined in symbiogenesis. The colloquium brought together researchers, empirical and theoretical, working at all levels on genomics, comparative genomics, and metagenomics to identify common and differentiating features of lateral gene transfer and to examine their implications for science and for human concerns.

  10. [Diagnosis and therapy of liver echinococcus (author's transl)].

    PubMed

    Gütgemann, A; Käufer, C; Prange, C H; Raschke, E; Bücheler, E; Biersack, H J

    1976-04-23

    From 1970 to April 1975 42 patients were treated for Echinococcus of the liver at the Bonn University Dept. of Surgery. There were 33 cases of E. cysticus and 9 cases of E. alveolaris. These two types of Echinococcus, different in parasitology and epidemiology present different clinical manifestation of disease with different course and prognosis. Angiography with celiaco- and superselective hepaticography are decisive for diagnosis. Therapy can only be surgical with total removal of the parasites. In E. cysticus this is almost always possible by enucleation-resection or pericystectomie following evacuation of the cyst and instillation of 20% sodium-chloride or formaldehyde. Such radicality is the exception in E. alveolaris. Here partial resections, biliodigestive and hepatodigestive anastomoses as palliative measures are carried out predominantly to ensure bile passage. PMID:988463

  11. Coexistence of rare arteries in the human celiaco-mesenteric system.

    PubMed

    Murakami, T; Mabuchi, M; Giuvarasteanu, I; Kikuta, A; Ohtsuka, A

    1998-10-01

    Some rare anomalies of the celiaco-mesenteric system were observed postmortem in a Japanese adult male: a) The left gastric, common hepatic, splenic and superior mesenteric arteries arose independently from the abdominal aorta. b) The anterior inferior pancreaticoduodenal artery of the superior mesenteric artery issued a hepatic artery which ascended along the anterior surface of the pancreas and gave off the right gastroepiploic, right gastric and cystic arteries. c) The common hepatic artery gave off an anastomosing branch to the superior mesenteric artery. d) The left gastric artery gave off the left accessory hepatic artery. e) The splenic artery issued the accessory middle colic artery. f) The left inferior phrenic artery gave off the esophageal branch. These anomalies are discussed in light of a typological system which we proposed in a previous paper for the celiaco-mesenteric system. PMID:9810433

  12. Macroscopic Anatomy of the Saimaa Ringed Seal (Phoca hispida saimensis) Lower Respiratory Tract.

    PubMed

    Laakkonen, Juha; Jernvall, Jukka

    2016-04-01

    We studied the macroscopic anatomy of the lower respiratory tract of the endangered Saimaa ringed seal (Phoca hispida saimensis). Examination of one adult and one young individual found dead showed that trachea had 85 and 86 complete cartilage rings. The adjacent cartilages exhibited very few random anastomoses. There was variation in the confirmation of the trachea between the cranial and caudal part of the trachea. The right lung was divided by partly incomplete inter-lobar fissures into cranial, middle, caudal, and accessory lobes. The left lung consisted of cranial, middle, and caudal lobes. The lungs were characterized by a high amount of interlobular connective tissue. Silicone casts were prepared of the two specimens to visualize the tracheobronchial branching which was similar to that of marine ringed seals but in the Saimaa ringed seal the right middle lobar bronchus originated at the same level as the accessory lobar bronchus. Anat Rec, 299:538-543, 2016. © 2016 Wiley Periodicals, Inc. PMID:26766601

  13. True aneurysm of brachial artery.

    PubMed

    Hudorović, Narcis; Lovričević, Ivo; Franjić, Dario Bjorn; Brkić, Petar; Tomas, Davor

    2010-10-01

    True upper extremity peripheral artery aneurysms are a rarely encountered arterial disorder. Following computer-tomography angiographic (CT-a) imaging examination, true saccular aneurysm, originating from the left brachial artery was diagnosed in the 77-year-old female without history of trauma. The aneurysm was resected by surgical intervention, and primary repair of the brachial artery was performed by interposition of a part of great saphenous vein harvested from the left groin and creation of two end-to-end anastomoses between interposition graft and previously resected part of brachial artery. No complication was observed during the follow-up. Surgical intervention for upper extremity aneurysms should be initiated without delay. Factors combined with minimal morbidity associated with repair suggest that surgical repair should be performed routinely for true upper extremity arterial aneurysms. PMID:20865459

  14. A Case of Superior Mesenteric Artery Aneurysm Mimicking an Abdominal Aortic Aneurysm and Presenting as a Pulsating Abdominal Mass

    PubMed Central

    Choi, Sang Tae; Kim, Keon Kuk; Kang, Jin Mo

    2016-01-01

    A 62-year-old male with a smoking history of 30 pack-years presented with a 1-year history of a periumbilical pulsating mass. He had been treated for hypertension for 2 years. Physical examination revealed a huge pulsating mass in the periumbilical abdomen. Femoral and popliteal arterial pulses were palpable. Computed tomography showed arterial dissection in the proximal segment of the superior mesenteric artery, a huge aneurysm (52×50 mm) with mural thrombus and two smaller aneurysms (20×20 mm) in the right ileocolic and ileal branches, along with atherosclerotic changes. Interposition using the great saphenous vein was performed after aneurysmal isolation and ligation of jejunal branches in the sac. Distal flow was reestablished by end-to-end and end-to-side anastomoses of the right ileocolic and ileal branches, respectively. No complications were observed at 1-year follow-up. PMID:27051659

  15. Myxoid adrenal adenoma with focal pseudoglandular pattern.

    PubMed

    De Padua, Michelle; Rajagopal, V

    2008-05-01

    Adrenal cortical tumors with myxoid change are rare tumors. To our knowledge, only 22 cases have been described so far in literature, which include 13 carcinomas and 9 adenomas. A pseudoglandular pattern has been described in 9 of these tumors. We report a case of a myxoid adenoma of the left adrenal gland in a 67-year-old woman, with a focal pseudoglandular pattern involving about 20% of the studied tumor. Rest of the tumor was composed of anastomosing cords of tumor cells. Abundant myxoid stroma was present, which stained positively with alcian blue and was weakly focally positive with periodic acid Schiff. Immunophenotype was consistent with an adrenal tumor, i.e., positive for vimentin, inhibin, and melan A. Cytokeratin AE1/AE3 and chromogranin were negative. MIB-1 index was < 0.1%. PMID:18579979

  16. The description of Centrorhynchus globirostris n. sp. (Acanthocephala: Centrorhynchidae) from the pheasant crow, Centropus sinensis (Stephens) in Pakistan, with gene sequence analysis and emendation of the family diagnosis.

    PubMed

    Amin, Omar M; Heckmann, Richard A; Wilson, Eric; Keele, Brianna; Khan, Aly

    2015-06-01

    A new species of Centrorhynchus (Centrorhynchidae) with receptacle insertion at the posterior third of the proboscis is described from the pheasant crow Centropus sinensis (Stephens) (Cuculidae) in Pakistan. Centrorhynchu sglobirostris n. sp. is similar to the 98 other known species of Centrorhynchus Lühe, 1911 in having long cylindrical trunk with anterior dilation and transverse anastomoses of the secondary lacunar vessels. However, specimens of C. globirostris differ from all other species of the genus by having a unique globular proboscis not divided into anterior proboscis with rooted hooks and posterior proboscis with rootless spines. Posterior hooks of C. globirostris emerge at the level of the receptacle insertion and are uniquely fully rooted. Sequencing and phylogenetic analysis of C. globirostris 18S and 28S ribosomal RNA genes reveals the genetic and evolutionary relationships between C. globirostris and other members of Centrorhynchidae which have representative orthologs in public databases. Comparison to known acanthocephalans confirms appropriate inclusion in the genus Centrorhynchus. PMID:25804972

  17. Alveolar antral artery isolation during sinus lift procedure with the double window technique.

    PubMed

    Maridati, Paolo; Stoffella, Enrico; Speroni, Stefano; Cicciu, Marco; Maiorana, Carlo

    2014-01-01

    The sinus lift technique, introduced in 1976 by Tatum and subsequently described by Boyne in 1980, is nowadays considered a safe and reliable procedure for the rehabilitation of the atrophic upper posterior maxilla. The alveolar antral artery (AAA) is anastomoses between the posterior superior alveolar artery (PSAA) and the infraorbital artery (IOA) and may be present in the sinusal antrostomy. The haemorrhage of this vascular bundle represents the second intra-operatory complication in term of frequency during sinus lift procedure. Purpose of this study was to illustrate and describe a new technique allowing the AAA isolation during sinus lift procedure in cases in which the artery is clearly present inside the surgical area, detectable through CT scan exam. Presence, course and possible identification of the alveolar antral artery are also discussed, according to the studies present in the literature. PMID:24949106

  18. Treatment of Iatrogenic Aortocoronary Arteriovenous Fistula with Coronary Covered Stent

    PubMed Central

    Ornek, Ender; Kundi, Harun; Kiziltunc, Emrullah; Cetin, Mustafa

    2016-01-01

    An 83-year-old man, who underwent coronary artery bypass operation of left internal mammary artery (LIMA) to left anterior descending (LAD) artery, with sequential saphenous vein to the first and second obtuse marginal (OM) branches of circumflex artery 5 years ago and coronary artery stent implantation to right coronary artery 2 months ago, was admitted to the hospital with syncope and chest pain. Aortosaphenous graft selective angiography revealed that first sequential side to side ligation was inadvertently anastomosed to left posterolateral coronary vein with resultant flow into the coronary sinus and distal end to side sequential anastomosis to OM 2 coronary artery which was filling very weakly. In order to close this iatrogenic coronary arteriovenous fistula and to supply saphenous vein flow to OM artery, we decided to implant a graft covered stent into the saphenous vein at the same session. PMID:27110409

  19. Right carinal pneumonectomy for a delayed diagnosis.

    PubMed

    Nistor, Cl; Motaş, Natalia; Motaş, C; Ion, Daniela; Davidescu, M; Vasilescu, Florina; Horvath, T

    2009-01-01

    The authors present the case of a male patient misdiagnosed with right upper lobe tuberculosis and repeatedly treated for this in the last two years, without response. In our institution, the source of the hemoptysis proved to be a pulmonary carcinoma, which in its evolution involved the carina and the last tracheal ring. Right carenal pneumonectomy with two tracheal ring resection is performed, with reconstruction of the airway by anastomosing the main left bronchus to trachea. The resection involved also the azygos vein and the lateral wall of the superior vena cava (angioplastic resection), the vagus nerve and the pericardium, the last are being reconstructed with synthetic mesh. Histopatologic diagnosis is squamous cell carcinoma moderately differentiated. The right tracheal sleeve pneumonectomy was the therapeutically choice for a middle-aged patient with recurrent hemoptysis and retrostenotic lung destruction. PMID:19942976

  20. Cancer développé sur dilatation kystique de la voie biliaire: à propos d’un cas

    PubMed Central

    Soufi, Mehdi; Lahlou, Mohammed Khalid; Chad, Bouziane

    2014-01-01

    Les auteurs rapportent un cas de dilatation kystique du cholédoque intra- pancréatique découvert chez une femme de 46 ans et compliqué d'un carcinome tubulo-papillaire n'envahissant pas le pancréas. Le traitement a consisté en une duodénopancréatectomie céphalique avec un curage ganglionnaire et anastomose hépatico-jéjunale; la survie était de 30 mois; les auteurs abordent les aspects radiologiques, anatomopathologiques, thérapeutiques et pronostiques de ces cancers développé sur dilatation kystique de la voie biliaire et discutent la place d'une radiothérapie complémentaire de la chirurgie susceptible d'améliorer la survie. PMID:25922635

  1. Eccrine syringofibroadenoma associated with well-differentiated squamous cell carcinoma.

    PubMed

    Kacerovska, Denisa; Nemcova, Jana; Michal, Michal; Kazakov, Dmitry V

    2008-12-01

    We report a case of an eccrine syringofibroadenoma (ESFA) associated with well-differentiated squamous cell carcinoma. The patient was an 85-year-old man, who had a 2.5x2.5-cm, brown-colored ulcerated nodule, with a fragile, flesh-colored bleeding surface located beyond the metacarpophalangeal joint of the second finger of his left hand. Histopathologically, there were areas of a well-differentiated squamous cell carcinoma, alternating with the typical area of ESFA characterized by anastomosing cords, strands, and columns of epithelial cells extending from the crusted epidermis into a thickened, edematous, myxoid vascular-rich dermis. Immunohistochemically, the areas with dysplastic epithelium were positive for p16, whereas the benign ESFA parts tested negative. Human papillomavirus was detected in the lesional tissue by polymerase chain reaction, and the subsequent sequencing analysis demonstrated that the virus was close to human papillomavirus type 107. PMID:19033931

  2. Definitive proof of endothelialization of a Dacron arterial prosthesis in a human being.

    PubMed

    Wu, M H; Shi, Q; Wechezak, A R; Clowes, A W; Gordon, I L; Sauvage, L R

    1995-05-01

    A 10 mm woven Dacron axillofemoral bypass graft was removed from a 65-year-old patient during redo surgery after an implant period of 26 months, because of a large seroma that surrounded the entire length of the graft. Tissue blocks were taken from representative areas along the entire length of the graft surface and evaluated by light microscopy with hematoxylin and eosin and Masson trichrome staining, scanning electron microscopy, transmission electron microscopy, and immunocytochemical staining. Paraffin-embedded sections were stained with smooth muscle cell alpha-actin, which demonstrated smooth muscle cells in the pseudointima, and Ham 56 stain to identify macrophages. Endothelial factor VIII/von Willebrand factor and Ulex europaeus agglutinin identified human endothelial cells on the flow surface, in areas far removed from the anastomoses to the native vessels. This is the first definitive proof in a human of endothelialization of a synthetic arterial graft beyond the pannus ingrowth zone. PMID:7769746

  3. Eccrine Syringofibroadenomatosis of the Soles.

    PubMed

    Polat, Muhterem; Üstün, Hüseyin

    2016-03-01

    Eccrine syringofibroadenoma is a rare adnexal tumor with acrosyringeal differentiation. It was first described by Mascaro in 1963. Its clinical presentation varies from a solitary nodule, keratotic papule, verrucous plaque, or palmoplantar keratoderma to multiple lesions with linear or diffuse distributions. Age at onset ranges from 16 to 80 years. Lesion distribution is wide and includes the face, back, abdomen, buttocks, extremities, and, rarely, nails. There are five subtypes of eccrine syringofibroadenoma. Histologically, eccrine syringofibroadenoma, independent of the subtype, is characterized by anastomosing cords of acrosyringeal cells forming ductal structures in a fibrovascular stroma and attached to the undersurface of the epidermis in multiple foci. In this article, we describe a 51-year-old woman diagnosed as having eccrine syringofibroadenomatosis. PMID:27031552

  4. Clinical experience with modified human umbilical cord vein for arterial bypass.

    PubMed

    Dardik, H D; Ibrahim, I M; Sprayregen, S; Dardik, I I

    1976-06-01

    Umbilical veins were removed from human cords, tanned with gluteraldehyde, and surrounded by a polyester fiber mesh. Arterial bypasses were performed with this material in eight persons with threatened limb loss and for whom no other graft material was available. The distal anastomoses were to the small vessels of the leg or to the popliteal artery below the knee. Limb salvage and function were obtained in five patients. Three of these also required early thrombectomy to obtain success. This complication may be related to the presence of gluteraldehyde oligomers and polymers of free aldehyde groups. Morphologic evaluation of the graft suggests that human umbilical cords are a potentially valuable source for vascular substitutes. PMID:1273747

  5. Pan-Nitinol Occluder and Special Delivery Device for Closure of Patent Ductus Arteriosus

    PubMed Central

    Jiang, Hai-bin; Bai, Yuan; Zong, Gang-jun; Han, Lin; Li, Wei-ping; Lu, Yang; Qin, Yong-wen; Zhao, Xian-xian

    2013-01-01

    The aim of this study was to evaluate a new type of occluder for patent ductus arteriosus. Patent ductus arteriosus was established in a canine model by anastomosing a length of autologous jugular vein to the descending aorta and the left pulmonary artery in an end-to-side fashion. Transcatheter closure of each patent ductus arteriosus was performed on 10 dogs, which were then monitored for as long as 6 months with aortography, echocardiography, and histologic evaluation. Transcatheter closure with use of the novel pan-nitinol device was successful in all canine models. Postoperative echocardiography showed that the location and shape of the occluders were normal, without any residual shunting. Further histologic evaluation confirmed that the occluder surface was completely endothelialized 3 months after implantation. Transcatheter patent ductus arteriosus closure with the pan-nitinol occluder can be performed safely and successfully in a canine model and shows good biological compatibility and low mortality rates. PMID:23466429

  6. Lymphovenous Anastomosis and Secondary Resection for Noonan Syndrome with Vulvar Lymphangiectasia.

    PubMed

    Winters, Harm; Tielemans, Hanneke J P; Ulrich, Dietmar J O

    2016-08-01

    In this case report we describe the use of a 2-stage approach to treat severe recurrent vulvar lymphangiectasia in a patient with Noonan syndrome. First, 3 functional lymphatic vessels were identified and anastomosed to venules in an end-to-end fashion. Then, in a second surgical procedure, the vulvar lesions were resected as much as possible and the vulva was reconstructed. By the 12-month follow-up the patient had recovered well. Although there were still some small vesicles on the left labia there was no more ooze, itch, and pain. Lymphatic mapping using indocyanine green showed improvement of the edema of her vulva region and patent LVA. In addition to the demonstration of this 2-stage approach, this case report also demonstrates the benefits of preemptive LVA before performing surgery that may be at high risk for postoperative lymph edema. PMID:27622088

  7. Use of Left Gastric Vein as an Alternative for Portal Flow Reconstruction in Liver Transplantation

    PubMed Central

    Goldoni, Marcos Bertozzi; Kruse, Cristine; Diedrich, João Alfredo; Giacomazzi, Caroline Becker; Negri, Estéfano Aurélio; Koop, Matheus; Sampaio, José Artur; Fontes, Paulo Roberto Ott; Waechter, Fábio Luiz

    2016-01-01

    Portal vein thrombosis is observed in up to 10% of liver transplant candidates, hindering execution of the procedure. A dilated gastric vein is an alternative to portal vein reconstruction and decompression of splanchnic bed. We present two cases of patients with portal cavernoma and dilated left gastric vein draining splanchnic bed who underwent liver transplantation. The vein was dissected and sectioned near the cardia; the proximal segment was ligated with suture and the distal segment was anastomosed to the donor portal vein. Gastroportal anastomosis is an excellent option for portal reconstruction in the presence of thrombosis or hypoplasia. It allows an adequate splanchnic drainage and direction of hepatotrophic factors to the graft. PMID:27595034

  8. The microvascular osteocutaneous femur transplant for covering combined alveolar ridge and floor of the mouth defects: preliminary report.

    PubMed

    Gaggl, Alexander; Bürger, Heinz; Chiari, Friedrich Michael

    2008-04-01

    In this preliminary report, the surgical technique of an oral defect coverage using the microvascular osteocutaneous flap from the distal medial femur is described and three clinical cases are reported. The new flap was used for covering combined defects of the alveolar ridge and the neighboring floor of the mouth after tumor surgery and irradiation. The bone part of the flap was supplied by the descending genicular artery and the soft tissue part by their first emission-the saphenous artery. Anastomoses were performed between the common part of the flap pedicle and cervical arteries or veins. There were no severe complications or transplant loss. All patients were successfully treated with dental implants (n = 12) 4 to 6 months after ridge reconstruction. The microvascular osteocutaneous femur transplant can be used successfully in individual reconstruction of the alveolar ridge and the neighboring floor of the mouth after tumor resection. PMID:18454356

  9. Urinary diversion and bowel cancer.

    PubMed Central

    Stewart, M.

    1986-01-01

    A retrospective survey of 278 patients who underwent urinary diversion for benign disease has revealed an excess risk factor for cancer at the ureterocolic anastomosis of approximately 100 fold. No malignancies were detected in isolated ileal or colon conduits, although recently a few such cases have been reported. Coupling this experience with a review of the literature, it would appear that the tumour is of colonic origin, adenoma and adenocarcinoma occurring at, or close to, the ureteric implant into the colon after a long latency of approximately 25 years, often in young patients. Nitrate reducing bacteria and N.nitroso compounds have been demonstrated in rectal urines of patients with ureterocolic anastomoses and also in some isolated loop urines. In fact, N.nitrosation and, possibly, carcinogenesis appears to depend not so much upon the kind of diversion, but rather the presence or absence of a mixed bacterial flora in the urine. PMID:3954318

  10. Viscous Moment, Mechanism of Slow Slip, and Subduction Megathrust Viscosity

    NASA Astrophysics Data System (ADS)

    Fagereng, A.

    2015-12-01

    Slow slip events (SSEs) represent transient slip velocities slower than earthquakes but faster than steady, average plate motion. SSEs repeating at the same location have characteristic slip magnitude and duration. Contrary to earthquakes, however, average slip relates to neither duration nor area. Variations in duration, slip, and slip rate can instead be tied to variations in effective viscosity, calculated from a viscous definition of moment. In this paradigm, the observation that deep slow slip events are slower and longer, implies a higher effective viscosity than in shallower, colder SSEs. Observed variations in effective viscosity and slip rate can be interpreted in terms of differences in driving stress and shear zone width, and likely arise in anastomosing shear zones containing a heterogeneous mixture of materials.

  11. Hybrid in situ replacement for Samson group V Staphylococcus aureus aortic graft infection

    PubMed Central

    Karpenko, A A; Ignatenko, P V; Beliaev, A M

    2013-01-01

    Aortic prosthesis replacements including extra-anatomical bypass procedures, in situ revascularisations with the neoaortoiliac system, antibiotic bounded prostheses or allogeneic grafts have high graft reinfection rates. We described a case of a 68-year-old man with Samson group V Staphylococcus aureus infection of his aortobifemoral graft. He underwent an explantation of the infected graft, wound debridement and a hybrid in situ allogeneic aortoiliofemoral replacement. During surgery one of the limbs of the cryopreserved human aortic allogeneic graft was anastomosed with the endarterectomised left common iliac artery, which later was angioplastied and stented. The closed system Jackson-Pratt drains were used to prevent perigraft fluid collection. The groin wound was treated with the vacuum-assisted closure dressing. On review in 6 months he remained symptom free. We conclude that a hybrid management of infected aortic prosthesis may reduce graft reinfection. PMID:23897382

  12. The PaPsr1 and PaWhi2 genes are members of the regulatory network that connect stationary phase to mycelium differentiation and reproduction in Podospora anserina.

    PubMed

    Timpano, Hélène; Chan Ho Tong, Laetitia; Gautier, Valérie; Lalucque, Hervé; Silar, Philippe

    2016-09-01

    In filamentous fungi, entrance into stationary phase is complex as it is accompanied by several differentiation and developmental processes, including the synthesis of pigments, aerial hyphae, anastomoses and sporophores. The regulatory networks that control these processes are still incompletely known. The analysis of the "Impaired in the development of Crippled Growth (IDC)" mutants of the model filamentous ascomycete Podospora anserina has already yielded important information regarding the pathway regulating entrance into stationary phase. Here, the genes affected in two additional IDC mutants are identified as orthologues of the Saccharomyces cerevisiae WHI2 and PSR1 genes, known to regulate stationary phase in this yeast, arguing for a conserved role of these proteins throughout the evolution of ascomycetes. PMID:27353975

  13. The human testicular artery and the pampiniform plexus--where is the connection?

    PubMed

    Skowroński, Adam; Jedrzejewski, Kazimierz

    2003-01-01

    The aim of the study was the microscopic evaluation of the human spermatic cord vessels, with special attention to the connection between the testicular artery and the veins of the pampiniform plexus. We used the corrosive cast method to visualise the angioarchitecture of the spermatic cord. Casts were evaluated using a scanning electron microscope. We observed that there is a narrow space (previously filled with the testicular artery wall), between the casts of the testicular artery and the veins of the pampiniform plexus. This area contains a capillary vessel net, which connects the testicular artery with the veins of the pampiniform plexus. There were no direct anastomoses between the testicular artery and the pampiniform plexus. We hypothesise that the capillary net described is the means of connection between the testicular artery and the pampiniform plexus, and that there can be a testicular artery net of its own vessels (vasa vasorum). PMID:14507047

  14. Bilateral cystic dysplasia of the rete testis with renal adysplasia.

    PubMed

    Bouron-Dal Soglio, Dorothée; Harvey, Isabelle; Jovanovic, Mubina; Oligny, Luc L; Fournet, Jean-Christophe

    2006-01-01

    Cystic dyplasia of the rete testis (CDRT) is an uncommon, generally unilateral lesion characterized by anastomosing cystic spaces lined by a flattened simple cuboidal epithelium in the rete testis. In the literature this lesion often is associated with an ipsilateral urogenital lesion such as renal agenesia or multicystic dysplasia of the kidney, in order of frequency. The pathogenesis is explained by some authors by their common embryologic origin. We are reporting the finding of bilateral CDRT associated with ultrasound-diagnosed renal adysplasia in a 20-week gestational age fetus with oligohydramnios. Although CDRT has been referred to as being associated with multicystic renal dysplasia or renal agenesis, the present case appears to be unique in combining all the malformations together. PMID:16822083

  15. Acardius anceps with evidence of intrauterine vascular occlusion: report of a case and discussion of the pathogenesis.

    PubMed

    Wolf, H K; MacDonald, J; Bradford, W B; Lanman, J T

    1991-01-01

    An acardiac anomaly (holoacardius anceps) showed advanced development of the head and lower body parts in the absence of all thoracic and upper abdominal viscera. Large vascular anastomoses in the vertebral canal formed the only blood supply to the head. The two-vessel umbilical cord of the acardius contained calcified mural thrombi in both vessels. Severe fetal hydrops resulted in an exceptionally large birth weight of 3720 g. Fibroblasts from the acardius showed chromosomal mosaicism. The surviving co-twin was remarkable for a widely patent ductus arteriosus, unilateral multicystic renal dysplasia, and a normal chromosome complement. The circumscribed absence of organ development in the thorax and upper abdomen of the acardius and the vascular anatomy with thrombosis of the umbilical vessels suggest that an occlusion of thoracic and abdominal vessels was significant in the development of this acardiac malformation and should be considered as a possible pathogenetic mechanism in similar cases of acardia. PMID:2014188

  16. Early experiences with magnetic rings in resection of the distal colon.

    PubMed

    Jansen, A; Keeman, J N; Davies, G A; Klopper, P J

    1980-01-01

    We have developed an anastomosis technique for resection of the distal colon based on the principle of submucosal layer apposition. The anastomosis apparatus consists of two rings of Ertalyte (polyester-polyethyleneterephtalate) containing two magnetic rings of polymer bonded rare earth cobalt. For low anastomoses we developed a magnetic ring holder, protecting cap and hexagonal connecting rod. The working principle is based on progressive compression leading to necrosis of the intermediate mucosal and submucosal layers by increasing magnetic force while bowel healing takes place. After 7 to 17 days the magnets cut through and are propelled by peristalis out of the anastomotic region. From our initial series of five patients we performed three sigmoid resections and two low anterior resections. There were no postoperative complications. Sigmoidoscopic and radiological investigations two weeks postoperatively, showed no evidence of leakage or anastomotic narrowing. The technique and the special advantages of the apparatus are discussed. PMID:7366876

  17. [Total debranching through mini-sternotomy].

    PubMed

    Ujihira, Kosuke; Morishita, Kiyofumi; Shibata, Tsuyoshi; Saga, Toshifumi; Baba, Toshio; Mawatari, Toru

    2013-10-01

    Aneurysms of the aortic arch are technically challenging to repair with thoracic endovascular aneurysm repair (TEVAR). Various optional techniques such as debranching or hybrid TEVAR enable landing zones to extend, however, there is still room for improvement. We have performed total debranching to facilitate TEVAR with adequate central neck length more than 2.5 cm. In summary our procedure has 3 features:mini-thoracotomy to minimize its surgical stress which might cause post-operative respiratory failure, side-to-side anastomosis of trifurcated graft with ascending aorta to avoid its kinking after chest closure, and the usage of Pruitt-Inahara shunt tube during anastomoses of the carotid artery. PMID:24105115

  18. Evolution insolite d'une plaie complexe de la voie biliaire principale post cholécystectomie cœlioscopique

    PubMed Central

    Mohamed, Hedfi; Hala, Bouhafa; Youssef, Elcadhi; Abdelhedi, Cherif; Karim, Sassi; Azza, Sridi; Adnen, Chouchene

    2016-01-01

    Depuis l'avènement de la chirurgie coelioscopique de la lithiase biliaire le nombre de plaies des voies biliaires a sensiblement augmenté dans la littérature en rapport avec la courbe d'apprentissage des opérateurs. Les plaies méconnues peuvent avoir des conséquences immédiates dramatiques et évoluer vers la péritonite biliaire. Ailleurs la réparation des fistules biliaires externes au stade de dilatation des voies biliaires nécessite une anastomose bilio digestive ou des résections hépatiques réglées. PMID:27279975

  19. Structural character of the Ghost Dance fault, Yucca Mountain, Nevada

    USGS Publications Warehouse

    Spengler, R.W.; Braun, C.A.; Linden, R.M.; Martin, L.G.; Ross-Brown, D. M.; Blackburn, R.L.

    1993-01-01

    Detailed structural mapping of an area that straddles the southern part of the Ghost Dance Fault has revealed the presence of several additional subparallel to anastomosing faults. These faults, mapped at a scale of 1:240, are: 1) dominantly north trending, 2) present on both the upthrown and downthrown sides of the surface trace of the Ghost Dance fault, 3) near-vertical features that commonly offset strata down to the west by 3 to 6 m (10 to 20 ft), and 4) commonly spaced 15 to 46 m (50 to 150 ft) apart. The zone also exhibits a structural fabric, containing an abundance of northwest-trending fractures. The width of the zone appears to be at least 213 m (700 ft) near the southernmost boundary of the study area but remains unknown near the northern extent of the study area, where the width of the study area is only 183 m (600 ft).

  20. [Experience with cryopreserved homografts used in aortofemoral position in infection of vascular prostheses].

    PubMed

    Karpenko, A A; Starodubtsev, V B; Ignatenko, P V; Zoloev, D G

    2015-01-01

    The authors share herein their experience in reconstructive interventions on the aortofemoral segment in infection of the implant in three 59-to-69-year-old male patients. Infection of the prosthesis was diagnosed by the clinical data, findings of MSCT angiography and duplex scanning of the infrarenal portion of the aorta and arteries of lower limbs. Pseudoaneurysms of distal anastomoses were revealed in two cases. All secondary reconstructions were performed with the use of a cryopreserved aortic bifurcation homograft in the in situ position with simultaneous removal of the infected implant. The results of inoculation from the removed implants yielded Staphylococcus aureus in two cases and Staphylococcus epidermidis in one case. One patient died 6 months later due to causes not related to the operative intervention, in the remaining two cases during one year no findings suggesting reinfection or steno-occlusive lesion of the aortofemoral segment have been revealed. PMID:26355933

  1. Clathria (Thalysias) (Poecilosclerida: Demospongiae: Porifera) from Brazil:
    New species and redescription of Clathria (Thalysias) basiarenacea (Boury-Esnault, 1973).

    PubMed

    Galindo, Helcy; Hooper, John N A; Pinheiro, Ulisses

    2014-01-01

    The subgenus Clathria (Thalysias) Duchassaing & Michelotti, 1864 has 97 valid species, of which 27 are recorded in the Atlantic Ocean. However, only three species are known from Brazil so far. Here we provide the redescription of Clathria (Thalysias) basiarenacea (Boury- Esnault, 1973), based on the discovery of new characters (additional category of auxiliary styles, and details of spicules), and describe a new species of Clathria (Thalysias) repens sp. nov., that differs from sister species in having a live orange color, a massively encrusting repent growth form with lamellate folds and anastomosed projections, and three categories of structural styles, of which the two auxiliary styles have microspined heads. We also invalidate the record of Clathria (Thalysias) procera (Ridley, 1884) for Brazil.  PMID:25544467

  2. Wound repair in Pocillopora.

    PubMed

    Rodríguez-Villalobos, Jenny Carolina; Work, Thierry Martin; Calderon-Aguilera, Luis Eduardo

    2016-09-01

    Corals routinely lose tissue due to causes ranging from predation to disease. Tissue healing and regeneration are fundamental to the normal functioning of corals, yet we know little about this process. We described the microscopic morphology of wound repair in Pocillopora damicornis. Tissue was removed by airbrushing fragments from three healthy colonies, and these were monitored daily at the gross and microscopic level for 40days. Grossly, corals healed by Day 30, but repigmentation was not evident at the end of the study (40d). On histology, from Day 8 onwards, tissues at the lesion site were microscopically indistinguishable from adjacent normal tissues with evidence of zooxanthellae in gastrodermis. Inflammation was not evident. P. damicornis manifested a unique mode of regeneration involving projections of cell-covered mesoglea from the surface body wall that anastomosed to form gastrovascular canals. PMID:27397755

  3. Gold Veins near Great Falls, Maryland

    USGS Publications Warehouse

    Reed, John Calvin, Jr.; Reed, John C.

    1969-01-01

    Small deposits of native gold are present along an anastomosing system of quartz veins and shear zones just east of Great Falls, Montgomery County, Md. The deposits were discovered in 1861 and were worked sporadically until 1951, yielding more than 5,000 ounces of gold. The vein system and the principal veins within it strike a few degrees west of north, at an appreciable angle to foliation and fold axial planes in enclosing rocks of the Wissahickon Formation of late Precambrian (?) age. The veins cut granitic rocks of Devonian or pre-Devonian age and may be as young as Triassic. Further development of the deposits is unlikely under present economic conditions because of their generally low gold content and because much of the vein system lies on park property, but study of the Great Falls vein system may be useful in the search for similar deposits elsewhere in the Appalachian Piedmont.

  4. Vascularised fibular grafts for reconstruction of the femur.

    PubMed

    Yajima, H; Tamai, S; Mizumoto, S; Ono, H

    1993-01-01

    From 1979 to 1990 we treated 20 patients with large bone defects or established nonunion of the femur by vascularised fibular grafts. There were 18 men and two women with an average age at operation of 36.6 years (16 to 69). Ten patients had infected nonunion, three had post-traumatic nonunion or a bone defect without infection, four had a defect after tumour resection, and three had other lesions. The mean length of the fibular grafts was 18.1 cm. Postoperative circulatory disturbances needed revision surgery in five patients, including three with circulatory problems in the monitoring flap, but not at their anastomoses. The outcome was successful in 19 of the 20 patients with bone union at means of 6.1 months at the proximal site and 6.6 months at the distal site. Three patients had fractures of the fibular grafts but all these united in two to three months after cast immobilisation. PMID:8421008

  5. Microneurovascular free digital pad transfer in the dog.

    PubMed

    Basher, A W; Fowler, J D; Bowen, C V; Clark, E G; Crosby, N L

    1990-01-01

    By cadaver dissections, the fifth digit of the canine hind limb was determined to have a consistent neurovascular anatomy, and therefore be a suitable donor for an axial pattern digital pad flap. The defined digital pad flap was transferred to the region of an excised metacarpal pad by microneurovascular anastomoses in five operations on four dogs. One flap failure was considered to result from failure of the venous anastomosis. In all four successful transfers, cutaneous sensation was reestablished on average in 78 days. There was histologic evidence of nerve regeneration across the anastomosis in one dog at week 24. The transferred pads of three dogs monitored for 15 months underwent hypertrophic changes. There were no complications in two active dogs. In one dog, superficial ulceration of a region of the flap adjacent to the pad required surgical revision. This dog continued to show mild lameness after daily runs of 3 to 4 km. PMID:1971973

  6. Pseudoangiomatous stromal hyperplasia of the breast in pediatric patients: an underrecognized entity.

    PubMed

    Shehata, Bahig M; Fishman, Inessa; Collings, Margaret H; Wang, Jenny; Poulik, Janet M; Ricketts, Richard R; Parker, Paul M; Heiss, Kurt; Bhatia, Amina M; Worcester, Heath D; Gow, Kenneth W

    2009-01-01

    Pseudoangiomatous stromal hyperplasia (PASH) is a benign lesion consisting of mammary stromal proliferation with anastomosing slits mimicking vascular spaces. Grossly, it most often resembles fibroadenoma, but may commonly be confused with angiosarcoma and other types of benign vascular proliferations. While PASH has been described in female and male adults since the mid-1980s, there have been only a few accounts in the pediatric population. We present a series of 12 pediatric patients with PASH, including a 3-year-old male, who we believe to be the youngest patient to present with this entity. In our study, PASH was found in 12% of tumors diagnosed preoperatively as fibroadenomas and in 12% of cases diagnosed preoperatively as gynecomastia. Our series documents that PASH is not uncommon in pediatric breast pathology and delineates important differences between adult and pediatric presentations of this entity. PMID:19606909

  7. Large pseudoangiomatous stromal hyperplasia complicated with gynecomastia and lobular differentiation in a male breast.

    PubMed

    Mizutou, Akiko; Nakashima, Kazutaka; Moriya, Takuya

    2015-01-01

    Pseudoangiomatous stromal hyperplasia (PASH) is a benign lesion often observed in parts of the mammary stroma in a variety of breast diseases. It is characterized by stromal myofibroblastic proliferation that possesses irregularly anastomosing slit-like pseudovascular spaces lined by a layer of spindle cells. PASH commonly occurs in premenopausal women; however, it has also been observed in men with gynecomastia. Although tumor-forming lesions are rare, we report on a case with a large PASH in a male breast complicated with gynecomastia. Imaging showed a tumor with a diameter of >10 cm in the left breast, and aspiration cytology revealed a benign lesion. Since the tumor was large and gradually increased in size, a simple mastectomy was performed. The tumorous lesion was diagnosed as PASH based on the pathological and immunohistological findings. It was complicated by gynecomastia with acinar and lobular formation, which resembled female mammary gland secretory activity that is observed during lactation. PMID:26101734

  8. Giant nodular pseudoangiomatous stromal hyperplasia (PASH) of the breast presenting as a rapidly growing tumour.

    PubMed

    Mezzabotta, Maurizio; Riccardi, Silvia; Bonvini, Simona; Declich, Paolo; Tavani, Enrico; Morandi, Eugenio

    2009-01-01

    Pseudoangiomatous stromal hyperplasia (PASH) is often a microscopic incidental finding in breast biopsies performed for benign or malignant diseases. In rare cases, it presents as a localised breast mass. Since Vuitch et al first described this condition in 1986, only 109 cases of PASH presenting as a palpable or mammographically detectable mass have been documented. PASH is characterised by a dense, collagenous proliferation of mammary stroma, forming inter-anastomosing capillary-like spaces. It is important to distinguish this benign lesion from a low-grade angiosarcoma. Here we describe the clinical, radiological and histological features of a very unusual case of PASH that presented as a rapidly growing breast lesion in a 37-year old woman. PMID:19694241

  9. Lasers in Cardiovascular Surgery—Current Status

    PubMed Central

    Hunter, John G.; Dixon, John A.

    1985-01-01

    The argon, carbon dioxide and neodymium-YAG lasers have been proposed as effective instruments for surgical procedures of the intact cardiovascular system. While argon and CO2 lasers cause superficial (0 to 1 mm) thermal injury, the Nd:YAG laser is better suited for effecting deep thermal necrosis (3 to 4 mm). Microsurgical vessel anastomoses can be done by “tissue welding” with any of the three clinical lasers. Myocardial revascularization may be accomplished by drilling “neocapillaries” in ischemic myocardium. Endocardial resection for destroying arrhythmic pathways and removing hypertrophied septal muscle has also been successfully accomplished with laser phototherapy. Last, laser-mediated vaporization of atherosclerotic plaque in the coronary arteries and peripheral circulation may offer a percutaneous approach to the treatment of arterial occlusive disease. Cardiovascular uses of lasers are purely investigational at the current time. Much more needs to be known before widespread clinical use of lasers in the cardiovascular system can occur. PMID:3160168

  10. Prograde Shearing In The Lower Crust: Seismic Consequences

    NASA Astrophysics Data System (ADS)

    Burlini, L.; Arbaret, L.; Burg, J.-P.

    Continental thickening can be associated at depth with strain localization into anas- tomosing shear zones. These shear zones, formed during metamorphism, are often obliterated by later thermal and tectonic events possibly related with the exhumation of mountain roots under retrograde conditions. Anastomosing shear zones exposed in the lower crust of the Kohistan arc, in Pakistan, are rather exceptional because they have parageneses indicating increasing pressure during progressive deformation. We investigated their seismic properties on rock samples with constant bulk chem- istry. The compressional wave velocity was experimentally determined at high con- fining pressure and temperature. We observed that density, average Vp and acoustic impedance increased from the protoliths through a gradient zone to the mylonitic rock, whilst seismic anisotropy reached a maximum in the gradient zone. These findings will be presented and discussed in terms of reflectivity of the lower crust in collision zones.

  11. Vascularization of hollow channel-modified porous silk scaffolds with endothelial cells for tissue regeneration.

    PubMed

    Zhang, Wenjie; Wray, Lindsay S; Rnjak-Kovacina, Jelena; Xu, Ling; Zou, Duohong; Wang, Shaoyi; Zhang, Maolin; Dong, Jiachen; Li, Guanglong; Kaplan, David L; Jiang, Xinquan

    2015-07-01

    Despite the promise for stem cell-based tissue engineering for regenerative therapy, slow and insufficient vascularization of large tissue constructs negatively impacts the survival and function of these transplanted cells. A combination of channeled porous silk scaffolds and prevascularization with endothelial cells was investigated to test the ability of this tissue engineering strategy to support rapid and extensive vascularization process. We report that hollow channels promote in vitro prevascularization by facilitating endothelial cell growth, VEGF secretion, and capillary-like tube formation. When implanted in vivo, the pre-established vascular networks in the hollow channel scaffolds anastomose with host vessels and exhibit accelerated vascular infiltration throughout the whole tissue construct, which provides timely and sufficient nutrients to ensure the survival of the transplanted stem cells. This tissue engineering strategy can promote the effective application of stem cell-based regeneration to improve future clinical applications. PMID:25934280

  12. Liver transplantation in a patient with cholangiocarcinoma and ulcerative colitis.

    PubMed Central

    Abouna, G. M.; Preshaw, R. M.; Silva, J. L.; Hollingsworth, W. J.; Hershfield, N. B.; Novak, W.; Shaw, D. T.; Vetters, J. M.

    1976-01-01

    A 39 year-old patient with cholangiocarcinoma and pre-existing ulcerative colitis was successfully treated by orthotopic liver transplantation. He was given low doses of prednisone and azathioprine and survived for more than 9 months, dying with tumour metastases, thrombosis of the inferior vena cava and an intra-abdominal abscess. At autopsy the homograft showed little evidence of rejection. Preoperatively the patient had septicemia. Removal of his liver was difficult. The discrepancy between donor and recipient in size of blood vessels and the presence of two hepatic arteries in the donor caused problems during the vascular anastomoses. During the operation cardiac arrest occurred. Postoperatively there were several medical and surgical problems, including intraperitoneal and gastrointestinal hemorrhage, paralysis of the right dome of the diaphragm, sinus bradycardia, massive diuresis, peroneal nerve palsy, and one major and three minor episodes of rejection, which were reversed by giving pulse doses of methylprednisolone intravenously. Images FIG. 1 FIG. 2 FIG. 5 PMID:184908

  13. [The method of the isolated reconstruction by gastropancreatoduodenal resection].

    PubMed

    Shchepotin, I B; Vasil'ev, O V; Lukashenko, A V; Rozumiĭ, D A; Priĭmak, V V

    2011-01-01

    The modification of the reconstructive stage of gastropancreatoduodenal resection aims to increase the security of the pancreatojejunoanastomosis by minimizing the impact of such aggressive substances as bile and pancreatic juice. The modification represents the isolated pancreatojejunoanastomosis on the Roux-en-Y intestinal loop and gastro- and hepaticojejunoanastomoses on the second intestinal loop, separated with the use of the stub. Thus, the method allows the separate passage of pancreatic juice, bile and gastric contents, excluding their impact on other anastomoses. The described modification was performed in 6 patients. There were no cases of the anastomotic insufficiency. The mean hospital stay was 10,5 days. Thus. The method proved to be effective and safe, providing good initial results. PMID:22334901

  14. Wound repair in Pocillopora

    USGS Publications Warehouse

    Rodríguez-Villalobos, Jenny Carolina; Work, Thierry M.; Calderon-Aguileraa, Luis Eduardo

    2016-01-01

    Corals routinely lose tissue due to causes ranging from predation to disease. Tissue healing and regeneration are fundamental to the normal functioning of corals, yet we know little about this process. We described the microscopic morphology of wound repair in Pocillopora damicornis. Tissue was removed by airbrushing fragments from three healthy colonies, and these were monitored daily at the gross and microscopic level for 40 days. Grossly, corals healed by Day 30, but repigmentation was not evident at the end of the study (40 d). On histology, from Day 8 onwards, tissues at the lesion site were microscopically indistinguishable from adjacent normal tissues with evidence of zooxanthellae in gastrodermis. Inflammation was not evident. P. damicornis manifested a unique mode of regeneration involving projections of cell-covered mesoglea from the surface body wall that anastomosed to form gastrovascular canals.

  15. Humanized Mouse Model to Study Bacterial Infections Targeting the Microvasculature

    PubMed Central

    Melican, Keira; Aubey, Flore; Duménil, Guillaume

    2014-01-01

    Neisseria meningitidis causes a severe, frequently fatal sepsis when it enters the human blood stream. Infection leads to extensive damage of the blood vessels resulting in vascular leak, the development of purpuric rashes and eventual tissue necrosis. Studying the pathogenesis of this infection was previously limited by the human specificity of the bacteria, which makes in vivo models difficult. In this protocol, we describe a humanized model for this infection in which human skin, containing dermal microvessels, is grafted onto immunocompromised mice. These vessels anastomose with the mouse circulation while maintaining their human characteristics. Once introduced into this model, N. meningitidis adhere exclusively to the human vessels, resulting in extensive vascular damage, inflammation and in some cases the development of purpuric rash. This protocol describes the grafting, infection and evaluation steps of this model in the context of N. meningitidis infection. The technique may be applied to numerous human specific pathogens that infect the blood stream. PMID:24747976

  16. Multilobular tumor of the mandible in a Pekingese dog

    PubMed Central

    Pakhrin, Bidur; Bae, Il-Hong; Jee, Hyang; Kang, Min-Soo

    2006-01-01

    Multilobular tumor of bone detected in a 2.5-year-old male Pekingese dog is reported. Grossly, the neoplasm consisted of multiple, variably sized, gritty, grayish-white to yellow nodules separated by thick collagenous septa. Histologically, these nodules contained multiple lobules of irregularly shaped and sized islands of well-differentiated osteoid and cartilage, separated by anastomosing fibrovascular septa. Chondrocytes and osteocytes were observed in the lacunae and in more osseous islands in the lobule, respectively. These lobules were surrounded by mesenchymal spindle cells. Mitotic figures were not evident. The neoplastic pattern was consistent with that of a multilobular bone tumor. Diagnosis was based on gross and light microscopic findings. The cause of this neoplasm was not determined. PMID:16871027

  17. Amniotic membrane covering for facial nerve repair☆

    PubMed Central

    Karaman, Murat; Tuncel, Arzu; Sheidaei, Shahrouz; Şenol, Mehmet Güney; Karabulut, Murat Hakan; Deveci, Ildem; Karaman, Nihan

    2013-01-01

    Amniotic membranes have been widely used in ophthalmology and skin injury repair because of their anti-inflammatory properties. In this study, we measured therapeutic efficacy and determined if amniotic membranes could be used for facial nerve repair. The facial nerves of eight rats were dissected and end-to-end anastomosis was performed. Amniotic membranes were covered on the anastomosis sites in four rats. Electromyography results showed that, at the end of the 3rd and 8th weeks after amniotic membrane covering, the latency values of the facial nerves covered by amniotic membranes were significantly shortened and the amplitude values were significantly increased. Compared with simple facial nerve anastomosis, after histopathological examination, facial nerve anastomosed with amniotic membrane showed better continuity, milder inflammatory reactions, and more satisfactory nerve conduction. These findings suggest that amniotic membrane covering has great potential in facial nerve repair. PMID:25206390

  18. Transient Intrapulmonary Shunting in a Patient Treated With β2-Adrenergic Agonists for Status Asthmaticus

    PubMed Central

    Jacobson, Joseph E.; Eldridge, Marlowe W.

    2014-01-01

    Intrapulmonary arteriovenous anastomoses (IPAVs) are large-diameter pathways that directly connect the arterial and venous networks, bypassing the pulmonary capillaries. Ubiquitously present in healthy humans, these pathways are recruited in experimental conditions by exercise, hypoxia, and catecholamines and have been previously shown to be closed by hyperoxia. Whether they play a role in pulmonary pathophysiology is unknown. Here, we describe IPAV recruitment associated with hypoxemia and right-to-left shunt in a patient with status asthmaticus, treated with agonists of the B2-adrenergic pathway. Our observation of IPAVs in a pediatric patient, mechanically ventilated with 100% O2, suggests that these pathways are recruited in clinically important circumstances and challenges the notion that IPAVs are always closed by alveolar hyperoxia. PMID:24639274

  19. [Treatment of ascites in cirrhotic patients].

    PubMed

    Elizalde, I; Zozaya, J M

    2001-09-01

    Ascites is the most frequent complication of hepatic cirrhosis and its appearance brings a reduction of survival. The treatment aims to mobilise the intraperitoneal liquid and to prevent its reaccumulation. The first step of treatment includes rest in bed, a hyposodic and spironolactone diet, alone or in combination with furosemide or torasemide. However, 10-20% of patients do not respond to treatment or develop adverse effects that limit its use, which is termed refractory ascites. These patients must be considered as possible candidates for a liver transplant and, when this is not possible, the chosen treatment is total paracentesis with an intravenous infusion of albumin. In patients who do not tolerate paracentesis, or who require its realisation with great frequency, other therapeutic options can be evaluated, such as surgical anastomoses, intrahepatic portosystemic percutaneous derivation and, in the final instance, peritoneo-venous shunt. PMID:12876580

  20. Staple Line/Anastomotic Reinforcement and Other Adjuncts: Do They Make a Difference?

    PubMed Central

    Betzold, Richard; Laryea, Jonathan A.

    2014-01-01

    Since the development of the stapled intestinal anastomosis, efforts have been aimed at reducing complications and standardizing methods. The main complications associated with stapled anastomoses include bleeding, device failure, and anastomotic failure (leaks and strictures). These complications are associated with increased cost of care, increase in cancer recurrence, decreased overall survival, poor quality of life, and in some cases the need for further procedures including a diverting ostomy. Reducing these complications therefore has important implications. To this end, techniques to reduce the incidence of anastomotic complications have been the focus of many investigators. In this review, we summarize the current staple line reinforcement technology as well as other adjunctive measures, and specifically discuss the role of biologic materials in this realm. PMID:25435824

  1. Follicular thyroid carcinoma characterized by abundant stromal components with chondroid and osseous metaplasia in a dog.

    PubMed

    Kobayashi, Ryosuke; Yamada, Naoaki; Kitamori, Takashi; Kitamori, Fumiyo; Sato, Kazunari; Doi, Takuya; Wako, Yumi; Sato, Junko; Tsuchitani, Minoru

    2014-08-01

    A dog developed a cervical mass, and computed tomography verified a mass surrounding the trachea with some pulmonary masses. Histopathologically, the cervical mass was composed of malignant neoplastic cells showing follicular appearance which reacted positive for thyroglobulin on immunohistochemistry. A characteristic feature of the tumor was abundant and metaplastic stromal components. Anastomosed collagenous tissues connecting to capsule of the tumor were abundant in the stroma. In parts of the collagenous tissues, mature cartilages and bones were continuously formed. There was no cellular atypia or invasion in the components. We diagnosed this case as follicular thyroid carcinoma with metaplastic stroma. This is the first case report that characterizes stromal components with chondroid and osseous metaplasia in a canine thyroid carcinoma. PMID:24805905

  2. Pathophysiology of Coronary Collaterals#

    PubMed Central

    Stoller, Michael; Seiler, Christian

    2014-01-01

    While the existence of structural adaptation of coronary anastomoses is undisputed, the potential of coronary collaterals to be capable of functional adaptation has been questioned. For many years, collateral vessels were thought to be rigid tubes allowing only limited blood flow governed by the pressure gradient across them. This concept was consistent with the notion that although collaterals could provide adequate blood flow to maintain resting levels, they would be unable to increase blood flow sufficiently in situations of increased myocardial oxygen demand. However, more recent studies have demonstrated the capability of the collateral circulation to deliver sufficient blood flow even during exertion or pharmacologic stress. Moreover, it has been shown that increases in collateral flow could be attributed directly to collateral vasomotion. This review summarizes the pathophysiology of the coronary collateral circulation, ie the functional adapation of coronary collaterals to acute alterations in the coronary circulation. PMID:23701025

  3. Lymphovenous Anastomosis and Secondary Resection for Noonan Syndrome with Vulvar Lymphangiectasia

    PubMed Central

    Tielemans, Hanneke J.P.; Ulrich, Dietmar J.O.

    2016-01-01

    Summary: In this case report we describe the use of a 2-stage approach to treat severe recurrent vulvar lymphangiectasia in a patient with Noonan syndrome. First, 3 functional lymphatic vessels were identified and anastomosed to venules in an end-to-end fashion. Then, in a second surgical procedure, the vulvar lesions were resected as much as possible and the vulva was reconstructed. By the 12-month follow-up the patient had recovered well. Although there were still some small vesicles on the left labia there was no more ooze, itch, and pain. Lymphatic mapping using indocyanine green showed improvement of the edema of her vulva region and patent LVA. In addition to the demonstration of this 2-stage approach, this case report also demonstrates the benefits of preemptive LVA before performing surgery that may be at high risk for postoperative lymph edema. PMID:27622088

  4. At the Root of the Wood Wide Web

    PubMed Central

    Avio, Luciano; Fortuna, Paola; Pellegrino, Elisa; Sbrana, Cristiana; Strani, Patrizia

    2006-01-01

    Arbuscular mycorrhizal (AM) fungi are mutualistic symbionts living in the roots of 80% of land plant species, and developing extensive, below-ground extraradical hyphae fundamental for the uptake of soil nutrients and their transfer to host plants. Since AM fungi have a wide host range, they are able to colonize and interconnect contiguous plants by means of hyphae extending from one root system to another. Such hyphae may fuse due to the widespread occurrence of anastomoses, whose formation depends on a highly regulated mechanism of self recognition. Here, we examine evidences of self recognition and non-self incompatibility in hyphal networks formed by AM fungi and discuss recent results showing that the root systems of plants belonging to different species, genera and families may be connected by means of anastomosis formation between extraradical mycorrhizal networks, which can create indefinitely large numbers of belowground fungal linkages within plant communities. PMID:19521468

  5. Multiple Small Intestine Perforations after Organophosphorous Poisoning: A Case Report.

    PubMed

    Mahajan, Rubina Khullar; Rajan, Sudha Jasmine; Peter, John Victor; Suryawanshi, Mayur Keshav

    2016-03-01

    Organophosphate poisoning has significant gastrointestinal manifestations including vomiting, diarrhea, cramps and increased salivation. We report an uncommon gastrointestinal complication of multiple small intestinal perforations following organophosphorus poisoning. A 28-year old male presented after ingesting dichlorvos mixed with alcohol. Following the initial cholinergic symptoms, the patient developed severe shock with fever, attributed to aspiration pneumonia. Despite appropriate antibiotics, shock was persistent. Over the next 24-hours, he developed abdominal distension, loose stools and high nasogastric aspirates. Computed tomography showed pneumoperitonium. Exploratory laparotomy revealed six perforations in the jejunum and ileum. The involved portion of the bowel was resected and re-anastomosed, following which only 80-cm of small bowel was left. Postoperatively, shock resolved over 72-hours. However, over the next few days, patient developed features of anastomotic leak. Since only a small portion of the small bowel was preserved, a conservative approach was adopted. He deteriorated further and finally succumbed to the illness. PMID:27134898

  6. Efficacy of Endoscopically Created Bypass Anastomosis in Treatment of Afferent Limb Syndrome: A Single-Center Study.

    PubMed

    Rodrigues-Pinto, Eduardo; Grimm, Ian S; Baron, Todd H

    2016-04-01

    Afferent limb syndrome is a postoperative complication of gastrointestinal surgery, resulting from obstruction of a biliary-enteric limb. Surgery has been the cornerstone of treatment for this condition, but advances in endoscopic and percutaneous techniques could offer less-invasive options. Creation of an internal endoscopic anastomosis between the obstructed afferent limb and an adjacent gastrointestinal lumen can relieve symptoms and might provide a long-term solution. We report the efficacy of endoscopic treatment of afferent limb syndrome using lumen-apposing self-expandable metal stents to create 3 types of enteric anastomoses: a jejunojejunostomy, 2 gastrojejunostomies, and a duodenuojejunostomy in patients who developed afferent limb obstruction following a resection for pancreaticobiliary cancer. PMID:26674590

  7. Surface plasmon interference on the surface of an aluminum-covered fiber core array for solgel fabrication of submicrometer gratings.

    PubMed

    Wang, Wenjie; He, Miao; Zhang, Yong; Li, Shuti; He, Anhe; Wang, Xin; Hu, Candong; Zhu, Qiuxiang; Zhou, Jun; Ning, Guoxiang

    2010-11-15

    An interesting method to fabricate submicrometer gratings (SMGs) utilizing the interference of surface plasmon waves (SPWs) is presented. The stationary wave field off the aluminum (Al) layer surface of an Al-covered UV fiber core, formed by the interference of the induced SPWs, has been employed as a submicrometer photolithography tool to inscribe SMGs on the surface of a self-processing hybrid HfO(2)/SiO(2) solgel film. Using atomic force microscopy, the period of the fabricated SMGs was measured as 105 nm. The intensity distribution of the stationary wave field was measured by a near-field scanning optical microscope and anastomosed with theoretical values calculated by using FDTD simulations. PMID:21082009

  8. Structural character of the Ghost Dance Fault, Yucca Mountain, Nevada

    SciTech Connect

    Spengler, R.W.; Braun, C.A.; Linden, R.M.; Martin, L.G.; Ross-Brown, D.M.; Blackburn, R.L.

    1993-12-31

    Detailed structural mapping of an area that straddles the southern part of the Ghost Dance Fault has revealed the presence of several additional subparallel to anastomosing faults. These faults, mapped at a scale of 1:240, are: (1) dominantly north-trending, (2) present on both the upthrown and downthrown sides of the surface trace of the Ghost Dance fault, (3) near-vertical features that commonly offset strata down to the west by 3 to 6 m (10 to 20 ft), and (4) commonly spaced 15 to 46 m (50 to 150 ft) apart. The zone also exhibits a structural fabric, containing an abundance of northwest-trending fractures. The width of the zone appears to be at least 213 m (700 ft) near the southernmost boundary of the study area but remains unknown near the northern extent of the study area, where the width of the study area is only 183 m (600 ft).

  9. Hybrid in situ replacement for Samson group V Staphylococcus aureus aortic graft infection.

    PubMed

    Karpenko, A A; Ignatenko, P V; Beliaev, A M

    2013-01-01

    Aortic prosthesis replacements including extra-anatomical bypass procedures, in situ revascularisations with the neoaortoiliac system, antibiotic bounded prostheses or allogeneic grafts have high graft reinfection rates. We described a case of a 68-year-old man with Samson group V Staphylococcus aureus infection of his aortobifemoral graft. He underwent an explantation of the infected graft, wound debridement and a hybrid in situ allogeneic aortoiliofemoral replacement. During surgery one of the limbs of the cryopreserved human aortic allogeneic graft was anastomosed with the endarterectomised left common iliac artery, which later was angioplastied and stented. The closed system Jackson-Pratt drains were used to prevent perigraft fluid collection. The groin wound was treated with the vacuum-assisted closure dressing. On review in 6 months he remained symptom free. We conclude that a hybrid management of infected aortic prosthesis may reduce graft reinfection. PMID:23897382

  10. A fundamental model of the human thermal system for prediction of thermal comfort

    SciTech Connect

    Takemori, Toshikazu; Nakajima, Tsuyoshi; Shoji, Yuko

    1996-07-01

    The authors have developed a fundamental model of the human thermal system (AVA model) for the prediction of thermal comfort. The distinguishing feature of this model is a more precise description of heat transfer by blood flow (that is, it includes arteriovenous anastomoses (AVA) of the extremities and a dual vascular network) that conventional models of human thermal systems. The following results were obtained: (1) the experimental verification under three different steady thermal conditions (22, 28 and 34 C) and an unsteady thermal condition (28.1 C {r_arrow} 47.1 {r_arrow} 28.3 C) which suggests that the AVA model can simulate body-temperature profiles well; (2) the visualized results of the model predictions demonstrate that the calculated tissue-temperature and blood-temperature distributions are physiologically plausible.

  11. Use of the frozen elephant trunk technique in complicated chronic dissection with porcelain aorta and visceral arteries originating from different lumens.

    PubMed

    Zembala, Michal O; Irimie, Vadim; Urbanski, Paul P

    2016-04-01

    A rare case of aortic arch aneurysm combined with chronic aortic dissection is reported. Because the visceral arteries originated from different, equivalently perfused lumens and the descending aorta was circumferentially calcified (porcelain aorta) limiting the possibilities of anastomosing, careful planning of the surgical strategy was of utmost importance. The complex surgery consisted of ascending and total arch replacement using the 'frozen elephant trunk' technique with Thoraflex™ Hybrid Prosthesis (Vascutek, Terumo, Inchinnan, Scotland); however, before insertion of the stent graft, an angioscopic resection of the dissection membrane in the proximal part of the descending aorta was carried out to ensure a complete expansion of the distal edge of the stent within the entire common lumen of the aorta and unimpaired distal flow in both lumens below the stent graft. The surgery and the postoperative course were uneventful. PMID:27002017

  12. A New Arteriovenous Fistula Model to Study the Development of Neointimal Hyperplasia

    PubMed Central

    Manning, Eddie; Skartsis, Nikolaos; Orta, Armando M.; Velazquez, Omaida C.; Liu, Zhao-Jun; Asif, Arif; Salman, Loay H.; Vazquez-Padron, Roberto I.

    2012-01-01

    This study describes an alternative arteriovenous fistula (AVF) model in the rat in which the animals develop significant neointimal hyperplasia (NIH) not only at the distal anastomotic site, but also throughout the fistula body. This aortocaval fistula was established by anastomosing the distal end of the renal vein to the abdominal aorta after unilateral nephrectomy. The increased hemodynamic stress resulting from exposing the renal vein to the arterial circulation induced venous NIH as early as 7 days after surgery. This experimental AVF was characterized by the early lack of endothelium, the accumulation of proliferating vascular smooth muscle cells and the neovascularization of the fistula adventitia. In summary, we have described an informative animal model to study the pathobiology of NIH in native AVF. PMID:22249138

  13. Potentiation of mycovirus transmission by zinc compounds via attenuation of heterogenic incompatibility in Rosellinia necatrix.

    PubMed

    Ikeda, Kenichi; Inoue, Kanako; Kida, Chiaki; Uwamori, Takahiro; Sasaki, Atsuko; Kanematsu, Satoko; Park, Pyoyun

    2013-06-01

    Heterogenic incompatibility is considered a defense mechanism against deleterious intruders such as mycovirus. Rosellinia necatrix shows strong heterogenic incompatibility. In the heterogenic incompatibility reaction, the approaching hyphae hardly anastomosed, a distinctive barrage line formed, and green fluorescent protein (GFP)-labeled hyphae quickly lost their fluorescence when encountering incompatible hyphae. In this study, transmission of a hypovirulence-conferring mycovirus to strains with different genetic backgrounds was attempted. Various chemical reagents considered to affect the programmed cell death pathway or cell wall modification were examined. Treatment with zinc compounds was shown to aid in transmission of mycoviruses to strains with different genetic backgrounds. In incompatible pairings, treatment with zinc compounds accelerated hyphal anastomosis; moreover, cytosolic GFP was transmitted to the newly joined hyphae. These results suggest that zinc compounds not only increase hyphal anastomosis but also attenuate heterogenic incompatibility. PMID:23563943

  14. Severe hypoxemia during carinal resection in the lateral position under one-lung ventilation of a non-dependent lung: a case report.

    PubMed

    Koo, Chang-Hoon; Jung, Yoo Sun; Lee, Yong-Hun; Kim, Hyun-Chang; Bahk, Jae-Hyon; Seo, Jeong-Hwa

    2016-06-01

    During one-lung ventilation (OLV) in the lateral position, the dependent, ventilated lung receives more blood flow than the non-dependent, non-ventilated lung owing to gravity, improving the match of ventilation and perfusion. Conversely, in the rare clinical situations when OLV is applied to the non-dependent lung, arterial oxygenation can get worse due to considerable shunt flow to the dependent non-ventilated lung. We report a case of severe hypoxemia during carinal resection under OLV of a non-dependent lung. In this case, OLV had to be applied to the non-dependent lung in the lateral position because the bronchus of the non-dependent lung was anastomosed with the trachea, whereas the bronchus of the dependent lung had already been resected for carinal resection. The subsequent hypoxemia resulting from the shunt flow to the dependent non-ventilated lung was treated successfully by ligating the pulmonary artery of the dependent lung. PMID:27274375

  15. Gastrointestinal tract obstruction secondary to post-operative oedema: does dexamethasone administration help?

    PubMed Central

    Atie, M.; Khoma, O.; Dunn, G.; Falk, G.L.

    2016-01-01

    Oedema can occur in handled tissues following upper gastrointestinal surgery with anastomosis formation. Obstruction of the lumen may result in delayed return of enteric function. Intravenous steroid use may be beneficial. Three cases of delayed emptying following fundoplication, gastro-enteric and entero-enteric anastomoses are reviewed. Conservative management with supportive measures failed. Dexamethasone was administered to treat the oedematous obstruction. A literature review in PubMed, Cochrane database and Medline for English language publications on the use of dexamethasone in the treatment of acute post surgical oedema of the upper gastrointestinal was conducted. Administration of dexamethasone led to resolution of symptoms and successful outcome. No reports on the use of steroids in this context were identified in the literature. The use of dexamethasone may effectively treat intestinal obstruction due to inflammatory or oedematous cause in the early post-operative period. PMID:27554826

  16. [Detubularized U-shaped enterocystoplasty after cystoprostatectomy].

    PubMed

    el Mrini, M; Aboutaieb, R; el Fatimi, A; Sarf, I; Joual, A; Bennani, S; Elmoussaoui, A; Benjelloun, S

    1996-01-01

    We reviewed the charts of 58 patients who underwent orthotopic bladder replacement after total cystoprostatectomy for muscle invasive bladder cancer. Mean age was 56 years. As described by Camey, 60 centimetres of small bowel, are isolated, detubularised then folded upon itself to form a U shaped reservoir, which is anastomosed to the urethra. Death occurred in 5%. Urologic complications observed were: urinary leakage (15%), ureteral reflux (6.8%), ureteral stenosis (8.6%) and stones of the neobladder (5.1%). 64.2% of the patients were immediately continent during the day. Nocturnal continence was obtained for 50% immediately and for 80% three months postoperatively. Detubularised and U shaped cystoplasty achieve a low pressure reservoir, with protection of the upper urinary tract, and a diurnal continence. Nocturnal continence is achieved later. PMID:8767813

  17. An Extraperitoneal Technique for Murine Heterotopic Cardiac Transplantation.

    PubMed

    Nowocin, A K; Brown, K; Edwards, L A; Meader, L; Hill, J I; Wong, W

    2015-09-01

    The mouse heterotopic cardiac transplantation model has been used extensively by investigators in the field of organ transplantation to study the rejection process, test new antirejection treatments, tolerance induction protocols or to understand basic immunological principles. Due to its extensive use, any small refinement of the technique would have a major impact on replacement, reduction and refinement (commonly known as the 3Rs). Here, we describe a novel approach to refine this model. The donor aorta and pulmonary artery are anastomosed peripherally to the femoral artery and vein of the recipient, respectively. The technical success rate is comparable to the conventional abdominal site, but it avoids a laparotomy and handling of the bowels making it less invasive method. As a result, recipients recover faster and require less postoperative analgesia. It is a major refinement under one of the 3Rs and would represent an advance in animal welfare in scientific research. PMID:25997384

  18. Ice sculpture in the Martian outflow channels

    NASA Technical Reports Server (NTRS)

    Lucchitta, B. K.

    1982-01-01

    Viking Orbiter and terrestrial satellite images are examined at similar resolution to compare features of the Martian outflow channels with features produced by the movement of ice on earth, and many resemblances are found. These include the anastomoses, sinuosities, and U-shaped cross profiles of valleys; hanging valleys; linear scour marks on valley walls; grooves and ridges on valley floors; and the streamlining of bedrock highs. Attention is given to the question whether ice could have moved in the Martian environment. It is envisaged that springs or small catastrophic outbursts discharged fluids from structural outlets or chaotic terrains. These fluids built icings that may have grown into substantial masses and eventually flowed like glaciers down preexisting valleys. An alternative is that the fluids formed rivers or floods that in turn formed ice jams and consolidated into icy masses in places where obstacles blocked their flow.

  19. The Channeled Scabland: A Retrospective

    NASA Astrophysics Data System (ADS)

    Baker, Victor R.

    2009-05-01

    The Channeled Scabland of east-central Washington in the United States is a complex of anastomosing rock-cut fluvial channels, cataracts, loess islands, rock basins, broad gravel deposits, and immense gravel bars. In the 1920s, J Harlen Bretz demonstrated that the Channeled Scabland formed by cataclysmic erosion and deposition from Pleistocene megaflooding derived from the margins of the Cordilleran Ice Sheet, particularly glacial Lake Missoula in western Montana and northern Idaho. Studies of this region and the high-energy flood processes that generated it are stimulating (a) discoveries of similar megaflood-related landscapes around the world and on Mars, (b) enhanced understanding of the processes involved in the fluvial erosion of bedrock, and (c) the use of paleoflood indicators for understanding the magnitudes and frequency of flooding.

  20. Post-granulite facies fluid infiltration in the Adirondack Mountains

    SciTech Connect

    Morrison, J.; Valley, J.W.

    1988-06-01

    Granulite facies lithologies from the Adirondack Mountains of New York contain alteration assemblages composed dominantly of calcite +/- chlorite +/- sericite. These assemblages document fluid infiltration at middle to upper crustal levels. Cathodoluminescence of samples from the Marcy anorthosite massif indicates that the late fluid infiltration is more widespread than initially indicated by transmitted-light petrography alone. Samples that appear unaltered in transmitted light show extensive anastomosing veins of calcite (< 0.05 mm wide) along grain boundaries, in crosscutting fractures, and along mineral cleavages. The presence of the retrograde calcite documents paleopermeability in crystalline rocks and is related to the formation of high-density CO/sub 2/-rich fluid inclusions. Recognition of this process has important implications for studies of granulite genesis and the geophysical properties of the crust.