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Sample records for notes hybrid transvaginal

  1. Transvaginal Hybrid NOTES Procedure for Treatment of Gallstone Ileus

    PubMed Central

    Tomizawa, Naoki; Andoh, Tatsumasa; Arakawa, Kazuhisa; Enokida, Yasuaki; Ozawa, Naoya

    2016-01-01

    Gallstone ileus is a rare mechanical bowel obstruction, and previously reported cases have been treated laparoscopically with good results. Although transvaginal hybrid NOTES without a minilaparotomy has been reported to decrease the incidence of surgical wound complications, to our knowledge, this procedure has not been used previously to treat gallstone ileus. We present a case of a 63-year-old woman who underwent transvaginal hybrid NOTES procedure for treatment of gallstone ileus. This case was admitted to our hospital following acute-onset abdominal pain and vomiting. We diagnosed gallstone ileus with cholecystoduodenal fistula by computed tomography and performed totally laparoscopic surgery using only three 5 mm abdominal ports with transvaginal specimen extraction and enterectomy. The patient's postoperative course was uneventful, and laparoscopic cholecystectomy and fistula repair were performed 8 months after the initial surgery. The patient experienced additional pain relief and good cosmetic outcomes. In conclusion, using transvaginal hybrid NOTES may become a future option to minimize the invasiveness of other laparoscopic procedures. PMID:27429831

  2. Transvaginal Hybrid NOTES Procedure for Treatment of Gallstone Ileus.

    PubMed

    Shiraishi, Takuya; Tomizawa, Naoki; Andoh, Tatsumasa; Arakawa, Kazuhisa; Enokida, Yasuaki; Ozawa, Naoya

    2016-01-01

    Gallstone ileus is a rare mechanical bowel obstruction, and previously reported cases have been treated laparoscopically with good results. Although transvaginal hybrid NOTES without a minilaparotomy has been reported to decrease the incidence of surgical wound complications, to our knowledge, this procedure has not been used previously to treat gallstone ileus. We present a case of a 63-year-old woman who underwent transvaginal hybrid NOTES procedure for treatment of gallstone ileus. This case was admitted to our hospital following acute-onset abdominal pain and vomiting. We diagnosed gallstone ileus with cholecystoduodenal fistula by computed tomography and performed totally laparoscopic surgery using only three 5 mm abdominal ports with transvaginal specimen extraction and enterectomy. The patient's postoperative course was uneventful, and laparoscopic cholecystectomy and fistula repair were performed 8 months after the initial surgery. The patient experienced additional pain relief and good cosmetic outcomes. In conclusion, using transvaginal hybrid NOTES may become a future option to minimize the invasiveness of other laparoscopic procedures. PMID:27429831

  3. Systematic analysis of the safety and benefits of transvaginal hybrid-NOTES cholecystectomy

    PubMed Central

    Bulian, Dirk R; Knuth, Jurgen; Lehmann, Kai S; Sauerwald, Axel; Heiss, Markus M

    2015-01-01

    AIM: To evaluate transvaginal hybrid-NOTES cholecystectomy (TVC) during its clinical establishment and compare it with the traditional laparoscopic technique (LC). METHODS: The specific problems and benefits of TVC were reviewed using a registry analysis, a comparative cohort study and a randomized clinical trial. At first, feasibility, safety and specific complications of the TVC were analyzed based on the first 488 data sets of the German NOTES Registry (GNR). Hereafter, we compared the early postoperative results of our first 50 TVC-patients with those of 50 female LC-patients matched by age, BMI and ASA classification. The same cohort was contacted an average of two years later to evaluate long-term results concerning pain and satisfaction with the aesthetic results and the overall postoperative results as well as sexual intercourse by means of two domains of the German version of the Female Sexual Function Index (FSFI-d). Consequently, we performed a randomized clinical trial comparing 20 TVC-patients with 20 needlescopic/3-trocar cholecystectomies (NC) also concerning the early postoperative results as well as pain, satisfaction and quality of life by means of the Eypasch Gastrointestinal Quality of Life Index (GIQLI) in the later course. Finally, we discussed the results in accordance with other published studies. RESULTS: The complication (3.5%) and conversion rates (4.1%) for TVC were low in the GNR and comparable to those of the LC. Access related intraoperative complications included injuries to the bladder (n = 4; 0.8%) and bowel (n = 3; 0.6%). The study cohort revealed less postoperative pain after TVC comparing to the LC-patients on the day of surgery (NRS, 1.5/10 vs 3.1/10, P = 0.003), in the morning (NRS, 1.9/10 vs 2.8/10, P = 0.047) and in the evening (NRS, 1.1/10 vs 1.8/10, P = 0.025) of postoperative day (POD) one. The randomized clinical trial consistently found less cumulative pain until POD 2 (NRS, 8/40 vs 14/40, P = 0.043), as well as until

  4. Emergency transvaginal hybrid natural orifice transluminal endoscopic surgery.

    PubMed

    Noguera, J F; Cuadrado, A; Sánchez-Margallo, F M; Dolz, C; Asencio, J M; Olea, J M; Morales, R; Lozano, L; Vicens, J C

    2011-05-01

    In a clinical series, 10 consecutive female patients with intra-abdominal infections were successfully treated with natural orifice transluminal endoscopic surgery (NOTES) performed transvaginally. The surgery, which consisted of a hybrid NOTES procedure using a transvaginal approach, was performed on an emergency basis by the surgical team on call. The indications for surgery were acute cholecystitis (n = 6), acute appendicitis (n = 2), and pelvic peritonitis (n = 2) with intra-abdominal infection. The procedure was successfully performed in all patients using a dual-channel endoscope and mini-laparoscopy assistance. This is the first clinical series in which NOTES has been performed on an emergency basis to treat intra-abdominal infections. Transvaginal surgery for intra-abdominal infection is a feasible procedure for groups experienced in the elective NOTES approach. PMID:21165824

  5. [Transvaginal hybrid natural orifice translumenal endoscopic surgery appendectomy].

    PubMed

    Wada, Norihito; Tanabe, Minoru; Kataoka, Fumio; Kitagawa, Yuko

    2013-11-01

    Natural orifice translumenal endoscopic surgery (NOTES) is considered the ultimate minimally invasive intervention for visceral disease. The transvaginal route is now the only one that can be used for NOTES procedures in daily clinical practice. We performed hybrid NOTES appendectomy that was preevaluated and approved by the Japan NOTES and Institutional Review Board. A 5-mm trocar was inserted transumbilically and used for laparoscope access. An additional transumbilical 2.3-mm port was placed, through which the surgeon inserted a grasper. We created a transvaginal port with a long 12-mm trocar. Laparoscopic instruments such as a vessel sealing system, surgical staplers, and a retrieval bag were introduced, and the surgical technique consequently became safer, although the access route was limited. The appendix was removed transvaginally. The patient did not need epidural anesthesia or any pain medication. The cosmetic results were better than that of conventional single-port surgery. Triangulation is achieved in this procedure, which makes the surgery easier. To generalize NOTES to many types of surgery and enable it to be performed in men, the transgastric approach is essential. The development of flexible instruments designed for NOTES is also necessary. PMID:24358726

  6. Transvaginal NOTES cholecystectomy in my partner? No way!

    PubMed Central

    Stefaniak, Tomasz; Dobrowolski, Sebastian; Makarewicz, Wojciech; Łachiński, Andrzej J.; Śledziński, Zbigniew

    2011-01-01

    Introduction Natural orifice transluminal endoscopic surgery (NOTES) transvaginal cholecystectomy is being intensively studied. A few studies have been recently published evaluating patients’ attitude towards NOTES with its individual accesses. However, the choice of a transvaginal access with its potential influence on sex life and fertility is not restricted entirely to women. The sexual partner would at least give his opinion or decide together with the woman. Aim The aim of the study was to assess the attitude of male sexual partners of potential NOTES transvaginal patients towards the surgical access. Material and methods Hundred males were asked for their opinion in a specially designed instrument. Results The general attitude of male sexual partners of potential NOTES transvaginal cholecystectomy patients is negative. With several possible problems and complications feared by the partners, they would mostly oppose or dissuade against NOTES transvaginal cholecystectomy. The cosmetic benefit seems not to justify undergoing a novelty procedure with potential complications threatening sexual life and procreation. This attitude was especially observed in young, sexually active males with high appreciation of sexual life. Conclusions Both scientific and educational efforts are required to prove safety and efficiency of NOTES transvaginal cholecystectomy beyond question. PMID:23255986

  7. Transvaginal endoscopic appendectomy.

    PubMed

    Shin, Eung Jin; Jeong, Gui Ae; Jung, Jun Chul; Cho, Gyu Seok; Lim, Chul Wan; Kim, Hyung Chul; Song, Ok Pyung

    2010-12-01

    Since Kalloo and colleagues first reported the feasibility and safety of a peroral transgastric approach in the porcine model in 2004, various groups have reported more complex natural orifice transluminal endoscopic surgery (NOTES) procedures, such as the cholecystectomy, splenectomy and liver biopsy, in the porcine model. Natural orifice access to the abdominal cavity, such as transgastric, transvesical, transcolonic, and transvaginal, has been described. Although a novel, minimally invasive approach to the abdominal cavity is a peroral endoscopic transgastric approach, there are still some challenging issues, such as the risk of infection and leakage, and the method of gastric closure. Hybrid-NOTES is an ideal first step in humans. Human hybrid transvaginal access has been used for years by many surgeons for diagnostic and therapeutic purposes. Here, we report a transvaginal flexible endoscopic appendectomy, with a 5-mm umbilical port using ultrasonic scissors in a 74-year-old woman with acute appendicitis. PMID:21221245

  8. New trend in endoscopic surgery: transvaginal appendectomy NOTES (Natural Orifice Transluminal Endoscopic Surgery).

    PubMed

    Tabutsadze, T; Kipshidze, N

    2009-03-01

    Natural Orifice Transluminal Endoscopic Surgery is a new method of mini invasive surgery, which involves passing surgical instruments, and a tiny camera, through a natural orifice, such as the mouth, vagina, urethra or rectum, what provides the access to the desired organ. The procedure is approved due to its benefits - less pain, quicker recoveries, fewer complications and no scar - as it lets us avoid major incisions through the skin, muscle and nerves of the abdomen. Besides that the transluminal access is considered to be the most safe and feasible for clinical application. Here are discussed the two operations of Transvaginal Appendectomy performed in Caucasus - Academician N. Kipshidze University Hospital in Tbilisi. The first patient - a 28-year woman, weight - 72 kg, height - 180 cm, married, has one child - was submitted to the hospital with anamnesis of 48 hours acute appendicitis, typical clinical semiotics and laboratory records. In the second case the patient was a 22-year old woman, height - 170 cm, weight - 68 kg, married, with 2 children. She was hospitalized with 24 hours acute appendicitis anamnesis and typical clinical semiotics and laboratory records. Both operations were performed under general anesthesia, using Karl Storz GmbH & Co. equipment. The duration of the first procedure was 76 minutes and the second operation lasted for 88 minutes. The operations were made without any technical difficulties or complications. None of the patients had the need of non-narcotic analgesia during the post-operational period. No gynecological or surgical problems or any complications were detected during the observation period. The patients had superior postoperative evolution, so the stationary stay made up 36 hours after the first operation and 30 hours after the second. Essentially NOTES is a new trend in endoscopic surgery - the non-scar surgery with major advantages compared to the conventional - the NOTES takes endoscopic surgery one step further in

  9. Transvaginal Appendectomy: A Systematic Review

    PubMed Central

    Yagci, Mehmet Ali; Kayaalp, Cuneyt

    2014-01-01

    Background. Natural orifice transluminal endoscopic surgery (NOTES) is a new approach that allows minimal invasive surgery through the mouth, anus, or vagina. Objective. To summarize the recent clinical appraisal, feasibility, complications, and limitations of transvaginal appendectomy for humans and outline the techniques. Data Sources. PubMed/MEDLINE, Cochrane, Google-Scholar, EBSCO, clinicaltrials.gov and congress abstracts, were searched. Study Selection. All related reports were included, irrespective of age, region, race, obesity, comorbidities or history of previous surgery. No restrictions were made in terms of language, country or journal. Main Outcome Measures. Patient selection criteria, surgical techniques, and results. Results. There were total 112 transvaginal appendectomies. All the selected patients had uncomplicated appendicitis and there were no morbidly obese patients. There was no standard surgical technique for transvaginal appendectomy. Mean operating time was 53.3 minutes (25–130 minutes). Conversion and complication rates were 3.6% and 8.2%, respectively. Mean length of hospital stay was 1.9 days. Limitations. There are a limited number of comparative studies and an absence of randomized studies. Conclusions. For now, nonmorbidly obese females with noncomplicated appendicitis can be a candidate for transvaginal appendectomy. It may decrease postoperative pain and enable the return to normal life and work off time. More comparative studies including subgroups are necessary. PMID:25614832

  10. Transvaginal appendectomy: a systematic review.

    PubMed

    Yagci, Mehmet Ali; Kayaalp, Cuneyt

    2014-01-01

    Background. Natural orifice transluminal endoscopic surgery (NOTES) is a new approach that allows minimal invasive surgery through the mouth, anus, or vagina. Objective. To summarize the recent clinical appraisal, feasibility, complications, and limitations of transvaginal appendectomy for humans and outline the techniques. Data Sources. PubMed/MEDLINE, Cochrane, Google-Scholar, EBSCO, clinicaltrials.gov and congress abstracts, were searched. Study Selection. All related reports were included, irrespective of age, region, race, obesity, comorbidities or history of previous surgery. No restrictions were made in terms of language, country or journal. Main Outcome Measures. Patient selection criteria, surgical techniques, and results. Results. There were total 112 transvaginal appendectomies. All the selected patients had uncomplicated appendicitis and there were no morbidly obese patients. There was no standard surgical technique for transvaginal appendectomy. Mean operating time was 53.3 minutes (25-130 minutes). Conversion and complication rates were 3.6% and 8.2%, respectively. Mean length of hospital stay was 1.9 days. Limitations. There are a limited number of comparative studies and an absence of randomized studies. Conclusions. For now, nonmorbidly obese females with noncomplicated appendicitis can be a candidate for transvaginal appendectomy. It may decrease postoperative pain and enable the return to normal life and work off time. More comparative studies including subgroups are necessary. PMID:25614832

  11. [Gynecological surgery using a transvaginal approach].

    PubMed

    Tanaka, Masaaki

    2013-11-01

    The vagina is a unique organ, directly abutting the peritoneal cavity but showing no visible scars after incision of the vaginal wall. Since 2003, we have performed ovarian cystectomy with a vaginal approach in 120 patients. To perform culdotomy without failure, we developed a new culdotomy technique with transvaginal ultrasound and an umbrella Hakko needle, which has potential applicability in transvaginal natural orifice translumenal endoscopic surgery (NOTES). All cystectomies were completed without conversion to laparotomy. Laparoscopy was required to complete cystectomy in 3% of cases. No major intraoperative complications, including rectal injury, occurred. Since 2009, we have started to use flexible endoscopy transvaginally. In 20 cases, this enabled us to observe or wash the intraperitoneal cavity and remove the cyst. An anonymous questionnaire was sent to 73 patients with a mean age of 31.9 years who had undergone vaginal ovarian cystectomy more than 6 months previously. This questionnaire included questions about fertility, dyspareunia, and satisfaction after surgery, and 60% of patients returned completed questionnaires. The pregnancy rate among women younger than 30 years of age was 60%, and none developed permanent dyspareunia. The average patient satisfaction score was 4.12 (on a 5-point scale). Transvaginal ovarian surgery can be an alternative to laparoscopic surgery for patients who desire minimally invasive treatment, and transvaginal NOTES is expected to become the new model of minimally invasive surgery. PMID:24358727

  12. Transvaginal ultrasound (image)

    MedlinePlus

    Transvaginal ultrasound is a method of imaging the genital tract in females. A hand held probe is inserted directly ... vaginal cavity to scan the pelvic structures, while ultrasound pictures are viewed on a monitor. The test ...

  13. Ovariohysterectomy in a dog by a hybrid NOTES technique

    PubMed Central

    Brun, Maurício V.; Silva, Marco A.M.; Mariano, Mirandolino B.; Motta, Adriana C.; Colomé, Lucas M.; Feranti, João P.S.; Pohl, Virgínia L.; Ataide, Michelli W.; Guedes, Rogério L.; Santos, Fabiane R.

    2011-01-01

    This report demonstrates the feasibility of an elective ovariosalpingohysterectomy by natural transluminal endoscopic surgery (NOTES) hybrid technique in a dog. A 5-mm abdominal cannula was used in combination with a 10-mm cannula (vaginal access). The patient’s quick recovery and the absence of complications are indicative of the effectiveness of this surgery. PMID:22131580

  14. Transvaginal appendectomy in morbidly obese patient.

    PubMed

    Yagci, Mehmet Ali; Kayaalp, Cuneyt; Ates, Mustafa

    2014-01-01

    Introduction. Laparoscopic appendectomy has significant benefits in obese patients. However, morbid obesity can be accepted as an exclusion criterion for natural orifice transluminal endoscopic surgery (NOTES). Here, we present a transvaginal appendectomy in a 66-year-old morbidly obese (BMI 36 kg/m(2), ASA III) patient. Case and Technique. Acute appendicitis was suspected based on history, physical examination, laboratory tests, and ultrasound findings. During laparoscopic surgery, a 5 mm trocar was inserted through the umbilicus and a 5 mm telescope was placed. A 12 mm trocar and a 5 mm grasper were inserted separately through the posterior fornix of the vagina under laparoscopic guidance. The appendix was divided with an endoscopic stapler through the transvaginal 12 mm trocar and removed from the same trocar. The operating time was 75 minutes with minimal blood loss (<10 mL). The patient was discharged 16 hours after surgery uneventfully and she did not require any analgesic administration. Conclusion. To the best of our knowledge, this is the first clinical case that focuses on the transvaginal appendectomy at morbid obesity. We can say that morbid obesity does not constitute an obstacle for treatment of acute appendicitis by transvaginal endoscopic surgery. PMID:25506028

  15. A Hybrid Approach to Extracting Disorder Mentions from Clinical Notes

    PubMed Central

    Wang, Chunye; Akella, Ramakrishna

    2015-01-01

    Crucial information on a patient’s physical or mental conditions is provided by mentions of disorders, such as disease, syndrome, injury, and abnormality. Identifying disorder mentions is one of the most significant steps in clinical text analysis. However, there are many surface forms of the same concept documented in clinical notes. Some are even recorded disjointedly, briefly, or intuitively. Such difficulties have challenged the information extraction systems that focus on identifying explicit mentions. In this study, we proposed a hybrid approach to disorder extraction, which leverages supervised machine learning, rule-based annotation, and an unsupervised NLP system. To identify different surface forms, we exploited rich features, especially the semantic, syntactic, and sequential features, for better capturing implicit relationships among words. We evaluated our method on the CLEF 2013 eHealth dataset. The experiments showed that our hybrid approach achieves a 0.776 F-score under strict evaluation standards, outperforming any participating systems in the Challenge. PMID:26306265

  16. A Hybrid Model for Automatic Emotion Recognition in Suicide Notes

    PubMed Central

    Yang, Hui; Willis, Alistair; de Roeck, Anne; Nuseibeh, Bashar

    2012-01-01

    We describe the Open University team’s submission to the 2011 i2b2/VA/Cincinnati Medical Natural Language Processing Challenge, Track 2 Shared Task for sentiment analysis in suicide notes. This Shared Task focused on the development of automatic systems that identify, at the sentence level, affective text of 15 specific emotions from suicide notes. We propose a hybrid model that incorporates a number of natural language processing techniques, including lexicon-based keyword spotting, CRF-based emotion cue identification, and machine learning-based emotion classification. The results generated by different techniques are integrated using different vote-based merging strategies. The automated system performed well against the manually-annotated gold standard, and achieved encouraging results with a micro-averaged F-measure score of 61.39% in textual emotion recognition, which was ranked 1st place out of 24 participant teams in this challenge. The results demonstrate that effective emotion recognition by an automated system is possible when a large annotated corpus is available. PMID:22879757

  17. Systematic Review and Meta-analysis of Complications in Transvaginal Approach in Laparoscopic Surgery.

    PubMed

    Komorowski, Andrzej L; Alba Mesa, Francisco; Bała, Małgorzata M; Mituś, Jerzy W; Wysocki, Wojciech M

    2015-12-01

    Transvaginal access is the most popular natural orifice translumenal technique in the minimally invasive surgery. Reviews on non-gynecological transvaginal approach morbidities reveal that rates vary greatly. A systematic review of transvaginal approach in non-gynecological intraabdominal procedures was carried out to assess the risk of complications. A systematic search was conducted using MEDLINE, EMBASE, PubMed, and the Cochrane Library from the inception of these databases to March 2012. The following keywords were searched: "transvaginal", "NOTES", "single incision", and "single port". From the total of 231 potentially eligible abstracts, 87 papers were retrieved and evaluated as fulfilling the eligibility criteria. The final analysis included 32 articles. The overall complications rate was 4.4 %, and complications related to the transvaginal port reached 2.4 %. Conversion rate to open surgery was 3.4 %. The incidence of postoperative urinary tract infection was 0.8 %. The mean operative time was 119 min. The mean hospital stay was 3.1 days (range 6 h-12 days). The technique of transvaginal access can offer several advantages for a patient and is associated with an acceptable rate of complications. PMID:27011470

  18. Anaphylaxis following a transvaginal ultrasound.

    PubMed

    Jakubovic, Baruch D; Saperia, Corey; Sussman, Gordon L

    2016-01-01

    Polyethylene glycol is a ubiquitous, water-soluble, organic compound found in a wide variety of commercially available products. While generally a benign substance, in rare instances, it can induce hypersensitivity reactions. Herein, we describe a case of anaphylaxis to polyethylene glycol-containing lubricating gel used for a transvaginal ultrasound. This case highlights the importance of early recognition of a rare cause of anaphylaxis that may occur in the health-care setting. It is of particular importance given the widespread use of similar lubricating materials in multiple practice settings for the use of internal examinations and ultrasonography. PMID:26807134

  19. Transvaginal Mini-Laparoscopic Splenectomy

    PubMed Central

    Yagci, Mehmet Ali A; Sumer, Fatih

    2015-01-01

    We aimed to perform a more and more minimal invasive splenectomy by only through two 5 mm umbilical trocars and one vaginal trocar. A 43-year-old female (BMI 31 kg/m2, ASA II) with immune thrombocytopenic purpura was planned for splenectomy. She had a history of a previous cesarean section for three times. Two 5 mm trocars were inserted separately through the umbilicus. We did not use any single port device or similar modifications. A 15 mm trocar was inserted through the posterior fornix of the vagina under umbilical laparoscopic vision. The 5 mm umbilical ports were used for camera and retraction of the spleen. The transvaginal port was used for dissection and division of the spleen by a 10-mm LigaSure Atlas vessel sealing system. No clips or staples were used. As the spleen became completely free in the abdomen, it was removed through the vagina in a bag without fragmentation. The operating time was 200 minutes and the blood loss was minimal (< 20 ml). No drain or abdominal fascia suturing was used but closing the posterior fornix of the vagina. Her postoperative course was uneventful and she was discharged on day two without complication. She did not require any analgesics postoperatively. Platelet values increased to 408.000 mm3 in the follow-up. To the best of our knowledge, this report described the most minimal invasive splenectomy even. Additionally, it provided an unfragmented spleen extraction. The transvaginal approach seems to be a feasible way to perform natural orifice splenectomy.  PMID:26543694

  20. Transvaginal Mini-Laparoscopic Splenectomy.

    PubMed

    Yagci, Mehmet Ali A; Kayaalp, Cuneyt; Sumer, Fatih

    2015-01-01

    We aimed to perform a more and more minimal invasive splenectomy by only through two 5 mm umbilical trocars and one vaginal trocar. A 43-year-old female (BMI 31 kg/m(2), ASA II) with immune thrombocytopenic purpura was planned for splenectomy. She had a history of a previous cesarean section for three times. Two 5 mm trocars were inserted separately through the umbilicus. We did not use any single port device or similar modifications. A 15 mm trocar was inserted through the posterior fornix of the vagina under umbilical laparoscopic vision. The 5 mm umbilical ports were used for camera and retraction of the spleen. The transvaginal port was used for dissection and division of the spleen by a 10-mm LigaSure Atlas vessel sealing system. No clips or staples were used. As the spleen became completely free in the abdomen, it was removed through the vagina in a bag without fragmentation. The operating time was 200 minutes and the blood loss was minimal (< 20 ml). No drain or abdominal fascia suturing was used but closing the posterior fornix of the vagina. Her postoperative course was uneventful and she was discharged on day two without complication. She did not require any analgesics postoperatively. Platelet values increased to 408.000 mm(3) in the follow-up. To the best of our knowledge, this report described the most minimal invasive splenectomy even. Additionally, it provided an unfragmented spleen extraction. The transvaginal approach seems to be a feasible way to perform natural orifice splenectomy. PMID:26543694

  1. Noted

    ERIC Educational Resources Information Center

    Nunberg, Geoffrey

    2013-01-01

    Considering how much attention people lavish on the technologies of writing--scroll, codex, print, screen--it's striking how little they pay to the technologies for digesting and regurgitating it. One way or another, there's no sector of the modern world that is not saturated with note-taking--the bureaucracy, the liberal professions, the…

  2. [The future of gastrointestinal therapeutic endoscopy: NOTES].

    PubMed

    Dray, X; Marteau, P

    2009-01-01

    Natural orifice translumenal endoscopic surgery (NOTES) allows access into the peritoneal cavity with a flexible endoscope, through the wall of the digestive or urogenital tracts. NOTES can be combined to laparoscopic surgery in so-called < hybrid > techniques. In the absence of any incision of the abdominal wall, NOTES procedures provide perfect cosmetic results, with virtually no risk of parietal complications, and with decreased postoperative pain. NOTES could particularly benefit to overweight patients and to patients receiving intensive or palliative care. Most NOTES studies have been performed on animal models, with great interest for both transgastric and transpelvic approaches. Successful NOTES peritoneoscopy, hysterectomy, oophorectomy, tubal ligation, gastrojejunal anastomosis, cholecystectomy, splenectomy, nephrectomy, and abdominal-wall hernia repair have been described. In human studies, the transvaginal route is preferred. NOTES clinical research focuses on low-morbidity procedures, such as cholecystectomy, appendectomy, and peritoneoscopy. Indirect benefits are expected from this research, with possible technological innovations in the field of endoscopic instrumentation (including sutures, anastomosis, traction and triangulation). Overall, NOTES is believed to make evolve both interventional endoscopy and minimally invasive surgery. PMID:19683406

  3. Total Laparoscopic Hysterectomy in Patients with Large Uteri: Comparison of Uterine Removal by Transvaginal and Uterine Morcellation Approaches

    PubMed Central

    Wang, Haibo; Li, Ping; Li, Xiujuan; Gao, Licai; Lu, Caihong; Zhao, Jinrong; Zhou, Ai-ling

    2016-01-01

    The aim of this study was to compare the clinical results of total laparoscopic hysterectomy (TLH) for large uterus with uterus size of 12 gestational weeks (g.w.) or greater through transvaginal or uterine morcellation approaches. We retrospectively collected the clinical data of those undergoing total laparoscopic hysterectomies between January 2004 and June 2012. Intraoperative and postoperative outcomes were compared between patients whose large uterus was removed through transvaginal or morcellation approaches. The morcellation group has significantly shorter mean operation time and uterus removal time and smaller incidence of intraoperative complications than the transvaginal group (all P < 0.05). No statistical significant difference regarding the mean blood loss, uterine weight, and length of hospital stay was noted in the morcellation and transvaginal groups (all P > 0.05). In two groups, there was one patient in each group who underwent conversion to laparotomy due to huge uterus size. With regard to postoperative complications, there was no statistical significant difference regarding the frequencies of pelvic hematoma, vaginal stump infection, and lower limb venous thrombosis in two groups (all P > 0.05). TLH through uterine morcellation can reduce the operation time, uterus removal time, and the intraoperative complications and provide comparable postoperative outcomes compared to that through the transvaginal approaches. PMID:27419141

  4. Transvaginal Laparoscopic Appendectomy Simultaneously with Vaginal Hysterectomy: Initial Experience of 10 Cases

    PubMed Central

    Tian, Yu; Wu, Shuo-Dong; Chen, Ying-Han; Wang, Dan-Bo

    2014-01-01

    Background Natural orifice transluminal endoscopic surgery (NOTES) involves the introduction of instruments through a natural orifice into the peritoneal cavity to perform surgical interventions. The vagina is the most widely used approach to NOTES. We report the utilization of the vaginal opening at the time of vaginal hysterectomy as a natural orifice for laparoscopic appendectomy. Material/Methods We reviewed cases of 10 patients with chronic appendicitis who underwent transvaginal laparoscopic appendectomy simultaneously with vaginal hysterectomy. A laparoscopic approach was established after removal of the uterus, and the appendix was removed transvaginally. Among the 10 cases, 5 were conducted under gasless laparoscopy by using a simple abdominal wall-lifting instrument. Results All procedures were performed successfully without intraoperative or major postoperative complications. The appendectomy portion of the procedure took approximately 21 minutes to 34 minutes. All patients were discharged less than 4 days after surgery, without external scars. Conclusions Transvaginal appendectomy with rigid laparoscopic instruments following vaginal hysterectomy appears to be a feasible and safe modification of established techniques, with acceptable outcomes. PMID:25300522

  5. Systemic Inflammatory Response After Natural Orifice Translumenal Surgery: Transvaginal Cholecystectomy in a Porcine Model

    PubMed Central

    Fan, Joe K. M.; Tong, Daniel K. H.; HO, David W. Y.; Luk, John; Law, Simon

    2009-01-01

    Objective: We analyzed circulating TNF-α and IL-6 to determine systemic inflammatory responses associated with transvaginal cholecystectomy in a porcine model. Methods: Six female pigs were used for a survival study after transvaginal cholecystectomy (NOTES group) using endoscopic submucosal dissection (ESD) instruments and a single-channel endoscope. Blood was drawn preoperatively and 24 hours and 48 hours postoperatively. Four pigs were used as controls. In addition, laparoscopic cholecystectomy was performed in 2 pigs for laparoscopic control. Results: In all 6 pigs in the NOTES group, no major intraoperative complications occurred. No significant differences were found between control, laparoscopic, and NOTES groups in terms of preoperative IL-6 level (P=0.897) and at 24 hours (P=0.790), and 48 hours postoperatively (P=0.945). Similarly, there was no significant difference in mean preoperative (P=0.349) and mean day 2 postoperative TNF-α levels (P=0.11). But a significant increase in day 1 postoperative TNF-α levels in the laparoscopic group compared with that in the control and NOTES groups was observed (P=0.049). One limitation of our study is that the sample size was relatively small. Conclusion: NOTES is safe in animal models in terms of anatomical and cellular level changes with minimal systemic inflammatory host responses elicited. Further study needs to be carried out in humans before NOTES can be recommended for routine use. PMID:19366533

  6. Tuboovarian Abscess Caused by Atopobium vaginae following Transvaginal Oocyte Recovery

    PubMed Central

    Geißdörfer, Walter; Böhmer, Christoph; Pelz, Klaus; Schoerner, Christoph; Frobenius, Wolfgang; Bogdan, Christian

    2003-01-01

    A 39-year-old woman with tubarian sterility fell ill with acute pelvic inflammatory disease 2 months after transvaginal oocyte recovery. Laparotomy revealed a large tuboovarian abscess, from which Atopobium vaginae, an anaerobic gram-positive coccoid bacterium of hitherto unknown clinical significance, was isolated. The microbial etiology and the risk of pelvic infections following transvaginal punctures are discussed. PMID:12791933

  7. Parametric mapping of contrasted ovarian transvaginal sonography.

    PubMed

    Korhonen, Katrina; Moore, Ryan; Lyshchik, Andrej; Fleischer, Arthur C

    2015-06-01

    The purpose of this study was to assess the accuracy of parametric analysis of transvaginal contrast-enhanced ultrasound (TV-CEUS) for distinguishing benign versus malignant ovarian masses. A total of 48 ovarian masses (37 benign and 11 borderline/malignant) were examined with TV-CEUS (Definity; Lantheus, North Billerica, MA; Philips iU22; Philips Medical Systems, Bothell, WA). Parametric images were created offline with a quantification software (Bracco Suisse SA, Geneva, Switzerland) with map color scales adjusted such that abnormal hemodynamics were represented by the color red and the presence of any red color could be used to differentiate benign and malignant tumors. Using these map color scales, low values of the perfusion parameter were coded in blue, and intermediate values of the perfusion parameter were coded in yellow. Additionally, for each individual color (red, blue, or yellow), a darker shade of that color indicated a higher intensity value. Our study found that the parametric mapping method was considerably more sensitive than standard region of interest (ROI) analysis for the detection of malignant tumors but was also less specific than standard ROI analysis. Parametric mapping allows for stricter cutoff criteria, as hemodynamics are visualized on a finer scale than ROI analyses, and as such, parametric maps are a useful addition to TV-CEUS analysis by allowing ROIs to be limited to areas of the highest malignant potential. PMID:26002525

  8. Towards scar-free surgery: An analysis of the increasing complexity from laparoscopic surgery to NOTES

    PubMed Central

    Chellali, Amine; Schwaitzberg, Steven D.; Jones, Daniel B.; Romanelli, John; Miller, Amie; Rattner, David; Roberts, Kurt E.; Cao, Caroline G.L.

    2014-01-01

    Background NOTES is an emerging technique for performing surgical procedures, such as cholecystectomy. Debate about its real benefit over the traditional laparoscopic technique is on-going. There have been several clinical studies comparing NOTES to conventional laparoscopic surgery. However, no work has been done to compare these techniques from a Human Factors perspective. This study presents a systematic analysis describing and comparing different existing NOTES methods to laparoscopic cholecystectomy. Methods Videos of endoscopic/laparoscopic views from fifteen live cholecystectomies were analyzed to conduct a detailed task analysis of the NOTES technique. A hierarchical task analysis of laparoscopic cholecystectomy and several hybrid transvaginal NOTES cholecystectomies was performed and validated by expert surgeons. To identify similarities and differences between these techniques, their hierarchical decomposition trees were compared. Finally, a timeline analysis was conducted to compare the steps and substeps. Results At least three variations of the NOTES technique were used for cholecystectomy. Differences between the observed techniques at the substep level of hierarchy and on the instruments being used were found. The timeline analysis showed an increase in time to perform some surgical steps and substeps in NOTES compared to laparoscopic cholecystectomy. Conclusion As pure NOTES is extremely difficult given the current state of development in instrumentation design, most surgeons utilize different hybrid methods – combination of endoscopic and laparoscopic instruments/optics. Results of our hierarchical task analysis yielded an identification of three different hybrid methods to perform cholecystectomy with significant variability amongst them. The varying degrees to which laparoscopic instruments are utilized to assist in NOTES methods appear to introduce different technical issues and additional tasks leading to an increase in the surgical time. The

  9. Exploration of the retroperitoneum using the transvaginal natural orifice transluminal endoscopic surgery technique.

    PubMed

    Zacharopoulou, Chrysoula; Nassif, Joseph; Allemann, Pierre; Dallemagne, Bernard; Perretta, Silvana; Marescaux, Jacques; Wattiez, Arnaud

    2009-01-01

    We sought to evaluate the feasibility of the retroperitoneum's exploration via natural orifice transluminal endoscopic surgery (NOTES) using transvaginal access in a porcine model, and its possible application in human beings. Six female pigs (25-30 kg) were used to establish anatomic landmarks and technical steps. Six additional pigs were used for the survival study. Under general anesthesia and with the pig supine, a 1-cm posterolateral colpotomy was performed with the double-channel gastroscope's needle knife. The incision was enlarged laterally using blunt dissection while keeping in contact with the psoas muscle. A retroperitoneal tunnel was created using carbon-dioxide dissection and the movements of the gastroscope up to the level of the kidney. The colpotomy site was closed using interrupted sutures (polyglactin 2/0). A follow-up laparoscopy and necropsy were performed 3 weeks postoperatively. Successful access to the retroperitoneum was achieved in all pigs with a mean operative time of 30 minutes. However, in the first 3 pigs used for the acute study, the peritoneum was perforated during the six-pig dissection and the procedure was abandoned because of the space's collapse. No perforation occurred during the survival study. An excellent view of the retroperitoneal space and structures, such as the vascular and lymphatic tissues, the kidney, the adrenal gland, and the ureter, was obtained. No intraoperative complications or bleeding or injury to any of the retroperitoneal structures occurred. The 3-week follow-up laparoscopy showed no adhesions or abscesses. These findings were confirmed at necropsy. The retroperitoneal space can be successfully accessed via NOTES. Transvaginal NOTES access to the retroperitoneum avoids any transparietal trocars, so it could decrease surgical trauma, be better tolerated, and offer better visualization, with the obvious gender limitation. Future clinical application in human beings may include procedures such as

  10. Note. Switch-Mode Hybrid Current Controllers for Quantum Cascade Lasers

    SciTech Connect

    Taubman, Matthew S.

    2013-01-07

    Chemical sensing in the mid-infrared has been revolutionized by the advent of quantum cascade lasers. Their higher current and voltage demands compared to laser diodes however, negatively impact size, weight and power footprint for fieldable systems, particularly in hot environments. This letter presents a switch-mode/linear hybrid controller design, furnishing low-noise drive current up to 2 amperes at compliance voltages up to 15 volts, with noise levels close to the Johnson noise of the internal resistors. Current modulation from near zero to 1.8 Amps is also demonstrated at frequencies up to a kilohertz.

  11. Transvaginal aspiration of ovarian cysts: our experience over 121 cases.

    PubMed

    Koutlaki, Nikoleta; Nikas, Ioannis; Dimitraki, Marina; Grapsas, Xenofon; Psillaki, Afrodite; Mandratzi, Jeyaver; Liberis, Anastasios; Liberis, Vasilios

    2011-05-01

    We performed an evaluation of ultrasound-guided transvaginal aspiration of ovarian cysts as a viable alternative to surgery in 104 reproductive and 17 postmenopausal women. One-hundred and twenty-one patients with a simple >4 cm diameter ovarian cyst, with a benign appearance on ultrasound as well as on clinical and blood examination, underwent transvaginal fine needle aspiration of the cyst under ultrasonographic control. One-hundred and four patients were of reproductive age and 12 were postmenopausal. Sixty women who were of reproductive age and in which OCP treatment was not contraindicated followed a six-month therapy with oral contraceptives after the intervention. In the group of patients of reproductive age under OCP treatment the cyst persisted in nine of the 60 women (recurrence rate 15%). In the other group of patients of reproductive age,under no OCP treatment, the recurrence rate was 47% (21 of the 44 women). In the group of postmenopausal patients, the cyst persisted in ten out of 17 cases (recurrence rate 58,9%). Transvaginal aspiration of ovarian cysts is a reliable alternative to surgery with many advantages such as excellent tolerance, low risk and cost of complications and recurrence. The OCP treatment after aspiration seems to increase the success rate of expectant management. PMID:21082900

  12. Natural orifice transluminal endoscopic surgery (NOTES) for clinical management of intra-abdominal diseases.

    PubMed

    Liu, Liu; Chiu, Philip W Y; Reddy, Nagewasher; Ho, Khek-Yu; Kitano, Seigo; Seo, Dong Wan; Tajiri, Hisao

    2013-11-01

    Clinical research on natural orifice transluminal endoscopic surgery (NOTES) has been increasingly reported over the past 5 years and more than 1200 patients have received various NOTES procedures. The present article reviews the clinical practice of NOTES for the treatment of intra-abdominal diseases, and was carried out through systematic search with specific keywords in major databases for NOTES-related clinical literature. The last date of the search was 15 August, 2012. Transvaginal cholecystectomy is the commonest NOTES procedure reported, and its clinical feasibility and safety was established through prospective case series and randomized trials. There is a regional difference in NOTES development with the majority of NOTES fromCaucasian countries being transvaginal cholecystectomy and most reports from Asian countries being NOTES-related procedures. Safe closure of gastrointestinal access remains challenging, and novel endoscopic instruments are essential to enhance future development of NOTES. PMID:23967798

  13. Note on starting the Numerov method more accurately by a hybrid formula of order four for an initial--value problem

    NASA Astrophysics Data System (ADS)

    Adee, S. O.; Onumanyi, P.; Sirisena, U. W.; Yahaya, Y. A.

    2005-03-01

    In this note we report a hybrid formula of order four for starting the Numerov method applied to the initial--value problem for y''=f(x,y), over the recently obtained result of order three by two different papers (J. Pure Appl. Sci. 2(2) (2002) 1, Abacus 29(2) (2002) 92), based on two different approaches. We illustrate the accuracy of the methods by two numerical examples.

  14. Achondrogenesis type 2 diagnosed by transvaginal ultrasound at 12 weeks' gestation.

    PubMed

    Soothill, P W; Vuthiwong, C; Rees, H

    1993-06-01

    Ultrasound examination at 12 weeks' gestation revealed severe generalised subcutaneous oedema in a pregnancy at risk for achondrogenesis type II. Transvaginal scanning confirmed the oedema and suggested abnormal limb development. The prenatal diagnosis was confirmed by X-ray examination after transvaginal termination. PMID:8372079

  15. Symptom Resolution After Operative Management of Complications From Transvaginal Mesh

    PubMed Central

    Crosby, Erin C.; Abernethy, Melinda; Berger, Mitchell B.; DeLancey, John O.; Fenner, Dee E.; Morgan, Daniel M.

    2014-01-01

    OBJECTIVE Complications from transvaginal mesh placed for prolapse often require operative management. The aim of this study is to describe the outcomes of vaginal mesh removal. METHODS A retrospective review of all patients having surgery by the Urogynecology group in the Department of Obstetrics & Gynecology at our institution for a complication of transvaginal mesh placed for prolapse was performed. Demographics, presenting symptoms, surgical procedures, and postoperative symptoms were abstracted. Comparative statistics were performed using the chi-squared or Fisher’s exact test with significance at p<0.05. RESULTS Between January 2008 and April 2012, 90 patients had surgery for complications related to vaginal mesh and 84 had follow-up data. The most common presenting signs and symptoms were: mesh exposure 62% (n=56), pain 64% (n=58), and dyspareunia 48% (n=43). During operative management, mesh erosion was encountered unexpectedly in a second area of the vagina in 5% (n=4), in the bladder in 1% (n=1), and in the bowel in 2% (n=2). After vaginal mesh removal, 51% (n=43) had resolution of all presenting symptoms. Mesh exposure was treated successfully in 95% of cases, while pain was only successfully treated in 51% of women. CONCLUSION Removal of vaginal mesh is helpful in relieving symptoms of presentation. Patients can be reassured that exposed mesh can almost always be successfully managed surgically, but pain and dyspareunia are only resolved completely in half of cases. PMID:24463673

  16. Transvaginal Aspiration of Ovarian Cysts: Long-Term Follow-up

    SciTech Connect

    Duke, D.; Colville, J.; Keeling, A.; Broe, D.; Fotheringham, T.; Lee, M.J.

    2006-06-15

    Background and purpose. Transvaginal aspiration of ovarian cysts has been advocated as a viable alternative to surgery in patients who are high-risk surgical candidates. We describe a retrospective study evaluating the results of transvaginal aspirations of benign ovarian cysts in patients at increased surgical risk, focusing on long-term follow-up for recurrence of the cyst and/or development of malignancy. Methods. Twenty-four women with ovarian cysts underwent 34 transvaginal drainages between October 1998 and December 2004. All patients were referred following diagnosis of a persistent ovarian cyst with a benign appearance on ultrasound. All patients were unsuitable candidates for surgery (history of previous pelvic surgery, n = 21; high risk for anesthesia, n = 1; and unsuitable for laparoscopy due to obesity, n = 2). Patients with a history of pregnancy, acute abdominal symptoms, or previous gynecologic malignancy were excluded. A 20G x 20 cm Chiba needle was used for transvaginal aspiration using an endocavity probe (Acuson XP, Mountain View, CA, USA; Siemens Sololine, Erlangen, Germany) and intravenous sedoanalgesia. Cysts were aspirated to dryness. Results. Long-term follow-up of patients was performed and revealed a recurrence rate of 75%. Eighty-three percent of cysts on the left and 42% of those on the right recurred. Nine of 15 (60%) patients with recurrence required further intervention. Two of 9 underwent surgical intervention only, 4 of 9 had repeat transvaginal aspiration(s) performed, and 3 of 9 had a combination of both transvaginal aspiration and surgery. No patient developed ovarian malignancy. Conclusion. Transvaginal cyst aspiration has many advantages including short hospital stay, rapid recovery, excellent patient tolerance, and a low rate of procedure-related complications. Our study demonstrates that ovarian cyst recurrence following transvaginal drainage is a more significant problem than previously documented, especially if the cyst is

  17. A transvaginal removal and repair of vesicovaginal fistula due to mesh erosion

    PubMed Central

    Mishra, Vineet V.; Tanvir, Tanvir; Choudhary, Sumesh; Goraniya, Nilesh

    2016-01-01

    Vesicovaginal fistula (VVF) is a devastating social problem. It can either result from obstetric trauma or following gynecological surgeries, malignancy, or radiation. We present a case of a 70-year-old woman who had a VVF following mesh augmentation surgery for anterior compartment prolapse. She required a transvaginal removal of the eroded mesh followed by a transvaginal repair of VVF using a Martius flap, 6 weeks later. Transvaginal removal of mesh is technically feasible and a good approach. Timing and route of surgery should be individualized. PMID:27499600

  18. Clinical complications after transvaginal oocyte retrieval: a retrospective analysis.

    PubMed

    Siristatidis, C; Chrelias, C; Alexiou, A; Kassanos, D

    2013-01-01

    There are little systematic data reported in the literature on complications observed after transvaginal oocyte retrieval (OR) guided by ultrasound. We report our experience in 542 in vitro fertilisation cycles. The frequency of severe complications in our patients was 0.72%; of these, two cases were bronchospasm during anaesthesia (0.36%) and two were cases of intraperitoneal bleeding (0.36%); minor vaginal bleeding was the most frequent complication (18.08%), which was treated easily. Through this retrospective analysis, it is evident that clinical suspicion is of particular importance in detecting post-OR complications on one hand, but on the other these complications are rare and most are treated conservatively. PMID:23259882

  19. Risk Factors for Mesh Exposure after Transvaginal Mesh Surgery

    PubMed Central

    Niu, Ke; Lu, Yong-Xian; Shen, Wen-Jie; Zhang, Ying-Hui; Wang, Wen-Ying

    2016-01-01

    Background: Mesh exposure after surgery continues to be a clinical challenge for urogynecological surgeons. The purpose of this study was to explore the risk factors for polypropylene (PP) mesh exposure after transvaginal mesh (TVM) surgery. Methods: This study included 195 patients with advanced pelvic organ prolapse (POP), who underwent TVM from January 2004 to December 2012 at the First Affiliated Hospital of Chinese PLA General Hospital. Clinical data were evaluated including patient's demography, TVM type, concomitant procedures, operation time, blood loss, postoperative morbidity, and mesh exposure. Mesh exposure was identified through postoperative vaginal examination. Statistical analysis was performed to identify risk factors for mesh exposure. Results: Two-hundred and nine transvaginal PP meshes were placed, including 194 in the anterior wall and 15 in the posterior wall. Concomitant tension-free vaginal tape was performed in 61 cases. The mean follow-up time was 35.1 ± 23.6 months. PP mesh exposure was identified in 32 cases (16.4%), with 31 in the anterior wall and 1 in the posterior wall. Significant difference was found in operating time and concomitant procedures between exposed and nonexposed groups (F = 7.443, P = 0.007; F = 4.307, P = 0.039, respectively). Binary logistic regression revealed that the number of concomitant procedures and operation time were risk factors for mesh exposure (P = 0.001, P = 0.043). Conclusion: Concomitant procedures and increased operating time increase the risk for postoperative mesh exposure in patients undergoing TVM surgery for POP. PMID:27453227

  20. Cervical tumor characterization by transvaginal color flow Doppler ultrasound.

    PubMed

    Carter, J. R.

    1999-07-01

    The aim of the study was to investigate the blood flow characteristics of benign cervical lesions and invasive cervical tumors and to determine if invasive cervical tumors can be predicted by transvaginal sonography (TVS) and color flow Doppler (CFD). The study design incorporated an open prospective collection of data from patients attending the Women's Cancer Center, University of Minnesota and the Sydney Women's Cancer Center. Inclusion criteria included patients with known benign or malignant cervical pathology. The study group of 66 patients comprised 32 patients with invasive cervical cancer and 34 patients with benign cervical lesions. Benign cervixes were significantly more likely to have absent or normal flow whereas malignant lesions were significantly more likely to have abnormal or increased flow (P < 0.0001). No differences in the uterine or intratumor systolic, diastolic, or mean velocity were found between the two groups. A reduction in the uterine artery pulsatility index (PI) and resistance index (RI) from 1.84 to 1.55 and 0.73 to 0.71, respectively, and also in the intracervical PI from 1.5 to 1.1, in the benign compared to invasive group was found, none of which reached statistical significance. However the intracervical RI was statistically lower (0.62) in malignant tumors compared to patients with benign lesions (0.71) (P = 0.03). The effect of menopause on blood flow characteristics was variable and overall not significant. While the uterine artery systolic velocity was significantly higher in premenopausal women, no such effect was found for the diastolic or mean velocity or the PI and RI. In postmenopausal women, the intratumor PI and RI were higher compared to premenopausal women. In conclusion, transvaginal CFD analysis of the uterine arterial or intratumor bed does not appear to be beneficial in attempting to distinguish benign from malignant cervical tumors. PMID:11240780

  1. Achondrogenesis type I diagnosed by transvaginal ultrasonography at 13 weeks' gestation.

    PubMed

    Meizner, I; Barnhard, Y

    1995-11-01

    We present the first transvaginal first-trimester diagnosis of achondrogenesis type I confirmed by radiographic and histologic studies. The ultrasonographic signs included severe short limb mesomelic dwarfism, large head with decreased ossification, and lack of vertebral ossification. PMID:7503212

  2. Transvaginal Ultrasound-Guided Biopsy of Deep Pelvic Masses: How We Do It.

    PubMed

    Plett, Sara K; Poder, Liina; Brooks, Rebecca A; Morgan, Tara A

    2016-06-01

    The purpose of this review is to discuss the rationale and indications for transvaginal ultrasound-guided biopsy. Transvaginal ultrasound-guided biopsy can be a helpful tool for diagnosis and treatment planning in the evaluation of pelvic masses, particularly when the anatomy precludes a transabdominal or posterior transgluteal percutaneous biopsy approach. A step-by-step summary of the technique with preprocedure and postprocedure considerations is included. PMID:27091918

  3. Transvaginal/Transumbilical Hybrid—NOTES—Versus 3-Trocar Needlescopic Cholecystectomy: Short-term Results of a Randomized Clinical Trial

    PubMed Central

    Knuth, Jürgen; Cerasani, Nicola; Sauerwald, Axel; Lefering, Rolf; Heiss, Markus Maria

    2015-01-01

    Objective: For cholecystectomy, both the needlescopic cholecystectomy (NC) 3-trocar technique using 2 to 3 mm trocars and the umbilical-assisted transvaginal cholecystectomy (TVC) technique have found their way into clinical routine. This study compares these 2 techniques in female patients who are in need of an elective cholecystectomy. Background: Natural orifice transluminal endoscopic surgery (NOTES) is a surgical concept permitting scarless intra-abdominal operations through natural orifices, such as the vagina. Because of the lack of an adequately powered trial, we designed this first randomized controlled study for the comparison of TVC and NC. Methods: This prospective, randomized, nonblinded, single-center trial evaluates the safety and effectiveness of TVC (intervention), compared with NC (control) in female patients with symptomatic cholecystolithiasis. The primary endpoint was intensity of pain until the morning of postoperative day (POD) 2. Secondary outcomes were among others intra- and postoperative complications, procedural time, amount of analgesics used, pain intensity until POD 10, duration of hospital stay, satisfaction with the aesthetic result, and quality of life on POD 10 as quantified with the Eypasch Gastrointestinal Quality of Life Index (GIQLI). Results: Between February 2010 and June 2012, 40 patients were randomly assigned to the interventional or control group. All patients completed follow-up. Procedural time, length of postoperative hospital stay, and the rate of intra- and postoperative complications were similar in the 2 groups. However, significant advantages were found for the transvaginal access regarding pain until POD 2, but also until POD 10 (P = 0.043 vs P = 0.010) despite significantly less use of peripheral analgesics (P = 0.019). In the TVC group, patients were significantly more satisfied with the aesthetic result (P < 0.001) and had a significantly better GIQLI (P = 0.028). Conclusions: Although comparable in terms of

  4. [Comparison of transabdominal and transvaginal sonography in extrauterine pregnancy].

    PubMed

    Schurz, B; Wenzl, R; Eppel, W; Manavi, M; Reinold, E

    1989-08-01

    In 19 patients the transvaginal (TVU) and in 24 patients the transabdominal (TAU) ultrasound approaches were compared in their ability to identify by visualisation the adnexal mass of ectopic pregnancy. The direct visualisation of ectopic pregnancy (EUP) was 25% in TAU and 94.7% in TVU approach (p less than 0.03). All women had a proven EUP in laparoscopy. TAU approach showed a significant inferiority (p less than 0.02) and TVU a significant superiority (p less than 0.08) in comparison to palpation. 83% out of 43 women had spotting. Unspecific signs for EUP like retrouterine fluid was seen in 20.9%. Line formed endometrium was seen in 6.9%, in 37.2% the thickness of endometrium was under 10 mm, in 55.8% more than 10 mm. An intrauterine pseudo-gestation sac was detected in 6.9%, corpus luteum formation in 37.2%. With vaginosonography organs can be seen at close range, therefore it is easier to recognise the specific signs of EUP - an extrauterine ring - formation surrounded by a dam-like structure of the tube. PMID:2477902

  5. Taking a Step Forward in Laparoscopic Donor Nephrectomy: Transvaginal Retrieval of Donor's Kidney.

    PubMed

    Tan, Ying Hao; Lim, Yu Ming Joel; Ng, Ying Woo; Tiong, Ho Yee

    2016-09-01

    Laparoscopic donor nephrectomy has been broadly recognized as the gold standard for kidney procurement used in kidney transplantation where it is not uncommon for donors to experience discomfort and aesthetic dissatisfaction over larger incision site. Natural orifice transluminal endoscopic surgery is a surgical approach that allows scarless intraabdominal operations through natural orifices, such as the vagina. In this case report, we describe the first case of transvaginal retrieval of donor's kidney at the National University Hospital, Singapore. A 51-year-old Malay lady with no significant medical history volunteered to a living-related kidney donor. Perioperative antibiotics were administered. A 12 mm Excel port was placed over the left iliac fossa with camera insertion. Two additional ports were inserted over the left rectus sheath edge and left costal margin under direct vision. An additional 5 mm port at the left loin was placed for lateral retraction. A vaginal probe was then inserted to facilitate posterior colpotomy and transection of the left uterosacral ligament. Pneumoperitoneum was subsequently maintained with a LiNA McCartney(®) Tube. A 15 mm Endocatch(®) bag was inserted for retrieval of the kidney. The left kidney was placed in the Endocatch bag after transection of the hilar vessels where the kidney was retrieved vaginally with ease. Colpotomy was closed vaginally using Vicryl-0 continuous suture. Total blood loss was noted as 50 mL with warm ischemia time being 7 minutes and the entire retrieval taking totally 20 minutes. Postoperative recovery was uneventful and the donor was discharged stable 3 days postoperation. The transplanted kidney retained normal graft function. Colpotomy retrieval for donor nephrectomy presents an innovative method for specimen retrieval with minimal disruption of donor anatomy. Doing away with laparotomy for kidney retrieval has indeed shown a reduction in recovery time, reduced postoperative pain, and

  6. Comparison of transvaginal and transabdominal ultrasonography in the diagnosis of ectopic pregnancy.

    PubMed

    Nahar, M N; Quddus, M A; Sattar, A; Shirin, M; Khatun, A; Ahmed, R; Sultana, F

    2013-12-01

    This cross sectional study was carried out in the department of Radiology and Imaging, Dhaka Medical College Hospital from July 2008 to June 2010 to compare the accuracy of transvaginal ultrasonography and transabdominal ultrasonography in the diagnosis of clinically suspected cases of ectopic pregnancy. Initially 60 patients with clinical suspicion of ectopic pregnancy were included in this study after analyzing selection criteria 30 patients underwent both transvaginal and transabdominal ultrasonography. 'Histopathological diagnosis' was considered gold standard against which accuracies of two diagnostic modalities were compared. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy of transabdominal ultrasonography as a diagnostic modality in evaluation of suspected ectopic pregnancy were 73.1%, 75%, 95%, 30% and 73.3% respectively where as transvaginal ultrasonography was found to have 92.3% sensitivity, 75% specificity, 96% positive predictive value, 60% negative predictive value and 90% accuracy. Transvaginal ultrasonography was superior to transabdominal ultrasonography in the evaluation of suspected ectopic pregnancies so, transvaginal ultrasonography is important for early and accurate diagnosis of ectopic pregnancy. PMID:26118156

  7. Technical Note: Determination of the metabolically active fraction of benthic foraminifera by means of Fluorescent In Situ Hybridization (FISH)

    NASA Astrophysics Data System (ADS)

    Borrelli, C.; Sabbatini, A.; Luna, G. M.; Nardelli, M. P.; Sbaffi, T.; Morigi, C.; Danovaro, R.; Negri, A.

    2011-08-01

    Benthic foraminifera are an important component of the marine biota, but protocols for investigating their viability and metabolism are still extremely limited. Classical studies on benthic foraminifera have been based on direct counting under light microscopy. Typically, these organisms are stained with Rose Bengal, which binds proteins and other macromolecules, but does not allow discrimination between viable and recently dead organisms. The fluorescent in situ hybridization technique (FISH) represents a new and useful approach to identify living cells possessing an active metabolism. Our work is the first test of the suitability of the FISH technique, based on fluorescent probes targeting the 18S rRNA, to detect live benthic foraminifera. The protocol was applied on Ammonia group and Miliolids, as well as on agglutinated polythalamous (i.e., Leptohalysis scottii and Eggerella scabra) and soft-shelled monothalamous (i.e., Psammophaga sp. and saccamminid morphotypes) taxa. The results from FISH analyses were compared with those obtained, on the same specimens assayed with FISH, from microscopic analysis of the cytoplasm colour, presence of pigments and pseudopodial activity. Our results indicate that FISH targets only metabolically active foraminifera, and allows discerning from low to high cellular activity, validating the hypothesis that the intensity of the fluorescent signal emitted by the probe is dependent upon the physiological status of cells. These findings support the usefulness of this molecular approach as a key tool for obtaining information on the physiology of living foraminifera, both in field and experimental settings.

  8. Successful management of viable cervical pregnancy by local injection of methotrexate guided by transvaginal ultrasonography.

    PubMed

    Timor-Tritsch, I E; Monteagudo, A; Mandeville, E O; Peisner, D B; Anaya, G P; Pirrone, E C

    1994-03-01

    We evaluated the feasibility of transvaginal methotrexate injection of viable cervical pregnancies to avoid complications of the "classic" surgical procedures in use and to preserve future fertility. Five viable cervical pregnancies, at 6 to 8 weeks, were treated. In three patients a spring-loaded automated puncture device and in two a manually operated simple needle guide mated to and guided by a transvaginal ultrasonography probe were used with 21-gauge needles. The puncture and injection treatment was successful and without complications in all five cases presented. This procedure may become a useful alternative to other, more radical or complex surgical approaches. PMID:8141192

  9. Obstetrical and Gynecological Devices; Reclassification of Surgical Mesh for Transvaginal Pelvic Organ Prolapse Repair; Final order.

    PubMed

    2016-01-01

    The Food and Drug Administration (FDA or the Agency) is issuing a final order to reclassify surgical mesh for transvaginal pelvic organ prolapse (POP) repair from class II to class III. FDA is reclassifying these devices based on the determination that general controls and special controls together are not sufficient to provide reasonable assurance of safety and effectiveness for this device, and these devices present a potential unreasonable risk of illness or injury. The Agency is reclassifying surgical mesh for transvaginal POP repair on its own initiative based on new information. PMID:26742182

  10. Appendicitis Diagnosed by Emergency Physician Performed Point-of-Care Transvaginal Ultrasound: Case Series

    PubMed Central

    Bramante, Robert; Radomski, Marek; Nelson, Mathew; Raio, Christopher

    2013-01-01

    Lower abdominal pain in females of reproductive age continues to be a diagnostic dilemma for the emergency physician (EP). Point-of-care ultrasound (US) allows for rapid, accurate, and safe evaluation of abdominal and pelvic pain in both the pregnant and non-pregnant patient. We present 3 cases of females presenting with right lower quadrant and adnexal tenderness where transvaginal ultrasonography revealed acute appendicitis. The discussion focuses on the use of EP- performed transvaginal US in gynecologic and intra-abdominal pathology and discusses the use of a staged approach to evaluation using US and computed tomography, as indicated. PMID:24106529

  11. Transvaginal Ultrasound for Endometrial Carcinoma Screening – Current Evidence-based Data

    PubMed Central

    Steiner, E.; Juhasz-Bösz, I.; Emons, G.; Kölbl, H.; Kimmig, R.; Mallmann, P.

    2012-01-01

    The value of transvaginal ultrasound in gynaecological examinations is beyond dispute. But it is of particular forensic importance that the validity of this type of imaging with regard to the reliable detection of early-stage malignancy is properly understood. Vaginal ultrasound screening in asymptomatic patients for the early detection of endometrial carcinoma is not useful from a medical point of view, nor is it cost-efficient. However, even though the validity of transvaginal ultrasound for screening has currently not been proven, the method should still be an integral part of gynaecological examinations. PMID:25278620

  12. Admixture of propofol and alfentanil. Use for intravenous sedation and analgesia during transvaginal oocyte retrieval.

    PubMed

    Sherry, E

    1992-06-01

    An admixture of propofol and alfentanil provides adequate sedation and analgesia during transvaginal oocyte retrieval in the absence of a paracervical block. In 100 patients the technique provided haemodynamic stability, sedation which was easily controlled, rapid recovery and universal patient acceptance. PMID:1616081

  13. Natural orifice transluminal endoscopic wedge hepatic resection with a water-jet hybrid knife in a non-survival porcine model

    PubMed Central

    Shi, Hong; Jiang, Sheng-Jun; Li, Bin; Fu, Deng-Ke; Xin, Pei; Wang, Yong-Guang

    2011-01-01

    AIM: To explore the feasibility of a water-jet hybrid knife to facilitate wedge hepatic resection using a natural orifice transluminal endoscopic surgery (NOTES) approach in a non-survival porcine model. METHODS: The Erbe Jet2 water-jet system allows a needleless, tissue-selective hydro-dissection with a pre-selected pressure. Using this system, wedge hepatic resection was performed through three natural routes (trans-anal, trans-vaginal and trans-umbilical) in three female pigs weighing 35 kg under general anesthesia. Entry into the peritoneal cavity was via a 15-mm incision using a hook knife. The targeted liver segment was marked by an APC probe, followed by wedge hepatic resection performed using a water-jet hybrid knife with the aid of a 4-mm transparent distance soft cap mounted onto the tip of the endoscope for holding up the desired plane. The exposed vascular and ductal structures were clipped with Endoclips. Hemostasis was applied to the bleeding cut edges of the liver parenchyma by electrocautery. After the procedure, the incision site was left open, and the animal was euthanized followed by necropsy. RESULTS: Using the Erbe Jet2 water-jet system, trans-anal and trans-vaginal wedge hepatic resection was successfully performed in two pigs without laparoscopic assistance. Trans-umbilical attempt failed due to an unstable operating platform. The incision for peritoneal entry took 1 min, and about 2 h was spent on excision of the liver tissue. The intra-operative blood loss ranged from 100 to 250 mL. Microscopically, the hydro-dissections were relatively precise and gentle, preserving most vessels. CONCLUSION: The Erbe Jet2 water-jet system can safely accomplish non-anatomic wedge hepatic resection in NOTES, which deserves further studies to shorten the dissection time. PMID:21412502

  14. [Selective embryonic or fetal reduction by surgical transvaginal ultrasonography].

    PubMed

    Delafontaine, D; Mugniot-bellamy, S; Simeon, S; Menard, M N

    1991-06-01

    The increased use of ovulation induction and of medically assisted fertilization procedures involving transfer of 3 or more ova has resulted in an increased frequency of multiple pregnancies. This paper describes 6 cases in which the number of embryos was reduced by a transvaginal transuterine route guided by sonography. 3 women with multiple pregnancies resulting from in vitro fertilization (IVF) in a fertility clinic in France and 3 patients referred to the clinic with multiple pregnancies after ovulation induction elsewhere underwent the procedure under general anesthesia in 1989-90. A needle was introduced through the vagina and the uterine wall and into the nearest gestational sac. A hypertonic solution of potassium chloride was injected into or neat the heart. The needle was withdrawn after verification that cardiac activity had ceased and that the remaining embryos were healthy. A follow-up sonography was done 24 hours later and the procedure repeated if necessary. The 3 IVF patients ranged in age from 26-37 years. The 2 triplet and 1 quadruple pregnancies were reduced to twin pregnancies and all resulted in births of healthy twins at between 36 weeks and term. The 3 patients in whom ovulation was induced ranged in age from 18-26 years. 1 had a miscarriage of undetermined etiology at 20 weeks and the other 2 pregnancies were still in progress after reduction to 2. The literature on the progress of multiple pregnancies is relatively limited. It is recognized however the multiple pregnancy increased the rate of prematurity, of low birth weight, and of intrauterine and perinatal mortality, with the risk increasing as the pregnancy order increases. It is generally advised that pregnancies of orders higher than 3 be reduced, but opinions are divided for triple pregnancies. Selective reduction represents a partial solution to the problem of multiple pregnancies, at the cost of psychological suffering for the parents and an increased risk of abortion with embryonic

  15. Rationale of first-line endoscopy-based fertility exploration using transvaginal hydrolaparoscopy and minihysteroscopy.

    PubMed

    De Wilde, R L; Brosens, I

    2012-08-01

    The transvaginal access for exploration of tubo-ovarian function in women with unexplained infertility has been revived since transvaginal hydrolaparoscopy (THL) was introduced in 1998. One prospective double-blind trial and several reviews have validated the diagnostic value of THL in comparison with laparoscopy for the exploration of women with unexplained infertility. A review of the recent literature confirms the efficacy and safety of the technique for first-line endoscopy-based exploration of fertility. The standard policy of 1-year delay for laparoscopic investigation in unexplained infertility is challenged. In older women and particularly in women experienced in fertility awareness methods, THL and minihysteroscopy can be performed after a waiting period of 6-12 months. PMID:22674201

  16. Apparatus Notes.

    ERIC Educational Resources Information Center

    Eaton, Bruce G., Ed.

    1980-01-01

    Presents four notes that report new equipment and techniques of interest to physics teachers. These notes deal with collosions of atoms in solids, determining the viscosity of a liquid, measuring the speed of sound and demonstrating Doppler effect. (HM)

  17. Suicide notes.

    PubMed

    O'Donnell, I; Farmer, R; Catalan, J

    1993-07-01

    Detailed case reports of incidents of suicide and attempted suicide on the London Underground railway system between 1985 and 1989 were examined for the presence of suicide notes. The incidence of note-leaving was 15%. Notes provided little insight into the causes of suicide as subjectively perceived, or strategies for suicide prevention. PMID:8353698

  18. Transvaginal versus transabdominal sonography in patients suspected of having ectopic pregnancy.

    PubMed

    Gramith, F; Sirr, S; Hollerman, J; Hawks, L

    1991-01-01

    To determine the value of transvaginal sonography in the evaluation of women with suspected ectopic pregnancy, we retrospectively studied 47 pregnant patients in whom both conventional transabdominal sonography (TAS) and transvaginal sonography (TVS) had been performed. Each patient had been given a standard TAS examination with the bladder moderately distended. After voiding, a TVS examination was performed. TAS and TVS were compared for their ability to reveal specific sonographic findings, including the double decidual sac sign, yolk sac, embryonic pole, and embryonic heart activity. Results indicate that the important sonographic findings of early pregnancy are more likely to be seen transvaginally than transabdominally. In 23% of the patients, only TVS provided the findings for diagnosis of the location and status of the pregnancy. In another 22%, the information gathered through TVS allowed increased confidence in the diagnostic accuracy of the TAS findings by providing additional findings. Therefore, in 45% of the cases, TVS influenced clinical decision-making. In no case was TVS less informative than TAS. These results support the claim that TVS contributes to diagnostic accuracy in early pregnancy. TVS should usually be used in conjunction with, and not as a substitute for, TAS. TVS is best used when TAS is not conclusive, or when immediate confirmation of an intrauterine pregnancy is desired. PMID:2002788

  19. Transvaginal Drainage of Pelvic Abscesses and Collections Using Transabdominal Ultrasound Guidance

    PubMed Central

    Ching, Kevin C.

    2015-01-01

    Objectives. To evaluate clinical outcomes following transvaginal catheter placement using transabdominal ultrasound guidance for management of pelvic fluid collections. Methods. A retrospective review was performed for all patients who underwent transvaginal catheter drainage of pelvic fluid collections utilizing transabdominal ultrasound guidance between July 2008 and July 2013. 24 consecutive patients were identified and 24 catheters were placed. Results. The mean age of patients was 48.1 years (range = 27–76 y). 88% of collections were postoperative (n = 21), 8% were from pelvic inflammatory disease (n = 2), and 4% were idiopathic (n = 1). Of the 24 patients, 83% of patients (n = 20) had previously undergone a hysterectomy and 1 patient (4%) was pregnant at the time of drainage. The mean volume of initial drainage was 108 mL (range = 5 to 570). Catheters were left in place for an average of 4.3 days (range = 1–17 d). Microbial sampling was performed in all patients with 71% (n = 17) returning a positive culture. All collections were successfully managed percutaneously. There were no technical complications. Conclusions. Transvaginal catheter drainage of pelvic fluid collections using transabdominal ultrasound guidance is a safe and clinically effective procedure. Appropriate percutaneous management can avoid the need for surgery. PMID:26113862

  20. Total laparoscopic subtotal gastrectomy with transvaginal specimen extraction is feasible in advanced gastric cancer

    PubMed Central

    Sumer, Fatih; Kayaalp, Cuneyt; Ertugrul, Ismail; Yagci, Mehmet Ali; Karagul, Servet

    2015-01-01

    Purpose Natural orifice specimen extraction (NOSE) is an ever-evolving advanced laparoscopic technique. NOSE minimizes surgical injury, involving a low risk of wound complications, fewer incisional hernias, faster recovery and less postoperative pain. Laparoscopic gastrectomy combined with NOSE is a procedure that can potentiate the advantages of both minimal invasive techniques. We aim to demonstrate the feasibility of laparoscopic subtotal gastrectomy with transvaginal specimen extraction in advanced gastric cancer. Case A 72-year-old woman with a 2 cm adenocarcinoma in gastric antrum was treated by laparoscopic subtotal gastrectomy and lymph node dissection. A totally laparoscopic Roux-en-Y gastrojejunostomy was constructed. Specimen was extracted through the posterior fornix of vagina without difficulty. Histopathology confirmed pT3pN0 tumor. After a 10-month follow-up the patient was asymptomatic and getting adjuvant chemoradiotherapy. Conclusions Transvaginal specimen extraction after laparoscopic gastric resection for advanced gastric cancer is a feasible procedure. It is offered to selected patients and of course only to female patients. Natural orifice surgery may provide faster recovery and decrease the wound related complications which may cause a delay on postoperative adjuvant chemo–radio therapies. We have presented, as far as we know, the first human case of a transvaginal extraction of an advanced gastric cancer after laparoscopic gastrectomy. PMID:26413924

  1. Surgical repair of rectocele. Comparison of transvaginal and transanal approach and personal technique.

    PubMed

    Leanza, V; Intagliata, E; Leanza, G; Cannizzaro, M A; Zanghì, G; Vecchio, R

    2013-01-01

    Rectocele is defined as a herniation of the rectal wall inside the vagina due to a defect of the recto-vaginal septum. It is traditionally considered a posterior compartment damage with weakness of posterior vaginal wall support resulting in a bulging of the rectum into the vaginal cavity. One of the main causes of rectal prolapse is the operative vaginal birth, although the evidence of the defect may occur after many years The treatment of rectocele is surgical, and the approach can be transperineal, transvaginal, and transanal or, in selected cases, transperitoneal through open or laparoscopic techniques. In this study we compare two transvaginal surgical techniques - i.e. the perineal body anchorage to the posterior septum and the traditional Denonvilliers' transversal suture after removing of the vaginal skin, with the mostly performed transanal procedure, the STARR - comparing the data from the literature on their results. Mean hospital stay, rectal symptoms, dyspareunia, quality of life, recurrence rate and postoperative complications have been considered. Both transvaginal and transrectal surgical techniques are effective to solve posterior compartment defect and to improve the quality of life. Vaginal approach may interfere with the sexual activity; furthermore it is associated with minimal postoperative pain than the transanal approach. Better anatomic results are assured after endovaginal surgery, while better rectal function prevail after the transanal approach. Vaginal techniques are more suitable to gynecologists, whereas the transrectal ones are usually performed by colo-proctologists or general surgeons. PMID:24342163

  2. Reinforcement of transvaginal repair using polypropylene mesh functionalized with basic fibroblast growth factor.

    PubMed

    Zhang, Dandan; Lin, Zhi Yuan William; Cheng, Ruoyu; Wu, Wei; Yu, Jia; Zhao, Xin; Chen, Xinliang; Cui, Wenguo

    2016-06-01

    Numerous modifications have been developed over the past two decades seeking to improve the transvaginal repair in the pelvic organ prolapse (POP) by using polypropylene (PP) mesh implants. The hydrophobicity of PP, however, presents a great hindrance for translating potential technologies into viable clinical applications. In this study, by manipulating self-polymerization and strong adhesive characteristics of dopamine, we developed a facile method to enhance the transvaginal repair by modifying PP meshes with polydopamine (PDA), which allowed easy grafting of basic fibroblast growth factor (bFGF) onto the surface of PP. Such surface modification of PP meshes with bFGF was found to efficiently promote bioactivity without changing the morphology or mechanical properties of the PP meshes. Additionally, bFGF-modified PP meshes significantly promoted cell viability and adhesion compared to the unmodified PP. Ultimately, after three months of implantation, the bFGF-modified PP meshes exhibited improved tissue repair with greater degree of organization of deposited collagen, increased tensile strength and reduced inflammatory response. Overall, the surface-modified PP meshes will be highly practical as templates for transvaginal repair in the POP treatment. PMID:26925721

  3. Survey of current practice in clinical transvaginal ultrasound scanning in the UK

    PubMed Central

    Shaw, Adam; Lees, Christoph

    2015-01-01

    During transvaginal ultrasound scanning, the fetus and other sensitive tissues are placed close to the transducer. Heating of these tissues occurs by direct conduction from the transducer and by absorption of ultrasound in the tissue. The extent of any heating will depend on the equipment and settings used, the duration of the scan, imaging modes and other aspects of scanning practice. To ensure that scans are performed with minimum risk, staff should have an appropriate knowledge of safety and follow guidelines issued by professional bodies. An online survey aiming to document current practice in transvaginal ultrasound in the UK was created and distributed to individuals performing this type of scanning. The survey posed questions about the respondents, the departments where scans were performed, the equipment used, knowledge of ultrasound safety, scanning practice and the frequency, duration and mode of transvaginal ultrasound scans for gynaecology, obstetrics and fertility applications. In all, 294 responses were obtained, mostly from sonographers (94%). From the analysis of the responses, it was clear that there was a good understanding of the general meaning of thermal and mechanical index and high awareness of guidelines issued by professional bodies. However, 40% of respondents stated that they rarely or never monitor Thermal or Mechanical indices during scanning. Scanning practice was consistent in terms of the duration of scans, scan protocols followed and use of imaging modes. The results highlight the importance of continued ultrasound safety training and promotion of safety guidelines to users. PMID:27433250

  4. Transvaginal Surgical Management of Cesarean Scar Pregnancy II (CSP-II): An Analysis of 25 Cases

    PubMed Central

    Zhang, Hui; Shi, Junrong; Yang, Yong’An; Liang, Yijuan; Gao, Xinping; Wang, Jing; Liu, Hui; Wu, Bingge; Zhao, Jinhui

    2015-01-01

    Background The aim of this study was to investigate the feasibility and clinical value of transvaginal surgical treatment for cesarean scar pregnancy (CSP-II). Material/Methods This study was a retrospective analysis of 25 CSP-II patients who received transvaginal surgical treatments. These patients were admitted in our hospital between January 2010 and June 2012. Results All surgical treatments were successful without overt complications. The average operation time was 61.5 minutes, the average intraoperative blood loss was 60.5 ml, the average hospital stay was 9.4 days and the average time that blood β-human chorionic gonadotropin (β-HCG) returned to normal range was 15 days. In all 25 patients, the cesarean scar mass located at the anterior wall of the lower uterine segment disappeared by B-ultrasound examination within 1 or 2 weeks after surgery. Postoperatively, the normal menstrual period started again with an average time of 28.9 days. No menstruation-related abnormalities, such as menstrual dripping or an abnormal amount of blood, were reported after surgery. Conclusions Transvaginal surgery for CSP-II is a novel surgical approach. It has several advantages, including a thorough one-time treatment lesion clearance, short operation time, minimized trauma, minimal intraoperative blood loss, quick reduction of blood β-HCG, and rapid menstruation recovery. It is a simple and feasible surgical approach of great clinical value and few treatment-related complications. PMID:26520674

  5. Chemistry Notes.

    ERIC Educational Resources Information Center

    School Science Review, 1980

    1980-01-01

    Presents 12 chemistry notes for British secondary school teachers. Some of these notes are: (1) a simple device for testing pH-meters; (2) portable fume cupboard safety screen; and (3) Mass spectroscopy-analysis of a mass peak. (HM)

  6. Diagnostic Usefulness of Transrectal Ultrasound Compared with Transvaginal Ultrasound Assessment in Young Korean Women with Polycystic Ovary Syndrome

    PubMed Central

    Lee, Da Eun; Park, So Yun; Lee, Sa Ra; Chung, Hye Won

    2015-01-01

    Objectives To determine the diagnostic performance of transrectal ultrasound in virgin patients with polycystic ovary syndrome (PCOS) by receiver operating characteristic (ROC) curve analysis, compared with conventional transvaginal ultrasound assessment. Methods Ultrasound examinations were performed in 963 Korean women, with transvaginal transducers in 677 women and transrectal transducers in 286 women at Ewha Womans University Mokdong Hospital. Transvaginal ultrasound examinations were performed in 494 normal control women and 183 PCOS patients according to National Institutes of Health (NIH) PCOS diagnostic criteria. In virgin patients, transrectal ultrasound examinations were performed in 141 normal control women and 145 PCOS patients. ROC curves were calculated for ovarian volume and follicle number. Results By transvaginal ultrasound examination, the ovarian volume showed an area under the ROC curve (AURC) of 0.838. An ovarian volume decision threshold > 7 cm3 had a sensitivity of 73.0% and a specificity of 84.2% for the diagnosis of PCOS. The follicle number showed an AURC of 0.886. A follicle number decision threshold ≥ 9 had a sensitivity of 78.6% and a specificity of 87.2% for the diagnosis of PCOS. By transrectal ultrasound examination, the ovarian volume and the follicle number showed AURCs of 0.815 as same thresholds with a sensitivity of 67.2% and 66.4%, respectively and a specificity of 86.8% each. Ovarian volume and follicle number by transvaginal and transrectal ultrasound assessment had a high diagnostic power for PCOS screening. Conclusion Transrectal ultrasound assessment is as effective as conventional transvaginal ultrasound for the detection of PCOS in virgin patients. PMID:26793680

  7. Drug-Induced Thrombocytopenia following a Transvaginal Oocyte Retrieval for In Vitro Fertilization

    PubMed Central

    Comstock, Ioanna A.; Longmire, Michelle; Aster, Richard H.; Milki, Amin A.

    2015-01-01

    Drug-induced immune thrombocytopenia has been associated with hundreds of medications and can lead to devastating consequences for the patient. We present a case of a healthy 33-year-old female undergoing in vitro fertilization who developed a severe drug-induced thrombocytopenia, petechiae, and a large hemoperitoneum after receiving Cefazolin antibiotic prophylaxis for a transvaginal oocyte retrieval. The patient was admitted to the intensive care unit for resuscitation with blood products. The presence of drug-dependent platelet antibodies to Cefazolin was confirmed serologically. PMID:25810935

  8. Blue Note

    SciTech Connect

    Murray Gibson

    2007-04-27

    Argonne's Murray Gibson is a physicist whose life's work includes finding patterns among atoms. The love of distinguishing patterns also drives Gibson as a musician and Blues enthusiast."Blue" notes are very harmonic notes that are missing from the equal temperament scale.The techniques of piano blues and jazz represent the melding of African and Western music into something totally new and exciting.

  9. Blue Note

    ScienceCinema

    Murray Gibson

    2010-01-08

    Argonne's Murray Gibson is a physicist whose life's work includes finding patterns among atoms. The love of distinguishing patterns also drives Gibson as a musician and Blues enthusiast."Blue" notes are very harmonic notes that are missing from the equal temperament scale.The techniques of piano blues and jazz represent the melding of African and Western music into something totally new and exciting.

  10. Transvaginal ultrasonography: a survey of the acceptability and its predictors among a native African women population

    PubMed Central

    Atalabi, Omolola M; Morhason-Bello, Imran O; Adekanmi, Ademola J; Marinho, Anthony O; Adedokun, Babatunde O; Kalejaiye, Adegoke O; Sogo, Kayode; Gbadamosi, Sikiru A

    2012-01-01

    Objective To determine the acceptability of transvaginal ultrasonography (TVU) and associated factors among Nigerian women. Method A cross-sectional survey was conducted among 3137 women who presented for transabdominal ultrasound scan between August and November 2010 in two referral hospitals in Nigeria. Data were obtained using a questionnaire. Descriptive and multivariate analysis was performed applying logistic regression analysis; predictors of willingness of participants regarding transvaginal ultrasound were identified using SPSS Statistics (SPSS Inc, Chicago, IL) version 17 software. Results The mean age of the women was 33.8 years (standard deviation = 7.9), with 88.8% currently married. About 84% were willing to have TVU, while 54.2% were indifferent about the gender of the sonologist. About 17.3% believed that the procedure is painful. Significant predictors of willingness to have TVU were previous sexual experience and douching, prior painful vaginal examination, and vaginal surgery. Conclusion The majority of Nigerian women expressed a willingness to have the TVU procedure without necessarily opting for any gender preference of the operator. Women should be adequately counseled on the operations of the procedure so as to be able to psychologically prepare for them. PMID:22312194

  11. Transvaginal Sonographic Evaluation of the Cervix in Asymptomatic Singleton Pregnancy and Management Options in Short Cervix

    PubMed Central

    Arisoy, Resul; Yayla, Murat

    2012-01-01

    Preterm delivery (PTD), defined as birth before 37 completed weeks of gestation, is the leading cause of perinatal morbidity and mortality. Evaluation of the cervical morphology and biometry with transvaginal ultrasonography at 16–24 weeks of gestation is a useful tool to predict the risk of preterm birth in low- and high-risk singleton pregnancies. For instance, a sonographic cervical length (CL) > 30 mm and present cervical gland area have a 96-97% negative predictive value for preterm delivery at <37 weeks. Available evidence supports the use of progesterone to women with cervical length ≤25 mm, irrespective of other risk factors. In women with prior spontaneous PTD with asymptomatic cervical shortening (CL ≤ 25 mm), prophylactic cerclage procedure must be performed and weekly to every two weeks follow-up is essential. This article reviews the evidence in support of the clinical introduction of transvaginal sonography for both the prediction and management of spontaneous preterm labour. PMID:22523687

  12. A proposal to reduce the risk of transmission of human papilloma virus via transvaginal ultrasound.

    PubMed

    Combs, C Andrew; Fishman, Alan

    2016-07-01

    Three steps must be followed to prevent the transmission of infection via a contaminated transvaginal ultrasound probe: cleaning the probe after every use, high-level disinfection, and covering the probe with a single-use barrier during the examination. There may be critical flaws in at least 2 of these steps as they are currently practiced. First, 2 widely used disinfectants, glutaraldehyde and orthophthalaldehyde, have recently been found to be ineffective at neutralizing human papilloma virus type 16 and type 18. Second, commercial ultrasound probe covers have an unacceptable rate of leakage (8-81%) compared to condoms (0.9-2%). We recommend the use of a sonicated hydrogen peroxide disinfectant system rather than aldehyde-type disinfectants. We recommend that the probe be covered with a condom rather than a commercial probe cover during transvaginal ultrasound examination. Combined with probe cleaning, these 2 steps are estimated to result in an 800 million- to 250 billion-fold reduction in human papilloma virus viral load, which should translate to greatly enhanced patient safety. PMID:26994654

  13. Does the addition of saline infusion sonohysterography to transvaginal ultrasonography prevent unnecessary hysteroscopy in premenopausal women with abnormal uterine bleeding?

    PubMed

    Short, John; Sharp, Benjamin; Elliot, Nikki; McEwing, Rachael; McGeoch, Graham; Shand, Brett; Holland, Kieran

    2016-08-01

    This observational case series in 65 premenopausal women with abnormal uterine bleeding evaluated whether transvaginal ultrasound followed by saline infusion sonohysterography (SIS) prevented unnecessary hysteroscopy. Although SIS indicated that hysteroscopy was unnecessary in eight women, this benefit was offset by the invasive nature of the scan, the number of endometrial abnormalities falsely detected by SIS and the cost of the additional investigation. PMID:27363343

  14. Effective Date of Requirement for Premarket Approval for Surgical Mesh for Transvaginal Pelvic Organ Prolapse Repair. Final order.

    PubMed

    2016-01-01

    The Food and Drug Administration (FDA or the Agency) is issuing a final order to require the filing of a premarket approval application (PMA) or notice of completion of a product development protocol (PDP) for surgical mesh for transvaginal pelvic organ prolapse (POP) repair. PMID:26742183

  15. Biology Notes.

    ERIC Educational Resources Information Center

    School Science Review, 1984

    1984-01-01

    Presents information on the teaching of nutrition (including new information relating to many current O-level syllabi) and part 16 of a reading list for A- and S-level biology. Also includes a note on using earthworms as a source of material for teaching meiosis. (JN)

  16. Classroom Notes

    ERIC Educational Resources Information Center

    International Journal of Mathematical Education in Science and Technology, 2007

    2007-01-01

    In this issue's "Classroom Notes" section, the following papers are discussed: (1) "Constructing a line segment whose length is equal to the measure of a given angle" (W. Jacob and T. J. Osler); (2) "Generating functions for the powers of Fibonacci sequences" (D. Terrana and H. Chen); (3) "Evaluation of mean and variance integrals without…

  17. Apparatus Notes.

    ERIC Educational Resources Information Center

    Eaton, Bruce G., Ed.

    1980-01-01

    This collection of notes describes (1) an optoelectronic apparatus for classroom demonstrations of mechanical laws, (2) a more efficient method for demonstrated nuclear chain reactions using electrically energized "traps" and ping-pong balls, and (3) an inexpensive demonstration for qualitative analysis of temperature-dependent resistance. (CS)

  18. Classroom Notes

    ERIC Educational Resources Information Center

    International Journal of Mathematical Education in Science and Technology, 2007

    2007-01-01

    In this issue's "Classroom Notes" section, the following papers are described: (1) "Sequences of Definite Integrals" by T. Dana-Picard; (2) "Structural Analysis of Pythagorean Monoids" by M.-Q Zhan and J. Tong; (3) "A Random Walk Phenomenon under an Interesting Stopping Rule" by S. Chakraborty; (4) "On Some Confidence Intervals for Estimating the…

  19. Transvaginal three-dimensional sonographic assessment of the embryonic brain: a pilot study

    PubMed Central

    BOITOR-BORZA, DAN; KOVACS, TUNDE; STAMATIAN, FLORIN

    2015-01-01

    Aims A very good knowledge of human embryology is mandatory not only for the correct sonographic assessment of the developing brain, but also for better understanding the origins of congenital anomalies involving the central nervous system. 3D transvaginal sonography may be an effective technique for imaging the developing brain. The aims of this explorative study are to demonstrate the feasibility of imaging the embryonic brain between 7 and 10 weeks of gestation for clinical studies by using a 3D high-frequency vaginal ultrasound transducer and to provide a reference for the morphology of the brain in the embryonic period. Materials and methods Four embryos of 9 mm, 17 mm, 23 mm and 31 mm crown-rump length respectively were assessed in vivo by transvaginal sonography. We gave a special attention to the embryonic brain. All patients were examined with a Voluson E10, BT 15 ultrasound scanner (GE Healthcare, Zipf, Austria), using a high-frequency 6–12 MHz/ 256-element 3D/4D transvaginal transducer. Three-dimensional sonography was performed routinely as the patients were scanned. The multiplanar display was used after selecting the best volume. The Omni view® software was used for digitally slicing the selected volumes. Results We describe the morphological details of the developing brains of four embryos ranging from 7 to 10 gestational weeks. In the human embryo 9 mm CRL the hypoechogenic cavities of the three primary vesicles (prosencephalon, mesencephalon, rhombencephalon) could be observed on a sagittal section. In the human embryo 17 mm CRL the prosencephalon was divided into the median diencephalon and two telencephalic vesicles, which were partially separated by the falx cerebri. In the human embryo 23 mm CRL the cerebral hemispheres developed and they were completely separated by the falx cerebri. The choroid plexus was evident inside the lateral ventricles and the fourth ventricle. In the human embryo 31 mm CRL the ventral thalamus was evident, and the

  20. Manipal Cervical Scoring System by Transvaginal Ultrasound in Predicting Successful Labour Induction

    PubMed Central

    Bajpai, Neha; Bhakta, Rajesh; Kumar, Pratap; Rai, Lavanya

    2015-01-01

    Introduction Induction of labour (IOL) nowadays is a common procedure in obstetric practice. The success of IOL largely depends upon “favourability” or “readiness” cervix which is traditionally assessed by manual examination and Scored as Bishop Score. However, this method is limited by subjectivity and reproducibility and though done in all the patients prior to IOL, several studies have demonstrated poor correlation between Bishop Score and outcome of labour. Objective To evaluate the role of preinduction transvaginal ultrasonographic (TVS) cervical assessment in predicting labour outcome and to compare its performance against Bishop Score in patients undergoing induction of labour (IOL). Setting A tertiary medical college hospital in Southern India. Design Prospective observational and investigational study. Materials and Methods Transvaginal ultrasound was performed in 131 patients who underwent labour induction at term with intact membranes and live fetus. Bishop Score was assessed by pervaginal examination and was compared with preinduction TVS cervical Score (parameters being cervical length, funneling, position of cervix and distance of presenting part from external os). Labour was induced within one hour of cervical assessment. The labour induction was considered successful if patient could get into active labour i.e., onset of regular uterine contractions (at interval of 2-3 minutes) and cervical dilatation of 4 cm or greater within 24 hours of induction. Results Labour induction was successful in 86.9% of patients. At cut off Scores of ≥ 4, TVS cervical Score performed better than Bishop Score (Sensitivity 77% vs. 65%, Specificity 93% vs. 86%). ROC analysis indicated that Area Under Curve (AUC) was more for TVS Score (0.90, 95% CI 0.84 – 0.95), compared to Bishop Score. It was found that an increase in cervical length and distance from the os by 1 mm from their means were associated with an increase in odds for failure of induction and there

  1. Note: Easy-to-maintain electron cyclotron resonance (ECR) plasma sputtering apparatus featuring hybrid waveguide and coaxial cables for microwave delivery.

    PubMed

    Akazawa, Housei

    2016-06-01

    The branched-waveguide electron cyclotron resonance plasma sputtering apparatus places quartz windows for transmitting microwaves into the plasma source not in the line of sight of the target. However, the quartz windows must be replaced after some time of operation. For maintenance, the loop waveguide branching from the T-junction must be dismounted and re-assembled accurately, which is a time-consuming job. We investigated substituting the waveguide branches with two sets of coaxial cables and waveguide/coaxial cable converters to simplify assembly as far as connection and disconnection go. The resulting hybrid system worked well for the purposes of plasma generation and film deposition. PMID:27370505

  2. Note: Easy-to-maintain electron cyclotron resonance (ECR) plasma sputtering apparatus featuring hybrid waveguide and coaxial cables for microwave delivery

    NASA Astrophysics Data System (ADS)

    Akazawa, Housei

    2016-06-01

    The branched-waveguide electron cyclotron resonance plasma sputtering apparatus places quartz windows for transmitting microwaves into the plasma source not in the line of sight of the target. However, the quartz windows must be replaced after some time of operation. For maintenance, the loop waveguide branching from the T-junction must be dismounted and re-assembled accurately, which is a time-consuming job. We investigated substituting the waveguide branches with two sets of coaxial cables and waveguide/coaxial cable converters to simplify assembly as far as connection and disconnection go. The resulting hybrid system worked well for the purposes of plasma generation and film deposition.

  3. Transvaginal ultrasound

    MedlinePlus

    ... germ cell neoplasms, sex-cord stromal tumors. In: Lentz GM, Lobo RA, Gershenson DM, Katz VL, eds. ... oviduct, ovary, ultrasound imaging of pelvic structures. In: Lentz GM, Lobo RA, Gershenson DM, Katz VL, eds. ...

  4. Transvaginal ultrasound

    MedlinePlus

    ... findings on a physical exam, such as cysts, fibroid tumors, or other growths Abnormal vaginal bleeding and ... the uterus and ovaries (such as cysts or fibroids) Twisting of the ovaries Risks There are no ...

  5. Teaching Notes

    NASA Astrophysics Data System (ADS)

    2001-05-01

    If you would like to contribute a teaching note for any of these sections please contact ped@iop.org. Contents: LET'S INVESTIGATE: Standing waves on strings MY WAY: Physics slips, trips and falls PHYSICS ON A SHOESTRING The McOhm: using fast food to explain resistance Eggs and a sheet STARTING OUT: After a nervous start, I'm flying ON THE MAP: Christ's Hospital CURIOSITY: The Levitron TECHNICAL TRIMMINGS: Brownian motion smoke cell LET'S INVESTIGATE

  6. High-throughput fiber-array transvaginal ultrasound/photoacoustic probe for ovarian cancer imaging

    NASA Astrophysics Data System (ADS)

    Salehi, Hassan S.; Kumavor, Patrick D.; Alqasemi, Umar; Li, Hai; Wang, Tianheng; Zhu, Quing

    2014-03-01

    A high-throughput ultrasound/photoacoustic probe for delivering high contrast and signal-to-noise ratio images was designed, constructed, and tested. The probe consists of a transvaginal ultrasound array integrated with four 1mm-core optical fibers and a sheath. The sheath encases transducer and is lined with highly reflecting aluminum for high intensity light output and uniformity while at the same time remaining below the maximum permissible exposure (MPE) recommended by the American National Standards Institute (ANSI). The probe design was optimized by simulating the light fluence distribution in Zemax. The performance of the probe was evaluated by experimental measurements of the fluence and real-time imaging of polyethylene-tubing filled with blood. These results suggest that our probe has great potential for in vivo imaging and characterization of ovarian cancer.

  7. Participation in transvaginal ovarian cancer screening: compliance, correlation factors, and costs.

    PubMed

    Pavlik, E J; van Nagell, J R; DePriest, P D; Wheeler, L; Tatman, J M; Boone, M; Sollars, S; Rayens, M K; Kryscio, R K

    1995-06-01

    The objective was to identify factors influencing participation in screening for ovarian cancer using transvaginal sonography in the free experimental program at the University of Kentucky over its 6+ year history. Database records for screenings, performed from 1987 to June 1994, were utilized. Computer sorts, 1990 census information as predictors, and stepwise multiple regression analysis were employed. Participation in the model ovarian screening program took 3-4 years to approach > 300 screens/month, with repeat screenings exceeding new subject participation in this time period. A number of participants traveled > 200 miles for screening on both initial and repeat encounters. Analysis of distance to the screening site, median family income, county physician population, and education levels indicated that distance and then education correlated best with participation. Unit screening cost shrank from $45 to under $25 when maximal participation was achieved. Distance and education correlated with participation. Expenses compare favorably with diagnostic procedures for other diseases. PMID:7774844

  8. Ureteral Injury with Delayed Massive Hematuria after Transvaginal Ultrasound-Guided Oocyte Retrieval

    PubMed Central

    Burnik Papler, Tanja; Vrtačnik Bokal, Eda; Šalamun, Vesna; Galič, Dejan; Smrkolj, Tomaž; Jančar, Nina

    2015-01-01

    We report a case of ureteral injury with delayed hematuria after transvaginal oocyte retrieval. A 28-year-old infertile patient with a history of previous laparoscopic resection of endometriotic nodes of both sacrouterine ligaments presented with abdominal pain one day after oocyte retrieval. Four days after oocyte retrieval, she presented with massive hematuria that reappeared 6 days after oocyte retrieval. Monopolar coagulation with wire electrode and insertion of a double-J-stent was performed during operative cystoscopy. The patient recovered completely after transfusion and had no signs of renal impairment after ureteric stent removal. This is the first report of ureteral injury after oocyte retrieval presenting itself with delayed massive hematuria and no signs of renal dysfunction or urinary leakage into retroperitoneal space. PMID:26146577

  9. Persistent postmolar gestational trophoblastic disease: use of transvaginal sonography and colour flow Doppler.

    PubMed

    Carter, J; Carlson, J; Hartenbach, E; Saltzman, A; Fowler, J; Carson, L; Twiggs, L B

    1993-11-01

    Invasive moles have been difficult to diagnose except at hysterectomy. Many patients with persistent gestational trophoblastic disease (GTD) have been treated without ever demonstrating the site of the persistent trophoblastic focus. High resolution transvaginal sonography (TVS) has provided a technique of demonstrating very small uterine lesions, previously unsuspected by transabdominal sonography. The addition of colour flow Doppler further increased diagnostic sensitivity and provides another means of monitoring response to therapy. Three patients with persistent GTD, scanned by TVS and CFD (colour flow Doppler) performed as part of their metastatic work-up are presented. The only abnormalities detected were foci demonstrated within the myometrium that demonstrated increased flow on CFD. Single agent chemotherapy was commenced and the patients were monitored periodically through their course with repeat ultrasonography. After an initial lag period, the lesions decreased in size as the beta-HCG titres fell. An unsuspected adnexal mass was diagnosed on 1 patient, later proving to be a mature ovarian teratoma. PMID:8179558

  10. Diagnostic Accuracy of Transvaginal Sonography in the Detection of Uterine Abnormalities in Infertile Women

    PubMed Central

    Niknejadi, Maryam; Haghighi, Hadieh; Ahmadi, Firoozeh; Niknejad, Fatemeh; Chehrazi, Mohammad; Vosough, Ahmad; Moenian, Deena

    2012-01-01

    Background Accurate diagnosis of uterine abnormalities has become a core part of the fertility work-up. A variety of modalities can be used for the diagnosis of uterine abnormalities. Objectives This study was designed to assess the diagnostic accuracy of transvaginal ultrasonography (TVS) in uterine pathologies of infertile patients using hysteroscopy as the gold standard. Patients and Methods This was a cross-sectional study carried out in the Department of Reproductive Imaging at Royan Institute from October 2007 to October 2008. In this study, the medical documents of 719 infertile women who were investigated with transvaginal ultrasound (TVS) and then hysteroscopy were reviewed. All women underwent hysteroscopy in the same cycle time after TVS. Seventy-six out of 719 patients were excluded from the study and 643 patients were studied. TVS was performed in the follicular phase after cessation of bleeding. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated for TVS. Hysteroscopy served as the gold standard. Results The overall sensitivity, specificity, positive and negative predictive values for TVS in the diagnosis of uterine abnormality was 79%, 82%, 84% and 71%, respectively. The sensitivity and PPV of TVS in detection of polyp were 88.3% and 81.6%, respectively. These indices were 89.2% and 92.5%, respectively for fibroma, 67% and 98.3%, respectively for subseptated uterus and 90.9% and 100%, respectively for septated uterus. Adhesion and unicornuated uterus have the lowest sensitivity with a sensitivity of 35% and PPV of 57.1%. Conclusion TVS is a cost-effective and non-invasive method for diagnosis of intrauterine lesions such as polyps, submucosal fibroids and septum. It is a valuable adjunctive to hysteroscopy with high accuracy for identification and characterization of intrauterine abnormalities. This may lead to a more precise surgery plan and performance. PMID:23329979

  11. Three-dimensional transvaginal tomographic ultrasound imaging for cervical cancer staging.

    PubMed

    Han, Xue-Song; Ning, Chun-Ping; Sun, Li-Tao; Li, Xiao-Ying; Peng, Yan-Qing; Dang, Mei-Zheng

    2015-09-01

    The objective of this study was to investigate the feasibility of using 3-D transvaginal tomographic ultrasound imaging (TUI) to stage patients with cervical carcinoma. Eighty women with cervical cancer who underwent transvaginal TUI examinations were enrolled. In all patients, cancer was confirmed pre-operatively by pathologic examination. Staging on the basis of clinical features, ultrasonography and magnetic resonance imaging was performed according to the International Federation of Gynecology and Obstetrics (FIGO) staging system. Clinical, TUI and magnetic resonance imaging staging was compared with that based on histology. Depth of invasion into the stroma was measured by TUI in 52 cases and compared with pathologic results. An interclass correlation coefficient was used to analyze reproducibility. In total, all 80 patients underwent surgical treatment. The accuracy of pre-operative staging, compared with histologic findings, was 92.50% for TUI, 82.50% for magnetic resonance imaging and 78.75% for clinical examination. The mean depth of lesions as measured with TUI was 12.5 ± 6.2 mm (range: 3.5-40.0 mm), and that measured on histology was 10.5 ± 8.0 mm (range: 3.0-40.0 mm). The interclass correlation coefficient of the two methods was 0.933 (95% confidence interval: 0.887-0.961). Pre-operative TUI is promising as a method for pre-operative staging of cervical carcinomas. TUI can also reliably assess lesion depth. PMID:26070421

  12. Tecnical Note: Analysis of non-regulated vehicular emissions by extractive FTIR spectrometry: tests on a hybrid car in Mexico City

    NASA Astrophysics Data System (ADS)

    Reyes, F.; Grutter, M.; Jazcilevich, A.; González-Oropeza, R.

    2006-11-01

    A methodology to acquire valuable information on the chemical composition and evolution of vehicular emissions is presented. The analysis of the gases is performed by passing a constant flow of a sample gas from the tail-pipe into a 10 L multi-pass cell. The absorption spectra within the cell are obtained using an FTIR spectrometer at 0.5 cm-1 resolution along a 13.1 m optical path. Additionally, the total flow from the exhaust is continuously measured from a differential pressure sensor on a textit{Pitot} tube installed at the exit of the exhaust. This configuration aims to obtain a good speciation capability by coadding spectra during 30 s and reporting the emission (in g/km) of both criteria and non-regulated pollutants, such as CO2, CO, NO, SO2, NH3, HCHO and some NMHC, during predetermined driving cycles. The advantages and disadvantages of increasing the measurement frequency, as well as the effect of other parameters such as spectral resolution, cell volume and flow rate, are discussed. To test and evaluate the proposed technique, experiments were performed on a dynamometer running FTP-75 and typical driving cycles for the Mexico City Metropolitan Area (MCMA) on a Toyota Prius hybrid vehicle. This car is an example of recent marketed automotive technology dedicated to reduced emissions, increasing the need for sensitive detection techniques. This study shows the potential of the proposed technique to measure and report in real time the emissions of a large variety of pollutants, even from a super ultra-low emission vehicle (SULEV). The emissions of HC's, NOx, CO and CO2 obtained here were compared to experiments performed in other locations with the same model vehicle. The proposed technique provides a tool for future studies comparing in detail the emissions of vehicles using alternative fuels and emission control systems.

  13. Transvaginal specimen extraction in a laparoscopic anterior resection of a sigmoid colon neoplasia with en bloc right salpingo-oophorectomy.

    PubMed

    García Flórez, L J; Argüelles, J; Quijada, B; Alvarez, V; Galarraga, M A; Graña, J L

    2010-06-01

    Laparoscopic colorectal surgery has well-known benefits. However, an abdominal incision, albeit much smaller than conventional surgery, is still needed. A transvaginal extraction of a sigmoid colon neoplasia with en bloc salpingo-oophorectomy and colorectal mechanical anastomosis is described. The technique is feasible and safe. The excellent recovery of the 86-year-old patient shows the potential future of the natural orifices endoscopic surgery. PMID:20135188

  14. Transvaginal Oocyte Retrieval Complicated by Life-Threatening Obturator Artery Haemorrhage and Managed by a Vessel-Preserving Technique.

    PubMed Central

    Bolster, Ferdia; Mocanu, Edgar; Geoghegan, Tony; Lawler, Leo

    2014-01-01

    We report the case of a 36-year-old woman with secondary infertility who underwent routine transvaginal oocyte retrieval as part of IVF treatment. Four days following the procedure she presented with life threatening haemorrhagic shock. She underwent surgical laparotomy followed by CT and selective angiography, which demonstrated haemorrhage from a pseudoaneurysm of the obturator artery. The haemorrhage was successfully managed endovascularly with a vessel preserving covered stent. PMID:25484463

  15. Laparoscopic Management or Laparoscopy Combined with Transvaginal Management of Type II Cesarean Scar Pregnancy

    PubMed Central

    Wang, Huan-Ying; Li, Yan-Na; Wei, Wei; Zhang, Da-Wei; Lu, Yu-Qiu; Zhang, Hao-Feng

    2013-01-01

    Objective: To evaluate the clinical effectiveness of laparoscopic management of cesarean scar pregnancy (CSP) by deep implantation. Background: A pregnancy implanting within the scar from a previous cesarean delivery is a rare condition of ectopic pregnancy. There are two different types of CSPs. Type I is caused by implantation of the amniotic sac on the scar with progression toward either the cervicoisthmic space or the uterine cavity. Type II (CSP-II) is caused by deep implantation into a previous CS defect with infiltrating growth into the uterine myometrium and bulging from the uterine serosal surface, which may result in uterine rupture and severe bleeding during the first trimester of pregnancy. Thus, timely management with an early and accurate diagnosis of CSP-II is important. However, laparoscopic management in CSP-II has not yet been evaluated. Methods: Eleven patients with CSP-II underwent conservative laparoscopic surgery or laparoscopy combined with transvaginal bilateral uterine artery ligation and resection of the scar with gestational tissue and wound repair to preserve the uterus from March 2008 to November 2011. Patients with CSP-II were diagnosed using color Doppler sonography, and the diagnosis was confirmed by laparoscopy. The operation time, the blood loss during surgery, the levels of β-human chorionic gonadotropin (β-hCG) before surgery, the time taken for serum β-hCG levels to return to <100 mIU/mL postoperatively, and the time for the uterine body to revert to its original state were retrospectively analyzed. Results: All 11 operations were successfully performed using laparoscopy with preservation of the uterus. One patient underwent a dilation and curettage after laparoscopic bilateral uterine artery ligation. Eight patients were treated solely by laparoscopic bilateral uterine artery ligation and resection of the scar with gestational tissue and wound repair. The remaining two patients underwent laparoscopic bilateral uterine artery

  16. Editorial Note

    NASA Astrophysics Data System (ADS)

    van der Meer, F.; Ommen Kloeke, E.

    2015-07-01

    With this editorial note we would like to update you on the performance of the International Journal of Applied Earth Observation and Geoinformation (JAG) and inform you about changes that have been made to the composition of the editorial team. Our Journal publishes original papers that apply earth observation data for the management of natural resources and the environment. Environmental issues include biodiversity, land degradation, industrial pollution and natural hazards such as earthquakes, floods and landslides. As such the scope is broad and ranges from conceptual and more fundamental work on earth observation and geospatial sciences to the more problem-solving type of work. When I took over the role of Editor-in-Chief in 2012, I together with the Publisher set myself the mission to position JAG in the top-3 of the remote sensing and GIS journals. To do so we strived at attracting high quality and high impact papers to the journal and to reduce the review turnover time to make JAG a more attractive medium for publications. What has been achieved? Have we reached our ambitions? We can say that: The submissions have increased over the years with over 23% for the last 12 months. Naturally not all may lead to more papers, but at least a portion of the additional submissions should lead to a growth in journal content and quality.

  17. Design of miniaturized illumination for transvaginal co-registered photoacoustic and ultrasound imaging

    PubMed Central

    Salehi, Hassan S.; Wang, Tianheng; Kumavor, Patrick D.; Li, Hai; Zhu, Quing

    2014-01-01

    A novel lens-array based illumination design for a compact co-registered photoacoustic/ultrasound transvaginal probe has been demonstrated. The lens array consists of four cylindrical lenses that couple the laser beams into four 1-mm-core multi-mode optical fibers with optical coupling efficiency of ~87%. The feasibility of our lens array was investigated by simulating the lenses and laser beam profiles using Zemax. The laser fluence on the tissue surface was experimentally measured and was below the American National Standards Institute (ANSI) safety limit. Spatial distribution of hemoglobin oxygen saturation (sO2) of a mouse tumor was obtained in vivo using photoacoustic measurements at multiple wavelengths. Furthermore, benign and malignant ovaries were imaged ex vivo and evaluated histologically. The co-registered images clearly showed different patterns of blood vasculature. These results highlight the clinical potential of our system for noninvasive photoacoustic and ultrasound imaging of ovarian tissue and cancer detection and diagnosis. PMID:25401021

  18. Robotic gastrectomy with transvaginal specimen extraction for female gastric cancer patients

    PubMed Central

    Zhang, Shu; Jiang, Zhi-Wei; Wang, Gang; Feng, Xiao-Bo; Liu, Jiang; Zhao, Jian; Li, Jie-Shou

    2015-01-01

    AIM: To describe the application of complete robotic gastrectomy with transvaginal specimen extraction (TVSE) for gastric cancer patients. METHODS: Between July and November 2014, eight female patients who were diagnosed with gastric adenocarcinoma underwent a TVSE following a full robot-sewn gastrectomy. According to the tumor location, the patients were allocated to two different groups; two patients received robotic total gastrectomy with TVSE and the other six received robotic distal gastrectomy with TVSE. RESULTS: Surgical procedures were successfully performed in all eight cases without conversion. The mean age was 55.3 (range, 42-69) years, and the mean body mass index was 23.2 (range, 21.6-26.0) kg/m2. The mean total operative time and blood loss were 224 (range, 200-298) min and 62.5 (range, 50-150) mL, respectively. The mean postoperative hospital stay was 3.6 (range, 3-5) d. The mean number of lymph nodes resected was 23.6 (range, 17-27). None was readmitted within 30 d of postoperation. During the follow-up, no stricture developed nor was any anastomotic leakage detected. CONCLUSION: It is possible to perform a TVSE following a full robot-sewn gastrectomy with standard D2 lymph node resection for female gastric cancer patients. PMID:26715817

  19. Spontaneous Rupture of Pyometra Causing Peritonitis in Elderly Female Diagnosed on Dynamic Transvaginal Ultrasound.

    PubMed

    Malvadkar, Sharad M; Malvadkar, Madhuri S; Domkundwar, Shilpa V; Mohd, Shariq

    2016-01-01

    Pyometra is collection of pus within the uterine cavity and is usually associated with underlying gynaecological malignancy or other benign causes. Spontaneous rupture of pyometra is a rare complication. We report a case of a 65-year-old female who presented with acute abdomen and was diagnosed with a ruptured uterus secondary to pyometra and consequent peritonitis on dynamic transvaginal sonography (TVS) which was later confirmed on contrast enhanced computed tomography (CECT). An emergency laparotomy was performed and about 800 cc of pus was drained from the peritoneal cavity. A rent was found in the anterior uterine wall and hence hysterectomy was performed. Histopathology revealed mixed inflammatory cell infiltrate with no evidence of malignancy. There are only 31 cases of ruptured pyometra reported till date, most of which were definitively diagnosed only on laparotomy. In only two of these cases the preoperative diagnosis was made on CECT. We report this case, as the correct and definitive diagnosis was made preoperatively on dynamic TVS. To our knowledge, this is the first case report revealing spontaneous ruptured pyometra being diagnosed preoperatively on dynamic TVS. This report is aimed at giving emphasis on the use of simple dynamic TVS for accurate diagnosis of rare spontaneous ruptured pyometra causing peritonitis. PMID:26989549

  20. Spontaneous Rupture of Pyometra Causing Peritonitis in Elderly Female Diagnosed on Dynamic Transvaginal Ultrasound

    PubMed Central

    Malvadkar, Sharad M.; Malvadkar, Madhuri S.; Domkundwar, Shilpa V.; Mohd, Shariq

    2016-01-01

    Pyometra is collection of pus within the uterine cavity and is usually associated with underlying gynaecological malignancy or other benign causes. Spontaneous rupture of pyometra is a rare complication. We report a case of a 65-year-old female who presented with acute abdomen and was diagnosed with a ruptured uterus secondary to pyometra and consequent peritonitis on dynamic transvaginal sonography (TVS) which was later confirmed on contrast enhanced computed tomography (CECT). An emergency laparotomy was performed and about 800 cc of pus was drained from the peritoneal cavity. A rent was found in the anterior uterine wall and hence hysterectomy was performed. Histopathology revealed mixed inflammatory cell infiltrate with no evidence of malignancy. There are only 31 cases of ruptured pyometra reported till date, most of which were definitively diagnosed only on laparotomy. In only two of these cases the preoperative diagnosis was made on CECT. We report this case, as the correct and definitive diagnosis was made preoperatively on dynamic TVS. To our knowledge, this is the first case report revealing spontaneous ruptured pyometra being diagnosed preoperatively on dynamic TVS. This report is aimed at giving emphasis on the use of simple dynamic TVS for accurate diagnosis of rare spontaneous ruptured pyometra causing peritonitis. PMID:26989549

  1. Second-trimester maternal serum alpha-fetoprotein, human chorionic gonadotropin, and unconjugated oestriol after early transvaginal multifetal pregnancy reduction.

    PubMed

    Groutz, A; Amit, A; Yaron, Y; Yovel, I; Wolman, I; Legum, C; Lessing, J B

    1996-08-01

    Maternal serum alpha-fetoprotein (MSAFP), human chorionic gonadotropin (hCG), and unconjugated oestriol (UE3) are used as second-trimester screening markers for the detection of various fetal abnormalities. Previous studies have suggested that second-trimester MSAFP is consistently elevated after late first-trimester transabdominal multifetal pregnancy reduction (MFPR). The present study was undertaken to evaluate the levels of all three markers after early transvaginal MFPR. Maternal serum was examined for MSAFP, hCG, and UE3 at 16-18 weeks' gestation in 28 patients who underwent transvaginal MFPR at approximately 10 weeks' gestation. The mean interval between the reduction procedure and the screening test was 7.2 +/- 0.9 weeks. The mean MSAFP value in 24 patients carrying viable twins was 2.49 +/- 0.99 multiples of the median (MOM). Two patients had elevated MSAFP values: one in association with omphalocoele and the other in relation to an adverse pregnancy outcome. All but two patients had normal hCG values (mean 1.98 +/- 1.26 MOM). Two cases with elevated hCG were associated with an adverse pregnancy outcome. Unconjugated oestriol values were within the normal range in all patients (mean 1.69 +/- 0.61 MOM). These results suggest that early transvaginal MFPR, at approximately 10 weeks' gestation, does not appear to influence second-trimester MSAFP, hCG, and UE3 levels. The values of these markers may therefore be interpreted by using the same criteria as those for the general obstetric population. PMID:8878282

  2. Screening of preterm labor in Yazd city: transvaginal ultrasound assessment of the length of cervix in the second trimester

    PubMed Central

    Dalili, Maryam; Karimzadeh Meybodi, Mohamad Ali; Ghaforzadeh, Mohamad; Farajkhoda, Tahmineh; Molavi-e Vardanjani, Hossein

    2013-01-01

    Background: Spontaneous preterm labor is one of the common obstetrics problems causing several physical, psychological and economical outcomes. Although due to these outcomes and the efficacy of cares for decreasing them, preterm labor screening is cost-effective and it is still one of the challenging issues in obstetrics. Objective: In this study preterm labor screening by using cervical transvaginal sonography was evaluated. Materials and Methods: This observational cohort study was performed in Yazd, Iran. Samples were selected from pregnant women at gestational age of 21-24 weeks who had single live fetus and referred to the obstetrics clinics of two selected hospitals in Yazd. Gestational age was estimated based on the sonography of the first trimester and cervical length measured by transvaginal sonography. Data analysis was done by using t and x2 test as well as ANOVA. Statistical significant level was considered as p<0.05. Results: From 450 participants, 47 cases had preterm labor and 6 cases had positive funneling. Mean age of women with term labor was 26.09±4.13 years and that of women with preterm labor was 26.7±3.51 years (p=0.334). Duration of pregnancy and cervical length significantly differed between women with and without funneling (p=0.001). The sensitivity and specificity of screening based on cervical length of 25mm were 55.5% (50.9-60.1%) and 93.6% (91.2-96%) respectively. Conclusion: Based on the results of the present study, transvaginal ultrasound assessment of cervical length in low risk women has an acceptable reliability for screening of preterm labor. PMID:24639757

  3. The impact of goal-directed transvaginal ultrasonography on clinical decision-making for emergency physicians.

    PubMed

    Sayrac, Neslihan; Bektas, Firat; Soyuncu, Secgin; Sayrac, Vefa

    2015-07-01

    The aim of study was to determine the impact of "goal-directed transvaginal ultrasonography" (TVUSG) on real-time clinical decision making of attending emergency physicians evaluating their level of certainty for preliminary diagnosis, admission, surgery, treatment, additional laboratory, and discharge in patients presenting with acute pelvic pain to the emergency department (ED). This prospective cross-sectional clinical study was conducted on sexually active female patients older than 18 years who presented with acute pelvic pain in the ED. The level of certainty of clinical decision making as mentioned above was measured by a visual analogue scale from 0 to 100 mm with 100 mm being most certain before and after TVUSG. Statistical analysis was performed on 88 patients. The mean age was 31.7 ±8.3 years with a median of 30 years. Among clinical decisions, there was a significant difference between pre-TVUSG and post-TVUSG certainty of the decision to perform preliminary diagnoses derived from patient's history and physical examination but not in the other outcomes (treatment, admission, surgery, and discharge). (P = .05). Of the patients included in the study, 11 (12.5%) were admitted to hospital, and 2 (2.3%) of them were operated on. The remaining 75 (85.2%) patients were discharged from the ED; of the patients that had been discharged, 18 (20.5%) patients later consulted another physician, and no further pathology could be discovered. In conclusion, US performed by attending emergency physicians may affect the certainty of their decisions in patients presenting with acute pelvic pain. This effect statistically significantly on the decision to determine preliminary diagnosis. PMID:25963680

  4. Comparison of ultrasound-guided vs laparoscopic transvaginal ovum pick-up (OPU) in simmental heifers.

    PubMed

    Santl, B; Wenigerkind, H; Schernthaner, W; Mödl, J; Stojkovic, M; Prelle, K; Holtz, W; Brem, G; Wolf, E

    1998-07-01

    Transvaginal ovum pick-up (OPU) offers several advantages over standard embryo transfer procedures. For a systematic comparison of the ultrasound-guided (U-OPU) and the laparoscopic OPU (L-OPU) method, groups of Simmental heifers were subjected to 1 of the 2 OPU-methods for 8 wk (15 sessions) followed by a treatment-free interval of 11 wk and then another 8-wk period of OPU using the alternative method. Parameters that were evaluated included the number of follicles aspirated, number and morphology of recovered cumulus-oocyte complexes (COCs), and developmental capacity of oocytes after in vitro maturation (IVM) and fertilization (IVF). Blood samples were also taken from the donors twice a wk for progesterone measurement. To evaluate effects of long-term OPU on subsequent fertility of donors, all heifers (n = 14) were inseminated during the first natural estrus after the OPU experiment. The proportion of Class I oocytes was significantly (P < 0.001) higher after U-OPU than after L-OPU (38.7% vs 21.0%). Following IVM/IVF, this difference in oocyte quality was reflected by the cleavage rate (U-OPU: 58.1%; L-OPU: 52.1%; P < 0.05) and the rate of development to morulae and blastocysts (U-OPU: 27.1%; L-OPU: 13.9%; P < 0.001). Among other factors, the greater changes in vacuum pressure during L-OPU vs U-OPU might be responsible for the difference in oocyte quality. This problem may be overcome by a more flexible system for regulating the vacuum. Progesterone levels were higher during the L-OPU than the U-OPU periods. Seven donors (50%) were diagnosed pregnant by ultrasonography on Day 28 and by palpation per rectum on Day 42. PMID:10734477

  5. Persistence of Microbial Contamination on Transvaginal Ultrasound Probes despite Low-Level Disinfection Procedure

    PubMed Central

    M'Zali, Fatima; Bounizra, Carole; Leroy, Sandrine; Mekki, Yahia; Quentin-Noury, Claudine; Kann, Michael

    2014-01-01

    Aim of the Study In many countries, Low Level Disinfection (LLD) of covered transvaginal ultrasound probes is recommended between patients' examinations. The aim of this study was to evaluate the antimicrobial efficacy of LLD under routine conditions on a range of microorganisms. Materials and Methods Samples were taken over a six month period in a private French Radiology Center. 300 specimens derived from endovaginal ultrasound probes were analyzed after disinfection of the probe with wipes impregnated with a quaternary ammonium compound and chlorhexidine. Human papillomavirus (HPV) was sought in the first set of s100 samples, Chlamydia trachomatis and mycoplasmas were searched in the second set of 100 samples, bacteria and fungi in the third 100 set samples. HPV, C. trachomatis and mycoplasmas were detected by PCR amplification. PCR positive samples were subjected to a nuclease treatment before an additional PCR assay to assess the likely viable microorganisms. Bacteria and fungi were investigated by conventional methods. Results A substantial persistence of microorganisms was observed on the disinfected probes: HPV DNA was found on 13% of the samples and 7% in nuclease-resistant form. C. trachomatis DNA was detected on 20% of the probes by primary PCR but only 2% after nuclease treatment, while mycoplasma DNA was amplified in 8% and 4%, respectively. Commensal and/or environmental bacterial flora was present on 86% of the probes, occasionally in mixed culture, and at various levels (10->3000 CFU/probe); Staphylococcus aureus was cultured from 4% of the probes (10-560 CFU/probe). No fungi were isolated. Conclusion Our findings raise concerns about the efficacy of impregnated towels as a sole mean for disinfection of ultrasound probes. Although the ultrasound probes are used with disposable covers, our results highlight the potential risk of cross contamination between patients during ultrasound examination and emphasize the need for reviewing the disinfection

  6. Transvaginal cholecystectomy vs conventional laparoscopic cholecystectomy for gallbladder disease: A meta-analysis

    PubMed Central

    Xu, Bin; Xu, Bo; Zheng, Wen-Yan; Ge, Hai-Yan; Wang, Li-Wei; Song, Zhen-Sun; He, Bin

    2015-01-01

    AIM: To compare the results of transvaginal cholecystectomy (TVC) and conventional laparoscopic cholecystectomy (CLC) for gallbladder disease. METHODS: We performed a literature search of PubMed, EMBASE, Ovid, Web of Science, Cochrane Library, Google Scholar, MetaRegister of Controlled Trials, Chinese Medical Journal database and Wanfang Data for trials comparing outcomes between TVC and CLC. Data were extracted by two authors. Mean difference (MD), standardized mean difference (SMD), odds ratios and risk rate with 95%CIs were calculated using fixed- or random-effects models. Statistical heterogeneity was evaluated with the χ2 test. The fixed-effects model was used in the absence of statistically significant heterogeneity. The random-effects model was chosen when heterogeneity was found. RESULTS: There were 730 patients in nine controlled clinical trials. No significant difference was found regarding demographic characteristics (P > 0.5), including anesthetic risk score, age, body mass index, and abdominal surgical history between the TVC and CLC groups. Both groups had similar mortality, morbidity, and return to work after surgery. Patients in the TVC group had a lower pain score on postoperative day 1 (SMD: -0.957, 95%CI: -1.488 to -0.426, P < 0.001), needed less postoperative analgesic medication (SMD: -0.574, 95%CI: -0.807 to -0.341, P < 0.001) and stayed for a shorter time in hospital (MD: -1.004 d, 95%CI: -1.779 to 0.228, P = 0.011), but had longer operative time (MD: 17.307 min, 95%CI: 6.789 to 27.826, P = 0.001). TVC had no significant influence on postoperative sexual function and quality of life. Better cosmetic results and satisfaction were achieved in the TVC group. CONCLUSION: TVC is safe and effective for gallbladder disease. However, vaginal injury might occur, and further trials are needed to compare TVC with CLC. PMID:25954114

  7. Is transabdominal ultrasound scanning of cervical measurement in mid-trimester pregnancy a useful alternative to transvaginal ultrasound scan?

    PubMed Central

    Chaudhury, Kalyansree; Ghosh, Mrinalkanti; Halder, Atin; Senapati, Sourav; Chaudhury, Sudeshna

    2013-01-01

    Objective The aim of this study is to assess the correlation between transabdominal and transvaginal ultrasound measurements of the cervix in pregnancy. If transabdominal ultrasound measurement of cervical length is found to provide effective information, it could be used in patient counselling and when making clinical decisions. Material and Methods One hundred and twenty seven pregnant patients between 18–26 weeks of pregnancy were enrolled in this prospective study for measuring cervical length, both by transabdominal and transvaginal ultrasound scan after bladder emptying. Transabdominal and transvaginal measurements were compared and correlated. Results In patients with transvaginal ultrasound scan (TVS) cervical length ≤32 mm, TVS cervical length was found to be shorter than by transabdominal ultrasound scan (TAS). Most of these patients needed >3 cm of vertical pocket of urine in the bladder for adequate visualisation of the cervix. In patients with TVS cervical length >32 mm, the TVS measurement of the cervix was longer than the TAS measurement of the cervix. In these patients, the cervix could be seen by TAS when there was either ≤3 cm vertical pocket of urine in the bladder or an empty bladder. Statistical tests showed that there is a significant difference between TAS and TVS cervical measurements and that there is a significant association between these two measurements. Conclusion Most of the patients needed variable degrees of bladder filling for adequate visualisation of the cervix. Although minimal bladder filling does not influence TAS measurements of cervical length, moderate fullness of the bladder does cause an apparent increase in TAS measurements of cervical length. If the cervical length is ≥30 mm by TAS, regardless of urine content in the bladder, the patient can be assured vis a vis their risk of preterm labour as far as cervical length is concerned. However, in patients with TAS cervical measurement <30 mm and where the bladder

  8. Adherence to Criteria for Transvaginal Ultrasound Imaging and Measurement of Cervical Length

    PubMed Central

    Iams, JD; Grobman, WA; Lozitska, A; Spong, CY; Saade, G; Mercer, BM; Tita, AN; Rouse, DJ; Sorokin, Y; Wapner, RJ; Leveno, KJ; Esplin, MS; Tolosa, JE; Thorp, JM; Caritis, SN; Van Dorsten, JP

    2014-01-01

    Background Adherence to published criteria for transvaginal imaging and measurement of cervical length is uncertain. We sought to assess adherence by evaluating images submitted to certify research sonographers for participation in a clinical trial. Study Design We reviewed qualifying test results of sonographers seeking certification to image and measure cervical length in a clinical trial. Participating sonographers were required to access training materials and submit 15 images, three each from five pregnant women not enrolled in the trial. One of two sonologists reviewed all qualifying images. We recorded the proportion of images that did not meet standard criteria (excess compression, landmarks not seen, improper image size, or full maternal bladder) and the proportion in which the cervical length was measured incorrectly. Failure for a given patient was defined as more than one unacceptable image, or more than two acceptable images with incorrect caliper placement or erroneous choice of the “shortest best” cervical length. Certification required satisfactory images and cervical length measurement from four or more patients. Results 327 sonographers submitted 4905 images. 271 sonographers (83%) were certified on the first, 41 (13%) on the second, and 2 (0.6%) on the third submission. 13 never achieved certification. Of 314 who passed, 196 submitted 15 acceptable images that were appropriately measured for all five women. There were 1277 deficient images: 493 were acceptable but incorrectly measured images from sonographers who passed certification because mis-measurement occurred no more than twice. Of 784 deficient images submitted by sonographers who failed the certification, 471 were rejected because of improper measurement (caliper placement and/or failure to identify the shortest best image), and 313 because of failure to obtain a satisfactory image (excessive compression, required landmarks not visible, incorrect image size, brief examination, and

  9. Transvaginal 3D Image-Guided High Intensity Focused Ultrasound Array

    NASA Astrophysics Data System (ADS)

    Held, Robert; Nguyen, Thuc Nghi; Vaezy, Shahram

    2005-03-01

    The goal of this project is to develop a transvaginal image-guided High Intensity Focused Ultrasound (HIFU) device using piezocomposite HIFU array technology, and commercially-available ultrasound imaging. Potential applications include treatment of uterine fibroids and abnormal uterine bleeding. The HIFU transducer was an annular phased array, with a focal length range of 30-60 mm, an elliptically-shaped aperture of 35×60 mm, and an operating frequency of 3 MHz. A pillow-shaped bag with water circulation will be used for coupling the HIFU energy into the tissue. An intra-cavity imaging probe (C9-5, Philips) was integrated with the HIFU array such that the focal axis of the HIFU transducer was within the image plane. The entire device will be covered by a gel-filled condom when inserted in the vaginal cavity. To control it, software packages were developed in the LabView programming environment. An imaging algorithm processed the ultrasound image to remove noise patterns due to the HIFU signal. The device will be equipped with a three-dimensional tracking system, using a six-degrees-of-freedom articulating arm. Necrotic lesions were produced in a tissue-mimicking phantom and a turkey breast sample for all focal lengths. Various HIFU doses allow various necrotic lesion shapes, including thin ellipsoidal, spherical, wide cylindrical, and teardrop-shaped. Software control of the device allows multiple foci to be activated sequentially for desired lesion patterns. Ultrasound imaging synchronization can be achieved using hardware signals obtained from the imaging system, or software signals determined empirically for various imaging probes. The image-guided HIFU device will provide a valuable tool in visualization of uterine fibroid tumors for the purposes of planning and subsequent HIFU treatment of the tumor, all in a 3D environment. The control system allows for various lesions of different shapes to be optimally positioned in the tumor to cover the entire tumor

  10. Note-Making with T-Notes.

    ERIC Educational Resources Information Center

    Clark, Elvis G.; Davis, Archie D.

    The T-Note system is an easy way for students to take notes, is organized for effective review, and is adaptable because it provides a system for recording five types of information typically presented in the classroom. The student first divides a single loose-leaf notebook page vertically down the middle, and horizontally about one or two inches…

  11. Evaluation of diagnostic utility, safety considerations, and effect on fertility of transvaginal ultrasound-guided ovarian biopsy in mares.

    PubMed

    Diel de Amorim, Mariana; Nairn, Dawne; Manning, Steve; Dedden, Ilse; Ripley, Elinorah; Nielsen, Kayla; Card, Claire

    2016-04-01

    Ultrasound-guided biopsies of corpora lutea have been previously used for research purposes in the mare and cow. However, the health effects and fertility after transvaginal luteal biopsies (TVLB) or transvaginal ovarian biopsies (TVOB) obtained for diagnostic purposes in cases of suspected ovarian tumors have not been previously evaluated in the horse. The aim of this study was to determine the effects on health and fertility of TVLB and TVOB in mares; 53 mares were included in the study (11 control non-biopsied mares, 37 TVLB mares biopsied on one or more of the following Days 8, 10, 12, 15, 21, and 5 TVOB mares with ovarian abnormalities), resulting in a total of 108 TVLB and TVOB cycles and 183 procedures. Mares were divided into Groups 1 to 3 by the number of TVLB per estrous cycle (mare in Group 1 had 1 TVLB procedure, mares in Group 2 had 2 TVLB procedures, and mares in Group 3 had 3 TVLB procedures). Group 4 comprised TVOB mare cycles with ovarian abnormalities (n = 5). Mares were examined to determine day of ovulation (Day 0) and the presence of a corpora lutea using transrectal ultrasonography. Mares were sedated, and an ultrasound-guided transvaginal biopsy was performed of luteal or ovarian tissue. Health effects of TVLB or TVOB were assessed by daily rectal temperatures, appetite, and general demeanor for 72 hours post-procedure, and 3 mares were examined at necropsy. Fertility was not significantly different in control and TVLB Groups 1 to 3 (P = 0.7648) and in the first or subsequent cycles where the ovulation was from an ovary that had a previous TVLB (P = 0.7147). A TVLB on Day 8 post-ovulation may induce an early return to estrus. In conclusion, the TVLB or TVOB procedure had no effect on health and fertility in this study if the procedure was correctly performed with good technique. Because of the low number of cycles (n = 37), the fertility data should be interpreted with caution. The TVOB may be applied in the diagnosis of mares with

  12. Guidelines for providing privileges and credentials to physicians for transvaginal placement of surgical mesh for pelvic organ prolapse.

    PubMed

    2012-01-01

    The adoption of new technology or procedures into a clinician's surgical armamentarium is driven by multiple factors. Patient safety and anticipated long-term improvement in outcomes should be the primary objective that guides a surgeon's decision to deliver care involving new procedures. Surgically complex procedures require a balance of knowledge, surgical skill, and experience, with appropriate ongoing surgical volume and monitoring of outcomes and adverse events. Transvaginal placement of surgical mesh for pelvic organ prolapse has the potential to improve quality of life and anatomic outcomes (especially in the anterior compartment), but also has potential serious adverse events as outlined by the FDA's July 2011 Safety Communication. This document provides Guidelines for privileging and credentialing of physicians planning to implement or continue using this new technology in clinical practice. PMID:22777366

  13. Solar Concepts: Teacher Notes.

    ERIC Educational Resources Information Center

    Gorham, Jonathan W.

    This volume of teacher notes describes teaching methods to support the material presented in the background text and to elaborate on basic solar concepts. Included are objectives and quizzes, teacher notes and bibliographies, and selected student projects. (Author/RE)

  14. Novel method of laparoendoscopic single-site and natural orifice specimen extraction for live donor nephrectomy: single-port laparoscopic donor nephrectomy and transvaginal graft extraction

    PubMed Central

    Jeong, Won Jun; Choi, Byung Jo; Hwang, Jeong Kye; Yuk, Seung Mo; Song, Min Jong

    2016-01-01

    Laparoscopic live donor nephrectomy (DN) has been established as a useful alternative to the traditional open methods of procuring kidneys. To maximize the advantages of the laparoendoscopic single-site (LESS) method, we applied natural orifice specimen extraction to LESS-DN. A 46-year-old woman with no previous abdominal surgery history volunteered to donate her left kidney to her husband and underwent single-port laparoscopic DN with transvaginal extraction. The procedure was completed without intraoperative complications. The kidney functioned well immediately after transplantation, and the donor and recipient were respectively discharged 2 days and 2 weeks postoperatively. Single-port laparoscopic DN and transvaginal graft extraction is feasible and safe. PMID:26878020

  15. Reference values for the cervical length measurement in the second trimester of pregnancy using the transvaginal ultrasound in a large Brazilian population

    PubMed Central

    Peixoto, Alberto Borges; da Cunha Caldas, Taciana Mara Rodrigues; Alamy, Ana Helena Bittencourt; Martins, Wellington P.; Bruns, Rafael Frederico

    2016-01-01

    To establish reference values for the cervical length (CL) measurement by transvaginal ultrasound between 20 and 24+6 weeks of gestation in a large Brazilian population. A retrospective cross-sectional study was performed with 996 singleton pregnancies. The CL measurement (mm) using the transvaginal ultrasound was obtained in a sagittal view and the calipers positioned to measure the linear distance between the triangular area of echodensity at the external os and the internal os. The median±standard deviation and ranges for the CL measurement (mm) was 37.0±10.7 (range, 8 to 51). CL measurement did not modify significantly with gestational age. The observed percentiles for the CL measurement (mm) considering all number case were the following: 5th, 28 mm; 50th, 37 mm; and 95th, 45 mm. Reference values for the CL measurement by transvaginal ultrasound between 20 and 24+6 weeks of gestation in a large heterogeneous Brazilian population were established. PMID:27462597

  16. Repeated ultrasound-guided transvaginal oocyte retrieval from cyclic Murrah buffaloes (Bubalus bubalis): oocyte recovery and quality.

    PubMed

    Gupta, V; Manik, R S; Chauhan, M S; Singla, S K; Akshey, Y S; Palta, P

    2006-01-01

    The present study was undertaken to explore the potential of the Murrah breed of buffaloes as donors of oocytes and to find out the recovery rate and oocyte quality in cyclic Murrah buffaloes subjected to oocyte recovery once a week. Murrah buffaloes (n = 5) were synchronized for estrus by a single prostaglandin injection schedule. The animals were subjected to transvaginal oocyte retrieval (TVOR) once weekly for 6 weeks, starting from Day 7 of the oestrous cycle (Day 0 = day of oestrus). TVOR was performed using an ultrasound machine with a 5 MHz transvaginal transducer, single lumen 19-gauge, 60 cm long needle and a constant vacuum pressure of 50 mmHg. The number and size of follicles in each ovary was determined before puncture. The follicles were characterized on the basis of their diameter as small (3-5 mm), medium (6-9 mm) and large (> or = 10 mm). The oocytes recovered were classified as grade A, cumulus-oocytes complexes (COCs) with > or = 5 layers of cumulus cells; grade B, those with two to four layers; grade C, partially denuded oocytes; and grade D, completely denuded oocytes. The mean (+/- S.E.M) number of small, medium and large follicles, and the number of total follicles observed per animal per session, which was 2.2 +/- 0.3, 0.6 +/- 0.2, 0.9 +/- 0.1 and 3.7 +/- 0.3, respectively, did not differ between animals or between puncture sessions. Small follicles constituted a major proportion (59%) of the total observed follicles. A mean (+/- S.E.M) number of 3.0 +/- 0.3 follicles were punctured and 2.0 +/- 0.3 oocytes recovered per animal per session, with a recovery rate of 68%. Out of the total 61 oocytes recovered, 36 (59%) were of grades A + B whereas 25 (41%) were of grades C + D. In conclusion, this study describes the potential of cyclic Murrah buffaloes as donors of oocytes collected by repeated TVOR once a week, without any adverse effects on follicular growth and oocyte recovery. It also describes an efficient system for carrying out TVOR in

  17. Sticky-Note Murals

    ERIC Educational Resources Information Center

    Sands, Ian

    2011-01-01

    In this article, the author describes a sticky-note mural project that originated from his desire to incorporate contemporary materials into his assignments as well as to inspire collaboration between students. The process takes much more than sticking sticky notes to the wall. It takes critical thinking skills and teamwork to design and complete…

  18. Transvaginal ovarian trauma, poor responders and improvement of success rates in IVF: anecdotal data and a hypothesis.

    PubMed

    Siristatidis, Charalampos; Vogiatzi, Paraskevi; Bettocchi, Stefano; Basios, George; Mastorakos, George; Vrachnis, Nikos

    2014-08-01

    In this report, we propose an intervention capable of improving IVF outcomes in subfertile women with poor ovarian response. This intervention derives from anecdotal data and observations in our daily practice, but most importantly from trials on experimental models and subfertile women with Polycystic Ovarian Syndrome (PCOS). Our hypothesis suggests that transvaginal induction of trauma to the ovary in the cycle preceding IVF should benefit poor ovarian responders and their lowered pregnancy rates by increasing - at least - the number of retrieved oocytes during oocyte retrieval. Up-to-the minute data show that, via this means, there is a unique response of the ovarian surface epithelium and stroma to the induced trauma. The potential pathways of this beneficial response involve an improvement of the raised gonadotrophins to act either through the mechanical reduction of the size of the ovary or through alterations of the hormonal profile by lowering LH, inhibin and local androgen concentrations through hypothalamic-pituitary axis feedbacks, the induction of increased blood flow to the ovaries, a differentiated local immune reaction and a non-elucidated as yet role of reactive oxygen species. In this report, we also describe the technique and the associated possible negative points while we try to point out the needed research steps to ensure its efficiency before it enters daily clinical practice. PMID:24837687

  19. A case of splenic metastasis of ovarian cancer treated with complete laparoscopic splenectomy and transvaginal specimen extraction.

    PubMed

    Takase, Yoshiaki; Tomizawa, Naoki; Enokida, Yasuaki; Shiraishi, Takuya; Katoh, Ryuji; Suto, Yujin; Sato, Hiroaki; Muroya, Ken; Kurosaki, Ryo; Kobayashi, Katsumi; Arakawa, Kazuhisa; Ando, Tatsumasa; Takesyohi, Izumi

    2016-12-01

    A 61-year-old woman was diagnosed with right inguinal lymph node and splenic metastasis of ovarian serous cystadenocarcinoma. We performed right inguinal lymph node dissection and total laparoscopic splenectomy in the supine position followed by transvaginal specimen extraction (TVSE). First, using three ports, we extracted the right inguinal lymph node. We repaired the posterior wall of the inguinal canal using a mesh plug. We added two ports and displaced the spleen from the retroperitoneum and lifted it using a snake retractor, disconnecting the hilum using an automatic suturing device. Next, the posterior wall of the vagina was intraperitoneally incised. And an Alexis® laparoscopic system was inserted into the vagina. The cap maintained aeroperitoneum, a collection bag was inserted in the abdominal cavity via the vagina, and the spleen was collected. When the spleen was removed from the body, partial fragmentation of the organ was required in the bag. Organ fragmentation was performed only within the bag, and we made sure not to tear the bag. The vaginal wound was laparoscopically sutured. The patient had no operative complications and was able to actively ambulate at the first day after surgery due to a slight postoperative pain. Total laparoscopic splenectomy with TVSE in the supine position may be a safe and feasible method for selected female patients. This technique enables minimally invasive surgery for female patients with splenic disease. PMID:26976616

  20. Design of optimal light delivery system for co-registered transvaginal ultrasound and photoacoustic imaging of ovarian tissue

    PubMed Central

    Salehi, Hassan S.; Kumavor, Patrick D.; Li, Hai; Alqasemi, Umar; Wang, Tianheng; Xu, Chen; Zhu, Quing

    2015-01-01

    A hand-held transvaginal probe suitable for co-registered photoacoustic and ultrasound imaging of ovarian tissue was designed and evaluated. The imaging probe consists of an ultrasound transducer and four 1-mm-core multi-mode optical fibers both housed in a custom-made sheath. The probe was optimized for the highest light delivery output and best beam uniformity on tissue surface, by simulating the light fluence and power output for different design parameters. The laser fluence profiles were experimentally measured through chicken breast tissue and calibrated intralipid solution at various imaging depths. Polyethylene tubing filled with rat blood mimicking a blood vessel was successfully imaged up to ∼30 mm depth through porcine vaginal tissue at 750 nm. This imaging depth was achieved with a laser fluence on the tissue surface of 20 mJ/cm2, which is below the maximum permissible exposure (MPE) of 25 mJ/cm2 recommended by the American National Standards Institute (ANSI). Furthermore, the probe imaging capability was verified with ex vivo imaging of benign and malignant human ovaries. The co-registered images clearly showed different vasculature distributions on the surface of the benign cyst and the malignant ovary. These results suggest that our imaging system has the clinical potential for in vivo imaging and characterization of ovarian tissues. PMID:26640774

  1. Transvaginal cervical length and tobacco use in Appalachian women: association with increased risk for spontaneous preterm birth.

    PubMed

    Findley, Joseph; Seybold, Dara J; Broce, Mike; Yadav, Dolly; Calhoun, Byron C

    2015-01-01

    Currently ACOG recommends that a mid-term screening strategy may be considered to identify short cervix in low risk populations in an effort to prevent preterm birth. Vaginal progesterone is recommended for women with a cervical length ≤20 mm. Cerclage is recommended for women with prior spontaneous preterm birth who are already receiving progesterone supplementition and CL is <25 mm. This study examined risk factors for spontaneous preterm birth (SPB) <35 weeks among a general obstetrical population prior to these ACOG recommendations. However, cervical cerclage was a possible intervention. Study population included 1,074 patients from 1 Jan 2007-30 Jun 2008 receiving mid-trimester transvaginal ultrasounds during prenatal care at a tertiary medical center clinic. Receiver operator characteristic (ROC) curve cutoff optimal value was ≤34 mm, (n=224), corresponding to 8.9% SPB with shortened cervices compared to 1.4% in patients with normal cervices (>34 mm; n=850; p<0.001 (Area Under the Curve (AUC) 76.6, p<0.001). Cervical lengths <30 mm had 12 times the risk of SPB (p<0.001) while 30-34 mm had 5 times (p=0.005). Tobacco use (≥10 cigarettes per day), p=0.030, and low BMI, p=0.034, had additive effect. Shortened cervical length during routine screening independently predicted SPB while heavy smoking with shortened cervix during pregnancy doubled risk compared to shortened cervix alone. PMID:26050294

  2. Endometrial evaluation with transvaginal ultrasonography for the screening of endometrial hyperplasia or cancer in premenopausal and perimenopausal women

    PubMed Central

    Kim, Min-Jeong; Kim, Jin-Ju

    2016-01-01

    Objective The aim of our study is to determine clinical factors and sonographic findings associated with endometrial hyperplasia or cancer (EH+) in premenopausal and perimenopausal women. Methods A total of 14,340 transvaginal ultrasonography examinations of 9,888 healthy premenopausal and perimenopausal women were included in this retrospective study. One hundred sixty-two subjects underwent endometrial biopsy based on abnormal uterine bleeding (AUB), sonographic endometrial abnormalities (thickened endometrium, endometrial mass, or endometrial stripe abnormality), or both. The clinical factors and sonographic endometrial abnormalities were evaluated with regard to EH+. Results Histologically verified EH+ was found in fourteen subjects (8.6%); ten cases of endometrial hyperplasia (EH) without atypia, three cases of EH with atypia (AEH), and one case of endometrial cancer. Neither clinical factors nor AUB were associated with EH+ (P=0.32) or AEH+ (P=0.72). Of sonographic findings, endometrial stripe abnormality was significantly associated with EH+ (P=0.003) and marginally associated with AEH+ (P=0.05), but a thickened endometrium was not associated with EH+ (P=0.43). Conclusion Endometrial stripe abnormality is a significant factor to predict EH+ in healthy premenopausal and perimenopausal women with and without AUB. However, simple measurement of endometrial thickness has a limited role in this capacity. PMID:27200309

  3. Mapping and characterizing endometrial implants by registering 2D transvaginal ultrasound to 3D pelvic magnetic resonance images.

    PubMed

    Yavariabdi, Amir; Bartoli, Adrien; Samir, Chafik; Artigues, Maxime; Canis, Michel

    2015-10-01

    We propose a new deformable slice-to-volume registration method to register a 2D Transvaginal Ultrasound (TVUS) to a 3D Magnetic Resonance (MR) volume. Our main goal is to find a cross-section of the MR volume such that the endometrial implants and their depth of infiltration can be mapped from TVUS to MR. The proposed TVUS-MR registration method uses contour to surface correspondences through a novel variational one-step deformable Iterative Closest Point (ICP) method. Specifically, we find a smooth deformation field while establishing point correspondences automatically. We demonstrate the accuracy of the proposed method by quantitative and qualitative tests on both semi-synthetic and clinical data. To generate semi-synthetic data sets, 3D surfaces are deformed with 4-40% degrees of deformation and then various intersection curves are obtained at 0-20° cutting angles. Results show an average mean square error of 5.7934±0.4615mm, average Hausdorff distance of 2.493±0.14mm, and average Dice similarity coefficient of 0.9750±0.0030. PMID:26241161

  4. Efficacy of transvaginal debridement and repair surgery for cesarean scar pregnancy: a cohort study compared with uterine artery embolism

    PubMed Central

    Chen, Yu-Qing; Liu, Hua-Shan; Li, Wen-Xin; Deng, Chen; Hu, Xiao-Wen; Kuang, Pei-Jun

    2015-01-01

    Objective: Compared with uterine artery embolism (UAE), we aimed to investigate the efficacy and safety of transvaginal debridement and repair surgery (TDRS) and analyze the association between postoperative recovery and individual related factors. Methods: A total of 128 patients diagnosed with cesarean scar pregnancy (CSP) from January 2006 to June 2014 were divided into 2 groups. Group A: 38 cases were treated with UAE. Group B: 90 cases were treated with TDRS, of whom 41 received preoperative chemotherapy. Results: The failure rate in Group A was 5.3% (2/38) and the 2 cases of secondary vaginal hemorrhage after UAE were cured by hysterectomy and TDRS respectively. All patients were successfully treated in Group B and the postoperative outcomes of the patients who received preoperative chemotherapy showed no statistically differences compared with those who didn’t. The hospital stays, serumβ-hCG and menstruation recovery in Group B were significantly shorter than those in Group A (P<0.001). In Group B, there was no significant correlation between serumβ-hCG recovery, menstruation recovery and individual related factors including serumβ-hCG, gestational age and maximum diameter of gestational sac at diagnosis. Conclusion: Compared with UAE, TDRS is safer, more effective and with a rapider recovery. As an alternative therapeutic option, its prognosis isn’t associated with some individual related factors. Furthermore, preoperative chemotherapy is unnecessary. PMID:26885053

  5. Reference range for uterine artery Doppler pulsatility index using transvaginal ultrasound at 20–24w6d of gestation in a low-risk Brazilian population

    PubMed Central

    Peixoto, Alberto Borges; Da Cunha Caldas, Taciana Mara Rodrigues; Tonni, Gabriele; De Almeida Morelli, Priscilla; Santos, Larissa D’amico; Martins, Wellington P.; Júnior, Edward Araujo

    2016-01-01

    Objective To establish reference range for uterine artery (UtA) Doppler pulsatility index (PI) using transvaginal ultrasound at 20–24w6d of gestation in a Brazilian population. Material and Methods A retrospective cross-sectional study in 847 low-risk pregnant women undergoing routine second trimester ultrasound examination was conducted from February 2012 through March 2015. The mean UtA PI was calculated using color Doppler ultrasound with UtA gated at the level of the internal os. Mean±standard deviation and ranges for UtA Doppler PI in relation to gestational age (GA) are reported. Polynomial regression was used to obtain the best fit using mean UtA Doppler PI and GA (weeks) with adjustments performed using determination coefficient (R2). The 5th, 50th, and 95th percentiles for the mean UtA Doppler PI in relation to GA were determined. Results The mean UtA Doppler PI ranged from 1.14 at 20 weeks to 0.95 at 24 weeks of gestation. The best-fit curve of mean UtA Doppler PI as a function of GA was a first-degree polynomial regression: mean UtA Doppler PI=1.900−0.038×GA (R2=0.01). Conclusion In summary, when the mean UtA PI Doppler values were measured by transvaginal ultrasound at 20–24w6d of gestation, decrease in UtA Doppler PI values with advancing GA was observed. Reference range for the mean UtA Doppler PI at 20–24w6d of gestation using the transvaginal ultrasound in a low-risk Brazilian population was established. We believe that this reference range may be of clinical value in daily obstetric practice. PMID:27026774

  6. Modeling the Dynamics of High-Grade Serous Ovarian Cancer Progression for Transvaginal Ultrasound-Based Screening and Early Detection

    PubMed Central

    Lee, Jung-Min; Levy, Doron

    2016-01-01

    High-grade serous ovarian cancer (HGSOC) represents the majority of ovarian cancers and accounts for the largest proportion of deaths from the disease. A timely detection of low volume HGSOC should be the goal of any screening studies. However, numerous transvaginal ultrasound (TVU) detection-based population studies aimed at detecting low-volume disease have not yielded reduced mortality rates. A quantitative invalidation of TVU as an effective HGSOC screening strategy is a necessary next step. Herein, we propose a mathematical model for a quantitative explanation on the reported failure of TVU-based screening to improve HGSOC low-volume detectability and overall survival.We develop a novel in silico mathematical assessment of the efficacy of a unimodal TVU monitoring regimen as a strategy aimed at detecting low-volume HGSOC in cancer-positive cases, defined as cases for which the inception of the first malignant cell has already occurred. Our findings show that the median window of opportunity interval length for TVU monitoring and HGSOC detection is approximately 1.76 years. This does not translate into reduced mortality levels or improved detection accuracy in an in silico cohort across multiple TVU monitoring frequencies or detection sensitivities. We demonstrate that even a semiannual, unimodal TVU monitoring protocol is expected to miss detectable HGSOC. Lastly, we find that circa 50% of the simulated HGSOC growth curves never reach the baseline detectability threshold, and that on average, 5–7 infrequent, rate-limiting stochastic changes in the growth parameters are associated with reaching HGSOC detectability and mortality thresholds respectively. Focusing on a malignancy poorly studied in the mathematical oncology community, our model captures the dynamic, temporal evolution of HGSOC progression. Our mathematical model is consistent with recent case reports and prospective TVU screening population studies, and provides support to the empirical

  7. Evaluation of transvaginal sonography in detecting endometrial polyps and the pregnancy outcome following hysteroscopic polypectomy in infertile women

    PubMed Central

    Zhu, Huili; Fu, Jing; Lei, Haike; Song, Yong; Shen, Licong; Huang, Wei

    2016-01-01

    The aims of the present study were to evaluate the effectiveness of transvaginal sonography (TVS) in the detection of endometrial polyps (EPs), and to assess the pregnancy outcome in infertile women following hysteroscopic polypectomy. A total of 145 women diagnosed with primary or secondary infertility and intrauterine disorders by TVS and hysterosalpingography (HSG) were included in the current study. All subjects were divided into three groups based on hysteroscopic findings, including the EP, intrauterine adhesion and normal groups. EPs were removed for biopsy and intrauterine adhesions were treated. Pregnancy rates between groups were compared. In total, 34 EPs were detected by TVS, while 45 subjects were later confirmed with EP by hysteroscopy. The sensitivity, specificity, positive predictive value and negative predictive value of TVS in the detection of EPs were 67, 96, 88.23 and 86.49%, respectively. Of the included patients, 120 subjects were followed up, including 40 patients diagnosed with EPs, 42 with intrauterine adhesions and 38 with normal cavities. The results indicated no statistically significant differences in the age, type and duration of infertility, least function (LF) score and classification of the extent of tubal disease with the distal fimbrial obstruction between the three groups. In addition, pregnancy rate and spontaneous abortion rate in the EP group following hysteroscopic polypectomy were 45 and 5.6%, respectively. No significant difference was observed in the fertility rate following surgery. In conclusion, TVS features high sensitivity, specificity and certain unique sonographic characteristics in diagnosing EPs, and may be used as a preliminary diagnostic procedure to select patients for hysteroscopy. Furthermore, hysteroscopic polypectomy is an important approach for the treatment of infertile patients with EPs and appears to help increase the pregnancy rate of previously infertile women. PMID:27446343

  8. Transvaginal closure of the bladder neck and placement of a suprapubic catheter for destroyed urethra after long-term indwelling catheterization.

    PubMed

    Zimmern, P E; Hadley, H R; Leach, G E; Raz, S

    1985-09-01

    We report on 6 women with continuous urinary incontinence as a late complication of an indwelling urethral catheter for neurogenic bladder. Pressure necrosis by the balloon resulted in progressive destruction of the entire urethra, with subsequent incontinence despite the catheter. Surgical attempts at bladder neck closure to correct the incontinence generally have been unsuccessful. Instead of supravesical urinary diversion, we performed transvaginal closure of the bladder neck and percutaneous placement of a permanent suprapubic tube cystostomy. All 6 patients remained dry after closure and none has shown upper urinary tract deterioration at followup for as long as 5 years. PMID:4040980

  9. [The future of "NOTES"].

    PubMed

    Maffei, Massimo; Dumonceau, Jean-Marc

    2008-09-01

    In 2003, the first peroral appendectomy was carried out in a human subject. In order to prevent the premature adoption in clinical practice of the so-called "Natural orifice transluminal endoscopic surgery" (NOTES), a rational framework for its development was proposed in 2005. After animal experimentation, further abdominal interventions were carried out in humans (example: cholecystectomy) through the mouth, vagina, or in a combined approach. The main advantage of NOTES compared to laparoscopic surgery is, from the patient viewpoint, the absence of body scar, but other benefits (example: less pain and costs) could prove to be significant. It is impossible to predict whether or not NOTES will enter in routine clinical practice, but it will generate significant improvements for digestive endoscopy. PMID:18831409

  10. Programmable Logic Application Notes

    NASA Technical Reports Server (NTRS)

    Katz, Richard

    2000-01-01

    This column will be provided each quarter as a source for reliability, radiation results, NASA capabilities, and other information on programmable logic devices and related applications. This quarter will start a series of notes concentrating on analysis techniques with this issues section discussing worst-case analysis requirements.

  11. Notes on Linguistics, 1998.

    ERIC Educational Resources Information Center

    Notes on Linguistics, 1998

    1998-01-01

    The four issues of the journal of language research and linguistic theory include these articles: "Notes on Determiners in Chamicuro" (Steve Parker); Lingualinks Field Manual Development" (Larry Hayashi); "Comments from an International Linguistics Consultant: Thumbnail Sketch" (Austin Hale); "Carlalinks Workshop" (Andy Black); "Implications of…

  12. Notes on Linguistics, 1999.

    ERIC Educational Resources Information Center

    Payne, David, Ed.

    1999-01-01

    The 1999 issues of "Notes on Linguistics," published quarterly, include the following articles, review articles, reviews, book notices, and reports: "A New Program for Doing Morphology: Hermit Crab"; "Lingualinks CD-ROM: Field Guide to Recording Language Data"; "'Unruly' Phonology: An Introduction to Optimality Theory"; "Borrowing vs. Code…

  13. Sawtooth Functions. Classroom Notes

    ERIC Educational Resources Information Center

    Hirst, Keith

    2004-01-01

    Using MAPLE enables students to consider many examples which would be very tedious to work out by hand. This applies to graph plotting as well as to algebraic manipulation. The challenge is to use these observations to develop the students' understanding of mathematical concepts. In this note an interesting relationship arising from inverse…

  14. Notes on Literacy, 1997.

    ERIC Educational Resources Information Center

    Notes on Literacy, 1997

    1997-01-01

    The 1997 volume of "Notes on Literacy," numbers 1-4, includes the following articles: "Community Based Literacy, Burkina Faso"; "The Acquisition of a Second Writing System"; "Appropriate Methodology and Social Context"; "Literacy Megacourse Offered"; "Fitting in with Local Assumptions about Literacy: Some Ethiopian Experiences"; "Gender in…

  15. NCTM Student Math Notes.

    ERIC Educational Resources Information Center

    Maletsky, Evan, Ed.; Yunker, Lee E., Ed.

    1986-01-01

    Five sets of activities for students are included in this document. Each is designed for use in junior high and secondary school mathematics instruction. The first Note concerns mathematics on postage stamps. Historical procedures and mathematicians, metric conversion, geometric ideas, and formulas are among the topics considered. Successful…

  16. Programmable Logic Application Notes

    NASA Technical Reports Server (NTRS)

    Katz, Richard; Day, John H. (Technical Monitor)

    2001-01-01

    This report will be provided each quarter as a source for reliability, radiation results, NASA capabilities, and other information on programmable logic devices and related applications. This quarter will continue a series of notes concentrating on analysis techniques with this issue's section discussing the use of Root-Sum-Square calculations for digital delays.

  17. Student Math Notes.

    ERIC Educational Resources Information Center

    Maletsky, Evan, Ed.

    1985-01-01

    Five sets of activities for students are included in this document. Each is designed for use in junior high and secondary school mathematics instruction. The first "Note" concerns magic squares in which the numbers in every row, column, and diagonal add up to the same sum. An etching by Albrecht Durer is presented, with four questions followed by…

  18. Notes and Discussion

    ERIC Educational Resources Information Center

    American Journal of Physics, 1978

    1978-01-01

    Includes eleven short notes, comments and responses to comments on a variety of topics such as uncertainty in a least-squares fit, display of diffraction patterns, the dark night sky paradox, error in the dynamics of deformable bodies and relative velocities and the runner. (GA)

  19. Notes on Linguistics, 1990.

    ERIC Educational Resources Information Center

    Notes on Linguistics, 1990

    1990-01-01

    This document consists of the four issues of "Notes on Linguistics" published during 1990. Articles in the four issues include: "The Indians Do Say Ugh-Ugh" (Howard W. Law); "Constraints of Relevance, A Key to Particle Typology" (Regina Blass); "Whatever Happened to Me? (An Objective Case Study)" (Aretta Loving); "Stop Me and Buy One (For $5...)"…

  20. Do postmenopausal women with thickened endometrium on trans-vaginal ultrasound in the absence of vaginal bleeding need hysteroscopic assessment? A Pilot Study.

    PubMed

    Laiyemo, R; Dudill, W; Jones, S E; Browne, H

    2016-02-01

    We aimed to determine the incidence of endometrial cancer in a cohort of postmenopausal women with thickened endometrium but no bleeding referred for hysteroscopy and determine the risk estimate of cancer using a cut-off of > 11 mm. This retrospective study of asymptomatic postmenopausal women with thickened endometrium on trans-vaginal scan referred for hysteroscopy was performed using data from 2008 to 2010. In total 63 women were identified. 2 cases of endometrial cancer were identified with an incidence of 3.17%. 22 cases had endometrial thickness (ET) > 11 mm of which 2 were malignant giving a risk estimate for endometrial cancer of 9.1%. 61 women had benign pathology, 40.98% had atrophic endometrium and 59.02% had benign polyp. In conclusion, the incidence of endometrial cancer in postmenopausal women with thickened endometrium on transvaginal scan without vaginal bleeding is low and ET of 11 mm or more seems realistic to use as a cut-off for referral for hysteroscopy. PMID:26466745

  1. Assessment of endometrial receptivity by transvaginal color Doppler and three-dimensional power Doppler ultrasonography in patients undergoing in vitro fertilization procedures.

    PubMed

    Kupesic, S; Bekavac, I; Bjelos, D; Kurjak, A

    2001-02-01

    The objective of this study was to investigate the usefulness of transvaginal color Doppler and three-dimensional power Doppler ultrasonography for the assessment of endometrial receptivity. A total of 89 patients undergoing in vitro fertilization procedures were evaluated for endometrial thickness and volume, endometrial morphology, and subendometrial perfusion on the day of embryo transfer. Neither the volume nor the thickness of the endometrium on the day of embryo transfer had a predictive value for conception during in vitro fertilization cycles (P > .05). Patients who became pregnant were characterized by a significantly lower resistance index, obtained from subendometrial vessels by transvaginal color Doppler ultrasonography (resistance index = 0.53 +/- 0.04 versus 0.64 +/- 0.04, pregnant versus not pregnant, respectively; P < .05), and a significantly higher flow index (13.2 +/- 2.2 versus 11.9 +/- 2.4; P < .05), as measured by a three-dimensional power Doppler histogram. No difference was found in the predictive value of scoring systems analyzing endometrial thickness and volume, endometrial morphology, and subendometrial perfusion by color Doppler and three-dimensional power Doppler ultrasonography. The high degree of endometrial perfusion shown by color Doppler ultrasonography and on three-dimensional power Doppler histograms on the day of embryo transfer can indicate a more favorable endometrial milieu for successful in vitro fertilization. PMID:11211132

  2. Uterine Leiomyomas: Safety and Efficacy of US-guided Suprapubic Transvaginal Radiofrequency Ablation at 1-year Follow-up.

    PubMed

    Wu, Xiang-Jun; Guo, Qing; Cao, Bing-Sheng; Tan, Li-Xia; Zhang, Hong-Yu; Cai, Yu-Ru; Gao, Bu-Lang

    2016-06-01

    Purpose To assess the safety and efficacy of ultrasonography (US)-guided suprapubic transvaginal (ST) radiofrequency ablation (RFA) in the treatment of symptomatic uterine leiomyomas at 1-year follow-up. Materials and Methods The institutional review board approved this prospective study, and all patients provided informed consent. ST RFA was performed as an outpatient procedure 3 days after menstruation in 51 women (age range, 32-52 years; mean age, 42.2 years) with 62 leiomyomas. The leiomyomas were assessed with conventional and contrast material-enhanced US before and after ST RFA for leiomyoma size, location, and blood flow. All patients were evaluated for postoperative complications, including abdominal pain, injury to surrounding tissues and organs, vaginal bleeding, increased vaginal discharge, fever, dyspnea, and menorrhagia, after ST RFA and at follow-up visits. The leiomyoma volumes, improvement in leiomyoma-related symptoms, effect on quality of life (QOL), and patient satisfaction were assessed and compared before and after ST RFA and at follow-up visits by using statistical analyses. Results Sixty-two leiomyomas were successfully treated with ST RFA until 90% of the leiomyoma was echogenic. At 1-month follow-up, 46 (74%) leiomyomas had no contrast enhancement, five (8%) had peripheral enhancement, eight (13%) had focal enhancement, and three (5%) had scattered enhancement at contrast-enhanced US. At 6-month follow-up, the number of leiomyomas that had no enhancement, peripheral enhancement, focal enhancement, or scattered enhancement was 43 (69%), seven (11%), nine (15%), and three (5%), respectively. The leiomyoma volumes were significantly (P < .05) reduced at 1-, 3-, 6-, and 12-month follow-up (from 33.0 cm(3) ± 25.1 [standard deviation] before treatment to 6.8 cm(3) ± 7.7 at 12-month follow-up). The mean percentage volume reduction at 1-, 3-, 6-, and 12-month follow-up was 28%, 57%, 63%, and 78%, respectively. The scores for symptoms and QOL

  3. Collection of oocytes through transvaginal ultrasound-guided aspiration of follicles in an Indian breed of cattle.

    PubMed

    Manik, R S; Singla, S K; Palta, P

    2003-04-15

    The present study was undertaken in Karan Fries, an Indian breed of cattle to (1) determine the number of follicles available for puncture and (2) explore the potential of this breed as a donor of developmentally competent oocytes. Ovum pick-up (OPU) was performed using an ultrasound machine with a transvaginal convex transducer (5 MHz) with a needle guide, single lumen 19-gauge 60 cm long needle and a vacuum pressure of 90 mmHg. The number and size of follicles in each ovary was determined before puncture. The follicles were characterized on the basis of their diameter as small (3-5 mm), medium (6-9 mm) and large (>/=10 mm). The oocytes recovered were classified by quality. They were matured in vitro, irrespective of their grade, in 50 microl droplets of the in vitro maturation (IVM) medium (TCM-199+10% fetal bovine serum(FBS)+5 microg/ml follicle stimulating hormone (folltropin)+1 microg/ml estradiol-17beta+0.2 mM sodium pyruvate), covered with paraffin oil, in 35 mm petridish for 24 h in a CO(2) incubator (5% CO(2) in air) at 38.5 degrees C. The cleavage rate was recorded at day 2 post-insemination after subjecting the oocytes to in vitro fertilization (IVF). The differences in follicular populations of all size categories among individual donors were not significant. A total of 92 oocytes were recovered by aspiration of 157 follicles, with an overall recovery rate of 59% (range 35-79%). Of these, 32% were of grades A and B and the rest of grades C and D. The mean numbers of total follicles and the oocytes recovered per session did not differ significantly among individual donors. Out of the 73 oocytes subjected to IVM and IVF, 24 reached 2-4 cell stage at day 2 post-fertilization, with a cleavage rate of 33%. The total number of oocytes recovered was correlated with the number of small (R=0.54, P<0.01) but not with the number of medium and large follicles. This study demonstrates the use of OPU as a means of obtaining developmentally competent oocytes from an

  4. 4. Panama Mount. Note concrete ring and metal rail. Note ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    4. Panama Mount. Note concrete ring and metal rail. Note cliff erosion under foundation at left center. Looking 297° W. - Fort Funston, Panama Mounts for 155mm Guns, Skyline Boulevard & Great Highway, San Francisco, San Francisco County, CA

  5. Note-Taking: Different Notes for Different Research Stages.

    ERIC Educational Resources Information Center

    Callison, Daniel

    2003-01-01

    Explains the need to teach students different strategies for taking notes for research, especially at the exploration and collecting information stages, based on Carol Kuhlthau's research process. Discusses format changes; using index cards; notes for live presentations or media presentations versus notes for printed sources; and forming focus…

  6. GnRH analogue treatment on LH surge day 0 followed by single transvaginal artificial insemination with frozen semen on day 5 in bitches

    PubMed Central

    OHTAKI, Tadatoshi; KOGA, Yasuna; ONO, Mamiko; WATANABE, Gen; TAYA, Kazuyoshi; TSUMAGARI, Shigehisa

    2014-01-01

    ABSTRACT Reproductive parameters were evaluated in 19 and 14 estrous beagles that received 100 µg of gonadotropin-releasing hormone (GnRH) and saline treatment, respectively, on the day of luteinizing hormone (LH) surge (Day 0; estimated by serial progesterone assay) and balloon catheter-aided single transvaginal artificial insemination of frozen semen on Day 5. Although the conception rate and litter size were similar between the GnRH and saline groups, the concentration of LH peak was significantly higher in GnRH-treated bitches (P<0.01). In addition, the actual LH surge did not occur on the estimated Day 0 in one saline-treated bitch. In clinical practice that daily progesterone assay is difficult, administration of GnRH on estimated Day 0 would be recommended to induce or enhance the LH surge for timely and successful insemination. PMID:25311914

  7. GnRH analogue treatment on LH surge day 0 followed by single transvaginal artificial insemination with frozen semen on day 5 in bitches.

    PubMed

    Ohtaki, Tadatoshi; Koga, Yasuna; Ono, Mamiko; Watanabe, Gen; Taya, Kazuyoshi; Tsumagari, Shigehisa

    2015-01-01

    Reproductive parameters were evaluated in 19 and 14 estrous beagles that received 100 µg of gonadotropin-releasing hormone (GnRH) and saline treatment, respectively, on the day of luteinizing hormone (LH) surge (Day 0; estimated by serial progesterone assay) and balloon catheter-aided single transvaginal artificial insemination of frozen semen on Day 5. Although the conception rate and litter size were similar between the GnRH and saline groups, the concentration of LH peak was significantly higher in GnRH-treated bitches (P<0.01). In addition, the actual LH surge did not occur on the estimated Day 0 in one saline-treated bitch. In clinical practice that daily progesterone assay is difficult, administration of GnRH on estimated Day 0 would be recommended to induce or enhance the LH surge for timely and successful insemination. PMID:25311914

  8. Transvaginal ultrasound-guided cumulus oocyte complexes aspiration and in vitro embryo production in suckled beef and lactating dairy cattle on pasture-based management conditions.

    PubMed

    Ratto, M H; Peralta, O A; Mogollon, G; Strobel, P; Correa, J

    2011-11-01

    This study was conducted to determine the use of repeated transvaginal ultrasound-guided cumulus oocyte complex (COC) aspiration on COC recovery rate, in vitro embryo production (IVP) and subsequent pregnancy rates in Holstein Friesian (HF) and Aberdeen Angus (AA) cows (Experiment 1), and in pregnant and non-pregnant Holstein Friesian cows (Experiment 2). Cycling, non-pregnant HF (n=17) and AA (n=32) cows with 40-70 days postpartum, between 3 and 5 years of age were used in the Experiment 1. All cows were submitted to repeated transvaginal ultrasound-guided COC aspiration twice a week for 5-7 weeks. Cumulus ooctye complexes (COC) were in vitro matured, fertilized and cultured for 8 days. An overall of 100 and 350 embryos from HF and AA cows respectively were cryopreserved using a conventional slow freezing (Experiment 1). A total of 81 and 285 frozen-thawed embryos from HF and AA cows respectively were transferred to recipient cows. Pregnancy diagnosis was performed at 60 and 150 days of gestation using transrectal ultrasonography. In Experiment 2, cycling non-pregnant (n=9) and pregnant (n=8) HF cows were submitted to repeated ultrasound-guided COC aspiration and COC were in vitro matured, fertilized and cultured as in Experiment 1, except that embryos were cryopreserved but not thawed and transferred as described for Experiment 1. The results of this study indicate that COC recovery rate and blastocyts production are affected by the breed of the donor cow. The quality of blastocyts produced from both breed did not differ in terms of pregnancy and calving rates (Experiment 1). The physiologic state of pregnancy did not affect COC recovery rate and blastocysts production per donor/session (Experiment 2). The use of ultrasound-guided COC aspiration and IVP could be a powerful technique to improve the genetic of beef and dairy cattle managed under pasture-based conditions management in the southern Chile. PMID:22030337

  9. Computerised cardiological case notes.

    PubMed Central

    Williams, K N; Brooksby, I A; Morrice, J; Houseago, S; Webb-Peploe, M M

    1982-01-01

    Optical Mark Reader forms have been used by the Cardiac Department at St Thomas's Hospital for six years to store clinical and haemodynamic data by computer. Forms are completed by clinical staff in outpatients and also for those patients undergoing cardiac catheterisation. Three documents are used to record the symptoms and signs at the clinical consultation, the results of relevant investigations, and the important findings at cardiac catheterisation. These documents are fed into a computer and data from them, together with a limited quantity of types information, are used to produce full clinical reports for our colleagues and the case notes. There reports have saved much secretarial and medical time. A variety of analyses is available for research and management purposes. PMID:7093086

  10. Flare Hybrids

    NASA Astrophysics Data System (ADS)

    Tomczak, M.; Dubieniecki, P.

    2015-12-01

    On the basis of the Solar Maximum Mission observations, Švestka ( Solar Phys. 121, 399, 1989) introduced a new class of flares, the so-called flare hybrids. When they start, they look like typical compact flares (phase 1), but later on, they look like flares with arcades of magnetic loops (phase 2). We summarize the characteristic features of flare hybrids in soft and hard X-rays as well as in the extreme ultraviolet; these features allow us to distinguish flare hybrids from other flares. In this article, additional energy release or long plasma cooling timescales are suggested as possible causes of phase 2. We estimate the frequency of flare hybrids, and study the magnetic configurations favorable for flare hybrid occurrence. Flare hybrids appear to be quite frequent, and the difference between the lengths of magnetic loops in the two interacting loop systems seem to be a crucial parameter for determining their characteristics.

  11. Online Class Size, Note Reading, Note Writing and Collaborative Discourse

    ERIC Educational Resources Information Center

    Qiu, Mingzhu; Hewitt, Jim; Brett, Clare

    2012-01-01

    Researchers have long recognized class size as affecting students' performance in face-to-face contexts. However, few studies have examined the effects of class size on exact reading and writing loads in online graduate-level courses. This mixed-methods study examined relationships among class size, note reading, note writing, and collaborative…

  12. Hangar no. 2 west door detail view. Note tracks. Note ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Hangar no. 2 west door detail view. Note tracks. Note box structures on doors for door opening mechanisms. Looking 4 N. - Marine Corps Air Station Tustin, Southern Lighter Than Air Ship Hangar, Near intersection of Windmill Road & Johnson Street, Tustin, Orange County, CA

  13. Research Notes and Information References

    SciTech Connect

    Hartley, III, Dean S.

    1994-12-01

    The RNS (Research Notes System) is a set of programs and databases designed to aid the research worker in gathering, maintaining, and using notes taken from the literature. The sources for the notes can be books, journal articles, reports, private conversations, conference papers, audiovisuals, etc. The system ties the databases together in a relational structure, thus eliminating data redundancy while providing full access to all the information. The programs provide the means for access and data entry in a way that reduces the key-entry burden for the user. Each note has several data fields. Included are the text of the note, the subject classification (for retrieval), and the reference identification data. These data are divided into four databases: Document data - title, author, publisher, etc., fields to identify the article within the document; Note data - text and page of the note; Sublect data - subject categories to ensure uniform spelling for searches. Additionally, there are subsidiary files used by the system, including database index and temporary work files. The system provides multiple access routes to the notes, both structurally (access method) and topically (through cross-indexing). Output may be directed to a printer or saved as a file for input to word processing software.

  14. The Anatomy of a Note.

    ERIC Educational Resources Information Center

    Moore, Herb

    1986-01-01

    Suggests that students can learn the physics of a musical note by learning how to synthesize sounds on a computer. Discusses ADSR (attack, decay, sustain, and release of a note) and includes a program (with listing) which students can use to examine ADSR on a Commodore 64 microcomputer. (JN)

  15. Research Notes and Information References

    Energy Science and Technology Software Center (ESTSC)

    1994-12-01

    The RNS (Research Notes System) is a set of programs and databases designed to aid the research worker in gathering, maintaining, and using notes taken from the literature. The sources for the notes can be books, journal articles, reports, private conversations, conference papers, audiovisuals, etc. The system ties the databases together in a relational structure, thus eliminating data redundancy while providing full access to all the information. The programs provide the means for access andmore » data entry in a way that reduces the key-entry burden for the user. Each note has several data fields. Included are the text of the note, the subject classification (for retrieval), and the reference identification data. These data are divided into four databases: Document data - title, author, publisher, etc., fields to identify the article within the document; Note data - text and page of the note; Sublect data - subject categories to ensure uniform spelling for searches. Additionally, there are subsidiary files used by the system, including database index and temporary work files. The system provides multiple access routes to the notes, both structurally (access method) and topically (through cross-indexing). Output may be directed to a printer or saved as a file for input to word processing software.« less

  16. Transvaginal photoacoustic imaging probe and system based on a multiport fiber-optic beamsplitter and a real time imager for ovarian cancer detection

    NASA Astrophysics Data System (ADS)

    Kumavor, Patrick D.; Alqasemi, Umar; Tavakoli, Behnoosh; Li, Hai; Yang, Yi; Zhu, Quing

    2013-03-01

    This paper presents a real-time transvaginal photoacoustic imaging probe for imaging human ovaries in vivo. The probe consists of a high-throughput (up to 80%) fiber-optic 1 x 19 beamsplitters, a commercial array ultrasound transducer, and a fiber protective sheath. The beamsplitter has a 940-micron core diameter input fiber and 240-micron core diameter output fibers numbering 36. The 36 small-core output fibers surround the ultrasound transducer and delivers light to the tissue during imaging. A protective sheath, modeled in the form of the transducer using a 3-D printer, encloses the transducer with array of fibers. A real-time image acquisition system collects and processes the photoacoustic RF signals from the transducer, and displays the images formed on a monitor in real time. Additionally, the system is capable of coregistered pulse-echo ultrasound imaging. In this way, we obtain both morphological and functional information from the ovarian tissue. Photoacousitc images of malignant human ovaries taken ex vivo with the probe revealed blood vascular and networks that was distinguishable from normal ovaries, making the probe potential useful for characterizing ovarian tissue.

  17. Does Unilateral Oocyte Retrieval due to Transvaginally Inaccessible Ovaries, Contrary to Common Beliefs, Affect IVF/ICSI Treatment Outcomes That Much?

    PubMed Central

    Olgan, Safak; Mumusoglu, Sezcan; Bozdag, Gurkan

    2016-01-01

    Objective. To investigate in vitro fertilization (IVF) treatment outcomes of unilateral oocyte retrieval in patients with transvaginally inaccessible ovaries. Study Design. Ninety-two women who underwent unilateral oocyte retrieval were retrospectively matched for age, antral follicle count, and body mass index with 184 women who underwent bilateral oocyte retrieval. Each patient in bilateral oocyte retrieval group had the same number of cumulus oophorus complexes (COCs) from single ovary and had comparable number of follicles (±2) on contralateral site where follicular aspiration was performed. Results. The number of COCs, metaphase-2 oocytes, 2-pronuclei, and top-quality embryos was significantly lower in unilateral oocyte retrieval group. However, proportion of patients with an embryo transfer of at least one top-quality embryo was found to be comparable between unilateral and bilateral oocyte retrieval. Subsequently, clinical pregnancy and live birth rates were found to be similar between the groups. The ROC curve analysis revealed (AUC = 0.74, 95% CI 0.63–0.86, p = 0.001) that retrieved COCs ≥ 5 from single ovary had sensitivity of 76.0% and specificity of 64.2% for occurrence of a clinical pregnancy. Conclusion. The patients with unilateral oocyte retrieval have reasonable chance of success with IVF. The retrieval of ≥5 COCs from accessible ovary might result in better treatment outcomes among these patients. PMID:27123444

  18. The effects of twisting and type of aspiration needle on the efficiency of transvaginal ultrasound-guided ovum pick-up in cattle.

    PubMed

    Sasamoto, Yoshihiko; Sakaguchi, Minoru; Katagiri, Seiji; Yamada, Yutaka; Takahashi, Yoshiyuki

    2003-10-01

    The effects of twisting and type (single- or double-lumen) of aspiration needle on the efficiency of transvaginal ultrasound-guided ovum pick-up (US-guided OPU) were investigated in cattle. The first study using slaughterhouse ovaries revealed that twisting of the needle during follicle aspiration improved the oocyte recovery rate without deleterious effects on the attachment of cumulus layers. Vacuum pressure affected the oocyte recovery and cumulus attachment, regardless of the needle type. The needle type did not affect the oocyte recovery or cumulus attachment with an optimized vacuum pressure. In the second study, US-guided OPU was performed in live cows using two types of needles with a vacuum pressure of 75 mmHg. The needle type did not affect the oocyte recovery or cumulus attachment of the recovered oocytes. The results revealed that twisting of the needle is effective in follicle aspiration, and suggested that a single-lumen needle is as useful as a double-lumen needle for US-guided OPU in cattle. PMID:14600345

  19. Does Unilateral Oocyte Retrieval due to Transvaginally Inaccessible Ovaries, Contrary to Common Beliefs, Affect IVF/ICSI Treatment Outcomes That Much?

    PubMed

    Olgan, Safak; Mumusoglu, Sezcan; Bozdag, Gurkan

    2016-01-01

    Objective. To investigate in vitro fertilization (IVF) treatment outcomes of unilateral oocyte retrieval in patients with transvaginally inaccessible ovaries. Study Design. Ninety-two women who underwent unilateral oocyte retrieval were retrospectively matched for age, antral follicle count, and body mass index with 184 women who underwent bilateral oocyte retrieval. Each patient in bilateral oocyte retrieval group had the same number of cumulus oophorus complexes (COCs) from single ovary and had comparable number of follicles (±2) on contralateral site where follicular aspiration was performed. Results. The number of COCs, metaphase-2 oocytes, 2-pronuclei, and top-quality embryos was significantly lower in unilateral oocyte retrieval group. However, proportion of patients with an embryo transfer of at least one top-quality embryo was found to be comparable between unilateral and bilateral oocyte retrieval. Subsequently, clinical pregnancy and live birth rates were found to be similar between the groups. The ROC curve analysis revealed (AUC = 0.74, 95% CI 0.63-0.86, p = 0.001) that retrieved COCs ≥ 5 from single ovary had sensitivity of 76.0% and specificity of 64.2% for occurrence of a clinical pregnancy. Conclusion. The patients with unilateral oocyte retrieval have reasonable chance of success with IVF. The retrieval of ≥5 COCs from accessible ovary might result in better treatment outcomes among these patients. PMID:27123444

  20. Stellarator hybrids

    SciTech Connect

    Furth, H.P.; Ludescher, C.

    1984-08-01

    The present paper briefly reviews the subject of tokamak-stellarator and pinch-stellarator hybrids, and points to two interesting new possibilities: compact-torus-stellarators and mirror-stellarators.

  1. The CZSaw notes case study

    NASA Astrophysics Data System (ADS)

    Lee, Eric; Gupta, Ankit; Darvill, David; Dill, John; Shaw, Chris D.; Woodbury, Robert

    2013-12-01

    Analysts need to keep track of their analytic findings, observations, ideas, and hypotheses throughout the analysis process. While some visual analytics tools support such note-taking needs, these notes are often represented as objects separate from the data and in a workspace separate from the data visualizations. Representing notes the same way as the data and integrating them with data visualizations can enable analysts to build a more cohesive picture of the analytical process. We created a note-taking functionality called CZNotes within the visual analytics tool CZSaw for analyzing unstructured text documents. CZNotes are designed to use the same model as the data and can thus be visualized in CZSaw's existing data views. We conducted a preliminary case study to observe the use of CZNotes and observed that CZNotes has the potential to support progressive analysis, to act as a shortcut to the data, and supports creation of new data relationships.

  2. 12 CFR 561.33 - Note account.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 12 Banks and Banking 5 2011-01-01 2011-01-01 false Note account. 561.33 Section 561.33 Banks and... SAVINGS ASSOCIATIONS § 561.33 Note account. The term note account means a note, subject to the right of... States Treasury Department regulations. Note accounts are not savings accounts or savings deposits....

  3. 12 CFR 561.33 - Note account.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 12 Banks and Banking 5 2010-01-01 2010-01-01 false Note account. 561.33 Section 561.33 Banks and... SAVINGS ASSOCIATIONS § 561.33 Note account. The term note account means a note, subject to the right of... States Treasury Department regulations. Note accounts are not savings accounts or savings deposits....

  4. Providing Study Notes: Comparison of Three Types of Notes for Review.

    ERIC Educational Resources Information Center

    Kiewra, Kenneth A.; And Others

    1988-01-01

    Forty-four undergraduates received different types of notes for review of a lecture (complete text, linear outline, or matrix), or received no notes. Any form of notes increased performance over no notes, with matrix and outline notes producing higher recall and matrix notes producing greatest transfer. (SLD)

  5. Some Notes on a Functional Equation. Classroom Notes

    ERIC Educational Resources Information Center

    Ren, Zhong-Pu; Wu, Zhi-Qin; Zhou, Qi-Fa; Guo, Bai-Ni; Qi, Feng

    2004-01-01

    In this short note, a mathematical proposition on a functional equation for f(xy)=xf(y) + yf(x)for x,y [does not equal] 0, which is encountered in calculus, is generalized step by step. These steps involve continuity, differentiability, a functional equation, an ordinary differential linear equation of the first order, and relationships between…

  6. Voluntary Use of Online Lecture Notes: Correlates of Note Use and Note Use as an Alternative to Class Attendance

    ERIC Educational Resources Information Center

    Grabe, Mark

    2005-01-01

    Note taking and note reviewing are essential college student learning activities. A large number of carefully controlled studies have evaluated student effectiveness in implementing each of these skills and have found that both can be improved by providing instructor notes. While the Internet now offers a practical method for providing notes, some…

  7. Notes.

    ERIC Educational Resources Information Center

    Physics Teacher, 1979

    1979-01-01

    Some topics included are: the relative merits of a programmable calculator and a microcomputer; the advantages of acquiring a sound-level meter for the laboratory; how to locate a virtual image in a plane mirror; center of gravity of a student; and how to demonstrate interference of light using two cords.

  8. NOTE

    PubMed

    Grandjean

    1997-01-15

    2H NMR quadrupolar splittings of clay suspensions monitor the orientation of water molecules near the solid surface. Two limiting water interfacial sites explain our results on montmorillonite, hectorite, and saponite suspensions. The location of cation isomorphous substitution and the Ca2+/Na+ molar ratio of exchangeable cations modulate their relative importance. With beidellite suspensions, water orientation at the clay surface cannot be described within the above scheme. PMID:9028911

  9. EndNote at Lehigh.

    ERIC Educational Resources Information Center

    Siegler, Sharon; Simboli, Brian

    2002-01-01

    Describes the experiences of librarians at Lehigh University in implementing campus-wide use of EndNote, a citation management software package that allows users to create a searchable library of downloaded or manually entered references for any type of publication to be able to insert citations and format footnotes or endnotes within a…

  10. A Note on Hamiltonian Graphs

    ERIC Educational Resources Information Center

    Skurnick, Ronald; Davi, Charles; Skurnick, Mia

    2005-01-01

    Since 1952, several well-known graph theorists have proven numerous results regarding Hamiltonian graphs. In fact, many elementary graph theory textbooks contain the theorems of Ore, Bondy and Chvatal, Chvatal and Erdos, Posa, and Dirac, to name a few. In this note, the authors state and prove some propositions of their own concerning Hamiltonian…

  11. Brief Note: Response to Benatar.

    PubMed

    Kelland, Lindsay-Ann

    2015-11-01

    In his response to my article entitled 'The Harm of Male-on-Female Rape: A Response to David Benatar', Benatar argues that I take his claims out of context, misrepresent them, and set up a straw man, which means, he claims, that I fail to respond to anything he has actually said. In this brief note, I respond to these allegations. PMID:25592400

  12. Lunar nomenclature: A dissenting note

    USGS Publications Warehouse

    Arthur, D.W.G.

    1976-01-01

    This note reviews the nature of the traditional (Ma??dler) lunar nomenclature and the recent developments based on the use of more than 2000 named provinces. It appears that the new nomenclature is less efficient than the old in many cases and may lead to an impossible publication situation. The unnecessary break with the past is especially critized. ?? 1976.

  13. Interacting binaries. Lecture notes 1992.

    NASA Astrophysics Data System (ADS)

    Nussbaumer, H.; Orr, A.

    These lecture notes represent a unique collection of information and references on current research on interacting binaries: S. N. Shore puts the emphasis on observations and their connection to relevant physics. He also discusses symbiotic stars. Cataclysmic variables are the subject of M. Livio's course, whereas E. P. J. van den Heuvel concentrates on more massive binaries and X-ray binaries.

  14. 49 CFR Appendix - Editorial Note:

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 16084; 28 CFR § 0.66). The Assistant Attorney General, Land and Natural Resources Division, has further.... Editorial Note: For Federal Register citations affecting appendix A to part 1, see the List of CFR Sections... provision of Public Law 91-393, approved September 1, 1970, 84 Stat. 835, amending R.S. 355 (40 U.S.C....

  15. Applied Fluid Mechanics. Lecture Notes.

    ERIC Educational Resources Information Center

    Gregg, Newton D.

    This set of lecture notes is used as a supplemental text for the teaching of fluid dynamics, as one component of a thermodynamics course for engineering technologists. The major text for the course covered basic fluids concepts such as pressure, mass flow, and specific weight. The objective of this document was to present additional fluids…

  16. Notes for Serials Cataloging. Second Edition.

    ERIC Educational Resources Information Center

    Geer, Beverley, Ed.; Caraway, Beatrice L., Ed.

    Notes are indispensable to serials cataloging. Researchers, reference librarians, and catalogers regularly use notes on catalog records and, as the audience for these notes has expanded from the local library community to the global Internet community, the need for notes to be cogent, clear, and useful is greater than ever. This book is a…

  17. Lecture Notes on Multigrid Methods

    SciTech Connect

    Vassilevski, P S

    2010-06-28

    The Lecture Notes are primarily based on a sequence of lectures given by the author while been a Fulbright scholar at 'St. Kliment Ohridski' University of Sofia, Sofia, Bulgaria during the winter semester of 2009-2010 academic year. The notes are somewhat expanded version of the actual one semester class he taught there. The material covered is slightly modified and adapted version of similar topics covered in the author's monograph 'Multilevel Block-Factorization Preconditioners' published in 2008 by Springer. The author tried to keep the notes as self-contained as possible. That is why the lecture notes begin with some basic introductory matrix-vector linear algebra, numerical PDEs (finite element) facts emphasizing the relations between functions in finite dimensional spaces and their coefficient vectors and respective norms. Then, some additional facts on the implementation of finite elements based on relation tables using the popular compressed sparse row (CSR) format are given. Also, typical condition number estimates of stiffness and mass matrices, the global matrix assembly from local element matrices are given as well. Finally, some basic introductory facts about stationary iterative methods, such as Gauss-Seidel and its symmetrized version are presented. The introductory material ends up with the smoothing property of the classical iterative methods and the main definition of two-grid iterative methods. From here on, the second part of the notes begins which deals with the various aspects of the principal TG and the numerous versions of the MG cycles. At the end, in part III, we briefly introduce algebraic versions of MG referred to as AMG, focusing on classes of AMG specialized for finite element matrices.

  18. Hybrid Arrays for Chemical Sensing

    NASA Astrophysics Data System (ADS)

    Kramer, Kirsten E.; Rose-Pehrsson, Susan L.; Johnson, Kevin J.; Minor, Christian P.

    In recent years, multisensory approaches to environment monitoring for chemical detection as well as other forms of situational awareness have become increasingly popular. A hybrid sensor is a multimodal system that incorporates several sensing elements and thus produces data that are multivariate in nature and may be significantly increased in complexity compared to data provided by single-sensor systems. Though a hybrid sensor is itself an array, hybrid sensors are often organized into more complex sensing systems through an assortment of network topologies. Part of the reason for the shift to hybrid sensors is due to advancements in sensor technology and computational power available for processing larger amounts of data. There is also ample evidence to support the claim that a multivariate analytical approach is generally superior to univariate measurements because it provides additional redundant and complementary information (Hall, D. L.; Linas, J., Eds., Handbook of Multisensor Data Fusion, CRC, Boca Raton, FL, 2001). However, the benefits of a multisensory approach are not automatically achieved. Interpretation of data from hybrid arrays of sensors requires the analyst to develop an application-specific methodology to optimally fuse the disparate sources of data generated by the hybrid array into useful information characterizing the sample or environment being observed. Consequently, multivariate data analysis techniques such as those employed in the field of chemometrics have become more important in analyzing sensor array data. Depending on the nature of the acquired data, a number of chemometric algorithms may prove useful in the analysis and interpretation of data from hybrid sensor arrays. It is important to note, however, that the challenges posed by the analysis of hybrid sensor array data are not unique to the field of chemical sensing. Applications in electrical and process engineering, remote sensing, medicine, and of course, artificial

  19. Hybrid microelectronic technology

    NASA Astrophysics Data System (ADS)

    Moran, P.

    Various areas of hybrid microelectronic technology are discussed. The topics addressed include: basic thick film processing, thick film pastes and substrates, add-on components and attachment methods, thin film processing, and design of thick film hybrid circuits. Also considered are: packaging hybrid circuits, automating the production of hybrid circuits, application of hybrid techniques, customer's view of hybrid technology, and quality control and assurance in hybrid circuit production.

  20. A note on "Kepler's equation".

    NASA Astrophysics Data System (ADS)

    Dutka, J.

    1997-07-01

    This note briefly points out the formal similarity between Kepler's equation and equations developed in Hindu and Islamic astronomy for describing the lunar parallax. Specifically, an iterative method for calculating the lunar parallax has been developed by the astronomer Habash al-Hasib al-Marwazi (about 850 A.D., Turkestan), which is surprisingly similar to the iterative method for solving Kepler's equation invented by Leonhard Euler (1707 - 1783).

  1. Recognizing Exponential Growth. Classroom Notes

    ERIC Educational Resources Information Center

    Dobbs, David E.

    2004-01-01

    Two heuristic and three rigorous arguments are given for the fact that functions of the form Ce[kx], with C an arbitrary constant, are the only solutions of the equation dy/dx=ky where k is constant. Various of the proofs in this self-contained note could find classroom use in a first-year calculus course, an introductory course on differential…

  2. Revising Lecture Notes: How Revision, Pauses, and Partners Affect Note Taking and Achievement

    ERIC Educational Resources Information Center

    Luo, Linlin; Kiewra, Kenneth A.; Samuelson, Lydia

    2016-01-01

    Note taking has been categorized as a two-stage process: the recording of notes and the review of notes. We contend that note taking might best involve a three-stage process where the missing stage is revision. This study investigated the benefits of revising lecture notes and addressed two questions: First, is revision more effective than…

  3. Hybrid Gear

    NASA Technical Reports Server (NTRS)

    Handschuh, Robert F. (Inventor); Roberts, Gary D. (Inventor)

    2016-01-01

    A hybrid gear consisting of metallic outer rim with gear teeth and metallic hub in combination with a composite lay up between the shaft interface (hub) and gear tooth rim is described. The composite lay-up lightens the gear member while having similar torque carrying capability and it attenuates the impact loading driven noise/vibration that is typical in gear systems. The gear has the same operational capability with respect to shaft speed, torque, and temperature as an all-metallic gear as used in aerospace gear design.

  4. Lecture notes for criticality safety

    SciTech Connect

    Fullwood, R.

    1992-03-01

    These lecture notes for criticality safety are prepared for the training of Department of Energy supervisory, project management, and administrative staff. Technical training and basic mathematics are assumed. The notes are designed for a two-day course, taught by two lecturers. Video tapes may be used at the options of the instructors. The notes provide all the materials that are necessary but outside reading will assist in the fullest understanding. The course begins with a nuclear physics overview. The reader is led from the macroscopic world into the microscopic world of atoms and the elementary particles that constitute atoms. The particles, their masses and sizes and properties associated with radioactive decay and fission are introduced along with Einstein's mass-energy equivalence. Radioactive decay, nuclear reactions, radiation penetration, shielding and health-effects are discussed to understand protection in case of a criticality accident. Fission, the fission products, particles and energy released are presented to appreciate the dangers of criticality. Nuclear cross sections are introduced to understand the effectiveness of slow neutrons to produce fission. Chain reactors are presented as an economy; effective use of the neutrons from fission leads to more fission resulting in a power reactor or a criticality excursion. The six-factor formula is presented for managing the neutron budget. This leads to concepts of material and geometric buckling which are used in simple calculations to assure safety from criticality. Experimental measurements and computer code calculations of criticality are discussed. To emphasize the reality, historical criticality accidents are presented in a table with major ones discussed to provide lessons-learned. Finally, standards, NRC guides and regulations, and DOE orders relating to criticality protection are presented.

  5. Lecture notes for criticality safety

    SciTech Connect

    Fullwood, R.

    1992-03-01

    These lecture notes for criticality safety are prepared for the training of Department of Energy supervisory, project management, and administrative staff. Technical training and basic mathematics are assumed. The notes are designed for a two-day course, taught by two lecturers. Video tapes may be used at the options of the instructors. The notes provide all the materials that are necessary but outside reading will assist in the fullest understanding. The course begins with a nuclear physics overview. The reader is led from the macroscopic world into the microscopic world of atoms and the elementary particles that constitute atoms. The particles, their masses and sizes and properties associated with radioactive decay and fission are introduced along with Einstein`s mass-energy equivalence. Radioactive decay, nuclear reactions, radiation penetration, shielding and health-effects are discussed to understand protection in case of a criticality accident. Fission, the fission products, particles and energy released are presented to appreciate the dangers of criticality. Nuclear cross sections are introduced to understand the effectiveness of slow neutrons to produce fission. Chain reactors are presented as an economy; effective use of the neutrons from fission leads to more fission resulting in a power reactor or a criticality excursion. The six-factor formula is presented for managing the neutron budget. This leads to concepts of material and geometric buckling which are used in simple calculations to assure safety from criticality. Experimental measurements and computer code calculations of criticality are discussed. To emphasize the reality, historical criticality accidents are presented in a table with major ones discussed to provide lessons-learned. Finally, standards, NRC guides and regulations, and DOE orders relating to criticality protection are presented.

  6. Strength of adhesive-bonded hybrid structures

    NASA Technical Reports Server (NTRS)

    Kirschke, L.; Prinz, R.; Schnell, H.

    1979-01-01

    Structures prepared from materials with different thermal and mechanical properties by means of fiber-strengthened binders can fail in a number of ways. The present lecture is focused on failures through debonding at the metal or at the fiber-reinforced plastic. A method for calculating the stress distribution in adhesive layers as a function of the load is outlined, and its usefulness in providing insight into the behavior of bonds in hybrid structures is noted. Means of eliminating the unfavorable effects of temperature, humidity, creep and relaxation on the bonds in the manufacture of hybrid structures are examined, along with test methods developed for such structures.

  7. Note on new KLT relations

    NASA Astrophysics Data System (ADS)

    Feng, Bo; He, Song; Huang, Rijun; Jia, Yin

    2010-10-01

    In this short note, we present two results about KLT relations discussed in recent several papers. Our first result is the re-derivation of Mason-Skinner MHV amplitude by applying the S n-3 permutation symmetric KLT relations directly to MHV amplitude. Our second result is the equivalence proof of the newly discovered S n-2 permutation symmetric KLT relations and the well-known S n-3 permutation symmetric KLT relations. Although both formulas have been shown to be correct by BCFW recursion relations, our result is the first direct check using the regularized definition of the new formula.

  8. 34 CFR 674.31 - Promissory note.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... the note on one page, front and back; or (ii) The institution may print the note on more than one page... of this part) (iii) The institution may— (A) Add either the penalty or late charge to the...

  9. Planet-B: Technical notes and drawings

    NASA Technical Reports Server (NTRS)

    Carignan, George R.

    1996-01-01

    The design of the transformer designated as T101 (061-0351) in the Filament/Bias module (061-0119) in the Planet-B NMS instrument was verified because of the differences from the GCMS and INMS instrument designs. A breadboard of a representation of the Hybrid 2301065, Bias Drive A driving a 2N3700 NPN transistor, with dual 75V secondaries, with loads, was used to test the circuit. The initial transformer design that was wound with bifilar secondaries was too unstable to test. The second 1408 transformer with a split bobbin and the feedback winding below the primary was also found to be unstable. (It was nearly impossible to keep the circuit from squeeging). The third transformer tested has the feedback on the outside of the resonant winding. The primary goal of the design was to have as tight a magnetic coupling as possible to the resonant winding, and as loose a coupling as possible to the primary. Further, the circuit AC ground is connected to the winding at the feedback end of the secondary winding. This transformer proved to be very stable - it is virtually impossible to make this design squeg. An emitter resistor (Rl29A) was added to this circuit, as referenced to the GCMS design, to protect Q102 from thermal runaway in the event of a turn on with a non- resonate circuit or load short. This was verified to protect Q102 for at least 30 seconds in the event of a short. Approximately 1% of the 4lmW input power is lost in this protection resistor under normal operation. The circuit was verified to operate normally when a radiated Q102 (2N3700), (low Beta) transistor was substituted for the normal 2N3700. It should be noted that the monitored drive voltage went to approximately 2.7V with this low gain transistor.

  10. ) Hybrid Composite

    NASA Astrophysics Data System (ADS)

    Show, Bijay Kumar; Mondal, Dipak Kumar; Maity, Joydeep

    2014-12-01

    In this research work, the dry sliding wear behavior of 6351 Al-(4 vol.% SiC + 4 vol.% Al2O3) hybrid composite was investigated at low sliding speed (1 m/s) against a hardened EN 31 disk at different loads. In general, the wear mechanism involved adhesion (along with associated subsurface cracking and delamination) and microcutting abrasion at lower load. While at higher load, abrasive wear involving microcutting and microploughing along with adherent oxide formation was observed. The overall wear rate increased with increasing normal load. The massive particle clusters as well as individual reinforcement particles were found to stand tall to resist abrasive wear. Besides, at higher load, the generation of adherent nodular tribo-oxide through nucleation and epitaxial growth on existing Al2O3 particles lowered down the wear rate. Accordingly, at any normal load, 6351 Al-(4 vol.% SiC + 4 vol.% Al2O3) hybrid composite exhibited superior wear resistance (lower overall wear rate) than the reported wear resistance of monolithic 6351 Al alloy.

  11. Hybrid Simulator

    Energy Science and Technology Software Center (ESTSC)

    2005-10-15

    HybSim (short for Hybrid Simulator) is a flexible, easy to use screening tool that allows the user to quanti the technical and economic benefits of installing a village hybrid generating system and simulates systems with any combination of —Diesel generator sets —Photovoltaic arrays -Wind Turbines and -Battery energy storage systems Most village systems (or small population sites such as villages, remote military bases, small communities, independent or isolated buildings or centers) depend on diesel generationmore » systems for their source of energy. HybSim allows the user to determine other "sources" of energy that can greatly reduce the dollar to kilo-watt hour ratio. Supported by the DOE, Energy Storage Program, HybSim was initially developed to help analyze the benefits of energy storage systems in Alaskan villages. Soon after its development, other sources of energy were added providing the user with a greater range of analysis opportunities and providing the village with potentially added savings. In addition to village systems, HybSim has generated interest for use from military institutions in energy provisions and USAID for international village analysis.« less

  12. 17 CFR 256.141 - Notes receivable.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... COMPANY ACT OF 1935 3. Current and Accrued Assets § 256.141 Notes receivable. This account shall include the cost of all notes receivable and similar evidences of amounts due within one year from persons... 17 Commodity and Securities Exchanges 3 2010-04-01 2010-04-01 false Notes receivable....

  13. Promoting Knowledge Transfer with Electronic Note Taking

    ERIC Educational Resources Information Center

    Katayama, Andrew D.; Shambaugh, R. Neal; Doctor, Tasneem

    2005-01-01

    We investigated the differences between (a) copying and pasting text versus typed note-taking methods of constructing study notes simultaneously with (b) vertically scaffolded versus horizontally scaffold notes on knowledge transfer. Forty-seven undergraduate educational psychology students participated. Materials included 2 electronic…

  14. 32 CFR 806b.5 - Personal notes.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 6 2010-07-01 2010-07-01 false Personal notes. 806b.5 Section 806b.5 National Defense Department of Defense (Continued) DEPARTMENT OF THE AIR FORCE ADMINISTRATION PRIVACY ACT PROGRAM... notes on individuals used as memory aids. Personal notes may become Privacy Act records if they...

  15. 31 CFR Appendixes to Chapter V - Note

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false Note Appendixes to Chapter V Money... CONTROL, DEPARTMENT OF THE TREASURY Ch. V, Nt. Appendixes to Chapter V—Note Notes: The alphabetical lists.... References to regulatory parts in chapter V or other authorities: : Western Balkans Stabilization...

  16. Hybridized tetraquarks

    NASA Astrophysics Data System (ADS)

    Esposito, A.; Pilloni, A.; Polosa, A. D.

    2016-07-01

    We propose a new interpretation of the neutral and charged X , Z exotic hadron resonances. Hybridized-tetraquarks are neither purely compact tetraquark states nor bound or loosely bound molecules but rather a manifestation of the interplay between the two. While meson molecules need a negative or zero binding energy, its counterpart for h-tetraquarks is required to be positive. The formation mechanism of this new class of hadrons is inspired by that of Feshbach metastable states in atomic physics. The recent claim of an exotic resonance in the Bs0 π± channel by the D0 Collaboration and the negative result presented subsequently by the LHCb Collaboration are understood in this scheme, together with a considerable portion of available data on X , Z particles. Considerations on a state with the same quantum numbers as the X (5568) are also made.

  17. Systems Engineering of Electric and Hybrid Vehicles

    NASA Technical Reports Server (NTRS)

    Kurtz, D. W.; Levin, R. R.

    1986-01-01

    Technical paper notes systems engineering principles applied to development of electric and hybrid vehicles such that system performance requirements support overall program goal of reduced petroleum consumption. Paper discusses iterative design approach dictated by systems analyses. In addition to obvious peformance parameters of range, acceleration rate, and energy consumption, systems engineering also considers such major factors as cost, safety, reliability, comfort, necessary supporting infrastructure, and availability of materials.

  18. 50 CFR 253.12 - Guaranteed note, U.S. note, and security documents.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 50 Wildlife and Fisheries 7 2010-10-01 2010-10-01 false Guaranteed note, U.S. note, and security documents. 253.12 Section 253.12 Wildlife and Fisheries NATIONAL MARINE FISHERIES SERVICE, NATIONAL OCEANIC... Fisheries Obligation Guarantee Program § 253.12 Guaranteed note, U.S. note, and security documents....

  19. Kepler Data Release 4 Notes

    NASA Technical Reports Server (NTRS)

    Van Cleve, Jeffrey (Editor); Jenkins, Jon; Caldwell, Doug; Allen, Christopher L.; Batalha, Natalie; Bryson, Stephen T.; Chandrasekaran, Hema; Clarke, Bruce D.; Cote, Miles T.; Dotson, Jessie L.; Gilliland, Ron; Girouard, Forrest; Haas, Michael R.; Hall, Jennifer; Ibrahim, Khadeejah; Klaus, Todd; Kolodziejczak, Jeff; Li, Jie; McCauliff, Sean D.; Middour, Christopher K.; Pletcher, David L.; Quintana, Elisa V.; Tenenbaum, Peter G.; Twicken, Joe; Uddin, Akm Kamal

    2010-01-01

    The Data Analysis Working Group have released long and short cadence materials, including FFIs and Dropped Targets for the Public. The Kepler Science Office considers Data Release 4 to provide "browse quality" data. These notes have been prepared to give Kepler users of the Multimission Archive at STScl (MAST) a summary of how the data were collected and prepared, and how well the data processing pipeline is functioning on flight data. They will be updated for each release of data to the public archive and placed on MAST along with other Kepler documentation, at http://archive.stsci.edu/kepler/documents.html. Data release 3 is meant to give users the opportunity to examine the data for possibly interesting science and to involve the users in improving the pipeline for future data releases. To perform the latter service, users are encouraged to notice and document artifacts, either in the raw or processed data, and report them to the Science Office.

  20. Hybrid mimics and hybrid vigor in Arabidopsis

    PubMed Central

    Wang, Li; Greaves, Ian K.; Groszmann, Michael; Wu, Li Min; Dennis, Elizabeth S.; Peacock, W. James

    2015-01-01

    F1 hybrids can outperform their parents in yield and vegetative biomass, features of hybrid vigor that form the basis of the hybrid seed industry. The yield advantage of the F1 is lost in the F2 and subsequent generations. In Arabidopsis, from F2 plants that have a F1-like phenotype, we have by recurrent selection produced pure breeding F5/F6 lines, hybrid mimics, in which the characteristics of the F1 hybrid are stabilized. These hybrid mimic lines, like the F1 hybrid, have larger leaves than the parent plant, and the leaves have increased photosynthetic cell numbers, and in some lines, increased size of cells, suggesting an increased supply of photosynthate. A comparison of the differentially expressed genes in the F1 hybrid with those of eight hybrid mimic lines identified metabolic pathways altered in both; these pathways include down-regulation of defense response pathways and altered abiotic response pathways. F6 hybrid mimic lines are mostly homozygous at each locus in the genome and yet retain the large F1-like phenotype. Many alleles in the F6 plants, when they are homozygous, have expression levels different to the level in the parent. We consider this altered expression to be a consequence of transregulation of genes from one parent by genes from the other parent. Transregulation could also arise from epigenetic modifications in the F1. The pure breeding hybrid mimics have been valuable in probing the mechanisms of hybrid vigor and may also prove to be useful hybrid vigor equivalents in agriculture. PMID:26283378

  1. Station Program Note Pull Automation

    NASA Technical Reports Server (NTRS)

    Delgado, Ivan

    2016-01-01

    Upon commencement of my internship, I was in charge of maintaining the CoFR (Certificate of Flight Readiness) Tool. The tool acquires data from existing Excel workbooks on NASA's and Boeing's databases to create a new spreadsheet listing out all the potential safety concerns for upcoming flights and software transitions. Since the application was written in Visual Basic, I had to learn a new programming language and prepare to handle any malfunctions within the program. Shortly afterwards, I was given the assignment to automate the Station Program Note (SPN) Pull process. I developed an application, in Python, that generated a GUI (Graphical User Interface) that will be used by the International Space Station Safety & Mission Assurance team here at Johnson Space Center. The application will allow its users to download online files with the click of a button, import SPN's based on three different pulls, instantly manipulate and filter spreadsheets, and compare the three sources to determine which active SPN's (Station Program Notes) must be reviewed for any upcoming flights, missions, and/or software transitions. Initially, to perform the NASA SPN pull (one of three), I had created the program to allow the user to login to a secure webpage that stores data, input specific parameters, and retrieve the desired SPN's based on their inputs. However, to avoid any conflicts with sustainment, I altered it so that the user may login and download the NASA file independently. After the user has downloaded the file with the click of a button, I defined the program to check for any outdated or pre-existing files, for successful downloads, to acquire the spreadsheet, convert it from a text file to a comma separated file and finally into an Excel spreadsheet to be filtered and later scrutinized for specific SPN numbers. Once this file has been automatically manipulated to provide only the SPN numbers that are desired, they are stored in a global variable, shown on the GUI, and

  2. Kepler Data Release 3 Notes

    NASA Technical Reports Server (NTRS)

    Cleve, Jeffrey E.

    2010-01-01

    This describes the collection of data and the processing done on it so when researchers around the world get the Kepler data sets (which are a set of pixels from the telescope of a particular target (star, galaxy or whatever) over a 3 month period) they can adjust their algorithms fro things that were done (like subtracting all of one particular wavelength for example). This is used to calibrate their own algorithms so that they know what it is they are starting with. It is posted so that whoever is accessing the publicly available data (not all of it is made public) can understand it .. (most of the Kepler data is under restriction for 1 - 4 years and is not available, but the handbook is for everyone (public and restricted) The Data Analysis Working Group have released long and short cadence materials, including FFls and Dropped Targets for the Public. The Kepler Science Office considers Data Release 3 to provide "browse quality" data. These notes have been prepared to give Kepler users of the Multimission Archive at STScl (MAST) a summary of how the data were collected and prepared, and how well the data processing pipeline is functioning on flight data. They will be updated for each release of data to the public archive and placed on MAST along with other Kepler documentation, at http:// archive.stsci.edu/kepler/documents.html .Data release 3 is meant to give users the opportunity to examine the data for possibly interesting science and to involve the users in improving the pipeline for future data releases. To perform the latter service, users are encouraged to notice and document artifacts, either in the raw or processed data, and report them to the Science Office.

  3. News Note: Screening for ovarian cancer shows no reduction in mortality

    Cancer.gov

    Simultaneous screening with a blood test for the biomarker CA-125 along with a transvaginal ultrasound (TVU), compared with usual care, did not reduce ovarian cancer mortality in American women. These results, from a National Cancer Institute (NCI) sponsored trial, also show that diagnostic evaluation following a false-positive result was associated with potentially harmful complications.

  4. [Natural orifice translumenal endoscopic surgery: historical and future perspectives].

    PubMed

    Yasuda, Kazuhiro; Shiroshita, Hidefumi; Inomata, Masafumi; Kitano, Seigo

    2013-11-01

    Natural orifice translumenal endoscopic surgery (NOTES) has gained much attention worldwide since the first report of transgastric peritoneoscopy in a porcine model in 2004. In this review, we summarize and highlight the current status and future directions of NOTES. Thousands of human NOTES procedures have been performed. The most common procedures are cholecystectomy and appendectomy, mainly performed through transvaginal access in a hybrid fashion with laparoscopic assistance, and the general complication rate is acceptable. Although much work is still needed to refine the techniques for NOTES, the development of NOTES has the potential to create a paradigm shift in minimally invasive surgery. PMID:24358724

  5. Idea Bank: Duct Tape Note Twister

    ERIC Educational Resources Information Center

    McHenry, Molly

    2008-01-01

    In this article, the author relates how she observed a middle school math teacher deliver a miserable class. She realized that she did the same thing to her music students. To engage her students, she developed "Note Twister," a music reading game using duct tape to form musical notes and the basic premise behind the game, "Twister." She finds…

  6. RNS. Research Notes and Information References

    SciTech Connect

    Hartley, D.S. III

    1988-05-01

    The RNS (Research Notes System) is a set of programs and databases designed to aid the research worker in gathering, maintaining, and using notes taken from the literature. The sources for the notes can be books, journal articles, reports, private conversations, conference papers, audiovisuals, etc. The system ties the databases together in a relational structure, thus eliminating data redundancy while providing full access to all the information. The programs provide the means for access and data entry in a way that reduces the key-entry burden for the user. Each note has several data fields. Included are the text of the note, the subject classification (for retrieval), and the reference identification data. These data are divided into four databases: Document data - title, author, publisher, etc., fields to identify the article within the document; Note data - text and page of the note; Sublect data - subject categories to ensure uniform spelling for searches. Additionally, there are subsidiary files used by the system, including database index and temporary work files. The system provides multiple access routes to the notes, both structurally (access method) and topically (through cross-indexing). Output may be directed to a printer or saved as a file for input to word processing software.

  7. RNS. Research Notes and Information References

    SciTech Connect

    Hartley, D.S. III )

    1988-05-01

    The RNS (Research Notes System) is a set of programs and databases designed to aid the research worker in gathering, maintaining, and using notes taken from the literature. The sources for the notes can be books, journal articles, reports, private conversations, conference papers, audiovisuals, etc. The system ties the databases together in a relational structure, thus eliminating data redundancy while providing full access to all the information. The programs provide the means for access and data entry in a way that reduces the key-entry burden for the user. Each note has several data fields. Included are the text of the note, the subject classification (for retrieval), and the reference identification data. These data are divided into four databases: Document data - title, author, publisher, etc., fields to identify the article within the document; Note data - text and page of the note; Sublect data - subject categories to ensure uniform spelling for searches. Additionally, there are subsidiary files used by the system, including database index and temporary work files. The system provides multiple access routes to the notes, both structurally (access method) and topically (through cross-indexingg). Output may be directed to a printer or saved as a file for input to word processing software.

  8. Model Disciplinary Policies. Research Note. Volume 0902

    ERIC Educational Resources Information Center

    Blazer, Christie

    2009-01-01

    This Research Note is in response to a request from the Office of Alternative Education to review and report on "model disciplinary policies" as used in school districts around the nation. The primary source of information used to prepare this Research Note came from a professional group identified by Alternative Education. The Advancement…

  9. Skin suicide note written in mehndi (henna).

    PubMed

    Behera, Chittaranjan; Swain, Rajanikanta; Bhardwaj, Daya Nand; Millo, Tabin

    2016-03-01

    Suicide messages on the skin are rare. Until now, in all reported cases, the writing tool used by the victims has been a pen. We report a suicide case by hanging in which the victim had written a note on her palm in mehndi, or henna, at a wedding ceremony three days before the fatal act. The note was discovered at autopsy. PMID:26612577

  10. Collection of "Clearinghouse Notes," 1995-96.

    ERIC Educational Resources Information Center

    Education Commission of the States, Denver, CO.

    During the 1995-96 year, the Education Commission of the States (ECS) Clearinghouse issued almost three dozen "Clearinghouse Notes" on a wide array of education issues. The notes, which are usually one to two pages long, show at a glance state legislation passed or pending on specific education issues. This packet contains the complete set of…

  11. Collection of "Clearinghouse Notes," 1997-98.

    ERIC Educational Resources Information Center

    Education Commission of the States, Denver, CO.

    This document is a collection of Education Commission of the States notes that address a wide array of education issues. The notes provide brief overviews of state legislation passed or pending on specific education issues. It analyzes such matters as performance-based accountability systems; state-level policies regarding accreditation in public…

  12. Suicide Notes in Hong Kong in 2000

    ERIC Educational Resources Information Center

    Wong, Paul W. C.; Yeung, April W. M.; Chan, Wincy S. C.; Yip, Paul S. F.; Tang, Arthur K. H.

    2009-01-01

    Suicide notes have been regarded as one of the most informative data sources to understand the reasons why people commit suicide. However, there is a paucity of suicide note studies, leaving researchers with an assumption that this phenomenon remains static over time. This study examines this assumption by comparing the characteristics of…

  13. Note Taking on Trial: A Legal Application of Note-Taking Research

    ERIC Educational Resources Information Center

    Kiewra, Kenneth A.

    2016-01-01

    This article is about note taking, but it is not an exhaustive review of note-taking literature. Instead, it portrays the application of note-taking research to an unusual and important area of practice--the law. I was hired to serve as an expert witness on note taking in a legal case that hinged, in part, on the completeness and accuracy of…

  14. Mysore study: A study of suicide notes

    PubMed Central

    Namratha, P.; Kishor, M.; Sathyanarayana Rao, T. S.; Raman, Rajesh

    2015-01-01

    Background: Suicide is one of the leading causes of preventable deaths. Recent data suggest South India as one of the regions with highest suicide rates in the world. In 2013, 134,799 people committed suicide in India according to the statistics released by the National Crime Records Bureau. Suicide note is one of the most important sources to understand suicide, which may be beneficial in suicide prevention. Studies on suicidal notes from this part of the world are sparse. Objective: The aim was to study the themes in suicide notes that might be useful in prevention strategies. Materials and Methods: A descriptive study of all suicide notes of those individuals who committed suicide between 2010 and 2013 available with Police Department, Mysore district was obtained and analyzed. Results: A total of 22 suicide note were available. A majority of suicide note was in age group of 16–40 years (86%) and most were men (59%). All suicide notes were handwritten, the majority (70%) in regional language Kannada. Length of notes varied from just few words to few pages. Contents of suicide notes included apology/shame/guilt (80%), love for those left behind (55%) and instruction regarding practical affairs (23%). Most have blamed none for the act (50%). 23% mentioned that they are committing suicide to prove their innocence. 32% mentioned a last wish. Conclusion: The majority of suicidal note contained “guilt” which is a strong indicator of possible depression in deceased. Creating awareness about suicide among public and ensuring access to professionals trained in suicide prevention is need of the hour in this part of the world. PMID:26816426

  15. Hybrid rocket propulsion

    NASA Technical Reports Server (NTRS)

    Holzman, Allen L.

    1993-01-01

    Topics addressed are: (1) comparison of the theoretical impulses; (2) comparison of the density-specific impulses; (3) general propulsion system features comparison; (4) hybrid systems, booster applications; and (5) hybrid systems, upper stage propulsion applications.

  16. Hybridization and hybrid speciation under global change.

    PubMed

    Vallejo-Marín, Mario; Hiscock, Simon J

    2016-09-01

    Contents 1170 I. 1170 II. 1172 III. 1175 IV. 1180 V. 1183 1184 References 1184 SUMMARY: An unintended consequence of global change is an increase in opportunities for hybridization among previously isolated lineages. Here we illustrate how global change can facilitate the breakdown of reproductive barriers and the formation of hybrids, drawing on the flora of the British Isles for insight. Although global change may ameliorate some of the barriers preventing hybrid establishment, for example by providing new ecological niches for hybrids, it will have limited effects on environment-independent post-zygotic barriers. For example, genic incompatibilities and differences in chromosome numbers and structure within hybrid genomes are unlikely to be affected by global change. We thus speculate that global change will have a larger effect on eroding pre-zygotic barriers (eco-geographical isolation and phenology) than post-zygotic barriers, shifting the relative importance of these two classes of reproductive barriers from what is usually seen in naturally produced hybrids where pre-zygotic barriers are the largest contributors to reproductive isolation. Although the long-term fate of neo-hybrids is still to be determined, the massive impact of global change on the dynamics and distribution of biodiversity generates an unprecedented opportunity to study large numbers of unpredicted, and often replicated, hybridization 'experiments', allowing us to peer into the birth and death of evolutionary lineages. PMID:27214560

  17. From hybrid swarms to swarms of hybrids

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The introgression of modern humans (Homo sapiens) with Neanderthals 40,000 YBP after a half-million years of separation, may have led to the best example of a hybrid swarm on earth. Modern trade and transportation in support of the human hybrids has continued to introduce additional species, genotyp...

  18. Mesoscale hybrid calibration artifact

    DOEpatents

    Tran, Hy D.; Claudet, Andre A.; Oliver, Andrew D.

    2010-09-07

    A mesoscale calibration artifact, also called a hybrid artifact, suitable for hybrid dimensional measurement and the method for make the artifact. The hybrid artifact has structural characteristics that make it suitable for dimensional measurement in both vision-based systems and touch-probe-based systems. The hybrid artifact employs the intersection of bulk-micromachined planes to fabricate edges that are sharp to the nanometer level and intersecting planes with crystal-lattice-defined angles.

  19. Hybrid armature projectile

    DOEpatents

    Hawke, R.S.; Asay, J.R.; Hall, C.A.; Konrad, C.H.; Sauve, G.L.; Shahinpoor, M.; Susoeff, A.R.

    1993-03-02

    A projectile for a railgun that uses a hybrid armature and provides a seed block around part of the outer surface of the projectile to seed the hybrid plasma brush. In addition, the hybrid armature is continuously vaporized to replenish plasma in a plasma armature to provide a tandem armature and provides a unique ridge and groove to reduce plasma blowby.

  20. Hybrid armature projectile

    DOEpatents

    Hawke, Ronald S.; Asay, James R.; Hall, Clint A.; Konrad, Carl H.; Sauve, Gerald L.; Shahinpoor, Mohsen; Susoeff, Allan R.

    1993-01-01

    A projectile for a railgun that uses a hybrid armature and provides a seed block around part of the outer surface of the projectile to seed the hybrid plasma brush. In addition, the hybrid armature is continuously vaporized to replenish plasma in a plasma armature to provide a tandem armature and provides a unique ridge and groove to reduce plasama blowby.

  1. Homoploid hybrid expectations

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Homoploid hybrid speciation occurs when a stable, fertile, and reproductively isolated lineage results from hybridization between two distinct species without a change in ploidy level. Reproductive isolation between a homoploid hybrid species and its parents is generally attained via chromosomal re...

  2. Hybrid quantum information processing

    SciTech Connect

    Furusawa, Akira

    2014-12-04

    I will briefly explain the definition and advantage of hybrid quantum information processing, which is hybridization of qubit and continuous-variable technologies. The final goal would be realization of universal gate sets both for qubit and continuous-variable quantum information processing with the hybrid technologies. For that purpose, qubit teleportation with a continuousvariable teleporter is one of the most important ingredients.

  3. Hybrid rocket instability

    NASA Technical Reports Server (NTRS)

    Greiner, B.; Frederick, R. A., Jr.

    1993-01-01

    The paper provides a brief review of theoretical and experimental studies concerned with hybrid rocket instability. The instabilities discussed include atomization and mixing instabilities, chuffing instabilities, pressure coupled combustion instabilities, and vortex shedding. It is emphasized that the future use of hybrid motor systems as viable design alternatives will depend on a better understanding of hybrid instability.

  4. Hybrid rocket instability

    NASA Astrophysics Data System (ADS)

    Greiner, B.; Frederick, R. A., Jr.

    1993-06-01

    The paper provides a brief review of theoretical and experimental studies concerned with hybrid rocket instability. The instabilities discussed include atomization and mixing instabilities, chuffing instabilities, pressure coupled combustion instabilities, and vortex shedding. It is emphasized that the future use of hybrid motor systems as viable design alternatives will depend on a better understanding of hybrid instability.

  5. A study of actions in operative notes.

    PubMed

    Wang, Yan; Pakhomov, Serguei; Burkart, Nora E; Ryan, James O; Melton, Genevieve B

    2012-01-01

    Operative notes contain rich information about techniques, instruments, and materials used in procedures. To assist development of effective information extraction (IE) techniques for operative notes, we investigated the sublanguage used to describe actions within the operative report 'procedure description' section. Deep parsing results of 362,310 operative notes with an expanded Stanford parser using the SPECIALIST Lexicon resulted in 200 verbs (92% coverage) including 147 action verbs. Nominal action predicates for each action verb were gathered from WordNet, SPECIALIST Lexicon, New Oxford American Dictionary and Stedman's Medical Dictionary. Coverage gaps were seen in existing lexical, domain, and semantic resources (Unified Medical Language System (UMLS) Metathesaurus, SPECIALIST Lexicon, WordNet and FrameNet). Our findings demonstrate the need to construct surgical domain-specific semantic resources for IE from operative notes. PMID:23304423

  6. 25 CFR 169.7 - Field notes.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... filed separately on tracing linen in such form that they may be folded readily for filing. Where field notes are placed on separate tracing linen, it will be necessary to place on the maps only a...

  7. 25 CFR 169.7 - Field notes.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... filed separately on tracing linen in such form that they may be folded readily for filing. Where field notes are placed on separate tracing linen, it will be necessary to place on the maps only a...

  8. 25 CFR 169.7 - Field notes.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... filed separately on tracing linen in such form that they may be folded readily for filing. Where field notes are placed on separate tracing linen, it will be necessary to place on the maps only a...

  9. 25 CFR 169.7 - Field notes.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... filed separately on tracing linen in such form that they may be folded readily for filing. Where field notes are placed on separate tracing linen, it will be necessary to place on the maps only a...

  10. 25 CFR 169.7 - Field notes.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... filed separately on tracing linen in such form that they may be folded readily for filing. Where field notes are placed on separate tracing linen, it will be necessary to place on the maps only a...

  11. Hybridization and extinction.

    PubMed

    Todesco, Marco; Pascual, Mariana A; Owens, Gregory L; Ostevik, Katherine L; Moyers, Brook T; Hübner, Sariel; Heredia, Sylvia M; Hahn, Min A; Caseys, Celine; Bock, Dan G; Rieseberg, Loren H

    2016-08-01

    Hybridization may drive rare taxa to extinction through genetic swamping, where the rare form is replaced by hybrids, or by demographic swamping, where population growth rates are reduced due to the wasteful production of maladaptive hybrids. Conversely, hybridization may rescue the viability of small, inbred populations. Understanding the factors that contribute to destructive versus constructive outcomes of hybridization is key to managing conservation concerns. Here, we survey the literature for studies of hybridization and extinction to identify the ecological, evolutionary, and genetic factors that critically affect extinction risk through hybridization. We find that while extinction risk is highly situation dependent, genetic swamping is much more frequent than demographic swamping. In addition, human involvement is associated with increased risk and high reproductive isolation with reduced risk. Although climate change is predicted to increase the risk of hybridization-induced extinction, we find little empirical support for this prediction. Similarly, theoretical and experimental studies imply that genetic rescue through hybridization may be equally or more probable than demographic swamping, but our literature survey failed to support this claim. We conclude that halting the introduction of hybridization-prone exotics and restoring mature and diverse habitats that are resistant to hybrid establishment should be management priorities. PMID:27468307

  12. Note-Taking Strategies for Students with Disabilities.

    ERIC Educational Resources Information Center

    Weishaar, Mary Konya; Boyle, Joseph R.

    1999-01-01

    Argues that it is critical for secondary students with disabilities to learn a variety of note-taking skills in order to become independent and successful students. Discusses three student-directed note-taking techniques: strategic note-taking, guided notes, and columnar format. Notes advice for implementing the strategies. (SR)

  13. Life testing of a nine-couple hybrid thermoelectric panel

    NASA Technical Reports Server (NTRS)

    Bifano, W. J.

    1973-01-01

    Life test data are presented for a nine couple thermoelectric panel of hybrid couples tested at an average hot junction temperature of 840 C (1113 K). In the hybrid couple, a hollow cylinder of p-type Si-Ge is used to encapsulate a segmented PbTe/Si-Ge n-leg. The output power and internal resistance of the panel as well as the resistances of the individual hybrid couples are presented as functions of test time covering a period of more than 4200 hours. Test results indicated improved stability relative to hybrid couples tested at higher temperatures. Thermal cycling of the panel resulted in an order of magnitude increase in room temperature resistance. However, very little change in resistance at operating temperatures was noted following the thermal cycles.

  14. Entanglement in Quantum-Classical Hybrid

    NASA Technical Reports Server (NTRS)

    Zak, Michail

    2011-01-01

    It is noted that the phenomenon of entanglement is not a prerogative of quantum systems, but also occurs in other, non-classical systems such as quantum-classical hybrids, and covers the concept of entanglement as a special type of global constraint imposed upon a broad class of dynamical systems. Application of hybrid systems for physics of life, as well as for quantum-inspired computing, has been outlined. In representing the Schroedinger equation in the Madelung form, there is feedback from the Liouville equation to the Hamilton-Jacobi equation in the form of the quantum potential. Preserving the same topology, the innovators replaced the quantum potential with other types of feedback, and investigated the property of these hybrid systems. A function of probability density has been introduced. Non-locality associated with a global geometrical constraint that leads to an entanglement effect was demonstrated. Despite such a quantum like characteristic, the hybrid can be of classical scale and all the measurements can be performed classically. This new emergence of entanglement sheds light on the concept of non-locality in physics.

  15. Hybrid radiator cooling system

    DOEpatents

    France, David M.; Smith, David S.; Yu, Wenhua; Routbort, Jules L.

    2016-03-15

    A method and hybrid radiator-cooling apparatus for implementing enhanced radiator-cooling are provided. The hybrid radiator-cooling apparatus includes an air-side finned surface for air cooling; an elongated vertically extending surface extending outwardly from the air-side finned surface on a downstream air-side of the hybrid radiator; and a water supply for selectively providing evaporative cooling with water flow by gravity on the elongated vertically extending surface.

  16. Managing hybrid marketing systems.

    PubMed

    Moriarty, R T; Moran, U

    1990-01-01

    As competition increases and costs become critical, companies that once went to market only one way are adding new channels and using new methods - creating hybrid marketing systems. These hybrid marketing systems hold the promise of greater coverage and reduced costs. But they are also hard to manage; they inevitably raise questions of conflict and control: conflict because marketing units compete for customers; control because new indirect channels are less subject to management authority. Hard as they are to manage, however, hybrid marketing systems promise to become the dominant design, replacing the "purebred" channel strategy in all kinds of businesses. The trick to managing the hybrid is to analyze tasks and channels within and across a marketing system. A map - the hybrid grid - can help managers make sense of their hybrid system. What the chart reveals is that channels are not the basic building blocks of a marketing system; marketing tasks are. The hybrid grid forces managers to consider various combinations of channels and tasks that will optimize both cost and coverage. Managing conflict is also an important element of a successful hybrid system. Managers should first acknowledge the inevitability of conflict. Then they should move to bound it by creating guidelines that spell out which customers to serve through which methods. Finally, a marketing and sales productivity (MSP) system, consisting of a central marketing database, can act as the central nervous system of a hybrid marketing system, helping managers create customized channels and service for specific customer segments. PMID:10107959

  17. Hybridization facilitates evolutionary rescue

    PubMed Central

    Stelkens, Rike B; Brockhurst, Michael A; Hurst, Gregory D D; Greig, Duncan

    2014-01-01

    The resilience of populations to rapid environmental degradation is a major concern for biodiversity conservation. When environments deteriorate to lethal levels, species must evolve to adapt to the new conditions to avoid extinction. Here, we test the hypothesis that evolutionary rescue may be enabled by hybridization, because hybridization increases genetic variability. Using experimental evolution, we show that interspecific hybrid populations of Saccharomyces yeast adapt to grow in more highly degraded environments than intraspecific and parental crosses, resulting in survival rates far exceeding those of their ancestors. We conclude that hybridization can increase evolutionary responsiveness and that taxa able to exchange genes with distant relatives may better survive rapid environmental change. PMID:25558281

  18. Benefits of an Electronic Consultation-Liaison Note System: Better Notes Faster

    ERIC Educational Resources Information Center

    Sola, Christopher L.; Bostwick, J. Michael; Sampson, Shirlene

    2007-01-01

    Objective: The authors determined the efficiency of electronic documentation in consultation-liaison psychiatry. METHOD: An electronic note system was customized for a psychiatric consultation note. Specific attention given to common diagnoses permitted rapid documentation. Results: Residents learned the system quickly. The standardized nature of…

  19. Online Notes: Differential Effects of Studying Complete or Partial Graphically Organized Notes

    ERIC Educational Resources Information Center

    Katayama, Andrew D.; Crooks, Steven M.

    2003-01-01

    The authors investigated in this study the effects of two electronic notes conditions (complete vs. partial) and two testing conditions (immediate vs. delayed) on three types of tests (fact, structure, and application). A 2 x 2 factorial multivariate analysis of variance (MANOVA) yielded no significant main effects for notes conditions on the fact…

  20. A Comparison of Suicide Note Writers with Suicides Who Did Not Leave Notes

    ERIC Educational Resources Information Center

    Callanan, Valerie J.; Davis, Mark S.

    2009-01-01

    There is disagreement in the suicide literature on the value of suicide notes as a data source, particularly regarding the extent to which suicide decedents who write notes differ from those who do not. Using 10 years of suicide cases from Summit County, Ohio, these two groups were compared on 40 variables including sociodemographic…

  1. A Note About HARP's State Trimming Method

    NASA Technical Reports Server (NTRS)

    Butler, Ricky W.; Hayhurst, Kelly J.; Johnson, Sally C.

    1998-01-01

    This short note provides some additional insight into how the HARP program works. In some cases, it is possible for HARP to tdm away too many states and obtain an optimistic result. The HARP Version 7.0 manual warns the user that 'Unlike the ALL model, the SAME model can automatically drop failure modes for certain system models. The user is cautioned to insure that no important failure modes are dropped; otherwise, a non-conservative result can be given.' This note provides an example of where this occurs and a pointer to further documentation that gives a means of bounding the error associated with trimming these states.

  2. Xyce parallel electronic simulator release notes.

    SciTech Connect

    Keiter, Eric Richard; Hoekstra, Robert John; Mei, Ting; Russo, Thomas V.; Schiek, Richard Louis; Thornquist, Heidi K.; Rankin, Eric Lamont; Coffey, Todd Stirling; Pawlowski, Roger Patrick; Santarelli, Keith R.

    2010-05-01

    The Xyce Parallel Electronic Simulator has been written to support, in a rigorous manner, the simulation needs of the Sandia National Laboratories electrical designers. Specific requirements include, among others, the ability to solve extremely large circuit problems by supporting large-scale parallel computing platforms, improved numerical performance and object-oriented code design and implementation. The Xyce release notes describe: Hardware and software requirements New features and enhancements Any defects fixed since the last release Current known defects and defect workarounds For up-to-date information not available at the time these notes were produced, please visit the Xyce web page at http://www.cs.sandia.gov/xyce.

  3. Application Note: Power Grid Modeling With Xyce.

    SciTech Connect

    Sholander, Peter E.

    2015-06-01

    This application note describes how to model steady-state power flows and transient events in electric power grids with the SPICE-compatible Xyce TM Parallel Electronic Simulator developed at Sandia National Labs. This application notes provides a brief tutorial on the basic devices (branches, bus shunts, transformers and generators) found in power grids. The focus is on the features supported and assumptions made by the Xyce models for power grid elements. It then provides a detailed explanation, including working Xyce netlists, for simulating some simple power grid examples such as the IEEE 14-bus test case.

  4. Suicide notes and cadaveric organ donation.

    PubMed

    Behera, C; Krishna, Karthik; Kumar, R

    2016-09-01

    A suicide note is an important tool for medico-legal investigation on the manner and circumstances surrounding the death. It can also act as a facilitator for organ donation when the victim expresses their wish to do so. This article cites four examples, where the victims had specifically mentioned a "last wish" to donate their organs. The importance of such "expressed consent" in suicide notes is discussed. Such observations are not found in available scientific literature and are of importance in countries where there is a long waiting list for organ recipients and a very large number of suicidal deaths. PMID:26992402

  5. From hybrid swarms to swarms of hybrids

    USGS Publications Warehouse

    Stohlgren, Thomas J.; Szalanski, Allen L; Gaskin, John F.; Young, Nicholas E.; West, Amanda; Jarnevich, Catherine S.; Tripodi, Amber

    2015-01-01

    Science has shown that the introgression or hybridization of modern humans (Homo sapiens) with Neanderthals up to 40,000 YBP may have led to the swarm of modern humans on earth. However, there is little doubt that modern trade and transportation in support of the humans has continued to introduce additional species, genotypes, and hybrids to every country on the globe. We assessed the utility of species distributions modeling of genotypes to assess the risk of current and future invaders. We evaluated 93 locations of the genus Tamarix for which genetic data were available. Maxent models of habitat suitability showed that the hybrid, T. ramosissima x T. chinensis, was slightly greater than the parent taxa (AUCs > 0.83). General linear models of Africanized honey bees, a hybrid cross of Tanzanian Apis mellifera scutellata and a variety of European honey bee including A. m. ligustica, showed that the Africanized bees (AUC = 0.81) may be displacing European honey bees (AUC > 0.76) over large areas of the southwestern U.S. More important, Maxent modeling of sub-populations (A1 and A26 mitotypes based on mDNA) could be accurately modeled (AUC > 0.9), and they responded differently to environmental drivers. This suggests that rapid evolutionary change may be underway in the Africanized bees, allowing the bees to spread into new areas and extending their total range. Protecting native species and ecosystems may benefit from risk maps of harmful invasive species, hybrids, and genotypes.

  6. Hybrid baryons [alpha].

    SciTech Connect

    Page, P. R.

    2002-01-01

    The authors review the status of hybrid baryons. The only known way to study hybrids rigorously is via excited adiabatic potentials. Hybrids can be modeled by both the bag and flux tube models. The low lying hybrid baryon is N 1/2{sup +} with a mass of 1.5 - 1.8 GeV. Hybrid baryons can be produced in the glue rich processes of diffractive {gamma}N and {pi}N production, {Psi} decays and p{bar p} annihilation. We review the current status of research on three quarks with a gluonic excitation, called a hybrid baryon. The excitation is not an orbital or radial excitation between the quarks. Hybrid baryons have also been reviewed elsewhere. The Mercedes-Benz logl in Figure 1 indicates two possible views of the confining interaction of three quarks, an essential issue in the study of hybrid baryons. In the logo the three points where the Y shape meets the boundary circle should be identified with the three quarks. There are two possibilities fo rthe interaction of the quarks: (1) a pairwise interaction of the quarks represented by the circle, or (2) a Y shaped interaction between the quarks, represented by the Y-shape in the logo.

  7. Hybrid Rocket Motor Test

    NASA Technical Reports Server (NTRS)

    1994-01-01

    A 10,000-pound thrust hybrid rocket motor is tested at Stennis Space Center's E-1 test facility. A hybrid rocket motor is a cross between a solid rocket and a liquid-fueled engine. It uses environmentally safe solid fuel and liquid oxygen.

  8. A Note on Evaluating Supplemental Instruction

    ERIC Educational Resources Information Center

    Paloyo, Alfredo R.

    2015-01-01

    Selection bias pervades the evaluation of supplemental instruction (SI) in non-experimental settings. This brief note provides a formal framework to understand this issue. The objective is to contribute to the accumulation of credible evidence on the impact of SI.

  9. Notes & Reflections. Issue 7, Fall 2004

    ERIC Educational Resources Information Center

    Fitzpatrick, Michele, Ed.

    2004-01-01

    "Notes & Reflections" offers practical information--ideas, strategies, tools, and resources--about topics of special interest to professional developers who are working to improve school performance. Today, professional development services to schools are provided by variety of people: teacher leaders; principals; and district, regional, and state…

  10. Science Notes: Dilution of a Weak Acid

    ERIC Educational Resources Information Center

    Talbot, Christopher; Wai, Chooi Khee

    2014-01-01

    This "Science note" arose out of practical work involving the dilution of ethanoic acid, the measurement of the pH of the diluted solutions and calculation of the acid dissociation constant, K[subscript a], for each diluted solution. The students expected the calculated values of K[subscript a] to be constant but they found that the…