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Sample records for proximal hypospadias repair

  1. Hypospadias repair

    MedlinePLUS

    Hypospadias repair is surgery to correct a defect in the opening of the penis that is present at birth. ... Hypospadias repair is done most often when boys are between 6 months and 2 years old. The surgery is ...

  2. The contemporary role of 1 vs. 2-stage repair for proximal hypospadias

    PubMed Central

    Dason, Shawn; Wong, Nathan

    2014-01-01

    This review discusses the most commonly employed techniques in the repair of proximal hypospadias, highlighting the advantages and disadvantages of single versus staged surgical techniques. Hypospadias can have a spectrum of severity with a urethral meatus ranging from the perineum to the glans. Associated abnormalities are commonly found with proximal hypospadias and encompass a large spectrum, including ventral curvature (VC) up to 50 degrees or more, ventral skin deficiency, a flattened glans, penile torsion and penoscrotal transposition. Our contemporary understanding of hypospadiology is comprised of a foundation built by experts who have described a number of techniques and their outcomes, combined with survey data detailing practice patterns. The two largest components of hypospadias repair include repair of VC and urethroplasty. VC greater than 20 degrees is considered clinically relevant to warrant surgical correction. To repair VC, the penis is first degloved—a procedure that may reduce or remove curvature by itself in some cases. Residual curvature is then repaired with dorsal plication techniques, transection of the urethral plate, and/or ventral lengthening techniques. Urethroplasty takes the form of 1- or 2-stage repairs. One-stage options include the tubularized incised urethroplasty (TIP) or various graft or flap-based techniques. Two-stage options also include grafts or flaps, including oral mucosal and preputial skin grafting. One stage repairs are an attractive option in that they may reduce cost, hospital stay, anesthetic risks, and time to the final result. The downside is that these repairs require mastery of multiple techniques may be more complex, and—depending on technique—have higher complication rates. Two-stage repairs are preferred by the majority of surveyed hypospadiologists. The 2-stage repair is versatile and has satisfactory outcomes, but necessitates a second procedure. Given the lack of clear high-quality evidence supporting the superiority of one approach over the others, hypospadiologists should develop their own algorithm, which gives them the best outcomes. PMID:26813851

  3. The Bracka two-stage repair for severe proximal hypospadias: A single center experience

    PubMed Central

    Joshi, Rakesh S.; Bachani, Mitesh K.; Uttarwar, Amit M.; Ramji, Jaishri I.

    2015-01-01

    Background: Surgical correction of severe proximal hypospadias represents a significant surgical challenge and single-stage corrections are often associated with complications and reoperations. Bracka two-stage repair is an attractive alternative surgical procedure with superior, reliable, and reproducible results. Purpose: To study the feasibility and applicability of Bracka two-stage repair for the severe proximal hypospadias and to analyze the outcomes and complications of this surgical technique. Materials and Methods: This prospective study was conducted from January 2011 to December 2013. Bracka two-stage repair was performed using inner preputial skin as a free graft in subjects with proximal hypospadias in whom severe degree of chordee and/or poor urethral plate was present. Only primary cases were included in this study. All subjects received three doses of intra-muscular testosterone 3 weeks apart before first stage. Second stage was performed 6 months after the first stage. Follow-up ranged from 6 months to 24 months. Results: A total of 43 patients operated for Bracka repair, out of which 30 patients completed two-stage repair. Mean age of the patients was 4 years and 8 months. We achieved 100% graft uptake and no revision was required. Three patients developed fistula, while two had metal stenosis. Glans dehiscence, urethral stricture and the residual chordee were not found during follow-up and satisfactory cosmetic results with good urinary stream were achieved in all cases. Conclusion: The Bracka two-stage repair is a safe and reliable approach in select patients in whom it is impractical to maintain the axial integrity of the urethral plate, and, therefore, a full circumference urethral reconstruction become necessary. This gives good results both in terms of restoration of normal function with minimal complication. PMID:25829670

  4. Prefabricated partial distal urethral in 2-staged repair of proximal hypospadias with severe chordee

    PubMed Central

    Fan, Zhi-Qiang; Sun, Jian-Tao; Huangfu, Xue-Hun; Chen, Guo-Xiao; Hao, Jian-Wei; Liu, Zhong-Hua

    2015-01-01

    Purpose: To describe a new technique for staged hypospadias repair in which the urethral plate is divided and tubularized transverse island flap prefabricated partial distal urethral at the time of the first stage. Materials and methods: Sixteen patients with proximal hypospadias associated with severe chordee were operated on using a new staged technique. At the time of the first stage, the urethral plate was divided and chordee was corrected. Then tubularized transverse island flap was used to prefabricate partial distal urethra. The defective urethra was repaired using the Thiersch-Duplay principle at the second stage. Results: All participants have completed both stages of the operation. The mean follow-up duration was 18.4 months (range from 6 to 72 months). In the first-stage surgery, the modified tabularized transverse preputial island flap was performed on 6 patients, whereas the modified preputial double-faced island flap was performed on the other 10 patients. All of the prefabricated partial distal neourethras had no evidence of stenosis or scarring. The result of the second-stage procedure was a complete penis with integrated urethral. All patients were satisfied with cosmetic and functional results. Neither stricture nor diverticula was observed. A good urinary stream during the urination was attained in 12 (75.0%) patients. Four cases (25.0%) developed urethrocutaneous fistula after the second stage repair. Conclusions: In our preliminary series, this procedure improved functional and cosmetic results. It may be applicable to most cases of proximal hypospadias. Even when complications occur, they are less severe compared to those of the traditional staged approach. PMID:25932188

  5. [Hypospadias--one-stage repair].

    PubMed

    Ionescu, S; Andrei, B; Tîrlea, S; Amăriuţei, O

    2012-01-01

    The tubularised incised plate (TIP) is a common surgical technique used in the treatment of hypospadias. The study includes 52 urethroplasties, performed between 2007-2010. We performed Mathieu urethroplasty in 12% of the cases, Duplay urethroplasy in 88% of the cases and we used the Snoodgrass technique in 82% of the cases. The hospital stay varied between 3-8 days after surgery. We included in the study 32 patients with distal penile hypospadias, 8 with proximal hypospadias and 12 with midshaft hypospadias. To prevent fistula formation it is important to perform well sealed sutures, to interpose subcutaneous tissue between the urethroplasty and the cutaneous sutures, not to overlap the urethral and cutaneous sutures. The incidence of urethral fistula after the Duplay procedure was higher then after the Mathieu procedure, but the cases operated by the Duplay technique were manier and more difficult. The complications were more frequent in the cases with proximal hypospadias than in the cases with distal hypospadias, as well as the reintervention rate but not related to the surgical techniques. We present elements of diagnostic, embriology and etiopathogeny of hypospadias. PMID:22844835

  6. Hypospadias repair - series (image)

    MedlinePLUS

    ... is at the tip or end of the penis. ... urethral opening is at the base of the penis, or along the inferior aspect of the shaft of the penis. Hypospadias is usually associated with an abnormal curvature ...

  7. Hypospadias Repair: A Single Centre Experience

    PubMed Central

    Majeed, Abdul; Ullah, Hidayat; Naz, Shazia; Shah, Syed Asif; Tahmeed, Tahmeedullah; Yousaf, Kanwal; Tahir, Muhammad

    2014-01-01

    Objectives. To determine the demographics and analyze the management and factors influencing the postoperative complications of hypospadias repair. Settings. Hayatabad Medical Complex Peshawar, Pakistan, from January 2007 to December 2011. Material and Methods. All male patients presenting with hypospadias irrespective of their ages were included in the study. The data were acquired from the hospital's database and analyzed with Statistical Package for Social Sciences (SPSS). Results. A total of 428 patients with mean age of 8.12 5.04 SD presented for hypospadias repair. Midpenile hypospadias were the most common. Chordee, meatal abnormalities, cryptorchidism, and inguinal hernias were observed in 74.3%, 9.6%, 2.8%, and 2.1% cases, respectively. Two-stage (Bracka) and TIP (tubularized incised urethral plate) repairs were performed in 76.2% and 20.8% of cases, respectively. The most common complications were edema and urethrocutaneous fistula (UCF). The complications were significantly lower in the hands of specialists than residents (P-value = 0.0086). The two-stage hypospadias repair resulted in higher complications frequency than single-stage repair (P value = 0.0001). Conclusion. Hypospadias surgery has a long learning curve because it requires a great deal of temperament, surgical skill and acquaintance with magnifications. Single-stage repair should be encouraged wherever applicable due to its lower postoperative complications. PMID:24579043

  8. The psychosexual aspects of hypospadias repair: A review

    PubMed Central

    Deibert, Christopher M.; Hensle, Terry W.

    2011-01-01

    Objective To review the psychosexual effects on men after hypospadias repair. Methods We reviewed all English-language publications in the MEDLINE database from the US National Library of Medicine with the search terms hypospadias adult, psychosexual hypospadias, psychosocial hypospadias, and social hypospadias. Each term returned 1036, 35, 19 and 68 results, respectively, which were reviewed. Results While improvements in surgical techniques have improved function, the abnormality and repair still causes a disruption in perceived quality of life for many men. After repair, many men suffer from a negative view of their genitals and some degree of sexual inhibition. However, they still maintain a satisfactory sex life. Conclusions Psychosexual effects of hypospadias repair they endure in adulthood, although affected men maintain satisfaction with their sexual life. PMID:26579312

  9. Hypospadias repair in the 1990s.

    PubMed

    Ellsworth, P; Cendron, M; Ritland, D; McCullough, M

    1999-01-01

    Hypospadias is a congenital anomaly in which the urethral meatus is abnormally located anywhere from the glans to the perineum. Refinements in pediatric anesthesia, surgical technique and instrumentation, and a greater understanding of the psychologic and emotional issues related to hypospadias repair have led to this procedure being performed at an earlier age. The goal of reconstruction is to bring the urethral meatus to the tip of the penis, to correct associated penile curvature if present, to create a conical-shaped glans, and to achieve cosmetically acceptable penile shaft skin coverage. The surgical technique employed varies with the penile anatomy and surgeon's preference. Complications may occur both immediately and long after the surgical procedure, and thus follow-up is necessary. PMID:9932174

  10. Failed hypospadias repair: An algorithm for secondary reconstruction using remaining local tissue.

    PubMed

    Nozohoor Ekmark, Ann; Svensson, Henry; Arnbjörnsson, Einar; Hansson, Emma

    2015-11-01

    Salvage hypospadias surgery is performed after failed primary reconstruction. Several treatment strategies have been suggested, all with pros and cons. The aim of this study was to evaluate our treatment algorithm for primary hypospadias repair applied to secondary cases in which a salvage procedure is indicated and, most importantly, local tissue is present. The algorithm was applied to 36 consecutive patients who had undergone a total of 109 surgical procedures before referral. In accordance with the algorithm, 12 patients without ventral curvature achieved a satisfactory result with one procedure by the use of local skin flaps. Six patients with moderate ventral curvature underwent orthoplasty, fistula closure, and/or urethral reconstruction using local skin flaps in one session. Eighteen patients with a severe ventral curvature or a proximal meatus were reconstructed in two stages using Byars' technique. After a median of two salvage procedures (range: 1-4), all patients but one, who awaits splitting of a skin bridge in the meatus, were successfully reconstructed. Two patients in active follow-up have potential problems requiring further surgery. Our findings indicate that failed hypospadias repairs are often due to an underestimation of the ventral curvature at the initial repair. Therefore, reevaluation of the degree of curvature is important. One-stage salvage repairs can be used, provided that none or minimal curvature remains. In cases of marked curvature, however, a meticulous resection of the chordee and ventral scarring is crucial. The subsequent repair of the large ventral defect and the long urethral reconstruction can, in most cases, be safely managed in a two-stage procedure. PMID:26195272

  11. Proximal Hamstring Repair Strength

    PubMed Central

    Harvey, Margaret Ann; Singh, Hardeep; Obopilwe, Elifho; Charette, Ryan; Miller, Suzanne

    2015-01-01

    Background: Proximal hamstring repair for complete ruptures has become a common treatment. There is no consensus in the literature about postoperative rehabilitation protocols following proximal hamstring repair. Some protocols describe bracing to prevent hip flexion or knee extension while others describe no immobilization. There are currently no biomechanical studies evaluating proximal hamstring repairs; nor are there any studies evaluating the effect of different hip flexion angles on these repairs. Hypothesis: As hip flexion increases from 0 to 90, there will be a greater gap with cyclical loading. Study Design: Controlled laboratory study. Methods: Proximal hamstring insertions were detached from the ischial tuberosity in 24 cadavers and were repaired with 3 single-loaded suture anchors in the hamstring footprint with a Krakow suture technique. Cyclic loading from 10 to 125 N at 1 Hz was then performed for 0, 45, and 90 of hip flexion for 1500 cycles. Gap formation, stiffness, yield load, ultimate load, and energy to ultimate load were compared between groups using paired t tests. Results: Cyclic loading demonstrated the least amount of gap formation (P < .05) at 0 of hip flexion (2.39 mm) and most at 90 of hip flexion (4.19 mm). There was no significant difference in ultimate load between hip flexion angles (326, 309, and 338 N at 0, 45, and 90, respectively). The most common mode of failure occurred with knot/suture failure (n = 17). Conclusion: Increasing hip flexion from 0 to 90 increases the displacement across proximal hamstring repairs. Postoperative bracing that limits hip flexion should be considered. Clinical Relevance: Repetitive motion involving hip flexion after a proximal hamstring repair may cause compromise of the repair. PMID:26665049

  12. Pattern of bacterial flora in local genital skin and surgical wounds in children undergoing hypospadias repair: a preliminary study.

    PubMed

    Ratan, S K; Sen, A; Ratan, J

    2002-06-01

    To evaluate the pattern of bacterial flora in children undergoing hypospadias repair, the following swabs were sent for 60 consecutive subjects: perimeatal swabs at admission and immediately before surgical scrub, and intraoperative and postoperative wound swabs (after the first change of operative dressing). A pure or predominant growth of organism that was not part of the local flora was labelled 'infection'. The peak incidence of infection (53%) was detected in swabs taken at admission. This decreased to 30% in immediately preoperative skin swabs, following local preparations. Coliforms and Staphylococcus aureus were the most commonly grown pathogens and were sensitive to cephalosporin and aminoglycoside. Proximity to the anus, poor personal hygiene in our study subjects (who were of low socioeconomic status) and the high temperature and humidity in our geographic region probably led to the high incidence of infection. The authors feel that the results of preoperative perimeatal swabs could help dictate antibiotic therapy in patients awaiting hypospadias repair. PMID:12137443

  13. Urethral Hairballs as a Long-Term Complication of Hypospadias Repair: Two Case Reports

    PubMed Central

    Kampantais, Spyridon; Dimitriadis, Charalampos; Laskaridis, Leonidas; Perdikis, Ioannis; Kirtsis, Petros; Toutziaris, Chrysovalantis

    2012-01-01

    Many times hair-bearing urethral grafts have been used inadvertently in the treatment of hypospadias. This can be accompanied with numerous troublesome long-term complications such as formation of stones, diverticula, and hairballs. We report two cases of men with a history of hypospadias repair being affected by such complications. We also discuss about their management and the effect of thioglycolic acid instillation to stop hair growth in the urethra mucosa in the second case. PMID:22924153

  14. Two-stage urethroplasty is a better choice for proximal hypospadias with severe chordee after urethral plate transection: a single-center experience

    PubMed Central

    Zheng, Da-Chao; Yao, Hai-Jun; Cai, Zhi-Kang; Da, Jun; Chen, Qi; Chen, Yan-Bo; Zhang, Ke; Xu, Ming-Xi; Lu, Mu-Jun; Wang, Zhong

    2015-01-01

    It is still debatable whether single- or two-stage urethroplasty is a more suitable technique for treating hypospadias with severe chordee after urethral plate transection. This retrospective study evaluated these two techniques. A total of 66 patients of proximal hypospadias with severe chordee were divided into two groups according to the techniques they underwent: 32 and 34 patients underwent single-stage (Duckett) or two-stage urethroplasty, respectively. Median ages at presentation were 7.5 years and 11.0 years in single-stage and two-stage repair groups, respectively. Median follow-ups were 28.5 months (20?60 months) and 35 months (18?60 months) in the single-stage and two-stage groups, respectively. The meatus of the neourethra was located at the top of the glans in all patients. No recurrence of chordee was found during follow-up, and all patients or parents were satisfied with the penile length and appearance. Complications were encountered in eight patients in both groups, with no statistically significant differences between the two techniques. The late complication rate of stricture was higher after the single-stage procedure (18.75% vs 0%). The complication rate after single-stage repairs was significantly lower in the prepubescent subgroup (10.52%) than in the postpubescent cohort (46.15%). These results indicate that the urethral plate transection effectively corrects severe chordee associated with proximal hypospadias during the intermediate follow-up period. Considering the higher rate of stricture after single-stage urethroplasty, two-stage urethroplasty is recommended for proximal hypospadias with severe chordee after urethral plate transection. PMID:25248656

  15. Surgical Repair of Late Complications in Patients Having Undergone Primary Hypospadias Repair during Childhood: A New Perspective

    PubMed Central

    Barbagli, Guido; Sansalone, Salvatore; Djinovic, Rados; Lazzeri, Massimo

    2012-01-01

    Background. The repair of complications in patients who had undergone hypospadias repair is still an open problem. Patients and Methods. We conducted a retrospective study of patients treated for late complications after hypospadias repair. Study inclusion criteria were patients presenting urethral, corpora cavernosa deformity, and/or penile defects due to previous hypospadias repair. Exclusion criteria were precancerous or malignant lesions and incomplete data on personal medical charts. Preoperative evaluation included clinical history, physical examination, urine culture, residual urine measurement, uroflowmetry, urethrography, urethral sonography, and urethroscopy. The patients were classified into four different groups. Success was defined as a normal functional urethra, with apical meatus, no residual penile curvature or esthetic deformity of the genitalia. Results. A total of 1,176 patients were entered in our survey. Out of the 1,176 patients, 301 patients (25.5%) underwent urethroplasty (group 1), 60 (5.2%) corporoplasty (group 2), 166 (14.1%) urethroplasty and corporoplasty (group 3), and 649 (55.2%) complex genitalia resurfacing (group 4). Mean followup was 60.4 months. Out of the 1,176 cases, 1,036 (88.1%) were considered successful and 140 (11.9%) failures. Conclusion. The majority of patients (55.2%) with failed hypospadias repair require surgical reconstruction to fully resurfacing the glans and penile shaft. PMID:22567003

  16. Surgical Repair of Late Complications in Patients Having Undergone Primary Hypospadias Repair during Childhood: A New Perspective.

    PubMed

    Barbagli, Guido; Sansalone, Salvatore; Djinovic, Rados; Lazzeri, Massimo

    2012-01-01

    Background. The repair of complications in patients who had undergone hypospadias repair is still an open problem. Patients and Methods. We conducted a retrospective study of patients treated for late complications after hypospadias repair. Study inclusion criteria were patients presenting urethral, corpora cavernosa deformity, and/or penile defects due to previous hypospadias repair. Exclusion criteria were precancerous or malignant lesions and incomplete data on personal medical charts. Preoperative evaluation included clinical history, physical examination, urine culture, residual urine measurement, uroflowmetry, urethrography, urethral sonography, and urethroscopy. The patients were classified into four different groups. Success was defined as a normal functional urethra, with apical meatus, no residual penile curvature or esthetic deformity of the genitalia. Results. A total of 1,176 patients were entered in our survey. Out of the 1,176 patients, 301 patients (25.5%) underwent urethroplasty (group 1), 60 (5.2%) corporoplasty (group 2), 166 (14.1%) urethroplasty and corporoplasty (group 3), and 649 (55.2%) complex genitalia resurfacing (group 4). Mean followup was 60.4 months. Out of the 1,176 cases, 1,036 (88.1%) were considered successful and 140 (11.9%) failures. Conclusion. The majority of patients (55.2%) with failed hypospadias repair require surgical reconstruction to fully resurfacing the glans and penile shaft. PMID:22567003

  17. Comparative Study of Snodgrass and Mathieu's Procedure for Primary Hypospadias Repair

    PubMed Central

    Hamid, Raashid; Baba, Aejaz A.; Shera, Altaf H.

    2014-01-01

    Objective. Present study was undertaken to compare the results of two single stage hypospadias repairs, namely, Tubularized Incised Plate (TIP) repair and Mathieu's repair. Methods. The study included 100 patients of distal penile hypospadias, from January, 2008 to January, 2013. After a detailed history, local examination was performed with reference to the site of meatus, shape of glans, and presence of chordee. TIP repair was performed in 52 patients and Mathieu's repair in 48 patients. On follow-up, the patients were examined for the position of meatus, shape of meatus, urinary stream, urethrocutaneous fistula, and stricture formation. Results. The mean age of presentation was 6.2??3.2 years (range 1.515years). The mean operative time was 63.7??14.3 (4590) minutes and 95.0??19.1 (70125) minutes in TIP and Mathieu's repair, respectively.Complications after surgery were urethero cutaneous fistula in 3(5.76%) and 7 (14.5%), meatal stenosis in 3(5.33%) and 4(8.33%), wound infection in 19.2% and 8.3% cases in TIP repair and Mathieu repair, respectively. The shape of meatus was slit-like and vertically oriented in 48(92.3%) patients who had undergone TIP repair. Conclusion. The Snodgrass repair is significantly faster, with more natural cosmetic appearance of the meatus than the Mathieu's repair. PMID:24944834

  18. The use of latex foley catheter in repair of hypospadias the most common seen congenital penile anomaly

    PubMed Central

    Polat, Haci; Yucel, Mehmet Ozgur; Cift, Ali; Gok, Alper; Benlioglu, Can; Lok, Ugur; Gulacti, Umut

    2015-01-01

    Objective: Hypospadias is the most common congenital penile anomaly occurring in 1/300 live births. Various surgery techniques are used in repair of hypospadias. Infant and children with hypospadias are usually admitted to emergency services by worried their parents for the first time. TIP urethroplasty is widely used in the repair of hypospadias, but the use of urethral catheters is still a matter for discussion. Herein, we described our experiences with the use of an unsutured latex foley catheter placed in the glans for 24 to 48 hours. Methods: A retrospective chart review was performed on 38 patients who underwent Tubularized incised plate (TIP) hypospadias repair from 2009 to 2011. Of these, 35 patients who had two-way latex Foley catheters placed for 24 h to 48 hands were followed for at least 12 month. Results: Excellent cosmetic results were obtained in all patients. Urinary tract infection developed in two patients (5.7%). one patient (2.8%) who had mild urethral repair breakdown was repaired in the office environment. Conclusion: We observed very low complication rates in application of a two-way latex Foley catheter in hypospadias surgery and found that this method can be used safely. Moreover, the catheter can be used for traction purposes during the procedure. At the end of the 24 to 48 h period, removal of the two-way latex urethral catheter with balloon does not harm the urethral repair. To reach a definite conclusion, larger studies are needed. PMID:26550278

  19. Functional and aesthetic results in hypospadias repair with Hinderer's techniques.

    PubMed

    Hinderer, U T

    2000-01-01

    In his editorial to the first issue of Aesthetic Plastic Surgery in 1976, the Managing Editor, Dr. Blair Rogers lays special emphasis on the publication of papers and reports dealing with the increasing role of Aesthetic Plastic Surgery as the final step in the overall rehabilitation of Reconstructive Surgery patients. In genitourinary malformations-hypospadias and epispadias-without any doubt a satisfactory sexual and urinary functional result is essential. However, also a normal aesthetic appearance, resembling a circumcised penis, and with the meatus at the tip of the glans, is becoming increasingly important, notably since the second half of the last century. An abnormal aesthetic appearance affects the patient's body image and has a negative influence on his self-esteem and sexual behaviour. Psychological stress is brought on from genital comparison with school-mates, in adulthood in gym changing rooms and, specifically, in sexual relations. In these days of greater sexual freedom, the knowledge of male genital anatomy and aesthetic appearance has considerably improved. Penile hypoplasia creates a psychological impact perhaps only comparable with that of female mammary hypoplasia. It is therefore unsurprising that not only normal aesthetic appearance after hypospadias surgery is essential, but also the demand for penile lengthening and girth augmentation has progressively increased over these past recent years. PMID:11084694

  20. The Influence of Pre-Operative Hormonal Stimulation on Hypospadias Repair

    PubMed Central

    Wong, Nathan C.; Braga, Luis H.

    2015-01-01

    Androgen stimulation to temporarily promote penile growth has been commonly used to facilitate hypospadias repair. Although some series suggest improvement in both functional and cosmetic outcomes, a recent systematic review and meta-analysis showed a possible relationship between pre-operative hormonal stimulation and higher complications. As a result, indications and treatment regimens remain controversial. Here, we review the available literature and present our clinical practice. PMID:25954736

  1. Method for correcting meatal stenosis after hypospadias repair.

    PubMed

    Kim, K S; King, L R

    1992-06-01

    Meatal stenosis is uncommon after hypospadias surgery even when the meatus is placed at the tip of the glans. However, when it occurs, such stenosis can be quite troublesome. A conventional meatotomy done in the presence of inflammation is often attended by recurrent stenosis. In such situations we therefore advocate placing a tourniquet around the base of the penis and raising a V-shaped flap of glans with the point of the V at the dorsum of the meatus. The stenosis is then incised along the back wall of the urethra down into non-inflamed tissues. The tip of the flap is sutured to this point and additional absorbable sutures are used to anchor the flap in place so that healthy tissue crosses the stenotic area. Recurrent stenosis after this maneuver is unusual. PMID:1615605

  2. Hypospadias repair using laser tissue soldering (LTS): preliminary results of a prospective randomized study

    NASA Astrophysics Data System (ADS)

    Kirsch, Andrew J.; Cooper, Christopher S.; Canning, Douglas A.; Snyder, Howard M., III; Zderic, Stephen A.

    1998-07-01

    Purpose: The purpose of this study was to evaluate laser tissue soldering using an 808 nm diode laser and wavelength- matched human albumin solder for urethral surgery in children. Methods: Currently, 30 boys, ages 3 months to 8 years were randomized to standard suturing (n equals 22) or 'sutureless' laser hypospadias repair (n equals 18). Laser soldering was performed with a human albumin solder doped with indocyanine green dye (2.5 mg/ml) using a laser power output of 0.5 W, pulse duration of 0.5 sec, and interval of 0.1 sec. Power density was approximately 16 W/cm2. In the laser group, sutures were used for tissue alignment only. At the time of surgery, neourethral and penile lengths, operative time for urethral repair, and number of sutures/throws were measured. Postoperatively, patients were examined for complications of wound healing, stricture, or fistula formation. Results: Mean age, severity of urethral defect, type of repair, and neourethra length were equivalent between the two groups. Operative time was significantly faster for laser soldering in both simple (1.6 plus or minus 0.21 min, p less than 0.001) and complex (5.4 plus or minus 0.28 min, p less than 0.0001) hypospadias repairs compared to controls (10.6 plus or minus 1.4 min and 27.8 plus or minus 2.9 min, respectively). The mean number of sutures used in the laser group for simple and complex repairs (3.3 plus or minus 0.3 and 8.1 plus or minus 0.64, respectively) were significantly (p less than 0.0001) less than for controls (8.2 plus or minus 0.84 and 20 plus or minus 2.3, respectively). Followup was between 3 months and 14 months. The overall complication rate in the laser group (11%) was lower than the controls (23%). However, statistical significance (p less than 0.05) was achieved only for the subgroup of patients undergoing simple repairs (LTS, 100% success versus suturing, 69% success). Conclusions: These preliminary results indicate that laser tissue soldering for hypospadias repair may be performed in a nearly sutureless fashion and in a more rapid manner than for conventional suturing. The trend towards a decreased rate of complications in the laser group at this time indicates that laser soldering may be an improved method of tissue closure for hypospadias repair. We continue to accrue patients to this study.

  3. The Cosmetic Results of a Simple Method for Repairing Preputial Skin Defect in Hypospadias

    PubMed Central

    Ghavami-Adel, Maryam; Mollaeean, Mansour; Hooman, Nakysa

    2014-01-01

    Objective: Hypospadias is a common birth defect of the penis. Besides the abnormal position of the urethral opening, there is usually a ventral preputial defect with preputial redundancy in dorsal shaft. There are many flap procedures for correcting this defect. Here, we present our experience of skin coverage procedure with better cosmetic results. Methods: It is a prospective study on patients with mid-shaft to glandular hypospadias operated from June 2008 to December 2012. The operations were performed by one surgeon in two hospitals and the cosmetic results were evaluated by the surgeon, parents, and another pediatric surgeon by a satisfaction questionnaire. In this procedure, inner prepuce was incised curvilinearly, remaining 5 mm in medial and 8 mm in lateral aspects of the inner prepuce. For skin repair, dorsal flaps were approximated in midline along median raphe. Findings: Sixty-three patients with mean age of 25.758.46 (7-93) months were followed up for 7.063.34 (2-15( months. There were 4 complications. The overall satisfaction with penile skin coverage was 93.7% for parents and 98.4% for surgeons. Patients age and primary site of meatus had a significant correlation with cosmetic results (P<0.05), while urethroplasty techniques and post-operative complications were not significant. Conclusion: Reapproximation of dorsal flaps in midline is a simple method and can be used in most cases of uncomplicated primary hypospadias. By this technique a more normal appearance can be achieved. PMID:25755862

  4. A modified onlay island flap vs. Mathieu urethroplasty for distal hypospadias repair: A prospective randomised study

    PubMed Central

    ElGanainy, Ehab O.

    2015-01-01

    Objective To compare the outcome of a modified onlay island flap (MOIF) with that of the Mathieu urethroplasty for distal hypospadias repair. Patients and methods In a prospective randomised study, 60 patients with coronal, subcoronal and distal penile hypospadias, with a urethral plate width of ?6mm, and minimal or no chordee, underwent either MOIF using a midline longitudinal outer preputial skin flap passed ventrally by penile buttonholing through dartos fascia incision, or a Mathieu urethroplasty. Closed envelopes were used for randomly selecting patients for each procedure. The operative duration, complications, cosmetic outcome, urinary stream and relatives satisfaction were reported for each procedure. Results Preoperative data (patients age and site of urethral meatus) and operative duration were insignificantly different between the groups (P=0.653, 0.786 and 0.710, respectively). There were no intraoperative complications in either group. The duration of follow-up was insignificantly different between the groups. Patients treated with the MOIF had a statistically significant lower complication rate (P=0.036), and a better cosmetic outcome, urinary stream and relatives satisfaction (P<0.001 for all). Conclusions The MOIF urethroplasty seemed to be better than the Mathieu urethroplasty in patients with distal hypospadias and narrow urethral plates. Further studies including more patients, and a longer follow-up with an objective evaluation of functional outcome should be encouraged to confirm these early results. PMID:26413341

  5. Urethroplasty by Use of Turnover Flaps (Modified Mathieu Procedure) for Distal Hypospadias Repair in Adolescents: Comparison With the Tubularized Incised Plate Procedure

    PubMed Central

    Bae, Seong Ho; Lee, Jun Nyung; Kim, Hyun Tae

    2014-01-01

    Purpose The purpose of this study was to examine whether urethroplasty with a turnover flap, as an alternative method of distal hypospadias repair in adolescents, improves the outcome of surgery. Materials and Methods Between January 2004 and December 2013, a total of 38 adolescents (aged 11-17 years) underwent distal hypospadias repair with either the tubularized incised plate (TIP) procedure (n=25) or the turnover flap procedure (n=13). The turnover flap procedure was performed with a proximal, ventral penile flap that was turned over to cover the urethral plate. Patient demographics, perioperative outcomes, complications, and postoperative uroflowmetry in each surgical group were analyzed retrospectively. Results The patient demographics were similar in the two groups. There were no significant differences in perioperative outcomes between the groups, including mean operative time, duration of hospital stay, and urethral catheterization. The number of patients with at least one complication, including wound dehiscence, urethrocutaneous fistula, meatal stenosis, and urethral stricture, was lower in the turnover flap group (1/13, 7.7%) than in the TIP group (11/25, 44%, p=0.030). The incidence of meatal stenosis was lower in the turnover flap group (0/12, 0%) than in the TIP group (6/25, 24%). In postoperative uroflowmetry, the plateau-shaped curve rate was lower in the turnover flap group (1/12, 8.3%) than in the TIP group (5/19, 26.3%); the peak flow was higher (p=0.030). Conclusions The turnover flap procedure is clinically useful for repairing adolescent distal hypospadias because it offers lower complication rates and better functional outcomes than TIP. PMID:25405018

  6. Simple procedure to repair distal penile hypospadias without chordee in adult males.

    PubMed

    Marzouk, E

    1989-01-01

    Penile, glanular and preputial flaps repair was done in 7 adult male patients with distal penile hypospadias without chordee. They suffered from psychological problems because of the abnormal shape of their penis. The procedure consisted in a simplified perimeatal-based flap technique with special attention given to the incision and suturing of the flaps. The operation resulted into a normally looking penis through the creation of a wide neourethra starting with a meatus at the apex of the glans and covered by a pliable elastic hair-less skin. This procedure is rapid, simple and needs a short hospitalization period without urinary diversion. It proved satisfactory for adults with distal penile hypospadias without chordee, resulting in a long penis, flat glans with pliable skin and well developed dorsal hooded foreskin. The procedure should be performed when the meatus is at a distance not suitable for meatoplasty and glanuloplasty or other techniques. It is recommended to correct the shape of the penis of any hypospadiac during childhood to prevent psychosexual neuroses in adulthood. PMID:2753689

  7. Efficacy of dexamethasone on postoperative analgesia in children undergoing hypospadias repair

    PubMed Central

    Shirazi, Mehdi; Mahmoudi, Hilda; Nasihatkon, Behnam; Ghaffaripour, Sina; Eslahi, Ali

    2016-01-01

    Background and Objective: Management of post operative pain in children undergoing hypospadiasis repair, accounts for optimized surgery outcomes and improved patients’ satisfaction. Thus, various studies have widely investigated the best approaches for the pain management. In this study our aim was to determine the effect of dexamethasone in combination with penile nerve block on the postoperative pain and complications in the children undergoing hypospadias surgery. Methods: In this randomized double-blind placebo controlled trial, after obtaining informed consent from parents or legal guardians, 42 children undergoing surgical treatment of hypospadias were randomized in two groups to receive either IV dexamethasone 0.5 mg/kg (n=23) or placebo (normal saline) (n=19) during the operation. Penile block was performed in both groups using Bupivacaine 0.5% (1mg/kg) at the end of the procedure. By the end of the operation, FLACC (Face, Leg, Activity, Cry, Consolability) pain score was assessed as the primary outcome of the study. Secondary outcomes includes timing and episodes of rescue medication consumption, post operative nausea \\vomiting and bleeding. All the outcomes were assessed in the recovery room and after 2, 6, 12, and 24 hours. Results: The median of FLACC pain scores at the recovery room and 2, 6, 12, and 24 hours post operation was 2, 1, 1, 1, and 2 for the dexamethasone group and 8, 8, 7, 7, and 8 for the placebo group respectively. This were significantly different (P<0.000). The median time of first rescue medication consumption was 8 hours post operation for the dexamethasone group and three hours for the placebo group which was significantly different (z= 4.57, p<0.000). The maximum episode of post operative rescue medication consumption in dexamethasone group was 4 episodes in only one patient and the minimum was one episode in 11 patients. In comparison numbers in placebo group were five episodes in seven patients and three episodes in four patients. The result indicated that there was statistically significant difference between two groups in terms of episodes of rescue medication consumption (Chi2= 31.4, p<0.000). Conclusion: Single dose of intravenous dexamethasone (0.5 mg/kg) in combination with penile block decreased the post operative pain measures, and total post operative analgesic requirement. It also increased the onset of the first analgesic requirement compared to penile block alone.

  8. Distal extension of the midline urethral-plate incision in the Snodgrass hypospadias repair: An objective assessment of the functional and cosmetic outcomes

    PubMed Central

    Al-Adl, Ahmed M.; El-Karamany, Tarek M.; Bassiouny, Ayman S.

    2014-01-01

    Objectives To objectively assess the functional and cosmetic outcomes of a modified tubularised incised-plate (TIP) urethroplasty (Snodgrass) technique, with particular attention to the uroflowmetry study and Hypospadias Objective Scoring Evaluation (HOSE) score. Patients and methods In a prospective case-series study, 43 consecutive patients with primary distal hypospadias were evaluated. The modified Snodgrass technique included an extension of the midline relaxing incision of the urethral plate from within the hypospadiac meatus to the very tip of the glans. The neourethra was tubularised starting at the neomeatus and proceeding proximally. The neourethra was covered with either a single or double dartos flap. In toilet-trained boys, at least 3months after surgery, the flow pattern, maximum (Qmax), and mean urinary flow rate (Qave) were recorded, and the results plotted against a recently published flow-rate nomogram from normal children. The postvoid residual urine volume was measured using ultrasonography. The cosmetic outcome was assessed using the HOSE system. Results The native meatus was coronal in 11 (26%), subcoronal in 23 (53%) and distal penile in nine (21%) of the patients. The median (range) age was 4.2 (0.514) years. The neourethra was covered by a single dorsal dartos flap in 25 and a double dartos flap in 18 patients. At a median (range) follow-up of 6 (324) months, the uroflowmetry findings in 26 uncomplicated toilet-trained boys with a median (range) age of 5.2 (3.314) years showed an abnormal Qmax below the fifth percentile in four (15%), with the Qave above the fifth percentile in all. The flow pattern was bell-shaped in nine boys (35%), interrupted/intermittent in five (19%), slightly flattened in 10 (39%) and a plateau in two (8%). A vertical slit-like meatus located at the distal glans was created in 39 (91%) boys, and at the proximal glans in four (9%). The urinary stream was single and straight in 39 and angled in four patients. A straight erection was observed in 42 (98%) boys. Four patients had preoperative mild penile torsion of <45, that was corrected by surgery. The mean (SD, range) HOSE score was 15.8 (0.6, 1316). Two patients had a small, single subcoronal fistula. Conclusion Extending the midline urethral plate-incision in the modified Snodgrass repair to the apical part of the glans can be done safely with a high rate of locating the neomeatus at the glans tip, with no resultant meatal stenosis. The functional and cosmetic results of the procedure are good, but long-term data and comparative studies are required to confirm these results. PMID:26019935

  9. A Complication in Hypospadias Surgery Due to Anchoring Suture

    PubMed Central

    Gollu, Gulnur; Kucuk, Gonul; Karabulut, Ayse An?l; Yagmurlu, Aydin; Cakmak, Murat

    2015-01-01

    The complication rates are still 190% both in proximal and distal hypospadias regardless of the surgeons experience and the usage of most developed techniques. The literature survey revealed few complications of glans penis including meatal stenosis, prolapsus and retraction. Despite our literature survey, we could not find any article concerning the permanent scar tissue at the dorsal part of glans following hypospadias surgeries. A new complication can be added to these, concerning glans which is the formation of postoperative scar tissue as a reaction to suture material used in traction, stent anchoring or both. The aim of this paper is to demonstrate four cases which had glanular scar due to traction suture following the surgical procedures for hypospadias repair. PMID:26180503

  10. Asymptomatic hypospadias with tight meatal stricture in the father of twelve children

    PubMed Central

    2013-01-01

    Hypospadias is a highly prevalent congenital anomaly. English articles, indexed in PubMed, published the long-term sexual and reproductive outcome following hypospadias repair. Almost all repairable cases of hypospadias are operated in childhood. Although distal hypospadias does not interfere with fertility, it is worthy reporting a case of an elderly man, who fathers 12 children and has no urologic complaint, presented with unrepaired coronal hypospadias and severely tight external urethral meatus. PMID:24579034

  11. Asymptomatic hypospadias with tight meatal stricture in the father of twelve children.

    PubMed

    Katib, Atif A

    2013-01-01

    Hypospadias is a highly prevalent congenital anomaly. English articles, indexed in PubMed, published the long-term sexual and reproductive outcome following hypospadias repair. Almost all repairable cases of hypospadias are operated in childhood. Although distal hypospadias does not interfere with fertility, it is worthy reporting a case of an elderly man, who fathers 12 children and has no urologic complaint, presented with unrepaired coronal hypospadias and severely tight external urethral meatus. PMID:24579034

  12. Hypospadias repair - discharge

    MedlinePLUS

    ... that was done depends on how severe the birth defect was. This may be the first surgery for this problem or it may be a follow-up procedure. Your child received general anesthesia before surgery to make him unconscious and unable to feel pain.

  13. Treatment of Hostile Proximal Necks During Endovascular Aneurysm Repair

    PubMed Central

    Navarro, Tulio Pinho; Bernardes, Rodrigo de Castro; Procopio, Ricardo Jayme; Leite, Jose Oyama; Dardik, Alan

    2014-01-01

    Endovascular aneurysm repair (EVAR) is a therapy that continues to evolve rapidly as advances in technology are incorporated into new generations of devices and surgical practice. Although EVAR has emerged as a safe and effective treatment for patients with favorable anatomy, treatment of patients with unfavorable anatomy remains controversial and is still an off-label indication for endovascular treatment with some current stent-grafts. The proximal neck of the aneurysm remains the most hostile anatomic barrier to successful endovascular repair with long-term durability. Open surgery for unfavorable necks is still considered the gold standard treatment in contemporary practice, despite the increased mortality and morbidity attributed to suprarenal cross-clamping, particularly in high-risk patients. Evolving technology may overcome the obstacles preventing endovascular treatment of unfavorable proximal neck anatomy; current approaches include purely endovascular as well as hybrid approaches, and generally include strategies that either extend the length of the short neck, move the proximal neck more proximally, or keep the short neck intact. These approaches include the use of debranching techniques, banding, chimneys, fenestrated and branched devices, filling the sac with endobags, endoanchors, and other novel devices. These newer-generation devices appear to have promising short- and midterm results. However, lack of good evidence of efficacy with long-term results for these newer approaches still precludes wide dissemination of endovascular solutions for the hostile proximal neck. PMID:26798712

  14. Management of adults with prior failed hypospadias surgery

    PubMed Central

    Craig, James R.; Wallis, Chad; Brant, William O.; Hotaling, James M.

    2014-01-01

    Hypospadias is one of the most prevalent anomalies of the male genitalia. Contemporary hypospadias repair is very successful, but patients that have the surgery fail often require multiple surgeries throughout their life. Complications from failed hypospadias repairs have a significant impact on patients both psychologically and physically. Failed hypospadias repair encompasses a spectrum of problems that include hypospadias recurrence with an ectopic meatus, urethral fistula, urethral stricture, and ventral penile curvature. Repairs of hypospadias complications can be challenging due to the poor quality of surrounding tissue from disruption of normal vasculature in the re-operative field associated with the underlying disorder. One of the most challenging issues is dealing with urethral strictures. There have been multiple methods described at repairs of these in both a single stage and multiple staged procedures. Particular attention has been directed towards applications of grafts due to worse outcomes with flaps. Buccal mucosa has emerged as the leading graft material in staged repairs. When counseling patients with failed hypospadias it is important to discuss the expected outcome as repairs directed towards a terminally positioned meatus with a straight phallus may require multiple surgeries due to post-operative complications as well as the necessity of proceeding in a staged approach. PMID:26816767

  15. Comparison of Transverse Island Flap Onlay and Tubularized Incised-Plate Urethroplasties for Primary Proximal Hypospadias: A Systematic Review and Meta-Analysis

    PubMed Central

    Xiao, Dongdong; Nie, Xin; Wang, Wenyue; Zhou, Juan; Zhang, Ming; Zhou, Zhe; Zhao, Yang; Gu, Meng; Wang, Zhong; Lu, Mujun

    2014-01-01

    Purpose This meta-analysis was conducted to compare postoperative outcomes between transverse island flap (TVIF) onlay and tubularized incised-plate (TIP) urethroplasties for primary proximal hypospadias. Materials and Methods A comprehensive literature search updated to 21st May 2014 was carried out for relevant studies. After literature identification and data extraction, odds ratio (OR) with 95% confidential interval (CI) was calculated to compare postoperative complication rate between TVIF onlay and TIP. Meta-regression and subgroup analyses were applied to find potential affective factors. Results A total of 6 studies including 309 patients receiving TVIF onlay and 262 individuals subjected to TIP met inclusion criteria. The synthetic data suggested that TVIF onlay and TIP were comparable in terms of total complication rate (OR 0.85, 95% CI 0.561.30, p?=?0.461), fistula (OR 0.68, 95% CI 0.381.21, p?=?0.194), recurrent curvature (OR 1.16, 95% CI 0.433.12, p?=?0.766), dehiscence (OR 0.95, 95% CI 0.332.74, p?=?0.920), diverticulum (OR 1.90, 95% CI 0.536.78, p?=?0.321), meatal stenosis (OR 0.74, 95% CI 0.202.77, p?=?0.651) and urethral stricture (OR 1.49, 95% CI 0.415.50, p?=?0.545), without significant heterogeneity for each comparison group. Meta-regression and subgroup analyses revealed no significant findings. One-way sensitivity analysis indicated that the results were stable. No publication bias was detected using both funnel plot and Eggers test. Also, there were no obvious differences observed in cosmetic and functional outcomes. Conclusions This meta-analysis suggests that TVIF onlay and TIP urethroplasties are clinically equivalent. Given the inherent limitations of included studies, this conclusion should be interpreted with caution and wait to be confirmed by more well-designed randomized controlled trials with high quality in the future. PMID:25197970

  16. Facts about Hypospadias

    MedlinePLUS

    ... Down Syndrome Data and Statistics Growth Charts Encephalocele Gastroschisis Hypospadias Microcephaly Omphalocele Spina Bifida Upper and Lower ... Down Syndrome Eye Defects Fetal Alcohol Syndrome Disorders Gastroschisis Heart Defects Coarctation of the Aorta Hypoplastic left ...

  17. Inpatients hypospadias care: Trends and outcomes from the American nationwide inpatient sample

    PubMed Central

    Sukumar, Shyam; Sood, Akshay; Hanske, Julian; Vetterlein, Malte; Elder, Jack S.; Fisch, Margit; Trinh, Quoc-Dien; Friedman, Ariella A.

    2015-01-01

    Purpose Hypospadias is the most common congenital penile anomaly. Information about current utilization patterns of inpatient hypospadias repair as well as complication rates remain poorly evaluated. Materials and Methods The Nationwide Inpatient Sample was used to identify all patients undergoing inpatient hypospadias repair between 1998 and 2010. Patient and hospital characteristics were attained and outcomes of interest included intra- and immediate postoperative complications. Utilization was evaluated temporally and also according to patient and hospital characteristics. Predictors of complications and excess length of stay were evaluated by logistic regression models. Results A weighted 10,201 patients underwent inpatient hypospadias repair between 1998 and 2010. Half were infants (52.2%), and were operated in urban and teaching hospitals. Trend analyses demonstrated a decline in incidence of inpatient hypospadias repair (estimated annual percentage change, -6.80%; range, -0.51% to -12.69%; p=0.037). Postoperative complication rate was 4.9% and most commonly wound-related. Hospital volume was inversely related to complication rates. Specifically, higher hospital volume (>31 cases annually) was the only variable associated with decreased postoperative complications. Conclusions Inpatient hypospadias repair have substantially decreased since the late 1990's. Older age groups and presumably more complex procedures constitute most of the inpatient procedures nowadays. PMID:26279829

  18. Endovascular Treatment of Proximal Bilateral Iliac Limb Dislocation and Kinking following Endovascular Abdominal Aortic Aneurysm Repair

    SciTech Connect

    Alerci, Mario; Wyttenbach, Rolf Bogen, Marcel; Segesser, Ludwig K. von; Gallino, Augusto; Inglese, Luigi

    2005-05-15

    We report the case of a 69-year-old man with a late type 1b endoleak due to proximal migration of both iliac limbs 5 years after endovascular repair of an abdominal aortic aneurysm. The endovascular method used to correct bilaterally this condition is described. Final angiographic control shows patency of the stent-graft without signs of endoleak.

  19. Do endocrine disruptors cause hypospadias?

    PubMed Central

    Botta, Sisir; Cunha, Gerald R.

    2014-01-01

    Introduction Endocrine disruptors or environmental agents, disrupt the endocrine system, leading to various adverse effects in humans and animals. Although the phenomenon has been noted historically in the cases of diethylstilbestrol (DES) and dichlorodiphenyltrichloroethane (DDT), the term “endocrine disruptor” is relatively new. Endocrine disruptors can have a variety of hormonal activities such as estrogenicity or anti-androgenicity. The focus of this review concerns on the induction of hypospadias by exogenous estrogenic endocrine disruptors. This has been a particular clinical concern secondary to reported increased incidence of hypospadias. Herein, the recent literature is reviewed as to whether endocrine disruptors cause hypospadias. Methods A literature search was performed for studies involving both humans and animals. Studies within the past 5 years were reviewed and categorized into basic science, clinical science, epidemiologic, or review studies. Results Forty-three scientific articles were identified. Relevant sentinel articles were also reviewed. Additional pertinent studies were extracted from the reference of the articles that obtained from initial search results. Each article was reviewed and results presented. Overall, there were no studies which definitely stated that endocrine disruptors caused hypospadias. However, there were multiple studies which implicated endocrine disruptors as one component of a multifactorial model for hypospadias. Conclusions Endocrine disruption may be one of the many critical steps in aberrant development that manifests as hypospadias. PMID:26816789

  20. Expression of Estrogen Receptor Alpha and Beta is Decreased in Hypospadias

    PubMed Central

    Qiao, Liang; Rodriguez, Esequiel; Weiss, Dana A.; Ferretti, Max; Risbridger, Gail; Cunha, Gerald R.; Baskin, Laurence S.

    2012-01-01

    Purpose Estrogenic endocrine disruptors acting via estrogen receptors ? and ? have been implicated in the etiology of hypospadias. However, the expression and distribution of estrogen receptors ? and ? in normal and hypospadiac human foreskins is unknown. We characterized the location and expression of estrogen receptors ? and ? in normal and hypospadiac foreskins. Materials and Methods We prospectively collected excess foreskin from 35 patients undergoing hypospadias repair and 15 patients undergoing elective circumcision. Hypospadias was classified as severe in 18 patients and mild in 17 based on the ectopic position of the meatus. mRNA expression levels in estrogen receptors ? and ? were quantified using reverse transcriptase polymerase chain reaction. Receptor location was characterized by immunohistochemical analysis. Additionally immunohistochemical analysis was performed in 4 archived human fetal penises. Results Mean SD ages were similar for the circumcision (9.5 3 months) and hypospadias repair groups (9 3 months, p = 0.75). mRNA expression levels in estrogen receptors ? and ? were significantly decreased in hypospadiac foreskin cases compared to controls (p <0.001), while no statistically significant differences were seen between foreskins with severe and mild hypospadias. Estrogen receptor ? immunostaining was strong in normal foreskin but weak in hypospadiac foreskin. Estrogen receptor ? immunoreactivity was most intense in the stratum basale and stratum spinosum. Estrogen receptor ? immunostaining was weak in normal and mild hypospadias foreskin, and undetectable in severe hypospadias. Fetal penises expressed strong estrogen receptor ? immunopositivity in the urethral plate epithelium, corpus spongiosum, corpora cavernosa and penile skin, while estrogen receptor ? immunostaining was not detected. Conclusions These data demonstrate a difference in estrogen receptor ? and ? expression and location in the foreskin of patients with hypospadias compared to controls. These findings are consistent with aberrant estrogenic effects having a role in the etiology of hypospadias. PMID:22341273

  1. Regulation of MUTYH, a DNA Repair Enzyme, in Renal Proximal Tubular Epithelial Cells

    PubMed Central

    Lu, Jianping; Li, Xinxiu; Zhang, Mingcao; Chen, Zhaohong; Wang, Yaping; Zeng, Caihong; Liu, Zhihong; Chen, Huimei

    2015-01-01

    MUTYH is a DNA repair enzyme that initiates a base excision repair (BER) by recognizing and removing 8-Oxoguanine (8-oxoG) and its paired adenine. We demonstrated that both TGF-?1 and H2O2 treatment led to an increased 8-oxoG in cultured human proximal tubule epithelial (HK-2) cells, while the former induced epithelial-mesenchymal transition and the latter caused cell apoptosis. Without stimulation, HK-2 cells showed MUTYH expression in mitochondria. TGF-?1 triggered a transient upregulation of mitochondrial MUTYH and induced the expression of nuclear isoforms, while H2O2 showed no role on MUTYH expression. Ureteral obstruction (UUO) mice exhibited high 8-oxoG reactivity with tubulointerstitial lesions. After obstruction, the MUTYH expression was increased only in tubules at day 3 and decreased with obvious tubular atrophy at day 10. Particularly, MUTYH was primarily located in normal tubular cytoplasm with a dominant mitochondrial form. A few cells with nuclear MUTYH expression were observed in the fibrotic interstitium. We confirmed that increased MUTYH expression was upregulated and positively correlated with the severity of kidney fibrosis. Thus, renal fibrosis caused a cell-type-specific and time-dependent response of oxidative DNA repairs, even within the same tissues. It suggests that intervention of MUTYH might be effective for therapies. PMID:26576226

  2. [Isolated hypospadias in 5 brothers].

    PubMed

    Mavrogenis, Stelios; Czeizel, Endre

    2015-08-16

    The healthy couple had five sons with hypospadias (glandular 1, coronal 4) without other child. Similar familial cluster has not reported in the sons of European parents without consanguinity. Mild form androgen insensitivity syndrome was expected in these 5 boys because of the X-linked androgen receptor gene, however, sequencing of the entire coding region (exons 1-8) and all intron-exon boundaries of the androgen receptor gene did not reveal abnormality and the CAG repeat was found in the normal range (21 repeats). This extreme familial cluster may help us to elucidate gene polymorphisms in the polygenic background of the multifactorial origin of isolated hypospadias. Therefore, the authors collaborate with a genetic institute in Pittsburg, USA to perform whole genome sequencing in these probands and their parents. PMID:26256499

  3. Proximal humerus osteolysis after revision rotator cuff repair with bioabsorbable suture anchors.

    PubMed

    Park, Andrew Y; Hatch, Joshua D

    2011-03-01

    Biodegradable anchors were designed to provide secure fixation while allowing for later resorption and replacement by host tissue. First-generation implants degraded relatively rapidly and caused foreign-body reactions, synovitis, fragmentation, and osteolysis. Newer implants have similar complications. It is not known if the primary cause of the osteolysis is biological (precipitated by breakdown products of the polymer) or mechanical (caused by initial loss of implant stability). Case reports have described glenoid osteolysis around biodegradable suture anchor placement for shoulder stabilization, but up until now, to our knowledge, only 1 case of proximal humerus osteolysis has been reported for these implants. Here we describe a semicrystalline, poly-L-lactic acid bioabsorbable suture anchor failure after revision rotator cuff repair with subsequent humeral tuberosity osteolysis. PMID:21720602

  4. Blunt traumatic aortic rupture of the proximal ascending aorta repaired by resection and direct anastomosis.

    PubMed

    Harmouche, Majid; Slimani, Eric Karim; Heraudeau, Adeline; Verhoye, Jean-Philippe

    2013-10-01

    Traumatic aortic injury represents 15% of motor vehicle related deaths with death occurring at the scene in 85% of the cases. Aortic disruptions usually occur at the isthmus in a transverse fashion with all three of the aortic layers being involved. Herein, we report the case of a 68-year old man with no prior medical history who was struck by a vehicle while riding his bicycle. The ruptured segment of aorta was resected circumferentially and interrupted horizontal mattress pledgeted prolene sutures were used to ensure full thickness aortic integrity of the proximal and distal aortic segments. The aorta was closed with a single-layer technique using 4/0 prolene suture. There were no postoperative complications and patient was discharged on Day 44. The case here discussed demonstrates a rare presentation of blunt aortic injury. The proximal ascending aorta is an unusual site of transection following blunt trauma with few reports in the literature. We were able to repair the aorta with direct suture, thus avoiding the use of artificial material. PMID:23838337

  5. Staged hybrid approach using proximal TEVAR and distal open repair for the treatment of extensive thoracoabdominal aortic aneurysms

    PubMed Central

    Johnston, William F.; Upchurch, Gilbert R.; Tracci, Margaret C.; Cherry, Kenneth J.; Ailawadi, Gorav; Kern, John A.

    2012-01-01

    Objective Repair of patients with extent I and II thoracoabdominal aortic aneurysms (TAAAs) is associated with significant morbidity and mortality, while repair of more distal extent III and IV TAAAs has a lower risk of mortality and paraplegia. Therefore, we describe an approach using thoracic endovascular repair (TEVAR) as the index operation to convert extent I and II TAAAs to extent III and IV TAAAs amenable to subsequent open aortic repair to minimize patient risk. Methods Between July 2007 and March 2012, 10 staged hybrid operations were performed to treat 1 extent I and 9 extent II TAAAs. Aortic aneurysm pathology included 5 chronic type B dissections, 3 acute type B dissections, and 2 penetrating aortic ulcers. Initially, the proximal descending thoracic aorta was repaired with TEVAR for coverage of the most proximal fenestration or penetrating ulcer, with 7 elective and 3 emergent repairs. Interval open distal aortic replacement was performed either in a short-term planned setting or for progressive dilation of the distal aortic segment. In the open repair, the proximal end of the graft was sewn directly to the distal end of the TEVAR and outer wall of the aorta. Results Average patient age was 48 years with the majority of patients male (60%). Risk factors included hypertension (80%), current tobacco use (50%), and Marfan syndrome (30%). Postoperative complications following TEVAR included endoleaks [type IA (n=1); type II (n=3)], pleural effusions (n=3), and acute kidney injury (n=1). Endovascular re-interventions were required in 3 cases. In dissection cases, persistent filling of the false lumen was common and associated with distal thoracic aortic dilation. Complications of open repair included acute kidney injury (n=2) but no cardiac, pulmonary, or neurologic morbidity. Median time between TEVAR and open repair was 14 weeks. Most importantly, there was no mortality or neurologic deficit after either procedure with a median follow up of 35 weeks. Conclusions A staged hybrid approach to extensive TAAAs combining proximal TEVAR followed by interval open distal TAAA repair is safe and appears to be an effective alternative to traditional open repair. This approach may decrease the significant morbidity associated with single stage open extent I and II TAAA repairs and may be applicable to many TAAA etiologies. PMID:22832268

  6. Contribution of the Proximal Nerve Stump in End-to-side Nerve Repair: In a Rat Model

    PubMed Central

    Jung, Jun Mo; Chung, Moon Sang; Kim, Min Bom

    2009-01-01

    Background The aim of this study was to evaluate the contribution of the proximal nerve stump, in end-to-side nerve repair, to functional recovery, by modifying the classic end-to-side neurorrhaphy and suturing the proximal nerve stump to a donor nerve in a rat model of a severed median nerve. Methods Three experimental groups were studied: a modified end-to-side neurorrhaphy with suturing of the proximal nerve stump (double end-to-side neurorrhaphy, Group I), a classic end-to-side neurorrhaphy (Group II) and a control group without neurorrhaphy (Group III). Twenty weeks after surgery, grasping testing, muscle contractility testing, and histological studies were performed. Results The grasping strength, muscle contraction force and nerve fiber count were significantly higher in group I than in group II, and there was no evidence of nerve recovery in group III. Conclusions The contribution from the proximal nerve stump in double end-to-side nerve repair might improve axonal sprouting from the donor nerve and help achieve a better functional recovery in an end-to-side coaptation model. PMID:19885060

  7. Hypospadias

    MedlinePLUS

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  8. Chordee without hypospadias: report of 79 Chinese prepubertal patients.

    PubMed

    Tang, Yun-Man; Chen, Shao-Ji; Huang, Lu-Gang; Wang, Ming-He

    2007-01-01

    A series of Chinese prepubertal patients with congenital chordee without hypospadias is presented and the clinical data described. From July 1999 to September 2006, 79 boys with congenital chordee without hypospadias were treated in the Department of Pediatric Surgery, West China Hospital of Sichuan University, China. The ages ranged from 21 months to 14 years, with a mean of 76.8 months (6.4 years). The patients were categorized according to structural defect into 4 groups, with the aid of intraoperative artificial erection. Group I included those with skin tethering (28 cases, 35.4%); group II, fascial chordee (22, 27.8%); group III, corporal disproportion (10, 12.7%); and group IV, urethral tethering (19, 24.1%). Chordee-related structural defect was considered the only criterion for classification, and urethral dysgenesis influenced the choice of surgical procedure. The chordee in group I patients was corrected with penile degloving; group II, release of dense fibrous tissue in addition; group III, dorsal-midline-plication-based correction; and group IV, longitudinal-island-flap-urethroplasty-based repair. At a mean follow-up of 14.8 months (range, 2 to 63), all patients had penile straightening except 1 group III patient with residual curvature that was managed upon reoperation. Glans dehiscence occurred in 1 group II patient who underwent a tubularized incised plate urethroplasty. Urethrocutaneous fistula and urethral stricture were found in 2 group IV patients who underwent island flap urethroplasty. With the categorization based on structural defect, chordee without hypospadias may be managed well with minimized complications. PMID:17409467

  9. The role of two-stage repair in modern hypospadiology

    PubMed Central

    Bracka, Aivar

    2008-01-01

    Hypospadias surgery continues to evolve. The enthusiasm for flap-based urethroplasty is waning and instead there is an increasing preference for urethroplasty that uses either the urethral plate alone or in combination with grafts. From the vast armamentarium of hypospadias repairs that are still in use, the author suggests a simple protocol of just three closely related procedures with which we can now repair almost all hypospadias. The tubularised incised plate (TIP) repair and the Snodgraft modification of the TIP principle are simple and effective one-stage solutions when partial circumference urethroplasty is required. Conversely, the Bracka two-stage graft repair remains an ideal and versatile solution when a full circumference urethroplasty is required. It is particularly appropriate for severe primary hypospadias associated with a poor plate and marked chordee and also to replace a scarred, hairy or balanitis xerotica obliterans diseased urethra in re-operative salvage hypospadias. PMID:19468400

  10. Risk factors for hypospadias in China

    PubMed Central

    Xu, Ling-Fan; Liang, Chao-Zhao; Lipianskaya, Julia; Chen, Xian-Guo; Fan, Song; Zhang, Li; Zhou, Jun; Tai, Sheng; Jiang, Chang-Qin

    2014-01-01

    This case-controlled study was designed to evaluate the association between various baseline parental factors and the risk of hypospadias in China. Patients were selected from tertiary referral hospitals in Anhui, a province in mid-eastern China. A questionnaire was given to the parents of each patient. The final database included 193 cases and 835 controls. The incidence of additional coexistent anomalies was 13.0%, primarily cryptorchidism (9.8%). Ten patients (5.1%) were from families with genital anomaly, including five families (2.6%) with hypospadias. The risks of hypospadias was higher for children of mothers > 35 (odds ratio [OR] =1.47) and < 18 (OR = 2.95) years of age, and in mothers who had consumed alcohol (OR = 2.67), used drugs (OR = 1.53) and had an infection (OR = 1.87) during pregnancy. The risk of hypospadias was also higher when mothers (OR = 1.68) and fathers (OR = 1.74) were engaged in agriculture. Other factors assessed were not associated with the risk of hypospadias. PMID:24875823

  11. Penile hair tourniquet resulting in hypospadias failure

    PubMed Central

    Jesus, Lisieux E.; Bragana, Jailma J.; Rocha, Julia M.; Dekermacher, Samuel; Anderson, Kleber M.

    2014-01-01

    Penile hair tourniquet (PHT) is a painless form of penile ischemia, typically seen in toddlers with long-haired mothers, caused by entanglement of hair on the balano-prepucial sulcus, normally associated with circumcision. Its association with hypospadias has been reported only once. A school-aged boy admitted for surgery to treat hypospadias failure was incidentally detected to have PHT and severe hourglass deformity of the penis. Urethral anastomosis and glanuloplasty were done after removal of the constricting ring, without complications. Normal erections were reported during follow up. Treatment may involve urethral reconstruction and penile reimplantation in extreme cases. PMID:25097325

  12. Repair-Mediated Duplication by Capture of Proximal Chromosomal DNA Has Shaped Vertebrate Genome Evolution

    PubMed Central

    Pace, John K.; Sen, Shurjo K.; Batzer, Mark A.; Feschotte, Cdric

    2009-01-01

    DNA double-strand breaks (DSBs) are a common form of cellular damage that can lead to cell death if not repaired promptly. Experimental systems have shown that DSB repair in eukaryotic cells is often imperfect and may result in the insertion of extra chromosomal DNA or the duplication of existing DNA at the breakpoint. These events are thought to be a source of genomic instability and human diseases, but it is unclear whether they have contributed significantly to genome evolution. Here we developed an innovative computational pipeline that takes advantage of the repetitive structure of genomes to detect repair-mediated duplication events (RDs) that occurred in the germline and created insertions of at least 50 bp of genomic DNA. Using this pipeline we identified over 1,000 probable RDs in the human genome. Of these, 824 were intra-chromosomal, closely linked duplications of up to 619 bp bearing the hallmarks of the synthesis-dependent strand-annealing repair pathway. This mechanism has duplicated hundreds of sequences predicted to be functional in the human genome, including exons, UTRs, intron splice sites and transcription factor binding sites. Dating of the duplication events using comparative genomics and experimental validation revealed that the mechanism has operated continuously but with decreasing intensity throughout primate evolution. The mechanism has produced species-specific duplications in all primate species surveyed and is contributing to genomic variation among humans. Finally, we show that RDs have also occurred, albeit at a lower frequency, in non-primate mammals and other vertebrates, indicating that this mechanism has been an important force shaping vertebrate genome evolution. PMID:19424419

  13. Repair-mediated duplication by capture of proximal chromosomal DNA has shaped vertebrate genome evolution.

    PubMed

    Pace, John K; Sen, Shurjo K; Batzer, Mark A; Feschotte, Cdric

    2009-05-01

    DNA double-strand breaks (DSBs) are a common form of cellular damage that can lead to cell death if not repaired promptly. Experimental systems have shown that DSB repair in eukaryotic cells is often imperfect and may result in the insertion of extra chromosomal DNA or the duplication of existing DNA at the breakpoint. These events are thought to be a source of genomic instability and human diseases, but it is unclear whether they have contributed significantly to genome evolution. Here we developed an innovative computational pipeline that takes advantage of the repetitive structure of genomes to detect repair-mediated duplication events (RDs) that occurred in the germline and created insertions of at least 50 bp of genomic DNA. Using this pipeline we identified over 1,000 probable RDs in the human genome. Of these, 824 were intra-chromosomal, closely linked duplications of up to 619 bp bearing the hallmarks of the synthesis-dependent strand-annealing repair pathway. This mechanism has duplicated hundreds of sequences predicted to be functional in the human genome, including exons, UTRs, intron splice sites and transcription factor binding sites. Dating of the duplication events using comparative genomics and experimental validation revealed that the mechanism has operated continuously but with decreasing intensity throughout primate evolution. The mechanism has produced species-specific duplications in all primate species surveyed and is contributing to genomic variation among humans. Finally, we show that RDs have also occurred, albeit at a lower frequency, in non-primate mammals and other vertebrates, indicating that this mechanism has been an important force shaping vertebrate genome evolution. PMID:19424419

  14. [Penoscrotal hypospadias with XXYY chromosome pattern].

    PubMed

    Neugebauer, H; Steichen-Gersdorf, E; Glatzl, J

    1991-01-01

    This is the report of a boy, 2 years and 4 months of age who presented with an penoscrotal hypospadia with normal appearing testes. Physical examination and routine laboratory tests revealed--besides a broad base of the nose and clinodactyly--no abnormality. The boy exhibits a normal speech development with retarded global intellectual development. Investigation of the hormon status revealed a disturbance of testosteron secretion and a hypergonadotropic hypogonadism. Chromosomal analysis in lymphocyte cultures revealed a XXYY karyotyp. This chromosomal pattern is seen in 3% of patients with Klinefelter syndrom; the estimated frequency is 1 in 25,000 population. A combination of an XXYY chromosomal pattern with a penoscrotal hypospadia has not been reported in the literature so far. PMID:1905392

  15. Intermittent unspecific osteitis and cortex atrophy of the proximal phalanx after surgical pulley repair.

    PubMed

    Lutter, Christoph; Schoeffl, Volker

    2015-01-01

    Climbing athletes frequently suffer from pulley ruptures, as the shear stress on the finger flexor tendon pulley system is extremely high, especially in the 'crimping position'. Studies showed that surgery only has to be performed in a multiple pulley rupture situation (grade IV injuries). This case describes a complication that appeared after performing a 'bone-encircling' technique recommended for climbers (modified 'one-and-a-half-loop' technique). Simultaneously with resumption of full-strength training after surgery and rehabilitation, the dorsolateral cortex of the proximal phalanx, to which the tendon transplant (palmaris longus tendon surrounding bone and flexor tendon of the finger) is entangled, developed an osteitis and atrophy. We investigated two athletes with the same complaints and symptoms. PMID:26628314

  16. The role of pre-operative androgen stimulation in hypospadias surgery

    PubMed Central

    2014-01-01

    The hormonal stimulation for the purpose of penile enlargement before the hypospadias repair has been commonly used, but rarely reported. In addition to functional outcome, dihydrotestosterone (DHT) pretreatment has been suggested to improve cosmetic outcome in a preliminary randomized study. Since the randomized and controlled clinical trials on this topic are insufficient, the hormonal agent, the route of administration, dosing schedule, and the timing of treatment has been remained controversial. In order to confirm the efficiency of hormonal treatment, further well designed randomized studies with a larger number of patients and a placebo group are warranted. PMID:26816790

  17. Vascular surgical society of great britain and ireland: changes in proximal aortic neck dimensions following endovascular repair of abdominal aortic aneurysm

    PubMed

    Walker; MacIerewicz; Whitaker; Gregson; Hopkinson

    1999-05-01

    BACKGROUND: Dilatation of the proximal neck following conventional open repair of abdominal aortic aneurysm (AAA) has been reported. Such continued dilatation following endovascular repair (EVR) could potentially be a disaster resulting in graft slippage, endoleak and aneurysm rupture. The aim of this study was to detect any change in proximal neck diameter following EVR of AAAs. METHODS: One hundred patients had undergone EVR of an AAA over a 4-year period in whom contrast-enhanced spiral computed tomography was performed both before and after EVR (1 week, 3, 6 and 12 months and annually thereafter). Change in aortic proximal neck diameter, change in maximum aortic diameter, presence of endoleaks, and change in length from the lowest renal artery to the aortic bifurcation was sought. RESULTS: The median anteroposterior and transverse diameter decreased from 64 mm before operation to 56 and 54 mm respectively after operation. This trend in reduction in maximum diameter was not seen in patients with endoleaks. There was no significant change in proximal neck diameter when measured at 5-mm intervals following EVR. There was also no significant change in the aortic length following EVR. CONCLUSION: There was no evidence of proximal neck dilatation or aneurysm length reduction following EVR of AAAs. PMID:10361203

  18. Lesser evaluated determinants of fistula formation in children with hypospadias.

    PubMed

    Ratan, S K; Sen, A; Pandey, R M; Hans, C; Roychaudhary, S; Ratan, J

    2001-03-01

    Determinants of fistula formation, some of them not previously evaluated, were studied in 30 consecutive children admitted for hypospadias repair to our centre. All children were screened for any urinary or local infections. Vicryl and catgut were used alternately for reconstruction of the neo-urethra. Per urethral drainage was employed in all patients. The presence of unfavourable local anatomical factors, the surgeon's satisfaction at the end of the procedure and duration of surgery were noted. The patients were followed up for any urethrocutaneous fistula. Unsatisfactory surgery (chi-square = 6.53, p = 0.01), unfavourable anatomical factors (chi-square = 10.80, p = 0.001) and local infection (chi-square = 5.66, p = 0.017) had a strong association with fistula formation, whereas urine leakage and a history of previous surgery had only a marginal association. On application of stepwise binary logistic regression, unfavourable local anatomical factors (OR [95% CI]: 13.19 [1.20-143.50]) and urine leakage (OR [95% CI]: 14.35 [1.20-171.45]) emerge as strong risk factors for urethrocutaneous fistula, and local infection (OR [95% CI]: 8.70 (0.93-81.01]) as a moderate risk factor. PMID:11321868

  19. Embolisation of a proximal type I endoleak post-Nellix aortic aneurysm repair complicated by reflux of Onyx into the Nellix endograft limb.

    PubMed

    Ameli-Renani, S; Das, R; Weller, A; Chung, R; Morgan, R A

    2015-06-01

    We report the first case of intervention for a proximal type 1 endoleak following Nellix endovascular aneurysm sealing repair of an aortic aneurysm. This was complicated by migration of Onyx into one of the Nellix graft limbs causing significant stenosis. Subsequent placement of a covered stent to affix the Onyx between the stent and the wall of the Nellix endograft successfully restored stent patency. PMID:25547081

  20. The prostatic utricle cyst with huge calculus and hypospadias: A case report and a review of the literature

    PubMed Central

    Wang, Weigang; Wang, Yuantao; Zhu, Dechun; Yan, Pengfei; Dong, Biao; Zhou, Honglan

    2015-01-01

    Prostatic utricle cysts with calculus and hypospadias are rare. There are a few reported cases. We present a case of a prostatic utricle cyst with huge calculus in a 25-year-old male. He had a history of left cryptorchidism and surgery for penoscrotal hypospadias in his infancy. He was referred for frequent micturition, urgency of urination, urine pain, terminal hematuria, and dysuria. A computed tomography (CT) revealed a retrovesical cystic lesion of low density, showing a 5 × 5-cm calcification. Retrograde urethrocystography showed a 5 × 5-cm high-density shadow in the posterior urethra. The cyst was incised by transperineal approach and the stone was clearly observed and removed. Urethral stricture repair was performed simultaneously. The patient recovered smoothly after surgery. PMID:26029314

  1. The prostatic utricle cyst with huge calculus and hypospadias: A case report and a review of the literature.

    PubMed

    Wang, Weigang; Wang, Yuantao; Zhu, Dechun; Yan, Pengfei; Dong, Biao; Zhou, Honglan

    2015-01-01

    Prostatic utricle cysts with calculus and hypospadias are rare. There are a few reported cases. We present a case of a prostatic utricle cyst with huge calculus in a 25-year-old male. He had a history of left cryptorchidism and surgery for penoscrotal hypospadias in his infancy. He was referred for frequent micturition, urgency of urination, urine pain, terminal hematuria, and dysuria. A computed tomography (CT) revealed a retrovesical cystic lesion of low density, showing a 5 × 5-cm calcification. Retrograde urethrocystography showed a 5 × 5-cm high-density shadow in the posterior urethra. The cyst was incised by transperineal approach and the stone was clearly observed and removed. Urethral stricture repair was performed simultaneously. The patient recovered smoothly after surgery. PMID:26029314

  2. Intrauterine growth restriction and hypospadias: is there a connection?

    PubMed Central

    2014-01-01

    Hypospadias is one of the most common congenital malformations of the genitourinary tract in males. It is an incomplete fusion of urethral folds early in fetal development and may be associated with other malformations of the genital tract. The etiology is poorly understood and may be hormonal, genetic, or environmental, but most often is idiopathic or multifactorial. Among many possible risk factors identified, of particular importance is low birth weight, which is defined in various ways in the literature. No mechanism has been identified for the association of low birth weight and hypospadias, but some authors propose placental insufficiency as a common inciting factor. Currently, there is no standardized approach for evaluating children with hypospadias in the setting of intrauterine growth restriction. We reviewed the available published literature on the association of hypospadias and growth restriction to determine whether it should be considered a separate entity within the category of disorders of sexual differentiation. PMID:25337123

  3. Snodgrass' urethroplasty in hypospadias surgery in Clinical Hospital Mostar--preliminary report.

    PubMed

    Brekalo, Zdrinko; Kvesi?, Ante; Nikoli?, Harry; Tomi?, Davor; Martinovi?, Vlatka

    2007-03-01

    Amongst the various methods of reconstructing the hypospadic urethra such as the MAGPI, Mathieu's and Preputial island flap urethroplasty method and the Snodgrass method, the latter is being used more frequently nowadays in patients with the urethral meatus located in the proximity of the penis. In the Pediatric ward at Mostar Clinical Hospital, we have recently adopted the Snodgrass method when reconstructing the hypospadic urethra. We herewith present our research regarding the successful results in adopting the aforementioned method. Success was evaluated according to the frequency of post-operative complications, as well as the patients' satisfaction with the functional and the cosmetic result of the urethra reconstruction. The conclusions relating to our research result in an addition basis from which to evaluate whether the Snodgrass method should receive privileged preference in future operative treatment of the hypospadias over others methods, as can be seen from our research. PMID:17598400

  4. Do adult men with untreated hypospadias have adverse outcomes? A pilot study using a social media advertised survey

    PubMed Central

    Schlomer, Bruce; Breyer, Benjamin; Copp, Hillary; Baskin, Laurence; DiSandro, Michael

    2014-01-01

    Objective Hypospadias is usually treated in childhood. Therefore, the natural history of untreated mild hypospadias is unknown. We hypothesized that men with untreated hypospadias, especially mild, do not have adverse outcomes. Materials Facebook was used to advertise an electronic survey to men older than 18 years. Men with untreated hypospadias identified themselves and indicated the severity of hypospadias with a series of questions. Outcomes included: Sexual Health Inventory for Men (SHIM), penile curvature and difficulty with intercourse, International Prostate Symptom Score (IPSS), Penile Perception Score (PPS), psychosexual milestones, paternity, infertility, sitting to urinate, and the CDC HRQOL-4 module. Results 736 men completed self-anatomy questions and 52 (7.1%) self-identified with untreated hypospadias. Untreated hypospadias participants reported worse SHIM (p < 0.001) and IPSS scores (p = 0.05), more ventral penile curvature (p = 0.003) and resulting difficulty with intercourse (p < 0.001), worse satisfaction with meatus (p = 0.011) and penile curvature (p = 0.048), and more sitting to urinate (p = 0.07). When stratified by mild and severe hypospadias, severe hypospadias was associated with more adverse outcomes than mild hypospadias. Conclusion Men with untreated hypospadias reported worse outcomes compared with non-hypospadiac men. Mild untreated hypospadias had fewer adverse outcomes than severe hypospadias. Research is needed to determine if treatment of childhood hypospadias improves outcomes in adults, especially for mild hypospadias. PMID:24613143

  5. Computational Embryology and Predictive Toxicology of Hypospadias (SOT)

    EPA Science Inventory

    Hypospadias, one of the most common birth defects in human male infants, is a condition in which the urethral opening is misplaced along ventral aspect of the penis. We developed an Adverse Outcome Pathway (AOP) framework and computer simulation that describes the pathogenesis of...

  6. EVC gene polymorphisms and risks of isolated hypospadias a preliminary study

    PubMed Central

    Kowal, Andrzej; Mostowska, Adrianna; Mydlak, Dariusz; Eberdt-Go??bek, Bo?ena; Misztal, Matthew; Jagodzi?ski, Pawe? P.

    2015-01-01

    Introduction Hypospadias has a complex etiology with both genetic and environmental factors contributing to the condition. Urogenital abnormalities including hypospadias, are found in 22% of cases with Ellis van Creveld syndrome (EvC). Mutations in the EVC gene can cause major and minor anomalies, which form phenotypes that partially overlap with those present in EvC. The aim of this study was to evaluate the association between nucleotide variants of the EVC gene and the risk of hypospadias. Material and methods Four single nucleotide polymorphisms (SNPs) of the EVC gene (rs3774856, rs2302075, rs1383180, rs7680768) were taken under investigation in 96 patients with isolated hypospadias and 284 matched controls. Genotyping of all polymorphisms was carried out by PCR and followed by appropriate restriction enzyme digestion (PCR-RFLP). Results Individuals homozygous for the SNP rs2302075 (p.Thr449Lys) showed an elevated risk for hypospadias. Haplotypes containing the rs2302075 variant also revealed modest associations with hypospadias, which did not survive multiple testing corrections. None of the other tested EVC polymorphisms displayed significant association with the risk of hypospadias, either in dominant or recessive inheritance models. Conclusions The results of this study suggest that polymorphic variants of the EVC gene do not substantially contribute to the risk of hypospadias based on our study population. However, further studies should help to clarify the relationship between polymorphisms of EVC and hypospadias. PMID:26251756

  7. Hormone therapy in hypospadias surgery: a systematic review.

    PubMed

    Netto, Jose Murillo B; Ferrarez, Carlos Eduardo P F; Schindler Leal, Anucha Andrade; Tucci, Silvio; Gomes, Carlos Augusto; Barroso, Ubirajara

    2013-12-01

    Surgical correction of hypospadias is proposed to improve the aesthetic and functional quality of the penis. Hormone therapy preceding surgical correction is indicated to obtain better surgical conditions. However, there is divergence in the literature regarding the hormone therapy of choice, time of its use before surgery, appropriate dose, and route of application. To try to elucidate this matter, an electronic survey of the databases PubMed and Cochrane Central Library was conducted, limited to articles in English published since 1980. Search strategy identified 14 clinical trials that matched the inclusion criteria. Analysis was made in terms of study design, classification of hypospadias, association with chordee and cryptorchidism, type of hormone, route of application, dose and duration of treatment, penile length before and after hormone therapy, glans circumference before and after hormone therapy, adverse effects, and surgical complications. From the trials evaluated it was not possible to determine the ideal neoadjuvant treatment. A preference for use of testosterone was observed. Intramuscular administration seems to have fewer adverse effects than topical treatment. Side effects were seldom described, and treated patients were not followed on a long-term basis. The scarcity of randomized and controlled clinical trials regarding the topic impairs the establishment of a protocol. In conclusion, although preoperative hormone therapy is currently used before hypospadias surgery, its real benefit in terms of improvement of the penis and surgical results has not been defined. PMID:23602841

  8. International trends in rates of hypospadias and cryptorchidism.

    PubMed Central

    Paulozzi, L J

    1999-01-01

    Researchers from seven European nations and the United States have published reports of increasing rates of hypospadias during the 1960s, 1970s, and 1980s. Reports of increasing rates of cryptorchidism have come primarily from England. In recent years, these reports have become one focus of the debate over endocrine disruption. This study examines more recent data from a larger number of countries participating in the International Clearinghouse for Birth Defects Monitoring Systems (ICBDMS) to address the questions of whether such increases are worldwide and continuing and whether there are geographic patterns to any observed increases. The ICBDMS headquarters and individual systems provided the data. Systems were categorized into five groups based on gross domestic product in 1984. Hypospadias increases were most marked in two American systems and in Scandinavia and Japan. The increases leveled off in many systems after 1985. Increases were not seen in less affluent nations. Cryptorchidism rates were available for 10 systems. Clear increases in this anomaly were seen in two U.S. systems and in the South American system, but not elsewhere. Since 1985, rates declined in most systems. Numerous artifacts may contribute to or cause upward trends in hypospadias. Possible "real" causes include demographic changes and endocrine disruption, among others. Images Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Figure 6 Figure 7 Figure 8 Figure 9 Figure 10 PMID:10090709

  9. Environmental and Genetic Contributors to Hypospadias: A Review of the Epidemiologic Evidence

    PubMed Central

    Carmichael, Suzan L.; Shaw, Gary M.; Lammer, Edward J.

    2012-01-01

    This review evaluates current knowledge related to trends in the prevalence of hypospadias, the association of hypospadias with endocrine-disrupting exposures, and the potential contribution of genetic susceptibility to its etiology. The review focuses on epidemiologic evidence. Increasing prevalence of hypospadias has been observed, but such increases tend to be localized to specific regions or time periods. Thus, generalized statements that hypospadias is increasing are unsupported. Due to limitations of study designs and inconsistent results, firm conclusions cannot be made regarding the association of endocrine-disrupting exposures with hypospadias. Studies with more rigorous study designs (e.g., larger and more detailed phenotypes) and exposure assessment that encompasses more breadth as well as depth (e.g., specific endocrine-related chemicals) will be critical to make better inferences about these important environmental exposures. Many candidate genes for hypospadias have been identified, but few of them have been examined to an extent that enables solid conclusions. Further studies are needed that include larger sample sizes, comparison groups that are more representative of the populations from which the cases were derived, phenotype-specific analyses, and more extensive exploration of variants. In conclusion, examining the associations of environmental and genetic factors with hypospadias remain important areas of inquiry, although our actual understanding of their contribution to hypospadias risk in humans is currently limited. PMID:22678668

  10. Correlation between the birth prevalence of isolated hypospadias and parental subfertility.

    PubMed

    Czeizel, A; Tóth, J

    1990-02-01

    Factors associated with the occurrence of isolated hypospadias have been studied. We previously reported a secular trend association between hypospadias occurrence and progestagen use by the Hungarian population. Further study does not support that secular trend association. The use of progestagens for the treatment of reproductive problems is a very complex issue, and there are other factors relating to male and female fertility that differentiate the hypospadias families from the controls. It appears that families with problems of subfertility are at increased risk for the occurrence of hypospadias. Our data support more recent studies, which do not demonstrate an association between the occurrence of hypospadias and the administration of progestagens in humans. PMID:2321160

  11. Microvascular Staged Phalloplasty Preserving Original Glans in a Severe Hypospadias: A Case Report

    PubMed Central

    Cavadas, Pedro C.; Rubi, Carlos G.

    2015-01-01

    Summary: Penile reconstruction is usually performed in patients with gender dysphoria; with penile loss because of trauma, infection, and tumors; and with congenital deformities like severe hypospadias, in which standard techniques do not achieve a good result. Hypospadias are one of the most common inherent genital anomalies in boys. Many surgical procedures have been published for total phallic reconstruction aiming at a functionally and aesthetically pleasing. We present a case of reconstruction of the penis in a severe hypospadias in a 40-year-old man by transferring the original glans to the forearm flap and a stiffening procedure with an osteocutaneous fibular flap 3 months after first surgery. Three months postoperatively, the final result was an acceptable sexual intercourse, normal voiding, and quite normal appearance. Microvascular staged phalloplasty preserving original glans in a severe hypospadia could be considered a surgical option for micropenis. Technical difficulties and microsurgical advanced skills are the main drawback of this approach. PMID:26894013

  12. Microvascular Staged Phalloplasty Preserving Original Glans in a Severe Hypospadias: A Case Report.

    PubMed

    Thione, Alessandro; Cavadas, Pedro C; Rubi, Carlos G

    2015-12-01

    Penile reconstruction is usually performed in patients with gender dysphoria; with penile loss because of trauma, infection, and tumors; and with congenital deformities like severe hypospadias, in which standard techniques do not achieve a good result. Hypospadias are one of the most common inherent genital anomalies in boys. Many surgical procedures have been published for total phallic reconstruction aiming at a functionally and aesthetically pleasing. We present a case of reconstruction of the penis in a severe hypospadias in a 40-year-old man by transferring the original glans to the forearm flap and a stiffening procedure with an osteocutaneous fibular flap 3 months after first surgery. Three months postoperatively, the final result was an acceptable sexual intercourse, normal voiding, and quite normal appearance. Microvascular staged phalloplasty preserving original glans in a severe hypospadia could be considered a surgical option for micropenis. Technical difficulties and microsurgical advanced skills are the main drawback of this approach. PMID:26894013

  13. Idiopathic female pseudohermaphroditism with urethral duplication and female hypospadias.

    PubMed

    D'Cunha, Aureen Ruby; Kurian, Jujju Jacob; Jacob, Tarun John K

    2016-01-01

    Female hypospadias is a rare anomaly of the female urethra where it opens on the anterior vaginal wall anywhere between the introitus and the fornix. It is often associated with other genitourinary anomalies such as Cloacal malformation, female pseudohermaphroditism, nonneurogenic neurogenic bladder and urethral duplication. Idiopathic female pseudohermaphroditism is extremely rare, and most cases occur secondary to adrenogenital syndrome or maternal androgen exposure. We report a unique case of a 1-year and 4-month-old girl who presented with ambiguous genitalia and renal failure secondary to a non-neurogenic neurogenic bladder. On further evaluation, she was found to have urethral duplication with a hypospadiac female urethra. She initially underwent a vesicostomy and was further planned to undergo an appendicular Mitrofanoff at an older age. The mainstay of treatment in these cases includes relief of bladder outlet obstruction and recovery of renal function by adequate urinary drainage. Clitoral reduction, if cosmetically warranted, may be planned at puberty. PMID:26965407

  14. Fine mapping analysis confirms and strengthens linkage of four chromosomal regions in familial hypospadias.

    PubMed

    Söderhäll, Cilla; Körberg, Izabella Baranowska; Thai, Hanh T T; Cao, Jia; Chen, Yougen; Zhang, Xufeng; Shulu, Zu; van der Zanden, Loes F M; van Rooij, Iris A L M; Frisén, Louise; Roeleveld, Nel; Markljung, Ellen; Kockum, Ingrid; Nordenskjöld, Agneta

    2015-04-01

    Hypospadias is a common male genital malformation and is regarded as a complex disease affected by multiple genetic as well as environmental factors. In a previous genome-wide scan for familial hypospadias, we reported suggestive linkage in nine chromosomal regions. We have extended this analysis by including new families and additional markers using non-parametric linkage. The fine mapping analysis displayed an increased LOD score on chromosome 8q24.1 and 10p15 in altogether 82 families. On chromosome 10p15, with the highest LOD score, we further studied AKR1C2, AKR1C3 and AKR1C4 involved in steroid metabolism, as well as KLF6 expressed in preputial tissue from hypospadias patients. Mutation analysis of the AKR1C3 gene showed a new mutation, c.643G>A (p.(Ala215Thr)), in a boy with penile hypospadias. This mutation is predicted to have an impact on protein function and structure and was not found in controls. Altogether, we homed in on four chromosomal regions likely to harbor genes for hypospadias. Future studies will aim for studying regulatory sequence variants in these regions. PMID:24986825

  15. Severe forms of concealed penis without hypospadias: Surgical strategies

    PubMed Central

    de Jesus, Lisieux Eyer; Dekermacher, Samuel; Anderson, Kleber M.

    2015-01-01

    Introduction: Concealed penis (CP) may vary in severity and includes megaprepuce (MP) as a variant. Many different surgical strategies have been described in order to maximize penile exposure and to deal with skin deficiency. We describe the strategies that we use to overcome technical problems in severe cases of CP. Materials and Methods: Six consecutive cases of severe CP (including 3 with MP) were treated in a 2-year period between January 2011 and April 2013. These patients were treated using extensive degloving, removal of dysplastic dartos, Alexander's preputial flap, scrotal flaps and skin grafts. Three patients had been previously circumcised. Cases associated with hypospadias, obesity, disorders of sexual differentiation and micropenises were excluded. Results: All six patients attained good results, with good exposure of the penis, ability to void standing with a well-directed flow and reasonable esthetic results. A technical algorithm for the treatment of primary or recurring cases of CP is proposed. Conclusion: Alexander s distally based ventral preputial flap is a useful technical resource to treat MP cases. Free skin grafts and/or laterally based scrotal flaps may be used to cover the penis after release in severe cases of CP. PMID:26604447

  16. Chordee without hypospadias: Operative classification and its management

    PubMed Central

    Singh, Sunita; Rawat, Jiledar; Kureel, Shiv Narayan; Pandey, Anand

    2013-01-01

    Context: Developing countries. Aims: To propose a operative classification of Chordee without hypospadias (CWH) with its management. Settings and Design: Tertiary referral centre; Retrospective study from January 2000 to January 2011. Materials and Methods: Total 26 patients were classified peroperatively into sixtypes (A: Cutaneous chordee? Degloving skin and dartos (1/26); B: Fibrous chordee? chordectomy (4/26);C: Corporocavernosalchordee? Corporoplasty Urethral mobilization (4/26); D: Urethral tethering with Hypoplastic urethra? Urethral mobilization urethral reconstruction because of hypoplastic urethra (14/26); E: Congenital short urethra? excision of urethra from the meatus and urethroplasty (2/26); and F: Complex chordee? Degloving Corporoplasty urethroplasty (1/26 patients). The follow-up over 6 months to 9 years were analyzed. Statistical Analysis: SPSS soft ware version 17.0 for Windows. Results: The mean age of surgery was 5.33 0.11 years. The success rate defined on uroflowmetry and voiding cystourethrography was 65.6%. The coronal urethra-cutaneous fistula developed in 26.9% (7/26) {including 7.7% (3/26) of associated metal stenosis}. The urethral stricture developed in 3.8% (1/26). Conclusions: CWH needs stepwise surgical management. The operative classification may help in better understanding and management of this difficult entity. Meticulous tissue handling and urethroplasty is needed for good and promising results. PMID:23798865

  17. Outcomes after ascending aorta and proximal aortic arch repair using deep hypothermic circulatory arrest with retrograde cerebral perfusion: analysis of 207 patients

    PubMed Central

    Perreas, Konstantinos; Samanidis, George; Dimitriou, Stergios; Kalogris, Panagiotis; Balanika, Marina; Antzaka, Christina; Khoury, Mazen; Michalis, Alkiviadis

    2012-01-01

    OBJECTIVES Correction of ascending aorta and proximal aortic arch pathology with numerous surgical techniques having been proposed over the years remains a surgical challenge. This study was undertaken to identify risk factors influencing outcome after aortic arch operations, requiring deep hypothermic circulatory arrest (DHCA). METHODS Between 1993 and 2010, 207 consecutive patients were operated for ascending aorta and proximal arch correction with the use of deep hypothermic circulatory arrest with retrograde cerebral perfusion. All patients were followed up with regular out-patient clinics, transthoracic echocardiography and, when required, chest computed tomography. RESULTS There were 102 (49.3%) emergencies (acute type A dissection) and 105 (50.7%) elective cases. Mean age: 63.512years. Mean circulatory arrest time was 25.413min. Unadjusted analysis of factors associated with 30-day mortality revealed emergency status, preoperative hemodynamic instability, acute dissection, reoperation, increased circulatory arrest time, postoperative bleeding, postoperative creatinine levels and presence of neurological dysfunction. Multi-adjusted analysis revealed duration of circulatory arrest as the only and main factor related to death. Thirty-day mortality was 2.4% for the elective and 7.2% for emergencies cases. Survival during long-term follow-up was 93, 82 and 53% at 1, 5 and 10years, respectively. CONCLUSIONS Ascending aorta and proximal aortic arch replacement with brief duration of deep hypothermic circulatory arrest combined with retrograde cerebral perfusion is a safe method with acceptable short- and long-tem results. PMID:22687431

  18. [Microbial contamination of penile tissues as a risk factor for complications in the treatment of hypospadia].

    PubMed

    Kogan, M I; Panchenko, S N; Nabokova, Iu A; Mitusov, V V; Shangichev, V A; Sizonov, V V

    2011-01-01

    Biopsy of the skin, fascia and urethra was performed in 29 cases of urethroplasty for hypospadia in children and adults. The patients were divided into two groups: group 1 (n=14) with primary plastic urethra and group 2 (n=15) with secondary urethroplasty of hypospadia with complication. Tissue samples were examined microbiologically and morphologically. Focal infection of penile skin was found after iodopiron sterilization as well as contamination of the skin, fascia and urethra in all the patients of group 2. Nonclostridial anaerobes dominated among the bacteria. Microbiological investigations in groups 1 and 2 proved a great role of Bacteriodes fragilic in the development of penile tissue inflammation. PMID:21815457

  19. Androgen receptor is overexpressed in boys with severe hypospadias, and ZEB1 regulates androgen receptor expression in human foreskin cells

    PubMed Central

    Qiao, Liang; Tasian, Gregory E.; Zhang, Haiyang; Cao, Mei; Ferretti, Max; Cunha, Gerald R.; Baskin, Laurence S.

    2012-01-01

    INTRODUCTION ZEB1 is overexpressed in patients with severe hypospadias. We examined the interaction between ZeB1 and the androgen receptor (AR) in vitro and the expression of AR in boys with hypospadias. RESULTS ZEB1 and AR colocalize to the nucleus. Estrogen upregulated ZEB1 and AR expression. Chromatin immunoprecipitation (ChIP) demonstrated that ZEB1 binds to an E-box sequence in the AR gene promoter. AR expression is higher in subjects with severe hypospadias than those with mild hypospadias and control subjects (P < 0.05). ZEB1 physically interacts with AR in human foreskin cells. DISCUSSION AR is overexpressed in patients with severe hypospadias. Environmental estrogenic compounds may increase the risk of hypospadias by facilitating the interaction between ZEB1 and AR. METHODS Hs68 cells, a fibroblast cell line derived from neonatal human foreskin, were exposed to 0, 10, and 100 nmol/l of estrogen, after which the cellular localization of ZEB1 and AR was assessed using immunocytochemistry. To determine if ZEB1 interacted with the AR gene, ChIP was performed using ZEB1 antibody and polymerase chain reaction (PCR) for AR. Second, AR expression was quantified using real-time PcR and western blot in normal subjects (n = 32), and subjects with mild (n = 16) and severe hypospadia (n = 16). PMID:22391641

  20. Proximal Nephron

    PubMed Central

    Zhuo, Jia L.; Li, Xiao C.

    2013-01-01

    The kidney plays a fundamental role in maintaining body salt and fluid balance and blood pressure homeostasis through the actions of its proximal and distal tubular segments of nephrons. However, proximal tubules are well recognized to exert a more prominent role than distal counterparts. Proximal tubules are responsible for reabsorbing approximately 65% of filtered load and most, if not all, of filtered amino acids, glucose, solutes, and low molecular weight proteins. Proximal tubules also play a key role in regulating acid-base balance by reabsorbing approximately 80% of filtered bicarbonate. The purpose of this review article is to provide a comprehensive overview of new insights and perspectives into current understanding of proximal tubules of nephrons, with an emphasis on the ultrastructure, molecular biology, cellular and integrative physiology, and the underlying signaling transduction mechanisms. The review is divided into three closely related sections. The first section focuses on the classification of nephrons and recent perspectives on the potential role of nephron numbers in human health and diseases. The second section reviews recent research on the structural and biochemical basis of proximal tubular function. The final section provides a comprehensive overview of new insights and perspectives in the physiological regulation of proximal tubular transport by vasoactive hormones. In the latter section, attention is particularly paid to new insights and perspectives learnt from recent cloning of transporters, development of transgenic animals with knockout or knockin of a particular gene of interest, and mapping of signaling pathways using microarrays and/or physiological proteomic approaches. PMID:23897681

  1. Ocular hypotelorism, submucosal cleft palate, and hypospadias: a new autosomal dominant syndrome.

    PubMed

    Schilbach, U; Rott, H D

    1988-12-01

    A syndrome characterized by ocular hypotelorism, submucosal cleft palate, and hypospadias in males was found in ten relatives over five generations of a family. Other anomalies are blepharophimosis, upslant of palpebral fissures, and a tendency to cutaneous syndactyly of 3rd and 4th fingers as well as 2nd and 3rd toes. Autosomal dominant inheritance is likely. PMID:3149147

  2. [Hypospadias in infancy I) pathophysiologic considerations II) hormonal balance studies (author's transl)].

    PubMed

    Glatzl, J

    1975-01-01

    Animal studies (Goldman, Jost) and test results in patients with hypospadias (Bongiovanni, Zachmann, Knorr) put up the question, whether all forms of hypospadias could be caused by a disturbance or peculiarity of the adrenal or gonadal androgen metabolism. Healthy volunteers and boys with glandal, penile and scrotal hypospadias were examined for their basal hormon status and response to stimulation. The following test-results are uniform, however due to the small number of cases, we would like to use these data more as a suggestion for peculiarities of the androgen metabolism, these are: 1. signs of quantitatively decreased testosteron production. 2. signs of qualitatively deranged testosteron-biosynthesis in patients with hypospadias due to a) decrease in certain enzymes in the testosteron-biosyntheticpathway (3-beta-hydroxysteroid-dehydrogenase, 17,20-desmolase, 17-beta-hydroxysteroid oxidoreductase) b) increased peripheral conversion of androgen metabolites 3. signs of a suggested "saving" of androgens in the catabolism of those compounds and, last not least 4. signs of gonadal transformation of the adrenals, seen by increased adrenal androgen production and an adrenal transformation of the gonads, which can ultimately be considered as faulty differentiation of these 2 organ systems. PMID:129752

  3. Effect of Pre-Designed Instructions for Mothers of Children with Hypospadias on Reducing Postoperative Complications

    ERIC Educational Resources Information Center

    Mohamed, Sanaa A.

    2015-01-01

    Hypospadias is a common congenital anomaly with a prevalence estimated to be as high as 1 in 125 live male births. Complications after surgical procedures are possible. The incidence of complications can be reduced by meticulous preoperative planning, and judicious postoperative care. So the aim of the study was to investigate the effect of…

  4. What is new in cryptorchidism and hypospadias--a critical review on the testicular dysgenesis hypothesis.

    PubMed

    Thorup, Jorgen; McLachlan, Robert; Cortes, Dina; Nation, Tamara R; Balic, Adam; Southwell, Bridget R; Hutson, John M

    2010-10-01

    It has been hypothesized that poor semen quality, testis cancer, undescended testis, and hypospadias are symptoms of one underlying entity--the testicular dysgenesis syndrome--leading to increasing male fertility impairment. Though testicular cancer has increased in many Western countries during the past 40 years, hypospadias rates have not changed with certainty over the same period. Also, recent studies demonstrate that sperm output may have declined in certain areas of Europe but is probably not declining across the globe as indicated by American studies. However, at the same time, there is increasing recognition of male infertility related to obesity and smoking. There is no certain evidence that the rates of undescended testes have been increasing with time during the last 50 years. In more than 95% of the cases, hypospadias is not associated with cryptorchidism, suggesting major differences in pathogenesis. Placental abnormality may occasionally cause both cryptorchidism and hypospadias, as it is also the case in many other congenital malformations. The findings of early orchidopexy lowering the risk of both infertility and testicular cancer suggest that the abnormal location exposes the cryptorchid testis to infertility and malignant transformation, rather than there being a primary abnormality. Statistically, 5% of testicular cancers only are caused by cryptorchidism. These data point to the complexity of pathogenic and epidemiologic features of each component and the difficulties in ascribing them to a single unifying process, such as testicular dysgenesis syndrome, particularly when so little is known of the actual mechanisms of disease. PMID:20920735

  5. Space Transportation System (STS)-133/External Tank (ET)-137 Intertank (IT) Stringer Cracking Issue and Repair Assessment: Proximate Cause Determination and Material Characterization Study

    NASA Technical Reports Server (NTRS)

    Piascik, Robert S.

    2011-01-01

    Several cracks were detected in stringers located beneath the foam on the External Tank (ET) following the launch scrub of Space Transportation System (STS)-133 on November 5, 2010. The stringer material was aluminum-lithium (AL-Li) 2090-T83 fabricated from sheets that were nominally 0.064 inches thick. The mechanical properties of the stringer material were known to vary between different material lots, with the stringers from ET-137 (predominately lots 620853 and 620854) having the highest yield and ultimate stresses. Subsequent testing determined that these same lots also had the lowest fracture toughness properties. The NASA Engineering and Safety Center (NESC) supported the Space Shuttle Program (SSP)-led investigation. The objective of this investigation was to develop a database of test results to provide validation for structural analysis models, independently confirm test results obtained from other investigators, and determine the proximate cause of the anomalous low fracture toughness observed in stringer lots 620853 and 620854. This document contains the outcome of the investigation.

  6. Solitary Crossed Renal Ectopia: Concurrence of Posterior Urethral Valve and Hypospadias

    PubMed Central

    Bagheri, Amin; Khorramirouz, Reza; Keihani, Sorena; Fareghi, Mehdi; Kajbafzadeh, Abdol-Mohammad

    2015-01-01

    Solitary crossed renal ectopia (SCRE) represents an exceedingly rare congenital disorder. Although skeletal and genitourinary abnormalities most commonly accompany this condition, vesicoureteral reflux (VUR) has been described in only a few cases. Here, we present two unique cases of SCRE complicated by high-grade VUR concomitant with posterior urethral valve in one case and hypospadias in the other one. We also provide a brief review of the literature on this subject. PMID:26167315

  7. Endocrine Disruptors in the Workplace, Hair Spray, Folate Supplementation, and Risk of Hypospadias: CaseControl Study

    PubMed Central

    Ormond, Gillian; Nieuwenhuijsen, Mark J.; Nelson, Paul; Toledano, Mireille B.; Iszatt, Nina; Geneletti, Sara; Elliott, Paul

    2009-01-01

    Background Hypospadias is one of the most common urogenital congenital anomalies affecting baby boys. Prevalence estimates in Europe range from 4 to 24 per 10,000 births, depending on definition, with higher rates reported from the United States. Relatively little is known about potential risk factors, but a role for endocrine-disrupting chemicals (EDCs) has been proposed. Objective Our goal was to elucidate the risk of hypospadias associated with occupational exposure of the mother to endocrine-disruptor chemicals, use of folate supplementation during pregnancy, and vegetarianism. Design We designed a casecontrol study of 471 hypospadias cases referred to surgeons and 490 randomly selected birth controls, born 1 January 199730 September 1998 in southeast England. Telephone interviews of mothers elicited information on folate supplementation during pregnancy and vegetarianism. We used a job exposure matrix to classify occupational exposure. Results In multiple logistic regression analysis, there were increased risks for self-reported occupational exposure to hair spray [exposed vs. nonexposed, odds ratio (OR) = 2.39; 95% confidence interval (CI), 1.404.17] and phthalate exposure obtained by a job exposure matrix (OR = 3.12; 95% CI, 1.0411.46). There was a significantly reduced risk of hypospadias associated with of folate use during the first 3 months of pregnancy (OR = 0.64; 95% CI, 0.440.93). Vegetarianism was not associated with hypospadias risk. Conclusions Excess risks of hypospadias associated with occupational exposures to phthalates and hair spray suggest that antiandrogenic EDCs may play a role in hypospadias. Folate supplementation in early pregnancy may be protective. PMID:19270804

  8. Exploration of gene-environment interactions, maternal effects, and parent-of-origin effects in the etiology of hypospadias

    PubMed Central

    van der Zanden, Loes F.M.; Galesloot, Tessel E.; Feitz, Wout F.J.; Brouwers, Marijn M.; Shi, Min; Knoers, Nine V.A.M.; Franke, Barbara; Roeleveld, Nel; van Rooij, Iris A.L.M.

    2013-01-01

    Purpose Hypospadias is a common congenital malformation of the male external genitalia. Association studies for single nucleotide polymorphisms (SNPs) in genes encoding steroid-5-alpha-reductase (SRD5A2), estrogen receptors 1 (ESR1) and 2 (ESR2), and activating transcription factor 3 (ATF3) have been equivocal. The aim of this study was to examine whether non-replication of findings for four SNPs in these genes could be due to interaction with environmental exposures. Materials and Methods We genotyped 712 Dutch hypospadias case-parent triads for the four SNPs, used questionnaire information to determine exposures, and performed association tests using the log-linear approach. We studied gene-environment interactions for the four SNPs with exposure to estrogens, cytokines or cigarette smoke, multiple pregnancy, being born small for gestational age, and maternal hypertension or preeclampsia, high BMI, or primiparity. In addition, the presence of maternal genetic and parent-of-origin effects was tested. Results Gene-environment interactions were identified for rs523349 in SRD5A2 with estrogen exposure and maternal hypertension or preeclampsia, as well as for rs11119982 in ATF3 with exposure to cytokines. Both SNPs only seemed to influence hypospadias risk in exposed cases. For rs6932902 in ESR1, only maternally derived alleles appeared to increase hypospadias risk in offspring. Conclusions This study shows that interactions between genetic and environmental factors may help to explain non-replication in genetic studies of hypospadias. PMID:23088992

  9. Remarkably low incidence of hypospadias in Greenland despite high exposure to endocrine disrupters; possible protective effect of androgen receptor genotype.

    PubMed

    Giwercman, Yvonne L; Kleist, Knud Erik; Giwercman, Aleksander; Giwercman, Charlotte; Toft, Gunnar; Bonde, Jens-Peter; Pedersen, Henning S

    2006-05-01

    Endocrine disrupters, such as persistent organohalogen pollutants (POPs) may cause hypospadias, which is a common congenital anomaly in males, affecting 0.2-0.7%. We hypothesized that hypospadias incidence would be high among Greenlanders, who are one of the most POP exposed populations on earth through consumption of contaminated sea mammals. Interestingly, among the 11 076 boys born in Greenland 1982-2002, only two cases of hypospadias were noted (incidence 0.02%; 95% CI: 0.002-0.06). Normal male sexual differentiation is dependent on the androgen receptor (AR). AR function is regulated by polymorphic repeats of CAG and GGN trinucleotide bases. In Greenland 85% were carriers of GGN=23, which in a previous report was less frequent in patients with hypospadias than in the general population. This finding indicates that AR genotype could contribute to a genetic predisposition in Greenlanders, who despite one of the worlds highest body burden of POPs, seem to be protected from hypospadias. PMID:16609370

  10. A role for fibroblast growth factor type-1 in nephrogenic repair. Autocrine expression in rat kidney proximal tubule epithelial cells in vitro and in the regenerating epithelium following nephrotoxic damage by S-(1,1,2,2-tetrafluoroethyl)-L-cysteine in vivo.

    PubMed

    Zhang, G; Ichimura, T; Maier, J A; Maciag, T; Stevens, J L

    1993-06-01

    The regenerating proximal tubule epithelium in the rat has striking similarity with rat kidney proximal tubule epithelial cells (RPTE) in primary culture (Wallin, A., Zhang, G., Jones, T. W., Jaken, S., and Stevens, J. L. (1992) Lab. Invest. 66, 474-484). We used this in vitro model to investigate mechanisms which may regulate aspects of nephrogenic repair in vivo, and in particular the role of fibroblast (heparin-binding) growth factor type-1 (FGF-1) expression. FGF-1 was present predominantly as a 14.3-kDa polypeptide in rat kidney. Biological activity and mRNA for FGF-1 increased dramatically in primary RPTE in culture along with an increase in a 18.3-kDa FGF-1. Cycloheximide blocked FGF-1 expression in primary culture indicating that the increase represents newly synthesized factor rather than release from the extracellular matrix. The maximal increase in expression occurs after the peak of RPTE proliferation. Activity was not present in the medium but intracellular FGF-1 was released from RPTE by scrape wounding. Immunohistochemical analysis showed that FGF-1 expression increased in regenerating proximal tubule epithelial cells 5 days after nephrotoxic damage. Collectively, the data suggest that autocrine expression of FGF-1 by regenerating proximal tubule epithelial cells plays a role in the regulation of nephrogenic repair. PMID:7685015

  11. Proximity fuze

    DOEpatents

    Harrison, Thomas R. (Stockton, CA)

    1989-08-22

    A proximity fuze system includes an optical ranging apparatus, a detonation circuit controlled by the optical ranging apparatus, and an explosive charge detonated by the detonation cirtcuit. The optical ranging apparatus includes a pulsed laser light source for generating target ranging light pulses and optical reference light pulses. A single lens directs ranging pulses to a target and collects reflected light from the target. An optical fiber bundle is used for delaying the optical reference pulses to correspond to a predetermined distance from the target. The optical ranging apparatus includes circuitry for providing a first signal depending upon the light pulses reflected from the target, a second signal depending upon the light pulses from the optical delay fiber bundle, and an output signal when the first and second signals coincide with each other. The output signal occurs when the distance from the target is equal to the predetermined distance form the target. Additional circuitry distinguishes pulses reflected from the target from background solar radiation.

  12. Proximity fuze

    DOEpatents

    Harrison, T.R.

    1987-07-10

    A proximity fuze system includes an optical ranging apparatus, a detonation circuit controlled by the optical ranging apparatus, and an explosive charge detonated by the detonation circuit. The optical ranging apparatus includes a pulsed laser light source for generating target ranging light pulses and optical reference light pulses. A single lens directs ranging pulses to a target and collects reflected light from the target. An optical fiber bundle is used for delaying the optical reference pulses to correspond to a predetermined distance from the target. The optical ranging apparatus includes circuitry for providing a first signal depending upon the light pulses reflected from the target, a second signal depending upon the light pulses from the optical delay fiber bundle, and an output signal when the first and second signals coincide with each other. The output signal occurs when the distance from the target is equal to the predetermined distance from the target. Additional circuitry distinguishes pulses reflected from the target from background solar radiation. 3 figs.

  13. AB128. Features of correction hypospadias in the young men

    PubMed Central

    Jumaev, B.Sh.; Halimov, R.R.; Shavakhabov, Sh.

    2014-01-01

    Purpose Examining the early and late results of adult urethroplasty in the adult patients. Materials and methods During the period from January 2006 to December 2013 at the Republican Specialized Center of Urology (training base of Tashkent Medical Academy) urethroplasty using various techniques was performed in 68 men. Mean age was 23.4 2.6 years (from 18 to 26 years). All patients have had previously foreskin removing (circumcision). Some form of surgical intervention on the penis was performed in 48 (70%) men formerly. Typically, earlier in childhood, there had been an unsuccessful attempt in urethroplasty in 39 patients, and straightening of the penis (excision of the chord) in seven cases. Dermal urethral fistula in the urethra was formed in 23 (34%) males: in 12 cases the aperture was situated in penoscrotal zone; in eight patientsin the shaft of the penis and in three patients - located in the coronary sulcus. Deformity of the penis due to insufficiently removing of the chord was in three patients. Causes of patients complaints were dissatisfaction with aesthetic appearance of the penis (all patients), the presence of a fistula and the absence of children after marriage (12 men). All the patients underwent routine clinical and laboratory investigations, biochemical analyzes, the investigation of sexual hormones levels, ultrasonography (to avoid abnormalities of the urinary tract) and uroflowmetry (to exclude bladder outlet obstruction). All patients have had an antibacterial therapy before the surgery in the case urinary tract of infection and urethroplasty was performed in the presence of sterile urine. Sine qua non of urethra plastic surgery was the decompression of the lower urinary tract, which was performed by setting a catheter into the bladder cavity via percutaneous suprapubic access. In to the neouretral lumen was performed of a small diameter catheter. Restoration of natural urination occurred 12-15 days after the surgery. Results The formation of the neourethra in all patients was completed in several stages. The first stage included the chord excision in seven patients with deformed penile curvature. S. E. Duplay method of urethral plastic surgery was performed in 32 (47%) patients, in 28 cases the meatus was formed at coronal sulcus, whereas in four men using glanduloplasty we managed to form the outer aperture of the urethra at the tip of the penis. After the surgery in 12 (37%) cases, because of purulent urethritis and wound dehiscence, the urinary fistulas were accured. The fistulas self-cured in two of the cases, in the remaining patients this occurred three months after the surgical repair. Due to the scarcity of the skin on the penis in 36 (53%) cases for the technique proposed by Cecil was used in creation of the urethra: the first stage creates the urethra and the skin defect on the penile skin flap is closed using the skin from the scrotum; the second stage (after three months) the uncoupling of the penoscrotal anastomosis was performed. After the Cecil surgery the purulent urethritis occurred in 10 (27%) patients, which caused the formation of urethral urinary fistulas in eight cases. After three months, urethral fistula was successfully eliminated surgically. It should be noted that in all patients in this group the urethral meatus was formed at the coronal sulcus, as the specialized nature of these operations according to Cecil do not provide another option. Conclusions Due to the scarcity of the skin on the penis in adult patients (including the lack of foreskin) urethroplasty should be performed in a multi-step process. There is no need to form the outer opening of the urethra on the penis balanus, however the location of the meatus on a physiological level allows for the best aesthetical result. Because of the risk of urethritis in men it is advisable before performing uretroplastic surgery to perform a derivation of urine using cystostomy.

  14. Intracellular and nuclear binding of [3H]dihydrotestosterone in cultured genital skin fibroblasts of patients with severe hypospadias.

    PubMed Central

    Schweikert, H U; Schlter, M; Romalo, G

    1989-01-01

    Androgens stimulate the development and growth of the male external genitalia. Because hypospadias is the most common congenital defect of the male urethra and because in most cases the cause of this malformation is unknown, we examined the hypothesis that the etiology of the severe forms of this disorder, which is frequently associated with other genital anomalies, might be explained by receptor abnormalities. Intracellular and nuclear binding of androgens were determined in cultured genital skin fibroblasts from 10 males who underwent circumcision for phimosis (controls A), 2 patients with 5 alpha-reductase deficiency (controls B), and 11 patients with severe forms of hypospadias of unknown etiology. Genital skin fibroblast monolayers were incubated for 60 min at 37 degrees C with varying concentrations of [3H]-dihydrotestosterone ([3H]DHT), and specific binding in whole cells and nuclei was measured. Maximum binding (Bmax) in the whole cell assay averaged 0.88 +/- 0.15 fmol . microgram DNA-1 (mean +/- SD) in the control group (controls A, 0.89 +/- 0.16 fmol . microgram DNA-1; controls B, 0.85 fmol . microgram DNA-1) and 0.7 +/- 0.25 fmol . microgram DNA-1 in the patients with hypospadias. In the latter group, Bmax in six patients was below the minimum values determined in the controls. Maximum specific nuclear binding in the control groups averaged 43% (range, 30-55%) of the corresponding intracellular binding. In contrast, nuclear binding in strains from patients with hypospadias was lower (range, 0-12% of whole cell Bmax). In particular, no high affinity saturable nuclear [3H]DHT binding could be measured in 6 of the 11 patients. We interpret these data to suggest that defective intracellular and/or nuclear binding might be the cause of defective genital development in some patients with severe hypospadias. PMID:2913055

  15. [Anterior hypospadias and chordee: a one-stage cure using a tubulated and reversed flap].

    PubMed

    Staerman, F; Babut, J M; Fremond, B

    1990-01-01

    A one stage urethroplasty using a tubulated and reversed flap was carried out by the authors in 74 cases of hypospadias with chordee between 1978 and 1988. The procedure is derived from the technic of Mustarde and the flip flap of Devine and Horton. The experience led to limit its indication to the patients who have a sufficient length of ventral skin of good quality between the hypospadic meatus and the peno scrotal junction to build the urethra up to the apex of the glans after correction of the chordee. This technic is simple and reliable: complications have been encountered in only two of the last forty cases (one fistula and one urethral stenosis) since the design of the flap was simplified. PMID:2341742

  16. [Hypospadias with chordee one-stage operation. An original procedure (author's transl)].

    PubMed

    Babut, J M; Allouis, M; Paul, J L

    1980-01-01

    The common management of hypospadias involves the chordee correction before reconstructing the urethra; then staging of operative cure is so often necessary. This inconvenience is avoided by neglecting some moderate chordees as it was recorded by the authors in their own retrospective series. For the last two years they are performing a one stage procedure with simultaneous correction of chordee and urethroplasty; they briefly review main other one-stage procedures before describing their own using a tubulated and inverted flap. Twenty cases were managed with this procedure and the results were found satisfactory as well as functionally and aesthetically in spite of three transient fistulas and two meatal stenosis. However, definitive conclusion cannot be drawn because of a too short follow-up. PMID:7237673

  17. Environmental and childhood lead contamination in the proximity of boat-repair yards in southern Thailand--I: pattern and factors related to soil and household dust lead levels.

    PubMed

    Maharachpong, Nipa; Geater, Alan; Chongsuvivatwong, Virasakdi

    2006-07-01

    High blood lead levels have recently been documented in schoolchildren living in communities adjacent to boat-repair yards in southern Thailand. In this study, the spatial pattern of lead contamination of soil and household dust in an area surrounding several boat-repair yards is described, and household factors associated with elevated dust lead are identified. A cross-sectional spatial study was conducted in a coastal residential area within a distance of 2 km from three major boat-repair yards situated on the east coast of peninsular Thailand. Household dust specimens were collected from an undisturbed position in the residences of children, aged 4-14 years, sampled randomly from all children living in the study area. Soil specimens were obtained from the interstices of a square grid, 70 x 70 m2, superimposed on the area. Geographic coordinates of residence and soil sampling positions were recorded and semivariograms and kriging used to contour the spatial distribution of lead in dust and soil. Environmental lead levels were also modeled in terms of direction and minimum distance from a boat-repair yard and, for household dust lead content, in terms of household variables, including occupation of household members in boat-repair work, type of house construction, and general cleanliness. Household dust and soil lead content ranged from 10 to 3025 mg/kg and from 1 to 7700 mg/kg, respectively. The distribution of soil lead peaked at the location of the boat-repair yards, but outside the yards the distribution was generally below 400 mg/kg and irregular. About 24% of household dust lead specimens were equal to or above 400 mg/kg, but showed significant decrease with increasing distance from the boat-repair yards, at rates of between 7% and 14% per 100 m. In houses where a family member was a worker in one of the major boatyards and in houses where occasional repair of small boats was undertaken, household dust lead levels were significantly elevated, by 65% (95% CI: 18-130%) and 31% (95% CI: 5-63%), respectively. Siting of boat-repair yards at a distance from residential areas and measures to reduce the spread of lead-containing dust are recommended to alleviate the problem of elevated household dust lead levels. PMID:16832871

  18. DNA repair

    SciTech Connect

    Friedberg, E.C.; Hanawalt, P.C. )

    1988-01-01

    Topics covered in this book included: Eukaryote model systems for DNA repair study; Sensitive detection of DNA lesions and their repair; and Defined DNA sequence probes for analysis of mutagenesis and repair.

  19. Hypospadias and variants in genes related to sex hormone biosynthesis and metabolism

    PubMed Central

    Carmichael, SL; Witte, JS; Ma, C; Lammer, EJ; Shaw, GM

    2013-01-01

    We examined whether variants in genes related to sex hormone biosynthesis and metabolism were associated with hypospadias in humans. We examined 332 relatively common tagSNPs in 20 genes. Analyses included 633 cases (84 mild, 322 moderate, 212 severe, 15 undetermined severity) and 855 population-based non-malformed male controls born in California from 1990–2003. We used logistic regression models to estimate odds ratios (OR) and 95 percent confidence intervals (CI) for each SNP. Several of the 332 studied SNPs had p<0.01: one in CYP3A4, four in HSD17B3, one in HSD3B1, 2 in STARD3 10 in SRD5A2 and seven in STS. In addition, haplotype analyses gave several associations with p<0.01. For HSD17B3, 14-SNP and 5-SNP blocks had ORs of 1.5 (95% CI 1.1, 2.0, p<0.001) and 2.8 (95% CI 1.6, 4.8, p<0.001), respectively. For SRD5A2, 9-SNP, 3-SNP and 8-SNP blocks had ORs of 1.7 (95% CI 1.3, 2.2, p<0.001), 1.4 (95% CI 1.1, 1.8, p=0.008) and 1.5 (95% CI 1.2, 1.9, p=0.002), respectively. Our study indicates that several genes that contribute to sex hormone biosynthesis and metabolism are associated with hypospadias risk. PMID:24281767

  20. Prenatal diagnosis of Wolf-Hirschhorn syndrome (4p-) in association with congenital hypospadias and foot deformity

    PubMed Central

    Aslan, Halil; Karaca, Nilay; Basaran, Seher; Ermis, Hayri; Ceylan, Yavuz

    2003-01-01

    Background Wolf-Hirschhorn syndrome is caused by distal deletion of the short arm of chromosome 4 (4p-). We report a case in which intrauterine growth restriction, hypospadias and foot deformity were detected by prenatal ultrasound examination at 29 weeks of gestation. Case Presentation A 31-year-old gravida 2 partus 1 woman was referred at 29 weeks' gestation with suspicion of intrauterine growth restriction. Sonographic examination revealed deformity of the right lower limb and undescended testes with an irregular distal penis. A cordocentesis was performed and chromosome analysis revealed a 46,XY,del(4)(p14) karyotype. Conclusion The prenatal detection of intrauterine growth restriction, hypospadias and foot deformity should lead doctors to suspect the presence of Wolf-Hirschhorn syndrome. PMID:12546710

  1. A49T, R227Q and TA repeat polymorphism of steroid 5 alpha-reductase type II gene and Hypospadias risk in North Indian children

    PubMed Central

    Samtani, Ratika; Bajpai, Minu; Ghosh, P.K.; Saraswathy, K.N.

    2014-01-01

    Background/Aims Hypospadias is a common congenital error of genital development, the frequency of which is increasing. As androgens have a significant role in the development of the male urethra, we sought to investigate the association between functional polymorphisms of SRD5A2 gene in relation to hypospadias. Methods We examined DNA samples of 96 cases and 105 controls for SRD5A2-A49T, R227Q and TA repeat gene polymorphisms. Result Absence of 49T locus and 227Q locus was observed in the present study. At the (TA) n repeat site, TA (0) allele was observed to be the most common allele in both cases (91.7%) and controls (90%). TA (9/9) genotype exhibited an odds ratio of 3.03 (95% C.I.=0.1850.14, p=0) with respect to only middle phenotypes. Analysis of the demographic data depicted the agricultural background aspect of the parents of the cases. 72.27% of the cases (affected with Hypospadias) have parents having agriculture as a primary occupation. Conclusion As longer TA repeats are associated with lower enzymatic activity and lower DHT levels as reported among Caucasians, this polymorphism may have an effect (rather small) in predisposing the population of the present study to the risk of Hypospadias of lesser severity. Due to small sample size, the 3.03 O.R. is not significant and a larger sample is needed to validate the results. Large scale screening of Hypospadias and other 46 X,Y disorders of sexual development is needed especially in India, where the majority of the population is from agricultural background. The results of the present study are likely to assist the health planners to initiate screening of Hypospadias among the farmer community to combat the risk of Hypospadias.

  2. Variation spatiotemporelle de la cryptorchidie et de l’hypospadias au Québec : Une étude exploratoire

    PubMed Central

    Guertin, Sophie; Lemieux, Karine-Sylvie; Makhoulian, Natalie; Michaud, Sébastien; Patry, Rose-Marie; Côté, Anne-Andrée; Gagnon, Fabien; Ayotte, Pierre; Bolduc, Stéphane

    2011-01-01

    Résumé Objectifs : La majorité des études effectuées au cours des dernières décennies ont mis en évidence une augmentation du nombre de cas de cryptorchidie et d’hypospadias entre 1970 et 1990. De plus, l’importante variabilité géographique de ces anomalies est bien décrite. Cette étude vise à mesurer la prévalence à la naissance de la cryptorchidie et de l’hypospadias au Québec, à vérifier si ces anomalies sont en augmentation et à en évaluer la répartition interrégionale. Méthode : Une étude épidémiologique descriptive a été réalisée à partir du nombre de garçons de cinq ans et moins hospitalisés pour une cryptorchidie ou un hypospadias au Québec de 1989 à 2004 selon les données du fichier administratif d’hospitalisation MED-ÉCHO. Les données sur les naissances provenaient de l’Institut de la statistique du Québec. Résultats : La prévalence annuelle moyenne pour 1000 naissances vivantes de sexe masculin est de 19,1 (IC à 95 % : 18,8–19,4) pour la cryptorchidie et 11,4 (IC à 95 % 11,1–11,6) pour l’hypospadias au Québec. Au cours de la période étudiée, la prévalence de cryptorchidie a légèrement diminué, alors que celle de l’hypospadias est demeurée stable. Comparativement à la province du Québec, des régions présentent une prévalence significativement différente de cryptorchidie et/ou d’hypospadias. . Conclusion : Au Québec, la prévalence de cryptorchidie est en légère diminution alors que celle de l’hypospadias est stable. Des variations régionales significatives sont observables. D’autres études sont nécessaires afin d’évaluer l’hypothèse d’un lien avec les contaminants environnementaux en émergence. L’implantation d’un système de surveillance des anomalies congénitales permettrait une représentation plus valide de la situation. PMID:21672476

  3. Eardrum repair

    MedlinePLUS

    Eardrum repair refers to one or more surgical procedures that are done to correct a tear or other damage to the eardrum (tympanic membrane). Ossiculoplasty is the repair of the small bones in the middle ear.

  4. Cri-du-chat (5p-) syndrome presenting with cerebellar hypoplasia and hypospadias: prenatal diagnosis and aCGH characterization using uncultured amniocytes.

    PubMed

    Chen, Chih-Ping; Huang, Ming-Chao; Chen, Yi-Yung; Chern, Schu-Rern; Wu, Peih-Shan; Su, Jun-Wei; Town, Dai-Dyi; Wang, Wayseen

    2013-07-25

    We present prenatal diagnosis of a de novo distal deletion involving 5p(5p15.1?pter) using uncultured amniocytes in a pregnancy with cerebellar hypoplasia, hypospadias and facial dysmorphisms in the fetus. We discuss the genotype-phenotype correlation and the consequence of haploinsufficiency of CTNND2, SEMA5A, TERT, SRD5A1 and TPPP. We speculate that haploinsufficiency of SRD5A1 and TPPP may be responsible for hypospadias and cerebellar hypoplasia, respectively, in this case. PMID:23500598

  5. [Hypospadia and infertility of Henry II of France (1519-1559)].

    PubMed

    Hatzinger, M; Al-Shajlawi, S; Sohn, M

    2014-03-01

    Henry II (1519-1559) of France was the second son of Francis I (1494-1547) and Claude de France (1498-1524) born in 1519 in St. Germain-en-Laye. After his older brother's and his father's death in 1547, he was anointed the French king in Reims. In 1533 already, as a 14-year-old boy, for reasons of state, he was married to the same aged Catherine de Medici (1519-1589), as her uncle was Pope Clement VII (1478-1534). The marriage remained childless for 11 years since Henry, due to a distinct hypospadia and a completely sexually inexperienced wife was unable to conceive children with her. His existing liaison to Diane de Poitiers (1499-1566) - a 19-year-older maid of honor of his father Francis I from 1537 until his death - influenced his sexual life immensely.The blame for the childless marriage was placed primarily on his wife, as Henry had become father of an illegitimate daughter with a mistress. Catherine then underwent all possible medical and alchemical procedures to finally give birth to the hoped Dauphin. Ironically, her rival for the favor of her husband, Diane de Poitiers was one of her greatest allies. She made clear that the cause lay with Henry and not with his wife. This was confirmed by the added solid physician Jean Fernel (1497-1558). His treatment of Henry and the simultaneous training of the unexperienced Catherine by Diane de Poitiers led to success.The result was the birth of Francis II (1544-1560) in 1544, the first of 10 children in 12 years. Thus, the dynasty was saved. After the death of Henry in a tragic tournament accident in 1559, three of his sons became kings of France. But the line of Valois remained without further descendants and was continued by Henry IV, the first Bourbon king in 1589. PMID:24585117

  6. Association of variants in genes involved in environmental chemical metabolism and risk of cryptorchidism and hypospadias.

    PubMed

    Qin, Xian-Yang; Kojima, Yoshiyuki; Mizuno, Kentaro; Ueoka, Katsuhiko; Massart, Francesco; Spinelli, Claudio; Zaha, Hiroko; Okura, Masahiro; Yoshinaga, Jun; Yonemoto, Junzo; Kohri, Kenjiro; Hayashi, Yutaro; Ogata, Tsutomu; Sone, Hideko

    2012-07-01

    We hypothesized that single-nucleotide polymorphisms (SNPs) of genes involved in environmental endocrine disruptors (EEDs) metabolism might influence the risk of male genital malformations. In this study, we explored for association between 384 SNPs in 15 genes (AHR, AHRR, ARNT, ARNT2, NR1I2, RXRA, RXRB, RXRG, CYP1A1, CYP1A2, CYP1B1, CYP2B6, CYP3A4, CYP17A1 and CYP19A1) and risk of cryptorchidism (CO) and hypospadias (HS) in 334 Japanese (JPN) males (141 controls, 95 CO and 98 HS) and 187 Italian (ITA) males (129 controls and 58 CO). In the JPN study group, five SNPs from ARNT2 (rs2278705 and rs5000770), CYP1A2 (rs2069521), CYP17A1 (rs4919686) and NR1I2 (rs2472680) were significantly associated at both allelic and genotypic levels with risk of at least one genital malformation phenotype. In the ITA study group, two SNPs in AHR (rs3757824) and ARNT2 (rs1020397) were significantly associated with risk of CO. Interaction analysis of the positive SNPs using multifactor dimensionality reduction demonstrated that synergistic interaction between rs2472680, rs4919686 and rs5000770 had 62.81% prediction accuracy for CO (P=0.011) and that between rs2069521 and rs2278705 had 69.98% prediction accuracy for HS (P=0.001) in JPN population. In a combined analysis of JPN and ITA population, the most significant multi-locus association was observed between rs5000770 and rs3757824, which had 65.70% prediction accuracy for CO (P=0.055). Our findings indicate that genetic polymorphisms in genes involved in EED metabolism are associated with risk of CO and HS. PMID:22648180

  7. Arthroscopic Surgical Techniques for the Management of Proximal Biceps Injuries.

    PubMed

    Werner, Brian C; Holzgrefe, Russell E; Brockmeier, Stephen F

    2016-01-01

    Current arthroscopic surgical techniques for the management of proximal biceps tendon disorders encompass 3 commonly advocated procedures: proximal biceps anchor reattachment (superior labrum anterior to posterior or SLAP repair), biceps tenotomy, and arthroscopic biceps tenodesis. The indications for each procedure vary based on injury pattern, symptomatic presentation, concomitant pathologic abnormality, and most notably, patient factors, such as age, functional demand, and specific sport or activity participation. Outcomes after SLAP repair are generally favorable, although recent studies have found biceps tenodesis to be the preferred treatment for certain patient populations. PMID:26614472

  8. Reappraisal of nerve repair.

    PubMed

    Millesi, H

    1981-04-01

    In every case of acute injury involving the nerve, the surgeon must decide whether a primary repair of an elective early secondary repair is the treatment of choice. In a clean-cut nerve without defect, immediate primary repair, using trunk-to-trunk coaptation with epineurial sutures, offers an optimal solution. In the periphery of the median and the ulnar nerves, in which motor and sensory fascicles are already separated, fascicular dissection is performed, and coaptation of fascicle groups should be done. In medical centers with excellent facilities, such nerve repair will give good results even in very severe lesions. This repair can be performed also as a delayed primary procedure. If there is a nerve defect, a primary grafting procedure must be considered. We do not recommend this as a routine procedure because the nerve grafts might be lost if a complication occurs. The decision to perform a planned early secondary repair is an equally good alternative, especially in cases of a nerve defect, severe concomitant injuries, or both. In case of a combined nerve and tendon lesion in the carpal tunnel, the nerve repair can be performed at a later procedure without exposing the repaired flexor tendons, thus avoiding adhesion between tendons and nerves. If a decision is made in favor of an early secondary repair, the two stumps can be approximated by stitches to prevent retraction, if this can be achieved without tension. Approximation under tension in case of a larger defect would damage the two stumps and create an even larger defect. Marking the nerve ends by sutures is not necessary because exploration with always start in normal tissue, exposing the nerves from the proximal or the distal segments. Early secondary repair is performed during the third week, or later if this is demanded by local conditions. When indicated, plastic surgical procedures can eliminate constricting scars and provide an optimal soft tissue environment. After exploration and preparation of the two stumps, the surgeon must decide whether direct suturing or a nerve graft is indicated. If after very limited mobilization and slight flexion the nerve stumps cannot be coapted easily, a nerve graft should be used. The quality of motor recovery decreases steadily after a 6 month delay of repair. Late secondary repairs or reoperation of failure of primary repair should be performed within this time limit, although this does not mean that motor recovery cannot occur after a longer time interval. Useful motor recovery was achieved in certain cases after 18 months or more. Obviously the results might have been better if the time interval had been shorter. If a patient is seen with a nerve lesion after a long time interval, nerve repair is still indicated if sensibility is the main functional objective. In other long-standing cases, the nerve repair is combined with tendon transfer or capsulorrhaphy. After a particularly long time interval or in old patients, only palliative surgery is indicated. PMID:7233326

  9. Bulk Topological Proximity Effect.

    PubMed

    Hsieh, Timothy H; Ishizuka, Hiroaki; Balents, Leon; Hughes, Taylor L

    2016-02-26

    Existing proximity effects stem from systems with a local order parameter, such as a local magnetic moment or a local superconducting pairing amplitude. Here, we demonstrate that despite lacking a local order parameter, topological phases also may give rise to a proximity effect of a distinctively inverted nature. We focus on a general construction in which a topological phase is extensively coupled to a second system, and we argue that, in many cases, the inverse topological order will be induced on the second system. To support our arguments, we rigorously establish this "bulk topological proximity effect" for all gapped free-fermion topological phases and representative integrable models of interacting topological phases. We present a terrace construction which illustrates the phenomenological consequences of this proximity effect. Finally, we discuss generalizations beyond our framework, including how intrinsic topological order may also exhibit this effect. PMID:26967436

  10. Bulk Topological Proximity Effect

    NASA Astrophysics Data System (ADS)

    Hsieh, Timothy H.; Ishizuka, Hiroaki; Balents, Leon; Hughes, Taylor L.

    2016-02-01

    Existing proximity effects stem from systems with a local order parameter, such as a local magnetic moment or a local superconducting pairing amplitude. Here, we demonstrate that despite lacking a local order parameter, topological phases also may give rise to a proximity effect of a distinctively inverted nature. We focus on a general construction in which a topological phase is extensively coupled to a second system, and we argue that, in many cases, the inverse topological order will be induced on the second system. To support our arguments, we rigorously establish this "bulk topological proximity effect" for all gapped free-fermion topological phases and representative integrable models of interacting topological phases. We present a terrace construction which illustrates the phenomenological consequences of this proximity effect. Finally, we discuss generalizations beyond our framework, including how intrinsic topological order may also exhibit this effect.

  11. Organic Food Consumption during Pregnancy and Hypospadias and Cryptorchidism at Birth: The Norwegian Mother and Child Cohort Study (MoBa)

    PubMed Central

    Brantsæter, Anne Lise; Torjusen, Hanne; Meltzer, Helle Margrete; Papadopoulou, Eleni; Hoppin, Jane A.; Alexander, Jan; Lieblein, Geir; Roos, Gun; Holten, Jon Magne; Swartz, Jackie; Haugen, Margaretha

    2015-01-01

    Background The etiologies of the male urogenital anomalies hypospadias and cryptorchidism remain unclear. It has been suggested that maternal diet and environmental contaminants may affect the risk of these anomalies via placental or hormonal disturbances. Objectives We examined associations between organic food consumption during pregnancy and prevalence of hypospadias and cryptorchidism at birth. Methods Our study includes 35,107 women participating in the Norwegian Mother and Child Cohort Study (MoBa) who delivered a singleton male infant. Information about use of six groups of organically produced food (vegetables, fruit, bread/cereal, milk/dairy products, eggs, and meat) during pregnancy was collected by a food frequency questionnaire. Women who indicated that they sometimes, often, or mostly consumed organic foods in at least one of the six food groups were classified as organic food consumers in analyses. Hypospadias and cryptorchidism diagnoses were retrieved from the Medical Birth Registry of Norway. We estimated odds ratios (ORs) and 95% confidence intervals (CIs) using multiple logistic regression. Results Seventy-four male newborns were diagnosed with hypospadias (0.2%), and 151 with cryptorchidism (0.4%). Women who consumed any organic food during pregnancy were less likely to give birth to a boy with hypospadias (OR = 0.42; 95% CI: 0.25, 0.70, based on 21 exposed cases) than women who reported they never or seldom consumed organic food. Associations with specific organic foods were strongest for vegetable (OR = 0.36; 95% CI: 0.15, 0.85; 10 exposed cases) and milk/dairy (OR = 0.43; 95% CI: 0.17, 1.07; 7 exposed cases) consumption. No substantial association was observed for consumption of organic food and cryptorchidism. Conclusions Consumption of organically produced foods during pregnancy was associated with a lower prevalence of hypospadias in our study population. These findings were based on small numbers of cases and require replication in other study populations. Citation Brantsæter AL, Torjusen H, Meltzer HM, Papadopoulou E, Hoppin JA, Alexander J, Lieblein G, Roos G, Holten JM, Swartz J, Haugen M. 2016. Organic food consumption during pregnancy and hypospadias and cryptorchidism at birth: the Norwegian Mother and Child Cohort Study (MoBa). Environ Health Perspect 124:357–364; http://dx.doi.org/10.1289/ehp.1409518 PMID:26307850

  12. Repair Mechanisms

    SciTech Connect

    Lacks, Sanford A.

    1999-07-09

    Maintaining the integrity of its genetic blueprint is of central importance for a living cell and the organism of which it is a part. To preserve the function of the genetic material within the cell and to ensure its accurate transmission to future generations, numerous mechanisms have evolved to repair errors and damage in DNA. As an example of the cellular resources devoted to this end, consider that of 1709 proteins encoded by the first bacterial genome to be sequenced, that of Haemophilus influenzae, at least 45 function in DNA repair mechanisms. The complementary, double-stranded structure of DNA, a crucial feature that allows it to be readily replicated, also facilitates its repair. The objects of repair range from mismatched bases resulting from errors in DNA replication to base damage and even gross distortion of the DNA structure by physical and chemical agents. In a few instances damage is directly reversed. Most repair mechanisms, however, first remove the damaged region together with a segment of the DNA strand in which it occurred and then resynthesize that segment correctly using the complementary strand as a template. Depending on the component initially removed or recognized, these mechanisms have been categorized as base excision, nucleotide (oroligonucleotide) excision, and mismatch repair. When the damage cannot be so simply repaired, a mechanism of recombinational repair, requiring interaction with another copy of the genome, may intervene.

  13. Perfluorooctane Sulfonate Concentrations in Amniotic Fluid, Biomarkers of Fetal Leydig Cell Function, and Cryptorchidism and Hypospadias in Danish Boys (1980–1996)

    PubMed Central

    Toft, Gunnar; Jönsson, Bo A.G.; Bonde, Jens Peter; Nørgaard-Pedersen, Bent; Hougaard, David M.; Cohen, Arieh; Lindh, Christian H.; Ivell, Richard; Anand-Ivell, Ravinder; Lindhard, Morten S.

    2015-01-01

    Background Exposure to perfluorooctane sulfonate (PFOS) may potentially disturb fetal Leydig cell hormone production and male genital development. Objectives We aimed to study the associations between levels of amniotic fluid PFOS, fetal steroid hormone, and insulin-like factor 3 (INSL3) and the prevalence of cryptorchidism and hypospadias. Methods Using the Danish National Patient Registry, we selected 270 cryptorchidism cases, 75 hypospadias cases, and 300 controls with stored maternal amniotic fluid samples available in a Danish pregnancy-screening biobank (1980–1996). We used mass spectrometry to measure PFOS in amniotic fluid from 645 persons and steroid hormones in samples from 545 persons. INSL3 was measured by immunoassay from 475 persons. Associations between PFOS concentration in amniotic fluid, hormone levels, and genital malformations were assessed by confounder-adjusted linear and logistic regression. Results The highest tertile of PFOS exposure (> 1.4 ng/mL) in amniotic fluid was associated with a 40% (95% CI: –69, –11%) lower INSL3 level and an 18% (95% CI: 7, 29%) higher testosterone level compared with the lowest tertile (< 0.8 ng/mL). Amniotic fluid PFOS concentration was not associated with cryptorchidism or hypospadias. Conclusions Environmental PFOS exposure was associated with steroid hormone and INSL3 concentrations in amniotic fluid, but was not associated with cryptorchidism or hypospadias in our study population. Additional studies are needed to determine whether associations with fetal hormone levels may have long-term implications for reproductive health. Citation Toft G, Jönsson BA, Bonde JP, Nørgaard-Pedersen B, Hougaard DM, Cohen A, Lindh CH, Ivell R, Anand-Ivell R, Lindhard MS. 2016. Perfluorooctane sulfonate concentrations in amniotic fluid, biomarkers of fetal Leydig cell function, and cryptorchidism and hypospadias in Danish boys (1980–1996). Environ Health Perspect 124:151–156; http://dx.doi.org/10.1289/ehp.1409288 PMID:26046833

  14. Capacitive proximity sensor

    DOEpatents

    Kronberg, J.W.

    1994-05-31

    A proximity sensor based on a closed field circuit is disclosed. The circuit comprises a ring oscillator using a symmetrical array of plates that creates an oscillating displacement current. The displacement current varies as a function of the proximity of objects to the plate array. Preferably the plates are in the form of a group of three pair of symmetric plates having a common center, arranged in a hexagonal pattern with opposing plates linked as a pair. The sensor produces logic level pulses suitable for interfacing with a computer or process controller. The proximity sensor can be incorporated into a load cell, a differential pressure gauge, or a device for measuring the consistency of a characteristic of a material where a variation in the consistency causes the dielectric constant of the material to change. 14 figs.

  15. Capacitive proximity sensor

    DOEpatents

    Kronberg, James W. (Aiken, SC)

    1994-01-01

    A proximity sensor based on a closed field circuit. The circuit comprises a ring oscillator using a symmetrical array of plates that creates an oscillating displacement current. The displacement current varies as a function of the proximity of objects to the plate array. Preferably the plates are in the form of a group of three pair of symmetric plates having a common center, arranged in a hexagonal pattern with opposing plates linked as a pair. The sensor produces logic level pulses suitable for interfacing with a computer or process controller. The proximity sensor can be incorporated into a load cell, a differential pressure gauge, or a device for measuring the consistency of a characteristic of a material where a variation in the consistency causes the dielectric constant of the material to change.

  16. Tendon repair

    MedlinePLUS

    Tendon repair can be performed using: Local anesthesia (the immediate area of the surgery is pain-free) Regional anesthesia (the local and surrounding areas are pain-free) General anesthesia (the patient ...

  17. The realtime operations of the space shuttle orbiter during rendezvous and proximity operations

    NASA Technical Reports Server (NTRS)

    Dougherty, Andrew

    1991-01-01

    The Shuttle first demonstrated the capability to perform precision proximity flying in 1983 when the SPAS-01 satellite was deployed and subsequently retrieved. This flight was intended to validate the capability of the Shuttle to perform proximity operations with a co-orbiting vehicle in preparation for the Solar Maximum Repair mission of the next year.

  18. Proximate Analysis of Coal

    ERIC Educational Resources Information Center

    Donahue, Craig J.; Rais, Elizabeth A.

    2009-01-01

    This lab experiment illustrates the use of thermogravimetric analysis (TGA) to perform proximate analysis on a series of coal samples of different rank. Peat and coke are also examined. A total of four exercises are described. These are dry exercises as students interpret previously recorded scans. The weight percent moisture, volatile matter,…

  19. Proximate Analysis of Coal

    ERIC Educational Resources Information Center

    Donahue, Craig J.; Rais, Elizabeth A.

    2009-01-01

    This lab experiment illustrates the use of thermogravimetric analysis (TGA) to perform proximate analysis on a series of coal samples of different rank. Peat and coke are also examined. A total of four exercises are described. These are dry exercises as students interpret previously recorded scans. The weight percent moisture, volatile matter,

  20. Proximal femural fractures: epidemiology

    PubMed Central

    Innocenti, Massimo; Civinini, Roberto; Carulli, Christian; Matassi, Fabrizio

    2009-01-01

    The Authors report briefly about epidemiology and prognosis of proximal femoral fractures in elderly people worldwide. Focusing particurarly on Italian population, the Authors report on the impact that this pathologic phenomenon has on the quality of life of patients and on general population, also from a social and economical point of view. A concise overview of the options treatment is also presented. PMID:22461159

  1. Subacute diabetic proximal neuropathy

    NASA Technical Reports Server (NTRS)

    Pascoe, M. K.; Low, P. A.; Windebank, A. J.; Litchy, W. J.

    1997-01-01

    OBJECTIVE: To evaluate the clinical, electrophysiologic, autonomic, and neuropathologic characteristics and the natural history of subacute diabetic proximal neuropathy and its response to immunotherapy. MATERIAL AND METHODS: For the 12-year period from 1983 to 1995, we conducted a retrospective review of medical records of Mayo Clinic patients with diabetes who had subacute onset and progression of proximal weakness. The responses of treated versus untreated patients were compared statistically. RESULTS: During the designated study period, 44 patients with subacute diabetic proximal neuropathy were encountered. Most patients were middle-aged or elderly, and no sex preponderance was noted. The proximal muscle weakness often was associated with reduced or absent lower extremity reflexes. Associated weight loss was a common finding. Frequently, patients had some evidence of demyelination on nerve conduction studies, but it invariably was accompanied by concomitant axonal degeneration. The cerebrospinal fluid protein concentration was usually increased. Diffuse and substantial autonomic failure was generally present. In most cases, a sural nerve biopsy specimen suggested demyelination, although evidence of an inflammatory infiltrate was less common. Of 12 patients who received treatment (with prednisone, intravenous immune globulin, or plasma exchange), 9 had improvement of their conditions, but 17 of 29 untreated patients (59%) with follow-up also eventually had improvement, albeit at a much slower rate. Improvement was usually incomplete. CONCLUSION: We suggest that the entity of subacute diabetic proximal neuropathy is an extensive and severe variant of bilateral lumbosacral radiculoplexopathy, with some features suggestive of an immune-mediated cause. It differs from chronic inflammatory demyelinating polyradiculoneuropathy in that most cases have a more restricted distribution and seem to be monophasic and self-limiting. The efficacy of immunotherapy is unproved, but such intervention may be considered in the severe and progressive cases or ones associated with severe neuropathic pain.

  2. Tissue repair

    PubMed Central

    2010-01-01

    As living beings that encounter every kind of traumatic event from paper cut to myocardial infarction, we must possess ways to heal damaged tissues. While some animals are able to regrow complete body parts following injury (such as the earthworm who grows a new head following bisection), humans are sadly incapable of such feats. Our means of recovery following tissue damage consists largely of repair rather than pure regeneration. Thousands of times in our lives, a meticulously scripted but unseen wound healing drama plays, with cells serving as actors, extracellular matrix as the setting and growth factors as the means of communication. This article briefly reviews the cells involved in tissue repair, their signaling and proliferation mechanisms and the function of the extracellular matrix, then presents the actors and script for the three acts of the tissue repair drama. PMID:21220961

  3. Proximity Networks and Epidemics

    NASA Astrophysics Data System (ADS)

    Guclu, Hasan; Toroczkai, Zoltn

    2007-03-01

    We presented the basis of a framework to account for the dynamics of contacts in epidemic processes, through the notion of dynamic proximity graphs. By varying the integration time-parameter T, which is the period of infectivity one can give a simple account for some of the differences in the observed contact networks for different diseases, such as smallpox, or AIDS. Our simplistic model also seems to shed some light on the shape of the degree distribution of the measured people-people contact network from the EPISIM data. We certainly do not claim that the simplistic graph integration model above is a good model for dynamic contact graphs. It only contains the essential ingredients for such processes to produce a qualitative agreement with some observations. We expect that further refinements and extensions to this picture, in particular deriving the link-probabilities in the dynamic proximity graph from more realistic contact dynamics should improve the agreement between models and data.

  4. Proximate analysis of coal

    SciTech Connect

    Donahue, C.J.; Rais, E.A.

    2009-02-15

    This lab experiment illustrates the use of thermogravimetric analysis (TGA) to perform proximate analysis on a series of coal samples of different rank. Peat and coke are also examined. A total of four exercises are described. These are dry exercises as students interpret previously recorded scans. The weight percent moisture, volatile matter, fixed carbon, and ash content are determined for each sample and comparisons are made. Proximate analysis is performed on a coal sample from a local electric utility. From the weight percent sulfur found in the coal (determined by a separate procedure the Eschka method) and the ash content, students calculate the quantity of sulfur dioxide emissions and ash produced annually by a large coal-fired electric power plant.

  5. Method for mask repair using defect compensation

    DOEpatents

    Sweeney, Donald W. (San Ramon, CA); Ray-Chaudhuri, Avijit K. (Livermore, CA)

    2001-01-01

    A method for repair of amplitude and/or phase defects in lithographic masks. The method involves modifying or altering a portion of the absorber pattern on the surface of the mask blank proximate to the mask defect to compensate for the local disturbance (amplitude or phase) of the optical field due to the defect.

  6. Outboard Repair.

    ERIC Educational Resources Information Center

    Hardway, Jack

    This consortium-developed instructor's manual for small engine repair (with focus on outboard motors) consists of the following nine instructional units: electrical remote control assembly, mechanical remote control assembly, tilt assemblies, exhaust housing, propeller and trim tabs, cooling system, mechanical gearcase, electrical gearcase, and

  7. Snowmobile Repair.

    ERIC Educational Resources Information Center

    Helbling, Wayne

    This guide is designed to provide and/or improve instruction for occupational training in the area of snowmobile repair, and includes eight areas. Each area consists of one or more units of instruction, with each instructional unit including some or all of the following basic components: Performance objectives, suggested activities for teacher and

  8. Motorcycle Repair.

    ERIC Educational Resources Information Center

    Hein, Jim; Bundy, Mike

    This motorcycle repair curriculum guide contains the following ten areas of study: brake systems, clutches, constant mesh transmissions, final drives, suspension, mechanical starting mechanisms, electrical systems, fuel systems, lubrication systems, and overhead camshafts. Each area consists of one or more units of instruction. Each instructional…

  9. Bladder exstrophy repair

    MedlinePLUS

    Bladder birth defect repair; Everted bladder repair; Exposed bladder repair; Repair of bladder exstrophy ... in boys and is often linked to other birth defects. Surgery is necessary to: Allow the child to ...

  10. DNA repair.

    PubMed Central

    O'Neil, Nigel; Rose, Ann

    2006-01-01

    The integrity of the genome is essential to the health of the individual and to the reproductive success of a species. Transmission of genetic information is in a selective balance between two opposing forces, the maintenance of genetic stability versus elimination of mutational change and loss of evolutionary potential. Caenorhabditis elegans provides many advantages for the study of DNA surveillance and repair in a multicellular organism. Several genes have been identified by mutagenesis and RNA interference that affect DNA damage checkpoint and repair functions. Many of these DNA damage response genes also play essential roles in DNA replication, cell cycle control, development, meiosis and mitosis. To date, no obvious DNA damage-induced checkpoint has been described in C. elegans somatic cells. In contrast, the DNA damage response in the germ line is characterized by two spatially separate checkpoints; mitotic germ nuclei proliferation arrest and apoptosis of damaged meiotic nuclei. Both of these responses are regulated by checkpoint genes including mrt-2, hus-1, rad-5 and cep-1, the C. elegans ortholog of the human tumour suppressor p53. The germ line DNA damage checkpoints in C. elegans provide an excellent model in which to study the genes required to maintain genomic stability and to test compounds which might have tumor suppressing properties. In addition to single gene studies, integration of data from high-throughput screens has identified genes not previous implicated in the DNA damage response and elucidated novel connections between the different repair pathways. Most of the genes involved are conserved between worms and humans, and in humans, are associated with either oncogenesis or tumor-suppression. Thus, studies of the physical and functional interactions of the components of the repair pathways in C. elegans will provide information about human repair disorders and cancer predisposition. PMID:18050489

  11. Turbine repair process, repaired coating, and repaired turbine component

    DOEpatents

    Das, Rupak; Delvaux, John McConnell; Garcia-Crespo, Andres Jose

    2015-11-03

    A turbine repair process, a repaired coating, and a repaired turbine component are disclosed. The turbine repair process includes providing a turbine component having a higher-pressure region and a lower-pressure region, introducing particles into the higher-pressure region, and at least partially repairing an opening between the higher-pressure region and the lower-pressure region with at least one of the particles to form a repaired turbine component. The repaired coating includes a silicon material, a ceramic matrix composite material, and a repaired region having the silicon material deposited on and surrounded by the ceramic matrix composite material. The repaired turbine component a ceramic matrix composite layer and a repaired region having silicon material deposited on and surrounded by the ceramic matrix composite material.

  12. Meniscal Repair

    PubMed Central

    Yoon, Kyoung Ho

    2014-01-01

    The meniscus has several important roles, such as transmission of the load, absorption of the shock in the knee joint, acting as a secondary anteroposterior stabilizer of the knee joint, and contributing to proprioception of the knee joint. Degenerative changes of the knee joint develop in the long-term follow-up even after partial meniscectomy. Thus, there has been growing interest in meniscal repair. In addition, with increased understanding of the important roles of the meniscal root and advancement of diagnostic methods, efforts have been made to ensure preservation of the meniscal roots. In this review article, we will discuss operative techniques and clinical outcomes of arthroscopic repair of the meniscus and the meniscal root and postoperative rehabilitation and complications as well. PMID:24944971

  13. Echosonography with proximity sensors

    NASA Astrophysics Data System (ADS)

    Thaisiam, W.; Laithong, T.; Meekhun, S.; Chaiwathyothin, N.; Thanlarp, P.; Danworaphong, S.

    2013-03-01

    We propose the use of a commercial ultrasonic proximity sensor kit for profiling an altitude-varying surface by employing echosonography. The proximity sensor kit, two identical transducers together with its dedicated operating circuit, is used as a profiler for the construction of an image. Ultrasonic pulses are emitted from one of the transducers and received by the other. The time duration between the pulses allows us to determine the traveling distance of each pulse. In the experiment, the circuit is used with the addition of two copper wires for directing the outgoing and incoming signals to an oscilloscope. The time of flight of ultrasonic pulses can thus be determined. Square grids of 5 × 5 cm2 are made from fishing lines, forming pixels in the image. The grids are designed to hold the detection unit in place, about 30 cm above a flat surface. The surface to be imaged is constructed to be height varying and placed on the flat surface underneath the grids. Our result shows that an image of the profiled surface can be created by varying the location of the detection unit along the grid. We also investigate the deviation in relation to the time of flight of the ultrasonic pulse. Such an experiment should be valuable for conveying the concept of ultrasonic imaging to physical and medical science undergraduate students. Due to its simplicity, the setup could be made in any undergraduate laboratory relatively inexpensively and it requires no complex parts. The results illustrate the concept of echosonography.

  14. Proximal hamstring avulsion in a professional soccer player.

    PubMed

    Sonnery-Cottet, B; Archbold, P; Thaunat, M; Fayard, J-M; Canuto, S M G; Cucurulo, T

    2012-12-01

    Acute hamstring strains are a common athletic injury, which may be treated non-operatively with a satisfactory outcome. A complete proximal hamstring avulsion is a rare and potentially career ending injury to an elite athlete. For these high demand patients, surgical reattachment should be immediately undertaken to shorten return to sport and to improve functional outcome. This report describes the occurrence of a complete avulsion of the proximal hamstrings in a professional footballer during an international match. We highlight the clinical presentation, the appropriate diagnostic investigations, the surgical technique and the rehabilitation protocol for this injury. The successful surgical reattachment of the common hamstring tendon was confirmed by magnetic resonance imaging done 5 months after repair and allowed the player a full return to competition at 6 months after surgery. Hamstrings isokinetic peak torque was 80% at 6 months and 106% at 11 months after repair comparing with the uninjured side. PMID:22926296

  15. Arthroscopic Transosseous Bony Bankart Repair

    PubMed Central

    Driscoll, Matthew D.; Burns, Joseph P.; Snyder, Stephen J.

    2015-01-01

    Restoration of glenoid bony integrity is critical to minimizing the risk of recurrence and re-creating normal kinematics in the setting of anterior glenohumeral instability. We present an arthroscopic suture anchorbased technique for treating large bony Bankart fractures in which the fragment is secured to the intact glenoid using mattress sutures placed through the bony fragment and augmented with soft-tissue repair proximal and distal to the bony lesion. This straightforward technique has led to excellent fragment reduction and good outcomes in our experience. PMID:25973373

  16. Delayed presentation of aortoesophageal fistula after endovascular repair.

    PubMed

    Kouritas, Vasileios K; Dedeilias, Panagiotis; Sotiriou, Konstantina; Klimopoulos, Serafim

    2016-01-01

    The incidence of aortoesophageal fistula after thoracic endovascular aortic repair has increased following an increase in thoracic endovascular aortic procedures. A 68-year-old man was diagnosed with aortoesophageal fistula 6 years after thoracic endovascular aortic repair of a descending aortic aneurysm. Due to massive hematemesis and instability, he underwent a left thoracotomy, graft repair of the aorta with stent removal, gastrostomy, and proximal esophagostomy. Unfortunately, he died 1 week later due to sepsis. Aortoesophageal fistula may present long after thoracic endovascular aortic repair, and clinicians treating such cases should always be aware of this complication. PMID:24899044

  17. Some properties of fuzzy soft proximity spaces.

    PubMed

    Demir, İzzettin; Özbakır, Oya Bedre

    2015-01-01

    We study the fuzzy soft proximity spaces in Katsaras's sense. First, we show how a fuzzy soft topology is derived from a fuzzy soft proximity. Also, we define the notion of fuzzy soft δ-neighborhood in the fuzzy soft proximity space which offers an alternative approach to the study of fuzzy soft proximity spaces. Later, we obtain the initial fuzzy soft proximity determined by a family of fuzzy soft proximities. Finally, we investigate relationship between fuzzy soft proximities and proximities. PMID:25793224

  18. Brain aneurysm repair

    MedlinePLUS

    ... aneurysm repair; Dissecting aneurysm repair; Endovascular aneurysm repair - brain; Subarachnoid hemorrhage - aneurysm ... Your scalp, skull, and the coverings of the brain are opened. A metal clip is placed at ...

  19. Eye muscle repair - discharge

    MedlinePLUS

    ... Lazy eye repair - discharge; Strabismus repair - discharge; Extraocular muscle surgery - discharge ... You or your child had eye muscle repair surgery to correct eye muscle ... term for crossed eyes is strabismus. Children most often ...

  20. Aortic aneurysm repair - endovascular

    MedlinePLUS

    EVAR; Endovascular aneurysm repair - aorta; AAA repair - endovascular; Repair - aortic aneurysm - endovascular ... leaking or bleeding. You may have an abdominal aortic aneurysm that is not causing any symptoms or problems. ...

  1. Mismatch repair.

    PubMed

    Fishel, Richard

    2015-10-30

    Highly conserved MutS homologs (MSH) and MutL homologs (MLH/PMS) are the fundamental components of mismatch repair (MMR). After decades of debate, it appears clear that the MSH proteins initiate MMR by recognizing a mismatch and forming multiple extremely stable ATP-bound sliding clamps that diffuse without hydrolysis along the adjacent DNA. The function(s) of MLH/PMS proteins is less clear, although they too bind ATP and are targeted to MMR by MSH sliding clamps. Structural analysis combined with recent real-time single molecule and cellular imaging technologies are providing new and detailed insight into the thermal-driven motions that animate the complete MMR mechanism. PMID:26354434

  2. INTERNAL REPAIR OF PIPELINES

    SciTech Connect

    Robin Gordon; Bill Bruce; Nancy Porter; Mike Sullivan; Chris Neary

    2003-05-01

    The two broad categories of deposited weld metal repair and fiber-reinforced composite repair technologies were reviewed for potential application for internal repair of gas transmission pipelines. Both are used to some extent for other applications and could be further developed for internal, local, structural repair of gas transmission pipelines. Preliminary test programs were developed for both deposited weld metal repairs and for fiber-reinforced composite repair. To date, all of the experimental work pertaining to the evaluation of potential repair methods has focused on fiber-reinforced composite repairs. Hydrostatic testing was also conducted on four pipeline sections with simulated corrosion damage: two with composite liners and two without.

  3. Hypertelorism and hypospadias associated with a de novo apparently balanced translocation between 8q22.3-23 and 20p13

    SciTech Connect

    Tar, A.; Ion, A.; Gyoervari, B.; Solyom, J.

    1997-01-20

    A de novo apparently balanced translocation involving chromosomes 8 and 20 was found in a 14-year-old boy with minor anomalies, mild skeletal abnormalities and ambiguous external genitalia including perineoscrotal hypospadias, rudimentary fused labioscrotal folds, bilateral cryptorchidism, and small penis. The karyotype was 46,XY, t(8;20)(q22.3-23;p13). No signs of other conditions known to be associated with structural anomalies of either chromosome 8 or 20 were present and incomplete masculinisation of the external genitalia appears to be the main component of the phenotype. Clinical and biological studies showed apparently normal testicular function in utero and after birth. Examinations excluded 5{alpha}-reductase deficiency or a block in any enzymatic steps of testosterone, glucocorticoid and mineralocorticoid biosynthesis. Coding sequences of the sex-determining gene (SRY) and androgen receptor gene (AR) were found to be identical to those of a normal male excluding their role in the cause of the present condition. Since several other reports describe the association of hypospadias and hypertelorism with deletions or translocations involving 8q, we suggest that a locus necessary for male sex differentiation is located at distal 8q. 24 refs., 3 figs.

  4. Tools for proximal soil sensing

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Proximal soil sensing (i.e. near-surface geophysical methods) are used to study soil phenomena across spatial scales. Geophysical methods exploit contrasts in physical properties (dielectric permittivity, apparent electrical conductivity or resistivity, magnetic susceptibility) to indirectly measur...

  5. Chitosan adhesive for laser tissue repair

    NASA Astrophysics Data System (ADS)

    Lauto, A.; Stoodley, M.; Avolio, A.; Foster, L. J. R.

    2006-02-01

    Background. Laser tissue repair usually relies on haemoderivate solders, based on serum albumin. These solders have intrinsic limitations that impair their widespread use, such as limited repair strength, high solubility, brittleness and viral transmission. Furthermore, the solder activation temperature (65-70 C) can induce significant damage to tissue. In this study, a new laser-activated biomaterial for tissue repair was developed and tested in vitro and in vivo to overcome some of the shortcomings of traditional solders. Materials and Methods. Flexible and insoluble strips of chitosan adhesive (surface area ~34 mm2, thickness ~20 ?m) were developed and bonded on sheep intestine with a laser fluence and irradiance of 52 +/- 2 J/cm2 and ~15 W/cm2 respectively. The temperature between tissue and adhesive was measured using small thermocouples. The strength of repaired tissue was tested by a calibrated tensiometer. The adhesive was also bonded in vivo to the sciatic nerve of rats to assess the thermal damage induced by the laser (fluence = 65 +/- 11 J/cm2, irradiance = 15 W/cm2) four days post-operatively. Results. Chitosan adhesives successfully repaired intestine tissue, achieving a repair strength of 0.50 +/- 0.15 N (shear stress = 14.7 +/- 4.7 KPa, n=30) at a temperature of 60-65 C. The laser caused demyelination of axons at the operated site; nevertheless, the myelinated axons retained their normal morphology proximally and distally.

  6. SLAP tear associated with a minimally displaced proximal humerus fracture.

    PubMed

    Kendall, Corey B; Tanner, Stephanie L; Tolan, Stefan J

    2007-12-01

    Nondisplaced proximal humerus fracture may be associated with soft tissue injury. This case report examines 2 cases of superior labral anterior-posterior (SLAP) tears in association with nondisplaced fractures of the proximal humerus. In the first case, the patient fell from a jet ski, causing a traction injury to his arm. A greater tuberosity fracture was identified. Magnetic resonance imaging (MRI) did not reveal a definitive labral tear. After conservative management had failed, a type IV SLAP tear and a small rotator cuff tear were arthroscopically identified and repaired. In the second case, a power company lineman fell from a lift and attempted to hold on with his dominant arm. A nondisplaced greater tuberosity and a surgical neck fracture were discovered. MR arthrography revealed no evidence of SLAP tear. Four months after injury, a type II SLAP tear was arthroscopically identified and repaired. In these 2 cases, the presence of the fracture likely slowed operative intervention because pain was attributed to the fracture itself, and not to the SLAP tear. If patients do not follow the usual course of improvement after a proximal humerus fracture from a superior traction mechanism, consideration should be given to associated superior labral tears that may require surgical intervention. PMID:18063188

  7. Peritrochanteric access and gluteus medius repair.

    PubMed

    Byrd, J W Thomas

    2013-01-01

    Access to the peritrochanteric space is simple and reproducible with the technique described in this report. Two anteriorly based portals are placed between the iliotibial band and the greater trochanter. Bursal tissue and debris can be cleared, optimizing visualization of the peritrochanteric space and the anatomic structures. Lesions of the gluteus medius are a common cause of lateral hip pain unresponsive to conservative treatment and have frequently been mischaracterized as recalcitrant trochanteric bursitis. These lesions are often amenable to endoscopic repair with techniques comparable to those used for rotator cuff problems in the shoulder. Portal placement and organization and execution of a gluteus medius repair are highlighted in a video example. Repair is carried out with laterally based portals in the peritrochanteric space. A viewing portal is placed posterior to the vastus lateralis ridge, with a working portal distal to the ridge. Anchors are placed from a proximal position, entering perpendicular to the cortical surface of the trochanter. PMID:24265992

  8. Abdominal aortic aneurysm repair.

    PubMed

    Cruz, C P; Drouilhet, J C; Southern, F N; Eidt, J F; Barnes, R W; Moursi, M M

    2001-01-01

    Newer, minimally invasive catheter-based endovascular technology utilizing stent grafts are currently being evaluated for abdominal aortic aneurysm (AAA) repair. A retrospective review of all (3 years) consecutive, non-ruptured elective AAA repairs was undertaken to document the results of AAA surgical repair in a modern cohort of patients to allow a contemporary comparison with the evolving endoluminal data. One hundred twenty-one AAAs were identified in a male veteran population. Mean age was 68.5 +/-7.7 years. Medical history review showed hypertension in 55%, heart disease in 73.5%, peripheral vascular disease in 21%, stroke and transient ischemic attacks in 22%, diabetes mellitus in 7%, renal insufficiency in 10%, and smoking history in 80%. The AAA size was documented with ultrasound (5.2 +/-1.3 cm, n=40) and computed tomography (5.6 +/-1.3 cm, n=100). Fifty-nine percent had angiography. Intraoperative end points included an operative time of 165 +/-6.3 minutes from incision to dressing placement. A Dacron tube graft was used in 78%, the remaining were Dacron bifurcated grafts. A suprarenal clamp was used in 8% for proximal aortic control with juxtarenal aneurysms. A pulmonary-artery catheter was placed in 69%. A transverse incision was used in 69% of patients and a midline incision was used in the rest. Estimated blood loss was 1505 +/-103 mL; cell saver blood returned 754 +/-53 mL; crystalloid/Hespan 4771 +/-176 mL; banked packed red blood cells 0.75 +/-0.11 U. Time to extubation was, in the operating room (78.5%), on the day of the operation (5.0%), postoperative day (POD) 1 (12.4%), POD2 (1.7%), POD3 (0.8%), and one case was performed with epidural anesthesia only. Postoperative end points included a 30-day mortality rate of 1.6% (two patients). Postoperative morbidity included wound dehiscence 0.8%; sepsis, urinary tract infection, wound infection, leg ischemia, ischemic colitis, and stroke each had an incidence of 1.6%; myocardial infarction, congestive heart failure, pneumonia, re-operation for suspected bleeding, and ileus or bowel obstruction occurred with an incidence of 3.3%. No significant increase in serum creatinine levels was noted. Time to enteral fluids/nutrition was 3.5 +/-0.08 days. Patients were out of bed to a chair or walking by 1.3 +/-0.06 days postoperatively. The length of stay in the intensive care unit (ICU) was 2.0 +/-0.12 days and postoperative hospital stay was 6.6 +/- 0.33 days. Transfusion requirement for the hospital stay was 1.6 +/-0.2 U per patient. This review highlights a cohort of male veteran patients with significant cardiac co-morbidity who have undergone repair with a conventional open technique and low mortality and morbidity rates. This group had rapid extubation, time to oral intake, and ambulation. In addition, ICU and hospital stays were relatively short. PMID:11565037

  9. Rapid road repair vehicle

    DOEpatents

    Mara, Leo M.

    1998-01-01

    Disclosed is a rapid road repair vehicle capable of moving over a surface to be repaired at near normal posted traffic speeds to scan for and find an the high rate of speed, imperfections in the pavement surface, prepare the surface imperfection for repair by air pressure and vacuum cleaning, applying a correct amount of the correct patching material to effect the repair, smooth the resulting repaired surface, and catalog the location and quality of the repairs for maintenance records of the road surface. The rapid road repair vehicle can repair surface imperfections at lower cost, improved quality, at a higher rate of speed than was was heretofor possible, with significantly reduced exposure to safety and health hazards associated with this kind of road repair activities in the past.

  10. Rapid road repair vehicle

    DOEpatents

    Mara, L.M.

    1998-05-05

    Disclosed is a rapid road repair vehicle capable of moving over a surface to be repaired at near normal posted traffic speeds to scan for and find at the high rate of speed, imperfections in the pavement surface, prepare the surface imperfection for repair by air pressure and vacuum cleaning, applying a correct amount of the correct patching material to effect the repair, smooth the resulting repaired surface, and catalog the location and quality of the repairs for maintenance records of the road surface. The rapid road repair vehicle can repair surface imperfections at lower cost, improved quality, at a higher rate of speed than was not heretofor possible, with significantly reduced exposure to safety and health hazards associated with this kind of road repair activities in the past. 2 figs.

  11. Indefinite Proximity Learning: A Review.

    PubMed

    Schleif, Frank-Michael; Tino, Peter

    2015-10-01

    Efficient learning of a data analysis task strongly depends on the data representation. Most methods rely on (symmetric) similarity or dissimilarity representations by means of metric inner products or distances, providing easy access to powerful mathematical formalisms like kernel or branch-and-bound approaches. Similarities and dissimilarities are, however, often naturally obtained by nonmetric proximity measures that cannot easily be handled by classical learning algorithms. Major efforts have been undertaken to provide approaches that can either directly be used for such data or to make standard methods available for these types of data. We provide a comprehensive survey for the field of learning with nonmetric proximities. First, we introduce the formalism used in nonmetric spaces and motivate specific treatments for nonmetric proximity data. Second, we provide a systematization of the various approaches. For each category of approaches, we provide a comparative discussion of the individual algorithms and address complexity issues and generalization properties. In a summarizing section, we provide a larger experimental study for the majority of the algorithms on standard data sets. We also address the problem of large-scale proximity learning, which is often overlooked in this context and of major importance to make the method relevant in practice. The algorithms we discuss are in general applicable for proximity-based clustering, one-class classification, classification, regression, and embedding approaches. In the experimental part, we focus on classification tasks. PMID:26313601

  12. Proximal Gastrectomy for Gastric Cancer

    PubMed Central

    Jung, Do Hyun; Ahn, Sang-Hoon; Kim, Hyung-Ho

    2015-01-01

    Laparoscopic proximal gastrectomy (LPG) is theoretically a superior choice of minimally-invasive surgery and function-preserving surgery for the treatment of proximal early gastric cancer (EGC) over procedures such as laparoscopic total gastrectomy (LTG), open total gastrectomy (OTG) and open proximal gastrectomy (OPG). However, LPG and OPG are not popular surgical options due to three main concerns: the first, oncological safety; the second, functional benefits; and the third, anastomosis-related late complications (reflux symptoms and anastomotic stricture). Numerous recent studies have concluded that OPG and LPG present similar oncological safety profiles and improved functional benefits when compared with OTG and LTG. While OPG with modified esophagogastrostomy does not provide satisfactory results, OPG with modified esophagojejunostomy showed similar rates of anastomosis-related late complications when compared to OTG. At this stage, no standard reconstruction method post-LPG exists in the clinical setting. We recently showed that LPG with double tract reconstruction (DTR) is a superior choice over LTG for proximal EGC in terms of maintaining body weight and preventing anemia. However, as there is no definitive evidence in favor of LPG with DTR, a randomized clinical trial comparing LPG with DTR to LTG was recommended. This trial, the Korean Laparoscopic Gastrointestinal Surgery Study-05 (NCT01433861), is expected to assist surgeons in choice of surgical approach and strategy for patients with proximal EGC. PMID:26161281

  13. DNA Mismatch Repair

    PubMed Central

    MARINUS, M. G.

    2014-01-01

    DNA mismatch repair functions to correct replication errors in newly synthesized DNA and to prevent recombination between related, but not identical (homeologous), DNA sequences. The mechanism of mismatch repair is best understood in Escherichia coli and is the main focus of this review. The early genetic studies of mismatch repair are described as a basis for the subsequent biochemical characterization of the system. The effects of mismatch repair on homologous and homeologous recombination are described. The relationship of mismatch repair to cell toxicity induced by various drugs is included. The VSP (Very Short Patch) repair system is described in detail. PMID:26442827

  14. Space station proximity operations windows: Human factors design guidelines

    NASA Technical Reports Server (NTRS)

    Haines, Richard F.

    1987-01-01

    Proximity operations refers to all activities outside the Space Station which take place within a 1-km radius. Since there will be a large number of different operations involving manned and unmanned vehicles, single- and multiperson crews, automated and manually controlled flight, a wide variety of cargo, and construction/repair activities, accurate and continuous human monitoring of these operations from a specially designed control station on Space Station will be required. Total situational awareness will be required. This paper presents numerous human factors design guidelines and related background information for control windows which will support proximity operations. Separate sections deal with natural and artificial illumination geometry; all basic rendezvous vector approaches; window field-of-view requirements; window size; shape and placement criteria; window optical characteristics as they relate to human perception; maintenance and protection issues; and a comprehensive review of windows installed on U.S. and U.S.S.R. manned vehicles.

  15. Endoluminal vacuum therapy for iatrogenic perforation of the proximal oesophagus.

    PubMed

    Mschler, O; Mller, M K

    2014-03-01

    Iatrogenic perforation of the upper gastrointestinal tract is one of the most serious complications of upper gastrointestinal endoscopy, with high rates of morbidity and mortality. Treatment is challenging because stent placement or surgical repair of the perforation in this area is often impossible. We report on two cases of iatrogenic perforations of the very proximal oesophagus and distal hypopharynx which could be successfully closed by using an endoluminal vacuum sponge treatment for 5 days. Thus, the endoluminal vacuum therapy may be a useful alternative to surgery in such cases of difficultly managable perforations of the upper oesophagus. PMID:24622870

  16. Cubesat Proximity Operations Demonstration (CPOD)

    NASA Technical Reports Server (NTRS)

    Villa, Marco; Martinez, Andres; Petro, Andrew

    2015-01-01

    The CubeSat Proximity Operations Demonstration (CPOD) project will demonstrate rendezvous, proximity operations and docking (RPOD) using two 3-unit (3U) CubeSats. Each CubeSat is a satellite with the dimensions 4 inches x 4 inches x 13 inches (10 centimeters x 10 centimeters x 33 centimeters) and weighing approximately 11 pounds (5 kilograms). This flight demonstration will validate and characterize many new miniature low-power proximity operations technologies applicable to future missions. This mission will advance the state of the art in nanosatellite attitude determination,navigation and control systems, in addition to demonstrating relative navigation capabilities.The two CPOD satellites are scheduled to be launched together to low-Earth orbit no earlier than Dec. 1, 2015.

  17. Diaphragmatic hernia repair - congenital

    MedlinePLUS

    Diaphragmatic hernia repair is surgery to correct an opening or space in a baby's diaphragm. This opening is called a hernia. ... diaphragm and into the abdominal cavity. The surgeon repairs the hole in the diaphragm. If the hole ...

  18. Phacomatosis cesiomarmorata with hypospadias and phacomatosis cesioflammea with Sturge-Weber syndrome, Klippel-Trenaunay syndrome and aplasia of veins -- case reports with rare associations.

    PubMed

    Kaur, Tejinder; Sharma, Nidhi; Sethi, Anisha; Kooner, Shitij; Banger, Harmeet

    2015-01-01

    Phacomatosis pigmentovascularis (PPV) is a rare genodermatosis characterized by the co-existence of an extensive vascular and a pigmentary nevus with or without extracutaneous manifestations. We report two such rare cases. The first is a 3-year-old boy exhibiting a rare association of cutis marmorata telangiectatica congenita with aberrant dermal melanocytosis along with hypospadias and melanosis oculi (traditionally classified as PPV type Vb or phacomatosis cesiomarmorata - Happle's classification). The other patient is a 5-year-old boy with Sturge-Weber syndrome, Klippel-Trenaunay syndrome, aplasia of iliac, femoral, and popliteal veins and congenital heart disease, associated with aberrant dermal melanocytosis and melanosis oculi (also classified as PPV type IIb or phacomatosis cesioflammea). These sporadic cases display a unique constellation of additional, previously unreported systemic associations, which will further expand the clinical spectrum of phacomatosis pigmentovascularis. PMID:26437284

  19. Microcephaly with agenesis of corticospinal tracts and arthrogryposis, hypospadias, single umbilical artery, hypertelorism, and renal and adrenal hypoplasia--previously undescribed syndrome.

    PubMed

    Coad, J E; Angel, C; Pierpont, M E; Gorlin, R J; Anderson, M L

    1997-09-01

    We describe a small, term, male infant with corticospinal tract aplasia secondary to motor cortex dysplasia from a neuronal proliferation and/or migrational defect. The infant also had microdolichocephaly, sloping forehead, hypertelorism, flat nose, apparently low-set ears, micrognathia, arthrogryposis without muscle wasting, cortical thumbs, rocker-bottom feet, scoliosis, single umbilical artery, and hypospadias with chordee. Oligohydramnios was present prenatally. Neurologic examination showed a comatose state, seizures, minimal spontaneous movement, minimal response to pain, and absent primitive reflexes. At autopsy, hypoplasia of kidneys and adrenal glands was found. There was no aqueductal stenosis or pulmonary hypoplasia. Chromosomes were apparently normal. These manifestations do not correspond to those of any recognized syndrome; therefore, this patient may represent a previously undefined syndrome. PMID:9286455

  20. Alternating proximal regularized dictionary learning.

    PubMed

    Salzo, Saverio; Masecchia, Salvatore; Verri, Alessandro; Barla, Annalisa

    2014-12-01

    We present an algorithm for dictionary learning that is based on the alternating proximal algorithm studied by Attouch, Bolte, Redont, and Soubeyran (2010), coupled with a reliable and efficient dual algorithm for computation of the related proximity operators. This algorithm is suitable for a general dictionary learning model composed of a Bregman-type data fit term that accounts for the goodness of the representation and several convex penalization terms on the coefficients and atoms, explaining the prior knowledge at hand. As Attouch et al. recently proved, an alternating proximal scheme ensures better convergence properties than the simpler alternating minimization. We take care of the issue of inexactness in the computation of the involved proximity operators, giving a sound stopping criterion for the dual inner algorithm, which keeps under control the related errors, unavoidable for such a complex penalty terms, providing ultimately an overall effective procedure. Thanks to the generality of the proposed framework, we give an application in the context of genome-wide data understanding, revising the model proposed by Nowak, Hastie, Pollack, and Tibshirani (2011). The aim is to extract latent features (atoms) and perform segmentation on array-based comparative genomic hybridization (aCGH) data. We improve several important aspects that increase the quality and interpretability of the results. We show the effectiveness of the proposed model with two experiments on synthetic data, which highlight the enhancements over the original model. PMID:25248086

  1. Proximity Sensors Make Robot Dexterous

    NASA Technical Reports Server (NTRS)

    Hess, Cliff; Li, Larry C. H.

    1990-01-01

    Control system enables robot hand to grasp objects of varied shapes. Key features of system: reflective proximity sensors furnishing data on position, orientation, and distance of object and software protocol controlling sequence of operations in approaching and grasping objects. Reflected-beam sensing concept applied to simple opposed-jaw industrial grippers as well as to dexterous robot hands.

  2. Optoelectronic Proximity Sensor Finds Edges

    NASA Technical Reports Server (NTRS)

    Bejczy, Antal K.

    1987-01-01

    Seams tracked for automatic control of welding. Optoelectronic system based on relatively simple array of optical proximity sensors locates edge of plate. Used to control automatic production machinery. System follows curved seams as well as straight ones, and neither special control programming nor precise initial positioning workpiece necessary for accurate tracking of seam.

  3. Unexpected and just missed: the separate influence of the appraisals of expectancy and proximity on negative emotions.

    PubMed

    Bossuyt, Evelien; Moors, Agnes; De Houwer, Jan

    2014-04-01

    Previous research has suggested that a goal-incongruent outcome leads to more intense negative emotions when it is unexpected and close to a goal-congruent outcome. Until now, however, no studies have disentangled the influence of the appraisals of expectancy and proximity on emotions. We experimentally manipulated each of these variables in 3 slot machine experiments and measured emotions via differences in motivation (i.e., the tendency to repair the goal incongruence) and feelings (i.e., disappointment, frustration, and anger). The experiments consisted of a series of trials that each started with the sequential presentation of 3 symbols. In case of a win trial, all symbols were equal (e.g., AAA) and the participant gained 10 cents; in case of a loss trial, one or more of the symbols differed and the participant gained 0 cents. Three different loss trials were compared: unexpected proximal ones (e.g., AAB), expected proximal ones (e.g., ABA), and expected distal ones (e.g., ABC). The tendency to repair was measured online via behavior as well as retrospectively via self-reports; feelings were measured retrospectively (Experiments 1 and 2) or online (Experiment 3). Unexpected losses seemed to increase the tendency to repair as well as feelings of disappointment (in all experiments) and feelings of frustration and anger (in Experiments 1 and 3). Proximal losses increased only the tendency to repair (in all experiments). This suggests that the appraisals of expectancy and proximity have a distinct influence on emotions. PMID:24364851

  4. Endovascular Repair versus Open Repair for Isolated Descending Thoracic Aortic Aneurysm

    PubMed Central

    Lee, Hyung Chae; Joo, Hyun-Chel; Lee, Seung Hyun; Lee, Sak; Chang, Byung-Chul; Yoo, Kyung-Jong

    2015-01-01

    Purpose To compare the outcomes of thoracic endovascular aortic repair (TEVAR) with those of open repair for descending thoracic aortic aneurysms (DTAA). Materials and Methods We compared the outcomes of 114 patients with DTAA and proximal landing zones 3 or 4 after TEVAR to those of 53 patients after conventional open repairs. Thirty-day and late mortality were the primary endpoints, and early morbidities, aneurysm-related death, and re-intervention were the secondary endpoints. Results The TEVAR group was older and had more incidences of dissecting aneurysm. The mean follow-up was 36±26 months (follow-up rate, 97.8%). The 30-day mortality in the TEVAR and open repair groups were 3.5% and 9.4% (p=0.11). Perioperative stroke and paraplegia incidences were similar between the groups [5.3% vs. 7.5% (p=0.56) and 7.5% vs. 3.5% (p=0.26), respectively]. Respiratory failure occurred more in the open repair group (1.8% vs. 26.4%, p<0.01). The incidence of acute kidney injury requiring dialysis was higher in the open repair group (1.8% vs. 9.4%, p<0.01). The cumulative survival rate was higher in the TEVAR group at 2 to 5 years (79.6% vs. 58.3%, p=0.03). The free from re-intervention was lower in the TEVAR group (65.3% vs. 100%, p=0.02), and the free from aneurysm-related death in the TEVAR and open repair groups were 88.5% and 86.1% (p=0.45). Conclusion TEVAR is safe and effective for treating DTAAs with improved perioperative and long-term outcomes compared with open repair. PMID:26069110

  5. Micropower RF material proximity sensor

    DOEpatents

    McEwan, T.E.

    1998-11-10

    A level detector or proximity detector for materials capable of sensing through plastic container walls or encapsulating materials is disclosed. Thus, it can be used in corrosive environments, as well as in a wide variety of applications. An antenna has a characteristic impedance which depends on the materials in proximity to the antenna. An RF oscillator, which includes the antenna and is based on a single transistor in a Colpitt`s configuration, produces an oscillating signal. A detector is coupled to the oscillator which signals changes in the oscillating signal caused by changes in the materials in proximity to the antenna. The oscillator is turned on and off at a pulse repetition frequency with a low duty cycle to conserve power. The antenna consists of a straight monopole about one-quarter wavelength long at the nominal frequency of the oscillator. The antenna may be horizontally disposed on a container and very accurately detects the fill level within the container as the material inside the container reaches the level of the antenna. 5 figs.

  6. Micropower RF material proximity sensor

    DOEpatents

    McEwan, Thomas E. (Livermore, CA)

    1998-01-01

    A level detector or proximity detector for materials capable of sensing through plastic container walls or encapsulating materials is of the sensor. Thus, it can be used in corrosive environments, as well as in a wide variety of applications. An antenna has a characteristic impedance which depends on the materials in proximity to the antenna. An RF oscillator, which includes the antenna and is based on a single transistor in a Colpitt's configuration, produces an oscillating signal. A detector is coupled to the oscillator which signals changes in the oscillating signal caused by changes in the materials in proximity to the antenna. The oscillator is turned on and off at a pulse repetition frequency with a low duty cycle to conserve power. The antenna consists of a straight monopole about one-quarter wavelength long at the nominal frequency of the oscillator. The antenna may be horizontally disposed on a container and very accurately detects the fill level within the container as the material inside the container reaches the level of the antenna.

  7. National Football League athletes' return to play after surgical reattachment of complete proximal hamstring ruptures.

    PubMed

    Mansour, Alfred A; Genuario, James W; Young, Jason P; Murphy, Todd P; Boublik, Martin; Schlegel, Theodore F

    2013-06-01

    Although hamstring strains are common among professional football players, proximal tendon avulsions are relatively rare. Surgical repair is recommended, but there is no evidence on professional football players return to play (RTP). We hypothesized that surgical reattachment of complete proximal hamstring ruptures in these athletes would enable successful RTP. Ten proximal hamstring avulsions were identified in 10 National Football League (NFL) players between 1990 and 2008. Participating team physicians retrospectively reviewed each player's training room and clinical records, operative notes, and imaging studies. The ruptures were identified and confirmed with magnetic resonance imaging. Of the 10 injuries, 9 had palpable defects. Each of the ruptures was managed with surgical fixation within 10 days of injury. All of the players reported full return of strength and attempted to resume play at the beginning of the following season, with 9 of the 10 actually returning to play. However, despite having no limitations related to the surgical repair, only 5 of the 10 athletes played in more than 1 game. Most NFL players who undergo acute surgical repair of complete proximal hamstring ruptures are able to RTP, but results are mixed regarding long-term participation. This finding may indicate that this injury is a marker for elite-level physical deterioration. PMID:23805425

  8. The HTV Proximity Communication System

    NASA Astrophysics Data System (ADS)

    Harada, Motoyuki; Takahashi, Tetsuo; Tanaka, Tetsuo

    2002-01-01

    National Space Development Agency of Japan (NASDA) is developing the H-II Transfer Vehicle (HTV) as an unmanned logistic support vehicle for the International Space Station (ISS). The HTV, which is launched by the H-IIA rocket, transports both pressurized and un-pressurized cargoes to the ISS, reloads disposal items from the ISS and performs destructive reentry over ocean area. NASDA plans the first flight of HTV in 2005 for demonstration. The HTV will contribute the ISS assembly and logistic re-supply operations with international commonality. For unmanned vehicle operation, communication link is critical with commanding and control, especially in proximity region to the ISS. As for the HTV operation, NASDA is developing dedicated communication system installed on the Japanese Experiment Module (JEM) of the ISS, which is called the Proximity Communication System (PROX). The HTV receives commands and transmits telemetry data through the PROX in its proximity operation to the ISS. To achieve this, the PROX can communicate with the HTV on its nominal trajectory within 23km of the ISS. Especially within 3km of the ISS, the PROX has capability to perform omni-directional communication to the HTV. The PROX also has GPS receiver and send GPS data to the HTV to support the HTV navigation for relative GPS navigation used in "far" range (500m away from the ISS). In addition to the above fundamental functions, the PROX has a capability of range and range-rate measurement between the ISS and the HTV by the pseudo noise (PN) code epoch and the Doppler shift frequency. This provides a reference data independent of "main" navigation methods (rendezvous sensor navigation or GPS navigation) of the HTV. The PROX also assists the ISS crew with its commanding device, called the Hardware Command Panel (HCP), to issue time-dependent safety-related critical commands for HTV berthing/un-berthing operation. When a failure occurs somewhere on "communication path" from the PROX Base Band Processor (BBP) to the HTV Guidance and Control Computer (GCC) including data handling and communication equipments, the PROX detects it by monitoring interruption of the "heartbeat" signal and conducts automatic redundancy switching of all the equipments on that "communication path" including those of the HTV. This paper describes the PROX functions such as communication, data handling and GPS navigation and some unique functions for the HTV proximity operation to the ISS.

  9. Proximal Biceps in Overhead Athletes.

    PubMed

    Chalmers, Peter N; Verma, Nikhil N

    2016-01-01

    The proximal long head of the biceps tendon and its attachment at the superior glenoid tubercle and labrum are subject to a spectrum of disorders in overhead athletes. Biceps disorders are commonly characterized by intermittent anterior or deep-seated shoulder pain exacerbated by activity. Diagnosis is reached via various physical examination maneuvers; MRI can be uncertain. Nonsteroidal anti-inflammatory medications, targeted ultrasound-guided corticosteroid injections, and supervised physical therapy are the mainstays of nonoperative treatment. Operative treatment, which remains controversial, provides reliable pain relief, restoration of function for activities of daily living, and low complication rates, but return to play can be unpredictable. PMID:26614475

  10. Proximal aortic stent-graft displacement with type I endoleak due to Heimlich maneuver.

    PubMed

    Lin, Peter H; Bush, Ruth L; Lumsden, Alan B

    2003-08-01

    The Heimlich maneuver has saved countless lives by relieving foreign body obstruction from the respiratory tract. Complications related to this life-saving technique, particularly involving the abdominal aorta, are extremely rare. We report the case of a patient who underwent successful endovascular abdominal aortic aneurysm (AAA) repair, with AAA reduction at postoperative surveillance. Endograft displacement after performance of the Heimlich maneuver resulted in a proximal type I endoleak. This case underscores both the potential for aortic trauma from the Heimlich maneuver and the risk for clinical failure as a result of abdominal compression after successful endovascular AAA repair. PMID:12891124

  11. Repairs of composite structures

    NASA Astrophysics Data System (ADS)

    Roh, Hee Seok

    Repair on damaged composite panels was conducted. To better understand adhesively bonded repair, the study investigates the effect of design parameters on the joint strength. The design parameters include bondline length, thickness of adherend and type of adhesive. Adhesives considered in this study were tested to measure their tensile material properties. Three types of adhesively bonded joints, single strap, double strap, and single lap joint were considered under changing bondline lengths, thickness of adherend and type of adhesive. Based on lessons learned from bonded joints, a one-sided patch repair method for composite structures was conducted. The composite patch was bonded to the damaged panel by either film adhesive FM-73M or paste adhesive EA-9394 and the residual strengths of the repaired specimens were compared under varying patch sizes. A new repair method using attachments has been suggested to enhance the residual strength. Results obtained through experiments were analyzed using finite element analysis to provide a better repair design and explain the experimental results. It was observed that the residual strength of the repaired specimen was affected by patch length. Method for rapid repairs of damaged composite structures was investigated. The damage was represented by a circular hole in a composite laminated plate. Pre-cured composite patches were bonded with a quick-curing commercial adhesive near (rather than over) the hole. Tensile tests were conducted on specimens repaired with various patch geometries. The test results showed that, among the methods investigated, the best repair method restored over 90% of the original strength of an undamaged panel. The interfacial stresses in the adhesive zone for different patches were calculated in order to understand the efficiencies of the designs of these patch repairs. It was found that the composite patch that yielded the best strength had the lowest interfacial peel stress between the patch and the host composite structure.

  12. Fibrosis: ultimate and proximate causes

    PubMed Central

    Thannickal, Victor J.; Zhou, Yong; Gaggar, Amit; Duncan, Steven R.

    2014-01-01

    Fibrotic disorders account for an increasing burden of disease-associated morbidity and mortality worldwide. Although numerous risk factors have been recognized, the etiologies of many of these clinical syndromes have not been identified, and they are often termed idiopathic or cryptogenic. Here, we provide an evolutionary perspective on fibrosis aimed at elucidating its etiopathogenesis. By asking the ultimate question of why this process evolved in multicellular organisms, we hope to uncover proximate explanations for how it causes disease in humans. We posit that physiological fibrosis-like reactions evolved as an essential process in host defense against pathogens and in normal wound healing. Based on this premise, we reason that pathological fibrosis is related to one or more of the following: unidentified infectious or noninfectious antigens, autoimmunity, impaired regenerative responses, and the antagonistically pleiotropic action of genes involved in wound healing or development. The importance of genetic susceptibility, epigenetics, aging, and the modern-day environment are highlighted. Consideration of both ultimate and proximate causation goes beyond philosophical cogitations, as it will better inform pathobiological mechanisms of disease and aid in the prevention and treatment of fibrotic diseases. PMID:25365073

  13. Protein Neighbors and Proximity Proteomics*

    PubMed Central

    Rees, Johanna S.; Li, Xue-Wen; Perrett, Sarah; Lilley, Kathryn S.; Jackson, Antony P.

    2015-01-01

    Within cells, proteins can co-assemble into functionally integrated and spatially restricted multicomponent complexes. Often, the affinities between individual proteins are relatively weak, and proteins within such clusters may interact only indirectly with many of their other protein neighbors. This makes proteomic characterization difficult using methods such as immunoprecipitation or cross-linking. Recently, several groups have described the use of enzyme-catalyzed proximity labeling reagents that covalently tag the neighbors of a targeted protein with a small molecule such as fluorescein or biotin. The modified proteins can then be isolated by standard pulldown methods and identified by mass spectrometry. Here we will describe the techniques as well as their similarities and differences. We discuss their applications both to study protein assemblies and to provide a new way for characterizing organelle proteomes. We stress the importance of proteomic quantitation and independent target validation in such experiments. Furthermore, we suggest that there are biophysical and cell-biological principles that dictate the appropriateness of enzyme-catalyzed proximity labeling methods to address particular biological questions of interest. PMID:26355100

  14. Ash Aggregates in Proximal Settings

    NASA Astrophysics Data System (ADS)

    Porritt, L. A.; Russell, K.

    2012-12-01

    Ash aggregates are thought to have formed within and been deposited by the eruption column and plume and dilute density currents and their associated ash clouds. Moist, turbulent ash clouds are considered critical to ash aggregate formation by facilitating both collision and adhesion of particles. Consequently, they are most commonly found in distal deposits. Proximal deposits containing ash aggregates are less commonly observed but do occur. Here we describe two occurrences of vent proximal ash aggregate-rich deposits; the first within a kimberlite pipe where coated ash pellets and accretionary lapilli are found within the intra-vent sequence; and the second in a glaciovolcanic setting where cored pellets (armoured lapilli) occur within <1 km of the vent. The deposits within the A418 pipe, Diavik Diamond Mine, Canada, are the residual deposits within the conduit and vent of the volcano and are characterised by an abundance of ash aggregates. Coated ash pellets are dominant but are followed in abundance by ash pellets, accretionary lapilli and rare cored pellets. The coated ash pellets typically range from 1 - 5 mm in diameter and have core to rim ratios of approximately 10:1. The formation and preservation of these aggregates elucidates the style and nature of the explosive phase of kimberlite eruption at A418 (and other pipes?). First, these pyroclasts dictate the intensity of the kimberlite eruption; it must be energetic enough to cause intense fragmentation of the kimberlite to produce a substantial volume of very fine ash (<62 μm). Secondly, the ash aggregates indicate the involvement of moisture coupled with the presence of dilute expanded eruption clouds. The structure and distribution of these deposits throughout the kimberlite conduit demand that aggregation and deposition operate entirely within the confines of the vent; this indicates that aggregation is a rapid process. Ash aggregates within glaciovolcanic sequences are also rarely documented. The early pyroclastic phase of the formation of Kima'Kho, a tuya in northern B.C., Canada produced a subaqueous pyroclastic cone which became emergent during the latter stages of formation. Armoured lapilli are pervasive within the emergent upper third of the sequence. No other types of ash aggregates have been observed. Petrographic and textural analysis of the armoured lapilli shows them to comprise a central 2-30 mm-sized, juvenile, vesiculated pyroclast, concentrically coated by mm-scale layers of 10-250 μm sized ash particles. At Kima'Kho, the armoured lapilli are shown to be a direct indicator of fallout from a sustained plume attended by concomitant production of pyroclastic density currents. The size and internal structure of the armoured lapilli provide constraints on the nature of the initial explosive phase of eruption at Kima'Kho. Their proximity to the vent also indicates rapid aggregation within the eruption plume. Within both sequences rapid aggregation of ash particles occurred in proximity to the vent. However, the conditions were substantially different leading to the production of armoured lapilli (no accretionary lapilli) at Kima'Kho and diverse ash aggregates but no armoured lapilli at A418. Here we investigate vent-proximal ash aggregation and the specific conditions which lead to the formation of coated ash pellets and armoured lapilli.

  15. Mitral Valve Repair

    MedlinePLUS

    ... a Thoracic Surgeon? Adult Cardiac Surgery What is Pediatric Heart Disease? What is Risk Adjustment? Valve Repair/Replacement Surgery Mitral Valve Replacement Aortic Valve Mitral Valve Repair Esophageal Surgery Lung/Thoracic Surgery Aneurysm Surgery Arrhythmia Surgery Other Types of Surgery Clinical ...

  16. Snowmobile Repair. Teacher Edition.

    ERIC Educational Resources Information Center

    Hennessy, Stephen S.; Conrad, Rex

    This teacher's guide contains 14 units on snowmobile repair: (1) introduction to snowmobile repair; (2) skis, front suspension, and steering; (3) drive clutch; (4) drive belts; (5) driven clutch; (6) chain drives; (7) jackshafts and axles; (8) rear suspension; (9) tracks; (10) shock absorbers; (11) brakes; (12) engines; (13) ignition and

  17. Cleft lip repair - series (image)

    MedlinePLUS

    A cleft lip is an abnormal opening in the middle of the upper lip. A cleft palate is an opening ... Cleft lip repair and cleft palate repair are indicated for: Repair of physical deformity Nursing, feeding, or speech ...

  18. INTERNAL REPAIR OF PIPELINES

    SciTech Connect

    Bill Bruce; Nancy Porter; George Ritter; Matt Boring; Mark Lozev; Ian Harris; Bill Mohr; Dennis Harwig; Robin Gordon; Chris Neary; Mike Sullivan

    2005-07-20

    The two broad categories of fiber-reinforced composite liner repair and deposited weld metal repair technologies were reviewed and evaluated for potential application for internal repair of gas transmission pipelines. Both are used to some extent for other applications and could be further developed for internal, local, structural repair of gas transmission pipelines. Principal conclusions from a survey of natural gas transmission industry pipeline operators can be summarized in terms of the following performance requirements for internal repair: (1) Use of internal repair is most attractive for river crossings, under other bodies of water, in difficult soil conditions, under highways, under congested intersections, and under railway crossings. (2) Internal pipe repair offers a strong potential advantage to the high cost of horizontal direct drilling when a new bore must be created to solve a leak or other problem. (3) Typical travel distances can be divided into three distinct groups: up to 305 m (1,000 ft.); between 305 m and 610 m (1,000 ft. and 2,000 ft.); and beyond 914 m (3,000 ft.). All three groups require pig-based systems. A despooled umbilical system would suffice for the first two groups which represents 81% of survey respondents. The third group would require an onboard self-contained power unit for propulsion and welding/liner repair energy needs. (4) The most common size range for 80% to 90% of operators surveyed is 508 mm (20 in.) to 762 mm (30 in.), with 95% using 558.8 mm (22 in.) pipe. Evaluation trials were conducted on pipe sections with simulated corrosion damage repaired with glass fiber-reinforced composite liners, carbon fiber-reinforced composite liners, and weld deposition. Additional un-repaired pipe sections were evaluated in the virgin condition and with simulated damage. Hydrostatic failure pressures for pipe sections repaired with glass fiber-reinforced composite liner were only marginally greater than that of pipe sections without liners, indicating that this type of liner is only marginally effective at restoring the pressure containing capabilities of pipelines. Failure pressures for larger diameter pipe repaired with a semi-circular patch of carbon fiber-reinforced composite lines were also marginally greater than that of a pipe section with un-repaired simulated damage without a liner. These results indicate that fiber reinforced composite liners have the potential to increase the burst pressure of pipe sections with external damage Carbon fiber based liners are viewed as more promising than glass fiber based liners because of the potential for more closely matching the mechanical properties of steel. Pipe repaired with weld deposition failed at pressures lower than that of un-repaired pipe in both the virgin and damaged conditions, indicating that this repair technology is less effective at restoring the pressure containing capability of pipe than a carbon fiber-reinforced liner repair. Physical testing indicates that carbon fiber-reinforced liner repair is the most promising technology evaluated to-date. In lieu of a field installation on an abandoned pipeline, a preliminary nondestructive testing protocol is being developed to determine the success or failure of the fiber-reinforced liner pipeline repairs. Optimization and validation activities for carbon-fiber repair methods are ongoing.

  19. INTERNAL REPAIR OF PIPELINES

    SciTech Connect

    Robin Gordon; Bill Bruce; Ian Harris; Dennis Harwig; George Ritter; Bill Mohr; Matt Boring; Nancy Porter; Mike Sullivan; Chris Neary

    2004-12-31

    The two broad categories of fiber-reinforced composite liner repair and deposited weld metal repair technologies were reviewed and evaluated for potential application for internal repair of gas transmission pipelines. Both are used to some extent for other applications and could be further developed for internal, local, structural repair of gas transmission pipelines. Principal conclusions from a survey of natural gas transmission industry pipeline operators can be summarized in terms of the following performance requirements for internal repair: (1) Use of internal repair is most attractive for river crossings, under other bodies of water, in difficult soil conditions, under highways, under congested intersections, and under railway crossings. (2) Internal pipe repair offers a strong potential advantage to the high cost of horizontal direct drilling when a new bore must be created to solve a leak or other problem. (3) Typical travel distances can be divided into three distinct groups: up to 305 m (1,000 ft.); between 305 m and 610 m (1,000 ft. and 2,000 ft.); and beyond 914 m (3,000 ft.). All three groups require pig-based systems. A despooled umbilical system would suffice for the first two groups which represents 81% of survey respondents. The third group would require an onboard self-contained power unit for propulsion and welding/liner repair energy needs. (4) The most common size range for 80% to 90% of operators surveyed is 508 mm (20 in.) to 762 mm (30 in.), with 95% using 558.8 mm (22 in.) pipe. Evaluation trials were conducted on pipe sections with simulated corrosion damage repaired with glass fiber-reinforced composite liners, carbon fiber-reinforced composite liners, and weld deposition. Additional un-repaired pipe sections were evaluated in the virgin condition and with simulated damage. Hydrostatic failure pressures for pipe sections repaired with glass fiber-reinforced composite liner were only marginally greater than that of pipe sections without liners, indicating that this type of liner is only marginally effective at restoring the pressure containing capabilities of pipelines. Failure pressures for larger diameter pipe repaired with a semi-circular patch of carbon fiber-reinforced composite lines were also marginally greater than that of a pipe section with un-repaired simulated damage without a liner. These results indicate that fiber reinforced composite liners have the potential to increase the burst pressure of pipe sections with external damage Carbon fiber based liners are viewed as more promising than glass fiber based liners because of the potential for more closely matching the mechanical properties of steel. Pipe repaired with weld deposition failed at pressures lower than that of un-repaired pipe in both the virgin and damaged conditions, indicating that this repair technology is less effective at restoring the pressure containing capability of pipe than a carbon fiber-reinforced liner repair. Physical testing indicates that carbon fiber-reinforced liner repair is the most promising technology evaluated to-date. The first round of optimization and validation activities for carbon-fiber repairs are complete. Development of a comprehensive test plan for this process is recommended for use in the field trial portion of this program.

  20. A patient with a unique frameshift mutation in GPC3, causing Simpson-Golabi-Behmel syndrome, presenting with craniosynostosis, penoscrotal hypospadias, and a large prostatic utricle.

    PubMed

    Villarreal, Diana D; Villarreal, Humberto; Paez, Ana Maria; Peppas, Dennis; Lynch, Jane; Roeder, Elizabeth; Powers, George C

    2013-12-01

    We present a Hispanic male with the clinical and molecular diagnosis of Simpson-Golabi-Behmel syndrome (SGBS). The patient was born with multiple anomalies not entirely typical of SGBS patients, including penoscrotal hypospadias, a large prostatic utricle, and left coronal craniosynostosis. In addition, he demonstrated endocrine anomalies including a low random cortisol level suspicious for adrenal insufficiency and low testosterone level. To our knowledge, this is the first report of a prostatic utricle in SGBS and the second report of craniosynostosis. The unique disease-causing mutation likely arose de novo in the mother. It is a deletion-insertion that leads to a frameshift at the p.p. S359 [corrected] residue of GPC3 and a premature stop codon after five more amino acids. p. S359 [corrected] is the same residue that is normally cleaved by the Furin convertase, although the significance of this novel mutation with respect to the patient's multiple anomalies is unknown. We present this case as the perinatal course of a patient with unique features of SGBS and a confirmed molecular diagnosis. PMID:24115482

  1. Severe intellectual disability, omphalocele, hypospadia and high blood pressure associated to a deletion at 2q22.1q22.3: case report

    PubMed Central

    2012-01-01

    Background Recently, array-comparative genomic hybridization (aCGH) platforms have significantly improved the resolution of chromosomal analysis allowing the identification of genomic copy number gains and losses smaller than 5 Mb. Here we report on a young man with unexplained severe mental retardation, autism spectrum disorder, congenital malformations comprising hypospadia and omphalocele, and episodes of high blood pressure. An ~ 6 Mb interstitial deletion that includes the causative genes is identified by oligonucleotide-based aCGH. Results Our index case exhibited a de novo chromosomal abnormality at 2q22 [del(2)(q22.1q22.3)dn] which was not visible at the 550 haploid band level. The deleted region includes eight genes: HNMT, SPOPL, NXPH2, LOC64702, LRP1B, KYNU, ARHGAP15 and GTDC1. Discussion aCGH revealed an ~ 6 Mb deletion in 2q22.1 to 2q22.3 in an as-yet unique clinical case associated with intellectual disability, congenital malformations and autism spectrum disorder. Interestingly, the deletion is co-localized with a fragile site (FRA2K), which could be involved in the formation of this chromosomal aberration. Further studies are needed to determine if deletions of 2q22.1 to 2q22.3 define a new microdeletion syndrome. PMID:22686481

  2. Proximity and emergency department use

    PubMed Central

    Bergeron, Patrick; Courteau, Josiane; Vanasse, Alain

    2015-01-01

    Abstract Objective To determine if geographic proximity to an emergency department (ED) is related to ED use in a metropolitan population of patients with cardiovascular risk factors. Design Population-based, retrospective cohort study. Setting The census metropolitan area of Montreal, Que. Participants Cohort of 99 400 patients with diabetes, hypertension, or dyslipidemia in 2007 without a history of cardiovascular disease. Each patient was spatially referred to 1 of 5857 dissemination areas (DAs). Main outcome measures Annual number of visits to an ED with respect to the distance between the centroid of a patients DA and the closest ED, controlling for age, sex, comorbidities, and neighbourhood immigration, social, and material characteristics. Multilevel logistic and negative binomial regressions were used to determine if the proximity to the closest ED was related to ED use, frequent ED use (? 4 visits in a year), and number of ED visits. Results A total of 25 889 (26.0%) patients in the cohort visited an ED at least once during a 1-year period, among which 4563 (4.6%) were frequent users with at least 4 visits. These frequent users were responsible for 28 249 (45.5%) of all 62 021 visits to EDs. The distance between a DA and its closest ED was significantly and negatively correlated with ED use (P < .001), even after controlling for confounding variables. Patients living in a DA close to an ED were also more likely to be frequent users, but the extent of use among them (range from 4 to 82 ED visits) was not related to the distance to the closest ED. Conclusion These results suggest that patients at risk of cardiovascular disease living in a metropolitan area are more likely to seek a medical encounter at the ED if they live closer to it. PMID:26505061

  3. INTERNAL REPAIR OF PIPELINES

    SciTech Connect

    Robin Gordon; Bill Bruce; Ian Harris; Dennis Harwig; George Ritter; Bill Mohr; Matt Boring; Nancy Porter; Mike Sullivan; Chris Neary

    2004-08-17

    The two broad categories of fiber-reinforced composite liner repair and deposited weld metal repair technologies were reviewed and evaluated for potential application for internal repair of gas transmission pipelines. Both are used to some extent for other applications and could be further developed for internal, local, structural repair of gas transmission pipelines. Principal conclusions from a survey of natural gas transmission industry pipeline operators can be summarized in terms of the following performance requirements for internal repair: (1) Use of internal repair is most attractive for river crossings, under other bodies of water, in difficult soil conditions, under highways, under congested intersections, and under railway. (2) Internal pipe repair offers a strong potential advantage to the high cost of horizontal direct drilling when a new bore must be created to solve a leak or other problem. (3) Typical travel distances can be divided into three distinct groups: up to 305 m (1,000 ft.); between 305 m and 610 m (1,000 ft. and 2,000 ft.); and beyond 914 m (3,000 ft.). All three groups require pig-based systems. A despooled umbilical system would suffice for the first two groups which represents 81% of survey respondents. The third group would require an onboard self-contained power unit for propulsion and welding/liner repair energy needs. (4) The most common size range for 80% to 90% of operators surveyed is 508 mm (20 in.) to 762 mm (30 in.), with 95% using 558.8 mm (22 in.) pipe. Evaluation trials were conducted on pipe sections with simulated corrosion damage repaired with glass fiber-reinforced composite liners, carbon fiber-reinforced composite liners, and weld deposition. Additional un-repaired pipe sections were evaluated in the virgin condition and with simulated damage. Hydrostatic failure pressures for pipe sections repaired with glass fiber-reinforced composite liner were only marginally greater than that of pipe sections without liners, indicating that this type of liner is only marginally effective at restoring the pressure containing capabilities of pipelines. Failure pressures for larger diameter pipe repaired with a semi-circular patch of carbon fiber-reinforced composite lines were also marginally greater than that of a pipe section with un-repaired simulated damage without a liner. These results indicate that fiber reinforced composite liners have the potential to increase the burst pressure of pipe sections with external damage Carbon fiber based liners are viewed as more promising than glass fiber based liners because of the potential for more closely matching the mechanical properties of steel. Pipe repaired with weld deposition failed at pressures lower than that of un-repaired pipe in both the virgin and damaged conditions, indicating that this repair technology is less effective at restoring the pressure containing capability of pipe than a carbon fiber-reinforced liner repair. Physical testing indicates that carbon fiber-reinforced liner repair is the most promising technology evaluated to-date. Development of a comprehensive test plan for this process is recommended for use in the field trial portion of this program.

  4. Responses of Proximal Tubular Cells to Injury in Congenital Renal Disease: Fight or Flight

    PubMed Central

    Chevalier, Robert L.; Forbes, Michael S.; Galarreta, Carolina I.; Thornhill, Barbara A.

    2013-01-01

    Most chronic kidney disease in children results from congenital or inherited disorders, which can be studied in mouse models. Following 2 weeks of unilateral ureteral obstruction (UUO) in the adult mouse, nephron loss is due to proximal tubular mitochondrial injury and cell death. In neonatal mice, proximal tubular cell death is delayed beyond 2 weeks of complete UUO, and release of partial UUO allows remodeling of remaining nephrons. Progressive cyst expansion develops in polycystic kidney disease (PKD), a common inherited renal disorder. The PCY mutant mouse (which develops late-onset PKD) develops thinning of the glomerulotubular junction in parallel with growth of cysts in adulthood. Renal insufficiency in nephropathic cystinosis, a rare inherited renal disorder, results from progressive tubular cystine accumulation. In the Ctns knock out mouse (a model of cystinosis), proximal tubular cells become flattened, with loss of mitochondria and thickening of tubular basement membrane. In each model, persistent obstructive or metabolic stress leads ultimately to the formation of atubular glomeruli. The initial “fight” response (proximal tubular survival) switches to a “flight” response (proximal tubular cell death) with ongoing oxidative injury and mitochondrial damage. Therapies should be directed at reducing proximal tubular mitochondrial oxidative injury to enhance repair and regeneration. PMID:23949631

  5. Responses of proximal tubular cells to injury in congenital renal disease: fight or flight.

    PubMed

    Chevalier, Robert L; Forbes, Michael S; Galarreta, Carolina I; Thornhill, Barbara A

    2014-04-01

    Most chronic kidney disease in children results from congenital or inherited disorders, which can be studied in mouse models. Following 2 weeks of unilateral ureteral obstruction (UUO) in the adult mouse, nephron loss is due to proximal tubular mitochondrial injury and cell death. In neonatal mice, proximal tubular cell death is delayed beyond 2 weeks of complete UUO, and release of partial UUO allows remodeling of remaining nephrons. Progressive cyst expansion develops in polycystic kidney disease (PKD), a common inherited renal disorder. The polycystic kidney and fibrosis (pcy)-mutant mouse (which develops late-onset PKD) develops thinning of the glomerulotubular junction in parallel with growth of cysts in adulthood. Renal insufficiency in nephropathic cystinosis, a rare inherited renal disorder, results from progressive tubular cystine accumulation. In the Ctns knockout mouse (a model of cystinosis), proximal tubular cells become flattened, with loss of mitochondria and thickening of tubular basement membrane. In each model, persistent obstructive or metabolic stress leads ultimately to the formation of atubular glomeruli. The initial "fight" response (proximal tubular survival) switches to a "flight" response (proximal tubular cell death) with ongoing oxidative injury and mitochondrial damage. Therapies should be directed at reducing proximal tubular mitochondrial oxidative injury to enhance repair and regeneration. PMID:23949631

  6. Residential Proximity to Environmental Hazards and Adverse Health Outcomes

    PubMed Central

    Maantay, Juliana A.; Chakraborty, Jayajit

    2011-01-01

    How living near environmental hazards contributes to poorer health and disproportionate health outcomes is an ongoing concern. We conducted a substantive review and critique of the literature regarding residential proximity to environmental hazards and adverse pregnancy outcomes, childhood cancer, cardiovascular and respiratory illnesses, end-stage renal disease, and diabetes. Several studies have found that living near hazardous wastes sites, industrial sites, cropland with pesticide applications, highly trafficked roads, nuclear power plants, and gas stations or repair shops is related to an increased risk of adverse health outcomes. Government agencies should consider these findings in establishing rules and permitting and enforcement procedures to reduce pollution from environmentally burdensome facilities and land uses. PMID:22028451

  7. Rehabilitation following meniscal repair.

    PubMed

    Cavanaugh, John T; Killian, Sarah E

    2012-03-01

    It has become increasingly more evident that the meniscus plays an important role in contributing to knee joint longevity. Advances in surgical techniques by orthopaedic surgeons to repair traumatized menisci have led to better long term outcomes, decreasing the incidence of articular cartilage degeneration. Advances have also been made in rehabilitative techniques following meniscal repair. These techniques along with sound rehabilitation principles to include a criteria based progression have contributed to excellent outcomes and earlier return to function and sport. The role of the meniscus, recent advances in surgical repair and the current post-operative rehabilitation techniques employed by sports rehabilitation specialists today are discussed. PMID:22442106

  8. Rapid road repair vehicle

    DOEpatents

    Mara, Leo M. (Livermore, CA)

    1999-01-01

    Disclosed are improvments to a rapid road repair vehicle comprising an improved cleaning device arrangement, two dispensing arrays for filling defects more rapidly and efficiently, an array of pre-heaters to heat the road way surface in order to help the repair material better bond to the repaired surface, a means for detecting, measuring, and computing the number, location and volume of each of the detected surface imperfection, and a computer means schema for controlling the operation of the plurality of vehicle subsystems. The improved vehicle is, therefore, better able to perform its intended function of filling surface imperfections while moving over those surfaces at near normal traffic speeds.

  9. Reusing Cadaveric Humeri for Fracture Testing After Testing Simulated Rotator Cuff Tendon Repairs

    PubMed Central

    Pitts, Todd C.; Knight, Alex N.; Burkhead, Wayne Z.

    2014-01-01

    Abstract The financial cost of using human tissues in biomedical testing and surgical reconstruction is predicted to increase at a rate that is disproportionately greater than other materials used in biomechanical testing. Our first hypothesis is that cadaveric proximal humeri that had undergone monotonic failure testing of simulated rotator cuff repairs would not differ in ultimate fracture loads or in energy absorbed to fracture when compared to controls (i.e., bones without cuff repairs). Our second hypothesis is that there can be substantial cost savings if these cadaveric proximal humeri, with simulated cuff repairs, can be re-used for fracture testing. Results of fracture tests (conducted in a backwards fall configuration) and cost analysis support both hypotheses. Hence, the bones that had undergone monotonic failure tests of various rotator cuff repair techniques can be re-used in fracture tests because their load-carrying capacity is not significantly reduced. PMID:25371862

  10. Hybrid Three-Stage Repair for Extended Thoracoabdominal Aortic Aneurysm: Report of A Case

    PubMed Central

    Tamura, Kentaro; Chikazawa, Genta; Sakaguchi, Taichi; Totsugawa, Toshinori; Yoshitaka, Hidenori

    2015-01-01

    A 67-year-old man complicated with back pain. The computed tomography (CT) scan showed an extended thoracoabdominal aneurysm. We successfully performed a three-stage hybrid repair using the visceral-renal debranching technique. For the first stage operation we performed Y-grafting with the debranching technique to create a distal landing zone. Then, for the second stage operation, we performed the hybrid procedure including total arch replacement (TAR) and antegrade stent graft deployment to create a proximal landing zone. Finally, additional thoracic endovascular aortic repair (TEVAR) between the distal and proximal landing zones was successfully accomplished as the third stage operation. PMID:26131031

  11. Laparoscopic Inguinal Hernia Repair

    MedlinePLUS

    ... Laparoscopic Inguinal Hernia Repair Surgery Patient Information from SAGES Download PDF Version Find a SAGES Surgeon About ... 2016 Meeting Information Healthy Sooner: Patient Information Contact SAGES Society of American Gastrointestinal and Endoscopic Surgeons 11300 ...

  12. Laparoscopic Ventral Hernia Repair

    MedlinePLUS

    ... Login Laparoscopic Ventral Hernia Repair Patient Information from SAGES Download PDF Version Find a SAGES Surgeon Approximately ... 2016 Meeting Information Healthy Sooner: Patient Information Contact SAGES Society of American Gastrointestinal and Endoscopic Surgeons 11300 ...

  13. Eye muscle repair

    MedlinePLUS

    ... eye; Resection and recession; Strabismus repair; Extraocular muscle surgery ... The goal of this surgery is to restore the eye muscles to a proper position. This will help the eyes move correctly. Eye muscle surgery ...

  14. Easily repairable networks

    NASA Astrophysics Data System (ADS)

    Fink, Thomas

    2015-03-01

    We introduce a simple class of distribution networks which withstand damage by being repairable instead of redundant. Instead of asking how hard it is to disconnect nodes through damage, we ask how easy it is to reconnect nodes after damage. We prove that optimal networks on regular lattices have an expected cost of reconnection proportional to the lattice length, and that such networks have exactly three levels of structural hierarchy. We extend our results to networks subject to repeated attacks, in which the repairs themselves must be repairable. We find that, in exchange for a modest increase in repair cost, such networks are able to withstand any number of attacks. We acknowledge support from the Defense Threat Reduction Agency, BCG and EU FP7 (Growthcom).

  15. Timpani Repair and Maintenance.

    ERIC Educational Resources Information Center

    Combs, F. Michael

    1980-01-01

    Rather than focusing on specific brands of timpani, these guidelines for repair cover mechanical problems of a general nature: pedals, dents, unclear tone, and squeaking. Preventive maintenance is discussed. (Author/SJL)

  16. Patent urachus repair

    MedlinePLUS

    Patent urachal tube repair ... belly. Next, the surgeon will find the urachal tube and remove it. The bladder opening will be ... surgeon uses the tools to remove the urachal tube and close off the bladder and area where ...

  17. Hammer toe repair

    MedlinePLUS

    Flexion contracture of the toe ... Several kinds of surgery can repair hammer toe. Your bone or foot doctor will recommend the kind that will work best for you. Some of the surgeries include: Remove parts of ...

  18. Femur fracture repair - discharge

    MedlinePLUS

    You had a fracture (break) in the femur, also called the thigh bone, in your leg. You may have needed surgery to repair ... surgeon will make a cut to open your fracture. Your surgeon will then use special metal devices ...

  19. Intestinal obstruction repair

    MedlinePLUS

    ... repaired or removed. This procedure is called bowel resection . If a section is removed, the healthy ends ... Fry RD, Mahmoud NN, Maron DJ, Bleier JIS. Colon and rectum. In: Townsend CM, Beauchamp RD, Evers ...

  20. Testicular torsion repair

    MedlinePLUS

    Testicular torsion repair is surgery to untangle a spermatic cord. The spermatic cord is the collection of blood vessels ... the scrotum that lead to the testicles. Testicular torsion develops when the cord twists. This pulling and ...

  1. INTERNAL REPAIR OF PIPELINES

    SciTech Connect

    Robin Gordon; Bill Bruce; Ian Harris; Dennis Harwig; Nancy Porter; Mike Sullivan; Chris Neary

    2004-04-12

    The two broad categories of deposited weld metal repair and fiber-reinforced composite liner repair technologies were reviewed for potential application for internal repair of gas transmission pipelines. Both are used to some extent for other applications and could be further developed for internal, local, structural repair of gas transmission pipelines. Preliminary test programs were developed for both deposited weld metal repair and for fiber-reinforced composite liner repair. Evaluation trials have been conducted using a modified fiber-reinforced composite liner provided by RolaTube and pipe sections without liners. All pipe section specimens failed in areas of simulated damage. Pipe sections containing fiber-reinforced composite liners failed at pressures marginally greater than the pipe sections without liners. The next step is to evaluate a liner material with a modulus of elasticity approximately 95% of the modulus of elasticity for steel. Preliminary welding parameters were developed for deposited weld metal repair in preparation of the receipt of Pacific Gas & Electric's internal pipeline welding repair system (that was designed specifically for 559 mm (22 in.) diameter pipe) and the receipt of 559 mm (22 in.) pipe sections from Panhandle Eastern. The next steps are to transfer welding parameters to the PG&E system and to pressure test repaired pipe sections to failure. A survey of pipeline operators was conducted to better understand the needs and performance requirements of the natural gas transmission industry regarding internal repair. Completed surveys contained the following principal conclusions: (1) Use of internal weld repair is most attractive for river crossings, under other bodies of water, in difficult soil conditions, under highways, under congested intersections, and under railway crossings. (2) Internal pipe repair offers a strong potential advantage to the high cost of horizontal direct drilling (HDD) when a new bore must be created to solve a leak or other problem. (3) Typical travel distances can be divided into three distinct groups: up to 305 m (1,000 ft.); between 305 m and 610 m (1,000 ft. and 2,000 ft.); and beyond 914 m (3,000 ft.). All three groups require pig-based systems. A despooled umbilical system would suffice for the first two groups which represents 81% of survey respondents. The third group would require an onboard self-contained power unit for propulsion and welding/liner repair energy needs. (4) Pipe diameter sizes range from 50.8 mm (2 in.) through 1,219.2 mm (48 in.). The most common size range for 80% to 90% of operators surveyed is 508 mm to 762 mm (20 in. to 30 in.), with 95% using 558.8 mm (22 in.) pipe. An evaluation of potential repair methods clearly indicates that the project should continue to focus on the development of a repair process involving the use of GMAW welding and on the development of a repair process involving the use of fiber-reinforced composite liners.

  2. Acute bilateral renal artery chimney stent thrombosis after endovascular repair of a juxtarenal abdominal aortic aneurysm.

    PubMed

    Scali, Salvatore T; Feezor, Robert J; Huber, Thomas S; Beck, Adam W

    2015-04-01

    The use of "chimney" stents to augment the proximal landing zone for endovascular aneurysm repair has been increasingly reported. Despite mounting enthusiasm for this technique, the durability of this type of repair and capability to preserve perfusion to target branches remains a paramount concern. Here, we report management of a patient presenting with acute bilateral renal chimney stent thrombosis and a type Ia endoleak. PMID:24246538

  3. Laparoscopic Paraesophageal Hernia Repair

    PubMed Central

    Medina, Laura; Peetz, Michael; Ratzer, Erick

    1998-01-01

    Background and Objective: Paraesophageal hernias are uncommon yet potentially lethal conditions. Their repair has now been facilitated by laparoscopic technology. We present a series of 20 patients with paraesophageal hernias repaired laparoscopically. Methods: Twenty patients with paraesophageal hernias had laparoscopic repairs. Eighteen patients had primary repair of their hiatal defect. Two required mesh reinforcement. Fifteen patients had a fundoplication procedure performed concomitantly. Results: Long-term follow-up is available on 17 patients. There was no in-hospital morbidity or mortality. Average length of stay was 2.3 days. One patient recurred in the immediate postoperative period. There were no other recurrences. The only death in the series occurred in the oldest patient 18 days postoperatively. He had been discharged from the hospital and died of cardiac failure. No patients have had complications from a paraesophageal hernia postoperatively. Conclusion: Laparoscopic repair of paraesophageal hernias is possible. Preoperative work-up should include motility evaluation to assess esophageal peristalsis as the majority of these will need a concomitant anti-reflux procedure. This data helps the surgeon to determine whether or not a complete or partial wrap should be done. Repair of the diaphragmatic defect can be accomplished in the majority of patients without the use of prosthetic material with excellent results. PMID:9876752

  4. Thumb proximal phalanx reconstruction with nonvascularized corticocancellous olecranon bone graft.

    PubMed

    Soong, Maximillian

    2015-01-01

    Large segmental bone defects of the phalanges reportedly have been treated with free vascularized grafts from the hand, foot, or knee, or with nonvascularized grafts from the iliac crest. A nonvascularized structural corticocancellous graft from a local site would be advantageous. The olecranon has been used as a source of both cancellous and corticocancellous graft. The authors describe a unique case of the use of nonvascularized corticocancellous olecranon bone graft for structural purposes in a mutilating thumb injury. The patient injured the left thumb with a miter saw, resulting in a large degloving wound over a severely comminuted fracture of the proximal phalanx, with segmental bone loss between a base fragment and displaced condylar fragments. Provisional pin fixation was performed at the time of initial emergent irrigation and debridement, along with repairs of the extensor pollicis longus, radial digital nerve, and dorsal digital nerve. This was followed 3 weeks later by non-vascularized corticocancellous bone grafting from the olecranon to the proximal phalanx under regional anesthesia. The thumb was mobilized at 11 weeks, and solid union was radiographically confirmed at 6 months. The patient achieved moderate active range of motion and was able to return to work as a physical therapist. The elbow healed uneventfully and without pain or fracture at the donor site. This case shows that robust structural bone graft for the phalanges may be obtained from the nearby olecranon, under regional anesthesia, without microsurgery, and with potential advantages over the iliac crest. PMID:25611412

  5. Range gated strip proximity sensor

    DOEpatents

    McEwan, Thomas E.

    1996-01-01

    A range gated strip proximity sensor uses one set of sensor electronics and a distributed antenna or strip which extends along the perimeter to be sensed. A micro-power RF transmitter is coupled to the first end of the strip and transmits a sequence of RF pulses on the strip to produce a sensor field along the strip. A receiver is coupled to the second end of the strip, and generates a field reference signal in response to the sequence of pulse on the line combined with received electromagnetic energy from reflections in the field. The sensor signals comprise pulses of radio frequency signals having a duration of less than 10 nanoseconds, and a pulse repetition rate on the order of 1 to 10 MegaHertz or less. The duration of the radio frequency pulses is adjusted to control the range of the sensor. An RF detector feeds a filter capacitor in response to received pulses on the strip line to produce a field reference signal representing the average amplitude of the received pulses. When a received pulse is mixed with a received echo, the mixing causes a fluctuation in the amplitude of the field reference signal, providing a range-limited Doppler type signature of a field disturbance.

  6. Range gated strip proximity sensor

    DOEpatents

    McEwan, T.E.

    1996-12-03

    A range gated strip proximity sensor uses one set of sensor electronics and a distributed antenna or strip which extends along the perimeter to be sensed. A micro-power RF transmitter is coupled to the first end of the strip and transmits a sequence of RF pulses on the strip to produce a sensor field along the strip. A receiver is coupled to the second end of the strip, and generates a field reference signal in response to the sequence of pulse on the line combined with received electromagnetic energy from reflections in the field. The sensor signals comprise pulses of radio frequency signals having a duration of less than 10 nanoseconds, and a pulse repetition rate on the order of 1 to 10 MegaHertz or less. The duration of the radio frequency pulses is adjusted to control the range of the sensor. An RF detector feeds a filter capacitor in response to received pulses on the strip line to produce a field reference signal representing the average amplitude of the received pulses. When a received pulse is mixed with a received echo, the mixing causes a fluctuation in the amplitude of the field reference signal, providing a range-limited Doppler type signature of a field disturbance. 6 figs.

  7. Proximal Priority Laser Therapy: PPLT

    NASA Astrophysics Data System (ADS)

    Ohshiro, Toshio

    2004-09-01

    The author has, in the past, classified treatment methods for pain geometrically as point, line, two-dimensional, three-dimensional treatment and has used these over the years. However as a practitioner of western medicine, the author originally treated pain only directed at the painful site, and encountered cases where local treatment did not suffice. The author proved with SPECT and the Rand Phantom that treating the neck which is the midpoint of the brain, the center of the nervous system and the heart, the center of circulation, increased cerebral blood flow and also that laser emitted to neck will reach the spinal chord no matter from where on the neck the laser is emitted. From such research and 25 years of clinical experience, the author has created an anatomy based, systemic treatment method called the Proximal Priority Laser Therapy (PPLT) where not only the cerebral cortex, spinal chord and peripheral nerves are treated but also the tracts of blood vessels and lymph ducts are treated as well. Treatment method and cases are presented herein.

  8. Stand-alone remotely interrogated device for the real-time health monitoring of bonded structural repairs

    NASA Astrophysics Data System (ADS)

    Galea, Stephen C.; Powlesland, Ian G.; Baker, Alan A.

    1997-11-01

    Adhesively-bonded fiber reinforced composite patches have been used extensively, over the last two decades, on Royal Australian Air Force aircraft to repair fatigue-cracked metallic aircraft components. The bonded repair to the cracked structure - crack patching - allows the restoration of strength and stiffness to the structure, as well as slowing crack growth by reducing stress intensity. However, especially for repairs to critical components the bonded repair needs continuous health monitoring to ensure structural integrity is not compromised. The ultimate goal for very demanding repair applications is to incorporate sensor, actuators and electronics in repair systems - smart repair systems - to monitor and report on the health of the repair and the repaired structure, as well as to actuate in order to prevent damage or failure of the repaired structure. The initial focus in the development of smart repair systems is on the assessment of new sensors and instrumentation which may be incorporate in bonded repair system in order to achieve on-line measurement of patch integrity and effectiveness. This application would allow the operator to move away from current costly time-based maintenance procedures toward real-time health condition monitoring of the bonded repair and the repaired structure. These systems would allow timely decisions on preventative and schedule maintenance before failure of the repair or repaired structure. To this end a 'stand-alone' data logger device, for the real-time health monitoring of bonded repaired system, which is in lose proximity to sensors on a repair is being developed. The instrumentation will measure, process and store sensor measurements during flight and then allow this data to be down loaded, after the flight, onto a PC, via remote data access.

  9. Proximal Participation: A Pathway into Work

    ERIC Educational Resources Information Center

    Chan, Selena

    2013-01-01

    In a longitudinal case study of apprentices, the term proximal participation was coined to describe the entry process of young people, with unclear career destinations, into the trade of baking. This article unravels the significance of proximal participation in the decision-making processes of young people who enter a trade through initial

  10. Proximate Sources of Collective Teacher Efficacy

    ERIC Educational Resources Information Center

    Adams, Curt M.; Forsyth, Patrick B.

    2006-01-01

    Purpose: Recent scholarship has augmented Bandura's theory underlying efficacy formation by pointing to more proximate sources of efficacy information involved in forming collective teacher efficacy. These proximate sources of efficacy information theoretically shape a teacher's perception of the teaching context, operationalizing the difficulty

  11. Proximal Participation: A Pathway into Work

    ERIC Educational Resources Information Center

    Chan, Selena

    2013-01-01

    In a longitudinal case study of apprentices, the term proximal participation was coined to describe the entry process of young people, with unclear career destinations, into the trade of baking. This article unravels the significance of proximal participation in the decision-making processes of young people who enter a trade through initial…

  12. Proximate Sources of Collective Teacher Efficacy

    ERIC Educational Resources Information Center

    Adams, Curt M.; Forsyth, Patrick B.

    2006-01-01

    Purpose: Recent scholarship has augmented Bandura's theory underlying efficacy formation by pointing to more proximate sources of efficacy information involved in forming collective teacher efficacy. These proximate sources of efficacy information theoretically shape a teacher's perception of the teaching context, operationalizing the difficulty…

  13. Intramedullary compression device for proximal ulna fracture

    PubMed Central

    Hong, Choon Chiet; Han, Fucai; Decruz, Joshua; Pannirselvam, Vinodhkumar; Murphy, Diarmuid

    2015-01-01

    Proximal ulna fractures account for 20% of all proximal forearm fractures. Many treatment options are available for such fractures, such as cast immobilisation, plate and screw fixation, tension band wiring and intramedullary screw fixation, depending on the fracture pattern. Due to the subcutaneous nature of the proximal forearm, it is vulnerable to open injuries over the dorsal aspect of the proximal ulna. This may in turn prove challenging, as it is critical to obtain adequate soft tissue coverage to reduce the risk of implant exposure and bony infections. We herein describe a patient with a Gustillo III-B open fracture of the proximal ulna, treated with minimally invasive intramedullary screw fixation using a 6.0-mm cannulated headless titanium compression screw (FusiFIX, Pronnas, France). PMID:25715859

  14. LCD testing and repair

    NASA Astrophysics Data System (ADS)

    Waters, Rodney L.; Pothoven, Floyd R.; Branst, Lee

    1994-04-01

    Active-matrix liquid crystal displays (AMLCD) have come into increasing use in a variety of applications. As the size of the displays has gotten larger, their proper testing and repair has become critical. Quite simply, it is too costly to discard displays that fail to pass initial tests. Schemes have been devised that test AMLCDs as to whether they are operating or not, i.e., test that merely indicate whether the display will work, or not, once it is assembled. That is no longer enough. Manufacturers must know why a device is inoperable and whether it can be repaired. Since AMLCDs are basically large integrated circuits, a number of test and repair techniques have been borrowed from the semiconductor industry. This paper describes a method by which AMLCDs, especially large area devices, can be tested and repaired. This method primarily involves the incorporation of electrical probing to test individual lines and pixels. Once the defects have been located, lasers are used to effect the required repairs via material removal and deposition.

  15. Base Excision Repair

    PubMed Central

    Krokan, Hans E.; Bjrs, Magnar

    2013-01-01

    Base excision repair (BER) corrects DNA damage from oxidation, deamination and alkylation. Such base lesions cause little distortion to the DNA helix structure. BER is initiated by a DNA glycosylase that recognizes and removes the damaged base, leaving an abasic site that is further processed by short-patch repair or long-patch repair that largely uses different proteins to complete BER. At least 11 distinct mammalian DNA glycosylases are known, each recognizing a few related lesions, frequently with some overlap in specificities. Impressively, the damaged bases are rapidly identified in a vast excess of normal bases, without a supply of energy. BER protects against cancer, aging, and neurodegeneration and takes place both in nuclei and mitochondria. More recently, an important role of uracil-DNA glycosylase UNG2 in adaptive immunity was revealed. Furthermore, other DNA glycosylases may have important roles in epigenetics, thus expanding the repertoire of BER proteins. PMID:23545420

  16. Chromosome Synapsis Alleviates Mek1-Dependent Suppression of Meiotic DNA Repair.

    PubMed

    Subramanian, Vijayalakshmi V; MacQueen, Amy J; Vader, Gerben; Shinohara, Miki; Sanchez, Aurore; Borde, Valrie; Shinohara, Akira; Hochwagen, Andreas

    2016-02-01

    Faithful meiotic chromosome segregation and fertility require meiotic recombination between homologous chromosomes rather than the equally available sister chromatid, a bias that in Saccharomyces cerevisiae depends on the meiotic kinase, Mek1. Mek1 is thought to mediate repair template bias by specifically suppressing sister-directed repair. Instead, we found that when Mek1 persists on closely paired (synapsed) homologues, DNA repair is severely delayed, suggesting that Mek1 suppresses any proximal repair template. Accordingly, Mek1 is excluded from synapsed homologues in wild-type cells. Exclusion requires the AAA+-ATPase Pch2 and is directly coupled to synaptonemal complex assembly. Stage-specific depletion experiments further demonstrate that DNA repair in the context of synapsed homologues requires Rad54, a repair factor inhibited by Mek1. These data indicate that the sister template is distinguished from the homologue primarily by its closer proximity to inhibitory Mek1 activity. We propose that once pairing or synapsis juxtaposes homologues, exclusion of Mek1 is necessary to avoid suppression of all templates and accelerate repair progression. PMID:26870961

  17. Chromosome Synapsis Alleviates Mek1-Dependent Suppression of Meiotic DNA Repair

    PubMed Central

    Subramanian, Vijayalakshmi V.; MacQueen, Amy J.; Vader, Gerben; Shinohara, Miki; Sanchez, Aurore; Borde, Valérie; Shinohara, Akira; Hochwagen, Andreas

    2016-01-01

    Faithful meiotic chromosome segregation and fertility require meiotic recombination between homologous chromosomes rather than the equally available sister chromatid, a bias that in Saccharomyces cerevisiae depends on the meiotic kinase, Mek1. Mek1 is thought to mediate repair template bias by specifically suppressing sister-directed repair. Instead, we found that when Mek1 persists on closely paired (synapsed) homologues, DNA repair is severely delayed, suggesting that Mek1 suppresses any proximal repair template. Accordingly, Mek1 is excluded from synapsed homologues in wild-type cells. Exclusion requires the AAA+-ATPase Pch2 and is directly coupled to synaptonemal complex assembly. Stage-specific depletion experiments further demonstrate that DNA repair in the context of synapsed homologues requires Rad54, a repair factor inhibited by Mek1. These data indicate that the sister template is distinguished from the homologue primarily by its closer proximity to inhibitory Mek1 activity. We propose that once pairing or synapsis juxtaposes homologues, exclusion of Mek1 is necessary to avoid suppression of all templates and accelerate repair progression. PMID:26870961

  18. Rescheduling with iterative repair

    NASA Technical Reports Server (NTRS)

    Zweben, Monte; Davis, Eugene; Daun, Brian; Deale, Michael

    1992-01-01

    This paper presents a new approach to rescheduling called constraint-based iterative repair. This approach gives our system the ability to satisfy domain constraints, address optimization concerns, minimize perturbation to the original schedule, produce modified schedules, quickly, and exhibits 'anytime' behavior. The system begins with an initial, flawed schedule and then iteratively repairs constraint violations until a conflict-free schedule is produced. In an empirical demonstration, we vary the importance of minimizing perturbation and report how fast the system is able to resolve conflicts in a given time bound. We also show the anytime characteristics of the system. These experiments were performed within the domain of Space Shuttle ground processing.

  19. Rescheduling with iterative repair

    NASA Technical Reports Server (NTRS)

    Zweben, Monte; Davis, Eugene; Daun, Brian; Deale, Michael

    1992-01-01

    This paper presents a new approach to rescheduling called constraint-based iterative repair. This approach gives our system the ability to satisfy domain constraints, address optimization concerns, minimize perturbation to the original schedule, and produce modified schedules quickly. The system begins with an initial, flawed schedule and then iteratively repairs constraint violations until a conflict-free schedule is produced. In an empirical demonstration, we vary the importance of minimizing perturbation and report how fast the system is able to resolve conflicts in a given time bound. These experiments were performed within the domain of Space Shuttle ground processing.

  20. Satellite Repair Program

    NASA Technical Reports Server (NTRS)

    Davis, Robert E.

    1991-01-01

    NASA-Goddard's Satellite Repair Program counts among its major achievements the successful use of welding in servicing equipment employed in the Flight Support System (FSS) structures addressed by the the Solar Maximum Repair Mission of 1984. The FSS berthing and positioning ring will again be employed with the Space Shuttle for the anticipated upgrading of the Hubble Space Telescope; the Explorer Platform (EP) mission will also use the FSS during the planned on-orbit exchange of the EUV Explorer payload for an X-ray Timing Explorer payload. The EP, to which attention is presently given, is the first spacecraft designed to be entirely serviceable by intravehicular activity or EVA.

  1. Satellite Repair Program

    NASA Astrophysics Data System (ADS)

    Davis, Robert E.

    NASA-Goddard's Satellite Repair Program counts among its major achievements the successful use of welding in servicing equipment employed in the Flight Support System (FSS) structures addressed by the the Solar Maximum Repair Mission of 1984. The FSS berthing and positioning ring will again be employed with the Space Shuttle for the anticipated upgrading of the Hubble Space Telescope; the Explorer Platform (EP) mission will also use the FSS during the planned on-orbit exchange of the EUV Explorer payload for an X-ray Timing Explorer payload. The EP, to which attention is presently given, is the first spacecraft designed to be entirely serviceable by intravehicular activity or EVA.

  2. Pectus excavatum repair - series (image)

    MedlinePLUS

    Repair of pectus excavatum may be recommended for: improved appearance (cosmetic repair) improved breathing (respiratory function) ... are removed 6 months later through a small skin incision under the arm. This procedure is usually ...

  3. Aortic aneurysm repair - endovascular - discharge

    MedlinePLUS

    ... term outcome of open or endovascular repair of abdominal aortic aneurysm. N Engl J Med . 2010 May 20;362( ... 20484396 . Greenhalgh RM, Powell JT. Endovascular repair of abdominal aortic aneurysm. N Engl J Med . 2008 Jan 31;358( ...

  4. Bone fracture repair - series (image)

    MedlinePLUS

    ... repair the fracture-frequently, metal rods, screws or plates are used to repair the bone, and remain ... placed in proper position and screws, pins, or plates are attached to or in the bone temporarily ...

  5. Electric motor model repair specifications

    SciTech Connect

    1995-08-01

    These model repair specifications list the minimum requirements for repair and overhaul of polyphase AC squireel cage induction motors. All power ranges, voltages, and speeds of squirrel cage motors are covered.

  6. Promoting proximal formative assessment with relational discourse

    NASA Astrophysics Data System (ADS)

    Scherr, Rachel E.; Close, Hunter G.; McKagan, Sarah B.

    2012-02-01

    The practice of proximal formative assessment - the continual, responsive attention to students' developing understanding as it is expressed in real time - depends on students' sharing their ideas with instructors and on teachers' attending to them. Rogerian psychology presents an account of the conditions under which proximal formative assessment may be promoted or inhibited: (1) Normal classroom conditions, characterized by evaluation and attention to learning targets, may present threats to students' sense of their own competence and value, causing them to conceal their ideas and reducing the potential for proximal formative assessment. (2) In contrast, discourse patterns characterized by positive anticipation and attention to learner ideas increase the potential for proximal formative assessment and promote self-directed learning. We present an analysis methodology based on these principles and demonstrate its utility for understanding episodes of university physics instruction.

  7. Effect of Delayed Peripheral Nerve Repair on Nerve Regeneration, Schwann Cell Function and Target Muscle Recovery

    PubMed Central

    Jonsson, Samuel; Wiberg, Rebecca; McGrath, Aleksandra M.; Novikov, Lev N.; Wiberg, Mikael; Novikova, Liudmila N.; Kingham, Paul J.

    2013-01-01

    Despite advances in surgical techniques for peripheral nerve repair, functional restitution remains incomplete. The timing of surgery is one factor influencing the extent of recovery but it is not yet clearly defined how long a delay may be tolerated before repair becomes futile. In this study, rats underwent sciatic nerve transection before immediate (0) or 1, 3, or 6 months delayed repair with a nerve graft. Regeneration of spinal motoneurons, 13 weeks after nerve repair, was assessed using retrograde labeling. Nerve tissue was also collected from the proximal and distal stumps and from the nerve graft, together with the medial gastrocnemius (MG) muscles. A dramatic decline in the number of regenerating motoneurons and myelinated axons in the distal nerve stump was observed in the 3- and 6-months delayed groups. After 3 months delay, the axonal number in the proximal stump increased 2–3 folds, accompanied by a smaller axonal area. RT-PCR of distal nerve segments revealed a decline in Schwann cells (SC) markers, most notably in the 3 and 6 month delayed repair samples. There was also a progressive increase in fibrosis and proteoglycan scar markers in the distal nerve with increased delayed repair time. The yield of SC isolated from the distal nerve segments progressively fell with increased delay in repair time but cultured SC from all groups proliferated at similar rates. MG muscle at 3- and 6-months delay repair showed a significant decline in weight (61% and 27% compared with contra-lateral side). Muscle fiber atrophy and changes to neuromuscular junctions were observed with increased delayed repair time suggestive of progressively impaired reinnervation. This study demonstrates that one of the main limiting factors for nerve regeneration after delayed repair is the distal stump. The critical time point after which the outcome of regeneration becomes too poor appears to be 3-months. PMID:23409189

  8. Factors influencing proximal dental contact strengths.

    PubMed

    Drfer, C E; von Bethlenfalvy, E R; Staehle, H J; Pioch, T

    2000-10-01

    The aim of this study was to systematically measure proximal contact strength in complete natural dentitions of 30 adults (25.3 +/- 3.0 years of age), and to analyze its relationship to tooth type, tooth location, chewing effort and time of day variation. The contact strengths were measured dynamically during removal of a calibrated 0.05-mm-thick metal strip between the proximal contacts of adjacent teeth. Proximal contact strengths were lower in the maxilla (2.51 +/- 1.36 N) compared to the mandible (4.26 +/- 1.88 N). Within the jaws, the lowest proximal contact strength was measured between canine and first premolar (2.91 +/- 1.79 N) and the highest between second premolar and first molar (3.73 +/- 1.95 N). Chewing increased the proximal contact strength within the maxilla (before: 2.51 +/- 1.36 N, after: 3.02 +/- 1.45 N) but it remained unchanged in the mandible (before: 4.26 +/- 1.88 N, after: 4.22 +/- 1.85 N). The proximal contact strength increased significantly from morning (3.39 +/- 1.86 N) to noon (3.61 +/- 1.77 N), and then decreased in the afternoon (3.43 +/- 1.60 N). It was concluded that proximal contact strength can be significantly influenced by location, tooth type, chewing and time of day variation. Based on the differences in distribution due to the effect of chewing and time of day, it is speculated that proximal contact strength is a physiological entity of multifactorial origin. PMID:11037752

  9. Fractures of the proximal tibial epiphysis.

    PubMed

    Burkhart, S S; Peterson, H A

    1979-10-01

    Fractures of the proximal tibial epiphysis are rare. A series of twenty-eight fractures classified according to the Salter-Harris method showed that nine were Type II and eight, Type IV. Lawn-mower injuries, a previously unreported mode of injury for this fracture, caused five of the eight Type-IV fractures and were associated with the worst prognosis by far. Two Type-V fractures in the proximal tibial epiphysis, previously unreported, are described. PMID:489664

  10. [Proximity, intimacy and promiscuity in care].

    PubMed

    Flicourt, Nadia

    2015-04-01

    Lying at the heart of the intimacy of the other person, the nature of care supposes that the caregiver identifies the components resulting from the proximity and the invasion of the patient's personal space, where perceptions and representations give rise to reactive emotions and behaviour. Between modesty and nudity, proximity and promiscuity, caregivers have to adjust their approach of proper care, limiting the risks of intrusion. PMID:26043630

  11. Laboratory For Telerobotic Repair

    NASA Technical Reports Server (NTRS)

    Fiorini, Paolo; Bejczy, Antal K.; Das, Hari; Zak, Haya

    1993-01-01

    Laboratory telerobotic system performs such complicated tasks as picking up tools, removing thermal blanket, and replacing screws. Human operator in control room operates remote robot with aid of video monitors, torque and force displays, and force feedback. System used to perform research and to develop telerobotic-repair capabilities equal to those of human operator.

  12. Repairing damaged platforms

    SciTech Connect

    Moore, R.E.; Kwok, P.H.; Wang, S.S.

    1995-10-01

    This paper introduces a unique method for strengthening of platforms and replacing damaged members. Extending the life of existing infrastructure is approved means of decreasing cash expenditures for new platforms and facilities. Platforms can be affected by corrosion, overloading and fatigue. The renovation and repair of existing offshore installations is an important part of offshore engineering. The basis behind this paper is an April, 1993 incident in the Arabian Gulf. A vessel broke loose from its moorings in a severe storm and collided with a wellhead platform. The collision severely damaged the platform buckling seven major support members and cracking joints throughout the structure. In view of the significant damage, there was an urgent need to repair the structure to avoid any further damage from potentially sever winter storm conditions. Various means of repair and their associated costs were evaluated: traditional dry hyperbaric welding, adjacent platforms, grouted clamped connections, and mechanical pipe connectors. The repair was completed using an innovative combination of clamps and wet welding to attach external braces to the structure.

  13. Laparoscopic paraesophageal hernia repair.

    PubMed

    Morrow, Ellen H; Oelschlager, Brant K

    2013-10-01

    Laparoscopic paraesophageal hernia repair is an operation that allows for relief of gastrointestinal and respiratory symptoms with a minimal recovery time and a high degree of satisfaction. It is a difficult and complex operation; however, if the important tenets are adhered to by surgeons with a lot of experience in laparoscopic PEH repair, the results are good. Patient selection is important. Older or frail patients who are asymptomatic should not have an operation, and some who are very symptomatic should probably consider just a reduction of their gastric volvulus and gastropexy. Still, most of the patients will be symptomatic and will be able to tolerate a laparoscopic definitive repair. The important aspects of repair include: complete resection of the hernia sac from the mediastinum, adequate esophageal mobilization, adequate closure of the hiatus, and fundoplication. The most troublesome aspect of the operation is the recurrence rate, which is up to 50% at 5 years of follow-up. Fortunately, most recurrences are asymptomatic and the vast majority of patients still have greatly improved quality of life. PMID:24105283

  14. Aircraft Propeller Hub Repair

    SciTech Connect

    Muth, Thomas R.; Peter, William H.

    2015-02-13

    The team performed a literature review, conducted residual stress measurements, performed failure analysis, and demonstrated a solid state additive manufacturing repair technique on samples removed from a scrapped propeller hub. The team evaluated multiple options for hub repair that included existing metal buildup technologies that the Federal Aviation Administration (FAA) has already embraced, such as cold spray, high velocity oxy-fuel deposition (HVOF), and plasma spray. In addition the team helped Piedmont Propulsion Systems, LLC (PPS) evaluate three potential solutions that could be deployed at different stages in the life cycle of aluminum alloy hubs, in addition to the conventional spray coating method for repair. For new hubs, a machining practice to prevent fretting with the steel drive shaft was recommended. For hubs that were refurbished with some material remaining above the minimal material condition (MMC), a silver interface applied by an electromagnetic pulse additive manufacturing method was recommended. For hubs that were at or below the MMC, a solid state additive manufacturing technique using ultrasonic welding (UW) of thin layers of 7075 aluminum to the hub interface was recommended. A cladding demonstration using the UW technique achieved mechanical bonding of the layers showing promise as a viable repair method.

  15. Repairs In Space

    NASA Technical Reports Server (NTRS)

    Covault, Craig

    2005-01-01

    Four thermal protection repair technologies will be carried by the STS-114 mission on Discovery when the space shuttle program resumes flights as early as mid-May. Three of the concepts will be tested in orbit and the fourth kept in reserve.

  16. Comprehensive Small Engine Repair.

    ERIC Educational Resources Information Center

    Hires, Bill; And Others

    This curriculum guide contains the basic information needed to repair all two- and four-stroke cycle engines. The curriculum covers four areas, each consisting of one or more units of instruction that include performance objectives, suggested activities for teacher and students, information sheets, assignment sheets, job sheets, visual aids,

  17. Basic Book Repair Methods.

    ERIC Educational Resources Information Center

    Schechter, Abraham A.

    This book addresses some common preservation techniques that invariably become necessary in library and archival collections of any size. The procedures are described in chronological sequence, and photographs show the techniques from the viewpoint of the person actually doing the work. The recommended repair methods can be accomplished using

  18. Basic Book Repair Methods.

    ERIC Educational Resources Information Center

    Schechter, Abraham A.

    This book addresses some common preservation techniques that invariably become necessary in library and archival collections of any size. The procedures are described in chronological sequence, and photographs show the techniques from the viewpoint of the person actually doing the work. The recommended repair methods can be accomplished using…

  19. Auto Repair Gets Technical.

    ERIC Educational Resources Information Center

    Steiger, Jim; Shoemaker, Byrl

    1989-01-01

    Rapid advances in automotive technology and the growth of the automotive service industry have created opportunities in car repair, parts supply, and body work. Certification is the best way for vocational educators to ensure that their programs prepare students for work in the automotive industry. (JOW)

  20. Automotive Body Repair Competencies.

    ERIC Educational Resources Information Center

    D'Armond, Jack; And Others

    Designed to provide a model curriculum and guidelines, this manual presents tasks that were identified by employers, employees, and teachers as important in a postsecondary auto body repair curriculum. The tasks are divided into ten major component areas of instruction: metalworking and fiberglass, painting, frame and suspension, glass and trim,…

  1. Automotive Body Repair Competencies.

    ERIC Educational Resources Information Center

    D'Armond, Jack; And Others

    Designed to provide a model curriculum and guidelines, this manual presents tasks that were identified by employers, employees, and teachers as important in a postsecondary auto body repair curriculum. The tasks are divided into ten major component areas of instruction: metalworking and fiberglass, painting, frame and suspension, glass and trim,

  2. Weld overlay repairs

    SciTech Connect

    Newton, B.R.

    1995-12-31

    Microbiologically Influenced Corrosion (MIC) has become a significant threat to the operability of many nuclear generating stations in the United States. The primary adverse effects of MIC are experienced in moderate energy systems (i.e., systems with maximum operating pressure {<=} 275 psig or maximum operating temperature {<=} 200 F) which provide service water for cooling of plant systems and components. Many plants use carbon steel piping (SA-106 Grade B) for the majority of their service water applications, and this piping material is susceptible to NHC attack. The configuration of NRC-related damage varies from localized pitting to general thinning. Discovery of NRC damage frequently occurs when leakage is observed at a through-wall pit. This leakage usually occurs while the plant is on-line, raising immediate NRC concerns regarding system operability--concerns which must be addressed within the confines of a Technical Specification action statement, typically 72 hours. If the piping damage is not addressed or corrected within this limited time frame, the plant must be shut down until corrective actions are completed. Code rules addressing repair of pipe wall thinning are being developed by the ASME Section 11 Task Group on Alternate Repair for Erosion and Corrosion. In conjunction with this Task Group, several test coupons have been developed to provide for analysis of weld overlay repairs. The resulting test data, as well as information available from other industry sources, is being used by the Task Group to develop Code rules that will address weld overlay repairs.

  3. Sutured tendon repair; a multi-scale finite element model.

    PubMed

    Rawson, Shelley D; Margetts, Lee; Wong, Jason K F; Cartmell, Sarah H

    2015-01-01

    Following rupture, tendons are sutured to reapproximate the severed ends and permit healing. Several repair techniques are employed clinically, with recent focus towards high-strength sutures, permitting early active mobilisation thus improving resultant joint mobility. However, the arrangement of suture repairs locally alters the loading environment experienced by the tendon. The extent of the augmented stress distribution and its effect on the tissue is unknown. Stress distribution cannot be established using traditional tensile testing, in vivo, or ex vivo study of suture repairs. We have developed a 3D finite element model of a Kessler suture repair employing multiscale modelling to represent tendon microstructure and incorporate its highly orthotropic behaviour into the tissue description. This was informed by ex vivo tensile testing of porcine flexor digitorum profundus tendon. The transverse modulus of the tendon was 0.2551 0.0818 MPa and 0.1035 0.0454 MPa in proximal and distal tendon samples, respectively, and the interfibrillar tissue modulus ranged from 0.1021 to 0.0416 MPa. We observed an elliptically shaped region of high stress around the suture anchor, consistent with a known region of acellularity which develop 72 h post-operatively and remain for at least a year. We also observed a stress shielded region close to the severed tendon ends, which may impair collagen fibre realignment during the remodelling stage of repair due to the lack of tensile stress. PMID:24840732

  4. Molecular basis of proximal renal tubular acidosis.

    PubMed

    Igarashi, Takashi; Sekine, Takashi; Watanabe, Hiroshi

    2002-01-01

    Proximal renal tubular acidosis (pRTA) results from an impairment of bicarbonate (HCO3-) reabsorption in the renal proximal tubules, characterized by a decreased HCO3- threshold. pRTA commonly occurs as a manifestation of a generalized functional defect in proximal tubules. In contrast, pRTA can occur without other functional defects in proximal tubules (isolated pRTA). Most of the isolated pRTA in children are hereditary. Recent progress in molecular biological analyses is unraveling the molecular basis of hereditary pRTA. Mutations in the kidney type Na+/HCO3- cotransporter gene (SLC4A4) cause permanent isolated proximal RTA with ocular abnormalities. Mutations in carbonic anhydrase II gene lead to osteopetrosis, RTA (pRTA, distal RTA or combined proximal and distal RTA), cerebral calcification, and mental retardation. SLC9A3, encoding the Na+/H+ exchanger, is a candidate gene for pRTA without other manifestations. These results help further understand the molecular basis of hereditary pRTA and characterize the clinical and genetic manifestations of the disorder. PMID:12027212

  5. Proximity sensor system development. CRADA final report

    SciTech Connect

    Haley, D.C.; Pigoski, T.M.

    1998-01-01

    Lockheed Martin Energy Research Corporation (LMERC) and Merritt Systems, Inc. (MSI) entered into a Cooperative Research and Development Agreement (CRADA) for the development and demonstration of a compact, modular proximity sensing system suitable for application to a wide class of manipulator systems operated in support of environmental restoration and waste management activities. In teleoperated modes, proximity sensing provides the manipulator operator continuous information regarding the proximity of the manipulator to objects in the workspace. In teleoperated and robotic modes, proximity sensing provides added safety through the implementation of active whole arm collision avoidance capabilities. Oak Ridge National Laboratory (ORNL), managed by LMERC for the United States Department of Energy (DOE), has developed an application specific integrated circuit (ASIC) design for the electronics required to support a modular whole arm proximity sensing system based on the use of capacitive sensors developed at Sandia National Laboratories. The use of ASIC technology greatly reduces the size of the electronics required to support the selected sensor types allowing deployment of many small sensor nodes over a large area of the manipulator surface to provide maximum sensor coverage. The ASIC design also provides a communication interface to support sensor commands from and sensor data transmission to a distributed processing system which allows modular implementation and operation of the sensor system. MSI is a commercial small business specializing in proximity sensing systems based upon infrared and acoustic sensors.

  6. Concomitant Posterior Hip Dislocation, Ipsilateral Intertrochanteric- and Proximal Tibial- Fractures with Popliteal Artery Injury: A Challenging Trauma Mélange

    PubMed Central

    Chotai, Pranit N.; Hart, Ryan; Wassef, Andrew

    2015-01-01

    Constellation of ipsilateral posterior hip dislocation, intertrochanteric- and proximal tibial fracture with popliteal artery injury is rare. Management of this presentation is challenging. A motor vehicle accident victim presented with these injuries, but without any initial signs of vascular compromise. Popliteal artery injury was diagnosed intra-operatively and repaired. This was followed by external fixation of tibial fracture, open reduction of dislocated hip and internal fixation of intertrochanteric fracture. Patient regained bilateral complete weight bearing and returned to pre-accident activity level. Apt surgical management including early repair of vascular injury in such a trauma mélange allows for a positive postoperative outcome. PMID:26918095

  7. Lawn and Garden Equipment Repair.

    ERIC Educational Resources Information Center

    Hardway, Jack; And Others

    This publication is designed to supplement the Comprehensive Small Engine Rapair guide by covering in detail all aspects of lawn and garden equipment repair not included in general engine repair or the repair of other small engines. It consists of instructional materials for both teachers and students, written in terms of student performance using

  8. Automotive Engine Maintenance and Repair.

    ERIC Educational Resources Information Center

    Marine Corps Inst., Washington, DC.

    This correspondence course, originally developed for the Marine Corps, is designed to provide students with an understanding of automotive engine maintenance and repair. The course contains six study units covering automotive engine maintenance and repair; design classification; engine malfunction, diagnosis, and repair; engine disassembly; engine

  9. Percutaneous correction of second toe proximal deformity: Proximal interphalangeal release, flexor digitorum brevis tenotomy and proximal phalanx osteotomy.

    PubMed

    Frey, S; Hlix-Giordanino, M; Piclet-Legr, B

    2015-10-01

    We report the results of a percutaneous technique to correct a proximal plantar flexion deformity of the second toe that combines several procedures: tenotomy of the Flexor Digitorum Brevis, plantar capsulotomy for release of the proximal interphalangeal joint and proximal phalangeal osteotomy. The goal of these procedures is to improve anatomical correction and preserve articular range of motion. From 2009 to 2011, 54 patients, mean age 64.4 years old (43-81) underwent surgery for a proximal deformity of the second toe. Associated tenotomy of the extensor digitorum longus and brevis was performed in the presence of an extension deformity of the metatarsophalangeal joint (24 cases). After a mean follow-up of 30.7 8.9 months, the rate of satisfaction and morphological correction was high (89.5% in both cases), as well as the number of flexible toes (88%). Active plantar flexion was preserved in 86% of the cases. This seems to be an effective technique to correct proximal plantar flexion deformity of the second toe, while preserving active plantar flexion. PMID:26321465

  10. Complications of Distal Biceps Repair.

    PubMed

    Garon, Mark Tyson; Greenberg, Jeffrey A

    2016-04-01

    Modern techniques to repair the distal biceps tendon include one-incision and 2-incision techniques that use transosseous sutures, suture anchors, interference screws, and/or cortical buttons to achieve a strong repair of the distal biceps brachii. Repair using these techniques has led to improved functional outcomes when compared with nonoperative treatment. Most complications consist of neuropraxic injuries to the lateral antebrachial cutaneous nerve, posterior interosseous nerve, stiffness and weakness with forearm rotation, heterotopic ossification, and wound infections. Although complications certainly affect outcomes, patients with distal biceps repairs report a high satisfaction rate after repair. PMID:26772952

  11. Minimally Invasive Spigelian Hernia Repair

    PubMed Central

    Baucom, Catherine; Nguyen, Quan D.; Hidalgo, Marco

    2009-01-01

    Introduction: Spigelian hernia is an uncommon ventral hernia characterized by a defect in the linea semilunaris. Repair of spigelian hernia has traditionally been accomplished via an open transverse incision and primary repair. The purpose of this article is to present 2 case reports of incarcerated spigelian hernia that were successfully repaired laparoscopically using Gortex mesh and to present a review of the literature regarding laparoscopic repair of spigelian hernias. Methods: Retrospective chart review and Medline literature search. Results: Two patients underwent laparoscopic mesh repair of incarcerated spigelian hernias. Both were started on a regular diet on postoperative day 1 and discharged on postoperative days 2 and 3. One patient developed a seroma that resolved without intervention. There was complete resolution of preoperative symptoms at the 12-month follow-up. Conclusion: Minimally invasive repair of spigelian hernias is an alternative to the traditional open surgical technique. Further studies are needed to directly compare the open and the laparoscopic repair. PMID:19660230

  12. Gene Therapy for Cartilage Repair

    PubMed Central

    Madry, Henning; Orth, Patrick; Cucchiarini, Magali

    2011-01-01

    The concept of using gene transfer strategies for cartilage repair originates from the idea of transferring genes encoding therapeutic factors into the repair tissue, resulting in a temporarily and spatially defined delivery of therapeutic molecules to sites of cartilage damage. This review focuses on the potential benefits of using gene therapy approaches for the repair of articular cartilage and meniscal fibrocartilage, including articular cartilage defects resulting from acute trauma, osteochondritis dissecans, osteonecrosis, and osteoarthritis. Possible applications for meniscal repair comprise meniscal lesions, meniscal sutures, and meniscal transplantation. Recent studies in both small and large animal models have demonstrated the applicability of gene-based approaches for cartilage repair. Chondrogenic pathways were stimulated in the repair tissue and in osteoarthritic cartilage using genes for polypeptide growth factors and transcription factors. Although encouraging data have been generated, a successful translation of gene therapy for cartilage repair will require an ongoing combined effort of orthopedic surgeons and of basic scientists. PMID:26069580

  13. Prokaryotic Nucleotide Excision Repair

    PubMed Central

    Kisker, Caroline; Kuper, Jochen; Van Houten, Bennett

    2013-01-01

    Nucleotide excision repair (NER) has allowed bacteria to flourish in many different niches around the globe that inflict harsh environmental damage to their genetic material. NER is remarkable because of its diverse substrate repertoire, which differs greatly in chemical composition and structure. Recent advances in structural biology and single-molecule studies have given great insight into the structure and function of NER components. This ensemble of proteins orchestrates faithful removal of toxic DNA lesions through a multistep process. The damaged nucleotide is recognized by dynamic probing of the DNA structure that is then verified and marked for dual incisions followed by excision of the damage and surrounding nucleotides. The opposite DNA strand serves as a template for repair, which is completed after resynthesis and ligation. PMID:23457260

  14. Histomorphometric changes in repaired mouse sciatic nerves are unaffected by the application of a scar-reducing agent

    PubMed Central

    Ngeow, Wei Cheong; Atkins, Simon; Morgan, Claire R; Metcalfe, Anthony D; Boissonade, Fiona M; Loescher, Alison R; Robinson, Peter P

    2011-01-01

    Microsurgical repair of transected peripheral nerves is compromised by the formation of scar tissue and the development of a neuroma, thereby limiting the success of regeneration. The aim of this study was to quantify histomorphometrically the structural changes in neural tissue that result from repair, and determine the effect of mannose-6-phosphate (M6P), a scar-reducing agent previously shown to enhance regeneration. In anaesthetised C57-black-6 mice, the left sciatic nerve was sectioned and repaired using four epineurial sutures. Either 100 ?L of 600 mm M6P (five animals) or 100 ?L of phosphate-buffered saline (placebo controls, five animals) was injected into and around the nerve repair site. A further group acted as sham-operated controls. After recovery for 6 weeks, the nerve was harvested for analysis using light and electron microscopy. Analysis revealed that when compared with sham controls, myelinated axons had smaller diameters both proximal and distal to the repair. Myelinated axon counts, axonal density and size all decreased across the repair site. There were normal numbers and densities of non-myelinated axons both proximal and distal to the repair. However, there were more Remak bundles distal to the repair site, and fewer non-myelinated axons per Remak bundle. Application of M6P did not affect any of these parameters. PMID:21812777

  15. Histomorphometric changes in repaired mouse sciatic nerves are unaffected by the application of a scar-reducing agent.

    PubMed

    Ngeow, Wei Cheong; Atkins, Simon; Morgan, Claire R; Metcalfe, Anthony D; Boissonade, Fiona M; Loescher, Alison R; Robinson, Peter P

    2011-11-01

    Microsurgical repair of transected peripheral nerves is compromised by the formation of scar tissue and the development of a neuroma, thereby limiting the success of regeneration. The aim of this study was to quantify histomorphometrically the structural changes in neural tissue that result from repair, and determine the effect of mannose-6-phosphate (M6P), a scar-reducing agent previously shown to enhance regeneration. In anaesthetised C57-black-6 mice, the left sciatic nerve was sectioned and repaired using four epineurial sutures. Either 100 ?L of 600 mm M6P (five animals) or 100 ?L of phosphate-buffered saline (placebo controls, five animals) was injected into and around the nerve repair site. A further group acted as sham-operated controls. After recovery for 6 weeks, the nerve was harvested for analysis using light and electron microscopy. Analysis revealed that when compared with sham controls, myelinated axons had smaller diameters both proximal and distal to the repair. Myelinated axon counts, axonal density and size all decreased across the repair site. There were normal numbers and densities of non-myelinated axons both proximal and distal to the repair. However, there were more Remak bundles distal to the repair site, and fewer non-myelinated axons per Remak bundle. Application of M6P did not affect any of these parameters. PMID:21812777

  16. Repairing damaged structures

    SciTech Connect

    Perano, A.C.

    1980-08-01

    While Grace Platform was being installed, damage was sustained to jacket members, varying from metal rubbing to denting and puncturing by a falling section of pile follower. Because the 12-legged jacket is in a water depth in excess of 300 ft it was necessary to use a remote controlled vehicle in order to establish a preliminary damage report to determine whether the structural integrity of the jacket with the damaged braces required repair, reinforcing, removal, or just to be left as they were. From information gathered on videotapes, it was possible to direct the divers to all questionable areas and to study each in detail. From the sketches, photographs and accompanying report, there was sufficient information and data for the designers of the platform to conduct an investigation and analysis of the areas in question. The analysis was performed using storm and seismic loading conditions. The results obtained determined damaged members. All parties concerned with the damage investigation agreed upon which structures needed to be repaired and under what conditions the repairs would take place.

  17. Proximal sano anastomosis aneurysm due to degeneration of bovine pericardial patch.

    PubMed

    ElZein, Chawki; Subramanian, Sujata; Roberson, David; Husayni, Tarek; Polimenakos, Anastasios; Ilbawi, Michel

    2012-09-01

    We report a 5-year-old girl with hypoplastic left heart syndrome who originally underwent a Norwood procedure with a Sano shunt. Subsequent procedures included a bidirectional Glenn and extracardiac Fontan with a Gore-Tex graft (W.L Gore and Associates, Flagstaff, AZ). The patient was found to have a heart murmur on a follow-up visit 3 years later. Echocardiography and computed tomography imaging showed an aneurysm of the proximal Sano anastomosis. The patient underwent successful surgical repair. PMID:22916755

  18. Jet Diffusion in Proximity of a Wall

    NASA Technical Reports Server (NTRS)

    Kuechemann, D.

    1949-01-01

    When auxiliary jet engines are installed on airframes; as well as in some new designs, the jet engines are mounted in such a way that the jet stream exhausts in close proximity to the fuselage. This report deals with the behavior of the jet in close proximity to a two-dimensional surface. The experiments were made to find out whether the axially symmetric stream tends to approach the flat surface. This report is the last of a series of four partial test reports of the Goettingen program for the installation of jet engines, dated October 12, 1943. This report is the complement of the report on intake in close proximity to a wall.

  19. Proximity operations concept design study, task 6

    NASA Technical Reports Server (NTRS)

    Williams, A. N.

    1990-01-01

    The feasibility of using optical technology to perform the mission of the proximity operations communications subsystem on Space Station Freedom was determined. Proximity operations mission requirements are determined and the relationship to the overall operational environment of the space station is defined. From this information, the design requirements of the communication subsystem are derived. Based on these requirements, a preliminary design is developed and the feasibility of implementation determined. To support the Orbital Maneuvering Vehicle and National Space Transportation System, the optical system development is straightforward. The requirements on extra-vehicular activity are such as to allow large fields of uncertainty, thus exacerbating the acquisition problem; however, an approach is given that could mitigate this problem. In general, it is found that such a system could indeed perform the proximity operations mission requirement, with some development required to support extra-vehicular activity.

  20. Primary proximal tubule injury leads to epithelial cell cycle arrest, fibrosis, vascular rarefaction, and glomerulosclerosis

    PubMed Central

    Bonventre, Joseph V

    2014-01-01

    Tubular injury has a major etiological role in fibrosis. For many years, this relationship has been dominated by the perception that epithelial cells are transformed into myofibroblasts that proliferate and generate fibrotic matrixthe so-called epithelial-to-mesenchymal transition. Here we focus on mechanisms by which injury to the tubule results in fibrosis because of paracrine mechanisms. Specific injury to the proximal tubule results in inflammation, reversible injury, and adaptive repair if the insult is mild, self-limited in time, and occurs in a background of a normal kidney. Repeated injury, in contrast, leads to maladaptive repair with sustained tubule injury, chronic inflammation, proliferation of interstitial myofibroblasts, vascular rarefaction, interstitial fibrosis, and glomerular sclerosis. During the maladaptive repair process after the renal insult, many tubular cells become arrested in the G2/M phase of the cell cycle. This results in activation of the DNA repair response with the resultant synthesis and secretion of pro-fibrotic factors. Pharmacologic interventions that enhance the movement through G2/M or facilitate apoptosis of cells that otherwise would be blocked in G2/M may reduce the development of fibrosis after kidney injury and reduce the progression of chronic kidney disease. PMID:26310195

  1. Distinct gene expression profiles of proximal and distal colorectal cancer: implications for cytotoxic and targeted therapy.

    PubMed

    Maus, M K H; Hanna, D L; Stephens, C L; Astrow, S H; Yang, D; Grimminger, P P; Loupakis, F; Hsiang, J H; Zeger, G; Wakatsuki, T; Barzi, A; Lenz, H-J

    2015-08-01

    Colorectal cancer (CRC) is a heterogeneous disease with genetic profiles and clinical outcomes dependent on the anatomic location of the primary tumor. How location has an impact on the molecular makeup of a tumor and how prognostic and predictive biomarkers differ between proximal versus distal colon cancers is not well established. We investigated the associations between tumor location, KRAS and BRAF mutation status, and the messenger RNA (mRNA) expression of proteins involved in major signaling pathways, including tumor growth (epidermal growth factor receptor (EGFR)), angiogenesis (vascular endothelial growth factor receptor 2 (VEGFR2)), DNA repair (excision repair cross complement group 1 (ERCC1)) and fluoropyrimidine metabolism (thymidylate synthase (TS)). Formalin-fixed paraffin-embedded tumor specimens from 431 advanced CRC patients were analyzed. The presence of seven different KRAS base substitutions and the BRAF V600E mutation was determined. ERCC1, TS, EGFR and VEGFR2 mRNA expression levels were detected by reverse transcriptase-PCR. BRAF mutations were significantly more common in the proximal colon (P<0.001), whereas KRAS mutations occurred at similar frequencies throughout the colorectum. Rectal cancers had significantly higher ERCC1 and VEGFR2 mRNA levels compared with distal and proximal colon tumors (P=0.001), and increased TS levels compared with distal colon cancers (P=0.02). Mutant KRAS status was associated with lower ERCC1, TS, EGFR and VEGFR2 gene expression in multivariate analysis. In a subgroup analysis, this association remained significant for all genes in the proximal colon and for VEGFR2 expression in rectal cancers. The mRNA expression patterns of predictive and prognostic biomarkers, as well as associations with KRAS and BRAF mutation status depend on primary tumor location. Prospective studies are warranted to confirm these findings and determine the underlying mechanisms. PMID:25532759

  2. Infrared-Proximity-Sensor Modules For Robot

    NASA Technical Reports Server (NTRS)

    Parton, William; Wegerif, Daniel; Rosinski, Douglas

    1995-01-01

    Collision-avoidance system for articulated robot manipulators uses infrared proximity sensors grouped together in array of sensor modules. Sensor modules, called "sensorCells," distributed processing board-level products for acquiring data from proximity-sensors strategically mounted on robot manipulators. Each sensorCell self-contained and consists of multiple sensing elements, discrete electronics, microcontroller and communications components. Modules connected to central control computer by redundant serial digital communication subsystem including both serial and a multi-drop bus. Detects objects made of various materials at distance of up to 50 cm. For some materials, such as thermal protection system tiles, detection range reduced to approximately 20 cm.

  3. Strategy for photostable proximity bioassays using lanthanides

    PubMed Central

    Haushalter, Jeanne P.; Faris, Gregory W.

    2011-01-01

    We report initial findings for research aimed at creating photostable lanthanide chelate reporters for proximity assays. These reporters take advantage of the nanometer scale distance dependence of fluorescence enhancement for molecules in the vicinity of noble metal nanoparticles and also capitalize on some unique properties of lanthanide chelates. This approach promises to lead to proximity assays that do not suffer from photobleaching and offer very high on/off enhancement ratios. Results for lanthanide chelates on silver island films and in colloidal suspensions are reported. Enhancement factors range from 1 to 2 orders of magnitude, with larger enhancements for strongly quenched lanthanides. PMID:17356638

  4. Evaluation of Onlay Island Flap Technique in Shallow Urethral Plate Hypospadiasis

    PubMed Central

    Mohajerzadeh, Leily; Mirshemirani, Alireza; Rouzrokh, Mohsen; Sadeghian, Naser; Khaleghnejad-Tabari, Ahmad; Mahdavi, Alireza; Poorhasan, Sareh

    2016-01-01

    Background: Hypospadias is one of the most common congenital genital anomalies in males that necessitates to be operated early in infancy (when 6 to 9 months old). On the other hand, hypospadias is a challenging field of pediatric urology with multiple reconstruction techniques. A perfect hypospadias repair is supposed to return urethral continuity with sufficient caliber, eradicate phallus curvature, and supply an acceptable appearance with low complications. Objectives: This study aimed to evaluate the outcomes of using onlay island flap technique in the repair of hypospadias with shallow urethral plate. Patients and Methods: In this prospective study within June 2012 to December 2013, we performed onlay island flap procedure to repair hypospadias with shallow urethral plate measuring less than 6 millimeter. This technique was selected for all types of hypospadiasis except subcoronal type. Nesbits dorsal plication procedure was established for chordee. In cases with very small glans, urethroplasty was performed without glansplasty. Results: Twenty three patients with mean age of 30 (range 10 - 60) months underwent onlay island flap repair; all had a shallow urethral plate < 6 mm, 3 had a very small glans, and 18 had chordee. Meatus was located in distal shaft in 5 cases, mid shaft in 8, proximal in 6 and penoscrotal type in 4 patients. Chordee was corrected with Nesbits dorsal plication in 16 cases. Complications were: meatal stenosis in 2 cases and urethrocutaneous fistula in 2 patients, all of which were repaired surgically. Mean follow up time was 13 (3 - 20) months. All cases that had glansplasty have excellent esthetic appearance. Conclusions: This technique offers acceptable results regarding meatal stenosis, urethrocutaneous fistula and esthetic outcome. PMID:26848382

  5. A physeal-sparing fibular collateral ligament and proximal tibiofibular joint reconstruction in a skeletally immature athlete.

    PubMed

    Williams, Brady T; James, Evan W; LaPrade, Robert F

    2016-03-01

    The purpose of this report was to describe the surgical technique for and outcomes after a modified physeal-sparing posterolateral corner reconstruction in a 12-year-old skeletally immature male with a mid-substance fibular collateral ligament tear, a proximal posterior tibiofibular ligament tear, and an anterior cruciate ligament avulsion fracture of the medial tibial eminence. A modified physeal-sparing posterolateral corner reconstruction was used to provide a near-anatomic reconstruction of the fibular collateral ligament and proximal posterior tibiofibular ligament. An anterior cruciate ligament repair was also performed. Varus stress radiographs obtained at 6 months postoperatively demonstrated resolution of lateral knee stability. Physical examination results demonstrated stability to anterior tibial translation and a stable proximal tibiofibular joint. Computed tomography showed that the surgical technique successfully avoided breeching the patient's physes. PMID:25108371

  6. Endovascular repair for retrograde type A aortic dissection with malperfusion.

    PubMed

    Takahashi, Shinya; Katayama, Keijiro; Takasaki, Taiichi; Sueda, Taijiro

    2016-02-01

    An 81-year-old man became semiconscious and suffered back pain followed by chest pain. Computed tomography showed retrograde acute type A aortic dissection with entries in the proximal and middle descending aorta, and an occluded true lumen of the right carotid artery. Emergency endovascular repair was performed. Immediately after deploying a stent-graft, aortography showed recanalization of the right carotid artery and no blood flow in the false lumen of the ascending aorta and aortic arch. The postoperative course was uneventful. Computed tomography at 6 months after the procedure showed obliteration of the false lumen and a patent right carotid artery. PMID:25182334

  7. Proximity correction for electron beam lithography

    NASA Astrophysics Data System (ADS)

    Marrian, Christie R.; Chang, Steven; Peckerar, Martin C.

    1996-09-01

    As the critical dimensions required in mask making and direct write by electron beam lithography become ever smaller, correction for proximity effects becomes increasingly important. Furthermore, the problem is beset by the fact that only a positive energy dose can be applied with an electron beam. We discuss techniques such as chopping and dose shifting, which have been proposed to meet the positivity requirement. An alternative approach is to treat proximity correction as an optimization problem. Two such methods, local area dose correction and optimization using a regularizer proportional to the informational entropy of the solution, are compared. A notable feature of the regularized proximity correction is the ability to correct for forward scattering by the generation of a 'firewall' set back from the edge of a feature. As the forward scattering width increases, the firewall is set back farther from the feature edge. The regularized optimization algorithm is computationally time consuming using conventional techniques. However, the algorithm lends itself to a microelectronics integrated circuit coprocessor implementation, which could perform the optimization faster than even the fastest work stations. Scaling the circuit to larger number of pixels is best approached with a hybrid serial/parallel digital architecture that would correct for proximity effects over 108 pixels in about 1 h. This time can be reduced by simply adding additional coprocessors.

  8. Proximity correction for e-beam lithography

    NASA Astrophysics Data System (ADS)

    Marrian, Christie R.; Chang, Steven; Peckerar, Martin C.

    1995-12-01

    As the critical dimensions required for masks and e-beam direct write become ever smaller, the correction of proximity effects becomes more necessary. Furthermore, the problem is beset by the fact that only a positive energy dose can be applied with the e-beam. We discuss here approaches such as chopping and dose shifting which have been proposed to meet the positivity requirement. An alternative approach is to treat proximity correction as an optimization problem. Two such methods, local area dose correction and optimization using a regularizer proportional to the informational entropy of the solution, are compared. A notable feature of the regularized proximity correction is the ability to correct for forward scattering by the generation of a 'firewall' set back from the edge of a feature. As the forward scattering width increases, the firewall is set back further from the feature edge. The regularized optimization algorithm is computationally time consuming using conventional techniques. However, the algorithm lends itself to a microelectronics integrated circuit coprocessor implementation which could perform the optimization much faster than even the fastest work stations. Scaling the circuit to larger number of pixels is best approached with a hybrid serial/parallel digital architecture which would correct for proximity effects over 108 pixels about one hour. This time can be reduced by simply adding additional coprocessors.

  9. Vortices in normal part of proximity system

    DOE PAGESBeta

    Kogan, V. G.

    2015-05-26

    It is shown that the order parameter Δ induced in the normal part of superconductor-normal-superconductor proximity system is modulated in the magnetic field differently from vortices in bulk superconductors. Whereas Δ turns zero at vortex centers, the magnetic structure of these vortices differs from that of Abrikosov's.

  10. Goal-Proximity Decision-Making

    ERIC Educational Resources Information Center

    Veksler, Vladislav D.; Gray, Wayne D.; Schoelles, Michael J.

    2013-01-01

    Reinforcement learning (RL) models of decision-making cannot account for human decisions in the absence of prior reward or punishment. We propose a mechanism for choosing among available options based on goal-option association strengths, where association strengths between objects represent previously experienced object proximity. The proposed

  11. Vortices in normal part of proximity system

    SciTech Connect

    Kogan, V. G.

    2015-05-26

    It is shown that the order parameter ? induced in the normal part of superconductor-normal-superconductor proximity system is modulated in the magnetic field differently from vortices in bulk superconductors. Whereas ? turns zero at vortex centers, the magnetic structure of these vortices differs from that of Abrikosov's.

  12. Proximity: Location, Time, and Opportunity to Communicate.

    ERIC Educational Resources Information Center

    Kirste, Kenneth K.; Monge, Peter R.

    Traditional measures of proximity all share three common weaknesses: (1) they are based on ratio-level measurement of physical distance that may not correspond to "psychological distance;" (2) they measure distance as a fixed rather than variable quantity; and (3) they measure distance between pairs of individuals rather than larger groups of

  13. Proximity algorithms for image models: denoising

    NASA Astrophysics Data System (ADS)

    Micchelli, Charles A.; Shen, Lixin; Xu, Yuesheng

    2011-04-01

    This paper introduces a novel framework for the study of the total-variation model for image denoising. In the model, the denoised image is the proximity operator of the total-variation evaluated at a given noisy image. The total-variation can be viewed as the composition of a convex function (the l1 norm for the anisotropic total-variation or the l2 norm for the isotropic total-variation) with a linear transformation (the first-order difference operator). These two facts lead us to investigate the proximity operator of the composition of a convex function with a linear transformation. Under the assumption that the proximity operator of a given convex function (e.g., the l1 norm or the l2 norm) can be readily obtained, we propose a fixed-point algorithm for computing the proximity operator of the composition of the convex function with a linear transformation. We then specialize this fixed-point methodology to the total-variation denoising models. The resulting algorithms are compared with the Goldstein-Osher split-Bregman denoising algorithm. An important advantage of the fixed-point framework leads us to a convenient analysis for convergence of the proposed algorithms as well as a platform for us to develop efficient numerical algorithms via various fixed-point iterations. Our numerical experience indicates that the methods proposed here perform favorably.

  14. Goal-Proximity Decision-Making

    ERIC Educational Resources Information Center

    Veksler, Vladislav D.; Gray, Wayne D.; Schoelles, Michael J.

    2013-01-01

    Reinforcement learning (RL) models of decision-making cannot account for human decisions in the absence of prior reward or punishment. We propose a mechanism for choosing among available options based on goal-option association strengths, where association strengths between objects represent previously experienced object proximity. The proposed…

  15. Proximal humerus fractures in children and adolescents.

    PubMed

    Lefvre, Y; Journeau, P; Angelliaume, A; Bouty, A; Dobremez, E

    2014-02-01

    Proximal humerus fractures are rare in paediatric traumatology. Metaphyseal fractures account for about 70% of cases and epiphyseal separation for the remaining 30%. The development and anatomy of the proximal humerus explain the various fracture types, displacements, and potential complications; and also help in interpreting the radiographic findings, most notably in young children. Physicians should be alert to the possibility of an underlying lesion or pathological fracture requiring appropriate diagnostic investigations, and they should consider child abuse in very young paediatric patients. Although the management of proximal humerus fractures remains controversial, the extraordinary remodelling potential of the proximal humerus in skeletally immature patients often allows non-operative treatment without prior reduction. When the displacement exceeds the remodelling potential suggested by the extent of impaction, angulation, and patient age, retrograde elastic stable intramedullary nailing (ESIN) provides effective stabilisation. As a result, the thoraco-brachial abduction cast is less often used, although this method remains a valid option. Retrograde ESIN must be performed by a surgeon who is thoroughly conversant with the fundamental underlying principles. Direct percutaneous pinning is a fall-back option when the surgeon's experience with ESIN is insufficient. Finally, open reduction is very rarely required and should be reserved for severely displaced fractures after failure of closed reduction. When these indications are followed, long-term outcomes are usually excellent, with prompt resumption of previous activities and a low rate of residual abnormalities. PMID:24394917

  16. Vortices in normal part of proximity system

    NASA Astrophysics Data System (ADS)

    Kogan, V. G.

    2015-05-01

    The order parameter induced in the normal part of the superconductor-normal-superconductor proximity system in the magnetic field can form vortices, which are similar but not the same as vortices in bulk superconductors, or it can be modulated laminarly with the field-dependent decay length.

  17. Object detection system using SPAD proximity detectors

    NASA Astrophysics Data System (ADS)

    Stark, Laurence; Raynor, Jeffrey M.; Henderson, Robert K.

    2011-10-01

    This paper presents an object detection system based upon the use of multiple single photon avalanche diode (SPAD) proximity sensors operating upon the time-of-flight (ToF) principle, whereby the co-ordinates of a target object in a coordinate system relative to the assembly are calculated. The system is similar to a touch screen system in form and operation except that the lack of requirement of a physical sensing surface provides a novel advantage over most existing touch screen technologies. The sensors are controlled by FPGA-based firmware and each proximity sensor in the system measures the range from the sensor to the target object. A software algorithm is implemented to calculate the x-y coordinates of the target object based on the distance measurements from at least two separate sensors and the known relative positions of these sensors. Existing proximity sensors were capable of determining the distance to an object with centimetric accuracy and were modified to obtain a wide field of view in the x-y axes with low beam angle in z in order to provide a detection area as large as possible. Design and implementation of the firmware, electronic hardware, mechanics and optics are covered in the paper. Possible future work would include characterisation with alternative designs of proximity sensors, as this is the component which determines the highest achievable accur1acy of the system.

  18. The Zone of Proximal "Teacher" Development

    ERIC Educational Resources Information Center

    Warford, Mark K.

    2011-01-01

    Toward the end of his short life, Lev Vygotsky found himself teaching teachers in a remote part of the USSR. Though his influence as a developmental psychologist is well-established, little is known about his approach to teacher development. This article applies the researcher's core concept, the zone of proximal development to teacher education.

  19. Interpersonal Violence between College Students: Proximal Influences.

    ERIC Educational Resources Information Center

    Marcus, Robert; Reio, Thomas; Kessler, Lauren; Cutler, Kelley; Fleury, John

    This paper presents the results of a 3 year study on violence between students at the University of Maryland. The study was designed to: (1) describe the prevalence of fighting between students; (2) analyze, by gender, students' description of their most recent physical fight with another for proximal influences on these altercations; (3) analyze…

  20. Current status of proximal gastric vagotomy.

    PubMed Central

    Schirmer, B D

    1989-01-01

    Proximal gastric vagotomy is nearing its twentieth year in clinical use as an operation for peptic ulcer disease. No other acid-reducing operation has undergone as much scrutiny or study. At this time, the evidence of such studies and long-term follow-up strongly supports the use of proximal gastric vagotomy as the treatment of choice for chronic duodenal ulcer in patients who have failed medical therapy. Its application in treating the complications of peptic ulcer disease, which recently have come to represent an increasingly greater percentage of all operations done for peptic ulcer disease, is well-tested. However, initial series suggest that it should probably occupy a prominent role in treating some of these complications, particularly in selected patients, in the future. The operation has the well-documented ability to reduce gastric acid production, not inhibit gastric bicarbonate production, and also minimally inhibit gastric motility. The combination of these physiologic results after proximal gastric vagotomy, along with preservation of the normal antropyloroduodenal mechanism of gastrointestinal control, serve to allow patients with proximal gastric vagotomy the improved benefits of significantly fewer severe gastrointestinal side effects than are seen after other operations for peptic ulcer disease. PMID:2644897

  1. Protein biomarker validation via proximity ligation assays.

    PubMed

    Blokzijl, A; Nong, R; Darmanis, S; Hertz, E; Landegren, U; Kamali-Moghaddam, M

    2014-05-01

    The ability to detect minute amounts of specific proteins or protein modifications in blood as biomarkers for a plethora of human pathological conditions holds great promise for future medicine. Despite a large number of plausible candidate protein biomarkers published annually, the translation to clinical use is impeded by factors such as the required size of the initial studies, and limitations of the technologies used. The proximity ligation assay (PLA) is a versatile molecular tool that has the potential to address some obstacles, both in validation of biomarkers previously discovered using other techniques, and for future routine clinical diagnostic needs. The enhanced specificity of PLA extends the opportunities for large-scale, high-performance analyses of proteins. Besides advantages in the form of minimal sample consumption and an extended dynamic range, the PLA technique allows flexible assay reconfiguration. The technology can be adapted for detecting protein complexes, proximity between proteins in extracellular vesicles or in circulating tumor cells, and to address multiple post-translational modifications in the same protein molecule. We discuss herein requirements for biomarker validation, and how PLA may play an increasing role in this regard. We describe some recent developments of the technology, including proximity extension assays, the use of recombinant affinity reagents suitable for use in proximity assays, and the potential for single cell proteomics. This article is part of a Special Issue entitled: Biomarkers: A Proteomic Challenge. PMID:23933049

  2. Stimulating endogenous cardiac repair.

    PubMed

    Finan, Amanda; Richard, Sylvain

    2015-01-01

    The healthy adult heart has a low turnover of cardiac myocytes. The renewal capacity, however, is augmented after cardiac injury. Participants in cardiac regeneration include cardiac myocytes themselves, cardiac progenitor cells, and peripheral stem cells, particularly from the bone marrow compartment. Cardiac progenitor cells and bone marrow stem cells are augmented after cardiac injury, migrate to the myocardium, and support regeneration. Depletion studies of these populations have demonstrated their necessary role in cardiac repair. However, the potential of these cells to completely regenerate the heart is limited. Efforts are now being focused on ways to augment these natural pathways to improve cardiac healing, primarily after ischemic injury but in other cardiac pathologies as well. Cell and gene therapy or pharmacological interventions are proposed mechanisms. Cell therapy has demonstrated modest results and has passed into clinical trials. However, the beneficial effects of cell therapy have primarily been their ability to produce paracrine effects on the cardiac tissue and recruit endogenous stem cell populations as opposed to direct cardiac regeneration. Gene therapy efforts have focused on prolonging or reactivating natural signaling pathways. Positive results have been demonstrated to activate the endogenous stem cell populations and are currently being tested in clinical trials. A potential new avenue may be to refine pharmacological treatments that are currently in place in the clinic. Evidence is mounting that drugs such as statins or beta blockers may alter endogenous stem cell activity. Understanding the effects of these drugs on stem cell repair while keeping in mind their primary function may strike a balance in myocardial healing. To maximize endogenous cardiac regeneration, a combination of these approaches could ameliorate the overall repair process to incorporate the participation of multiple cellular players. PMID:26484341

  3. Stimulating endogenous cardiac repair

    PubMed Central

    Finan, Amanda; Richard, Sylvain

    2015-01-01

    The healthy adult heart has a low turnover of cardiac myocytes. The renewal capacity, however, is augmented after cardiac injury. Participants in cardiac regeneration include cardiac myocytes themselves, cardiac progenitor cells, and peripheral stem cells, particularly from the bone marrow compartment. Cardiac progenitor cells and bone marrow stem cells are augmented after cardiac injury, migrate to the myocardium, and support regeneration. Depletion studies of these populations have demonstrated their necessary role in cardiac repair. However, the potential of these cells to completely regenerate the heart is limited. Efforts are now being focused on ways to augment these natural pathways to improve cardiac healing, primarily after ischemic injury but in other cardiac pathologies as well. Cell and gene therapy or pharmacological interventions are proposed mechanisms. Cell therapy has demonstrated modest results and has passed into clinical trials. However, the beneficial effects of cell therapy have primarily been their ability to produce paracrine effects on the cardiac tissue and recruit endogenous stem cell populations as opposed to direct cardiac regeneration. Gene therapy efforts have focused on prolonging or reactivating natural signaling pathways. Positive results have been demonstrated to activate the endogenous stem cell populations and are currently being tested in clinical trials. A potential new avenue may be to refine pharmacological treatments that are currently in place in the clinic. Evidence is mounting that drugs such as statins or beta blockers may alter endogenous stem cell activity. Understanding the effects of these drugs on stem cell repair while keeping in mind their primary function may strike a balance in myocardial healing. To maximize endogenous cardiac regeneration, a combination of these approaches could ameliorate the overall repair process to incorporate the participation of multiple cellular players. PMID:26484341

  4. Type I Endoleak-like Phenomenon Causing Rupture of the Replaced Aneurysm Sac 12 Years after Open Repair of Abdominal Aortic Aneurysm

    PubMed Central

    Matsushita, Masahiro; Ikezawa, Teruo; Banno, Hiroshi

    2008-01-01

    Only a few cases of endoleak following conventional abdominal aortic aneurysm repair have been reported. We treated a patient with a type I endoleak-like phenomenon occuring 12 years after conventional abdominal aortic aneurysm repair. Computed tomography demonstrated dilation of the surgically replaced, once-shrunken aneurysm sac to a diameter of 3.5 cm. Thrombus was identified between the graft and the sac. Four months later the sac ruptured, and emergency repair was performed. Dehiscence of the proximal anastomosis causing dilation and tearing of the sac was found. Dilation of a surgically replaced aneurysm sac after initial shrinkage may suggest an endoleak-like phenomenon requiring second repair. PMID:23555348

  5. Development of stroke-induced quadriplegia after endovascular repair of blunt aortic injury pseudoaneurysm

    PubMed Central

    Amoudi, Abdullah S.; Merdad, Anas A.; Makhdoom, Ahmed Q.; Jamjoom, Reda A.

    2015-01-01

    Endovascular repair of blunt aortic injury is now a first-line approach in management. This can warrant coverage of the left subclavian artery (LSA), which could lead to posterior strokes. In this case report, we present a severe complication of endovascular repair of a traumatic aortic aneurysm. A 53-year-old man presented with blunt aortic injury, endovascular repair was carried out where the left subclavian artery was covered. The intervention had a 100% technical success. Twelve hours later, he was discovered to have quadriplegia, a CT scan showed a large left cerebellar infarction extending to the medulla oblongata and proximal spinal cord. Strokes complicate 3% of thoracic endovascular aortic repairs, 80% of those strokes occur in patients who had their LSAs covered. Most patients however, tolerate the coverage. Although our patient had a dominant right vertebral artery, and lacked risks for these strokes, he developed an extensive stroke that left him quadriplegic. PMID:25630782

  6. Repair of abdominal aortic aneurysm by transfemoral endovascular graft placement.

    PubMed Central

    Moore, W S; Vescera, C L

    1994-01-01

    PURPOSE: The authors describe the initial clinical experience with a new device, approved by the FDA for investigation, for repair of abdominal aortic aneurysm by transfemoral endovascular insertion of an aortic graft. METHODS: Sixty-nine patients with abdominal aortic aneurysms were screened, and ten were found to be suitable for endovascular grafting. Repair was done in the operating room using general anesthesia. One femoral artery was surgically exposed, and the device, containing a premeasured graft with proximal and distal self-expanding fixation devices, was inserted with fluoroscopic control through an open arteriotomy. FINDINGS: Eight of ten patients underwent successful graft placement, and two patients required conversion to an open repair. On follow-up, six of eight patients who underwent graft placement functioned normally, with documented aneurysm thrombosis. Two patients who underwent graft placement functioned normally, with contrast computed tomography evidence of incomplete aneurysm thrombosis, but without further expansion. CONCLUSION: Transfemoral repair is safe and appears to be effective. Phase II study currently is appropriate, with need for long-term follow-up. Images Figure 1. Figure 2. Figure 3. Figure 4. Figure 5. Figure 6. Figure 7. PMID:8092899

  7. DNA repair in cultured keratinocytes

    SciTech Connect

    Liu, S.C.; Parsons, S.; Hanawalt, P.C.

    1983-07-01

    Most of our understanding of DNA repair mechanisms in human cells has come from the study of these processes in cultured fibroblasts. The unique properties of keratinocytes and their pattern of terminal differentiation led us to a comparative examination of their DNA repair properties. The relative repair capabilities of the basal cells and the differentiated epidermal keratinocytes as well as possible correlations of DNA repair capacity with respect to age of the donor have been examined. In addition, since portions of human skin are chronically exposed to sunlight, the repair response to ultraviolet (UV) irradiation (254 nm) when the cells are conditioned by chronic low-level UV irradiation has been assessed. The comparative studies of DNA repair in keratinocytes from infant and aged donors have revealed no significant age-related differences for repair of UV-induced damage to DNA. Sublethal UV conditioning of cells from infant skin had no appreciable effect on either the repair or normal replication response to higher, challenge doses of UVL. However, such conditioning resulted in attenuated repair in keratinocytes from adult skin after UV doses above 25 J/m2. In addition, a surprising enhancement in replication was seen in conditioned cells from adult following challenge UV doses.

  8. DNA excision repair at telomeres.

    PubMed

    Jia, Pingping; Her, Chengtao; Chai, Weihang

    2015-12-01

    DNA damage is caused by either endogenous cellular metabolic processes such as hydrolysis, oxidation, alkylation, and DNA base mismatches, or exogenous sources including ultraviolet (UV) light, ionizing radiation, and chemical agents. Damaged DNA that is not properly repaired can lead to genomic instability, driving tumorigenesis. To protect genomic stability, mammalian cells have evolved highly conserved DNA repair mechanisms to remove and repair DNA lesions. Telomeres are composed of long tandem TTAGGG repeats located at the ends of chromosomes. Maintenance of functional telomeres is critical for preventing genome instability. The telomeric sequence possesses unique features that predispose telomeres to a variety of DNA damage induced by environmental genotoxins. This review briefly describes the relevance of excision repair pathways in telomere maintenance, with the focus on base excision repair (BER), nucleotide excision repair (NER), and mismatch repair (MMR). By summarizing current knowledge on excision repair of telomere damage and outlining many unanswered questions, it is our hope to stimulate further interest in a better understanding of excision repair processes at telomeres and in how these processes contribute to telomere maintenance. PMID:26422132

  9. Posterolateral Knee Reconstruction Versus Repair

    PubMed Central

    McCarthy, Mark; Ridley, TJ; Bollier, Matthew; Cook, Shane; Wolf, Brian; Amendola, Annunziato

    2015-01-01

    Background Recent literature has shown that posterolateral corner injuries of the knee have poor results when treated with repair, when compared to reconstruction. Our study sought to compare outcomes of posterolateral knee injuries treated with repair versus reconstruction and report results from our institution, with the hypothesis that acute repairs have comparable results to reconstructions. Methods We identified patients with posterolateral knee reconstruction or repair from January 1, 2000 to March 1, 2012. Patients returned for outcome measures, clinical exam and varus stress radiographs. Further, each patient underwent a chart review. Varus stress radiographs were obtained in 20 control knees, with no history of knee trauma, to our two cohort groups. Results 26 knees in 25 patients (17 reconstructions and 9 repairs) were evaluated in clinic at mean of 42 months postoperatively for repairs and 38 months postoperatively for reconstructions. Average IKDC scores for reconstruction and repair were 68 and 71, respectively. Average Lysholm scores for these groups were 83 for reconstructions and 83 for repairs. No statistically significant differences existed. Average varus gapping at zero degrees was 8.21 and 8.84 millimeters (mm) for reconstructions and repairs, respectively. Average varus gapping at 20 degrees knee flexion was 11.25 mm for reconstructions and 10.34 mm for repairs. No statistically significant differences were observed in varus gapping between the two groups. Each patient chart was reviewed for complications. There were 2 failures in the 44 patient reconstruction group (4.7%) and 2 failures in the 18 patient repair group (11.1%). We noted a high rate (10/19 patients) of primarily distally-based injuries in our repair group. All failures were treated with revision reconstructions. Conclusion We found low failure rates in both groups. All knees in the repair group were operated within three weeks of injury. Our repair knees had a high rate of distally based avulsion and, were felt to have acceptable tissue that could be successfully repaired. We recommend posterolateral knee repair in cases with distally based avulsions that can be operatively treated within 3 weeks of injury, and have good tissue quality at the time of surgery. Level of Evidence IV PMID:26361440

  10. Surgically Relevant Bony and Soft Tissue Anatomy of the Proximal Femur

    PubMed Central

    Philippon, Marc J.; Michalski, Max P.; Campbell, Kevin J.; Goldsmith, Mary T.; Devitt, Brian M.; Wijdicks, Coen A.; LaPrade, Robert F.

    2014-01-01

    Background: Hip endoscopy facilitates the treatment of extra-articular disorders of the proximal femur. Unfortunately, current knowledge of proximal femur anatomy is limited to qualitative descriptions and lacks surgically relevant landmarks. Purpose: To provide a quantitative and qualitative analysis of proximal femur anatomy in reference to surgically relevant bony landmarks. Study Design: Descriptive laboratory study. Methods: Fourteen cadaveric hemipelvises were dissected. A coordinate measuring device measured dimensions and interrelationships of the gluteal muscles, hip external rotators, pectineus, iliopsoas, and joint capsule in reference to osseous landmarks. Results: The vastus tubercle, superomedial border of the greater trochanter, and femoral head-neck junction were distinct and reliable osseous landmarks. The anteroinferior tip of the vastus tubercle was 17.1 mm (95% CI: 14.5, 19.8 mm) anteroinferior to the center of the gluteus medius lateral insertional footprint and was 22.9 mm (95% CI: 20.1, 25.7 mm) inferolateral to the center of the gluteus minimus insertional footprint. The insertions of the piriformis, conjoint tendon of the hip (superior gemellus, obturator internus, and inferior gemellus), and obturator externus were identified relative to the superomedial border of the greater trochanter. The relationship of the aforementioned footprints were 49% (95% CI: 43%, 54%), 42% (95% CI: 33%, 50%), and 64% (95% CI: 59%, 69%) from the anterior (0%) to posterior (100%) margins of the superomedial border of the greater trochanter, respectively. The hip joint capsule attached distally on the proximal femur 18.2 mm (95% CI: 14.2, 22.2 mm) from the head-neck junction medially on average. Conclusion: The vastus tubercle, superomedial border of the greater trochanter, and the femoral head-neck junction were reliable osseous landmarks for the identification of the tendinous and hip capsular insertions on the proximal femur. Knowledge of the interrelationships between these structures is essential for endoscopic navigation and anatomic surgical repair and reconstruction. Clinical Relevance: The qualitative and quantitative clinically relevant anatomic data presented here will aid in the diagnosis of proximal femur pathology and will provide a template for anatomic repair or reconstruction. PMID:26535335

  11. Surgical repair of aneurysms involving the distal aortic arch.

    PubMed

    Kay, G L; Cooley, D A; Livesay, J J; Reardon, M J; Duncan, J M

    1986-03-01

    The surgical approach to aneurysms involving the transverse aortic arch usually requires either techniques for perfusion or hypothermic circulatory arrest. A simplified approach may be warranted when the aneurysmal process begins in the distal aortic arch and spares the innominate artery. Between November, 1975, and January, 1984, 32 patients (22 men, 10 women; median age 61 years) underwent repair of aneurysms of the distal aortic arch by simple cross-clamping of the diseased aortic segment. In each, the aneurysm arose distal to the innominate artery and involved the arch at the origin of the left subclavian or left common carotid artery. Proximal control was achieved by cross-clamping the aortic arch between the innominate and left carotid arteries. No shunts or extracorporeal bypass circuits were employed. Proximal hypertension was controlled by sodium nitroprusside infusion. All patients were heparinized. A mean aortic cross-clamp time of 27 +/- 10 minutes was required for Dacron graft replacement in 28 patients and Dacron patch repair in three patients. Surgical repair was accomplished successfully in 32 patients. The 30 day mortality was 3% with an in-hospital mortality of 6%. There were no complications as a result of myocardial infarction or stroke. Paraplegia (three patients) was related to cross-clamp time (less than 30 minutes, 0/18; greater than 30 minutes, 3/13 [p less than 0.001]) and distal extent of the aneurysm (localized, 0/22; extensive, 3/9 [p less than 0.001]). Transient renal failure (two patients) was related to cross-clamp time (less than 30 minutes, 0/18; greater than 30 minutes, 2/13 [p less than 0.001]). This experience supports the use of simple aortic cross-clamping for aneurysms of the distal aortic arch, especially if an expeditious repair can be accomplished. PMID:3951244

  12. Characteristics of He II Proximity Profiles

    NASA Astrophysics Data System (ADS)

    Zheng, Wei; Syphers, David; Meiksin, Avery; Kriss, Gerard A.; Schneider, Donald P.; York, Donald G.; Anderson, Scott F.

    2015-06-01

    The proximity profile in the spectra of z? 3 quasars, where fluxes extend blueward of the He ii Ly? wavelength 304 (1+z) , is one of the most important spectral features in the study of the intergalactic medium (IGM). Based on the Hubble Space Telescope spectra of 24 He ii quasars, we find that the majority of them display a proximity profile, corresponding to an ionization radius as large as 20 Mpc in the source's rest frame. In comparison with those in the H i spectra of the quasars at z ? 6, the He ii proximity effect is more prominent and is observed over a considerably longer period of reionization. The He ii proximity zone sizes decrease at higher redshifts, particularly at z\\gt 3.3. This trend is similar to that for H i, signaling an onset of He ii reionization at z? 4. For quasar SDSS1253+6817 (z = 3.48), the He ii absorption trough displays a gradual decline and serves as a good case for modeling the He ii reionization. To model such a broad profile requires a quasar radiation field whose energy distribution between 4 and 1 Rydberg is considerably harder than normally assumed. The UV continuum of this quasar is indeed exceptionally steep, and the He ii ionization level in the quasar vicinity is higher than the average level in the IGM. These results are evidence that a very hard EUV continuum from this quasar produces a large ionized zone around it. Distinct exceptions are the two brightest He ii quasars at z ? 2.8, for which no significant proximity profile is present, probably implying that they are very young.

  13. Factors affecting proximal tubular reabsorption during development

    SciTech Connect

    Kaskel, F.J.; Kumar, A.M.; Lockhart, E.A.; Evan, A.; Spitzer, A.

    1987-01-01

    Studies performed in several animal species have demonstrated that glomerulotubular balance is maintained throughout development despite the many changes that occur in the factors known to control it. In an attempt to understand the nature of this phenomenon the authors quantified the magnitude and described the profile of these changes in guinea pigs. The changes in physical forces were assessed from measurements of hydrostatic and oncotic pressures, whereas those in the permeability characteristics of the proximal tubule epithelium were estimated from permanence to radioactivity-labelled macromolecules of graded radii, histologic measurements of the intercellular channels, and measurements of end-proximal ratio of tubular fluid-to-plasma osmolality (TF/P/sub osm/). Between 1 and 50 days of age the net pressure for reabsorption increased from 15.0 to 30.9 mmHg with the major change occurring during the first 2-3 wk of postnatal life. The urinary recovery of (/sup 3/H)inulin, (/sup 14/C)sucrose, and (/sup 14/C)creatinine, injected in the early segment of proximal tubules did not vary with age. The urinary recovery of (/sup 14/C)mannitol increased from 92% at birth to 100% at 49 days of age. The length of the zonulae occludens and the width of the intercellular channels did not change during this period. The findings support the hypothesis that during early postnatal life glomerulotubular balance is made possible by a high permeability of the proximal tubule, which compensates for the low net reabsorptive pressure. As the animal matures and the proximal tubule epithelium becomes tighter, for glomerulotubular balance to be maintained, an increase in the number of intercellular channels and in the active transport of sodium need to be postulated.

  14. Endoscopic craniosynostosis repair

    PubMed Central

    2014-01-01

    Introduction Craniosynostosis is a rare condition that affects approximately one child in every 2,000 live births, and involves pathological fusion of two or more skull bones. Consequences of craniosynostosis include possible limitation of brain growth and cosmetic effects on the appearance of the child. Traditional repairs for these conditions over the past 3-4 decades have involved an open operation with a large skin incision and major manipulations of the skull bones. More recently, minimally invasive endoscopic techniques have been developed to release the skull bones, followed by postoperative treatment with either an external orthosis or internal springs and distractors to achieve the desired correction. Methods In this review minimally invasive endoscopic repair will be reviewed. A general overview of the condition and techniques for correction will be discussed, followed by specific application of these surgeries for different craniosynostosis diagnoses. Attention to the subtleties of each specific condition will be highlighted. Summary Over the past two decades clinical experience and a large number of publications have substantiated the benefits of minimally invasive endoscopic techniques for the treatment of craniosynostosis. These techniques have clear benefits for selected patients, and should be part of the standard of care for this condition at craniofacial centers.

  15. Inguinal hernia repair - series (image)

    MedlinePLUS

    ... wall, the muscle tissue is repaired, and the skin is closed. ... sports for at least 3 weeks. The hernia repair is not at risk, but a blow to the incision could burst the skin closure. Expect complete recovery from surgery in about ...

  16. Major Appliance Repair. Teacher Edition.

    ERIC Educational Resources Information Center

    Smreker, Eugene; Calvert, King

    This module is a comprehensive text on basic appliance repair, designed to prepare students for entry-level jobs in this growing field. Ensuring a firm grounding in electrical knowledge, the module contains 13 instructional units that cover the following topics: (1) major appliance repair orientation; (2) safety and first aid; (3) fundamentals of

  17. Instructional Guide for Autobody Repair.

    ERIC Educational Resources Information Center

    Virginia Polytechnic Inst. and State Univ., Blacksburg. Dept. of Education.

    The curriculum guide was developed to serve as a statewide model for Virginia auto body repair programs. The guide is designed to 1,080 hours of instruction in eleven blocks: orientation, introduction, welding and cutting, techniques of shaping metal, body filler and fiberglass repairs, body and frame, removing and replacing damaged parts, basic…

  18. Cobbler's Technique for Iridodialysis Repair

    PubMed Central

    Pandav, Surinder Singh; Gupta, Parul Chawla; Singh, Rishi Raj; Das, Kalpita; Kaushik, Sushmita; Raj, Srishti; Ram, Jagat

    2016-01-01

    We describe a novel “Cobbler's technique” for iridodialysis repair in the right eye of a patient aged 18 years, with a traumatic iridodialysis secondary to open globe injury with an iron rod. Our technique is simple with easy surgical maneuvers, that is, effective for repairing iridodialysis. The “Cobbler's technique” allows a maximally functional and cosmetic result for iridodialysis.

  19. Abdominal aortic aneurysm repair - open

    MedlinePLUS

    Open abdominal aortic aneurysm repair is surgery to fix a widened part in your aorta. This is called an aneurysm. The ... Open surgery to repair an abdominal aortic aneurysm is sometimes ... is bleeding inside your body from the aneurysm. You may have an ...

  20. Exploring advanced mask repair options

    NASA Astrophysics Data System (ADS)

    Fisch, Emily; Brodsky, Colin; Flanigan, Philip; Lawliss, Mark; Rankin, Jed; Thibault, David

    2005-05-01

    The extension of 193 nm lithography to the 65 and 45nm nodes transfers the development challenges from those associated with a new wavelength to those required to push an existing technology further. With respect to mask repair, new challenges are introduced as the mask features shrink and OPC becomes increasingly aggressive. These same factors increase mask costs to provide strong motivation for enhancing existing repair capabilities. The business case for investing in repair has only become stronger for leading edge 193 nm masks. This paper evaluates several repair techniques on a range of clear and opaque defects in Cr, MoSi and quartz features. A systematic approach is used to evaluate options for understanding the quality of a repair. Though conventional reconstruction techniques are used, we also explore non-intuitive repairs. These non-standard repairs attempt to reconstruct the printed image without duplicating the designed physical structure. An understanding of each method's process latitude is gained. AIMS analysis, lithographic simulations, and wafer print results are used to refine the understanding of repair specifications.

  1. Pipe inspection and repair system

    NASA Technical Reports Server (NTRS)

    Schempf, Hagen (Inventor); Mutschler, Edward (Inventor); Chemel, Brian (Inventor); Boehmke, Scott (Inventor); Crowley, William (Inventor)

    2004-01-01

    A multi-module pipe inspection and repair device. The device includes a base module, a camera module, a sensor module, an MFL module, a brush module, a patch set/test module, and a marker module. Each of the modules may be interconnected to construct one of an inspection device, a preparation device, a marking device, and a repair device.

  2. Industrial motor repair in the United States

    SciTech Connect

    Schueler, V.; Leistner, P.; Douglass, J.

    1994-09-01

    This report characterizes the motor repair industry in the United States; summarizes current motor repair and testing practice; and identifies barriers to energy motor repair practice and recommends strategies for overcoming those barriers.

  3. MG53-mediated cell membrane repair protects against acute kidney injury

    PubMed Central

    Lin, Peihui; Tan, Tao; Wang, Zhen; Chen, Ken; Zhou, Xinyu; Gumpper, Kristyn; Zhu, Hua; Ludwig, Thomas; Mohler, Peter J.; Rovin, Brad; Abraham, William T.; Zeng, Chunyu; Ma, Jianjie

    2015-01-01

    Injury to the renal proximal tubular epithelium (PTE) represents the underlying consequence of acute kidney injury (AKI) after exposure to various stressors, including nephrotoxins and ischemia/reperfusion (I/R). Although the kidney has the ability to repair itself after mild injury, insufficient repair of PTE cells may trigger inflammatory and fibrotic responses, leading to chronic renal failure. We report that MG53, a member of the TRIM family of proteins, participates in repair of injured PTE cells and protects against the development of AKI. We show that MG53 translocates to acute injury sites on PTE cells and forms a repair patch. Ablation of MG53 leads to defective membrane repair. MG53-deficient mice develop pronounced tubulointerstitial injury and increased susceptibility to I/R-induced AKI compared to wild-type mice. Recombinant human MG53 (rhMG53) protein can target injury sites on PTE cells to facilitate repair after I/R injury or nephrotoxin exposure. Moreover, in animal studies, intravenous delivery of rhMG53 ameliorates cisplatin-induced AKI without affecting the tumor suppressor efficacy of cisplatin. These findings identify MG53 as a vital component of reno-protection, and targeting MG53-mediated repair of PTE cells represents a potential approach to prevention and treatment of AKI. PMID:25787762

  4. Tunable Magnetic Proximity Effects in Graphene Junctions

    NASA Astrophysics Data System (ADS)

    Lazic, Predrag; Belashchenko, Kirill; Zutic, Igor

    2015-03-01

    The characteristic length of the magnetic proximity effects exceed the thickness of a graphene layer leading to an important, but typically overlooked, modifications of equilibrium and transport properties, as well as the implications for graphene spintronics. Using the first-principles studies that integrate a real space density functional theory (GPAW) with the state-of-the art boundary elements electrostatic code based on the Robin Hood method, we explore tunable electronic structure and magnetic proximity effects in the ferromagnet/insulator/graphene junctions. We show that the inclusion of a finite-size gate electrodes and van der Walls interaction lead to nontrivial effects that could also be important in other two-dimensional materials beyond graphene. Work supported by US ONR, NSF-DMR and Nebraska NSF MRSEC.

  5. Goal-proximity decision-making.

    PubMed

    Veksler, Vladislav D; Gray, Wayne D; Schoelles, Michael J

    2013-01-01

    Reinforcement learning (RL) models of decision-making cannot account for human decisions in the absence of prior reward or punishment. We propose a mechanism for choosing among available options based on goal-option association strengths, where association strengths between objects represent previously experienced object proximity. The proposed mechanism, Goal-Proximity Decision-making (GPD), is implemented within the ACT-R cognitive framework. GPD is found to be more efficient than RL in three maze-navigation simulations. GPD advantages over RL seem to grow as task difficulty is increased. An experiment is presented where participants are asked to make choices in the absence of prior reward. GPD captures human performance in this experiment better than RL. PMID:23551486

  6. Proximity-induced superconductivity in Weyl semimetals

    NASA Astrophysics Data System (ADS)

    Khanna, Udit; Kundu, Arijit; Pradhan, Saurabh; Rao, Sumathi

    2014-11-01

    We study superconducting proximity effects in Weyl semimetals (WSM) with broken time-reversal symmetry by tunnel-coupling one of its surfaces to an s -wave superconductor using the Green's function approach. We find that the band structure develops coherence peaks, but despite the presence of metallic states in the bulk, the coherence peaks do not extend far into the bulk and remain confined to a few layers close to the interface, similar to the proximity effect in the topological insulators (TI) which are gapped in the bulk. The Weyl nodes remain unaffected, and in that sense, no true gap develops. We also study the induced p - and s -wave pairing amplitudes classified by their symmetries, as a function of the various parameters of the theory, and note the exponential decay of the induced pairings in the bulk both in the TI and the WSM, even at finite chemical potential.

  7. Painful Spastic Hip Dislocation: Proximal Femoral Resection

    PubMed Central

    Albiana, Javier; Gonzalez-Moran, Gaspar

    2002-01-01

    The dislocated hip in a non-ambulatory child with spastic paresis tends to be a painful interference to sleep, sitting upright, and perineal care. Proximal femoral resection-interposition arthroplasty is one method of treatment for this condition. We reviewed eight hips, two bilateral cases, with a mean follow-up of 30 months. Clinical improvement was observed in all except one case, with respect to pain relief and sitting tolerance. Some proximal migration was observed in three cases, despite routine post-operative skeletal traction in all cases and careful soft tissue interposition. One case showed significant heterotopic ossification which restricted prolonged sitting. This patient needed some occasional medication for pain. PMID:12180614

  8. Proteomics of Primary Cilia by Proximity Labeling.

    PubMed

    Mick, David U; Rodrigues, Rachel B; Leib, Ryan D; Adams, Christopher M; Chien, Allis S; Gygi, Steven P; Nachury, Maxence V

    2015-11-23

    While cilia are recognized as important signaling organelles, the extent of ciliary functions remains unknown because of difficulties in cataloguing proteins from mammalian primary cilia. We present a method that readily captures rapid snapshots of the ciliary proteome by selectively biotinylating ciliary proteins using a cilia-targeted proximity labeling enzyme (cilia-APEX). Besides identifying known ciliary proteins, cilia-APEX uncovered several ciliary signaling molecules. The kinases PKA, AMPK, and LKB1 were validated as bona fide ciliary proteins and PKA was found to regulate Hedgehog signaling in primary cilia. Furthermore, proteomics profiling of Ift27/Bbs19 mutant cilia correctly detected BBSome accumulation inside Ift27(-/-) cilia and revealed that ?-arrestin 2 and the viral receptor CAR are candidate cargoes of the BBSome. This work demonstrates that proximity labeling can be applied to proteomics of non-membrane-enclosed organelles and suggests that proteomics profiling of cilia will enable a rapid and powerful characterization of ciliopathies. PMID:26585297

  9. Proximal tibial fracture following total knee arthroplasty.

    PubMed

    Krause, Heike; Dunleavy, Kim

    2011-09-01

    The patient was a 74-year-old man, with a history of total knee arthoplasty 14 years earlier, after having sustained a pathological fracture of the proximal diaphysis of the left tibia following a fall. Given the unstable nature of the fracture and the severe osteolysis noted below the total knee arthroplasty, surgical management 1 day after the fall entailed packing cancellous bone graft into the defect and realigning the fracture. PMID:21885911

  10. Isolated Proximal Tibiofibular Dislocation during Soccer

    PubMed Central

    Chiu, Casey; Sheele, Johnathan Michael

    2015-01-01

    Proximal tibiofibular dislocations are rarely encountered in the Emergency Department (ED). We present a case involving a man presenting to the ED with left knee pain after making a sharp left turn on the soccer field. His physical exam was only remarkable for tenderness over the lateral fibular head. His X-rays showed subtle abnormalities of the tibiofibular joint. The dislocation was reduced and the patient was discharged from the ED with orthopedic follow-up. PMID:26713164

  11. Space robotic system for proximity operations

    NASA Technical Reports Server (NTRS)

    Magnani, P. G.; Colomba, M.

    1989-01-01

    Key to an efficient accomplishment of space station servicing operations is the development of a scenario where the presence of man in space is well integrated with the capability of teleoperated and automatic robot system outside the stations. Results focusing on mission requirements, trajectory sequences, propulsion subsystem features, and manipulative kit characteristics relevant to proximity servicing during a Man Tended Free Flyers Robotic Mission (MTFF-RM) are illustrated.

  12. Transverse Stress Fracture of the Proximal Patella

    PubMed Central

    Atsumi, Satoru; Arai, Yuji; Kato, Ko; Nishimura, Akinobu; Nakazora, Shigeto; Nakagawa, Shuji; Ikoma, Kazuya; Fujiwara, Hiroyoshi; Sudo, Akihiro; Kubo, Toshikazu

    2016-01-01

    Abstract Among stress fractures associated with sports activities, patellar stress fracture is rare. Regarding patella stress fractures, so far only distal transverse or lateral longitudinal fractures have been reported, but there are no reports of transverse fractures occurring in the proximal patella. We describe an extremely rare case of transverse stress fracture of proximal patella in a 9-year-old athlete. A 9-year old boy, who participated in sports (sprints and Kendo) presented with left knee pain without any external injury. In plain radiographs, a fracture line was observed in the proximal 1/3 of the left patella, and a patella stress fracture was diagnosed. For treatment, because 7 months of conservative therapy showed no improvement, internal fixation was carried out using Acutrak screws, and bone union was thus achieved. Three months after the operation, he was able to return to his previous level of athletic sports activity. Regarding the mechanism of onset, it is believed that the causes are longitudinal traction force and patellofemoral contact pressure. On the other hand, the contact region of the patella with the femur changes with the flexion angle of the knee. In the current case, the fracture occurred at a site where the patella was in contact with the femur at a flexion angle of >90°, so it is believed that it occurred as a clinical condition from being subjected to repeated longitudinal traction force and patellofemoral contact pressure at a flexion angle of >90°, during the sports activities of sprints and Kendo. The nonunion of the transverse stress fracture of his proximal patella was successfully treated with internal fixation using Acutrak screws. PMID:26871789

  13. Human proximal tubule cells form functional microtissues.

    PubMed

    Prange, Jenny A; Bieri, Manuela; Segerer, Stephan; Burger, Charlotte; Kaech, Andres; Moritz, Wolfgang; Devuyst, Olivier

    2016-04-01

    The epithelial cells lining the proximal tubules of the kidney mediate complex transport processes and are particularly vulnerable to drug toxicity. Drug toxicity studies are classically based on two-dimensional cultures of immortalized proximal tubular cells. Such immortalized cells are dedifferentiated, and lose transport properties (including saturable endocytic uptake) encountered in vivo. Generating differentiated, organotypic human microtissues would potentially alleviate these limitations and facilitate drug toxicity studies. Here, we describe the generation and characterization of kidney microtissues from immortalized (HK-2) and primary (HRPTEpiC) human renal proximal tubular epithelial cells under well-defined conditions. Microtissue cultures were done in hanging drop GravityPLUS™ culture plates and were characterized for morphology, proliferation and differentiation markers, and by monitoring the endocytic uptake of albumin. Kidney microtissues were successfully obtained by co-culturing HK-2 or HRPTEpiC cells with fibroblasts. The HK-2 microtissues formed highly proliferative, but dedifferentiated microtissues within 10 days of culture, while co-culture with fibroblasts yielded spherical structures already after 2 days. Low passage HRPTEpiC microtissues (mono- and co-culture) were less proliferative and expressed tissue-specific differentiation markers. Electron microscopy evidenced epithelial differentiation markers including microvilli, tight junctions, endosomes, and lysosomes in the co-cultured HRPTEpiC microtissues. The co-cultured HRPTEpiC microtissues showed specific uptake of albumin that could be inhibited by cadmium and gentamycin. In conclusion, we established a reliable hanging drop protocol to obtain functional kidney microtissues with proximal tubular epithelial cell lines. These microtissues could be used for high-throughput drug and toxicology screenings, with endocytosis as a functional readout. PMID:26676951

  14. Endovascular Aortic Aneurysm Repair with Chimney and Snorkel Grafts: Indications, Techniques and Results

    SciTech Connect

    Patel, Rakesh P.; Katsargyris, Athanasios Verhoeven, Eric L. G.; Adam, Donald J.; Hardman, John A.

    2013-12-15

    The chimney technique in endovascular aortic aneurysm repair (Ch-EVAR) involves placement of a stent or stent-graft parallel to the main aortic stent-graft to extend the proximal or distal sealing zone while maintaining side branch patency. Ch-EVAR can facilitate endovascular repair of juxtarenal and aortic arch pathology using available standard aortic stent-grafts, therefore, eliminating the manufacturing delays required for customised fenestrated and branched stent-grafts. Several case series have demonstrated the feasibility of Ch-EVAR both in acute and elective cases with good early results. This review discusses indications, technique, and the current available clinical data on Ch-EVAR.

  15. Axillary Artery Injury Caused by Fracture of Humerus Neck and Its Repair Using Basilic Vein Graft

    PubMed Central

    Kalia, Sandeep; Sehgal, Manik

    2014-01-01

    Proximal humerus fractures are rarely associated with axillary artery injury. We present a case of a 59-year-old female who had fracture neck humerus along with absent pulsations in the left upper limb after blunt trauma. Computed tomographic angiogram revealed complete occlusion of the left axillary artery. Urgent surgical intervention was done in the form of fixation of fracture followed by exploration and repair of axillary artery. Axillary artery was contused and totally occluded by fractured edge of humerus. Repair of the axillary artery was done using basilic vein graft harvested through the same incision. Postprocedure pulsations were present in the upper limb. PMID:25061530

  16. Coal bunker repairs

    SciTech Connect

    Emmons, M.H.; Hoffman, M.G. )

    1992-01-01

    Detroit Edison's St. Clair Power Plant (STCPP) Units 1 through 4 are 1950's vintage fossil fueled units with an average capacity of 163 megawatt per unit. Each unit had identical 2190 ton bunkers. The Unit No. 1 bunker had been experiencing noticeable exterior deterioration at the lower level internal support system. An internal bunker inspection revealed large deflections in the network of beams supporting the bunker side walls. A complete collapse of the internal support beams was imminent. Failure of these beams would have transferred the coal pressure loads to the bunker skin and external stiffeners which were not capable of sustaining the load and were also showing signs of distress. This paper presents the temporary repair installed immediately after inspection, the redesign of the lower internal support system and construction procedures involved in bringing the bunker back into operating condition.

  17. Repairing leaks in casings

    SciTech Connect

    Harris, K.L.; Vinson, E.F.; Bour, D.L.; Ewert, D.P.; Ekstrand, B.B.

    1992-06-23

    This patent describes a method for repairing a hole in a casing disposed in a wellbore. It comprises locating the hole in the casing; isolating the hole by defining a space within the casing in communication with the hole; introducing into the space a volume of a slurry of hydraulic cement in water; permitting the slurry to penetrate into the hole from the space; and maintaining the slurry in the hole for a time sufficient to enable the slurry to form a rigid plug of cement in the hole; wherein the slurry is comprised of a mixture of water and the hydraulic cement in the ratio of from about 0.5 to about 5.0 pounds of water per pound of cement.

  18. TPS Inspection and Repair

    NASA Technical Reports Server (NTRS)

    Parazynski, Scott

    2012-01-01

    Dr. Scott Parazynski provided a retrospective on the EVA tools and procedures efforts NASA went through in the aftermath of Columbia for the Shuttle Thermal Protection System (TPS) inspection and repair. He describes his role as the lead astronaut on this effort, and covered all of the Neutral Buoyancy Lab (NBL), KC 135 (reduced gravity aircraft), Precision Air Bearing Floor (PABF), vacuum chamber and 1 G testing that was done in order to develop the tools and techniques that were flown. Parazynski also discusses how the EVA community worked together to resolve a huge safety issue, and how his work in the spacesuit was critical to overcoming a design limitation of the Space Shuttle.

  19. Links between soil modelling and proximal sensing

    NASA Astrophysics Data System (ADS)

    Aitkenhead, Matt; McBratney, Alex; Minasny, Budiman

    2015-04-01

    Proximal sensing of soils can provide valuable information for soil modelling, by providing baseline data and validating model predictions through direct observation of soil characteristics. A wide range of soil parameters can be estimated using proximal sensing of soils (PSS), often simultaneously using single hand-held systems, of which there are many types. The benefits for soil modelling include direct observation of modelled parameters, rapid assessment in field conditions and digital data acquisition, making the transfer of information to soil models relatively straightforward. This is an active area of development, with research into improved methods of field-based capture of soil parameters directly relevant for soil modelling. A number of challenges exist, including the removal of or accounting for the effects of field conditions (e.g. soil moisture and structure), and the development of libraries of data that will allow calibration models to be produced. We present an overview of PSS as it relates to soil modelling, including equipment types, calibration approaches, cloud-based processing, soil parameters and processes estimated using PSS, and opportunities and challenges for the future. We also identify and discuss the possibilities for integration of modelling and proximal sensing within precision agriculture/precision land management.

  20. Proximity sensing with wavelet generated video

    NASA Astrophysics Data System (ADS)

    Noel, Steven E.; Szu, Harold H.

    1998-10-01

    In this paper we introduce wavelet video processing of proximity sensor signals. Proximity sensing is required for a wide range of military and commercial applications, including weapon fuzzing, robotics, and automotive collision avoidance. While our proposed method temporarily increases signal dimension, it eventually performs data compression through the extraction of salient signal features. This data compression in turn reduces the necessary complexity of the remaining computational processing. We demonstrate our method of wavelet video processing via the proximity sensing of nearby objects through their Doppler shift. In doing this we perform a continuous wavelet transform on the Doppler signal, after subjecting it to a time-varying window. We then extract signal features from the resulting wavelet video, which we use as input to pattern recognition neural networks. The networks are trained to estimate the time- varying Doppler shift from the extracted features. We test the estimation performance of the networks, using different degrees of nonlinearity in the frequency shift over time and different levels of noise. We give the analytical result that the signal-to-noise enhancement of our proposed method is at least as good as the square root of the number of video frames, although more work is needed to completely quantify this. Real-time wavelet-based video processing and compression technology recently developed under the DOD WAVENET program offers an exciting opportunity to more fully investigate our proposed method.

  1. Trajectories in Close Proximity to Asteroids

    NASA Technical Reports Server (NTRS)

    Scheeres, D. J.

    2000-01-01

    Spacecraft motion in close proximity to irregularly shaped, rotating bodies such as asteroids presents a unique dynamical environment as compared to most space missions. There are several fundamental novelties in this environment that spacecraft must deal with. These include the possibility of orbital instabilities that can act over very short time spans (on the order of hours for some systems), possible non-uniform rotation of the central gravity field, divergence of traditional gravity field representations when close to the asteroid surface, dominance of perturbing forces, an extremely large asteroid model parameter space that must be prepared for in the absence of reliable information, and the possibility of employing new and novel trajectory control techniques such as hovering and repeated landings on the asteroid surface. An overview of how these novelties impact the space of feasible close proximity operations and how different asteroid model properties will affect their implementation is given. In so doing, four fundamental types of close proximity operations will be defined. Listed in order of increasing technical difficulty these are: (1) close, stable orbits; (2) low-altitude flyovers; (3) landing trajectories; and (4) hovering trajectories. The feasibility and difficulty of implementing these operations will vary as a function of the asteroid shape, size, density, and rotation properties, and as a function of the spacecraft navigation capability. Additional information is contained in the original extended abstract.

  2. Management of proximal humerus fractures in adults.

    PubMed

    Vachtsevanos, Leonidas; Hayden, Lydia; Desai, Aravind S; Dramis, Asterios

    2014-11-18

    The majority of proximal humerus fractures are low-energy osteoporotic injuries in the elderly and their incidence is increasing in the light of an ageing population. The diversity of fracture patterns encountered renders objective classification of prognostic value challenging. Non-operative management has been associated with good functional outcomes in stable, minimally displaced and certain types of displaced fractures. Absolute indications for surgery are infrequent and comprise compound, pathological, multi-fragmentary head-splitting fractures and fracture dislocations, as well as those associated with neurovascular injury. A constantly expanding range of reconstructive and replacement options however has been extending the indications for surgical management of complex proximal humerus fractures. As a result, management decisions are becoming increasingly complicated, in an attempt to provide the best possible treatment for each individual patient, that will successfully address their specific fracture configuration, comorbidities and functional expectations. Our aim was to review the management options available for the full range of proximal humerus fractures in adults, along with their specific advantages, disadvantages and outcomes. PMID:25405098

  3. Reoperations after tricuspid valve repair: re-repair versus replacement

    PubMed Central

    Hwang, Ho Young; Kim, Kyung-Hwan; Kim, Ki-Bong

    2016-01-01

    Background Data demonstrating results of reoperation after initial tricuspid valve repair are scarce. We evaluated outcomes of tricuspid reoperations after tricuspid valve repair and compared the results of tricuspid re-repair with those of tricuspid valve replacement (TVR). Methods From 1994 to 2012, 53 patients (56±15 years, male:female =14:39) underwent tricuspid reoperations due to recurrent tricuspid regurgitation (TR) after initial repair. Twenty-two patients underwent tricuspid re-repair (TAP group) and 31 patients underwent TVR (TVR group). Results Early mortality occurred in 6 patients (11%). Early mortality and incidence of postoperative complications were similar between the 2 groups. There were 14 cases of late mortality including 9 cardiac deaths. Five- and 10-year free from cardiac death rates were 82% and 67%, respectively, without any intergroup difference. Recurrent TR (> moderate) developed in 6 TAP group patients and structural valve deterioration occurred in 1 TVR group patient (P=0.002). Isolated tricuspid valve surgery (P=0.044) and presence of atrial fibrillation during the follow-up (P=0.051) were associated with recurrent TR after re-repair. However, the overall tricuspid valve-related event rates were similar between the 2 groups with 5- and 10-year rates of 61% and 41%, respectively. Conclusions Tricuspid valve reoperation after initial repair resulted in high rates of operative mortality and complications. Long-term event-free rate was similar regardless of the type of surgery. However, great care might be needed when performing re-repair in patients with atrial fibrillation and those who had isolated tricuspid valve disease due to high recurrence of TR after re-repair. PMID:26904221

  4. Repair of postirradiation damage to colorectum: a progress report

    SciTech Connect

    Bricker, E.M.; Johnston, W.D.; Patwardhan, R.V.

    1981-05-01

    The results of 21 operations for repair of rectovaginal fistula and/or stricture secondary to irradiation for pelvic cancer are presented. The operations rely on the use of proximal nonirradiated colon with normal blood supply for effecting the repair. In patients having had a previous colostomy, it is possible to use the proximal end of the bypassed colon for this purpose. There is minimal dissection of the rectal ampulla and the presacral space is never entered. Continuity is established by anastomosis to the anterior rectal wall via an abdominal approach alone, or by a combined abdominovaginal or abdominoperineal approach. It has been found that nonirradiated colon of normal vascularity can be expected to heal to irradiated colon or rectum, thus making the extensive resections associated with correction of these abnormalities unnecessary. The functional result in 18 of 19 patients who underwent this procedure was satisfactory to excellent. One patient had a poor result because of partial rectal incontinence. Two operations out of the 21 were total failures and one of these patients died of complications secondary to irradiation damage to the small intestine. One patient has not yet had final colostomy closure. The results are considered promising enough to warrant continued trial.

  5. Brachiocephalic Artery Cannulation in Proximal Aortic Surgery that Requires Circulatory Arrest

    PubMed Central

    Unal, Mehmet; Akar, Ilker; Ince, Ilker; Aslan, Cemal; Koc, Fatih; Kafali, Haluk

    2014-01-01

    The brachiocephalic artery is an alternative cannulation site in the repair of ascending aortic lesions that require circulatory arrest. We evaluate the effectiveness and safety of this technique. Proximal aortic surgery was performed in 32 patients from 2006 through 2012 via brachiocephalic artery cannulation and circulatory arrest. Twenty-four (75%) of the patients were men. The mean age was 48.69 9.43 years (range, 3068 yr). Twelve had type I dissection, 2 had type II dissection, and 18 had true aneurysms of the ascending aorta. All operations were performed through a median sternotomy. The arterial cannula was inserted through an 8-mm vascular graft anastomosed to the brachiocephalic artery in an end-to-side fashion. In dissections, the distal anastomosis was performed without clamping the aorta. The patients were cooled to 24 C, and circulatory arrest was established. The brachiocephalic and left carotid arteries were clamped, and antegrade cerebral perfusion was started at a rate of 10 mL/kg/min. Cardiopulmonary bypass was resumed after completion of the distal anastomosis and the initiation of rewarming. The proximal anastomosis was then performed. None of the patients sustained a major neurologic deficit, but 5 patients experienced transient postoperative agitation (<24 hr). There were 2 early deaths (6.25%), on the 3rd and the 11th postoperative days, both unrelated to the cannulation technique. Brachiocephalic artery cannulation through a graft can be a safe and effective technique in proximal aortic surgical procedures that require circulatory arrest. PMID:25593522

  6. Repairing pipes on the fly

    SciTech Connect

    1997-04-01

    When piping develops leaks, the natural instinct is to shut the process down, purge the lines and call in maintenance crews to make the repairs. There is, however, an alternative: on-the-fly repairs. Through the use of specialized tools, equipment and technicians, shut-off valves can be installed and leaks repaired without interrupting production. The split sleeve offers one of the simpler approaches to on-the-fly repairs. Two half cylinders with inside diameter slightly larger than the outside diameter slightly larger than the outside diameter of the pipe to be repaired are slipped over the latter some distance form the leak and loosely bolted together. The cylinder is then slid over the leaking area and the bolts tightened. Gaskets inside the half cylinders provide the needed seal between the pipe and the cylinder. Installing a shut-off valve in an operating pipeline requires much more specialized equipment and skills than does repairing a leak with a split sleeve. A device available from International Piping Services Co. allows a trained crew to isolate a section of pipe, drill out the isolated portion, install a blocking valve and then remove the isolation system--all while continuing to operate the pipeline at temperatures to 700 F and pressures to 700 psi. But Herb Porter, CEO of Ipsco, cautions that unlike the repairing leaks with a split sleeve, installing a blocking valve on-the-fly always demands the services of a highly trained crew.

  7. DNA Repair Deficiency in Neurodegeneration

    PubMed Central

    Jeppesen, Dennis Kjølhede; Bohr, Vilhelm A.; Stevnsner, Tinna

    2011-01-01

    Deficiency in repair of nuclear and mitochondrial DNA damage has been linked to several neurodegenerative disorders. Many recent experimental results indicate that the post-mitotic neurons are particularly prone to accumulation of unrepaired DNA lesions potentially leading to progressive neurodegeneration. Nucleotide excision repair is the cellular pathway responsible for removing helix-distorting DNA damage and deficiency in such repair is found in a number of diseases with neurodegenerative phenotypes, including Xeroderma Pigmentosum and Cockayne syndrome. The main pathway for repairing oxidative base lesions is base excision repair, and such repair is crucial for neurons given their high rates of oxygen metabolism. Mismatch repair corrects base mispairs generated during replication and evidence indicates that oxidative DNA damage can cause this pathway to expand trinucleotide repeats, thereby causing Huntington’s disease. Single-strand breaks are common DNA lesions and are associated with the neurodegenerative diseases, ataxia-oculomotor apraxia-1 and spinocerebellar ataxia with axonal neuropathy-1. DNA double-strand breaks are toxic lesions and two main pathways exist for their repair: homologous recombination and non-homologous end-joining. Ataxia telangiectasia and related disorders with defects in these pathways illustrate that such defects can lead to early childhood neurodegeneration. Aging is a risk factor for neurodegeneration and accumulation of oxidative mitochondrial DNA damage may be linked with the age-associated neurodegenerative disorders Alzheimer’s disease, Parkinson’s disease and amyotrophic lateral sclerosis. Mutation in the WRN protein leads to the premature aging disease Werner syndrome, a disorder that features neurodegeneration. In this article we review the evidence linking deficiencies in the DNA repair pathways with neurodegeneration. PMID:21550379

  8. Mutation Rates, Spectra, and Genome-Wide Distribution of Spontaneous Mutations in Mismatch Repair Deficient Yeast

    PubMed Central

    Lang, Gregory I.; Parsons, Lance; Gammie, Alison E.

    2013-01-01

    DNA mismatch repair is a highly conserved DNA repair pathway. In humans, germline mutations in hMSH2 or hMLH1, key components of mismatch repair, have been associated with Lynch syndrome, a leading cause of inherited cancer mortality. Current estimates of the mutation rate and the mutational spectra in mismatch repair defective cells are primarily limited to a small number of individual reporter loci. Here we use the yeast Saccharomyces cerevisiae to generate a genome-wide view of the rates, spectra, and distribution of mutation in the absence of mismatch repair. We performed mutation accumulation assays and next generation sequencing on 19 strains, including 16 msh2 missense variants implicated in Lynch cancer syndrome. The mutation rate for DNA mismatch repair null strains was approximately 1 mutation per genome per generation, 225-fold greater than the wild-type rate. The mutations were distributed randomly throughout the genome, independent of replication timing. The mutation spectra included insertions/deletions at homopolymeric runs (87.7%) and at larger microsatellites (5.9%), as well as transitions (4.5%) and transversions (1.9%). Additionally, repeat regions with proximal repeats are more likely to be mutated. A bias toward deletions at homopolymers and insertions at (AT)n microsatellites suggests a different mechanism for mismatch generation at these sites. Interestingly, 5% of the single base pair substitutions might represent double-slippage events that occurred at the junction of immediately adjacent repeats, resulting in a shift in the repeat boundary. These data suggest a closer scrutiny of tumor suppressors with homopolymeric runs with proximal repeats as the potential drivers of oncogenesis in mismatch repair defective cells. PMID:23821616

  9. Heterogeneous polymerase fidelity and mismatch repair bias genome variation and composition.

    PubMed

    Lujan, Scott A; Clausen, Anders R; Clark, Alan B; MacAlpine, Heather K; MacAlpine, David M; Malc, Ewa P; Mieczkowski, Piotr A; Burkholder, Adam B; Fargo, David C; Gordenin, Dmitry A; Kunkel, Thomas A

    2014-11-01

    Mutational heterogeneity must be taken into account when reconstructing evolutionary histories, calibrating molecular clocks, and predicting links between genes and disease. Selective pressures and various DNA transactions have been invoked to explain the heterogeneous distribution of genetic variation between species, within populations, and in tissue-specific tumors. To examine relationships between such heterogeneity and variations in leading- and lagging-strand replication fidelity and mismatch repair, we accumulated 40,000 spontaneous mutations in eight diploid yeast strains in the absence of selective pressure. We found that replicase error rates vary by fork direction, coding state, nucleosome proximity, and sequence context. Further, error rates and DNA mismatch repair efficiency both vary by mismatch type, responsible polymerase, replication time, and replication origin proximity. Mutation patterns implicate replication infidelity as one driver of variation in somatic and germline evolution, suggest mechanisms of mutual modulation of genome stability and composition, and predict future observations in specific cancers. PMID:25217194

  10. DNA-protein crosslink repair.

    PubMed

    Stingele, Julian; Jentsch, Stefan

    2015-08-01

    DNA-protein crosslinks (DPCs) are highly toxic DNA adducts, but whether dedicated DPC-repair mechanisms exist was until recently unknown. This has changed with discoveries made in yeast and Xenopus laevis that revealed a protease-based DNA-repair pathway specific for DPCs. Importantly, mutations in the gene encoding the putative human homologue of a yeast DPC protease cause a human premature ageing and cancer predisposition syndrome. Thus, DPC repair is a previously overlooked genome-maintenance mechanism that may be essential for tumour suppression. PMID:26130008

  11. Proximity and Interactive Learning in University-Firm Relationships

    ERIC Educational Resources Information Center

    Thune, Taran

    2009-01-01

    This paper addresses the question of whether proximity is always necessary for interactive learning, as proposed by recent European innovation theory. Recent research has provided a refined conceptualization of proximity, but there is little empirically-based knowledge about the actual role that proximity plays in relationships intended to foster

  12. Proximal tubule function and response to acidosis.

    PubMed

    Curthoys, Norman P; Moe, Orson W

    2014-09-01

    The human kidneys produce approximately 160-170 L of ultrafiltrate per day. The proximal tubule contributes to fluid, electrolyte, and nutrient homeostasis by reabsorbing approximately 60%-70% of the water and NaCl, a greater proportion of the NaHCO3, and nearly all of the nutrients in the ultrafiltrate. The proximal tubule is also the site of active solute secretion, hormone production, and many of the metabolic functions of the kidney. This review discusses the transport of NaCl, NaHCO3, glucose, amino acids, and two clinically important anions, citrate and phosphate. NaCl and the accompanying water are reabsorbed in an isotonic fashion. The energy that drives this process is generated largely by the basolateral Na(+)/K(+)-ATPase, which creates an inward negative membrane potential and Na(+)-gradient. Various Na(+)-dependent countertransporters and cotransporters use the energy of this gradient to promote the uptake of HCO3 (-) and various solutes, respectively. A Na(+)-dependent cotransporter mediates the movement of HCO3 (-) across the basolateral membrane, whereas various Na(+)-independent passive transporters accomplish the export of various other solutes. To illustrate its homeostatic feat, the proximal tubule alters its metabolism and transport properties in response to metabolic acidosis. The uptake and catabolism of glutamine and citrate are increased during acidosis, whereas the recovery of phosphate from the ultrafiltrate is decreased. The increased catabolism of glutamine results in increased ammoniagenesis and gluconeogenesis. Excretion of the resulting ammonium ions facilitates the excretion of acid, whereas the combined pathways accomplish the net production of HCO3 (-) ions that are added to the plasma to partially restore acid-base balance. PMID:23908456

  13. Delayed homicides and the proximate cause.

    PubMed

    Lin, Peter; Gill, James R

    2009-12-01

    Delayed homicides result from complications of remote injuries inflicted by "the hands of another." The investigation of delayed homicides may be a challenge due to a number of factors including: failure to report the death to the proper authorities, lack of ready and adequate documentation of the original injury and circumstances, and jurisdictional differences between the places of injury and death. The certification of these deaths also requires the demonstration of a pathophysiologic link between the remote injury and death. In sorting through these issues, it is helpful to rely upon the definition of the proximate cause of death. Over a 2-year period in New York City, there were 1211 deaths certified as homicide of which 42 were due to injuries sustained greater than 1 year before death. The survival interval ranged from 1.3 to 43.2 years. The most common immediate causes of death were: infections (22), seizures (7), and intestinal obstructions/hernias (6). Common patterns of complications included infection following a gunshot wound of the spinal cord, seizure disorder due to blunt head trauma, and intestinal obstruction/hernia due to adhesions from an abdominal stab wound. Spinal cord injuries resulted in paraplegia in 14 instances and quadriplegia in 8. The mean survival interval for paraplegics was 20.3 years and 14.8 years for quadriplegics; infections were a frequent immediate cause of death in both groups, particularly infections due to chronic bladder catheterization. The definition of proximate cause originated with civil law cases and was later applied to death certification as the proximate cause of death. The gradual extinction of the "year and a day rule" for the limitation of bringing homicide charges in delayed deaths may result in more of these deaths going to trial. Medical examiners/coroners must be able to explain the reasoning behind these death certifications and maintain consistent standards for the certification of all delayed deaths due to any injury (homicides, suicides, and accidents). PMID:19901806

  14. Proximal Tubule Function and Response to Acidosis

    PubMed Central

    2014-01-01

    Summary The human kidneys produce approximately 160–170 L of ultrafiltrate per day. The proximal tubule contributes to fluid, electrolyte, and nutrient homeostasis by reabsorbing approximately 60%–70% of the water and NaCl, a greater proportion of the NaHCO3, and nearly all of the nutrients in the ultrafiltrate. The proximal tubule is also the site of active solute secretion, hormone production, and many of the metabolic functions of the kidney. This review discusses the transport of NaCl, NaHCO3, glucose, amino acids, and two clinically important anions, citrate and phosphate. NaCl and the accompanying water are reabsorbed in an isotonic fashion. The energy that drives this process is generated largely by the basolateral Na+/K+-ATPase, which creates an inward negative membrane potential and Na+-gradient. Various Na+-dependent countertransporters and cotransporters use the energy of this gradient to promote the uptake of HCO3− and various solutes, respectively. A Na+-dependent cotransporter mediates the movement of HCO3− across the basolateral membrane, whereas various Na+-independent passive transporters accomplish the export of various other solutes. To illustrate its homeostatic feat, the proximal tubule alters its metabolism and transport properties in response to metabolic acidosis. The uptake and catabolism of glutamine and citrate are increased during acidosis, whereas the recovery of phosphate from the ultrafiltrate is decreased. The increased catabolism of glutamine results in increased ammoniagenesis and gluconeogenesis. Excretion of the resulting ammonium ions facilitates the excretion of acid, whereas the combined pathways accomplish the net production of HCO3− ions that are added to the plasma to partially restore acid-base balance. PMID:23908456

  15. Mechanism of proximal NaCl reabsorption in the proximal tubule of the mammalian kidney.

    PubMed

    Berry, C A; Rector, F C

    1991-03-01

    In the mammalian proximal tubule NaCl reabsorption occurs by both passive and active transport processes. Passive NaCl reabsorption occurs in the presence of a high luminal chloride and a low luminal bicarbonate concentration. These anion gradients provide the driving forces for diffusive Na and Cl movement. Na is driven by the lumen positive PD effected by the greater permeability of the tubular wall to Cl than to HCO3. Cl is driven by its high tubular concentration. Passive NaCl reabsorption accounts for only about 10% to 15% of total proximal NaCl transport. The remaining proximal NaCl is reabsorbed by active transport processes and occurs both in the presence or absence of anion gradients reabsorption. Two mechanisms of active NaCl reabsorption participate in active NaCl reabsorption along the proximal tubule. Firstly, active NaCl reabsorption is electrogenic. In the early proximal tubule Na enters to cell coupled to organic solute transport. This Na reabsorption generates a lumen negative PD and effects "coupled" electrogenic NaCl reabsorption. This mechanism is limited by the supply of organic solutes and is blunted by the greater Na than Cl permeability in the proximal tubule; it probably can account for no more than 10% of proximal NaCl reabsorption. In the terminal proximal tubule, the proximal straight tubule, the apical membrane appears to possess a channel for Na entry. This Na reabsorption also generates a lumen negative PD and effects "simple" electrogenic NaCl reabsorption. This mechanism is limited by the low transport capacity of this segment and probably accounts for no more than 5% to 10% of total proximal NaCl reabsorption. The great bulk of proximal NaCl reabsorption occurs along the entire proximal tubule by active, transcellular electroneutral NaCl reabsorption. The precise cellular transport mechanisms responsible for this process are only recently being defined. At the apical membrane parallel ion exchangers are responsible for NaCl entry into the cell. Na enters via the apical membrane Na-H antiporter. Cl most likely crosses the apical membrane by some combination of Cl-OH and Cl-HCO2 exchangers but not via a Cl-HCO3 exchanger. The relative contributions of Cl-OH and Cl-HCO2 exchange have not been defined. There are two important considerations in this question. First is the availbility of OH versus HCO2. Although there is an infinite supply of OH and a small equilibrium supply of HCO2, it is possible that the luminal concentration of HCO2 could be increased by an USL that raises the concentration of HCO2 to a degree sufficient to supply H2CO2 recycling for physiological transcellular Cl transport rates.(ABSTRACT TRUNCATED AT 400 WORDS) PMID:2034928

  16. Anatomic Double-Bundle Reinsertion After Acute Proximal Anterior Cruciate Ligament Injury Using Knotless PushLock Anchors

    PubMed Central

    Weninger, Patrick; Wepner, Florian; Kissler, Florian; Enenkel, Michael; Wurnig, Christian

    2015-01-01

    Direct anterior cruciate ligament (ACL) repair has been described with different suture techniques after acute ACL injury, but these procedures showed high failure rates. Recent studies, however, led to a better understanding of the biology of primary ACL healing. This article describes a novel technique combining the healing response technique with primary anatomic double-bundle ACL reinsertion after an acute proximal ACL tear using nonabsorbable No. 2 FiberWire (Arthrex, Naples, FL) and PushLock knotless suture anchors (Arthrex). We recommend this technique for patients with acute proximal avulsiontype ACL injuries. Postoperatively, we recommend a knee brace locked in full extension for at least 4weeks to ensure adequate immobilization and then to increase knee flexion slowly over the next 4weeks for subsequent healing of the ACL repair. Our technique combines anatomic positioning and reinsertion of the ACL bundles with microfracturing of the region delivering stem cells and growth factors to the repaired ACL, creating optimal conditions for the healing period. In certain cases this technique might be an alternative to conventional ACL reconstruction with autograft or allograft tendons. PMID:25973366

  17. Anatomic Double-Bundle Reinsertion After Acute Proximal Anterior Cruciate Ligament Injury Using Knotless PushLock Anchors.

    PubMed

    Weninger, Patrick; Wepner, Florian; Kissler, Florian; Enenkel, Michael; Wurnig, Christian

    2015-02-01

    Direct anterior cruciate ligament (ACL) repair has been described with different suture techniques after acute ACL injury, but these procedures showed high failure rates. Recent studies, however, led to a better understanding of the biology of primary ACL healing. This article describes a novel technique combining the "healing response technique" with primary anatomic double-bundle ACL reinsertion after an acute proximal ACL tear using nonabsorbable No. 2 FiberWire (Arthrex, Naples, FL) and PushLock knotless suture anchors (Arthrex). We recommend this technique for patients with acute proximal avulsion-type ACL injuries. Postoperatively, we recommend a knee brace locked in full extension for at least 4 weeks to ensure adequate immobilization and then to increase knee flexion slowly over the next 4 weeks for subsequent healing of the ACL repair. Our technique combines anatomic positioning and reinsertion of the ACL bundles with microfracturing of the region delivering stem cells and growth factors to the repaired ACL, creating optimal conditions for the healing period. In certain cases this technique might be an alternative to conventional ACL reconstruction with autograft or allograft tendons. PMID:25973366

  18. Anatomy of the sural nerve in a computer?assisted model: implications for surgical minimal?invasive Achilles tendon repair

    PubMed Central

    Citak, Musa; Knobloch, Karsten; Albrecht, Knut; Krettek, Christian; Hufner, Tobias

    2007-01-01

    Background Sural nerve injuries are an evident risk especially of minimal?invasive surgical Achilles tendon repair. However, detailed anatomical studies focusing on the relationship of the sural nerve with the Achilles tendon at various levels are scarce, even pending in two planes. Aim To determine the position and course of the sural nerve in relation to the Achilles tendon in two planes after trans?section and computer?assisted determination. Methods The exact course of the sural nerve was determined in 10 cadavers (55.3?years, 1989?years), using a computer?assisted method in two planes (transversal/sagittal). Results The sural nerve crossed the Achilles tendon at 11 (8.712.4)?cm proximal to the tuber calcanei. The distance between the lateral crossing and the proximal musculotendineus junction was 35 (2058)?mm. Starting from the tuber calcanei, the distance was 2/2?mm (transversal/sagittal plane) at 11?cm proximal to the tuber calcanei, 4/4?mm at 10?cm proximal, 5/6?mm at 9?cm, 8/10?mm at 5?cm and 11/18?mm at the tuber calcanei. Conclusion In the lateral crossing region of the sural nerve and the lateral proximal Achilles tendon 912?cm proximal to the tuber calcanei, a close relationship of both anatomical structures can be visualised using computer?assisted measurements; caution is suggested to prevent sural nerve entrapment in either open or percutaneous Achilles tendon repair. PMID:17347315

  19. Complications of Proximal Biceps Tenotomy and Tenodesis.

    PubMed

    Virk, Mandeep S; Nicholson, Gregory P

    2016-01-01

    The long head of biceps tendon (LHBT) is a well-recognized cause of anterior shoulder pain. Tenotomy or tenodesis of the LHBT is an effective surgical solution for relieving pain arising from the LHBT. Cosmetic deformity of the arm, cramping or soreness in the biceps muscle, and strength deficits in elbow flexion and supination are the three most common adverse events associated with tenotomy of the LHBT. Complications associated with tenodesis of the LHBT include loss of fixation resulting in cosmetic deformity, residual groove pain, pain or soreness in the biceps muscle, infection, stiffness, hematoma, neurologic injury, vascular injury, proximal humerus fracture, and reflex sympathetic dystrophy. PMID:26614476

  20. Space station proximity operations and window design

    NASA Technical Reports Server (NTRS)

    Haines, Richard F.

    1988-01-01

    On-orbit proximity operations (PROX-OPS) consist of all extravehicular activity (EVA) within 1 km of the space station. Because of the potentially large variety of PROX-OPS, very careful planning for space station windows is called for and must consider a great many human factors. The following topics are discussed: (1) basic window design philosophy and assumptions; (2) the concept of the local horizontal - local vertical on-orbit; (3) window linear dimensions; (4) selected anthropomorphic considerations; (5) displays and controls relative to windows; and (6) full window assembly replacement.

  1. Corrections beyond the proximity force approximation

    NASA Astrophysics Data System (ADS)

    Teo, L. P.; Bordag, M.; Nikolaev, V.

    2011-12-01

    We recalculate the first analytic correction beyond proximity force approximation for a sphere in front of a plane for a scalar field and for the electromagnetic field. We use the method of Bordag and Nikolaev [J. Phys. AJPHAC50305-4470 41, 164002 (2008)10.1088/1751-8113/41/16/164002]. We confirm their result for Dirichlet boundary conditions whereas we find a different one for Robin, Neumann and conductor boundary conditions. The difference can be traced back to a sign error. As a result, the corrections depend on the Robin parameter. Agreement is found with a very recent method of derivative expansion.

  2. Open Subpectoral Tenodesis of the Proximal Biceps.

    PubMed

    Voss, Andreas; Cerciello, Simone; Yang, Justin; Beitzel, Knut; Cote, Mark P; Mazzocca, Augustus D

    2016-01-01

    This article summarizes both the various techniques for an open subpectoral biceps tenodesis as well as the biomechanics associated with these procedures. It provides information regarding the indications and contraindications to support the surgeon's decision. Furthermore, a postoperative protocol as well as an outcome overview is presented to address postoperative care. A short summary of the recent literature regarding potential complications is included to provide further insight on this technique. The open subpectoral tenodesis of the long head of the biceps is a safe and reproducible technique with a low complication rate for patients with pathologies of the proximal biceps. PMID:26614473

  3. Proximal Biceps Tendon and Rotator Cuff Tears.

    PubMed

    Virk, Mandeep S; Cole, Brian J

    2016-01-01

    The long head of biceps tendon (LHBT) is frequently involved in rotator cuff tears and can cause anterior shoulder pain. Tendon hypertrophy, hourglass contracture, delamination, tears, and tendon instability in the bicipital groove are common macroscopic pathologic findings affecting the LHBT in the presence of rotator cuff tears. Failure to address LHBT disorders in the setting of rotator cuff tear can result in persistent shoulder pain and poor satisfaction after rotator cuff repair. Tenotomy or tenodesis of the LHBT are effective options for relieving pain arising from the LHBT in the setting of reparable and selected irreparable rotator cuff tears. PMID:26614474

  4. DNA Repair and Chromosomal Translocations.

    PubMed

    Bohlander, Stefan K; Kakadia, Purvi M

    2015-01-01

    The balance between DNA damage, especially double strand breaks, and DNA damage repair is a critical determinant of chromosomal translocation frequency. The non-homologous end-joining repair (NHEJ) pathways seem to play the major role in the generation of chromosomal translocations. The "landscape" of chromosomal translocation identified in malignancies is largely due to selection processes which operate on the growth advantages conveyed to the cells by the functional consequences of chromosomal translocations (i.e., oncogenic fusion proteins and overexpression of oncogenes, both compromising tumor suppressor gene functions). Newer studies have shown that there is an abundance of local rearrangements in many tumors, like small deletions and inversions. A better understanding of the interplay between DNA repair mechanisms and the generation of tumorigenic translocations will, among many other things, depend on an improved understanding of DNA repair mechanisms and their interplay with chromatin and the 3D organization of the interphase nucleus. PMID:26376870

  5. Nucleotide excision repair in humans.

    PubMed

    Spivak, Graciela

    2015-12-01

    The demonstration of DNA damage excision and repair replication by Setlow, Howard-Flanders, Hanawalt and their colleagues in the early 1960s, constituted the discovery of the ubiquitous pathway of nucleotide excision repair (NER). The serial steps in NER are similar in organisms from unicellular bacteria to complex mammals and plants, and involve recognition of lesions, adducts or structures that disrupt the DNA double helix, removal of a short oligonucleotide containing the offending lesion, synthesis of a repair patch copying the opposite undamaged strand, and ligation, to restore the DNA to its original form. The transcription-coupled repair (TCR) subpathway of NER, discovered nearly two decades later, is dedicated to the removal of lesions from the template DNA strands of actively transcribed genes. In this review I will outline the essential factors and complexes involved in NER in humans, and will comment on additional factors and metabolic processes that affect the efficiency of this important process. PMID:26388429

  6. Precision Instrument and Equipment Repairers.

    ERIC Educational Resources Information Center

    Wyatt, Ian

    2001-01-01

    Explains the job of precision instrument and equipment repairers, who work on cameras, medical equipment, musical instruments, watches and clocks, and industrial measuring devices. Discusses duties, working conditions, employment and earnings, job outlook, and skills and training. (JOW)

  7. Cleft lip and palate repair

    MedlinePLUS

    Orofacial cleft; Craniofacial birth defect repair; Cheiloplasty; Cleft rhinoplasty; Palatoplasty; Tip rhinoplasty ... A cleft lip is a birth defect: A cleft lip may be just a small notch in the lip. It may also be a complete split in the ...

  8. Taking control of cavitation repair

    SciTech Connect

    Fulton, E.

    1994-05-01

    Eliminating surprises and emergencies is the key of mastering cavitation-erosion repair. Innovations in runner design, new welding techniques and materials, and integrated maintenance scheduling add to that mastery.

  9. 40 CFR 63.1024 - Leak repair.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... reading measured by Method 21 of 40 CFR part 60, appendix A at the time the leak is successfully repaired... purged material resulting from immediate repair would be greater than the fugitive emissions likely to result from delay of repair, and (ii) When repair procedures are effected, the purged material...

  10. 40 CFR 63.1005 - Leak repair.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... successful repair of the leak. (3) Maximum instrument reading measured by Method 21 of 40 CFR part 60... emissions of purged material resulting from immediate repair would be greater than the fugitive emissions likely to result from delay of repair, and (ii) When repair procedures are effected, the purged...

  11. 40 CFR 63.1024 - Leak repair.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... reading measured by Method 21 of 40 CFR part 60, appendix A at the time the leak is successfully repaired... purged material resulting from immediate repair would be greater than the fugitive emissions likely to result from delay of repair, and (ii) When repair procedures are effected, the purged material...

  12. 40 CFR 63.1005 - Leak repair.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... successful repair of the leak. (3) Maximum instrument reading measured by Method 21 of 40 CFR part 60... emissions of purged material resulting from immediate repair would be greater than the fugitive emissions likely to result from delay of repair, and (ii) When repair procedures are effected, the purged...

  13. The cytoplasmic protein Pacsin 2 in kidney development and injury repair

    PubMed Central

    Yao, Gang; Luyten, Annouck; Takakura, Ayumi; Plomann, Markus; Zhou, Jing

    2014-01-01

    The protein kinase C and casein kinase 2 substrate in neurons (Pacsin) is a subfamily of membrane-binding proteins that participates in vesicle trafficking and cytoskeleton organization. Here, we studied Pacsin 2 in kidney development and repair following injury. In the postnatal developing kidneys, Pacsin 2 was found to be expressed in both ureteric bud- and mesenchyme-derived structures including proximal and distal tubules, Bowman's capsule, and the glomerular tuft. In the adult kidney, its expression was decreased in proximal tubules but increased in glomerular tuft when compared to that in the developing kidneys. Interestingly, Pacsin 2 expression was significantly upregulated during the repair phase after ischemiareperfusion injury, especially on the apical brush border of proximal tubules that experienced massive damage. Pacsin 2 localized to the primary cilia of renal epithelial cells. Knockdown of Pacsin 2 by shRNA did not affect the cell cycle or cell polarity; however, it increased the length of primary cilia, and resulted in significant tubulogenic defects in three-dimensional cell culture. Thus, we propose that Pacsin 2 contributes to kidney development and repair in a nephron-specific manner. PMID:23235565

  14. Aircraft Metal Skin Repair and Honeycomb Structure Repair; Sheet Metal Work 3: 9857.02.

    ERIC Educational Resources Information Center

    Dade County Public Schools, Miami, FL.

    The course helps students determine types of repairs, compute repair sizes, and complete the repair through surface protection. Course content includes goals, specific objectives, protection of metals, repairs to metal skin, and honeycomb structure repair. A bibliography and post-test are appended. A prerequisite for this course is mastery of the…

  15. Large steam turbine repair: A survey

    SciTech Connect

    Findlan, S.J.; Lube, B. )

    1991-07-01

    This report covers a survey taken to document the current state-of-the-art in repairs to large steam turbines. One objective was to provide information to assist utilities in making repair or replacement decisions. The survey revealed that a large number of repairs have been successfully repaired involving both mechanical and welding repair techniques. Repair techniques have been improving in recent years and are being used more frequently. No guidelines or codes exist for the repair of steam turbine components so each repair is primarily controlled by agreement between the utility, contractor and insurer. Types of repairs are reviewed in this report and in addition, the capabilities of various contractors who are currently active in providing repair service. 40 refs., 10 figs., 4 tabs.

  16. Updated Classification System for Proximal Humeral Fractures

    PubMed Central

    Guix, Jos M. Mora; Pedrs, Juan Sala; Serrano, Alejandro Castao

    2009-01-01

    Proximal humeral fractures can restrict daily activities and, therefore, deserve efficient diagnoses that minimize complications and sequels. For good diagnosis and treatment, patient characteristics, variability in the forms of the fractures presented, and the technical difficulties in achieving fair results with surgical treatment should all be taken into account. Current classification systems for these fractures are based on anatomical and pathological principles, and not on systematic image reading. These fractures can appear in many different forms, with many characteristics that must be identified. However, many current classification systems lack good reliability, both inter-observer and intra-observer for different image types. A new approach to image reading, following a well-designed set and sequence of variables to check, is needed. We previously reported such an image reading system. In the present study, we report a classification system based on this image reading system. Here we define 21 fracture characteristics and apply them along with classical Codman approaches to classify fractures. We base this novel classification system for classifying proximal humeral fractures on a review of scientific literature and improvements to our image reading protocol. Patient status, fracture characteristics and surgeon circumstances have been important issues in developing this system. PMID:19574487

  17. Updated classification system for proximal humeral fractures.

    PubMed

    Mora Guix, Jos M; Pedrs, Juan Sala; Serrano, Alejandro Castao

    2009-06-01

    Proximal humeral fractures can restrict daily activities and, therefore, deserve efficient diagnoses that minimize complications and sequels. For good diagnosis and treatment, patient characteristics, variability in the forms of the fractures presented, and the technical difficulties in achieving fair results with surgical treatment should all be taken into account. Current classification systems for these fractures are based on anatomical and pathological principles, and not on systematic image reading. These fractures can appear in many different forms, with many characteristics that must be identified. However, many current classification systems lack good reliability, both inter-observer and intra-observer for different image types. A new approach to image reading, following a well-designed set and sequence of variables to check, is needed. We previously reported such an image reading system. In the present study, we report a classification system based on this image reading system. Here we define 21 fracture characteristics and apply them along with classical Codman approaches to classify fractures. We base this novel classification system for classifying proximal humeral fractures on a review of scientific literature and improvements to our image reading protocol. Patient status, fracture characteristics and surgeon circumstances have been important issues in developing this system. PMID:19574487

  18. Proximate determinants of fertility in peninsular Malaysia.

    PubMed

    Tey, Nai Peng; Ng, Sor Tho; Yew, Siew Yong

    2012-05-01

    The continuing decline in fertility despite a contraction in contraceptive use in Peninsular Malaysia since the mid-1980s has triggered considerable interest in the reasons behind this phenomenon, such as increase in abortion, sterility, and out-of-wedlock pregnancy. Fertility decline has been attributed to rapid socioeconomic development, which can only influence fertility through the intermediate variables. Application of vital statistics, population census, and survey data of Peninsular Malaysia on Bongaarts's model vindicates that marriage postponement and contraceptive use are the 2 most important proximate determinants of fertility, but the effects are not uniform across the ethnic groups. For instance, the predicted total fertility rate for Chinese and Malays are 2.9 and 1.6, respectively, compared with the observed level of 3.0 and 1.9. Postpartum infecundability and abortion also play a part in explaining ethnic fertility differentials. The fertility inhibiting effects of these proximate determinants have significant implications on reproductive health and future population growth. PMID:21490114

  19. Superconducting Proximity Effect in Thin Semiconducting Films

    NASA Astrophysics Data System (ADS)

    Vissers, Michael; Flexner, Soren; Welander, Paul; Inderhees, Kevin; McArdle, Tim; Eckstein, Jim

    2008-03-01

    We report results using a novel 3 terminal device structure that provides two independent resistance measurements that we use to examine the influence of the superconducting proximity effect on both the transport properties of the thin film N layer by quantifying its sheet resistance, Rs, as well as independently measuring the junction conductance across the N-S boundary, Gc. When the N layer is a degenerate semiconductor the changes in these quantities are large. Gc increases much more than the factor of 2 that Andreev Reflection or BTK theory predicts, and both Gc and Rs exhibit reentrance as temperature decreases. We interpret these effects as being due to a transition between a phase fluctuating and phase stiff proximity effect in the N layer. This manifests itself by moving the N-S electrical boundary into the semiconductor, increasing Gc, while simultaneously removing volume available to normal transport forcing the measured Rs to increase. This work was supported by the DOE BES at the F. Seitz Materials Research Laboratory at the University of Illinois, Urbana.

  20. Superconducting Proximity Effect in Thin Semiconducting Films

    NASA Astrophysics Data System (ADS)

    Vissers, Michael; Inderhees, Kevin; McArdle, Tim; Law, Stephanie; Goldbart, Paul; Greene, Laura; Eckstein, Jim

    2009-03-01

    We report results using a novel 3 terminal device to study the influence of the superconducting proximity effect on the sheet resistance of the N-layer, Rs, as well as the junction conductance across the N-S boundary, Gc. When the N-layer is a degenerate semiconductor the changes in these quantities are large. In samples with large Gc, we find that the N-layer sheet resistance below the SC transition increases as T decreases. We can also extract the actual J-E relationship by modeling the spatial current profile beneath the injector electrode. We interpret these effects as being due to a phase stiff proximity effect in the N layer moving the N-S electrical boundary into the semiconductor as the temperature is lowered, thereby removing volume available to normal transport, and causing the measured Rs to increase. This work was supported by the DOE BES at the F. Seitz Materials Research Laboratory at the University of Illinois, Urbana.

  1. Artificial Topological Superconductor by the Proximity Effect

    NASA Astrophysics Data System (ADS)

    Xu, Jin-Peng; Liu, Canhua; Wang, Mei-Xiao; Ge, Jianfeng; Liu, Zhi-Long; Yang, Xiaojun; Chen, Yan; Liu, Ying; Xu, Zhu-An; Gao, Chun-Lei; Qian, Dong; Zhang, Fu-Chun; Jia, Jin-Feng

    2014-05-01

    Topological superconductors (TSCs), featuring fully gapped bulk and gapless surface states as well as Majorana fermions, have potential applications in fault-tolerant topological quantum computing. Because TSCs are very rare in nature, an alternative way to study the TSC is to artificially introduce superconductivity into the surface states of a topological insulator through the proximity effect [X. L. Qi, T. L. Hughse, S. Raghu, and S. C. Zhang, Phys. Rev. Lett. 102, 187001 (2009); L. Fu and C. L. Kane, Phys. Rev. Lett. 100, 096407 (2008); J. Alicea, Rep. Prog. Phys. 75, 076501 (2012); C. W. J. Beenakker, Annu. Rev. Condens. Matter Phys. 4, 113 (2013)]. Here we report the experimental realization of the proximity effect-induced TSC in Bi2Te3 thin films grown on a NbSe2 substrate, as demonstrated by the density of states probed using scanning tunneling spectroscopy. We observed Abrikosov vortices and Andreev lower energy bound states on the surface of the topological insulator, with the superconducting coherence length depending on the film thickness and the magnetic field. These results also indicate that the topological surface states of Bi2Te3 thin films are superconducting and, thus, that the Bi2Te3/NbSe2 is an artificial TSC. The feasibility of fabricating a TSC with an individual Majorana fermion bound to a superconducting vortex for topological quantum computing is discussed.

  2. Carbon nanotube proximity influences rice DNA

    NASA Astrophysics Data System (ADS)

    Katti, Dinesh R.; Sharma, Anurag; Pradhan, Shashindra Man; Katti, Kalpana S.

    2015-07-01

    The uptake of carbon nanotubes (CNT) influences the output of plants, potentially through interactions between the DNA and CNTs. However, little is known about the changes in the plant DNA due to CNT proximity. We report changes in rice plant DNA in the proximity of single walled CNT (SWCNT) using molecular dynamics simulations. The DNA experiences breaking and forming of hydrogen bonds due to unzipping of Watson-Crick (WC) nucleobase pairs and wrapping onto SWCNT. The number of hydrogen bonds between water and DNA nucleobases decreases due to the presence of SWCNT. A higher number of guanine-cytosine (Gua-Cyt) WC hydrogen bonds break as compared to adenine-thymine (Ade-Thy), which suggests that Gua and Cyt bases play a dominant role in DNA-SWCNT interactions. We also find that changes to non-WC nucleobase pairs and van der Waals attractive interactions between WC nucleobase pairs and SWCNT cause significant changes in the conformation of the DNA.

  3. True Aneurysm of the Proximal Brachial Artery

    PubMed Central

    Ramakrishna, Pinjala; Mahapatra, Sandeep; Rajesh, Ratna

    2013-01-01

    A 35-year-old farmer presented with complaints of pain in the right upper limb for 1 month and bluish discoloration of the right-hand finger tips with tingling and numbness. He sustained injury to the right upper limb while lifting a heavy object 1 mo previously. There was an ovoid swelling of 4 2 cm on the medial aspect of the right arm, 12 cm above the medial epicondyle at the level of the armpit with visible pulsations. There was distal neurovascular deficit. Duplex scan of the right upper limb arterial system revealed a pseudoaneurysm of the proximal right brachial artery, with dampened monophasic flow in the ulnar artery and no flow in the radial artery. Spiral computed tomography angiogram showed the presence of an echogenic periarterial lesion in the proximal brachial artery suggestive of pseudoaneurysm or an extrinsic compression by hematoma. Distal brachial artery was found to have filled with thrombus, with non-opacification of the radial and the distal ulnar artery. The patient was posted for excision of the aneurysmal arterial segment. A 5-cm-long reversed segment of vein graft was interposed in between the cut ends of the brachial artery. Histopathology: Specimen shows a part of the vessel wall composed of intimal, medial, and adventitial layers with intraluminal thrombus showing evidence of recanalization suggestive of true aneurysm of the brachial artery.

  4. An improved proximity force approximation for electrostatics

    SciTech Connect

    Fosco, Cesar D.; Instituto Balseiro, Universidad Nacional de Cuyo, R8402AGP Bariloche ; Lombardo, Fernando C.; IFIBA ; Mazzitelli, Francisco D.

    2012-08-15

    A quite straightforward approximation for the electrostatic interaction between two perfectly conducting surfaces suggests itself when the distance between them is much smaller than the characteristic lengths associated with their shapes. Indeed, in the so called 'proximity force approximation' the electrostatic force is evaluated by first dividing each surface into a set of small flat patches, and then adding up the forces due two opposite pairs, the contributions of which are approximated as due to pairs of parallel planes. This approximation has been widely and successfully applied in different contexts, ranging from nuclear physics to Casimir effect calculations. We present here an improvement on this approximation, based on a derivative expansion for the electrostatic energy contained between the surfaces. The results obtained could be useful for discussing the geometric dependence of the electrostatic force, and also as a convenient benchmark for numerical analyses of the tip-sample electrostatic interaction in atomic force microscopes. - Highlights: Black-Right-Pointing-Pointer The proximity force approximation (PFA) has been widely used in different areas. Black-Right-Pointing-Pointer The PFA can be improved using a derivative expansion in the shape of the surfaces. Black-Right-Pointing-Pointer We use the improved PFA to compute electrostatic forces between conductors. Black-Right-Pointing-Pointer The results can be used as an analytic benchmark for numerical calculations in AFM. Black-Right-Pointing-Pointer Insight is provided for people who use the PFA to compute nuclear and Casimir forces.

  5. Obesity and Supermarket Access: Proximity or Price?

    PubMed Central

    Aggarwal, Anju; Hurvitz, Philip M.; Monsivais, Pablo; Moudon, Anne V

    2012-01-01

    Objectives. We examined whether physical proximity to supermarkets or supermarket price was more strongly associated with obesity risk. Methods. The Seattle Obesity Study (SOS) collected and geocoded data on home addresses and food shopping destinations for a representative sample of adult residents of King County, Washington. Supermarkets were stratified into 3 price levels based on average cost of the market basket. Sociodemographic and health data were obtained from a telephone survey. Modified Poisson regression was used to test the associations between obesity and supermarket variables. Results. Only 1 in 7 respondents reported shopping at the nearest supermarket. The risk of obesity was not associated with street network distances between home and the nearest supermarket or the supermarket that SOS participants reported as their primary food source. The type of supermarket, by price, was found to be inversely and significantly associated with obesity rates, even after adjusting for individual-level sociodemographic and lifestyle variables, and proximity measures (adjusted relative risk = 0.34; 95% confidence interval = 0.19, 0.63) Conclusions. Improving physical access to supermarkets may be one strategy to deal with the obesity epidemic; improving economic access to healthy foods is another. PMID:22698052

  6. Synostosis of the Proximal Tibiofibular Joint

    PubMed Central

    Sferopoulos, Nikolaos K.

    2010-01-01

    The incidence of synostosis of the proximal tibiofibular joint (TFJ) was assessed among 1029 patients examined for osteoarthritis of the knee in a 4-year period. Radiographic evidence of a synostosis of the proximal TFJ was demonstrated in 3 knees (3 patients). The synostosis appeared incidental and was not the cause of symptoms in any of them. These patients were further examined with MRI and/or CT scans. In two cases, which were found to be primary (idiopathic), the synostosis was complete and bony. In a third case the lesion was secondary (acquired) to surgical reconstruction for a depressed fracture of the lateral tibial plateau. This iatrogenic complication followed open reduction, internal fixation, and grafting with synthetic bone. The bridging of the joint on the CT views was partial and compatible with ectopic calcification rather than ossification. The patients were treated conservatively and were followed for an average period of 3 years. No evidence that the synostosis accelerated the onset or progression of the degenerative changes to the ipsilateral knee could be verified. PMID:20592991

  7. Synostosis of the proximal tibiofibular joint.

    PubMed

    Sferopoulos, Nikolaos K

    2010-01-01

    The incidence of synostosis of the proximal tibiofibular joint (TFJ) was assessed among 1029 patients examined for osteoarthritis of the knee in a 4-year period. Radiographic evidence of a synostosis of the proximal TFJ was demonstrated in 3 knees (3 patients). The synostosis appeared incidental and was not the cause of symptoms in any of them. These patients were further examined with MRI and/or CT scans. In two cases, which were found to be primary (idiopathic), the synostosis was complete and bony. In a third case the lesion was secondary (acquired) to surgical reconstruction for a depressed fracture of the lateral tibial plateau. This iatrogenic complication followed open reduction, internal fixation, and grafting with synthetic bone. The bridging of the joint on the CT views was partial and compatible with ectopic calcification rather than ossification. The patients were treated conservatively and were followed for an average period of 3 years. No evidence that the synostosis accelerated the onset or progression of the degenerative changes to the ipsilateral knee could be verified. PMID:20592991

  8. Efficacy of Low Level Laser Therapy After Hand Flexor Tendon Repair

    SciTech Connect

    Ayad, K. E.; Abd El Mejeed, S. F.; El Gohary, H. M.; Abd Elrahman, M.; Bekheet, A. B.

    2009-09-27

    Flexor tendon injury is a common problem requiring suturing repair followed by early postoperative mobilization. Muscle atrophy, joint stiffness, osteoarthritis, infection, skin necrosis, ulceration of joint cartilage and tendocutaneous adhesion are familiar complications produced by prolonged immobilization of surgically repaired tendon ruptures. The purpose of this study was to clarify the importance of low level laser therapy after hand flexor tendon repair in zone II. Thirty patients aging between 20 and 40 years were divided into two groups. Patients in group A (n = 15) received a conventional therapeutic exercise program while patients in group B (n = 15) received low level laser therapy combined with the same therapeutic exercise program. The results showed a statistically significant increase in total active motion of the proximal and distal interphalangeal joints as well as maximum hand grip strength at three weeks and three months postoperative, but improvement was more significant in group B. It was concluded that the combination of low level laser therapy and early therapeutic exercises was more effective than therapeutic exercises alone in improving total active motion of proximal and distal interphalangeal joints and hand grip strength after hand flexor tendon repair.

  9. Efficacy of Low Level Laser Therapy After Hand Flexor Tendon Repair

    NASA Astrophysics Data System (ADS)

    Ayad, K. E.; El Gohary, H. M.; Abd Elrahman, M.; Abd El Mejeed, S. F.; Bekheet, A. B.

    2009-09-01

    Flexor tendon injury is a common problem requiring suturing repair followed by early postoperative mobilization. Muscle atrophy, joint stiffness, osteoarthritis, infection, skin necrosis, ulceration of joint cartilage and tendocutaneous adhesion are familiar complications produced by prolonged immobilization of surgically repaired tendon ruptures. The purpose of this study was to clarify the importance of low level laser therapy after hand flexor tendon repair in zone II. Thirty patients aging between 20 and 40 years were divided into two groups. Patients in group A (n = 15) received a conventional therapeutic exercise program while patients in group B (n = 15) received low level laser therapy combined with the same therapeutic exercise program. The results showed a statistically significant increase in total active motion of the proximal and distal interphalangeal joints as well as maximum hand grip strength at three weeks and three months postoperative, but improvement was more significant in group B. It was concluded that the combination of low level laser therapy and early therapeutic exercises was more effective than therapeutic exercises alone in improving total active motion of proximal and distal interphalangeal joints and hand grip strength after hand flexor tendon repair.

  10. Identification and characterization of uvrA, a DNA repair gene of Deinococcus radiodurans.

    PubMed Central

    Agostini, H J; Carroll, J D; Minton, K W

    1996-01-01

    Deinococcus radiodurans is extraordinarily resistant to DNA damage, because of its unusually efficient DNA repair processes. The mtcA+ and mtcB+ genes of D. radiodurans, both implicated in excision repair, have been cloned and sequenced, showing that they are a single gene, highly homologous to the uvrA+ genes of other bacteria. The Escherichia coli uvrA+ gene was expressed in mtcA and mtcB strains, and it produced a high degree of complementation of the repair defect in these strains, suggesting that the UvrA protein of D. radiodurans is necessary but not sufficient to produce extreme DNA damage resistance. Upstream of the uvrA+ gene are two large open reading frames, both of which are directionally divergent from the uvrA+ gene. Evidence is presented that the proximal of these open reading frames may be irrB+. PMID:8955293

  11. Abdominal Aortic Aneurysm Repair Using Nellix EndoVascular Aneurysm Sealing.

    PubMed

    van den Ham, Leo H; Zeebregts, Clark J; de Vries, Jean-Paul P M; Reijnen, Michel M P J

    2015-05-01

    Since the dawn of endovascular aortic aneurysm repair (EVAR), starting from its initial report in 1991, there has been a significant evolution in stent graft design and delivery systems. Complications, mostly endoleaks, and re-intervention rates after EVAR remain amongst the most challenging aspects in comparison with traditional open repair. The use of a sac-anchoring endograft changes the approach of aneurysm exclusion. The Nellix EndoVascular Aneurysm Sealing system (Endologix Inc., Irvine, CA) consists of balloon expandable stents surrounded by endobags that are filled with a polymer thereby sealing the aneurysm. By sealing the aneurysm sac instead of exclusion with only proximal and distal fixation, the risk of stent migration and endoleaks is theoretically diminished. Current investigational use is aimed to confirm clinical success, decreased complication, and secondary intervention rates compared to conventional endovascular repair. PMID:26055014

  12. Cytosine methylation and DNA repair.

    PubMed

    Walsh, C P; Xu, G L

    2006-01-01

    Cytosine methylation is a common form of post-replicative DNA modification seen in both bacteria and eukaryotes. Modified cytosines have long been known to act as hotspots for mutations due to the high rate of spontaneous deamination of this base to thymine, resulting in a G/T mismatch. This will be fixed as a C-->T transition after replication if not repaired by the base excision repair (BER) pathway or specific repair enzymes dedicated to this purpose. This hypermutability has led to depletion of the target dinucleotide CpG outside of special CpG islands in mammals, which are normally unmethylated. We review the importance of C-->T transitions at non-island CpGs in human disease: When these occur in the germline, they are a common cause of inherited diseases such as epidermolysis bullosa and mucopolysaccharidosis, while in the soma they are frequently found in the genes for tumor suppressors such as p53 and the retinoblastoma protein, causing cancer. We also examine the specific repair enzymes involved, namely the endonuclease Vsr in Escherichia coli and two members of the uracil DNA glycosylase (UDG) superfamily in mammals, TDG and MBD4. Repair brings its own problems, since it will require remethylation of the replacement cytosine, presumably coupling repair to methylation by either the maintenance methylase Dnmt1 or a de novo enzyme such as Dnmt3a. Uncoupling of methylation from repair may be one way to remove methylation from DNA. We also look at the possible role of specific cytosine deaminases such as Aid and Apobec in accelerating deamination of methylcytosine and consequent DNA demethylation. PMID:16570853

  13. 49 CFR 1242.42 - Administration, repair and maintenance, machinery repair, equipment damaged, dismantling retired...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 9 2010-10-01 2010-10-01 false Administration, repair and maintenance, machinery repair, equipment damaged, dismantling retired property, fringe benefits, other casualties and insurance... maintenance, machinery repair, equipment damaged, dismantling retired property, fringe benefits,...

  14. Parallel Proximity Detection for Computer Simulation

    NASA Technical Reports Server (NTRS)

    Steinman, Jeffrey S. (Inventor); Wieland, Frederick P. (Inventor)

    1997-01-01

    The present invention discloses a system for performing proximity detection in computer simulations on parallel processing architectures utilizing a distribution list which includes movers and sensor coverages which check in and out of grids. Each mover maintains a list of sensors that detect the mover's motion as the mover and sensor coverages check in and out of the grids. Fuzzy grids are includes by fuzzy resolution parameters to allow movers and sensor coverages to check in and out of grids without computing exact grid crossings. The movers check in and out of grids while moving sensors periodically inform the grids of their coverage. In addition, a lookahead function is also included for providing a generalized capability without making any limiting assumptions about the particular application to which it is applied. The lookahead function is initiated so that risk-free synchronization strategies never roll back grid events. The lookahead function adds fixed delays as events are scheduled for objects on other nodes.

  15. [Ophthalmologists in the proximity of Adolf Hitler].

    PubMed

    Rohrbach, J M

    2012-10-01

    Adolf Hitler met or at least knew about 5 ophthalmologists. The chair of ophthalmology in Berlin, Walther Löhlein, personally examined Hitler's eyes at least two times. The chair of ophthalmology in Breslau, Walter Dieter, developed "air raid protection spectacles" with the aid of high representatives of the NS-system and probably Adolf Hitler himself. Heinrich Wilhelm Kranz became rector of the universities of Giessen and Frankfurt/Main. He was known as a very strict advocate of the NS-race hygiene. Werner Zabel made plans for Hitler's diet and tried to interfere with Hitler's medical treatment. Finally, Hellmuth Unger was an influential representative of the medical press and a famous writer. Three of his novels with medical topics were made into a film which Hitler probably saw. Hitler had, so to say, a small "ophthalmological proximity" which, however, did not play a significant role for himself or the NS-state. PMID:22664943

  16. Proximal interphalangeal joint instability in the dog.

    PubMed

    Guilliard, M J

    2003-09-01

    A prospective study into the use of transarticular external skeletal fixation in the treatment of proximal interphalangeal instability was undertaken. Only dogs with soft tissue injuries were included. All the dogs except one were greyhounds or related breeds. A hypothesis was proposed that if the articular surfaces were held in normal congruency for a period of time then the development of periarticular fibrosis would alone give sufficient joint support. Joint congruency was maintained by the application of a unilateral external skeletal fixator for approximately three weeks. Complications were common and were due to frame impingement on the neighbouring digit, pin tract infection and pin loosening, and all resolved following frame removal and antibiotic therapy. Careful pin placement and prophylactic antibiotic treatment prevented complications in subsequent cases. All dogs returned to normal function with no lameness, with the exception of one racing greyhound which had a recurrence of the instability. PMID:14510329

  17. Parallel Proximity Detection for Computer Simulations

    NASA Technical Reports Server (NTRS)

    Steinman, Jeffrey S. (Inventor); Wieland, Frederick P. (Inventor)

    1998-01-01

    The present invention discloses a system for performing proximity detection in computer simulations on parallel processing architectures utilizing a distribution list which includes movers and sensor coverages which check in and out of grids. Each mover maintains a list of sensors that detect the mover's motion as the mover and sensor coverages check in and out of the grids. Fuzzy grids are included by fuzzy resolution parameters to allow movers and sensor coverages to check in and out of grids without computing exact grid crossings. The movers check in and out of grids while moving sensors periodically inform the grids of their coverage. In addition, a lookahead function is also included for providing a generalized capability without making any limiting assumptions about the particular application to which it is applied. The lookahead function is initiated so that risk-free synchronization strategies never roll back grid events. The lookahead function adds fixed delays as events are scheduled for objects on other nodes.

  18. Proximity Effects in Superconductor-Graphene Junctions

    NASA Astrophysics Data System (ADS)

    Cuellar, Fabian A.; Perconte, David; Martin, Marie-Blandine; Dlubak, Bruno; Piquemail, Maelis; Bernard, Rozenn; Trastoy, Juan; Moreau-Luchaire, Constance; Seneor, Pierre; Villegas, Javier E.; Kidambi, Piran; Hofmann, Stephan; Robertson, John

    2015-03-01

    Superconducting proximity effects are of particular interest in graphene: because of its band structure, an unconventional (specular) Andreev reflection is expected. In this context, high-Tc superconductor-graphene junctions are especially attractive. In these, the size of the superconducting energy-gap may exceed the graphene doping inhomogeneities around the Dirac point, which should favor the observation of the specular Andreev reflection. Yet, the fabrication of high-Tc superconductor-graphene junctions is challenging: the usual growth and lithography processes in both materials are incompatible. We report here on a fabrication method that allow us to fabricate planar cuprate superconductor-graphene junctions, which we characterize via conductance spectroscopy. We analyze the features in the conductance spectra as a function of graphene doping, and discuss them in the framework of the Andreev reflection. Work supported by Labex Nanosaclay.

  19. DC Proximal Newton for Nonconvex Optimization Problems.

    PubMed

    Rakotomamonjy, Alain; Flamary, Remi; Gasso, Gilles

    2016-03-01

    We introduce a novel algorithm for solving learning problems where both the loss function and the regularizer are nonconvex but belong to the class of difference of convex (DC) functions. Our contribution is a new general purpose proximal Newton algorithm that is able to deal with such a situation. The algorithm consists in obtaining a descent direction from an approximation of the loss function and then in performing a line search to ensure a sufficient descent. A theoretical analysis is provided showing that the iterates of the proposed algorithm admit as limit points stationary points of the DC objective function. Numerical experiments show that our approach is more efficient than the current state of the art for a problem with a convex loss function and a nonconvex regularizer. We have also illustrated the benefit of our algorithm in high-dimensional transductive learning problem where both the loss function and regularizers are nonconvex. PMID:25910256

  20. Surgical Approaches to the Proximal Interphalangeal Joint.

    PubMed

    Cheah, Andre Eu-Jin; Yao, Jeffrey

    2016-02-01

    The proximal interphalangeal (PIP) joint may be affected by many conditions such as arthropathy, fractures, dislocations, and malunions. Whereas some of these conditions may be treated nonsurgically, many require open surgical intervention. Open interventions include implant arthroplasty or arthrodesis for arthropathy, open reduction internal fixation, or hemi-hamate arthroplasty for dorsal fracture-dislocations. Volar plate arthroplasty and corrective osteotomy for malunion about the PIP joint are also surgeries that may be required. The traditional approach to the PIP joint has been dorsal, which damages the delicate extensor apparatus with subsequent development of an extensor lag. This has led surgeons to explore volar and lateral approaches to the PIP joint. In this article, we describe each of these surgical approaches, discuss their advantages and disadvantages, and provide some guidance on which approach to choose based on the surgery that is to be performed. PMID:26708513

  1. Optical proximity correction with hierarchical Bayes model

    NASA Astrophysics Data System (ADS)

    Matsunawa, Tetsuaki; Yu, Bei; Pan, David Z.

    2015-03-01

    Optical Proximity Correction (OPC) is one of the most important techniques in today's optical lithography based manufacturing process. Although the most widely used model-based OPC is expected to achieve highly accurate correction, it is also known to be extremely time-consuming. This paper proposes a regression model for OPC using a Hierarchical Bayes Model (HBM). The goal of the regression model is to reduce the number of iterations in model-based OPC. Our approach utilizes a Bayes inference technique to learn the optimal parameters from given data. All parameters are estimated by the Markov Chain Monte Carlo method. Experimental results show that utilizing HBM can achieve a better solution than other conventional models, e.g., linear regression based model, or non-linear regression based model. In addition, our regression results can be fed as the starting point of conventional model based OPC, through which we are able to overcome the runtime bottleneck.

  2. Proximal forearm fractures: our clinical experience.

    PubMed

    Concari, Galeazzo; Pedrazzini, Alessio; Vaienti, Enrico; Pogliacomi, Francesco

    2002-01-01

    Forearm traumas are frequent and sometimes complex; soft tissue damages associated with bone lesions could be underestimated and so compromise the final result, in spite of a good reduction and osteosynthesis. Articular and iuxta-articular proximal radius and ulna fractures, which can be associated to radio-humeral dislocations in Monteggia lesions, are less frequent compared to diaphyseal fractures and can present a lot of therapeutical difficulties and a high rate of complications. These complications are avoided and reduced if the treatment is quick and focused on stable osteosynthesis and anatomical reduction of the fragments of the fracture and followed, as soon as possible, by rehabilitation. The authors present the 10 years experience of Parma Orthopaedics Institute with a follow-up of at least 12 months. PMID:12643076

  3. Algorithms for treating redundancy in repairable and non-repairable systems

    SciTech Connect

    Campbell, J.E.; Longsine, D.E.; Atkins, J.

    1993-10-01

    This report presents equations and computational algorithms for analyzing reliability of several forms of redundancy in repairable and non-repairable systems. For repairable systems, active, standby, and R of N redundancy with and without repair are treated. For non-repairable systems, active, standby, and R of N redundancy are addressed. These equations can be used to calculate mean time between failures, mean time to repair, and reliability for complex systems involving redundancy.

  4. Isosmotic volume reabsorption in rat proximal tubule

    PubMed Central

    1980-01-01

    A theoretical model incorporation both active and passive forces has been developed for fluid reabsorption from split oil droplets in rat intermediate and late proximal tubule. Of necessity, simplifying assumptions have been introduced; we have assumed that the epithelium can be treated as a single membrane and that the membrane "effective" HCO3 permeability is near zero. Based on this model with its underlying assumptions, the following conclusions are drawn. Regardless of the presence or absence of active NaCl transport, fluid reabsorption from the split oil droplet is isosmotic. The reabsorbate osmolarity can be affected by changes in tubular permeability parameters and applied forces but is not readily altered from an osmolarity essentially equal to that of plasma. In a split droplet, isosmotic flow need not be a special consequence of active Na transport, is not the result of a particular set of permeability properties, and is not merely a trivial consequence of a very high hydraulic conductivity; isosmotic flow can be obtained with hydraulic conductivity nearly an order of magnitude lower than that previously measured in the rat proximal convoluted tubule. Isosmotic reabsorption is, in part, the result of the interdependence of salt and water flows, their changing in parallel, and thus their ratio, the reabsorbate concentration being relatively invariant. Active NaCl transport can cause osmotic water flow by reducing the luminal fluid osmolarity. In the presence of passive forces the luminal fluid can be hypertonic to plasma, and active NaCl transport can still exert its osmotic effect on volume flow. There are two passive forces for volume flow: the Cl gradient and the difference in effective osmotic pressure; they have an approximately equivalent effect on volume flow. Experimentally, we have measured volume changes in a droplet made hyperosmotic by the addition of 50 mM NaCl; the experimental results are predicted reasonably well by our theoretical model. PMID:7441196

  5. Proximity of adjacent velocities and collision detection.

    PubMed

    Lemon, Carissa; Andersen, George

    2015-09-01

    Previous research has demonstrated that the detection of an impending collision on a linear trajectory is specified by an object maintaining constant bearing (position in the visual field). Additionally, velocity information adjacent to an approaching object has been shown to alter the ability to determine bearing information. In the present study we examined the effect of proximity of adjacent velocity on collision detection judgments. Observers were presented with 3D scenes consisting of either a ground plane or with a ground plane with objects in the scene that extended vertically from the ground. These scene objects were presented on either both sides of the scene or on only one the side scene (the side opposing the approaching object). Two independent variables were manipulated: the presence of adjacent velocities (scene objects absent, scene objects present on both sides, and scene objects present on only one side), and display duration (1000ms and 5000ms). We found that sensitivity to detect a collision (d') decreased with display duration (F(1, 7)= 101.194, p< .001) and with the presence of scene objects (F(2, 7)= 5.744, p=0.015). Post-hoc analysis indicated scene objects on both sides compared to scene objects on only one side did not differ significantly from one another but scene objects absent differed significantly from scene objects present on both sides. These results demonstrate that the effect of adjacent velocities found in previous research was not due to the mere presence of objects within the scene and that proximity of adjacent velocities is the important factor. This provides further evidence suggesting opponent motion mechanisms in area MT average velocities across local regions in the visual field. Meeting abstract presented at VSS 2015. PMID:26326698

  6. The design of repairable advanced composite structures

    NASA Technical Reports Server (NTRS)

    Hart-Smith, L. J.

    1985-01-01

    This paper addresses the repair of advanced composite structures by mechanical fasteners or by adhesive bonding. It is shown that many of today's composite designs are unreasonably difficult to repair. Conversely, the knowledge to design repairable structures is already available, if only it is applied during the initial design stage. Bolted or riveted repairs require only the avoidance of extremely orthotropic composite fiber patterns; those near the quasi-isotropic layup are the most suitable. Mildly orthotropic fiber patterns are appropriate for structures in which there is a dominant load direction. Thick composite structures are shown to require bolted or riveted repairs while thin structures favor adhesively bonded permanent repairs, although provisions can be easily made for temporary mechanical repairs. The reasons why integrally stiffened cocured composite designs are usually impractical to repair are explained and alternative repairable design concepts are presented.

  7. Protein damage, repair and proteolysis.

    PubMed

    Chondrogianni, Niki; Petropoulos, Isabelle; Grimm, Stefanie; Georgila, Konstantina; Catalgol, Betul; Friguet, Bertrand; Grune, Tilman; Gonos, Efstathios S

    2014-02-01

    Proteins are continuously affected by various intrinsic and extrinsic factors. Damaged proteins influence several intracellular pathways and result in different disorders and diseases. Aggregation of damaged proteins depends on the balance between their generation and their reversal or elimination by protein repair systems and degradation, respectively. With regard to protein repair, only few repair mechanisms have been evidenced including the reduction of methionine sulfoxide residues by the methionine sulfoxide reductases, the conversion of isoaspartyl residues to L-aspartate by L-isoaspartate methyl transferase and deglycation by phosphorylation of protein-bound fructosamine by fructosamine-3-kinase. Protein degradation is orchestrated by two major proteolytic systems, namely the lysosome and the proteasome. Alteration of the function for both systems has been involved in all aspects of cellular metabolic networks linked to either normal or pathological processes. Given the importance of protein repair and degradation, great effort has recently been made regarding the modulation of these systems in various physiological conditions such as aging, as well as in diseases. Genetic modulation has produced promising results in the area of protein repair enzymes but there are not yet any identified potent inhibitors, and, to our knowledge, only one activating compound has been reported so far. In contrast, different drugs as well as natural compounds that interfere with proteolysis have been identified and/or developed resulting in homeostatic maintenance and/or the delay of disease progression. PMID:23107776

  8. Reprogramming Cells for Brain Repair

    PubMed Central

    Guarino, Alyx T.; McKinnon, Randall D.

    2013-01-01

    At present there are no clinical therapies that can repair traumatic brain injury, spinal cord injury or degenerative brain disease. While redundancy and rewiring of surviving circuits can recover some lost function, the brain and spinal column lack sufficient endogenous stem cells to replace lost neurons or their supporting glia. In contrast, pre-clinical studies have demonstrated that exogenous transplants can have remarkable efficacy for brain repair in animal models. Mesenchymal stromal cells (MSCs) can provide paracrine factors that repair damage caused by ischemic injury, and oligodendrocyte progenitor cell (OPC) grafts give dramatic functional recovery from spinal cord injury. These studies have progressed to clinical trials, including human embryonic stem cell (hESC)-derived OPCs for spinal cord repair. However, ESC-derived allografts are less than optimal, and we need to identify a more appropriate donor graft population. The cell reprogramming field has developed the ability to trans-differentiate somatic cells into distinct cell types, a technology that has the potential to generate autologous neurons and glia which address the histocompatibility concerns of allografts and the tumorigenicity concerns of ESC-derived grafts. Further clarifying how cell reprogramming works may lead to more efficient direct reprogram approaches, and possibly in vivo reprogramming, in order to promote brain and spinal cord repair. PMID:24961526

  9. Repairing Solar Max: The Solar Maximum Repair Mission

    NASA Technical Reports Server (NTRS)

    Mcmahan, T.; Neal, V.

    1984-01-01

    Technology and procedures designed for replacing a faulty attitude control module and scientific instruments on the only orbiting solar observatory are described. The rationale for the repair mission is given and the operations of the flight support system within the cargo bay of the space shuttle are discussed. The use of the manned maneuvering unit in capturing the satellite and of the remote manipulator arm in berthing it are discussed, as well as the space tools to be used for repair operations. The space crew and their responsibilities are identified.

  10. Bonded composite repair of composite structures

    NASA Astrophysics Data System (ADS)

    Mahler, Mary A.

    Repair and maintenance cost drives a large percentage of the lifetime cost of aircraft structures. Understanding repair issues can lead to a structure that significantly lowers the lifetime cost. Advanced composite materials, while offering the potential to increase aircraft capabilities with minimum weight, are more susceptible to repairable damage than conventional aircraft materials. Improved inspection and repair methods are required to ensure structural integrity and aircraft readiness in the existing operational environment. Many of today's innovative composite designs may result in aircraft structures that are unreasonably difficult to repair. As a first step, technical issues associated with bonded composite repair of composite structures were investigated. An extensive literature review identified many areas where real world composite repairs are being used successfully. An electronic database was developed summarizing the publications found during the literature review. The database includes publication, experimental test results and analytical results of advanced composite bonded repairs. The current analysis of repair does not account for the variations that exist in repair. To facilitate the analysis, a finite element interface was developed to provide analysts with a tool that would create complete finite element models of repaired structures efficiently and in a 3-dimensional view. The finite element models created by the developed interface were successfully correlated to test data for accuracy of the results. Parametric studies were performed using the interface to evaluate effects of repair variables. Thermal impact of repair on the repair panel is one area lacking attention in the repair literature. To understand the impact of heat and thermal gradients of the repair, an analytical investigation was performed to evaluate. the parameters affected by heat. For a solid laminate, the temperature at the adhesive bondline was investigated. The primary focus is on sandwich panels where heat transfer is known to impact the repair process. The internal pressure from the heat of the repair process and moisture trapped in honeycomb structure was evaluated and shown to produce sufficient pressure to disbond the facesheet from the core.

  11. Sirtuins, Metabolism, and DNA repair

    PubMed Central

    Choi, Jee-Eun; Mostoslavsky, Raul

    2014-01-01

    Cells evolve to actively coordinate nutrient availability with cellular activity in order to maintain metabolic homeostasis. In addition, active pathways to repair DNA damage are crucial to avoid deleterious genomic instability. In recent years, it has become increasingly clear that availability of intermediate metabolites may play an important role in DNA repair, suggesting that these two seemingly distant cellular activities may be highly coordinated. The sirtuin family of proteins now described as deacylases (they can also remove acyl groups other than acetyl moieties), it appears to have evolved to control both metabolism and DNA repair. In this review, we discuss recent advances that lay the foundation to understanding the role of sirtuins in these two biological processes, and the potential crosstalk to coordinate them. PMID:25005742

  12. Robotic equipment for pipeline repair

    SciTech Connect

    Gibson, D.E.; Barratt, K.; Paterson, J.

    1995-12-31

    Hyperbaric welding provides the most reliable method for connection or repair of subsea oil and gas pipelines. Research on hyperbaric arc welding processes indicates that it should be possible to achieve stable welding conditions with Gas Tungsten Arc (GTA) to approximately 600m, and with Gas Metal Arc (GMA) and Plasma Arc to at least 1,000m. These depths are well beyond the limits of manned saturation diving. At the present time the limitation on the maximum depth to which these processes can be applied, in practice, is the requirement for completely diverless operation deeper than approximately 350m. Fully diverless hyperbaric welding is not presently available to the industry but several diverless pipeline repair systems which utilize mechanical connectors have been developed. This paper reviews the present status of mechanized hyperbaric welding systems currently being used in the North Sea and discusses some of the work being done to achieve fully diverless robotic pipeline repair with both welding and connectors.

  13. Weld Repair of Irradiated Materials

    SciTech Connect

    Kanne, W.R. Jr.

    1999-02-24

    Maintenance of an accelerator for production of tritium will require replacement or modification of components that have been exposed to neutron irradiation. A primary repair option is welding, but conventional repair welding processes produced severe cracking in irradiated stainless steel. Optical metallography, scanning electron microscopy, and transmission electron microscopy have shown that the cracks are: intergranular, primarily in the weld heat-affected zone, characterized by a dimple structure on the crack surface, and associated with helium bubbles which grow during welding. A model has been developed which qualitatively shows the interaction of three primary and three secondary variables producing helium embrittlement cracking. A shallow penetration overlay technique was successfully demonstrated to minimize cracking in irradiated 304 stainless steel that contained 10 appm helium. The overlay technique provides a potential method for repair or modification of accelerator materials exposed to irradiation.

  14. Weld repair of irradiated materials

    SciTech Connect

    Kanne, W.R. Jr.; Louthan, M.R. Jr.; Rankin, D.T.; Tosten, M.H.

    1999-09-01

    Maintenance of an accelerator for production of tritium will require replacement or modification of components that have been exposed to neutron irradiation. A primary repair option is welding, but conventional repair welding processes produced severe cracking in irradiated stainless steel. Optical metallography, scanning electron microscopy, and transmission electron microscopy have shown that the cracks are: intergranular, primarily in the weld heat-affected zone, characterized by a dimple structure on the crack surface, and associated with helium bubbles that grow during welding. A model has been developed that qualitatively shows the interaction of three primary and three secondary variables producing helium embrittlement cracking. A shallow penetration overlay technique was successfully demonstrated to minimize cracking in irradiated 304 stainless steel that contained 10 appm helium. The overlay technique provides a potential method for repair or modification of accelerator materials exposed to irradiation.

  15. Proximal Myopathy: A Rare Presentation of Celiac Disease.

    PubMed

    Suthar, Renu; Sankhyan, Naveen; Thapa, B R; Singhi, Pratibha

    2013-11-01

    Celiac disease presenting as proximal myopathy is rarely seen, particularly in children. We report a 5-year-old girl who presented with bilateral lower limb weakness and on examination had proximal myopathy. She also had florid rickets and short stature. On investigation, the underlying etiology turned out to be celiac disease. Proximal myopathy with celiac disease can be secondary to the disease per se or due to associated osteopenia and rickets. PMID:23965397

  16. Simulation Of Failures And Repairs

    NASA Technical Reports Server (NTRS)

    Vallone, Antonio; Craig, Jack P.

    1989-01-01

    Automated Reliability/Availability/Maintainability (ARAM) computer program one of software tools designed to assess candidate architectures of data-management system of the Space Station. Evaluates reliability, availability, and maintainability characteristcs of conceptual system. Uses data representing redundancy and maintainability characteristics of system, and reliability parameters of components of equipment. Design based upon simulation of failures and possible subsequent repairs of each unit of equipment included in system. Analyzes effects of failures and repairs on system and maintains statistics of behavior of system from which results of simulation obtained. Written for IBM PC XT/AT or compatible computer.

  17. Mountain Plains Learning Experience Guide: Automotive Repair. Course: Engine Repair.

    ERIC Educational Resources Information Center

    Schramm, C.; Osland, Walt

    One of twelve individualized courses included in an automotive repair curriculum, this course covers theory and construction, inspection diagnoses, and service and overhaul of automotive engines. The course is comprised of five units: (1) Fundamentals of Four-Cycle Engines, (2) Engine Construction, (3) Valve Train, (4) Lubricating Systems, and (5)…

  18. Proximity Operations and Docking Sensor Development

    NASA Technical Reports Server (NTRS)

    Howard, Richard T.; Bryan, Thomas C.; Brewster, Linda L.; Lee, James E.

    2009-01-01

    The Next Generation Advanced Video Guidance Sensor (NGAVGS) has been under development for the last three years as a long-range proximity operations and docking sensor for use in an Automated Rendezvous and Docking (AR&D) system. The first autonomous rendezvous and docking in the history of the U.S. Space Program was successfully accomplished by Orbital Express, using the Advanced Video Guidance Sensor (AVGS) as the primary docking sensor. That flight proved that the United States now has a mature and flight proven sensor technology for supporting Crew Exploration Vehicles (CEV) and Commercial Orbital Transport Systems (COTS) Automated Rendezvous and Docking (AR&D). NASA video sensors have worked well in the past: the AVGS used on the Demonstration of Autonomous Rendezvous Technology (DART) mission operated successfully in spot mode out to 2 km, and the first generation rendezvous and docking sensor, the Video Guidance Sensor (VGS), was developed and successfully flown on Space Shuttle flights in 1997 and 1998. 12 Parts obsolescence issues prevent the construction of more AVGS units, and the next generation sensor was updated to allow it to support the CEV and COTS programs. The flight proven AR&D sensor has been redesigned to update parts and add additional capabilities for CEV and COTS with the development of the Next Generation AVGS at the Marshall Space Flight Center. The obsolete imager and processor are being replaced with new radiation tolerant parts. In addition, new capabilities include greater sensor range, auto ranging capability, and real-time video output. This paper presents some sensor hardware trades, use of highly integrated laser components, and addresses the needs of future vehicles that may rendezvous and dock with the International Space Station (ISS) and other Constellation vehicles. It also discusses approaches for upgrading AVGS to address parts obsolescence, and concepts for minimizing the sensor footprint, weight, and power requirements. In addition, the testing of the brassboard and proto-type NGAVGS units will be discussed along with the use of the NGAVGS as a proximity operations and docking sensor.

  19. Acute Osteoclast Activity following Subchondral Drilling Is Promoted by Chitosan and Associated with Improved Cartilage Repair Tissue Integration

    PubMed Central

    Chen, G.; Sun, J.; Lascau-Coman, V.; Chevrier, A.; Marchand, C.; Hoemann, Caroline D.

    2011-01-01

    Objective: Cartilage-bone integration is an important functional end point of cartilage repair therapy, but little is known about how to promote integration. We tested the hypothesis that chitosan-stabilized blood clot implant elicits osteoclasts to drilled cartilage defects and promotes repair and cartilage-bone integration. Design: Bilateral trochlear defects in 15 skeletally mature rabbit knees were microdrilled and then treated with chitosan–glycerol phosphate (GP)/blood implant with fluorescent chitosan tracer and thrombin to accelerate in situ solidification or with thrombin alone. Chitosan clearance, osteoclast density, and osteochondral repair were evaluated at 1, 2, and 8 weeks at the outside, edge, and through the proximal microdrill holes. Results: Chitosan was retained at the top of the drill holes at 1 week as extracellular particles became internalized by granulation tissue cells at 2 weeks and was completely cleared by 8 weeks. Osteoclasts burst-accumulated at microdrill hole edges at 1 week, in new woven bone at the base of the drill holes at 2 weeks, and below endochondral cartilage repair at 8 weeks. Implants elicited 2-fold more osteoclasts relative to controls (P < 0.001), a more complete drill hole bone repair, and improved cartilage-bone integration and histological tissue quality. Treated and control 8-week cartilage repair tissues contained 85% collagen type II. After 8 weeks of repair, subchondral osteoclast density correlated positively with bone-cartilage repair tissue integration (P < 0.0005). Conclusions: Chitosan-GP/blood implant amplified the acute influx of subchondral osteoclasts through indirect mechanisms, leading to significantly improved repair and cartilage-bone integration without inducing net bone resorption. Osteoclasts are cellular mediators of marrow-derived cartilage repair integration. PMID:26069578

  20. Differences in cardiac microcirculatory wave patterns between the proximal left mainstem and proximal right coronary artery

    PubMed Central

    Hadjiloizou, Nearchos; Davies, Justin E.; Malik, Iqbal S.; Aguado-Sierra, Jazmin; Willson, Keith; Foale, Rodney A.; Parker, Kim H.; Hughes, Alun D.; Francis, Darrel P.; Mayet, Jamil

    2008-01-01

    Despite having almost identical origins and similar perfusion pressures, the flow-velocity waveforms in the left and right coronary arteries are strikingly different. We hypothesized that pressure differences originating from the distal (microcirculatory) bed would account for the differences in the flow-velocity waveform. We used wave intensity analysis to separate and quantify proximal- and distal-originating pressures to study the differences in velocity waveforms. In 20 subjects with unobstructed coronary arteries, sensor-tipped intra-arterial wires were used to measure simultaneous pressure and Doppler velocity in the proximal left main stem (LMS) and proximal right coronary artery (RCA). Proximal- and distal-originating waves were separated using wave intensity analysis, and differences in waves were examined in relation to structural and anatomic differences between the two arteries. Diastolic flow velocity was lower in the RCA than in the LMS (35.1 21.4 vs. 56.4 32.5 cm/s, P < 0.002), and, consequently, the diastolic-to-systolic ratio of peak flow velocity in the RCA was significantly less than in the LMS (1.00 0.32 vs. 1.79 0.48, P < 0.001). This was due to a lower distal-originating suction wave (8.2 6.6 103 vs. 16.0 12.2 103 Wm?2s?1, P < 0.01). The suction wave in the LMS correlated positively with left ventricular pressure (r = 0.6, P < 0.01) and in the RCA with estimated right ventricular systolic pressure (r = 0.7, P = 0.05) but not with the respective diameter in these arteries. In contrast to the LMS, where coronary flow velocity was predominantly diastolic, in the proximal RCA coronary flow velocity was similar in systole and diastole. This difference was due to a smaller distal-originating suction wave in the RCA, which can be explained by differences in elastance and pressure generated between right and left ventricles. PMID:18641272

  1. Tracheoesophageal fistula and esophageal atresia repair

    MedlinePLUS

    ... to medicines Breathing problems Risks of surgery include: Bleeding Collapsed lung ( pneumothorax ) Food leakage from the area that is repaired Infection Low body temperature ( hypothermia ) Narrowing of the repaired organs Re-opening of the fistula

  2. 40 CFR 280.33 - Repairs allowed.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... that repairs will prevent releases due to structural failure or corrosion as long as the UST system is... specifications. (d) Repaired tanks and piping must be tightness tested in accordance with § 280.43(c) and §...

  3. 40 CFR 280.33 - Repairs allowed.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... that repairs will prevent releases due to structural failure or corrosion as long as the UST system is... specifications. (d) Repaired tanks and piping must be tightness tested in accordance with § 280.43(c) and §...

  4. Final report [DNA Repair and Mutagenesis - 1999

    SciTech Connect

    Walker, Graham C.

    2001-05-30

    The meeting, titled ''DNA Repair and Mutagenesis: Mechanism, Control, and Biological Consequences'', was designed to bring together the various sub-disciplines that collectively comprise the field of DNA Repair and Mutagenesis. The keynote address was titled ''Mutability Doth Play Her Cruel Sports to Many Men's Decay: Variations on the Theme of Translesion Synthesis.'' Sessions were held on the following themes: Excision repair of DNA damage; Transcription and DNA excision repair; UmuC/DinB/Rev1/Rad30 superfamily of DNA polymerases; Cellular responses to DNA damage, checkpoints, and damage tolerance; Repair of mismatched bases, mutation; Genome-instability, and hypermutation; Repair of strand breaks; Replicational fidelity, and Late-breaking developments; Repair and mutation in challenging environments; and Defects in DNA repair: consequences for human disease and aging.

  5. 46 CFR 160.006-2 - Repairing.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    .... No repairs, except in emergency, shall be made to an approved life preserver without advance notice... small holes, tears, or rips in the envelope cover fabric may be repaired, at the discretion of...

  6. 46 CFR 160.006-2 - Repairing.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    .... No repairs, except in emergency, shall be made to an approved life preserver without advance notice... small holes, tears, or rips in the envelope cover fabric may be repaired, at the discretion of...

  7. 46 CFR 160.006-2 - Repairing.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    .... No repairs, except in emergency, shall be made to an approved life preserver without advance notice... small holes, tears, or rips in the envelope cover fabric may be repaired, at the discretion of...

  8. 46 CFR 160.006-2 - Repairing.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    .... No repairs, except in emergency, shall be made to an approved life preserver without advance notice... small holes, tears, or rips in the envelope cover fabric may be repaired, at the discretion of...

  9. 46 CFR 160.006-2 - Repairing.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    .... No repairs, except in emergency, shall be made to an approved life preserver without advance notice... small holes, tears, or rips in the envelope cover fabric may be repaired, at the discretion of...

  10. Abdominal aortic aneurysm repair - open - discharge

    MedlinePLUS

    AAA - open - discharge; Repair - aortic aneurysm - open - discharge ... You had open aortic aneurysm surgery to repair an aneurysm (a widened part) in your aorta, the large artery that carries blood to your ...

  11. A Knotless Labro-Bicipital Repair Technique for SLAP Lesions

    PubMed Central

    Koyuncu, zgr; Eren, Ilker; Seyahi, Aksel; Uludag, Serkan; Demirhan, Mehmet

    2015-01-01

    Fixation methods for SLAP lesions are still controversial, and the strength of the fixation, suture and knot irritation, and placement and number of anchors are still being discussed. This uncertainty is directly related to the function and anatomy of the superior labrum and attached biceps. Knotless fixation methods close to the biceps anchorage at the 12-o'clock position are favored in recent literature. We describe a practical SLAP repair technique, with a mattress configuration through the biceps anchorage, using a single knotless anchor. Fixing the biceps attachment instead of the labrum alone, in proximity to the biceps, without sutures or knots left in contact with the other intra-articular structures is the superiority of the described technique. PMID:26697310

  12. Ex vivo renal repair: technical tips, when, and why.

    PubMed

    Nelms, Justin K; Benjamin, Marshall E

    2013-12-01

    Ex vivo renal artery repair combined with cold perfusion protection is an operative technique for managing complex renal artery lesions. Most diseases of the renal artery are proximal, and typically treated either medically, by endovascular means, or surgically. When surgery of the main renal artery is required, it can typically be performed with warm renal ischemia times of <30 minutes. However, in more distal disease, which can involve the segmental branches, a much more complicated surgical reconstruction can be anticipated. This often will necessitate warm ischemia times of >45 minutes, and can lead to direct renal nephron damage. In this setting, the ex vivo technique with cold perfusion can allow for lengthy reconstructive times of several hours without any measurable harm to renal function. The technique can be performed with low morbidity and mortality, an excellent rate of renal salvage, and preservation of renal function. PMID:25220327

  13. PTH 1-34 (teriparatide) may not improve healing in proximal humerus fractures.

    PubMed

    Johansson, Torsten

    2016-02-01

    Background and purpose - There is solid evidence from animal experiments that parathyroid hormone (PTH) improves fracture healing. So far, only 3 papers on PTH and fracture repair in humans have been published. They suggest that PTH may enhance fracture healing, but the results do not appear to justify specific clinical recommendations. This study was carried out to determine whether teriparatide enhances fracture healing of proximal humerus fractures. Patients and methods - 40 post-menopausal women with a proximal humerus fracture were randomized to either daily injections with 20 g teriparatide (PTH 1-34 (Forteo)) for 4 weeks or control treatment. At randomization, the patients were asked to assess how their pain at rest and during activity (visual analog scale (VAS)) and also function (DASH score) had been prior to the fracture. At 7 weeks and again at 3 months, their current state was assessed and the tests were repeated, including radiographs. 2 radiologists performed a blind qualitative scoring of the callus at 7 weeks. Callus formation was arbitrarily classified as "normal" or "better". Results - 39 patients completed the follow-up. The radiographic assessment showed a correct correlation, "better" in the teriparatide group and "normal" in the control group, in 21 of the 39 cases. There were no statistically significant differences in pain, in use of strong analgesics, or in function between the groups at the follow-up examinations. Interpretation - There were no radiographic signs of enhanced healing or improved clinical results in the group treated with teriparatide. PMID:26179771

  14. Effects of thrust reversing in ground proximity

    NASA Technical Reports Server (NTRS)

    Joshi, P. B.; Hughes, R. V.

    1987-01-01

    The changes in stability and control characteristics encountered by a thrust reversing aircraft during its final approach, landing, and ground roll are described. These changes include a strong pitch-up accompanied by the loss of horizontal tail and aileron control effectiveness. The magnitude of reverser induced changes in ground effect are much larger than corresponding changes in free air. Some unexpected unsteady motions exhibited in wind tunnel by an aircraft model with reversers operating in ground proximity are also described. The cause of this oscillatory behavior was determined to be an unsteady interaction between the wall jets formed by impingement of reverser jets on the ground and the on-coming free stream. Time histories of rolling moments measured by the wind tunnel balance or support system were removed and frequencies were scaled by Strouhal number to full scale. Corrected time series were used to simulate the motion of a fighter aircraft with thrust reversers in ground effect. The simulation predicted large roll angles and nose down attitude at touchdown. Some phenomena of jet attachment to solid surfaces are discussed and areas for future research are recommended.

  15. Proximity operations considerations affecting spacecraft design

    NASA Astrophysics Data System (ADS)

    Staas, Steven K.

    Proximity operations can be defined as the maneuvering of two or more spacecraft within 1 nautical mile range, with relative velocity less than 10 feet per second. The passive vehicle is nontranslating and should provide for maintenance of the desired approach attitude. It must accommodate the active (translating) vehicle induced structural loads and performance characteristics (mating hardware tolerances), and support sensor compatibility (transponder, visual targets, etc.). The active vehicle must provide adequate sensor systems (relative state information, field-of-view, redundancy), flight control hardware (thruster sizing, minimal cross-coupling, performance margins, redundancy) and software (reconfigurable, attitude/rate modes, translation and rotation fine control authority) characteristic, and adequate non-propulsive consumables such as power. Operational concerns must be considered. These include the following: (1) the desired approach trajectory and relative orientation; (2) the active vehicle thruster plume effects (forces, torques, contamination) on the passive vehicle; and (3) procedures for contingencies such as loss of communications, sensor or propulsion failures, and target vehicle loss of control.

  16. Interactive orbital proximity operations planning system

    NASA Technical Reports Server (NTRS)

    Grunwald, Arthur J.; Ellis, Stephen R.

    1989-01-01

    An interactive, graphical proximity operations planning system was developed which allows on-site design of efficient, complex, multiburn maneuvers in the dynamic multispacecraft environment about the space station. Maneuvering takes place in, as well as out of, the orbital plane. The difficulty in planning such missions results from the unusual and counterintuitive character of relative orbital motion trajectories and complex operational constraints, which are both time varying and highly dependent on the mission scenario. This difficulty is greatly overcome by visualizing the relative trajectories and the relative constraints in an easily interpretable, graphical format, which provides the operator with immediate feedback on design actions. The display shows a perspective bird's-eye view of the space station and co-orbiting spacecraft on the background of the station's orbital plane. The operator has control over two modes of operation: (1) a viewing system mode, which enables him or her to explore the spatial situation about the space station and thus choose and frame in on areas of interest; and (2) a trajectory design mode, which allows the interactive editing of a series of way-points and maneuvering burns to obtain a trajectory which complies with all operational constraints. Through a graphical interactive process, the operator will continue to modify the trajectory design until all operational constraints are met. The effectiveness of this display format in complex trajectory design is presently being evaluated in an ongoing experimental program.

  17. Interactive orbital proximity operations planning system

    NASA Technical Reports Server (NTRS)

    Grunwald, Arthur J.; Ellis, Stephen R.

    1988-01-01

    An interactive graphical proximity operations planning system was developed, which allows on-site design of efficient, complex, multiburn maneuvers in a dynamic multispacecraft environment. Maneuvering takes place in and out of the orbital plane. The difficulty in planning such missions results from the unusual and counterintuitive character of orbital dynamics and complex time-varying operational constraints. This difficulty is greatly overcome by visualizing the relative trajectories and the relevant constraints in an easily interpretable graphical format, which provides the operator with immediate feedback on design actions. The display shows a perspective bird's-eye view of a Space Station and co-orbiting spacecraft on the background of the Station's orbital plane. The operator has control over the two modes of operation: a viewing system mode, which enables the exporation of the spatial situation about the Space Station and thus the ability to choose and zoom in on areas of interest; and a trajectory design mode, which allows the interactive editing of a series of way points and maneuvering burns to obtain a trajectory that complies with all operational constraints. A first version of this display was completed. An experimental program is planned in which operators will carry out a series of design missions which vary in complexity and constraints.

  18. Proximal spinal muscular atrophy: current orthopedic perspective.

    PubMed

    Haaker, Gerrit; Fujak, Albert

    2013-01-01

    Spinal muscular atrophy (SMA) is a hereditary neuromuscular disease of lower motor neurons that is caused by a defective "survival motor neuron" (SMN) protein that is mainly associated with proximal progressive muscle weakness and atrophy. Although SMA involves a wide range of disease severity and a high mortality and morbidity rate, recent advances in multidisciplinary supportive care have enhanced quality of life and life expectancy. Active research for possible treatment options has become possible since the disease-causing gene defect was identified in 1995. Nevertheless, a causal therapy is not available at present, and therapeutic management of SMA remains challenging; the prolonged survival is increasing, especially orthopedic, respiratory and nutritive problems. This review focuses on orthopedic management of the disease, with discussion of key aspects that include scoliosis, muscular contractures, hip joint disorders, fractures, technical devices, and a comparative approach of conservative and surgical treatment. Also emphasized are associated complications including respiratory involvement, perioperative care and anesthesia, nutrition problems, and rehabilitation. The SMA disease course can be greatly improved with adequate therapy with established orthopedic procedures in a multidisciplinary therapeutic approach. PMID:24399883

  19. Semiconductor detectors with proximity signal readout

    SciTech Connect

    Asztalos, Stephen J.

    2014-01-30

    Semiconductor-based radiation detectors are routinely used for the detection, imaging, and spectroscopy of x-rays, gamma rays, and charged particles for applications in the areas of nuclear and medical physics, astrophysics, environmental remediation, nuclear nonproliferation, and homeland security. Detectors used for imaging and particle tracking are more complex in that they typically must also measure the location of the radiation interaction in addition to the deposited energy. In such detectors, the position measurement is often achieved by dividing or segmenting the electrodes into many strips or pixels and then reading out the signals from all of the electrode segments. Fine electrode segmentation is problematic for many of the standard semiconductor detector technologies. Clearly there is a need for a semiconductor-based radiation detector technology that can achieve fine position resolution while maintaining the excellent energy resolution intrinsic to semiconductor detectors, can be fabricated through simple processes, does not require complex electrical interconnections to the detector, and can reduce the number of required channels of readout electronics. Proximity electrode signal readout (PESR), in which the electrodes are not in physical contact with the detector surface, satisfies this need.

  20. Acidification in the rat proximal jejunum.

    PubMed Central

    Blair, J A; Lucas, M L; Matty, A J

    1975-01-01

    1. Production of hydrogen ions by the rat proximal jejunum was investigated using the everted sac technique. 2. Acidification occurred in the absence of glucose, increasing on addition of glucose to reach a maximal value. An apparent Km of 1-78 mM was derived for the glucose-dependent process. 3. Acidification in the presence of glucose was inhibited by 10 mM-2:4-dinitrophenol, 10 mM phlorrhizin, 10 mM aminophylline and anaerobiosis. 4. Histamine, ethylenediamine tetraacetic acid (EDTA), ouabain and acetazolamide, compounds known to alter acid production in gastric mucosa had no effect on jejunal acidification. 5. Galactose and 3-O-methylglucose failed to increase acidification; in contrast, mannose and fructose did lead to increases, indicating metabolic origin of the hydrogen ions. 6. Serosal and mucosal lactate production were measured and the calculated percentage of hydrogen ions possibly derived from this source was shown to account for only a small proportion of acidification. 7. The greatest increase in acidification with minimal simultaneous production of lactate occurred with ATP which was shown not to enter intestinal tissues. 8. A hypothesis for acidification, that of the break-down at the mucosal surface of ATP from intracellular metabolic sources, is proposed and its relevance to the postulated microclimate is discussed. PMID:238029

  1. Proximity-induced superconducting transition temperature

    SciTech Connect

    Farrell, M.E. , U.S. Naval Air Development Center, Warminster, Pennsylvania 18974-5000 ); Bishop, M.F. )

    1989-12-01

    We have calculated the proximity-induced superconducting transition temperature for a thin weak-coupling normal metal in contact with an infinitely thick strong-coupling superconductor. The model considered is that of aluminum in perfect contact with superconducting lead, where both metals are clean. The energy-dependent gap is calculated numerically as a function of temperature for the strong-coupling Pb superconductor with the Eliashberg equations, and this is used to calculate the induced energy-dependent gap in the weak-coupling Al metal through the modified Eliashberg equations for the normal-metal-superconductor configuration. In this latter calculation the presence of the Al metal is assumed to have a negligible effect on the energy gap of the Pb. We find the transition temperature of Al to be enhanced to 4.5 K, compared with its bulk transition temperature of 1.2 K. In addition, we find that the magnitude of the zero-temperature Al gap is enhanced from 0.17 to 0.68 meV.

  2. Proximate industrial activity and psychological distress

    PubMed Central

    Downey, Liam; Jackson, James S.; Merrill, J. Bryce; Saint Onge, Jarron M.; Williams, David R.

    2009-01-01

    This paper examines the role that gender, occupational status, and family status play in moderating the effect of industrial activity on the psychological well-being of nearby residents. Using a unique spatial assessment of industrial activity and an environmental risk/social stressor framework in conjunction with individual-level data from the Detroit Area Study (DAS) and demographic data from the U.S. census, we find that residents of neighborhoods in close proximity to industrial activity report elevated levels of psychological distress compared to residents of neighborhoods removed from this type of activity. These influences are more pronounced among women but gender differences are also contingent upon occupational and family statuses. We show that specific combinations of work and family statuses make persons particularly vulnerable to the influence of this environmental stressor and women are two and a half times more likely than men to have these vulnerable statuses. This study makes an important contribution to the environmental health literature because it reminds researchers of the fundamental influence of social roles when examining the link between environmental risks and mental health. PMID:19444334

  3. Effective proximity retrieval by ordering permutations.

    PubMed

    Chavez, Edgar; Figueroa, Karina; Navarro, Gonzalo

    2008-09-01

    We introduce a new probabilistic proximity search algorithm for range and K-nearest neighbor (K-NN) searching in both coordinate and metric spaces. Although there exist solutions for these problems, they boil down to a linear scan when the space is intrinsically high-dimensional, as is the case in many pattern recognition tasks. This, for example, renders the K-NN approach to classification rather slow in large databases. Our novel idea is to predict closeness between elements according to how they order their distances towards a distinguished set of anchor objects. Each element in the space sorts the anchor objects from closest to farthest to it, and the similarity between orders turns out to be an excellent predictor of the closeness between the corresponding elements. We present extensive experiments comparing our method against state-of-the-art exact and approximate techniques, both in synthetic and real, metric and non-metric databases, measuring both CPU time and distance computations. The experiments demonstrate that our technique almost always improves upon the performance of alternative techniques, in some cases by a wide margin. PMID:18617721

  4. Dynamic proximity of spatio-temporal sequences.

    PubMed

    Horn, David; Dror, Gideon; Quenet, Brigitte

    2004-09-01

    Recurrent networks can generate spatio-temporal neural sequences of very large cycles, having an apparent random behavior. Nonetheless a proximity measure between these sequences may be defined through comparison of the synaptic weight matrices that generate them. Following the dynamic neural filter (DNF) formalism we demonstrate this concept by comparing teacher and student recurrent networks of binary neurons. We show that large sequences, providing a training set well exceeding the Cover limit, allow for good determination of the synaptic matrices. Alternatively, assuming the matrices to be known, very fast determination of the biases can be achieved. Thus, a spatio-temporal sequence may be regarded as spatio-temporal encoding of the bias vector. We introduce a linear support vector machine (SVM) variant of the DNF in order to specify an optimal weight matrix. This approach allows us to deal with noise. Spatio-temporal sequences generated by different DNFs with the same number of neurons may be compared by calculating correlations of the synaptic matrices of the reconstructed DNFs. Other types of spatio-temporal sequences need the introduction of hidden neurons, and/or the use of a kernel variant of the SVM approach. The latter is being defined as a recurrent support vector network (RSVN). PMID:15484877

  5. Spintronic anisotropy: proximity-induced superparamagnetism

    NASA Astrophysics Data System (ADS)

    Misiorny, Maciej; Hell, Michael; Wegewijs, Maarten

    2014-03-01

    Superparamagnetism of molecular magnets, i.e. the preferential alignment of their spins along an easy axis, is a useful effect for nanoscale applications as it prevents undesired spin reversals. In these systems such a stabilization of axial spin states is ensured by the magnetic anisotropy barrier stemming from intrinsic spin-orbit coupling. Here we demonstrate that any spin-isotropic high-spin quantum dot coupled to ferromagnets can in fact acquire such superparamagnetic properties in a spintronic way, even though spin-orbit interaction is negligible. We predict a proximity-induced spin-anisotropy barrier, which has hallmarks of a spintronic exchange-field of quadrupolar nature: it is highly localized, electrically controllable, increases with tunnel coupling and spin-polarization. Such a field is a generalization of the dipolar exchange field that relates to a current-induced spin-torque, effect well established in spintronics. We acknowledge the financial support from the DFG (FOR 912), the Foundation for Polish Science (M.M.) and the Alexander von Humboldt Foundation (M.M.).

  6. Ranging/tracking system for proximity operations

    NASA Technical Reports Server (NTRS)

    Nilsen, P.; Udalov, S.

    1982-01-01

    The hardware development and testing phase of a hand held radar for the ranging and tracking for Shuttle proximity operations are considered. The radar is to measure range to a 3 sigma accuracy of 1 m (3.28 ft) to a maximum range of 1850 m (6000 ft) and velocity to a 3 sigma accuracy of 0.03 m/s (0.1 ft/s). Size and weight are similar to hand held radars, frequently seen in use by motorcycle police officers. Meeting these goals for a target in free space was very difficult to obtain in the testing program; however, at a range of approximately 700 m, the 3 sigma range error was found to be 0.96 m. It is felt that much of this error is due to clutter in the test environment. As an example of the velocity accuracy, at a range of 450 m, a 3 sigma velocity error of 0.02 m/s was measured. The principles of the radar and recommended changes to its design are given. Analyses performed in support of the design process, the actual circuit diagrams, and the software listing are included.

  7. URIC ACID AND TISSUE REPAIR

    PubMed Central

    NERY, Rodrigo Araldi; KAHLOW, Barbara Stadler; SKARE, Thelma L; TABUSHI, Fernando Issamu; CASTRO, Adham do Amaral e

    2015-01-01

    Uric acid, a metabolic product of purines, may exert a role in tissue healing. In this review we will explore its role as an alarm initiating the inflammatory process that is necessary for tissue repair, as a scavenger of oxygen free radicals, as a mobilizer of progenitor endothelial cells and as supporter of adaptive immune system. PMID:26734804

  8. Repair of extended laryngotracheal stenosis.

    PubMed

    Friedman, W H; Biller, H F; Som, M L

    1975-03-01

    The most challenging laryngotracheal stenosis are those that exceed 5 cm in length and involve more than one area of the larynx and trachea contiguously. A successful technique for the repair of these injuries with a three-stage laryngotracheal trough was created followed by anterior tracheal wall replacement with a skin-Marlex-muscle pedicle flap. PMID:1091247

  9. Small Engine Repair Course Outline.

    ERIC Educational Resources Information Center

    DeClouet, Fred

    Small engines as referred to here are engines used on lawn mowers, chain saws, power plants, outboards, and cycles. It does not include engines used on automobiles. The course outlined is intended to show how small two-cycle and four-cycle gas engines are constructed, how they operate, what goes wrong, and how to service and repair them. It is

  10. How the Brain Repairs Stuttering

    ERIC Educational Resources Information Center

    Kell, Christian A.; Neumann, Katrin; von Kriegstein, Katharina; Posenenske, Claudia; von Gudenberg, Alexander W.; Euler, Harald; Giraud, Anne-Lise

    2009-01-01

    Stuttering is a neurodevelopmental disorder associated with left inferior frontal structural anomalies. While children often recover, stuttering may also spontaneously disappear much later after years of dysfluency. These rare cases of unassisted recovery in adulthood provide a model of optimal brain repair outside the classical windows of…

  11. How the Brain Repairs Stuttering

    ERIC Educational Resources Information Center

    Kell, Christian A.; Neumann, Katrin; von Kriegstein, Katharina; Posenenske, Claudia; von Gudenberg, Alexander W.; Euler, Harald; Giraud, Anne-Lise

    2009-01-01

    Stuttering is a neurodevelopmental disorder associated with left inferior frontal structural anomalies. While children often recover, stuttering may also spontaneously disappear much later after years of dysfluency. These rare cases of unassisted recovery in adulthood provide a model of optimal brain repair outside the classical windows of

  12. Airframe Repair Specialist (AFSC 53153).

    ERIC Educational Resources Information Center

    Air Univ., Gunter AFS, Ala. Extension Course Inst.

    This airframe repairman course comprises the self-study portion of an on-the-job training program. It deals with the job-related knowledge requirements for airframe repairs that are required to progress from the 3 to 5 skill level of the career field. It contains five volumes. Volume 1 (27 hours) covers the general subjects related to the…

  13. Microwave Oven Repair. Teacher Edition.

    ERIC Educational Resources Information Center

    Smreker, Eugene

    This competency-based curriculum guide for teachers addresses the skills a technician will need to service microwave ovens and to provide customer relations to help retain the customer's confidence in the product and trust in the service company that performs the repair. The guide begins with a task analysis, listing 20 cognitive tasks and 5…

  14. [A Nobel Prize for DNA repair].

    PubMed

    Jordan, Bertrand

    2016-01-01

    This year's Nobel Prize for chemistry recognizes the seminal contributions of three researchers who discovered the existence and the basic mechanisms of DNA repair: base excision repair, mismatch repair, and nucleotide excision repair. They have since been joined by many scientists elucidating diverse aspects of these complex mechanisms that now constitute a thriving research field with many applications, notably for understanding oncogenesis and devising more effective therapies. PMID:26850617

  15. Bringing mask repair to the next level

    NASA Astrophysics Data System (ADS)

    Edinger, K.; Wolff, K.; Steigerwald, H.; Auth, N.; Spies, P.; Oster, J.; Schneider, H.; Budach, M.; Hofmann, T.; Waiblinger, M.

    2014-10-01

    Mask repair is an essential step in the mask manufacturing process as the extension of 193nm technology and the insertion of EUV are drivers for mask complexity and cost. The ability to repair all types of defects on all mask blank materials is crucial for the economic success of a mask shop operation. In the future mask repair is facing several challenges. The mask minimum features sizes are shrinking and require a higher resolution repair tool. At the same time mask blanks with different new mask materials are introduced to optimize optical performance and long term durability. For EUV masks new classes of defects like multilayer and phase defects are entering the stage. In order to achieve a high yield, mask repair has to cover etch and deposition capabilities and must not damage the mask. These challenges require sophisticated technologies to bring mask repair to the next level. For high end masks ion-beam based and e-based repair technologies are the obvious choice when it comes to the repair of small features. Both technologies have their pro and cons. The scope of this paper is to review and compare the performance of ion-beam based mask repair to e-beam based mask repair. We will analyze the limits of both technologies theoretically and experimentally and show mask repair related performance data. Based on this data, we will give an outlook to future mask repair tools.

  16. Auto Body Repair and Repainting: Instructional Units.

    ERIC Educational Resources Information Center

    Manuel, Edward F.; Penner, Wayman R.

    The guide contains 11 sections, each consisting of one or more units of instruction designed to provide students with entry-level skills in auto body repair. The sections deal with: introductory and related information; body and frame construction; tools; welding; basic metal repair; hardware, glass, and trim; major metal repair; refinishing;

  17. Standardized Curriculum for Automotive Body Repair.

    ERIC Educational Resources Information Center

    Mississippi State Dept. of Education, Jackson. Office of Vocational, Technical and Adult Education.

    Standardized curricula are provided for two courses for the secondary vocational education program in Mississippi: automotive body repair I and II. The nine units in automotive body repair I are as follows: introduction; related information; basic tool usage and safety; body and frame construction; basic sheet metal repair; preparing for

  18. 33 CFR 115.40 - Bridge repairs.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 33 Navigation and Navigable Waters 1 2010-07-01 2010-07-01 false Bridge repairs. 115.40 Section 115.40 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY BRIDGES BRIDGE LOCATIONS AND CLEARANCES; ADMINISTRATIVE PROCEDURES § 115.40 Bridge repairs. Repairs to a bridge which...

  19. 33 CFR 115.40 - Bridge repairs.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 33 Navigation and Navigable Waters 1 2012-07-01 2012-07-01 false Bridge repairs. 115.40 Section 115.40 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY BRIDGES BRIDGE LOCATIONS AND CLEARANCES; ADMINISTRATIVE PROCEDURES § 115.40 Bridge repairs. Repairs to a bridge which...

  20. 33 CFR 115.40 - Bridge repairs.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 33 Navigation and Navigable Waters 1 2014-07-01 2014-07-01 false Bridge repairs. 115.40 Section 115.40 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY BRIDGES BRIDGE LOCATIONS AND CLEARANCES; ADMINISTRATIVE PROCEDURES § 115.40 Bridge repairs. Repairs to a bridge which...

  1. 33 CFR 115.40 - Bridge repairs.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 33 Navigation and Navigable Waters 1 2013-07-01 2013-07-01 false Bridge repairs. 115.40 Section 115.40 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY BRIDGES BRIDGE LOCATIONS AND CLEARANCES; ADMINISTRATIVE PROCEDURES § 115.40 Bridge repairs. Repairs to a bridge which...

  2. 33 CFR 115.40 - Bridge repairs.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 33 Navigation and Navigable Waters 1 2011-07-01 2011-07-01 false Bridge repairs. 115.40 Section 115.40 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY BRIDGES BRIDGE LOCATIONS AND CLEARANCES; ADMINISTRATIVE PROCEDURES § 115.40 Bridge repairs. Repairs to a bridge which...

  3. 46 CFR Sec. 19 - Ship Repair Summaries.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 8 2010-10-01 2010-10-01 false Ship Repair Summaries. Sec. 19 Section 19 Shipping MARITIME ADMINISTRATION, DEPARTMENT OF TRANSPORTATION A-NATIONAL SHIPPING AUTHORITY PROCEDURE FOR ACCOMPLISHMENT OF VESSEL REPAIRS UNDER NATIONAL SHIPPING AUTHORITY MASTER LUMP SUM REPAIR...

  4. 46 CFR Sec. 19 - Ship Repair Summaries.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 46 Shipping 8 2012-10-01 2012-10-01 false Ship Repair Summaries. Sec. 19 Section 19 Shipping MARITIME ADMINISTRATION, DEPARTMENT OF TRANSPORTATION A-NATIONAL SHIPPING AUTHORITY PROCEDURE FOR ACCOMPLISHMENT OF VESSEL REPAIRS UNDER NATIONAL SHIPPING AUTHORITY MASTER LUMP SUM REPAIR...

  5. 46 CFR Sec. 19 - Ship Repair Summaries.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 46 Shipping 8 2014-10-01 2014-10-01 false Ship Repair Summaries. Sec. 19 Section 19 Shipping MARITIME ADMINISTRATION, DEPARTMENT OF TRANSPORTATION A-NATIONAL SHIPPING AUTHORITY PROCEDURE FOR ACCOMPLISHMENT OF VESSEL REPAIRS UNDER NATIONAL SHIPPING AUTHORITY MASTER LUMP SUM REPAIR...

  6. 46 CFR Sec. 19 - Ship Repair Summaries.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 8 2011-10-01 2011-10-01 false Ship Repair Summaries. Sec. 19 Section 19 Shipping MARITIME ADMINISTRATION, DEPARTMENT OF TRANSPORTATION A-NATIONAL SHIPPING AUTHORITY PROCEDURE FOR ACCOMPLISHMENT OF VESSEL REPAIRS UNDER NATIONAL SHIPPING AUTHORITY MASTER LUMP SUM REPAIR...

  7. 46 CFR Sec. 19 - Ship Repair Summaries.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 46 Shipping 8 2013-10-01 2013-10-01 false Ship Repair Summaries. Sec. 19 Section 19 Shipping MARITIME ADMINISTRATION, DEPARTMENT OF TRANSPORTATION A-NATIONAL SHIPPING AUTHORITY PROCEDURE FOR ACCOMPLISHMENT OF VESSEL REPAIRS UNDER NATIONAL SHIPPING AUTHORITY MASTER LUMP SUM REPAIR...

  8. Welding/brazing for Space Station repair

    NASA Technical Reports Server (NTRS)

    Dickinson, David W.; Babel, H. W.; Conaway, H. R.; Hooper, W. H.

    1990-01-01

    Viewgraphs on welding/brazing for space station repair are presented. Topics covered include: fabrication and repair candidates; debris penetration of module panel; welded repair patch; mechanical assembly of utility fluid line; space station utility systems; Soviet aerospace fabrication - an overview; and processes under consideration.

  9. 30 CFR 56.14104 - Tire repairs.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 30 Mineral Resources 1 2014-07-01 2014-07-01 false Tire repairs. 56.14104 Section 56.14104 Mineral... Devices and Maintenance Requirements 56.14104 Tire repairs. (a) Before a tire is removed from a vehicle for tire repair, the valve core shall be partially removed to allow for gradual deflation and...

  10. 30 CFR 56.14104 - Tire repairs.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 30 Mineral Resources 1 2012-07-01 2012-07-01 false Tire repairs. 56.14104 Section 56.14104 Mineral... Devices and Maintenance Requirements 56.14104 Tire repairs. (a) Before a tire is removed from a vehicle for tire repair, the valve core shall be partially removed to allow for gradual deflation and...

  11. 30 CFR 56.14104 - Tire repairs.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 30 Mineral Resources 1 2013-07-01 2013-07-01 false Tire repairs. 56.14104 Section 56.14104 Mineral... Devices and Maintenance Requirements 56.14104 Tire repairs. (a) Before a tire is removed from a vehicle for tire repair, the valve core shall be partially removed to allow for gradual deflation and...

  12. 30 CFR 57.14104 - Tire repairs.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 30 Mineral Resources 1 2013-07-01 2013-07-01 false Tire repairs. 57.14104 Section 57.14104 Mineral... Devices and Maintenance Requirements 57.14104 Tire repairs. (a) Before a tire is removed from a vehicle for tire repair, the valve core shall be partially removed to allow for gradual deflation and...

  13. 30 CFR 57.14104 - Tire repairs.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 30 Mineral Resources 1 2014-07-01 2014-07-01 false Tire repairs. 57.14104 Section 57.14104 Mineral... Devices and Maintenance Requirements 57.14104 Tire repairs. (a) Before a tire is removed from a vehicle for tire repair, the valve core shall be partially removed to allow for gradual deflation and...

  14. 30 CFR 57.14104 - Tire repairs.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 30 Mineral Resources 1 2012-07-01 2012-07-01 false Tire repairs. 57.14104 Section 57.14104 Mineral... Devices and Maintenance Requirements 57.14104 Tire repairs. (a) Before a tire is removed from a vehicle for tire repair, the valve core shall be partially removed to allow for gradual deflation and...

  15. 30 CFR 57.14104 - Tire repairs.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 30 Mineral Resources 1 2011-07-01 2011-07-01 false Tire repairs. 57.14104 Section 57.14104 Mineral... Devices and Maintenance Requirements § 57.14104 Tire repairs. (a) Before a tire is removed from a vehicle for tire repair, the valve core shall be partially removed to allow for gradual deflation and...

  16. 30 CFR 57.14104 - Tire repairs.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Tire repairs. 57.14104 Section 57.14104 Mineral... Devices and Maintenance Requirements § 57.14104 Tire repairs. (a) Before a tire is removed from a vehicle for tire repair, the valve core shall be partially removed to allow for gradual deflation and...

  17. 30 CFR 56.14104 - Tire repairs.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Tire repairs. 56.14104 Section 56.14104 Mineral... Devices and Maintenance Requirements § 56.14104 Tire repairs. (a) Before a tire is removed from a vehicle for tire repair, the valve core shall be partially removed to allow for gradual deflation and...

  18. 30 CFR 56.14104 - Tire repairs.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 30 Mineral Resources 1 2011-07-01 2011-07-01 false Tire repairs. 56.14104 Section 56.14104 Mineral... Devices and Maintenance Requirements § 56.14104 Tire repairs. (a) Before a tire is removed from a vehicle for tire repair, the valve core shall be partially removed to allow for gradual deflation and...

  19. Standardized Curriculum for Shoe and Boot Repair.

    ERIC Educational Resources Information Center

    Mississippi State Dept. of Education, Jackson. Office of Vocational, Technical and Adult Education.

    This curriculum guide for shoe and boot repair was developed by the state of Mississippi to standardize vocational education course titles and core contents. The objectives contained in this document are common to all shoe and boot repair programs in the state. The guide contains objectives for shoe and boot repair I and II courses. Units in

  20. Fix-It Careers: Jobs in Repair

    ERIC Educational Resources Information Center

    Torpey, Elka Maria

    2010-01-01

    From auto mechanic to HVAC technicians, many occupations require repair skills. For jobseekers with the right skills, there are many advantages to a repair career. Repair work provides millions of jobs throughout the United States. Wages are often higher than average. And in many occupations, the employment outlook is bright. Plus, most repair…

  1. Standardized Curriculum for Small Engine Repair.

    ERIC Educational Resources Information Center

    Mississippi State Dept. of Education, Jackson. Office of Vocational, Technical and Adult Education.

    This curriculum guide for small engine repair was developed by the state of Mississippi to standardize vocational education course titles and core contents. The objectives contained in this document are common to all small engine repair programs in the state. The guide contains objectives for small engine repair I and II courses. Units in course I

  2. Utility guidelines for controlled deposition repair welding

    SciTech Connect

    Neary, C.M.

    1996-06-01

    This paper reviews experimental results from the EQI work performed to develop controlled deposition repairs for Cr-Mo steels without postweld heat treatment (PWHT) which are pertinent to electric utility applications, gives recommended guidelines for evaluating if controlled deposition welding is appropriate for a particular repair, and provides a listing of potential applications for controlled deposition repair welding.

  3. Welding/brazing for Space Station repair

    NASA Astrophysics Data System (ADS)

    Dickinson, David W.; Babel, H. W.; Conaway, H. R.; Hooper, W. H.

    Viewgraphs on welding/brazing for space station repair are presented. Topics covered include: fabrication and repair candidates; debris penetration of module panel; welded repair patch; mechanical assembly of utility fluid line; space station utility systems; Soviet aerospace fabrication - an overview; and processes under consideration.

  4. Laparoscopic Repair of Ventral Hernias

    PubMed Central

    Heniford, B Todd; Park, Adrian; Ramshaw, Bruce J.; Voeller, Guy

    2003-01-01

    Objective: To evaluate the efficacy and safety of laparoscopic repair of ventral hernias. Summary Background Data: The recurrence rate after standard repair of ventral hernias may be as high as 12-52%, and the wide surgical dissection required often results in wound complications. Use of a laparoscopic approach may decrease rates of complications and recurrence after ventral hernia repair. Methods: Data on all patients who underwent laparoscopic ventral hernia repair (LVHR) performed by 4 surgeons using a standardized procedure between November 1993 and October 2002 were collected prospectively (85% of patients) or retrospectively. Results: LVHR was completed in 819 of the 850 patients (422 men; 428 women) in whom it was attempted. Thirty-four percent of completed LVHRs were for recurrent hernias. The patient mean body mass index was 32; the mean defect size was 118 cm2. Mesh, averaging 344 cm2, was used in all cases. Mean operating time was 120 min, mean estimated blood loss was 49 mL, and hospital stay averaged 2.3 days. There were 128 complications in 112 patients (13.2%). One patient died of a myocardial infarction. The most common complications were ileus (3%) and prolonged seroma (2.6%). During a mean follow-up time of 20.2 months (range, 1-94 months), the hernia recurrence rate was 4.7%. Recurrence was associated with large defects, obesity, previous open repairs, and perioperative complications. Conclusion: In this large series, LVHR had a low rate of conversion to open surgery, a short hospital stay, a moderate complication rate, and a low risk of recurrence. PMID:14501505

  5. Cartilage repair: 2013 Asian update.

    PubMed

    Hui, James H P; Goyal, Deepak; Nakamura, Norimasa; Ochi, Mitsuo

    2013-12-01

    Despite financial and regulatory hurdles, Asian scientists and clinicians have made important contributions in the area of cartilage repair. Because it is impossible to include observations on all the published articles in one review, our attempt is to highlight Asian progress in this area during recent years (2005 to the present), reviewing research development and clinical studies. In the former, our discussion of in vitro studies focuses on (1) potential sources of stem cells--such as mesenchymal stem cells (MSCs) from marrow, cord blood, synovium, and mobilized peripheral blood--which are capable of enhancing cartilage repair and (2) the use of growth factors and scaffolds with and without cells. Our discussion of animal studies attempts to summarize activities in evaluating surgical procedures and determining the route of cell administration, as well as studies on matrices and scaffolds. It ranges from the use of small animals such as rats and rabbits to larger animals like pigs and dogs. The local adherent technique, enhancement of microfracture with poly(l-lactic-co-glycolic acid) scaffold, adenovirus-mediated bone morphogenic protein (BMP) genes, and MSCs--whether they are magnetically labeled, suspended in hyaluronic acid, or immobilized with transforming growth factor-? (TGF-?)--have all been able to engineer a repair of the osteochondral defect. Although published Asian reports of clinical studies on cartilage repair are few, the findings of relevant trials are summarized in our discussion of these investigations. There has been a long history of use of laboratory-derived MSCs for cartilage repair. Recent progress has suggested the potential utility of cord blood and mobilized peripheral blood in this area, as well as more injectable bone marrow (BM)-derived stem cells. Finally, we make a few suggestions on the direction of research and development activities and the need for collaborative approaches by regulatory agencies. PMID:24286798

  6. Proximate and ultimate causes of punishment and strong reciprocity.

    PubMed

    Barclay, Pat

    2012-02-01

    While admirable, Guala's discussion of reciprocity suffers from a confusion between proximate causes (psychological mechanisms triggering behaviour) and ultimate causes (evolved function of those psychological mechanisms). Because much work on "strong reciprocity" commits this error, I clarify the difference between proximate and ultimate causes of cooperation and punishment. I also caution against hasty rejections of "wide readings" of experimental evidence. PMID:22289305

  7. Analysis of pattern density on process proximity compensation

    NASA Astrophysics Data System (ADS)

    Jung, Sunwook; Lo, Fred; Yang, Tien-Chu; Yang, Ta-Hong; Chen, Kuang-Chao; Lu, Chih-Yuan

    2007-03-01

    The challenges of ever-smaller CD (Critical Dimension) budget for advanced memory product requires tight ACLV (Across-Chip Line-width Variation) control. In addition to the lithographic MOPC (Model-based Optical Proximity Correction) for DCD (photo CD) control, the process correction for etch proximity effect can no longer be ignored. To meet on our requirement on final CD accuracy for critical layer, a set of test pattern, that represents memory array in one of our critical layers, has been generated for both photo and etch process characterizations. Through the combination of different pattern-coverage areas in the test mask and wafer map design, various local (chip-level) pattern densities of 40%~70% and global (wafer-level) pattern densities of 35%~65% were achieved for optical and etch proximity study. The key contributors to the process proximity effect were identified and voluminous data has been extracted from the memory block like patterns for statistical analysis. The photo and etch proximity effects were hence modeled as function of memory block separation, local pattern density as well as global pattern density. Finally, the respective photo and etch proximity effects through model-based proximity correction and rule-based proximity correction were applied in a multi-step flow to products.

  8. Flexor Tendon Entrapment at the Malunited Base Fracture of the Proximal Phalanx of the Finger in Child

    PubMed Central

    Lee, Young-Keun; Park, Soojin; Lee, Malrey

    2015-01-01

    Abstract The proximal phalangeal base is the most commonly fractured hand bone in children. Such fractures are rarely reported as irreducible due to flexor tendon entrapment. Here, we describe a patient who sustained a malunited fracture on the right fifth finger proximal phalanx with flexor tendon entrapment after treatment with closed reduction with K-wires fixation. A 13-year-old patient came to the clinic following a bicycle accident 6 weeks ago. He presented with flexion limitation in his small finger on the right hand. During physical examination, the patient felt no pain, and the neurovascular structures were intact. However range of motion (ROM) in his small finger was not normal. Plain radiographs displayed a Salter–Harris type II fracture of the small finger proximal phalanx base and volar angulation with callus formation. During the operation, it was established that the flexor digitorum superficialis (FDS) around the fracture had a severe adhesion, whereas the flexor digitorum profundus (FDP) was entrapped between the volarly displaced metaphyses and the epiphyses and united with the bone. We removed the volarly displaced metaphyses and freed FDP and repaired the A2 pulley. The bone was anatomically fixed with K-wires. In the treatment after the operation, on the 2nd day, the patient was permitted the DIP joint motion by wearing a dynamic splint. At the 12-months follow-up, the patient had regained full ROM with no discomfort and the proximal phalanx growth plate of the small finger closed naturally with normal alignment. When treating a proximal phalangeal base fracture in children, the possibility of flexor tendon entrapment should be considered and should be carefully dealt with in its treatment. PMID:26334897

  9. A prospective randomized study of conservative versus surgical treatment of unstable palmar plate disruption in the proximal interphalangeal finger joint.

    PubMed

    Werlinrud, Jens Christian; Petersen, Kirstin; Lauritsen, Jens; Larsen, Søren; Schrøder, Henrik

    2013-04-01

    The aim of this study was to assess the effect of conservative versus operative treatment for unstable palmar plate disruption in the proximal interphalangeal (PIP) joint of the fingers with respect to preservation of joint stability, mobility, and pain. The study was conducted as a prospective study in which 83 patients were randomly assigned into 2 groups: (1) conservative treatment with a rigid splint for 2 weeks, (2) surgical reattachment of the palmar plate in local anesthesia followed by 2 weeks of immobilization in a plaster cast. Both groups were thereafter treated by taping to the neighboring finger for 3 weeks. With regard to hyperextension instability, stiffness, and pain, there is no significant difference in outcome between patients with traumatic palmar plate lesions and hyperextension instability treated with surgical repair and patients treated conservatively with a splint. We do not recommend primary surgical repair of unstable isolated palmar plate lesions in the proximal interphalangeal joints of the 4 ulnar fingers. Type of study/level of evidence Therapeutic, Level II. PMID:23436143

  10. Transport Magnetic Proximity Effects in Platinum

    NASA Astrophysics Data System (ADS)

    Huang, Ssu-Yen

    2013-03-01

    Platinum (Pt) metal, being non-magnetic and having a strong spin-orbit coupling interaction, has been central in detecting pure spin current and establishing most of the recent spin-based phenomena. Thus, it is important to ascertain the transport and magnetic characteristics of thin Pt films in contact with a ferromagnet. In this work, we use both electric and thermal means to conclusively show the transport magnetic proximity effects (MPE) of thin Pt film in contact with ferromagnetic insulator YIG. At thicknesses comparable to, and less than, the spin diffusion length, the strong ferromagnetic characteristics in Pt films on YIG are indistinguishable from those of ferromagnetic permalloy on YIG. The MPE occurs at the interface and decreases exponentially away from the interface, concentrating in only a few monolayers. As a result, the pure spin current detected by a thin Pt is tainted with a spin polarized current. The pure spin current phenomena, such as the inverse spin Hall effect and the spin Seebeck effect, have been contaminated with the anomalous Hall effect and the anomalous Nernst effect respectively. These results raise serious questions about the suitability, and the validity, of using Pt in establishing pure spin current phenomena; on the other hand, a much stronger spin-based effect can be induced by the MPE at the interface. This research is in collaboration with X. Fin, Y. P. Chen, J. Wu, and J. Q. Xiao (University of Delaware), T. Y. Chen (Arizona State University) and D. Qu, W. G. Wang, and C. L. Chien (The Johns Hopkins University).

  11. Interactive orbital proximity operations planning system

    NASA Technical Reports Server (NTRS)

    Grunwald, Arthur J.; Ellis, Stephen R.

    1990-01-01

    An interactive graphical planning system for on-site planning of proximity operations in the congested multispacecraft environment about the space station is presented. The system shows the astronaut a bird's eye perspective of the space station, the orbital plane, and the co-orbiting spacecraft. The system operates in two operational modes: (1) a viewpoint mode, in which the astronaut is able to move the viewpoint around in the orbital plane to range in on areas of interest; and (2) a trajectory design mode, in which the trajectory is planned. Trajectory design involves the composition of a set of waypoints which result in a fuel-optimal trajectory which satisfies all operational constraints, such as departure and arrival constraints, plume impingement constraints, and structural constraints. The main purpose of the system is to present the trajectory and the constraints in an easily interpretable graphical format. Through a graphical interactive process, the trajectory waypoints are edited until all operational constraints are satisfied. A series of experiments was conducted to evaluate the system. Eight airline pilots with no prior background in orbital mechanics participated in the experiments. Subject training included a stand-alone training session of about 6 hours duration, in which the subjects became familiar with orbital mechanics concepts and performed a series of exercises to familiarize themselves with the control and display features of the system. They then carried out a series of production runs in which 90 different trajectory design situations were randomly addressed. The purpose of these experiments was to investigate how the planning time, planning efforts, and fuel expenditures were affected by the planning difficulty. Some results of these experiments are presented.

  12. Nanocrystal Bioassembly: Asymmetry, Proximity, and Enzymatic Manipulation

    SciTech Connect

    Claridge, Shelley A

    2008-05-01

    Research at the interface between biomolecules and inorganic nanocrystals has resulted in a great number of new discoveries. In part this arises from the synergistic duality of the system: biomolecules may act as self-assembly agents for organizing inorganic nanocrystals into functional materials; alternatively, nanocrystals may act as microscopic or spectroscopic labels for elucidating the behavior of complex biomolecular systems. However, success in either of these functions relies heavily uponthe ability to control the conjugation and assembly processes.In the work presented here, we first design a branched DNA scaffold which allows hybridization of DNA-nanocrystal monoconjugates to form discrete assemblies. Importantly, the asymmetry of the branched scaffold allows the formation of asymmetric2assemblies of nanocrystals. In the context of a self-assembled device, this can be considered a step toward the ability to engineer functionally distinct inputs and outputs.Next we develop an anion-exchange high performance liquid chromatography purification method which allows large gold nanocrystals attached to single strands of very short DNA to be purified. When two such complementary conjugates are hybridized, the large nanocrystals are brought into close proximity, allowing their plasmon resonances to couple. Such plasmon-coupled constructs are of interest both as optical interconnects for nanoscale devices and as `plasmon ruler? biomolecular probes.We then present an enzymatic ligation strategy for creating multi-nanoparticle building blocks for self-assembly. In constructing a nanoscale device, such a strategy would allow pre-assembly and purification of components; these constructs can also act as multi-label probes of single-stranded DNA conformational dynamics. Finally we demonstrate a simple proof-of-concept of a nanoparticle analog of the polymerase chain reaction.

  13. Unique proximal tibial morphology in strepsirrhine primates.

    PubMed

    White, Jessica L; Gebo, Daniel L

    2004-11-01

    Although the morphology of the tibial plateau in primates has received very little attention in the literature, it does exhibit features of phylogenetic and functional interest. This paper describes the morphology of the tibial plateau (particularly the intercondylar region) in extant and fossil primates, and in three mammalian outgroups: the pen-tailed tree shrew (Ptilocercus), tree shrew (Tupaia), and flying lemur or dermopteran (Cynocephalus). Extant and fossil strepsirrhine primates exhibit an eminence with a single spine, which contrasts with the intercondylar morphology of haplorhine primates. Most extant platyrrhines, all catarrhine primates (including humans), and some fossil haplorhines possess an eminence with two spines (medial and lateral) connected by a ridge of bone that intersects the intercondylar groove. Tarsius and callitrichines possess an eminence with a reduced medial spine that superficially resembles that of strepsirrhine primates. Dermopterans also exhibit a morphology similar to that of strepsirrhines. In Scandentia, the intercondylar morphology of Tupaia is similar to that of rodents, whereas Ptilocercus resembles tarsiers and callitrichines. We hypothesize that proximal tibiae with either a single spine or reduced medial spine morphology facilitate a greater degree of knee rotation about the eminence relative to the double-spine condition, and are likely associated with more frequent adoption of vertical body positions. In contrast, a double-spine eminence limits knee rotation and is probably associated with greater use of horizontal supports. Although the polarity is complicated by the unknown phylogenetic status of likely sister taxa, it seems most probable that the single-spine morphology is a derived feature of strepsirrhines. PMID:15538762

  14. Selection of proximal fusion level for degenerative scoliosis and the entailing proximal-related late complications

    PubMed Central

    Zhu, Yi; Wang, Kaifeng; Wang, Bo; Wang, Huimin; Jin, Zhaohui; Zhu, Zhenqi; Liu, Haiying

    2015-01-01

    Objective: To determine the optimal selection of proximal fusion level for degenerative scoliosis (DS) and investigate the long-term proximal-related complications. Methods: Profiles of 95 consecutive patients with DS who underwent posterior long instrumented fusion were analyzed retrospectively. Perioperative parameters were reviewed stratified into 3 groups according to the relationship between the upper instrumented vertebrae (UIV), horizontal vertebrae (HV) and upper end vertebrae (UEV), namely HV Group (UIV = HV or above), HV-UEV Group (UIV = between HV and UEV) and UEV Group (UIV = UEV or below) in coronal plane and 3 groups in sagittal plane according to segment levels. Clinical and radiographic parameters were studied statistically. Results: Average follow-up was 7.8 years (range, 5-13 years). HV Group showed a significant increase in operative time, intraoperative blood loss, postoperative in-bed time, and hospital stays. UEV Group showed greater average Cobb angle, AVT and DW. UEV Group showed significant increase in operative time, blood loss, postoperative in-bed time, and inpatient stay. All three groups showed significant improvement in ODI compared to baseline, while there was no significant difference in LL between three groups. Proximal-related late complications included recurrent junctional scoliosis in 4 cases and junctional kyphosis in 4 cases. Conclusions: Recurrent junctional scoliosis developed more commonly when the fusion was at or below the UEV, and fusion at L1 or L2 showed the highest incidence of junctional kyphosis. Long instrumented fusion to T11 or T12 appeared to be a reasonable alternative when the UIV was above UEV in DS. PMID:26131158

  15. Proximity-1: Simulating the CCSDS Proximity-1 Protocol for ExoMars

    NASA Astrophysics Data System (ADS)

    Blommestijn, R.; Lange, J.; Taylor, C.; Winton, A.

    2009-05-01

    This paper describes the development a functional model of the Proximity-1 protocol, the integration of this model into the ESA VSRF Functional Engineering Simulator (FES) and the demonstration of this protocol in a representative (Exo) Mars environment. The work is mainly performed as part of a Young Graduate Trainee program. ESA has also contracted GMV (Spain) to adapt and extend the environment and spacecraft models of the VSRF-FES for the ExoMars mission. The overall aim is to demonstrate and verify communication protocols in "context", having the ExoMars mission as a specific example case.

  16. Chromatin Disassembly and Reassembly During DNA Repair

    PubMed Central

    Linger, Jeffrey G.; Tyler, Jessica K.

    2008-01-01

    Current research is demonstrating that the packaging of the eukaryotic genome together with histone proteins into chromatin is playing a fundamental role in DNA repair and the maintenance of genomic integrity. As is well established to be the case for transcription, the chromatin structure dynamically changes during DNA repair. Recent studies indicate that the complete removal of histones from DNA and their subsequent reassembly onto DNA accompanies DNA repair. This review will present evidence indicating that chromatin disassembly and reassembly occur during DNA repair and that these are critical processes for cell survival after DNA repair. Concomitantly, candidate proteins utilized for these processes will be highlighted. PMID:17303193

  17. Anatomical Considerations of the Suprascapular Nerve in Rotator Cuff Repairs

    PubMed Central

    Tom, James A.; Shah, Mitesh P.; Lee, Dan J.; Cerynik, Douglas L.; Amin, Nirav H.

    2014-01-01

    Introduction. When using the double interval slide technique for arthroscopic repair of chronic large or massive rotator cuff tears, the posterior interval release is directed toward the scapular spine until the fat pad that protects the suprascapular nerve is reached. Injury to the suprascapular nerve can occur due to the nerve's proximity to the operative field. This study aimed to identify safe margins for avoiding injury to the suprascapular nerve. Materials and Methods. For 20 shoulders in ten cadavers, the distance was measured from the suprascapular notch to the glenoid rim, the articular margin of the rotator cuff footprint, and the lateral border of the acromion. Results. From the suprascapular notch, the suprascapular nerve coursed an average of 3.42 cm to the glenoid rim, 5.34 cm to the articular margin of the rotator cuff footprint, and 6.09 cm to the lateral border of the acromion. Conclusions. The results of this study define a safe zone, using anatomic landmarks, to help surgeons avoid iatrogenic injury to the suprascapular nerve when employing the double interval slide technique in arthroscopic repair of the rotator cuff. PMID:24724030

  18. Study of hotspot repair using cellular automata method

    NASA Astrophysics Data System (ADS)

    Nagase, Norimasa; Takeuchi, Kanji; Sakurai, Mitsuo; Itoh, Takahisa; Okada, Tomoyuki

    2014-07-01

    In advanced semiconductor manufacturing, model-based optical proximity correction is commonly used to compensate for image errors. The final pattern is generated using correction values determined by lithography simulation. Image errors such as patterns with insufficient correction or patterns with excessive correction can be generated. These patterns with errors are called hotspots. Such errors are conventionally detected by lithography simulation of OPC patterns. When a hotspot is detected by lithography simulation, it has to be repaired manually or by repeated use of OPC tool. However, it is difficult to obtain correct pattern for a complicated shape, and the correction procedure may require a significant amount of additional processing. In order to solve this issue, we examine application of cellular automata (CA) method for hotspot correction. It is known that CA method can be used for weather or traffic analysis and prediction. In this report, we studied the CA method for deriving simple hotspot repair rule based on lattice cell-like models for light intensity distribution and OPC patterns. We will report on the results of hotspot correction technique with the OPC pattern using CA method.

  19. 40 CFR 798.5500 - Differential growth inhibition of repair proficient and repair deficient bacteria: “Bacterial DNA...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... recommendations as specified under 40 CFR part 792, subpart J the following specific information should be... repair proficient and repair deficient bacteria: âBacterial DNA damage or repair tests.â 798.5500 Section... inhibition of repair proficient and repair deficient bacteria: “Bacterial DNA damage or repair tests.”...

  20. 40 CFR 798.5500 - Differential growth inhibition of repair proficient and repair deficient bacteria: “Bacterial DNA...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... recommendations as specified under 40 CFR part 792, subpart J the following specific information should be... repair proficient and repair deficient bacteria: âBacterial DNA damage or repair tests.â 798.5500 Section... inhibition of repair proficient and repair deficient bacteria: “Bacterial DNA damage or repair tests.”...

  1. 40 CFR 798.5500 - Differential growth inhibition of repair proficient and repair deficient bacteria: “Bacterial DNA...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... recommendations as specified under 40 CFR part 792, subpart J the following specific information should be... repair proficient and repair deficient bacteria: âBacterial DNA damage or repair tests.â 798.5500 Section... inhibition of repair proficient and repair deficient bacteria: “Bacterial DNA damage or repair tests.”...

  2. Shuttle orbiter TPS flight repair kit development

    NASA Technical Reports Server (NTRS)

    1979-01-01

    The design and application of a TPS repair kit is presented. The repair kit is designed for on orbit use by a crew member working in the manned maneuvering unit (MMU). The kit includes the necessary equipment and materials to accomplish the repair tasks which include the following: HRSI emittance coating repair, damaged tile repair, missing tile repair, and multiple tile repair. Two types of repair materials required to do the small area repair and the large area repair are described. The materials area cure in place, silicone base ablator for small damaged areas and precured ablator tile for repair of larger damaged areas is examined. The cure in place ablator is also used as an adhesive to bond the precured tiles in place. An applicator for the cure in place ablator, designed to contain a two-part silicon compound, mix the two components at correct ratio, and dispense the materials at rates compatible with mission timelines established for the EVA is described.

  3. Current Biomechanical Concepts for Rotator Cuff Repair

    PubMed Central

    2013-01-01

    For the past few decades, the repair of rotator cuff tears has evolved significantly with advances in arthroscopy techniques, suture anchors and instrumentation. From the biomechanical perspective, the focus in arthroscopic repair has been on increasing fixation strength and restoration of the footprint contact characteristics to provide early rehabilitation and improve healing. To accomplish these objectives, various repair strategies and construct configurations have been developed for rotator cuff repair with the understanding that many factors contribute to the structural integrity of the repaired construct. These include repaired rotator cuff tendon-footprint motion, increased tendon-footprint contact area and pressure, and tissue quality of tendon and bone. In addition, the healing response may be compromised by intrinsic factors such as decreased vascularity, hypoxia, and fibrocartilaginous changes or aforementioned extrinsic compression factors. Furthermore, it is well documented that torn rotator cuff muscles have a tendency to atrophy and become subject to fatty infiltration which may affect the longevity of the repair. Despite all the aforementioned factors, initial fixation strength is an essential consideration in optimizing rotator cuff repair. Therefore, numerous biomechanical studies have focused on elucidating the strongest devices, knots, and repair configurations to improve contact characteristics for rotator cuff repair. In this review, the biomechanical concepts behind current rotator cuff repair techniques will be reviewed and discussed. PMID:23730471

  4. The Value of Accurate Magnetic Resonance Characterization of Posterior Cruciate Ligament Tears in the Setting of Multiligament Knee Injury: Imaging Features Predictive of Early Repair vs Reconstruction.

    PubMed

    Goiney, Christoper C; Porrino, Jack; Twaddle, Bruce; Richardson, Michael L; Mulcahy, Hyojeong; Chew, Felix S

    2016-01-01

    Multiligament knee injury (MLKI) represents a complex set of pathologies treated with a wide variety of surgical approaches. If early surgical intervention is performed, the disrupted posterior cruciate ligament (PCL) can be treated with primary repair or reconstruction. The purpose of our study was to retrospectively identify a critical length of the distal component of the torn PCL on magnetic resonance imaging (MRI) that may predict the ability to perform early proximal femoral repair of the ligament, as opposed to reconstruction. A total of 50 MLKIs were managed at Harborview Medical Center from May 1, 2013, through July 15, 2014, by an orthopedic surgeon. Following exclusions, there were 27 knees with complete disruption of the PCL that underwent either early reattachment to the femoral insertion or reconstruction and were evaluated using preoperative MRI. In a consensus fashion, 2 radiologists measured the proximal and distal fragments of each disrupted PCL using preoperative MRI in multiple planes, as needed. MRI findings were correlated with what was performed at surgery. Those knees with a distal fragment PCL length of ?41mm were capable of, and underwent, early proximal femoral repair. With repair, the distal stump was attached to the distal femur. Alternatively, those with a distal PCL length of ?32mm could not undergo repair because of insufficient length and as such, were reconstructed. If early surgical intervention for an MLKI involving disruption of the PCL is considered, attention should be given to the length of the distal PCL fragment on MRI to plan appropriately for proximal femoral reattachment vs reconstruction. If the distal PCL fragment measures ?41mm, surgical repair is achievable and can be considered as a surgical option. PMID:26183069

  5. Laparoscopic fascial suture repair of parastomal hernia

    PubMed Central

    Zia, Khawaja; McGowan, David Ross; Moore, Etienne

    2013-01-01

    Parastomal hernia is a recognised complication following stoma formation, representing a challenging problem to surgeons. At least three approaches for parastomal hernia repair have been described: fascial suture repair, relocation of stoma and local repair with use of mesh. In simple fascial suture repair only open techniques have been described. Relocation of stoma can be complicated with another parastomal hernia at the new site and risk of incisional hernia at the site of previous stoma. Mesh repair can be either open or laparoscopic. The recurrence rate and complications of parastomal hernia repair remain very high. We have invented a simple fascial suture laparoscopic repair of parastomal hernia with the use of the Crochet hook needle (EndoClose). This new technique may result in reduced pain, earlier discharge from hospital and reduced risk of infection as there is no mesh used as well as reduced risk of seroma formation. PMID:23780775

  6. Minimally disruptive schedule repair for MCM missions

    NASA Astrophysics Data System (ADS)

    Molineaux, Matthew; Auslander, Bryan; Moore, Philip G.; Gupta, Kalyan M.

    2015-05-01

    Mine countermeasures (MCM) missions entail planning and operations in very dynamic and uncertain operating environments, which pose considerable risk to personnel and equipment. Frequent schedule repairs are needed that consider the latest operating conditions to keep mission on target. Presently no decision support tools are available for the challenging task of MCM mission rescheduling. To address this capability gap, we have developed the CARPE system to assist operation planners. CARPE constantly monitors the operational environment for changes and recommends alternative repaired schedules in response. It includes a novel schedule repair algorithm called Case-Based Local Schedule Repair (CLOSR) that automatically repairs broken schedules while satisfying the requirement of minimal operational disruption. It uses a case-based approach to represent repair strategies and apply them to new situations. Evaluation of CLOSR on simulated MCM operations demonstrates the effectiveness of case-based strategy. Schedule repairs are generated rapidly, ensure the elimination of all mines, and achieve required levels of clearance.

  7. Methods of repairing a substrate

    NASA Technical Reports Server (NTRS)

    Riedell, James A. (Inventor); Easler, Timothy E. (Inventor)

    2011-01-01

    A precursor of a ceramic adhesive suitable for use in a vacuum, thermal, and microgravity environment. The precursor of the ceramic adhesive includes a silicon-based, preceramic polymer and at least one ceramic powder selected from the group consisting of aluminum oxide, aluminum nitride, boron carbide, boron oxide, boron nitride, hafnium boride, hafnium carbide, hafnium oxide, lithium aluminate, molybdenum silicide, niobium carbide, niobium nitride, silicon boride, silicon carbide, silicon oxide, silicon nitride, tin oxide, tantalum boride, tantalum carbide, tantalum oxide, tantalum nitride, titanium boride, titanium carbide, titanium oxide, titanium nitride, yttrium oxide, zirconium boride, zirconium carbide, zirconium oxide, and zirconium silicate. Methods of forming the ceramic adhesive and of repairing a substrate in a vacuum and microgravity environment are also disclosed, as is a substrate repaired with the ceramic adhesive.

  8. Mild incomplete cleft lip repair.

    PubMed

    Chen, Jianbing; Shen, Weimin; Jie, Cui

    2012-07-01

    Of all the methods for repair of the unilateral cleft lip, none has gained as much popularity as the rotation advancement. Limitation of the technique leads to various modifications. It is well known that different cleft lip patients have different deformities. However, the modifications are always focused on nasal symmetry and alar base position. We found out that some microform incomplete cleft lip patients have distinctive appearance, of which the cleft located on the lower upper lip, nasal deformity is mild, and distinctive appearance presents a terrace before the peak on cleft side where it is always marked no. 9 according to rotation-advancement principle. We describe an individual technique to repair this kind of condition, which is different from Millard rotation-advancement principle. The design marking of the technique is around the cleft, and no additional incisions are located on the white lip and nasal base. PMID:22777452

  9. DNA repair capacity of zebrafish

    PubMed Central

    Sussman, Raquel

    2007-01-01

    Damage to the genome is unavoidable in living creatures, because of sunlight exposure as well as environmental chemicals present in food and drinking water. There is a need to monitor and purify the drinking water; therefore, several methods of detection have been developed. A very promising model system for this purpose is the zebrafish (Danio rerio), which is endowed with special qualities for detecting external as well as internal abnormalities. Grossman and Wei's assay [Grossman L, Wei Q (1995) Clin Chem 12:18541863], which measures the expression level of a nonreplicating recombinant plasmid DNA containing a UV-damaged luciferase reporter gene, shows that zebrafish can repair chromosomal lesions to a much greater extent than the human population. This vertebrate model is still very promising after possible down-regulation of the DNA repair enzymes. PMID:17686971

  10. Surgical reconstruction of the proximal vertebral artery.

    PubMed

    Diaz, F G; Ausman, J I; de los Reyes, R A; Pearce, J; Shrontz, C; Pak, H; Turcotte, J

    1984-11-01

    The authors have reviewed their experience in the management of 55 patients admitted to Henry Ford Hospital with symptoms of vertebrobasilar insufficiency and associated proximal vertebral artery stenosis or occlusion. In 48 patients, the symptoms occurred as multiple repeated events, five of which resulted in permanent deficits. The remaining seven patients had single events, four of which caused permanent deficit. These patients had been treated unsuccessfully with antiplatelet agents (37 cases) and with anticoagulant drugs (15 cases) before surgery. Most patients had multiple angiographic abnormalities, including bilateral vertebral stenosis in 19 cases, unilateral vertebral stenosis and contralateral occlusion in 18, unilateral vertebral hypoplasia and contralateral stenosis in 10, subclavian artery stenosis with steal in seven, and bilateral vertebral artery occlusion in one case. Posterior communicating arteries could not be demonstrated angiographically in 18 patients. Thirty-four patients had associated stenotic or occlusive lesions of the internal carotid artery. Forty-eight underwent a vertebral-to-carotid artery transposition. Of these, 18 had an associated carotid endarterectomy and seven had a vertebral artery endarterectomy immediately before the transposition. Two patients had saphenous vein grafts, one from the subclavian and one from the common carotid artery to the vertebral artery. Other surgical procedures included vertebral artery ligation in one case, transposition of the vertebral artery to the thyrocervical trunk in two cases and to the subclavian artery in one case, and endarterectomy of the origin of the vertebral artery in one case. All but two patients had complete resolution of their symptoms: one had persistent dizziness and the other had syncopal episodes. Complications included transient Horner's syndrome (30 cases) which became permanent in four cases, vocal cord paralysis (three cases), elevated hemidiaphragm without respiratory difficulty (two cases), and superficial would infection (one case). There were no deaths. Although the presentation of patients with vertebrobasilar insufficiency is generally characteristic, we believe that a specific diagnosis can be established only by angiographic means. Anticoagulants have been used to alleviate symptoms in some cases but are ineffective in solving the primary hemodynamic problem. Surgical reconstruction of the affected area deserves further evaluation in the management of these patients. PMID:6491733

  11. A novel method for utilizing AIMS to evaluate mask repair and quantify over-repair or under-repair condition

    NASA Astrophysics Data System (ADS)

    Uzzel, Doug; Garetto, Anthony; Magnusson, Krister; Tabbone, Gilles

    2013-09-01

    The ZEISS AIMS™ platform is well established as the industry standard for qualifying the printability of mask features based on the aerial image. Typically the critical dimension (CD) and intensity at a certain through-focus range are the parameters which are monitored in order to verify printability or to ensure a successful repair. This information is essential in determining if a feature will pass printability, but in the case that the feature does fail, other metrology is often required in order to isolate the reason why the failure occurred, e.g., quartz level deviates from nominal. Photronics-nanoFab, in collaboration with Carl Zeiss, demonstrate the ability to use AIMSTM to provide quantitative feedback on a given repair process; beyond simple pass/fail of the repair. This technique is used in lieu of Atomic Force Microscopy (AFM) to determine if failing post-repair regions are "under-repaired" (too little material removed) or "over-repaired" (too much material removed). Using the ZEISS MeRiT E-beam repair tool as the test platform, the AIMSTM technique is used to characterize a series of opaque repairs with differing repair times for each. The AIMSTM technique provides a means to determine the etch depth based on through-focus response of the Bossung plot and further to predict the amount of MeRiT® recipe change required in order to bring out of spec repairs to a passing state.

  12. Laparoscopic Repair of Paraesophageal Hernias

    PubMed Central

    Borao, Frank; Squillaro, Anthony; Mansson, Jonas; Barker, William; Baker, Thomas

    2014-01-01

    Background and Objectives: Laparoscopy has quickly become the standard surgical approach to repair paraesophageal hernias. Although many centers routinely perform this procedure, relatively high recurrence rates have led many surgeons to question this approach. We sought to evaluate outcomes in our cohort of patients with an emphasis on recurrence rates and symptom improvement and their correlation with true radiologic recurrence seen on contrast imaging. Methods: We retrospectively identified 126 consecutive patients who underwent laparoscopic repair of a large paraesophageal hernia between 2000 and 2010. Clinical outcomes were reviewed, and data were collected regarding operative details, perioperative and postoperative complications, symptoms, and follow-up imaging. Radiologic evidence of any size hiatal hernia was considered to indicate a recurrence. Results: There were 95 female and 31 male patients with a mean age ( standard deviation) of 71 14 years. Laparoscopic repair was completed successfully in 120 of 126 patients, with 6 operations converted to open procedures. Crural reinforcement with mesh was performed in 79% of patients, and 11% underwent a Collis gastroplasty. Fundoplications were performed in 90% of patients: Nissen (112), Dor (1), and Toupet (1). Radiographic surveillance, obtained at a mean time interval of 23 months postoperatively, was available in 89 of 126 patients (71%). Radiographic evidence of a recurrence was present in 19 patients (21%). Reoperation was necessary in 6 patients (5%): 5 for symptomatic recurrence (4%) and 1 for dysphagia (1%). The median length of stay was 4 days. Conclusion: Laparoscopic paraesophageal hernia repair results in an excellent outcome with a short length of stay when performed at an experienced center. Radiologic recurrence is observed relatively frequently with routine surveillance; however, many of these recurrences are small, and few patients require correction of the recurrence. Furthermore, these small recurrent hernias are often asymptomatic and do not seem to be associated with the same risk of severe complications developing as the initial paraesophageal hernia. PMID:25392650

  13. Which mesh for hernia repair?

    PubMed Central

    Brown, CN; Finch, JG

    2010-01-01

    INTRODUCTION The concept of using a mesh to repair hernias was introduced over 50 years ago. Mesh repair is now standard in most countries and widely accepted as superior to primary suture repair. As a result, there has been a rapid growth in the variety of meshes available and choosing the appropriate one can be difficult. This article outlines the general properties of meshes and factors to be considered when selecting one. MATERIALS AND METHODS We performed a search of the medical literature from 1950 to 1 May 2009, as indexed by Medline, using the PubMed search engine (). To capture all potentially relevant articles with the highest degree of sensitivity, the search terms were intentionally broad. We used the following terms: ‘mesh, pore size, strength, recurrence, complications, lightweight, properties’. We also hand-searched the bibliographies of relevant articles and product literature to identify additional pertinent reports. RESULTS AND CONCLUSIONS The most important properties of meshes were found to be the type of filament, tensile strength and porosity. These determine the weight of the mesh and its biocompatibility. The tensile strength required is much less than originally presumed and light-weight meshes are thought to be superior due to their increased flexibility and reduction in discomfort. Large pores are also associated with a reduced risk of infection and shrinkage. For meshes placed in the peritoneal cavity, consideration should also be given to the risk of adhesion formation. A variety of composite meshes have been promoted to address this, but none appears superior to the others. Finally, biomaterials such as acellular dermis have a place for use in infected fields but have yet to prove their worth in routine hernia repair. PMID:20501011

  14. Repair of the nasal sidewall.

    PubMed

    Salmon, P J M

    2014-09-01

    Repair of the nasal sidewall after skin cancer excision is generally best approached with the use of local flaps for aesthetic reasons. The sidewall may be divided into upper and lower sections and defects described as small, medium or large. In this section I will review the flaps that I feel make best use of adjacent tissue reservoirs allowing aesthetic placement of incisions while protecting free margins and function, and that reward the operator with reliably superior results for the patient. PMID:25124309

  15. Revisional Laparoscopic Parastomal Hernia Repair

    PubMed Central

    Shalhoub, Joseph; Selvapatt, Nowlan; Darzi, Ara; Ziprin, Paul

    2008-01-01

    Background: We herein report a laparoscopically performed re-do operation on a patient who had previously undergone a laparoscopic parastomal hernia repair. Case Report: We describe the case of a 71-year-old patient who presented within 3 months of her primary laparoscopic parastomal hernia repair with recurrence. On relaparoscopy, dense adhesions to the mesh were found, and the mesh had migrated into the hernia sac. This had allowed loops of small bowel to herniate into the sac. The initial part of the procedure involved the lysis of adhesions. A piece of Gore-Tex DualMesh with a central keyhole and a radial slit was cut so that it could provide at least 3 cm to 5 cm of overlap of the fascial defect. The tails of the mesh were wrapped around the bowel, and the mesh was secured to the margins of the hernia with circumferential metal tacking and 4 transfascial sutures. The patient remains in satisfactory condition and no recurrence or any surgery-related problem has been observed during 8 months of follow-up. Conclusion: Revisional laparoscopic repair of parastomal hernias seems feasible and has been shown to be safe and effective in this case. The success of this approach depends on longer follow-up reports and standardization of the technical elements. PMID:19275858

  16. Animal models of cartilage repair

    PubMed Central

    Cook, J. L.; Hung, C. T.; Kuroki, K.; Stoker, A. M.; Cook, C. R.; Pfeiffer, F. M.; Sherman, S. L.; Stannard, J. P.

    2014-01-01

    Cartilage repair in terms of replacement, or regeneration of damaged or diseased articular cartilage with functional tissue, is the ‘holy grail’ of joint surgery. A wide spectrum of strategies for cartilage repair currently exists and several of these techniques have been reported to be associated with successful clinical outcomes for appropriately selected indications. However, based on respective advantages, disadvantages, and limitations, no single strategy, or even combination of strategies, provides surgeons with viable options for attaining successful long-term outcomes in the majority of patients. As such, development of novel techniques and optimisation of current techniques need to be, and are, the focus of a great deal of research from the basic science level to clinical trials. Translational research that bridges scientific discoveries to clinical application involves the use of animal models in order to assess safety and efficacy for regulatory approval for human use. This review article provides an overview of animal models for cartilage repair. Cite this article: Bone Joint Res 2014;4:89–94. PMID:24695750

  17. Nucleotide excision repair in yeast.

    PubMed

    Prakash, S; Prakash, L

    2000-06-30

    In nucleotide excision repair (NER) in eukaryotes, DNA is incised on both sides of the lesion, resulting in the removal of a fragment approximately 25-30 nucleotides long. This is followed by repair synthesis and ligation. The proteins encoded by the various yeast NER genes have been purified, and the incision reaction reconstituted in vitro. This reaction requires the damage binding factors Rad14, RPA, and the Rad4-Rad23 complex, the transcription factor TFIIH which contains the two DNA helicases Rad3 and Rad25, essential for creating a bubble structure, and the two endonucleases, the Rad1-Rad10 complex and Rad2, which incise the damaged DNA strand on the 5'- and 3'-side of the lesion, respectively. Addition of the Rad7-Rad16 complex to this reconstituted system stimulates the incision reaction many fold. The various NER proteins exist in vivo as part of multiprotein subassemblies which have been named NEFs (nucleotide excision repair factors). Rad14 and Rad1-Rad10 form one subassembly called NEF1, the Rad4-Rad23 complex is named NEF2, Rad2 and TFIIH constitute NEF3, and the Rad7-Rad16 complex is called NEF4. Although much has been learned from yeast about the function of NER genes and proteins in eukaryotes, the underlying mechanisms by which damage is recognized, NEFs are assembled at the damage site, and the DNA is unwound and incised, remain to be elucidated. PMID:10915862

  18. Proximal margin modifications for all-ceramic veneers.

    PubMed

    Priest, George

    2004-05-01

    Conventional ceramic veneers circumvent contact areas and extend palatally in the gingival third of the tooth only. Veneers are no longer considered reversible therapy. With the objective of longevity in mind, proximal extensions beyond contact areas maximize the functional and aesthetic potential of veneers and maintain conservative tooth preparations. The clinical and laboratory advantages of proximal veneer extensions for anterior teeth significantly outweigh the disadvantage of increased tooth structure removal. This article presents a modified preparation technique for the proximal extension of ceramic veneer preparations in the anterior region. PMID:15279231

  19. Reverse Transfer of the Proximal Vascularized Fibula to Reconstruct the Lateral Malleolus: A Case Report and Literature Review.

    PubMed

    Gao, You-Shui; Zhang, Chang-Qing; Sheng, Jia-Gen

    2016-01-01

    Defects of the lateral malleolus and distal fibula occur occasionally, mainly because of severe trauma or wide resection of fibular neoplasms. These bony defects should be reconstructed to avoid persistent pain and to prevent an abnormal gait induced by ankle instability. Various methods of repair have been developed, including allografting, autologous iliac crest transplantation, scapular apophysis transplantation, and arthrodesis and prosthetic reconstruction. A reverse transfer of the proximal vascularized fibula is also effective. Its morphologic advantage is apparent, and the surgery is simple and direct, with no need for vascular anastomosis. We treated recurrent fibrous dysplasia in the distal fibula of a young male with wide resection and reconstruction using reverse transfer of the proximal, vascularized fibula. At the 6-year follow-up examination, the patient had an American Orthopaedic Foot and Ankle Society ankle-hindfoot score of 100, without any apparent complications. Additionally, we critically reviewed other methods for reconstructing the lateral malleolus and distal fibula and have concluded that reverse transfer of the proximal vascularized fibula compares favorably and could be the treatment of choice. PMID:25998472

  20. Light-operated proximity detector with linear output

    DOEpatents

    Simpson, Marc L.; McNeilly, David R.

    1985-01-01

    A light-operated proximity detector is described in which reflected light intensity from a surface whose proximity to the detector is to be gauged is translated directly into a signal proportional to the distance of the detector from the surface. A phototransistor is used to sense the reflected light and is connected in a detector circuit which maintains the phototransistor in a saturated state. A negative feedback arrangement using an operational amplifier connected between the collector and emitter of the transistor provides an output at the output of the amplifier which is linearly proportional to the proximity of the surface to the detector containing the transistor. This direct proportional conversion is true even though the light intensity is varying with the proximity in proportion to the square of the inverse of the distance. The detector may be used for measuring the distance remotely from any target surface.